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

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Outbreaks and Emergencies Bulletin, Week 37: 9 - 15 September 2019
...
Democratic Republic of the Congo

3 116 Cases
2 090 Death
67% CFR

EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu and
Ituri provinces in Democratic Republic of the Congo continues, with 13
health zones and 51 health areas reporting confirmed cases in the past
21 days (24 August to 13 September 2019). Since our last report on 8
September 2019 (Weekly Bulletin 36), there have been 37 new confirmed
cases and 26 new deaths. The principle hot spots of the outbreak in
the past 21 days are Kalunguta (22%; n=35), Mambasa (17%; n=28),
Mandima (15%; n=24) and Beni (13%; n=21). Nine health zones, namely
Mambasa, Komanda, Mandima, Kalunguta, Kyondo, Mabalako, Beni,
Kayna and Katwa have reported new confirmed cases in the past seven
days and remain points of attention. The health zones of Alimbongo and
Oicha have a total of 21 days without notification of new confirmed cases.
As of 13 September 2019, a total of 3 116 EVD cases, including 3 005
confirmed and 111 probable cases have been reported. To date, confirmed
cases have been reported from 29 health zones: Ariwara (1), Bunia (4),
Komanda (49), Lolwa (3), Mambasa (49), Mandima (281), Nyakunde
(1), Rwampara (8) and Tchomia (2) in Ituri Province; Alimbongo (5),
Beni (669), Biena (16), Butembo (281), Goma (1), Kalunguta (180),
Katwa (648), Kayna (26), Kyondo (25), Lubero (31), Mabalako (373),
Manguredjipa (18), Masereka (50), Musienene (84), Mutwanga (32),
Nyiragongo (3), Oicha (55), Pinga (1) and Vuhovi (103) in North Kivu
Province and Mwenga (6) in South Kivu Province.

As of 13 September 2019, a total of 2 090 deaths were recorded,
including 1 979 among confirmed cases, resulting in a case fatality ratio
among confirmed cases of 66% (1 979/3 005). The cumulative number
of health workers affected is now 159, which is 5% of the confirmed and
probable cases to date.

Contact tracing is ongoing in 14 health zones. A total of 13 294 contacts
are under follow-up as of 13 September 2019, of which 11 891 have been
seen in the past 24 hours, comprising 89% of the contacts, comparable
to that during the past seven days (90%). Alerts in the affected provinces
continue to be raised and investigated. Of 3 093 alerts processed (of
which 2 980 were new) in reporting health zones on 13 September 2019,
2 992 were investigated and 497 (17%) were validated as suspected
cases.

PUBLIC HEALTH ACTIONS

Surveillance activities continue, including case investigations, active
case finding in health facilities and communities, and identification
and listing of contacts around the latest confirmed cases. Crossborder collaboration continues, particularly in Uganda and Rwanda.

As of 13 September 2019, a cumulative total of 220 529 people has
been vaccinated since the start of the outbreak in August 2018.

Point of Entry/Point of Control (PoE/PoC) screening continues, with
over 94 million screenings to date. A total of 111/117 (95%) PoE/
PoC transmitted reports as of 13 September 2019.

The protocol for treatment of Ebola patients in Democratic Republic
of the Congo has been revised following data from a randomized
clinical trial showing, for the first time, that Ebola treatments improve
survival rates. Two of the four trial drugs were found to have the
greatest efficacy and are now being provided to confirmed cases
under the compassionate use protocol.

There are continued community reintegration and psychosocial
activities for patients discharged from ETCs, along with
psychoeducation sessions to strengthen community engagement
and collaboration in the response.

Water, sanitation and hygiene (WASH) activities continue and during
this week, 136 households and two schools were equipped with
infection prevention and control and WASH inputs.

Community awareness and mobilization messages are being updated, revised and
harmonized and have been pre-tested by the commission and will subsequently be
shared in coordination and sub-coordination activities.

In Butembo a dialogue was held with community leaders and transit agency
officials to reinforce their commitment to strict adherence to prevention measures
in the community, including points of entry and WASH measures; in Mutwanga, the
Ruwenzori Sector Chief appealed for the community to collaborate with response
teams and compliance with hygiene measures; in Mwenga, 63 local leaders, school
authorities and women?s association members from Kalambi health area were briefed
on EVD and community engagement.

SITUATION INTERPRETATION

There are early signs of the outbreak easing, including the decrease in numbers of new
confirmed cases in Beni and Mandima and the lack of new confirmed cases for 21 days in
Alimbongo and Oicha. However, it is too soon to know if this is an indication of a decrease
in transmission intensity of EVD. Local authorities and partners need to continue their robust
response to the disease, using both novel and proven public health measures to ensure that
there is no further geographical spread of the disease.

https://apps.who.int/iris/bitstream/handle/10665/327408/OEW37-0915092019.pdf

https://www.afro.who.int/node/11740

 

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Ebola: finally, a second vaccine will be used in the DRC

Wednesday 18 September 2019 - 12:51

ACTUALITE.CD

The DRC will introduce a second vaccine in the fight against Ebola virus disease from 15 October.

Dr. Eteni Longondo, Minister of Health, is preparing to sign the letter authorizing this second vaccine of his return from the mission he began since Monday in eastern DRC.

This vaccine is produced by Janssen Pharmaceutica, a Belgian pharmaceutical company subsidiary of Johnson & Johnson, based in Beerse in the province of Antwerp. The first clinical trials of this product were conducted in Sierra Leone.

So far, the only vaccine to be used is rVSV-ZEBOV, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of May 20, 2018.

https://actualite.cd/2019/09/18/ebola-finalement-un-deuxieme-vaccin-va-etre-utilise-en-rdc

 

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Translation Google

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 17
SEPTEMBER 2019

Date: Wednesday, 18 September 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,145, of which 3,034 confirmed and 111 probable. At
In total, there were 2,103 deaths (1,992 confirmed and 111 probable) and 961 people healed.

 430 suspected cases under investigation;

 15 new confirmed cases, including:
o 8 in North Kivu, including 4 in Beni and 4 Kalunguta;
o 7 in Ituri, including 5 in Mambasa, 1 in Komanda and 1 in Mandima.

 5 new confirmed deaths, including:
o 2 community deaths, including 1 in North Kivu in Kalunguta and 1 in Ituri in Mambasa;
o 3 confirmed deaths, 2 in North Kivu in Mabalako and 1 in Ituri in Komanda.

 1 person cured out of CTE in North Kivu in Butembo.

 No health worker is among the newly confirmed cases. The accumulation of cases
confirmed / probable among health workers is 159 (5% of all cases
confirmed / probable), including 41 deaths.
...

NEWS

Endorsement of the SRP4 operational action plans in Goma by the Minister of Health

 The Minister of Health, Dr. Eteni Longondo, endorsed this Wednesday, September 18, 2019 at
Headquarters for the Coordination of the Ebola Response to the #Ebola Virus Disease in Goma
in North Kivu Province, the Operational Action Plan (OAP) of the Fourth Plan
strategic response (SRP 4.1);

 He did so on behalf of the Congolese Government in the presence of the Technical Secretary of the Committee
multi-sectoral response in the provinces of North Kivu and Ituri, stating that
the development of these plans is of a participatory nature while emphasizing the obligation of
regularity of technical and financial reporting;

 "I remain attentive to the evolution of the epidemic and plan to organize by the end of October an evaluation
halfway through the implementation of the PRS 4, "said Minister Eteni,

 This endorsement is fourth on the five orientations that the Minister of Health, end mission
in North Kivu and Ituri, to give the teams of the response for the continuation of their activities on ground.

 The other four orientations include the effective use of expertise
response to #MVE alongside international experts supporting the DRC in
this frame. To this end, he requested the technical secretariat of the CMRE and the management of the
epidemiological surveillance to forward the list of all national experts on the #MVE
for an urgent deployment aimed at gap coverage in Human Resources;

 He also emphasized financial accountability in addition to technical accountability, prior to
officially surrender, five all-terrain vehicles on the ten acquired government of the
Republic. These vehicles will support the various field activities;

 He invited the coordination of the response to reflect on the rationality of many of the actors
which are now planned at around 10,000 for communication,
epidemiological surveillance and follow-up of contacts;

 He finally promised, in the context of the multisectoriality of the response, to share with his colleagues
concerned with the pillars of security, community involvement and funding to follow closely
implementation of these other pillars of support to the public health pillar with a view to resolving
weaknesses in the implementation of the earlier Plans of the response;

 In addition, the Deputy General Coordinator of the Response, Dr. Justus Nsio Mbeta, established the
difference between SRP3 and SRP4. The SRP4, he said, was built on the analysis of the SRP3 based
essentially on the pillar of the public health response with a security base, while
PRS 4 is proposed along with three other pillars, namely improving engagement
security and other services, as well as the planning and monitoring of
Finance ._ *

Minister of Health Visits Epidemic Response Laboratory at #Ebola Virus Disease

 Prior to his return to Kinshasa, the Minister of Health, Dr. Eteni Longondo, paid a visit to
Goma Provincial Hospital, where he inquired about the day-to-day work of the lab technicians
committed to the response to the #Ebola Virus Disease epidemic;

 He took the opportunity to visit the various services of this health facility
before declaring that this visit is part of the strengthening of
health targeting access to quality care for all Congolese;

 For the #Ebola virus disease, Dr Eteni deplored, in general, the resistance of
communities with regard to this Disease. #EVD, he said, is a reality that continues
to threaten the Congolese people. Nevertheless, he pointed out, we are witnessing
a lower mortality rates. _*
...
https://www.dropbox.com/s/u8i3my874ggn2xx/CMRE_Bulletin Ebola du 18 septembre 2019.pdf?dl=0

 

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Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news: Update
19 September 2019

The intensity of the Ebola virus disease (EVD) transmission in the Democratic Republic of the Congo increased slightly from last week, with 57 new confirmed cases reported in North Kivu and Ituri provinces from 11-17 September 2019 versus 40 in the previous week. In the past week, localised, minor security incidents have impacted the response, including safe and dignified burials (SDB) and vaccination activities in Mambasa and Komanda Health Zones.

In addition, there was a major security incident in Lwemba, within Mandima Health Zone, from 14-17 September. The event was a community response to the death of a local healthcare worker from EVD. Due to the violence that occurred during the incident, all activities have been suspended in the area until further notice. This has a serious impact on the response activities on the ground, and it could lead to gaps or delays in the reporting of new EVD cases in this hotspot area. Overall, these incidents underscore the need for continued and proactive engagement and sensitizing of local communities throughout areas with EVD transmission and high-risk areas that may not currently be affected.

During the past 21 days (from 28 August through 17 September 2019), a total of 145 confirmed cases were reported from 14 health zones (Table 1, Figure 2), with the majority coming from the health zones of Kalunguta (21%, n=30), Mambasa (21%, n=30), and Mandima (19%, n=27). With 14 cases in the last 21 days, there is a relative decrease in cases coming from Beni Health Zone. Masereka and Lolwa Health Zones cleared 21 days without a new confirmed case of EVD.

As of 17 September, a total of 3145 EVD cases were reported, including 3034 confirmed and 111 probable cases, of which 2103 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1760) were female, 29% (898) were children aged less than 18 years, and 5% (159) were health workers.

Under Pillar 1 of the current Strategic Response Plan, the estimated funding requirement for all partners for the period July to December 2019 is US$ 287 million, including US$ 120-140 million for WHO. As of 19 September 2019, close to US$ 60 million have been received by WHO, with further funds committed or pledged. Currently available funds will close the financing gap just up until the end of October 2019. Further resources are needed to fund the response through to December 2019. WHO is appealing to donors to provide generous support. A summary of funding received by WHO since the start of this outbreak can be found here.

Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 17 September 2019*

Enlarge image

*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi.

Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 17 September 2019*

Enlarge image

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 17 September 2019**

Enlarge image

**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.

Public health response

For further information about public health response actions by the Ministry of Health, 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

WHO risk assessment

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, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.

Given the continued shift in outbreak hotspots, heterogeneity in transmission dynamics, and suspected delays in reporting due to security incidents, marginal variations in case numbers need to be interpreted with caution. These factors, coupled with high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of the Congo, and across porous borders to neighbouring countries, increase the risk of geographical spread – both within the Democratic Republic of the Congo and to neighbouring countries. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up and sustained.

