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WHO: The Democratic Republic of the Congo investigates suspected Ebola case in North Kivu (August 20, 2022) - Confirmed - Outbreak declared over

Shiloh

Shiloh

Editor, Senior Moderator
Source: https://www.afro.who.int/countries/...-investigates-suspected-ebola-case-north-kivu

The Democratic Republic of the Congo investigates suspected Ebola case in North Kivu
20 August 2022

Brazzaville/Kinshasa – Health authorities in the Democratic Republic of the Congo are investigating a suspected case of Ebola virus disease, in the country’s eastern province of North Kivu. Thecountry’s National Institute of Biomedical Research (INRB) is in the process of testing samples to determine if the patient contracted Ebola.
The suspected case is a 46-year-old woman who died on 15 August 2022 in Beni, a town located in North Kivu. The case received care at the Beni Referral Hospital, initially for other ailments, but subsequently, exhibited symptoms consistent with Ebola virus disease.
“While the analysis is ongoing, WHO is already on-the-ground supporting health officials to investigate the case and prepare for a possible outbreak,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.
WHO staff are working with health authorities to identify anyone who came in contact with the suspected case and monitor their health. WHO will also work to ensure proper infection prevention and control measures are in place, that treatment can be made available for those who need it, and to raise awareness about Ebola among local communities.
 
Translation Google

Ebola: non-compliance with barrier gestures despite the notification of a suspected case in Beni

Posted on Mon, 22/08/2022 - 13:24 | Modified on Mon, 22/08/2022 - 16:00


Four days after the announcement of a suspected case of Ebola in Beni, community response measures have not yet been taken in certain public places in the city, the Radio Okapi reporter noted on Monday August 22.

The government spokesman, the Minister of Communication and Media, Patrick Muyaya announced Friday August 19 in the report of the Council of Ministers, that a suspected case of Ebola had been notified Monday August 15, at the hospital reference general of Beni.

The patient died and his samples were sent to Kinshasa for in-depth analysis.

Meanwhile, in the city of Beni, no new Ebola response arrangements are being made.

In all public places, people behave as usual.

This is the case, in particular, at the central car park in Beni where public transport vehicles leave and return from Butembo at any time.

The old hand washing devices are dry at the parking lot entry point. The water tank doesn't even have taps anymore.

Only the office of the President of the Association of Congolese Drivers (ACCO) in this car park has a washbasin supplied with water at its entrance.

Drivers found in this office say they are unaware of the suspected Ebola case in the city.

At the Kilokwa central market, too, handwashing facilities are almost non-existent.

It is only in front of the buildings of financial institutions, such as banks, that there are hand washing devices, and everyone is obliged by the doormen to wash their hands before entering the bank.

At the Beni general hospital, there are washing devices at the entrance, but only a few people stop there to wash their hands.

https://www.radiookapi.net/2022/08/...stes-barrieres-malgre-la-notification-dun-cas
 
August 2022 EVD case in DRC linked to 2018-2020 Nord Kivu EVD outbreak

Ebolavirus
Aug 21
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Aug 22
10h ago
mbalaplacide
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The new case of Ebola Virus Disease in Beni is genetically linked to the 2018-2020 Nord Kivu/Ituri EVD outbreak and does not represent a new spillover event.**

Context

On Monday, August 15, 2022, the Institut National de Recherche Biomédicale (INRB) Beni mobile laboratory received an oropharyngeal secretion sample taken from a deceased patient who was being treated at the Beni General Reference Hospital (HGR-Beni). The sample tested positive for Ebola virus (EBOV) using the Cepheid Xpert Ebola assay with ct- values of 32.5 for viral glycoprotein (GP), and 28.2 for viral nucleoprotein (NP). For quality control and confirmation, samples were sent to the Rodolphe Mérieux INRB-Goma Laboratory on Tuesday August 16, 2022, where the analysis confirmed the EVD case.

The patient was admitted on July 23, 2022 to the Internal Medicine department of the HGR-Beni for cough, headache, polyarthralgia, intense physical asthenia dating back several days and for which she had self-medicated with non-specified drugs. She was HIV-positive on antiretroviral treatment, and she had also presented with tuberculosis for which she was receiving anti-tuberculosis treatment. On August 13, 2022, her health condition deteriorated with the onset of bronchial congestion and kidney failure, which prompted her transfer to the intensive care unit for better care. She died on August 15, 2022. In total her hospitalization lasted 23 days. The body was collected by the family the same day for burial.

On August 17, 2022, 131 contacts were listed, including 60 front-line healthcare workers and 71 co-patients. Of the 131 pre-listed contacts, 59 of the 60 HCWs are vaccinated. The vaccination status of the index case and 71 co-patients is not yet known.

Sequencing

Sequencing analysis was conducted at the Rodolphe Mérieux INRB-Goma Laboratory, thanks to genomic support provided by the Africa CDC Pathogen Genomic Initiative.

