Ebola Outbreak in DRC is still an Emergency

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Ebola outbreak in the Democratic Republic of Congo (DRC) still constitutes a public health emergency, the International Health Regulations Emergency Committee for Ebola Virus Disease has said. 

The Emergency Committee was convened on 12 February 2020 by the WHO Director-General under the International Health Regulations to review the current Ebola disease outbreak in the DRC.

The Committee noted that the risk is now high at national and regional levels, and low at the global level, a statement released by the WHO said.

The Committee expressed concern that withdrawing the Public Health Emergency of International Concern (PHEIC) declaration now might have adverse consequences for the response efforts through diminishing focus.

Additionally, although the primary concern of the Committee is Ebola, there are serious ongoing outbreaks of other diseases, including measles and cholera, in the DRC.

“The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response,” the statement said.

Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between February, 3 and 9 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

The Committee called for sustained political commitment and multi-sectoral coordination approach to the response in DRC; engaging and building trust with survivors associations to facilitate rapid detection; and strengthening capacity, implementation and coordination for community awareness among others.

Further, the Committee urges DRC to continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads. However, it says no country should close its borders or place any restrictions on travel and trade. The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.

It also advises that preparedness in non-affected provinces of DRC and the health system must be strengthened to respond to concurrent health emergencies. It encourages the continued implementation of optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts.

For countries at risk, the Committee urges them to maintain their workwith partners to improve their preparedness for detecting and managing imported or locally acquired cases. This includes the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance. Countries should are further urged to continue to map population movements and sociological patterns that can predict risk of disease spread.

Risk communications and community engagement, especially at points of entry, should be maintained.

The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

The Ebola virus causes an acute, serious illness which is often fatal if untreated. EVD first appeared in 1976 in two simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The 2014–2016 outbreak in West Africa was the largest Ebola outbreak since the virus was first discovered in 1976. The outbreak started in Guinea and then moved across land borders to Sierra Leone and Liberia. In Eastern Africa, Uganda has registered major outbreaks in2000, 2007, 2011-2012. The current 2018-2019 outbreak in eastern DRC is highly complex, with insecurity adversely affecting public health response activities.

KEY FACTS ABOUT EBOLA:

  • Ebola virus disease (EVD) is a severe, often fatal illness in humans.
  • The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
  • A person infected with Ebola cannot spread the disease until they develop symptoms which include: fever, fatigue, muscle pain, headache, sore throat, vomiting, diarrhea, rash, impaired kidney and liver function; and in some cases, both internal and external bleeding (for example, oozing from the gums, or blood in the stools).
  • Supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.
  • An experimental Ebola vaccine proved highly protective against EVD in a major trial in Guinea in 2015. 
  • Good outbreak control relies on applying a package of interventions, including case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.

Compiled by Carol Natukunda

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