Kinshasa/Brussels - Late on Monday, September 10, the Congolese Ministry of Health (MoH) officially declared an outbreak of Ebola hemorrhagic fever in the West Kasai province, in central Democratic Republic of Congo (DRC). Laboratories in Atlanta, USA, and in Franceville, Gabon, have confirmed the presence of Ebola virus in samples. Not all these deaths are necessarily due to Ebola however. The presence of other diseases is also suspected, such as Shigella dysentery. Since the end of April, cases of an unknown illness started to be reported in the region of Mweka, a town of 9,000 inhabitants in West Kasai, about two days drive from Kananga, the provincial capital. Over the last two weeks, more and more suspected cases were reported in the health zones of Mweka, Kampungu, Luebo, and even one as far away as Kananga.
MSF is working in the health centre of Kampungu, the most affected health zone. There are 12 patients currently hospitalized, of whom three are in severe conditions. According to the World Health Organization (WHO), a total of 362 suspected cases have been reported and 166 people have died - a mortality rate of approximately 45%. Vulnerable people, such as children and elderly, seem to be most affected by the disease. Patients present high fever, headaches, vomiting, diarrhoea and, in a few cases, external bleedings. Within two or three days, patients die from dehydration.
No vaccine nor treatment exist for this type of fever, so MSF isolates patients to prevent contamination, treats the symptoms and reduces the suffering of patients. While waiting for the results of the samples, patients have been isolated, treated with antibiotics and put under perfusion to combat dehydration. Since September 2, a team from MSF's Congo Emergency Pool (PUC) has been working in Kampungu. The team consists of a medical doctor, nurse and logistician, and has already been reinforced by a Coordinator from the Emergency Unit from Brussels, Belgium, two water-and-sanitation specialists and a social worker. Additional doctors, nurses, logisticians, water-and-sanitation specialists, an epidemiologist and an expert in Ebola fever, will arrive in West Kasai in the coming days, bringing the MSF team to a total of 15 people.
MSF has built considerable experience in previous outbreaks of Hemorrhagic fever, of Ebola or Marburg types: in Angola (2005), Gabon (1997 and 2002), Uganda (2001), Congo-Brazzaville (2003/2004), southern Sudan (2004). In DRC, MSF responded to a big Ebola outbreak in Kikwit, capital of the neighbouring province of Bandundu, in 1995. This epidemic killed 244 people between May and August 1995. On Wednesday (September 12), "Ebola kits" will be sent by plane from Lubumbashi and from Kinshasa on Thursday.
These kits are made up of several modules: protection kits for the team - surgeon and plastic gloves, boots, glasses, masks, protection uniforms, apron and hoods - for single use. The disease is highly contagious and protection clothing can only be used once and then must be carefully destroyed.
Additional material designed to take samples from sick patients and to transport them will reach Kananga on Thursday. Medical supplies, such as perfusions, antibiotics, anti-malaria drugs, as well as food rations, are being prepared in the DRC capital, Kinshasa, and are scheduled to arrive in West Kasai province on Wednesday. Water and sanitation material, such as water tanks and chlorine for disinfection will also be sent.
The MSF team will continue to; isolate infected persons in the health centre of Kampungu; actively trace the people who have been in contact with sick patients; and raise awareness among the population about the basic rules to prevent the transmission of the disease.