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Democratic Republic of the Congo: UNICEF DR Congo Ebola Situation Report North Kivu and Ituri - 17 March 2019

Source: UN Children s Fund Country: Democratic Republic of the Congo
Highlights Out of 21 EVD affected Health Zones, Katwa and Butembo Health Zones (HZs) remain the current epicentre of the Ebola outbreak, reporting 57.4 per cent of all cases. With 7 out of 21 affected HZs not having reported any new cases for at least 30 days (EVD incubation period is 21 days), the number of EVD active geographical areas has reduced. Kayna HZ has recorded its second confirmed case, close to the city of Goma. The number of new cases per week has declined from more than 50 cases per week in January to ca. 25 cases per week between February and mid-March. Insecurity and cases of community resistance and refusals against the EVD response remain a major concern for both, the communities and response teams: On 09 March the ETC in Butembo was attacked for a second time by armed men. On 14 March, the Ebola Transit Centre (TC) in Biena was burned down by community members and followed by intimidations of response teams. SITUATION IN NUMBERS 960 total reported cases
(MoH, 17 March 2019) 895 confirmed cases
(MoH, 17 March 2019) 262 children lt;18 among confirmed
cases (MoH/WHO, 17 March 2019) 538 deaths among confirmed cases
(MoH, 17 March 2019) 3,914 contacts under surveillance
(MoH, 17 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 895 confirmed cases up to date. The outbreak continues to take place in the provinces North Kivu and Ituri, both affected by conflict and armed violence. Even though, according to WHO risk assessments, the risk of spillover to neighbouring provinces and countries remains high, international spread has thus far been successfully prevented since the start of this outbreak seven months ago. While children and women used to be disproportionately affected by the outbreak, the representation of EVD-infected women, men, and children has become more balanced in the past two months. Among all confirmed and probable cases, 23.6 per cent are confirmed cases of children under age 13. The percentage of newly EVD infected children under age five has been declining. While in January approximately half of all cases among children were under age five, 2 as at 9 March, only 15 per cent of EVD confirmed children were 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 2019. Between September and December 2018, women represented 62 per cent of all EVD cases, since February 2019, EVD cases among women were reduced to 52 per cent of all cases3 . During the reporting period, a total of 54 newly confirmed EVD cases were recorded and 21 EVD infected individuals died. The total number of deaths among confirmed cases reaches 538 individuals, a percentage increase of 8.9 per cent since the previous report (total of 494 deaths among confirmed cases). The case fatality rate among confirmed cases has increased from 59 to 60 per cent since the last report. The case lethality rate among children under age five is 62 – 83 per cent, similar to the rate among children from 6 to 12 years (57 – 81 per cent). According to WHO, a total of 77 health care workers (confirmed and probable cases) have been infected with Ebola since the start of the epidemic, which is 8.6 per cent of all cases, and 25 of them died (32.4 per cent). During the reporting period, 5 health workers were newly infected with EVD. A total of 308 individuals with confirmed EVD infection have recovered from the disease, 4 of those during the reporting period. Thus, the recovery rate is currently at 34.4 per cent. The two neighbouring health zones Katwa and Butembo remain the epicentres of the epidemic having reported 57.4 per cent of all cases during the past 14 days. As at 12 March, in Katwa HZ, 14 out of 18 health areas have reported at least one confirmed case. Each time there were cases in other towns, they have been linked back to Katwa and Butembo – reflecting the ability of response teams to follow the outbreak closely. Despite the increase of the total number of HZ affected by the disease from 20 to 21 with one newly confirmed case in Lubero HZ, the number of currently EVD-active geographic areas has decreased. Transmission has been stopped in 7 out of 20 affected HZ: Tchomia (for 175 days), Nyakunde (87 days), Komanda (66 days), Mutwanga (42 days), Mangurejipa (41 days), Mabalako (40 days), Oicha (36 days), Bunia (32 days). After having passed the 21-day threshold (25 days without any confirmed EVD cases), on 12 and 13 March Beni HZ recorded 3 new confirmed cases (one dead, two alive) in Mangina health area. A second confirmed case was reported in Kayna HZ, which is of particular concern due to its proximity to the city of Goma and the current cholera outbreak in this HZ. Insecurity and cases of community resistance and refusals of the EVD response remain the number one concern – both for the communities at large and the responders. On 09 March the ETC in Butembo was attacked by armed men for a second time, with one policemen killed. On 14 March, the local Ebola Transit Centre (TC) in Mambowa in Biena HZ was burned down. One community member was killed during police efforts trying to disperse the crowd and a nearby community health centre and several houses were looted. The TC was set on fire by residents following their refusal of the examination of an EVD suspected community death by EVD response teams. Following the incident EVD response teams have received threats by community members. This incident was preceded by attacks on the Ebola Treatment Centres (ETCs) by armed men in Katwa and Butembo in late February. According to the Director General of the World Health Organisation (WHO), the challenge is to maintain the balance between protecting patients and staff from attacks by armed groups and building community trust and ownership. During his visit of the ETC in Butembo, he emphasised that the challenges currently being seen in Katwa and Butembo were those previously seen in Beni. Community resistance and mistrust would have to be anticipated as communities are always cautious and sceptical due to decades of conflict in this area.


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