Ebola Outbreak Continues to Grow in Active Conflict Zones of the DRC

Two weeks have passed since the declaration of an Ebola outbreak in the North Kivu Province and the death toll has already surpassed that of the previous outbreak in the Democratic Republic of the Congo (DRC).

As of August 21, the World Health Organization (WHO) has reported a total of 103 cases of Ebola virus in the North Kivu Province, including 76 laboratory-confirmed cases, 27 probable cases in deceased patients, and 34 confirmed deaths.

A total of 8 health care workers have been infected in the outbreak thus far in Mangina, a city in the province. As a result of the number of infected health care workers, the Ministry of Health has brought in an entire new staff.

“[A] worrisome problem, in Mangina is the number of health workers that are already infected with Ebola… the Mangina health facilitiy is a small facility with no more than 75 health workers…” Tedros Adhanom Ghebreyesus, PhD, director-general of the World Health Organization said in a press conference held on August 14. “Because of the contacts the other health workers may have because of the other confirmed cases, all health workers were advised to stay at home and replacement health workers were already provided to run the health facility.”

Dr. Tedros further explained that a unique concern regarding this outbreak is that it is occurring in active conflict area and a dense population. The insecurity in the region caused by rebel groups fighting in the area has resulted in over 1 million displaced Congolese individuals. Displacement has spurred high population movement both in the country and across the border into neighboring countries.

In the province, there are a number of highly active conflict zones referred to as red zones. Some red zones are inaccessible, presenting an environment for Ebola to run rampant amongst populations living within these zones. While these zones are difficult for health care workers to access, they are also difficult for individuals living in the zones to exit, thus, efforts to stop the spread of the disease are significantly hindered.

In an effort to strengthen outbreak response efforts, the WHO issued a statement calling for free and secure access in the DRC on August 23.

“It’s a place where there are huge challenges as far as security is concerned, and there is a need for us to work within the context of our colleagues in the United Nations and also to work with local communities to make sure that we have access when there is need to have access, [and so] we know it’s safe to go into places to take action,” said Mathsidiso Moeti, MsC, WHO Regional Director for Africa in a video featured in the statement.

A ring vaccination campaign will be implemented this week with the rVSV-ZEBOV vaccine, according to the latest External Situation Report issued on August 14. The vaccination of health care workers began on August 8, and at least 40 health workers have been vaccinated thus far.

The WHO has also strengthened surveillance capacities at points of entry (POEs). This effort includes 18 international POEs along the border in North Kivu; over 30 points of internal connection for travelers, refugees, and migrants, which includes transit centers and sites of congregation; and additional points of entry in other areas of the DRC, such as international airports.

To date, there have been no reported cases in the neighboring nations of Uganda and Rwanda. However, there are campaigns underway to increase awareness in these nations and health officials are making preparations in case the outbreak spreads.

Contagion® will continue to post updates as they become available.

For the most recent case counts associated with the Tenth Ebola Outbreak in the Democratic Republic of the Congo, check out the Contagion^® Outbreak Monitor.

Updated on 8/22/18 at 8:41 AM EDT to reflect updated case counts.