Ebola continues decline, but mobile patients still pose a risk

Ebola movements

World Bank / Vincent Tremeau/ Flickr cc

A steady decline in the number of Ebola cases in the Democratic Republic of the Congo (DRC) outbreak continued last week, with just nine new cases reported from three health zones, but a new illness was reported from Oicha, which recently passed 30 days with no new cases, according to the latest update from the World Health Organization (WHO).

In other developments, the DRC reported 2 more cases, lifting the outbreak total to 3,298, according to the WHO's online Ebola dashboard.

WHO's latest detailed assessment

Over the past 3 weeks, the three remaining hot spots are Mabalako, Beni, and Mandima. Though the number of cases this week continues to fall, the WHO warned that the outbreak response will continue to face complex challenges, which include rural and hard to reach locations.

The case from Oicha was an individual who died in the community, a factor known to pose a high risk of virus spread. Also, the WHO noted that the patient had links to Kalunguta, Oicha, and Mandima health zones. Family members and the community were at first resistant to responders, but the WHO said a multidisciplinary team has now started an investigation. So far, it's not known how the person contracted Ebola.

On a positive note, the WHO said all cases from Beni and Mabalako over the past week are linked to known transmission chains, a promising sign that most or all contacts of confirmed cases are being registered.

In its update on entry point monitoring, the WHO described a recent example of ongoing challenges responders face regarding the movement of potentially infected people—and corpses—across the outbreak region.

On Nov 17, a group in a car and on motorbikes moving southward refused screening at the Mavivi checkpoint, near Beni. Officials alerted workers at other checkpoints around Beni who stopped the convoy, which included the body of a 35-year-old man who died in Oicha and whose family wanted to bury him in Kabasha, located about 12 miles southeast of Beni. Samples from the man's body were positive for Ebola, and after responders negotiated with the family, a safe and dignified burial was conducted in Kabasha, their hometown.

In its conclusion noting that high vigilance is needed amid encouraging trends, the WHO said, "While movement of symptomatic cases continues, it is critical that all areas of the response remain effective, engaged and fully resourced."

Two new cases, death toll steady

Along with the report of two new cases, the WHO's dashboard said 537 suspected Ebola cases are still under investigation. No new deaths were reported, keeping the fatality count at 2,196.

Yesterday the DRC's Ebola technical committee (CMRE) said the new death reported yesterday involved a patient who died at Beni's Ebola treatment center.

The numbers of people vaccinated against Ebola continues to rise. So far, a campaign in two Goma health zones to immunize people with the newly launched two-dose Johnson & Johnson vaccine (Ad26.ZEBOV, MVA-BN Filo) has reached 243 people. Meanwhile, 254,151 people have received VSV-EBOV, the main vaccine that has been used since August 2018 to battle the outbreak.

See also:

Nov 19 WHO Ebola situation report

Nov 20 CMRE report

WHO online Ebola dashboard

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