The Ebola virus claimed more than 11,300 lives in West Africa when it swept through Guinea, Sierra Leone and Liberia in the 2013-2016 outbreak. Now there are concerns of a new outbreak of the virus with news of its spread to Congo, with health officials now confirming a 2^nd outbreak in the Equater province.

The most recent outbreak is largely confined to Guinea, in West Africa. Three people have died from the virus so far, forcing the government to declare an Ebola epidemic. A total of seven patients fell ill after attending the burial of a nurse, reporting symptoms of diarrhea, vomiting and bleeding, leading to the three deaths. The health ministry said all cases were adults over the age of 25 and that contact tracing was ongoing despite the cases being isolated.

Neighbouring countries have been put on heightened alert after fears the outbreak could spread between areas such as Liberia and Sierra Leone, which have relatively weak healthcare systems.

Eastern Congo also confirmed the discovery of the virus at the beginning of February, as three cases were identified.

The outbreak in 2013 was catastrophic; nearly 30,000 people across the three nations were infected with the disease, which is spread via contact with an infected person’s bodily fluids. From its epicenter in West Africa the epidemic reached Nigeria, Spain, the US and UK, only slowing in June 2016 when the WHO declared the outbreak in Liberia over.

World Health Organization officials have confirmed that newly developed vaccines will be acquired through them. A treatment centre is set to be set up in Geoueké for patients. Officials are testing a number of Ebola treatments but none are licensed yet.

In December 2016 a team in Guinea announced that a new and effective vaccine had been developed however it has not yet been approved by any regulatory bodies. The experimental vaccine has been shown to provide 100 per cent protection against the disease as it was used in the dying days of the last outbreak.

Already a stockpile of 300,000 doses of the medication has been built up should an outbreak flare up again.

Adapted from dailyexpress

LT

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An Ebola treatment centre at the epicentre of the current outbreak in eastern Democratic Republic of Congo has resumed operations after it was closed in response to an attack last week, the Congolese health ministry said on Sunday.

The facility in the city of Butembo was one of two centres torched by unknown assailants in the space of a few days, prompting Medecins Sans Frontieres (MSF) to suspend medical activities.

Aid workers have faced mistrust in some areas as they work to contain the Ebola outbreak, which has become the worst in Congo’s history.

The ministry said the Butembo treatment centre reopened on Saturday. “For now it is managed by the ministry in collaboration with the World Health Organisation and UNICEF,” it said in a statement.

MSF has not said when it might resume medical activities in the area.

The current Ebola epidemic, first declared last August, is believed to have killed at least 561 people so far and infected over 300 more.

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Congo’s Ebola outbreak has entered “a new phase” after a case of the deadly virus was detected for the first time in the northwest city of Mbandaka, with a population of about one million people, the health minister said late on Wednesday.

So far, the 23 deaths believed to have been caused by Democratic Republic of Congo’s latest Ebola outbreak had been detected in more isolated areas, giving authorities a better chance of ring-fencing the virus.

The first urban case to be announced threatens to change that. The World Health Organisation, which on Wednesday deployed the first experimental vaccines in the vast central African country, had expressed concern about the disease reaching Mbandaka, which would make the outbreak far harder to tackle.

Adding to concerns is the city’s location on the banks of the Congo River, a major thoroughfare for trade and transport into the capital, Kinshasa. The Congo Republic is on the other side of the river.

“We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone,” Health Minister Oly Ilunga Kalenga said in a statement.

“Since the announcement of the alert in Mbandaka, our epidemiologists are working in the field to identify people who have been in contact with suspected cases.” He said authorities would intensify population tracing at all air, river and road routes out of the city.

It is the ninth time Ebola has been recorded in Congo since the disease made its first known appearance near its northern Ebola river in the 1970s.

Ebola is most feared for the internal and external bleeding it can cause in victims owing to damage done to blood vessels.

Before Wednesday’s announcement, there had been only two cases of the virus confirmed by lab tests.

First vaccine batch
The first batch of over 4,000 Ebola vaccines was sent by the WHO to Kinshasa on Wednesday. The Health Ministry said vaccinations would start by early next week, the first time the vaccine would come into use since it was developed two years ago.

The vaccine, developed by Merck and Co Inc, is still not licensed but proved effective during limited trials in West Africa in the biggest-ever outbreak of Ebola, which killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014 to 2016.

Before the latest confirmed case, Peter Salama, the WHO’s deputy director-general for emergency preparedness and response, said the current number of suspected, probable or confirmed cases stood at 42, with 23 deaths attributed to the outbreak. He said another 4,000-vaccine batch was expected soon.

