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    EPIDEMIOLOGICAL SITUATION
    EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI ON JANUARY 07, 2020

    Wednesday, January 08, 2020

    Since the start of the epidemic, the cumulative number of cases has been 3,392, of which 3,274 have been confirmed and 118 are probable. In total, there were 2,235 deaths (2,117 confirmed and 118 probable) and 1,122 people healed;
    • 521 suspected cases under investigation;
    1 New confirmed case in North Kivu in Beni;
    • 1 new death among the confirmed cases, of which:
    o No community death was recorded;
    o 1 death from confirmed cases in North Kivu in Beni;
    • No healed person has left the CTE;
    • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (approximately 5% of all confirmed / probable cases), including 41 deaths;
    Beni again notified a confirmed case after 29 days of silence.
    ...
    NEWS
    Beni reports confirmed # Ebola case after 29 days of silence

    • This is a known contact from Aloya-Metal for more than a week, announced the head of the epidemiological surveillance pillar at the Sub-coordination of the response to the epidemic of the #Ebola virus disease. Beni in North Kivu, Dr. Bibiche Matadi;
    • He is a 40-year-old man at the CTE of Beni in the Bundji health area, listed as the contact for a deceased and confirmed #Ebola case on December 21, 2019 in Mabalako and whose signs had started on December 16, 2019;
    • The Beni health zone is again re-infected from the Bundji health area, where the displaced persons from Lwemba and Aloya are placed in search of the vaccine against the Ebola virus;
    • For Dr Bibiche Matadi, this notification is due to the late warning and misinformation in the population camp. She said that a vaccination ring was installed in this health area to limit the spread of the virus;
    • To this end, it called on the population of Bundji to be vaccinated, to facilitate follow-up and all the other activities of the response which will be carried out around this new case of Beni;
    • 108 contacts were pre-listed around this case, including 14 family members, 1 pastor, 55 neighbors, 13 co-patients, 22 visitors and 3 care providers. The contact listing continues.

    Interception of four high-risk contacts at the Control Point in Kalaunguta in North Kivu
    • Four high-risk contacts, all from the same family, were intercepted at the Maboya Control Point in Kalunguta in the province of North Kivu;
    • They are listed around the confirmed case “Ebola of January 6, 2020 in Aloya in the health zone of Mabalako and presented each other the signs of the #Ebola virus disease, in particular fever, physical asthenia, anorexia, redness of the eyes and cough;
    • They were taken to the #Ebola Treatment Center in Mangina;
    • In addition, the disruption of surveillance activities at the Mutsanga and Kyaghala checkpoints in the Katwa health zone, also in North Kivu, has been reported following clashes between the FARDC and unidentified individuals.
    ...

    https://us3.campaign-archive.com/?u=...&id=40eaf9fb41
    "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


    • Source: https://www.who.int/csr/don/09-janua...-ebola-drc/en/
      Ebola virus disease – Democratic Republic of the Congo

      Disease outbreak news: Update
      9 January 2020



      Twelve new confirmed cases were reported from 1 to 7 January in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri Provinces. The confirmed cases in this week were reported from nine health areas in four health zones: Butembo (42%, n=5), Mambasa (33%, n=4), Mangina (17%, n=2), and Beni (8%, n=1). The new case reported in Beni is linked to a transmission chain that originated in Aloya Health Area, Mabalako Health Zone.

      In the past 21 days (18 December 2019 to 7 January 2020), 41 confirmed cases were reported from 13 health areas within six active health zones in North Kivu and Ituri Provinces (Figure 2, Table 1): Mabalako (49%, n=20), Butembo (22%, n=9), Kalunguta (12%, n=5), Mambasa (10%, n=4), Katwa (5%, n=2), and Beni (2%, n=1). Mabalako Health Zone remains the main hotspot of the outbreak having reported 49% of confirmed cases in the past 21 days. Although the majority of the cases (76%, n=31) are linked to known chains of transmission, there are concerns around the reintroduction of the disease into health zones with dense populations which have previously been cleared, such as Butembo, Katwa, and Beni Health Zones. The sources of exposure for five new cases reported in Kalunguta Health Zone and four new cases reported in Mambasa Health Zone in the past 21 days are currently under investigation.

      As of 7 January, a total of 3392 EVD cases were reported, including 3274 confirmed and 118 probable cases, of which 2235 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1903) were female, 28% (n=956) were children aged less than 18 years, and 169 (5% of all reported cases) were healthcare workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 7 January 2020*





      Enlarge image



      *3392 confirmed and probable cases, reported as of 7 January 2020. Excludes n=173 cases for whom onset dates not reported. 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, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyakunde, 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 7 January 2020*





      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 7 January 2020**





      Enlarge image



      **Total cases and areas affected 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: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 concluded that the national and regional risk levels remain very high, while global risk levels remain low. 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. 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 practise 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:

      Comment


      • WEEKLY BULLETIN ON OUTBREAKS
        AND OTHER EMERGENCIES
        Week 2: 6 – 12 January 2020
        Data as reported by: 17:00; 12 January 2020
        ...
        Ebola virus disease Democratic Republic of the Congo


        3 395 Cases
        2 235 Deaths
        66% CFR


        EVENT DESCRIPTION

        The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
        and Ituri provinces in Democratic Republic of the Congo continues,
        with seven health zones and 14 health areas reporting confirmed
        cases in the past 21 days (22 December 2019 to 11 January 2020).
        Since our last report on 5 January 2020 (Weekly Bulletin 1), there
        have been seven new confirmed cases and two new deaths. The
        principle hot spots of the outbreak in the past 21 days are Mabalako
        (38%; n=14 cases), Butembo (22%; n=8), Kalunguta (14%; n=5)
        and Mambasa (11%; n=4). Four health zones, Museienene, Beni,
        Mabalako and Mambasa have reported new confirmed cases in
        the past seven days. The new confirmed case in Beni is the first
        for 29 days, with the last confirmed case reported on 8 December
        2019 and the new confirmed case in Musienene Health Zone was
        registered in Katolo health area, not previously affected by EVD. The
        last new confirmed case in Musienene Health Zone was detected on
        31 August 2019.

        As of 11 January 2019, a total of 3 395 EVD cases, including 3 277
        confirmed and 118 probable cases have been reported. To date,
        confirmed cases have been reported from 29 health zones: Ariwara
        (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (82), Mandima
        (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in Ituri
        Province; Alimbongo (5), Beni (698), Biena (19), Butembo (295),
        Goma (1), Kalunguta (198), Katwa (653), Kayna (28), Kyondo (25),
        Lubero (31), Mabalako (453), Manguredjipa (18), Masereka (50),
        Musienene (85), Mutwanga (32), Nyiragongo (3), Oicha (65), Pinga
        (1) and Vuhovi (103) in North Kivu Province and Mwenga (6) in
        South Kivu Province.

        As of 11 January 2020, a total of 2 235 deaths were recorded,
        including 2 114 among confirmed cases, resulting in a case fatality
        ratio among confirmed cases of 65% (2 117/3 277). The cumulative
        number of health workers remains 169, which is 5% of the confirmed
        and probable cases to date.

        Contact tracing is ongoing in 11 health zones. A total of 3 769
        contacts are under follow-up as of 11 January 2020, of which 3 365
        (89.3%) have been seen in the past 24 hours. Alerts in the affected
        provinces continue to be raised and investigated. Of 4 578 alerts
        processed (of which 4 448 were new) in reporting health zones on
        11 January 2020, 4 481 were investigated and 460 (10.3%) were
        validated as suspected cases.

        PUBLIC HEALTH ACTIONS

        Response and surveillance activities continue in all affected areas,
        with disruption to surveillance activities at the PoC at Mutsanga
        and Kyaghala in Katwa after a confrontation with National Police;
        there was an abrupt stop to vaccination activities in the Biakato
        Mines area after rumours of a probable attack on responders.
        As of 7 January 2020, a cumulative total of 264 682 people have
        been vaccinated since the start of the outbreak in August 2018.
        Point of Entry/Point of Control (PoE/PoC) screening continues,
        with over 138 million screenings to date. A total of 106/109
        (99.7%) PoE/PoC transmitted reports as of 11 January 2020.
        Water, sanitation and hygiene (WASH) activities continue, with six
        health facilities evaluated in Beni and Mabalako health zones and
        IPC kits were dontated, while 23 health facilities were monitored
        in Oicha, Mabalako and Mambasa.

        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.

        Traditional healers and managers of private structures which had
        contact with suspected EVD cases were persuaded to participate
        in response activities after community dialogue in Aloya,
        Mabalako Health Zone and a forum for popular expression was
        also organized with village chiefs and civil society leaders with
        the aim of removing resistance to the off-protocol vaccination
        organized in Métal and Aloya.

        SITUATION INTERPRETATION

        New confirmed cases continue to be reported in Mabalako, Butembo
        and Kalunguta in North Kivu Province and in Mambasa in Ituri Province.
        The new confirmed cases in Mambasa are of concern, since there had
        been no new confirmed cases in Ituri Province for 66 days. Additionally,
        new cases were confirmed in Beni and Musienene where there have
        been non new confirmed cases for 29 and 132 days respectively.
        Resistance to response activities continues, particulary in North Kivu
        Province.
        However, there are continued efforts to engage with the
        community and to upscale response activities in affected regions in
        order to bring the outbreak to a close.

        https://apps.who.int/iris/bitstream/...0612012020.pdf
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • Translation Google

          EPIDEMIOLOGICAL SITUATION
          EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI ON JANUARY 13, 2020


          Tuesday, January 14, 2020

          • Since the start of the epidemic, the cumulative number of cases has been 3,403, of which 3,285 have been confirmed and 118 are probable. In total, there were 2,236 deaths (2,118 confirmed and 118 probable) and 1,123 people healed;
          • 502 suspected cases under investigation;
          5 new cases confirmed in North Kivu at 4 Mabalako and 1 at Beni;
          • 1 new death among the confirmed cases, of which:
          o No community death was recorded;
          o 1 death among the confirmed cases of the CTE in North Kivu in Beni;
          • 1 healed person leaving the CTE in North Kivu in Butembo;
          • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (approximately 5% of all confirmed / probable cases), including 41 deaths.
          ...
          https://us3.campaign-archive.com/?u=...&id=0925511401
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • Translation Google


            Ituri: four Ebola response workers seriously injured in attack on youths armed with edged weapons

            Posted on Wed, 1/15/2020 - 11:23 | Modified on Wed, 15/01/2020 - 11:23

            Angry demonstrators, armed with knives, attacked a response team against Ebola on Monday 13 January in Bandimwame, a town located 32 kilometers from Mambasa-center (Ituri).

            Seven officers were in a vehicle when they were attacked. Four of them were seriously injured and were taken to Nyakunde hospital 45 kilometers from Bunia.

            The other three response officers who were in the vehicle fled into the forest. Two of them went out a few hours after the incident. One is still missing.

            Angry youths suspected the response team had mutilated the body of a dead child at the Ebola treatment center in Mambasa.

            Rather, Ituri response coordinator Christoph Shako said the officers were on their way to Bandimwame to secure the burial of a dead child at the Ebola Treatment Center in Mambasa.

            He recommends that the local community continue to observe hygiene measures, because this epidemic is not yet under control.

            For his part, the administrator of the Mambasa territory asks the population not to give in to rumors to commit violence against the response team.

            He adds that thirteen people were arrested by the police, including the chief of the locality of Bandimwame for investigations.


            https://www.radiookapi.net/2020/01/1...esses-dans-une
            "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


            • Source: https://www.who.int/csr/don/16-janua...-ebola-drc/en/
              Ebola virus disease – Democratic Republic of the Congo

              Disease outbreak news: Update
              16 January 2020



              Fourteen new confirmed cases were reported from 8 to 14 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. The confirmed cases were reported from Mabalako (64%, n=9), Beni (29%, n=4) and Musienene (7%, n=1) Health Zones in North Kivu Province. All new confirmed cases (100%, 14/14) reported in the past seven days were registered contacts prior to symptom onset and had epidemiological links to the transmission chain which originated from Aloya Health Area in Mabalako Health Zone.

              In the past 21 days (25 December 2019 to 14 January 2020), 40 confirmed cases were reported from 14 health areas within seven active health zones in North Kivu and Ituri Provinces (Figure 1, Figure 2, Table 1): Mabalako (43%, n=17), Butembo (20%, n=8), Beni (13%, n=5), Mambasa (10%, n=4), Kalunguta (8%, n=3), Katwa (5%, n=2), and Musienene (3%, n=1). Mabalako Health Zone remains the current hotspot of the outbreak, having reported 43% of confirmed cases in the past 21 days. The majority of cases (88%, 35/40) reported from this period are linked to known chains of transmission, which is similar to the period from 4 to 24 December 2019 (89%, 47/53). In the past 21 days, 8% (3/36) of the confirmed EVD deaths were people who died in the community, outside of Ebola treatment centres. From these three community deaths, 15 additional cases occurred, which reinforces the need for continued activities to follow contacts, detect symptomatic patients as early as possible, and engage communities in response efforts.

              As of 14 January, a total of 3406 EVD cases were reported, including 3288 confirmed and 118 probable cases, of which 2236 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1910) were female, 28% (n=960) were children aged less than 18 years, and 169 (5% of all reported cases) were health care workers.

              In the coming week, there will be nine health zones in North Kivu and Ituri Provinces that will have contacts in or entering their high-risk period (seven to 13 days after last exposure to the virus). In Kalunguta Health Zone, North Kivu Province, where five individuals were confirmed with EVD from 24 to 28 December 2019, all 153 contacts have cleared their 21-day follow-up, with no new cases reported. In Mambasa Health Zone, Ituri Province, where four new cases were reported from 4 to 5 January 2020, more than 400 followed contacts are nearing the end of their high-risk period.

              It has been 20 months since the outbreak was first declared on 8 May 2018. The number of cases reported per week is lower than the period from March to September 2019 (Figure 1). However, there are several health areas which are difficult to reach due to insecurity, including Mandima Health Zone, where there are rumours of several community deaths in Lwemba Health Area. Continued response efforts in active health zones, including in insecure areas, and preventing reintroduction of the disease into health zones with dense populations which have previously been cleared are crucial to ending ongoing transmission. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 14 January 2020*





              Enlarge image



              *3406 confirmed and probable cases, reported as of 14 January 2020. Excludes n=173 cases for whom onset dates not reported. 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, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Mutwanga, Mwenga, Nyakunde, 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 14 January 2020*





              Enlarge image
              Table 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 14 January 2020**





              Enlarge image



              **Total cases and areas affected 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: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 concluded that the national and regional risk levels remain very high, while global risk levels remain low. 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. 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 practise 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:

              Comment


              • WEEKLY BULLETIN ON OUTBREAKS
                AND OTHER EMERGENCIES
                Week 3: 13 - 19 January 2020

                Data as reported by: 17:00; 19 January 2020
                ...
                Ebola virus disease Democratic Republic of the Congo

                3 412 Cases
                2 237 Deaths
                66% CFR

                EVENT DESCRIPTION

                The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
                and Ituri provinces in Democratic Republic of the Congo continues,
                with six health zones and 13 health areas reporting confirmed cases
                in the past 21 days (29 December 2019 to 18 January 2020). Since
                our last report on 12 January 2020 (Weekly Bulletin 2), there have
                been 16 new confirmed cases and two new deaths. The principle hot
                spots of the outbreak in the past 21 days are Mabalako (35%; n=13
                cases), Beni (27%; n=10), Butembo (19%; n=7), and Mambasa
                (11%; n=4). Two health zones, Beni and Mabalako, have reported
                new confirmed cases in the past seven days.

                As of 18 January 2019, a total of 3 412 EVD cases, including 3 293
                confirmed and 119 probable cases have been reported. To date,
                confirmed cases have been reported from 29 health zones: Ariwara
                (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (82), Mandima
                (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in Ituri
                Province; Alimbongo (5), Beni (705), Biena (19), Butembo (295),
                Goma (1), Kalunguta (198), Katwa (653), Kayna (28), Kyondo (25),
                Lubero (31), Mabalako (462), Manguredjipa (18), Masereka (50),
                Musienene (85), Mutwanga (32), Nyiragongo (3), Oicha (65), Pinga
                (1) and Vuhovi (103) in North Kivu Province and Mwenga (6) in
                South Kivu Province.

                As of 18 January 2020, a total of 2 237 deaths were recorded,
                including 2 118 among confirmed cases, resulting in a case fatality
                ratio among confirmed cases of 64% (2 118/3 293). As of 18
                January 2020, the total number of health workers affected has risen
                to 171, still representing 5% of confirmed and probable cases.
                Contact tracing is ongoing in seven health zones. A total of 2 688
                contacts are under follow-up as of 18 January 2020, of which 2 539
                (94.5%) have been seen in the past 24 hours. Alerts in the affected
                provinces continue to be raised and investigated. Of 5 018 alerts
                processed (of which 4 939 were new) in reporting health zones on
                18 January 2020, 4 916 were investigated and 438 (8.9%) were
                validated as suspected cases.

                PUBLIC HEALTH ACTIONS

                Response and surveillance activities continue in all affected
                areas. However, there was an attack on reponse teams in
                Masereka during the reporting period, and the security situation
                in Bunia is precarious.

                As of 18 January 2020, a cumulative total of 269 480 people have
                been vaccinated since the start of the outbreak in August 2018.

                Point of Entry/Point of Control (PoE/PoC) screening continues,
                with over 140 million screenings to date. A total of 106/109
                (97.2%) PoE/PoC transmitted reports as of 18 January 2020.

                Water, sanitation and hygiene (WASH) activities continue, with
                16 health facilities evaluated in Beni and Mabalako health zones
                and 283 hand washing points evaluated in Oicha, Mabalako and
                Mambasa.

                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.

                In Beni, the Bundji neighbourhood chief and community leaders
                mobilized the local population to increase vigilance with visitors
                and collaboration with response teams. In addition, 218 heads
                of households around the last confirmed cases in Mabalako and
                Beni health zones were sensitized to response activities; in Ndini
                a public forum was organized with the nearby town of Beni to
                alert the population to the resurgence of EVD in Beni Health Zone.

                SITUATION INTERPRETATION

                New confirmed cases continue to be reported in Beni, Mabalako and
                Butembo in North Kivu Province in areas that have not seen new
                cases for several weeks. Resistance to response activities continues,
                particularly in North Kivu Province, which continues to hamper response
                efforts, with resulting resurgence of transmission.
                There are continued
                efforts to engage with the community and to upscale response activities
                in affected regions in order to bring the outbreak to a close.

                https://apps.who.int/iris/bitstream/...1319012020.pdf
                "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


                • Source: https://www.who.int/csr/don/23-janua...-ebola-drc/en/

                  Ebola virus disease – Democratic Republic of the Congo

                  Disease outbreak news: Update
                  23 January 2020

                  Nine new confirmed cases were reported from 15 to 21 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. All of the cases were reported from Beni Health Zone in North Kivu Province. Eight of the cases (8/9) were registered contacts prior to symptom onset; all nine had epidemiological links to a confirmed case.
                  In the past 21 days (1 to 21 January 2020), 35 confirmed cases were reported from 11 health areas within five active health zones in North Kivu and Ituri Provinces (Figure 1, Figure 2, Table 1): Beni (n=14), Mabalako (n=11), Butembo (n=5), Mambasa (n=4), and Musienene (n=1). Beni and Mabalako Health Zones remain the current hotspots of the outbreak, having reported 71% of confirmed cases in the past 21 days. Of the 35 people confirmed with EVD in the past 21 days, 24 were isolated and provided care within the first two days after the onset of symptoms, meaning they have better chances of survival and are less likely to infect contacts in the community. In the past 21 days, only one confirmed EVD death occurred in the community, outside of an Ebola treatment centre.
                  In recent weeks, contacts of confirmed cases have been offered the option of staying in supportive accommodation allocated for identified EVD contacts where they are provided with food and other essential goods. This allows for systematic daily follow-up of contacts and enables prompt isolation and provision of care to contacts that become symptomatic. As a result, the median time to isolation in the past 21 days has decreased from three days to one day (interquartile range 0-3).
                  The number of new confirmed cases reported each week has remained stable over the past six weeks, with approximately 14 new EVD cases reported weekly. In addition, improved surveillance indicators such as the proportion of cases listed as contacts and followed prior to detection, and the decreased time to isolation of cases are encouraging signs.
                  As of 21 January, a total of 3416 EVD cases were reported, including 3297 confirmed and 119 probable cases, of which 2238 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1912) were female, 28% (n=963) were children aged less than 18 years, and 5% (n=172) of all reported cases) were healthcare workers.
                  Analysis of ongoing chain of transmission

                  As of 21 January, the current transmission chain is comprised of 82 confirmed and probable cases reported in 13 health areas in six health zones; Mabalako, Beni, Biena, Butembo, Katwa, and Musienene Health Zones. The transmission chain originated from one individual who was classified as a relapse of EVD in Aloya Health Area, Mabalako Health Zone (first reported in the Disease Outbreak News published on 19 December 2019). The individual, which is the first and only case of relapse documented in this outbreak, was infected in June 2019, relapsed in November, and passed away in December.
                  Further analyses indicate that the individual directly infected 29 people while symptomatic in the community for nine days before being isolated. Of the cases who were directly infected from this case, 11/29 were through possible nosocomial transmission. The remaining 52 cases resulted from onward transmissions.
                  Based on available information regarding the place of exposure for cases in this transmission chain, the main drivers are individuals exposed in the community due to delays to case isolation (50%, 41/82), possible nosocomial transmission (37%, 30/82), and community deaths where cases were exposed during funerals (2%, 2/82). The estimated reproduction number (R), which is the expected number of secondary cases produced by a single infection in a susceptible population, of this transmission chain was not statistically significantly different from the overall mean R of this outbreak, likely due to the limited sample size of cases in the transmission chain which originated in Aloya Health Area. These findings reinforce the importance of early identification of cases and safe and dignified burials.
                  Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 21 January 2020*




                  Enlarge image
                  *3416 confirmed and probable cases, reported as of 21 January 2020. Excludes n=169 cases for whom onset dates not reported. 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, Bunia, Goma, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Mutwanga, Mwenga, Nyakunde, 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 21 January 2020*




                  Enlarge image
                  Table 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 21 January 2020**




                  Enlarge image
                  **Total cases and areas affected 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: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 concluded that the national and regional risk levels remain very high, while global risk levels remain low.
                  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. 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 practise 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:

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                  Comment


                  • WEEKLY BULLETIN ON OUTBREAKS
                    AND OTHER EMERGENCIES
                    Week 4: 20 - 26 January 2020

                    Data as reported by: 17:00; 26 January 2020
                    ...
                    Ebola virus disease Democratic Republic of the Congo

                    3 416 Cases
                    2 239 Deaths
                    66% CFR


                    EVENT DESCRIPTION

                    The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
                    and Ituri provinces in Democratic Republic of the Congo continues,
                    with four health zones and seven health areas reporting 28 new
                    confirmed cases in the past 21 days (5 to 25 January 2020). Since
                    our last report on 19 January 2020 (Weekly Bulletin 3), there have
                    been five new confirmed cases and three new deaths. The principle
                    hot spots of the outbreak in the past 21 days are Beni (54%; n=15),
                    Mabalako (36%; n=10 cases) and Butembo (12%; n=4).
                    One health
                    zone, Beni, has reported new confirmed cases in the past seven
                    days.

                    As of 25 January 2019, a total of 3 417 EVD cases, including 3 298
                    confirmed and 119 probable cases have been reported. To date,
                    confirmed cases have been reported from 29 health zones: Ariwara
                    (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (82), Mandima
                    (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in Ituri
                    Province; Alimbongo (5), Beni (710), Biena (19), Butembo (295),
                    Goma (1), Kalunguta (198), Katwa (653), Kayna (28), Kyondo (25),
                    Lubero (31), Mabalako (462), Manguredjipa (18), Masereka (50),
                    Musienene (85), Mutwanga (32), Nyiragongo (3), Oicha (65), Pinga
                    (1) and Vuhovi (103) in North Kivu Province and Mwenga (6) in
                    South Kivu Province.

                    As of 25 January 2020, a total of 2 240 deaths were recorded,
                    including 2 121 among confirmed cases, resulting in a case fatality
                    ratio among confirmed cases of 64% (2 121/3 298). As of 25
                    January 2020, the total number of health workers affected has risen
                    to 172, still representing 5% of confirmed and probable cases.
                    Contact tracing is ongoing in five health zones. A total of 2 112
                    contacts are under follow-up as of 25 January 2020, of which 2 017
                    (95.5%) have been seen in the past 24 hours. Alerts in the affected
                    provinces continue to be raised and investigated. Of 5 572 alerts
                    processed (of which 5 471 were new) in reporting health zones on
                    25 January 2020, 5 439 were investigated and 494 (9.1%) were
                    validated as suspected cases.

                    PUBLIC HEALTH ACTIONS

                    Response and surveillance activities continue in all affected
                    areas. However, there was an attack on reponse teams in
                    Masereka during the reporting period, and the security situation
                    in Bunia is precarious.

                    Military personnel have been deployed to Munze, a town a few
                    kilometres away from Mangina, to counter militia incursions that
                    could disrupt response activities in the area.

                    As of 25 January 2020, a cumulative total of 275 485 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 144 million screenings to date. A total of 105/109
                    (96.3%) PoE/PoC transmitted reports as of 22 January 2020.

                    Water, sanitation and hygiene (WASH) activities continue, with
                    392 healthworkers briefed in Beni, Oicha. Butembo and Mambasa
                    and there was formative assessment of 553 hand-washing points
                    in the same health zones.

                    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.

                    A mass campaign “let’s all vaccinate against EVD” was launched
                    in Aloya, Mabalako Health Zone and Mambasa. In addition, the
                    commission continued with community dialogue to persuade the
                    community to be vaccinated and to persuade traditional healers
                    and health structures to collaborate in the transfer of suspected
                    cases to the Ebola treatement and transit centres in Aloya, Beni
                    and Biakato.

                    SITUATION INTERPRETATION

                    New confirmed cases continue to be reported in Beni and Mabalako and
                    Butembo in North Kivu Province. Enhanced surveillance performance
                    has helped ensure faster isolation of sick individuals, which in turn
                    decreases the likelihood of infection in the community. Continued
                    access and heightened vigilance is required to sustain these gains in
                    case investigation and contact tracing activities.

                    https://apps.who.int/iris/bitstream/...2026012020.pdf
                    "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


                    • Source: https://www.who.int/csr/don/30-janua...-ebola-drc/en/
                      Ebola virus disease – Democratic Republic of the Congo

                      Disease outbreak news: Update
                      30 January 2020



                      From 22 to 28 January five new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. All five cases were reported from Beni Health Zone and had epidemiological links to the transmission chain which originated in Aloya Health Area, Mabalako Health Zone. The most likely exposure for all these cases was through nosocomial infection in traditional practitioner facilities. All of the cases were identified as contacts but were not followed up at the time of detection.

                      One confirmed case reported on 20 January stayed in the community for four days prior to being admitted to an Ebola treatment centre (ETC) and infected two additional people in the community. These two individuals, reported on 27 January, stayed four to five days in the community while symptomatic prior to isolation. One other confirmed case stayed in the community for eight days after symptom onset and passed away in the community on 28 January. Confirmed cases who spend time in the community increase the risk of transmission of EVD to contacts. Therefore, further cases can be expected in the coming two weeks in Bundji and Kanzulinzuli Health Areas and neighbouring health areas in Beni Health Zone.

                      In the past 21 days (8 to 28 January 2020), 28 confirmed cases were reported from five health areas within three active health zones in North Kivu Province (Figure 1, Figure 2, Table 1): Beni (n=18), Mabalako (n=9), and Musienene (n=1). Beni Health Zone remains the current hotspot of the outbreak, having reported 64% of confirmed cases in the past 21 days. As of 28 January, the following health zones marked more than 21 days without confirmed cases of EVD: Mambasa Health Zone in Ituri Province (23 days), and Butembo (25 days) Health Zone in North Kivu Province. Of the 28 people confirmed with EVD in the past 21 days, 20 were isolated and provided care within the first two days after symptom onset, which means that they have better chances of survival and are less likely to infect contacts in the community.

                      In the past 21 days encouraging trends about the development of the outbreak have been observed. The past epidemiological week (20 to 26 January 2020) saw the smallest number of cases reported since the beginning of the response; cases have been reported in five health areas in three health zones; contact tracing performance as well as the daily number of reported alerts continue to improve over time (Figure 3, Figure 4). Contact tracing has notably improved as a result of the provision of accommodation and essential services in Beni Health Zone to known contacts who have agreed to be followed. Despite these encouraging signs, continuous vigilance is warranted in order to overcome remaining challenges. Possible nosocomial transmission linked to traditional practitioner facilities remains a major driver of the current outbreak and poses specific challenges such as contact identification.

                      As of 28 January, a total of 3421 EVD cases were reported, including 3302 confirmed and 119 probable cases, of which 2242 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1918) were female, 28% (n=963) were children aged less than 18 years, and 5% (n=172) of all reported cases were health care workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 28 January 2020*





                      Enlarge image



                      **3421 confirmed and probable cases, reported as of 28 January 2020. Excludes n=169 cases for whom onset dates not reported. 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, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Mutwanga, Mwenga, Nyakunde, 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 28 January 2020*





                      Enlarge image
                      Figure 3. Alerts of Ebola virus disease reported, investigated, and validated daily from outbreak affected areas in the Democratic Republic of the Congo, as of 28 January 2020





                      Enlarge image
                      Figure 4. Number of contacts registered and followed up each day, as of 28 January 2020





                      Enlarge image
                      Table 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 28 January 2020**





                      Enlarge image



                      **Total cases and areas affected 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: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 concluded that the national and regional risk levels remain very high, while global risk levels remain low. 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. 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 practise 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:

                      Comment


                      • Translation Google

                        North Kivu: Dr Muyembe announces the relocation of the coordination of the response to Ebola in Beni

                        Posted on Fri, 1/31/2020 - 10:32 AM | Modified on Fri, 31/01/2020 - 10:32

                        The national coordination of the response to Ebola will soon be based again in Beni, the new epicenter of this epidemic. The announcement was made Thursday, January 30, to the Governor of North Kivu Province by Dr. Jean-Jacques Muyembe, coordinator of the technical secretariat of the multisectoral committee for the response to the Ebola virus disease.

                        For Dr Muyembe, this relocation will bring coordination closer to the affected area for quick responses.

                        The situation is currently alarming in Beni, where new positive cases of Ebola have been recorded following population movements.

                        He also said that precautionary measures were being taken to save people in North Kivu from the coronavirus epidemic, which is raging in China.

                        https://www.radiookapi.net/2020/01/3...dination-de-la
                        "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


                        • WEEKLY BULLETIN ON OUTBREAKS
                          AND OTHER EMERGENCIES
                          Week 5: 27 January - 2 February 2020
                          Data as reported by: 17:00; 2 February 2020
                          ...


                          Ebola virus disease Democratic Republic of the Congo

                          3 428 Cases
                          2 250 Deaths
                          66% CFR

                          EVENT DESCRIPTION

                          The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
                          and Ituri provinces in Democratic Republic of the Congo continues.
                          Since our last report on 26 January 2020 (Weekly Bulletin 4), there
                          have been seven new confirmed cases in Beni (n=6) and Mabalako
                          (n=1), with six new deaths. In the past 21 days (12 January to 1
                          February 2020), 28 new confirmed cases were reported in Beni
                          (64%; n=18) and Mabalako (36%; n=10 cases) health zones.
                          At the
                          same time, 27 health zones have not reported confirmed cases for
                          more than 21 days.

                          As of 1 February 2019, a total of 3 423 EVD cases, including 3 305
                          confirmed and 123 probable cases have been reported. To date,
                          confirmed cases have been reported from 29 health zones: Ariwara
                          (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (82), Mandima
                          (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in Ituri
                          Province; Alimbongo (5), Beni (716), Biena (19), Butembo (295),
                          Goma (1), Kalunguta (198), Katwa (653), Kayna (28), Kyondo (25),
                          Lubero (31), Mabalako (463), Manguredjipa (18), Masereka (50),
                          Musienene (85), Mutwanga (32), Nyiragongo (3), Oicha (65), Pinga
                          (1) and Vuhovi (103) in North Kivu Province and Mwenga (6) in
                          South Kivu Province.

                          As of 1 February 2020, a total of 2 250 deaths were recorded,
                          including 2 127 among confirmed cases, resulting in a case fatality
                          ratio among confirmed cases of 64% (2 127/3 305). As of 1 February
                          2020, the total number of health workers affected remains at 172,
                          representing 5% of confirmed and probable cases.
                          Contact tracing is ongoing in three health zones. A total of 2 374
                          contacts are under follow-up as of 1 February 2020, of which 2 053
                          (86.5%) have been seen in the past 24 hours. Alerts in the affected
                          provinces continue to be raised and investigated. Of 4 965 alerts
                          processed (of which 4 963 were new) in reporting health zones on
                          1 February 2020, 4 963 were investigated and 447 (9.0%) were
                          validated as suspected cases.

                          PUBLIC HEALTH ACTIONS

                          Response and surveillance activities continue in all affected
                          areas. However, the security situation is worrying in some areas.
                          In Oicha a new incursion resulted in civilian casualties and in
                          Musienene and Biena response activities have been paralyzed by
                          the presence of armed militia. In Butembo and Katwa, security
                          has been reinforced.

                          As of 1 February 2020, a cumulative total of 283 899 people have
                          been vaccinated since the start of the outbreak in August 2018.
                          Point of Entry/Point of Control (PoE/PoC) screening continues,
                          with over 146 million screenings to date. A total of 104/109
                          (95.4%) PoE/PoC transmitted reports as of 1 February 2020.
                          Water, sanitation and hygiene (WASH) activities continue and as
                          of 1 February 2020, 133 health facilities have been evaluated in
                          Beni, Oicha, Kalunguta, Butembo and Mabalakao; at the same
                          time 255/290 providers were briefed on IPC measures.

                          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.

                          The Deputy Mayor of Beni, who is determined to end EVD in his
                          town, accompanied contacts identified to the vaccination site at
                          the Kanzulinzuli health area; additionally, 49 heads of household
                          around the confirmed case of 28 January 2020, were persuaded
                          to participate in response activities.

                          SITUATION INTERPRETATION

                          New confirmed cases continue to be reported in Beni and Mabalako
                          Health Zones. The ongoing insecurity in these regions is of grave
                          concern, with the potential to disrupt response activities,
                          which will
                          lead to further transmission of EVD. Continued access and heightened
                          vigilance is required as well as the need to maintain case investigation
                          and contact tracing activities.

                          https://apps.who.int/iris/bitstream/...0102022020.pdf
                          "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


                          • Source: https://www.who.int/csr/don/06-febru...-ebola-drc/en/
                            Ebola virus disease – Democratic Republic of the Congo

                            Disease outbreak news: Update
                            6 February 2020



                            From 29 January to 4 February four new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. All four cases were reported in Beni Health Zone, North Kivu Province. Three cases had epidemiological links to the transmission chain which originated in Aloya Health Area, Mabalako Health Zone, and their most likely exposure was through nosocomial infection in traditional practitioner facilities. The fourth and most recent case reported in Beni Health Zone was not a known contact at the time of detection, stayed in the community for nine days after symptom onset, and passed away in the community on 4 February. Confirmed cases who spend time in the community increase the risk of transmission of EVD to contacts.

                            In the past 21 days (15 January to 4 February January 2020), 18 confirmed cases, including three community deaths, were reported from three health areas within two active health zones in North Kivu Province (Figure 1, Figure 2, Table 1): Beni (n=17) and Mabalako (n=1). The reduction of geographic spread of EVD cases and the declining trend in case incidence observed in the past 21 days are encouraging. In addition, monthly surveillance indicators have overall improved since October 2019. These indicators include an increase in proportion of cases registered as contacts, a decrease in the proportion of community deaths among new reported cases, a decrease in delay to isolation, and a decrease in the monthly case fatality ratio.

                            These improvements are fragile and should not be interpreted as an indication that response efforts can be reduced. Among the 18 people confirmed with EVD in the past 21 days, nine cases were isolated and provided care three or more days after symptom onset, which increases the possibility of community transmission. The four most recent cases reported in Beni Health Zone in the past seven days were not under surveillance at the time of detection. Therefore, heightened vigilance of the response is critical, including continued identification of cases and contacts, follow up of contacts, and continuing to improve infection prevention and control in health care facilities.

                            As of 4 February, a total of 3429 EVD cases were reported, including 3306 confirmed and 123 probable cases, of which 2251 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1920) were female, 28% (n=967) were children aged less than 18 years, and 5% (n=172) of all reported cases were health care workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 4 February 2020*





                            Enlarge image



                            *3429 confirmed and probable cases, reported as of 4 February 2020. Excludes n=169 cases for whom onset dates not reported. 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, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Manguredjipa, Masereka, Mutwanga, Mwenga, Nyakunde, 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 4 February 2020*





                            Enlarge image
                            Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu Province, Democratic Republic of the Congo, data as of 4 February 2020**





                            Enlarge image



                            **Total cases and areas affected 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: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 concluded that the national and regional risk levels remain very high, while global risk levels remain low. 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. 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 practise 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:

                            Comment




                            • World Health Organization (WHO)

                              @WHO
                              ˇ
                              1h
                              "Tomorrow, the Emergency Committee will meet to assess whether the #Ebola outbreak in #DRC continues to constitute a public health emergency of international concern"-
                              @DrTedros

                              "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


                              • Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020

                                12 February 2020
                                Statement

                                Geneva, Switzerland The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).

                                Proceedings of the meeting


                                Members and advisors of the Emergency Committee were convened by teleconference.

                                The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.

                                Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.

                                Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

                                Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

                                The Chair then reviewed the agenda for the meeting and introduced the presenters.

                                Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

                                The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

                                Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.

                                The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.

                                A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.

                                The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.

                                The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.

                                Context and Discussion


                                The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.

                                Conclusions and Advice


                                It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

                                The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.

                                The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.

                                The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.

                                The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).

                                For DRC:
                                • Sustain the political commitment and multisectoral coordination approach to the response.
                                • Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
                                • Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
                                • Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
                                • Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
                                • Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
                                • Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
                                • Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
                                • Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
                                • Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).

                                For countries at risk:
                                • At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
                                • Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
                                • Risk communications and community engagement, especially at points of entry, should be maintained.

                                For all countries:
                                • As recommended previously, no country should close its borders or place any restrictions on travel and trade.
                                • The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.

                                The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

                                Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

                                The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.

                                https://www.who.int/news-room/detail...-february-2020
                                "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

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