Kinshasa, DR Congo: A new outbreak of Ebola virus has hit the Democratic Republic of Congo, just days after the last outbreak was declared over. Four cases have been positively identified and more are likely, Congo’s health minister, Dr. Oly Ilunga Kalenga, said in a statement Wednesday.
“Just a week after announcing the end of the ninth epidemic of Ebola virus disease in the Equator Province, the Democratic Republic of Congo is facing a new epidemic,” Kalenga said. He added that there was no indication that the two most recent outbreaks, separated by more than 1,500 miles, are related.
More than 50 people were infected in the most recent outbreak and 33 died, according to Congolese officials.
The health ministry has been checking into reports of viral hemorrhagic fever in North Kivu Province, in the northeastern part of the vast Central African nation, since last weekend. Twenty people have died and 26 people have symptoms that could indicate any number of viral infections, including Ebola.
“Of the six samples analyzed, four were positive for Ebola virus,” Kalenga said.
It’s the third outbreak in just over a year in Congo. This time, the country could be ahead of the game. Thousands of doses of vaccine were shipped to the country during the last outbreak and the health ministry geared up to test samples, educate people about the spread of the virus and get experts to the site of the outbreak quickly.
“Although we did not expect to face a 10th epidemic so early, the detection of the virus is an indicator of the proper functioning of the surveillance system put in place by the General Directorate for Disease Control,” Kalenga said.
Outbreaks of Ebola have occurred regularly in Central Africa since the virus was first identified in 1976, but none has ever been as serious as the 2014-2016 epidemic, which killed 11,000 people in Liberia, Sierra Leone and Guinea in West Africa.
“Since we are coming out of another Ebola outbreak, we have kept staff and equipment in place,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a statement.
“This allows us to have a head start in response to this cluster.”
The area affected is on a lake and near the borders of Uganda and Rwanda, which raises the possibility of international spread. WHO says more than 1 million displaced people, who have fled war and unrest, live in the region.
North Kivu Province, the volatile region in the Democratic Republic of Congo where the new outbreak is centered, creates security complications that health officials did not confront in the outbreak they just defeated in northwest Équateur Province, 1,550 miles away. The World Health Organization is worried about the safety of medical workers in North Kivu and their access to areas controlled by militants.
“This new cluster is occurring in an environment which is very different from where we were operating in the northwest,” said Dr. Peter Salama, the deputy director general of the health agency and the head of its emergency response unit. “This is an active conflict zone. The major barrier will be safely accessing the affected population.”
The new cases are in and around the remote village of Mangina, near the city of Beni and the border with Uganda. The area has been chronically plagued by fighting between government forces and armed rebel groups. Last year, 15 United Nations peacekeepers were killed in an attack on a compound in North Kivu.
The region also hosts more than one million people displaced by conflict throughout the country and shares porous borders with Rwanda and Uganda.
The World Health Organization said it was working with those neighboring nations to ensure that they were prepared to respond to the disease.
But aid groups fear that the fighting and humanitarian crisis in North Kivu will only compound the difficulties of defeating Ebola. People on the move can frustrate the critical need to determine chains of infection.
“People are hungry and at risk of disease, and many have had to flee their homes,” said Jose Barahona, Oxfam’s country director for the Democratic Republic of Congo. “Ebola poses a serious risk to communities already on the edge and threatens our ability to help them.”
Michelle Gayer, the director of emergency health for the International Rescue Committee, said the new outbreak’s location made it unlike what she saw in Équateur and West Africa.
“We are in a different context again in the sense that, yes, it’s actually in small rural areas that we know of to date, however it’s in a zone where there has been a lot of insecurity and a lot of armed groups and a large amount of displacement,” Ms. Gayer said.
Simply getting to an affected community, she said, would be challenging.
“It is already hard because of geography,” Ms. Gayer explained. “And we can only go where we can go if there is this insecurity.”
