Ebola virus disease – Democratic Republic of the Congo

No new cases of Ebola virus were reported as of February 17, and on March 3, the only person who confirmed to have EVD in the last 21 days (Figure 1) was discharged from the Ebola Treatment Center after recovering twice and tested negative for the virus . This is an important milestone in the epidemic. 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.

As of March 3, 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= 1927) were women, 28% (n= 973) were children under the age of 18 and 5% (n= 171) were healthcare professionals.

The World Health Organization’s financial response to Ebola for the period January – June 2020 (SRP 4.1) is $ 83 million. Thanks to the generosity of donors during 2019, WHO had funds available to transfer funds, however, WHO now requires $ 40 million to ensure continuity of activities.

Ebola virus survivors

The Ebola virus can exist in the body fluids of some survivors, and it can infect others. In at least one case, a return was observed during this outbreak, triggering a new transmission chain that lasted several months. At the individual level, people who have recovered from EVD can develop medical and psychological complications. EVD survivors should be supported when they return to their communities to take care of any complications after EVD.

In response to these needs, and based on lessons learned from previous epidemics, a multidisciplinary EVD survivor care monitoring program was launched just three months after the epidemic was declared by the Ministry of Health and the National Institut de Recherche biomédicale. (INRB), with support from the World Health Organization and the World Food Program. It was the first time that a national EVD survivor program had been implemented in the early stages of the EVD epidemic.

The program includes monthly visits to health clinics for at least 18 months to monitor the clinical, biological and psychological aspects of the health and well-being of each survivor. Each month, more than 85% of survivors attend clinics. This indicates that survivors and their communities accept, trust and trust the program. In addition, survivors are offered specialized services by trained local professionals who work in close collaboration with survivor associations. These include ophthalmic care, neurological care, psychosocial support, laboratory services, pregnancy management and pediatric care. The program continued to adapt to the evolution of the epidemic. Five dedicated clinics are currently operating in Beni, Butembo, Goma, Mangini and Mambasi.

Since the outbreak of the epidemic, 1160 people have recovered from EVD. These include 50 (4%) infants under 1 year of age, 55 (5%) children aged 1 to 4 years, 145 (13%) children aged 5 to 17 years and 910 (78%) adults aged 18 years or older. Of the total survivors, 641 (55%) are women, including eight women who were pregnant at the time of EVD infection and survived with a viable fetus. In order to ensure proper monitoring of pregnancy and safe birth, WHO has supported the implementation of dedicated care for these women. This is the first time that women who were pregnant while ill with EVD have recovered with healthy babies, and there is a major shift in supporting pregnant women who have recovered from EVD.

In order to provide adequate and necessary care for EVD survivors, it is important to maintain the program for at least 18 months after the outbreak is declared. Furthermore, concerted research efforts are needed to better understand and respond to survivors’ needs. WHO will support INRB and its partners in these efforts.

Figure 1: Confirmed and probable cases of Ebola disease by weeks of onset of disease by health field. Data as of March 3, 2020 *

*Excludes n = 153 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 a health zone that has not reported new cases in the last 42 days.

Figure 2: Confirmed and probable cases of Ebola disease by weeks of disease onset by health belt. Data as of March 3, 2020 *

Table 1: Confirmed and probable cases of Ebola disease and number of health areas affected by the health zone, North Kivu Province, Democratic Republic of the Congo, data as of March 3, 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: