H5N1

Ebola in the DRC: A girl about 1 year old, third case in Goma

Via Actualite.cd: Ebola in the DRC: A girl about 1 year old, third case in Goma. Excerpt from the Google translation:

A girl of about a year was declared positive for Ebola virus disease, becoming the confirmed case in the city of Goma, capital of North Kivu Province.  

The patient is the girl of the second case detected Tuesday and died Wednesday morning. His illness was taken care of late. The gold miner arrived at the treatment center on the 11th day of his illness. 

Living in Kiziba in the suburbs of Goma, the second case, unrelated to the first, had caught the virus after living in a mining area in Ituri province. 

City of about two million inhabitants, Goma, border with Rwanda is built on the shores of Lake Kivu which separates it from the city of Bukavu (South Kivu). This volcanic city has an international airport.   

The third case appeared 17 days after the first or 24 hours after the second. On Tuesday evening, provincial and health authorities called on the people of Goma to collaborate with the response teams and assured "neighboring countries that all measures are being taken to strengthen surveillance at points of entry and sanitary control".

UK: Lyme disease cases may be three times higher than estimated

Via The Guardian: UK Lyme disease cases may be three times higher than estimated. Excerpt:

Cases of Lyme disease in the UK may be three times higher than previous estimates, according to new research. 

After analysing the anonymous medical records of 8.4 million people from across the UK, scientists forecast that the total number of Lyme disease diagnoses in the UK could top 8,000 in 2019, compared with previous estimates of between 2,000 and 3,000 annual diagnoses. 

Lyme disease is a bacterial infection, which is passed on through being bitten by an infected tick. The small spider-like creatures feed off the blood of animals and are typically found in dense, moist vegetation.

Lyme disease has many symptoms, making it difficult to diagnose. Early symptoms can be similar to those of flu, and about a quarter of cases will develop a circular red rash around the bite. Full clinical diagnosis requires a blood test, but the study found that more than half of patients in 2012, the most recent year with complete data, were treated with only “suspected” or “possible” Lyme disease.  

If caught early, most cases can be successfully treated with antibiotics within four weeks, but the infection can lead to permanent damage to the joints and nervous system.

The research, published in the journal BMJ Open, found that half of cases occurred between June and August. Although there were diagnoses across all regions of the UK during the period studied, Scotland had the highest number of cases, at 27% of the total. The authors suggest this could be due to the region’s wetter climate and popularity with hikers. The south-west and south of England also recorded a higher than average number of cases. 

The data showed that the number of diagnoses increased almost tenfold over the period studied. This, the researchers said, was partly down to increased caution by GPs and greater public awareness. 

“The exact number isn’t so important,” said Dr Victoria Cairns, the lead author of the study. “The point is that it’s a lot, and it’s everywhere, and that’s why people should be informed.”  

Dr Anne Cruikshank, the Royal College of GPs’ clinical champion for Lyme disease, said: “These levels are not a big surprise to those of us who know about Lyme disease. I expect the 8,000 figure may be an underestimate, since the data shows that positive lab results have doubled every five years.”

DRC Ebola: Daily updates resume

Thanks to Helen Branswell for alerting us all to the return of the MoH daily updates: EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Wednesday, July 31, 2019. Excerpt from the Google translation:

EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI   

Wednesday, July 31, 2019   

The Epidemiological Situation of Ebola Virus Disease, July 30, 2019   

• Since the beginning of the epidemic, the cumulative number of cases is 2 701, of which 2 607 are confirmed and 94 are probable. In total, there were 1,813 deaths (1,719 confirmed and 94 probable) and 776 people healed. 

• 293 suspected cases under investigation; 

• 11 new confirmed cases, including 3 in Vuhovi, 1 in Mandima, 1 in Mambasa, 1 in Kalunguta and 1 in Nyiragongo (Goma); 

• Continued search for the confirmed case in the health zone of Lubero dated 25/07/2019; 

• 10 new confirmed case deaths: 

º 2 community deaths, including 1 in Beni and 1 in Mandima; 

º 6 deaths at CTE, including 3 in Beni, 2 in Mabalako and 1 in Butembo; 

º 2 deaths at the CT of Beni; 

• 6 people recovered from CTEs, including 4 Mabalako, 1 in Katwa and 1 in Butembo; 

• Two live health workers are among the new confirmed cases of Mambasa (non-vaccinated) and Vuhovi (vaccinated). The cumulative number of confirmed / probable cases among health workers is 148 (5% of all confirmed / probable cases), including 41 deaths.  

