Get subscribed to our newsletter
Get interesting updates to your email inbox.
Until his last breath, Salomon Nduhi Kambale insisted he had been poisoned by someone and that was the reason he was vomiting blood. The 30-year-old man wouldn’t give community health teams his phone number, and when they found it, he hung up on them.
Health workers were desperate to persuade him to get vaccinated for Ebola after a friend fell ill with the lethal and highly contagious disease.
But within days, Nduhi was dead. His widow and their four young children were given his positive Ebola test result and a chilling warning from a team of health workers: “If you don’t accept vaccination, you can prepare to die.”
Deep distrust — along with political instability and deadly violence — has severely undermined efforts by public health authorities in Congo to curb the outbreak by tracing and vaccinating those who may have come into contact with infected people.
Health experts agree the experimental Ebola vaccine has saved multitudes in Congo. But after nearly a year and some 171,000 doses given, the epidemic shows few signs of waning. The virus has killed more than 1,700 people and has now arrived in the region’s largest city, Goma. The World Health Organization last week declared the outbreak a global health emergency.
During the 2014-16 Ebola epidemic in West Africa, which left more than 11,300 people dead, health workers could only dream of a vaccine with a 97.5 percent effectiveness rate that could improve the odds of survival even in those already infected.
“We have it now and it’s not the miracle we wanted it to be,” said Dr. Joanne Liu, president of Doctors Without Borders. “The fact that we’ve used so much vaccine, and the epidemic hasn’t stopped, that shows us that contact tracing is not great.”
WHO says as many as 90 percent of those eligible for vaccination have accepted it, but that figure only includes those who gave contact tracers enough information to be included on a list. The success rate excludes those who distrusted health workers and fled, or those who couldn’t be found in the first place.
Health workers have been using what is known as a ring vaccination strategy: The vaccine is first given to those who were in close contact with a sick person. Then a second so-called ring is created by giving the vaccine to those who were in contact with those people.
Because of the difficulties in making that strategy work, some people didn’t get vaccinated until they had already been infected with the virus, and they developed Ebola anyway. That increased doubts about the vaccine in communities where the public health campaigns led by outsiders already were viewed with suspicion and hostility.
“The rumors were if you got vaccinated you would die,” said Liboke Kakule Muhingi, a 43-year-old farmer in Mangina, where the epidemic began last August.
His mother was among the first to die. Then, one by one, six of his sisters who had cared for their ailing mother were killed by Ebola. Kakule accepted the vaccine and made sure his wife and eight children got it, too.
“If I hadn’t, we’d all be dead,” he said.
In some cases, health teams have been unable to reach certain areas because of violence or rebel activity. Earlier this month, the head of the Congolese health ministry’s response efforts in Beni was at one point unable to return from a field visit while the military battled ADF rebels, who are linked to the Islamic State.
More often, though, contact lists have fallen apart simply because people have deliberately evaded health workers or did not understand they shouldn’t travel after being exposed. A pastor who became the first confirmed case in Goma had apparently put down fake names at health checkpoints to avoid detection. He had been sickened in the town of Butembo and then took a bus while ill.
WHO and the Congolese health ministry have now switched tactics and are offering the vaccine to anyone who wants it.
With Ebola’s arrival in Goma, a city of more than 2 million people, some wonder whether there will be enough of the vaccine if the outbreak continues.
The vaccine’s manufacturer, Merck, said it has 245,000 1-millileter doses on hand and that could rise to 900,000 over the next 18 months. The dose in Congo also has been reduced to 0.5 mL, effectively doubling the supply.
“Whether or not the available doses are sufficient to fulfill the demands depends on the evolution of the outbreak, the access to the communities and the successful expansion of the production of additional doses by Merck in early 2020,” WHO said.
There is a second experimental vaccine, produced by Johnson & Johnson, but health officials in Congo have said it will not be used because it needs further testing and would cause too much confusion. It requires two doses given one month apart.
It’s unclear how long the Merck vaccine will protect people. Scientists know from early studies that it lasts for at least a year, but the epidemic is approaching that limit. The only study to report longer vaccine durability tracked only a small number of healthy volunteers in Geneva for two years.
