Because a the end of the Ebola epidemic is not in sight, calls for Doctors without borders, a new vaccination strategy by the WHO. What is the dispute?
Painstaking containment attempt: A relief team care for an Ebola patient in Beni
The circumstances under which the Doctors and their helpers in combat currently in the Democratic Republic of the Congo, the virus disease, Ebola, are much more complicated than in the first worldwide Ebola epidemic, 2013, in West Africa. Because in addition to the medical plight of a citizen prevails in Parts of the Congo war.
Compared with the disastrous first epidemic, the current outbreak has progressed, with over 2000 dead less dramatic. In 2013, there were more than 11,000 deaths. Responsible for this decline, the victims of the vaccines, there are now numbers.
During the first major epidemic in Liberia, Sierra Leone and the ivory coast of the pharmaceutical group Merck had developed under high pressure into a vaccine. This came just too late for the current outbreak in the Congo, however, he was able to make its effectiveness very good proof.
Reserves retention is good, but how much is too much?
However, the vaccine is not available in unlimited quantities. A few hundred thousand doses of the vaccine, perhaps even significantly more than one Million – can restore the company Merck in the foreseeable future. Foreseeable – that is to say: you are at the latest available next year.
So far, more than 200,000 people were vaccinated in the Congo, and again so many doses of the vaccine, Merck has also in stock. How much vaccine, but the Doctors in the Congo is shipped and where it is used in the world wakes health organization (WHO).
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WHO spokesman Christian Lindmeier said Ring-vaccinations have proved successful.
And WHO thinks strategically: Alone in the Congo, 80 million people live. Add to this the very real risk that the disease could also skip to neighbouring countries – and in particular its million cities.
So the vaccine target needs to be used carefully. “This happens after a strategy has been clarified by an independent panel of experts, the Strategic Advisory Group of Experts (SAGE), and explained,” says the WHO spokesman, Christian Lindmeier, in an interview with Deutsche Welle. “It is applied to a so-called Ring vaccination.”
Therefore, vaccination of an Infected or probably infected Person initially, the first Ring. These are the people to whom the Patient has direct contact. “This can represent a family of up to 100 people,” says Lindmeier.
Next, all vaccinated, the had to the contact persons of the first ring contact are then. “So we quickly get into the hundreds or even thousands of people. This strategy has proved to be very helpful and useful in the environment,” says the WHO spokesman.
Tedious search for contact persons
However, it is not so easy to find all of the contact people quickly, with whom an Infected person had contact. So what to do if the Patient was on a market?
“These rings are placed the same way, no matter whether it is on a market, in a Church, in a Bus or on a motorcycle. Or just in your own family,” says Lindmeier. “This is where this quite extreme, tedious work begins, but more than 90 percent successful.”
It is a tough work. Approximately 1600 employees of the Congolese health service are constantly contact people to find out and check who needs a vaccination.
Add to this the 5000 colleagues in 200 Teams that constantly have the Ebola Situation and also all of the suspected cases in the view. Alone in the last week of September, the Teams have observed more than 12,000 people who are considered to be suspected cases. With the majority of the Ebola-guard talk every day.
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6500 helpers are busy with the search and care of Ebola patients and their contact persons.
Doctors without borders: The Evil resolutely combat
Yes, it is tiresome, I have to say Natalie Roberts of Doctors without borders, your WHO colleagues – so hard that the WHO and all the Ebola-fighting aid organisations involved should agree on a new strategy, says Roberts. Because, according to your estimate, will often be found approximately half of the contact people never.
The fact that it always comes back to outbreaks, even in areas that Ebola was actually free – not to show that the Ring strategy is working, says Roberts.
Your Council: WHO should generally be more generous with the output of the vaccinations and not only for those vaccinated, the contact person rings. So should be vaccinated after an outbreak of Ebola, even better, all the villages or all the people in a particular Region.
“The regulation is applied very restrictively. The doses of the vaccine will not be released until a certain number of people on the contact list, waiting for their vaccination,” says Roberts. “That makes it very hard to make the vaccination more accessible to people, because the issue in front of the place is handled with restraint.”
