Ebola Outbreaks in Africa

Authored by
Last reviewed
April 10, 2021

Ebola Outbreaks in Africa

The first Ebola virus disease outbreak occurred in remote villages in Central Africa, near tropical rainforests, in 1976. The 2014–2016 outbreak in West Africa was the largest and most complex Ebola virus disease (EVD) outbreak since the virus was first discovered. It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts, says the WHO.

This case report published by the NEJM journal on April 1, 2021, shows the need for continued monitoring of vaccine and therapeutic interventions and the power of having locally available genomic capabilities to support the outbreak response. Relapse of EVD appears to be a rare event; however, relapse, like sexual transmission, should be recognized as a mechanism for onward transmission from persons with persistent infections. More data are needed to understand the mechanism and risk factors of EVD relapse to prevent future transmission events and protect patients and their families and communities.

12th Ebola Outbreak in Africa

April 9, 2021 - Since the last update from Guinea, two new confirmed Ebola cases and three probable cases, including three deaths, have been reported by the WHO. All new cases are being reported from the Soulouta sub-prefecture in the prefecture and region of N¶Zerekore. Ring vaccination around this new case has started, and, as of 2 April 2021, 129 contacts have been vaccinated. The Agence Nationale de Securite Sanitaire reports an additional two suspect cases from the N'Zerekore region, one of whom refuses to be isolated in a healthcare facility and one escaped case who also refused isolation. The 42-day countdown to declaring the end of the 12th Ebola outbreak was therefore canceled when the first confirmed case, since the countdown began, was reported on 1 April 2021.

April 5, 2021 - The WHO African regional office Twitted four new Ebola cases that have been reported in Guinea's Ebola outbreak, increasing the total to 23 during 2021.

April 2, 2021 - The WHO Africa Tweeted 'Ring vaccination site set up in Soulouta village, Guinea, one day after a new Ebola case was reported. The WHO is supporting rapid Ebola vaccination roll out in the village. So far, 129 contacts linked to the recent case have been vaccinated.

April 1, 2021 - A new Ebola case was reported in Guinea today, the first reported case since March 4, 2021. The case was reported in Soulouta village, N'Zérékoré, stated a WHO Tweet.

March 26, 2021 - Washington public health authorities monitor 23 low-risk people who recently arrived from Guinea and the Democratic Republic of the Congo. These West African countries are experiencing outbreaks of Ebola virus disease. In Washington, local public health authorities have been in contact with these people, who are considered “people under control” for 21 days after they arrive in the USA. The US Centers for Disease Control and Prevention recently issued an order requiring airlines to collect and provide the government with contact information for passengers in Guinea or the Democratic Republic of the Congo in the 21 days before arrival in the USA.

March 25, 2021 - UNICEF confirmed 14 cases of Ebola were confirmed in Guinea, including 5 confirmed deaths and 9 recoveries. And 4,345 people have been inoculated (including 1,801 frontline staff) since the official launch of the vaccination on February 23, 2021. In the DRC, a total of 11 confirmed cases of Ebola virus (EVD) and 1 probable case, resulting in five Deaths (+1 probable death), have been recorded in the health zones of Biena, Katwa, Musienene, and Butembo since the resurgence of the disease in February 2021, in North Kivu province.

March 23, 2021 - The WHO African Region Tweeted, 'The last Ebola patient in DRC was discharged from a treatment center in Katwa yesterday! With no more confirmed Ebola cases, a 42-day countdown to declaring the end of DRC's 12th Ebola outbreak begun just 37 days after the resurgence of the virus. Our WHO teams remain on the ground to support health authorities with surveillance, pathogen detection, clinical management & community engagement. The current outbreak was declared on February 7, 2021.

March 16, 2021 - The Africa CDC reported since the last brief (9 March 2021), one new probable case, two new deaths, and four new recoveries of Ebola virus disease have been reported from the Democratic Republic of Congo (DR Congo) and Guinea. Cumulatively, 30 EVD cases, 15 deaths (CFR: 50%), and eight recoveries have been reported from DR Congo (12 cases; 6 deaths; 2 recoveries) and Guinea (18; 9; 6). Seven healthcare workers are amongst the confirmed cases: DR Congo (2) and Guinea (5). As of today, no confirmed case has been reported from Sierra Leone.

March 15, 2021 - This situation report presents the latest updates on the reappearance of the Ebola virus disease notified since February 2021 in Guinea. The report describes the actions carried out by the International Organization for Migrations in response to this epidemic. These epidemiological data are updated as of 12th March 2021. Cumulatively, 18 cases of EVD had been notified, including 14 confirmed and 4 probable cases; 7 people (3 confirmed and 4 suspected) are currently hospitalized at the ETC of N'Zérékoré.

