The Ministry of Health of the Democratic Republic of the Congo declared an outbreak of Ebola virus disease (EVD) in the country after a case was confirmed from Mbandaka, Equateur province. The onset of symptoms was on 5 April. The case subsequently died on 21 April, and a safe and dignified burial was performed.

The second case, a family member, was confirmed on 25 April. As of 27 April, 267 contacts have been identified; other measures, including contact tracing, further investigations, and decontamination of households and health facilities, are ongoing. 

“The risk of regional and international spread of this epidemic cannot be ruled out as the town of Mbandaka borders the Congo River and has river and land connections with the capital Kinshasa, the Republic of Congo, the Central African Republic and Angola,” the WHO said in a statement on Thursday.

In addition, the WHO adds, Mbandaka has air links with the province of South Ubangi, which borders the Central African Republic and the Republic of Congo, and with Kinshasa, WHO however describes the current risk as “moderate” at the regional level and “low” at the international level.

This is the third EVD outbreak in Equateur province and the sixth in the country since 2018. Previous outbreaks in Equateur province occurred in 2020 and 2018, with 130 and 54 confirmed and probable cases recorded, respectively.

On 23 April 2022, the Ministry of Health of the Democratic Republic of the Congo declared an outbreak of Ebola virus disease (EVD) after laboratory confirmation of a case, a 31-year-old male from Mbandaka.  a city of approximately 1.2 million people in the north-western Equateur province.

The case had symptoms onset on 5 April, with fever and headache, and was under home treatment with antimalarial drugs and antibiotics before being admitted to two health facilities between 16 and 21 April, where infection prevention and control (IPC) measures were inadequate.

Given the persistence of symptoms and appearance of haemorrhagic signs on 21 April, he was admitted to the General Referral Hospital in Wangata. He died on 21 April after which a safe and dignified burial was conducted. A blood sample taken by the provincial laboratory in Mbandaka tested positive for the Ebola virus by reverse transcriptase-polymerase chain reaction (RT-PCR) on 21 April, and an oral swab analysed on 22 April also tested positive for Ebola virus. For confirmation, blood samples and oral swabs were sent to the reference laboratory, the National Institute of Biomedical Research (INRB) in Kinshasa and tested positive for the Ebola virus by RT-PCR.

On 25 April, health authorities confirmed a second EVD case, a 25-year-old woman from Mbandaka who was a family member of the first case. She developed symptoms on 13 April and was treated at home for five days. While symptomatic, she visited a prayer house, a health centre, a pharmacy and a nurse’s home. She died on 25 April and a safe and dignified burial was performed on the same day. 

Ebola virus disease is present in animal reservoirs in the Democratic Republic of the Congo and before this EVD outbreak, the country had reported 13 EVD outbreaks since 1976. The current outbreak is the third EVD outbreak in Equateur province and the sixth in the country since 2018. The last outbreak in the Equateur Province was declared over in November 2020, after 130 confirmed and probable cases were recorded and nearly six months after the first cases were reported (more details, published in Disease outbreak news on 18 November 2020).  

Full genome sequencing was performed at the INRB in Kinshasa and results indicate that this outbreak represents a new spill-over from the animal population.

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