Ebola virus disease – Democratic Republic of the Congo

No new cases have been reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo since 17 February 2020 (Figure 1). However, due to challenges related to continued insecurity and population displacement in previous hotspots, limited access to some affected communities, and potential shortages of resources amidst other local and global emergencies, there remains a high risk of re-emergence of the virus. Therefore, it is critical to maintain surveillance and response operations in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

Active outbreak response activities continue, which include investigating and validating new alert cases, supporting appropriate care and rapid diagnosis of suspected cases (which continue to be detected), supporting survivors through a multi-disciplinary programme, and strategically transitioning activities. From 18 to 24 March, an average of 4619 alerts were reported and investigated daily. Of these alerts, 358 were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. From 16 to 22 March, 2747 samples were tested including: 1479 blood samples from alive, suspected cases; 374 swabs from community deaths; and 894 samples from re-tested patients. Overall, laboratory activity was conducted at similar levels as compared to the prior week.

Last week, nine historical probable cases were validated, whose dates of symptom onset were between October 2018 and July 2019, bringing the cumulative number of probable cases to 143. Further historical probable cases are expected to be validated as investigations into past cases continue.

As of 24 March 2020, a total of 3453 EVD cases were reported from 29 health zones (Table 1), including 3310 confirmed and 143 probable cases, of which 2273 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 57% (n=1935) were female, 29% (n=979) were children aged less than 18 years, and 5% (n=171) were health care workers.

WHO has not received funding for the Ebola response since December 2019. An urgent injection of US $20 million is required to ensure that response teams have the capacity to maintain the appropriate level of operations through to the beginning of May 2020. If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak. For more information, please see this statement.

Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 24 March 2020*

*Excludes n=149 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. ‘Non-active zones’ indicate health zones that have not reported new cases in the last 42 days.

Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu Province, Democratic Republic of the Congo, data as of 24 March 2020**

**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.

Public health response

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain high, while global risk levels remain low.

WHO advice

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see: