The Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo (DRC) witnessed a notable increase in the past weeks leading to a spike in the number of recorded Ebola cases. As of May 4, the Ebola death toll had risen to 1,008, which is a provisional figure as there could be many more unreported cases.
Since the Ebola outbreak was declared in August 2018, more than 1,000 people have died from the disease. Over the months, governments and humanitarian aids have made several efforts to contain the virus. But there are reports of counter effect following unverified claims that the virus was brought into the country deliberately.
This misleading information has led to mistrust towards health personnel and attacks on outbreak response teams. In addition, violence and insecurity, as well as the stigma in the local communities, lead to low turnouts to Ebola Treatment Centres (ETCs). On April 19, 2019, an armed militia attacked a hospital in Katwa, leading to the death of two healthcare workers and Dr Richard Mouzoko Kiboung, a WHO epidemiologist. This led to a temporary suspension of Ebola response activities in some high-risk health areas.
Following the recent rise in numbers, which is not expected at this stage of the outbreak, the figures show that there is a great need to address issues of insecurity amidst other challenges. Between March 27 and April 16 2019, a total of 249 confirmed cases were reported. This number was reported from 55 health areas, which represented 39 percent of the 143 health areas across different zones. However, the disease remained confined to a limited geographical area within North Kuvi and Ituri provinces.
According to the World Health Organization (WHO), a total of 1290 confirmed and probable EVD cases were reported as of April 16, of which 833 died (case fatality rate 65 percent). Of the 1290 cases with reported age and sex, 725 were female, and 361 were children aged less than 18 years. The number of healthcare workers affected has increased to 89, 7 percent of total cases, including 32 deaths.
In addressing the current challenges that limit Ebola response activities, authorities are deliberating on how to introduce a more sustainable approach. To this end, WHO, the UN, and the government of the DRC are actively “collaborating to review current strategic and operational security measures to ensure the protection of healthcare workers in the field, and improve effective coordination and information sharing amongst all security elements covering the response,” says WHO.
The global health organization further stated, “Existing operational security measures continue to be implemented and strengthened as well, including the establishment of security perimeters around the residences of EVD response personnel, increasing security at fixed locations, enhancing the joint quick response team (QRT) capacities of local police and UN security forces, and ensuring staff compliance with tracking procedures and adherence to curfew.” In addition to revising security measures, efforts in community outreach through direct dialogue with various community leaders are also being intensified.
On April 12, 2019, the International Health Regulation (IHR) Emergency Committee convened in Geneva, Switzerland to discuss ways to tackle the outbreaks in DRC. At the meeting, discussions centred on whether or not the EVD outbreak posed a Public Health Emergency of International Concern (PHEIC). While the Emergency Committee and the WHO Director-General reiterated their serious concern at the recent rise in the number of cases and the high risk of regional spread upon consultation with various technical experts and further review of available epidemiological data, it was concluded that the current outbreak did not constitute a PHEIC.
Thankfully, despite the many challenges facing efforts to contain the disease, there are a few significant results. As of May 2, a total of 415 EVD patients who received care at ETCs in Congo had been discharged.