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Printed From: Avian Flu Talk
Category: Disease / Flu Tracking
Forum Name: Ebola
Forum Description: (Tracking the Ebola virus)
URL: http://www.avianflutalk.com/forum_posts.asp?TID=38702
Printed Date: February 21 2019 at 2:41am


Topic: DR CONGO
Posted By: Technophobe
Subject: DR CONGO
Date Posted: December 20 2018 at 2:27am
Well it seemed about time to update this (after all, the numbers have entered the second tier of the poll http://www.avianflutalk.com/poll-how-large-will-the-current-ebola-outbreak-be_topic38553_post274794.html#274794" rel="nofollow - http://www.avianflutalk.com/poll-how-large-will-the-current-ebola-outbreak-be_topic38553_post274794.html#274794 ) and about time I used the actual ebola topic room.

Up to 319 people dead as Congo Ebola outbreak worsens

By Bethlehem Feleke and Susan Scutti, CNN

Updated 1024 GMT (1824 HKT) December 19, 2018

One of the deadliest Ebola outbreaks in history continues to worsen in the Democratic Republic of Congo with as many as 319 people now dead.
The Ministry of Health said Tuesday that 542 Ebola cases had been recorded in the province of North Kivu -- 494 of which have been confirmed. Of the 319 believed to have died from the virus so far, 271 have been confirmed.
On average, Ebola -- which causes fever, severe headache and in some cases hemorrhaging -- kills about half of those infected, but fatality rates in individual outbreaks have varied.

The World Health Organization (WHO) said efforts to contain the outbreak have been hampered due to "non-engagement" from local communities and armed conflict in the region.

North Kivu, which includes the cities of Beni, Kalunguta and Mabalako, remains the epicenter of the outbreak, though cases have been reported in neighboring Ituri province, according to the WHO. The two provinces are among the most populated in the nation and border Uganda, Rwanda and South Sudan.

The public health agency estimates that more than a million refugees and internally displaced people are traveling through and out of North Kivu and Ituri, which could hasten the spread of the virus further.
The death of Ebola?

The death of Ebola? 01:32
The Congo outbreak is the second-deadliest ever, behind only in West Africa in 2014, when the virus killed more than 11,000 people. It is Congo's 10th epidemic since 1976, and second this year.

Source and video: https://edition.cnn.com/2018/12/18/health/ebola-democratic-republic-of-congo-intl/index.html" rel="nofollow - https://edition.cnn.com/2018/12/18/health/ebola-democratic-republic-of-congo-intl/index.html

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Absence of proof is not proof of absence.



Replies:
Posted By: EdwinSm,
Date Posted: December 20 2018 at 10:55pm
From that poll,it is now in the bracket that the majority expected (ie 300-1000 limited regional spread), and had a long way to go to reach the "regional epidemic".

This Ebola outbreak seems to be slowly trudging along, with no end in sight, but it has not exploded like the West African (2014) outbreak.


Posted By: Technophobe
Date Posted: January 10 2019 at 4:57pm
UPDATE

Ebola virus disease – Democratic Republic of the Congo

Disease outbreak news: Update
10 January 2019

WHO and partners continue to respond to the ongoing Ebola virus disease (EVD) outbreak in one of the most complex settings possible. A decline in case incidence has been seen in Beni, the former epicentre. This is a strong positive indication of how effective the response can be despite multiple challenges. However, in Beni and elsewhere, trends must be interpreted cautiously, as delayed detection of cases is expected following recent temporary disruption in response activities due to insecurity. Nevertheless, WHO and partners remain committed, under the government’s leadership and through collaboration across agencies, to addressing challenges and ending the outbreak.

As of 8 January 2019, there have been a total of 628 EVD cases1 (580 confirmed and 48 probable), including 383 deaths (overall case fatality ratio: 61%). Thus far, 222 people have recovered, been discharged from an Ebola Treatment Centre (ETC) and enrolled in a dedicated program for monitoring and supporting survivors.

During the last 21 days (19 December 2018 to 8 January 2019), cases have been reported from ten health zones where the outbreak remains active, including: Katwa (18), Butembo (16), Oicha (13), Beni (13), Kalungata (6), Mabalako (5), Komanda (3), Musienene (2), Kyondo (1) and Nyankunde (1). Overall, cases have occurred in localised hotspots within 16 health zones found in North Kivu and Ituri provinces (Figure 1). Surveillance activities are being maintained to rapidly detect resurgences or reintroduction events in all areas.

Trends in numbers of new cases occurring (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas, with encouraging declines in case incidence in areas such as Beni. Hard-earned progress could still be lost from prolonged periods of insecurity hampering containment efforts.

Amongst confirmed and probable EVD cases, 61% (385/628) were female and 30% (189/628) were children aged less than 18 years. This includes a high number of cases in infants aged less than 1 year (38) and 1-4 years (58). While investigations to understand the risk factors for this disproportionate burden are ongoing, response teams continue to prioritise these population groups to mitigate, wherever possible, the risk of transmission.

All alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries continue to be monitored and investigated. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, Uganda, South Sudan, Rwanda and in a traveller returning from Burundi to Sweden. To date, EVD has been ruled out in all alerts outside the outbreak affected areas. International travellers who may have come into contact with the virus, including a doctor who returned to the United States of America after providing medical assistance in the Democratic Republic of the Congo, are also being followed closely; all remain asymptomatic.

Source and LOTS OF additional info: https://www.who.int/csr/don/10-january-2019-ebola-drc/en/" rel="nofollow - https://www.who.int/csr/don/10-january-2019-ebola-drc/en/

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 12 2019 at 10:53am
UPDATE   May I draw everyone's attention to the final paragraph thereof; it is quite revealing.

Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 10 January 2019
Report
from World Health Organization
Published on 10 Jan 2019

WHO and partners continue to respond to the ongoing Ebola virus disease (EVD) outbreak in one of the most complex settings possible. A decline in case incidence has been seen in Beni, the former epicentre. This is a strong positive indication of how effective the response can be despite multiple challenges. However, in Beni and elsewhere, trends must be interpreted cautiously, as delayed detection of cases is expected following recent temporary disruption in response activities due to insecurity. Nevertheless, WHO and partners remain committed, under the government’s leadership and through collaboration across agencies, to addressing challenges and ending the outbreak.

As of 8 January 2019, there have been a total of 628 EVD cases1 (580 confirmed and 48 probable), including 383 deaths (overall case fatality ratio: 61%). Thus far, 222 people have recovered, been discharged from an Ebola Treatment Centre (ETC) and enrolled in a dedicated program for monitoring and supporting survivors.

During the last 21 days (19 December 2018 to 8 January 2019), cases have been reported from ten health zones where the outbreak remains active, including: Katwa (18), Butembo (16), Oicha (13), Beni (13), Kalungata (6), Mabalako (5), Komanda (3), Musienene (2), Kyondo (1) and Nyankunde (1). Overall, cases have occurred in localised hotspots within 16 health zones found in North Kivu and Ituri provinces (Figure 1). Surveillance activities are being maintained to rapidly detect resurgences or reintroduction events in all areas.

Trends in numbers of new cases occurring (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas, with encouraging declines in case incidence in areas such as Beni. Hard-earned progress could still be lost from prolonged periods of insecurity hampering containment efforts.

Amongst confirmed and probable EVD cases, 61% (385/628) were female and 30% (189/628) were children aged less than 18 years. This includes a high number of cases in infants aged less than 1 year (38) and 1-4 years (58). While investigations to understand the risk factors for this disproportionate burden are ongoing, response teams continue to prioritise these population groups to mitigate, wherever possible, the risk of transmission.

All alerts in affected areas, in other provinces in the Democratic Republic of the Congo, and in neighbouring countries continue to be monitored and investigated. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, Uganda, South Sudan, Rwanda and in a traveller returning from Burundi to Sweden. To date, EVD has been ruled out in all alerts outside the outbreak affected areas. International travellers who may have come into contact with the virus, including a doctor who returned to the United States of America after providing medical assistance in the Democratic Republic of the Congo, are also being followed closely; all remain asymptomatic.

Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordination, surveillance, contact tracing, laboratory capacity, infection prevention and control, clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials, cross-border surveillance, and preparedness activities in neighbouring provinces and countries.

For detailed information about the public health response actions by 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 reviewed its risk assessment for the outbreak and the risk remains very high at the national and regional levels; the global risk level remains low. This outbreak of EVD is affecting north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of EVD at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities.

As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.

WHO advice

International traffic: 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 passengers leaving the Democratic Republic of the Congo. 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.

For more information, see:

    WHO Director-General concludes New Year visit to Ebola-affected areas in the Democratic Republic of the Congo
    Women join hands to oust Ebola from the Democratic Republic of the Congo
    Summary report for the SAGE meeting of October 2018
    Statement on the October 2018 meeting of the IHR Emergency Committee on the Ebola virus disease outbreak in the Democratic Republic of the Congo
    WHO Interim recommendation Ebola vaccines
    WHO recommendations for international travellers related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo
    Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
    Ebola virus disease fact sheet

1Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning – trends during this period should be interpreted cautiously.


Source: [url] https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-32" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-32

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 16 2019 at 1:09am
World's 2nd-deadliest Ebola outbreak reaches 600 confirmed cases

By Morgan Winsor

LONDON — Jan 15, 2019, 6:09 AM ET



The second-largest, second-deadliest Ebola outbreak in history has reached 600 confirmed cases in five months, health officials said.

Since the outbreak was declared in the Democratic Republic of the Congo on Aug. 1, a total of 649 people have reported symptoms of hemorrhagic fever in the country's northeastern provinces of North Kivu and Ituri. Among those cases, 600 have tested positive for Ebola virus disease, which causes an often-fatal type of hemorrhagic fever, according to Monday night's bulletin from the country's health ministry.

The growing outbreak has a case fatality rate of around 61 percent. There have been 396 deaths thus far, including 347 people who died from confirmed cases of Ebola. The other deaths are from probable cases, the ministry said.

On average, about half of all Ebola patients succumb to the deadly virus, though case fatality rates have varied from 25 to 90 percent in past outbreaks, according to the World Health Organization, the global health arm of the United Nations.

The ongoing outbreak is one of the world's worst, second only to the 2014-2016 outbreak in multiple West African nations that infected 28,652 people and killed 11,325, according to data from the U.S. Centers for Disease Control and Prevention.

This is also the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo and the most severe that the Central African nation has seen since 1976, when scientists first identified the virus near the eponymous Ebola River.

Ebola virus disease, which has a relatively long incubation period of approximately eight to 21 days, is transmitted through contact with blood or secretions from an infected person, either directly or through contaminated surfaces, needles or medical equipment.

The two provinces where cases in the latest outbreak are being reported share porous borders with South Sudan, Uganda and Rwanda, raising the risk of national and regional spread.

Health workers are facing a number of other challenges to contain the virus, including sporadic attacks from armed groups operating in the mineral-rich, volatile borderlands as well as resistance from the local population in an area that never before had been affected by an Ebola outbreak.

However, this is the first time that a vaccine for prevention and therapeutic treatments are available for use in an Ebola outbreak. The vaccine, which was developed by American pharmaceutical company Merck, has proved effective against the country's previous outbreak in the western province of Equateur.

Nearly 60,000 people have been vaccinated in the outbreak zone since Aug. 8, according to the country's health ministry, which has said that the number of Ebola cases would probably have already surpassed 10,000 if it weren't for the vaccination teams.

Still, the ministry has warned that the epidemic is expected to last for "several" more months and the risk of transmission will remain high.


Source:   ABC News https://abcnews.go.com/International/worlds-2nd-deadliest-ebola-outbreak-reaches-600-confirmed/story?id=60383138" rel="nofollow - https://abcnews.go.com/International/worlds-2nd-deadliest-ebola-outbreak-reaches-600-confirmed/story?id=60383138

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Absence of proof is not proof of absence.


Posted By: CRS, DrPH
Date Posted: January 17 2019 at 8:40pm
^I'm really amazed that we have heard so little about this outbreak in the popular press! We hear "crickets" in the US news channels about this.

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CRS, DrPH


Posted By: Technophobe
Date Posted: January 18 2019 at 3:10pm

Ebola cases in Congo expected to double amid fears outbreak could cross borders

With health system at breaking point, uncertainty over how virus is being transmitted prompts fears it could range beyond DRC
Global development is supported by
Bill and Melinda Gates Foundation
About this content

Rebecca Ratcliffe

Fri 18 Jan 2019 11.57 GMT
Last modified on Fri 18 Jan 2019 18.30 GMT

The number of Ebola cases recorded each day in the Democratic Republic of the Congo is expected to more than double, with concern mounting that uncertainty over how the virus is being transmitted could result in it spreading to neighbouring countries.

On Thursday, the World Health Organization (WHO) reiterated its warning that there is a very high risk of the outbreak spreading not only across DRC but also to Uganda, Rwanda and even South Sudan. The heightened danger of transmission is due to extensive travel between the affected areas.

Efforts to contain the DRC outbreak were hampered after violence related to December’s elections halted prevention work. About 30 health facilities were targeted by protesters in Beni, while efforts to trace anyone who has had contact with the virus were partially suspended due to security concerns.

From October to December, six cases were recorded daily across all affected areas in the east, but numbers are increasing, said Jean-Philippe Marcoux, Mercy Corps’ country director for DRC.

“Now it’s doubling – it’s very possible that it can double again,” said Marcoux. “If we don’t significantly increase the resources, it will keep increasing. It will spread progressively to other health areas and it will be there for a long time.”

Two health centres supported by Mercy Corps are being rebuilt after they were burned to the ground by protesters over the Christmas period. Protesters were angry at a decision to postpone the presidential election in some areas of the country.

Though most of Mercy Corps’ work resumed in January, activities are still hampered by instability, the presence of armed groups and shortages of trained health professionals. Alongside the Ebola crisis, DRC is also experiencing outbreaks of cholera, polio and malaria, according to the WHO, piling more pressure on the country’s overstretched health system.

In some areas, approximately half of recent cases recorded were nosocomial – meaning that transmission occurred in health centres – said Marcoux.

“That is an indication that much more needs to be done at the level of health centres to prevent infection from spreading,” he said.

Marcoux added that greater funding is required for training and monitoring of health workers, and to do preventative community outreach work in areas where it is feared the disease could spread.

There are also concerns that, in some areas, the source of transmission is unclear in up to half of recent cases.
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As such cases increase, there is a growing risk of unsafe burial practices among communities that have not received specialist support from contact-tracing teams.

Since the outbreak began in August, the WHO has recorded 668 confirmed or probable cases and 410 deaths. Since 1 December, more than a third of cases have occurred in children under 15. Of these, 16 cases were in babies under 12 months.

“If no more is done this will spread to other areas within DRC, and spread to neighbouring countries that are close to affected areas – Uganda, Rwanda, even South Sudan,” said Marcoux.

It is expected the disease will be present for at least another nine to 12 months, he added.

In a situation report, the WHO warned the outbreak was at a critical stage: “The persistence of insecurity threatens to reverse recent progress achieved around disease hotspots such as Beni and Butembo.”

Source (The Guardian is highly respected by the way) https://www.theguardian.com/global-development/2019/jan/18/ebola-cases-congo-expected-to-double-fears-outbreak-could-cross-borders-world-health-organization-drc" rel="nofollow - https://www.theguardian.com/global-development/2019/jan/18/ebola-cases-congo-expected-to-double-fears-outbreak-could-cross-borders-world-health-organization-drc

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 21 2019 at 9:22am
Big Update

Ebola heads for major city: Outbreak in the Democratic Republic of the Congo which has killed 419 people is moving towards a trading hub home to one million inhabitants

    If the virus spreads to Goma 'all bets are off' in attempts to control the virus
    Cases are appearing in towns further south from the centre of the outbreak
    At least 685 people have been infected in the epidemic which began in August

By Sam Blanchard Health Reporter For Mailonline

Published: 09:13, 21 January 2019 | Updated: 15:26, 21 January 2019


The deadly Ebola outbreak in the Democratic Republic of the Congo is spreading towards a city home to one million people.

Cases have begun appearing in a district between the two major cities involved in the epidemic, suggesting the virus is spreading south.

If Ebola does make it to the major city of Goma then 'all bets are off' for the bid to control the outbreak, one health official said.

A total of 419 people have died in the killer outbreak already, with the DRC's health ministry reporting 685 cases.

Experts fear Ebola is spreading south from the smaller cities of Beni and Butembo, where most of the outbreak has taken place so far, to Goma, which has a population of one million people and is close to the border with Rwanda


Experts fear Ebola is spreading south from the smaller cities of Beni and Butembo, where most of the outbreak has taken place so far, to Goma, which has a population of one million people and is close to the border with Rwanda

A total of 419 people have now died of Ebola, the Democratic Republic of Congo's health ministry tweeted yesterday. There have been 685 cases of the illness which began in August

The health ministry reported on Friday that there had been four Ebola cases confirmed in the town of Kayina.

The area is halfway between the cities of Butembo, where people are already dying of Ebola, and Goma, where experts fear it could wreak havoc.

Goma has almost double the population of Butembo, meaning there is a much higher potential for the virus to spread quickly.

And Goma sits on the border with Rwanda, adding an extra threat of Ebola spreading out of the country.

'These are crossroad cities and market towns,' Dr Peter Salama, head of the World Health Organization's Health Emergencies Program told Vox.

He said the contagious illness spreading in areas where people are constantly travelling in and out 'raises the alarm'.

The WHO and DRC's health ministry have already sent rapid response and vaccination teams to Kayina, and they've set up a lab in Goma as a precaution.

More than 60,000 people have been given an experimental vaccine to protect against the Ebola virus (pictured, a woman being vaccinated in Mangina, North Kivu)

More than 60,000 people have been given an experimental vaccine to protect against the Ebola virus (pictured, a woman being vaccinated in Mangina, North Kivu)

Vaccination has helped to slow the spread of the virus, experts say, but ongoing violent conflict, political protests and distrust of medical workers makes it particularly difficult to control.

Aggressive protests since a controversial election in December – which the losing party claims was rigged – continue to endanger patients and health workers.

Experts predict the country has months more suffering in store before the outbreak comes to an end.

But this could be longer if the illness breaks out of the North Kivu region, in the country's north-east, where it has so far been contained.
Violent political protests surrounding a controversial election in December – which the losing party has claimed was rigged – have put health workers and Ebola patients in danger of attack (Pictured: A crowd of protestors wait to cast their votes in Kinshasa, the capital city)

Violent political protests surrounding a controversial election in December – which the losing party has claimed was rigged – have put health workers and Ebola patients in danger of attack (Pictured: A crowd of protestors wait to cast their votes in Kinshasa, the capital city)
Families cannot be near or touch their relatives who have died of Ebola because the virus, which is spread through bodily fluids, can still be passed on after death


Families cannot be near or touch their relatives who have died of Ebola because the virus, which is spread through bodily fluids, can still be passed on after death

Writing in Foreign Policy last week, Ebola expert Laurie Garret said: 'Were Ebola to reach [Goma], a top WHO official told me, “all bets are off,” for stopping the epidemic.'

And she added: 'If Ebola hitchhikes its way in an unwitting human carrier across Lake Edward into Uganda, down the highway to Goma and Rwanda, or up the Semliki River toward South Sudan, the world community will face tough choices.

'Option one: Keep on muddling through with the tools, personnel, and funding that have carried the response to date.

'Option two: Declare a global public health emergency, escalating financing and on-the-ground response to the multibillion-dollar scale seen in West Africa.

'Option three: Dedicate massive financial resources to pushing Merck and other vaccine-makers to rapidly manufacture millions of doses, and deploy literal armies, acting as security alongside an enormous public health deployment to immunize tens of millions of people in the region.'
WHAT IS EBOLA AND HOW DEADLY IS IT?

Ebola, a haemorrhagic fever, killed at least 11,000 across the world after it decimated West Africa and spread rapidly over the space of two years.

That epidemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The country, rocked by back-to-back civil wars that ended in 2003, was hit the hardest by the fever, with 40 per cent of the deaths having occurred there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN?

An analysis, published in the New England Journal of Medicine, found the outbreak began in Guinea - which neighbours Liberia and Sierra Leone.

A team of international researchers were able to trace the epidemic back to a two-year-old boy in Meliandou - about 400 miles (650km) from the capital, Conakry.

Emile Ouamouno, known more commonly as Patient Zero, may have contracted the deadly virus by playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN?
WHICH COUNTRIES WERE STRUCK DOWN BY EBOLA DURING THE 2014-16 EPIDEMIC? (CDC figures) COUNTRY                                                    CASES      DEATHS     DEATH RATE (%)
GUINEA     3,814      2,544     66.7%
SIERRA LEONE      14,124      3,956      28.0%
LIBERIA      10,678      4,810      45.0%
NIGERIA      20      8      40.0%
SENEGAL      1      0      N/A
SPAIN      1      0      N/A
US      4      1      25.0%
MALI      8      6      75.0%
UK      1      0      N/A
ITALY      1      0      N/A

Figures show nearly 29,000 people were infected from Ebola - meaning the virus killed around 40 per cent of those it struck.

Cases and deaths were also reported in Nigeria, Mali and the US - but on a much smaller scale, with 15 fatalities between the three nations.

Health officials in Guinea reported a mysterious bug in the south-eastern regions of the country before the WHO confirmed it was Ebola.

Ebola was first identified by scientists in 1976, but the most recent outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS?

Scientists believe Ebola is most often passed to humans by fruit bats, but antelope, porcupines, gorillas and chimpanzees could also be to blame.

It can be transmitted between humans through blood, secretions and other bodily fluids of people - and surfaces - that have been infected.

IS THERE A TREATMENT?

The WHO warns that there is 'no proven treatment' for Ebola - but dozens of drugs and jabs are being tested in case of a similarly devastating outbreak.

Hope exists though, after an experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people. The results were published in The Lancet journal.

Source, video, photos, further information, links and a better copy of the graph of cases:    https://www.dailymail.co.uk/health/article-6614653/Ebola-outbreak-DR-Congo-moving-major-city-home-one-million-inhabitants.html#" rel="nofollow - https://www.dailymail.co.uk/health/article-6614653/Ebola-outbreak-DR-Congo-moving-major-city-home-one-million-inhabitants.html#


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 23 2019 at 4:24pm

DR Congo confirms record number of Ebola cases in one day

Drugmaker set to ship experimental vaccines by end of next month as DRC struggles to contain the virus.
4 hours ago

The Democratic Republic of Congo (DRC) on Wednesday confirmed 14 new cases of Ebola virus in its eastern borderlands, the largest one-day increase since the current outbreak was declared in August.

In all, the haemorrhagic fever is believed to have killed 439 people and infected another 274 in the eastern provinces of North Kivu and Ituri.

The epidemic in a volatile part of the DRC is the second worst ever, according to the World Health Organization (WHO).

The largest outbreak occured in 2013-2016 in West Africa. More than 28,000 cases were confirmed.
DRC efforts to fight Ebola resume in Beni after deadly violence

The news comes shortly after drugmaker Merck said it will ship another approximately 120,000 doses of an experimental Ebola vaccine to Congo by the end of next month.

Associate Vice President Lydia Ogden told the World Economic Forum that the company is committed to having a ready stockpile of 300,000 doses and already has shipped 100,000 to the WHO.

Health officials have called the experimental vaccine highly effective against the virus.

The DRC health ministry says more than 63,000 people have received the vaccine in the outbreak that was declared on August 1 in the country's densely populated northeast near Uganda and Rwanda.

Carrying out vaccinations is complicated by rebel attacks, poor infrastructure and in some cases hostility from communities that have never faced an Ebola outbreak before.

Aid groups have been forced to halt Ebola prevention activities in the past due to violence.

Source and video:    https://www.aljazeera.com/news/2019/01/dr-congo-confirms-record-number-ebola-cases-day-190123184221003.html" rel="nofollow - https://www.aljazeera.com/news/2019/01/dr-congo-confirms-record-number-ebola-cases-day-190123184221003.html

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 24 2019 at 3:43pm
Ebola infects 3 more in DRC; virus evidence found in West Africa bat

Lisa Schnirring | News Editor | CIDRAP News

Jan 24, 2019

Three more people in the Democratic Republic of the Congo (DRC) were confirmed as having Ebola in the country's ongoing outbreak, and in a related development, researchers from Liberia and the United States today reported genetic evidence of the Ebola outbreak virus in a bat in Liberia, the first such detection in West Africa.

Also, the DRC media reported another security incident in the outbreak region, and researchers published new findings on clinical patterns and health worker vaccination from studies conducted in Sierra Leone during its outbreak in 2014-16.
Cases continue in Katwa hot spot

The DRC's health ministry today said two of the latest patients are from Katwa, one of the latest outbreak hot spots located just southeast of Butembo, and Biena health zone, which is west of Butembo.

The illnesses bring the overall outbreak total to 715, but the ministry noted that it has removed a duplicate case from Mabalako from its count. The number includes 666 confirmed and 49 probable cases.

Health officials are still investigating 236 suspected cases, and teams have now immunized 65,963 people with the Merck's unlicensed VSV-EBOV vaccine.

Also, the ministry said 4 more people died from their infections, including a patient from Biena who died in the community setting and 3 who died in Ebola treatment centers—2 in Butembo and 1 in Katwa. So far 443 deaths have been reported in the DRC outbreak.

In Beni, which was the main Ebola hot spot but has recently shown a steep drop in cases, a group of people vandalized a local hospital the night of Jan 21, apparently targeting Ebola responders that they thought were inside, according to a translation of a local media report.

The attackers threatened to burn the facility and destroyed the door and windows before they were scared off, the report said. A nurse quoted in the story said the facility had hosted Ebola vaccinators, that they felt safe there, and that she welcomed their help in fighting the epidemic.
Bat findings provide more reservoir clues

Liberia's government and its partners, which include Center for Infection and Immunity (CII) at the Columbia University Mailman School of Public Health and EcoHealth Alliance, announced the bat findings today in a press release.

As part of bat sampling with the US Agency for International Development (USAID) PREDICT project, scientists found Ebola genetic material and Ebola antibodies in a greater long-fingered bat from Nimba district in northeastern Liberia, according to a press release from Columbia University's Mailman School of Public Health. The project also included researchers from Columbia's Center for Infection and Immunity and EcoHealth Alliance.

The bat species that yielded Ebola evidence is found in West Africa and other regions and is important to agriculture, because they eat insects that damage crops. Unlike other bats, the long-fingered type doesn't roost in homes or building and instead are found in forests, caves, and mines. According to the report, Liberia's government is using that information to teach the public about how to avoid exposure and increase their awareness of the animals' positive impact on the environment.

Evidence from 20% of the bat's genome suggests that it is closely related to the Zaire Ebola virus species, which was involved in West Africa's massive 2014-16 outbreak and is also implicated in the current DRC outbreak. Researchers at CII are trying to determine if the strain from the bat is a genetic match with the one that caused West Africa's outbreak.

The researchers said the finding brings scientists closer to understanding the source of Ebola in humans.

Simon Anthony, DPhil, assistant professor of epidemiology at CII, said in the release that there has been speculation that Ebola in humans came from bats, but no direct evidence has yet been found. "It is possible that there are also other bat species that carry Ebola. Going forward, we will be analyzing additional specimens to fill in the picture," he said.

According to a news report on the discovery in Science today, two other Ebola species were found in a related insect-eating bat, but other indications have pointed to fruit bats as a possible reservoir. Jon Epstein, DVM, with EcoHealth Alliance and who leads the USAID-PREDICT project in Liberia, told Science that the new finding hints at the possibility that Ebola has multiple hosts that may vary by region.

Another researcher not involved in the work, Fabian Leendertz, DVM, with the Robert Koch Institute in Berlin, told Science that a next step would be to sample the insects that the bats eat to see if they harbor the virus.

In other Ebola research developments, scientists reported new findings related to clinical disease in kids and vaccination in health workers, both based on experiences in Sierra Leone's outbreak:

    A review of clinical disease and treatment outcomes in 139 patients younger than 15 years found that 56.1% were girls and 51.1% were students and that certain factors at the time of admission were associated with greater odds of dying from the disease, according to the report today in BMC Infectious Diseases. The factors included male gender, abdominal pain, vomiting, conjunctivitis, and difficulty breathing.

    A 2018 survey on staff turnover and Ebola vaccine acceptance in 305 health workers in Sierra Leone found that 76% of them had a positive opinion of Ebola vaccination and that vaccination against Ebola is feasible if employment is stable, but repeated vaccination at the start of employment may be needed to maintain high vaccination coverage. Researchers reported their findings yesterday in Vaccine.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-3-more-drc-virus-evidence-found-west-africa-bat" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-3-more-drc-virus-evidence-found-west-africa-bat

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 25 2019 at 4:59pm
Ebola death toll surges in DR Congo


The number of people killed in an Ebola outbreak in eastern DR Congo has risen to 443, health authorities have announced, as new President Felix Tshisekedi began his first full day in office on Friday.

The rising death toll -- up by more than 40 in the past ten days -- emphasises the challenge of controlling the epidemic in the strife-torn east and is just one of a host of complex issues facing Tshisekedi.

Tshisekedi was sworn in on Thursday following a long-delayed and bitterly disputed election, replacing Joseph Kabila after 18 turbulent years in charge of sub-Saharan Africa's biggest country.

In his inaugural address, Tshisekedi promised a new era of respect for human rights. He also faces entrenched poverty, corruption and fighting between militias who control parts of the east.

In a bulletin on Thursday, the health ministry outlined the growth of the Ebola outbreak.

"Since the start of the epidemic, the total number of cases is 715, including 666 confirmed and 49 probable. In all, there have been 443 deaths" in the provinces of North Kivu and Ituri, the ministry said.

DR Congo, formerly Zaire, has seen 10 outbreaks of the highly contagious haemorrhagic disease since it was first identified in 1976 near the Ebola river in the northwest of the country.

The latest outbreak was declared on August 1 in the region of Beni, a major market town in North Kivu, and quickly spread to neighbouring Ituri province.

The ministry said 248 people have recovered from the Ebola virus, while "236 suspect cases" were under investigation -- down one from the previous bulletin on January 15.

The Beni region and parts of Ituri regularly come under attack from local armed groups and foreign rebels, particularly the feared Allied Democratic Forces (ADF) from neighbouring Uganda.

The presidential election, held on December 30, was cancelled in Beni, officially because of the Ebola outbreak and regional insecurity.

© 2019 AFP

Source: France 24    https://www.france24.com/en/20190125-ebola-death-toll-surges-dr-congo" rel="nofollow - https://www.france24.com/en/20190125-ebola-death-toll-surges-dr-congo

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 25 2019 at 5:02pm
Hmmm.................   I think no new news there from France 24, despite being dated for today. I wonder if the news is now being reported from a "safe distance".

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 28 2019 at 6:44am
Public Release: 28-Jan-2019
NIAID-sponsored clinical trial of Ebola vaccines begins at Cincinnati Children's Hospital Medical Center

Study in healthy adults tests body's immune response

Cincinnati Children's Hospital Medical Center



CINCINNATI--A Phase 1 clinical trial of investigational vaccines intended to protect against Zaire ebolavirus (Ebola) is underway at Cincinnati Children's Hospital Medical Center in the United States. The study is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH).

Cincinnati Children's is one of nine NIH/NIAID-funded Vaccine and Treatment Evaluation Units (VTEUs). Part of an international effort to stop Ebola from spreading, the trial will test two experimental vaccines together for their safety and ability to produce an immune response in healthy volunteer participants.

"Researchers are looking for new ways to stop these outbreaks and to treat people who become infected and develop Ebola virus disease. The development of preventive vaccines for Ebola is a top global public health priority," said Paul Spearman, MD, of Cincinnati Children's and lead investigator of the trial. He is director of the ivision of Infectious Diseases.

Ebola is a serious and sometimes fatal disease caused by infection with one of the Ebola viruses. Ebola virus disease has a wide-ranging fatality rate of about 30-90 percent, depending on virus species. The hemorrhagic fever can affect organs, damage blood vessels and the body's ability to regulate itself. Once a person is infected with an Ebola virus, it can then be spread from person to person through close contact with infected body fluids.

Ebola viruses have generally caused infections in a small number of people in Central Africa each year, although there have been several Ebola outbreaks since 2013. The Ebola epidemic in West Africa that began in 2013 made more than 28,000 people sick, causing more than 11,000 deaths and spread into other countries around the world. A current outbreak in the Democratic Republic of Congo has so far caused more than 700 confirmed and probable cases of Ebola virus disease.

Blueprint for Immunity

Researchers on the current study will examine how the vaccines work in the body to stimulate responses in the immune system that may protect against Ebola viruses. Laboratory evaluations of the vaccines are led by Karnail Singh, PhD, in the Division of Infectious Diseases at Cincinnati Children's. Singh's laboratory focuses on the development, characterization and evaluation of candidate vaccines for Ebola virus disease.

The trial is studying two experimental Ebola vaccines; the ChAd3-EBO-Z vaccine and the MVA-BN®-Filo vaccine. These are weakened live-vector vaccines that cannot effectively grow in human cells but generate strong immune responses to Ebola virus proteins.

Spearman said previous laboratory research shows combining the two vaccines is a promising approach to generate potentially protective anti-Ebola responses. A major goal of the current trial is to use systems biology tools that provide a biological blueprint of the responses. This will provide a better understanding of why adding a MVA- BN®-Filo booster after priming the body with ChAd3-EBO-Z enhances the character and magnitude of immune response.

This study will enroll up to 60 healthy volunteers between 18 to 45 years of age. Volunteers will be randomly assigned to one of three groups. All participants will receive one dose of the ChAd3-EBO-Z vaccine followed by a second dose eight days later of either: 1) the ChAd3-EBO-Z (20 participants); 2) the MVA-BN®-Filo vaccine (20 participants), or 3) a placebo (20 participants).

Participants will be monitored closely for adverse events for six months after initial vaccination during at least 12 clinic visits. During these visits, volunteers will receive blood tests to evaluate potential immune responses to both of the experimental vaccines. Each volunteer will participate in the trial for approximately seven months.

###

For information about enrolling to volunteer for the study, click here or call 513-636-7699.
For more background information about the study, visit this link at ClinicalTrials.gov or use the identifier NCT03583606. Funding support from NIAID comes via HHSN272201300016.

Legacy of Vaccine Development

Cincinnati Children's is an active participant in global vaccine research and has a long legacy of vaccine development. This includes the oral polio vaccine and a vaccine for rotavirus. As an NIH-sponsored Vaccine and Treatment Evaluation Unit, Cincinnati Children's is helping study vaccines for seasonal influenza, H7N9 bird flu, Shigella, respiratory syncytial virus (RSV), and others.

Source and video:    https://www.eurekalert.org/pub_releases/2019-01/cchm-nct012519.php" rel="nofollow - https://www.eurekalert.org/pub_releases/2019-01/cchm-nct012519.php

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 28 2019 at 6:45am
South Sudan vaccinates health workers against Ebola

Yambio, 28 January 2019 – The Ministry of Health of South Sudan, with support from the World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF and the US Centers for Disease Control and Prevention (CDC) and other partners, today started vaccinating health workers and other front-line responders against Ebola as part of preparedness measures to fight the spread of the disease.

Vaccination began in Yambio, Gbudue State, but health workers in Tombura, Yei and Nimule as well as the capital city, Juba, will also be offered the vaccine. These are high-risk areas bordering the Democratic Republic of the Congo (DRC), now experiencing its tenth outbreak of Ebola. The outbreak began 1 August 2018. Neighbouring countries have not reported any cases of Ebola, but preparedness is crucial.

As part of these preparedness activities, South Sudan received 2 160 doses of the Ebola vaccine (rVSV-ZEBOV) from Merck, the vaccine developer. The vaccine offers protection against the Zaire strain of the virus, which is the one affecting DRC at present.

“It is absolutely vital that we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “WHO is investing a huge amount of resources into preventing Ebola from spreading outside DRC and helping governments ramp up their readiness to respond should any country have a positive case of Ebola.”

Vaccination is one of a raft of preparedness measures South Sudan is putting into place. WHO has deployed more than 30 staff members to support these activities.

In particular, WHO has helped train 60 health workers in good clinical practice principles and protocol procedures to administer the yet-to-be-licensed Ebola vaccine. To detect any travellers entering the country who may be infected with the virus, the Ministry of Health, with the support of its partners, has established 17 screening points. Nearly 1 million people have been screened to date.

WHO is also supporting engagement with communities, active surveillance for the disease at the community and health facility levels, strengthening capacity for infection prevention and control and case management, and supporting dissemination of Ebola information through the media. Local laboratory capacity to test samples taken from people suspected of having Ebola is also being strengthened. Protective gear for responders has been stockpiled in a dedicated warehouse.

Gavi, the Vaccine Alliance, in addition to its work making the Ebola vaccine stockpile available, is providing US$2 million to support the WHO’s vaccination efforts in countries neighbouring the DRC, including South Sudan.

“Although research is ongoing, the evidence so far suggests the Ebola vaccine is a highly effective tool to help stop epidemics and can be used to prevent this national outbreak from becoming a regional one,” said Dr Seth Berkley, CEO of Gavi. “Vaccinating front-line workers and health workers in South Sudan border regions will be crucial: an outbreak in South Sudan would be deeply concerning.”

Uganda began vaccinating its front-line workers in November 2018. So far, more than 2 600 health workers in eight high-risk districts have been immunized. In DRC, more than 66 000 people have been vaccinated – more than 21,000 of them are health and other front-line workers. Rwanda also plans to vaccinate its front-line responders.

The yet-to-be-licensed rVSV-ZEBOV vaccine has been shown to be highly protective against the Zaire strain of the Ebola virus in a major trial. Though not yet commercially licensed, the vaccine is being provided under what is known as “compassionate use” in the ongoing Ebola outbreak in North Kivu province of DRC as part of recommendations from the Strategic Advisory Group of Experts on Immunization. This vaccine was also used in the Ebola outbreak in Equateur province of DRC in May–July 2018.

Source:    http://www.afro.who.int/news/south-sudan-vaccinates-health-workers-against-ebola?country=876&name=South%20Sudan" rel="nofollow - http://www.afro.who.int/news/south-sudan-vaccinates-health-workers-against-ebola?country=876&name=South%20Sudan

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 29 2019 at 6:37am
UPDATE

Congo Ebola cases rise to 736 as problems noted in Katwa

Lisa Schnirring | News Editor | CIDRAP News| Jan 28, 2019

Over the weekend and through today, the Democratic Republic of the Congo (DRC) reported 15 more Ebola cases, including 5 earlier probable infections from Komanda, one of the areas where responders had faced security challenges.

Also, the country's health ministry shed more light today on factors that have fueled a steep rise in cases in Katwa, which has become the current hot spot, and South Sudan today launched a campaign to immunize health workers and frontline responders with VSV-EBOV vaccine.
Case count climbs to 736

In the latest three daily updates, the latest cases were from a several locations. Of the 10 confirmed cases, 4 are in Beni, an area where cases have declined but was once the outbreak's epicenter. Two others are in Oicha, and four are in Katwa, the current hot spot.

The five probable cases in Komanda were added after investigations into deaths that occurred in November and December concluded that they were likely due to Ebola.

The new cases boost the overall outbreak total to 736 cases, which include 682 confirmed and 54 probable infections. In its update today, the ministry said health officials are still investigating 161 suspected Ebola cases.

Besides the 5 deaths in the earlier probable cases, the health ministry reported 8 more deaths, including 7 patients from Ebola treatment centers in Katwa, Butembo, and Mabalako. One of the deaths involved a patient from Oicha who died in the community.

The latest deaths push the outbreak's overall fatality count to 459.
Disruptions, reluctance in Katwa

In its update today, the DRC's health ministry said several factors have led to a significant increase in cases in Katwa this month, including local groups that have obstructed response activities such as immunization, household decontamination, and safe and dignified burials.

And despite broad community sensitization efforts, many Katwa residents continue to deny that Ebola exists, the ministry said. It added, "However, significant progress in community involvement in Katwa has been achieved, in particular through greater involvement of women's associations."

Also, demonstrations related to problems with the DRC's national election in late December brought the outbreak response to a standstill for several days, the ministry said, which resulted in a large drop in Ebola alerts that officials received and investigated. As a result, people with Ebola weren't quickly taken to Ebola treatment centers for care, and contacts weren't vaccinated.

Several "dead" days since the beginning of the year in Butembo and Katwa have also slowed the Ebola response. "When the response is slow, the risk of geographical expansion of the epidemic increases due to uncontrolled displacement of patients and their contacts," it said.

After the response interruptions, people who were contacts of confirmed cases moved and brought the virus to two new health zones in January: Mangurujipa and Kayina. And investigators found that Kayina's confirmed case-patients are members of a Katwa family who participated in the unsafe burial of a relative. Infections have been confirmed in 21 family members.
Officials push back against assertions

In an unusual step, the health ministry in its Jan 26 update disputed some information in a Jan 15 Foreign Policy article that discussed the challenges in the DRC's outbreak.

It said the article contained some "dubious and problematic" assertions, for example, that the health workers were threatened by soldiers, gangs, arms smugglers, and rapists. The health ministry clarified that most assaults and threats on responders have come from people the residents of Ebola-affected communities. It added that several Ebola cases have been detected in areas controlled by armed groups that have agreed to work with response teams to curb the outbreak.

The health ministry also said the article inappropriately linked possible sexual transmission in survivors and the use of rape as a weapon of war. It said no cases of "military rape or rape contamination" have been reported in outbreak areas and that there is no objective evidence to back up the assumption that "rapist and robber soldiers" could spread the virus.

The ministry said Ebola survivors and their families are being followed by clinical psychologists and that so far rape has not been mentioned as a source of trauma in populations affected by the outbreak.
South Sudan vaccine launch

In South Sudan, which has a border not far from the DRC's outbreak area, the health ministry and its partners today began vaccinating health workers and frontline responders against Ebola as part of larger preparedness efforts, according to a statement today from the World Health Organization (WHO) South Sudan office. Groups supporting the efforts include the WHO; Gavi, the Vaccine Alliance; UNICEF; and the US Centers for Disease Control and Prevention.

Vaccination began in Yambio in Gbudue state, and health workers in the cities of Tombura, Yei, Nimule, and South Sudan's capital city of Juba—all considered high-risk areas—will also be offered the vaccine.

The country has received 2,160 doses of VSV-EBOV from Merck.

Matshidiso Moeti, MD, the WHO's regional director for Africa, said in the statement, "It is absolutely vital that we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo." The WHO said it has deployed more than 30 staff members to support preparedness efforts in South Sudan, has helped train 60 health workers, and established 17 screening points that have screened nearly 1 million people so far.

Gavi has assisted with the Ebola vaccine stockpile and has provided $2 million to support WHO vaccination efforts in countries that neighbor the DRC's Ebola-affected area.

In November, health officials launched a similar vaccination campaign in Uganda, one of the other neighboring countries.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/congo-ebola-cases-rise-736-problems-noted-katwa" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/congo-ebola-cases-rise-736-problems-noted-katwa

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 31 2019 at 5:32am
Unicef says this is now the second largest ebola outbreak in history

With children accounting for 30% of the confirmed and probable Ebola cases, UNICEF scales up its response to halt spread of the disease

30 January 2019 – Since the latest Ebola outbreak in the Democratic Republic of the Congo (DRC) was declared six months ago on 1st August 2018, more than 740 people – 30 per cent of whom are children – have been infected with the disease, including over 460 who have died, and 258 that have survived Ebola. Alongside the Government and partners, UNICEF is scaling up its response to assist victims, control the spread of the disease and ultimately end the deadly outbreak.

This is the 10th Ebola outbreak in the DRC and the country’s worst. It is also the world’s second largest Ebola outbreak in history after the one in West Africa in 2014-2016. The response to this latest outbreak continues to be hampered by insecurity, frequent movement of people in the affected areas, and resistance from some communities.

“While we have been able to largely control the disease in Mangina, Beni and Komanda, the virus continues to spread in the Butembo area, largely because of insecurity and population movement,” said Dr. Gianfranco Rotigliano, UNICEF Representative in the DRC. “We are scaling up our response and deploying additional staff in the health zones of Butembo and Katwa, where 65 per cent of the new Ebola cases in the last three weeks have occurred.”

Since the beginning of the epidemic, UNICEF and its partners have deployed more than 650 staff to work with Government, civil society, churches, and non-governmental organizations – to assist people and families who’ve been infected and to raise awareness about the best hygiene and behavioral practices to prevent Ebola from spreading.

UNICEF’s Ebola response focuses on community engagement, providing water and sanitation, making schools safe from Ebola and supporting children and families infected and affected by Ebola. UNICEF aims to control and prevent the spread of the disease, and ultimately stop the outbreak; to reduce Ebola-related deaths among those infected; and to provide protection, alleviate suffering and give assistance to affected children and families.

People who’ve been infected, as well as affected families and their children, including children orphaned by Ebola and unaccompanied children, continue to receive psychosocial support to help them cope with the consequences of the Ebola disease. UNICEF is also providing a protective environment for children in schools and nutrition assistance, including to children and adults in Ebola Treatment Centers.

“Our teams in Mangina, Beni, Oicha, Komanda, Butembo and Lubero are working tirelessly with this multi-pronged approach to end the Ebola outbreak as quickly as possible, and to help affected children and families,” stressed Dr. Rotigliano.

Source:    https://www.unicef.org.uk/press-releases/ebola-outbreak-dr-congo-second-largest-history/" rel="nofollow - https://www.unicef.org.uk/press-releases/ebola-outbreak-dr-congo-second-largest-history/

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: January 31 2019 at 1:48pm
Ebola infects 9 more in DRC as ill traveler sparks response measures


Lisa Schnirring | News Editor | CIDRAP News| Jan 30, 2019


The number of people infected in the Democratic Republic of the Congo (DRC) Ebola outbreak grew by nine today, as health officials in the neighboring Haut Uele province took steps to prevent the spread of a disease from a resident who was exposed to the virus in Katwa.
Spike in Katwa cases continues

Of the nine newly confirmed cases announced today by the DRC health ministry, eight are in Katwa, the current hot spot where authorities face complex challenges, including insecurity, community resistance, and the after effects of a response slowdown in late December caused by election-related protests.

The other case is in Beni. Investigations are under way into 187 suspected Ebola cases. Today's developments push the outbreak total to 752 cases, including 698 confirmed and 54 probable cases.

The health ministry also said 4 more people died from their Ebola infections, 3 of them in community settings in Katwa and 1 in the Butembo Ebola treatment center. The new fatalities lift the outbreak's death count to 465.

Infected traveler in Haut Uele province

A health team has been sent to a city of Watsa in neighboring Haut Uele province after a young trader was hospitalized there after his likely exposure in Katwa, the health ministry said in its update today, noting that Oly Ilunga Kalenga, MD, the country's health minister, arrived there yesterday to oversee operations.

Haut Uele province is north of Ituri province and borders South Sudan. So far, Ebola cases in the current outbreak have been confirmed in only two DRC provinces: North Kivu and Ituri.

The man lives in Watsa but travels back and forth between Butembo and his hometown. An investigation into his illness suggests he was exposed to Ebola during a stay in Katwa, which is on the eastern outskirts of Butembo. Watsa is about 300 miles north of Butembo.

Healthcare teams were sent to vaccinate relatives and frontline health workers and to decontaminate the patient's home and the health center where he was treated.

Soldiers among recent deaths in Beni

In a separate development, two soldiers with the DRC's army have died from Ebola in Beni, Agence-France Presse (AFP) reported today, quoting an army spokesman.

The army source told AFP that three other soldiers are under observation and that steps have been taken to prevent illness in DRC troops.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-9-more-drc-ill-traveler-sparks-response-measures" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/01/ebola-infects-9-more-drc-ill-traveler-sparks-response-measures

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 01 2019 at 12:21pm
Today's Update
Ebola virus disease - Democratic Republic of the Congo: Disease outbreak news, 31 January 2019
Report
from World Health Organization
Published on 31 Jan 2019 — View Original
preview
Download PDF (769 KB)

The Ministry of Health (MoH), WHO and partners continue to respond to an outbreak of Ebola virus disease (EVD), despite persistent challenges around security and community mistrust impacting response measures. Relatively high numbers of cases were reported in recent weeks (Figure 1), mostly driven by the outbreak in Katwa Health Zone; the current focus of large scale response activities. Smaller clusters continue to be reported beyond Katwa Health Zone, including from Beni and Oicha; however, teams have quickly and systematically responded to these clusters to prevent onward transmission and guard against further geographical expansion of the outbreak. Teams are also working actively to strengthen community trust and participation in all affected areas.

As we approach six months since declaration of the outbreak, there have been a total of 752 EVD cases1 (698 confirmed and 54 probable) reported, including 465 deaths (overall case fatality ratio: 62%) as of 29 January 2019. Thus far, 259 people have been discharged from Ebola Treatment Centres (ETCs) and enrolled in a dedicated program for monitoring and supporting survivors. Among cases with a reported age and sex, 59% (439/750) were female, and 30% (224/749) were aged less than 18 years; including 115 children under 5 years.

During the last 21 days (9 January – 29 January 2019), 118 new cases have been reported from 11 health zones (Figure 2), including: Katwa (80), Beni (9), Butembo (7), Kayina (5), Manguredjipa (4), Oicha (4), Biena (3), Kyondo (2), Musienene (2), Komanda (1) and Vuhovi (1). In addition, five historic probable cases from Komanda Health Zone were reported during the past week with illness onset dating back to November 2018.

The outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission events in private and public health centres. Since 1 December 2018, 86% (125/145) of cases in these areas had visited or worked in a health care facility before or after their onset of illness. Of those, 21% (30/145) reported contact with a health care facility before their onset of illness, suggesting possible nosocomial transmission. In Katwa during the past 3 weeks (since 9 January), 49 health structures were identified where confirmed cases were hospitalised, including nine health centres where nosocomial transmission potentially occurred. Moreover, during the same period, eight new health care worker (HCW) infections were reported in Katwa; overall, 65 HCWs have been infected to date. Response teams are following up with the identified health care facilities to address gaps around triage, case detection and infection prevention and control measures.

