Responding to the Ebola virus disease outbreak in DR Congo: When will we learn from Sierra Leone?

Latest reports from WHO suggest that the Ebola virus disease outbreak in North Kivu and Ituri provinces, DR Congo, is serious and rapidly escalating. As of May 19, 2019, there were 1826 confirmed cases and 1218 deaths, making it the second largest outbreak of Ebola virus disease in history, with a case fatality rate of 66%— much higher than previous outbreaks.1 Jeremy Farrar, director of the Wellcome Trust, has called the situation “terrifying”.2 Although ring vaccination is helping to contain transmission, it requires sufficient coverage of contact individuals and efficacy has been shown only beyond 10 days after vaccination.3 All critical response interventions (case and contact detection, community education, treatment, and vaccines) are being severely impeded by armed violence in the region: there are numerous active militia groups in North Kivu and Ituri provinces,4 and the political instability and violence make it difficult to establish secure bases.