Today the Democratic Republic of the Congo (DRC) recorded 13 new Ebola cases in its daily update. Six of the new cases are in Butembo, three in Oicha, and two each in Beni and Katwa.

The outbreak totals now stand at 471 cases, of which 423 are confirmed and 48 are probable; 273 people have died. And the World Health Organization (WHO) said yesterday that it is concerned about reintroduction of the virus into the outbreak region.

Officials confirmed five new deaths yesterday and today, including a community death in Komanda, which raises the risk of transmission among care givers. A total of 106 suspected cases are still under investigation, the DRC health ministry said.

Facing violence, community resistance

Today Oly Ilunga Kalenga, MD, the DRC's minister of health, held a press conference in Kinshasa to update the public on the outbreak, now in its fifth month. He said the past 3 weeks have seen cases spike in Butembo and Katwa, and he attributed the increase to three major causes.

First, Kalenga said these communities are marked by high population density and mobility, as it is the major trading region of North Kivu. He also said that small pockets of violent, community resistance have limited response efforts at time.

"The expression of reluctance by the community is more violent than the reluctance usually observed during previous Ebola outbreaks," Kalenga said. "A minority of the population in these areas express their reluctance through the regular destruction of medical equipment and health centers as well as the physical attacks of health workers."

Finally, Kalenga said that 44 health workers have contracted Ebola during this outbreak, or 9% of the case total, and 12 have died. Infections in healthcare workers are always problematic during Ebola outbreaks, as they lead to nosocomial infections, he said.

Kalenga estimated that tens of thousands of Congolese have been protected from the disease through the use Merck's unlicensed Ebola vaccine, which has been used throughout the region since August. As of today, 41,226 people have been vaccinated, including 3,556 in Butembo.

DRC, Uganda coordinate responses

Yesterday health officials from the DRC and neighboring Uganda met in Goma for a bilateral information exchange, which aimed to strengthen disease surveillance on the border.

According to All Africa, the countries agreed to mapping common border crossing points for joint screening.

Also yesterday, the World Health Organization (WHO) published its 18th situation report on the outbreak. From Nov 27 to Dec 3, officials confirmed 31 Ebola cases in eight health districts.

"The health zones of Komanda, Masereka and Mabalako have reported one new confirmed case each, respectively 61 days, 48 days and 56 days after confirmation of previously confirmed cases, and investigations are ongoing regarding links and travel history from other areas to these cases," the WHO said. It added that the reemergence of Ebola in these three zones highlights the possibility of virus reintroduction in communities throughout North Kivu and Ituri provinces.

The WHO said the outbreak remains "serious and unpredictable." Contact surveillance activity continues, with 5,335 people being actively traced as of Dec 3. On average, health workers receive 212 alerts to possible infections per day, of which 64 are validated as suspected cases.

See also:

Dec 6 DRC update

Dec 6 All Africa news story

Dec 6 WHO situation report