Global health officials are concerned about the potential consequences of the disruption to Ebola surveillance in the DRC outbreak caused by civil unrest.
Updated: 9/25/18 at 4:20 PM EDT
The World Health Organization (WHO) is voicing concern over a number of variables that could lead to more challenging circumstances in the Ebola outbreak that is ongoing in the Democratic Republic of the Congo (DRC).
During the month of September, the number of new cases associated with the outbreak decreased significantly, compared with August. As of September 23, 2018, just 19 new cases have been confirmed since September 1, 2018.
However, due to widespread violence in the city of Beni, all of the efforts made by WHO to contain the outbreak have been suspended for the time being, and officials are concerned about the repercussions.
On Saturday, September 23, 2018, rebel forces launched an attack in the city of Beni, located in the North Kivu province. A total of 21 individuals were killed in the conflict, including 17 civilians.
In an update on September 24, 2018, Minister of Health Olly Ilunga Kalenga indicated that a mourning period was being observed, effectively suspending all activities related to Ebola prevention; however, the treatment centers continue to remain open to treat all active Ebola cases. (See tweet)
As a result of the unrest, civil organizations have called for the mourning period to be extended until Friday, September 28, 2018. Conditions of the morning period include suspension of all Ebola prevention activities, including door-to-door surveillance, distribution of vaccines, tracking contacts of the ill and deceased, and conducting prevention education.
“We’ve heard this morning, that that [the mourning period], which was yesterday, has now been extended right through to Friday of this week,” Peter Salama, PhD, WHO deputy director of emergency preparedness and response, said in an interview, “which basically means for the UN family, including WHO, a lockdown in Beni. Our operations are in effect suspended.”
Since the start of the outbreak, the city of Beni has seen the second highest number of confirmed cases with 29 confirmed cases and 4 probable cases.
Dr. Salama reported that due to the mourning period, the WHO staff were only able to access 20% of the contacts of the ill that they intended to evaluate. The number of vulnerable individuals that may become infected during this period could continue to grow.
On September 25, 2018, the Ministry of Health reported that the mayor of Beni met with the president of the civil society of Beni and reached an agreement that Ebola prevention activities could resume during the remainder of the mourning period. As such, the Ebola prevention activities conducted by the Ministry of Health and partner organizations including the WHO may resume.
According to the United Nations, the mourning periods could extend to nearby cities that are also experiencing the brunt of the Ebola outbreak.
The total outbreak case count includes 150 cases, 119 of which are confirmed and 31 probable. There has been a total of 100 deaths, 69 of which in patients confirmed to have Ebola, and the remaining death linked to probable cases.
In addition to the civil unrest in Beni, health officials are also concerned because 2 cases have been reported in the city of Tchimona which is located along the border of Uganda. Of the 2 ill, 1 has died and the other has been placed in isolation in a local hospital.
According to a tweet issued by Dr. Salama, the spread to Tchioma is particularly concerning because the first patient to fall ill avoided the health workers and refused care. The second patient was the spouse of the initial patient.
Uganda is considering the new cases to be a serious threat to the country and has scaled up preparation in case the outbreak spreads.
The Uganda Ministry of Health has subsequently launched Ebola vaccination simulations for health workers in 5 high-risk districts of the country. Additionally, Uganda has implemented entry screening and surveillance for anyone experiencing Ebola-like symptoms.
For the most recent case counts associated with the Tenth Ebola Outbreak in the DRC, check out the Contagion® Outbreak Monitor.