The operating environment has become increasingly insecure and socio-politically complex. Insecurity remains a major impediment to ensuring timely response interventions in the affected communities. Ebola virus disease (EVD) response activities in Butembo and Katwa remained limited; however, these are gradually resuming following a comprehensive reinforcement of security measures and community engagement efforts. The overall security situation, nevertheless, remains volatile. While no significant injuries or damages are reported this week, access and activities in parts of Mandima, Masereka, Kalunguta and Vuhovi, remain irregular due to the presence of armed groups and other security concerns. New EVD cases are expected to continue to increase, in tandem with incidents of insecurity in these hotspot areas over the coming weeks, placing significant strain on response teams and the security resources available to secure their movements.
Incidence of EVD cases in the Democratic Republic of the Congo this week saw a considerable, although not unexpected, rise compared to the week prior. This observation is in line with previous instances where a disruption to response activities was followed by a spike in the number of new cases. Transmission remains most intense in the Katwa, Butembo, and Mandima hotspot areas (Figure 1 and Table 1). In addition, notable recurring re-introduction events having been documented in previously affected health zones such as Mabalako and Musienene, followed by local amplification and extension to affect new heath areas. In the 21 days between 10 â€“ 30 April 2019, 70 health areas within 15 health zones reported new cases; 45% of the 157 health areas affected to date (Table 1 and Figure 2). During this period, a total of 292 confirmed cases were reported, the majority of which were from the health zones of Katwa (47%, n=137), Butembo (13%, n=38), Mandima (11%, n=32), Mabalako (7%, n=20), and Musienene (6%, n=17).