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

Translation Google

Ituri: arrest of 6 suspects involved in the rampage of health centers in Biakato

Posted on Fri, 18/10/2019 - 12:21 | Modified on Fri, 18/10/2019 - 12:21

Six people suspected of being involved in the ransacking of health centers organizing Ebola response activities were arrested on Thursday (October 17th) in Biakato (Ituri). Police say they detained these people for investigative reasons.

On Wednesday night to Thursday, four health facilities in Biakato were targeted. According to medical sources, these men attacked the response devices following rumors surrounding the death of a resident at the Mangina treatment center.

It was around 7 pm that a group of mainly young people invaded four health facilities from Biakato-center to Mupanda and Bandikindu in the Babila Teturi group in charge of Babila babombi. These are Bora Uzima health posts, Ushindi, Bismillah Clinic and Grace Pediatrics.

According to the testimony of some human rights activists who went there on Thursday, these protesters first ransacked all the handwashing devices and isolated posts of suspected cases of Ebola. They then threatened to kill the head of Bora Uzima health post.

The latter was saved thanks to the intervention of one of his men who dissuaded his companions on the pretext that this nurse is not a member of the response team.

Police say they have already apprehended six suspects. She says for the moment that the situation is relatively calm in Biakato-entre.

However, the police are asking the population to alert the security forces in time to prevent violence against the response team in the area.

https://www.radiookapi.net/2019/10/...uspects-impliques-dans-le-saccage-des-centres
 
Translation Google

Mambasa: Mayi-Mayi Mazembe attack Mahulo health center

Posted on Fri, 18/10/2019 - 17:55 | Modified on Fri, 18/10/2019 - 18:03

Armed men identified as Mai-Mai Mazembe ransacked the Mahulo health center in Lwemba locality on Thursday night.

It is one of the medical facilities where the Ebola response activities in the Mambasa territory take place. The human rights NGO, the Convention for the Development of Forest People (CODEPEF), indicates that these assailants armed with knives, also set fire to the depots where drugs and food for Ebola patients were stored. .

According to this NGO, these gunmen chanted hostile songs to the retaliatory team during the Luemba attack. They went directly to the Health Center. Laurent Keya, deputy head of this organization says that the pharmacy and the food depot have been ransacked.

The Administrator of this territory indicates that arrangements will be made to secure this area. In the meantime, Idrissa Koma is asking people to continue to help the response team to eradicate this disease.

For the third time, within a week, Ebola response sites have been attacked by armed men in this region of Mambasa.


https://www.radiookapi.net/2019/10/...azembe-attaquent-le-centre-de-sante-de-mahulo
 
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DRC: WHO maintains Ebola as a public health emergency of international concern

Posted on Sat, 19/10/2019 - 09:15 | Edited on Sat, 19/10/2019 - 09:15

The World Health Organization (WHO) has decided to maintain the current Ebola epidemic in the DRC as a public health emergency of international concern. The statement was made Friday, October 18 in Geneva, after the meeting of the Emergency Committee convened by the Director General of WHO under the International Health Regulations (IHR). Three months have passed since the declaration of the Public Health Emergency of International Concern (PHEIC) on July 17.

In the field, WHO teams have found that access and security issues have an impact on case finding and investigation, contact tracing, safe and dignified burials, decontamination of affected homes, and immunization circles in parts of the Mandima health zone.

This is reflected in the decrease in the proportion of confirmed cases registered as contacts (from 57% to 13%) and in the increase in the proportion of deaths outside Ebola treatment centers or transit centers ( from 14% to 27%) last week.

"The relatively low number of alerts reported in the two areas in the last 42 days, 32% less than expected, is also reflected , " said the UN agency based in Geneva.
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https://www.radiookapi.net/2019/10/...ola-comme-urgence-de-sante-publique-de-portee

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Attacks on Ebola response teams: Mambasa health workers leave jobs

Posted on Mon, 21/10/2019 - 08:22 | Edited Mon, 21/10/2019 - 08:22

A dozen health facilities involved in the response to Ebola do not work in Lwemba locality in the territory of Mambasa. According to local health sources, almost all staff have fled because of violence by some residents and armed men who resist response measures. The response team is asking the relevant authorities to strengthen the presence of law enforcement to secure sanitary facilities and agents.

According to Mandima Health District Chief Medical Officer, there are 16 health facilities where the response activities at the Lwemba Health Center are taking place. But less than five are operational to date. He said that several agents fled to Biakato at 18 km, following the repeated attacks of these health structures by some residents and Mai-Mai militia.

The last case was recorded on Saturday, October 19th. Two buildings at Lwemba General Hospital were set on fire. Seven motorcycles and drugs were burned. He denounces the violence that paralyzes the response activities in this entity where new cases of Ebola are recorded almost daily. Mandima Health District Chief Medical Officer recommends that the authorities reinforce the presence of military officers to secure health facilities and staff.

In Biakato, on the other hand, response activities are operational in all 26 health units in this health zone. However, the population still shows resistance despite an awareness campaign to persuade them to appropriate the fight. This in order to eradicate this disease in these two entities that are the focus of this epidemic in Ituri.

https://www.radiookapi.net/2019/10/...-de-riposte-ebola-les-employes-des-structures
 
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 21, 2019

Tuesday, October 22, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,248, of which 3,131 are confirmed and 117 are probable. In total, there were 2,172 deaths (2055 confirmed and 117 probable) and 1044 people cured.
• 446 suspected cases under investigation;
• 1 new probable case validated in Ituri in Mandima;
• 4 new confirmed cases, including:
o 2 cases in North Kivu, including 1 in Kalunguta and 1 in Mabalako;
o 2 cases in Ituri, including 1 in Mambasa and 1 in Mandima;
• No new confirmed deaths recorded;
• No cured person has left CTE;
• No health worker is 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.