Health workers have recorded confirmed, probable and suspected cases of Ebola in three health zones of Congo’s Equateur province, and have identified 432 people who may have had contact with the disease, the WHO said.
Supplies sent to Congo included more than 300 body bags for safe burials in affected communities. The vaccine will be reserved for people suspected of coming into contact with the disease, as well as health workers.

The vaccine requires storage at a temperature between -60 and -80 degrees C, tricky in a country with unreliable electricity.

“We are now tracing more than 4,000 contacts of patients and they have spread out all over the region of northwest Congo, so they have to be followed up and the only way to reach them is motorcycles,” Salama said.

Source – Gulf News

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The World Health Organisation (WHO) said on Friday it was preparing for “the worst case scenario” in a fresh outbreak of Ebola in the Democratic Republic of Congo.

“We are very concerned, and we are planning for all scenarios, including the worst-case scenario,” WHO’s head of emergency response, Peter Salama, told reporters in Geneva.

WHO has tallied 32 suspected or confirmed cases in the northwestern area of Bikoro, on the shores of Lake Tumbathe near the border with the Republic of Congo, including 18 deaths, between April 4 and May 9.

The cases include three healthcare workers, including one who has died, Salama said.

The outbreak, declared by the DRC health ministry on Tuesday, is the DRC’s ninth known outbreak of Ebola since 1976 when the deadly viral disease was first identified in then-Zaire by a Belgian-led team.

Salama said the affected region of the vast strife-torn central African country is very remote and hard to reach, with a dire lack of functioning infrastructure.

“Access is extremely difficult… It is basically 15 hours by motorbike from the closest town,” he said.

WHO already has a team on the ground and is preparing to send up to 40 more specialists in epidemiology, logistics, contact tracing and other areas to the region in the coming week or so.

Salama also said the United Nations (UN) health organisation hoped to have a mobile lab up and running on site this weekend.

At the same time, WHO and the World Food Programme are working to set up an “air-bridge” to help bring in the supplies needed, he said, adding though that only helicopters could be used until an airfield could be cleared to allow larger planes to land.

The response “is going to be extremely challenging, and very costly”, he said.

The WHO is also awaiting a green light from DRC authorities to begin a vaccination campaign in the area, using an available stockpile of an experimental vaccine, he said.

As for the risk, Salama said WHO was especially concerned about the near-term spread of the disease including to Mbandaka, the capital of Equateur province, which has around one million inhabitants and is only a few hours away from Bikoro.

“If we see a town of that size infected with Ebola, then we are going to have a major urban outbreak,” he warned.

In addition, he said that the surrounding nine countries had been put on “high alert”. The WHO was especially concerned about the possible spread to neighbouring Republic of Congo and the Central African Republic, which has connections to the affected area through the river systems.

He stressed however that the possibility of the international spread of the disease was still considered “low”, but said the situation was constantly being evaluated.

Source – Gulf News

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People affected by the Ebola virus are showing signs of post-traumatic stress disorder a year after epidemic defeated.

Sierra Leone – Hassan sits silently and stares into the distance, he has tired of brushing his hair and an upright comb is tangled into the back of his curls. The 17-year-old speaks quietly, using few words in a calm and gentle manner, but people in his community are scared of him.

They say he is crazy and fear what he might do next. A few days ago he was seen screaming and dancing on the spot, and not long before that he had dressed in his sister’s clothes. Then, of course, there are the times when he sits alone and talks to himself in incoherent mumbles.

Hassan is just one of many Sierra Leoneans whose mental health suffered as a result of the Ebola virus and without the necessary support it has gradually deteriorated over the past year.

One year ago, President Ernest Bai Koroma solemnly took to the airwaves to announce the end of the Ebola epidemic in Sierra Leone, as confirmed by the World Health Organization.

The disease, which killed more than 3,580 people in 18 months, left behind a legacy of psychological suffering which is little discussed and under-supported. The nation has only 21 mental health nurses and one elderly psychiatrist for a population of more than 6 million.

Lack of support
Had Hassan received any form of psycho-social support he might not have dropped out of school, nor would he be scared to leave the compound around his house.

Before his parents died from Ebola he was a bright and promising young pupil with top grades in business studies and English. After school he would go to play football with his friends in the neighbourhood and then come home to study.

He was particularly close to his mother. When she used to come back from the provinces bearing fruits to trade in town, he would always run at once to hug her. His sister, Isha, laughs at the memory. “Our mother used to bring mangoes and honey for all of us, but Hassan would always rush to her and take his first. She really adored him and he’d joke he was the favourite child and that all the presents were for him”.

It was during a joint trip up-country that his parents both contracted Ebola and came home complaining of a fever, only to die a week later. Soon after this Hassan started to exhibit unusual behaviour.

