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  • 17 November 2018 - 22H01

    Sixteen Ebola WHO staff evacuated amid DR Congo clashes


    BENI (DR CONGO) (AFP) -

    The World Health Organization (WHO) said Saturday that 16 staff members have been temporarily evacuated from DR Congo's restive eastern city of Beni after a shell hit the building they were staying in.

    The incident occurred in the Ebola-plagued region during clashes between UN peacekeepers from the MONUSCO mission and the Allied Democratic Forces (ADF) militia on Friday night.

    "It was in exchanges of fire that the house was hit by a shell", Michel Yao, WHO's co-ordinator for Ebola response operations in Beni, told AFP.

    No one was injured, he said, adding that it was not known whether the shell came from the militia, the UN peacekeepers or the Congolese army backing them.

    The 16 WHO workers, out of a total of 191 in Beni, were "traumatised" and left for the eastern city of Goma on Saturday to "de-stress", Yao said.
    ...
    https://www.france24.com/en/20181117...-congo-clashes
    "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

    Comment


    • Translation Google
      DIRECTORATE GENERAL FOR DISEASE CONTROL
      EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

      Sunday 18 November 2018


      The epidemiological situation of the Ebola Virus Disease dated November 17, 2018 :
      • Since the beginning of the epidemic, the cumulative number of cases is 366, of which 319 are confirmed and 47 are probable. In total, there were 214 deaths (167 confirmed and 47 probable).
      • 66 suspected cases under investigation.
      • 8 new confirmed cases, including 5 in Beni and 3 in Katwa.
      • 1 new case death confirmed in Katwa.

      /! \ Cleaning the current database



      Remarks:
      • To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
      • The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
      • A community death is a death in the community, outside of a licensed health center.
      News of the response

      security
      • Contrary to what has been reported in some international media, the Ministry of Health has not suspended the Ebola response. Following the attack of a MONUSCO base in the Boikene district, Ruwenzori commune, in the city of Beni, by an armed group on the evening of Friday, November 16, 2018, the field activities in Beni did not take place normally at the beginning of the day on Saturday 17 November. After assessing the security situation, all field activities, except vaccination, were able to resume idling on Saturday afternoon. This Sunday, November 18, the riposte could advance normally to Beni.


      ...
      https://us13.campaign-archive.com/?u...&id=5794bf500d
      "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

      Comment


      • WHO statement on latest attacks in the Democratic Republic of the Congo

        17 November 2018 Statement Geneva

        Following deadly attacks on Friday in the town of Beni, in the Democratic Republic of the Congo, Ebola response activities are continuing.

        While all WHO, Ministry of Health and partner staff are safe and accounted for, 16 WHO staff were evacuated to Goma for psychological care after their residence was hit by a shell which did not explode.

        Ebola response operations were on-going but limited in Beni on Saturday.

        Vaccination was suspended and the operations centre was closed, but teams still went out into the communities to follow up on some alerts of potential cases, to meet contacts and ensure they are still well, and to bring sick people to treatment centres. The treatment centers, which are run by partners, remained operational.

        The response was not affected in areas outside Beni. On Sunday, all activities have re-launched, including vaccination.

        “WHO will continue to work side-by-side with the ministry and our partners to bring this Ebola outbreak to an end,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We honour the memory of those who have died battling this outbreak, and deplore the continuing threats on the security of those still working to end it.”

        http://www.who.int/news-room/detail/...c-of-the-congo
        "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

        Comment


        • Translation Google
          DIRECTORATE GENERAL FOR DISEASE CONTROL
          EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

          Monday 19 November 2018


          The epidemiological situation of the Ebola Virus Disease dated November 18, 2018 :
          • Since the beginning of the epidemic, the cumulative number of cases is 373, of which 326 are confirmed and 47 are probable. In total, there were 216 deaths (169 confirmed and 47 probable) and 108 people cured.
          • 72 suspected cases under investigation.
          • 7 new confirmed cases, including 3 in Beni, 3 in Katwa and 1 in Butembo.
          • 2 new confirmed cases, including 1 in Butembo and 1 in Katwa.
          • 1 new person healed in Beni.





          Remarks:
          • To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
          • The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
          • A community death is a death in the community, outside of a licensed health center.
          News of the response

          Press point in Beni
          • On Monday, November 19, 2018, the Coordinator of the response, Dr. Ndjoloko Tambwe Bathe, held a press briefing in Beni to present the evolution of the epidemic and reassure the population of the ongoing commitment of the Ministry of Health and international partners to end the Ebola outbreak in North Kivu province. Despite the evacuation of 20 WHO staff over the weekend, the human resources deployed in Beni remain very important. The Ministry of Health has more than 900 experts in Beni, of which almost 85% are locals who have been trained to participate effectively in all pillars of the response. WHO has 191 national and international consultants who continue to work in Beni. Added to this are the hundreds of other people employed by the other organizations involved in the response. In addition, he recalled that according to the new community-based monitoring approach, it is the local actors who lead more field activities with the technical support of national and international experts.
          • Dr. Bathe also discussed the epidemiological situation in the health zone of Kalunguta, which is a red zone. The spread of the epidemic in the village of Kanihunga was caused by the arrival of a confirmed case from Beni who fled several weeks ago to escape the monitoring teams. The Minister of Health, Dr Oly Ilunga Kalenga, instructed the coordination of the response to provide substantial technical and medical support to all health centers in this area so that they can provide quality care to the population. Thanks to the goodwill of the village leaders who granted access to the response teams, 895 people were vaccinated in the village.
          • In order to contain the epidemic in and around Butembo Health Zone, the coordination decided to send additional intervention teams to the Katwa, Kalunguta and Lubero areas to support local health care providers.
          Vaccination
          • Resumption of vaccination in Beni since Sunday, November 18, 2018.
          • Since the start of vaccination on August 8, 2018, 32,108 people have been vaccinated , including 15,962 in Beni, 4,544 in Mabalako, 3,453 in Katwa, 1,663 in Mandima, 1,715 in Butembo, 1,672 in Kalunguta, 732 in Masereka, 434 in Bunia, 359 to Vuhovi, 355 to Tchomia, 292 to Mutwanga, 241 to Kyondo, 240 to Komanda, 234 to Musienene, 178 to Oicha, and 34 to Alimbongo.

          Epidemiological Data Summary
          Week 46 (12-18 November 2018)


          For the week of November 12 to 18, 2018 , we recorded:
          • 423 suspected cases investigated and tested in the laboratory.
          • 33 new confirmed cases , including 15 in Beni, 10 in Katwa, 6 in Kalunguta and 2 in Butembo.
          • 13 new confirmed cases, including 6 in Beni, 5 in Butembo and 2 in Katwa.
          • 7 probable cases in Kalunguta.
          • 7 new people healed , including 5 in Beni, 1 in Butembo and 1 in Mabalako.

          ...
          https://us13.campaign-archive.com/?u...&id=133e4b89be
          "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

          Comment


          • EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

            Wednesday, November 21, 2018
            The epidemiological situation of the Ebola Virus Disease dated November 20, 2018 :
            • Since the beginning of the epidemic, the cumulative number of cases is 386, of which 339 are confirmed and 47 are probable. In total, there were 219 deaths (172 confirmed and 47 probable) and 113 people healed.
            • 48 suspected cases under investigation.
            • 13 new confirmed cases, including 7 in Katwa, 2 in Beni, 2 in Kalunguta, 1 in Oicha and 1 in Mutwanga.
            • 2 new deaths of confirmed cases, including 1 in Beni and 1 in Mutwanga.
            • 3 new people healed in Butembo
            Copyright © 2018 Ministry of Health of the Democratic Republic of Congo, All rights reserved.

            Comment


            • Source: https://reliefweb.int/report/somalia...-november-2018
              Ebola virus disease – Democratic Republic of the Congo

              Disease outbreak news: Update
              22 November 2018

              Containing the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is a complex and challenging task but WHO remains confident that the outbreak can be successfully contained in collaboration with the Ministry of Health (MoH) and partners.
              On 16 November 2018, an armed group attacked the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) base in the Boikene District, in the city of Beni, close to the UN Ebola response residences. Response operations in Beni were briefly paused but all activities, including vaccination, resumed by 18 November. WHO condemns the attacks on peacekeepers who are integral to the ongoing efforts to manage the EVD outbreak. WHO will continue to evaluate the situation and risks involved, and remain vigilant about measures to protect responders and civilians.
              Health centres have been identified as a source of disease transmission. Medications administered via injections were a notable cause of infection. Current efforts are focused on improving infection prevention and control (IPC) measures, including providing water and products for cleaning, training health providers at informal health centres and encouraging the provisision of medications which do not require injections.
              During the reporting period (14 – 20 November), 36 new confirmed EVD cases were reported from Beni, Mutwanga, Kalunguta, Butembo, Katwa and Oicha while seven probable cases were reported from Kalunguta. Seven of the new cases were newborn babies and infants aged less than two years, six were children aged between 2 – 17 years and one case was a pregnant woman. Five health workers from Beni and Katwa were among the newly infected; 39 health workers have been infected to date. Ten additional survivors were discharged from Ebola treatment centres (ETCs) in Beni (six) and Butembo (four) and reintegrated into their communities; 113 patients have recovered to date.
              As of 20 November, 386 EVD cases (339 confirmed and 47 probable), including 219 deaths (172 confirmed and 47 probable)1, have been reported in 11 health zones in North Kivu Province and three health zones in Ituri Province (Figure 1). The overall trends in weekly case incidence reflect continued community transmission in several cities and villages in North Kivu (Figure 2). Given the expected delays in case detection and ongoing data reconciliation activities, trends, especially in the most recent weeks, must be interpreted cautiously.
              The risk of the outbreak spreading to other provinces in the Democratic Republic of the Congo, as well as to neighbouring countries, remains very high. Over the course of the past week, alerts have been reported from Uganda and Zambia; EVD has been ruled out for all alerts to date.
              Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 20 November 2018 (n=386)




              Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 20 November 2018 (n=382)*




              * Onset date unknown for four cases. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning – trends during this period should be interpreted cautiously.
              Public health response

              The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordinating the response, surveillance, contact tracing, laboratory capacity, IPC, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance and preparedness activities in neighbouring provinces and countries. To support the MoH, WHO is working intensively with a wide range of multisectoral and multidisciplinary regional and global partners and stakeholders for EVD response, research and urgent preparedness, including in neighbouring countries.
              For detailed information about the public health response actions by WHO and partners, see the latest situation reports published by the WHO Regional Office for Africa:
              WHO risk assessment

              This outbreak of EVD is affecting north-eastern provinces of the country, which border Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include: transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and the displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities. WHO’s risk assessment for the outbreak is currently very high at the national and regional levels; the global risk level remains low. WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.
              As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
              WHO advice

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


              Comment


              • Translation Google
                DIRECTORATE GENERAL FOR DISEASE CONTROL
                EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                Friday 23 November 2018


                The epidemiological situation of the Ebola Virus Disease dated 22 November 2018 :
                • Since the beginning of the epidemic, the cumulative number of cases is 399, 352 confirmed and 47 probable. In total, there were 228 deaths (181 confirmed and 47 probable) and 118 people healed.
                • 91 suspected cases under investigation.
                • 6 new confirmed cases, including 2 in Beni, 2 in Katwa, 1 in Oicha and 1 in Musienene.
                • 6 new confirmed cases, including 3 in Beni (including 1 postponed from 22/11/2018), 1 in Oicha, 1 in Butembo and 1 in Musienene.
                • 1 new person healed in Beni.



                /! \ The data presented in this table is subject to further changes after thorough investigations.

                Remarks:
                • To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                • The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
                • A community death is a death in the community, outside of a licensed health center.
                News of the response

                Work meeting in Lubero
                • This Friday, November 23, 2018, the coordination of the response made a short trip to Lubero to participate in a working meeting with the rapid intervention team arrived in the locality on Wednesday, November 21, 2018. Following the increase of cases in the health zone of Butembo and its surroundings, the coordination decided to send additional intervention teams to the areas of Katwa, Kalunguta and Lubero. The role of the teams in Lubero is to strengthen the epidemiological surveillance in a preventive way and to train local health care providers to identify and treat possible cases of Ebola and high-risk contacts from Butembo. Healthcare providers, who accept it, will also be vaccinated.
                Vaccination
                • Since the start of vaccination on August 8, 2018, 34,091 people have been vaccinated , including 16,635 in Beni, 4,544 in Mabalako, 4,309 in Katwa, 2,090 in Butembo, 1,751 in Kalunguta, 1,663 in Mandima, 732 in Masereka, 434 in Bunia, 359 to Vuhovi, 355 to Tchomia, 292 to Mutwanga, 241 to Kyondo, 240 to Komanda, 234 to Musienene, 178 to Oicha, and 34 to Alimbongo.



                ...
                https://us13.campaign-archive.com/?u...&id=104902cbb9
                "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

                Comment


                • MIN HEALTH - PRESS RELEASE - 24 NOVEMBER 2018

                  The Ethics Committee approves the Randomized Clinical Trial Protocol for Experimental Therapeutic Ebola Treatments


                  Kinshasa, 24 November 2018 - The Ethics Committee of the School of Public Health of the University of Kinshasa has issued, in its decision ESP / CE / 129/2018, a favorable opinion on the protocol of the randomized clinical trial the feasibility, safety and efficacy of experimental treatments for patients with Ebola Virus Disease (EVD).

                  Since the beginning of the Ebola outbreak in North Kivu, four therapeutic molecules have been used to treat patients in all established Ebola treatment centers (ETCs), namely mAb 114, ZMapp, Remdesivir and Regeneron.

                  To date, these four therapeutic treatments have been administered to the majority of Ebola patients in the current compassionate epidemic, or, more formally, under the Emergency Controlled Use Protocol for Unlicensed Interventions. (MEURI). However, the use of therapeutic treatments under this protocol does not provide for the generalization of scientific evidence collected on the efficacy and safety of each of these treatments. In addition, compassionate use is only permitted when there is no clinical trial in progress.

                  The joint scientific committee has now agreed on a clinical trial protocol. Valuable information on the effectiveness of the treatments obtained in the clinical trial will help develop these treatments on a larger scale to save more lives.

                  The clinical trial began this week with three of the four therapeutic molecules, namely Zmapp, mAb 114 and Remdesivir, only in the CTE of Beni. In the future, the test could be extended to other sites and include the fourth molecule. For the moment, the other CTEs in place will continue to administer therapeutic treatments on a compassionate basis according to the MEURI protocol.

                  From a practical point of view, the patient (or their family) will have to give their firm and informed consent to participate in the clinical trial and to benefit from a therapeutic treatment, just as it was the case when compassionate. The major difference is that the choice of treatment administered to the patient will be randomized, that is to say it will no longer be based on a decision of the CTE doctors, but will be done by lottery for avoid any risk of subjectivity.

                  Patients may refuse to participate in the clinical trial. They will still receive a level of care equal to the participating patients and will continue to benefit from symptomatic treatments (such as rehydration, blood transfusions, blood pressure monitoring) whose benefits remain significant. Patients participating in the clinical trial will continue to be treated in the CTE, symptomatic treatments will always be administered in addition to therapeutic treatments, and will be followed by clinicians until fully recovered.

                  The number of patients who will participate in the clinical trial during the current outbreak will depend on the evolution of the epidemic and the willingness of patients to participate. Data collected during the North Kivu epidemic alone is unlikely to be sufficient for a complete study and to draw definitive conclusions about the safety and efficacy of these molecules. Thus, the current clinical trial protocol may extend over a five-year period to cover several EVD outbreaks in several affected countries.

                  Professor Jean-Jacques Muyembe, Director General of the National Institute of Biomedical Research (INRB), and Dr. Richard T. Davey Jr., Deputy Director of the Division of Clinical Research of the National Institute of Allergy and Infectious Diseases (NIAID), are the two Principal Investigators (PI) of this clinical trial.

                  END
                  ...
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                  ---------------------------------------------------------------
                  DIRECTORATE GENERAL FOR DISEASE CONTROL
                  EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                  Saturday, November 24, 2018


                  The epidemiological situation of the Ebola Virus Disease dated 23 November 2018 :
                  • Since the beginning of the epidemic, the cumulative number of cases is 403, 356 confirmed and 47 probable. In total, there were 231 deaths (184 confirmed and 47 probable) and 120 people healed.
                  • 56 suspected cases under investigation.
                  • 4 new confirmed cases, 2 in Katwa, 1 in Kalunguta and 1 in Beni.
                    • The case confirmed in Musienene reported in the bulletin of November 23, 2018 was reclassified to Butembo after investigations.
                  • 3 new deaths of confirmed cases, including 2 in Katwa and 1 in Butembo.
                  • 2 new people healed in Butembo.
                  ...
                  https://us13.campaign-archive.com/?u...&id=affd57dff1
                  "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

                  Comment


                  • Translation Google
                    DIRECTORATE GENERAL FOR DISEASE CONTROL
                    EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                    Sunday 25 November 2018


                    The epidemiological situation of the Ebola Virus Disease dated November 24, 2018 :
                    • Since the beginning of the epidemic, the cumulative number of cases is 412, 365 confirmed and 47 probable. In total, there were 236 deaths (189 confirmed and 47 probable) and 120 people healed.
                    • 75 suspected cases under investigation.
                    • 9 new confirmed cases, including 4 in Beni, 2 in Butembo, 2 in Kalunguta and 1 in Katwa.
                    • 5 new deaths of confirmed cases, including 2 in Beni, 2 in Butembo, and 1 in Katwa.
                    ...
                    https://us13.campaign-archive.com/?u...&id=97a997e756
                    "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

                    Comment


                    • Translation Google
                      DIRECTORATE GENERAL FOR DISEASE CONTROL
                      EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                      Monday, November 26, 2018


                      The epidemiological situation of the Ebola Virus Disease dated November 25, 2018 :
                      • Since the beginning of the epidemic, the cumulative number of cases is 419, of which 372 are confirmed and 47 are probable. In total, there were 240 deaths (193 confirmed and 47 probable) and 123 people cured.
                      • 59 suspected cases under investigation.
                      • 7 new confirmed cases, including 3 in Butembo, 2 in Katwa, 1 in Kalunguta and 1 in Beni.
                      • 4 new deaths of confirmed cases, including 1 in Beni, 1 in Butembo, 1 in Katwa and 1 in Kalunguta.
                      • 3 new people healed, including 2 in Beni and 1 in Butembo.
                      ...
                      https://us13.campaign-archive.com/?u...&id=248cc081d9
                      "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

                      Comment


                      • Ebola virus disease – Democratic Republic of the Congo

                        Disease outbreak news: Update
                        29 November 2018


                        As the Ebola virus disease (EVD) outbreak approaches five months since declaration, responding to the outbreak continues to be a challenge; nevertheless, in collaboration with the Ministry of Health (MoH) and partners, WHO remains focused on the ongoing containment efforts to end the outbreak. The MoH, WHO and partners are intensively focusing response activities in areas where EVD transmission continues, including Butembo, Katwa, Beni and Kalunguta.
                        During the reporting period (21—27 November 2018), 36 new cases were reported: 13 in Beni, nine in Katwa, six in Kalungunta, six in Butembo, one in Kyondo and one in Oicha. Two health workers from Katwa and Kyondo were among the newly infected; 42 health workers have been infected to date. Twelve additional survivors were discharged from Ebola treatment centres (ETCs) in Beni (six) and Butembo (six), and reintegrated into their communities; 125 patients have recovered to date.
                        For the past two months, WHO has been responding to the developing situation in Katwa, Butembo, Beni and Kalungunta. Preliminary data indicate an impact of the public health control measures in Beni and Kalunguta. Community engagement remains a challenge in Katwa. Despite substantial progress, the high proportion of cases who were not previously registered as contacts and therefore not followed-up by the surveillance teams, needs to be improved. Concerns have been raised regarding the high number of young children affected (aged one year or less). In total, 36 cases have been reported among newborn babies and children aged less than two years and 17 cases among pregnant women have been reported since the beginning of the outbreak.
                        As of 27 November, 422 EVD cases (375 confirmed and 47 probable)1, including 242 deaths, have been reported in 11 health zones in North Kivu Province and three health zones in Ituri Province (Figure 1). Given the expected delays in case detection and reporting, overall trends in weekly case incidence must be interpreted cautiously, in the most recent weeks (Figure 2).
                        The risk of the outbreak spreading to other provinces in the Democratic Republic of the Congo, as well as to neighbouring countries, remains very high. Over the course of the past week, alerts have been reported from South Sudan and Uganda; EVD has been ruled out for all alerts to date.
                        Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 27 November 2018 (n=422)




                        Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 27 November 2018 (n=416)*




                        *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning – trends during this period should be interpreted cautiously.
                        Public health response

                        The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordinating the response, surveillance, contact tracing, laboratory capacity, Infection Prevention Control (IPC), clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance and preparedness activities in neighbouring provinces and countries. To support the MoH, WHO is working intensively with a wide range of multisectoral and multidisciplinary regional and global partners and stakeholders for EVD response, research and urgent preparedness, including in neighbouring countries. Currently, 300 WHO specialists are deployed to the DRC to support the ongoing response.
                        For detailed information about the public health response actions by WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:WHO risk assessment

                        This outbreak of EVD is affecting north-eastern provinces of the country, which border Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include: travel between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities. WHO’s risk assessment for the outbreak is currently very high at the national and regional levels; the global risk level remains low. WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.
                        As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
                        WHO advice

                        International traffic: WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
                        For more information, see:
                        https://www.who.int/csr/don/29-novem...-ebola-drc/en/
                        "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

                        Comment



                        • DRC - Country's worst Ebola epidemic continues to spread



                          NEW YORK, DECEMBER 3, 2018

                          Ebola has reached the city of Butembo and a number of more isolated areas that are difficult to access as the epidemic continues to spread through the Democratic Republic of Congo (DRC)’s North Kivu province.

                          Teams from the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) are expanding work in the affected region to help bring the
                          Ebola epidemic under control.

                          This is DRC’s tenth outbreak and the most serious in that country since the virus was discovered in 1976. During the current outbreak, there have been a total of 440 cases (392 confirmed and 48 probable) and more than 200 confirmed deaths, according to the World Health Organization (WHO).

                          “We are very concerned by the epidemiological situation in the Butembo area,” said John Johnson, MSF project coordinator in Butembo, a city of a million people. So far, the number of cases in Butembo city center is low, however the number of cases is rising quickly in the eastern suburbs and outlying, isolated districts".
                          Ebola has reached the city of Butembo and a number of more isolated areas that are difficult to access as the epidemic continues to spread through the Democratic Republic of Congo (DRC)’s North Kivu province.
                          “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 ~~~ GertvanderHoek@gmail.com ~~~

                          Comment


                          • Translation Google
                            DIRECTORATE GENERAL FOR DISEASE CONTROL
                            EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                            Tuesday, December 4, 2018


                            The epidemiological situation of the Ebola Virus Disease dated December 3, 2018 :
                            • Since the beginning of the epidemic, the cumulative number of cases is 453, of which 405 are confirmed and 48 are probable. In total, there were 268 deaths (220 confirmed and 48 probable) and 144 people cured.
                            • 71 suspected cases under investigation.
                            • 9 new confirmed cases, including 1 in Beni, 1 in Katwa, 1 in Mabalako and 6 in Komanda.
                            • 8 new deaths of confirmed cases, including 1 in Beni, 3 in Butembo, 1 in Mabalako, 3 in Komanda (3 community deaths).
                            • 4 new people healed, including 3 outings from Butembo CTE and 1 from CTE de Beni.




                            /! \ The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

                            Remarks:
                            • To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                            • The probable case category includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
                            • A community death is a death in the community, outside of a licensed health center.
                            News of the response


                            Epidemiological surveillance
                            • An outbreak of Ebola cases was reported in a village in the health zone of Komanda, located 1h30 from Beni. This outbreak is linked to a confirmed case died at the CTE of Beni last week. A vaccination team was dispatched to Komanda and began vaccinating the family and neighboring households on Monday, December 3, 2018.


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                            "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

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                            • Translation Google
                              DIRECTORATE GENERAL FOR DISEASE CONTROL
                              EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                              Thursday, December 6, 2018


                              The epidemiological situation of the Ebola Virus Disease dated December 5, 2018 :
                              • Since the beginning of the epidemic, the cumulative number of cases is 471, of which 423 are confirmed and 48 are probable. In total, there were 273 deaths (225 confirmed and 48 probable) and 149 people cured.
                              • 106 suspected cases under investigation.
                              • 13 new confirmed cases, including 6 in Butembo, 3 in Oicha, 2 in Beni and 2 in Katwa.
                              • 2 new deaths of confirmed cases in Butembo.
                              • 3 new people healed out of Butembo CTE.




                              /! \ The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

                              Remarks:
                              • To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                              • The probable case category includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
                              • A community death is a death in the community, outside of a licensed health center.
                              News of the response


                              Press conference of the Minister of Health
                              • The Minister of Health, Dr. Oly Ilunga Kalenga, held a press conference in Kinshasa this Thursday, December 6, 2018 to inform the national and international opinion on the evolution of the Ebola epidemic. His presentation focused mainly on the main points of attention for coordinating the response:
                                • Situation Concern in Butembo and Katwa : In the past three weeks, a significant increase in Ebola cases has been observed in Butembo and Katwa. The main challenges in these areas are related to the high density and mobility of the population in this major trading city of North Kivu. Moreover, the expression of reluctance by the community is more violent than the reluctance usually observed during previous Ebola outbreaks. A minority of the population in these areas express their reluctance through the regular destruction of medical equipment and health centers as well as the physical attacks of health workers.
                                • Prevention and control of infections : Another unusual aspect of this epidemic is the role played by centers of traditional health practitioners in the nosocomial transmission of the virus. A parallel consequence of these nosocomial infections is the contamination of a large number of healthcare providers. To date, 44 health workers have been infected (9% of the total number of cases), of whom 12 have died. Strengthening infection prevention and control measures in public, private and traditional health facilities is one of the priorities of the teams today.
                                • Vaccination : With more than 40,000 vaccinated people, vaccination teams have prevented tens of thousands of cases and deaths. Without the intervention of the agents of the response, the country would probably have already reached more than 10,000 Ebola cases in 4 months, or nearly half of the balance sheet of the epidemic in West Africa that lasted 2 years. years.
                                • Conclusion : The Minister of Health concluded his presentation by acknowledging the remarkable work of the response teams in preventing the spread of the epidemic to Goma, Bunia and neighboring countries. However, he said the epidemic will last for several months and that the risk of spread will remain high until the epidemic is completely extinguished.


                              ...
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                              "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

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                              • Translation Google

                                BUTEMBO: The dispensary of Hope destroyed by the population

                                Posted on: 05/12/2018 at 17h24min10s
                                By Radio Moto Butembo-Beni

                                This clinic, known as Mateso's in the Kimbulu KISITU cell, was demolished by the young people from the Kisebere Cell in the Wayene Ward on Wednesday, December 5th. It is alleged that the medical staff at this center transferred a patient to Matanda General Hospital.

                                KAHAMBU MAHAMBA, the patient, passed away the evening of Tuesday, December 04, 2018. Following this death, young people destroyed this health facility maliciously. Windows, a sink, a plastic tablet, a thermos of a patient, and a thermometer were savagely destroyed. People met on the spot note that, it is thanks to the alert of a neighbor that one did not attend a human damage. In fact, all the occupants of the Hope structure have fled. The perpetrators seemed to be saying that they suspect that the deceased was transferred following a problem with Ebola virus disease.

                                Posted on: 05/12/2018 at 17h24min10sBy Radio Moto Butembo-Beni

                                http://radiomotofm.info/lirearticle....a%20population

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                                The diocese of Butembo-Beni receives 3 experts opening in the response against Ebola

                                Published on: 07/12/2018 at 17h23min10s

                                By Radio Moto Butembo-Beni

                                The diocese of Butembo-Beni receives 3 experts opening in the response against Ebola

                                Two WHO experts and one from UNICEF, working in the sub-coordination of the Ebola response in Butembo and surrounding areas were received Thursday, December 06, 2018 at the diocese of Butembo diocese. They reflected on new strategies for stopping the chain of transmission of Ebola virus disease in the diocese.

                                On occasion, the Bishop occasionally called on his pastoral collaborators to increase awareness. "To all, we ask that they do not tire of returning to the mortiferous nature of this disease that spares no one. Do not get tired, "said Bishop Sikuli PALUKU.

                                He advised members of the YIRA community not to desecrate graves by digging up people who died of the Ebola virus for fear of being infected. "When we were children, we were already afraid of the cemetery. It's the wizard who goes there. It is the non-respect of the culture of going to dig up the dead. It is exposing yourself to being contaminated because, as we have been told, what you have to avoid is not to touch the dead person because it is obvious that one is automatically contaminated. " he added.


                                Published on: 07/12/2018 at 17h23min10s
                                By Radio Moto Butembo-Beni


                                http://radiomotofm.info/lirearticle....contre%20Ebola
                                "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

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