March 12, 2021 - An ongoing analysis found the new Ebola cases are directly linked to human cases in the 2013-2016 West Africa EVD outbreak. The new genomes are most closely related to five identical Ebola virus Makona variant genomes sampled in August 2014 from the same region but are diverged by 12 (EBOV-0002) and 13 (EBOV-0003) substitutions (compared to KR534588). This number of substitutions is far less than what would be expected during sustained human-to-human transmission. "Therefore, the index case of the 2021 Guinea cluster was likely infected from a persistent source, such as via sexual transmission from a [Ebola] survivor," Please note, though, that this data is still based in progress and should be considered preliminary, said these researchers.

March 3, 2021 - Since the last brief (23 February 2021), 11 new confirmed cases, one new death, and two new recoveries of Ebola virus disease (EVD) have been reported in Nzérékoré, Guinea, and North Kivu, Democratic Republic of Congo (DR Congo). This represents a 47% increase in the total number of cases reported this week than the last brief. Cumulatively, 28 EVD cases, 11 deaths (CFR: 39%), and two recoveries have been reported from DR Congo (11 cases; 4 deaths; 2 recoveries) and Guinea (17; 6; 2). Seven healthcare workers are amongst the confirmed cases: DR Congo (2) and Guinea (5).

February 26, 2021 - The U.S. CDC reported the U.S. government would funnel travelers from DRC and Guinea to six U.S. airports. Airlines will collect and transmit passenger information to the CDC for public health follow-up and intervention for all passengers boarding a flight to the U.S. in DRC or Guinea within the previous 21 days. Passengers can expect verification of data on arrival to ensure completeness and accurateness of contact information. This information will be shared with U.S. state and local health departments to monitor arrivals in their jurisdiction appropriately.

February 25, 2021 - The WHO reported nine cases, including five deaths had been reported in Guinea. While no confirmed Ebola cases have been recorded outside of the country, six nations bordering Guinea are finalizing their national preparedness and readiness operational plans according to a WHO readiness assessment tool. The overall state of readiness in the six countries is nearly 66% which is still lower than the benchmark of 80%. 

February 23, 2021 - The WHO announced the vaccination began in Guinea after receiving more than 11,000 doses of Merck's Ervebo rVSV-ZEBOV Ebola vaccine from its headquarters in Geneva. The WHO is also organizing the deployment of over 8,500 doses received directly from Merck in the initial phase of immunization.

February 22, 2021 - The WHO African Region tweeted, 'A supply of over 11,000 #Ebola vaccines sent by @WHO arrived in Conakry airport, #Guinea. The cargo was transported from Senegal by government plane after bad weather caused a stop-over in Dakar. Timely vaccination will be crucial in curbing the Ebola outbreak.'

February 18, 2021 - The World Health Organization announced it was deploying teams of experts to support the national authorities ramp up the response and avert widespread infections. In Guinea, health authorities declared an Ebola outbreak on 14 February after three cases detected in Gouécké, a rural community in N’Zerekore prefecture, tested positive for the virus. It is the first Ebola outbreak in Guinea since 2016, when a large one was successfully brought under control. More than 100 WHO staff, deployed from other countries and from within Guinea, are expected to be part of the Ebola response by the end of February 2020. Meanwhile, in the DRC, so far, there are four confirmed Ebola cases, including two deaths that are epidemiologically linked. WHO has around 20 experts supporting national and provincial health authorities. About 8,000 vaccine doses were still available in the country at the end of the 11th Ebola outbreak. The vaccination of people at high risk was officially launched in Butembo, the outbreak’s epicenter, on 15 February. So far, nearly 70 people have been vaccinated.

February 18, 2021 - The WHO reported, 'With efforts gathering pace to promptly tackle the new Ebola outbreaks in Guinea and the Democratic Republic of the Congo, the WHO is deploying teams of experts to support the national authorities ramp up the response and avert widespread infections. A consignment of more than 11,000 doses of the Ebola vaccine is expected to arrive in Guinea this weekend. Also, more than 8,500 doses will be shipped from the United States of America for a total of 20,000 doses. A 30-strong vaccination team has already been mobilized locally and is ready to deploy as soon as the vaccines are received.

February 16, 2021 - The WHO Weekly Bulletin focuses on public health emergencies occurring in the WHO African Region. In Guinea, health authorities declared an outbreak of the Ebola virus on February 14, 2021, in the rural community of Gouéké in N’Zerekore prefecture after the national laboratory confirmed three cases. Initial investigations found that a nurse from a local health facility had died on 28 January 2021 after presenting with headache, fatigue, nausea, vomiting, abdominal pain, and a temperature of 38ºC, after an initial diagnosis of malaria on 23 January 2021. She was buried on 1 February 2021 in Gouéké. So far, a total of seven cases have been reported, with three deaths (case fatality ratio 42.9%). Gueckedou and Conakry's laboratories have tested three more samples, where results returned positive for the Ebola virus. All had attended the nurse’s burial.

