With vaccine in hand, Ebola response teams are struggling to track those who need it

Tuesday, October 23, 2018
By Paul Martin

OCTOBER 23, 2018

The Ebola response teams in the Democratic Republic of the Congo are having increasing trouble keeping track of where the virus is spreading, a problem that threatens containment efforts and undermines the effectiveness of the vaccination program there.

Public health officials had been hopeful that an experimental vaccine could help curb the spread of the outbreak. But, for that to happen, response teams must be able to identify people who have been in contact with Ebola patients. Persistent violence in the outbreak zone has made that hard to do.

More than half of the recently detected cases haven’t been on lists of contacts. And even retrospective detective work is failing to piece some of these people into the transmission chain, the World Health Organization acknowledged.

“We have a number of indicators right now showing that our ability to quickly detect cases and follow up on their contacts has been seriously challenged by the safety issues,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who has been tracking the epidemic.

Vaccine, he said, “can’t be given to people you don’t know exist.”

The severe insecurity problems in North Kivu, the province in northeastern DRC where Ebola is spreading, are throwing up major challenges for the outbreak response. There have been repeated attacks by rebel forces on Beni, the current Ebola hot spot, stymying efforts to track Ebola patients and their contacts.

The further behind the virus that the response teams get, the more difficult it will be to use the still-unlicensed vaccine, made by Merck, to its maximum effect, experts acknowledged.

The response team in North Kivu has vaccinated a prodigious number of people — more than 20,000 so far in the province and in parts of neighboring Ituri province, where a few cases have occurred. That count rises by hundreds of people most days.

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