DR Congo

Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 17: Declaration of End of Ebola Virus Disease Outbreak

Situation Report
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Situation Update

On 24 July 2018, the Ministry of Health of the Democratic Republic of Congo declared the end of the ninth outbreak of Ebola virus disease (EVD) in the country. The announcement comes 42 days (two incubation periods) after blood samples from the last confirmed Ebola patient twice tested negative for the disease.

WHO Director-General, Dr Tedros Adhanom Ghebreyesus, and Regional Director for Africa, Dr Matshidiso Moeti, joined Minister of Health Dr Oly Ilunga for the announcement in Kinshasa. “The outbreak was contained due to the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of the Ministry of Health. That kind of leadership, allied with strong collaboration between partners, saves lives,” said Dr Tedros1 . “WHO moved quickly and efficiently,” said Dr Moeti, “We also demonstrated the tremendous capacity of the African region. More than three-quarters of the 360 people deployed to respond came from within the region.” No new laboratory-confirmed EVD cases have been detected since the last case developed symptoms on 2 June 2018 (Figure 1). From 20 through 21 July 2018, WHO supported a workshop to harmonize, reconcile and validate the wide range of data arising from the outbreak response. The workshop brought together teams responsible for coordination, surveillance, case management, laboratory investigations and vaccinations in Mbandaka, Bikoro, Itipo, Iboko and Kinshasa to share their findings, and resolve differences in data records. As a result of this exercise, changes to the number of confirmed and probable cases line listed, including deaths among these cases, were formalized. These changes only affected the reclassification of data records of past cases, who were otherwise known to field investigators and received full follow-up.

As of 24 July 2018, there have been a total of 54 Ebola virus disease cases (38 confirmed and 16 probable), with illness onset between 5 April and 2 June 2018 (Figure 1). Of these cases, 33 died (overall case fatality ratio: 61%), including 17 deaths among confirmed cases. Cases were reported from three health zones (Figure 2): Bikoro (n=21; 10 confirmed, 11 probable), Iboko (n=29; 24 confirmed, 5 probable), and Wangata (n=4; all confirmed). Seven cases were health care workers, of which two died.

Context 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, Équateur Province. The event was initially reported on 3 May 2018 by the Provincial Health Division of Équateur 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. 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-outbreaks-drc/en/.