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Online Discussion: Tracking new emerging diseases and the next pandemic

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Why the DRC’s latest Ebola outbreak is more worrisome than the last

By Maeva Bambuck Feb 26, 2019

BENI, Congo — It's now more than six months since the start of an Ebola outbreak in the eastern part of the Democratic Republic of Congo. And even though doctors were better prepared for this outbreak, it's already been particularly deadly, partly because it's happening in a war zone.

The current epidemic of the virus has claimed about 500 lives, and there's concern it may spread to a major population center.

When the virus hit last August, doctors had learned from previous outbreaks in Central Africa and the western part of DRC how to quickly set up treatment centers, gear up doctors with hazmat suits, and organize the response, which includes caregiving by people who survived the virus and are now immune.

But Ebola is a cruel killer, and by hitting north Kivu it targeted an already vulnerable population. An Islamist militant group called the Allied Defence Force (ADF) is fighting the army for territory and terrorizing the population. Roads are often too dangerous for medical response teams to reach the sick and stop them from spreading the disease.

“Once a village is attacked, there’s a movement of people, so the sick person moves, and the disease spreads from one village to another," said Justus Nsio Mbeta, a representative of the Ministry of Health in the village of Beni. In addition, gangs often take advantage of the lawlessness to loot villages and kidnap women.

As part of the response, the pharmaceutical giant Merck is sending a new batch of promising experimental vaccines to the World Health Organization in the region to vaccinate healthy populations as well as in neighboring countries to stop the spread of the virus. It can't come soon enough, with the health community worrying Ebola might reach Goma, a densely populated city of 1 million, where it would spread faster than in the countryside. So far, there have not been any reported cases.


"Clearly, we can't become complacent," Matshidiso Moeti, WHO's regional director for Africa, said earlier this month. "The greatest risk, which is related to insecurity, continues to be a factor."

Source:   https://news.vice.com/en_us/article/9kpnx8/why-the-drcs-latest-ebola-outbreak-is-more-worrisome-than-the-last
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Ebola outbreak: Minister rages at 'evil' arson attack on centre which left one dead

THE arson attack on an Medicins Sans Frontieres-run Ebola treatment facility in the Democractic Republic of Congo which resulted in the death of one man was the work of "irresponsible groups motivated by evil intentions", the country's health minister Oly Ilunga Kalenga has said.

By Ciaran McGrath

PUBLISHED: 09:43, Thu, Feb 28, 2019 | UPDATED: 09:55, Thu, Feb 28, 2019

The facility, in the east of the country, was attacked late on Sunday, forcing staff to evacuate patients, while one man believed to be the brother of a patient being treated there died while apparently trying to escape in circumstances which have yet to be established. More than six months after the beginning of the Ebola outbreak in North-Kivu and Ituri, the epidemic is not under control with more than 870 confirmed patients and more than 540 deaths, with authorities admitting efforts to contain the spread of the deadly disease were being hampered by ignorance and suspicion. In a statement released by the Ministry of Health, Mr Kalenga condemed the "destruction by malicious individuals of the Katwa Ebola Treatment Centre".

He added: "It is unacceptable that anyone should attack both weak, sick people and health workers who are themselves members of this community."

Four patients confirmed as having Ebola and six patients suspected of having the disease had been in the care of Katwa CTE, one of two the health zones in the town of Butembo.

He added: "None of the patients were hurt and all were transferred to the Butembo CTE to continue their treatment.

"Two carers who had stayed with hospitalised members of their family were attacked by the aggressors.

"Unfortunately one of them died trying to escape and the other is currently in hospital.

"We salute the courage of the Congolese health-workers who stayed all night at the side of the sick until evacuation was possible, despite the serious risks they faced. Several health workers were slightly injured during the panic provoked by the arrival of the attackers.

"For several weeks, while the number of sick and dead increased at Katwa, the medical teams were confronted by an alarming increase of violent acts perpetrated by members of the community."

Sunday had marked the day Katwa, which has recorded 239 case, with 182 deaths, overtook the epicentres of Mangina and Beni as an Ebola hotspot, he explained.

From the start, all those responding to the crisis were aware that the security situation in the region, notably the presence of numerous armed groups, would be a factor which would make the work of the teams more difficult, Mr Kalenga said.

But what was notable in the situation of the town of Butembo was that the violence shown to the medical teams had come not from armed groups but from the community itself.

He added: "It is regrettable that certain fringes of the population fail to recognise the investment of both human and financial services made by the Government of the Republic."

In all the Ebola epidemics, Mr Kalenga said the funding provided for fighting the disease also helps to strengthen the health system in order to improve the quality of care offered to the general population.

He explained: "Health infrastructures are renewed, new equipment is installed and hygiene measures improved. Unfortunately, criminal and anti-social behaviour weakens the health system to the detriment of the population itself

"We can no longer accept that the lives of our health-workers, whose sole objective is to protect the country from this scourge, should be put in danger. Our health-workers should be able to carry on their work in complete safety.

"In the course of the past six months, we have made made considerable progress in our response to the the tenth Ebola epidemic in the country's history

"It would be tragic to see all these efforts destroyed and the epidemic spread throughout the country because of irresponsible groups motivated by evil intentions."

Source and video:   https://www.express.co.uk/news/world/1093665/ebola-news-evil-arson-attack-health-centre-outbreak
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 02 2019 at 8:45am
Why Doctors Without Borders Is Suspending Work In The Ebola Epicenter In Congo

By Nurith Aizenman

All Things Considered, · The aid group Doctors without Borders is suspending its work in the epicenter of the Ebola outbreak in the Democratic Republic of Congo. The move comes after two separate attacks on its treatment centers there. The organization says, at best, it will be weeks before it returns.

"When I send my teams I need to be sure that they are going to come back alive," says Emmanuelle Massart, the on-the-ground emergency coordinator for Doctors Without Borders in the region. "The attacks were really, really violent."

The first took place last Sunday night.

"It started around ten o'clock," says Massart.

Somewhere between 20 to 100 men converged on the group's treatment center in a rural suburb called Katwa.