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Doctor without borders of Natalie Roberts calls for more people to be vaccinated in the affected areas.
Regional vaccination campaigns instead of ring system
Roberts argues that the disease could be better to contain it, when inoculated promptly, generously, as if one is very keen to keep vaccination reserves in the rear, for an even more severe outbreak prepared.
“There is an effective vaccine, but which is rationed,” says Roberts. “The Argument is: Maybe we need the vaccine later. But how can you tell when this point is reached, when we are in the middle of the second most serious epidemic of Ebola? They reached the already huge urban areas, such as Butembo and Beni. These are big cities. Nevertheless, vaccination is used to stop the spread of the epidemic.”
The Physician compares the medical doctor in the Congo, with firefighters: “it is as would you try to extinguish a fire by pouring out every day a glass of water.”
Your recommendation: “If you want to stop the epidemic really and prevent a larger epidemic, the cities reached, we Kinshasa and Goma, we have to use the available doses of the vaccine now, so that the epidemic spread before.”
More: Doctors without borders: “Almost every sixth Ebola-Infected under five”
Vaccination is the most effective weapon against the deadly Virus. But there are only enough doses for directly affected.
Hope for the second vaccine
The WHO maintains, however, was little more than a vaccination strategy. The vaccine from Merck to stay for those reserved, which are acutely exposed to the most. A reason for this: The vaccine produces very quickly an immune response against Ebola, and can therefore help people in areas where it has just a short time before cases of the disease are given.
The WHO also refers to a logistic disadvantage of the Merck vaccine: It needs to be cooled during storage and Transport of extremely strong down to -60 to -79 degrees Celsius. Also it makes it difficult for the vaccine to be used in regular doctor’s offices or to keep dispensaries out of stock.
But now there is hope that regular Physicians get access to a vaccine: The company Johnson & Johnson has developed a promising vaccine that only needs to be up to -20 degrees cooled. Starting in mid-October, the new vaccine could be in the Congo – as a Phase III study, the last stage of the admission procedure. In numerous Phase II studies, he showed a good immune response in the subject.
About 1.5 million doses of the vaccine are already available and the vaccine may apparently be produced faster than the previous Merck vaccine. The aid organization Doctors without borders is part of the consortium that will test the vaccine in the Congo.
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Ebola – fear of faster spreadFirst infections in the city
The message of the first Ebola cases in the city of Goma in the East of the Democratic Republic of the Congo is disturbing. In densely populated areas, it falls to the deadly Virus especially easy to spread rapidly. Women and children are particularly vulnerable; weak organisms are more susceptible to infection with Ebola.
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Ebola – fear of faster spreadCross-Border Risk
Ebola is highly contagious, makes any national borders. So the concern that the spread of the deadly virus in Rwanda, its geographical proximity to Goma because of the particularly large. Briefly, therefore, the border crossing was closed. Uganda has been affected: In the neighboring country of Congo, the first people are also sick.
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Ebola – fear of faster spreadWar and poor infrastructure
Medical assistants to go to their limits, the spread of the virus to contain, and provide for the Sick. The tense political situation and armed conflicts in some regions of the Republic, however, hinder the fight against Ebola for aid workers. But also the poor infrastructure and the distrust of the population exacerbate the crisis.
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Ebola – fear of faster spreadThe first symptoms
The first symptoms of the Ebola-Infected high fever, head and body aches – are similar to those of a flu. In the course of the disease, internal bleeding and organ failure – the result: the death of the patient. A person is infected, are limited treatment options. In order to protect the fellow human beings, appeal to the authorities to the population: report, don’t hide!
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Ebola – fear of faster spreadVaccination is the only protection
Since 2015, there is a vaccine that is supposed to have according to the WHO assessments a “nearly exact” effect. However, large parts of the population of the vaccination distrust, some even believe that the disease was a staging of the government, to get donations. Also, transportation is difficult, because the cooling chain of -80 degrees Celsius may be interrupted at any time.
