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

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    North Kivu: Mayi-Mayi group attacks and burns Ebola treatment center in Butembo

    Posted on Mon, 25/02/2019 - 13:01 | Edited Mon, 25/02/2019 - 13:01

    A Mayi-Mayi group attacked and burned the Ebola Treatment Center (ETC) in Katwa, Butembo, on Monday, February 25th. The mayor of this city, Sylvain Kanyamanda, who evaluated the damage claims that these militiamen were wearing knives.

    "We found that the hut was burned. And next to this hut, there was a vehicle that serves to move the staff Physicians who manages this treatment center that was burned and some motorcycles. All around the center, we also found that there are two sets of fire generators. They also attacked the logistics and material cell of this center. As for human lives, until late we were there until 3am we did not observe a death case, "explains Sylvain Kanyamanda.

    He also announced that the patients who were being cared for in this center have just been transferred to another Ebola treatment center in Butembo.

    "There was internment of ten patients. These patients were evacuated to other Ebola treatment centers. The danger is permanent and if the population does not want to become aware, we will disappear in this city. And they are Mai-Mai. They had knives, machetes and fuel cans in their hands, "says Kanyamanda.


    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • Translation Google
      DIRECTORATE GENERAL FOR DISEASE CONTROL
      EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

      Monday 25 February 2019


      The epidemiological situation of the Ebola Virus Disease dated February 24, 2019 :
      • Since the beginning of the epidemic, the cumulative number of cases is 872, 807 confirmed and 65 probable. In total, there were 548 deaths (483 confirmed and 65 probable).
      • 176 suspected cases under investigation;
      • 3 new confirmed cases in Katwa;
      • 2 new deaths from confirmed cases in Katwa, all are community deaths;
      • 1 new person cured at the CTE of Beni.
      /! \ Cleaning databases in progress: Revision of the database of people cured. We will start sharing the number of cures as soon as the revision is complete .





      Remarks:
      • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, 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 probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
      • A community death is any death occurring outside of an Ebola Treatment Center.
      News of the response
      The Katwa CTE burned in the night from Sunday to Monday
      • The Ebola Treatment Center (ETC) in Katwa, one of Butembo's health zones, was ransacked and set on fire on the night of Sunday 24th to Monday 25th February 2019. This fire resulted in the death of nurse who was trying to escape.
      >>>>> Read the communiqu? of the Ministry of Health <<<<<
      • These uncivil acts, perpetrated by unidentified perpetrators, began around 10 pm Sunday. For this purpose, the Mayor of Butembo town, Sylvain Mbusa Kanyamanda, who condemned these acts, explained that this attack started with the generators which resulted in the interruption of the electric current that occurred before the fire of some cells, including the center's logistics cell.
      • The deceased nurse would have fallen into a creek as he tried to flee. On the other hand, the ten patients who were hospitalized in this CTE were not affected and were transferred to other health facilities. Of these patients, four are confirmed carriers of the Ebola virus and have been transferred to the Butembo CTE. The six suspected patients were transferred to the Alima transit center in Katwa.
      • Butembo's mayor is urging the people of the country to work with Ebola response teams to stop the spread of the disease in the city. He also denounced the incivists whose intention is the destabilization of health experts. The specialized services continue the investigations, according to the mayor, to identify the perpetrators of this attack.

      CENI President raises awareness about Ebola Virus Disease
      • The President of the Independent National Electoral Commission (INEC), Corneille Naanga, on Sunday visiting the Butembo Ebola Subcommittee on Ebola response, appealed to all Congolese, especially those in areas affected by the Ebola virus disease to respect the different councils of health professionals to fight against this disease.
      • The objective of his mission in Beni and Butembo was to evaluate the preparations for the elections of national and provincial deputies to be held on March 31, 2019.
      • He took advantage of his visit to not only raise awareness about the Ebola virus disease, but especially to encourage the teams of the response for their work, which he himself qualifies as commendable. "Ebola has not only started in North Kivu. This is the tenth epidemic that the DRC is experiencing. It is a very dangerous disease, "he said, adding that he will deploy a large team for the elections. "We ourselves have just received instructions that once the teams are in the field, they will be vaccinated and we will also follow all the advice of health professionals. "These elections will involve all neighborhoods, even the neighborhoods where the Ebola outbreak continues," said Corneille Naanga.


