Orientale, Dem. Rep. Congo - Ebola Bundibugyo: 36 suspected deaths (25 confirmed/probable), 800+ contacts traced, 77 suspected cases (52 confirmed/probable) since March 2012

[Treyfish]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Ebola: Uganda sends medical team to Congo
Publish Date: Aug 20, 2012




By Anne Mugisa And Ismael Kasooha
The Ministry of Health will send health experts to the Democratic Republic of Congo (DRC) to help them combat an outbreak of the deadly Ebola haemorrhagic fever there.
The ministry?s permanent secretary, Dr. Asuman Lukwago, said this was intended to prevent the disease from spilling over into Uganda, which is emerging from another Ebola epidemic.
By yesterday, reports indicated that one person had died of Ebola and three others were infected in northeastern Congo.
The outbreak is in Isiro, a busy town in the DRC?s Oriental province which shares a border with Uganda. ..http://www.newvision.co.ug/news/6343...-to-congo.html

[Treyfish]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

DRC: a form of border control to stop the spread of Ebola virus

August 20, 2012 at 3:33


Now, every traveler must complete a form on arrival in Kinshasa in all border crossings. The National Hygiene border, former leadership of international quarantine announced this control on Sunday, August 19 to restrict the spread of Ebola haemorrhagic fever.

According to the deputy national director of the National Hygiene border, Dr. Michel Musudi, this medical form is a way to collect from the traveler the symptoms of Ebola.

"This fact sheet will tell where he is going and who they should contact. On the plug, it has the destination address. In case he showed symptoms of the disease at the border, we could take her to a health center. If there are many signs that fall within the definition of cases, we will harvest samples. And if it turns out that the person is positive, can be traced to any individuals with whom she had contact. "

Indeed, the director of the National Institute of biomedical research and virologist, Dr. Muyembe has recalls that there is to date, "no drug or vaccine against Ebola virus." He said the only remedy against this disease is to break the transmission chain. And for this we must:
Isolate the sick;
Protect the medical team;
Detect anyone in contact with patients;
Follow them for 21 days to isolate and analyze their blood during fever.

Before the introduction of this sheet border, the Crisis Committee epidemics District Isiro, where cases have been detected for the current outbreak, had taken some steps to stop the spread of the disease.

Hand hygiene and food is highly recommended. It is forbidden to shake hands or be in contact with someone with this disease. Moreover, it is forbidden to touch or wash the body of a deceased person of Ebola hemorrhagic fever.

The Ebola outbreak was declared in the DRC last week with twelve cases including six deaths, according to the district medical officer of Isiro Interim Health, Dr. Jacques Gumbaluka. The Minister of Public Health, Dr. Felix Kabange Numbi said last weekend that the disease was detected in the Dungu district in Isiro and Vianana in the Eastern Province.

"There was an alert in Bukavu in South Kivu. But the analyzes are ongoing, "said the ministerhttp://radiookapi.net/actualite/2012...-virus-debola/

[alert]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

A somewhat questionable report that this outbreak may have hegan with a hunter finding a dead antelope in the forest. Antelopes are not known as a carrier of Ebola, as far as I am aware:

http://www.lobservateur.cd/index.php?option=com_content&view=article&id=7964:ministre-de-la-sante-publique-la-fievre-hemorragique-debola-signalee-dans-la-province-orientale&catid=47:nation&Itemid=49

[snip]

This epidemic has been reported in the Eastern Province precisely in Dungu, Viadana and Isiro. In these three jurisdictions has already recorded 12 confirmed cases including 7 deaths: In Dungu, there was 1 death; Isiro, 3 deaths and Viadana, 3 deaths. The current outbreak of Ebola in the Eastern Province is part of a hunter who d?pi?c? an antelope found dead in the forest.

[alert]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

A somewhat questionable report that this outbreak may have hegan with a hunter finding a dead antelope in the forest. Antelopes are not known as a carrier of Ebola, as far as I am aware:

http://www.lobservateur.cd/index.php?option=com_content&view=article&id=7964:ministre-de-la-sante-publique-la-fievre-hemorragique-debola-signalee-dans-la-province-orientale&catid=47:nation&Itemid=49

[snip]

This epidemic has been reported in the Eastern Province precisely in Dungu, Viadana and Isiro. In these three jurisdictions has already recorded 12 confirmed cases including 7 deaths: In Dungu, there was 1 death; Isiro, 3 deaths and Viadana, 3 deaths. The current outbreak of Ebola in the Eastern Province is part of a hunter who dépiécé an antelope found dead in the forest.

OK. I've been thinking about this, and can think of several explanations for this report:

1. The animal was misidentified, and in reality was a primate such as a chimpanzee or ape that died of the Ebola virus.

2. The antelope was killed or scavenged by an Ebola-infected primate or bat, who left blood or other bodily fluids behind, which the hunter came in contact with.

3. Antelopes really can carry the Ebola virus, something no one ever reported before. The antelope could have been infected by a bat.

4. The hunter who ate the dead antelope really died of anthrax or something else unrelated to the Ebola outbreak; his case was just mistakenly associated with this outbreak. The confirmed cases are the more recent ones, as the earliest cases likely died without sample.

5. The fact that a hunter scavenged a dead antelope has nothing to do with the source of the outbreak; locals may just be looking for an explanation and trained to blame wild animals. Given that there are 12-14 suspected cases, it isn't too hard to imagine that at least one of them might have eaten a wild animal in the couple weeks preceeding his death.

We will have to wait to see if we can get confirmation or further details of this report.

[alert]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Hat-tip Pathfinder.

http://www.romandie.com/news/n/_Fievre_Ebola_MSF_Belgique_renforce_son_equipe_dans_le_nord_est_de_la_RD_Congo52200820121905.asp

Ebola: MSF (Belgium) strengthens its team in the north-eastern DR Congo

KINSHASA - Doctors Without Borders (MSF-Belgium) strengthens its intervention Isiro in the northeast of the Democratic Republic of Congo (DRC), where an outbreak of Ebola haemorrhagic fever has begun.

Three people arrived Monday and five more are expected on Tuesday to help teams of the World Health Organization (WHO) and the National Department of Health, told AFP Weggheleire of Anga, medical coordinator for MSF Belgium .

The virus activity in this region is different from that which affected neighboring Uganda, according to the same source. DRC is struck by the virus less virulent Bundibungyo-theoretically-, while in Uganda it was a strain that has plagued Sudan, said Madame de Weggleheire.

The alert was launched 10 days ago and after thorough examination, WHO confirmed Saturday that the epidemic has infected a dozen people and killed about ten others.

The epidemic extends Isiro, a city of about 200,000 inhabitants to neighboring communities as Viadana, Dungu and Pahoua.

[snip]

[Catbird]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Uganda sending health team to DR Congo.

New Vision:

"Ebola: Uganda sends medical team to CongoPublish Date: Aug 20, 2012

The Ministry of Health will send health experts to the Democratic Republic of Congo (DRC) to help them combat an outbreak of the deadly Ebola haemorrhagic fever there.

The ministry?s permanent secretary, Dr. Asuman Lukwago, said this was intended to prevent the disease from spilling over into Uganda, which is emerging from another Ebola epidemic.

By yesterday, reports indicated that one person had died of Ebola and three others were infected in northeastern Congo.

The outbreak is in Isiro, a busy town in the DRC?s Oriental province which shares a border with Uganda.

?We are just coming out of battling Ebola. We have to take all measures, including the possibility of sending a team there to help them stop it and ensuring that it does not spill over here,? Lukwago said yesterday. "

[Treyfish]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

South Sudan Border Closed Following Ebola Outbreak in DRC


The Acting Governor of Western Equatoria State Sapana Abuyi has ordered for the closure of the border between Western Equatoria State and Democratic Republic of Congo following reports of Ebola disease outbreak in Dungu and Isiro Provinces in Democratic Republic of Congo.


20 August 2012



Medicins Sans Frontieres (MSF) staffs attend an Ebola patient inside an isolation ward in Bundibugyo December 12, 2007 in this picture released by MSF.(Reuters/Claude Mahoudeau/MSF/Handout)
By Joseph Nashion
YAMBIO, 20 August 2012 [Gurtong] - Reports indicate that at least one person has died after an outbreak of the deadly Ebola virus in the north-east of the Democratic Republic of Congo.
The governor issued an order yesterday barring travellers from moving between the two countries in a preventive move aimed at preventing the spread of the deadly disease.
?Any person presently at the boarder should refrain from direct body contacts and hand-shaking with anybody from across the border in DRC,? says the order signed by the Acting Governor.
The security agents have been instructed not to allow the movements of people as the market places at the border remain closed.
All state institutions, departments and travellers between the two countries have been urged to strictly adhere to the order.
?All health personnel in the state are ordered to be on high alert and monitor the situation,? says Abuyi.
The South Sudan government had in July issued an Ebola alert following the disease outbreak in Uganda.
South Sudan and Democratic Republic of Congo share a lot in terms of population movements and trade. As a result people moving from one place to other could spread the disease.
A total of 36 cases with 16 deaths have been recorded in Uganda since July. Two of them are health workers.
Ebola is a highly infectious disease, which presents with high grade fever and bleeding tendencies. It is very infectious, kills in a short time but can easily be prevented.
The signs and symptoms of the disease include fever, vomiting, diarrhoea, abdominal pain, headache, measles‐like rash, red eyes and sometimes with bleeding from body openings.
Ebola can be spread through direct physical contact with body fluids like saliva, blood, stool, vomit, urine, vaginal secretions and sweat from an infected person and soiled linen used by a patient.
It can also be spread through using skin piercing instruments that have been used by an infected person.
A person can get it by getting in touch with a dead body of a person who has died of the disease.
There is neither cure nor treatment, but some infected people have recovered from the disease.http://www.gurtong.net/ECM/Editorial...ak-in-DRC.aspx

[Ronan Kelly]

Re: Dem. Rep. Congo - 11 probable/confirmed cases (9 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Ebola outbreak in Democratic Republic of Congo (update 20 August 2012)
20 August 2012 - On 17 August 2012, the Ministry of Health (MoH) of the Democratic Republic of Congo (DRC) notified the World Health Organization (WHO) of an outbreak of Ebola haemorrhagic fever in Province Orientale in Eastern DRC.

As of 20 August 2012, a total of 15 (13 probable and 2 confirmed) cases with 10 deaths had been reported. The reported cases and deaths have occurred in 3 health zones as follows: 12 cases and 8 deaths in Isiro, including three (3) health care workers who have died; 2 cases and no deaths in Pawa; and 1 fatal case in Dungu.

The Congolese Ministry of Health has convened a National Task Force and is working with several partners including WHO, UNICEF, M?decins sans Fronti?res (MSF) Suisse, MSF Belgique and the United States Centres for Disease Control and Prevention (CDC). Similar Task Forces have been established at provincial and district levels to oversee and guide the response.

A joint MoH, WHO and MSF emergency response team is in the field to conduct a detailed epidemiological investigation and support case management. Control activities that are being carried out include active case finding and contact tracing, enhanced surveillance, case management, public information and social mobilization, and reinforcing infection control practices.

WHO is supporting the Ministry of Health in the areas of coordination, surveillance, field epidemiology, laboratory, case management, outbreak logistics, public information and social mobilization. An additional team of epidemiologists, a logistician, an anthropologist and social mobilization officers is being mobilized from the DRC, Republic of Congo, the WHO AFRO regional rapid response team, WHO Inter-Country Support team (IST) based in Gabon, and WHO HQ, for possible deployment in the field.

WHO does not recommend that any travel or trade restrictions be applied to Democratic Republic of Congo.

http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/3665-ebola-outbreak-in-democratic-republic-of-congo-update-20-august-2012.html

[alert]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

From ProMED moderator CP:

Published Date: 2012-08-20 22:00:04
Subject: PRO/AH/EDR> Ebola hemorragic fever - Congo DR (04): (OE)
Archive Number: 20120820.1253396

EBOLA HEMORRHAGIC FEVER - DEMOCRATIC REPUBLIC OF CONGO (04): ORIENTALE PROVINCE
************************************************** *****************************
A ProMED-mail post

http://www.promedmail.org

ProMED-mail is a program of the
International Society for Infectious Diseases

http://www.isid.org

[snip]

This report raises the number of fatalities from the 6 reported by the WHO on 17 Aug 2012 to 10. No additional information is provided beyond that contained in the WHO statement reported in ProMED-mail post 'Ebola hemorrhagic fever - Congo DR (03): (OE) Bundibugyo virus conf 20120818.1250930'. The number of people affected, previously given as 10, is not stated. Further information is awaited. The simultaneous outbreak of Ebola virus infection in close proximity, caused by different strains of the virus, suggests that some climatic or environmental factor may be involved.