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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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Summary of epidemiological data at week 42 (October 14-20, 2019)

• Number of new probable cases: 2
• Number of confirmed new cases: 21
• Number of new confirmed deaths: 19
o Community deaths : 8
o Confirmed deaths in CTE: 11
• Number of new cures: 11
• Number of health zones removed from the list: 2
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• A community death is any death that occurs outside of an 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
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[TD]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu
from 14 to 20 October 2019
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[TD]Confirmed and probable EVD cases by health zone and disease start date Ituri Province, North Kivu and South Kivu up to SE 42 2019[/TD]
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[TD]DRC and its nine bordering countries sign the Joint Transboundary Framework on Ebola Response to the Epidemic

• The Democratic Republic of the Congo and its nine neighbors (Angola, Burundi, Central African Republic, Republic of Congo, Rwanda , South Sudan, Uganda, United Republic of Tanzania and Zambia) signed Monday in Goma after the meeting of ministers, senior health officials and immigration, as well as various partners, a framework common to strengthen cross-border collaboration on Ebola and other epidemic preparedness and response to the Ebola epidemic;
• These ten countries have identified the Ebola Virus Disease epidemic in northeastern DRC, which has lasted more than a year, as a concern, particularly a growing risk of spread to neighboring countries. They also recognized the common threat this epidemic poses to health and economic security in the Great Lakes subregion and other parts of Africa, as well as the need to develop an action plan to mitigate the effects of these threats;
• For the Deputy Minister of Health of the DRC, Mr. Albert Mpeti Biyombo, it is good for the DRC to formalize a framework of collaboration and adopt a roadmap with the neighboring countries on the preparation and response to Ebola. "In this way, we will be able to pool our resources to strengthen health security and safety, "said Albert Mpeti,
• North Kivu Province Governor Carly Nzanzu Kasivita, recognizing the solidarity shown by through this meeting, stated that the results achieved will allow all to agree on cross-border communication mechanisms on EVDs and on a common action plan for preparing and responding to emergencies;
• For the Regional Director of the World Organization for Africa (WHO Africa), Dr. Matshidiso Moeti, these events underscore the immense importance of cross-border collaboration to improve the sharing and exchange of information to contain epidemics, harmonize resources, increase coordination and prevent diseases from crossing borders, especially since other diseases are also a major threat;
• It emphasized that cross-border movement of people, goods and services can increase the risk of transmitting infectious pathogens that cause diseases such as Ebola, cholera, measles and yellow fever;
• According to Dr. Moeti, information sharing is improving, but its level must be acceptable. " We need countries to openly share the information needed to save lives. Our mission is to establish cross-border collaboration that will cover all epidemics and public health emergencies , "she said;
• African Union Commissioner for Social Affairs, Amira Elfadil Mohammed, proposed the establishment of a cross-border collaboration and asset-sharing mechanism to alleviate suffering and minimize the social and economic impact of epidemics;
• The ministerial meeting was jointly organized by the Government of the DRC, through its Ministry of Health and Technical Secretariat of the Multisectoral Committee for the Response to Ebola Virus Disease (ST / CMRE), the WHO and the World Health Commission. African Union through its African Centers for Disease Control and Prevention (CDC Africa).

Description of the probable case of Mandima: A new probable case validated in the Mandima health zone in Ituri

• This is a 24-year-old woman notified on October 14, 2019. She died in the Biakato Mines Health Area at Yosefu Village in Mandima Health Zone in Ituri Province. This woman was not listed as a contact and was not vaccinated;
• The date of onset of signs in this woman dates back to October 4, 2019, with the date of exposure from September 17 to September 30, 2019, by fever and abdominal pain in hospitalization at the Codemuco Medical Center (CMC);
• From September 28 to October 10, 2019, this woman was hospitalized at the CMC where she had a caesarean section on a term pregnancy. It was October 10th that bleeding occurred at the level of the operative wound. She left this medical facility against medical advice to Ndombilo Biakato Mines and died on October 11 en route;
• The body was transported and buried at Yosefu Village without a dignified and secure burial, or with oral removal;
• This woman was co-patient of a confirmed case on October 11, 2019 taken care of at the CMC CODEMUCO from September 30th to October 3rd, 2019. Her son and her husband are confirmed by EVD, respectively on October 16th and 19th, 2019;
• Public health actions around this case were conducted in collaboration with Oicha's response team.[/TD]
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[TD]• A vaccination team was deployed to open a ring around the confirmed case of 20 October 2019 in the Epulu Health Area in Mambasa 75 km from Mambasa center in North Kivu province on the road to Kisangani;
• Two rings were opened around the two confirmed cases of 17 October 2019 in Binase and Salama / Madidi Health Areas in the Mambasa Health Zone in Ituri;
• The Satellite Ring opened at Mambasa prison in Ituri around the confirmed case of 12 October 2019 in the Nyakunde ZS in North Kivu was closed;
• A vaccination ring of front-line staff was opened in the city of Bunia in Ituri;
• The vaccination of taximen motorcyclists continues in the sub-coordinations of Butembo, Beni, Mangina in Mabalako in North Kivu and Mambasa in Ituri;
• Continued immunization of newly recruited front-line staff (LRP) in Kyondo Health Zone (HGR Kyondo) and Kayna Health Area (Bulinda Health Area), Musienene (Kimbulu Reference Health Center) and Butembo (Vulindi Health Area);
• Since the start of vaccination on August 8, 2018, 241,253 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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Ituri: 17 positive cases of Ebola recorded in a week in the Mangina Health Zone

Posted on Wed, 23/10/2019 - 14:17 | Modified on Wed, 23/10/2019 - 14:17

Seventeen positive Ebola cases have been registered for more than a week in the Mandima health zone in Mambasa territory (Ituri). These figures are published this Wednesday by the response coordination.

However, the response team regrets the persistence of resistance in some localities in the territory of Mambasa where activities are idling.

The Ebola outbreak surveillance team reports that three positive cases have been recorded since Monday in the Mandima Health Zone. According to the same source, 14 cases were reported last week in this health entity.

The assistant response coordinator from Goma who is on mission in the area indicates that these new cases are not due to the spread of the disease in this area. But are rather the results of the intensification of response activities, particularly in the health area of ​​Biakato. Clearly, he said, sensitized people now accept to bring suspects into health centers.

But some residents continue to show resistance especially in Lwemba where activities have resumed timidly, say medical sources.

