Total of three cases confirmed in city of 1 million people, raising fears of wider outbreak

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This article is more than 1 year old

Two more cases of Ebola have been confirmed in the north-western city of Mbandaka in the Democratic Republic of the Congo, health officials have said.

The report brings to three the number of confirmed cases in the city of 1 million people, raising the prospect of a wider outbreak than feared.

The DRC is one of Africa’s most fragile states, with millions threatened by hunger, disease and low-level conflict. Political instability has intensified since the refusal of Joseph Kabila to step down as president when his second term ended in 2016.

International aid is pouring in to reinforce health services, with a campaign of vaccinations due to begin on Sunday. The health ministry declared it had activated an action plan in Mbandaka.

After visiting the city, which is 360 miles (580km) from the capital, Kinshasa, the health minister, Oly Ilunga, announced on television that all healthcare would be free. “Financial hurdles should not in any way be a brake to having access to healthcare, especially at a time of epidemic,” he said.

Prof Jean-Jacques Muyembe, the director general of the DRC’s National Institute for Biomedical Research, told the Guardian on Friday that “the situation had evolved overnight with the confirmation of two new cases” in the Wangata neighbourhood of Mbandaka.

“It is very concerning. It’s a big city. We are all doing everything we can, but nonetheless with Ebola there are always surprises,” said Muyembe.



The discovery of the first case in Mbandaka this week was described as a “major gamechanger” by the World Health Organization. An emergency meeting of experts was held on Friday to consider the danger of the disease spreading to other countries. “At the global level, the risk is currently low,” the WHO said.

Late on Thursday, the DRC health ministry confirmed 11 previously suspected cases of Ebola and two more deaths, taking the total number of cases, including 25 deaths, to 45.

All the deaths so far have occurred in Bikoro, a rural area about 75 miles from Mbandaka. The presence of the disease in more isolated areas has given authorities a better chance of preventing its spread.

Muyembe said laboratory results released late on Thursday had confirmed the two new cases. He was unable to give any further details about whether the individuals knew each other. The aid agency Médecins san Frontières, however, said it was aware of only one new laboratory-based confirmation from Mbandaka.

Mbandaka is located on the banks of the Congo river, a key trade and transport route into Kinshasa, though experts said water transport between the cities could take weeks, slowing any potential spread of the disease. Air transport is limited and expensive.

Ebola has twice made it to DRC’s capital in the past and was rapidly stopped.

Ilunga said epidemiologists were working to identify people who had been in contact with suspected cases, and authorities would intensify population tracing on routes out of Mbandaka.

This is a big task even for medical services in developed countries, but the DRC is one of the world’s poorest.

Four times the size of France, the DRC has been chronically unstable and episodically racked by violence since it gained independence from Belgium in 1960. Hospitals, roads and electricity have problems, especially in remote areas.

In Mbandaka, medical staff have been issued with infrared pistol thermometers to check travellers for high temperatures, as well as soap and basins of water, and logbooks for writing down visitors’ names and addresses.

In the privately run port of Menge, health ministry workers were systematically checking people’s temperatures with thermometers. But Joseph Dangbele, a port official, said: “We don’t have enough of the thermometers, so people are crowding up and getting annoyed.”

On Thursday, a doctor at Mbandaka general hospital, who requested anonymity, said more than 300 people in the city had either direct or indirect contact with Ebola.

Despite police being deployed in key areas, residents showed little confidence in authorities’ response.

Gaston Bongonga said: “Delegations come here and then go, but on the ground, you don’t see any change. They were all unable to hold back Ebola in Bikoro because they don’t do anything effective.”

Residents of Bikoro said there were only two checkpoints on a 60-mile stretch of road. One said: “This isn’t effective because many people travelling by motorbike or on foot evade inspection.”

Ebola has been recorded nine times in the DRC since the disease first appeared near the northern Ebola river in the 1970s. It can cause internal and external bleeding.

More than 4,000 shots of a newly developed vaccine were sent by the WHO to Kinshasa on Wednesday.

Congo enters uncharted territory as it faces gravest Ebola challenge to date Read more

The vaccine, developed by Merck, is not licensed but proved effective during limited trials in west Africa, where the biggest recorded outbreak of Ebola killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014 to 2016.</s>Three new cases of Ebola have been confirmed in the Democratic Republic of the Congo's (DRC) sprawling northwest, taking the number of suspected infections to 43, according to the health minister.

The outbreak, previously reported in a remote rural area of the country, recorded its first confirmed cases in Mbandaka, a city of 1.2 million, as the spread of the haemorrhagic fever raised alarm.

"Three new cases were reported (in Mbandaka) and tested positive for the Ebola virus," Health Minister Oly Ilunga said in the statement.

