Ebola, the Democratic Republic of Congo Burden

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According to the World health organization the Government of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease (EVD) in Bikoro in Equateur Province today. The outbreak declaration occurred after laboratory results confirmed two cases of EVD.

The Ministry of Health of Democratic of the Congo (DRC) informed to the world health organization (WHO) that two out of five samples collected from five patients tested positive for Ebola at the Institute National de Recherche Biomédicale (INRB) in Kinshasa. While other More specimens are being collected for testing.

According to the world health organization they are working closely with the Government of the DRC to rapidly scale up its operations and mobilize health partners using the model of a successful response to a similar Ebola outbreak in 2017.

“Our top priority is to get to Bikoro to work alongside the Government of the Democratic Republic of the Congo and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak,” said Dr Peter Salama, WHO Deputy Director-General, Emergency Preparedness and Response. “Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.”

Today the first multidisciplinary team comprised of experts from WHO, Médecins Sans Frontières and Provincial Division of Health travelled to Bikoro to strengthen coordination and investigations.

Bikoro is situated in Equateur Province on the shores of Lake Tumba in the north-western part of the country near the Republic of the Congo. All cases were reported from iIkoko Iponge health facility located about 30 kilometres from Bikoro. Health facilities in Bikoro have very limited functionality, and rely on international organizations to provide supplies that frequently stock out.

“We know that addressing this outbreak will require a comprehensive and coordinated response. WHO will work closely with health authorities and partners to support the national response. We will gather more samples, conduct contact tracing, engage the communities with messages on prevention and control, and put in place methods for improving data collection and sharing,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.

This is DRC’s ninth outbreak of EVD since the discovery of the virus in the country in 1976. In the past five weeks, there have been 21 suspected viral haemorrhagic fever in and around the iIkoko Iponge, including 17 deaths.

“WHO is closely working with other partners, including Médecins Sans Frontières, to ensure a strong, response to support the Government of the Democratic Republic of the Congo to prevent and control the spreading of the disease from the epicentre of iIkoko Iponge Health Zone to save lives,” said Dr Allarangar Yokouide, WHO Representative in the DRC.

Upon learning about the laboratory results today, WHO set up its Incident Management System to fully dedicate staff and resources across the organization to the response. WHO plans to deploy epidemiologists, logisticians, clinicians, infection prevention and control experts, risk communications experts and vaccination support teams in the coming days. WHO will also be determining supply needs and help fill gaps, such as for Personal Protective Equipment (PPE). WHO has also alerted neighbouring countries.

WHO released US$ 1 million from its Contingency Fund for Emergencies to support response activities for the next three months with the goal of stopping the spread of Ebola to surrounding provinces and countries.

On 20 November 2014, as per WHO recommendations, the MoH of DRC and WHO declared the end of the Ebola outbreak that started on 24 August 2014 and resulted in a total of 38 laboratory confirmed cases and 28 probable case including 49 deaths in Boende, Equateur province. This was the seventh outbreak of EVD since its discovery in 1976 in DRC.

In 2014 over 66 cases of ebola including 49 deaths diagnosed initially in Equateur province (Watsi Kengo, Lokolia, Boende, and Boende Muke) in 2012, 36 cases including 13 deaths Orientale province – Isiro (Bundibugyo virus). In 2008–2009, 32 cases including 15 deaths in Kasaï-Occidental (Zaire virus). In 2007: 264 cases including 187 deaths in Kasaï-Occidental (Zaire virus). In 1995: 315 cases and 250 deaths occurred in Kikwit and surrounding area. While in

1977 only 1 case was discovered (Zaire virus).

1976 over 318 cases including 280 deaths in Yambuku (Zaire virus) occurred.

There are five identified subtypes of Ebola virus. The subtypes have been named after the location where they have been first detected. Three of the five subtypes have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa. Ebola–Zaire, Ebola–Sudan and Ebola–Bundibugyo. EHF is a febrile haemorrhagic illness which causes death in 25–90% of all cases.

 The Ebola virus causes an acute, serious illness which is often fatal if untreated. The average EVD case fatality rate is around 50%. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

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