Scott McPherson's Web Presence

Zoe Young has updated her diary.  The intrepid MSF (that's Doctors Without Borders to you and me) health care worker has her feet in the proverbial Boots On The Ground at what could be the worst outbreak of Ebola in recorded history.

For the record:  The worst known Ebola outbreak was in Uganda in 2000 and 2001.  It infected 425 and killed just over half of its victims (224), for a 53% case fatality rate.  The link to the official death tolls, locations of previous Ebola outbreaks and subtype of Ebola virus can be found at the CDC Website at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/ebolatable.htm  

So far, this new outbreak in the Congo has infected some 375 people and killed 168, according to the Washington Post in an article that ran Wednesday, September 19th.  The Free Press of Namibia (http://www.namibian.com.na/2007/September/world/07BA07B404.html) is reporting a death toll of 172 out of 381 cases, as of Friday, September 21st.

Zoe Young's amended diary can be found at: http://www.msf.org/msfinternational/invoke.cfm?objectid=1DAA2EDF-15C5-F00A-252C43D5B5FB4969&component=toolkit.article&method=full_html

I think you get the point.  The cases and deaths are still increasing. Angolan officials are also ramping up for what they fear could be an extension of the outbreak into their nation. Please take the time to read the Washington Post article, found below.

Congo's Ebola Outbreak Could Be Worst in Years

By Craig Timberg
Washington Post Foreign Service
Wednesday, September 19, 2007; A19

JOHANNESBURG, Sept. 18 -- International medical personnel and supplies are being airlifted to a remote region of central Congo to combat what threatens to become the world's most serious outbreak of the deadly Ebola virus in years.

Only nine cases of the disease have been confirmed by laboratory tests. But medical authorities suspect the virus has killed 168 people and sickened 375 others across a heavily forested region where villages are linked only by deeply rutted dirt roads. Health officials said it is possible that new cases will continue to emerge over the coming months.

"It's a serious outbreak," said Peter H. Kilmarx, an official with the U.S. Centers for Disease Control and Prevention who toured the area last weekend. "Every day there is a new town with a reported suspect case."

The outbreak's epicenter, which is serviced by a dirt-and-grass airstrip, consists of three towns in Congo's Kasai Occidental province, but the affected area appears to stretch for more than 100 miles.

Kilmarx, speaking from the Congolese capital of Kinshasa, said that one village market he visited had been abandoned and that many Congolese in the area appeared reluctant to shake hands for fear of contracting the highly contagious disease.

Efforts to control Ebola depend on identifying and isolating those who are infected. There is no cure, and many who contract the virus die, typically from acute flu-like symptoms such as high fever, headaches and diarrhea. Hemorrhaging also is common, and bodily fluids containing the virus are the main source of transmission. In previous outbreaks, caretakers and those involved in burying victims were particularly susceptible.

"The only thing you can do is isolate the patient and avoid other infections," said Josep Prior, the top official with Doctors Without Borders in Congo, speaking from Kinshasa. "It's quite shocking. It's not easy to endure such a thing."

The international medical aid group has taken the lead in a global response that also includes the World Health Organization and the CDC team. These groups are assisting Congolese medical authorities in tracking the disease, alerting the public and caring for the ill.

Doctors Without Borders has converted a mud-walled building with a tin roof into a 15-bed isolation ward. To prevent infection, members of medical teams wear protective suits along with surgical masks, gloves and boots. Orange plastic fencing, stretched between tree branches pounded into the ground, keeps potential onlookers away.

As doctors across the region report suspected new cases, medical teams are preparing to visit villages by truck and motorbike in search of people with symptoms. That process may yield many more cases, and two mobile laboratories being flown to the area will speed the process of confirming cases.

Anyone who had contact with an infected person is supposed to be identified, but the logistics are daunting in an area where roadways are so damaged by war and neglect that a trip of only several miles can take an hour.

Doctors Without Borders also is assisting Congolese authorities in attempting to keep medical facilities open. Without proper training and protective clothing, some medical personnel are reluctant to treat patients with Ebola.

Gregory Hartl, a spokesman for the World Health Organization, said other diseases, including typhoid, malaria and shigellosis, may be responsible for some of the deaths now attributed to Ebola. Reports of suspicious deaths date to April. WHO also has called for international help to control the outbreak.

Cases of Ebola have been reported over the past decade in Congo, Sudan, Uganda, Gabon and South Africa. An outbreak in Congo in 2003 killed 128 people; an outbreak there in 1995 killed 250.

If we read the Post article carefully, we see confirmation of Zoe's statement in her diary that three epidemics are raging in the south of Congo:  Ebola, Shigella, and Typhoid.  Confirmation of Ebola infection can only be accomplished by a fluid/blood sample; at least, until the person begins to ooze blood from every orifice of his/her body.  If proper decontamination procedures have not been followed from the initial contact with the infected, however, the consequences -- for the medical worker, the gravedigger, not to mention the entire village population -- are lethal.  Since Ebola starts as an abdominal pain and diarrhea, it is easy for people to mistake Ebola as just another illness.

Authorities are also looking with apprehension at the 100-mile long corridor of gristly death that reaches across the jungle.  Based on what they are finding -- abandoned village markets, very scared people, and a serious lack of trained medical personnel -- the chances for additional infections, be they individual Africans or entire villages, is strong.

The Washington Post story can be found at: http://www.washingtonpost.com/wp-dyn/content/article/2007/09/18/AR2007091801047.html

A Reuters headline of September 20th talks about "Congolese no longer kiss as Ebola seems to spread."  The story lists 174 deaths out of 385 cases. It is at: http://www.alertnet.org/thenews/newsdesk/L20801216.htm .