Ebola Breach: Vomiting Patients "In Active Phase" Smuggled Out Of Quarantine, Die Within Hours

Congo health officials are scrambling to contain the country's newest Ebola outbreak, which has made its way from the small remote town of Bikoro to the town of Mbandaka, home to around 1.2 million residents.

On Thursday, Dr. Jean-Clement Cabrol of Doctors Without Borders revealed that two vomiting patients "in the active phase of the disease" were smuggled out of quarantine on Monday, put on motorcycles, and taken to a prayer meeting with 50 people - where they died hours later.

"The escape was organised by the families, with six motorcycles as the patients were very ill and couldn’t walk,” Cabrol said at a news briefing in Geneva after returning from the affected region. 

They were taken to a prayer room with 50 people to pray. They were found at two in the morning, one of them dead and one was dying. So that’s 50-60 contacts right there. The patients were in the active phase of the disease, vomiting.”

Health officials started trying to trace the motorcycle drivers and other people who came into contact with the patients as soon as the escape was reported, Dr. Peter Salama, head of emergency response at the World Health Organization (WHO), told Reuters on Thursday. -Reuters

“From the moment that they escaped, the (health) ministry, WHO and partners have been following very closely every contact,” he said.

Ebola is highly contagious through bodily fluids, and can move from infected animals to humans who come into contact with contaminated blood. For those who come into contact with the disease, the incubation period lasts between two and 21 days, with a fatality rate of 42.3% in the current outbreak.

While Congo's health ministry says the death toll stands at 12, the WHO puts the total number at 52 cases and 22 deaths as of Wednesday, while the number of suspected cases has spiked over the last several days.

Most of the cases have occurred in men in their 40's, with men in their 20's hit second hardest. 

The current outbreak began in the small lakefront town of Bikoro and quickly began to spread. The outbreak was declared on May 8, and by mid-May concern began mounting. As CBC notes, "The river is a lifeline, essential for moving people and products through a massive country with weak infrastructure. But the river's role in daily life also raises the alarm for some health officials, since Congo's capital Kinshasa is downriver from Mbandaka."

While there is no known cure for Ebola, vaccines are currently being tested in Congo right now with help from the WHO and other partners. The vaccines is not yet licensed but has shown promise in clinical trials. The plan is to vaccinate the most at-risk individuals first

So far, front-line health-care workers have been vaccinated, as have family members and others who have had close contact with Ebola patients.

Dr. Peter Salama, deputy director general for Emergency Preparedness and Response of the World Health Organization, told CBC's As It Happens that the ring vaccination method "was used in a trial a couple of years ago in Guinea to demonstrate that this vaccine, used with that strategy, can be 100 per cent effective."

The pharmaceutical giant Merck has a licensing agreement to develop the vaccine. If it works as researchers hope it will, Merck told CBC News in a statement, it will "make the vaccine available to the world's poorest countries at the lowest possible, not-for-profit price." -CBC

Lack of trust between patients, their families, and healthcare professionals, along with religious practices, are often the reason for Ebola patients to resist or refuse modern healthcare options. In many parts of the affected region it is standard practice to wash the body of the dead, for example, which can rapidly spread the disease. 

“Patient adherence is paramount,” said Brienne Prusak, a press officer for Doctors Without Borders “The quicker patients are admitted, the greater their chance of survival and the greater the chance of limiting the spread of Ebola.”