Location of the Ebola virus disease outbreak in Ikoko Impenge near Bikoro, DRC. Click on image to enlarge. Freely downloadable from here or https://doi.org/10.6084/m9.figshare.6233540
UPDATE #1, #2
The World Health Organization has reported that the Democratic Republic of the Congo (f. Zaire) has declared a new outbreak of Ebola virus disease (EVD). The announcement follows laboratory confirmation of the presence of infections by a strain of the genus Ebolavirus, species Zaire ebolavirus.[1,10]
Ebola virus disease in Bikoro
Figure 2. Suspected, probable and confirmed cases and deaths in the DRC EVD outbreak.
Most cases seem to be located at the Ikoko Impenge village health facility located about 30-60 kilometres from the market town of Bikoro.[1,11] The market town is located in Équateur Province, on the shores of Lake Tumba near Lake Tumba (see the adjacent map) and has river access to other villages and the DRC’s western border with Republic of the Congo.
The outbreak has reportedly been ongoing for 5 weeks of viral haemorrhagic fever and includes 21 suspected cases and 17 deaths.[1,3] That makes the proportion of fatal cases 80% but this number is likely to change as the outbreak evolves).
Only 2 of 5 collected samples collected by WHO-dispatched teams have been confirmed (Figure 2) by the Institut National de Recherche Biomédicale (INRB) laboratory in the DRC to date.[1,9]
What to watch
Figure 3. March-April OCHA report from the Great Lakes region, Africa.[12]
We’re starting at 5 weeks into this outbreak.[1] We’re in the early days of a collaborative effort to characterise and contain the outbreak, but it will be interesting to read why testing for ebolaviruses took this long. Remote communities and rugged terrain are often to blame here, but even so, 5 weeks seems long.
It is now clear that the rVSV-ZEBOV Merck vaccine, used in the West African epidemic and recently shown to provide lasting protection against Zaire ebolavirus,[16,5,] is being rolled out.
Yesterday I spoke by phone with the Minister of Health of the Democratic Republic of the Congo @OlyIlunga to discuss the #Ebola response in #DRC. We agreed to ship vaccines as quickly as possible so they can be used to save lives.
— Tedros Adhanom Ghebreyesus (@DrTedros) May 11, 2018
To make matters worse for containment of an EVD outbreak in this region (Figure 3), there is food insecurity, refugees crises and cholera in the DRC and in neighbouring Tanzania, Rwanda and Uganda.[12] You may recall the worlds biggest EVD epidemic in West Africa was confused with cholera early on because of some clinical similarities among early EVD cases including diarrhoea, vomiting, and severe dehydration.[13]
References…
- New Ebola outbreak declared in Democratic Republic of the Congo
http://www.who.int/news-room/detail/08-05-2018-new-ebola-outbreak-declared-in-democratic-republic-of-the-congo - Ebola returns to the Democratic Republic of the Congo (DRC): Zaire…
https://virologydownunder.blogspot.com.au/2017/05/ebola-returns-to-democratic-republic-of.html - Ebola outbreak declared in Democratic Republic of Congo
https://edition.cnn.com/2018/05/08/health/ebola-outbreak-who-bn/index.html - Ebola: DR Congo confirms new outbreak in country’s north-west
http://www.bbc.com/news/world-africa-44045842 - Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30165-8/fulltext - Ebola Virus Disease, WHO Africa
http://www.afro.who.int/health-topics/ebola-virus-disease - Ebola virus disease, WHO
http://www.who.int/ebola/en/ - Disease Outbreak News (DONs)
http://www.who.int/csr/don/en/ - Seventeen deaths reported in Congo as Ebola outbreak confirmed
https://uk.reuters.com/article/us-health-ebola-congo/seventeen-deaths-reported-in-congo-as-ebola-outbreak-confirmed-idUKKBN1I91VS - DRC: at least 17 people dead in confirmed Ebola outbreak
https://www.theguardian.com/world/2018/may/08/drc-confirms-two-cases-of-ebola-in-north-western-town - Two cases of Ebola confirmed in Democratic Republic of Congo
https://www.aljazeera.com/news/2018/05/cases-ebola-confirmed-democratic-republic-congo-180508142327264.html - GREAT LAKES REGION: Humanitarian Snapshot (March – April 2018), OCHA
https://reliefweb.int/sites/reliefweb.int/files/resources/GLR_humanitarian_snapshot_23%20April%202018.pdf - Origins of the 2014 Ebola epidemic
http://www.who.int/csr/disease/ebola/one-year-report/virus-origin/en/ - Democratic Republic of the Congo Ebola Situation Report #1, 10 May 2018
https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-situation-report-1-10-may-2018 - DRC: 2 Ebola cases confirmed, 17 deaths suspected in 9th outbreak since 1976
http://www.newtimes.co.rw/africa/drc-2-ebola-cases-confirmed-17-deaths-suspected-9th-outbreak-1976 - https://academic.oup.com/jid/article/214/suppl_3/S360/2388110
- Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!)
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32621-6/fulltext
Updates…
- Altered spelling of Ikoko Impenge from WHO’s “iIkoko Iponge“ ; added info on cholera and human travel in and around the DRC
- Added links for RT-PCR confirmation of species Zaire ebolavirus
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Indeed refugee crises, food insecurity and many public health challenges including cholera and strained health systems could complicate the implementation of interventions to contain the Ebola outbreak in DRC. On the other hand this is not the first outbreak in the region, will the old strategies and experience combined with the vaccine be able to contain and get the disease under control?