ROMA (ITALPRESS) – The Ebola epidemic caused by the Bundibugyo virus in the Democratic Republic of the Congo does not stop. According to data from the National Institute of Public Health in Congo spread on 18 September, cases confirmed are 7.541 and deaths 3.639, with a lethality of 48%. On 5 August there were 3.748 cases and 1.657 deaths: in seven weeks numbers doubled. This is what emerges from the update bulletin of the Artemisialab – Cesmet – Rome Traveler Clinic, directed by the infectious and tropicalist Paolo Meo.
“We talk about an out of control epidemic in a technical sense – explains Meo. The international response has grown a lot, but has not yet been able to bend the national curve or stop the geographical expansion.”.
From the beginning of August the country averaged about 80 new cases confirmed a day, without signs of descent. The provinces affected have passed from five to seven, the health areas from 49 to 62, on an area comparable to that of the United Kingdom. In North Kivu, close to Uganda and Rwanda, weekly cases almost doubled in two weeks. In Katwa, Butembo district, literacy exceeds 68%.
The World Health Organization admits that many deaths still occur in homes and not in care centers, often among people who did not appear in any contact list. There are therefore chains of contagion that no one is following. The WHO Emergency Committee estimated that real infections could be three or four times the ones confirmed. He also warned that, without a rapid change of course, the epidemic could exceed that of Western Africa in 2013-2016, which counted over 28,000 cases and more than 11,000 deaths.
There is no lack of positive signals, that the Artemisialab – Cesmet report: in the most affected areas of Ituri the transmission is in decline, the contacts followed went up to 87.6%, the healed exceed 1.800. Uganda has closed its epidemic. “But, as Doctors Without Frontiers says, the epidemic is not shrinking: it is moving,” Meo notes.
The case that worries: the South-Ubangi. On September 10, the virus was confirmed in the South-Ubangi, at the extreme north-west of the country, over a thousand kilometers from the epicenter and border with the Central African Republic and Congo-Brazzaville. The patient, a 23-year-old man already deceased, would cross the country with transits, according to Congolese sources, also in Rwanda and Uganda.
“One boy who crosses the middle of Congo and two borders tells better than any model as this epidemic spreads,” says Meo. “The international risk does not travel by plane to Europe: it travels by road, by motorbike and by boat between the neighbouring countries. ”
What about Italy? The bulletin of the Artemisialab Travel Centre – Cesmet separates the facts from fears. New cases exported outside Africa have not been reported since 13 July. In Europe the cases were three, all healthcare or humanitarian workers, all healed and without secondary counters. The European Centre for Disease Prevention and Control (ECDC) estimates very low the import risk. Ebola is not a respiratory virus: it is transmitted only by direct contact with the biological liquids of a sick person, and who is infected but without symptoms not infected.
“Whosoever asks me if he must be afraid, I answer frankly: for those who live in Italy the risk of getting sick of Ebola remains very remote – says Meo -. The risk I’m interested in is another: that you get used to reading these numbers as a distant news. And that the day when a co-operator or a missionary will return with fever, no one asks where he comes from. The first defense of Europe is not the airport: it is the right question to the triage”.
The Order of the Ministry of Health of 29 May obliges those returning from Congo or Uganda to declare themselves to the ASL within 24 hours. It has a validity of 120 days and expires then around 26 September. At the close of the Artemisialab – Cesmet bulletin no delays were detected.
“In case of renewal – Meo suggests – the list of countries should be reviewed: Uganda is out of the epidemic, while today count more flows from Central Africa and Congo-Brazzaville”.
On the other hand, the United States extended until 11 October the blocking of admissions for those recently in Congo, Uganda or South Sudan.
There is no vaccine yet or an effective treatment demonstrated against the Bundibugyo virus. Three vaccines and three therapies are being tested. On September 21, the WHO announced in Ituri the start of the trial with Ervebo, the vaccine recorded against the Zaire virus, on first-line personnel. Specific vaccine efficacy studies are expected between October and November.
The Artemisialab Travel Centre – Cesmet recommends to postpone non-essential travel in the affected provinces; Kinshasa and the south of the country remain outside the transmission areas. It also recalls that malaria remains the most likely cause of fever and must be prevented from chemoprophylaxis.
For those who return with fever within 21 days it is recommended not to spontaneously present themselves to the emergency room: first call to the doctor or ASL and declare the trip.
– photos of repertoire IPA Agency –
(ITALPRESS).
