SitRep 078

Report date 2026-07-31

Published

July 31, 2026

Caution

Machine translation from the French original with Google Gemini. No person has reviewed it.

Every number on this page was compared against the French transcription, and the page is published only if they match. The wording carries no such check. Before relying on any figure, read it in the original PDF.

Affected provinces (5) HAUT-UELE, ITURI, NORD-KIVU, SUD-KIVU & TSHOPO Affected health zones (49) • Haut-Uélé (5/13): Boma Mangbetu, Isiro, Pawa, Rungu and Wamba • Ituri (28/36): Aru, Aungba, Bambu, Bunia, Damas, Drodro, Gethy, Kilo, Komanda, Lita, Logo, Mambasa, Mangala, Mongbwalu, Nizi, Nyankunde, Rimba, Rwampara, Tchomia, Kambala, Nia-Nia, Fataki, Mandima, Lolwa, Boga, Ariwara, Mahagi and Adja. • Nord-Kivu (11/34): Beni, Butembo, Goma, Kalunguta, Katwa, Kyondo, Oicha, Vuhovi, Mabalako, Masereka and Musienene. • Sud-Kivu (1/34): Miti-Murhesa • Tshopo (4/23): Kabondo, Lubunga, Makiso-Kisangani, Mangobo Reporting date 31 July 2026 Publication date 01 August 2026

CONFIRMED CASES — 5 PROVINCES 3 674 +69 new cases (Ituri 53 · N-Kivu 12 · Haut-Uélé 4)

CONFIRMED DEATHS · CASE FATALITY RATE 1 621· (44,1 %) +34 deaths (Ituri 25 · Nord-Kivu 9)

SUSPECTED CASES OF THE DAY 321 Ituri 206 · N-Kivu 87 · Haut-Uélé 22 · Sud-Kivu 6

PATIENTS IN ISOLATION 760 Ituri 525 · N-Kivu 196 · Haut-Uélé 37 · Tshopo 2

RECOVERED — CUMULATIVE 666 +15 recovered (Ituri 13 · Nord-Kivu 2)

NATIONAL CONTACT TRACING 78,0 % 14 436 / 18 508 seen · Ituri 80,0 % - N-Kivu 74,7 % - H-Uélé 66,7 % - Sud-Kivu 100 %

1 Epidemiological highlights

• Epidemiological situation: No new health zone affected in the last 24 hours. The cumulative total remains at 49 affected health zones out of 140 across the five provinces. Tshopo, for its part, reports a fifth affected zone, Wanie-Rukula, where the 7th provincial case was confirmed on 29 July; this classification is not integrated into the cumulative totals pending harmonisation with the provincial health division.

• Case evolution: Over the last 24 hours, 69 new confirmed cases, 34 confirmed deaths and 15 recoveries were recorded.

o Ituri: 53 new confirmed cases were notified in Bunia (16), Nizi (10), Fataki (8), Rwampara (6), Nia-Nia (6), Mongbwalu (4), Lita (1), Mangala (1) and Nyankunde (1), as well as 25 deaths including 15 community deaths (60,0 %). Eleven (11) positive re-samplings were also returned.

o Nord-Kivu: 12 new confirmed cases were notified in Beni (7), Katwa (2), Butembo (1), Kalunguta (1) and Musienene (1), as well as 9 deaths including 5 community deaths. The retained provincial cumulative total reaches 378 confirmed cases and 251 deaths, representing a case fatality rate of 66,4 %.

o Haut-Uélé: 4 new confirmed cases were notified (Isiro 3 and Pawa 1) and no deaths were validated today. The provincial cumulative total rises to 57 confirmed cases and 28 deaths, representing a case fatality rate of 49,1 %, distributed across 5 health zones out of 13.

o Tshopo: no new confirmed cases or deaths were reported. The provincial cumulative total remains at 7 confirmed cases, 5 deaths and 1 recovered patient, representing a case fatality rate of 71,4 %.

o Sud-Kivu: The provincial cumulative total remains at 3 confirmed cases including 1 death and 2 recovered patients. Contact tracing resumes: 78 contacts listed, 23 discharged and 55 under follow-up, all seen (100 %), including 41 in encampment; the note reads “These are contacts of a confirmed death imported from the province of Tshopo”. The number of days without a new confirmed case in Miti-Murhesa: is 52 days since 10 June, the actual interval is 51 days.

• Analysis: Ituri remains the epicentre of the outbreak, accounting for 87,9 % of cumulative cases and 76,8 % of the day’s new confirmations. Contact tracing rises to 78,0 % compared to 75,3 % the previous day, but remains well below the operational threshold of 95 %, whilst the isolation load increases to 760 patients for an overall bed occupancy rate of 72,4 %.

EPIDEMIOLOGICAL AND OPERATIONAL CONTEXT

Declared on 15 May 2026, the 17th outbreak of Ebola virus disease (MVE (Ebola virus disease)) due to Bundibugyo ebolavirus continues its evolution in a complex humanitarian and security context. Initially confined to the Mongbwalu ZS (health zone) (Ituri), it spread to five provinces (Ituri, Nord-Kivu, Sud-Kivu, Haut-Uélé and Tshopo), now affecting 49 health zones. Population movements, insecurity, artisanal mining activities and cross-border trade with Uganda and South Sudan continue to promote transmission. Multisectoral coordination remains mobilised in order to strengthen surveillance, intensify response interventions and limit the spread of the outbreak.

[FIGURE: Figure 1 — Chronology of events in the Ebola-Bundibugyo virus disease outbreak]

2 Descriptive epidemiological analysis

2.1 Distribution by province and active clusters

TABLE 1 — DISTRIBUTION OF CONFIRMED CASES AND DEATHS BY PROVINCE
Province Confirmed cases Deaths Case fatality rate Affected health zones New cases (24 h)
Ituri 3 229 1 336 41,4 % 28 / 36 (77,8 %) 53
Nord-Kivu 378 251 66,4 % 11 / 34 (32,4 %) 12
Haut-Uélé 57 28 49,1 % 5 / 13 (38,5 %) 4
Tshopo 7 5 71,4 % 4 / 23 (17,4 %) 0
Sud-Kivu 3 1 33,3 % 1 / 34 (2,9 %) 0
Total 3 674 1 621 44,1 % 49 sur 140 69

The province of Ituri remains the epicentre of the 17th Ebola virus disease (MVE) outbreak, accounting for 87,9 % of confirmed cases (n = 3 229) and 82,4 % of deaths (n = 1 336), representing a case fatality rate of 41,4 %. The health zones of Bunia (896 cases), Rwampara (633), Mongbwalu (545), Nizi (387), Lita (132) and Nyankunde (115) remain the most affected and account for 83,9 % of cases reported at provincial level and 73,7 % at national level.

2.2 Breakdown by health zone

TABLE 2 — CONFIRMED CASES AND DEATHS BY PROVINCE AND HEALTH ZONE (CUMULATIVE AND SITUATION OF THE DAY)
Province / Health zone Cumulative number Cases (n) Cumulative number Deaths (n) Cumulative Case fatality rate Situation of the day (24 h) New cases Situation of the day (24 h) Community deaths (Swab+). Situation of the day (24 h) Confirmed intra-CTE deaths Situation of the day (24 h) Total confirmed deaths
Ituri 3 229 1 336 41,4% 53 15 10 25
Ituri Adja 11 1 9,1% 0 0 0 0
Ituri Aru 5 5 100,0% 0 0 0 0
Ituri Ariwara 7 2 28,6% 0 0 0 0
Ituri Aungba 9 5 55,6% 0 0 0 0
Ituri Bambu 60 12 20,0% 0 0 0 0
Ituri Boga 1 1 100,0% 0 0 0 0
Ituri Bunia 896 259 28,9% 16 2 0 2
Ituri Damas 17 8 47,1% 0 0 0 0
Ituri Drodro 10 6 60,0% 0 0 0 0
Ituri Fataki 35 17 48,6% 8 5 0 5
Ituri Gethy 1 0 0,0% 0 0 0 0
Ituri Kambala 2 0 0,0% 0 0 0 0
Ituri Kilo 29 11 37,9% 0 0 0 0
Ituri Komanda 36 25 69,4% 0 0 0 0
Ituri Lita 132 79 59,8% 1 0 4 4
Ituri Logo 9 3 33,3% 0 0 0 0
Ituri Lolwa 7 2 28,6% 0 0 0 0
Ituri Mahagi 4 1 25,0% 0 0 0 0
Ituri Mambasa 9 6 66,7% 0 0 0 0
Ituri Mandima 16 12 75,0% 0 0 0 0
Ituri Mangala 102 64 62,7% 1 0 0 0
Ituri Mongbwalu 545 259 47,5% 4 0 1 1
Ituri Nia-Nia 101 53 52,5% 6 1 2 3
Ituri Nizi 387 187 48,3% 10 7 1 8
Ituri Nyankunde 115 32 27,8% 1 0 1 1
Ituri Rimba 9 4 44,4% 0 0 0 0
Ituri Rwampara 633 258 40,8% 6 0 1 1
Ituri Tchomia 41 24 58,5% 0 0 0 0
Nord-Kivu 378 251 66,4% 12 5 4 9
Nord-Kivu Beni 57 46 80,7% 7 4 1 5
Nord-Kivu Butembo 83 65 78,3% 1 0 1 1
Nord-Kivu Goma 1 0 0,0% 0 0 0 0
Nord-Kivu Kalunguta 6 3 50,0% 1 0 0 0
Nord-Kivu Katwa 168 102 60,7% 2 0 2 2
Nord-Kivu Kyondo 13 8 61,5% 0 0 0 0
Nord-Kivu Mabalako 1 0 0,0% 0 0 0 0
Nord-Kivu Masereka 4 0 0,0% 0 0 0 0
Nord-Kivu Musienene 40 23 57,5% 1 1 0 1
Nord-Kivu Oicha 4 3 75,0% 0 0 0 0
Nord-Kivu Vuhovi 1 1 100,0% 0 0 0 0
Sud-Kivu 3 1 33,3% 0 0 0 0
Sud-Kivu Miti-Murhesa 3 1 33,3% 0 0 0 0
Haut-Uélé 57 28 49,1% 4 0 0 0
Haut-Uélé Boma Mangbetu 12 4 33,3% 0 0 0 0
Haut-Uélé Isiro 19 9 47,4% 3 0 0 0
Haut-Uélé Pawa 10 7 70,0% 1 0 0 0
Haut-Uélé Rungu 1 0 0,0% 0 0 0 0
Haut-Uélé Wamba 15 8 53,3% 0 0 0 0
Tshopo 7 5 71,4% 0 0 0 0
Tshopo Kabondo 1 1 100,0% 0 0 0 0
Tshopo Lubunga 1 0 0,0% 0 0 0 0
Tshopo Makiso-Kisangani 4 3 75,0% 0 0 0 0
Tshopo Mangobo 1 1 100,0% 0 0 0 0
Total 3 674 1 621 44,1% 69 20 14 34

2.3 Mapping of confirmed cases

The spatial distribution confirms transmission mainly concentrated in Ituri, notably in the health zones of Bunia, Rwampara, Mongbwalu, Nizi, Lita and Nyankunde, with transmission continuing in already affected zones without new geographical spread over the last 24 hours.

[FIGURE: FIGURE 2 — SPATIAL DISTRIBUTION OF HEALTH ZONES HAVING REPORTED CONFIRMED CASES]

Transmission in already affected health zones, highlighting the need to maintain simultaneously intensive interventions at the epicentre level and preparedness activities in neighbouring provinces.

2.4 Temporal analysis — epidemic curves

The epidemic curve shows sustained transmission during weeks W26 to W31, with fluctuations linked to notification delays and the progressive consolidation of data.

[FIGURE: FIGURE 3 — EPIDEMIC CURVE BY WEEK OF NOTIFICATION]

[FIGURE: FIGURE 4 EPIDEMIC CURVE BY DATE OF ONSET OF SYMPTOMS (DHIS2 LINE LIST)]

The outbreak remains in a phase of sustained transmission, with a high level of virus circulation. Recent fluctuations should be interpreted with caution due to notification delays and progressive data consolidation.

2.5 Demographic characteristics

The age pyramid shows a predominance of working-age adults (18–50 years). Minors under 18 years and people over 50 years are proportionally less affected.

[FIGURE: FIGURE 5 — CONFIRMED CASES BY SEX AND AGE GROUP]

[FIGURE: FIGURE 6 — DEATHS BY SEX AND AGE GROUP (AMONG CONFIRMED CASES)]

The breakdown of cases by sex remains balanced. The predominance of cases among working-age adults reflects more frequent community and occupational exposures, whilst the proportion of paediatric cases demonstrates the persistence of intrafamilial transmission.

3 Surveillance, testing and transmission

3.1 Alert management and sources

TABLE 3 — EPIDEMIOLOGICAL ALERT MANAGEMENT
Indicator Ituri Nord-Kivu Haut-Uélé Tshopo Sud-Kivu Total
Carried over (D-1) 1 169 19 ND 49 238
New alerts received 530 864 3 ND 6 1 403
Total alerts of the day 531 1 033 22 ND 55 1 641
Alerts investigated 408 852 22 ND 10 1 292
Investigation rate (24 h) 76,8% 82,5% 100,0% ND 18,2% 78,7%
Validated alerts — live 125 38 21 ND 6 190
Validated alerts — deceased (comm.) 81 49 1 ND 0 131
Total suspected cases of the day 206 87 22 ND 6 321

In total, 1 641 alerts were managed (including 1 403 new ones), 1 292 investigated within 24 hours (78,7 %) and 321 validated (190 live and 131 community deaths). Nord-Kivu carries most of the volume with 852 alerts investigated at 82,5 %, whilst Ituri stands at 76,8 % out of 531 alerts and Sud-Kivu investigates only 10 out of 55 (18,2 %). Haut-Uélé investigated all of its 22 alerts. Tshopo did not report its alerts for 31 July: its indicators remain not available.

3.2 Laboratory: tests and positivity

→ Ituri: 238 samples documented in the collection network, of which 64 positive (55 live and 7 deaths), — 53 new confirmed cases and 11 re-samplings, representing an apparent positivity of 27,1 %.

→ Nord-Kivu: 127 samples received, among which 12 positive (Beni 7, Butembo 5), representing a positivity of 9,4 %; 44 analyses remain ongoing.

→ Haut-Uélé: 17 samples received, of which 8 analysed: 4 positive results (Isiro 3 and Pawa 1) and 1 invalid result. Only one of the thirteen planned laboratories is operational, at the Cliniques universitaires de l’Uélé in Isiro; the installations in Wamba and Boma Mangbetu are scheduled and a 10 kW solar kit was received from WHO.

→ Tshopo: no samples were reported for the day of 31 July; the provincial cumulative total remains at 7 positive out of 47 tests. Non-compliant samples continue to be reported in the health zones of Lubunga and Opienge, and samples continue to arrive at the laboratory without an investigation form.

→ Sud-Kivu: 11 samples received, none positive. The health zone of Miti-Murhesa remains the only affected one in the province.

3.3 Contact tracing

TABLE 4 — CONTACT TRACING OF CONFIRMED CASES
Province Contacts under follow-up Contacts seen Follow-up rate
Ituri* 11 980 9 588 80,0%
Nord-Kivu* 5 911 4 418 74,7%
Tshopo ND ND ND
Haut-Uélé 562 375 66,7%
Sud-Kivu 55 55 100,0%
Total 18 508 14 436 78,0 %
  • In Ituri and Nord-Kivu, the follow-up rate was calculated only for ZS having reported. The ZS of Kambala, Damas and Mandima (Ituri) and Rungu (Haut-Uélé) did not have usable data at the time of report consolidation. Tshopo did not report its contact tracing for 31 July.

Contact tracing remains insufficient at the national level (78,0 %), below the operational threshold of 95 %, even though it progressed by 2,7 points compared to the previous day. Ituri ensured follow-up of 9 588 contacts out of 11 980 (80,0 %), with the zones of Kambala, Damas and Mandima having not reported. Nord-Kivu achieved 4 418 contacts seen out of 5 911 (74,7 %) and Haut-Uélé 375 out of 562 (66,7 %), with the zone of Rungu remaining without usable data. Sud-Kivu, which is resuming follow-up after several cycles of interruption, saw all of its 55 contacts (100 %). Tshopo did not report its data for 31 July.

3.4 Points of entry and points of control (PoE/PoC)

3.4.1 — Alerts at crossing points (24 h)

Ituri — 4 alerts notified Four alerts were notified at crossing points in the province, including two validated live alerts; none was referred to the CT (transit centre)/CTE (Ebola treatment centre). One lifeless body was intercepted and swabbed (100 %). Four PoC — Mud’zibala, Nyamusasi, Mandje and Irumu Centre — did not transmit their data, with completeness standing at 93,3 % (56/60). Out of 102 561 travellers screened, 96,9 % were screened, 96,5 % washed their hands and 99,5 % were sensitised.

Nord-Kivu — 2 alerts notified Two alerts were notified: one live alert at the Matombo PoC, validated and referred to the CT/CTE (100 %), and one lifeless body intercepted at the Mukulia PoC. Fifteen of the sixteen PoE/PoC reported, with the Makeke PoC not having transmitted (completeness 93,8 %). Out of 59 834 travellers screened, 97,4 % were screened, washed their hands and were sensitised.

Tshopo — not reported No PoE/PoC slide is present in the 31 July deck: the province’s indicators are noted as ND (not available) in Table 5, with the exception of the proportion of activated PoC (4 out of 19), confirmed by the challenges slide. The last available data, published in the previous report, pertained to the day of 29 July.

Haut-Uélé — 0 alerts notified No alert was notified at the activated PoE/PoC of the province. The PoE/PoC pillar slides are blank in the 31 July deck — actual absence verified after file conversion — such that the number of travellers screened and the proportions of screening, handwashing and sensitisation are noted as ND in Table 5.

3.4.2 Monitoring indicators at PoE/PoC

TABLE 5 — MONITORING INDICATORS AT POINTS OF ENTRY AND POINTS OF CONTROL (POE/POC)
Indicators Ituri Nord-Kivu Sud-Kivu Tshopo Haut-Uélé Overall
Proportion of activated PoC and reinforced PoE 100 % (60/60) 100 % (16/16) 100 % (9/9) 21,1 % (4/19) ND 85,6 %*
Number of persons having passed through PoE/PoC 102 561 59 834 83 848 ND ND 246 243
% of travellers screened 96,9 % 97,4 % 100 % ND ND 98,1 %*
% of travellers having washed hands 96,5 % 97,4 % 100 % ND ND 97,9 %*
% of travellers sensitised 99,5 % 97,4 % 100 % ND ND 99,1 %*
Number of alerts notified 4 2 0 ND 0 6
Number of validated live alerts 2 1 0 ND 0 3
Number of lifeless bodies intercepted today 1 1 0 ND 0 2
Number of problematic contacts intercepted today 0 0 0 ND 0 0
% of validated live alerts referred to CT/CTE 0 % (0/2) 100 % (1/1) 0 ND 0 33,3 % (1/3)
% of lifeless bodies swabbed 100 % (1/1) ND 0 ND 0 ND
Number of positive results among referred suspected cases 0 0 0 ND 0 0

