New Ebola patients in Western Kasai, DRC
14 January 2009
As of January 13, 46 patients in total have shown symptoms of Ebola hemorrhagic fever in the Western Kasai province, central Democratic Republic of Congo (DRC). Seven patients have been confirmed positive to the Ebola virus after sample analysis in laboratories. Of the seven confirmed, one has died. The 39 remaining patients are all suspected cases, of whom 13 have died. There are currently three patients suspected with Ebola in an isolation centre built by MSF in Kampungu, a village located in the centre of the province. Two patients are so-called "contact people"; they were in contact with one of the patients who was suspected or confirmed with the Ebola virus. In this case, the first two new patients were in contact with a woman who died earlier and who was confirmed as infected with Ebola. One patient is her three-year-old child, the other is her sister who took care of her child since her death. It is necessary to monitor "contact people" to break the line of contamination of the Ebola outbreak. The MSF team on the ground is currently following-up about 200 people every day. "All three patients are doing fine" The third patient in the isolation centre comes from a village some 20 km from Kampungu and has not been in contact with any previous patient. "We were fearing the virus could also be located outside Kampungu and Kaluamba," said Dr. Michel Van Herp, MSF epidemiologist. "However, until last night, his symptoms resembled more those of typhoid fever. Nonetheless, as long as we don't have confirmation he is negative for the Ebola virus, or he is not presenting any symptoms anymore, he will be staying in the isolation centre. Our team took samples from all three patients to confirm the presence or absence of the virus. For the moment, all three patients are doing fine. They are eating, walking by themselves and do not require any re-hydration." MSF takes measures to avoid contamination in the isolation centre. The team is following strict protocols to make sure that the medical teams, the patient's family and the patients themselves are protected again contamination. Patients stay in the isolation until their symptoms disappear. This will mean they have survived a suspected Ebola infection or were not infected with the deadly virus. An Ebola contamination can only be confirmed by analysis of samples done by a specialised laboratory. A patient is a suspected case until samples sent to a laboratory confirm his infection or lack of infection with the Ebola virus. Ebola symptoms can resemble those of malaria or other diseases such as typhoid fever or shigellosis at the beginning. This is the reason also why patients are given medication against malaria and antibiotics. MSF also provides psychological support. "Type of Ebola" Until now, out of the seven confirmed Ebola patients, one person has died. This might seem a rather low death toll for an Ebola outbreak. "It is true that we are not talking about the usual death rates that come along with Ebola outbreaks," explained Van Herp. "The reason is that although it has been confirmed we are in the presence of an Ebola outbreak, it has not yet been confirmed which type of Ebola we are faced with. The Zaire-type of Ebola kills 70 to 90 percent of those infected but we could actually be in the presence of a 'less lethal' Ebola strain. Still we can not forget that 13 suspected patients also died, making the death toll 14 people." Last year, an Ebola outbreak that occurred in the same area where 186 people died, but other deadly diseases are thought to have been involved too. An MSF team of 18 is currently working in Western Kasai. The team consists of doctors, an epidemiologist, a psychologist, nurses, water and sanitation specialists, health promoters, and logisticians.