[I think I agree. Something has changed. We had one human Ebola infection total in 42 months, and now we had two outbreaks with different strains within a couple weeks. Has something increased human contact with apes or bats? Is there a large, multi-strain epizootic occurring in animals? Has recent construction or developemnt driven large number of infected animals into populated areas? Unclear. - alert]

[Treyfish]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Deadly Ebola virus strikes Congo

http://edition.cnn.com/video/?utm_source=dlvr.it&utm_medium=twitter&utm_campaign=cnni_headlines#/video/world/2012/08/21/intv-congo-ebola-outbreak-bazira.cnn?eref=edition

[James S]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

The simultaneous outbreak of Ebola virus infection in close proximity, caused by different strains of the virus, suggests that some climatic or environmental factor may be involved.

DRC: Violence hampers aid work in Ituri

Photo: Richard Pituwa/IRIN
?We have buried too many people? ? District Commissioner Freddy BosombaBUNIA, 21 August 2012 (IRIN) - Inter-ethnic tensions have again turned violent in north-eastern Democratic Republic of Congo?s Ituri region, compromising the delivery of humanitarian aid to more than 100,000 people, according to officials there.

Some 13 civilians have been killed in recent weeks, according to civil society sources.

An estimated 60,000 people, mostly civilians, were killed in Ituri between 1998 and 2003 as ethnically aligned armed groups vied for control of power and resources, notably gold deposits.

According to a 27 July memo by a coalition of civil society organizations, the decomposed bodies of five members of the Hema community were found in Kapuru, a settlement on the shore of Lake Albert in an area under the control of the Front de la resistance patriotique en Ituri (FRPI) armed group, about 100km south of Bunia, Ituri?s main city.

?The rebels captured six of them as they were heading to Uganda to visit a sick relative, demanding money,? recounted the brother of one of the victims.

?The rebels said, ?You have refused to join our group, we?re going to kill you,? and they opened fire. One of them escaped after the rebels cut off his hand with a machete,? he added.

The spokesperson for the Hema-sud community, Aliegera Kwonke, said, ?We in the Hema community feel targeted. The FRPI don?t allow us to go about our business, our roads are blocked, our crops looted. Our people are massacred under the noses of the army. We don?t feel safe.?

A few days after the bodies were found, a member of the Ngity community disappeared in the same area, prompting demonstrations in the lakeside villages of Nyamavi and Soni by Ngity youths brandishing machetes and other weapons.

On 2 August, the population of Ndimo, 160km southwest of Bunia, barricaded the road leading to North Kivu Province and displayed the corpses of five people killed by unidentified assailants.

http://www.irinnews.org/Report/96144/DRC-Violence-hampers-aid-work-in-Ituri

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With the civil unrest and roads being barricaded - it might be that many people are fleeing/traveling in the remote backwoods. Thus allowing more contact with the virus.

In 1998 the Orientale villages of Durba and Watsa were the center of an outbreak of Marburg hemorrhagic fever among gold mine workers, so we know the virus is endemic.

The map below locates that outbreak.


<img src="http://wwwnc.cdc.gov/eid/images/03-0355-F1.jpg">


Commenting on the 1998 outbreak Dr. Bausch notes that the outbreak was "consistent with multiple parallel primary introductions rather than a single one amplified by secondary spread" - so the bug is out there in the wild.

http://wwwnc.cdc.gov/eid/article/9/12/03-0355_article.htm

[Shiloh]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Source: http://wireupdate.com/ebola-kills-3-...toll-to-9.html

Ebola kills 3 health care workers in DR Congo, raising death toll to 9
Posted about 11 hours ago

KINSHASA, DR CONGO (BNO NEWS) -- Three health care workers in the northeastern region of the Democratic Republic of the Congo are believed to have died from Ebola, raising the number of fatalities from the outbreak to at least nine, local and international health authorities said on Tuesday.

