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Ebola Virus Disease-Democratic Republic of the Congo: Disease Outbreak News, April 16, 2020-Democratic Republic of the Congo

 


Three newly confirmed cases of Ebola virus disease (EVD) were reported during ongoing outbreaks in the Democratic Republic of the Congo from April 10 to 14, 2020 (Figure 1). All cases were reported from the Beni Health Zone in North Kivu. Two people died in the community after visiting several medical facilities. Infection of a third individual is epidemiologically associated with one of these cases. The individual is currently being treated at the Ebola Treatment Center. Prior to this development, the last person was confirmed twice negative by the EVD test and was discharged from the treatment center on March 3, 2020.

Specimens from all confirmed cases were used for gene sequencing to support the surveillance team in source investigations and to determine if these cases were linked to known linkages. Of the transmission sent to the Institut de Recherche Biomedicale (INRB). A total of 332 contacts for these cases were registered, 248 of which were tracked on April 14, 2020, 200 of which were vaccinated by three active vaccination teams. Approximately 6,000 doses are available in the Beni Health Zone, but WHO predicts potential challenges for the vaccine pipeline as flight capacity is constrained by the 2019 coronavirus disease (COVID-19) outbreak doing.

From April 8th to 14th, 2020, an average of 2015 alerts were reported and investigated per day. Of these, an average of 177 alerts were verified daily as suspicious cases, requiring specialized care and laboratory testing to rule out EVD. Alert rates have declined over the past three weeks as the team fell into other emergencies, including COVID-19. Other challenges include the presence of armed groups, limited access to some of the health areas affected, contact transfers, and lack of reporting to the Central Coordination of Outbreak Responses. Timely testing of suspicious cases continues to be provided by 11 laboratories. From April 6 to 12, 2020, 968 samples were tested, including 466 blood samples from suspected surviving cases. 274 cotton swabs due to the death of the community. 228 samples from reexamined patients. Overall, laboratory activity was reduced by 28% compared to the previous week.

On April 9, 2020, two new potential cases with onset of symptoms in November 2019 and December 2019 were retrospectively examined. As of April 14, 2020, a total of 3458 EVD cases were reported from 29 health zones (Table 1), and of the 3313 confirmed cases and 145 estimated cases, 2277 had died (total Death rate 66%). Of the likely cases identified, 56% (n = 1943) were women, 28% (n = 982) were children under the age of 18, and 5% (n = 171) were healthcare workers.

An emergency injection of $ 20 million is needed to ensure that the response team can maintain an adequate level of operation until the beginning of May 2020. Details are available from End, but there is a potential for flare-ups in Ebola in the Democratic Republic of Congo.

It was not expected that a newly confirmed case 40 days after the last person was diagnosed negative was discharged from care. WHO’s recommended criteria for declaring the end of an EVD outbreak include a 42-day waiting period due to the potential for undetected chains of infection or new flares. Sequencing analysis informs the source of infection and is important in detecting missed cases in the chain of infections that led to this cluster. It is imperative to remain vigilant, maintain strong oversight, rapid detection and response capabilities, and continue to engage community leaders to address or mitigate community distrust in the affected areas.

Public health support

For more information on public health preparedness by the Department of Health, WHO, and partners, see the latest status report published by the WHO Africa Regional Office.

WHO risk assessment

On April 14, 2020, WHO revised its risk rating for this event from high to moderate at national and regional levels, but remained low at global level. The risk assessment will be continuously reassessed for the next few days based on the shared information available.

For more information, Statement on the meeting of the International Health Regulations (2005) of the Ebola Virus Disease Emergency Committee in the International Democratic Republic of the Congo, 14 April 2020

WHO advice

WHO advises on restrictions on travel to and from the Democratic Republic of the Congo, based on currently available information. The Ebola vaccination certificate requirements are not a valid basis for restricting cross-border travel or for issuing visas to travelers to / from affected countries. WHO will continue to carefully monitor and, if necessary, verify travel and trade measures related to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travelers should seek medical advice before traveling and practice proper hygiene. For more information, WHO recommendations on international transportation related to the outbreak of Ebola virus disease in the Democratic Republic of Congo.

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