Update on the Outbreak of Ebola Virus Disease (EVD) in the DRC – 5/25/19Jenny Abercrombie
IN THE NEWS
Note: There have been previous posts on Ebola to the Health Intelligence Page. Please see those articles for background, as well as more detailed information on EVD. You can find these articles by clicking on the button marked ‘View all Posts & Resources,’ found at the bottom of the In the News and Outbreaks/Emerging Diseases categories, and then looking for Ebola. The current outbreak began in August 2018 but there was another DRC outbreak earlier in 2019 on the Western coast. There was also a multi-country outbreak in 2014-15 that included a few cases in the USA; some were imported but two were HCWs with exposure to an imported case.
All Ebola experts and involved stakeholders and workers agree that the current outbreak in the Northeastern part of the DRC is a crisis/emergency. What is not agreed upon by some of those experts and leaders is whether this is only a public health emergency for the local area, where the infection is currently spreading, and to the provinces and the bordering countries around it OR, if it poses a more global public health threat, similar to what occurred in the 2014/15 Ebola Outbreak. This Ebola Virus Disease (EVD) outbreak is in its tenth (10th) month for the Northeastern part of the Democratic Republic of the Congo (DRC) and its case number, death toll, and geographic spread continues to increase at even faster rates than in its first six (6) months (it began in August 2018).
The World Health Organization (WHO) has identified the area (both nationally and regionally) as “high risk” due to the river, travel, and proximity of the surrounding areas and bordering countries. These at-risk areas include the whole of the DRC, as well as the bordering countries Uganda, Rwanda, and South Sudan. However, the WHO considers global risk to be low. Therefore, the WHO has advised against any restriction of travel or trade based on the current situation. In part, that decision is based on the concern that it might only compound the ability to move goods, money, personnel, etc. in and out of the country. All of these are needed, in greater numbers, to control the epidemic.
A special panel of Ebola experts has met twice (the last time in April), under the auspices of the CDC, to decide if there is a Public Health Emergency of International Concern (PHEIC). And, so far, the response from that panel is that no global threat announcement is warranted at this time. However, many Ebola experts and outbreak-involved groups (NGOs), along with some concerned governments, are uncomfortable with this decision. Some of them have expressed their concerns and/or officially raised awareness (alert) levels, particularly for travelers.
There are several reasons for that concern, with the focus on:
- the significantly increasing number of cases and number of deaths;
- the percentage of both that are occurring in the community and not in Ebola Treatment Centers or Transit Centers;
- the ongoing violence in the area and against those individuals and centers involved in the outbreak.
The experts outline these and other concerns, with their rationale, in articles (with hyperlinks) that are included in the pdf found attached to this article, named DRC Ebola Links and Resources (5/25/19). A common refrain is, how much worse would the infected case numbers and fatality rate be if there wasn’t an effective vaccine in use? They didn’t have that in the 2014/15 Outbreak.
A more complete synopsis of the ongoing EVD outbreak, including implications and recommendations for First Responders, can be found in the Outbreaks/Emerging Diseases category of the Health Intelligence Page and labeled Ebola – 5/25/19. A separate page, with links to information and resources can also be found there.