"In total, 43 cases of haemorrhagic fever have been flagged in the region of which 17 are confirmed, 21 are probable, and five are suspected cases," he said.

In Geneva, the United Nations's World Health Organization (WHO) put the death toll at 25 but said 45 cases have been recorded, 14 of which have been confirmed by lab tests.

The WHO on Friday said the latest Ebola outbreak did not warrant being labelled an emergency of "international concern", adding that Kinshasa's response along with its own had been "rapid and comprehensive".

The government announced the outbreak of the deadly virus in northwestern Equateur province on May 8.

In the WHO's parlance, "a public health emergency of international concern" is an "extraordinary event" in which a disease may spread across borders and requires a vigorous international response.

Ebola is both lethal and highly contagious, which makes it difficult to contain, especially in urban environments where people are mobile and come into contact with others more often.

It is notorious for its high fatality rate and extreme symptoms, which can include internal and external bleeding.

The current outbreak, the ninth to hit the DRC since Ebola was identified in 1976, involves the same strain of the virus that struck three West African countries in 2013-2015 and sparked an international panic.

It went on to kill more than 11,300 people in the deadliest ever Ebola epidemic.</s>The Ebola outbreak in the Democratic Republic of Congo has spread to a city, the World Health Organization said Thursday, raising concern the deadly virus may prove tougher to contain.

"One new case of Ebola virus disease has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people in Equateur Province in northwestern Democratic Republic of the Congo," the UN's health agency said in a statement.

The outbreak, publicly declared on May 8, had previously been reported in a rural area of Equateur that lies roughly 150 kilometres (93 miles) from Mbandaka.

"This is a concerning development," WHO director-general Tedros Adhanom Ghebreyesus said in the statement.

The agency said it was deploying around 30 experts to Mbandaka "to conduct surveillance in the city."

Forty-four cases have been reported in the outbreak so far, including three confirmed, 20 probable and 21 suspected, according to the WHO's tally.</s>The Democratic Republic of Congo's Ebola outbreak has spread to a provincial capital, prompting the World Health Organization (WHO) to call an emergency meeting.

The outbreak was announced last week in the remote rural area of Bikoro. So far 45 cases have been reported and 25 people are known to have died.

But cases have also been confirmed in Mbandaka, about 150km away, which is home to almost 1.2 million people.

The city lies on the Congo River, a busy transport corridor to the capital Kinshasa, where more than 10 million people live.</s>(KINSHASA, Congo) — Congo’s Ebola outbreak has spread to a crossroads city of more than 1 million people in a troubling turn that marks the first time the vast, impoverished country has encountered the lethal virus in an urban area.

“This is a major, major game-changer in the outbreak,” Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, warned on Thursday.

A single case of Ebola was confirmed in Mbandaka, a densely populated provincial capital on the Congo River, Congo’s Health Minister Oly Ilunga said late Wednesday. The city is about 150 kilometers (93 miles) from Bikoro, the rural area where the outbreak was announced last week.

Late Thursday, Congo’s Ministry of Health announced 11 new confirmed Ebola cases and two deaths tied to cases in the country’s northwest, including one in a suburb of Mbandaka.

A total of 45 cases of Ebola have now been reported in Congo in this outbreak: 14 confirmed, 21 probable and 10 suspected, the ministry said, after results from lab tests returned Thursday.

There has been one new death in Bikoro, where the first death took place. That new death had epidemiological ties to another case. The other death was a suspected case in Wangata, a suburb of Mbandaka on the Congo River, the ministry said. No details were given on the death’s links to the newly confirmed case.

Only one of the 25 dead has been confirmed as Ebola, it said, adding that no new health professionals have been contaminated. One nurse had died, and three others were among suspected cases since the outbreak began.

Medical teams have been rushing to track down anyone thought to have had contact with infected people, while WHO is shipping thousands of doses of an experimental vaccine.

Until now, the outbreak was confined to remote rural areas, where Ebola, which is spread by bodily fluids, travels more slowly.

“We’re certainly not trying to cause any panic in the national or international community,” Salama said. But “urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Mbandaka, a city of almost 1.2 million, is in a busy travel corridor in Congo’s northwest Equateur province and is upstream from the capital, Kinshasa, a city of about 10 million. It is an hour’s plane ride from Kinshasa or a four- to seven-day trip by river barge.

Salama also noted Mbandaka’s proximity to neighboring countries, including Central African Republic and Republic of Congo.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

Those exposed will for the first time in Congo receive Ebola vaccinations, the health minister said. WHO has sent 4,000 doses to Congo and said it will dispatch thousands more in the coming days as needed.

“This is a concerning development, but we now have better tools than ever before to combat Ebola,” Tedros Adhanom Ghebreyesus, WHO director-general, said of the new urban case.

The vaccine has been shown to be highly effective against Ebola. It was tested in Guinea during the outbreak that killed more than 11,300 people in West Africa from 2014 to 2016.