The Congolese Ministry of Health said it is aware of at least fifteen suspected Ebola cases, including nine fatal cases. The initial death toll given on Friday was risen to nine after three health care workers died in the town of Isiro, located in the province of Orientale which borders the Central African Republic and South Sudan to the north and Uganda to the east.

In addition to the nine deaths in Isiro, three other suspected Ebola cases have also been reported in the town. Two suspected cases have further been reported in Pawa, about 42 kilometers (26 miles) south of Isiro, and one fatal case has been reported in Dungu, some 139 kilometers (86 miles) northeast of Isiro...

[Giuseppe]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK). Edited.]

Ebola outbreak in DR Congo: ECDC rapid risk assessment

23 Aug 2012 / ECDC



An outbreak of Ebola haemorrhagic fever is ongoing in the Democratic Republic of Congo (DRC) with 15 cases reported, including nine deaths in Orientale province in eastern DRC. ECDC has published a rapid risk assessment to assess the risk at an EU level associated with this outbreak.

The risk of the outbreak spreading to the EU is extremely low.

It is unlikely, but not impossible, that travellers infected in DRC could arrive in the EU while incubating the disease and develop symptoms while in the EU. These cases would most likely seek medical attention and be isolated, preventing further transmission.

It is the first time that the Ebola species Bundibugyo has been laboratory confirmed as the cause of an Ebola outbreak in DRC. This finding indicates that the current outbreak in DRC is not related to the recently ended outbreak in Uganda, which was caused by the Ebola species Sudan.

As the incubation period can last up to three weeks, it is likely that additional cases will be identified in the coming weeks.

However, control measures currently implemented in DRC with the support of international partners, e.g. isolation of cases and active monitoring of contacts, should prevent further spread of the disease.

The WHO is currently not recommending any travel or trade restrictions be applied to DRC.



Read more:

• ECDC Rapid Risk Assessment: Outbreak of Ebola haemorrhagic fever in the Democratic Republic of Congo, 23 August 2012
• Ebola factsheet for professionals
• Ebola health topic page
• ECDC Rapid Risk Assessment: Outbreak of Ebola haemorrhagic fever in Uganda, 2 August 2012

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[JimO]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

Is there any relationship between this outbreak and the one in Uganda?

[Catbird]

Re: Dem. Rep. Congo - 15 probable/confirmed cases (10 fatal) of hemorrhagic fever in Orientale province - Ebola Bundibugyo confirmed

This IRIN article, dated today, discusses the death of the hunter who found the dead antelope. But what is interesting is the reference to cases beginning about a month ago.

http://www.irinnews.org/Report/96160/DRC-Bushmeat-blamed-for-Ebola-outbreak

"...At least 10 people in the province had died from suspected Ebola by 20 August, according to the UN World Health Organization (WHO), which first reported the outbreak on 17 August. Local sources say the first symptoms were spotted about a month ago.

...Jacques Gumbaluka, chief of the Haut-Uele health zone in Isiro, said that about one month ago a number of children under age five presented at health centres with anaemia. Then adults began to be admitted with unexplained bleeding and fever. "You have to know that the blood flows in vessels, but when the blood is flowing out of vessels it is a big problem, it becomes a drama," he said."


This WHO report specifies the locations of the cases.

http://www.who.int/csr/don/2012_08_21/en/

"As of 20 August 2012, a total of 15 (13 probable and 2 confirmed) cases with 10 deaths have been reported in Province Orientale in Eastern DRC. The reported cases and deaths have occurred in 3 health zones as follows: 12 cases and 8 deaths in Isiro, including three (3) health care workers who have died; 2 cases and 1 death in Pawa; and 1 fatal case in Dungu. "


But this MSF UK report of today gives slightly different numbers.

http://www.msf.org.uk/articledetail.aspx?fId=Ebola_outbreak_in_DRC_20120823

"Date Published: 23/08/2012 04:44

...So far there have been nine deaths in the current outbreak, only one of which has been laboratory-confirmed as Ebola. Twelve more people are suspected of having the disease, one of whom has been admitted to the treatment centre in Isiro. One patient who contracted the disease has made a full recovery. "