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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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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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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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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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Rumour and violence rife as Congo Ebola outbreak surges out of control
Global health


Attacks on health centres are impeding efforts to contain an epidemic that has claimed nearly 900 lives in nine months
Global development is supported by
Bill and Melinda Gates Foundation


Esdras Tsongo in Butembo and Rebecca Ratcliffe

Wed 24 Apr 2019 07.00 BST
Last modified on Wed 24 Apr 2019 07.02 BST

A Congolese Red Cross worker writes on a cross the name of Kahambu Tulirwaho, who died of Ebola, before a burial service at a cemetery in Butembo.

Archippe Kamuha knows the signs of Ebola well: diarrhoea, bleeding, persistent fever. But if the 25-year-old developed such symptoms, she would not contact specialist health workers.

“I know that if I go [to a treatment centre], I’ll die. All my friends who go there don’t come home, they die,” said Kamuha, whose home town, Butembo, in north-eastern Democratic Republic of the Congo, is at the centre of the country’s escalating Ebola outbreak.

Since the epidemic began last August, 1,340 confirmed and probable cases of Ebola have been recorded, more than 250 cases since the beginning of April, and 874 people have died – among them are Kamuha’s teenage cousin and a friend’s daughter.

Agencies blame the recent surge in transmission on a continued lack of trust in communities and violent attacks on treatment centres in February and March, which forced health workers to wind down some services.

On Friday, violence erupted when an armed group stormed a hospital in Butembo, reportedly ordered foreigners to go home and accused them of bringing Ebola to DRC. Dr Richard Valery Mouzoko Kiboung, an epidemiologist from Cameroon who was working for the World Health Organization, was killed during the attack. Hours later, a group armed with machetes tried to burn down an Ebola treatment centre in neighbouring Katwa.

The latest attacks are likely to aggravate the epidemic, as insecurity prevents agencies from treating new cases. “It’s going from bad to worse right now,” said Jean-Philippe Marcoux, Mercy Corps’ country director for DRC. “This is symptomatic of the deficiencies of the response – in terms of community engagement and communication.”

April has already seen a higher number of cases reported than any other month since the outbreak began.

Health experts have warned repeatedly that the disease is not under control and that agencies face unprecedented challenges. Transmission is occurring in highly populated areas where health systems are weak and more than 100 armed groups operate.

A government decision in December to suspend voting in the presidential election in Ebola-affected areas also led to the response being politicised, increasing the distrust in an already traumatised region. Rumours – such as that Ebola doesn’t exist, or that it’s used as a money-making scheme – are common.

“Health workers want to make a lot of money, they don’t want the virus to end,” said Aimee Lwanzo, a 27-year-old shopkeeper from Butembo. “I don’t trust the [Ebola response], they want to protect the money, not the life of Congolese. It’s a trade for some, and a loss for others.”

A failure to encourage patients to go quickly to Ebola treatment centres is also a major reason for the stubbornly high rate of cases. Despite efforts to make protective equipment appear less intimidating, such centres are still associated with deadly disease, a perception exacerbated by the use of police escorts by some health teams.

Among the victims of Ebola announced last week was a nurse from Katwa, who had declined an experimental vaccination offered to health workers. She developed signs of the disease after coming into contact with an Ebola patient, according to the Ministry of Health. She hid at home, where she was cared for by her colleagues, and went to a health facility in Butembo only after her condition deteriorated. She later died there.
Health workers are seen through a bullet hole left in the window of an Ebola treatment centre in Butembo, which was attacked in March

The longer a patient waits before getting proper treatment, the less likely it is they will survive.

“People seek healthcare in lots of different places – there are Ministry of Health centres, private clinics, traditional healers,” said Natalie Roberts, emergency operations manager for Médecins sans Frontières (MSF). Not all providers collaborate with the response or refer patients for specialist care.

Agencies are trying to integrate specialist Ebola care into existing general government facilities, said Roberts, in an effort to better meet community needs.

Transmission rates between patients in general health centres are alarming, according to MSF, and one of the biggest risk factors associated with the disease.

A report by WHO’s Africa regional office, released last week, said workers were tracing 534 people who had contact with a medical doctor who died of Ebola in Beni earlier in April.

An experimental vaccine, made by Merck and thought to be highly effective, is being offered to frontline workers as well as known contacts of Ebola patients, and in turn, their contacts. However, health workers warn that there are also delays in reaching contacts. Around one in 10 people offered the vaccine either decline the offer or are absent.

It is likely that a second experimental vaccine, developed by Janssen Pharmaceuticals, could be rolled out within the next two months, according to Yap Boum, professor at Mbarara University, Uganda. It’s thought the vaccine will be used as a preventative measure in surrounding areas where the disease has not yet spread, but this will require large numbers of health workers to administer the treatment.

“The human resource is really the key point,” said Boum, who is also regional representative for Epicenter Africa, the research arm of MSF. “Then you have the logistics: how are you going to deploy it? It seems simple, but when you are in DRC and you see the state of the roads and you are in rainy season, it complicates some of those things.
Victorine Siherya, an Ebola survivor working as a caregiver to babies who are confirmed Ebola cases, holds an infant outside the red zone at the Ebola treatment centre in Butembo

“The vaccine is not the [magic] bullet,” he added. “We may use the second vaccine, but if there is still distrust in the community [the outbreak] will continue.”

Last week, DRC’s president, Felix Tshisekedi, visited Beni, a city affected by Ebola, to implore communities to accept the disease is real and trust health workers. “It is not an imaginary disease,” he said. Traditional leaders also met in Butembo, where they too urged communities to take the threat of Ebola seriously and pressed response teams to better adapt to the needs of communities.

One concern is that communities see large amounts of money flowing into the area exclusively for Ebola. Kate Learmonth, a health coordinator for the International Federation of Red Cross and Red Crescent Societies, said: “[People are saying], ‘We also have cholera and measles …’ There’s a number of other concerns, and so the community is coming back and saying they want to be very much involved [in decision making].”

Dr Oliver Johnson, who worked on the frontline of the Ebola crisis in west Africa and whose book, Getting to Zero, documents a litany of mistakes made during the outbreak, said that improvements have been made in how the World Health Organization responds to crises. But he added that there has been a huge focus on vaccine and diagnostic innovations, and far less on building community trust.

Responses have to be led at local level, and this requires major investment and time, he said. “One part of this has got to be a redoubling of international support for the outbreak from DfID, and the international community more broadly, to enable those trusted people from communities to have those kinds of conversations.

“Right now, how much does the British or American government actually care about lives of people in north-eastern DRC? How much are they seeing this as a security concern?”

In Butembo, Kamuha fears the death count will continue to rise. Last week, the local health officer had announced that nine people had died of the disease. “Even a baby died. It’s shocking.This virus, whose origin I don’t know, will kill our entire city,” she said.

Source:   https://www.theguardian.com/global-development/2019/apr/24/rumour-violence-congo-drc-ebola-outbreak-out-of-control
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: April 30 2019 at 9:25pm
Originally posted by Technophobe Technophobe wrote:

I'm not sure that is as reassuring as the WHO wants us to believe.


I agree! Don't you find it interesting that world interest in Ebola is much less than it was during the previous outbreak (2014 to 2016)? I suppose it is because this outbreak is largely confined to the DR Congo, although I'm now reading about potential case "leakage" across the border with Uganda!

Inevitably, Ebola will leave the African continent and end up in some place like India, where it will explode. It's just a matter of time.

Be safe!
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After 6 pages of spam on this thread, there is some Ebola news to post.

DR Congo Ebola deaths pass 1,000

Bad as that is there has also been 119 documented attacks on medical centres and staff since January. That is over 1 attack per 10 deaths. It must really be very hard being medical staff in that situation.

BBC report
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 08 2019 at 3:25am
WHO urges broader use of Ebola vaccine as case numbers climb in DR Congo

Published 10 hours ago on 08 May 2019

KINSHASA, May 8 ― The World Health Organization yesterday urged a dramatic broadening of Ebola vaccination in the Democratic Republic of Congo, where the latest outbreak of the virus has killed more than 1,000 people.

More than 111,000 people have already received the protective jab, through a so-called ring vaccination approach aimed at immunising every person who has been in contact with the sick, and all of their contacts.

But this has not proved enough to stop the highly contagious virus from spreading in regions of DRC wracked with insecurity.

“The number of new cases continues to rise, in part due to repeated incidents of violence affecting the ability of response teams to immediately identify and create vaccination rings around all people at risk of contracting Ebola,” WHO said in a statement.

WHO's Strategic Advisory Group of Experts (SAGE) therefore recommended “expanding the population eligible for vaccination” with the already deployed rVSV-ZEBOV vaccine, the statement said.

That vaccine, developed by Merck, remains unlicenced but has been widely shown to be safe and effective.

The experts also recommended introducing another experimental vaccine, the MVA-BN developed by Johnson & Johnson.

They suggest giving the vaccine not only to contacts and contacts of contacts, but also to entire neighbourhoods and villages where cases have been reported within the past 21 days.

Vaccine 'saving lives'

“We know that vaccination is saving lives in this outbreak,” WHO chief Tedros Adhanom Ghebreyesus said in the statement.

“We also know that we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible,” he added.

The WHO experts also suggested cutting the doses given of the vaccine, insisting lower doses were equally efficient.

They said contacts and contacts of contacts should get half of 1.0 millilitre-doses they have received until now, while those in the broader community could make do with 0.2 millilitres.

The central African country declared a 10th outbreak of Ebola in 40 years last August centred in the city of Beni in North Kivu province before the virus spread into the neighbouring Ituri region.

The current outbreak is the second deadliest on record, after an epidemic that killed more than 11,300 people in West Africa in 2014-2016.

Efforts to roll back the outbreak of the haemorrhagic fever have been hampered by fighting but also by resistance within communities to preventative measures, care facilities and safe burials.

WHO had initially voiced hope it would be able to contain the outbreak, thanks in part to its ring-vaccination strategy.

But in recent weeks senior WHO officials have conceded that insecurity, scarce financial resources and local politicians turning people against health workers had seriously undermined the containment effort.

The UN health agency stressed yesterday that providing vaccination to the broader community could also enhance acceptance of the vaccine and other control measures.

In another move to improve relations, WHO said it aimed to ensure, by the end of this month, that a majority of vaccination team members stem from affected communities and speak the local languages. ― AFP-Relaxnews

Source:   https://www.malaymail.com/news/life/2019/05/08/who-urges-broader-use-of-ebola-vaccine-as-case-numbers-climb-in-dr-congo/1750753
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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 40
Report
from World Health Organization
Published on 07 May 2019 — View Original
preview
Download PDF (1.02 MB)

1. Situation update

The escalation of Ebola virus disease (EVD) transmission in the North Kivu and Ituri provinces of the Democratic Republic of the Congo continued this past week, with a total of 106 new confirmed cases reported.

The majority of these cases originated primarily from hotspot areas within Katwa, Mandima, Butembo, Musienene, Beni, and Mabalako health zones.

In the 21 days between 15 April – 5 May 2019, 76 health areas within 14 health zones reported new cases, representing 47% of the 163 health areas affected to date (Table 1 and Figure 2). During this period, a total of 298 confirmed cases were reported, the majority of which were from the health zones of Katwa (40%, n=120), Mandima (13%, n=40), Butembo (13%, n=38), Musienene (8%, n=25), Mabalako (8%, n=24), and Beni (6%, n=19).

As of 5 May 2019, a total of 1572 EVD cases, including 1506 confirmed and 66 probable cases, were reported.

A total of 1045 deaths were reported (overall case fatality ratio 66%), including 979 deaths among confirmed cases. Of the 1572 confirmed and probable cases with known age and sex, 55% (870) were female, and 28% (445) were children aged less than 18 years. The number of healthcare workers affected has risen to 95 (6% of total cases), including 34 deaths.

The past week showed a continued deterioration of the security situation in Butembo city. Response activities were temporarily suspended in Butembo and neighbouring health zones from 4-5 May 2019 following a civil demonstration by members of a local moto-taxi drivers union. Although response operations later resumed following negotiations with community leaders, threats of attacks persisted against some healthcare facilities and healthcare providers. In a separate event, on 3 May 2019, a safe and dignified burial (SDB) team in Katwa was also attacked after conducting a SDB of a confirmed case.

In Butembo, current efforts aim to enhance security measures collectively through the UN Security Management System. Efforts included updating security risk management processes by addressing procedural, operational and physical security measures.

Source:    https://reliefweb.int/re/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-55 - https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-55
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 24 2019 at 3:17pm
EBOLA CRISIS: Battle to combat Congo outbreak ‘is FAILING’ as death toll passes 1,200 mark

THE battle to combat the Ebola epidemic in the Congo has reached frightening new levels as experts warn the attempt to control the crisis “is failing” amid a new 1,200 victim death toll.

By Carly Read
PUBLISHED: 16:56, Fri, May 24, 2019 | UPDATED: 17:51, Fri, May 24, 2019

The killer disease is now spiralling out of control, with grieving locals in the central African Republic now unable to hold regular funerals for their loved ones because victims have to be buried by medical workers in highly protective suits. This is causing anger because of the disruption of age-old traditions in the region, and as a result is prompting distraught families to shun the aid of medics and specialist consultants. Recent figures show more than 100 new cases of the disease are being recorded every week.

Since an outbreak in the area last August, 1,200 people have so far died.

Up to 337 of those deaths happened in the first week of May alone, the Daily Mail reports.

This is approximately a quarter of the death toll.

Whitney Elmer, director of the non-governmental organisation Mercy Corps, said: “The current approach to the Ebola epidemic in DRC is failing to control and contain the spread of the disease.

“Over the past few weeks we’ve heard time and again that the response needs a rethink – now with over 100 new Ebola cases a week, it is time for a change in approach.”

Mercy Corps is urging the World Health Organisation (WHO) to take a more active role in the epidemic by sending in more health workers to help combat the highly contagious illness.

The charity has also asked the WHO to set up their Scale-Up Protocol for the Control of Infectious Disease (IASC).

As well as shipping in more aid workers this would see the organisation send in supplies from other countries.

Source:   https://www.express.co.uk/news/world/1131710/ebola-latest-death-toll-congo-mercy-corps-world-health-organisation-united-nations
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 29 2019 at 3:56pm

Congo Ebola response must be elevated to maximum level, UN told

Charities call for outbreak to be put on a par with crises in Yemen, Syria and Mozambique as death toll reaches 1,287
Global development is supported by
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Rebecca Ratcliffe

Wed 29 May 2019 12.13 BST

The UN has been urged by charities to ramp up Ebola prevention work in the Democratic Republic of the Congo to the highest level of emergency response.

Only three crises – Yemen, Syria and Mozambique – are treated as the equivalent of a level-three response, activated when agencies are unable to meet needs on the ground.

Charities including Mercy Corps and Oxfam said the same declaration should also be made in DRC, following a recent acceleration in the spread of Ebola.

Almost 2,000 cases of Ebola have been recorded since the outbreak began in August. As of Monday, 1,287 people have died from the disease.
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Violence by armed groups and community mistrust have severely undermined attempts to halt the epidemic, forcing health workers to suspend vaccination and treatment work.

Whitney Elmer, country director of DRC for Mercy Corps, said that declaring the equivalent of a level-three emergency would bring “manifold benefits” by clarifying the roles of agencies, allowing greater access to resources and attracting greater global attention.

“There has never been an epidemic of this complexity or size in the DRC,” said Elmer, adding that the crisis requires a new structure in line with its scale.

The global humanitarian coordination body, Inter-Agency Standing Committee, will consider the call when it meets on Wednesday. Among the factors to be considered are the scale and complexity of an epidemic, and the risk of a failure to respond effectively.

A level-three emergency, now known as a system-wide scale up, does not indicate the severity of the crisis, but is activated where there is a mismatch between need and agencies’ ability to respond.

On Tuesday, Mike Ryan, assistant director-general of the World Health Organization’s emergency preparedness and response programme, said progress had been made in fighting Ebola, including a drop in transmission of the disease in health facilities.

