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Ebola in the Congo

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    Posted: October 21 2019 at 5:19pm


NEWS 21 October 2019
The Ebola outbreak is finally slowing down

The World Health Organization says that the rate of new infections in the Democratic Republic of the Congo has dropped, as a vaccine moves closer to approval.
Amy Maxmen

Precautions against the Ebola epidemic in Democratic Republic of the Congo.

The use of an experimental Ebola vaccine has helped to curtail an outbreak of the virus in the Democratic Republic of the Congo.Credit: JC Wenga/Anadolu/Getty

The Ebola outbreak in the eastern Democratic Republic of the Congo (DRC) is finally waning, the World Health Organization (WHO) said on 18 October. The good news came as a vaccine that has helped to contain the virus’s spread moved a step closer to regulatory approval.

Fifty people were diagnosed with Ebola in the DRC between 25 September and 15 October, the WHO said. At the outbreak’s peak in April, roughly 300 new infections were reported in three weeks. Since the outbreak began in August 2018, almost 3,250 people have been infected and more than 2,150 have died.

But the drop in infections is not a reason to relax efforts to contain the virus, WHO director-general Tedros Adhanom Ghebreyesus told reporters on 18 October. “We must treat every case as if it is the first since every case has the potential to spark a new outbreak,” he said.

Ebola responders have pushed the virus out of Beni, a city in the DRC’s North Kivu province that has been a centre of the outbreak. But the WHO still considers the outbreak to be a public health emergency of international concern. Ebola is continuing to spread in remote parts of North Kivu and Ituri provinces, where violence has complicated the fight against Ebola.

An independent emergency committee of health experts that advises the WHO will convene again in three months to decide whether the crisis still merits the public-health-emergency designation.
Green light for vaccine

There was more good news on 18 October, when the European Medicines Agency (EMA) recommended that the European Commission approve an Ebola vaccine produced by the pharmaceutical company Merck.

About 240,000 people considered to be at risk from Ebola have been vaccinated with Merck’s vaccine during the DRC outbreak, but the vaccine is still considered to be an experimental product by regulators worldwide and cannot be marketed. Most Ebola specialists agree that the outbreak would have been much worse without the vaccine.

The EMA will make a recommendation within 10 weeks on whether to approve the vaccine for sale. The European Commission typically follows the counsel of the EMA.

The US Food and Drug Administration fast-tracked the vaccine’s application for approval in September. Its decision is expected in March 2020. Seven other experimental Ebola vaccines are at earlier stages of development.

Source:   https://www.nature.com/articles/d41586-019-03197-w

Sorry folks, I tried to post this on the Ebola Congo thread. Apparently I do not have permission to post there.     Hmmmm,    I thought I was a moderator.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: October 21 2019 at 10:39pm
Good news at last. Thanks for posting it.


Having given the vaccine to nearly a quarter of a million people should yield a lot of data. I just wonder if the EMA has time to process that data, as giving an answer in 10 weeks sounds like they are being pushed to make a rushed decision.

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forget Ebola
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Don't forget Ebola!.....................


Any let up in Ebola response could risk escalation of outbreak in DRC, warns IRC

Report
from International Rescue Committee
Published on 29 Oct 2019 — View Original

Goma, DRC, October 29, 2019 — As the daily number of reported Ebola cases continues to be in single digits, the International Rescue Committee (IRC) reaffirms that we must double down on our efforts to reach zero cases. Any let up in the response could risk a flare up of cases, and in turn prolong the outbreak.

Dalia al-Awqati, Ebola Response Director in the Democratic Republic of Congo (DRC) at the IRC said: “Whilst we have seen the number of reported cases drop in the past weeks, cases continue to arise, and the challenges we face in controlling the spread are undiminished. We are walking on a tightrope. We know that it does not take much for cases in a new area to escalate quickly, as we have seen following previous lulls in cases in this outbreak. It only takes one infected person to travel to a new area to start a new transmission chain. Given the 21 day incubation period, the chances of this are relatively high.”

Many of the areas in which the disease is now present represent a significant challenge to the response due to their remoteness and poor infrastructure, meaning curbing transmission continues to require significant effort. Increasingly we are working with small communities with pre-existing challenges such as lack of access to water and poor access to basic services.

For example, to travel the 36km [22 miles] to Mayuwano from the small town of Mambasa in southwest Ituri province takes two hours on a good day. On a bad day the road is simply impassable. Once in Mayuwano, there is little infrastructure meaning that all materials for triages need to be brought along the increasingly damaged road, which the community also relies on. This example also brings to light the challenges that many people in North Kivu and southwest Ituiri face everyday, with or without an Ebola outbreak.

The risk of spread from the DRC to neighboring countries remains high. This means maintaining high levels of preparedness in these countries until the very end of the outbreak in DRC. This includes both monitoring for and responding to Ebola cases, as well as working to ensure that existing humanitarian programming is resilient to a potential outbreak.