WHO advice

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 travellers to/from the affected countries. 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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

...
https://www.who.int/csr/don/19-septe...-ebola-drc/en/

 

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Translation google

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 19
SEPTEMBER 2019

Date: Friday, September 20th, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,157, of which 3,046 confirmed and 111 probable. At

In total, there were 2,111 deaths (2000 confirmed and 111 probable) and 966 people healed.

 503 suspected cases under investigation;

 7 new confirmed cases, including:
o 1 in North Kivu, Katwa;
o 6 in Ituri, including 5 in Mambasa, 1 in Komanda.

 3 new confirmed deaths, including:
o No community deaths among confirmed cases;
o 3 confirmed deaths in North Kivu, including 2 Butembo and 1 in Beni.

 3 cured people released from the CTE in North Kivu, including 1 in Beni, 1 in Butembo and 1 in Katwa.

 One health worker, living and unvaccinated, is one of the new confirmed cases in Katwa. The
cumulative confirmed / probable cases among health workers is 160 (5% of all
confirmed / probable cases), including 41 deaths.
...

NEWS

Clarification of the Technical Secretary of the Multisectoral Committee on the Response to the Epidemic to Disease
to virus #Ebola, the Prof. Jean Jacques Muyembe Tamfum, on the introduction of the second vaccine against
the #Ebola virus in #RDC

 The second vaccine is not an invention of Prof Muyembe or his team. It's a
recommendation of the special group advising WHO on immunization. At its
meeting of May 7, 2019, this group made two main recommendations. The first was
the use of the full dose of the rVSV-ZEBOV vaccine so far, ie 1 mm per individual and
prediction of a possible shortage, we advise the use of the second adjusted dose of 0.5
mm to gain the number of dose to give to the contacts.

 If the epidemic continues, there will always be the risk of stock-outs. Hence the recommendation
to use the second vaccine, especially preventive. We have made an inventory of candidates
current vaccine at the National Institute for Biomedical Research (INRB), as an institute
research, and we selected three vaccine candidates. These are Chinese, Russian and
American-Belgian (including the Jonshon & Jonshon (J & J) vaccine).

 When we pass all the criteria, we realize that the J & J vaccine has the most data
scientists. This justifies our choice on J & J which has passed several stages demonstrating that it is
nontoxic and can protect.

 The only problem for this vaccine is that it will give itself in two bites. The first bite protects
against the #Ebola Zaire virus and the second, which is 25 or 50 days later, protects against
other # Ebola viruses (Sudan, Bundibudio, etc.). Everyone knows that # Republic
# # of the Congo, there are two viruses circulating: #Ebola Zaire virus and type
Bundibudio. The J & J vaccine will protect the population against these two viruses that circulate in the
country.

 This vaccine is safe for the population. It has already been used in Uganda and it is the
second year that we continue to vaccinate the population with this vaccine in Guinea. Currently,
Rwanda is ready to use this vaccine to protect its population that comes for reasons of
trade in # Democratic Republic of #Congo.

 It is a vaccine that other countries use and why we can not use it in the DRC
to protect our people. Do not confuse the two vaccines. The rVSV-ZEBOV vaccine
currently used, concerns infected areas, namely the provinces of # North Kivu and
# Ituri, while the second vaccine will be used in uninfected areas. We think
first, to protect all these small Congolese merchants who go to Rwanda all day,
because at least 64 thousand people cross each day at the Little Goma Barrier to go to
Rwanda. We must also protect Rwanda.

 We will first start by vaccinating this population and then expanding it to create
a corridor of people certainly immune to South Kivu who has been threatened. Where we are
want to protect this population and also protect caregivers, as well as all
those who work in the care structures.

...
https://www.dropbox.com/s/lbii08w4uo1sxyj/CMRE_Bulletin Ebola du 20 septembre 2019.pdf?dl=0

 

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Translation Google

Ituri: For support to the Komanda CTE which has more confirmed positive EVD cases

Bunia, 21 Septe 2019 (ACP) .- The head of the Ebola Treatment Center (CTE) of Komanda, Claude Banga pleaded Thursday for the presence of a permanent partner of the central government to support daily this CTE which has more confirmed positive cases of Ebola virus disease in bed compared to all CTEs opened today in the country, 23, during the visit of the Special Representative of the UN Under-Secretary-General in charge of Ebola response, David Gresly.

He said that since August 1, 2019, there is no longer a permanent partner outside the international NGO Samaritan's Purse that supports the CTE, but he said, this assistance is not not feeling, resulting in poor patient care resulting in lack of food, lack of fuel for the light and the problem of drugs. ACP / ZNG / KJI

https://acpcongo.com/ituri-pour-lap...compte-plus-de-cas-positifs-confirmes-de-mve/


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Seven Ebola patients cured and released Saturday from CTEs in north-eastern DRC

Kinshasa, 22 September 2019 (ACP) .- Seven Ebola patients were cured and released on Saturday from Ebola treatment centers (ETCs) in northeastern DRC, including six in Komanda, Ituri, and one in Beni. North Kivu, reports the daily bulletin on the epidemiological situation of this disease reached Sunday at the ACP.

According to the source, three new confirmed cases were also recorded on the same Saturday, including one Beni, one in Mambasa and one in Mandima. There were also three new confirmed case deaths, two in Komanda and one in Katwa. Note that no community deaths were reported among confirmed cases.

Since the declaration of this Ebola outbreak on August 1, 2018, the cumulative number of cases is 3,160, of which 3,049 are confirmed and 111 are probable. In total, there were 2.114 deaths (2003 confirmed and 111 probable) and 973 people healed. Currently, 491 suspected cases are under investigation.

...
https://acpcongo.com/sept-malades-debola-gueris-et-sortis-samedi-des-cte-au-nord-est-de-la-rdc/

 

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Ebola in Ituri: 9 new cases registered in Butama

Posted on Sun, 22/09/2019 - 16:08 | Edited on Sun, 22/09/2019 - 16:08

Nine positive Ebola cases were notified between Wednesday and Friday 20 September in Butama, a village located 15 km from Mambasa center on the Mambasa-Makeke axis in the Mputu group. The information was given this Sunday, September 22 by Dr. Pascal Mbukana, Chief Medical Officer of Mambasa Health Zone.

According to him, these patients are among the people who had opposed receiving the vaccine after handling the corpses of people who died of this disease in this village. He added that the residents of this entity had also refused to allow the response team to decontaminate infected households.

