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DRC EBOLA EPIDEMIC ENDS

Ebola Virus

BY RICHARD DRASIMAKU

ARUA: MONDAY, DECEMBER 20, 2021

The Ebola Virus Disease (EVD) that killed nine people and infected two others in North Kivu province of the Democratic Republic of Congo is over.

The World Health Organisation (WHO) has confirmed that the December 16, 2021 announcement of an end to the EVD outbreak in Beni health zone by the Ministry of Health (MoH) of DRC was done in conformity with its recommendations.

To declare an end to EVD outbreak, WHO recommends that no new case should have been detected 42 days after the second negative test of the last confirmed case.

Accordingly, WHO has advised against any travel or trade restrictions with DRC based on the current risk assessment and past evidence of outbreaks of Ebola.

On October 8, DRC confirmed an outbreak of EVD after samples taken from a 3-year-old boy died after developing Ebola like symptoms were analyzed to confirm the viral disease.

The boy had developed physical weakness, loss of appetite, abdominal pain, breathing difficulty, dark stool and blood in the vomit and later died on 6 October.

He lived in the same community where three members of the same family died in September after experiencing Ebola-like symptoms.

That outbreak had generated fear among the Ugandan community in the DRC bordering districts of Kanungu, Rukungiri, Kisoro, and Kabale.

WHO says from the time of the declaration of the outbreak up to the announcement of an end to the epidemic, a total of 11 cases (eight confirmed, three probable) including nine deaths and two survivors have been reported from Beni.

Of the nine deaths, seven were in the community and two occurred at the Ebola Treatment Centre (ETC).

The overall case fatality ratio (CFR) was 82% (9/11) among total cases while 75% (6/8) among confirmed cases.

Children under the age of five years accounted for 50% (4/8) of all confirmed cases. To date, all contacts completed their 21-day follow-up period and were discharged from active follow-up.

Additionally, a total of 21,916 alerts were reported from nine health zones including 15,642 from Beni.

WHO has noted that this latest outbreak was not unexpected given the fact that EVD is enzootic in the DRC and the Ebola virus is present in animal reservoirs in the region meaning that the risk of re-emergence through exposure to an animal host cannot be excluded.

WHO advice

WHO advises the following risk reduction measures as an effective way to reduce EVD transmission in humans.

  • To reduce the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • To reduce the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Appropriate personal protective equipment should be worn when taking care of ill patients. Regular hand washing is required after visiting patients in hospital, as well as after touching or coming into contact with any body fluids.
  • To reduce the risk of possible transmission from virus persistence in some body fluids of survivors, WHO recommends providing medical care, psychological support and biological testing (until two consecutive negative tests) through an EVD survivors care programme. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.
  • Continue training and re-training of health workforce for early detection, isolation, and treatment of EVD cases as well as re-training on safe and dignified burials and the IPC ring approach.
  • Ensure availability of PPE and IPC supplies to manage ill patients and for decontamination
  • Conduct health facility assessments (“Scorecard”) of adherence to IPC measures in preparedness for managing Ebola patients (this includes WASH, waste management PPE supplies, triage/screening capacity, etc.)
  • Engage with communities to reinforce safe and dignified burial practices

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