Article by
Dani Reiter
Updated
November 12th, 2019

Mistrust Impacting Ebola Outbreak Reporting

WHO says there is poor understanding of Ebola Zaire transmission mechanism and symptoms

young boy in africa

The number of confirmed cases of Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) has been relatively low in recent weeks, with only 15 new confirmed cases reported during the epidemiological week of October 7th through October 13, 2019.

This is actually good news when compared to the past year.

But these encouraging signs are offset by issues with access and security, says the World Health Organization (WHO), in a statement published on October 17, 2019.

This is reflected in the decline in the proportion of confirmed cases listed as contacts (from 57% to 13%) and an increase in the proportion of cases dying outside of Ebola Treatment Centres or Transit Centres (from 14% to 27%) this past week. 

This is further demonstrated by the relatively low numbers of alerts reported over the past 42 days.

Since the current Ebola Zaire outbreak in the DRC began in August 2018 and through October 15, 2019, a total of 3,227 EVD cases were reported, of which 2,154 cases died (overall case fatality ratio 67%).

A recent qualitative investigation in targeted health zones indicated that ‘there is a poor understanding among the population and local health workers of the transmission mechanism and symptoms of the disease, compounded with an environment of mistrust surrounding the origin of the disease, and reason for vaccination.’

This mistrust may impact the reporting of cases and engagement with response activities. 

Less than half of the respondents indicated that they would call a hotline if a member of their community was suspected of having Ebola, and only half of the people reported that they would encourage a family member to go to a Treatment/Transit Centre if they were suspected of having Ebola. 

This WHO investigation highlights the importance of engaging communities in response activities in the upcoming weeks.

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Furthermore, the WHO Director-General will reconvene the Emergency Committee under the International Health Regulations (IHR), as 3 months have passed since the declaration of the public health emergency of international concern (PHEIC) on July 17th.

Additionally, the WHO continues to advise against any restriction of travel to, and trade with, the DRC based on the currently available information. 

Since there is currently no licensed vaccine to protect people from the Ebola virus, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travelers to/from the affected countries.

Merck’s V920 (rVSVΔG-ZEBOV-GP), a recombinant, replication-competent Ebola vaccine, and Jannsen’s Ad26.ZEBOV/MVA-BN, a heterologous prime-boost Ebola vaccine regimen, are currently being tested in Africa.

However, travelers to the DRC should seek medical advice before travel and should practice good hygiene.

Previously, the US State Department said, ‘Travelers to the DRC should remain aware of the situation and avoid direct contact with people who are ill, when possible. They should also monitor themselves for symptoms of Ebola both during and for 3 weeks after travel.’

Related Ebola vaccine news

Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

Ebola news published by Vax-Before-Travel