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Many cases in DRC Ebola outbreak coming from health centers

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Matshidiso Moeti

Six months into the 10th and largest Ebola virus outbreak in the Democratic Republic of the Congo, or DRC, officials said many confirmed cases are coming from health care centers.

“As we look back on the 6 months, we can see the strategies that have been successful in controlling the outbreak in some areas ... though we continue to see flare ups and outbreaks in other areas,” Matshidiso Moeti, MBBS, MSc, WHO regional director for Africa, said during a news conference.

Strategies that have worked to control the outbreak, she said, have involved engaging with communities, especially with women and religious groups, and case investigation and contact tracing. Widespread use of an investigational vaccine and investigational drugs also have aided the response.

However, as Moeti explained, transmission remains a problem, with one in every five confirmed cases reporting contact with a health center before the onset of the disease.

According to WHO, the outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission in health centers. WHO said 86% of cases in these areas since Dec. 1 reported having visited or working in a health care facility before becoming ill. Additionally, in the past 3 weeks, 49 health structures were identified where confirmed cases were hospitalized and eight new infected health workers were reported.

“In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress and we also provide incentives to encourage best practices,” Moretti said. “In addition, we work closely with facilities and the community to ensure that they report all deaths and have safe and dignified burials.”

Moeti said strengthening the health system is crucial to fight outbreaks, including an ongoing malaria outbreak in Beni. Officials had to deploy additional WHO teams to work along with the Ebola response teams to get control of that outbreak.

“Ultimately, this outbreak has put into even sharper focus the weaknesses and the gaps in the health care system and reinforced our ultimate message — stronger health systems are the only way to rapidly detect, respond to, and eventually, end outbreaks,” Moeti said.

The case count in the Ebola outbreak has reached 759, including 705 confirmed cases and 414 confirmed deaths. So far, more than 70,000 people have been vaccinated in the DRC, and 2,600 health care workers in bordering Uganda and South Sudan also have been vaccinated. Moeti said preparing bordering countries is a priority in controlling the outbreak, although an international public health emergency of international concern has not been declared.

“I feel optimistic that in the places where we started with a combination of interventions, that we have been able to bring the situation there almost under control,” Moeti said. “We’ve seen a change in our engagement with communities, we’ve invested a lot in it, and we have been very pleased with the support from local leaders who have been able to work with us to carry the message and engage the community.”

However, she added there is still a lot to be done to stabilize and bring the situation under control. – by Caitlyn Stulpin

Disclosure: Moeti reports no relevant financial disclosures.