surveillance and response teams on the ground confirmed three new cases of Ebola in Beni health zone in mid-April. On 25 June 2020, the outbreak was declared ended. As a new and separate outbreak, the Congolese health ministry reported on 1 June 2020 that there were cases of Ebola in Équateur Province in north-western DRC, described as the eleventh Ebola outbreak since records began. This separate outbreak was declared over as of 18 November following no reported cases for 42 days, and caused 130 cases and 55 deaths. Epidemiology As indicated below and per numbers offered by the United Nations the final death toll was 2,280 with a total of 3,470 cases in DRC in almost a two-year period. This was made very difficult due to the ongoing military attacks in the region which created a perfect storm for the virus, despite there being a vaccine. rVSV-ZEBOV or Ebola Zaire vaccine live, is a vaccine that prevents Ebola caused by the Zaire ebolavirus. The graph of reported cases reflects cases that were not able to have a laboratory test sample before burial as probable cases. Democratic Republic of the Congo On 1 August 2018, the North Kivu health division notified Congo's health ministry of 26 cases of hemorrhagic fever, including 20 deaths. Four of the six samples that were sent for analysis to the National Institute of Biological Research in Kinshasa came back positive for Ebola and an outbreak was declared on that date. The index case is believed to have been the death and unsafe burial of a 65-year-old woman on 25 July in Mangina, quickly followed by the deaths of seven close family members. This outbreak started just days after the end of the outbreak in Équateur province. On 1 August, just after the Ebola epidemic had been declared, Doctors Without Borders/Médecins Sans Frontières (MSF) arrived in Mangina, the point of origin of the outbreak, to mount a response. On 2 August, Oxfam indicated it would be taking part in the response to this latest outbreak in the DRC. On 4 August, the WHO indicated that the current situation in the DRC, due to several factors, warranted a "high risk assessment" at the national and regional level for public health. By 3 August, the virus had developed in multiple locations; cases were reported in five health zones – Beni, Butembo, Oicha, Musienene and Mabalako – in North Kivu