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Wednesday, July 25, 2018

WHO:Ebola contained by 'complex' rapid response, not just vaccine

Nurses working with the World Health Organization prepare to administer vaccines at the town all of Mbandaka
© Provided by AFP Nurses working with the World Health Organization prepare to administer vaccines at the town all of Mbandaka

The World Health Organization has a message for those trying to understand how the latest Ebola outbreak was contained so quickly: don't give the new vaccine all the credit.
Compared to the 2013-2015 West African outbreak, which exploded into an epidemic that killed more than 11,300 people, the response to the latest flare up of the virus in the Democratic Republic of Congo was a clear success.

In an interview with AFP, WHO's deputy chief for emergency response Mike Ryan conceded that the new vaccine deployed in DRC was "a fantastic tool", but "we can't say (it) made the difference."
He instead highlighted factors like the fast local and international response as well as "painful lessons" learnt after WHO's severely criticised handling of the West African epidemic, which plunged the UN agency into an existential crisis, according to public health experts.
Data analysis in the coming weeks will clarify the role played by the rVSV-ZEBOV vaccine in stemming the outbreak that stretched from May 8 to July 24 and claimed 33 lives, according to Kinshasa.
"At this point I can only say that (the vaccine) probably played a part, but it was a small part in a very sophisticated and complex response," Ryan added.

What went right?

For Ryan, quick reaction was the key.
"The main reason we were faster, quicker and more effective this time was that we launched a response very, very early.
"We investigated early, we responded aggressively, we isolated cases quickly, we put in place excellent contact tracing and then in addition to that we were able to vaccinate contacts," he said.
That swift reaction in a remote part of northeastern DRC marked a stark contrast to the West African epidemic, when WHO's former chief Margaret Chan was accused of failing to sound an early global alarm about an impending catastrophe.
"WHO has learnt a lot from the last outbreak, a lot of painful lessons," Ryan said.

Hope not death

More than 3,300 people in DRC's affected Bikoro region were vaccinated, but Ryan said that entering communities with a vaccine had advantages beyond prophylactic defences against Ebola.
"The fact that we were bringing vaccines to communities meant we were bringing hope not death," he said.

A health worker in the Central African Republic monitors the temperature of a young traveller from DRCongo
© Provided by AFP A health worker in the Central African Republic monitors the temperature of a young traveller from DRCongo
  "So people were rushing forward saying 'can we be vaccinated' and that changes the dynamic because the communities now sense that the international community is bringing in salvation, not the end of the world."
Health responders were at times attacked amid the height of the West African epidemic and a more cooperative population inevitably makes it easier to trace contacts and identify patients.
"I certainly think the local communities in this Ebola response were highly receptive to the intervention, more so maybe than in West Africa," Ryan said.
Overall, the successful DRC response served as another reminder for WHO that travel restrictions do not work.
He called such measures "a highly expensive and a highly ineffective way of containing disease."

He pointed to Congo River, which in the latest outbreak risked becoming a route through which sick patients might spread the virus throughout DRC and beyond.
But WHO and the Congolese government opted for screening and sensitisation along the river, rather than movement restrictions.
The river, he said, "is the lifeblood of the country. This is the economic highway... Are we going to block (this) the vital economic artery?"

 AFP




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