Ebola virus disease – Democratic Republic of the Congo

From January 29 to February 4, four new confirmed cases of the current Ebola Outbreak (EVD) in the Democratic Republic of Congo have been reported. All four cases were reported in the Beni Health Zone, North Kivu Province. Three cases had epidemiological links with the transmission chain originating from Aloya Health Area, Mabalako Health Zone, and their most likely exposure was nosocomial infection in traditional physician facilities. The fourth and most recent case reported at Beni Health Zone at the time of the detection was unknown contact, remained in the community for nine days after the onset of symptoms and passed away in the community on February 4. Confirmed cases of community time increase the risk of EVDs being transferred to contacts.

In the past 21 days (15 January to 4 February 2020), 18 confirmed cases have been reported, including three community deaths from three health areas within two active health zones in North Kivu province (Figure 1, Figure 2. table 1): Beni (n= 17) and Mabalako (n= 1). The geographic spread of EVD cases and the declining trend of cases occurring over the past 21 days is encouraging. In addition, monthly surveillance indicators have generally improved since October 2019. These indicators include an increase in the proportion of cases registered as contacts, a decrease in the proportion of community fatalities among newly reported cases, a reduction in delays to isolation, and a decrease in the monthly case fatality rate.

These improvements are fragile and should not be interpreted as indicating that response efforts can be reduced. Among 18 people who have been confirmed with EVD in the past 21 days, nine cases were isolated and cared for three or more days after the onset of symptoms, increasing the possibility of transmission from the community. The four most recent cases reported in the Beni Health Zone in the past seven days were not monitored at the time of detection. Increased vigilance of reactions is therefore critical, including continuous identification of cases and contacts, monitoring of contacts, and continued improvement of infection prevention and control in healthcare settings.

As of February 4, a total of 3429 EVD cases were reported, including 3306 confirmed and 123 probable cases, of which 2251 cases died (66% overall case fatality rate) (Table 1). Of the total confirmed and probable cases, 56% (n= 1920) were women, 28% (n= 967) were children under the age of 18 and 5% (n= 172) of all reported cases were healthcare professionals.

Figure 1: Confirmed and probable cases of Ebola disease by weeks of onset of disease by health field. Data as of February 4, 2020 *

*3429 confirmed and probable cases, reported on February 4, 2020. Excludes n = 169 cases for which start dates have not been reported. Data in recent weeks is subject to delays in confirmation and reporting, as well as ongoing data cleanup. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kayna, Command, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Mutwanga, Mwenga, Nyakunde, Nyiragongo, Oicha, Pinga, Rwampara, Vuvi, Thoomu , Tchomia

Figure 2: Confirmed and probable cases of Ebola virus disease by weeks of disease onset by health field. Data as of February 4, 2020 *

Table 1: Confirmed and probable cases of Ebola disease and number of affected health areas by health zone, North Kivu, Democratic Republic of the Congo, data as of 4 February 2020 **

**The total cases and areas affected during the last 21 days are based on the initial alert date of the case and may differ from the date of confirmation and daily report of the Ministry of Health.

Public health response

For further information on the public health response activities of the Ministry of Health, WHO and partners, see the latest status reports published by the WHO Regional Office for Africa:

WHO risk assessment

WHO continually monitors changes in the epidemiological situation and outbreak context to ensure that response support is adapted to evolving circumstances. The latest assessment concluded that national and regional risk levels are still very high, while global risk levels are still low.

Tip of WHO

WHO advises against any restrictions on travel to and trade with the Democratic Republic of the Congo, based on currently available information. All applications for Ebola vaccination certificates are not a reasonable basis for restricting movement across borders or issuing visas to travelers to / from affected countries. WHO continues to closely monitor and, if necessary, review travel and trade measures regarding this event. At present, no country has implemented travel measures that significantly impede international traffic to and from the Democratic Republic of the Congo. Travelers should seek medical attention before traveling and should be based on good hygiene. More information is available at WHO recommendations for international traffic related to the Ebola epidemic in the Democratic Republic of the Congo.

For more information, see: