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Online Discussion: Tracking new emerging diseases and the next pandemic

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 28 2019 at 3:56am

Community mistrust worsening DR Congo Ebola outbreak: study

A new study says a quarter of people interviewed in eastern DR Congo last year believe Ebola is not real.
3 hours ago

Community mistrust worsening DR Congo Ebola outbreak: study
At least 639 people have died from Ebola since August in DR Congo in what is now the second deadliest outbreak in history [Samuel Mambo/Reuters]


One in four people interviewed in eastern Democratic Republic of the Congo (DRC) last year believed Ebola wasn't real, according to a new study, underscoring the enormous challenges healthcare workers are now facing.

Health workers said public mistrust is now the biggest obstacle to stopping the epidemic, with many refusing vaccines, resisting treatment and concealing symptoms, as the world's second-biggest Ebola outbreak spreads.

This mistrust resulted in people being 15 times less likely to seek medical treatment at an Ebola health centre, according to the study published in the Lancet Infectious Diseases journal.

The study, released on Wednesday, was based on interviews conducted last September, about a month after the outbreak began. It comes as the number of probable and confirmed cases exceeds 1,000.

At least 639 people have died from Ebola in eastern DRC since August in what is now the second-deadliest outbreak in history, according to the World Health Organization.
Attacks on DRC's Ebola treatment facilities threatens progress (1:57)

In recent weeks, there have been, on average, eight new cases a day, said the country's health ministry.

The response to the outbreak has been hampered by a series of deadly attacks on Ebola health centres since the study was completed. As a result, Doctors Without Borders has stopped staffing two health centres at the outbreak's epicentre after violent attacks.

Researchers found that trust in public authorities had already fallen in the cities of Beni and Butembo before Ebola hit, due to decades of conflict and poor governance.
Accelerated distrust

"It's been three years now that we saw a declining level of trust in those actors, and the Ebola crisis comes on top of that and accelerates the distrust," said Patrick Vinck of Harvard University, who led the research.

"In some ways, we are now paying the consequences of many years of lack of interest and focus on this issue."

Eva Erlach, the community engagement and accountability delegate for the International Federation of Red Cross and Red Crescent Societies (IFRC), said the findings show how the level of trust correlates with preventive behaviours.

The organisation has had more than 800 trained volunteers working to get prevention messages out amid the region's security challenges.

"There is still a part of the community who do not believe that Ebola is real and we definitely still need to continue focusing on community engagement," said Erlach, who was not part of the study. "And this is why this report is so helpful, even if it's from September."
READ MORE
Ebola outbreak response in DR Congo criticised

WHO Director-General Tedros Adhanom Ghebreyesus said earlier this month he was encouraged "to see the communities accepting the response more and more".

The study highlights just how pervasive misinformation has been in places in eastern DRC like Beni and Butembo, where in-person interviews were conducted with 961 people.

Some 25.5 percent of those interviewed did not believe Ebola was real. In addition, nearly 45.9 percent of people thought the Ebola outbreak was being fabricated to destabilise the region or for financial gain.

Additionally, 18.2 percent believed all three of those statements, the study found.

Volatile security situation

Those who didn't believe Ebola was real were far less likely to agree to take the Ebola vaccine or go to a treatment centre. Ebola is spread through the bodily fluids of those infected, and isolating them is key to stopping transmission.
Attacks on Ebola treatment centres in eastern DRC also hamper the health response [John Wessels/AFP]

This outbreak has been uniquely challenging because of the volatile security situation in the region. Eastern DRC is home to numerous armed groups and the Ebola epidemic has deepened the political and economic grievances of many in the area. The fact that people in Ebola-affected areas were excluded from voting in the December presidential election has only heightened conspiracy theories.

Tariq Riebl of the International Rescue Committee, who is currently working in eastern DRC, said the findings released Wednesday mirror what he and his colleagues are seeing on the ground. Concern remains about how Ebola prevention efforts are going because new cases are still emerging.

"Once you reach a wider outbreak zone, especially urban zones, the community engagement and prevention side of things is almost more important than the treatment side," Riebl said.

"If you can't have those messages out successfully, it doesn't matter if you have all the treatment options available because no one is ever arriving to take advantage of that," he said.

The world's worst epidemic of Ebola, a haemorrhagic fever, killed more than 11,300 people in West Africa from 2013 to 2016.

Source:   https://www.aljazeera.com/news/2019/03/community-mistrust-worsening-dr-congo-ebola-outbreak-study-190328062938247.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2019 at 12:36pm
Ebola outbreak SHOCK: One in four believe deadly virus is FAKE – study finds

ONE in four people surveyed in towns at the epicentre of the Ebola outbreak in the Democratic Republic of Congo have said that they do not believe the virus is real, a study published in the Lancet Infectious Diseases journal on Wednesday found, as the disease continues to claim lives.

By Romina McGuinness
PUBLISHED: 15:09, Fri, Mar 29, 2019 | UPDATED: 15:30, Fri, Mar 29, 2019

Harvard University researchers said that public mistrust in health workers and authorities is now the biggest obstacle to thwarting the epidemic, with many refusing vaccines, resisting treatment and hiding symptoms. Those who believed rumours that Ebola is a hoax and does not exist were 15 times less likely to seek formal medical help and five times less likely to accept vaccination, found the study, based on 961 interviews carried out in September. Ebola is a severe and often fatal disease that causes haemorrhaging, fever and bloody vomiting and spreads through direct contact with body fluids.

While Ebola victims are not contagious until they develop symptoms, their bodies remain infectious after death.

The virus has infected some 1,022 people and killed around 639 in eastern DR Congo since August, according to the health ministry.

In recent weeks, there has been on average eight new cases per day, an uptick that has sparked concern among aid agencies.

The researchers found that trust in public authorities had already been eroding in the hotspot cities of Beni and Butembo before Ebola struck local populations there, mostly due to decades of armed conflict and poor governance.

Patrick Vinck, the study’s lead author from Harvard Medical School, “It’s been three years now that we saw a declining level of trust in those actors, and the Ebola crisis comes on top of that and accelerates the distrust.

“In some ways, we are now paying the consequences of many years of lack of interest and focus on this issue.”

Community resistance is said to be highest in and around Butembo, the latest epicentre of the second-deadliest outbreak in history.

Jean-Philippe Marcoux, country director for the international aid group Mercy Corps, warned: “We need to – as much as possible and rapidly – scale down the presence of security forces with response teams, because it is creating more harm than good right now.”

Rebels have an active and open presence in the area and health workers are often escorted by police and soldiers for security, which makes villagers all the more suspicious, aid workers have warned.

Attacks on clinics and responders have become common. The aid agency Médecins Sans Frontières (MSF) was forced to suspend its Ebola activities in DR Congo last month after one of its clinics was torched in an arson attack.

MSF’s international president Joanne Liu has since urged the Congolese authorities to de-militarise the Ebola response, warning the disease would continue to run amok unless the community trusted the authorities and were treated humanely.

Mrs Liu told reporters in Geneva: “The existing atmosphere can only be described as toxic.”

violence

She added that aid workers were increasingly seen as the enemy and that the presence of security and police forces only served to deepen suspicions Ebola is being used as a political tool.

Mrs Lieu said: “There is a lot of militarisation of the Ebola response.

“Using police to force people into complying with health measures is not only unethical, it’s totally counterproductive. The communities are not the enemy.”

The world’s worst epidemic of Ebola killed more than 11,300 people in West Africa from 2013 to 2016.

DR Congo has been trapped in violence for more than two decades, and the east has multiple armed groups all fighting for control of the mineral-rich land.


Source:   https://www.express.co.uk/news/world/1107234/ebola-outbreak-congo-africa-harvard-university-study-ebola-fake
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: April 01 2019 at 2:52pm

WHO: Congo Ebola Outbreak Spreading Faster Than Ever
April 01, 2019 4:15 PM

    Reuters



GENEVA —

Democratic Republic of Congo's Ebola outbreak is spreading at its fastest rate yet, eight months after it was first detected, the World Health Organization (WHO) said on Monday.

