Three new confirmed cases of Ebola were reported in Beni on 10 and 12 April, with two patients since passing away after visiting healthcare facilities. The third, who is still alive, was a contact of one of the victims. Before the identification of these three cases, the last confirmed Ebola patient in the DRC tested negative twice and was discharged from a treatment centre on 3 March 2020. The new cases came only three days before the country expected to declare an end to the outbreak which was first announced in August 2018, however it is noted that the current resurgence was ultimately not unexpected because of the presence of human and animal reservoirs in the DRC; the virus is transmitted from wild animals and spreads through human-to-human transmission. The World Health Organisation (WHO) believes that further cases will be identified, especially as the source of these three infections in Beni remains unconfirmed.
"We have to anticipate and be prepared for additional small outbreaks."
The World Health Organisation discussing the infections in Beni
The International Health Regulations Emergency Committee for Ebola in DRC, which operates under WHO, believes that the Ebola outbreak in the DRC continues to constitute a Public Health Emergency of International Concern. Despite this, it is not expected that the outbreak will re-emerge in full force; flare-ups are expected at towards the end of an Ebola outbreak. WHO has stated that the rapid risk assessment is moderate at the national and regional levels, and low at the global level.
WHO teams in Beni are providing support and have investigated alerts, identified and vaccinated contacts, decontaminated affected homes and health facilities, and sent samples for sequencing. To date, 213 contacts of these three new cases have been identified, 90 of whom have since been vaccinated. Three vaccination teams have been activated, with approximately 6000 doses available in Beni, however WHO anticipates that the air traffic and flight restrictions imposed amid the COVID-19 pandemic may cause challenges with the distribution of the vaccine.
Three vaccination teams have been activated, with approximately 6000 doses available in Beni
It is, however, feared that the response in the DRC is threatened by the presence of nearby armed groups, a lack of funding, and the COVID-19 pandemic, which is putting pressure not only on WHO’s funding and resources but also on healthcare facilities in Beni, where two cases of COVID-19 have been confirmed.
In an update of the epidemiological situation provided by DRC’s Ministry of Health, it was announced that between its declaration of the outbreak in August 2018 and 8 April 2020, a total of 3453 Ebola cases were reported, of which 2273 cases died, equating to a case fatality rate of 66%.
Reflecting on the new Ebola cases, WHO Emergencies Chief Mike Ryan said: “Maybe that’s our lesson for COVID-19: There is no exit strategy until you’re in control of the situation. You must always be ready to start again … never be surprised.”
Featured image: NIAID Integrated Research Facility