Doctors Without Borders to pull out of Congo as Ebola scare wanes

Doctors Without Borders will end its involvement in the international response to an outbreak of the Ebola virus in the heart of Africa later this month, a sign that public health officials believe the outbreak has been largely contained.

Doctors Without Borders, also called Medecins Sans Frontieres (MSF), had been tasked with operating treatment facilities in four towns in the Democratic Republic of the Congo (DRC) where patients tested positive for the Ebola virus. The group cared for 38 patients, 24 of whom survived.

{mosads}MSF began winding down its involvement in the Congolese outbreak late last month, handing over operation of Ebola wards in the towns of Itipo and Bikoro to Congo’s Ministry of Health. 

The group will finish building an Ebola ward at the largest hospital in Mbandaka, a city of more than a million residents that sits right on the Congo River. It will also dismantle an Ebola treatment center it had established on the outskirts of town. 

And on July 15, MSF will hand over control of an Ebola treatment center in the town of Iboko, near the epicenter of the outbreak, to the health ministry.

“This Ebola outbreak is not yet officially over, but we are very pleased with the progress that has been made,” said Henry Gray, who led MSF’s involvement in the DRC. 

After breaking out in the remote Iboko district in the Equateur Province in April, the Ebola virus traveled through several towns before infecting four people in Mbandaka. A total of 55 cases were identified, including 38 that were confirmed through laboratory tests. Of those cases, 28 people died, a fatality rate of 54 percent.

The last case was diagnosed June 6. 

Public health officials have been following more than 1,500 people who came into contact with those infected by the virus, a practice known as contact tracing, according to the latest situation report from the World Health Organization (WHO).

Ebola has an incubation period of up to 21 days, and all 1,500 of those contacts made it through the three-week window without coming down with the disease, making it likely that the outbreak has been contained.

If no new cases emerge, the Congo will be declared free of the Ebola virus on July 22, once it has made it through two consecutive 21-day incubation periods without a new confirmed case.

This outbreak, the ninth known in modern times in the country, marks the first in which an investigational vaccine was deployed to protect front-line health care workers and those who might come into contact with the virus. A total of 3,268 people received the vaccine, known as rVSVDG-ZEBOV-GP, including traditional healers, those responsible for burying bodies, and even taxi drivers.

Public health experts have largely been impressed by the scale of the international response to what could have proven a disastrous outbreak, just three years after an epidemic in the West African nations of Guinea, Sierra Leone and Liberia claimed at least 11,300 lives. 

The WHO raced more than 250 virus hunters, lab technicians and other experts to Equateur Province, as well as ambulances and megaphones and arranging educational talks in the impacted communities. The agency has asked funders for $57 million to pay for the response, about $33.9 million of which has been covered so far. The U.S. Agency for International Development contributed $5.3 million to that fund.

The outbreak in Equateur Province could have proven much worse, especially because the virus popped up in a major port city on the banks of the Congo River. The river is the main thoroughfare for trade and commerce through the heart of Africa, and health officials worried the virus could spread on any of the barges headed up river, to major cities like Kisangani, or down river to Kinshasa, a city of more than 11 million people.

As an indication of the concern over Ebola spreading up and down the river, the WHO, the World Bank and non-governmental organizations funded preparedness and readiness initiatives in Rwanda, Burundi, the Republic of Congo and the Central African Republic.