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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.
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