Public health response

The MoH continues to strengthen response measures, with support from WHO and partners. For detailed information about the public health response actions by WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

WHO risk assessment

WHO reviewed its risk assessment for the outbreak and the risk remains very high at the national and regional levels; the global risk level remains low. This Ebola virus outbreak is affecting north-eastern provinces of the Democratic Republic of the Congo bordering Uganda, Rwanda and South Sudan. There is a potential risk for transmission of Ebola virus at the national and regional levels due to extensive travel between the affected areas, the rest of the country, and neighbouring countries for economic and personal reasons as well as due to insecurity. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities.

As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.

WHO advice

International traffic: 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 passengers leaving the Democratic Republic of the Congo. 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.

Source:    https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-35" rel="nofollow - https://reliefweb.int/report/democratic-republic-congo/ebola-virus-disease-democratic-republic-congo-disease-outbreak-35

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 12:48am
Statement on Ebola outbreak in Democratic Republic of the Congo

Dr Matshidiso Moeti, WHO Regional Director for Africa

Today marks 6 months since the 10th outbreak of Ebola was declared in the Democratic Republic of the Congo. Before I say anything else, I want to recognize and thank our WHO and partner colleagues in the field for their courage, commitment and professionalism. They make us all proud. I also want to acknowledge the steadfast leadership of the Democratic Republic of Congo Ministry of Health and other colleagues. No country would wish to face this deadly pathogen, and their spirit of cooperation is what allows us all to face the virus together.

As we look back on these 6 months, we can clearly see the strategies that have been successful at controlling the outbreak in some of the affected areas such as Mangina, Béni, Komanda and Oicha, though we continue to face flare-ups in some of these areas and outbreaks in others.

What has worked is public health measures such as training health workers on infection prevention and control in health centres; closer engagement with communities--particularly women’s and religious groups; other public health measures such as case investigation, and contact tracing, alongside the use of newer tools. So far 70,000 people have agreed and received the investigational vaccine, and 350 patients have been treated with therapeutic drugs, available for the first time at this scale.

In each town or area, the outbreak has slightly different drivers. The outbreaks in Butembo and Katwa health zones are partly being driven by transmission in private and public health centres, with about a fifth of patients reporting contact with a health care facility before their onset of illness. The rest are being infected within communities.

We therefore tailor our actions accordingly both in the health facilities and at community level.

Let me provide some examples:

    In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress, and provide incentives to encourage best practices. We’re also working with the highest risk health facilities in as yet non-affected health zones in North Kivu and surrounding provinces, and countries.
    In addition, we work with health facilities to ensure they and the communities report all deaths, allowing teams to conduct safe and dignified burials.
    WHO, the Red Cross, UNICEF, and other partners work together to collect and analyze community feedback, to ensure our actions are tailored appropriately and address community concerns and needs.
    Underpinning this all, the UN peacekeeping force provides us the security umbrella under which we can function.

These are the approaches that work. But let us step back to consider the context. The Ebola outbreak is happening in a country that is also responding to outbreaks of polio, cholera, measles, and monkeypox and the health needs related to the ongoing humanitarian crisis in other provinces. This is putting a lot of pressure on the health system in general.

In Béni, one of the Ebola affected areas, we had to respond to a malaria outbreak at the same time as the Ebola response. This required additional teams working hand-and-hand with our Ebola response teams. The malaria Mass Drug Administration campaign reaching 300,000 people in Béni, and helped to alleviate pressure on the health system.

Ultimately, this outbreak has put into even sharper focus the weaknesses in the health system, and reinforced, once again, our ultimate message: stronger health systems are the only way to rapidly detect, respond and eventually end outbreaks.

By using proven public health measures and newer tools at hand, under the government’s leadership and working collaboratively across agencies, WHO is committed to addressing these challenges and ending the outbreak.


Source:    https://afro.who.int/media-centre/statements-commentaries/statement-ebola-outbreak-democratic-republic-congo" rel="nofollow - https://afro.who.int/media-centre/statements-commentaries/statement-ebola-outbreak-democratic-republic-congo

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 12:49am
I'm not sure that is as reassuring as the WHO wants us to believe.

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 02 2019 at 9:01am
HEALTHCENTRE SUPERSPREADERS?

Many cases in DRC Ebola outbreak coming from health centers
February 1, 2019
Matshidiso Moeti, MBBS, MSc
Matshidiso Moeti

Six months into the 10th and largest Ebola virus outbreak in the Democratic Republic of the Congo, or DRC, officials said many confirmed cases are coming from health care centers.

“As we look back on the 6 months, we can see the strategies that have been successful in controlling the outbreak in some areas ... though we continue to see flare ups and outbreaks in other areas,” Matshidiso Moeti, MBBS, MSc, WHO regional director for Africa, said during a news conference.

Strategies that have worked to control the outbreak, she said, have involved engaging with communities, especially with women and religious groups, and case investigation and contact tracing. Widespread use of an investigational vaccine and investigational drugs also have aided the response.

However, as Moeti explained, transmission remains a problem, with one in every five confirmed cases reporting contact with a health center before the onset of the disease.

According to WHO, the outbreak in Katwa and Butembo health zones is partly being driven by nosocomial transmission in health centers. WHO said 86% of cases in these areas since Dec. 1 reported having visited or working in a health care facility before becoming ill. Additionally, in the past 3 weeks, 49 health structures were identified where confirmed cases were hospitalized and eight new infected health workers were reported.

“In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress and we also provide incentives to encourage best practices,” Moretti said. “In addition, we work closely with facilities and the community to ensure that they report all deaths and have safe and dignified burials.”

Moeti said strengthening the health system is crucial to fight outbreaks, including an ongoing malaria outbreak in Beni. Officials had to deploy additional WHO teams to work along with the Ebola response teams to get control of that outbreak.

“Ultimately, this outbreak has put into even sharper focus the weaknesses and the gaps in the health care system and reinforced our ultimate message — stronger health systems are the only way to rapidly detect, respond to, and eventually, end outbreaks,” Moeti said.

The case count in the Ebola outbreak has reached 759, including 705 confirmed cases and 414 confirmed deaths. So far, more than 70,000 people have been vaccinated in the DRC, and 2,600 health care workers in bordering Uganda and South Sudan also have been vaccinated. Moeti said preparing bordering countries is a priority in controlling the outbreak, although an international public health emergency of international concern has not been declared.

“I feel optimistic that in the places where we started with a combination of interventions, that we have been able to bring the situation there almost under control,” Moeti said. “We’ve seen a change in our engagement with communities, we’ve invested a lot in it, and we have been very pleased with the support from local leaders who have been able to work with us to carry the message and engage the community.”

However, she added there is still a lot to be done to stabilize and bring the situation under control. – by Caitlyn Stulpin

Source:    https://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B1914c63f-ccca-4478-be05-3818387d56f9%7D/many-cases-in-drc-ebola-outbreak-coming-from-health-centers" rel="nofollow - https://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B1914c63f-ccca-4478-be05-3818387d56f9%7D/many-cases-in-drc-ebola-outbreak-coming-from-health-centers

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Absence of proof is not proof of absence.


Posted By: Dutch Josh
Date Posted: February 02 2019 at 10:56pm
Techno; thank you for the Ebola-updates.

With this many diseases in the region several risks;
-The symptoms may be related to the wrong disease (so people could spread ebola because their disease could be mistaken for cholera at first-as an example)
-A "melting pot" for virusses, bacteria etc. (not only in humans but also other species) could-maybe-produce a new virus/bacteria (or add to a flu-virus ???) wich would worsen the healthcrises even further.

DJ-In my opinion this outbreak (with the mix of climate change, enviromental problems) is not getting enough attention (and thus money).
It is like a "small fire" going on for a longer period suddenly exploding.
There are at present to many countries with failed/weak governments, to many extremists willing to use bio-weapons-for now ebola is a central-africa problem, but "a new disease" may develop and could turn into a major global health risk.

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We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein


Posted By: Technophobe
Date Posted: February 03 2019 at 4:02am
Ebola has never really been considered a threat to us in the West. Consequentially it is usually underfunded, Josh.

Things are slowly improving and the main problems in this case are the remoteness of the location and the lack of previous funding for research (for instance: there is a vaccine but it does not travel well).

But at least some attention is being paid to it now. Here is another bit of recent research, this time on the infection control measures:

Protecting those on the frontline from Ebola

Date:
    February 2, 2019
Source:
    Medical University of South Carolina
Summary:
    Online training has increased the knowledge of health care workers about effective prevention of Ebola up to 19 percent and reduced critical errors to 2.3 percent in a small cohort. These findings suggest that the program could improve protection of health care workers from Ebola and, because it will be easily accessible via the Internet, could be especially useful in low-resource settings.
Share:

FULL STORY

In a world where we can travel the globe by jet, diseases that were once thought to plague faraway places can now strike close to home.

The U.S. had to learn this the hard way. In 2014, a patient harboring Ebola returned home to Dallas, Texas from Liberia. Within 15 days of this person's arrival, the Centers for Disease Control and Prevention (CDC) had confirmed two secondary cases in nurses who were treating the infected patient.

Ebola virus is very easily contracted from body fluids -- a mere ten viral particles will do it -- and people who get it have up to a 78 percent chance of dying. Health care workers are among the most vulnerable.

According to a 2015 report by the World Health Organization, health care workers can have an infection rate up to 32 times higher than the general population in certain parts of the world. Infected health care workers can unknowingly spread the disease, and once sick, are unable to care for patients.

In addition to a human toll, Ebola also exacts an economic one. Treatment of an Ebola patient in the U.S. can range from $30,000-$50,000 per day, limiting the number of hospitals who can treat it, and making its spread a very costly problem

The best hope for controlling this lethal foe is to prevent it. Researchers at the Medical University of South Carolina (MUSC) have created an online software package via the SmartState spin-off company, SimTunes, LLC, to train health care workers using simulation in safe Ebola disease response. They report promising findings in a small cohort of MUSC health care workers in an article published in the December 2018 issue of Health Security.

"This training program takes information from multiple resources, including the CDC, the National Ebola Training and Education Center and the European Network for Infectious Diseases," says Lacey MenkinSmith, M.D., assistant professor of Emergency Medicine at MUSC and first author of this article.

"What makes the program unique is that it combines all that information into one training program that is widely distributable."

"The entire course, including background material and hands-on simulation practice, is delivered over the Internet, so people can be trained immediately," adds Jerry G. Reves, M.D., distinguished professor and emeritus dean of the College of Medicine at MUSC and principal investigator of the CDC-funded study.

The software package includes a self-study component, a "hands-on" simulation workshop and a data-driven performance assessment toolset. A post-test evaluates trainees' knowledge of Ebola treatment, and software tracks and scores individual and team performance in Ebola treatment scenarios.

This training package aims to reduce the number of critical errors and risky actions committed when treating an Ebola patient. Critical errors put an individual at risk of infection or contaminate the clean zone. Risky actions increase the chance of committing a critical error.

The researchers tested the usefulness of their software package in 18 health care workers at MUSC, a state treatment center for Ebola. The health care workers were divided into two groups based on their experience level with treating high-risk infectious disease. The software package increased the knowledge of both groups about effective prevention by up to 19 percent.

Both groups also performed extremely well in simulation scenarios, with only 2.3 percent of 341 total steps flagged for critical errors in both groups. These scenarios included cleaning up spills, putting on a biosuit correctly and properly responding to a needle stick. Practicing all of these scenarios helps to reduce the risk of infection of the health care workers treating the Ebola patient.

These results validate this software package as a way to streamline and adequately educate health care workers on proper techniques to reduce infection when treating an Ebola patient.

The MUSC team plans next to test their training program in other health care settings relevant to Ebola. These include community hospitals, where Ebola patients might first be seen, or intermediary hospitals, which would care for them until they could be sent to a treatment center like MUSC.

MenkinSmith, who specializes in global emergency medicine, would also like to test the program in developing countries, and is planning to use the course in Uganda.

"I want to see how we can adapt what we have to a place that is a low-resource health care setting, such as a site like Uganda that I am set to visit," says MenkinSmith. Uganda's neighbor, the Democratic Republic of Congo, is currently experiencing an Ebola outbreak.

"Instituting this training at various universities and hospitals across the world will take time and adjustments" says Reves. "However, this represents the beginning of a concrete way to ensure that health care workers are protected from Ebola with just-in-time training anywhere in the world."

Story Source:

Materials provided by Medical University of South Carolina. Note: Content may be edited for style and length.

Journal Reference:

    Lacey MenkinSmith, Kathy Lehman-Huskamp, John Schaefer, Myrtede Alfred, Ken Catchpole, Brandy Pockrus, Dulaney A. Wilson, J. G. Reves. A Pilot Trial of Online Simulation Training for Ebola Response Education. Health Security, 2018; 16 (6): 391 DOI: 10.1089/hs.2018.0055

Medical University of South Carolina. "Protecting those on the frontline from Ebola." ScienceDaily. ScienceDaily, 2 February 2019. <www.sciencedaily.com/releases/2019/02/190202171849.htm>.


