2014 Democratic Republic of the Congo Ebola virus outbreak
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In 2014, an outbreak of
Ebola virus disease Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
in the
Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
(DRC) occurred.
Genome sequencing Whole genome sequencing (WGS), also known as full genome sequencing, complete genome sequencing, or entire genome sequencing, is the process of determining the entirety, or nearly the entirety, of the DNA sequence of an organism's genome at a ...
has shown that this outbreak was not related to the 2014–15 West Africa Ebola virus epidemic, but was of the same
EBOV ''Zaire ebolavirus'', more commonly known as Ebola virus (; EBOV), is one of six known species within the genus ''Ebolavirus''. Four of the six known ebolaviruses, including EBOV, cause a severe and often fatal hemorrhagic fever in humans and ot ...
species. It began in August 2014 and was declared over in November of that year, after 42 days without any new cases. This is the 7th outbreak there, three of which occurred during the period of
Zaire Zaire (, ), officially the Republic of Zaire (french: République du Zaïre, link=no, ), was a Congolese state from 1971 to 1997 in Central Africa that was previously and is now again known as the Democratic Republic of the Congo. Zaire was, ...
.


Epidemiology


Index patient

The outbreak was traced to a woman living in Ikanamongo Village in the remote northern Équateur province who fell ill after handling
bushmeat Bushmeat is meat from wildlife species that are hunted for human consumption, most often referring to the meat of game in Africa. Bushmeat represents a primary source of animal protein and a cash-earning commodity for inhabitants of humid tropi ...
. Despite treatment in a local clinic, the woman died on 11 August 2014. At the time of her death, her diagnosis was
hemorrhagic fever Viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses in which fever and hemorrhage are caused by a viral infection. VHFs may be caused by five distinct families of RNA viruses: the families ''Filoviridae'', ''Flav ...
of unknown
etiology Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, e ...
. Subsequent laboratory studies confirmed she had died of
Ebola virus disease Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
.


Response

Medecins Sans Frontieres/Doctors without Borders (MSF) deployed a team of 50 staff to the area and opened two EVD treatment centers with a combined capacity of 50 beds. MSF, together with the country's Ministry of Health and the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO) worked to heighten public awareness and ensure that surveillance, contact tracing, and follow-up activities were carried out in order to limit the spread of the disease. There are no roads to the affected area, which made working conditions difficult.


Subsequent cases

By 18 August, 13 people, including three health care workers, were reported to have died of Ebola-like symptoms in Équateur province, a province that lies about north of the capital
Kinshasa Kinshasa (; ; ln, Kinsásá), formerly Léopoldville ( nl, Leopoldstad), is the capital and largest city of the Democratic Republic of the Congo. Once a site of fishing and trading villages situated along the Congo River, Kinshasa is now one o ...
. On 26 August, the Équateur Province Ministry of Health confirmed an outbreak of Ebola to the WHO. On 2 September, the WHO said that there were currently 31 deaths in the Northern
Boende Boende is a town and capital of Tshuapa Province, lying on the Tshuapa River, in the Democratic Republic of Congo. It is a river port with riverboats sailing to Kinshasa via Mbandaka and is also home to an airport. As of 2009 it had an estimated ...
area in the province of Équateur and 53 confirmed, suspected or likely cases. On 9 September, the WHO raised the number of cases to 62 and the death toll to 35 from possible or confirmed Ebola cases. Included in this number were 9 health-care workers with 7 deaths among them. In total, 386 contacts were listed and 239 contacts were being followed. The outbreak was still contained in Jeera county in the Boende region. As of 28 October, there had been 66 cases reported. In total, 49 deaths had been reported, including eight among health care workers. No new reported contacts were being followed and twenty days had passed since the last reported case tested negative for the second time and was discharged. It was stated that the DRC would therefore be declared free of Ebola disease 42 days after the date of the second negative test if no new cases were reported. The outbreak was declared over on 15 November 2014.


Subsequent findings

In October 2014, it was reported that more recent findings suggested that there may have been several previous cases. The husband of the woman that was believed to have been the
index case The index case or patient zero is the first documented patient in a disease epidemic within a population, or the first documented patient included in an epidemiological study. It can also refer to the first case of a condition or syndrome (not n ...
told an investigation team that shortly before she became ill she had visited two women who later died from Ebola-like symptoms. Other village residents also told the team that all the pigs in the village had died just before the illness hit the village and they had eaten the pigs. According to the research team, "it was the third time, after 2007 and 2012, that widespread pig deaths had preceded Ebola outbreaks in humans in the DR Congo...and it has been established that the pigs that died in 2012 carried the Ebola virus." Pig to human transmission has never been proven in previous outbreaks, but villagers have been told to avoid eating them and the investigation is ongoing.


