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Printed From: Avian Flu Talk
Category: Disease / Flu Tracking
Forum Name: Ebola
Forum Description: (Tracking the Ebola virus)
URL: http://www.avianflutalk.com/forum_posts.asp?TID=38702
Printed Date: December 08 2019 at 3:37am


Topic: DR CONGO
Posted By: Technophobe
Subject: DR CONGO
Date Posted: December 20 2018 at 2:27am
Well it seemed about time to update this (after all, the numbers have entered the second tier of the poll http://www.avianflutalk.com/poll-how-large-will-the-current-ebola-outbreak-be_topic38553_post274794.html#274794" rel="nofollow - http://www.avianflutalk.com/poll-how-large-will-the-current-ebola-outbreak-be_topic38553_post274794.html#274794 ) and about time I used the actual ebola topic room.

Up to 319 people dead as Congo Ebola outbreak worsens

By Bethlehem Feleke and Susan Scutti, CNN

Updated 1024 GMT (1824 HKT) December 19, 2018

One of the deadliest Ebola outbreaks in history continues to worsen in the Democratic Republic of Congo with as many as 319 people now dead.
The Ministry of Health said Tuesday that 542 Ebola cases had been recorded in the province of North Kivu -- 494 of which have been confirmed. Of the 319 believed to have died from the virus so far, 271 have been confirmed.
On average, Ebola -- which causes fever, severe headache and in some cases hemorrhaging -- kills about half of those infected, but fatality rates in individual outbreaks have varied.

The World Health Organization (WHO) said efforts to contain the outbreak have been hampered due to "non-engagement" from local communities and armed conflict in the region.

North Kivu, which includes the cities of Beni, Kalunguta and Mabalako, remains the epicenter of the outbreak, though cases have been reported in neighboring Ituri province, according to the WHO. The two provinces are among the most populated in the nation and border Uganda, Rwanda and South Sudan.

The public health agency estimates that more than a million refugees and internally displaced people are traveling through and out of North Kivu and Ituri, which could hasten the spread of the virus further.
The death of Ebola?

The death of Ebola? 01:32
The Congo outbreak is the second-deadliest ever, behind only in West Africa in 2014, when the virus killed more than 11,000 people. It is Congo's 10th epidemic since 1976, and second this year.

Source and video: https://edition.cnn.com/2018/12/18/health/ebola-democratic-republic-of-congo-intl/index.html" rel="nofollow - https://edition.cnn.com/2018/12/18/health/ebola-democratic-republic-of-congo-intl/index.html

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Absence of proof is not proof of absence.



Replies:
Posted By: EdwinSm,
Date Posted: December 20 2018 at 10:55pm
From that poll,it is now in the bracket that the majority expected (ie 300-1000 limited regional spread), and had a long way to go to reach the "regional epidemic".

This Ebola outbreak seems to be slowly trudging along, with no end in sight, but it has not exploded like the West African (2014) outbreak.


Posted By: Technophobe
Date Posted: January 10 2019 at 4:57pm
UPDATE

Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news: Update
10 January 2019

WHO and partners continue to respond to the ongoing Ebola virus disease (EVD) outbreak in one of the most complex settings possible. A decline in case incidence has been seen in Beni, the former epicentre. This is a strong positive indication of how effective the response can be despite multiple challenges. However, in Beni and elsewhere, trends must be interpreted cautiously, as delayed detection of cases is expected following recent temporary disruption in response activities due to insecurity. Nevertheless, WHO and partners remain committed, under the government’s leadership and through collaboration across agencies, to addressing challenges and ending the outbreak.

As of 8 January 2019, there have been a total of 628 EVD cases1 (580 confirmed and 48 probable), including 383 deaths (overall case fatality ratio: 61%). Thus far, 222 people have recovered, been discharged from an Ebola Treatment Centre (ETC) and enrolled in a dedicated program for monitoring and supporting survivors.

During the last 21 days (19 December 2018 to 8 January 2019), cases have been reported from ten health zones where the outbreak remains active, including: Katwa (18), Butembo (16), Oicha (13), Beni (13), Kalungata (6), Mabalako (5), Komanda (3), Musienene (2), Kyondo (1) and Nyankunde (1). Overall, cases have occurred in localised hotspots within 16 health zones found in North Kivu and Ituri provinces (Figure 1). Surveillance activities are being maintained to rapidly detect resurgences or reintroduction events in all areas.

Trends in numbers of new cases occurring (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas, with encouraging declines in case incidence in areas such as Beni. Hard-earned progress could still be lost from prolonged periods of insecurity hampering containment efforts.

Amongst confirmed and probable EVD cases, 61% (385/628) were female and 30% (189/628) were children aged less than 18 years. This includes a high number of cases in infants aged less than 1 year (38) and 1-4 years (58). While investigations to understand the risk factors for this disproportionate burden are ongoing, response teams continue to prioritise these population groups to mitigate, wherever possible, the risk of transmission.

All alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries continue to be monitored and investigated. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, Uganda, South Sudan, Rwanda and in a traveller returning from Burundi to Sweden. To date, EVD has been ruled out in all alerts outside the outbreak affected areas. International travellers who may have come into contact with the virus, including a doctor who returned to the United States of America after providing medical assistance in the Democratic Republic of the Congo, are also being followed closely; all remain asymptomatic.

Source and LOTS OF additional info: https://www.who.int/csr/don/10-january-2019-ebola-drc/en/" rel="nofollow - https://www.who.int/csr/don/10-january-2019-ebola-drc/en/

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 12 2019 at 10:53am
UPDATE   May I draw everyone's attention to the final paragraph thereof; it is quite revealing.

Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 10 January 2019
Report
from World Health Organization
Published on 10 Jan 2019

WHO and partners continue to respond to the ongoing Ebola virus disease (EVD) outbreak in one of the most complex settings possible. A decline in case incidence has been seen in Beni, the former epicentre. This is a strong positive indication of how effective the response can be despite multiple challenges. However, in Beni and elsewhere, trends must be interpreted cautiously, as delayed detection of cases is expected following recent temporary disruption in response activities due to insecurity. Nevertheless, WHO and partners remain committed, under the government’s leadership and through collaboration across agencies, to addressing challenges and ending the outbreak.

As of 8 January 2019, there have been a total of 628 EVD cases1 (580 confirmed and 48 probable), including 383 deaths (overall case fatality ratio: 61%). Thus far, 222 people have recovered, been discharged from an Ebola Treatment Centre (ETC) and enrolled in a dedicated program for monitoring and supporting survivors.

During the last 21 days (19 December 2018 to 8 January 2019), cases have been reported from ten health zones where the outbreak remains active, including: Katwa (18), Butembo (16), Oicha (13), Beni (13), Kalungata (6), Mabalako (5), Komanda (3), Musienene (2), Kyondo (1) and Nyankunde (1). Overall, cases have occurred in localised hotspots within 16 health zones found in North Kivu and Ituri provinces (Figure 1). Surveillance activities are being maintained to rapidly detect resurgences or reintroduction events in all areas.

Trends in numbers of new cases occurring (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas, with encouraging declines in case incidence in areas such as Beni. Hard-earned progress could still be lost from prolonged periods of insecurity hampering containment efforts.

Amongst confirmed and probable EVD cases, 61% (385/628) were female and 30% (189/628) were children aged less than 18 years. This includes a high number of cases in infants aged less than 1 year (38) and 1-4 years (58). While investigations to understand the risk factors for this disproportionate burden are ongoing, response teams continue to prioritise these population groups to mitigate, wherever possible, the risk of transmission.

All alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries continue to be monitored and investigated. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, Uganda, South Sudan, Rwanda and in a traveller returning from Burundi to Sweden. To date, EVD has been ruled out in all alerts outside the outbreak affected areas. International travellers who may have come into contact with the virus, including a doctor who returned to the United States of America after providing medical assistance in the Democratic Republic of the Congo, are also being followed closely; all remain asymptomatic.

Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordination, surveillance, contact tracing, laboratory capacity, infection prevention and control, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials, cross-border surveillance, and preparedness activities in neighbouring provinces and countries.

For detailed information about the public health response actions by 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 reviewed its risk assessment for the outbreak and the risk remains very high at the national and regional levels; the global risk level remains low. This outbreak of EVD is affecting north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of EVD at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities.

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

WHO advice

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

For more information, see:

    WHO Director-General concludes New Year visit to Ebola-affected areas in the Democratic Republic of the Congo
    Women join hands to oust Ebola from the Democratic Republic of the Congo
    Summary report for the SAGE meeting of October 2018
    Statement on the October 2018 meeting of the IHR Emergency Committee on the Ebola virus disease outbreak in the Democratic Republic of the Congo
    WHO Interim recommendation Ebola vaccines
    WHO recommendations for international travellers related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo
    Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
    Ebola virus disease fact sheet

1Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning – trends during this period should be interpreted cautiously.


Source: [url] https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-32" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-32

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 16 2019 at 1:09am
World's 2nd-deadliest Ebola outbreak reaches 600 confirmed cases

By Morgan Winsor

LONDON — Jan 15, 2019, 6:09 AM ET



The second-largest, second-deadliest Ebola outbreak in history has reached 600 confirmed cases in five months, health officials said.

Since the outbreak was declared in the Democratic Republic of the Congo on Aug. 1, a total of 649 people have reported symptoms of hemorrhagic fever in the country's northeastern provinces of North Kivu and Ituri. Among those cases, 600 have tested positive for Ebola virus disease, which causes an often-fatal type of hemorrhagic fever, according to Monday night's bulletin from the country's health ministry.

The growing outbreak has a case fatality rate of around 61 percent. There have been 396 deaths thus far, including 347 people who died from confirmed cases of Ebola. The other deaths are from probable cases, the ministry said.

On average, about half of all Ebola patients succumb to the deadly virus, though case fatality rates have varied from 25 to 90 percent in past outbreaks, according to the World Health Organization, the global health arm of the United Nations.

The ongoing outbreak is one of the world's worst, second only to the 2014-2016 outbreak in multiple West African nations that infected 28,652 people and killed 11,325, according to data from the U.S. Centers for Disease Control and Prevention.

This is also the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo and the most severe that the Central African nation has seen since 1976, when scientists first identified the virus near the eponymous Ebola River.

Ebola virus disease, which has a relatively long incubation period of approximately eight to 21 days, is transmitted through contact with blood or secretions from an infected person, either directly or through contaminated surfaces, needles or medical equipment.

The two provinces where cases in the latest outbreak are being reported share porous borders with South Sudan, Uganda and Rwanda, raising the risk of national and regional spread.

Health workers are facing a number of other challenges to contain the virus, including sporadic attacks from armed groups operating in the mineral-rich, volatile borderlands as well as resistance from the local population in an area that never before had been affected by an Ebola outbreak.

However, this is the first time that a vaccine for prevention and therapeutic treatments are available for use in an Ebola outbreak. The vaccine, which was developed by American pharmaceutical company Merck, has proved effective against the country's previous outbreak in the western province of Equateur.

Nearly 60,000 people have been vaccinated in the outbreak zone since Aug. 8, according to the country's health ministry, which has said that the number of Ebola cases would probably have already surpassed 10,000 if it weren't for the vaccination teams.

Still, the ministry has warned that the epidemic is expected to last for "several" more months and the risk of transmission will remain high.


Source:   ABC News https://abcnews.go.com/International/worlds-2nd-deadliest-ebola-outbreak-reaches-600-confirmed/story?id=60383138" rel="nofollow - https://abcnews.go.com/International/worlds-2nd-deadliest-ebola-outbreak-reaches-600-confirmed/story?id=60383138

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Absence of proof is not proof of absence.


Posted By: CRS, DrPH
Date Posted: January 17 2019 at 8:40pm
^I'm really amazed that we have heard so little about this outbreak in the popular press! We hear "crickets" in the US news channels about this.

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CRS, DrPH


Posted By: Technophobe
Date Posted: January 18 2019 at 3:10pm

Ebola cases in Congo expected to double amid fears outbreak could cross borders

With health system at breaking point, uncertainty over how virus is being transmitted prompts fears it could range beyond DRC
Global development is supported by
Bill and Melinda Gates Foundation
About this content

Rebecca Ratcliffe

Fri 18 Jan 2019 11.57 GMT
Last modified on Fri 18 Jan 2019 18.30 GMT

The number of Ebola cases recorded each day in the Democratic Republic of the Congo is expected to more than double, with concern mounting that uncertainty over how the virus is being transmitted could result in it spreading to neighbouring countries.

On Thursday, the World Health Organization (WHO) reiterated its warning that there is a very high risk of the outbreak spreading not only across DRC but also to Uganda, Rwanda and even South Sudan. The heightened danger of transmission is due to extensive travel between the affected areas.

Efforts to contain the DRC outbreak were hampered after violence related to December’s elections halted prevention work. About 30 health facilities were targeted by protesters in Beni, while efforts to trace anyone who has had contact with the virus were partially suspended due to security concerns.

From October to December, six cases were recorded daily across all affected areas in the east, but numbers are increasing, said Jean-Philippe Marcoux, Mercy Corps’ country director for DRC.

“Now it’s doubling – it’s very possible that it can double again,” said Marcoux. “If we don’t significantly increase the resources, it will keep increasing. It will spread progressively to other health areas and it will be there for a long time.”

Two health centres supported by Mercy Corps are being rebuilt after they were burned to the ground by protesters over the Christmas period. Protesters were angry at a decision to postpone the presidential election in some areas of the country.

Though most of Mercy Corps’ work resumed in January, activities are still hampered by instability, the presence of armed groups and shortages of trained health professionals. Alongside the Ebola crisis, DRC is also experiencing outbreaks of cholera, polio and malaria, according to the WHO, piling more pressure on the country’s overstretched health system.

In some areas, approximately half of recent cases recorded were nosocomial – meaning that transmission occurred in health centres – said Marcoux.

“That is an indication that much more needs to be done at the level of health centres to prevent infection from spreading,” he said.

Marcoux added that greater funding is required for training and monitoring of health workers, and to do preventative community outreach work in areas where it is feared the disease could spread.

There are also concerns that, in some areas, the source of transmission is unclear in up to half of recent cases.
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As such cases increase, there is a growing risk of unsafe burial practices among communities that have not received specialist support from contact-tracing teams.

Since the outbreak began in August, the WHO has recorded 668 confirmed or probable cases and 410 deaths. Since 1 December, more than a third of cases have occurred in children under 15. Of these, 16 cases were in babies under 12 months.

“If no more is done this will spread to other areas within DRC, and spread to neighbouring countries that are close to affected areas – Uganda, Rwanda, even South Sudan,” said Marcoux.

It is expected the disease will be present for at least another nine to 12 months, he added.

In a situation report, the WHO warned the outbreak was at a critical stage: “The persistence of insecurity threatens to reverse recent progress achieved around disease hotspots such as Beni and Butembo.”

Source (The Guardian is highly respected by the way) https://www.theguardian.com/global-development/2019/jan/18/ebola-cases-congo-expected-to-double-fears-outbreak-could-cross-borders-world-health-organization-drc" rel="nofollow - https://www.theguardian.com/global-development/2019/jan/18/ebola-cases-congo-expected-to-double-fears-outbreak-could-cross-borders-world-health-organization-drc

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 21 2019 at 9:22am
Big Update

Ebola heads for major city: Outbreak in the Democratic Republic of the Congo which has killed 419 people is moving towards a trading hub home to one million inhabitants

    If the virus spreads to Goma 'all bets are off' in attempts to control the virus
    Cases are appearing in towns further south from the centre of the outbreak
    At least 685 people have been infected in the epidemic which began in August

By Sam Blanchard Health Reporter For Mailonline

Published: 09:13, 21 January 2019 | Updated: 15:26, 21 January 2019


The deadly Ebola outbreak in the Democratic Republic of the Congo is spreading towards a city home to one million people.

Cases have begun appearing in a district between the two major cities involved in the epidemic, suggesting the virus is spreading south.

If Ebola does make it to the major city of Goma then 'all bets are off' for the bid to control the outbreak, one health official said.

A total of 419 people have died in the killer outbreak already, with the DRC's health ministry reporting 685 cases.

Experts fear Ebola is spreading south from the smaller cities of Beni and Butembo, where most of the outbreak has taken place so far, to Goma, which has a population of one million people and is close to the border with Rwanda


Experts fear Ebola is spreading south from the smaller cities of Beni and Butembo, where most of the outbreak has taken place so far, to Goma, which has a population of one million people and is close to the border with Rwanda

A total of 419 people have now died of Ebola, the Democratic Republic of Congo's health ministry tweeted yesterday. There have been 685 cases of the illness which began in August

The health ministry reported on Friday that there had been four Ebola cases confirmed in the town of Kayina.

The area is halfway between the cities of Butembo, where people are already dying of Ebola, and Goma, where experts fear it could wreak havoc.

Goma has almost double the population of Butembo, meaning there is a much higher potential for the virus to spread quickly.

And Goma sits on the border with Rwanda, adding an extra threat of Ebola spreading out of the country.

'These are crossroad cities and market towns,' Dr Peter Salama, head of the World Health Organization's Health Emergencies Program told Vox.

He said the contagious illness spreading in areas where people are constantly travelling in and out 'raises the alarm'.

The WHO and DRC's health ministry have already sent rapid response and vaccination teams to Kayina, and they've set up a lab in Goma as a precaution.

More than 60,000 people have been given an experimental vaccine to protect against the Ebola virus (pictured, a woman being vaccinated in Mangina, North Kivu)

More than 60,000 people have been given an experimental vaccine to protect against the Ebola virus (pictured, a woman being vaccinated in Mangina, North Kivu)

Vaccination has helped to slow the spread of the virus, experts say, but ongoing violent conflict, political protests and distrust of medical workers makes it particularly difficult to control.

Aggressive protests since a controversial election in December – which the losing party claims was rigged – continue to endanger patients and health workers.

Experts predict the country has months more suffering in store before the outbreak comes to an end.

But this could be longer if the illness breaks out of the North Kivu region, in the country's north-east, where it has so far been contained.
Violent political protests surrounding a controversial election in December – which the losing party has claimed was rigged – have put health workers and Ebola patients in danger of attack (Pictured: A crowd of protestors wait to cast their votes in Kinshasa, the capital city)

Violent political protests surrounding a controversial election in December – which the losing party has claimed was rigged – have put health workers and Ebola patients in danger of attack (Pictured: A crowd of protestors wait to cast their votes in Kinshasa, the capital city)
Families cannot be near or touch their relatives who have died of Ebola because the virus, which is spread through bodily fluids, can still be passed on after death


Families cannot be near or touch their relatives who have died of Ebola because the virus, which is spread through bodily fluids, can still be passed on after death

Writing in Foreign Policy last week, Ebola expert Laurie Garret said: 'Were Ebola to reach [Goma], a top WHO official told me, “all bets are off,” for stopping the epidemic.'

And she added: 'If Ebola hitchhikes its way in an unwitting human carrier across Lake Edward into Uganda, down the highway to Goma and Rwanda, or up the Semliki River toward South Sudan, the world community will face tough choices.

'Option one: Keep on muddling through with the tools, personnel, and funding that have carried the response to date.

'Option two: Declare a global public health emergency, escalating financing and on-the-ground response to the multibillion-dollar scale seen in West Africa.

'Option three: Dedicate massive financial resources to pushing Merck and other vaccine-makers to rapidly manufacture millions of doses, and deploy literal armies, acting as security alongside an enormous public health deployment to immunize tens of millions of people in the region.'
WHAT IS EBOLA AND HOW DEADLY IS IT?

Ebola, a haemorrhagic fever, killed at least 11,000 across the world after it decimated West Africa and spread rapidly over the space of two years.

That epidemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The country, rocked by back-to-back civil wars that ended in 2003, was hit the hardest by the fever, with 40 per cent of the deaths having occurred there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN?

An analysis, published in the New England Journal of Medicine, found the outbreak began in Guinea - which neighbours Liberia and Sierra Leone.

A team of international researchers were able to trace the epidemic back to a two-year-old boy in Meliandou - about 400 miles (650km) from the capital, Conakry.

Emile Ouamouno, known more commonly as Patient Zero, may have contracted the deadly virus by playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN?
WHICH COUNTRIES WERE STRUCK DOWN BY EBOLA DURING THE 2014-16 EPIDEMIC? (CDC figures) COUNTRY                                                    CASES      DEATHS     DEATH RATE (%)
GUINEA     3,814      2,544     66.7%
SIERRA LEONE      14,124      3,956      28.0%
LIBERIA      10,678      4,810      45.0%
NIGERIA      20      8      40.0%
SENEGAL      1      0      N/A
SPAIN      1      0      N/A
US      4      1      25.0%
MALI      8      6      75.0%
UK      1      0      N/A
ITALY      1      0      N/A

Figures show nearly 29,000 people were infected from Ebola - meaning the virus killed around 40 per cent of those it struck.

Cases and deaths were also reported in Nigeria, Mali and the US - but on a much smaller scale, with 15 fatalities between the three nations.

Health officials in Guinea reported a mysterious bug in the south-eastern regions of the country before the WHO confirmed it was Ebola.

Ebola was first identified by scientists in 1976, but the most recent outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS?

Scientists believe Ebola is most often passed to humans by fruit bats, but antelope, porcupines, gorillas and chimpanzees could also be to blame.

It can be transmitted between humans through blood, secretions and other bodily fluids of people - and surfaces - that have been infected.

IS THERE A TREATMENT?

The WHO warns that there is 'no proven treatment' for Ebola - but dozens of drugs and jabs are being tested in case of a similarly devastating outbreak.

Hope exists though, after an experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people. The results were published in The Lancet journal.

Source, video, photos, further information, links and a better copy of the graph of cases:    https://www.dailymail.co.uk/health/article-6614653/Ebola-outbreak-DR-Congo-moving-major-city-home-one-million-inhabitants.html#" rel="nofollow - https://www.dailymail.co.uk/health/article-6614653/Ebola-outbreak-DR-Congo-moving-major-city-home-one-million-inhabitants.html#


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 23 2019 at 4:24pm

DR Congo confirms record number of Ebola cases in one day

Drugmaker set to ship experimental vaccines by end of next month as DRC struggles to contain the virus.
4 hours ago

The Democratic Republic of Congo (DRC) on Wednesday confirmed 14 new cases of Ebola virus in its eastern borderlands, the largest one-day increase since the current outbreak was declared in August.

In all, the haemorrhagic fever is believed to have killed 439 people and infected another 274 in the eastern provinces of North Kivu and Ituri.

The epidemic in a volatile part of the DRC is the second worst ever, according to the World Health Organization (WHO).

The largest outbreak occured in 2013-2016 in West Africa. More than 28,000 cases were confirmed.
DRC efforts to fight Ebola resume in Beni after deadly violence

The news comes shortly after drugmaker Merck said it will ship another approximately 120,000 doses of an experimental Ebola vaccine to Congo by the end of next month.

Associate Vice President Lydia Ogden told the World Economic Forum that the company is committed to having a ready stockpile of 300,000 doses and already has shipped 100,000 to the WHO.

Health officials have called the experimental vaccine highly effective against the virus.

The DRC health ministry says more than 63,000 people have received the vaccine in the outbreak that was declared on August 1 in the country's densely populated northeast near Uganda and Rwanda.

Carrying out vaccinations is complicated by rebel attacks, poor infrastructure and in some cases hostility from communities that have never faced an Ebola outbreak before.

Aid groups have been forced to halt Ebola prevention activities in the past due to violence.

Source and video:    https://www.aljazeera.com/news/2019/01/dr-congo-confirms-record-number-ebola-cases-day-190123184221003.html" rel="nofollow - https://www.aljazeera.com/news/2019/01/dr-congo-confirms-record-number-ebola-cases-day-190123184221003.html

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 24 2019 at 3:43pm
Ebola infects 3 more in DRC; virus evidence found in West Africa bat

Lisa Schnirring | News Editor | CIDRAP News

Jan 24, 2019

Three more people in the Democratic Republic of the Congo (DRC) were confirmed as having Ebola in the country's ongoing outbreak, and in a related development, researchers from Liberia and the United States today reported genetic evidence of the Ebola outbreak virus in a bat in Liberia, the first such detection in West Africa.

Also, the DRC media reported another security incident in the outbreak region, and researchers published new findings on clinical patterns and health worker vaccination from studies conducted in Sierra Leone during its outbreak in 2014-16.
Cases continue in Katwa hot spot

The DRC's health ministry today said two of the latest patients are from Katwa, one of the latest outbreak hot spots located just southeast of Butembo, and Biena health zone, which is west of Butembo.

The illnesses bring the overall outbreak total to 715, but the ministry noted that it has removed a duplicate case from Mabalako from its count. The number includes 666 confirmed and 49 probable cases.

Health officials are still investigating 236 suspected cases, and teams have now immunized 65,963 people with the Merck's unlicensed VSV-EBOV vaccine.

Also, the ministry said 4 more people died from their infections, including a patient from Biena who died in the community setting and 3 who died in Ebola treatment centers—2 in Butembo and 1 in Katwa. So far 443 deaths have been reported in the DRC outbreak.

In Beni, which was the main Ebola hot spot but has recently shown a steep drop in cases, a group of people vandalized a local hospital the night of Jan 21, apparently targeting Ebola responders that they thought were inside, according to a translation of a local media report.

The attackers threatened to burn the facility and destroyed the door and windows before they were scared off, the report said. A nurse quoted in the story said the facility had hosted Ebola vaccinators, that they felt safe there, and that she welcomed their help in fighting the epidemic.
Bat findings provide more reservoir clues

Liberia's government and its partners, which include Center for Infection and Immunity (CII) at the Columbia University Mailman School of Public Health and EcoHealth Alliance, announced the bat findings today in a press release.

As part of bat sampling with the US Agency for International Development (USAID) PREDICT project, scientists found Ebola genetic material and Ebola antibodies in a greater long-fingered bat from Nimba district in northeastern Liberia, according to a press release from Columbia University's Mailman School of Public Health. The project also included researchers from Columbia's Center for Infection and Immunity and EcoHealth Alliance.

The bat species that yielded Ebola evidence is found in West Africa and other regions and is important to agriculture, because they eat insects that damage crops. Unlike other bats, the long-fingered type doesn't roost in homes or building and instead are found in forests, caves, and mines. According to the report, Liberia's government is using that information to teach the public about how to avoid exposure and increase their awareness of the animals' positive impact on the environment.

Evidence from 20% of the bat's genome suggests that it is closely related to the Zaire Ebola virus species, which was involved in West Africa's massive 2014-16 outbreak and is also implicated in the current DRC outbreak. Researchers at CII are trying to determine if the strain from the bat is a genetic match with the one that caused West Africa's outbreak.

The researchers said the finding brings scientists closer to understanding the source of Ebola in humans.

Simon Anthony, DPhil, assistant professor of epidemiology at CII, said in the release that there has been speculation that Ebola in humans came from bats, but no direct evidence has yet been found. "It is possible that there are also other bat species that carry Ebola. Going forward, we will be analyzing additional specimens to fill in the picture," he said.

According to a news report on the discovery in Science today, two other Ebola species were found in a related insect-eating bat, but other indications have pointed to fruit bats as a possible reservoir. Jon Epstein, DVM, with EcoHealth Alliance and who leads the USAID-PREDICT project in Liberia, told Science that the new finding hints at the possibility that Ebola has multiple hosts that may vary by region.

Another researcher not involved in the work, Fabian Leendertz, DVM, with the Robert Koch Institute in Berlin, told Science that a next step would be to sample the insects that the bats eat to see if they harbor the virus.

In other Ebola research developments, scientists reported new findings related to clinical disease in kids and vaccination in health workers, both based on experiences in Sierra Leone's outbreak:

    A review of clinical disease and treatment outcomes in 139 patients younger than 15 years found that 56.1% were girls and 51.1% were students and that certain factors at the time of admission were associated with greater odds of dying from the disease, according to the report today in BMC Infectious Diseases. The factors included male gender, abdominal pain, vomiting, conjunctivitis, and difficulty breathing.

    A 2018 survey on staff turnover and Ebola vaccine acceptance in 305 health workers in Sierra Leone found that 76% of them had a positive opinion of Ebola vaccination and that vaccination against Ebola is feasible if employment is stable, but repeated vaccination at the start of employment may be needed to maintain high vaccination coverage. Researchers reported their findings yesterday in Vaccine.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-3-more-drc-virus-evidence-found-west-africa-bat" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-3-more-drc-virus-evidence-found-west-africa-bat

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 25 2019 at 4:59pm
Ebola death toll surges in DR Congo


The number of people killed in an Ebola outbreak in eastern DR Congo has risen to 443, health authorities have announced, as new President Felix Tshisekedi began his first full day in office on Friday.

The rising death toll -- up by more than 40 in the past ten days -- emphasises the challenge of controlling the epidemic in the strife-torn east and is just one of a host of complex issues facing Tshisekedi.

Tshisekedi was sworn in on Thursday following a long-delayed and bitterly disputed election, replacing Joseph Kabila after 18 turbulent years in charge of sub-Saharan Africa's biggest country.

In his inaugural address, Tshisekedi promised a new era of respect for human rights. He also faces entrenched poverty, corruption and fighting between militias who control parts of the east.

In a bulletin on Thursday, the health ministry outlined the growth of the Ebola outbreak.

"Since the start of the epidemic, the total number of cases is 715, including 666 confirmed and 49 probable. In all, there have been 443 deaths" in the provinces of North Kivu and Ituri, the ministry said.

DR Congo, formerly Zaire, has seen 10 outbreaks of the highly contagious haemorrhagic disease since it was first identified in 1976 near the Ebola river in the northwest of the country.

The latest outbreak was declared on August 1 in the region of Beni, a major market town in North Kivu, and quickly spread to neighbouring Ituri province.

The ministry said 248 people have recovered from the Ebola virus, while "236 suspect cases" were under investigation -- down one from the previous bulletin on January 15.

The Beni region and parts of Ituri regularly come under attack from local armed groups and foreign rebels, particularly the feared Allied Democratic Forces (ADF) from neighbouring Uganda.

The presidential election, held on December 30, was cancelled in Beni, officially because of the Ebola outbreak and regional insecurity.

© 2019 AFP

Source: France 24    https://www.france24.com/en/20190125-ebola-death-toll-surges-dr-congo" rel="nofollow - https://www.france24.com/en/20190125-ebola-death-toll-surges-dr-congo

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 25 2019 at 5:02pm
Hmmm.................   I think no new news there from France 24, despite being dated for today. I wonder if the news is now being reported from a "safe distance".

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 28 2019 at 6:44am
Public Release: 28-Jan-2019
NIAID-sponsored clinical trial of Ebola vaccines begins at Cincinnati Children's Hospital Medical Center

Study in healthy adults tests body's immune response

Cincinnati Children's Hospital Medical Center



CINCINNATI--A Phase 1 clinical trial of investigational vaccines intended to protect against Zaire ebolavirus (Ebola) is underway at Cincinnati Children's Hospital Medical Center in the United States. The study is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH).