Source:    https://www.sciencedaily.com/releases/2019/02/190202171849.htm" rel="nofollow - https://www.sciencedaily.com/releases/2019/02/190202171849.htm

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 04 2019 at 4:17pm
Experts are calling for a declaration of a public health emergency
Cases rise to 785


Lisa Schnirring | News Editor | CIDRAP News| Feb 04, 2019



© UNICEF / Herrmann

Over the weekend and through today, the Democratic Republic of the Congo's (DRC's) health ministry reported 22 more cases, many from the current hot spot Katwa, but seven other areas also reported new cases.

In other developments, a group of experts today urged the World Health Organization's (WHO's) emergency committee to meet again to consider declaring a public health emergency, and clinical experts pushed for more use of renal replacement therapy to prevent kidney failure in critically ill Ebola patients.
Latest case details

Of the 22 new cases, the health ministry announced 11 of them in its update today. Among those lab-confirmed cases, 10 are in Katwa, with the following areas also reporting cases: Kyondo (4), Butembo (2), Kalunguta (2), Mabalako (1), Mangurujipa (1), Mutwanga (1), and Vuhovi (1). The increase lifts the outbreak's overall total to 785 cases, 731 of them confirmed and 54 listed as probable.

Health officials are still investigating 165 suspected Ebola infections.

In its latest updates the health ministry said 13 more people have died from their infections, 7 in community settings and 6 in Ebola treatment centers. Locations for community deaths, a factor that increases the risk of virus transmission, include Mangurujipa, Mutwanga, Mabalako, Kyondo, Katwa, and Vuhovi.

In a promising development, the ministry said contacts identified in Komanda have completed their 21-day follow-up period. And the number of people immunized with the experimental VSV-EBOV vaccine has risen to 73,309, roughly half of them in Beni and Katwa.
Experts call for global alert

Writing in a Lancet commentary today, several global health experts called for the WHO to reconvene its Ebola emergency committee and consider declaring a public health emergency of international concern (PHEIC) to address the threat of cross-border spread and to trigger more high-level support for the response. Several of the international experts are from Georgetown University's O'Neill Institute for National and Global Health Law and Johns Hopkins' Center for Health Security.

The emergency committee last met in October 2018, and its members said they didn't consider the event at that time to be a PHEIC. WHO emergency committees typically meet every 3 months or sooner, if needed.

The authors of the commentary said cases have more than tripled since then, with illnesses detected in 18 health zones and less than 20% of cases coming from known contact lists. They also said a widening outbreak could destabilize the region, especially in South Sudan, where tenuous peace is haunted by continued violence and predicted famine.

Declaring a PHEIC could specify proactive measures that are needed to shore up the response and send a clear signal that UN leadership and high-level political, financial, and technical support are urgently needed.

The expert commenters acknowledged that a PHEIC might escalate conflict by raising the international response's profile. "Like any complex multilateral negotiation, cultural competence and smart diplomacy are required. Outsiders are unlikely to be privy to all on-the-ground realities and risks," the team wrote, adding that problems—if they happen—would require urgent reform of the process.

"WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone," they wrote, noting that the WHO and United Nations will likely increasingly be called on to response to complex humanitarian crises.
Supportive care, reporting delays

In other medical literature developments:

    Experts from Canada and Africa writing in The Lancet today pushed for higher standards for supportive care for patients in Africa's outbreaks. Pointing out the role of renal failure in critically ill patients whose conditions deteriorate, they said that, although conventional dialysis isn't always feasible in many field settings, renal replacement therapy is an option when sterile water is scarce. They wrote that the bags are sealed until use, the approach is feasible, and the treatment would give patients time to recover from Ebola and associated acute renal failure.
    Georgia State University scientists who analyzed reporting dates in the DRC's current outbreak in the journal Epidemics yesterday described a two-wave pattern early in the outbreak, with the one surge in the first half of August and the other in late September, likely linked to local armed conflict. They said reporting delays have shown an 81.1% decline and that the epidemic appears to have reached a steady state, averaging about 35 cases a week during the 8 weeks preceding Jan 15.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/02/drc-ebola-cases-surge-785" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/drc-ebola-cases-surge-785

Feb 4 Lancet commentary on public health emergency declaration:    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2819%2930243-0/fulltext#%20" rel="nofollow - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30243-0/fulltext#%20

PDF:    https://www.printfriendly.com/p/g/KNWht5" rel="nofollow - https://www.printfriendly.com/p/g/KNWht5


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 05 2019 at 1:48am

The Ebola outbreak in Eastern Congo is moving toward a major city. That’s not good.


With at least 680 cases, it’s already the second-largest Ebola outbreak in history.

By Julia Belluz@juliaoftorontojulia.belluz@voxmedia.com Updated Jan 22, 2019, 1:13pm EST


At least 680 people have been infected with the Ebola virus in the Democratic Republic of Congo. It’s the second-largest Ebola outbreak in history, with 414 deaths so far, and the first Ebola outbreak in an active war zone, DRC’s eastern North Kivu and Ituri provinces.

But it could get worse: Health officials are concerned that Ebola appears to be spreading in the direction of Goma, a major population center in DRC.

Last week, DRC’s health ministry confirmed four cases of the deadly virus in Kayina, a town in North Kivu, where fighting among rebel and militia groups has repeatedly interrupted the painstaking work of health workers who are responding to the outbreak.

Kayina happens to be halfway between Butembo, currently one of the outbreak’s most worrisome hotspots, and Goma, where a million people live. Two of the patients died, and two were traveling to Goma when they were picked up at a checkpoint en route and sent back to Kayina for treatment.

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So far, the outbreak has not affected DRC’s biggest cities. But Ebola in Kayina “raises the alarm” for Ebola reaching Goma, Peter Salama, the head of the new Health Emergencies Program at the World Health Organization, told Vox on Friday.

Goma is a major transportation hub, with roads and highways that lead to Rwanda. “These are crossroad cities and market towns,” Salama added. People there are constantly on the move doing business, and also because of the insecurity in North Kivu. Ebola in Goma is a nightmare scenario WHO and DRC’s health ministry are scrambling to prevent.

Together, they’ve deployed a rapid response team, including a vaccination team, to Kayina. And if the virus moves on to Goma, Salama says Ebola responders are ready. They’ve already mobilized teams there, set up a lab, and prepared health centers where sick people can be cared for in isolation.

But as Ebola expert Laurie Garrett wrote in Foreign Policy last week, Ebola in Goma could also trigger a rare global public health emergency declaration by WHO, escalating the severity of an already dangerous outbreak.

An Ebola vaccine has been no match for DRC’s social and political chaos
WHO

When Ebola strikes, it’s like the worst and most humiliating flu you could imagine. People get the sweats, along with body aches and pains. Then they start vomiting and having uncontrollable diarrhea. They experience dehydration. These symptoms can appear anywhere between two and 21 days after exposure to the virus. Sometimes patients go into shock. In rare cases, they bleed.

The virus is spread through direct contact with the bodily fluids, like vomit, urine, or blood, of someone who is already sick and has symptoms. The sicker people get, and the closer to the death, the more contagious they become. (That’s why caring for the very ill and attending funerals are especially dangerous.)

Because we have no cure for Ebola, health workers use traditional public health measures: finding, treating, and isolating the sick, and breaking the chains of transmission so the virus stops spreading.

They mount vigorous public health awareness campaigns to remind people to wash their hands; that touching and kissing friends and neighbors is a potential health risk; and that burial practices need to be modified to minimize the risk of Ebola spreading at funerals.

They also employ a strategy called “contact tracing”: finding all the contacts of people who are sick, and following up with them for 21 days — the period during which Ebola incubates.

In this outbreak, there’s also an additional tool: an effective experimental vaccine. Since the outbreak was declared in August, more than 61,000 people have been vaccinated. But while the vaccine has tempered Ebola’s spread, it hasn’t overcome the social and political chaos in DRC, which has been called the world’s most neglected crisis.

“The brutality of the conflict is shocking,” Jan Egeland, head of the Norwegian Refugee Council, told the Thomson Reuters Foundation, “the national and international neglect outrageous.”
Presidential elections have “ratcheted up” the tension in an already tense situation

On December 30, after years of delays, voters went to the polls to elect a new president. In the days leading up to the election, tensions in North Kivu “ratcheted up,” Salama said. Protesters stormed Doctors Without Borders treatment centers in Beni, a recent outbreak hotspot, shutting them down for several days.

In January, the country’s electoral commission announced interim election results suggesting opposition leader Felix Tshisekedi had likely won the election. But leaked data and external analyses show there are irregularities with the voter count that point toward election fraud.

“All the outside observers — the African Union, the European Union, the Catholic Church — say the results of the election have been rigged,” and the people actually voted in Martin Fayalu for president, said Severine Autesserre, a political science professor at Barnard College, and author of the book The Trouble with the Congo. When the final results are announced in the coming days, more protests and riots are likely to follow.

But though the political instability isn’t making the Ebola response any easier, the war in Congo’s eastern provinces is a far bigger challenge. The 25-year-long conflict has displaced more than a million people, and made the already dangerous work of an Ebola response even more deadly, Autesserre said.

Between August and November, Beni had experienced more than 20 violent attacks, which put the outbreak response there on pause for days at a time. That meant cases had gone uncounted, and Ebola continued to spread.

There’s also some more encouraging news, according to Salama: The outbreak of more than 200 people in Beni, a North Kivu town marred by decades of violence, has been brought under control.

“Many people would have been extremely skeptical that the outbreak in Beni could be controlled as quickly given force of infection we were seeing in November and December, and the fact that we’ve had nothing but volatility and insecurity since then,” Salama said. “But the fact that Beni has had only one confirmed case in two weeks is giving us a lot of hope and optimism.”

As of Friday, the two biggest hotspots in the outbreak were Butembo, with 51 cases, and a neighboring city, Katwa, with 119 cases. But the outbreak is geographically dispersed. There are active Ebola cases in 12 of the country’s “health zones,” the districts around which the DRC’s health system is organized. Because of the insecurity and difficulty reaching people, only 30 to 40 percent are coming from known contact lists, Salama said. That means the virus might already be in places no one’s discovered yet.

Source:    https://www.vox.com/science-and-health/2019/1/18/18188199/drc-ebola-outbreak" rel="nofollow - https://www.vox.com/science-and-health/2019/1/18/18188199/drc-ebola-outbreak


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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 05 2019 at 9:57am

Long-running Ebola outbreak is now an international health emergency, say experts

Anne Gulland, Global health security correspondent

5 February 2019 • 10:38am

The current outbreak of Ebola in the Democratic Republic of Congo (DRC) is now so severe it should be declared an international health emergency, experts have warned.

In an article in the Lancet medical journal a group of international lawyers has urged the World Health Organization to declare the situation a public health emergency of international concern, which they hope would shine an international spotlight on the outbreak, currently the second largest in history.

Since the outbreak was declared last August there have been 774 cases of the disease and 481 deaths, and emergency responders have had to contend with outbreaks of violence and high levels of mistrust among the affected communities.

WHO’s emergency committee last met in October but since that time the number of cases of the disease have tripled, the outbreak has expanded into 18 health zones and governments have withdrawn personnel “fearing for their safety”, the Lancet warns. And the risk of the disease spreading across the border to Uganda, Rwanda and South Sudan is also high.

Mark Eccleston-Turner, one of the authors of the Lancet paper and a law lecturer at Keele University, said that declaring an international health emergency would not give WHO any more funding but he added: “Its main function is as a signal to the international community that this outbreak is serious, it requires more effort, more resources and a coordinated international response."

At the beginning of the 2014-15 Ebola outbreak in West Africa, which eventually led to nearly 30,000 cases including 11,000 deaths, the WHO came in for heavy criticism for being slow to grasp its severity and to declare an international emergency.

Dr Eccleston-Turner said that when an international health emergency was finally declared in August 2014 it triggered the involvement of the United Nations which described the outbreak as a threat to global peace and security.

He added: “WHO has learned some of the lessons of the West Africa outbreak and seems to be in a much better position now. But we cannot have complacency or hesitancy at WHO.”

But the situation in the summer of 2014 was very different: Ebola was spreading like wildfire in three countries, there was concern it would spread beyond Africa and there was no clear strategy for dealing with the disease. There was also no vaccine to control the spread of the disease or treatments for those infected.

By contrast today, international agencies have at their disposal a vaccine, four experimental treatments for patients as well as a tried and tested containment strategy.

The Lancet paper states that declaring a public health emergency would be "a clarion call to galvanise high-level political, financial, and technical support... It would provide a clear signal from the world's global health body that UN leadership is urgent.”

