Ebola resurgence in Democratic Republic of Congo, WHO warns

Alexandra Thompson
·4-min read

Watch: Ebola case in eastern DRC

Ebola has resurged in the Democratic Republic of Congo (DRC), the World Health Organization (WHO) has confirmed.

On 7 February, the country’s ministry of health announced that a new case of the life-threatening infection had arisen in Butembo, a city in the eastern North Kivu province.

The unnamed 42-year-old woman – the wife of an Ebola survivor – died on 3 February, two days after seeking treatment for symptoms.

Butembo was one of the epicentres of the DRC’s 10th Ebola outbreak, which lasted nearly two years and was declared over on 25 June 2020.

Read more: Ebola drug ‘highly effective’ in coronavirus patient with rare immune disease

It is “not unusual for sporadic cases to occur following a major outbreak”, according to the WHO.

More than 70 contacts of the deceased woman have been identified so far.

A blood collection tube label as fake ebola virus positive
An unnamed woman has died after testing positive for Ebola in eastern Democratic Republic of Congo. (Stock, Getty Images)

Ebola is the only disease to have been twice declared a public health emergency of international concern (PHEIC), the highest alarm the WHO can sound.

At least 11,300 people died between 2014 and 2016 when an outbreak hit the West African countries Sierra Leone, Guinea and Liberia.

Ebola has an average case-fatality rate of 50%, ranging from 25% to 90% in past outbreaks.

It was declared a PHEIC again when it struck the DRC between 2018 and 2020.

Read more: The health emergencies you didn't hear about in 2020

The 23-month outbreak was said to be particularly challenging to overcome due to it taking place in an active conflict zone.

By the time it was declared over in June, the outbreak was the second largest on record, killing 2,299 people.

Two people attending to a woman with a virus lying on a stretcher in a field hospital with bio hazard symbol in the foreground
Ebola has an average death rate of around 50%. (Posed by models, Getty Images)

In the resurgence case, the woman reportedly went to the Biena health centre, nearly 60 miles (90km) south-west of Butembo, on 1 February with Ebola symptoms – which can include a fever, severe headache and unexplained bleeding.

After testing positive for the virus, she was transferred to the Matanda Hospital in Butembo, where she died.

The WHO has trained local laboratory technicians, contact tracers and vaccination teams, with an “enormous” capacity being put in place after the DRC’s last outbreak.

Community groups are also raising awareness of Ebola and putting in place a “survivor programme”.

Sites visited by the deceased woman are being disinfected.

Read more: Should we limit animal contact to prevent coronavirus outbreaks?

“The expertise and capacity of local health teams has been critical in detecting this new Ebola case and paving the way for a timely response,” said Dr Matshidiso Moeti, the WHO’s regional director for Africa.

“WHO is providing support to local and national health authorities to quickly trace, identify and treat the contacts to curtail the further spread of the virus.”

Samples from the deceased woman have been sent to the National Institute of Biomedical Research’s main laboratory in the DRC’s capital Kinshasa for sequencing.

This will enable scientists to identify the variant of the virus she died with and its link to previous outbreaks.

On 1 June, 2020, the DRC’s 11th Ebola outbreak was confirmed in the west of the country.

Genetic sequencing has revealed the variant, which is still circulating, is different from ones that previously affected the country. Although unclear, an animal source is likely to blame, the WHO has said.

While Ebola is a different class of viruses from the circulating coronavirus, both are thought to have originated in bats before jumping into humans, possibly via another species.

Fruit bats are thought to be “natural Ebola hosts”, with the virus reaching humans through “close contact with the blood, secretions, organs or other bodily fluids of infected animals”.

These animals may include the bats themselves, as well as “chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest”.

Ebola then spreads from person to person via direct contact through broken skin or mucous membranes, like in the mouth and nostrils.

An infection can arise if an individual comes into contact with the blood or bodily fluids of a person who has Ebola or died with it, with transmission frequently occurring during burial ceremonies.

Objects can also become contaminated with the blood, faeces or vomit of an Ebola patient or victim.

Treatment focuses on supportive care, like rehydration, and easing specific symptoms. Ebola has no proven therapy, but a patient may be given experimental drugs.

The experimental vaccine rVSV-ZEBOV has been shown to be “highly protective”.

Previous Ebola outbreaks have led to the development of the Coalition for Epidemic Preparedness Innovations (Cepi), which has funded many coronavirus vaccine trials.

Watch: Doctor who discovered Ebola warns of deadly viruses yet to come