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

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Ituri-Ebola: vice-governor confirms new case in Tchomia

September 25, 2018 |

The new confirmed case is that of the husband of the woman who died with this Ebola outbreak at the general reference hospital in Tchomia last Thursday south of Bunia.

The interim governor Pacific Keta Upar specifies that this new case is taken care of by the caregiver deployed in the region.

"At the same time anyone who has been in direct or indirect contact is being vaccinated in Tagba, Kasenyi and Tchomia. To date, there are about twenty-five vaccinated, "he said.

A strong delegation of members of the provincial government, the Ministry of Health, members of the provincial safety committee and partners involved in the health sector had visited the Tagba weekend where the woman lived before finding the died in Chomia hospital.

Purpose of this delegation: to get involved in the activities of the response against this epidemic, to sensitize, to encourage the population, the traditional chiefs not to panic rather to accompany the health care and to respect the sanitary measures to prevent the propagation of the virus in this health zone.


Dieu merci Thuambe

http://7sur7.cd/new/ituri-ebola-le-vice-gouverneur-confirme-un-nouveau-cas-a-tchomia/

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU Tuesday 25 September 2018 The epidemiological situation of Ebola Virus Disease dated 24 September 2018 : A total of 151 cases of haemorrhagic fever were reported in the region, 120 confirmed and 31 probable. Of the 120 confirmed, 70 died and 41 are cured . 11 suspected cases are under investigation. 1 new case confirmed in Beni. 1 confirmed case death in Beni. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Days of the dead city in Beni Following the violence that occurred this Saturday, September 22, 2018 in Beni, the civil society had called the population to respect 5 days dead city to protest the violence. They demanded that all commercial activity and all activities of the response be halted during this period. On Tuesday, September 25, 2018, the coordinator of the response, Dr Ndjoloko Tambwe Bathe, and the mayor of the city of Beni invited the president of the civil society of Beni to explain the dangers of stopping the response for a whole week. After the meeting, understanding the severity of the epidemic, Beni's civil society president announced that all the response teams, from both the government and partner organizations, could continue to work during these dead city days. So, Medical care To date, 39 patients have been treated with mAb 114, Remdesivir, or Zmapp. Of these 39 patients, 19 are cured and have been discharged, 12 have died and 8 are still hospitalized. surveillance To date, 5,572,092 travelers have been checked at the various entry points set up. Vaccination Since the start of vaccination on 8 August 2018, 11,773 people have been vaccinated , including 4,122 in Mabalako, 3,652 in Beni, 1,632 in Mandima, 884 in Butembo, 803 in Katwa, 270 in Masereka, 164 in Komanda, 121 in Oicha, 65 in Kinshasa (medical staff to deploy), and 60 in Tchomia

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN NORTH KIVU PROVINCE Thursday 27 September 2018 The epidemiological situation of the Ebola Virus Disease dated September 26, 2018 : A total of 154 cases of haemorrhagic fever were reported in the region, of which 123 confirmed and 31 probable. Of the 123 confirmed, 70 died and 43 are cured . 11 suspected cases are under investigation. 3 new confirmed cases in Beni. Of these new confirmed cases, two are known contacts from the same family who did not want to be vaccinated but who voluntarily went to the Ebola Treatment Center as soon as the first symptoms appeared. No new deaths. 2 new people healed in Beni. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Days of the dead city in Beni and Butembo This Thursday, September 27, 2018, the Governor of the Province of North Kivu, Julien Paluku, participated in the daily meeting of the coordination of the response to Beni and visited the CTE. He encouraged the teams and reminded them that they had all the support of the provincial government. In Butembo, the dead city day was lifted and all commercial activities in the city resumed, allowing the response to resume field activities. Collaboration of the community in Ndindi All riposte activities were held normally in Beni this Thursday. In the Ndindi district, the cradle of resistance, the teams of the riposte were greeted without a hitch by the population. The local committee of community leaders had called for a catch-up session for unimmunized contacts and household decontamination of the latest confirmed cases from the neighborhood. Unlike the previous weeks, there was a lot of enthusiasm among neighborhood residents who voluntarily registered for vaccination. Vaccination Launch of the vaccination of several contacts and contacts of confirmed cases of Tchomia that were located in Bunia. These contacts readily agreed to collaborate with the health authorities. Since the beginning of the vaccination August 8, 2018, 12,029 people were vaccinated , including 4.122 to Mabalako, 3662 in Beni, 1632 at Mandima 884 in Butembo, 903 to Katwa, 270 Masereka, 164 Komanda 156 Tchomia Oicha 121 to 65 in Kinshasa (medical personnel to deploy), and 50 Bunia.

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Source: http://www.who.int/csr/don/27-septem...-ebola-drc/en/
Ebola virus disease ? Democratic Republic of the Congo

Disease outbreak news
27 September 2018

The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. While substantial progress has been made, the situation is precarious given recent increases in insecurity, incidents of community reluctance and geographical spread.
There have been a number of incidents in recent days, notably in Beni, which have led to loss of life among the local communities. WHO response activities have been severely limited as Beni and other towns mark a period of mourning for those who were killed. Security in Beni and other areas remains challenging.
The Ministry of Health (MoH), WHO and partners continue to work closely with people in the affected areas to overcome reluctance and mistrust which has developed among some communities. Rumours, misinformation and traditional practices have led some families to opt to care for sick relatives at home; some patients have also left health facilities to seek alternative care. Together this results in health workers being unable to provide optimal treatment, and also increases the risk of infection for relatives and local community members. These factors have contributed to the geographical spread of the outbreak.
The movement of several cases across health zones in recent weeks is concerning; one infected individual who recently moved to Kalunguta Health Zone is the first to move into a 'red' zone - highly insecure and challenging environments where implementing response activities is extremely difficult, if not impossible. Responders are employing a range of new techniques in these red zones, including using armed escorts and training local health workers to trace contacts.
Where they have access, response teams continue to enhance activities to prevent new clusters and the potential spread to new areas. WHO continues to work in the affected areas, side-by-side with national and international partners, to support the response led by the MoH. There continues to be challenges with identifying all contacts, registered contacts being lost to follow up, delayed recognition of EVD in health centres, poor infection prevention and control (IPC) in health centres, and reluctance among some cases to be treated in Ebola treatment centres (ETCs). The priority remains strengthening all components of the public health response in all affected areas, as well as continuing to enhance operational readiness and preparedness in the non-affected provinces of the Democratic Republic of the Congo and in neighbouring countries.
Since the last Disease Outbreak News (data as of 18 September), nine new confirmed EVD cases were reported: five from Beni, one from Butembo and one from Mabalako health zones in North Kivu Province, as well as two from Tchomia Health Zone in Ituri Province. These are the first confirmed EVD cases to be reported from Tchomia Health Zone which is near the Ugandan border; both cases, a couple, were linked to the ongoing Beni transmission chain. Two of the remaining seven cases have been linked to ongoing transmission chains within the respective communities, while the last five cases are under investigation.
As of 25 September 2018, a total of 151 EVD cases (120 confirmed and 31 probable), including 101 deaths (70 confirmed and 31 probable)¹, have been reported in seven health zones in North Kivu Province (Beni, Butembo, Kalunguta, Mabalako, Masereka, Musienene and Oicha), and two health zones in Ituri Province (Mandima and Tchomia) (Figure 1). An overall decreasing trend in weekly case incidence continues (Figure 2); however, these trends must be interpreted with caution given the expected delays in case reporting, the ongoing detection of sporadic cases and the security situation which is limiting contact tracing. Of the 149 confirmed and probable cases for whom age and sex information is known, 23%, 20% and 22% are aged 15-24, 25-34 and 35-44 years, respectively; females (56%) accounted for the greatest proportion of cases (Figure 3). Cumulatively, 19 (18 confirmed and one probable) health workers have been affected to date, three of whom have died.
The MoH, WHO and partners continue to closely monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo and in neighbouring countries. As of 25 September, 17 suspected cases in the Democratic Republic of the Congo are awaiting laboratory testing. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, as well as in neighbouring countries; and to date, EVD has been ruled out in all alerts from neighbouring provinces and countries.
Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 25 September 2018 (n=151)




Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 25 September 2018 (n=147)*




*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning.
Figure 3: Confirmed and probable Ebola virus disease cases by age and sex, data as 25 September 2018 (n=149)*




*Age and/or sex unknown for n=2 cases.
Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordinating the response, surveillance, contact tracing, laboratory capacity, IPC measures, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance and preparedness activities in neighbouring provinces and countries.

• As of 18 September, 201 experts have been deployed by WHO to support response activities including emergency coordinators, epidemiologists, laboratory experts, logisticians, clinical care specialists, communicators and community engagement specialists.
• Over 5700 contacts have been registered, of which 1660 remain under surveillance as of 25 September². From 19 to 25 September, a high proportion of contacts ranging between 95-98% were followed up daily; however, coverage fell to between 60-76% from 23 to 25 September due to the suspension of field activities in Beni and a new front of operations in Tchomia..
• As of 25 September, 63 vaccination rings have been defined in addition to 26 rings of health workers and other frontline workers. These rings include the contacts (and their contacts) of all confirmed cases from the last four weeks. To date, 12 029 people consented and were vaccinated, including 5041 health or frontline workers and 2497 children. The ring vaccination teams are currently active in three health areas in North Kivu and two in Ituri.
• ETCs are operational in Beni and Mangina with support from the Alliance for International Medical Action (ALIMA) and M?decins Sans Fronti?res (MSF), respectively. MSF Switzerland and the MoH are supporting an ETC in Butembo. International Medical Corps (IMC) is supporting the recently opened Makeke ETC in Ituri Province. MSF and the MoH are setting up a 12-bed isolation facility in Kasenyi.
• WASH and IPC activities are ongoing in the Democratic Republic of the Congo and are supported by several partners in the field. Numerous activities have occurred in health facilities in the affected areas including facility assessments, decontamination of centres, establishment of triage areas and training on standard precautions as well as Ebola-specific IPC measures.
• The MoH, WHO, UNICEF, Red Cross and partners are intensifying activities to engage with local communities in the affected areas. Community feedback is being systematically collected and concerns are being addressed. Local frontline community outreach workers are collaborating with Ebola response teams to strengthen community engagement and psychosocial support in contact tracing, patient care, SDBs and vaccination of close contacts. The focus continues to be on intensifying activities aimed at addressing community concerns through direct partnership with community members.
• Red Cross SDB teams are trained and operational in Mabalako, Beni and Butembo health zones. Due to the new confirmed EVD cases in Ituri, the Red Cross is strengthening response capacity in Bunia where one SDB team was initially trained. In preparation, training of Red Cross SDB teams in Goma started on 24 September. Civil protection SDB teams from Beni, Butembo and Oicha have been trained as part of the ?red zone strategy?. As of 24 September, Red Cross SDB teams have successfully responded to 144 of the 176 SDB alerts received; 37% of alerts were for community deaths, 36% were from ETCs and 27% were from non-ETC health facilities. In addition, four alerts were sent to the civil protection SDB teams.
• Expert teams have deployed to six at-risk provinces (Bas Uele, Haut Uele, Ituri, Maniema, South Kivu and Tanganika) to facilitate implementation of priority readiness actions, including strengthening multisectoral coordination, surveillance for early detection, laboratory diagnostic capacity, points of entry (PoE) surveillance, rapid response teams, risk communication, social mobilization and community engagement, psychosocial support, case management and IPC capacities, operations support, and logistics.
• As of 25 September, health screening has been established at 45 PoEs and close to six million travellers have been screened and over 17 000 means of travel have been decontaminated at these PoEs.
• To support the MoH, WHO is working intensively with a wide range of multisectoral and multidisciplinary regional and global partners and stakeholders for EVD response, research and urgent preparedness, including in neighbouring countries. Among the partners are a number of UN agencies and international organizations including International Organization for Migration (IOM), the United Nations Children's Fund (UNICEF), World Food Programme (WFP), United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Inter-Agency Standing Committee (IASC), European Civil Protection and Humanitarian Aid Operation (ECHO), UK Public Health Rapid Support Team, multiple Clusters, and peacekeeping operations; World Bank and regional development banks; African Union, Africa Centers for Disease Control and Prevention (CDC), and regional agencies; Health Cluster partners and NGOs including ALIMA, ADECO, AFNAC, CARITAS, CEPROSSAN, CARE, COOPI, CORDAID, ICRC, IFRC, INTERSOS, MEDAIR, MSF, OXFAM, PNHF, Samaritan?s Purse, and SCI; Global Outbreak Alert and Response Network (GOARN), Steering Committee, technical networks and operational partners, and the Emergency Medical Team (EMT) Initiative. GOARN partners continue to support the response through deployment for response and readiness activities in non-affected provinces and in neighbouring countries and to different levels of WHO.

WHO risk assessment

This outbreak of EVD is affecting north-eastern provinces of the Democratic Republic of the Congo, which border Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include the transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and the displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri continues to hinder the implementation of response activities. Since the last Disease Outbreak News on 20 September 2018, WHO has assessed the risk to be very high at the national and regional levels, and low globally³.
As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities³. WHO will continue to work with neighbouring countries and partners to ensure health authorities are alerted and are operationally ready to respond.
WHO advice

WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no countries have implemented any travel restriction to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
For more information, see:

• WHO Interim recommendation Ebola vaccines
• WHO recommendations for international travellers
• Ebola virus disease in the Democratic Republic of the Congo ? Operational readiness and preparedness in neighbouring countries
• Ebola virus disease fact sheet

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¹The number of cases is subject to change due to ongoing reclassification, retrospective investigation, and the availability of laboratory results.
²The total number of contacts under surveillance is highly dynamic with new cases being registered daily, and those who complete 21 days of post-exposure follow up, without developing symptoms, are released from surveillance.
³Please note that these sentences under ?WHO risk assessment? were updated on 28 September 2018.

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU Friday 28 September 2018 The epidemiological situation of the Ebola Virus Disease dated 27 September 2018 : A total of 155 cases of haemorrhagic fever were reported in the region, of which 124 were confirmed and 31 were probable. Of the 124 confirmed, 71 died and 45 are cured . 15 suspected cases are under investigation. 1 new case confirmed in Beni. 1 new confirmed case death in Beni. 2 new people healed in Butembo. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Epidemiological surveillance All contacts in the Masereka Health Zone have come out of their 21-day follow-up period. Caregivers at the Mangina Reference Health Center, who had been discharged early in the epidemic as contacts, have also completed their follow-up period and will be able to return to work in the next few days. Vaccination Since the beginning of vaccination on August 8, 2018, 12,250 people have been vaccinated , including 4,122 in Mabalako, 3,712 in Beni, 1,632 in Mandima, 884 in Butembo, 993 in Katwa, 270 in Masereka, 164 in Komanda, 177 in Tchomia, 121 in Oicha, 110 in Bunia and 65 in Kinshasa (medical staff to deploy).

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN NORTH KIVU PROVINCE Saturday 29 September 2018 The epidemiological situation of the Ebola Virus Disease dated 28 September 2018 : A total of 157 cases of haemorrhagic fever were reported in the region, 126 confirmed and 31 probable. Of the 126 confirmed, 71 died and 45 are cured . 23 suspected cases are under investigation. 2 new confirmed cases, including 1 in Beni and 1 in Butembo. No new deaths. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Epidemiological surveillance The last confirmed case reported to Butembo is a woman who started the symptoms around September 20th. At first, family members, who are supporters of national deputy Crispin Mbindule Mitono, refused to transfer her to the Ebola Treatment Center (ETC) and hid her. The family refused to see the teams of the response in the absence of the members of the "Standing Parliament", a pressure group of the Furu district in Butembo. When the condition of the patient deteriorated, the pressure group, which was in negotiation with Butembo's sub-coordination, finally called on the emergency team to transfer the patient to the CTE. . Upon their arrival at CTE, samples were taken and they were positive. Thus, all of the patient's family members, members of the lobby group, and the member of Parliament herself were registered as at-risk contacts. This Saturday, September 29, 2018, all those at risk have agreed to be vaccinated in the health zone of Katwa. As a reminder, last August, the MP said in the media that the Ebola Virus Disease was created in laboratories and was moved from the province of Ecuador to Beni to exterminate the population. He also advised against his supporters to accept the vaccination. Thus, the involvement of the MP and the pressure group is a major step forward in social mobilization and the lifting of the last Butembo resistance wall.

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU Sunday, September 30, 2018 The epidemiological situation of the Ebola Virus Disease dated September 29, 2018 : A total of 159 cases of haemorrhagic fever were reported in the region, of which 127 confirmed and 32 probable. Of the 127 confirmed, 72 died and 45 are cured . 13 suspected cases are under investigation. 1 new confirmed case in Beni, who died shortly after arriving at the Ebola Treatment Center (ETC) 1 new probable case in Beni, who is a contact of the last confirmed case but who died a day earlier and was buried by his family in an unsecured way. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Press conference in Beni The coordinator of the response, Dr. Ndjoloko Tambwe Bathe, held a press conference this Sunday, September 30, 2018 in Beni. He returned to the impact of the dead city days on the activities of the riposte: The contact follow-up coverage rate increased from 98% to less than 50% during the dead-city days. There has been a slowdown in active case-finding in health facilities and in the community due to lack of team mobility. There has been a slowdown in monitoring activities at ports of entry and a disruption of water supply at some ports of entry. No vaccination activity for 3 days and poor follow up of people already vaccinated. No samples were collected or analyzed on the 25th of September. Failure to respect the principle that all households and health facilities through which positive cases have been passed must be disinfected within 24 hours. Non-supply of inputs and protective equipment for health care providers and patients in facilities where positive cases have been passed. Difficulty distributing hand washing kits in schools. No awareness activities or psychological support sessions could be organized. The coordinator insisted that the stigmatization of the population in Beni must be stopped. Contrary to what is often repeated in the media, the population of the city has been very cooperative with the teams of the response. This collaboration is to be commended and encouraged. More and more contacts are voluntarily registering with vaccination teams, patients voluntarily present themselves to the CTE when they become ill, and bereaved families call emergency teams to proceed with the dignified and secure burial of their patients. close deceased. The cases of resistance in the city of Beni are actually concentrated around one or two families that caused the spread of the epidemic in Butembo and Tchomia. This is why it is important for the whole community to be involved in stopping the spread of the disease. Vaccination Since the beginning of vaccination on August 8, 2018, 12,940 people have been vaccinated , including 4,193 in Mabalako, 3,958 in Beni, 1,632 in Mandima, 1,143 in Katwa, 944 in Butembo, 270 in Masereka, 230 in Tchomia, 220 in Bunia, 164 in Komanda, 121 in Oicha and 65 in Kinshasa (medical staff to deploy).

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DRC-Ebola: 6 cases confirmed after suspension of Beni riposte activities

Monday, October 1, 2018 - 08:53

Six confirmed cases of Ebola were recorded in Beni (North Kivu) during the five-day general strike called by civil society to protest killings of people by suspected ADF fighters.

The strike led to the temporary cessation of immunization activities and at least 243 people who were in contact with the patients could not be vaccinated, reports the health authorities.

"These events related to the massacres have not had any impact on the response and we have not been able to investigate all the alerts that have come in. Hospital surveillance at ports of entry and checkpoints has been suspended. As a result, there were two cases in the general hospital that were positive, our vaccination teams could not build the belts on the confirmed cases, and during that period there were six confirmed cases for 243 contacts that were not able to be vaccinated because of these actions of the strike, and all follow-up contacts were not made, "said Sunday Dr. Bath? Tambwe, general coordinator of the response to Ebola .

Several samples could not be examined during the strike. The latter was suspended last Friday.

"For hospitalized patients we were unable to conduct some tests including biochemistry and dermatology routine care of patients in treatment centers," said the health manager.

The tenth epidemic reported in the country has already killed 104 people in and around Beni and two localities in Ituri province. 159 cases of haemorrhagic fever were reported in the region, of which 127 confirmed and 32 probable. These figures could increase because 13 suspected cases are under investigation, say the health authorities.

Yassin Kombi

https://actualite.cd/2018/10/01/rdc-ebola-6-cas-confirmes-apres-la-suspension-des-activites-de-la-riposte-beni

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Two suspected cases of Ebola virus detected in Bunia

Kinshasa01-10-2018

Health - The provincial governor who said this after the meeting of the strategic committee against Ebola held in the meeting room of the provincial governorate, said that this mother and her child shared the same room with a woman who died of this disease on Thursday, August 20 current, at the general reference hospital of Tchomia, 65 km from Bunia.

Two suspected cases of Ebola virus, a mother and her child are under observation at the general reference hospital in Bunia pending the results of samples taken to the laboratory of the National Institute of Biological Research (lN RB) in Beni (North Kivu), announced Thursday to press the governor of Ituri ad interim Pacific Keta Upar.

The provincial governor who said this after the meeting of the strategic committee against Ebola held in the meeting room of the provincial governorate, said that this mother and her child shared the same room with a woman died of this disease on Thursday, August 20 current, at the general reference hospital of Tchomia, 65 km from Bunia.

In addition, the results of sampling four other suspected cases proved negative before announcing, on the one hand, the provision by the province of an ambulance that is in the city of Bunia to transport patients to viruses. Ebola and suspected cases at the Tchomia locality and, on the other hand, the beginning of Friday the mobile laboratory activities of the INRB installed in the same locality.

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https://www.digitalcongo.net/article/5bb21e2f5a27e00004c3597b/

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU Monday, October 1, 2018 The epidemiological situation of the Ebola Virus Disease dated 30 September 2018 : A total of 161 cases of haemorrhagic fever were reported in the region, 129 confirmed and 32 probable. Of the 129 confirmed, 73 died and 45 are cured . 9 suspected cases are under investigation. 2 new confirmed cases, including 1 in Beni and 1 in Komanda (Ituri) Beni's confirmed case is the daughter of a confirmed case who died at the Beni Ebola Treatment Center on September 22, 2018. The family had refused follow-up and vaccination. The girl is dead. The confirmed case of Komanda is a man belonging to Ndindi's family who is behind the pockets of resistance in the city of Beni. Some infected members of this family had caused the spread of the virus in Butembo and Tchomia by refusing follow-up and recommendations from the health authorities. After the death of the first confirmed case in Tchomia, who was his sister-in-law, he fled to Komanda. He was found hospitalized in a health post in Komanda. He will be transferred to the Tchomia isolation center and the health post will be fully disinfected. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Epidemiological surveillance The city of Beni remains the main focus of the Ebola Virus Disease epidemic. For week 39, from 24 to 30 September 2018, Beni recorded: 8/9 new confirmed cases reported 1/1 new probable case reported, 4/4 new deaths reported. Vaccination Since the start of vaccination on August 8, 2018, 13,208 people have been vaccinated , including 4,207 in Mabalako, 4,095 in Beni, 1,632 in Mandima, 1,193 in Katwa, 944 in Butembo, 270 in Masereka, 260 in Tchomia, 257 in Bunia, 164 in Komanda, 121 in Oicha and 65 in Kinshasa (medical staff to deploy).

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Butembo / North Kivu: Aggression against the response team at the funeral of a dead lady of Ebola

Writing Matininfos.net October 3, 2018

On Tuesday, October 2, the town of Butembo, about 300km north of Goma, recorded a fifth case of death from Ebola virus disease. After preparations for her dignified and secure burial, the retaliation team met fierce opposition at the Ngese cemetery that the deceased's family chose for burial. Behavior likely to increase cases of contamination and spread of the disease.

EBOLA-Tuesday, October 2, it is 14:30 in Butembo. The funeral procession of the DHS members (Safe and dignified burial) of the Ebola response arrives at the "Ngese" cemetery in the eastern part of the city. This team comes to bury a dead lady at the CTE (Ebola Treatment Center). While the Red Cross members who are taking care of the burial of the Ebola victims wanted to proceed with the burial, a group of young people with stones and sticks of the woods interfered.

These angry young people even wanted to rob the body of the deceased, claiming that she did not die of Ebola and that the coffin was empty, testifies a resident of Ngese who attended the scene. "When the team wanted to bury the body of the dead Ebola woman in agreement with the family, at the cemetery there was a group of people waiting for the Ebola riposte team. The gang robbed the body of the team's hands by threatening to burn two Red Cross members alive while others were manipulating the body of the deceased, "he says.

The driver of the vehicle carrying the body was able to escape and bring the body back to the Ebola Treatment Center, CTE, "he continued. Other young people pretended that the coffin used is too small compared to the size and mass of the deceased. As a result, the body was not buried on Tuesday. He spent the night at CTE.

"Attack the disease and not the agents"

The two Red Cross members escaped from the hands of their attackers and took refuge in a health center just meters from the cemetery. But young people have also attacked this health facility. Police sources say the altercations resulted in two injured DRC Red Cross workers, a ransomed aid vehicle and health center.

On the morning of Wednesday, October 3, a delegation of family members and relatives of the dead lady arrives at the CTE. With the response team, a compromise is found for the lady to be buried with dignity. "It is a scourge of this Ebola outbreak that we must fight and not attack the aid workers and other volunteers who help fight this disease," advises Edgard Katembo Mateso, president of the civil society. Elements of the order were deployed to the place to disperse these young people.

Umbo Salama, from Butembo

https://www.matininfos.net/butembo-nord-kivu-agression-contre-lequipe-de-riposte-a-lenterrement-dune-dame-morte-debola/

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI Wednesday, October 3, 2018 The epidemiological situation of the Ebola Virus Disease dated October 2, 2018 : A total of 162 cases of haemorrhagic fever have been reported in the region, 130 confirmed and 32 probable. Of the 130 confirmed, 74 died and 46 are cured . 17 suspected cases are under investigation. 1 new case confirmed in Beni. 1 new person healed in Beni. No new deaths. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Epidemiological surveillance Komanda's confirmed case was finally transferred to Beni's Ebola Treatment Center (ETC) for better management. His wife and child were vaccinated and isolated in the same CTE. Vaccination The two vaccination belts in Bunia have been closed. Vaccination continues in 6 belts distributed in the Beni, Tchomia, Komanda, and Mabalako health zones. Since the start of vaccination on August 8, 2018, 13,750 people have been vaccinated , including 4,375 in Beni, 4,254 in Mabalako, 1,632 in Mandima, 1,283 in Katwa, 944 in Butembo, 307 in Bunia, 307 in Tchomia, 270 in Masereka, 192 in Komanda, 121 in Oicha and 65 in Kinshasa (medical staff to deploy). The Governor of North Kivu Province, Julien Paluku, has just joined the long list of local and provincial leaders who have agreed to be vaccinated against Ebola to raise awareness. Nine provincial deputies from North Kivu were also vaccinated in Butembo on Wednesday, October 3, 2018. The local press was invited which allowed them to widely disseminate the messages of awareness. The Ebola vaccine remains the most effective way to preventively protect people at risk. Unfortunately, because of rumors and misinformation, some people at risk continue to be suspicious of the vaccine. Thus, the involvement of local leaders who lead by example is important to deconstruct preconceptions. The effectiveness of the vaccine is optimal when administered within the first 48 hours after exposure to a confirmed case. If the vaccine is administered late and the person is already at an advanced stage of the 21-day incubation period, the risk of developing the disease, even after vaccination, is still present. Hence the importance for people at risk of getting vaccinated early and respecting the days of follow-up by vaccination teams. Vaccination of the Governor of North Kivu Province, Julien Paluku

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Butembo: The governor of North Kivu is vaccinated for the example against the Ebola virus

By Editors - October 4, 2018
...

By Augustin Mosange, one of our correspondents in North Kivu

On the occasion of his visit yesterday, Wednesday, October 3 in Butembo, the governor of North Kivu Julien Paluku took the opportunity to be vaccinated against the Ebola virus raging in parts of his province. Vaccination took place at the Makasi Health Center in Kimemi Commune.

Julien Paluku intended to set an example and encourage the population of Butembo to do the same to fight against the spread of the Ebola virus in parts of the province of North Kivu.

It must be said that in Butembo, commercial city of more than one million inhabitants of the east of the DRC, the population is mainly skeptical of the vaccination recommended by the health authorities. It is sometimes even hostile to Ebola response teams.

Last Tuesday, two Red Cross agents who wanted to bury a deceased victim of the Ebola virus were sequestered by a group of young people whose identity remains unknown. The incident took place in the Furu district, located in the north of the city, deemed very hostile to the Ebola response teams.

106 victims of the Ebola virus in North Kivu, including five in Butembo, since 1 August

"I would like to reassure the public that the vaccine we are being given is used to prevent the spread of this disease so that we can escape it. So I would like to break that rumor that there would be vaccines for one class of people and another vaccine for the population that would be sentenced to death. These are false rumors distilled in the opinion that jeopardizes the health of the population, "said yesterday Julien Paluku after being vaccinated.

Still, for many people in Butembo, the Ebola response is more of a "business" than a health response. "If it's really business, then come and get vaccinated anyway," he told the crowd, warning him to be wary of those who would dissuade them from getting vaccinated or even instructions from the health authorities.

A reference to the comments made in particular by the national deputy (UNC) of Beni, Crispin Mbindule, who said in the local media last August, that the Ebola virus was created in laboratories and moved from the province of Ecuador in the north-west of the country (where the virus was declared at the beginning of the year) to North Kivu in order to exterminate the population.

Not sure, however, that the Governor's warnings are enough to reassure the population, very worried about the risk of spreading the virus. Since 1 August, the Ebola virus has killed 106 people in North Kivu, including five in the city of Butembo alone.

As a reminder, the effectiveness of the Ebola vaccine is optimal when it is administered within the first 48 hours after exposure to a confirmed case. If the vaccine is given later, knowing that the incubation period is 21 days, the risk of developing the disease, even once vaccinated, is still present.

https://congolibere.com/butembo-le-gouverneur-du-nord-kivu-se-fait-vacciner-pour-lexemple-contre-le-virus-ebola/

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WORLD NEWSOCTOBER 3, 2018 / 12:46 PM / UPDATED 8 HOURS AGO

Attack on Congolese Red Cross Ebola ambulance wounds three volunteers
...
Serge Thierry, a regional ICRC representative, told Reuters that three local Red Cross volunteers were wounded, two seriously, in the attack by angry residents.

?Security measures were taken immediately. Burials are suspended until further notice,? he said by telephone, referring to ICRC activity in and around Butembo city in Beni region.
...

https://www.reuters.com/article/us-health-ebola-congo-attack/attack-on-icrc-ebola-ambulance-in-congo-wounds-three-volunteers-idUSKCN1MD2DC

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Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news
4 October 2018

The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. WHO faces a precarious situation given recent increases in insecurity, incidents of community mistrust, and increased geographical spread.
The period of mourning and general strike (ville morte) in Beni, Butembo and Mabalako has officially ended; the ville morte was organized by civil society leaders following an attack in Beni on 22 September, in which 21 people were killed. Activities that had slowed during the ville morte period included health workers being unable to reach and monitor the health of Ebola patient contacts, social mobilization and community engagement efforts significantly slowed or suspended, risk communications seriously constrained or suspended in areas highly impacted by EVD, and severe limitations on field teams’ ability to investigate alerts of suspected cases and carry out safe and dignified burials. WHO operations are currently back to full scale; however, WHO remains vigilant given ongoing security constraints.
The Ministry of Health (MoH), WHO and partners continue to work closely with people in the affected areas. Most communities support the response efforts and are open to vaccination and treatment; collaboration between communities and local authorities is ongoing to overcome the reluctance and mistrust which has developed in some places. Faced with rumours and misinformation, some families have chosen to care for sick relatives at home, increasing the risk of transmission to caregivers, family and children. Some patients have also left health facilities to seek alternative care, or actively avoid follow-up from health workers. Despite concerted efforts by local community leaders to ensure safe and dignified burials, in some cases these are rejected in favour of traditional practices. Avoiding contact with health workers, home care and unsafe burials all increase the risk to patients themselves, caregivers, children and other family members, and to health/frontline workers, and have contributed to the spread of the outbreak.
The affected areas now cover hundreds of kilometres, including a confirmed case who has moved into a ‘red zone’ - a highly insecure and challenging environment where implementing response activities is extremely difficult. The geographic expansion further strains frontline resources, as an effective Ebola response requires hubs established in multiple locations, as close as possible to the affected population.
Where they have access, response teams continue to enhance activities to prevent new clusters and the potential spread to new areas. WHO continues to work in the affected areas, side-by-side with national and international partners, to support the response led by the MoH. The outbreak’s spread into new, insecure areas in Tchomia Health Zone (with close proximity to the Ugandan border), as well as ongoing security concerns, continues to challenge the overall response. In light of these conditions, WHO revised its risk assessment and elevated the national and regional levels from ‘high risk’ to ‘very high risk’; globally, the risk remains low.
Since the last Disease Outbreak News (data as of 2 October), ten (10) new confirmed EVD cases were reported: eight from Beni and one from Butembo Health Zones in North Kivu, and one from Komanda Health Zone in Ituri. Eight of these confirmed cases have been linked to known cases or transmission chains within the respective communities, while the two other cases remain under investigation.
As of 2 October 2018, a total of 162 EVD cases (130 confirmed and 32 probable), including 106 deaths (74 confirmed and 32 probable) , have been reported in seven health zones in North Kivu Province (Beni, Butembo, Kalunguta, Mabalako, Masereka, Musienene and Oicha), and three health zones in Ituri Province (Mandima, Komanda and Tchomia) (Figure 1). An overall slightly decreasing trend in weekly case incidence continues (Figure 2); however, these trends must be interpreted with caution given the expected delays in case reporting, the ongoing detection of sporadic cases, and security concerns which limit contact tracing and investigation of alerts. Of the 155 confirmed and probable cases for whom age and sex information is known, 22%, 19% and 23% are aged 15-24, 25-34 and 35-44 years, respectively; females (55%) accounted for the greatest proportion of cases (Figure 3). Cumulatively, 19 (18 confirmed and one probable) health workers have been affected to date, three of whom have died.
The MoH, WHO and partners continue to closely monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries. As of 2 October, 11 suspected cases in the Democratic Republic of the Congo are awaiting laboratory testing. Since the last Disease Outbreak News report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, as well as in neighbouring countries. To date, EVD has been ruled out in all alerts from neighbouring provinces and countries.
Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 2 October 2018 (n=162)




Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 2 October 2018 (n=160)*




*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning.
Figure 3: Confirmed and probable Ebola virus disease cases by age and sex, data as 2 October 2018 (n=155)*




*Age and/or sex unknown for n=7 cases.
Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordinating the response, surveillance, contact tracing, laboratory capacity, IPC measures, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance and preparedness activities in neighbouring provinces and countries.

• As of 2 October, over 200 experts have been deployed by WHO to support response activities including emergency coordinators, epidemiologists, laboratory experts, logisticians, clinical care specialists, communicators and community engagement specialists.
• Over 5700 contacts have been registered, of which approximately 1900 remain under surveillance as of 2 October 2 . Following the conclusion of a ville morte imposed in Beni, Butembo and Mabalako Health Zones, there has been a marked improvement in the proportion of follow-up contacts on the day of reporting, with the proportion rising to 93% (1768/1900) from 78% (1401/1785) seven days prior. Beni Health Zone has the greatest challenges in contact tracing as a result of the deteriorating security situation.
• As of 2 October, 69 vaccination rings have been defined in addition to 26 rings of health and frontline workers. To date, 13,758 people consented and were vaccinated, including 5678 health or frontline workers and 2915 children. Ebola Treatment Centres (ETCs) are operational in Beni and Mangina with support from the Alliance for International Medical Action (ALIMA) and M?decins Sans Fronti?res (MSF), respectively. MSF Switzerland and the MoH are supporting an ETC in Butembo. International Medical Corps (IMC) is supporting the recently opened Makeke ETC in Ituri Province. MSF and the MoH are setting up a 12-bed isolation facility in Kasenyi. An isolation unit is being developed from existing facilities in Tchomia.
• WASH and IPC activities are ongoing in the Democratic Republic of the Congo and are supported by several partners in the field. Numerous activities have occurred in health facilities in the affected areas including facility assessments, decontamination of centres, establishment of triage areas and training on standard precautions as well as Ebola-specific IPC measures. A comprehensive plan to strengthen IPC in 200 health facilities, with WHO’s support, aims to: train medical staff; provide IPC kits; and replace incinerated materials in health facilities and households.
• The MoH, WHO, UNICEF, Red Cross and partners are intensifying activities to engage with local communities in the affected areas. Due to conditions imposed by a community-declared ville morte from 24-28 September 2018, social mobilization teams were in lockdown for five days in Beni and unable to engage with communities; the situation in Beni has since improved. Engagement with local leaders in Ndindi in the past weeks has helped increase community ownership, with positive signs that leaders are actively reporting suspected cases through a telephone hotline. More collaboration has also been observed between local authorities and community focal points. Local frontline community outreach workers are collaborating with Ebola response teams to strengthen community engagement and psychosocial support in contact tracing, patient care, SDBs and vaccination of close contacts. In Butembo, community engagement was strengthened through collaboration with a popular singer, Mayaya Santa, producing a song with key messages about Ebola response. The activation of Tchomia’s communication commission has been a priority, and a meeting organized with two religious networks successfully reached 233 leaders from 141 churches in Tchomia Health Zone; youth leaders and motor taxi associations were also engaged as part of the meeting.
• Red Cross SDB teams are trained and operational in Mangina, Beni, Butembo, Oicha and Tchomia. Further operational capacity is being built in Bunia. Trained SDB teams in Mambasa and Goma are without full operational capacity at this point. As of 1 October, Red Cross SDB teams have successfully responded to 162 of the 194 SDB alerts received. In addition, six alerts had not been responded to due to security concerns, and one alert response was pending.
• The WHO Regional Office for Africa has updated the regional preparedness plan and reprioritized neighbouring countries based on proximity to North Kivu, the current EVD epicentre. The new prioritizations are as follows: Priority 1: Rwanda, Uganda, South Sudan and Burundi; Priority 2: Angola, Congo, Central African Republic, Tanzania, Zambia. These countries were prioritised based on their capacity to manage EVD and viral haemorrhagic fever outbreaks, and their connections and proximity to the areas currently reporting EVD cases.
• WHO and partners have supported the strengthening of Public Health Emergency Operations Centre (PHEOC) in five countries (Rwanda, South Sudan, Tanzania, Uganda, and Zambia). Although PHEOC has not been fully established in the remaining countries, the MoH has a national taskforce that meets regularly to discuss EVD preparedness measures. WHO, in collaboration with the MoH and other partners in the field, has developed and updated their national contingency plan and shared this with all key stakeholders. WHO, in collaboration with partners (CDC, UNICEF, OCHA, IOM, GOARN, UK-Med, etc), is supporting the deployment of experts to provide technical support to the Ministries of Health on the implementation of EVD preparedness activities.
• As of 2 October, health screening has been established at 53 Points of Entry (PoEs) and close to 6.5 million travellers have been screened. IOM and PNHF have revised the PoE strategy for Ituri, with more focus on on-site supervision of local surveillance staffs at PoEs by IOM epidemiologists.
• To support the MoH, WHO is working intensively with a wide range of multisectoral and multidisciplinary regional and global partners and stakeholders for EVD response, research and urgent preparedness, including in neighbouring countries. Among the partners are a number of UN agencies and international organizations including: European Civil Protection and Humanitarian Aid Operation (ECHO; International Organization for Migration (IOM); the United Nations Children's Fund (UNICEF); UN High Commission for Refugees (UNHCR); World Food Programme (WFP); United Nations Office for the Coordination of Humanitarian Affairs (OCHA); Inter-Agency Standing Committee (IASC); UK Public Health Rapid Support Team; multiple Clusters, peacekeeping operations and the UN mission; UN Department of Safety and Security (UNDSS); World Bank and regional development banks; African Union, Africa Centres for Disease Control and Prevention (CDC), and regional agencies; Health Cluster partners and NGOs including ALIMA, ADECO, AFNAC, CARITAS DRC, CEPROSSAN, CARE International, COOPI, CORDAID/PAP-DRC, ICRC, IFRC, Red Cross of the Democratic Republic of the Congo, INTERSOS, IRC, MEDAIR, MSF, PNHF, Samaritan’s Purse, and SCI; Global Outbreak Alert and Response Network (GOARN), Steering Committee, EDPLN, ECCARN, technical networks and operational partners, and the Emergency Medical Team (EMT) Initiative. GOARN partners continue to support the response through deployment for response and readiness activities in non-affected provinces and in neighbouring countries and to different levels of WHO.

WHO risk assessment

This outbreak of EVD is affecting north-eastern provinces of the country, which borders Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include the transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and the displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri may hinder the implementation of response activities. On 28 September 2018, based on the worsening security situation, WHO revised its risk assessment for the outbreak, elevating the risk at national and regional levels from high to very high. The risk remains low globally. WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.
As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
WHO advice

WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international travel to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
For more information, see:

• WHO Interim recommendation Ebola vaccines
• WHO recommendations for international travellers
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Ebola virus disease fact sheet

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1The number of cases is subject to change due to ongoing reclassification, retrospective investigation, and the availability of laboratory results.
2The total number of contacts under surveillance is highly dynamic with new cases being registered daily, and those who complete 21 days of post-exposure follow up, without developing symptoms, are released from surveillance.

http://www.who.int/csr/don/04-octobe...-ebola-drc/en/

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DIRECTORATE GENERAL FOR DISEASE CONTROL

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI Monday, October 8, 2018 The epidemiological situation of the Ebola Virus Disease dated 7 October 2018 : A total of 181 cases of haemorrhagic fever were reported in the region, 146 confirmed and 35 probable. Of the 146 confirmed, 80 died and 50 are cured . 21 suspected cases are under investigation. 4 new confirmed cases, 2 in Beni and 2 in Butembo. 2 new confirmed cases, including 1 in Beni and 1 in Butembo. Remarks: To avoid that the total number of cases varies (up or down) daily, the suspect cases have been placed in a separate category. Thus, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table. The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not. News of the response Epidemiological surveillance For several days, we have seen an upsurge in the number of confirmed cases in the city of Beni. This increase in the number of cases in Beni confirms the assessment that infected people who have escaped follow-up and vaccination are beginning to develop the disease. However, the increase in the number of alerts reported in the city of Beni reflects the strengthening of surveillance. The factors contributing to this situation are mainly misinformation, non-collaboration of the population with the response teams and insecurity. More than two months after the declaration of the epidemic, the community continues to prevent the safe and dignified burial, and at-risk contacts still refuse vaccination and 21-day follow-up. According to new forecasts, the number of cases reported in the city of Beni could exceed the number of cases in Mabalako, the epicenter of this epidemic, which has already reported 91 cases including 65 deaths. In view of the situation, a series of administrative measures will be taken by the urban authorities of Beni to reinforce the respect by the population of the rules imposed by the health emergency. In addition, the Beni Ebola Treatment Center (ETC), which currently has 16 beds, will be expanded to accommodate at least 60 patients, additional doses of vaccines have been ordered, and additional epidemiologists will be deployed for alerts investigations. Vaccination Since the start of vaccination on August 8, 2018, 15,114 people have been vaccinated , including 5,250 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,100 in Butembo, 434 in Bunia, 355 in Tchomia, 270 in Masereka, 240 to Komanda, 121 to Oicha.

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