Risk level and Uncertainties
➚ Risk level
➃ very high at the national level (WHO assess.)
➂ high at the regional level (WHO assess.)
➀ weak at the global level (WHO assess.)
➚ ➀ Risk for actors without activities within the DRC – Put the risk under watch
Main concerned actors: travel and tourism, NGOs, Mining companies (notably Cobalt, Copper) – risk to evaluate according to specific location and activities.
Facts and analysis
WHO Figures – From 4 April through 17 May 2018:
- 45 suspected, probable and confirmed (14) cases of Ebola reported
- 25 deaths (+2 / 15 May)
- 527 contacts have been identified and are being followed-up and monitored
A new outbreak of Ebola virus disease (EVD) is taking place in the Democratic Republic of Congo.
On 8 May 2018, the DRC notified the WHO “two confirmed cases of Ebola virus disease occurring in Bikoro health zone, Equateur province”. Since then, we have been following closely the evolution of the disease.
On 17 May 2018, the WHO raised the level of risk as a new “laboratory-confirmed case from the city of Mbandaka”, was “notified by the country’s Ministry of Health”. Mbandaka counts 1,2 million habitants. By 18 May 2018, 3 cases would thus be confirmed in Mbandaka. The city is a port that “lies on the eastern bank of the Congo River, Africa’s 2nd longest after the Nile. Tens of millions of people live along the river, and the capitals of Congo, the Central African Republic and Congo Republic lie along it and its tributaries. This creates a much more precarious situation for spread of EV than Bikoro, the epicenter of the outbreak (ProMed, 17 April)”.
As a result, on 18 May 2018, the WHO convened an emergency committee to assess the latest Ebola outbreak. It decided that to this date, this outbreak should not be considered a public health emergency of international concern — a PHEIC. The committee will reconvene if the outbreak spreads and reassess the situation then. Besides measures of “vigorous response”, and of strengthening preparedness and surveillance for neighbouring countries, the main advice is as follows:
“Exit screening, including at airports and ports on the Congo river, is considered to be of great importance; however entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value”.
According to the WHO situation report of 17 May 2018, The level of public health risk assessed by the WHO has been changed to
- very high at the national level
- high at the regional level.
- weak at the global level
Considering the three main drivers identified during the West African Ebola outbreak (2014-2015), the existence of available Ebola vaccine rVSVDG-ZEBOV-GP which have been shown as highly effective, and are already being sent to the DRC is a favourable factor to see the outbreak controlled. “WHO is sending 7540 doses of the rVSV-ZEBOV Ebola vaccine, which is enough for 50 rings of 150 people. 4300 doses of vaccine have already arrived in Kinshasa. Logistics and vaccination teams are being put in place to start vaccination as soon as possible”(WHO).
The difficulty to store and then move the vaccine to the affected areas is however a concern, as the state of health care in the region. Médecins Sans Frontières (MSF) is already taking measures to “step up its response in the affected area”.
For worldwide actors without any direct activity in the DRC, the issue is thus to put under watch but still of relatively low concern.
Signals and Sources
Ebola: two more cases confirmed in Mbandaka in DRC – The Guardian
Two more cases of Ebola have been confirmed in the north-western city of Mbandaka in the Democratic Republic of the Congo, health officials have said. The report brings to three the number of confirmed cases in the city of 1 million people, raising the prospect of a wider outbreak than feared.
Statement on the 1st meeting of the IHR Emergency Committee regarding the Ebola outbreak in 2018 – WHO
The 1st meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the Ebola Virus Disease (EVD) outbreak in the Democratic Republic of the Congo took place on Friday 18 May 2018, from 11:00 to 14:00 Geneva time (CET).
Ebola virus disease – Democratic Republic of the Congo – Disease outbreak news – WHO -17 May 2018
Ebola virus disease – Democratic Republic of the Congo
Disease outbreak news for Ebola in DRC.
DRC: Ninth Ebola outbreak in 40 years hits urban area – MSF – 17 May 2018
DRC: Ninth Ebola outbreak in 40 years hits urban area
An outbreak of Ebola has been declared in Equateur province, Democratic Republic of Congo (DRC). The outbreak, in the northeast of the country, has affected 44 people who have presented symptoms of haemorrhagic fever in the region; 3 confirmed as Ebola, and 23 deaths have been notified by the national health authorities.