      Vaccination
      • Since the start of vaccination on 8 August 2018, 83,517 people have been vaccinated , including 21,357 in Katwa, 20,613 in Beni, 10,220 in Butembo, 6,109 in Mabalako, 2,839 in Kalunguta, 2,581 in Goma, 2,317 in Komanda, 2,084 in Oicha, 1,813 to Mandima, 1,325 to Kyondo, 1,357 to Karisimbi, 1,283 to Kayina, 1,094 to Bunia, 1,064 to Vuhovi, 920 to Masereka, 772 to Mutwanga, 767 to Biena, 700 to Lubero, 590 to Rutshuru, 583 to Musienene, 527 in Nyankunde, 496 in Mangurujipa, 426 in Rwampara (Ituri), 355 in Tchomia, 333 in Lolwa 280 in Mambasa, 254 in Alimbongo, 207 in Kirotshe, 141 in Nyiragongo, 97 in Watsa (Haut-U?l?) and 13 in Kisangani .
      • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.



      ...
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • Ebola response in Democratic Republic of the Congo risks slowdown

        26 February 2019 News Release

        Geneva, Switzerland


        WHO Director-General Dr Tedros Adhanom Ghebreyesus today called on donors to continue funding the response to the Ebola outbreak in the Democratic Republic of the Congo or risk backsliding. There is an urgent need for US $148 million for all partners involved in the response to continue their work. So far, under US $10 million has been pledged.

        The call comes a week ahead of Dr Tedros’ next mission to DRC. He is scheduled to meet President Tshisekedi in Kinshasa before travelling to the Ebola-stricken areas of Butembo and Katwa.

        “The situation is unprecedented: there has never been an Ebola outbreak in these conditions, with such a highly mobile population and with many gaps in the health system .” said Dr Tedros.

        “The security context is another major concern. I am deeply saddened by reports that a health facility run by M?decins Sans Fronti?res in Katwa was attacked on Sunday night. Nevertheless, together with partners and with the Democratic Republic of the Congo government in the lead, we have made major gains. Hundreds of deaths have been averted, maybe even thousands. But the outbreak is not over and we urgently need additional funding to see it through.”

        Over 80,000 people have been vaccinated and over 400 have received treatment. Thousands of suspect cases have been monitored, tested and transferred to other centres once they were confirmed to not have Ebola. More than 40,000 contacts have been identified and reached daily for three weeks each to ensure they did not fall sick as well. WHO alone has shipped over 300 metric tons of supplies, including vaccination supplies and 470,000 sets of personal protective equipment for partners running treatment centres.

        Alongside the response in the country, hundreds of health workers, border officers and other responders in neighbouring countries have been trained and prepared for a responding to a potential case.

        Response partners have contained the outbreak in successive health zones, and prevented transmission to neighbouring countries, demonstrating that success is possible despite the difficult context. However, the on-going transmission in Butembo and Katwa, with the potential for the outbreak to reach into even more volatile and dangerous areas – where almost no partners could be able to operate. This is why support is needed now. Only if current actions are sustained and intensified will we be able to end this outbreak in the coming months.

        The response plan for the period February to July, which brings together the planned actions and funding needs of all partners, was launched by the country’s health minister on 13 February. It anchors the response in local health system structures, strengthening the capacities of local responders, especially at provincial and local levels, and deepening the involvement of local communities, especially women’s groups and survivors.

        “We have a shared responsibility to end this outbreak,” said Dr Tedros, adding that the continuing generous technical and financial support from the donor community is proof of the global commitment to stopping the outbreak. “We now need them to join us in the final push. No country or partner can face this deadly virus alone. The impact on public health and the economic ramifications can expand far beyond one country or continent. We promise we won’t relent until we’ve stopped this outbreak. But beating Ebola, wherever it may be, is expensive. It requires all of us to work together.”

        https://www.who.int/news-room/detail...risks-slowdown


        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • -----------------------------------------------------------------

          North Kivu: MSF Ebola centre inoperative after violent attack

          Press Release26 February 2019

          MSF’s Ebola treatment centre was attacked and partly burnt down, forcing services to be suspended

          The attack and suspension hampers response to DRC’s worst-ever Ebola outbreak

          Organisations, including MSF, have failed to gain trust from communities; approaches to people must change

          KATWA – Following a violent attack on an Ebola Treatment Centre in North Kivu, Democratic Republic of Congo (DRC), where the facility was partially burnt down, M?decins Sans Fronti?res (MSF) has decided to suspend activities at the centre. The suspension will severely limit access to essential health services.

          At 10pm on 24 February, unidentified assailants attacked the MSF-managed Ebola Treatment Centre in Katwa. After throwing stones at the facility, they set parts of the structure on fire and destroyed wards and equipment. The brother of a patient died while reportedly trying to flee the scene. The exact circumstances of his death are still unclear.

          “This attack was traumatic for patients, their relatives and staff present inside the centre at the time,” said Emmanuel Massart, MSF’s Emergency Coordinator in Katwa. “We managed to relocate all four confirmed and six suspected patients to nearby treatment centres, but this attack has crippled our ability to respond to what is now the epicentre of the outbreak.”

          ...
          https://www.msf.org/msf-ebola-centre...republic-congo




          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • Why Does Ebola Keep Spreading In Congo? Here's A Major Clue

            February 25, 20195:02 PM ET

            NURITH AIZENMAN
            ...
            Yao is leading the World Health Organization's on-the-ground response to the ongoing Ebola outbreak in the Democratic Republic of the Congo. And as each new person falls sick, his team must race to figure out how the person got infected.
            ...
            But some weeks ago, as cases started erupting around two towns, Katwa and Butembo, the investigators found that patient after patient had something else in common: They had all recently visited a health clinic for treatment for some other disease such as a respiratory infection or malaria.

            "They would say, 'I went to the hospital. They treated me. I got clear [of that illness]. And then a few days after, I start having fevers.' " Fevers that were the first of signs of Ebola.
            ...
            When Yao started visiting the clinics, it was pretty obvious how this was happening: Even government-run facilities such as large hospitals hadn't set up triage tents to separate possible Ebola patients from everyone else.

            "This disease is not well-known in this part of the country. It is the first time," Yao explains, even though Ebola has broken out in other parts of the DRC on multiple occasions.

            Even more problematic, says Yao, are the hundreds of unofficial private health facilities in this area. Some are large operations. In many other cases, says Yao, "it's just a house ? a very old house."
            ...

            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • Translation Google
              DIRECTORATE GENERAL FOR DISEASE CONTROL
              EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

              Tuesday, February 26, 2019


              The epidemiological situation of the Ebola Virus Disease dated February 25, 2019 :
              • Since the beginning of the epidemic, the cumulative number of cases is 875, of which 810 are confirmed and 65 are probable. In total, there were 551 deaths (486 confirmed and 65 probable).
              • 196 suspected cases under investigation;
              • 3 new confirmed cases, including 1 in Mandima, 1 in Vuhovi and 1 in Butembo;
              • 3 new deaths of confirmed cases, including 1 in Mandima, 1 in Vuhovi and 1 in Butembo, all are community deaths;
              • 1 new person healed out of Butembo CTE.
              /! \ Cleaning databases in progress: Revision of the database of people cured. We will start sharing the number of cures as soon as the revision is complete .





              Remarks:
              • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, 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 probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
              • A community death is any death occurring outside of an Ebola Treatment Center.
              News of the response

              Revision of databases
              • The different databases are being revised to check and harmonize them. In discussion with the different partners involved in epidemiological surveillance, the decision was made to reclassify all cases in the health zone where they started the symptoms of the disease. Several questions arose as to the classification of some cases that had moved between two or even three health zones between the onset of symptoms and their death. In these particular cases, only thorough investigations can determine where the person has started to show signs of the disease, which may take several days. Pending the results of the investigations, some of these cases are tentatively classified in the health zone where they were detected.
              • These cases include the patient from Katwa who fled to Bunia with her family after falling ill in her area of ​​residence but whose body was found in Komanda. This patient was initially classified in Komanda but was reclassified to the Katwa Health Zone after completion of the in-depth investigation.
              • On Tuesday, February 26, 2019, Lubero District Chief Medical Officer said that a case of Ebola had been detected in the health zone of Lubero. This is a young woman from Katwa, who was known to be in contact with another confirmed case and who refused to be transferred to the Ebola Treatment Center when she became ill. She ran away from Katwa for Lubero. She died the next day at the Lubero General Referral Hospital from where the alert was launched. This patient was classified in the health zone of Katwa, where her first symptoms appeared.
              • ...
              https://us13.campaign-archive.com/?u...&id=e40a2cdcce


              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment


              • Translation Google

                Ebola treatment center held by MSF attacked in the East

                1 hour ago
                AFP

                An Ebola treatment center held by M?decins sans Fronti?res (MSF) was attacked Wednesday in Butembo, the epicenter of the hemorrhagic fever epidemic in the eastern part of the Democratic Republic of Congo. we learned from concordant sources.

                "Butembo's ETC (Ebola Treatment Center) has just been attacked by attackers armed with guns and arrows, they have just burned the first CTE reception facilities, fortunately the police have just stopped Action is under way, "Sylvain Kanyamanda, the mayor of the city, told AFP.

                "We do not yet know who did this," said a member of the National Intelligence Agency (ANR).

                "MSF confirms that a security incident is currently taking place at the Butembo CTE, we have no more information to share at the moment," the NGO said.

                "Butembo's CSE policemen repelled the assailants' attack and managed to extinguish the fire, some (of the center) is burned, and we regret the death of a policeman," he told reporters. AFP Colonel Richard Mbambi, Butembo police chief.

                Another CTE held by this NGO was attacked in the night from Sunday to Monday in Katwa, not far from Butembo, making it impossible to take care of patients.
                ...

                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • Translation Google

                  MSF in DRC
                  @MSFcongo
                  1 hr1 hour ago

                  MSF deplores the attack on the #Ebola treatment center in Butembo, North Kivu. @MSFcongo & @MinSanteRDC are actively working to ensure that all patients, companions and staff are safe, many of whom have fled the fire.
                  -----------------------------------------------------------------------------------------------
                  Koma Ebola
                  ‏@EbolaKoma
                  5 hrs5 hours ago

                  #EbolaReport: The Ebola Treatment Center (ETC) at # Itav, in #Butembo, has just been burned by unknown people. No assessment is available at the moment. Our correspondents on the spot note the presence of the police and the army on the site.

                  "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                  -Nelson Mandela

                  Comment


                  • Doctors w/o BordersVerified account @MSF_USA 3 hrs3 hours ago More



                    BREAKING: Awful news from DRC - just days after MSF?s Ebola treatment center in Katwa was attacked, today there was an attack on our treatment center in Butembo. We?re focused now on ensuring the safety of our patients and staff. https://www.doctorswithoutborders.org/what-we-do/news-stories/news/drc-msf-ebola-treatment-center-butembo-attacked?






                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


                    • Translation Google
                      DIRECTORATE GENERAL FOR DISEASE CONTROL
                      EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                      Wednesday, February 27, 2019


                      The epidemiological situation of the Ebola Virus Disease dated February 26, 2019 :
                      • Since the beginning of the epidemic, the cumulative number of cases is 879, of which 814 are confirmed and 65 are probable. In total, there were 553 deaths (488 confirmed and 65 probable).
                      • 229 suspected cases under investigation;
                      • 4 new confirmed cases, including 3 in Katwa and 1 in Butembo;
                      • 2 new deaths of confirmed cases, 1 in Katwa and 1 in Butembo, all are community deaths.
                      /! \ Cleaning databases in progress: Revision of the database of people cured. We will start sharing the number of cures as soon as the revision is complete .





                      Remarks:
                      • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, 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 probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
                      • A community death is any death occurring outside of an Ebola Treatment Center.
                      News of the response

                      Attack on Butembo Ebola Treatment Center
                      • On the evening of Wednesday, February 27, 2019, unidentified gunmen attacked the Butembo CTE co-managed by M?decins Sans Fronti?res and the Ministry of Health. This attack took place only three days after the arson attack of the Katwa CTE, the neighboring health zone.
                      • At the time of the attack, 38 suspected patients and 12 confirmed patients were treated at the CTE. Of the suspected patients, 32 fled. And among the confirmed cases, 8 were found in their single rooms. Research is underway to find the 4 confirmed fugitives. All the patients found, as well as the medical staff, are safe and unharmed. The patients were temporarily transferred to the Butembo Transit Center operationalized by Alima.

                      Workshop on the implementation of the 3 th Strategic Plan Response
                      • On Tuesday, February 26, 2019, the Minister of Health, Dr Oly Ilunga Kalenga, opened in Goma, the workshop on the implementation of the third strategic plan for response to the Ebola epidemic (SRP 3) in provinces of North Kivu and Ituri. This workshop brought together all the national and international actors of the response, including all the health authorities of the different health zones of the region.
                      • The purpose of the two-day workshop was to explain the PSR 3 to all local health authorities, senior staff of strategic coordination and sub-coordination as well as to gain ownership of the plan to ensure better Implementation.
                      • This new plan focuses on three important areas:
                        1. The anchoring of the response in the local health system : The leadership and the expertise of the response belong to the specialized teams while the optimization of the functioning of the health system is the responsibility of the actors of the local health system (Provincial Division of Health). Health, Health Zone and Health Area).
                        2. Establishment of an information management system : The informationmanagement mechanism has been strengthened to improve data collection and analysis at all levels.
                        3. The importance of accountability : An important addition in SRP 3 is the accountability framework for each stakeholder involved in the response, both local providers and international partners. This accountability framework clearly identifies the roles and responsibilities of each organization in the response to assess their performance on the ground.


                      ...
                      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                      -Nelson Mandela

                      Comment


                      • Barry Rodrigue@barryr33082845 53m53 minutes ago More



                        #Butembo at the moment. Crisis meeting with the Staff. @drmichelyao1 #WHO Incident Manager for #Ebola Response in #DRC (middle). After Ebola Treatment Unit attack yesterday night #MSF and @ALIMA_ORG experts in case management have been relocated in #B?ni and #Bunia.









                        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                        -Nelson Mandela

                        Comment


                        • WHO expresses concern over damage to Ebola treatment facilities in the Democratic Republic of the Congo




                          BRAZZAVILLE/28 February 2019 –The World Health Organization (WHO) is deeply concerned about the recent attacks on the M?decins Sans Fronti?res (MSF)-run Ebola treatment centres on 24 February in Katwa and on 27 February in Butembo in the Democratic Republic of the Congo. Such attacks are deplorable for their immediate impact on lives and for the risk of spreading the disease further. They are profoundly disrespectful of the dedicated work of local, regional and international responders.

                          Following the most recent Butembo attack, WHO and partners are working to ensure the safety of the patients and staff. Patients have been transferred to the Katwa transit centre, which WHO is expanding to house and treat these additional patients. It is a priority of the response to ensure quality clinical care for the patients. Staff on the ground are also working to follow up with the four convalescent patients who sought shelter elsewhere during the violence.

                          MSF reported that their staff were safe. Likewise, WHO staff in the area are all accounted for. However, security services did experience casualties.
                          These attacks have occurred in areas with ongoing transmission of Ebola in the community and could lead to increases in transmission and result in more hardship for the local community. The violence and disruption to the treatment centres also make it difficult for Ebola responders to carry out field work.

                          WHO teams on the ground continue to work tirelessly to respond to the challenges. WHO is working closely with our partners to determine appropriate action to ensure the overall Ebola response is maintained. Working with the Ministry of Health and our partners, our priority continues to be to end the outbreak.
                          ...

                          https://afro.who.int/media-centre/st...form=hootsuite

                          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                          -Nelson Mandela

                          Comment


                          • Source: https://www.who.int/csr/don/28-febru...-ebola-drc/en/
                            Ebola virus disease ? Democratic Republic of the Congo

                            Disease outbreak news: Update
                            28 February 2019

                            The Ebola virus disease (EVD) outbreak is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern, while simultaneously, small clusters continue to occur in various geographically dispersed locations. During the last 21 days (6 ? 26 February 2019), 77 new cases have been reported from 33 health areas within nine health zones (Figure 1), including: Katwa (45), Butembo (19), Vuhovi (4), Kyondo (3), Kalunguta (2), Oicha (1), Beni (1), Mandima (1), and Rwampara (1).
                            Although there are decreasing trends in case incidence (Figure 2), the high proportion of community deaths reported among confirmed cases and relatively low number of new cases who were known contacts under surveillance could increase the risk of further chains of transmission in affected communities. Response teams must maintain a high degree of vigilance across all areas with declining case incidence and contact tracing activity, as well as in areas with active cases, to rapidly detect new cases and prevent onward transmission. Following attacks this week on the treatment centres in Katwa and Butembo, WHO is working with partners to ensure the safety of the patients and staff. These incidents are disruptive to the response on many levels and can also hamper surveillance activities in the field.
                            As of 26 February, 879 EVD cases1 (814 confirmed and 65 probable) have been reported, of which 57% (499) were female and 30% (264) were children aged less than 18 years. Cumulatively, cases have been reported from 119 of 301 health areas across 19 health zones. Overall, 553 deaths (case fatality ratio: 63%) have been reported and as of 19 February 2019, 257 survivors have been reported. There is ongoing cleaning of the case database to correct the number deaths and survivors discharged from Ebola Treatment Centres (ETCs).
                            Figure 1: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 23 February 2019




                            Enlarge image
                            Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 26 February 2019*




                            Source: Ministry of Health, Democratic Republic of the Congo
                            *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning ? trends during this period should be interpreted cautiously.
                            Public health response

                            For further detailed information about the public health response actions by the MoH, 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. National and regional risk levels remain very high, though global risk levels remain low. This EVD outbreak is affecting primarily the north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of EVD at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons, as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria, measles), and a long-term humanitarian crisis. Additionally, the fragile security situation in North Kivu and Ituri, further limits the implementation of response activities.
                            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. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. 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

                            International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
                            For more information, see:



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

                            Comment


                            • Translation Google
                              DIRECTORATE GENERAL FOR DISEASE CONTROL
                              EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                              Thursday, February 28, 2019


                              The epidemiological situation of the Ebola Virus Disease dated February 27, 2019 :
                              • Since the beginning of the epidemic, the cumulative number of cases is 885, of which 820 are confirmed and 65 are probable. In total, there were 555 deaths (490 confirmed and 65 probable).
                              • 227 suspected cases under investigation;
                              • 6 new confirmed cases, including 5 in Katwa and 1 in Kalunguta;
                                • The new case confirmed in Kalunguta is a known contact of a confirmed case of Katwa who had refused follow-up and vaccination.
                              • 2 new deaths of confirmed cases, including 1 in Katwa and 1 in Kalunguta (all community deaths);
                              • 1 new person healed out of CTE de Beni.
                              /! \ Cleaning databases in progress: Revision of the database of people cured. We will start sharing the number of cures as soon as the revision is complete .





                              Remarks:
                              • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, 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 probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
                              • A community death is any death occurring outside of an Ebola Treatment Center.
                              News of the response


                              Minister's visit to Butembo
                              • On Thursday, February 28, 2019, the Minister of Health, Dr. Oly Ilunga Kalenga, accompanied by the Representative of the WHO in the DRC, went to Butembo to inquire about the situation on the ground following the two arson that destroyed Ebola Treatment Centers in Katwa and Butembo.
                              • These two incidents greatly disrupted the response teams. For several days, these teams have been the target of attacks and threats that have significantly slowed down the response activities, particularly the follow-up of contacts, the investigation of alerts, the vaccination of contacts, and the prevention and control activities. infections (PCI). Thus, it will be expected a significant upsurge of cases in health areas of Katwa and Butembo in the coming days. The Minister met with members of the sub-coordination and field teams to reassure them of the support and full support of the Ministry of Health.
                              • With the mayor of the city and the coordinator of the Butembo sub-coordination, the Minister visited the sites of the two burned CTEs. The Minister urged the Mayor of Butembo that it will be impossible to control the epidemic in the city until the security of the agents of the response is assured.


                              ...
                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                              -Nelson Mandela

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                              • Democratic Republic of Congo

                                Medical activities suspended after Ebola treatment centre attack


                                Statement 28 February 2019

                                M?decins Sans Fronti?res (MSF) has put on stand-by its medical activities in the epicentre of the Ebola epidemic, in Butembo and Katwa, in the province of North Kivu, Democratic Republic of the Congo, following an attack on an Ebola treatment centre in Butembo city during the evening of 27 February.

                                Unidentified assailants set some of the compound?s facilities and vehicles on fire. The blazes were contained, but the teams were obliged to immediately cease patient care. At the time of the attack, there were 57 patients admitted in the treatment centre, which was run alongside the Ministry of Health; 15 of the patients were confirmed to have Ebola.

                                This incident comes only days after another Ebola treatment facility, also supported by MSF teams in the neighbouring district of Katwa, was attacked on 24 February ? also forcing its suspension. MSF has evacuated its staff from the area for their safety pending a thorough analysis of the risks associated with continuing to provide medical care there.
                                ...

                                An MSF Ebola treatment centre in Butembo, North Kivu, was attacked on 27 February, just days after another treatment centre in nearby Katwa was partly burnt down.
                                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                                -Nelson Mandela

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