Ebola virus disease – Democratic Republic of the Congo

More than 21 days have passed since the last confirmed case of Ebola virus (EVD) was recorded (Figure 1). On March 9, the last 46 contacts completed follow-up. These are important outbreak events, as more than one maximum incubation period has passed without confirmed EVD cases. However, there is still a high risk of EVD recurrence and a critical need to maintain response operations – as highlighted in The WHO recommended criteria for declaring the end of the EVD epidemic.

Extensive surveillance, pathogen detection, clinical management and other response activities are currently underway. They include, but are not limited to, examining and confirming new alert cases, supporting appropriate care and prompt diagnosis of suspected cases that continue to be detected on a daily basis, and supporting survivors through a multidisciplinary program that helps mitigate the potential risks of recurrence. Over 32,000 alerts were reported and investigated during the last week (March 4 to March 10, 2020), and 2584 alerts were confirmed as suspicious cases; specialized care and laboratory testing are required to exclude EVD. From March 2 to March 8, 2818 samples were tested, including: 1574 blood samples from live, suspected cases; 376 community death swabs; and 868 samples of retested patients. Overall, this is a decrease of 16% over the previous week.

Throughout the outbreak, alert rates have steadily increased as active and passive case finding systems have strengthened, reaching additional health areas with epidemic development and continually adapting to the local context. With the decline in the confirmed incidence of cases and the gradual transition to routine disease surveillance systems, alert rates in some areas have begun to decline over time. However, it is still important that appropriate levels of surveillance must be maintained until the end of the epidemic declaration in order to quickly detect vomiting, reintroduction or new developments, thus providing an opportunity to implement effective control measures and avoid possible recurrence of the epidemic.

As of March 10, 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1, Figure 2), including 3310 confirmed and 134 probable cases, of which 2264 cases (66% overall mortality rate). Of the total confirmed and probable cases, 56% (n = 1931) were women, 28% (n = 975) were children under 18, and 5% (n = 171) were health care professionals.

Figure 1: Confirmed and probable cases of Ebola disease by weeks of onset of disease by health field. Data as of March 10, 2020 *

*Excludes n = 148 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. “Inactive zones” means health zones that have not reported new cases in the last 42 days.

Table 1: Confirmed and likely cases of Ebola virus and number of affected health areas by health zone, North Kivu, Democratic Republic of the Congo, data as of March 10, 2020 **

**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 Ministry of Health’s confirmation and daily reporting dates.

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 remain high, while global risk levels remain 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. Currently, 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: