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

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[TD="class: mcnTextContent"]DIRECTORATE GENERAL FOR DISEASE CONTROL[/TD]
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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, October 3, 2018

The epidemiological situation of the Ebola Virus Disease dated October 2, 2018 :

• A total of 162 cases of haemorrhagic fever have been reported in the region, 130 confirmed and 32 probable.
• Of the 130 confirmed, 74 died and 46 are cured .
• 17 suspected cases are under investigation.
• 1 new case confirmed in Beni.
• 1 new person healed in Beni.
• No new deaths.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Epidemiological surveillance

• Komanda's confirmed case was finally transferred to Beni's Ebola Treatment Center (ETC) for better management. His wife and child were vaccinated and isolated in the same CTE.

Vaccination

• The two vaccination belts in Bunia have been closed. Vaccination continues in 6 belts distributed in the Beni, Tchomia, Komanda, and Mabalako health zones.
• Since the start of vaccination on August 8, 2018, 13,750 people have been vaccinated , including 4,375 in Beni, 4,254 in Mabalako, 1,632 in Mandima, 1,283 in Katwa, 944 in Butembo, 307 in Bunia, 307 in Tchomia, 270 in Masereka, 192 in Komanda, 121 in Oicha and 65 in Kinshasa (medical staff to deploy).
• The Governor of North Kivu Province, Julien Paluku, has just joined the long list of local and provincial leaders who have agreed to be vaccinated against Ebola to raise awareness. Nine provincial deputies from North Kivu were also vaccinated in Butembo on Wednesday, October 3, 2018. The local press was invited which allowed them to widely disseminate the messages of awareness.
• The Ebola vaccine remains the most effective way to preventively protect people at risk. Unfortunately, because of rumors and misinformation, some people at risk continue to be suspicious of the vaccine. Thus, the involvement of local leaders who lead by example is important to deconstruct preconceptions.
• The effectiveness of the vaccine is optimal when administered within the first 48 hours after exposure to a confirmed case. If the vaccine is administered late and the person is already at an advanced stage of the 21-day incubation period, the risk of developing the disease, even after vaccination, is still present. Hence the importance for people at risk of getting vaccinated early and respecting the days of follow-up by vaccination teams.

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Vaccination of the Governor of North Kivu Province, Julien Paluku​

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Butembo: The governor of North Kivu is vaccinated for the example against the Ebola virus

By Editors - October 4, 2018
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By Augustin Mosange, one of our correspondents in North Kivu

On the occasion of his visit yesterday, Wednesday, October 3 in Butembo, the governor of North Kivu Julien Paluku took the opportunity to be vaccinated against the Ebola virus raging in parts of his province. Vaccination took place at the Makasi Health Center in Kimemi Commune.

Julien Paluku intended to set an example and encourage the population of Butembo to do the same to fight against the spread of the Ebola virus in parts of the province of North Kivu.

It must be said that in Butembo, commercial city of more than one million inhabitants of the east of the DRC, the population is mainly skeptical of the vaccination recommended by the health authorities. It is sometimes even hostile to Ebola response teams.

Last Tuesday, two Red Cross agents who wanted to bury a deceased victim of the Ebola virus were sequestered by a group of young people whose identity remains unknown. The incident took place in the Furu district, located in the north of the city, deemed very hostile to the Ebola response teams.

106 victims of the Ebola virus in North Kivu, including five in Butembo, since 1 August

"I would like to reassure the public that the vaccine we are being given is used to prevent the spread of this disease so that we can escape it. So I would like to break that rumor that there would be vaccines for one class of people and another vaccine for the population that would be sentenced to death. These are false rumors distilled in the opinion that jeopardizes the health of the population, "said yesterday Julien Paluku after being vaccinated.

Still, for many people in Butembo, the Ebola response is more of a "business" than a health response. "If it's really business, then come and get vaccinated anyway," he told the crowd, warning him to be wary of those who would dissuade them from getting vaccinated or even instructions from the health authorities.

A reference to the comments made in particular by the national deputy (UNC) of Beni, Crispin Mbindule, who said in the local media last August, that the Ebola virus was created in laboratories and moved from the province of Ecuador in the north-west of the country (where the virus was declared at the beginning of the year) to North Kivu in order to exterminate the population.

Not sure, however, that the Governor's warnings are enough to reassure the population, very worried about the risk of spreading the virus. Since 1 August, the Ebola virus has killed 106 people in North Kivu, including five in the city of Butembo alone.

As a reminder, the effectiveness of the Ebola vaccine is optimal when it is administered within the first 48 hours after exposure to a confirmed case. If the vaccine is given later, knowing that the incubation period is 21 days, the risk of developing the disease, even once vaccinated, is still present.

https://congolibere.com/butembo-le-...vacciner-pour-lexemple-contre-le-virus-ebola/

 

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WORLD NEWSOCTOBER 3, 2018 / 12:46 PM / UPDATED 8 HOURS AGO

Attack on Congolese Red Cross Ebola ambulance wounds three volunteers
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Serge Thierry, a regional ICRC representative, told Reuters that three local Red Cross volunteers were wounded, two seriously, in the attack by angry residents.

?Security measures were taken immediately. Burials are suspended until further notice,? he said by telephone, referring to ICRC activity in and around Butembo city in Beni region.
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https://www.reuters.com/article/us-...n-congo-wounds-three-volunteers-idUSKCN1MD2DC

 

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Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news
4 October 2018

The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. WHO faces a precarious situation given recent increases in insecurity, incidents of community mistrust, and increased geographical spread.
The period of mourning and general strike (ville morte) in Beni, Butembo and Mabalako has officially ended; the ville morte was organized by civil society leaders following an attack in Beni on 22 September, in which 21 people were killed. Activities that had slowed during the ville morte period included health workers being unable to reach and monitor the health of Ebola patient contacts, social mobilization and community engagement efforts significantly slowed or suspended, risk communications seriously constrained or suspended in areas highly impacted by EVD, and severe limitations on field teams’ ability to investigate alerts of suspected cases and carry out safe and dignified burials. WHO operations are currently back to full scale; however, WHO remains vigilant given ongoing security constraints.
The Ministry of Health (MoH), WHO and partners continue to work closely with people in the affected areas. Most communities support the response efforts and are open to vaccination and treatment; collaboration between communities and local authorities is ongoing to overcome the reluctance and mistrust which has developed in some places. Faced with rumours and misinformation, some families have chosen to care for sick relatives at home, increasing the risk of transmission to caregivers, family and children. Some patients have also left health facilities to seek alternative care, or actively avoid follow-up from health workers. Despite concerted efforts by local community leaders to ensure safe and dignified burials, in some cases these are rejected in favour of traditional practices. Avoiding contact with health workers, home care and unsafe burials all increase the risk to patients themselves, caregivers, children and other family members, and to health/frontline workers, and have contributed to the spread of the outbreak.
The affected areas now cover hundreds of kilometres, including a confirmed case who has moved into a ‘red zone’ - a highly insecure and challenging environment where implementing response activities is extremely difficult. The geographic expansion further strains frontline resources, as an effective Ebola response requires hubs established in multiple locations, as close as possible to the affected population.
Where they have access, response teams continue to enhance activities to prevent new clusters and the potential spread to new areas. WHO continues to work in the affected areas, side-by-side with national and international partners, to support the response led by the MoH. The outbreak’s spread into new, insecure areas in Tchomia Health Zone (with close proximity to the Ugandan border), as well as ongoing security concerns, continues to challenge the overall response. In light of these conditions, WHO revised its risk assessment and elevated the national and regional levels from ‘high risk’ to ‘very high risk’; globally, the risk remains low.
Since the last Disease Outbreak News (data as of 2 October), ten (10) new confirmed EVD cases were reported: eight from Beni and one from Butembo Health Zones in North Kivu, and one from Komanda Health Zone in Ituri. Eight of these confirmed cases have been linked to known cases or transmission chains within the respective communities, while the two other cases remain under investigation.
As of 2 October 2018, a total of 162 EVD cases (130 confirmed and 32 probable), including 106 deaths (74 confirmed and 32 probable) , have been reported in seven health zones in North Kivu Province (Beni, Butembo, Kalunguta, Mabalako, Masereka, Musienene and Oicha), and three health zones in Ituri Province (Mandima, Komanda and Tchomia) (Figure 1). An overall slightly decreasing trend in weekly case incidence continues (Figure 2); however, these trends must be interpreted with caution given the expected delays in case reporting, the ongoing detection of sporadic cases, and security concerns which limit contact tracing and investigation of alerts. Of the 155 confirmed and probable cases for whom age and sex information is known, 22%, 19% and 23% are aged 15-24, 25-34 and 35-44 years, respectively; females (55%) accounted for the greatest proportion of cases (Figure 3). Cumulatively, 19 (18 confirmed and one probable) health workers have been affected to date, three of whom have died.
The MoH, WHO and partners continue to closely monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries. As of 2 October, 11 suspected cases in the Democratic Republic of the Congo are awaiting laboratory testing. Since the last Disease Outbreak News report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, as well as in neighbouring countries. To date, EVD has been ruled out in all alerts from neighbouring provinces and countries.
Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 2 October 2018 (n=162)

Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 2 October 2018 (n=160)*

*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning.
Figure 3: Confirmed and probable Ebola virus disease cases by age and sex, data as 2 October 2018 (n=155)*

*Age and/or sex unknown for n=7 cases.
Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordinating the response, surveillance, contact tracing, laboratory capacity, IPC measures, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance and preparedness activities in neighbouring provinces and countries.

• As of 2 October, over 200 experts have been deployed by WHO to support response activities including emergency coordinators, epidemiologists, laboratory experts, logisticians, clinical care specialists, communicators and community engagement specialists.
• Over 5700 contacts have been registered, of which approximately 1900 remain under surveillance as of 2 October 2 . Following the conclusion of a ville morte imposed in Beni, Butembo and Mabalako Health Zones, there has been a marked improvement in the proportion of follow-up contacts on the day of reporting, with the proportion rising to 93% (1768/1900) from 78% (1401/1785) seven days prior. Beni Health Zone has the greatest challenges in contact tracing as a result of the deteriorating security situation.
• As of 2 October, 69 vaccination rings have been defined in addition to 26 rings of health and frontline workers. To date, 13,758 people consented and were vaccinated, including 5678 health or frontline workers and 2915 children. Ebola Treatment Centres (ETCs) are operational in Beni and Mangina with support from the Alliance for International Medical Action (ALIMA) and M?decins Sans Fronti?res (MSF), respectively. MSF Switzerland and the MoH are supporting an ETC in Butembo. International Medical Corps (IMC) is supporting the recently opened Makeke ETC in Ituri Province. MSF and the MoH are setting up a 12-bed isolation facility in Kasenyi. An isolation unit is being developed from existing facilities in Tchomia.
• WASH and IPC activities are ongoing in the Democratic Republic of the Congo and are supported by several partners in the field. Numerous activities have occurred in health facilities in the affected areas including facility assessments, decontamination of centres, establishment of triage areas and training on standard precautions as well as Ebola-specific IPC measures. A comprehensive plan to strengthen IPC in 200 health facilities, with WHO’s support, aims to: train medical staff; provide IPC kits; and replace incinerated materials in health facilities and households.
• The MoH, WHO, UNICEF, Red Cross and partners are intensifying activities to engage with local communities in the affected areas. Due to conditions imposed by a community-declared ville morte from 24-28 September 2018, social mobilization teams were in lockdown for five days in Beni and unable to engage with communities; the situation in Beni has since improved. Engagement with local leaders in Ndindi in the past weeks has helped increase community ownership, with positive signs that leaders are actively reporting suspected cases through a telephone hotline. More collaboration has also been observed between local authorities and community focal points. Local frontline community outreach workers are collaborating with Ebola response teams to strengthen community engagement and psychosocial support in contact tracing, patient care, SDBs and vaccination of close contacts. In Butembo, community engagement was strengthened through collaboration with a popular singer, Mayaya Santa, producing a song with key messages about Ebola response. The activation of Tchomia’s communication commission has been a priority, and a meeting organized with two religious networks successfully reached 233 leaders from 141 churches in Tchomia Health Zone; youth leaders and motor taxi associations were also engaged as part of the meeting.
• Red Cross SDB teams are trained and operational in Mangina, Beni, Butembo, Oicha and Tchomia. Further operational capacity is being built in Bunia. Trained SDB teams in Mambasa and Goma are without full operational capacity at this point. As of 1 October, Red Cross SDB teams have successfully responded to 162 of the 194 SDB alerts received. In addition, six alerts had not been responded to due to security concerns, and one alert response was pending.
• The WHO Regional Office for Africa has updated the regional preparedness plan and reprioritized neighbouring countries based on proximity to North Kivu, the current EVD epicentre. The new prioritizations are as follows: Priority 1: Rwanda, Uganda, South Sudan and Burundi; Priority 2: Angola, Congo, Central African Republic, Tanzania, Zambia. These countries were prioritised based on their capacity to manage EVD and viral haemorrhagic fever outbreaks, and their connections and proximity to the areas currently reporting EVD cases.
• WHO and partners have supported the strengthening of Public Health Emergency Operations Centre (PHEOC) in five countries (Rwanda, South Sudan, Tanzania, Uganda, and Zambia). Although PHEOC has not been fully established in the remaining countries, the MoH has a national taskforce that meets regularly to discuss EVD preparedness measures. WHO, in collaboration with the MoH and other partners in the field, has developed and updated their national contingency plan and shared this with all key stakeholders. WHO, in collaboration with partners (CDC, UNICEF, OCHA, IOM, GOARN, UK-Med, etc), is supporting the deployment of experts to provide technical support to the Ministries of Health on the implementation of EVD preparedness activities.
• As of 2 October, health screening has been established at 53 Points of Entry (PoEs) and close to 6.5 million travellers have been screened. IOM and PNHF have revised the PoE strategy for Ituri, with more focus on on-site supervision of local surveillance staffs at PoEs by IOM epidemiologists.
• To support the MoH, WHO is working intensively with a wide range of multisectoral and multidisciplinary regional and global partners and stakeholders for EVD response, research and urgent preparedness, including in neighbouring countries. Among the partners are a number of UN agencies and international organizations including: European Civil Protection and Humanitarian Aid Operation (ECHO; International Organization for Migration (IOM); the United Nations Children's Fund (UNICEF); UN High Commission for Refugees (UNHCR); World Food Programme (WFP); United Nations Office for the Coordination of Humanitarian Affairs (OCHA); Inter-Agency Standing Committee (IASC); UK Public Health Rapid Support Team; multiple Clusters, peacekeeping operations and the UN mission; UN Department of Safety and Security (UNDSS); World Bank and regional development banks; African Union, Africa Centres for Disease Control and Prevention (CDC), and regional agencies; Health Cluster partners and NGOs including ALIMA, ADECO, AFNAC, CARITAS DRC, CEPROSSAN, CARE International, COOPI, CORDAID/PAP-DRC, ICRC, IFRC, Red Cross of the Democratic Republic of the Congo, INTERSOS, IRC, MEDAIR, MSF, PNHF, Samaritan’s Purse, and SCI; Global Outbreak Alert and Response Network (GOARN), Steering Committee, EDPLN, ECCARN, technical networks and operational partners, and the Emergency Medical Team (EMT) Initiative. GOARN partners continue to support the response through deployment for response and readiness activities in non-affected provinces and in neighbouring countries and to different levels of WHO.

WHO risk assessment

This outbreak of EVD is affecting north-eastern provinces of the country, which borders Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include the transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and the displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri may hinder the implementation of response activities. On 28 September 2018, based on the worsening security situation, WHO revised its risk assessment for the outbreak, elevating the risk at national and regional levels from high to very high. The risk remains low globally. WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.
As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
WHO advice

WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. 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 travel 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:

• WHO Interim recommendation Ebola vaccines
• WHO recommendations for international travellers
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Ebola virus disease fact sheet

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1The number of cases is subject to change due to ongoing reclassification, retrospective investigation, and the availability of laboratory results.
2The total number of contacts under surveillance is highly dynamic with new cases being registered daily, and those who complete 21 days of post-exposure follow up, without developing symptoms, are released from surveillance.

http://www.who.int/csr/don/04-octobe...-ebola-drc/en/

 

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[TD="class: mcnTextContent"]DIRECTORATE GENERAL FOR DISEASE CONTROL[/TD]
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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Monday, October 8, 2018

The epidemiological situation of the Ebola Virus Disease dated 7 October 2018 :

• A total of 181 cases of haemorrhagic fever were reported in the region, 146 confirmed and 35 probable.
• Of the 146 confirmed, 80 died and 50 are cured .
• 21 suspected cases are under investigation.
• 4 new confirmed cases, 2 in Beni and 2 in Butembo.
• 2 new confirmed cases, including 1 in Beni and 1 in Butembo.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Epidemiological surveillance

• For several days, we have seen an upsurge in the number of confirmed cases in the city of Beni. This increase in the number of cases in Beni confirms the assessment that infected people who have escaped follow-up and vaccination are beginning to develop the disease. However, the increase in the number of alerts reported in the city of Beni reflects the strengthening of surveillance.
• The factors contributing to this situation are mainly misinformation, non-collaboration of the population with the response teams and insecurity. More than two months after the declaration of the epidemic, the community continues to prevent the safe and dignified burial, and at-risk contacts still refuse vaccination and 21-day follow-up.
• According to new forecasts, the number of cases reported in the city of Beni could exceed the number of cases in Mabalako, the epicenter of this epidemic, which has already reported 91 cases including 65 deaths. In view of the situation, a series of administrative measures will be taken by the urban authorities of Beni to reinforce the respect by the population of the rules imposed by the health emergency. In addition, the Beni Ebola Treatment Center (ETC), which currently has 16 beds, will be expanded to accommodate at least 60 patients, additional doses of vaccines have been ordered, and additional epidemiologists will be deployed for alerts investigations.

Vaccination​

• Since the start of vaccination on August 8, 2018, 15,114 people have been vaccinated , including 5,250 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,100 in Butembo, 434 in Bunia, 355 in Tchomia, 270 in Masereka, 240 to Komanda, 121 to Oicha.

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[TD="class: mcnTextContent"]DIRECTORATE GENERAL FOR DISEASE CONTROL[/TD]
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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Tuesday, October 9, 2018

The epidemiological situation of the Ebola Virus Disease dated 8 October 2018 :

• A total of 188 cases of haemorrhagic fever were reported in the region, 153 confirmed and 35 probable.
• Of the 153 confirmed, 83 died and 51 are cured . The others are hospitalized in the different Ebola Treatment Centers installed.
• 20 suspected cases are under investigation.
• 7 new confirmed cases, including 6 in Beni and 1 in Masereka.
  • Among the 6 new cases of Beni are 3 community deaths in the Butanuka district. These are 3 children who have been in consultation at the same clinic.
• 1 new person healed in Beni.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Administrative measures in the city of Beni

• Following the numerous attacks on the response teams and the non-respect of infection prevention and control measures in several traditional health centers in the city of Beni, the urban authorities have adopted a new urban decree introducing measures to Ebola response.
• These measures include:
  • Authorization for the response teams to call on the security forces during safe and dignified collections and burials;
  • The obligation for the family of a deceased person to present a death certificate signed by the medical authority before obtaining a burial permit;
  • The obligation for all health professionals, healers and traditional healers to refer any suspicious case to the Ebola Treatment Center (ETC) at the risk of having their center closed and being prohibited from practicing any form of medicine;
  • The prohibition to deliberately keep a suspicious case and prevent him from going to the ETC under penalty of being penalized.

Vaccination​

• Since the start of vaccination on August 8, 2018, 15,279 people have been vaccinated , including 5,385 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,100 in Butembo, 434 in Bunia, 355 in Tchomia, 300 in Masereka, 240 to Komanda, 121 to Oicha.

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=84019e121c

 

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[h=2]Latest numbers as of 9 October 2018[/h] Total cases: 194
- Confirmed cases: 159
- Probable cases: 35



Deaths: 122
- Confirmed: 87
- Probable: 35

 

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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, October 10, 2018

The epidemiological situation of the Ebola Virus Disease dated 9 October 2018 :

• A total of 194 cases of haemorrhagic fever were reported in the region, of which 159 confirmed and 35 probable.
• Of the 159 confirmed, 87 died and 53 are cured . The others are hospitalized in the different Ebola Treatment Centers installed.
• 25 suspected cases are under investigation.
• 6 new confirmed cases in Beni, including 3 community deaths in the Butanuka district.
• 4 new deaths of confirmed cases in Beni, including the 3 community deaths mentioned above.
• 2 new people healed in Beni.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Vaccination

• Since the start of vaccination on August 8, 2018, 15,525 people have been vaccinated , including 5,616 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 434 in Bunia, 355 in Tchomia, 330 in Masereka, 240 to Komanda, 121 to Oicha.

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=a5fba67edf

 

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Press Release

Ebola cases spike in DRC, daily case rate more than doubles since September
...
MEDIA CONTACTS
Jess Wanless
International Rescue Committee
+44 7384 258293
Jessica.Wanless@rescue-uk.org
IRC Global Communications
+1 646 761 0307
communications@rescue.org

New York, NY, October 11, 2018 — The International Rescue Committee is alarmed by a significant increase in the number of new Ebola cases in North Kivu, Democratic Republic of Congo (DRC).

As of October 9, there have been 194 confirmed and probable cases and 120 deaths from this Ebola outbreak. In just nine days, there have been 33 new cases and 15 deaths. This is in contrast to 41 new cases and 27 deaths in the entire month of September. We are seeing 2.5 times the number of new cases each day compared to the previous month.

The vast majority of these new cases and deaths are occurring in Beni, the new epicenter of the outbreak. Violence and insecurity led to a suspension of Ebola response programming between September 25 and 29, and yesterday, once again, programs were temporarily suspended due to violence. IRC teams are still waiting for the green light to resume their activities.

Michelle Gayer, Senior Director of Emergency Health at the International Rescue Committee, said:

“The current spike in Ebola cases and deaths is extremely worrying. The number of new cases each day has more than doubled since the start of October. It’s likely that the forced suspension in programming due to insecurity and community resistance in and around Beni are major factors in this.

This is a sign not only that the outbreak is not under control, but that without full engagement from the community, things could get a lot worse. We have recently seen the transmission of Ebola within a school, opening up a new front in the fight against the disease.

We are operating within a highly volatile environment where the security situation continues to deteriorate, threatening the lives and livelihoods of the community and disrupting the response. Programs are again suspended today due to unrest and violence. Each time the Ebola response is interrupted lives are at risk. Teams are not able to trace the contacts of patients, vaccinate those in need and ensure safe burial practices.

We are at a critical moment in the response and our teams are highly concerned that the number of new cases could continue to escalate. It’s vital that over the coming days organizations continue to work alongside the local community to strengthen the relationship and work to increase access to people in need.”

The IRC is operating in and around Beni, as well as in other areas affected by this Ebola outbreak, to limit and control the spread of the disease. In Beni Hospital and surrounding clinics, the IRC is leading on infection prevention and control, which is vital to halt the spread of the disease. The IRC has been operating in North Kivu since 1996, providing emergency health services to the community.

https://www.rescue.org/press-release...bles-september

 

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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Thursday 11 October 2018

The epidemiological situation of the Ebola Virus Disease dated October 10, 2018 :

• A total of 200 cases of haemorrhagic fever were reported in the region, including 165 confirmed and 35 probable.
• Of the 165 confirmed, 90 died and 53 are cured . The others are hospitalized in the different Ebola Treatment Centers installed.
• 26 suspected cases are under investigation.
• 6 new confirmed cases, including 5 in Beni and 1 Masereka.
• 3 new confirmed cases in Beni.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Epidemiological surveillance

• Since the beginning of October, a significant increase in the number of new cases has been observed mainly in Beni.
• Between 1 [SUP]th[/SUP] and 11 October 2018, 39 new ones were reported, including 32 only in Beni, representing 82% of all cases reported this period.
• More specifically, 35 of all new cases were reported between October 4 and 11, 2018 (the last 7 days). Of these 35 cases, 29 were in Beni, or 82%.

Fun and dignified burial

• On Wednesday, October 10, 2018, members of the community stole the body of a woman who died at the Beni Ebola Treatment Center on her way to the cemetery. When the woman died, the family asked the response team to make some concessions regarding the burial ceremony of the deceased. In particular, they requested that the hearse be driven by one of their acquaintances and that 5 family members wear personal protective equipment in order to carry the casket. This request was accepted by the response team provided that the procession was followed by a police vehicle.
• However, as the procession made its way to the cemetery, the driver of the hearse suddenly changed course to get back to the family plot in the Butsili district of Beni. Arrived in the plot, several young people from a neighboring neighborhood then violently chased the police and kept the body with them. Panicking and realizing their mistake, they finally went to the cemetery before the end of the day and let the 5 family members wearing the personal protective equipment proceed to the burial of the house. deceased.
• This Thursday, October 11, 2018, several members of the family volunteered to Beni's General Referral Hospital to get vaccinated. They guaranteed that no one had manipulated the body of the deceased between the CTE and the cemetery. Neither the coffin nor the body bag were opened.
• In addition, residents of the Butsili neighborhood held an extraordinary meeting on Thursday at the local office and made a statement to apologize to the response teams. Young people in the neighborhood promised that they would not let such a situation happen again in their neighborhood.

Vaccination

• Since the start of vaccination on 8 August 2018, 15,807 people have been vaccinated , including 5,838 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 434 in Bunia, 390 in Masereka, 355 in Tchomia, 240 to Komanda, 121 to Oicha.
• Many local figures continue to be vaccinated in the presence of the press in order to convince the population to trust the teams of the response and to accept vaccination. On Wednesday, October 10, 2018, the Honorable Jean Chrysostome Vahamwiti and his colleagues Kola Kiove and D?sir? Mutayombe were vaccinated. And this Thursday, October 11, 2018, it was the turn of the Honorable Boris Maelezo to participate in this major awareness campaign. All had only one message for the people of Beni: Mobilize to end this Ebola outbreak.

​

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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Friday, October 12, 2018

The epidemiological situation of the Ebola Virus Disease dated 11 October 2018 :

• A total of 205 cases of haemorrhagic fever were reported in the region, including 170 confirmed and 35 probable.
• Of the 170 confirmed, 95 died and 54 are cured . The others are hospitalized in the different Ebola Treatment Centers (ETCs) installed.
• 32 suspected cases are under investigation.
• 5 new confirmed cases, including 3 in Beni, 1 in Kalunguta (1 community death) and 1 Mabalako.
• 5 new confirmed cases, including 4 in Beni and 1 in Kalunguta.
• 1 new person healed in Mabalako.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Beni Emergency Operations Center

• A MONUSCO plumber working at the coordination headquarters in Beni tested positive for Ebola and is currently hospitalized at the CTE in Beni.
• The plumber would have been contaminated after having spent a stay in the center of a traditional health practitioner while a confirmed case had been taken care of before being transferred to the CTE. The surveillance team has already started the investigation to identify all contacts and prevent transmission of the virus.
• The response teams, most of whom had already been vaccinated before deployment, had to leave headquarters earlier this Friday so that a team of hygienists could begin the disinfection work of the entire site. In addition, the plumber's colleagues have voluntarily registered to be vaccinated as of this Saturday, October 13th. As a precaution, they were all put on paid leave for a period of 21 days.

Vaccination

• Since the start of vaccination on August 8, 2018, 16,202 people have been vaccinated , including 6,163 in Beni, 4,289 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 460 in Masereka, 434 in Bunia, 355 in Tchomia, 240 to Komanda, 121 to Oicha.

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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Saturday 13 October 2018

The Epidemiological Status of Ebola Virus Disease, October 12, 2018 :

• A total of 207 cases of haemorrhagic fever were reported in the region, of which 172 confirmed and 35 probable.
• Of the 172 confirmed, 95 died and 54 are cured . The others are hospitalized in the different Ebola Treatment Centers (ETCs) installed.
• Number of suspect cases not available today.
• 2 new cases confirmed in Beni.
• No new deaths.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.

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News of the response​

Press Conference of the Minister of Health in Kinshasa

• The Minister of Health, Dr. Oly Ilunga Kalenga, held a press conference at his Cabinet this Saturday, October 13, 2018 to present the evolution of the Ebola Virus Disease epidemic in the provinces of North Kivu and Ituri.
• Dr. Oly Ilunga Kalenga reviewed the latest developments in the Beni epidemic, which is now the main focus. He highlighted the factors that have slowed down the progress of the response in the city, namely community resistance, insecurity, dead city days, and the lack of involvement of traditional healers. This situation has created a gray area for the response teams. Due to difficulties in identifying and following up contacts, the majority of new confirmed cases reported this month are not part of the list of known contacts and epidemiological links are identified only after a thorough investigation. Thus, only the continuation of the investigations will allow us to determine the real extent of this second wave of confirmed cases in Beni.
• However, there are positive developments including a significant increase in the number of alerts received and investigated per day. This indicates a strengthening of surveillance.

• Faced with these challenges, coordination has begun to develop a new response plan that takes into account these additional dimensions related to realities on the ground. This new approach is based on co-targeting, which aims to ensure that concerted actions are carried out by multidisciplinary teams around cases and alerts. In addition, the city of Beni has been divided into 18 operational zones that correspond to the 18 health areas of the city with specific response teams.

Vaccination

• Since the start of vaccination on August 8, 2018, 16,518 people have been vaccinated , including 6,453 in Beni, 4,315 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 460 in Masereka, 434 in Bunia, 355 in Tchomia, 240 to Komanda, 121 to Oicha.

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[TD="class: mcnTextContent"] EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Sunday, October 14, 2018

The epidemiological situation of the Ebola Virus Disease dated October 13, 2018 :

• A total of 211 cases of haemorrhagic fever were reported in the region, including 176 confirmed and 35 probable.
• Of the 176 confirmed, 100 have died and 55 are cured . The others are hospitalized in the different Ebola Treatment Centers (ETCs) installed.
• 24 suspected cases under investigation.
• 4 new confirmed cases, including 2 in Beni, 1 in Masereka and 1 in Butembo.
  • Of these new confirmed cases, 3 are community deaths (dignified and secure burials made)
  • The number of confirmed cases in Beni has exceeded the number of confirmed cases in Mabalako, the epicenter of the epidemic.
• 5 new confirmed cases, including 2 in Beni, 2 in Mabalako and 1 in Butembo.
• 1 new person healed in Beni.

Remarks:​

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
• A community death is a death in the community, outside of a licensed health center.

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News of the response​

Vaccination

• Since the beginning of vaccination on August 8, 2018, 16,973 people have been vaccinated , including 6,832 in Beni, 4,351 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 500 in Masereka, 434 in Bunia, 355 in Tchomia, 240 to Komanda, 121 to Oicha.

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=9861793bb6

 

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EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Monday, October 15, 2018 ​

The epidemiological situation of the Ebola Virus Disease dated 14 October 2018 :

• A total of 214 cases of haemorrhagic fever were reported in the region, of which 179 were confirmed and 35 were probable.
• Of the 179 confirmed, 104 died and 55 are cured . The others are hospitalized in the different Ebola Treatment Centers (ETCs) installed.
• 25 suspected cases under investigation.
• 3 new confirmed cases in Beni, all community deaths (dignified and secure burials made).
• 4 new deaths of confirmed cases in Beni, including the 3 community deaths mentioned above

<snip>​

​

this chart shows the increase in the number of alerts notified in the city of Beni indicating an improvement of the surveillance system as well as a better collaboration of the community which makes more and more use of the emergency teams.​

​

https://mailchi.mp/sante.gouv.cd/ebola_kivu_15oct​

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[tetano]

[h=1]UN: Ebola outbreak is worrying but not a global emergency[/h] GENEVA (AP) ? The World Health Organization says it is "deeply concerned" by the ongoing Ebola outbreak in Congo but the situation does not yet warrant being declared a global emergency.
After convening an expert group to assess the epidemic on Wednesday, the U.N. health agency said "response activities need to be intensified and ongoing vigilance is critical."
Aid organizations have expressed alarm as the rate of new Ebola cases more than doubled this month and resistance to efforts to stop the virus has turned violent. WHO has warned the risk of Ebola spreading in the region is "very high" as confirmed cases were reported close to the Ugandan border. It says the risk of international spread is low.

https://www.sfchronicle.com/news/me...eak-is-worrying-but-not-a-global-13314800.php

 

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EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, October 17, 2018 The epidemiological situation of Ebola Virus Disease dated October 16, 2018 :

• A total of 220 cases of haemorrhagic fever were reported in the region, 185 confirmed and 35 probable.
• Of the 185 confirmed, 107 died and 57 are cured . The others are hospitalized in the different Ebola Treatment Centers (ETCs) installed.
• 34 suspected cases under investigation.
• 4 new confirmed cases, including 3 in Beni and 1 in Butembo.
• 3 new confirmed cases in Beni.
• 4,798 contacts to follow to date.

Remarks:

• To avoid that the total number of cases varies (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.
• The category of probable cases includes all reported deaths for which it was not possible to obtain biological samples for laboratory confirmation. The investigations will determine whether these deaths are related to the epidemic or not.
• A community death is a death in the community, outside of a licensed health center.

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[TD] Meeting of the Emergency Committee for the International Health Regulations (IHR)

• The Emergency Committee for International Health Regulations, convened by the Director General of the World Health Organization (WHO), Dr. Tedros Adhanom, met this Wednesday, October 17, 2018 to determine whether the epidemic of Current Ebola in the Democratic Republic of the Congo is a public health emergency of international concern. At the end of the deliberations, the Committee unanimously concluded that the epidemic is not at this stage a public health emergency of international concern. The level of risk of spread at the international level is kept low but very high at national and regional level.
• The Committee recognizes that the Ebola epidemic is taking place in a complex context with significant challenges:
  • The epidemic is in an area of ​​active conflict with protracted humanitarian crises;
  • Community mistrust due to a variety of reasons, including the security situation, and people who avoid follow-up or go to the health center late;
  • The identification of new cases without known epidemiological link is a major concern that requires more detailed epidemiological mapping;
  • In-band vaccination efforts have achieved high coverage rates among eligible populations (almost 90%) but this method relies entirely on effective contact monitoring.
• However, the Committee noted several positive developments:
  • The Committee commended the Government of the DRC, WHO and all partners in the response for the progress made under difficult circumstances;
  • All pillars of the response operate on a large scale and are adjusted in real time;
  • Surveillance activities are laudable but need to be intensified;
  • MONUSCO provides logistical and security support to the response;
  • Vaccines and experimental therapeutics are being widely used for the first time;
  • Traveler control at points of entry is carried out on a very large scale;
  • Preparatory activities in neighboring countries are ongoing, although these require significant additional financial support.
• The Minister of Health, Dr. Oly Ilunga Kalenga, shares this assessment of the response. This tenth Ebola outbreak presents many risks and challenges identified from the start. Despite a complex social and security context, the teams that have been on the ground since the day after the outbreak was announced are doing an admirable job. The response plan is constantly evaluated and adjusted to respond effectively and quickly to the challenges of instability in the region. The Ministry of Health takes note of the Committee's recommendations and will incorporate them into the new response plan.

Vaccination

• Since the start of vaccination on August 8, 2018, 18,465 people have been vaccinated , including 7,999 in Beni, 4,391 in Mabalako, 1,663 in Mandima, 1,392 in Katwa, 1,085 in Butembo, 570 in Masereka, 434 in Bunia, 355 in Tchomia, 240 to Komanda, 121 to Oicha, 110 to Musienene and 105 to Kalunguta.

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[TD] THE EMERGENCY COMMITTEE ON INTERNATIONAL SANITARY REGULATIONS

The IHR Emergency Committee's statement of Wednesday, October 17, 2018 is available by following this link (in English).
Click here to learn more about the IHR Emergency Committee, its role, composition and mission.

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https://t.co/XhPu3PhE8n

 

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Lost in translation in above post, should have been:

• 4 new confirmed cases, including 3 in Beni and 1 in Butembo.
• 3 new confirmed cases of deaths in Beni.

These numbers do not add up as there were 179 confirmed cases on the 15th + 4 new confirmed cases on the 16th != 185 confirmed cases.

 

[Pathfinder]

An Ebola outbreak presents a new mystery involving children

By HELEN BRANSWELL @HelenBranswell OCTOBER 19, 2018
...
The disproportionate number of recent infections among children in the Democratic Republic of Congo ? specifically in Beni, the outbreak?s current hot spot ? has come as a surprise; typically young children don?t make up a big proportion of cases during an Ebola outbreak.

But in the first two weeks of October, nearly 60 percent of the newly reported cases in and around Beni were children under the age of 16, Dr. Peter Salama, of the World Health Organization, told STAT.
...
At this point, they have a theory ? though Salama stressed that it is only that at this stage.

It is currently peak malaria season in Beni. Children in particular can become severely ill when they contract malaria. And it appears that a lot of the children who contracted Ebola in Beni had recently seen medical practitioners or traditional healers.

If a clinic or traditional healer is treating an undiagnosed Ebola patient, other people also present could become infected. That is believed to have happened recently to a plumber who worked on the U.N. peacekeepers? compound at Beni.

It?s also possible that children who were brought for care for malaria might have received a therapy ? something injectable ? that could explain the exposures, Salama said.
...
https://www.statnews.com/2018/10/19/ebola-outbreak-new-mystery-children/

 

[Pathfinder]

HEALTH NEWSOCTOBER 19, 2018 / 11:50 AM / UPDATED AN HOUR AGO

U.S. official optimistic Congo Ebola outbreak can be controlled

Giulia Paravicini


KINSHASA (Reuters) - The leading Ebola expert at the U.S. Centers for Disease Control and Prevention (CDC) said on Friday he believed an outbreak in Congo can be brought under control quickly and that the high rate of new cases is due largely to improved detection.
...
?We compared the evolution of this epidemic to other epidemics to see if the increase had been more rapid, and there was no difference,? Rollins said in an interview.

?What happened in the last week is that the health ministry has decided ... to research the cases more actively because they would see cases arrive that had no link to patients already treated or registered as known contacts.?

He added that the introduction 10 days ago of a new World Bank-supported program to pay people by mobile phone to report cases has encouraged quicker reporting.
...

https://www.reuters.com/article/us-...bola-outbreak-can-be-controlled-idUSKCN1MT2FR

 

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[h=1]?Dark day?: Congo rebels kill 2 health agents fighting Ebola[/h]
...rebels shot and killed two medical agents ... The health ministry statement late Saturday said Mai Mai rebels surged from the forest and opened fire on the unarmed agents with the army?s rapid intervention medical unit ... The daytime attack appeared premeditated ... Health workers in this outbreak have described hearing gunshots daily, carrying out Ebola containment work under armed escort and having to end their work by sundown to lower the risk of attack.

https://www.apnews.com/d356722e08aa43e8a6475046b513d62e