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Ebola in DRC: 2018

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Democratic Republic of Congo: Ebola Outbreak

Latest News: 

30 October 2018: Since the beginning of August (01/08) an Ebola epidemic has been declared in East-Congo. The epidemic is not under control, a total of 162 (127 confirmed + 35 probable) people have died Read more about the outbreak: Crisis info #4

5 September 2018: Since the beginning of the outbreak over 4,100 contacts have been identified and more than 2,300 are being followed up by the Congolese Ministry of Health. Find out more here

16 August 2018: Doctors Without Borders (MSF) opened a treatment centre on Tuesday 14 August in Mangina, a small town considered to be the epicentre of the outbreak. 

1 August 2018The tenth Ebola outbreak in the  Democratic Republic of Congo was declared on 1st August in the North Kivu province, on the north-eastern part of the country. So far, 74 cases and 34 deaths have already been reported by the health authorities. 

Latest News:

25 July 2018: MSF Welcomes the announcement of the end of the Ebola epidemic in the Democratic Republic of Congo

Between May and mid-July, MSF teams ran a three-month long emergency intervention in Equateur Province to respond to the Ebola outbreak. Throughout the course of the outbreak, Congolese Ministry of Health teams supported by MSF in Bikoro, Itipo, Mbandaka and Iboko, provided care to 38 confirmed patients, 24 of whom survived and returned to their homes. Sadly 17 died. More than 120 other patients who showed symptoms consistent with Ebola were isolated and tested before being allowed to return home after testing negative for the virus.

A total of 3,199 people were vaccinated against Ebola with the investigational Ebola vaccine rVSVDG-ZEBOV-GP under WHO’s Expanded Access Framework by teams from MSF, WHO and the Congolese Ministry of Health. MSF teams alone vaccinated some 1,673 people in the Bikoro and Itipo areas, including the contacts of confirmed Ebola patients and their contacts, and frontline workers (health workers, burial workers, traditional healers and motorbike taxi drivers) considered to be most at risk of contracting the virus.

MSF, Doctors Without Borders, DRC, end of Ebola outbreak
Since the beginning of the outbreak, MSF set up its medical response along with national health authorities, providing care, isolation of patients and health promotion activities. Photo: MSF/Louise Annaud

2 July 2018: MSF hands over Ebola response activities in DRC

After a two-month emergency intervention in Equator Province, Democratic Republic of Congo (DRC), Doctors Without Borders (MSF) teams have begun handing over Ebola response activities to the Congolese Ministry of Health and other non-governmental organisations in Mbandaka, Bikoro, Itipo and Iboko.

Find out more here

19 June 2018: 

Since the Ebola epidemic in DRC was declared on 8 May 2018, there have been 38 confirmed Ebola cases and 28 deaths (of whom 14 were not confirmed Ebola patients but probable deaths recorded in the community but never tested for Ebola) have been notified by the national health authorities in the Equateur region. Twenty-four patients (confirmed as Ebola cases) have recovered from the disease and been discharged from treatment centres.

There have been no Ebola positive patients under treatment in DRC for a week. Papa Wangi was discharged on the 11th of June in Itipo and thankfully no one has tested positive since, (check out MSF DRC’s Twitter for his story!) so we are now at day 8 of a count to 42 to end the epidemic.

That said, hundreds of contacts remain under surveillance and areas of uncertainty remain in some villages, so this good news could change quickly. MSF is in no position to make predictions about the end of the outbreak. We treat the patients in front of us and respond to what we see on the ground instead.

Marie-Vincent, shares how she recovered from Ebola here

  Suspect Cases  Probable Cases Laboratory-confirmed cases Deaths among confirmed patients Deaths in total
Mbandaka Health Zone 0 0 4 3 3
Bikoro Health Zone 4 11 10 7 18
Iboko Health Zone (including Itipo) 4 3 24 4 7
Ingende Health Zone 2 0 0 0 0
Total  10 14 38 14 28

6 June 2018: 

Latest figures (source: DRC Ministry of Health) – date of info: 5/06/2018

Since the Ebola epidemic in DRC was declared on 8 May 2018, 60 people who presented symptoms of haemorrhagic fever, including 37 confirmed Ebola cases and 27 deaths (of whom 13 were confirmed as Ebola), have been notified by the national health authorities in the Equateur region, where the outbreak started. 23 patients (confirmed Ebola cases) have recovered from the disease and been discharged from treatment centres.

  Suspected Cases  Proabale Cases  Laboratory-confirmed cases Deaths
Mbandaka Health Zone 1 0 4 3
Bikoro Health Zone  11 10 
Iboko Health Zone (including Itipo)  3 23  3
Total  14  37  13 

Paul Jawor MSF water and sanitation expert, explains the challenges MSF teams are facing as a 'race against time' in this article here

30 May 2018: 

Since the Ebola epidemic in DRC was declared on 8 May 2018, 54 people who presented symptoms of haemorrhagic fever, including 35 confirmed Ebola cases and 25 deaths (of whom 12 were confirmed as Ebola), have been notified by the national health authorities in the Equateur region, where the outbreak started. 

  Suspect cases Probable Cases  Laboratory-confirmed cases Deaths
Mbandaka 1 0 4
Bikoro 1 11 10  16 
Iboko 4 2 21 6
Total  6 13 35  25

Yesterday, Doctors Without Borders (MSF), started vaccinating Ebola frontline workers in Bikoro, Equateur Province, Democratic Republic of Congo (DRC), find out more about it here

5 things to know about the Ebola vaccination: Watch the video below

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

Where  Overall Cases  Confirmed 
Bikoro 29 10
Mbandaka 6 4
Iboko 11 7
Total 46 21

VACCINATION TRIAL: 
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”.

MSF, Doctors Without Borders, Ebola outbreak, DRC
Mbandaka hospital in Equateur province, DRC. Photo: Louise Annaud/MSF

 

MSF response:

  • 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.

MSF, Doctors Without Borders, DRC, Ebola
Hygienist decontaminating his boots inside Boende Ebola treatment centre, DRC.
Archived image from 2014 by: Gabriele François Casini/MSF

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.
MSF, Doctors Without Borders, DRC, Ebola
Two members of the MSF team decontaminating a latrine in the backyard of a house in Ituku. 
Archived image from 2014 by: Gabriele François Casini/MSF

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.

Photo: Samuel Aranda 

MSF previous work around Ebola:

2017 Lessons from previous Ebola outbreaks

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.

DRC 2017 MSF sends response team to Likati, DRC

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). 

West Africa Ebola Outbreak 2014-2015

Photo: Moore/Getty Images

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.