The nine patients are being treated at the Ebola treatment center in Mambasa center, reassured Dr. C?lestin Mwanzembe, coordinator of the response to Mambasa.

A medical team organized on Friday, September 20, a field trip to vaccinate high-risk people, disinfect the affected households and raise awareness to collaborate with the response team. This, in order to cut the chain of transmission of this epidemic that continues to plague this region.

Since the beginning of the epidemic, the cumulative number of cases is 3,157, of which 3,046 confirmed and 111 probable.

In total, there were 2,111 deaths (2000 confirmed and 111 unlikely) and 966 people healed, reports the Multisectoral Committee's Ebola Response Bulletin.

The same document indicates that 503 suspected cases under investigation.

https://www.radiookapi.net/2019/09/...la-en-ituri-9-nouveaux-cas-enregistres-butama

 

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Independent Ebola vaccination committee is needed to overcome lack of WHO transparency

Press Release 23 September 2019
...
PARIS/GOMA ? More than a year into the ongoing Ebola outbreak in northeastern Democratic Republic of Congo (DRC), the disease has killed over 2,000 people. The mortality rate in this outbreak is around 67 per cent, which is comparable with the mortality rate in the 2014-2016 West Africa outbreak, when neither therapeutic treatments, nor a vaccine, were available. While a highly effective vaccine is now able to offer some protection, the number of people vaccinated is not enough. The pace of vaccination activities is too slow and only a fraction of the eligible population is benefiting from this critical tool, says M?decins Sans Fronti?res (MSF). One reason is the opaque management of the vaccine supplies by the World Health Organization (WHO), who imposes strict limits on the number of doses deployed in the field. MSF urges for an independent committee to be formed to manage Ebola vaccination programmes.

...
https://www.msf.org/ebola-drc-independent-ebola-vaccination-committee-needed

 

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Translation Google

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT 21
SEPTEMBER 2019

Date: Sunday, September 22, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,164, of which 3,053 confirmed and 111 probable. At
In total, there were 2,115 deaths (2004 confirmed and 111 probable) and 975 people healed.

 415 suspected cases under investigation;

 4 new confirmed cases, including:
o No confirmed cases have been recorded in North Kivu;
o 4 in Ituri, including 2 in Komanda, 1 in Mambasa and 1 in Mandima.

 1 new confirmed deaths, including:
o No community deaths among confirmed cases;
o 1 confirmed death in Ituri in Komanda.

 2 people cured out of CTE in North Kivu in Beni.

 No health worker is among the newly confirmed cases. The accumulation of cases
confirmed / probable among health workers is 160 (5% of all cases
confirmed / probable), including 41 deaths.
...

https://www.dropbox.com/s/agbrrboa5qkz47i/CMRE_Bulletin Ebola du 22 septembre 2019.pdf?dl=0

 

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Second Ebola vaccine to complement ?ring vaccination? given green light in DRC

23 September 2019 Statement Geneva, Switzerland

The health authorities in the Democratic Republic of the Congo (DRC) have announced plans to introduce a second experimental Ebola vaccine, manufactured by Johnson & Johnson, from mid- October. This vaccine, which is given as a 2-dose course, 56 days apart, will be provided under approved protocols to targeted at-risk populations in areas that do not have active Ebola transmission as an additional tool to extend protection against the virus.

?The DRC authorities, in deciding to deploy the second experimental vaccine to extend protection against this deadly virus, have once again shown leadership and their determination to end this outbreak as soon as possible,? said WHO Director-General, Dr Tedros Adhanom Ghebreyesus.

?The evaluation of the second Ebola vaccine will help ensure that we have potentially an additional tool to prevent the expansion of the outbreak and also a potential tool to protect populations before outbreaks hit areas at risk,? said Dr Matshidiso Moeti, WHO?s Regional Director for Africa.

The Johnson & Johnson vaccine will complement the current vaccine (rVSV-ZEBOV-GP, manufactured by Merck), which has proven highly effective and safe, and which has helped protect thousands of lives. The Merck vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola. To date over 223,000 people have received this vaccination during the current outbreak.

In May 2019, WHO?s Strategic Advisory Group of Experts on Immunization (SAGE) reviewed use of vaccines in the ongoing Ebola outbreak and issued recommendations. These included adjusting the dose of the Merck vaccine, evaluating a second vaccine under appropriate protocols, changing strategies when insecurity makes it difficult to reach people ? such as providing pop-up vaccination stations -- and increasing the number of people vaccinated within communities with ongoing transmission, sometimes vaccinating whole villages.

?In everything we do, we are driven by science,? Dr Tedros said. ?The advice we were given by SAGE in May has been applied, always taking into account community needs and preferences, as we know this will make the approach more effective. The changes made have saved thousands of lives in this outbreak.?

New therapeutics and better use of treatment protocols have also saved many lives. ?To date, 973 people have been successfully treated and released from Ebola treatment centres, and we expect that the 1000th survivor will return to his or her community in the coming weeks,? Dr Moeti said.

Innovative vaccine strategies

The introduction of the second experimental vaccine is in line with the SAGE recommendations as are a number of other innovations.
The main vaccination strategy used with the rVSV-ZEBOV-GP vaccine is a ?ring strategy? where all people who have come into contact with someone with a confirmed case of Ebola are given the vaccine. Where people are stigmatized or feel under threat protected, temporary ?pop-up?, vaccination sites are set up, often at health posts, rather than near the homes of individuals infected with Ebola. This allows people to come for vaccination at a safe, more anonymous site, but also increases protection for vaccinators in areas where there is ongoing conflict and insecurity.

Another approach being used to offer vaccination for people at high risk of contracting Ebola is ?targeted geographic vaccination?. This strategy involves vaccinating everyone in the neighbourhood, or village, rather than vaccinating only the known contacts and contacts of contacts. Targeted geographic vaccination was used successfully when the outbreak spread to Chowe in South Kivu. Over 90 percent of people who are offered vaccination accept it. Since the start of the outbreak WHO and partners have worked to recruit and train Congolese nationals from within Ebola-affected communities as vaccinators to increase community acceptance and also transfer skills to the region. Now, the majority of ring vaccination team members are trained healthcare workers, doctors and medical students from affected communities who speak local languages and understand community concerns.

There are enough vaccine doses on the ground to meet the current needs, with WHO logisticians ensuring a minimum supply of 10,000 doses at all times, and overall supplies of the vaccine are being constantly monitored. Considering the current number of cases being reported and the doses required to vaccinate around each case, the doses available of the rVSV-ZEBOV-GP vaccine are considered sufficient. Merck has provided WHO with 245,000 doses for DRC and neighbouring countries and built a stockpile of 190,000 doses that are ready to send to DRC. Merck also aims to release 650,000 doses over the next six to 18 months under its replenishment strategy. Under the current SAGE recommendations this means that there are 390,000 doses currently and additional 1.3 million doses will be available.

?The Merck vaccine is highly efficacious, and we?ll soon have a second vaccine to increase the number of those being protected against the virus?, said Dr Tedros. ?But vaccine and therapeutics are only some of the tools -- the key to ending the outbreak is community ownership. With the communities fully engaged, and with all partners stepping up and rallying behind our common goal, we can and will end this outbreak.?

https://www.who.int/news-room/detai...ent-ring-vaccination-given-green-light-in-drc

 

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[FONT=&quot]Barry Rodrigue‏ @barryr33082845 8h8 hours ago [/FONT]

[FONT=&quot]Butama a village located at 15 km to #Mambasa. The situation is critical. Number of positive cases have been reported. It's urgent for @BarakaHumudi @WHO #RCCE and the team to Strengthen #Riskcommunication & Community Engagement activities. Dr Celestin MoH is part of this mission[/FONT]

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Outbreaks and Emergencies Bulletin, Week 38: 16 - 22 September 2019
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Ebola virus disease Democratic Republic of the Congo

3 164 Cases
2 115 Deaths
67% CFR

EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu and
Ituri provinces in Democratic Republic of the Congo continues, with 13
health zones and 43 health areas reporting confirmed cases in the past
21 days (1-21 September 2019). Since our last report on 15 September
2019 (Weekly Bulletin 37), there have been 48 new confirmed cases and
25 new deaths. The principle hot spots of the outbreak in the past 21
days are Mambasa (25%; n=33 cases), Mandima (19%; n=25 cases),
Kalunguta (18%; n=23 cases) and Beni (11%; n=14 cases). Eight health
zones, namely Mambasa, Komanda, Mandima, Beni, Katwa, Kayna,
Kalunguta and Biena have reported new confirmed cases in the past
seven days and remain points of attention.

As of 21 September 2019, a total of 3 164 EVD cases, including 3 053
confirmed and 111 probable cases have been reported. To date, confirmed
cases have been reported from 29 health zones: Ariwara (1), Bunia (4),
Komanda (53), Lolwa (3), Mambasa (65), Mandima (289), Nyakunde
(1), Rwampara (8) and Tchomia (2) in Ituri Province; Alimbongo (5),
Beni (675), Biena (18), Butembo (281), Goma (1), Kalunguta (187),
Katwa (650), Kayna (28), Kyondo (25), Lubero (31), Mabalako (373),
Manguredjipa (18), Masereka (50), Musienene (84), Mutwanga (32),
Nyiragongo (3), Oicha (56), Pinga (1) and Vuhovi (103) in North Kivu
Province and Mwenga (6) in South Kivu Province.

As of 21 September 2019, a total of 2 115 deaths were recorded,
including 2 004 among confirmed cases, resulting in a case fatality ratio
among confirmed cases of 66% (2 004/3 053). The cumulative number
of health workers affected remains 160, which is 5% of the confirmed
and probable cases to date.

Contact tracing is ongoing in 14 health zones. A total of 11 335 contacts
are under follow-up as of 21 September 2019, of which 10 154 (90%)
have been seen in the past 24 hours, slightly higher than the percentage
seen in the past seven days (86%). Alerts in the affected provinces
continue to be raised and investigated. Of 2 744 alerts processed (of
which 2 679 were new) in reporting health zones on 21 September 2019,
2 720 were investigated and 415 (15%) were validated as suspected
cases.

On 17 July 2019, the WHO Director-General, Dr Tedros Ghebreyesus
declared the EVD outbreak in Democratic Republic of the Congo a Public
Health Emergency of International Concern (PHEIC), following a meeting
of the International Health Regulations Committee for EVD.

PUBLIC HEALTH ACTIONS

Surveillance activities continue, including case investigations, active
case finding in health facilities and communities, and identification
and listing of contacts around the latest confirmed cases. Crossborder collaboration continues, particularly in Uganda and Rwanda.

Security issues have affected EVD response in Mandima Health
Zone, with cautious resumption of response activities in the Alima
health area, while there have been six days of inactivity in Lwemba
health area.

As of 21 September 2019, a cumulative total of 226 231 people have
been vaccinated since the start of the outbreak in August 2018.

Point of Entry/Point of Control (PoE/PoC) screening continues, with
over 97 million screenings to date. A total of 113/117 (97%) PoE/
PoC transmitted reports as of 21 September 2019.

Five of the 16 alerts notified on 21 September 2019 were validated
as suspected cases; laboratory tests for Ebola virus were negative
in all cases.

The protocol for treatment of Ebola patients in Democratic Republic of the Congo has
been revised following data from a randomized clinical trial showing, for the first time,
that Ebola treatments improve survival rates. Two of the four trial drugs were found to
have the greatest efficacy and are now being provided to confirmed cases under the
compassionate use protocol.

There are continued community reintegration and psychosocial activities for patients
discharged from ETCs, along with psychoeducation sessions to strengthen community
engagement and collaboration in the response.

Water, sanitation and hygiene (WASH) activities continue and during this week, 76
households and 29 public places were equipped with infection prevention and control
and WASH inputs in Mambasa and Beni.

Community awareness and mobilization messages are being updated, revised and
harmonized and have been pre-tested by the commission and will subsequently be
shared in coordination and sub-coordination activities.

In Goma approaches were discussed with Uganda?s communication team on the
community re-integration of a contact in Uganda after 21 days of follow-up; the National
Minister of Health endorsed the first PAO of Strategic Response Plan 4 for the overall
coordination of the EVD response; the representative of the UN Secretary-General for
the EVD response visited teams in Komanda Health Zones? sub-coordination response,
as well as the Makayanga Ebola treatment centre.

