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Online Discussion: Tracking new emerging diseases and the next pandemic

Ebola Again

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EdwinSm, View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: August 11 2018 at 10:30pm
3 000 doses is not much if they have to change the strategy to blanket vaccinations.

This does look like it might get out of hand, despite Congo's good reputation in handling Ebola outbreaks.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 12 2018 at 7:16am

Health chiefs issue ‘EBOLA ALERT’ amid fears outbreak about to CROSS BORDERS

HEALTH chiefs have issued an ebola alert amid fears the outbreak as about to cross borders – with four new cases confirmed.
By Henry Holloway / Published 11th August 2018



Ugandan medical authorities have issued a “high risk” alert spurred by the continuing outbreak of the Ebola haemorrhagic fever in the Democratic Republic of Congo.

Heath secretary Dr Diana Atwine issued to the warning on Twitter – including details of symptoms and fact sheets about treating ebola.

It comes as authorities in the Congo continue to detect new cases of the killer disease.

And health bosses are preparing to deploy an experimental treatment in a bid to curb the ebola outbreak.

Health workers are being vaccinated as they continue to fight the infection.
r Atwine urged people in Uganda to share the warning – revealing a phone line to report cases.

She said: “There is a confirmed Ebola outbreak in the [Congo] putting Uganda at high risk.

“Ebola is a serious disease that kills many with a very short period of time.

“The general public should remain clam and be on alert."

Source and full article:   www.dailystar.co.uk/news/world-news/722708/ebola-outbreak-africa-uganda-congo-warning-death-toll-vaccine-borders-threat-alert-symptom
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 15 2018 at 2:53am
Health officials are "worried" as the outbreak seems to be spreading. You can read a report on that here:   https://edition.cnn.com/2018/08/14/health/congo-ebola-outbreak-update/index.html

Also there is a new ebola drug about to be trialled in the area. Details on that development are available here:   https://www.thetimes.co.uk/article/new-drug-for-ebola-outbreak-2bt6cg59n
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 17 2018 at 12:50pm
Congo Ebola outbreak: 78 cases, 44 deaths, 10 health workers infected

Updated 1547 GMT (2347 HKT) August 17, 2018

(CNN)There have been 78 cases of Ebola reported in the current outbreak in North Kivu and Ituri provinces of the Democratic Republic of Congo as of Wednesday, the World Health Organization said Friday.
Of those cases, 51 are confirmed, and 27 are probable. This includes 44 deaths.
The reported cases are in five health zones in North Kivu and one health zone in Ituri, but all of the cases are linked to the "outbreak epi-center" in Mangina, the agency said.

In addition, 10 health care workers have become infected with the disease. Nine of those cases are confirmed, and the one probable case is a worker who died.
"These health care workers were likely exposed in clinics, not Ebola treatment centres (ETCs), many of which may have been infected before the declaration of the outbreak," according to a statement from WHO.
The agency is working to "increase awareness of Ebola among health care and other frontline workers, and to strengthen infection prevention and control (IPC) measures."
The affected provinces share a border with Uganda and Rwanda and are densely populated. Ongoing conflict and violence in the area pose security concerns for those working to contain the outbreak.
This is the 10th outbreak in Congo, where the virus is endemic.

This outbreak is now bigger than the previous outbreak in Equateur province that was declared over July 24. During that outbreak, 53 cases were reported, including 29 deaths, according to Dr. Tedros Adhanom Ghebreyesus, director-general of WHO. Health officials said last week that the two outbreaks are not related.
The viral hemorrhagic fever is transmitted from person to person by infected bodily fluids such as blood, saliva, feces and breast milk. It is highly infectious but not highly contagious.
Vaccination has begun in North Kivu province among health care workers and some residents.

Source:   https://edition.cnn.com/2018/08/17/health/congo-ebola-outbreak-update-bn/index.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 17 2018 at 3:39pm
This ts the Daily Star paper - IMHO a comic bit here is the report anyway:

Ebola outbreak cases expected to SOAR as victims can’t be helped in ‘NO-GO ZONES’

THE cases of deadly Ebola in the Democratic Republic of Congo (DRC) are expected to increase as aid workers cannot access affected regions deemed to be “no-go zones”.



The World Health Organisation (WHO) is becoming increasingly concerned about Congo’s current outbreak of Ebola, which has killed an estimated 44 people.

Health officials have not been able to identify all people exposed to the lethal virus in the African nation's North Kivu region, where security issues are stopping aid workers reaching some areas.

The North Kivu has been ravaged by armed ethnic conflict between Congo’s military and the Hutu Power group Democratic Forces for the Liberation of Rwanda (FDLR) since 2004.

Meanwhile, health authorities in Congo are scrambling to contain the outbreak as neighbouring countries Burundi, Rwanda, South Sudan and Uganda are braced for it to spread across borders.

A total of 78 Ebola cases have been confirmed and 1,500 people have been identified as contacts of infected people, according to official WHO figures.

"We don't know if we are having all transmission chains identified,” WHO spokesman Tarik Jasarevic said in a press conference in Geneva.   

“We expect to see more cases as a result of earlier infections and infection developing into illness.”

On Tuesday WHO Director-General Dr Tedros Adhanom Ghebreyesus expressed concerns that the virus would be harder to contain after visiting North Kivu, where the outbreak is concentrated.

“Before I went there I was really worried because of the different nature of the Ebola outbreak in eastern DRC,” he told a press conference.

“But after the visit I am actually more worried because of what we have observed there first hand.”

He said the conditions in North Kivu, where around 100 armed groups are operating, make it more likely that the deadly hemorrhagic fever will spread.

“The environment is really conducive for Ebola to transmit freely,” said Dr Tedros. “This is a very dangerous outbreak.

“What makes the outbreak in eastern DRC or northern Kivu more dangerous is there is a security challenge – there is active conflict in that area.”

