Early in an outbreak, everything is questions…

Map of interesting locations in the Ebola virus outbreak in the Democratic Republic of the Congo. Coloured pins mark locations of suspected, probable and confirmed human EVD case detections. The adjacent waterways connect Bikoro to the DRC capital, Kinshasa, and to Bangui, capital of the Central African Republic. 

Nothing is clear during the early days of an outbreak of Ebola virus.

Nothing is usually clear in the early days of an outbreak of any infectious disease.

Numbers, the source of the outbreak, place names and maps, estimates of severity and declarations of doom and gloom wax and wane.

While we wait to hear more detail passed on from those on the ground who are best able to gather accurate information, this post is just a very rough summary of where we might be at.

The Bikoro Health Zone, shown bounded by a solid red line. Map created by MSF, hosted by reliefweb [1]

There’s an outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo, occurring in the Bikoro Health Zone (highlight in the map).

This Health Zone covers quite a big area and it includes the town of Bikoro as well as Ikoko-Impenge. The neighbouring Iboko Health Zone includes Itipo while the Ingende Health Zone includes Ingende.

These 4 communities have all been implicated in having suspected, probable or confirmed cases (of which there are still only 2 as far as I can tell).[2,3,4]

Bikoro has a general hospital and both Ikoko-Impenge and Itipo have health centres. These can be seen more clearly at the reliefweb.int website version of the MSF map’s PDF and if you zoom in on some satellites maps.[1,7]

Of the first 5 samples collected, all from hospitalized patients, 3 were from Ikoko-Impenge and 2 from Bikoro.[2] The 2 RT-PCR confirmed cases were hospitalized in Ikoko-Impenge; whether an infection was acquired there or elsewhere is not clear.

21 suspected cases were initially reported, 17 with links with another suspected case and 17 which were fatal. These 21 have not been sampled as described in the Tweet below. Ongoing data are being provided by Dr. Oly Ilunga Kalenga (Minister for Health) and the Ministry of Health, DRC. Dr Kalenga has been publishing a running tally of the outbreak’s cases using communiques [6] and Twitter (@OlyIlunga – highly recommended follow)

The current tally is 34 suspected + probable + confirmed cases breakdown as reported by the World Health Organisation (WHO) Regional Office for Africa External Situation Report [4]…


  1. Dem. Rep. of the Congo – Equateur Province / Mbandaka area – Population distribution.
    Maps created 11MAY2018 by the GIS Unit, Medcins Sans Frontieres and hosted on reliefweb
  2. Ebola virus disease – Democratic Republic of the Congo, WHO, 10MAY2018
  3. WHO Officials Fear Latest Ebola Outbreak in Congo Could Spread to Big Cities
  4. WHO EBOLA VIRUS DISEASE, Democratic Republic of Congo External Situation Report 1
  5. Statement of the Minister of Health at the press briefing on the Ebola epidemic in Bikoro this Thursday, May 10, 2018 
  6. https://us13.campaign-archive.com/home/?u=89e5755d2cca4840b1af93176&id=aedd23c530
  7. http://satellites.pro/#-0.952950,18.759201,9

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