Health researchers in the Democratic Republic of the Congo interview people as part of their contact tracing, seeking to find those who came into contact with people infected with Ebola. Michel Lunanga/Getty Images hide title toggle title Michel Lunanga/Getty Images The key to ending any infectious disease outbreak, especially one for which there is no
Health researchers in the Democratic Republic of the Congo interview people as part of their contact tracing, seeking to find those who came into contact with people infected with Ebola.
Michel Lunanga/Getty Images
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The key to ending any infectious disease outbreak, especially one for which there is no approved vaccine, such as the current Ebola outbreak in the Democratic Republic of the Congo, is to achieve slightly ahead of the virus.
To do this, health officials must quickly identify possible routes by which a virus could spread, a practice known as contact tracing, he says. Armand Sprecherdoctor specializing in infectious diseases from Doctors Without Borders.
“We find a sick person and say, ‘Who was in contact with that sick person? Who took care of them? Who did the laundry, who touched them? Or who went to a funeral where someone had died from this?'” he says.
Transmitted through bodily fluids, the virus can only travel to these contacts. Identifying them all quickly, informing them of their exposure, and monitoring them can help prevent them from spreading the virus to others and help them get care more quickly if they develop symptoms. “It’s labor-intensive, but if you can do it right, you can control the outbreak very well,” Sprecher says.
Health officials do not have a good handle on the current outbreak.
Just over two months later, more than 1,000 people have died and more than 2,400 have become ill from the virus. The daily case count shows no signs of slowing down. Perhaps most worrying is that more than 80% of new cases They are appearing outside of known contacts.
“That’s a red flag for me,” he says. Nahid Bhadeliaan infectious disease doctor at Boston University who has worked on previous Ebola responses. “This means that many more people have this disease than we think, and contact tracing is not progressing.”
That high percentage could be due to the inability to trace all contacts of the cases, which gives them only a partial view of the known chains of transmission.
The outbreak is centered in a region with many transient workers and ongoing conflicts, which can make it difficult to track everyone who comes into contact with a known case. More contact tracers would be helpful, and the World Health Organization (WHO) announced that 21,000 community workers are currently being trained.
But it’s also likely that entire chains of transmission are occurring out of sight of health officials before a very sick (or dead) person enters their radar. “There are probably many more cases that we are missing,” Bhadelia says. “This means that people come much later for medical care, which means that their survival rates “It could be lower.”
Many people do not come to clinics at all. According to the WHO, approximately two-thirds of deaths occur outside the health system.
“There are still many people with symptoms that could be consistent with concern for an Ebola diagnosis who are becoming ‘hidden,'” he says. Boghuma Titanjiinfectious disease physician at Emory University. Instead, he says they may be seeking care from traditional healers, staying home with their family, or unable to access, or even deliberately avoiding, treatment centers.
“It’s important to remember that there is a lot of stigma associated with Ebola,” he says. And where this outbreak is taking place, there is “a lot of distrust of medical science and the people who are investigating the outbreak.”
The fact that so many illnesses and deaths occur in the dark, out of the sight of health officials and doctors, has made answering more difficultTitanji says. “I look at it as just seeing the tip of the iceberg, but not being able to see how big it is because we just don’t have the lens to allow us to see it.”
Improving that vision, in part, will require building trust with affected communities. It’s hard work, says Bhadelia, but some recent good news in the answer might help: start of clinical trials for treatments and a medication that could protect exposed people from getting sick.
“I think you can build trust by providing better care,” Bhadelia says, “and that better care can, of course, be access to potentially promising treatments.”
Access to these therapies is still quite limited, as they are only available through clinical trials. But Bhadelia hopes that over time, the prospect of receiving better care or a medication that can prevent illness after an exposure may entice more people to seek help through clinics or contact tracers. Ultimately, he says that’s what it takes to reduce the toll of this outbreak and get it under control.
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