Democratic Republic of Congo: Ebola cases confirmed in Bikoro, Equator Province
22 May 2018:
Epidemiological situation – May 22nd , 2018 (source: DRC Ministry of Health)
- 51 people already presenting symptoms of hemorrhagic fever (FHV)
- 28 laboratory - confirmed cases
- 21 possible cases
- 2 suspects cases
- 26 deaths
21 May 2018:
Epidemiological situation – May 21st , 2018 (source: DRC Ministry of Health)
- 46 people already presenting symptoms of hemorrhagic fever (FHV)
- 21 laboratory-confirmed cases
- 21 possible cases
- 4 suspects cases
- 26 deaths
The Ministry of Health and the World Health Organization (WHO) are starting vaccinations today in Mbandaka. MSF will begin vaccinating frontline health workers later this week in Bikoro. The vaccinations will take the form of a ‘ring’ strategy. This involves identifying newly diagnosed and laboratory-confirmed cases of Ebola and tracing the people they have been in contact with. These people and their contacts will constitute the ‘ring’. Frontline health workers in the affected area will also be offered the possibility of vaccination, as they are most at risk of exposure to the virus and thereby of developing Ebola.
People who are vaccinated continue to follow the same infection control protocols as before and, in the case of frontline health workers, continue wearing protective equipment. It is important to note that vaccination is just one tool in the fight against Ebola. The ‘pillars’ of an Ebola intervention must continue in order to stem the spread. These consist of isolating people who are sick and providing medical and psychological care, tracing and following up contacts, informing people about the disease, how to prevent it and where to seek care, supporting existing healthcare, and temporarily changing cultural behaviour, such as around funerals.
18 May 2018:
Updated figures (18th May 2018- source : DRC Ministry of Health) – 17 laboratory-confirmed cases overall (4 cases from Mbandaka and 13 cases from the Bikoro area)- These cases are part of the 45 people already presenting symptoms of hemorrhagic fever. Deaths have raised at 25.
Context : the IHR (International Health Regulation) Emergency Committee, where the World Health Organization plays the coordinating role, met today (18th May 2018) to evaluate the situation related to Ebola outbreak in DRC Equateur region. Conditions to declare a PHEIC (Public Health Emergency of International Concern) have not been met. However, the WHO declared that the Ebola health risk assessment in DRC has raised to “moderate” to “very high”.
- Situation is worrying, and MSF teams in the field are assessing and adapting their response as the context evolves
- MSF teams are currently in the Mbandaka and Bikoro areas and are putting in place twoEbola Treatment Centres of 20 beds each
- Teams are already treating patients in the isolation areas in Bikoro (10 patients) and Mbandaka (4 patients) hospitals
- MSF and its research centre Epicentre are also working closely with the Ministry of Health and the WHO don the implementation of the Ebola vaccine
17 may 2018
The Ebola outbreak continues in the Equateur province, with one new laboratory-confirmed case from the city of Mbandaka, which has a population of more than a million and is a busy port city located on the Congo River. This new case is linked with the epicentre of the epidemic, the east of Lake Tumba.
Since the beginning of the epidemic, 44 overall people who have presented symptoms of haemorrhagic fever, 3 confirmed as Ebola, and 23 deaths have been notified by the national health authorities in the region. To tackle the epidemic and limit as much as possible the risk of it spreading, Doctors Without Borders (MSF) is stepping up its response in the affected areas (Mbandaka and Bikoro).
10 May 2018
“MSF has worked alongside the Congolese authorities in the past to care for patients suffering from Ebola and bring outbreaks under control,” says Julien Raickman, MSF head of mission in Democratic Republic of Congo (DRC). “At the moment there is an experienced MSF team in Bikoro, made up of medics, water and sanitation experts, health promoters, logisticians and an epidemiologist. The team is working with the national authorities and other international organizations to assess the situation and to ensure that the outbreak is contained.”
In the afternoon of 8 May, national health authorities confirmed a new Ebola outbreak in the Bikoro health zone of Equateur Province, in the central-east part of the Democratic Republic of Congo (DRC).
Alongside the Ministry of Health and other international organizations, the Doctors Without Borders (MSF) DRC Emergency Team is already on-site in order to further assess the situation and to deploy a rapid and tailored response to the emergency. This approach will enable detection of further suspect cases and then to contain the epidemic.MSF is also working closely with the authorities and all partners in Kinshasa to put together a coordinated and successful response plan, able to adapt according to the needs on the ground.
Epidemiological situation: according to the Congolese Ministry of Health, since the beginning of the epidemic (declared publicly on May 8th) in the Bikoro health district (North-West of the country, Equator province) there are 2 biologically confirmed Ebola cases, as well as 9 patients suspected of having Ebola, and one who is suspected to have died from the disease. The size and scope of the epidemic it is not yet fully understood. An epidemiological evaluation team comprised of staff from MSF, the DRC Ministry of Health and WHO – World Health Organization is on the ground investigating from where the cases originated.
- Context info: the Bikoro health district is part of Equator province, in the north-west of the Democratic Republic of Congo. It is a region covered by the Equatorial forest and crisscrossed by rivers. It is known to be extremely remote and difficult to access with many areas, which are only reachable by canoe. Bikoro, the small city where the Ebola cases have been detected, is approximately at 4-hour drive from Mbandaka (the province of Equator). Connections with Bikoro are also possible via Lake Ntumba, which the local community uses as well to reach the Congo River. Compared to the last two Ebola epidemics in DRC (Boende and Likati) the current location is less remote and more easily accessible. In addition, the region has patchy cellphone network coverage, which makes communication with some health districts from the main city – Mbandaka- extremely difficult and epidemiological surveillance a real challenge. As it is often the case in DRC, the local population in the area often first refer to traditional healers before looking for treatment in local health structures when the fall ill.
