July 20, 2018

The Democratic Republic of Congo has experienced sporadic Ebola activity since as early as 1976, when health officials identified almost 320 cases, including 280 deaths in Yambuku and surrounding areas. The most recent outbreak reported in DRC was the ninth outbreak since then. While risk to the general population remained low, health officials performed contact tracing and monitoring to identify Ebola cases as quickly as possible and minimize the impact of the outbreak. On July 24, this outbreak was declared over, after 42 days (two complete incubation periods) since the last confirmed case was discharged.

Timeline of 2018 Ebola Outbreak

In April 2018, health officials in the Democratic Republic of Congo (DRC) identified cases of hemorrhagic fever. On May 8, the DRC notified the WHO of an Ebola virus disease (EVD) outbreak in Bikoro, Équateur Province. At that time, DRC officials had confirmed two cases of Ebola from five samples sent to the Institut National de Recherche Biomedicale (INRB) in Kinshasa. By May 30, at least 53 cases had been identified, including 36 confirmed cases. Health authorities asserted throughout the outbreak that EVD infection posed little risk to those not in direct contact with patients and that most of the affected area was remote with few navigable roads.

On May 15, 2018, the US CDC issued a "Watch-Level 1" travel health notice due to Ebola virus activity in the Bikoro area of Equateur Province, DRC. This is the lowest of three levels and emphasizes the need for travelers to practice usual health precautions - predominantly using diligence in hand hygiene, avoiding contact with blood or bodily fluid from a sick person, and monitoring oneself for fever for 21 days after being in an affected area. The notice was later updated on June 8 to include Iboko and the city of Mbandaka.

On June 12, health officials discharged the last confirmed Ebola virus patient in Équateur Province from an Ebola treatment center. Since then, the WHO has concluded contact tracing activities of those with potential exposure to the virus during their 21-day follow-ups. An Ebola outbreak is considered over when no cases are reported for at least 42 days, which is double the longest incubation period.

On July 24, the outbreak was declared over, with a total of 53 cases, including 38 confirmed cases and 29 deaths. All cases were identified in BikoroIboko, and Wangata health zones in western Équateur Province. 

African Nations Respond

In response to the DRC Ebola outbreak, several African countries tightened health screenings at air, sea, and land borders starting May 10. Nigeria, Ghana, Kenya, Tanzania, and Zambia announced reinforced screening procedures, including temperature scans, at all border entry locations; such measures usually result in longer wait times for incoming travelers to those countries, especially at major airports. Passengers arriving from DRC will likely receive particular attention and may continue to be monitored after gaining admission into the country. The measures will remain in place until further notice. Strong screening measures by Nigeria's border control agents helped limit the spread of Ebola into the country in the 2014-2016 West Africa Ebola outbreak. Other countries in West and East Africa are now imposing similar heightened screening measures.

Ebola Vaccination Strategy

The DRC Ministry of Health began an Ebola vaccination campaign on May 21 in Mbandaka. Priority was given to health professionals in contact with Ebola patients, followed by all close contacts and contacts of contacts in an effort to interrupt transmission.  By the end of the campaign, health officials vaccinated 3,330 eligible individuals:

  • Iboko: 1,530
  • Wangata: 893
  • Bikoro: 779
  • Ingende: 107
  • Kinshasa: 21

On June 2, local health authorities, with the support of the WHO, held a day of awareness in Kinshasa with 50 community representatives from key at-risk areas in the city. These locations experience significant travel to and from Équateur Province through ports and a local airport. Individuals were trained on early symptom identification and tasked with encouraging community members to visit a health center at the first sign of illness. In addition to community members, leaders from the General Directorate of Migration, port chiefs, and provincial commissioners attended the educational sessions.

Looking Ahead

DRC has robust measures in place to address sporadic Ebola outbreaks, including strengthening disease surveillance and deploying health workers with specialized training to perform safe burials. It is important to emphasize that a major outbreak in DRC is unlikely, especially given the broad mitigation and reporting activities and the fact that outbreaks tend to occur in remote areas.


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