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Ebola in the Congo

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    Posted: October 21 2019 at 5:19pm


NEWS 21 October 2019
The Ebola outbreak is finally slowing down

The World Health Organization says that the rate of new infections in the Democratic Republic of the Congo has dropped, as a vaccine moves closer to approval.
Amy Maxmen

Precautions against the Ebola epidemic in Democratic Republic of the Congo.

The use of an experimental Ebola vaccine has helped to curtail an outbreak of the virus in the Democratic Republic of the Congo.Credit: JC Wenga/Anadolu/Getty

The Ebola outbreak in the eastern Democratic Republic of the Congo (DRC) is finally waning, the World Health Organization (WHO) said on 18 October. The good news came as a vaccine that has helped to contain the virus’s spread moved a step closer to regulatory approval.

Fifty people were diagnosed with Ebola in the DRC between 25 September and 15 October, the WHO said. At the outbreak’s peak in April, roughly 300 new infections were reported in three weeks. Since the outbreak began in August 2018, almost 3,250 people have been infected and more than 2,150 have died.

But the drop in infections is not a reason to relax efforts to contain the virus, WHO director-general Tedros Adhanom Ghebreyesus told reporters on 18 October. “We must treat every case as if it is the first since every case has the potential to spark a new outbreak,” he said.

Ebola responders have pushed the virus out of Beni, a city in the DRC’s North Kivu province that has been a centre of the outbreak. But the WHO still considers the outbreak to be a public health emergency of international concern. Ebola is continuing to spread in remote parts of North Kivu and Ituri provinces, where violence has complicated the fight against Ebola.

An independent emergency committee of health experts that advises the WHO will convene again in three months to decide whether the crisis still merits the public-health-emergency designation.
Green light for vaccine

There was more good news on 18 October, when the European Medicines Agency (EMA) recommended that the European Commission approve an Ebola vaccine produced by the pharmaceutical company Merck.

About 240,000 people considered to be at risk from Ebola have been vaccinated with Merck’s vaccine during the DRC outbreak, but the vaccine is still considered to be an experimental product by regulators worldwide and cannot be marketed. Most Ebola specialists agree that the outbreak would have been much worse without the vaccine.

The EMA will make a recommendation within 10 weeks on whether to approve the vaccine for sale. The European Commission typically follows the counsel of the EMA.

The US Food and Drug Administration fast-tracked the vaccine’s application for approval in September. Its decision is expected in March 2020. Seven other experimental Ebola vaccines are at earlier stages of development.

Source:   https://www.nature.com/articles/d41586-019-03197-w

Sorry folks, I tried to post this on the Ebola Congo thread. Apparently I do not have permission to post there.     Hmmmm,    I thought I was a moderator.
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Good news at last. Thanks for posting it.


Having given the vaccine to nearly a quarter of a million people should yield a lot of data. I just wonder if the EMA has time to process that data, as giving an answer in 10 weeks sounds like they are being pushed to make a rushed decision.

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forget Ebola
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Don't forget Ebola!.....................


Any let up in Ebola response could risk escalation of outbreak in DRC, warns IRC

Report
from International Rescue Committee
Published on 29 Oct 2019 — View Original

Goma, DRC, October 29, 2019 — As the daily number of reported Ebola cases continues to be in single digits, the International Rescue Committee (IRC) reaffirms that we must double down on our efforts to reach zero cases. Any let up in the response could risk a flare up of cases, and in turn prolong the outbreak.

Dalia al-Awqati, Ebola Response Director in the Democratic Republic of Congo (DRC) at the IRC said: “Whilst we have seen the number of reported cases drop in the past weeks, cases continue to arise, and the challenges we face in controlling the spread are undiminished. We are walking on a tightrope. We know that it does not take much for cases in a new area to escalate quickly, as we have seen following previous lulls in cases in this outbreak. It only takes one infected person to travel to a new area to start a new transmission chain. Given the 21 day incubation period, the chances of this are relatively high.”

Many of the areas in which the disease is now present represent a significant challenge to the response due to their remoteness and poor infrastructure, meaning curbing transmission continues to require significant effort. Increasingly we are working with small communities with pre-existing challenges such as lack of access to water and poor access to basic services.

For example, to travel the 36km [22 miles] to Mayuwano from the small town of Mambasa in southwest Ituri province takes two hours on a good day. On a bad day the road is simply impassable. Once in Mayuwano, there is little infrastructure meaning that all materials for triages need to be brought along the increasingly damaged road, which the community also relies on. This example also brings to light the challenges that many people in North Kivu and southwest Ituiri face everyday, with or without an Ebola outbreak.

The risk of spread from the DRC to neighboring countries remains high. This means maintaining high levels of preparedness in these countries until the very end of the outbreak in DRC. This includes both monitoring for and responding to Ebola cases, as well as working to ensure that existing humanitarian programming is resilient to a potential outbreak.

The IRC has been responding to the Ebola outbreak in North Kivu and Ituri since its declaration in August last year working in more than 90 health facilities in Beni, Mabalako, Butembo, Goma and in southwest Ituri, leading on infection prevention and control (IPC). The IRC is also working in women’s and children’s protection and community engagement, and integrating Ebola-related protection concerns in areas where the IRC supports primary health care services. The IRC has a long-standing presence in this area of North Kivu and continues to equally address pre-existing and persistent health and protection needs related to displacement and insecurity in this area now impacted by Ebola.

The IRC has been working in the Democratic Republic of Congo since 1996 responding to the humanitarian crisis in the east. It has since evolved into one of the largest providers of humanitarian assistance and post-conflict development, with life-saving programming in health, economic recovery, women’s and children’s protection, and livelihoods.

MEDIA CONTACTS

Jess Wanless
International Rescue Committee
+44 7384 258293

Jessica.Wanless@rescue.org
IRC Global Communications
+1 646 761 0307
communications@rescue.org
Source:   https://reliefweb.int/report/democratic-republic-congo/any-let-ebola-response-could-risk-escalation-outbreak-drc-warns-irc

...............at least not yet.
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Ebola: Attackers kill DR Congo journalist shining light on virus

2 hours ago

A Congolese journalist who had been raising awareness about the Ebola virus in the Democratic Republic of Congo has been killed at his home.

The army said unidentified attackers raided Papy Mumbere Mahamba's home in Lwebma, in the north-eastern province of Ituri, killing him, wounding his wife and burning their house down.

DR Congo is experiencing the world's second-worst Ebola epidemic on record.

People working to stop the virus are often targets of attacks.

Mahamba's murder is likely to have been fuelled by deep suspicion of the Ebola virus and mistrust of those who are working to stop it, the BBC World Service's Africa editor Will Ross says.
What happened?

Mr Mahamba had just hosted an Ebola awareness programme on a community radio station when the attack took place.

Professor Steve Ahuka, national coordinator of the fight against Ebola, confirmed the reports from the army that a "community worker" involved in the fight against Ebola had been killed.

    Six steps to stop Ebola from spreading
    Ebola: Your questions answered
    Ebola outbreak in five graphics

A journalist at Radio Lwemba, the local radio station where he worked, also confirmed the details. Jacques Kamwina told AFP news agency that Mahamba had been stabbed to death.
What is the situation with Ebola in the DRC?

The DRC declared an Ebola epidemic in August 2018. More than 2,000 lives have been lost amid a total of 3,000 confirmed infections, according to the World Health Organization (WHO).

The outbreak is affecting the DRC's North Kivu, South Kivu and Ituri provinces.

In July, the WHO said the situation there was a "public health emergency of international concern."

Efforts to control the outbreak have been hampered by violence against healthcare workers and Ebola treatment facilities.

Some do not believe that the virus exists or do not trust health workers, leading people to avoid treatment.

Over the last year there have been some 200 attacks on health workers, ambulances and health centres.
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, BBC:   https://www.bbc.co.uk/news/world-africa-50283286
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LATEST UPDATE

Fifteen confirmed cases were reported in the past week (30 October – 5 November) in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. While the number of new cases is consistent with the weekly average of 19 confirmed cases in the past 21 days, there is notable daily fluctuation of cases.

Violence this week in Lwemba Health Area in Mandima Health Zone caused the death of an Ebola response community health worker and left his spouse critically injured. WHO and partners condemned the attack, adding that acts of violence against individuals involved with the response are unacceptable and compromise the ability of health workers to assist communities impacted by the devastating effects of Ebola.

During the past 21 days (16 October – 5 November), 54 confirmed cases were reported from seven active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in four health zones: Mandima (39%, n=21), Mabalako (31%, n=17), Beni (11%, n=6) , and Mambasa (11%, n=6). The vast majority (83%) of these cases were linked to Biakato Mines Health Area in Mandima Health Zone, with the remaining 10 cases linked to known chains of transmission in Binase, Katwa and Lwemba Health Areas.

In this context, reintroduction into previously cleared or unaffected neighbouring areas can be expected and possible geographical spread should be closely assessed and monitored. Approximately half (51%) of the cases reported in the past 21 days were located outside of the health zone where they had got infected, with the majority of these movements going to or coming from Mandima Health Zone. An analysis of population movement indicates that travel within the region is directed eastward from Mambasa to Komanda and towards Bunia, southward between Mambasa and Mangina, and further south and south-east through Beni to Butembo, and all the way to Kasindi and crossing into Uganda. Points of entry and points of control continue to be strengthened by response teams based on movement of cases and populations. This week, a case was detected while traveling through a newly-opened point of control, reinforcing the importance of enhancing screening along these major passages, transitways and border points. An example of reinforcement activities underway is the introduction of a EVD laboratory in Kasindi Health Area in the past week, close to the border with Uganda. This will facilitate the rapid identification of cases and earlier initiation of response activities.

As of 5 November, a total of 3285 EVD cases were reported, including 3167 confirmed and 118 probable cases, of which 2191 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1852) were female, 28% (n=930) were children aged less than 18 years, and 5% (n=163) were health workers.

Public health response

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

Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 8 October 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.

While the relatively lower case incidence observed is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security within affected communities. Concurrent with the decline in case incidence, there was a shift in hotspots from urban settings to more rural, hard-to-reach communities, within a more concentrated geographical area. These areas bring additional challenges to the response, including an extremely volatile security situation, difficulty accessing some remote areas, delays to engaging with the community which in turn lead to mistrust and misunderstandings, and potential under-reporting of cases. In such environments, risks of resurgence remain very high, as do the risks of re-dispersion of the outbreak with cases travelling outside of hotspots to seek healthcare or for other reasons. These risks continue to be mitigated by the substantial response and preparedness activities in the Democratic Republic of the Congo and neighboring countries, with support from a consortium of international partners.

WHO advice

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 travellers to/from the affected countries. 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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

LINKS

Sourcehttps://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-75
View Original:   https://www.who.int/csr/don/07-november-2019-ebola-drc/en/
Main WHO Site:   https://reliefweb.int/organization/who

Further links:


WHO resources and updates on Ebola virus disease:   https://www.who.int/health-topics/ebola/
News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities:   https://reliefweb.int/report/democratic-republic-congo/ebola-cases-reach-3000-drc-who-calls-all-partners-fulfill-promises
Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries:   https://reliefweb.int/report/democratic-republic-congo/ebola-cases-reach-3000-drc-who-calls-all-partners-fulfill-promises
Second Ebola vaccine to complement “ring vaccination” given green light in DRC:   https://reliefweb.int/report/democratic-republic-congo/second-ebola-vaccine-complement-ring-vaccination-given-green-light
Update on Ebola drug trial: two strong performers identified:   https://reliefweb.int/report/democratic-republic-congo/update-ebola-drug-trial-two-strong-performers-identified
Ebola response funding:   https://www.who.int/emergencies/diseases/ebola/drc-2019/funding
Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization:   https://www.who.int/immunization/policy/sage/en/
Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 18 October 2019:   https://www.who.int/immunization/policy/sage/en/
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Never ending story this one....







Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖

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Only not as much fun as that film.
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Outbreak Update

Thu 7 November 2019. WHO/AFRO Ebola dashboard, World Health Organization Regional Office for Africa:

3286 cases (including 0 new confirmed case), of which 3168 confirmed/ 118 probable cases, 531 suspected cases/ 51 cases in the last 21 days/ 1063 survivors/ 2191 deaths/ 5.7K contacts being followed out of 6.6K identified
Outbreak Response

Fri 7 Nov 2019. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola):

79 / 100 bikers were vaccinated, as part of the launch of the biker vaccination in Beni in the Kazabimyole health area;

Since vaccination began on 8 Aug 2018, 248 004 people have been vaccinated with the VSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck.

Since the beginning of the epidemic, the total number of travelers checked (temperature measurement) at the sanitary control points is 114 221 518.

To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country’s major cities and prevent the spread of the epidemic in neighboring countries





Source:   https://cepi.net/news_cepi/disease-outbreak-update-ebola-mers-rift-valley-fever-and-lassa-outbreaks-continue/
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12 November 2019
Make Ebola a thing of the past: First vaccine against deadly virus approved

The drug, which has already been given to hundreds of thousands of people in the Democratic Republic of the Congo, can now be distributed more widely.

The world finally has an Ebola vaccine. On 11 November, European regulators approved a vaccine that has already helped to control deadly outbreaks of the virus — the first time any immunization against Ebola has passed this hurdle.

The decision by the European Medicines Agency (EMA) to allow US pharmaceutical company Merck to market its vaccine means that the product can now be stockpiled and, potentially, distributed more widely, in particular in Africa. In 2015, Gavi, the Vaccine Alliance — a global health partnership that funds vaccine supplies in low-income countries — told Ebola-vaccine manufacturers that it would commit to purchasing vaccines once they had been approved by a “stringent health authority” such as the EMA.

Although several other vaccines against Ebola — a haemorrhagic fever that causes severe diarrhoea, vomiting and bleeding — are in development, Merck’s is the only one that has been tested during an outbreak, where it was shown to be highly effective in preventing infection.

The vaccine, first patented in 2003, has been administered on an emergency basis to quell the ongoing outbreak in the Democratic Republic of the Congo (DRC), which has killed some 2,000 people since it started last year. It was also used during a 2018 outbreak in that country, and in Guinea in 2015. In the current DRC outbreak, hundreds of thousands of people have received the Merck shot, including more than 60,000 health-care workers in DRC and several neighbouring countries.

“This is a vaccine with huge potential,” said Seth Berkley, chief executive of Gavi in Geneva, Switzerland, in a press release after the EMA decision. “It has already been used to protect more than 250,000 people in the DRC and could well make major Ebola outbreaks a thing of the past.” The organization has supported the stockpiling and delivery of Ebola vaccines and hopes to build up a global supply that could be rolled out quickly during future outbreaks of the virus.

The EMA’s approval “makes a big difference”, says David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine. But he stresses that research into the Merck vaccine and development of further Ebola vaccines must continue. “The message is that the research is not done. It must continue,” he adds. “It’s really important to continue to study vaccines and develop those second- and third-generation vaccines.” These could offer longer-lasting immunity, target more than one species of Ebola and be easier to store.

Merck’s vaccine, which is marketed under the name Ervebo and known to researchers as rVSV-ZEBOV-GP, was tested in a clinical trial conducted in Guinea towards the end of the 2014–16 Ebola outbreak in West Africa. There, the vaccine was administered to people who had been in contact with someone who was infected with Ebola, or with their subsequent contacts. It was found to offer a high level of protection against infection.

Health workers have used this strategy — known as ring vaccination — in the two other outbreaks in which rVSV-ZEBOV-GP has been deployed. But Heymann says it’s important to determine whether the Merck vaccine could be used in other ways — for instance, administered preventively to emergency health workers who might encounter Ebola in the distant future. This would mean determining how long the vaccine’s protection lasts, and whether an additional dose — a booster — can extend immunity.

Such studies are in the works with rVSV-ZEBOV-GPand competing vaccines, says Adrian Hill, a vaccinologist at the University of Oxford, UK. “The question remains, which vaccine would you give to, say, health-care workers to prevent them getting Ebola?”

Merck’s product protects against the Zaire species of the Ebola virus, which is behind the current DRC outbreak and the 2014–16 West Africa outbreak. It will be important to develop vaccines against other species of the virus — especially the Sudan species, which has caused seven known outbreaks since 1976, says Hill, who helped test an Ebola vaccine that was shelved by the London-based pharmaceutical company GSK in August.

There are seven other Ebola vaccines in various stages of clinical testing, according to the World Health Organization (WHO) in Geneva. In September 2019, the WHO announced that a vaccine manufactured by Johnson & Johnson in New Brunswick, New Jersey, would be used in the current DRC outbreak. Last week, the company submitted that vaccine for EMA approval.

Unlike the Merck vaccine, which is given in one dose, the Johnson & Johnson immunization requires a booster shot administered 56 days after the first injection. In the DRC, it will be given to populations at risk of Ebola, such as health-care workers, in areas where the virus is not already circulating.

And next month, Gavi’s board will decide whether to establish a global stockpile of Ebola vaccine. Merck, which is headquartered in Kenilworth, New Jersey, is also seeking approval of the vaccine by the US Food and Drug Administration.

Source:   https://www.nature.com/articles/d41586-019-03490-8
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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 69

from World Health Organization
Published on 26 Nov 2019 View Original

Situation Update

In the week of 18 to 24 November 2019, seven new confirmed EVD cases were reported from four health zones in two affected provinces in Democratic Republic of the Congo. The majority of the confirmed cases in this week came from Mabalako Health Zone (57%; n=4).

Violence and civil unrest in the week have led to the suspension of Ebola response activities in some areas of Beni, Butembo, and Oicha health zones. On 26 November 2019, some response personnel were temporarily relocated from Beni, though most remain in place to continue responding. The immediate focus will be on maintaining the safety and welfare of response personnel while preserving essential response activities in these places.

The disruptions to the response and lack of access to Ebola-affected communities is threatening to reverse recent progress. As seen previously during this outbreak, such disruptions limit contact tracing, surveillance, and vaccination efforts, and they often result in increased transmission.

In the past 21 days (from 4 to 24 November 2019), 12 health areas and four health zones have reported cases (Table 1, Figure 2). During this period, a total of 28 confirmed cases were reported, with the majority reported from Mabalako (54%; n=15 cases) and Beni (32%; n=9). There have been no new confirmed cases in Nyakunde Health Zone for 42 days.

As of 24 November 2019, a total of 3303 EVD cases, including 3185 confirmed and 118 probable cases have been reported, of which 2199 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1862) were female, 28% (935) were children aged less than 18 years, and 5% (163) were healthcare workers.


Source and further links:   https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-84
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WHO evacuates staff amid violence in Ebola outbreak zone

Mackenzie Bean - 17 hours ago

Increased violence from militia groups in the Democratic Republic of Congo spurred the World Health Organization to pull one-third of its workforce from an Ebola outbreak zone this week, reports Nature.

The organization temporarily evacuated about 40 people from the city of Beni. The remaining 80 team members stationed in the city have mostly halted efforts to trace and vaccinate known contacts of Ebola patients, thereby hindering outbreak containment efforts.

The WHO expects Ebola cases to rise as a result, according to Christian Lindmeier, a spokesperson for the health agency.

As of Nov. 27, the WHO has reported 3,304 confirmed and probable Ebola cases linked to the outbreak, including 2,198 deaths.

Source:   https://www.beckershospitalreview.com/quality/who-evacuates-staff-amid-violence-in-ebola-outbreak-zone.html
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Technophobe: It was all coming under control, but now this threatens the success of the fight.