Tarik Jasarevic, a WHO spokesman, said: “WHO and our partners in DRC and neighbouring countries are watching carefully to detect any signs that we might need to call an expert committee... If and when we see those signs, the director general will call a meeting.”

Speaking to the Telegraph last week Mike Ryan, WHO assistant director general for emergencies, said the current strategy was working as the outbreak is being brought under control in the affected areas.

But while the outbreak has been largely contained in the cities of Beni and Mangina it has now moved "like a bush fire" to the city of Katwa, which has seen around two thirds of the new cases of the disease over the last month.

“The real challenge is containing the disease before it moves on to the next city. We know that’s been the pattern in the past - this is a highly mobile population which means there’s a high risk that cases will move to another city or region,” said Dr Ryan.

He added: “From the air the outbreak looks like a conflagration but it’s more like a series of bush fires.”

This is the 10th outbreak of the disease in DRC, after being identified in what was then Zaire in 1976. But it is the first time that Ebola has been in the North Kivu region in the north east of the country.

Dr Ryan said that there was much distrust of the international community and even some health workers have refused the vaccine.

He said: “Participation of the community is crucial, without it tension and misunderstanding come in. The vast majority of the responders are local and we’re doing a tremendous amount of training.”

He added that standards of care had much improved during this outbreak thanks to the work of agencies such as Médecins Sans Frontières (MSF) and US-based Alliance for International Medical Action (Alima).

"Credit to MSF and Alima - standards of care are definitely rising. We have intensive care specialists embedded in treatment centres and they provide extra assistance with managing patients. There is now improved hydration and monitoring of blood chemistry - the centres are more like intensive care units now," he said.


Source:    https://www.telegraph.co.uk/news/0/long-running-ebola-outbreak-now-international-health-emergency/" rel="nofollow - https://www.telegraph.co.uk/news/0/long-running-ebola-outbreak-now-international-health-emergency/

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Absence of proof is not proof of absence.


Posted By: EdwinSm,
Date Posted: February 05 2019 at 10:37pm
Unlike the West African outbreak which suddenly explode across a region, this Congo outbreak seems to be very slow moving. But, sadly, it is moving in the wrong (outward) direction.


Posted By: Technophobe
Date Posted: February 09 2019 at 12:12pm
DR Congo Ebola death toll passes 500 —Health ministry

Published February 9, 2019


More than 500 people have died from the latest outbreak of Ebola in DR Congo, but a vaccination programme has prevented thousands more deaths, the country’s health minister told AFP.

“In total, there have been 502 deaths and 271 people cured,” said a health ministry bulletin published late on Friday, reporting on the outbreak in the east of the country.

But Health Minister Oly Ilunga Kalenga said that, for the first time, a vaccination programme had protected 76,425 people and prevented “thousands” of deaths.

“I believe we have prevented the spread of the epidemic in the big cities” in the region, he said.

“The teams also managed to contain the spread of the epidemic to neighbouring countries,” he added.

“The biggest problem is the high mobility of the population,” the minister added.

The outbreak started last August in the North Kivu region, which borders Uganda and Rwanda.

The Spanish wing of the aid agency Doctors Without Borders reported on Twitter Saturday that there had been a surge in cases since January 15.

Rwanda, Uganda and South Sudan, further north, were all now on alert, it added.

The security situation in the east of the country, where armed rebels have terrorised the population for years, has made treating the disease difficult.

Source:    https://punchng.com/dr-congo-ebola-death-toll-passes-500-health-ministry/" rel="nofollow - https://punchng.com/dr-congo-ebola-death-toll-passes-500-health-ministry/

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Absence of proof is not proof of absence.


Posted By: Dutch Josh
Date Posted: February 10 2019 at 4:28am
https://www.climatestotravel.com/climate/democratic-republic-congo" rel="nofollow - https://www.climatestotravel.com/climate/democratic-republic-congo

Flooding could worsen the situation in the area. March-May could be wet.

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We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein


Posted By: Technophobe
Date Posted: February 12 2019 at 2:49am
[I have so many comments, I don't know where to start.]


Ebola vaccine offered in exchange for sex, say women in Congo

As experts urge global warning over outbreak, women and girls in Beni report alleged exploitation
Global development is supported by
Bill and Melinda Gates Foundation

Kate Holt in Beni and Rebecca Ratcliffe

Tue 12 Feb 2019 07.00 GMT
Last modified on Tue 12 Feb 2019 07.02 GMT

An unparalleled Ebola vaccination programme in the Democratic Republic of the Congo has become engulfed in allegations of impropriety, amid claims that women are being asked for sexual favours in exchange for treatment.

Research by several NGOs has revealed that a deep mistrust of health workers is rife in DRC and gender-based violence is believed to have increased since the start of the Ebola outbreak in August.

The research, presented at a national taskforce meeting in Beni, follows calls by international health experts urging the World Health Organization to consider issuing a global alert in relation to the outbreak. The experimental vaccine has been described by the WHO as “highly, highly efficacious” and hopes have been pinned on it controlling the outbreak.
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In one study cited, multiple respondents raised concerns over individuals offering Ebola-related services, such as vaccinations, in exchange for sexual favours.

The risk of exploitation by frontline Ebola workers was also mentioned by several focus groups.

Concerns were raised over a reported increase in stigma and violence facing women. Some women are blamed for failing to prevent the spread of the disease, according to the research by the International Rescue Committee (IRC), whose study was cited in the presentation.

Women, who are responsible for caring for the sick and ensuring that children wash their hands, faced a rising workload, with many feeling traumatised and exhausted, the recent meeting was told. One participant in a focus group said women are isolated during their periods, and are being accused of having the virus.

The IRC has since said those claims were based on preliminary findings. The charity, which consulted more than 30 focus groups, added in a statement that it is still analysing research: “We will take the findings and work with partners to address concerns raised and ensure that women and girls are protected.”

Trina Helderman, senior health and nutrition adviser for Medair’s global emergency response team, said the Ebola response should have established a higher standard of protection for women.

“This region of DRC has a long history of sexual violence and exploitation of women and girls. Though shocking, this is an issue that could have been anticipated,” said Helderman. “Humanitarian actors should have been more prepared to put safety measures in place to prevent this from happening.”

On Thursday, the health ministry urged people to report anyone offering services such as vaccinations or other treatment in exchange for money.

The ministry said it was aware of separate rumours, spread on social media, that women working on the Ebola response had been given jobs in exchange for sexual favours. In a statement, it said it took such claims seriously, and advised that women should only meet with recruiters wearing an official badge.

The warnings come as international health experts urged the WHO to consider issuing a global alert in relation to the outbreak. Writing in the Lancet, they said the response had been complicated by a “storm of detrimental factors”, including political instability, conflict and large numbers of people on the move.

Since August, there have been 811 Ebola cases, and 510 deaths as a result of the virus. The WHO has warned that there is a very high risk of the outbreak spreading not only across DRC but to Uganda, Rwanda and South Sudan. There are also concerns that the source of transmission is unclear in one in five cases.

Suspicion of authorities and health agencies has further hampered efforts to contain the response, said Eva Erlach, of the International Federation of Red Cross and Red Crescent Societies. The agency has analysed feedback from thousands of people living in Ebola-affected areas.

“Across all locations there are lots and lots of people who do not think that Ebola is real, that it is just a way for humanitarian organisations to make money, or that it was just used to postpone elections,” said Erlach.

Last week, agencies were urged to work closely with women’s groups and local community leaders to build trust in services.

Tarik Jasarevic, a spokesman for the WHO, which supports the Ebola response, said most community engagement activities are already led by national DRC experts who work closely with local networks. There are around 20 dialects spoken in North Kivu and Ituri, he added.

“Together, we continually adapt and work to improve our response to adjust to local challenges in this delicate social, political, economic context,” he said.

Jasarevic added that sexual exploitation is a grave concern, and said the agency continually monitors its services.

“A large part of the communication effort with communities is to inform them that all Ebola services are free,” he said. “We will continue to check and improve measures we have in place to prevent, monitor and report on any such incidents. More can always be done.”

Source:    [url]https://www.theguardian.com/global-development/2019/feb/12/ebola-vaccine-offered-in-exchange-for-sex-say-women-in-congo-drc]


Posted By: Technophobe
Date Posted: February 13 2019 at 9:42am

Ebola outbreak in violence-plagued DRC a worst-case scenario
Author
Dr. Theodore Karasik
February 13, 2019 15:36

Recently, several rebel militia members fighting over the northeastern corner of the Democratic Republic of the Congo (DRC) died of Ebola. Rebels dying from Ebola is a development that merits deeper examination.
The fact that Ebola, which has killed more than 500 people in this outbreak, is now truly mixing with the country’s violent landscape is a complicating factor, as international health care officials are developing an inoculation ring in Rwanda, Uganda and South Sudan that began in mid-January. In effect, a program of spatial containment is being instituted.

This Ebola outbreak is the second worst case so far. Luckily, experimental vaccination programs are working, but administering these programs in violence-prone areas is difficult at best. DRC Health Minister Oly Ilunga Kalenga said that the vaccination program had been administered to 76,425 people and had prevented “thousands” of deaths by stopping the spread of Ebola to “big cities.” The vaccine is not 100 percent effective as it is still experimental. International health authorities are concerned that the disease can still spread.

The DRC security situation is most problematic in the east of the country, where dozens of armed militias struggle over resources such as gold, diamonds, copper and coltan for profit and power. The area is home to the vast majority of the country’s 70 armed groups, all pursuing shifting local and national agendas. Most of them are small, numbering less than 200 fighters, but the havoc they have wreaked over decades, especially in North and South Kivu, have made eastern DRC the epicenter of deadly violence and humanitarian crises. This mix makes treating Ebola problematic, as this is the first time that an Ebola outbreak is occurring in an area with daily violence. The DRC’s ongoing instability caused by militia activity is creating mistrust in the population toward health workers.

For international aid organizations, this is a worst-case scenario, where victims carrying a deadly disease are unable to be treated because of attacks by machete-carrying rebels with heavy caliber weaponry. An attack by the Allied Democratic Forces (ADF) late last year killed 18 people in the town of Beni, halting local efforts to contain the spread of Ebola through this unstable area.

The DRC’s ongoing instability caused by militia activity is creating mistrust in the population toward health workers.

Armed militias that target DRC civilians and foreign aid workers make it difficult, if not impossible, for response teams to reach and work in the nation’s most isolated areas — a serious issue since the beginning of this outbreak. The ADF militia was initially created by rebels to oppose Ugandan President Yoweri Museveni, but the rebel group has also focused operations on the DRC’s North Kivu province.

This part of Central Africa is where 2.5 million people, mostly civilians, were killed between 1998 and 2002, especially involving ethnic hatred between the Hutu and the Tutsi people, which had formed the basis of the 1994 Rwandan genocide. One cannot overstate the complex landscape of ethnic identities and shifting alliances that occur between these groups. Throwing a deadly disease on top of this rebel instability makes for a combustible situation. An attack by any one of the dozen or so militias in an Ebola outbreak area collapses the ability to conduct safe practices. In the chaos, village mobs are known to try to bury their dead who died from Ebola by trying to steal the corpse, in a complete break of protocol.

The implementation of a set of spatial protocols that, from the start of the current Ebola outbreak, quickly identified areas of disease activity with the goal of preventing diffusion is now expanding instead of shrinking. Disease infection rates among the militia groups are unknown and, given their population, these groups could act as not only an incubator but also a transmitter into more distant areas. The number of fighters and their supporting infrastructure is likely to number in the tens of thousands. These rebels fall outside any international Ebola protocols, unless they are capable of stealing the medicine and then administering it themselves in highly unstable conditions, which would lay the foundation for further infections. These militias have access to medical facilities and possess a particular level of capability and capacity, yet are clearly unprepared for a disease such as Ebola.
Other military actors on the ground matter too. Naturally, the DRC’s military is actively engaged against the militias. The DRC military’s role in the Ebola crisis is focused on securing supply lines, but it frequently needs to concentrate on other internal issues. The Congolese army receives support from the UN’s Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), which has helped in the Ebola response since the beginning of the outbreak through the provision of logistical support, office facilities, transportation, communication and security.

Meanwhile, the DRC’s military engagement with these militias is now also being influenced by Russian advisers. Let us also recall that Russia’s private military company, Wagner Group, is involved across several sectors of the country. Finally, the US is nearby in Gabon. How these actors respond to the next chapter of this outbreak of Ebola in a violent, rebel-infested zone will most likely be determined by a highly uncoordinated effort among security actors.
A deadly disease such as Ebola being carried through rebel communities and their networks is an issue that needs urgent attention from government authorities, in addition to a communication plan to educate those who may be assisting such networks. Add in the terrain, corruption and crime and the ability for authorities to address the spread of the disease is severely weakened. The ability for militias to transmit Ebola unchecked is a public health and national security concern.

