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Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges

The current Ebolavirus disease (EVD) outbreak in the provinces of North Kivu and Ituri is the tenth outbreak affecting the Democratic Republic of Congo (DRC); the first outbreak occurring in a war context, and the second most deadly Ebolavirus outbreak on record following the 2014 outbreak in West A...

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Autores principales: Inungu, Joseph, Iheduru-Anderson, Kechi, Odio, Ossam J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AIMS Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940573/
https://www.ncbi.nlm.nih.gov/pubmed/31909070
http://dx.doi.org/10.3934/publichealth.2019.4.502
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author Inungu, Joseph
Iheduru-Anderson, Kechi
Odio, Ossam J
author_facet Inungu, Joseph
Iheduru-Anderson, Kechi
Odio, Ossam J
author_sort Inungu, Joseph
collection PubMed
description The current Ebolavirus disease (EVD) outbreak in the provinces of North Kivu and Ituri is the tenth outbreak affecting the Democratic Republic of Congo (DRC); the first outbreak occurring in a war context, and the second most deadly Ebolavirus outbreak on record following the 2014 outbreak in West Africa. The DRC government's response consisted of applying a package of interventions including detection and rapid isolation of cases, contact tracing, population mapping, and identification of high-risk areas to inform a coordinated effort. The coordinated effort was to screen, ring vaccinate, and conduct laboratory diagnoses using GeneXpert (Cepheid) polymerase chain reaction. The effort also included ensuring safe and dignified burials and promoting risk communication, community engagement, and social mobilization. Following the adoption of the “Monitored Emergency Use of Unregistered Products Protocol,” a randomized controlled trial of four investigational treatments (mAb114, ZMapp, and REGN-EB3 and Remdesivir) was carried out with all consenting patients with laboratory-confirmed EVD. REGN-EB3 and mAb114 showed promise as treatments for EVD. In addition, one investigational vaccine (rVSV-ZEBOV-GP) was used first, followed by a second prophylactic vaccine (Ad26.ZEBOV/MVA-BN-Filo) to reinforce the prevention. Although the provision of clinical supportive care remains the cornerstone of EVD outbreak management, the DRC response faced daunting challenges including general insecurity, violence and community resistance, appalling poverty, and entrenched distrust of authority. Ebolavirus remains a public health threat. A fully curative treatment is unlikely to be a game-changer given the settings of transmission, zoonotic nature, limits of effectiveness of any therapeutic intervention, and timing of presentation.
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spelling pubmed-69405732020-01-06 Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges Inungu, Joseph Iheduru-Anderson, Kechi Odio, Ossam J AIMS Public Health Perspectives The current Ebolavirus disease (EVD) outbreak in the provinces of North Kivu and Ituri is the tenth outbreak affecting the Democratic Republic of Congo (DRC); the first outbreak occurring in a war context, and the second most deadly Ebolavirus outbreak on record following the 2014 outbreak in West Africa. The DRC government's response consisted of applying a package of interventions including detection and rapid isolation of cases, contact tracing, population mapping, and identification of high-risk areas to inform a coordinated effort. The coordinated effort was to screen, ring vaccinate, and conduct laboratory diagnoses using GeneXpert (Cepheid) polymerase chain reaction. The effort also included ensuring safe and dignified burials and promoting risk communication, community engagement, and social mobilization. Following the adoption of the “Monitored Emergency Use of Unregistered Products Protocol,” a randomized controlled trial of four investigational treatments (mAb114, ZMapp, and REGN-EB3 and Remdesivir) was carried out with all consenting patients with laboratory-confirmed EVD. REGN-EB3 and mAb114 showed promise as treatments for EVD. In addition, one investigational vaccine (rVSV-ZEBOV-GP) was used first, followed by a second prophylactic vaccine (Ad26.ZEBOV/MVA-BN-Filo) to reinforce the prevention. Although the provision of clinical supportive care remains the cornerstone of EVD outbreak management, the DRC response faced daunting challenges including general insecurity, violence and community resistance, appalling poverty, and entrenched distrust of authority. Ebolavirus remains a public health threat. A fully curative treatment is unlikely to be a game-changer given the settings of transmission, zoonotic nature, limits of effectiveness of any therapeutic intervention, and timing of presentation. AIMS Press 2019-11-20 /pmc/articles/PMC6940573/ /pubmed/31909070 http://dx.doi.org/10.3934/publichealth.2019.4.502 Text en © 2019 the Author(s), licensee AIMS Press This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
spellingShingle Perspectives
Inungu, Joseph
Iheduru-Anderson, Kechi
Odio, Ossam J
Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title_full Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title_fullStr Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title_full_unstemmed Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title_short Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges
title_sort recurrent ebolavirus disease in the democratic republic of congo: update and challenges
topic Perspectives
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940573/
https://www.ncbi.nlm.nih.gov/pubmed/31909070
http://dx.doi.org/10.3934/publichealth.2019.4.502
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