Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 2
1. Situation update
The Ministry of Health in the Democratic Republic of the Congo, WHO and partners are responding to a new Ebola virus disease (EVD) outbreak in the eastern North Kivu Province. On 6 August 2018, the INRB confirmed that the current outbreak is caused by a distinct Ebolavirus (EBOV) strain, different from the one that caused the outbreak in Equateur Province in May-July 2018. This means that, although both events are caused by Zaire Ebolavirus species, the two outbreaks are not connected.
Since our last situation report on 7 August 2018 (External Situation Report 1), 14 additional confirmed EVD cases and seven deaths have been reported. As of 12 August 2018, a total of 57 EVD cases, including 41 deaths have been reported. Of the 57 cases, 30 have been laboratory confirmed and 27 remain probable. Of the 41 deaths, 14 occurred in confirmed cases. Eight healthcare workers (7 confirmed, 1 probable) have been affected, of which one has died. Six health zones in two provinces have reported confirmed and probable EVD cases, including Beni, Butembo, Oicha, Mabalako, and Musienene in North-Kivu Province, and Mandima in Ituri Province (Figure 1). An additional 58 suspected cases are currently pending laboratory testing to confirm or exclude EVD.
As of 11 August, a total of 990 contacts are under surveillance in Mabalako (790), Beni (141) and Mandima (59) health zones. Of these, 129 are healthcare workers in Mabalako (72) and Beni (57) health zones. On 11 August 2018, 940 (95%) contacts were successfully followed up.
On 1 August 2018, the Ministry of Health of the Democratic Republic of the Congo notified WHO of a new outbreak of Ebola virus disease (EVD) in North Kivu Province, in the eastern part of the country. The event was initially reported by the North Kivu Provincial Health authority on 28 July 2018 when a cluster of 26 cases of acute haemorrhagic fever, including 20 deaths (mostly in the community), occurred in Mabalako Health Zone during mid-late July 2018. Local health officials additionally identified sporadic, antecedent deaths in the community since May 2018 (tentatively classified as probable cases), which are subject to ongoing investigations to determine if they are related to the current outbreak.
Blood specimens collected from six hospitalized case-patients on 31 August 2018 were shipped to the Institut National de Recherche Biomédicale (INRB) in Kinshasa. On 1 August 2018, four of the six blood specimens tested positive for Ebolavirus by GeneXpert automated-polymerase chain reaction (PCR) and conventional PCR. The Ministry of Health Officially declared the outbreak on 1 August 2018.
The province of North Kivu is among the most populated provinces, with eight million inhabitants. It shares borders with four other provinces (Ituri, South Kivu, Maniema and Tshopo) as well as with Uganda and Rwanda. The subregion has been experiencing intense insecurity and worsening humanitarian crisis, with over one million internally displaced people and a continuous efflux of refugees to the neighbouring countries, including Uganda, Burundi and Tanzania.