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Democratic Republic of the Congo: UNICEF DR Congo Ebola Situation Report North Kivu and Ituri - 03 March 2019

Source: UN Children s Fund Country: Democratic Republic of the Congo
Highlights • Out of 20 affected health zones, Katwa remains the current epicentre of the Ebola outbreak, reporting 62 per cent of all cases, followed by Butembo reporting 24 per cent of cases. • Insecurity, combined with resistance and refusals against the response, remain high in current hotspots: in Katwa health zone, the Ebola Treatment Centre (ETC) was burned down and the ETC in Butembo was attacked by armed men. • Having passed the 42-day threshold without cases, Komanda health zone celebrated its success in having currently contained the disease. • 9 out of 20 affected health zones did not report any new cases. • One EVD case in Beni (female) is suspected to be the result of sexual transmission through a recovered EVD survivor. • The overall strategic coordination of the response has moved to the city of Goma. UNICEF relocated a number of senior staff to support the Ministry of Health accordingly. SITUATION IN NUMBERS 897 total reported cases
(MoH, 03 March 2019) 832 confirmed cases
(MoH, 03 March 2019) 246 children lt;18 among confirmed cases
(MoH/WHO, 03 March 2019) 494 deaths among confirmed cases
(MoH, 03 March 2019) 4,765 contacts under surveillance
(MoH, 03 March 2019) UNICEF Ebola Response Appeal
US$ 50.15 million Key Epidemiological Developments Being the second largest known Ebola outbreak in history, the outbreak in the Democratic Republic of Congo (DRC) has reached a total of 832 confirmed cases up to date. Children and women continue to be disproportionately affected by the outbreak, with children under 18 accounting for 30 per cent of confirmed and probable cases. Approximately half of cases among children are under age five. While women have accounted for 57 per cent of EVD cases in average since the start of the outbreak, sex distribution among EVD cases has become more balanced in the recent period as EVD cases among women were reduced to 51 per cent during February 2019. According to WHO, since the start of the epidemic, at least 36 women with EVD were pregnant, which represents 12 per cent of cases in women aged 15-49 years (total 299 women) and 4 per cent of all EVD-infected women. At least 18 women were breastfeeding, which accounts to 6 per cent of cases in women aged 15-49 years and 2 per cent of cases overall. The outbreak is currently taking place in the provinces North Kivu and Ituri, both affected by conflict and armed violence. In accordance with WHO risk assessments, the risk of EVD spreads to other areas remains very high, due to frequent travels between affected areas as well as travels to the rest of the country and neighbouring countries.
During the reporting period, a total of 57 newly confirmed EVD cases were recorded, which is a 29 per cent increase of newly confirmed cases compared to the previous reporting period in which 44 newly confirmed cases were recorded. With the total number of confirmed cases reaching 832, there is an overall increase of cases by 7.3 per cent since the last report (775 confirmed cases). Among the confirmed cases is also the first suspected EVD case (female) of sexual transmission through a recovered survivor. The total number of deaths among confirmed cases reaches 494 individuals, an increase of 4.4 per cent since the previous report (total of 473 deaths among confirmed cases). The case fatality rate among confirmed cases has decreased from 61 to 59 per cent since the last report. Since the beginning of the response, a total of 531 orphans and 624 children separated from their EVD-infected mother and/ or father were identified and assisted by UNICEF. According to WHO, a total of 72 health care workers have been infected with Ebola since the start of the epidemic, which is 8 per cent of all cases, and 24 of them died. During the reporting period, 4 health workers were newly infected with EVD. A total of 304 individuals with confirmed EVD infection have recovered from the disease, 10 of those during the reporting period. The recovery rate is currently at 36.5 per cent. Katwa health zone remains the hotspot of the epidemic having reported 62 per cent of all cases during the past 21 days. In the past two weeks, the number of affected health areas have increased from 9 to 14 out of a total of 18 health areas in Katwa health zone. Butembo, as a bordering health zone, has registered 24 per cent of all cases in 9 out of 15 health areas during the reporting period so that EVD cases are largely concentrated in and around the two health zones of Katwa and Butembo. While community resistance and refusals of response measures remain a major challenge in those hotspot areas, insecurity is the number one concern – both for the responders and the communities. The ETC in Katwa health zone was burned down on 24/25 February and on 27 February the Ebola Treatment Centres (ETC) in Butembo was attacked by unidentified armed men. Both attacks are still under investigation. One health worker died during the attack in Katwa, while the 15 unharmed patients (11 suspected and 4 confirmed cases) were relocated to the CTE in Butembo, where they survived a second attack. In Butembo, one policeman died and three health workers got injured. Among the 50 patients at the ETC in Butembo were 12 confirmed EVD cases and 38 suspect cases. Out of the confirmed cases, 4 patients fled from the CTE and out of the suspected cases, 32 fled and have partly not been found yet. The other patients from the CTE in Butembo were temporarily moved to the closest Transit Centre (TC). Three days after the incident, the CTE Butembo was reopened to manage patients under the leadership of the Ministry of Health in cooperation with WHO and UNICEF. The reconstruction of the CTE in Katwa has begun. In Komanda health zone, no more cases were recorded since 10 January 2019. Not having had any cases for 53 days and thus having passed the 42-day threshold, Komanda health zone celebrated the containment of the disease under the motto that “this battle has been won but that the war is not over yet, the fight continues”. The celebrations were used to raise further awareness about EVD and to encourage the community to remain engaged and to continue to take precautions. In total, 9 out of 20 affected health zones did not report any new cases during the reporting period (Tchomia (since 161 days), Nyakunde (73 days), Komanda (52 days), Mutwanga (28 days), Mangurejipa (27 days), Mabalako (26 days), Oicha (25 days), Bunia (18 days), Vuhovi (16 days). In accordance with the new strategy regarding epidemiological surveillance at entry points, a total of 322 alerts were issued so far. Among the 145 valid alerts 6 EVD cases have been confirmed up to date. Since the beginning of vaccinations against Ebola on 08 August 2018, a total of 85,989 individuals at increased risk of EVD infection (health workers, persons who had contact with EVD infected individuals, contact of contacts, and EVD frontline workers) have been vaccinated in North Kivu and Ituri provinces, reaching 98.1 per cent of the current target of 86,984 individuals to be vaccinated


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