Ebola: one year anniversary of epidemic in DRC is “unwanted milestone”BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5004 (Published 01 August 2019) Cite this as: BMJ 2019;366:l5004
The Democratic Republic of the Congo is grappling with the world’s second largest Ebola epidemic on record, with more than 1800 confirmed deaths and 2600 confirmed infections since the outbreak in the North Kivu province was declared exactly one year ago on 1 August 2018.
WHO declared the outbreak in DRC a “public health emergency of international concern” under the International Health Regulations on17 July, making it the fifth declaration of its kind.
At a press briefing to mark the anniversary WHO confirmed a second death from Ebola virus disease in Goma, a densely populated city of a million people on the border of Rwanda and a gateway for potential further transmission of the disease to other countries. The agency had previously cited the first confirmed case in Goma as a contributing factor for deciding to upgrade the crisis to a public health emergency.1 The two cases in Goma are not linked, said officials.
Shortly afterwards Rwanda announced that it was closing its border with DRC, a move criticised by the DRC president’s office as regretful and going against WHO advice.
Matshidiso Moeti, WHO’s regional director for Africa, said during the press briefing that the one year anniversary was “not a milestone we ever wanted to mark—but it’s a moment to reflect on the lessons we have learnt in the past year.“
The outbreak has been complicated by aggression towards healthcare workers, conflict, and uncertainty over the supply of resources to support the population.2
Since DRC’s health minister Oly Ilunga resigned from his post after the health emergency was declared, the management of the country’s response was placed under direct supervision of the president. In his letter to President Félix Tshisekedi, Ilunga raised concerns over the introduction of a second, still experimental Ebola vaccine.3 It would cause further mistrust and confusion among the communities affected, he said.4
Merck’s single dose vaccine, which is currently being used in the region, targets communities at risk, while the newer vaccine from Johnson and Johnson is designed to protect populations not immediately at risk.
Moeti told reporters that DRC’s head of state had appointed a high level task force chaired by one of the country’s senior Ebola experts and that an acting health minister has been designated, to continue collaboration with WHO.
WHO, Unicef, the World Food Programme, and the UN undersecretary general for humanitarian affairs and emergency relief reported that a government led response, in collaboration with communities and partners, had so far led to the vaccination of 170000 people, treatment of 1300 people, and screening of 77 million national and international travellers.5
WHO health officials warned of the need to increase preparedness in DRC and in neighbouring countries, including Burundi, Rwanda, Uganda, and South Sudan.
The 2014-16 outbreak in west Africa remains the largest Ebola outbreak since the virus was first discovered in 1976, during which 11325 people died.6
Ebola: one year overview
24 July 2018—End of ninth outbreak of Ebola virus disease in DRC
1 August—DRC’s health ministry declares new Ebola outbreak in northeastern region. Tracing activities are begun, and human resources and materials deployed
3 August —Number of cases reaches 43 (13 confirmed, 30 probable), with 33 deaths
7 August—Ebola confirmed in Zaire, but a different strain
17 October—WHO announces that the situation does not constitute a public health emergency of international concern
29 November—Outbreak becomes second biggest ever recorded of Ebola
11 June 2019—Uganda announces confirmed cases of Ebola, the first to cross border from DRC
14 July—First case in Goma
17 July—WHO announces a public health emergency of international concern
21 July—Numbers reach 2498 confirmed cases and 1649 confirmed deaths in DRC
1 August—One year anniversary of the 10th Ebola outbreak in DRC