On 8 May 2018, the Ministry of Health (MOH) of the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola virus disease in Bikoro Health Zone, Equateur Province, which is northwest Congo. According to the Health Emergency Information and Risk Assessment conducted by the World Health Organization (WHO), it is difficult to estimate the magnitude of the epidemic due to the nature of the pathogen and the current lack of epidemiological and demographic information. As the risk for community transmission in DRC is high, the Taiwan Centers for Disease Control (Taiwan CDC) has raised the travel notice for Ebola virus for DRC to Level 2: Alert, advising travelers visiting DRC to take actions to reduce their risk of Ebola infection on May 15, 2018.

During April 4 and May 13, 2018, a total of 39 cases, including 2 confirmed cases, 25 probable cases, 12 suspected cases, and 19 deaths, were reported in Bikoro Health Zone, Equateur Province, which is northwest Congo. Among them, 3 are healthcare workers. On the other hand, during March and April 2018, 120 unexplained deaths occurred in Ituri Province, which is northeast Congo. The cause of these deaths are still being investigated. According to the Ebola situation report published by WHO, the risk of transmission at the regional level is moderate due in part to the proximity of the epidemic focus to the Congo River, the existence of a border with the Republic of Congo and the river which links with the capitals of the Republic of Congo and the Democratic Republic of Congo and the Central African Republic. As the ongoing outbreak in DRC does not fall within the criteria of a Public Health Emergency of International Concern (PHEIC), WHO will continue to closely monitor the event and re-evaluate the risk assessment according to the evolution of the situation and the available information.

The Ebola virus is transmitted by direct contact with body fluids such as blood, excretions, and semen of an infected human or wild animals such as monkey, monkey and bat. The incubation period varies between 2 and 21 days. Infected individuals are not contagious during the incubation period, but can spread the virus once symptoms develop. Symptoms usually begin with sudden onset of high fever, severe fatigue, muscle aches, headache, and sore throat, which are followed by vomiting, diarrhea, abdominal pain, maculopapular rash, and internal and external bleeding. Severe cases usually experience decreased functions of the liver, the kidneys and the central nervous system, shock, and multiple organ failure. The case fatality rate can be as high as 90%. Currently, there is no approved vaccine to prevent the disease. Only an experimental vaccine to be tested in large-scale efficacy trials is available at the moment.

Although the Ebola outbreak has occurred in a remote area in DRC and the risk of transmission to Taiwan at the moment is low, Taiwan CDC still advises travelers to follow its “Two Don’ts and One Do” advice in protecting themselves against Ebola: (1) Do not travel to Ebola-affected areas; if you must travel to an area with an Ebola outbreak, avoid contact with and consumption of wild animals such as fruit bats and primates, (2) Do not visit hospitals or have direct contact with patients, and (3) Do pay attention to personal hygiene and take preventive measures such as washing hands frequently and wear a mask when coughing. In addition, travelers are urged to monitor their own health for 21 days after their return to Taiwan. If symptoms such as fever, vomiting, diarrhea or rash develop, please seek immediate medical attention and voluntarily inform the doctor of any recent travel and exposure history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC’s website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).