In the past week, from 21 to 27 October, 20 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. The incidence of new confirmed EVD cases remains steady as response teams are being strengthened in hotspot areas.
The majority (75%) of newly confirmed cases this past week continue to be reported from or linked to Biakato Mine Health Area, Mandima Health Zone, including four new cases detected outside of Mandima in individuals who recently travelled to Biakato. However, within three health zones beyond Mandima, local transmission was observed. In Mabalako, seven new cases were reported, of which three were linked to Biakato, one case reported local family contact, and one case was a copatient of a confirmed case within a local health facility, suggesting possible nosocomial exposure; investigations are ongoing for the remaining two cases. Kalunguta Health Zone reported two confirmed cases this week, one of which traveled from Biakato to be seek treatment. In Mambasa Health Zone, a chain of transmission linked to the burial of a probable case persists, with one additional case reported in the past week after reporting five cases in the week before.
After over 22 days with no cases reported, Butembo Health Zone reported two new confirmed case. These cases were resident in Kalunguta Health Zone, and similarly exposed in Biakato. Thus far, there is no evidence of onward transmission in Butembo; nonetheless, these events demonstrate the high risk of reintroduction to previously cleared health zones.
In the 21 days from 7 to 27 October 2019, the number of affected health areas has remained the same, with 16 health areas and nine health zones reporting cases. During this period, a total of 56 confirmed cases were reported, with the majority coming from the health zones of Mandima (54%; n=30 cases) and Mabalako (18%; n=10 cases). As of 27 October 2019, a total of 3264 EVD cases were reported, including 3147 confirmed and 117 probable cases, of which 2181 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1838) were female, 28% (926) were children aged less than 18 years, and 5% (163) were healthcare workers.
Under Pillar 1, the public health pillar 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$ 140 million for WHO. As of 28 October 2019, US$ 69.5 million has been received by WHO, with additional funds committed or pledged. Further resources are needed to fully fund the response through to December 2019 and into Q1 2020. Under Pillar 5, the Regional Preparedness pillar, the funding requirement for all partners is US$ 66 million, of which WHO requires US$ 21 million. As of 28 October 2019, WHO has received US$ 4.3 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.