"They started to throw stones. And then they started to put part of the center on fire – where we had all the logistical and water and sanitation equipment. And then ... the triage center and the cars."

After about 15 minutes the attackers scattered. But the center was already in ruins.

The next attack was on Wednesday night — at a treatment center seven miles away, in a city called Butembo. This time the assailants were even more brazen.

"They used a car to ram the gate," says Massart. "There were men inside. They divide in different teams. They start to destroy things. They start shooting. So the police arrive and they start shooting at each other."

The gun battle lasted about 30 minutes. One officer was killed.

At the time, there were several dozen patients at the center who were suspected or confirmed to have Ebola. Many of them just picked up and ran.

Massart arrived on the scene soon after and says everyone was traumatized. His colleagues told him, "You are afraid for your life. You feel completely helpless."

Officials of the World Health Organization say several patients are still at large. The rest have been moved to a center in Katwa operated by another international charity, called Alima. The facility was originally a transit center to house people suspected of Ebola until they could be moved somewhere else for treatment. But the government and WHO are working with Alima to equip it to offer the full panoply of care.

The need is great. Katwa is the newest hot spot in this seven-month-long outbreak, with more than 200 new cases in recent weeks that bring the overall total in Congo to nearly 900 cases.

Massart says despite this dire prognosis, Doctors Without Borders will not return until it can be sure there will be no more attacks.

Requesting protection from the Congolese police or military or even United Nations peacekeepers is not an option, he says.

"It's a general principle of Doctors Without Borders that if you accept the protection of one side you will be the target of the other," he says.

Instead, the group maintains that the best way to stay safe is to make sure you win the support of the community. "Normally, the population understands that you are doing something good for them, so they will protect you," he says.

And while it's not yet clear who the assailants were in the two attacks, Massart says the larger takeaway is clear. In Katwa and Butembo, "there is a level of mistrust that we have to correct very, very quickly."

He adds that it's not surprising. Katwa and Butembo are in an isolated, impoverished area with a history of armed conflict that's made people wary of — and sometimes even hostile to — outsiders.

Add to this the fact that Ebola is a disease that has never reached this region before and that at first blush doesn't seem all that different from more familiar diseases.

"At the beginning you will have the same symptoms as malaria or typhoid fever – things that the communities are used to dealing with. So Ebola is seen as a disease like the other ones, and they don't see why we should put people in treatment centers."

After all, malaria can be deadly too. But they have never been foreign medical workers insisting that as soon as a family member shows signs of it you need to send them off to a bunch of strangers in plastic suits.

This mistrust has serious consequences beyond the attacks. Because people don't come forward for treatment, a very high number are dying of Ebola in their communities. And at that end stage of the disease, they are at their most contagious.

And while Doctors Without Borders and other groups have done some work educating communities about Ebola, it clearly has not been sufficient, says Massart. In particular, "we should have involved the community in the decision making."

For instance, he says, instead of simply erecting the Ebola treatment center in a location chosen by the government, "we should have gone to the community and said, 'Where do you think we should put it?' "

The failure to consult the local population seems surprising given that Doctors Without Borders has a long history of treating Ebola in areas where there's been community resistance. And the Katwa center was opened in January, long after numerous episodes of violent resistance in earlier hot spots of this very outbreak.

Massart says part of the problem is that there are so many different groups involved in the response – and each one handles different aspects.

"We are very known for patient care, and that's where we have been put," he says.

And in Katwa, "there were other people that were in charge of community engagement and communication. So we didn't do it ourselves because it was supposed to be done and done well [by others.] But unfortunately it was not."

Now he says, Doctors Without Borders is rethinking its role. The group will continue to provide patient care in other less violent areas of the outbreak.

But in Katwa and Butembo, he wonders: "Is patient care where we will have the biggest impact? Or should we put more forces in community engagement?"

Source:   https://text.npr.org/s.php?sId=699462782
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Ebola treatment centre in Congo reopens after attack - ministry

By Reuters• last updated: 04/03/2019 - 00:02

KINSHASA (Reuters) - An Ebola treatment centre at the epicentre of the current outbreak in eastern Democratic Republic of Congo has resumed operations after it was closed in response to an attack last week, the Congolese health ministry said on Sunday.

The facility in the city of Butembo was one of two centres torched by unknown assailants in the space of a few days, prompting Medecins Sans Frontieres (MSF) to suspend medical activities.

Aid workers have faced mistrust in some areas as they work to contain the Ebola outbreak, which has become the worst in Congo's history.

The ministry said the Butembo treatment centre reopened on Saturday. "For now it is managed by the ministry in collaboration with the World Health Organization and UNICEF," it said in a statement.

MSF has not said when it might resume medical activities in the area.

The current Ebola epidemic, first declared last August, is believed to have killed at least 561 people so far and infected over 300 more.

(Reporting by Giulia Paravicini and Fiston Mahamba; Writing by Alessandra Prentice and Peter Cooney)

Source:   https://www.euronews.com/2019/03/04/ebola-treatment-centre-in-congo-reopens-after-attack-ministry
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Ebola defence: South Sudan steps up border checks

Al Jazeera reports from South Sudan's first line of defence against the latest outbreak.

by Hiba Morgan
15 hours ago

more on Africa


The international aid charity, Doctors Without Borders (MSF), has suspended its operations in the wake of Ebola outbreak in the Democratic Republic of the Congo (DRC) after two of its treatment centres were attacked.

Now there are concerns the disease will spread to neighbouring countries, including South Sudan. More than 500 people have died from Ebola in DRC since August.

Al Jazeera's Hiba Morgan reports from the town of Yei in South Sudan, close to the Congolese border.


Source and video:   https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities
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CDC issues Ebola preparedness reminder to U.S. health care facilities
Mar 04, 2019 - 02:30 PM

The ongoing outbreak of Ebola virus disease in the Democratic Republic of Congo serves as a reminder for U.S. health care facilities to review their infection prevention and control processes to safely identify and manage patients with communicable infections, the Centers for Disease Control and Prevention said today. The CDC communication reviews the steps that facilities should implement as a routine part of triage to quickly identify, isolate and inform public health authorities about patients who may have communicable infections; current Ebola infection prevention and control recommendations for U.S. health care facilities; the U.S. Regional Treatment Network for Ebola and Other Special Pathogens; and other resources. The DRC Ministry of Health last August declared a new outbreak of Ebola in North Kivu Province, resulting to date in nearly 900 cases and more than 560 deaths, according to the World Health Organization.



Source: https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities
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Attacks may worsen Ebola epidemic in Congo, officials warn


Re-infections could happen in places where the outbreak was brought under control, WHO warns
Thomson Reuters · Posted: Mar 04, 2019 7:13 PM ET | Last Updated: March 5

A woman cries in front of a hospital during the funeral of a child, suspected of dying from Ebola, in Beni, Congo, in December. Health officials are worried even more people will become infected in the outbreak as attacks disrupt treatment efforts. (Goran Tomasevic/Reuters)

Aid workers at the epicentre of the worst Ebola epidemic in the history of Congo say they are facing a spike in attacks and threats, slowing their work and potentially triggering a surge of new cases.

While two Doctors Without Borders facilities treating Ebola patients in North Kivu province were attacked last week, aid workers said they are only the latest in a series of violent events.

Three Canadians — one doctor and two nurses — were working in those centres but are safe, a spokesperson for the organization said.

One of the facilities has since reopened.

"We had at least 10 cars that were broken into in Katwa," said Michel Yao, incident manager for the World Health Organization (WHO), referring to an attack last month in an area in the eastern trading hub of Butembo — a city with strong links to neighbouring Uganda.

"There are increasing attacks on different teams," Yao told the Thomson Reuters Foundation, the charitable arm of Reuters that covers humanitarian news, by telephone from Butembo.

He cited the difficult conditions faced by aid staff working on disinfection, safe burials, support of health facilities, and those providing vaccinations to treat Ebola.

The current Ebola epidemic, first declared in August, is believed to have killed at least 561 people so far and infected over 300 more.

It is unclear who exactly is behind the attacks, said Jean-Philippe Marcoux, country director for the Mercy Corps charity in Congo.

"It's a minority of groups but sometimes they react violently and target response workers," Marcoux said. "To a certain extent, Ebola has been politicized during the run up to [December's presidential] elections."

    Congo opposition, ruling coalition both claim to have won chaotic election

Some communities believe the Ebola response to be part of a political conspiracy to control or exclude the local population from the electoral process, he said.

In some neighbourhoods, locals ignore potentially life-saving precautions, Marcoux added.

"They refuse treatment, they refuse followups, they refuse vaccinations and they refuse assistance for the [safe] burials."

    Experts call for emergency declaration on Ebola in Congo

    Ebola spreads to high-risk area of Congo, WHO says

"The teams and staff are very scared," WHO's Yao said. "When our team enters [certain areas], they are suddenly surrounded by hostile people who are even armed."

"We saw bullet marks on the wall," Yao added, referring to the attack on the Ebola treatment centre in Butembo last week.

The centre was set on fire while an extended gun battle between the attackers and security forces ensued, health officials said.

The torching of the two centres prompted Doctors without Borders to suspend medical activities.

"It will definitively affect the prognosis of people surviving Ebola," Yao said.

"The fear is that if we cannot work in the coming days and weeks, we will have a major surge of cases in Butembo. I cannot exclude re-infection in places where the outbreak has been brought under control. This is really our fear."

Source:   https://www.cbc.ca/news/health/attacks-could-worsen-ebola-epidemic-in-congo-1.5042815
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 06 2019 at 7:44am
Disease Outbreak News from WHO

Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news: Update
28 February 2019

The Ebola virus disease (EVD) outbreak is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern, while simultaneously, small clusters continue to occur in various geographically dispersed locations. During the last 21 days (6 – 26 February 2019), 77 new cases have been reported from 33 health areas within nine health zones (Figure 1), including: Katwa (45), Butembo (19), Vuhovi (4), Kyondo (3), Kalunguta (2), Oicha (1), Beni (1), Mandima (1), and Rwampara (1).

Although there are decreasing trends in case incidence (Figure 2), the high proportion of community deaths reported among confirmed cases and relatively low number of new cases who were known contacts under surveillance could increase the risk of further chains of transmission in affected communities. Response teams must maintain a high degree of vigilance across all areas with declining case incidence and contact tracing activity, as well as in areas with active cases, to rapidly detect new cases and prevent onward transmission. Following attacks this week on the treatment centres in Katwa and Butembo, WHO is working with partners to ensure the safety of the patients and staff. These incidents are disruptive to the response on many levels and can also hamper surveillance activities in the field.

As of 26 February, 879 EVD cases1 (814 confirmed and 65 probable) have been reported, of which 57% (499) were female and 30% (264) were children aged less than 18 years. Cumulatively, cases have been reported from 119 of 301 health areas across 19 health zones. Overall, 553 deaths (case fatality ratio: 63%) have been reported and as of 19 February 2019, 257 survivors have been reported. There is ongoing cleaning of the case database to correct the number deaths and survivors discharged from Ebola Treatment Centres (ETCs).
Figure 1: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 23 February 2019
Enlarge image
Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 26 February 2019*

Source: Ministry of Health, Democratic Republic of the Congo

*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning – trends during this period should be interpreted cautiously.
Public health response

For further detailed information about the public health response actions by the MoH, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

    Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. National and regional risk levels remain very high, though global risk levels remain low. This EVD outbreak is affecting primarily the north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of EVD at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons, as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria, measles), and a long-term humanitarian crisis. Additionally, the fragile security situation in North Kivu and Ituri, further limits the implementation of response activities.

As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
WHO advice

International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.

Source, maps and graphics:   https://www.who.int/csr/don/en/
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DNI Coats Meets with HHS Secretary Azar to Discuss Ebola Outbreak

NEWS RELEASE

FOR IMMEDIATE RELEASE

ODNI News Release No. 9-19, March 5, 2019



DNI Coats Meets with HHS Secretary Azar

to Discuss Ebola Outbreak



Director of National Intelligence Daniel R. Coats today met with Secretary of Health and Human Services Alex Azar to discuss the current Ebola outbreak and ways the Intelligence Community can support HHS with future outbreaks of infectious diseases.



During the meeting, they discussed lessons learned from the 2014 Ebola epidemic and how the IC can partner with HHS.



“I appreciate the opportunity to discuss these important issues with Secretary Azar,” said DNI Coats. “The IC strives to provide the best intelligence possible to inform US-led containment and relief efforts.”



The current Ebola outbreak began in July 2018 in the Democratic Republic of the Congo and has resulted in nearly 550 deaths as of the end of February. It is the second worst Ebola outbreak ever and has the potential to trigger a major humanitarian crisis.

Source:   https://www.dni.gov/index.php/newsroom/press-releases/item/1960-dni-coats-meets-with-hhs-secretary-azar-to-discuss-ebola-outbreak
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The Battle Against One of the Worst Ebola Epidemics Ever Is in Trouble

Distrust, fear and lack of communication from aid groups have alienated communities in the Democratic Republic of Congo, leading some people to spurn treatment and even attack treatment centers.

By Denise Grady

    March 7, 2019

The family of a young woman who died from Ebola last month in the Democratic Republic of Congo dressed her body, put makeup on her face and propped her up in a car, hoping to make her look alive so they could drive her through checkpoints set up to prevent spread of the disease.

It was dangerous: Corpses are highly infectious. But they wanted to bury her in another town, next to her husband, who also had died of Ebola. Their desperate ploy failed. They were stopped at a checkpoint, according to a report from the country’s Ministry of Health.

The family’s flight, and apparent lack of understanding that bodily fluids spread the disease, help explain why this Ebola outbreak, in its seventh month, has become the second largest ever.

No end is in sight, despite the use of promising antiviral drugs and a vaccine that were not widely available in past epidemics. The deadliest outbreak occurred from 2014 to 2016, in Guinea, Liberia and Sierra Leone, and sickened 28,610 people and killed 11,308.

Last August, an unrelated outbreak began in the war-torn northeastern part of the Democratic Republic of Congo. So far, 907 cases and 569 deaths have been attributed to the disease, near the country’s borders with Rwanda, South Sudan and Uganda. The region has decent roads and a highly mobile population, experts said, so there is constant concern that the disease will spread to those countries.

More than 80,000 people have been vaccinated, and although hard data is lacking, experts suspect that without the vaccine, the epidemic would have grown much larger.

But efforts to stamp out the disease are failing in some areas because many people still don’t understand Ebola, and also because heavy-handed measures by outside organizations, local police and the military have alienated the communities, officials from aid groups and doctors who have worked in the region said. Fearful of being confined in isolation units, people have avoided testing and treatment. They do not want outside interference in rituals around death and burial.

“Ebola responders are increasingly being seen as the enemy,” Dr. Joanne Liu, president of Doctors Without Borders, said at a news conference in Geneva on Thursday. “In the last month alone, there were more than 30 different incidents and attacks against elements of the response.”

“The existing atmosphere can only be described as toxic,” she said.

Some people in the region question why the vaccine is being given only to certain people — including health workers and contacts of patients — and not to everyone, she said. Many wonder why outside aid has flooded in for Ebola, but not for malaria, diarrhea or other common, debilitating diseases that afflict many more people. Some have asked aid workers where they were when militias were carrying out massacres of civilians.

The northeastern part of the country where the epidemic has struck has been a conflict zone for decades, with more than 100 armed groups, as well as security forces posing a constant threat of violence to the population.

Distrust of outsiders is entrenched, and grew in two areas, Beni and Butembo, after the government barred residents there from voting in the long-delayed elections in December, supposedly because of concerns about the spread of Ebola. Many people thought the government had used the disease as an excuse to keep them from voting, and some of their anger turned against the outside groups that had drawn so much attention to Ebola.

Recent attacks on two treatment centers operated by Doctors Without Borders led the group to close them, and brought a scorching and highly unusual self-assessment by Dr. Liu, who included her organization among those that had fallen short. She urged medical teams to treat Ebola patients “as humans and not as a biothreat.”

She blamed not the communities, but the responders, for failing to win people’s trust.

“They hear constant advice to wash their hands, but nothing about the lack of soap and water,” Dr. Liu said. “They see their relatives sprayed with chlorine and wrapped in plastic bags, buried without ceremony. Then they see their possessions burned.”

In a piercing essay published on Thursday in The New England Journal of Medicine, another physician from Doctors Without Borders, Dr. Vinh-Kim Nguyen, wrote: “Early in the epidemic, we witnessed armed agents forcibly bringing patients in for treatment. In a population already traumatized by violence and forceful responses to numerous crises, such tactics fuel distrust of responders, which prompts patients to flee and spawns violence.”

Dr. Nguyen also noted that when Ebola teams were accompanied by security forces, they were met with fear and distrust, especially of forced vaccination. But when the security forces were absent, people would actually ask to be vaccinated.

“The lesson is clear: Guns and public health don’t mix,” he wrote.

Dr. Liu said aid groups needed to offer help in ways the community would accept, even if it meant helping families to safely care for Ebola patients at home, or giving them information and equipment to carry out safe burials on their own.

We’ll bring you stories that capture the wonders of the human body, nature and the cosmos.

The key to stopping past epidemics had been to isolate the sick and track everyone who might have been exposed, until there were no more new cases. But that approach is not succeeding in Congo.

“More than 40 percent of the deaths are right now happening in the community,” outside of treatment centers, Dr. Liu said. “That means we have not reached them and they have not sought our care.”

It also means that untold numbers of people around these patients have been exposed and may have contracted the disease.

A spokesman for the World Health Organization, Tarik Jasarevic, confirmed that 40 percent of deaths were occurring in the community.

“But, and this is key, despite these worrying figures, the response has managed to bring the outbreak under control in 10 of 19 affected health zones, where there have not been cases in three weeks or more,” he said in an email. “The incidence numbers have dropped steadily since November. Clearly the response has had traction in these places, despite the challenges of community mistrust engendered by the years of conflict they have endured.”

But he also acknowledged that building trust was an important part of the work to be done.

“In every newly affected town, W.H.O. and partner social scientists and anthropologists work with local leaders to understand the context and tailor the approach to what works,” he said. As an example, he cited Beni, where the community had been hostile, but health workers were able to bring the outbreak under control within weeks.

“Other areas, like Katwa/Butembo continue to be a challenge,” Mr. Jasarevic said.

Dr. Liu said that about 35 percent of the new cases were in people who were not in known chains of transmission.

“That means we do not know how they got it,” she said.

Mr. Jasarevic differed, saying that many infected people were eventually traced back to previously identified chains.

The epidemic continues to smolder, and could still flare more dangerously, said Dr. Daniel G. Bausch, a professor at the London School of Hygiene and Tropical Medicine.

”I don’t think we should be complacent,” he said. “I don’t want to be alarmist, either, but one unlucky event can change everything.” As an example, he cited an infected person carrying the disease to a densely populated area not prepared to deal with it.

Another problem, Dr. Liu said, is that some patients do not seek treatment until it is too late to save them.

“Ebola still has the upper hand,” she said.

Steve Wembi contributed reporting from Kinshasa, Democratic Republic of Congo.


Source:   https://www.nytimes.com/2019/03/07/health/ebola-epidemic-congo.html
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[When it comes to scientific magazines, Nature is about as respected as you can get.]

NEWS 08 March 2019
Violence propels Ebola outbreak towards 1,000 cases
Surging conflict in the Democratic Republic of the Congo is hampering efforts to stamp out the virus.

Amy Maxmen

Medical workers lead a young girl into the unconfirmed Ebola patients ward in Beni, northeastern DRC.

More than 900 people have been sickened by the Ebola virus since it began spreading in the Democratic Republic of the Congo (DRC) in early August. The outbreak, now the second-largest ever recorded, shows no sign of slowing — fuelled, aid workers and government officials say, by a toxic cocktail of violence and mistrust.

Conflict in the northeastern DRC, the centre of the Ebola outbreak, has surged in recent months. Political protesters robbed and burned an Ebola-treatment facility in Beni in late December, after the DRC government blocked more than one million people in areas stricken by Ebola from voting in the country’s presidential election. And last month, armed assailants torched treatment centres in Butembo and Katwa. Front-line Ebola responders in those cities — who disseminate health messages, track down potential cases and bury the dead — face threats and assaults nearly every day.

The constant violence has hampered efforts to contain the virus. “There’s so many armed groups in this place that you don’t know where the next problem will happen,” says one front-line responder, who asked for anonymity because he is not authorized to speak to the press. “We are thrown into the fire.”

Just as worrisome, epidemiologists say, are recent data from the World Health Organization (WHO) that suggest the virus is spreading undetected. During the last three weeks of February, 43% of the people who died from Ebola in Katwa and Butembo were found dead in their communities — not isolated in hospitals in the late stages of the illness, when the disease is most infectious. And three-quarters of those diagnosed with Ebola had not previously been identified as contacts of people who had contracted the virus.

Taken together, the statistics suggest that the virus is spreading outside known chains of transmission, making it harder to contain and driving up the mortality rate compared to previous outbreaks. The current death rate of about 60% is higher than it was during the much larger 2014–16 Ebola crisis in West Africa, despite improvements since then in how people with Ebola are cared for, including the introduction of several experimental drugs.

“We can have the best treatments in the world, but it won’t decrease mortality if patients don’t come in or come in too late,” says Chiara Montaldo, medical coordinator for aid group Médecins Sans Frontières (MSF, also known as Doctors Without Borders) in the DRC’s North Kivu province.

Uncharted territory

This Ebola outbreak is the tenth in the DRC since the virus was discovered there in 1976. It is by far the largest and longest ever to strike the country, with an estimated 907 cases and 569 deaths, as of 5 March (see 'Advancing outbreak'). Unlike earlier epidemics, this one began in war-torn northeastern DRC, where waves of conflict have killed up to six million people since 1997.

The region is home to dozens of armed groups, and is also a stronghold for opponents of the DRC’s ruling political party. Many residents are suspicious of the effort to stamp out the Ebola outbreak, because they see it as intertwined with the government’s treatment of its political foes. The decision last year by former president Joseph Kabila to block people in the cities of Beni, Butembo and Yumbi from voting — to prevent Ebola's spread — exacerbated those suspicions.

A sustained response from the DRC Ministry of Health, the WHO and MSF, among other groups, has curtailed the outbreak in the communities where the virus first emerged, such as Mabalako, Komanda and Beni. But as people move, so does Ebola. The virus has spread into new areas, including Butembo and Katwa.

Source: World Health Organization

Ongoing violence prompted MSF to suspend its activities in the two cities on 28 February. Leading public-health agencies outside the DRC, such as the US Centers for Disease Control and Prevention, have deemed North Kivu province — where Butembo and Katwa are located — too risky to enter. Instead, epidemiologists from the United States and other Western countries are monitoring the situation from afar.

The WHO has kept its staff in place, but is considering whether to use United Nations peacekeeping troops to help secure the clinics and compounds where its employees work. “We are worried for our people,” says Ibrahima Socé-Fall, the WHO’s assistant director-general for emergency response, who is based in Brazzaville in the Republic of the Congo, just across a river from the DRC. In the meantime, the WHO has stepped up discussions with community leaders and is preparing residents to help carry out the Ebola response. “We want to reduce the dependency on international partners,” Socé-Fall says.
Sounding the alarm

To help halt Ebola’s spread, some health-policy analysts want the WHO to designate the DRC outbreak a public-health emergency of international concern. That could increase international cooperation and mobilize aid, as it did when the WHO declared a public emergency seven months into the West African Ebola epidemic of 2014-16.

The WHO estimates the cost of stamping out the current Ebola outbreak in the DRC at US$148 million. As of 26 February, WHO member countries had committed less than $10 million, according to the agency’s director-general, Tedros Adhanom Ghebreyesus.

“If this isn’t a global health emergency, what is?” says Lawrence Gostin, a health-law and policy specialist at Georgetown University in Washington DC. The ongoing conflict in the northeastern DRC makes the outbreak extraordinary, he says, and the thousands of people regularly passing from the northeastern DRC into South Sudan, Uganda and Rwanda increases the risk that the virus will spread.

Proponents of an emergency declaration say that it would enable the WHO to denounce government actions that could harm the Ebola response, such as the DRC’s voting restrictions last year or the United States' decision to stay out of the outbreak zone. A declaration could also put pressure on the DRC to improve health services and security in communities traumatized by Ebola and violence, says Oyewale Tomori, an independent virologist in Ibadan, Nigeria.

Since October, the WHO has repeatedly decided against declaring a public-health emergency, saying that Ebola is unlikely to spread globally and that aid groups are providing sufficient help to limit the outbreak. Some specialists in global health speculate that the WHO’s reluctance to declare an emergency is influenced by geopolitical issues, too. Declaring an emergency might trigger countries around the DRC to block border checkpoints, for example, which could depress the region’s economy and make it harder to know when people with Ebola enter other countries.

And David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine, says that leaders of armed groups in the region might use an emergency declaration as leverage to negotiate for territory, resources or power, in exchange for allowing Ebola responders to do their jobs. “Infectious agents can be held hostage,” he says.

Then there’s the issue of whether an emergency declaration does anything at all. Adia Benton, an anthropologist at Northwestern University in Evanston, Illinois, says that the turning point in the West Africa epidemic may not have been the decision to declare an emergency, but the news of a handful of cases of Ebola in the United States. Whether or not the WHO sounds the alarm in the current outbreak, she fears that it will continue to fester — just as the world has largely ignored arson, starvation and violence in the DRC for a quarter-century.



Source:   https://www.nature.com/articles/d41586-019-00805-7
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CIDRAP Report


CIDRAP - DRC reports 2 new Ebola cases; study notes seroprevalence in region


Today, 05:27 PM

[Their] Source: http://www.cidrap.umn.edu/news-persp...valence-region


DRC reports 2 new Ebola cases; study notes seroprevalence in region

Lisa Schnirring | News Editor | CIDRAP News | Mar 13, 2019

The Ebola total in the Democratic Republic of the Congo (DRC) grew by two today, and a new serologic study from five central African countries, including the DRC, found a low prevalence, hinting that exposure to the virus is probably rare outside of outbreaks.

Two cases in lesser hot spots

The two latest cases were reported in Mandima in Ituri province, which has reported a handful of recent cases, and from Kalunguta in North Kivu province, an insecure area where vaccination teams were recently held by an armed group.

The cases lift the outbreak total to 927, which includes 862 confirmed and 65 probable cases. No new deaths were reported, keeping the fatality count at 584.

Meanwhile, the number of people vaccinated continued to rise, with 87,668 people immunized. Nearly a fourth of them have been in Katwa, one of the current main hot spots.

Seroprevalence in central Africa

For the study, an international team of researchers, hoping to get a better handle on serologic prevalence of Ebola and the geographic range of hemorrhagic fever viruses, tested 2,430 blood samples that had been collected from 1997 to 2012 for other studies.

The countries are the Republic of Congo, the DRC, Uganda, Ghana, and Cameroon. The team published its findings yesterday in Emerging Infectious Diseases.

The experts screened the samples for antibodies using a microneutralization assay and a new luciferase immunoprecipitation system assay. Samples that were positive for Ebola antibodies were confirmed by enzyme-linked immunosorbent assay (ELISA).

For the Republic of Congo and the DRCboth of which have reported Ebola outbreaksserologic prevalence was 2% to 3.5%, generally consistent with earlier studies. Higher prevalence rates were seen in samples from rural areas compared with urban areas.

They also found a 1.3% prevalence in southern Cameroon, an area thought to be at risk for the spread of Marburg virus, another viral hemorrhagic fever pathogen. The country hasn't reported any Ebola cases, and the authors said the findings suggests a low risk of exposure. An 1983 serologic survey for different parts of the country had found a 3% to 14.5% seroprevalence.

Taken together, the team said evidence of past Ebola exposure in different parts of central Africa might be explained by migration of people from known exposure areas or where the virus hasn't been detected yet. The authors added that some areas might be at increased risk of human exposure because of Ebola or related viruses, owing to environmental, societal, and behavioral practices.


My source:   https://*******.com/forum/forum/local-regional-communities-and-organizations/cidrap/809218-cidrap-drc-reports-2-new-ebola-cases-study-notes-seroprevalence-in-region

See also:
Mar 13 DRC report:   https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=1135a99949
Mar 12 Emerg Infect Dis report:   https://wwwnc.cdc.gov/eid/article/25/5/18-0115_article
ReliefWeb Map:   https://reliefweb.int/map/democratic-republic-congo/drc-ebola-virus-disease-outbreak-situation-overview-dg-echo-daily-1
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WHO Update

14 Mar 2019

Ebola virus disease Democratic Republic of the Congo: Disease outbreak news, 14 March 2019
Report
from World Health Organization
Published on 14 Mar 2019 View Original


The public health response to the Ebola virus disease (EVD) outbreak continues to make gains. During the last 21 days (20 February 12 March 2019), no new cases have been detected in 10 of the 20 health zones that have been affected during the outbreak (Figure 1). There has also been fewer new cases observed over the past five weeks compared to January 2019 and earlier in the outbreak (Figure 2).

Currently, the greatest concern centres on the neighbouring urban areas of Katwa and Butembo, which continue to contribute about three-quarters of recent cases. Clusters in other areas of North Kivu and Ituri provinces have been linked to chains of transmission in Katwa and Butembo, and have thus far been contained to limited local transmissions with relatively small numbers of cases. A total of 74 confirmed cases were reported during the last 21 days from 32 of the 125 health areas affected to date (Table 1). Risk of further chains of transmission and spread remain high, as highlighted by the recent spread to Lubero Health Zone, and reintroduction to Biena Health Zone following a prolonged period without new cases.

Response teams are fully operational in all outbreak affected areas and there are encouraging improvements in community acceptance of the response, despite the challenges of ongoing insecurity caused by armed groups. For example, during the last 21 days in Katwa and Butembo, 88% of the 256 families with a family member who died and was suspected to have EVD, accepted the support from response teams to conduct a safe and dignified burial. Seventy-four new vaccination rings were launched, with over 90% of people eligible for vaccination accepting to do so, and over 90% of these participated in follow-up visits. A total of 5974 people (including 2159 health and frontline workers) consented and were vaccinated this period; overall 87,632 people have been vaccinated to date. Vaccination teams are continuing to follow-up on 12 rings wherein the families have not yet accepted the intervention, and two other rings that are in the process of being defined. Seven field laboratories have remained fully operational, sustaining similar testing rates as previous weeks. During the past week, 1213 samples from new suspected cases, community deaths and previously confirmed cases were tested within 48 hours. Outreach teams made up mostly of local volunteers also met with 6000 households during the past week, building local knowledge of Ebola, and referring sick individuals to either Ebola Treatment Centres (ETCs) or other health facilities as appropriate. In the last two weeks, community dialogues were held in several villages in Katwa and Vuhovi to find ways in engaging community members to build trust and ownership in the Ebola response.

Efforts to strengthen case finding and investigation, and contact tracing activities are also bearing fruit. Of 74 confirmed cases reported in the last 21 days, 83% (62 cases) have been epidemiologically linked to active chains of transmission; either listed as contacts at illness onset (47 cases) or linked retrospectively to other cases or health centre where they were likely exposed (15 cases). Investigations are ongoing to identify links for the remaining cases.

Challenges include further attacks by armed groups on affected communities and ETCs, elements of community mistrust, and persistent delays in getting people into care in ETCs for various reasons. The Ministry of Health, WHO and partners continue to work actively to build community trust and participation in the response, while reinforcing security measures to protect patients and response teams. The ETC in Butembo has been rebuilt following two attacks and is treating patients again, and the Katwa Transit Centre remains operational.

Since the beginning of the outbreak to 12 March 2019, 927 EVD cases1 (862 confirmed and 65 probable) have been reported, of which 57% (525) were female and 30% (280) were children aged less than 18 years. Cumulatively, cases have been reported from 125 of 319 health areas across 20 health zones of the North Kivu and Ituri provinces (Table 1). Overall, 584 deaths (case fatality ratio: 63%) have been reported, and 308 patients have been discharged from ETCs.

Public health response

For further detailed information about the public health response actions by the MoH, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

    Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The latest assessment on 6 March 2019 concluded that the national and regional risk levels remain very high, while global risk levels remain low. The outbreak has continued with a similar epidemiological profile to the last assessment. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community resistance and mistrust, exacerbated by political tensions and insecurity, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas; reducing the overall effectiveness of interventions. These events occur amidst declining trends in case incidence; however, the high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity.

WHO advice

International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.

Source and many links: https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-41
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 20 2019 at 5:02pm
Congo Ebola outbreak spreads to city of Bunia

GOMA, Democratic Republic of Congo (Reuters) - Health authorities in Democratic Republic of Congo have confirmed a case of Ebola in another city of close to 1 million people, the health ministry said on Wednesday.

Bunia is the second-largest city in eastern Congo to confirm a case of the haemorrhagic fever during the current outbreak, which was declared last August and is believed to have killed 610 people and infected 370 more to date.

The head of the World Health Organization (WHO) said last week that the outbreak was concentrated in two areas and could be stopped by September, but poor security in Congo’s militia-ravaged east and community resistance to health workers continue to hamper the response.

The confirmed case in Bunia is a six-month-old infant, whose parents appear to be well, Congo’s health ministry said in a daily bulletin. Investigations are underway to identify how the child was infected, it added.

The cities of Butembo, which has a slightly larger population than Bunia, and Beni, which is slightly smaller, have also experienced Ebola cases.

The current outbreak is the second-deadliest in history behind the 2013-16 epidemic in West Africa that is believed to have killed more than 11,000 people.

Five Ebola centers have been attacked since last month, sometimes by armed assailants. The violence led French medical charity Medecins Sans Frontieres (MSF) to suspend its activities at the epicenter of the outbreak last month.

Source Reuters:   https://www.reuters.com/article/us-health-ebola-congo/congo-ebola-outbreak-spreads-to-city-of-bunia-idUSKCN1R12VF

Absence of proof is not proof of absence.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: March 20 2019 at 11:28pm
We are getting close to the number of deaths (610) doubling since the first post of this thread (319) back in the latter half of December.


ps. While the title is correct I nearly always read "DR Congo" as "Doctor Congo", instead of the "Democratic Republic of Congo"!
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Me too.
Absence of proof is not proof of absence.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2019 at 4:11am
Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news

21 March 2019

Report
from World Health Organization

Published on 21 Mar 2019 — View Originalhttps://reliefweb.int/organization/who


Download PDF (1.06 MB)https://www.who.int/csr/don/21-march-2019-ebola-drc/en/

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces has recently shown an increase in the number of cases reported by week, after many weeks of overall decline (Figure 1). This rise is not unexpected and, in part, likely a result of the increased security challenges, including the recent direct attacks on treatment centers, and pockets of community mistrust, which slowed some response activities in affected areas for a few days.

Katwa, Butembo, Masereka and Mandima account for over 80% of all cases in the last 21 days. A total of 97 confirmed cases were reported during the last 21 days from 38 of the 130 health areas affected to date (Table 1, Figure 2). This week, EVD was confirmed in an infant who died in Bunia Health Zone, but whose parents are in good health. This is the first confirmed case from this health zone; a previous case was identified from neighbouring Rwampara Health Zone in early February. While investigations are ongoing to determine the source of the infection, teams in place have rapidly implemented response activities including contact tracing, vaccination and heightened surveillance. Given the geographical spread of the epidemic and the high mobility in this region, the risk of Ebola spreading to unaffected areas or being reintroduced to previously affected areas remains high.

Response teams are fully operational in all outbreak affected areas. There are encouraging improvements in community acceptance of the response, despite the ongoing challenges of insecurity caused by armed groups. Over 90% of people eligible for vaccination have accepted to do so, and over 90% of these individuals having participated in follow-up visits. To date, 89 855 people have been vaccinated. Vaccination teams are continuing to follow-up on the rings where some families have not yet accepted the intervention.

Field laboratories have sustained similar testing rates as previous weeks. On average, 1300 samples are tested weekly and more than 23 000 samples have been tested to date with a turnaround time of less than 48 hours. Ebola Treatment Centres (ETCs) and Transit Centres continue to operate, and the Katwa Transit Centre is being scaled up by ALIMA to increase capacity to respond to the outbreak in that area. To date, 335 patients have received one of the four investigational therapeutics under the MEURI protocol (compassionate use), and 80 patients under the RCT protocol.

In Butembo, Katwa, and Vuhovi health zones, response teams have continued to engage communities through various community dialogue platforms. Five community dialogue platforms have been organised in three health areas in Katwa, one health area in Butembo and one health area in Vuhovi. This initiative allows community members to participate and lead in decisions regarding Ebola response interventions in their localities. In other EVD-affected areas, ongoing activities include systematic collection of community feedback and responding to community concerns through adjustments of activities in consultation with community leaders and influencers. Community outreach activities are carried out in faith-based settings, market places, and schools with the collaboration of faith-based leaders and civil society groups (including women and youth). Civil society groups and community health volunteers also assist in the door-to-door community outreach activities on a regular basis.

Since the beginning of the outbreak to 19 March 2019, 980 EVD cases1 (915 confirmed and 65 probable) have been reported, of which 57% (554) were female and 30% (293) were children aged less than 18 years. Cumulatively, cases have been reported from 130 of 339 health areas across 21 health zones of the North Kivu and Ituri provinces (Table 1). Overall, 610 deaths (case fatality ratio: 62%) have been reported, and 317 patients have been discharged after treatment in ETCs.

Public health response

For further detailed information about the public health response actions by the MoH, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

Ebola situation reports: Democratic Republic of the Congohttps://www.who.int/ebola/situation-reports/drc-2018/en/

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community resistance and mistrust, exacerbated by political tensions and insecurity, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas; reducing the overall effectiveness of interventions. The high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity.

WHO advice

International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.


Source:   https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-42
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: 19 hours 29 minutes ago at 4:46pm

WHO reaffirms commitment to Democratic Republic of the Congo as Ebola outbreak nears 1000 cases amid increased violence

WHO calls on international community to join urgent push to end outbreak
23 March 2019 Statement

Geneva/Brazzaville/Goma


As the Ebola outbreak in the Democratic Republic of the Congo (DRC) approaches 1000 cases amid increased violence, WHO reaffirmed its commitment both to ending the outbreak and working with the government and communities to build resilient health systems.

Since the outbreak was declared in August 2018 there have been 993 confirmed and probable cases and 621 deaths in North Kivu and Ituri provinces.

“We use words like ‘cases’ and ‘containment’ to be scientific, but behind every number is a person, a family and a community that is suffering,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This outbreak has gone on far too long. We owe it to the people of North Kivu to work with them in solidarity not only to end this outbreak as soon as possible, but to build the health systems that address the many other health threats they face on a daily basis.”

More than 96 000 people have been vaccinated against Ebola in DRC, along with health workers in Uganda and South Sudan. As of 21 March, 38 of 130 affected health areas have active transmission. More than 44 million border screenings have helped to slow the spread of Ebola in this highly mobile population. No cases have spread beyond North Kivu and Ituri provinces, and no cases have crossed international borders.

However, the risk of national and regional spread remains very high, especially when episodes of violence and instability impact the response.

“As we mourn the lives lost, we must also recognize that thousands of people have been protected from this terrifying disease,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We are working in exceptionally challenging circumstances, but thanks to support from donors and the efforts of the Ministry of Health, WHO and partners, we have saved thousands of lives.”

WHO has more than 700 people in DRC and is working hard with partners to listen to the affected communities and address their concerns and give them greater ownership of the response, particularly in the current outbreak hotspots of Katwa and Butembo.

“The communities affected by this outbreak are already traumatized by conflict,” said Dr Tedros. ”Their fear of violence is now compounded by fear of Ebola. Community engagement takes time. There are no quick fixes. But we are learning and adapting to the evolving context every day.”

Despite the challenges, most communities accept response interventions. More than 90% of those eligible for vaccination accept it and agree to post-vaccination follow-up visits. Independent analysis of vaccination data indicate that the vaccine is protecting at least 95% of those who receive it in a timely manner. More than 80% of people also accept safe and dignified burials, a key to preventing onward transmission.

“Despite the increased frequency of attacks by armed groups, WHO will stay the course and will work with communities to end this outbreak together with the Ministry of Health and partners,” said Dr Tedros. “We need redoubled support from the international community, and a commitment to push together to bring this outbreak to an end.”

For the next 6 months, the combined financial need for all response partners is at least US$ 148 million. As of 19 March, US$ 74 million had been received.

“We count on donors to help close the funding gap so we can end this outbreak as soon as possible,” said Dr Tedros. “We will still be in DRC long after this outbreak has finished, working with the government and communities on the road to universal health coverage. We are committed to improving the health of the people of DRC now and in years to come.”


Source:   https://www.who.int/news-room/detail/23-03-2019-who-reaffirms-commitment-to-the-democratic-republic-of-the-congo-as-ebola-outbreak-nears-1-000-cases-amid-increased-violence
Absence of proof is not proof of absence.
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