SITUATION INTERPRETATION

The persistence of hot spots and the shift in transmission intensity between the main hotspots
remains of grave concern, as does continued sporadic transmission in other health areas.
Incidents of community suspicion and general insecurity continue to complicate and challenge
the overall EVD response and the interruption of response activities in Mandima Health Zone
will have affected contact tracing and case recognition and management. However, in areas
where robust public health measures have succeeded, no new confirmed cases have been
reported, showing that these approaches need to continue. Local and national authorities need
to continue their input, along with partners and donors, to ensure that gains continue and
ultimately bring the outbreak to a close.

...
https://apps.who.int/iris/bitstream/handle/10665/327836/OEW38-1622092019.pdf

https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates

 

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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 23 SEPTEMBER 2019

The Epidemiological Status of Ebola Virus Disease on September 23, 2019 Tuesday, September 24, 2019


Since the beginning of the epidemic, the cumulative number of cases is 3,170, of which 3,059 confirmed and 111 probable. In total, there were 2,119 deaths (2008 confirmed and 111 probable) and 979 people healed.

• 447 suspected cases under investigation;
• 1 probable case has been validated in Ituri at Mambasa;
• 2 new confirmed cases in North Kivu at Oicha;
• 1 new confirmed deaths in Ituri in Mandima;
• 4 people recovered from CTEs, including 3 in North Kivu, including 2 in Beni and 1 in Katwa, and 1 in Ituri in Komanda;
• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

/! \ 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 .

NEWS

A new probable case validated in Ituri in the health zone of Mambasa.

• A new probable case has been validated in the health zone of Mambasa in ITURI;
• This is a 39-year-old woman, a traditional healer, who died in the Salama Health Area in the Madidi district. She was not listed as a contact and was not vaccinated;
• The start date of the signs back to the 1 [SUP]st[/SUP] September 2019, with the period of time of exposure of 15 to 28 August 2019, by fever, headache, anorexia and chest pain;
• From 01 [SUP]st[/SUP] to 03 September, this woman has worn the home self-medication and was hospitalized from 4 to 6 September in St Peter Medical Center. The alert was launched on September 4, 2019 following the alteration of the conscience, reason for consultation in Saint-Pierre. It has been investigated and validated, but the family has categorically refused the transfer to the ETC. Persuasion has not succeeded;
• The patient was brought home by her family on September 6, where she died at around 10 pm Oral sampling and dignified and secure burial did not occur by refusal of his family;
• This woman was known contact of one of the patients who died on August 18, 2019 and confirmed on August 19, 2019 that she had been treated on August 16, 2019. She had refused the listing,
• 45 contacts are listed around this traditional healer, 3 of whom became suspicious and confirmed positive for #Ebola Virus Disease. This is her husband, mother and son, all admitted to CTE Komanda.
• This probable case was notified on 04 September 2019.

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https://mailchi.mp/3dcebce216f1/situation-pidmiologique-au-24-septembre-2019?e=9281954762[/TD]
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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 24, 2019

The Epidemiological Situation of Ebola Virus Disease on September 24, 2019

Wednesday, September 25, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,175, of which 3,063 confirmed and 112 probable. In total, there were 2,122 deaths (2010 confirmed and 112 probable) and 980 people healed.
? 523 suspected cases under investigation;
? 4 new confirmed cases, including:
? 1 in North Kivu in Kalunguta;
? 3 in Ituri, including 2 Komanda and 1 in Mambasa;
? 2 new confirmed deaths, including;
? 2 community deaths in Ituri, including 1 in Komanda and 1 in Mambasa;
? No deaths occurred among confirmed cases managed in ETCs;
? 1 person cured out of CTE in North Kivu in Beni;
? No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

The data presented in this table are subject to change after extensive investigation and after redistribution of cases and deaths in their respective health areas.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE ON THE RESPONSE TO THE #EBOLA VIRUS DISEASE are as follows:
1. Respect basic hygiene measures, including regular washing of hands with soap and water or ashes. ;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any sick person with the symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding)
If all the citizens respect the health measures advocated by the Secretariat, it is possible to quickly end this 10th epidemic

VACCINATION
? Continuation of wide ring vaccination around 2 confirmed cases in Mataba health area in Kalunguta, North Kivu after reluctance was relieved by communication around two cases
? Three Beni vaccination teams were deployed to Mambasa in Ituri to begin vaccination in the geographical ring in Binase and Madidi Health Areas;
? Training of Good Clinical Practice Trainers and Immunization Procedure for the 2nd Ebola Vaccine Jonshon & Jonshon continues in Goma;
? Since the start of vaccination on August 8, 2018, 227,961 people have been vaccinated;
? 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 May 20, 2018.


INPUT POINT MONITORING
? A surveillance provider at the Control Point (PoC) Chai in Ituri was arrested by a FARDC (General) military officer. Indeed, this officer had refused to submit to the sanitary control of the PoC. This provider was released later in the day;
? PoC Komba in Butembo, North Kivu is the second day of inactivity. This is due to the persistence of insecurity following the incursion of the armed incivists to the Malende village not far from the PoC;
? Since the beginning of the epidemic, the total number of travelers checked (temperature measurement) at the sanitary control points is 98,817,987;
? To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.
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[h=1]Ebola virus disease ? Democratic Republic of the Congo[/h] Disease outbreak news: Update
26 September 2019

