DRC - Ebola outbreak in North Kivu and Ituri: July 30, 2018+

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Ebola control: 22,000 doses of vaccines available in Goma

Posted on Wed, 13/11/2019 - 16:37 | Modified on Wed, 13/11/2019 - 16:37

The vaccination campaign against the Ebola virus disease with the Johnson and Johnson vaccine will be launched shortly. The news was announced Tuesday, November 12 in Goma by the team response to this disease, stating that at least twenty-two thousand doses of vaccines are already available in the capital of North Kivu.

The health areas of Majengo and Kahembe are targeted for this vaccination, according to the general coordinator of the Ebola response, Steve Ahuka Mundeke.

"The official launch will probably be done next week by the authorities. But, the beginning of the technical activities will begin this Thursday, November 14, "he said.

In the meantime, he continued, this team is raising awareness among communities about this new vaccine, organizing the technical circuit, setting up the centers where people will be vaccinated and "starting in a pilot way a small vaccination that we We will officially launch next week in the presence of our authorities. "

In Goma, for example, forecasts at this level of discussions about who to vaccinate will also depend on the evolution of the epidemic . "But for the moment, we have targeted the two sites: Kahembe and Majengo in the health zone of Karisimbi. We targeted 50,000 people, "Mundeke said.

https://www.radiookapi.net/2019/11/...bola-22-000-doses-de-vaccins-disponibles-goma

 

[Shiloh]

Source: https://www.who.int/csr/don/14-november-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
14 November 2019



Six new confirmed cases were reported in the past week (6 to 12 November) in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. All six cases resulted from local transmission in Beni and in Mabalako Health Zones, and all were known contacts of a confirmed case. While all cases can be linked to earlier transmission chains in Biakato Mines Health Area, Mandima Health Zone, that health area has not reported a case since 4 November.

In the past week, Kalunguta Health Zone reported 21 days with no new confirmed EVD cases and Katwa Health Zone cleared 42 days with no new confirmed cases. As the number of cases decreases steadily, other case indicators appear to be encouraging. The proportion of registered contacts among cases prior to symptom onset is increasing over time, reaching 100% (6/6) in the past 7 days. Trends in proportion of community deaths among confirmed cases have also improved. In past 3 weeks, 12% (3/34) of cases were community deaths, compared to 28% (17/61) in the previous 3-week period (9-29 October) and 33% over the course of the entire outbreak. AA shorter delay from symptom onset to admission to isolation of alive EVD patients has also been reported. Between 24 August and 1 October 2019 the delay averaged 4.1 days, compared to 3.2 days between 2 October and 12 November 2019.

However, concerns remain around the recent shift of cases to Mabalako Health Zone. In the past 21 days (23 October – 12 November), 40 confirmed cases were reported from five active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in three health zones: Mabalako (40%, n= 16), Mandima (33%, n= 13), and Beni (20%, n= 8). Ongoing local transmission in Bingo and Ngoyo Health Areas in Mabalako Health Zone is challenging because security issues have caused access and response difficulties in these areas.

As of 12 November, a total of 3291 EVD cases were reported, including 3173 confirmed and 118 probable cases, of which 2193 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1856) were female, 28% (n=930) were children aged less than 18 years, and 5% (n=163) were health workers.

This week the World Health Organization prequalified an Ebola vaccine for the first time. The injectable Ebola vaccine, Ervebo, manufactured by Merck (known as MSD outside the US and Canada) has met WHO standards for quality, safety and efficacy and can now be procured for at-risk countries by United Nations agencies and Gavi, the Vaccine Alliance. This decision will not have an immediate impact on the availability of the vaccine or how current doses are used in the Democratic Republic of the Congo, but is a step towards greater availability in the future. [h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 12 November 2019*[/h]

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*Excludes n=184 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Oicha, Pinga, Rwampara, Tchomia, and Vuhovi. . [h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of reported cases by health areas. Data as of 12 November 2019*[/h]

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[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 12 November 2019**[/h]

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**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health. [h=3]Public health response[/h]
For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

[h=3]WHO risk assessment[/h]
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment, carried out on 8 October 2019, concluded that the national and regional risk levels remain very high, while global risk levels remain low.

While the relatively lower case incidence observed is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security within affected communities. Concurrent with the decline in case incidence, there was a shift in hotspots from urban settings to more rural, hard-to-reach communities, within a more concentrated geographical area. These areas bring additional challenges to the response, including an extremely volatile security situation, difficulty accessing some remote areas, delays to engaging with the community which in turn lead to mistrust and misunderstandings, and potential under-reporting of cases. In such environments, risks of resurgence remain very high, as do the risks of re-dispersion of the outbreak with cases travelling outside of hotspots to seek healthcare or for other reasons. These risks continue to be mitigated by the substantial response and preparedness activities in the Democratic Republic of the Congo and neighboring countries, with support from a consortium of international partners. [h=3]WHO advice[/h]
WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News release: As Ebola cases reach 3000 in DRC, WHO calls on all partners to fulfil promises to communities
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Second Ebola vaccine to complement “ring vaccination” given green light in DRC
• Update on Ebola drug trial: two strong performers identified
• Ebola response funding
• The Strategic Advisory Group of Experts (SAGE) on Immunization
• Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization
• Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 18 October 2019

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 46: 11 - 17 November 2019
Data as reported by: 17:00; 17 November 2019
...

Ebola virus disease Democratic Republic of the Congo

3 292 Cases
2 195 Deaths
67% CFR

EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
and Ituri provinces in Democratic Republic of the Congo continues,
with four health zones and 11 health areas reporting confirmed cases
in the past 21 days (27 October to 16 November 2019). Since our
last report on 10 November 2019 (Weekly Bulletin 45), there have
been five new confirmed cases and two new deaths. The principle
hot spots of the outbreak in the past 21 days are Mabalako (46%;
n=13 cases), Beni (29%; n=8) and Mandima (21%; n=6 cases). Two
health zones, Beni and Mabalako, have reported new confirmed
cases in the past seven days.

As of 16 November 2019, a total of 3 292 EVD cases, including
3 174 confirmed and 118 probable cases have been reported. To
date, confirmed cases have been reported from 29 health zones:
Ariwara (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (78),
Mandima (339), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (687), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (395), Manguredjipa (18), Masereka
(50), Musienene (84), Mutwanga (32), Nyiragongo (3), Oicha (62),
Pinga (1) and Vuhovi (103) in North Kivu Province and Mwenga (6)
in South Kivu Province.

As of 16 November 2019, a total of 2 195 deaths were recorded,
including 2 077 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 65% (2 077/3 174). The cumulative
number of health workers remains 163, which is 5% of the confirmed
and probable cases to date.

Contact tracing is ongoing in six health zones. A total of 4 857
contacts are under follow-up as of 16 November 2019, of which
4 375 (90%) have been seen in the past 24 hours. Alerts in the
affected provinces continue to be raised and investigated. Of 3 663
alerts processed (of which 3 592 were new) in reporting health zones
on 16 November 2019, 3 578 were investigated and 422 (12%) were
validated as suspected cases.

PUBLIC HEALTH ACTIONS

Surveillance activities continue, including case investigations,
active case finding in health facilities and communities, and
identification and listing of contacts around the latest confirmed
cases. Cross-border collaboration continues, particularly with
Uganda and Rwanda.
As of 16 November 2019, a cumulative total of 253 234 people
have been vaccinated since the start of the outbreak in August
2018.

Vaccination with the Johnson & Johnson vaccine (Ad26.ZEBOV/
MVA-BN-Filo) continued in the Krisimbi Health Zone, with
147 people vaccinated on 16 November 2019, bringing the
cumulative total of people vaccinated with this vaccine to 240
since its introduction on 14 November 2019.

Point of Entry/Point of Control (PoE/PoC) screening continues,
with over 118 million screenings to date. A total of 106/110
(97%) PoE/PoC transmitted reports as of 16 November 2019.

There are continued community reintegration and psychosocial activities
for patients discharged from ETCs, along with psychoeducation sessions to
strengthen community engagement and collaboration in the response.
Water, sanitation and hygiene (WASH) activities continue, and in the Biakato area
35 households and 20 health facilities were briefed on IPC and WASH activities on
16 November 2019.

Community awareness and mobilization messages are being updated, revised and
harmonized and have been pre-tested by the commission and will subsequently
be shared in coordination and sub-coordination activities.
A press conference was held in Goma for local, national and international
journalists on the new Johnson & Johnson vaccine.

SITUATION INTERPRETATION

The drop in newly confirmed cases is encouraging, although transmission is still occurring
in Mandima, Mabalako and Beni. However, a high level of vigilance is still required,
with particular atttention to contact tracing and case recognition. While movement of
symptomatic cases continues, it is critical that all areas of the response remain effective,
engaged and fully resourced.


https://apps.who.int/iris/bitstream/item/334140/OEW46-18112019.pdf
https://www.afro.who.int/publications/outbreaks-and-emergencies-bulletin-week-46-11-17-november-2019

 

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Translation Google


Lubero / Ebola: Hygienists escape lynching in Masereka Health Zone

November 19th

After one year and three months of Ebola virus disease in the provinces of North Kivu and Ituri, community resistance continues to be observed in the health zone of Masereka, in the Lubero territory, in the North Kivu.

Hygienists in the Rwese health area escaped a popular lynching while collecting data, ie a Swab, on a death in Vutovo, a village to the west of the village. Luotu commune.

"We were driven to the mourning site by the family of the deceased, when we showed them the dead bag, they were agitated and wanted to unload on us," said Monday, November 18, an area hygienists of Rwese health at Hurricane FM.

For Masereka District Chief Medical Officer Dr. Samuel, this situation could jeopardize work in his health zone which, for the time being, had totaled more than forty-two days without recording any positive case of the disease.

It should be remembered that the Masereka Health Zone was the second zone of contamination of the Ebola virus disease after that of Mangina in October 2018.

Maombi Visika Changle

https://ouraganfm.com/?Lubero-Ebola-les-hygienistes-echappent-au-lynchage-dans-la-zone-de-sante-de

 

[Shiloh]

Source: https://notifier.in/item/0qm7qm8ujt3xt78kltzmzbiiw342ykk3/1341096.html
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[TD="class: main_title, bgcolor: transparent"]External Situation Report 68: 20 November 2019[/TD]
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[TD="class: main_content, bgcolor: #ffffff"]Over the last three months, there has been a steady decrease in the incidence of confirmed Ebola Virus Disease (EVD) cases in Democratic Republic of the Congo (DRC). In the week of 11 to 17 November 2019, nine new confirmed EVD cases were reported from three health zones in two affected provinces, compared to 126 cases reported at the peak of the epidemic in the last week of April 2019. No cases were reported from both Mandima and Mambasa health zones. After over 30 days with no new cases, Oicha Health Zone reported a new confirmed community death with links to Kalunguta, Oicha and Mandima health zones. Following initial resistance from family members and the community, a multidisciplinary team has now commenced investigations around this case. So far, the source of exposure is yet to be identified. All other cases reported in Beni and Mabalako health zones in the past week have been linked to known chains of transmission.



Although the number of weekly reported cases is decreasing, it is expected that the outbreak response will encounter more complex circumstances as some transmission continues within rural and hard to reach communities. Multidisciplinary response teams are building on sustained progress by enhancing efforts to thoroughly engage with the community in order to investigate all new cases, to improve contact tracing and access to vaccination and consequently break the remaining transmission chains.



In the 21 days from 28 October to 17 November 2019, 12 health areas and five health zones have reported cases. During this period, a total of 31 confirmed cases were reported, with Mabalako (45%; n=14 cases), Beni (29%; n=9) and Mandima (19%; n=6) cases as the principal hot spots.



As of 17 November 2019, a total of 3296 EVD cases were reported, including 3178 confirmed and 118 probable cases, of which 2196 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1854) were female, 30% (996) were children aged less than 18 years, and 5% (162) were healthcare workers.



Please click here to download the complete situation report (PDF).

You can access our archives of Ebola virus disease situation reports. You can also sign up here to receive regular updates on outbreaks and other emergencies in the WHO African Region.[/TD]
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[Shiloh]

Source: https://www.who.int/csr/don/21-november-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
21 November 2019



Seven new confirmed cases were reported in the past week (13 to 19 November) in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. After more than 30 days with no new cases, Oicha Health Zone reported a new confirmed EVD case, which was a community death. This case had links to Kalunguta, Mandima, Mabalako, and Oicha Health Zones and was transported within Beni Health Zone after death. A multidisciplinary team has commenced investigation of this chain of transmission. The source of exposure is yet to be identified; samples have been sent to the laboratory in Katwa Health Zone for sequencing to support the identification of the source case. All other cases reported in Beni and Mabalako Health Zones in the past week have been linked to known chains of transmission.

This week, security incidents attributed to armed conflict occurred in multiple areas included in the response, including Beni, Oicha, and Kyondo Health Zones. These were primarily due to ongoing military operations against non-state armed groups and retaliatory attacks on the local population. Although there have not been any reports of violence aimed at the response, the insecurity and related protests by communities led to the suspension of response activities in some areas of Beni, Butembo, and Oicha Health Zones. This violence and the disruptions to the response are threatening to reverse recent progress. As seen previously during this outbreak, such disruptions limit contact tracing and surveillance efforts and often result in increased transmission.

In the past 21 days (30 October to 19 November), 28 confirmed cases were reported from four active health zones in North Kivu and Ituri provinces (Figure 2, Table 1) with the majority reported in three health zones: Mabalako (50%, n=14), Beni (29%, n=8), and Mandima (18%, n=5). The majority of the cases (93%, n=26) are linked to known chains of transmission. The largest of the two active chains of transmission includes two cases who were both symptomatic in the community for a long period of time, which led to secondary and tertiary transmission. Mambasa and Butembo Health Zones passed 21 days with no new confirmed cases reported.

As of 19 November, a total of 3298 EVD cases were reported, including 3180 confirmed and 118 probable cases, of which 2197 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1859) were female, 28% (n=931) were children aged less than 18 years, and 5% (n=163) were health workers. [h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 19 November 2019*[/h]

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*Excludes n=184 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Pinga, Rwampara, Tchomia, and Vuhovi. [h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of reported cases by health areas. Data as of 19 November 2019*[/h]

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[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 19 November 2019**[/h]

Enlarge image



**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health. [h=3]Public health response[/h]
For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

[h=3]WHO risk assessment[/h]
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low.

While the relatively lower case incidence observed is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security within affected communities. Concurrent with the decline in case incidence, there was a shift in hotspots from urban settings to more rural, hard-to-reach communities, within a more concentrated geographical area. These areas bring additional challenges to the response, including an extremely volatile security situation, difficulty accessing some remote areas, delays to engaging with the community which in turn lead to mistrust and misunderstandings, and potential under-reporting of cases. The recent security events and disruption of response activities underscore the fact that the risk of resurgence remains very high, as do the risks of re-dispersion of the outbreak with cases travelling outside of hotspots to seek healthcare or for other reasons. These risks continue to be mitigated by the substantial response and preparedness activities in the Democratic Republic of the Congo and neighbouring countries, with support from a consortium of international partners. [h=3]WHO advice[/h]
WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News and updates on the Ebola outbreak in the Democratic Republic of the Congo
• Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization
• The Strategic Advisory Group of Experts (SAGE) on Immunization
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Update on Ebola drug trial: two strong performers identified
• Ebola response funding

 

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Translation Google

DRC: Protesters invade UN camp in Beni

AFP
Posted at 12:49 pm - Updated 54 minutes ago

Rioters invaded and set fire to a UN camp in Beni, eastern Democratic Republic of Congo, on Monday, where residents denounce a new massacre of civilians attributed to the armed group of ADF and " inaction " "Blue Helmets.

A civilian base of the United Nations Mission in Congo (MONUSCO) was invaded and partially burned by protesters demanding the departure of the oldest and most expensive UN peacekeeping mission.

" Houses of UN personnel have been attacked and vandalized, " said a spokeswoman for Monusco AFP. Monusco announced a crisis meeting early in the afternoon.
...
Before attacking the UN camp in Beni, protesters set fire to the town hall in the city, which was partially destroyed.
...
The fight against Ebola interrupted

NGO volunteers in Beni were invited to stay home on Monday, " safe from shooting angles and far from windows and doors, " humanitarian sources said.

The fight against the Ebola epidemic, which rages in the region of Beni, is interrupted since Friday.

" The situation in Beni is preventing our teams from working, the activities of the response are still dormant because the agents can not go out, " said the coordinator of the response, Dr. Jean-Jacques Muyembe.

The health authorities are worried about a possible resumption of cases of contamination, down sharply in recent weeks.

" There is a risk in that the patients are not followed, " said Professor Muyembe.

...
https://www.rtbf.be/info/monde/deta...res-un-nouveau-massacre-de-civils?id=10373694

 

[Shiloh]

Source: https://apnews.com/444a95f488fd4103a7a72cb2db96645d

Rebel attacks in eastern Congo kill several Ebola responders
By AL-HADJI KUDRA MALIRO and CARA ANNA27 minutes ago

BENI, Congo (AP) — Rebels killed four Ebola response workers in an overnight ambush in eastern Congo, the World Health Organization said Thursday, warning that the attack will give the waning outbreak new momentum in what has been called a war zone.

“We are heartbroken that our worst fears have been realized,” WHO chief Tedros Adhanom Ghebreyesus said. It was by far the deadliest such attack in the second-worst Ebola outbreak in history, the United Nations health agency said.

The dead included a member of a vaccination team, two drivers and a police officer. Many of the six others wounded were with Congo’s health ministry.

Mai-Mai fighters attacked a camp housing scores of aid workers overnight in Biakato, local official Salambongo Selemani told The Associated Press. Warnings had been posted demanding that the health workers leave or face “the worst,” Selemani said.

The other attack targeted an Ebola response coordination office in Mangina, WHO said. Allied Democratic Forces rebels are to blame, Beni territory administrator Donat Kasereka Kibwana said.

WHO’s emergencies director Dr. Mike Ryan, however, said neither the attackers’ identities nor their motivation had been confirmed but it was “unmistakably a directed attack at the response.” More than 100 WHO staffers and other aid workers were evacuated...

 

[Shiloh]

Source: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
28 November 2019



Six new confirmed cases were reported between 20 to 26 November in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. Half of the confirmed cases in this week came from Mabalako Health Zone (50%, n=3), and one case each came from Mandima, Oicha, and Beni Health Zones.

In the past week, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations.

On the night of 27 November, an attack on the Ebola response camp in Biakato Mines resulted in the deaths of three responders and the injury of six others. Staff were evacuated, and the majority of response activities in the area have been suspended. On the same night, a separate attack on the Ebola coordination office in Mangina resulted in the death of a police officer guarding the facility.

