Getting to zero in the DR Congo Ebola outbreak

• Published in: The Lancet infectious diseases Vol. 20; no. 4; pp. 395 - 397
• Main Authors: Dhillon, Ranu S, Srikrishna, Devabhaktuni, Chowell, Gerardo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.04.2020; Elsevier Limited
• Subjects: Contact tracing; Ebola virus; Ebolavirus; Epidemics; Infectious diseases; Outbreaks; Population; Replacement level; Risk management; Upper bounds; Vaccination; Vaccines; Viral diseases
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(20)30056-6

In June, 2019, WHO reported that the mean R for the Ebola outbreak in eastern DR Congo was 1·04, just above replacement level.2 Using case tallies from June and a previously published methodology, we similarly estimated the mean R to be 1·04.3 To account for the possibility that hidden transmission might be greater, we calculated the upper bound of the 95% CI for the average R during this same period to be 1·3. Based on high-end estimates from past outbreaks, in a worst case scenario where unseen transmission is substantially greater, Ebola's R would probably not exceed 2·7.4 We estimated the proportion of the population that needs to be protected from infection by vaccination (which has 97·5% efficacy) or equally effective combinations of behaviour change, safe burial practices, contact tracing, isolation, and treatment to bring R below 1.5 If the current R is 1·04, 1·3, or 2·7, vaccine or equivalent coverage would need to reach 3·8%, 23·1%, or 63% of the at-risk population. [...]the ongoing Ebola outbreak in DR Congo can be ended within months, if challenges to access and buy-in can be sufficiently overcome to reach an adequate proportion of at-risk populations with effective control interventions.