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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 EPIDEMIC IN NORTH KIVU AND ITURI PROVINCES AS AT DECEMBER 10 , 2019

    Wednesday, December 11, 2019
    • Since the start of the epidemic, the cumulative number of cases has been 3,340, including 3,222 confirmed and 118 probable. In total, there were 2,210 deaths (2,092 confirmed and 118 probable) and 1,088 people healed.
    • 441 suspected cases under investigation;
    • 10 new confirmed cases in North Kivu Mabalako, all from the Aloya health area;
    • No new deaths among the confirmed cases;
    • 1 person cured out of the CTE in Ituri in Biakato;
    • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths;
    • The activities of the response to the epidemic of the Ebola virus disease are paralyzed in the sub-coordination of Beni, Mangina and Biakato for security reasons;
    • ...
    https://us3.campaign-archive.com/?u=...&id=9646f3bd4e
    "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/12-decem...-ebola-drc/en/ Ebola virus disease – Democratic Republic of the Congo

      Disease outbreak news: Update
      12 December 2019



      Twenty-seven new confirmed cases were reported from 4 to 10 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. The confirmed cases in this week were reported from seven health areas in four health zones: Mabalako (67%, n=18), Beni (22%, n=6), Mandima (7%, n=2), and Oicha (4%, n=1). This is a substantial increase in the number of reported cases, compared to the average of seven confirmed cases for the previous three weeks. All of these cases are linked to three transmission chains. Of these 27 new cases, 20 (74%) were registered contacts, including 10 (37%) who were being followed up regularly. One community death was reported in an individual whose body was intercepted by response personnel at a point of control as they were being transported from Lwemba Health Area; a safe and dignified burial was performed. All other cases were referred to an Ebola Treatment Centre.

      The majority of these new cases are linked to a single chain of transmission, in which one individual was a potential source of infection for 17 people. This is the second documentation of EVD illness in this individual within a 6-month period. An investigation is ongoing to understand the circumstances around this case. Among the possibilities being investigated are reinfection and relapse. Reinfection would mean a person who has recovered from EVD is infected with EVD from another person; there has never been a documented case of this. Rare cases of relapse have been documented, in which a person who has recovered from EVD gets disease symptoms again.

      In the past week, there were six new cases among health workers; five of which were traditional practitioners, bringing the total number of health workers infected in this outbreak to 169 (5% of all reported cases).

      In Beni and Mabalako Health Zones, the overall average percentage of contacts under surveillance in the last seven days has returned to levels seen prior to the security events in past weeks. The volume of alerts and the proportion of alerts investigated within 24 hours has made similar improvements.

      In the past 21 days (20 November to 10 December), 42 confirmed cases were reported from 15 of the 71 (21%) health areas within four neighbouring active health zones in North Kivu and Ituri provinces (Figure 2, Table 1): Mabalako (60%, n=25), Mandima (19%, n=8), Beni (17%, n=7), and Oicha (5%, n=2). The majority of the cases (95%, n=40) are linked to known chains of transmission. Mambasa Health Zone recently cleared 42 days without any new confirmed cases.

      As of 10 December, a total of 3340 EVD cases were reported, including 3222 confirmed and 118 probable cases, of which 2210 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1881) were female, and 28% (n=941) 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 10 December 2019*





      Enlarge image
      Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 10 December 2019*





      Enlarge image



      *3340 confirmed and probable cases, reported as of 10 December 2019. Excludes n=173 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Butembo, Goma, Kalunguta, Katwa, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Pinga, Rwampara, Tchomia, and Vuhovi. 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 10 December 2019**





      Enlarge image



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

      For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:WHO risk assessment

      WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low.

