The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues to be closely monitored by the Ministry of Health (MoH), WHO and partners. Of concern is the increased incidence of confirmed cases reported in the past four weeks, most notably in the city of Beni and communities around Butembo. Security remains the biggest challenge faced by the response teams in Beni and Butembo, undermining the response activities. Continued security incidents severely impact both civilians and frontline workers, forcing suspension of EVD response activities and increasing the risk that the virus will continue to spread. Moreover, with heightened transmission of the virus in outbreak affected areas, the risk of exportation of cases to neighbouring provinces and countries is increased. Neighbouring countries need to be ready in case the outbreak spreads beyond the Democratic Republic of the Congo.
Since WHO’s last situation report issued on 23 October 2018 (External Situation Report 12), an additional 36 new confirmed EVD cases and 19 new deaths have been reported. As of 28 October 2018, a total of 274 confirmed and probable EVD cases, including 174 deaths, have been reported – a case fatality ratio (CFR) of 63.5%. Among the 274 cases, 239 are confirmed and 35 are probable cases. Of the 174 deaths reported since the beginning of the outbreak, 139 were among confirmed cases and 35 among probable cases. The proportion of deaths among confirmed cases is 58.2% (139/239). On 28 October, 32 new suspected cases were under investigation in Beni (22), Mabalako (3), Butembo (3), Mandima (2), Masereka (1) and Kalunguta (1).
As of 28 October 2018, 73 cases have recovered, been discharged from Ebola treatment centres (ETCs), and reintegrated into their communities. On 28 October, 32 new patients were admitted to ETCs, bringing the total of hospitalized patients to 77 (45 suspected cases and 32 confirmed cases). On that day, the ETCs in Beni and Butembo recorded a bed occupancy rate of 85% (51/60) and 70% (13/30), respectively.
Among the 271 cases with known age and sex, 56% (n=153) are female, and adults aged 15-44 account for 57% (n=155) (Figure 2). Four new confirmed cases have been reported among healthcare providers (one doctor and 3 nurses) working at various community health centres around Beni, bringing the total health workers affected to 25, including 24 confirmed and three deaths.
The confirmed cases were reported from six health zones in North Kivu Province: Beni (124), Mabalako (71), Butembo (24), Masereka (4), Kalunguta (2), and Oicha (2); and three health zones in Ituri Province: Mandima (9), Tchomia (2) and Komanda (1). Beni has surpassed Mabalako in terms of cumulative number of confirmed cases.
The 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 the Gambia, South Sudan, Tanzania, and Uganda. To date, EVD has been ruled out in all alerts from neighbouring provinces and countries.