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

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[TD="class: mcnTextContent"]EPIDEMIOLOGICAL SITUATION [/TD]
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[TD="class: mcnTextContent"] EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 28, 2019

The Epidemiological Situation of Ebola Virus Disease, September 28, 2019


Friday, September 29, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,188, of which 3,074 are confirmed and 114 are probable. In total, there were 2.129 deaths (2015 confirmed and 114 probable) and 991 people healed.

• 426 suspected cases under investigation;
• 2 new confirmed cases, including:

• 1 in North Kivu in Butembo;
• 1 in Ituri at Mambasa;

• 1 new confirmed death at CTE in North Kivu in Beni;
• 2 people healed from ETCs in North Kivu, including 1 Butembo and 1 in Katwa;

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.

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[TD]EPIDEMIOLOGICAL SITUATION [/TD]
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 29 SEPTEMBER 2019

The Epidemiological Situation of Ebola Virus Disease, September 29, 2019

Monday, September 30, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,191, of which 3,077 are confirmed and 114 are probable. In total, there were 2,133 deaths (2019 confirmed and 114 probable) and 991 people healed .
• 346 suspected cases under investigation;
• 3 new confirmed cases, including:
• 1 in North Kivu in Kalunguta;
• 2 in Ituri, including 1 in Mambasa and 1 in Mandima;
• 4 new confirmed deaths in Ituri, including:
• 1 community death in Ituri 1 in Mandima;
• 3 confirmed deaths in CTEs in Ituri, including 2 in Mambasa and 1 Komanda;
• 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.

Summary of epidemiological data at week 39 (from 23 to 29/09/19)

• Number of new probable cases: 3
• Number of new confirmed cases: 20
• Number of new cures: 16
• Number of new deaths: 12
• Community : 4
• Confirmed deaths: 8

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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.
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LEXICON
• A community death is any death that occurs outside a #Ebola Treatment Center.
• A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.[/TD]
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[TD]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu
as of 29 September 2019[/TD]
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Epidemic curve 30.09.19[/TD]
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[TD]Local providers in 17 Mambasa's Silent and Hard-to-reach Health Areas in Ituri sensitized on EVD

• One hundred and two local providers of 17 silent and hard-to-reach health areas in the sub-coordination of the response to the epidemic Ebola Virus Disease (EVD) in Mambasa were sensitized from 29 to 30 September 2019 in the women's ward at Mambasa in Ituri province on this disease;

• This took place during a briefing day for the purpose of helping to stop the transmission of Ebola Virus Disease in this sub-coordination in order to prevent its spread to other health zones. , DRC provinces and neighboring countries;

• This day also had the objective of setting up a functional alert system in the community and in the health structures of the target health areas and a communication system allowing a rapid response in case of notification of a validated alert. , a new confirmed or probable case and accelerate ownership of the response by communities, their leaders and local health system actors;

• These local providers were trained on EVD basics, early definitions / detections of cases and actions to be taken, as well as escalation of alerts, risk communication and community engagement. They were also trained on dignified and safe burial (DHS), active case finding, community-level monitoring tools and reporting system, risk communication and community engagement;

• Awareness Day was opened by Mambasa Territory Administrator Mr. Idriss Koma Kukodila in the presence of the Deputy General Coordinator for Ebola Response to the Epidemic, Dr. Justus Nsio Mbeta, Physician the coordination of the Mambasa Health Zone, representing the Mambasa sub-coordinator and the field coordinators of WHO and UNICEF;

• The sub-coordination of the Mambasa response includes 3 health zones, including Mambasa, Lolwa and Mandima and 28 health areas, including 6 hot spots reporting cases within 14 days. These include Binase, Lolwa, Mambasa, Salama, Mandima and Some;

• The 17 health areas are: Banana, Tabala, Bandishende, Makoko II, Epulu, Salate, Molokai, Bukulani, Akokora, Pede, Bakaiko Kenya, Nduye, Bongupanda, Malembi, Bahaka, Lolwa and Some. These are health areas that do not report EVD alerts and are areas of difficult access and insecurity.

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Outbreaks and Emergencies Bulletin, Week 39: 23 - 29 September 2019
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Ebola virus disease Democratic Republic of the Congo

3 188
Cases

2 129
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 35 health areas reporting confirmed cases in the past
21 days (8 to 28 September 2019). Since our last report on 22 September
2019 (Weekly Bulletin 38), there have been 21 new confirmed cases and
14 new deaths. The principle hot spots of the outbreak in the past 21
days are Mambasa (27%; n=29 cases), Mandima (22%; n=24 cases),
Kalunguta (14%; n=15 cases) and Komanda (12%; n=13 cases). Seven
health zones have reported new confirmed cases in the past seven days,
namely Mambasa, Butembo, Mandima, Komanda, Lolwa, Kalunguta and
O?cha. There have been no response activities in Lwemba health area,
Mandima Health Zone, for the past 13 days for security reasons; dialogue
is underway with the population in order to try to resolve the situation.
As of 28 September 2019, a total of 3 188 EVD cases, including 3 074
confirmed and 114 probable cases have been reported. To date, confirmed
cases have been reported from 29 health zones: Ariwara (1), Bunia (4),
Komanda (56), Lolwa (4), Mambasa (70), Mandima (296), Nyakunde
(1), Rwampara (8) and Tchomia (2) in Ituri Province; Alimbongo (5),
Beni (675), Biena (18), Butembo (283), Goma (1), Kalunguta (188),
Katwa (650), Kayna (28), Kyondo (25), Lubero (31), Mabalako (373),
Manguredjipa (18), Masereka (50), Musienene (84), Mutwanga (32),
Nyiragongo (3), Oicha (58), Pinga (1) and Vuhovi (103) in North Kivu
Province and Mwenga (6) in South Kivu Province.

As of 28 September 2019, a total of 2 129 deaths were recorded,
including 2 015 among confirmed cases, resulting in a case fatality ratio
among confirmed cases of 66% (2 015/3 074). The cumulative number
of health workers is 161, which is 5% of the confirmed and probable
cases to date.

Contact tracing is ongoing in 14 health zones. A total of 7 775 contacts
are under follow-up as of 28 September 2019, of which 7 114 have been
seen in the past 24 hours, comprising 91% of the contacts. Alerts in the
affected provinces continue to be raised and investigated. Of 2 854 alerts
processed (of which 2 765 were new) in reporting health zones on 28
September 2019, 2 754 were investigated and 426 (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.

As of 28 September 2019, a cumulative total of 230 055 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 100 million screenings to date. A total of 112/117 (96%) PoE/
PoC transmitted reports as of 28 September 2019.

Fourteen of the 28 alerts notified on 25 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, 24
households and three health facilities 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 Bukavu, South Kivu, there was an educational talk on EVD with the Inbanda and
Kadutu Civil Protection Brigade of communes and a toll free number for response was
shared.

SITUATION INTERPRETATION

The lack of response activities for a full 13 days in Mandima Health Zone is of grave concern,
as it is likely that contacts are being lost to follow-up, new cases are not being reported and
transmission chains are not being broken. Hot spots persist as well as sporadic transmission in
other health areas. However, in areas where robust public health measures have succeeded, no
new confirmed cases have been reported, showing that these approaches need to continue. The
fact that Beni is no longer a hot spot and that Pinga has seen no new confirmed cases in the past
42 days is encouraging. 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/10665/328264/OEW39-2329092019.pdf
https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates

 

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[TD]EPIDEMIOLOGICAL SITUATION [/TD]
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 30 SEPTEMBER 2019

Tuesday, October 01, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,194, of which 3,080 are confirmed and 114 are probable. In total, there were 2,136 deaths (2022 confirmed and 114 probable) and 991 people cured.
• 388 suspected cases under investigation;
• 3 new confirmed cases, including:
• 2 in North Kivu, including 1 in Kalunguta and 1 in Oicha;
• 1 in Ituri in Mandima;
• 3 new confirmed deaths in Ituri, including:
• 1 community death in North Kivu in Kalunguta;
• 2 confirmed deaths in CTEs, including 1 in North Kivu in Oicha and 1 in Ituri in Mandima;
• No healed person left the CTE;
• 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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[TD]Nine high-risk contacts from #MVE from Lwemba in Ituri intercepted in Ngongolyio, North Kivu

• Beni's Ebola Virus Disease Sub-Coordinator, Dr. Pierre-Celeste Adike , announced on Tuesday October 01, 2019 that nine high-risk contacts of a confirmed case of #Ebola Virus Disease from Lwemba, a Health Area of ​​Mandima Health Zone in Ituri Province in inter-ethnic conflict and insecurity, were intercepted Tuesday by the community in the Ngongolyo Health Area in North Kivu;
• They were intercepted by a neighborhood chief, who automatically alerted the rebel teams at Beni level. A rapid intervention team was dispatched to this place, where the presence of the mayor of the city of Beni was also noted;
• These nine people were in transit in Beni to one of their family members for Kabasha in Kalunguta in Butembo's sub-coordination, where they resided from Lwemba, where they went to attend a bereavement. Immediately after this interception, the members of the host family were vaccinated;
• The follow-up of these nine contacts will continue in Butembo, especially since their names have already been communicated in all the coordinations of the response;
• As a reminder, for 15 days, the response activities have been suspended in Lwemba following inter-ethnic conflicts and insecurity.

Coordinating the Epidemic Response to #Ebola Virus Disease for the Consumable Products Provided by Mambasa Economic Operators in Ituri

• Overall Coordination of the Epidemic Response to Virus Disease #Ebola (MVE) has expressed support for the supply of consumables provided and offered by Mambasa's economic operators in Ituri province.
• Vice President of the Economic Federation of Congo (FEC) of Mambasa, Alpha Nasibu Katele, who told the press on Monday to coordinate the response of Mambasa at the end of a meeting chaired by the coordinator Deputy Director of Epidemic Response to the #Ebola Virus Disease, Dr Justus Nsio Mbeta in the presence of the FEC President and some members of the MECCA Committee, some Mambasa traders and partners supporting the response, including WHO, ALIMA and the Red Cross.
• According to Mr. Alpha Nasibu, economic operators in Mambasa are able to refuel the base of the response in building materials, food and want a rotation be made between traders regarding the rental of large car for everything the world can benefit from the demand for the response.
• This meeting was for the response to interact with economic operators to harmonize products that the response can buy locally in Mambasa, especially since other needs of the response are international and there is also has deposits that are already pre-positioned to meet some possible needs.
• During this meeting, they were asked to list the products that could be available in Mambasa to allow the response to remove them from its list to be ordered elsewhere or to warn the economic operators of Mambasa of their stock on such or such other product.
• Indeed, there has already been a first meeting between the economic operators of Mambasa and the teams of Riposte. During this first meeting, economic operators complained that the response commands their consumables elsewhere, while in this territory economic operators are ready to respond favorably to their needs.[/TD]
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[TD]VACCINATION [/TD]
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[TD]• A total of 15 days without opening of vaccination rings around 5 confirmed cases in the Lwemba Health Area in Mandima due to inter-ethnic conflicts and insecurity;
• No opening of an expanded ring ring around confirmed cases from 30 September in Biakato health area in Mandima as a result of community reluctance.
• A Satellite Ring was opened in the Lolwa Health Area in Mandima;
• Since the start of vaccination on August 8, 2018, 230,956 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 20 May 2018.
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Mambasa: Armed men attack Ebola response team in Biakato

Posted on Tue, 01/10/2019 - 14:01 | Edited on Tue, 01/10/2019 - 14:01

Armed men identified as Mayi-Mayi militia attacked an Ebola health response team in Biakato, Mambasa territory, on Sunday night.

About 30 men armed with knives and rifles have invested the locality of Biakato in Djugu territory, reports the human rights NGO Convention for the Development of Forest Peoples (CODEPEF).

According to this NGO, the gunmen entered the residence housing the medical staff who were part of the response team.

The deputy coordinator of this NGO, Laurent Keya said that these armed men "seek to avenge the death of the nurse who died of Ebola at the Mangina treatment center". For these militiamen, this health worker who is their brother was killed voluntarily by the response team.

It is thanks to the rapid intervention of the police that the lives of these people have been spared. This situation worries the people of Biakato who live in fear.

The NGO CODEPEF calls for the strengthening of the military and police forces in the localities of Biakato and Luemba to protect the population against the attacks of these militiamen who are active in the region.

According to local sources, some residents of Lwemba and surrounding villages are supporting this armed group to oppose the fight against Ebola.


https://www.radiookapi.net/2019/10/...-attaquent-une-equipe-de-riposte-contre-ebola

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Beni: an attack pushed back to the CTE of Mangina

POSTED BY: RMBB WRITING 02/10/2019

An incursion of gunmen was pushed back on Wednesday morning at the Ebola Treatment Center, CTE Mangina.

The alert is from the Congolese National Police Subcommission Mangina, commune located more or less 30 kilometers from Beni city.

The attackers turned back after they missed their goal. There was also no loss in human life, says Major Maurice LOFANJOLA, commander of the PNC Mangina. He congratulates his constituents for their courage in the fight against insecurity.

http://www.radiomoto.net/2019/10/02/beni-une-attaque-repoussee-au-cte-de-mangina/

 

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Christina Mukongoma Malkia
@ChristinaMk9

#RDC#EBOLA : All agents of the riposte based in Biakato will be followed for 21 days from this Wednesday, October 2, 2019. Basically a confirmed case of Ebola occurred in this sub base.the patient was transferred to the CTE de mangina, in the same territory of #Beni .
2:58 AM ? Oct 2, 2019

 

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 01 OCTOBER 2019

Wednesday, October 02, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,197, of which 3,083 confirmed and 114 probable. In total, there were 2,136 deaths (2022 confirmed and 114 probable) and 994 people cured.
• 430 suspected cases under investigation;
• 3 new confirmed cases, including:

• 1 in North Kivu, Katwa;
• 2 in Ituri in Mandima;

• No new confirmed deaths have been recorded;
• 3 people cured out of ETCs, including 2 in Ituri in Komanda and 2 in North Kivu in Butembo;
• 1 health worker, living and vaccination, is one of the new confirmed cases of Mandima. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.
• 16 [SUP]th[/SUP] day without response activities in the health area Lwemba to Mandima in Ituri.

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[Shiloh]

Source: https://www.who.int/csr/don/03-october-2019-ebola-drc/en/

[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
3 October 2019

The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues this week with 20 new confirmed cases reported in North Kivu and Ituri provinces from 25 September to 1 October 2019, versus 29 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. With over half (55%) of cases in the past week coming from Mambasa and Mandima Health Zones, there is a clear shift in the hot spots of the outbreak from high density, urban settings, such as Butembo, Katwa, and Beni, to more rural areas with a lower population density. This results in a change in the transmission dynamics, with more community-based transmission and less possible transmission in healthcare facilities. Conversely, this may introduce new issues in terms of accessibility and logistical challenges to reach affected villages, especially as we enter the rainy season.
In Mambasa Health Zone, delays in raising EVD awareness and involving the community and civil society in the response have led to community mistrust. To strengthen the participation of local communities in the response, WHO is working with the community, civil society, and partners in Mambasa Health Zone to engage women’s groups and enhance community-based surveillance. While in Lwemba, within Mandima Health Zone, poor EVD awareness compounded with armed conflict has led to heightened tensions between local communities and Ebola response teams. This has resulted in difficulties in investigating community deaths. Therefore, it is likely that the number of cases and community deaths in this area is under reported.
During the past 21 days (from 11 September through 1 October 2019), a total of 106 confirmed cases were reported from 13 health zones (Table 1, Figure 2), with the majority of cases from Mandima (26%, n=27), Mambasa (25%, n=26), Kalunguta (15%, n=16), and Komanda (12%, n=13) health zones.
As of 1 October, a total of 3197 EVD cases were reported, including 3083 confirmed and 114 probable cases, of which 2136 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1790) were female, 28% (906) were children aged less than 18 years, and 5% (161) 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 2 Oct 2019, to US$ 61 million have been received by WHO, with further funds committed or pledged. Further resources are needed to fund the response through to December 2019 as well as into Q1 2020. 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 1 October 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, 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 1 October 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 1 October 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.
Despite overall decreases in the number of cases, there is sustained transmission in Mambasa and Mandima Health Zones, with operational challenges due to ongoing tensions between the community and the response team. The lack of response activities for a full two weeks in Mandima Health Zone has resulted in contacts of EVD cases being lost to follow-up and possible under-reporting of EVD cases. WHO is working with the community, civil society, and partners to strengthen engagement of local communities. As the outbreak progresses and fewer cases are reported resources can be diverted to scaling up areas which enhance detection and prevention of cases, particularly community engagement, case investigation and coordination between pillars.
[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.
For more information, please see:

• WHO resources and updates on Ebola virus disease
• News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities
• SAGE Interim Recommendations on Vaccination against Ebola Virus Disease (EVD)
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Second Ebola vaccine to complement “ring vaccination” given green light in DRC
• Update on Ebola drug trial: two strong performers identified
• Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favourable Results with Two of Four Candidates
• Ebola response funding
• WHO and partners to help the Government boost health facility defences against Ebola in the Democratic Republic of the Congo

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 03 OCTOBER 2019

Friday, October 04, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,201, of which 3,087 are confirmed and 114 are probable. In total, there were 2.139 deaths (2025 confirmed and 114 probable) and 999 people cured.

