To: promed@usa.healthnet.org
Subject: PROMED: Ebola - Zaire: WHO Press Releases (4 July, 29 June)
Date sent: Fri, 07 Jul 1995 18:59:06 EDT
From: Stephen Morse
EBOLA - ZAIRE: WHO PRESS RELEASES (4 JULY, 29 JUNE 1995)
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[The two most recent WHO press releases on Ebola in Zaire, dated
4 July and 29 June 1995, are included in this posting. -- Moderator]
WHO PRESS RELEASES ON EBOLA IN ZAIRE
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Press Release WHO/52
4 July 1995
EBOLA EPIDEMIC IN ZAIRE COULD BE OVER BY SEPTEMBER, SAYS WHO
DIRECTOR-GENERAL
It is possible that the outbreak of Ebola haemorrhagic fever in Zaire
could be officially declared at an end in the next two months, Dr
Hiroshi Nakajima, Director-General of the World Health Organization
said today. Dr Nakajima was speaking after returning to WHO's
headquarters in Geneva yesterday from a fact-finding mission to Zaire.
"I hope that we will be able to announce that the epidemic is over by
the end of September, and perhaps sooner," Dr Nakajima said. "However,
before we can do that, a period equal to twice the maximum incubation
period of the disease - that is, 42 days - needs to have passed from
the date of recovery or burial of the last case, with no new cases
identified through active searching. We are now counting one day at a
time".
A total of 296 suspected or confirmed cases of the disease have been
reported, of whom 233 are known to have died. The fact that no new
case has been reported since June 20 reinforces optimism among medical
experts in Zaire that the epidemic is well past its peak.
Dr Nakajima said that although the Ebola virus was the same as that
which caused an outbreak in Zaire in 1976, the pattern of the latest
epidemic was markedly different, in that it consisted of a series of
waves of cases, whereas there was only one major wave of cases in
1976. This was due to differences in transmission of the virus, which
in 1976 was largely through contaminated needles and syringes, while
in the latest situation, transmission was thought to have occurred in
the majority of cases directly from person to person through contact
with blood or other body fluids.
The Director-General also confirmed today that WHO will organize an
international medical conference to assess the latest epidemic and the
national and international response to it. The conference will be held
early next year in Kinshasa, Zaire.
Many thousands of residents of Kikwit, the centre of the epidemic,
turned out in the streets of the city to give an enthusiastic welcome
to Dr Nakajima and other WHO officials, including Dr Ebrahim Samba,
the WHO Regional Director for Africa. According to local health
officials, life in Kikwit has returned to normal and the welcome
reflected residents' recognition of the leading role that WHO played
in bringing the epidemic under control.
Dr Nakajima visited the two hospitals in Kikwit which treated the
first Ebola cases and talked to doctors, local Red Cross workers, and
some of the patients who are recovering from the disease. Dr Nakajima
was given a full briefing by members of the International Committee on
Scientific and Technical Coordination, which was set up to combat the
outbreak.
Dr Nakajima outlined WHO's own plan of action on Ebola that will run
until 31 December 1995. In a series of meetings during his four-day
visit to Zaire, Dr Nakajima gave details of the plan to government
officials, foreign diplomats, heads of United Nations agencies and
other organizations based in Zaire.
The priorities of the plan are to ensure the containment of the
epidemic; to better understand the Ebola virus epidemiology and its
clinical manifestations; to ensure overall administrative, technical
and scientific coordination of the international team in Kikwit; and
to strengthen national response to potentially epidemic diseases. The
plan will be implemented under the direction of Dr Samba at the WHO
Regional Office for Africa in Brazzaville, Congo.
During his visit, Dr Nakajima observed a general deterioration in
Zaire's health infrastructure due to the country's economic
difficulties. There was a shortage of medical supplies, health workers
were paid little and their pay was delayed, and there was a lack of
public confidence in the health system.
