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The Ebola Virus Disease (EVD) epidemic in the provinces of North Kivu and Ituri in the Democratic Republic of the Congo continues to pose challenges, with persistent security incidents and resistance from the population to intervention. Since our last report on January 23, 2019, 44 new confirmed cases and five new probable EVD cases have been reported, including 28 deaths. The five probable cases (all deceased) were reported retrospectively to Komanda following an update of the case clbadification. The number of cases in the Katwa and Butembo areas continues to increase rapidly.
Between the beginning of the epidemic and 28 January 2019, a total of 743 EVD cases, including 689 confirmed and 54 probable cases (Table 1), were reported in 18 health zones in North Kivu and from Ituri (Figure 1). Eleven of the 18 health zones affected have active transmission in progress and have reported at least one confirmed case in the last 21 days (January 8 to 28, 2019). During this period, a total of 114 confirmed and probable cases were reported, of which 63% (72/114) were reported in the Katwa Health Zone alone. Overall, the majority of cases occurred in urban centers and cities, including Katwa (72), Beni (8), Butembo (7), Komanda (6), Kayna (5), Oicha (4) ), Manguredjipa (4), Biena (3), Kyondo (2), Musienene (2) and Vuhovi (1). Trends in case incidence reflect the persistence of the epidemic in a geographically dispersed area (Figure 1, Figure 2). Cases reported weekly have increased over the past three weeks, mainly due to the outbreak in Katwa. After several weeks of decline in the number of cases in Beni, six cases have been reported in the last seven days, all related to known chains of transmission.
As of January 28, 2019, a total of 461 deaths were reported, of which 407 were confirmed cases. The case fatality rate among confirmed cases is 59% (407/689). Two new confirmed health workers have been reported since the last report. Since the beginning of the epidemic, 63 health workers have been infected and 21 deaths. Since December 1, 2018, 67% (189/281) of the cases have visited or worked in a health facility before or after the onset of the disease. Of these, 18% (51/281) reported having been in contact with a health facility before the onset of the disease, suggesting possible nosocomial transmission. Health facilities capable of transmitting nosocomiales have been identified and the intervention teams are following up to fill the gaps in triage, case detection and infection prevention and control measures.
The Ministry of Health, WHO and its partners continue to monitor and investigate all alerts in the affected areas, in other provinces of the Democratic Republic of the Congo and in neighboring countries. . To date, all alerts outside areas affected by the outbreak have been excluded from the Ebola virus.
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