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Sunday, June 18, 2017

Fighting Ebola in Africa

"It was a dream response .. better than the best-case scenario. Everybody worked together, which was beautiful to see. The response was very quick, very strong and very well co-ordinated."
"[The nurse in the DRC whose swift response helped avert an outbreak of Ebola] deserves a medal."
"We want to learn from him [how he was able to quickly reach a determined conclusion, then seek to have it verified, to use his reaction as a model elsewhere]."
"[The latest Ebola outbreak] tells you that you don't need vaccines and drugs if everything is done perfectly. But, at the same time, it is nice to have them if you need them."
Dr. Gary Kobinger, director, Centre for Research in Infectious Diseases, Laval University
Ebola in DRC, 2017 video
Still from WHO video
In the two years between 2014 and 2016, the largest Ebola outbreak in history took place in West Africa, killing over 11,000 people before it was brought under control. And while the World Health Organization holds that the risk of further cases of Ebola remains low, a small number of confirmed cases of Ebola have been identified, and some are suspected but not verified.

In West Africa matters did not proceed in a medically sound manner in identifying the Ebola outbreak, much less treating it and isolating patients so the highly communicable disease did not spread. Among the people struck, a lot of hostility and misinformed judgements interfered with medical personnel attempting to do their utmost to stifle the outbreak and treat those affected.

There was delay and there was a panicked reaction during the West African Ebola outbreak. In an isolated village in Guinea villagers were convinced that health workers were in fact infecting people, not helping them. Villagers attacked the health workers, refusing to accept that they were there for a defined purpose, to help stop the spread of the disease, to educate people how best to proceed to avoid contamination.

In early May, in a remote area of the Democratic Republic of Congo a male nurse's swift action helped to prevent another cataclysmic outbreak of Ebola by flagging an ill patient as presenting in his opinion, as a candidate for Ebola when he appeared to be suffering from hemorrhagic fever. The nurse quickly forwarded a sample of the patient's blood for testing.

That sample was conveyed on back country roads by motorcycle from that remote region to Kinshasa, the country's capital, where testing could be carried out. And when it was, it was confirmed that the patient did indeed have Ebola, as the nurse suspected. The result of that confirmation enabled medical teams to respond with alacrity to prevent an outbreak.

The Democratic Republic of Congo, it may be recalled, has been embroiled in an interior conflict for years where marauding bands of rebel groups attack villages, slaughter and rape and lay waste. When the government has dispatched the military to combat the rebels another type of mayhem similar to that mounted by the rebels occurs, with DRC soldiers engaging in mass rape. Millions of people were killed and though the conflicts have ebbed, in some parts of the country rebel militias prevail.

Dr. Gary Kobinger, who had set up a laboratory in one of the regions affected in DRC, tested suspected cases of Ebola, aiding in surveillance of the spread of the disease. People in the remote areas which had been affected, he said, were cooperative with health authorities, enabling them to trace the spread and ultimately contain it, unlike what had occurred in West Africa.

Dr. Kobinger as the former head of the special pathogens program at the National Microbial Laboratories in Winnipeg was involved in the development of the experimental Ebola vaccine, VSV-EBOV, along with the anti-viral treatment, ZMapp. It is his intention to speak with the alert nurse to gain an understanding of the type of training he had received.

Dr. Koninger is involved in helping to build capacity in those parts of Africa affected by Ebola, for the purpose of protecting against future outbreaks of infectious diseases, with the hope also of improving local health care and research. To that end, he is being funded by the International Development Research Centre.

The anti-viral therapies and the Ebola vaccine, created at the National Microbial Laboratories in Winnipeg are still experimental, but before their creation no drugs were available to prevent or fight Ebola. The WHO has authorized their use in special situations and they have proven their value, though still undergoing testing.

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