4. Clinical management

TABLE 6 — OCCUPANCY OF HEALTHCARE FACILITIES (CTE/CT/CI)
Indicator Ituri Nord-Kivu Haut-Uele Tshopo Overall
Number of beds 821 141 68 20 1 050
Inpatients (D-1) 518 190 22 1 731
Total admissions (24 h) 73 47 ND 1 121
Total admissions 844 368 47 2 1 261
Discharges Deceased 14 4 ND 0 18
Discharges Non-cases 38 33 ND 0 71
Discharges Recovered 13 2 ND 0 15
Discharges Escaped 1 1 ND 0 2
Discharges Transferred to HGR 0 0 ND 0 0
Total discharges (24 h) 66 40 ND 0 106
Patients in isolation (end of D) 525 196 37 2 760
Patients in isolation (end of D) of which confirmed 304 27 16 1 348
Patients in isolation (end of D) of which suspected 221 169 21 1 412
Occupancy rate 63,9% 139,0% 54,4% 10,0% 72,4%

In total, 760 patients were in isolation, including 348 confirmed cases and 412 suspected cases, for an overall bed occupancy rate of 72,4 % (760 patients for 1 050 beds), with 121 admissions and 106 discharges (15 recovered, 18 deaths, 71 non-cases and 2 escaped). Ituri accounts for most of the load with 525 patients in isolation (304 confirmed, 221 suspected) across 821 beds, representing 63,9 % occupancy. In Nord-Kivu, 196 patients are in isolation (27 confirmed, 169 suspected) for an occupancy rate of 139,0 % (141 beds, capacity not reported for five cycles); the movement for the day does not balance by one unit and the retained value is that of the detail by zone. Haut-Uélé has 37 patients in isolation (16 confirmed, 21 suspected) for 68 beds distributed across five CTE (54,4 %), with the Wamba CTE exceeding its capacity for confirmed cases (125 %); its admissions and discharges for the day are noted as ND, the clinical management pillar having not reported. Tshopo has 2 patients in isolation for 20 beds (10,0 %). Despite a provincial occupancy rate of 63,9 % in Ituri, six facilities remain beyond or at the limit of their capacity for confirmed cases: CTE Nizi (322 %), CTE Lita (140 %), CTE ISTM (107 %), CTE Bunia (105 %), CTE CME (100 %) and CTE Fataki (100 %); three CT are saturated for suspected cases: Logo (125 %), Kigonze (113 %) and HGR (general referral hospital) Kilo (100 %).

5 Mental health and psychosocial support (SMSPS (mental health and psychosocial support))

TABLE 7 — SMSPS KEY INDICATORS
SMSPS key indicators Ituri Nord-Kivu
New confirmed cases having benefited from SMSPS interventions 19 (76,0%) 5 (33,3%)
Confirmed cases under follow-up 145 (71,1%) 8 (100,0%)
New suspected cases 23 (40,4%) 56 (57,1%)
Suspected cases under follow-up 120 (71,4%) 45 (68,2%)
Laboratory results announced (of which positive) 50 (17) 48 (15)
Separated children — day nursery / community 1/76 0/7
Caregivers at the CTE 354 34
Frontline personnel (PPL) 15 40
Household and community members 93 65
SDB supported (SMSPS) 19 7

6 Frontline personnel (PPL (person released from treatment (discharged patient))) affected

TABLE 8 — FRONTLINE PERSONNEL (PPL) INFECTED WITH EVD IN ITURI
Health zone Confirmed cases Recovered Hospitalised Deaths
Bunia 35 19 1 14
Rwampara 33 25 1 7
Mongbwalu 21 10 2 9
Nyankunde 14 11 1 2
Nia-Nia 20 1 13 4
Lita 4 1 2 1
Nizi 3 0 0 3
Mangala 4 2 1 1
Bambu 2 2 0 0
Kilo 2 1 1 0
Logo 3 0 3 0
Total — létalité 29,1 % 141 72 25 41

PPL = health personnel and frontline providers.

In Ituri, 141 PPL are confirmed including 41 deaths, representing a case fatality rate of 29,1 %. The breakdown by health zone totals only 138 PPL (72 recovered, 25 hospitalised and 41 deaths): three PPL remain unallocated and must be broken down by the provincial health division. In Nord-Kivu, 11 PPL are confirmed among whom 3 deaths; Haut-Uélé reports 3, representing 5,3 % of its confirmed cases, including one hospitalised at the Isiro CTE.

7 Response activities by pillar

COORDINATION Holding of the response coordination meeting and monitoring of the activities of the.

CONTINUITY OF ESSENTIAL HEALTH SERVICES (CSSE) → Ituri: Continuation of the baseline assessment of free healthcare, phase 1: the free healthcare unit is established (PTF, INSP (National Institute of Public Health), DPS, CSSE pillar, EUP Fass, CDR), hotspot zones and facilities are prioritised, the free package is defined and mapping of partners is completed. 163 ESS were preselected across 137 health areas in 36 zones, including 92 state, 48 faith-based and 23 private; 43 of them already receive support from a partner. Costing establishes a monthly need of 2 209 095 to 3 976 371 USD (77 ESS PCA for 1 842 329 USD and 86 ESS PMA for 366 766 USD). The official directive prohibiting any payment in targeted FOSA and contracting with stakeholders remain uncompleted. Phase 2, “sanitary security”, plans for triage at the entrance, a separate circuit for suspected cases and express SOP/MEGS/PCI training.

