Ebola outbreak declared over in Democratic Republic of Congo

The outbreak of Ebola in the Democratic Republic of Congo (DRC) has been declared over with authorities praising the swift and effective response.

It is now 42 days since the last case of the haemorrhagic fever was notified, meaning that the incubation period for any new cases of the disease to emerge has passed.

The outbreak - which affected 53 people, killing 29 - was first declared on 8 May in Bikoro, a rural area in Equateur province.

There were fears the disease would spread because of the area’s proximity to the Congo river, one of the main transport routes in the country, linking the province to the capital of DRC, Kinshasa, as well as Brazzaville, the capital of neighbouring Republic of Congo.

The disease also spread to Mbandaka, a city of more than a million people, prompting fears it would take hold and run out of control.

However, a fast response by the World Health Organization (WHO), the DRC ministry of health and many other partners meant the outbreak was quickly contained.

Dr Tedros Adhanom Ghebreyesus, WHO director general, paid tribute to all those who helped prevent the outbreak turning into a repeat of the 2014 West Africa epidemic, which claimed 11,000 lives.

“The outbreak was contained due to the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of the ministry of health. That kind of leadership, allied with strong collaboration between partners, saves lives,” said Dr Tedros.

Many people have attributed the success of this outbreak to the deployment of the rVSV-ZEBOV vaccine - the first time a vaccine has been used during an Ebola emergency.

Frontline health workers were vaccinated, alongside the contacts of patients who were infected and the contacts of those contacts - more than 1000 people were vaccinated and about 98 per cent of those eligible received the jab.

Jeremy Farrar, director of the Wellcome Trust, said swift action by the government of DRC and WHO meant the vaccine was deployed quickly.

“As a result the epidemic has been stopped much earlier than would otherwise have happened. Had a vaccine been available earlier alongside other critical public health interventions in the devastating epidemic of 2014 to 2016, thousands of lives might have been saved,” he said.

He added: “In future outbreaks, we must build on the success of this approach and make sure that a comprehensive research programme is immediately initiated so that we can learn what works and as a result save lives.”

Around 360 people took part in the response, including 30 people from the ministry of health in Guinea who helped with the ring vaccination programme. Guinea was one of the countries hit hard by the 2014 Ebola outbreak and a trial of the vaccination took place here.

Dr Matshidiso Moeti, WHO regional director for Africa, said the experts from Guinea transferred “expertise which will enable the DRC to mount an effective response both within its borders and beyond”.

DRC is the country with the greatest experience at combating Ebola outbreaks - this was its ninth outbreak of the disease first discovered in the country, then known as Zaire, in 1976.

Dr Victor Illanes, a haemorrhagic fever specialist with Médecins Sans Frontières, who spent a month in DRC, said the response was much quicker than during the West African outbreak. Then it took WHO five months to declare an international public health emergency, by which time 1000 people had died.

“One thing that was different with this outbreak was there were a lot of people on the ground. The response was far more energetic than in previous outbreaks. When there was the urban expansion [of the disease] that was a major concern - everyone came very quickly,” he said.

Dr Illanes said that previous outbreaks in DRC have been in rural areas - because they are sparsely populated with few roads they peter out quickly.

“Congo is changing - there are more roads now and better chances for an outbreak to spread. Congo is incredibly big - the country is used to dealing with the disease but it doesn’t have huge capacity. It wouldn’t be able to deal with a big outbreak on its own,” he said.

Doctors discussed using an experimental treatment but because the outbreak ended sooner than expected this was not necessary, said Dr Illanes.

“Hopefully we’ll be able to use some of the investigational drugs during the next outbreak,” he said.

Oxfam’s humanitarian programme manager in the DRC, Tamba Emmanuel Danmbi-saa, said local communities were hit hard during the outbreak. Because of fears over the spread of the disease they were unable to have normal social contact and their livelihoods were affected.

“People didn’t have freedom to shake each other’s hands, phsyical contact was impossible and social gatherings were prohibited. It was difficult for people to go about their normal economic activity,” he said.

One of Oxfam’s key activities was raising awareness of preventive measures and Mr Danmbi-saa paid tribute to communities for their role in stopping the disease in its tracks.

“The declaration of Ebola being over is a big victory for the community because they played a crucial role in this. They were the victims but they also played their part in stopping the disease,” he said.

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