Second outbreak of Ebola virus disease in Democratic Republic of Congo

77

Following the announcement of the end of the Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo (DRC) on 24 July 2018 (see WHO press release: http://www.who.int/news-room/detail/24-07-2018-ebola-outbreak-in-drc-ends-who-calls-for-international-efforts-to-stop-other-deadly-outbreaks-in-the-country), the Health Ministry of the DRC announced a second outbreak of EVD within its borders on 1 August 2018 (see WHO website: http://www.who.int/ebola/en/ and http://apps.who.int/iris/bitstream/handle/10665/274306/SITREP_EVD_DRC_20180904-eng.pdf?ua=1).

By 4 September, total of 129 cases of hemorrhagic fever have been identified, of which 89 had a fatal outcome. Laboratory testing confirmed EVD for 98 of the cases investigated, with 31 cases remaining probable (i.e. not laboratory confirmed).  Sixteen of these cases were reported in healthcare workers. The numbers of cases will continue to fluctuate in coming days as the investigation continues to confirm and discount cases. The cases have been reported from the health zones of the North Kivu and Ituri Provinces, located towards the eastern border of the DRC. This is a remote and conflicted location in the DRC, located more than 3000 Km from the capital Kinshasa (https://www.afro.who.int/news/who-calls-free-and-secure-access-responding-ebola-outbreak-democratic-republic-congo). The Mabalako Health Zone, North Kivu Province remains the epi-center of the outbreak, reporting more than 70 % of cases to date. Containment efforts, including vaccination and strengthening of cross-border surveillance, have been mobilized (http://apps.who.int/iris/bitstream/handle/10665/274306/SITREP_EVD_DRC_20180904-eng.pdf?ua=1), with the current reporting of new cases showing a downward trend. A total of five experimental therapeutics have been approved for emergency use in DRC for EVD affected patients  (http://apps.who.int/iris/bitstream/handle/10665/274306/SITREP_EVD_DRC_20180904-eng.pdf?ua=1).

Genomic sequencing analysis of outbreak samples have indicated the involvement of the Ebola virus Zaire strain in this outbreak. The previous outbreak in the Equateur Province also involved the Zaire strain, but the two outbreaks are unrelated.

According to the WHO situation report dated 4 September, there are no confirmed cases of cross-border spread associated with this outbreak. WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. WHO continues to monitor travel and trade measures in relation to this event. The regulations for evidence of a valid yellow fever vaccination certificate apply. Precautions against malaria should be applied as per routine practice. Malaria must be considered a high priority in the investigation and management of any febrile traveler.

Follow these links to read more about EVD:

National Institute for Communicable Diseases: http://www.nicd.ac.za/index.php/ebola-virus-disease/

World Health Organization, Ebola virus disease webpage: http://www.who.int/ebola/en/.

World Health Organization, Ebola frequently asked questions: http://www.who.int/csr/disease/ebola/faq-ebola/en/

World Health Organization, Ebola vaccines frequently asked questions: http://www.who.int/ebola/drc-2018/faq-vaccine/en/