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

Fighting Ebola When Mourners Fight the Responders
...
By Joseph GoldsteinPhotographs by Finbarr O?Reilly
May 19, 2019

...
Many of the symptoms of Ebola resemble those of more common maladies, such as malaria. At one quarantine facility in Beni, fewer than 2 percent of patients tested positive for Ebola, according to interviews with health officials and an epidemiological report provided by a medical organization.

Mistrust settled in, affecting even those who have seen Ebola up close.

?The way my wife died, it is not Ebola that killed her that day,? said H?ritier Bedico Zawadi, an engineer, one sleepless month after the death of his wife, Suzanne Kahindo Kitseghe, a 29-year-old doctor.

She had been exposed to the disease when a patient at her hospital wouldn?t stop bleeding, a classic Ebola symptom, after an IV line had been inserted, according to Dr. Michel Kalongo, an official in the local doctors union who knew Dr. Kahindo.

Dr. Kahindo had not been vaccinated, probably because she was pregnant and pregnant women were initially discouraged from receiving the vaccine. When she began to feel ill, she believed she had malaria and continued to see patients, even helping deliver a patient?s baby.
...
Dr. Kahindo was barely conscious on April 10 when colleagues sent her to an Ebola treatment center, where she died the next day. Her husband said that when other doctors expressed condolences, they often said, ?Your wife didn?t die of Ebola.?

Gazing up at the night sky, Mr. Zawadi said that even though his wife had tested positive for Ebola, he was having trouble making up his mind about what to believe. ?Emotionally, I?m broken.?
...
Full text:
https://www.nytimes.com/2019/05/19/world/africa/ebola-outbreak-congo.html
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Sunday 19 May 2019

The epidemiological situation of the Ebola Virus Disease dated May 18, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,816, of which 1,728 are confirmed and 88 are probable. In total, there were 1,209 deaths (1,121 confirmed and 88 probable) and 482 people healed.
  • 291 suspected cases under investigation;
  • 15 new confirmed cases, including 4 in Butembo, 4 in Mabalako, 2 in Katwa, 2 in Beni, 1 in Musienene, 1 in Kalunguta and 1 in Mandima;
  • 11 new deaths of confirmed cases, including
    • 6 community deaths, 2 in Butembo, 2 in Mabalako, 1 in Katwa and 1 in Beni;
    • 5 deaths at CTE, including 4 in Butembo and 1 in Mabalako;
  • 16 new healers came out of CTE, including 12 in Butembo and 4 in Katwa.
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Epidemiological surveillance
  • Investigations continue around the first confirmed patient in the Alimbongo Health Zone. According to the initial results, the patient was contaminated after participating in an unsecured burial of a family member who died in Katwa.
...
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=d03659c5ff
 
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Monday, May 20, 2019

The epidemiological situation of the Ebola Virus Disease dated 19 May 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,826, 1,738 confirmed and 88 probable. In total, there were 1,218 deaths (1,130 confirmed and 88 probable) and 484 people healed.
  • 245 suspected cases under investigation;
  • 10 new confirmed cases, including 3 in Mabalako, 3 in Kalunguta, 2 in Beni 1 in Katwa and 1 in Butembo;
  • 9 new deaths of confirmed cases, including
    • 4 community deaths, 2 in Kalunguta, 1 in Mabalako and 1 in Beni;
    • 5 deaths at CTE, including 3 in Butembo, 1 in Mabalako and 1 in Katwa;
  • 2 new healed from the CTE of Butembo.
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  • A vehicle of the riposte was slightly damaged and three policemen were slightly injured after a stone attack of a convoy of a dignified and secure burial team (EDS) occurred at the Kanzunza cemetery in Butembo town on Sunday. May 19, 2019. In recent times, people living near certain public cemeteries are hostile to the EDS teams that are burying those who died of Ebola. The urban authorities and the coordination of the response organized a meeting on this subject on Monday, May 20, 2019.
...
103 Contaminated health workers
The cumulative number of confirmed / probable cases among health workers is 103 (5.6% of all confirmed / probable cases), including 34 deaths.
One health worker in Mabalako, vaccinated less than 10 days ago, is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 103 (5.6% of all confirmed / probable cases), including 34 deaths.

...
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=d83d66306b

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Translation Google

DRC: Ebola fight hindered by lack of public trust

The fight against the Ebola epidemic, in the provinces of North Kivu and Ituri, faces the resistance of the population who remains uninformed about the dangerousness of the disease.

His Majesty Mfumu Difima is leading a large delegation of customary chiefs from different provinces of the Democratic Republic of the Congo. The leader of the DRC customary chiefs visiting Beni deplores that the current mistrust of the population is also the consequence of political manipulation.

