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DRC - Ebola outbreak in North Kivu and Ituri: July 30 - current

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  • Source: https://www.who.int/csr/don/11-april-2019-ebola-drc/en/
    Ebola virus disease – Democratic Republic of the Congo

    Disease outbreak news: Update
    11 April 2019

    The rise in number of Ebola virus disease (EVD) cases observed in the North Kivu provinces of the Democratic Republic of the Congo continues this week. During the last 21 days (20 March to 9 April 2019), 57 health areas within 11 health zones reported new cases; 40% of the 141 health areas affected to date (Table 1 and Figure 2). During this period, a total of 207 probable and confirmed cases were reported from Katwa (83), Vuhovi (41), Mandima (29), Beni (21), Butembo (15), Oicha (8), Masereka (4), Lubero (2), Musienene (2), Kalunguta (1), and Mabalako (1).
    As of 9 April, a total of 1186 confirmed and probable EVD cases have been reported, of which 751 died (case fatality ratio 63%). Of the 1186 cases with reported age and sex, 57% (675) were female, and 29% (341) were children aged less than 18 years. The number of healthcare workers affected has risen to 87 (7% of total cases), including 31 deaths. To date, a total of 354 EVD patients who received care at Ebola Treatment Centres (ETCs) have been discharged.
    WHO Director-General Dr. Tedros Adhanom Ghebreyesus has convened the Emergency Committee for a meeting on 12 April, to consider whether the current EVD outbreak constitutes a public health emergency of international concern and to provide recommendations.
    Progress on the ground this week focused primarily on intensifying infection prevention and control (IPC) activities in and around outbreak hotspot areas. IPC teams are concentrating their efforts at addressing reluctance to decontamination activities amongst some local residents by actively engaging in regular direct dialogues with community leaders. Along with intensifying decontamination efforts, other IPC measures being undertaken include rapid evaluation of IPC practices in healthcare facilities and patients’ homes and identifying facilities at increased risk of contact with EVD cases. Results from these rapid evaluations demonstrated a range of IPC gaps depending on the type of facility, which were then promptly addressed through supplementary supervision. Reoccurring issues include limited knowledge of standard precautions, lack of triage and isolation capacity, insufficient supplies (e.g., of personal protective equipment), inappropriate waste management, and lack of capacity for decontaminating medical equipment. These findings highlight the importance of maintaining supportive supervision and mentorship at priority facilities throughout the response. WHO is confident that strengthening these IPC measures would be an integral means of slowing the spread of EVD in the outbreak areas.
    WHO and partners in Risk Communication and Community Engagement are continuing with activities to build and maintain a trusting relationship between communities and the Ebola response teams. Dialogues with community committees are ongoing in the hotspot areas of Butembo, Katwa, and Vuhovi, and form a key part of a larger increase ownership of the Ebola response by the communities. Information about community disquiet are systematically collected and monitored to ensure that any misunderstanding leading to reluctance, refusal, or resistance of the Ebola response is followed up with and resolved as quickly as possible. This has been made possible by feedback from the community members, received through ongoing dialogue and various research activities within both the Democratic Republic of the Congo, and neighbouring areas.
    In an effort to address the feedback received and specific concerns over the outbreak response, guided visits of the Ebola Treatment Centres (ETCs) in various affected areas have been organized. Students and community associations who attended these guided visits to the ETCs can see first-hand how EVD patients are treated and help stop the potential dissemination of misinformation surrounding EVD and the ongoing response efforts.
    The security situation has remained calm for the past week as well. Provisional results released on 9 April by the Commission Électorale Nationale Indépendante concerning the national and provincial legislative elections in Beni, Butembo city (North Kivu), and Yumbi territory (Mai-Ndombe) have caused no significant unrest or disruption to outbreak response activities.
    The continued increase in cases this past week reflects the complex reality of conducting an effective outbreak response in a geographically difficult area with a highly fluid population, intermittent attacks by armed groups, and limited healthcare infrastructure. Despite these challenges, WHO and partners remain committed to limiting the spread of EVD amongst these vulnerable populations through the continued strengthening of our multi-faceted response efforts.
    Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 9 April 2019*




    *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning.
    Figure 2: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 9 April 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 9 April 2019**




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

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

    WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community mistrust, exacerbated by political tensions and insecurity, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas; reducing the overall effectiveness of interventions. The high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity.
    WHO advice

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


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

    Comment


    • World Health Organization (WHO)Verified account @WHO 1m1 minute ago More



      WHO Director-General @DrTedros has accepted the International Health Regulations Emergency Committee’s recommendation that the #Ebola outbreak in #DRC does not constitute a Public Health Emergency of International Concern.






      WHO African Region, WHO DR CONGO and Tedros Adhanom Ghebreyesus



      "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


      • Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12th April 2019

        12 April 2019 Statement

        Geneva


        The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding Ebola virus disease (EVD) in the Democratic Republic of the Congo took place on Friday, 12th April, 2019, from 13:00 to 17:20 Geneva time (CET).

        Key Findings:

        It was the view of the Committee the ongoing Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo does not constitute a Public Health Emergency of International Concern (PHEIC). However, the Committee wished to express their deep concern about the recent increase in transmission in specific areas, and therefore the potential risk of spread to neighbouring countries.

        The Committee also wishes to commend the efforts of responders from the government of the Democratic Republic of Congo, the World Health Organization and partners to contain the outbreak in a complex and difficult setting.

        Additionally, the Committee has provided the following public health advice:
        • The committee advises to redouble efforts to detect cases as early as possible, identify and follow up all contacts, ensure the highest level of coverage vaccination of all contacts and contacts of contacts.
        • Sustained efforts must be made to prevent nosocomial transmission and to shorten time between onset of disease and access to high standards of care and therapeutics at Ebola treatment units.
        • Special emphasis should be placed on addressing the rise in case numbers in the remaining epicentres, notably Butembo, Katwa, Vuhovi, and Mandima.
        • The Committee advises WHO and all partners to identify, target, and scale up community dialogue and participation, engagement of traditional healers, and other community engagement tactics to strengthen and broaden community acceptance.
        • The Committee also noted the need to follow the recommendations of SAGE with regards to the vaccination strategy provided at its latest meeting[1].
        • The safety of responders should be prioritized, while avoiding the securitization of the response.
        • Because there is a very high risk of regional spread, neighbouring countries should continue to accelerate current preparedness and surveillance efforts, including vaccination of health care workers and front-line workers in surrounding countries.
        • Cross-border collaboration should continue to be strengthened, including timely sharing of data and alerts, cross-border community engagement and awareness raising. In addition, work should be done to better map population movements and understand social networks bridging national boundaries.
        • The Committee maintains its previous advice that it is particularly important that no international travel or trade restrictions should be applied. Exit screening, including at airports, ports, and land crossings, is of great importance; however, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.
        • The committee strongly emphasized the critical need to strengthen currents efforts in both preparedness and response. This will require substantial, immediate and sustained additional financial support.
        • While there is no added benefit to declaring a PHEIC at this stage, there was concern about current levels of transmission requiring close attention to the evolving situation. The committee advised the WHO Director General to continue to monitor the situation closely and reconvene the Emergency Committee as needed.
        Proceedings of the meeting

        Members and advisors of the Emergency Committee met by teleconference. Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo on the epidemiological situation, the response strategies, and recent adaptations, including a shift in strategy to improve engagement of the community in the response.

        A representative of the Office of the Deputy Special Representative of the Secretary-General (MONUSCO) reported on the work of MONUSCO, including its logistics and security activities to support the response.

        The WHO Secretariat gave an update on the current situation and provided detail of the response to the current Ebola outbreak and preparedness activities in neighbouring countries.

        The Committee’s role was to provide to the Director-General its views and perspectives on:
        • Whether the event constitutes a Public Health Emergency of International Concern (PHEIC)
        • If the event constitutes a PHEIC, what Temporary Recommendations should be made.
        Based on the above advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 April 2019 did not declare the Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern. In light of the advice of the Emergency Committee, WHO advises against the application of any travel or trade restrictions. The Director-General thanked the Committee Members and Advisors for their advice.

        https://www.who.int/news-room/detail/12-04-2019-statement-on-the-meeting-of-the-international-health-regulations-(2005)-emergency-committee-for-ebola-virus-disease-in-the-democratic-republic-of-the-congo-on-12th-april-2019

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



        Biographies of Members of, and Advisers to the Meeting of the International Health Regulations (IHR) Emergency Committee for Ebola Viral Disease in the Democratic Republic of the Congo on 12 April 2019

        https://www.who.int/ihr/procedures/e...iographies/en/




        "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: a warning to taximen in full organization of a march against the teams of response

          Posted on: 12/04/2019 at 19h01min39s
          By Radio Moto Butembo-Beni

          The Board of Directors of the Association of Taximen Motorcycles and Cars, ATAMOV, calls its members to vigilance. This call follows messages circulating in social networks.

          According to these non-authentic messages, taximen and members of other organizations are organizing a march against the response teams and their equipment in Butembo, Monday, April 15. On behalf of the General Directorate of ATAMOV, its president notes in a press release published this Friday, April 12, that this structure does not recognize the author or the reason for this event.

          Master MUMBERE MISISA Jackson calls instead members of ATAMOV to facilitate and participate in the protection actions of the response teams. "Any member who will be questioned by the officers of the order for having joined in any movement undermining public order will be responsible for its actions," warns the press release signed by Master MUMBERE MISISA Jackson.


          Posted on: 12/04/2019 at 19h01min39s
          By Radio Moto Butembo-Beni

          http://radiomotofm.info/lirearticle.php?billet=5694
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


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

            Friday, April 12, 2019


            The epidemiological situation of the Ebola Virus Disease dated April 11, 2019 :
            • Since the beginning of the epidemic, the cumulative number of cases is 1,220, of which 1,154 are confirmed and 66 are probable. In total, there were 772 deaths (706 confirmed and 66 probable) and 364 people cured.
            • 287 suspected cases under investigation;
            • 14 new confirmed cases, including 8 in Katwa, 2 in Vuhovi, 1 in Mandima, 1 in Butembo, 1 in Komanda, and 1 in Beni;
            • 8 new confirmed case deaths, including
              • 4 community deaths in Katwa;
              • 4 deaths at CTE, 2 in Katwa, 1 in Butembo and 1 in Beni;
            • 6 new cures including 4 from the Butembo CTE, 1 from the Katwa CTE and 1 from the CTE de Beni;
            • One Beni health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 88 (7.2% of all confirmed / probable cases), including 31 deaths.

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






            Remarks:
            • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
            • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
            • The category of probable cases includes all the deaths for which it has not been possible to obtain biological samples for laboratory confirmation but where investigations revealed epidemiologically linked to a confirmed or probable case.
            • A community death is any death occurring outside of an Ebola Treatment Center.
            News of the response


            Emergency Committee of the World Health Organization
            • The meeting of the Emergency Committee for International Health Regulations, convened by the Director-General of WHO, was held this Friday, April 12, 2019. The Emergency Committee concluded that the Ebola outbreak in the provinces North Kivu and Ituri did not constitute a public health emergency of international concern. However, the Committee expressed its deep concern about the recent increase in transmission in some areas, and thus the potential risk of spread in neighboring countries.
            • The Committee also commended the efforts of the Government of the Democratic Republic of Congo's response teams, the World Health Organization and partners to contain the epidemic in a complex and difficult environment.
            • In addition, the Committee made the following public health recommendations:
              • No restrictions on travel or international trade should be imposed and exit screening at airports, ports and land borders remains an important activity;
              • Redouble efforts to detect cases as early as possible, identify and track contacts, and ensure maximum immunization coverage of all contacts and contacts;
              • Increase efforts to prevent nosocomial transmission and reduce the time between onset of illness and access to quality health care in Ebola treatment centers;
              • Pay particular attention to respond to the increasing number of cases in the remaining epicenters, including Butembo, Katwa, Vuhovi and Mandima;
              • Identify, target and expand community dialogue and participation, involvement of traditional healers and other techniques to strengthen and broaden community acceptance;
              • Implement the latest recommendations of the WHO Strategic Advisory Group of Experts (SAGE) on the immunization strategy, ie the inclusion of pregnant women and children under one year of age in the vaccination strategy in a belt;
              • The security of the actors of the response must be a priority, while avoiding the security of interventions;
              • Given the very high risk of regional spread, neighboring countries need to continue to accelerate their preparedness and surveillance efforts, including immunization of primary care providers;
              • Continue to strengthen cross-border collaboration, including data sharing and alerts, cross-border community engagement and awareness raising. In addition, it is also recommended to improve the mapping of population movements and the understanding of social networks that transcend national borders.
            • The members and advisers of the Emergency Committee met by teleconference. Representatives from the DRC Ministry of Health gave a presentation on the epidemiological situation, response strategies and recent adaptations, including the strategy to improve community engagement. MONUSCO representatives discussed their logistics and security activities to support the response. Finally, the WHO Secretariat presented in detail the situation on the evolution of the current epidemic as well as the preparedness activities in neighboring countries.


            Vaccination
            • Depuis le début de la vaccination le 8 août 2018, 98.422 personnes ont été vaccinées, dont, 24.903 à Katwa, 21.640 à Beni, 12.045 à Butembo, 6.331 à Mabalako, 4.172 à Mandima, 3.070 à Goma, 3.080 à Kalunguta, 2.540 à Oicha, 2.347 à Komanda, 1.795 à Vuhovi, 1.729 à Masereka, 1.630 à Kayina, 1.569 à Kyondo, 1.487 à Bunia, 1.357 à Karisimbi, 1.193 à Lubero, 1.025 à Biena, 997 à Musienene, 772 à Mutwanga, 690 à Rutshuru, 557 à Rwampara (Ituri), 527 à Nyankunde, 496 à Mangurujipa, 420 à Mambasa, 355 à Tchomia, 333 à Lolwa, 342 à Kirotshe, 254 à Alimbongo, 250 à Mweso, 245 à Kibirizi, 161 à Nyiragongo, 97 à Watsa (Haut-Uélé) et 13 à Kisangani.
            • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.



            ...
            https://us13.campaign-archive.com/?u...&id=a7e1c65e2b
            "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


            • Preliminary results on the efficacy of rVSV-ZEBOV-GP Ebola vaccine using the ring vaccination strategy in the control of an Ebola outbreak in the Democratic Republic of the Congo: an example of integration of research into epidemic response.


              https://www.who.int/csr/resources/pu...april-2019.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
                DIRECTORATE GENERAL FOR DISEASE CONTROL
                EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

                Saturday, April 13, 2019


                The epidemiological situation of the Ebola Virus Disease dated April 12, 2019 :
                • Since the beginning of the epidemic, the cumulative number of cases is 1,240, of which 1,174 are confirmed and 66 are probable. In total, there were 792 deaths (726 confirmed and 66 probable) and 365 people cured.
                • 269 ​​suspected cases under investigation;
                • 20 new confirmed cases, including 16 in Katwa, 1 in Vuhovi, 1 in Mandima, and 2 in Beni;
                • 20 new confirmed case deaths, including
                  • 12 community deaths, including 10 in Katwa, 1 in Beni and 1 in Mandima;
                    • The community death of Beni is a stillborn baby whose mother, confirmed case, died at the CTE on April 11th. The baby died during the transfer of the mother to the CTE.
                  • 8 deaths at CTE, including 5 in Katwa, 2 in Butembo and 1 in Beni;
                • 1 new healed from the CTE of Butembo.

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






                Remarks:
                • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
                • The category of probable cases includes all the deaths for which it has not been possible to obtain biological samples for laboratory confirmation but where investigations revealed epidemiologically linked to a confirmed or probable case.
                • A community death is any death occurring outside of an Ebola Treatment Center.
                News of the response


                Vaccine Efficacy Study
                • The National Institute of Biomedical Research (INRB) and the World Health Organization (WHO) have published preliminary results of a study on the efficacy of the rVSV-ZEBOV-GP vaccine to control the Ebola outbreak. The objective of the study was to better understand if the vaccine was effective and help prevent the number of cases when used as part of the belt vaccination strategy. A more detailed analysis is being prepared and will be published in a scientific journal.
                • The researchers analyzed the data of those vaccinated between 1 st May 2018 and 25 March 2019. According to the data collected, the efficiency of the rVSV-GP-ZEBOV vaccine is estimated at 97.5%. These first results confirm previous observations on the very high efficacy of the rVSV-ZEBOV-GP against Ebola vaccine to control the spread of the epidemic. The belt vaccination strategy has been shown to be effective because of the rapid protection of those vaccinated after a single injection and the high coverage achieved in the different vaccination belts (91%).
                • Of a sample of over 90,000 people vaccinated against Ebola, 71 developed the disease. Of these 71 people, 15 people developed the disease more than 10 days after vaccination, of which 7 were health workers. In this first group, no one died of Ebola. The other 56 people developed the first symptoms less than 10 days after being vaccinated, that is, before they could develop their immunity. It is estimated that the vaccine takes 10 days to offer maximum immune protection. In this second group, 9 people died. This indicates that the vaccine has reduced the overall mortality rate among the vaccinated people who developed the disease.

                Validation workshop of the implementation framework of the 3 rd strategic response plan (PSR-3)
                • From 10 to 12 April 2019, Minister of Health Dr. Oly Ilunga Kalenga chaired a workshop on the validation of the implementation framework for PSR-3 in Goma. The objective of this workshop was to reframe the implementation of the RSP-3, focusing on three specific deliverables, namely to clarify the organizational chart of the response taking into account the new actors, to define a plan of action unique and inclusive by sub-coordination and pillar, as well as developing a accountability and performance framework for all actors in the national and international response.
                • As the Minister of Health has pointed out, the current Ebola outbreak is taking place in an extremely complex and challenging environment that requires a constant review of response strategies. He emphasized the importance of maintaining a healthy framework for consultation and collaboration among the many national and international organizations involved in this response to ensure the effectiveness of all interventions with greater community involvement.

                Vaccination
                • Since the beginning of vaccination on 8 August 2018, 98,966 persons have been vaccinated , including 25,131 in Katwa, 21,678 in Beni, 12,243 in Butembo, 6,371 in Mabalako, 4,182 in Mandima, 3,080 in Kalunguta, 3,070 in Goma, 2,540 in Oicha, 2.347 to Komanda, 1.795 to Vuhovi, 1.729 to Masereka, 1.630 to Kayina, 1.569 to Kyondo, 1.487 to Bunia, 1.357 to Karisimbi, 1.193 to Lubero, 1.027 to Musienene, 1.025 to Biena, 772 to Mutwanga, 690 to Rutshuru, 557 in Rwampara (Ituri), 527 in Nyankunde, 496 in Mangurujipa, 420 in Mambasa, 355 in Tchomia, 333 in Lolwa, 342 in Kirotshe, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.
                • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.



                ...
                https://us13.campaign-archive.com/?u...&id=cfa55c58ea
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


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

                  Sunday, April 14, 2019


                  The epidemiological situation of the Ebola Virus Disease dated April 13, 2019 :
                  • Since the beginning of the epidemic, the cumulative number of cases is 1,251, of which 1,185 are confirmed and 66 are probable. In total, there were 803 deaths (737 confirmed and 66 probable) and 371 people cured.
                  • 290 suspected cases under investigation;
                  • 11 new confirmed cases, including 7 in Katwa, 2 in Mandima, 1 in Vuhovi, and 1 in Butembo;
                  • 11 new confirmed case deaths, including
                    • 6 community deaths, 2 in Katwa, 2 in Mandima, 1 in Vuhovi and 1 in Butembo;
                    • 5 deaths at CTE / CT, 2 in Katwa, 2 in Butembo and 1 in Beni;
                  • 6 new cures, including 4 from the Butembo CTE, 1 from the Beni CTE and 1 from the Katwa CTE.

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



                  ...

                  https://us13.campaign-archive.com/?u...&id=a1596542c9
                  "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                  -Nelson Mandela

                  Comment


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

                    Monday, April 15, 2019


                    The epidemiological situation of the Ebola Virus Disease dated April 14, 2019 :
                    • Since the beginning of the epidemic, the cumulative number of cases is 1,264, of which 1,198 confirmed and 66 probable. In total, there were 814 deaths (748 confirmed and 66 probable) and 374 people cured.
                    • 231 suspected cases under investigation;
                    • 13 new confirmed cases, including 7 in Katwa, 2 in Mabalako, 1 in Mandima, 1 in Musienene, 1 in Butembo and 1 in Oicha;
                    • 11 new confirmed case deaths, including
                      • 6 community deaths, including 4 in Katwa and 2 in Mabalako;
                      • 5 deaths at CTE, including 3 in Katwa and 2 in Butembo;
                    • 3 new cures, including 1 from the Butembo CTE, 1 from the Beni CTE and 1 from the Mabalako CTE;
                    • One Katwa health worker is among the new confirmed cases (community deaths).
                      • This is an unvaccinated nurse who was in contact with a confirmed patient. When she started the illness, she hid and was cared for at home by her colleagues from 4 to 13 April 2019. Following the deterioration of her clinical condition, she consulted a health center in Butembo where she is. died.
                      • The cumulative number of confirmed / probable cases among health workers is 89 (7% of all confirmed / probable cases) including 32 deaths.

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






                    Remarks:
                    • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                    • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
                    • The probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
                    • A community death is any death occurring outside of an Ebola Treatment Center.
                    News of the response

                    More than 100,000 vaccinated people
                    • This Sunday, April 14, 2019, the cap of 100,000 people vaccinated against Ebola in the provinces of North Kivu and Ituri has been reached. Of these 100,000, 27,766 are front-line health workers, 26,328 are high-risk contacts for confirmed cases, and 46,376 are contacts.
                    • So far, the only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, after the approval of the Ethics Committee in its decision of 19 May 2018. The strategy used, called vaccination, aims to create a circle of people immunized against the Ebola virus around a confirmed patient in order to break the chain of transmission.
                    • Preliminary results from a study by the National Institute for Biomedical Research (INRB) and the World Health Organization (WHO) confirmed the very high efficiency of the vaccine and vaccination belt to limit the spread of Ebola outbreak. Moreover, the significant increase in new cases confirmed in recent weeks, particularly in active households in Butembo and Katwa, is partly explained by the temporary cessation of vaccination activities in March following the rise in violence against the teams of the response. Because of the problems of violence and safety, 45 vaccination rings could not be opened around confirmed cases.


