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Ebola Back in Africa: in DR Congo

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    Posted: May 13 2017 at 12:47am
It's only just shown up.


Lets hope it is dealt with EARLY this time.  Humans being as bad as they are at learning lessons, I don't think so, but here's hoping...............

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Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news 
13 May 2017

On 9 May 2017, WHO was informed of a cluster of undiagnosed illness and deaths including haemorrhagic symptoms in Likati Health Zone, Bas Uele Province in the north of the Democratic Republic of the Congo (DRC), bordering Central African Republic. Since 22 April, nine cases including three deaths have been reported. Six cases are currently hospitalized.

On 11 May 2017, the Ministry of Health (MoH) of DRC informed WHO that of the five samples collected from suspected cases, one tested positive by RT-PCR for Ebola virus subtype Zaire at the Institut National de Recherche Biomédicale (INRB) in Kinshasa. Additional specimens are currently being tested and results, including sequencing, are awaited to describe the outbreak.

On 10 May 2017, a multidisciplinary team led by the MoH and supported by WHO and partners was deployed to the field and are expected to reach the affected area on 12 or 13 May 2017 to conduct an in depth field investigation.

The investigation is currently ongoing and information is available for only three of the suspected cases: The first case (and possibly the index case), a 39-year-old male presented onset of symptoms on 22 April 2017 and deceased on arrival at the health facility. He presented with haematuria, epistaxis, bloody diarrhoea, and haematemesis. Two contacts of this case are being investigated: a person who took care of him during transport to the health care facility (he has since developed similar symptoms) and a moto-taxi driver (deceased) who transported the patient to the health care facility.

Personal Protective Equipment (PPE) for health care workers has been shipped on 12 May 2017 to Kisangani. Additional kits are currently being prepared and will be shipped as soon as available.

Background and epidemiological situation

On 20 November 2014, as per WHO recommendations, the MoH of DRC and WHO declared the end of the EVD outbreak that started on 24 August 2014 and resulted in a total of 38 laboratory confirmed cases and 28 probable case including 49 deaths in Boende, Equateur province. This was the seventh outbreak of EVD since its discovery in 1976 in DRC.

  • 2014: 66 cases of EVD including 49 deaths diagnosed initially in Equateur province (Watsi Kengo, Lokolia, Boende, and Boende Muke).
  • 2012: 36 cases including 13 deaths Orientale province - Isiro (Bundibugyo virus).
  • 2008–2009: 32 cases including 15 deaths in Kasaï-Occidental (Zaire virus).
  • 2007: 264 cases including 187 deaths in Kasaï-Occidental (Zaire virus).
  • 1995: 315 cases and 250 deaths occurred in Kikwit and surrounding area.
  • 1977: 1 case (Zaire virus).
  • 1976: 318 cases including 280 deaths in Yambuku (Zaire virus).

There are five identified subtypes of Ebola virus. The subtypes have been named after the location where they have been first detected. Three of the five subtypes have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa. Ebola–Zaire, Ebola–Sudan and Ebola–Bundibugyo. EHF is a febrile haemorrhagic illness which causes death in 25–90% of all cases.

Public health response

The following public health response measures have been implemented:

  • The national committee against viral haemorrhagic fever has been reactivated and will continue meeting every day to coordinate the response.
  • Strengthening of surveillance and investigation including contact tracing are ongoing.
  • WHO will provide assistance and technical support. The deployment to DRC of an additional WHO multidisciplinary team is currently considered to support the response of national authorities.
  • The Global Outbreak Alert and Response Network (GOARN) has been activated to provide additional support if required.
  • The need and feasibility of potential Ebola ring vaccination is being discussed.

WHO risk assessment

To date, the outbreak is reported in a remote and hard to reach area and appears to be geographically relatively limited. However, Investigations are ongoing to assess the full extent of the outbreak and therefore high vigilance still needs to be maintained.

WHO does not recommend any restriction of travel and trade to DRC based on the currently available information.


Source:   http://www.who.int/csr/don/13-may-2017-ebola-drc/en/

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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2017 at 11:07am
On the plus side (if there's ever a plus side to an Ebola outbreak), at least it's happening in a part of Africa that came to terms with it a long time ago. They probably know more about it than anyone, whereas the outbreak in West Africa was shrouded in misinformation and superstition that fueled it's spread.

Fingers crossed this ends quickly with minimal loss of life.




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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2017 at 11:39am
I can't yet comment on the local response, but the UN is sending a team there and the WHO's team are due to arrive today. So, internationally there seems to be an improvement in response time.  GOARN has not "gorn" over there yet but they are on alert.

On the downside, the outbreak is on the border with the Central Africa Republic and sick people do seem to want to run, as if viruses were adverse to hopping across borders.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2017 at 12:11pm
Ps. It seems I was a bit tardy only reporting this last week.  The first patient arrived for treatment back on the 22nd April.  This article includes a timeline as well as a lot of other details.


