Last reviewed: 10 Mar 2021
Last updated: 04 Mar 2021
04 Mar 2021

New Ebola outbreaks in the Democratic Republic of the Congo and Guinea

An Ebola outbreak was declared in the Democratic Republic of the Congo on 7 February 2021. The index case was confirmed in the North Kivu province. The source of infection is still under investigation.[29]

Another outbreak was declared in Guinea on 14 February 2021. A cluster of cases were reported in the sub-prefecture of Gouécké, Nzérékoré region between 18 January and 13 February 2021. The index case was a nurse who had originally presented at a health centre in Gouécké. The species of virus is yet to be determined, and laboratory analyses are ongoing.

The new outbreaks come shortly after the monoclonal antibody treatments atoltivimab/maftivimab/odesivimab and ansuvimab were approved in some countries towards the end of 2020.

See Epidemiology

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Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • exposure to Ebola virus in previous 21 days
  • fever
  • myalgia
  • conjunctival injection

Other diagnostic factors

  • fatigue
  • anorexia
  • diarrhoea
  • vomiting
  • severe headache
  • abdominal pain or heartburn
  • cough, dyspnoea, chest pain
  • sore throat
  • prostration
  • tachypnoea
  • maculopapular rash
  • bleeding
  • hepatomegaly
  • lymphadenopathy
  • hiccups
  • tachycardia
  • hypotension
  • neurological signs

Risk factors

  • living or working in, or arrival from, endemic area in previous 21 days
  • contact with infected body fluids
  • occupational exposure
  • butchering or consumption of meat from infected (or potentially infected) animals
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR)
  • malaria investigations

Investigations to consider

  • serum electrolyte levels
  • serum creatinine and urea
  • blood lactate
  • ABG
  • FBC
  • coagulation studies
  • urinalysis
  • LFTs
  • serum amylase level
  • serum blood glucose
  • blood cultures
  • antigen-capture enzyme-linked immunosorbent assay (ELISA)
  • IgM and IgG antibodies
  • chest x-ray

Treatment algorithm

Contributors

Senior Lecturer (Honorary Consultant)

Liverpool School of Tropical Medicine and Royal Liverpool University Hospital

Liverpool

UK

Disclosures

NJB is an author of several references cited in this monograph. NJB is partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. He is affiliated with the Liverpool School of Tropical Medicine. Views expressed in this monograph are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England.

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital

Liverpool

UK

Disclosures

MF declares that he has no competing interests.

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Disclosures

TEF is an author of a number of references cited in this monograph. TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General and the Wellcome Trust. TEF has received research grants from the Medical Research Council and the UK Public Health Rapid Support Team (UK-PHRST).

Clinical Lecturer

University College London

Honorary Clinical Lecturer

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

CFH declares that she has no competing interests.

Dr Nicholas J. Beeching, Dr Manuel Fenech, Dr Tom E. Fletcher, and Dr Catherine F. Houlihan would like to thank Dr Colin Brown (Infectious Disease Lead, Kings Sierra Leone Partnership) for his helpful comments and insights. CB declares that he has no competing interests.

Peer reviewersVIEW ALL

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Professor of Medicine and Epidemiology

UT Health Medical School

Medical Director of Epidemiology

Memorial Hermann Texas Medical Center

Houston

TX

Disclosures

LO-Z declares that he has no competing interests.

Consultant in Microbiology and Infectious Diseases

Royal Free London NHS Foundation Trust

London

UK

Disclosures

SM declares that he has no competing interests.

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