Ebola and the elections

Indeed, after the postponement of the elections in the region of Beni and Butembo, the inhabitants accused the former power to have taken Ebola as an excuse to deprive them of their right to vote.

According to him, this suspicion had a first consequence: traditional healers, traditional doctors, had to take over patients who no longer wanted to go to Ebola treatment centers.

"To bring back the collaboration between the population, the leaders and the teams of the response and also, to make that this collaboration can lead the inhabitants to come declare themselves when they are sick, so that this disease is very quickly neutralized, like this was the case just a month or two ago when we actually did not have these kinds of problems, "says Mfumu Difima, emphasizing the role of traditional leaders in the fight against the disease.

The contribution of religious leaders

Already, the work of these customary chiefs is felt in the town of Butembo. They exchange with different social strata of the city today considered a center of resistance against medical teams.

Traditional chiefs were, for example, with Butembo youth gathered in the Urban Youth Council.

Mwami Chiefs spokesperson Viringa Mayani Ajani also wants to use traditional rites to fight Ebola, though he remains discreet:

"The custom has its secrets and its talents, we can not unveil what we are going to do customarily, but I guarantee you that we are working hard to eradicate the disease. once and for all."

The young people of Butembo seem in any case already to be more sensitive. They have just set up a commission to follow the recommendations made by the customary chiefs.

"We have traditionally known that traditional chiefs are the authorities that are more accepted, they enjoy a certain legitimacy of the population.At the end of the discussions there were recommendations that were given and that even to accompany these recommendations there we have instituted a commission to follow up on these recommendations, "said Edulphose Bwakanakazi, vice president of Butembo's Urban Youth Council.

Some observers believe that things are now going in the right direction in Butembo. A note of hope as the city was previously the symbol of resistance against Ebola.

To further improve the situation, some expatriates are being replaced by Congolese in the various strategic positions of the struggle. One more element to reduce the resistance in the population.

Date 20.05.2019

https://www.dw.com/fr/rdc-la-lutte-c...ion/a-48801466
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Tuesday, May 21, 2019

The epidemiological situation of the Ebola Virus Disease dated May 20, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,847, of which 1,759 are confirmed and 88 are probable. In total, there were 1,223 deaths (1,135 confirmed and 88 probable) and 487 people healed.
  • 292 suspected cases under investigation;
  • 21 new confirmed cases, including 5 in Beni, 5 in Kalunguta, 4 in Butembo, 4 in Musienene, 2 in Mabalako and 1 in Masereka:
  • 5 new deaths of confirmed cases, including
    • 3 community deaths, 2 in Butembo and 1 in Musienene;
    • 2 deaths at the CTE of Beni;
  • 3 new healed CTE patients, 2 in Butembo and 1 in Katwa;
  • One health worker in Masereka, vaccinated, is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 104 (5.6% of all confirmed / probable cases), including 34 deaths.
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/! \ 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.
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  • On the sidelines of the 72 [SUP]nd[/SUP] World Health Assembly (WHA) in Geneva, Dr. Oly Ilunga, Minister of Health, WHO Director General Dr. Tedros Adhanom Ghebreyesus, and Director of the WHO Regional Office in Africa (AFRO), Dr Matshidiso Moeti, reported on the evolution of the Ebola outbreak and regional preparedness activities at a meeting of AMS Committee A on Tuesday 21 May 2019.
  • All stakeholders recognized that the main barrier to ending this epidemic is the security context and violence against the response teams. The Minister of Health recalled that, from the point of view of public health, Ebola virus disease is not a particularly difficult disease to contain, especially since the country currently has a diagnostic, therapeutic medical arsenal and comprehensive preventive for the first time in the history of the virus. He recalled that to break the chain of transmission, it is enough to do a series of important activities around the confirmed cases, dead or alive, in particular the sensitization, the epidemiological investigations, the disinfection of the household, the vaccination and the follow-up of the contacts, and funerals worthy and secure. All these activities are available but teams are sometimes prevented from doing them because of insecurity or mistrust of the population. The Director of WHO emphasized that the Ebola epidemic in the DRC is still ongoing, not because the teams do not have the means or the skills but because they can not get regular access to the sick in the communities. If the security environment improves and access to communities is guaranteed, the response teams will be able to put an end to this epidemic. not because the teams do not have the means or the skills but because they can not get regular access to the sick in the communities. If the security environment improves and access to communities is guaranteed, the response teams will be able to put an end to this epidemic. not because the teams do not have the means or the skills but because they can not get regular access to the sick in the communities. If the security environment improves and access to communities is guaranteed, the response teams will be able to put an end to this epidemic.
  • While welcoming the work of the Congolese Government in containing the Ebola outbreak, the Director of WHO-AFRO presented the progress of regional preparedness in case the Ebola outbreak spreads outside the DRC. To date, no cases of Ebola have been detected in DRC's neighboring countries thanks to the efforts of the Government and partners, who have examined more than 50 million travelers at the various health checkpoints located east of the DRC. country. As part of the regional preparedness plan, the nine countries bordering the DRC now have an emergency plan, 16 Ebola treatment centers have been built in neighboring countries, 270 technical experts have been deployed to support the efforts of border countries,
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=426ac0da89
 
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Translation Google

Bafwasende: Calm has returned after the brisk morning tension.

