World

Epidemics that weren’t: How countries shut down recent outbreaks


When Ebola swept through eastern Congo in 2018, tracking cases was a struggle. Doctor Billy Yumaine, a public health official, recalls the steady flow of people moving back and forth across the border with Uganda while others hid sick family members in their homes for fear of the authorities. It took at least a week to get test results, and health officials struggled to isolate patients in the meantime.
It took two years for the country to bring that outbreak under control, and more than 2,300 people have died.
A similar disaster threatened the Congo in September 2021. Members of a family in North Kivu province fell ill with fever, vomiting and diarrhea, respectively. Then their neighbors also got sick.
But that set off a series of steps that Congo took after the 2018 outbreak. Patients were tested, cases were quickly confirmed as a new Ebola outbreak, and immediately, The medical staff traced 50 contacts of the families.
They then tested possible patients at medical centers and screened those at crowded border posts, stopping anyone showing symptoms of dengue. Local labs that were set up after the previous outbreak tested more than 1,800 blood samples.
It made a difference: This time, Ebola claimed only 11 lives.
“Those people died, but we kept the number 11 dead, whereas before we lost thousands,” said Yumaine.
You may not have heard that story. You may not have heard of deadly outbreaks Nipah the virus that a doctor and her colleagues stopped in southern India last year. Or the rabies outbreak that threatens to spread throughout Tanzania’s nomadic Masai communities. Quick-witted public health officials tested it after a handful of children died.
Over the past few years, headlines and social feeds have been dominated by outbreaks around the world. Have Covidof course, but also mpox (formerly known as monkey pox), cholera, resurgent polio, and measles. But dozens of other outbreaks flared, threatened — and then snuffed out. While it may not feel like it, we’ve learned a thing or two about how to do this, and sometimes, we get it right.
A report by the global health strategy organization Determined to save lives recorded six disasters without. They all appear in developing countries, including those that, like Congo, have some of the most fragile health systems in the world.
While cutting-edge vaccine technology and genome sequencing have received a lot of attention during the Covid years, the interventions that helped prevent these six pandemics have been less than appealing: building trust and confidence. community trust in the local health system. Train local staff on how to effectively report a suspicious matter. Provide funding for rapid distribution, to deploy contact tracing devices or for rabies vaccination to a village. Increase laboratory capacity in areas far from urban centers. Instruct people to move quickly at the first sign of a potential disaster.
“Outbreaks don’t happen because of a single failure; they occur due to a variety of errors,” says Dr. Tom Frieden, CEO of Resolve and former director of the US Centers for Disease Control and Prevention. “And epidemics that don’t happen won’t happen because there are a bunch of barriers that will prevent them from happening.”
Yumaine told me that the key step in stamping out the Ebola outbreak in Congo by 2021 is for health officials in each community to be trained in how to respond. The Kivu area has experienced decades of armed conflict and insecurity, and its population faces the near-constant threat of displacement. In previous public health emergencies, when people were told they would have to quarantine because of Ebola exposure, they feared it was a ploy to get them out of their way.
“In the past, people from Kinshasa always came with these messages,” he said, referring to the country’s capital. But this time, the quarantine and isolation guidelines come from reliable sources, so people are more willing to listen and be tested.
“We are able to give local control to local people because they have been trained,” he said.
Because laboratories have been set up in the area, people suspected of having Ebola can be tested in a day or two instead of having to wait a week or more for samples to be sent more than 1,600 miles to Kinshasa.
In the southern Indian state of Kerala, Dr. Chandni Sajeevanhead of emergency department at Kozhikode Government Medical College Hospitalled the response to an outbreak of Nipah, a virus carried by fruit bats, in 2018. 17 of 18 infected people died, including a young nurse trainee nurse. take care of the first victims.
“It was something very scary,” Chandni said. Hospital staff took an intensive infection control crash course, wearing “moon suits” that seemed so foreign in the pre-COVID era. Nurses grieve over the passing of their colleague.
Three years later, in 2021, Chandni and her team are relieved that the bat breeding season has passed without any infections. And then, in May, deep into India’s terrible COVID wave, a 12-year-old boy with a high fever was brought to the clinic by his parents. That clinic was full, so he was transferred to the next clinic, and then to a third clinic, where he tested negative for Covid.
But a vigilant clinician noticed that the child had encephalitis. He sent a sample to the national virology laboratory. It quickly confirmed that this was a new case of the Nipah virus. By then, the child may have been in contact with hundreds of people, including dozens of healthcare workers.
The system Chandni and her colleagues adopted after the 2018 outbreak started working: isolation center, moon suit, testing anyone for Nipah fever as well as COVID. She holds daily press conferences to quell rumors and bring attention to people who may be sick — while staying away from bats and their droppings, which litter the coconut groves where children live. play. Teams were sent to catch bats to monitor. All those who have come into contact with the sick boy are quarantined for 21 days.
“Everybody, ambulance drivers, elevator operators, security guards – this time, they got to know about Nipah and how to behave to not spread it,” she said.

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