Research and analysis

HPR volume 13 issue 15: news (3 May)

Updated 20 December 2019

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EVD outbreak in eastern DRC: ninth update

There has been a significant deterioration in the outbreak of Ebola virus disease in eastern Democratic Republic of the Congo in the last month.

As of 30 April 2019, 1,429 confirmed and 66 probable cases have been reported in North Kivu and Ituri provinces [1]. Of these, 406 were newly confirmed cases reported between 1 and 30 April, more than twice the number reported in the last monthly update, and the largest monthly total to date in this outbreak (figure 1).

Figure 1. Total EVD cases by month.

Figure 1. Total EVD cases by month. Data provided by DRC MoH [2].

The week to 29 April had the highest number of cases to date (127) during this outbreak (figure 2). There have been 984 deaths, 294 since the last update.

Figure 2. New and total confirmed cases by week.

Figure 2. New and total confirmed cases by week. Data provided by DRC MoH [2].

During April, the main hotspot of transmission was again Katwa (with 184/406, 45%, of cases), with Butembo, Mandima and Vuhovi reporting a further 127 cases (31%). Over three-quarters of April’s cases came from these four health zones, with 15 reporting confirmed cases in the 21 days to 30 April. The number of health zones reporting cases since August 2018 is unchanged at 21. Further healthcare workers were confirmed as cases during April, bringing the total to 92.

Outbreak response continues to be challenged by low proportions of new cases amongst contacts under surveillance, frequent deaths in the community among confirmed cases, transmission linked to nosocomial settings, and delays in case detection and isolation in Ebola treatment centres [3].

During April, the worst attacks yet on response activities took place. A violent armed attack on a hospital in Butembo led to the death of a WHO epidemiologist, injured two other response workers, and destroyed infrastructure. [4] As a result, there have been significant periods when response activities were suspended. In addition, there were other security incidents and intermittent suspensions in Katwa, and access remains challenging in several areas [5].

The WHO IHR Emergency Committee met on 12 April 2019, but did not declare the outbreak to be a public health emergency of international concern. [6] On the same day, WHO published preliminary findings as to the efficacy of the rVSV-ZEBOV-GP Ebola vaccine [7].

Despite the critical situation in DRC, the risk to the UK public remains very low to negligible. The situation is being monitored closely and the risk assessment is regularly reviewed.

Further information sources

References

  1. DRC Ministry of Health update, 1 May 2019 (in French).
  2. DRC Ministry of Health daily updates (in French).
  3. WHO Disease Outbreak News update, 25 April 2019
  4. DRC Ministry of Health, 19 April 2019 (in French).
  5. WHO Disease Outbreak News update, 2 May 2019
  6. WHO IHR Emergency Committee statement, 12 April 2019.
  7. WHO preliminary results of vaccine efficacy, 12 April 2019.

Infection reports in this issue

This issue includes:

Laboratory reports of respiratory infections made to PHE from PHE and NHS laboratories in England and Wales: weeks 14 to 17, 2019.

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