The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues this past week, with a steady and sustained transmission intensity. While the security situation remained relatively calm in the Butembo/Katwa area, there was a resumption of violent community resistance incidents in Beni, coinciding with increased cases and response activities. Armed groups’ movements continued to be reported in Musienene and Manguredjipa, impacting on access to the Kambau health area, neighbouring Mabalako’s hotspot health area, Aloya. The overall security situation in Ituri (Bunia, Komanda) remains tense following the spate of attacks in early June 2019.
Indicators over the past few weeks demonstrated early signs of transmission easing in intensity in some major hotspots such as Butembo and Katwa. However, concerns remain over the concurrent increase in the number of new cases occurring in areas that previously had lower rates of transmission, such as the Komanda, Lubero, and Rwampara health zones. During this past week, Komanda reported the first new case of EVD following 11 days without new cases. In Lubero and Rwampara, rigorous surveillance and contract tracing efforts were able to successfully identify a single chain of transmission in each of the respective health zones. These findings were then swiftly followed up by prompt interventions to prevent further transmission.
Overall, EVD case incidence rates remained largely unchanged in the past week (Figure 1). In the 21 days between 3-23 June 2019, 63 health areas within 16 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces (Table 1 and Figure 2). During this period, a total of 239 confirmed cases were reported, the majority of which were from the health zones of Mabalako (35%; n=84), Beni (15%; n=35), Mandima (14%; n=33), Katwa (7%; n=16), and Kalunguta (6%; n=14). As of 23 June 2019, a total of 2247 EVD cases, including 2153 confirmed and 94 probable cases, were reported. A total of 1510 deaths were reported (overall case fatality ratio 67%), including 1416 deaths among confirmed cases. Of the 2247 confirmed and probable cases with known age and sex, 57% (1273) were female, and 29% (654) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 126 (6% of total cases).