LOGISTICS → Ituri: Reception of a second-hand 20 KVA generator and an IT kit (computer, multifunction printer, overhead projector), donations from UNICEF to the Surveillance, PCI (infection prevention and control) and CREC pillars. Delivery of PCI and PECH kits to the ZS of Aungba, Kambala, Lolwa, Mambasa, Angumu, Fataki, Damas and Rimba, PCI kits to the SGI warehouse and the Nia-Nia CTE, and PECH equipment to the Bunia CME CTE; supplement from Africa CDC of one standard Starlink and five mini Starlinks. The vehicle fleet includes 38 vehicles and 10 ambulances distributed between the pillars and nine health zones; 320 litres of fuel were provided to the Safety and Security pillar. Out of 26 ambulances surveyed, 23 are available and 3 broken down (1 in Bambu, 1 FARDC and 1 in the Rwampara ZS); 33 trips were carried out, of which 29 successful, for 25 patients evacuated, with 4 refusals in Bunia. Work ongoing at the Rwankole CTE (tiling, paving and electrical installation) and erection of expansion tents at the Nia-Nia CTE.

→ Nord-Kivu: Delivery of PCI inputs to the Musienene ZS; reception of medicines (donation UG-PDSS) and dignity kits and buckets (donation UNFPA); deployment of pillar teams in the health zones. Logistical indicators remain degraded: 50 functional motorcycles out of 100 expected, 6 vehicles out of 7, 5 ambulances out of 30, no hearses out of 20, 2 CTE constructed according to standards out of 11 and no CT out of 36; no zone is exempt from stockouts of PCI inputs and only 4 zones out of 11 are supplied with holistic clinical management inputs. Tshopo: water supply to the PK 23 PoC, packing and delivery of a PCI kit to the Wanie-Rukula ZS, visit to the construction site of the high-capacity CTE with COUSP (public health emergency operations centre), IMA and MSF; the fleet remains limited to 4 liaison vehicles, 4 motorcycles and 4 ambulances for a requirement of 10 vehicles and 27 motorcycles, and Village Reach delivered only 500 of the 1 000 litres of diesel promised.

PCI / WASH → Ituri: Beginning of the training of 50 healthcare providers and hygienists from the Nizi ZS with support from FHI 360; provision of category 3 PCI-WASH kits in three health facilities (PS CBCA, CS CNCA and CS Bigo) with support from PPSSP/UNICEF and 10 handwashing devices at the Gouvernorat 2 market (FAEVU support). 25 rings opened around cases and 28 sites identified, all decontaminated within 48 hours, representing an execution rate of 100 %; decontamination of 27 of the 69 case households within 48 hours (39,1 %), mainly in Nizi (14), Bunia (5), Rwampara (3), Mongbwalu (2) and Mandima (1); 39 ESS monitored and supported (Bunia 25, Nizi 7, Rwampara 7) out of a target of 394; 180 providers trained (Bunia 140, Bambu 27, Drodro 13). Completeness of PCI reporting remains low, at 10 health zones out of 29 (34 %).

→ Nord-Kivu: Continuation of the training of 20 focal points and 20 PCI/WASH supervisors from the Kalunguta ZS with support from WHO; decontamination of one confirmed case household out of 14 in Musienene and of 3 ESS where cases stayed (Katwa 1, Musienene 2); score card evaluation of one ESS in Beni, average score 51,6 %; monitoring and support of 67 ESS (Beni 38, Oicha 24, Katwa 3, Kyondo 2) and briefing of 240 providers during formative supervisions. Nine staff exposure risk assessments were performed, of which eight at high risk. Completeness reaches only 4 zones out of 11. Tshopo: PCI evaluation of the Konga Konga displaced persons site, score 19,4 %, decontamination of the site and the FONAREV dispensary, delivery of a PCI kit and mattresses to CS Madula and briefing of providers on triage and water chlorination.

COMMUNICATION (RCCE / CREC) → Ituri: 2 717 people reached during 5 home visits, 2 550 during 12 educational talks, 5 325 during 13 mass sensitisations, 4 182 in churches, mosques and markets and 1 282 during 10 community dialogues; 12 people engaged following advocacy. Mass sensitisation of approximately 300 people at the Hoho market (Rwampara ZS) for demystification of the body bag and chlorinated water through practical demonstration, with support from WHO, REMED, Africa CDC, UNICEF and FHI 360. 104 community alerts raised (100 live, 4 deaths); 14 resistances recorded and none lifted, all in the Bunia ZS; 35 feedbacks collected of which 5 clarified (25 %). Capacity building: 35 youth leaders in Mambasa (IMA), 26 IT, ITA and members of ECZ in Mongbwalu (Africa CDC), 30 RECO (community health worker) in Nizi (MEDAIR, FHI 360) and 42 Caritas agents in Bunia (CRS funding). Two radio programmes produced, six spots broadcast, 36 community radio stations engaged.

