Published Date: 2012-08-24 11:42:05
Subject: PRO/AH/EDR> Ebola virus disease - Congo DR (06): (OE)
Archive Number: 20120824.1260808
EBOLA VIRUS DISEASE - DEMOCRATIC REPUBLIC OF CONGO (06): (ORIENTALE)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 23 Aug 2012
Source: UN Integrated Regional Information Networks (IRIN) News [summ., edited]
Congo DR: bushmeat blamed for Ebola outbreak
Health officials in the Democratic Republic of Congo's north eastern Orientale Province are urging the population to desist from activities that could put them at risk of contracting the Ebola virus, including contact with infected individuals and the consumption of bushmeat. At least 10 people in the province had died from suspected Ebola by 20 Aug 2012, according to the World Health Organization (WHO), which first reported the outbreak on 17 Aug 2012. Local sources say the 1st symptoms were spotted about a month ago. 9 of the deaths -- which included 3 health workers -- occurred in the district of Isiro, and one occurred in Dungu District. WHO reports a total of 15 cases so far, 13 probable and 2 confirmed. "The death case in Dungu was a hunter. Once in the bush he saw a dead antelope and did not care to ask why it had died. He immediately took [the carcass] and went to eat it... He fell sick and passed away," said the Congo DR's Health Minister Kabange Numbi.
Bushmeat -- the meat of wild animals, including hoofed animals, primates and rodents -- is often the main source of animal protein available to people in parts of the Congo DR. It is also a livelihood source for people in the Congo basin, according to a 2011 paper by the Center for International Forestry Research. According to WHO, "Ebola virus is introduced into the human population through close contact with the blood, secretions, organs, or other bodily fluids of infected animals." Fruit bats are considered to be the natural host of the virus.
"Ebola virus is an animal disease, and when people are having contact with animals in the bush, as people in some in parts of our country rely on bushmeat for their livelihood... and don't care to avoid eating meat they've got from dead animals that they often find in bushes [they risk contracting the disease]," said Mondoge Vitale, head of disease control at WHO's Kinshasa office.
The strain of ebolavirus in the Congo has been identified as Bundibugyo strain of ebolavirus -- named for a Ugandan district that borders the Congo DR. The western district of Kibaale in neighbouring Uganda was recently hit by an outbreak of the Sudan strain of ebolavirus, which killed at least 16 people. The fatality rate for the Bundibugyo strain has ben estimated at about 40 percent.
Contingency measures have been put in place to contain the outbreak. The Health Ministry has established national- and district-level taskforces and is working with partners, including the Medecins sans Frontieres (MSF), the United States Centers for Disease Control and Prevention (CDC), the UN Children's Fund (UNICEF), and WHO. "The measures include the sensitisation of the communities, protection of health workers -- in the zone where the outbreak has been declared they have been given protection equipment... We have beefed up the screening at Kisangani Port [a commercial hub in Orientale Province] to watch the outbreak across the Congo River toward the capital, Kinshasa," said Numbi. "[We are also] reinforcing screening at Kisangani Airport for passengers coming and going out to other countries' airports."
Orientale Province borders the Central African Republic, South Sudan, and Uganda. South Sudan is already on high alert following the outbreak in neighbouring Uganda. MSF has deployed experts to set up isolation facilities and surveillance systems in affected areas, but officials say their work is being hampered by a lack of information. "As long as the surveillance system is not properly enforced, we are not sure whether we may have missed some cases who have not been in contact with health facilities," said Olympia de la Rosa, a health adviser in MSF's Emergency Unit.
The Congo DR has experienced several fatal [Ebola virus disease] outbreaks in the past. In 1976, at least 280 people died from the Zaire strain of ebolavirus, which killed another 250 people in 1995 and 187 in 2007, according to the CDC.
ProMED-mail Rapporteur Mary Marshall
[This report does not provide direct evidence of the role of bushmeat consumption in this outbreak. The source of Ebola virus infection in this and other outbreaks remains uncertain. Frequently bats have been implicated as a source of infection. In the contemporaneous Ebola virus outbreak across the border in Uganda in Nakisamata village, several species of bats (tentatively identified as belonging to the genera _Epomophorus_, _Hipposideros_, _Pipistrellus_, and _Chaerephon_) were found roosting in unoccupied houses and several classrooms of the village schoolhouse where the index case (a young girl) attended classes, about 400 metres (0.25 mi) from her home. 64 bats were collected, but testing of these bats found no evidence of Ebola virus infection (Shoemaker T, MacNeil A, Balinandi S, et al: Reemerging Sudan Ebola virus disease in Uganda, 2011. Emerg Infect Dis [serial on the Internet] 2012 Sept [date cited]. http://dx.doi.org/10.3201/eid1809.111536).
A map of the provinces of the Democratic Republic of Congo is available at http://www.mapsofworld.com/democratic-republic-of-congo/democratic-republic-of-congo-political-map.html. The HealthMap/ProMED-mail interactive map of the Democratic Republic of the Congo can be accessed at http://healthmap.org/r/35-r. - Mod.CP]