DRC declares end to Ebola outbreak

The Democratic Republic of the Congo (DRC) health minister today declared the end of the country's ninth Ebola outbreak, coming just 11 weeks after health officials sounded the alarm in early May.

Ebola outbreaks are typically declared over when two incubation periods have passed after the last patient is released from treatment with no new confirmed cases.  Over the course of the outbreak, the DRC recorded 54 cases, 33 of them fatal. Of the 54 cases, 38 were lab-confirmed and 16 were classified as probable.

Fast response to early-warning signs

Though the country is experienced in managing Ebola outbreaks, health minister Oly Ilunga Kalenga, MD, said in a statement today that officials noted early warning signs that the outbreak had the potential to evolve into a major crisis. Illnesses emerged in two remote, heavily forested health zones at the same time and health workers were infected, a factor known to intensify the spread of the virus.

He said the fears were confirmed when the first cases were found in the city of Mbandaka, the capital of Equateur Province. The urban center has river connections that posed a threat to Kinshasa, the DRC capital, and neighboring countries. "Although the scale of the crisis we were facing was unprecedented, the speed and effectiveness put in place by the government and its partners were also exceptional," Kalenga said.

Response strengths included excellent collaboration of all responders under the government's leadership, deploying within 24 hours a rapid response team from Kinshasa, installing in less than 48 hours an air bridge between Kinshasa, Mbandaka, and Bikoro with assistance from United Nations groups, first-time administration of a vaccine against Ebola to help break disease transmission chains, deploying three mobile labs to help rapidly confirm cases, and introducing free healthcare in seven of the province's health zones that covered nearly 1 million people.

Kalenga praised the dedication and professionalism of DRC health providers as well as partners who aligned themselves with the government's priorities. "Beyond the response to the epidemic, this unprecedented alignment of all stakeholders is the only way that will allow us to achieve our sole objective, namely to improve the health and well-being of the Congolese population," he said.

Praise for DRC, donors

World Health Organization (WHO) officials joined Kalenga in Kinshasa for today's announcement. Tedros Adhanom Ghebreyesus, PhD, the WHO's director-general, said in a statement, "The outbreak was contained due to the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of the Ministry of Health. That kind of leadership, allied with strong collaboration between partners, saves lives."

Tedros urged the DRC and the international community to build on the momentum of the quick Ebola containment to tackle other outbreaks affecting the DRC, including polio and cholera. "We must continue to work together, investing in strengthened preparedness and access to healthcare for the most vulnerable," he said.

The WHO said within hours of the May 8 outbreak declaration, it released $2 million from its emergency contingency fund, deployed a team to help DRC responders, and activated an emergency incident management system.

Matshidiso Moeti, MD, who directs the WHO's regional office for Africa, said the response in the DRC also showed the response capacity of the African region, with more than three quarters of 360 people deployed coming from within the region. "Dozens of experts from Guinea spent weeks leading Ebola vaccination efforts here, transferring expertise which will enable the DRC to mount an effective response both within its borders and beyond," she said.

Overall, the WHO spent $4 million from its contingency fund. The WHO and its partners appealed for $57 million to curb the spread of Ebola in the DRC, which resulted in $63 million from donors. Support came from numerous donors, which included Italy, the United Kingdom, Germany, the United States, Norway, Canada, Japan, and the European Union. Financial assistance also came from groups including the United Nations, Wellcome Trust, and the World Bank.

Technical expertise came from many sources, including Guinea, and Merck provided vaccines that were used to protect more than 3,300 people, the WHO said.

The US Centers for Disease Control and Prevention (CDC), which has worked in the DRC since 2002, today in a statement commended the DRC and its response partners for ending the outbreak of the disease, first detected in the country in 1976. "This good news reinforces the importance of having efficient surveillance systems in place and strong leadership to stop outbreaks at their source and save lives," it said.

Doctors Without Borders (MSF) teams supported treatment, surveillance, and safe burials in the outbreak's four hot spots and its teams vaccinated about 1,673 people in the Bikoro and Itipo areas. Micaela Serafini, MD, MPH, medical director for MSF in Geneva, said today in a statement that the group welcomes today's announcement.

MSF analyzing vaccination data

As for the investigational VSV-EBOV vaccine, she said, "The data is still being analyzed, but we are encouraged that this vaccination—as well as the rapid international response and concerted outreach efforts into remote communities—contributed to stemming the spread of this deadly virus. Vaccination provides an additional tool for fighting such epidemics."

Serafini said though Ebola remains a threat to the DRC, the group is heartened by some advances made in the latest outbreak. "We also hope that the resources dedicated to this Ebola intervention in Equateur Province will have a long-term positive impact in the future by strengthening the capacity of DRC's health system," she added.

Enhanced surveillance continues

After Ebola outbreaks are declared over, enhanced surveillance for the disease typically continues for 90 days. Health officials will be on the lookout for flare-ups that can occur due to the lingering threat in survivors.

The virus can survive for extended periods in immune-protected body sites such as eyes and testes. Sexual transmission, for example, has been suspected as the source of illness clusters that occurred in the wake of West Africa's outbreak.

See also:

Jul 24 DRC health ministry statement

Jul 24 WHO statement

Jul 24 CDC statement

Jul 24 MSF statement

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