Ebola Outbreak in Northeastern Part of the Democratic Republic of the Congo Update

IN THE NEWS

As of August 22, 2018, the number of those diagnosed or suspected of having Ebola Virus Disease (EVD) continues to increase and the death toll continues to rise as well.  In fact, in the three (3) weeks since this outbreak was announced, the total number of cases, as well as the deaths, have surpassed the total seen in the eleven (11) weeks of the DRC Northwestern outbreak that ended July 25, 2018.  Specifically, according to the World Health Organization (WHO), as of 8/22/18, there were a total of 103 cases, with 76 cases confirmed and 27 probable, and a total of 63 deaths, with 36 confirmed and 27 probably caused by EVD.

The CDC released an updated Travel Notice that states (see below for the complete updated notice):
Key Points:

• There is +an outbreak of Ebola in North Kivu (Kivu Nord) province in the Democratic Republic of the Congo (DRC).
• The outbreak is in a part of the country identified by the US State Department as a “reconsider travel” zone due to armed group activity and major outbreaks of violence targeting civilians.
• Travelers to this area could be infected if they come into contact with an infected person’s blood or body fluids.
• Travelers should seek medical care immediatelyif they develop symptoms of fever, headache, body aches, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes during or after travel.

The WHO and the Ministry of Health for the DRC have declared this outbreak a risk for continued disease progression in the current areas, as well as neighboring or close-by countries but is considered low risk for a global outbreak, since travel precautions were already in place because of the violence.  This should help prevent spread outside of the African region although travel cases and spread are always possible.

The DRC Ministry of Health, the WHO and other International Partners are all combining forces to provide contact surveillance, which is now up to 95% after initial difficulties tracking case contacts (those exposed to those with confirmed or suspected Ebola), largely because of inaccessibility due to the violence in some of the affected areas.  Another issue has been the abutting countries of Rwanda and Uganda and the movement of refugees fleeing the DRC violence into those countries, which makes tracking of those who may be ill or exposed difficult to follow up with and, therefore, a risk to those and other neighboring countries.  There has been an all-out effort, which has been becoming more effective, to educate officials in the other countries, set up border stations for traveler screening, and quick outreach if there is any question about the spread of the disease.  As of August 24, 2018, there have been 14 health care workers who were confirmed to have Ebola, many of them exposed to it before EVD had been diagnosed in the patients for whom they were caring.

More EVD treatment centers have been set up and comprehensive teams have been formed to provide surveillance, laboratory testing, teaching of infection control procedures (what to do and what not to do). There has also been Ring Vaccination for health care and other workers that have or may have come in contact with or treating those that might be ill/exposed, as well as for other contacts of EVD cases. As of the report today by Dr. Salama, the WHO’s Deputy Director-General for Emergency Preparedness and Response, 2,613 people have been vaccinated, with 500 of them being HCWs and vaccinations to continue.  Also, recently approved by the Ethics Committee for the DRC are five (5) investigational treatments for use in this outbreak.  Use of these treatments is based on a case-by-case evaluation of patient condition, how easy it is to implement, and whether the treating medical center/team is able to effectively use it.  To date, the treatments have been used on 14 patients with promising results, with more treatments expected to follow.  All of these tools are expected to help manage this outbreak.

Reports and updates on this outbreak are being posted on the DRC Ministry of Health’s page, as well as by the WHO.  The CDC provides updates as well, but suggests consulting the WHO’s Update Page for the most current information.  Links to those sites are provided below:

The WHO DRC Ebola Outbreak:
https://www.who.int/news/item/01-08-2018-cluster-of-presumptive-ebola-cases-in-north-kivu-in-the-democratic-republic-of-the-congo

The CDC DRC Ebola Outbreak Report:
https://www.cdc.gov/vhf/ebola/outbreaks/drc/2018-august.html

The CDC Traveler’s Report for the DRC Area of Ebola Outbreak:
https://wwwnc.cdc.gov/travel/notices/watch/ebola-democratic-republic-of-the-congo

Translated DRC Ministry of Health Ebola Outbreak Report:
https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=https://mailchi.mp/9abcbef79b2c/ebola_kivu_22aout%3Fe%3Df27b7f5a19&edit-text=&act=url

Download the Full Update, and Read EMS Specific Recommendations