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

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  • Translation Google
    EPIDEMIOLOGICAL SITUATION
    EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

    Thursday, June 6, 2019


    The epidemiological situation of the Ebola Virus Disease dated June 5, 2019 :
    • Since the beginning of the epidemic, the cumulative number of cases is 2,031, 1,937 confirmed and 94 probable. In total, there were 1,367 deaths (1,273 confirmed and 94 probable) and 552 people healed.
    • 293 suspected cases under investigation;
    • 6 new confirmed cases, 2 in Musienene, 2 in Mandima, 1 in Butembo and 1 in Mabalako;
    • 10 new confirmed cases deaths:
      • 3 community deaths, including 1 in Butembo, 1 in Musienene and 1 in Mabalako;
      • 7 deaths at CTE, including 4 in Mabalako and 3 in Butembo.
    ...
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • Source: https://www.who.int/csr/don/06-june-2019-ebola-drc/en/
      Ebola virus disease ? Democratic Republic of the Congo

      Disease outbreak news: Update
      6 June 2019

      As the Ebola virus disease (EVD) outbreak surpasses the 2000 case mark, indicators over the past two weeks provide early signs of an easing of the transmission intensity. This follows a period of improved security and therefore access to communities, allowing response teams to operate more freely. A total of 88 confirmed cases were reported each week for the past two epidemiological weeks, down from a peak of 126 cases per week observed in April. Declines in the incidence of new cases have been most apparent in hotspots such as Katwa, Mandima and Beni health zones. Concurrently, improvements in the proportion of cases among contacts registered prior to onset (up from 30% three weeks ago to 55% last week), and a lower proportion of cases resulting from transmission within community health facilities (from 31% during the first week of April 2019 to 9% during the last week of May 2019), are encouraging. Nevertheless, both indicators are below where we would aim to be. The outbreak continues to be contained within 12 active health zones in North Kivu and Ituri provinces.
      However, substantive rates of transmission continue within affected communities, and further waves of the outbreak may be expected. An increase in the incidence of new cases has been reported from Mabalako Health Zone in recent weeks, and high infection rates continue within Butembo metropolitan. Times between detecting, reporting and admission of cases at Ebola treatment/transit centres (ETCs) remains too long (median 6 days, interquartile range 4?9 days in the past 3 weeks), with about a third (34% in the past 3 weeks) of cases dying outside of ETCs. Collectively these indicators highlight that the risks associated with this outbreak remain very high.
      In the 21 days between 15 May to 4 June 2019, 80 health areas within 12 health zones reported new cases, representing 12% of the 664 health areas within North Kivu and Ituri provinces (Table 1 and Figure 2). During this period, a total of 280 confirmed cases were reported, the majority of which were from the Mabalako (27%, n=75), Butembo (23%, n=63), Katwa (16%, n=44), Beni (11%, n=30), Kalunguta (8%, n=23), Mandima (7%, n=19) and Musienene (5%, n=14) health zones.
      As of 4 June 2019, a total of 2025 EVD cases, including 1931 confirmed and 94 probable cases, were reported. A total of 1357 deaths were reported (overall case fatality ratio 67%), including 1263 deaths among confirmed cases. Of the 2025 confirmed and probable cases with known age and sex, 58% (1170) were female, and 29% (589) were children aged less than 18 years. The number of healthcare workers affected has risen to 110 (5% of total cases).
      Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 4 June 2019*




      Enlarge image
      *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
      Figure 2: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 4 June 2019




      Enlarge image
      Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 4 June 2019**




      Enlarge image
      **Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
      Public health response

      For further 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. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Weekly increases in the number of new cases were observed from February through mid-May 2019, with lower though still substantial rates since then. A general deterioration of the security situation, and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity, especially over the past four weeks, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas, reducing the overall effectiveness of interventions. However, recent community dialogue, outreach initiatives, and restoration of access to certain hotspot areas have resulted in some improvements in community acceptance of response activities and case investigation efforts. In order to ensure staff safety and security, security mitigation measures are being enhanced, and procedural, operational, and physical security challenges are being addressed. The high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to nosocomial infection, persistent delays in detection and isolation in ETCs, and challenges in the timely reporting and response to probable cases, are all factors increasing the likelihood of further chains of transmission in affected communities and increasing the risk of geographical spread both within the Democratic Republic of the Congo and to neighbouring countries. The high rates of population movement occurring from outbreak affected areas to other areas of the Democratic Republic of the Congo and across porous borders to neighbouring countries during periods of heightened insecurity further compounds these risks. Additional risks are posed by the long duration of the current outbreak, fatigue amongst response staff, and ongoing strain on limited resources. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have likely increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up.
      WHO advice

      WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. 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, please see:


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      • Translation Google
        EPIDEMIOLOGICAL SITUATION
        EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

        Friday, June 7, 2019


        The epidemiological situation of the Ebola Virus Disease dated June 6, 2019 :
        • Since the beginning of the epidemic, the cumulative number of cases is 2,039, 1,945 confirmed and 94 probable. In total, there were 1,373 deaths (1,279 confirmed and 94 probable) and 552 people healed.
        • 283 suspected cases under investigation;
        • 8 new confirmed cases, including 3 in Mabalako, 2 in Mandima, 1 in Beni, 1 in Butembo and 1 in Katwa;
        • 6 new confirmed case deaths:
          • 5 community deaths, 2 in Mabalako, 2 in Mandima and 1 in Beni;
          • 1 death at the CTE of Butembo.
        ...

        111 Contaminated health workers

        One Mabalako health worker, vaccinated, was one of the new confirmed cases.

        The cumulative number of confirmed / probable cases among health workers is 111 (5.4% of all confirmed / probable cases), including 37 deaths.
        ...
        "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

          North Kivu-Ebola: Altercation between the population and the response team this Saturday in Cantine

          Sat 08/06/2019 - 17:29

          Ebola 7SUR7.CD

          The situation remained hectic this Saturday in Mangato district, Cantine-Aloya locality in Beni territory.

          Indeed, it was reported an uprising of the population against Ebola response teams that came from Mangina to fight against this virus in this part of the territory of Beni where many positive cases are currently recorded.

          According to Mangina's civil society, despite the sensitization, the population of Cantine persists in their doubts about the existence of this epidemic in the eastern part of the country.

          Unfortunately, he laments, patients who flee this locality come again contaminate the city of Mangina where the virus is more and more contained by the response for some months now.

          Civil society reports that it was the inhabitants of Cantine, in collusion with the Mai-Mai, who forced the response teams to turn back and that the worst would be lived if the police did not intervene in time.

          "It has been a week since Ebola cases are being registered at the Mangina Ebola treatment centers, and most of these cases come from Cantine and Mabalako. The population has risen against the response teams, all the teams have returned to the base, and we learn at the last minute that it is the mixed population of the Mai-Mai, "said the civil society.

          Other sources report that a lady was hit by a bullet during this tug.

          Isaac Kisatiro from Butembo

          La situation est restée agitée ce samedi au quartier Mangato, localité de Cantine-Aloya en territoire de Beni. En effet, il a été signalé un soulèvement de la population contre les équipes de riposte à la maladie Ebola qui venait de Mangina en vue de mener une lutte contre ce virus dans cette partie du territoire de Beni où de nombreux cas positifs sont actuellement enregistrés. Selon la société civile de Mangina, en dépit de la sensibilisation, la population de Cantine persiste dans son doute au sujet de l'existence de cette épidémie dans la partie Est du pays.

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

          Comment


          • Translation Google
            EPIDEMIOLOGICAL SITUATION
            EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

            Saturday, June 8, 2019


            The epidemiological situation of the Ebola Virus Disease dated June 7, 2019 :
            • Since the beginning of the epidemic, the cumulative number of cases is 2,047, of which 1,953 are confirmed and 94 are probable. In total, there were 1,381 deaths (1,287 confirmed and 94 probable) and 556 people healed.
            • 273 suspected cases under investigation;
            • 8 new confirmed cases, including 3 in Mandima, 2 in Katwa, 1 in Rwampara, 1 in Butembo and 1 in Mabalako;
            • 8 new confirmed cases deaths:
              • 4 community deaths, including 1 in Mandima, 1 in Rwampara, 1 in Butembo and 1 in Mabalako;
              • 4 CTE deaths, 2 in Mabalako, 1 in Beni and 1 in Katwa;
            • Four new cures emerged from CTEs, including 3 in Butembo and 1 in Beni.


            /! \ The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas .


            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.
            • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
            • 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.
            Distribution of Ebola Virus Disease (EVD) cases by health zone in the provinces of Ituri and North Kivu as of 7 June 2019.
            • 1 new health zone did not report a case for 21 days: Lubero.
            • 1 health zone has started to report cases again: Rwampara
            • In total, 11 of the 22 affected health zones did not report new confirmed cases for at least 21 days.
            Epidemiological curve since January 2019
            NEWS


            Community deaths in Rwampara
            • The community death in Rwampara Health Zone, Ituri province, is the mother of a child who died of Ebola in Oicha at the beginning of May. She was neither vaccinated nor followed. When she became ill, she was treated for home poisoning by a traditional healer. After a few days, she was admitted to a first health post. Due to the deteriorating symptoms, her family wanted to transfer her to another health center but she died on the way. The dignified and secure burial has been realized.

            "Everything about Ebola" conference at the University of Assumption in Congo (UAC)
            • This Saturday, June 8, 2019, an Ebola conference was organized for UAC students in Butembo. The students had the opportunity to ask all their questions about the disease and about the response mechanisms to the teams present at the conference. They talked about vaccines, response strategies, and how to manage the disease. Several Ebola conferences are organized in the different universities of Butembo to inform the students who will, in turn, raise their awareness.

            Situation of providers in Mabalako
            • Contrary to civil society statements, no providers' strike took place in Mabalako this Saturday, June 8, 2019, and the response activities proceeded as planned.
            • Regarding the payment of Ebola premiums from providers working in the Mabalako sub-coordination, the Ministry of Health was informed of irregularities in the payment of these premiums by national, provincial and local agents. These irregularities take the form of unjustified extensions in the field and an organized system of double premium payments. The General Inspectorate of Health has been seized and investigations are under way.
            ...
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment



            • Translation Google

              Ituri: a person dies of Ebola in the city of Bunia

              Posted on Sun, 09/06/2019 - 17:09 | Edited on Sun, 09/06/2019 - 17:09

              A woman died Friday, June 7 of the Ebola virus disease in the city of Bunia (Ituri). According to Dr. Louis Tsulo, chief medical officer of health division in Ituri, who gives this news this Sunday, June 9, the victim came from the city of Beni in North Kivu where she was wanted by the response team.

              "There is a body of a lady who has tested positive for Ebola. Going back in history, she went to Beni. She was the contact we were looking for there. She died at home, "said Dr. Louis Tsulo.

              He added that all the measures are taken to contain the spread of this disease. He invites the people of Bunia to calm and respect hygiene measures.

              "Since yesterday, Saturday, we are identifying all the contacts around the case. And in relation to these contacts, we will observe them for 21 days. Contacts will also benefit from vaccination. Our team disinfected the household where she was. In the city of Bunia all steps are being taken to quickly stop the circulation of the virus in the city, "says Dr. Louis Tsulo.

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

              Comment


              • Translation Google
                EPIDEMIOLOGICAL SITUATION
                EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                Sunday, June 9, 2019


                The epidemiological situation of the Ebola Virus Disease dated June 8, 2019 :
                • Since the beginning of the epidemic, the cumulative number of cases is 2,056, of which 1,962 confirmed and 94 probable. In total, there were 1,384 deaths (1,290 confirmed and 94 probable) and 564 people cured.
                • 271 suspected cases under investigation;
                • 9 new confirmed cases, including 4 in Mabalako, 2 in Butembo, 1 in Mangurujipa, 1 in Musienene and 1 in Beni;
                • 3 new confirmed cases deaths:
                  • 1 community death in Mabalako;
                  • 2 deaths at CTE Mabalako;
                • 8 new healed CTEs, including 6 in Katwa and 2 in Butembo.
                ...
                112 Contaminated health workers

                One Mabalako health worker, vaccinated, is one of the new confirmed cases. The nurse accepted her transfer to the CTE as soon as the positive result was announced. He is the second health worker at the same Mabalako health clinic to be infected with Ebola after several infected patients have been admitted.

                The cumulative number of confirmed / probable cases among health workers is 112 (5.4% of all confirmed / probable cases) including 37 deaths.
                ...
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • Translation Google
                  EPIDEMIOLOGICAL SITUATION
                  EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                  Monday, June 10, 2019


                  The epidemiological situation of the Ebola Virus Disease dated 9 June 2019 :
                  • Since the beginning of the epidemic, the cumulative number of cases is 2.062, of which 1,968 are confirmed and 94 are probable. In total, there were 1,390 deaths (1,296 confirmed and 94 probable) and 569 people healed.
                  • 280 suspected cases under investigation;
                  • 6 new confirmed cases, including 3 in Mabalako, 1 in Mandima, 1 in Beni and 1 in Musienene;
                  • 6 new confirmed case deaths:
                    • 1 community death in Musienene;
                    • 5 deaths at CTE, including 3 in Katwa and 2 in Butembo;
                  • 5 new cures emerged from ETCs, including 3 in Butembo and 2 in Beni.
                  ...

                  113 Contaminated health workers

                  One Mabalako health worker, vaccinated, is one of the new confirmed cases.


                  The cumulative number of confirmed / probable cases among health workers is 113 (5.5% of all confirmed / probable cases), including 37 deaths.

                  https://us13.campaign-archive.com/?u...&id=abf2fe2bc2
                  "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

                    BUNIA: A CONFIRMED EBOLA CASE REGISTERED IN HOHO DISTRICT

                    Posted By: Loikaon: June 10, 2019In: healthNo Comments Print Email
                    ...
                    This is a woman from Beni in neighboring North Kivu who has spent 5 days interned since June 06, 2019 in the health center la Charit? located Hoho district, in the south-western periphery of the city.

                    "The woman arrived in our center, she showed no sign of Ebola. In her complaint, she told us about abdominal pain and acute gastritis. We interned for 5 days. Her temperature was normal, she had no bleeding, but she had diarrhea for only 1 day "testifies the nurse holding this medical structure, his words were collected by our confreres of radio channel revelation of Bunia.

                    According to the same source, it was on the 6th day that the patient's health deteriorated badly. The decision was then made to transfer to the Salama clinic for better care, but the victim died along the way.

                    Her body was then deposited in the morgue of the General Reference Hospital of Bunia where samples taken by the Ebola response team will reveal a positive result.

                    The response coordinator, interviewed by buniaactualite.com, said she quickly rushed to the scene, immediately alerted, to put in place all the provisions to list all the people who came into contact with the victim.

                    Editor

                    https://buniaactualite.com/bunia-un-...quartier-hoho/

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

                    Comment


                    • Translation Google
                      EPIDEMIOLOGICAL SITUATION
                      EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                      Tuesday 11 June 2019


                      The epidemiological situation of the Ebola Virus Disease dated June 10, 2019 :
                      • Since the beginning of the epidemic, the cumulative number of cases is 2,071, 1,977 confirmed and 94 probable. In total, there were 1,396 deaths (1,302 confirmed and 94 probable) and 575 people healed.
                      • 284 suspected cases under investigation;
                      • 9 new confirmed cases, including 3 in Musienene, 2 in Mabalako, 1 in Mandima, 1 in Katwa, 1 in Mangurujipa and 1 in Beni;
                      • 6 new confirmed case deaths:
                        • 2 community deaths, including 1 in Musienene and 1 in Mabalako;
                        • 4 deaths at CTE, including 1 in Katwa, 1 in Butembo, 1 in Mabalako and 1 in Beni;
                      • 6 new cures out of ETCs, including 4 in Mabalako and 2 in Butembo,
                      • One of the non-vaccinated Musienene safe and dignified burial team is one of the new confirmed cases. He was a nurse to his late Ebola brother. He had not been vaccinated at the same time as the new recruits because, when he was recruited, he told his superiors that he had already been vaccinated.
                      ... Family of high-risk contacts found in Uganda
                      • A family of high-risk contacts from Aloya, in the Mabalako Health Zone, was found in Uganda on Tuesday, June 11, 2019. Among these contacts is a five-year-old child who has been confirmed to have Virus Disease. Ebola and her family were isolated at the Ebola Treatment Unit in Bwera, Uganda.
                      • The DRC Ministry of Health press release on this subject is available at the following link . The press release can also be downloaded in PDF format by clicking here .
                      ...

                      "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

                        Ministry of Health
                        DRC
                        @ MinSanteRDC
                        3h 3 hours ago

                        The 5 year old boy suffering from # Ebola in Uganda died this morning. The results of the laboratory tests of the other 5 members of his family revealed that 2 other people are also contaminated by Ebola: his grandmother and his 3-year-old brother. They are all in isolation in Bwera.
                        ...

                        Ministry of Health
                        DRC
                        @ MinSanteRDC

                        Among the six other family members who stayed in # DRC and who were transferred to the # Ebola Treatment Centre of # Beni , laboratory tests confirmed that 5 are also suffering from Ebola

                        4:39 AM - 12 Jun 2019
                        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                        -Nelson Mandela

                        Comment


                        • Translation Google
                          EPIDEMIOLOGICAL SITUATION
                          EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                          Wednesday, June 12, 2019


                          The epidemiological situation of the Ebola Virus Disease dated 11 June 2019 :
                          • Since the beginning of the epidemic, the cumulative number of cases is 2,084, including 1,990 confirmed and 94 probable. In total, there were 1,405 deaths (1,311 confirmed and 94 probable) and 579 people healed.
                          • 339 suspected cases under investigation;
                          • 13 new confirmed cases, including 7 in Mabalako, 4 in Beni, 1 in Kalunguta and 1 in Komanda;
                          • 9 new confirmed case deaths:
                            • 7 community deaths, including 5 in Mabalako, 1 in Kalunguta and 1 in Komanda;
                            • 2 deaths at CTE, including 1 in Katwa and 1 in Butembo;
                          • 4 new cures out of ETCs, 2 in Beni and 2 in Butembo.
                          INFO : All family members of the Ebola case in Uganda are not yet included in the caseload. The confirmed cases of the family, both on the Ugandan and Congolese side, will be officially added in the epidemiological situation that will be published this Thursday, June 13, 2019.
                          ... Case of Ebola Virus Disease in Uganda
                          • The first confirmed case of Ebola in Uganda, a five-year-old boy, passed away on the morning of Wednesday, June 12, 2019. His dignified and safe burial will be on Thursday, June 13, 2019 in Kasese, the district where he resided with his parents. .
                          • Laboratory tests have confirmed that of the six family members who have crossed the border, two others are also infected with Ebola. This is the 50 year old grandmother and the 3 year old brother of the deceased boy. Of the six family members left in Kasindi and transferred to the Beni Ebola Treatment Center, five were tested positive. Around this family, about 50 contacts were listed in Kasese on the Ugandan side and 80 contacts in Kasindi on the Congolese side. Kasindi's vaccination ring was opened on Wednesday.
                          • On Wednesday, June 12, 2019, the Congolese and Ugandan health authorities also held a meeting in Kasese, about 140 kilometers from Beni, to discuss mechanisms for cross-border collaboration. The Ugandan Minister of Health, Dr Jane Ruth Aceng, led the Ugandan delegation while the Congolese side was led by Dr. Gaston Tshapenda, coordinator of Beni.
                          • The main decisions taken are:
                            • Strengthen surveillance at ports of entry, especially secondary roads;
                            • Maintain continuous information sharing in real time between the two countries;
                            • Start vaccinating the contacts as soon as possible. The DRC has already donated 400 doses of rVSV-ZEBOV vaccine to Uganda. The DRC is willing to send vaccination teams to Uganda to vaccinate all contacts more quickly if needed;
                            • Repatriate all family members in the DRC after obtaining their informed consent. Since the father of the deceased child was Ugandan, the family was free to choose the place of hospitalization. Living family members have all agreed to return to the DRC for further medical treatment and 21-day follow-up. The advantage of continuing medical treatment in the DRC is the possibility of benefiting from new therapeutic molecules that are not yet available in Uganda;
                            • Finalize the Memorandum of Understanding between Uganda and the DRC that will define the procedures for in-depth health collaboration between the two countries.
                          ...
                          115 Contaminated health workers

                          Two Mabalako health workers, unvaccinated, are among the new confirmed cases. One of the health workers died in the health center where he was working (community death).

                          The cumulative number of confirmed / probable cases among health workers is 115 (5.5% of all confirmed / probable cases), including 38 deaths.

                          ...


                          "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


                          • The Latest: Congo pastor likely behind Uganda's Ebola cases

                            ByTHE ASSOCIATED PRESS BWERA, Uganda ? Jun 13, 2019, 12:07 PM ET
                            ...
                            Dr. Michael Ryan tells The Associated Press he does not believe the man, a pastor, was on a list of high-risk Ebola contacts in Congo.
                            ...
                            The pastor spread the virus to at least three family members. His 5-year-old grandson was the first Ebola case in Uganda and the first death. The boy's grandmother also died.

                            Ryan says about 55% of new Ebola cases in Congo last week were previously identified as potential contacts, suggesting significant problems in health workers' ability to monitor where the virus is spreading.
                            ...

                            ? Jamey Keaten in Geneva

                            "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/13-june-2019-ebola-drc/en/
                              Ebola virus disease ? Democratic Republic of the Congo

                              Disease outbreak news: Update
                              13 June 2019

                              The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) continues to show a decrease in the number of new cases in hotspots such as Katwa, Beni and Kalunguta health zones. However, in other areas such as Mabalako and Butembo, moderate rates of transmission continue. With ongoing EVD transmission within communities in 12 health zones in North Kivu and Ituri provinces, factors such as persistent delays in case detection, approximately a third of cases dying outside of Ebola treatment or transit centres, and high population mobility, pose a high risk of geographical spread both within the DRC and to neighbouring countries. This was highlighted by the recent exportation of cases to Uganda ? the first confirmed cases detected outside of North Kivu and Ituri province since the onset of the outbreak over 10 months ago. For more information, please see Disease Outbreak News on EVD in Uganda
                              Weekly decrease in the incidence of new cases have been reported in several health zones; however, increase or a continuation of the outbreak has been observed in others (Figure 1). In the 21 days, between 22 May to 11 June 2019, 62 health areas within 12 health zones reported new cases, representing 9% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 212 confirmed cases were reported, the majority of which were from the health zones of Mabalako (33%, n=69), Butembo (18%, n=39), Katwa (14%, n=30) Mandima (11%, n=23) and Beni (9%, n=20). Single confirmed cases were also reported from Rwampara and Komanda health zones this past week following a prolonged period since the last reported case, with both cases acquiring the infection in the aforementioned hotspots.
                              As of 11 June 2019, a total of 2084 EVD cases, including 1990 confirmed and 94 probable cases, were reported. A total of 1405 deaths were reported (overall case fatality ratio 67%), including 1311 deaths among confirmed cases. Of the 2084 confirmed and probable cases with known age and sex, 57% (1194) were female, and 29% (605) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected rising to 118 (6% of total cases).
                              Taking these recent events into consideration, the WHO Director-General will convene the Emergency Committee under the International Health Regulations (IHR) on 14 June 2019. The independent group of public health experts will provide their views to the Director-General on whether the event constitutes a public health emergency of international concern (PHEIC). If the event is determined to constitute a PHEIC, the Director-General will issue Temporary Recommendations, which are usually health measures aimed at reducing the international spread of Ebola and avoiding unnecessary interference with international traffic. A statement giving an account of the meeting and its conclusions will be posted on the WHO website immediately after the meeting.
                              Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 11 June 2019*




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                              *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
                              Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 11 June 2019*




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                              Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 11 June 2019*




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                              **Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
                              Public health response

                              For further 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. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Weekly increases in the number of new cases were observed from February through mid-May 2019, with lower though still substantial rates since then. A general deterioration of the security situation, and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity, especially over the past four weeks, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas, reducing the overall effectiveness of interventions. However, recent community dialogue, outreach initiatives, and restoration of access to certain hotspot areas have resulted in some improvements in community acceptance of response activities and case investigation efforts. In order to ensure staff safety and security, security mitigation measures are being enhanced, and procedural, operational, and physical security challenges are being addressed. The high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to nosocomial infection, persistent delays in detection and isolation in ETCs, and challenges in the timely reporting and response to probable cases, are all factors increasing the likelihood of further chains of transmission in affected communities and increasing the risk of geographical spread both within the Democratic Republic of the Congo and to neighbouring countries. The high rates of population movement occurring from outbreak affected areas to other areas of the Democratic Republic of the Congo and across porous borders to neighbouring countries during periods of heightened insecurity further compounds these risks. Additional risks are posed by the long duration of the current outbreak, fatigue amongst response staff, and ongoing strain on limited resources. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have likely increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up.
                              WHO advice

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

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                              • Translation Google
                                EPIDEMIOLOGICAL SITUATION
                                EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                                Thursday 13 June 2019


                                The epidemiological situation of the Ebola Virus Disease dated June 12, 2019 :
                                • Since the beginning of the epidemic, the cumulative number of cases is 2.108, of which 2.014 are confirmed and 94 are probable. In total, there were 1,411 deaths (1,317 confirmed and 94 probable) and 585 people healed.
                                • 335 suspected cases under investigation;
                                • 24 new confirmed cases, including 13 in Mabalako, 4 in Beni, 3 in Mandima, 1 in Katwa, 1 in Butembo, 1 in Mangurujipa and 1 in Rwampara;
                                  • Uganda's index case and 7 other family members were classified in Mabalako, the health zone where they began to develop symptoms. Of these 8 confirmed cases from the same family, 5 remained in the DRC and 3 had crossed the border.
                                • 6 new confirmed case deaths:
                                  • 3 community deaths, 2 in Mandima and 1 in Mangurujipa;
                                  • 3 CTE deaths, including 1 in Mabalako and 2 in Bwera (Uganda);
                                    • The 2 deaths of Bwera are the 5-year-old boy and the 50-year-old grandmother who were classified in Mabalako;
                                • Six new cures emerged from CTEs, including four in Katwa, one in Beni and one in Butembo.
                                ... Case of Ebola Virus Disease in Uganda
                                • This Thursday, June 13, 2019, five family members were repatriated to the DRC. Returnees are the mother of the index case, the 3-year-old brother (who is a confirmed Ebola case), a 6-month-old baby, the father of Ugandan children, and the nanny. Thus, to date, no more cases of Ebola are found in Uganda.
                                ...
                                116 Contaminated health workers

                                One Mabalako health worker, vaccinated, is one of the new confirmed cases.

                                The cumulative number of confirmed / probable cases among health workers is 116 (5.5% of all confirmed / probable cases), including 38 deaths.

                                ...


                                "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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