The second-largest Ebola outbreak in history has spread to a city in the east of the Democratic Republic of Congo, as health experts worry whether stocks of an experimental vaccine will run out.
Butembo, with more than one million residents, is now reporting cases of the deadly haemorrhagic fever. That complicates Ebola containment work already challenged by rebel attacks elsewhere in the DRC that have made tracking the virus almost impossible in some isolated villages.
"We are very concerned by the epidemiological situation in the Butembo area," said John Johnson, project co-ordinator with Doctors Without Borders. New cases are increasing quickly in Butembo's eastern suburbs and outlying, isolated districts, the charity said.
The outbreak declared on August 1 is now second only to the devastating West Africa outbreak that killed more than 11,300 people between 2014 and 2016. There are currently 471 Ebola cases, of which 423 are confirmed, including 225 confirmed deaths, the DRC's health ministry said on Thursday.
Without the teams that vaccinated more than 41,000 people so far, this outbreak could have already seen more than 10,000 Ebola cases, the ministry said.
This is by far the largest use of the promising but still-experimental Ebola vaccine, which is owned by Merck. The company keeps a stockpile of 300,000 doses, and preparing them takes months.
"We are extremely concerned about the size of the vaccine stockpile," the World Health Organisation's emergencies director, Peter Salama said.
Health workers received a dose in a "ring vaccination" approach, but in some cases all residents of hard-to-reach communities were offered it. The prospect of mass vaccination in a major city like Butembo has raised concerns. Dr Salama called this approach "extremely impractical".
This Ebola outbreak is like no other, with attacks by rebel groups halting containment work for days at a time. Some wary locals resisted vaccinations or safe burials of Ebola victims as health workers battle misinformation in a region that has never encountered the virus before.
A "fringe population" has regularly destroyed medical equipment and attacked workers, Health Minister Oly Ilunga Kalenga said last week.
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Read more:
UN says seven peacekeepers killed in fight against Congo rebels
Death toll tops 200 in DR Congo Ebola outbreak
Deadly attack in centre of Ebola outbreak stalls work
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Thousands of people have been organised by Red Cross societies and others to go house-to-house dispelling rumours and checking on possible contacts of victims.
Fatoumata Nafo-Traore, Africa regional director for the International Federation of Red Cross and Red Crescent Societies, joined an awareness campaign in the outbreak's epicentre, Beni, this week.
The head of one family thanked her for the face-to-face contact, saying he did not even have a radio and did not understand what was happening. "Ignorance is the enemy," another resident said.
Given the years of conflict in eastern DRC, it is essential that households trust why the health workers are there, Dr Nafo-Traore said.
Although she called the insecurity "very worrying", she said that with new tools at hand, including vaccines, "there is great hope".
The specs: 2018 Ducati SuperSport S
Price, base / as tested: Dh74,900 / Dh85,900
Engine: 937cc
Transmission: Six-speed gearbox
Power: 110hp @ 9,000rpm
Torque: 93Nm @ 6,500rpm
Fuel economy, combined: 5.9L / 100km
Company profile
Name: Infinite8
Based: Dubai
Launch year: 2017
Number of employees: 90
Sector: Online gaming industry
Funding: $1.2m from a UAE angel investor
Company%20Profile
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The specs: 2018 Chevrolet Trailblazer
Price, base / as tested Dh99,000 / Dh132,000
Engine 3.6L V6
Transmission: Six-speed automatic
Power 275hp @ 6,000rpm
Torque 350Nm @ 3,700rpm
Fuel economy combined 12.2L / 100km
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CREW
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BIOSAFETY LABS SECURITY LEVELS
Biosafety Level 1
The lowest safety level. These labs work with viruses that are minimal risk to humans.
Hand washing is required on entry and exit and potentially infectious material decontaminated with bleach before thrown away.
Must have a lock. Access limited. Lab does not need to be isolated from other buildings.
Used as teaching spaces.
Study microorganisms such as Staphylococcus which causes food poisoning.
Biosafety Level 2
These labs deal with pathogens that can be harmful to people and the environment such as Hepatitis, HIV and salmonella.
Working in Level 2 requires special training in handling pathogenic agents.
Extra safety and security precautions are taken in addition to those at Level 1
Biosafety Level 3
These labs contain material that can be lethal if inhaled. This includes SARS coronavirus, MERS, and yellow fever.
Significant extra precautions are taken with staff given specific immunisations when dealing with certain diseases.
Infectious material is examined in a biological safety cabinet.
Personnel must wear protective gowns that must be discarded or decontaminated after use.
Strict safety and handling procedures are in place. There must be double entrances to the building and they must contain self-closing doors to reduce risk of pathogen aerosols escaping.
Windows must be sealed. Air from must be filtered before it can be recirculated.
Biosafety Level 4
The highest level for biosafety precautions. Scientist work with highly dangerous diseases that have no vaccine or cure.
All material must be decontaminated.
Personnel must wear a positive pressure suit for protection. On leaving the lab this must pass through decontamination shower before they have a personal shower.
Entry is severely restricted to trained and authorised personnel. All entries are recorded.
Entrance must be via airlocks.
Tips to avoid getting scammed
1) Beware of cheques presented late on Thursday
2) Visit an RTA centre to change registration only after receiving payment
3) Be aware of people asking to test drive the car alone
4) Try not to close the sale at night
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6) Call 901 if you see any suspicious behaviour
Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
The lowdown
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The specs
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Analysis
Members of Syria's Alawite minority community face threat in their heartland after one of the deadliest days in country’s recent history. Read more
The five pillars of Islam
Zayed Sustainability Prize
Our family matters legal consultant
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
Three tips from La Perle's performers
1 The kind of water athletes drink is important. Gwilym Hooson, a 28-year-old British performer who is currently recovering from knee surgery, found that out when the company was still in Studio City, training for 12 hours a day. “The physio team was like: ‘Why is everyone getting cramps?’ And then they realised we had to add salt and sugar to the water,” he says.
2 A little chocolate is a good thing. “It’s emergency energy,” says Craig Paul Smith, La Perle’s head coach and former Cirque du Soleil performer, gesturing to an almost-empty open box of mini chocolate bars on his desk backstage.
3 Take chances, says Young, who has worked all over the world, including most recently at Dragone’s show in China. “Every time we go out of our comfort zone, we learn a lot about ourselves,” she says.