April has brought worsening conditions to the ongoing Ebola outbreak in North Kivu province, Democratic Republic of the Congo (DRC), according to the latest disease outbreak news update from the World Health Organization (WHO), as cases continue to mount.
Both community resistance and violent attacks are on the rise in hot spots such as Katwa and Butembo, the WHO said, and a perceived lull in cases only reflects that surveillance activity has been interrupted due to ongoing security threats.
Efforts halted in some areas
"This past week witnessed a notable escalation of security incidents surrounding the Ebola virus disease (EVD) response efforts," the agency said.
The outbreak region saw two violent attacks on health centers treating Ebola patients, resulting in the death of one WHO epidemiologist, and the injury of two other health workers. Today officials in the DRC said 11 people suspected to have carried out the attack have been arrested.
"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," the WHO said. In addition, the WHO said residences of response personnel will have strengthened security perimeters.
Yesterday, the Associated Press (AP) reported that some clinicians in the region are threatening to strike because of recent attacks. Yesterday in Butembo nurses and doctors dressed in white marched to city hall to give a memorandum to the mayor asking for more protection.
20 cases in past 2 days
Yesterday and today, the DRC recorded 20 new Ebola cases, including 10 death—5 that took place in the community, which raise the risk of disease spread.
The outbreak totals now stand at 1,373 cases, of which 1,307 are confirmed and 66 are probable. Officials have confirmed 890 deaths, and 248 suspected cases are still under investigation.
Overall, the outbreak has a 65% case-fatality rate. Of the total patients, 56% (765) are female, and 28% (386) are children. The total number of health workers infected in the outbreak has reached 90 (7% of all cases), including 33 deaths.
The WHO said that from Apr 3 to Apr 23, 255 confirmed cases were reported in Katwa (132), Butembo (29), Vuhovi (29), Mandima (21), Beni (15), Mabalako (9), Kalunguta (6), Musienene (6), Masereka (5), Oicha (2), and Kyondo (1).
Within those cases are, according to the WHO, a high proportion of community deaths reported among confirmed cases, a relatively low proportion of new cases who were known contacts under surveillance, and the existence of transmission chains linked to nosocomial infection. These factors contribute to the ongoing nature of the outbreak.
The ring vaccination with Merck's rVSV-ZEBOV vaccine continues, with 105,233 people vaccinated to date, including 28,146 in Katwa, 22,969 in Beni, and 12,696 in Butembo.
Apr 25 WHO DON
Apr 24 WHO situation report
Apr 24 AP story
Apr 24 DRC report
Apr 25 DRC report