Since 20 November, violence and civil unrest have limited response activities in Beni and Oicha. On 26 November, about one-third of WHO’s Ebola response personnel in Beni were temporarily relocated to Goma. The disruptions to the response and lack of access to Ebola-affected communities are threatening to reverse recent progress. As seen previously during this outbreak, such disruptions often result in increased transmission and a subsequent rise in the number of cases due to impacts on surveillance and control efforts such as active case finding, contact tracing, and vaccination.

Following insecurity, the volume of reported daily alerts from healthcare facilities and the community has dropped in Beni in the four-day period from 23 to 26 November from approximately 400 per day to 120-150 per day. Proportionally similar reductions in the number of alerts have also been observed in Butembo, following two days of protests. In addition, recent security events have had an impact on contact tracing activities, which involves monitoring registered contacts of EVD cases for signs of infection, particularly in Oicha where only 15% of contacts were under surveillance as of 26 November. The overall average percentage of contacts under surveillance in the last 7 days is 86%, but it dropped as low as 59% on 25 November. These are essential functions of the response that are well known to reduce the risk of spread of the virus, and the fluctuations in performance following insecurity may enable new chains of transmission.

In the past 21 days (6 to 26 November), 19 confirmed cases were reported from four neighbouring, active health zones in North Kivu and Ituri provinces (Figure 2, Table 1): Mabalako (63%, n=12), Beni (21%, n=4), Oicha (11%, n=2), and Mandima (5%, n=1). The majority of the cases (95%, n=18) are linked to known chains of transmission. In the previous 21 day period (16 October to 5 November), 55 confirmed cases were reported from seven health zones.

As of 26 November, a total of 3304 EVD cases were reported, including 3186 confirmed and 118 probable cases, of which 2199 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1862) were female, 28% (n=935) were children aged less than 18 years, and 5% (n=163) were health workers. [h=4]Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 26 November 2019*[/h]

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*Excludes n=184 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Pinga, Rwampara, Tchomia, and Vuhovi. [h=4]Figure 2: Confirmed and probable Ebola virus disease cases by week of reported cases by health areas. Data as of 26 November 2019*[/h]

Enlarge image
[h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 26 November 2019**[/h]

Enlarge image



**Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health. [h=3]Public health response[/h]
For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

[h=3]WHO risk assessment[/h]
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. [h=3]WHO advice[/h]
WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News and updates on the Ebola outbreak in the Democratic Republic of the Congo
• Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization
• The Strategic Advisory Group of Experts (SAGE) on Immunization
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Update on Ebola drug trial: two strong performers identified
• Ebola response funding

 

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT NOVEMBER 27, 2019

Thursday, November 28, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,309, of which 3,191 are confirmed and 118 are probable. In total, there were 2,201 deaths (2,083 confirmed and 118 probable) and 1077 people healed.
• 443 suspected cases under investigation;
• 5 new confirmed cases, including:
o 4 in Ituri in Mandima;
o 1 in North Kivu in Mabalako;
• 2 new deaths of confirmed cases, including:
o 2 new community deaths in Ituri in Mandima;
o No deaths among confirmed cases in CTEs;
• No cured person has emerged from CTEs;
• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 163 (5% of all confirmed / probable cases), including 41 deaths;

The data presented in this table are subject to change after extensive investigation and after redistribution of cases and deaths in their respective health areas.
--------------------------------
LEXICON
• A community death is any death that occurs outside a #Ebola Treatment Center.
• A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.[/TD]
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[TD]Distribution of Ebola Virus Disease (EVD) Cases by Health Zone in the Provinces of Ituri and North Kivu
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[TD]Three members of the Ebola Virus Epidemic response killed in an attack in Biakato, Ituri
• Following the attack on the sub-coordination of the Biakato response in Ituri on the night of Wednesday 27th to Thursday 28 November 2019, 3 members of the Ebola response teams in this sector lost their lives ;
• It is a provider and a driver of the vaccination committee and another driver;
• In addition to these three deaths, there are 7 wounded and 6 others with psychological disorders and extensive material damage.
• A good number of these teams from Biakato were evacuated in three waves to Goma. As soon as they arrived, they were greeted by a coordination team led by Prof. Steve Ahuka, general coordinator, who also visited the wounded before going to inquire about the security conditions and accommodation of evacuees. He did not fail to comfort them.[/TD]
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[TD]• The vaccination commission is in mourning. A service provider and a driver of his team were killed on the night of Wednesday 27 November 2019 following attacks at the Biakato base in Ituri;
• 2nd day without vaccination activity with the 2nd J & J vaccine following the disorders initiated by young people related to the security situation in Beni;
• 724 people were vaccinated, until Tuesday, November 26, 2019, with the 2nd Ad26.ZEBOV / MVA-BN-Filo vaccine (Johnson & Johnson) in the two health zones of Karisimbi in Goma;
• Since the start of vaccination on August 8, 2018 with the rVSV-ZEBOV vaccine, 255,373 people have been vaccinated;
• Approved October 22, 2019 by the Ethics Committee of the School of Public Health of the University of Kinshasa and October 23, 2019 by the National Ethics Committee, the second vaccine, called Ad26.ZEBOV / MVA-BN -Filo, is produced by Janssen Pharmaceuticals for Johnson & Johnson;
• This new vaccine is in addition to the first, the rVSV-ZEBOV, vaccine used until then (since August 08, 2018) in this epidemic manufactured by the pharmaceutical group Merck, after approval of the Ethics Committee on May 20, 2018. has recently been pre-qualified for registration.

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Violence in DR Congo Ebola hotspot leaves people ‘caught in crossfire’

UNHCR/Natalia Micevic
Members of the Mbuti indigenous community stand beside their shelters at a makeshift site for internally displaced persons in Beni territory, North Kivu. 29 November 2019
Humanitarian Aid
Attacks on communities in an Ebola outbreak hotspot in eastern Democratic Republic of the Congo (DRC) have sparked a humanitarian crisis and threatened aid distribution, the UN said on Friday, amid reports of serious civil unrest.

Tensions in eastern Beni territory in DRC’s North Kivu province have been rising since the launch of a Government-led security operation against the Allied Democratic Forces (ADF) on 30 October, UN refugee agency (UNHCR) spokesperson Charlie Yaxley told journalists in Geneva.

Armed groups have been targeting civilians and displaced populations in the region, killing scores of people and leaving others “caught in the crossfire”, he added.

