Health officials in the Democratic Republic of Congo's north-eastern Orientale Province are urging the population to desist from activities that could put them at risk of contracting the Ebola virus, including contact with infected individuals and the consumption of bushmeat.
At least 10 people in the province had died from suspected Ebola by 20 August, according to the UN World Health Organization (WHO), which first reported the outbreak on 17 August. Local sources say the first symptoms were spotted about a month ago.
Nine of the deaths - which included three health workers - occurred in the district of Isiro, and one occurred in Dungu District. WHO reports a total of 15 cases so far, 13 probable and two confirmed.
"The death case we got in Dungu was a hunter. Once in the bush he saw a dead antelope and did not care to ask why it had died. He immediately took [the carcass] and went to eat it... He fell sick and passed away," said the DRC's Health Minister Kabange Numbi.
Bushmeat - the meat of wild animals, including hoofed animals, primates and rodents - is often the main source of animal protein available to people in parts of the DRC. It is also a livelihood source for people in the Congo basin, according to a 2011 paper by the Center for International Forestry Research.
According to WHO, "Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals." Fruit bats are considered to be the natural host of the virus.
"Ebola virus is an animal disease... people some in parts of our country rely on bushmeat for their livelihood... and don't care to avoid eating meat they've got from dead animals that they often find in the bush," said Mondoge Vitale, head of disease control at WHO's Kinshasa office.
The strain of Ebola in the Congo has been identified as Ebola-Bundibugyo - named for a Ugandan district that borders the DRC. The western district of Kibaale in neighbouring Uganda was recently hit by an outbreak of another strain, Ebola-Sudan, which killed at least 16 people.
There is no vaccine for the highly infectious disease, which causes fever and bleeding from orifices and can cause death within days. The fatality rate for the Bundibugyo strain is estimated at about 40 percent.
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Jacques Gumbaluka, chief of the Haut-Uele health zone in Isiro, said that about one month ago a number of children under age five presented at health centres with anaemia. Then adults began to be admitted with unexplained bleeding and fever.
Contingency measures have been put in place to contain the outbreak. The health ministry has established national- and district-level taskforces and is working with partners, including the NGO Médecins sans Frontières (MSF), the United States Centers for Disease Control and Prevention (CDC), the UN Children's Fund (UNICEF) and WHO.
"The measures include the sensitization of the communities, protection of health workers - in the zone where the outbreak has been declared they have been given protection equipment," said Numbi.
He added that the government had beefed up screening at Kisangani Port, a commercial hub in Orientale Province, to prevent the outbreak reaching the capital, Kinshasa, and was reinforcing screening at Kisangani Airport to contain it within the country.
Orientale Province borders the Central African Republic, South Sudan and Uganda. South Sudan is already on high alert following the outbreak in neighbouring Uganda.
MSF has deployed experts to set up isolation facilities and surveillance systems in affected areas, but officials say their work is being hampered by a lack of information. "As long as the surveillance system is not properly enforced, we are not sure whether we may have missed some cases who have not been in contact with health facilities," said Olympia de la Rosa, a health adviser in MSF's Emergency Unit.
The DRC has experienced several fatal Ebola outbreaks in the past. In 1976, at least 280 people died from the Ebola-Zaire strain, which killed another 250 people in 1995 and 187 in 2007, according to the CDC.
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