1. Situation update
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in Democratic Republic of the Congo (DRC) continues. In the past week, 68 new confirmed EVD cases with an additional 43 deaths have been reported from 13 health zones across the two affected provinces. Most (59%) of the new cases reported in the past seven days were from Beni (n=29) and Mandima (n=11) Health Zones.
Data from a randomized clinical trial were announced this week. The data show, for the first time, that Ebola treatments improve survival rates. Two of the four drugs trialled were found to have the most efficacy, and as a result, changes have been made to the treatment of Ebola patients in the Democratic Republic of the Congo. This should encourage communities to seek care early and is an important step to finding an effective treatment for Ebola. More information is available in the following article, "Update on Ebola drug trial: two strong performers identified".
No new confirmed cases have been reported in Goma city since our last report, with a total of four confirmed cases reported from Goma (n=1) and Nyiragongo (n=3) health zones to date. The two remaining cases in Goma city, who were infected via direct contact with the case reported on 30 July, are being discharged from the hospital today. A total of 232 contacts (including 114 high risk contacts) of the Nyiragongo cases remain under surveillance. Ongoing vaccination activities have reached the majority (98%) of eligible contacts, and 1314 contacts, contacts-of-contacts and frontline workers have been vaccinated to date.
A case was confirmed in the Lolwa Health Zone, which is the first confirmed case in that Health Zone to date, bringing the total number of affected health zones over the course of the outbreak to 27. The case-patient travelled from Mandima to Lolwa, where symptoms started. Currently, there is no evidence of local transmission of EVD in this health zone. Close follow up and identification of contacts is ongoing to minimize the chance of local transmission.
Of the eight cases reported in Mambasa Health Zone in the past 21 days, the majority have epidemiological links to Somé Health Area, with limited local transmission in Mambasa thus far. On 10 August 2019, a case was detected in Butembo Health Zone who had a protracted travel history from Mongbwalu Health Zone, via Beni. If the date of onset and symptoms is confirmed, this would be the first instance of a case originating from this Health Zone. In depth investigations are ongoing to establish any epidemiological links to this case that can reveal more detail as how and where the case-patient became infected.
In the 21 days from 22 July through 11 August 2019, 69 health areas within 17 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces. During this period, a total of 237 confirmed cases were reported, with the majority coming from the health zones of Beni (43%, n=103) and Mandima (21%, n=50).
As of 11 August 2019, a total of 2831 EVD cases were reported, including 2737 confirmed and 94 probable cases, of which 1892 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases with reported sex and age, 57% (1601) were female, and 29% (810) were children aged less than 18 years. Cases continue to be reported among health workers, with the cumulative number infected rising to 151 (5% of all confirmed and probable cases).