The challenges of containment will alarm health officials after an unprecedented outbreak of the disease between 2014 and 2016 killed more than 11,000 people across western Africa.

Cases of the disease, a type of viral hemorrhagic fever, were confirmed in Britain, Italy, Spain and the United States, where one person died.

The epidemic of 2014 to 2016 was the most widespread outbreak of Ebola in history, plaguing countries such as Guinea, Liberia, and Sierra Leone with death and economic woe.

In June 2016, the outbreak was officially declared over, but the virus is still present in several African countries.

People who remain most at risk are those who care for infected people or handle their blood or fluid, such as hospital workers, laboratory workers and family members, according to NHS guidance.

To date, the latest outbreak is the ninth time Congo has been struck by the disease, which kills between 25-90% of those affected.

The most recent outbreak of Ebola in Congo was declared contained in July 2017, having killed four out of the eight it infected.

Source:   https://www.dailystar.co.uk/news/world-news/723874/ebola-outbreak-virus-2018-congo-symptoms-who-latest-news
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 17 2018 at 3:41pm
This looks more promising:


Congo’s new Ebola outbreak is hitting health care workers hard

By Jon CohenAug. 17, 2018 , 10:50 AM

Health care workers have been especially hard hit by the current outbreak of Ebola in the northeastern part of the Democratic Republic of the Congo (DRC). To date, nine of the 51 confirmed cases of Ebola have been in people caring for the ill, says Peter Salama, an epidemiologist based in Geneva, Switzerland, who heads the response to the outbreak for the World Health Organization (WHO).

“There’s an extremely low level of knowledge and awareness about Ebola in the area,” Salama says. “Early on, the health care workers took no precautions whatsoever, and unfortunately, we’re expecting more confirmed cases from that group.”

The outbreak is the 10th in the DRC since the disease first surfaced in 1976, and though it is the first to occur in this region of the country, Salama says he was surprised how little the affected communities knew about the deadly disease. In the past, health care workers have often been heavily affected during the early days of outbreaks, but the massive Ebola outbreak that caused more than 28,000 cases in West Africa in 2014–16 brought more attention to the risks and proper responses than ever before.
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The virus has spread to seven health districts in North Kivu and Ituri, two northeastern provinces near the border with Uganda that have long been plagued by armed conflict between insurgent groups and government forces. This could vastly complicate efforts to contain its spread, as workers may have to travel with armed escorts. So far, however, security issues have not hampered the attempts to isolate the infected and to treat people, educate communities about personal hygiene precautions and safe burials, and conduct surveillance, Salama says. That's in part because the majority of cases are in a single village, Mangina, where response teams have been able to work safely.

In addition to the confirmed cases, there are 27 probable ones. So far, 44 of the probable and confirmed cases have died. An experimental vaccine that has performed well in other studies now is being used in health care workers and others who may have come in contact with confirmed cases. Salama says more than 500 people have received the vaccine so far. In addition to response teams from the DRC’s Ministry of Public Health and WHO, two nongovernmental organizations, Doctors Without Borders and the Alliance for International Medical Action, have opened Ebola treatment centers to isolate and treat patients.

Robert Redfield, head of the U.S. Centers for Disease Control and Prevention in Atlanta, visited Kinshasa on Wednesday to meet with Minister of Public Health Oly Ilunga Kalenga. The next day, Kalenga led Redfield and a U.S. delegation to North Kivu, where the Americans toured an Ebola treatment center in the city of Beni.

Salama, who visited the affected area last week, led the WHO’s response to the DRC's previous outbreak, which officially ended 1 week before this one surfaced. “It’s taking all the partners a little longer to get moving in this outbreak to be at the scale required to really deal with what is one of the more complex outbreaks of Ebola we’ve had in recent years,” says Salama, noting that they badly need more financial support from international donors. “This is a really tough one.”

Source:   http://www.sciencemag.org/news/2018/08/congo-s-new-ebola-outbreak-hitting-health-care-workers-hard
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 17 2018 at 4:22pm
This is the update from the WHO:

Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news
17 August 2018

On 1 August 2018, the Ministry of Health (MoH) of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease (EVD) in the town of Mangina, Mabalako Health Zone, North Kivu Province. Confirmed cases have since between reported from Beni and Mandima health zones, Ituri Province; however, all confirmed exposures and transmission events to date have been linked back to the outbreak epi-centre, Mangina. North Kivu and Ituri are among the most populated provinces in the country, share borders with Uganda and Rwanda, and experience conflict and insecurity, with over one million internally displaced people and migration of refugees to neighbouring countries.

As of 15 August 2018, 78 EVD cases (51 confirmed and 27 probable), including 44 deaths, have been reported.1 Since the DON published on 9 August, 34 new confirmed cases have been reported: seven from Ituri Province (Mandima Health Zone) and 27 from North Kivu Province (one in Beni and 26 in Mabalako health zones). The 78 confirmed or probable cases reside in five health zones in North Kivu and one health zone in Ituri. The majority of cases (39 confirmed and 21 probable) have been reported from Mangina in Mabalako Health Zone (Figure 1). As of 15 August, 24 suspected cases are currently pending laboratory testing to confirm or exclude EVD.

Eight new confirmed cases among health care workers have been reported, bringing the total number of infected health care workers to 10 (nine confirmed and one probable deceased case). These health care workers were likely exposed in clinics, not Ebola treatment centres (ETCs), many of which may have been infected before the declaration of the outbreak. WHO and partners are working to increase awareness of Ebola among health care and other frontline workers, and to strengthen infection prevention and control (IPC) measures.

The MoH, WHO and partners continue to systematically monitor and rapidly investigate all alerts in other provinces and in neighbouring countries. Since the last DON was published, alerts in several provinces of the Democratic Republic of Congo as well as in Uganda, Rwanda, and the Central African Republic were investigated; EVD was ruled out for all.

Source:   http://www.who.int/csr/don/17-august-2018-ebola-drc/en/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 18 2018 at 7:15am
The WHO publishes regular ebola updates at:   http://www.who.int/ebola/en/ but this series of pages resist copying across to AFT.

This prece was available however:   

Current situation: DRC 2018

    National response plan North Kivu Province
    10 August 2018
    Strategic response plan Équateur Province
    29 May 2018
    Ebola outbreak response
    Presentation by Dr Peter Salama, 23 May 2018
    FAQ: Compassionate use of investigational vaccine for the Ebola outbreak in DRC
    Updated 23 May 2018
    Ebola treatments approved for compassionate use in current outbreak
    6 June 2018
    Consultation on Clinical Trial Design for Ebola Virus Disease
    21 June 2018

'And this recent article (yesterday) was sumarised by Reuters:
Congo Ebola outbreak kills 44 as aid workers struggle to contain spread in conflict zone

Posted yesterday at 7:59pm

A deadly Ebola outbreak in a conflict-hit area of the Democratic Republic of Congo (DRC) poses an "unprecedented" challenge to health workers trying to access victims and contain the disease, medical charities said.
Key points:

    Latest outbreak started just a week after another was declared to be over
    Longstanding conflict in the region has made people more susceptible to disease
    WHO are concerned an epidemic could break out in security blindspots

At least 44 people have died and 78 people have been infected in the Congo's tenth Ebola outbreak since the deadly virus was discovered in the 1970s, according to the World Health Organisation.

At least 1,500 people have been potentially exposed to the deadly virus in North Kivu province but the violence means officials cannot be sure if they have identified all the chains by which it is spreading in the east of the vast country.

"We don't know if we are having all transmission chains identified. We expect to see more cases as a result of earlier infections and these infections developing into illness," WHO spokesman Tarik Jasarevic told a news briefing in Geneva.

"The worst-case scenario is that we have these security blindspots where the epidemic could take hold that we don't know about," he said.

The latest outbreak started just a week after the country declared an end to a separate outbreak and marks the first time responders have had to work in an active conflict zone, where armed groups regularly kill and kidnap civilians.

"With Ebola, this situation is unprecedented. It will make the response longer and more expensive," said Michelle Gayer, director of emergency health for the International Rescue Committee (IRC), which is working to contain the outbreak.
Ms Gayer said longstanding conflict in the region has made people more susceptible to disease because of poor sanitation and high levels of malnutrition and displacement, with many people now living in camps.

Treatment centres have been set up in towns that are violence free, but surveillance teams cannot access surrounding areas to check for cases, said Papys Lame of the Alliance for International Medical Action (ALIMA).

    "Measures are in place to be able to manage it as best as possible despite the insecurity," he said.

The virus, which spreads via bodily fluids and causes vomiting, bleeding and diarrhoea, has already spread from its epicentre in North Kivu province to neighbouring Ituri province since the first cases were detected on August 1.

Two children have already died from the disease, and centres in Beni and Mangina were treating six children infected by the disease or suspected to be.

UNICEF said it had also identified 53 orphaned children who have lost their parents to Ebola.

"The impact of the disease on children is not limited to those who have been infected or suspected," Gianfranco Rotigliano, the UNICEF representative in Congo, said in a statement.

"Many children are faced with the illness or death of their parents and loved ones, while some children have lost large parts of their families and become isolated. These children urgently need our support".
Health news

For the latest on Ebola follow our Infectious Diseases page

The WHO is having to rely on local health workers in the "red zones" deemed too unsafe for its staff to enter, and has been unable to send in experts, regional emergencies director Ibrahima Soce Fall said.

Authorities are trying to negotiate access with the militia, the WHO director-general said earlier this week.

It has been difficult to raise support and awareness because the outbreak so closely followed another one, Mr Fall said.

"We mobilised very quickly the money needed to respond to the first outbreak, but now we are going back to the same donors and there can be this kind of fatigue," he said.

    "It is really important for the international community to know that this outbreak is more complex."

Millions died in civil wars in eastern Congo from 1996 to 2003, but Ituri province had experienced relative peace until violence erupted again this year.

Ethnic rivalries and militia fighting throughout the country have been fanned by a breakdown of state authority since President Joseph Kabila refused to step down at the end of his mandate in 2016.

Reuters

Topics: ebola, diseases-and-disorders, health, unrest-conflict-and-war, congo-the-democratic-republic-of-the

Source:   http://www.abc.net.au/news/2018-08-18/congo-ebola-outbreak-kills-44-in-conflict-zone/10135226
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 18 2018 at 1:28pm
Technophobe: The death toll is still rising.

Militia threat hampers Ebola fight in Congo as disease kills 47

Militia violence in Democratic Republic of Congo has prevented aid workers from reaching some potential cases in an outbreak of Ebola that has so far killed 47 people, the World Health Organization said on Friday.

GENEVA: Militia violence in Democratic Republic of Congo has prevented aid workers from reaching some potential cases in an outbreak of Ebola that has so far killed 47 people, the World Health Organization said on Friday.

Over 2,000 people have been potentially exposed to the virus that began in North Kivu province, but the violence means officials cannot be sure if they have identified all the chains by which it is spreading in the east of the vast country.

"We don't know if we are having all transmission chains identified. We expect to see more cases as a result of earlier infections and these infections developing into illness," WHO spokesman Tarik Jasarevic told a news briefing in Geneva.

"The worst-case scenario is that we have these security blind spots where the epidemic could take hold that we don't know about," he said.

Congo's Health Ministry said confirmed and probable cases numbered 87 in total, including 47 deaths. About 2,150 people have been identified as contacts of people infected with the disease, which causes fever, vomiting and diarrhea.

Health workers "have a huge amount of work to do to follow up on these contacts, to continue the investigations and the active search for cases, as well as to prepare the ground for the vaccination teams," the ministry said in a statement late on Friday.
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The outbreak is spreading across the lush farmlands of eastern Congo. Its epicenter is the town of Mangina in North Kivu province and it has already reached neighboring Ituri province.