But insecurity has continued to undermine the response, he added, repeatedly preventing work to identify and vaccinate people at risk of Ebola. There have been 174 attacks on health facilities so far this year, a threefold increase compared with the period from August to December 2018.

In some areas, health workers are afraid to wear protective equipment because they fear they will be targeted by armed groups, according to the WHO.

Médecins Sans Frontières warned it is “extremely worried” about the unpredictability of new cases.

The vast majority of new confirmed cases – more than 80% – have not been identified as contacts of people known to have Ebola, according to MSF. “This means that the listing of contacts and surveillance are not effective,” the charity said in a statement.

Since the start of the outbreak, there have been 1,926 confirmed or probable cases of Ebola. A third of those who have fallen ill are children, which is a higher proportion than in previous outbreaks.

Last week, the UN announced several measures to strengthen its response, including the appointment of a new emergency coordinator, David Gressly.

Tamba Emmanuel Danmbi-saa, Oxfam’s humanitarian program manager in the DRC, said the announcement was a step forward. “This demonstrates the importance that is being placed on the response,” he said. “Now having this translated into concrete actions to enable to us to deliver services and access funds as required will be critical.”

“The profile of the response needs to be raised,” he said, adding that more funding needs to be allocated to humanitarian and community engagement work, and that greater efforts should be made to negotiate safe access for charities.
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“The approach does not have to be a normal approach … if it means engaging with leaders of militias, we need to do that,” he said.
'Terrifying' Ebola epidemic out of control in DRC, say experts
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The risk of Ebola spreading to other provinces in eastern Congo and to neighbouring countries remains very high.

Russell Geekie, spokesman for the UN Office for the Coordination of Humanitarian Affairs, said the UN was introducing measures in Goma, as well as in four neighbouring countries.

He added that the broader, protracted humanitarian crisis in DRC also requires urgent attention. “A tenth of the global caseload of people in need of humanitarian assistance is in the Democratic Republic of the Congo,” Geekie said in a statement.

The humanitarian appeal for DRC, which requires $1.65bn (£1.3bn) to assist 9 million people this year, is only 16% funded.

Source:   https://www.theguardian.com/global-development/2019/may/29/congo-ebola-response-must-be-elevated-to-maximum-level-un-told
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DR Congo Ebola outbreak: More than 2,000 cases reported

More than 2,000 cases of Ebola have been recorded in the Democratic Republic of Congo in the last 10 months, officials have said.

Two thirds of the cases have been fatal, the health ministry added.

The outbreak in the east of DR Congo is the second biggest in history, with a significant spike in new cases noted in recent weeks.

But health workers' attempts to contain the outbreak has been hindered by mistrust and violence.

Despite the fact that more than 1,300 people have died of the disease since August, the charity Oxfam says its teams are meeting people every single day who still don't believe the virus exists, the BBC's Africa editor Will Ross reports.

    Ebola disbelief widespread in Congo hotspots
    Why Ebola keeps coming back

Others don't trust the health workers, which leads people with symptoms to avoid treatment, thus making it harder to stop the virus spreading.

Currently it is contained within two provinces, but it is becoming harder to monitor the spread of the virus because of violence in the country's eastern region.

Between January and May there were more than 40 attacks on health facilities. However, outbreaks of violence have reduced in recent weeks.

The World Health Organisation said the risk of a global spread is low, but it was very likely cases would spread into neighbouring countries.

Most Ebola outbreaks are over quickly and affect small numbers of people. Only once before has an outbreak been still growing more than eight months after it began - that was the epidemic in West Africa between 2013 and 2016, which killed 11,310 people.
What is Ebola?

    Ebola is a virus that initially causes sudden fever, intense weakness, muscle pain and a sore throat.
    It progresses to vomiting, diarrhoea and both internal and external bleeding.
    People are infected when they have direct contact through broken skin, or the mouth and nose, with the blood, vomit, faeces or bodily fluids of someone with Ebola.
    Patients tend to die from dehydration and multiple organ failure.

Source and video:   https://www.bbc.co.uk/news/world-africa-48522299
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