May 21, 2019 Francois Okonda

Calm returned in mid-day Tuesday, May 21, 2019 after the sharp tension observed in the morning in the city of Bafwasende, located more than 260 kilometers from Kisangani on the RN4. The angry population protests against the presence of a non-governmental organization that came to vaccinate against the current Ebola outbreak in the sister and neighboring provinces of North Kivu and Ituri learned depechesdelatshopo from local sources. All the news was paralyzed.

For the inhabitants, there is no question of vaccinating in Bafwasende where there is still no case of Ebola.

And to express their disagreement, they were in the street and strapped the vehicle of said NGO.

The police quickly intervened to restore the order while proceeding to the interpellation of certain demonstrators.

The provisional record of the clashes shows six wounded and a damaged vehicle.

Reacting about this in social networks, an analyst who knows the area well writes:
"The capital of the Bafwasende territory has hosted a strong community Yira (Nande) of Butembo, active in trade and agriculture. It is possible that the activities of the response suffer the same fate, resistance, in Bafwasende as what happens in the cities of Beni and Butembo. As there is also intense commercial exchange between Butembo and Bafwasende, any suspect case not properly supported, can unfortunately infiltrate to Kisangani. A strong need for awareness is urgent in Bafwasende. "
Note that all our efforts to reach the administrator of the territory of Bafwasende have not succeeded.

Frok.
The dispatches of the tshopo

https://depechesdelatshopo.com/2019...me-est-revenu-apres-la-vive-tension-du-matin/
 
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, May 22, 2019

The epidemiological situation of the Ebola Virus Disease dated 21 May 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,866, of which 1,778 are confirmed and 88 are probable. In total, there were 1,241 deaths (1,153 confirmed and 88 probable) and 490 people healed.
  • 307 suspected cases under investigation;
  • 19 new confirmed cases, including 8 in Butembo, 5 in Katwa, 2 in Beni, 2 in Mabalako, 1 in Mandima and 1 in Kalunguta;
  • 18 new deaths of confirmed cases, including
    • 8 community deaths, including 4 in Butembo, 2 in Mabalako, 1 in Katwa and 1 in Kalunguta;
    • 10 deaths at CTE, including 5 in Mabalako, 2 in Butembo, 2 in Katwa and 1 in Beni;
  • 3 new healings from the CTE Mabalako.

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Ebola, already 105 health workers contaminated: "We absolutely must stop transmission in health facilities" [Myke Ryan / WHO]

Thursday, May 23, 2019 - 08:00

A health worker in Katwa (North Kivu), unvaccinated, is among the new confirmed cases of Ebola virus disease, the Ministry of Health reported on Wednesday (May 22nd). This brings to 105 the number of health workers affected at 98 (5.6% of all confirmed / probable cases) including 35 deaths.

"We must stop, absolutely stop transmission in health facilities. This is a disaster, it is a real tragedy to have transmissions in the very places where people go for care. It takes a big plan of action to speed up infection control at the health facility level, "Dr. Michael Ryan, Executive Director of the Program at the World Health Organization, told ACTUALITE.CD. ), specializing in the management of health emergencies.
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"We are in discussion with the Ministry of Health to extend the vaccination, to take a more aggressive approach with the vaccine. We must move the response, a very deep response in the community, not in Kinshasa, not in Goma, but in the community, " he added.

https://actualite.cd/2019/05/23/ebo...-doit-absolument-arreter-la-transmission-dans
 
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BENI: NZUKI SIKUMBILI at war against night buryers in Bashu Chiefdom

POSTED BY: RMBB WRITING 22/05/2019

NZUKI SIKUMBILI warns all those who will be guilty of clandestine nocturnal funerals of people in Bashu Chiefdom. In fact, this has been experienced since Ebola virus disease manifested its virulence in and around Butembo, especially in the Bashu chiefdom. Cluster leader Bunyuka issued a related alert on Monday, May 20, 2019 during the weekly parade held in Butungera, chiefdom of the Bashu chiefdom.

The concern of MUHINDO SIVIHWA chief of Bunyuka is that these kinds of burials expose the inhabitants to the Ebola virus disease.

To escape the vigilance of the authorities, families in mourning organize burial ceremonies at night. If the family members of the deceased must move to another area, they pack the body as a package. Conditions are sin against human dignity.

In response to this, the administrative secretary of the Bashu chieftainship condemns the practitioners of this rite. NZUKI SIKUMBILI warns all those who will be guilty of it again for another time.

"What is against the law and what is against our custom. And if I throw a warning against those people, if at least they can continue to do so, we'll get their hands on them. Not only because we are the agents of the state, but also because we are customary; because custom can not admit to treating the dead that way. So I warn this population there that will continue to bury the people who are nit, who will continue to transport the corpses in bags, "he said in a loud voice.

Facilitating the response team to perform a dignified and secure funeral can now prevent members or relatives of the deceased from Ebola. But it must be recognized that an EDS is a practice that deserves to be lifeless, sensitizes caregivers.

http://www.radiomoto.net/2019/05/22/...erie-de-bashu/

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LUBERO / Territory: targeted threats to nurses in the Musienene Health Zone

POSTED BY: RMBB WRITING 23/05/2019

Nurses in the Musienene Health Zone live under perpetual, accented and targeted threats these days. The perpetrators of these threats are arms carriers or not, who prohibit nurses in the area from getting involved in the fight against Ebola. Yet contributing to the response to this epidemic is imperative.

The denunciation was communicated to Radio Moto Butembo-Beni, this Thursday, May 23, 2019. This, after the nurses of the Health Zone of Musienene met Monday, May 20, 2019, to assess the conditions of their work. It is a situation which destabilizes the health activities of the nursing staff and limits the movement and the freedom in our services, returns Bavon VUSOKE, rapporteur of the meeting of Sunday.

Fearing loss of life and the displacement of health care workers and overflowing threats, Bavon VUSOKE communicates some recommendations from nurses in the Musienene Health Zone.

"We have chosen some possible solutions: that each health facility is organized in a communication system: always have telephone units and always buy Motorola; that the Ministry of Health of the Interior and Defense and Security collaborate locally to protect us and that the politico-administrative authorities get involved to eradicate this phenomenon, to do what is possible and not impossible, to organize the minimum services , only the day when the risk is probably lower; consider a dry strike, if no improvement; to persuade all employees of sincere interpersonal and interprofessional collaboration, "said Bavon VUSOKE.

As a reminder, the caregiver becomes more and more victim of several forms of threat. Several health facilities no longer operate in the territory of Beni and Lubero, or even in Butembo town as a result of the clandestine life chosen by doctors, nurses threatened or other stakeholders in the response. This, to the disadvantage of patients requiring care.

http://www.radiomoto.net/2019/05/23/...-de-musienene/
 
Source: https://www.who.int/csr/don/23-may-2019-ebola-drc/en/
[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
23 May 2019

Although this past week continues to bear witness to a steady rise in the number of Ebola virus disease (EVD) cases in the Democratic Republic of the Congo, the overall security situation has allowed for the resumption of most response activities. While no major insecurity incidents have occurred, outbreak response teams, local healthcare workers, and community members cooperating with response efforts, are increasingly subjected to threats made against them by armed groups present in hotspot areas such as Katwa and Butembo. These threats are often disseminated through leaflets or direct intimidation. Armed groups? presence, activities and increasing direct threats against response teams continue to be reported in other EVD affected areas, in particular Lubero, Masereka, Mabalako, Kalunguta, and Vuhovi, resulting in some healthcare workers being unwilling to don personal protective equipment or perform critical Infection Prevention Control (IPC) measures out of fear of violence being levied against them or the healthcare facilities where they operate.
During the past three weeks, reports indicate that transmission remains most intense in seven main hotspot areas: Beni, Butembo, Kalunguta, Katwa, Mabalako, Mandima, and Musienene. Collectively, these health zones account for the vast majority (93%) of the 349 cases reported in the last 21 days between 1 - 21 May 2019 (Figure 1 and Table 1). During this period, new cases were reported from 91 health areas within 15 of the 22 health zones affected to date (Figure 2).
As of 21 May, a total of 1866 confirmed and probable EVD cases have been reported, of which 1241 died (case fatality ratio 67%). Of the total cases with recorded sex and age, 56% (1051) were female and 30% (545) were children aged less than 18 years. The number of healthcare workers affected has risen to 105 (6% of total cases). 490 EVD patients who received care at ETCs have been successfully discharged.
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 21 May 2019*[/h]
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*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
[h=4]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 21 May 2019[/h]
figure_2_20190523.png



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[h=4]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 21 May 2019**[/h]
table_1_20190523.png



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**Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
[h=3]Public health response[/h] 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:
[h=3]WHO risk assessment[/h] WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Weekly increases in the number of new cases has been ongoing since late February 2019. A general deterioration of the security situation, and 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. However, recent community dialogue, outreach initiatives, and restoration of access to certain hotspot areas have resulted in some improvements in community acceptance of response activities and case investigation efforts. The high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to nosocomial infection, persistent delays in detection and isolation in ETCs, and challenges in the timely reporting and response to probable cases, are all factors increasing the likelihood of further chains of transmission in affected communities and increasing the risk of geographical spread both within the Democratic Republic of the Congo and to neighbouring countries. The high rates of population movement occurring from outbreak affected areas to other areas of the Democratic Republic of the Congo and across porous borders to neighbouring countries during periods of heightened insecurity further compounds these risks. Additional risks are posed by the long duration of the current outbreak, fatigue amongst response staff, and ongoing strain on limited resources. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have likely increased capacity to rapidly detect cases and mitigated local spread. However, these efforts must continue to be scaled-up at this time.
[h=3]WHO advice[/h] WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
For more information, please see:
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Thursday 23 May 2019

The epidemiological situation of the Ebola Virus Disease dated 22 May 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,877, of which 1,789 are confirmed and 88 are probable. In total, there were 1,248 deaths (1,160 confirmed and 88 probable) and 490 people healed.
  • 298 suspected cases under investigation;
  • 11 new confirmed cases, including 6 in Butembo, 1 in Katwa, 1 in Beni, 1 in Mabalako, 1 in Mandima and 1 in Kalunguta;
  • 7 new deaths of confirmed cases, including
    • 2 community deaths in Butembo;
    • 5 deaths at CTE, including 1 in Mabalako, 1 in Butembo and 3 in Beni.

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/! \ 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 varying (up or down) daily, 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.
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[TD="class: mcnTextContent"]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu as of 21 May 2019[/TD]
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[TD="class: mcnTextContent"]Epidemiological curve since January 2019[/TD]
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NEWS​
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  • This Thursday, May 23, 2019, the United Nations has taken a series of measures to strengthen their support for the response to Ebola in the Democratic Republic of Congo. In particular, by strengthening its political commitment and operational support, the United Nations wants to help improve the environment in which the response teams work to facilitate access to affected communities.
  • Click here to read the full press release.
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  • Nurses in the Musienene Health Zone have denounced the death threats and destruction of health facilities they have received in recent days because of their role in the Ebola response. The Musienene nurses held an extraordinary meeting on Thursday, May 23, 2019 to evaluate their working conditions. They asked the politico-administrative authorities to get involved in putting an end to this phenomenon of violence against health workers because, if the threats do not stop, they plan to go on a dry strike.
  • Because of this targeted violence, several doctors and nurses in the Beni and Lubero territories had to move or temporarily leave their homes, forcing some health facilities to close their doors. This is especially the case in the Kyondo Health Zone where activities have been suspended at the Kyakumba Reference Health Center since Tuesday, May 21, 2019, since the attending physician and the nursing staff left the feared zone for their safety. .
  • Between 1 [SUP]th [/SUP] August 2018 and 20 May 2019, 132 attacks against medical units were recorded as part of the Ebola outbreak, causing four deaths and 38 injuries among health workers and patients. As the Minister of Health, Dr. Oly Ilunga Kalenga, recalled at the 72 [SUP]nd[/SUP] World Health Assembly in Geneva, this violence against health workers must be condemned unreservedly and a clear distinction must be made between community involvement and targeted violence by armed militias. Linking the two is tantamount to stigmatizing the entire community of affected communities, portraying them as deeply violent communities, and blaming the health workers who are the first victims of this targeted violence.

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FIGURES OF THE RESPONSE​
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[TD="class: mcnTextContent, width: 546"] 122,695 Vaccinated
persons
  • 827 people vaccinated on 22/05/2019.
  • Of those vaccinated, 33,718 are high-risk contacts (CHR), 60,094 are contacts of contacts (CC), and 28,883 are first-line providers (PPL).
  • Persons vaccinated by health zone: 32,281 in Katwa, 24,944 in Beni, 15,549 in Butembo, 9,596 in Mabalako, 6,033 in Mandima, 4,379 in Kalunguta, 3,070 in Goma, 3,048 in Komanda, 2,569 in Oicha, 1,998 in Lubero, 1,985 in Masereka , 1,980 to Kayna, 1,935 to Vuhovi, 1,817 to Kyondo, 1,647 to Musienene, 1,587 to Karisimbi, 1,487 to Bunia, 1,040 to Biena, 1,012 to Mutwanga, 690 to Rutshuru, 557 to Rwampara (Ituri), 527 to Nyankunde, 496 to Mangurujipa, 494 to Alimbongo, 420 to Mambasa, 355 to Tchomia, 342 to Kirotshe, 333 to Lolwa, 250 to Mweso, 245 to Kibirizi, 161 to Nyiragongo, 97 to Watsa (Haut-U?l?) and 13 to 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.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=b22728e784
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Friday, May 24, 2019

The epidemiological situation of the Ebola Virus Disease dated 23 May 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,888, of which 1,800 are confirmed and 88 are probable. In total, there were 1,254 deaths (1,166 confirmed and 88 probable) and 492 people cured.
  • 343 suspected cases under investigation;
  • 11 new confirmed cases, including 3 in Mabalako, 3 in Katwa, 2 in Butembo, 2 in Mandima and 1 in Kalunguta;
  • 6 new deaths of confirmed cases, including:
    • 5 community deaths, 2 in Mandima, 1 in Butembo, 1 in Katwa and 1 in Kalunguta;
    • 1 death at Katwa CTE;
  • 2 new healings from the Katwa CTE.
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Doctors Without Borders

Ebola outbreak in DRC: Crisis Update May 2019

MAY 24, 2019
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It will not be possible to end this outbreak if there is no trust built between the Ebola response and the affected people. We have to listen to the needs of communities, restore their choice when it comes to managing their health, and involve them in every aspect of the Ebola response.
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MSF is extremely worried about the lack of visibility on the actual epidemiological situation as more than 80 percent of new confirmed cases have not been identified as contacts. Additionally, as few as 32 percent of the new confirmed cases were linked back to known contacts. This means that the listing of contacts and surveillance are not effective. Contact tracing is essential to control the evolution of the outbreak. This also mean that while the number of new cases being reported is high, the real number is likely to be even higher.

https://www.doctorswithoutborders.o...ews/ebola-outbreak-drc-crisis-update-may-2019
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Saturday, May 25, 2019

The Epidemiological Situation of Ebola Virus Disease on May 24, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1.903, of which 1.809 confirmed and 94 probable. In total, there were 1,270 deaths (1,176 confirmed and 94 probable) and 492 people healed.
  • 287 suspected cases under investigation;
  • 9 new confirmed cases, including 4 in Butembo, 4 in Mabalako and 1 in Vuhovi;
  • 6 new probable cases validated, 3 in Butembo, 2 in Katwa and 1 in Vuhovi;
  • 10 new deaths of confirmed cases, including
    • 3 community deaths, 2 in Mabalako and 1 in Butembo;
    • 7 deaths at CTE, 2 in Katwa, 2 in Mabalako, 2 in Butembo and 1 Beni.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ca4187ade1
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Sunday, May 26, 2019

The epidemiological situation of the Ebola Virus Disease dated 25 May 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,912, 1,818 confirmed and 94 probable. In total, there were 1,277 deaths (1,183 confirmed and 94 probable) and 496 people healed.
  • 277 suspected cases under investigation;
  • 9 new confirmed cases, including 6 in Mabalako, 1 in Beni, 1 in Kalunguta and 1 in Butembo;
  • 7 new deaths of confirmed cases, including
    • 3 community deaths, 2 in Mabalako and 1 in Beni;
    • 4 deaths at CTE, 2 in Katwa, 1 in Beni and 1 in Butembo;
  • 4 new cures from the CTE, including 2 in Katwa, 1 in Beni and 1 in Butembo.
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  • The triage of Vulamba health center, in the health zone of Butembo, was vandalized by strangers in the night of 25 to 26 May 2019.
  • On Saturday, May 25, 2019, part of the population of Vusahiro village, in the Mabalako health zone, rose up and attacked the local Ebola response team of village residents who were trained to carry out some response activities. A hygienist from the Infection Prevention and Control team died of his injuries when he was transferred to the Mabalako Reference General Hospital. The Vusahiro Health Center was ransacked and looted, and three houses in the village were burned.
...
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=7f0ff1c4e9
 
Source: https://www.businesslive.co.za/bd/w...l-another-ebola-health-worker-in-eastern-drc/

Villagers kill another Ebola health worker in eastern DRC
Efforts to tackle the latest outbreak of the deadly disease are subject to continued sabotage by both militia and locals
27 May 2019 - 16:26 Agency Staff

Kinshasa ? Villagers in eastern Democratic Republic of Congo (DRC) killed a health worker and looted an Ebola treatment centre, according to an official report seen Monday by AFP.

?Part of the population of Vusahiro village, in the health sector of Mabalako (North Kivu province), rose up and attacked the local team fighting back against Ebola,? said the daily health ministry bulletin dated Sunday. It said the incident happened on Saturday.

?A hygiene agent in the team for the prevention and control of infections died of his injuries during his transfer to the hospital,? health authorities said in the bulletin.

?The health centre in Vusahiro was trashed and looted and three village houses were burned down,? the bulletin added.

In a separate incident the triage centre at Valumba in the Butembo health sector was vandalised overnight on Saturday to Sunday, the report said...
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Monday, May 27, 2019

The epidemiological situation of the Ebola Virus Disease dated May 26, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,920, 1,826 confirmed and 94 probable. In total, there were 1,281 deaths (1,187 confirmed and 94 probable) and 500 people healed.
  • 252 suspected cases under investigation;
  • 8 new confirmed cases, including 3 in Butembo 2 in Mabalako, 1 in Katwa, 1 in Vuhovi and 1 in Mandima;
  • 4 new confirmed cases deaths, including
    • 1 community death in Mabalako;
    • 3 deaths at CTE, including 1 in Mabalako, 1 in Butembo and 1 in Beni;
  • 4 new cures from the CTE, including 2 in Katwa, 1 in Beni and 1 in Butembo.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=cc57ab9338
 
Translation Google

Beni-Ebola: the agents of the response demand the payment of 5 months of salary arrears in Mangina

BY ADMIN ON MAY 27, 2019 HEALTH, SOCIETY

Local and provincial agents engaged in the Ebola response on Monday, May 27, 2019, launched a strike in Mangina, an agglomeration located about 30 kilometers, west of Beni, North Kivu (eastern DR Congo) .

According to the Forces viviales locales, doctors and nurses require the payment of 5 months of salary arrears.

The disaffected paralyzed all the activities of the Ebola response in this part of North Kivu.

Mangina's civil society, through its vice-president Freddy Mbayahi, fears the soaring spread of the disease in the area.

For example, civil society is asking the National Ministry of Health and its partners, including the World Health Organization (WHO), to intervene as soon as possible before the worst happens.

Fabrice Ngima

https://afriqueinfomagazine.net/ben...nt-de-5-mois-darrieres-de-salaires-a-mangina/

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BUTEMBO: THE COMMUNITY AUTHORITY DENOUNCES THE BEHAVIOR OF THE POPULATION WHO HIDES NOW SICK IN HOMES

Posted: May 28, 2019 Written by Writer Rtvh Butembo

The burgomaster of the commune of Mususa expresses concern about the attitude still adopted by some inhabitants of his entity in the face of the Ebola virus disease.

While the disease continues to cause many casualties in the region, some residents are still resolving to hide the sick exposing more the entire community regret MBAYITOYA BOVIC.

This practice is observed in several cells of the district BWINONGO in the south of the commune of MUSUSA indicates the municipal authority.

Burgomaster MBAYTOYA BOVIC reminds his constituents that the Ebola virus disease remains a danger for all and requires the contribution of all for its eradication.

Editor

http://www.rtvh.info/index.php/671-...ion-qui-cache-desormais-des-malades-dans-les- houses
 
OPINION: Ebola patients are human beings not biosecurity threats

by Val?rie Gruhn | Medecins Sans Frontieres (MSF) - International

Tuesday, 28 May 2019 14:00 GMT
...
Val?rie Gruhn is a nurse who has worked for MSF in DRC, Iraq, and Kenya. She is based in Brooklyn, New York, where she is a registered nurse.

In February, I worked as a nurse with Doctors Without Borders/M?decins Sans Fronti?res (MSF) in Katwa, North Kivu ? a town in the Democratic Republic of Congo in the epicenter of the current Ebola outbreak ? until attacks on two of our treatment centers forced us to evacuate.
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Behind every Ebola ?case? were real people that were afraid?afraid to have their limited belongings burned to prevent the disease from spreading, afraid they wouldn?t be able to celebrate the lives of their loved ones when burying them, afraid they would be taken against their will into a treatment center.

We focused on only the ones who got infected and their families that we referred to as contacts. However, we missed everyone else who lived in fear of becoming the next case. We spoke of survivors as those who survived the disease, but not people who survived the violence of their past and the new hostility we created.

The messages diffused lacked hope and the response lacked humanity. We failed to act on their needs and suffering, and therefore, we failed to gain their trust. The heavy, strictly enforced intervention generated fear and resentment among the population. Hence, they fought what they considered to be a greater threat than Ebola: the international response.

It will not be possible to end this outbreak without building the trust of those affected. We have to listen to the needs of communities, see them as people, give them choices when it comes to managing their health, and involve them in every aspect of the Ebola response.
...

http://news.trust.org//item/20190528125144-caqn4/
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Tuesday, May 28, 2019

The epidemiological situation of the Ebola Virus Disease dated May 27, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,926, 1,832 confirmed and 94 probable. In total, there were 1,287 deaths (1,193 confirmed and 94 probable) and 503 people healed.
  • 383 suspected cases under investigation;
  • 6 new confirmed cases, including 2 in Katwa, 2 in Butembo and 2 Mabalako;
  • 6 new deaths of confirmed cases, including
    • 1 community death in Katwa;
    • 5 deaths at CTE, including 3 in Butembo and 2 in Mabalako;
  • 3 new healings from the CTE, 2 in Katwa and 1 in Butembo.
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/! \ 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. Thus, 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.
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[TD="class: mcnTextContent"]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu as of May 27, 2019[/TD]
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[TD="class: mcnTextContent"]Epidemiological curve since January 2019[/TD]
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[TD="class: mcnTextContent"] WEEKLY SUMMARY OF EPIDEMIOLOGICAL DATA

Week 21 (May 20-26, 2019)

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For the week from May 20 to May 26, 2019, we recorded:
  • 2,056 suspected cases investigated and tested in the laboratory
  • 88 new confirmed cases
    • The main outbreaks of the epidemic are Mabalako, Butembo and Katwa.
  • 6 new probable cases validated (the 3 probable cases of Masereka had been erroneously reported to Butembo)
  • 57 deaths of confirmed cases
    • Of the 57 deaths, 25 were community deaths, or 43.9%, and 32 occurred in an ETC.
  • 16 new healed people came out of ETCs

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Diplomatic visit to Butembo
  • Swedish Ambassador in the DRC Maria H?kansson and British Foreign Minister Harriett Baldwin visited Ebola response teams in Butembo on Monday, May 27, 2019. After the courtesy of the mayor of the city , the two hosts visited different sites of the Ebola response, starting with a vaccination site. They also visited the CTE and the CTE nursery in Butembo. After all these visits, the Swedish Ambassador and the British Foreign Minister visited the Auberge, where Butembo co-ordinates, where they discussed with the teams the situation of the epidemic, the challenges and constraints of the riposte. In addition, they had discussions with women leaders and representatives of religious denominations in Butembo,
Support for providers of the Mabalako sub-coordination
  • The Ministry of Health warmly thanks all the local providers who are the main architects of the Ebola response despite the many risks and difficulties they face. All agents involved in the response are entitled to receive their bonus in accordance with the scale in effect since the beginning of this response.
  • The Ministry of Health was informed of the decision of some health workers in Mabalako to go on strike on Monday, May 27, 2019. The strike ended on Tuesday, May 28, 2019. These agents are demanding alleged Ebola unpaid premiums between the months of August and December 2018 by the Health System Development Program (HSDP). Based on information collected from the Ministry of Health and the PDSS, there are no Ebola premium arrears for the year 2018.
  • However, the situation of these providers needs to be clarified. In fact, after analyzing the lists of strike providers sent to the national coordination by Mangina's sub-coordinator, it appears that they are providers working at the Ebola Treatment Center (ETC) in Mabalako. As a reminder, the management of the CTE Mabalako was entrusted successively to two international NGOs who have ensured the organization of services and payment of Ebola premiums from providers since the beginning of the response. In the future, it will be important to clarify the contract transfer procedure of providers when an agency or agency leaves a health zone to avoid misunderstandings.
  • It is important to note that the Ministry of Health has developed, with the support of the World Bank, a manual of simplified human resource management procedures related to the response to the EVD epidemic. The manual states that bonuses are not cumulative and any case of fraud, or attempted fraud, will now be followed by sanctions or even disciplinary measures. The manual also provides several types of control for the payment of premiums. Monitoring missions are carried out every month in the different sub-coordinations to check the lists of providers and the evidence of service rendered (attendance lists). The last mission dates from the beginning of May to validate the payment lists for the month of April 2019. However, during the various checks carried out since January 2019,
  • Discussions continue with Mabalako's sub-coordination to determine the merits of these claims. In order to avoid such situations in the future and to ensure greater transparency in the management of human resources, all the agents involved in the response will have to sign standard contracts which will be included in a single database for all organizations involved in the response to Ebola.
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106 Contaminated health workers

One health worker in Katwa, unvaccinated (refusal), is one of the new confirmed cases and one of the new deaths (community deaths).

The cumulative number of confirmed / probable cases among health workers is 106 (5.5% of all confirmed / probable cases), including 36 deaths.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ea916757bb
 
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