Generational Dynamics World View

[John J. Xenakis]

*** 18-May-18 World View -- New Ebola outbreak in major DR Congo city is called potentially 'explosive'

This morning's key headlines from GenerationalDynamics.com

• New Ebola outbreak in major DR Congo city is called potentially 'explosive'
  
• Applying lessons learned, WHO and MSF move quickly to contain Ebola outbreak
  

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**** New Ebola outbreak in major DR Congo city is called potentially 'explosive'
****


Hospital in Mbandaka, DRC, where Ebola patients will be treated (WHO)

The Democratic Republic of Congo (DRC) was only marginally affected by
the massive Ebola epidemic that struck eastern Africa (Sierra Leone,
Liberia and Guinea) in 2014-2016. DRC itself has had its own Ebola
outbreaks 9 times since 1976, but all of them have occurred in rural
villages, where they were easily contained.

What's different now is that a new Ebola outbreak has spread to a
large, densely packed port city, with the possibility of rapid
transmission within the city, as well as transmission along the Congo
River to other countries.

As far as is currently known, the latest outbreak began in a small
inland village called Ikoko Impenge, accessible only by motorbike.
However, the outbreak only became known on May 8, when the DRC
notified the World Health Organization (WHO) that there were two
confirmed cases identified in another inland village, Bikoro. By
Thursday, 23 deaths had occurred from Ebola cases in isolated rural
villages, giving authorities a better chance of ring-fencing the
outbreak before it could spread.

On Thursday, the World Health Organization announced that the Ebola
outbreak had reached a "new phase," as new Ebola cases were identified
in Mbandaka, a large heavily populated urban city of about 1.2 million
people. It's believed that the disease was brought to Mbandaka by two
or three people who had attended the funeral of an Ebola victim in
Bikoro.

The spread of the outbreak to Mbandaka is "explosive," according to
senior WHO official Peter Salama:

<QUOTE>"This is a major development in the outbreak. We have
urban Ebola, which is a very different animal from rural Ebola.
The potential for an explosive increase in cases is now there.

This puts a whole different lens on this outbreak and gives us
increased urgency to move very quickly into Mbandaka to stop this
new first sign of transmission."<END QUOTE>

There are two reasons why the outbreak in Mbandaka could be explosive:

• With a large, densely packed population, it will be easy for
  the virus to spread from person to person through human contact. Once
  infected, a person may not show symptoms for as many as 21 days,
  meaning that an infected person could infect many other people before
  he even knows of his own infection. It's theoretically possible that
  this has already happened, and that there will be many new cases in
  the next 3-4 weeks.
  
  
• Mbandaka is a port city on the Congo River, one of the longest and
  deepest rivers in the world, almost 3,000 miles long. With heavy
  traffic traveling from port to port along the river, the infection
  could spread to DRC's capital city Kinshasa, with a population of 11.6
  million, or it could spread to Brazzaville, population 2 million, the
  capital city of the neighboring country, the Republic of The Congo
  (sometimes called Congo-Brazzaville to distinguish it from DRC).
  Kinshasa and Brazzaville are situated opposite each other on the Congo
  River south of Mbandaka, and once Ebola reaches those two cities, it
  could spread further to other countries, or to other
  continents.

The World Health Organization on Friday is convening an emergency
meeting to “consider the international risks” of the Ebola outbreak,
and to decide whether to officially declare an international
emergency. STAT News and BBC and Al Jazeera and World Health Organization and United Nations

****
**** Applying lessons learned, WHO and MSF move quickly to contain Ebola outbreak
****

The World Health Organization (WHO) was heavily criticized for moving
too slowly to contain the Ebola outbreak in Guinea, Sierra Leone and
Liberia from 2014 to 2016, and so is now moving quickly to try to
contain the new outbreak in DRC.

The Emergency Committee meeting that WHO is convening on Friday will
decide whether to declare a "public health emergency of international
concern," which would mean getting access to more resources. So this
step may be taken even though the outbreak is still confined to DRC.

Médecins Sans Frontières (MSF, Doctors Without Borders) has sent
multiple teams to hospitals in Mbandaka and Bikoro. MSF is sending
tons of supplies to Mbandaka, including medical kits; protection and
disinfection kits containing isolation items such as protective
clothing, gloves, and boots; logistical and hygiene kits containing
items such as plastic sheets, chlorine spray kits, and water treatment
kits; and palliative drugs to treat Ebola symptoms, such as strong
painkillers, anti-anxiety drugs, and antibiotics.

A new experimental Ebola vaccine has been developed since the
2014-2016 outbreak, and MSF has 4,000 doses available to use to
control the outbreak in Mbandaka. A vaccine cannot help someone who
is already sick, but it will be used in conjunction with the
methodology of "contact tracing." Once a potential victim is
identified, then contact tracing means that potential contacts ae
located, and their contacts are located, and so forth, and all of
those people could be given the new vaccine.

However, it's not clear that any of these methods will prevent an
explosive spread of Ebola. In 2014, Ebola spread rapidly in Liberia's
capital city Monrovia, particularly in the West Point slum area, with
more than 70 000 people crowded together on a peninsula, with no
running water, sanitation or garbage collection. If there is a
similar slum area in Mbandaka, Kinshasa, or Brazzaville, then the
spread could be equally massive. TRT World and Doctors Without Borders and AP and World Health Organization

Related Articles

• DR Congo boycotts its own international humanitarian conference for DR Congo (14-Apr-2018)
  
  
• DR Congo's Joseph Kabila brings the art of power and corruption to new heights (24-Jul-2017)
  
  
• West Africa at significant economic risk as Ebola panic intensifies (16-Aug-2014)
  
  
• World Health Organization says Ebola outbreak is 'in decline' (30-Oct-2014)
  
  
• Forecasting the Ebola endgame and Global Risk (19-Oct-2014)
  

KEYS: Generational Dynamics, Democratic Republic of Congo, DRC, Ebola,
Ikoko Impenge, Bikoro, Mbandaka, Kinshasa,
Republic of The Congo, Brazzaville,
World Health Organization, WHO, Peter Salama,
Médecins Sans Frontières, Doctors Without Borders, MSF,
Sierra Leone, Guinea, Liberia, Monrovia, West Point

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