WHO has said it will use the “ring vaccination” method. It involves vaccinating contacts of those feared infected, contacts of those contacts, and health care and other front-line workers.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.</s>An outbreak of Ebola, once confined to remote rural areas in the Democratic Republic of the Congo, now has spread to an area just outside of city of more than one million people, health officials said Thursday.

Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, called the new development “a major, major game-changer in the outbreak.”

The announcement came from the office of the Congo’s health minister late Wednesday night after it was learned that there was a single case of Ebola reported in Mbandaka, a densely populated city just under 100 miles from the site of the last reported case.

Since the outbreak began, there has been a total of 45 cases: 14 confirmed, 21 probable and 10 suspected. Only one of the 25 deaths actually has been confirmed by the health ministry as Ebola.

The fatal disease is spread by bodily fluids and can spread rapidly in densely populated regions.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus initially is transmitted to people from wild animals, including bats and monkeys.

While there is no specific treatment for the deadly disease, which has a 90 percent fatality rate, WHO has shipped thousands of doses of an experimental vaccine to the region.

As the outbreak continues to grow, fears that it may spread abroad linger as many remember the West African Epidemic in 2014.

Eleven people were treated for Ebola in the United States in 2014, two of whom died, according to the Center for Disease Control and Prevention.

The Associated Press contributed to this report.</s>iStock/Thinkstock(NEW YORK) — The current Ebola outbreak in the Democratic Republic of Congo has spread from rural areas to a city of nearly 1.2 million people, the country’s health ministry said Wednesday.

Situated along the Congo River, Mbandaka is a densely populated transit hub at the crossroads of Equateur province, the health ministry said, raising fears that the Ebola virus will be easily passed on. Ebola spreads through direct contact with bodily fluids of infected people.

Downstream from Mbandaka is the country’s capital, Kinshasa, which is home to roughly 10 million people.

“The arrival of Ebola in an urban area is very concerning and WHO and partners are working together to rapidly scale up the search for all contacts of the confirmed case in the Mbandaka area,” said Matshidiso Moeti, the World Health Organization’s regional director for Africa.

A new suspected case of Ebola was recorded this week in Wangata, one of the three health zones of Mbandaka, the capital of the northwestern Equateur province. Laboratory tests on two samples from Wangata confirmed one specimen as positive for Ebola, while the other was negative.

It’s the first time in the region’s ongoing outbreak that a case has been detected in an urban health zone, with all other cases reported in remote, rural areas of Equateur province. And until now, all the confirmed cases of Ebola were in Bikoro health zone, some 90 miles south of Mbandaka.

“We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone,” the Democratic Republic of Congo’s Minister of Health Oly Ilunga Kalenga said in a statement in French late Wednesday. “Since the announcement of the alert in Mbandaka, our epidemiologists are working in the field with community relays to identify people who have been in contact with suspected cases.”

As of Thursday, a total of 45 cases of hemorrhagic fever had been recorded in the Democratic Republic of Congo since the outbreak was announced on May 8. That number includes 14 confirmed cases of Ebola, 21 probable cases and 10 suspected cases. Health care workers have been among those infected, according to the country’s health ministry.

There have been 25 deaths among these cases, including one person who died from a confirmed case of Ebola.

There are several types of hemorrhagic fever in the Democratic Republic of Congo, the health ministry noted; thus, not all suspected cases are necessarily Ebola.

It’s the Central African nation’s ninth Ebola outbreak since 1976 when scientists first identified the deadly virus.

The health ministry said it had received 5,400 doses of Ebola vaccine Wednesday morning. Thousands more were expected to arrive in the coming days.

The World Health Organization (WHO), which is working with the Democratic Republic of Congo’s health ministry and its partners, announced Thursday that it has deployed 30 experts to conduct surveillance in Mbandaka, following news of the confirmed case there.

Doctors Without Borders, or MSF as its often called by its French acronym, said it too is stepping up its response to stop the spread of the current Ebola outbreak in the Democratic Republic of Congo.

“With the new case confirmed in Mbandaka, the scenario has changed, and it has become more serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, MSF emergency coordinator in Mbandaka. “It is paramount to trace the suspect case in order to have a clearer view on how it reached the city.”

The International Federation of Red Cross and Red Crescent Societies, which is also assisting the country amid the current outbreak, said communities across Equateur province must be alerted of the rising risk of Ebola to stop the virus from spreading further.

“Local volunteers and health workers are the community’s alarm system,” said Ben Adinoyi, who heads the International Federation of Red Cross and Red Crescent Societies’ health unit for Africa. “They are our eyes and ears on the ground. They are critical to the early identification and containment of new cases.”

“They need to be activated across the province and even beyond,” he added. “If we don’t, then the virus may spread too far and too quickly.”

