Democratic Republic of Congo - Ebola outbreak May 2017 - MOH, WHO - 8 cases (5 confirmed, 3 probable), 4 deaths reported - additional suspect cases un

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EBOLA VIRUS DISEASE
Democratic Republic of Congo

External Situation Report 5
Date of issue: 19 May 2017

1. Situation update

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners continue
to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond
to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province located in the northeast
of the country.

On 19 May 2017, three new EVD cases were reported, including one probable case in Ngayi and two suspected
cases in a new health area called Ngabatala. The suspected cases are being investigated and will
be classified accordingly. As of 19 May 2017, a total of 32 EVD cases [two confirmed, three probable and 27
suspected] have been reported. To date, four deaths have been reported, giving a case fatality rate of 13%.

The reported cases are from five health areas, namely Nambwa (11 cases and two deaths), Muma (three
cases and one death), Ngayi (14 cases and one death), Azande (two cases and no deaths), and Ngabatala
(two cases and no deaths). Most of the cases presented with fever, vomiting, bloody diarrhoea and other
bleeding symptoms and signs. The outbreak currently remains confined to Likati Health Zone. According to
available information at this stage, no healthcare workers have been affected.

Out of the five blood samples analysed at the national reference laboratory, Institut National de Recherche
Biom?dicale (INRB) in Kinshasa, two were confirmed Zaire ebolavirus. At least 416 close contacts have been
registered in Likati Health Zone and are being monitored.

This EVD outbreak in the Democratic Republic of Congo was notified to WHO by the Ministry of Health
(MOH) on 11 May 2017. The cluster of cases and deaths of previously unidentified illness have been reported
since late April 2017. Likati Health Zone shares borders with two provinces in the Democratic Republic of
the Congo and with the Central African Republic (Fig. 1). The affected areas are remote and hard to reach,
with limited communication and transport networks. The current outbreak is the eighth EVD outbreak in the
Democratic Republic of Congo since the disease was first discovered in 1976 in Yambuku (then Zaire).
...

Ebola Situation report: 19 May 2017

http://www.afro.who.int/en/ebola/ebola-situation-reports.html

 

[Pathfinder]

Translation Google

Coordination and resource mobilization meeting with WHO technical and financial partners to address the Ebola epidemic in Likati (Bas-U?l?, Northern DR Congo)

KINSHASA, May 20, 2017: While the Ministry of Public Health has finalized its plan to respond to the epidemic of the Ebola virus (MVE) in Likati, with a budget associated with this plan costed at 14.7 the WHO Representative in the DRC, Dr. Allarangar Yokouide, brought together technical and financial partners (TFPs) in the WHO conference room on Saturday, 20 May 2017, to discuss the The current response. He wished to present the budget proposed by the Ministry of Public Health to all the stakeholders in order to obtain the commitment of each one to support the efforts of the Government against the very deadly haemorrhagic virus. As of May 20, 2017, the epidemic has already reached a total of 34 suspected cases with 4 deaths (case fatality rate: 11.76%) in the Likati health zone (Bas-U?l? province, more or less 1400 kilometers north of the DRC).

On that occasion, Dr Allarangar indicated that the purpose of the meeting between technical and financial partners was to "organize ourselves in such a way that we complement each other in the current response and that the contribution of all stakeholders The most effective, coordinated and transparent possible in the face of this health emergency ". This is a first meeting between the PTF since the declaration of the epidemic of the Ebola virus by the Minister of Public Health, Dr. Oly Ilunga Kalenga on May 12, 2017.

"The urgent needs and challenges are enormous. Whether it is logistics for the deployment of personnel and equipment and inputs in the field, active search for suspected cases, monitoring of contacts in remote health areas and difficult access, An effective and transparent coordination of everything we do in response to this health emergency is more necessary than ever in such circumstances, "he added.

He invited the partners to become more involved in the various committees set up by the National Coordinating Committee (CNC) led by the MSP, "so that our proposals are both constructive and taken into account".

"It is very crucial that this response plan be as coherent as possible, in a spirit of shared responsibility, with precise details such as who does what, in which health area, with what means and budget, That each partner can define his intervention so as not to duplicate efforts on the ground, "insisted Mr Daniel Carter, DFID Health Advisor in the DRC.

In the wake of this, several proposals were formulated by the partners. For example, UNICEF is willing to provide motorcycles in its warehouse in Goma, North Kivu, to boost the mobility of social mobilizers working in communication for development and community involvement, but also teams that Actively search for suspected cases and follow-up contacts.

The United Nations Stabilization Mission of the Congo (MONUSCO), WFP (UNHAS), the European Union (EU) are also available and are ready to strengthen logistics in terms of airlift with aircraft to link Health and facilitate the various rotations of personnel and materials. "ECHOFlight's three planes can not provide medical evacuation, but Civil Protection can activate the emergency device to reinforce the transport of teams and medical kits on the ground," said Mr Thomas Dehermann-Roy, Head of Office, ECHO in the DRC. "The United States is also willing to provide the logistics necessary for aviation in the area, to open up the affected localities, but a better mapping of the runways and their capacity to accommodate the type of aircraft adapted to this kind of health crisis, 'Said Raimi Ewetola, country director of CDC in the DRC.

Speaking in turn, Viviane Nzeusseu of the International Federation of Red Cross and Red Crescent Societies (IFRC) offered his organization's commitment to work closely with the DRC Red Cross, In particular on the aspects of awareness and safe burials in the event of the death of Ebola patients; While the African Development Bank (AfDB) will, if necessary, provide financial support for some health interventions that remain to be clarified during this epidemic.
...
http://www.afro.who.int/fr/republiq...r-faire-face-a-lepidemie-debola-a-likati.html

 

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Translation Google

Ebola: fears about a possible extension of the epidemic in Wapinda

Posted on Sun, 21/05/2017 - 10:41 | Modified on Sun, 21/05/2017 - 10:41
Ebola Wapinda DRC Health News National

The Ubangi Provincial Health Division announced on Saturday (May 20th) to have strengthened epidemiological surveillance at the Wapinda Health Zone, located 2km from the Likati Health Zone in Bas-U?l? where the Ebola epidemic has been declared.

The proximity and migration flow between the two provinces raises fears of a possible extension of the epidemic, says Dr Davos Davene, head of the North-Ubangi health division.

"The three health areas that make up the epicenter of the disease are located within two kilometers of Wapinda health. The cost of health care in this North-Ubangi health center is reduced, because we are receiving funding from the FIS. This makes us fear a massive influx of people from the epidemic home to the Wapinda health zone, "says Dr. Davos Davene.

He noted that at the provincial level, a contingency plan has been finalized to prevent this disease.

The epidemic of the Ebola virus was officially declared on May 11, 2017, after confirmation by the National Institute for Biomedical Research (INRB) of the results of analysis of blood samples taken from suspect cases. This is the eighth episode of the Ebola virus in the DRC.

http://www.radiookapi.net/2017/05/2...une-eventuelle-extension-de-lepidemie-wapinda

 

[Gert van der Hoek]

Fourth person in probable Ebola death in Congo: WHO


MAY 21, 2017

A fourth person has likely died from Ebola in remote northeastern Democratic Republic of Congo, the World Health Organization said on Sunday, as the overall number of cases rose to 37 from 29.

Of the 37 cases of hemorrhagic fever discovered since early May, two have been confirmed as Ebola, three, including the latest death, are considered probable and 32 are suspected, WHO's Congo spokesman Eugene Kabambi told Reuters.

Health authorities are monitoring 416 people who came into contact with sufferers and have dispatched mobile laboratories to the zone to more quickly test people who display symptoms, Kabambi said.

READ MORE

 

[Gert van der Hoek]

Ebola Situation report: 21 May 2017

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province located in the northeast of the country.

On 20 May 2017, three suspected EVD cases and one death were reported from Muma and Ngay health areas in Likati Health Zone. The suspected cases are being investigated and will be classified accordingly. As of 20 May 2017, a total of 37 suspected EVD cases and four deaths been reported, giving a case fatality rate of 11%.

