The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues this week with 29 new confirmed cases reported in North Kivu and Ituri provinces from 18-24 September 2019, versus 57 in the previous week. This decrease in the number of cases should be interpreted with caution, as operational and security challenges in certain health zones make it difficult to undertake case detection and response functions.
There has been a recent increase in localized security or community-related incidents in several areas of operation. The recent major security incident in Lwemba, within Mandima Health Zone, has halted response activities for the past nine days. This has limited contact tracing efforts, with 169 and 162 contacts lost to follow up in Lwemba and Mambasa, respectively.
As of 24 September, a total of 3175 EVD cases were reported, including 3063 confirmed and 112 probable cases, of which 2122 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1778) were female, 28% (902) were children aged less than 18 years, and 5% (161) were health workers.
The Democratic Republic of the Congo health authorities have endorsed the use of a second investigational Ebola vaccine with at-risk populations in areas that do not have active EVD transmission. Regular vaccination activities in EVD-affected areas will continue. The Merck/MSD vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola. The Johnson & Johnson vaccine will be deployed by a consortium, including the Ministry of Health, Democratic Republic of the Congo National Institute for Biomedical Research, Coalition for Epidemic Preparedness Innovations, Médecins Sans Frontières (MSF), MSF Epicentre, United Kingdom Public Health Rapid Support Team, Wellcome Trust, and Janssen Vaccines & Prevention B.V. The Institut national de la santé et de la recherche médicale will coordinate the data safety and monitoring board.
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travelers to/from the affected countries.
