1. Situation update
In the past week, from 28 October to 3 November 2019, 10 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. Though the number of new confirmed EVD cases reported is lower this week, compared to the 20 cases reported last week, security issues and poor access continue to slow response activities in certain health zones. This can prevent the detection of cases in these hard to reach areas.
Violence this week in Lwemba Health Area in the Mandima Health Zone, caused the death of an Ebola response community health worker, and left his spouse critically injured with multiple wounds. WHO and partners condemned the attack, adding that acts of violence against individuals involved with the response are unacceptable and compromise the ability of health workers to provide assistance to communities impacted by the devastating effects of Ebola.
In Biakato Mines, strengthening of community engagement through community dialogue between local leaders and youth groups may have contributed to the improvement of response activities.
The majority (90%) of newly confirmed cases are still being linked back to chains of transmission in Biakato Mine Health Area, and 80% of confirmed cases were registered as contacts. Cases with a history of travel through or a stay in Biakato Mines have been reported in other health areas of Mandima health zone, as well as other health zones, such as Mabalako and Beni. Secondary transmission in these health zones can be expected in the coming weeks. With evidence of population movement eastward from Mambasa to Komanda and towards Bunia, and southward between Mambasa and Mangina, and further south-east through Beni all the way to Kasindi into Uganda, the importance of remaining vigilant and enhancing screening along these major transit roadways and border points is essential.
In the 21 days from 14 October to 3 November 2019, the number of affected health areas has fallen slightly, with 14 health areas and seven health zones reporting cases (Table 1, Figure 2). During this period, a total of 51 confirmed cases were reported, with the majority coming from the health zones of Mandima (51%; n=26 cases), Mabalako (25%; n=13 cases) and Mambasa (12%; n=6 cases)). Nyankunde Health Zone cleared 21 days without a new confirmed case of EVD.
As of 3 November 2019, a total of 3274 EVD cases were reported, including 3157 confirmed and 117 probable cases, of which 2185 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1843) were female, 28% (927) were children aged less than 18 years, and 5% (163) were healthcare workers.