Health Professionals

Clinical Updates

21 September 2012

Ebola haemorrhagic fever: Democratic Republic of Congo – update

The Ebola outbreak in the health zones of Isiro and Viadana, Haut Uélé district in Province Orientale, Democratic Republic of Congo (DRC), is ongoing.  As of 15 September 2012, the World Health Organization reports a total of 72 cases, (14 laboratory confirmed, 32 probable, 26 suspected), of which 19 have been fatal (six confirmed, 13 probable) [1].

There have been no confirmed cases of Ebola reported outside Haute Uelé district [1].

Geographic distribution of Ebola in DRC (as of 8 September 2012). [2]

 

The Ministry of Health, DRC, has convened a National Task Force in response to this outbreak. Other organisations, including WHO, US Centers for Disease Control and Prevention and Médecins Sans Frontières are assisting in the investigation and management of the outbreak.  Control activities include surveillance, case finding and contact tracing and education reinforcing infection control measures [3].

Ebola is known to occur in DRC [3-5]; the previous most recent outbreak, in Mweka and Luebo Health Districts, Province Kasai-Occidental was declared over in February, 2009 [5].

Ebola haemorrhagic fever

Ebola haemorrhagic fever is a severe disease caused by a virus of the Filoviridae family. There are five serotypes of Ebola virus, of which four have caused disease in humans: Ebola Zaïre, Ebola Sudan, Ebola Côte d’Ivoire, and Ebola Bundibugyo [6].  The natural reservoir for Ebola is not known, but non-human primates can become ill with Ebola [7].

Following an incubation period of four to 10 days (range two to 21 days) illness 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 occur.

This can lead to multi-organ failure, shock, and death. Ebola is transmitted via direct contact with the bodily fluids of an infected person. Ebola has also been reported following contact with the tissues of infected animals.

Advice for travellers

The risk to a traveller of contracting Ebola is very low in the absence of direct contact with the blood or body fluids of an infected person, animal, or objects, such as needles, that have been contaminated with blood or body fluids. There have been no known imported cases of Ebola in the United Kingdom.

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 precautions.

Travellers who have been potentially exposed to Ebola virus should seek medical attention immediately if they experience any symptoms consistent with Ebola within the first 21 days of return to the UK.

United Kingdom guidance on the management and control of viral haemorrhagic fevers (VHF) has been written by the Advisory Committee on Dangerous Pathogens.

Guidance for healthcare workers who will be working with VHF patients in African healthcare settings has been written by the CDC in conjunction with WHO.

References

1. World Health Organization. Ebola Outbreak in Democratic Republic of Congo. [Accessed 21 September, 2012]. Available at: http://www.who.int/csr/don/2012_09_18/en/index.html

2. World Health Organization. Regional Office for Africa. Outbreak Bulletin. 2 (6);  13 September 2012. [Accessed 21 September, 2012]. Available at: http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/3688-outbreak-bulletin-vol-2-issue-6-13-september-2012.html

3. Arthur R R. Ebola in Africa - Discoveries in the past decade. Euro Surveill. 2002; 7(3):pii=342. [Accessed 21 September 2012]. Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=342

4. Health Protection Agency. Locations of cases/outbreaks Marburg and Ebola haemorrhagic fevers. [Accessed 21 September 2012]. Available at: http://www.hpa.org.uk/web/HPAweb&HPAweb_C&HP

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5. World Health Organization. Global Alert and Response. End of Ebola Outbreak in Democratic Republic of Congo. [Accessed 21 Sewptember 2012]. Available at: http://www.who.int/csr/don/2009_02_17/en/index.html

6. Health Protection Agency. Ebola. [Accessed 21 September 2012]. Available at: http://www.hpa.org.uk/Topics/InfectiousDiseases/

InfectionsAZ/Ebola/

7. Beeching NJ, Fletcher TE, Hill DR, Thomson GL. Travellers and viral haemorrhagic fevers: what are the risks? Int J Anti Micro Agents 36:S26-S35, 2010.

 

Links

Health Protection Agency: Ebola

World Health Organization: Factsheet Ebola