As outbreak responders in the Democratic Republic of the Congo (DRC) continue to gauge the scope of a recently declared Ebola outbreak in Kasai province, 68 suspected cases have now been identified, 20 of them confirmed by lab tests, Ngashi Ngongo, MD, PhD, MPH, who leads incident management for the Africa Centres for Disease Control and Prevention (Africa CDC), said today during a weekly health emergencies briefing.
The initial cases were reported from two health zones, mainly in Bulape but also in Mweka. Ngongo said suspected cases are now reported in two more health districts, Mushenge and Dekese.
Africa CDC said the identification of more affected health districts raises the risk of cross-border transmission, especially to Angola, requiring scaled-up surveillance, case management, and infection prevention and control measures.
Funeral attendance may have amplified spread
Ngongo said the suspected cases include several people who died before the Ebola outbreak was identified. He added that many people attended their funerals, some traveling from other health zones, and may have been exposed to the virus. Viral loads are known to be extremely high after death, and unsafe burial practices, including washing and touching deceased people, are known to transmit the virus, which spreads through infected body fluids.
The number of deaths remains relatively stable, at 16, for a case-fatality rate of 23.5%. Ngongo said nine people are in medical care, including four who are in critical condition.
So far, outbreak responders have identified 401 case contacts, and 398 of them are under follow-up.
Ngongo said the DRC has 2,000 vaccine doses, and so far, 68 frontline healthcare workers have been vaccinated. Regarding treatments, Africa CDC has transported 100 doses of the monoclonal antibody MAb144 (ansuvimab-zykl, also known as Ebanga) to the Bulape health zone, the outbreak’s epicenter.
The Ebola outbreak is the DRC’s 16th, and the seventh to affect Kasai province. The index patient is a 34-year-old pregnant woman who died in a hospital on August 25. Africa CDC said an attending lab technician and nurse died of similar symptoms. Genetic sequencing of five samples suggests a new zoonotic spillover.
MSF, WHO open Ebola treatment center
In a related development, Doctors Without Borders (MSF) yesterday said that, in coordination with the DRC health ministry and the World Health Organization (WHO), it has joined the multiagency response and is on the ground in Kasai province.
“Our teams began supporting the General Referral hospital in Bulape almost immediately,” said Brice de la Vigne, MSF emergency coordinator. “We helped reinforce triage protocols, supplied essential medicines and personal protective equipment, and conducted training in infection prevention and control, and symptomatic care.”
The MSF and WHO have established an Ebola treatment center within the hospital compound, which began admitting its first patients on September 9. There are currently 12 MSF staff in Bulape. MSF teams are also visiting nearby healthcare facilities to strengthen infection prevention and control protocols and train health workers.