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Ebola – fear of faster spreadVaccinate – and more
Organizations and volunteers are working at full speed to be faster than the Virus. Their prevention work goes far beyond the to Vaccinate in addition. In addition to the Distribute of protective suits and gloves is also training medical professionals and educating about the ways of Contracting as well as correct Hygiene is essential.
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Ebola – fear of faster spreadDuty to Act
Flowers for the dead: In West Africa, over 11,000 people lost 2014 and 2015, the fight against the deadly Virus. The Ebola outbreak in the Congo is the worst after the epidemic in West Africa – more than 1800 people lost since 2018 your life. Red alert: Now quick Action from politicians, Doctors and experts is in demand.
Different vaccines – other applications
But the new vaccine from Johnson & Johnson has a drawback: It must be administered in two doses. Between the two vaccinations, 56 days apart are. Only after the second immunization, it is protected against Ebola. Therefore, the new vaccine is particularly suitable for the prevention.
“Can not be used in an Outbreak, immediately used, if we need to reach within days, immediately an immunization,” said Christian Lindmeier of the world health organization. “This vaccine would be better suited to vaccinate in more remote regions, where infections are perhaps possible, people who have a lot of contacts – for example, staff in health centers. The vaccine is sure to be an excellent additional weapon against Ebola.”
Effective means to fight against the dangerous Virus, so there is quite. The current dispute about the correct vaccination strategy is likely, if the manufacturers continue their production in the coming months is high and the number of Reserve available doses is on the rise.
At the end of the other big hurdle remains, however, for the Doctors and the many helpers on site: Due to the dangerous security situation they can’t reach their patients often.
More: prick and immune? That’s how vaccines work
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No Chance for viruses and bacteria with a strong immune systemThe Hustle And Bustle!
The immune system needs many different fuels. Fruits and vegetables provide you. They feed as colorful: oranges, red peppers, green leafy vegetables, red cabbage provide a colorful Potpourri of vitamins and a great natural source of Vitamin C.
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No Chance for viruses and bacteria with a strong immune systemVaccination status check!
In order to bring the immune system up to the current state, you should have all the necessary vaccinations. Adults often forget the vaccinations from the Kinfheit refresh. So in the certificate of vaccination look: Is the immunization against Tetanus, diphtheria, whooping cough, Polio, Hepatitis, pneumococcal, Meningitis, measles, Mumps, rubella, influenza and other still in place? Best to ask the doctor!
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No Chance for viruses and bacteria with a strong immune systemThe viruses run away.
Scientific studies suggest that a regular exercise of the muscles (Jogging, Nordic Walking, go for a walk) starting at three times a week for 20 minutes, the defense is demonstrably increases. But beware: if you auspowert too much, exhausted immune system.
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No Chance for viruses and bacteria with a strong immune systemStrongly sleep!
Adequate sleep not only ensures recovery. During the deep stages of sleep, neurotransmitters are released, which mobilise the immune system.
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No Chance for viruses and bacteria with a strong immune systemHave fun!
Studies show that good mood and fun favor for life a strong immune system. Laugh and Play not bring more quality of life, but increase defenses!
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No Chance for viruses and bacteria with a strong immune systemAvoid Stress!
Negative Stress stimulates the release of adrenaline and Cortisol. These hormones shut down the immune. A conscious Stress and time management contributes to the fact that the body comes to rest and new energy can refuel. Targeted relaxation exercises such as Meditation, autogenic Training, and Yoga can support the immune system significantly.
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No Chance for viruses and bacteria with a strong immune systemGo for a walk!
Walks in the fresh air with changing temperature stimuli and movement – both of which stimulates the body’s defenses. In addition, the mucous membranes benefit from better blood circulation, thanks to the higher humidity you with virus attacks to make you feel better.
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No Chance for viruses and bacteria with a strong immune systemBeware Of Sugar!
Studies have shown that Burning short-chain sugars, many vitamins are not consumed, the body then available.
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No Chance for viruses and bacteria with a strong immune systemHot and Cold!
“Exchange-showers” train the thermoregulation and the blood vessels. Warm-cold-warm-cold is the motto. You can support the shower by a vigorous Massage with a Massage sponge or a brush This stimulates the immune system in addition.