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Ebola virus disease – Democratic Republic of the Congo


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From 19 to 25 February, no new confirmed cases of Ebola virus disease (EVD) were reported. This was the first time since the beginning of the response that no new confirmed cases were reported over a seven-day period (Figure 1). The most recent case was reported in Beni Health Zone, North Kivu Province on 17 February. While the lack of new confirmed cases reported in the last seven days is a major achievement, the outbreak remains active and risk of additional cases emerging remains high. In the past 21 days (5 to 25 February 2020), four confirmed cases were reported from two health areas in Beni Health Zone in North Kivu Province (Figure 2, Table 1). Even with strengthened surveillance operations, transmission of Ebola virus outside of groups currently under surveillance cannot be excluded. Ebola virus also persists in some survivors’ body fluids, with potential to infect others. In at least one instance during this outbreak, relapse – in which a person who has recovered from EVD develops symptoms again – was observed, sparking a new chain of transmission which has taken several months to interrupt. To mitigate a potential resurgence of the outbreak, it is critical to maintain response capacities to rapidly detect and respond to any new cases, and to prioritize survivor support and monitoring and the maintenance of cooperative relationships with the survivors’ associations.

Substantial surveillance, pathogen detection, and clinical management activities are currently ongoing, including validating alerts, following remaining contacts who were potentially exposed to the virus, supporting rapid diagnostics of suspected cases, and working with community members to strengthen surveillance on people who pass away in the communities. As of 25 February, 510 contacts are currently under surveillance, of which 97% were followed daily in the last seven days. In the last seven days, more than 5100 alerts per day were reported and investigated, of which over 400 alerts (including ~70 community deaths) were validated as suspected EVD cases; requiring laboratory testing and specialized care within the established Ebola treatment and transit centres. On average, suspect cases stay in these facilities for three days before EVD can be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 operational laboratories deployed in cities that have been affected by the outbreak. From 17 to 23 February, more than 3600 samples were tested.

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