WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 24: 8 - 14 June 2020
Data as reported by: 17:00; 14 June 2020
...
Ebola virus disease Democratic Republic of the Congo
(?quateur Province)
17 Cases
11 Deaths
64.7% CFR
EVENT DESCRIPTION
The Ebola virus disease (EVD) outbreak in ?quateur Province,
Democratic Republic of the Congo, continues to evolve. Since our last
report (Weekly Bulletin 23), five additional confirmed EVD cases and five
deaths have been reported. Two new health zones, Bolomba and Iboko,
reported confirmed EVD cases during the reporting period – bringing the
number of affected health zones to five. As of 13 June 2020, a total of
17 EVD cases (14 confirmed and three probable) with 11 deaths (case
fatality ratio 64.7%) have been reported in five health zones: Mbandaka
(6 confirmed, 3 probable, 7 deaths), Bikoro (3 confirmed, 3 deaths),
Wangata (2 confirmed, 1 death), Bolomba (2 confirmed) and Iboko (1
confirmed). The case fatality ratio among confirmed cases is 57.1%
(8 deaths/14 confirmed cases). Two health workers are among the
confirmed cases since the start of the outbreak, 11.8% of all cases.
Iboko Health Zone, the newly affected health zone that reported
confirmed EVD case on 12 June 2020, is 240 km from Mbandaka.
The confirmed case-patient was not a listed contact and has not
been vaccinated. Preliminary investigations show that he lives in Air
Congo, in the Mbandaka Health Zone, which is currently affected by the
outbreak. Additionally, the only surviving case from the Bikoro Health
Zone died on 12 June 2020. As of 13 June 2020, nine health areas in
affected health zones have reported cases, including two in Bikoro, one
in Bolomba, one in Iboko, three in Mbandaka and two in Wangata.
A total of 49 new contacts were recorded as of 13 June 2020, with 47 in
Mbandaka and two in Wangata. There are 923 contacts under follow-up,
of which 639 (69.2%) have been seen in the past 24 hours. On 13 June
2020, 21 alerts with one death were reported. Of these 20 (95.2%) were
investigated and four (20.0%) were validated as new suspected cases.
PUBLIC HEALTH ACTIONS
The Representative of the Special Assistant to the Secretary General
of the United Nations, the Resident Coordinator and the Humanitarian
Affairs Coordinator carried out a working mission to Mbandaka on
12 June 2020, in order to see what response was needed on the
ground.
A multidisciplinary group covering all response pillars was deployed
to Bolomoba, 250 km from Mbandaka on 12 June 2020.
On 13 June 2020, 6 384 travellers were screened among the 5 780
registered at the 14/16 active PoCs that reported. Since the start of
the response, a total of 134 569 screenings of travellers were carried
out among 140 360 travellers registered at the active PoCs.
A screening tent was installed in the port of Onatra on 13 June 2020.
As of 13 June 2020, seven samples were received in the Mbandaka
laboratory, of which five were tested; none were positive for Ebola
virus. Since the start of the response, 77 samples have been tested.
A total of 200 people, including 80 in Mbandaka, 40 in Wangata, 40
in Bikoro and 40 in Bolomba were vaccinated with rVSV-ZEBOV-GP
on 13 June 2020.
Since 5 June 2020, a total of 2 514 people have been vaccinated,
including 806 contacts, 1 574 contacts of contacts and 134 probable
contacts. There are six vaccination rings, with four in Mbandaka, one
in Bikoro and one in Bolomba.
One confirmed case was admitted to the Wangata ETC, with
two suspected cases under observation in the transit centre at
Mbankanda General Referral Hospital. Negotiations are ongoing to
transfer the remaining two confirmed cases in the community and to
transfer the case newly confirmed on 12 June 2020 to an isolation
facility.
The two confirmed cases in Bolomba remain isolated at the reference
hospital in Bolomba, while the confirmed case in Iboko is being
cared for at the Itipo reference health centre in the Iboko Health Zone.
Training modules for ETC staff have been finalised, and 27 health
workers in Bolombo Health Zone were briefed on EVD prevention
measures and the use of personal protective equipment.
Infection prevention and control measures continue with IPC
assessments of health facilities in the health areas of Mbandaka Health
Zone; an IPC team travelled to Iboko Health Zone to decontaminate
the health facility after confirmation of a case, along with briefing five
hygienists and Red Cross volunteers in the same visit. IPC activities
were carried out in the Bolomba Health Zone.
To date 40 leaders of associations in the Bolenge, Mbandaka and
Wangata health zones have been made aware of EVD prevention
measures, with leaflets distributed; 50 households in the Libiki health
area, Mbandaka Health Zone were sensitized on EVD prevention,
with the commission providing support to the communication teams
in the various active health zones.
The security situation remains relatively calm with the exception of
some isolated cases of resistance to response interventions.
SITUATION INTERPRETATION
This new outbreak of EVD comes in the context of a country already
burdened with a long-standing EVD outbreak in North Kivu and Ituri, the
COVID-19 outbreak (affecting mainly Kinshasa), an ongoing measles
outbreak and a complex humanitarian crisis. Mbandaka is a large town with
a population of 1.2 million people with air and river links to Kinshasa and
Boende, and there has already been local spread to Bolomoba, which is 240
km away. In addition, there are already isolated incidences of resistance
to response, which leads to disruption of case finding, contact tracing
and follow-up, in particular. The risk of disruption to surveillance and
routine public health activities as a result of the COVID-19 response will
potentially harm the country’s ability to rapidly contain the re-emergence of
EVD. Public health measures, particularly a strong and robust surveillance
system, required to detect, isolate and treat new suspected cases as early
as possible is required to break any new chains of transmission, along with
full community engagement with response measures.
https://apps.who.int/iris/bitstream/handle/10665/332416/OEW24-0814062020.pdf