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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
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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
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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/
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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
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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
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post 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
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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


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

See also:
Mar 13 DRC report:   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
ReliefWeb Map:   https://reliefweb.int/map/democratic-republic-congo/drc-ebola-virus-disease-outbreak-situation-overview-dg-echo-daily-1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post 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
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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

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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post 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"!
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Me too.
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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 Originalhttps://reliefweb.int/organization/who


Download PDF (1.06 MB)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 Congohttps://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
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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
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post 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/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post 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
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Community mistrust worsening DR Congo Ebola outbreak: study

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Volatile security situation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

violence

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

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

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

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

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


Source:   https://www.express.co.uk/news/world/1107234/ebola-outbreak-congo-africa-harvard-university-study-ebola-fake
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WHO: Congo Ebola Outbreak Spreading Faster Than Ever
April 01, 2019 4:15 PM

    Reuters



GENEVA —

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

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

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

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

Deaths occur outside treatment centers

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

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

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

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

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

New outreach program

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

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

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


Source:   https://www.voanews.com/a/who-congo-ebola-outbreak-spreading-faster-than-ever-/4857426.html
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Congo Ebola outbreak spreading faster than ever - WHO
Reuters|Published: 04.02.19 , 15:09

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


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


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


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


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

Source:   https://www.ynetnews.com/articles/0,7340,L-5488425,00.html
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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 35
Report from World Health Organization

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

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

1. Situation update

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

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

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


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

Report

from World Health Organization

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


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

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

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

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

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

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

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

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

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

Public health response

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

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

WHO risk assessment

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

WHO advice

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


Source:   https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-45
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Ebola outbreak grows by 12 as CDC issues new HCW advice

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

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

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

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

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

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

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

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

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

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

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

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


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


Esdras Tsongo in Butembo and Rebecca Ratcliffe

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

Be safe!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post 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.

BBC report
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WHO urges broader use of Ebola vaccine as case numbers climb in DR Congo

Published 10 hours ago on 08 May 2019

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

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

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

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

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

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

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

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

Vaccine 'saving lives'

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

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

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

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

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

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

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

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

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

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

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

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

1. Situation update

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

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

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

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

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

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

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

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

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

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

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

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

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

This is approximately a quarter of the death toll.

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

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

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

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

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

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

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

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

Wed 29 May 2019 12.13 BST

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Ebola disbelief widespread in Congo hotspots
    Why Ebola keeps coming back

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

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

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

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

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

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

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