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First Ebola patient in eastern DRC's largest city dies

The first Ebola patient in the eastern Democratic Republic of the Congo’s largest city has died, authorities have said.

The spread of the virus to Goma, a city of roughly 1 million people and a regional transport hub, has raised fears the outbreak, already the second deadliest ever Ebola epidemic, could spread more widely.

Ebola virus disease (EVD) first appeared in 1976 in two outbreaks, located in what is now known as South Sudan and the Democratic Republic of Congo. The latter outbreak was in a village near the Ebola River, giving the disease takes its name.

Ebola causes fever, aches and diarrhoea and attacks the immune system, causing blood clotting cells to malfunction so that victims bleed extensively and die if their immune system cannot fight off the viral infection. It is spread from person to person through body fluids.

 Infected patients are isolated and treated by medical teams wearing full protective body suits who try to boost their immune response. The average case fatality rate is around 50% – and health-care workers have frequently been infected. Burial ceremonies involving direct contact with the body of the deceased can also contribute to transmission.

A vaccine, still experimental, has proven to be highly effective in preventing the disease, according to the World Health Organization. They estimate that since 1976 Ebola has killed around 13,000 people, most notably in outbreaks in Sierra Leone, Liberia and Guinea between 2014 and 2016.

The patient was a priest who became infected during a visit to the town of Butembo, one of the epicentres of the outbreak, before taking a bus to Goma, Congolese officials have said.

He was being driven from Goma to a clinic in Butembo on Monday to receive treatment when he died, North Kivu province’s governor, Carly Nzanzu, said.

The World Health Organization said on Monday health officials had identified 60 people who had come into contact with the pastor since he was taken ill and half of them had been vaccinated.

Goma, a lakeside city more than 220 miles south of where Ebola was first detected a year ago, is the largest city to be affected by the outbreak. Many of the region’s usable roads pass through Goma and it is a focus of air and water transport too.

Goma map

According to the latest government statistics, the disease continues to spread and has infected more than 2,500 people. Nearly 1,700 have died and 700 recovered.

Three Ebola cases that originated in Congo were confirmed in neighbouring Uganda a month ago, but no new cases have since been registered there.

Rwandan authorities have called for calm. Diane Gashumba, the health minister, said 2,600 health workers had been vaccinated. “This Ebola epidemic has now reached close to Rwanda. There is a need to be more vigilant and to avoid unnecessary visits to Goma,” she said.

The pastor became ill last week in Butembo but decided to travel to Goma, North Kivu province, on Sunday. While in Butembo, the 46-year-old held regular services in seven churches, during which he laid his hands on worshippers, including people who were ill, the health ministry said.

Officials called on local communities to take precautions such as washing their hands and avoiding physical contact with anyone suspected of contamination with the virus.

The number of people moving around or through the zone worst hit by Ebola has been a big challenge for health services. Another problem has been attacks against health workers and treatment facilities. On Monday, two Ebola awareness workers were killed in the affected zone.

Eastern DRC is home to a variety of armed groups, and Mai-Mai militia fighters are active near the hardest-hit towns. Health teams have been unable to access areas affected by violence to vaccinate people at risk of infection and to bring infected patients into isolation.

How bad is the current outbreak?

More than 2,100 people have been infected with Ebola in the Democratic Republic of the Congo since August last year, making the outbreak the second largest in history. More than 1,412 people have died.

The disease has been spreading at an unprecedented rate. While it took eight months to reach 1,000 reported cases, it took just 71 days to double that figure.

What exactly is Ebola and how does it spread?

Ebola causes fever, aches and diarrhoea and attacks the immune system, causing blood clotting cells to malfunction so that victims bleed extensively and die if their immune system cannot fight off the viral infection. It is spread from person to person through body fluids. 

Can it be treated?

Infected patients are isolated and treated by medical teams wearing full protective body suits who try to boost their immune response.

A vaccine, still experimental, has proven to be highly effective in preventing the disease, according to the World Health Organization.

Why is it spreading even though there’s a vaccine?

The history of conflict in the DRC has lead to a suspicion of outsiders: rumours that health workers are making money from the crisis – or that Ebola doesn’t even exist – continue to circulate. Aid agencies have been accused of failing to address community mistrust. 

A government decision in December to suspend voting in the presidential election in Ebola-affected areas fuelled the idea that the disease is being used as a political tool. 

There have been repeated attacks on health workers and facilities, slowing down vaccination programmes. Health workers have resorted to using police escorts, which has in turn exacerbated a feeling of intimidation among local people.

At other times the violence against health teams has come from residents who do not want their loved ones taken to treatment centres or buried in accordance with guidelines aimed at reducing Ebola transmission.

On a visit to the eastern DRC last week, Rory Stewart, the UK’s international development secretary, said the year-long Ebola outbreak was on the edge of spiralling out of control and the World Health Organization should declare it an international emergency.

Additional reporting by Ignatius Ssuuna in Goma

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