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Ebola outbreak: DR Congo confirms first cases

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  • #16
    Re: Ebola outbreak: DR Congo confirms first cases


    Congo confirms first Ebola cases
    Geoffrey York
    JOHANNESBURG — The Globe and Mail
    Published Sunday, Aug. 24 2014, 7:46 PM EDT
    Last updated Sunday, Aug. 24 2014, 7:49 PM EDT

    ...Last week, the World Health Organization insisted the Congo deaths were not caused by Ebola. But on Sunday, a WHO spokesman said the earlier statement was based on “premature information.” Now the global organization says it is waiting for further tests in Congo...

    ...The outbreak has been “contained” in an area in Equateur province...Other reports said the government is setting up a quarantine area with tight controls for 100 kilometres around the site of the outbreak...

    ...The government says the samples in Congo suggest the presence of the Sudanese strain of the virus, while the West African outbreak was caused by a different strain, the Zaire strain, the most lethal form of the virus.

    One of the two samples in Congo, however, was officially reported to contain a mixture of the Sudanese and Zaire strains – a claim that puzzled many Ebola analysts on Sunday...


    • #17
      Re: Ebola outbreak: DR Congo confirms first cases

      A dual infection would be most feasible in a wild-type host, but would suggest that the host is quite widespread across Africa and can migrate a long way.

      Two different infectious types of virus would also suggest a dual introduction i.e high presence/ predominance of virus in the host.

      On Googling, it seems some species of bats do migrate, so its quite possible.


      • #18
        Re: Ebola outbreak: DR Congo confirms first cases

        Clarification please,

        The mystery disease in Congo is not Ebola but something else, and they also have Ebola on top of that, but its not the same type as the current west African outbreak, which gives us a dual outbreak, but of more limited scope currently?

        Is that right?

        Also, is there any chance their wrong about the Mystery disease in Congo being Ebola as well?


        • #19
          Re: Ebola outbreak: DR Congo confirms first cases

          Originally posted by Pirante View Post
          Clarification please,

          The mystery disease in Congo is not Ebola but something else, and they also have Ebola on top of that, but its not the same type as the current west African outbreak, which gives us a dual outbreak, but of more limited scope currently?
          Correct, different species of ebolavirus. The current West Africa one is Zaire, this is Sudan, though oddly one seems to be both Zaire and Sudan, and nobody really seems to know what that means.

          Unrelated simultaneous outbreaks have occurred before, in 1976 and 2012.

          Also, is there any chance their wrong about the Mystery disease in Congo being Ebola as well?
          The CFR seems to be well below what one would expect from even the mildest Ebola, and six of the eight samples tested negative.

          Going through the hundreds of reported cases and working out which is and isn't Ebola looms as a tough task.


          • #20
            Re: Ebola outbreak: DR Congo confirms first cases


            Ebola: DRC appeals for funds to fight the epidemic

            August 25, 2014


            The DRC government has asked Monday, August 25 the financial support of its national and international partners to contain the epidemic hemorrhagic fever officially declared last evening in Djera, a town of Equateur province in the north-east of the country . The Minister of Public Health, Felix Kabange made ​​the call during a meeting with ambassadors and heads of diplomatic missions accredited in the DRC.

            "We remain open to the contribution of both national and international community. The challenge is logistics sector because Djera is eccentric. We will have to put up camp at this sector and this requires extremely funds. And beyond the fact that we will place the Ebola treatment center. There is no water in the area, therefore, there must be a mechanism in order to bring water, "said the minister.

            The quarantine of Djera creates a new challenge, said Felix Kabange, the additional food intake to about 50,000 inhabitants of this town already enclosed.

            "We need your support, your support so that together we can contain this epidemic," pleaded the Congolese minister.

            Besides the initial contingency plan valued at 2.5 million USD, the government needs two million American dollars to fight back against the epidemic while the overall plan requires approximately 4.5 million USD.

            Radio Okapi
            “Addressing chronic disease is an issue of human rights – that must be our call to arms"
            Richard Horton, Editor-in-Chief The Lancet

            ~~~~ Twitter:@GertvanderHoek ~~~ ~~~


            • #21
              Re: Ebola outbreak: DR Congo confirms first cases

              ..Below, the entire communication from the Minister of Health, Dr Felix Kabange Numbi, as he delivered yesterday on RTNC, while giving full details of the reported presence of the Ebola virus to Djera, Ecuador... Dear compatriots,
              Since December 2013, the outbreak of the Ebola virus disease, prevalent in West Africa, including Liberia, Guinea, Sierra Leone and Nigeria. In those days, more than 2,000 cases were reported, of which 1,145 deaths. Faced with this public health emergency of international concern, the Democratic Republic of Congo has raised the alert threshold at entry points and the level of supervision of all hemorrhagic fevers within the country.
              Before the occurrence of haemorrhagic fever of undetermined origin, served in the Health Zone Boende in the Province of Ecuador, the President of the Republic, His Excellency Joseph Kabila, head of state, instructed the Government to hold two crisis meetings on Tuesday 19 and Friday, August 22, 2014, chaired by the Prime Minister.
              It was decided during the first meeting, sent a delegation led by the Minister of Public Health in the territory of Boende.

              The facts on ground shows that the disease has killed 13 people, including five health workers, patients were 11 people in isolation and over 80 contacts were identified and monitored by a specialized team.
              The Government of the Republic presents its condolences to all the bereaved families.

              After analyzing eight samples field, the National Institute of Biomedical Research (INRB) has confirmed that two samples were positive to Ebola. A sample is positive for Sudan strain and one positive sample in a cross strain, Sudan Zaire. Of aligots were sent to the International Center for Medical Research in Franceville, Gabon, for the determination of strain in the coming hours.
              'So I said to this day, the outbreak of the Ebola virus disease in Sector Djera, Boende territory, district Tshuapa, Equator Province in the DRC'.
              This epidemic has no connection with that outbreak in West Africa and is the <sup>7th</sup> epidemic in the DRC since the Great Yamboko occurred in 1976 in the province of Ecuador.
              The experience gained from previous epidemics 6 Ebola will be put to use to contain the disease.
              'I recall that the epidemic is confined to the area Djera, located about 600 kilometers from Mbandaka, Chief town of the Province of Ecuador, is over 1,200 km from the city-province of Kinshasa DRC capital. Actions are already underway on land with the contribution of local authorities, health personnel and the Government of the Republic.

              The Government of the Republic invites the public to remain calm and respect the protection measures including regular hand washing with soap after critical moments.

              Before the disease Ebola in the area Djera, the Government of the Republic met this afternoon of Sunday, August 24, 2014, in crisis meeting with the Prime Minister, on the instruction of the President of the Democratic Republic of Congo.
              And the Government of the DRC announced the following measures:
              1. Quarantining sector Djera. Sorting and filtering will be from Lomela River, located 16 kilometers from Boende and security services will be involved;
              2. The establishment of a processing center Lokolia;
              3. Installation of the International Technical Coordination Committee and Scientific acronym CICTS to Lokolia. A camp will be built for this purpose, for multiple interventions;
              4. The installation of a mobile laboratory Lokolia, the epicenter of the epidemic for the laboratory diagnosis in real time;
              5. The deployment of experts to Lokolia and its surroundings, including all skills. It should be noted that health workers who managed the previous outbreaks in DRC will be involved and deployed in the field.
              6. Staffing all ports and airports in Ecuador Laser thermometer;
              7. The prohibition of hunting on the entire range of the district Tshuapa;
              8. Strengthening all the measures already announced to date, including the equipping of protection to all medical personnel, active case finding and monitoring of all cases contacted, secure confirmed cases and funerals unexplained deaths in the community, awareness, isolation of all cases, disinfecting homes of all confirmed cases or deaths in the community, staffing of all essential drug industry structures of Djera and free care for the entire period of the epidemic, staff motivation and the motivation of the response team, the psychosocial care of all those infected and affected people, building capacity of local service providers throughout the territory of Boende.
              'The leadership of the response to the outbreak of the Ebola virus disease is provided by the President of the Republic, Head of State, His Excellency Joseph Kabila and Prime Minister, His Excellency Matata Ponyo Mapon hold regular crisis meetings with all concerned Ministries'.
              The Government of the DRC remains available to all support of National as well as international community. An Information Point will be open, from this Monday, August 25, 2014, the Ministry of Public Health to regularly inform the public and the international community. A hotline will be announced in the coming hours to answer all the questions here.
              I remember that there is no Ebola in the City-Province of Kinshasa, capital of DRC, much less Mbandaka, Chief town of the Province of Ecuador, and the epidemic is restricted to date , sector Djera in Boende territory and that all measures have been taken by the Government to contain this epidemic in the Territory Boende.
              Thank youhttps://translate.googleusercontent....gP6KijYHyOcG6Q
              Last edited by sharon sanders; August 25th, 2014, 10:27 AM. Reason: added bolding and underlining of strain info



              • #22
                Re: Ebola outbreak: DR Congo confirms first cases

                Translation Google

                Guest Africa
                | Download this edition

                Released Monday, August 25, 2014

                F. Kabangue Numbi, "We have quarantined the area of Jera"

                Sonia Rolley

                The DRC authorities confirmed Sunday that Ebola was indeed present in the Equateur province. Eleven people have died from the disease. The Ebola virus has been identified, but the epidemic has nothing to do with the one that spreads currently in West Africa. That's at least according to the Congolese Minister of Health, Felix Kabangue Numbi, micro RFI.

                RFI: Are you sure, sir, that it is Ebola and why are you sure?

                Felix Kabangue Numbi: Because we just had the first result of the National Institute of Biomedical Research in Kinshasa (INRB) which shows that of the eight samples we brought from Jera, there are two samples that are positive, positive sample Ebola virus strain Sudan and another sample with a cross strain Sudan-Zaire. That's why for the determination of the strain, we'll wait in the next hours [culture results] of the Institute of Franceville [who received the samples] that were prepared by Kinshasa to determine the strain.

                How to explain that there are actually different strains?

                It is probably a single strain. In fact, there is not much difference between the Zaire strain and the Sudan strain. The laboratory in Kinshasa has not the same security as the laboratory in Franceville, so we could not do the sequencing. It will be done at Franceville and then we can determine the strain.

                Is this is the same strain as the West Africa?

                We do not know how to confirm. . What I can confirm is that the epidemic we have in Jera is completely independent of that of West Africa. It is an epidemic whose "index case" [the first confirmed case NDLR] is located at in the sector of Jera. And if it turns out that it is the Sudan strain, it will demonstrate that even on the original layout, it will be two different strains. But already there are two epidemics that are quite distinct. There are no links, because for there to be a link, there must be a contact case that comes from West Africa.

                The area of concerned, this is an area that is in the forest, a very isolated area, and where no one has had contact with the outside. And already the mission that we did Friday last week in Jera, including Lokolia and Watikengo allowed us precisely to go up the chain and to find even a probable "index case."

                We have a lady who died Aug. 11, who was pregnant. The doctor who operated on this lady, because you had to retrieve the child, has died, the nurse who attended the intervention has died; hygienist who disinfected the operating room died; the husband of this lady, who is a pastor and hunter by trade, is one of the two cases that are positive. So we think we have an "index case" and therefore it is an epidemic that is totally independent of that outbreak in West Africa.

                What actions will you take from now? You had already taken a precautionary measure, will there be new or more precise measures?

                Indeed, we have just decided to quarantine the sector of Jera. Since there is Lomela river located at 16 km from Boende which is a completely natural barrier, we will use it for sorting and filtering all who can enter or exit the sector Jera .. . and the Minister of Internal Security was instructed that the service of safety is involved.

                We will set up a treatment center in Lokolia itself and we decided to install the International Committee of Technical and Scientific Coordination (CICTS) in Lokolia at the epicenter of the epidemic in order to act directly.

                The installation of a mobile laboratory at Lokolia has for interest to ensure laboratory diagnosis in real time to enable us to quickly load and unload the "contact cases" that are identified. We have to use all the health personnel who managed the previous outbreaks. It must be said that this epidemic is the seventh, so the president has asked us to get all the staff who managed the previous epidemics to deploy at Jera sector so that support is the best from the start. Of course we will also equip all ports and airports in Equateur, laser thermometers, we have extended the ban on hunting in the area of Tshuapa and for governor, he will go to all province of Equateur.

                What is the state of the epidemic in terms of patients and in terms of death yet?

                We have thirteen deaths, we have eleven people who are contacts in isolation.

                Are you optimistic?

                We remain optimistic. First, the alert was sounded soon enough. Second, we had the chance to establish the chain of transmission. Usually it takes time (two to three weeks), but then we have the chain of transmission that has been drawn upon our return Jera, and support and the response was even par. And I hope, by the grace of God and the work that is being done, I am confident that we can quickly stop the chain of transmission.

                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela


                • #23
                  Re: Ebola outbreak: DR Congo confirms first cases

                  The INDEX case died 11 august and the reporting of many deaths came the 20th of august. Meaning less then 10 days between death of index case and the death of 12 contacts. In sawyer chain the death was 12, 17, 20 and 25 days after index death.
                  Sounds like a very agressive strain and a short incubation time. Or?

                  Can it really be the index case that died 11 august?


                  • #24
                    Re: Ebola outbreak: DR Congo confirms first cases

                    There are a few explanations:

                    First -

                    The index case - presumed, died on Aug 11 - unknown but reasonable to suggest that based on the disease is the index case may have presented with signs and symptoms beginning August 1. The contacts to this case may have been exposed at initial onset of signs - aka August 1, and by August 3, probably more like August 9 or 10, the contacts could have also started presenting with disease signs and died ten days later (within the normal onset to death time frame) on August 20.

                    Second -

                    The contacts to Sawyer were monitored and received higher level medical care from the illness onset, for the known disease - Ebola. Appropriate treatment was provided in the Sawyer Chain as compared to the unknown treatment for the undiagnosed disease that eventually turned out to be Ebola in the DRC. The enhanced medical support - blood transfusions, coagulation monitoring and medications, IV fluids, etc... may extend the life by a few days.


                    • #25
                      Re: Ebola outbreak: DR Congo confirms first cases

                      Mbandaka is de capital city of Equateur Province

                      A suspected case of hemorrhagic fever recorded in Mbandaka

                      August 26, 2014 at 8:23

                      Medical sources report a suspected case of hemorrhagic fever discovered Monday, August 25 in the town of Mbandaka in Equateur. This is a lady of 65 years living in the neighborhood Bongondjo which was conducted at the General Hospital Reference Wangata.

                      "Indeed, on Monday at about 10:01 suspected case was transferred to the General Referral Hospital Wangata" confirms provincial medical inspector and interim coordinator of the Provincial Committee of the fight against Ebola outbreak in Ecuador, Dr. Franck Boembi.

                      The doctor tells the patient and the family members who accompanied him were isolated.

                      "In connection with the practical arrangements that are made ​​locally here in Mbandaka, we had to identify a site where all suspected cases will be routed. This site is located within the General Hospital Wangata "says Dr. Frank Boembi.

                      Acting provincial medical inspector invites the public to exercise caution and respect for hygiene. He says the local radio educate townspeople about it.
                      This suspected case of hemorrhagic fever was reported after the declaration of an outbreak of Ebola in Djera within the province of Ecuador.

                      Radio Okapi
                      “Addressing chronic disease is an issue of human rights – that must be our call to arms"
                      Richard Horton, Editor-in-Chief The Lancet

                      ~~~~ Twitter:@GertvanderHoek ~~~ ~~~


                      • #26
                        Re: Ebola outbreak: DR Congo confirms first cases


                        Mbandaka:the suspected case has nothing to do with Ebola says Felix Kabange

                        August 26, 2014 at 12:29

                        After identifying a suspected case of hemorrhagic fever in Mbandaka (Equateur), the Health Minister Felix Kabange Numbi, invites the people of this city in peace. In a statement Tuesday, August 26 at Radio Okapi, [B] asserts that this suspected case has nothing to do with the Ebola epidemic in the area Djera [/ B], in the same province.

                        "I know that there is a lady of 65 years we have brought to the hospital in Wangata and people have said right away that there Ebola, while this is a case that has nothing like Ebola, "said Felix Kabange Numbi.

                        Originally posted by Gert van der Hoek View Post
                        Mbandaka : le cas suspect d&#233;tect&#233; n’a rien &#224; voir avec Ebola, affirme F&#233;lix Kabange

                        le 26 ao&#251;t, 2014 &#224; 12:29 | sous

                        Apr&#232;s l’identification d’un cas suspect de fi&#232;vre h&#233;morragique &#224; Mbandaka (Equateur), le ministre de la Sant&#233;, F&#233;lix Kabange Numbi, invite la population de cette ville au calme. Dans une d&#233;claration faite mardi 26 ao&#251;t &#224; Radio Okapi, il affirme que ce cas suspect n’a rien &#224; voir avec l’&#233;pid&#233;mie d’Ebola qui s&#233;vit dans le secteur de Djera, dans la m&#234;me province.

                        &#171; Je sais qu’il y a une dame de 65 ans qu’on a amen&#233; &#224; l’h&#244;pital de Wangata et les gens ont d&#233;clar&#233; tout de suite qu’il y a Ebola, alors que c’est un cas qui n’a rien &#224; voir avec Ebola &#187;, d&#233;clare F&#233;lix Kabange Numbi.

                        Radio Okapi
                        “Addressing chronic disease is an issue of human rights – that must be our call to arms"
                        Richard Horton, Editor-in-Chief The Lancet

                        ~~~~ Twitter:@GertvanderHoek ~~~ ~~~


                        • #27
                          Re: Ebola outbreak: DR Congo confirms first cases


                          MSF can only offer limited help in Congo Ebola outbreak
                          KINSHASA/DAKAR Tue Aug 26, 2014 3:04pm BST

                          (Reuters) - Medicins Sans Frontieres (MSF), the leading organization in fighting Ebola, said on Tuesday it could provide only limited support to tackle a new outbreak in Democratic Republic of Congo as it was already overstretched by the worst ever epidemic...

                          ...MSF said that four of its samples had tested positive for the virus, without specifying whether these were in addition to two cases already confirmed by the government at the weekend...


                          • #28
                            Re: Ebola outbreak: DR Congo confirms first cases

                            MSF Sending Ebola Specialists and Supplies to DRC

                            August 26, 2014

                            KINSHASA—Doctors Without Borders/M&#233;decins Sans Fronti&#232;res (MSF) has launched a response to the confirmed Ebola viral hemorrhagic fever outbreak in Equateur Province, Democratic Republic of Congo (DRC). The medical organization, present in DRC for more than 30 years, is sending doctors, nurses, logistics experts, and hygiene specialists to the epicenter of this outbreak.

                            “We received confirmation on Sunday that four of the samples our team took last week have tested positive for Ebola virus,” says Jeroen Beijnberger, MSF Medical Coordinator in DRC. “We are responding fast to try to isolate the suspected and confirmed patients and to start the work of contact tracing.”

                            Working with the Congolese Ministry of Health, MSF is setting up an Ebola management center in Lokolia, the area most affected by the outbreak in the Boende health zone. “Our key objective for now is to do all we can to stop the outbreak spreading and to protect other people from catching the virus,” says Beijnberger.

                            No link with the Ebola outbreak in West Africa has been established, although that cannot be categorically discounted. “For now, we consider this outbreak as an unfortunate coincidence,” says Beijnberger. “We are trying to confirm the origin of the outbreak, but at this time nothing points to a direct link with the epidemic in Guinea, Liberia, and Sierra Leone.”

                            In the first phase of response to a new hemorrhagic fever outbreak, protection of patients and health workers is the top priority. Good coordination is also required to ensure that all levels of leadership—from the highest government levels to the local community leaders and village chiefs—pass accurate and constructive information to the population, that burial teams are organized with proper infection control measures, and that contact tracing and epidemiological monitoring are done swiftly and efficiently to avoid the spread of the outbreak.

                            “Usually, we would be able to mobilize specialist hemorrhagic fever teams, but we are currently responding to a massive epidemic in West Africa,” says Beijnberger. “This is limiting our capacity to respond to the epidemic in Equateur Province. We need other organizations to step up and joint the efforts to support the Ministry of Health. We will not be able to do this one alone.”

                            “Addressing chronic disease is an issue of human rights – that must be our call to arms"
                            Richard Horton, Editor-in-Chief The Lancet

                            ~~~~ Twitter:@GertvanderHoek ~~~ ~~~


                            • #29
                              Re: Ebola outbreak: DR Congo confirms first cases

                              Translation Google

                              Information on the disease Ebola in Equateur (DRC) No. 2 on 25 August 2014

                              Category: Status Reports Publication Date

                              1 status of the disease

                              Declaration of the epidemic by the Minister of Public Health on August 24, 2014

                              13 people died of the disease (CFR 54%), including five health workers, on 24 suspected cases (16 women and 8 men)

                              11 people held in isolation

                              24 cases (16 women and 8 men) of Ebola virus disease identified in the area of health Boende, from July 28 to August 18, 2014

                              80 contacts identified for monitoring

                              4 samples positive out of 8 after a second analysis INRB

                              565 suspected cases investigated with gastroenteritis, diarrhea and vomiting.

                              Index cases identified at Ikanamongo (100 km of Boende): a woman who died on August 11 after consuming bushmeat hunted by her husband and that contaminated her doctor and her husband.

                              Strain not yet unidentified , between Zaire and Sudan. Awaiting the results from the laboratory in Franceville (Gabon).

                              No link between the epidemic of West Africa, given the remoteness of the area.

                              7th epidemic since 1976, date of the discovery of the disease in the DRC

                              No cases reported in Kinshasa or Mbandaka

                              2 information on the disease

                              Fatality rate can reach 90%.
                              Transmission to humans from wild animals and then spread in populations by human transmission
                              No vaccine or specific treatment approved, either for humans or animals.

                              3 Geography places

                              Isolated area, surrounded by two rivers

                              4 health areas concerned in the health zone of Boende, at 1200 km from Kinshasa

                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                              -Nelson Mandela


                              • #30
                                Re: Ebola outbreak: DR Congo confirms first cases

                                A New Strain Of Ebola Emerges In Democratic Republic Of Congo

                                by Nurith Aizenman

                                <time datetime="2014-08-25">August 25, 2014 4:06 PM ET</time>

                                4 min 14 sec

                                A new outbreak of Ebola is being reported in the Democratic Republic of Congo. But scientists say it's not related to the Ebola epidemic going on in West Africa.

                                ROBERT SIEGEL, HOST:
                                Another country is reporting deaths from the Ebola virus. The government in the Democratic Republic of Congo has confirmed that two people there have died and many more are infected. The outbreak appears unrelated to the epidemic now sweeping through West Africa. NPR's Nurith Aizenman is in Monrovia, the capital of Liberia. And she joins us now with the latest. And first, Nurith, what's known about what's happening in Congo?

                                NURITH AIZENMAN, BYLINE: Well, as you said, Robert, there are these confirmed death. And Congolese officials say they suspect more have died and there are many more infected with Ebola. This is in a remote northwestern region of that country. They sent out samples and two have come back positive for Ebola. But it's important to stress that the strain of Ebola identified in Congo is not the same one that's causing the epidemic in West Africa. It doesn't appear that it was brought in from West Africa. It's a different strain that seems to have popped up in Congo of its own accord. And while that may sound alarming, it is useful to understand that that is the region where Ebola first originated in the 1970s.
                                The virus has emerged there six more times since and unlike West Africa, we're not talking about an area where people are constantly streaming in and out. Congolese officials also have experience dealing with Ebola. And each time it's reared its head there, they have managed to quash it before it could get out of the area. So there is reason to hope that this Congo outbreak can be contained more quickly and more easily than the one in West Africa..