                    Vaccination
                    • Since vaccination began on August 8, 2018, 100,470 people have been vaccinated , including 25,917 in Katwa, 21,908 in Beni, 12,437 in Butembo, 6,451 in Mabalako, 4,220 in Mandima, 3,080 in Kalunguta, 3,070 in Goma, 2,540 in Oicha, 2,423 at Komanda, 1,845 at Vuhovi, 1,729 at Masereka, 1,630 at Kayina, 1,619 at Kyondo, 1,487 at Bunia, 1,357 at Karisimbi, 1,193 at Lubero, 1,027 at Musienene, 1,025 at Biena, 772 at Mutwanga, 690 at Rutshuru, 557 in Rwampara (Ituri), 527 in Nyankunde, 496 in Mangurujipa, 420 in Mambasa, 355 in Tchomia, 333 in Lolwa, 342 in Kirotshe, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.
                    • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.



                    ...
                    https://us13.campaign-archive.com/?u...&id=a5f59b7690
                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


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

                      Tuesday, April 16, 2019


                      The epidemiological situation of the Ebola Virus Disease dated April 15, 2019 :
                      • Since the beginning of the epidemic, the cumulative number of cases is 1,273, of which 1,207 are confirmed and 66 are probable. In total, there were 821 deaths (755 confirmed and 66 probable) and 374 people cured.
                      • 303 suspected cases under investigation;
                      • 9 new confirmed cases, including 3 in Katwa, 3 in Butembo, 1 in Masereka, 1 in Mandima and 1 in Kyondo;
                      • 7 new confirmed case deaths, including
                        • 4 community deaths, 2 in Butembo, 1 in Katwa and 1 in Mandima;
                        • 3 deaths at CTE, 2 in Butembo and 1 in Katwa.

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






                      Remarks:
                      • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                      • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
                      • The probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
                      • A community death is any death occurring outside of an Ebola Treatment Center.
                      News of the response


                      Visit of the Head of State to Beni
                      • This Tuesday, April 16, 2019, the President of the Republic, Felix Tshisekedi, visited the teams of the response during his trip to Beni. He visited the Ebola Treatment Center where he witnessed the release of a cured patient to whom he gave the clearance certificate. He spoke at length with various agents of the response who explained the functioning of the response, including patient care and mobile laboratories of the National Institute of Biomedical Research (INRB). He commended the health workers for their work in keeping the epidemic alive in only two provinces of the country, without reaching neighboring countries, and provided them with state support. Otherwise,


                      Vaccination
                      • Since the beginning of the vaccination on August 8, 2018, 101,249 people have been vaccinated , including 26,316 in Katwa, 22,059 in Beni, 12,447 in Butembo, 6,556 in Mabalako, 4,250 in Mandima, 3,080 in Kalunguta, 3,070 in Goma, 2,540 in Oicha, 2.477 to Komanda, 1.845 to Vuhovi, 1.729 to Masereka, 1.649 to Kyondo, 1.630 to Kayina, 1.487 to Bunia, 1.357 to Karisimbi, 1.193 to Lubero, 1.027 to Musienene, 1.025 to Biena, 772 to Mutwanga, 690 to Rutshuru, 557 in Rwampara (Ituri), 527 in Nyankunde, 496 in Mangurujipa, 420 in Mambasa, 355 in Tchomia, 333 in Lolwa, 342 in Kirotshe, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.
                      • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

                      WEEKLY SUMMARY OF EPIDEMIOLOGICAL DATA

                      Week 15 (April 8-14, 2019)




                      For the week of April 8 to 14, 2019, we recorded:
                      • 7.297 new notified alerts
                        • There has been a clear increase in the number of alerts received in the past 5 weeks.
                        • The vast majority of these alerts come from the community and health facilities. This indicates better community collaboration with the response teams. There has also been a decrease in violence against teams, including in areas of Katwa, Butembo and Vuhovi, which until now have been difficult for health workers to access.
                      • 1,933 suspected cases investigated and tested in the laboratory
                      • 110 new confirmed cases :
                        • Katwa is the main focus with 60 cases (54.5%).
                        • A health zone has been removed from the list of zones that have notified at least one confirmed case in the last 21 days: Kayna. A health zone is back in the list: Komanda.
                        • As the chart below shows, the number of new confirmed cases notified weekly has increased significantly in the last 5 weeks following targeted attacks against the Katwa and Butembo CTEs.
                      • 83 deaths of confirmed cases :
                        • The main source of death is Katwa with 51 deaths, or 62.4% of the total number of new deaths during the week;
                        • Of the 83 deaths, 49 were community deaths, or 59%, and 34 occurred in an ETC.
                      • 24 new people healed :
                        • The number of cures discharged from ETCs each week continues to increase. We went from 19 new cures at week 14 to 24 new cures at week 15.

