The Democratic Republic of the Congo's (DRC) ministry of health recorded 19 new cases of Ebola today in the ongoing outbreak in North Kivu and Ituri provinces. Eleven new deaths were also recorded.
The new cases raise the outbreak total to 1,739, including 1,147 deaths. A total of 332 suspected cases are still under investigation. Six of the newly recorded deaths occurred in the community, raising the risk of further transmission.
Vaccination stopped for 5 days
In a situation update published yesterday, the World Health Organization (WHO) described the recent spike in cases as part of a "stop and go" pattern that's come to define this outbreak.
"Particularly in Butembo and Katwa, response has been reduced to a 'stop and go' pattern, where a day or two of activity is followed by a day or two of suspended or limited activity," the WHO said. "Meanwhile, security measures have been strengthened at many healthcare facilities to aid the resumption of critical healthcare services."
In the 3-week period between Apr 22 and May 12, 343 confirmed cases were reported, with 30% in Katwa, 13% each in Mandima and Mabalako, and 12% in Butembo. These hotspots have been the epicenter of virus activity since January.
The overall case-fatality ratio for this outbreak is 66%. Of the confirmed cases with known age and sex, 56% are female and 29% are children under the age of 18. The number of healthcare workers infected remains 101 (6% of total cases).
The WHO also released new details about a case contact from Beni who traveled to Kampala, Uganda on May 5, when he was on his 7th day of follow-up surveillance.
As of May 8 the man was safely returned to Beni where he will remain until contact tracing is complete. So far, he does not have any symptoms of Ebola.
A total of 14,459 case contacts are currently under surveillance as of May 12, the WHO said, with follow-up rates of around 84%.
The WHO also confirmed vaccination efforts were halted for 5 days recently in Butembo, Katwa, Kalunguta, Vuhovi, Lubero and Masereka health zones following the uprising of motorcycle taxis, which blocked roads, but has resumed in Butembo and Katwa, and continues in Mabalako, Beni, and Mandima.
Today, the DRC confirmed 116,233 people have been vaccinated with Merck's VSV-EBOV since August.
Experts express concern over violence
A feature of this outbreak has been the continued attacks on health care and response workers, which is part of a rising global trend, according to the Safeguarding Health in Conflict Coalition 2018 report.
Last year, 167 health workers died in conflict settings across the globe and at least 710 were injured in more than 900 targeted attacks, up from 701 attacks reported in 2017.
The report is based on data collected from the WHO and the United Nations, and was published today in the British Medical Journal.
Ron Klain, the United States Ebola czar during the West African outbreak, said yesterday at the Pandemic and Biosecurity Forum in Washington, DC, that the WHO's response is inadequate in this type of violent setting.
"If the biggest problems we have right now in the DRC are security, instability, the attacks on health care workers, the attacks on responders, the community resistance — and that community resistance is violent and dangerous — the WHO has no capacity to respond to that," Klain said, according to a news story on Devex, a global development media platform.
Klain has suggested a "white-helmeted security battalion" be employed to protect health workers.
The WHO also concluded its situation report in a somber tone, acknowledging the difficulty of the outbreak.
"The continued increase in the number of new EVD cases in the Democratic Republic of the Congo is worrying, as there appears to be no end in sight to the difficult security situation, complicated by the challenging political environment," the WHO said.
May 15 DRC update
May 14 WHO situation report
May 15 Devex story
May 15 BMJ study