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

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  • #31
    Translation Google
    DIRECTORATE GENERAL FOR DISEASE CONTROL
    EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
    Monday 13 August 2018


    The epidemiological situation of the Ebola Virus Disease dated August 12, 2018 :
    • A total of 57 cases of haemorrhagic fever were reported in the region, of which 30 confirmed and 27 probable.
    • 58 suspected cases are under investigation .
    • 5 new confirmed cases, including 1 in Mandima (Ituri) and 4 in Mabalako (all health care providers from the Mangina Reference Health Center)
    • 2 deaths of confirmed cases, including 1 in Mabalako and the confirmed case in Mandima (Ituri)




    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.
    News of the response
    • The first patient discharged cured of Ebola Treatment Center (CTE) of Beni is a girl of 13 years old. Psychosocial experts from the Ministry of Health visited family members to prepare them psychologically and facilitate their psychosocial reintegration.
    • The CTE management teams in Beni and Mangina have started using the therapeutic molecule Mab 114 as part of the treatment of patients with Ebola Virus Disease. The Mab 114, which stems from the research done by Professor Jean-Jacques Muyembe on the serum of a survivor of the Ebola epidemic in Kikwit in 1995, has become the first therapeutic molecule against the virus to be used in the part of an active Ebola outbreak in the Democratic Republic of Congo.
      During the previous epidemic in the Province of Ecuador last May, a joint scientific committee and an ethics committee had approved the use of five experimental therapeutic molecules, namely Mab 114, ZMapp, Remdesivir, Favipiravir and Regn3450 - 3471 - 3479. However, because of the rapid mastery of the previous epidemic, none of the molecules could be administered and they remained in the laboratories of the National Institute of Biomedical Research (INRB) in Kinshasa.
      When the tenth epidemic broke out in North Kivu province in July, the INRB asked the companies producing each of these molecules to give their authorization for their use again and an amended protocol of administration before submit the request for approval to the Ethics Committee. To date, all molecules have already arrived at Beni, with the exception of ZMapp, which requires storage at -20 degrees Celsius. The ethics committee has already approved the amended protocol of administration provided by the producers of MAB 114. The other four complete files have just been submitted to the Ethics Committee and the National Regulatory Authority for approval.
    • The death in the Mandima Health Zone, Ituri Province, is a man who was admitted to the Mangina Reference Health Center in North Kivu Province for heart problems. After being treated, he returned to his village in the Mandima Health Zone, about 400 meters from CSR Mangina, where he died. The samples taken were positive.

    ...
    https://us13.campaign-archive.com/?u...&id=ee37814de8
    "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


    • #32
      WHO: Press Conference - Update on Ebola operations in DRC (Geneva, 14 August 2018)
      14 Aug 2018 -
      Speaker:
      · Dr Tedros Adhanom Ghebreyesus, WHO Director-General

      http://webtv.un.org/meetings-events/...abic&sort=date
      "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


      • #33
        Ebola in DR Congo: conflict zones could constitute ‘hiding places’ for the deadly virus – WHO chief



        WHO-Eugene Kabambi
        On 8 August 2018, the vaccination of frontline health care workers started, followed by the vaccination of community contacts and their contacts, in Mangina, North Kivu, the epicenter of the 10th Ebola epidemic to hit the Democratic Republic of the Congo. There are currently 3220 doses of rVSV-ZEBOV Ebola vaccine available in Kinshasa.

        14 August 2018
        Health

        Following a two-day mission in the Democratic Republic of Congo, the Head of the World Health Organization (WHO) on Tuesday repeated his call for warring parties in conflict-riven North Kivu to stop fighting, and allow health teams access to areas affected by the recent Ebola outbreak in the region.



        Speaking at a press briefing in Geneva, WHO Director-General Tedros Adhenom Ghebreyesus, stated that his visit to Beni and Mangina - epicentre of the outbreak which started about a week ago - left him “more worried” than he had been over containing the outbreak on the western side of the country, which officially ended late last month.
        We are asking the international community to help in ensuring access into the inaccessible areas - Tedros Adhernom Ghebreyesus, WHO Chief
        “What makes the outbreak in Eastern DRC or Northern Kivu more dangerous, is that there is a security challenge. There is active conflict in that area,” he stressed, noting that since January, the area had seen more than 120 violent incidents, including killings and kidnappings of civilians.

        Referring to the areas where armed groups are operating, he said they could be “hiding places” for the virus. “We have difficulty accessing those areas, and people in those areas will have difficulty moving to places where they can get the support they need,” he explained.

        “We are asking the international community to help in ensuring access into the inaccessible areas,” Mr. Tedros pleaded. “We also call on the warring parties for a cessation of hostilities because the virus is dangerous to all, it doesn’t choose between this group or that group,” he stressed.

        According to WHO and the Ministry of Health, the number of cases so far stands at 57 confirmed or suspected cases, with 41 deaths, already surpassing the previous Ebola outbreak in the country’s Equateur Province, with 53 cases and 29 deaths. In addition, WHO reports that the number of women infected in Kivu so far is much higher than the number of men infected.

        MONUSCO/Alain Coulibaly

        In addition to the lack of access, the head of WHO cited several factors that complicate the operational environment for Ebola responders, including the high population density in North Kivu, which was not an issue in Equateur Province; as wells as large-scale population movements within the region and across borders with neighbouring countries which continue. Some one million people have been internally-displaced so far by fighting.

        Mr. Tedros also reported that seven health workers have been infected to date, explaining that this presents additional challenges for the response.

        Mr. Tedros assured that, although all these factors render this outbreak “more difficult to manage,” WHO is continuing to provide support to the Ministry of Health and “doing all we can to be more aggressive than the virus”. Case-finding efforts have led to the identification of over 600 potential virus carriers so far; vaccinations and treatment programmes are underway, and awareness-raising has been stepped up within affected communities, through radio broadcasts and other community-wide communication.

        In his statement, Dr. Ghebreyesus commended the partnership and joint efforts by the Government of DRC, WHO, the UN stabilization mission in-country (MONUSCO), UN Children’s Fund (UNICEF) and various international non-profit organisations in order to defeat the virus.
        Thanking donors for their efforts and support in helping defeat the previous outbreak in the Equateur Province, he concluded by calling on the international community to “speed up the financing” to respond to this new crisis.

        "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


        • #34
          Translation Google
          DIRECTORATE GENERAL FOR DISEASE CONTROL
          EPIDEMIOLOGICAL SITUATION IN NORTH KIVU PROVINCE
          Tuesday 14 August 2018


          The epidemiological situation of the Ebola Virus Disease dated August 13, 2018 :
          • A total of 66 cases of haemorrhagic fever were reported in the region, 39 confirmed and 27 probable.
          • 36 suspected cases are under investigation .
          • 9 new confirmed cases, including 6 in Mandima and 3 in Mabalako
          • 1 case death confirmed in Mandima





          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.
          News of the response

          Supported
          • The Mangina Ebola Treatment Center (CTE) is operational and all patients who were in the temporary CTE are now being treated in the new CTE.

          Provincial collaboration
          • After the notification of the positive case in the health zone of Mandima, in the Ituri Province, a delegation of coordination of the response, led by Dr. Ndjoloko Tambwe Bathe, Director General of the General Direction of Fight against the Disease (DGLM), traveled to Mambasa to meet the Governor of Ituri Province. During this visit, the delegation made a plea for the involvement of the authorities in the preparation and response in the province.
          • A delegation from the Province of South Kivu, composed of the Provincial Minister of Health, the Chief Medical Officer of the Provincial Health Division and the WHO Focal Point, spent three days in Goma to better coordinate preparedness and response activities. in the two neighboring provinces. The health authorities of the North Kivu Province notably presented to their counterparts the procedures for collecting samples, managing and investigating alerts.

          ...
          https://us13.campaign-archive.com/?u...&id=db91643b40
          "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


          • #35
            Translation Google
            DIRECTORATE GENERAL FOR DISEASE CONTROL
            EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
            Wednesday, August 15, 2018


            The epidemiological situation of the Ebola Virus Disease dated 14 August 2018 :
            • A total of 73 cases of haemorrhagic fever were reported in the region, 46 confirmed and 27 probable.
            • 40 suspected cases are under investigation .
            • 7 new confirmed cases in Mabalako, including 1 care provider from the Mangina Reference Health Center. All of these new confirmed cases are probable and known case contacts.
            • 1 confirmed case death in Mabalako.





            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.
            News of the response

            Supported
            • The work of the Ebola Treatment Center (ETC) in Beni has been completed and the transfer of patients will begin.

            Vaccination
            • Belt vaccination of identified contacts of confirmed cases reported in Mandima Health Zone, Ituri Province, started on Wednesday, August 15, 2018.

            ...
            https://us13.campaign-archive.com/?u...&id=f3c4687d55
            "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


            • #36
              Source: http://www.who.int/csr/don/14-august-2018-ebola-drc/en/

              Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries

              Disease outbreak news
              14 August 2018

              Following the declaration on 1 August 2018 of a new Ebola virus disease (EVD) outbreak in North Kivu, Democratic Republic of the Congo, WHO conducted a formal rapid risk assessment, which determined that the public health risk for this outbreak is high at the regional level. This assessment took into consideration that, with eight million inhabitants, North Kivu is one of the most densely populated provinces in the country. North Kivu borders four other provinces (Ituri, South Kivu, Maniema and Tshopo), as well as Uganda and Rwanda. Moreover, the province has been experiencing intense insecurity and a deteriorating humanitarian crisis, with over one million internally displaced people and high rates of cross border movement to and from neighbouring countries.
              On 5 May 2018, during the previous EVD outbreak in Équateur Province, Democratic Republic of the Congo, the WHO Regional Office for Africa identified nine neighbouring countries (Angola, Burundi, Central African Republic, Republic of the Congo, Rwanda, South Sudan, Tanzania, Zambia and Uganda), where Preparation Support Teams were deployed to assess countries’ readiness using the WHO standardized checklist, and to provide technical support to countries to develop and initiate national contingency plans in collaboration with partners.
              Currently for the EVD outbreak in North Kivu, the WHO Regional Office for Africa has prioritized four of the nine countries (Burundi, Rwanda, South Sudan and Uganda) neighbouring the Democratic Republic of the Congo to enhance operational readiness and preparedness (Figure 1). These four countries were prioritised based on their capacity to manage EVD and viral haemorrhagic fever (VHF) outbreaks, and their proximity to the areas currently reporting EVD cases. In addition, Kinshasa, Mai-Ndombe, Tshuapa, Tshopo, South Kivu, Ituri, Bas-Uélé, Sankuru and Maniema provinces were prioritized for readiness activities. This update will primarily focus on the four of the nine priority countries.
              Figure 1: Countries identified for enhanced operational readiness and preparedness activities




              WHO is deploying Preparedness Support Teams to these and other neighbouring countries, as was done during the previous EVD outbreak in Équateur Province. These missions aim to assess countries’ readiness using a WHO checklist and to provide technical support to countries to develop and implement national contingency plans in collaboration with partners. The operational and preparedness activities will focus on the following thematic areas:
              Coordination:

              • WHO has established a network of health and non-health partners that are supporting countries to implement and scale up preparedness and readiness activities.
              • The Global Outbreak Alert and Response Network (GOARN) continues to support these activities. Experts in laboratory, case management, surveillance, clinical management, infection prevention and control (IPC), and risk communication have been requested and are being deployed systematically.
              • The United States Centre for Disease Control (CDC) has deployed experts to Geneva to support WHO Headquarters team working on the response. The United Nations Children Fund (UNICEF) and International Federation of Red Cross (IFRC) are deploying senior coordinators to liaise with the WHO Headquarters team in Geneva.
              • WHO is working with experts from Emergency Medical Teams to support training and strengthen case management readiness.
              • Five teams from the Stop Transmission of Polio Program were repurposed to provide support in Uganda.
              • Burundi has established an EVD coordination committee and commissioned seven sub-committees for monitoring EVD activities based on the standardized WHO checklist.
              • In Rwanda, an Ebola partners’ coordination forum was established to support preparedness activities.

              Surveillance:

              • All targeted countries have implemented heightened surveillance and are readily detecting and investigating alert and suspected VHF cases.
              • The national electronic Early Warning Alert and Response (EWAR) system in Rwanda continues to be used to detect suspected VHF cases.

              Rapid response teams (RRTs):

              • In July 2018, joint RRTs in Uganda was trained incoordination, surveillance, risk communication and potential case investigations. Several teams from this training were deployed on 2 August 2018 to four high-risk areas in Uganda: Kabarole (Fort Portal), Kasese, Ntoroko and Bundibugyo.
              • By 10 August, RRTs were in place in all four priority countries: Uganda, South Sudan, Rwanda and Burundi. Plans are being developed for a multidisciplinary rapid response training in Rwanda.

              Points of entry (POEs):

              • The Ministry of Health (MoH) of the Democratic Republic of the Congo is strengthening surveillance capacities in 18 international POEs in North Kivu. Similar efforts will also be made at POEs in other vulnerable provinces. More than 30 additional points of internal connection for travellers, migrants and displaced people were identified; similar surveillance activities are ongoing at these points, including hand hygiene, traveller screening, management of alerts, and risk communication. The MoH will also enhance surveillance activities at refugee transit centers and other congregation sites.
              • Points of entry screening have been identified and implemented in the following neighbouring countries: Burundi, Central African Republic, Rwanda, South Sudan, Uganda and Zambia.

              Laboratory:

              • An initial 25 rapid diagnostic tests (RDTs) were sent to Rwanda. A further 50 RDTs and additional resources will be sent to strengthen laboratory capacity.
              • Of the four prioritized countries, only Uganda has the laboratory capacity to test for EVD and other VHFs by polymerase chain reaction (PCR). The remaining three countries have the capacity to test using RDTs and have mechanisms in place to send samples to a WHO reference laboratory. However, two laboratory experts from CDC will be arriving in Rwanda on 15 August 2018 to support the MoH for laboratory activities and preparedness.
              • In South Sudan, WHO has trained 20 medical laboratory staff on biosafety and EVD diagnostic testing and has also provided probes for EVD testing using GeneXpert.

              Case management and IPC

              • Expert networks of case management and IPC specialists have been alerted to the request for assistance for operational readiness and preparedness in non-Ebola affected provinces of the Democratic Republic of the Congo and surrounding countries.
              • Posters for how to identify EVD symptoms are available at health care facilities in English (Uganda and Rwanda), and French (Rwanda and Burundi).
              • The WHO Emerging Diseases Clinical Assessment and Response Network (EDCARN) member IMAI-IMCI alliance hosted a clinical training for health care workers in Uganda earlier this year.
              • All four prioritized countries have identified health facilities that will be used to for the isolation and treatment of suspected cases.

              Risk communication:

              • As of June 2018, 32 risk communicators were trained in Uganda; additional risk communication activities have been initiated.
              • Risk communication messages in Rwanda have been disseminated through national radio and television broadcasts.
              • Training on risk communication for both EVD and Rift Valley fever (RVF) are planned in South Sudan.
              • The United Nations Children’s Fund (UNICEF), the Red Cross and the International Committee of the Red Cross have invested in risk communication, community mobilization and IPC in the Republic of the Congo and the Central African Republic.

              Logistics

              • Uganda has been equipped with five VHF kits, 25 RDTs, chlorine, personal protective equipment (PPE) kits and 58 digital infrared thermometers have been prepositioned in high-risk districts.
              • PPE kits, thermoflash and RDTs have been prepositioned in all surrounding countries in preparation for suspected cases.
              • The World Food Programme (WFP) has provided support with logistics, transportation and food in the Republic of the Congo and Central African Republic.

              WHO Regional Strategic Plan for EVD Operational Readiness and Preparedness

              The aforementioned activities are in addition to the operational readiness and preparedness activities already underway in response to the previous outbreak in Équateur Province. Early this year, WHO and partners, in collaboration with country ministries of health, developed a nine-month (June 2018 – February 2019) Strategic Plan1 , which aims to align activities and ensure that the countries bordering the Democratic Republic of the Congo are prepared and operationally ready to implement timely and effective risk mitigation, detection and response measures should suspected EVD cases be detected. The findings of the WHO Preparedness Support Team missions helped to identify key challenges and priorities as well as informed the development of the national EVD contingency plans.
              Under the leadership of the Ministries of Health, preparedness activities are already being implemented in the nine countries with technical and financial support provided by national budgets, WHO and partners. In response to the specific risks posed by the current outbreak, Burundi, Rwanda, South Sudan and Uganda will be reclassified as Priority 1 countries under a revised plan which is being finalized.
              WHO advice

              As the MoH, WHO and partners strengthen response activities to control the outbreak in the Democratic Republic of the Congo, it is important for neighbouring provinces and countries to continue to enhance operational readiness and preparedness activities.
              WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. WHO continues to monitor and verify, if necessary, travel and trade measures in relation to this event.
              For more information, see:


              Comment


              • #37
                Translation Google
                DIRECTORATE GENERAL FOR DISEASE CONTROL
                EPIDEMIOLOGICAL SITUATION IN NORTH KIVU PROVINCE
                Thursday, August 16, 2018


                The epidemiological situation of the Ebola Virus Disease dated August 15, 2018 :
                • A total of 78 cases of haemorrhagic fever were reported in the region, 51 confirmed and 27 probable.
                • 24 suspected cases are under investigation .
                • 5 new confirmed cases in Mabalako, including 1 health staff from the Mangina Reference Health Center. All of these new confirmed cases are probable and known case contacts.
                • 2 deaths of confirmed cases in Beni.
                * An analysis of the databases revealed that the death of the confirmed case in Mandima had been counted twice. Thus, there are 3 deaths in Mandima (and not 4), including 1 of a confirmed case and 2 probable cases.





                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.
                News of the response

                Global health security
                • On Wednesday, August 15, 2015, the Minister of Health, Dr. Oly Ilunga Kalenga, received in audience Ms. Jennifer Haskell, Chargé d'Affaires of the Embassy of the United States in the DRC, Dr. Robert Redfield Jr, Director of the Centers for Disease Control and Prevention (CDC), and Dr. Raimi Ewetola, Country Director of the CDC in the Democratic Republic of Congo. Because of its size and central position in Africa, the DRC has an important role to play in global health security. Discussions focused on bilateral cooperation between the Ministry of Health and the CDC, CDC training programs for field epidemiologists, and future perspectives for strengthening collaboration.
                • The day after this first interview, the Minister of Health led the American delegation to the heart of the response, in Beni in North Kivu Province. After a presentation of the epidemiological situation through coordination, the guests went to the Beni General Referral Hospital where they visited the new Ebola Treatment Center.

                Provincial collaboration
                • After the meeting with the coordination in Beni, the Minister of Health separated from his hosts in order to go to Bunia, capital of the Ituri Province, where a first confirmed case of Ebola was notified August 12th. He was welcomed by a provincial government delegation including the Governor, the Deputy Governor, the Provincial Minister of Health and the Provincial Minister of the Interior. Since the declaration of the epidemic in North Kivu Province, the provincial government of Ituri had set up crisis coordination and strengthened prevention and surveillance measures given the proximity between the epicenter of the epidemic in Mangina and the Mandima Health Zone in Ituri Province. Indeed, the health zones of Mangina and Mandima are separated by less than 400 meters and population movements are very frequent. Many farmers live with their families in Mangina but work in fields in Mandima. The Minister of Health congratulated the provincial government for its proactivity that has already saved several lives.


                Vaccination
                • Since vaccination began on August 8, 2018, 316 people have been vaccinated , including 176 in Mabalako, 100 in Beni and 40 in Mandima.

                ...
                https://us13.campaign-archive.com/?u...&id=051b0b8bd8
                "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


                • #38
                  Source: http://www.who.int/csr/don/17-august-2018-ebola-drc/en/
                  Ebola virus disease – Democratic Republic of the Congo

                  Disease outbreak news
                  17 August 2018

                  On 1 August 2018, the Ministry of Health (MoH) of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease (EVD) in the town of Mangina, Mabalako Health Zone, North Kivu Province. Confirmed cases have since between reported from Beni and Mandima health zones, Ituri Province; however, all confirmed exposures and transmission events to date have been linked back to the outbreak epi-centre, Mangina. North Kivu and Ituri are among the most populated provinces in the country, share borders with Uganda and Rwanda, and experience conflict and insecurity, with over one million internally displaced people and migration of refugees to neighbouring countries.
                  As of 15 August 2018, 78 EVD cases (51 confirmed and 27 probable), including 44 deaths, have been reported.1 Since the DON published on 9 August, 34 new confirmed cases have been reported: seven from Ituri Province (Mandima Health Zone) and 27 from North Kivu Province (one in Beni and 26 in Mabalako health zones). The 78 confirmed or probable cases reside in five health zones in North Kivu and one health zone in Ituri. The majority of cases (39 confirmed and 21 probable) have been reported from Mangina in Mabalako Health Zone (Figure 1). As of 15 August, 24 suspected cases are currently pending laboratory testing to confirm or exclude EVD.
                  Eight new confirmed cases among health care workers have been reported, bringing the total number of infected health care workers to 10 (nine confirmed and one probable deceased case). These health care workers were likely exposed in clinics, not Ebola treatment centres (ETCs), many of which may have been infected before the declaration of the outbreak. WHO and partners are working to increase awareness of Ebola among health care and other frontline workers, and to strengthen infection prevention and control (IPC) measures.
                  The MoH, WHO and partners continue to systematically monitor and rapidly investigate all alerts in other provinces and in neighbouring countries. Since the last DON was published, alerts in several provinces of the Democratic Republic of Congo as well as in Uganda, Rwanda, and the Central African Republic were investigated; EVD was ruled out for all.
                  For more information, see:
                  Figure 1. Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, 15 August 2018




                  Public health response

                  The MoH rapidly initiated response mechanisms in North Kivu and Ituri provinces with support from WHO and partners. Priorities include the establishment and strengthening of surveillance, contact tracing, laboratory capacity, IPC, clinical management, vaccination, risk communication and community engagement, safe and dignified burials, response coordination, cross-border surveillance, and preparedness activities in neighbouring provinces and countries.
                  • During a two-day mission to the outbreak epi-centre, the WHO Director-General (DG), WHO Regional Director (RD) for Africa and WHO Deputy Director-General (DDG), Emergency Preparedness and Response, together with the Minister of Health, observed the launch of Ebola vaccination activities, visited the Emergency Operations Centre (EOC), met with partners and staff to discuss the challenges ahead, and assessed response measures and needs.
                  • The WHO DG and the RD then visited Uganda where they were briefed by the WHO Representative on the country’s EVD preparedness. The DG and RD later met the Uganda Prime Minister, the Minister of Foreign Affairs, the Minister of Health, and the Minister of State for Primary Health Care to discuss EVD preparedness and WHO support.
                  • The MoH has activated a multi-partner incident management system and an EOC to coordinate the response, with the main centre in Beni and the field coordination centre in Mangina. WHO has established an incident management team with personnel from the WHO Country Office, Regional Office for Africa and headquarters who are collaborating closely to ensure a comprehensive and effective response to the outbreak.
                  • On 8 August, the MoH, with support from WHO and partners, launched the Ebola ring vaccination activities for high-risk populations. In the first days, health care and other frontline workers were vaccinated. As of 15 August, a total of five rings have been defined around 13 recently confirmed cases. Within these initial rings, more than 500 contacts and their contacts consented and received rVSV-ZEBOV Ebola vaccine thus far. Teams are continuing to identify and vaccinate all eligible contacts to help interrupt transmission of the virus.
                  • The MoH and WHO continue to strengthen surveillance in the affected and surrounding areas. As of 15 August, nearly 1600 contacts, including more than 120 health workers, in North Kivu and Ituri provinces have been registered and are being followed up on daily basis.
                  • As of 15 August, WHO has deployed over 100 technical and logistics specialists to support response activities. Global Outbreak Alert and Response Network (GOARN) partner institutions continue to support the response as well as ongoing readiness and preparedness activities in non-affected provinces of the Democratic Republic of the Congo and in bordering countries. For more information about operational readiness and preparedness activities, please see the DON published on 14 August.
                  • In addition to the mobile laboratory established in Beni on 3 August, local testing with Xpert Ebola has since been established in hospital facilities in Beni, Goma, and Mangina to facilitate the timely diagnosis of suspected cases.
                  • The Alliance for International Medical Action (ALIMA) and Médecins Sans Frontières (MSF) have established 60-bed ETCs in Beni and Mangina, respectively. The partners are preparing the ETCs to provide therapeutics under the monitored emergency use of unregistered and experimental interventions (MEURI) protocol in collaboration with MoH and Institut National de Recherche Biomédicale (INRB). WHO is providing technical expertise support on site and assisting with the creation of a data safety management board.
                  • The MoH team, with support from UNICEF, are training 90 psychosocial agents to provide psychosocial care to patients and other affected people.
                  • Knowledge, Attitude and Practice (KAP) surveys were conducted in Beni and Mabalako health zones to assess the levels of EVD awareness in the communities. Findings from the survey will be used to improve the risk communication, social mobilization and community engagement strategy.
                  • Two planes with supplies of cold chain equipment, isolation units and vehicles arrived in Beni on 11 and 12 August.

                  WHO risk assessment

                  This latest outbreak of EVD is affecting north-eastern provinces of the Democratic Republic of the Congo which border Uganda. Potential risk factors for transmission of EVD at the national and regional levels include the transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing several epidemics and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri may hinder the implementation of response activities. Based on this context, the public health risk was assessed to be high at the national and regional levels, and low globally.
                  WHO advice

                  The Strategic Advisory Group of Experts (SAGE) working group on Ebola vaccines and the SAGE members have reviewed the epidemiological situation and the evidence available with regard to the different candidate Ebola vaccines and the impact of different interventions. While ring vaccination remains the preferred strategy (as stated in the April 2017 SAGE report, a geographic targeted approach was proposed as an exceptional alternative if the ring vaccination around a laboratory-confirmed case of Ebola proves unfeasible. The following interim recommendation was agreed upon: “Should an Ebola disease outbreak occur before the candidate vaccine is licensed, SAGE recommended that the rVSV-ZEBOV Ebola vaccine be promptly deployed under the Expanded Access framework, with informed consent and in compliance with Good Clinical Practice. If the outbreak is caused by an Ebola virus species other than Zaire, consideration should be given to the use of other candidate vaccines that target the putative viral species”.
                  For more information, see:
                  As investigations continue to establish the full extent of this outbreak and the risk of national and regional spread remains high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. WHO will continue to work with neighbouring countries and partners to ensure health authorities are alerted and are operationally ready to respond.
                  WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event.
                  For more information, see:



                  1The number of cases is subject to change due to ongoing reclassification, retrospective investigation, and the availability of laboratory results.


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                  • #39
                    Translation Google
                    DIRECTORATE GENERAL FOR DISEASE CONTROL
                    EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
                    Friday 17 August 2018


                    The epidemiological situation of the Ebola Virus Disease dated August 16, 2018 :
                    • A total of 87 cases of haemorrhagic fever have been reported in the region, 60 confirmed and 27 probable.
                    • 21 suspected cases are under investigation .
                    • 9 new confirmed cases in Mabalako, including 2 care providers from the Mangina Reference Health Center. All of these new confirmed cases are probable and known case contacts.
                    • 4 deaths from confirmed cases in Mabalako.
                    * An analysis of the databases revealed that a non-case discharged from the Beni Ebola treatment center had been registered as a death. Thus, there are 3 deaths of confirmed cases in Beni, not 4.





                    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.
                    News of the response

                    Acceleration of the response to the epicenter of the epidemic
                    • On Friday, August 17, 2018, the Minister of Health, Dr. Oly Ilunga Kalenga, visited the teams deployed in Mangina (Mabalako Health Zone). In particular, he spoke with the additional surveillance teams sent in reinforcements who arrived since yesterday on site. With 2,157 contacts already registered, they have a huge amount of work to do to follow up on these contacts, to continue the investigations and the active search for cases, as well as to prepare the ground for the vaccination teams. The Minister then visited the new Mangina CTE which has a capacity of 50 beds. However, due to the rapid increase in confirmed cases, the coordination is considering the construction of a second CTE in Mangina.

                    A CTE care provider in Mangina puts on personal protective equipment

                    ...
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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

                    Comment


                    • #40
                      Translation Google
                      DIRECTORATE GENERAL FOR DISEASE CONTROL
                      EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
                      Saturday 18 August 2018


                      The epidemiological situation of the Ebola Virus Disease dated August 17, 2018 :
                      • A total of 90 cases of haemorrhagic fever were reported in the region, 63 confirmed and 27 probable.
                      • 25 suspected cases are under investigation .
                      • 3 new confirmed cases in Mabalako, including 1 care provider from the Mangina Reference Health Center. All of these new confirmed cases are probable and known case contacts.
                      • 2 deaths of confirmed cases in Mabalako.





                      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.
                      ...
                      https://us13.campaign-archive.com/?u...&id=a31174d27f
                      "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


                      • #41
                        Translation Google
                        DIRECTORATE GENERAL FOR DISEASE CONTROL
                        EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
                        Sunday 19 August 2018


                        The epidemiological situation of the Ebola Virus Disease dated August 18, 2018 :
                        • A total of 91 cases of haemorrhagic fever were reported in the region, 64 confirmed and 27 probable.
                        • 12 suspected cases are under investigation .
                        • 1 new confirmed case in Mabalako, which is a known and followed probable case contact.
                        • 1 confirmed case death in Mabalako.




                        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.
                        News of the response

                        Monitoring and follow-up of contacts
                        • Investigations by field epidemiologists have already invalidated several probable cases (or historical deaths) in the Mabalako area. This means that these historic deaths were not caused by the Ebola outbreak. Thus, several hundred contacts registered for these probable cases have been cleaned from the list of registered contacts. To date, surveillance teams have registered 1,609 contacts to follow . The invalidated probable cases will be officially removed from the summary table later when the investigations are completed.
                        • Of these contacts to be followed, there are 41 who are in a red zone to which the surveillance teams do not have access because of the security situation. Of these 41 contacts, 15 were able to travel to Beni to facilitate their follow-up and the organization of their vaccination. For the other contacts who remained in the red zone, the nursing staff of the on-site health center work with the community relays to ensure their follow-up and transmit the data daily to the coordination by phone.
                        Vaccination
                        • Immunization activities continue at the three sites of Mabalako, Beni and Mandima. Since vaccination began on August 8, 2018, 873 people have been vaccinated , including 467 in Mabalako, 256 in Beni and 150 in Mandima.


                        ...
                        https://us13.campaign-archive.com/?u...&id=793d5e7266
                        "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


                        • #42
                          EBOLA - Hope is at the end of the tunnel in Mangina - (East of the DRC)

                          Mangina (North Kivu), 17 August 2018 - "I was under a lot of stress and experienced insomnia mixed with nightmare all night," says Sister Darlène Mwasi, a registered nurse at the Mangina referral health centre, which is more than 30 kilometres southwest of the town of Beni in North Kivu.

                          As soon as the official confirmation on 1 August 2018, that the deadly Ebola virus had indeed arrived in Mangina, "I had tears in my eyes; it was a shock I had never experienced before," added the nurse.

                          Recorded as the tenth outbreak of the Ebola virus, Zaire strain, affecting the Democratic Republic of Congo in less than a week after the declaration of the end of the one that had affected the Equateur Province since May 2018, this highly deadly disease has appeared in a volatile and unpredictable zone due to the presence of armed groups.

                          The analysis of the first six samples, four of which tested positive at the INRB (Institut national de recherche biomédicale) national laboratory brought fear to everyone : the east of the DRC was in turn affected.

                          The nurse seemed to lack words to describe a rather unusual health emergency, in her eyes, that occurs at the health centre she is working. The first suspected cases were admitted at the end of July 2018, with the patients showing signs of intense and sudden fever, accompanied by chills, diarrhoea, vomiting or extremely intense fatigue.

                          “At first we thought it was severe malaria, as we used to have here before. And, as you know, our health workers were the first to receive and examine the affected patients without personal protective equipment,” explains Sister Darlène Mwasi. Since then, "we now have eight of our nurses infected; it's really sad," she adds.

                          The occurrence of Ebola in the area has created a wave of concern among the population. “I have seen many people die here since the disease was reported, and we were told that these people had died of Ebola,” says Athanase Ndungo Bonané, 67, a guard at the Mangina referral health centre for over 14 years.

                          He watches over these hospitals day and night and regularly sees all kinds of patients arriving for basic health care. “Suddenly, I had a painful feeling that we were all going to die here,” he confides in Kiswahili, one of the four most spoken official languages in all of eastern Democratic Republic of Congo.

                          From the very first hours of the response, the key components were strengthened: local coordination in Mangina with the presence of numerous experts, epidemiological surveillance on several places between North Kivu and Ituri, installation of hand washing devices using chlorine and temperature monitoring at the entrance to buildings and at priority entry and exit points, active case investigation, contacts tracing, sensitization of the population, case management, etc.

                          “In seeing these quick and effective health interventions, especially the Ebola vaccination, my friends in the neighbourhood and I have been relieved,'' said the energetic guard at the health centre.

                          According to preliminary investigations conducted by the competent health authorities, "at least 75 staff of this health establishment in Mangina have been in direct or indirect contact with confirmed cases of Ebola, without protection, and are allowed to rest at home to be better monitored daily for 21 days, the incubation period," said Dr. Bathé Ndjoloko Tambwe, Director General of Disease Control (DGLM) of the Ministry of Health.

                          To remedy this situation, “a reasonable financial contribution will be provided as motivation,” he stresses before indicating that other health workers from neighbouring health zones replace them during this period.

                          At the same time, to ensure that everyone has access to care during this period of the epidemic, the Ministry of Health decided to provide free care to all patients attending health centres in the region.

                          These positive advances are welcomed by other health officials in the region. “This will help us to provide not only the free patient care, but also with rapid detection of cases in our health facilities,” notes Musubao Tongo, a treating nurse who came from the nearby health zone of Oïcha with about fifty other colleagues to help out at the Mangina health centre.

                          Built in 1976 and managed by the Diocese of Butembo, a neighbouring town of Beni, Mangina's reference health centre is among the largest in the area, with an installed capacity of 119 beds. According to the figures of this health unit, each month, around 250 to 300 patients are admitted and between 700 and 800 outpatients are taken care of.

                          A note of hope that changes everything

                          The Minister of Health and partners (WHO, UNICEF, MSF, ALIMA, etc.) immediately made an initial visit to the place of the outbreak on 2 August 2018 for a rapid assessment of this outbreak. Then dozens of experts, all humanitarian organizations combined, set foot on Mangina's soil to organize the response.

                          The entire response mechanism has been put in place as a matter of urgency in order to ramp up and contain the disease. WHO has deployed its epidemiologists, logisticians, data managers, specialists in risk communication, social mobilization and community engagement, experts in infection prevention and control, etc., as well as a team of experts in the field of health care.
                          Other partners have also provided experts in various fields to effectively support local teams in the Mabalako health zone, which includes the affected Mangina health area.

                          “You see a small village like that, which was not so known before, and suddenly, it becomes famous and the whole world is interested in it. It gives us hope that the epidemic will be controlled quickly to allow us to go about our normal business,” said the nurse in a calm voice.

                          She added: “This is the first time we have seen the national health minister, the WHO Director-General and the Regional Director for Africa here. Their visit and the start of vaccination for people at risk have kept us in good spirits.”

                          https://www.afro.who.int/news/ebola-...ngina-east-drc
                          "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


                          • #43
                            Translation Google
                            DIRECTORATE GENERAL FOR DISEASE CONTROL
                            EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
                            Monday 20 August 2018


                            The epidemiological situation of the Ebola Virus Disease dated 19 August 2018 :
                            • A total of 96 cases of haemorrhagic fever were reported in the region, 69 confirmed and 27 probable.
                            • 5 suspected cases are under investigation .
                            • 5 new confirmed cases in Mabalako.
                            • 5 confirmed case deaths in Mabalako.




                            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.
                            News of the response

                            Free care
                            • The Ministry of Health has decreed free healthcare in the three health zones most affected by the epidemic, namely Mabalako, Oicha and Béni. Since Monday, August 20, 2018, free care is effective in the 7 public health centers of Mabalako and will be effective in other affected areas in the coming days.
                            Vaccination
                            • Immunization activities continue at the three sites of Mabalako, Beni and Mandima. Since vaccination began on August 8, 2018, 1,273 people have been vaccinated , including 697 in Mabalako, 367 in Beni and 209 in Mandima.
                            Supported
                            • A new Ebola Treatment Center (ETC) will be built in Makeke, Mandima Health Zone in Ituri Province. During the last visit of the Minister of Health to Mangina, the epicenter of the epidemic, it was found that the 50-bed CTE installed by Médecins Sans Frontières (MSF) was filling up rapidly and could no longer accommodate additional patients given the rapid increase in confirmed and suspicious cases to be supported. Thus, the coordination made the decision to install a second CTE in this area. Due to the lack of space in Mangina and the demands of the population, this new CTE will be built in Makeke, a neighboring area of ​​Mangina, which also reported confirmed cases.
                            Response Plan
                            • The response plan submitted by the Ministry of Health has been approved and all funds necessary for its implementation have been lifted. The Ministry of Health thanks the partners for their collaboration and contribution to the response.



                            ...
                            https://us13.campaign-archive.com/?u...&id=604fda8a2d
                            "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


                            • #44
                              Translation Google
                              DIRECTORATE GENERAL FOR DISEASE CONTROL
                              EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU
                              Tuesday 21 August 2018


                              The epidemiological situation of the Ebola Virus Disease dated August 20, 2018 :
                              • A total of 102 cases of haemorrhagic fever were reported in the region, 75 confirmed and 27 probable.
                              • 9 suspected cases are under investigation.
                              • 6 new confirmed cases, including 4 in Mabalako, 1 in Beni and 1 in Oicha.
                              • 4 confirmed cases, including 3 in Mabalako and 1 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.
                              News of the response

                              Supported
                              • The Ethics Committee approved the use of four additional experimental therapeutic molecules, namely ZMapp, Remdesivir, Favipiravir and Regn3450 - 3471 - 3479. Ebola Treatment Centers (ETC) treatment and care teams will be able to use these molecules for the treatment of patients infected with Ebola virus disease. The protocols for administering these molecules meet strict conditions related in particular to the condition of the patient, the ease of use of the treatment and the capacity of the medical team of the CTE. This Tuesday, August 21, 2018, the Remdesivir, produced by Gilead Sciences, was administered to a patient treated at CTE Beni, which is doing well. As a reminder, the mAb114 has started to be used since Saturday, August 11, 2018.

                              Vaccination
                              • Immunization activities continue at the three sites of Mabalako, Beni and Mandima. Since vaccination began on August 8, 2018, 1,693 people have been vaccinated , including 903 in Mabalako, 471 in Beni and 319 in Mandima.


                              ...
                              https://us13.campaign-archive.com/?u...&id=b6c7746a89
                              "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


                              • #45
                                Translation Google

                                Ebola: Stray dogs and cats pose great danger, says Dr. KAWA


                                Posted on: 22/08/2018 at 15h37min43s
                                By Radio Moto Butembo-Beni

                                This specialist in animal health calls for caution in the domestication of animals during this period of the Ebola virus outbreak. Dr KAWA NDAGHALA is the urban leader of the agriculture, fisheries and livestock service in Butembo.

                                In an interview with Radio Moto Butembo-Beni this Tuesday, August 21, 2018, Dr. KAWA NDAGHALA Robert invites breeders of dogs, cats and other animals to fight against the spread of the disease. This requires the partitioning of these animals into plots, he advises.

                                "Regarding dogs and cats, they are animals that can vehicular the disease from trash cans, from unhealthy places where the disease is already located. I do not speak of Butembo, but of all places. Especially those who have no fence, they do not know where their animals can go. We must therefore avoid the wandering of these animals. Dogs and cats that are not kept permanently at home can come back with dangerous things, "warns Dr. KAWA NDAGHALA.

                                Dr. KAWA NDAGHALA Robert asks those who have monkeys at home to remove them from their homes. Indeed, monkeys are among the animals already certified vectors of Ebola in the same way as the bat.

                                Our interlocutor has also issued a warning to those who still sell smoked meat and rats to the Kaghuntura shrine in Butembo. Dr. KAWA NDAWA Robert falls and calls all residents to avoid handling dead animals. In case of finding the disease of the beast, it is better to call quickly veterinarians, he concludes.

                                https://radiomotofm.info/lirearticle...Docteur%20KAWA
                                "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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