It is not very long, but it is very informative.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 17 2017 at 9:17am
To continue the timeline, this is an update of the situation in DR Congo:

As of 16 May 2017, the updated epidemiological situation presents a combined total of:
 21 suspected cases.
 3 deaths (case fatality rate of 15%). Nambwa health district notified the greatest number of the earliest cases: 13 in all, with two deaths (case fatality: 16%). 
 Over 40 contacts, spread over 4  health districts - Azande, Nambwa, Ngayi and Muna – are being traced with the help of community relay agents to ensure that they do not develop the disease.






*There is lots more in the article.
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Anyone who wants an even more detailed in-depth timeline/current report/breakdown can get the WHO's PDF to download on:  http:///reliefweb.int/sites/reliefweb.int/files/resources/EbolaDRC-1652017-eng.pdf
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 18 2017 at 1:30pm
The number of cases, sadly but not unexpectedly, has risen to 18.


Of course that is the New York Times - so it must be fake news.  Wink
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As Ebola outbreak grows, question of using vaccine becomes more urgent

By Jon Cohen
As health officials and aid workers head to a remote corner of the Democratic Republic of the Congo to respond to an outbreak of Ebola virus disease, a key question remains: Will the government authorize the use of a promising experimental vaccine? The vaccine hadstunning results in a clinical trial in Guinea in 2015, but it has yet to be licensed for broad use.

As DRC officials weigh whether to use the vaccine, new details are emerging about the outbreak, which so far includes 20 suspected cases and three deaths, including the first, or “index,” case. Most cases are in the Bas-Uélé health zone that borders the Central African Republic. Three teams there are working on identifying suspect cases, educating the communities, and investigating villages where “nonsecure” funerals have taken place. They are also contacting a traditional healer in Nambwa who “received the index case"—a 45-year-old man who first sought help on 22 April—for 6 days.


Source and full article:   http://www.sciencemag.org/news/2017/05/ebola-outbreak-grows-question-using-vaccine-becomes-more-urgent




(I can't help but notice that discrepancies are arising in the number of cases being reported.  I suspect that this is due to the difficulties in mapping the disease's progression in such a remote area.  It does not bode all that well for timely control.) - M

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WHO: 400 contacts being traced in Congo's Ebola outbreak

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DAKAR, Senegal — May 18, 2017, 6:24 AM ET
This article does rather make my previous point for me.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 19 2017 at 10:23am
The total of suspected infections has now risen to 29   Source:   http://www.itv.com/news/2017-05-19/congo-ebola-outbreak-cases-rise/

Despite that, the risk of it escaping from the local African area is estimated to be extremely low by the ECDC.  This is mostly due to the fantastically remote area affected.  

The WHO are monitoring the outbreak.  With their usual relaxed attitude to such things, they have offered no risk predictions about spread.   Source:   http:///reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-external-situation-2

All lack of faith in the WHO aside, with the Congo's past experience of the disease, the conclusion of extremely low onward transmission risk seems a reasonable one: Congolise outbreaks have usually been contained in the past and this one is in the most remote of areas.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 20 2017 at 1:31pm


This is the latest update from the WHO.  A summary amounts to: "'Nothing more to report at present."  For those who still want to read it:

REPORT
from World Health Organization
Published on 20 May 2017 View Originalapplication/pdfDownload PDF (1.93 MB)

Ebola Virus Disease - Democratic Republic of the Congo: External Situation Report 5 (19 May 2017)


1. Situation update

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province located in the northeast of the country.

On 19 May 2017, three new EVD cases were reported, including one probable case in Ngayi and two suspected cases in a new health area called Ngabatala. The suspected cases are being investigated and will be classified accordingly. As of 19 May 2017, a total of 32 EVD cases [two confirmed, three probable and 27 suspected] have been reported. To date, four deaths have been reported, giving a case fatality rate of 13%. The reported cases are from five health areas, namely Nambwa (11 cases and two deaths), Muma (three cases and one death), Ngayi (14 cases and one death), Azande (two cases and no deaths), and Ngabatala (two cases and no deaths). Most of the cases presented with fever, vomiting, bloody diarrhoea and other bleeding symptoms and signs. The outbreak currently remains confined to Likati Health Zone. According to available information at this stage, no healthcare workers have been affected.

Out of the five blood samples analysed at the national reference laboratory, Institut National de Recherche Biomédicale (INRB) in Kinshasa, two were confirmed Zaire ebolavirus. At least 416 close contacts have been registered in Likati Health Zone and are being monitored.

This EVD outbreak in the Democratic Republic of Congo was notified to WHO by the Ministry of Health (MOH) on 11 May 2017. The cluster of cases and deaths of previously unidentified illness have been reported since late April 2017. Likati Health Zone shares borders with two provinces in the Democratic Republic of the Congo and with the Central African Republic (Fig. 1). The affected areas are remote and hard to reach, with limited communication and transport networks. The current outbreak is the eighth EVD outbreak in the Democratic Republic of Congo since the disease was first discovered in 1976 in Yambuku (then Zaire).


