Ebola, first appeared on the map in 1976 in the Democratic Republic of Congo (DRC). Identified as a deadly zoonotic disease. Ebola spreads to humans through contact with bodily fluids and tissues of infected animals after which transmission can occur human-to-human via the same mode of transmission (direct contact with bodily fluids). What started with two cases in the Bikoro region in May of 2018 turned into the 9th Ebola outbreak since 1976 which lasted from May 2018 to July 2018 and resulted in 54 cases and 33 deaths.
In the following case study, Alyson Marcinkowski discusses the facts of the outbreak, going into detail regarding the management of the case and the public health implications of the outcomes. As Marcinkowski explains, the DRC’s Ministry of Health (MoH) was initially alerted to 21 cases of hemorrhagic fever and 17 community deaths which, upon further evaluation, were identified as symptoms pertaining to Zaire ebolavirus, the deadliest strain of Ebola as identified by Médecins Sans Frontières (MSF). Within 5 days, the outbreak was declared and it was officially coming to an end by July 24, 2018, with the last case reported on July 3, 2018.
Over the course of 3 months, the DRC MoH handled the response and management of the outbreak with speed and efficiency. They immediately deployed a Rapid Response Team to the Bikoro region and issued samples to be taken via RT-PCR and sent to a lab for confirmation. The WHO was also mobilized and they set up an Incident Management System to provide technical and operational support to the MoH. Marcinkowski explains that the multi-agency response and operation included identification and isolation of cases, contact tracing, and community mobilization among other disaster responses.
However, Marcinkowski also highlights the gaps in outbreak management, for example, the DRC faced limitations due to its weak health care system as a result of an ingrained history of political conflict. The DRC also relies greatly on international aid which can pose a logistical challenge in the need for timely execution of response. The geographic location of Bikoro was also an issue as it was a couple of hundred miles upriver and was difficult to access both by road and air. Marcinowski explains that, given the frequent nature of Ebola outbreaks in this region, the DRC should consider an investment in infrastructure improvement and the establishment of a laboratory in these outbreak areas.
Overall, the DRC’s 9th Ebola outbreak illuminated better management practices for future outbreaks. As Marcinowski states, the main takeaway from this event is that “early detection, contact tracing, safer burial practices and community engagement” along with a greater emphasis on vaccine rollout are essential to controlling Ebola outbreaks. These efforts should continue to be perfected and streamlined to allow for greater efficiency moving forward.
Read the case study.