The tragic death of the WHO epidemiologist following an attack by armed militia at an Ebola treatment centre (ETC) in Katwa has saddened colleagues and increased security concerns. Many Ebola response activities were suspended in the wake of his death as teams mourned his passing and as further security measures were being reviewed. Two other healthcare workers were injured in the attack but are currently recovering from their injuries.
This past week saw a slight decline in the number of new Ebola virus disease (EVD) cases reported in the North Kivu and Ituri provinces of the Democratic Republic of the Congo, with a total of 80 new confirmed cases reported. However, this reduction should be interpreted with caution following the disruption of surveillance and case investigation activities. Documented transmission, however, remains geographically confined, with the majority of recent cases being reported from hotspot areas within Katwa, Vuhovi, Butembo, Mandima, and Beni health zones. During the last 21 days (2 – 22 April 2019), a total of 253 confirmed and no probable cases were reported: Katwa (130), Vuhovi (31), Butembo (29), Mandima (21), Beni (17), Mabalako (8), Kalunguta (6), Masereka (5), Musienene (3), Oicha (2), and Kyondo (1). During this period, 59 health areas in 11 health zones reported new cases; 41% of the 145 health areas affected to date (Table 1 and Figure 2).
As of 22 April 2019, a total of 1353 EVD cases, including 1287 confirmed and 66 probable cases, were reported. A total of 880 deaths were reported (overall case fatality ratio 65%), including 814 deaths among confirmed cases. Of the 1353 confirmed and probable cases with known age and sex, 56% (758) were female, and 28% (381) were children aged less than 18 years. The number of healthcare workers affected remains 90, including 33 deaths.
As the security and safety of response personnel remain a top priority, efforts are being made across all major stakeholders, including WHO, the UN, and the government of the Democratic Republic of the Congo to strengthen both strategic and operational security measures, and identify any potential security gaps in the field. Additional security measures such as revising movement protocols, improving physical security at all fixed locations, and revamping contingency measures are being reviewed and further intensified. Analyses resultant from these reviews will be used to update the security risk management process. Engagement with communities through direct dialogue is ongoing to gain greater community acceptance, as this is key to an effective response, as well as to ensuring the security and safety of both the outbreak response workers and the patients they are serving. Nevertheless, the overall security situation at this time remains volatile and challenging.