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DRC - Three new Ebola cases confirmed in eastern Congo - October 18, 2021

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  • #16

    WEEKLY BULLETIN ON OUTBREAKS
    AND OTHER EMERGENCIES

    Week 51: 13 – 19 December 2021
    Data as reported by: 17:00; 19 December 2021

    ...

    Ebola virus disease Democratic Republic of the Congo

    11 Cases
    9 Death
    81.8% CFR


    EVENT DESCRIPTION

    On 16 December 2021, the Ministry of Health (MoH) of the
    Democratic Republic of Congo declared the end of the EVD
    outbreak that affected Beni Health Zone in North Kivu Province,
    DRC. This was following a 42-day countdown with no cases that
    started the day after the date of sampling of the second negative
    blood specimen taken from the last confirmed case.

    Between 8 October and 16 December 2021, a total of 11 cases
    (eight confirmed, three probable) including nine deaths and two
    survivors have been registered. The overall case fatality ratio
    (CFR) was 82% (9/11) among the probable and confirmed cases
    and 75% (6/8) among the confirmed cases.

    The first laboratory confirmed case was a 3-year-old male
    who developed symptoms in early October including physical
    weakness, loss of appetite, abdominal pain, breathing difficulty,
    dark stool and blood in his vomit. He died on 6 October. On
    7 October, samples from the child were tested for EVD at the
    National Institute of Biomedical Research (INRB), laboratory in
    Beni by reverse transcription polymerase chain reaction (RTPCR).
    On 8 October these were sent to the Rodolphe Mérieux
    INRB Laboratory in Goma and tested positive for EVD by RT-PCR
    on the same day. On the same day the Democratic Republic of
    Congo MoH announced a new laboratory confirmed case of EVD
    had been detected in Butsili Health Area, Beni Health Zone in
    North Kivu Province.

    The laboratory confirmed case followed a cluster of three
    deaths (two children and their father) who were neighbours of
    the 3-year-old boy. These three patients died on 14, 19 and 29
    September after developing symptoms consistent with Ebola,
    however, none were tested for the virus, so they are considered
    as probable cases.

    During the outbreak period, three (16%) out of the 19 health
    areas in Beni Health Zone reported EVD confirmed cases, namely,
    Butsili (6 cases), Bundji (1 case) and Ngilinga (1 case). Children
    under the age of five years accounted for 50% (4/8) of the cases.
    All the listed contacts completed the 21-day follow-up period and
    were discharged from active follow-up.

    PUBLIC HEALTH ACTIONS

    The declaration of the outbreak was made on 8 October 2021
    by the Minister of Health.

    Alert monitoring continued using both active case finding
    from health facilities visited during active case search,
    passive surveillance and to a lesser extent community-based
    surveillance. From 8 October to 14 December, a total of 21
    916 alerts were reported from nine health zones including
    15 642 from Beni, 21 558 (98%) of which were investigated,
    1709 were validated as suspected cases of EVD.

    Vaccination with ERVEBO started on 25 November. As of 14
    December 2021, a total of 1 193 frontline workers have been
    vaccinated with ERVEBO.

    Cumulatively, a total 1 827 samples including 834 swabs
    have been tested; of which eight were confirmed EVD cases
    at INRB field laboratories in Beni, Butembo, Mangina and
    Goma.

    Trainings and training boosters of the health workforce for
    early detection, isolation, and treatment of EVD cases as
    well as safe and dignified burials protocols and the infection
    prevention and control (IPC) were conducted.

    The MoH, along with the INRB and other partners supported
    the establishment of an Ebola Treatment Centre and other
    health facilities with capacities to care for suspected cases.

    WHO and partners supported the strengthening of infection
    prevention and control capacities at 83 priority health facilities
    through IPC kit donations, training, supportive supervision,
    evaluation and other activities.

    Full genome sequencing performed by the INRB in Kinshasa
    of the sample from the initial confirmed case indicates that
    this cluster was not the result of a new zoonosis from an
    animal reservoir but was linked to a persistent Ebola virus
    infection.

    14 points of entry and controls were set-up. From the
    declaration of the outbreak to 12 December, 4 745 892
    people were screened, 216 alerts were validated, none were
    confirmed.

    Different community groups have been reached to raise Ebola
    awareness and were engaged in response interventions.
    Risk communication and community sensitisation were
    conducted throughout the course of the outbreak using a
    wide range of channels of communications (community
    dialogues, community radio, social media, etc).

    In the community, 200 people participated in 23 psychosocial
    sessions on different aspects of the EVD response.

    Psychosocial support has been offered to five affected
    families in preparation for receiving their test results.

    SITUATION INTERPRETATION

    The EVD outbreak in Beni Health Zone, North Kivu of the
    Democratic Republic of Congo, has been declared over. The
    current re-emergence of EVD is the fifth outbreak in less than three
    years. Detection of EVD cases was not unexpected given that the
    virus is enzootic in some animal populations in the country. WHO
    continues to support the Ministry of Health in implementing the
    EVD survivor care programme. The two people who recovered
    will be entitled to an 18 month medical and psychological followup
    along with biological testing. WHO considers that ongoing
    challenges in terms of access and security, epidemiological
    surveillance, coupled with the emergence of COVID-19, as well
    as cholera and measles outbreaks might jeopardize the country’s
    ability to rapidly detect and respond to any re-emergence

    PROPOSED ACTIONS

    Reducing the risk of wildlife-to-human transmission from
    contact with infected fruit bats or monkeys/apes and the
    consumption of their raw meat. Animals should be handled
    with gloves and other appropriate protective clothing. Animal
    products (blood and meat) should be thoroughly cooked
    before consumption.

    To reduce the risk of possible transmission from virus
    persistence in some body fluids of survivors, WHO
    recommends providing medical care, psychological support
    and biological testing (until two consecutive negative tests)
    through an EVD survivors care programme. WHO does not
    recommend isolation of male or female convalescent patients
    whose blood has tested negative for Ebola virus.

    Training and training boosters of health workforce should
    continue for early detection, isolation, and treatment of EVD
    cases as well as re-training on safe and dignified burials and
    the IPC ring approach.

    https://apps.who.int/iris/bitstream/...1319122021.pdf
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

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