Congo has experienced 10 Ebola outbreaks since the virus was discovered on the Ebola River in 1976, altogether killing some 900 people.

An epidemic between 2013 and 2016 killed more than 11,300 people in West Africa.

The United Nations children's agency UNICEF said an unusually high proportion of the people affected in this outbreak were children.

Two children have already died from the disease, and centers in Beni and Mangina were treating six children infected by the disease or suspected to be.

UNICEF said it had also identified 53 orphaned children who have lost their parents to Ebola.

"The impact of the disease on children is not limited to those who have been infected or suspected," Gianfranco Rotigliano, the UNICEF representative in Congo, said in a statement.

"Many children are faced with the illness or death of their parents and loved one

s, while some children have lost large parts of their families and become isolated. These children urgently need our support".

The WHO said more than 500 people including health workers have been vaccinated against the disease. It had deployed more than 100 experts to Mangina and Beni towns to oversee tracing, vaccination and safe burials.

There were, however, "red zones" near Mangina that aid workers could not enter for security reasons, Jasarevic said.

(Reporting by Stephanie Nebehay; Additonal reporting by Angus MacSwan and Edward McAllister; Editing by Alison Williams, Toni Reinhold)
Source: Reuters

My source:   https://www.channelnewsasia.com/news/world/militia-threat-hampers-ebola-fight-in-congo-as-disease-kills-47-10628334
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 21 2018 at 3:08pm
Ebola in the DRC: Death toll rises in second outbreak

The second Ebola virus outbreak this year in the DRC is already nearly twice as deadly as the first and shows no signs of slowing.

9 hours ago

The number of deaths from a new Ebola outbreak in the Democratic Republic of the Congo (DRC) continues to rise.

Since it was declared in the northern Kivu province 3 weeks ago, 55 people have died of the virus and 69 people are confirmed to be infected.

It is the tenth time Ebola has struck the DRC since 1976. It has had twice as many outbreaks as any other country.

Vaccines are providing new hope, with education filling in where medicine cannot.

Source:   https://www.aljazeera.com/news/2018/08/ebola-drc-death-toll-rises-outbreak-180821132003714.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 21 2018 at 3:43pm
.................... 'And the official line.............

Democratic Republic of the Congo (DRC): Ebola virus disease outbreak - Revised One International Appeal n° MDRCD026

Report


from International Federation of Red Cross And Red Crescent Societies
Published on 21 Aug 2018
preview
Download PDF (885.05 KB)

This second revised One International Appeal (OIA) seeks a total of 9.1 million Swiss francs to enable the International Federation of Red Cross and Red Crescent Societies (IFRC) to support the Democratic Republic of the Congo Red Cross (DRC RC) and International Red Cross and Red Crescent Movement (Movement) partners to respond to the ongoing Ebola Virus Disease (EVD) in North Kivu, while continuing to support the DRC RC in reinforcing its organizational epidemic preparedness to deal with a potential new EVD outbreak in Equateur. This revised OIA aims to support 800,000 people for 9 months with a specific focus on risk communication, social mobilization and community engagement, surveillance and response mechanisms, Infection and Prevention Control (IPC) support to health facilities and at community level, Safe and Dignified Burials (SDBs), Psychosocial support (PSS) as well as National Society capacity building. While the operation focuses on typical responses to an EVD outbreak through the aforementioned pillars in North Kivu, it supports transition from response to EVD preparedness strategies in Equateur. The OIA is revised reflecting the evolving situation of the two Ebola outbreaks and comprises operational support from the International Committee of the Red Cross (ICRC), which has ensured permanent presence in North Kivu for over two decades. The activities in this OIA are fully aligned with the response strategy of the DRC Ministry of Health (MoH) and will be implemented in close coordination with the MoH, WHO and other organizations in the country. The planned response reflects information available at this time of the evolving operation and will be adjusted based on further developments and assessments, which will be detailed in the Emergency Plan of Action (EPoA).


Source:   https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-drc-ebola-virus-disease-outbreak-2
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 23 2018 at 1:01am
[Technophobe: Sorry folks, this newspaper is the "Daily Star" a sort of adult comic. Please take the hyperbole with a pinch of salt]

Ebola OUTBREAK: Death toll SOARS to 55 as authorities announce crisis plan

THE death toll of the latest outbreak of the Ebola virus has risen to 55 since the start of August as authorities struggle to control the spread of the disease.
Published 22nd August 2018



Health officials in the Democratic Republic of the Congo (DNC), southern Africa, announced five new victims in the town of Mabalako-Mangina, close to the epicentre of the outbreak in Beni, North Kivu province.

The government has announced free treatment for all victims against the disease for the next three months as they desperately try to control the outbreak.

Beni's mayor Jean Edmond Nyonyi Masumbuko Bwanakawa said locals would not have to pay for treatment in the towns of Beni, Mabalako-Mangina and Oicha starting this week.

In a statement, the country's health ministry said: "96 cases of haemorrhagic fever were reported in the region, 69 of which had been confirmed and 27 were seen as probable."

But it did say the number of estimated "contacts" — people who may have had contact with infected victims — had been scaled down fro 2,157 to 1,609 following scientific tests.

The Ebola virus spreads fast, authorities have struggled to control the latest outbreak, with 20 killed in one town alone in the DRC.

Whole regions of the country are described as "no-go zones" as aid workers can't access them.


Source:   https://www.dailystar.co.uk/news/world-news/724842/ebola-outbreak-africa-democratic-republic-of-congo-warning-death-toll-vaccines-borders
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 25 2018 at 3:31am
Who do you believe?

The WHO says: "Response to DRC Ebola outbreak going well."

The Telegraph says: "Ebola cases in DR Congo pass 100 as disease is found near country's highly insecure 'red zone'."

