DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - malaria, shigella confirmed - 24 cases, 13 deaths under investigation for possible hemorrhagic fever - 2 positive for ebola Aug 24

[Shiloh]

Source: http://in.reuters.com/article/2014/0...0GK1CC20140820


Illness with Ebola-like symptoms kills several in Congo: locals

KINSHASA Wed Aug 20, 2014 6:49pm IST

(Reuters) - Democratic Republic of Congo has sent its health minister and a team of experts to the remote northern Equateur province after several people died there from a disease with Ebola-like symptoms, a local official and a professor said on Wednesday.

It was not immediately clear if there was any connection with Ebola. An epidemic of that disease has killed more than 1,200 people in Guinea, Liberia, Sierra Leone and Nigeria.

"An illness is spreading in Boende but we don't know the origin," said Michel Wangi, a spokesman for the governor's office. "The government has sent a team of experts from the INRB(National Institute of Biomedical Research) this morning led by the health minister (Felix) Kabange Numbi and acting governor Sebastian Impeto."..

[Treyfish]

Re: Congo: Illness with Ebola-like symptoms kills several

Fears Ebola has 'spread to Congo after 10 people die'

<time datetime="2014-08-20" pubdate="" class="time-edited">Last updated Wed 20 Aug 2014</time>
There are fears Ebola could have spread to the Democratic Republic of Congo after 10 people died from a disease with Ebola-like symptoms, local officials said.
The deceased, which included four health workers, lived in a remote part of the northern Equateur province of Boende. The country has now sent its health minister and a team of experts to the area to confirm if it is the deadly virus.
Michel Wangi, a spokesman for the governor' office, said: "An illness is spreading in Boende but we don't know the origin."
So far the disease has killed more than 1,200 people in Guinea, Liberia, Sierra Leone and Nigeria.http://www.itv.com/news/update/2014-...10-people-die/

[Treyfish]

Re: Congo: Illness with Ebola-like symptoms kills several

Illness with Ebola-like symptoms kills several in Congo

UPDATED 20 AUGUST 2014

Democratic Republic of Congo has sent its health minister and a team of experts to the remote northern Equateur province after several people died there from a disease with Ebola-like symptoms, a local official and a professor said.
0

Democratic Republic of Congo has sent its health minister and a team of experts to the remote northern Equateur province after several people died there from a disease with Ebola-like symptoms, a local official and a professor said on Wednesday.

It was not immediately clear if there was any connection with Ebola. An epidemic of that disease has killed more than 1,200 people in Guinea, Liberia, Sierra Leone and Nigeria.

"An illness is spreading in Boende but we don't know the origin," said Michel Wangi, a spokesman for the governor's office. "The government has sent a team of experts from the INRB(National Institute of Biomedical Research) this morning led by the health minister (Felix) Kabange Numbi and acting governor Sebastian Impeto."
A professor accompanying the delegation in the presidential plane confirmed that they were en route this morning to find out "the exact nature of the illness that caused the Boende deaths".

An Equateur resident who asked not to be named said that around ten people had died, including four health care workers, after suffering from fever, diarrhoea and bleeding from the ears and nostrils - all symptoms of the deadly Ebola virus.

Highly-contagious, Ebola can kill up to 90 percent of its victims. There is no known vaccine and the few forms of treatment that exist are experimental.

Congo does not share a border with any of the countries affected by the virus in West Africa. But the country has seen several outbreaks since the first case was detected near the Ebola River in northern Congo in 1976.

http://www.health24.com/Medical/infectious-diseases/Ebola/Illness-with-Ebola-like-symptoms-kills-several-in-Congo-20140820

[Treyfish]

DRC-an unknown disease kills 65 people in 4 weeks Djera

Ecuador: an unknown disease kills 65 people in 4 weeks Djera

published there 12 hours, 9 minutes | Last Update August 21, 2014 at 9:35 |

<table class="shashinThumbnailsTable" id="shashinGroup_1_1" style="float: left;"><caption>
</caption><tbody><tr><td> The Minister of Public Health, Felix Kabange Numbi on 31/05/2013 in Kinshasa, during the official launch ceremony of the acceleration of the reduction of maternal mortality and child in the DRC framework. Radio Okapi / Ph. John Bompengo
</td></tr></tbody></table>
An unidentified disease has killed 65 people in about 4 weeks in the area of health Djera, Tshuapa district, 25 kilometers Boende-center in the province of Ecuador. The Minister of Public Health, Felix Kabange Numbi, the acting governor of Ecuador, S?bastien Impeto, as well as experts from the World Health Organization (WHO) arrived Wednesday, August 20 at Boende to investigate this disease, and care for patients.
Health sources on the ground say they have been alerted since July on a contagious disease that affects three areas of health Wetsikengo, Lokalia and Wafanya in Boende territory. The disease is characterized by severe diarrhea, fever and vomiting. According to the same health sources, four nurses, who cared for the sick, are among the victims.
Moreover, the disease would progress to the locality of Wetsikengo near Tshuapa River.
Teams of WHO and the health zone Boende, rushed to the scene, took samples which are being analyzed at the National Institute of Biomedical Research (INRB) in Kinshasa.
Pending the results of the examinations, the Minister Felix Kabange Numbi pledged to send another team of doctors in the health area of Djera, about twenty miles of Boende.
This mission will still resample that will, from this weekend, to have more details on this illness, he said. https://translate.googleusercontent....nyu5zzR3QpMfSA

[Treyfish]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera

At least 70 dead from hemorrhagic illness in northern Congo- WHO

Source: Reuters - Thu, 21 Aug 2014 17:15 GMT Author: Reuters


DAKAR, Aug 21 (Reuters) - At least 70 people have died in northern Democratic Republic of Congo from an outbreak of hemorrhagic gastroenteritis, the World Health Organization (WHO) said on Thursday, denying that the illness was Ebola.
"This is not Ebola," a WHO spokesman said in an email to Reuters on Thursday. A WHO report dated Thursday and seen by Reuters said that 592 people had contracted the disease, of whom 70 died. (Reporting by Emma Farge; Editing by Daniel Flynn) http://www.trust.org/item/20140821170644-l0n3l/?source=fiTheWire%29

[Treyfish]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera

70 die from illness in Congo, WHO denies Ebola link

<time itemprop="datePublished" pubdate="" datetime="2014-08-21T14:47-04:00">Published August 21, 2014</time>

At least 70 people have died in northern Democratic Republic of Congo from an outbreak of hemorrhagic gastroenteritis, the World Health Organization said on Thursday, denying that the illness was Ebola.
A WHO report dated Thursday and seen by Reuters said that 592 people had contracted the disease, of whom 70 died. Five health care workers, including one doctor, are among the dead.
"This is not Ebola," a WHO spokesman said in an email to Reuters on Thursday.
A local priest who asked not to be named said that the illness had affected several villages and estimated that the death toll was over 100 people.
Kinshasa sent its health minister, Felix Kabange Numbi, and a team of experts on Wednesday to the region after reports of several deaths.
The outbreak began in the remote jungle province of Equateur where the first case of Ebola was reported in 1976, prompting speculation that it was the same illness that has killed more than 1,350 people in an outbreak now raging in West Africa.
Symptoms of the two diseases are similar; they include vomiting, diarrhoea and internal bleeding. But the fatality rate for this outbreak of haemorrhagic gastroenteritis is much lower than the West Africa Ebola outbreak, at around 12 percent versus close to 60 percent.
The WHO, which sent representatives to the area on Wednesday together with the Congolese team of experts, said four samples would be flown from the town of Boende on Friday to the capital Kinshasa for further testing.
Medical charity MSF said it had also sent a team to Equateur province to assess the situation. MSF said it was too early to confirm what the disease was.http://www.foxnews.com/health/2014/0...es-ebola-link/

[alert]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera

I have merged the two threads since it is clear this is the same outbreak. It is also a small relief to know this is not Ebola (and probably not Marburg or CCHF due to the 12% CFR).

But what is it? If the reports of hemorrhage are wrong, it might be cholera. Untreated cholera can have a CFR of 12% or more, but would it affect HCW? A single case of Lassa was reported in DRC a couple years ago, but an outbreak this size seems unlikely. Some kind of dysentery is possible as well perhaps. Yellow fever should also be investigated, especially if the patients have not been vaccinated.

[alert]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

Several additional possibilities here, including typhoid and E. coli:

http://afludiary.blogspot.com/2014/08/who-drc-outbreak-definitely-not-ebola.html

Thursday, August 21, 2014

WHO: DRC Outbreak `Definitely Not Ebola?

# 8983

With the Ebola outbreak raging out of control in Western Africa it is natural to assume that any other report of a `hemorrhagic outbreak? carrying significant mortality in that part of the world might also be due to one of the Ebola (or Marburg) viruses.




In recent days we?ve seen media reports of an unidentified outbreak in the DRC, described as having a`hemorrhagic? component, and that it has claimed as many as 70 lives over the past few weeks. Major symptoms included fever, vomiting, and diarrhea.



While early speculation centered around the possibility of Ebola, today, Gregory Hartl ? spokesperson for the World Health Organization ? confirmed that it definitely isn?t Ebola.


image



Good news, but not terribly surprising.



The reality is, there are plenty of other pathogens out there capable of producing these types of symptoms. E. Coli, Listeria monocytogenes, Salmonella typhi (Typhoid Fever) and Campylobacter jejuni for instance, all have a long (and bloody) history of causing severe gastroenteritis.



The infamous 2011 EHEC Outbreak in Germany ? traced to E. Coli contaminated sprouts ? infected over 4,000 people, produced hundreds of cases of kidney failure, and killed 50 people.



In Canada, 14 years ago , there was an outbreak in Walkerton, a small community northwest of Toronto, where nearly half of the residents (2,300) developed gastroenteritis. Of these, 65 were hospitalized, 27 developed hemolytic uremic syndrome (HUS) and seven died (cite A fatal waterborne disease epidemic in Walkerton, Ontario).



The bottom line from that report:



The pathogens identified as being primarily responsible were Escherichia coli 0157:H7 and Campylobacter jejuni although other pathogens were likely to have been present



A little bit of research also turned up a gastroenteritis outbreak Kinshasa, DRC a decade ago that claimed 77 lives and sickened more than 2500. This from Irin News in 2004.




DRC: Gastroenteritis hits Kinshasa, kills 77 children

KINSHASA, 14 July 2004 (IRIN) - Some 77 children have died and 2,599 others are infected following an outbreak of gastroenteritis in Kinshasa, the capital of the Democratic Republic of the Congo, according to a health ministry official.


The associate director of epidemiology at the health ministry, Dr Vital Mondonge Makuma, told IRIN on Wednesday that the disease, caused by a strain of the Escherichia coli bacterium, broke out six weeks ago. It was particularly dangerous to children aged below five years, he added.



There are also viral causes of gastroenteritis (caused by noroviruses, other caliciviruses, astroviruses and adenoviruses for the most part) ? and while they are seldom fatal in healthy individuals ? they can produce significant mortality in people with comorbidities.



And there?s no lack of parasites capable of inducing serious gastroenteritis as well (Giardia, Cryptosporidium, etc.)




The point here isn?t to try to pin down what the outbreak in the Congo is.



There are a number of plausible options, including many I haven?t mentioned. The doctors and epidemiologists on the ground will figure it out, and I?m certain they will let us know when they do.




But it does remind us that while we obsess over the horrors of Ebola - a thousand times more people will be killed this year by far more mundane causes - like waterborne diseases, malaria, and childhood pneumonia.



But since they don?t provoke the kind of visceral response that Ebola does, we somehow find the intestinal fortitude to tolerate them.



Posted by Michael Coston at 6:48 PM

[Pathfinder]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

It is "febrile gastroenteritis with haemorrhaging" according to Gregory H&#228;rtl on twitter:

RDC - flamb&#233;e en province d'Equateur est une gastro-ent&#233;rite f&#233;brile avec h&#233;morragie. Pas Ebola.

https://twitter.com/HaertlG

[Pathfinder]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

Translation Google

DRC: 13 people died of hemorrhagic fever "of unknown origin" (Official)

22Aug2014

Thirteen people died of hemorrhagic fever "of unknown origin" since August 11 in the north-west of the Democratic Republic of Congo, a country where it was discovered the Ebola virus that has left more than 1,300 dead in Africa west, has-been learned from the Minister of Health.

"Thirteen people have died since August 11 hemorrhagic fever of undetermined origin. Thirteen people died developed fever, diarrhea, vomiting and terminally ill, vomiting of blackish material," said Dr. Felix Kabange Numbi.

About 80 people who had contact with the deceased patients are followed at their home in Boende Moke, Lokolia, Watsikengo and Lokula, localities in the Equateur province (northwest), said the Congolese minister. They will be monitored daily for 21 days.

In case of fever, diarrhea, vomiting or any form of bleeding, they will be conducted in health centers, and to Lokolia Watsikengo, he has still shown.

Lokolia and Watsikengo, distant thirty miles, are the epicenters of the disease. The authorities have created commissions to the patient monitoring, hygiene, sanitation and safe burials.

Samples have been taken and should be treated at the National Institute of Biomedical Research (INRB) and the laboratory in Franceville, Gabon, to determine the exact orgine disease. "We should have the results in seven days," the minister said.

In addition, a system of free care was set up and a health care could be converted to Lokolia next week.

The first victim of hemorrhagic fever was a pregnant woman and the other twelve people died after being in contact with her during her illness and after his death.

"Five health workers have died, including a doctor, two nurses, a medical officer and a waiter. Other victims are relatives or the villagers who attended the funeral," said the minister, adding that since protection kits were distributed to health workers.

An Ebola outbreak occurred at the beginning of the year in Guinea. It killed at least 1,350 people, including 576 in Liberia, Guinea and 374 396 in Sierra Leone, according to the latest report of the World Health Organization (WHO), adopted August 18, with a marked acceleration in recent weeks .

In late July, the DRC had embellished its alert threshold, announced tighter screening of passengers coming from affected countries, as well as pre-positioning of all the guard staff and diagnosis.

The Ebola virus is particularly evident in bleeding, vomiting and diarrhea. Its mortality rate can range from 25 to 90% and there is no approved vaccine. It is spread by direct contact with blood, body fluids or tissues of infected humans or animals.

The disease was first discovered in 1976 in the Congolese province of Ecuador. Since then, the Democratic Republic of Congo (DRC) has seen several deadly epidemics. The last 36 was officially dead between August and November 2012 in the Northeast.

hab / mf

http://www.afp.com/en/info/2751115/

[Pathfinder]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

Translation Google

Equateur: the unknown disease has killed 10 more

published there 6 hours, 39 minutes | Last Update August 22, 2014 at 7:56 |

The unidentified illness plaguing the territory Boende in Equateur province has a total of 75 deaths, ten more than the previous record. Provincial authorities announced Thursday, Aug. 21. The delegation led by the Minister of Health and Acting Governor of Equateur was still Watsikengo Thursday in the area of health Djera, 25 kilometers Boende-center. In Mbandaka, the provincial capital, a crisis meeting was held.

The meeting was attended by the Minister of Budget, Gertrude Ndjoli Bekombe, the provincial medical inspector, Franck Boembi, and representatives of public institutions, civil society and humanitarian partners.

The aim was to establish a committee of provincial struggle to cope with the disaster.

The last two victims of this disease were recorded Wednesday Watsikengo, said the interim medical inspector, Dr. Franck Boembi.

The latter still talking about a situation of alert in the province, pending the results of analysis of samples sent to the National Institute for Biomedical Research (INRB) in Kinshasa.

Another suspect case would be registered in Bongondjo area, Mbandaka. The husband of a 37-year old victim says his wife had a high fever and blood flows before dying. But no samples were taken from the body of the victim, buried immediately after his death.
...

http://radiookapi.net/actualite/2014/08/22/equateur-la-maladie-inconnue-fait-10-morts-de-plus/

[Treyfish]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

<dl class="article-info"><dd class="published">DRC: results from the "unknown disease" is heavier than 75 dead

Published Friday, August 22, 2014 2:31 p.m. </dd></dl>
Seventy-five people have died of an unidentified disease that is a hemorrhagic fever "of unknown origin" in Equateur province (north-west of the Democratic Republic of Congo), said Friday the UN radio Okapi citing provincial authorities.
This estimate is much higher than the one given Thursday by the Congolese Minister of Health, Dr. Felix Kabange Numbi.

Radio Okapi, a UN-sponsored, was reported Thursday in the death of 65 people in about four weeks in the health area Djera in the areas of health Wetsikengo, Lokalia Wafanya and in the territory of Boende a town about 300 km east of Mbandaka, the capital of Equateur province.

This "unknown disease" made ten more deaths, said Friday the radio.

A spokesman at the headquarters of the World Health Organization (WHO) in Geneva, Gregory H&#228;rtl has about him reported "cases of gastroenteritis."

According to Mr Numbi, some 80 people who were in contact with the deceased patients are followed at home.

The appearance of this disease comes amid an outbreak of Ebola hemorrhagic fever unprecedented since the emergence of the virus in 1976 - when two simultaneous outbreaks in Sudan and the DRC (then Zaire) - killed at least 1,350 dead on 2.473 cases in four countries in West Africa (Liberia, Sierra Leone, Guinea and most recently Nigeria).
Too early to talk about deadly hemorrhagic fever, according to WHO and MSF

It is too early to say that it is a hemorrhagic fever that has killed at least thirteen - or 75, according to UN radio Okapi - people in the northwest of the Democratic Republic of Congo (DRC) warned Friday WHO and Doctors Without Borders (MSF).

"Many died with bleeding symptoms, but it also has severe malaria who can also give these symptoms, or typhoid fever," said an official of the World Health Organization (WHO) based in Kinshasa under the condition of anonymity told AFP.

"We are still waiting biological confirmations to determine what kind of disease it is," he told AFP Amandine Colin, communications officer for MSF in Kinshasa, whose teams are present in the affected area, Boende territory of the Province of Ecuador (northwest).

The Congolese Minister of Health, Dr. Felix Kabange Numbi said Thursday AFP that "13 people have died since August 11 hemorrhagic fever of unknown origin," stressing that it presented "in terminally ill, vomiting of blackish material. "

Samples have been taken and should be treated at the National Institute of Biomedical Research (INRB) and the laboratory in Franceville, Gabon, to determine the exact origin of the disease. "We should have the results in seven days," the minister said.
Friday, the death toll remained "unchanged", said Dr. Kabange Numbi told AFP, while the UN radio Okapi reported a record 75 deaths.

Lokolia and Watsikengo, distant thirty miles, are the epicenters of the disease. The authorities have created commissions to the patient monitoring, hygiene, sanitation and safe burials. http://translate.google.com/translat...23.U_dU8rH3dac

[alert]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

Black blood instead of red might be an important clue. That suggests the blood is being digested before being released. If this is H2H spread, it may also have a very short incubation period, with 2-3 generations within 10 days. The timing is certainly not consistent with H2H spread with a 21 day incubation period.

http://www.onewovision.com/actu-rdc/RDC-la-fievre-hemorragique-d-origine-indeterminee-sous-controle-ministre,i-20140822-e745

Today - AFP Friday, August 22, 2014 - Viewed 3 times

DRC: hemorrhagic fever of unknown origin "under control" (Minister)



The Congolese Minister of Health, Dr. Felix Kabange Numbi, announced Friday that the hemorrhagic fever of unknown origin that has thirteen deaths since August 11 in the north-west of the Democratic Republic of Congo was "under control."

The situation "is under control at Boende, especially the shaft down to Lokolia. (...) Until now the disease is contained in areas Lokolia and Watsikengo" he he reporters, back from these regions in the province of Ecuador.

He recalled that 13 people - including a pregnant woman, five health workers and a baby a month - had died since August 11 after suffering a hemorrhagic fever "of unknown origin" who, after three or four days, causes in patients vomiting and diarrhea with "black blood."

Lokolia and Watsikengo, distant thirty miles, are the epicenters of the disease. The minister said the "extension risk" fever "remain low" because of the "natural barriers" to achieve these very remote areas, take the plane, road, boat and motorcycle.

About 80 people who had contact with the deceased patients were followed from their home in Boende Moke, Lokolia, Watsikengo and Lokula. Of the 80 contacts, "there are eleven who presented with fever and diarrhea and pr?sentemment were already isolated," said the minister.

Friday morning, an official of the World Health Organization (WHO) has sent experts to the affected during the minister's visit area, and Doctors Without Borders (MSF), has on-site felt that it was still too early to speak of "hemorrhagic fever".

"We just get the 8 samples" taken in the province of Ecuador and were deposited at the National Institute of Biomedical Research (INRB), announced the Minister of Health. "We hope that in seven to eight days to come, we will have the diagnosis," said he added.

The unknown disease that occurs when Ebola was discovered in the DRC in 1976 virus epidemic has done since the beginning of the year in West Africa at least 1,350 dead, including 576 in Liberia, Guinea and 396 in 374 in Sierra Leone, according to a latest report of WHO, dated 18 August.

hab / jmc

[Treyfish]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera, Equateur Province - not Ebola

Ecuador: Government reports "cases of hemorrhagic fever of unknown origin"

published there 11 minutes, | Last Update August 22, 2014 at 7:17



Haemorrhagic fever of unknown origin killed 13 people, including five members of the medical profession, to Djerba, in the territory of Boende, Equateur province. The Health Minister, Felix Kabange Numbi, announced Friday, Aug. 22, in Kinshasa. He held a press conference after staying in the health areas affected by the disease. According to the Minister Kabange this hemorrhagic fever was preceded by an outbreak of malaria and bloody diarrhea, which killed more than 60 people in this region. "We arrived at Boende and we went in the sector Djera, which is the most affected. We can say here that there are suspected cases of hemorrhagic fever of unknown origin, "he said.
Among the 13 victims of hemorrhagic fever, there is one doctor, two nurses hold, a medical officer and a waiter.
Kabange Numbi assured that the DRC government has taken all measures to stop the chain of infection.
"We have distributed protective equipment in all four health areas concerned, we have drugs to them. And we began to monitor cases pending laboratory results, "said he said.
Eight samples were deposited at the National Institute of Biomedical Research (INRB) and samples will also be sent in Franceville, Gabon, for quality control, the minister said, assuring that the situation is under control.
"We hope that in 7-8 days to come, we will have the diagnosis. I want to assure you that Boende, it's quiet. There is no panic, "Has he said.
Onsite Boende, commission communication was established to inform enough people about hygiene measures to deal with this epidemic.https://translate.googleusercontent....E8MaEDnJnzXthA

[curiosity]

Re: DRC-an unknown disease kills 65 people in 4 weeks Djera

I have merged the two threads since it is clear this is the same outbreak. It is also a small relief to know this is not Ebola (and probably not Marburg or CCHF due to the 12% CFR).

But what is it? If the reports of hemorrhage are wrong, it might be cholera. Untreated cholera can have a CFR of 12% or more, but would it affect HCW? A single case of Lassa was reported in DRC a couple years ago, but an outbreak this size seems unlikely. Some kind of dysentery is possible as well perhaps. Yellow fever should also be investigated, especially if the patients have not been vaccinated.

Internal Radiation Absorption?

http://www.merckmanuals.com/professional/injuries_poisoning/radiation_exposure_and_contamination/radiation_exposure_and_contamination.html

Excerpt Table 2: Effects of Whole-Body Irradiation From External Radiation or Internal Absorption

Hemorrhage

Vomiting

Severe diarrhea

High fever

Electrolyte disturbance

Shock

N/A (patients die in < 48 h)