      Although the number of new confirmed cases has remained relatively low, the interruption of response activities due to attacks, violence and unrest threatens to reverse recent progress. WHO and response partners are working to adapt the response strategy to protect communities from a resurgence of the outbreak while keeping all responders safe. WHO advice

      WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

      For more information, please see:

      Comment


      • Translation Google
        EPIDEMIOLOGICAL SITUATION
        EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH AND Kivu Ituri AT 11 DEC EMBER 2019


        Thursday, December 12, 2019


        • Since the start of the epidemic, the cumulative number of cases is 3,343, of which 3,225 are confirmed and 118 probable. In total, there were 2,210 deaths (2,092 confirmed and 118 probable) and 1,088 people healed.
        • 432 suspected cases under investigation;
        3 new confirmed cases in North Kivu Mabalako and Biena;
        • No new deaths among the confirmed cases;
        • No one is cured out of the CTE;
        • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths;
        • After 85 days without cases, the Biena health zone located in North Kivu province has again notified a confirmed case. The last case was notified on September 16, 2019.
        ...
        NEWS
        New Ebola case confirmed and notified to Biena after 85 days of silence

        • The Biena health zone located in North Kivu province has notified a new confirmed case #Ebola after 85 days without case notification since September 16, 2019;
        • He is a 28-year-old living man, unvaccinated and not listed as a contact in the Mandelya health area;
        • The date of the beginning of the signs dates back to December 07, 2019 with the date of the exposure period from November 20 to December 03, 2019 by headache and musculo-articular pain;
        • This man arrived at Mandelya village on December 09, 2019 and went to the Health Center named after this village on December 10, 2019 following abdominal pain and mel?na (symptom characterized by evacuation via anus of blood black, pasty and foul-smelling, mixed with stool or not (stools are often described as tarry and can be seen either by the patient or by the doctor during the digital rectal examination);
        • The alert was launched on December 11 by this health center and the patient was sent to the #Ebola Treatment Center in Mangina, after validation, as a suspected case. The same day #MVE cases were confirmed;
        • This patient would have consulted the Afya Bora traditional center on an outpatient basis in the Mabalako health zone in North Kivu from November 29 to December 06, 2019, from which several confirmed cases have recently emerged.

        ...
        "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-Ebola: "We are now dealing with a controllable epidemic around the health zones" (Dr Muyembe)

          Saturday December 14, 2019 - 6:32 pm

          The Technical Secretary of the Multisectoral Committee for the Response to the Ebola Epidemic, Dr Jean Jacques Muyembe Tamfum gave an update on the situation of Ebola this Saturday, December 14. He says that currently, the epidemic is controllable, and that it is possible to follow all infected cases.

          “The advantage is that we know these chains of transmission. Before we had to look. Today we can follow all the infected to vaccinate them. So we no longer get along with an uncontrollable epidemic. We are now dealing with a controllable epidemic around the health zones. It is enough that we have maximum security, we will have the maximum results, "said Jean Jacques Muyembe during a press conference in Kinshasa.

          He said that the response to Ebola has no problem with funding.

          "We do not have funding problems to carry out the response to Ebola which is a priority for President F?lix Tshisekedi. We are working together with the Minister of Health, Budget and Finance under the Prime Minister's umbrella. We have nothing to complain about, but the needs are enormous on the ground. And we manage to master most of the parameters, ”he added.

          The province of North Kivu no longer shows signs of Ebola, but currently the epidemic is entrenched in the province of Ituri.

          “In July, there were three provinces infected with Ebola: North Kivu, Ituri and South Kivu. Today, we can say that North Kivu is under control. The virus remains concentrated in Ituri, not in all health zones, only in Mabalako and Mandima, ”he said.

          In Ituri, the security situation characterized by the activism of the armed men hampers the response. Dr Muyembe who remains reassuring still reserves to give forecasts on the end of the disease. The latter has already left 2,211 people dead since August 1, 2018.

          Jordan Mayenikini

          "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 EPIDEMIC IN THE PROVINCES OF NORTH AND Kivu Ituri AT 14 DEC EMBER 2019


            Sunday, December 15, 2019

            Since the start of the epidemic, the cumulative number of cases has been 3,346, including 3,228 confirmed and 118 probable. In total, there were 2,213 deaths (2,095 confirmed and 118 probable) and 1,089 people healed.
            • 491 suspected cases under investigation;
            • 2 new cases in North Kivu at Mabalako;
            • No new deaths among the confirmed cases;
            • No healed person has left the CTE;
            • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths.
            ...
            ENTRY POINT SURVEILLANCE
            • Disruption of activities at PoC Pk5 (S / C Beni) after a massacre of the population around this PoC the night of December 13 to 14 by armed rioters not otherwise identified.  The tarpaulins covering the PoC Biakato Mayi screening device were torn apart by unknown persons during the night of December 13-14 (S / C Biakato);
            ...

            https://us3.campaign-archive.com/?u=...&id=008422c2fb
            "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

              Dr Jean-Jacques Muyembe: "The number of Ebola cases is increasing but we will take things back in hand"

              Posted on Mon, 12/16/2019 - 09:23 | Modified Mon, 12/16/2019 - 15:14


              The technical secretary of the multisectoral committee for the response to the Ebola virus disease in the DRC, Dr Jean-Jacques Muyembe Tanfum, confirms the increase in cases of Ebola patients, after the recent armed attacks against the response teams in Biakato in the province of Ituri.

              According to him, from November 29 to December 11, 2019, 34 cases were recorded in the various health zones.

              More than 10 cases from the Aloya health area have been reported in Biakato. Despite the challenges facing the response to Ebola virus disease, Dr. Muyembe plans to "take matters into his own hands" in the days to come.

              "We are seeing the number of cases starting to increase here and there, but we are not giving up. We believe that in the coming days, we will take matters into our own hands. [We must] restore security with the help of MONUSCO, with our Armed Forces of the DRC and the Police to have more security around the treatment centers and the accommodation of our agents, "said Dr Muyembe.

              In this interview with Billy Yvan Lutumba, he talks about areas that have already been cleaned, the insecurity that is holding back treatment and the projections made by the response team.

              Le secrétaire technique du comité multisectoriel de la riposte contre la maladie à virus Ebola en RDC, Dr Jean-Jacques Muyembe Tanfum, confirme l’augmentation de cas des malades à virus Ebola, après les récentes attaques armées contre les équipes de riposte à Biakato dans la province de l’Ituri. Selon lui, du 29 novembre au 11 décembre 2019, 34 cas ont été enregistrés dans les différentes zones de santé. Plus de 10 cas en provenance de l’aire de santé d’Aloya ont été signalés à Biakato.
              "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


              • Please see:

                US - CDC Health Advisory: Guidance for Using Rapid Diagnostic Tests for Ebola in the United States - December 16, 2019

                Comment


                • Source: https://www.who.int/csr/don/19-decem...-ebola-drc/en/
                  Ebola virus disease – Democratic Republic of the Congo

                  Disease outbreak news: Update
                  19 December 2019



                  Eleven new confirmed cases were reported from 11 to 17 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. The confirmed cases in this week were reported from three health areas in three health zones: Mabalako (82%, n=9), Biena (9%, n=1), and Butembo (9%, n=1). This is the first confirmed case in Butembo Health Zone in 54 days.

                  All 11 cases reported in the past seven days are linked to the case in Aloya Health Area, in which one individual was a potential source of infection for 28 people. Based on the preliminary sequencing of samples from this individual, this is being classified as a relapse of EVD. Rare cases of relapse - in which a person who has recovered from EVD gets disease symptoms again - have been documented during past outbreaks, but this is the first relapse documented in this outbreak.

                  The volume of alerts reported has returned to levels seen before recent security incidents. The average proportion of contacts under surveillance in the last seven days has returned to previously observed levels. However, Mabalako, the health zone with the highest volume of contacts, has the lowest performance, with 82% of contacts under surveillance.

                  In the past 21 days (27 November to 17 December), 47 confirmed cases were reported from 13 of the 102 (13%) health areas within six neighbouring active health zones in North Kivu and Ituri provinces (Figure 2, Table 1): Mabalako (66%, n=31), Mandima (15%, n=7), Beni (13%, n=6), Butembo (2%, n=1), Oicha (2%, n=1), and Biena (2%, n=1). The majority of the cases (94%, n=44) are linked to known chains of transmission.

                  As of 17 December, a total of 3351 EVD cases were reported, including 3233 confirmed and 118 probable cases, of which 2217 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1886) were female, 28% (n=941) were children aged less than 18 years, and 5% (n=169) were healthcare workers. In depth analysis: EVD in young children

                  WHO periodically conducts in-depth epidemiological analyses so that data can help drive evidence-based improvements in response activities. A previous in-depth analysis of EVD cases in children aged under 5 years was presented in the Disease Outbreak News in May 2019.

                  As of 17 December 2019, over a quarter of all confirmed EVD cases have been children aged less than 18 years (28%, 898/3233). Children from 1-4 years of age accounted for 9% (293/3233) of reported EVD cases and children under 1 year of age accounted for 6% (182/3233) of reported cases. The age distribution of EVD cases has remained relatively constant throughout the outbreak. The case fatality ratio (CFR) among children aged 1-4 is 78% and among children under 1 year is 70%. These figures are similar to those observed in the 2014-16 West Africa EVD outbreak1.

                  The data from this outbreak reveal a relationship between a person’s age group and their pathway to care for EVD infection. Of persons who have died from EVD, death in the community occurred among 44% (80/182) of deaths among children under 1 year of age and 49% (145/294) of deaths among children 1-4 years of age. In contrast, 26%(575/2248) of deaths among persons aged 18 years or older were in the community. If a child infected with EVD presents to a HCF, they do so, on average, sooner than adults after symptom onset. Although they present sooner, the proportion of children with EVD being referred from a HCF to an ETC is lower than adults. Among all cases admitted to a HCF, 38% of cases aged 1-4 years and 32% of cases aged less than 1 year die outside of ETCs, without referral, compared to 15% of cases aged 18 years or older.

                  The reasons for poor referral need to be further investigated, but might include, among others, the challenges for healthcare workers to recognise the symptoms of EVD in children and reluctance or concern by parents or guardians for children to be transferred to ETCs. However, when referral from HCF to an ETC does happen, this is done quickly across all age groups and the case fatality within ETCs is similar across all age groups.

                  Of all confirmed EVD cases among children under 1 year of age, 47% (86/182) are registered as contacts; in children aged 1-4, 31% (91/293) are registered as contacts. The relative risk (RR) of not being known as a contact of an EVD case is significantly higher among paediatric cases compared to adults (age 18+), with a RR of 1.18 (95%CI: 1.03-1.35) among children aged less than 1 year and 1.49 (1.34-1.66) among children aged 1-4 years. In addition, the RR of not being a contact under follow up is higher among children aged 1-4 years (RR:1.22, 95%CI: 1.13-1.32), compared to adults.

                  Social science analyses found that children were less often listed as contacts because of their parents’ fears or concerns about referral to ETCs or vaccination, or they were not listed as contacts because of the parents’ perception that children were not contacts and would not have been exposed. Among parents and healthcare workers, there appears to be limited understanding of transmission routes of EVD. There are ongoing efforts to better understand healthcare workers knowledge, attitudes, and understanding of risk factors for transmission among children.

                  Specific actions are being taken to improve outcomes for children infected with EVD. Children of all ages that have suspected or confirmed EVD are cared for at ETCs with specific supportive care protocols. Paediatric equipment, medicines, and trained specialists are available to provide clinical support at ETCs. All eligible children with confirmed EVD are enrolled in investigational therapeutic protocols after informed consent is obtained. The Pamoja Tulinde Maisha (PALM [“Together Save Lives” in the Kiswahili language]) randomized controlled trial enrolled 172 children under 18 years of age. Of these, 86 were below the age of 5, and in this age group both mAb114 and REGN-EB reduced mortality when coupled with optimized supportive care.

                  Children also receive nutritional care and support from psychologists while in an ETC. This includes supporting and providing information related to infant feeding for children separated from their parents or orphaned due to EVD. Within ETCs, children are cared for by survivors at all times so that they are not alone. As with all age groups, infants and young children who survive EVD infection are offered support via a specialized programme of care for Ebola survivors. Pregnant women that have survived EVD are followed closely in the survivor program and return to ETCs for delivery by a multi-disciplinary team that has obstetric and paediatric expertise. To date, six healthy babies have been born to women who were pregnant at the time of EVD diagnosis and survived. UNICEF and partners are working with EVD survivors and creating infant and young child feeding counselling support groups. They are also supporting the screening and referral of malnourished children under 2 years of age. There is an ongoing effort design ETUs in a way that ensures care delivered to Ebola patients is patient-centred, especially for the most young and vulnerable.

                  Partners are also working to improve the health of children in EVD-affected areas by strengthening the continuity of primary healthcare, supporting vaccination against preventable diseases, and preventing malaria through mosquito net distribution and the provision of antimalarial drugs.

                  1Ebola Virus Disease among Children in West Africa Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 17 December 2019*





                  Enlarge image
                  Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 17 December 2019*





                  Enlarge image



                  *3351 confirmed and probable cases, reported as of 10 December 2019. Excludes n=173 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Butembo, Goma, Kalunguta, Katwa, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Pinga, Rwampara, Tchomia, and Vuhovi. 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 17 December 2019**





                  Enlarge image



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

                  For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:WHO risk assessment

                  WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. WHO advice

                  WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

                  For more information, please see:

                  Comment



                  • WEEKLY BULLETIN ON OUTBREAKS
                    AND OTHER EMERGENCIES
                    Week 51: 16 - 22 December 2019
                    Data as reported by: 17:00; 22 December 2019
                    ...
                    Ebola virus disease Democratic Republic of the Congo

                    3 358 Cases
                    2 224 Deaths
                    66% CFR

                    EVENT DESCRIPTION

                    The Ebola virus disease (EVD) outbreak in North Kivu, South
                    Kivu and Ituri provinces in Democratic Republic of the Congo
                    continues, with six health zones and 11 health areas reporting
                    confirmed cases in the past 21 days (1-21 December 2019).
                    Since our last report on 15 December 2019 (Weekly Bulletin 50),
                    there have been 15 new confirmed cases and 14 new deaths.
                    The principle hot spots of the outbreak in the past 21 days are
                    Mabalako (73%; n=33 cases) and Beni (13%; n=6). Two health
                    zones, Butembo and Mabalako, have reported new confirmed
                    cases in the past seven days.

                    As of 21 December 2019, a total of 3 358 EVD cases, including
                    3 240 confirmed and 118 probable cases have been reported. To
                    date, confirmed cases have been reported from 29 health zones:
                    Ariwara (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (78),
                    Mandima (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in
                    Ituri Province; Alimbongo (5), Beni (695), Biena (19), Butembo
                    (287), Goma (1), Kalunguta (193), Katwa (651), Kayna (28),
                    Kyondo (25), Lubero (31), Mabalako (439), Manguredjipa (18),
                    Masereka (50), Musienene (84), Mutwanga (32), Nyiragongo (3),
                    Oicha (65), Pinga (1) and Vuhovi (103) in North Kivu Province
                    and Mwenga (6) in South Kivu Province.

                    As of 21 December 2019, a total of 2 224 deaths were recorded,
                    including 2 106 among confirmed cases, resulting in a case
                    fatality ratio among confirmed cases of 65% (2 106/3 240). The
                    cumulative number of health workers remains 169, which is 5%
                    of the confirmed and probable cases to date.

                    Contact tracing is ongoing in seven health zones. A total of 5 137
                    contacts are under follow-up as of 21 December 2019, of which
                    4 457 (86.8%) have been seen in the past 24 hours. Alerts in
                    the affected provinces continue to be raised and investigated. Of
                    4 275 alerts processed (of which 4 211 were new) in reporting
                    health zones on 21 December 2019, 4 197 were investigated and
                    446 (10.6%) were validated as suspected cases.

                    PUBLIC HEALTH ACTIONS

                    Response activities have resumed in Lwemba, Mandima
                    Health Zone, as a result of intense community dialogue and
                    popular forums.

                    As of 21 December 2019, a cumulative total of 258 895 people
                    have been vaccinated since the start of the outbreak in August
                    2018. There is low participation in vaccination activities in
                    Mabalako due to persistent community resistance.

                    Point of Entry/Point of Control (PoE/PoC) screening
                    continues, with over 131 million screenings to date. A
                    total of 101/109 (95%) PoE/PoC transmitted reports as of
                    21 December 2019. Unfortunately, the PoC in Goma was
                    attacked on the afternoon of 18 December 2019.

                    Water, sanitation and hygiene (WASH) activities continue, with IPC and WASH
                    teams assessing 25 health facilities in the Mabalako and Butembo health
                    zones and 20 IPC kits offered to a school in Oicha.

                    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.
                    As of 21 December 2019, 94% (79/84) of the health facilities have received
                    support from the teams in charge of IPC/WASH in the Mabalako and Oicha
                    health zones. In addition, 77 providers were briefed on IPC in the Beni,
                    Mabalako and Oicha health zones.

                    SITUATION INTERPRETATION

                    New confirmed cases continue to be reported, which was expected after the recent
                    disruption of response activities in Beni, Butembo, Mandima, Mangina and Oicha.
                    Response activities have been upscaled wherever possible to break this resurgence
                    in transmission.

                    "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: 3 new Ebola cases confirmed in Butembo on January 1, 2020

                      Published on 02/01/2020 - 10:44
                      7sur7

                      3 new patients, suffering from the epidemic of the Ebola virus disease, were registered in the city of Butembo on January 1, 2020, that is during the New Year festivities.

                      Two cases were tested at the Butembo Treatment Center and one at the Katwa center, according to the daily report on the epidemiological situation published by the technical secretariat of the Riposte Multisectoral Committee.

                      These new cases are triggered when until December 28, the Katwa health zone had completed 86 days without a confirmed case. But since then, new patients keep appearing, causing new concerns for a city of Butembo which became the epicenter of the disease between March and June 2019 following repetitive attacks on response teams.

                      It should be noted that with 652 confirmed cases since the start of the epidemic, the Katwa health zone is the second most affected after that of Beni, which has so far had 695. The total number of cases recorded in the North -Kivu, Sud-Kivu and Ituri is 3,380 thus causing the death of 2,232 and at least 1,114 cures.

                      Jo?l Kaseso and Glody Murhabazi

                      3 nouveaux patients, souffrant de l'épidémie de la maladie à virus Ebola, ont été enregistrés dans la ville de Butembo le 1er janvier 2020, soit pendant les festivités de nouvel an. Deux cas ont été testés au Centre de Traitement de Butembo et un autre au centre de Katwa, d'après le rapport quotidien sur la situation épidémiologique publié par le secrétariat technique du Comité Multisectoriel de Riposte.
                      "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/02-janua...-ebola-drc/en/
                        Ebola virus disease – Democratic Republic of the Congo

                        Disease outbreak news: Update
                        2 January 2020



                        Since the last disease outbreak news published on 19 December 2019, 29 new confirmed cases were reported from 18 to 31 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu province. The confirmed cases in this week were reported from eight health areas in four health zones: Mabalako (62%, n=18), Butembo (14%, n=4), Kalunguta (17%, n=5), and Katwa (7%, n=2). Three of the four cases reported in Butembo in the past fourteen days are linked to a transmission chain of more than 50 people that originated in Aloya Health Area, Mabalako Health Zone. One individual classified as a relapse case of EVD, infected several other individuals within the family and through nosocomial transmission (for more information, please see the disease outbreak news published on 19 December 2019). In Kalunguta Health Zone, the five cases reported between 24 and 28 December 2019, are a distinct epidemiologically linked chain of transmission, although the source of exposure is currently under investigation.

                        In the past 21 days (11 December to 31 December), 40 confirmed cases were reported from 10 health areas within five neighbouring active health zones in North Kivu province (Figure 2, Table 1): Mabalako (68%, n=27), Butembo (13%, n=5), Kalunguta (13%, n=5), Katwa (5%, n=2), and Biena (3%, n=1). The majority of the cases (75%, n=30) are linked to known chains of transmission.

                        As of 31 December, a total of 3380 EVD cases were reported, including 3262 confirmed and 118 probable cases, of which 2232 cases died (overall case fatality ratio 66%) (Table 1). Of the total confirmed and probable cases, 56% (n=1900) were female, 28% (n=953) were children aged less than 18 years, and 168 (5% of all reported cases) were healthcare workers. Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 31 December 2019*





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                        *3380 confirmed and probable cases, reported as of 31 December 2019. Excludes n=173 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Beni, Bunia, Goma, Kayna, Komanda, Kyondo, Lolwa, Lubero, Mandima, Mambasa, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyakunde, Nyiragongo, Oichia, 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 31 December 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 31 December 2019**





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

                        For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:WHO risk assessment

                        WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. WHO advice

                        WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

                        For more information, please see:

