A second outbreak of an ebolavirus in the DRC

The Ministry of Health, the Democratic Republic of the Congo has confirmed 4 new cases of an ebolavirus infection in a new loaction of the country. Earlier there had been reports of 26 cases of fever, diarrhoea, vomiting, nasal bleeding and death since May. There have been at least 20 deaths attributed to the outbreak thus far.

Lab results now confirm this as the second geographically discrete outbreak in 2018 for the DRC.

Map of the Democratic Republic of the Congo from the World Food Program via ReliefWeb. North Kivu Provincde is klocated in eth northeeastern region of the DRC, on the eastern  border

Which member of the genus Ebolavirus?

No details are available on the specific species of ebolavirus so it remains unclear if the Ebola virus (the one specifically deiosgend to pretect ffomr disease due to members of the species Zaire ebolavirus) vaccine can be used. If it can, hopefully, it will be deployed more quickly than in the last outbreak.

The Government of the Democratic Republic of the Congo #DRC 🇨🇩 announced today that preliminary lab results indicate a cluster of #Ebola cases in North Kivu province, some 2500 km from Equateur province.

— World Health Organization (WHO) (@WHO) August 1, 2018


 

Where in the DRC?

 

Map of the DRC from Congo Initiative.

The suggestion so far is that the outbreak has occurred in the Province of North Kivu in a place called Mangina in the eastern Mabalako health zone, about 30 kilometers (18 miles) west of Beni, a city of more than 230,000 people and that it is a distinct outbreak from the one that occurred about 1,800km (from the city of Mbandaka to that of Butembo according to Google Maps) to the east earlier this year. That will become more clear once some detail becomes available. These would include contact tracing of the earliest cases to see if there is any history of travel from the Equateur province, and also genetic details from sequencing the newly identified ebolavirus strains to look for differences and similarities to those viruses characterised from the western outbreak.

 

Pinpointing Mangina in the DRC. Map snipped from GeoHack.

This region of the DRC is suffering from conflict (including thousands of cases of sexual violence), food insecurity and the displacement of many people. The Province borders and actively trades with Uganda and Rwanda, with waterways in abundance as this is part of the African Great Lakes region. Mangina seems to be removed from the waterways but we armchair observers await better maps to get an idea of the layout.

It is interesting to see in the map to the left, that the town of Bundibugyo in the self-name district of Uganda, is not too far off. An ebolavirus species, Bundibugyo ebolavirus (BEBOV), was named after a virus isolated from outbreak cases in this region in 2007.

This region will bring a raft of new challenges to the containment of ebolavirus outbreak.

Despite high levels of vigilance for Ebola virus cases on the other side of the country, this outbreak may have been percolating for 2 to 3 months. The harsh reality of how difficut it is to keep on top of emerging virus outbreaks when they occur in relatively remote, under-resourced regions suffering conflict is exemplified by this one.

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