1. Situation update
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues to evolve. However, the Ministry of Health, WHO and partners have made progress in response to the outbreak. Recent trends (Figure 1) suggest that control measures are working; however, these trends must be interpreted with caution. The outbreak remains active in Beni, Mabalako and Mandima health zones, and additional risks remain following the movement of several cases from these areas to Butembo and Masereka in recent weeks.
Since our last situation report on 4 September 2018 (External situation report 5), an additional 10 new confirmed or probable EVD cases have been reported from Butembo (2), Beni (5) Mabalako (1), Mandima (1), and Masereka (1) and nine new deaths. Currently there are nine suspected cases under investigation (Table 1).
As of 9 September 2018, a total of 132 confirmed and probable EVD cases, including 91 deaths and 36 cases who have recovered, have been reported. Among the 132 cases, 101 are confirmed and 31 are probable. Of the 91 deaths, 60 occurred in confirmed cases.
Among the 123 cases with known age and sex, 58% (71/123) are female and 59% (56/95) of confirmed cases and females aged 44 years were most affected. Among men, the most affected age group is also 35-44 years (Figure 2). The data available for age and sex among deaths are limited. However, where known (n=38) the distribution is similar to known cases.
A total of 17 health workers (16 confirmed and 1 probable) have been affected, three of whom have died. All health workers’ exposures occurred in health facilities outside the dedicated Ebola treatment centres (ETCs).
The epicentres of the outbreak remain Mabalako Health Zone and Beni Health Zone in North Kivu Province, reporting 67.46% (n=87/13229) and 18% (n=24) of all confirmed and probable cases, respectively and 70.769% (63/8991) deaths, including 66 confirmed and 21 probable cases (Table 1 and Figure 3). Additionally, six other health zones in North Kivu Province and one in Ituri Province have reported confirmed and probable cases (Table 1 and Figure 2).
Since the 17 August 2018, a cumulative total of 5306 contact contacts have been listed. Over the past week, 75-97% of contacts were followed-up daily. Response teams are addressing a delay in establishing fully functional contact tracing activities in Butembo and Masereka, which has resulted in a dip in contact tracing performance in the past two days. Several challenges faced by the teams have been overcome and it is anticipated that contact performance will return to high rates in the coming days.
The Ministry of Health (MoH), WHO and partners are monitoring and investigating all alerts in affected areas, in other provinces in the Democratic Republic of the Congo (including Kisangani and Tshopo provinces) and in neighbouring countries. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo as well as in Uganda, Rwanda and the Central African Republic; and to date, EVD has been ruled out in all alerts from neighboring provinces and countries.