The reported cases are from five health areas, namely Nambwa (12 cases and three deaths), Muma (four cases and no deaths), Ngayi (16 cases and one death), Azande (three cases and no deaths), and Ngabatala (two cases and no deaths). No healthcare workers have been affected to date. The majority of the cases presented with fever, vomiting, bloody diarrhoea and other bleeding symptoms and signs.

The outbreak currently remains confined to Likati Health Zone.

The Institut National de Recherche Biom?dicale (INRB) mobile laboratory in Likati has begun processing samples with 22 samples testing negative by PCR.

To date of the five blood samples analysed at the national reference laboratory in Kinshasa two were confirmed as Zaire ebolavirus.

As of 20 May 362 contacts remain under daily follow up for signs and symptoms of Ebola.

All seven response committees are now established and functional at national level, namely Monitoring, Case management, WASH and biosafety, Laboratory and research, Pyscho-social management, Logistics and Communication. Additionally response teams have been established in the three most affected areas, Nambwa, Muma and Ngay.

This EVD outbreak in the Democratic Republic of Congo was notified to WHO by the Ministry of Health (MoH) on 11 May 2017. The cluster of cases and deaths of previously unidentified illness have been reported since late April 2017. Likati Health Zone shares borders with two provinces in the Democratic Republic of the Congo and with the Central African Republic (Figure 1). The affected areas are remote and hard to reach, with limited communication and transport networks.


LINK TO FULL REPORT, INCL. MAPS

 

[alert]

The fact that we have 22 negative results, compared to only 2 positive ones, combined with the fact that the CFR of this outbreak appears to be only 11% (with not that many cases still actively ill) suggests to me that something else besides Ebola is causing a lot of the suspected cases.

There were previous reports of cholera in the area in one of the above posts.

 

[Gert van der Hoek]

Ebola Situation report: 22 May 2017


22 May 2017

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province located in the northeast of the country.

On 21 May 2017, six suspected EVD cases were reported from Nambwa health area in Likati Health Zone. As of 21 May a total of two confirmed cases have been reported, three probable cases and 38 suspected cases.

The Institut National de Recherche Biom?dicale (INRB) mobile laboratory in Likati has begun processing samples with 33 samples initially testing negative by PCR. Confirmatory testing is under way and results are expected tomorrow.

To date of the five blood samples analysed at the national reference laboratory in Kinshasa two were confirmed as Zaire ebolavirus.

The reported cases are from five health areas, namely Nambwa (24 cases* and three deaths), Muma (four cases and no deaths), Ngayi (10 cases* and one death), Azande (three cases and no deaths), and Ngabatala (two cases and no deaths). No healthcare workers have been affected to date.

The majority of the cases presented with fever, vomiting, bloody diarrhoea and other bleeding symptoms and signs. The outbreak currently remains confined to Likati Health Zone. On 21 May, three additional contacts were identified, therefore 365 contacts remain under daily follow up for signs and symptoms of Ebola.

All seven response committees are now established and functional at national level, namely Monitoring, Case management, WASH and biosafety, Laboratory and research, Pyscho-social management, Logistics and Communication. Additionally response teams have been established in the three most affected areas, Nambwa, Muma and Ngay.

LINK TO FULL REPORT, INCL. MAPS

 

[alert]

Having viewed that entire report, I'm trying to figure out who the second confirmed case is. It's not either of the contacts of the first case who died, nor the fourth death, as those are the three probable cases. (The fourth death also doesn't appear to be a contact of the first three cases.) It's also not any patient who is still ill, because all five patients in an ETU are classified as suspected.

​It seems to be either another contact of the index case that hasn't been explicitly mentioned, or a contact of one of his two probable case contacts. Either way, that patient has already recovered.

​The date of isolation of the latest confirmed case is given as May 11. And 33 of the 38 suspect cases have already tested negative.

 

[Pathfinder]

Congo's Ebola outbreak threatens CAR after violence forces thousands across border

Thu May 25, 2017 11:22am GMT Print | Single Page [-] Text [+]
By Kieran Guilbert

DAKAR, May 25 (Thomson Reuters Foundation) - An Ebola outbreak in the Democratic Republic of Congo could spread to the neighbouring Central African Republic, where militia violence has forced thousands of people to flee across the border, the World Health Organization said on Thursday.

Two cases of the virus have been confirmed by the WHO in Congo's remote northeastern Bas-Uele province since early May. Four people have died so far among the 43 suspected and confirmed cases.
...
Yet recent attacks by Christian militias in Central African Republic's border town of Bangassou have driven about 2,750 people into Bas-Uele, raising the risk that the Ebola outbreak could spread across the border, a WHO representative said.

"There is a big concern about Ebola spreading to Central African Republic after this displacement," said Michel Yao, the WHO's representative in the Central African Republic.
...
http://af.reuters.com/article/commoditiesNews/idAFL8N1IQ63I

 

[Pathfinder]

EBOLA VIRUS DISEASE
Democratic Republic of Congo
External Situation Report 14
Date of information: 27 May 2017

1. Situation update

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners continue
to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond
to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of
the country.

On 27 May 2017, no new confirmed or probable EVD cases were reported and six new suspected cases
were reported, all originating from Likati Health Zone. On 27 May thirty cases previously reported as suspected
cases have now been re-classified as ?not a case? following laboratory analysis. The last confirmed
case was reported on 11 May 2017. Following further investigation, one previously reported suspect case has
been reclassified as probable by the field epidemiology team in Likati, based on the current case definitions.
Currently there are a total of two confirmed cases, four probable and 16 suspected cases. The confirmed
and probable cases were reported from Nambwa (one confirmed and three probable) and Muma (one confirmed
and one probable). The suspected cases have been reported from seven health areas (Nambwa,
Muma, Ngayi, Azande, Ngabatala, Mobenge and Mabongo). The outbreak currently remains confined to
Likati Health Zone. As of 27 May, 357 contacts are being followed up for signs and symptoms of Ebola.
Based on limited available data on confirmed and probable cases, modelling suggests the risk of further cases
is low, and decreases with each day without new confirmed/probable cases. As of the reporting date, 76%
of simulated scenarios predict no further cases in the next 30 days.
...

Ebola Situation report: 28 May 2017

http://www.afro.who.int/en/ebola/ebola-situation-reports.html

 

[tetano]

[h=1]Congo approves use of Ebola vaccination to fight outbreak[/h] Democratic Republic of Congo's health ministry has approved the use of a new Ebola vaccine to counter an outbreak in its northeast that has killed four people, a spokesman said on Monday.
"The non-objection was given. Now there's a Medecins Sans Frontieres team that is arriving (in Congo) today to validate the protocol with the technical teams," Jonathan Simba, a health ministry spokesman, said by telephone.
The vaccine, known as rVSV-ZEBOV and developed by Merck, is not yet licensed but was shown to be highly protective against Ebola in clinical trials published last December. [nL5N1EG4IP]

https://uk.reuters.com/article/us-health-ebola-congo-idUKKBN18P0WN

 

[alert]

Having viewed that entire report, I'm trying to figure out who the second confirmed case is. It's not either of the contacts of the first case who died, nor the fourth death, as those are the three probable cases. (The fourth death also doesn't appear to be a contact of the first three cases.) It's also not any patient who is still ill, because all five patients in an ETU are classified as suspected.

​It seems to be either another contact of the index case that hasn't been explicitly mentioned, or a contact of one of his two probable case contacts. Either way, that patient has already recovered.

​The date of isolation of the latest confirmed case is given as May 11. And 33 of the 38 suspect cases have already tested negative.

​An above post indicates that at least 30 of the suspect cases have now been discarded. As any epidemiological links to confirmed/probable cases or any fatal outcome results in a probable case, it seems reasonable to assume all the suspect cases will be discarded (since they have all recovered and none have any link to a probable case). Where does that leave us now?