The IRC has been responding to the Ebola outbreak in North Kivu and Ituri since its declaration in August last year working in more than 90 health facilities in Beni, Mabalako, Butembo, Goma and in southwest Ituri, leading on infection prevention and control (IPC). The IRC is also working in women’s and children’s protection and community engagement, and integrating Ebola-related protection concerns in areas where the IRC supports primary health care services. The IRC has a long-standing presence in this area of North Kivu and continues to equally address pre-existing and persistent health and protection needs related to displacement and insecurity in this area now impacted by Ebola.

The IRC has been working in the Democratic Republic of Congo since 1996 responding to the humanitarian crisis in the east. It has since evolved into one of the largest providers of humanitarian assistance and post-conflict development, with life-saving programming in health, economic recovery, women’s and children’s protection, and livelihoods.

MEDIA CONTACTS

Jess Wanless
International Rescue Committee
+44 7384 258293

Jessica.Wanless@rescue.org
IRC Global Communications
+1 646 761 0307
communications@rescue.org
Source:   https://reliefweb.int/report/democratic-republic-congo/any-let-ebola-response-could-risk-escalation-outbreak-drc-warns-irc

...............at least not yet.
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Ebola: Attackers kill DR Congo journalist shining light on virus

2 hours ago

A Congolese journalist who had been raising awareness about the Ebola virus in the Democratic Republic of Congo has been killed at his home.

The army said unidentified attackers raided Papy Mumbere Mahamba's home in Lwebma, in the north-eastern province of Ituri, killing him, wounding his wife and burning their house down.

DR Congo is experiencing the world's second-worst Ebola epidemic on record.

People working to stop the virus are often targets of attacks.

Mahamba's murder is likely to have been fuelled by deep suspicion of the Ebola virus and mistrust of those who are working to stop it, the BBC World Service's Africa editor Will Ross says.
What happened?

Mr Mahamba had just hosted an Ebola awareness programme on a community radio station when the attack took place.

Professor Steve Ahuka, national coordinator of the fight against Ebola, confirmed the reports from the army that a "community worker" involved in the fight against Ebola had been killed.

    Six steps to stop Ebola from spreading
    Ebola: Your questions answered
    Ebola outbreak in five graphics

A journalist at Radio Lwemba, the local radio station where he worked, also confirmed the details. Jacques Kamwina told AFP news agency that Mahamba had been stabbed to death.
What is the situation with Ebola in the DRC?

The DRC declared an Ebola epidemic in August 2018. More than 2,000 lives have been lost amid a total of 3,000 confirmed infections, according to the World Health Organization (WHO).

The outbreak is affecting the DRC's North Kivu, South Kivu and Ituri provinces.

In July, the WHO said the situation there was a "public health emergency of international concern."

Efforts to control the outbreak have been hampered by violence against healthcare workers and Ebola treatment facilities.

Some do not believe that the virus exists or do not trust health workers, leading people to avoid treatment.

Over the last year there have been some 200 attacks on health workers, ambulances and health centres.
What is Ebola?

Ebola is a virus that initially causes sudden fever, intense weakness, muscle pain and a sore throat.

It progresses to vomiting, diarrhoea and both internal and external bleeding.

People are infected when they have direct contact through broken skin, or the mouth and nose, with the blood, vomit, faeces or bodily fluids of someone with Ebola.

Patients tend to die from dehydration and multiple organ failure.

Source, BBC:   https://www.bbc.co.uk/news/world-africa-50283286
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LATEST UPDATE

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.

Public health response

For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

Ebola situation reports: Democratic Republic of the Congo

WHO risk assessment

WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 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.

WHO advice

WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

LINKS

Sourcehttps://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-75
View Original:   https://www.who.int/csr/don/07-november-2019-ebola-drc/en/
Main WHO Site:   https://reliefweb.int/organization/who

Further links:


WHO resources and updates on Ebola virus disease:   https://www.who.int/health-topics/ebola/
News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities:   https://reliefweb.int/report/democratic-republic-congo/ebola-cases-reach-3000-drc-who-calls-all-partners-fulfill-promises
Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries:   https://reliefweb.int/report/democratic-republic-congo/ebola-cases-reach-3000-drc-who-calls-all-partners-fulfill-promises
Second Ebola vaccine to complement “ring vaccination” given green light in DRC:   https://reliefweb.int/report/democratic-republic-congo/second-ebola-vaccine-complement-ring-vaccination-given-green-light
Update on Ebola drug trial: two strong performers identified:   https://reliefweb.int/report/democratic-republic-congo/update-ebola-drug-trial-two-strong-performers-identified
Ebola response funding:   https://www.who.int/emergencies/diseases/ebola/drc-2019/funding
Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization:   https://www.who.int/immunization/policy/sage/en/
Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 18 October 2019:   https://www.who.int/immunization/policy/sage/en/
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Never ending story this one....







12 Monkeys...............
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Only not as much fun as that film.
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Outbreak Update

Thu 7 November 2019. WHO/AFRO Ebola dashboard, World Health Organization Regional Office for Africa:

3286 cases (including 0 new confirmed case), of which 3168 confirmed/ 118 probable cases, 531 suspected cases/ 51 cases in the last 21 days/ 1063 survivors/ 2191 deaths/ 5.7K contacts being followed out of 6.6K identified
Outbreak Response

Fri 7 Nov 2019. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola):

79 / 100 bikers were vaccinated, as part of the launch of the biker vaccination in Beni in the Kazabimyole health area;

Since vaccination began on 8 Aug 2018, 248 004 people have been vaccinated with the VSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck.