    Dr. Theodore Karasik is a non-resident senior fellow at the Lexington Institute and a national security expert, specializing in Europe, Eurasia and the Middle East. He worked for the RAND Corporation and publishes widely in the US and international media.
Disclaimer: Views expressed by writers in this section are their own and do not necessarily reflect Arab News' point-of-view

Source:    http://www.arabnews.com/node/1451516" rel="nofollow - http://www.arabnews.com/node/1451516


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Absence of proof is not proof of absence.


Posted By: EdwinSm,
Date Posted: February 14 2019 at 3:03am
If more fighters die, will that change the dynamics to allow health care workers access?

Or will we have to see enough deaths in various groups so that most of them can no longer function? With 70 or so armed groups that would need a terrible death rate


Posted By: Technophobe
Date Posted: February 14 2019 at 12:45pm
Ebola infects 4 more in DRC as death prompts testing in Uganda

Lisa Schnirring | News Editor | CIDRAP News | Feb 13, 2019


UNMEER, Martine Perret / Flickr cc

In the latest developments in the Democratic Republic of the Congo (DRC) Ebola outbreak, the health ministry reported four new cases, as details emerged about a suspected Ebola death that triggered a swift response in Uganda, where the man's samples tested negative for the virus.

The new cases signal continued activity in some of the outbreak's current main hot spots, and the close-call in Uganda shows how fear of cross-border spread has prompted intensive tracking of contacts.
New cases in 2 hot spots

The newly confirmed Ebola cases in the DRC include two patients in Katwa and two in Butembo. Also, health officials are still investigating 177 suspected illnesses.

One more person died from Ebola, a patient who was being treated at Katwa's Ebola treatment center.

The new cases lift the outbreak total to 823 cases, which includes 762 confirmed and 61 probable cases. So far, 517 deaths have been reported.

In the VSV-EBOV immunization campaign, 79,464 people have been vaccinated since Aug 8, 2018, more than half of them in Beni, Katwa, and Butembo.

A family's transport of a Ugandan man who died on Feb 8 in the DRC's outbreak region across the border and back into Uganda sparked intensive contact tracing, location of the body, and sample testing, according to a statement yesterday from the World Health Organization (WHO) African regional office.

The 46-year-old man was a construction worker who had been living and working the DRC for the past 8 years. He was first admitted to the hospital in Bunia, one of the towns in Ituri province that has reported Ebola cases, in November 2018 with symptoms that included chest pain and a sometimes-bloody cough.

Over the past week his condition worsened and he died at Bunia Hospital, where staff issued a death certificate and released his body to relatives, which included a group of 13 people from Tororo in Uganda. The group used the death certificate to cross the border and other checkpoints with the body. According to the statement, the death certificate said the man's cause of death was cardiac failure and pulmonary tuberculosis.

After learning of the incident, Uganda's health ministry—with support from the WHO—intercepted the man's relatives and the vehicle with the dead body in it before they reached their village in Tororo district. A ministry burial team and surveillance officer took oral swabs, conducted a verbal autopsy, and made plans to conduct a safe and dignified burial.

Yonas Tegegn Woldermariam, MD, the WHO's Uganda representative, said in the statement, "The immediate reporting by UMA and quick action by health workers as exhibited last night in this particular incident is what determines how quickly we respond and contain Ebola. I urge other Ugandans to take this as an excellent example as we prepare for a possible importation of EVD cases."

Uganda's health ministry said on Twitter that its teams conducted a dignified burial of the man in Tororo and that all people who were in close contact with the body have been quarantined. It added that samples taken from the dead man were sent to the Uganda Virus Research Institute, where they tested negative for Ebola. It emphasized that there are no confirmed Ebola cases from Uganda.

As part of preparedness efforts for possible spread of the virus across the border, Uganda has been vaccinating healthcare and front-line workers in high-risk districts since Nov 7. So far 3,587 have been immunized, the health ministry said.

Source:    http://www.cidrap.umn.edu/news-perspective/2019/02/ebola-infects-4-more-drc-death-prompts-testing-uganda" rel="nofollow - http://www.cidrap.umn.edu/news-perspective/2019/02/ebola-infects-4-more-drc-death-prompts-testing-uganda

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 15 2019 at 7:59am
EUROPEAN DISEASE CONTROL: RISK ASSESSMENT UPDATE

Rapid risk assessment: Ebola virus disease outbreak in North Kivu and Ituri Provinces, Democratic Republic of the Congo – third update risk assessment.


This is the third update of the rapid risk assessment published on the 9 August 2018. It addresses the public health risk associated with the current Ebola virus outbreak in the Democratic Republic of the Congo (DRC) and its implications for EU/EEA citizens. This update was triggered by the persistence of the Ebola virus disease (EVD) transmission in urban settings, the continuous increase in the number of reported cases during the last four weeks, the persistent occurrence of new cases among contacts unknown at the time of EVD diagnostics and current challenges for the prevention and control of EVD.

Executive summary

This epidemic in North Kivu and Ituri Provinces is the largest ever recorded in DRC and the second largest worldwide. As of 6 February 2019, the Ministry of Health of the Democratic Republic of the Congo has reported 791 Ebola virus disease cases, including 737 confirmed and 54 probable cases. A total of 492 deaths occurred during the reporting period, consisting of an overall case fatality rate of 62%.

As of 29 January 2019, 65 healthcare workers have been reported among the confirmed cases.

While the majority of the cases have been reported in urban settings, some have also been reported in rural health zones surrounding urban centres. This suggests that transmission is also ongoing in rural areas. The weekly number of cases has increased to approximately 40 for three consecutive weeks, indicating that the viral circulation in the community is persistent.

Persistence of Ebola virus circulation

Despite the impressive mobilisation of response actors, significant challenges remain in this complex setting marked by a long-term humanitarian crisis and an unstable security context. According to WHO, the persistence of Ebola virus circulation in the community is driven by the sub-optimal infection prevention and control practices in primary healthcare, incomplete contact tracing and follow-up, delays in detection and isolation of new cases and community deaths leading to potential exposure of relatives to EVD.

Efforts are on-going to strengthen community-led efforts to support key EVD prevention and control interventions. Outbreak response activities continue in order to offer high quality case management, perform ring vaccination campaigns, provide the community with safe and dignified burials and ensure Points of Entry screening.

New EVD cases are expected to be reported in the coming weeks. A geographical extension is still possible, given the prolonged humanitarian crisis in the region, the important crossborder population flows to and from neighbouring provinces and countries, and the observed adverse impact of security incidents and community reticence which is hindering the implementation of EVD prevention and control measures.
Risk to the EU

The probability that EU/EEA citizens living or travelling in EVD-affected areas of DRC will be exposed to the virus is low, provided they adhere to precautionary measures. There are no international airports in the affected areas with direct flights to the EU/EEA Member States, which limits the risk of the virus being introduced into these countries. The overall risk of introduction and further spread of Ebola virus within the EU/EEA remains very low. However, the risk can only be eliminated by stopping transmission at local level.


Source:    https://ecdc.europa.eu/en/publications-data/risk-assessment-ebola-virus-outbreak-north-kivu-and-ituri-third-update" rel="nofollow - https://ecdc.europa.eu/en/publications-data/risk-assessment-ebola-virus-outbreak-north-kivu-and-ituri-third-update

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 16 2019 at 8:29am
South Sudan conducts an Ebola Tabletop Exercise
Report
from World Health Organization
Published on 12 Feb 2019 — View Original

12 February 2019, Juba – South Sudan conducted an Ebola virus disease (EVD) Tabletop exercise (TTX) for National Rapid Response Team (NRRT) on 12 February 2019. The exercise aimed at enhancing NRRT’s operational readiness by familiarizing participants with the EVD Standard Operating Procedures (SOPs) on Rapid Response Team (RRT) activation, deployment and field investigation procedures. It also provided participants with an opportunity to evaluate current capabilities and resources for prompt deployment in response to any suspected EVD case.

A total of 70 participants drawn from eight teams comprising of epidemiologists, clinicians, risk communication experts, laboratory technicians, and infection prevention and control experts were engaged in the one-day TTX exercise. The scenario developed for the exercise allowed the participants to be tested on all the aspects of RRT activation, mobilization, deployment, and field investigation. During the simulation, the participants identified gaps in the current SOPs and proposed recommendations for improving the current guidelines.

As the EVD outbreak in DRC evolves, the risk of cross border spread remains high for South Sudan along with 3 other countries neighboring DRC. It is therefore important that the country attains and maintains operational readiness for prompt response to suspected EVD cases. A multi-disciplinary RRT that works to ensure rapid, coordinated detection, investigation, and response to outbreaks of disease are one of the key pillars of the EVD preparedness framework.

Mr Mathew Tut, the Director for Emergency Preparedness and Response and PHEOC Manager of the Ministry of Health said: “due to the history of previous EVD outbreaks, increasing global travel and proximity to DRC and the threat of cross-border spread, it is our responsibility to be prepared for effective alert management at any time”.

Although South Sudan has not confirmed any EVD case, the risk of Ebola importation from North Kivu and Ituri of the Democratic Republic of Congo (DRC) within the country and regionally is very high due to porous border, trade, IDPs and refugees coupled with insecurity, says Dr Olu Olushayo, WHO Representative for South Sudan.

We acknowledge our donors, the United States Agency for International Development (USAID), the Department for International Development (DFID), Canada, and Germany for supporting the ongoing efforts to strengthen the country’s preparedness capacities and mitigate the risk of EVD importation.

Source:    https://reliefweb.int/report/south-sudan/south-sudan-conducts-ebola-tabletop-exercise" rel="nofollow - https://reliefweb.int/report/south-sudan/south-sudan-conducts-ebola-tabletop-exercise

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Absence of proof is not proof of absence.


Posted By: Technophobe
Date Posted: February 19 2019 at 4:11pm
[News on this outbreak seems to be thinning out. The crisis is continuing but there seems to be a lack of news from the usual sources.]

However vice news have included it in their TV broadcast here:    https://www.youtube.com/watch?v=zNCjDEOF710" rel="nofollow - https://www.youtube.com/watch?v=zNCjDEOF710 and here is an article from The Mirror in Ireland:

Irish aid workers braced for 'Ebola disaster' in war-torn Congo

Irish Aid has stumped up €100,000 in emergency funding to back Concern’s life-saving work

By Saoirse McGarrigle

22:37, 19 FEB 2019

Irish aid workers are bracing themselves for a potential Ebola disaster in war-torn Congo.

Mark Johnson, 33, is on the ground with charity Concern as they fight to contain the fatal virus.

The lawyer from Goatstown, Dublin, told the Irish Mirror on Tuesday night that tackling the health crisis is hampered by the armed conflict.

Irish Aid has stumped up €100,000 in emergency funding to back Concern’s life-saving work.

Mark said: “At the moment it is confined to North Kivu, we are working in the more southern parts to prevent it spreading.

“We are doing this by distributing masks, gloves, chemicals to clean healthcare centres and also train healthcare workers on what to do in the situation.

"The DRC is already a humanitarian crisis, Ebola is now another layer to it. Beni in North Kivu is the epicentre of the breakout, but it is also gripped by a violent conflict.

“Armed groups are conducting massacres regularly. There is also a severe shortage of food. We are working with communities to repair the water system.”

During the Ebola crisis in West Africa between 2014 and 2016, the World Health Organisation was slow to react but Mark insists lessons have been learned.

He added: “The most updated figures we have today are that 838 people have been infected and 537 have been killed. The rate that we are getting there is quicker and faster than the last time.”

The number of recorded deaths was 370 at the beginning of this year, the death toll had reached 537 by the end of last week. This is an increase of 45%. At least 22 of the dead are health workers.

Concern are using the new funding to train more than 350 health workers in how to control the outbreak as it nears Goma, the capital city of North Kivu with a population of over one million.

Mark said: “It is vital that we do all that we can to contain the spread. There are a few theories about how it is transmitted.

“It’s believed to be carried by bats and ends up transmitted to other animals. In this territory they eat a lot of bush meat. Hunting and killing an animal like that, the blood is transmitted from animals to humans. The symptoms – there is nothing very distinctive about it.

“A very high fever, nausea, headaches and when it gets serious they start bleeding from the nose and mouth and also vomiting.”

“[It is] very difficult for healthcare workers to identify Ebola as a lot of cholera is also in the region.

“When the patient is extremely sick, they are also extremely contagious. When the person dies, the corpse is very contagious.

“Burial practice would generally involve the family cleaning the body and touching the body.”

Source and video:    https://www.irishmirror.ie/news/irish-news/irish-aid-workers-braced-ebola-14023173" rel="nofollow - https://www.irishmirror.ie/news/irish-news/irish-aid-workers-braced-ebola-14023173

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Absence of proof is not proof of absence.



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