After a two-month emergency intervention in Equateur Province, Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières (MSF) teams have begun handing over Ebola response activities to the Congolese Ministry of Health (MoH) and other nongovernmental organizations (NGOs) in Mbandaka, Bikoro, Itipo, and Iboko.
“This Ebola outbreak is not yet officially over but we are very pleased with the progress that has been made,” said Henry Gray, MSF emergency coordinator in Equateur Province. “Given the low volume of cases and the increasing expertise of local staff the Ministry of Health is well placed to finish the work which we started together.”
Throughout the course of the outbreak, officially declared on May 8, 2018, Congolese MoH teams supported by MSF in Bikoro, Itipo, Mbandaka, and Iboko provided care to 38 confirmed patients, 24 of whom survived and returned to their homes. Sadly, 14 died. Over 120 other patients who presented with symptoms consistent with Ebola were isolated and tested before being allowed to return home after testing negative for the virus.
Working with partners
The handover process began with the closure of MSF’s Ebola Transit Center at the Itipo General Reference Hospital on June 20. All new suspected patients are now cared for at the nearby Ebola treatment center managed by the organization ALIMA, which is also taking care of outreach and surveillance activities in the affected areas and will assist the MoH in running a clinic for Ebola survivors.
MSF subsequently handed over the Ebola treatment center at Bikoro’s General Reference Hospital on June 25 to MoH staff, who continue to isolate and test those suspected of being infected by the Ebola virus. All outreach, surveillance, health promotion, disinfection, and safe burial activities in Bikoro have also been handed over to the MoH and other NGOs.
An MSF team is currently constructing a small isolation unit at the Mbandaka General Reference Hospital. Once completed, any new suspect patient will be isolated and tested for the virus in this new facility. The 40 bed Ebola treatment center constructed by MSF on the outskirts of Mbandaka will be disinfected and dismantled by early July.
An encouraging response
On July 15, the Iboko General Reference Hospital’s Ebola treatment center will be the last MSF-supported structure to be handed over to the MoH . In the meantime, MSF will continue surveillance and outreach activities and support the hospital with pediatric care and infection prevention and control.
Finally, given that no new cases of Ebola have been reported since June 6, MSF teams, alongside the World Health Organization (WHO), have completed the “ring vaccination” of all contacts of confirmed Ebola patients, as well as the contacts of their contacts with the investigational Ebola vaccine rVSVDG-ZEBOV-GP. Likewise, MSF’s vaccination of frontline workers in Bikoro and Iboko health zones was completed on June 23. If there are no new confirmed cases of Ebola, the 21-day followup of the last frontline workers vaccinated by MSF—and MSF’s vaccination activities in Equateur Province—will be completed on July 14.
We’re encouraged that there has been a massive international response to this Ebola outbreak, but Congolese people are much more likely to be affected by malaria, measles, cholera, or violence-related displacement than Ebola. In addition to the medical activities that MSF already runs alongside the Ministry of Health around DRC, MSF is now responding to a new outbreak of Cholera in Mbuji Maji (Eastern Kasai Province) and assessing how to best respond to the consequences of recent violence in Tshikula (Central Kasai province).
Henry Gray, MSF emergency coordinator in Equateur Province
Should there be no more confirmed cases of Ebola, the outbreak will be officially declared over by the Congolese health authorities on July 22. This date is 42 days (twice Ebola’s maximum incubation period) and one day after a safe burial was held for the last confirmed patient who died at the Ebola treatment center in Bikoro.
In total, 3,199 people were vaccinated against Ebola with the investigational Ebola vaccine rVSVDG-ZEBOV-GP under WHO’s Expanded Access Framework by teams from MSF, WHO, and the Congolese Ministry of Health. MSF teams alone vaccinated some 1,673 people in the Bikoro and Itipo areas, including the contacts of confirmed Ebola patients and their contacts and frontline workers (health workers, burial workers, traditional healers, and motorbike taxi drivers) considered to be most at risk of contracting the virus.
