Health officials in the Democratic Republic of the Congo (DRC) said yesterday that an Ebola case has been detected in a previously unaffected health zone, which is located between the two current hot spots, and that eight more cases have been confirmed, based on reports yesterday and today.

Also, the World Health Organization (WHO) again said the increase in Beni and Butembo is concerning, as security incidents threaten residents and frontline workers and pockets of resistance pose tough challenges.

First case in Vuhovi health zone

In its daily update yesterday, the DRC's health ministry said one of three new cases is from Vuhovi health zone, an area between Beni and Butembo. The patient is the husband of a confirmed patient who died in a Butembo Ebola treatment center on Oct 26.

The man refused follow-up and transfer to an Ebola treatment center and died at a Vuhovi health center. where samples were obtained.

Patients with Ebola who are treated in community health centers rather than Ebola treatment centers pose a higher risk of virus spread, given that isolation and infection prevention and control practices aren't as common.

Besides the man who died in Vuhovi, three other deaths were reported yesterday, two from Beni and one from Butembo, and one new death was reported today, that of a patient from Beni.

In today's update, the ministry reported six more cases, four in Beni and two in Butembo.

The new developments lift the overall outbreak total to 285 cases, including 250 confirmed and 35 probable. The fatality count is now at 180.

Also, health officials today said they are investigating 41 suspected Ebola cases.

New surveillance strategy

In other outbreak developments, the health ministry said recent investigation have shown that many of Beni's traditional medicine centers aren't referring patients with suspected Ebola infections to Ebola treatment centers in a timely manner.

To address the gap, officials are implementing a new surveillance strategy covering the city's 254 public and private health centers to see if hospitalized patients have symptoms that resemble Ebola.

"This active search strategy of cases explains the significant increase of the isolated suspect cases and taken in recent days in Beni. On average, surveillance teams visit 140 health facilities a day," the health ministry said.

Also, the health ministry today announced free healthcare in all parts of Butembo health zone as a way to encourage residents to quickly seek care. Free healthcare is already available in Beni, Mabalako, and Oicha health zones.

Amid concerns, significant response improvements

In an update today, the WHO said that, despite the spike in cases in Beni and Butembo over the past 4 weeks, it has seen some significant improvements, including strong performances by field teams conducting investigations, vaccinations, and community engagement and risk communication in target areas.

The agency said that, of 32 cases confirmed since its last update on Oct 25, 24 were in Beni, 7 were in Butembo, and 1 was in Vuhovi. The WHO added that the cases from Butembo are from suburbs and villages within and around the city.

Of the new cases, 14 were in known contacts and one was retrospectively linked to a known transmission chain. Responders are still investigating how 17 were infected.

See also:

Oct 31 DRC update

Nov 1 DRC update

Nov 1 WHO disease outbreak notification