Each of the past two weeks has registered a record number of new cases, marking a sharp setback for efforts to respond to the second biggest outbreak ever, as militia violence and community resistance have impeded access to affected areas.

Less than three weeks ago, the WHO said the outbreak of the haemorrhagic fever was largely contained and could be stopped by September, noting that weekly case numbers had halved from earlier in the year to about 25.

But the number of cases hit a record 57 the following week, and then jumped to 72 last week, said WHO spokesman Christian Lindmeier. Previous spikes of around 50 cases per week were documented in late January and mid-November.

Deaths occur outside treatment centers

More alarmingly, about three-quarters of Ebola deaths last week occurred outside of treatment centers, according to Congo health ministry data, meaning there is a much greater chance they transmitted the virus to those around them.

"People are becoming infected without access to response measures," Lindmeier told Reuters.

The current outbreak is believed to have killed 676 people and infected 406 others. Another 331 patients have recovered.

In the past two months, five Ebola centers have been attacked, some by armed militiamen. That led French medical charity Medecins Sans Frontieres (MSF) to suspend its activities in two of the most affected areas.

Another challenge has been a mistrust of first responders. A survey conducted last September by medical journal The Lancet found that a quarter of people sampled in two Ebola hotspots did not believe the disease was real.

New outreach program

Lindmeier said new approaches to community outreach were showing signs of progress and that some previously hostile local residents had recently agreed to grant health workers access.

One treatment center that closed in February after being torched by unknown assailants reopened last week.

More than 11,000 people died in West Africa's 2013-16 Ebola outbreak. Since then, health authorities have worked to speed up their responses and deployed an experimental vaccine and treatments, both of which have been considered effective.


Source:   https://www.voanews.com/a/who-congo-ebola-outbreak-spreading-faster-than-ever-/4857426.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: April 02 2019 at 2:07pm
Congo Ebola outbreak spreading faster than ever - WHO
Reuters|Published: 04.02.19 , 15:09

Democratic Republic of Congo's Ebola outbreak is spreading at its fastest rate yet, eight months after it was first detected, the World Health Organization (WHO) said on Monday.


Each of the past two weeks has registered a record number of new cases, marking a sharp setback for efforts to respond to the second biggest outbreak ever, as militia violence and community resistance have impeded access to affected areas.


Less than three weeks ago, the WHO said the outbreak of the haemorrhagic fever was largely contained and could be stopped by September, noting that weekly case numbers had halved from earlier in the year to about 25.


But the number of cases hit a record 57 the following week, and then jumped to 72 last week, said WHO spokesman Christian Lindmeier. Previous
spikes of around 50 cases per week were documented in late January and mid-November.


More alarmingly, more than half of the Ebola deaths last week occurred outside of treatment centres, according to Congo health ministry data, meaning there is a much greater chance they transmitted the virus to those around them.

Source:   https://www.ynetnews.com/articles/0,7340,L-5488425,00.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: April 03 2019 at 12:36pm
Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 35
Report from World Health Organization

Published on 02 Apr 2019 View Original:   http://newsletters.afro.who.int/outbreak-dashboards/1ixibaybkkq62s8q096ext?email=true&a=11&p=54796147

Download PDF (1.21 MB):   https://reliefweb.int/organization/who

1. Situation update

This past week saw a notable increase in the number of Ebola virus disease (EVD) cases, with 72 newly confirmed cases and one new probable case reported in the last seven days; the largest proportion of which were from Katwa and Vuhovi health zones (Figure 1). During the last 21 days (11-31 March 2019), 57 health areas within 12 health zones reported new cases; 42% of the 135 health areas affected to date (Table 1 and Figure 2). During this period, a total of 164 confirmed cases were reported from Katwa (46), Vuhovi (34), Mandima (25), Masereka (19), Beni (12), Butembo (10), Oicha (8), Kayna (3), Lubero (3), Kalunguta (2), Bunia (1) and Musienene (1). WHO and partners remain concerned by these recent developments and are continuing to adapt strategies to strengthen the response to limit the further spread of EVD in these health areas.