• 451 suspected cases under investigation;
• 3 new confirmed cases, including:

• 1 in North Kivu in Beni;
• 2 in Ituri, including 1 in Mambasa and 1 in Mandima;

• 2 new confirmed deaths in North Kivu, including 1 in Beni and 1 in Mabalako;
• 4 people healed from the CTE in North Kivu in Beni;
• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.
• 18 [SUP]th[/SUP] day without response activities in the health area Lwemba to Mandima in Ituri.
• ...

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[TD]The 10 [SUP]th[/SUP] epidemic Ebola virus disease in DRC reached its 1000 [SUP]th[/SUP] cured

• - The thousandth cured of the Ebola Virus Disease came out Friday of the Mangina CTE in Mabalako in North Kivu Province;
• - Indeed, this [SUP]1000th[/SUP] cured is part of four healed Friday of this CTE. It is about a woman, quarantine gone, case contact of her nephew with the Air of Health of Lwemba with Mandima in Ituri. As soon as she felt the fever, she went to the Health Center, where she was detected as a suspected case and transferred directly to the CTE. She was confirmed and followed her treatment until recovery. She advises the population to go quickly to the Health Center and not fear the CTE to cure Ebola Virus Disease;
• - Among these four cures, there is also a health provider. This is an ambulance hygienist, the 1001 [SUP]st[/SUP] healed, who was contaminated during the unloading of his personal protective equipment (PPE). He recommended a lot of protection and precautions to all hygienists when removing PPE. And in case of possible contamination, do not panic, but rather go quickly to the Health Center for appropriate treatment;
• - For the Ebola Epidemic Epidemic Response Coordinator, Dr. Faustin Bile Saka, these healers will be the ambassadors for the response in their respective communities and testify that when we arrive early we have the chance to come out healed like them. He handed out the certificates of release to the cured, with the various partners of the response, WHO and IMC to the 1000, 1001, 1002 and 1003 [SUP]th[/SUP] cures of the Ebola Virus Disease in the DRC;
• - As a miracle, the 10th epidemic of the Ebola Virus Disease began around the end of July 2018 and declared in early August 2019 in Mangina and it is still in Mangina, where came the 1000th cured.
• ...

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT OCTOBER 04, 2019

Saturday, October 05, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,204, of which 3,090 are confirmed and 114 are probable. In total, there were 2.141 deaths (2027 confirmed and 114 probable) and 1004 people cured.

• 451 suspected cases under investigation;
• 3 new confirmed case, including:

• 1 in North Kivu at Oicha;
• 2 in Ituri, including 1 in Lolwa and 1 in Mandima ;

• 2 new confirmed deaths, including:

• 1 in North Kivu, including 1 in Oicha;
• 1 confirmed death in Ituri in Mandima ;

• 5 people healed from ETCs in North Kivu, including 4 in Mabalako and 1 in Beni;
• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.
• 19 [SUP]th[/SUP] day without response activities in Lwemba to Mandima health area in Ituri, where the ongoing dialogue in the community.

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North Kivu: victim of threats, MSF plans to reduce its interventions in Masisi and Walikale

Posted on Sat, 05/10/2019 - 13:53 | Modified on Sat, 05/10/2019 - 13:53

The international organization Doctors Without Borders (MSF), based in Goma, plans to further reduce its humanitarian interventions in the Masisi and Walikale territories of North Kivu. In a statement issued Friday, October 4, the NGO said that this measure would apply if his teams continue to be threatened, or are not sufficiently protected in this region.

"Our teams have recently faced a number of security threats and incidents in the Walikale and Masisi territories ..." , said MSF head of North Kivu Antony Kergosien.

He added that these security threats and incidents have "forced his organization to temporarily reduce its humanitarian activities in the region, which, in turn, deprives local populations of essential medical care. "

"If our teams, convoys and facilities are not respected and protected, we will have to re-evaluate our ability to intervene and adjust our medical and humanitarian programs in the health zones concerned," continued Kergosien.

The MSF / North Kivu communiqu? does not give any details about the perpetrators of the threats to its teams in Masisi and Walikale nor to what level would the resizing of its interventions.

However, MSF recalls that the security of humanitarian actors is essential to ensure their presence and intervention, and therefore demands that it and other humanitarian organizations operating in the region have unimpeded access to no more need for attention.

Since 1981, MSF has been working in the Democratic Republic of Congo, where it provides the population with medical, surgical, pediatric and obstetric care, as well as the management of malnutrition and HIV / AIDS. It also responds to epidemics like measles and Ebola.

https://www.radiookapi.net/2019/10/...ces-msf-envisage-de-reduire-ses-interventions

 

[Pathfinder]

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DRC: Ebola response agents threatened by Mai-Mai in Mambasa

Posted on Mon, 07/10/2019 - 09:50 | Edited Mon, 07/10/2019 - 09:50

Ebola response agents and their facilities are under heavy threat of Mayi-Mayi militia attacks in Mambasa territory (Ituri). They have issued leaflets in several places to announce an imminent attack, said Sunday, October 6 the administrator of the territory. The NGO CODEPEF reports that some residents have already left the outlying areas of Mambasa.

Leaflets were collected from three different locations, in which the militiamen announced their imminent incursion into Mambasa center. According to the administrator of the territory, these armed men even launched telephone messages to blackmail the response team.

They demand - through these messages - money to organize the funeral of one of their brother who died of Ebola about three weeks ago in Mangina.

According to the NGO CODEPEF, among the attack targets of these militiamen, there is in particular the Ebola treatment center installed in the general reference hospital of Mambasa, the hotel pygmies, which hosts the agents of riposte , and the grouping office, which hosted the response team.

Panicking, some residents fled to Mambasa center to avoid being victims. Some agents of riposte are afraid to go on ground.

The deputy coordinator of the NGO CODEPEF, Laurent Keya, indicates that these threats are taken very seriously, because these militiamen have already attacked Lwemba and Bikatato and do several damage:

"We ourselves have seen these tacts, which announced the attacks of these elements Mai-Mai to the chief town of the territory of Mambasa. Why do they want to come to attack Mambasa? We, the people of Mambasa, accept that organizations come to work here ... "

The administrator of the Mambasa territory ensures that all steps are taken to secure the population and response activities, "which are proceeding normally. Local sources report that the FARDC has intensified patrols in Mambasa-center.

https://www.radiookapi.net/2019/10/...riposte-ebola-menaces-par-des-mai-mai-mambasa

 

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The DRC has launched the use of the new vaccine to protect against different types of Ebola virus

By TopCongo FM 88.4 Useful Frequency October 8, 2019 3 0 2 Minutes Read

"This vaccine here Johnson & Johnson protects you against other types of Ebola virus, including Sudan and Bundibugyo. This vaccine has a second advantage, it contains the antigens of other viruses because EVSV only protects against Ebola Zaire virus. At home, the Ebola Bundibugyo virus is circulating. For example, the outbreak of Isiro in 2012 was caused by the strain Ebola Bundibugyo, " said Tuesday the coordinator of the multisectoral committee in charge of the response to this disease.

The new vaccine concerns all trafficking between the DRC and Rwanda, including small cross-border businesses, to reassure that Ebola will not cross the border.

The inhabitants of Karisimbi and Majengo health areas are also concerned.

According to Professor Jean-Jacques Muyembe, this vaccine will also be given to people in areas not yet affected by Ebola.

Since the beginning of the epidemic, the cumulative number of cases is 3,205, of which 3,091 confirmed and 114 probable. In total, there were 2,142 deaths (2,028 confirmed and 114 probable) and 1,006 people healed.

"363 suspected cases are under investigation and a new case has been confirmed at CTE North Kivu in Oicha. No new deaths were confirmed and 2 cured people had just come out of the CTE Butembo, "says epidemiological bulletin issued October 6 by the Committee in charge of the response to Ebola.

Which also reveals that no "health worker among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths, " learned TOP CONGO FM.

Alain Tshibanda

https://topcongofm.net/la-rdc-a-lan...teger-contre-differents-types-du-virus-ebola/

 

[Shiloh]

Source: https://www.who.int/csr/don/10-october-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
10 October 2019



The number of reported cases of Ebola virus disease (EVD) consistently declined in recent weeks, with 14 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 30 September through 6 October (Figure 1). At peak transmission in April 2019, there were 126 cases in the week. Although the decline in case incidence is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security.

In mid-September, serious security incidents in Lwemba Health Area, Mandima Health Zone, stalled outbreak response activities for more than two weeks. To improve confidence and community engagement in response activities, an open forum for discussion and reconciliation was held in Lwemba with partners and civil society last week. Response activities have since resumed but remain limited. Improved access may result in enhanced case finding and contact tracing therefore could result in an increase in the number of reported cases and contacts in the area.

There is a shift in hot spots from urban settings to more rural, hard-to-reach communities, across a more concentrated geographical area. During the past 21 days (from 18 September through 8 October), a total of 59 confirmed cases were reported from ten health zones (Table 1, Figure 2), with almost four out of five confirmed cases from four health zones: Mandima (31%, n=18), Mambasa (29%, n=17), Komanda (10%, n=6), Oicha (8%, n=5). This brings additional challenges to the response, including an extremely volatile security situation, difficulty accessing some remote areas, relatively poorer Ebola awareness and delays to engaging with the community leading to mistrust and misunderstandings, and potential under-reporting of cases, especial around some mining sites. The occurrence of transmission along a major road in from Komanda and Mambasa also poses greater risk of spread westward to other major cities in the country (such as to Kisangani).

As of 8 October, a total of 3207 EVD cases were reported, including 3093 confirmed and 114 probable cases, of which 2144 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 59% (n=1797) were female, 31% (n=909) were children aged less than 18 years, and 5% (n=162) were health workers.

As of 4 October, 1000 people have survived EVD in this outbreak. Since November 2018, the Ministry of Health and the Institute of Biomedical Research laboratory, with support from WHO, have undertaken a programme to aid in the reintegration of survivors into the community. The programme provides to EVD survivors monthly clinical, biological and psychological follow-up for a year after their discharge from the treatment center. Currently there are three operational clinics located in Beni, Butembo and Mangina.

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 10 October, US$ 60.4 million have been received by WHO, with additional funds committed or pledged. Further resources are needed to fund the response through to December 2019 and into the first quarter of 2020.

Under Pillar 5, Regional Preparedness, the funding requirement for all partners is US$ 66 million, of which WHO requires US$ 21 million. As of 8 October, WHO has received US$ 1.6 million. Whilst some additional pledges are in the pipeline, increased funding for preparedness in neighboring countries is urgently needed. 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 8 October 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 8 October 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 8 October 2019**[/h]

Enlarge image



**Total cases and areas affected 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 8 October 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.

Substantial progress has been made in the response over the past month with the number of new confirmed cases on a stable decline. With ongoing transmission shifting from major metropolitan hotspots to rural health zones, vigilance is required as these areas can be difficult to access and face security challenges. Response strategies must continue to be adapted to the local context and capacities for operational readiness and preparedness should be enhanced and sustained in non-outbreak affected areas including major transit routes. [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.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities
• SAGE Interim Recommendations on Vaccination against Ebola Virus Disease (EVD)
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Second Ebola vaccine to complement “ring vaccination” given green light in DRC
• Update on Ebola drug trial: two strong performers identified
• Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favourable Results with Two of Four Candidates
• Ebola response funding
• WHO and partners to help the Government boost health facility defences against Ebola in the Democratic Republic of the Congo

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 11, 2019

Saturday, October 12, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,212, of which 3,098 are confirmed and 114 are probable. In total, there were 2,148 deaths (2034 confirmed and 114 probable) and 1031 people cured.

• 466 suspected cases under investigation;
• 2 new confirmed cases at CTE in Ituri in Mandima;
• 2 new confirmed deaths, including:

• 2 community deaths in Ituri in Mandima;
• No confirmed deaths in CTE;

• 3 people healed from the CTE, including 2 in Ituri in Komanda and 1 in North Kivu in Katwa;
• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

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[TD]Organization of a press conference on the evolution of Ebola Virus Disease in Kinshasa

• - The Technical Secretary of the Multisectoral Committee for Ebola Virus Epidemic Response (CMRE), Prof. Jean Jacques Muyembe Tamfum chaired this Saturday, October 12, 2019 in Kinshasa press conference during which he reported on the 10 [SUP]th [/SUP]epidemic Ebola virus disease in DRC since its declaration on 1 [SUP]st [/SUP]August 2018 to date;
• - To this end, he showed the strategies used in the response of this epidemic and spoke of the recourse to technological innovations, while recalling that the Head of State, President F?lix-Antoine Tshisekedi Tshilombo, placed him at head of the technical secretariat of CMRE, with two main missions. This includes ending the epidemic as soon as possible and capitalizing on the achievements of this epidemic to strengthen the DRC's health system, starting with the three provinces affected by this epidemic;
• - Speaking of the evolution of the response, he reported some tangible progress, notably from July 2019, where 90 confirmed cases per week were recorded, or 15 per day, while currently there are fewer than 20 case by week, ie 1 to 3 cases per day, or even zero cases confirmed as the 05 October 2019 last. " In this period, three provinces were active (North and South Kivu, as well as Ituri), while today only the province of Ituri is affected . Today, only 9 zones are affected of the 22 recorded in July 2019, "said the technical secretary of the CMRE;
• - He said that for now the epidemic is concentrated in the North from where it came before revealing itself in Mangina and Mabalako in North Kivu. Hence all efforts are concentrated to put an end to this epidemic as quickly as possible;
• - Regarding strategies to end this epidemic, the Pof. Muyembe spoke about the change of approach that is now multisectoral and that at present, the outline of the epidemic is placed under the leadership of the presidency of the Democratic Republic of Congo with as coordinator the Prime Minister. This committee has a technical secretariat which directs the general coordination managed by Prof. Steve Ahuka and the provincial sub-coordinators of the response;
• - The second strategy was to maintain the motivation of the teams on the spot. This has been regularized with the support of the World Bank. An operating budget is now given to the coordination in Goma as well as all the co-ordination;
• - The other strategy is to give more importance to national leadership. A partnership has been built with WHO, UNICEF and MSF that support coordination in Goma. Nationals are at the forefront and partners support. This has changed a lot on the field, says Professor Muyembe;
• - Finally, notes the Technical Secretary, innovations have been made with this epidemic with the use of experimental vaccines, first RVSV zebov from Merck with belt vaccination which has shown its effectiveness;
• - " It is time to use a new vaccine, following the recommendations of the SAGE expert group that advises WHO on immunization. On May 15, 2019, this group recommended using an adjusted dose of the RVSV vaccine to prevent a possible shortage due to the fact that the epidemic lasts a long time, "Prof. Muyembe;
• - He added: " His second recommendation was to use a second preventive vaccine. After proposals, it is the Johnson & Johnson vaccine that presents the most data on the scientific level . He announced that the teams are prepared to give correct communication and to vaccinate the population;
• - He recalled that this second vaccine is used in West Africa since 2013, will also be used in Rwanda and Goma to protect the Congolese compatriots of Goma, where more than 64,000 of them cross the border daily. to go to Gisenyi and vice versa;
• - The 1 [SUP]st[/SUP] batch of the vaccine J & J, 500 000 doses will arrive in the DRC from 18 October 2019 and the vaccination will not start at the beginning of November 2019 in two towns of Goma to extend then in d other provinces;
• - The clinical trials carried out by the DRC will serve the whole world, since now two molecules tested are now available to break the chain of transmission during the next appearances of the Ebola virus.
• - " From this year, Ebola became a curable disease because we found medicines to cure the sick. It can also be avoided by immunization, especially if both are presented in time, "concluded the technical secretary of the Multisectoral Ebola Epidemic Response Committee at Ebola Virus Disease. . Muyembe Tamfum.

