The Democratic Republic of the Congo (DRC) is approaching the conclusion of its 16th Ebola Virus Disease (EVD) outbreak, with health authorities anticipating an official declaration that the epidemic has ended in early December if no new cases emerge.
The outbreak, which was declared in the rural Bulape Health Zone of Kasai Province on September 4, 2025, has reported 64 total cases comprising 53 confirmed and 11 probable infections, along with 43 deaths. No new cases have been documented since late September, marking a significant milestone in containment efforts.
The last confirmed patient was reportedly discharged from the Ebola Treatment Centre on October 19, initiating a mandatory 42 day countdown representing two full incubation cycles required before authorities can declare the area free of the virus. This observation period allows health officials to ensure no additional transmission has occurred within the community.
Five cases occurred among health workers, including four nurses and one laboratory technician, with three of these frontline responders tragically dying from the disease. The infections among healthcare personnel underscored gaps in infection prevention and control measures at the outbreak’s onset.
The outbreak has remained geographically confined to six health areas within Bulape Health Zone, specifically Bambalaie, Bulape, Bulape Communautaire, Dikolo, Ingongo and Mpianga. This geographic containment represents a major success for response teams working in challenging terrain.
A swift and coordinated response by the DRC Ministry of Health, the World Health Organization (WHO), the United States Centers for Disease Control and Prevention (CDC) and other international partners proved key to containing the spread. More than 42,000 individuals received vaccinations, with priority given to frontline health workers, contacts of confirmed cases and their secondary contacts.
The index case was a 34 year old pregnant woman who was admitted to a local hospital on August 20 with symptoms including high fever, bloody diarrhea, hemorrhaging, vomiting and severe physical weakness. She died on August 25 from multiple organ failure. Two healthcare workers who cared for her later developed similar symptoms and died, triggering the investigation that confirmed the outbreak.
Genomic sequencing performed by the National Institute of Biomedical Research suggests this represented a new introduction of the disease into the human population from an unknown infected animal rather than a resurgence from previous outbreaks.
The response benefited from the DRC’s substantial experience managing Ebola outbreaks. This marks the country’s 16th EVD outbreak since the virus was first identified in 1976. The most recent previous outbreak occurred in Equateur Province in 2022 and was brought under control within three months.
The country had a stockpile of treatments and 2,000 doses of the Ervebo Ebola vaccine already prepositioned in Kinshasa, which were quickly moved to Kasai to vaccinate contacts and frontline health workers. This rapid deployment of medical countermeasures contributed significantly to limiting transmission.
Despite the progress, significant health challenges persist in the region. Limited access to affected rural areas due to poor road conditions complicated response efforts throughout the outbreak. Inadequate water and sanitation infrastructure increased risks of disease transmission in communities.
The outbreak occurred in a complex epidemiological and humanitarian context, as the country faces several concurrent outbreaks including mpox, cholera and measles. These competing health emergencies strained the country’s resources and capacity to respond effectively.
The epicenter in Bulape sits approximately 100 to 200 kilometers from both Tshikapa, the capital of Kasai Province, and the Angolan border. This proximity to population centers and international boundaries heightened concerns about potential regional spread and necessitated enhanced surveillance measures.
The International Federation of Red Cross and Red Crescent Societies classified the event as a Red Emergency and launched an $18 million emergency appeal on September 16 to scale up response operations. The outbreak’s epicenter encompasses an area of approximately 3.5 million people where health facilities remain sparse and road networks severely degraded.
Response measures included establishing checkpoints to restrict movement in and out of Bulape Health Zone, suspending classes and graduation ceremonies in Mweka Territory, and closing weekly markets to reduce opportunities for transmission. The first Ebola Treatment Centre was set up in the compound of Bulape General Reference Hospital with support from WHO and Doctors Without Borders.
Contact tracing teams monitored thousands of individuals who may have been exposed to confirmed cases. A total of 1,985 contacts remained under follow up as of early October, with 98.6 percent successfully located and monitored on a given day. This high rate of contact follow up proved essential for rapidly identifying and isolating new cases.
The case fatality ratio of approximately 67 percent exceeds the average 50 percent mortality rate typically associated with Ebola outbreaks. The elevated death rate likely reflects delays in case recognition and limited early diagnostic capacity in the rural setting where the outbreak emerged.
Health authorities administered the mAb114 monoclonal antibody treatment to patients at the Ebola Treatment Centre. The first patients received this therapeutic intervention on September 9, shortly after the treatment facility became operational. Early treatment with approved therapeutics significantly improves survival rates for Ebola patients.
The outbreak reinforced several technical imperatives for epidemic preparedness in the DRC and similar contexts. These include timely case investigation and early diagnostic capacity to narrow delays between symptom onset and isolation, sustained infection prevention capacity building at primary care level especially for obstetric units, and robust cross border surveillance protocols to prevent regional transmission.
Ebola virus disease spreads through close contact with blood, secretions, organs or other bodily fluids of infected animals or people. Fruit bats are thought to be the natural hosts. The disease causes fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising. The incubation period ranges from 2 to 21 days.
The anticipated December declaration would mark another successful conclusion to an Ebola outbreak in the DRC, demonstrating the effectiveness of established response protocols and international cooperation. However, the recurrent nature of outbreaks in the country underscores ongoing risks from zoonotic spillover events in regions where humans and wildlife reservoir species interact.
The 42 day observation period represents a critical final phase requiring continued vigilance from health authorities and community members. Any single new case during this countdown would reset the clock and delay the official end of outbreak declaration.
Looking forward, strengthening primary healthcare infrastructure, improving diagnostic capacity in rural areas and maintaining trained rapid response teams will prove essential for detecting and containing future outbreaks before they can spread widely. The lessons learned from this outbreak will inform preparedness efforts across the region.
Source: newsghana.com.gh
