1. Situation update
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo, continues to prove challenging to contain as ongoing security incidents and community mistrust hamper response efforts. Since our last report on 30 January 2019, 42 additional confirmed EVD cases have been reported, including 23 deaths among confirmed cases. Two healthcare workers were among the newly confirmed cases, bringing the total number of health workers infected to 65, with 22 deaths.
From the beginning of the outbreak to 3 February 2019, a total of 785 EVD cases, including 731 confirmed and 54 probable cases (Table 1), were reported from 18 health zones in the provinces of North Kivu and Ituri (Figure 1). Twelve of the 18 affected health zones have ongoing active transmission, reporting at least one confirmed case in the last 21 days (14 January 2019 to 3 February 2019). Over this period, a total of 123 confirmed cases were reported and the majority of the cases occurred in urban centres and towns including Katwa (78), Butembo (10), Beni (9), Kayna (5), Kyondo (5), Manguredjipa (4), Oicha (4), Biena (3), Kalunguta (2), Mabalako (1), Mutwanga (1), and Vuhovi (1). Katwa, Butembo, and Beni remain notable hotspots for the outbreak, with 97/123 (79%) of cases reported in the last three weeks originating from these areas. Trends in case incidence reflect an increase in the number of cases since the start of this year and continuation of the outbreak across a geographically widely dispersed area (Figure 1, Figure 2). Mabalako, Kalunguta, and Vuhovi are back in the list of health zones that have reported newly confirmed cases in the past 21 days.
As of 3 February 2019, a total of 484 deaths were reported, including 431 deaths among confirmed cases. The case fatality ratio among confirmed cases is 59% (431/731). The sex ratio among confirmed cases is 1.4 (454 females to 331 males).
The Ministry of Health (MoH), WHO and partners continue to monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries. To date, all alerts outside the outbreak affected areas have been investigated or laboratory tested to rule out EVD.