Is the End in Sight for DRC Ebola Outbreak?

The last person in the Democratic Republic of the Congo (DRC) confirmed to have Ebola was discharged from care on March 4, 2020. The outbreak was first declared in August 2018, and has claimed 2264 lives.

The patient, a woman named Semida Masika, was followed by celebrating hospital workers as she was released from a hospital in Beni.

The DRC outbreak has been the second largest Ebola outbreak in history, surpassed only by the West Africa outbreak of 2013-16.

On March 6, World Health Organization (WHO) assistant director-general Ibrahima Socé Fall, MD, explained in a statement that the end was in sight, but that vigilance would be necessary moving forward.

“The outbreak isn’t over. WHO recommends waiting 2 full incubation periods, that’s 42 days, after the last person tests negative a second time before declaring the end of the outbreak,” Fall said.

In part due to this waiting period, an International Health Regulations Emergency Committee decided that the Ebola outbreak remained a Public Health Emergency of International Concern during a meeting in February.

Recent memory supports Fall’s caution. New flare-ups occurred after the end of the outbreak during the West Africa epidemic.

In addition, the precarious social situation in the DRC limits critical surveillance and prevention activities. Because of armed conflict between the government and various opposition groups, contact tracing is difficult.

“Ebola transmission outside of groups currently under monitoring cannot be ruled out. A single case could reignite the epidemic,” said WHO spokesman Tarik Jasarevic.

Other challenges also present concerning opportunities for flare-ups. The virus can persist in bodily fluids of survivors months after recovery. Ebola is also found in animals within the region. Additionally, the virus can persist in used needles, syringes, and vials.

The possibility of more Ebola cases is real, but the good news of Masika’s discharge marks what could be the beginning of the end of the outbreak. Other threats, however, are already here.

“The health system has to be strong to stop much more than Ebola. It has to stop malaria, measles, cholera, and now COVID-19,” Fall said.

To learn more about how the DRC outbreak compares to the West African outbreak, and what comes next, listen to Ebola: Past, Present, Future, episode 5 of the Contagion® Connect podcast. In this podcast, Contagion® interviewed John Johnson, project lead for Ebola vaccination with Médecins Sans Frontières, as well as Jason Kindrachuk, PhD, a microbiologist who was on the ground during the West Africa outbreak.

For the latest case counts in the Ebola outbreak in the DRC, visit the Contagion® Outbreak Monitor.