Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020

Keïta, Mory; Lucaccioni, Héloïse; Ilumbulumbu, Michel Kalongo; Polonsky, Jonathan; Nsio-Mbeta, Justus; Panda, Gaston Tshapenda; Adikey, Pierre Celeste; Ngwama, John Kombe; Tosalisana, Michel Kasereka; Diallo, Boubacar; Subissi, Lorenzo; Dakissaga, Adama; Finci, Iris; Almeida, Maria Moitinho de; Guha-Sapir, Debarati; Talisuna, Ambrose; Délamou, Alexandre; Dagron, Stéphanie; Keiser, Olivia; Ahuka‐Mundeke, Steve

doi:10.3201/eid2712.210290

Cited by 18 publications

(16 citation statements)

References 18 publications

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“…A probable case was considered to be any suspected case evaluated by a clinician or a patient who met the suspected case definition, with a notion of contact with a confirmed or probable case, who had died without having laboratory confirmation by PCR. A confirmed case of EVD was defined as any suspected case with a confirmed laboratory PCR result [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Investigation of and Strategies to Control the Final Cluster of the 2018–2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo

Keïta

Polonsky

Finci

et al. 2022

Open Forum Infectious Diseases

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Background On April 10, 2020, while the independent committee of the International Health Regulation was meeting to decide whether the 10th Ebola outbreak in the Demogratic Republic of Congo still constituted a Public Health Emergency of International Concern, a new confirmed case was reported in the city of Beni, the last epicenter of the epidemic. This study aimed to understand the source of this cluster and learn from the implemented control strategies for improved response in the future. Methods We conducted a combined epidemiological and genomic investigation to understand the origins and dynamics of transmission within this cluster and describe the strategy that successfully controlled the outbreak. Results Eight cases were identified as belonging to this final cluster. A total of 1028 contacts were identified. Whole-genome sequencing revealed that all cases belonged to the same cluster, the closest sequence to which was identified as a case from the Beni area with symptom onset in July 2019 and a difference of just 31 nucleotides. Outbreak control measures included community confinement of high-risk contacts. Conclusions This study illustrates the high risk of additional flare-ups in the period leading to the end-of-outbreak declaration and the importance of maintaining enhanced surveillance and confinement activities to rapidly control Ebola outbreaks.

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Section: Methodsmentioning

confidence: 99%

Investigation of and Strategies to Control the Final Cluster of the 2018–2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo

Keïta

Polonsky

Finci

et al. 2022

Open Forum Infectious Diseases

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“…Traditional burial practices, violent attacks on HCWs, and general community mistrust towards “Western” treatments were cited as major contributors to the propagation of the infection [ 8 ]. The outbreak ended on 25 June 2020 [ 52 ]. At the same time, a small outbreak in Bikoro, DRC was reported on 8 May 2018, which ended on 24 July 2018 [ 1 ].…”

Section: Epidemiologymentioning

confidence: 99%

Epidemiology of Ebolaviruses from an Etiological Perspective

et al. 2023

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Since the inception of the ebolavirus in 1976, 32 outbreaks have resulted in nearly 15,350 deaths in more than ten countries of the African continent. In the last decade, the largest (2013–2016) and second largest (2018–2020) ebolavirus outbreaks have occurred in West Africa (mainly Guinea, Liberia, and Sierra Leone) and the Democratic Republic of the Congo, respectively. The 2013–2016 outbreak indicated an alarming geographical spread of the virus and was the first to qualify as an epidemic. Hence, it is imperative to halt ebolavirus progression and develop effective countermeasures. Despite several research efforts, ebolaviruses’ natural hosts and secondary reservoirs still elude the scientific world. The primary source responsible for infecting the index case is also unknown for most outbreaks. In this review, we summarize the history of ebolavirus outbreaks with a focus on etiology, natural hosts, zoonotic reservoirs, and transmission mechanisms. We also discuss the reasons why the African continent is the most affected region and identify steps to contain this virus.

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“…In Guinea, the WHO supported the strengthening of the alert system. 34 A green number (a toll-free telephone line) was set up over the outbreak period that community members could call to alert the health system of any health event in the community, including but not limited to EVD-related concerns.…”

Section: The Outbreak Period (14 February 2021 To 19 June 2021)mentioning

confidence: 99%

“…33 In Guinea, the WHO supported the strengthening of the alert system. 34 A green number (a toll-free telephone line) was set up over the outbreak period that community…”

Section: Emergency Operation Centresmentioning

confidence: 99%

Investing in preparedness for rapid detection and control of epidemics: analysis of health system reforms and their effect on 2021 Ebola virus disease epidemic response in Guinea

et al. 2023

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The 2014–2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea’s health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO’s recommendations for ensuring better preparedness for (and, therefore, a response to) health emergencies. The investments included the scaling up of Integrated Disease Surveillance and Response; Joint External Evaluation of International Health Regulation capacities; National Action Plan for Health Security; Simulation Exercises; One Health platforms; creation of decentralised structures such as regional and prefectural Emergency Operation Centres; Risk assessment and hazard identification; Expanding human resources capacity; Early Warning Alert System and community preparedness. These investments were tested in the subsequent 2021 EVD outbreak and other epidemics. In this case, there was a timely declaration and response to the 2021 EVD epidemic, a lower-case burden and mortality rate, a shorter duration of the epidemic and a significant reduction in the cost of the response. Similarly, there was timely detection, response and containment of other epidemics including Lassa fever and Marburg virus disease. Findings suggest the utility of the preparedness activities for the early detection and efficient containment of outbreaks, which, therefore, underlines the need for all countries at risk of infectious disease epidemics to invest in similar reforms. Doing so promises to be not only cost-effective but also lifesaving.

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Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020

Cited by 18 publications

References 18 publications

Investigation of and Strategies to Control the Final Cluster of the 2018–2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo

Investigation of and Strategies to Control the Final Cluster of the 2018–2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo

Epidemiology of Ebolaviruses from an Etiological Perspective

Investing in preparedness for rapid detection and control of epidemics: analysis of health system reforms and their effect on 2021 Ebola virus disease epidemic response in Guinea

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