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Ebola Virus Disease Outbreak in the Democratic Republic of Congo and Guinea
Health advisory
March 12, 2021
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- Be aware that two outbreaks of Ebola Virus Disease (EVD) are ongoing, one in the Democratic Republic of the Congo (DRC) and one in Guinea.
- Healthcare facilities should review EVD infection prevention and control guidance and facility protocols to safely identify and manage patients with possible EVD
- Document a thorough travel history for all patients to identify EVD and other diseases that need specific infection control precautions and/or treatment
- Evaluate patients who have consistent signs and symptoms AND risk factors for EVD
- Identify patients with risk factors and with fever and other signs and symptoms of infection that might warrant isolation pending/during medical evaluation
- Healthcare facilities should have contact information for infection control personnel and the local public health jurisdiction readily available to staff for rapid reporting of potential/suspected EVD and other notifiable communicable diseases
- Be familiar with early signs and symptoms of EVD, which typically start 2 to 21 days following contact with an EVD case (average of 8-10 days). These include:
- Fatigue, fever, severe headache, muscle pain
- Progression to diarrhea, vomiting, abdominal pain, and unexplained bruising and bleeding
- Be familiar with risk factors for EVD exposure, including the following within 3 weeks of sign and symptom onset:
- Residence in or travel to an area with ongoing EVD transmission
- Attendance of a funeral in an area with active EVD transmission
- Close contact with a sick person who was recently in an area with active EVD transmission
- Contact with blood, tissue, or bodily fluids of a patient known or suspected of EVD infection
- Contact with semen of a person who has recovered from EVD
- Direct contact with fruit bats or non-human primates from areas with active EVD transmission
- Consider EVD in patients with compatible signs and symptoms AND possible EVD exposure within 21 days prior to sign or symptom onset
- Counsel patients planning travel to DRC or Guinea about EVD and health protection measures
- Isolate all suspected EVD cases and report suspected cases to Public Health – Seattle & King County IMMEDIATELY at (206) 296-4774. It is not necessary to complete the medical evaluation before notifying Public Health.
On February 7, 2021 the Ministry of Health (MOH) in the DRC announced that a case of EVD had been confirmed in North Kivu Province. North Kivu was previously affected by EVD during the 2018- 2020 Ebola outbreak, which was declared over on June 25, 2020. Sequencing suggests that this case is linked to cases in the area during the 2018–2020 outbreak and may be caused by a persistent infection in a survivor, either through relapse or sexual transmission.
On February 14, 2021 an outbreak was declared in the Nzérékoré Prefecture, Guinea by the Guinea MOH. As with DRC, case and death counts are unreliable at this time and rapidly evolving. Nzérékoré Prefecture, which shares a border with Liberia, was affected by the 2014-2016 West Africa outbreak. Sequencing of samples from these cases are pending to determine if the current outbreak is linked to cases from the previous outbreak.
As of March 9, 2021, WHO has not deemed this outbreak a public health event of international concern and advised against travel or trade restrictions, although this situation has the potential to rapidly evolve. As of March 2021, all flights into the US from DRC and Guinea are routed through one of 6 designated airports. Airlines collect and send passenger information to CDC for public health follow-up and intervention for all passengers boarding a flight to the U.S. who were in DRC or Guinea within the previous 21 days. Self-monitoring for symptoms of EVD is being advised for persons returning to the United States from Ebola outbreak areas but with no high-risk exposure. To date, PHSKC has provided self-monitoring guidance to one King County resident with recent travel from an Ebola-affected country.