Today the Democratic Republic of the Congo (DRC) recorded 18 new cases in the ongoing Ebola outbreak in North Kivu and Ituri province, the largest single-day jump since the outbreak began last August. The previous record was 16 cases, on Apr 7.

The spike in cases raises the outbreak total to 1,186, which includes 1,120 confirmed and 66 probable infections. Officials also confirmed 10 new deaths, raising the fatality count to 751. Ten of the new deaths occurred in the community, which raises the risk of disease spread.

Emergency committee to meet

In light of these developments, World Health Organization Director-General Tedros Adhanom Ghebreyesus, PhD, announced today he has reconvened an Emergency Committee under the International Health Regulations (IHR) on Ebola in the DRC.

According to a press release from the WHO emailed to journalists, the committee will meet on Apr 12 in Geneva to decide whether the outbreak constitutes a public health emergency of international concern, and what recommendations should be made to manage the outbreak. This will be the second meeting of the committee on this outbreak; the first took place in October.

"A rising number of security incidents have been restricting access to affected communities in key areas, for vital operations such as surveillance, case investigation, contact tracing and vaccination," the WHO said.

"Transmission has intensified in Butembo/Katwa and surrounding health zones of Vuhovi and Massereka. These factors have led to an increase in cases reported in recent weeks, after a period of decline."

Of the 18 cases recorded today by the DRC, 11 are in Katwa, 3 in Vuhovi, 3 in Mandima, and 1 in Beni.

WHO: 199 cases in 3 weeks

In its latest outbreak update yesterday, the WHO said 199 cases have been confirmed in the 21 days from Mar 18 to Apr 7.

Between Apr 1 and 7 alone, the DRC recorded 65 cases of the viral hemorrhagic disease, predominantly in Katwa, Mandima, Butembo, and Vuhovi, the WHO said. In total, eight health zones reported cases from Apr 5 to Apr 7, and in the past 3 weeks 13 health zones reported new cases. Katwa has the most Ebola cases in recent weeks, with 69.

In addition, cases recorded since Apr 7 illustrate even further that the month is shaping up to be the outbreak's worst, according to data from the DRC health ministry. Officials recorded 40 cases in the 3 days since Apr 7, or 105 in 10 days—more than 10 per day.

"The number of new confirmed cases continues to rise, and the geographical spread of these new cases makes robust contact tracing and line-listing difficult," the WHO said, noting that the continued infection of healthcare workers is of particular concern.

As of Apr 7, a total of 85 health workers had been infected with the virus, 30 fatally, the WHO said. The case-fatality rate of the outbreak stands at 63%, with 57% of cases occurring in female patients, and 29% in children.

In the first week of April, health officials in the DRC received an average of 1,100 alerts per day, of which an average of 992 (90.2%) were investigated within 24 hours of reporting. Officials have been able to track 83% to 87% of contacts, with 8,678 contacts currently under surveillance.

Vaccination, lab testing continues

Eight labs in the North Kivu and Ituri provinces currently test all samples for Ebola, and, as of this week, the laboratory in Katwa has been equipped to sequence whole-virus genomes in order to provide virus transmission chain analysis.

Medical teams in the outbreak zones are also holding specialty eye clinics for survivors, the WHO said in a news story today. After the West Africa outbreak of 2014-2016, researchers discovered that up to 20% of Ebola survivors develop significant eye problems

The WHO said ring vaccination campaigns continue in Beni, Katwa, Butembo, Mandima, Bunia, Vuhovi and Lubero health zones around confirmed cases, and in Goma for front-line providers. Officials have now vaccinated 97,376 people in the DRC, its health ministry said.

See also:

Apr 10 DRC update

Apr 9 WHO situation report

Apr 10 WHO news story

Oct 17, 2018, CIDRAP News story "WHO: DRC Ebola outbreak not international emergency"