The latest Ebola case in the Democratic Republic of Congo comes amid an outbreak of violence that has spread rapidly in the country’s restive Kasai region. The violence was sparked by existing tensions between customary chiefs in Kasai-Central Province and the government in 2016, but the widening conflict has since pulled in militias, armed groups and security forces across an area the size of Germany.

The violence has forced families to flee their homes. About 3.8 million people in the Kasai region, including 2.3 million children, are in need of humanitarian assistance, according to the United Nations.</s>The World Health Organization has raised the threat level for an outbreak of Ebola in the Democratic Republic of the Congo after additional suspected cases of the disease were identified in Mbandaka, a Congo River port city with over a million residents. Mbandaka, importantly, also serves as a hub for traffic across equatorial Africa—a region where national borders can be especially “porous,” making the risk of international spread all the greater, says an emergency committee of the WHO.

The new suspected cases of the disease follow the reports of 45 others and 25 deaths across the country since April 4. Fourteen of those cases were confirmed as Ebola, according to the global health organization, which now assesses the risk of much wider spread in the region to be “very high,” the agency’s second-highest threat level.

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The WHO now says nine countries neighboring Congo are “at high risk of spread.”

In what could be a milestone of progress—and I emphasize “could be”—the threat of outbreak will be met this time with a new weapon, a vaccine that has been demonstrated in at least some human trials to have “high protective efficacy and effectiveness to prevent Ebola virus disease.” The Merck vaccine rVSV-ZEBOV, developed at the Public Health Agency of Canada’s National Microbiology Laboratory, was tested in several thousand people who were either contacts or “contacts of contacts” of individuals with confirmed Ebola virus disease after a 2015-16 outbreak in Guinea, West Africa. None of those vaccinated developed the disease after 10 days, even as 16 people in the unvaccinated comparator group did, according to a report in . It remains unclear how long that apparent protective effect will last, though evidence suggests than antibodies to the disease in vaccinated individuals can last two years or more.

At least a few researchers have suggested that there should be a question mark on this recent study, despite the large number of people tested. But public health officials are moving forward with what they call a “ring vaccination.” The WHO tweeted out on Wednesday that “A first batch of 4000 #Ebola vaccine doses” had just arrived in Kinshasa, the Congo’s capital city.

We will see soon enough if we’ve reached a turning point in one of the greatest public health challenges around.</s>Ebola in the Democratic Republic of Congo (DRC) is on the rise and confirms 14 new cases.

‘Ebola outbreak in the Democratic Republic of Congo (DRC) has entered a "new phase" where the virus spreads from rural areas into a larger city and confirms 14 new cases affected with Ebola virus disease.’

A government statement late on Thursday said the 11 new confirmed cases and one new related death were reported in the town of Bikoro in Equateur, where the Ebola outbreak was officially announced on May 8 by authorities.It said the new death has epidemiologic ties to another case. Another lethal case in Wangata on Thursday was a suspected one, Xinhua news agency reported.The government statement said the total number of Ebola cases is now 45, including 10 suspected cases, 21 probable cases and 14 confirmed cases.The Ebola outbreak in the DRC has entered a "new phase" after it spread to a large city, Health Minister Oly Ilunga said on Wednesday.The new case of Ebola virus disease has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people in Equateur Province in northwestern Congo, the World Health Organization confirmed Thursday, CNN reported.The spread of the virus from rural areas into a city has raised fears it could quickly spread and become harder to control. A newly confirmed case in a densely populated part of the country will complicate attempts to control the outbreak, the statement said.Ilunga said of the current 25 deaths, only one has been confirmed as Ebola, adding that no new health professionals have been contaminated.The first 4,000 doses of experimental vaccine from the World Health Organisation (WHO) to combat the Ebola outbreak arrived on Wednesday in the national capital Kinshasa.The Ebola vaccine called rVSV-ZEBOV -- has been shown to be safe in humans and highly effective against the virus, according to the WHO. The vaccination campaign would first target health workers.The DRC is at its ninth Ebola outbreak since 1976. Ebola is a highly infectious disease spread through contact with even small amounts of bodily fluid of an infected person. Its early flu-like symptoms are not always easily detected.Source: IANS</s>KINSHASA (Reuters) - Three new cases of Ebola were confirmed in northwest Congo’s regional capital of Mbandaka on Friday, in a part of the city lying next to the Congo River, the health ministry said.

The ministry statement late on Friday said the suspected cases had been reported in the neighborhood of Wangata, next to the river, on Thursday. Samples had been taken for testing. A further suspected case also arrived on Friday in the city of one million, it said.
Two more cases of ebola reported in the city of Mbandaka in the Democratic Republic of the Congo. 25 people have died this year in the country from the disease, with a wider outbreak feared.