- Last Ebola epidemic in Equator province: the last confirmed Ebola epidemic in this area affected Boende health district and took place in 2014. During the epidemic there were 24 confirmed Ebola cases. At that time, OCB’s DRC Emergency Pool (PUC) intervened with the support of OCBA teams, and treated 65 patients suspected of suffering from Ebola.
Current MSF operational capacity for responding to Ebola outbreak in DRC:
- Field level- Bikoro: MSF DRC Emergency Team has been on-site since last Saturday (5 May), and it’s working with the Ministry of Health and the WHO-World Health Organization to assess the situation and support the deployment of a rapid and tailored response to the emergency.
- Kinshasa + HQ level: MSF experts from the Emergency Pool in Brussels (more than 20 people expected for the moment) are arriving in Kinshasa this weekend, to join the experienced PUC teams already in the field. In addition, MSF supply teams in Kinshasa are preparing medical and logistical material to send to Bikoro as soon as possible. A chartered cargo plane will be sent from Brussels in order to further strengthen our supply capacity and ensure we have the medical supplies, personal protection equipment and logistical material needed to respond to the epidemic.
Main MSF Priorities at Field and Coordination Level:
- Work on a clear epidemiological picture of the context as well as contact tracing, in order to understand the evolution of the epidemic, and to put in place an adequate response alongside the Ministry of Health and the other partners;
- Health promotion activities in the community, to ensure that the population is aware about the ways Ebola is transmitted its symptoms and the need for rapid referral of suspected cases to properly equipped health structures;
- Treatment and isolation of suspected cases of Ebola. All suspected and confirmed Ebola patients must be treated in isolation by staff who are trained in infection control protocols and wearing protective clothing
- Water and sanitation activities including safe burial to limit the transmission of the virus.
What is it like to be a Southern African doctor working in an Ebola Outbreak?
Dr Stefan Kruger worked as part of MSF's team responding to the Ebola outbreak in Sierra Leone in 2014-2015. He shared his experience.
*Blogs first published on The Daily Vox's website.
What do I know about Ebola? I’m just a doctor…
In the days leading up to the start of my first Ebola mission, I frantically wrack my brain for any and all knowledge I have on the lethal illness.
There are snippets of a medical school lecture entitled “Viral Haemorrhagic Fevers”. It is filed somewhere next to Haemochromatosis and Klippel-Feil syndrome, in a section of the brain labelled “things you are unlikely to need again after the exams”.
I remember beautifully detailed pictures taken under electron microscopes, I remember the class Filoviridae, and the name Peter Pyott seems to ring a bell. My go-to electronic medical reference has scanty information on clinical management, but copious notes on the identification of Bioterrorism.
It also states that “even a single case of Ebola or Marburg virus outside of Africa is a public health emergency”. As a South African, I find this rather offensive.
A sense of unease develops as messages pour in from well-meaning friends, saying “Be careful,” and “Don’t get sick.” My briefings at MSF headquarters are reassuring – with a disease that occurs as seldom as Ebola there aren’t many experts in the world.
I find comfort in the fact that a good handful of them have the letters MSF written on their business cards.
Before my departure, one of them sits me down in her office and rolls out a map on the table. From memory, she recounts all the significant happenings and dates around the current outbreak.
I remark on how widely dispersed the confirmed cases have been. “Exactly,” she says. “And that’s the biggest problem.”
Finally, I am handed a small red book that contains MSF’s most up to date guidelines on running a field hospital during a Haemorrhagic fever outbreak. I instantly recognise it as my dearest ally in the battle I am about to enter.
Read more about Dr Kruger's experience responding to the outbreak of Ebola in West Africa in 2014-2015.
MSF previous work around Ebola:
Four people died in the most recent Ebola outbreak that occurred in a remote, forested area of the Democratic Republic of Congo (DRC). This small outbreak (five laboratory-confirmed and three probable cases) was quickly curtailed. MSF shares lessons learned from this first occurrence of the deadly virus since the end of the large-scale Ebola outbreak that devastated West Africa in 2014-2015.
In May 2017, one case of Ebola was confirmed by the World Health Organisation (WHO) in the Likati health zone of Bas Uele Province in the north of the Democratic Republic of Congo.
2016 Research About Ebola
Two years after the West African Ebola outbreak was declared in Guinea, MSF published a review of its Ebola-related research carried out in Guinea, Sierra Leone and Liberia, including clinical, epidemiological and anthropological research
DRC 2014 Ebola Epidemic confirmed in DRC
In August 2014, Doctors Without Borders (MSF) launched a response to the confirmed Ebola viral hemorrhagic fever outbreak in Equateur Province, Democratic Republic of Congo (DRC).
Photo: Moore/Getty Images
On 25 March 2014, Guinea’s Ministry of Health reported an Ebola outbreak in four southeastern districts. The virus then spread to neighbouring countries Sierra Leone and Liberia, eventually resulting in an unprecedented outbreak with over 10,000 people dead across West Africa.
Learn more about Ebola here.