Ebola virus disease outbreak in Democratic Republic of Congo 2018
The Democratic Republic of Congo (DRC) is phasing through new EBOLA virus disease (EVD) outbreak. The life-threatening (CFR>75%) deadly hemorrhagic fever is caused by Ebola virus infection. As of now, the current outbreak is majorly prevailing in three health zones in Equateur Province of DRC. Multinational multi-agencies are dealing with the situation. Let's understand the situation well.
2018 DRC EVD Declaration
May 3: Equateur Provincial Health division reports 21 cases of undiagnosed illness (17 died), from Ikoko-Impenge health centre.
May 5: Team from DRC ministry of health visited Ikoko-Impinge health zone, found 5 case-patients (2 admitted to Bikoro General Hospital and 3 admitted to Ikoko-Impenge health centre), samples.
May 6: Samples submitted to Institute National de Recherche Biomédicale (INRB), Kinshasa.
May 7: Two samples tested positive for ZEBOV (Zaire strain of EBOLA virus) qRT-PCR.
May 8: Official declaration of national outbreak.
Case Summary[Equator Province May 21]
|Confirmed cases||Probable cases||Suspect cases||Total cases||Death||CFR|
- Area: 130 442 square Km
- Population: 2 543 936
- Health Zones: 16 (Bikaro, Iboko, Wangata and 13 other)
- Health centres: 284
Zone wise case report May 21
- Around 600 contacts have been identified to determine index case.
- Area: 1075 square Km
- Population: 163, 065
- Health centres: 19
- Hospitals: 3
The Ikoko-Impenge village (not accessible by road and telephone) is located 45 km away from Bikaro.
THE BRIEF HISTORY OF MAJOR EVD OUTBREAKS IN DRC [1976-2017]
|August 1976 to November 1976||ZEBOV||318||280||88%||Équateur province|
|January 1995 to July 1995||KEBOV||315||250||79%||Kwilu Province|
|June 2005 to July 2005||ZEBOV||12||10||83%||Cuvette-Ouest province|
|August 2007 to November 2007||ZEBOV||264||187||71%||Kasai Occidental Province|
|December 2008 to February 2009||ZEBOV||32||15||47%||Kasai Occidental Province|
|June 2012 to November 2012||BEBOV||87(#36)||36(#13)||41% |
|August 2014 to November 2014||ZEBOV||69||49||71%||Équateur province|
|May 2017 to |
ZEBOV: Zaire EBOLA virus; BEBOV: Bundibugyo EBOLA virus; CFR: case fatality rate; #36/#13 & #36% represents laboratory-confirmed cases (refer to Table-1 in the linked manuscript).
- Z-EBOV, K-EBOV and B-EBOV had caused 831 deaths in DRC from 1976-2017.
- The average CFR for DRC EVD is 75% (41% to 88%).
Case management in DRC
- Multinational multi agencies (WHO, MSF, NICD and many others) are dealing with the situation.
- Symptomatic treatment of infection consequences is the possible treatment option available.
- Experimental ring vaccination with rVSVΔG-ZEBOV vaccine [7540 doses are already placed in the field, additional 8000 doses will arrive soon] has been approved for in field use in DRC for dealing with the ongoing situation of EVD.
- Ebola virus can spread from infected bodily fluids contacts. In order to deal with the situation trained medical staffs are been deployed on ground in the DRC.
- Tracking contacts.
- Making people understand with the situation is really difficult task [recently three patients escaped quarantine centre (2 died, and 1 has returned to quarantine centres), religious and emotional practices don't fall in line with medical interventions].
- Dealing with the situation to restrict the outback with no further case fatalities.
- The confirmed case from Mabandaka (580 km from the capital Kinshasa), the city with population more than 1 million has mounted paramount chellenges to deal with the situation and such cases might boil the out the situation.
- Minimization of bats to human (bats are the natural reservoir for EBOLA), bats to animals and human to human transmission.
The national health emergency for DRC is not yet over.