                      Visit of the President of the Republic to the Beni Ebola Treatment Center
                      ...
                      https://us13.campaign-archive.com/?u...&id=56b9184dbe
                      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                      -Nelson Mandela

                      Comment


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

                        Wednesday, April 17, 2019


                        The epidemiological situation of the Ebola Virus Disease dated April 16, 2019 :
                        • Since the beginning of the epidemic, the cumulative number of cases is 1,290, of which 1,224 are confirmed and 66 are probable. In total, there were 833 deaths (767 confirmed and 66 probable) and 379 people cured.
                        • 251 suspected cases under investigation;
                        • 17 new confirmed cases, including 11 in Katwa, 4 in Butembo, and 2 in Mandima;
                        • 12 new deaths of confirmed cases, including
                          • 10 community deaths, including 7 in Katwa, 2 in Mandima and 1 in Butembo;
                          • 2 deaths at Butembo CTE;
                        • 5 new cures, including 3 from the Katwa CTE, 1 from Beni and 1 from Butembo.

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






                        Remarks:
                        • In order to prevent the total number of cases from going up or down daily, the suspect cases have been placed in a separate category. For example, suspect cases with positive laboratory tests will be added to the confirmed category, while negative ones (non-cases) will be removed from the table.
                        • Deaths occurring at the level of the CTEs are provisionally recorded in the health zones of CTE implantation pending reclassification in the health zone of case notification.
                        • The probable case category includes all deaths for which it was not possible to obtain biological samples for laboratory confirmation but where the investigations revealed an epidemiological link with a confirmed or probable case.
                        • A community death is any death occurring outside of an Ebola Treatment Center.
                        News of the response

                        Community leaders get more involved in raising awareness
                        • The customary chiefs of the Beni-Lubero territory, meeting within the National Alliance of Traditional Chiefs of North Kivu in Butembo, sent a message of sensitization to the population and recommendations to the teams of the response to put an end to the Ebola outbreak at home. Taking into account the seriousness of the situation, they asked the population to dissociate themselves from anyone who minimizes the Ebola disease, and to consider that Ebola is a disease that really exists. In addition, he asked the mothers and girls, who traditionally take care of the hygiene and care of the sick at home, not to throw stones at the teams of the response. Finally,
                        • Two national deputies from Ituri province, Kambale Ezechiel Barnabas and Kakule Mupopolo Floribert, carried out a 3-day mission to Biakato, in Mandima health zone, to raise awareness and ask them to collaborate with the teams of the response. This locality has experienced a significant increase in confirmed Ebola cases in recent weeks because of the difficulty of the response teams in accessing the sick as a result of community reluctance. They closed their trip with a rally on Sunday, April 14, 2019 in the presence of the administrator of the territory during which they recalled the preventive measures to respect to stop the spread of the epidemic.
                        • In Lubero, the Territorial Youth Council has launched a youth engagement to end the Ebola outbreak at home. Council members have put in place measures to support the efforts of the response teams, particularly community-based surveillance and hygiene compliance in their communities.

                        Glimmer of hope in Katwa and Butembo
                        • A panic has blown over the Katwa and Butembo areas because of the accelerated spread of the epidemic in the community following targeted attacks against the two CTEs in the city. Rising insecurity and violence against the response teams had prevented them from carrying out essential interventions to break the chain of transmission and slow the spread of the epidemic in the community, especially contact tracing, vaccination and decontamination of households.
                        • However, Dr. Jean-Paul Mundama, president of the prevention committee in Butembo, is optimistic and notes with satisfaction the lifting of resistance in the most resistant homes of the city, such as Mutsanga and Wayene. Thus, the teams begin to discover the hidden patients in the community. If all public health interventions around confirmed cases and deaths are unhindered, the chain of transmission will be broken down, the number of cases will begin to decline and the epidemic can be controlled. Although the rapid increase in the number of confirmed cases in recent weeks may be worrying, the epidemic is actually concentrated in some well-defined health areas and there has been no geographical spread of the virus. The epidemic has just resumed in areas that had already been affected because of patient mobility. The main outbreaks of the epidemic remain concentrated in the health zones of Katwa, Vuhovi, Masereka and Mandima.




