Congo’s 10th Ebola outbreak deemed ‘top degree difficulty’ by officials

The Democratic Republic of the Congo, or DRC, is facing its 10th Ebola outbreak just 1 week after declaring the end of the last, and according to officials, this outbreak may be more complicated than the previous one.

The outbreak was announced on Aug. 1, when the Ministry of Health informed WHO that of six samples sent to the Institut National de Recherche Biomédicale in Kinshasa following a cluster of illnesses, four tested positive for Ebola virus.

“We cannot rule out that this is connected [to the previous outbreak],” Peter Salama, MBBS, MPH, WHO deputy director-general for emergency preparedness and response, said at a press conference. “There is no evidence to suggest there is a concrete link — it’s a distance of 2,500 kilometers away. But we know that the vectors and the animal reservoirs, in this case fruit bats, can travel far distances.”

Although not all sicknesses and deaths have been confirmed as Ebola cases, officials say 20 people have died, including one health care worker, and noted that two other health care workers are infected.

They anticipate the number of cases to rise in the coming days.

Most cases are centered in the Mangina health area, roughly 30 kilometers from the city of Beni. Officials say 10 locations are affected, many near forests and borders, Uganda’s border being only 50 kilometers away from one infected area, which is the same concern faced during the previous outbreak.

“We have many of the same constraints and complicating factors [as the last outbreak],” Salama said. “One additional factor is the issue of security. Here, we’re responding to an outbreak of a high-threat pathogen with a high mortality rate in the context of a war zone.”

Salama said this brings the outbreak to the “top of the degree of difficulty scale,” and that the threat of rebel groups in the area will add to the complexity of containment operations.

“Although we have access, we don’t know to what extent we will have to rely on armed escorts for broader tracing outside of those small towns,” he said.

Cooperation from rebel groups in the area will be a critical determining factor in how officials can respond to the outbreak, especially in terms of vaccinations.

Officials believe this outbreak is caused by the Zaire strain of the virus, just as the ninth outbreak was.

“There’s good news and bad news with this,” Salama said. “The bad news is [this strain] has the highest fatality rate — 50% and higher. It’s the most deadly strain. The good news is we do have a safe and effective vaccine.”

Officials said 3,300 people were vaccinated during the last outbreak. However, Salama explained that the ring vaccination strategy previously used may not be feasible due to poor access and the size of the affected area.

“It’s a very complex operation,” he said.

Officials have 3,000 doses of Merck’s V920 experimental vaccine on hand and are awaiting confirmation of the Zaire strain.

If the lab results confirm it, Salama says they will be ready. – by Caitlyn Stulpin

Disclosures: Salama reports no relevant financial disclosures.

The Democratic Republic of the Congo, or DRC, is facing its 10th Ebola outbreak just 1 week after declaring the end of the last, and according to officials, this outbreak may be more complicated than the previous one.

The outbreak was announced on Aug. 1, when the Ministry of Health informed WHO that of six samples sent to the Institut National de Recherche Biomédicale in Kinshasa following a cluster of illnesses, four tested positive for Ebola virus.

“We cannot rule out that this is connected [to the previous outbreak],” Peter Salama, MBBS, MPH, WHO deputy director-general for emergency preparedness and response, said at a press conference. “There is no evidence to suggest there is a concrete link — it’s a distance of 2,500 kilometers away. But we know that the vectors and the animal reservoirs, in this case fruit bats, can travel far distances.”

Although not all sicknesses and deaths have been confirmed as Ebola cases, officials say 20 people have died, including one health care worker, and noted that two other health care workers are infected.

They anticipate the number of cases to rise in the coming days.

Most cases are centered in the Mangina health area, roughly 30 kilometers from the city of Beni. Officials say 10 locations are affected, many near forests and borders, Uganda’s border being only 50 kilometers away from one infected area, which is the same concern faced during the previous outbreak.

“We have many of the same constraints and complicating factors [as the last outbreak],” Salama said. “One additional factor is the issue of security. Here, we’re responding to an outbreak of a high-threat pathogen with a high mortality rate in the context of a war zone.”

Salama said this brings the outbreak to the “top of the degree of difficulty scale,” and that the threat of rebel groups in the area will add to the complexity of containment operations.

“Although we have access, we don’t know to what extent we will have to rely on armed escorts for broader tracing outside of those small towns,” he said.

Cooperation from rebel groups in the area will be a critical determining factor in how officials can respond to the outbreak, especially in terms of vaccinations.

Officials believe this outbreak is caused by the Zaire strain of the virus, just as the ninth outbreak was.

“There’s good news and bad news with this,” Salama said. “The bad news is [this strain] has the highest fatality rate — 50% and higher. It’s the most deadly strain. The good news is we do have a safe and effective vaccine.”

Officials said 3,300 people were vaccinated during the last outbreak. However, Salama explained that the ring vaccination strategy previously used may not be feasible due to poor access and the size of the affected area.

“It’s a very complex operation,” he said.

Officials have 3,000 doses of Merck’s V920 experimental vaccine on hand and are awaiting confirmation of the Zaire strain.

If the lab results confirm it, Salama says they will be ready. – by Caitlyn Stulpin

Disclosures: Salama reports no relevant financial disclosures.

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