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• - A new vaccination ring was opened around two confirmed cases from 10 October 2019 in the Biakato Health Area in Mangina / AS Biakato mine with low participation due to a strong community reluctance;
• - Vaccination of newly recruited front-line staff continues at Kyondo Reference Hospital and Kayna Health Zone in Bulinda, North Kivu;
• - Continuation of Local Polio Vaccination Days integrated with Vitamin A supplementation and Mebendazole deworming in 17 health zones at the Butembo antenna in North Kivu;
• - Since the beginning of vaccination on August 8, 2018, 237,165 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 20 May 2018.

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 12, 2019

Sunday, October 13, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,218, of which 3,104 are confirmed and 114 are probable. In total, there were 2,150 deaths (2036 confirmed and 114 probable) and 1032 people cured.

• 429 suspected cases under investigation;
• 6 new confirmed cases to CTEs, including;

• 4 in North Kivu, including 2 in Beni and 2 in Kalunguta
• 2 in Ituri, including 1 in Mandima and 1 in Nyakunde;

• 2 new confirmed deaths, including:

• 1 community death in North Kivu in Kalunguta;
• 1 new confirmed death in CTE in North Kivu in Beni;

• 1 person healed out of CTE in Ituri in Mambasa;
• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

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[TD]New health area infected with Ebola virus in Ituri

• - A new Health Area has been affected by Ebola Virus Disease in Ituri. This is the Maroro Health Area in the Nyakunde Health Zone;
• - Indeed, Nyakunde was already at 294 days without notifying a new confirmed case of EVD and returned to zero following this new affection;
• - Of all the 6 cases reported this Sunday, October 13, 2019, none of them were listed as contact, nor monitored regularly or vaccinated;
• - It is also reported that the alerts of all these cases are coming back from the community and their contacts are being listed, the investigations are continuing, the decontamination of the patients' households is being carried out and the ring of vaccination has been opened around all these cases.

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Outbreaks and Emergencies Bulletin, Week 41: 7 - 13 October 2019

Ebola virus disease Democratic Republic of the Congo

3 218 Cases
2 150 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 14 new confirmed cases and an additional eight deaths since
our last report on 7 October 2019 (Weekly Bulletin 40). Six health
zones (Mandima, Beni, Kalunguta, Nyankunde, Lolwa and Oicha)
have reported new confirmed cases in the past seven days with a
new health area, Marabo, in Nyankunde Health Zone, reporting a
confirmed case. In the past 21 days (22 September to 12 October
2019), 23 health areas across 10 health zones have reported a
confirmed case. The principle hot spots of the outbreak in the past
21 days are Mandima (41%; n=21 cases), Mambasa (14%; n=7
cases), and Oicha (12%; n=6 cases).

As of 12 October 2019, a total of 3 218 EVD cases, including
3 104 confirmed and 114 probable cases have been reported. To
date, confirmed cases have been reported from 29 health zones:
Ariwara (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (72),
Mandima (310), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (677), Biena (18), Butembo
(283), Goma (1), Kalunguta (192), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (373), Manguredjipa (18), Masereka
(50), Musienene (84), Mutwanga (32), Nyiragongo (3), Oicha (62),
Pinga (1) and Vuhovi (103) in North Kivu Province and Mwenga (6)
in South Kivu Province.

As of 12 October 2019, a total of 2 150 deaths were recorded,
including 2 036 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 66% (2 036/3 104). The cumulative
number of health workers affected is 162, which is 5% of the
confirmed and probable cases to date.

Contact tracing is ongoing in 11 health zones. A total of 5 622
contacts are under follow-up as of 12 October 2019, of which 4
988 have been seen in the past 24 hours, comprising 89% of the
contacts. Alerts in the affected provinces continue to be raised and
investigated. Of 3 190 alerts processed (of which 3 078 were new) in
reporting health zones on 12 October 2019, 3 039 were investigated
and 429 (14%) 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. Cross-border collaboration continues, particularly with
Uganda and Rwanda.

As of 12 October 2019, a cumulative total of 237 632 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 105 million screenings to date. A total of 108/112
(96%) PoE/PoC transmitted reports as of 12 October 2019.

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, 5
households in Mandima 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.

SITUATION INTERPRETATION

The number of new confirmed cases does seem to be declining, but previous experience
shows that this trend needs to be interpreted with caution. Notwithstanding this, 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/10665/329330/OEW41-0713102019.pdf

https://www.afro.who.int/node/11863

 

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DRC-Ituri: Mayi-Mayi threatens to attack Ebola response in Lwemba

BY AFRICA INFO MAGAZINE ON OCTOBER 17, 2019SOCIETY

A new Mayi-Mayi militia leaflet, threatening to attack the agents involved in the Ebola response, was collected on Thursday, October 17, 2019, in Lwemba, Babila-Babombi chiefdom, Mambasa territory, in the province of Ituri (North-East of DR Congo).

On Tuesday, October 15, 2019, leaflets for information and warning were collected in the town of Lwemba, more than 60 kilometers from the capital of the Mambasa territory.

The human rights NGO Convention for the Development of Forest Peoples, through its Deputy Coordinator Laurent Kyeya, says he is "concerned" by this recurrent situation.

"In these leaflets, the Mai-Mai have had to claim the recent Lwemba attack that resulted in cascading fires of the homes of returnees, customary chiefs and opinion leaders.

In the wake, they warned that they will "attack, on Saturday 19 and Sunday, October 20, 2019, all those who work in the response to Lwemba.

"This situation has created a generalized psychosis for the people of this locality and those of other parties affected by the Ebola outbreak," she warned.