Rebels shoot dead three Ebola medics working on containing the second-worst outbreak of the disease in history in Congo

By Ross Ibbetson For Mailonline and Ap

Published: 10:06, 28 November 2019 | Updated: 11:19, 28 November 2019



    The three were killed when Mai-Mai Rebels raided a UN health agency base
    They were shot in Biakoto, eastern Congo, along with a local resident last night
    Warnings had been posted earlier for health workers to leave or face 'the worst'
    Some rebel groups active in the region believe Ebola is just but a political ploy



Congolese rebels have shot dead three Ebola medics working on containing the second-worst outbreak of the disease in history.

The three health workers were killed when Mai-Mai fighters raided a United Nations health agency base overnight in Biakoto, eastern Congo.

'We are heartbroken that our worst fears have been realised,' Tedros Adhanom Ghebreyesus, head of the World Health Organisation, said on Twitter on Thursday.

One resident also was killed and Congolese forces killed one attacker and captured two others, Selemani said.

Warnings had been posted earlier demanding that the health workers leave or face 'the worst,' the official said.

This is not the first time that health workers trying to contain the second-worst Ebola outbreak in history have been targeted.

Some have called this outbreak more complicated than any other. Several rebel groups are active in the region, and local officials say some believe Ebola is nothing but a political ploy.

'Imagine, a doctor leaves home in the U.S. or elsewhere to come sleep in a tent to help save us from this scourge of Ebola and yet poorly educated young people want to attack him. ... It is very deplorable,' said Fiston Kamango, a youth leader in Biakato.

The latest attacks come after days of deadly unrest in the city of Beni, where residents outraged by repeated rebel attacks stormed the local U.N. peacekeeping base, demanding more protection.

WHO evacuated 49 of its staffers there, leaving 71 in place.

Ebola response work was put on lockdown in Beni, dismaying health experts who say every attack hurts crucial efforts to contain the deadly virus.

The number of cases had been dropping in the yearlong outbreak which has killed more than 2,100 people. Several days this month, zero cases were reported. Previously, cases have surged after attacks on health workers and facilities.

In one example of how any pause can sharply affect Ebola containment efforts, WHO has said no one in Beni could be vaccinated against the virus on Monday. The health agency previously could trace more than 90% of contacts of infected people in the city but now that figure is just 17%, a U.N. spokesman said Tuesday.

Residents accuse Congolese and U.N. forces of not doing enough to protect civilians from the rebels who fight for control of the region's vast mineral wealth.

The Allied Democratic Forces armed group alone is blamed for the murders of more than 1,500 people in and around Beni in the past four years.

The latest rebel attack outside Beni killed 19 people, the U.N. said Wednesday.

After an emergency meeting Monday, President Felix Tshisekedi decided to allow joint operations between Congolese and U.N. forces in Beni following the protests that also burned the town hall.

Far from the capital, Kinshasa, some traumatized residents in the densely populated border region near Uganda and Rwanda are wary of outsiders, further complicating the Ebola containment work in a part of Congo that had never recorded the virus before.

Health workers continue to battle misinformation and reluctance to seek treatment for the virus that is largely spread via close contact with the bodily fluids of infected people, including the dead.




Source:   https://www.dailymail.co.uk/news/article-7734855/Rebels-shoot-dead-three-Ebola-medics-working-containing-disease-Congo.html

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Ebola Outbreak in Congo Likely to Resurge After Clinic Attacks
.......TWO STEPS BACK
Emily Shugerman

Gender Reporter
Published Nov. 29, 2019 12:53PM ET

Health officials warned Ebola was likely to resurge in Congo after a series of attacks on health-care centers working to control the epidemic. Armed groups killed four response workers and injured five others at a camp in Biakato Mines on Thursday, in what is thought to be the deadliest attack on an Ebola clinic yet. The Red Cross, World Health Organization, World Food Programme and others have all suspended operations or experienced interruptions due to the violence, according to Reuters. The WHO said the disease outbreakwhich has killed more than 2,000 people to datehad slowed in recent weeks, but may gain steam in the absence of the response efforts.

Source:   https://www.thedailybeast.com/ebola-outbreak-in-congo-likely-to-resurge-after-clinic-attacks
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UPDATE

Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 5 December 2019


Nine new confirmed cases were reported from 27 November to 3 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. The confirmed cases in this week were reported from Mandima (56%, n=5) and Mabalako (44%, n=4) Health Zones.

In the past two weeks, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations. As a result, several key activities of the response experienced diminished performance, including the volume of reported and investigated alerts and the number of contacts registered and followed (Figure 1, Figure 2). The volume of alerts from health zones affected by insecurity is lower than usual, and this has led to an overall reduction in the average number of alerts reported in the last seven days. Of the 3346 alerts reported, 96% were investigated within 24 hours.

The overall average percentage of contacts under surveillance in the last seven days is 70%, which is below the average for November prior to these security events (Figure 2). This is due mainly to performance being suboptimal in some areas of Beni, Mabalako, and Oicha Health Zones, with only 82% of contacts followed in Beni, 68% in Mabalako, and 42% in Oicha. These numbers are improving slowly since the events, but fluctuations illustrate the continued impact that security events have on response activities.

In the past 21 days (13 November to 3 December), 22 confirmed cases were reported from 10 of the 71 health areas within four neighbouring active health zones in North Kivu and Ituri provinces (Figure 3, Table 1): Mabalako (55%, n=12), Mandima (27%, n=6), Beni (9%, n=2), and Oicha (9%, n=2). The majority of the cases (91%, n=20) are linked to known chains of transmission. In the past 21 days, a higher proportion of cases (31%, n=8) have reported a funeral as their potential exposure to EVD compared to the average since January 2019 (7%); this is because of two separate community clusters in the health areas of Lwemba (six cases) and Bingo (two cases) linked to the burials of two probable cases.

As of 3 December, a total of 3313 EVD cases were reported (Figure 4), including 3195 confirmed and 118 probable cases, of which 2207 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1866) were female, 28% (n=936) were children aged less than 18 years, and 5% (n=163) were health workers.

Public health response

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

Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low.

Although the number of new confirmed cases has remained relatively low, the interruption of response activities due to attacks, violence and unrest threatens to reverse recent progress. WHO and response partners are working to adapt the response strategy to protect communities from a resurgence of the outbreak while keeping all responders safe.

WHO advice

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. 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 practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.


Source and several links:   https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-79
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NEW FEARS AS ONE PERSON GETS DISEASE TWICE


Spike in Ebola cases alarms health officials in DRC

Many cases blamed on a single individual who appears to have caught virus for second time

Global development is supported by
Bill and Melinda Gates Foundation
About this content

Peter Beaumont

Fri 13 Dec 2019 15.01 GMT
Last modified on Fri 13 Dec 2019 20.25 GMT

Health officials are investigating an alarming spike in Ebola cases in the Democratic Republic of the Congo, with many blamed on a single individual who appears to have contracted the disease for a second time this year.

Amid the struggle to bring the 16-month outbreak under control, the World Health Organization noted an almost 300% increase in cases in the last three weeks, with 17 of 27 linked to a single chain of transmission.

According to officials, it appears to be the second time the person has been documented as suffering from Ebola in six months. An investigation is being held to understand the circumstances around the case.

Ten cases were notified on Wednesday in Mabalako, North Kivu province, where the individual is believed to be from, after another six on Tuesday, according to officials who noted that three out of the six were practitioners of traditional medicine.

The spike – and the worrying circumstances behind it – appears to buck a trend towards a declining number of cases, although security issues in the key zones of Beni, Biakato and Mangina had recently paralysed the response after violent attacks on health workers.

Among the possibilities being examined are reinfection with the disease – which would ring the most serious alarm bells as no case of reinfection has ever been recorded before – or a relapse.

While rare cases of relapse have been documented, in which a person who has recovered from Ebola gets its symptoms again, reinfection would mean a person who has recovered has been infected anew with the virus by another person, a circumstance so far undocumented.

Experts have long been anxious about the risk of recurrence because the virus can persist for months in areas of the body that are immunologically protected, including semen, vaginal fluids, sweat, aqueous humour, urine, breast milk and even spinal fluid after initial onset and recovery.

That has led researchers to speculate about the continued risk of transmission in individuals not showing any symptoms, including through sexual activity, leading to reactivation of the illness.

Reinfection, relapse and recurrence are all sources of acute concern in controlling the outbreak, as Ebola survivors are employed widely in treatment centres in DRC on the assumption they cannot usually recontract or transmit the disease.

In July another patient died from what was also presumed to be a relapse or reinfection, calling into question the assumption that Ebola survivors have lifelong immunity from the virus.

According to figures from the African Union as of 8 December, the Ebola outbreak in DRC has claimed 2,209 lives since it broke out, with 3,327 recorded cases.

Source:   https://www.theguardian.com/global-development/2019/dec/13/spike-ebola-cases-alarms-health-officials-drc
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Experts breathe sigh of relief as WHO say Ebola patient was not reinfected with the deadly disease

Source and full article:   https://www.telegraph.co.uk/global-health/science-and-disease/experts-breathe-sigh-relief-say-ebola-patient-not-reinfected/
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LATEST UPDATE


January 02, 2020
WHO: Ebola virus disease – Democratic Republic of the Congo

WHO has published Ebola virus disease – Democratic Republic of the Congo. Excerpt:

    Since the last disease outbreak news published on 19 December 2019, 29 new confirmed cases were reported from 18 to 31 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu province. The confirmed cases in this week were reported from eight health areas in four health zones: Mabalako (62%, n=18), Butembo (14%, n=4), Kalunguta (17%, n=5), and Katwa (7%, n=2). Three of the four cases reported in Butembo in the past fourteen days are linked to a transmission chain of more than 50 people that originated in Aloya Health Area, Mabalako Health Zone.

    One individual classified as a relapse case of EVD, infected several other individuals within the family and through nosocomial transmission (for more information, please see the disease outbreak news published on 19 December 2019).

    In Kalunguta Health Zone, the five cases reported between 24 and 28 December 2019, are a distinct epidemiologically linked chain of transmission, although the source of exposure is currently under investigation.

    In the past 21 days (11 December to 31 December), 40 confirmed cases were reported from 10 health areas within five neighbouring active health zones in North Kivu province (Figure 2, Table 1): Mabalako (68%, n=27), Butembo (13%, n=5), Kalunguta (13%, n=5), Katwa (5%, n=2), and Biena (3%, n=1). The majority of the cases (75%, n=30) are linked to known chains of transmission.

    As of 31 December, a total of 3380 EVD cases were reported, including 3262 confirmed and 118 probable cases, of which 2232 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1900) were female, 28% (n=953) were children aged less than 18 years, and 168 (5% of all reported cases) were healthcare workers.


Source:   https://crofsblogs.typepad.com/h5n1/2020/01/who-ebola-virus-disease-democratic-republic-of-the-congo.html
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Update

08 Jan 2020

Ebola virus disease (EVD): Democratic Republic of Congo- update
New confirmed cases continue to be reported in North Kivu and Ituri Provinces
Ebola virus disease (EVD): Democratic Republic of Congo- update

The outbreak of Ebola virus disease (EVDV) in Democratic Republic of Congo is ongoing. As of 5 January 2020, a total of 3,390 cases have been reported (3272 confirmed cases and 118 probable cases) including 2,233 deaths [1]. Since the last report on 23 December 2019, new cases are confirmed in the north east of the country; Butembo, Kalunguta, Katwa and Mabalako in North Kivu Province and the first confirmed cases in Mambasa, Ituri Province for 66 days [1].

A weekly situation report is published by the WHO.

On 18 October 2019, the Emergency Committee (EC) met to reassess the Public Health Emergency of International Concern (PHEIC) for EVD under the IHR (2005) that was declared in July 2019. The EC acknowledged progress made towards limiting the spread and impact of the disease including the success of a ring vaccination strategy and preparedness efforts of neighbouring countries. However, the EC expressed concern that many challenges remain, including issues relating to security, population movement and access to hard to reach communities. The committee concluded that the event remained a PHEIC under the IHR (2005 The Statement of the Emergency Committee (18 October 2019) is available from WHO [2].

The epidemic of Ebola Virus Disease (EVD) in DRC began on 1 August 2018 [3]. The region is affected by a long-standing humanitarian crisis; the security situation remains unpredictable and poses an ongoing challenge to outbreak response and containment activities [4]. Recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo are available from the WHO [5].

The European Centre for Disease prevention and Control (ECDC) consider that the probability that EU/EEA citizens living or travelling in EVD-affected areas of DRC will be exposed to the virus is low, provided they adhere to precautionary measures [6]. This outbreak continues to present a negligible to very low risk to the UK public [7].
Advice for travellers

The Foreign and Commonwealth Office (FCO) has restrictions on travel to some areas of DRC: travellers are recommended to review the current information prior to departure.

Visitors to EVD-affected areas face a low risk of becoming infected if usual and enhanced precautions are followed:

    Avoid contact with symptomatic patients/their bodily fluids; corpses and/or bodily fluids from deceased patients, and all wild animals, alive and dead.
    Avoid handling or eating bush/wild meat (the meat of wild or feral mammals killed for food).
    Wash and peel fruit and vegetables before consumption.
    Wash hands regularly and carefully using soap and water (or alcohol gel when soap is unavailable).
    Practise safer sex (using barrier contraception).

Get medical advice if you become ill within 21 days after getting home. You should call NHS111 or contact your GP by telephone; although it is very unlikely you have EVD, you should mention any potential exposure to the virus including dates and itinerary of travel.

EVD is a severe, often fatal illness in humans and is introduced into human populations by close contact with the blood and other bodily fluids and organs of infected wild animals such as antelopes, bats, chimpanzees, gorillas and monkeys. The virus then spreads from person to person by direct contact with blood, faeces, vomit, organs or other bodily fluids of infected persons; Infection can be transmitted via contact with objects, like contaminated needles or soiled clothing. Outbreaks have been spread by traditional burial practices, when mourners have direct contact with the deceased (such as touching or washing the body, which still contains high levels of Ebola virus) [8].

Hospital workers have been infected through close contact with infected patients and insufficient use of correct infection control precautions and barrier nursing procedures. Sexual transmission has been documented, as the virus can be present in semen for months after recovery [9].
Humanitarian and other aid workers

    Risk to UK personnel (non-clinical) working outside the affected areas in DRC is very low.
    For those working in affected areas, risk will vary, depending on activities undertaken.
    Exposure risk for those working directly with infected individuals, such as in treatment centres, is low, if strict barrier techniques have been implemented and all staff are provided with and trained in use of appropriate personal protective equipment [10].

Additional advice can been found in the Public Health England guidance (PHE): Ebola virus disease: information for humanitarian aid workers.

Individuals planning to go to outbreak areas for humanitarian activities should follow advice from their deploying organisation before they travel. PHE is operating a returning workers scheme for humanitarian and healthcare workers who will be residing in England, Wales, Scotland or Northern Ireland after they have completed their deployments. Deploying organisations are asked to register their workers with the scheme in advance of their return to the UK. Further information on the returning workers scheme is available from PHE.

This outbreak is being closely monitored and the risk will be re-evaluated if the epidemiological situation changes. Travellers should monitor NaTHNaC and FCO updates on a regular basis for more information.

There is no licensed vaccine for general use in travellers to prevent EVD. Two currently unlicensed vaccines are available for high risk populations in EVD risk regions in DRC [11,12].
Advice for health professionals

In the event of a symptomatic person with a relevant travel history presenting for health care, the Imported Fever Service should be contacted via your local infectious disease clinicians or microbiologists in order to discuss testing. The Rare and Imported Pathogens Laboratory will test patient samples if appropriate. Infection control recommendations and other clinical management advice are provided in the national viral haemorrhagic fever guidelines.


Source and rescource links:   https://travelhealthpro.org.uk/news/484/ebola-virus-disease-evd-democratic-republic-of-congo-update
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UPDATE

Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 16 January 2020
Report
from World Health Organization
Published on 16 Jan 2020 — View Original
preview
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Fourteen new confirmed cases were reported from 8 to 14 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. The confirmed cases were reported from Mabalako (64%, n\=9), Beni (29%, n\=4) and Musienene (7%, n\=1) Health Zones in North Kivu Province. All new confirmed cases (100%, 14/14) reported in the past seven days were registered contacts prior to symptom onset and had epidemiological links to the transmission chain which originated from Aloya Health Area in Mabalako Health Zone.

In the past 21 days (25 December 2019 to 14 January 2020), 40 confirmed cases were reported from 14 health areas within seven active health zones in North Kivu and Ituri Provinces (Figure 1, Figure 2, Table 1): Mabalako (43%, n\=17), Butembo (20%, n\=8), Beni (13%, n\=5), Mambasa (10%, n\=4), Kalunguta (8%, n\=3), Katwa (5%, n\=2), and Musienene (3%, n\=1). Mabalako Health Zone remains the current hotspot of the outbreak, having reported 43% of confirmed cases in the past 21 days. The majority of cases (88%, 35/40) reported from this period are linked to known chains of transmission, which is similar to the period from 4 to 24 December 2019 (89%, 47/53). In the past 21 days, 8% (3/36) of the confirmed EVD deaths were people who died in the community, outside of Ebola treatment centres. From these three community deaths, 15 additional cases occurred, which reinforces the need for continued activities to follow contacts, detect symptomatic patients as early as possible, and engage communities in response efforts.

As of 14 January, a total of 3406 EVD cases were reported, including 3288 confirmed and 118 probable cases, of which 2236 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n\=1910) were female, 28% (n\=960) were children aged less than 18 years, and 169 (5% of all reported cases) were health care workers.

In the coming week, there will be nine health zones in North Kivu and Ituri Provinces that will have contacts in or entering their high-risk period (seven to 13 days after last exposure to the virus). In Kalunguta Health Zone, North Kivu Province, where five individuals were confirmed with EVD from 24 to 28 December 2019, all 153 contacts have cleared their 21-day follow-up, with no new cases reported. In Mambasa Health Zone, Ituri Province, where four new cases were reported from 4 to 5 January 2020, more than 400 followed contacts are nearing the end of their high-risk period.

It has been 20 months since the outbreak was first declared on 8 May 2018. The number of cases reported per week is lower than the period from March to September 2019 (Figure 1). However, there are several health areas which are difficult to reach due to insecurity, including Mandima Health Zone, where there are rumours of several community deaths in Lwemba Health Area. Continued response efforts in active health zones, including in insecure areas, and preventing reintroduction of the disease into health zones with dense populations which have previously been cleared are crucial to ending ongoing transmission.

Public health response

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

    Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low.

WHO advice

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. 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 practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

Source, PDF and links:   https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-85
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[url]https://www.zerohedge.com/health/ebola-reappears-central-africa-very-moment-last-outbreak-declared-over[/url]

The World Health Organization (WHO) said on Sunday it's closely monitoring the potential reemergence of Ebola in central Africa, after two Ebola deaths were recorded there within just a matter of days

Health officials thought they had witnessed the end of the second-deadliest outbreak of the virus on record there, after not a single case had appeared in nearly seven weeks.

The WHO has since 2018 considered the DRC at hotspot for the deadly disease, potentially threatening surrounding countries and the rest of Africa. Ebola has killed over 2,200 since an outbreak began in August 2018. The country has been struggling since to get a handle on it.

[url]https://www.reuters.com/article/us-health-ebola-congo/congo-records-second-ebola-death-in-days-who-idUSKCN21U0CF?il=0[/url]

BENI, Democratic Republic of Congo (Reuters) - Democratic Republic of Congo recorded a second Ebola death in days following more than seven weeks without a new case, the World Health Organization said on Sunday.

-

Flare-ups or one-off transmissions are common towards the end of Ebola outbreaks, and a new case does not necessarily mean that the virus will spread out of control again.

-

Two new vaccines have helped contain the virus, though public mistrust and militia attacks prevented health workers from reaching some hard-hit areas.

We cannot solve our problems with the same thinking we used when we created them.
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