The deadly Ebola outbreak in eastern Congo lasted six months on Friday and officials have found a worrying number of confirmed cases linked to health centers.
These infections are considered a major problem that highlights the bad practices and the risk of spread among patients and workers. Combined with community resistance in an unstable and densely populated area that has never been confronted with the Ebola virus, the task of containing the epidemic remains difficult.
In the current epicenter, the communities of Butembo and Katwa, 86% of Ebola cases since December 1 "have visited or worked in a Health care before or after the onset of their illness, "said the World Health Organization.
In the past three weeks in Katwa, 49 "health facilities" where confirmed cases have been hospitalized have been identified, and eight new infected health workers have been reported, said the WHO.
With 759 cases of Ebola, of which 705 confirmed and 414 confirmed deaths, this epidemic has become the second largest epidemic of Ebola in history, behind the epidemic in Africa. the West that killed more than 11,000 people in 2014-2016.
No end is in sight.
"This is a particularly complex area and characterized by such insecurity," Dr. Ibrahima Soce Fall, WHO Regional Director for Emergencies, told Associated Press. "We have been able to control many hot spots, but it will take some time to actually end the epidemic."
Katwa is the latest community to introduce officials to a population that is wary of foreigners after years of rebel attacks in the region.
"They do not trust the Congolese authorities because they have been exposed to insecurity and conflict for over 20 years," Fall said. "You can not control this type of outbreak without the involvement of the community for rapid detection." In Beni, one of the first epicentas, it took months for some communities to trust, he added.
People still often choose to go to traditional health centers rather than hospitals.
"Many people have been infected in these facilities.If you have malaria, you may be in the same place as someone with Ebola," said Fall. "They do not have a doctor and the people who work are not qualified."
Many of the initial symptoms of Ebola, including fever and muscle aches, are similar to those of malaria and other common diseases in the area.
Katwa is also concerned that 80% of Ebola cases have not been attributed to known contacts of other infected people. This means that officials can not know exactly where the virus is spreading and who is most at risk, said Laurence Sailly, chief of mission in the Congo of Doctors Without Borders.
This rate is lower in communities that have had cases early in the epidemic, reflecting the progress of health workers.
Whenever the Ebola virus appears in a new community, health workers need to start from scratch to explain the disease. Some ask rebel groups to be vaccinated and to seek contacts from infected people.
There is also concern about deaths occurring outside health centers, with some people still hesitant to ask for help. Ebola patients at home potentially infect many more people than alone, and experts say they are highly infectious shortly before their deaths.
The WHO and the Congo Ministry of Health have started testing and recording all deaths outside health centers.
Many Congolese remain worried.
"I'm scared of Ebola and I think the outbreak is far from over," said Manoa Lebabo, a 20-year-old resident of Beni.
Editors of the associated press, Al-Hadji Kudra Maliro in Beni, Congo and Jamey Keaten in Geneva, also contributed.
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