Wednesday, 5 February, 2003, 15:29 GMT 
from the BBC News
(original article)

By Pascale Harter 
BBC, Brazzaville 

In the north of Congo-Brazzaville, 16 people have died in a suspected outbreak of the Ebola virus. 

The Congolese authorities say they are extremely concerned that the virus might spread. 

The Congolese Ministry of Health says 16 people are known to have died so far, but communications with the villages of Kele and Mbou, 800 kilometres north of Brazzaville in the Region of Cuvette West, are difficult. 

Doctor Joseph Mboussa, Director in the Ministry of Health, says a villager has been dying every few days since the outbreak began on 4 January, and already the death toll could be much higher than 16. 

Gorillas wiped out 

The authorities were first alerted to a possible outbreak when a clan of gorillas in the Cuvette West Region began to die. 

Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, and the disease has now claimed more than 80% of the gorilla clan. 

The Ebola virus is easily spread just by skin contact with an infected primate or person. 

Doctor Mboussa says this makes the virus particularly difficult to contain, as Congolese funeral rites dictate that the body of a deceased person be washed by the family before burial. 

The current outbreak is believed to have been caused by villagers eating primates which were already infected with Ebola. 

Staple food 

An emergency team of health ministry workers was scheduled to leave for the region on Wednesday to investigate the outbreak and try to contain it, following delays caused by a shortage of petrol and funds for the trip. 

Ebola experts working for the World Health Organisation in Libreville and Geneva also expect to leave soon to investigate the outbreak. 

Some years ago in the neighbouring Democratic Republic of Congo, then President Mobutu Sese Seko adopted a controversial policy of putting an infected village in quarantine. 

The Ebola virus was contained but the entire village was wiped out. 

The Congolese health ministry has so far asked local inhabitants not to travel, but the authorities are hopeful they will not have to resort to such drastic measures. 

The forestry ministry already has several teams in place trying to make locals aware of the dangers of eating primates, but they admit it is a losing battle in a region where bush meat has formed a staple part of people's diets for centuries. 
 

Wednesday, 12 February, 2003, 15:07 GMT 
from the BBC News
(original article)

At least 48 people are now known to have died in a suspected outbreak of Ebola in the north of Congo- Brazzaville, near the border with Gabon. 

There is no cure for Ebola, which causes up to 95% of its victims to bleed to death. 

The authorities in Brazzaville have not yet been unable to confirm the virus is the cause of the deaths. 

At first inhabitants of the villages of Kelle and Mbomo where people have been dying daily in recent weeks, refused to co-operate with emergency teams from the ministry of health and the World Health Organisation (WHO), sent to investigate a possible Ebola outbreak. 

Instead they accused the health teams of bringing the virus to the area themselves, and refused to give blood samples from their dead. 

Wild game 

The samples have been sent from Kelle and Mbomo, 800 kilometres north of the capital, Brazzaville, to a laboratory in Libreville, Gabon, and results of the Ebola tests are expected within the next five days. 

In the meantime, the ministry of health and the WHO are treating the deaths as a confirmed Ebola outbreak and taking measures to contain the spread of the virus, which is easily passed by contact with body fluids and between humans and animals. 

The ministry says its emergency teams have now succeeded in convincing inhabitants of the area to stay away from church and not to travel. 

The teams are also trying to stop people in the region from eating wild game such as gorilla, gazelle and antelope. 

These are among the animals which have been dying off in the surrounding forest and have already tested positive for Ebola. 

Ebola killed 43 people in Congo and 53 others in neighbouring Gabon between October 2001 and February 2002. 

The WHO says more than 1,000 people have died of Ebola since the virus was first identified in 1976 in western Sudan and in a nearby region of Congo. 
 

Thursday, February 13, 2003 Posted: 9:43 AM EST (1443 GMT)
Reuters via CNN News
(original article)

BRAZZAVILLE, Congo  -- Nearly 50 people have been killed in Congo Republic by a spreading outbreak of suspected Ebola virus thought to be linked to the consumption of infected monkey meat, health authorities said Wednesday. 
 

Passed on by infected body fluids, Ebola kills anywhere from 50 to 90 percent of its victims through massive internal bleeding, depending on the strain. There is no known cure. 

Congo's top health official in the fight against Ebola, Joseph Mboussa, said four deaths had been recorded in the Mbomo district and 44 in nearby Kelle, where the outbreak surfaced over the past two weeks. 

The affected region is about 440 miles from the capital, Brazzaville, and near the border with Gabon. 

"The situation is very serious and Sunday alone eight people died in Kelle," Mboussa told reporters. 

"These are cases of hemorrhagic fever, but we are still trying to confirm whether it is indeed Ebola. ... Suspicions are strong given the number of dead in just a few weeks." 

Mboussa said that Ebola virus had been confirmed in tests on the bodies of animals found dead in surrounding forests -- where gorillas, chimpanzees, monkeys and antelopes starting dying in large numbers late last year. 

He suspected that local people had eaten the meat of the dead animals. Bushmeat has been a staple for as long as anyone can remember in central Africa's forests and is also a popular delicacy in its cities. 

"You can well try to stop people eating bushmeat, but you have to give people something to replace it," Mboussa said. 

To try to stop the highly infectious virus spreading, all the schools and churches in Kelle have been closed and people told to stay at home, but cordoning off the entire region would be difficult given its network of tiny forest trails. 

Ebola left at least 73 people dead in Congo and Gabon in an outbreak from October 2001 to February 2002. That epidemic was also linked to the consumption of infected primates. (See DeWitt Gabon report.) 

The disease was named after a river in Congo's neighboring Democratic Republic of Congo, where it was discovered in 1976. The worst outbreak was in that country in 1995 when over 250 people died. 

The World Health Organization sent a team to northwestern Congo last week to investigate the suspected outbreak. 
 

Thursday, February 13, 2003 
The Associated Press via ABC News

(original article)

Republic of Congo Quarantines Region of a Suspected Ebola Outbreak
 

Citing a suspected Ebola outbreak, officials Thursday quarantined a central region of the Republic of Congo and appealed for international help.

At least 50 people have died from hemorrhagic fever in Cuvette West, a forested region that is home to 30,000 people. Officials are awaiting lab results to determine if Ebola caused the deaths.

Health Minister Alain Moka appealed for international aid, saying: "The situation in that region is extremely grave."

Moka said 51 people have died. The Geneva-based World Health Organization confirmed 50 deaths. Sixty-one others are ill.

Ebola is one of the world's deadliest viral diseases, causing rapid death through massive blood loss in up to 90 percent of those infected. The disease spreads through bodily fluids. Primates, a food source for many central Africans, can carry the infection.

Officials have prohibited everyone except emergency workers from entering or leaving Cuvette West or moving between its towns, Moka said.

Churches, schools and government offices have been shuttered, and public gatherings banned. Mobile speaker systems were being rushed in to broadcast instructions to people in their homes.

Government and WHO experts have taken blood from victims to determine if the disease is Ebola.

Moka said some villagers terrified by medical experts in gleaming head-to-toe protective suit have scattered into the jungle, complicating quarantine efforts.

"Right now, the teams are having a lot of trouble working with the villagers, who believe the disease is a terrible curse. The population doesn't believe in Ebola," Moka said. "And when they see the men in the white suits, they flee."

WHO spokesman Dick Thompson said the agency was not aware of the quarantine and would advise against it. "Ebola quarantines haven't been found to be effective," he said.

The outbreak is centered in the Cuvette West towns of Mbomo, Kelle and Yembelangoye.

Ebola generally kills rapidly, meaning the disease burns out before it can spread great distances. WHO says more than 1,000 people have died of Ebola since the virus was first identified in 1976.

Thursday, 13 February, 2003, 13:03 GMT 

from the BBC News
(original article)
 

At least 48 people are known to have died in recent weeks in a suspected outbreak of Ebola in the Cuvette area of Congo-Brazzaville, near the border with Gabon. 

When the last Ebola outbreak in Gabon killed 53 people year ago, the authorities were accused of not doing enough to help those affected. 
 

There is no cure for Ebola, which causes up to 95% of its victims to bleed to death. 

More than 1,000 people have died of Ebola since the virus was first identified in 1976 in western Sudan and in a nearby region of Congo, according to the World Health Organisation. 

No chances 

The health authorities in Gabon say there are no suspected cases of Ebola in the country but they are taking no chances. 

There have been four Ebola outbreaks in the country. 

A team of experts from the Health Ministry and the Medical Research International Centre in Franceville has been sent to two areas in the north-east, near the border with Congo, which were contaminated last year. 

Guidelines have also been issued to locals to prevent the suspected Ebola outbreak in Congo from spreading. 

Bush meat 

People have been asked not to touch dead animals in the forest, or those with an unusual behaviour - when they do not try to flee when hunted, for instance. 

People have also been told to report any suspected case of Ebola to the health authorities. 

The areas at risk are covered in forest which stretches across the Congo Basin, which also takes in the Democratic Republic of Congo and the Central African Republic. 

The authorities in Congo-Brazzaville have not yet been unable to confirm the Ebola virus is the cause of the 48 deaths reported this week. 

But the ministry of health is having blood samples from five of the deceased analysed in Gabon. 

Results of the Ebola tests are expected within the next four days. 
 

UN Integrated Regional Information Networks 
February 14, 2003 
Posted to the web February 14, 2003 

(original article)

Brazzaville

The government of the Republic of Congo on Thursday quarantined the Cuvette-Ouest Region due to an outbreak of haemorrhagic fever, suspected to be the Ebola virus.

"We are still waiting for lab confirmation, but it looks almost certain that this is an outbreak of Ebola," Iain Simpson, responsible for media relations and communications at the Communicable Diseases Programme of the World Health Organization (WHO), told IRIN from Geneva on Friday. "We are moving forward as though this is confirmed, assembling a team including case management experts and epidemiologists to travel to Congo as soon as practicable."

The epidemic has already caused 51 deaths, Minister of Health and Population, Alain Moka, told a news conference in the capital, Brazzaville, on Thursday.

The districts of Mbomo and Kelle have been the hardest hit. The village of Ebelangoy, where 38 deaths have already been recorded, is nearly deserted, as residents have fled towards Kelle and the surrounding area.

"The conditions are ripe for a rapid, large-scale spread of the disease, and we have the worst to fear," said Moka.

A series of emergency measures has been taken by the government in an effort to contain the situation: health personnel present in affected districts are being increased; mobile radio stations have been dispatched to inform local populations about haemorrhagic fever; government officials and other prominent Congolese personalities have been asked to participate in the public awareness campaign; all schools in the affected zones have been closed; small transistor radios are being distributed to families throughout the region so that people can receive instruction about the epidemic; public gatherings and movement between villages has been prohibited; and 40 million F CFA (US $68,161) has been made available for the deployment of additional medical teams on the ground.

Moka emphasized that additions measures would be taken. "The situation is far from being brought under control, because no one wants to be told that their family or village has been exposed to Ebola," he said.

One WHO staff member in Brazzaville lamented the "terrible fate" that had befallen Mbomo district, which is experiencing its second outbreak of haemorrhagic fever within one year.

He warned of the challenge of working with terrified populations.

"With the refusal of the population to cooperate, it is difficult to carry out our work and achieve good results," he said, recalling that a member of the Ebola investigation mission that was dispatched in June 2002 to the town of Olloba was attacked by frenzied villagers who were suspicious of the health team's presence. It was only after a local Red Cross official intervened that the health worker was spared.

Authorities were first alerted to a possible Ebola outbreak when a clan of gorillas in the region began to die. Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, and the disease has now claimed more than 80 percent of the gorilla clan. The current outbreak is believed to have been caused by villagers eating primates that were infected with Ebola.

Ebola is a haemorrhagic fever transmitted through direct contact with body fluids of infected persons or other primates. There is no cure, and between 50 percent and 90 percent of victims die.
 

By Christian Tsoumou

BRAZZAVILLE (Reuters) - The death toll from a suspected outbreak of the deadly Ebola virus in Congo Republic has crept up to 51 and people have begun fleeing into dense forest to escape what some believe to be an evil spell.

Authorities have tried to impose tight restrictions on movement in the hope of preventing the spread of the outbreak, the second reported in little over a year in the remote northwest. It is thought to have been caused by the consumption of infected monkey meat.

Health Minister Alain Moka said late on Thursday that 46 people had died in the Kelle region, and five in the nearby Mbomo region. On Wednesday, health officials put the death toll at 48.

The area is 440 miles from the capital Brazzaville, near the border with Gabon. It has been placed under quarantine and no one is allowed in or out without authorization.

Ebola, which is passed on by infected body fluids, kills 50% to 90% of its victims through massive internal bleeding, depending on the strain. There is no known cure.

Moka said the government had allocated $66,000 to fighting the highly contagious disease and sending medical teams to the affected area.

Mobile radio stations and loudspeakers will be used to give advice to inhabitants. All movement between villages has been forbidden and sports competitions and cultural events banned, Moka said.

But people have begun fleeing their homes as the disease has claimed more victims, raising fears it will spread further. Many locals believe the disease is caused by a spell cast by witch doctors.

On Wednesday, Congo's top official in the fight against Ebola, Joseph Mboussa, said authorities were still trying to determine whether the outbreak was Ebola but suspicions were strong because of the high number of deaths in such a short time.

Mboussa said the Ebola virus had been confirmed in tests on the bodies of animals found in surrounding forests where gorillas, chimpanzees, monkeys and antelopes started dying in large numbers late last year.

Bushmeat has long been a staple in central Africa's forests and is also a popular delicacy in its cities.

Ebola killed at least 73 people in Congo and Gabon in an outbreak from October 2001 to February 2002. That epidemic was also linked to the consumption of infected primates.

The disease was named after a river in Congo's neighboring Democratic Republic of Congo, where Ebola was discovered in 1976. The worst outbreak was in that country in 1995 when over 250 people died.

BRAZZAVILLE, Republic of Congo (AP) -- U.N. health officials confirmed on Wednesday that a disease outbreak killing scores of people in the Republic of Congo was Ebola and warned that the highly lethal haemorrhagic fever could still be spreading. 
 

So far, 73 people have been infected, of whom 59 have died, according to WHO investigators. Government health officials in the tiny Central African nation report 80 cases with 67 deaths. 

The Cuvette West region, where the deaths have occurred, has been quarantined by the government since last week. 

Blood samples drawn from victims in the region tested positive for the Ebola virus, Josef Mboussa, a top official in Republic of Congo's health ministry, said. 

The disease is one of the world's deadliest, causing rapid death through massive blood loss in up to 90 percent of those infected. 

Ebola spreads through bodily fluids. Primates, hunted by many central Africans for food, can also carry the infection. 

"There will probably be more deaths due to the complexity of the disease," Mboussa said. 

Mboussa was not able to say if medical examiners were registering new infections in the region; the first reports of the illness reached the capital, Brazzaville, over two weeks ago. 

Ebola's two- to 21-day incubation period makes it difficult to gauge how quickly the outbreak may still be moving, Simpson said. 

The forested Cuvette West region has 30,000 inhabitants spread among provincial towns and small villages. The disease has centred in the villages of Kelle and Mbomo. 

Efforts to investigate the outbreak are being stymied. Frantic villagers terrified by Ebola's horrific symptoms have fled from health workers in their head-to-toe protective suits. 

Along with medical personnel, anthropologists have been sent to the region to help explain the disease to the people. 

"The villagers are very scared; they see people getting sick and dying," Simpson said. "We're trying to get them to understand the situation." 

Ebola killed 43 people in Republic of Congo and 53 others in Gabon between October 2001 and February 2002. 

WHO says more than 1,000 people have died of Ebola since the virus was first identified in 1976 in western Sudan and in a region of Congo. 
 

GENEVA -- Laboratory tests have confirmed that the Ebola virus is the cause of an outbreak of haemorrhagic fever in the northwest of the Republic of the Congo. As of Tuesday, 18 February, 80 cases have been reported including 64 deaths. Most of the cases -- 72 people reported ill with 59 deaths -- are in the district of Kéllé.

