1. Situation update
The recent escalation in the number of Ebola virus disease (EVD) cases continues in the North Kivu provinces of the Democratic Republic of the Congo. This past week saw 65 new confirmed cases reported in the last seven days, predominantly from the areas of Katwa, Mandima, Butembo, and Vuhovi. During the last 21 days (18 March to 7 April 2019), 58 health areas within 13 health zones reported new cases; 42% of the 137 health areas affected to date (Table 1 and Figure 2). During this period, a total of 199 confirmed cases were reported from Katwa (69), Vuhovi (36), Mandima (30), Beni (18), Butembo (16), Masereka (13), Oicha (8), Kayna (2), Lubero (2), Musienene (2), Kalunguta (1), Bunia (1) and Mabalako (1).
As of 7 April 2019, 1154 EVD cases, including 1088 confirmed and 66 probable cases, were reported. A total of 731 deaths were reported (overall case fatality ratio 63%), including 665 deaths among confirmed cases. Of the 1154 confirmed and probable cases with reported age and sex, 57% (662) were female, and 29% (331) were children aged less than 18 years. The number of healthcare workers affected has risen to 85, including 30 deaths, with three new health workers among the newly confirmed cases in Katwa and one in Musienene.
This week also saw further strengthening of Infection, Prevention and Control (IPC) activities in the various outbreak hotspots. IPC teams on the ground are partaking in community dialogues with local leaders of different health zones to address persisting community reluctance related to decontamination efforts. Current IPC activities continue to be vigorously conducted as per protocol, with IPC rings open around every confirmed case. This includes decontamination of the healthcare facilities and homes, rapid evaluation of IPC practices at healthcare facilities, and identification of other healthcare facilities within a 500 m (urban) or 1 km (rural) radius due to being at high risk of receiving contacts of the case. Based on the results of the healthcare facility assessments, IPC teams follow up with supportive supervision to address any IPC gaps identified, which range from once a day to once a week depending on severity. WHO is confident that a robust implementation of effective IPC measures will aid in slowing the spread of EVD in hotspot areas in the coming weeks.