Children and Ebola Virus Disease: Trying to Halt an Outbreak

October 15, 2019

Link to research article

https://www.nejm.org/doi/full/10.1056/NEJMsr1904253

Article Citation

Kalenga LI, Moeti M, Sparrow A, Nguyen V-K, Lucey D, Ghebreyesus TA. The Ongoing Ebola Epidemic in the Democratic Republic of Congo, 2018-2019. N Engl J Med. 2019;381:373-383.

First Dose

  • The current outbreak of Ebola virus disease (Ebola) in the Democratic Republic of Congo (DRC) is the 10th and largest outbreak in the DRC since Ebola was reported in Zaire in 1976.
  • The case fatality rate in the current outbreak is 67%. As of May 7, 2019, there were 1600 cases and 1069 deaths; 30% of cases were children <18 years old.
  • There are several social factors exacerbating the outbreak, including armed attacks on health care workers and increasing distrust of the health care response.
  • The response during this outbreak in the DRC includes a vaccine administered to individuals exposed to persons with Ebola, using a “ring” strategy, with preliminary efficacy of 97.5%.

Key Points to Remember

  • In the DRC, malaria, neonatal complications, pneumonia, diarrheal disease, and tuberculosis are the leading causes of premature death. Life expectancy at birth is 60 years; the infant mortality rate is 70 per 1000 live births (by comparison, the infant mortality rate in the US is approximately 6 per 1000 live births).
  • The current outbreak began in April 2018. Subsequently, there have been cases transmitted in the community and also cases thought to be have been contracted through nosocomial transmission.
  • The vaccination strategy includes high-risk contacts, and also health care workers; in the latter group, nearly 30,000 have been vaccinated.
  • In April 2019, the vaccination program was expanded to include children over 6 months of age and lactating women. Child-focused data about vaccine efficacy are not yet available.
  • Progress against outbreaks of Ebola in the DRC has been interrupted by armed attacks on health care workers, which have forced recurring suspensions of health care efforts. Consequently, the outbreak has worsened because transmission has flared without sufficient surveillance and control of cases.

Summary Author

Matthew M. Davis, MD, MAPP

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