Cincinnati Children's is one of nine NIH/NIAID-funded Vaccine and Treatment Evaluation Units (VTEUs). Part of an international effort to stop Ebola from spreading, the trial will test two experimental vaccines together for their safety and ability to produce an immune response in healthy volunteer participants.

"Researchers are looking for new ways to stop these outbreaks and to treat people who become infected and develop Ebola virus disease. The development of preventive vaccines for Ebola is a top global public health priority," said Paul Spearman, MD, of Cincinnati Children's and lead investigator of the trial. He is director of the ivision of Infectious Diseases.

Ebola is a serious and sometimes fatal disease caused by infection with one of the Ebola viruses. Ebola virus disease has a wide-ranging fatality rate of about 30-90 percent, depending on virus species. The hemorrhagic fever can affect organs, damage blood vessels and the body's ability to regulate itself. Once a person is infected with an Ebola virus, it can then be spread from person to person through close contact with infected body fluids.

Ebola viruses have generally caused infections in a small number of people in Central Africa each year, although there have been several Ebola outbreaks since 2013. The Ebola epidemic in West Africa that began in 2013 made more than 28,000 people sick, causing more than 11,000 deaths and spread into other countries around the world. A current outbreak in the Democratic Republic of Congo has so far caused more than 700 confirmed and probable cases of Ebola virus disease.

Blueprint for Immunity

Researchers on the current study will examine how the vaccines work in the body to stimulate responses in the immune system that may protect against Ebola viruses. Laboratory evaluations of the vaccines are led by Karnail Singh, PhD, in the Division of Infectious Diseases at Cincinnati Children's. Singh's laboratory focuses on the development, characterization and evaluation of candidate vaccines for Ebola virus disease.

The trial is studying two experimental Ebola vaccines; the ChAd3-EBO-Z vaccine and the MVA-BN®-Filo vaccine. These are weakened live-vector vaccines that cannot effectively grow in human cells but generate strong immune responses to Ebola virus proteins.

Spearman said previous laboratory research shows combining the two vaccines is a promising approach to generate potentially protective anti-Ebola responses. A major goal of the current trial is to use systems biology tools that provide a biological blueprint of the responses. This will provide a better understanding of why adding a MVA- BN®-Filo booster after priming the body with ChAd3-EBO-Z enhances the character and magnitude of immune response.

This study will enroll up to 60 healthy volunteers between 18 to 45 years of age. Volunteers will be randomly assigned to one of three groups. All participants will receive one dose of the ChAd3-EBO-Z vaccine followed by a second dose eight days later of either: 1) the ChAd3-EBO-Z (20 participants); 2) the MVA-BN®-Filo vaccine (20 participants), or 3) a placebo (20 participants).

Participants will be monitored closely for adverse events for six months after initial vaccination during at least 12 clinic visits. During these visits, volunteers will receive blood tests to evaluate potential immune responses to both of the experimental vaccines. Each volunteer will participate in the trial for approximately seven months.

###

For information about enrolling to volunteer for the study, click here or call 513-636-7699.
For more background information about the study, visit this link at ClinicalTrials.gov or use the identifier NCT03583606. Funding support from NIAID comes via HHSN272201300016.

Legacy of Vaccine Development

Cincinnati Children's is an active participant in global vaccine research and has a long legacy of vaccine development. This includes the oral polio vaccine and a vaccine for rotavirus. As an NIH-sponsored Vaccine and Treatment Evaluation Unit, Cincinnati Children's is helping study vaccines for seasonal influenza, H7N9 bird flu, Shigella, respiratory syncytial virus (RSV), and others.

Source and video:    https://www.eurekalert.org/pub_releases/2019-01/cchm-nct012519.php" rel="nofollow - https://www.eurekalert.org/pub_releases/2019-01/cchm-nct012519.php

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 28 2019 at 6:45am
South Sudan vaccinates health workers against Ebola

Yambio, 28 January 2019 – The Ministry of Health of South Sudan, with support from the World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF and the US Centers for Disease Control and Prevention (CDC) and other partners, today started vaccinating health workers and other front-line responders against Ebola as part of preparedness measures to fight the spread of the disease.

Vaccination began in Yambio, Gbudue State, but health workers in Tombura, Yei and Nimule as well as the capital city, Juba, will also be offered the vaccine. These are high-risk areas bordering the Democratic Republic of the Congo (DRC), now experiencing its tenth outbreak of Ebola. The outbreak began 1 August 2018. Neighbouring countries have not reported any cases of Ebola, but preparedness is crucial.

As part of these preparedness activities, South Sudan received 2 160 doses of the Ebola vaccine (rVSV-ZEBOV) from Merck, the vaccine developer. The vaccine offers protection against the Zaire strain of the virus, which is the one affecting DRC at present.

“It is absolutely vital that we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “WHO is investing a huge amount of resources into preventing Ebola from spreading outside DRC and helping governments ramp up their readiness to respond should any country have a positive case of Ebola.”

Vaccination is one of a raft of preparedness measures South Sudan is putting into place. WHO has deployed more than 30 staff members to support these activities.

In particular, WHO has helped train 60 health workers in good clinical practice principles and protocol procedures to administer the yet-to-be-licensed Ebola vaccine. To detect any travellers entering the country who may be infected with the virus, the Ministry of Health, with the support of its partners, has established 17 screening points. Nearly 1 million people have been screened to date.

WHO is also supporting engagement with communities, active surveillance for the disease at the community and health facility levels, strengthening capacity for infection prevention and control and case management, and supporting dissemination of Ebola information through the media. Local laboratory capacity to test samples taken from people suspected of having Ebola is also being strengthened. Protective gear for responders has been stockpiled in a dedicated warehouse.

Gavi, the Vaccine Alliance, in addition to its work making the Ebola vaccine stockpile available, is providing US$2 million to support the WHO’s vaccination efforts in countries neighbouring the DRC, including South Sudan.

“Although research is ongoing, the evidence so far suggests the Ebola vaccine is a highly effective tool to help stop epidemics and can be used to prevent this national outbreak from becoming a regional one,” said Dr Seth Berkley, CEO of Gavi. “Vaccinating front-line workers and health workers in South Sudan border regions will be crucial: an outbreak in South Sudan would be deeply concerning.”

Uganda began vaccinating its front-line workers in November 2018. So far, more than 2 600 health workers in eight high-risk districts have been immunized. In DRC, more than 66 000 people have been vaccinated – more than 21,000 of them are health and other front-line workers. Rwanda also plans to vaccinate its front-line responders.

The yet-to-be-licensed rVSV-ZEBOV vaccine has been shown to be highly protective against the Zaire strain of the Ebola virus in a major trial. Though not yet commercially licensed, the vaccine is being provided under what is known as “compassionate use” in the ongoing Ebola outbreak in North Kivu province of DRC as part of recommendations from the Strategic Advisory Group of Experts on Immunization. This vaccine was also used in the Ebola outbreak in Equateur province of DRC in May–July 2018.

Source:    http://www.afro.who.int/news/south-sudan-vaccinates-health-workers-against-ebola?country=876&name=South%20Sudan" rel="nofollow - http://www.afro.who.int/news/south-sudan-vaccinates-health-workers-against-ebola?country=876&name=South%20Sudan

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 29 2019 at 6:37am
UPDATE

Congo Ebola cases rise to 736 as problems noted in Katwa

Lisa Schnirring | News Editor | CIDRAP News| Jan 28, 2019

Over the weekend and through today, the Democratic Republic of the Congo (DRC) reported 15 more Ebola cases, including 5 earlier probable infections from Komanda, one of the areas where responders had faced security challenges.

Also, the country's health ministry shed more light today on factors that have fueled a steep rise in cases in Katwa, which has become the current hot spot, and South Sudan today launched a campaign to immunize health workers and frontline responders with VSV-EBOV vaccine.
Case count climbs to 736

In the latest three daily updates, the latest cases were from a several locations. Of the 10 confirmed cases, 4 are in Beni, an area where cases have declined but was once the outbreak's epicenter. Two others are in Oicha, and four are in Katwa, the current hot spot.

The five probable cases in Komanda were added after investigations into deaths that occurred in November and December concluded that they were likely due to Ebola.

The new cases boost the overall outbreak total to 736 cases, which include 682 confirmed and 54 probable infections. In its update today, the ministry said health officials are still investigating 161 suspected Ebola cases.

Besides the 5 deaths in the earlier probable cases, the health ministry reported 8 more deaths, including 7 patients from Ebola treatment centers in Katwa, Butembo, and Mabalako. One of the deaths involved a patient from Oicha who died in the community.

The latest deaths push the outbreak's overall fatality count to 459.
Disruptions, reluctance in Katwa

In its update today, the DRC's health ministry said several factors have led to a significant increase in cases in Katwa this month, including local groups that have obstructed response activities such as immunization, household decontamination, and safe and dignified burials.

And despite broad community sensitization efforts, many Katwa residents continue to deny that Ebola exists, the ministry said. It added, "However, significant progress in community involvement in Katwa has been achieved, in particular through greater involvement of women's associations."

Also, demonstrations related to problems with the DRC's national election in late December brought the outbreak response to a standstill for several days, the ministry said, which resulted in a large drop in Ebola alerts that officials received and investigated. As a result, people with Ebola weren't quickly taken to Ebola treatment centers for care, and contacts weren't vaccinated.

Several "dead" days since the beginning of the year in Butembo and Katwa have also slowed the Ebola response. "When the response is slow, the risk of geographical expansion of the epidemic increases due to uncontrolled displacement of patients and their contacts," it said.

After the response interruptions, people who were contacts of confirmed cases moved and brought the virus to two new health zones in January: Mangurujipa and Kayina. And investigators found that Kayina's confirmed case-patients are members of a Katwa family who participated in the unsafe burial of a relative. Infections have been confirmed in 21 family members.
Officials push back against assertions

In an unusual step, the health ministry in its Jan 26 update disputed some information in a Jan 15 Foreign Policy article that discussed the challenges in the DRC's outbreak.

It said the article contained some "dubious and problematic" assertions, for example, that the health workers were threatened by soldiers, gangs, arms smugglers, and rapists. The health ministry clarified that most assaults and threats on responders have come from people the residents of Ebola-affected communities. It added that several Ebola cases have been detected in areas controlled by armed groups that have agreed to work with response teams to curb the outbreak.

The health ministry also said the article inappropriately linked possible sexual transmission in survivors and the use of rape as a weapon of war. It said no cases of "military rape or rape contamination" have been reported in outbreak areas and that there is no objective evidence to back up the assumption that "rapist and robber soldiers" could spread the virus.

The ministry said Ebola survivors and their families are being followed by clinical psychologists and that so far rape has not been mentioned as a source of trauma in populations affected by the outbreak.
South Sudan vaccine launch

In South Sudan, which has a border not far from the DRC's outbreak area, the health ministry and its partners today began vaccinating health workers and frontline responders against Ebola as part of larger preparedness efforts, according to a statement today from the World Health Organization (WHO) South Sudan office. Groups supporting the efforts include the WHO; Gavi, the Vaccine Alliance; UNICEF; and the US Centers for Disease Control and Prevention.

Vaccination began in Yambio in Gbudue state, and health workers in the cities of Tombura, Yei, Nimule, and South Sudan's capital city of Juba—all considered high-risk areas—will also be offered the vaccine.

The country has received 2,160 doses of VSV-EBOV from Merck.

Matshidiso Moeti, MD, the WHO's regional director for Africa, said in the statement, "It is absolutely vital that we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo." The WHO said it has deployed more than 30 staff members to support preparedness efforts in South Sudan, has helped train 60 health workers, and established 17 screening points that have screened nearly 1 million people so far.

Gavi has assisted with the Ebola vaccine stockpile and has provided $2 million to support WHO vaccination efforts in countries that neighbor the DRC's Ebola-affected area.

In November, health officials launched a similar vaccination campaign in Uganda, one of the other neighboring countries.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/congo-ebola-cases-rise-736-problems-noted-katwa" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/congo-ebola-cases-rise-736-problems-noted-katwa

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 31 2019 at 5:32am
Unicef says this is now the second largest ebola outbreak in history

With children accounting for 30% of the confirmed and probable Ebola cases, UNICEF scales up its response to halt spread of the disease

30 January 2019 – Since the latest Ebola outbreak in the Democratic Republic of the Congo (DRC) was declared six months ago on 1st August 2018, more than 740 people – 30 per cent of whom are children – have been infected with the disease, including over 460 who have died, and 258 that have survived Ebola. Alongside the Government and partners, UNICEF is scaling up its response to assist victims, control the spread of the disease and ultimately end the deadly outbreak.

This is the 10th Ebola outbreak in the DRC and the country’s worst. It is also the world’s second largest Ebola outbreak in history after the one in West Africa in 2014-2016. The response to this latest outbreak continues to be hampered by insecurity, frequent movement of people in the affected areas, and resistance from some communities.

“While we have been able to largely control the disease in Mangina, Beni and Komanda, the virus continues to spread in the Butembo area, largely because of insecurity and population movement,” said Dr. Gianfranco Rotigliano, UNICEF Representative in the DRC. “We are scaling up our response and deploying additional staff in the health zones of Butembo and Katwa, where 65 per cent of the new Ebola cases in the last three weeks have occurred.”

Since the beginning of the epidemic, UNICEF and its partners have deployed more than 650 staff to work with Government, civil society, churches, and non-governmental organizations – to assist people and families who’ve been infected and to raise awareness about the best hygiene and behavioral practices to prevent Ebola from spreading.

UNICEF’s Ebola response focuses on community engagement, providing water and sanitation, making schools safe from Ebola and supporting children and families infected and affected by Ebola. UNICEF aims to control and prevent the spread of the disease, and ultimately stop the outbreak; to reduce Ebola-related deaths among those infected; and to provide protection, alleviate suffering and give assistance to affected children and families.

People who’ve been infected, as well as affected families and their children, including children orphaned by Ebola and unaccompanied children, continue to receive psychosocial support to help them cope with the consequences of the Ebola disease. UNICEF is also providing a protective environment for children in schools and nutrition assistance, including to children and adults in Ebola Treatment Centers.

“Our teams in Mangina, Beni, Oicha, Komanda, Butembo and Lubero are working tirelessly with this multi-pronged approach to end the Ebola outbreak as quickly as possible, and to help affected children and families,” stressed Dr. Rotigliano.

Source:    https://www.unicef.org.uk/press-releases/ebola-outbreak-dr-congo-second-largest-history/" rel="nofollow - https://www.unicef.org.uk/press-releases/ebola-outbreak-dr-congo-second-largest-history/

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 31 2019 at 1:48pm
Ebola infects 9 more in DRC as ill traveler sparks response measures


Lisa Schnirring | News Editor | CIDRAP News| Jan 30, 2019


The number of people infected in the Democratic Republic of the Congo (DRC) Ebola outbreak grew by nine today, as health officials in the neighboring Haut Uele province took steps to prevent the spread of a disease from a resident who was exposed to the virus in Katwa.
Spike in Katwa cases continues

Of the nine newly confirmed cases announced today by the DRC health ministry, eight are in Katwa, the current hot spot where authorities face complex challenges, including insecurity, community resistance, and the after effects of a response slowdown in late December caused by election-related protests.

The other case is in Beni. Investigations are under way into 187 suspected Ebola cases. Today's developments push the outbreak total to 752 cases, including 698 confirmed and 54 probable cases.

The health ministry also said 4 more people died from their Ebola infections, 3 of them in community settings in Katwa and 1 in the Butembo Ebola treatment center. The new fatalities lift the outbreak's death count to 465.

Infected traveler in Haut Uele province

A health team has been sent to a city of Watsa in neighboring Haut Uele province after a young trader was hospitalized there after his likely exposure in Katwa, the health ministry said in its update today, noting that Oly Ilunga Kalenga, MD, the country's health minister, arrived there yesterday to oversee operations.

Haut Uele province is north of Ituri province and borders South Sudan. So far, Ebola cases in the current outbreak have been confirmed in only two DRC provinces: North Kivu and Ituri.

The man lives in Watsa but travels back and forth between Butembo and his hometown. An investigation into his illness suggests he was exposed to Ebola during a stay in Katwa, which is on the eastern outskirts of Butembo. Watsa is about 300 miles north of Butembo.

Healthcare teams were sent to vaccinate relatives and frontline health workers and to decontaminate the patient's home and the health center where he was treated.

Soldiers among recent deaths in Beni

In a separate development, two soldiers with the DRC's army have died from Ebola in Beni, Agence-France Presse (AFP) reported today, quoting an army spokesman.

The army source told AFP that three other soldiers are under observation and that steps have been taken to prevent illness in DRC troops.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-9-more-drc-ill-traveler-sparks-response-measures" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-9-more-drc-ill-traveler-sparks-response-measures

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 01 2019 at 12:21pm
Today's Update
Ebola virus disease - Democratic Republic of the Congo: Disease outbreak news, 31 January 2019
Report
from World Health Organization
Published on 31 Jan 2019 — View Original
preview
Download PDF (769 KB)

The Ministry of Health (MoH), WHO and partners continue to respond to an outbreak of Ebola virus disease (EVD), despite persistent challenges around security and community mistrust impacting response measures. Relatively high numbers of cases were reported in recent weeks (Figure 1), mostly driven by the outbreak in Katwa Health Zone; the current focus of large scale response activities. Smaller clusters continue to be reported beyond Katwa Health Zone, including from Beni and Oicha; however, teams have quickly and systematically responded to these clusters to prevent onward transmission and guard against further geographical expansion of the outbreak. Teams are also working actively to strengthen community trust and participation in all affected areas.

As we approach six months since declaration of the outbreak, there have been a total of 752 EVD cases1 (698 confirmed and 54 probable) reported, including 465 deaths (overall case fatality ratio: 62%) as of 29 January 2019. Thus far, 259 people have been discharged from Ebola Treatment Centres (ETCs) and enrolled in a dedicated program for monitoring and supporting survivors. Among cases with a reported age and sex, 59% (439/750) were female, and 30% (224/749) were aged less than 18 years; including 115 children under 5 years.

During the last 21 days (9 January – 29 January 2019), 118 new cases have been reported from 11 health zones (Figure 2), including: Katwa (80), Beni (9), Butembo (7), Kayina (5), Manguredjipa (4), Oicha (4), Biena (3), Kyondo (2), Musienene (2), Komanda (1) and Vuhovi (1). In addition, five historic probable cases from Komanda Health Zone were reported during the past week with illness onset dating back to November 2018.

The outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission events in private and public health centres. Since 1 December 2018, 86% (125/145) of cases in these areas had visited or worked in a health care facility before or after their onset of illness. Of those, 21% (30/145) reported contact with a health care facility before their onset of illness, suggesting possible nosocomial transmission. In Katwa during the past 3 weeks (since 9 January), 49 health structures were identified where confirmed cases were hospitalised, including nine health centres where nosocomial transmission potentially occurred. Moreover, during the same period, eight new health care worker (HCW) infections were reported in Katwa; overall, 65 HCWs have been infected to date. Response teams are following up with the identified health care facilities to address gaps around triage, case detection and infection prevention and control measures.

Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. For detailed information about the public health response actions by WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

WHO risk assessment

WHO reviewed its risk assessment for the outbreak and the risk remains very high at the national and regional levels; the global risk level remains low. This Ebola virus outbreak is affecting north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of Ebola virus at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities.

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

WHO advice

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

Source:    https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-35" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-35

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 12:48am
Statement on Ebola outbreak in Democratic Republic of the Congo

Dr Matshidiso Moeti, WHO Regional Director for Africa

Today marks 6 months since the 10th outbreak of Ebola was declared in the Democratic Republic of the Congo. Before I say anything else, I want to recognize and thank our WHO and partner colleagues in the field for their courage, commitment and professionalism. They make us all proud. I also want to acknowledge the steadfast leadership of the Democratic Republic of Congo Ministry of Health and other colleagues. No country would wish to face this deadly pathogen, and their spirit of cooperation is what allows us all to face the virus together.

As we look back on these 6 months, we can clearly see the strategies that have been successful at controlling the outbreak in some of the affected areas such as Mangina, Béni, Komanda and Oicha, though we continue to face flare-ups in some of these areas and outbreaks in others.

What has worked is public health measures such as training health workers on infection prevention and control in health centres; closer engagement with communities--particularly women’s and religious groups; other public health measures such as case investigation, and contact tracing, alongside the use of newer tools. So far 70,000 people have agreed and received the investigational vaccine, and 350 patients have been treated with therapeutic drugs, available for the first time at this scale.

In each town or area, the outbreak has slightly different drivers. The outbreaks in Butembo and Katwa health zones are partly being driven by transmission in private and public health centres, with about a fifth of patients reporting contact with a health care facility before their onset of illness. The rest are being infected within communities.

We therefore tailor our actions accordingly both in the health facilities and at community level.

Let me provide some examples:

    In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress, and provide incentives to encourage best practices. We’re also working with the highest risk health facilities in as yet non-affected health zones in North Kivu and surrounding provinces, and countries.
    In addition, we work with health facilities to ensure they and the communities report all deaths, allowing teams to conduct safe and dignified burials.
    WHO, the Red Cross, UNICEF, and other partners work together to collect and analyze community feedback, to ensure our actions are tailored appropriately and address community concerns and needs.
    Underpinning this all, the UN peacekeeping force provides us the security umbrella under which we can function.

These are the approaches that work. But let us step back to consider the context. The Ebola outbreak is happening in a country that is also responding to outbreaks of polio, cholera, measles, and monkeypox and the health needs related to the ongoing humanitarian crisis in other provinces. This is putting a lot of pressure on the health system in general.

In Béni, one of the Ebola affected areas, we had to respond to a malaria outbreak at the same time as the Ebola response. This required additional teams working hand-and-hand with our Ebola response teams. The malaria Mass Drug Administration campaign reaching 300,000 people in Béni, and helped to alleviate pressure on the health system.

Ultimately, this outbreak has put into even sharper focus the weaknesses in the health system, and reinforced, once again, our ultimate message: stronger health systems are the only way to rapidly detect, respond and eventually end outbreaks.

By using proven public health measures and newer tools at hand, under the government’s leadership and working collaboratively across agencies, WHO is committed to addressing these challenges and ending the outbreak.


Source:    https://afro.who.int/media-centre/statements-commentaries/statement-ebola-outbreak-democratic-republic-congo" rel="nofollow - https://afro.who.int/media-centre/statements-commentaries/statement-ebola-outbreak-democratic-republic-congo

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 12:49am
I'm not sure that is as reassuring as the WHO wants us to believe.

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 9:01am
HEALTHCENTRE SUPERSPREADERS?

Many cases in DRC Ebola outbreak coming from health centers
February 1, 2019
Matshidiso Moeti, MBBS, MSc
Matshidiso Moeti

Six months into the 10th and largest Ebola virus outbreak in the Democratic Republic of the Congo, or DRC, officials said many confirmed cases are coming from health care centers.

“As we look back on the 6 months, we can see the strategies that have been successful in controlling the outbreak in some areas ... though we continue to see flare ups and outbreaks in other areas,” Matshidiso Moeti, MBBS, MSc, WHO regional director for Africa, said during a news conference.

Strategies that have worked to control the outbreak, she said, have involved engaging with communities, especially with women and religious groups, and case investigation and contact tracing. Widespread use of an investigational vaccine and investigational drugs also have aided the response.

However, as Moeti explained, transmission remains a problem, with one in every five confirmed cases reporting contact with a health center before the onset of the disease.

According to WHO, the outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission in health centers. WHO said 86% of cases in these areas since Dec. 1 reported having visited or working in a health care facility before becoming ill. Additionally, in the past 3 weeks, 49 health structures were identified where confirmed cases were hospitalized and eight new infected health workers were reported.

“In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress and we also provide incentives to encourage best practices,” Moretti said. “In addition, we work closely with facilities and the community to ensure that they report all deaths and have safe and dignified burials.”

Moeti said strengthening the health system is crucial to fight outbreaks, including an ongoing malaria outbreak in Beni. Officials had to deploy additional WHO teams to work along with the Ebola response teams to get control of that outbreak.

“Ultimately, this outbreak has put into even sharper focus the weaknesses and the gaps in the health care system and reinforced our ultimate message — stronger health systems are the only way to rapidly detect, respond to, and eventually, end outbreaks,” Moeti said.

The case count in the Ebola outbreak has reached 759, including 705 confirmed cases and 414 confirmed deaths. So far, more than 70,000 people have been vaccinated in the DRC, and 2,600 health care workers in bordering Uganda and South Sudan also have been vaccinated. Moeti said preparing bordering countries is a priority in controlling the outbreak, although an international public health emergency of international concern has not been declared.

“I feel optimistic that in the places where we started with a combination of interventions, that we have been able to bring the situation there almost under control,” Moeti said. “We’ve seen a change in our engagement with communities, we’ve invested a lot in it, and we have been very pleased with the support from local leaders who have been able to work with us to carry the message and engage the community.”

However, she added there is still a lot to be done to stabilize and bring the situation under control. – by Caitlyn Stulpin

Source:    https://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B1914c63f-ccca-4478-be05-3818387d56f9%7D/many-cases-in-drc-ebola-outbreak-coming-from-health-centers" rel="nofollow - https://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B1914c63f-ccca-4478-be05-3818387d56f9%7D/many-cases-in-drc-ebola-outbreak-coming-from-health-centers

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Absence of proof is not proof of absence.


Posted By: Dutch Josh
Date Posted: February 02 2019 at 10:56pm
Techno; thank you for the Ebola-updates.

With this many diseases in the region several risks;
-The symptoms may be related to the wrong disease (so people could spread ebola because their disease could be mistaken for cholera at first-as an example)
-A "melting pot" for virusses, bacteria etc. (not only in humans but also other species) could-maybe-produce a new virus/bacteria (or add to a flu-virus ???) wich would worsen the healthcrises even further.

DJ-In my opinion this outbreak (with the mix of climate change, enviromental problems) is not getting enough attention (and thus money).
It is like a "small fire" going on for a longer period suddenly exploding.
There are at present to many countries with failed/weak governments, to many extremists willing to use bio-weapons-for now ebola is a central-africa problem, but "a new disease" may develop and could turn into a major global health risk.

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


Posted By: Technophobe
Date Posted: February 03 2019 at 4:02am
Ebola has never really been considered a threat to us in the West. Consequentially it is usually underfunded, Josh.

Things are slowly improving and the main problems in this case are the remoteness of the location and the lack of previous funding for research (for instance: there is a vaccine but it does not travel well).

But at least some attention is being paid to it now. Here is another bit of recent research, this time on the infection control measures:

Protecting those on the frontline from Ebola

Date:
    February 2, 2019
Source:
    Medical University of South Carolina
Summary:
    Online training has increased the knowledge of health care workers about effective prevention of Ebola up to 19 percent and reduced critical errors to 2.3 percent in a small cohort. These findings suggest that the program could improve protection of health care workers from Ebola and, because it will be easily accessible via the Internet, could be especially useful in low-resource settings.
Share:

FULL STORY

In a world where we can travel the globe by jet, diseases that were once thought to plague faraway places can now strike close to home.

The U.S. had to learn this the hard way. In 2014, a patient harboring Ebola returned home to Dallas, Texas from Liberia. Within 15 days of this person's arrival, the Centers for Disease Control and Prevention (CDC) had confirmed two secondary cases in nurses who were treating the infected patient.

Ebola virus is very easily contracted from body fluids -- a mere ten viral particles will do it -- and people who get it have up to a 78 percent chance of dying. Health care workers are among the most vulnerable.

According to a 2015 report by the World Health Organization, health care workers can have an infection rate up to 32 times higher than the general population in certain parts of the world. Infected health care workers can unknowingly spread the disease, and once sick, are unable to care for patients.

In addition to a human toll, Ebola also exacts an economic one. Treatment of an Ebola patient in the U.S. can range from $30,000-$50,000 per day, limiting the number of hospitals who can treat it, and making its spread a very costly problem

The best hope for controlling this lethal foe is to prevent it. Researchers at the Medical University of South Carolina (MUSC) have created an online software package via the SmartState spin-off company, SimTunes, LLC, to train health care workers using simulation in safe Ebola disease response. They report promising findings in a small cohort of MUSC health care workers in an article published in the December 2018 issue of Health Security.

"This training program takes information from multiple resources, including the CDC, the National Ebola Training and Education Center and the European Network for Infectious Diseases," says Lacey MenkinSmith, M.D., assistant professor of Emergency Medicine at MUSC and first author of this article.

"What makes the program unique is that it combines all that information into one training program that is widely distributable."

"The entire course, including background material and hands-on simulation practice, is delivered over the Internet, so people can be trained immediately," adds Jerry G. Reves, M.D., distinguished professor and emeritus dean of the College of Medicine at MUSC and principal investigator of the CDC-funded study.

The software package includes a self-study component, a "hands-on" simulation workshop and a data-driven performance assessment toolset. A post-test evaluates trainees' knowledge of Ebola treatment, and software tracks and scores individual and team performance in Ebola treatment scenarios.

This training package aims to reduce the number of critical errors and risky actions committed when treating an Ebola patient. Critical errors put an individual at risk of infection or contaminate the clean zone. Risky actions increase the chance of committing a critical error.

The researchers tested the usefulness of their software package in 18 health care workers at MUSC, a state treatment center for Ebola. The health care workers were divided into two groups based on their experience level with treating high-risk infectious disease. The software package increased the knowledge of both groups about effective prevention by up to 19 percent.

Both groups also performed extremely well in simulation scenarios, with only 2.3 percent of 341 total steps flagged for critical errors in both groups. These scenarios included cleaning up spills, putting on a biosuit correctly and properly responding to a needle stick. Practicing all of these scenarios helps to reduce the risk of infection of the health care workers treating the Ebola patient.

These results validate this software package as a way to streamline and adequately educate health care workers on proper techniques to reduce infection when treating an Ebola patient.

The MUSC team plans next to test their training program in other health care settings relevant to Ebola. These include community hospitals, where Ebola patients might first be seen, or intermediary hospitals, which would care for them until they could be sent to a treatment center like MUSC.

MenkinSmith, who specializes in global emergency medicine, would also like to test the program in developing countries, and is planning to use the course in Uganda.

"I want to see how we can adapt what we have to a place that is a low-resource health care setting, such as a site like Uganda that I am set to visit," says MenkinSmith. Uganda's neighbor, the Democratic Republic of Congo, is currently experiencing an Ebola outbreak.

"Instituting this training at various universities and hospitals across the world will take time and adjustments" says Reves. "However, this represents the beginning of a concrete way to ensure that health care workers are protected from Ebola with just-in-time training anywhere in the world."

Story Source:

Materials provided by Medical University of South Carolina. Note: Content may be edited for style and length.

Journal Reference:

    Lacey MenkinSmith, Kathy Lehman-Huskamp, John Schaefer, Myrtede Alfred, Ken Catchpole, Brandy Pockrus, Dulaney A. Wilson, J. G. Reves. A Pilot Trial of Online Simulation Training for Ebola Response Education. Health Security, 2018; 16 (6): 391 DOI: 10.1089/hs.2018.0055

Medical University of South Carolina. "Protecting those on the frontline from Ebola." ScienceDaily. ScienceDaily, 2 February 2019. <www.sciencedaily.com/releases/2019/02/190202171849.htm>.


Source:    https://www.sciencedaily.com/releases/2019/02/190202171849.htm" rel="nofollow - https://www.sciencedaily.com/releases/2019/02/190202171849.htm

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 04 2019 at 4:17pm
Experts are calling for a declaration of a public health emergency
Cases rise to 785


Lisa Schnirring | News Editor | CIDRAP News| Feb 04, 2019



© UNICEF / Herrmann

Over the weekend and through today, the Democratic Republic of the Congo's (DRC's) health ministry reported 22 more cases, many from the current hot spot Katwa, but seven other areas also reported new cases.

In other developments, a group of experts today urged the World Health Organization's (WHO's) emergency committee to meet again to consider declaring a public health emergency, and clinical experts pushed for more use of renal replacement therapy to prevent kidney failure in critically ill Ebola patients.
Latest case details

Of the 22 new cases, the health ministry announced 11 of them in its update today. Among those lab-confirmed cases, 10 are in Katwa, with the following areas also reporting cases: Kyondo (4), Butembo (2), Kalunguta (2), Mabalako (1), Mangurujipa (1), Mutwanga (1), and Vuhovi (1). The increase lifts the outbreak's overall total to 785 cases, 731 of them confirmed and 54 listed as probable.

Health officials are still investigating 165 suspected Ebola infections.

In its latest updates the health ministry said 13 more people have died from their infections, 7 in community settings and 6 in Ebola treatment centers. Locations for community deaths, a factor that increases the risk of virus transmission, include Mangurujipa, Mutwanga, Mabalako, Kyondo, Katwa, and Vuhovi.

In a promising development, the ministry said contacts identified in Komanda have completed their 21-day follow-up period. And the number of people immunized with the experimental VSV-EBOV vaccine has risen to 73,309, roughly half of them in Beni and Katwa.
Experts call for global alert

Writing in a Lancet commentary today, several global health experts called for the WHO to reconvene its Ebola emergency committee and consider declaring a public health emergency of international concern (PHEIC) to address the threat of cross-border spread and to trigger more high-level support for the response. Several of the international experts are from Georgetown University's O'Neill Institute for National and Global Health Law and Johns Hopkins' Center for Health Security.

The emergency committee last met in October 2018, and its members said they didn't consider the event at that time to be a PHEIC. WHO emergency committees typically meet every 3 months or sooner, if needed.

The authors of the commentary said cases have more than tripled since then, with illnesses detected in 18 health zones and less than 20% of cases coming from known contact lists. They also said a widening outbreak could destabilize the region, especially in South Sudan, where tenuous peace is haunted by continued violence and predicted famine.

Declaring a PHEIC could specify proactive measures that are needed to shore up the response and send a clear signal that UN leadership and high-level political, financial, and technical support are urgently needed.

The expert commenters acknowledged that a PHEIC might escalate conflict by raising the international response's profile. "Like any complex multilateral negotiation, cultural competence and smart diplomacy are required. Outsiders are unlikely to be privy to all on-the-ground realities and risks," the team wrote, adding that problems—if they happen—would require urgent reform of the process.

"WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone," they wrote, noting that the WHO and United Nations will likely increasingly be called on to response to complex humanitarian crises.
Supportive care, reporting delays

In other medical literature developments:

    Experts from Canada and Africa writing in The Lancet today pushed for higher standards for supportive care for patients in Africa's outbreaks. Pointing out the role of renal failure in critically ill patients whose conditions deteriorate, they said that, although conventional dialysis isn't always feasible in many field settings, renal replacement therapy is an option when sterile water is scarce. They wrote that the bags are sealed until use, the approach is feasible, and the treatment would give patients time to recover from Ebola and associated acute renal failure.
    Georgia State University scientists who analyzed reporting dates in the DRC's current outbreak in the journal Epidemics yesterday described a two-wave pattern early in the outbreak, with the one surge in the first half of August and the other in late September, likely linked to local armed conflict. They said reporting delays have shown an 81.1% decline and that the epidemic appears to have reached a steady state, averaging about 35 cases a week during the 8 weeks preceding Jan 15.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/02/drc-ebola-cases-surge-785" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/drc-ebola-cases-surge-785

Feb 4 Lancet commentary on public health emergency declaration:    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2819%2930243-0/fulltext#%20" rel="nofollow - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30243-0/fulltext#%20

PDF:    https://www.printfriendly.com/p/g/KNWht5" rel="nofollow - https://www.printfriendly.com/p/g/KNWht5


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 05 2019 at 1:48am

The Ebola outbreak in Eastern Congo is moving toward a major city. That’s not good.


With at least 680 cases, it’s already the second-largest Ebola outbreak in history.

By Julia Belluz@juliaoftorontojulia.belluz@voxmedia.com Updated Jan 22, 2019, 1:13pm EST


At least 680 people have been infected with the Ebola virus in the Democratic Republic of Congo. It’s the second-largest Ebola outbreak in history, with 414 deaths so far, and the first Ebola outbreak in an active war zone, DRC’s eastern North Kivu and Ituri provinces.

But it could get worse: Health officials are concerned that Ebola appears to be spreading in the direction of Goma, a major population center in DRC.

Last week, DRC’s health ministry confirmed four cases of the deadly virus in Kayina, a town in North Kivu, where fighting among rebel and militia groups has repeatedly interrupted the painstaking work of health workers who are responding to the outbreak.

Kayina happens to be halfway between Butembo, currently one of the outbreak’s most worrisome hotspots, and Goma, where a million people live. Two of the patients died, and two were traveling to Goma when they were picked up at a checkpoint en route and sent back to Kayina for treatment.

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So far, the outbreak has not affected DRC’s biggest cities. But Ebola in Kayina “raises the alarm” for Ebola reaching Goma, Peter Salama, the head of the new Health Emergencies Program at the World Health Organization, told Vox on Friday.

Goma is a major transportation hub, with roads and highways that lead to Rwanda. “These are crossroad cities and market towns,” Salama added. People there are constantly on the move doing business, and also because of the insecurity in North Kivu. Ebola in Goma is a nightmare scenario WHO and DRC’s health ministry are scrambling to prevent.

Together, they’ve deployed a rapid response team, including a vaccination team, to Kayina. And if the virus moves on to Goma, Salama says Ebola responders are ready. They’ve already mobilized teams there, set up a lab, and prepared health centers where sick people can be cared for in isolation.

But as Ebola expert Laurie Garrett wrote in Foreign Policy last week, Ebola in Goma could also trigger a rare global public health emergency declaration by WHO, escalating the severity of an already dangerous outbreak.

An Ebola vaccine has been no match for DRC’s social and political chaos
WHO

When Ebola strikes, it’s like the worst and most humiliating flu you could imagine. People get the sweats, along with body aches and pains. Then they start vomiting and having uncontrollable diarrhea. They experience dehydration. These symptoms can appear anywhere between two and 21 days after exposure to the virus. Sometimes patients go into shock. In rare cases, they bleed.

The virus is spread through direct contact with the bodily fluids, like vomit, urine, or blood, of someone who is already sick and has symptoms. The sicker people get, and the closer to the death, the more contagious they become. (That’s why caring for the very ill and attending funerals are especially dangerous.)

Because we have no cure for Ebola, health workers use traditional public health measures: finding, treating, and isolating the sick, and breaking the chains of transmission so the virus stops spreading.

They mount vigorous public health awareness campaigns to remind people to wash their hands; that touching and kissing friends and neighbors is a potential health risk; and that burial practices need to be modified to minimize the risk of Ebola spreading at funerals.

They also employ a strategy called “contact tracing”: finding all the contacts of people who are sick, and following up with them for 21 days — the period during which Ebola incubates.

In this outbreak, there’s also an additional tool: an effective experimental vaccine. Since the outbreak was declared in August, more than 61,000 people have been vaccinated. But while the vaccine has tempered Ebola’s spread, it hasn’t overcome the social and political chaos in DRC, which has been called the world’s most neglected crisis.

“The brutality of the conflict is shocking,” Jan Egeland, head of the Norwegian Refugee Council, told the Thomson Reuters Foundation, “the national and international neglect outrageous.”
Presidential elections have “ratcheted up” the tension in an already tense situation

On December 30, after years of delays, voters went to the polls to elect a new president. In the days leading up to the election, tensions in North Kivu “ratcheted up,” Salama said. Protesters stormed Doctors Without Borders treatment centers in Beni, a recent outbreak hotspot, shutting them down for several days.

In January, the country’s electoral commission announced interim election results suggesting opposition leader Felix Tshisekedi had likely won the election. But leaked data and external analyses show there are irregularities with the voter count that point toward election fraud.

“All the outside observers — the African Union, the European Union, the Catholic Church — say the results of the election have been rigged,” and the people actually voted in Martin Fayalu for president, said Severine Autesserre, a political science professor at Barnard College, and author of the book The Trouble with the Congo. When the final results are announced in the coming days, more protests and riots are likely to follow.

But though the political instability isn’t making the Ebola response any easier, the war in Congo’s eastern provinces is a far bigger challenge. The 25-year-long conflict has displaced more than a million people, and made the already dangerous work of an Ebola response even more deadly, Autesserre said.

Between August and November, Beni had experienced more than 20 violent attacks, which put the outbreak response there on pause for days at a time. That meant cases had gone uncounted, and Ebola continued to spread.

There’s also some more encouraging news, according to Salama: The outbreak of more than 200 people in Beni, a North Kivu town marred by decades of violence, has been brought under control.

“Many people would have been extremely skeptical that the outbreak in Beni could be controlled as quickly given force of infection we were seeing in November and December, and the fact that we’ve had nothing but volatility and insecurity since then,” Salama said. “But the fact that Beni has had only one confirmed case in two weeks is giving us a lot of hope and optimism.”

As of Friday, the two biggest hotspots in the outbreak were Butembo, with 51 cases, and a neighboring city, Katwa, with 119 cases. But the outbreak is geographically dispersed. There are active Ebola cases in 12 of the country’s “health zones,” the districts around which the DRC’s health system is organized. Because of the insecurity and difficulty reaching people, only 30 to 40 percent are coming from known contact lists, Salama said. That means the virus might already be in places no one’s discovered yet.

Source:    https://www.vox.com/science-and-health/2019/1/18/18188199/drc-ebola-outbreak" rel="nofollow - https://www.vox.com/science-and-health/2019/1/18/18188199/drc-ebola-outbreak


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 05 2019 at 9:57am

Long-running Ebola outbreak is now an international health emergency, say experts

Anne Gulland, Global health security correspondent

5 February 2019 • 10:38am

The current outbreak of Ebola in the Democratic Republic of Congo (DRC) is now so severe it should be declared an international health emergency, experts have warned.

In an article in the Lancet medical journal a group of international lawyers has urged the World Health Organization to declare the situation a public health emergency of international concern, which they hope would shine an international spotlight on the outbreak, currently the second largest in history.

Since the outbreak was declared last August there have been 774 cases of the disease and 481 deaths, and emergency responders have had to contend with outbreaks of violence and high levels of mistrust among the affected communities.

WHO’s emergency committee last met in October but since that time the number of cases of the disease have tripled, the outbreak has expanded into 18 health zones and governments have withdrawn personnel “fearing for their safety”, the Lancet warns. And the risk of the disease spreading across the border to Uganda, Rwanda and South Sudan is also high.

Mark Eccleston-Turner, one of the authors of the Lancet paper and a law lecturer at Keele University, said that declaring an international health emergency would not give WHO any more funding but he added: “Its main function is as a signal to the international community that this outbreak is serious, it requires more effort, more resources and a coordinated international response."

At the beginning of the 2014-15 Ebola outbreak in West Africa, which eventually led to nearly 30,000 cases including 11,000 deaths, the WHO came in for heavy criticism for being slow to grasp its severity and to declare an international emergency.

Dr Eccleston-Turner said that when an international health emergency was finally declared in August 2014 it triggered the involvement of the United Nations which described the outbreak as a threat to global peace and security.

He added: “WHO has learned some of the lessons of the West Africa outbreak and seems to be in a much better position now. But we cannot have complacency or hesitancy at WHO.”

But the situation in the summer of 2014 was very different: Ebola was spreading like wildfire in three countries, there was concern it would spread beyond Africa and there was no clear strategy for dealing with the disease. There was also no vaccine to control the spread of the disease or treatments for those infected.

By contrast today, international agencies have at their disposal a vaccine, four experimental treatments for patients as well as a tried and tested containment strategy.

The Lancet paper states that declaring a public health emergency would be "a clarion call to galvanise high-level political, financial, and technical support... It would provide a clear signal from the world's global health body that UN leadership is urgent.”

Tarik Jasarevic, a WHO spokesman, said: “WHO and our partners in DRC and neighbouring countries are watching carefully to detect any signs that we might need to call an expert committee... If and when we see those signs, the director general will call a meeting.”

Speaking to the Telegraph last week Mike Ryan, WHO assistant director general for emergencies, said the current strategy was working as the outbreak is being brought under control in the affected areas.

But while the outbreak has been largely contained in the cities of Beni and Mangina it has now moved "like a bush fire" to the city of Katwa, which has seen around two thirds of the new cases of the disease over the last month.

“The real challenge is containing the disease before it moves on to the next city. We know that’s been the pattern in the past - this is a highly mobile population which means there’s a high risk that cases will move to another city or region,” said Dr Ryan.

He added: “From the air the outbreak looks like a conflagration but it’s more like a series of bush fires.”

This is the 10th outbreak of the disease in DRC, after being identified in what was then Zaire in 1976. But it is the first time that Ebola has been in the North Kivu region in the north east of the country.

Dr Ryan said that there was much distrust of the international community and even some health workers have refused the vaccine.

He said: “Participation of the community is crucial, without it tension and misunderstanding come in. The vast majority of the responders are local and we’re doing a tremendous amount of training.”

He added that standards of care had much improved during this outbreak thanks to the work of agencies such as Médecins Sans Frontières (MSF) and US-based Alliance for International Medical Action (Alima).

"Credit to MSF and Alima - standards of care are definitely rising. We have intensive care specialists embedded in treatment centres and they provide extra assistance with managing patients. There is now improved hydration and monitoring of blood chemistry - the centres are more like intensive care units now," he said.


Source:    https://www.telegraph.co.uk/news/0/long-running-ebola-outbreak-now-international-health-emergency/" rel="nofollow - https://www.telegraph.co.uk/news/0/long-running-ebola-outbreak-now-international-health-emergency/

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Absence of proof is not proof of absence.


Posted By: EdwinSm,
Date Posted: February 05 2019 at 10:37pm
Unlike the West African outbreak which suddenly explode across a region, this Congo outbreak seems to be very slow moving. But, sadly, it is moving in the wrong (outward) direction.


Posted By: Technophobe
Date Posted: February 09 2019 at 12:12pm
DR Congo Ebola death toll passes 500 —Health ministry

Published February 9, 2019


More than 500 people have died from the latest outbreak of Ebola in DR Congo, but a vaccination programme has prevented thousands more deaths, the country’s health minister told AFP.

“In total, there have been 502 deaths and 271 people cured,” said a health ministry bulletin published late on Friday, reporting on the outbreak in the east of the country.

But Health Minister Oly Ilunga Kalenga said that, for the first time, a vaccination programme had protected 76,425 people and prevented “thousands” of deaths.

“I believe we have prevented the spread of the epidemic in the big cities” in the region, he said.

“The teams also managed to contain the spread of the epidemic to neighbouring countries,” he added.

“The biggest problem is the high mobility of the population,” the minister added.

The outbreak started last August in the North Kivu region, which borders Uganda and Rwanda.

The Spanish wing of the aid agency Doctors Without Borders reported on Twitter Saturday that there had been a surge in cases since January 15.

Rwanda, Uganda and South Sudan, further north, were all now on alert, it added.

The security situation in the east of the country, where armed rebels have terrorised the population for years, has made treating the disease difficult.

Source:    https://punchng.com/dr-congo-ebola-death-toll-passes-500-health-ministry/" rel="nofollow - https://punchng.com/dr-congo-ebola-death-toll-passes-500-health-ministry/

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Absence of proof is not proof of absence.


Posted By: Dutch Josh
Date Posted: February 10 2019 at 4:28am
https://www.climatestotravel.com/climate/democratic-republic-congo" rel="nofollow - https://www.climatestotravel.com/climate/democratic-republic-congo

Flooding could worsen the situation in the area. March-May could be wet.

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


Posted By: Technophobe
Date Posted: February 12 2019 at 2:49am
[I have so many comments, I don't know where to start.]


Ebola vaccine offered in exchange for sex, say women in Congo

As experts urge global warning over outbreak, women and girls in Beni report alleged exploitation
Global development is supported by
Bill and Melinda Gates Foundation

Kate Holt in Beni and Rebecca Ratcliffe

Tue 12 Feb 2019 07.00 GMT
Last modified on Tue 12 Feb 2019 07.02 GMT

An unparalleled Ebola vaccination programme in the Democratic Republic of the Congo has become engulfed in allegations of impropriety, amid claims that women are being asked for sexual favours in exchange for treatment.

Research by several NGOs has revealed that a deep mistrust of health workers is rife in DRC and gender-based violence is believed to have increased since the start of the Ebola outbreak in August.

The research, presented at a national taskforce meeting in Beni, follows calls by international health experts urging the World Health Organization to consider issuing a global alert in relation to the outbreak. The experimental vaccine has been described by the WHO as “highly, highly efficacious” and hopes have been pinned on it controlling the outbreak.
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In one study cited, multiple respondents raised concerns over individuals offering Ebola-related services, such as vaccinations, in exchange for sexual favours.

The risk of exploitation by frontline Ebola workers was also mentioned by several focus groups.

Concerns were raised over a reported increase in stigma and violence facing women. Some women are blamed for failing to prevent the spread of the disease, according to the research by the International Rescue Committee (IRC), whose study was cited in the presentation.

Women, who are responsible for caring for the sick and ensuring that children wash their hands, faced a rising workload, with many feeling traumatised and exhausted, the recent meeting was told. One participant in a focus group said women are isolated during their periods, and are being accused of having the virus.

The IRC has since said those claims were based on preliminary findings. The charity, which consulted more than 30 focus groups, added in a statement that it is still analysing research: “We will take the findings and work with partners to address concerns raised and ensure that women and girls are protected.”

Trina Helderman, senior health and nutrition adviser for Medair’s global emergency response team, said the Ebola response should have established a higher standard of protection for women.

“This region of DRC has a long history of sexual violence and exploitation of women and girls. Though shocking, this is an issue that could have been anticipated,” said Helderman. “Humanitarian actors should have been more prepared to put safety measures in place to prevent this from happening.”

On Thursday, the health ministry urged people to report anyone offering services such as vaccinations or other treatment in exchange for money.

The ministry said it was aware of separate rumours, spread on social media, that women working on the Ebola response had been given jobs in exchange for sexual favours. In a statement, it said it took such claims seriously, and advised that women should only meet with recruiters wearing an official badge.

The warnings come as international health experts urged the WHO to consider issuing a global alert in relation to the outbreak. Writing in the Lancet, they said the response had been complicated by a “storm of detrimental factors”, including political instability, conflict and large numbers of people on the move.

Since August, there have been 811 Ebola cases, and 510 deaths as a result of the virus. The WHO has warned that there is a very high risk of the outbreak spreading not only across DRC but to Uganda, Rwanda and South Sudan. There are also concerns that the source of transmission is unclear in one in five cases.

Suspicion of authorities and health agencies has further hampered efforts to contain the response, said Eva Erlach, of the International Federation of Red Cross and Red Crescent Societies. The agency has analysed feedback from thousands of people living in Ebola-affected areas.

“Across all locations there are lots and lots of people who do not think that Ebola is real, that it is just a way for humanitarian organisations to make money, or that it was just used to postpone elections,” said Erlach.

Last week, agencies were urged to work closely with women’s groups and local community leaders to build trust in services.

Tarik Jasarevic, a spokesman for the WHO, which supports the Ebola response, said most community engagement activities are already led by national DRC experts who work closely with local networks. There are around 20 dialects spoken in North Kivu and Ituri, he added.

“Together, we continually adapt and work to improve our response to adjust to local challenges in this delicate social, political, economic context,” he said.

Jasarevic added that sexual exploitation is a grave concern, and said the agency continually monitors its services.

“A large part of the communication effort with communities is to inform them that all Ebola services are free,” he said. “We will continue to check and improve measures we have in place to prevent, monitor and report on any such incidents. More can always be done.”

Source:    [url]https://www.theguardian.com/global-development/2019/feb/12/ebola-vaccine-offered-in-exchange-for-sex-say-women-in-congo-drc]


Posted By: Technophobe
Date Posted: February 13 2019 at 9:42am

Ebola outbreak in violence-plagued DRC a worst-case scenario
Author
Dr. Theodore Karasik
February 13, 2019 15:36

Recently, several rebel militia members fighting over the northeastern corner of the Democratic Republic of the Congo (DRC) died of Ebola. Rebels dying from Ebola is a development that merits deeper examination.
The fact that Ebola, which has killed more than 500 people in this outbreak, is now truly mixing with the country’s violent landscape is a complicating factor, as international health care officials are developing an inoculation ring in Rwanda, Uganda and South Sudan that began in mid-January. In effect, a program of spatial containment is being instituted.

This Ebola outbreak is the second worst case so far. Luckily, experimental vaccination programs are working, but administering these programs in violence-prone areas is difficult at best. DRC Health Minister Oly Ilunga Kalenga said that the vaccination program had been administered to 76,425 people and had prevented “thousands” of deaths by stopping the spread of Ebola to “big cities.” The vaccine is not 100 percent effective as it is still experimental. International health authorities are concerned that the disease can still spread.

The DRC security situation is most problematic in the east of the country, where dozens of armed militias struggle over resources such as gold, diamonds, copper and coltan for profit and power. The area is home to the vast majority of the country’s 70 armed groups, all pursuing shifting local and national agendas. Most of them are small, numbering less than 200 fighters, but the havoc they have wreaked over decades, especially in North and South Kivu, have made eastern DRC the epicenter of deadly violence and humanitarian crises. This mix makes treating Ebola problematic, as this is the first time that an Ebola outbreak is occurring in an area with daily violence. The DRC’s ongoing instability caused by militia activity is creating mistrust in the population toward health workers.

For international aid organizations, this is a worst-case scenario, where victims carrying a deadly disease are unable to be treated because of attacks by machete-carrying rebels with heavy caliber weaponry. An attack by the Allied Democratic Forces (ADF) late last year killed 18 people in the town of Beni, halting local efforts to contain the spread of Ebola through this unstable area.

The DRC’s ongoing instability caused by militia activity is creating mistrust in the population toward health workers.

Armed militias that target DRC civilians and foreign aid workers make it difficult, if not impossible, for response teams to reach and work in the nation’s most isolated areas — a serious issue since the beginning of this outbreak. The ADF militia was initially created by rebels to oppose Ugandan President Yoweri Museveni, but the rebel group has also focused operations on the DRC’s North Kivu province.

This part of Central Africa is where 2.5 million people, mostly civilians, were killed between 1998 and 2002, especially involving ethnic hatred between the Hutu and the Tutsi people, which had formed the basis of the 1994 Rwandan genocide. One cannot overstate the complex landscape of ethnic identities and shifting alliances that occur between these groups. Throwing a deadly disease on top of this rebel instability makes for a combustible situation. An attack by any one of the dozen or so militias in an Ebola outbreak area collapses the ability to conduct safe practices. In the chaos, village mobs are known to try to bury their dead who died from Ebola by trying to steal the corpse, in a complete break of protocol.

The implementation of a set of spatial protocols that, from the start of the current Ebola outbreak, quickly identified areas of disease activity with the goal of preventing diffusion is now expanding instead of shrinking. Disease infection rates among the militia groups are unknown and, given their population, these groups could act as not only an incubator but also a transmitter into more distant areas. The number of fighters and their supporting infrastructure is likely to number in the tens of thousands. These rebels fall outside any international Ebola protocols, unless they are capable of stealing the medicine and then administering it themselves in highly unstable conditions, which would lay the foundation for further infections. These militias have access to medical facilities and possess a particular level of capability and capacity, yet are clearly unprepared for a disease such as Ebola.
Other military actors on the ground matter too. Naturally, the DRC’s military is actively engaged against the militias. The DRC military’s role in the Ebola crisis is focused on securing supply lines, but it frequently needs to concentrate on other internal issues. The Congolese army receives support from the UN’s Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), which has helped in the Ebola response since the beginning of the outbreak through the provision of logistical support, office facilities, transportation, communication and security.

Meanwhile, the DRC’s military engagement with these militias is now also being influenced by Russian advisers. Let us also recall that Russia’s private military company, Wagner Group, is involved across several sectors of the country. Finally, the US is nearby in Gabon. How these actors respond to the next chapter of this outbreak of Ebola in a violent, rebel-infested zone will most likely be determined by a highly uncoordinated effort among security actors.
A deadly disease such as Ebola being carried through rebel communities and their networks is an issue that needs urgent attention from government authorities, in addition to a communication plan to educate those who may be assisting such networks. Add in the terrain, corruption and crime and the ability for authorities to address the spread of the disease is severely weakened. The ability for militias to transmit Ebola unchecked is a public health and national security concern.

    Dr. Theodore Karasik is a non-resident senior fellow at the Lexington Institute and a national security expert, specializing in Europe, Eurasia and the Middle East. He worked for the RAND Corporation and publishes widely in the US and international media.
Disclaimer: Views expressed by writers in this section are their own and do not necessarily reflect Arab News' point-of-view

Source:    http://www.arabnews.com/node/1451516" rel="nofollow - http://www.arabnews.com/node/1451516


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Absence of proof is not proof of absence.


Posted By: EdwinSm,
Date Posted: February 14 2019 at 3:03am
If more fighters die, will that change the dynamics to allow health care workers access?

Or will we have to see enough deaths in various groups so that most of them can no longer function? With 70 or so armed groups that would need a terrible death rate


Posted By: Technophobe
Date Posted: February 14 2019 at 12:45pm
Ebola infects 4 more in DRC as death prompts testing in Uganda

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


UNMEER, Martine Perret / Flickr cc

In the latest developments in the Democratic Republic of the Congo (DRC) Ebola outbreak, the health ministry reported four new cases, as details emerged about a suspected Ebola death that triggered a swift response in Uganda, where the man's samples tested negative for the virus.

The new cases signal continued activity in some of the outbreak's current main hot spots, and the close-call in Uganda shows how fear of cross-border spread has prompted intensive tracking of contacts.
New cases in 2 hot spots

The newly confirmed Ebola cases in the DRC include two patients in Katwa and two in Butembo. Also, health officials are still investigating 177 suspected illnesses.

One more person died from Ebola, a patient who was being treated at Katwa's Ebola treatment center.

The new cases lift the outbreak total to 823 cases, which includes 762 confirmed and 61 probable cases. So far, 517 deaths have been reported.

In the VSV-EBOV immunization campaign, 79,464 people have been vaccinated since Aug 8, 2018, more than half of them in Beni, Katwa, and Butembo.

A family's transport of a Ugandan man who died on Feb 8 in the DRC's outbreak region across the border and back into Uganda sparked intensive contact tracing, location of the body, and sample testing, according to a statement yesterday from the World Health Organization (WHO) African regional office.

The 46-year-old man was a construction worker who had been living and working the DRC for the past 8 years. He was first admitted to the hospital in Bunia, one of the towns in Ituri province that has reported Ebola cases, in November 2018 with symptoms that included chest pain and a sometimes-bloody cough.

Over the past week his condition worsened and he died at Bunia Hospital, where staff issued a death certificate and released his body to relatives, which included a group of 13 people from Tororo in Uganda. The group used the death certificate to cross the border and other checkpoints with the body. According to the statement, the death certificate said the man's cause of death was cardiac failure and pulmonary tuberculosis.

After learning of the incident, Uganda's health ministry—with support from the WHO—intercepted the man's relatives and the vehicle with the dead body in it before they reached their village in Tororo district. A ministry burial team and surveillance officer took oral swabs, conducted a verbal autopsy, and made plans to conduct a safe and dignified burial.

Yonas Tegegn Woldermariam, MD, the WHO's Uganda representative, said in the statement, "The immediate reporting by UMA and quick action by health workers as exhibited last night in this particular incident is what determines how quickly we respond and contain Ebola. I urge other Ugandans to take this as an excellent example as we prepare for a possible importation of EVD cases."

Uganda's health ministry said on Twitter that its teams conducted a dignified burial of the man in Tororo and that all people who were in close contact with the body have been quarantined. It added that samples taken from the dead man were sent to the Uganda Virus Research Institute, where they tested negative for Ebola. It emphasized that there are no confirmed Ebola cases from Uganda.

As part of preparedness efforts for possible spread of the virus across the border, Uganda has been vaccinating healthcare and front-line workers in high-risk districts since Nov 7. So far 3,587 have been immunized, the health ministry said.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/02/ebola-infects-4-more-drc-death-prompts-testing-uganda" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/ebola-infects-4-more-drc-death-prompts-testing-uganda

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 15 2019 at 7:59am
EUROPEAN DISEASE CONTROL: RISK ASSESSMENT UPDATE

Rapid risk assessment: Ebola virus disease outbreak in North Kivu and Ituri Provinces, Democratic Republic of the Congo – third update risk assessment.


This is the third update of the rapid risk assessment published on the 9 August 2018. It addresses the public health risk associated with the current Ebola virus outbreak in the Democratic Republic of the Congo (DRC) and its implications for EU/EEA citizens. This update was triggered by the persistence of the Ebola virus disease (EVD) transmission in urban settings, the continuous increase in the number of reported cases during the last four weeks, the persistent occurrence of new cases among contacts unknown at the time of EVD diagnostics and current challenges for the prevention and control of EVD.

Executive summary

This epidemic in North Kivu and Ituri Provinces is the largest ever recorded in DRC and the second largest worldwide. As of 6 February 2019, the Ministry of Health of the Democratic Republic of the Congo has reported 791 Ebola virus disease cases, including 737 confirmed and 54 probable cases. A total of 492 deaths occurred during the reporting period, consisting of an overall case fatality rate of 62%.

As of 29 January 2019, 65 healthcare workers have been reported among the confirmed cases.

While the majority of the cases have been reported in urban settings, some have also been reported in rural health zones surrounding urban centres. This suggests that transmission is also ongoing in rural areas. The weekly number of cases has increased to approximately 40 for three consecutive weeks, indicating that the viral circulation in the community is persistent.

Persistence of Ebola virus circulation

Despite the impressive mobilisation of response actors, significant challenges remain in this complex setting marked by a long-term humanitarian crisis and an unstable security context. According to WHO, the persistence of Ebola virus circulation in the community is driven by the sub-optimal infection prevention and control practices in primary healthcare, incomplete contact tracing and follow-up, delays in detection and isolation of new cases and community deaths leading to potential exposure of relatives to EVD.

Efforts are on-going to strengthen community-led efforts to support key EVD prevention and control interventions. Outbreak response activities continue in order to offer high quality case management, perform ring vaccination campaigns, provide the community with safe and dignified burials and ensure Points of Entry screening.

New EVD cases are expected to be reported in the coming weeks. A geographical extension is still possible, given the prolonged humanitarian crisis in the region, the important crossborder population flows to and from neighbouring provinces and countries, and the observed adverse impact of security incidents and community reticence which is hindering the implementation of EVD prevention and control measures.
Risk to the EU

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. There are no international airports in the affected areas with direct flights to the EU/EEA Member States, which limits the risk of the virus being introduced into these countries. The overall risk of introduction and further spread of Ebola virus within the EU/EEA remains very low. However, the risk can only be eliminated by stopping transmission at local level.


Source:    https://ecdc.europa.eu/en/publications-data/risk-assessment-ebola-virus-outbreak-north-kivu-and-ituri-third-update" rel="nofollow - https://ecdc.europa.eu/en/publications-data/risk-assessment-ebola-virus-outbreak-north-kivu-and-ituri-third-update

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 16 2019 at 8:29am
South Sudan conducts an Ebola Tabletop Exercise
Report
from World Health Organization
Published on 12 Feb 2019 — View Original

12 February 2019, Juba – South Sudan conducted an Ebola virus disease (EVD) Tabletop exercise (TTX) for National Rapid Response Team (NRRT) on 12 February 2019. The exercise aimed at enhancing NRRT’s operational readiness by familiarizing participants with the EVD Standard Operating Procedures (SOPs) on Rapid Response Team (RRT) activation, deployment and field investigation procedures. It also provided participants with an opportunity to evaluate current capabilities and resources for prompt deployment in response to any suspected EVD case.

A total of 70 participants drawn from eight teams comprising of epidemiologists, clinicians, risk communication experts, laboratory technicians, and infection prevention and control experts were engaged in the one-day TTX exercise. The scenario developed for the exercise allowed the participants to be tested on all the aspects of RRT activation, mobilization, deployment, and field investigation. During the simulation, the participants identified gaps in the current SOPs and proposed recommendations for improving the current guidelines.

As the EVD outbreak in DRC evolves, the risk of cross border spread remains high for South Sudan along with 3 other countries neighboring DRC. It is therefore important that the country attains and maintains operational readiness for prompt response to suspected EVD cases. A multi-disciplinary RRT that works to ensure rapid, coordinated detection, investigation, and response to outbreaks of disease are one of the key pillars of the EVD preparedness framework.

Mr Mathew Tut, the Director for Emergency Preparedness and Response and PHEOC Manager of the Ministry of Health said: “due to the history of previous EVD outbreaks, increasing global travel and proximity to DRC and the threat of cross-border spread, it is our responsibility to be prepared for effective alert management at any time”.

Although South Sudan has not confirmed any EVD case, the risk of Ebola importation from North Kivu and Ituri of the Democratic Republic of Congo (DRC) within the country and regionally is very high due to porous border, trade, IDPs and refugees coupled with insecurity, says Dr Olu Olushayo, WHO Representative for South Sudan.

We acknowledge our donors, the United States Agency for International Development (USAID), the Department for International Development (DFID), Canada, and Germany for supporting the ongoing efforts to strengthen the country’s preparedness capacities and mitigate the risk of EVD importation.

Source:    https://reliefweb.int/report/south-sudan/south-sudan-conducts-ebola-tabletop-exercise" rel="nofollow - https://reliefweb.int/report/south-sudan/south-sudan-conducts-ebola-tabletop-exercise

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 19 2019 at 4:11pm
[News on this outbreak seems to be thinning out. The crisis is continuing but there seems to be a lack of news from the usual sources.]

However vice news have included it in their TV broadcast here:    https://www.youtube.com/watch?v=zNCjDEOF710" rel="nofollow - https://www.youtube.com/watch?v=zNCjDEOF710 and here is an article from The Mirror in Ireland:

Irish aid workers braced for 'Ebola disaster' in war-torn Congo

Irish Aid has stumped up €100,000 in emergency funding to back Concern’s life-saving work

By Saoirse McGarrigle

22:37, 19 FEB 2019

Irish aid workers are bracing themselves for a potential Ebola disaster in war-torn Congo.

Mark Johnson, 33, is on the ground with charity Concern as they fight to contain the fatal virus.

The lawyer from Goatstown, Dublin, told the Irish Mirror on Tuesday night that tackling the health crisis is hampered by the armed conflict.

Irish Aid has stumped up €100,000 in emergency funding to back Concern’s life-saving work.

Mark said: “At the moment it is confined to North Kivu, we are working in the more southern parts to prevent it spreading.

“We are doing this by distributing masks, gloves, chemicals to clean healthcare centres and also train healthcare workers on what to do in the situation.

"The DRC is already a humanitarian crisis, Ebola is now another layer to it. Beni in North Kivu is the epicentre of the breakout, but it is also gripped by a violent conflict.

“Armed groups are conducting massacres regularly. There is also a severe shortage of food. We are working with communities to repair the water system.”

During the Ebola crisis in West Africa between 2014 and 2016, the World Health Organisation was slow to react but Mark insists lessons have been learned.

He added: “The most updated figures we have today are that 838 people have been infected and 537 have been killed. The rate that we are getting there is quicker and faster than the last time.”

The number of recorded deaths was 370 at the beginning of this year, the death toll had reached 537 by the end of last week. This is an increase of 45%. At least 22 of the dead are health workers.

Concern are using the new funding to train more than 350 health workers in how to control the outbreak as it nears Goma, the capital city of North Kivu with a population of over one million.

Mark said: “It is vital that we do all that we can to contain the spread. There are a few theories about how it is transmitted.

“It’s believed to be carried by bats and ends up transmitted to other animals. In this territory they eat a lot of bush meat. Hunting and killing an animal like that, the blood is transmitted from animals to humans. The symptoms – there is nothing very distinctive about it.

“A very high fever, nausea, headaches and when it gets serious they start bleeding from the nose and mouth and also vomiting.”

“[It is] very difficult for healthcare workers to identify Ebola as a lot of cholera is also in the region.

“When the patient is extremely sick, they are also extremely contagious. When the person dies, the corpse is very contagious.

“Burial practice would generally involve the family cleaning the body and touching the body.”

Source and video:    https://www.irishmirror.ie/news/irish-news/irish-aid-workers-braced-ebola-14023173" rel="nofollow - https://www.irishmirror.ie/news/irish-news/irish-aid-workers-braced-ebola-14023173

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 21 2019 at 10:32am
US AID UPDATE - Quite Detailed

file:///C:/Users/Margaret/AppData/Local/Temp/EVD-Week-7-1.pdf" rel="nofollow - file:///C:/Users/Margaret/AppData/Local/Temp/EVD-Week-7-1.pdf

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 22 2019 at 2:46am
[It occurred to me that this was a good time to point this out to anyone worrying about the spread of ebola.]

Ebola has killed just over 500 in this outbreak and has an R0 of between 1 and 2. According to the most recent figures (2018 is not calculated yet) measles killed 110,000 in 2017 and has an R0 of between 12 and 18.

Vaccines are available for both.

[Put things in perspective?]

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 22 2019 at 1:24pm
ANOTHER HURDLE HURTS FIGHT

More Ebola in DRC as nurse's murder halts efforts in Vuhovi

Stephanie Soucheray | News Reporter | CIDRAP News | Feb 21, 2019


© UNICEF / Nybo

The Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo (DRC) grew by 5 cases today, according to the daily update from the country's ministry of health.

There are now 853 cases (788 confirmed and 65 probable), including 531 deaths, and 177 cases are still under investigation. The new confirmed cases include three in Katwa and one each in Kyondo and Kalunguta.

Also reported today were two community deaths in confirmed cases in Katwa. Community deaths raise the risk of transmission.

The ministry of health also detailed the temporary halting of surveillance activities in Vuhovi, after a nurse from the Bisongo health center was abducted and murdered. Officials said a group of unidentified people carried out the attack.

"Contrary to certain information that has circulated, the patients of the Vuhovi General Reference Hospital have not been hunted, and they continue to be cared for on site," the health ministry said, adding that it is encouraging health workers to resume outbreak activities.
New vaccination campaign

Today front-line workers in the Lolwa health zone, which lies between Komanda and Rwampara on the road connecting Beni to Bunia, were vaccinated in a preventive effort, the ministry said.

Since August, 82,144 people in the DRC and surrounding countries have been vaccinated with Merck’s rVSV-ZEBOV vaccine. About half of those vaccinations have taken place in Katwa and Beni.

Today the World Health Organization (WHO) published an outbreak update and noted that Katwa and Butembo remain the areas of concern.

No new cases have been recorded in Beni for more than 3 weeks, but, from Jan 30 to Feb 19, 40 health areas in 12 health zones recorded 79 cases: Katwa (46), Butembo (15), Kyondo (4), Vuhovi (4), Kalunguta (2), Oicha (2), Biena (1), Mabalako (1), Manguredjipa (1), Masereka (1), Mutwanga (1), and Rwampara (1).

"Trends in the case incidence have been encouraging; however, other indicators (such as the continued high proportion of community deaths, persistent delays in case detection, documented local travel amongst many cases, and relatively low numbers of cases among contacts under surveillance) suggest a high risk of further chains of transmission in affected communities," the WHO said.

"Response teams must maintain a high degree of vigilance across all areas with declining case and contact tracing activity, as with areas with active cases, to rapidly detect new cases and prevent onward transmission."

The WHO said the case-fatality rate for the outbreak is 62%.
Survival trend for favipiravir recipients

In research news, today the Journal of Infectious Diseases published a retrospective study on survival rates of Ebola patients who received favipiravir in Guinea during the West African Ebola outbreak in 2015.

Favipiravir, also known as T-705 or Avigan, is an experimental antiviral drug manufactured by Toyama Chemical of Japan.

In the study, the case-fatality rate in favipiravir-treated patients was lower than in untreated patients (31/73 [42.5%] vs 52/90 [57.8%], P = 0.053 in univariate analysis), but the authors write that the effect did not reach statistical significance.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/02/more-ebola-drc-nurses-murder-halts-efforts-vuhovi" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/more-ebola-drc-nurses-murder-halts-efforts-vuhovi

See also:

Feb 21 DRC report:    https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=0769f86b80" rel="nofollow - https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=0769f86b80

Feb 21 WHO update:    https://www.who.int/csr/don/21-february-2019-ebola-drc/en/" rel="nofollow - https://www.who.int/csr/don/21-february-2019-ebola-drc/en/




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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 25 2019 at 3:50pm
New cases, torched center spotlight Katwa as Ebola hot zone

Stephanie Soucheray | News Reporter | CIDRAP News | Feb 25, 2019


Late last night rebel forces set fire to a Doctors Without Borders (MSF) Ebola treatment center in Katwa, forcing MSF to evacuate patients and staff. The attack—coupled with new cases recorded in the city this weekend—have made Katwa the epicenter of the Democratic Republic of the Congo's (DRC's) Ebola outbreak.

"Attacks like this could undo the progress we have made. Despite this setback, we will keep working with the government, partners & communities to end this outbreak," said World Health Organization Director-General Tedros Adhanom Ghebreyesus, PhD, on Twitter earlier this morning.

According to Reuters, MSF announced on Twitter today that the treatment center is closed. Today the ministry of health said a nurse died while trying to escape the fire, but the 10 patients housed in the center had all been safely relocated to other treatment centers.

The attack is the latest setback to Ebola response efforts. Since the outbreak began last August, several rebel groups of have attacked both health workers and clinics and spread misinformation about vaccination and Ebola transmission.
13 new cases in 3 days

Over the weekend and through today, the DRC recorded 13 new Ebola cases, 8 in Katwa and 5 in Butembo. Katwa has now surpassed Beni as having the most cases during this outbreak. There were also 12 deaths recorded, including 5 community death in Katwa.

"Katwa remains the main focus of the epidemic. In the last 21 days, 86 new confirmed cases were reported, of which 49 (57%) were reported in Katwa," The DRC health ministry said in its update yesterday.

"Katwa surpassed Beni in terms of number of cases and deaths. To date, Beni has reported 235 cases (226 confirmed and 9 probable) and 127 deaths while Katwa is 239 cases (228 confirmed and 11 probable) and 182 deaths."

The mortality rate of cases in Katwa has also been markedly higher than in Beni, 76% versus 54%. Health officials said the difference is attributed to the higher percentage of community deaths and vaccination refusals in Katwa.

"This situation demonstrates the importance of increasing community engagement and active case finding in the community and health facilities in Katwa," the ministry said.

The new cases raise outbreak totals to 872 cases, of which 807 are confirmed and 65 are probable. There have also been 548 deaths, and 176 suspected cases are still under investigation.

Since the outbreak began, 83,517 people have been vaccinated with rVSV-ZEBOV in a ring vaccination campaign, including 21,357 in Katwa and 20,613 in Beni.
Phase 1 vaccine trials

Currently only Merck's unlicensed rVSV-ZEBOV has been okayed for use in the DRC. But today the Journal of Infectious Diseases published two phase 1 trials involving prime-boost Ebola vaccines, Ad26.ZEBOV, manufactured by Johnson & Johnson, and MVA-BN-Filo, made by Bavarian Nordic.

Both vaccines were well-tolerated and immunogenic up to a year in healthy volunteers from Kenya, Uganda, and Tanzania.

Source:   [url] http://www.cidrap.umn.edu/news-perspective/2019/02/new-cases-torched-center-spotlight-katwa-ebola-hot-zone%5b" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/new-cases-torched-center-spotlight-katwa-ebola-hot-zone[ .url]

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 26 2019 at 2:57pm
Why the DRC’s latest Ebola outbreak is more worrisome than the last

By Maeva Bambuck Feb 26, 2019

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

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

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

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

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

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


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

Source:    https://news.vice.com/en_us/article/9kpnx8/why-the-drcs-latest-ebola-outbreak-is-more-worrisome-than-the-last" rel="nofollow - https://news.vice.com/en_us/article/9kpnx8/why-the-drcs-latest-ebola-outbreak-is-more-worrisome-than-the-last

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 28 2019 at 6:02am
Ebola outbreak: Minister rages at 'evil' arson attack on centre which left one dead

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

By Ciaran McGrath

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source and video:    https://www.express.co.uk/news/world/1093665/ebola-news-evil-arson-attack-health-centre-outbreak" rel="nofollow - https://www.express.co.uk/news/world/1093665/ebola-news-evil-arson-attack-health-centre-outbreak

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 02 2019 at 8:45am
Why Doctors Without Borders Is Suspending Work In The Ebola Epicenter In Congo

By Nurith Aizenman

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

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

The first took place last Sunday night.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source:    https://text.npr.org/s.php?sId=699462782" rel="nofollow - https://text.npr.org/s.php?sId=699462782

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 03 2019 at 5:00pm
Ebola treatment centre in Congo reopens after attack - ministry

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

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

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

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

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

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

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

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

Source:    https://www.euronews.com/2019/03/04/ebola-treatment-centre-in-congo-reopens-after-attack-ministry" rel="nofollow - https://www.euronews.com/2019/03/04/ebola-treatment-centre-in-congo-reopens-after-attack-ministry

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 04 2019 at 2:24pm

Ebola defence: South Sudan steps up border checks

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

by Hiba Morgan
15 hours ago

more on Africa


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

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

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


Source and video:    https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities" rel="nofollow - https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 04 2019 at 2:26pm

CDC issues Ebola preparedness reminder to U.S. health care facilities
Mar 04, 2019 - 02:30 PM

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



Source: https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities" rel="nofollow - https://www.aha.org/news/headline/2019-03-04-cdc-issues-ebola-preparedness-reminder-us-health-care-facilities

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 05 2019 at 1:45pm
Attacks may worsen Ebola epidemic in Congo, officials warn


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

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

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

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

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

One of the facilities has since reopened.

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

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

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

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

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

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

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

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

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

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

    Experts call for emergency declaration on Ebola in Congo

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

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

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

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

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

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

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

Source:    https://www.cbc.ca/news/health/attacks-could-worsen-ebola-epidemic-in-congo-1.5042815" rel="nofollow - https://www.cbc.ca/news/health/attacks-could-worsen-ebola-epidemic-in-congo-1.5042815

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 06 2019 at 7:44am
Disease Outbreak News from WHO

Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news: Update
28 February 2019

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

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

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

Source: Ministry of Health, Democratic Republic of the Congo

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

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

    Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

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

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

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

Source, maps and graphics:    https://www.who.int/csr/don/en/" rel="nofollow - https://www.who.int/csr/don/en/

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 06 2019 at 9:50am
DNI Coats Meets with HHS Secretary Azar to Discuss Ebola Outbreak

NEWS RELEASE

FOR IMMEDIATE RELEASE

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



DNI Coats Meets with HHS Secretary Azar

to Discuss Ebola Outbreak



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



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



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



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

Source:    https://www.dni.gov/index.php/newsroom/press-releases/item/1960-dni-coats-meets-with-hhs-secretary-azar-to-discuss-ebola-outbreak" rel="nofollow - https://www.dni.gov/index.php/newsroom/press-releases/item/1960-dni-coats-meets-with-hhs-secretary-azar-to-discuss-ebola-outbreak

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 08 2019 at 4:37am
The Battle Against One of the Worst Ebola Epidemics Ever Is in Trouble

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

By Denise Grady

    March 7, 2019

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Source:    https://www.nytimes.com/2019/03/07/health/ebola-epidemic-congo.html - https://www.nytimes.com/2019/03/07/health/ebola-epidemic-congo.html


Posted By: Technophobe
Date Posted: March 08 2019 at 12:25pm
[When it comes to scientific magazines, Nature is about as respected as you can get.]

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

Amy Maxmen

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

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

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

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

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

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

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

Uncharted territory

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

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

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

Source: World Health Organization

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

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

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

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

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

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

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

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

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



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


Posted By: Technophobe
Date Posted: March 13 2019 at 4:32pm
CIDRAP Report


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


Today, 05:27 PM

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


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

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

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

Two cases in lesser hot spots

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

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

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

Seroprevalence in central Africa

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

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

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

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

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

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


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

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


Posted By: Technophobe
Date Posted: March 14 2019 at 3:28pm
WHO Update

14 Mar 2019

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


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

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

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

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

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

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

Public health response

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

    Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

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

WHO advice

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

Source and many links: https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-41 - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-41


Posted By: Technophobe
Date Posted: March 20 2019 at 5:02pm
Congo Ebola outbreak spreads to city of Bunia

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

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

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

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

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

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

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

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



-------------
Absence of proof is not proof of absence.


Posted By: EdwinSm,
Date Posted: March 20 2019 at 11:28pm
We are getting close to the number of deaths (610) doubling since the first post of this thread (319) back in the latter half of December.


ps. While the title is correct I nearly always read "DR Congo" as "Doctor Congo", instead of the "Democratic Republic of Congo"!


Posted By: Technophobe
Date Posted: March 21 2019 at 1:25am
Me too.

-------------
Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 22 2019 at 4:11am
Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news

21 March 2019

Report
from World Health Organization

Published on 21 Mar 2019 — View Original https://reliefweb.int/organization/who" rel="nofollow - https://reliefweb.int/organization/who


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

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

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

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

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

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

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

Public health response

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

Ebola situation reports: Democratic Republic of the Congo https://www.who.int/ebola/situation-reports/drc-2018/en/" rel="nofollow - https://www.who.int/ebola/situation-reports/drc-2018/en/

WHO risk assessment

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

WHO advice

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


Source:    https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-42" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-42

-------------
Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 23 2019 at 4:46pm

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

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

Geneva/Brazzaville/Goma


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

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

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

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

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

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

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

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

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

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

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

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


Source:    https://www.who.int/news-room/detail/23-03-2019-who-reaffirms-commitment-to-the-democratic-republic-of-the-congo-as-ebola-outbreak-nears-1-000-cases-amid-increased-violence" rel="nofollow - https://www.who.int/news-room/detail/23-03-2019-who-reaffirms-commitment-to-the-democratic-republic-of-the-congo-as-ebola-outbreak-nears-1-000-cases-amid-increased-violence

-------------
Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 24 2019 at 2:17pm

“It’s Really Worrying Right Now.” An Ebola Outbreak in the Democratic Republic of Congo is NOT Under Control


By: Mark Leon Goldberg on March 24, 2019

The second worst Ebola outbreak in history is currently unfolding in the Democratic Republic of Congo. Since August last year there have been nearly 1,000 confirmed cases and over 600 deaths.

The DRC is a very large country and these cases are so far confined to the eastern part of the country. This is also the region of the Democratic Republic of Congo that has long been mired in conflict and insecurity. In recent weeks, Ebola treatment centers have been attacked forcing medical staff to suspend operations. Meanwhile, new ebola cases are confirmed on a nearly daily basis.

On the line to discuss is Karin Huster, the field coordinator for Medicins Sans Frontiers/Doctors Without Border in the DRC. She spoke to me from the city of Goma, the largest city in the eastern part of the DRC. We kick off discussing recent attacks on two Ebola treatment centers run by Doctors Without Borders, and then have a longer conversation about the trajectory of this outbreak and what can be done to halt its spread.

One thing that comes though in this conversation is that this outbreak is not under control. Karin Hester explains why the current strategy has not be able to stop the transmission of Ebola and explains how this outbreak can be halted.

The Ebola outbreak in DRC has fallen from the headlines. This episode provides you with a grounds-eye view of why this outbreak continues to fester.

Source: https://www.undispatch.com/its-really-worrying-right-now-an-ebola-outbreak-in-the-democratic-republic-of-congo-is-not-under-control/" rel="nofollow - https://www.undispatch.com/its-really-worrying-right-now-an-ebola-outbreak-in-the-democratic-republic-of-congo-is-not-under-control/

-------------
Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 25 2019 at 6:24am
Press Release

Ebola outbreak in DRC surpasses 1000 cases, daily case rate on the rise
As Ebola response workers face violence on an almost daily basis, working in partnership with the community is the key to bringing this outbreak to an end.

London, UK, March 24th, 2019, March 24, 2019 — A thousand people have now contracted Ebola since the outbreak was declared in Democratic Republic of Congo (DRC) in August. This tragic milestone is a reminder that this outbreak is not yet under control and in order to make progress more must be done to work in partnership with the affected community. The ongoing mistrust facing health workers and the response is a symptom of the years of insecurity they have endured, and a sign that those responding must work even harder to combat the stigma and misunderstanding held by some in the community.



Tariq Riebl, IRC’s Emergency Response Director in DRC said: “Alarmingly at this stage in the outbreak, the number of cases of Ebola is once again on the rise. In the past week we have seen 58 new cases - this is the highest number in a week in 2019. With mistrust and security issues, cases are likely to be going unreported and the true figure could be even higher. These numbers show that despite the hard work being done, this outbreak is far from over. Insecurity and violence has led to the IRC and other agencies being forced to frequently suspend programs, which time and again we have seen lead to a spike in cases.



“Data shows us that working with the community is the key to stopping this outbreak. Without greater engagement we will see more lives lost. IRC’s team in North Kivu are redoubling their efforts to understand the concerns of people living in the impacted communities and to work with them to quash this outbreak. In the past weeks IRC teams have run a series of community meetings to understand their concerns as well as establishing focal points within affected neighborhoods and villages.


“We are already almost seven months into this outbreak and at this stage we should be seeing the case rate declining, not on the rise. With an optimistic outlook this outbreak is predicted to last another six months -- but realistically we could be looking towards another year of fighting this disease. The Ministry of Health and partners including the IRC are working around the clock to curtail the outbreak as quickly as possible to reduce the loss of life and further damage to the community.”



Leading on infection prevention and control, the IRC is working in 59 health clinics, training health workers to recognize symptoms and safely triage and transfer suspected Ebola patients to treatment centers; as well as working in women’s and children’s protection and community sensitization.



With more than 13 million people in need of aid, DRC is one of the world’s most complex, chronic and long-standing humanitarian crises. 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 protection, and livelihoods

Source:    https://www.rescue-uk.org/press-release/ebola-outbreak-drc-surpasses-1000-cases-daily-case-rate-rise-0" rel="nofollow - https://www.rescue-uk.org/press-release/ebola-outbreak-drc-surpasses-1000-cases-daily-case-rate-rise-0

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 28 2019 at 3:56am

Community mistrust worsening DR Congo Ebola outbreak: study

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Volatile security situation

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

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

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

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

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

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

Source:    https://www.aljazeera.com/news/2019/03/community-mistrust-worsening-dr-congo-ebola-outbreak-study-190328062938247.html" rel="nofollow - https://www.aljazeera.com/news/2019/03/community-mistrust-worsening-dr-congo-ebola-outbreak-study-190328062938247.html

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: March 29 2019 at 12:36pm
Ebola outbreak SHOCK: One in four believe deadly virus is FAKE – study finds

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

violence

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

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

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

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

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


Source:    https://www.express.co.uk/news/world/1107234/ebola-outbreak-congo-africa-harvard-university-study-ebola-fake" rel="nofollow - https://www.express.co.uk/news/world/1107234/ebola-outbreak-congo-africa-harvard-university-study-ebola-fake

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: April 01 2019 at 2:52pm

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

    Reuters



GENEVA —

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

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

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

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

Deaths occur outside treatment centers

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

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

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

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

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

New outreach program

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

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

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


Source:    https://www.voanews.com/a/who-congo-ebola-outbreak-spreading-faster-than-ever-/4857426.html - https://www.voanews.com/a/who-congo-ebola-outbreak-spreading-faster-than-ever-/4857426.html


Posted By: Technophobe
Date Posted: April 02 2019 at 2:07pm
Congo Ebola outbreak spreading faster than ever - WHO
Reuters|Published: 04.02.19 , 15:09

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


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


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


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


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

Source:    https://www.ynetnews.com/articles/0,7340,L-5488425,00.html - https://www.ynetnews.com/articles/0,7340,L-5488425,00.html


Posted By: Technophobe
Date Posted: April 03 2019 at 12:36pm
Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 35
Report from World Health Organization

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

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

1. Situation update

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

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

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


Source:    https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-50 - https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-50


Posted By: Technophobe
Date Posted: April 04 2019 at 12:47pm
This shows a map of how widespread the outbreak is:    https://reliefweb.int/map/democratic-republic-congo/drc-ebola-virus-disease-outbreak-situation-overview-dg-echo-daily-2 - https://reliefweb.int/map/democratic-republic-congo/drc-ebola-virus-disease-outbreak-situation-overview-dg-echo-daily-2

Scary!


Posted By: Technophobe
Date Posted: April 12 2019 at 3:40am
Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 11 April 2019

Report

from World Health Organization

Published on 11 Apr 2019 — View Original:    https://reliefweb.int/organization/who" rel="nofollow - https://reliefweb.int/organization/who


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

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

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

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

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

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

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

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

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

Public health response

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

    Ebola situation reports: Democratic Republic of the Congo:     https://www.who.int/ebola/situation-reports/drc-2018/en/" rel="nofollow - https://www.who.int/ebola/situation-reports/drc-2018/en/

WHO risk assessment

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

WHO advice

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


Source:    https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-45" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-45

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: April 18 2019 at 3:32pm
Ebola outbreak grows by 12 as CDC issues new HCW advice

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

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

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

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

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

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

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

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

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

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

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

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

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: April 24 2019 at 1:39pm

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


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


Esdras Tsongo in Butembo and Rebecca Ratcliffe

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source:    https://www.theguardian.com/global-development/2019/apr/24/rumour-violence-congo-drc-ebola-outbreak-out-of-control" rel="nofollow - https://www.theguardian.com/global-development/2019/apr/24/rumour-violence-congo-drc-ebola-outbreak-out-of-control

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Absence of proof is not proof of absence.


Posted By: CRS, DrPH
Date Posted: April 30 2019 at 9:25pm
Originally posted by Technophobe Technophobe wrote:

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


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

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

Be safe!

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CRS, DrPH


Posted By: EdwinSm,
Date Posted: May 03 2019 at 9:52pm
After 6 pages of spam on this thread, there is some Ebola news to post.

DR Congo Ebola deaths pass 1,000

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

https://www.bbc.com/news/world-africa-48155280" rel="nofollow - BBC report


Posted By: Technophobe
Date Posted: May 08 2019 at 3:25am
WHO urges broader use of Ebola vaccine as case numbers climb in DR Congo

Published 10 hours ago on 08 May 2019

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

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

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

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

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

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

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

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

Vaccine 'saving lives'

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

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

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

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

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

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

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

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

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

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

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

Source:    https://www.malaymail.com/news/life/2019/05/08/who-urges-broader-use-of-ebola-vaccine-as-case-numbers-climb-in-dr-congo/1750753" rel="nofollow - https://www.malaymail.com/news/life/2019/05/08/who-urges-broader-use-of-ebola-vaccine-as-case-numbers-climb-in-dr-congo/1750753


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Absence of proof is not proof of absence.


Posted By: Guests
Date Posted: May 08 2019 at 10:11am
Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 40
Report
from World Health Organization
Published on 07 May 2019 — View Original
preview
Download PDF (1.02 MB)

1. Situation update

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

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

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

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

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

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

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

Source:    https://reliefweb.int/re/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-55 - https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-55


Posted By: Technophobe
Date Posted: May 24 2019 at 3:17pm
EBOLA CRISIS: Battle to combat Congo outbreak ‘is FAILING’ as death toll passes 1,200 mark

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

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

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

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

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

This is approximately a quarter of the death toll.

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

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

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

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

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

Source:    https://www.express.co.uk/news/world/1131710/ebola-latest-death-toll-congo-mercy-corps-world-health-organisation-united-nations" rel="nofollow - https://www.express.co.uk/news/world/1131710/ebola-latest-death-toll-congo-mercy-corps-world-health-organisation-united-nations

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: May 29 2019 at 3:56pm

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

Charities call for outbreak to be put on a par with crises in Yemen, Syria and Mozambique as death toll reaches 1,287
Global development is supported by
Bill and Melinda Gates Foundation
About this content

Rebecca Ratcliffe

Wed 29 May 2019 12.13 BST

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The risk of Ebola spreading to other provinces in eastern Congo and to neighbouring countries remains very high.

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

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

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

Source:    https://www.theguardian.com/global-development/2019/may/29/congo-ebola-response-must-be-elevated-to-maximum-level-un-told" rel="nofollow - https://www.theguardian.com/global-development/2019/may/29/congo-ebola-response-must-be-elevated-to-maximum-level-un-told

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: June 05 2019 at 4:41am
DR Congo Ebola outbreak: More than 2,000 cases reported

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

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

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

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

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

    Ebola disbelief widespread in Congo hotspots
    Why Ebola keeps coming back

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

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

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

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

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

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

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

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Absence of proof is not proof of absence.



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