Since the beginning of the epidemic, the total number of travelers checked (temperature measurement) at the sanitary control points is 114 221 518.

To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country’s major cities and prevent the spread of the epidemic in neighboring countries





Source:   https://cepi.net/news_cepi/disease-outbreak-update-ebola-mers-rift-valley-fever-and-lassa-outbreaks-continue/
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12 November 2019
‘Make Ebola a thing of the past’: First vaccine against deadly virus approved

The drug, which has already been given to hundreds of thousands of people in the Democratic Republic of the Congo, can now be distributed more widely.

The world finally has an Ebola vaccine. On 11 November, European regulators approved a vaccine that has already helped to control deadly outbreaks of the virus — the first time any immunization against Ebola has passed this hurdle.

The decision by the European Medicines Agency (EMA) to allow US pharmaceutical company Merck to market its vaccine means that the product can now be stockpiled and, potentially, distributed more widely, in particular in Africa. In 2015, Gavi, the Vaccine Alliance — a global health partnership that funds vaccine supplies in low-income countries — told Ebola-vaccine manufacturers that it would commit to purchasing vaccines once they had been approved by a “stringent health authority” such as the EMA.

Although several other vaccines against Ebola — a haemorrhagic fever that causes severe diarrhoea, vomiting and bleeding — are in development, Merck’s is the only one that has been tested during an outbreak, where it was shown to be highly effective in preventing infection.

The vaccine, first patented in 2003, has been administered on an emergency basis to quell the ongoing outbreak in the Democratic Republic of the Congo (DRC), which has killed some 2,000 people since it started last year. It was also used during a 2018 outbreak in that country, and in Guinea in 2015. In the current DRC outbreak, hundreds of thousands of people have received the Merck shot, including more than 60,000 health-care workers in DRC and several neighbouring countries.

“This is a vaccine with huge potential,” said Seth Berkley, chief executive of Gavi in Geneva, Switzerland, in a press release after the EMA decision. “It has already been used to protect more than 250,000 people in the DRC and could well make major Ebola outbreaks a thing of the past.” The organization has supported the stockpiling and delivery of Ebola vaccines and hopes to build up a global supply that could be rolled out quickly during future outbreaks of the virus.

The EMA’s approval “makes a big difference”, says David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine. But he stresses that research into the Merck vaccine and development of further Ebola vaccines must continue. “The message is that the research is not done. It must continue,” he adds. “It’s really important to continue to study vaccines and develop those second- and third-generation vaccines.” These could offer longer-lasting immunity, target more than one species of Ebola and be easier to store.

Merck’s vaccine, which is marketed under the name Ervebo and known to researchers as rVSV-ZEBOV-GP, was tested in a clinical trial conducted in Guinea towards the end of the 2014–16 Ebola outbreak in West Africa. There, the vaccine was administered to people who had been in contact with someone who was infected with Ebola, or with their subsequent contacts. It was found to offer a high level of protection against infection.

Health workers have used this strategy — known as ring vaccination — in the two other outbreaks in which rVSV-ZEBOV-GP has been deployed. But Heymann says it’s important to determine whether the Merck vaccine could be used in other ways — for instance, administered preventively to emergency health workers who might encounter Ebola in the distant future. This would mean determining how long the vaccine’s protection lasts, and whether an additional dose — a booster — can extend immunity.

Such studies are in the works with rVSV-ZEBOV-GPand competing vaccines, says Adrian Hill, a vaccinologist at the University of Oxford, UK. “The question remains, which vaccine would you give to, say, health-care workers to prevent them getting Ebola?”

Merck’s product protects against the Zaire species of the Ebola virus, which is behind the current DRC outbreak and the 2014–16 West Africa outbreak. It will be important to develop vaccines against other species of the virus — especially the Sudan species, which has caused seven known outbreaks since 1976, says Hill, who helped test an Ebola vaccine that was shelved by the London-based pharmaceutical company GSK in August.

There are seven other Ebola vaccines in various stages of clinical testing, according to the World Health Organization (WHO) in Geneva. In September 2019, the WHO announced that a vaccine manufactured by Johnson & Johnson in New Brunswick, New Jersey, would be used in the current DRC outbreak. Last week, the company submitted that vaccine for EMA approval.

Unlike the Merck vaccine, which is given in one dose, the Johnson & Johnson immunization requires a booster shot administered 56 days after the first injection. In the DRC, it will be given to populations at risk of Ebola, such as health-care workers, in areas where the virus is not already circulating.

And next month, Gavi’s board will decide whether to establish a global stockpile of Ebola vaccine. Merck, which is headquartered in Kenilworth, New Jersey, is also seeking approval of the vaccine by the US Food and Drug Administration.

Source:   https://www.nature.com/articles/d41586-019-03490-8
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