​The index case is a confirmed death. The two people who transported him are probable deaths. The second confirmed case (who we don't know who it is) has recovered. The fourth death is a probable case. And there is a fourth probable case that is still alive (and might be ill or might have recovered) but must have some link to one of the first four cases.

​So that makes 6 cases, 4 deaths, for a CFR of 67%. Not the 10-13% originally reported.

​As the last isolation date of a confirmed case is May 11, most of the contacts will be released from observation within the next couple days.

 

[Pathfinder]

EBOLA VIRUS DISEASE
Democratic Republic of the Congo
External Situation Report 16
Date of information: 29 May 2017

1. Situation update

WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue
to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond
to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of
the country.

On 29 May 2017, no new confirmed, probable or suspected EVD cases were reported. The last confirmed
case was reported on 11 May 2017. Currently there are a total of two confirmed cases, three probable and
14 suspected cases. The confirmed and probable cases were reported from Nambwa (two confirmed and
two probable) and Ngayi (one probable). The suspected cases are reported from four health areas (Nambwa,
Muma, Ngayi and Ngabatala). The outbreak currently remains confined to Likati Health Zone. As of 29 May,
101 contacts remain under follow up for signs and symptoms of Ebola.

The previously undertaken modelling to determine the risk of further cases was updated with newly available
onset dates for the five confirmed / probable cases. Results suggest the risk of further cases is currently low
but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting
date, 72% of simulated scenarios predict no further cases in the next 30 days.
...
As of 29 May, 6 of the 14 suspected cases have tested PCR-negative for EVD and are awaiting serology testing for further analysis.
...

Ebola Situation report: 30 May 2017

http://www.afro.who.int/en/ebola/ebola-situation-reports.html

 

[alert]

The exclusion of the surviving probable case above (reducing the number of probable cases from 4 to 3) raises the apparent CFR of this outbreak to 80%.

​Update: CIDRAP is reporting that there are now only 3 deaths in this outbreak: http://www.cidrap.umn.edu/news-perspective/2017/05/drc-approves-use-ebola-vaccine

​which would imply the excluded probable case is the unlinked fatality, which if true, would make the CFR 60% (3 deaths in 5 cases).

 

[alert]

Two additional retrospectively confirmed cases:

Published Date: 2017-06-03 08:58:32
Subject: PRO / EN> Ebola disease, controlled epidemic - DR Congo (04): (Northeast)
Archive Number: 20170603.5080845
EBOLA VIRUS DISEASE, CONTROLLED EPIDEMIC - DEMOCRATIC REPUBLIC OF CONGO (04): (NORTHEAST)
************************************************** **************************************************
A communication from ProMED-mail
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Fri 2 June 2017
Source: VOA Africa via AFP [edited]
https://www.voaafrique.com/a/kinshasa-annonce-la-maitrise-de-l-epidemie-d-ebola/3884276.html


Kinshasa announces the control of the Ebola epidemic
--------------------------
The Congolese authorities announced that they had controlled the spread of the Ebola haemorrhagic fever epidemic 3 weeks after its declaration in a landlocked area in the north-eastern Democratic Republic of the Congo.
After 21 days, "we can say that the spread of the epidemic has been controlled," Congolese health minister Oly Ilunga told reporters.
Since [April 21, 2017], "we count 7 cases of which 3 are probable [and] 4 confirmed in the laboratory. Of these cases, 4 died," he said.
According to Ilunga, "no healthcare professional has developed the disease", "no contact of deceased patients has developed a viral haemorrhagic fever" and "all tests performed on suspect cases are negative to date" .
The haemorrhagic fever caused by this virus is highly contagious and the duration of incubation of the Ebola virus is 21 days.
During the month of May, the Congolese government had authorized vaccine tests against the Ebola virus in the country. "But for various reasons, including logistics, vaccines have not yet arrived in the DRC to this day," said Minister Ilunga.
The epidemic that affects the DRC is the 8th epidemic of Ebola since the discovery of this virus on its soil in [1976]. The disease was detected in an isolated area of ​​Bas-U?l?, about 1300 km northeast of Kinshasa.
This new epidemic is the first outbreak in Ebola since the terrible epidemic that struck West Africa between the end of [2013 and 2016], causing more than 11,300 deaths in some 29,000 cases, more than 99 In Guinea, Liberia and Sierra Leone.

