Disease outbreak news: Update
31 January 2019
The Ministry of Health (MoH), WHO and partners continue to respond to an outbreak of Ebola virus disease (EVD), despite persistent challenges around security and community mistrust impacting response measures. Relatively high numbers of cases were reported in recent weeks (Figure 1), mostly driven by the outbreak in Katwa Health Zone; the current focus of large scale response activities. Smaller clusters continue to be reported beyond Katwa Health Zone, including from Beni and Oicha; however, teams have quickly and systematically responded to these clusters to prevent onward transmission and guard against further geographical expansion of the outbreak. Teams are also working actively to strengthen community trust and participation in all affected areas.
As we approach six months since declaration of the outbreak, there have been a total of 752 EVD cases1 (698 confirmed and 54 probable) reported, including 465 deaths (overall case fatality ratio: 62%) as of 29 January 2019. Thus far, 259 people have been discharged from Ebola Treatment Centres (ETCs) and enrolled in a dedicated program for monitoring and supporting survivors. Among cases with a reported age and sex, 59% (439/750) were female, and 30% (224/749) were aged less than 18 years; including 115 children under 5 years.
During the last 21 days (9 January – 29 January 2019), 118 new cases have been reported from 11 health zones (Figure 2), including: Katwa (80), Beni (9), Butembo (7), Kayina (5), Manguredjipa (4), Oicha (4), Biena (3), Kyondo (2), Musienene (2), Komanda (1) and Vuhovi (1). In addition, five historic probable cases from Komanda Health Zone were reported during the past week with illness onset dating back to November 2018.
The outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission events in private and public health centres. Since 1 December 2018, 86% (125/145) of cases in these areas had visited or worked in a health care facility before or after their onset of illness. Of those, 21% (30/145) reported contact with a health care facility before their onset of illness, suggesting possible nosocomial transmission. In Katwa during the past 3 weeks (since 9 January), 49 health structures were identified where confirmed cases were hospitalised, including nine health centres where nosocomial transmission potentially occurred. Moreover, during the same period, eight new health care worker (HCW) infections were reported in Katwa; overall, 65 HCWs have been infected to date. Response teams are following up with the identified health care facilities to address gaps around triage, case detection and infection prevention and control measures.