The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern. Simultaneously, relatively small clusters of cases have been observed in other areas of North Kivu and Ituri provinces, which stem from chains of transmission in Katwa and Butembo, but these clusters have largely been contained to limited local transmissions.

Over the last 21 days, no new cases have been detected in 11 of the 20 health zones affected to date, and within the recently affected health zones, transmission has been limited to 34 out of 154 health areas. The response has had traction in these places, despite the challenges of community mistrust engendered by the years of conflict they have endured. The risk of further chains of transmission and spread, however, remain high, as demonstrated by the recent spread to Lubero Health Zone and the reintroduction to Biena Health Zone following a prolonged period without new cases. These events highlight the importance of the response teams remaining active and vigilant across all areas, including those with lower case incidence, to rapidly detect new cases and prevent onward transmission.

As of 10 March 2019, a total of 923 EVD cases, including 858 confirmed and 65 probable cases, were reported from 20 health zones in the North Kivu and Ituri provinces. Overall, cases have been reported from 125 of 319 health areas across 20 health zones. A total of 582 deaths were reported (overall case fatality ratio 63%), including 517 deaths among confirmed cases. Of confirmed and probable cases with reported age and sex, 57% (523/922) were female, and 30% (279/923) were children aged less than 18 years. The cumulative total of confirmed and probable cases among health workers is 74, including 26 deaths.

Nine of the 20 health zones (45%) that have reported at least one case of EVD to date have active virus transmission, reporting at least one confirmed case in the last 21 days (18 February to 10 March 2019). Conversely, there are 11 health zones (55%) where no cases of EVD have been reported in the last 21 days. In total thirty-four (22%) health areas in the 9 zones reported one or more cases.

A total of 80 confirmed cases were reported from Katwa (45), Butembo (18), Mandima (7), Kalunguta (3), Kyondo (2), Masereka (2), Lubero (1), Beni (1) and Biena (1). Most cases were reported in Katwa and Butembo, accounting for 79% (63/80) of cases reported in the last three weeks. A new health zone, Lubero, has reported a confirmed case for the first time, with links to a confirmed case in Butembo.

The Ministry of Health (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. To date, all reported alerts outside the outbreak affected areas have been investigated or laboratory tested to rule out EVD.
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