The World Health Organisation (WHO) has confirmed an outbreak of the Ebola virus disease in the Democratic Republic of Congo, where eleven suspected cases including three deaths have been reported, since 22 April. WHO does not recommend any restriction of travel and trade to DRC, based on the currently available information.
In particular, on 9 May 2017, WHO was informed of a cluster of undiagnosed illness and deaths including haemorrhagic symptoms in Likati Health Zone, Bas Uele Province in the north of the Democratic Republic of the Congo (DRC), bordering Central African Republic. One sample tested was positive by RT-PCR for Ebola virus subtype Zaire at the Institut National de Recherche Biomédicale (INRB) in Kinshasa. Additional specimens are currently being tested and results, including sequencing, are awaited to describe the outbreak.
A multidisciplinary team led by the Ministry of Health (MoH) of DRC and supported by WHO is currently conducting an investigation. Personal Protective Equipment (PPE) for health care workers has been shipped, on 12 May 2017, to Kisangani. Additional kits are currently being prepared and will be shipped as soon as available.
The following public health response measures have been implemented:
- The national committee against viral haemorrhagic fever has been reactivated and will continue meeting every day to coordinate the response.
- Strengthening of surveillance and investigation including contact tracing are ongoing.
- WHO will provide assistance and technical support. The deployment to DRC of an additional WHO multidisciplinary team is currently considered to support the response of national authorities.
- The Global Outbreak Alert and Response Network (GOARN) has been activated to provide additional support if required.
- The need and feasibility of potential Ebola ring vaccination is being discussed.
There are five identified subtypes of Ebola virus. The subtypes have been named after the location where they have been first detected. Three of the five subtypes have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa, Ebola–Zaire, Ebola–Sudan and Ebola–Bundibugyo. EHF is a febrile haemorrhagic illness which causes death in 25–90% of all cases.
On 20 November 2014, as per WHO recommendations, the MoH of DRC and WHO had declared the end of the EVD outbreak that started on 24 August 2014. During this period, UK P&I Club issued an advisory for seafarers, to prevent contracting the Ebola disease when in a high risk area, recommending:
- Exercise good personal hygiene at all times with regular hand washing.
- Avoid shaking hands with local authorities, agents and stevedores, etc. in the affected areas.
- A bucket or wash station containing chlorine, water and powdered soap should be placed at the gangway for all persons boarding the ship to wash and disinfect their hands. Similar wash stations should be placed in other prominent locations on the ship.
- No direct bodily contact should be made with local individuals, whether they are suspected to be infected or not.
- All crew should be monitored for whether they are displaying any symptoms of Ebola and if any are observed this should be immediately reported to authorities.
- Where possible, contact should be avoided with any severely ill people and seafarers should not handle items that may have come in contact with an infected person’s blood or body fluids.
- Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
- Avoid contact with animals or with raw meat.
- Avoid hospitals where Ebola patients are being treated.
- Medical attention should be sought if any crew members develop fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes.
WHO notes that the current outbreak is reported in a remote and hard to reach area and appears to be geographically relatively limited. However, investigations are ongoing to assess the full extent of the outbreak and therefore high vigilance still needs to be maintained.