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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 (MoH), WHO and partners making progress in response to the outbreak. A recent increase in the incidence of new cases (Figure 1) reflects the multitude of challenges faced by response teams in recent weeks. The outbreak remains active predominantly in Beni Health Zone, although additional risks remain following the confirmation of EVD cases in Butembo and Mabalako.
Since WHO’s last situation report on 2 October 2018 (External Situation Report 9), an additional 19 new confirmed EVD cases and nine new deaths have been reported. A total of 21 new suspected cases are under investigation in Beni (13), Mabalako (4), Masereka (2) and Tchomia (1).
As of 7 October 2018, a total of 181 confirmed and probable EVD cases, including 115 deaths, have been reported – resulting in a global case fatality ratio (CFR) of 63.5%. Among the 181 cases, 146 are confirmed and 35 are probable. The CFR among confirmed cases only was 54.8% (80/146). As of 7 October 2018, 50 cases have recovered, been discharged from ETCs, and re-integrated into their communities. A total of 32 cases (14 confirmed and 18 suspected) remain hospitalized in the ETCs.
Among the 159 cases with known age and sex, 55% (n=87) are female. Among both males and females, the most affected age group is 35-44 years old (Figure 2). Cumulatively, 19 health workers have been affected, of whom 18 are confirmed cases; three health workers have died. All health workers’ exposures occurred in health facilities outside the dedicated Ebola treatment centres (ETCs).
The confirmed cases were reported from nine health zones: Mabalako (70), Beni (49), Oicha (2), Masereka (1), Butembo (11), Kalunguta (1), Mandima (9), Tchomia (2), and Komanda (1). The epicentres of the outbreak remain Mabalako and Beni Health Zones in North Kivu Province, reporting 50.3% (n=91) and 31.5% (n=57) of all confirmed and probable cases respectively. Beni, Butembo and Mabalako continue to report an increasing number of new cases, indicating the persistence of Ebola virus transmission in these areas. The Beni Health Zone has reported 66% of all cases reported since September 2018. Of the total deaths reported to date, 56.5% (n=65) were from Mabalako, while 30.4% (n=35) were from Beni.
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 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. To date, EVD has been ruled out in all alerts from neighbouring provinces and countries.