This past week saw the continued rise in the number of Ebola virus disease (EVD) cases in the North Kivu and Ituri provinces of the Democratic Republic of the Congo, with a total of 110 new confirmed cases. Documented transmission, however, remains geographically confined, with the majority of recent cases reported from the health zones of Katwa, Mandima, Butembo, and Vuhovi. During the last 21 days (25 March to 14 April 2019), 55 health areas within 11 health zones reported new cases; 38% of the 144 health areas affected to date (Table 1 and Figure 2). During this period, a total of 238 confirmed and probable cases were reported from Katwa (119), Vuhovi (41), Mandima (27), Beni (20), Butembo (14), Oicha (7), Mabalako (5), Kalunguta (1), Masereka (1), Musienene (1), and Lubero (1).
As of 14 April 2019, a total of 1264 EVD cases, including 1198 confirmed and 66 probable cases, were reported. A total of 814 deaths were reported (overall case fatality ratio 64%), including 748 deaths among confirmed cases. Of the 1264 confirmed and probable cases with reported age and sex, 56% (712) were female, and 28% (355) were children aged less than 18 years. The number of healthcare workers affected has risen to 89, including 32 deaths, with four new health workers confirmed in the last week; all from community health centres within hotspot areas.
On 12 April 2019, the WHO Director-General convened the International Health Regulation (IHR) Emergency Committee on the EVD outbreak in the Democratic Republic of the Congo. The IHR Emergency Committee commended the efforts of frontline responders from the government of the Democratic Republic of the Congo, WHO, and partners to contain the outbreak in a complex and difficult setting. However, they expressed deep concern about the recent increase in transmission in specific areas and the potential risk of spread to neighbouring countries. The Emergency Committee also provided public health advice to accelerate case detection and contact follow up, to prevent nosocomial transmission and shorten the time between onset of disease and access to high standards of care and therapeutics, strengthen and broaden community acceptance, accelerate preparedness in neighbouring countries including vaccination of health care workers and front-line workers, and strengthen crossborder collaboration, including mapping of population movements and understanding social networks. The Committee has also re-iterated its advice against any travel or trade restrictions in relation to this outbreak and strongly emphasized the need for substantial, immediate, and sustained additional financial support for both preparedness and response efforts. At this time, the Emergency Committee does not believe that the ongoing Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo constitutes a Public Health Emergency of International Concern (PHEIC). Based on the advice of the Emergency Committee, reports made by the affected State Party, and the currently available epidemiological information, the Director-General did not declare the EVD outbreak in the Democratic Republic of the Congo to be a PHEIC. For the complete WHO statement concerning the 12 April IHR Emergency Committee meeting.

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