Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 34
1. Situation update
The ongoing Ebola virus disease (EVD) outbreak in the North Kivu and Ituri provinces saw a rise in the number of new cases this past week across several areas. Currently response teams are facing daily challenges in ensuring timely and thorough identification and investigation of all cases amidst a backdrop of sporadic violence from armed groups and pockets of mistrust in some affected communities. Despite this, progress is being made, with areas recently emerging with clusters of cases such as Mandima, Masereka, and Vuhovi gradually becoming accessible to response teams and accepting of proven interventions to break chains of transmission.
During the last 21 days (4-24 March 2019), 50 health areas within 13 health zones reported new cases; 38% of the 133 health areas affected to date (Table 1 and Figure 2). During this period, a total of 115 confirmed cases were reported from Katwa (31), Masereka (19), Mandima (17), Vuhovi (15), Butembo (14), Kalunguta (4), Beni (4), Kayna (3), Lubero (3), Oicha (2), Bunia (1), Biena (1), and Kyondo (1).
As of 24 March 2019, a total of 1016 EVD cases, including 951 confirmed and 65 probable cases, were reported. This includes 634 deaths (overall case fatality ratio 62%), including 569 deaths among confirmed cases. Of 1015 confirmed and probable cases with reported age and sex, 57% (575) were female, and 30% (304) were children aged less than 18 years.
The number of healthcare workers affected has risen to 78, including 27 deaths.
The WHO response is continuing to step up collaboration with communities to increase community acceptance on the ground. Community engagement efforts to encourage greater participation and ownership of the outbreak response is ongoing and has yielded some success in certain health zones/areas. Notable strides have also been made in improving Infection, Prevention and Control (IPC) capacities in health facilities. Since January, IPC field teams have decontaminated over 250 health facilities and households, provided over 100 supply kits, and trained over 3000 healthcare workers in IPC.
A recent National IPC workshop has been completed to aid the implementation of new IPC strategies, while the establishment of an IPC task force has further improved partner communication and coordination at all levels. The work is however ongoing and IPC teams continue to respond to new instances of nosocomial transmission with the emergence of clusters in previously unaffected communities and health facilities.
Security remains a major challenge for ongoing outbreak response efforts. Though successes have been reported from the field, notably in the 10-day lull prior to this past weekend, the overall situation remains fragile. WHO and partners have recently established operational analysis and coordination centres to both gain a more holistic understanding of how communities can be engaged more effectively, as well as to increase awareness of the day-to-day operations to ensure the safety of frontline healthcare workers and the communities they are aiding. WHO and partners have also strengthened physical security in the treatment centres as well as in healthcare workers accommodation.