By Deng Machol
Juba – The Ministry of Health of South Sudan has begun vaccinating health workers and other front-line responders against Ebola as part of preparedness measures to fight the spread of the deadly – disease.
South Sudan Health Ministry started it with support from the World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF and the US Centers for Disease Control and Prevention (CDC) and other partners.
“The Ministry of Health (MoH) would like to inform the general public that, South Sudan will kick start the Ebola vaccination exercises for selected healthcare and frontline workers who are operating in high risk areas, most of which border the Democratic Republic of Congo (DRC) against Ebola virus disease (EVD) as part of national preparedness efforts,” Dr. Riek Gai Kok, South Sudan Health Minister. The vaccination is to protect healthcare and frontline workers who are at high risk of contracting Ebola in case of an outbreak.”
The vaccination began in Yambio, Gbudue State, western part of the country but will be extended to other health workers in Tombura, Yei and Nimule as well as the capital city, Juba. These are high-risk areas bordering the Democratic Republic of the Congo (DRC), now experiencing its tenth outbreak of Ebola.
The outbreak began 1 August 2018. Neighbouring countries have not reported any cases of Ebola, but preparedness is crucial.
As part of these preparedness activities, South Sudan received 2 160 doses of the Ebola vaccine (rVSV-ZEBOV) from Merck, the vaccine developer. The vaccine offers protection against the Zaire strain of the virus, which is the one affecting DRC at present.
“It is absolutely vital that we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “WHO is investing a huge amount of resources into preventing Ebola from spreading outside DRC and helping governments ramp up their readiness to respond should any country have a positive case of Ebola.”
Vaccination is one of a raft of preparedness measures South Sudan is putting into place. WHO has deployed more than 30 staff members to support these activities.
The WHO has helped train 60 health workers in good clinical practice principles and protocol procedures to administer the yet-to-be-licensed Ebola vaccine. To detect any travellers entering the country who may be infected with the virus.
However, the Ministry of Health, with the support of its partners, has established 17 screening points. Nearly 1 million people have been screened to date.
The WHO is also supporting engagement with communities, active surveillance for the disease at the community and health facility levels, strengthening capacity for infection prevention and control and case management, and supporting dissemination of Ebola information through the media. Local laboratory capacity to test samples taken from people suspected of having Ebola is also being strengthened. Protective gear for responders has been stockpiled in a dedicated warehouse.
Gavi, the Vaccine Alliance, in addition to its work making the Ebola vaccine stockpile available, is providing US$2 million to support the WHO’s vaccination efforts in countries neighbouring the DRC, including South Sudan.
“Although research is ongoing, the evidence so far suggests the Ebola vaccine is a highly effective tool to help stop epidemics and can be used to prevent this national outbreak from becoming a regional one,” said Dr Seth Berkley, CEO of Gavi. “Vaccinating front-line workers and health workers in South Sudan border regions will be crucial: an outbreak in South Sudan would be deeply concerning.”
Uganda began vaccinating its front-line workers in November 2018. So far, more than 2 600 health workers in eight high-risk districts have been immunized. In DRC, more than 66 000 people have been vaccinated – more than 21,000 of them are health and other front-line workers. Rwanda also plans to vaccinate its front-line responders.
The yet-to-be-licensed rVSV-ZEBOV vaccine has been shown to be highly protective against the Zaire strain of the Ebola virus in a major trial.
Though not yet commercially licensed, the vaccine is being provided under what is known as “compassionate use” in the ongoing Ebola outbreak in North Kivu province of DRC as part of recommendations from the Strategic Advisory Group of Experts on Immunization. This vaccine was also used in the Ebola outbreak in Equateur province of DRC in May–July 2018.
Ebola Virus Disease transmission in DRC continues in North Kivu and Ituri provinces. Butembo and Katwa are the current hot spots and represent 65% of new confirmed cases in the past 21 days. As of 25 January 2019, a total of 724 Ebola cases, including 451 deaths, have been reported from the DRC – an immediate neighbour of South Sudan. Of these, 57 cases occurred among health workers.
There are no confirmed cases of Ebola in South Sudan. But, South Sudan is at particularly high risk of imported cases due to the cross-border movement of people and goods, hence protecting frontline and health care workers from getting infected with Ebola is the highest priority for the
Ministry of Health in South Sudan.
The vaccination exercise is part of the on-going efforts of the Ministry of Health and partners including the World Health Organization (WHO), and partners to strengthen the country’s preparedness capacities and mitigate the risk of EVD importation from the raging outbreak in DRC.