As DRC Ebola cases grow, expert sees parallels to Guinea

In an external situation report released today, the World Health Organization (WHO) said two new suspected Ebola cases are being investigated in the Democratic Republic of Congo (DRC), and a US expert says events are unfolding in ways reminiscent of Guinea in 2014 at the onset of a massive West Africa outbreak.

The new cases are in Azande and Nambwa, both in the Likati health district. There are now 21 suspected cases of the deadly virus, and 3 deaths.

A map accompanying the situation report shows Azande located far east of the Likati health district, on the border of South Sudan. But the written report only names Central African Republic as a country bordering the districts with suspected Ebola.

In addition to two new cases, the WHO's report says that 400 close contacts of patients are now being monitored, a steep rise from 125 contacts reported yesterday. Five new blood samples are also being tested now at the Institut National de Recherche Biomedicale (INRB) laboratory in Kinshasa, and INRB is deploying two mobile laboratories to Buta and Likati.

For now, the number of confirmed Ebola infections remains at two.

Three countries have now implemented entry screening at airports (Nigeria, Tanzania, and Zimbabwe).

Similarities to Guinea

The case in Azande concerns Ebola expert Dan Lucey, MD, MPH, a microbiologist and immunologist with Georgetown University's O'Neill Institute for National and Global Health Law. Lucey said that any potential case on the border of South Sudan is worrisome, because cross-border spread in that part of Africa could have great consequences for controlling and monitoring the outbreak.

Lucey said that he saw some similarities between what's happening in DRC and what happened in Guinea in 2014.

"Both outbreaks began in a remote location, and both had cases presenting without traditional hemorrhagic features," said Lucey in an interview. Moreover, Lucey said that a report from the WHO's African Regional Office dated May 12 denoted a cluster of illnesses in Bangbo, which is near Azande.

Lucey said his curiosity was piqued, and in searching Bangbo he discovered a FluTrackers post describing 34 deadly cases of diarrhea on Apr 7 and 8. FluTrackers is an infectious disease news message board. He is careful to note that the illnesses occur in a region familiar with cholera and meningitis, but if the cluster was indeed Ebola, the outbreak could be more widely spread than previously thought.

National budget of $8 million set

Also in today's situation report was the first mention of the DRC government's working budget of about $8 million US dollars for the national fight the outbreak.

In addition, the WHO has donated 3,000 sets of personal protective equipment (PPE) to Likati and 100 body bags. Its office in the DRS has finalized a response plan and $1.4 million budget.

See also:

May 17 WHO situation report

May 12 WHO African region weekly bulletin

Apr 17 FluTrackers post

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