The new strategy of giving shots to anyone who wants them involves setting up “pop-up” sites in the neighborhoods most affected. Last week a vaccination team headed to the neighborhood in Beni where Nduhi’s wife had stayed after he died.
Outside the mud-brick home where his children still lived, a pickup truck full of plastic tables and chairs pulled over. Soon a tent was set up, and vaccination teams donned eye protection and yellow surgical gowns. Neighborhood children climbed the trees to watch.
Baraka Kathembo Makasi, a 22-year-old motorbike taxi driver, brought his wife and two children with him.
“At first I refused,” he said, “but I started seeing people die and decided to go.” (VOA)
High drama was witnessed in Kanpur Dehat for over an hour when a man, upset over his wife's alleged affair with a local man, climbed the tower with his children and threatened to commit suicide. The incident took place on Monday near Gandhi Nagar in Akbarpur, when the man threatened to commit suicide after throwing his kids down from a height of nearly 40-feet. Chaos prevailed around the area and the locals informed the police that rushed to the spot.
After about half-an-hour of convincing, the police managed to bring him and his children down. The man told the police that his wife's affair was going on with his neighbor. He had complained to the police, but no action was taken. Police said that as per the man, his wife had developed an illicit relationship with a man, living nearby their house. "As per the man, in his absence, his neighbor visited his house often. He said that he had reprimanded his neighbor many times, but to no avail," said the police.
The man had complained to the police, but no action was taken. | Pixabay
The man had also lodged a complaint with the police but no action was taken. On the other hand, Akbarpur police said that on the basis of the complaint, action for breach of peace has been taken against the neighbor accused of luring his wife. Circle officer (CO) Akbarpur Arun Kumar said that the police are trying to sort out the issue. "Whatever action is appropriate will be taken," the official added. (IANS/SP)
(Keywords : Kanpur, Uttar Pradesh, man, wife, alleged, affair, children, India, police, neighbor, complaint, suicide, accuse, drama.)
The US forces continued their bombardment of buildings and institutions in Syria's northeastern Hasakah province, as part of their alleged manhunt of Islamic State (IS) fugitives, state news agency SANA reported. The US forces are shelling buildings and public institutions on Tuesday in the vicinity of the Sina'a prison in the Gweiran neighborhood in Hasakah "on the pretext of hunting down IS militants who fled the prison," said SANA.
The Syrian Foreign Ministry has slammed the US airstrikes as civilian casualties have been reported. | Wikimedia Commons
The shelling came in tandem with waves of raids by the Kurdish-led Syrian Democratic Forces (SDF) to homes in the surrounding areas, rounding up many civilians and taking them to unknown locations, the state news agency added. On January 20, IS inmates inside the Sina'a prison, which is controlled by the SDF, started a riot that was coordinated with IS militants from outside, who detonated the prison's gates with two booby-trapped vehicles, succeeding to free some prisoners.
The incident triggered clashes between IS and the SDF as well as US airstrikes on the areas, where the IS fugitives could have sought shelter in, Xinhua news agency reported. The clashes and airstrikes are still ongoing as the SDF has so far failed to contain the situation and storm the prison. The Syrian Foreign Ministry has slammed the US airstrikes as civilian casualties have been reported. Hasakah province is largely controlled by the US-backed SDF, while certain areas, particularly in the city of Qamishli, are still under the control of the Syrian government. (IANS/ MBI)
(Keywords: US forces, shelling, bombarding, syria, islamic state, civilian casualties, qamishli, tandem, syrian democratic forces)
The circulating avian influenza outbreaks, including in India, do not seem to pose the 'high' risk but surveillance and biosecurity measures are necessary to reduce spillover risk between poultry and wild birds, a UN-backed scientific task force said. Throughout the past autumn and current winter in the northern hemisphere, multiple avian influenza outbreaks, caused predominantly by the H5N1 HPAI virus, plus other subtypes, including H5N8, have occurred in India, the UK, the Netherlands and Israel with the ever recorded mortality of the Svalbard barnacle geese in Solway Coast.