“I remember coming into the room to find him wearing one of our mother’s necklaces,” says Isha. “He asked me where our parents were and I told him they were dead. He shook his head and said I was lying. He said that he could see our mother standing in front of him”.

The last real glimpse that Hassan and Isha had of their parents was when their corpses were carried out of the house by a burial team. This denied them the chance to have a traditional funeral, something which might have given Hassan a degree of closure.

As Ebola-infected corpses were so contagious, teams of trained burial workers in protective clothing would move from house to house picking up the dead and carrying them off to graveyards.

These teams would often collect up to 15 bodies in a day and the work was emotionally traumatic and physically demanding. Big wages were offered to burial workers to try and compensate them for the difficult nature of their work.

Many of them also bear a heavy psychological burden today.

Haunted by memories
Former burial worker Patrick, 29, is extremely proud to have played a role in the fight against Ebola, “I did it for my country,” he says.

Yet his patriotism comes at quite some cost. One year on he is still suffering bouts of depression and is regularly haunted by flashbacks.

“The dreams come often,” he says, “I remember that when there were a lot of bodies in the morgue they’d stack them up one by one – like bags of rice. That’s the vision that usually comes to my mind.”

He adds that it happens not only at night, but also in the daytime if something triggers a memory.
“When I’m thinking of that and someone is trying to get my attention I simply can’t hear them”, he says. “After it happens, I won’t eat for the rest of the day.”

During his time as a burial worker he took to drink and drugs to drive away the memories, but at a medical check-up soon after Ebola he was warned that any more toxins in his system could be fatal. Now he only drinks occasionally, when the flashbacks really won’t disappear.

After the outbreak was over Patrick said that he found it very difficult to re-adjust to normal life. He admits that he and other members of the burial team would sometimes turn up at hospital morgues just to look at the dead bodies. “It made us feel like we were still engaged,” he says, adding that he rarely does it any more.

Patrick says that he was lucky to receive psycho-social support from NGOs IsraAid and Concern.

He has now founded a charity of his own, called Protect Sierra Leone, which is made up of ex-Ebola response workers and focuses on sanitation issues.

Mounting frustration
Burial workers were badly stigmatised, not only for preventing families from carrying out traditional funerals, but because of the money they were making.

Their monthly salaries were six times the minimum wage and people accused them of profiting from Ebola just as others lost their livelihoods. Jobs became particularly scarce in the agricultural sector as quarantine restrictions meant that farmers were unable to sell their produce around the country.

Rice farmer Emanuel Focko comes from Kpondu, the first village in Sierra Leone to become infected with Ebola.

He remembers the frustration he felt during the outbreak.

“I was struggling so much that I could barely take care of myself and my family,” he says. “I really had no money. Then at some point people in my village started receiving help from an NGO, but they told me I wasn’t eligible because no one in my immediate family had contracted Ebola.”

Apparently maddened by jealousy and desperation, Emanuel one day stormed into his village and started attacking a pregnant woman with a stick. Those nearby responded by pinning him to the ground and tying him up with rope.

“They maltreated me beyond belief,” he says. “They tied my legs and hands so tight that it tore my skin.” He stretches out his arms to show the deep scars around his wrists.

Mental health nurse Martin, who was summoned from a town three hours away to deal with the case, remembers it well.

“He was in a terrible state when I arrived, screaming and crying, desperate to break the ropes. I untied him and gave him some medicine, then I stayed all night to keep him calm. After a while he started to talk about his problems, he said Ebola had taken everything.”

After what he did, Emanuel is still treated as an outcast by his village today, and his wounds cause him pain when he’s working in the field.

Martin also believes that his psychological problems are not yet cured and would like to be able to pay Emanuel more visits. “The problems are financial though,” he says. “Emanuel can’t afford to pay me and I can’t afford to keep buying the medicine and petrol on my salary.”

Under-funded
Ebola left its psychological wound on many, not only the people who lost their loved ones, but also members of the response team and those who saw their livelihoods ruined.

But when President Koroma announced his recovery priority plans in June 2016 no mention was made of the nation’s mental health.

While aid money is being set aside for education, energy and medical improvements, very little has reached the under-funded mental health sector.

No real research has been undertaken into the psychological impact of Ebola.

Joshua Duncan, coordinator for the Mental Health Coalition of Sierra Leone, told Al Jazeera: “It is believed that [Ebola virus disease] affected people are now showing signs of post-traumatic stress disorder,” but admits that “up until now there is no data”.

While the Ebola virus ostensibly left Sierra Leone a year ago, much of the population still wear invisible scars that they have little chance of fighting until they receive due support.

Photo File – Health workers carry the body of a suspected Ebola victim for burial at a cemetery in Freetown, Sierra Leone, December 21, 2014

Source – Al Jazeera

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