In the past week, from 30 September to 6 October, 14 new confirmed Ebola virus disease (EVD) cases, with an additional nine deaths, have been reported from seven health zones in two affected provinces in the Democratic Republic of the Congo. Although the decline in the number of new cases is encouraging, the recent fluctuations in case numbers per week must be interpreted with caution, as case reporting is contingent upon the level of access and security.
During mid-September, serious security incidents in Lwemba Health Area, Mandima Health Zone, stalled outbreak response activities for more than two weeks. Response activities have since resumed but remain limited. Last week, an open forum for discussion and reconciliation was held in Lwemba with partners and civil society to dispel mistrust and enhance engagement in future response activities. Improved access may result in enhanced case finding and an increase in the number of reported cases from the area.
In the 21 days from 16 September to 6 October, 28 health areas in 11 health zones reported new cases. During this period, a total of 73 confirmed cases were reported, with the majority coming from the health zones of Mambasa (30%; n=22 cases), and Mandima (23%; n=17 cases). In the past 21 days, 10 cases were reported from Komanda and Oicha Health Zones with links to cases from Beni and Mambasa health zones. Issues with under reporting are possible in the Oicha Health Zone, as poor access and security constraints limit response activities. The occurrence of transmission along a major road in from Komanda and Mambasa also poses greater risk of spread westward to other major cities in the Democratic Republic of the Congo (e.g. Kisangani).
As of 6 October 2019, a total of 3205 EVD cases were reported, including 3091 confirmed and 114 probable cases, of which 2142 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 59% (1796) were female, 30% (909) were children aged less than 18 years, and 5% (162) were healthcare workers.
As of 4 October 2019, 1000 people have survived EVD in this outbreak. Of the approximately 1555 confirmed cases admitted to Ebola treatment centers, 1000 of them, or nearly two thirds, have survived. The reintegration of survivors into community can create opportunities to discuss their experiences and strengthen the participation of local communities in the response. Many survivors are working within the response, and are an important part of caring for the sick and reaching out to communities. A programme is in place to monitor survivor health and support them in the year after they leave care.
Under Pillar 1 of the Strategic Response Plan, the estimated funding requirement for all partners for the period July to December 2019 is US$ 287 million, including US$ 120-140 million for WHO. As of 8 October 2019, US$ 60.4 million has been received by WHO, with additional funds committed or pledged. Further resources are needed to fund the response through to December 2019 and into Q1 2020.
Under Pillar 5 Regional Preparedness, the funding requirement for all partners is US$ 66 milllion, of which WHO requires US$ 21 million. As of 8 October 2019, WHO has received US$ 1.6 million. While some additional pledges are in the pipeline, increased funding for preparedness in neighbouring countries is urgently needed. WHO is appealing to donors to provide generous support. A summary of funding received by WHO since the start of this outbreak can be found here.