Milestones :: Perspectives
Ebola – Democratic Republic of the Congo
Ebola virus disease – Democratic Republic of the Congo
Disease Outbreak News (DONs) 27 September 2018
The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. While substantial progress has been made, the situation is precarious given recent increases in insecurity, incidents of community reluctance and geographical spread.
There have been a number of incidents in recent days, notably in Beni, which have led to loss of life among the local communities. WHO response activities have been severely limited as Beni and other towns mark a period of mourning for those who were killed. Security in Beni and other areas remains challenging.
The Ministry of Health (MoH), WHO and partners continue to work closely with people in the affected areas to overcome reluctance and mistrust which has developed among some communities. Rumours, misinformation and traditional practices have led some families to opt to care for sick relatives at home; some patients have also left health facilities to seek alternative care. Together this results in health workers being unable to provide optimal treatment, and also increases the risk of infection for relatives and local community members. These factors have contributed to the geographical spread of the outbreak.
The movement of several cases across health zones in recent weeks is concerning; one infected individual who recently moved to Kalunguta Health Zone is the first to move into a ‘red’ zone – highly insecure and challenging environments where implementing response activities is extremely difficult, if not impossible. Responders are employing a range of new techniques in these red zones, including using armed escorts and training local health workers to trace contacts.
Where they have access, response teams continue to enhance activities to prevent new clusters and the potential spread to new areas. WHO continues to work in the affected areas, side-by-side with national and international partners, to support the response led by the MoH. There continues to be challenges with identifying all contacts, registered contacts being lost to follow up, delayed recognition of EVD in health centres, poor infection prevention and control (IPC) in health centres, and reluctance among some cases to be treated in Ebola treatment centres (ETCs). The priority remains strengthening all components of the public health response in all affected areas, as well as continuing to enhance operational readiness and preparedness in the non-affected provinces of the Democratic Republic of the Congo and in neighbouring countries.
Since the last Disease Outbreak News (data as of 18 September), nine new confirmed EVD cases were reported: five from Beni, one from Butembo and one from Mabalako health zones in North Kivu Province, as well as two from Tchomia Health Zone in Ituri Province. These are the first confirmed EVD cases to be reported from Tchomia Health Zone which is near the Ugandan border; both cases, a couple, were linked to the ongoing Beni transmission chain. Two of the remaining seven cases have been linked to ongoing transmission chains within the respective communities, while the last five cases are under investigation.
As of 25 September 2018, a total of 151 EVD cases (120 confirmed and 31 probable), including 101 deaths (70 confirmed and 31 probable)1, have been reported in seven health zones in North Kivu Province (Beni, Butembo, Kalunguta, Mabalako, Masereka, Musienene and Oicha), and two health zones in Ituri Province (Mandima and Tchomia) (Figure 1). An overall decreasing trend in weekly case incidence continues (Figure 2); however, these trends must be interpreted with caution given the expected delays in case reporting, the ongoing detection of sporadic cases and the security situation which is limiting contact tracing. Of the 149 confirmed and probable cases for whom age and sex information is known, 23%, 20% and 22% are aged 15-24, 25-34 and 35-44 years, respectively; females (56%) accounted for the greatest proportion of cases (Figure 3). Cumulatively, 19 (18 confirmed and one probable) health workers have been affected to date, three of whom have died.
The MoH, WHO and partners continue to closely monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo and in neighbouring countries. As of 25 September, 17 suspected cases in the Democratic Republic of the Congo are awaiting laboratory testing. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, as well as in neighbouring countries; and to date, EVD has been ruled out in all alerts from neighbouring provinces and countries.
:: 08: Situation report on the Ebola outbreak in North Kivu 25 September 2018
WHO calls for protection of humanitarian workers and civilians in Democratic Republic of the Congo
26 September 2018 News Release
The response to the outbreak of Ebola in North Kivu and Ituri provinces in the Democratic Republic of the Congo is at a critical juncture, threatened by worsening insecurity, mistrust from affected communities, and extension into previously unaffected areas…
But there is a risk now that hard-won gains may be lost.
First, there has been an increase in frequency and severity of attacks by armed opposition groups. Attacks by armed opposition groups on the town Beni, in North Kivu, where the Ministry of Health and partners have based their response, have occurred with alarming frequency. Most recently a deadly attack on 22 September left 21 dead, including 17 civilians.
As a result, WHO and its UN partners were asked to halt operations in Beni, while the city mourns its dead. As of today, some operations have begun to resume, but even a gap of two days has resulted in health workers not being able to reach contacts of Ebola patients to monitor their health; or investigate alerts of potential cases.
Meanwhile, some families have chosen to care for sick relatives at home, often because they have been misinformed, and because a natural fear of the disease is now being exploited by local politicians.
Others sick with Ebola travel widely to seek alternative care, putting themselves, their families and health workers at risk. This has brought infection to new locations, where teams cannot provide them with access to treatment, or provide protective vaccines to their contacts. These include security red zones which are difficult to access, and to areas bordering Uganda.
WHO calls on all relevant parties, and the governments or groups that have influence over these parties, to help protect responders and civilians.
WHO also calls on governments in surrounding countries to accelerate the preparedness activities which they have begun, with WHO support, to ensure a level of readiness should they face cases of Ebola themselves.
KINSHASA/DAKAR/NEW YORK/GENEVA, 28 September 2018 – Recent survivors of the Ebola virus and UNICEF are partnering to help prevent further transmission of the deadly disease in the eastern Democratic Republic of the Congo (DRC). As part of this effort, the survivors are sharing their stories during public events and through public radio in Ebola-affected communities.
Forty-three people have survived the Ebola virus since the beginning of the latest outbreak in August.
“The survivors are living proof that it is possible to recover from the Ebola virus disease, especially if it is detected and treated early,” said Dr. Gianfranco Rotigliano, UNICEF Representative in the DRC. “The testimonies of these Ebola-survivors help us to reduce the fear in the communities and to encourage people with Ebola-like symptoms to look for early treatment, thereby avoiding the risk of further contamination.”
Lack of awareness of prevention measures and treatment of the disease among the population increases the risk of further transmission, as shown by the newly confirmed case of Ebola in the Tchomia health zone. In response to this case, UNICEF has deployed a team to help with the Ebola-response put in place by the Government and now has response teams operating in Mangina, Beni, Butembo and Tchomia…