Virology

Results from virus sequencing of samples from the Ebola outbreak in the Democratic Republic of Congo have shown that the virus is the Zaire species in a lineage most closely related to a virus from the 1995 Ebola outbreak in
Kikwit Kikwit is the largest city of Kwilu Province, lying on the Kwilu River in the southwestern part of the Democratic Republic of the Congo. Kikwit is also known in the region under the nickname "The Mother". The population is approximately 458,000 ( ...
. The Zaire species of the virus is indigenous to the area. When the outbreak was first reported there were fears that an ongoing epidemic in West Africa may have spread to the DRC, however results from virus characterization, together with findings from the epidemiological investigation, showed that the outbreak in DRC is a distinct and independent event, with no relationship to the outbreak in West Africa.


History of Ebola outbreaks in the DRC

Multiple documented outbreaks of
Ebola virus disease Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
have occurred in the DRC since 1976, which are summarised in the table below. The first case of Ebola disease ever recorded occurred in August 1976 in
Yambuku Yambuku is a small village in Mongala Province in northern Democratic Republic of the Congo. It was the center of the first documented outbreak of Ebola virus disease, in 1976, with the World Health Organization identifying a man from Yambuku as ...
, a small village in
Mongala District Mongala District (french: District du Mongala, nl, District Mongala) was a district of the Belgian Congo and the Democratic Republic of the Congo. It went through various changes in extent. It covered roughly the same area as the present Mongala ...
in northern Democratic Republic of the Congo (then known as
Zaire Zaire (, ), officially the Republic of Zaire (french: République du Zaïre, link=no, ), was a Congolese state from 1971 to 1997 in Central Africa that was previously and is now again known as the Democratic Republic of the Congo. Zaire was, ...
). The first victim of the disease was the village school headmaster, who had toured an area near the Central African Republic border along the
Ebola river The Ebola River ( or ), also commonly known by its indigenous name Legbala, is the headstream of the Mongala River, a tributary of the Congo River, in northern Democratic Republic of the Congo. It is roughly in length. The name ''Ebola'' is a F ...
in mid-August. On 8 September, he died of what would become known as Ebola virus disease. Subsequently, a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with other cases. A total of 318 cases and 280 deaths (an 88% fatality rate) resulted from this outbreak, which, along with an outbreak in
Sudan Sudan ( or ; ar, السودان, as-Sūdān, officially the Republic of the Sudan ( ar, جمهورية السودان, link=no, Jumhūriyyat as-Sūdān), is a country in Northeast Africa. It shares borders with the Central African Republic t ...
that had begun a few weeks previously, were the first outbreaks of Ebola ever recorded. The virus responsible for the initial outbreak, named after the nearby Ebola river, was first thought to be
Marburg virus Marburg virus (MARV) is a hemorrhagic fever virus of the ''Filoviridae'' family of viruses and a member of the species '' Marburg marburgvirus'', genus ''Marburgvirus''. It causes Marburg virus disease in primates, a form of viral hemorrhagic f ...
but was later identified as a new type of virus related to Marburg.


See also

*
2017 Democratic Republic of the Congo Ebola virus outbreak The Democratic Republic of the Congo (DRC) was identified by the World Health Organization (WHO) on 11 May 2017 as having one Ebola-related death. As of 8 June 2017, there were five confirmed cases and three probable cases. Of these, four survi ...
*
2018 Équateur province Democratic Republic of the Congo Ebola virus outbreak Eighteen or 18 may refer to: * 18 (number), the natural number following 17 and preceding 19 * one of the years 18 BC, AD 18, 1918, 2018 Film, television and entertainment * ''18'' (film), a 1993 Taiwanese experimental film based on the short s ...
*
2018 Kivu Democratic Republic of the Congo Ebola virus outbreak The Kivu Ebola epidemic was an outbreak of Ebola virus disease (EVD) that ravaged the eastern Democratic Republic of the Congo (DRC) in Central Africa from 2018 to 2020. Between 1 August 2018 and 25 June 2020 it resulted in 3,470 reported cases ...


References


Further reading

* *


External links


ICTV Files and Discussions — Discussion forum and file distribution for the International Committee on Taxonomy of Viruses

Genomic data on Ebola virus isolates and other members of the ''Filoviridae'' family

Ebola Hemorrhagic Fever — CDC.gov

The Ebola Virus
3D model of the Ebola virus, prepared by Visual Science, Moscow.
ICTV Files and Discussions — Discussion forum and file distribution for the International Committee on Taxonomy of Viruses

FILOVIR — scientific resources for research on filoviruses
{{Epidemics 2014 in the Democratic Republic of the Congo 2014 disease outbreaks Disease outbreaks in the Democratic Republic of the Congo
Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...