WHO has published its weekly update: Ebola virus disease – Democratic Republic of the Congo. These reports are useful because they tell us more than the DRC MOH updates. Excerpt, with my bolding, and then a comment:
The Ministry of Health (MoH), WHO and partners have continued to face challenges in the containment and control of the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. The number of reported cases increased during recent weeks, most notably from the Katwa health zone where response teams have faced pockets of community mistrust. The outbreak has also extended southwards to Kayina health zone, a high security risk area. Teams are working actively to build community trust and scale up response activities around these new clusters.
Figure 1 shows that as of 22 January 2019, there have been a total of 713 EVD cases (664 confirmed and 49 probable), including 439 deaths (overall case fatality ratio: 62%). Thus far, 247 people have been discharged from Ebola Treatment Centres (ETCs), with many having enrolled in a dedicated program for monitoring and supporting survivors. Among cases with a reported age and sex, 59% (420/710) of cases were female, and 30% (214/708) were aged less than 18 years; including 108 infants and children under 5 years. Sixty-one healthcare workers have been infected to date.
During the last 21 days (2 January – 22 January 2019), 102 new cases have been reported from 13 health zones (Figure 2), including: Katwa (62), Butembo (12), Oicha (6), Kayina (5), Beni (2), Manguredjipa (3), Kyondo (3), Kalungata (2), Komanda (1), Musienene (2), Biena (2), Mabalako (1), and Vuhovi (1).
The current outbreak hotspots of Butembo and Katwa encompass an urban area with a population of approximately one million people. Of the 148 cases reported in Katwa to date, less than half (55/148) were registered as contacts at the time of illness onset. Moreover, 10% (14/148) of these cases comprised of healthcare workers, and among those with available information, 42% (45/107) reported having attended a funeral in the weeks prior to illness onset.
Collectively, these figures suggest that the observed increase in Katwa is being driven by a combination of both healthcare facility and community-based transmissions. Health protection and control measures such as infection prevention and control in health centers, vaccination for healthcare and other frontline workers, and safe and dignified burial practices, are being strengthened to interrupt the chains of transmission.
It must be near-impossible to overcome community suspicion when even the healthcare workers can't protect themselves against infection. However good the response's communication efforts in this outbreak, they haven't been good enough.