The government of the Republic of Congo, in Brazzaville, has requested assistance from the World Health Organization (WHO). A joint Ministry of Health-WHO assessment team travelled from Brazzaville to the site of the outbreak two weeks ago. WHO is providing further support from WHO headquarters in Geneva and from the Global Outbreak Alert and Response Network, which is coordinated by WHO.

Ebola haemorrhagic fever (EHF) is one of the most virulent viral diseases known to humankind, causing death in 50-90% of all clinically ill cases. The Ebola virus is transmitted by direct contact with the blood, body fluids and tissues of infected persons. In past outbreaks, health workers have become sick after contact with the bodily fluids of patients they were treating. Several experts in clinical case management, epidemiology and social mobilisation from the WHO Global Alert and Response Network have either already arrived in the country or are on their way to the affected area to assist the government in controlling this outbreak.

The case management experts will be assisting health care workers as well as providing training in barrier nursing practices. Extra equipment for barrier nursing -- including masks, gloves, suits and visors -- has been shipped to the country and is being transported to the affected area.

Medical anthropologists will also be arriving with the WHO team. Their job will be to help educate the public in measures they can take to protect themselves from further spread of the disease. These measures will include identifying safe and unsafe burial practices.

The outbreak is the second time Ebola has struck this region in the past 15 months. A previous outbreak, which began in a neighbouring country in December 2001 and then spread into the Republic of the Congo, infected 59 people in Congo, 50 of whom died.

Earlier this month, gorilla deaths were reported north of Mbomo, the second focus of this outbreak. In December, tests done on dead primates found in the area were positive for Ebola.

Since then, health officials have been attempting to obtain blood samples from humans but victims or their survivors have denied requests citing cultural concerns. The current samples were collected from Kelle on 13 February and have all tested positive for the Ebola virus.
 

BRAZZAVILLE, Congo (Reuters) -- Congolese villagers have stoned and beaten to death four teachers accused of casting an evil spell to cause an outbreak of the deadly Ebola disease that has killed nearly 70 people, a local official said Friday. 

The outbreak of Ebola in the districts of Kelle and Mbomo near the central African country's northern border with Gabon is thought by scientists to have been caused by the consumption of infected monkey meat. 

But many locals believe occult forces are at work. 

"In Kelle, people continue to believe that the Ebola disease is a spell that has been cast on them by witches, and four teachers accused of being the cause of the disease have been beaten and stoned to death," said Dieudonne Hossie, a local official. He did not say when the teachers were killed. 

"We call on the people of Kelle to be calm. It is the Ebola virus which is raging in the area. It is not an evil spell, it is a scientifically proven virus," Hossie, who was speaking on the official Radio-Congo, said. 

On Wednesday, the World Health Organisation confirmed the outbreak of haemorrhagic fever was Ebola, and put the death toll at 64. State radio put the death toll at 68 on Friday. 

This is the second Ebola outbreak in little more than a year in Congo's remote northwest. Kelle and Mbomo have been placed in quarantine, schools and churches have been closed and people are banned from entering or leaving the area. 

Ebola, which is passed on by infected body fluids, kills 50 percent to 90 percent of its victims through massive internal bleeding, depending on the strain of the disease. 

Hossie said those responsible for the deaths of the four teachers would be brought to trial. He also said that in the capital Brazzaville, 700 km (440 miles) from the affected area, people from Kelle had drawn up lists of suspected witches to be killed. 

Ebola killed at least 73 people in Congo and Gabon in an outbreak from October 2001 to February 2002. That epidemic was also linked to the consumption of infected primates. 

The disease takes its name from a river in neighbouring Democratic Republic of Congo, where Ebola was discovered in 1976. The worst outbreak was in that country in 1995 when more than 250 people died. 
 

The Ebola virus is sweeping through the gorilla population of north-western Congo, killing hundreds of the protected species, say scientists.

"This is an ecological catastrophe," said the Spanish primate expert Magdalena Bermejo in Libreville, Gabon.

Some 500 of the 800 gorillas registered in the Lorri gorilla sanctuary 25 miles from the Republic of Congo's border with Gabon had died in five months, she said. The haemorrhagic fever has since January also killed 67 villagers in the region, where bush meat forms part of the diet.

The equatorial forests of Congo and Gabon are home to about 80 per cent of the world's plains gorilla population, totalling about 75,000 animals. They were "key to the survival of the species", said Ms Bermejo.

Health officials in Congo have quarantined the densely forested region of Cuvette-Ouest, stopping anyone without a permit from travelling between villages in an attempt to contain the outbreak among humans.

"Ebola leads us to fear a catastrophic decline in the great apes population of central Africa," said Conrad Aveling of Ecofac, a conservation programme financed by the European Union.
 

Wed, Feb. 26, 2003
LOUIS OKAMBA
Associated Press
(original article)

BRAZZAVILLE, Republic of Congo - An Ebola outbreak in Republic of Congo has killed 79 people but appears to be slowing down, health investigators said Wednesday.

The rate of new infections has started tapering off in the quarantined region of Cuvette West, where the deaths have occurred, World Health Organization spokesman Iain Simpson said in Geneva.

Last week, health officials registered only eight new cases compared to as many as 25 in previous weeks. Nearly 100 people are still battling the disease.

"I'm not suggesting that we won't see more cases, because we probably will," Simpson said. "But we're hopeful that the number of new cases will still drop."

The viral disease is one of the world's deadliest, causing rapid death through massive blood loss in up to 90 percent of those infected. Ebola spreads through bodily fluids. Primates, hunted by many central Africans for food, can carry the infection.