Source:  http://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-external-situation-3

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 23 2017 at 9:48am
Although the extreme remoteness of the region where ebola has re-emerged limits the natural spread of the disease and I think escape of the infection from said area remains quite unlikely, the odds of such a spread did rise with the refugee situation.

This report is only a few hours old and the process continues apace.

"A new report says the Democratic Republic of Congo (DRC) had the highest number of people displaced by conflict in the world in 2016."



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: May 30 2017 at 11:26am

DR Congo is tackling a new Ebola outbreak with an experimental vaccine


In its battle to stop the spread of the Ebola after a recent outbreak, a new WHO-backed vaccine is the Democratic Republic of Congo’s weapon of choice.

On May 12, the World Health Organization declared an Ebola outbreakin DR Congo after it confirmed three deaths. At the time, the United Nations health agency said there was no cause for panic. Now, with as many as 52 suspected cases, DR Congo’s health ministry is stepping up its response and has approved the use of a new experimental vaccine to stop the outbreak.

In published findings from tests of the vaccine, rVSV-ZEBOV, it showed a 100% protection rate. During trials conducted in Guinea, thousands of people tested were all confirmed as virus-free within 10 days. While WHO said at the time that the vaccine will not be available for mass use until 2018, pharmaceutical giants Merck, backed by GAVI, a global vaccine alliance, made 300,000 doses of the vaccine available in the event of an outbreak.

That foresight could yet pay off in DR Congo where officials claim thatup to 400 people that may have had contact with some of the individuals suspected of carrying the virus are now being tracked down. In a previous outbreak mainly in the West African countries of Liberia, Sierra Leone and Guinea, the Ebola virus killed over 11,000 people as health services were ill-prepared to respond to the outbreak.

For its part, WHO also admitted to a slow response to the outbreak. In contrast, the Congolese government reacted quickly (link in French) to its outbreak, sending a team of doctors and scientists to the affected area to treat the suspected cases and investigate the extent of infection.

DR Congo’s relative containment of the virus so far has been attributed to the outbreak’s occurrence in a remote part of the country’s northeast. But that may yet prove a pitfall as the remoteness of the area could hamper a vaccination campaign as officials will have to deal with issues such as difficult logistics and storage for the vaccine which needs to be kept in containers set at a temperature of -80 degrees Celsius.


Source:   https://qz.com/993985/an-ebola-vaccine-has-been-approved-for-use-in-dr-congos-outbreak/


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: June 01 2017 at 10:38am
I still do not think this is going anywhere.  But, for those who are interested, this is the latest update:

Ebola Virus Disease - Democratic Republic of the Congo: External Situation Report 18 (01 June 2017)

REPORT
from World Health Organization
Published on 31 May 2017

Date of information: 31 May 2017

1. Situation update

WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health (MoH) in the Democratic Republic of the Congo to rapidly investigateand respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of the country.

On 31 May 2017, no new confirmed, probable or suspected EVD cases were reported. The last confirmed case was reported on 11 May 2017. There are currently a total of two confirmed, three probable and 12 suspected cases.

The confirmed and probable cases were reported from Nambwa (two confirmed and two probable) and Ngayi (one probable). The suspected cases are reported from four health areas (Nambwa, Muma, Ngayi and Ngabatala).The outbreak remains confined to Likati Health Zone. As of 31 May, 29 further contacts completed the monitoring period and did not show signs and symptoms of Ebola, 72 contacts remain under follow up.

The previously undertaken modelling to determine the risk of further cases was updated with newly available onset dates for the five confirmed / probable cases. Results suggest the risk of further cases is currently low but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting date, 76% of simulated scenarios predict no further cases in the next 30 days.

All seven response committees are functional at a national level, namely monitoring, case management,water sanitation and hygiene (WASH) and biosafety, laboratory and research, pyscho-social management,logistics, and communication. Additionally response teams have been established in the affected areas.

This EVD outbreak in the Democratic Republic of the Congo was notified to WHO by the MoH on 11 May 2017. The cluster of cases and deaths of previously unidentified illness had been reported since late April 2017. Likati Health Zone shares borders with two provinces in the Democratic Republic of the Congo and with the Central African Republic (Figure 1). The affected area is remote and hard to reach, with limited communication and transport infrastructure.


Source:   http://eliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-external-situation-15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 03 2017 at 11:52am
It is officially over.  http://qz.com/1020238/the-ebola-outbreak-in-dr-congo-is-over-says-the-world-health-organization/                             
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: July 03 2017 at 7:36pm
For now.....lol
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 03 2017 at 8:17pm
I still need boots for Ebola. I have the rest of the gear. I also need gas masks for any pandemic that comes our way. Just need to get my sh*t together.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 04 2017 at 4:53am
Respect!  Wow you are an example to all us preppers, FluMom.  I do not even know where my NBC suit is - and I am in the middle of restocking my bug-out-bag!
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