Ebola Vaccination in the Democratic Republic of the Congo

On May 8, the government of the Democratic Republic of the Congo (DRC) announced that a new outbreak of Ebola virus disease (EVD) was affecting the Bikoro area in Equateur Province. The Ebola virus causes a severe acute illness that is often fatal if left untreated. The average case fatality rate for EVD is approximately 50%. The virus is transmitted to humans by wild animals and spreads among the human population through human-to-human transmission. This is the ninth EVD outbreak in the DRC since the virus was first discovered in the country in 1976. In total, from April 4, 2018, to May 27, 2018, the World Health Organization (WHO) reported 54 reported cases of EVD, including 25 deaths (a case fatality rate of 46%). Of these 54 cases, 35 have been confirmed, 13 are probable cases, and 6 remain suspected cases. In total, 5 health workers have been affected. Three health zones have been affected since early April: Iboko (27 cases, including 6 deaths), Bikoro (22 cases, including 16 deaths), and Wangata (5 cases, including 3 deaths). A suspected case in the Ntondo health zone tested negative. At this stage, 906 contacts have been identified and are being monitored. The Ministry of Health is leading the response in the affected health zones with support from WHO and partners. Priorities include strengthening surveillance and contact tracing, laboratory capacity, infection control, case management, community engagement, the safe and dignified burial of the deceased, response coordination, and vaccination.WHO is using as a model the response carried out in 2017 to a similar outbreak of EVD in the north of the country, the effectiveness of which was due to several factors: suspected cases were quickly reported to local authorities; blood samples could be analyzed immediately thanks to strengthened national laboratory capacity; the government identified and announced the outbreak early; rapid response activities were carried out by local and national health authorities with strong support from international partners; and access to flexible funding was swift.On May 21, 2018, more than 7,500 doses of an experimental Ebola vaccine (11,000 people had participated in a trial in Guinea in 2017) were sent to the DRC to carry out vaccination operations in Equateur Province. The ring vaccination strategy requires identifying as soon as possible all contacts of recently confirmed cases, as well as the contacts of those contacts. At present, the International Health Regulations (IHR) Emergency Committee has determined that the conditions for a public health emergency of international concern have not been met.