And to add:
"This is how the CODEPEF / Ituri asks security authorities to first identify these Mayi-Mayi groups because, until today, they remain unknown. Then neutralize them to guarantee security for the population of Mambasa territory, in general, and that of the Babila-Babombi chiefdom, in particular. "

Fabrice Ngima

https://afriqueinfomagazine.net/rdc...aque-agents-de-riposte-contre-ebola-a-lwemba/

 

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Ituri: The fight against Ebola confronted by the presence of May May in the health zone of Mangina

Posted on Wed, 16/10/2019 - 16:37 | Changed on Wed, 16/10/2019 - 16:40

The Ebola Response Team in Mangina, Mambassa Territory reports that since August 2018, it has registered approximately 310 positive cases of Ebola.

She says there is a high prevalence in recent days as a result of population resistance mainly in the health areas of Lwemba and Biakato. According to the local response team, "there is insecurity due to the presence of May May militiamen who control certain localities. It's been a month since the agents do not reach the village of Baiti and others where there are many suspicious cases, "says this source.

Regarding security in this area, the Mambasa Territory Administrator reports that "Putsa and Yombe local chiefs took machetes last week to attack the returnee team that has withdrawn from the area. The deputy chief of Butama locality has also urged its population to refuse to be vaccinated, "said the administrator of Mambasa.

The latter says that he has dismissed the deputy head of Butama. He also suspended the local leaders of Putsa and Yombe, for having "manifested the resistance".

Another problem encountered in the response to the Ebola virus disease, "is the state of disrepair of roads that does not facilitate the transfer of patients and the mobility of the response team in the area."

Response coordination requires the intervention of the competent authorities to put an end to these obstacles that may favor the spread of the disease in the region.

https://www.radiookapi.net/2019/10/...la-confrontee-la-presence-des-mai-mai-dans-la

 

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Source: https://www.who.int/csr/don/17-october-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
17 October 2019



The number of confirmed cases of Ebola virus disease (EVD) has been relatively low in recent weeks, with 15 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 7 October through 13 October (Figure 1). These encouraging signs are offset by a marked increase in case incidence in Biakato Mine Health Area, Mandima Health Zone. During the past 21 days (from 25 September through 15 October), a total of 50 confirmed cases were reported from ten health zones (Table 1, Figure 2), of which two-thirds (62%, n=31) were reported from or had transmission links to Biakato Mine Health Area.

Issues with access and security are impacting case finding and investigations, contact tracing, safe and dignified burials, decontamination of affected residences, and vaccination rings in parts of Mandima Health Zone. This is reflected in the decline in the proportion of confirmed cases listed as contacts (from 57% to 13%) and increase in the proportion of cases dying outside of Ebola Treatment Centres or Transit Centres (from 14% to 27%) this past week. This is further demonstrated by the relatively low numbers of alerts reported in the two areas over the past 42 days, with 32% less than the expected number.

A recent qualitative investigation in these health zones indicated that there is poor understanding among the population and local health workers of the transmission mechanism and symptoms of the disease, compounded with an environment of mistrust surrounding the origin of the disease, and reason for vaccination. This may impact the reporting of cases and engagement with response activities. Less than half of the respondents indicated that they would call a hotline if a member of their community was suspected of having Ebola, and almost half reported that they would encourage a family member to go to a Treatment/Transit Centre if they were suspected of having Ebola. Furthermore, less than half of individuals interviewed understood the functions of different interventions in the response, and less than 5% were involved in the response. This investigation highlights the importance of engaging communities in response activities in the upcoming weeks.

As of 15 October, a total of 3227 EVD cases were reported, including 3113 confirmed and 114 probable cases, of which 2154 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1811) were female, 28% (n=918) were children aged less than 18 years, and 5% ((n=162) were health workers.

The Director-General will reconvene the Emergency Committee under the International Health Regulations (IHR), as three months have passed since the declaration of the public health emergency of international concern (PHEIC) on 17 July. The committee will review progress in the implementation of the Temporary Recommendations issued by the Director-General on 17 July, discuss whether the event still constitutes a PHEIC, and if yes, advise for new or updated Temporary Recommendations under the IHR. The current recommendations are available here as will be the upcoming statement.

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$ 140 million for WHO. As of 17 October 2019, US$ 69.5 million has been received by WHO, with additional funds committed or pledged. Further resources are needed to fully fund the response through to December 2019 and into Q1 2020.

Under Pillar 5, Regional Preparedness, the funding requirement for all partners is US$ 66 million, of which WHO requires US$ 21 million. As of 17 October 2019, WHO has received US$ 4.3 million. While some additional pledges are in the pipeline, increased funding for preparedness in neighboring countries is urgently needed. 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 15 October 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, 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 17 October 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 15 October 2019**[/h]

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**Total cases and areas affected 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 8 October 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.

Although the decline in case incidence is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security within affected communities. Concurrent with the decline in case incidence, there has been a further shift in hotspots from urban settings to more rural, hard-to-reach communities, within a more concentrated geographical area. These areas bring additional challenges to the response, including: an extremely volatile security situation; difficulty accessing some remote areas; relatively poorer Ebola awareness and delays to engaging with the community leading to mistrust and misunderstandings; and, potential under-reporting of cases. In such environments, risks of resurgence remain very high, as do the risks of re-dispersion of the outbreak with cases travelling outside of hotspots to seek healthcare or for other reasons. These risks continue to be mitigated by the substantial response and preparedness activities in the DRC and neighboring countries, with support from a consortium of international partners. [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.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Second Ebola vaccine to complement “ring vaccination” given green light in DRC
• Update on Ebola drug trial: two strong performers identified
• Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favourable Results with Two of Four Candidates
• Ebola response funding
• WHO and partners to help the Government boost health facility defences against Ebola in the Democratic Republic of the Congo
• The Strategic Advisory Group of Experts (SAGE) on Immunization
• Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization

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