The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues this week with 29 new confirmed cases reported in North Kivu and Ituri provinces from 18-24 September 2019, versus 57 in the previous week. This decrease in the number of cases should be interpreted with caution, as operational and security challenges in certain health zones make it difficult to undertake case detection and response functions.
There has been a recent increase in localized security or community-related incidents in several areas of operation. About a third of community incidents from August 2019, to date, occurred in Mambasa Health Zone. To strengthen the participation and engagement of local communities in this area, a WHO team of social scientists, community engagement, risk communication, and health promotion experts was set up to implement the Strategic Response Plan 4 (SRP4) approach and strategy together with La Commission Communication de Risque et Engagement Communautaire (CREC) sub-commission. The recent major security incident in Lwemba, within Mandima Health Zone, has halted response activities for the past nine days. This has limited contact tracing efforts, with 169 and 162 contacts lost to follow up in Lwemba and Mambasa, respectively.
During the past 21 days (from 18 September through 24 September 2019), a total of 126 confirmed cases were reported from 13 health zones (Table 1, Figure 2), with the majority of cases from Mambasa (25%, n=31), Mandima (18%, n=23), and Kalunguta (16%, n=20) health zones. Musienene Health Zone cleared 21 days without a new confirmed case of EVD.
As of 24 September, a total of 3175 EVD cases were reported, including 3063 confirmed and 112 probable cases, of which 2122 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1778) were female, 28% (902) were children aged less than 18 years, and 5% (161) were health workers.
The Democratic Republic of the Congo health authorities have endorsed the use of a second investigational Ebola vaccine with at-risk populations in areas that do not have active EVD transmission. Regular vaccination activities in EVD-affected areas will continue. The Merck/MSD vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola. The Johnson & Johnson vaccine will be deployed by a consortium, including the Ministry of Health, Democratic Republic of the Congo National Institute for Biomedical Research, Coalition for Epidemic Preparedness Innovations, M?decins Sans Fronti?res (MSF), MSF Epicentre, United Kingdom Public Health Rapid Support Team, Wellcome Trust, and Janssen Vaccines & Prevention B.V. The Institut national de la sant? et de la recherche m?dicale will coordinate the data safety and monitoring board.
Under Pillar 1 of the current Strategic Response Plan, the estimated funding requirement for all partners for the period July to December 2019 is US$ 287 million, including US$ 120-140 million for WHO. As of 26 September 2019, close to US$ 60 million have been received by WHO, with further funds committed or pledged. Currently available funds will close the financing gap just up until the end of October 2019. Further resources are needed to fund the response through to December 2019. WHO is appealing to donors to provide generous support. A summary of funding received by WHO since the start of this outbreak can be found here.
[h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 24 September 2019*[/h]

Enlarge image
*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi.
[h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 24 September 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 24 September 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 information about public health response actions by the Ministry of Health, 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 last assessment, carried out on 5 August 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.
The recent fluctuations in case numbers per week must be interpreted with caution, as case reporting is dependent upon the level of security in the response areas. After more than a week with no response operations in Lwemba Health Area, within Mandima Health Zone, an increase in the number of reported cases is expected in the coming weeks as response activities resume.
[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 travellers to/from the affected countries. 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. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

...
https://www.who.int/csr/don/26-september-2019-ebola-drc/en/

 

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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 25 SEPTEMBER 2019

The Epidemiological Situation of Ebola Virus Disease on September 25, 2019 Thursday, September 26, 2019



Since the beginning of the epidemic, the cumulative number of cases is 3,178, of which 3,066 confirmed and 112 probable. In total, there were 2,126 deaths (2014 confirmed and 112 probable) and 981 people healed.

? 483 suspected cases under investigation;
? 3 new confirmed cases, including:
? No cases in North Kivu;
? 3 in Ituri, including 2 in Mandima and 1 in Mambasa;
? 4 new confirmed deaths, including;
? 1 community death in Ituri in Mandima;
? 3 deaths of confirmed cases in North Kivu, including 2 in Katwa and 1 in Beni;
? 1 person cured out of CTE in North Kivu in Butembo;
? No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

The data presented in this table are subject to change after extensive investigation and after redistribution of cases and deaths in their respective health areas.

NEWS
Six people from Mambasa cured of Ebola Virus Disease out of Komanda CTE in Ituri *
? The Ebola Treatment Center (ETC) in Komanda, Ituri Province unloaded on Thursday September 26, 2019 six people who were cured of Ebola virus disease, all from Mambasa;
? For the director of the Komanda CTE, Claude Banga Lonema, this treatment center receives patients from the Nyakunde and Komanda health zones, as well as from Mambasa well before the construction of its CTE, which has become functional for almost a week;
? For the director of the CTE of Komanda, Dr. Claude Banga Lonema, all these cures are the work of a whole team, including medical and paramedical staff, psychosocial teams, nutritionists and hygienists and guards, to whom he is grateful for all their efforts in this day-to-day treatment center, as well as dedication and their apostolate;
? The coordinator ai of the Subcommittee on Response and Chief Medical Officer of the Komanda Health Zone, Dr. Faustin Singo Ngozo, said on this occasion that the success and success of Ebola Virus Disease is an asset for everyone in the response. This success must be shared, because if surveillance does not work, there will always be notification of deaths. The presence of cures at the Komanda CTE shows that epidemiological surveillance has been successful in detecting cases in a timely manner and has enabled the care physicians to have sufficient time to treat these patients. To this end, he recommended mutual support among all the teams in the response to push him out of the way to harm the epidemic, which he said has lasted too long, to continue working with the same momentum. He also asked the six healings to help the response in sensitizing everyone in his respective environment. Military healing, he said, is a resource that can educate his colleagues to end this epidemic;
? Among the Mambasa healers who were discharged from the Komanda Treatment Center were an 8-year-old girl, a man in uniform, including the Armed Forces of the Democratic Republic of the Congo, and the village chief of Makoko II, a village in strong resistance. The latter two promised to raise awareness about Ebola Virus Disease in their respective communities;
? This triumphant exit of the six cured Mambasa, an area where there is still resistance against the MVE, was made in the presence of several partners, including delegates of WHO and UNICEF:
? Started by the prayer, this ceremony also ended with prayer and a family photo between the cures and the teams of the response committed in this ETC;
? Immediately after, their exits from the CTE of Komanda, the cured were accompanied by the teams of the response to Mambasa, their respective health zone, where a festive atmosphere awaited them;
? The Komanda CTE is located in the Mangiva Health Area, precisely in Makayanga village in the health zone of Komanda, 100 km from the Mambasa health zone.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE FOR THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Respect basic hygiene measures, including regular washing of hands with soap and water or with ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any sick person with the symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding)
If all the citizens respect the health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic

VACCINATION
? Ring vaccination expanded around 2 confirmed cases in Mataba Health Area in Kalunguta, North Kivu. two more vaccination rings, in the same health zone, are waiting to be opened in Lisasa and Kabasha Health Zones
? Since the start of vaccination on August 8, 2018, 228,430 people have been vaccinated;
? The only vaccine to be used in this epidemic is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical company Merck, after approval by the Ethics Committee in its decision of 20 May 2018.
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https://mailchi.mp/c3bf7debc92f/situation-pidmiologique-au-26-septembre-2019?e=9281954762[/TD]
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Possibly related to the Congo outbreak but there isn't enough information yet to support conclusions...

Health Information for Travelers to Tanzania, including Zanzibar

On September 10, 2019, CDC and the World Health Organization (WHO) were made aware of unofficial reports regarding the unexplained death of a person two days earlier from probable Ebola virus disease (EVD) in Dar es Salaam, United Republic of Tanzania. This person reportedly traveled around the country while ill, including the cities of Songea, Njombe, and Mbeya. Questions continue to emerge about the cause of death and whether there are additional cases linked to the death. (For more information, see Cases of Undiagnosed Febrile Illness – United Republic of Tanzania. CDC is working closely with international public health partners, including the Tanzania Ministry of Health and WHO, to monitor the situation and will provide updates as needed. The ongoing risks from this event are unknown, but at this time and based on available information (which is incomplete), no travel restrictions to Tanzania are indicated. However, travelers should remain aware of the situation and avoid direct contact with people who are ill, when possible. They should also monitor themselves for symptoms of EVD (fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, unexplained bruising or bleeding) both during and for 3 weeks after travel.

Source: CDC

 

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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 26, 2019

The Epidemiological Situation of Ebola Virus Disease on September 26, 2019


Friday, September 27, 2019

? Since the beginning of the epidemic, the cumulative number of cases is 3,183, of which 3,069 are confirmed and 114 are probable. In total, there were 2,128 deaths (2014 confirmed and 114 probable) and 989 people healed.
? 416 suspected cases under investigation;
? 2 new probable cases in Ituri, including 1 in Komanda and 1 in Mambasa;
? 3 new confirmed cases, including:
? No cases in North Kivu;
? 3 in Ituri, including 1 in Lolwa, 1 in Mambasa and 1 in Mandima;
? No new confirmed deaths have been recorded;
? 8 cured people released from CTEs, including 6 in Ituri in Komanda and 2 in North Kivu in Beni;
? No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

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Two new probable cases validated in Ituri in the health zones of Komanda and Mambasa

For the probable case of Komanda notified on September 10, 2019:

? It is about a little boy, infant of 7 months, died in the Area Idohu health center in Ndimo village Antenna in Komanda, Ituri province. This infant has not been listed as contact and has not been vaccinated;
? The date of onset of the signs dates back to September 07, 2019, with the date of exposure from August 21 to September 3, 2019, by fever;
? From 07 to 10 September, this baby was cared for at Rwenzori Health Station, where he was diagnosed with malaria. He died on September 10, 2019 and the alert was issued on the death by the health care staff of this center;
? The body was taken by his father before the arrival of the investigative team, resulting in a failed and secure buccal discharge and burial;
? This child was an unlisted contact of his cousin, confirmed on August 24, 2019 and died at the Ebola Treatment Center (ETC) on August 25, to whom he had visited with his mother at Rohi Health Station from August 20 to August 23 / 2019;
? 11 contacts are listed around this case, including 5 family members, 2 co-patients and 4 care providers, all vaccinated.
For the probable case of Mambasa, notified on August 29, 2019:
? This is a 28-year-old man who died in the Salama Health Area in Madidi district of Mambasa in Ituri province. It has not been listed as a contact and has not been vaccinated;
? The date of onset of the signs is 21 August 2019, with exposure date from 04 to 17 August 2019, fever, headache, chills and polyarthralgia;
? From August 21st to 27th, this man was hospitalized at Saint-Pierre Health Center with no improvement. The patient came out of this center at his own request that same day to be brought for prayer sessions at the Assembly of Saints Church until his death on August 29, 2019;
? That same 29th of August, the body of the deceased was moved from the church to his home, located in a district of the Boyomais, very reluctant to the retaliatory activities. The body was buried on August 30, 2019 without oral sampling (Swab) or dignified and secure burial (EDS);
? Before her illness, two of her family members died in a painting reminiscent of #Ebola Virus Disease. This is his son, who died on August 18, 2019, and his father, whose date of death was not specified, all of whom did not receive either swab or EDS;
? After his death, his brother, who had accompanied him to the health center and to the church, also taking part in the funeral, had died and confirmed #MVE on September 12, 2019 with the date of the beginning of signs on September 3, 2019.
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https://us3.campaign-archive.com/?u=b34a30571d429859fb249533d&id=83f4836ead

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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 27, 2019

The Epidemiological Situation of the Ebola Virus Disease on September 27, 2019

Saturday, September 28, 2019

? Since the beginning of the epidemic, the cumulative number of cases is 3,186, of which 3,072 are confirmed and 114 are probable. In total, there were 2,128 deaths (2014 confirmed and 114 probable) and 989 people healed.
? 446 suspected cases under investigation;
? 3 new confirmed cases, including:
? No cases in North Kivu;
? 3 in Ituri, including 2 in Mandima and 1 Komanda;
? No new confirmed deaths have been recorded;
? No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

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https://us3.campaign-archive.com/?u=b34a30571d429859fb249533d&id=f63bc1cf18[/TD]
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Ituri: CTE Lwemba closed after attacks, local leaders fear the spread of the disease

09/27/2019 by laprunellerdc

The activities of the Ebola response are still suspended several days after the fire of ten houses including health facilities by residents hostile to the response in the locality of Lwemba, territory of Mambasa in Ituri Province .

This situation is being observed since the popular uprising of the hostile inhabitants of this locality against Ebola response teams the night of Sunday 15 to Monday 16 September 2019.

More than 10 days later, the community leaders of the region are coming out of their silence. They are asking for the urgent involvement of the politico-administrative and health authorities to save lives against this dangerous Ebola Virus Disease.

According to our sources on the spot in Lwemba, several people started to show the signs of the disease.

To do this, community leaders fear the high-risk contacts that had manipulated the body of the deceased Ebola nurse during this popular uprising spread the disease to the corners where the situation is calm.

Local community leaders report that they have started to raise awareness so that the situation can not get worse.

The latter nevertheless criticized the fact that the sick inhabitants lack where to be treated and they now tend to flee to the still unaffected environments. A serious situation, they say, that could spread the disease.

It is worth remembering that the population of Lwemba had risen against the teams of the response after the death by Ebola at the Ebola Treatment Center in Mangina of Ally Kasereka Imatha, a death she had not well digested.

In protest, the residents took to the streets and set fire to four health facilities next to some 20 community relay houses.

Roger Kakulirahi, from mambasa

https://www.laprunellerdc.info/2019...ocaux-craignent-la-propagation-de-la-maladie/