Villagers believing the disease to be a curse initially fled from emergency medical workers earlier this month.

An education campaign has since persuaded them to seek treatment if they think they've been exposed, Simpson said.

Ebola generally kills rapidly and has so far afflicted far-flung regions of Africa, meaning the disease has burned out before spreading great distances.

Earlier this month, reports reached the capital, Brazzaville, of an outbreak of a hemorrhagic fever in the forested Cuvette West region, which has 30,000 inhabitants spread among towns and villages.
 

26 Feb 2003 
Reuters
(original article)

GENEVA (Reuters) - The International Federation of Red Cross and Red Crescent Societies (IFRC) on Wednesday launched an appeal for $130,000 to stem an outbreak of the deadly Ebola virus in Congo which has killed 75 people so far.

"There is an urgent need for preventative measures and public information to stop this highly contagious disease spreading," the IFRC said in a statement.

The World Health Organisation (WHO) said on Tuesday that the outbreak in the Kelle and Mbomo districts near the central African country's border with Gabon had reached 93 cases but was under control.

The IFRC will use the funds to advise local populations on ways to prevent the disease, such as not eating wild "bushmeat", not touching dead animals and adopting safe practices during funeral rites.

This outbreak is thought to have been triggered off by human consumption of infected monkey meat, but many villagers believe occult forces are at work. Four teachers accused of casting an evil spell to cause the outbreak were stoned and beaten to death.

"Enforcing effective control measures while establishing trust and respecting the fears, traditions and beliefs of the community is very difficult in the context of death and despair," said IFRC senior epidemiologist Bernard Moriniere.

The appeal, aimed at the IFRC's national societies, governments and the general public, is intended to raise funds to help 50,000 people in remote areas of Congo for three months.

Ebola, which is passed on by infected body fluids, kills between 50 and 90 percent of its victims through massive internal bleeding, depending on the strain of the disease.

It killed 73 people in Congo and Gabon in an epidemic from October 2001 to February 2002. 

UN Integrated Regional Information Networks 
February 27, 2003 
Posted to the web February 27, 2003 

Nairobi 

(original article)

A consignment of much-needed food aid sent by the government reached the districts of Kelle and Mbomo in Cuvette-Ouest Region of the Republic of Congo (ROC) on Wednesday, the World Health Organisation reported from the capital, Brazzaville.

The cargo included 70 25-kg sacks of rice, 15 cartons of canned sardines, 25 cartons of salted fish, 10 25-litre containers of cooking oil, 30 sacks of salt, 10 cartons of laundry soap, and 50 cartons of matches.

The goods will be shared among displaced populations of six villages - Yembelangoye, Nzoukou, Ongonda, Ambomi, Abolo and Entsiami; hospital patients, including national Red Cross workers; and government administration agents who have remained in Kelle

WHO reported that as at Wednesday, a total of 91 "probable" cases of Ebola had been identified, and three additional "suspected" cases had been reported, resulting in 79 deaths.

Meanwhile, on Thursday, members of parliament had met Minister Philippe Mvouo in support of government efforts to help contain a climate of panic that had overcome the region, the ROC news agency Depeches de Brazzaville reported.

Calling itself the Association pour le developpement du district de Kelle, the group denounced the killing of four teachers by the local population, who suspected them of having spread the Ebola virus through witchcraft.

"The first major decision we have taken is to organise a collection of funds to assist those suffering from illness and hunger. With the money collected, we will establish a committee that will purchase needed goods to be distributed by humanitarian organisations," an association representative, Dieudonne Ossie, was quoted as saying.

"I hope that very soon our brothers of the Cuvette-Ouest Region living here in Brazzaville will relay the information being provided by scientific teams to their families up-country that this is not a matter of sorcery, but rather, a virus," he added.

WHO also noted that public awareness-raising efforts regarding the Ebola virus were under way throughout the Cuvette-Ouest Region in an effort to gain the confidence of terrified residents.

WHO added that experts in clinical management and a logistician have joined the international team from the Global Outbreak Alert and Response Network, the Congolese Ministry of Health and WHO. Isolation wards have been set up in Kelle and Mbomo Hospitals, and are receiving patients.

Thousands of people have fled a town in one of the two areas of Congo-Brazzaville most affected by the Ebola virus, which in the last two months has killed more than 80 people. 

The BBC's Pascale Harter travelled to the town of Kelle - near the border with Gabon - to find it completely deserted. 

She says the town's inhabitants fled after a witch-doctor told them they would all be dead in four days. 

The World Health Organisation has been holding meetings with local leaders trying to raise awareness about what causes Ebola - in particular the dangers of eating wild animals or touching the bodies of whose who have died of the disease. 

Hiding 

Our correspondent told the BBC's Focus on Africa programme that about 2,000 of Kelle's inhabitants had gone into hiding. 

She says it is a tense and frightening atmosphere - everyone is nervous about getting Ebola. 

The disease begins with high fever, diarrhoea, bleeding from the nose and gums, and can eventually induce massive internal haemorrhages. 

But our correspondent says there is a great level of misunderstanding among the population about what causes it. 

Four teachers have been killed by a mob after being accused of causing the outbreak. 

And people have been unwilling to seek medical help - only about five people have been hospitalised and one is showing signs of pulling through. 

The WHO has appealed for international aid to cover the costly isolation techniques used in containing the Ebola virus as well as securing food for the population. 

The Congolese Government has already appealed to the United Nations World Food Programme for help. 

