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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 82

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From 24 February to 1 March 2020, no new confirmed cases of Ebola virus disease (EVD) were reported in the Democratic Republic of the Congo (Figure 1). In the past 21 days (10 February to 1 March), the outbreak has been confined to a relatively small geographic area. During this period, two new confirmed cases were reported from one health area in Beni Health Zone, North Kivu Province (Figure 2, Table 1).
It has been more than 42 days since new cases were detected in all health zones except Beni and Mabalako, though surveillance activities are ongoing in all health zones to avoid resurgence of the outbreak.

Transmission of Ebola virus can occur in groups outside current surveillance activities, even with strengthened operations. Ebola virus persists in some survivors’ body fluids, with potential to infect others and relapse was observed in at least one instance during this outbreak, sparking a new chain of transmission. It is thus crucial to maintain response capacities to rapidly detect and respond to any new cases and to prioritize continued survivor support, monitoring and cooperative relationships with the survivors’ associations. These activities will reinforce surveillance capacity and trust.

Ongoing surveillance, pathogen detection, and clinical management activities include alert validation, contact follow-up, supporting rapid diagnostics of suspected cases, and building partnerships with community members to strengthen investigation of potential EVD patients who pass away in communities. As of 1 March, 139 contacts are currently under surveillance, of which 99% were followed daily in the last seven days. More than 5100 alerts per day continue to be reported and investigated, of which over 400 alerts (including ~70 community deaths) are validated as suspected EVD cases, requiring laboratory testing and specialized care within the established Ebola treatment and transit centres. On average, suspect cases stay in these facilities for three days before EVD can be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 operational laboratories deployed in cities that have been affected by the outbreak. From 24 February to 1 March, more than 3300 samples were tested.

WHO’s financial need for the Ebola Response for January to June 2020 (SRP 4.1) is US$ 83 million.
Thanks to the generosity of donors during 2019, WHO had some carry-over funding available, however,
WHO immediately requires US$ 40 million to ensure continuity of activities.

As of 1 March 2020, a total of 3444 EVD cases, including 3310 confirmed and 134 probable cases have been reported, of which 2264 cases died (overall case fatality ratio 66%). Since August 2018, a total of 134 probable cases have been validated. Of the total confirmed and probable cases, 56% (1927) were female, 28% (973) were children aged less than 18 years, and 5% (171) were healthcare workers .