Lack of basic resources after years of war, including limited health care, puts North Kivu residents further at risk. Ebola can often spread through community gatherings or funerals, or though contamination at health clinics.
The Health Ministry said a team of 12 experts arrived in the affected area on Thursday, with a mobile laboratory and protective equipment to begin a coordinated response.
The ministry also said additional security measures were in place to ensure the protection of health care workers. The World Health Organization also began sending experts to the area.
“Since we are coming out of another Ebola outbreak, we have kept staff and equipment in place,” said Dr. Matshidiso Moeti, the organization’s regional director for Africa. “This allows us to have a head start in response to this cluster.”
EARLIER: Ebola Outbreak in DR Congo Over – WHO, DRC
Today marks the end of the ninth outbreak of Ebola in the Democratic Republic of the Congo (DRC). World Health Organization (WHO) Director-General, Dr Tedros Adhanom Ghebreyesus, and Regional Director for Africa, Dr Matshidiso Moeti, joined DRC Minister of Health Dr Oly Ilunga for the announcement in Kinshasa.
“The outbreak was contained due to the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of the Ministry of Health. That kind of leadership, allied with strong collaboration between partners, saves lives,” said Dr Tedros.
The World Health Organization (WHO) said it congratulates the country and all those involved in ending the outbreak, while urging them to extend this success to combatting other diseases in DRC.
Unlike previous Ebola outbreaks in the country, this one involved four separate locations, including an urban centre with river connections to the capital and to neighbouring countries, as well as remote rainforest villages. There were initial concerns that the disease could spread to other parts of DRC, and to neighbouring countries.
Within hours of the outbreak being declared on 8 May, WHO released US$2 million from its Contingency Fund for Emergencies, deployed a team to augment capacity in the field, and activated an emergency incident management system.
“WHO moved quickly and efficiently,” said Dr Moeti, “We also demonstrated the tremendous capacity of the African region. More than three-quarters of the 360 people deployed to respond came from within the region. Dozens of experts from Guinea spent weeks leading Ebola vaccination efforts here, transferring expertise which will enable the DRC to mount an effective response both within its borders and beyond.”
Dr Tedros urged the DRC Government and the international community to build on the positive momentum generated by the quick containment of the Ebola outbreak.
“This effective response to Ebola should make the Government and partners confident that other major outbreaks affecting the country such as cholera and polio can also be tackled,” said Dr Tedros. “We must continue to work together, investing in strengthened preparedness and access to healthcare for the most vulnerable.”
Several groups administered a new experimental vaccine to front-line health workers and to those who had come into contact with Ebola patients, a practice known as ring vaccination. About 3,300 people received the vaccine, and though researchers will have to continue to monitor their progress, none of those who received the vaccine got sick.
The vaccine had been tested toward the tail end of the outbreak that struck Liberia, Guinea and Sierra Leone three years ago. A team of about 50 Guinean epidemiologists deployed to Congo to help administer the vaccine.
In interviews with public health officials over the last month, many lavished praise on both the Congolese health ministry and the World Health Organization, which had come under scrutiny for its lackluster response to the previous outbreak in West Africa.
“There is a lot of partners coming from different countries, and WHO is coordinating that so we don’t duplicate,” Pierre Rollin, the top Ebola expert at the Centers for Disease Control and Prevention, said in an interview before he deployed to Congo.
About a dozen members of a CDC team based in Kinshasa, the Congolese capital, deployed to Mbandaka, Bikoro and the tiny village of Itipo to assist with contact tracing, lab testing and coordination.
The region is so remote that the teams had to fly on United Nations planes to Mbandaka before taking helicopters to more far-flung villages. The CDC teams slept in tents in the oppressive humidity, and responders worked out of temporary facilities or community buildings that had been seconded as treatment or laboratory facilities.
“These are very rural locations where sometimes it can take a couple hours to find a contact by a single path,” Ben Dahl, who led the CDC response, said in an interview from Kinshasa.