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                        • Translation Google
                          EPIDEMIOLOGICAL SITUATION
                          EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI ON 02 JANUARY 2020

                          Friday, January 03, 2020
                          • Since the start of the epidemic, the cumulative number of cases is 3,385, of which 3,267 are confirmed and 118 probable. In total, there were 2,232 deaths (2,114 confirmed and 118 probable) and 1,114 people healed;
                          • 389 suspected cases under investigation;
                          3 new confirmed cases in North Kivu Butembo;
                          • No new deaths from confirmed cases, including:
                          o No community deaths have been recorded;
                          o No deaths among the confirmed cases;
                          • No healed person has left the CTE;
                          • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (approximately 5% of all confirmed / probable cases), including 41 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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                          • Translation Google

                            DRC: "As long as Ebola persists in neighboring areas, Butembo will always be exposed" (Coordination of the response)

                            Sunday, January 5, 2020 - 5:10 p.m.
                            ...
                            During a press conference held this Sunday, January 5 in Butembo, following the resurgence of the epidemic in the city, the representative of the World Health Organization (WHO) in strategic coordination, Doctor Aboubacar Diallo, explained that the high density and the movement of the population in the region make the city of Butembo vulnerable.

                            “As long as the epidemic persists around Butembo, Butembo will never be spared. That is clear, given the movement of the population, and let's not forget that it is the capital here, it is the big city. The people who are in Aloya, in Mambasa, they prefer to come to be treated here in the big city of Butembo. And that is why Butembo will always be exposed, as long as the epidemic still exists ”, he warned at the microphone of ACTUALITE.CD.

                            Until last Saturday, the strategic coordination of the response against the Butembo Ebola virus disease said it had recorded, during the last 21 days, 10 positive cases of Ebola in Butembo, in particular in its health zones of Katwa and Butembo. An epidemic that resurfaces in a city where no case had been reported for 56 days.

                            According to Dr. Aboubacar Diallo, these new notified cases are linked to a person from Mabalako, where he had been identified as the contact for a confirmed case, but who had not been followed up for the required 21 days.

                            Over 150 contacts lost to follow-up

                            Butembo's strategic coordination calls on residents and healthcare providers to cooperate with response teams to find more than 150 lost contacts. For Doctor Atibasay Jean Paul, interim coordinator of the response to Butembo, this cooperation will allow response teams to identify contacts related to new cases of Ebola, and therefore cut the chain of contamination.

                            Claude Sengenya


                            "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


                            • WEEKLY BULLETIN ON OUTBREAKS
                              AND OTHER EMERGENCIES

                              Week 1: 30 December 2019 - 5 January 2020
                              Data as reported by: 17:00; 5 January 2020
                              ...
                              Ebola virus disease Democratic Republic of the Congo

                              3 388 Cases
                              2 233 Deaths
                              66% CFR


                              EVENT DESCRIPTION

                              The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu and
                              Ituri provinces in Democratic Republic of the Congo continues, with
                              six health zones and 11 health areas reporting confirmed cases in the
                              past 21 days (15 December 2019 to 4 January 2020). Since our last
                              report on 29 December 2019 (Weekly Bulletin 51), there have been
                              13 new confirmed cases and one new death. The principle hot spots
                              of the outbreak in the past 21 days are Mabalako (55%; n=23 cases),
                              Butembo (24%; n=10) and Kalunguta (12%; n=5). Four health zones
                              and 10 health areas have had active cases in the past 21 days. Five
                              health zones, Katwa, Kalunguta, Butembo, Mambasa and Mabalako,
                              have reported new confirmed cases in the past seven days.

                              As of 4 January 2019, a total of 3 388 EVD cases, including 3 270
                              confirmed and 118 probable cases have been reported. To date,
                              confirmed cases have been reported from 29 health zones: Ariwara
                              (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (80), Mandima
                              (347), Nyakunde (2), Rwampara (8) and Tchomia (2) in Ituri Province;
                              Alimbongo (5), Beni (695), Biena (19), Butembo (295), Goma (1),
                              Kalunguta (198), Katwa (653), Kayna (28), Kyondo (25), Lubero (31),
                              Mabalako (452), Manguredjipa (18), Masereka (50), Musienene (84),
                              Mutwanga (32), Nyiragongo (3), Oicha (65), Pinga (1) and Vuhovi
                              (103) in North Kivu Province and Mwenga (6) in South Kivu Province.

