1. Situation update
The Ministry of Health in the Democratic Republic of the Congo, World Health Organization (WHO) and partners continue to respond to the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces since 1 August 2018. Since our last situation report on 22 August 2018 (External situation report 3), an additional nine new confirmed EVD cases and 16 new deaths have been reported. Fourteen other suspected cases were under investigation to confirm or exclude EVD. On 26 August 2018, no new confirmed EVD cases were recorded; three deaths among confirmed cases were reported, one in Béni and two in Mabalako; and there were 25 case-patients admitted in the Ebola treatment centres (ETCs) in Mangina (20), Béni (3) and Goma (2).
As of 26 August 2018, a total of 111 confirmed and probable EVD cases, including 75 deaths (case fatality ratio 67.6%), have been reported. Of the 111 cases, 83 are confirmed and 28 are probable. Of the 75 deaths, 47 occurred in confirmed cases. A total of 15 healthcare workers have been affected, of which 14 are confirmed and one has died. Since the onset of the outbreak, 18 case-patients have recovered from the disease, were discharged and re-integrated into their communities. Among 107 out of 111 confirmed and probable cases for which age and sex information is known, the age group 30–44 accounted for 25% (27/107) of all cases, with women accounting for 55% of cases (59/107).
Mabalako Health Zone in North Kivu Province remains the epicentre of the outbreak, accounting for 77% (85/111) of all cases, including 64 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 26 August 2018, a total of 2 445 contacts were under follow up, of which 1 903 (79%) were seen on the reporting day. Over the past two days, the contact tracing exercise was affected by some community resistance, especially in Bingo health area in Mabalako Health Zone and Botsuli health area in Béni Health Zone, as well as by insecurity in Oicha Health Zone.
Alerts have been reported and investigated in several provinces of the Democratic Republic of the Congo as well as its neighbouring countries, namely Burundi, Central African Republic, Rwanda, and Uganda, 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 movement of refugees to neighbouring countries, including Uganda, Burundi and Tanzania. The Democratic Republic of the Congo is also experiencing multiple disease outbreaks, including circulating vaccine-derived poliovirus type 2, cholera, measles, monkeypox, etc.