                        Vaccination
                        • Since the beginning of the vaccination on August 8, 2018, 101,589 people have been vaccinated , including 26,646 in Katwa, 22,179 in Beni, 12,447 in Butembo, 6,596 in Mabalako, 4,300 in Mandima, 3,080 in Kalunguta, 3,070 in Goma, 2,540 in Oicha, 2.507 to Komanda, 1.845 to Vuhovi, 1.729 to Masereka, 1.649 to Kyondo, 1.630 to Kayina, 1.487 to Bunia, 1.357 to Karisimbi, 1.193 to Lubero, 1.027 to Musienene, 1.025 to Biena, 772 to Mutwanga, 690 to Rutshuru, 557 in Rwampara (Ituri), 527 in Nyankunde, 496 in Mangurujipa, 420 in Mambasa, 355 in Tchomia, 333 in Lolwa, 342 in Kirotshe, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.
                        • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.



                        ...
                        https://us13.campaign-archive.com/?u...&id=00313a5e4f
                        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                        -Nelson Mandela

                        Comment


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

                          Thursday 18 April 2019


                          The epidemiological situation of the Ebola Virus Disease dated April 17, 2019 :
                          • Since the beginning of the epidemic, the cumulative number of cases is 1,302, of which 1,236 are confirmed and 66 are probable. In total, there were 843 deaths (777 confirmed and 66 probable) and 380 people healed.
                          • 325 suspected cases under investigation;
                          • 12 new confirmed cases, including 5 in Katwa, 3 in Mandima, 2 in Vuhovi, 1 in Kalunguta and 1 in Beni;
                          • 10 new deaths of confirmed cases, including
                            • 7 community deaths, including 3 in Mandima, 2 in Vuhovi, 1 in Katwa, and 1 in Kalunguta;
                            • 3 deaths at CTE, 2 in Butembo and 1 in Katwa;
                          • 1 new healed from the CTE of Komanda.

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



                          ...
                          https://us13.campaign-archive.com/?u...&id=89828c7c0f
                          "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

                            LUBERO Territory: death of an Ebola confirmed case in MAYIBA; an alarming risk of spreading the disease

                            Posted on: 18/04/2019 at 19h46min03s
                            By Radio Moto Butembo-Beni

                            A death of a confirmed Ebola case was reported, Wednesday, April 17, 2019, in MAYIBA, in the health zone of BIENA in Lubero territory. The state's delegated official in Njiapanda confirms this news communicated to him by medical sources.

                            Master MONGA MABANGA regrets that the Ebola response team did not have access to the body of the victim to secure his burial. Another concern is the non-decontamination of the health facility and home that the patient attended before his death. In view of this situation, Master MONGA MABANGA Julio fears a spread of the disease in health zone of BIENA.

                            "Well, we still had a probable case. At the moment I am talking to you, there has been a probable case in MAYIBA where there is someone who has fled Butembo. He was interned, 4 days later, he passed away. We wanted to secure the body, it did not hold. The body is brought back from MAYEBA to Fungula macho. You know, it's already in Bapere. There are still people who will touch the body ... ", he worries.

                            Posted on: 18/04/2019 at 19h46min03s
                            By Radio Moto Butembo-Beni


                            https://radiomotofm.info/lirearticle.php?billet=5722
                            "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

                              Attack at UCG / BUTEMBO university clinics: doctor killed and several other recorded damages

                              Posted on: 19/04/2019 at 15h48min19s
                              By Radio Moto Butembo-Beni

                              Diurnal attack of the Clinics of the Catholic University of Graben, UCG the day of this Holy Friday at 14h local time. The unidentified militiamen have just killed a foreign doctor, burned a health workers truck, burned the triage center and caused several other property damage. These clinics are located in Butembo in Malende district in Kimemi commune. They host an Ebola response team that triage cases of the disease. This attack comes after strangers signed an incursion on the night of Thursday, April 18 to Friday, April 19 to the community of priests of UCG Butembo.

                              https://radiomotofm.info/lirearticle.php?billet=5725
                              "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


                              • Tedros Adhanom Ghebreyesus

                                Verified account

                                @DrTedros
                                59m59 minutes ago

                                The @WHO family lost a dear colleague in the hospital attack in Butembo, #DRC, today.
                                My colleagues and I are grieving over the loss of this courageous colleague who was saving lives to end #Ebola.
                                We are outraged by the attack. Health workers are #NotATarget

                                Tedros Adhanom Ghebreyesus

                                Verified account

                                @DrTedros
                                3h3 hours ago
                                More
                                This is a very sad day. We just learned of one fatality, as well as some people injured, in the attack on hospital in Butembo, #DRC. Butembo is the epicenter of the ongoing #Ebola outbreak. Health workers are working around the clock to save lives. Health workers are #NotATarget.
                                "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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