Ebola in the Eastern Democratic Republic of Congo: One Health approach to infectious disease control

Sikakulya, Franck katembo; Mulisya, Olivier; Munyambalu, Dalton Kambale; Bunduki, Gabriel Kambale

As of 17 November 2019, a total of 3296 EVD cases were reported, including 3178 confirmed and 118 probable cases, of which 2196 individuals died and 1075 survived (overall case fatality ratio 67%) in the eastern DRC [9] . Most of these cases have been reported in the community, however a few cases have also been reported in healthcare settings [9] . The DRC Ministry of Health (MoH), supported by the World Health Organization (WHO) and a range of regional and international partners are implementing EVD response plans in these affected areas. A package of interventions, such as screening of suspect cases at points of entry, case detection, contact tracing, laboratory testing, case management and infection prevention and control, safe and dignified burials, ring vaccination (This involved vaccination of infected individuals; direct contacts of infected individuals, and contacts of those contacts); and therapeutics, laboratory facilities with capacity for EVD confirmatory testing, safe and dignified burials, community mobilization, and free access to healthcare services, have been used for containing and eliminating this deadly disease [10, 11] . Conducting contacts tracing and early symptoms detection in this unstable setting remains a challenge. The population is highly mobile with individuals often hiding, refusing to subject themselves to follow-up examinations, or traveling to distant homes in heavily forested areas and other destinations [5] . The rVSV-ZEBOV experimental vaccine has been offered to healthcare and frontline workers, case contacts, and contacts of contacts, and the GeneXpert diagnostic test tool has been introduced for rapid diagnosis of the Zaire strain of EVD [9, 12, 13] . From 8 August 2018 to 22 July 2019, 171,052 people have been vaccinated using the rVSV-ZEBOV-GP vaccine with an efficacy of 97.5% according to the WHO [5, 14] . Despite these efforts, the number of cases has increased sharply.