NAIROBI, Kenya — The second-worst Ebola outbreak in history is over, the World Health Organization said on Thursday, after nearly two years and 2,280 deaths.
Efforts to fight the outbreak in eastern Congo were hampered by mistrust from community members, feuds between government officials, attacks on health care facilities and the emergence of new hot spots. The announcement came even as the country contended with the world’s largest measles epidemic as well as the coronavirus pandemic.
The response drew on 16,000 front-line workers, technological innovation and a new vaccine. Ebola, a hemorrhagic fever that is transmitted through contact with sick or dead people or animals, causes fever, bleeding, weakness and abdominal pain. The average fatality rate is about half.
This was Congo’s 10th known outbreak of Ebola. The country is continuing to fight a separate, smaller eruption of the disease that began in the northwestern city of Mbandaka.
“It wasn’t easy,” Dr. Matshidiso Moeti, the W.H.O. regional director for Africa, said of fighting the virus. “At times it seemed like a mission impossible. Ending this Ebola outbreak is a sign of hope for the region and the world, that with solidarity and science and courage and commitment, even the most challenging epidemics can be controlled.”
The 10th Ebola outbreak was declared on Aug. 1, 2018, and infected at least 3,463 people in the provinces of North Kivu, South Kivu and Ituri provinces. In July 2019, it was designated a global health emergency and became the worst known Ebola outbreak since one in West Africa between 2014 and 2016 infected 28,616 people and killed more than 11,000 in Guinea, Liberia and Sierra Leone.
But as health care workers sought to contain the virus, rebel groups kept attacking Ebola treatment centers, burning vehicles and buildings. Aid agencies including the United Nations Children’s Fund and Doctors Without Borders evacuated their teams and suspended medical activities.
The World Health Organization said it had recorded 420 attacks on health facilities, resulting in 11 deaths and 86 injuries.
The spread of false information about Ebola also impeded efforts to fight the epidemic. Community members remained wary of officials and humanitarian agencies whom they believed were using the disease to kill them or profit on their backs. Many stayed away from health centers believing the disease did not exist — complicating efforts to trace or treat it.
But experts said that learning to work with community members and understanding their needs was essential in eventually tackling the disease.
“One of the most important lessons that has been learned is the need to engage with, work with and support communities to be knowledgeable and empowered to play their role,” said Dr. Moeti of the W.H.O.
Technological experiments, like the building of secure “CUBE” emergency rooms, were instrumental in curbing the outbreak. The rooms’ transparent walls and external plastic sleeves and gloves enabled medical teams to attend to Ebola patients without having to put on cumbersome protective gear, and allowed patients to see family members without risk of contamination.
The air-conditioned chambers could be deployed within 72 hours from the initial alert of an outbreak, set up in 90 minutes and reused up to 10 times.
“We had some very difficult moments during these two years,” said Nicolas Mouly, program manager for emergency response at the Alliance for International Medical Action, a nonprofit that developed the chambers. The end of the outbreak, he said, was “very great news.”
New treatments also played a critical role in bringing the outbreak to a halt. The injectable vaccine Ervebo, developed by the American pharmaceutical company Merck, proved successful, with nearly 300,000 doses administered in Congo.
“The Ebola repose was a victory for science,” Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, said on Thursday. “The rapid rollout of highly effective vaccines saved lives and slowed the spread of Ebola. For the first time, the world now has a licensed Ebola vaccine.”
Yet despite these efforts, the disease refused to go. In early April, as officials counted down the 42-day incubation period to declare the outbreak over, a case emerged. And in early June, a fresh outbreak flared up 750 miles away in Mbandaka, a city of 1.2 million. Six cases were initially reported, with at least five people dead.
This was announced even as Congo fought the world’s largest measles outbreak, which since 2019 has infected 369,520 people and killed 6,779. Congo has also reported 6,213 coronavirus cases, with 142 deaths and 870 recoveries.
On Thursday, Dr. Tedros struck a hopeful note despite the recent flare-up of the further outbreak, the country’s 11th since Ebola was first identified in 1976.
“Today is a joyous occasion,” he said.
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