As health officials in Nebraska monitor an American potentially exposed to Ebola, outbreak response activities have been impeded in the DRC following the cutting of internet connections by the government.
As the North Kivu Ebola outbreak in the Democratic Republic of Congo (DRC) enters its fifth month, health officials in Nebraska announced that an American is currently being monitored following a potential exposure to the virus while in the remote region of the country.
On January 2, 2019, the University of Nebraska Medical Center issued a statement indicating that an unidentified American citizen who had been providing assistance in the DRC was potentially exposed to the virus and therefore transported to Omaha on December 29, 2018, to be monitored by health officials.
According to the statement, the individual has not exhibited any Ebola symptoms but will continue to be monitored for up to 2 weeks.
"This person may have been exposed to the virus but is not ill and is not contagious," Ted Cieslak, MD, an infectious diseases specialist with Nebraska Medicine and associate professor of epidemiology in the University of Nebraska Medical Center College of Public Health, said in a statement. "Should any symptoms develop, the Nebraska Medicine/UNMC team is among the most qualified in the world to deal with them."
Nebraska Medicine is home to the Nebraska Biocontainment Unit, the largest of only a few biocontainment units in the United States. These units are capable of caring for patients infected with the most deadly and infectious of diseases (like Ebola). In 2014, 3 patients with Ebola contracted during the 2014-2015 outbreak that devastated Sierra Leone, Guinea, and Liberia, were treated in Nebraska, and in 2015 health officials with Nebraska Medicine conducted routine monitoring of several individuals after exposure to the virus.
If the individual that is currently being monitored in Nebraska develops any symptoms of Ebola virus infection, they will be admitted to the Biocontainment Unit.
Although the institution cannot comment on the individual patient, when asked how the medical team plans to treat the patient, Taylor Wilson, senior media relations coordinator at Nebraska Medicine told Contagion®, “We do have access to many of the experimental therapies, and would use whatever methods we deemed necessary to treat a patient who did have Ebola.”
As of January 1, 2019, there were a total of 603 cases of Ebola virus infection in the DRC, 555 of which were confirmed. There have been 318 confirmed deaths. Beni remains the epicenter of the outbreak with 217 confirmed cases, followed by Mabalako with 86 cases.
In addition to the challenges of the outbreak, political turmoil related to the presidential election on December 30, 2018, has incited more violence in the DRC.
According to The Associated Press, the DRC’s government made a decision to exclude approximately 1 million voters living in the outbreak zones—such as Beni and Butembo—from voting in the election. After the announcement of the decision, protests erupted which included vandalism to Ebola treatment facilities and violence that impeded prevention and treatment activities for several days.
Following the election, the DRC government cut internet connection and access to SMS services for DRC citizens. According to the AP article, the government indicated the media blackout was implemented to maintain order after incorrect results were publicized on Twitter.
Reuters reported that Barnabe Kikaya bin Karubi, a senior adviser to outgoing President Joseph Kablia, stated that internet and SMS connections would remain suspended until January 6, 2019, when the election results will be announced.
The internet outage has also impeded response efforts for the ongoing outbreak. On January 2, 2019, the DRC Ministry of Health issued a tweet that the daily outbreak report would be delayed due to technical difficulties.
Il risque d'avoir des retards dans l'envoi des bulletins #Ebola dans les prochains jours à cause de problèmes techniques. Excusez-nous pour le dérangement.
There might be some delays in the sending of daily Ebola updates due to technical issues. Sorry for the inconvenience.
— Ministère de la Santé RDC (@MinSanteRDC) January 2, 2019
Ambassadors to the DRC from several nations issued a statement on December 31, 2018, calling for calm and requesting that the government refrain from blocking access to the internet.
Additionally, the US Department of State issued a press release on January 3, 2019, expressing concern over the canceled elections in Beni and Butembo.
“As the Congolese people, the region, and the world await patiently for the results of these elections, the internet must be restored and the media allowed to report freely,” deputy spokesperson Robert Palladino wrote in the statement. “There are moments in every nation’s history when individuals and political leaders step forward and do the right thing. This is one of those moments for the DRC.”
Contagion® will continue to monitor the situation in the DRC and provide updates as they become available.