                              As of 4 January 2020, a total of 2 233 deaths were recorded, including
                              2 114 among confirmed cases, resulting in a case fatality ratio among
                              confirmed cases of 65% (2 115/3 270). The cumulative number
                              of health workers remains 169, which is 5% of the confirmed and
                              probable cases to date.

                              Contact tracing is ongoing in seven health zones. A total of 4 133
                              contacts are under follow-up as of 4 January 2020, of which 3 495
                              (84.6%) have been seen in the past 24 hours. Alerts in the affected
                              provinces continue to be raised and investigated. Of 4 633 alerts
                              processed (of which 4 542 were new) in reporting health zones on
                              4 January 2020, 4 525 were investigated and 464 (10.3%) were
                              validated as suspected cases.

                              PUBLIC HEALTH ACTIONS

                              Response activities continue where possible.

                              As of 1 January 2020, a cumulative total of 261 285 people have
                              been vaccinated since the start of the outbreak in August 2018.
                              Point of Entry/Point of Control (PoE/PoC) screening continues,
                              with over 136 million screenings to date. A total of 106/109
                              (97.2%) PoE/PoC transmitted reports as of 4 January 2020.

                              Water, sanitation and hygiene (WASH) activities continue, with
                              17 health facilities evaluated in Mabalako and Butembo health
                              zones, while 321 health workers were briefed in Oicha, Mabalako,
                              Butembo and Mambasa.

                              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.

                              On 4 January 2020 a community dialogue was held with young
                              people from Beni citizen’s movements, during which they renewed
                              their commitment to combating community resistance. Similarly,
                              a dialogue was organized with community representatitives to
                              lift resistance to response in new outbreaks of EVD in Mondo
                              and Katsya in Butembo Health Zone, and at the same time 38
                              householders in this zone were sensitized around response
                              activities to the last reported confirmed case.

                              SITUATION INTERPRETATION

                              New confirmed cases continue to be reported in Mabalako, Butembo
                              and Kalunguta in North Kivu Province and in Mambasa in Ituri Province.
                              The new confirmed cases in Mambasa are of concern, since there had
                              been no new confirmed cases in Ituri Province for 66 days. Resistance
                              to response activities continues, particulary in North Kivu Province.

                              However, there are continued efforts to engage with the community and
                              to upscale response activities in affected regions in order to bring the
                              outbreak to a close.

                              https://apps.who.int/iris/bitstream/...1-05012020.pdf
                              "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: 3 new cases of Ebola in Mambasa, 63 days later

                                Posted on Tue, 1/7/2020 - 4:11 PM | Modified on Tue, 07/01/2020 - 16:11
                                ...
                                These cases appear after 63 days without a confirmed case in the capital of this territory. The response coordinator in Ituri, Christophe Shako, told Radio Okapi that these patients were already admitted to the local treatment center and that more than 200 people contacted were already identified.

                                Christophe Shako has promised further investigations to contain the disease. He asked the local population to keep calm, all those contacted by the sick being known:

                                “We are more than two hundred contacts who have been listed and the investigations continue. We will dig further to find other contacts. We will list them and will be followed for twenty-one days ”.

                                The Ituri response coordinator recalls that the three Ebola patients are friends. They were in Bunia on December 15. They showed signs on December 31.

                                Before being admitted to the Ebola virus treatment center, they were treated by a traditional healer, then in a health center.

                                Trois nouveaux cas positifs d’Ebola ont été enregistrés depuis samedi 4 décembre à Mambasa-centre, à environ 165 kilomètres au sud-ouest de Bunia. Ces cas apparaissent après 63 jours sans cas confirmé au chef-lieu de ce territoire. Le coordonnateur de riposte en Ituri, Christophe Shako, a précisé à la Radio Okapi que ces malades étaient déjà admis au centre de traitement local et que plus de 200 personnes contactées étaient déjà identifiées. Christophe Shako a promis la poursuite des investigations pour contenir la maladie.

                                "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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