1. Situation update
The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo. On 27 June 2018, all the people who were exposed to the last confirmed EVD case-patient completed their mandatory 21-day follow up without developing symptoms. This is an important milestone. The last confirmed EVD case in Equateur Province was cured and discharged from the Ebola treatment centre (ETC), following two negative tests on serial laboratory specimens, on 12 June 2018. The response is now focused on intensive surveillance, including active case finding and investigation of suspected cases and alerts.
Since our last report on 26 June 2018 (External Situation report 13), 13 suspected EVD cases were reported in Bikoro (10), Iboko (2) and Wangata (1) health zones. Of the 13 suspected cases, 11 tested negative, while two suspected cases reported on 30 June 2018 are awaiting collection of the second specimens for a repeat test after the first specimens tested negative.
Since the beginning of the outbreak (on 4 April 2018), a total of 55 EVD cases and 29 deaths have been reported, as of 1 July 2018. Of the 55 cases, 38 have been laboratory confirmed, 15 were probable cases (deaths for which it was not possible to collect laboratory specimens for testing) and two were suspected cases. One community death that occurred on 20 May 2018 in Iboko Health Zone was retrospectively identified and reclassified as a probable case, increasing the number of probable cases from 14 to 15. Of the 53 confirmed and probable cases, 29 died, giving a case fatality rate of 54.7%. Twenty-eight (53%) confirmed and probable cases were from Iboko, followed by 21 (40%) from Bikoro and four (8%) from Wangata health zones. Five healthcare workers have been affected, with four confirmed cases and two deaths. A total 24 casepatients with confirmed EVD have been cured since the onset of the outbreak.
On 8 May 2018, the Ministry of Health of the Democratic Republic of the Congo notified WHO of an EVD outbreak in Bikoro Health Zone, Equateur Province. The event was initially reported on 3 May 2018 by the Provincial Health Division of Equateur when a cluster of 21 cases of an undiagnosed illness, involving 17 community deaths, occurred in Ikoko-Impenge health area. A team from the Ministry of Health, supported by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge health area on 5 May 2018 and found five case-patients, two of whom were admitted in Bikoro General Hospital and three were in the health centre in Ikoko-Impenge. Samples were taken from each of the five cases and sent for analysis at the Institute National de Recherche Biomédicale (INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola virus, Zaire ebolavirus species, by reverse transcription polymerase chain reaction (RT-PCR) on 7 May 2018, and the outbreak was officially declared on 8 May 2018. The index case in this outbreak has not yet been identified and epidemiologic investigations are ongoing, including laboratory testing. This is the ninth EVD outbreak in the Democratic Republic of the Congo over the last four decades, with the most recent one occurring in May 2017. Further information on past outbreaks is available at: http://www.who.int/ebola/historical-outbreaksdrc/en/.