Congo-Kinshasa: Experimental Ebola Treatments OK'd in DRC as Cases Top 100

OMS / S. Hawkey
(file photo)
23 August 2018

The Ebola outbreak in North Kivu province, Democratic Republic of the Congo (DRC) shows no signs of slowing down, as health officials approved the use of four additional Ebola treatments at Ebola treatment centers (ETCs) in the eastern part of the country.

As of yesterday, the DRC's health ministry reported a total of 102 cases (6 new), with 75 confirmed; 59 people have died, and 9 additional cases are suspected.

The DRC also updated information regarding immunization: Since vaccination began on Aug 8, 1,693 people have been vaccinated: 903 in Mabalako, 471 in Beni, and 319 in Mandima health zones.

Four new treatments approved for use

Last week DRC officials begin using the experimental monoclonal antibody treatment mAb114 in Beni on 10 patients. Now, ZMapp, remdesivir, favipiravir, and Regn 3450-3471-3479 are also approved for use in ETCs, the country's health ministry said.

"The protocols for administering these molecules meet strict conditions related in particular to the condition of the patient, the ease of use of the treatment and the capacity of the medical team of the [ETC]," the ministry of health said in a translated update. "This Tuesday, August 21, 2018, the Remdesivir, produced by Gilead Sciences, was administered to a patient treated at [ETC] Beni, which is doing well. As a reminder, the mAb114 began to be used since Saturday, August 11, 2018. It was administered to 10 patients who are experiencing a positive evolution."

In its latest weekly outbreak bulletin, the World Health Organization's (WHO's) regional office of Africa shared new details of the response measures being taken in North Kivu.

The WHO said that, as of Aug 18, only 59% of contacts had been successfully followed up on, but contacts in Mandima health zone were not followed up for "an apparent community resistance."

That resistance comes in a region divided among 130 rebel groups. The area is also home to more than 1 million refugees, making it one of the DRC's most dangerous places.

"The coming days are going to be critical in the evolution of the outbreak as the people who were earlier exposed to infections continue to develop the disease," the WHO said. "It is also a defining moment in the race to contain the outbreak, during which new exposures to infections should be averted, disrupting further transmission.

"This can only be achieved through meticulous field work to identify every single contact and transmission chain. There is an urgent need to continue scaling up and improve effectiveness and efficiency of all aspects of the response."

Role of population boom

Today the New England Journal of Medicine published a commentary on recent Ebola outbreaks, highlighting the connection between Central Africa's population boom and an increased risk of the disease.

Before 2013, the authors write, Ebola outbreaks were usually confined to small rural clusters of cases that had limited ability to spread over large geographic areas.

But as the population booms and roads expand across the continent to accommodate a growing economic infrastructure, the region is at a greater risk for disease spread that must be combatted with preventative public health spending, write the authors, led by Vincent J. Munster, PhD. Munster serves as the chief of the virus ecology unit at the US National Institute of Allergy and Infectious Diseases.

"Rather than spending exorbitant amounts reactively for control operations, international donors could invest in long-term public health and prevention infrastructure," they write. Part of that investment, they say, should come in the form of human capital—more rural health workers trained to identify Ebola, and more African scientists to strengthen research infrastructure.

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