The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continued with a steady transmission intensity this week. Indicators demonstrated the early signs of transmission easing in intensity in some major hotspots, such as Butembo and Katwa. The current hotspots are the health zones of Beni, Mabalako, and Mandima, with some cases being exported from these hotspot areas into unaffected health zones. There is a slight but notable increase in the number of new cases occurring in areas that previously had lower rates of transmission, such as the Komanda, Lubero, and Rwampara/ Bunia health zones. On 30 June, a case who had travelled overland from Beni was confirmed in Ariwara, more than 460 kilometres north of Beni, towards the borders with Uganda and South Sudan. This is the first confirmed case in this health zone, and a response team was deployed from Bunia to investigate and implement public health actions in Ariwara. Uganda and South Sudan have mobilized quickly, building on the preparedness efforts during the last months. Arua district in Uganda shares a border with Ariwara health zone, with high volume of trade and population movement. The Arua District Task Force in Arua mobilized on 2 July to agree on a plan of action, the Ministry of Health (MoH) immediately dispatched the National Rapid Response Team for needs assessment, and the vaccination team from Kasese was also dispatched to Arua district on 3 July to start vaccinating the front-line health workers. In South Sudan, WHO and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) convened a joint meeting with implementing partners on 2 July to plan and coordinate field missions. Joint teams were dispatched to Yei State on 3 July to support operational readiness activities.
In the 21 days from 12 June through 02 July 2019, 73 health areas within 20 health zones reported new cases, representing 11% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 285 confirmed cases were reported, the majority of which were from the health zones of Mabalako (30%, n=85), Beni (27%, n=76), Mandima (8%, n=23), Lubero (6%, n=16) and Kalunguta (5%, n=14). As of 02 July 2019, a total of 2369 EVD cases, including 2275 confirmed and 94 probable cases, were reported (Table 1). A total of 1598 deaths were reported (overall case fatality ratio 68%), including 1504 deaths among confirmed cases. Of the 2369 confirmed and probable cases with known age and sex, 56% (1334) were female, and 29% (691) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected rising to 130 (6% of total cases).