DRC – Ebola
DONS – Ebola virus disease – Democratic Republic of the Congo
21 March 2019
[Excerpts; Editor’s text bolding]
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces has recently shown an increase in the number of cases reported by week, after many weeks of overall decline… This rise is not unexpected and, in part, likely a result of the increased security challenges, including the recent direct attacks on treatment centers, and pockets of community mistrust, which slowed some response activities in affected areas for a few days…
… Since the beginning of the outbreak to 19 March 2019, 980 EVD cases1 (915 confirmed and 65 probable) have been reported, of which 57% (554) were female and 30% (293) were children aged less than 18 years. Cumulatively, cases have been reported from 130 of 339 health areas across 21 health zones of the North Kivu and Ituri provinces (Table 1). Overall, 610 deaths (case fatality ratio: 62%) have been reported, and 317 patients have been discharged after treatment in ETCs….
WHO risk assessment
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community resistance and mistrust, exacerbated by political tensions and insecurity, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas; reducing the overall effectiveness of interventions. The high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity…