Ebola virus disease – Democratic Republic of the Congo

From January 22 to 28, five new confirmed cases of the current Ebola Outbreak (EVD) in the Democratic Republic of the Congo were reported. All five cases were reported from the Beni Health Zone and had epidemiological links to the transmission chain that originated in Aloya Health Zone, Mabalako Health Zone. The most likely exposure for all these cases was nosocomial infection in traditional physician facilities. All cases were identified as contacts but were not followed up at the time of detection.

One confirmed case reported on Jan. 20 remained in the community for four days before being admitted to the Ebola Treatment Center (ETC) and infected two additional people in the community. The two reported staying for four to five days in the community for Jan. 27, while symptomatic before isolation. Another confirmed case remained in the community for eight days after the onset of symptoms and passed away in the community on January 28. Confirmed cases of community time increase the risk of EVDs being transferred to contacts. Therefore, further cases can be expected in the next two weeks in the Bundji and Kanzulinzula health zones and adjacent health areas in the Beni health zone.

In the last 21 days (January 8-28, 2020), 28 confirmed cases from five health areas within the three active health zones in North Kivu province have been reported (Figure 1, Figure 2, Table 1): Beni (n= 18), Mabalako (n= 9) and Musienene (n= 1). The Beni Health Zone is still the focus of the epidemic, recording 64% of confirmed cases in the past 21 days. As of January 28, the following health zones marked more than 21 days without confirmed EVD cases: Mambasa Health Zone in Ituri Province (23 days) and Butembo Health Zone (25 days) in North Kivu Province. Of the 28 people who have been confirmed with EVD in the past 21 days, 20 are isolated and cared for within the first two days of the onset of symptoms, meaning they are more likely to survive and less likely to become infected in community contacts.

The past 21 days have seen encouraging trends in the epidemic. In the past epidemiological week (January 20-26, 2020), the lowest number of cases reported since the beginning of the response was recorded; cases were reported in five health areas in three health zones; contact monitoring performance as well as daily logged alerts continue to improve over time (Figure 3, Figure 4). Contact monitoring has improved significantly as a result of the provision of accommodation and basic services in the Beni Health Zone to well-known contacts who have agreed to follow. Despite these encouraging signs, constant vigilance is guaranteed to overcome the remaining challenges. The possible nosocomial transmission associated with the physician institution remains a major driver of the current epidemic and poses specific challenges, such as contact identification.

As of January 28, a total of 3421 EVD cases were reported, including 3302 confirmed and 119 probable cases, of which 2242 cases died (66% overall mortality rate) (Table 1). Of the total confirmed and probable cases, 56% (n= 1918) were women, 28% (n= 963) 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 January 28, 2020 *

** 3421 confirmed and probable cases, reported since January 28, 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 January 28, 2020 *

Figure 3. Ebola virus disease notifications, reported, investigated and validated daily from epidemic affected areas in the Democratic Republic of the Congo, as of January 28, 2020

Figure 4. Number of registered and monitored contacts every day since January 28, 2020

Table 1: Confirmed and probable cases of Ebola disease by weeks of onset of disease by health field. Data as of January 28, 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: