People living close to the epicentre of an Ebola outbreak which has killed 131 people have told BBC News of their fear, as a World Health Organization (WHO) representative warned cases may be spreading faster than originally thought.

An Ebola outbreak in the Democratic Republic of Congo has been declared a public health emergency of international concern, by the World Health Organization (WHO).

The latest outbreak is challenging because it involves a rare strain of Ebola for which there is no vaccine, and cases have been found in an area affected by conflict.

One man in the Democratic Republic of Congo’s Ituri province, the epicentre of the outbreak, said infected people were dying « very fast », and added: « Ebola has tortured us. »

Officials said more than 513 cases were suspected in DR Congo as of Tuesday, while one person has died in neighbouring Uganda.

The WHO’s Dr Anne Ancia told the BBC that the more the agency investigates the outbreak, the clearer it becomes cases have spread to other areas.

Modelling by the London-based MRC Centre for Global Infectious Disease Analysis released on Monday suggested there had been « substantial » under-detection, and that it could not rule out there had already been more than 1,000 cases.

The study suggested that the current outbreak is « larger than currently ascertained » and that its « true magnitude remains uncertain ».

A man who spoke to BBC News and identified himself as Bigboy said people are « really scared » and doing what they can to protect themselves.

He said locals are taking precautions such as washing hands with clean water, but added that he wished they could get access to other protective supplies such as face masks.

Another Ituri local, Alfred Giza, said people in the community are aware of the threat and waiting to receive face masks to protect themselves, but that he would not know what to do if a family member or friend contracted the disease.

The Red Cross warned that Ebola can escalate quickly if cases are not identified early, communities lack information and health systems are overwhelmed, adding that « we are seeing all those conditions » in the current outbreak.

On Tuesday, DR Congo President Félix Tshisekedi called for « calm » and urged Congolese citizens to remain vigilant, after holding a crisis meeting on Monday evening.

WHO chief Tedros Adhanom Ghebreyesus, who declared the outbreak an international emergency last week, said he was « deeply concerned about the scale and speed of the epidemic ».

It is feared the outbreak may have been ongoing for several weeks before it was first detected on 24 April.

There is no vaccine for the strain of Ebola virus fuelling the latest rise in cases, but the WHO is evaluating whether other drugs may provide protection.

Speaking to BBC Newsday, Ancia said DR Congo’s Ituri province was a « very unsecured area with lots of movement of population », making it difficult for the agency to investigate and help control the disease.

She continued: « The more we are investigating this outbreak, the more we realise that it has already disseminated at least a little bit across border and also in other provinces. »

The outbreak has spread to the province of South Kivu, where the population has been affected by a humanitarian crisis for many years, she added.

There has also been a case in eastern DR Congo’s biggest city, Goma, which has a population of around 850,000 people and under the control of Rwandan-backed rebels.

High levels of insecurity in several provinces mean people move around often, increasing the risk and spread of the virus, she said.

Several African countries are taking precautions by tightening border screenings and preparing health facilities. Neighbouring Rwanda has also closed its borders with DR Congo. Uganda has told people to avoid hugging and shaking hands.

An American citizen, believed to be missionary group doctor Peter Stafford, is being evacuated from DR Congo after developing symptoms over the weekend.

Germany’s health ministry told the BBC a US citizen was being taken to the country for treatment.

The US Centers for Disease Control and Prevention (CDC) said it was working to evacuate at least six other Americans who were exposed.

WHO and other agencies are working with governments and communities to try to stop the spread of the virus, urging residents to follow preventative measures and report to the nearest health facility if they experience any symptoms.

What is Ebola and how does it spread?

Ebola is caused by a virus and initially causes symptoms similar to the flu, with fever, headache and tiredness.

As the disease progresses, vomiting and diarrhoea develop and it can lead to organ failure. Some, but not all, patients develop internal and external bleeding.

The virus spreads from one person to another by contact with infected bodily fluids such as blood or vomit.

The Bundibugyo strain fuelling this rise in cases is rare, and has previously only caused two outbreaks, when it killed about a third of those infected.

Between 2014 and 2016, more than 28,600 people were infected by Ebola in West Africa, the largest outbreak of the virus since its discovery in 1976.

It was caused by the Zaire strain, for which there is an approved vaccine.

The disease spread to a number of countries in West Africa and beyond, including Guinea, Sierra Leone, the US, UK and Italy, killing 11,325 people.

World Opinion + BBC News

L’article What is Ebola and why is stopping the latest outbreak so difficult? est apparu en premier sur World Opinion | Alternative Média.

As a scientist, I firmly believe that scientific progress will provide the exit strategy from this pandemic. But I’ve often worried that we may not be able to achieve what’s needed to prevent the spread of this virus, or that doing so would take a very long time. Never have I been happier to be proved wrong.

Britain is the first country to authorise emergency use of a vaccine for Sars-CoV-2, the virus that causes Covid-19. So how did we get here so quickly? To gain the seal of approval from the Medicines and Healthcare products Regulatory Agency, the UK body that makes sure medicines are safe, the vaccine, developed by Pfizer and BioNTech, has been through three phases of clinical trials. In the third phase, it was administered to more than 43,000 volunteers with no serious safety concern. The data shows that the vaccine is 95% effective at preventing the development of Covid, with similar efficacy observed across age, gender, race and ethnicity groups, including older adults.

The vaccine is a messenger RNA (mRNA) vaccine, which stands for “messenger ribonucleic acid”. Messenger RNA is essentially the blueprint that living cells use to turn gene sequences intothe proteins that form their fundamental structures. Once injected, the mRNA in the vaccine is translated into a viral protein, which our immune systems detect. The body generates an immune response in reaction to these viral proteins, which can’t by themselves cause disease, and this provides protection against developing Covid-19.

In the field of vaccine research, this kind of technology is entirely new. Some scientists were sceptical that mRNA vaccines could provide the key to controlling this pandemic. But mRNA vaccines are surprisingly straightforward: they’re just a smart way of getting a viral protein to generate an immune response, and after a few days the mRNA is degraded by the body, leaving behind only immunity to Covid.

To generate a good immune response, two doses of the vaccine will be given 21 days apart, with recipients protected from about a week after their second dose. To avoid unnecessary delays the MHRA, with advice from the Commission on Human Medicines, the government’s independent expert scientific advisory body, has undertaken a rigorous “rolling review” of data about the vaccine as it became available from continuing studies. This showed the vaccine was safe, and it has been approved for use in the UK population as of next week.

The European commission had recommended that member states wait for approval from the European Medicines Agency (EMA) before authorising the vaccine, which is expected to arrive later in December. But despite the claims of some ministers that Brexit played a role in the UK’s ability to quickly approve the vaccine, this isn’t true: under EU law, national agencies in Europe are permitted to use emergency procedures allowing them to domestically distribute a vaccine for temporary use. The MHRA, which is considered the world leader in the regulation of medicines and vaccines, confirmed this in a recent statement.

The UK has already purchased 40m doses of the vaccine, with 800,000 due to be rolled out to some of the most vulnerable people in our society through a network of more than 50 hospitals. The NHS and government departments have been working on the logistics of the programme for some time. First in line to receive the vaccine are people most at risk of mortality and morbidity from Covid-19.

The Joint Committee on Vaccination and Immunisation (JCVI) issued a revised vaccine priority list on 2 December, based on the phase of the pandemic we’re in. The JCVI has determined that the best strategy is for older adults – especially those in care homes and their carers, as well as frontline health and social care workers – to be the top priority in the first phase of the vaccination programme. Clinically extremely vulnerable adults, many of whom have spent this year shielding indoors, have been moved higher up this list since the JCVI’s last guidance was published, and will now be fourth in line to receive the vaccine.

Once the most vulnerable people have been vaccinated, the plan is to vaccinate those who are at increased risk of exposure to Covid-19 because of their jobs, such as first responders, teachers, transport workers and the military. This phase of the programme may alter over time as more data and information becomes available about the impact of the pandemic and the vaccine.

The greatest remaining challenge is whether we are all willing to accept and trust the vaccine. Some worry that, in order to have made a vaccine so fast, corners must have been cut. But they really haven’t been. Others have been concerned that mRNA vaccines represent a new technology that could potentially alter the DNA of the recipient – again, this is untrue. It’s certainly the case that vaccines have taken years to develop in the past, but most of that time was often not spent undertaking clinical trials, but raising the money for trials to take place, negotiating contracts and applying for regulatory approval. Historic vaccine trials have rarely taken place during a pandemic like this one, while millions of people are being exposed to infection on a daily basis and thousands of them are keen to participate in trials.

Despite the many horrors of 2020, there have been benefits – we have learned that if you divert an almost limitless amount of funding and focus a large proportion of the world’s scientists, regulatory bodies and other critical infrastructure towards a single endeavour, you can achieve extraordinary things very fast. For me, the question is not how have we managed to achieve a vaccination for Covid-19 in such a short period of time, but rather: why have we not yet managed to make the same impact on diseases such as tuberculosis, HIV and malaria, which have been killing millions of people for many years? And what could happen if we turned this urgent global effort towards the other challenges we face – such as environmental breakdown, or the insidious creep of antimicrobial resistance?

Much as we hate to admit it, humans are not entirely rational creatures. Many of our fears about vaccines will not be abated by people presenting us with scientific data. We make decisions like this based largely on whether we trust the advice we are being given. I could deluge you with research data about why the vaccine is safe, but I suspect the most useful thing that medics and scientists can do is to urge people to say yes to the vaccine when it is offered. And when my turn comes, you will find me waiting impatiently in the queue for my vaccination.

Dr Charlotte Summers is a lecturer in intensive care medicine at the University of Cambridge

theguardian.com

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