Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 45

Report
from World Health Organization
Published on 12 Jun 2019

Ebola in Uganda

Date of issue: 12 June 2019
Data as reported by: 12 June 2019

1. Situation update

On 11 June 2019, the Ugandan Ministry of Health confirmed an outbreak of Ebola virus disease (EVD) in Kasese District, at the border with the Democratic Republic of the Congo. The index case in this outbreak is a 5-year-old boy who fell ill after a visit to Mabalako Health Zone in Democratic Republic of the Congo to attend the burial of his grand-father, a confirmed EVD case, who died in the community on 1 June 2019. The boy and his mother re-entered Uganda (where they reside) through the Bwera Border on 10 June 2019 and presented to Kagando hospital (the same day) with a bleeding diathesis (nose bleeding, vomiting blood, blood in stool and urine) in addition to other symptoms, which included muscle pain, headache, fatigue and abdominal pain. Because of a high index of suspicion of a viral haemorrhagic disease, the case-patient was immediately referred to Bwera Hospital, where a designated Ebola treatment centre (ETC) has been established as part of EVD preparedness. Blood specimens were obtained and transported to the Uganda Virus Research Institute (UVRI) on 10 June 2019. Test results released by UVRI on 11 June 2019 showed that the sample was positive for Ebola Zaire on the first polymerase chain reaction (PCR) run. Additionally, the sample was positive on Ebola rapid diagnostic testing. A third confirmatory test (using EboZai NP primers and probe) was also positive for Ebola Zaire. The Uganda Minister of Health and the WHO Representative in Uganda, in a joint press conference held at 9:00 pm on 11 June 2019, formally declared the EVD outbreak. The child died in the early hours of 12 June 2019.

Two family relations to the index case (the mother and a sibling) developed symptoms and were isolated in Bwera ETC on 11 June 2019. Blood specimens collected and shipped to the UVRI on 11 June 2019 tested positive for EVD on 12 June 2019. Another suspected case has been admitted to the ETC and the test result is pending. A total of eight contacts have been identified and are being closely monitored.

The Ugandan Ministry of Health, WHO and partners have deployed a multisectoral rapid response team to the affected district. Further update on this event will be provided as information comes in.

Ebola in Democratic Republic of the Congo

Date of issue: 12 June 2019
Data as reported by: 10 June 2019

2. Situation update

In the Democratic Republic of the Congo the EVD outbreak continues to show a decrease in the number of new cases, with 54 new confirmed cases reported in the past week, compared to 88 cases reported per week during the last two weeks. While a relatively lower incidence of new cases continues to be seen some hotspots such as Katwa, Beni and Kalunguta health zones, elsewhere the situation appears more tenuous. Active transmission is ongoing in communities within 11 health zones in North Kivu and Ituri provinces.

In the 21 days between 20 May to 10 June 2019, 68 health areas within 11 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces (Table 1 and Figure 2). During this period, a total of 218 confirmed cases were reported, the majority of which were from the health zones of Mabalako (29%, n=64), Butembo (22%, n=47), Katwa (16%, n=35), Mandima (11%, n=24) and Beni (8.2%, n=18). One new confirmed case was reported from Rwampara Health Zone following a prolonged period since the last reported case. This latest case was linked to a confirmed case within Beni Health Zone.

As of 10 June 2019, a total of 2071 EVD cases, including 1977 confirmed and 94 probable cases, were reported. A total of 1396 deaths were reported (overall case fatality ratio 67%), including 1302 deaths among confirmed cases. Of the 2062 confirmed and probable cases with known age and sex, 58% (1187) were female, and 29% (598) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected rising to 115 (6% of total cases).