As of 11 May, 34 Ebola cases were reported in the area, including 2 confirmed, 18 probable (deceased) and 14 suspected cases. Five samples were collected from 5 patients and two have been confirmed by the laboratory. Bikoro health zone is 250 km from Mbandaka, capital of Equateur Province in an area of the country that is very hard to reach.
A team including WHO experts and staff from the Provincial Division of Health and Médecins Sans Frontières (MSF), arrived in Bikoro on 10 May. This first group of responders gathered more data to understand the extent and causes of the epidemic. The team will also create an active case search and contact tracing, establish Ebola treatment units to care for patients, set up mobile labs, and engage the community on safe practices. WHO will also work with national authorities in planning more public health measures such as vaccination campaigns.
The response plan to the outbreak includes the following:
- Case investigation, and contact tracing;
- Community engagement and social mobilization;
- Case management and infection prevention and control;
- Safe and dignified burials;
- Research response including the use of ring vaccination and antivirals;
- Coordination and operations support.
In its latest Disease Outbreak News, WHO listed the risks to nearby countries as moderate. WHO has however alerted those countries and is working with them on border surveillance and preparedness for potential outbreaks.
This is the ninth outbreak, since the discovery of the Ebola virus in the country in 1976.
First symptoms generally include:
- Sudden onset of fever,
- Muscle pain,
- Sore throat.
This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding.
The virus is endemic to DRC, and causes an acute, serious illness which is often fatal if untreated. The virus is transmitted to human through contact with wild animals and can then be passed from person to person. Ebola is fatal in about 50% of cases.
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This happened due to close contact with patients when infection control precautions are not strictly practiced.
Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Ebola.
People remain infectious as long as their blood contains the virus.
Supportive care-rehydration with oral or intravenous fluids and treatment of specific symptoms, improves survival. There is no proven treatment available for Ebola. However, a range of potential treatments including blood products, immune therapies and drug therapies are being evaluated.
An experimental Ebola vaccine proved highly protective against the deadly virus in a major trial in Guinea. The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11 841 people during 2015. Among the 5837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.
Good outbreak control relies on a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction should focus on the following:
- Reducing the risk of wildlife-to-human transmission: Animals should be handled with gloves and other appropriate protective clothing. Animal products should be thoroughly cooked before consumption.
- Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
- Reducing the risk of possible sexual transmission: WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.
- Outbreak containment measures: Prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.