Personally, I believe the Telegraph. The WHO has a drive to avoid panic and newspapers want to excite us but the WHO has deliberately downplayed past outbreaks and epidemics of disease before, whilst the Telegraph has a fairly clean record. Only time will tell for certain.

The sources of Today's information are to be found here:

Telegraph: https://www.telegraph.co.uk/news/2018/08/24/ebola-cases-dr-congo-reaches-100-disease-confirmed-near-countrys/
WHO: https://punchng.com/response-to-drc-ebola-outbreak-going-well-who/
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Congo Ebola outbreak: Two recover after experimental treatment; cases top 110

By Meera Senthilingam, CNN

Updated 1207 GMT (2007 HKT) August 27, 2018

(CNN)Two of the first 16 people to receive an experimental treatment for Ebola have recovered in the current outbreak in North Kivu and Ituri provinces of the Democratic Republic of Congo, the World Health Organization said Monday.
Five experimental Ebola therapies have been approved to treat people infected with the Ebola virus, said WHO spokesperson Tarik Jasarevic. Two are already in use and the other three will follow suit.

"This is a major advancement in an Ebola response," Jasarevic told CNN, adding that it's hoped that more recoveries will soon be reported.
As of August 25, a total of 111 cases were reported, of which 83 are confirmed and 28 probable. This includes 72 deaths.
Fourteen health-care workers have been infected, with one dead.
The cases have been reported in five health zones in North Kivu province and one health zone in Ituri, but all the cases have been traced back to the outbreak's epicenter in Mabalako, according to the WHO.
Vaccination also began among those at risk of infection, though children below age of 1 and pregnant and breastfeeding women are not eligible.
On August 20, 7,160 additional doses of vaccines arrived in Kinshasa and were to be promptly transported to Beni. An additional 2,160 doses of vaccine were expected to be shipped by the end of last week.
Two recovered
This outbreak is now bigger than the previous outbreak in Equateur province that was declared over July 24. During that outbreak, 53 cases were reported, including 29 deaths.
To aid the response, all five available experimental treatments for Ebola have been approved for use at Ebola treatment centers.
To date, 13 patients have received the monoclonal antibody cocktail mAb114 and three patients were given the antiviral Remdesivir, the WHO confirmed. Two of the people given mAb114 have recovered.
Observations and follow-up continue following the approved protocol, according to Jasarevic.
The remaining three treatments -- Favipiravir (GS5734), REGN3470-3471-3479 and ZMapp -- will be used, with each treatment chosen by clinicians on a case-by-case basis.
The treatments can be used as long as informed consent is obtained from patients and protocols are followed, with close monitoring and reporting of any adverse events.
"It's very important to monitor," said Jasarevic. "These drugs are all different."
The current outbreak was first declared by Congo's Ministry of Health on August 1, after which a rapid response effort was initiated.
The disease is endemic to Congo, and this is the nation's 10th outbreak since the discovery of the virus in the country in 1976.
The Ebola virus is transmitted from person to person by infected bodily fluids such as blood, saliva, feces and breast milk. Humans can also be exposed to the virus, for example, by butchering infected animals.
It is highly infectious but not highly contagious.

Source:   https://edition.cnn.com/2018/08/27/health/congo-ebola-outbreak-update-experimental-treatment-africa-intl/index.html
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A Dangerous Twist To The Latest Ebola Outbreak

By Nurith Aizenman

NPR.org, August 27, 2018 · It was the news they'd been dreading. Last week, world health officials learned that a doctor's wife had contracted Ebola. She is from Oicha, a town in the eastern part of the Democratic Republic of Congo that is surrounded by a violent insurgent militia called the Allied Democratic Forces.

Her case is one of many in an outbreak that's been ongoing since the start of August. But it was the first to be confirmed in a location that is extremely dangerous for health workers to reach because of the conflict raging in that part of the country.

So far, the number of confirmed cases — more than 80 since the start of this month – has been in line with previous flare-ups in that country that were controlled in a matter of months. But the dangerous twist to this outbreak is requiring health workers to come up with creative strategies to reach those in need.

To get a sense of just how insecure this part of the DRC can be, consider the experience of a top official in the World Health Organization — Dr. Peter Salama, deputy director-general of emergency preparedness and response. Just over a week ago he stopped at a town called Beni near the epicenter of the outbreak.

"The night we were there, there was an attack on civilians — about 20 kilometers [about 12 miles] from where we were staying," he says. "And at least four or five people were murdered."

There are at least 20 armed rebel groups active in the area, notes Salama. And he adds that several of them have also made a practice of kidnapping and killing humanitarian workers.

Until last week's case in Oicha, says Salama, nearly all Ebola cases in this outbreak have been in towns and villages that health workers can get to relatively safely. As soon as they confirm a case they've been rushing to the sick person's town or village to find and vaccinate everyone that the patient has had contact with — and anyone who's had close contact with those contacts. The vaccine is experimental, and the strategy is called "ring vaccination."

"You form in a sense a protective ring around that ... confirmed case," says Salama.

The Oicha case complicated that approach.

It's likely that the doctor's wife wasn't the only person there who had gotten infected. According to Salama, sometime earlier the doctor himself had been ill with what health officials now suspect was Ebola – although he had already recovered and is now testing negative. And a third person who had died in Oicha is considered a probable Ebola case.

A WHO team was able to travel to Oicha – and identify and start vaccinating nearly 100 people who had contact with the infected person. But to get there they needed an armed escort of U.N. peacekeepers. That's not ideal says, Salama: "There certainly is risk with being too closely associated with any fighting force." Health workers need to be perceived as impartial in order to operate in areas where multiple sides are battling each other.

And Salama says WHO has already decided they'll have to suspend ring vaccination if a case surfaces in a village or town that's too dangerous to visit long enough to meticulously trace the sick person's contacts. Instead they'll move to a less effective strategy: basically making a much briefer visit to vaccinate anyone and everyone they come across before it's time to leave.