But the WFP has warned that it was already hopelessly overstretched in providing food aid for 60,000 people who have fled ongoing fighting in the Pool Region of Congo.

Nearly 90 people have been killed by the Ebola virus in the remote forests of Congo Republic since the latest outbreak of the disease hit the central African country just over a month ago.

CONGO’S HEALTH ministry said on Tuesday that 88 people out of the 97 who have so far contracted the disease have died and another 130 people suspected of contact with Ebola sufferers were under surveillance. 

Ebola, which is passed on by infected body fluids, kills between 50 and 90 percent of its victims through massive internal bleeding, depending on the strain of the disease. There is no known cure for Ebola. 

The Ebola outbreak surfaced in the Kelle and Mbomo districts near Congo’s border with Gabon, some 440 miles north of the country’s capital Brazzaville. 

The Geneva-based World Health Organization said on Tuesday it had recorded 86 deaths from the disease out of 108 cases, of which 94 were in Kelle and the rest in Mbomo. 

“The isolation wards and other preventive measures are working very well. So again, we’re seeing a slight decline in new cases but (remain) certainly very much on the alert watching for more,” WHO spokeswoman Christine McNab told reporters.

“The new case count has somewhat slowed...The WHO and global response unit are still there very much in action, assisting with case detection and case management,” she said. 

A government and parliamentary delegation was due to visit the afflicted region, known as Cuvette-Ouest. Ebola experts from around the world were also due to meet in Brazzaville on Tuesday to discuss the outbreak. 

PRIMATE DISEASE SPREADS 

Scientists believe this outbreak was triggered by the consumption of infected monkey meat. Bush meat is a staple among remote forest communities and deemed a delicacy in many cities.

Primates started dying in large numbers toward the end of last year and Congo launched an appeal to the international community on Monday to help protect central Africa’s primates, especially gorillas, who are being decimated by the disease. 

“Measures must be taken in the central African sub-region to eradicate this illness. Primates being wiped out by Ebola don’t need passports to migrate from one country to another,” Forest and Environment Minister Henri Djombo told state radio. 

However many villagers believe occult forces are at work. Four teachers accused of casting an evil spell to cause the Ebola outbreak were stoned and beaten to death in February. 

Ebola killed 73 people in Congo and Gabon in an epidemic from October 2001 to February 2002. 

The disease takes its name from a river in neighboring Democratic Republic of Congo where Ebola was discovered in 1976. The worst outbreak was in that country in 1995 when more than 250 people died. 
 

By Pascale Harter 
BBC, isolation ward, Brazzaville military hospital, Congo 
(source)
 
When a disembodied voice from behind a mask asks you how often you're vomiting, and examines your body for signs of blood beneath the skin from internal haemorrhaging, you know you've got something very bad. The gloves and goggles worn by the doctor let you know you are no longer a healthy body to be protected from illness but a living virus to be protected against. You feel you are already a lost cause, even though you know the doctors need to be protected. I had been feeling ill since returning from the north of Congo reporting on the current Ebola epidemic.

Ebola is one of the deadliest viruses in the world, killing up to 90% of its victims in days and few of those unfortunate enough to get it survive to tell their story. And the initial symptoms are like almost any other illness including malaria: Tiredness, a fever and vomiting.

Feeling

Whilst in the north I had asked a doctor in the village of Kalle at the epicentre of the outbreak: "How do your patients feel when they see you in that outfit?" He was preparing to go into an isolation ward wearing a green protective suit, plastic boots, a head cap, goggles and a mask. Two pairs of surgical gloves were taped securely to his sleeves. As it turned out I now know exactly how patients feel on seeing such an apparition. The answer is terrified.

Scare

Ebola is a messy, undignified death of uncontrollable vomiting, diarrhoea and bleeding. Any contact at all with these fluids would transmit Ebola. My having what could have been Ebola symptoms and arriving from an outbreak zone were enough to scare most of the staff here at the military hospital in Brazzaville. After some understandable hysteria on my arrival, it was eventually decided that I should be given a malaria test. The most junior medic to be found was forced to perform the task. He stood outside my isolation room trembling visibly. As he pricked my finger hurriedly, I saw the sweat gathering behind his goggles.

Lonely deaths

Major illnesses usually elicit sympathy and caring but Ebola just creates fear and panic. I've been here for five days while my blood is taken to a laboratory in Gabon to be tested for Ebola. Although I am fine now - and over the malaria - the government cannot let me go until they have a negative result. In the meantime I have friends to bring me water and food. But most of the Ebola patients dying in the isolation ward in Kelle are not so lucky. Even their families are too scared to bring them bring them water. Ebola is not only a gruesome death but a lonely one.

And Ebola victims know this as soon as they see the green-suited men in their goggles and masks. 
 

Sat March 15, 2003 10:33 AM ET 
(source)
 
BRAZZAVILLE (Reuters) - Six more people have been killed by the Ebola virus in Congo Republic, taking the death toll in the central African country's latest outbreak to 106, the government said on Saturday.

 A health ministry source also told Reuters some workers toiling to stop the spread of the lethal disease were among the victims, but the outbreak was being brought under control.

Ebola killed 73 people in Gabon and in the same remote forests of Congo in an epidemic from October, 2001, to February, 2002, but experts fear this outbreak is more virulent.

The World Health Organization (WHO) said on Friday it had recorded 118 cases, meaning that 90 percent of those infected by Ebola had died.

The disease is passed on by infected body fluids and kills between 50 and 90 percent of sufferers, depending on the strain. It starts with a high fever and headache and can lead to massive internal bleeding.