As of 31 March 2019, a total of 1089 EVD cases, including 1023 confirmed and 66 probable cases, were reported; the new probable case is from Vuhovi. A total of 679 deaths were reported (overall case fatality ratio 62%), including 613 deaths among confirmed cases. Of 1089 confirmed and probable cases with reported age and sex, 58% (629) were female, and 29% (318) were children aged less than 18 years. The number of healthcare workers affected has risen to 81, including 28 deaths.

Despite these setbacks, it should be noted that the recent shift in strategy of increasing community outreach from earlier weeks, is gradually yielding tangible results on the ground. In Katwa, the Ebola Treatment Centre was reopened after frank and open dialogue with the community. Previously reluctant communities are now permitting access to healthcare providers once again, with residents actively participating in the renewed response efforts at times. Incidents in the community are now also rigorously followed up to minimize any potential misunderstanding, which may inadvertently contribute to community reluctance, refusal, or resistance to response efforts. In the outbreak hotspots of Katwa, Butembo and Vuhovi, persistent efforts aimed at encouraging community dialogues saw the establishment of Ebola community committees across 16 health areas. Although these community engagement interventions take time to win over the trust and cooperation of the local population, they are an integral tool in aiding the acceptance of WHO response efforts to curtail the spread of EVD in these challenging social/geographic settings. Successes observed this past week are positive indicators that these measures should be maintained whilst continually adapting to the evolving context.


Source:   https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-50
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Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 11 April 2019

Report

from World Health Organization

Published on 11 Apr 2019 — View Original:   https://reliefweb.int/organization/who


Download PDF:   (765.22 KB)https://www.who.int/csr/don/11-april-2019-ebola-drc/en/

The rise in number of Ebola virus diseases cases observed in the North Kivu provinces of the Democratic Republic of the Congo continues this week. During the last 21 days (20 March to 9 April 2019), 57 health areas within 11 health zones reported new cases; 40% of the 141 health areas affected to date (Table 1 and Figure 2). During this period, a total of 207 probable and confirmed cases were reported from Katwa (83), Vuhovi (41), Mandima (29), Beni (21), Butembo (15), Oicha (8), Masereka (4), Lubero (2), Musienene (2), Kalunguta (1), and Mabalako (1).

As of 9 April, a total of 1186 confirmed and probable EVD cases have been reported, of which 751 died (case fatality ratio 63%). Of the 1186 cases with reported age and sex, 57% (675) were female, and 29% (341) were children aged less than 18 years. The number of healthcare workers affected has risen to 87 (7% of total cases), including 31 deaths. To date, a total of 354 EVD patients who received care at Ebola Treatment Centres (ETCs) have been discharged.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus has convened the Emergency Committee for a meeting on 12 April, to consider whether the current EVD outbreak constitutes a public health emergency of international concern and to provide recommendations.

Progress on the ground this week focused primarily on intensifying infection prevention and control (IPC) activities in and around outbreak hotspot areas. IPC teams are concentrating their efforts at addressing reluctance to decontamination activities amongst some local residents by actively engaging in regular direct dialogues with community leaders. Along with intensifying decontamination efforts, other IPC measures being undertaken include rapid evaluation of IPC practices in healthcare facilities and patients’ homes and identifying facilities at increased risk of contact with EVD cases. Results from these rapid evaluations demonstrated a range of IPC gaps depending on the type of facility, which were then promptly addressed through supplementary supervision. Reoccurring issues include limited knowledge of standard precautions, lack of triage and isolation capacity, insufficient supplies (e.g., of personal protective equipment), inappropriate waste management, and lack of capacity for decontaminating medical equipment. These findings highlight the importance of maintaining supportive supervision and mentorship at priority facilities throughout the response. WHO is confident that strengthening these IPC measures would be an integral means of slowing the spread of EVD in the outbreak areas.

WHO and partners in Risk Communication and Community Engagement are continuing with activities to build and maintain a trusting relationship between communities and the Ebola response teams. Dialogues with community committees are ongoing in the hotspot areas of Butembo, Katwa, and Vuhovi, and form a key part of a larger increase ownership of the Ebola response by the communities. Information about community disquiet are systematically collected and monitored to ensure that any misunderstanding leading to reluctance, refusal, or resistance of the Ebola response is followed up with and resolved as quickly as possible. This has been made possible by feedback from the community members, received through ongoing dialogue and various research activities within both the Democratic Republic of the Congo, and neighbouring areas.

