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Ebola Again

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There have been rumours of the disease spreading to Mubende.  This is publically refuted by The Ugandan government.   Source and Full article:   https://reliefweb.int/report/uganda/press-statement-rumoured-ebola-outbreak-mubende-district
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The Daily Express (we call it the distress) is claiming the outbreak is out of control.

It is a bank holiday here, so all the kids are out of school; consequently my internet connection is horrendous!  As a result, I can't post the article. GRRRR!!!  Anyway, here is the link:  https://www.express.co.uk/news/world/965899/ebola-crisis-outbreak-out-of-control-virus-kills-dozens-democratic-republic-of-congo
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“The point of modern propaganda isn’t only to misinform or push an agenda. It is to exhaust your critical thinking, to annihilate truth.” Gary Kasparov
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More regions to be vaccinated, experimental drugs to be tried in Congo Ebola outbreak

By Meera Senthilingam, CNN


Updated 1448 GMT (2248 HKT) May 29, 2018


(CNN)More than 400 people have been vaccinated and more than 800 contacts traced in the city of Mbandaka in the Democratic Republic of Congo.

Use of the experimental vaccine, known as rVSV-ZEBOV, will now spread to the more rural regions of Iboko and Bikoro where the majority of cases have occurred.

Vaccination began in the urban setting of Mbandaka to "prevent an urban outbreak" as well as further spread along the nearby Congo river, to reduce "risk through the interior of DRC and surrounding countries," Dr. Peter Salama, the deputy director-general of the World Health Organization's Health Emergencies Program said Tuesday.
He confirmed the outbreak spread to Mbandaka after two brothers visited Bikoro to attend a funeral and traveled back to the city.

"Mbandaka is relatively safeguarded at the moment," he said, adding that officials "haven't seen an explosive increase in cases" and the teams have reason to "cautiously optimistic."
There have been 54 cases of Ebola reported in Congo, including 25 deaths. Thirty-five of those case have been confirmed with laboratory tests.
Salama said 47 of the cases were in the more rural regions of Bikoro and Iboko where control efforts will now be focused. "That's where the next phase of vaccination must go."
The vaccine is proving to be a very acceptable intervention to the community in Mbandaka, Salama said. "There are no reports of refusal of the vaccination."
"Over 90% of eligible people are getting vaccinated," said Dr. Michael Ryan, WHO assistant director-general for Emergency Preparedness and Response, highlighting that this is a strong coverage rate for any vaccine.
health worker prepares an Ebola vaccine to administer to health workers during a vaccination campaign in Mbandaka, Congo.
More than 900 contacts are being followed in Congo, and the number is likely to increase.
The Ebola vaccine being provided has been shown to be safe in humans and highly effective against the Ebola virus, according to the WHO. A 2016 study found it to be 100% effective in trials in Guinea in coordination with the country's Ministry of Health after the 2014-15 outbreak.

Therapeutics to be tried

Five experimental drugs to treat Ebola virus disease, including ZMapp and Remdesivir, have now arrived in the country and will be trialed under strict experimental research protocols, Salama said.
This means they will have to be used as part of a clinical trial, with ethical review and informed patient consent.
Officials expect to get formal approval for delivery in the coming days.
W
HO officials hope to introduce the life-saving therapies to patients, but their use will require sophisticated monitoring. Some of the treatments require IV infusion, while others require daily assessment of liver and kidney function, according to Ryan.
In 2014, ZMapp became known when it was used to treat two American missionary workers, Dr. Kent Brantly and Nancy Writebol, who contracted Ebola in Liberia. Prior to that, the experimental drug had been tested only in monkeys.
This is "not a simple effort to do this kind of trial in this kind of environment," said Salama. But "if we don't learn now we'll never know which drugs to use in this situation."
Vaccination, therapeutic and control efforts have and will be carried out through partnerships between WHO, the International Federation of the Red Cross and Red Crescent Societies, Medecins sans Frontieres (Doctors Without Borders) and many other NGOs on the ground in Congo.
Control efforts will expand to four more provinces considered to be at risk, the IFRC confirmed.
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Ebola virus disease, which most commonly affects people and nonhuman primates such as monkeys, gorillas and chimpanzees, is caused by one of five Ebola viruses. On average, about 50% of people who become ill with Ebola die.
The first human outbreaks of Ebola occurred in 1976, one in the north of what is now Congo and in the region that is now South Sudan.
Humans can be infected by other humans if they come in contact with bodily fluids from an infected person or contaminated objects from infected persons. Humans can also be exposed to the virus, for example, by butchering infected animals.
West Africa experienced the largest recorded outbreak of Ebola over a two-year period beginning in March 2014; a total of 28,616 confirmed, probable and suspected cases were reported in Guinea, Liberia and Sierra Leone, with 11,310 deaths, according to the WHO.

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WHO 'Cautiously Optimistic' on Ebola Outbreak

May 30, 2018 -- The United Nations' World Health Organization on Tuesday said it was "cautiously optimistic" that efforts to slow the spread of Ebola in a Congolese city were working.

There are still cases occurring in more remote areas, however, the WHO said, with a total of 35 confirmed cases, 12 of which have been fatal.

So far, more than 400 people have received an experimental Ebola vaccine that's never before been used in an emerging outbreak, the Associated Press reported.


Source and option for more:  https://www.webmd.com/a-to-z-guides/news/20180530/who-cautiously-optimistic-on-ebola-outbreak

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Ebola outbreak response shifts to remote DRC hot spots

May 29, 2018

Officials from World Health Organization (WHO) today said they're cautiously optimistic about curbing the spread of Ebola in the city Mbandaka, Democratic Republic of the Congo (DRC), adding that the next phase of the outbreak response will focus on two remote hot spots in Bikoro and Iboko, where most of the cases have been reported.

At a briefing in Geneva today live-streamed on the WHO's Twitter feed, health officials also said DRC's health ministry is finalizing protocols for testing five therapeutic treatments and that a trial of a second experimental Ebola vaccine—a prime-boost regimen developed by Johnson & Johnson—may take place in the outbreak setting.

Peter Salama, MD, the WHO's deputy director-general of emergency response, said that, as of May 27, 54 Ebola cases have been reported. The number includes 35 confirmed, 13 probable, and 6 suspected cases. So far 25 deaths have been reported.

Salama said the updated numbers add one suspected case in Wangata health zone, which is in Mbandaka. Tests have ruled out Ebola in three suspected cases, one from Ntondo health zone. Response teams are monitoring more than 900 contacts in the DRC's three hot spots.

Response in remote epicenters

Of the outbreak's 54 cases, 47 are from Bikoro and Iboko, Salama said. "That's where our priorities must be going forward." He said on Twitter yesterday that the WHO surged more staff over the weekend to respond to reports of increasing cases in Iboko.

More than 400 people have been immunized in a ring vaccination campaign in Mbandaka involving Merck's experimental VSV-EBOV vaccine that began on May 21, targeting contacts of Ebola cases, plus contacts of contacts. He said besides the city's large size, the initial response centered on the area because of the risk of spread to other parts of the DRC as well as two neighboring countries, the Republic of Congo and the Central African Republic.

Vaccination in the city went very smoothly, and so far there haven't been any reports of vaccine refusal, Salama said, adding that vaccinators have reached about 90% of the contacts targeted for immunization.

Though there is a 10-day window after vaccination before immunity kicks in, he said there hasn't been an explosion of cases in the city, a positive development that's part of what's fueling cautious optimism. Salama said there are three transmission chains in Mbandaka: one involving brothers who attended a funeral in Bikoro, one linked to a patient who visited a health center in Bikoro, and one who attended a community church gathering.

Now, it's time to battle the outbreak at its source, in Bikoro and Iboko, he said.

Michael Ryan, MD, the WHO's assistant director-general for emergency response, who just returned from the outbreak region, spoke of the huge logistical challenging in laying the groundwork for the response in the remote settings where most of the illnesses are occurring, but he said he is encouraged by the response he saw to the vaccination campaign in Mbandaka. "It's the first time in my experience where walking into villages with the vaccine teams you see hope and not terror," he said.

Doctors Without Borders (MSF) said today that it started vaccinating healthcare workers yesterday in Bikoro and that immunization will be offered to contacts of patients as part of the ring vaccination approach.

The group said the vaccine is one element of a larger strategy to control the spread of Ebola.

