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  • Source: https://www.who.int/csr/don/13-febru...-ebola-drc/en/
    Ebola virus disease – Democratic Republic of the Congo

    Disease outbreak news: Update
    13 February 2020



    This week, the case incidence continued to be low in the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (Figure 1). From 5 to 11 February, three new confirmed cases were reported in Beni Health Zone, North Kivu Province. All three cases have epidemiological links to a transmission chain originating in Aloya Health Area, Mabalako Health Zone, with possible nosocomial exposure in Beni. The most recent case reported from Beni Health Zone on 11 February was isolated one day after symptom onset. Early detection of cases reduces the probability of transmission of EVD in the community and significantly improves the clinical outcome for the patients.

    In the past 21 days (22 January to 11 February 2020), 12 confirmed cases, including three community deaths, were reported from four health areas within two active health zones in North Kivu Province (Figure 2, Table 1): Beni (n=11) and Mabalako (n=1). It has been 42 days since Katwa Health Zone has reported new cases. The continued reduction of geographic spread of EVD cases and the declining trend in case incidence observed in the past 21 days are encouraging; however, these improvements remain fragile and should not be interpreted as an indication that response efforts can be reduced. Continued vigilance is essential to improve infection prevention and control in health care facilities, as well as ensuring early identification and follow up of cases and contacts.

    As of 11 February, a total of 3432 EVD cases were reported, including 3309 confirmed and 123 probable cases, of which 2253 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1923) were female, 28% (n=968) were children aged less than 18 years, and 5% (n=172) of all reported cases were health care workers.

    On 12 February, the WHO Director-General reconvened the Emergency Committee under the International Health Regulations (IHR). The Committee reviewed progress in the implementation of the Temporary Recommendations issued on 18 October 2019. Updates on the outbreak were provided by representatives of the Ministry of Health of the Democratic Republic of the Congo, the UN Ebola Emergency Response Coordinator and the WHO Secretariat. The situation in neighbouring countries was reviewed, as well as preparedness in nonaffected areas of the Democratic Republic of the Congo. It was the view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC). Further details can be found in the Emergency Committee Statement.

    On 10 February, WHO published new guidlines for healthcare providers regarding the management of pregnant and breastfeeding women in the context of Ebola virus disease. The document reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola, and will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak. The news release of this guideline can be found here. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 11 February 2020*





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    *3432 confirmed and probable cases, reported as of 11 February 2020. Excludes n=163 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. Non-active health zones indicate health zone that have not reported cases in the last 42 days. Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 11 February 2020*





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    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 11 February 2020**





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    **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

    On 12 February 2020, WHO revised the risk assessment for this event from Very High down to High at the national and regional levels, while the risk level was maintained as Low at the global level. 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. This assessment acknowledged improvements in case incidence and other epidemiological indicators, and the strengthened local and regional capacities. Dynamics of the outbreak, however, remain contingent upon access for response teams to affected areas. Continued insecurity remains a barrier the outbreak response effort. The limited number of community deaths still occasionally reported among new EVD cases can perpetuate transmission, with potential for new cases to arise outside of groups under surveillance. Ebola virus may persist in some survivors’ body fluids. In a limited number of instances, secondary transmissions from exposure to body fluids of survivors have been documented. We should expect further clusters of cases following exposure to survivors’ infected body fluids in the coming few months. This risk can be mitigated through the dedicated programme for survivor care and monitoring. At both a national and regional level, potential limitations imposed on response and preparedness activities (e.g. shortages of funding, loss of access to communities due to deterioration in security, etc.), could reverse the gains that have been made in controlling the outbreak. 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


    • Source: https://www.who.int/csr/don/20-febru...-ebola-drc/en/

      Ebola virus disease – Democratic Republic of the Congo

      Disease outbreak news: Update
      20 February 2020

      During the past week, the incidence of new Ebola virus disease (EVD) cases has remained low (Figure 1). From 12 to 18 February, one new confirmed case was reported. The case was reported in Beni Health Zone, North Kivu Province and had an epidemiological link to a confirmed case reported on 5 February. As the case was alerted and transferred to an Ebola Treated Centre four days after symptom onset, there remains a risk that onward transmission to contacts may have occurred, and further cases may be expected from the currently active chain of transmission. Ebola virus may also persist in some survivors’ body fluids for several months, and in a limited number of instances, transmissions from exposure to body fluids of survivors have been documented during this outbreak. The ongoing programme for survivor care helps mitigate the risks of re-introduction events.
      To maintain operations and prevent re-emergence of the outbreak, WHO is requesting funding. Under the Strategic Response Plan (SRP 4.1), WHO’s financial need for the Ebola Response from January to June 2020 is US $83 million. Thanks to the generosity of many donors during 2019, WHO has some carry-over funding, which has been applied to maintain operations through February 2020. USD $40 million is currently needed to ensure continuity of response and preparedness activities to bring the case incidence to zero, and continue building strong, resilient health systems.
      In the past 21 days (29 January to 18 February 2020), eight confirmed cases were reported from four health areas within two active health zones in North Kivu Province (Figure 2, Table 1): Beni (n=7) and Mabalako (n=1). It has been more than 42 days since Butembo and Mambasa Health Zones reported new cases. The continued reduction of geographic spread of EVD cases and the declining trend in case incidence observed in the past 21 days are encouraging.
      As of 18 February, a total of 3433 EVD cases were reported, including 3310 confirmed and 123 probable cases, of which 2253 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1924) were female, 28% (n=969) were children aged less than 18 years, and 5% (n=172) of all reported cases were health care workers. Substantial case finding activities continue with more than 5000 alerts reported and investigated daily, among which, approximately 450 suspected EVD cases are detected each day who require laboratory testing and specialized care within the established Ebola treatment and transit centres.
      Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 18 February 2020*




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      *3433 confirmed and probable cases, reported as of 18 February 2020. Excludes n=161 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. Non-active health zones indicate health zone that have not reported cases in the last 42 days.
      Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 18 February 2020*




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      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 18 February 2020**




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      **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 high, while global risk levels remain low. This assessment acknowledged improvements in case incidence and other epidemiological indicators, and the strengthened local and regional capacities. Dynamics of the outbreak, however, remain contingent upon access for response teams to affected areas. Continued insecurity remains a barrier to the outbreak response effort.
      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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      • Source: https://www.who.int/csr/don/27-febru...-ebola-drc/en/
        Ebola virus disease – Democratic Republic of the Congo

        Disease outbreak news: Update
        27 February 2020



        From 19 to 25 February, no new confirmed cases of Ebola virus disease (EVD) were reported. This was the first time since the beginning of the response that no new confirmed cases were reported over a seven-day period (Figure 1). The most recent case was reported in Beni Health Zone, North Kivu Province on 17 February. While the lack of new confirmed cases reported in the last seven days is a major achievement, the outbreak remains active and risk of additional cases emerging remains high. In the past 21 days (5 to 25 February 2020), four confirmed cases were reported from two health areas in Beni Health Zone in North Kivu Province (Figure 2, Table 1). Even with strengthened surveillance operations, transmission of Ebola virus outside of groups currently under surveillance cannot be excluded. Ebola virus also persists in some survivors’ body fluids, with potential to infect others. In at least one instance during this outbreak, relapse – in which a person who has recovered from EVD develops symptoms again – was observed, sparking a new chain of transmission which has taken several months to interrupt. To mitigate a potential resurgence of the outbreak, it is critical to maintain response capacities to rapidly detect and respond to any new cases, and to prioritize survivor support and monitoring and the maintenance of cooperative relationships with the survivors’ associations.

        Substantial surveillance, pathogen detection, and clinical management activities are currently ongoing, including validating alerts, following remaining contacts who were potentially exposed to the virus, supporting rapid diagnostics of suspected cases, and working with community members to strengthen surveillance on people who pass away in the communities. As of 25 February, 510 contacts are currently under surveillance, of which 97% were followed daily in the last seven days. In the last seven days, more than 5100 alerts per day were reported and investigated, of which over 400 alerts (including ~70 community deaths) were validated as suspected EVD cases; requiring laboratory testing and specialized care within the established Ebola treatment and transit centres. On average, suspect cases stay in these facilities for three days before EVD can be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 operational laboratories deployed in cities that have been affected by the outbreak. From 17 to 23 February, more than 3600 samples were tested.

        To maintain operations and prevent potential resurgence of the outbreak, WHO requires further funding. Under the Strategic Response Plan (SRP 4.1), WHO’s financial need for the Ebola Response from January to June 2020 is US $83 million. Thanks to the generosity of many donors during 2019, WHO has some carry-over funding, which has been applied to maintain operations through February 2020. USD $40 million is currently needed to ensure continuity of activities to bring the case incidence to zero, and to continue building strong and resilient health systems.

        As of 25 February, a total of 3444 EVD cases were reported, including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1928) were female, 28% (n=974) were children aged less than 18 years, and 5% (n=172) were health care workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 25 February 2020*





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        *Excludes n=155 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. ‘Non-active zones’ indicate health zone that have not reported new cases in the last 42 days. Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 25 February 2020*





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        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 25 February 2020**





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        **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 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


        • Source: https://www.who.int/csr/don/05-March-2020-ebola-drc/en/
          Ebola virus disease – Democratic Republic of the Congo

          Disease outbreak news: Update
          5 March 2020



          No new cases of Ebola virus disease have been reported since 17 February, and on 3 March, the only person confirmed to have EVD in the last 21 days (Figure 1) was discharged from an Ebola Treatment Centre after recovering and testing negative twice for the virus. This is an important milestone in the outbreak. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

          As of 3 March 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1, Figure 2), including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (n=1927) were female, 28% (n=973) were children aged less than 18 years, and 5% (n=171) were health care workers.

          WHO’s financial need for the Ebola Response for January to June 2020 (SRP 4.1) is US $83 million. Thanks to the generosity of donors during 2019, WHO had some carry-over funding available, however, WHO now requires US$ 40 million to ensure continuity of activities. Survivors of Ebola virus disease

          Ebola virus may persist in some survivors’ body fluids, with potential to infect others. In at least one instance during this outbreak, relapse was observed, sparking a new chain of transmission which has taken several months to interrupt. At the individual level, people who have recovered from EVD may develop medical and psychological complications. EVD survivors should be offered support when they return to their communities in order to care for any post-EVD complications.

          In response to these needs, and based on lessons learned from previous outbreaks, a multi-disciplinary follow-up programme for EVD survivor care was initiated just three months after the declaration of the outbreak by the Ministry of Health and the Institut National de Recherche Biomédicale (INRB), with the support of the World Health Organization and the World Food Programme. It was the first time a national EVD survivor programme was implemented in the early phase of an EVD outbreak.

          The programme entails monthly visits to health clinics for at least 18 months to follow up with clinical, biological and psychological aspects of each survivor’s health and well-being. Each month, more than 85% of survivors come to the clinics. This suggests that survivors and their communities accept, trust and have confidence in the programme. In addition, survivors are offered specialized services by trained local professionals, working in close collaboration with survivors’ associations. This includes ophthalmic care, neurological care, psychosocial support, laboratory services, pregnancy management and paediatric care. The programme has continued to adapt with the evolution of the outbreak. Five dedicated clinics are currently operating in Beni, Butembo, Goma, Mangina, and Mambasa.

          Since the beginning of the outbreak, 1160 people have recovered from EVD. This includes 50 (4%) infants under 1-year-old, 55 (5%) children aged 1 to 4 years old, 145 (13%) children aged 5 to 17, and 910 (78%) adults aged 18 years or older. Of the total survivors, 641 (55%) are female, including eight women that were pregnant at the time of EVD infection, and survived with a viable foetus. To ensure proper pregnancy follow-up and safe delivery, WHO supported the implementation of dedicated care for these women. This is the first time women who were pregnant while sick with EVD have recovered with healthy babies and is a major breakthrough in supporting pregnant women who recovered from EVD.

          In order to provide appropriate and needed care for EVD survivors it is essential to sustain the programme for at least 18 months after the outbreak is declared over. Furthermore, concerted research efforts are required to better understand and respond to survivor needs. WHO will support INRB and partners in these endeavours. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 3 March 2020*





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          *Excludes n=153 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. ‘Non-active zones’ indicate health zone that have not reported new cases in the last 42 days. Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 3 March 2020*





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          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 3 March 2020**





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          **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 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


          • Source: https://www.who.int/csr/don/12-March-2020-ebola-drc/en/
            Ebola virus disease – Democratic Republic of the Congo

            Disease outbreak news: Update
            12 March 2020



            It has been over 21 days since the last confirmed case of Ebola virus disease (EVD) has been reported (Figure 1). On 9 March, the last 46 contacts finished their follow-up. These are important milestones in the outbreak as over one maximum incubation period has passed without any confirmed cases of EVD. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

            Extensive surveillance, pathogen detection, clinical management and other response activities are currently ongoing. These include, but are not limited to, investigating and validating new alert cases, supporting appropriate care and rapid diagnostics of suspected cases which continue to be detected each day, and supporting survivors through a multi-disciplinary programme to help mitigate potential risks of re-emergence. Over the course of the past week (4–10 March 2020), over 32 000 alerts were reported and investigated, and 2584 alerts were validated as suspected cases; requiring specialized care and laboratory testing to rule-out EVD. From 2 to 8 March, 2818 samples were tested including: 1574 blood samples from alive, suspected cases; 376 swabs from community deaths; and 868 samples from re-tested patients. Overall, this was a 16% decrease in testing compared to the previous week.

            Throughout the outbreak, alert rates steadily climbed as active and passive case finding systems were strengthened, reaching additional health zones with the evolution of the outbreak, and continuously adapted to suit local context. With the decline in confirmed case incidence and gradual transition toward routine disease surveillance systems, alert rates have expectantly begun to decline in some areas. It, however, remains important for appropriate levels of surveillance to be maintained through the end of outbreak declaration to rapidly detect relapse, reintroduction or new emergence events, thereby providing an opportunity to implement effective control measures and avoid a potential resurgence of the outbreak.

            As of 10 March 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1, Figure 2), including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (n=1931) were female, 28% (n=975) were children aged less than 18 years, and 5% (n=171) were health care workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 10 March 2020*





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            *Excludes n=148 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. ‘Non-active zones’ indicate health zones that have not reported new cases in the last 42 days. 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 10 March 2020**





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            **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 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


            • Source: https://www.who.int/csr/don/19-March-2020-ebola-drc/en/

              Ebola virus disease – Democratic Republic of the Congo


              Disease outbreak news: Update
              19 March 2020



              There have been no new cases of Ebola virus disease (EVD) reported in the ongoing outbreak in the Democratic Republic of the Congo since 17 February 2020. However, because there is still a risk of re-emergence of EVD, it is critical to maintain surveillance and response operations until and after the end of outbreak declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

              Unfortunately, the response faces increasing limitations that could result in delayed detection and control of flare-ups. These limitations include a funding shortfall, ongoing insecurity and lack of access to some areas, and limited staffing and resources amidst other local and global emergencies.

              No funding for the Ebola response has been received by WHO since December 2019. An urgent injection of USD 20 million is required to ensure that response teams have the capacity to maintain the appropriate level of operations through to the beginning of May 2020. If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak. For more information, please see this statement.

              Ongoing response activities include investigating and validating new alert cases, supporting appropriate care and rapid diagnosis of suspected cases (which continue to be detected), supporting survivors through a multi-disciplinary programme, and strategically transitioning activities. From 9 to 15 March, over 32 000 alerts were reported and investigated. Of these, 2550 alerts were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. During this same period, 2760 samples were tested, including 1565 blood samples from alive suspected cases, 405 swabs from community deaths, and 790 samples from re-tested patients.

              As of 17 March 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1), including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (n=1931) were female, 28% (n=975) were children aged less than 18 years, and 5% (n=171) were health care workers.
              Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 17 March 2020*






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              *Excludes n=148 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. ‘Non-active zones’ indicate health zones that have not reported new cases in the last 42 days.
              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 17 March 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 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


              • Source: https://www.who.int/csr/don/26-March-2020-ebola-drc/en/

                Ebola virus disease – Democratic Republic of the Congo


                Disease outbreak news: Update
                26 March 2020



                No new cases have been reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo since 17 February 2020 (Figure 1). However, due to challenges related to continued insecurity and population displacement in previous hotspots, limited access to some affected communities, and potential shortages of resources amidst other local and global emergencies, there remains a high risk of re-emergence of the virus. Therefore, it is critical to maintain surveillance and response operations in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

                Active outbreak response activities continue, which include investigating and validating new alert cases, supporting appropriate care and rapid diagnosis of suspected cases (which continue to be detected), supporting survivors through a multi-disciplinary programme, and strategically transitioning activities. From 18 to 24 March, an average of 4619 alerts were reported and investigated daily. Of these alerts, 358 were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. From 16 to 22 March, 2747 samples were tested including: 1479 blood samples from alive, suspected cases; 374 swabs from community deaths; and 894 samples from re-tested patients. Overall, laboratory activity was conducted at similar levels as compared to the prior week.

                Last week, nine historical probable cases were validated, whose dates of symptom onset were between October 2018 and July 2019, bringing the cumulative number of probable cases to 143. Further historical probable cases are expected to be validated as investigations into past cases continue.

                As of 24 March 2020, a total of 3453 EVD cases were reported from 29 health zones (Table 1), including 3310 confirmed and 143 probable cases, of which 2273 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 57% (n=1935) were female, 29% (n=979) were children aged less than 18 years, and 5% (n=171) were health care workers.

                WHO has not received funding for the Ebola response since December 2019. An urgent injection of US $20 million is required to ensure that response teams have the capacity to maintain the appropriate level of operations through to the beginning of May 2020. If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak. For more information, please see this statement.
                Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 24 March 2020*






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                *Excludes n=149 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. ‘Non-active zones’ indicate health zones that have not reported new cases in the last 42 days.
                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 24 March 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 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.

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