The President of Zaire, His Excellency Marshall Mobutu Sese Seko, and
the Prime Minister, His Excellency Mr Kengo Wa Dondo, expressed during
meetings with Dr Nakajima their personal commitments to improving
Zaire's health infrastructure.
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Press Release WHO/50
29 June 1995
EBOLA FEVER EPIDEMIC: WHO DIRECTOR-GENERAL VISITS KIKWIT
In a follow-up to the Ebola fever epidemic, the Director-General of
the World Health Organization, Dr Hiroshi Nakajima, arrives in Zaire
tonight on a fact-finding mission which includes a visit to Kikwit,
the centre of the epidemic.
Dr Nakajima, who is being accompanied on the four-day visit to Zaire
by the WHO Regional Director for Africa, Dr Ebrahim Samba, travels to
Kikwit on Saturday 1 July, after meetings scheduled with the
President, the Prime Minister, the Health Minister and other senior
officials of the Government of Zaire. He will visit the two hospitals
in Kikwit which treated the first Ebola cases, and meet members of the
International Committee on Scientific and Technical Coordination which
was set up to combat the epidemic.
According to the Committee's latest figures, there has been a total of
296 suspected or confirmed cases of Ebola haemorrhagic fever in the
Kikwit area, of whom 232 are known to have died.
Dr Nakajima said: "WHO believes the acute phase of the epidemic is
over, but concern remains about the risk of sporadic transmission of
the virus in the community, and about transmission in health
facilities if adequate isolation and barrier nursing procedures do not
continue to be enforced".
Before the epidemic can officially be declared at an end, a period
equal to twice the maximum incubation period of the disease - that is,
42 days - will need to have passed from the date of recovery or burial
of the last case, with no new cases identified through active
searching.
"WHO is certain that the main peak of the epidemic has been contained,
and anticipates a few more cases before the epidemic comes to an end,
mainly those who were infected within the preceding three weeks", Dr
Nakajima said. "It is of crucial importance that an undiagnosed case
does not become again the cause of amplification of the epidemic in a
hospital setting, and extreme attention to ensuring that health
workers are using barrier nursing techniques and respecting universal
precautions is a priority".
Dr Nakajima said WHO had prepared a plan of action that will run from
1 July until 31 December 1995. The priorities of the plan are to:
- ensure the containment of the epidemic;
- better understand the Ebola virus epidemiology and its clinical
manifestations;
- ensure overall administrative, technical and scientific coordination
of the International Committee in Kikwit;
- strengthen national response to potentially epidemic diseases.
An important purpose of Dr Nakajima's visit is to try to reinforce the
need for stronger infrastructure in Zaire to prevent and control any
further outbreaks of Ebola and other infectious diseases. This will
require efforts at a national level with the assistance of the
international community.
Dr Nakajima's visit will also underline the need for a global
surveillance network to detect, assess and respond to outbreaks of new
and re-emerging diseases in different parts of the world.
WHO has been able to assert its leading role in controlling the Ebola
epidemic by providing staff from its African Regional Office in
Brazzaville and from its headquarters in Geneva. On Sunday 7 May, WHO
headquarters was notified by the Regional Office that there was a
suspected Ebola haemorrhagic fever outbreak in Zaire. Two days later,
on 9 May, staff from Brazzaville and Geneva left for Zaire, arriving
on 10 May, and were joined from 12 - 14 May by an international team
which included staff from the Centres for Disease Control in Atlanta,
Georgia, the Institut Pasteur in Paris, and the National Institute for
Virology in Sandringham, South Africa.
One of the first tasks of the team was to assess the situation and to
provide direct patient care at Kikwit General Hospital, the centre of
the outbreak. Measures were taken to establish acceptable standards of
hygiene, disinfection and protection of hospital staff, care of
patients, and safe disposal and burial of those who had died from the
disease. Active surveillance of cases and tracing of contacts were
then established, both in Kikwit and surrounding villages. It became
apparent that Ebola cases had been present in the region since January
1995, but had not been recognized as such. These measures are
estimated to have saved hundreds of lives.
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