Ebola virus disease – Democratic Republic of the Congo

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From 6 to 12 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo (Figure 1). Since the resurgence of the outbreak on 10 April 2020, seven confirmed cases have been reported from Kasanga, Malepe and Kanzulinzuli Health Areas in Beni Health Zone. Of these, one is receiving care at the Beni Ebola treatment centre (ETC), one who was receiving care at the ETC recovered and was discharged, and one remains in the community, 35 days after symptom onset. Efforts to locate this individual are being undertaken to test and provide care for this person. Four of the people confirmed to have Ebola died, including two community deaths and two deaths in the ETC in Beni. So far, no definitive source of infection has been identified.

As of 12 May, 90 contacts are currently under surveillance, of which 41 are high-risk contacts who had direct contact with body fluids of the last confirmed case. All contacts have exited their high-risk period (seven to 13 days after last exposure). Contacts from the previous six cases reported in April have exited their follow-up period. Of the 41 high-risk contacts, 37 have been vaccinated. A total of 1486 people have been vaccinated in Beni and Karisimbi since 10 April 2020.

From 6 to 12 May 2020, an average of 2536 alerts were reported per day, of which 2524 were investigated within 24 hours. Of these, an average of 330 alerts were validated as suspected cases each day, requiring specialized care and laboratory testing to rule-out EVD. In the past three weeks, the alert rate has improved notably in Beni and Butembo sub-coordinations. From 4 to 10 May 2020, 2494 samples were tested including 1843 blood samples from alive, suspected cases; 318 swabs from community deaths; and 333 samples from re-tested patients. Overall, laboratory activities increased by 18% compared to the previous week.

As of 12 May 2020, a total of 3462 EVD cases, including 3317 confirmed and 145 probable cases have been reported. Of these, 2279 people died (overall case fatality ratio 66%) and 1170 survived. Of the total confirmed and probable cases, 57% (n=1970) were female, 29% (n=1002) were children aged less than 18 years, and 5% (n=171) were health care workers.

The cluster of EVD cases that emerged in April highlights the importance of heightened vigilance for the response in the face of significant challenges around community engagement, access to affected areas, ongoing insecurity issues, and limited response capacity due to other local and global emergencies. The origin of this recent chain of transmission should continue to be investigated in order to prepare for similar events in the future. It is crucial to detect, isolate, test and treat new suspected cases as early as possible to improve the chances of survival of the people affected, and to break the chain of transmission. Strong coordination and communication among partners, authorities and affected communities is essential, as well as continued support for and engagement with EVD survivors.

Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 12 May 2020*

*Excludes n=74/3462 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. ‘Non-active zones’ indicate health zones that have not reported new cases in the last 42 days.

Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu Province, Democratic Republic of the Congo, data as of 12 May 2020**

**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.

Public health response

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

WHO risk assessment

On 14 April 2020, WHO revised the risk assessment for this event from High to Moderate at the national and regional levels, while the risk level remained Low at the global level. The risk assessment will be continuously reassessed in the coming days based on available and shared information.

For further information, please see the Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 14 April 2020

WHO advice

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information regarding this EVD outbreak. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo in relation to this EVD outbreak. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see:

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