2018 Équateur province Ebola outbreak
The 2018 Équateur province Ebola outbreak occurred in the north-west of the Democratic Republic of the Congo (DRC) from May to July 2018. It was contained entirely within Équateur province, and was the first time that vaccination with the rVSV-ZEBOV Ebola vaccine had been attempted in the early stages of an Ebola outbreak,[6] with a total of 3,481 people vaccinated.[7][8][9] It was the ninth recorded Ebola outbreak in the DRC.[7]
This article is about the Ebola virus outbreak in Équateur province of the Democratic Republic of the Congo in 2018. For the second Ebola outbreak in DRC in the same year, see Kivu Ebola epidemic.
The outbreak began on 8 May 2018, when it was reported that 17 people were suspected of having died from EVD near the town of Bikoro in the Province of Équateur.[10] The World Health Organization declared the outbreak after two people were confirmed as having the disease.[1][11] On 17 May, the virus was confirmed to have spread to the inland port city of Mbandaka, causing the WHO to raise its assessment of the national risk level to "very high",[12][13] but not yet to constitute an international public health emergency.[14] The WHO declared the outbreak over on 24 July 2018, with 33 confirmed deaths.[15][16][3]
Subsequent to the end of this outbreak, the Kivu Ebola epidemic commenced in the eastern region of the country on 1 August 2018;[17] it was declared over on 25 June 2020 with 2,280 deaths recorded.[18] A further separate outbreak in the Province of Équateur was announced on 1 June 2020 by the Congolese health ministry, described as the eleventh Ebola outbreak since records began.[19] This eleventh outbreak was declared over as of 18 November following no reported cases for 42 days,[20] having caused 130 cases and 55 deaths.[21]
Containment challenges[edit]
The Bikoro area had three hospitals, but the area's health services were described by WHO as predominantly having "limited functionality";[24] they received supplies from international bodies but experienced frequent shortages. More than half of the Bikoro area cases were in Ikoko-Impenge, a village not connected to the road system.[24][25] Bikoro lies in dense rain forest,[22] and the area's remoteness and inadequate infrastructure hindered treatment of EVD patients, as well as surveillance and vaccination efforts.[42]
Adherence was another challenge: on 20–21 May, three individuals with EVD in an isolation ward of a treatment center in Mbandaka fled; two later died after attending a prayer meeting, at which they may have exposed 50 other attendees to the virus.[50][51][52][53]
Bushmeat was believed to be one vector of infection, but bushmeat vendors at the Mbandaka market told reporters that they did not believe Ebola was real or serious.[54] Hostility towards health workers trying to offer medical assistance was also reported.[55] On 29 May, the WHO forecast that there would be 100–300 cases by the end of July.[56]