  

 /! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas.

NEWS

Response operations

Organization of the Coordination Workshop for the Ebola Response to the Ebola Epidemic

• The Technical Secretariat of the Multi-sectoral Epidemic Response Committee of the EVD is organizing a coordination workshop from 31 July to 02 August 2019 to coordinate the response to the EVD epidemic at the Karibu Hotel in Goma in the province of North Kivu.

• This workshop aims to brief the Technical Secretariat of the Multisectoral Committee by coordinating the response on the organization of the current response in order to enable it to make informed decisions thus avoiding a major disruption of the response.

• It will enable the Technical Secretariat to inquire about the current epidemiological situation of EVD and the main challenges to be addressed, to learn about the current response structure (organization of the different levels of coordination) and the new strategic plan for the response. (PSR4) and synergy with the security, humanitarian and financial sectors, as well as the operational readiness of DRC neighboring countries to create a favorable environment for the response.

• It will also allow the Technical Secretariat to discuss challenges and perspectives related to priority themes (pillars). This workshop will result in the priority actions to be carried out over the next 90 days and the overall orientations on the response, as well as the new organizational structure of the response.

• It should be noted that under SRP-4, effective and coherent change in strategies, effective coordination, consistent standards and support are envisaged for the most vulnerable communities at risk in the provinces of North Kivu and Ituri while preventing the spread of the epidemic in other provinces and countries bordering the DRC.

Death of the second confirmed case of Ebola in Goma

• The second confirmed Ebola case from Goma died on Wednesday 31 July 2019 at the CTE Nyiragongo de Goma located in the General Reference Hospital of this city.

• This last case of Goma is a patient, who began to present the symptoms of EVD on July 22, 2019. On July 30, 2019 he went to the Goma General Referral Hospital (HGR), located in the Nyiragongo Health Zone, where he was directly transferred to the CTE for appropriate care. The CTE is installed within this HGR.

• Previously, he was treated as an outpatient by a nurse in a private community health center in the Nyiragongo Health Zone.

FIGURES OF THE RESPONSE

180,558 vaccinated persons

• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

Health checkpoints

80,118,963 people under control

• 80 entry points (PoE) and operational health checkpoints (PoC).

Infected healthcare workers

148 contaminated health workers

• Two live health workers are among the new confirmed cases of Mambasa (non-vaccinated) and Vuhovi (vaccinated).

• The cumulative number of confirmed / probable cases among health workers is 148 (5% of all confirmed / probable cases), including 41 deaths.

DR Congo Ebola epidemic widens on eve of first anniversary

Via Yahoo News, an AFP report: DR Congo Ebola epidemic widens on eve of first anniversary. In addition, we have reports of a confirmed third case in Goma, a child, but few details. Excerpt:

Goma (DR Congo) (AFP) - An epidemic of Ebola in eastern DR Congo sharply widened on Wednesday, the eve of the first anniversary of the outbreak, with the announcement of a death in a major city and the quarantining of 15 people in a province that had previously escaped the disease.  

A total of 1,803 lives have been lost in the second worst outbreak of Ebola on record, according to figures released Wednesday. 

The Democratic Republic of Congo's pointman on the crisis, Jean-Jacques Muyembe, said a second person had died of Ebola in Goma, a densely-populated city on the border with Rwanda that has transport links to many parts of East Africa. 

"A patient who was confirmed with Ebola in Goma has died. Every measure has been taken to block the chain of transmission," Muyembe told AFP. 

Goma is the capital of North Kivu province, which has borne the brunt of the outbreak that began on August 1 2018.  

It is a lakeside city of more than two million people that has an airport with flights to the capital Kinshasa, Uganda's Entebbe and Addis Ababa, the capital of Ethiopia, as well as a port that links to Bukavu and South Kivu province. 

Health experts fear outbreaks in major cities, where population density and high mobility make it far harder to isolate patients and trace contacts compared to the countryside.  

Aruna Abedi, the chief Ebola coordinator in North Kivu, said the second fatality had arrived at a treatment centre "11 days after falling ill".  

"His was really a hopeless case, because the illness was already at an advanced stage and he died overnight Tuesday." 

Abedi urged the public to respond swiftly to symptoms of Ebola and "not hide suspect cases".  

"The treatment centre is not a dying room -- you have to bring the patient in early," he said. 

- Public health emergency -  

The first death in Goma, reported on July 16, sparked a wave of concern. 