In an effort to address the feedback received and specific concerns over the outbreak response, guided visits of the Ebola Treatment Centres (ETCs) in various affected areas have been organized. Students and community associations who attended these guided visits to the ETCs can see first-hand how EVD patients are treated and help stop the potential dissemination of misinformation surrounding EVD and the ongoing response efforts.

The security situation has remained calm for the past week as well. Provisional results released on 9 April by the Commission Électorale Nationale Indépendante concerning the national and provincial legislative elections in Beni, Butembo city (North Kivu), and Yumbi territory (Mai-Ndombe) have caused no significant unrest or disruption to outbreak response activities.

The continued increase in cases this past week reflects the complex reality of conducting an effective outbreak response in a geographically difficult area with a highly fluid population, intermittent attacks by armed groups, and limited healthcare infrastructure. Despite these challenges, WHO and partners remain committed to limiting the spread of EVD amongst these vulnerable populations through the continued strengthening of our multi-faceted response efforts.

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:    https://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 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-45
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Ebola outbreak grows by 12 as CDC issues new HCW advice

Stephanie Soucheray | News Reporter | CIDRAP News | Apr 18, 2019

Today the health ministry of the Democratic Republic of the Congo (DRC) confirmed another 12 cases of Ebola in an ongoing outbreak in North Kivu and Ituri provinces. The cases raise the outbreak total to 1,302.

Of the 1,302 cases, 1,236 are confirmed and 66 are probable. The ministry said the death toll has now reached 843. A total of 325 suspected cases are still under investigation.

Of the 12 new cases 5 are in Katwa, 3 in Mandima, 2 in Vuhovi, and 1 each in Kalunguta and Beni. Ten deaths have also been recorded, including seven community deaths. Community deaths raise the risk of transmission to case contacts, including funeral attendees.

The DRC also said the ring vaccination campaign with Merck's rVSV-ZEBOV continues, with 102,505 people vaccinated since Aug 8, including 27,022 in Katwa, 22,289 in Beni, and 12,468 in Butembo.

In its fourth rapid risk assessment released during this outbreak, the European Centre for Disease Prevention and Control (ECDC) said there is still ongoing Ebola virus disease (EVD) transmission in both urban and rural settings.

"More EVD cases are expected in the coming weeks and a wider geographical extension is still possible given the prolonged humanitarian crisis in the region," the ECDC said, noting that since mid-March, weekly case counts have increased to 52 to 73 cases per week.

Despite the ongoing transmission, the ECDC said the risk of spread to the European Union remains low.
Travel advice for US health workers

Earlier this week, the US Centers for Disease Control and Prevention (CDC) published recommendations for all US-based healthcare and emergency response workers traveling to and from the outbreak region, including a pre-departure assessment for symptoms of the virus for any workers traveling from Ebola outbreak areas to the United States.

The CDC suggests that all people traveling to an Ebola outbreak zone understand the importance of self-monitoring for fever and symptoms 21 days after leaving the outbreak region.

Of note, the CDC said workers may opt to receive the Ebola vaccine as part of ongoing studies based at the National Institutes of Health. Employees should also be up-to-date on all travel vaccinations, and have access to personal protective equipment during their stay.

Source:   http://www.cidrap.umn.edu/news-perspective/2019/04/ebola-outbreak-grows-12-cdc-issues-new-hcw-advice
Apr 18 DRC update :   http://translate.google.com/translate?hl=auto&langpair=auto|en&u=https%3A%2F%2Fus13.campaign-archive.com%2F%3Fu%3D89e5755d2cca4840b1af93176%26id%3D89828c7c0f
Apr 17 ECDC assessment :   https://ecdc.europa.eu/en/publications-data/rapid-risk-assessment-ebola-virus-disease-outbreak-north-kivu-and-ituri-0
Apr 16 CDC recommendations :   https://wwwnc.cdc.gov/travel/page/recs-organizations-sending-workers-ebola
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