Long-term disease surveillance in Bandundu region, Democratic Republic of the Congo: A model for early detection and prevention of Ebola hemorrhagic fever

After the large-scale outbreak of Ebola hemorrhagic fever (EHF) in Bandundu region, Democratic Republic of the Congo, a program was developed to help detect and prevent future outbreaks of EHF in the region. The long-term sur veillance and prevention strategy is based on early recognition by physicia ns, immediate initiation of enhanced barrier-nursing practices, and the use of an immunohistochemical diagnostic test performed on formalin-fixed skin specimens of patients who die of suspected viral hemorrhagic fever. The pr ogram was implemented in September 1995 during a 4-day workshop with 28 loc al physicians representing 17 of 22 health zones in the region, Specimen co llection kits were distributed to clinics in participating health zones, an d a follow-up evaluation was conducted after 6 months. The use of a formali n-fixed skin specimen for laboratory confirmation of EHF can provide an app ropriate method for EHF surveillance when linked with physician training, u se of viral hemorrhagic fever isolation precautions, and follow-up investig ation.