Ebola-Zaire confirmed in DRC outbreak that killed 3

Today the World Health Organization (WHO) confirmed an outbreak of Zaire-strain Ebola virus disease in a person who died in the Democratic Republic of the Congo (DRC), part of an outbreak of nine suspected cases and three deaths.

The Zaire strain is the same one that caused an international public health emergency, more than 28,000 illnesses, and more than 11,000 deaths in West Africa in 2014 to 2016.

Ring vaccination could be used

"WHO and partners are completing the epidemiological investigation to better understand the extent of the current outbreak and who are potentially at risk of Ebola," WHO spokesperson Tarik Jasarevic told CIDRAP News. "If pertinent, ring vaccination, as used in the phase 3 study in Guinea, would be the recommended delivery strategy."

The Minister of Public Health of the Democratic Republic of the Congo (DRC), Oly Ilunga Kalenga, MD, in a statement today from the WHO's regional office in Africa described "an outbreak of Ebola Virus Disease (EVD)" in Likati health district (Aketi, Bas-Uele province), in northern DRC. Five specimens have been tested at the country's National Biomedical Research Institute, the national reference laboratory, and one specimen was positive for Ebola virus, Zaire serotype.

According to the WHO, the DRC warned the organization on May 9 of a "cluster of undiagnosed illness and deaths including hemorrhagic symptoms." There have been nine cases of suspected Ebola since Apr 22, including three deaths in Likati, for a case-fatality rate of 33%.

According to Reuters, the WHO's DRC spokesman Eugene Kabamba said that Likati "is in a very remote zone, very forested, so we are a little lucky. We always take this very seriously."

"The Likati health district is in a remote area, but contact tracing is essential to contain the epidemic in its focus; the DRC can rely on very experienced health workers for this purpose," said Dr Yokouide Allarangar, WHO representative in the DRC, in the WHO Africa statement.

He added, "The first teams of epidemiologists, biologists, and experts in the areas of social mobilization, risk communication and community engagement, and also personnel specializing in water, hygiene and sanitation, are scheduled to reach the affected area today or tomorrow."

Colleen Kraft, MD, associate professor of infectious diseases at Emory University, told CIDRAP News that the outbreak is behaving like outbreaks that came before West Africa's massive event. "It's in a remote area, and an area where there's already awareness in that region to test for Ebola, because they've seen it before."

This is the eighth Ebola outbreak in the DRC since 1976. In 2014, the country controlled an outbreak in the Boende region, another remote part of the country. That outbreak, which took 49 lives, was unrelated to the West African outbreak of Ebola that happened concurrently.

Zaire strain targeted by Merck vaccine

Reuters also reported that Gavi, the Vaccine Alliance, has 300,000 emergency doses of rVSV-ZEBOV, the Ebola vaccine developed during the outbreak in West Africa. Clinical trials have shown the vaccine to be very protective against Ebola-Zaire.

Today Medicins sans Frontieres (MSF) said it would be sending an emergency team of 14 people to Likati to work with the DRC's Ministry of Health.

"The MSF emergency team will conduct an assessment of the situation and may construct an Ebola treatment centre and help care for those suspected or confirmed to be affected by the virus. If required, MSF may also assist local health posts with the triage and referral of suspected Ebola patients, implement a mobile surveillance system and ensure that the hygiene procedures required to halt the spread of the virus are implemented across the affected area."

News editor Lisa Schnirring contributed to this story.

See also:

May 12 WHO Africa announcement

May 12 Reuters story

May 12 MSF statement

CDC page on DRC's 2014 Ebola outbreak

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