Mike Ryan, MD, the World Health Organization (WHO) executive director of health emergencies, said today that the Ebola virus in the Democratic Republic of the Congo (DRC) has been "squeezed into a small geographical area"—a triangle between Mambasa, Beni, Mandima, and Komanda.
"The virus is now back to where it began in Mandima, the same rural zones where it transmitted at low intensity for several months before last August," Ryan said in a press conference.
It is in this shared space between North Kivu and Ituri provinces where the virus will see its final days, Ryan said, as transmission has slowed to a trickle.
Ryan offered several signs that the tide has turned on the DRC's 14-month-long Ebola outbreak, the second largest in history:
- Currently, only 27 health zones in the DRC are affected by the deadly virus, down from 207 at the outbreak's peak.
- The disease has been pushed out of the region’s bigger cities, including Katwa, Beni, and Butembo.
- The R0 (R-naught), how many cases each confirmed case infects on average, is now at an outbreak low of 0.69.
- And less than 1% of recent deaths have occurred in the community, which lowers the risk of transmission.
"Now we have to kill the virus," Ryan said. "And we can only end the outbreak if we maintain the response."
Keys to ending outbreak
Ryan said there were several keys to ending transmission. First, there will be increased community surveillance in the outbreak zones, which will be challenging. The current hot spots are in villages with high activity from the Allied Democratic Forces (ADF), a militant terrorist organization.
Second, surveillance around Beni also needs to be increased.
"There is always a chance for further amplification," Ryan said.
Today the WHO will determine if the outbreak still warrants a public health emergency of international concern.
Only one new case today
For the fourth day in a row, the WHO's Ebola dashboard reflects only 1 new infection, raising the outbreak total to 3,208 cases, including 2,144 deaths. A total of 468 suspected cases are still under investigation.
Today the DRC's Ebola technical committee (CMRE) confirmed that Mandima was the location for yesterday's single case.
Ryan said the WHO and its partners have vaccinated more than 236,000 people in the past year and treated nearly 800 patients.
WHO Ebola dashboard
Oct 9 DRC CMRE report