Democratic Republic of Congo Ebola Outbreak (2018)
In 2018, the Democratic Republic of Congo (DRC) faced two significant Ebola virus outbreaks, the first occurring in Équateur province from May to July, resulting in 33 deaths among 54 reported cases. The more severe second outbreak began in August in the Kivu region, exacerbated by ongoing military conflicts, and by early 2019 had claimed over 500 lives, marking it as the second-worst Ebola outbreak in history. The World Health Organization (WHO) officially declared the first outbreak on May 8, 2018, and contained it by July 24. However, shortly after, a second outbreak was declared in North Kivu, complicating response efforts due to the region's violent environment and public distrust, further hampered by attacks on medical personnel. This outbreak also unfolded against a tense political backdrop, with a presidential election leading to Felix Tshisekedi assuming power in January 2019. Despite the administration of an experimental vaccine to over 61,000 people, the situation remained precarious, with cases reported near major urban areas, raising concerns about potential wider transmission. The DRC, which witnessed the first discovery of the Ebola virus in 1976, continues to grapple with the dual challenges of public health crises and endemic violence.
Democratic Republic of Congo Ebola Outbreak (2018)
Date: May 8, 2018–
Place: Democratic Republic of Congo
Summary
In 2018 the Democratic Republic of Congo (DRC) experienced two outbreaks of Ebola virus disease, one smaller and the other quite large and severe, extending into 2019. The first outbreak occurred in Équateur province, in the northwest of the country, lasting from May to July and killing thirty-three people. The second outbreak began in August in the northeastern Kivu region; by February 2019, exacerbated by the region’s military conflict, this outbreak had killed more than 500 people, making it the second-worst Ebola outbreak in history.
Key Events
- May 8, 2018—World Health Organization (WHO) officially declares an outbreak of the Ebola virus in the DRC’s Équateur province, with two confirmed cases; it is the ninth outbreak in the country’s history.
- July 24, 2018—WHO declares the outbreak over; a total of fifty-four cases were reported, of whom thirty three died.
- August 1, 2018—The WHO declares a new potential outbreak—the country’s tenth—in North Kivu province after four blood samples test positive for the virus.
- November 29, 2018—At more than 400 cases and more than 240 deaths, the outbreak becomes the second largest on record.
Status
In early February 2019, the DRC health ministry reported that Ebola deaths in the Kivu region had surpassed five hundred; the only death toll higher was the enormous West African Ebola outbreak of 2013–16, in which more than ten thousand people died. The public health response to the 2018–19 Ebola outbreak was complicated by the fact that it was the first to have occurred within an active conflict zone. It also took place amid a contentious presidential election campaign that brought Felix Tshisekedi to power in January 2019.
In January, cases of Ebola were discovered in Kayina, a town in North Kivu province located between Butembo, where numerous cases have been found, and Goma, one of the country’s largest cities, with a population of around 1 million. Peter Salama, head of the Health Emergencies Program for the WHO, told reporters that the potential for Ebola reaching Goma could become a global issue because individuals travel through Goma to many different locations internationally. More than 61,000 people were treated with an experimental but effective vaccine during the outbreak, but this effort too was compromised by the political instability and violence in the Kivu region of the DRC.
In-Depth Overview
According to the Council for Foreign Relations, there were as many as one hundred armed groups operating in the eastern region of the DRC in the 2010s, leaving the population under nearly constant threat of violence. The United Nations estimated there were some 4.5 million internally displaced persons in the DRC, and more than 800,000 refugees who have fled the country. Against a backdrop of political violence that has afflicted the country in one form or another since its independence from Belgium in 1960, the DRC is also where the devastating Ebola virus was first discovered in 1976. Since then, more than a dozen outbreaks of Ebola virus disease (formerly Ebola hemorrhagic fever, commonly just called Ebola) have occurred in Africa—with most affecting the DRC.
The Ebola virus spreads through direct human contact and the transfer of bodily fluids. Infected individuals begin to display symptoms between two and twenty-one days after exposure. Symptoms are similar to many strains of the influenza virus, but typically more severe, including vomiting and diarrhea and sometimes internal and external bleeding. The virus is fatal about half the time, and there is as yet no proven treatment, although experimental vaccines have been in development since 2015.
In April of 2018, several cases of hemorrhagic fever were reported in the northwestern Équateur province of the DRC, and on May 8, the WHO officially announced a new Ebola outbreak. By May 18, at least one case of Ebola had been confirmed in the provincial capital of Mbandaka, increasing fears that the disease would spread more widely. However, quick response by the WHO and national public health officials contained the virus, and the outbreak was declared over on July 24, with a death toll of thirty-three.
Barely a week after the end of the outbreak in Équateur, DRC health officials announced another outbreak, across the country in North Kivu province, after four cases tested positive. Efforts to address the outbreak were complicated by the fact that the provinces of North and South Kivu, which border Rwanda and Uganda, are among the most violent in the country. Response efforts were hampered both by outbreaks of violence and a high level of general distrust in the population. On November 18, for example, an armed group attacked UN peacekeepers and WHO workers in the city of Beni in North Kivu, the epicenter of the outbreak. By the end of November there were 426 Ebola cases and at least 242 deaths, making it the second-deadliest outbreak of Ebola in history. Violence from armed rebel groups continued to hamper efforts of medical professionals to reach some of the hardest hit areas of the region.
Key Figures
Tedros Adhanom Ghebreyesus: World Health Organization director-general.
Peter Salama: Executive director, World Health Organization health emergencies program.
Oly Ilunga Kalenga: Democratic Republic of the Congo minister of health.
Felix Tshisekedi: President of the Democratic Republic of Congo.
Bibliography
Belluz, J. (2018, October 15). Ebola showed up in a war zone. It’s not going well. Vox. Retrieved from https://www.vox.com/science-and-health/2018/10/11/17959850/ebola-outbreak-congo-2018
Garrett, L. (2019, January 15). Ebola has gotten so bad, it’s normal. Foreign Policy. Retrieved from https://foreignpolicy.com/2019/01/15/ebola-has-gotten-so-bad-its-normal/
Hauser, J., & Cullinane, S. (2018, November 18). Congo health workers face violence as Ebola virus spreads. CNN. Retrieved from https://www.cnn.com/2018/11/18/health/dr-congo-ebola-cases-deaths-rise/index.html
Ratcliffe, R. (2019, January 18). Ebola cases in Congo expected to double amid fears outbreak could cross borders. The Guardian. Retrieved from https://www.theguardian.com/global-development/2019/jan/18/ebola-cases-congo-expected-to-double-fears-outbreak-could-cross-borders-world-health-organization-drc
Violence in the Democratic Republic of Congo. (2019, February 14). Council on Foreign Relations. Retrieved from https://www.cfr.org/interactives/global-conflict-tracker#!/conflict/violence-in-the-democratic-republic-of-congo