Micaela Serafini, MD, MPH, MSF's medical director in Geneva, said the group will be closely monitoring people who are voluntarily vaccinated and that, based on results in Guinea's outbreak, officials are confident about its use in the current outbreak. "The results of the trial suggest that the vaccine will present a real benefit to people at high risk of contracting Ebola, protecting them against the infection," she said.

Salama said vaccination is slated to begin this week in Iboko.

Opportunity to test treatments

The DRC government is eager to begin using experimental treatments in Ebola treatment units, and Salama said the programs and their companion clinical trials will likely begin in the coming days. They include ZMapp (a monoclonal antibody cocktail), Remdesivir (an antiviral), Regeneron (a monoclonal antibody treatment), favipiravir (a small-molecule antiviral), and a monoclonal antibody known as 114.

He said that doing clinical trials, especially in the remote settings, will be a challenge, given that some of the drugs involved intravenous administration over 6 to 12 hours and daily assessment of kidney and liver function.

Salama said the trials, done under the auspices of the health ministry, will, it is hoped, test the efficacy of all five drugs and assess how they compare to each other.

"If we don't use the opportunity to learn in this situation, we'll never be able to know which is better," he said.

Research on a second vaccine?

Salama said one of the critical questions researchers hope to answer with current trials under way as part of ring vaccination with VSV-EBOV is duration of protection. He said data from the trial in Guinea suggest the vaccine's protection lasts well over a year, and health officials suspect it might last much longer than that.

He said officials are exploring, along with the DRC government, if there's an opportunity to test whether another vaccine that works in a different way has the potential to protect for an even longer period.

The second vaccine approach, part of a prime-boost strategy, involves a dose of the adenovirus vectored Ad26.ZEBOV developed by Johnson & Johnson and a dose of MVA-BN-Filo from Bavarian Nordic.

Source:   http://www.cidrap.umn.edu/news-perspective/2018/05/ebola-outbreak-response-shifts-remote-drc-hot-spots

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New research suggests that we might be able to foresee when and where the next Ebola outbreak will occur if we take a close look at the migratory patterns of bats.

You are all probably aware of this theory, but if you want the rest it is at:   https://www.medicalnewstoday.com/articles/321909.php?utm_source=newsletter&utm_medium=email&utm_campaign=weekly
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As Aid Workers Move to the Heart of Congo’s Ebola Outbreak, ‘Everything Gets More Complicated’

Medical investigators will need to overcome the rural region’s extreme logistical hurdles to reconstruct transmission chains, vaccinate contacts and halt the spread.


Aiming to squelch an Ebola outbreak that has infected 54 people, killing almost half of them, aid workers in the Democratic Republic of the Congo have begun giving an experimental vaccine to people in the rural region at the epicenter of the outbreak.

Epidemiologists working in the remote forests have not yet identified the first case, nor many of the villagers who may have been exposed. Investigators will need to overcome extreme logistical hurdles to reconstruct how the virus was transmitted, vaccinate contacts and halt the spread.

“For an epidemic to be under control, you need a clear epidemiological picture,” said Dr. Henry Gray, the emergency coordinator for Doctors Without Borders.

“If you don’t know the stories of the people involved — who their families were, what their jobs were, where they went to weddings and funerals — then you don’t know the epidemic.”

Almost 500 people received the experimental vaccine, VSV-EBOV, last week around Mbandaka, a riverfront city of more than 1.5 million people where four Ebola cases have been confirmed.

Mbandaka is a priority because it is a traffic hub. The Republic of the Congo lies just across the Congo River, and Kinshasa, Congo’s capital of 10 million, is less than 500 miles downstream.

Aid workers are using the ring method: The vaccine is given to groups of people in contact with each Ebola case, such as family caregivers, as well as the contacts of those contacts.

About 7,500 doses are available to vaccinate 50 rings of 150 people each, according to Dr. Peter Salama, the deputy director-general for emergency response at the World Health Organization. An additional 8,000 doses will follow.

The W.H.O. is monitoring more than 900 contacts throughout Équateur province. As the vaccination program expands to the Bikoro and Iboko communities, where most cases have been reported, teams are relying on contact tracing to identify the most urgent recipients.

“This is where everything gets more complicated,” said Chiran Livera, the operation leader in Congo for the International Federation of Red Cross and Red Crescent Societies.

The villages surrounding Bikoro and Iboko are among the most isolated and densely wooded pockets of Congo. Aid workers must use motorbikes to navigate cratered dirt roads that flood during the rainy season. Maps of some regions are incomplete, and vast gaps in cellular service thwart efforts to report data to central operations.

“Following the virus’s narrative may sounds easy to do on a suburban street outside Chicago,” said Dr. Salama. “But when you’re traveling hundreds of kilometers in a forest by motorbike to find each person, that’s very different epidemiological work.”

If the outbreak worsens, a second vaccination may be offered to health workers. That vaccine, developed by Johnson and Johnson, requires two doses and would take longer than VSV-EBOV’s seven to 10 days to become effective — but may protect health workers for several years.

The Congolese Ministry of Health is planning to deploy up to five experimental treatments, though the two most highly recommended by the W.H.O. may prove impractical in a remote setting.

ZMapp, a cocktail of three antibodies used in West Africa, must be given in multiple doses and must be refrigerated. Remdesivir, a drug developed by Gilead Sciences, requires intensive monitoring of liver and kidney function — nearly impossible for treatment centers without electricity, running water or standard equipment.

Another option, called MAb114, began safety trials earlier this month. Made from the antibodies of an Ebola survivor, it can be crystallized and reconstituted with saline-like fluids in the field.

“These are all investigative products,” Dr. Salama said. Vaccine makers have struggled to show efficacy without live Ebola cases in which to test their drugs. “Many consider this outbreak their chance to prove themselves,” he said.

Drug companies are not alone in that mission.

The W.H.O.’s emergency committee gathered 10 days after the Congolese government notified the organization of an Ebola case, a stark contrast to the West African epidemic in 2014, when the group did not convene until almost 1,000 people had died.

Since May 8, the W.H.O. has sent 156 technical experts to the region. A mobile laboratory has been set up to expedite case confirmations in Bikoro; another is planned for Mbandaka. A cellular tower has been erected in Mbandaka to help workers trace people who may have been infected throughout the region.

The W.H.O. has more than doubled its budget request to $56 million from $26 million to account for the possibility of the virus may reach an urban setting.

“The biggest problem of 2014 was that there had never been an Ebola epidemic before,” said Ron Klain, the White House’s Ebola response coordinator for West Africa. “This time, there is an intensity, a focus, a pace. No one is underestimating the risk, and that alone is a big advantage.”

Another advantage is context: Unlike West Africa, Congo has experienced eight previous Ebola outbreaks since the virus was identified in 1976. Aid workers who arrived in Kinshasa this month found pre-established surveillance protocols, according to Mr. Livera.

The W.H.O.’s strategy assumes the virus will ultimately infect 100 to 300 people. Each rural case may infect 10 contacts, and each urban case may infect 30. Response activities may continue into July, according to a revised plan released May 27.

Until investigators identify the index case, it is impossible to discern whether the first patient detected in April was truly the first human case or the hundredth, according to Dr. Gianfranco Rotigliano, the regional director of Unicef. Until then, it is impossible to quantify the crisis.

“These are the early days of the outbreak,” Dr. Salama said. “There can be lulls. We’ve seen that before. But there only needs to be one event — a super-spreader, like a funeral — to cause an explosion.”


Source:   https://www.nytimes.com/2018/06/01/health/ebola-congo-outbreak.html

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Ebola vaccinations rise in Congo as outbreak takes hold

More than 680 people have received Ebola vaccinations in the three areas of the Democratic Republic of Congo (DRC) where dozens of cases of the deadly virus have been confirmed, the country's health ministry has said.

Health experts are pushing to find contacts of those infected, having already located more than 1,000.

As of Friday evening (GMT), there have been 37 confirmed Ebola cases in the DRC, including 12 deaths.

There are another 13 probable cases, according to the country's health ministry.

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Officials from the ministry could be seen on Friday in Mbandaka.

The city of 1.2 million people is the provincial capital of northwest Equateur province.

The officials were registering a young girl, whose parents died from the virus. She is now under UNICEF's care.

Further away, a young boy is sitting in a chair with a high fever. He is suspected of having been infected with the virus and has been placed in quarantine as a precaution.

While nearly 500 people have been vaccinated in Mbandaka since 21 May, ignorance about the virus' existence is still a threat.

"Most people here in Mbandaka and maybe in Bikoro and elsewhere are still ignorant. They have not yet understood that Ebola really exists," Dr. Hiller Manzimbo, a hospital director, told The Associated Press.

Manzimbo was referring, among others, to Irene Mbwo, the widow of an Ebola victim, who does not recognise that her husband died from the virus and has refused the vaccine herself.

"They just told me that he died of Ebola, but they did not publish his blood results," she told The Associated Press. "But how can they claim that he died of Ebola, when they say that those who came in contact with him will see symptoms of infection within three days, and I told them at the hospital today that I have been clean for 21 days?" she insisted.

In an Ebola plan released this week by the World Health Organisation (WHO), the UN's health agency predicted there could be up to 300 cases in the coming months, noting there could be three times as many contacts to chase if the virus spreads in urban, as opposed to rural, areas.

Although WHO officials said "more than half" of newly confirmed Ebola cases had been previously identified, a substantial portion of cases are showing up that were not being monitored, meaning the disease is in some cases spreading unnoticed.

The WHO also said officials would likely need more triage, isolation and treatment centres, possibly including one in the capital, Kinshasa. It said additional aircraft, helicopters and boats were needed to manage the challenging logistics of the outbreak and that it might ultimately cost 56 million US dollars to contain Ebola.

The UN health agency said that based on an initial assessment of Bikoro, "there is an approximate movement of over 1,000 people per day by river, road and air at major points of entry."It recommended that neighbouring countries strengthen their capacity to identify imported cases of Ebola, including by implementing exit screening.

The WHO said the risk of spread to elsewhere in Africa was high but that the risk of global transmission was low. It added that even though experts had concluded the outbreak conditions do not currently merit being declared a global emergency, the situation would be re-evaluated if the epidemic spikes significantly or if there is international spread.


Source:   https://www.tvnz.co.nz/one-news/world/ebola-vaccinations-rise-in-congo-outbreak-takes-hold

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Ebola outbreak: Case counts, Africa CDC Deploys Teams


June 3, 2018

In an update on the Ebola Virus Disease (EVD) outbreak in Equateur Province, Democratic Republic of the Congo (DRC), the case counts as of June 1 are as follows:

37 confirmed cases, 13 probable and seven suspected for a total of 57 cases, including 25 deaths since early April 2018.

The outbreak remains localized to the three health zones initially affected: Iboko, Bikoro and Wangata.

Since the launch of the vaccination exercise on 21 May 2018, a total of 682 people have been vaccinated. The targets for vaccination are front-line health professionals, people who have been exposed to confirmed EVD cases and contacts of these contacts.

After recruiting and training 18 Congolese volunteers, Africa CDC has just deployed them to Equateur province to support the response to Ebola Virus Disease in DR Congo.

The responders, who are former volunteers of the African Union Support to the Ebola Outbreak in West Africa (ASEOWA) in the 2014-16 outbreak, they also participated in the post-Ebola enhanced surveillance in the Democratic Republic of Congo in July 2017 in the province of Bas-Uélé.


Source   http://outbreaknewstoday.com/ebola-outbreak-case-counts-africa-cdc-deploys-teams-66543/

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Disease outbreak news : Ebola virus disease – Democratic Republic of the Congo: Points of Entry, 5 June 2018

Report
from World Health Organization
Published on 05 Jun 2018 View Original

In response to the ongoing outbreak of Ebola in the Democratic Republic of the Congo, WHO in collaboration with the Government of the Democratic Republic of the Congo, the International Organization for Migration (IOM), Africa Centres for Disease Control and Prevention (Africa CDC) and other partners, has developed a comprehensive strategic response plan for points of entry. The aim of the plan is to avoid the spread of the disease to other provinces or at the international level. The plan includes mapping strategic points of entry and the locations of areas where travellers congregate and interact with the local population, and therefore are at risk of Ebola virus disease transmission based on population movement. The plan also includes implementing health measures at the identified points of entry/traveller congregation points, such as risk communication and community engagement, temperature checks, provision of hand hygiene and sanitation materials, and the development of alert, investigation and referral procedures.

As of 18 May 2018, a total of 115 points of entry/traveller congregation points have been listed and mapped along cordon sanitaires in Mbandaka, Bikoro, Iboko, larger Equateur Province, and Kinshasa. Of these, some 30 points of entry have been prioritized for in-depth assessments and for implementing relevant prevention, detection and control measures. These include major ports and congregation points along the Congo river, as well as the two airports and the international port in Kinshasa. Areas of large gatherings such as markets are also being assessed. Along the Congo river there are many private smaller ports and points of congregation with a low volume of traffic. Proper screening cannot be conducted at all 115 points, and the efforts currently focus on the 30 prioritized points of entries/ traveller congregation points, as well as on risk communications activities and community engagement.

Entry and exit screening measures have been implemented at the Mbandaka airport, as well as in some terminals of the Kinshasa international airport. These include travel health declaration, visual observation for symptoms, temperature check and travel health promotion measures, as well as procedures for referral of suspect cases.

The International Health Regulations Emergency Committee, was convened by the WHO Director-General on 18 May 2018, and advised against the application of any travel or trade restrictions to the Democratic Republic of the Congo in relation to the current Ebola outbreak, as flight cancellations and other travel restrictions may hinder the international public health response and may cause significant economic damage to the affected country (see link below). The Emergency Committee also advised that exit screening, including at airports and ports on the Congo river, is considered to be of great importance; however entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.

Statement of the 1st meeting of the International Health Regulations Emergency Committee

WHO is monitoring travel and trade measures in relation to the current outbreak. As of 28 May, 23 countries have implemented entry screening for international travellers coming from the Democratic Republic of the Congo, but there are currently no restrictions of international traffic in place.

WHO advice

The Emergency Committee convened by the Director-General on 18 May 2018 noted that the Ebola outbreak does not currently meet the conditions for a Public Health Emergency of International Concern (PHEIC). The Committee issued comprehensive Public Health Advice , in particular with regards to the fact that there should be no international travel or trade restrictions, that neighbouring countries should strengthen preparedness and surveillance, and that during the response, safety and security of staff should be ensured, and protection of responders of national and international staff should prioritised.

WHO has also issued travel advice for international travellers in relation to the current Ebola outbreak in the Democratic Republic of the Congo (see link below).

WHO recommendations for international travellers related to the Ebola virus disease outbreak in the Democratic Republic of the Congo

Travellers going through the exit screening from the Democratic Republic of the Congo

Effective exit screening helps prevent the exportation and spread of disease to other areas. During exit screening at international airports and points of entry, travellers will be assessed for signs and symptoms of an illness consistent with Ebola virus disease, or identified as contacts potentially exposed to Ebola virus disease.

  • Travellers with a possible exposure to Ebola virus and who are sick should postpone international travel and seek immediate medical assistance if there is a possible exposure to Ebola virus disease;

  • Any person with an illness consistent with Ebola virus disease will not be allowed to travel unless the travel is part of an appropriate medical evacuation (see link below);

  • Travellers should plan to arrive early at the travel facility and expect delays related to public health screening;

  • Travellers will be required to complete a Traveller Public Health Declaration, and these will be reviewed prior to clearance to board;

  • Temperature measurement will be required, in addition to normal security provisions;

  • Boarding may be denied based on public health criteria.

Exit screening at airports, ports and land crossings: Interim guidance for Ebola virus disease Travellers with symptoms on board a conveyance

There is a possibility that a person who has been exposed to Ebola virus and developed symptoms may board a commercial flight or other mode of transport, without informing the transport company of his/her status. Such travellers should seek immediate medical attention upon arrival, mention their recent travel history, and then be isolated to prevent further transmission. Information of close contacts of this person on board the aircraft (e.g. passengers one seat away from the ill traveller on the same flight, including across an aisle, and crew who report direct body contact with the ill traveller) should be obtained through collaboration with various stakeholders at points of entry (e.g. airline reservation system) in order to undergo contact tracing.

Returning travellers

The risk of a traveller becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to areas where primary cases have been reported. Transmission requires direct contact with blood or fluids of infected persons or animals (alive or dead), all unlikely exposures for the average traveller (see link below).

Travel and transport risk assessment: Ebola Interim guidance for public health authorities and the transport sector

There is, however, a risk for health care workers and volunteers, especially if involved in caring for Ebola virus disease patients. The risk can be considered low, unless adequate infection prevention and control measures (such as use of clean water and soap or alcohol-based hand rubs, personal protective equipment, safe injection practices and proper waste management) are not followed, including at points of medical care at ports, airports and ground crossings.

As the incubation period for Ebola is between 2 to 21 days, travellers involved in caring for Ebola virus disease patients or who suspect possible exposure to Ebola virus in the affected areas, should take the following precautions for 21 days after returning:

  1. Stay within reach of a good quality health care facility;
  2. Be aware of the symptoms of infection; and,
  3. Seek immediate medical attention (e.g. through hotline telephone numbers) and mention their recent travel history if they develop Ebola virus disease like symptoms.

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Church suspends sacraments as deadly Ebola outbreak spreads

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Doctors Without Borders Southern Africa appeals for funds to tackle Ebola outbreak

Doctors Without Borders or Médecins Sans Frontières (MSF) Southern Africa has launched an appeal to raise funds to fight the Ebola outbreak in the Democratic Republic of Congo

EbolaEbola has caused thousands of deaths since the first outbreak in 2013. (Image source: EU Civil Protection and Humanitarian Aid Operations/Flickr)

MSF said in a statement that 25 people had died since the outbreak was declared on 8 May, with 35 confirmed cases of Ebola recorded so far.

MSF said it would use funds collected towards care for diagnosed patients and isolation, outreach activities, follow-up with patients, activities to inform people about the risks of Ebola and safe burials.

Most of the Ebola cases are in the country's remote Bikoro health zone, which lacks the healthcare infrastructure to tackle the spread of Ebola.

The WHO last month reported one confirmed case of Ebola in Mbandaka, a city of 1.2mn.

This is a cause for worry because Mbandaka, which is close to the Congo River, which sees significant regional traffic.

The Ebola virus, which has caused several thousand deaths, is a communicable viral disease which causes severe bleeding, organ failure and could lead to death.

The first outbreak of the disease was recorded in Guinea in 2013 and later spread to Guinea, Liberia, and Sierra Leone, with minor outbreaks in other regions.

The International Federation of Red Cross and Red Crescent Societies (IFRC), last month, called for aid to the tune of about US$15.1mn to support its operations in tackling the Ebola outbreak in the DRC.

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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 8

Report
from World Health Organization
Published on 05 Jun 2018

1. Situation update

The outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo remains active. On 3 June 2018, six new suspected EVD cases have been reported in Bikoro (5) and Wangata (1) Health Zones. Three laboratory specimens (from suspected cases reported on 2 June 2018) tested negative. No new confirmed EVD cases and no new deaths have been reported since our last situation update on 1 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 56 EVD cases and 25 deaths (case fatality rate 44.6%) have been reported, as of 3 June 2018. Of the 56 cases, 37 have been laboratory confirmed, 13 are probable (deaths for which it was not possible to collect laboratory specimens for testing) and six are suspected. Of the confirmed and probable cases, 25 (50%) are from Iboko, followed by 21 (42%) from Bikoro and four (8%) from Wangata health zones. A total of five healthcare workers have been affected, with four confirmed cases and two deaths.

Context

On 8 May 2018, the Ministry of Health of the Democratic Republic of the Congo notified WHO of an EVD outbreak in Bikoro Health Zone, Equateur Province. The event was initially reported on 3 May 2018 by the Provincial Health Division of Equateur when a cluster of 21 cases of an undiagnosed illness, involving 17 community deaths, occurred in Ikoko-Impenge health area. A team from the Ministry of Health, supported by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge health area on 5 May 2018 and found five case-patients, two of whom were admitted in Bikoro General Hospital and three were in the health centre in Ikoko-Impenge. Samples were taken from each of the five cases and sent for analysis at the Institute National de Recherche Biomédicale (INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola virus, Zaire ebolavirus species, by reverse transcription polymerase chain reaction (RT-PCR) on 7 May 2018, and the outbreak was officially declared on 8 May 2018. The index case in this outbreak has not yet been identified and epidemiologic investigations are ongoing, including laboratory testing.

This is the ninth EVD outbreak in the Democratic Republic of the Congo over the last four decades, with the most recent one occurring in May 2017. The outbreak has remained localised to the three health zones initially affected: Iboko (23 confirmed cases, 2 probable, 5 deaths), Bikoro (10 confirmed cases, 11 probable, 5 suspected, 17 deaths) and Wangata (4 confirmed cases, 1 suspected, 3 deaths). As of 31 May 2018, a total of 880 contacts remain under active follow-up.


Source:   https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-6

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Angola shuts its border with the Democratic Republic of Congo to contain Ebola outbreak that is feared to have killed 25

The Ebola virus has hit three parts of the DRC, near the border with Gabon

Angola has not been hit but officials have closed a segment of the border

It is the segment where Angolans and Congolese most often interact 

While the current outbreak looks possible to contain, experts say measures like border closures may be key to controlling the virus

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 08 2018 at 2:51am
Not a lot of real information seems to be coming out of the DRC at the moment.  But, at least, the health messages seem to be getting through.]

Church in Congo suspends sacraments during Ebola outbreak

Jun 7, 2018

CATHOLIC NEWS SERVICE


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'Strong progress' in calming Congo Ebola outbreak: WHO

9 Jun, 2018 4:45am

DAKAR, Senegal (AP) — "Strong progress" has been made in calming Congo's deadly Ebola outbreak in a city of 1.2 million and in the rural outpost where the epidemic was declared one month ago, the World Health Organization said Friday, but now the focus turns to "some of the most remote territory on Earth."

Health officials expressed cautious optimism as the pace of new cases has slowed. Congo's health ministry late Thursday announced a new confirmed Ebola case, bringing the total to 38, including 13 deaths.

The new case is in the remote Iboko health zone in Congo's northwest. Health workers also have been chasing contacts of those infected in Mbandaka city, a provincial capital on the heavily traveled Congo River, and in Bikoro town where the outbreak was declared.

While Ebola's spread to a major city has complicated efforts to track all contacts of those infected, the presence of the virus in Iboko poses another world of problems.

The forested terrain is so rough that even four-wheel-drive vehicles can't reach the area, which has no electricity, WHO's emergency response chief Peter Salama told reporters in Geneva. Motorcycles are only now arriving and health workers are sleeping 15 to 20 people to a tent.

"This is a major logistical and boots-on-the-ground epidemiological endeavor now," Salama said, adding that work there will go on for weeks.

WHO has vaccinated more than 1,000 people over the past two weeks in all areas of the outbreak, including health workers who are at high risk. The virus spreads via bodily fluids of infected people, including the dead.

"There's been very strong progress in the outbreak response, particularly in relation to two of three sites," Salama said. "Phase one, to protect urban centers and towns, has gone well and we can be cautiously optimistic."

He warned, however, that experts are not in a position to document all chains of transmission of the virus, so "there may still yet be unknown chains out there and there may still be surprises in this outbreak."

This is Congo's ninth Ebola outbreak since 1976, when the hemorrhagic fever was first identified.

WHO said it is supporting emergency response and preparedness efforts by nine neighboring countries. Republic of Congo and Central African Republic are closest to the outbreak and are highest priority, but Congo is also bordered by Angola, Burundi, Rwanda, South Sudan, Tanzania, Uganda and Zambia.

WHO says the Ebola response will cost more than $15.5 million over nine months.

Source:   https://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=12067268

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Congo Ebola outbreak: WHO records 62 cases, 27 deaths



NEW YORK - World Health Organisation (WHO) experts said they have recorded 62 Ebola cases in the Democratic Republic of Congo (DRC) during this latest outbreak, with 38 confirmations and 27 deaths.

Deputy Director-General for Emergency Preparedness and Response of WHO, Dr Peter Salama reported in Geneva that “very strong progress” in response to the Ebola outbreak in the DRC, one month after the start of the diseases.

He said that the first phase – protecting urban centres and towns – “has gone well, and we can be cautiously optimistic.”

“There have been 62 Ebola cases in the DRC during this latest outbreak, with 38 confirmations and 27 deaths.

“The latest case, confirmed on Thursday, was in the remote Iboko health zone in the northwest, an indication that the outbreak is ongoing, he said.

Salama, who just returned from a two-day visit to the DRC said: “There’s been very strong progress in the outbreak response, particularly in relation to two of the initial three sites: Mbandaka and Bikoro”.

Mbandaka, in northwest DRC, has a population of around one million,and it is the capital of Equateur province, where the small town of Bikoro also is located.

“We’re cautiously optimistic but there’s a lot of very tough work to do in phase two before we say that we’re on the top of this outbreak and we’ve learned the hard way in the past never to underestimate Ebola,” Salama said.

He said the focus now was on rural isolated communities in the Iboko health zone which would present logistical and other challenges.

Salama described it as among the most remote territory on Earth, mainly inhabited by indigenous populations, while WHO currently has 80 staff in the area.

“We’re talking about an enormous logistical effort required to reach every alert of a case. And then if there is a confirmation of a case, every contact of those cases,” he explained. (NAN)


Source:  https://www.enca.com/africa/congo-ebola-outbreak-who-records-62-cases-27-deaths

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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 11 2018 at 11:48am
In tracking filovirus reservoirs, fruit bats have been implicated for ebola, though apparently no virus has yet been isolated. Since VSV-EBOV is based on VSV, and VSV-Indiana was originally isolated from a cow in July of 1925, the Salmonella connection to Mbandaka links US and UK. Salmonella has been isolated from fruit bats in India: Pteropus.

Salmonella mbandaka
' A single isolate of S. mbandaka exhibted multidrug resistance to tetracycline, amoxicillin/clavulanic acid and ampicillin....'

UK / Cattle / Animal Feed
'....We show that UK isolates of S. mbandaka is comprised of one of clonal lineage which is adapted to proficient utilisation of metabolites from soya beans under ambient conditions.'

This links to Australia, for the progenitor plant which is ancestor to the soybean:

Novel RNA Viruses Within Plant Parasitic Cyst Nematodes
journals.plos.org/plosone/article?id=10.1371/journal.pone.0193881
'....SCN (soybean cyst nematode, Heterodera glycines) NLV and BLV are negative-sense RNA viruses....An additional viral genome was identified from Globodera pallida (potato cyst nematode). The virus is a picorna-like virus, a positive-sense virus.'

This links to polio (picornavirus) vaccinations at Mbandaka (formerly Coquilhatville). 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 12 2018 at 1:59pm
If ebola is vectored by fruit bats, though no virus has yet to be found infecting them, then bat flies are suspect. Nipah virus infects Eidolon dupreanum, though E. helvum is infected by Lagos bat virus, which is the link to HIV-2.

'No. 73  Lagos Bat Virus

Isolated by L.R. Boulger, Lagos, Nigeria.

Time of Collection: Feb 1956

Susceptibility to Experimental Infection:  Monkey (Cercocebus torquatus torquatus), 5th passage, no evidence of infection.'
(Catalogue of Arboviruses of the World)

Just as HIV-2 does not affect sooty mangabeys, Lagos bat virus (Rhabdoviridae) does not seem to affect other mangabeys such as C. torquatus.


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Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 10

Report
from World Health Organization
Published on 12 Jun 2018 

1. Situation Update

The outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo remains active. One month into the response, there is cautious optimism about the situation in Bikoro and Wangata (especially Mbandaka) health zones where the last confirmed EVD case was reported on 16 May 2018. The primary focus of the response has moved from the urban areas of Equateur Province to the most remote and hard-to-reach places in Itipo and the greater Iboko Health Zone.

On 10 June 2018, two new suspected EVD cases were reported in Iboko Health Zone. Thirteen laboratory specimens (from suspected cases reported previously) tested negative. No new confirmed EVD cases and no new deaths have been reported on the reporting date. Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case was reported in Iboko Health Zone on 2 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 55 EVD cases and 28 deaths (case fatality rate 50.9%) have been reported, as of 10 June 2018. Of the 55 cases, 38 have been laboratory confirmed, 14 are probable (deaths for which it was not possible to collect laboratory specimens for testing) and three are suspected. Of the confirmed and probable cases, 27 (52%) are from Iboko, followed by 21 (40%) from Bikoro and four (8%) from Wangata health zones. A total of five healthcare workers have been affected, with four confirmed cases and two deaths.

The outbreak has remained localised to the three health zones initially affected: Iboko (24 confirmed cases, 3 probable, 2 suspected, 7 deaths), Bikoro (10 confirmed cases, 11 probable, 1 suspected, 18 deaths) and Wangata (4 confirmed cases, 3 deaths).

The number of contacts requiring follow-up is progressively decreasing with many completing the required follow-up period. As of 10 June 2018, a total of 634 contacts were under follow up, of which 633 (99.8%) were reached on the reporting date.

Context

On 8 May 2018, the Ministry of Health of the Democratic Republic of the Congo notified WHO of an EVD outbreak in Bikoro Health Zone, Equateur Province. The event was initially reported on 3 May 2018 by the Provincial Health Division of Equateur when a cluster of 21 cases of an undiagnosed illness, involving 17 community deaths, occurred in Ikoko-Impenge health area. A team from the Ministry of Health, supported by WHO and Médecins Sans Frontières (MSF), visited Ikoko-Impenge health area on 5 May 2018 and found five case-patients, two of whom were admitted in Bikoro General Hospital and three were in the health centre in Ikoko-Impenge. Samples were taken from each of the five cases and sent for analysis at the Institute National de Recherche Biomédicale (INRB), Kinshasa on 6 May 2018. Of these, two tested positive for Ebola virus, Zaire ebolavirus species, by reverse transcription polymerase chain reaction (RT-PCR) on 7 May 2018, and theoutbreak was officially declared on 8 May 2018. The index case in this outbreak has not yet been identified and epidemiologic investigations are ongoing, including laboratory testing.

This is the ninth EVD outbreak in the Democratic Republic of the Congo over the last four decades, with the most recent one occurring in May 2017.

Source:   https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-8
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 13 2018 at 1:30pm
There seems no published reports of fruit-bat eating habits in the areas of interest for this latest outbreak. Feline immunodeficiency virus links to big cats and jungle cats such as leopards, linking "cat scratch fever" (Bartonella) to Nipah virus (Paramyxoviridae) and fruit bats:

Exposure to Bat-Associated Bartonella
'....128,000 bats on average, are hunted for food yearly in southern Ghana alone. Serologic evidence of human infections with novel paramyxoviruses from Eidolon helvum supports concerns regarding this contact.'

During rubber-exploiting years in the Congo, the workers slept in wooden cages constructed from available materials, which were not always effective against leopards. Thomas Duncan's ebola med, brincidofovir, is the ether lipid analogue of cidofovir. Cidofovir potently inhibits cytomegalovirus. Congo chevrotain (Tragulus) mothers teach their young to eat the twigs of Pycnanthus, which anti-cytomegalovirus compounds include dihydroguaiaretic acid.

(Hungary, 2010) Dihydroguaiaretic Acid / CMV


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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 13 2018 at 2:32pm
CMV-Based Ebola Vaccine
(Hamilton, Montana; Devon, UK; Braunschwieg, Germany; Riverside, California; Portland, Oregon)

The chevrotainian "ghost sequence" from Pycnanthus (Myristaceae) is the signal for myristoylation, Gly-Ala-Gly-X-Ser, linking poliovirus and rhinovirus inhibitors:

(May 2018) Poliovirus/Rhinovirus Inhibitors

(1988) Anti-HIV-1 / Myristoylation
'....inhibited the myristoylation of the proteolytic cleavage of the gag-coded polyprotein Pr53gag to p24 but did not affect the processing of gp160.'

'p. 728:  At some time in late 1959 or early 1960, a (polio vaccination) campaign was staged at the large town of Coquilhatville ("Coq," now Mbandaka) in Equateur Province.

p. 738:  Equally, we know that one of the last campaigns in the Congo, that at Coquilhatville (Mbandaka), the one that Courtois later hoped to have monitored by the CDC, does not correlate with the early spread of HIV-1, for a retrospective test of 250 sera taken from Mbandaka in 1969 revealed no HIV positives.' 
(Hooper, The River: A Journey to the Source of HIV/AIDS)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 14 2018 at 10:22am
VSV-EBOV, a Diptera-based vaccine compares with CMV-based vaccines, because some bat fly parasites are blind. Thus, Iboko, for example, links to CMV retinitis:

Iboko / CMV Retinitis
'....CMV retinitis (6%)....cataract and glaucoma constituted a public health problem in this rural area of Zaire.'

One reason Tragulus mothers teach their young to eat Pycnanthus twigs is here:

(May 2018 India)  Newborn Glaucoma / CMV

Nigeria / CMV Retinitis / HIV-AIDS

Having mentioned the "ghost sequence" for myristoylation, one link to poliovirus and rhinovirus is here:

Anti-Poliovirus N-Myristoylation

Ebola and Marburg are Mononegavirales. Mononegavirales sequences found in the soybean cyst nematode, link the Tragulus-Pycnanthus assemblage:

(2014 Mississippi State University)  Heterodera glycines Myristoylation

Thus, the progenitor of the soybean in Australia may have reacted against a Mononegavirales vector sometime during evolution.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 18 2018 at 9:47am
To help verify that major viruses are involved in the region of the latest ebola outbreak, this report has a map:

WHO Officials Fear Latest Ebola Outbreak in Congo Could Spread to Big Cities
'....or Bangui, the capital of the Central African Republic, to the north.'

Institute Pasteur, Bangui

Edward Hooper (The River) shows Yaounde, Cameroon on the map but does not mention polio at Quesso, and the WHO does not seem to mention it either, or on the internet. Unfortunately, we no longer have the citation for the polio cases at Quesso. Quesso is on the Sangha River at the southernmost tip of Cameroon, which river borders the area that was the origin of the HIV-O subtype. The Sangha connects the Congo below Mbandaka. Yaounde includes the region for the origin of HIV-1. Many animals from southern and southeastern Cameroon end up at the market in Yaounde.

Congo's Ebola Outbreak Poses Challenges for Bush Meat
'....four years ago....it was widely suspected that the epidemic began when a 2-year-old boy in Guinea was infected by a bat.'
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 18 2018 at 2:24pm

[Although 'contained' is not the same as over, the signs are good it is under control.]


How DRC’s Ebola Outbreak Has Been Contained

The Ebola outbreak in Congo has been closely tracked and, so far, well-contained, in stark contrast to the 2014 West Africa outbreak that killed thousands of people.
By SALEM SOLOMON | June 18, 2018

The Ebola outbreak in the Democratic Republic of the Congo appears to be in its waning days. Despite 28 deaths as of early June, health officials are cautiously optimistic that they are bringing the outbreak under control. So far, it’s a striking turnaround from the 2014 West Africa outbreak, which killed more than 11,000 people in Liberia, Sierra Leone and Guinea, and traveled as far as Glasgow, Scotland, and Dallas, Texas.

Despite difficult-to-traverse terrain and local communities’ skepticism of health care workers, from the start of the outbreak, officials got in front of the disease and kept it in check. Several factors made the DRC response markedly different than previous outbreaks, saving countless lives.


1. Long distances between villages and an underdeveloped infrastructure slowed the spread of the disease.

The DRC’s remoteness made it difficult for health care workers to access affected communities, but it also impeded the spread of the disease. For the most part, infected individuals did not leave their communities, and outsiders didn’t come in, greatly limiting the number of infections. In contrast, in 2014, at the height of the West Africa epidemic, Ebola spread quickly through densely populated cities.

Source:   https://projects.voanews.com/drc-ebola-outbreak/

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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 19 2018 at 9:55am
The paradox in this containment story is that whereas in 2014 the human was vector, in 2018 the ebola reservoir remains at large despite a vaccine, just as it did in 2014. 

Because ebola sequences have been detected in small mammals at Bangui, both polio and HIV coalesce three theories in southeastern Cameroon: SIV-contaminated polio vaccine, SIV-contaminated bush meat, and contaminated reused hypodermic needles for general use).

There is no doubt that polio cases at Quesso are documented, though we cannot retrieve a citation at this time. Quesso is also spelled Ouesso, and a Pubmed search retrieves only one reference:

Ouesso / HIV Subtype Diversity
'....p24 gag....'

Thomas Duncan's ebola med, brincidofovir, is an ether-lipid analogue that reveals clues to its synthesis: myristoylation is also documented for HIV-1. Therefore, whereas myristoylation is a lipidation modification (compared with brincidofovir), sumoylation is a post-translational modification.

Ebola VP40 Sumoylation

Ebola Zaire Sumoylation


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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 19 2018 at 1:31pm
Thomas Duncan's ebola meds are based on anti-CMV compounds such as cidofovir, which links to anti-CMV compounds of the Tragulus food, Pycnanthus. Thus chevrotains were eating anti-CMV compounds throughout their evolution.

(2017) CMV Sumoylation-Dependent Post-Translational Modification

Foot-and-mouth disease virus is a Picornavirus, and the chevrotainian "ghost sequence" reveals an antiviral strategy of the Myristaceae:

In summary, FMDV Lpro has evolved to recognize two specific substrates at two different cleavage sites by providing a deep hydrophobic pocket to interact specifically with residues such as leucine at the P2 site, and subsequently modulating the interaction through subtle requirements at the P1 or P1' sites. Would it not have been easier for the FMDV Lpro to have evolved to recognize a unique cleavage site? This would mean cleaving between L and VP4 at a site containing a P1 Gly and a P1' Arg, as found in the cleavage site of of eIF4GI, or cleaving the eIF4GI between a P1 lysine and a P1' Gly, as found in the polyprotein cleavage site.

The first possibility cannot be an option as the N-terminal region of VP4 contains the recognition signal for myristoylation (GlyAlaGlyXSer); any attempt of the virus to introduce basic residues would lead to an inability to myristoylate VP4 and hence a defect in viral replication. The second option does not seem possible either, as the sequence LeuLys*Gly cannot be found in a position that would allow proteolysis to separate the eIF4GI binding domains for eIF4E and eIF4A.'
(Skern T, et al, Structure and Function of Picornavirus Proteinases, in Molecular Biology of Picornaviruses [2002] p. 209)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: June 20 2018 at 3:18pm
The Hot Zone: A Terrifying True Story
Book by Richard Preston

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

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 22 2018 at 10:43am
Ltest: 

Health officials cautiously optimistic dangerous Ebola outbreak is over

June 21, 2018

There is cautious optimism that a dangerous Ebola outbreak in the Democratic Republic of the Congo is over, the head of the World Health Organization’s emergency response operations said Thursday.

Transmission of the deadly virus appears to have stopped — though it is not yet time to pull back on the response operation, Dr. Peter Salama, deputy director-general for emergency preparedness and response, told STAT.

“Overall I’d be very confident that we’ve broken the back of this outbreak,” Salama said, noting that the WHO will discuss with the DRC government in coming days how long to maintain response operations and when to think about declaring the outbreak over.

While there have been 28 fatalities due to Ebola, there hasn’t been a newly confirmed diagnosis since early June. And while surveillance teams keep finding and testing people who are sick, time and again tests have shown that what ails them is not Ebola.

Typically infectious disease outbreaks are declared over when there hasn’t been a new case for two full incubation periods of the particular disease. Ebola’s incubation period is two to 21 days, so 42 days is the bare minimum. As of Thursday, 19 days had passed without a new case.

But the WHO is likely to be cautious, particularly in light of the West African Ebola outbreak that ran from late 2013 to 2016.

That epidemic appeared to be coming under control in 2015 and 2016, and on several occasions the WHO declared the outbreak over in one of the affected countries. Then a cluster of new cases would be spotted.

Investigation of the new cases brought to light that a phenomenon previously thought to be mainly a theoretical risk: The Ebola virus persisted in some survivors for weeks and in some cases even months — notably in eyeballs and testicles — often reigniting spread of the disease.

Investigations found most of the new cases were linked to sexual contact with a survivor; mother-to-infant transmission via breast milk was seen in one case.

The same kind of risks “mustn’t be underestimated” in the latest outbreak, said Dr. Jeremy Farrar, director of Britain’s Wellcome Trust, one of the first entities to step up to help fund this outbreak response.

“You would hate to declare it over prematurely,” he said, noting that having to unwind operations and rebuild them later would be difficult and would undermine morale.

The use of an experimental Ebola vaccine in the outbreak may diminish the risk of straggler cases, or even sexually transmitted infections from survivors, however.

The vaccine, being developed by Merck, was offered to health care workers as well as the contacts of cases — and their contacts — in what’s called a ring vaccination approach. The idea is to stop spread of the virus by protecting anyone who might be at risk of contracting it.

Acceptance of the vaccine was astonishingly high — almost everyone offered a chance to be vaccinated took it. Salama said in nine of 11 vaccination rings, all the people offered the vaccine agreed to be vaccinated. In the other two rings, 98 percent agreed. “It was really heartening,” he said.

It is too early to say for sure, but Salama believes the vaccination effort helped to contain the outbreak, which involved spread in three locations — the city of Mbandaka, on the Congo River, the town of Bikoro, and the village of Iboko.

“Just eyeballing the data, the fact that these outbreaks really stopped in their tracks … to me is suggestive that the vaccination had some impact,” he said. Salama noted infections dried up despite the fact that contact tracing — finding people who had been exposed to cases to monitor them for signs of Ebola — only really got to high levels late in May. That is about a week after vaccination began in Mbandaka and around the time it started in Bikoro and Iboko.

The outbreak post-mortems will include an effort to explore the question more fully, Salama said. Scientists will look at when contacts of cases were exposed to sick people and then when they were vaccinated to try to discern if the vaccine may have prevented infections.

“We’ll know more on that when we do more modeling post-outbreak with the full data set,” Salama said. “But for the regular transmission, certainly that’s extremely likely. And even [to prevent] sexual transmission, it’s possible.”

None of the experimental Ebola therapies shipped to DRC ended up being used in this outbreak. By the time the country’s scientific and ethics advisory committees had studied the drugs and agreed they would be administered, there were no patients left to treat.

“It is a lost opportunity,” Salama acknowledged.

But he noted that in a small 2017 outbreak in DRC, the same thing happened with a proposal to use the experimental vaccine. The groundwork laid then led to quicker approval of the vaccine this time, he said, and the review of the experimental drugs in this outbreak could speed approvals the next time DRC — on its ninth Ebola outbreak — has to fight this disease. “For next time, I think it will happen much more quickly,” Salama said.





Source:   https://www.statnews.com/2018/06/21/ebola-outbreak-optimism/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 22 2018 at 12:25pm
We (this writer and many quoted authors) are developing a Japanese alphabet (rather than a syllabary). This alphabet will serve to communicate more efficiently in various languages. An example of translational blunders for ebola reporting is here:

www. for Ebola in America and Other Fake Problems Our Leaders Love to Fight
'In 1972, an American doctor, Thomas Cairns doing missionary work in the Congo, cut himself with a scalpel during an autopsy on a patient who had died of ebola -- a disease yet unknown to medical science. He survived because his wife, even under those conditions, treated him with a basic drip.'

This translation is dubious, because it does not mention bananas. The original Russian written by Yulia Latynina of Novaya Gazeta, states:

'On vyshil.
He survived.

Znaete kak?
Know how?

Pravil'no, ego zhena v krytoi bananovimi list'iami khizine stavila emu samodel'nye kapel'nitsy
Correctly, his wife covered it with banana leaves from the hut (roof) placed into a homemade dropper.'

Similarly, Japanese ebola experts assisted the WHO on 20 separate occasions during the Liberia and Sierra Leone ebola outbreak. This is what one usually sees when visiting the Yomiuri news site:

Yomirui Online

This page is in English:
kyoiku.yomiuri.co.jp/2017.3.15eigo_mondai.pdf
'....ebola....The Tokyo-based center will use drones capable of long distances at high speeds in Zambia....Toyama Chemical Co. Ltd. will provide T-705 or Favipiravir, a medicine which is not yet approved for ebola virus disease treatment.'

Drones should be applicable for vector-reservoir studies as well, and an efficient alphabet (rather than the now-existing Japanese syllabary), will assist in speed and efficiency of communication.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 23 2018 at 1:14am
[Not quite over - but in retreat]

Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 12

Report
from World Health Organization
Published on 22 Jun 2018 View Original

1. Situation Update

The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo. Over one month into the response, further spread of EVD has largely been contained. However, in spite of the progress made, there should be no room for laxity and complacency until the outbreak is controlled. The focus of the response remains on intensive surveillance, including active case finding, investigation of suspected cases and alerts and contact tracing.

On 20 June 2018, four new suspected EVD cases were reported in Iboko (2) and Bikoro (2) health zones. Four laboratory specimens (from suspected cases reported previously) tested negative. Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case- patient in Iboko Health Zone developed symptoms on 2 June 2018, was confirmed on 6 June 2018 and died on 9 June 2018.

Since the beginning of the outbreak (on 4 April 2018), a total of 61 EVD cases and 28 deaths have been reported, as of 20 June 2018. Of the 61 cases, 38 have been laboratory confirmed, 14 were probable cases (deaths for which it was not possible to collect laboratory specimens for testing) and nine were suspected cases. Of the 52 confirmed and probable cases, 28 died – giving a case fatality rate of 54%. Twenty-seven (52%) confirmed and probable cases were from Iboko, followed by 21 (40%) from Bikoro and four (8%) from Wangata health zones. Five healthcare workers have been affected, with four confirmed cases and two deaths.

The number of contacts requiring follow-up is progressively decreasing, with a total of 1 527 contacts having completed the mandatory 21-day follow-up period. As of 20 June 2018, 179 contacts were under follow up and all (100%) were reached on the reporting date.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 25 2018 at 9:15am
The ridiculously complex URL for the following report, even when transcribed correctly, still does not work, exemplifying the dangers when communicating during an epidemic. The reader must scroll down to retrieve it:
Healio ITJ in the journals
'....22 Jun 2018 Ebola Flare-Ups in West Africa Linked to 'Persistently' Infected Survivors'

What this means for the DRC is that two species of Marburg virus were circulating there in 2000 and the total deaths form them have never been published. Thus, the first-ever report of filoviruses being sequestered in the sexual glands was from the Marburg case in Kenya in 1980.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 25 2018 at 9:24am
The ebola report for West Africa, above, is not the originally-shown URL.  According to Promedmail, 843 have been vaccinated at Mbandaka (Coquilhatville), 779 at Bikoro, 1518 at Iboko, 107 at Ingende, and 21 at Kinshasa. There are polio and HIV/AIDS links to Mbandaka and Kinshasa.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 26 2018 at 10:36am
For polio and ebola vaccination histories at Mbandaka, the link is to Niemann-Pick which is also the link to Koprowski's oral polio vaccine and Poland, as well as cerebral spinal fluid taken from chimpanzees at Lindi Camp. Both polio and Niemann-Pick are mentioned in this report:

(1973) Poland / Polio / Niemann-Pick

Niemann-Pick Type C1 is Critical for Ebola Virus Entry
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Lysosomal is a keyword for Niemann-Pick.

Polio-Influenza Vaccines / Lysosomal
http://www.ncbi.nlm.nih.gov/pubmed/28383105

VSV-EBOV was the vaccine used at Mbandaka (843 vacinees), recalling that anti-ebola brincidofovir is an ether lipid analogue of cidofovir. Indeed, in Nieman-Pick disease patients have either a zero or low esterification profile, and in alcoholism, ester bonds are changed to ether bonds in cell walls.

At a certain point, the mechanisms involved become less clear, and names of compounds will change to number names, as in this report from Harvard:

(Ap 2016) VSV / Lysosomal / ZCL278
http://www.ncbi.nlm.nih.gov/pubmed/26912630
'....VSV....lysosomal....'
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 12:59am
["Contained" is old news but there have been no new cases sonce the 6th of June.]

Ebola Outbreak in Democratic Republic Congo is ‘largely contained’: WHO

26 June 2018

Almost two months after the start of the latest Ebola outbreak in the Democratic Republic of Congo (DRC), United Nations health experts announced on Tuesday that the deadly disease has “largely been contained”. 

A total of 55 cases of Ebola have been recorded during the current outbreak of the often-deadly viral infection and 28 people have died, according to the World Health Organization (WHO).

Ebola is endemic in DRC and has been identified there nine times, since 1976. Before the current outbreak in Equateur Province, the most recent episode of the disease was in 2017, in northern Likati province. Four people died and four survived, according to WHO.

Spokesperson Tarik Jasarevic said that the development was an “important step” but “it is not the end”.

Experience has shown us that it only takes one case to set off a fast-moving outbreak - Tarik Jasarevic (WHO)

“We are cautiously confident regarding the situation and know that a continued aggressive response is required,” he said, adding that “experience has shown us that it only takes one case to set off a fast-moving outbreak.”

Ahead of the WHO announcement, there were fears that the disease might continue its spread from rural north-western DRC, along the key Congo River transport route, to the capital Kinshasa, which is home to 10 million people; and also spread to neighbouring countries.

Those concerns were based on the grim toll and progress of the Ebola epidemic in West Africa between 2013 and 2016, which killed more than 11,000 people in Guinea, Liberia and Sierra Leone.

To counter the threat from the current outbreak – and making use of a new vaccine - the UN agency and Doctors Without Frontiers (MSF) quickly coordinated over an inoculation programme that began in the DRC city of Mbandaka, where around one million people live.

This was followed by another round of preventive vaccination in and around the town of Bikoro to the south, where the initial Ebola victims were identified.

According to WHO, the last confirmed case of Ebola in DRC was on 6 June.

Since then, all probable and suspect cases have been declared negative.

A key tactic used to counter the spread of the haemorrhagic disease has been contact-tracing.

During this current episode, WHO and MSF have traced contacts of those who are suspected of having the disease, administering more than 3,200 vaccinations.

The last 161 people to have come into contact with suspected Ebola virus carriers will finish their mandatory follow-up period on 27 June, at which point they will be declared virus-free, WHO says. 

Meanwhile, on the ground in DRC, health teams are following as many as 20 suspect cases a day, said Mr Jasarevic: “We need to keep the work going in DRC to make sure that all suspect cases are being looked for and make sure that there are no new cases.”

https://news.un.org/en/story/2018/06/1013122

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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 7:06am
Filoviruses were discovered in 1967, and yet no proof is extant that bats are infected with the virus. If such a report exists, we'd like to see it displayed on this thread because Africans believing that bats have something to do with the epidemic are as yet a fairy tale. What is the precise reservoir and vector? Nature is not opposed to invention, invention being part of nature itself. Nature is opposed to myth.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 9:01am
Because Mononegavirales sequences have been found in the genome of the soybean cyst nematode (Heterodera), the trajectory links to Australia and by default, a possible explanation for the origins of the Reston ebola virus (Phillipines):

Progenitor of the Soybean, Australia
'....Table 2. Soybean Pathogens....Glycine microphylla: Soybean Cyst Nematode....'

Because VSV-EBOV vaccine is Diptera-based, the investigative trajectory includes bat-flies as ectoparasites of fruit bats.

'Family Hippoboscidae....Wings either normally developed with 6 or 7 longitudinal veins and alula, or reduced and nonfunctional in Hippoboscinae; wings and halter absent in Melophagus.... Obligate blood-sucking ectoparasites of birds and mammals. Reproduction by adenotropic viviparity. The mature larvae (third instar) are usually deposited away from the host and very soon transform into puparia; though in Melophagus they are laid and pupate in the host's hair.
....
Hippoboscinae, Tribe Ornithomyini.

Ornithoica Rondani, 1878 Ornithoeca emend. O. bistativa Maa, 1966. Pacif. Insects Monogr. 10: 52 (Ornithoica) Type Locality: Borneo Tenom. Sabah -- Distr. Asia: Iran; Oriental Region

O. podicipis von Roeder, 1892: Mitt. naturh. Mus. Hamb. 10(2), Dipteren: 4 (Ornithoica). Type Locality: Sansibar -- Distr. North Africa: Egypt, East Africa.

O. stipituri (Schiner, 1868): Reise Novara, Zool. 2(1)B, 374. Type Locality: Sudney -- Distr.: Asia, Japan, Indoustralia Region.

O. unicolor Speiser, 1900: Annali Mus. cov. Stor. nat Giacomo Doria (2) (20) 40: 556 (Ornithoica) Type Locality: "Sumatra am Singalang-Berge" -- Distr. USSR: KZ, FE; Asia: Japan; Oriental Region.'
(Catalogue of Palearctic Diptera, V. 11 Scathophagidae -- Hypodermatidae, pp. 215 -17)  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 9:12am
Note ebola virus antibodies discovered in orangutans on Sumatra and Borneo.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 9:28am
The 1980 Kenya case of Marburg was a Frenchman who trekked to Mt. Elgon, but also fed birds that came into his house. He was an electrician for the irrigation pumps at the Nzoia sugar factory.

Nzoia Ebola and Marburg Antibodies

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 10:35am
Originally posted by MikeL MikeL wrote:

Note ebola virus antibodies discovered in orangutans on Sumatra and Borneo.
Good!  That could mean a bit of real justice for poachers and illegal loggers.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 11:50am
Linking the Hippoboscidae to orangutans also means Pongids co-existing with hominids in Ethiopia, which has been documented. Following the Marburg virus evidence links to Edward Hooper's mention of chimpanzee skulls being sent to the museum in Turvuren(see The River: A Journey to the Source of HIV and AIDS).

'Subgenus Ardmoeca Maa, 1969. 

A. schoutedeni (Bequaert, 1945) Psyche 52: 93 (Lynchia) Type Locality: "Mongende, Belgian Congo" -- Distr. USSR: Kazhakstan; Oriental Region.'
(Catalogue of Palaearctic Diptera, V. 11, p. 221)

One must dig deeper to find the chimpanzee connection:

J. Bequaert, Notes on Hippoboscidae.19.
psyche.entclub.org/52/52-088.html
'Specimens Examined: Belgian Congo: Holotype, male, Mongende, off cormorant, Halietor africanus (Gmelin) (H. Schouteden, Congo Museum, Turvuren); Kenya Colony: Allotype, female, Naivasha, off Phalacorcorax carbo lucidus (Lichtenstein) (A. Meinertzhagen, Museum of Comparative Zoology, Cambridge).'

The Marburg-infected electrician (1980) worked at Nzoia, so here is the trajectory of the journey to the hospital in Nairobi, which passes through Naivasha:

Trans-Nzoia County

Lake Naivasha

Naivasha

If not mistaken, cormorants on Lake Naivasha would link to the Marburg-infected electrician who fed crows and other birds at his home. Hippoboscidae links to crows and bats:

'Family Nycteribiidae....Blood-sucking ectoparasites of Chiroptera with adenotropic vivparity. Females bear third instar larvae away from the host, in the neighbourhood of the roosting place; larva is pressed to the substrate, pupation follows immediately. Female larviparous, returning to the host. Emerged imago without ptilinum, puparial operculum opened by the action of the first pair of legs. After hardening the insect searches for its host.
(Çatalogue of Palaerctic Diptera, p. 227)


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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 12:13pm
There is a link to Kashmir, West Sumatra, and the Rothschild collection:

'Subfamily Nycteribiinae, Nycteribia Latreille

Subgenus Nycteribia Latreille, 1796

N. allotopa (Speiser, 1901) Arch. Naturgesch. 67(1): 47 (Nycteribia (Lystropodia)) Type Locality: Liang si Paghe (West-Sumatra) -- Distr. Asia: Afghanistan, China; Oriental Region.

N. allotopa mikado Maa, 1967, Pacif. Insects, 9(4):748 (Nycteribia). Type Locality: Syozyodo Cave, Wiigata-ken, Honshu (Japan) -- Distr. Japan (Honshu); Ryukyu Islands

N. dentata Theodor, 1967: Illustr. Cat. Rothschild Coll. Nycteribiidae (Brit. Mus. Nat. Hist., Publ. 655), London 61: (Nycteribia). Type Locality: "Kashmir (Bumbroo Cave, Matan, Palhgam Road") -- Distr. Asia: Afghanistan; India.'
(Catalogue, op cit, pp.227-8)

Both N. allotopa mikado and N. dentata were discovered the year of the Marburg virus outbreak in Germany, though the Germans would find out that the Marburg agent was circulating in Uganda as early as 1961.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikeL Quote  Post ReplyReply Direct Link To This Post Posted: June 27 2018 at 12:49pm
Following the watercourse from Mbandaka (formerly Coquilhatville), the Ruki River flows into the Busira arriving at Bandaka and Boende. Though yet to find it on a map, Mongende is apparently close to Boende.
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