→ Nord-Kivu: Involvement of the burgomaster of the commune of Bungulu in sensitising his community on prevention measures and safety of intervention teams. Briefing of 17 managers of private health facilities in the Rwenzori commune (Beni ZS) on CREC, community-based surveillance and standard precautions; capacity building of 35 writing club facilitators, AVEC members and psychosocial agents in Vuhovi; prevention radio programme in Njiapanda (Biena ZS) with 76 listeners’ concerns addressed; community dialogue in Itebero with leaders and managers of mining squares on the forest and Kahuzi-Biega National Park axes. 20 825 households visited and 33 785 people reached door-to-door, 4 402 in public places and 1 271 during dialogues and talks; 1 199 people engaged and 210 suspected case alerts raised by community actors; all 34 targeted radio stations broadcast.

→ Tshopo: Meeting of the pillar with situational analysis and deployment of teams by axes (12 participants); advocacy with authorities and influencers in Kisangani for contact tracing of the 7th case (15 participants); focus group with leaders of the Konga Konga displaced persons camp (27 participants); community dialogue and sensitisation at the displaced persons camp, 867 people reached. Support for the training of rapid response teams, follow-up of 7 community alerts in Mangobo and continued broadcasting of spots. Haut-Uélé: continuation of mass sensitisations in churches, 3 816 people reached during home visits in 1 272 households, 1 426 during mass sensitisations and 63 during talks; 3 of the 14 targeted radio stations broadcast; beginning of the translation of IEC tools into Mayogo and Mangbetu.

HOLISTIC CLINICAL MANAGEMENT (PECH) → Ituri: 13 new recovered patients; 525 patients in isolation (304 confirmed, 221 suspected), 73 new admissions and 66 discharges including 14 deaths, 38 non-cases and 1 escaped; 993 hot meals served (139 confirmed, 129 suspected, 690 contacts and 35 PPL), 20 specific diets and 8 children under 6 months on infant formula. The cumulative total of recovered patients reaches 611. Pillar meeting with partners, transfer of patients from ESS, CT and community to CTE, announcement of results and monitoring of expansion and construction work of CTE; continuation of provider training in GIH-mhGAP and monitoring of PECH data entry into DHIS2 at the Bunia HGR CTE.

→ Nord-Kivu: Cumulative total of 142 confirmed cases admitted to CTE/CT for 48 deaths, representing an intra-CTE mortality of 34 %, and 13 lost to follow-up. 47 admissions for the day and 40 discharges (4 deaths, 33 non-cases, 2 recovered and 1 escaped), for 196 patients in isolation at the end of the day (27 confirmed, 169 suspected). Hot meals served to 74 confirmed, 328 suspected, 100 frontline providers and 294 caregivers, and 152 households supported in general food distribution; one separated infant is cared for on breast-milk substitute in Kalunguta. Training of isolation facility providers at Beni HGR and Bundji and Boikene CS with IMC support, evaluation mission in Musienene and joint APATEMACO/WFP supervision in Butembo and Katwa.

→ Haut-Uélé and Tshopo: 2 confirmed were admitted (Boma Mangbetu 1, Wamba 1) and 5 suspected (Wamba 3, Pawa 2), for 37 patients hospitalised at the end of the day (16 confirmed, 21 suspected), admissions and discharges of the day not being reported; Wamba CTE exceeds its capacity in confirmed cases (125 %) and Boma Mangbetu CTE lacks personnel. Visit to the Cliniques universitaires, Libiki Hospital and CS Tuluba, where a PPL is supported. Tshopo: one new admission and no discharges, bringing to 2 the number of patients in isolation; the confirmed case hospitalised at HC Kisangani CTE is stable, on the third day; continuation of experimental treatment of 3 high-risk contacts among frontline providers in the Madula AS (health area) (Wanie-Rukula ZS); cumulative total of hospitalised confirmed cases stands at 4 cases including 2 deaths, 1 recovered and 1 under treatment.

RESEARCH, INNOVATION & VACCINATION → Ituri: Launch of Africa CDC research activities by the Incident Manager, Prof. Steve Ahuka. Pillar meeting and training of investigators for the rapid qualitative survey with Africa CDC support. Final session of challenges analysis for the nine key response pillars and validation of formulated recommendations, with WHO support. Perspectives: start of the community survey after briefing of investigators, organisation of two conferences within the academic community of Bunia and continuation of receipt of partner protocols for analysis and certification. No vaccination activity is reported by the provinces today.

