One Ebola Outbreak Follows Another in DRC
Just as the Democratic Republic of the Congo (DRC) was ending its longest and largest outbreak of the Ebola virus in the eastern provinces, another emerged in the northwest in early June.
The DRC’s 10th outbreak of the deadly virus began in August 2018 and was eliminated on June 25, 2020. In 23 months, there were 3,470 cases and 2,287 deaths, including 41 healthcare workers.
The 11th outbreak was announced on June 1 after a cluster of cases was discovered in and around the Equateur province’s capital city of Mbandaka. To date, the World Health Organization (WHO) has reported 124 cases and 50 deaths.On June 9, the WHO declared no link between the 10th and 11th outbreaks, also saying the virus in the new outbreak is distinct from the one that circulated in Equateur province during the country’s ninth outbreak in 2018.
“With 100 Ebola cases in less than 100 days, the outbreak in Equateur Province is evolving in a concerning way,” Dr. Matshidiso Moeti, World Health Organization (WHO) regional director for Africa, said on the organization’s website. “The virus is spreading across a wide and rugged terrain which requires costly interventions, and with COVID-19 draining resources and attention, it is hard to scale up operations.”
The WHO said the outbreak has spread to 12 of the province’s health zones – over about 180 miles of dense forest, making it hard to reach affected villages and harder to investigate the virus’ origin.
Médecins Sans Frontières (MSF) has teams at work in five of Equateur province’s 18 health zones in nine treatment and isolation facilities.
On its website, MSF reports severe challenges reaching remote health zones. There is just one helicopter available in the region. Traversing densely forested roads and trails often requires hours of motorcycling at a speed just above walking. Many zones are accessible only by canoeing across rivers and lakes.
These waterways, used by thousands every week, are of great concern in terms of this outbreak spreading to Kinshasa, the DRC’s capital city, as well as neighboring countries.
Mbandaka, a major port on the Congo River with 1 million residents, connects to Kinshasa, a megacity of more than 14 million, by a heavily trafficked river route.
Directly across the river from Kinshasa is Brazzaville, the capital of the Republic of the Congo and home to more than 2.4 million. All along the Equateur Province, the border is porous with robust trading.
MSF also reports issues with educating rural communities on proper epidemic practices like isolating, reporting and testing community deaths, and adjusting traditional burial rituals to prevent exposure.
Many of the tools used to quell the 10th outbreak of Ebola in the DRC – vaccination, contact tracing, and education – offer hope in the fight to end the newest Ebola outbreak.
On December 19, 2019, the U.S. Food and Drug Administration approved a vaccine to prevent the deadliest strain, the Zaire Ebola virus. The WHO reported that 31,179 people have been vaccinated since June 5.
The DRC Ministry of Health, the WHO and other partners rapidly set up a surveillance system. When the WHO team arrived in 2018, there were 153 contacts listed for tracing. Two weeks later, 400 contacts were listed with 94% monitored regularly.
“To end the Ebola outbreak, you have to stop the chain of transmission, and contact tracing is the only way to stop the chain of transmission,” Ebola expert Pierre Rollin of the U.S. Centers for Disease Control and Prevention said on the WHO website.
The government and partner organizations also developed an effective blueprint for making inroads with remote communities. Epidemiologists and teams of health workers connect with local leaders, build trust, test for infection, and dispel misinformation — a major cause of security risks in the militia-controlled eastern provinces.
Fortunately, that kind of instability is not present in the northwest. But health responders must often overcome deep distrust in remote villages.
“We learned over years of working on Ebola in DRC how important it is to engage and mobilize communities,” WHO spokeswoman Fadéla Chaib said on the organization’s website. “WHO is working with UNICEF in engaging religious, youth and community leaders to raise awareness about Ebola.”
To fight the 11th outbreak, the U.S. Agency for International Development on September 7 announced more than $15 million in assistance to help end the outbreak. The WHO provided $2.3 million.
Despite these contributions, funding is a constant concern.
“Without extra support, the teams on the ground will find it harder to get ahead of the virus,” Moeti said. “COVID-19 is not the only emergency needing robust support. As we know from our recent history, we ignore Ebola at our peril.”