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’Dream’ response and ’little miracles’ help quell latest Ebola outbreak

A quick-thinking male nurse in a remote part of the Democratic Republic of Congo — who had not been paid for at least a year — is one of the “little miracles” that helped prevent the latest Ebola outbreak from turning into a repeat of the deadly West Africa epidemic, according to Canada’s leading Ebola expert.


The nurse quickly flagged a very sick patient as likely suffering from some form of hemorrhagic fever. He immediately sent a blood sample for testing. Although it took a few days to get the sample on rough roads by motorcycle from the remote region of the country to its capital, Kinshasa, for testing, confirmation came quickly: the patient had Ebola, the deadly virus that terrorized West Africa just two years ago and caused an international public health panic.

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Gary Kobinger,

That action by the nurse working virtually on his own enabled a quick response, said Gary Kobinger, who helped develop the experimental Ebola vaccine, VSV-EBOV, as well as the anti-viral treatment, ZMapp. Kobinger, who just returned from DRC, plans to meet the nurse when he returns to the country in the fall, saying he “deserves a medal.”

The nurse’s actions contrast with what happened in West Africa where cases of Ebola were misdiagnosed or not diagnosed for months before the outbreak was understood. In contrast with the widely criticized international response to the West Africa Ebola epidemic, Kobinger said local and international health authorities reacted quickly in DRC, which helped prevent the outbreak from getting out of control.

“It was a dream response … better than the best-case scenario,” he said. “Everybody worked together, which was beautiful to see. The response was very quick, very strong and very well-coordinated.”

Although the outbreak, which began in early May, has not been declared over, the World Health Organization said this week that the risk of further cases is low. There have been five confirmed, three probable and one suspected case of Ebola. Of the confirmed and probable cases, four survived and four died, according to the WHO.

In West Africa, there were more than 11,000 deaths between 2014 and 2016, by far the biggest Ebola outbreak in history. The two outbreaks were the same species of Ebola as in the West African outbreak; further research will determine whether the latest was a new variant with different characteristics, such as lower transmission rates, for example.

Kobinger travelled to DRC soon after the outbreak was confirmed and set up a lab in one of the remote regions affected, where he tested suspected cases and helped conduct surveillance of the disease’s spread. He said people in the areas affected were open and engaged, which enabled health authorities to better trace the possible spread of Ebola and contain it. The West African outbreak was marked by both delay and panic: in one village in Guinea, health workers were attacked by villagers who believed they were spreading Ebola.

Among other things, Kobinger’s portable laboratory was able to confirm that a woman who had suffered a miscarriage during a severe sickness in fact had Ebola. Workers were able to test family, neighbours and health-care workers who treated her to make sure they hadn’t also contracted the disease.

He said he hopes to talk to the nurse who alerted officials to the outbreak in November when he returns to DRC, to better understand what kind of training helped him identify the first patient. That information could help better train other front-line health workers. “We want to learn from him.”

Kobinger said the nurse, who has not been paid for at least a year, will be recognized for his contribution in the fight against Ebola. Kobinger said he hopes that also means he begins getting paid.

Kobinger, former head of the special pathogens program at the National Microbial Laboratories in Winnipeg, is now director of the Centre for Research in Infectious Diseases at Laval University. He has just received funding from the International Development Research Centre to help build capacity in parts of Africa affected by Ebola, as a way to protect against future massive outbreaks of infectious diseases and improve local health care and research.

The outbreak in DRC also represents the first time there have been tools to use against the deadly virus. Until the development of the Ebola vaccine, created at the National Microbial Laboratories in Winnipeg, and anti-viral therapies, all of which are still experimental, there were no drugs to prevent or fight Ebola. The government in DRC asked to be able to use the experimental Ebola vaccine, if needed. But, in the end, it decided a vaccination campaign wasn’t warranted.

Kobinger said the fast and well-coordinated response to the latest Ebola outbreak “tells you that you don’t need vaccines and drugs if everything is done perfectly. But, at the same time, it is nice to have them if you need them.”

Mugiejor A

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