There is no known cure for Ebola and the authorities have battled the disease by cordoning off affected areas and trying to stop locals eating primates believed to be infected by Ebola.

Bush meat is a staple among remote forest communities and deemed a delicacy in many cities. The WHO said a workshop had been organized in the capital Brazzaville to train doctors and nurses to deal with viral hemorrhagic fever patients.

The disease takes its name from a river in the Democratic Republic of Congo where it was discovered in 1976. The worst outbreak was in that country in 1995 when more than 250 people died.

17:20 14 March 03
Sharon Bhattacharya

NewScientist.com news service
 
Scientists are flying out to equatorial Africa to sample birds in an attempt to identify the mysterious reservoir of the Ebola virus, which has caused repeated fatal outbreaks in the region.

The most recent, in the Republic of Congo, was first detected on 4 January. On Friday, health ministry official Joseph Mboussa, said the death toll had risen to 106, out of a total of 120 cases. 

The haemorrhagic fever can kill up to 90 per cent of its victims. In Congo, people are thought to have contracted the virus through contact with infected gorilla meat. 

But scientists do not know the identity of the long-term reservoir of the disease, from which the gorillas caught the disease. "And as long as we haven't established the source of reservoir of the Ebola virus, it's an illusion to think of an appropriate cure," warned William Karesh, of the US Wildlife Conservation Society recently.

Structural Similarities

Birds were implicated as a possible host to the deadly virus by David Sanders and Scott Jeffers at Purdue University, Indiana, and Anthony Sanchez, at the US Centers of Disease Control in Atlanta, Georgia, who showed in December that there are strong structural similarities between Ebola and some bird retroviruses.

"The biochemistry of entry of Ebola [into a cell] is really similar to bird retroviruses. It is clear that they have a common ancestor." Sanders told New Scientist."We suggest the possibility that the current natural reservoir is a bird host - it's consistent with Ebola's epidemiology."

The central African rift valley separates the ranges of bird species into distinct western and eastern groupings. Ebola outbreaks occur in central and western Africa but not in the east - consistent with being confined to the bird populations on one side of the rift valley.

Sanders says gorillas or other primates cannot be the long-term reservoir of Ebola because they die too quickly, meaning the virus would die out too.
 

Gloves and Masks

Now Townsend Peterson, an ornithologist at the University of Kansas, Nate Rice at Purdue, and colleagues are flying out to Equatorial Guinea, with all arriving by the end of March. 

In addition to ecological research projects, they will be collecting samples of liver and spleen tissue from about 100 bird species. The researchers will be protected by gloves and masks. 

Peterson says his previous work tracking the ecology of outbreaks of filoviruses - the group to which Ebola belongs - had suggested that mammals were a more likely reservoir. Bats are one possibility. But Sander's study means that "birds certainly merit examination", he says.

The samples will be sent to Sanchez, a molecular virologist at the CDC, who will test for the viral proteins that identify Ebola. "There is this link with avian retroviruses," he told New Scientist: "It's a long shot - but we'll see what happens."

While you are waiting... read below to learn about Ebola in Africa....

Saturday, 8 February, 2003, 15:45 GMT 
from the BBC News
(original article)

Theories on the origins of the 30 or more new diseases to affect humans over the past two decades are widespread, but many of the most frightening appear to have emerged from sub-Saharan Africa. 

Ebola and a few other haemorrhagic fevers have been responsible for a tiny number of deaths compared to Aids, and the number of cases reported outside Africa has been miniscule. 

But the devastating speed at which they strike, and the far higher possibility of transmission from human to human have made the thought of a major outbreak a terrifying prospect.

Flu symptoms at first 

Scientists first became aware of the potential of Ebola to destroy whole communities in the mid 1970s, when severe outbreaks in Sudan and the former Zaire killed a total of approximately 440 people. 

The Zaire strain of the virus is the most deadly to date, proving fatal in just under 90% of those who contracted. 

The virus can be passed on either via dirty needles, or by person to person spread, and symptoms start to appear anytime from a few days later, up to almost a fortnight. 

By then, the virus will have reproduced itself many times and spread through the blood to many organs. 

The major organs it affects are the liver, kidneys, spleen and reproductive organs. 

Very often, flu-like symptoms such as a sore throat, headache and high temperature are the first sign of infection. 

This is followed by nausea, vomiting and diarrhoea. 
The victim may start to become delirious and dehydrated. They can begin to bleed internally, either from the major organs themselves or from tiny blood vessels, the digestive tract and gums. 

Eventually, this can cause enough blood loss to cause shock and respiratory problems, leading quickly in many cases to death. 

Treatment eludes doctors 

There is still no treatment for Ebola readily available - no standard anti-viral therapies such as interferon have any effect. If someone beats Ebola they do it by themselves. 

After the initial Sudan and former Zaire outbreaks, there was another small outbreak in Sudan in 1979. 

But it was not until 1995 - again the former Zaire, that a major outbreak occurred, centred around the town of Kikwit. 

This time 316 people were infected - almost exactly the same number as the first Zaire outbreak, and 245 died. 

The menace of Marburg 

But Ebola is not the only viral haemorrhagic fever which claims lives in Africa, and beyond. 

Marburg fever gets its name from the town in Germany in which it broke out in 1967 and shares its symptoms with Ebola.

It claimed seven lives from the 25 infected in Marburg and Frankfurt. 

The disease was transmitted from African green monkeys brought to Germany for animal experimentation. 

