1. Situation update
There was a steady increase in the number of Ebola virus disease (EVD) cases reported during this week in the Democratic Republic of the Congo. The past week was marked by a relative decrease in the number and severity of security incidents, and most response activities were conducted as planned. However, despite this short lull, the situation remains highly unpredictable, as threats against EVD response teams and facilities continue to be received, especially in the Butembo/Katwa hotspot. As such, further attacks or attempted attacks remain likely in the short term. Additionally, in line with the trend observed in the previous few weeks, armed groups’ presence, activities, and increasing direct threats against EVD response teams (leaflets and intimidation of local health workers collaborating with response teams) continue to be reported in Lubero, Kalunguta, Mabalako, Masereka, and Komanda. Another particularly concerning development is that some healthcare workers are refusing to wear personal protective equipment and clothing in healthcare facilities, and performing only normal infection prevention and control measures due to threats of violence by members of the community.
Community members in hotspot areas such as Katwa, Mandima, and Mabalako reportedly continue to feel frustrated by the outbreak response, as indicated in the latest community feedback. However, the Ministry of Health (MoH), WHO, and partners remain committed to strengthening community engagement efforts to help address their feedback, encourage greater participation and ownership of various response activities, and urge individuals suspected to have contracted EVD to proactively engage with response workers and to seek care early in order to improve their chances of survival, as well as to reduce the risks of transmission in the community. Meanwhile, an Infection Prevention and Control (IPC) campaign is currently in progress at four healthcare facilities in Butembo and Katwa. The campaign is promoting key messages for healthcare workers to aid in stopping transmission of EVD within healthcare facilities, specifically addressing hand hygiene and the importance of safe injections. Activities will be in place throughout the week to promote IPC in these facilities.
This week, week ending 19th May, a total of 121 new confirmed cases were reported this week. Most of these cases originated from hotspot areas within the Mabalako, Beni, Butembo, Kalunguta, Katwa, Mandima and Musienene, health zones. In the 21 days between 29 April to 19 May 2019, 86 health areas within 16 health zones reported new cases, representing 48.6% of the 177 health areas affected to date (Table 1 and Figure 2). During this period, a total of 338 confirmed cases were reported, the majority of which were from the health zones of Katwa (22%, n=75), Mabalako (18%, n=62), Butembo (13%, n=44), Beni (11%, n=36), Kalunguta (10%, n=33), Mandima (9%, n=32) and Musienene (9%, n=31).
Cumulatively, as of 19 May 2019, a total of 1826 EVD cases, including 1738 confirmed and 88 probable cases, were reported. A total of 1218 deaths were reported (overall case fatality ratio 67%), including 1130 deaths among confirmed cases. Of the 1826 confirmed and probable cases with known age and sex, 54% (993) were female, and 30% (540) were children aged less than 18 years. The number of healthcare workers affected has risen to 102 (6% of total cases).