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Ebola Outbreak Continues in Kikwit; Further Spread Feared

By Bob Drogin
Los Angeles Times

Anxious health officials warned Monday that an outbreak of incurable Ebola disease is still raging near the town of Kikwit, and that two "suspected" cases of the deadly virus have now been found here in the crowded capital.

Abdelhalim Senouci, head of the international federation of International Red Cross societies in Africa, said "the situation is still not stable," in Kikwit.

Although figures on the caseload vary, most of the dozens of confirmed cases of Ebola have been found in Kikwit, where, "It is very, very bad," Senouci warned.

He said three Zairian doctors returning to Kinshasa from Kikwit had been placed under a 28-day medical quarantine as a precautionary measure. "They were working in the field," he explained.

In addition, Dr. Lonyangela Bopenda, Zaire's secretary general of health, announced that two people who traveled from Kikwit to Kinshasa, a city of at least 4 million people, may now have the disease.

But he insisted there was no immediate cause for alarm. "We have two suspected cases," he said. "We have no certainty."

One patient, a nurse, was under observation in a Kinshasa hospital. But the other, a river boat captain, has disappeared since his discharge from a clinic where he was treated for acute diarrhea. Doctors now suspect Ebola was the cause.

"They're looking for him now," said Sammy Chumfong, a spokesman for the World Health Organization here.

Chumfong said WHO doctors and scientists are satisfied, for now, that the virus still appears to be largely localized around Kikwit and is unlikely to spread enough to become a full-blown epidemic. "It hasn't spread (widely) outside the containment area," he said. "We're happy with that."

The Red Cross, however, has launched a public education campaign in the capital. It began printing for distribution 10,000 pamphlets.

The pamphlets, printed in four local languages, use simple drawings to explain how the Ebola virus is transmitted by blood, sperm or other bodily fluids, and how to recognize its symptoms.

The virus causes severe headache, fever, vomiting and bloody diarrhea. In nine out of 10 cases, it attacks the body so relentlessly that death comes within days from massive bleeding of major internal organs. There is no vaccine or cure.

In Geneva, the WHO reported it has confirmation of 17 new Ebola deaths, along with four new cases of Ebola, all of them in Kikwit, the city east of Kinshasa where the outbreak began in March, said agency spokesman Richard Leclair.

That brought the total of confirmed cases to 84. Of those, 77 have died, including a fourth Italian nun who was caring for Ebola patients at Kikwit General Hospital.

The WHO said it expects a sharp increase in Ebola cases in the coming weeks. Monday's report was more pessimistic than previously, when WHO officials said they were optimistic about controlling the epidemic.

"WHO experts expect a significant increase in cases during the next two to three weeks among people who are incubating the disease having been exposed to it in the care of relatives or neighbors," Leclair said.

He said the WHO still hopes that improved information about Ebola would eventually contain the spread of the disease. "In two or three weeks we will have higher numbers but from that point it should start going down quite rapidly, but we have no way of guaranteeing it," he said.

Earlier Moday, WHO spokesman Thomson Prentice said in Geneva that, even if Ebola were confirmed in the Zairian capital, that wouldn't represent an acceleration of the epidemic.

"It would not be a great surprise if one case or more than one case occurred in Kinshasa," he said, adding: "It doesn't follow that more people will get infected because transmission is quite difficult."