"Because we may only have access for a couple of hours with armed vehicles and armed escorts," says Salama. In such places, the longer you stay, the greater the risk.

Another group that's having to tweak its usual Ebola-fighting approach is Doctors Without Borders, which has opened a treatment facility in a town called Mangina, not far from Oicha.

A critical concern in stemming this outbreak involves the homes of patients. Karin Huster, an emergency coordinator with the group, says that, if this were a typical Ebola outbreak, for every patient that comes in Doctors Without Borders would be sending a team back to their house to decontaminate it — a specially-trained group wearing protective suits who would spray every single surface with chlorine.

"To make sure that then that it's safe for the familiy to live in this place," Huster explains.

Many of these families live in areas that are too dangerous for Doctors Without Borders to travel to — especially since it's against the group's policy to go in with armed guards.

One idea under consideration is to build a model of a typical house so Doctors Without Borders could use it to teach families how to decontaminate their homes safely with a take-home kit.

"It might not be professionally done the way we would do it," says Huster. "But it would be much better than having nothing done to the house."

Doctors without Borders is also considering training patients who recover from the virus to become ambassadors of a sort — educating their communities about the disease when they go home. Again, says Huster, it's not a perfect solution. Among other reasons, calling attention to Ebola survivors could stigmatize them.

"You always have to do this in a careful way," she says.

But when it comes to responding to an Ebola outbreak in a conflict zone, she says, "if we don't find creative ways to deal with it, we'll never control it."

Source:   https://text.npr.org/s.php?sId=641536981
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Congo's Ebola outbreak still spreading, with possible signs of hope

By Jen Christensen, CNN

Updated 1808 GMT (0208 HKT) August 31, 2018

(CNN)The ongoing outbreak of Ebola in the Democratic Republic of Congo is at "a key juncture," the World Health Organization said Friday.
Since the outbreak was declared August 1, 116 people have been infected, including 77 deaths. As of Wednesday, 86 of the cases were confirmed by lab results, and 30 were probable.

Cases of Ebola are being reported in five health zones in North Kivu province and one health zone in Ituri, both in the northeastern part of the country. This area borders Uganda, Rwanda and South Sudan, where security concerns and an ongoing humanitarian crisis factor into the ability to contain the outbreak.

However, control measures seem to be working, WHO said.
Patients are getting to treatment centers quickly, and most are getting help within an hour of diagnosis. With this highly infectious disease transmitted from person to person through bodily fluids like saliva, blood, breast milk and feces, patient care is key to reducing the infection rate.

Health care workers have been following up immediately with people who may have come into contact with Ebola patients, to make sure they are not infected, WHO said. Ring vaccination efforts have also been quickly scaled up, reaching people who may have come into contact with those patients.

That's the good news, but there are still new cases and concerns among health workers over containing the virus.

"The outbreak trend must be interpreted with caution," WHO said.
Over the past week, 13 additional confirmed or probable cases were reported, mostly in the city of Beni. WHO is concerned that those numbers could grow, as people are still involved in "risky behavior" that could spread Ebola. There are still unsafe burial practices, a reluctance to communicate with health care workers trying to trace the disease, and a resistance to seeking help from health care workers, in addition to general problems with infection prevention and control.
Also a concern: The number of health care workers infected is now 15, including one death. WHO believes that these infected workers were probably exposed to Ebola in health facilities that are not specifically set up as treatment centers.

This is the 10th Ebola outbreak in Congo, where the virus is endemic, since it was discovered in 1976.

WHO is working with local health care workers on disease control, and together, they are raising awareness about how to handle patients with Ebola and vaccinate people who are most at risk.
On Monday, WHO reported that two of the first 16 people who got an experimental treatment for Ebola during this outbreak have recovered. Five experimental Ebola therapies have been approved to treat those who are sick.

Source:   https://edition.cnn.com/2018/08/31/health/congo-ebola-outbreak-update/index.html
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Ebola Attacked Congo Again. But Now Congo Seems to Be Winning

Sept. 2, 2018

New cases are dropping sharply, vaccination is going well and schools are about to open. But it is too soon to declare victory, experts said.

The month-old Ebola outbreak in the Democratic Republic of Congo, which emerged unexpectedly in a dangerous region and quickly soared to over 100 cases, now appears to be fading.

Only a handful of new cases appear each week, and the region's two treatment centers, full until recently, now have fewer than 30 patients in their 78 beds.

More than 3,500 contacts of known cases are being followed, more than 4,000 doses of vaccine have been given and officials feel hopeful enough to allow schools in the area — North Kivu Province, on the eastern border with Uganda — to open as usual on Monday.

However, it is far too early to relax, health experts warned.

“We cannot say the outbreak is under control yet,” said Dr. Oly Ilunga, the country’s health minister, echoing a warning from Tedros Adhanom Ghebreyesus, director general of the World Health Organization.

“While the number of confirmed cases has slowed down lately, we must remain vigilant,” Dr. Ilunga said. “An Ebola outbreak works in waves, and the first wave hit us hard.”

That wave, he explained, comprised people infected before health workers arrived, and these patients may have infected a second wave of family members, neighbors and medical workers who are still in their incubation periods.

“Over the next few days,” he said on Friday, “many contacts will come out of their 21-day surveillance periods, and we’ll know to what extent we managed to break the transmission chain.”

As of Friday, there were 118 confirmed or probable cases and 77 deaths, and the threat of more is still so high that officials have not halted construction of a third treatment center.

If the outbreak does fade out, credit will again go to rapid action by the Congolese government and global health agencies, as well as to a new, highly protective Merck vaccine.

Although five experimental treatments for infected patients recently won approval for emergency use, so far too few patients have received them to draw conclusions about how well they may work.

One reason experts are reluctant to declare the outbreak contained is that some remote towns have not been visited because of armed groups roaming the area.

