The Ministry of Health in the Democratic Republic of the Congo, WHO and partners are responding to an Ebola virus disease (EVD) outbreak since 1 August 2018, with the epicentre being Mangina town in Mabalako Health Zone, North Kivu Province, in the east of the country. Confirmed cases have also been reported from Beni Health Zone (North Kivu Province) and Mandima Health Zone (Ituri Province).
Since our last situation report on 14 August 2018 (External situation report 2), an additional 45 new confirmed EVD cases and 18 new deaths have been reported. Nine other suspected cases are under investigation to confirm or exclude EVD. By 20 August 2018, 39 case-patients were admitted in Ebola treatment centres (ETCs) in Mabalako (36) and Beni (3).
As of 20 August 2018, a total of 102 confirmed and probable EVD cases, including 59 deaths, have been reported. Of the 102 cases, 75 are confirmed and 27 are probable. Of the 59 deaths, 32 occurred in confirmed cases and 27 remain probable. A total of 13 cases have been reported among health workers, of which, 12 are confirmed and one has died. Since the onset of the outbreak, a total of 10 case-patients have recovered from the disease and were discharged and re-integrated into their communities. Among the 88 cases out of the 102 confirmed and probable cases for which age and sex are known, the median age was 32 years (age range: 0-74), with the age group 30-39 being most affected, accounting for 28% (25/88) cases. Women accounted for 58% (51/88) of all cases.
The epicentre of the outbreak remains Mabalako Health Zone in North Kivu Province, reporting 80% (82) of all cases, including 61 confirmed and 21 probable cases. Additionally, four other health zones in North Kivu Province and one in Ituri Province have reported confirmed and probable cases (Table 1).
As of 20 August 2018, a total of 2 408 contacts were listed, of these, 637 completed their 21-day mandatory follow up period. A total of 1 782 are currently under surveillance, of which 1 686 (95%) were seen on the reporting day.
The Ministry of Health, WHO and partners are monitoring and investigating alerts in other provinces in the Democratic Republic of the Congo and in neighbouring countries. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo as well as in Uganda, Rwanda and the Central African Republic, and, to date, EVD has been ruled out in all these alerts.
North Kivu and Ituri are among the most populated provinces in the Democratic Republic of the Congo. North Kivu shares borders with Uganda and Rwanda. The provinces have been experiencing intense insecurity and a worsening humanitarian crisis, with over one million internally displaced people and a continuous efflux of refugees to neighbouring countries, including Uganda, Burundi and Tanzania. The Democratic Republic of the Congo is also experiencing multiple disease outbreaks, including three separate outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the provinces of Mongola, Maniema and Haut Lomami/Tanganyika/Haut Katanga/Ituri, cholera in 12 provinces, measles spread across the country, and monkeypox.