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New Delhi, April 26, 2019 :
This past week witnessed a notable escalation of security incidents surrounding the Ebola virus disease (EVD) response efforts. On 19 April, an attack on a hospital in Katwa by armed militia resulted in the tragic death of Dr Richard Mouzoko Kiboung, a WHO epidemiologist, and the injury of two other healthcare workers. To ensure the safety of all outbreak responders, Ebola response activities have been temporarily halted in some high-risk health areas until security measures can be reinforced.
WHO, the UN, and the government of the Democratic Republic of the Congo are actively collaborating to review current strategic and operational security measures to ensure the protection of healthcare workers in the field, and improve effective coordination and information sharing amongst all security elements covering the response. Existing operational security measures continue to be implemented and strengthened as well, including the establishment of security perimeters around the residences of EVD response personnel, increasing security at fixed locations, enhancing the joint quick response team (QRT) capacities of local police and UN security forces, and ensuring staff compliance with tracking procedures and adherence to curfew. These measures and other security risk management processes will be continually updated to reflect the needs of the evolving security situation on the ground.
In addition to revising security measures, efforts in community outreach through direct dialogue with various community leaders are also being intensified. Since January, there has been a notable increase in community resistance incidents, primarily around Katwa and Butembo. Incidents in April are anticipated to reach or go beyond March levels. As gaining community understanding and acceptance is integral to our ability to mount an effective outbreak response, community engagement efforts remain a significant element of our response to alleviate future security risks to healthcare workers, develop and increase local community capacity to ensure continuity of response operations, and improve the overall security situation in EVD hotspot areas.
Incidence of EVD cases in the Democratic Republic of the Congo this week saw a lull compared to the week prior (Figure 1). However, this observation should be interpreted with caution and in the context of the recent disruption to response activities and case reporting in certain hotspot areas. In the 21 days between 3 – 23 April 2019, 62 health areas within 11 health zones reported new cases; 42% of the 147 health areas affected to date (Table 1 and Figure 2). During this period, a total of 255 confirmed cases were reported from Katwa (132), Butembo (29), Vuhovi (29), Mandima (21), Beni (15), Mabalako (9), Kalunguta (6), Musienene (6), Masereka (5), Oicha (2), and Kyondo (1).
As of 23 April, a total of 1367 confirmed and probable EVD cases have been reported, of which 885 died (case fatality rate 65%). Of the total cases, 56% (765) were female, and 28% (386) were children aged less than 18 years. The number of healthcare workers affected has risen to 90 (7% of total cases), including 33 deaths. To date, a total of 392 EVD patients who received care at Ebola Treatment Centres (ETCs) have been discharged.
Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 23 April 20191.
Figure 2: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 23 April 2019.
Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 23 April 2019**.
Total cases and areas affected based during the last 21 days are based on the initial date of case alert, and may differ from date of confirmation and daily reporting by the Ministry of Health.
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