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

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

Wednesday, May 29, 2019

The epidemiological situation of the Ebola Virus Disease dated May 28, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,945, of which 1,851 are confirmed and 94 are probable. In total, there were 1,302 deaths (1,208 confirmed and 94 probable) and 512 people cured.
  • 297 suspected cases under investigation;
  • 19 new confirmed cases, including 6 in Mabalako, 3 in Mandima, 3 in Butembo, 2 in Kalunguta, 1 in Musienene, 1 in Masereka, 1 in Vuhovi, 1 in Katwa and 1 in Beni;
  • 15 new deaths of confirmed cases, including
    • 10 community deaths, including 3 in Mabalako, 3 in Mandima, 1 in Vuhovi, 1 in Masereka, 1 in Katwa and 1 in Kalunguta;
    • 5 deaths at CTE, including 3 in Butembo and 2 in Mabalako;
  • 9 new healings from the CTE, including 6 in Butembo and 3 in Mabalako.
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108 Contaminated health workers

Two health workers, including one in Kalunguta and one in Mabalako, all vaccinated, are among the new confirmed cases.

The cumulative number of confirmed / probable cases among health workers is 108 (5.5% of all confirmed / probable cases), including 36 deaths.
...

https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=fe8219ebf2
 
Translation Google

Butembo: Religious Leaders Hold Social Symposium to Support Ebola Response

Posted the game, 30/05/2019 - 11:18 | Changed the game, 30/05/2019 - 11:18

The Church of Christ in Congo (ECC), the Catholic Diocese of Butembo-Beni and the Butembo Revival Churches are organizing a social symposium to support the response to Ebola. This activity, which opened Wednesday, May 29, will end Friday, May 31.

"The purpose of the symposium is Ebola virus disease raging here in and around Butembo. We want to get together and try to study the causes of the resistance, and the attacks on the nursing staff. We will also analyze the causes of the resistance and we can see what are the solutions that can be envisaged, to succeed in eradicating this disease, "said Bishop Isse Somo, representative of the Churches of Christ in Congo in Butembo, current focus of the Ebola outbreak.

He said that this symposium will involve the participation of all social strata of the city.
...
https://www.radiookapi.net/2019/05/...religieux-organisent-un-symposium-social-pour
 
Source: https://www.who.int/csr/don/30-may-2019-ebola-drc/en/
[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
30 May 2019

A decline in the number of confirmed Ebola virus disease (EVD) cases has been reported this week (22 to 28 May). Over the past seven days, a total of 73 new confirmed cases were reported compared to the previous where 127 new confirmed cases were reported. This should be interpreted with caution given the complex operating environment and fragility of the security situation. Katwa, one of the epicenters of the outbreak, reported fewer cases this week and other health zones such as Mabalako, Kalunguta and Mandima have also seen a decline in case reporting. Active transmission was reported in 14 of the 22 health zones that have been affected to date. Other initial encouraging findings such as a lower proportion of reported nosocomial infections, a lower proportion of community deaths and a higher proportion of registered contacts at case detection have also been reported. Weekly fluctuations in these indicators have been reported in the past and uncertainties remain with regards to the ability of the surveillance system to identify all new cases in areas faced with ongoing insecurity. Operations are still regularly hampered by security issues, and the risk of national and regional spread remains very high.
Mabalako reported 24% (73/309) of the new confirmed cases in the past 21 days. Nine out of the 12 Mabalako health areas have reported new confirmed cases during this period. In the 21 days between 8 to 28 May 2019, 83 health areas within 14 health zones reported new cases, representing 46% of the 180 health areas affected to date (Table 1 and Figure 2). During this period, a total of 309 confirmed cases were reported, the majority of which were from the Mabalako (24%, n=73), Butembo (21%, n=64), Katwa (14%, n=42), Beni (11%, n=34), Kalunguta (10%, n=31), Musienene (7%, n=23) and Mandima (6%, n=20) health zones.
As of 28 May 2019, a total of 1945 EVD cases, including 1851 confirmed and 94 probable cases, were reported. A total of 1302 deaths were reported (overall case fatality ratio 67%), including 1208 deaths among confirmed cases. Of the 1945 confirmed and probable cases with known age and sex, 58% (1122) were female, and 29% (572) were children aged less than 18 years. The number of healthcare workers affected has risen to 108 (6% of total cases).
All alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries continue to be monitored and investigated. To date, EVD has been ruled out in all alerts outside the outbreak affected areas. On 3 June, a pilgrimage is planned to Namugongo, Uganda to commemorate the death of Catholics and Anglican martyrs. Preparedness activities surrounding the pilgrimage are ongoing.
[h=3]EVD Cases in Under Five-Year Olds[/h] WHO periodically conducts in-depth epidemiological analyses so that data can help reveal any gaps and drive evidence-based response improvements. An in-depth analysis of EVD cases in children under five-years of age demonstrated some noteworthy trends. As of 28 May, children under the age of five accounted for 15% (300/1949) of EVD cases reported, with children under one year of age accounting for 6% (118/1949). Of the 300 cases in children under the age of five, 19 were probable cases (19/94, 20% of all probable cases).
Data indicate that children under the age of five are being brought into healthcare facilities sooner than cases over the age of five (2.4 days vs. 3.2 days respectively), but most of these cases are not being referred to ETCs, and instead attend multiple local healthcare facilities. These cases visited on average 1.5 healthcare facilities, compared to 1.2 healthcare facilities for cases aged over five-years of age. These observations show that in general, parents are willing to seek medical attention for their children at healthcare facilities but are reluctant to bringing their children to ETCs, perhaps out of fear of being far from home and without the support of family members. More work needs to be done to reduce fear and misunderstanding of ETCs and to reduce any other barriers to access, with a special focus on this age group. All cases that may not be adequately isolated including children under five-years of age may pose a considerable transmission risk to healthcare workers, patients, and members of the community.
With regards to contact-tracing, 28% of EVD cases under five-years of age are registered as contacts, compared to 41% in cases over five-years of age. Although EVD cases under five years of age are less frequently listed as contacts, proportions of cases both below and over five-years of age are under surveillance remain similar (18% vs. 20% respectively). The reasons underlying these low figures are unclear at this time and further investigations are ongoing.
As of 28 May, the overall case fatality rate (CFR) of EVD cases in children under the age of five stands at 77%. This CFR was notably higher than that of EVD cases over five-years of age at 57%. These figures are in line with those observed in the 2014 West Africa EVD outbreak[SUP]1[/SUP] . There are a number of possible explanations for the higher CFR in this vulnerable population: the lower proportion of cases that present to ETCs, higher baseline mortalities in this population in general, and the inability to vaccinate cases who were not listed as contacts. Community deaths (i.e. any EVD deaths occurring outside of Ebola treatment centres/Transit centres (ETCs/TCs) account for 76% of deaths due to EVD in children under the age of five and 65% above the age of five. Of the community deaths of children under the age of five, 54% died in a healthcare facility.
As expected, the CFRs of EVD cases both younger and older than five-years of age (50% and 39% respectively) who sought treatment at ETCs is markedly lower than those who did not (86% and 68% respectively). The relative difference in CFRs between the two groups reduces upon admission into an ETC. This again reinforces the need to continue strengthening efforts to work with communities to encourage all affected populations, and in particular parents of young children, to seek treatment at ETCs as early as possible in order to give them the best chance of survival. Overall, the fact that these observed trends indicate that while it is promising to see lower CFRs in young children treated in ETCs, and to see that parents are willing to seek medical attention for their children at healthcare facilities, much emphasis needs to be made at improving contact listing of children under five years of age and encouraging parents to bring their children to be treated in ETCs. It must also be stressed that the proportions and resultant associations described above must be interpreted with caution given the often-limited demographic information available and are subject to change due to the fluid nature of the ongoing EVD outbreak.
Efforts are ongoing to encourage community-based facilities to refer suspected cases to ETCs/TCs, however these activities can be further strengthened. Children of all ages, including infants, that have suspected or confirmed EVD, are cared for at ETUs with specific optimized, supportive care protocols. Paediatric-specific equipment, medicines and trained specialists are available to provide clinical support at ETCs for this age group. All confirmed children are also rapidly enrolled in investigational therapeutic protocols after informed consent is obtained. Children receive nutritional care and psychosocial support from psychologists while at the ETC and are cared for 24/7 by care providers from survivors so they are not alone. As with all age groups, infants and young children are offered support via a specialized programme of care for Ebola survivors. In addition, pregnant women that have survived EVD are followed closely in the survivor program and return to ETCs for delivery by a multi-disciplinary team that has obstetric and paediatric expertise.
In light of these findings, UNICEF and WHO are working with partners in supporting activities related to nutritional care and psychosocial support of EVD patients, particularly for parents and children. These include supporting and providing information related to infant feeding for children separated from their parents or orphaned. UNICEF is working with EVD survivors and creating infant and young child feeding (IYCF) counselling support groups. They are also supporting the screening of malnourished children under two years old and their referral to Nutritional Units for assistance. Psychosocial support and material assistance are being conducted in outbreak areas where nurseries for children who have been separated from their mothers are set up and psychosocial support is provided to family members accompanying EVD affected persons and their contacts.
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 28 May 2019*[/h]
figure1_20190530.PNG



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*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
[h=4]Figure 2: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 28 May 2019[/h]
figure2_20190530.png



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[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 28 May 2019**[/h]
table1__20190530.png



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

Thursday 30 May 2019

The epidemiological situation of the Ebola Virus Disease dated May 29, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,954, 1,860 confirmed and 94 probable. In total, there were 1,312 deaths (1,218 confirmed and 94 probable) and 521 people healed.
  • 342 suspected cases under investigation;
  • 9 new confirmed cases, including 3 in Katwa, 2 in Mabalako, 2 in Beni, 1 in Vuhovi and 1 in Kalunguta;
  • 10 new deaths of confirmed cases, including
    • 5 community deaths, including 1 in Katwa, 1 in Mabalako, 1 in Beni, 1 in Vuhovi and 1 in Kalunguta;
    • 5 deaths at CTE, including 3 in Butembo and 2 in Mabalako;
  • 9 new healings from the CTE, including 6 in Butembo and 3 in Mabalako.
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Social Symposion against Ebola
  • The religious leaders of Butembo launched Thursday, May 30, 2019, the Symposium Social Against Ebola. This meeting, initiated by the religious leaders, will last two days and will bring together all the resistant layers of the population. The aim of the Symposium is to give the people of Butembo the opportunity to work together to find a lasting solution to get out of the crisis and recreate a bond of trust between the population, local authorities and the agents of the response.

Ebola Hackathon
  • After a successful first edition in Kinshasa last March, the Ebola hackathon returns for a second edition in Goma. From Thursday, May 30 to Friday, May 31, 2016, 60 young students will work to develop new solutions using new technologies to help fight Ebola while also promoting the right to health. This second hackathon is organized in collaboration with Internews, Kinshasa Digital, Path, the DRC Information Media Association and the French Institute of Goma.
  • As a reminder, the first edition of the Ebola hackathon took place from March 2 to 3, 2019 in Kinshasa. The winning team of this first edition is called Lokole , a name inspired by the traditional drum. Their project was to develop a mobile application that allows community relays and people to share information in real time with the coordination of the Ebola response. Thanks to financial support from the World Bank and technical support from the Ministry of Health, the Lokole team is following an incubation program at Ingenious City where they will develop a prototype of the project which will then be tested with ground.
...
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ec82fcca83
 
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Butembo: Locals set conditions for working with Ebola response teams

The people of Butembo held a free expression about the mistrust displayed in the eradication of Ebola virus disease through a social symposium on the epidemic organized by religious of all faiths in the city.

For them, if the resistance against the disease continues, it is because there is initially a bad awareness on the part of the teams of response against this epidemic.

"Where have you ever seen a sick person in the world being picked up by the police at his home followed by a motorcade?" One of the participants said.

Given the mistrust of the Ebola virus disease in the region, the inhabitants of Butembo city are demanding the withdrawal of funding committed to the response for its eradication because they say, as long as the people committed in the response will continue to collect colossal amounts the month, Ebola will not end.

Another cause that these believe to be the basis of resistance against Ebola virus disease is the lack of respect for the customs and customs of the environment.

"In our Nande custom, we know that you have to dig a grave after someone's death, which is not the case for the Ebola response teams. now in Kitatumba cemetery, there are plenty of tombs dug in advance, and we wonder if they wake up knowing the number of people who will die of Ebola or how, "they complain.

Remember that this social symposium on Ebola virus disease is organized by religious denominations with the objective of "making community commitments to contribute to the eradication of Ebola virus disease in the city of Butembo and its surroundings".

Launched last Thursday, May 30, this conference on Ebola virus disease ends this Saturday.

Joel Kaseso / Correspondent 7SUR7.CD in Butembo

https://www.7sur7.cd/2019/05/31/but...onditions-pour-collaborer-avec-les-equipes-de
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Friday, May 31, 2019

The epidemiological situation of the Ebola Virus Disease dated May 30, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 1,974, of which 1,880 are confirmed and 94 are probable. In total, there were 1,323 deaths (1,229 confirmed and 94 probable) and 525 people cured.
  • 328 suspected cases under investigation;
  • 20 new confirmed cases, including 7 in Mabalako, 4 in Katwa, 3 in Butembo, 2 in Beni, 2 in Musienene, 1 in Mandima and 1 in Kalunguta;
  • 11 new deaths of confirmed cases, including
    • 7 community deaths, including 4 in Mabalako, 1 in Butembo, 1 in Musienene and 1 in Mandima;
    • 4 deaths at CTE, including 3 in Butembo and 1 in Beni;
  • 4 new healings from the CTE, 2 in Butembo and 2 in Katwa.
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109 Contaminated health workers
One vaccinated Mabalako health worker is one of the new confirmed cases (community deaths). The health worker self-medicated and refused to be transferred to the CTE.
The cumulative number of confirmed / probable cases among health workers is 109 (5.5% of all confirmed / probable cases), including 37 deaths.
...
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=4c27290b67
 
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Butembo: "Red Cross" suspends its intervention for 6 months in Bulengera

POSTED BY: RMBB WRITING 31/05/2019

The Butembo Red Cross movement suspends its activities in Bulengera commune for a period of six months. This, following the malicious destruction of the JUHUDI health facility in VULINDA cell, KYAGHALA district in Bulengera commune.

The decision fell on Friday, May 31, after an emergency meeting of representatives of the Butembo Red Cross movement at the Red Cross headquarters. Emmanuel KIVIHYA, one of the participants talks about the essence of the decision taken.

"They started a strike. There will be no more help coming from the red cross at Bulengera commune given the fire at the JUHUDI medical center. They also decided that justice could do its job for the people who committed the crimes at the JUHUDI medical center and do their research wherever they will be. All the help that the Red Cross has always given, especially in the coordination of Bulengera, will no longer be given during the 6 months from today,? he said.

http://www.radiomoto.net/2019/05/31...ion-pendant-6-mois-dans-la-commune-bulengera/
 
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EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Saturday, June 1, 2019

The epidemiological situation of the Ebola Virus Disease dated May 31, 2019 :
Since the beginning of the epidemic, the cumulative number of cases is 1,982, of which 1,888 are confirmed and 94 are probable. In total, there were 1,332 deaths (1,238 confirmed and 94 probable) and 531 people healed.
350 suspected cases under investigation;
8 new confirmed cases, including 3 in Butembo, 2 in Beni, 2 in Katwa and 1 in Mangurujipa;
9 new deaths of confirmed cases, including
4 community deaths, including 2 in Beni, 1 in Mangurujipa and 1 in Butembo;
5 deaths at CTE, including 3 in Katwa and 2 in Mandima;
6 new healings from the CTE, including 4 in Mandima, 1 in Beni and 1 in Butembo.
...
https://us13.campaign-archive.com/?u...&id=5e35fa33ba


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EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Sunday, June 2, 2019

The epidemiological situation of the Ebola Virus Disease dated 1 June 2019 :
Since the beginning of the epidemic, the cumulative number of cases has been 1,994, 1,900 confirmed and 94 probable. In total, there were 1,339 deaths (1,245 confirmed and 94 probable) and 533 people healed.
325 suspected cases under investigation;
12 new confirmed cases, including 5 in Mabalako, 3 in Katwa, 2 in Beni and 2 in Butembo;
7 new deaths of confirmed cases :
5 community deaths, 2 in Mabalako, 1 in Beni, 1 in Katwa and 1 in Butembo;
2 deaths at CTE, including 1 in Butembo and 1 in Mabalako;
2 new healings from the CTE, including 1 in Butembo and 1 in Mabalako.
...
Vaccination
By a decision of May 23, 2019, the Ethics Committee of the School of Public Health of the University of Kinshasa approved the amendment of the compassionate belt vaccination protocol for the rVSV-ZEBOV vaccine aimed at expanding the targets pregnant women after the first trimester and lactating women identified as contacts. For minors, it is maintained that children can be vaccinated from the age of 6 years. Between 26 November 2018 and 26 May 2019, 319 pregnant women and 603 lactating women registered as contacts could not be vaccinated.
...
https://us13.campaign-archive.com/?u...&id=f056f28558
 
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Butembo: Nurses threaten to go on strike to claim risk premiums and safety

Sunday, June 2, 2019 - 22:20
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In addition to not paying their risk premiums, the nurses have also lashed out at attacks and violence that they continue to suffer as a result of their involvement in the response to the Ebola virus disease that has already hundreds of deaths. Thus, they decided to continue the suspension of prevention activities, including prenatal consultation (CPN), preschool consultation (CPS) and routine vaccinations, as it has been for nearly three months now in the city. of Butembo.

"The Mayor (of Butembo, Editor's note) has requested that a minimum service of CPN, CPS and routine vaccinations be organized. But we are not going to start them, especially since the inhabitants who claim them are the same ones who continue to keep the malicious people who threaten us. Today, some nursing staff no longer sleep at home, they no longer arrive at their health centers, fearing for their safety. Some refrigerators (which allow the conservation of vaccines, Editor's note) have been damaged, health centers burned: where will we hold sessions of CPN, CPS or vaccination? Where will we find the inputs we use during the vaccination? We are therefore maintaining the suspension of prevention activities while waiting for the urban authority to convene an exchange framework to establish responsibilities, "said Kambale Vake Okelo.

Note that following this measure of nurses to suspend prevention activities, nearly 2,500 children born since March have not yet been vaccinated against measles, tuberculosis, poliomyelitis and many other diseases in the city. of Butembo.
...
Claude Sengenya, in Butembo

https://actualite.cd/2019/06/02/but...greve-pour-reclamer-leurs-primes-de-risque-et
 
Translation Google

Posted on 03/06/2019

Ebola: 170 attacks on health care workers in the DRC
...
The transfer of skills to Congolese does not eradicate attacks

The latest episode is the assassination last week of a Congolese agent of a prevention team attacked at home by villagers.

"Part of the population of Vusahiro village, in the health zone of Mabalako (North Kivu), has risen and attacked the local team of the Ebola response," says the bulletin of the Ministry of Health . "A hygienist from the infection prevention and control team died from his injuries while being transferred to the hospital."

This tragic event may question the relevance of the strategy of entrusting the fight against the disease to local populations to reduce disputes.

Congolese teams engaged in the response to Ebola pay a heavy price: "We see it every day. Skills are transferred to local staff, but staff then return home at night and are potentially at risk of attack. So when some say that all we have to do to defeat Ebola is to transfer the skills to the local level then everything will be fine, and no, that's not true. It's a real problem. When we transfer skills, we also transfer risks. And we have to make sure that the local staff gets the best possible protection, "says Michael Ryan, the director of emergency operations at WHO.
...
https://www.jim.fr/en_direct/pro_so...ignants_en_rdc_177901/document_actu_pro.phtml
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Monday 3 June 2019

The epidemiological situation of the Ebola Virus Disease dated June 2, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,008, 1,914 confirmed and 94 probable. In total, there were 1,346 deaths (1,252 confirmed and 94 probable) and 539 people cured.
  • 281 suspected cases under investigation;
  • 14 new confirmed cases, including 7 in Mabalako, 3 in Butembo, 2 in Katwa, 1 in Mandima and 1 in Kalunguta;
  • 7 new confirmed case deaths:
    • 6 community deaths, including 4 in Mabalako, 1 in Katwa and 1 in Butembo;
    • 1 death at the CTE of Butembo;
  • 6 new cures out of the CTE, including 3 in Mabalako, 2 in Butembo and 1 in Beni.
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/! \ The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas .

Remarks:
  • In order to prevent the total number of cases from 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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[TD="class: mcnTextContent"]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu as of 2 June 2019[/TD]
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Evolution of the Ebola epidemic
  • The bar of 2,000 cases was passed Sunday, June 2, 2019. Despite this course, developments in recent weeks are positive although vigilance remains in place. Among the positive developments, we count:
    • Slight improvement in the security situation : The last armed attack on the teams and operations of the Ebola response, which cost the life of Dr. Richard Valery Mouzoko Kiboung, dates back more than a month. Although threats against the response remain high, the reduction in targeted attacks has allowed teams to catch up with the spread of the epidemic. However, the security situation remains volatile and unpredictable. With respect to incidents of reluctance or community resistance, the majority of these incidents are resolved through the involvement of community leaders, sensitizers and psychosocial experts.
    • Geographic containment of the epidemic Despite the difficulties of the response teams in doing their job because of the security situation, the epidemic continues to be contained geographically, thus protecting the rest of the country and neighboring countries. To date, no cases of Ebola have crossed the borders of the Democratic Republic of Congo and the epidemic has not spread to the most risky major urban centers, namely Goma, Bunia and Kisangani. However, the risk remains high given the significant movement of the population. In addition, since the beginning of the epidemic, 188 health areas in 22 health zones across the provinces of North Kivu and Ituri have recorded at least one case of Ebola. As of 2 June 2019, nine health zones, including 106 health areas (56% of the total), have spent more than 21 days without notifying new confirmed cases. The nine health zones concerned are Kyondo, Oicha, Kayna, Mutwanga, Komanda, Bunia, Rwampara, Nyankunde and Tchomia.
  • The main challenges to be met to end this epidemic are:
    • Epidemiological surveillance : In order to break the chain of transmission, all contacts of confirmed cases must be listed and followed for 21 days. Now, among the 911 new confirmed cases reported from 1 [SUP]th [/SUP]January and May 7, 2019, only 398 (44%) were registered as regular contacts. Thus, listing and follow-up of contacts needs to be strengthened by involving more the authorities and community leaders.
    • Infection Prevention and Control (ICP) : Infection prevention and control measures need to be strengthened in community health facilities to reduce the rate of nosocomial infection. Between 25 and 30% of infections occur in health facilities.
    • Community deaths : The community death rate remains high. Between 28 and 43% of deaths reported each week occur outside of an Ebola treatment center or transit center. These deaths occur either in private hospitals and clinics, in community health centers or at home. However, the contagiosity of a patient being maximum after his death, dignified and secure burials can limit the community spread of the virus. What is positive is that the majority of community deaths have a dignified and secure burial.
  • A comprehensive analysis of the evolution of the ongoing Ebola outbreak is available in a scientific article written by Dr. Oly Ilunga Kalenga, Dr. Tedros A. Ghebreyesus and Dr. Matshidiso Moeti.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=307c1f0c6f
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Tuesday, June 4, 2019

The epidemiological situation of the Ebola Virus Disease dated June 3, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,020, 1,926 confirmed and 94 probable. In total, there were 1,354 deaths (1,260 confirmed and 94 probable) and 542 people healed.
  • 305 suspected cases under investigation;
  • 12 new confirmed cases, including 4 in Mandima, 2 in Katwa, 2 in Mabalako, 2 in Butembo, 1 in Beni and 1 in Kalunguta;
  • 8 new confirmed cases deaths:
    • 6 community deaths, including 3 in Mandima, 1 in Butembo, 1 in Katwa and 1 in Beni;
    • 2 deaths at CTE, including 1 in Mabalako and 1 in Katwa;
  • 3 new healings from the CTE, 2 in Beni and 1 in Butembo.
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The Komanda lab was robbed overnight on June 3-4, 2019. The thieves took away two laptops, a GeneXpert device used to test samples and other materials found in the lab.

A dozen people were killed by suspected rebels during an armed incursion in the neighborhood of Rwangoma, in Beni, which occurred on the night of June 3, 2019. Exchanges of fire began in the evening, shortly after the response teams left Rwangoma where they organized a community dialogue. This Tuesday morning, hundreds of protesters took to the streets and several commercial activities were paralyzed in the city. The Beni response teams worked slowly and cautiously, but no response activity was temporarily suspended.
...
110 Contaminated health workers

1 Beni health worker, vaccinated, was among the new confirmed cases of the day of 1 th June 2019.
The cumulative number of confirmed / probable cases among health workers is 110 (5.4% of all confirmed / probable cases) including 37 deaths.
...

https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=3058738c30
 
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, June 5, 2019

The epidemiological situation of the Ebola Virus Disease dated June 4, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,025, 1,931 confirmed and 94 probable. In total, there were 1,357 deaths (1,263 confirmed and 94 probable) and 552 people healed.
  • 295 suspected cases under investigation;
  • 5 new confirmed cases, 2 in Katwa, 1 in Kalunguta, 1 in Mabalako and 1 in Mandima;
  • 3 new confirmed cases deaths:
    • 2 community deaths, 1 in Katwa and 1 in Kalunguta;
    • 1 death at the CTE of Mabalako;
  • 10 new healed from the CTE, including 8 in Katwa and 2 in Butembo.
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  • The Minister of Health undertook a two-day mission to Goma, Beni and Aloya (Mabalako). Mabalako, which was the epicenter of the epidemic in August 2018, is facing a new outbreak concentrated in the health area of ​​Aloya. Nearly one third of new confirmed cases recorded in the last 21 days come from this area, making Mabalako the first hot spot of the outbreak followed by Butembo and Katwa.
  • During the Minister of Health's visit to Aloya, a popular assembly was held in the city center with a delegation of customary chiefs. The population was very receptive to the awareness messages and committed to ending Ebola at home as soon as possible.

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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ad47b18ff1
 
WHO sees progress in Ebola response, but others see a grimmer reality

By HELEN BRANSWELL JUNE 6, 2019
...
The CDC?s director, Dr. Robert Redfield, warned Tuesday that the world needs to prepare for the possibility the epidemic could drag on for another year or two. And Tariq Riebl, an emergency response director for the International Rescue Committee, said the sharp rise in case in cases this spring, at a time when an outbreak ought to be coming under control, suggested drastic changes are needed. ?This response requires a total and complete reset,? Riebl said.

The WHO?s Dr. Mike Ryan, who is executive director of the global health agency?s emergencies program, said Redfield?s estimation was a worst-case scenario.
...
https://www.statnews.com/2019/06/06...la-response-but-others-see-a-grimmer-reality/

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UN says about 25% of Ebola cases could be going undetected

2 hours ago

GENEVA (AP) ?
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Ryan told journalists in Geneva that WHO believes it is probably detecting only 75 percent of all Ebola cases.
...
https://www.apnews.com/8b5341809e1e4c7c885a52a9e661e843
 
Translation Google

Ebola: the procession of the Minister of Health stoned at the entrance of the City of Beni

2019-06-05

The official Procession of the Minister of Health of the DRC, Oly Ilunga has just been attacked this Wednesday, June 5, 2019 at the entrance of the City of Beni in North Kivu by unknown persons.

"In this convoy was the National and Provincial Ministers of Health, they were accompanied by the coordination of the response when they would have met a motorcade of bikers who were driving in the opposite direction to go to bury a person," said the communication service of the Ministry of Health. And to add:

And to add: "People who were part of the procession or passers-by would have begun throwing pebbles on the official vehicles.It was at the entrance of the city of Beni. There would be a slightly injured person who would already be transported to the hospital for care. The hospital is located in the Komanda Health Zone, "said the DirCom of the Ministry of Health.

This attack against the officials comes one day after the robbery of the Laboratory of the same zone of health of Komanda. The latter is located in the territory of Irumu, in the province of Ituri. The attack took place on the night of June 3 to 4, according to a report by the same ministry.

The balance sheet reported two laptops, a GeneXpert device used to test samples and other materials found in the laboratory carried by these incivists.

One day and a few hours earlier, on the night of June 3, 2019, another armed attack by the alleged rebels took place in the Rwangoma neighborhood, still in Beni. During this incursion, sources on the spot reported the death of a dozen civilians.

Exchanges of fire would have started in the evening, shortly after the response teams left Rwangoma where they organized a community dialogue.
...
https://sunriserdc.com/postview.php?Cat=2&Article=346

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DRC-Beni: vehicles of Minister Oly Ilunga procession stoned

46 minutes ago By Editor

(Kinshasa, June 6, 2019) the facts occurred at Bundji 5 km from the city center of Beni where the vehicles of the delegation have faced projectiles.

Some vehicles saw their windows broken by protesters denouncing the killings of 11 civilians this June 5, 2019 in Rwangoma and Kimbya, perpetrated by the alleged Ugandan rebels Adf.

This stone attack occurred on the way back from the town of Cantine-Aloya in the territory of Beni where health minister Oly Ilunga went to sensitize the population in the fight against the Ebola virus disease.
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Eriksson Luhembwe/DEPECHE.CD

http://www.depeche.cd/rdc-beni-les-v...ga-caillasses/
 
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Thursday, June 6, 2019

The epidemiological situation of the Ebola Virus Disease dated June 5, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,031, 1,937 confirmed and 94 probable. In total, there were 1,367 deaths (1,273 confirmed and 94 probable) and 552 people healed.
  • 293 suspected cases under investigation;
  • 6 new confirmed cases, 2 in Musienene, 2 in Mandima, 1 in Butembo and 1 in Mabalako;
  • 10 new confirmed cases deaths:
    • 3 community deaths, including 1 in Butembo, 1 in Musienene and 1 in Mabalako;
    • 7 deaths at CTE, including 4 in Mabalako and 3 in Butembo.
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https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=97857be35c
 
Source: https://www.who.int/csr/don/06-june-2019-ebola-drc/en/
[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
6 June 2019

As the Ebola virus disease (EVD) outbreak surpasses the 2000 case mark, indicators over the past two weeks provide early signs of an easing of the transmission intensity. This follows a period of improved security and therefore access to communities, allowing response teams to operate more freely. A total of 88 confirmed cases were reported each week for the past two epidemiological weeks, down from a peak of 126 cases per week observed in April. Declines in the incidence of new cases have been most apparent in hotspots such as Katwa, Mandima and Beni health zones. Concurrently, improvements in the proportion of cases among contacts registered prior to onset (up from 30% three weeks ago to 55% last week), and a lower proportion of cases resulting from transmission within community health facilities (from 31% during the first week of April 2019 to 9% during the last week of May 2019), are encouraging. Nevertheless, both indicators are below where we would aim to be. The outbreak continues to be contained within 12 active health zones in North Kivu and Ituri provinces.
However, substantive rates of transmission continue within affected communities, and further waves of the outbreak may be expected. An increase in the incidence of new cases has been reported from Mabalako Health Zone in recent weeks, and high infection rates continue within Butembo metropolitan. Times between detecting, reporting and admission of cases at Ebola treatment/transit centres (ETCs) remains too long (median 6 days, interquartile range 4?9 days in the past 3 weeks), with about a third (34% in the past 3 weeks) of cases dying outside of ETCs. Collectively these indicators highlight that the risks associated with this outbreak remain very high.
In the 21 days between 15 May to 4 June 2019, 80 health areas within 12 health zones reported new cases, representing 12% of the 664 health areas within North Kivu and Ituri provinces (Table 1 and Figure 2). During this period, a total of 280 confirmed cases were reported, the majority of which were from the Mabalako (27%, n=75), Butembo (23%, n=63), Katwa (16%, n=44), Beni (11%, n=30), Kalunguta (8%, n=23), Mandima (7%, n=19) and Musienene (5%, n=14) health zones.
As of 4 June 2019, a total of 2025 EVD cases, including 1931 confirmed and 94 probable cases, were reported. A total of 1357 deaths were reported (overall case fatality ratio 67%), including 1263 deaths among confirmed cases. Of the 2025 confirmed and probable cases with known age and sex, 58% (1170) were female, and 29% (589) were children aged less than 18 years. The number of healthcare workers affected has risen to 110 (5% of total cases).
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 4 June 2019*[/h]
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*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
[h=4]Figure 2: Confirmed and probable Ebola virus disease cases by health area, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 4 June 2019[/h]
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[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 4 June 2019**[/h]
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**Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
[h=3]Public health response[/h] For further detailed information about the public health response actions by the MoH, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:
[h=3]WHO risk assessment[/h] WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Weekly increases in the number of new cases were observed from February through mid-May 2019, with lower though still substantial rates since then. A general deterioration of the security situation, and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity, especially over the past four weeks, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas, reducing the overall effectiveness of interventions. However, recent community dialogue, outreach initiatives, and restoration of access to certain hotspot areas have resulted in some improvements in community acceptance of response activities and case investigation efforts. In order to ensure staff safety and security, security mitigation measures are being enhanced, and procedural, operational, and physical security challenges are being addressed. The high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to nosocomial infection, persistent delays in detection and isolation in ETCs, and challenges in the timely reporting and response to probable cases, are all factors increasing the likelihood of further chains of transmission in affected communities and increasing the risk of geographical spread both within the Democratic Republic of the Congo and to neighbouring countries. The high rates of population movement occurring from outbreak affected areas to other areas of the Democratic Republic of the Congo and across porous borders to neighbouring countries during periods of heightened insecurity further compounds these risks. Additional risks are posed by the long duration of the current outbreak, fatigue amongst response staff, and ongoing strain on limited resources. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have likely increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up.
[h=3]WHO advice[/h] WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Friday, June 7, 2019

The epidemiological situation of the Ebola Virus Disease dated June 6, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,039, 1,945 confirmed and 94 probable. In total, there were 1,373 deaths (1,279 confirmed and 94 probable) and 552 people healed.
  • 283 suspected cases under investigation;
  • 8 new confirmed cases, including 3 in Mabalako, 2 in Mandima, 1 in Beni, 1 in Butembo and 1 in Katwa;
  • 6 new confirmed case deaths:
    • 5 community deaths, 2 in Mabalako, 2 in Mandima and 1 in Beni;
    • 1 death at the CTE of Butembo.
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111 Contaminated health workers

One Mabalako health worker, vaccinated, was one of the new confirmed cases.

The cumulative number of confirmed / probable cases among health workers is 111 (5.4% of all confirmed / probable cases), including 37 deaths.
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North Kivu-Ebola: Altercation between the population and the response team this Saturday in Cantine

Sat 08/06/2019 - 17:29

Ebola 7SUR7.CD

The situation remained hectic this Saturday in Mangato district, Cantine-Aloya locality in Beni territory.

Indeed, it was reported an uprising of the population against Ebola response teams that came from Mangina to fight against this virus in this part of the territory of Beni where many positive cases are currently recorded.

According to Mangina's civil society, despite the sensitization, the population of Cantine persists in their doubts about the existence of this epidemic in the eastern part of the country.

Unfortunately, he laments, patients who flee this locality come again contaminate the city of Mangina where the virus is more and more contained by the response for some months now.

Civil society reports that it was the inhabitants of Cantine, in collusion with the Mai-Mai, who forced the response teams to turn back and that the worst would be lived if the police did not intervene in time.

"It has been a week since Ebola cases are being registered at the Mangina Ebola treatment centers, and most of these cases come from Cantine and Mabalako. The population has risen against the response teams, all the teams have returned to the base, and we learn at the last minute that it is the mixed population of the Mai-Mai, "said the civil society.

Other sources report that a lady was hit by a bullet during this tug.

Isaac Kisatiro from Butembo

https://www.7sur7.cd/2019/06/08/nor...ation-et-lequipe-de-riposte-ce-samedi-cantine
 
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EPIDEMIOLOGICAL SITUATION​
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[TD="class: mcnTextContent"] EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Saturday, June 8, 2019

The epidemiological situation of the Ebola Virus Disease dated June 7, 2019 :
  • Since the beginning of the epidemic, the cumulative number of cases is 2,047, of which 1,953 are confirmed and 94 are probable. In total, there were 1,381 deaths (1,287 confirmed and 94 probable) and 556 people healed.
  • 273 suspected cases under investigation;
  • 8 new confirmed cases, including 3 in Mandima, 2 in Katwa, 1 in Rwampara, 1 in Butembo and 1 in Mabalako;
  • 8 new confirmed cases deaths:
    • 4 community deaths, including 1 in Mandima, 1 in Rwampara, 1 in Butembo and 1 in Mabalako;
    • 4 CTE deaths, 2 in Mabalako, 1 in Beni and 1 in Katwa;
  • Four new cures emerged from CTEs, including 3 in Butembo and 1 in Beni.
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/! \ The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas .


Remarks:
  • In order to prevent the total number of cases from 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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[TD="class: mcnTextContent, width: 546"] Distribution of Ebola Virus Disease (EVD) cases by health zone in the provinces of Ituri and North Kivu as of 7 June 2019.
  • 1 new health zone did not report a case for 21 days: Lubero.
  • 1 health zone has started to report cases again: Rwampara
  • In total, 11 of the 22 affected health zones did not report new confirmed cases for at least 21 days.
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Epidemiological curve since January 2019 ​
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NEWS​
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Community deaths in Rwampara
  • The community death in Rwampara Health Zone, Ituri province, is the mother of a child who died of Ebola in Oicha at the beginning of May. She was neither vaccinated nor followed. When she became ill, she was treated for home poisoning by a traditional healer. After a few days, she was admitted to a first health post. Due to the deteriorating symptoms, her family wanted to transfer her to another health center but she died on the way. The dignified and secure burial has been realized.
"Everything about Ebola" conference at the University of Assumption in Congo (UAC)
  • This Saturday, June 8, 2019, an Ebola conference was organized for UAC students in Butembo. The students had the opportunity to ask all their questions about the disease and about the response mechanisms to the teams present at the conference. They talked about vaccines, response strategies, and how to manage the disease. Several Ebola conferences are organized in the different universities of Butembo to inform the students who will, in turn, raise their awareness.
Situation of providers in Mabalako
  • Contrary to civil society statements, no providers' strike took place in Mabalako this Saturday, June 8, 2019, and the response activities proceeded as planned.
  • Regarding the payment of Ebola premiums from providers working in the Mabalako sub-coordination, the Ministry of Health was informed of irregularities in the payment of these premiums by national, provincial and local agents. These irregularities take the form of unjustified extensions in the field and an organized system of double premium payments. The General Inspectorate of Health has been seized and investigations are under way.
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