Health officials in the Democratic Republic of the Congo are racing to investigate a potential Ebola outbreak after a 3-year-old boy died of the disease on October 6. Researchers confirmed the toddler’s infection with the deadly viral disease on October 8, according to a report by the World Health Organization.
The boy’s death closely follows the suspicious deaths of three of his neighbors, a father and his two daughters. One of the daughters died on September 14, followed by the father’s death on September 19 and the other daughter’s death on September 29. The family displayed symptoms consistent with Ebola but were not tested for the virus. The two daughters, however, had tested positive for malaria.
The family’s deaths, along with the toddler’s, occurred in the Butsili Health Area, which is close to Beni city, one of the epicenters of the 2018–2020 Ebola outbreak in DRC’s North Kivu Province. That outbreak led to 3,470 cases and 2,287 deaths. Additionally, North Kivu experienced a smaller Ebola outbreak earlier this year, between February and May, that involved 12 cases and six deaths.
It’s too soon to tell if the new cases are linked to any of the past outbreaks or if they are the result of a new zoonotic spillover event. The Ebola virus is known to present in animal populations in this region of the DRC. But it’s also possible that the virus could re-emerge from a dormant infection in a person.
Last month, a large group of international researchers published results showing that Ebola can emerge after years of being dormant in an infected person—and then spark a new outbreak. That re-emergence appeared to be the cause for a small outbreak in Guinea that began in January of this year; it was declared over in June. Genetic analysis of the Ebola virus variants in that small outbreak showed they were most closely linked to variants seen in the massive West African outbreak between 2013 and 2016. That outbreak was the largest in recorded history, causing more than 28,000 cases and 11,000 deaths, mostly in Guinea, Liberia, and Sierra Leone.
Health officials responding to the new cluster of deaths in the Butsili Health Area are keen to determine if the cases are linked to past outbreaks. “Determining if the outbreaks are linked is important,” Dr. Fiona Braka, manager of emergency response at the World Health Organization’s Africa office, told The Telegraph Monday. Braka noted that samples have been sent to the National Institute of Biomedical Research in Kinshasa for sequencing. “We expect that by the end of the work week, we should have the results,” she said.
Meanwhile, health officials are working to try to limit the spread of the disease. In an initial risk assessment, the WHO noted that the four patients were separately admitted to several health facilities in which “infection prevention and control measures might not have been optimal.” Additionally, the victims were buried without following safe and dignified burials protocols to prevent the spread of the virus through infected bodily fluids.
As of October 9, the WHO reported that a total of 148 contacts have been identified and are under follow-up observation by the response team.
Though the DRC has built up a large capacity to detect and respond to Ebola outbreaks, the WHO expressed concern that the country faces considerable challenges to mounting effective responses. The issues include poverty, community mistrust, weak health systems, and political instability, all of which are accelerating the rate of the emergence of Ebola in the DRC. The WHO also noted that the country is dealing with outbreaks of COVID-19, cholera, meningitis, and measles, which could “jeopardize the country’s ability to rapidly detect and respond to the re-emergence of [Ebola] cases.”