18 October 2007

Ebola in the Democratic Republic of the Congo - Update

An outbreak of Ebola haemorrhagic fever was reported in the Province of Kasai-Occidental, Democratic Republic of the Congo (DRC) on 11 September 2007 [1]. Three hundred and seventy-two suspected cases were originally reported, however, due to the confirmation of other aetiologies, including typhoid and Shigella dysenteriae type 1, in cases associated with the outbreak, the number of cases due to Ebola was unknown.

As of 3 October 2007, 76 suspected cases of Ebola haemorrhagic fever have been identified, 25 of which were laboratory confirmed [2]. Epidemiological evidence suggests the outbreak has slowed, and contact tracing is continuing to ensure all possible lines of transmission are broken. As of 3 October 2007, 187 contacts of suspected and confirmed cases have been identified and put under medical observation.

The international response team is working with the Ministry of Health in DR Congo to control the outbreak. Suspected cases are being monitored in isolation facilities and contacts are being traced. Infection control measures have been put in place in health centres and hospitals in the affected area, and information on infection control is being disseminated to provincial health authorities across the country. Community health education is underway, with radio sketches on Ebola prevention being broadcast and key messages being conveyed through churches, schools, and markets, as well as other civil society groups to reach as wide a spectrum of the population as possible [3].

Advice for travellers

Ebola haemorrhagic fever is a severe disease caused by a virus of the Filoviridae family. Following an incubation period of around four to ten days (range: two to 21 days) the disease presents with the sudden onset of fever, headache, joint and muscle aches, and weakness. As the infection progresses, nausea, vomiting and diarrhoea, shortness of breath, confusion, and haemorrhage can all occur. This can lead to multi-organ failure, shock, and death in severe cases.

The likelihood of travellers contracting Ebola is low unless there has been direct contact with the blood or body fluids of infected persons, or with objects, such as needles, that have been contaminated with body fluids.

Travellers should avoid all contact with infected patients. Those who are providing medical care or are involved in the evaluation of an outbreak should observe strict barrier protection measures. Travellers who have been potentially exposed to Ebola virus should seek medical attention immediately if they experience any of the above symptoms within the first 21 days of return to the UK.

UK guidance on the management and control of viral haemorrhagic fevers (VHF) has been written by the Advisory Committee on Dangerous Pathogens: http://www.hpa.org.uk/infections/topics_az/VHF/ACDP_VHF_

guidance.pdf.

Guidance for healthcare workers who will be working with VHF patients in African healthcare settings, has been written by the US Centers for Disease Control and Prevention (CDC) in conjunction with the World Health Organization: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual.htm

References

1. World Health Organization. Ebola haemorrhagic fever in the Democratic Republic of the Congo. 11 September 2007. Accessed 15 October 2007. Available at http://www.who.int/csr/don/2007_09_11/en/index.html
2. World Health Organization. Ebola haemorrhagic fever in the Democratic Republic of the Congo – Update 4. 3 October 2007. Accessed 15 October 2007. Available at http://www.who.int/csr/don/2007_10_03a/en/index.html
3. World Health Organization. Ebola haemorrhagic fever in the Democratic Republic of the Congo – Update 3. 27 September 2007. Accessed 15 October 2007. Available at http://www.who.int/csr/don/2007_09_27/en/index.html

Links

Centers for Disease Control and Prevention, United States. Ebola hemorrhagic fever. On-line resource accessed 12 September 2007. Available at:  http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola.ht

m

World Health Organization. Ebola Haemorrhagic Fever. On-line resource accessed 13 September 2007. Available at:

http://www.who.int/mediacentre/factsheets/fs103/en/