1. Situation update
There have been no new cases of Ebola virus disease (EVD) reported since 17 February 2020. The last individual confirmed to have Ebola was discharged from an Ebola Treatment Centre on 3 March after recovering and testing negative for the virus twice. On 9 March, the last contacts finished their follow-up period. These developments are significant milestones in this outbreak. However, there is still a high risk of re-emergence of EVD, and it is critical to maintain response activities to rapidly detect and respond to any new cases, and to continue ongoing support and health monitoring operations for EVD survivors – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.
There is ongoing surveillance, pathogen detection, and clinical management activities in previously affected areas, including alert validation, rapid diagnosis of suspected cases, and building partnerships with community members to strengthen investigation of potential EVD deaths in communities. Insecurity remains a challenge in continuing response activities, which could delay the detection of potential flare-ups.
From 23 to 29 March 2020, 31 265 alerts were reported and investigated. Of these, 2223 alerts were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. On average, people stay in these facilities for three days while waiting for EVD to be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 laboratories. From 23 to 29 March 2020, 2376 samples were tested including: 1322 blood samples from alive, suspected cases; 365 swabs from community deaths; and 689 samples from re-tested patients. Overall, laboratory activities decreased by 14% compared to the prior week.
Alert rates steadily climbed since the beginning of the outbreak response as active and passive case finding systems were strengthened and adapted to suit the local context, reaching additional health zones involved in the evolution of the outbreak. Alert rates have begun to decline, as expected, as the incidence of confirmed cases decreased and disease surveillance activities gradually transitioned toward routine operations. In the current stage of the outbreak, it remains important to maintain appropriate levels of surveillance through the end of outbreak declaration to rapidly detect relapse, reintroduction or new emergence events, implement effective control measures if necessary and avoid a potential resurgence of the outbreak.
As of 31 March 2020, a total of 3453 EVD cases were reported from 29 health zones (Table 1), including 3310 confirmed and 143 probable cases, of which 2273 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (1935) were female, 28% (979) were children aged less than 18 years, and 5% (171) were healthcare workers.
WHO has not received funding for the Ebola response in the Democratic Republic of the Congo since December 2019. An urgent injection of US$ 20 million is required to ensure that response teams have the capacity to maintain the appropriate level of operations through to the beginning of May 2020, and are able to rapidly respond to any flare-ups. If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak. For more information see this recent statement: https://www.who.int/news-room/detail/06-03-2020-end-in-sight-but-flare-u...