International officials managing the response may be unaware of local conditions. Spontaneous visits by such people to outbreak areas may be resented by local residents as well as local workers, who are paid a fraction of what their Western counterparts earn.
Years of partnership and preparation between the African Center of Excellence for Genomics of Infectious Disease, the Irrua Specialist Teaching Hospital in Nigeria, and the Massachusetts-based Broad Institute ensured the samples were rapidly sequenced in Nigeria by local labs. This response, marked by cooperation and in-country capability, may be the model for the years ahead, as scientists from both Broad in the US and Nigeria believe the chances are high of emerging virus outbreaks occurring more frequently.
While premeditated attacks on treatment centers have been attributed to armed groups, there have also been a series of spontaneous assaults on health workers. These stem from a deep distrust towards those in the response, and a lack of understanding of what Ebola is.
The DRC is a very large country and these cases are so far confined to the eastern part of the country. This is also the region of the Democratic Republic of Congo that has long been mired in conflict and insecurity. In recent weeks, Ebola treatment centers have been attacked forcing medical staff to suspend operations. Meanwhile, new Ebola cases are confirmed on a nearly daily basis.
In recent weeks, more than 40 percent of new cases in the hotspot towns of Katwa and Butembo had no known links to other cases, meaning doctors have lost track of where the virus is spreading.
There's growing concern that the very steps the government and the World Health Organization are taking to curb the rising violence from organized groups — for instance, bringing in military, police and UN peacekeepers to provide protection — could sow further mistrust and fuel additional resistance from ordinary people.
Officials say many in the Democratic Republic of the Congo are mistrustful of health workers and resist their help — sometimes violently. Aid groups are proposing strategies to win people over.
Researchers are now able to take advantage of mobile technologies that can mimic viral properties and combine them with people’s thirst for adventure games. Which means that every student body, housing complex, and workplace could prepare for the public health and sociological implications of an outbreak.
The Epidemic Intelligence Service (EIS) program was started during the Cold War to create a group of people who could be quickly deployed to halt outbreaks such as those from, for example, biological weapons. When a health department requests urgent help from the US Centers for Disease Control and Prevention (CDC), at least one EIS officer and/or other subject-matter experts travel to the front line.
Since the beginning of the year, more than 40 per cent of new cases are people who died of Ebola in the communities. At the epicenter of the epidemic, in Katwa and Butembo, 43 per cent of patients in the last three weeks were still being infected without known links to other cases.