Ebola patients slip out of Congo hospital as medics try to curb outbreak

MBANDAKA, Democratic Republic of Congo, May 23 (Reuters) - Three patients infected with the Ebola virus slipped out of an isolation ward at a hospital in Democratic Republic of Congo, health officials said, as medics raced to stop the deadly disease from spreading in the busy river port of Mbandaka.

The cases represent a setback to costly efforts to contain the virus, including the use of an experimental vaccine, and show efforts to stem its spread can be hampered by age-old customs or skepticism about the threat it poses.

Two patients left the hospital in Mbandaka on Monday night with the help of family members, then headed to a church, the World Health Organization's spokesman in Congo, Eugene Kabambi, told Reuters.

One died at home the next day and was buried with the help of medical charity Medecins Sans Frontieres (MSF). The other was sent back to hospital and died that night, Kabambi said.

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Children attend a class session at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka
A World Health Organization (WHO) worker prepares to administer a vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe
Congolese Health Ministry officials arrange the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe TPX IMAGES OF THE DAY
A teacher leads a class at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
A Congolese child washes her hands as a preventive measure against Ebola at the Church of Christ in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe
Equipment and apparatus are seen inside the laboratory of the National Institute for Biomedical Research (INRB) in Kinshasa, Democratic Republic of Congo May 18, 2018. REUTERS/Kenny Katombe
A World Health Organization (WHO) worker administers a vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe
A vendor calls for clients as she holds smoked monkey meat and a variety of bush meat at an open-air market during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
Equipment and apparatus are seen inside the laboratory of the National Institute for Biomedical Research (INRB) in Kinshasa, Democratic Republic of Congo May 18, 2018. REUTERS/Kenny Katombe
A child attends a class at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
A Congolese health worker checks the temperature of passengers disembarking from a Congo Airways plane in Mbandaka, Democratic Republic of Congo May 19, 2018. REUTERS/Kenny Katombe
Congolese women row their boats on the Congo River during the vaccination campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 22, 2018. REUTERS/Kenny Katombe
Equipment and apparatus are seen inside the laboratory of the National Institute for Biomedical Research in Kinshasa, Democratic Republic of Congo May 18, 2018. REUTERS/Kenny Katombe
World Health Organization (WHO) workers prepare a centre for vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe
A World Health Organization (WHO) worker prepares to administer a vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe
Children attend a class at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
A general view shows equipment and apparatus inside the laboratory of the National Institute for Biomedical Research (INRB) in Kinshasa, Democratic Republic of Congo May 18, 2018. REUTERS/Kenny Katombe
Patients seeking medical attention sit at the health centre in the commune of Wangata, during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
People and traffic are seen along a street in Ngaba commune of Kinshasa, Democratic Republic of Congo May 18, 2018. REUTERS/Kenny Katombe
Medical workers are seen at the health centre in the commune of Wangata during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
A Congolese health worker instructs residents about washing their hands as a preventive measure against Ebola in Mbandaka, Democratic Republic of Congo May 19, 2018. REUTERS/Kenny Katombe
Children attend a class at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
A laboratory worker uses a microscope at the health centre in the commune of Wangata during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of Congo, May 23, 2018. REUTERS/Kenny Katombe
Congolese women row their boats on the Congo River during the vaccination campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 22, 2018. REUTERS/Kenny Katombe
Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe
A Congolese woman carries a snake for food at the shores of the Congo River during the vaccination campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 22, 2018. REUTERS/Kenny Katombe
A Congolese health worker records medical data of passengers at the airport in Mbandaka, Democratic Republic of Congo May 19, 2018. REUTERS/Kenny Katombe
World Health Organization (WHO) medical supplies to combat the Ebola virus are seen packed in crates at the airport in Mbandaka, Democratic Republic of Congo May 19, 2018. REUTERS/Kenny Katombe
A Congolese man washes his hands as a preventive measure against Ebola in Mbandaka, Democratic Republic of Congo May 19, 2018. REUTERS/Kenny Katombe
Packaged Ebola-response materials wait to be transported to the Democratic Republic of Congo in this May 16, 2018 picture obtained from social media video, in Brussels, Belgium. DOCTORS WITHOUT BORDERS/MEDECINS SANS FRONTIERES (MSF)/via REUTERS ATTENTION EDITORS - THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY. MANDATORY CREDIT.
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Health Ministry sources, who asked not to be named, said two police officers had been deployed to help track them down.

Another patient who was close to being discharged left on Sunday evening but was later found, Kabambi said.

The WHO and MSF said they could not force patients to stay in hospital but hoped that growing awareness of the disease and its risks would convince people to follow medical advice.

"This is a hospital. It's not a prison. We can't lock everything," Henry Gray, the head of the MSF mission in Mbandaka, told Reuters.

WHO spokesman Tarik Jasarevic said health workers had redoubled efforts to trace contacts with the patients. Health workers have drawn up a list of 628 people who have had contact with known cases who will need to be vaccinated.

"It is unfortunate but not unexpected," he said. "It is normal for people to want the loved ones to be at home during what could be the last moments of life."

The report came as another WHO official warned that the fight to stop Democratic Republic of Congo's ninth confirmed outbreak of Ebola had reached a critical point.

"The next few weeks will really tell if this outbreak is going to expand to urban areas or if we’re going to be able to keep it under control," WHO's emergency response chief, Peter Salama, said at the U.N. body's annual assembly. "We’re on the epidemiological knife edge of this response."

KINSHASA FEARS

Health officials are particularly concerned by the disease's presence in Mbandaka, a crowded trading hub upstream from the capital Kinshasa, a city of 10 million people. The river runs along the border with the Republic of Congo.

The WHO said health officials received an alert on Wednesday from Kinshasa's main hospital, but the health ministry said later that it was a false alarm.

The outbreak, first spotted near the town of Bikoro, about 60 miles south of Mbandaka, is believed to have killed at least 27 people so far.

The WHO said health workers were following up on three separate transmission chains for cases in Mbandaka's Wangata neighborhood - one linked to a funeral, one to a church and another to a rural health facility.

There is no proven treatment for Ebola but Congolese authorities have asked the U.S. National Institute of Allergy and Infectious Diseases (NIAID) to test an experimental treatment, an antibody called mAb114, NIAID Director Anthony Fauci told Reuters on Wednesday.

Fauci said mAb114, which is made from the antibodies of a survivor of a 1995 Ebola outbreak in Congo, is promising because it comes in crystallized form and does not need to be kept cold.

The WHO is also in talks with the Kinshasa government to get its approval to use Mapp Biopharmaceutical's experimental ZMapp treatment.

A health ministry spokeswoman said any experimental treatments would first require approval by an ethics panel at Kinshasa University.

The disease was first discovered in Congo in the 1970s. It is spread through direct contact with body fluids from an infected person, who suffers severe bouts of vomiting and diarrhea.

More than 11,300 people died in an Ebola outbreak in the West African countries of Guinea, Liberia and Sierra Leone between 2013 and 2016.

(Additional reporting by Tom Miles and Stephanie Ulmer-Nebehay in Geneva, Julie Steenhuysen in Chicago and Aaron Ross in Dakar; writing by Joe Bavier and Aaron Ross; editing by Janet Lawrence and Mark Heinrich)

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