Since 17 February, there have been no new cases of Ebola virus disease (EVD) reported from Democratic Republic of the Congo. This is a positive sign; however, there is still a high risk of re-emergence of EVD, and challenges related to limited resources, continued insecurity, population displacement in previous hotspots and limited access to some affected communities. It is essential to maintain surveillance and response activities, in addition to contining tosupport and monitor the health of EVD survivors in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.
Outbreak response efforts continue, including extensive surveillance, pathogen detection, and clinical management activities in previously affected areas, in addition to alert validation, supporting appropriate care and rapid diagnosis of suspected cases, building partnerships with community members to strengthen investigation of potential EVD deaths in communities, and strategically transitioning activities. Insecurity remains a challenge in continuing response efforts, which could delay the detection of potential flare-ups.
From 30 March to 5 April 2020, 31 265 alerts were reported and investigated. Of these, 2223 alerts were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. On average, people stay in these facilities for three days while waiting for EVD to be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 laboratories. From 30 March to 5 April 2020, 2376 samples were tested including: 1322 blood samples from alive, suspected cases; 365 swabs from community deaths; and 689 samples from re-tested patients. Overall, laboratory activities decreased by 14% compared to the prior week.
Since the beginning of the outbreak response, alert rates steadily climbed due to the active and passive case finding systems being strengthened and adapted to suit the local context, reaching additional health zones involved in the evolution of the outbreak. As expected, alert rates declined as the incidence of confirmed cases decreased and disease surveillance activities gradually transitioned toward routine operations. However, it remains important to maintain appropriate levels of surveillance throughthe end of outbreak declarationin order to rapidly detect relapse, re-introduction or new emergence events, implement effective control measures if necessary and avoid a potential resurgence of the outbreak.
As of 5 April 2020, a total of 3453 EVD cases were reported from 29 health zones (Table 1), including 3310 confirmed and 143 probable cases, of which 2273 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (1935) were female, 28% (979) were children aged less than 18 years, and 5% (171) were healthcare workers.
An urgent injection of US$ 20 million is required to ensure that response teams have the capacity to maintain the appropriate level of operations through to the beginning of May 2020, and are able to rapidly respond to any flare-ups. If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak. For more information see this recent statement: https://www.who.int/newsroom/detail/06-03-2020-end-in-sight-but-flare-up...