Ebola outbreak declared in Democratic Republic of Congo; towns locked down in Kasai province

Health authorities in the Democratic Republic of Congo (DRC) have declared an Ebola outbreak after recording 58 suspected cases and 20 deaths, local officials and international agencies said, prompting lockdowns in multiple towns in Kasai province.

The outbreak was reported in the towns of Bulape and Mweka in Kasai. Local authorities have placed residents under confinement, erected checkpoints along territorial borders to block travel, and restricted movement in an effort to prevent further transmission. The U.S. Centers for Disease Control and Prevention posted a Level 1 travel alert advising Americans to take precautions if traveling to the DRC, while adding that there are no reported cases outside the country and that the risk of infection in the United States is low.

The World Health Organization reported that the first confirmed case identified in this outbreak was a pregnant woman who sought care at Bulape General Reference Hospital on Aug. 20 with high fever, bloody stool, excessive bleeding and weakness. She died five days later from organ failure, and testing on Sept. 4 confirmed Ebola.

Authorities said four of the 20 deaths were among healthcare workers. Francois Mingambengele, administrator of the Mweka territory that includes Bulape, told Reuters that many residents had gone into hiding in nearby bush areas and that officials feared movement out of Bulape could spread the disease to other communities. "The problem is that we're afraid that the movement of people from Bulape could lead to contamination in other communities," he said.

Ebola is transmitted through direct contact with the blood or body fluids of a person who is sick with or has died from Ebola, contact with contaminated objects, or contact with infected animals such as bats and nonhuman primates. Symptoms can include fever, headache, muscle pain and weakness, diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising. The disease can progress to organ failure and has had mortality rates as high as 90 percent in outbreaks without adequate medical care.

There are two Food and Drug Administration-approved treatments for Ebola—Inmazeb and Ebanga—and an FDA-approved vaccine that is currently used for people responding to outbreaks and not available to the general public. International and local health teams typically deploy contact tracing, isolation of suspected cases, safe burials and vaccination or ring vaccination strategies among contacts and frontline workers to limit spread.

Earlier this year an outbreak in neighboring Uganda was attributed to the Sudan virus, a species of ebolavirus that causes a severe hemorrhagic fever and marked bleeding from body orifices in some cases. That outbreak involved 12 confirmed cases, two probable cases and four deaths and was declared over in April. The DRC has faced multiple Ebola outbreaks in recent years; this is the country’s first Ebola outbreak in three years and the first in Kasai province since 2008.

Public health authorities noted that while local conditions are critical to contain spread, the international risk remains low. In the United States earlier this year, two patients in New York who had recently traveled from Uganda and exhibited symptoms were suspected of having Ebola but subsequently tested negative. The first confirmed Ebola patient in the U.S. was diagnosed in 2014 after traveling from Liberia and later died.

Health officials in the DRC and international partners said investigations and response operations were ongoing, including case confirmation, contact tracing and measures to secure health facilities, protect health workers and provide care to those affected. They urged residents to report symptoms promptly, avoid contact with sick individuals and follow instructions from public health teams as response efforts continue.