The swab sample, BEN1-22, was sequenced in triplicate (A/B/C) at the Pathogen Genomics Sequencing satellite Laboratory in Goma using the Oxford Nanopore Technologies (ONT) sequencing platform. Sequencing libraries were prepared using an amplicon sequencing approach (Mbala-Kingebeni, 2021; Grubaugh et al., 2019; Quick et al. 2017), generating identical genomes with 99.2%, 97% and 97.8% genome coverage, respectively.

The genome sequence generated from sample BEN1-22 group with other sequences from the Nord Kivu/Ituri Ebola virus disease (EVD) outbreak between 2018 and 2020. The new sequence is most closely related to a cluster of cases occurring in Beni around November/December 2018 and had six additional mutations from this cluster. If the new EVD case was the result of continued human-to-human transmission we would have expected many more mutations to have occurred during this time. Therefore, our initial findings indicate that this case likely represents a new flare-up of the 2018-2020 Nord Kivu/Ituri EVD outbreak, initiated by transmission of Ebola virus from a persistently infected survivor or a survivor who experienced a relapse. This case may be the index case, or there may be previous cases that were not detected. Epidemiological investigations are ongoing to determine the source.

...
https://virological.org/t/august-202...d-outbreak/889
 
Source: https://www.ctvnews.ca/health/new-e...n-congo-linked-to-previous-outbreak-1.6037112


New Ebola case confirmed in eastern Congo, linked to previous outbreak
Reuters
Published Aug. 22, 2022 11:42 a.m. EDT


DAKAR -

A new case of Ebola virus has been confirmed in the city of Beni in eastern Democratic Republic of Congo, the country's National Institute for Biomedical Research (INRB) said on Monday.

Testing showed the case was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces, which killed nearly 2,300 people, said a statement from Placide Mbala, chief of the Pathogen Genomics Laboratory at INRB.

Another flare-up from that outbreak killed six people last year. Congo's most recent outbreak was in a different part of the country, and was declared over in July after five deaths...
 
The Democratic Republic of the Congo declares Ebola resurgence in North Kivu

23 August 2022

Brazzaville/Kinshasa – Health authorities in the Democratic Republic of the Congo declared a resurgence of Ebola late last night, following confirmation of one case in the country’s eastern province of North Kivu.

A 46-year-old woman died on 15 August 2022 in Beni, a town located in North Kivu. She received care at the Beni Referral Hospital, initially for other ailments, but subsequently exhibited symptoms consistent with Ebola virus disease

Both the Beni and Goma branches of the country’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Analyses showed that the case was genetically linked to the 2018-2020 Ebola outbreak in North Kivu and Ituri Provinces—the country’s longest and largest.

“Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning. However, health authorities in North Kivu have successfully stopped several Ebola flare-ups and building on this expertise will no doubt bring this one under control quickly,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.

WHO staff and health authorities in the Democratic Republic of Congo working to stem the spread of the disease, having identified 160 contacts whose health is being closely monitored. Investigations are ongoing to determine the vaccination status of the confirmed case.

There are 1000 doses of the rVSV-ZEBOV Ebola vaccines available in the country’s stockpile, 200 of which will be sent to Beni this week. Ring-vaccination—where contacts and contacts of contacts are vaccinated to curb the spread of the virus and protect lives—is expected to begin shortly.

The last flare-up in North Kivu’s Beni health zone was brought under control in about two months, ending on 16 December 2021. There were 11 cases (eight confirmed, three probable), including six deaths.

https://www.afro.who.int/countries/...country=975&name=Democratic Republic of Congo
 
Translation Google

Ebola in Beni: "Community engagement is the key to success for any response", notes Dr Michel Tosalisana
'
Published on Thu, 25/08/2022 - 09:19 | Edited on Thu, 08/25/2022 - 09:19


The Minister of Public Health officially declared, on Sunday August 21, the epidemic of the Ebola virus disease in Beni (North Kivu).

Guest of Radio Okapi, the head doctor of the Beni health zone, Dr Michel Tosalisana indicates that the victim died and the samples taken from his body attested that it is the strain of Ebola Zaire, which raged in the region between the years 2018 and 2019.

He says he has already identified 79 contacts and the follow-up is following up in different health zones in North Kivu.

“ We ask the population to adhere to the actions of the field teams. Community engagement is key to any successful response. When we wash our hands, we avoid dirty hand diseases and at the same time, we avoid COVID-19 and Ebola. These habits must remain everywhere, starting with myself ,” said Dr. Michel Tosalisana.

Dr Michel Tosalisana talks with Sadiki Abubakar

(Audio in French)

https://www.radiookapi.net/2022/08/2...le-de-reussite


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

DRC-Ebola: start of vaccination of health workers in Beni

Thursday, August 25, 2022 - 1:38 p.m.

The Democratic Republic of Congo is experiencing the 15th outbreak of the Ebola virus disease. A few days after the official announcement of the epidemic, a vaccination campaign was launched on Thursday at the Beni general reference hospital.

"The objective is to protect front-line workers who will in turn vaccinate contacts," the WHO said.

More than 200 doses of Ervebo vaccines (rVSV-ZEBOV) have been provided by WHO to vaccinate frontline health workers, identified contacts and contacts of contacts.

“No new confirmed cases have been reported. The only positive case, deceased, dates back to August 15, 2022”, says the UN agency.

According to the government, the trigger case for the 15th epidemic is genetically linked to the 2018-2020 Ebola epidemic in the provinces of Ituri, North Kivu and South Kivu, the longest and the largest recorded in the country. This is a 46-year-old woman who died on August 15, 2022 in Beni.

The last outbreak in Beni Health Zone, North Kivu was brought under control in about two months, ending on December 16, 2021. There had been 11 cases (eight confirmed, three probable), including six deaths.

Clement MUAMBA

https://actualite.cd/2022/08/25/rdc-ebola-debut-de-vaccination-des-agents-de-sante-beni
 
Source: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON404


Ebola virus disease - Democratic Republic of the Congo

25 August 2022


Outbreak at a glance
On 21 August 2022, the Ministry of Health (MoH) of the Democratic Republic of the Congo announced that a new laboratory-confirmed case of Ebola Virus Disease (EVD) had been detected in Beni health zone in the province of North Kivu. The case, a 46-year old woman who had co-morbidities, died on 15 August 2022 after being hospitalized for 23 days. Oropharyngeal secretion samples were taken after death on 15 August 2022 and tested positive for EVD. The body was buried before the EVD results were known. Field investigations are ongoing to identify hospital and community contacts. The last EVD outbreak in the Democratic Republic of the Congo was in Equateur province and declared over on 4 July 2022.
Outbreak overview
On 21 August 2022, the Ministry of Health (MoH) of the Democratic Republic of the Congo announced that a new laboratory-confirmed case of Ebola Virus Disease (EVD) had been detected in a 46-year-old woman living in the city of Beni, in the province of North Kivu.
The case was hospitalized and treated for 23 consecutive days—from 23 July to 15 August 2022—for symptoms thought to be related to her known co-morbidities, including cough, headache, polyarthralgia (joint pain), and physical asthenia (general fatigue). The patient died in hospital on 15 August 2022 and the body was returned to the family for burial. To date, there is no information on the Ebola vaccination status of the deceased case.
On 15 August 2022, a sample of the oropharyngeal secretions was taken from the body and tested positive by reverse transcription polymerase chain reaction (RT-PCR) at the National Institute for Biomedical Research (INRB), Beni. For quality control purposes, the sample was then tested at the Rodolphe Mérieux INRB Laboratory in Goma, which confirmed the results by RT-PCR on 16 August 2022. The body was returned to the family prior to receiving the laboratory results and subsequently buried on 16 August 2022.
A total of 134 hospital contacts (60 health care personnel and 74 co-patients) have been identified. As of 24 August, nine family contacts have also been identified. There are ongoing investigations by response teams in the health facility where the patient was being treated, as well as in the community.
The sequencing carried out at the Rodolphe Mérieux Laboratory of INRB in Goma confirmed this case is genetically linked to the 2018-2020 outbreak in North Kivu, Ituri and South Kivu provinces (Ebola Zaire strain) and not a new spillover event. (For more information on this outbreak, please see the Disease Outbreak News published on 26 June 2020). Samples were also sent to INRB-Kinshasa for genomic sequencing.
Epidemiology of Ebola virus disease
EVD is a rare but severe, often fatal illness in humans. It is a viral haemorrhagic fever caused by the Ebola virus which is often fatal if untreated. The virus is transmitted to people through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats (thought to be the natural hosts). It spreads through human-to-human transmission via direct contact with blood or body fluids of a person who is sick with or has died from Ebola, objects that have been contaminated with body fluids from a person sick with Ebola or the body of a person who died from Ebola.
The average EVD case fatality ratio is around 50% and has varied from 25% to 90% in past outbreaks. Providing supportive care - rehydration with oral or intravenous fluids - and treatment of specific symptoms improves survival. The incubation period (time from infection to onset of symptoms) ranges from 2 to 21 days. A person infected with Ebola cannot spread the disease until they develop symptoms.

Public health response

The MoH of the Democratic Republic of the Congo, in collaboration with WHO and other partners, has launched response measures to control the outbreak and prevent its spread.
Investigations are underway, including identifying the source of contamination, contacts, contacts of contacts, defining the risks of exposure at the different departments of the hospital, and strengthening infection prevention and control (IPC) measures at the hospital.
Building on local capacities at the health zone level, outbreak control interventions are being organized in the field and include case investigation, contact tracing, strengthening of surveillance system, isolation of suspected cases and providing care, laboratory confirmation, IPC measures in health facilities, as well as community engagement and social mobilization.
EVD response interventions include:
  • Strong engagement with communities focusing on EVD prevention, early recognition of symptoms and care seeking and vaccination;
  • Case investigations, active case search and contact tracing activities;
  • Re-activation of the alert system;
  • Activation of points of control at key border crossings;
  • Strengthening, as needed, the functional laboratory in Beni;
  • Preparation for ring vaccination using the Ervebo licensed vaccine and targeting contacts of the confirmed case and their contacts along with frontline workers. The International Coordinating Group for Vaccine Provision approved the use of the remaining doses available in country. Vaccines are being shipped to Goma and Beni and ultra-cold chain being assessed and set-up as needed.
  • Treatment course of monoclonal antibodies are available in country;
  • On-going assessment and rehabilitation of Beni Ebola Treatment Centre and strengthening of screening, triage and isolation capacities of other health facilities;
  • IPC measures have been initiated and include decontamination of health facilities, assessment and support to health facilities and training of health care workers on implementation of IPC measures, and water and sanitation rehabilitation;
  • Capacities for safe and dignified burials are being assessed.
WHO risk assessment

Preliminary information indicates that the first case was hospitalized at the health facility for 23 days without being diagnosed with EVD and died before EVD was confirmed by the laboratory. There is a risk of spread of EVD in the Province, and infection among health workers and co-patients in the health facility where the case was admitted.
The current resurgence is not unexpected given that EVD is endemic in the country and Ebola virus is present in animal reservoirs in the region. The virus can persist in some bodily fluids of EVD survivors. In a limited number of cases, secondary transmissions resulting from exposure to body fluids of EVD survivors have been documented. Relapses in EVD survivors have been reported. Moreover, the frequent detection of outbreaks in recent years can also be explained by new developments in Ebola control, such as the use of GeneXpert machines, as well as the strengthening of surveillance and detection following successive epidemics and the scaling up of Integrated Disease Surveillance and Response (IDSR).
The re-emergence of EVD is a major public health concern in the Democratic Republic of the Congo and there are still gaps in the country's capacity to recover, prepare and respond to outbreaks.
The Beni area is also affected by insecurity from armed groups. There have been more frequent protests against the security measures put in place by the authorities and against the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), which further increases the risk of refusal of outbreak control measures and therefore the possibility of spread of the disease. The concurrent outbreaks in the country (COVID-19, cholera, measles, polio, yellow fever, monkeypox, etc) as well as the protracted humanitarian situation in the province of North Kivu, have put increasing pressure on the health system and the available resources.
The risk at the national level is assessed as high. The risk at the regional and global levels is assessed as moderate and low, respectively. WHO is closely monitoring the situation and the risk assessment will be updated as new information becomes available.

WHO advice

WHO recommends the following risk reduction measures as an effective way to reduce transmission of Ebola virus disease in humans:
  • Reduce the risk of wildlife-to-human transmission through contact with infected fruit bats or monkeys/great apes and consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reduce the risk of human-to-human transmission through direct or close contact with people showing symptoms of Ebola, especially with their bodily fluids. Appropriate personal protective equipment should be worn when caring for sick patients. Regular hand washing is necessary after visiting patients in a hospital, as well as after touching or coming into contact with bodily fluids.
  • Reduce the risk of possible sexual transmission, based on further analysis of ongoing research and review by the WHO Advisory Group on the Ebola Virus Disease Response. WHO recommends that male EVD survivors practice safer sex for 12 months from the onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend the isolation of male or female convalescent patients whose blood has tested negative for Ebola virus.
  • Engage with communities to support implementation of preventive behaviour and to foster acceptance of outbreak response measures.
  • Continue training and retraining of health personnel for early detection, isolation and treatment of EVD cases as well as retraining on safe and dignified burials.
  • Ensure availability of PPE and IPC supplies to manage sick patients and for decontamination.
  • Prepare for vaccination of health workers, contacts, and contacts-of-contacts using the Ervebo licensed vaccine.
  • For those who have already been vaccinated for more than six months, the Strategic Advisory Group of Experts (SAGE) on vaccination recommends that they be revaccinated if they are among the contacts or contacts-of-contacts of the confirmed case of EVD.
  • Provide access to Ebola specific monoclonal antibodies to treat confirmed cases, as per latest guidelines.
  • Collaborate with communities to strengthen safe and dignified burial practices.
Based on the current risk assessment and previous evidence on Ebola outbreaks, WHO advises against any travel and trade restrictions to the Democratic Republic of the Congo.

