Outbreaks and Emergencies Bulletin, Week 19: 5 May - 11 May 2018
Ebola virus disease Democratic Republic of the Congo
39
Cases
19
Deaths
48.7%
CFR
EVENT DESCRIPTION
On 8 May 2018, the Ministry of Health of the Democratic Republic of
the Congo notified WHO of an outbreak of Ebola virus disease in Bikoro
Health Zone, in the north-western Equateur Province. The event was
initially reported by the provincial health authority on 3 May 2018 when
a cluster of 21 cases of an undiagnosed illness, involving 17 community
deaths, occurred in Ikoko-Impenge health area. The event reportedly
occurred between early-April and early-May 2018, with the initial casepatients
presenting with fever, vomiting, abdominal pain, conjunctivitis,
and diarrhoea, which were not responsive to antibiotics or antimalarial. A
few of the case-patients reportedly had bleeding diathesis.
On 5 May 2018, the national rapid response team (RRT) obtained five
blood specimens from the initial case-patients (admitted in two local
health facilities). The specimens were received at the Institute National
de Recherche Biom?dicale (INRB) in Kinshasa on 6 May 2018. Test
results released by the INRB on 7 May 2018 showed that two of the
five specimens were positive for Zaire Ebolavirus species by reverse
transcription polymerase chain reaction (RT-PCR). Accordingly, the
Ministry of Health formally declared an outbreak of Ebola virus disease
on 8 May 2018.
As of 13 May 2018, a total of 39 suspected cases of Ebola virus disease,
including 19 deaths (case fatality rate 48.7%), have been reported. Two
probable cases (positive on rapid diagnostic test) were reported on 13
May 2018. Of the 34 suspected cases, two were confirmed, 18 have been
classified as probable and 12 remains suspected cases. Three healthcare
workers have been affected, one of them died. The outbreak has been localised to three health areas, namely Bikoro (29 cases), Iboko (8 cases) and Wangata (2 cases).
As of 13 May 2018, a total of 362 contacts have been listed and are being followed up. Further investigations to describe and characterize the outbreak are ongoing.
PUBLIC HEALTH ACTIONS
On 8 May 2018, the Minister of Health of the Democratic Republic of the Congo held a press conference to formally declare the outbreak of Ebola virus disease,
done in collaboration with the WHO Representative.
On 8 May 2018, the three levels of WHO (Headquarter (HQ), Regional Office for Africa (AFRO) and Country Office in the Democratic Republic of the Congo) issued
a joint News Release to announce the outbreak of Ebola virus disease to the global community.
The WHO Director General, Deputy Director General for emergencies and the Regional Director for WHO African Region, accompanied by senior staff, visited
the Democratic Republic of Congo from 12-13 May 2018 to assess the situation and direct the continuing response, in support of the national health authorities.
The Ministry of Health has reactivated coordination structures at the national, provincial and local levels, with involvement of all partners. At the national level,
daily coordination meetings are ongoing, chaired by the Minister of Health and attended by all humanitarian partners. Additionally, a health cluster meeting took
place 10 May 2018 to mobilize partners to respond to the outbreak.
WHO is in full response mode in support of the national authorities, working with key partners, including MSF, World Food Programme (WFP), UNICEF,
International Federation of Red Cross and Red Crescent Societies (IFRC) and the Congolese Red Cross, UNOCHA and MONUSCO , US Centers for Disease Control
and Prevention (US-CDC), the International Organization for Migration (IOM), and others.
WHO has established its Incident Management System of fully dedicated staff and resources across the three levels of the organization to support response to
the outbreak. Arrangements for immediate deployment of technical experts, including epidemiologists, clinicians, infection prevention and control experts, risk
communications specialists, logisticians, and vaccination support teams have been finalised. An advance team, including the Incident Manager, has arrived incountry
on 9 May 2018.
WHO released US$ 1 million from its Contingency Fund for Emergencies to support response activities for the next three months, with the goal of containing the
outbreak promptly.
On 9 May 2018, the Ministry of Health, in conjunction with WHO and M?decins Sans Fronti?res (MSF), deployed additional teams of technical experts to the
affected health zone to support outbreak investigations and local response. More deployments will be effected in the coming days.
Surveillance, case management, risk communication, and psychosocial support have all been initiated and are being strengthened. Infection prevention and
control and water, sanitation and hygiene (WASH) activities are ongoing with the start of safe water supply installation at Bikoro General Hospital and supervision
of waste management activities at the local market.
SITUATION INTERPRETATION
The Democratic Republic of the Congo has confirmed a new outbreak of Ebola virus disease, coming just about a year since the last outbreak was declared on 11 May
2017. This is the ninth outbreak of Ebola virus disease in the country since the virus was discovered in 1976 (in the same country).
The Ministry of Health and other national authorities, WHO and partners have mounted a response to the outbreak. The objective of the response is to rapidly contain
the current outbreak in the localized affected area. To achieve this, rapid scaling up of the proven containment measures is paramount. It is critical to ensure adequate
presence of qualified and experienced staff on the ground, as well as the necessary logistics. Given the known logistical challenges on the ground (in terms of access,
communication and accommodation), adequate logistical preparation and support is crucial. Alongside, there is a need to mobilize adequate financial resources to
facilitate the response, thus the need to quickly finalize the national response plan, to be used as a tool for resource mobilization.
http://apps.who.int/iris/bitstream/h...-511042018.pdf
http://www.afro.who.int/publications...ay-11-may-2018
