The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues with a similar transmission intensity, according to a WHO External Situation Report 49 issued on July 9. While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, WHO says there has been an increase in cases in Beni and a high incidence continues in parts of Mabalako Health Zone.
As of July 7, 2019, a total of 2,418 EVD cases, including 2324 confirmed and 94 probable cases, were reported. A total of 1,630 deaths were reported (overall case fatality ratio 67 percent), including 1,536 deaths among confirmed cases. Of the 2,418 confirmed and probable cases with known age and sex, 56 percent were female, and 29 percent were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 131 (5 percent of total cases).
After the first reported case in the Ariwara Health Zone on June 30, 2019, WHO says no new cases have been observed in that health zone. A response team deployed to that zone continues to identify contacts, engage the community, and vaccinate individuals at risk. Response support from the bordering countries of Uganda and South Sudan continues to support operational readiness activities. Furthermore, resources are being put towards monitoring the Uganda Democratic Republic of the Congo border in that area.
Overall, EVD case incidence rates remained largely unchanged in the past week. In the 21 days between 17 June to 7 July 2019, 70 health areas within 21 health zones reported new cases, representing 11 percent of the 664 health areas within North Kivu and Ituri provinces.
During this period, a total of 250 confirmed cases were reported, the majority of which were from the health zones of Beni (36 percent) and Mabalako (22 percent), which are the main active areas in the outbreak.
The Ministry of Health (MoH) and other national authorities in the Democratic Republic of the Congo, WHO, and partners are implementing several outbreak control interventions together with teams in the surrounding provinces, who are taking measures to ensure that they are response ready. An overview of key activities is summarized below.
Surveillance and laboratory: An average of 1,775 alerts were received per day over the past seven days, of which 93 percent were investigated within 24 hours of reporting.
There are eight laboratories with Ebola virus diagnostic capacity operational in the Democratic Republic of the Congo (located in Mangina, Goma, Komanda, Beni, Butembo, Katwa, Bunia and Kinshasa). All the laboratories are using GeneXpert as the primary diagnostic tool.
A laboratory with the capacity to sequence whole virus genome has been established in Katwa to support virus transmission chain analysis. Sequencing support is also available at the Kinshasa INRB laboratory.
Case management: There are currently 14 operational treatment and transit centers (TC). On November 24, 2018, MoH announced the launch of a randomized control trial (RCT) for Ebola therapeutics. The RCT is now enrolling and treating patients at Ebola treatment center (ETC) sites in Beni, Butembo, Katwa, and Mangina.
The ETCs in Komanda and Bunia continue to enroll confirmed patients into the compassionate use, MEURI, protocol. All patients cared for in ETCs also receive optimized supportive care.
The Mangina ETC/TC has expanded its bed capacity to 90, in order to manage the increased number of suspected and confirmed cases. The Bunia TC has been converted to an ETC. The decentralized approach to transit centers is expanding, with the opening of a decentralized transit center in Vuhovi on July 2 by the MoH and ALIMA.
Infection prevention and control (IPC) and Water, Sanitation and Hygiene (WASH): IPC and WASH activities continue in health facilities and the community. Activities in health facilities currently focus on decontamination, briefing of healthcare workers (HCW) on basic IPC principles, evaluation of IPC practices, and provision of supplies. In communities, teams are supporting decontamination of households where confirmed cases have stayed, and provision of supplies.
Infection, prevention and control activities have started in Ariwara Health Zone, including evaluation of the IPC capabilities of three health facilities, briefing of health workers on specimen collection and preservation, preparation of an isolation room and the start of formation of 59 core IPC focal points on the Aloya, Mabalako and Ngazi axis.
For a complete list of actions MOH is taking, visit WHO for the full report.