Further information
Citable reference: World Health Organization (25 August 2022). Disease Outbreak News; Ebola virus disease- Democratic Republic of the Congo. Available at: https://www.who.int/emergencies/dise...em/2022-DON404


See all DONs related to this event
Read more about Ebola virus disease
 
Translation Google

DRC: unobserved barrier gestures after the declaration of the 15th Ebola epidemic in Beni (Story)

August 31, 2022 in Health

Barrier measures against the Ebola virus disease (EVD) are struggling to be observed in the city of Beni (North Kivu) after the declaration in the area of ​​the 15th Ebola epidemic on August 22 by the National Ministry of health. Wearing a mask, washing hands in public places or social distancing are not observed. Everything seems to believe that the city has nothing threatening.

Factual account

During a round carried out in the city center and in certain public places of Beni, Tuesday, August 30, there is a total relaxation of barrier measures against the Ebola virus disease. At the entrance to the Mayangose ​​market not far from the town hall, just like inside, no measures have yet been taken, hand washing kits are not installed there. People don't wear a mask in a craze favorable to the spread of the virus, everyone seems to ignore the health threat against the city.

This same situation can be observed at the central market of Kilokwa, where no sanitary device is visible. In travel agencies, drivers as well as passengers do not hesitate to travel, in large numbers, stuck in cars, without masks.

The churches have not yet realized this danger to the city. Followers of religious denominations are visible in these public places without masks. In banking, micro-finance and supermarket institutions, rigor is not yet felt in the requirement to wear masks and wash hands.

This situation constitutes a favorable climate for the spread of this disease. The neighboring entities of Beni, including the city of Butembo are thus exposed to contamination.

In the meantime, the vaccination against Ebola, launched in the city of Beni, last Thursday, August 25, by the urban authority, is slow to know a massive adhesion of the population.

This Tuesday, August 30, the communication officer within the Provincial Health Division (DPS) branch of Butembo, which controls the city of Beni, deplored "the total relaxation" of preventive measures against the Ebola virus disease, in Butembo and Beni. Mumbere Luhavo Damaz, however, reassured about the follow-up of "contact cases" and the continuation of the vaccination campaign against this epidemic.

It should be recalled that during the tenth Ebola epidemic declared in the Beni region, in 2018, more than 2,000 people died. This epidemic, one of the most serious in the history of the DRC, had set fire to several parts of North Kivu, including the city of Butembo and the territory of Lubero. Its end is declared on June 25, 2020.

Didy Vitava

https://www.agoragrandslacs.net/rdc...ion-de-la-15eme-epidemie-debola-a-beni-recit/
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 35: 22 - 28 August 2022
Data as reported by: 17:00; 28 August 2022
...

Ebola Virus Disease Democratic Republic of the Congo

1 case
1 Death
100% CFR

EVENT DESCRIPTION

Following the declaration of the Ebola virus disease (EVD)
outbreak in the Democratic Republic of the Congo, laboratory
results genetically linked the confirmed case to the 2018-2020
outbreak in North Kivu and Ituri provinces.

As of 26 August 2022, one confirmed case, a 46-year-old woman,
who died on 15 August has been reported giving a case fatality
ratio (CFR) of 100%. No new confirmed case was reported in
the past week. Only one health zone (Beni) and one health area,
(Butanuka) have been affected at the moment.

About 177 contacts have been listed since the onset of the
outbreak, among them two were found already deceased in
the community on 24 and 25 August respectively. Laboratory
samples collected on the dead bodies tested negative for Ebola.

Of the total contacts listed, four became suspected cases and
samples were collected for laboratory analysis. Among the 22
health areas of the Beni health zone, 21 have at least one listed
contact, with Kanzulinzuli 55 (31.1%) and Butanuka 33 (18.6%)
health areas leading in number of contacts.

Regarding alerts, a total of 176 alerts including three deaths
were reported as of 27 August 2022, 175 alerts (98.9%) were
investigated, of which 10 (5.7%) were validated as suspected
cases of Ebola and samples collected from all of them. Out of
the 176 alerts reported, 129 (73.3%) are from active case search,
41 (23.3%) from healthcare facilities and six (3.4%) from the
community.

From 15 to 27 August 2022, a total of 122 samples (73 swabs)
were collected and analyzed, of which one sample (1 swab) tested
positive for the Ebola virus.

Vaccination activities of contacts and contacts of contacts were
launched on 25 August 2022 and are still ongoing. Two vaccination
sites have been set up so far in two health areas (Kanzuli-General
Hospital and Butanuka). The vaccine stock in the country as of 28
August 2022 is 885 doses (123 in Beni, 762 in Kinshasa).

PUBLIC HEALTH ACTIONS

On 21 August 2022, the national Minister of Health declared
an outbreak of Ebola virus disease in the Equateur Province,
Democratic Republic of the Congo.

WHO experts based in the Democratic Republic of the
Congo are supporting the national authorities to ramp up
key outbreak response areas including testing, contact
tracing, infection prevention and control, treatment as well
as working with communities to support the public health
measures to prevent infections.

Rapid response teams have been deployed to conduct
detailed investigation in the community to identify the source
of contamination, contacts, define the risks of exposure in
the various departments of the hospital and to strengthen
the prevention and control of infections.

A total of 177 contacts have been listed and are under close
monitoring.

Vaccination activities have been launched on 25 August
targeting firstly the contacts and contacts of contacts. A
total of 77 contacts have been vaccinated so far, including
44 frontline health workers as of 28 August 2022.

Infection prevention and control evaluation has been
conducted in three health facilities and all of them were
found to be at high risk.

Risk communication activities on prevention measures are
ongoing.

SITUATION INTERPRETATION

This new EVD outbreak occurs in an ongoing complex security
and humanitarian contexts in the eastern part of DRC. The
population’s distrust toward the security measures put in place
by the authorities and could impact the implementation of control
measures. Gaps in resource mobilization for full implementation
of the response plan should be filled as soon as possible. It is
essential that all contacts are identified and followed up on a
regular basis, the current contact follow-up performance must
be improved to reach the target of 100% of contact follow-up in
the last 24 hours.

https://apps.who.int/iris/bitstream/handle/10665/362112/OEW35-2228082022.pdf
 
Translation Google

Ebola in Beni: 21 days, without a new case

Published on Thu, 08/09/2022 - 22:07 | Edited on Thu, 08/09/2022 - 22:07

The health zone of Beni (North Kivu) totaled, Thursday, September 8, 21 days without having recorded a new case of Ebola virus.

The head doctor of this health zone, Michel Tosalisana, said that the count continues until it totals forty-two days to declare the end of this epidemic:

“If no other new cases are recorded within these 42 days, the epidemic will be declared over in the area”.

He indicated that so far, it is the only first case, who died at the Beni general reference hospital, which has been notified.

At least 170 contacts had also been identified and followed up by the response teams.

Dr. Michel Tosalisana added that vaccination activities are continuing normally.

https://www.radiookapi.net/2022/09/08/actualite/sante/ebola-beni-21-jours-sans-un-nouveau-cas
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 37: 5 - 11 September 2022
Data as reported by: 17:00; 11 September 2022
...

Ebola Virus Disease Democratic Republic of the Congo

1 cases
1 Deaths
100% CFR

EVENT DESCRIPTION

Twenty-six (26) days have passed since health authorities in
the Democratic Republic of the Congo declared an outbreak of
Ebola Virus Disease on 21 August 2022 in Butanuka health area,
Beni health zone. No new case has been reported so far as of 11
September 2022 and 16 days are remaining before the declaration
of the end of this outbreak if no new case is identified. To date,
there has been one confirmed case and one death (case fatality
ratio (CFR) =100%), in one affected health area (Butanuka) in
Beni health zone.

Among the contacts listed since the onset of the outbreak, 23
contacts were from Beni health zone, three from Oicha health
zone and one form Mutwanga health zone. A total of 27 contacts
remain missing, all of which were patients admitted at the same
hospital with the confirmed case. Other four contacts previously
missing were found in good health condition in the past week.

Since the onset of the outbreak, a total of 51 suspected cases
have been admitted to the Ebola treatment center, of which 47
were discharged as no cases and four are still under isolation.

Regarding alerts, a total of 296 alerts including five deaths
were reported as of 10 September 2022, and all of them were
investigated, of which 17 (5.7%) were validated as suspected
cases of Ebola and samples collected from them. Out of the
326 alerts reported, 164 (55.4%) are from active case search,
45 (15.0%) from through passive surveillance from healthcare
facilities and 87 (29.4%) from the community.

From 15 to 11 September 2022, a total of 406 samples (190
swabs) were collected and analyzed, of which one sample (1
swab) tested positive for the Ebola virus.

PUBLIC HEALTH ACTIONS

Coordination meetings organized by the national and
provincial health authorities with the participation of other
partners including WHO continue.

Advocacy meeting toward health partners was organised for
additional resource mobilisation for the response activities.

Vaccination activities have been launched on 25 August
targeting firstly the contacts and contacts of contacts. A total
of 289 contacts vaccinated so far, including 221 frontline
health workers as of 11 September 2022.

Psychosocial support and follow up was provided to admit
suspected cases, some of their family members and orphans
of the dead suspected cases.

Risk communication activities on prevention measures
including educative talks, community dialogues and
sensitisations are also ongoing

Assessment and monitoring of infection prevention and
control (IPC) practices at health facilities are also ongoing as
well the on job briefing of health provider on IPC measures.

Alerts management as well as active case search activities
are also ongoing

Case management including nutritional and psychosocial
follow up are also ongoing

SITUATION INTERPRETATION

The ongoing EVD outbreak in the eastern DRC has 16 days left
to the end of outbreak declaration if no new case is reported.
The need to mobilize more resources for the implementation of
response activities is still relevant even if no new case has been
reported. Population movements following security incidents
are reported in the affected area of Beni. This situation may
jeopardize the ongoing efforts for the control of this outbreak.
Gaps in resource mobilization for full implementation of the
response plan should be filled as soon as possible. Furthermore,
it is essential that all contacts are identified and followed up on a
regular basis.

https://apps.who.int/iris/bitstream/handle/10665/362665/OEW37-0511092022.pdf
 
Democratic Republic of the Congo Ebola outbreak declared over, Uganda boosts response

27 September 2022

Brazzaville/Kampala/Kinshasa – The Democratic Republic of the Congo today declared the end of an Ebola outbreak that re-emerged six weeks ago in the country’s North Kivu Province. The announcement came as neighbouring Uganda races to curb an unrelated outbreak declared last week.

With only one case confirmed, the just-ended outbreak was one of the Democratic Republic of the Congo’s least catastrophic. A previous outbreak – the country’s 14th in which there were four confirmed cases and five deaths – was declared over on 4 July this year.

The Ebola outbreaks in the Democratic Republic of the Congo have been caused by the Zaire ebolavirus – one of the six species of the Ebola genus. Uganda is fighting a fast-evolving outbreak of Sudan ebolavirus, with 36 cases (18 confirmed and 18 probable) and 23 deaths reported as of the 25 September.

In the Democratic Republic of the Congo, improving Ebola outbreak readiness and response is paying off. Only a few days after the outbreak in North Kivu was declared, the health authorities rolled out a vaccination drive using the ring strategy. More than 500 people were vaccinated including 350 contacts, contacts of contacts and frontline workers. Nearly all the 182 people who had come into contact with the initial case were monitored over 21 days and cleared once confirmed as not being at high-risk.

Analyses of samples taken from the confirmed case showed that the outbreak was genetically linked to the 2018–2020 Ebola outbreak in North Kivu and Ituri provinces—the country’s longest and largest. Although the current outbreak in North Kivu has been declared over, health authorities are maintaining surveillance measures and remain ready to respond to any flare-ups.

“The Democratic Republic of the Congo has built up impressive expertise in controlling the virus and we can marshal the lessons learnt to beat back the Ebola outbreak in Uganda,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “While an effective vaccine is not yet available for the Sudan ebolavirus, this is just one tool. We can and have brought Ebola to heel with robust contact tracing, detection, isolation of cases and good supportive care.”

In Uganda, the Sudan ebolavirus outbreak has now affected three districts: Mubende, Kyegegwa and Kassanda across 120 kilometres. To date, 399 contacts have been identified and are being monitored as the search continues to identify other people who may be at-risk. Uganda has strong testing capacity for Ebola, with 5000 tests currently available for use.

There are 30 people undergoing care—13 of whom are confirmed to have Ebola and 17 of whom are suspected to have contracted the disease. While there is no specific treatment for Sudan ebolavirus, those who are sick are receiving supportive care, which significantly improves their prognosis. An isolation unit has been set up in the Mubende Regional Referral Hospital and preparations are underway for an additional Ebola Treatment Unit. WHO has also deployed three viral haemorrhagic fever kits with medical supplies, medicines and personal protective equipment. More kits will be deployed based on need.

WHO is supporting Uganda to improve readiness in health districts which have not reported any Ebola cases by building on previous preparedness efforts and providing refresher trainings for clinicians on surveillance, case detection and management. The Organization is strengthening infection prevention and control in health facilities and is supporting simulation exercises in high-risk districts.

Additionally, WHO is assisting rapid response teams in neighbouring countries to strengthen case investigation, contact tracing and working with communities, as well as prepositioning critical medical equipment and supplies including personal protective equipment in high-risk countries.

Through its Contingency Fund for Emergencies, WHO is providing US$ 500 000 to support Uganda’s Ebola control efforts and another US$ 300 000 from its preparedness programme to support readiness activities in the neighbouring countries.


https://www.afro.who.int/countries/...outbreak-declared-over-uganda-boosts-response
 
Source: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON411


Ebola Virus Disease –Democratic Republic of the Congo

29 September 2022

Situation at a glance
On 27 September 2022, the Ministry of Health (MoH) of the Democratic Republic of the Congo declared the end of the Ebola virus disease (EVD) outbreak that affected Butanuka health area, Beni health zone, North Kivu province. In accordance with WHO recommendations, the declaration was made 42 days (twice the maximum incubation period for Ebola virus infections) after the burial of the last and only confirmed case.
Description of the outbreak
On 21 August 2022, the MoH of the Democratic Republic of the Congo declared an Ebola outbreak following laboratory confirmation via reverse transcriptase-polymerase chain reaction (RT-PCR) of Ebola virus in a fatal case in Beni health zone, North Kivu province.
The case was a 46-year-old woman hospitalized and treated from 23 July to 15 August (23 days) for symptoms that included cough, headache, polyarthralgia (joint pain), and physical asthenia (general fatigue), thought to be related to her known co-morbidities. The patient died in hospital on 15 August 2022. The body was returned to the family and buried in a traditional manner on 16 August prior to receipt of the laboratory results.
Samples of blood and oropharyngeal secretions tested positive for Zaire ebolavirus by RT-PCR at the National Institute for Biomedical Research in Beni (INRB) on 15 August and these were confirmed at Rodolphe Mérieux INRB Laboratory in Goma on 16 August. The outbreak was declared by the MoH following EVD confirmation testing and genetic sequencing.
No additional confirmed or probable cases have been identified since 16 August. Of the 182 contacts of the case, 172 were identified and monitored for 21 days. The 10 contacts who were not followed up were unable to be reached.
Investigations are still ongoing to determine the source of the outbreak.

Public health response

Overall response: TheMoH, together with WHO and other partners, conducted response measures to control the outbreak and prevent further spread. National and district emergency management committees were activated to coordinate the response. Multidisciplinary teams were deployed to actively search and provide care for cases; identify, reach and follow-up contacts; and sensitize communities on outbreak prevention and control interventions.
Alerts and testing: During this outbreak, from 21 August to 27 September 2022, a total of 9173 alerts were reported from Beni health zone, and all (100%) were investigated, including 607 (7%) validated as suspected cases of EVD. A total of 682 samples were tested for EVD.
Points of entry: A total of 2390 (92%) of 2608 travelers registered at points of entry were screened for EVD, and no alerts were detected.
Vaccination: As of 27 September, 550 persons in the affected health zone have been vaccinated against EVD using the ring strategy, targeting contacts and contacts of contact. Frontline health care workers made up the majority of those vaccinated (483).

WHO risk assessment

This latest EVD outbreak in the Democratic Republic of the Congo is declared over, with no new cases reported for 42 days after the burial of the last and only confirmed case on 16 August 2022. This case is genetically linked to the 2018-2020 outbreak in North Kivu, Ituri and South Kivu provinces. (For more information on this outbreak, please see the WHO outbreak account related to the 2018-2020 event). The source of this most recent outbreak has not yet been identified.
A future outbreak is not unexpected given that EVD is endemic in the country. Ebola virus is enzootic and a resurgence from viral persistence in survivors described in recent epidemics. Re-emergence of EVD is a major public health concern in the Democratic Republic of the Congo; gaps remain in the country's capacity to recover, prepare for, and respond to outbreaks. The concurrent outbreaks in the country (COVID-19, cholera, measles, polio, yellow fever, monkeypox, etc) as well as the protracted humanitarian situation in the Eastern part of the country have put increasing pressure on the health system and the available resources.
A confluence of environmental and socioeconomic factors — including community mistrust, weak health systems, and political instability — in some specific areas such as North Kivu province can increase the risk for new outbreaks of EVD. Moreover, improved capacities in detection, laboratory confirmation and increased surveillance may explain the increased frequency in detecting EVD outbreaks. Nevertheless, WHO is concerned that ongoing challenges regarding insecurity as well as health system challenges (epidemiological surveillance, IPC programmes and practices in health care settings), coupled with the emergence of COVID-19 and other ongoing outbreaks, may jeopardize the country's ability to rapidly detect and respond to any re-emergence.

WHO advice

WHO advises the following risk reduction measures as an effective way to reduce EVD transmission in humans:
  • Reduce the risk of wildlife-to-human transmission from contact with infected fruit bats or non-human primates and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing.
  • Reduce the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Appropriate personal protective equipment should be worn when taking care of ill patients. Regular hand washing is required after visiting patients in hospital, as well as after touching or coming into contact with any body fluids.
  • Continue training and retraining of health personnel for early detection, isolation and treatment of EVD cases as well as retraining on safe and dignified burials.
  • Reduce the risk of possible transmission from virus persistence in some body fluids of survivors. WHO recommends providing medical care, psychological support and biological testing (until two consecutive negative tests) through an EVD survivors care programme. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for the Ebola virus.
  • Reduce amplification of transmission through health care by strengthening IPC programmes within the health care system.
  • Provide ongoing training of the health workforce for early detection, isolation, and treatment of EVD cases as well as re-training on safe and dignified burials and the IPC ring approach.
  • Engage with communities to reinforce safe and dignified burial practices.
  • Build and maintain capacities for logistic support in at-risk areas or countries.
  • Based on the current risk assessment and prior evidence on Ebola outbreaks, WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo.
Further information
Citable reference: World Health Organization (29 September 2022). Disease Outbreak News; Ebola Virus Disease –Democratic Republic of the Congo. Available at: https://www.who.int/emergencies/dise...em/2022-DON411
 
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