Health worker among 5 new cases in DRC Ebola outbreak

Five more Ebola cases have been confirmed in the Democratic Republic of the Congo's (DRC's) latest Ebola outbreak, all from the main hot spot and one of them involving another healthcare worker. They bring the outbreak total to 78 cases.

In other outbreak developments, Robert Redfield, MD, director of the US Centers for Disease Control and Prevention (CDC), visited the outbreak area this week, and outbreak responders made more progress with administering vaccine.

Main hot spots are in 3 health zones

The latest confirmed cases all involve people who live near Mangina in the North Kivu province's Mabalako Health Zone, according to a daily update yesterday from the DRC's health ministry. One is in a health worker from Mangina Reference Health Center.

So far 10 Ebola infections have been reported in health workers, 9 confirmed and one listed as probable. The World Health Organization (WHO) said in an update today that the health workers were probably exposed in clinics, not Ebola treatment centers, before the outbreak was declared.

Infections in health workers are known to intensify Ebola outbreaks, and health officials in the DRC have temporarily replaced all health workers in Mangina reference health centers so that all the facility's staff could be isolated and monitored for symptoms. Health officials took similar actions regarding a health center in Beni.

All of the new cases involve probable and known case contacts, the health ministry said. However, global health officials are deeply worried that inaccessible "red zones" due to armed conflict might be hiding pockets of Ebola cases.

The outbreak total now stands at 78 cases as of Aug 15, which includes 51 confirmed infections and 27 listed as probable. So far, 44 people have died from Ebola. Health officials are still investigating 24 suspected cases, down from about 40 reported earlier in the week.

So far, the cases are limited to five health zones in North Kivu province, mostly from Mangina in Mabalako health zone, and one health zone in neighboring Ituri province.

Another worry about the outbreak is the high risk of regional spread because of large numbers of displaced people and frequent travel between regions. Earlier this week, health officials said lab tests ruled out a few suspected cases in Uganda. The WHO, which is helping four priority countries step up their preparedness efforts, said Ebola was also ruled out after investigating suspected cases in other DRC provinces, Rwanda, and the Central African Republic, as well.

Vaccination focusing on 5 rings

The DRC's health ministry began vaccination in the outbreak zone on Aug 8, starting with health workers. Contacts of Ebola cases and contacts of contacts are slated to receive doses of VSV-EBOV in a ring vaccination strategy.

The WHO said five rings have been identified surrounding 13 recently confirmed cases, and more than 500 people have been vaccinated so far. It added that teams are still working to identify and immunize all eligible contacts.

The health ministry said vaccination is under way in Mabalako (the area that covers Mangina), Beni, and Mandima (the affected health zone in Ituri province).

CDC officials visit outbreak area

In yesterday's update, the DRC said its health minister, Oly Ilunga Kalenga, MD, PhD, on Aug 15 met with US embassy official Jennifer Haskell, CDC Director Redfield, and the CDC's DRC representative, Raimi Ewetola, MD, DrPH, MPH.

The group discussed cooperation between the health ministry and the CDC, training programs for field epidemiologists, and future options for strengthening collaboration.

The next day, the health ministry took the group to visit the outbreak response area, focusing on Beni, where they toured Beni General Referral Hospital, where a new Ebola treatment center is located.

See also:

Aug 17 WHO update

Aug 16 DRC health ministry report

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