1. Situation update
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues to be closely monitored, with the Ministry of Health, WHO and partners making progress in response to the outbreak. Recent trends (Figure 1) suggest that control measures are working, although these trends must be interpreted with caution. The outbreak remains ongoing in Beni, Mabalako and Mandima health zones, and additional risks remain following the movement of several cases from these areas to Butembo and Masereka in recent weeks.
Since our last situation report on 11 September 2018 (External Situation Report 6), an additional 10 new confirmed EVD cases and six deaths have been reported (Table 1). As of 16 September 2018, there are seven suspected cases under investigation, with five new confirmed cases in Beni, three in Butembo and two in Mabalako, with four new deaths in confirmed cases in Beni and two in Mabalako (Table 1). Two new cases in healthcare workers have been reported in the last week. Cumulatively, 19 health workers have been affected (18 confirmed and one probable), three of whom have died. All health workers’ exposures occurred in health facilities outside the dedicated ETCs.
As of 16 September 2018, a total of 142 confirmed and probable EVD cases, including 97 deaths, have been reported. Among the 142 cases, 111 are confirmed and 31 are probable. Of the 97 deaths, 66 occurred in confirmed cases. Among the 135 cases with known age and sex, 56% (n=75) are female. Among females the most affected age group is 25-34 years, while among men the most affected age group is 35-44 years (Figure 2). As of 16 September 2018, 38 cases have recovered and been discharged from Ebola treatment centres (ETCs).
A total of 16 cases (10 confirmed and 6 suspected) remain hospitalized in Mangina (2), Beni (8) and Butembo (6). On this reporting date, there were nine new admissions to Ebola treatment centres in Beni (5), Butembo (3) and Mangina (1). Two patients were discharged on the same day, one a previously suspected case and one a previously confirmed case who has now recovered.
The epicentres of the outbreak remain Mabalako and Beni health zones in North Kivu Province, reporting 63% (n=89) and 20% (n=29) of all confirmed and probable cases, respectively. However, since late August 2018, most new cases have occurred in Beni or are related to a Beni transmission chain. Of the total deaths to date, 67% (n=65) are from Mabalako, while 24% (n=23) are from Beni (Table 1 and Figure 3). Additionally, six other health zones in North Kivu Province and one in Ituri Province have reported confirmed and probable cases (Table 1 and Figure 3).
The Ministry of Health (MoH), WHO and partners are monitoring and investigating all alerts in affected areas, in other provinces in the Democratic Republic of the Congo (including Kisangani and Tshopo provinces) and in neighbouring countries. As of 16 September 2018, seven suspected cases are awaiting laboratory testing within outbreak affected areas (Table 1). Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo as well as in Uganda and South Sudan; and to date, EVD has been ruled out in all alerts from neighbouring provinces and countries.