Aid teams’ security ‘can’t be guaranteed any more’

In a statement on Friday, Herv? Verhoosel, spokesperson for the UN World Food Programme (WFP) said that the agency had temporarily suspended aid distribution “because both our staff – and more importantly the staff of the partners who are working with us on the ground – the security was not guaranteed anymore, and the access was very difficult”.

World Health Organization (WHO)✔@WHO
? Nov 28, 2019
Replying to @WHO
The situation in #DRC is still evolving. WHO will provide updates as new information comes in. http://bit.ly/35RUkP9

Dead and injured following attacks on Ebola responders in the Democratic Republic of the Congo


Two attacks in eastern Democratic Republic of the Congo have killed 4 workers responding to the Ebola outbreak and injured 5 others. The attacks occurred overnight on a shared living camp in Biakato...
who.int​

World Health Organization (WHO)✔@WHO
"We are doing everything possible to bring the injured and front-line workers in the impacted areas to safety.
We will continue to work with the #DRC Government, partners & @MONUSCO to ensure the security of our staff & other health workers"-@DrTedros #Ebola

130
9:54 AM - Nov 28, 2019
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As a result, “thousands of people will not receive food assistance in the coming days,” he added.

According to UNHCR, Beni town is home to around 500,000 people. “We understand there’s at least 275,000 people in the surrounding areas who’ve already been displaced, and conditions are quite dire and deteriorating,” Mr. Yaxley said.

Armed groups preying on children


Children need immediate support, he continued, as many “have lost their parents or have arrived unaccompanied. Forced recruitment by armed groups is a real threat to the safety of children and women also face widespread sexual violence, abuse and risk of exploitation.”

The development comes as people in eastern DRC continue to be targeted by a multitude of armed groups, with at least 100 people reportedly killed in violent attacks in the Beni region and thousands displaced since 2 November, UNHCR said.

Highlighting the impact of the insecurity in Beni and Oicha on frontline healthworkers tasked with tracing anyone who has come into contact with people infected with Ebola, Christian Lindmeier, spokesperson for the UN World Health Organization (WHO), said that surveillance levels had dropped from 86 to 59 per cent at the start of the week.

According to WHO, around one-third of WHO’s Ebola response personnel in Beni have been temporarily relocated to Goma.

Drop in frontline access ‘sure’ to hamper Ebola prevention


“These are essential functions of the response that are well known to reduce the risk of spread of the virus and the fluctuations in performance following insecurity may enable – well, we’re actually pretty sure it will enable - new chains of transmission,” he explained.

As of 26 November, a total of 3,304 cases of Ebola have been reported, of which 2,199 people have died since the outbreak was declared on 1 August 2018, WHO reported.

In an appeal for an end to the violence in and around Beni, UNCHR’s Mr. Yaxley warned that humanitarian agencies needed “immediate access to support the affected population. Hundreds of households are currently sleeping in churches and schools.”

Some groups of people were “trapped”, he said, noting that they were surrounded by armed forces and facing “ongoing attacks against schools (and) health centres. Even where people are known to be sheltering, they’re being displaced again because of these attacks by armed groups. At times, people are getting caught in the crossfire.”

In its latest update on the outbreak, the country’s Ministry of Health noted the “disruption of activities in the sectors of Beni and Butembo, following popular demonstrations at the killing of civilians”.

“Widespread violence” had erupted in the town of Beni nine days ago, the WFP official told journalists, precipitating the decision to temporarily move “non-essential staff” to Goma in the south of the country.

‘Constant’ attacks must stop: WHO


The development also follows attacks by armed groups on Wednesday at a camp in Biakato Mines and an Ebola response coordination office that claimed the lives of three responders and a police officer, injuring six others.

Condemning the violence, the WHO appealed for the “constant” attacks to stop, the development risks reversing significant progress made against the epidemic, with infections falling to just a handful in recent weeks.

Earlier this month in the town of Lwemba, Ituri province, attackers killed an Ebola response community health worker and left his wife critically injured before burning down their home. The victim was also a reporter for a community radio station, helping to raise Ebola awareness.

https://news.un.org/en/story/2019/11/1052441

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 48: 25 November - 1 December 2019
Data as reported by: 17:00; 1 December 2019
...
Ebola virus disease
Democratic Republic of the Congo

3 313 Cases
2 203 Deaths
67% CFR

EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu
and Ituri provinces in Democratic Republic of the Congo continues,
with four health zones and 11 health areas reporting confirmed
cases in the past 21 days (7-27 November 2019). Since our last
report on 24 November 2019 (Weekly Bulletin 47), there have been
12 new confirmed cases and six new deaths. The principle hot spots
of the outbreak in the past 21 days are Mabalako (54%; n=14 cases),
Mandima (23%; n=6) and Beni (15%; n=4). Four health zones, Beni,
Mabalako, Mandima and Oicha have reported new confirmed cases
in the past seven days.

On the evening of 27 November 2019, there were two separate
attacks, one on the responder’s camp in Biakato Mines and one on
the Ebola coordination office in Mangina, in which four people have
died (3 in Biakato Mines and 1 in Mandima), including a member
of a vaccination team, two drivers and a police officer. WHO staff
have been evacuated from Biakato Mines to Goma, while remaining
in place in Mangina. In Oicha, a new incursion by rebels resulted in
several civilian casualties and demonstrations have been reported in
Goma. As of 2 December 2019, North Kivu Province has declared
‘ville mort’ and response activities have been suspended across the
province.

As of 30 November 2019, a total of 3 313 EVD cases, including
3 195 confirmed and 118 probable cases have been reported. To
date, confirmed cases have been reported from 29 health zones:
Ariwara (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (78),
Mandima (345), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (689), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28), Kyondo
(25), Lubero (31), Mabalako (406), Manguredjipa (18), Masereka
(50), Musienene (84), Mutwanga (32), Nyiragongo (3), Oicha (64),
Pinga (1) and Vuhovi (103) in North Kivu Province and Mwenga (6)
in South Kivu Province.

As of 30 November 2019, a total of 2 203 deaths were recorded,
including 2 085 among confirmed cases, resulting in a case fatality
ratio among confirmed cases of 65% (2 085/3 195). The cumulative
number of health workers remains 163, which is 5% of the confirmed
and probable cases to date.

Contact tracing is ongoing in three health zones. A total of 1 069
contacts are under follow-up as of 30 November 2019, of which 720
(67%) have been seen in the past 24 hours. Alerts in the affected
provinces continue to be raised and investigated. Of 3 448 alerts
processed (of which 3 295 were new) in reporting health zones on
30 November 2019, 3 208 were investigated and 349 (11%) were
validated as suspected cases.

PUBLIC HEALTH ACTIONS

Surveillance and response activities are currently compromised
by a resurgence of insecurity in affected regions.

As of 30 November 2019, a cumulative total of 255 441 people
have been vaccinated since the start of the outbreak in August
2018.

Point of Entry/Point of Control (PoE/PoC) screening continues,
with over 121 million screenings to date. A total of 97/109 (89%)
PoE/PoC transmitted reports as of 30 November 2019.

Water, sanitation and hygiene (WASH) activities continue, with IPC/WASH
kits donated to 30 health facilities, with support and follow-up provided to 131
healthcare structures in Bunia, Butembo, Mutwanga, Mambasa and Mangina.

Community awareness and mobilization messages are being updated, revised and
harmonized and have been pre-tested by the commission and will subsequently
be shared in coordination and sub-coordination activities.

Response activities remain highly disrupted in the subcoordinations of Goma,
Beni, Butembo, Mangina, Biakato and Mambasa following the volatile security
situation.

The general coordination participated in a mass in tribute to a collegue who died
in the Biakato attack.

Awareness raising was carried out among 30 households around the latest
confirmed case in Alima, Mandima Health Zone.

SITUATION INTERPRETATION

Although the decrease in new confirmed cases is continuing, the slowing and actual
stopping of response activities in the Biakato Mines area and Mangina Health Zones are
of major concern, as is the shutdown of all response activities in North Kivu Province for
two days for the ‘ville mort’. Previous experience has shown that this will potentially have
major adverse effects on surveillance, case finding and contact tracing, which could lead
to a resurgence in transmission. It is critical that all areas of response remain effective,
engaged and fully resourced.

https://apps.who.int/iris/bitstream/handle/10665/330027/OEW48-02122019.pdf

 

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Ebola: another 4 dead in Ituri

Posted on Tue, 03/12/2019 - 15:39 | Edited on Tue, 03/12/2019 - 15:39

Four people died of Ebola in Mambasa territory in Ituri, since the departure of health workers, NGOs and UN agencies on Friday, 29 November, to help fight the disease. Medical sources report that the disease situation is alarming, particularly in Biakato and Lwemba.

The victims of the Ebola virus disease are multiplying. According to the NGO CODEPEF, three people - all members of the same family - died of Ebola Saturday, November 30 in Lwemba. His deputy coordinator, Laurent Keya, said it was a death in the community, which could affect the entire local population. He pleaded for the immediate redeployment of the response team, as all activities were suspended for the time being.

Several people are already showing symptoms of the disease, warns the Mandima health district chief of health. Added to this are several suspect cases not yet identified.

The local population is asking the provincial government to strengthen the police positions in the area and to equip them. The purpose of this request is to protect the population and the response team to enable it to eradicate this growing disease.

https://www.radiookapi.net/2019/12/03/actualite/sante/ebola-encore-4-morts-en-ituri

 

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DRC: UN launches airlift to save Ebola patients in Biakato

Posted on Wed, 04/12/2019 - 12:10 | Edited on Wed, 04/12/2019 - 15:05

The United Nations Coordination for the Response to Ebola Virus Disease in the DRC, in collaboration with MONUSCO, launched Wednesday, December 4, the first airlift on Biakato in the territory of Mambasa (Ituri), where the epidemic is raging. Its leader, David Gressly, said this operation consists of deploying teams temporarily, by helicopter, to carry out response activities in the field to contain this disease.

"It's very important now to contain the virus, so that it does not escape (from Biakato) to make contaminations elsewhere," said David Gressly.

The decision to introduce the airlift was made following recurrent attacks by the militia, which forced all the agents in charge of the response to leave the region. Mr. Gressly also announces the deployment of the blue helmets and the FARDC to secure this area.
...
The facilities of the NGO Doctors Without Borders (MSF), the World Health Organization (WHO) and the Ebola treatment center in Biakato were attacked on the night of Monday to Tuesday, December 3rd. There was no death, but several material damage. According to local sources, the perpetrators of these attacks are not yet identified.

All Ebola response activities had been suspended there, after the attack on the local treatment center during the night of 28-29 November by suspected Mai-Mai. This attack had three deaths and several wounded.

https://www.radiookapi.net/2019/12/...aerien-pour-sauver-les-malades-debola-biakato

 

[Shiloh]

Source: https://www.who.int/csr/don/05-december-2019-ebola-drc/en/
[h=1]Ebola virus disease – Democratic Republic of the Congo[/h] Disease outbreak news: Update
5 December 2019



Nine new confirmed cases were reported from 27 November to 3 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces. The confirmed cases in this week were reported from Mandima (56%, n=5) and Mabalako (44%, n=4) Health Zones.

In the past two weeks, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations. As a result, several key activities of the response experienced diminished performance, including the volume of reported and investigated alerts and the number of contacts registered and followed (Figure 1, Figure 2). The volume of alerts from health zones affected by insecurity is lower than usual, and this has led to an overall reduction in the average number of alerts reported in the last seven days. Of the 3346 alerts reported, 96% were investigated within 24 hours.

The overall average percentage of contacts under surveillance in the last seven days is 70%, which is below the average for November prior to these security events (Figure 2). This is due mainly to performance being suboptimal in some areas of Beni, Mabalako, and Oicha Health Zones, with only 82% of contacts followed in Beni, 68% in Mabalako, and 42% in Oicha. These numbers are improving slowly since the events, but fluctuations illustrate the continued impact that security events have on response activities.

In the past 21 days (13 November to 3 December), 22 confirmed cases were reported from 10 of the 71 health areas within four neighbouring active health zones in North Kivu and Ituri provinces (Figure 3, Table 1): Mabalako (55%, n=12), Mandima (27%, n=6), Beni (9%, n=2), and Oicha (9%, n=2). The majority of the cases (91%, n=20) are linked to known chains of transmission. In the past 21 days, a higher proportion of cases (31%, n=8) have reported a funeral as their potential exposure to EVD compared to the average since January 2019 (7%); this is because of two separate community clusters in the health areas of Lwemba (six cases) and Bingo (two cases) linked to the burials of two probable cases.