Thus far, fighting has not hampered the response, said Florence Marchal, spokeswoman for the United Nations peacekeeping mission in the region.

Congolese health workers escorted by peacekeepers were able to safely reach Oicha, the only town in a “red zone” with confirmed Ebola cases.

However, just two weeks ago, Ms. Marchal said, as many as 18 Congolese soldiers were killed in an attack in North Kivu, probably by the Allied Democratic Forces, a Ugandan rebel group.

Ebola experts also said they would not let down their guard because they remembered a brief, deceptive lull in the early days of the 2014 West African outbreak before it reached three capital cities and exploded, killing more than 11,000 people.

But with each new outbreak, medical groups are bringing new technologies and tactics to bear on the disease.

A new vaccine, rVSV-ZEBOV, proved itself in the recent outbreak in Congo’s central Équateur Province that began in April and was declared over on July 24.

Even though the virus had spread from a rural area to a thriving lakeside town and ultimately to a big city, Mbandaka, the outbreak was quickly stopped by inoculating health workers and the rings of contacts of each known case.

Techniques pioneered in that outbreak are playing even more prominent roles in this one.

For example, in Mangina and Beni, the towns at the epicenter, the Ministry of Public Health immediately sent about 150 hospital staff personnel into home quarantine and replaced them with others who had been trained in donning and safely removing protective gear.

To encourage patients to come in, the ministry also made all care at public hospitals free — for any illness.

Then, as soon as possible, health officials vaccinated all medical personnel. Those steps reduced a major risk factor — medical workers who catch the virus from one patient and unwittingly pass it to others before they themselves collapse. (In the early days of any outbreak, most people coming to hospitals do not have Ebola but malaria, bacterial infections or other crises, like difficult pregnancies.)

Soon afterward, Alima, the Alliance for International Medical Action, deployed its new Biosecure Emergency Care Units, which it calls “cubes,” in its treatment center in Beni.

The rooms, made of clear, flexible plastic with sleeves, gloves and bodysuits built into the walls, allow nurses to safely perform about 80 percent of the care an Ebola patient needs without having to put on hot, cumbersome gowns, hoods, rubber aprons, boots and goggles.

Wearing full gear, caregivers can look terrifying, especially to children.

“Now they can see us as human beings,” said Claude Mahoudeau, Alima’s emergency response coordinator.

Nurses can check vital signs, feed patients and change intravenous drip rates, said Augustin Augier, Alima’s secretary general, and may eventually start inserting intravenous needles from outside. Workers must still enter the cube to clean up diarrhea and vomit, unless patients are strong enough to do it themselves and then seal the soiled linens in bags and pass them out through a portal.

The chambers are air-conditioned for comfort. Also, patients’ relatives can safely sit outside and talk to them.

The cubes “sound like a very interesting idea” said Leah Feldman, medical coordinator for the Doctors Without Borders treatment center in Mangina, who said she plans to visit Alima’s center soon.

Her center keeps patients and relatives separated by two rows of waist-high fencing; those who are bedridden can talk on phones.

Families will only bring in their sick if they can see they are well cared for, she said. “It can’t be that they just go inside and come out later in a body bag.”

Medically, the most exciting prospect on the horizon is that, as of Aug. 22, Congo has approved the emergency use of five potential treatments: two antiviral drugs, remdesivir and favipiravir; and three cocktails of antibodies originally found in recovered patients, including ZMapp, mAb114 and Regn3450-3471-3479.

Previously, only about half of Ebola patients were saved if they got supportive treatment, including fluid replacement and fever control, in time.

Being consistently able to cure most patients would be a terrific advance, experts said, reducing the terrifying aura around the virus to one more like that surrounding cholera.

[Like the Science Times page on Facebook. | Sign up for the Science Times newsletter.]

In the 19th century, cholera swept away millions, and it can still can go on lethal rampages, as it recently has in Haiti, Somalia and Yemen. But cholera can also be controlled and its fatality rate cut to less than 1 percent if vaccines, antibiotics and fluid replacement are deployed quickly.

Few Ebola victims have received the experimental treatments, and the results have not been compiled.

As of Thursday, according to the W.H.O., 19 patients had been given remdesivir, ZMapp or mAb114. One died, two survived and 16 were still on treatment. (Remdesivir is given for 10 days.)

But “Ebola is tricky,” warned Ms. Feldman, a trauma nurse working on her fourth outbreak. “Patients can look like they’re doing better and then crash.”

Despite the lull, the International Medical Corps, a nonprofit group of volunteer doctors and nurses, is still working to complete a 50-bed unit in Makeke.

“The decrease is promising, but I don’t think we can relax,” said Ky Luu, the I.M.C.’s chief operating officer. “When we were tasked to do it, the other two centers were at capacity, and cases could still ramp up.”

Building in such a remote area is not easy. Besides isolation wards, toilets and showers for 50 patients, a center must have a laboratory with generators and freezers, gowning and decontamination areas, screening areas for new patients, bathrooms, kitchens and on-site housing for up to 200 staff.

Even before that, the ground had to be cleared and hundreds of yards of dirt road had to be graded. Because it is the rainy season, heavy equipment was bogged down.

“We’re hiring local people to do it with shovels,” Mr. Luu said.



Source:   https://www.nytimes.com/2018/09/02/health/ebola-virus-congo-outbreak-2018.html
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[Once again they seem to have spoken too soon.]

EBOLA CRISIS: Latest outbreak in Congo claims MORE lives as death toll rises to 82
EBOLA has claimed the lives of four more victims as the death toll from the deadly disease hits 82 after another outbreak in the Democratic Republic of Congo.
By Carly Read
PUBLISHED: 21:46, Wed, Sep 5, 2018 | UPDATED: 21:52, Wed, Sep 5, 2018

EBOLA has claimed the lives of four more victims as the death toll from the deadly disease hits 82 after another outbreak in the Democratic Republic of Congo.

