DRC - Ebola outbreak in North Kivu and Ituri: July 30, 2018+

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 07
SEPTEMBER 2019

Date: Sunday, September 08, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,079, of which 2,968 are confirmed and 111 are probable.

In total, there were 2,064 deaths (1,953 confirmed and 111 probable) and 922 people healed.

 403 suspected cases under investigation;

 6 new confirmed cases, including:
o 4 in North Kivu, including 2 in Beni, 1 in Katwa and 1 in Kyondo;
o 2 in Ituri, including 1 in Mambasa and 1 in Mandima.

 5 new confirmed deaths in North Kivu:
o 3 community deaths, including 1 in North Kivu in Beni and 2 in Ituri, including 1 in
Mambasa and 1 in Mandima;
o 2 deaths in the ETC in North Kivu, including 1 in Butembo and 1 in the Katwa CTE.

 3 cured people released from CTEs in North Kivu, including 2 in Beni and 1 in Butembo.

 No health worker is among the newly confirmed cases. The accumulation of cases
confirmed / probable among health workers is 157 (5% of all cases
confirmed / probable), including 41 deaths.

...
MONITORING AT ENTRY POINTS

 High-risk contact was intercepted at Kiwanja PoC in Rutshuru territory in
North Kivu. This is a 21-year-old woman who is on the twelfth day (D12) of follow-up. She is
unvaccinated and is a contact of the confirmed case of Butembo from 27 August 2019. This woman
has presented no sign relating to EVD at the time of her interception. She was handed
to the surveillance team who organized her return to Butembo for further follow-up.

 Since the beginning of the epidemic, the accumulation of controlled travelers (temperature rise) at the points
until September 4, 2019, is 92,350,244;

 To date, a total of 98 entry points (PoE) and sanitary control points (PoCs) have been issued
in the provinces of North Kivu and Ituri to protect the country's major cities and
prevent the spread of the epidemic in neighboring countries.
...

https://www.dropbox.com/s/mu5eibdm7mdg5d6/CMRE_Bulletin%20Ebola%20du%2008%20septembre%202019.pdf?dl=0

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI ON 06
SEPTEMBER 2019

Date: Saturday, September 07, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,073, of which 2,962 confirmed and 111 probable.

In total, there were 2,059 deaths (1,948 confirmed and 111 probable) and 919 people healed.

 452 suspected cases under investigation;

 4 new confirmed cases, including:
o 2 in North Kivu, including 1 in Butembo and 1 in Kyondo;
o 2 in Ituri in Mambasa.

 2 new confirmed deaths in North Kivu:
o 1 community death in North Kivu at Kyondo;
o 1 death in the CTE in North Kivu in Butembo.

 1 person cured out of CTE in North Kivu in Beni.

 1 health worker is one of the new confirmed cases of Butembo. The accumulation of cases
confirmed / probable among health workers is 157 (5% of all cases
confirmed / probable), including 41 deaths.

...

https://www.dropbox.com/s/5qc0mm4gkr0yjmt/CMRE_Bulletin%20du%2007%20septembre%202019.pdf?dl=0

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 05
SEPTEMBER 2019

Date: Friday, September 06, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,069, of which 2,958 are confirmed and 111 are probable. the

In total, there were 2,057 deaths (1,946 confirmed and 111 probable) and 918 people healed.

 415 suspected cases under investigation;

 2 new probable cases in North Kivu, including 1 in Butembo and 1 in Biena;

 13 new confirmed cases, including:
o 10 in North Kivu, including 4 in Kalunguta, 2 in Beni, 2 in Kayna, 1 in Butembo and 1 in Katwa;
o 3 in Ituri, including 2 in Mandima and 1 in Mambasa.

 3 new confirmed deaths in North Kivu:
o 2 community deaths in North Kivu, including 1 in Kalunguta and 1 in Katwa;
o 1 death in the CTE in North Kivu in Mabalako.

 4 cured people released from CTEs in North Kivu, including 3 Beni and 1 in Butembo.

 No health worker is among the newly confirmed cases. The accumulation of cases
confirmed / probable among health workers is 156 (5% of all cases
confirmed / probable), including 41 deaths.
...

