Ebola virus disease - Democratic Republic of the Congo

From 13 to 19 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo (Figure 1). Since the resurgence of the outbreak on 10 April 2020, seven confirmed cases have been reported from Kasanga, Malepe and Kanzulinzuli Health Areas in Beni Health Zone. Of these, two cases who were receiving care at the ETC recovered and were discharged, and one remains in the community (status unknown). The four other people confirmed to have Ebola died, including two community deaths and two deaths in the ETC in Beni. No new cases have been reported since 27 April. The last person confirmed to have Ebola recovered and was discharged from the treatment centre on 14 May 2020. On the same day, the Ministry of Health of the Democratic Republic of the Congo declared the launch of the 42-day countdown to the end of the outbreak. On 18 May, all 90 contacts who remained under surveillance completed their 21-day follow up.

A total of 1486 people have been vaccinated in Beni and Karisimbi since 10 April 2020. To date, no definitive source of infection has been identified.

From 13 to 19 May 2020, an average of 2832 alerts were reported per day, of which 2827 (over 99%) were investigated within 24 hours. Of these, an average of 385 alerts were validated as suspected cases each day, requiring specialized care and laboratory testing to rule-out EVD. In the past three weeks, the alert rate has improved in affected health zones. Timely testing of suspected cases continues to be provided from eight laboratories. From 11 to 17 May 2020, 2869 samples were tested including 2081 blood samples from alive, suspected cases; 382 swabs from community deaths; and 406 samples from re-tested patients. Overall, laboratory activities increased by 15% compared to the previous week.

As of 19 May 2020, a total of 3462 EVD cases, including 3317 confirmed and 145 probable cases have been reported. Of these, 2279 people died (overall case fatality ratio 66%) and 1171 survived. Of the total confirmed and probable cases, 57% (n=1970) were female, 29% (n=1002) were children aged less than 18 years, and 5% (n=171) were health care workers. Since the beginning of the outbreak 250 292 contacts have been registered, and since August 2018, 303 867 people (frontline workers; contacts and contacts of contacts of confirmed cases) have been vaccinated against EVD with the rVSV-ZEBOV-GP vaccine.

Efforts to retrieve the missing confirmed case and investigations into the origin of the recent cluster in Beni Health Zone are still ongoing. Given the long duration and large magnitude of the Ebola outbreak in Ituri, North Kivu, and South Kivu Provinces in the Democratic Republic of the Congo and the endemicity of Ebola virus in animal reservoirs in the region, there is a risk of re-emergence of the virus leading up to the declaration of the end of the outbreak, as well as beyond. In the coming weeks and months, it is crucial to maintain a strong and robust surveillance system in order to detect, isolate, test and treat new suspected cases as early as possible, to improve outcome of potential cases, and to interrupt any new chains of transmission. Maintaining strong communication and coordination among partners, authorities and affected communities, as well as continuing support for and engagement with EVD survivors are essential in this outbreak response.

Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 19 May 2020*

Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu Province, Democratic Republic of the Congo, data as of 19 May 2020** 

**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

On 14 April 2020, WHO revised the risk assessment for this event from High to Moderate at the national and regional levels, while the risk level remained Low at the global level. The risk assessment will be continuously reassessed in the coming days based on available and shared information.

For further information, please see the Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 14 April 2020

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information regarding this EVD outbreak. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo in relation to this EVD outbreak. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

• WHO resources and information on Ebola virus disease
• WHO resources and information on Ebola survivors
• WHO recommended criteria for declaring the end of the Ebola virus disease outbreak
• Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 14 April 2020
• Ebola response funding