May 3
DRC health ministry declared the end of the country's 12th Ebola outbreak, given that 42 days have passed with no new cases since the last patient was released from treatment.
Guinea
- situation still isn't stable; some contacts lost to follow up; 1 confirmed case remaining in the community, which raises the risk of further spread
“These shared mutations make it unlikely that the new cases are a result of a new spillover from the animal reservoir, but instead are directly linked to human cases in the 2013-2016 West Africa EVD outbreak.”
https://virological.org/t/guinea-2021-ebov-outbreak/643
”Ebola survivors, who face a lot of hardship already. Many have not only lost friends and family to the virus, but also struggle with long-term aftereffects, such as muscle pains and eye problems. In a study published in February, Delaporte found that about half of more than 800 Ebola survivors in Guinea still reported symptoms 2 years after their illness, and one-quarter after 4 years.”
“One important message to the public should be that some people infected with Ebola show few symptoms, meaning people may be survivors without knowing it. “So don’t stigmatize Ebola survivors—you don’t know that you are not a survivor yourself,” Keita says.
April 2
“the case comes in the wake of a cluster of suspicious deaths in the area. Local officials said after the latest case was confirmed, residents first blocked access to response teams, and other people with suspected infections fled the area.”
https://www.cidrap.umn.edu/news-perspective/2021/04/news-scan-apr-02-2021
DRC 2021 EBOV outbreak
March 23
“DRC last patient discharged & 42 day countdown begins until the country is declared free from ebola virus again.”
Apr 1
DRC Ebola outbreak relapse patient linked to 91 cases
“He was sick during the DRC's recent large outbreak that spanned 2018 to 2020, the country's 10th and by far the largest.”
“6 months after he received the VSV-EVOV vaccine his 1st ebola illness occurred in 2019. His care included treatment with the mAb114 monoclonal antibody. His semen sample, tested 2 months later, was negative for the virus. About five months after his 2nd ebola infection resulted in death.”
“Genetic analysis of virus from the man's 1st & 2nd infection found that they differed by only two mutations, confirming that his 2nd infection was a relapse.”
“While symptomatic with the 2nd infection, the man was in the community for 8 days and visited two health centers. Investigators found 29 cases that were linked to those exposures, with related cases that totaled 91 across six health zones over the next 4 months.”
“The authors said the case raises questions about the true efficacy of the vaccine, which studies suggest is 100%, and whether passive immunotherapy in rare instances could be associated with relapse. Also, they write that, though rare, relapse cases—as with sexually transmitted cases—should be noted as a potential transmission source.”
https://www.nejm.org/doi/full/10.1056/NEJMoa2024670