The Ebola hemorrhagic fever has already killed more than 500 people in the democratic Republic of the Congo (DRC) and affected more than 800 people
Declared six months ago in regions of the north-east of the country, North Kivu and Ituri, the tenth outbreak of Ebola in the country is out of control. The violence affecting these areas prevent medical teams from entering certain areas and pushing the inhabitants terrorized to flee in the forest or in Uganda, the risk of spread of the epidemic in regions which are inaccessible and the border country. “In this very difficult context, the doctors identify new cases for which it is sometimes impossible to find the sick with which they were able to be in contact. These holes in the chains of transmission are a real barrier to contain this epidemic, which is the most severe in the history of the DRC,” said professor Eric Delaporte, infectious disease specialist and director of a research unit of international (IRD, Inserm, Montpellier university), who collaborates with teams congolese.
” READ ALSO – The Ebola epidemic in the DRC worsens The infectiologist also highlights another difficulty: some people with Ebola do not show symptoms (vomiting, fever, diarrhea, headache, kidney and liver failure), according to its latest study published in The Lancet Infectious Diseases. “The clinical spectrum of the infection Ebola varies from nothing to death,” says-t it.The funeral rites of the dangereuxRéalisés with 1,400 contacts to survivors or victims of the terrible outbreak of 2013-2016 in Guinea, these works of the franco-guinean demonstrate that 4 % of people infected with the virus after being in contact with a patient are asymptomatic or suffer only light signs. Gone unnoticed, these 56 individuals had not been placed into quarantine and taken care of to a treatment center Ebola (CTE). They have therefore been able to spread the virus. “The doctors identify new cases for which it is sometimes impossible to find the sick with which they were able to be in contact” Pr Eric Delaporte, infectious disease specialist and director of a research unit of international scientists believe, however, that approximately one-quarter of these patients are invisible should be considered suspect. . Well, in theory. “The reality is more complex, glides on Pr Delaporte. How to differentiate diarrhea, fever, and a fever related to a minor infection to those caused by Ebola? At the beginning of the epidemic, the caregivers were not alerted by these signs everyday, which would explain why they were among the first victims”, he explains. It is also possible that the patients knew infected and have preferred to stay at home. “The population was very scared of the CTE and of the doctors in the diving bell. They were many to believe that these centres were mouroirs. “These works also confirm that the funeral rites are associated with a very high risk of being infected by the virus. In fact, 6 % of asymptomatic patients and 17 % of patients presenting with few symptoms have been infected in preparing the body for burial. Ancestral practices that it has been adapted to reduce the risk of contamination, in spite of great resistance of the people.
An anger and a distrust that can be found in the DRC where several flights of human remains in the CTE have been reported. In the light of these results, the researchers remind us that the surveillance and vaccination of case contacts and community involvement are of the cornerstones of the fight against Ebola. However, the Pr Delaporte points out that the diagnostic tests typically used do not allow identification of individuals infected during the initial phase. “With the conventional test, it is possible to detect the virus in the blood of a patient, on average up to two weeks after his contamination. After the test will be negative,” he explains.
To overcome this pitfall, the team has designed a serological test very efficient, able to accurately diagnose an infection.
This new technique has already been sent to the DRC to strengthen the monitoring system.