Kikwit Ebola Outbreak in DRC (1995)

Name: Kikwit Ebola Outbreak in DRC (1995)
Uploaded: 2025-05-20
Duration: 10 min 52 s
Description: The lecture Kikwit Ebola Outbreak in DRC (1995) by Jean-Jacques Muyembe-Tamfum, MD, PhD is from the course Ebola.

by Jean-Jacques Muyembe-Tamfum, MD, PhD

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00:00 So we are now in 1995, 19 years after Yambuku outbreak. So, as I said, I was alerted by the Bishop of Kikwit. And the city of Kikwit is located in the south of the capital, Kinshasa, in a savanna region. Several community deaths, including healthcare workers and Italian missionary nurses, were affected. And t he outbreak started in January and remained undetected three months. The outbreak spread initially at a small scale through the 150 bed Kikwit two hospital, then expanded significantly at the 300 bed Kikwit General Hospital. So the alert reported patients with severe bloody diarrhea. In 1995, in Kikwit, a savanna region, 19 years after Yambuku outbreak. As I said previously, the outbreak started in January and the first alert was given only on April, and we started the investigation in May. So, the most important thing was the training of health care workers on the protective equipment and safety protocol. And also, to avoid the transmission of the disease by hands. We introduced the new greeting protocols during this outbreak. Okay. So, the most important thing was to, to detect the cause of these outbreaks. So we started the investigation on the course of this outbreak. We started with bacteriological investigation. So, 19 seven samples, stool sample were collected, but only four were positive for Shigella. And also we collected nine blood samples for blood culture for salmonella Typhi. But all samples were negative. So the blood diarrhea observed is likely of viral origin, possibly Ebola rather than bacterial. The infection may have been acquired through blood exposure during surgical procedures, and also anti-malaria drugs and antibiotics were ineffective s imilarly to my observation in Yambuku two decades ago. And the second investigation was epidemiological. So I used this triangle and this triangle with three questions: who was sick, when the disease started and where the disease was observed. So, the answer to these three questions, give me the answer. Give me the solution. I think that it was not a bacterial or disease. Maybe it was a viral disease. So I look for the epidemiological links between cases. All the doctors who observed this told me that the first patient they saw was a lab technician or 36 year old who was transferred from Kikwit to hospital, the small hospital to the Kikwit General Hospital for suspicion of intestinal perforation. So it was in the operating room, and after this operation, the anesthesiologist developed the same symptoms and die. And the sister, who was the nurse who take care of this patient, also developed the same symptoms and died and so on and so on. So the anesthesiologist will, in fact, two doctors, one of them die. And, the the nurse was an Italian sister will infect six of our nuns in the convent. So this is the start of the outbreak. So to confirm this hypothesis, I collect 14 blood samples and sent to our Institute of Tropical Medicine in Belgium. And from then the samples were sent to CDC. And confirming the hypothesis of confirming the presence of Ebola in this savanna region. So, this is the the second big outbreak of Ebola in DRC. And during this outbreak, we try to treat eight patients with the blood of convalescent patients, and only one of these patients died. So seven were cured. So for us, the antibodies against Ebola c an be like a mean to treat Ebola patients. So here I show you a woman who was treated by blood transfusion from convalescent in Kikwit outbreaks. So this is the highlights of Ebola virus outbreak in Kikwit in 1995. If you compare the population of Kikwit outbreak and yambuku. So in 1976 outbreak Yambuku in Yambuku. Yambuku is a small rural village located in the equatorial forest. And in 1995, Kikwit is an urban area. So this was the first urban Ebola epidemic with a large population. More than 300,000 inhabitants. With the potential spread threatened to Kinshasa, that is the capital with 5 million at that time and Brazzaville 1 million inhabitants. So, this was our worry about these outbreaks. And at this, this outbreak, I was appointed as the Ebola response coordinator. Under WHO guidance, we established outbreak control strategies that became standard practice across Africa. And we treated eight Ebola patients using blood from outbreak survivors with only one fatality. And we show that a proper training and personal protective equipment effectively protect health care workers from infection. And the key limitation of the treatment with convalescent blood transfusion during the Ebola outbreak in Kikwit. We cannot use these these strategy, this method, because our study was only an observational study without a control group. And also the study was conducted towards the end of the outbreak. May be the virus, possibly lose its virulence and also because of small sample size, we use only eight patients, but we continue to believe that antibodies can neutralize Ebola virus.

About the Lecture

The lecture Kikwit Ebola Outbreak in DRC (1995) by Jean-Jacques Muyembe-Tamfum, MD, PhD is from the course Ebola.

Included Quiz Questions

How did the 1995 Kikwit outbreak differ from the 1976 Yambuku outbreak in terms of setting and population impact?

Kikwit was the first urban Ebola epidemic with over 300,000 inhabitants, while Yambuku was a small rural village in equatorial forest
Yambuku was an urban outbreak with major population centers, while Kikwit was a remote rural village
Both outbreaks occurred in similar rural forest settings with comparable population sizes
Kikwit was a coastal outbreak affecting port cities, while Yambuku was an inland mountain outbreak
Yambuku affected multiple countries simultaneously, while Kikwit was contained to a single province

What three-question approach was used to investigate the source and spread of the Kikwit outbreak?

Who was sick, when the disease started, and where the disease was observed
What caused the disease, how it spread, and why it was fatal
Which treatments worked, when to isolate patients, and where to send samples
How many were infected, what symptoms appeared, and when they recovered
Where patients lived, what they ate, and when they became symptomatic

Who was identified as the first patient in the Kikwit outbreak and how did transmission begin?

A 36-year-old laboratory technician who underwent surgery, leading to infection of the anesthesiologist and nursing staff
An Italian missionary nurse who contracted the disease while caring for community patients
A traditional healer who treated patients with herbal remedies in the community
A bushmeat hunter who brought infected animal carcasses to the local market
A pregnant woman who delivered at the hospital and infected the obstetric team

What were the results of the first experimental convalescent blood transfusion therapy during the Kikwit outbreak?

Seven out of eight patients treated with convalescent blood survived, with only one fatality
All eight patients treated with convalescent blood made complete recoveries
Five out of eight patients survived, but with significant complications
Only three patients survived, showing limited effectiveness of the treatment
Two patients survived but developed severe side effects from the transfusion

Why was the Kikwit outbreak particularly concerning from a public health perspective?

It threatened potential spread to major population centers including Kinshasa with 5 million inhabitants and Brazzaville with 1 million
It was the first outbreak to demonstrate airborne transmission between urban buildings
It showed resistance to all available treatments and preventive measures
It occurred during the rainy season when transportation was most difficult
It coincided with a cholera epidemic that complicated the medical response

Author of lecture Kikwit Ebola Outbreak in DRC (1995)

Jean-Jacques Muyembe-Tamfum, MD, PhD

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