The Scientific Task Force on Avian Influenza and Wild Birds, co-convened by the Convention on the Conservation of Migratory Species of Wild Animals (CMS) and the UN's Food and Agriculture Organization (FAO), on Monday recommended that surveillance and biosecurity measures are reinforced to reduce spillover risk between poultry and wild birds. The Task Force has convened and produced recommendations and guidance for authorities and managers of countries affected or at risk. Wild birds, including globally threatened species, are victims of HPAI viruses causing avian influenza. Affected sites also include areas of international relevance for conservation such as protected wetlands.
More than 2,400 migratory water birds died in the Pong wetlands in Himachal last year because of avian influenza. | Unsplash
It is essential that authorities with responsibility for animal health apply the One Health approach for communicating and addressing avian influenza. That means recognising the health of humans, domestic and wild animals, plants, and the wider environment and acting with a coordinated and unified approach. The Task Force reminds authorities of their international obligations to ensure their response to the pathogenic virus does not include the culling of wild birds, nor actions that would cause damage to natural ecosystems, especially wetlands.
Ruth Cromie, who coordinated the work of the Task Force and the production of the statement, said: "Avian influenza represents a One Health issue threatening health across the board. The highly pathogenic viruses are still relatively new in wild birds and this winter's high levels of mortality remind us of their vulnerability and that working to promote healthy wildlife benefits us all." H5N1 is currently the avian influenza lineage most found in Africa and Eurasia in both poultry and wild birds. The wide range of wild birds affected include wildfowl, waders, gulls, cranes, grebes, herons, pelicans, gamebirds, corvids and raptors (diurnal and nocturnal), in addition to sporadic cases in mammals such as red fox (Vulpes vulpes), Eurasian otter (Lutra lutra) and harbor Phoca vitulina and grey seal Halichoerus grypus.
Consider occupational exposure, e.g. those working on poultry culling operations. | Unsplash
In terms of human health, the currently circulating H5N1 HPAI viruses do not seem to pose the same zoonotic risk as the 'original' Asian lineage H5N1 (clade 2.2 and their derivatives plus clade 188.8.131.52b H5N6 viruses currently in China). In general, the risk can be considered low, recognising that some agencies now consider occupational exposure, e.g. those working on poultry culling operations, as low or moderate. In India, several instances of bird flu were reported in 2021. More than 2,400 migratory water birds, and almost half of them being endangered bar-headed goose, died in the Pong wetlands in Himachal Pradesh last year and that avian influenza (H5N1) was the cause.
Besides the bar-headed goose, the other species that died were the shoveler, the river tern, the pochard and the common teal. An 11-year-old boy died at All India Institute of Medical Sciences in Delhi last year due to avian influenza, country's first fatality. India reported the first outbreak of avian influenza in 2006. RSPB Scotland is calling for an emergency local moratorium restricting shooting on the Solway for the rest of the wildfowling season. It calls for urgent action to reduce the devastating impacts of avian influenza. New statistics from the most recent counts show that the UK is this winter experiencing the worst outbreak of this deadly disease on record, with migratory geese which 'over winter' on the Solway being the hardest hit.
According to RSPB Scotland, the latest population counts of the Svalbard barnacle goose show a drop in numbers from 43,703 in November last year to 27,133 in this month's count. This represents a decline of 38 per cent in the Svalbard breeding population of this species from winter 2020-21. CMS Executive Secretary Amy Fraenkel said: "Through late 2021 and early 2022 there have been numerous outbreaks of highly pathogenic avian influenza H5N1, with severe impacts on migratory birds. "The CMS Secretariat responded by convening the Scientific Task Force on Avian Influenza and Wild Birds together with the FAO. We are pleased to share its advice and key recommendations for countries affected or at risk, and look forward to continuing our collaborative work to minimize risks to humans, poultry and wild populations of migratory birds." (IANS/SP)
(Keywords : avian, influenza, surveillance, United Nation, scientists, breeding, population, birds, affected, countries, poultry, migratory, health, issue, virus, responsibility, international, ecosystem.)