In the latest weekly situation report on the ongoing Ebola outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo (DRC), the World Health Organization (WHO) said half of all recent deaths are taking place in the community—a worrisome sign.
Community deaths, which occur outside of a hospital or Ebola treatment center, threaten to extend the transmission chain of a given case and further accelerate the mounting case count.
The WHO also said that two of the recent cases in Beni were in nurses, bringing the total of healthcare workers infected during this outbreak to 27, including 26 confirmed and 3 deaths. And vaccination efforts have expanded to front-line healthcare workers in neighboring Uganda, the agency noted.
Also today. the WHO said on its Ebola outbreak dashboard there were 3 new cases of Ebola, bringing the outbreak total to 308, including 191 deaths.
As of Nov 4, the case-fatality ratio (CFR) of the outbreak was 62% (186/300). But with more than 30 cases reported in the week of Oct 30 and this week, that percentage could be higher. The outbreak has affected women in greater numbers, with 59% of cases occurring in females, the WHO said. The majority (59%) of cases have also been in teens and younger adults, ages 15 to 44.
A total of 88 patients (as of Nov 4) have recovered, and 91 remain hospitalized at Ebola treatment centers.
About half of all cases in this outbreak have originated in Beni, which has been the site of violence from rebel armed forces who have opposed outbreak response efforts.
"The provinces have been experiencing intense insecurity and a worsening humanitarian crisis, with over one million internally displaced people and continuous movement of refugees to neighbouring countries, including Uganda, Burundi, and Tanzania," the WHO said.
Vaccination, surveillance efforts still under way
Health officials have tracked more than 16,000 case contacts during this outbreak, of which more than 4,000 are still being traced. On average, health workers on the ground are getting 161 alerts of potential cases each day; about 52 cases per day are validated as suspected cases.
"Over the past week, high contact follow-up rates were achieved (ranging 90-92% per day)," the WHO said. However, a large proportion of newly identified cases continue to be detected among individuals who were not previously identified as contacts."
The surveillance activities go hand in hand with the ongoing implementation of a ring vaccination campaign in the DRC. As of Nov 4, officials have identified168 rings, and approximately 27,000 people in the DRC have been vaccinated against the virus, including at least 9,105 healthcare workers and 7,006 children.
Today health officials in Uganda announced that the first wave of health officials have been vaccinated in Ntoroko district, which borders the DRC, according to a WHO news release. Workers in five other high-risk districts bordering the DRC will also be vaccinated.
So far, no Ugandans have contracted the virus during this outbreak.
Nov 6 WHO situation report
Nov 7 WHO Ebola dashboard
Nov 7 WHO Uganda news release