SAFE AND DIGNIFIED BURIALS (EDS) → Ituri: stands at 3 061 alerts for 2 496 EDS conducted between 20 May and 30 July. 72 new alerts and 24 carried over, 54 EDS conducted (56 %), 12 failures and 31 postponed to the following day; 42 swabs were performed, including 30 in the community and 12 in healthcare facilities. Alerts are broken down into 47 community and household alerts, 14 in ESS and 8 in CTE. Beginning of the training of two EDS teams in the Tchomia ZS and conclusion of that of the two teams in the Mangala ZS; 18 EDS benefited from psychosocial support.

→ Nord-Kivu: 33 death alerts received, 33 bodies swabbed and secured and 31 EDS conducted, with no failures; 16 swabbed and secured bodies remain pending. Deaths occurring in ESS constitute the majority of alerts, mainly in Beni (14) and Katwa (12). 34 community deaths benefited from an EDS and 43 were swabbed.

PREVENTION OF SEXUAL EXPLOITATION AND ABUSE (PSEA / PRSEAH) → Ituri: Beginning of briefing and sensitisation by focal points of Fataki and Mandima ZS, and continuation of cascade briefing in Ariwara ZS with WHO support. 62 people briefed (56 men, 6 women), bringing the cumulative total to 2 659 people having signed the code of conduct in seven health zones, and 477 people sensitised (223 men and boys, 254 women and girls), bringing the cumulative total to 15 806. Twelve CBCM were revitalised in Mongbwalu.

8 Main challenges, impacts and required actions

No. Challenges Impact Required actions
1 Reluctance towards post-mortem sampling (SDB/swabs), community resistance and insecurity targeting SDB teams (attack at Muchanga bridge, disruption of activities in Nyankunde) Confirmation delay, underestimation of cases, disruption of key activities Intensify RCCE, involve religious and community leaders, secure teams, increase the number of SDB teams
2 Non-payment of service providers (strike in Bunia and Rwampara ZS; resumption announced after intervention of the military governor of Ituri) Interruption of response activities, including safe and dignified burials Regularise payment of service providers; secure dedicated funding
3 Insufficient CTE/CT capacity: occupancy of 139,0 % in Nord-Kivu (capacity of 141 beds: not reported for five cycles) and six facilities beyond their capacity for confirmed cases in Ituri, including Nizi CTE at 322 % and Lita CTE at 140 %; Admission delays, increased risk of nosocomial transmission Accelerate construction and expansion of CTE, deploy temporary structures, systematically report bed capacities
4 Insufficient contact tracing performance: Ituri 80,0 %, Nord-Kivu 74,7 %, Haut-Uélé 66,7 % and Sud-Kivu 100 %, Tshopo not having reported; Kambala, Damas and Mandima (Ituri) and Rungu (Haut-Uélé) ZS without usable data Transmission chains not interrupted Train, deploy and motivate community health workers (RECO); reinforced supervision; consolidate recovery observed in Ituri
5 Insufficient ambulances and prepositioning at PoC Transfer and isolation delays Preposition ambulances (including at PoE/PoC), deploy CT per ZS
6 Insufficient supply of essential medicines and medical supplies Weakening of overall clinical management Advocacy and urgent supply of essential medicines
7 Insufficient IPC inputs (PPE, chlorine) and limited functional triage units (181/1170, or 15 %) High risk of nosocomial infections (141 PPL cases including 41 deaths in Ituri; 11 PPL including 3 deaths in Nord-Kivu and 3 confirmed PPL in Haut-Uélé) Urgent supply, strengthening of IPC training
8 Geographical spread (Haut-Uélé, Tshopo) and high mobility Risk of urban, riverine and cross-border spread Activate the 23 priority PoE/PoC in Haut-Uélé; strengthen cross-border coordination
9 Installation of local laboratories (Rwampara, Fataki, Bambu-mine, Boga and Mambasa) Long confirmation delays, undetected transmission Accelerate deployment of decentralised diagnostic capacities
10 Insufficient financial resources Limitation of pillar implementation Urgent resource mobilisation, advocacy with partners
11 Insecurity and limited access (CODECO, ADF) Restriction of operations Strengthening of security coordination and humanitarian access
12 Continuity of essential health services (CEHS) compromised Increase in indirect mortality (non-Ebola) Effective implementation of free healthcare, strengthening of CEHS

9 Field activity photos

[PHOTO]

[PHOTO]

Public forum on the perception of the fight against MVE and community involvement in the response against this outbreak at the RUGHENDA roundabout/AS RUGHENDA in the town of But

For the Institut National de la Santé Publique (INSP) of the DRC

The Director-General of INSP Dr MWAMBA KAZADI Dieudonné E-mail: dieudonne.mwamba@insp.cd Tel.: +243 816 040 145

The COU-SP Coordinator Prof. NGANDU Christian E-mail: Christian.ngandu@insp.cd Tel.: +243998091915

The Incident Manager Prof. AHUKA MUNDEKE Steve E-mail: steve.ahuka@unikin.ac.cd

With the technical support of the World Health Organization (OMS) and Africa CDC

FOR ANY ADDITIONAL INFORMATION, PLEASE CONTACT

Source