As of 3 December, a total of 3313 EVD cases were reported (Figure 4), including 3195 confirmed and 118 probable cases, of which 2207 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (n=1866) were female, 28% (n=936) were children aged less than 18 years, and 5% (n=163) were health workers. [h=4]Figure 1: Alerts reported, investigated, and validated daily. Data as of 3 December 2019*[/h]

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[h=4]Figure 2: Number of contacts registered and followed up each week. Data as of 3 December 2019*[/h]

Enlarge image



*Data are presented as the most up to date information at the time of reporting. [h=4]Figure 3: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 3 December 2019**[/h]

Enlarge image
[h=4]Figure 4: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 3 December 2019**[/h]

Enlarge image



**Excludes n=184 cases for whom onset dates not reported. Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Ariwara, Biena, Bunia, Goma, Kalunguta, Kayna, Komanda, Kyondo, Lolwa, Lubero, Manguredjipa, Masereka, Musienene, Mutwanga, Mwenga, Nyankunde, Nyiragongo, Pinga, Rwampara, Tchomia, and Vuhovi. [h=4]Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 3 December 2019***[/h]

Enlarge image



***Total cases and areas affected during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health. [h=3]Public health response[/h]
For further information about public health response actions by the Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

• Ebola situation reports: Democratic Republic of the Congo

[h=3]WHO risk assessment[/h]
WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low.

Although the number of new confirmed cases has remained relatively low, the interruption of response activities due to attacks, violence and unrest threatens to reverse recent progress. WHO and response partners are working to adapt the response strategy to protect communities from a resurgence of the outbreak while keeping all responders safe. [h=3]WHO advice[/h]
WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. Any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practise good hygiene. Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

For more information, please see:

• WHO resources and updates on Ebola virus disease
• News and updates on the Ebola outbreak in the Democratic Republic of the Congo
• Highlights from the Meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization
• The Strategic Advisory Group of Experts (SAGE) on Immunization
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries
• Update on Ebola drug trial: two strong performers identified
• Ebola response funding

 

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 05 DECEMBER 2019

Friday, December 06, 2019
• Since the beginning of the epidemic, the cumulative number of cases is 3,320, of which 3,202 are confirmed and 118 are probable. In total, there were 2,209 deaths (2091 confirmed and 118 probable) and 1084 people healed.
• 452 suspected cases under investigation;
• 4 suspected cases reported in the Osso Health Area in Lubutu, Maniema Province. 2 samples are being analyzed at the Goma laboratory and 2 others are being sent to the Goma laboratory. Additional information being collected;
• 2 new confirmed cases in North Kivu, including:
o 1 in North Kivu in Mabalako
o 1 in Ituri in Mandima;
• 2 new deaths of confirmed cases, including:
o 1 community death among confirmed cases in Ituri in Mandima;
o 1 death of confirmed cases in North Kivu in Mabalako;
• No cured person has emerged from CTEs;
• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths;
• Ebola response activities are paralyzed in Beni, Mangina and Biakato sub-coordination for security reasons;
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[TD]• 1255 people were vaccinated with the 2nd Ad26.ZEBOV / MVA-BN-Filo vaccine (Johnson & Johnson) in the two health zones of Karisimbi in Goma;
• 60 people, including 33 high-risk contacts and 27 contacts of contacts, were vaccinated around the confirmed Beni case in the Kanzulinzuli Health Area in Beni / HGR, North Kivu;
• Since the start of vaccination on August 8, 2018 with the rVSV-ZEBOV vaccine, 255,945 people have been vaccinated;
• Approved October 22, 2019 by the Ethics Committee of the School of Public Health of the University of Kinshasa and October 23, 2019 by the National Ethics Committee, the second vaccine, called Ad26.ZEBOV / MVA-BN -Filo, is produced by Janssen Pharmaceuticals for Johnson & Johnson;
• This new vaccine complements the first, the rVSV-ZEBOV, vaccine used until then (since August 08, 2018) in this epidemic manufactured by the pharmaceutical group Merck, after approval of the Ethics Committee on May 20, 2018. It has recently been pre-qualified for registration.[/TD]
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[TD]• Sanitary control activities were resumed in the various entry and control points of the Beni and Mangina sub-coordinations in North Kivu;
• A lifeless body of a 44-year-old man was intercepted at Makeke Checkpoint, coming from Lwemba for Makeke, whose result came back positive.
• Health control activities are disrupted in the Biakato Sub-Coordination in Ituri;
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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT 06 DECEMBER 2019

Saturday, December 07, 2019
• Since the beginning of the epidemic, the cumulative number of cases is 3,319, of which 3,201 are confirmed and 118 are probable. In total, there were 2,209 deaths (2091 confirmed and 118 probable) and 1084 people healed.
• 439 suspected cases under investigation;
• 4 suspected cases were notified on 05 December 2019 in the Osso health area in Lubutu, Maniema province. The first 2 samples analyzed in the Goma laboratory returned negative to the Ebola virus and 1 case was invalidated. The sample is still being sent to the Goma laboratory for the remaining 1 case;
• 1 case of reinfection of Mabalako was not counted;
• No new confirmed cases;
• No new deaths among confirmed cases;
• No cured person has emerged from CTEs;
• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths;
• Ebola response activities are paralyzed in Beni, Mangina and Biakato sub-coordination for security reasons;
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HEALTH NEWSDECEMBER 8, 2019 / 7:12 AM / UPDATED AN HOUR AGO

Congo authorities say Ebola survivor falls ill a second time

Fiston Mahamba

...
In a daily report on the epidemic, the Congolese health authorities reported that a survivor in Mabalako, North Kivu province, had fallen ill with the virus again, but did not give further details.

Representatives of the World Health Organization and Congo’s National Institute of Biomedical Research (INRB) said tests were being carried out to determine what had happened.

“Clinically, we will check whether it is a reinfection to know if it is the same virus and if the person has been infected by another source,” Ahuka Steve Mundeke, a virologist at INRB, told Reuters.

