Ebola virus disease – Democratic Republic of the Congo

From February 19 to 25, no new confirmed cases of Ebola virus (EVD) were reported. This was the first time since the beginning of the response that no new confirmed cases were recorded over a seven-day period (Figure 1). The latest case was reported in the health zone of Beni, North Kivu province on February 17th. Although the lack of new confirmed cases reported in the last seven days is a great achievement, the epidemic remains active and the risk of additional cases occurring is still high. In the past 21 days (5 to 25 February 2020), four confirmed cases were reported from two health areas in the Beni Health Zone in North Kivu Province (Figure 2, Table 1). Even with enhanced surveillance operations, transmission of Ebola virus outside groups currently under surveillance cannot be ruled out. Ebola virus also exists in the body fluids of some survivors, with the potential to infect others. In at least one case, a relapse was observed during this outbreak – in which a person who had recovered from EVD developed symptoms again, triggering a new transmission chain that took several months to break. To mitigate a possible outbreak, it is critical to maintain the ability to respond quickly to detect and respond to new cases, and to prioritize the support and monitoring of survivors and maintain cooperative relationships with survivor associations.

Significant surveillance, pathogen detection, and clinical management are currently underway, including confirmation of alerts following remaining contacts potentially exposed to the virus, supporting rapid diagnosis of suspected cases, and working with community members to strengthen surveillance of people dying in communities. As of February 25, 510 contacts are currently monitored, of which 97% are monitored daily over the last seven days. Over the last seven days, more than 5100 warnings have been reported and investigated, of which over 400 warnings (including ~ 70 community deaths) have been confirmed as suspected EVD cases; requiring laboratory testing and specialized care within established Ebola treatment and treatment centers. On average, suspected cases remain in these facilities for three days before EVD can be finally ruled out (i.e., after two negative polymerase chain reaction tests at 48-hour intervals), while care of their disease under isolation precautions. Timely testing of suspected cases continues in the 11 operating laboratories deployed in affected cities. From February 17 to 23, more than 3600 samples were tested.

WHO requires further funding to maintain operations and prevent a possible outbreak of the epidemic. According to the Strategic Response Plan (SRP 4.1), WHO’s financial need for an Ebola response from January to June 2020 is $ 83 million. Thanks to the generosity of many donors during 2019, WHO has some portable funding, which is applicable to sustain operations until February 2020. Currently, $ 40 million is needed to ensure continuity of activities to reduce the coincidence to zero and continue to build strong and resilient health systems.

As of February 25, a total of 3444 EVD cases were reported, including 3310 confirmed and 134 probable cases, of which 2264 were deaths (66% overall mortality rate) (Table 1). Of the total confirmed and probable cases, 56% (n= 1928) were women, 28% (n= 974) were children under the age of 18 and 5% (n= 172) 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 25, 2020 *

*Excludes n = 155 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 February 25, 2020 *

Table 1: Confirmed and likely cases of Ebola virus and number of health areas affected by the health zone, North Kivu, Democratic Republic of the Congo, data as of February 25, 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. 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: