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

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    Ebola in the DRC: For Jean-Jacques Muyembe, "a second vaccine is not our priority"

    06 AUG 2019
    Updated 06.08.2019 at 20:24 by
    Jean-Luc Eyguesier

    In the DRC, Professor Jean-Jacques Muyembe Tamfun has headed since the end of July 2019 the committee of experts responsible for the "national response" against the Ebola epidemic in the north-east, which recently won Goma. The co-discoverer of the Ebola virus does not rule out the use of a second vaccine, but explains today that "it is not the priority". Interview.

    Uganda announced on Monday (August 5th) that it has begun testing an experimental Ebola vaccine that could be used in the neighboring Democratic Republic of Congo. In this country, the epidemic has killed more than 1,800 people in one year.

    The trial of the MVA-BN vaccine produced by the Belgian laboratory Janssen, a subsidiary of the American Johnson & Johnson is expected to last two years, said the Council of Medical Research (MRC) of Uganda in a statement.

    The subject is debated in the Democratic Republic of Congo, where the former Minister of Health was openly opposed to its use. He finally resigned on 22 July, feeling disavowed after appointing a committee of experts to oversee control of the Ebola response led by Professor Jean-Jacques Muyembe Tamfun, National Director of the Institute for Biomedical Research from Kinshasa.

    He says he is much more in favor of this experimental vaccine even if for him, "it is not the priority". Since July, the epidemic has gained Goma, already two deaths in this major city in the east of the country.


    TV5MONDE: There is much talk of using a second vaccine, developed by Johnson & Johnson Laboratories, to complement Merck's rVSV vaccine to fight the Ebola outbreak in eastern DRC. Has a decision been made?

    Dr. Muyembe: For now, this is not our priority, we want to first control this epidemic that has arrived in a big city of the DRC (Goma), a hub for travelers. We still use the Merck rVSV vaccine. This second vaccine is a recommendation of the group of experts advising WHO on immunization and at its meeting on May 5, he suggested using it as a preventive vaccine.

    In our research institute, we have studied several candidate vaccines and it turns out that the Johnson & Johnson vaccine is the one for which we have the most scientific data. In addition, it allows to provide the largest number of doses. So, at first glance, our choice fell on this vaccine, but it should be noted that it is a vaccine under study, not yet approved.

    It is said that you personally support the use of this Johnson & Johnson vaccine. Is it true ?

    Dr. Muyembe: I am the director of the National Institute of Biomedical Research and my team has studied it. It is not me who wants to impose a vaccine, but on the basis of scientific evidence, the team of researchers thought that this second vaccine could be used. Moreover, it is already used and tested in Guinea and now in Uganda.

    What does it bring more than the Merck vaccine?

    Dr. Muyembe: Its advantage is that it is preventive, like that of measles. The intention was to create a "curtain" of immunized people between the currently infected area in North Kivu and Goma. Geographically, there is a whole region between the two that is not affected by the epidemic and if we act there, we create a "belt" that stops the spread of the virus and thus we protect the city of Goma. It was the hypothesis.

    This vaccine requires two injections 56 days apart, is this realistic in North Kivu conditions?

    Dr. Muyembe: The problem is not the logistical effort. Moreover for the first vaccine, the "Merck", it was said that it would be impossible for cold chain issues among others, but we get there. At the Institute, we have the experience of vaccination against yellow fever ... All this is a question of methodology, communication with the population. If the population accepts, there is no problem.

    What is even more important is to do some research. During this epidemic, we must do some research to find solutions for future epidemics. Not just for today's epidemic.

    In your opinion, how do you convince the population that has often been hostile to caregivers?

    Dr. Muyembe: Everyone is asking for a vaccine, and we know that with the first, the rVSV, we can not vaccinate a large population (for reasons of availability). Moreover, it proved its effectiveness while it was still in experimental form. It was during the Guinea epidemic in 2014, and we have confirmed it here in 2018, but we must continue the research.

    As for the hostility of the populations, it is the weakness of our response whose communication is not anchored. We must strengthen it, get the commitment of the people. As long as we do not have this community commitment, it is unlikely that we will be able to successfully extinguish this epidemic.
    ...
    Another problem is insecurity in the region.

    Dr. Muyembe: Yes, that's even the main problem. That's why we say that the fight against Ebola is not just a public health problem. In our current strategy, we will include other responsible sectors. The problem of insecurity concerns the Ministry of the Interior, and then we have to integrate the Ministry of Defense to escort the teams, and still others...

    You will go to Rwanda. What is the purpose of this meeting with the Rwandan authorities?

    Dr. Muyembe: The disease is on our side and we must do everything to reassure the Rwandan authorities about the efforts we are making, how we control our borders. There will be meetings at the political and expert level. When the WHO Director General made this epidemic a public health emergency "of international concern", he added in his recommendations that there is no point in closing the borders to prevent displacement.

    He urged neighboring countries not to choose this strategy, but rather to cooperate and be transparent. We need Rwanda and Rwanda needs the DRC.

    Many countries in the region are worried. Are you worried about a regional extension of the epidemic?

    Dr. Muyembe: If there is a risk of extension, it is more important inside the DRC than in neighboring countries, but we have teams that monitor travel and contacts to minimize the risk of spread to neighboring countries.

    The President of the Republic entrusted you with the national coordination of the fight against the epidemic. What is your feeling about this load?

    Dr. Muyembe: Three months ago, we said that we could control this epidemic in three months, given our experience in this area. Unfortunately, this appointment has just been made and the situation on the ground has completely changed.

    Still, we remain confident and in three or four months we can stop this epidemic. The challenge is great and the responsibility is heavy, but we count a lot on the support of the population, the support of the civil society and our partners to carry out quality work.

    Jean-Luc Eyguesier
    Updated 06.08.2019 at 20:24

    En RDC, le professeur Jean-Jacques Muyembe Tamfun dirige depuis fin juillet 2019 le comité d'experts chargé de la "riposte nationale" contre l'épidémie d'Ebola qui sévit dans le Nord-Est, et qui a récemment gagné Goma. Le co-découvreur du virus Ebola n'écarte pas l'usage d'un deuxième vaccin, mais explique aujourd'hui que "ce n'est pas la priorité". Entretien.
    "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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      DRC: Seven Ebola deaths in Mambasa

      Posted on Tue, 06/08/2019 - 19:40 | Modified on Tue, 06/08/2019 - 19:40

      Three people died of Ebola on Monday, August 5, in Mayuano and Lolwa in Mambasa territory, said Franklin Yakani, interim administrator of the Ituri territory. This news brings to seven the number of deaths recorded in the space of four days in this entity, he said, adding that the response team is working hard to contain the disease.

      Among the victims, two people died of Ebola in Mayuano 32 km from Mambasa center. This is a girl of 20 years and a child of three years, says the interim administrator. Another case of death was recorded on the same Monday in Lolwa 62 km from the capital of the territory.

      According to the same source, four more cases of death were reported on Friday, August 2 in Mambasa-Center and Some. "In Mambasa, the same day, there were two confirmed cases and two deaths as well. Thirty people were vaccinated, "said Yakani.

      The response team is vaccinating the people contacted to prevent the spread of the disease, he said.

      The coordinator of the Ituri response team, Christophe Shako, said that at Some - which is considered the epicenter of the disease - the vaccine is being given to the entire population to contain Ebola. According to him, it was difficult to identify high-risk contacts, some of which are hidden among the population.

      Trois personnes sont mortes de la maladie à virus Ebola, lundi 5 août, à Mayuano et à Lolwa en territoire de Mambasa, a indiqué mardi Franklin Yakani, l’administrateur intérimaire de ce territoire de l’Ituri. Cette nouvelle porte à sept le nombre de décès enregistrés en l’espace de quatre jours dans cette entité, a-t-il précisé, ajoutant que l’équipe de riposte travaille d’arrache-pied pour contenir la maladie. Parmi les victimes, deux personnes sont mortes d’Ebola à Mayuano à 32 km de Mambasa-centre.
      "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/08-augus...-ebola-drc/en/
        Ebola virus disease ? Democratic Republic of the Congo

        Disease outbreak news: Update
        8 August 2019

        The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks with an average of 86 cases per week (range 80 to 91 cases per week) in the past six weeks (Figure 1). There are currently no confirmed cases of EVD outside of the Democratic Republic of the Congo.
        In the 21 days from 17 July through 6 August 2019, 65 health areas within 16 health zones reported new cases (Table 1, Figure 2). During this period, a total of 257 confirmed cases were reported, with the majority coming from the health zones of Beni (46%, n=119) and Mandima (23%, n=58). The majority of recent cases in Mandima Health Zone were reported from the northern health areas of Som? (n=39) and Mayuano (n=8). Of the eight cases reported in Mambasa Health Zone in the past 21 days, the majority have epidemiological links to Som? Health Area, with limited local transmission in Mambasa thus far.
        No new confirmed cases have been reported in Goma city since our last report, with a total of four confirmed cases reported from Goma (n=1) and Nyiragongo (n=3) health zones to date. Of the four cases, two have died and two are in an Ebola Treatment Centre(ETC). On 3 August, all 256 contacts related to the first confirmed case in Goma Health Zone (reported 14 July), finished their 21-day follow up period. A total of 232 contacts (including 114 high risk contacts) of the Nyiragongo cases remain under surveillance. Ongoing vaccination activities have reached the majority (98%) of eligible contacts, and 1314 contacts, contacts of contacts and frontline workers vaccinated to date.
        New infections continue to be reported among personnel working in community health posts and other facilities. In the last 21 days, 14 new cases were reported among health workers from Mandima (n=5), Beni (n=4), and one each in Katwa, Mambasa, Masereka, Oicha, and Vuhovi. Cumulatively, 149 (5%) healthcare workers have been infected to date.
        As of 6 August, a total of 2781 EVD cases were reported, including 2687 confirmed and 94 probable cases, of which 1866 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1572) were female, and 28% (791) were children aged less than 18 years.
        Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 6 August 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, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Manguredjipa, 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 6 August 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 6 August 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 information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:
        WHO risk assessment

        WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
        Substantial rates of transmission continue within outbreak affected areas of North Kivu and Ituri provinces, with demonstrated extension to new high risk areas and across borders in recent months, although without sustained local transmission in these areas. The high proportion of community deaths, 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 of cases, and challenges in accessing some communities due to insecurity and pockets of community reticence are all factors increasing the likelihood of further chains of transmission in affected communities. The report of confirmed cases and local transmission in Goma, capital of North Kivu with a population of over two million inhabitants, highlights the potential of spread within the Democratic Republic of the Congo and to neighbouring countries. Bolstered by months of preparedness, a sizable response, including exhaustive contact tracing and ring vaccination, was rapidly implemented upon detection of these cases with the aim of preventing tertiary spread or sustained local transmission in Goma city.
        The security situation over the past week increased in volatility, with the continued presence of non-state armed groups observed throughout operational areas. In Beni Health Zone, a number of recent attacks by suspected ADF elements that resulted in numerous civilian casualties led to a demonstration on 7 August 2019 in Beni/Mavivi to protest against the continued insecurity in the area. This was followed by larger demonstrations on 8 August in Beni due to an attack by ADF in Mbau on the Beni/Oicha axis that led to six civilian deaths, including a prominent civil society leader. EVD operations in the area have been temporarily suspended until the situation calms. The continuity of response activities is facilitated by the close monitoring of the operational environment and the corresponding implementation of appropriate security measures.
        The factors mentioned above, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread ? both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.
        WHO advice

        On 17 July 2019, the Director-General convened the Emergency Committee under the International Health Regulations (IHR) to review the situation on the Ebola outbreak in the Democratic Republic of the Congo. The Director-General accepted the Emergency Committee?s recommendation that the outbreak constitutes a Public Health Emergency of International Concern (PHEIC). Further information, including temporary recommendations advised by the Emergency Committee, is available in the statement, speech by WHO Director General, and news release.
        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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.
        For more information, please see:


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        • Translation Google

          Ebola in the DRC: theft of prevention equipment in Kisangani

          By Le Figaro with AFP Posted on 09/08/2019 at 16:17

          Ebola prevention materials were stolen in Kisangani, a large city in the north-east of the Democratic Republic of Congo, seriously weakening the capacity of health teams, AFP told AFP on Friday.

          "We lost a thermoflash. It was stolen, there is no trace of a large amount of chlorine and vials of yellow fever vaccine. All our statistics on the prevention of Ebola are also lost, "told AFP Dr. Paulin Muteba, coordinator of the national hygiene program of the province of Tshopo (north-east) in Kisangani. The thermoflash makes it possible to take the temperature without contact, first step in the detection of a possible presence of the disease. This equipment disappeared Tuesday during a forced evacuation operation of this Congolese State service of a building he occupied, by a court decision.

          "We had only nine thermoflashes, one broken down and one stolen. With a thermoflash, we can not control more than 15,000 passengers who come from Ituri because more than 20,000 people checked, the results are biased, "said Dr. Paulin Muteba. "This situation will also disrupt the prevention activities at Kisangani airport," added the doctor: "without chlorine mixed with water, passengers will not wash their hands and we can no longer disinfect vehicles from Bunia in Ituri ".

          The Ituri region is marginally affected by the outbreak of Ebola reported last August in Beni, neighboring North Kivu province. Located 480 km west of Beni, Kisangani, capital of Tshopo province, is an important commercial hub of more than 1.6 million inhabitants. It has important exchanges with the neighboring province of Ituri and the territory of Beni, the epicenter of the Ebola epidemic in North Kivu (east). A possible spread of the haemorrhagic fever epidemic to large, densely populated urban centers and beyond the DRC's borders would give it a new dimension.

          Du matériel de prévention contre le virus Ebola a été volé à Kisangani, grande ville du nord-est de la République démocratique du 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


          • Translation Google

            DRC: Lolwa, a new health zone affected by Ebola in Ituri

            Saturday, August 10, 2019 - 01:48

            A first confirmed case of Ebola Virus Disease has been detected in the locality of Lolwa, in Mambasa territory in Ituri province.

            The first case is a 30-year-old woman "whose signs began to manifest in Some in the health zone of Mandima.", Indicated in his bulletin, published Friday, the technical secretariat of the multisectoral committee of the response against the Ebola outbreak.

            The woman "used self-medication from 03 to 04 August 2019 until she left Some for Lolwa and was hospitalized at the Lolwa General Hospital on 05 August 2019, where the alert was issued.

            She has been investigated, validated and placed in isolation, "reports the same source.

            She is still alive and investigations to identify her contacts "continue," according to the newsletter.

            Lolwa is located 60 km east of the city of Mambasa, in the Babila Bakwanza chiefdom on the national road number 4 which connects the city of Bunia, capital of Ituri to Kisangani, chief town of Tshopo. This health zone is the ninth affected by Ebola in Ituri, the twenty - seventh in the two provinces (North - Kivu and Ituri) devastated by the epidemic for a year.

            The record is heavy: 1873 deaths including 1779 among the 2,699 confirmed cases, according to the last official count.

            Ituri alone records 175 deaths among the 318 confirmed and probable cases. The worst-hit health area is Katwa with 451 deaths, followed by Beni with 394 deaths and Butembo with 312.

            Another health area heavily affected by Ebola is Mabalako near Beni.

            It has already notified 282 deaths. All these localities are located in the northern part of North Kivu province.

            Un premier cas confirmé de la Maladie à Virus Ebola a été détecté dans la localité de Lolwa , en territoire de Mambasa dans la province de l'Ituri.

            "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: Two Promising Treatments Lower Mortality Rate

              These two treatments are antibodies that neutralize the ability of the virus to affect other cells.

              franceinfo with AFP
              France T?l?visions
              Updated 13/08/2019 | 10:36
              published on 13/08/2019 | 10:28

              The hope of a cure for the Ebola virus is emerging. Two drugs have significantly increased the survival rate of patients in a clinical trial conducted in the Democratic Republic of Congo , announced Monday, August 12, the US health authorities, who co-funded the study.

              These two treatments, titled REGN-EB3 and mAb114, are monoclonal antibodies that work by neutralizing the ability of the virus to affect other cells. "They are the first drugs that, in the context of a solid scientific study, have clearly shown a significant decrease in mortality in people with Ebola," said to AFP Anthony Fauci, director of the American Institute of Infectious Diseases and Allergies.

              A mortality rate below 30%

              Of the approximately 500 people whose data were analyzed (out of a total of 681 participants), mortality fell to 29% with REGN-EB3. This rate reaches 34% with mAb114. For comparison, the mortality rate is between 60 and 67% for people not taking any treatment.

              The current phase of this study, initiated in November in the African country, will be stopped so that all future patients receive these treatments. Patients may choose to take these two treatments instead of two other medications, Zmapp and Remdesivir. The mortality rates for the latter two products are 49% and 53% respectively. The US authorities added that the final analysis of the data collected would be carried out at the end of September or the beginning of October, and that the complete results would then be published.


              ---------------------------------------------------------------

              DRC: "There is now an effective and curative treatment against Ebola", (Dr. Muyembe)

              Posted Mar 13/08/2019 - 11:18
              7SUR7.CD

              The Ebola virus disease, which has been raging in two eastern DRC provinces for a year now, now has "a cure and not an experimental treatment".

              Within Ebola treatment centers in North Kivu and Ituri, will now be incorporated two treatment molecules, tested in the laboratory of the National Institute of Biomedical Research "INRB" Jean-Jacques Muyembe, current coordinator response and secretary of the multi-sectoral committee.

              Dr. Jean-Jacques Muyembe gave this clarification on the treatment on Tuesday, August 13 in Goma, after the discharge ceremony of two patients cured, after about two weeks spent in CTE.

              "There is a cure now. We have two molecules that are very effective and can heal quickly. These are the two molecules that we will now use in ETCs, and these patients in Goma have received, "he reassured.

              Before going further: "This is mAb114 and REGN-EB3, these are the two molecules that will now be used because according to the studies and the results we obtained in the lab, these are the two molecules that are effective.

              Dr. Muyembe also assured that currently the city of Goma, capital of North Kivu with more than one million inhabitants is out of danger, since about 200 contacts and suspected cases have been identified and are waiting for results and monitoring at points of entry is reinforced.

              Glody Murhabazi from Goma


              La maladie à virus Ebola qui sévit dans deux provinces de l’Est de la RDC depuis maintenant un an, a désormais « un traitement curatif et non expérimental ». Au sein des centres de traitement d'Ebola du Nord-Kivu et de l’Ituri, seront désormais incorporés deux molécules de traitement, expérimentées dans le laboratoire de l’Institut National des Recherches Biomédicales « INRB » de Jean-Jacques Muyembe, actuel coordonnateur national de la riposte et secrétaire du comité multi sectoriel.
              "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: police disperse protest against Ebola response team

                Posted on Tue, 13/08/2019 - 17:39 | Edited on Tue, 13/08/2019 - 17:39

                Police on Tuesday (August 13th) dispersed a demonstration by residents of the Mputu district in Mambassa Center (Ituri) against the Ebola response team. In fact, a resident of the neighborhood, suffering from Ebola, died Monday, August 12 at the treatment center of Makayanga.

                According to protesters who develop a conspiracy theory around this case, this death is orchestrated by the response team to obtain funding for its activities.

                Police officers were deployed at strategic points in the city of Mambasa center, as at the Mambasa Reference General Hospital where a temperature control and hand washing device is installed.

                The police commander in Mambassa reports that youths are threatening to attack this site to show their anger.

                According to Franklin Yakani, administrator of the interim territory of Mambassa, the protesters say they are not convinced that the victim, a resident of their neighborhood, died of Ebola.

                The coordinator of the Ebola response in Ituri, Christophe Shako says it is a high-risk contact that has been tested positive. The latter had lost his son on July 30, died of Ebola. The man and his wife had all been admitted to the Makayanga Treatment Center.

                According to statistics provided by the medical team, the health zone of Mambassa has registered to date sixteen confirmed cases of Ebola, with six deaths.

                La police a dispersé, mardi 13 août, une manifestation des habitants du quartier Mputu à Mambassa-Centre (Ituri) contre l’équipe de riposte contre la maladie à virus Ebola. En effet, un habitant du quartier, atteint d’Ebola, est décédé lundi 12 août au centre de traitement de Makayanga. Selon les manifestants qui développent une théorie du complot autour de ce cas, ce décès est orchestré par l’équipe de riposte pour obtenir un financement de ses activités.
                "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/15-augus...-ebola-drc/en/
                  Ebola virus disease ? Democratic Republic of the Congo

                  Disease outbreak news: Update
                  15 August 2019

                  The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks, with an average of 81 cases per week (range 68 to 91 cases per week) in the past six weeks (Figure 1). There are currently no confirmed cases of EVD outside of the Democratic Republic of the Congo.
                  This week, initial data from a randomized clinical trial (RCT) of EVD therapeutics were announced. The data showed that two of the four treatments trialled were more effective in treating EVD. As a result, patients in the four Ebola treatment centres that participated in the RCT will now be randomized to receive the two better performing treatments. Patients in treatment centres not participating in the RCT will continue to be able to access those treatments under a compassionate use protocol. This change will help ensure that every treatment centre patient receives the best possible treatment with the greatest chance of survival, based on the most recent evidence.
                  The data indicates that when people are willing and able to access care soon after the onset of symptoms, they have an increased chance of survival. Providing each patient with optimal supportive care, closely monitoring their progress, and addressing any other health issues has saved lives and will continue to be a top priority. More information is available in the following update and press release.
                  No new confirmed cases have been reported in Goma city since our last report, with a total of four confirmed cases reported from Goma (n=1) and Nyiragongo (n=3) health zones to date. Two cases, who were infected via direct contact with the case reported on 30 July, received treatment at an Ebola Treatment Centre in Goma city and were discharged on 13 August. A total of 203 contacts of the Nyiragongo cases remain under surveillance.
                  In the 21 days from 24 July through 13 August 2019, 66 health areas within 17 health zones reported new cases (Table 1, Figure 2). During this period, a total of 228 confirmed cases were reported, with the majority coming from the health zones of Beni (42%, n=96) and Mandima (20%, n=46). A case was confirmed in Lolwa Health Zone, which is the first confirmed case in that health zone to date, bringing the total number of affected health zones over the course of the outbreak to 27. The case travelled from Mandima to Lolwa, where they became symptomatic. Currently, there is no evidence of local transmission of EVD in this health zone. Close identification and follow up of contacts is ongoing to minimize the chance of local transmission.
                  New infections continue to be reported among personnel working in community health posts and other facilities. In the last 21 days, 11 new cases were reported among health workers from Beni (n=3), Mandima (n=2), and one each in Katwa, Mabalako, Mambasa, Masereka, Mutwanga, and Vuhovi. Cumulatively, 151 (5%) health workers have been infected to date.
                  As of 13 August, a total of 2842 EVD cases were reported, including 2748 confirmed and 94 probable cases, of which 1905 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 57% (1608) were female, and 29% (815) were children aged less than 18 years.
                  Pillar 1 of the fourth Strategic Response Plan (SRP4) for the control of the EVD outbreak in the Democratic Republic of the Congo is now available on the WHO website. Other pillars of the plan and their funding needs are being finalized by response partners and will be progressively released.
                  Pillar 1 covers the core public health response to the outbreak; the funding requirement for all partners to sustain the health response as outlined in this plan is 287 million US dollars, including 120-140 million US dollars for WHO. So far, 15.3 million US dollars have been received, with further funds pledged but not yet received. Despite recent announcements of new contributions, WHO?s operations are impacted by a lack of cash flow. The funding shortfall is immediate and critical. A summary of funding received by WHO since the start of this outbreak can be found here.
                  Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 13 August 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, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Nyankunde, Nyiragongo, Oicha, Rwampara, Tchomia, and Vuhovi.
                  Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 13 August 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 13 August 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 information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:
                  WHO risk assessment

                  WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
                  Substantial rates of transmission continue within outbreak affected areas of North Kivu and Ituri provinces, with demonstrated extension to new high risk areas and across borders in recent months, although without sustained local transmission in these areas. The high proportion of community deaths, 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 of cases, and challenges in accessing some communities due to insecurity and pockets of community reticence are all factors increasing the likelihood of further chains of transmission in affected communities.
                  The factors mentioned above, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread ? both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.
                  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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.
                  For more information, please see:

                  Comment


                  • Translation Google

                    North Kivu: Attack of Ebola response teams lamented in Kasindi

                    Goma, August 16, 2019 (ACP) .- A team of health workers engaged in the response to EBOLA virus disease, faced a violent attack Thursday during an intervention in the health facility "UMOJA" in the neighborhood Lumumba in Lubiriha health area.

                    According to the witnesses contacted on the spot, this team whose mission was the decontamination of this medical training as well as the vaccination of the contacts cases of a healthcare professional infected with the EBOLA virus, after having proceeded to the nursing care of a wife of a FARDC soldier, who died last week, being confirmed positive for the viral disease, was forced to turn back.

                    The delegate official of the governor assigned to Kasindi, Kambale Sivavuhirwa Barth?l?my who confirmed this information, notes a crisis of operational communication in the strategy of coordinating the response in his jurisdiction.

                    The same is true for Kapepya Ngali Zebre Nzolene, president of the Basongora group, which highlights the lack of collaboration between the teams involved in the response to the Ebola virus disease.

                    For his part, David Kirongozi, a human rights defender, strongly condemns this attitude, which is a violation of human rights.

                    It should also be noted that efforts to contain the spread of Ebola virus disease at the Kasindi border post are hampered by resistance fueled by a series of rumors and intoxications within the local community. ACP / Fng / DNM / May

                    "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





                    • Credit: Radio Okapi

                      Walikale (marqu? en rouge sur la carte) au Nord Kivu.

                      Credit: Radio Okapi


                      --------------------------------------------
                      Ebola spreads to remote, militia-run Congo territory

                      GOMA, Congo (Reuters) - Authorities in the Democratic Republic of Congo have confirmed a new case of Ebola in the remote, militia-controlled territory of Walikale, hundreds of kilometers away from where previous cases near the border with Uganda and Rwanda occurred, the Health Ministry said overnight.

                      Pinga, the village where the case was reported, lies about 150 km (95 miles) northwest of Goma, one of the towns affected by the Ebola epidemic, and much further away from the epicenter of the epidemic in Butembo and Beni.
                      ...
                      Walikale is controlled almost entirely by a Mai Mai ethnic militia, surrounded by forest and difficult to access because of poor roads.
                      ...
                      https://www.reuters.com/article/us-h...-idUSKCN1V90O7

                      ---------------------------------------------------------------



                      FISTONMAHAMBA @ FMLrousse4h 4 hours ago more



                      # DRC : The Health Zone # Pinga , which has said the first case of the virus disease # Ebola in the territory of # Walikale (more isolated area of North Kivu) is a region under full control of the militia Nduma Defense of Congo-Renovated, led by Guidon Shimiray Mwissa





                      "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

                        August 19th, 2019 | Radio Campaigns by J?r?mie Soupou.

                        The people of Mambasa are calling on the government to build a CTE in their territory for early treatment of Ebola patients who are currently registering in this province of Ituri.

                        The territory of Mambasa where the #Ebola virus disease continues to kill has never had an Ebola Treatment Center (ETC). Because of the many deaths recorded in recent days, the majority of inhabitants think that setting up a CTE is a priority.

                        "We ask the authorities to do their best to build a CTE here in Mambasa. Because if someone is sick he will get so tired at the CTE of Komanda with the speed of the ambulance.

                        That they bring us an Ebola treatment center here at home it will still be very good. Because to transfer the patient from Mambasa to Komanda with this distance and the poor condition of the road only complicate things. If we build a CTE on site here everything will be fine. "

                        Contacted on this subject, Christophe Shako, the response coordinator for the province of Ituri assures to have taken into consideration this request of the inhabitants of the territory of Mambasa.

                        "It has been a week since the newly installed Goma technical secretariat sent an expert to the subject and we tried to talk to him. We found that everyone is in favor of setting up an Ebola treatment center in Mambasa and setting up a well-researched laboratory for the detection of cases that are positive for the Ebola Ii virus in Mambasa. However, the road condition is very bad from Mambasa to Komanda but also the Ituri bridge is not rehabilitated. If there is a suspected case of Ebola in the ambulance that is in a bedridden state, it must support three hours or four hours of travel time. This situation complicates things. We can not say what day will be built this CTE, this skill is the coordination of the response. "

                        Recall that 139 people died of Ebola in Mambasa territory since the outbreak of this outbreak in August 2018.

                        Les habitants de Mambasa demandent au gouvernement de construire un CTE dans leur territoire pour une prise en charge rapide des patients d’#Ebola qui s’enregistrent actuellement dans cette provinc…

                        "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

                          Details on the first case of Ebola in Pinga, North Kivu and the third confirmed case of Mwenga in South Kivu

                          Kinshasa, August 20, 2019 (ACP) .- The first confirmed case of Ebola in the health zone of Pinga in North Kivu is a 70-year-old woman living in the Kailenge health area, whose signs are manifested the 10 August 2019, indicates the daily bulletin on the epidemiological situation of this disease arrived Tuesday with the ACP.

                          From 13 August to date, she is hospitalized at Pinga General Reference Hospital (PGRH) and was isolated from 15 August 2019. The results of the sample sent to the Goma laboratory on 17 August 2019 were positive for EVD on the same day.

                          A first rapid response team was dispatched and left by road August 18, 2019 to reach Pinga Monday, August 19, 2019, while a 2 nd team is down by helicopter on the same Monday. Recall that Pinga is an area of ​​insecurity and poor telephone network coverage.

                          As for the third case of Mwenga in South Kivu, this is a 17-month-old male child who died, who was listed as a contact in the Chow? health area. This child is co-patient of the first confirmed case of Mwenga from August 15, 2019 at the Kangolo Health Center. This child began to show the first signs from July 29 to August 11, 2019 and was hospitalized at the health center cited above from August 9 to 11, 2019 to return home from August 12 to 14, 2019. The date of the beginning of symptoms is August 15, 2019.

                          He was hospitalized from 15 to 16 August 2019 at the Kilunge Health Center, from where the alert was launched by the investigative team as part of the contact listing. The patient was then taken to the Chow? Ebola Treatment Center (ETC). He was confirmed Ebola case on August 17, 2019. He died on August 18, 2019 in the same CTE. Twenty-seven (27) contacts have already been listed around this case.

                          Eleven new confirmed Ebola cases reported Monday in northeastern DRC

                          Eleven new confirmed Ebola cases were reported Monday in north-eastern DRC, including three in Kayna, two in Beni, one in Kalunguta, one in Musienene and one in Butembo, North Kivu, and one case in Mandima, one in Komanda and one in Mambasa in Ituri,

                          There were also four new confirmed case deaths, including two community deaths (one in Butembo and one in Musienene), one death at the Butembo Ebola Treatment Center, and one death at the Mwenga transit center in the South. Kivu. In addition, six patients were cured and released from CTEs, including five in Butembo and one in Komanda.

                          Since the declaration of the Ebola outbreak on 1 st August 2018, the total of cases is 2,888, including 2,794 confirmed and 94 probable. In total, there were 1,938 deaths (1,844 confirmed and 94 probable) and 868 people healed. Currently, 301 suspected cases are under investigation.

                          The data presented in this table are likely to change at a later stage, after extensive investigations and after redistribution of cases and deaths in their respective health zones. ACP / Fng / May / CFM / JLL / CKM


                          "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

                            Butembo: Property Damage Recorded in Rebellion Incursion at Kambuli Health Center

                            Posted Mar 20/08/2019 - 18:20
                            7SUR7.CD

                            Armed men on May 20, 2019, attacked the Kambuli Health Center, a health facility located in the Ngingi District, in Mususa commune in the town of Butembo (North Kivu).

                            The information delivered to 7SUR7.CD by Mbaytoya Bovick, bourgmestre of the said commune, indicates that the enemy, during his visit, vandalized all material goods of the Kambuli Health Center.

                            "Several material goods have been vandalized, including the malicious destruction of Ebola prevention kits," he said.

                            The municipal authority of Mususa calls, moreover, the inhabitants of Ngingi to calm while reassuring on an important device of the security forces and defense deployed in the region.

                            Jo?l Kaseso from Butembo

                            Des hommes en armes assimilés aux miliciens Maï-Maï ont, ce mardi 20 août 2019, attaqué le Centre de santé Kambuli, une structure sanitaire située dans le Quartier Ngingi, en commune Mususa dans la ville de Butembo (Nord-Kivu). Les informations livrées à 7SUR7.CD par Mbaytoya Bovick bourgmestre de ladite commune renseignent que l’ennemi a, lors de son passage, vandalisé tous les biens matériels du Centre de Santé Kambuli. "Plusieurs biens matériels ont été vandalisés. C’est notamment la destruction méchante des Kits de prévention contre Ebola", a-t-il indiqué.

                            "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/22-augus...-ebola-drc/en/
                              Ebola virus disease ? Democratic Republic of the Congo

                              Disease outbreak news: Update
                              22 August 2019

                              The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity (Figure 1). While the last few weeks of the outbreak have been characterized by the geographic expansion of cases to new health zones, we continue to see high case numbers, sustained local transmission, and inter-health zone movement of cases both into and out of the hotspot areas of Beni, Mandima, and Butembo. In the past 21 days from 31 July through 20 August 2019, 69 health areas within 19 health zones reported new cases (Table 1, Figure 2). During this period, a total of 216 confirmed cases were reported, with the majority coming from the health zones of Beni (31%, n=66), Mandima (18%, n=38), and Butembo (8%, n=18). High risks of transmission are also associated with an emerging cluster in the city of Mambasa, which has reported 14 cases in the past 21 days. The response continues to address these hotspots through early case detection and thorough investigation, strong contact identification and follow up, and engagement with the local communities.
                              Two new health zones reported cases in the past week: Mwenga Health Zone in South Kivu and Pinga Health Zone in North Kivu. In Mwenga, four confirmed cases were reported after two individuals (mother and child) had contact with a confirmed case in Beni before travelling south. The father of the child was subsequently confirmed positive as was a co-patient in a community health facility where the first case initially sought care.
                              In Pinga, one confirmed case has been reported with no apparent epidemiological links to other cases and no recent travel or visitors from outbreak affected areas. Pinga presents an added challenge to response teams in terms of remoteness, limited telecommunications, security risks, and resistance within the affected family and community.
                              As of 20 August, a total of 2927 EVD cases were reported, including 2822 confirmed and 105 probable cases, of which 1961 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 58% (1697) were female, and 28% (830) were children aged less than 18 years. To date, 154 health workers have been infected.
                              Eleven additional probable cases were validated last week, among these were cases who died in the community in Katwa, Kyondo, Vuhovi, and Mabalako health zones during March through June 2019 with epidemiological links to the outbreak; these cases could not be sampled for laboratory testing to confirm/exclude EVD.
                              On 19 August 2019, a ?ville morte? protest took place in Beni, Butembo, and Oicha in response to recent attacks by armed groups on civilians. This resulted in a temporary suspension of Ebola response activities. Operations resumed on 20 August 2019 with increased caution, and further demonstrations are anticipated. The suspension of Ebola response activities often results in an increase of case numbers and spread of cases to new areas in the subsequent weeks.
                              Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 20 August 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, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi.
                              Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 20 August 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 20 August 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 information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:
                              WHO risk assessment

                              WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
                              The response to the EVD outbreak in Democratic Republic of the Congo remains challenged by continued insecurity, unrest, pockets of community resistance and funding shortfalls. Although there is a slight declining trend in the overall number of new confirmed cases reported this week, the disease continues to spread to new health zones. This was again demonstrated in a case who travelled 700 km from the original place of exposure in Beni in North Kivu to Mwenga in South Kivu. The high proportion of community deaths, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to possible nosocomial infection, persistent delays in detection and isolation of cases, and challenges in accessing some communities due to insecurity and pockets of community reticence are all factors increasing the likelihood of further chains of transmission in affected communities.
                              While response strategies keep evolving to adapt to the local context, capacities for operational readiness and preparedness should continue to be enhanced and sustained in non-outbreak affected areas including neighbouring countries. WHO is calling for a more coordinated approach in which NGOs and UN partners collectively accelerate all activities, with all partners being accountable for their role in the response within the common goal of ending the outbreak.
                              The factors mentioned above, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread ? both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.
                              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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.
                              For more information, please see:

                              Comment


                              • Outbreaks and Emergencies Bulletin, Week 34: 19 - 25 August 2019

                                Ebola virus disease Democratic Republic of the Congo

                                2 968
                                Cases

                                1 986
                                Deaths

                                67%
                                CFR


                                EVENT DESCRIPTION

                                The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu and
                                Ituri provinces in Democratic Republic of the Congo continues. As of
                                24 August 2019, a total of 2 968 EVD cases, including 2 863 confirmed
                                and 105 probable cases have been reported. In the last 21 days (4 to 24
                                August 2019), 18 health zones have reported at least one confirmed case.

                                To date, confirmed cases have been reported from 27 health zones: Goma
                                (1), Alimbongo (5), Nyiragongo (3), Beni (652), Biena (16), Butembo
                                (277), Kalunguta (151), Katwa (643), Kayna (21), Kyondo (20), Lubero
                                (31), Mabalako (369), Manguredjipa (18), Masereka (50), Musienene (81),
                                Mutwanga (24), Oicha (54), Pinga (1) and Vuhovi (103) in North Kivu
                                Province; and Lolwa (3), Mambasa (21), Ariwara (1), Bunia (4), Komanda
                                (41), Rwampara (8), Mandima (258), Nyankunde (1), and Tchomia (2) in
                                Ituri Province, and Mwenga (4) in South Kivu.

                                As of 24 August 2019, a total of 1 986 deaths were recorded, including
                                1 881 among confirmed cases, resulting in a case fatality ratio among
                                confirmed cases of 66% (1 881/2 863). The cumulative number of health
                                workers affected has risen to 155, which is 5% of the confirmed and
                                probable cases to date.

                                Beni and Mandima are currently the main hot spots of the outbreak reporting
                                30% (n=61) and 14% (n=29) of the cases in the past 21 days respectively.
                                Seventeen health zones, Mabalako, Beni, Butembo, Kalunguta, Katwa,
                                Kayna, Komanda, Mutwanga, Mandima, Lolwa, Mambasa, Musienene,
                                Masereka, Oicha, Alimbongo and Mwenga have reported new confirmed
                                cases in the past seven days and remain points of attention.

                                Contact tracing is ongoing in 20 health zones. A total of 17 293 contacts
                                are under follow-up as of 24 August 2019, of which 15 368 have been seen
                                in the past 24 hours, comprising 89% of the contacts, which is a higher
                                percentage than during the past seven days (85%). Alerts in the affected
                                provinces continue to be raised and investigated. Of 2073 alerts processed
                                (of which 1996 were new) in reporting health zones on 24 August 2019,
                                1973 were investigated and 396 (20%) were validated as suspected cases.

                                On 17 July 2019, the WHO Director-General, Dr Tedros Ghebreyesus
                                declared the EVD outbreak in Democratic Republic of the Congo a Public
                                Health Emergency of International Concern (PHEIC), following a meeting
                                of the International Health Regulations Committee for EVD.

                                PUBLIC HEALTH ACTIONS

                                Surveillance activities continue, including case investigations,
                                active case finding in health facilities and communities, and
                                identification and listing of contacts around the latest confirmed
                                cases. Cross-border collaboration continues, particularly in
                                Uganda and Rwanda.

                                As of 24 August 2019, a cumulative total of 204 772 people has
                                been vaccinated since the start of the outbreak in August 2018.

                                Point of Entry/Point of Control (PoE/PoC) screening continues,
                                with over 88 million screenings to date. A total of 98/106 (92%)
                                PoE/PoC transmitted reports as of 24 August 2019.

                                The protocol for treatment of Ebola patients in Democratic Republic
                                of the Congo has been revised following data from a randomized
                                clinical trial showing, for the first time, that Ebola treatments
                                improve survival rates. Two of the four trial drugs were found to
                                have the greatest efficacy and are now being provided to confirmed
                                cases under the compassionate use protocol.

                                There are continued community reintegration and psychosocial
                                activities for patients discharged from ETCs, along with
                                psychoeducation sessions to strengthen community engagement
                                and collaboration in the response.

                                Teams of psychologists continue negotiations to obtain the support
                                of relatives of two confirmed cases from Mutwanga Health Zone to
                                participate in prevention activities.

                                The communication commission collaborated with the psychosocial care commission
                                to overcome resistance in a suspected case validated in Goma, who had been working
                                in a mine in Manguredjipa Health Zone and who was travelling to Bukavu.

                                Water, sanitation and hygiene (WASH) activities continue where possible, but were
                                not possible around a confirmed case in Mandima because of insecurity.

                                Community awareness and mobilization messages are being updated, revised and
                                harmonized and have been pre-tested by the commission and will subsequently be
                                shared in coordination and sub-coordination activities.

                                Young members of the Catholic Parish of Beni City have made a public commitment
                                to counter community incidents in the Kasanga health area; the coordination of
                                Goma launched a message of community involvement in the response to EVD on the
                                occasion of the inauguration of the new provincial committee of the Revival Church of
                                the Congo and the new regional bishop; in Kayna the Mwama of the Batangi Chiefdom
                                facilitated a community dialogue and called on all leaders in the jurisdiction to engage
                                resolutely in the EVD response; 30 traditional practitioners and pharmacy tenant from
                                Mayuano were briefed on EVD risk communication and a meeting was held with
                                school principals from Mambasa schools on the prevention of EVD in preparation for
                                the start of the school year.

                                SITUATION INTERPRETATION

                                The response to the EVD outbreak in Democratic Republic of the Congo remains challenged by
                                continued insecurity and pockets of community resistance. The small declining trend seen in the
                                past three weeks must be interpreted with caution, given the spread to a new health zone within
                                North Kivu and to the previously unaffected province of South Kivu. However, the lack of further
                                cases in the city of Goma underlines just how effective proven public health measures can be
                                when implemented immediately and effectively. This also emphasises how important response
                                preparedness continues to be in both unaffected provinces and neighbouring countries. Local
                                authorities and partners need to continue their robust response to the disease, using both novel
                                and proven community health and public health measures, while donors need to ensure that the
                                funding is present to enable this and ensure that the declining trend continues.



                                The WHO Health Emergencies Programme is currently monitoring 62 events in the region. This week's edition covers key new and ongoing events, including: Circulating vaccine-derived poliovirus type 2 in Ghana Ebola virus disease in Democratic Republic of the Congo Cholera in Cameroon Humanitarian crisis in Democratic Republic of 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

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