The DRC has improved testing capacity for Ebola with two facilities operating in or near the epicenter. But this still may not be enough to keep up with a rapidly expanding disease.
The DRC has improved testing capacity for Ebola with two facilities operating in or near the epicenter. But this still may not be enough to keep up with a rapidly expanding disease.
Sophia Mulei, a laboratory technologist, works with a control sample inside the Viral Hemorrhagic Fever Laboratory at Uganda Virus Research Institute in Entebbe, Uganda. The lab is one of the primary centers for the testing of Ebola samples. Health officials in the Democratic Republic of Congo began worrying about possible Ebola cases in mid-April. Deaths in the northeastern part of the country that seemed like they may have been caused by the deadly virus prompted officials to take samples.
They then sent them to the lab in Bunia. , general director of INRB, DRC's national biomedical research center. The lab ran the samples on GeneXpert, a machine that automates the process of detecting specific bits of viral DNA. The results came back negative for Ebola.
So did more samples a couple of weeks later. The problem was that GeneXpert, the machine that forms the backbone of DRC's Ebola surveillance, couldn't detect the rare species that was circulating, says Muyembe. So it was mid-May before officials rang the alarm bell andallowed the outbreak to grow into one of the largest Ebola outbreaks ever. Suspected cases ballooned to over 1,100 as labs struggled to keep up with incoming samples.
"The initial response has been pretty significantly hampered by the lack of appropriate diagnostics on the ground," says Caia Dominicus, senior technical adviser for the independent non-profit. If officials can't test in a timely manner, they can't get patients to isolate and prevent the virus from spreading, she says.
"Diagnostic capacity has improved significantly from where we were three and a half weeks ago," says Abdirahman Mahamud, who directs health emergency alert and response operations at the World Health Organization. The backlog of cases has mostly disappeared, but he warns current testing capacity is not enough to keep up with an outbreak that the U.S. Centers for Disease Control and Prevention projects "We are very much aware we are still behind the curve," says Mahamud.
"If transmission continues, both geographically, or the case load increases, we will require additional surge. "One big reason testing capacity has improved to date is a machine called RADI-One. It's a device that can detect Bundibugyo in patient samples, and requires less training and equipment than typical lab-based testing.
That ease of use allows it to be deployed in smaller clinics that are closer to the outbreak, includingCurrently, seven labs — and one mobile lab — are able to process tests across northeastern DRC. Larger labs, like the one in Bunia, can currently process over 100 samples per day, according to a laboratory technician. The technician requested that NPR not use their name due to fears of losing the job for speaking to the media without authorization.
"Right now, we really don't have a backlog and the samples that arrive are analyzed right away and the turnaround time is basically one to twelve hours," says the technician. Yap Boum, a senior official at Africa CDC, said on a press call Wednesday that Africa CDC is working with WHO and DRC health officials to have 50 RADI-One testing machines by the end of June. More will likely be needed, says Dominicus, and"there just aren't that many machines available.
" WHO and Africa CDC are in talks with the small South Korean manufacturer, KH Medical, to get more, but that'll take time. There are other tests that could be deployed, but they would need to be validated first, she says, and"they're not the traditional systems that have been used, so there's a necessity to train staff.
""Sample transport is a major bottleneck. It can take days, some areas are almost completely inaccessible," says Dominicus. Add in ongoing conflict, population displacement and community mistrust make for"a much more difficult diagnostics situation," she says.. A pinprick of blood placed on a thin strip of paper could give results in minutes as opposed to hours or days.
"The faster you detect someone's positive, the faster you can actually isolate them and stop them from spreading it onwards," saysRapid tests are less sensitive than lab-based tests, meaning they're more likely to miss positive cases. But they could still play a key role in better understanding the true scope of the outbreak and reining it in.
"We need to have a rapid test for the community," says Muyembe. In addition to testing the living, Muyembe says rapid tests could screen the dead, too. Burials in DRC often involve community members touching the deceased, whichDespite that need, there are no rapid tests approved for Bundibugyo.
There are several designed for more common species of Ebola which, a global health physician who advised Guinea on the 2014 Ebola outbreak thinks it's worth it, as developing therapeutics or "Validating or having some sense of its performance characteristics could be done relatively quickly," he says. Patient samples coming into labs for traditional testing could be simultaneously evaluated on these rapid tests, he says, to see how they compare.
Scaling up both lab-based and rapid tests will take significant investment. Often diagnostics are overlooked, compared with vaccines or therapeutics, says Dominicus, of IPPS.
"It's underfunded, but they give us the information we need to make key decisions," she says. "Without them we're flying blind. " Bundibugyo is rare, but not unheard of. If appropriate diagnostics had been in place before this outbreak, Dominicus says it may not have gotten so bad. "That delay in diagnostic ability set the response back. "
Please follow us on Google to support usUnited States Latest News, United States Headlines
Similar News: You can also read news stories similar to this one that we have collected from other news sources.
US urges Europe to impose Ebola travel bans ahead of World CupThe Trump administration has called on European nations to follow Washington's lead and impose travel restrictions on people who have recently been in Central African countries affected by the Ebola outbreak.
Read more »
US Urges Europe to Impose Ebola Travel Restrictions Amid World Cup ConcernsThe Trump administration is pressing European Union nations to implement travel bans on visitors from Ebola-affected regions in Africa, citing the upcoming FIFA World Cup as a key factor. While the US has already enforced quarantine measures, European officials and the WHO caution against such restrictions, arguing they are ineffective and could worsen the outbreak by hindering collaboration.
Read more »
US Presses Europe to Adopt Stricter Travel Restrictions Amid Ebola OutbreakThe Trump administration is urging European nations to implement tougher travel restrictions from Ebola-affected regions, with Secretary of State Marco Rubio directly appealing to the European Commission president. The US warns that without action, trans-Atlantic travel could be affected, as Europe handles most direct flights from Africa. The plea comes amid a deadly outbreak in Congo and scrutiny over US health aid cuts.
Read more »
Ebola testing has improved in DRC, but still isn't nearly enoughThe DRC has improved testing capacity for Ebola, with two facilities operating in or near the epicenter. But this still may not be enough to keep up with a rapidly expanding disease.
Read more »