Today Tedros Adhanom Ghebreyesus, PhD, director-general of the World Health Organization (WHO) said he was cautiously optimistic that the Ebola outbreak in the Democratic Republic of the Congo (DRC) is stabilizing, while another top WHO official said response efforts are having an impact.

Tedros, who goes by his first name, told Reuters he would be traveling to DRC on Sunday to check on progress 1 month after the outbreak began in the rural Bikoro health zone, which would mark his second visit to the outbreak region.

His optimism was echoed by Peter Salama, MD, the WHO’s deputy director-general of emergency response. Salama gave a press briefing over the WHO’s Twitter account earlier today.

The outbreak stands at 62 cases, including 27 deaths, with the most recent confirmed case identified on Jun 2 in a known contact from Iboko health zone. Iboko, the most rural of the outbreak sites, was the focus of Salama’s briefing. Bikoro health zone and Wangata health zone both reported their last confirmed case in mid-May.

“This tells us the response is having an impact in those two locations,” said Salama, referring to the robust ring vaccination campaign launched 2 weeks ago with Merck’s VSV-EBOV. More than 98% of known contacts have been vaccinated, Salama said. “But we know to never underestimate Ebola.”

Salama said vaccinating contacts in a big city (Mbandaka, in Wangata health zone and home to more than 1 million people) and a smaller rural town (Bikoro) was the first phase of the outbreak response. Phase two will focus on Iboko.

“Contact tracing has been a huge challenge in this hard-to-reach area,” Salama said, describing Iboko as a remote community in a heavily forested part of the DRC. The village has no electricity, and WHO workers travel by motorcycles because four-wheeled vehicles have a hard time navigating area roads.

“It takes an enormous logistical challenge to reach suspected cases and contacts,” Salama said. He also said many cases in the area are connected to a super-spreader, a female nurse who treated people both formally and informally.

Community engagement and education will be emphasized in the coming weeks, as 50% of Iboko’s population is indigenous. According to a story from All Africa, community engagement in rural communities means educating schoolchildren on hygiene and dispelling rumors that Ebola is fake or a curse, among other steps.

Chinese vaccine team and rapid tests

Yesterday, the DRC’s Ministry of Health said a team of Chinese experts was arriving today in Kinshasa to assist the Congolese health authorities and reportedly bringing an experimental Chinese Ebola vaccine to health authorities, according to Stat today. To date, DRC has approved only the use of Merck’s vaccine.

Finally, yesterday The Lancet published a letter by US experts who suggested that, although costly, using rapid diagnostic tests (RDTs) during the outbreak would be beneficial to identify all transmission chains of Ebola present in the DRC. Failing to do so in West Africa during the 2014-2016 outbreak allowed the disease to spread, the authors said.

“Deploying RDTs in this manner might seem costly and operationally burdensome, but, as learned from the west African epidemic, finding all chains of transmission cannot be left to chance and the ultimate cost of missing them can become far greater,” the authors write.

See also:

WHO’s Twitter feed

Jun 8 Reuters story

Jun 8 Stat article

Jun 8 All Africa story

Jun 7 Lancet correspondence