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

Pathfinder · Mar 4, 2019

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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, March 4, 2019

The epidemiological situation of the Ebola Virus Disease dated 3 March 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 897, of which 832 * confirmed and 65 probable. In total, there were 563 deaths (498 confirmed and 65 probable) and 304 people healed.

* A confirmed non-classified case has been added to Butembo

171 suspected cases under investigation;
2 new confirmed cases in Butembo;
2 new deaths from confirmed cases of Butembo:
- 1 community death in Butembo;
- 1 death of confirmed cases at Katwa TC;
2 people healed out of Butembo CTE.

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

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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News of the response

Evolution of the epidemiological situation

Considerable progress has been made in recent weeks. To date, 19 health zoneshave reported at least one case of Ebola during the epidemic. Of these 19 areas, 11 did not register new confirmed cases for more than 21 days . They are Biena, Kayna, Komanda, Mabalako, Manguredjipa, Masereka, Musienene, Mutwanga, Nyakunde, Oicha and Tchomia. In addition, 6 other health zones reported only 1 to 4 new cases , namely Beni, Kalunguta, Kyondo, Mandima, Rwampara, Vuhovi.

These data demonstrate that the epidemic is relatively controlled in the majority of affected health areas. The two health zones that continue to fuel this epidemic remain Butembo and Katwa, which reported more than 86% of new confirmed cases in the last 21 days. In the last 21 days, 80 new cases have been reported, including 48 in Katwa (60%) and 21 in Butembo (26.25%).

Epidemiological situation as of February 26, 2019

Epidemiological situation as of March 3, 2019

Community engagement in Butembo

Following targeted attacks on Ebola treatment centers in Katwa and Butembo last week, the Ebola response team in Butembo and surrounding areas launched an action plan to end community incidents that disrupted its activities to defeat this epidemic. During his last visit, the Minister of Health, Dr. Oly Ilunga Kalenga, asked the coordinator of the on-site response to launch a community dialogue to better understand the expectations of the population.

This plan was elaborated by Butembo's communication subcommittee on February 27, 2019. After its validation by Dr Jean-Christophe SHAKO, coordinator of the response in this city, this action plan is being implemented by the leaders of the sub-committee. -commission communication supported by UNICEF and WHO since 1 March 2019. On the one hand, they hold consultation sessions with community leaders in Butembo to discuss the issue of resistance and violence against the work of the response. On the other hand, the communication sub-committee would like, through these consultation sessions, to obtain the contribution of the Butembo and Katwa forces in order to define ways and means to put an end to the community incidents. Note that religious leaders, politicians, women's associations and cell chiefs from Butembo and Katwa health areas, where more resistance has been recorded, have already been heard. They gave some way out of this community crisis, which is due to the fact that most members of the community tend to associate Ebola with death, the political problems of insecurity and postponement of elections in the community. region.

When the response teams arrived in Butembo in September 2018, they had already met with political and administrative authorities, economic operators, religious and political leaders, opinion leaders, lobbyists and social groups. civil. However, despite the involvement of several influential groups in society, part of the population did not feel that their concerns were sufficiently taken into account. Thus, all these community consultation sessions scheduled for a dozen days will lead to the establishment of a permanent consultation framework between the response team and the community in order to

Vaccination

Since the start of vaccination on 8 August 2018, 85,375 people have been vaccinated , including 21,892 in Katwa, 20,740 in Beni, 10,628 in Butembo, 6,109 in Mabalako, 2,869 in Kalunguta, 2,633 in Goma, 2,317 in Komanda, 2,084 in Oicha, 2,013 to Mandima, 1,357 to Karisimbi, 1,340 to Kayina, 1,340 to Kyondo, 1,254 to Bunia, 1,064 to Vuhovi, 920 to Masereka, 772 to Mutwanga, 769 to Lubero, 767 to Biena, 690 to Rutshuru, 625 to Musienene, 527 in Nyankunde, 496 in Mangurujipa, 469 in Rwampara (Ituri), 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-U?l?) and 13 in Kisangani.

The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

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Pathfinder · Mar 7, 2019

Democratic Republic of Congo

Ebola response failing to gain the upper hand on the epidemic

Press Release 7 March 2019
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Seven months into the largest ever Ebola outbreak in the Democratic Republic of the Congo (DRC), the Ebola response is failing to bring the epidemic under control in a climate of deepening community mistrust, M?decins Sans Fronti?res (MSF) said at a press conference in Geneva today.

Since the beginning of the year, more than 40 per cent of new cases are people who died of Ebola in the communities. At the epicentre of the epidemic, in Katwa and Butembo, 43 per cent of patients in the last three weeks were still being infected without known links to other cases.

?We have a striking contradiction: on the one hand a rapid and large outbreak response with new medical tools such as vaccines and treatments that show promising outcomes when people come early ? and on the other hand, people with Ebola are dying in their communities, and do not trust the Ebola response enough to come forward,? said International President of MSF, Dr Joanne Liu.
...
https://www.msf.org/ebola-response-failing-gain-upper-hand-epidemic-democratic-republic-congo

Pathfinder · Mar 7, 2019

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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

Thursday, March 7, 2019

The epidemiological situation of the Ebola Virus Disease dated March 6, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 913, of which 848 are confirmed and 65 are probable. In total, there were 574 deaths (509 confirmed and 65 probable) and 306 people healed.

* The probable new case of Masereka has been removed from the caseload pending validation by the Supervisory Committee.

181 suspected cases under investigation;
7 new confirmed cases, including 5 in Katwa, 1 in Butembo and 1 Kyondo;
6 new confirmed case deaths:
- 3 community deaths, including 1 in Katwa, 1 in Kyondo and 1 in Butembo;
- 3 deaths at CTE, including 2 deaths in Butembo and 1 in Mabalako;
2 people healed out of Butembo CTE.

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

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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News of the response

Role of security in the areas affected by the Ebola outbreak

There appears to be a lack of understanding of the role of law enforcement in Ebola-affected areas. Police and the military are not involved in Ebola response activities and their role has never been to force compliance with sanitary measures.

Given the numerous security incidents against the agents of the response but also against the families and members of the community who adhere to the response, the Ministry of Health asked the Ministry of the Interior to ensure the security of the goods and services. people in the area. It is unacceptable for health workers to be threatened and assaulted in the course of their work. Likewise, it is unacceptable that families are prevented from burying their relative in a dignified and secure manner because of groups of unseemly people.

As local health workers do not have the privilege of being exfiltrated when security conditions deteriorate, there is a need to increase security to ensure a successful response. In addition, since the arrival of the response teams in North Kivu in August 2018, the improvement of the security situation in the region is a permanent demand of the population. The return of security is, moreover, one of the conditions issued by MSF to return to Butembo and Katwa.

Arrival of the Director General of WHO in Kinshasa

The Director General of WHO, Dr. Tedros Adhanom Ghebreyesus, arrived this Thursday, March 7, 2019 in Kinshasa. He is accompanied by Dr. Matshidiso Moeti, Regional Director, WHO Office for Africa, Dr. lbrahima Soce Fall, WHO Regional Director for Emergencies, Stewart Simonson, Assistant Director-General for the WHO. Administration, and Pierre Formenty, WHO expert on dangerous pathogens.

The Minister of Health, Dr Oly Ilunga Kalenga, received the delegation to his Cabinet and thanked the WHO for its field work alongside the Congolese teams. He particularly emphasized the contribution of WHO to the rapid rehabilitation of Ebola Treatment Centers in Butembo and Katwa. The reopening of the Butembo CTE, just days after the attack by gunmen, sends a strong message to those trying to disrupt the Ebola response, which is that the agents will remain in office until the end of the war. epidemic.

The Director General of WHO congratulated the Minister and the Government of the Republic for their strong leadership. Although the epidemic is not yet fully under control, the efforts made have made it possible to contain the epidemic geographically in two provinces of the country. This result is remarkable considering the mobility of the population and the security context. However, the risk of spread in other provinces and neighboring countries remains present as long as the epidemic remains active.

During the exchanges, particular emphasis was placed on community engagement strategies. Community dialogue has shown that the public wants the Government and the partners not only to fight Ebola alone, but also to help them improve their general living conditions. The Ministry of Health initiated the design of a community development and recovery program to ensure economic and social recovery in the affected provinces after the end of the Ebola outbreak.

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Pathfinder · Mar 8, 2019

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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

Friday, March 8, 2019

The epidemiological situation of the Ebola Virus Disease dated March 7, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 918, 853 confirmed and 65 probable. In total, there were 578 deaths (513 confirmed and 65 probable) and 306 people healed.
190 suspected cases under investigation;
5 new confirmed cases, including 2 in Katwa, 1 Kalunguta, 1 in Lubero and 1 in Mandima;
4 new confirmed cases deaths:
- 2 community deaths, including 1 in Kalunguta and 1 in Lubero;
- 2 deaths from confirmed cases at Butembo CTE.

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

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 confirmation in the laboratory 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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News of the response

New health zone affected: Lubero

A confirmed case has been notified to Lubero. This is the twentieth health zone that has recorded at least one case of Ebola during the epidemic. This is a young woman who is the known contact of a confirmed patient who died on February 21, 2019 in Butembo. She categorically refused to be vaccinated and to follow 21-day contacts. When she became ill, she consulted a tradipractician before taking home treatment. She died at home. The response team installed in Lubero for several months has ensured the completion of his burial dignified and secure as well as the listing of his contacts.

Vaccination

Immunization of front-line health workers in the health zones of Mweso and Kibirizi began on Thursday, March 7, 2019. These two health zones are neighboring areas in Katwa that currently have the highest number of confirmed cases. Visitors from Katwa regularly visit these areas. Thus, in order to protect health workers, the coordination decided to vaccinate all providers in the surrounding health zones in order to limit the spread of the disease.

Since the start of vaccination on 8 August 2018, 86,346 people have been vaccinated , including 22,017 in Katwa, 20,796 in Beni, 10,875 in Butembo, 6,109 in Mabalako, 2,889 in Kalunguta, 2,633 in Goma, 2,317 in Komanda, 2,084 in Oicha, 2.303 to Mandima, 1.357 to Karisimbi, 1.340 to Kayina, 1.340 to Kyondo, 1.254 to Bunia, 1.064 to Vuhovi, 990 to Masereka, 772 to Mutwanga, 769 to Lubero, 767 to Biena, 690 to Rutshuru, 663 to Musienene, 527 in Nyankunde, 519 in Rwampara (Ituri), 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-U?l?), 50 in Mweso and 25 in Kibirizi and 13 in Kisangani.

The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

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Shiloh · Mar 8, 2019

Source: https://www.who.int/csr/don/7-march-2019-ebola-drc/en/
[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
7 March 2019

The Ebola virus disease (EVD) outbreak is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern, while small clusters continue simultaneously in some geographically dispersed locations. During the last 21 days (13 February ? 5 March 2019), 76 new confirmed and probable cases have been reported from 31 health areas within nine health zones (Figure 1), including: Katwa (44), Butembo (17), Mandima (6), Masereka (3), Kalunguta (2), Beni (1), Vuhovi (1), Kyondo (1), and Rwampara (1). The emerging cluster in Mandima health zone is occurring in a previously unaffected village, with five of the recent cases epidemiologically linked and the sixth case likely exposed in Butembo; nonetheless, there remains a high risk of further spread. Similarly, recent cases (two confirmed and one probable) in Masereka stem from a Butembo chain of transmission. These events highlight the importance for response teams to remain active across all areas, including those with lower case incidence, to rapidly detect new cases and prevent onward transmission.
As of 5 March, 907 EVD cases[SUP]1[/SUP] (841 confirmed and 66 probable) have been reported, of which 57% (514) were female and 30% (273) were children aged less than 18 years. Cumulatively, cases have been reported from 121 of 301 health areas across 19 health zones of the North Kivu and Ituri provinces. Overall, 569 deaths (case fatality ratio: 63%) have been reported, and 304 patients have been discharged from Ebola Treatment Centres (ETCs). Although declining trends in case incidence are currently being observed, the high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, persistent delays in detection and isolation in ETCs (related as well to recent violent incidents), and challenges in the timely reporting and response to probable cases, all increase the likelihood of further chains of transmission in affected communities and continued spread.
Following the attacks on two ETCs in Katwa and Butembo, patients were temporarily transferred to the Katwa Transit Centre. On 2 March, the Butembo ETC was rehabilitated and resumed treatment of EVD patients. Response teams are progressively resuming activities in all affected areas with the exception of two health areas where security and community resistance remain a challenge.
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 03 March 2019[/h]

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[h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 5 March 2019*[/h]

*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning ? trends during this period should be interpreted cautiously.
[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:

Ebola situation reports: Democratic Republic of the Congo

[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. National and regional risk levels remain very high, though global risk levels remain low. This EVD outbreak is primarily affecting the north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of EVD at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons, as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria, measles) and a long-term humanitarian crisis. Additionally, the fragile security situation in North Kivu and Ituri, further limits the implementation of response activities.
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. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
[h=3]WHO advice[/h] International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
For more information, see:

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

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[h=3]Related links[/h]

Pathfinder · Mar 9, 2019

Translation Google

Police officer killed in attack at Ebola treatment center in DRC

Paris Match | Posted on the 09/03/2019 at 12h24

Writing, by AFP

A policeman was killed in Butembo, Democratic Republic of Congo, in the attack on an Ebola treatment center.

A new attack of an Ebola treatment center (ETC) on Saturday killed one policeman in Butembo, one of the main outbreaks of this epidemic, just hours before the arrival of the Director General of the WHO. in this eastern city of the Democratic Republic of Congo, we learned from his mayor.

The Director General of WHO, Dr. Tedros Adhanom Ghebreyesus and his delegation, came to take stock of the situation of the Ebola epidemic in the DRC, arrived Saturday at 11:30 (9:30 GMT) in Butembo, a major commercial center. million inhabitants and one of the main foci of Ebola.

"The Butembo CTE suffered an attack, firing began around 6 am (4 am GMT) and then resumed 30 minutes later with the resistance of the army and the police," Timoth?e Muissa Kiesse told AFP. , Mayor of Butembo.

"The army and the police have been able to catch one of the attackers, a Mai-Mai militia, which will reveal the motives for the CTE attack," said Muissa Kiesse.

"A health staff has also been shot (gunshot), taken care of at the hospital, and we hope his case will improve," he said. "This is the third attack on a CTE," said Muissa Kiesse.

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https://www.parismatch.com/Actu/Int...n-centre-de-traitement-d-Ebola-en-RDC-1611582

Pathfinder · Mar 11, 2019

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Monday, March 11, 2019

The epidemiological situation of the Ebola Virus Disease dated March 10, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 923, of which 858 are confirmed and 65 are probable. In total, there were 582 deaths (517 confirmed and 65 probable) and 308 people cured.
150 suspected cases under investigation;
2 new confirmed cases, including 1 in Butembo and 1 in Biena;
No new case deaths confirmed.

/! \ 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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News of the response

Mission to Kighali village (health zone of Lubero)

The coordinator of the Butembo sub-coordination, Dr. Jean-Christophe Shako, made a mission to Kighali, a village located 45 km from Lubero-center, on Monday, March 11, 2019. The mission in this village was risky because it is surrounded by hills from which armed groups monitor any movement of vehicles and people.

The aim of the response team was to remove community reluctance against vaccination and household decontamination following the detection of a confirmed case and possible probable cases in the village. The confirmed case is a woman, a known but reluctant contact, who fled Butembo to seek refuge in Kighali. In order to limit the risk of spread of the virus in this village, it was important to carry out all the response activities around the case, namely the listing of contacts, vaccination, the decontamination of households and health facilities, the establishment of the 21-day tracking system, as well as food distribution for all contacts.

The day before, a team of three epidemiologists had entered the village to investigate. On site, they had met with fierce reluctance from the community and were seriously injured by the angry mob. On Monday, Dr. Shako managed to remove this reluctance thanks to the involvement of local leaders including the mwami, the group leader, the priest, the territory administrator and the zone chief medical officer.

A large crowd gathered to listen to the speeches of all the speakers. They spoke in turn about the importance of hosting response teams, not attacking them, being vaccinated and respecting all other preventive measures. These words seem to have convinced the population, in particular about sixty contacts who have quickly registered to benefit from the vaccination and start the 21-day follow-up program. A call has been made to other contacts who are still hidden.

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ad8e2a185f

Pathfinder · Mar 12, 2019

Translation Google

LUBERO / Territory: BIENA records new Ebola case after 30 days without reported case

Posted on: 12/03/2019 at 17h14min29s
By Radio Moto Butembo-Beni

The BIENA health zone has registered a new case. This, after 30 days passed without any case notified in this area. The case was recorded Sunday, March 10 at MAMBOWA hospital.

It is a 2-year-old child who has been in contact with his father who died of Ebola in Butembo two weeks ago. On the morning of Monday, March 11th, the coordination of the Ebola response team in the Biena Health Zone confirms the transfer of this case to the CTE Butembo. The district medical officer indicates that efforts are being made in terms of vaccination of contacts of the confirmed case.

Note that the week before March 10, in the awareness mission against Ebola, the sensitization team was invaded by residents from Katanga to Vuyinga. One of the sensitizers was heavily beaten and remains interned in a health facility of the place.

Posted on: 12/03/2019 at 17h14min29s
By Radio Moto Butembo-Beni

http://radiomotofm.info/lirearticle.php?billet=5540

Pathfinder · Mar 14, 2019

(From a blog)

Translation Google

TUE14

The ebola riposte burned in Mambowa / Lubero

Another CTE of Medecins Sans Frontieres was burned in Mambowa in the sector of Bapere / Lubero. According to local sources, a boy was shot and wounded on his legs, which caused the population to chase even the vehicles of response teams, which were destroyed. The group also ransacked the Mambowa referral general hospital, a CBCA hospital, and destroyed in addition the response team vehicles, the CBCA Jeep carrying the delegation of the Health Department of the CBCA. CBCA. It all started with the death of a father in Ngazimoya, still in the same area, which would be a suspected case of ebola. The teams of the riposte arrived at the place to take care of this body but the population did not accept to yield this body. For now the population of Njiapanda is in the streets of Bapere area singing hostile songs against the team of responses.

https://congoaujourlejour.blogspot.com/2019/03/un-hopital-des-medecins-sans-frontieres.html

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DRC: Another Ebola Treatment Center burned in Mambowa (Lubero)

Thursday, March 14, 2019 - 10:56

Another Ebola treatment center (ETC) was ransacked and burned on Thursday 14 March in Mambowa, near Nziapanda-Mangurejipa, in the health zone of Biena, in Lubero territory (North Kivu).

An administrative officer at the Manguredjipa Reference General Hospital tells ACTUALIT?.CD that it was local youth who took to the CTE to express their resistance to the attempt to take samples from the body of one of their children. died in a health facility in Mambowa.

The protesters then set fire to the home of the province governor's deputy delegate in the area, whom they accused of alerting Ebola counter-agents for the removal, the source said.

The Burning Isolation Center is managed by the World Health Organization (WHO) after the withdrawal of MSF and hosted 17 patients before being burned.

The police and the DRC armed forces intervened to protect the patients and to disperse the protesters with warning shots. For the moment, witnesses on the spot report clashes between the police and the demonstrators.

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https://actualite.cd/2019/03/14/rdc-un-autre-centre-de-traitement-debola-incendie-mambowa-lubero

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DRC-Ebola: A shot dead following clashes between police and perpetrators of the Mambowa CTE fire

Thursday, March 14, 2019 - 13:47

A young man was killed and the other shot after the fire of an Ebola treatment center (ETC) on Thursday, March 14 in Mambowa, on the Nziapanda-Mangurejipa road, health zone of Biena, in Lubero territory (North Kivu).

According to Bwanamudogo Jackson, an agent in an agricultural cooperative based in Njiapanda (80 km west of Butembo), the dead young man was returning from the field when he encountered loyalist forces chasing after him, with warning shots, the authors of the CTE fire erected in Mambowa by Doctors Without Borders (MSF), but currently managed by the World Health Organization (WHO).

"The young man who was carrying firewood was hit by one of a stray bullet. He is dead. For now, the protesters have just dropped off her body at the Nziapanda Police Office. Apart from him, there is also another protester shot by wounds, and angry health professionals would refuse to treat for the moment, "he says.

In addition to the Burning Ebola Treatment Center and the recorded human injuries, a driver from the Biena Health Zone told ACTUALITE.CD that five vehicles, including two from MSF kept on site after the organization's withdrawal, been stoned by protesters.

Until 13:00, sources on the spot reported clashes between demonstrators and police. Socio-economic activities are suspended in Nziapanda.

"Protesters throw projectiles at police and soldiers, and they respond with warning shots. Which causes tension. Since 10am, all socio-economic activities are at stops. Shops have closed, "adds Bwanamudogo.

An administrative officer at Manguredjipa General Reference Hospital indicates that it was local youth who learned at CTE to express their resistance to an attempt to take samples from the body of one of their deceased in a health facility. Mambowa. The protesters also set fire to the home of the provincial governor deputy delegate in the area, whom they accused of alerting the Ebola counterparts to take samples from the body of their dead comrade.

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https://actualite.cd/2019/03/14/rdc...ffourees-entre-forces-de-lordre-et-auteurs-de

Pathfinder · Mar 14, 2019

WHO says Ebola area contained but Congo needs long-term support

by Reuters
Thursday, 14 March 2019 16:01 GMT

GENEVA, March 14 (Reuters) - The Ebola outbreak in Democratic Republic of Congo is now concentrated in two areas and could be stopped by September, but the world must tackle Congo's broader crisis to make it count, the head of the World Health Organization said on Thursday.
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"We have averted a much larger outbreak," WHO chief Tedros Ghebreyesus Adhanom told a news conference, adding that the affected area was contained and shrinking within a certain geographic area.

"Our target now is to finish it within the next six months."
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http://news.trust.org//item/20190314155004-g137v/

Shiloh · Mar 14, 2019

Source: https://www.who.int/csr/don/14-march-2019-ebola-drc/en/
[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
14 March 2019

The public health response to the Ebola virus disease (EVD) outbreak continues to make gains. During the last 21 days (20 February ? 12 March 2019), no new cases have been detected in 10 of the 20 health zones that have been affected during the outbreak (Figure 1). There has also been fewer new cases observed over the past five weeks compared to January 2019 and earlier in the outbreak (Figure 2).
Currently, the greatest concern centres on the neighbouring urban areas of Katwa and Butembo, which continue to contribute about three-quarters of recent cases. Clusters in other areas of North Kivu and Ituri provinces have been linked to chains of transmission in Katwa and Butembo, and have thus far been contained to limited local transmissions with relatively small numbers of cases. A total of 74 confirmed cases were reported during the last 21 days from 32 of the 125 health areas affected to date (Table 1). Risk of further chains of transmission and spread remain high, as highlighted by the recent spread to Lubero Health Zone, and reintroduction to Biena Health Zone following a prolonged period without new cases.
Response teams are fully operational in all outbreak affected areas and there are encouraging improvements in community acceptance of the response, despite the challenges of ongoing insecurity caused by armed groups. For example, during the last 21 days in Katwa and Butembo, 88% of the 256 families with a family member who died and was suspected to have EVD, accepted the support from response teams to conduct a safe and dignified burial. Seventy-four new vaccination rings were launched, with over 90% of people eligible for vaccination accepting to do so, and over 90% of these participated in follow-up visits. A total of 5974 people (including 2159 health and frontline workers) consented and were vaccinated this period; overall 87,632 people have been vaccinated to date. Vaccination teams are continuing to follow-up on 12 rings wherein the families have not yet accepted the intervention, and two other rings that are in the process of being defined. Seven field laboratories have remained fully operational, sustaining similar testing rates as previous weeks. During the past week, 1213 samples from new suspected cases, community deaths and previously confirmed cases were tested within 48 hours. Outreach teams made up mostly of local volunteers also met with 6000 households during the past week, building local knowledge of Ebola, and referring sick individuals to either Ebola Treatment Centres (ETCs) or other health facilities as appropriate. In the last two weeks, community dialogues were held in several villages in Katwa and Vuhovi to find ways in engaging community members to build trust and ownership in the Ebola response.
Efforts to strengthen case finding and investigation, and contact tracing activities are also bearing fruit. Of 74 confirmed cases reported in the last 21 days, 83% (62 cases) have been epidemiologically linked to active chains of transmission; either listed as contacts at illness onset (47 cases) or linked retrospectively to other cases or health centre where they were likely exposed (15 cases). Investigations are ongoing to identify links for the remaining cases.
Challenges include further attacks by armed groups on affected communities and ETCs, elements of community mistrust, and persistent delays in getting people into care in ETCs for various reasons. The Ministry of Health, WHO and partners continue to work actively to build community trust and participation in the response, while reinforcing security measures to protect patients and response teams. The ETC in Butembo has been rebuilt following two attacks and is treating patients again, and the Katwa Transit Centre remains operational.
Since the beginning of the outbreak to 12 March 2019, 927 EVD cases[SUP]1[/SUP] (862 confirmed and 65 probable) have been reported, of which 57% (525) were female and 30% (280) were children aged less than 18 years. Cumulatively, cases have been reported from 125 of 319 health areas across 20 health zones of the North Kivu and Ituri provinces (Table 1). Overall, 584 deaths (case fatality ratio: 63%) have been reported, and 308 patients have been discharged from ETCs.
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 10 March 2019[/h]

Enlarge image
[h=3]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 12 March 2019[/h]

[h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 12 March 2019*[/h]

*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning.
[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:

Ebola situation reports: Democratic Republic of the Congo

[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 latest assessment on 6 March 2019 concluded that the national and regional risk levels remain very high, while global risk levels remain low. The outbreak has continued with a similar epidemiological profile to the last assessment. Attacks on ETCs in Katwa and Butembo represented the first large-scale and organized attacks targeted directly at the Ebola response, and were of a different order of magnitude to episodes of mistrust in communities or dangers of being caught in crossfire between fighting parties. In addition, the persistence of pockets of community resistance and 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. These events occur amidst declining trends in case incidence; however, the high proportion of community deaths reported among confirmed cases, persistent delays in detection and isolation in ETCs, challenges in the timely reporting and response to probable cases, collectively increase the likelihood of further chains of transmission in affected communities and increased risk of geographical spread within the Democratic Republic of the Congo and to neighbouring countries. As do the risk of increased population movement anticipated during periods of heightened insecurity.
[h=3]WHO advice[/h] International traffic: WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
For more information, see:

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

Pathfinder · Mar 14, 2019

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Thursday, March 14, 2019

The epidemiological situation of the Ebola Virus Disease dated March 13, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 932, of which 867 are confirmed and 65 are probable. In total, there were 587 deaths (522 confirmed and 65 probable) and 309 people cured.
210 suspected cases under investigation;
5 new confirmed cases, including 3 in Mandima, 1 in Kalunguta and 1 in Lubero;
3 new deaths of confirmed cases, including
- 1 community death in Mandima;
- 2 deaths at Butembo CTE;
1 new patient cured out of CTE Butembo.

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

Remarks:

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

Incident at Biena

The Mambowa Transit Center, in the Biena Health Zone, was ransacked by the mob following the refusal of the population to allow a team to retake a sample from the body of a man suspected of having died. Ebola in a local health center. The crowd also attacked Biena's General Reference Hospital, including a newly rehabilitated building.

The police intervened to disperse the crowd. Unfortunately, one young man died after being hit by a stray bullet and another was injured. All riposte activities were suspended for the day.

A delegation consisting of the administrator of the territory and several notables of the region will go to Biena from Friday, March 15, 2019 to discuss with the population to appease the situation. The Ministry of Health has asked the Ministry of the Interior to open an investigation into the incidents that occurred during the day.

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Pathfinder · Mar 15, 2019

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

Friday, March 15, 2019

The epidemiological situation of the Ebola Virus Disease dated 14 March 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 936, 871 confirmed and 65 probable. In total, there were 591 deaths (526 confirmed and 65 probable) and 310 people cured.
240 suspected cases under investigation;
4 new confirmed cases, including 1 in Mandima, 1 in Katwa, 1 in Butembo and 1 in Kayina;
4 new confirmed case deaths, including
- 2 community deaths, including 1 in Mandima and 1 in Butembo;
- 2 deaths at CTE, including 1 Mabalako and 1 in Beni (these are 2 cases notified to Mandima reported in the bulletin of Thursday, March 14, 2019);
1 new patient cured out of CTE Butembo.

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

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Pathfinder · Mar 16, 2019

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

Saturday, March 16, 2019

The epidemiological situation of the Ebola Virus Disease dated March 15, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 943, of which 878 are confirmed and 65 are probable. In total, there were 594 deaths (529 confirmed and 65 probable) and 311 people healed.
237 suspected cases under investigation;
7 new confirmed cases, including 2 in Kyondo, 2 in Katwa, 1 in Butembo, 1 in Masereka and 1 in Vuhovi;
3 new deaths of confirmed cases, including
- 2 community deaths, including 1 in Masereka and 1 in Katwa;
- 1 death at CTE Mabalako (this is a patient from Mandima);
1 new patient cured out of CTE Butembo.

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

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Pathfinder · Mar 17, 2019

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

Sunday, March 17, 2019

The epidemiological situation of the Ebola Virus Disease dated March 16, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 951, 886 confirmed and 65 probable. In total, there were 598 deaths (533 confirmed and 65 probable) and 312 people cured.
231 suspected cases under investigation;
8 new confirmed cases, including 3 in Katwa, 3 in Vuhovi, and 2 in Masereka;
4 new confirmed case deaths, including
- 2 community deaths, including 1 in Vuhovi and 1 in Katwa;
- 2 deaths at the CTE, including 1 in Butembo and 1 in Beni (identification of the origin of the patient in progress);
1 new patient cured out of CTE Butembo.

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

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News of the response

Case clusters in Vuhovi and Masereka

The case cluster in Vuhovi is made up of family members who were reluctant to respond. After several days of refusing to vaccinate and follow up contacts, several members of this family became ill at the same time. Following the last community death in this family, several neighbors and other villagers moved and asked to be vaccinated. After discussions with the community engagement and psycho-social care teams, the family leaders themselves undertook, in a letter addressed to the coordination of the response, not to oppose to their activities. They asked that their sick relatives be transferred to the CTE and that the rest of the family be vaccinated.

Masereka's cases are family members of another confirmed patient who died on March 4, 2019.

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https://us13.campaign-archive.com/?u...&id=47ab3c2f03

Pathfinder · Mar 17, 2019

(From a blog)

MAR 17

A death of ebola again in Beni

A case of death of ebola at the CME Nyakunde in Beni a case from Biakato

Posted 42 minutes ago by la question de Chebeya

https://congoaujourlejour.blogspot.com/2019/03/un-deces-d-encore-beni.html

Pathfinder · Mar 18, 2019

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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, March 18, 2019

The epidemiological situation of the Ebola Virus Disease dated March 17, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 960, 895 confirmed and 65 probable. In total, there were 603 deaths (538 confirmed and 65 probable) and 314 people cured.
172 suspected cases under investigation;
9 new confirmed cases, including 3 in Katwa, 2 in Vuhovi, 2 in Masereka, 1 in Butembo and 1 in Kalunguta;
5 new deaths of confirmed cases, including
- 4 community deaths, including 3 in Katwa and 1 in Kalunguta;
- 1 death at the CTE of Butembo;
2 new patients recovered from CTE Butembo.

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

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=92766b012a

Pathfinder · Mar 18, 2019

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Ituri-ebola: SOS from Pacific Keta on the risk of large-scale contamination in Mandima

According to the interim governor of Ituri, 2 deaths and 13 new contaminations to the outbreak of ebola virus disease have just been registered again in the localities of Biakato and Lwemba in Mandima health zone in Mambasa territory located about 200 km southwest of Bunia in Ituri.

During a press briefing Saturday, March 16, 2019 in Bunia, Pacific Keta Upar lamented the weak collaboration of the local population with the response teams, which he said could increase the risk of contamination in this part of his province .

"We regret to announce the outbreak of ebola in Biakato and Lwemba in the Mandima health zone, we describe the poor collaboration of the population of these two entities that could promote the large-scale contamination of our population" did he declare.
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Buniaactualite.com via orientalinfo.net

17/03/2019 / BY WRITING

https://www.orientalinfo.net/03/17/i...lle-a-mandima/

Pathfinder · Mar 19, 2019

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A new approach against the Ebola epidemic in the DRC

By Simon Roz? Published on 19-03-2019 Last modified 19-03-2019 at 14:30

More than seven months after its start, the Ebola epidemic in the north-east of the Democratic Republic of Congo (DRC) has just exceeded 600 deaths. The World Health Organization (WHO) however considers the epidemic contained, and even plans to see the end in six months. An achievable goal, but one that requires a change of approach.

Every day, new cases of Ebola in the DRC are counted on the fingers of one hand. Clearly, a peak has passed, prompting WHO to declare the epidemic "contained". For many observers, the use of this term is probably a bit premature. "The epidemic is not under control," says Dr. Natalie Roberts. The emergency director of M?decins sans Fronti?res Paris has just returned from North Kivu. It parallels the epidemic that has hit West Africa: "There is a risk today of seeing an outbreak and many more cases. Our goal is to understand what are the risk factors and avoid what we saw in West Africa. The epidemic seemed then contained, but it preceded such an outbreak. In the DRC, we still do not understand why and how people catch Ebola. "

During her stay, however, Natalie Roberts was able to observe the situation, which led her to formulate several hypotheses. Nosocomial transmissions at the hospital are thus at the top of its list, as is the so-called chain of contamination: the contacts of a sick person with those around him. It must be possible to trace this thread. "When a case is identified in a family, our teams arrive to identify contacts," explains Jean-Christophe Shako. The coordinator of the disease response does this work every day in Butembo. "All contacts are listed, vaccinated. Then we decontaminate the structure, clean it up. We mostly follow all contacts for twenty-one days. "Long-term work and the doctor regularly observes the reluctance of the population, which complicates the task even more, with potentially serious consequences. "If these operations are not carried out, contacts will develop the disease. That's what's causing us problems now. "

Go faster in the care

Ebola is indeed a scary disease, and the first reflex is not to go to an Ebola center as soon as the first symptoms appear. The sick simply go to the nearest hospital. This has two perverse effects: the increase in nosocomial infections mentioned by Natalie Roberts, but also a crucial loss of time. The doctor estimates that, on average, patients go to three different health centers before going to an Ebola facility.

To remedy this, the idea is to change the approach and move towards greater integration of the Ebola treatment chain into already existing structures. In Lubero, for example, "there is no Ebola center, we only have the general reference hospital," says Dr. Gr?goire Tshilongo of MSF. "All the patients go through there, there is only one sorting. We have an isolation room for all suspected cases. We can keep them there and take the samples. If the test is positive, the patient is referred to an Ebola specific course. If he is negative, he is treated in the hospital.

For MSF, this approach has several advantages. Firstly, there is no longer a waste of time in the management of the disease: the patient has access to screening as soon as he or she enters the treatment pathway. The establishment of isolation rooms in a general hospital also limits the risks of nosocomial infections.

However, this system should be generalized in order to equip each health center in the region with personnel and infrastructures that can be in contact with the disease. The World Health Organization seems to be moving in this direction. "Our priority must be working with communities by building their capacity to cope with the epidemic," said Tedros Ghebreyesus Adhanom, WHO's Director General. "I fully agree with MSF on this, it's now part of our strategy. "

An unstable security context

The end of the epidemic is therefore possible. However, it will be necessary to override the security risk: "In this region, there are armed conflicts since many decades and the communities are always cautious", continues the boss of WHO, which warns against the risk that the epidemic is on the rise "if the security situation continues to deteriorate. "

http://www.rfi.fr/afrique/20190319-rdc-ebola-approche-msf-oms-insecurite

Pathfinder · Mar 19, 2019

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

Tuesday, March 19, 2019

The epidemiological situation of the Ebola Virus Disease dated March 18, 2019 :

Since the beginning of the epidemic, the cumulative number of cases is 968, 903 confirmed and 65 probable. In total, there were 606 deaths (541 confirmed and 65 probable) and 315 people cured.
234 suspected cases under investigation;
8 new confirmed cases, including 4 in Masereka, 2 in Katwa, 1 in Kayina and 1 in Mandima;
3 new deaths of confirmed cases, including
- 2 community deaths: 1 in Katwa and 1 in Mandima;
- 1 death at the CTE of Butembo;
1 new patient cured out of CTE Butembo.

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

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=5317c06d25

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

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