HPR volume 12 issue 17: news (18 May)
Updated 21 December 2018
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PHE advises on risk and precautions related to EVD in the DRC
In early May 2018, the Democratic Republic of Congo (DRC) reported its ninth Ebola virus disease (EVD) outbreak. All cases to date have been reported in Equateur Province in the north west of the country.
As of 16 May, the DRC Ministry of Health has reported a total of 45 cases, of which 14 are confirmed, 21 are probable and 10 are suspected [1]. To date, 25 of these cases have died (56% case fatality rate). The cases are reported across 3 health zones in the province – Bikoro (36 cases), Iboko (5 cases) and Wangata (4 cases). The confirmed case in Wangata has an epidemiological link with Bikoro (attended a funeral).
Table 1. Case table for EVD outbreak in Equateur Province as of 16 May 2018. Data provided by DRC MoH
| Confirmed | Probable | Suspected | |
|---|---|---|---|
| Bikoro | 13 | 19 | 4 |
| Iboko | 0 | 2 | 3 |
| Wangata (part of Mbandaka city) | 1 | 0 | 3 |
| TOTAL | 14 | 21 | 10 |
While Bikoro and Iboko are relatively rural areas, the Wangata health zone sits in Mbandaka, the provincial capital with a population of 1.2 million. The city is also located on the Congo River, a major river used for transporting both goods and people both within DRC and to neighbouring countries.
The DRC Ministry of Health have agreed to the use of the experimental vaccine rVSV-ZEBOV as one component of their comprehensive response. 5,400 doses of the vaccine have arrived in country and will be administered to healthcare workers (both national and international), contacts of cases and contacts of those contacts starting next week.
The latest WHO risk assessment (dated 17 May 2018) states that the confirmed case in Wangata increases the risk of spread within the DRC and to neighbouring countries [2]. WHO has therefore assessed the public health risk as very high at the DRC national level and high at the regional level. At the global level the risk is currently low. WHO does not recommend any travel or trade restrictions be applied to the DRC based on the current available information.
In response to the confirmation of a case in Wangata, WHO convened an International Health Regulations Emergency Committee to assess the situation and determine if the outbreak should be declared a public health emergency of international concern [2].
The risk to the UK public is currently very low to negligible. The situation is being monitored closely and the risk assessment reviewed as new information becomes available.
Table 2. Previous EVD outbreaks in the DRC (1976-2017)
| Year | Province | Cases | Deaths | Virus species |
|---|---|---|---|---|
| 2017 | Bas Uele | 8 | 4 | Zaire |
| 2014 | Equateur | 66 | 49 | Zaire/ |
| 2012 | Haut-Uele [Orientale~] | 36 | 13 | Bundibugyo |
| 2008/09 | Kasai [Kasaï-Occidental~] | 32 | 15 | Zaire |
| 2007 | Kasai [Kasaï-Occidental~] | 264 | 187 | Zaire |
| 1995 | Kwilu | 315 | 250 | Zaire |
| 1977 | Mongola | 1 | n/a | Zaire |
| 1976 | Mongola | 318 | 280 | Zaire |
~ Previous name for Province or area of outbreak.
Travel advice
The risk of being infected with EVD during a visit to DRC is negligible to very low, but the risk will depend on the areas of the country visited and the activities undertaken while there. Ideally travellers should avoid outbreak areas. There is no UK-licensed vaccine for use in travellers to prevent infection.
Individuals travelling to outbreak areas for humanitarian activities should seek additional advice from their sending organisation on infection control and health and safety guidance.
Further information sources
- PHE website Ebola collection: Ebola virus disease: clinical management and guidance
- NaTHNaC: Travel Health Pro website
- WHO website EVD home page: Ebola virus disease
References
- DRC Ministry of Health.
- WHO (17 May). EVD – DRC.
Healthcare associated infection annual report for Scotland published
Health Protection Scotland has published its ninth HAI annual report on the surveillance of healthcare associated infections in Scotland covering the period January to December 2017 [1].
The report includes data on a similar set of categories of HCAIs that are covered by mandatory reporting requirements in England (for example Gram-negative bacteraemia and CPEs) and is accompanied by a series of infographic presentations, each covering a different category of HCAI.
Scotland’s strategy on antimicrobial resistance and its Controlling Antimicrobial Resistance in Scotland (CARS) programme, mirrors PHE’s ESPAUR strategy for England, whose next annual report is due to be published in October.
The HPS report includes a focus on controlling the risk of HCAI-related sepsis in healthcare, in line with the WHO’s current campaign on that theme.
Reference
- Health Protection Scotland (May 2018). Healthcare associated infection annual report 2017.
Infection reports in this issue of HPR
This issue includes reports on:
- Common animal associated infections (England and Wales): Q1/2018
- Salmonella and shigella infections (faecal specimens) England and Wales, reports to PHE: March/April 2018
- Common GI infections, England and Wales: laboratory reports: weeks 14 to17, 2018
- Less common GI infections, England and Wales: laboratory reports: Q1, 2018
- Reported norovirus outbreaks (suspected and lab-confirmed) in hospitals: weeks 14 to17, 2018