The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo, continues to prove challenging to contain as ongoing security incidents and pockets of community mistrust hamper response efforts. Following our last report on 12 February 2019, 24 new EVD cases have been reported, including 20 confirmed and four probable cases. The four probable cases were all deaths that occurred in November and December 2018 in Komanda Health Zone, with a clinical history consistent with EVD but without the opportunity to be tested.
From the beginning of the outbreak to 17 February 2019, a total of 840 EVD cases, including 775 confirmed and 65 probable cases, were reported from 19 health zones in the North Kivu and Ituri provinces. A total of 537 deaths were reported (overall case fatality ratio 64%), including 472 deaths among confirmed cases. To date, 294 people have been discharged from Ebola Treatment Centres (ETCs) and enrolled in a dedicated monitoring and support programme. Of confirmed and probable cases with reported age and sex, 57% (481/841) were female, and 30% (253/842) were children aged less than 18 years. No new cases among healthcare workers were reported in the last week, leaving the number of healthcare workers infected to 68 with 21 deaths.
Thirteen (13) of the 19 affected health zones have active virus transmission, reporting at least one confirmed case in the last 21 days (28 January to 17 February 2019). Over this period, a total of 88 confirmed cases were reported from Katwa (55), Butembo (15), Kyondo (4), Vuhovi (4), Kalunguta (2), Biena (1), Komanda (1), Mabalako (1), Manguredjipa (1), Masereka (1), Mutwanga (1), Oicha (1), and Bunia (1) – a newly affected health zone. The major urban centres of Katwa and Butembo remain notable areas where most cases were reported, with 80% (70/88) of cases reported in the last three weeks. Beni did not report cases in the last three weeks and dropped off the list of health zones with active transmission. Overall, cases have been reported from 119 of 309 (39%) health areas (a subdivision of health zones) across 19 health zones. Thirty-five health areas have reported at least one case in the last 21 days. Trends in case incidence show that the outbreak is continuing, with lower transmission intensity across these geographically dispersed areas.
The Ministry of Health (MoH), WHO and partners continue to monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo and in neighbouring countries. To date, all reported alerts outside the outbreak affected areas have been investigated or laboratory tested to rule out EVD.