This after the fire last week of two buildings that contained drugs and seven motorcycles of the response team.

In Mambasa center, one segment of the population also continues to oppose Ebola prevention measures.

According to the administrator of the territory, some young people ransacked Tuesday the house of an imam accused of supporting the team against Ebola. The police fired shots of summons to disperse the crowd who wanted to attack the agents of riposte. This demonstration was organized after the death on Tuesday of a woman at the Ebola treatment center in Mambasa-center.

https://www.radiookapi.net/2019/10/...la-enregistres-en-une-semaine-dans-la-zone-de
 
Source: https://www.who.int/csr/don/24-october-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
24 October 2019



The number of confirmed cases of Ebola virus disease (EVD) remains relatively low this week, with 21 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 14 – 20 October. The observed fluctuation in case incidence (Figure 1) may be expected given the challenges faced by response teams in the prior weeks.

Biakato Health Area in Mandima Health Zone reported almost half the number of new confirmed cases in the past week (52%, n=11) and had links to the majority of cases (76%, n=16). The movement of 5 cases exposed in Biakato Mines Health Area, but detected outside of the area, brings forth operational challenges for teams on the ground. Movement of cases while symptomatic not only increases the risk of spread of EVD to unaffected and previously cleared geographic areas, it also hinders timely case investigations, contact tracing, and response measures implemented to limit the risk of transmission.

The deployment of additional support to the Biakato Mines Health Area has led to improvements in response efforts in the past week. The proportion of confirmed cases listed as contacts has increased from 13% to 57%. Similarly, in the past week there has been an increase from 47% to 90% in confirmed cases with a known epidemiological link to a case. Nevertheless, both indicators are below the level we would aim to be at this stage. As case incidence declines, continued strengthening of community-based surveillance and alerts from health facilities to rapidly detect flare-ups is a high priority for all areas.

During the past 21 days (from 2 – 22 October), 50 confirmed cases were reported from eight active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in three health zones: Mandima (52%, n=26), Mambasa (12%, n=6), and Mabalako (10%, n=5). The major metropolitan area of Butembo city, comprising Katwa and Butembo health zones, which reported almost 1000 cases to date, recently cleared 21 days without newly detected cases. While this milestone highlights advances in the response, movement of cases to previously cleared health zones can quickly result in resurgence. An example of this was the detection of cases in Mabalako, all linked to Biakato Mines, after not reporting a confirmed case for 33 days. To mitigate the risk of onward transmission, ensuring community access and full operational readiness in cleared health zones and strategic at-risk communities is essential.

As of 22 October, a total of 3250 EVD cases were reported, including 3133 confirmed and 117 probable cases, of which 2174 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1827) were female, 28% (n=921) were children aged less than 18 years, and 5% (n=163) were health workers.

On 18 October, the Director-General reconvened the Emergency Committee under the International Health Regulations. The Committee reviewed progress in the implementation of the Temporary Recommendations issued by the Director-General on 17 July 2019. Updates on the outbreak were provided by representatives of the Democratic Republic of the Congo, as well as the UN Ebola Emergency Response Coordinator and the WHO Secretariat. Updates on preparedness in the neighbouring countries were provided by the United Republic of Tanzania, Republic of Uganda and the WHO Regional Office for Africa. It was the view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR. The Committee provided this advice to the Director-General, who issued revised Temporary Recommendations under the IHR.

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 21 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 21 October 2019, WHO has received US$ 4.3 million. While some additional pledges are in the pipeline, increased funding for preparedness in neighbouring 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 24 October 2019*[/h]
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*Excludes n=184 cases for whom onset dates not reported. 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 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 24 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:
[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.

While the relatively lower case incidence observed 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 was 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; delays to engaging with the community which in turn lead 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 neighbouring 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:
 
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 23, 2019

Thursday, October 24, 2019
  • Since the beginning of the epidemic, the cumulative number of cases is 3,256, of which 3,139 are confirmed and 117 are probable. In total, there were 2,177 deaths (2060 confirmed and 117 probable) and 1045 people healed.
  • 486 suspected cases under investigation;
  • 6 new confirmed cases, including:
  • 2 cases in North Kivu 1 in Butembo and 1 in Kalunguta;
  • 4 cases in Ituri in Mandima;
  • 3 new confirmed deaths, including:
  • 1 community death in Ituri in Mandima;
  • 2 deaths of confirmed cases in CTEs in North Kivu, including 1 in Butembo and 1 in Mabalako;
  • No healed person left CTE;
  • 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 the funeral at the general coordination of the response to the epidemic at the EVM in Goma
  • - The general coordination of the response to the Ebola virus disease #Ebola organized this Thursday, October 24, 2019 in Goma, capital of North Kivu province the funeral of one of the agents of the Vaccination Commission , Dr. Munze Manke Julienne Judith, died Tuesday, October 22 at 7:15 am at Butembo Graben University Clinics following a short illness;
  • - A Mass of thanksgiving was organized in memory of the illustrious disappeared. In the following activities, there was a testimony;
  • - His biography was read by the general coordinator of the epidemic response to the #Ebola Virus Maldie, Prof. Steve Ahuka: Born in Kinshasa on October 10, 1983, graduated in Surgery and Delivery Medicine at Gamal Abdel Nasser University in Conakry, Guinea. She returned to Kinshasa in March 2011, where she practiced as a doctor in several formations of the city. In 2014, she joined the National Emergency and Humanitarian Actions Program of the Ministry of Health, where she worked as an emergency physician. In this capacity, Dr. Judith has taken part in numerous humanitarian actions for the populations of the DRC and in several neighboring countries. She was recruited in the medical care of the repressed Brazzaville in 2014.
  • - His body was repatriated to Kinshasa at the end of this ceremony. The mortal remains of the famous disappeared arrived Wednesday at the General Provincial Hospital of Goma reference from Butembo.
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  • - Start of construction of the Biakato Mine Control Point (PoC) screening devices in the Mandina Health Zone in Ituri;
  • - A joint team of the National Border Hygiene Program (PNHF), the International Organization for Migration (IOM) and United Nations Police (UNPOL) came down to Komanda in Ituri to assess the security situation of the PoC strategic;
  • - In addition, another joint mission was organized by the PNHF in collaboration with IOM and OCHA on the Mbau-Mandina-MANGINA-Mandumbi and Biakato axis to make an inventory of these PoCs;
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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 43: 21 - 27 October 2019
Data as reported by: 17:00; 27 October 2019

Ebola virus disease Democratic Republic of the Congo

3 263 Cases
2 180 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 nine health zones and 20 health areas reporting confirmed cases
in the past 21 days (6 to 26 October 2019). Since our last report
on 20 October 2019 (Weekly Bulletin 42), there have been 23 new
confirmed cases and 11 new deaths. The principle hot spots of the
outbreak in the past 21 days are Mandima (54%; n=30 cases) and
Mabalako (16%; n=9 cases). Five health zones, Mandima, Butembo,
Kalunguta, Mabalako and Mambasa have reported new confirmed
cases in the past seven days.

As of 26 October 2019, a total of 3 263 EVD cases, including
3 146 confirmed and 117 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 (77),
Mandima (333), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (679), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (382), 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 27 October 2019, a total of 2 180 deaths were recorded,
including 2 060 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 66% (2 063/3 146). The cumulative
number of health workers is 163, which is 5% of the confirmed and
probable cases to date.

Contact tracing is ongoing in ten health zones. A total of 4 437
contacts are under follow-up as of 26 October 2019, of which 3
572 have been seen in the past 24 hours, comprising 81% of the
contacts. Alerts in the affected provinces continue to be raised and
investigated. Of 3 182 alerts processed (of which 3 081 were new) in
reporting health zones on 26 October 2019, 3 041 were investigated
and 357 (12%) 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
On 18 October, the Director-General reconvened the EC to review
progress in the implementation of the Temporary Recommendations
issued by the Director-General on 17 July 2019 and it was the view
of the EC that this event still constitutes a PHEIC.

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 26 October 2019, a cumulative total of 243 322 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 109 million screenings to date. A total of 108/112
(96%) PoE/PoC transmitted reports as of 26 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.

A clinic in Mabolio health area, Beni Health Zone was closed due to the high risk
of nosocomial infection.

Water, sanitation and hygiene (WASH) activities continue and on 22 October 2019,

2 health facilities and 2 households visited by 3 of the 4 confirmed cases reported
on 21 October 2019 were decontaminated. The confirmed case in Mabalako has
not yet been identifies, while the household of the confirmed case in Mambasa
has not yet benefited from IPC and WASH activities because of family resistance.
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.

Communication, mobilization and community engagement officials from
different religious groupings in Goma have started training on EVD response; the
Biakato sub-coordination committee participated in the evaluation of community
engagement activities with 37 religious leaaders from the Biakato-Mines health
area, to resolve community resistance to response measures.

SITUATION INTERPRETATION

Improvements in response indicators in the past week are encouraging and testament to
the resilience of response teams. However, substantive rates of transmission remain in
Mandima Health Zone, with smaller clusters elsewhere, which require a concerted effort
from all response teams and international partners to control. It is critical that all areas
of the response remain effective, engaged and fully resourced, with response activities
continuing to be scaled and adapted to the evolving local context.

https://apps.who.int/iris/bitstream/handle/10665/329488/OEW43-2127102019.pdf
https://www.afro.who.int/node/11915
 
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 28, 2019

Tuesday, October 29, 2019
  • Since the beginning of the epidemic, the cumulative number of cases is 3,268, of which 3,151 are confirmed and 117 are probable. In total, there were 2,182 deaths (2065 confirmed and 117 probable) and 1048 people cured.
  • 475 suspected cases under investigation;
  • 4 new confirmed cases, including:
  • 3 in North Kivu, including 2 in Mabalako and 1 in Beni;
  • 1 in Ituri in Mandima;
  • 1 new confirmed death, of which:
  • No community deaths have been recorded;
  • 1 death of cases confirmed in the CTE in North Kivu in Mabalako;
  • 2 people healed from the 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;
  • Continued research of the patient confirmed on 23 October 2019 in Mandima in Ituri and fleeing into the community.

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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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Epidemiological data summary at week 43 (21-27 October 2019)
  • Number of probable new cases: 1
  • Number of new confirmed cases: 20
  • Number of new confirmed deaths: 9
  • Community deaths: 3
  • Deaths confirmed in CTEs: 6
  • Number of new healings: 2
  • Number of health zones removed from the list: 1
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LEXICON
• A community death is any death that occurs outside of an 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
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[TD]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu
from 21 to 27 October 2019
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[TD]Confirmed and probable EVD by health zone and date of onset of illness Ituri province, North Kivu and South Kivu to SE 43 2019[/TD]
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[TD]Launch of the EVM SRP4 mid-term review in Goma in the provinces of North and South Kivu and Ituri
  • - Minister of Health Dr. Eteni Longondo on Tuesday launched the workshop on the Operational Review of the Integrated Strategy for Ebola Virus Disease (EVD) Response in the North and South Kivu Provinces Ituri (SRP4);
  • - " After 14 months of epidemic, more in a conventional emergency response.Each intervention must strengthen post-Ebola health systems;
  • - One of the expected results in this workshop is the revision of the SRP4 in SRP4.1 focusing initially on the elimination of the epidemic and on the other hand, on the integration of the interventions of a stabilization strategy and capitalization in health zones, where the epidemic has been fought and in other risk areas , "said the Minister of Health;
  • - To this end, it recommended to the technical partners to provide a framework for the provincial and national actors and not to replace them in order to allow the reinforcement of the capacities of the human resources and to perpetuate the fight;
  • - " The stakes of the Ebola Virus Disease, go beyond the DRC. Africa and the world have their eyes fixed on the floor as to the follow-up to the management of this 10 [SUP]th[/SUP] epidemic , "said Dr. Eteni, recalling that the recent ministerial meeting in Goma, October 21, 2019 testifies African integration in the fight against Ebola and also against its spread in other countries;
  • - " Our response is based on scientific evidence and the improvement and quality of our interventions. The results are there, but we must be vigilant to reach the zero cases of Ebola Virus Disease by strengthening surveillance, community engagement and security, "confirmed the technical secretary of the Multisectoral Committee for the Response to the Epidemic. Ebola Virus Disease, Prof. Jean-Jacques Muyembe Ntamfum;
  • - The North Kivu provincial health minister, Mo?se Kakule Kanyere, on behalf of the governor, wished that the reflections of these meetings focus on the end of the epidemic;
  • - " I would like to draw the attention of all stakeholders in the response to MVE on the need to reframe the interventions towards strengthening the health system to contain all eventualities can meet after this 10 [SUP]th[/SUP] epidemic and continue to meet to the best of our health sector. This response aims to revive our socio-economic situation through development projects in the three provinces affected by the Ebola Virus Disease , "said Provincial Minister Kanyere;
  • - It should be remembered that this workshop aims to assess the level of implementation of planned interventions for SRP-4 of the tenth epidemic at EVD.
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 29, 2019

Wednesday, October 30, 2019
  • Since the beginning of the epidemic, the cumulative number of cases is 3,269, of which 3,152 are confirmed and 117 are probable. In total, there were 2,182 deaths (2065 confirmed and 117 probable) and 1048 people cured.
  • 532 suspected cases under investigation;
  • 1 new confirmed cases in Ituri in Mambasa;
  • No new confirmed deaths have been recorded;
  • No healed person left the ETC;
  • 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;
  • Continued research of the patient confirmed on 23 October 2019 in Mandima in Ituri and fleeing into the community.
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[TD]Continuation of the EVM SRP4 mid-term review in Goma in the provinces of North and South Kivu and Ituri
  • - The Mid-Term Review Workshop of the Fourth Integrated Strategic Operational Plan for the Ebola Response to the Epidemic in the North, South Kivu and Ituri Provinces (SRP4) launched on Tuesday 29 October 2019 in Goma by the Minister of Health, Dr. Eteni Longondo continues until 31 October in Goma in the presence of the technical secretary of the response to the Ebola Virus Disease, Prof. Jean-Jacques Muyembe Ntamfum, North Kivu provincial health minister, representing the governor of this province and the various technical and financial partners of the response;
  • - The second day of these meetings, from 29 to 31 October 2019, was more focused on the zero Ebola case strategy in the DRC. Indeed, according to the general coordinator of Ebola response to the epidemic, Prof. Steve Ahuka, the Zero Case Strategy is very important because it will bring the DRC towards the end of the Ebola outbreak. will also help prepare for the post-Ebola era by strengthening the health system so that it is more responsive to future outbreaks;
  • - " The decline in the number of cases is not the end of the epidemic.However, efforts need to be strengthened to stop Ebola transmission by reducing the time between the onset of signs and treatment. "Said Prof. Steve Ahuka, adding that " In recent weeks, there has been a significant reduction in cases from 100 per week to July to around the twenties. Question now to think about how to have zero cases, so stop the transmission ";
  • - During this second day, there was also a question of evaluating the funds allocated to the response and its use with a view to reorienting priorities;
  • - The other most important strategy, said the general coordinator, is to be able to immunize the largest number of the population. Why will introduce a 2 [SUP]nd[/SUP]vaccine that will be given in areas not infected with MVE to create a large number of people protected from the disease, so that in case of a possible outbreak, as this one does can not take action;
  • - This 2 [SUP]nd[/SUP] vaccine, he added, will be given to all volunteers and eligible in the regions, where these vaccinations will be organized. He reported that this vaccination will start first in the health zone of Karisimbi in Goma and will continue progressively in other regions;
  • - It has, for this purpose, stressed that all of these strategies are aimed at protecting the population and constitute a benefit for the largest number of Congolese targeted areas benefiting from the 2 [SUP]nd[/SUP] vaccine;
  • - This second day was also focused on the presentation of active sub-coordination and continue to report cases of Ebola Virus Disease, followed by those who have not reported cases for some time. We illustrate the case of South Kivu Province and Chomia Health Zone in North Kivu at 63 and 402 days, respectively, without notification of cases. It also presented the contribution of the various pillars to the response, common services, community engagement and some safety aspects in support of public health activities.
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Source: https://www.who.int/csr/don/31-october-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
31 October 2019



The ongoing Ebola virus disease (EVD) outbreak in the North Kivu and Ituri provinces saw a stabilization in the number of new cases this past week, with 19 confirmed cases reported in the past week (23–29 October), essentially equivalent to the 20 confirmed cases the week before. The majority (63%) of newly confirmed cases link back to chains of transmission in Biakato Mine Health Area, Mandima Health Zone, including a further three cases detected outside of Mandima in individuals who recently travelled from Biakato.

Onward local transmission has been observed in a limited number of towns and villages within family/social networks or health centers where cases visited prior to their detection and admission to treatment. In Mabalako, seven new cases were reported, of which two were linked to Biakato, two reported local family contact, and two were contacts within local health facilities, suggesting possible nosocomial exposure; investigations are ongoing for the remaining case. In Mambasa Health Zone, one additional case was reported, linked to a large cluster of cases. In Butembo, after over 21 days with no cases, two were reported this week. Both were residents of Kalunguta Health Zone where they were likely exposed. Thus far, there is no evidence of onward transmission in Butembo; nonetheless, these events demonstrate the high risks of reintroduction and resurgence in previously cleared health zones.

During the past 21 days (from 9 – 29 October), 59 confirmed cases were reported from eight active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in three health zones: Mandima (49%, n=29), Mabalako (20%, n=12), and Mambasa (10%, n=6). As of 29 October, a total of 3269 EVD cases were reported, including 3152 confirmed and 117 probable cases, of which 2182 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1841) were female, 28% (n=926) were children aged less than 18 years, and 5% (n=163) were health workers. [h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 29 October 2019*[/h]
figure1_20191031.PNG




Enlarge image



*Excludes n=184 cases for whom onset dates not reported. 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 reported cases by health areas. Data as of 29 October 2019*[/h]
figure2_20191031.PNG




Enlarge image
[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 29 October 2019**[/h]
table1_20191031.PNG




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:
[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.

While the relatively lower case incidence observed 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 was 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; delays to engaging with the community which in turn lead 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 neighbouring 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:

 
Translation Google

Ituri: Lwemba Community Radio reporter killed by gunmen

Posted on Sun, 03/11/2019 - 11:17 | Edited on Sun, 03/11/2019 - 11:24

In Ituri, armed men identified in May-May attacked Lwemba, located 55 kilometers south of Mambasa center, on Saturday, November 3.

According to the Organization for the Defense of Human Rights Convention for the Development of Forest Peoples (CODEPEF), dozens of men armed with rifles and machetes raided Lwemba-mahulo in the Babila-Teturi group as chieftaincy chiefs. babombi around 20 hours.

The same source, these assailants fired shots before breaking into the house of a journalist from the Community Radio Lwemba.

The latter, aged thirty-five was killed on the field.

His wife was badly wounded with a machete in her private parts.

The victim was involved in the response to Ebola as a community relay.

His house was burned. His sixteen year old child managed to escape during the attack, he was found this Sunday.

According to local sources, the journalist had just hosted an awareness program on Ebola on his radio before this tragedy happened.

The CODEPEF condemns the umpteenth attack of the locality of Lwemba in less than two weeks by armed men. It challenges the authorities as to the safety of people and their property. The Mambasa Territory Administrator indicates that security measures will be strengthened in this entity to prevent further attacks in this area.

https://www.radiookapi.net/2019/11/...-de-la-radio-communautaire-lwemba-tue-par-des

------------------------------------------------------------------------------------------

OLPA demands investigation after assassination of a journalist in Lwemba, Ituri

Posted on Mon, 04/11/2019 - 08:26 | Edited Mon, 04/11/2019 - 09:41

The Observatory of Press Freedom in Africa (OLPA), requires a serious investigation after the murder of journalist Papy Mahamba Mumbere, journalist at the community radio Lwemba (RCL) station emitting in the village Lwemba located about fifty kilometers from Mambasa center in the province of El'Ituri.

In a statement dated November 3, published in Goma, OLPA reports that Papy Mahamba Mumbere was savagely murdered in the evening of November 2, 2019, at his home, by unidentified individuals with knives. "After mutilating the journalist, the attackers also wounded the journalist's wife before burning down her residence," the organization said.

The journalist was also involved in Ebola response operations in that part of the country as a community worker.

According to this Congolese organization for the defense and promotion of freedom of the press, since the end of September 2019, several radio stations in the Mambasa territory have decided to stop broadcasting the programs on the fight against the Ebola virus as a result of the the hostility of a large section of the population to the response to Ebola.

OLPA condemns this assassination and calls on the Ituri authorities to conduct serious investigations to elucidate the circumstances of this heinous act, in order to find the intellectual and material perpetrators of this crime. "

https://www.radiookapi.net/2019/11/...e-apres-lassassinat-dun-journaliste-lwemba-en
 
The Ministry of Health and the United Nations condemn attack on health worker supporting the Ebola response in the Democratic Republic of the Congo

Goma, 3 November 2019 – The interministerial technical secretariat of the response to the Ebola outbreak, the Ministry of Health and their partners from the United Nations (the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and the United Nations Emergency Ebola Response Operations (UNEERO)) condemn in the strongest possible terms the violence that took place last night in Lwemba in Ituri Province, in north-eastern Democratic Republic of the Congo.

The violence caused the death of an Ebola response community health worker and left his spouse critically injured with multiple wounds.

The victim was also a reporter for a community radio station in Lwemba and was involved in raising the awareness of his community regarding the country’s tenth Ebola outbreak, which began over a year ago and is impacting the provinces of Ituri, North Kivu and South Kivu.

The motive behind the attack is still unclear.

Authorities have begun an investigation of the murder and are looking into whether it is connected to the ongoing Ebola response. Two suspects have been apprehended.

Any act of violence against individuals involved with the response is unacceptable and compromises the ability of health workers to provide assistance to communities impacted by the devastating effects of Ebola.

All relevant authorities, including the Congolese National Police, the National Intelligence Agency and the Armed Forces of the Democratic Republic of the Congo, are working to ensure that the perpetrators of this heinous act are brought to justice as swiftly as possible.

The interministerial technical secretariat of the response to the Ebola outbreak, the Ministry of Health and its United Nations partners (WHO, UNICEF and UNEERO) offer their deepest condolences and sympathies to the families of those affected by this tragedy and to the broader community where this violence took place.

Since 1 January 2019, WHO has documented more than 300 attacks on health care that have caused 6 deaths and 70 injuries of health care workers and patients in the country.

Every attack sets back the Ebola response, which cannot function without an environment conducive for response teams to access and help the population.

https://www.afro.who.int/news/minist...ebola-response
 
Outbreaks and Emergencies Bulletin, Week 44: 28 October - 3 November 2019
...
Ebola virus disease Democratic Republic of the Congo

3 274 Cases
2 185 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 seven health zones and 15 health areas reporting confirmed
cases in the past 21 days (13 October to 2 November 2019). Since
our last report on 27 October 2019 (Weekly Bulletin 43), there have
been 11 new confirmed cases and five new deaths. The principle hot
spots of the outbreak in the past 21 days are Mandima (53%; n=28
cases), Mabalako (25%; n=13 cases) and Mamabasa (11%; n=6).
Four health zones, Mandima, Mabalako, Beni and Mambasa have
reported new confirmed cases in the past seven days.

As of 2 November 2019, a total of 3 274 EVD cases, including
3 157 confirmed and 117 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 (78),
Mandima (338), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (680), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (386), 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 2 November 2019, a total of 2 185 deaths were recorded,
including 2 068 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 65% (2 068/3 157). The cumulative
number of health workers remains 163, which is 5% of the confirmed
and probable cases to date.

Contact tracing is ongoing in ten health zones. A total of 6 078
contacts are under follow-up as of 2 November 2019, of which
5 237 have been seen in the past 24 hours, comprising 86% of the
contacts. Alerts in the affected provinces continue to be raised and
investigated. Of 4 165 alerts processed (of which 4 068 were new) in
reporting health zones on 2 November 2019, 4 075 were investigated
and 513 (13%) 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. Cross-border collaboration continues, particularly with
Uganda and Rwanda.

As of 2 November 2019, a cumulative total of 246 672 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 113 million screenings to date. A total of 109/112
(96%) PoE/PoC transmitted reports as of 2 November 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, with
a campaign to promote hand hygiene finished in Biakato on 2
November 2019, while hygienists in the Base of Life briefed on
standard PCI procedures.

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.

Biakato’s sub-coordination teams have intensified the message of risk
communication and community engagement in the reintegration of cured patients
in the health areas of Lwemba and Biakato Mines along with a community dialogue
held with grassroots leaders and women and youth associations to further
strengthen community involvement.

SITUATION INTERPRETATION

Substantive rates of transmission remain in Mandima Health Zone, with smaller clusters
elsewhere, which require a concerted effort from all response teams and international
partners to control. Movement of symptomatic cases still occurs
, so it is critical that
all areas of the response remain effective, engaged and fully resourced, with response
activities continuing to be scaled and adapted to the evolving local context.

https://apps.who.int/iris/bitstream/handle/10665/329654/OEW44-281003112019.pdf
https://www.afro.who.int/node/11952
 
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT NOVEMBER 04, 2019

Tuesday, November 05, 2019
  • Since the beginning of the epidemic, the cumulative number of cases is 3,282, of which 3,164 are confirmed and 118 are probable. In total, there were 2,188 deaths (2070 confirmed and 118 probable) and 1059 people healed.
  • 542 suspected cases under investigation;
  • 1 probable case in North Kivu at Kalunguta;
  • 7 new confirmed cases, including:
  • 6 in North Kivu, including 3 in Beni and 3 in Mabalako;
  • 1 in Ituri in Mandima;
  • 2 new confirmed deaths in North Kivu, including:
  • 1 community death in Beni;
  • 1 confirmed death at the CTE of Beni;
  • 4 people cured out of ETCs, 3 in North Kivu, including 2 in Beni and 1 in Butembo, and 1 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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Translation Google

DRC: activities still paralyzed after murder of journalist in Lwemba

Posted on Tue, 05/11/2019 - 19:20 | Modified on Tue, 05/11/2019 - 19:20

All health facilities are closed since Sunday in the locality of Lwemba in Mambasa territory after the murder of a journalist by armed men "who resist Ebola response measures," said Tuesday, November 5, the Defense Organization of human rights Convention for the Development of Forest Peoples (CODEPEF). Patients travel 18 kilometers on foot or on bicycles for treatment in the neighboring town of Biakato. The NGO also fears the spread of the Ebola epidemic in this area, where the response activities are suspended.

Economic and academic activities slow down in Lwemba after Sunday's attack on gunmen who killed journalist Papy Mahamba. The consequences are more serious in the health field.

Local sources specify health posts, health centers and pharmacies are also closed. All health workers and even the response team fled to Biakato, 18 kilometers away.

They claim to be the target of armed men, "some of whom are hidden among the population. "This situation forces the patients of Lwemba to move to Biakato to seek treatment, using an impassable and unsecured road, lamented Laurent Keya, interim coordinator of CODEFEF.

This NGO launches an alert to the authorities to save lives in distress and prevent the spread of Ebola in the area.

The administrator of the Mambasa territory says a security meeting extended to partners in the fight against Ebola is being held on Tuesday, November 5 in Mambasa center. It is a question of stopping the necessary measures for the eradication of this epidemic.

Armed men identified to the Mai-Mai attacked Lwemba, located 55 kilometers south of Mambasa center in Ituri, from Saturday to Sunday, November 3. According to the CODEPEF, dozens of men armed with rifles and machetes raided Lwemba-mahulo in the Babila-Teturi group in the Babila-Babombi chieftaincy around 20 hours. The same source, these assailants fired shots before entering the house of the journalist, they killed on the spot.

https://www.radiookapi.net/2019/11/...s-paralysees-apres-le-meurtre-dun-journaliste
 
Translation Google

Beni: motorcycles and drugs burned by the Mai-Mai at the Ngoyo health center in the city of Mangina

November 7, 2019

The alleged Mayi-Mayi rebel men raided the evening of Wednesday, November 6th, in Mangina, a city located more or less 27 kilometers west of the city of Beni in the territory bearing the same name, in the province of North Kivu.

These outlaws specifically targeted the Ngoyo health center, which they attempted to torch many times.

However, several batches of the drugs were destroyed by these strangers who also burned down at least three motorcycles that were on the scene, indicates a witness joined by the Writing of INTERVIEW.CD, the morning of this Thursday, November 7th.

The same source added that these gun carrying gunmen who came from the Mabuku area, were looking for the nurse-in-charge (IT) of this health center, and an agent for the counter-attack. Ebola but he did not find.

It should be noted that shortly before this crime, these bandits threatened another agent of the response to the Ebola virus disease that they beat and released a little later.

"The unknown gun bearers visited the Ngoyo health center, destroyed drugs and burned three motorcycles. They were looking for the I.T of this health center. During the day, these thugs had arrested an agent of the Ebola response they typed, luckily he escaped, "a Mangina resident told interview.cd.

The latter adds that these Mai-Mai have looted the property of citizens surrounding this health facility, without giving further details.

It should be remembered that the fight against the Ebola virus disease is facing multiple resistance, not to mention the security challenge it faces in the provinces of North Kivu and Ituri.

Christopher Mulakirwa

https://linterview.cd/beni-des-moto...-au-centre-de-sante-ngoyo-en-cite-de-mangina/
 
Source: https://www.who.int/csr/don/07-november-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
7 November 2019



Fifteen confirmed cases were reported in the past week (30 October – 5 November) in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. While the number of new cases is consistent with the weekly average of 19 confirmed cases in the past 21 days, there is notable daily fluctuation of cases.

Violence this week in Lwemba Health Area in Mandima Health Zone caused the death of an Ebola response community health worker and left his spouse critically injured. WHO and partners condemned the attack, adding that acts of violence against individuals involved with the response are unacceptable and compromise the ability of health workers to assist communities impacted by the devastating effects of Ebola.

