On 4 September 2025, the Ministry of Health of the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola Virus Disease (EVD) in Kasai Province, following confirmation of Zaire ebolavirus by the National Institute of Biomedical Research (INRB) in Bulape and Mweka Health Zones. As of 19... September, there have been 48 total cases (38 confirmed, 10 probable) with 31 deaths (21 confirmed, 10 probable) and a CFR of 64.5%. Among laboratory confirmed cases, 16 deaths were recorded (CFR: 45.7%). Four deaths occurred among health workers, underscoring the risk of nosocomial transmission. Most cases (39.7%) are among adults aged 20 years and above, in a densely populated, remote, and under-resourced area.
The outbreak is driven by multiple risk factors, including transmission in health facilities with limited infection prevention and control (IPC) measures and personal protective equipment (PPE), incomplete contact tracing, delayed detection, and unsafe burial practices. High population mobility between Bulape and Tshikapa, reliance on traditional healers, and the concurrent mpox outbreak are further straining the fragile health system and increasing the risk of geographic spread.
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The document provides a standardized protocol for evaluating the Early Warning Alert and Response Network (EWARN), a surveillance system used during humanitarian emergencies when regular national health surveillance may be disrupted. The purpose of EWARN is to detect outbreaks of communicable diseas...es early and enable rapid public health response. The guidance explains how the system should be assessed in terms of its structure, implementation, effectiveness, and usefulness. It outlines the key steps of evaluation: preparation, system description, data collection, and post-evaluation reporting. The protocol highlights common challenges observed in previous EWARN implementations, such as delays in establishing the system, limited data quality, weak outbreak response, and lack of clear transition plans back to routine surveillance systems. It emphasizes the need to evaluate both weekly disease reporting and alert verification processes, and to review attributes such as simplicity, data quality, timeliness, sensitivity, and stability. The document also provides templates for interviews, data review forms, and laboratory assessment, as well as guidance on conducting remote evaluations when access is limited. The overall goal of the protocol is to ensure that EWARN functions effectively to detect and respond to outbreaks and that practical recommendations are developed to improve the system’s performance and sustainability in emergency settings.
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