Officials say the latest victims all died this week.

Since August 28, 11 more cases the highly contagious illness have been reported in the Central African country, the World Health Organisation (WHO) confirmed.

In an attempt to contain the virus, aid workers have educated nearly 2.5 million Africans on how to reduce the risk of it spreading.

But officials admitted they are struggling to locate the area where the disease is being transmitted because the source of the outbreak lies near a dangerous conflict zone.

Saturday marked a month since the start of the latest outbreak, with 122 cases of Ebola reported so far.

Of the cases, the WHO said nearly 70 percent of patients died despite health officials rolling out treatment drugs, Mail Online reports.

In the latest report on the epidemic, the WHO warned “recent trends suggest control measures are working”.

But reports of the virus spreading to the he city of Beni in the North Kivu region in north-east of the Congo near the Uganda border tell a different story.

Of the confirmed Ebola cases, up to 16 health workers have contracted the disease.

UNICEF this week said it has now reached 2,454,000 people with its Ebola prevention messages in the past month.

A UNICEF representative said: “An increasing number of communities are now aware about Ebola and how to prevent its transmission.

ebola outbreak
Oofficials admitted they are struggling to locate the area where the disease is being transmitted (Image: GOOGLEMAPS)

“The active involvement of concerned communities is key to stopping the spread of the disease.”

The representative added: “We are working closely with them to promote hand-washing and good hygiene practices, and to identify and assist people that might be infected with the virus.”

The latest outbreak comes as a new Ebola virus strain has been discovered in bats in Sierra Leone.

The new type of virus has has never been detected in sick humans or other animals, a study from the University of California found.

The newly identified strain - called Bombali - has the potential to infect human cells but it is not yet known whether it has already caused human infections or if it is even harmful to humans.

Ebola is an infectious and frequently fatal disease marked by fever and severe internal bleeding.

Other symptoms include vomiting, severe headache, muscle pain diarrhoea and fatigue.

Source, map and related articles:   https://www.express.co.uk/news/world/1013584/ebola-outbreak-latest-democratic-republic-congo-africa-unicef-world-health-organisation
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Ebola: Outbreak in DR Congo claims 90 lives

10 September 2018

The charity Oxfam says that the next few weeks are critical to contain the virus, which has claimed 90 lives since 1 August.

This is the ninth time an Ebola outbreak has been recorded in DR Congo. The virus was first discovered there in 1976 - when the country was known as Zaire - and is named after the Ebola river.

In 2014, more than 11,000 people were killed by Ebola in Guinea, Sierra Leone and Liberia.

The epicentre of the recent outbreak is the densely populate town of Mangina.

The charity is concerned that fear is making some people take huge health risks.

"Some people are avoiding taking sick family members to Ebola treatment centres, because they see them as 'prisons' or 'places of death'," says Mr Barahona.

"A significant number of people who have been in touch with someone contagious have fled their homes and, in some cases, people are resisting handing over bodies of their deceased loved ones, making the threat of the virus spreading much more acute.

"People are facing the virus for the first time, so they are understandably shocked and scared.

"If you add in the appearance of health workers in space-age hazard suits and the fact they've been living with the threat of violence for decades, you can imagine how terrifying the situation is."

Rose, 28, is a market trader. She is a mother to six children.

"I have been selling rice and beans since I was 16 years old but nothing is selling now," she says. "People from outside don't come anymore, they are afraid of being contaminated.

"I have two displaced families living with me. One couple and their three children and a widowed father who lost his wife and two children in the conflict. He came to my house with his other three children. They fled armed groups who killed many people.

"I am the only person working in the home. For several days, it's very difficult to feed everyone. I cannot buy meat, fish or vegetables anymore. Since this morning, I have not been able to sell a single bag of beans."

Justin, 36, is a journalist.

"In the space of two and a half weeks, we have lost 10 family members," he says. "Eight were women, including my mother, my aunt and my niece.

"My mother took her sister-in-law to the hospital. That's how she caught the virus. My father is also in the hospital. I do not know how long he will live.

"Since help has arrived, it is clear that there are fewer cases of deaths. But we do not understand the slow pace of medical care.

"I am a journalist, so as soon as I have the strength I hope to go back to work, testify to what has happened to us and raise awareness.

"Currently, we are in shock. I hope there will be psychological care."

Marie is also a market trader in Mangina.

"My biggest fear is that the children are not eating enough," she says. "I'm afraid they will become malnourished.

"Access to Uganda is difficult. Buyers are stopped at the border. I know a local restaurateur who could not get any food last week because they didn't let her enter Uganda."

Yvette, 40, cares for 10 children, seven of which are her own and three the children of her neighbour, who died from Ebola.

"She was only 35 and died at the beginning of the outbreak," Yvette says. "We have been neighbours for more than 10 years.

"The little girl fell sick after the death of her mother. Her eyes are inflamed. Their mother had a small plot of land that we are keeping for these three children. Two of them go to school.

"We learned that the children were on the list of those who would be vaccinated, so we are waiting for the arrival of the community relay [teams]. It is true that the community is afraid of us. We feel isolated."

Louise is a community leader in a district within Mangina.

"It is a very serious disease that strikes us," she says. "Many women have died here in Mangina, at least 20 women. They are almost all from the same family.

"It must be said that in our community, it is the women who tend to the sick people. They also clean them, and wash the clothes.

"From the beginning of the outbreak, we called a community meeting and we decided to isolate any dead bodies. It was not easy because we do not have a mortuary in Mangina and people usually stay with the body for several days.

"Since the beginning of the outbreak, we can't shake hands in the village. We take hygiene measures, we try to build latrines, but it's difficult with the few means we have. Materials are expensive.

"We must start by training ourselves, the leaders, in awareness so that we can raise awareness in return."

Source, pictures and personal stories:   https://www.bbc.co.uk/news/in-pictures-45473046
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