DRC: Four killed in health center attacks in North Kivu and Ituri, November 28 /update 63

Event

The World Health Organisation (WHO) confirmed that at least four people were killed and several others were injured in two simultaneous attacks targeting Ebola response centers in Mangina (North Kivu) and Byakoto (Ituri) on Thursday, November 28. The attacks, which have affected Ebola response programs, were reportedly carried out by Maï-Maï militiamen. Further spread of the disease is likely in the area.

Attacks targeting those involved in the fight against Ebola - including healthcare workers - and Ebola treatment facilities remain possible in North Kivu, South Kivu, and Ituri provinces over the near term as the disease continues to spread in these areas. According to national health officials, the EVD epidemic death toll in South Kivu, North Kivu, and Ituri provinces has reached 2198 victims as of late November. This represents a total number of victims since the beginning of the outbreak in August 2018, during which at least 3301 cases have been reported. Authorities stated that the risk of regional transmission remains high given the region's high level of insecurity, porous borders, and transient population.

Context

Ebola healthcare workers and treatment facilities have been repeatedly attacked by militants operating in the area in recent weeks and months.

The government's limited presence in the DRC's eastern provinces as well as the presence of numerous armed groups and local self-defense militias have led to continued insecurity in the area. Humanitarian organizations have stated that security conditions in North and South Kivu provinces present a major obstacle to delivering humanitarian assistance to those in need.

EVD is extremely virulent. The disease is transmitted to humans via direct contact with the blood, secretions, organs, or other bodily fluids of infected animals. The disease can then be transmitted between humans and is highly contagious, particularly during the hemorrhagic phase. Ebola is characterized by the sudden onset of high fever, weakness, joint and muscle pain, and headache. A sore throat is also a common early symptom. These symptoms are followed by nausea/vomiting, diarrhea, rashes, kidney and liver failure, and, in some cases, internal and external bleeding.

Advice

Individuals in affected provinces are advised to monitor the situation, remain vigilant for militant activity, and take measures to prevent the contraction and spread of Ebola virus disease (EVD), including:

• Avoid contact with infected individuals and any items that have been in their close proximity.
• Avoid consuming bush meat and only handle animals when wearing gloves and appropriate protective wear.
• Animal products (e.g. meat and blood) should be thoroughly cooked before consumption.
• Adhere to a strict observance of hygienic precautions (e.g. wash hands regularly, etc.).
• Avoid crowded areas (e.g. stadiums, markets, train stations, etc.).

Individuals exhibiting the abovementioned symptoms and traveling in an area of active EVD transmission should seek immediate medical attention and comply with all directives issued by local health authorities.