Democratic Republic of Congo - Ebola outbreak May 2017 - MOH, WHO - 8 cases (5 confirmed, 3 probable), 4 deaths reported - additional suspect cases under investigation

[tetano]

Congo approves use of Ebola vaccination to fight outbreak

Democratic Republic of Congo's health ministry has approved the use of a new Ebola vaccine to counter an outbreak in its northeast that has killed four people, a spokesman said on Monday.
"The non-objection was given. Now there's a Medecins Sans Frontieres team that is arriving (in Congo) today to validate the protocol with the technical teams," Jonathan Simba, a health ministry spokesman, said by telephone.
The vaccine, known as rVSV-ZEBOV and developed by Merck, is not yet licensed but was shown to be highly protective against Ebola in clinical trials published last December. [nL5N1EG4IP]

https://uk.reuters.com/article/us-health-ebola-congo-idUKKBN18P0WN

[alert]

Having viewed that entire report, I'm trying to figure out who the second confirmed case is. It's not either of the contacts of the first case who died, nor the fourth death, as those are the three probable cases. (The fourth death also doesn't appear to be a contact of the first three cases.) It's also not any patient who is still ill, because all five patients in an ETU are classified as suspected.

It seems to be either another contact of the index case that hasn't been explicitly mentioned, or a contact of one of his two probable case contacts. Either way, that patient has already recovered.

The date of isolation of the latest confirmed case is given as May 11. And 33 of the 38 suspect cases have already tested negative.

An above post indicates that at least 30 of the suspect cases have now been discarded. As any epidemiological links to confirmed/probable cases or any fatal outcome results in a probable case, it seems reasonable to assume all the suspect cases will be discarded (since they have all recovered and none have any link to a probable case). Where does that leave us now?

The index case is a confirmed death. The two people who transported him are probable deaths. The second confirmed case (who we don't know who it is) has recovered. The fourth death is a probable case. And there is a fourth probable case that is still alive (and might be ill or might have recovered) but must have some link to one of the first four cases.

So that makes 6 cases, 4 deaths, for a CFR of 67%. Not the 10-13% originally reported.

As the last isolation date of a confirmed case is May 11, most of the contacts will be released from observation within the next couple days.

[Pathfinder]

EBOLA VIRUS DISEASE
Democratic Republic of the Congo
External Situation Report 16
Date of information: 29 May 2017

1. Situation update

WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue
to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond
to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of
the country.

On 29 May 2017, no new confirmed, probable or suspected EVD cases were reported. The last confirmed
case was reported on 11 May 2017. Currently there are a total of two confirmed cases, three probable and
14 suspected cases. The confirmed and probable cases were reported from Nambwa (two confirmed and
two probable) and Ngayi (one probable). The suspected cases are reported from four health areas (Nambwa,
Muma, Ngayi and Ngabatala). The outbreak currently remains confined to Likati Health Zone. As of 29 May,
101 contacts remain under follow up for signs and symptoms of Ebola.

The previously undertaken modelling to determine the risk of further cases was updated with newly available
onset dates for the five confirmed / probable cases. Results suggest the risk of further cases is currently low
but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting
date, 72% of simulated scenarios predict no further cases in the next 30 days.
...
As of 29 May, 6 of the 14 suspected cases have tested PCR-negative for EVD and are awaiting serology testing for further analysis.
...

Ebola Situation report: 30 May 2017

http://www.afro.who.int/en/ebola/ebola-situation-reports.html

[alert]

The exclusion of the surviving probable case above (reducing the number of probable cases from 4 to 3) raises the apparent CFR of this outbreak to 80%.

Update: CIDRAP is reporting that there are now only 3 deaths in this outbreak: http://www.cidrap.umn.edu/news-persp...-ebola-vaccine

which would imply the excluded probable case is the unlinked fatality, which if true, would make the CFR 60% (3 deaths in 5 cases).

[alert]

Two additional retrospectively confirmed cases:

Published Date: 2017-06-03 08:58:32
Subject: PRO / EN> Ebola disease, controlled epidemic - DR Congo (04): (Northeast)
Archive Number: 20170603.5080845
EBOLA VIRUS DISEASE, CONTROLLED EPIDEMIC - DEMOCRATIC REPUBLIC OF CONGO (04): (NORTHEAST)
************************************************** **************************************************
A communication from ProMED-mail

http://www.promedmail.org

ProMED-mail is a program of the
International Society for Infectious Diseases

http://www.isid.org

Date: Fri 2 June 2017
Source: VOA Africa via AFP [edited]

https://www.voaafrique.com/a/kinshasa-annonce-la-maitrise-de-l-epidemie-d-ebola/3884276.html

Kinshasa announces the control of the Ebola epidemic
--------------------------
The Congolese authorities announced that they had controlled the spread of the Ebola haemorrhagic fever epidemic 3 weeks after its declaration in a landlocked area in the north-eastern Democratic Republic of the Congo.
After 21 days, "we can say that the spread of the epidemic has been controlled," Congolese health minister Oly Ilunga told reporters.
Since [April 21, 2017], "we count 7 cases of which 3 are probable [and] 4 confirmed in the laboratory. Of these cases, 4 died," he said.
According to Ilunga, "no healthcare professional has developed the disease", "no contact of deceased patients has developed a viral haemorrhagic fever" and "all tests performed on suspect cases are negative to date" .
The haemorrhagic fever caused by this virus is highly contagious and the duration of incubation of the Ebola virus is 21 days.
During the month of May, the Congolese government had authorized vaccine tests against the Ebola virus in the country. "But for various reasons, including logistics, vaccines have not yet arrived in the DRC to this day," said Minister Ilunga.
The epidemic that affects the DRC is the 8th epidemic of Ebola since the discovery of this virus on its soil in [1976]. The disease was detected in an isolated area of Bas-U?l?, about 1300 km northeast of Kinshasa.
This new epidemic is the first outbreak in Ebola since the terrible epidemic that struck West Africa between the end of [2013 and 2016], causing more than 11,300 deaths in some 29,000 cases, more than 99 In Guinea, Liberia and Sierra Leone.

-
Press Release:
ProMED-mail


[The occurrence of the EVD in northeastern DRC has caused a lot of ink. This resurgence has caused concern not only to the national community, but also and especially to the international community. There are still epidemics of the disease in West Africa. The situation on the ground has evolved from an epidemic declared to a controlled epidemic to a continuous epidemic and a risk of spreading the epidemic. But at the moment, there is a real mastery of the epidemic. This is hardly surprising, as the country has extensive experience in the fight against Ebola epidemics. This epidemic is the 8th episode that the country has experienced. The technical and financial partners also mobilized to lend strong hands to the local skills. It is recalled that the epidemic of the EVD in Guinea was slow in responding; According to a number of observers, has been the main cause of the spread of the disease beyond Ground Zero (the starting point of the epidemic).

[alert]

http://apps.who.int/iris/bitstream/10665/255630/1/EbolaDRC-06062017.pdf

[snip]

WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health (MoH) in the Democratic Republic of the Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of the country.

On 05 June 2017, one case has been retrospectively confirmed as positive for EVD by serology with a date of onset of 29 April 2017. This case was previously reported as a suspected case and is part of the known transmission chain. The contacts for this individual have already been followed up and graduated from the contact follow up period. The date of the last confirmed case reported remains as 11 May 2017.
One new suspected case has been reported as of 5 June 2017 in the Ngayi health area, with 15 associated contacts being followed up daily, a sample has been taken to test for EVD. Therefore there are currently a total of five confirmed, three probable and one suspected case. Of these, four survived and four died, resulting in a case fatality rate of 50%.
The confirmed and probable cases were reported from Nambwa (four confirmed and two probable), Ngayi (one probable) and Mabongo (one confirmed). The outbreak remains confined to Likati Health Zone. Modelling suggests the risk of further cases is currently low but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting date, 76% of simulated scenarios predict no further cases in the next 30 days

[Pathfinder]

Translation Google


DRC: The end of the Ebola epidemic in Likati

Posted on Sat, 01/07/2017 - 12:07 | Modified on Sat, 01/07/2017 - 13:01

Health Minister Oly Ilunga Kalenga announced on Saturday (July 1) the end of the epidemic of Ebola haemorrhagic fever that has affected the Likati (Bas-Uele) health zone since May 2017.

In its press release, Oly Ilunga Kalenga assured that this decision has complied with health regulations for the surveillance of Hemorrhagic Fever Viruses (FHV).

Since 2 June 2017, no other new confirmed cases of Ebola haemorrhagic fever have been recorded in the Bas-Uele province. And a period of 42 days without any new cases was observed before the declaration of the end of this epidemic, explained to the press the Minister of Health.

He attributes the end of this epidemic to the response activities that the Ministry of Health services have carried out with the support of some partners including WHO, UNICEF, USAID, WFP and MONUSCO.

All the national and provincial professionals deployed in the endemic zone to fight this disease are doing well, welcomed the minister who also praised their courage to serve the nation.

Balance sheet

According to the minister, the epidemic of Ebola haemorrhagic fever that occurred on 11 May 2017 in Likati resulted in the death of 4 of the 5 confirmed cases.

The 583 people who have been in contact with suspected cases have been tested negative, the minister said in his statement.

He has pleaded for the improvement and stabilization of the health system of the Bas-Uele province "highly destabilized", stressing that "without strengthening the health system, no effective epidemiological surveillance is possible".

http://www.radiookapi.net/2017/07/01/actualite/sante/rdc-la-fin-de-lepidemie-debola-declaree-likati