The Democratic Republic of Congo declared an end to its most recent Ebola outbreak in North Kivu after three months and 11 confirmed cases. But there's a possibility of new cases emerging, responders warned.
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Genomic sequencing linked this recent outbreak to the previous outbreak, which started in 2018 and lasted for nearly two years, resulting in 3,481 cases. The country has experienced four Ebola outbreaks in less than three years.
The virus can persist in survivors long after infection, and there are over 1,100 survivors of the disease from outbreaks in eastern DRC. It's also a heavily forested region, which can serve as a reservoir for the virus, so it’s important that strong surveillance continues to detect future cases, Dr. Balla Conde, manager of operations for DRC's Ebola response at the International Federation of Red Cross and Red Crescent Societies, told Devex.
“We have to be very cautious because we can have this scenario again,” Conde said.
The country made this declaration 42 days after the last Ebola patient was discharged — this is considered twice the maximum incubation period for Ebola infections. For the next three months, suspicious deaths will be tested for the virus, among other forms of surveillance. Following this period, strong levels of surveillance need to be maintained in the routine health systems, Conde said.
He added that without adequate funding, surveillance in the coming three months would be a challenge. Community surveillance structures are in place to raise the alarm when there are suspicious deaths or people with symptoms that match Ebola and provide some coverage levels in hard-to-reach areas. But there are concerns that inadequate funding will limit the ability of responders to strengthen these systems, he said.
Another key component of surveillance is contact tracing because any one case can spiral into many — and it’s a disease with a high mortality rate. In the 2018 outbreak in the region, 66% of people who contracted the virus died. But health responders have continuously faced challenges with surveillance in North Kivu because of insecurity in the region. It’s also an area with a lot of mobility, fluid borders, and a weak health system, Conde said.
An ongoing Ebola outbreak in Guinea was linked to the previous outbreak in the West African region in 2014 through 2016.