February 16, 2021 - The Africa CDC Tweeted that Guinea's Ebola outbreak total has now climbed to 17 cases, with five people dying from the disease. Sixteen cases are from N'Zerekore prefecture in the country's southeast, where the initial cases were reported. And the number of Ebola cases in the Democratic Republic of the Congo remains at four, including two fatalities.

February 16, 2021 - Mark Lowcock, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Tweeted, 'Today I am allocating $15 million from @UNCERF to respond to the Ebola outbreaks in Guinea and the DRC. The funding will help these countries respond to the outbreak and support neighboring countries to prepare.

February 15, 2021 - The WHO African Region Tweeted:#Ebola vaccination campaign officially launched in #Butembo #DRC — just one week after the virus's resurgence. Health workers at Matanda health center, where the first Ebola patient was treated, were the first to be vaccinated. Furthermore, Doctors Without/Médecins Sans Frontières announced it is rapidly putting together an Ebola team in Guinea to support the Ministry of Health's Ebola response.

February 15, 2021 - The WHO announced the new Ebola cases were confirmed by the national laboratory, which occurred in Gouéké in N’Zerekore prefecture, in southern Guinea. Initial investigations found that a nurse from a local health facility died on January 28, 2021. Following her burial, six people who attended the funeral reported Ebola-like symptoms, and two of them later died. The other four are in hospital. Guinea was one of the three most affected countries in the 2014-2016 West Africa Ebola outbreak, which was the largest since the virus was first discovered in 1976. Michel Yao, Ph.D., director of strategic health operations, said the samples belong to the Zaire subtype, the same one that fueled the earlier West Africa outbreak. That Ebola outbreak, which saw some 28,000 cases, including 11,000 fatalities, started in Guinea and then moved across land borders to Sierra Leone and Liberia in western Africa.

February 14, 2021 - Local media (CGTN Africa) reported the Democratic Republic of Congo confirmed the fourth Ebola case in North Kivu province. The WHO stated it is already working with health authorities in Liberia and Sierra Leone to beef up community surveillance of patients in their border districts and strengthen their capacity to test for cases and conduct surveillance in health facilities. WHO is reaching out to Cote d’Ivoire, Mali, Senegal, and other countries at risk in the sub-region.

February 14, 2021 - Aljazeera reported three fatalities from Ebola hemorrhagic fever occurred in the southeastern region of Nzerekore, Guinea. Guinea is a country in West Africa, bordered on the west by the Atlantic Ocean. On March 23, 2014, the World Health Organization reported an EVD outbreak in the forested rural region of southeastern Guinea. Identifying these EVD cases marked the beginning of the West Africa Ebola epidemic, the largest in history.

February 12, 2021 - The Democratic Republic of Congo confirmed a third Ebola case in North Kivu province. Provincial health minister Eugene Nzanzu Salita said, "We are in a meeting to gather all the information on the investigations done around this case," said Salita. The recent outbreak would be DRC's 12th Ebola outbreak.

February 11, 2021 - NPR reported a second person who had contracted the Ebola virus disease died in the DRC. The latest victim was from the North Kivu province, the World Health Organization and the DRC's health ministry said in a statement.

February 10, 2021 - The WHO reported, 'The resurgence is not unexpected given that EVD is endemic in the Democratic Republic of the Congo and that Ebola virus is present in animal reservoirs in the region. The risk of re-emergence through exposure to animal hosts or bodily fluids of Ebola survivors cannot be excluded. It is also not unusual for sporadic cases to occur following a major outbreak. WHO recommends providing medical care, psychological support, and biological testing (until two consecutive negative tests) through an EVD survivors care program to reduce the risk of transmission from virus persistence in some survivors' body fluids. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for the Ebola virus.

February 7, 2021 - The Minister of Health of the Democratic Republic of the Congo declared an outbreak of EVD after the laboratory confirmation of one case in North Kivu Province. The case was an adult female living in Biena Health Zone. More than 70 people who came into contact with the dead woman have been tracked, and the places she visited are being disinfected, said the World Health Organization, which is helping with the response.

Previous Ebola Virus Outbreaks

On November 18, 2020, the DRC Minister of Health, Eteni Longondo, declared the 11th outbreak of Ebola virus disease had ended. The declaration came 42 days after the last case tested negative twice. This outbreak took place in Equateur Province in the northwest area of the DRC. The 10th outbreak resulted in 3,470 cases, including 2,287 deaths. The start of the outbreak was declared in August 2018, and the end was declared on 25 June 2020.

This latest outbreak in the western DRC arose during the period in which the 10th Ebola outbreak in the eastern DRC was coming to an end. Genetic sequencing results confirmed as a separate event.

However, the 9th Ebola outbreak occurred between May and July 2018, in the same part of the country as this most recent outbreak, and led to 54 cases and 33 deaths.