The Ebola outbreak that started in August in the north of the Democratic Republic of Congo (DRC) is now under control, as no new cases have been detected since the last confirmed infection was diagnosed on October 4 in the town of Boende.
Médecins Sans Frontières/Doctors Without Borders (MSF), which had deployed around 70 members to the area following the announcement of the outbreak, has withdrawn its teams. Surveillance efforts, however, are being maintained, and MSF has worked to enhance the capacity of local authorities to respond to any new developments.
Ebola outbreaks over after 42 days without a case
According to the World Health Organization, the outbreak in DRC infected 66 people, 49 of whom died. Usually, an Ebola outbreak is officially considered over after 42 days without a case. “Closing an Ebola intervention has two phases,” says José Mas, coordinator of MSF's intervention. “There is a first period of 21 days after the last confirmed case and during this time one of the main tasks is tracing those who have been in contact with that last patient. Then there is a second buffer period of 21 days to make sure no more cases arise.”
“At MSF,” Mas adds, “we try our best to secure an effective and forceful response in the event of a new outbreak. In Congo, we have worked with local authorities to maintain an operational treatment centre in Equateur. We have also made a donation of medicines and equipment for water and sanitation, and the staff is the same that has worked during this last outbreak, so they are properly trained.” Despite the withdrawal, MSF has teams stationed in other parts of DRC who can return to the area in case of a new alert. One of those teams is located in the nearby city of Mbandaka, by the Congo River, from where emergency response can be activated if necessary. (The recent outbreak was registered in the province of Equateur, where in 1976 the Ebola virus was first identified and named after the Ebola River, a tributary of the Congo.)
'Fear is always a problem in an Ebola outbreak'
The MSF intervention started last July when a survey team was sent to confirm the presence of Ebola in the area. After the outbreak was officially declared, two treatment centres were set up in collaboration with the DRC government in the towns of Lokolia and Boende. Of the 65 people admitted to the centres, 25 had confirmed infection, 13 were able to recover, and 12 died.
Besides providing attention at the treatment centres, MSF teams also contact tracking, disinfection of houses and support for safe burials. A very important task was the sensitization of the local community about the risks of the virus. "Fear is always a problem in an Ebola outbreak. There is a lot of misunderstanding, lots of rumours and misinformation. And information is precisely what it takes to understand the disease and cope with the epidemic," says Segimon Garcia, anthropologist and the coordinator of the MSF health promotion team in this intervention.
The usual fears aroused by any Ebola epidemic have been accentuated by the huge outbreak currently taking place in West Africa. Unlike that situation, the outbreak in DRC — the seventh the country has seen — has been what experts consider a “classic outbreak,” located in a remote area far from urban centres.
Different factors in Congo outbreaks vs. West Africa
“In Congo, there had previously been several Ebola outbreaks, but they were in the middle of the jungle,” says Núria Carrera, the MSF coordinator at the Boende treatment centre. “Distances are greater there, transportation is more difficult and people cannot move that much, so the outbreak remains limited and contamination is more difficult. In these conditions, the risk of dissemination of the virus is much lower."
An early response was also able to contain the epidemic in an early stage. “Containment measures such as contact tracing, an alert system and the medical care of the patients were taken at the right time,” says Mas, something that was not possible in the early stages of the West African outbreak.