During the past 21 days (16 October – 5 November), 54 confirmed cases were reported from seven active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in four health zones: Mandima (39%, n= 21), Mabalako (31%, n= 17), Beni (11%, n= 6) , and Mambasa (11%, n= 6). The vast majority (83%) of these cases were linked to Biakato Mines Health Area in Mandima Health Zone, with the remaining 10 cases linked to known chains of transmission in Binase, Katwa and Lwemba Health Areas.

In this context, reintroduction into previously cleared or unaffected neighbouring areas can be expected and possible geographical spread should be closely assessed and monitored. Approximately half (51%) of the cases reported in the past 21 days were located outside of the health zone where they had got infected, with the majority of these movements going to or coming from Mandima Health Zone. An analysis of population movement indicates that travel within the region is directed eastward from Mambasa to Komanda and towards Bunia, southward between Mambasa and Mangina, and further south and south-east through Beni to Butembo, and all the way to Kasindi and crossing into Uganda. Points of entry and points of control continue to be strengthened by response teams based on movement of cases and populations. This week, a case was detected while traveling through a newly-opened point of control, reinforcing the importance of enhancing screening along these major passages, transitways and border points. An example of reinforcement activities underway is the introduction of a EVD laboratory in Kasindi Health Area in the past week, close to the border with Uganda. This will facilitate the rapid identification of cases and earlier initiation of response activities.

As of 5 November, a total of 3285 EVD cases were reported, including 3167 confirmed and 118 probable cases, of which 2191 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n= 1852) were female, 28% (n= 930) were children aged less than 18 years, and 5% (n= 163) were health workers. [h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 5 November 2019*[/h]
figure1_20191107.PNG




Enlarge image



*Excludes n=184 cases for whom onset dates not reported. 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 reported cases by health areas. Data as of 5 November 2019*[/h]
figure2_20191107.PNG




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[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 5 November 2019**[/h]
table1_20191107.PNG




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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:
[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.

While the relatively lower case incidence observed 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 was a 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, delays to engaging with the community which in turn lead 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 Democratic Republic of the Congo 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:
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 45: 4 November – 10 November 2019
Data as reported by: 17:00; 10 November 2019
...
Ebola virus disease Democratic Republic of the Congo

3 287 Cases
2 193 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 seven health zones and 18 health areas reporting confirmed
cases in the past 21 days (20 October to 9 November 2019). Since
our last report on 3 November 2019 (Weekly Bulletin 44), there have
been 12 new confirmed cases and eight new deaths. The principle
hot spots of the outbreak in the past 21 days are Mandima (37%;
n=17 cases), Mabalako (37%; n=17 cases) and Beni (13%; n=6
cases). Three health zones, Mabalako, Beni and Mandima, have
reported new confirmed cases in the past seven days.

As of 9 November 2019, a total of 3 287 EVD cases, including
3 169 confirmed and 118 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 (78),
Mandima (339), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (685), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (392), 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 9 November 2019, a total of 2 193 deaths were recorded,
including 2 073 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 65% (2 075/3 169). The cumulative
number of health workers remains 163, which is 5% of the confirmed
and probable cases to date.

Contact tracing is ongoing in nine health zones. A total of 6 137
contacts are under follow-up as of 9 November 2019, of which 5
267 have been seen in the past 24 hours, comprising 86% of the
contacts. Alerts in the affected provinces continue to be raised and
investigated. Of 3 832 alerts processed (of which 3 846 were new) in
reporting health zones on 9 November 2019, 3 832 were investigated
and 482 (13%) 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. Cross-border collaboration continues, particularly with
Uganda and Rwanda.

As of 9 November 2019, a cumulative total of 249 855 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 116 million screenings to date. A total of 108/112
(96%) PoE/PoC transmitted reports as of 9 November 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, with five health
facilities and six out of seven households that were visited by confirmed cases
decontaminated. In addition, 54 households and four schools were provided with
PCI and WASH facilities.

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.

A guided tour of the newly opened Ebola treatment centre in Kalunguta was
conducted to improve perceptions on the care of patients; in Biakato health area,
the leader of the ‘Vatican bloc’, once the instigator of community resistance, was
vaccinated in public to improve community perception of vaccination.

SITUATION INTERPRETATION

Substantive rates of transmission remain in Mandima Health Zone, with smaller clusters
elsewhere
, which require a concerted effort from all response teams and international
partners to control. Movement of symptomatic cases still occurs, so it is critical that
all areas of the response remain effective, engaged and fully resourced, with response
activities continuing to be scaled and adapted to the evolving local context.

https://apps.who.int/iris/bitstream/handle/10665/329898/OEW45-0410112019.pdf

https://www.afro.who.int/node/11976
 
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Ebola in DRC: radio stops broadcasting for fear of reprisals

By RFI Published on 12-11-2019 Modified on 12-11-2019 at 02:36

A local radio committed to fighting the Ebola epidemic in eastern Democratic Republic of Congo announced on Monday that it stopped broadcasting for fear of reprisals that had already killed one of its journalists.

Lwemba community radio in Mambasa territory announced on Monday that it will stop broadcasting. In question: the threats hovering over the journalists engaged in the fight against the Ebola disease. On November 2, one of the radio hosts, Papy Mahamba, was murdered at his house by a group of the Mai Mai militia . His wife was injured and his house burned by the same aggressors. The director of the radio also reports escaping two kidnapping attempts.

For Franklin Yakani, acting administrator of Mambasa, the militia is attacking all actors in the fight against the Ebola epidemic. " Radio is the channel used to raise awareness [of the epidemic], because there is a group of people who deny the existence of the disease," he told RFI. Today, there are three targets. We have the radios, we also have the customary chiefs, who help to sensitize the population, and the staffs of international, national or local NGOs. "

Since September, several radio stations in the Mambasa area have decided to stop broadcasting Ebola programs because of the hostility of a large section of the population, according to a press organization. , OLPA.

http://www.rfi.fr/afrique/20191112-ebola-rdc-radio-lwemba-cesse-emettre-crainte-represailles
 
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