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Ebola in Democratic Republic of the Congo

Warning - Level 3, Avoid Nonessential Travel
Alert - Level 2, Practice Enhanced Precautions
Watch - Level 1, Practice Usual Precautions

What is Ebola?

Ebola virus disease (also known as Ebola hemorrhagic fever) is a rare and deadly disease that periodically causes outbreaks in several African countries. It is spread by direct contact with blood or body fluids of a person infected with Ebola virus. It is also spread by contact with contaminated objects or infected animals.

Symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. Skin rash, red eyes, and internal and external bleeding may be seen in some patients.

Key Points

  • An outbreak of Ebola is occurring in the Bikoro area, Equateur province in the northwest corner of the Democratic Republic of the Congo (DRC). Cases have also been found in nearby Iboko and the large city of Mbandaka.
  • Travelers could be infected if they come into contact with an infected person’s blood or body fluids.
  • Travelers should seek medical care immediately if they develop symptoms of fever, headache, body aches, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes during or after travel.

What is the current situation?

An outbreak of Ebola is occurring in the Bikoro area, Equateur province in the northwest corner of the Democratic Republic of the Congo (DRC). As of May 20, 2018, cases of Ebola, including some deaths, have been confirmed in the Bikoro health zone, Iboko, and in the Wangata health zone in the large city of Mbandaka. Additional suspected cases of Ebola, including some deaths, have been reported but not confirmed.

In its statement on the May 18, 2018, Emergency Committee meeting, to the World Health Organization noted the Ebola outbreak in DRC has several characteristics that are of particular concern:

  • the risk of more rapid spread given that Ebola has now been found in an urban area
  • there are several outbreaks in remote and hard to reach areas
  • health care staff have been infected, which may be a risk for further spread.

The risk of spread to other countries in the region is particularly high since Mbandaka is near the Congo River, which has significant regional traffic across country borders. However, the WHO committee noted several factors that may help control spread of the outbreak. These include the current rapid and comprehensive response; multiple interventions underway (e.g., enhanced surveillance, deployment of mobile laboratories); and advanced preparations for use of an investigational vaccine. The WHO Committee also advised against the application of travel or trade restrictions. CDC and WHO continue to monitor the situation closely.

Who is at risk?

The risk to most travelers to the DRC is low. Travelers could be infected if they come into contact with an infected person’s blood or body fluids. Health care workers caring for patients with Ebola and family and friends caring for an infected person are at highest risk.

What can travelers do to protect themselves?

There is no approved or widely available vaccine or specific treatment for Ebola, and many people who get the disease die. Therefore, it is important to take steps to prevent Ebola.

  • Take steps to prevent illness.
    • Avoid contact with other people’s blood or body fluids.
    • Do not handle items that may have come in contact with a person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).
    • Avoid contact with wild animals or with raw bush meat.
    • Avoid funeral or burial rituals that require handling a dead body.
  • Pay attention to your health during travel and after you leave the DRC.
    • Monitor your health for fever and other symptoms for 21 days.
    • Seek medical care immediately if you have traveled to the DRC and have been exposed to body fluids and develop symptoms of fever, headache, body aches, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes.
    • Tell the doctor about your recent travel and your symptoms before you go to his or her office or emergency room. Advance notice will help the doctor care for you and protect other people who may be in the office or hospital.
    • Although the risk for Ebola is low in travelers to DRC, other infectious disease risks remain high, including the risk for malaria. Seek medical care and proper treatment if you feel ill during travel or after returning.

Special Recommendations for Health Care Workers in the Outbreak Area

Health care workers whose work puts them at risk of exposure to patients with Ebola should follow these steps:

  • Wear protective clothing, including masks, gloves, gowns, and eye protection.
  • Discuss options for vaccination with the organization you are working with. DRC, WHO and other partners are offering vaccine to priority populations such as frontline health care workers. The vaccine is investigational and was shown to be highly protective against Ebola in a major trial in 2015 in Guinea.
    • Get vaccinated before traveling, if possible.
    • The National Institutes of Health (NIH) has an open-label clinical trial, entitled “Pre-Exposure Prophylaxis in Individuals at Potential Occupational Risk for Ebola Virus Exposure” or “PREPARE,” to vaccinate adult volunteers (including deploying health care workers and other responders) against Ebola. Study sites are located at the NIH in Bethesda, MD, and Emory University in Atlanta, GA.
  • Practice proper infection control and sterilization measures. For more information, see "Infection Control for Viral Haemorrhagic Fevers in the African Health Care Setting."

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