1. Situation update
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo persists and continues to be closely monitored. Since our last report on 1 January 2019, 17 newly confirmed cases have been reported.
From the beginning of the outbreak through 6 January 2019, a total of 625 EVD cases, including 577 confirmed and 48 probable cases (Table 1), were reported from 16 health zones in the two neighbouring provinces of North Kivu and Ituri (Figure 1), of which ten health zones reported at least one confirmed case in the last 21 days (17 December 2018 � 6 January 2019). Over this period, 80 confirmed cases were reported from ten health zones, the majority of which were concentrated in major urban centres and towns in Beni (12), Butembo (15), Kalunguta (6), Katwa (19), Komanda (4), Kyondo (1), Mabalako (9), Musienene (1), Nyankunde (1), and Oicha (12).
Trends in case incidence (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas. The reported number of cases in epidemiological week 1 (31 December 2018 - 6 January 2019) has increased with 27 new confirmed cases compared to 19 new confirmed cases in week 52 (24 - 30 December 2018).
During week 1, the number of reported deaths among confirmed cases was 13, of which three (23%) were community deaths. Promising declines in case incidence in areas such as Beni have continued. However, here and elsewhere, these trends must be interpreted cautiously, as delayed detection of cases is expected following recent temporary disruption in response activities due to insecurity. The outbreak remains highly active across all areas listed above. Hard-earned progress could still be lost from prolonged periods of insecurity hampering containment efforts.
As of 6 January 2018, a cumulative total of 377 deaths were reported, including 329 deaths among confirmed cases. The case fatality ratio among confirmed cases is 57% (329/577). An additional health worker was identified retrospectively among the cases, and the number of healthcare workers infected to date is now 55, with 18 deaths.
The MoH, WHO and partners continue to monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, Uganda, South Sudan, and a traveller returning from Burundi to Sweden. To date, EVD has been ruled out in all alerts outside the above-mentioned outbreak affected areas. International travellers who may have come into contact with the virus, including a doctor who returned to the United States of America after providing medical assistance in the Democratic Republic of the Congo, are also being followed closely; all remain asymptomatic to date.
Source: World Health Organization