DESCRIPTION OF PROBABLE CASES

 The case of Butembo is a girl, 2 weeks old infant, who died on March 20, 2019 at the Center
hospitable "All is Grace" in the Vuvatsi Area (Vuthawa / Matembe) in Butembo, North Kivu.
She was contact of her mother, not followed for refusal and unvaccinated, which was confirmed by EVD on
March 14, 2019 and died on March 15, 2019 at CTE. This child was hospitalized at CH "Everything is
Grace 'March 19, 2019 following the occurrence of fevers, but without success. The alert was launched on
same day by Community Relays (ReCo). There is reluctance to burial
dignified and secure (EDS). 25 contacts, including 16 family members, 3 CH and 6 others
people have been listed around this case;

 The case of Biena is a 22-year-old woman, unvaccinated, who died on 16 December 2018
home of a traditional healer who was followed on an outpatient basis, but without success since
December 09th. This is an unlisted contact of his mother, confirmed Ebola case on November 24
2018. The 22-year-old woman, accompanied by her older brother, had traveled by motorcycle on 10
December to Biena. She stayed in Biena until December 15 and her condition worsened
with haemorrhagic signs. The alert was launched by Vuvo's IT, while the body was
already buried before the arrival of the investigation team and EDS. 10 contacts, all members of
his family, have been listed around this case.

...

https://www.dropbox.com/s/fkrrp0fwwnpnx7e/CMRE_Bulletin%20Ebola%20du%2006%20septembre%202019.pdf?dl=0

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 04
SEPTEMBER 2019

Date: Thursday, 05 September 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,054, of which 2,945 are confirmed and 109 are probable.

In total, there were 2,052 deaths (1,943 confirmed and 109 probable) and 914 people healed.

 405 suspected cases under investigation;

 5 new confirmed cases, including:
o 3 in North Kivu, including 1 in Butembo, 1 in Kalunguta and 1 in Mutwanga;
o 2 in Ituri, including 1 in Mambasa and 1 in Mandima.

 2 new confirmed deaths, including 1 in North Kivu and 1 in Ituri:
o 1 community deaths in Ituri in Mambasa;
o 1 death in CTEs in North Kivu in Mabalako.

 The first removal of the suspected case of EVD in Walikale, North Kivu, was negative.

 2 people cured out of CTE in North Kivu in Beni.

 No health worker is among the newly confirmed cases. The accumulation of cases
confirmed / probable among health workers is 156 (5% of all cases
confirmed / probable), including 41 deaths.

FOCUS

One month of activities of the Technical Secretariat of the Multisectoral Committee for the Response to Virus Disease
Ebola in North Kivu and Ituri

 Since 26 July 2019, the Technical Secretariat of the Multisectoral Committee for the Response to
the Ebola Virus Disease has taken office to end the Virus Disease epidemic
Ebola that has been raging for a year and a month already in the DRC, particularly in the provinces of
North and South Kivu, as well as in Ituri;

 Immediately after delivery and resumption with the former coordination of the MVE response, the Secretary
Professor Jean-Jacques Muyembe Tamfum, accompanied by the entire team of
Secretariat, went to the headquarters of the General Coordination of the Goma Response in
North Kivu;

 On site, the team toured two border crossings called Large and Small Barriers in
the purpose of inquiring about the evolution of the epidemic on the ground and, thus, putting in place strategies
that can quickly put an end to this 10th epidemic;

 They organized the overall coordination of the response, providing it with the means to
financial and technical aspects, and by regularizing the administrative situation of staff deployed on
field ;

 In terms of the results of this first month of work, we can note a greater involvement and
the appropriation of the response by the politico-administrative authority and the community,
all levels. What constitutes a remarkable innovation and whose materialization is the
great walk that gathered more than 6000 people in Goma. This march was organized by
the governor of North Kivu who until then continues to make efforts alongside the teams
response to a common goal, including ending the most serious epidemic
deadly Ebola in the Democratic Republic of the Congo;

 However, there are still several challenges to overcome this epidemic. This is between
others of the high mobility of people with as a solution the strengthening of
Entry Points (POE) and Control Points (POC) thanks to geolocation.

 Another challenge is the poor control of the infection due to the number of structures
unreliable health. This can be remedied by improving coverage and quality
care and regulation of health posts by the Provincial Inspectorate of Health.

 The challenge of insecurity preventing the response teams from working well, thus limiting the
speed of interventions is one of the biggest challenges of the response;

 Nevertheless, the Technical Secretariat is already recording some improvements,
fall in the numbers of community deaths, improved follow-up of contacts for a
complete investigation, where all the people constituting the chain around a confirmed case
are detected. We note here that the Entry and Control Points manage to retain several cases
contacts, suspects or confirmed before transferring them to the various treatment centers
Ebola (CTE) for further investigation or appropriate management. The
Technical Secretariat's strategy is to do a quick test for all the bodies;

 A new CTE has been built on a surface of one hectare and a half by the international NGO
MSF in Munigi, in the peripheral part of Goma, to face any eventuality. This new
CTE has a capacity of 72 beds with several screening pavilions. It includes
compartments for the nursing staff and the administration with the particularity of having
larger single rooms with individual latrines. Another advance is
adoption of the Integrated Strategic Plan for Ebola Response (SRP4);

 Interim Minister of Health Pierre Kangudia Mbayi led a strong delegation
Congolese in Rwanda, on 6 August, where he flew with his Rwandan counterpart a meeting
bilateral agreement aimed at strengthening collaboration between the two countries to eradicate the 10th
epidemic of EVD, declared as a public health emergency of international concern
by the World Health Organization;

 Following this meeting, WHO organized a meeting from 14 to 15 August 2019
transboundary border crossing in Goma with the Democratic Republic of the Congo, where
1 year the Ebola outbreak and 4 of its bordering countries, namely Uganda, Burundi,
Rwanda and South Sudan;

 On 16 August, two first confirmed cases of Ebola were reported in South Kivu,
territory of Mwenga more than 150 km from Bukavu, where a suspect case was also
reported as of August 25, 2019;

 It should also be noted that the DRC took part in the 69th session of the Regional Committee of
WHO for Africa held from 19 to 23 August 2019 in Brazzaville. The DRC, whose
the delegation was led by Interim Health Minister Pierre Kangudia Mbayi
was congratulated through Professor Muyembe, himself a participant and speaker, for
its efforts in finding solutions to eradicate EVD. "I am embarrassed
when we talk about Ebola for the DRC. Ebola is not the only disease that is
confronted the DRC, "said the WHO DG, Tedros Adhenom, during the meeting,
calling on the international community to get involved in the fight against other diseases
such as malaria and measles;

 The Technical Secretary of the Multisectoral Committee for the Response to Ebola Virus Disease, the
Professor Jean-Jacques Muyembe Tamfum received the 3rd Hideyo Noguchi Prize for
Africa, in the category "medical research" for its efforts in the fight against
against Ebola virus disease in eastern DRC. This prize was awarded on Friday
30 August on the sidelines of the 7th edition of the Tokyo Conference for the Development of
Africa (TICAD 7);

 In order to block the spread of Ebola Virus Disease in the city of
Kinshasa, a training of trainers on preparing for the response to the virus disease
Ebola in this city was organized by the Technical Secretariat and the Ministry of Health
through its National Border Health Program with JICA and JDR of 29
August 30, 2019. This training falls within the framework of the declaration of the tenth
Ebola outbreak as a public health emergency of international concern;

 Ebola is now curative thanks to the success of two molecules, including Mab114 and Regneb3. These are two effective molecules for treatment according to detection and management
fast case. Mab114 is a monoclonal antibody from a collaboration of more than one
decade between the National Institute for Biomedical Research (INRB) led by Prof. Muyembe
and the United States National Institute of Health (NIH);

 In addition to these two molecules, there is vaccination which is the best method
prevention to limit the transmission chain of the Ebola virus;

 The population and health workers are expected to follow the Goma experience demonstrating that the
total victory over this epidemic depends on the involvement of all. This can also be the case in
all affected and not yet contaminated areas, including the provinces and neighboring countries of the
DRC, in order to release as quickly as possible the sites of this monstrous disease, that we have,
today, the opportunity to heal and prevent. END_*
...

https://www.dropbox.com/s/q2y9zuwnlk8eyfy/CMRE_Bulletin%20Ebola%20du%2005%20septembre%202019.pdf?dl=0

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 03
SEPTEMBER 2019

Date: Wednesday, 04 September 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,049, of which 2,940 are confirmed and 109 are probable. the
In total, there were 2,050 deaths (1,941 confirmed and 109 probable) and 912 people healed.

 444 suspected cases under investigation;

 6 new confirmed cases, including:
o 4 in North Kivu, including 2 in Kalunguta, 1 in Katwa and 1 in Kayna;
o 2 in Ituri, including 1 in Mambasa and 1 in Mandima.

 5 new confirmed deaths, including 3 in North Kivu and 2 in Ituri:
o 3 community deaths, including 1 in North Kivu in Katwa and 2 in Ituri, including 1 in
Mambasa and 1 in Mandima;
o 2 deaths in CTEs in North Kivu, including 1 in Katwa and 1 in Mabalako.

 1 suspect death MVE was recorded this 03 September 2019 in Walikale, North Kivu. The
general coordination of the response is being deployed by an intervention team
fast (EIR).

 1 person healed out of CTE in Ituri in Komanda.
...

https://www.dropbox.com/s/atw89ess5l1zizj/CMRE_Bulettin%20Ebola%20du%2004%20septembre%202019.pdf?dl=0

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SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 02
SEPTEMBER 2019

Date: Tuesday, 03 September 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,043, of which 2,934 are confirmed and 109 are probable.

In total, there were 2,045 deaths (1,936 confirmed and 109 probable) and 905 people healed.

 327 suspected cases under investigation;

 4 new probable cases in North Kivu, including 2 in Butembo and 2 in Kalunguta;

 3 new confirmed cases, including:
o 1 in North Kivu in Kalunguta;
o 2 in Ituri, including 1 in North Kivu in Mambasa and 1 in Ituri in Mandima.

 6 new confirmed case deaths, including 5 in North Kivu and 1 in Ituri:
o 2 community deaths, including 1 in North Kivu in Kalunguta and 1 in Ituri in Mandima;
o 4 deaths in CTEs in North Kivu, including 1 in Beni, 1 in Mabalako, 1 in Butembo and 1 in
in Katwa.

 3 cured people released from ETCs, including 2 in North Kivu, including 1 in Butembo and 1 in Katwa, as well as
than 1 in Mwenga.

 No health worker is among the newly confirmed cases. The accumulation of cases
Confirmed / probable among health workers is 156 (5% of all confirmed / probable cases), including 41 deaths.
...

https://www.dropbox.com/s/t6w9kq6w9mlei8l/CMRE_Bulletin%20Ebola%20du%2003%20septembre%202019.pdf?dl=0

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Ituri: 3 new Ebola cases confirmed in Mambasa

Posted on Mon, 02/09/2019 - 15:52 | Edited Mon, 02/09/2019 - 15:52

Three new confirmed cases of EVD were recorded on Saturday and Sunday, 1 September, in the Mambasa Health Zone. The information was given this Monday, September 2nd by the provincial coordinator of the response to this epidemic, Christophe Shako.

According to him, these cases bring to ten the number of registered patients, four of whom died within a week in this environment. In total, he notes, 36 Ebola cases, 14 of which have already been recorded since July in the same health zone.

Of the last three cases, there is a 40-year-old man from Mane, accompanied by his wife and four children. The man died on Saturday in Mambasa center. Two of her children who were showing signs of Ebola were transferred on Sunday 1 September to the Ebola treatment center in Komanda.

According to Christophe Shako, the coordinator of the Ituri response, these two children, one of whom is two years old, are all reported this morning with the Ebola virus disease. This significant rise in confirmed cases of Ebola in the health zone of Mambasa in recent days worries the teams of the response. Christophe Shako calls on the community to work together to stop this rapid spread of the epidemic.

The mother of these children is currently under observation at the Mayuwano treatment center in Komanda, the source said.

https://www.radiookapi.net/2019/09/02/actualite/sante/ituri-3-nouveaux-cas-debola-confirmes-mambasa

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DRC-Ebola: In total, 50 contacts are listed around the case of the 9-year-old girl who died in Uganda

Saturday, August 31st 2019 - 12:25

ACTUALITE.CD

The technical secretariat of the Ebola response identified 50 people in Lubiriha, North Kivu, who had been in contact with the 9-year-old girl who died Friday in Uganda. Of these contacts, seven people are considered front-line contacts.

The girl was from Lubiriha health area (Majengo) located in Mutwanga health zone in North Kivu province.

The response team explained that she was co-patient of a case that had died and was confirmed on August 16, 2019 at Umoja health post, during the period from August 10 to 16, 2019, who had refused to be followed and vaccinated.

Since the beginning of the epidemic, the cumulative number of cases is 3,017, of which 2,912 are confirmed and 105 are probable. In total, there were 2,015 deaths (1,910 confirmed and 105 probable) and 902 people healed. Currently 399 suspected cases under investigation.

The same source indicates that this child had been brought to Uganda by her mother on August 28, 2019 after reoccurrence of the fever associated with asthenia and diarrhea, whereas from 24 to 27 of the same month, she had been consulted on an outpatient basis. at the Sinai Pamusi clinic with a slight improvement.

Japhet Toko

https://www.actualite.cd/2019/08/31/rdc-ebola-au-total-50-contacts-sont-listes-autour-du-cas-de-la-fillette-de-9-ans-decedee

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Situation au (situation on the) Thursday, August 29, 2019

Excerpt:

Cas confirm?s et probables (Confirmed and probables) 3,017

Cas confirm?s (Confirmed) 2,912
Cas probables (Probables) 105
Cas suspects (Suspected cases) 416

2,006 D?c?s (2,006 Deaths)
902 survivants (902 survivors)

Nouveaux cas confirm?s New confirmed cases: 13

Mambasa 3
Mutwanga 3
Kalunguta 2
Beni 1
Butembo 1
Katwa 1
Mandima 1
Musienene 1

https://who.maps.arcgis.com/apps/opsdashboard/index.html#/e70c3804f6044652bc37cce7d8fcef6c

[sharon sanders]

Dr. Robert R. RedfieldVerified account @CDCDirector 5m5 minutes ago More



.@CDCgov has recently doubled the number of #Ebola outbreak response experts in #DRC and will have 30 responders on ground by 9/1 to work on case investigation, contact tracing, disease tracking, community engagement, laboratory testing, border health, and more.

[Shiloh]

Source: https://www.who.int/csr/don/29-augus...-ebola-drc/en/
Ebola virus disease ? Democratic Republic of the Congo

Disease outbreak news: Update
29 August 2019

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu, and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to the previous six weeks, with an average of 77 cases per week (Figure 1). In the past 21 days from 7 August through 27 August 2019, 66 health areas within 18 health zones reported new cases (Table 1, Figure 2). During this period, a total of 203 confirmed cases were reported, with the majority coming from the health zones of Beni (28%, n=57), Mandima (11%, n=22), and Kalunguta (11%, n=22). In addition, Mambasa continues to show signs of an emerging hotspot, with 16 reported cases in the past 21 days. The response continues to address these hotspots through early case detection and thorough investigation, strong contact identification and follow up, and engagement with the local communities.
Two additional cases have been reported in South Kivu?s Mwenga Health Zone, bringing the total to six cases since 15 August. These individuals are family members of one of the recent cases. Although this indicates two generations of local transmission within Mwenga, the new cases are individuals who were under surveillance, and they were able to quickly receive care when they became ill.
On 22 August, Nyiragongo Health Zone (which includes suburbs of Goma city) passed 21 days without additional confirmed cases detected, and all contacts completed the 21-day follow-up period. Surveillance and response activities within Goma city and surrounding areas will continue, as risks of further introduction of EVD from active areas remain high.
As of 27 August, a total of 2997 EVD cases were reported, including 2892 confirmed and 105 probable cases, of which 1998 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 58% (1740) were female, and 28% (842) were children aged less than 18 years. To date, 156 health workers have been infected.
Pillar 1 of the fourth Strategic Response Plan (SRP4) for the control of the EVD outbreak in the Democratic Republic of the Congo is available on the WHO website. Pillar 1 covers the core public health response to the outbreak. The current estimated funding requirement for all partners for the period July to December 2019 is US$ 287 million, including US$ 120-140 million for WHO. As of 27 August, US$ 45.3 million have been received by WHO, with further funds committed or pledged. Current available funds will close the financing gap up until the end of September 2019. Further resources are needed to fund the response through to December 2019 and WHO is appealing to donors to provide generous support. A summary of funding received by WHO since the start of this outbreak can be found here.
Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 27 August 2019*




Enlarge image
*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi.
Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 27 August 2019*




Enlarge image
Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 27 August 2019**




Enlarge image
**Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
Public health response

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
The response to the EVD outbreak in Democratic Republic of the Congo remains challenged by continued insecurity, unrest, pockets of community resistance and funding shortfalls. The high proportion of community deaths, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to possible nosocomial infection, persistent delays in detection and isolation of cases, and challenges in accessing some communities due to insecurity and pockets of community reticence are all factors increasing the likelihood of further chains of transmission in affected communities.
While response strategies keep evolving to adapt to the local context, capacities for operational readiness and preparedness should continue to be enhanced and sustained in non-outbreak affected areas including neighbouring countries. WHO is calling for a more coordinated approach in which NGOs and UN partners collectively accelerate all activities, with all partners being accountable for their role in the response within the common goal of ending the outbreak.
The factors mentioned above, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread ? both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.
WHO advice

WHO advises against any restriction of travel to, and trade with, 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 travellers to/from the affected countries. 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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.
For more information, please see:

• WHO resources and updates on Ebola virus disease
• SAGE Interim Recommendations on Vaccination against Ebola Virus Disease (EVD)
• Ebola virus disease in the Democratic Republic of the Congo ? Operational readiness and preparedness in neighbouring countries
• Update on Ebola drug trial: two strong performers identified
• Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favourable Results with Two of Four Candidates
• Ebola response funding

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Situation au (situation on the) Wednesday, August 28, 2019

Excerpt:

Nouveaux cas confirm?s (New confirmed cases): 7

Kalunguta 3
Mambasa 2
Mabalako 1
Mutwanga 1

3,004 Cas confirm?s et probables (Confirmed and probables)
1,998 D?c?s (1,998 Deaths)

https://who.maps.arcgis.com/apps/opsdashboard/index.html#/e70c3804f6044652bc37cce7d8fcef6c

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Outbreaks and Emergencies Bulletin, Week 34: 19 - 25 August 2019

Ebola virus disease Democratic Republic of the Congo

2 968
Cases

1 986
Deaths

67%
CFR


EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu and
Ituri provinces in Democratic Republic of the Congo continues. As of
24 August 2019, a total of 2 968 EVD cases, including 2 863 confirmed
and 105 probable cases have been reported. In the last 21 days (4 to 24
August 2019), 18 health zones have reported at least one confirmed case.

To date, confirmed cases have been reported from 27 health zones: Goma
(1), Alimbongo (5), Nyiragongo (3), Beni (652), Biena (16), Butembo
(277), Kalunguta (151), Katwa (643), Kayna (21), Kyondo (20), Lubero
(31), Mabalako (369), Manguredjipa (18), Masereka (50), Musienene (81),
Mutwanga (24), Oicha (54), Pinga (1) and Vuhovi (103) in North Kivu
Province; and Lolwa (3), Mambasa (21), Ariwara (1), Bunia (4), Komanda
(41), Rwampara (8), Mandima (258), Nyankunde (1), and Tchomia (2) in
Ituri Province, and Mwenga (4) in South Kivu.

As of 24 August 2019, a total of 1 986 deaths were recorded, including
1 881 among confirmed cases, resulting in a case fatality ratio among
confirmed cases of 66% (1 881/2 863). The cumulative number of health
workers affected has risen to 155, which is 5% of the confirmed and
probable cases to date.

Beni and Mandima are currently the main hot spots of the outbreak reporting
30% (n=61) and 14% (n=29) of the cases in the past 21 days respectively.
Seventeen health zones, Mabalako, Beni, Butembo, Kalunguta, Katwa,
Kayna, Komanda, Mutwanga, Mandima, Lolwa, Mambasa, Musienene,
Masereka, Oicha, Alimbongo and Mwenga have reported new confirmed
cases in the past seven days and remain points of attention.

Contact tracing is ongoing in 20 health zones. A total of 17 293 contacts
are under follow-up as of 24 August 2019, of which 15 368 have been seen
in the past 24 hours, comprising 89% of the contacts, which is a higher
percentage than during the past seven days (85%). Alerts in the affected
provinces continue to be raised and investigated. Of 2073 alerts processed
(of which 1996 were new) in reporting health zones on 24 August 2019,
1973 were investigated and 396 (20%) were validated as suspected cases.

On 17 July 2019, the WHO Director-General, Dr Tedros Ghebreyesus
declared the EVD outbreak in Democratic Republic of the Congo a Public
Health Emergency of International Concern (PHEIC), following a meeting
of the International Health Regulations Committee for EVD.

PUBLIC HEALTH ACTIONS

Surveillance activities continue, including case investigations,
active case finding in health facilities and communities, and
identification and listing of contacts around the latest confirmed
cases. Cross-border collaboration continues, particularly in
Uganda and Rwanda.

As of 24 August 2019, a cumulative total of 204 772 people has
been vaccinated since the start of the outbreak in August 2018.

Point of Entry/Point of Control (PoE/PoC) screening continues,
with over 88 million screenings to date. A total of 98/106 (92%)
PoE/PoC transmitted reports as of 24 August 2019.

The protocol for treatment of Ebola patients in Democratic Republic
of the Congo has been revised following data from a randomized
clinical trial showing, for the first time, that Ebola treatments
improve survival rates. Two of the four trial drugs were found to
have the greatest efficacy and are now being provided to confirmed
cases under the compassionate use protocol.

There are continued community reintegration and psychosocial
activities for patients discharged from ETCs, along with
psychoeducation sessions to strengthen community engagement
and collaboration in the response.

Teams of psychologists continue negotiations to obtain the support
of relatives of two confirmed cases from Mutwanga Health Zone to
participate in prevention activities.

The communication commission collaborated with the psychosocial care commission
to overcome resistance in a suspected case validated in Goma, who had been working
in a mine in Manguredjipa Health Zone and who was travelling to Bukavu.

Water, sanitation and hygiene (WASH) activities continue where possible, but were
not possible around a confirmed case in Mandima because of insecurity.

Community awareness and mobilization messages are being updated, revised and
harmonized and have been pre-tested by the commission and will subsequently be
shared in coordination and sub-coordination activities.

Young members of the Catholic Parish of Beni City have made a public commitment
to counter community incidents in the Kasanga health area; the coordination of
Goma launched a message of community involvement in the response to EVD on the
occasion of the inauguration of the new provincial committee of the Revival Church of
the Congo and the new regional bishop; in Kayna the Mwama of the Batangi Chiefdom
facilitated a community dialogue and called on all leaders in the jurisdiction to engage
resolutely in the EVD response; 30 traditional practitioners and pharmacy tenant from
Mayuano were briefed on EVD risk communication and a meeting was held with
school principals from Mambasa schools on the prevention of EVD in preparation for
the start of the school year.

SITUATION INTERPRETATION

The response to the EVD outbreak in Democratic Republic of the Congo remains challenged by
continued insecurity and pockets of community resistance. The small declining trend seen in the
past three weeks must be interpreted with caution, given the spread to a new health zone within
North Kivu and to the previously unaffected province of South Kivu. However, the lack of further
cases in the city of Goma underlines just how effective proven public health measures can be
when implemented immediately and effectively. This also emphasises how important response
preparedness continues to be in both unaffected provinces and neighbouring countries. Local
authorities and partners need to continue their robust response to the disease, using both novel
and proven community health and public health measures, while donors need to ensure that the
funding is present to enable this and ensure that the declining trend continues.

https://apps.who.int/iris/bitstream/handle/10665/326596/OEW34-1925082019.pdf

https://www.afro.who.int/node/11652

[Shiloh]

Source: https://www.who.int/csr/don/22-augus...-ebola-drc/en/
Ebola virus disease ? Democratic Republic of the Congo

Disease outbreak news: Update
22 August 2019

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity (Figure 1). While the last few weeks of the outbreak have been characterized by the geographic expansion of cases to new health zones, we continue to see high case numbers, sustained local transmission, and inter-health zone movement of cases both into and out of the hotspot areas of Beni, Mandima, and Butembo. In the past 21 days from 31 July through 20 August 2019, 69 health areas within 19 health zones reported new cases (Table 1, Figure 2). During this period, a total of 216 confirmed cases were reported, with the majority coming from the health zones of Beni (31%, n=66), Mandima (18%, n=38), and Butembo (8%, n=18). High risks of transmission are also associated with an emerging cluster in the city of Mambasa, which has reported 14 cases in the past 21 days. The response continues to address these hotspots through early case detection and thorough investigation, strong contact identification and follow up, and engagement with the local communities.
Two new health zones reported cases in the past week: Mwenga Health Zone in South Kivu and Pinga Health Zone in North Kivu. In Mwenga, four confirmed cases were reported after two individuals (mother and child) had contact with a confirmed case in Beni before travelling south. The father of the child was subsequently confirmed positive as was a co-patient in a community health facility where the first case initially sought care.
In Pinga, one confirmed case has been reported with no apparent epidemiological links to other cases and no recent travel or visitors from outbreak affected areas. Pinga presents an added challenge to response teams in terms of remoteness, limited telecommunications, security risks, and resistance within the affected family and community.
As of 20 August, a total of 2927 EVD cases were reported, including 2822 confirmed and 105 probable cases, of which 1961 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 58% (1697) were female, and 28% (830) were children aged less than 18 years. To date, 154 health workers have been infected.
Eleven additional probable cases were validated last week, among these were cases who died in the community in Katwa, Kyondo, Vuhovi, and Mabalako health zones during March through June 2019 with epidemiological links to the outbreak; these cases could not be sampled for laboratory testing to confirm/exclude EVD.
On 19 August 2019, a ?ville morte? protest took place in Beni, Butembo, and Oicha in response to recent attacks by armed groups on civilians. This resulted in a temporary suspension of Ebola response activities. Operations resumed on 20 August 2019 with increased caution, and further demonstrations are anticipated. The suspension of Ebola response activities often results in an increase of case numbers and spread of cases to new areas in the subsequent weeks.
Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 20 August 2019*




Enlarge image
*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi.
Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 20 August 2019*




Enlarge image
Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 20 August 2019**




Enlarge image
**Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
Public health response

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
The response to the EVD outbreak in Democratic Republic of the Congo remains challenged by continued insecurity, unrest, pockets of community resistance and funding shortfalls. Although there is a slight declining trend in the overall number of new confirmed cases reported this week, the disease continues to spread to new health zones. This was again demonstrated in a case who travelled 700 km from the original place of exposure in Beni in North Kivu to Mwenga in South Kivu. The high proportion of community deaths, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to possible nosocomial infection, persistent delays in detection and isolation of cases, and challenges in accessing some communities due to insecurity and pockets of community reticence are all factors increasing the likelihood of further chains of transmission in affected communities.
While response strategies keep evolving to adapt to the local context, capacities for operational readiness and preparedness should continue to be enhanced and sustained in non-outbreak affected areas including neighbouring countries. WHO is calling for a more coordinated approach in which NGOs and UN partners collectively accelerate all activities, with all partners being accountable for their role in the response within the common goal of ending the outbreak.
The factors mentioned above, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread ? both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.
WHO advice

WHO advises against any restriction of travel to, and trade with, 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 travellers to/from the affected countries. 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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.
For more information, please see:

• WHO resources and updates on Ebola virus disease
• SAGE Interim Recommendations on Vaccination against Ebola Virus Disease (EVD)
• Ebola virus disease in the Democratic Republic of the Congo ? Operational readiness and preparedness in neighbouring countries
• Update on Ebola drug trial: two strong performers identified
• Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favourable Results with Two of Four Candidates
• Ebola response funding

[Pathfinder]

Translation Google

Butembo: Property Damage Recorded in Rebellion Incursion at Kambuli Health Center

Posted Mar 20/08/2019 - 18:20
7SUR7.CD

Armed men on May 20, 2019, attacked the Kambuli Health Center, a health facility located in the Ngingi District, in Mususa commune in the town of Butembo (North Kivu).

The information delivered to 7SUR7.CD by Mbaytoya Bovick, bourgmestre of the said commune, indicates that the enemy, during his visit, vandalized all material goods of the Kambuli Health Center.

"Several material goods have been vandalized, including the malicious destruction of Ebola prevention kits," he said.

The municipal authority of Mususa calls, moreover, the inhabitants of Ngingi to calm while reassuring on an important device of the security forces and defense deployed in the region.

Jo?l Kaseso from Butembo

https://www.7sur7.cd/2019/08/20/butembo-des-degats-materiels-enregistres-dans-une-incursion-rebelle-au-centre-de-sante