“We have had cases where the virus persists in immune reservoirs,” said Margaret Harris, a spokeswoman for the World Health Organisation (WHO). “In rare cases the virus can cause symptoms again. We are investigating now to see whether this was what happened.”
...
https://www.reuters.com/article/us-...urvivor-falls-ill-a-second-time-idUSKBN1YC0CX

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 49: 2 - 8 December 2019
Data as reported by: 17:00; 8 December 2019
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Ebola virus disease Democratic Republic of the Congo

3 320 Cases
2 209 Deaths
67% CFR

EVENT DESCRIPTION

The Ebola virus disease (EVD) outbreak in North Kivu, South
Kivu and Ituri provinces in Democratic Republic of the Congo
continues, with response operations cautiously being restored
following the intense insecurity and civil unrest. Since our last
report on 1 December 2019 (Weekly Bulletin 48), there have
been seven new confirmed cases and six new deaths reported
from four health zones, Beni, Mabalako, Mandima and Oicha.
In the past 21 days (17 November to 7 December 2019), four
health zones and 11 health areas reported confirmed cases,
with the principle hot spots being Mabalako (43%; n=12 cases),
Mandima (25%; n=7), Beni (21%; n=6) and Oicha (11%; n=3).
As of 7 December 2019, a total of 3 320 EVD cases, including
3 202 confirmed and 118 probable cases have been reported. To
date, confirmed cases have been reported from 29 health zones:
Ariwara (1), Bunia (4), Komanda (56), Lolwa (6), Mambasa (78),
Mandima (346), Nyakunde (2), Rwampara (8) and Tchomia (2) in
Ituri Province; Alimbongo (5), Beni (693), Biena (18), Butembo
(285), Goma (1), Kalunguta (193), Katwa (651), Kayna (28),
Kyondo (25), Lubero (31), Mabalako (407), Manguredjipa (18),
Masereka (50), Musienene (84), Mutwanga (32), Nyiragongo (3),
Oicha (65), Pinga (1) and Vuhovi (103) in North Kivu Province
and Mwenga (6) in South Kivu Province.

As of 7 December 2019, a total of 2 209 deaths were recorded,
including 2 091 among confirmed cases, resulting in a case
fatality ratio among confirmed cases of 65% (2 091/3 202). The
cumulative number of health workers remains 163, which is 5%
of the confirmed and probable cases to date.

Contact tracing is ongoing in five health zones. A total of 2 907
contacts are under follow-up as of 7 December 2019, of which
2 318 (80%) have been seen in the past 24 hours. Alerts in the
affected provinces continue to be raised and investigated. Of
4 128 alerts processed (of which 3 956 were new) in reporting
health zones on 7 December 2019, 4 022 were investigated and
391 (10%) were validated as suspected cases.

PUBLIC HEALTH ACTIONS

Response activities have cautiously restarted in Beni,
Butembo and Mangina, but the security situation remains
tense and response activities are still severely compromised.

As of 7 December 2019, a cumulative total of 256 229 people
have been vaccinated since the start of the outbreak in
August 2018.

Point of Entry/Point of Control (PoE/PoC) screening
continues, with over 125 million screenings to date. A total
of 104/109 (95%) PoE/PoC transmitted reports as of 7
December 2019.

Water, sanitation and hygiene (WASH) activities continue, with IPC briefing
session for 298 providers in six health zone (Mangina, Butembo, Musienene,
Kalunguta, Mambasa and Bunia); a supply of 49 070 litres of water was
provided for handwashing facilities in Mambasa and Buinia health zones.
Community awareness and mobilization messages are being updated,
revised and harmonized and have been pre-tested by the commission and
will subsequently be shared in coordination and sub-coordination activities.

SITUATION INTERPRETATION

The general decline in reported new cases has continued, although with response
activities compromised in Beni, Butembo and Mangina, it is possible that cases
and community deaths have not been recorded. The trend, especially for this and
the coming weeks, should be interpreted cautiously as we watch the impact of the
disruption in response operations due to heightened insecurity and civil unrest.
It is critical that all areas of response remain effective, engaged and fully resourced.

https://apps.who.int/iris/bitstream/handle/10665/330076/OEW49-09122019.pdf

 

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[TD]EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT 09 DECEMBER 2019

Tuesday, December 10, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,324, of which 3,206 are confirmed and 118 are probable. In total, there were 2,209 deaths (2091 confirmed and 118 probable) and 1087 people healed.
• 436 suspected cases under investigation;
• 4 suspected cases were notified on 05 December 2019 in the Osso health area in Lubutu, Maniema province. 1 case was invalidated. Among the 3 remaining suspects, the first samples of 2 suspects are negative and their clinical evolution is good. They are in agreement of the second levy. One suspect died and the oral sample was not taken and the body was secured and returned to the family.
• 6 new confirmed cases, including:
o 5 in North Kivu Mabalako;
o 1 in Ituri in Mandima;
• Three traditional healers registered among new confirmed cases, including 2 in Mabalako and 1 in Mandima;
• 1 new death among confirmed cases, including:
o No community deaths among confirmed cases;
o 1 confirmed death in North Kivu in Mabalako
• No cured person has emerged from CTE;
• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (5% of all confirmed / probable cases), including 41 deaths;
• Ebola response activities are paralyzed in Beni, Mangina and Biakato sub-coordination for security reasons;
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[TD]Dialogue between the CMRE Technical Secretary and the Biakato Community
• The Technical Secretary of the Multisectoral Ebola Response Ebola Response Committee, Prof. Jean-Jacques Muyembe Ntamfum, accompanied by the Assistant Director-General for Intervention in Emergencies WHO, Dr. Soce-Ibrahima Fall, and a strong delegation from the overall coordination of the response, carried out a mission to - return this Tuesday, December 10, 2019 to Biakato Mines in the territory of Mambasa in Ituri;
• As soon as he arrived, Prof. Muyembe went to the Biakato Mines CTE where he met with the community of Biakato in the presence of his chieftaincy chief;
• Several recommendations were made during this meeting, the biggest of which is the return of the teams of the response to Biakato, in order to put an end to this epidemic with the promise of securing them. This epidemic, according to the population, risks exterminating their families;
• For its part, the technical secretary promised to study their recommendations and put them into practice, announcing the forthcoming vaccination of the entire population of Biakato;
• It went to the satisfaction of the whole community, represented in this meeting by different local stakeholders;
• The Technical Secretary, in addition to the Director-General of WHO, was accompanied by the Coordinator-General for the Response and some members of the General Coordination (Communication and Security Committees) and the Coordinator of the Subcommittee. Biakato Commission and some members of WHO and UNICEF;
• This meeting coincided with the release of the first Ebola cure, the first confirmed case of the same Ebola Treatment Center (ETC).
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