Other well-known haemorrhagic fevers are: 

• Lassa fever - first noticed in the 1960s after an outbreak in Nigeria, and is spread from rodents, the natural host
• Rift Valley fever - mainly found in sub-Saharan Africa, and spread by mosquitoes
• Congo-Crimean haemorrhagic fever - found in many parts of Africa, the Middle East and even warmer parts of the former Soviet Union, in which an outbreak is ongoing. It is spread by ticks

Scientists have developed vaccinations against both Ebola and Marburg which work on laboratory animals, and there are promising signs of some therapies that can be used on victims. 
 

Much of the scientific work underway is focused on finding the original source of the disease - the reservoir. 

One project examined thousands of animals in the rainforests of West Africa in a bid to isolate those hosting the virus. 

Some scientists say that the growing number of so-called emerging diseases are due to increasing forays by humans into the tropical forests. 

This brings them into contact with new creatures - and new infections - making it possible there could be even more powerful viruses waiting to play havoc in the human body. 
 

Stefan Lovgren
for National Geographic News
February 19, 2003
(original article)
 

Knowing how people may initially have contracted the virus has given medical experts a jumpstart on the epidemic, which has so far killed at least 64 people. But the larger question remains. Where does the deadly Ebola virus hide between outbreaks? 

"Primates die from Ebola," just like humans, said Dick Thompson, a spokesperson for the World Health Organization, which has sent a team of experts to the region. "The virus must live somewhere else in the environment." 

The search for a natural host has eluded scientists ever since the first Ebola epidemics in 1976. The quest is a catch-22. While an outbreak offers the best opportunity to find the natural reservoir, the priority for virus hunters is to contain the epidemic. In the process, the trail often goes cold because the virus kills so swiftly it covers its tracks. 

Ebola is one of the most contagious viruses known to man. A simple handshake can transmit the disease. Depending on the strain, Ebola kills anywhere from 50 to 90 percent of its victims through massive internal bleeding. Worst of all, there is no cure. 

Finding out where the virus is hiding between outbreaks would help predict how often it will strike and could aid in the adoption of safety measures. The genetic variability of the virus in its natural host may help design a vaccine. 

Immune to Ebola 

There has long been speculation among scientists that bats are the natural reservoir for Ebola. In scientific experiments, researchers have injected bats with the Ebola virus, and the bats have survived. "You find bats in almost every outbreak," said Bob Swanepoel, head of the Special Pathogens Division at South Africa's National Institute for Communicable Diseases. 

Bats were found in the roof of a Sudanese cotton factory where six people died in a 1976 epidemic. A Danish student died of Ebola after visiting a bat-infested cave in Kenya. At least 60 miners in northeastern Congo died from Marburg, an Ebola-related virus that may share Ebola's natural reservoir, during a 1999 outbreak. Six of the seven mining quarries were open, the seventh was located underground with an estimated 30,000 bats living in it. All of the miners who contracted the disease worked in the underground mine. 

Swanepoel has collected bats during several Ebola and Marburg outbreaks. "We have seen evidence of Ebola in bats," he said. "But we have never been able to isolate the virus." He believes only a fraction of the bats may host the virus. Catching the right specimens is almost impossible. 

Transmitting the Virus 

The latest outbreak began after researchers from the Wildlife Conservation Society reported a massive decline in ape populations in the Lossi Gorilla Sanctuary in northern Republic of Congo. In mid-December, scientists from the Centre International de Recherches Medicales de Franceville (CIRMF) in neighboring Gabon collected samples from four gorilla and two chimpanzee carcasses and confirmed the presence of Ebola in all six cases. 

Even without lab confirmation on the human deaths, scientists are treating this epidemic as an Ebola outbreak. "The clinical presentation of the cases, the high death rates and confirmed reports of primate deaths which tested positive for Ebola all point in that direction," said the WHO's Thompson. 

The first victim, or "index case," is believed to have eaten or come in contact with an infected animal. An Ebola epidemic in the same region in 2001, which killed 73 people, was also linked to people eating infected primates. After the initial infection, the virus is usually transmitted from human to human. 

Containing the epidemic is particularly difficult because the affected villages are tucked into impenetrable forests about 440 miles (710 kilometers) from Brazzaville, the capital of the Republic of Congo. Cordoning off the area is impossible. Cultural practices also complicate efforts. Religious rites, for example, dictate that family members wash the body of a dead person before burial. 

While past outbreaks have been concentrated in, say, a village, the current epidemic is "multi-centric," or spread over a vast area. This suggests that the natural host for Ebola could also be active over a large area. Scientists have speculated that insects, or maybe birds, could carry the virus. 

New Research 

In December, a Purdue University science team presented new research that links Ebola with birds. According to the study, the outer protein shell of filoviruses, such as Ebola, have a biochemical structure similar to retroviruses carried by birds, making a common evolutionary origin more likely. 

"There can be no doubt now that an ancestral virus had a shell that evolved to become the shells of the Ebola virus and bird retroviruses," said David Sanders, the professor who headed the research team. 

Sanders stresses that his discovery does not prove that birds are the natural reservoir for Ebola. But it makes them more plausible hosts. The prospect of migratory birds carrying Ebola has obvious health implications. 

Some scientists already worry that Ebola could mutate and become airborne. Recent outbreaks have suggested it can evolve on its own. All the Ebola subtypes have shown the ability to be spread through airborne particles under research conditions. One strand, Ebola-Reston, may have been transmitted from monkey to monkey through the air in a Virginia science lab. So far there have been no similar transmissions involving humans.