The number of new Ebola virus disease (EVD) cases has continued to decrease in recent weeks in Katwa and Butembo, with a total of eight cases reported in these two health zones combined in the past week. On the other hand, case incidence in Mabalako, especially in Aloya Health Area, has grown substantially. In this area, in addition to transmission within community and social settings, an increased number of healthcare worker (HCW) and potential nosocomial infections have been reported, highlighting the ongoing need for further improvement in protecting HCWs and patients in health facilities in these emerging areas. Reintroduction events were also detected in Lubero, Komanda and Rwampara health zones in recent weeks, pointing to the ongoing risk of spread associated with the outbreak in the Democratic Republic of the Congo. These events are also a strain on limited resources available to support operations, including the security required to maintain access across multiple geographical areas.

Overall, case incidence has slightly increased in the past week. In the 21 days between 27 May to 16 June 2019, 64 health areas within 17 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces. During this period, a total of 248 confirmed cases were reported, the majority of which were from the health zones of Mabalako (38%, n=93), Katwa (12%, n=30), Mandima (11%, n=27), Butembo (10%, n=26) and Beni (10%, n=24). As of 16 June 2019, a total of 2168 EVD cases, including 2074 confirmed and 94 probable cases, were reported. A total of 1449 deaths were reported (overall case fatality ratio 67%), including 1355 deaths among confirmed cases. Of the 2168 confirmed and probable cases with known age and sex, 57% (1226) were female, and 29% (632) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 121 (6% of total cases).

On 14 June 2019, a meeting of the Emergency Committee was convened by the WHO Director-General under the International Health Regulations (IHR). The Committee expressed its deep concern about the ongoing outbreak, which, despite some positive epidemiological trends, especially in the epicentres of Butembo and Katwa, shows that the extension and/or reinfection of disease in other areas like Mabalako, presents, once again, challenges around community acceptance and security. In addition, the response continues to be hampered by a lack of adequate funding and strained human resources. It was noted that the cluster of cases in Uganda is not unexpected, and the rapid response and initial containment is a testament to the importance of preparedness in neighbouring countries. It was the view of the Committee that the outbreak is a health emergency in the Democratic Republic of the Congo and the region but does not meet all the criteria for a Public Health Emergency of International Concern (PHEIC). The Committee provided public health advice, which it strongly urged countries and responding partners to heed.

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