-
Press Release:
ProMED-mail
<Promed-fra@promedmail.org>

[The occurrence of the EVD in northeastern DRC has caused a lot of ink. This resurgence has caused concern not only to the national community, but also and especially to the international community. There are still epidemics of the disease in West Africa. The situation on the ground has evolved from an epidemic declared to a controlled epidemic to a continuous epidemic and a risk of spreading the epidemic. But at the moment, there is a real mastery of the epidemic. This is hardly surprising, as the country has extensive experience in the fight against Ebola epidemics. This epidemic is the 8th episode that the country has experienced. The technical and financial partners also mobilized to lend strong hands to the local skills. It is recalled that the epidemic of the EVD in Guinea was slow in responding; According to a number of observers, has been the main cause of the spread of the disease beyond Ground Zero (the starting point of the epidemic).

 

[alert]

http://apps.who.int/iris/bitstream/10665/255630/1/EbolaDRC-06062017.pdf

​[snip]

WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health (MoH) in the Democratic Republic of the Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of the country.

On 05 June 2017, one case has been retrospectively confirmed as positive for EVD by serology with a date of onset of 29 April 2017. This case was previously reported as a suspected case and is part of the known transmission chain. The contacts for this individual have already been followed up and graduated from the contact follow up period. The date of the last confirmed case reported remains as 11 May 2017.
One new suspected case has been reported as of 5 June 2017 in the Ngayi health area, with 15 associated contacts being followed up daily, a sample has been taken to test for EVD. Therefore there are currently a total of five confirmed, three probable and one suspected case. Of these, four survived and four died, resulting in a case fatality rate of 50%.
The confirmed and probable cases were reported from Nambwa (four confirmed and two probable), Ngayi (one probable) and Mabongo (one confirmed). The outbreak remains confined to Likati Health Zone. Modelling suggests the risk of further cases is currently low but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting date, 76% of simulated scenarios predict no further cases in the next 30 days

 

[Pathfinder]

Translation Google


DRC: The end of the Ebola epidemic in Likati

Posted on Sat, 01/07/2017 - 12:07 | Modified on Sat, 01/07/2017 - 13:01

Health Minister Oly Ilunga Kalenga announced on Saturday (July 1) the end of the epidemic of Ebola haemorrhagic fever that has affected the Likati (Bas-Uele) health zone since May 2017.

In its press release, Oly Ilunga Kalenga assured that this decision has complied with health regulations for the surveillance of Hemorrhagic Fever Viruses (FHV).

Since 2 June 2017, no other new confirmed cases of Ebola haemorrhagic fever have been recorded in the Bas-Uele province. And a period of 42 days without any new cases was observed before the declaration of the end of this epidemic, explained to the press the Minister of Health.

He attributes the end of this epidemic to the response activities that the Ministry of Health services have carried out with the support of some partners including WHO, UNICEF, USAID, WFP and MONUSCO.

All the national and provincial professionals deployed in the endemic zone to fight this disease are doing well, welcomed the minister who also praised their courage to serve the nation.

Balance sheet

According to the minister, the epidemic of Ebola haemorrhagic fever that occurred on 11 May 2017 in Likati resulted in the death of 4 of the 5 confirmed cases.

The 583 people who have been in contact with suspected cases have been tested negative, the minister said in his statement.

He has pleaded for the improvement and stabilization of the health system of the Bas-Uele province "highly destabilized", stressing that "without strengthening the health system, no effective epidemiological surveillance is possible".


http://www.radiookapi.net/2017/07/01/actualite/sante/rdc-la-fin-de-lepidemie-debola-declaree-likati