In that case, a man described as an evangelical preacher had travelled from Goma to Butembo, one of the towns hardest hit by the outbreak. While there, he preached at seven churches and regularly touched worshippers, including the sick, before returning to Goma. 

The day after his announced death, the UN's World Health Organization (WHO) declared the epidemic a "public health emergency of international concern" -- a move designed to step up the global response.  

The WHO has since said a shortage in funding was finally being filled after several countries renewed pledges of financial aid. 

The World Bank also announced this month it would deploy a further $300 million (269 million euros) in addition to $100 million already provided. 

 Many people in Goma voiced frustration and despair. 

"I'm now afraid that this disease will reach us. We used to hear about it from a distance and now the virus is in our town," said 27-year-old worker Anuarite Sifa. 

"Why hasn't the Butembo-Goma road been sealed off?" she asked. 

Joseph Bakisula, 32, said: "This new death proves that Ebola was already in Goma. May God help us, otherwise it will be catastrophic for us and other towns" connected to Goma.  

"The authorities have to take other steps to protect us."  

Meanwhile, in neighbouring South Kivu province, which had previously skirted the epidemic, a senior official in Birava said 15 people had been quarantined. 

They comprised "a mum and her six children who came from Goma as well as other members of her family who had come to meet them," said the official, Christian Birhinjira.  

Birava is located about 30 kilometres (18 miles) from Bukavu, the capital of South Kivu.

MSF: DRC Ebola outbreak response struggling one year on

Via MSF.org: DRC Ebola outbreak response struggling one year on. Excerpt:

As the worst Ebola outbreak in Democratic Republic of Congo’s (DRC) history approaches its second year, the number of new Ebola cases recorded each week is hovering near its highest levels since the beginning of the epidemic. 

In July 2019, between 80 and 100 people were diagnosed with the disease every week. The outbreak is also continuing to spread geographically. Uganda saw its first Ebola patients in June, though they had travelled from DRC, while Goma, a city of 1.5 million people, recorded its second case just this week.

Following the declaration of the epidemic on 1 August 2018, a massive response was rapidly launched, aided by tools that were either unavailable or severely limited in previous Ebola outbreaks, such as an investigational vaccine and developmental treatments. 

Despite this, the outbreak seems headed in the wrong direction and in July was declared a Public Health Emergency of International Concern (PHEIC). Since last August, Ebola has infected over 2,600 people, and killed 1,700 in DRC. 

A year on, we must review what must now be done to bring the outbreak to an end.  

Building trust amidst insecurity 

Insecurity is frequently mentioned as one of the main challenges for the Ebola intervention. Northeastern DRC has been an area of active conflict for the past quarter century and is rife with the presence of armed groups. 

Alongside this, healthcare workers associated with the Ebola response are still not trusted. They have been specifically targeted, sometimes resulting in crucial activities such as contact tracing, alert investigation or vaccination campaigns to be suspended, limited or cancelled. 

Médecins Sans Frontières (MSF) knows this all too well. In February, the Ebola treatment centres in Katwa and Butembo were attacked, forcing us to withdraw our teams from those centres.

Honduras: Dengue rages against the littlest

Via La Prensa: Honduras: dengue se ensaña con los más pequeños.[Dengue rages against the littlest ones] Excerpt, with my translation:

Las últimas cifras de la epidemia del dengue siguen colocando a los menores de entre 5 y 9 años como los más vulnerables.  

The latest numbers from the dengue epidemic continue to show children between 5 and 9 as the most vulnerable.

De ahí que los médicos enfatizan que los padres deben estar pendientes del primer síntoma de la enfermedad. También que los pacientes adultos y menores deben acudir de inmediato a los centros de salud u hospitales, ya que la llegada tardía es una de las causas que ponen en riesgo su vida. 

Doctors emphasize that parents should be aware of the first symptom of the disease. Adults and children alike should report at once to the health centres or hospitals, since late arrival  can put their lives at risk.

En el país ya se reportan 34,840 personas afectadas por esta enfermedad; y se registran hasta la fecha 150 hondureños muertos, pero solo han confirmado 59.  

The country reports 34,840 persons affected by dengue, with 150 Hondurans dead though only 59 have been confirmed.

En el hospital Mario Rivas de San Pedro Sula han sido atendidos en lo que va del año más de 8,600 enfermos con dengue con signos de alarma y graves.

In Mario Rivas Hospital in San Pedro Sula, over 8,600 patients have been diagnosed with signs of dengue hemorrhagic fever.

In Zimbabwe, the water taps run dry and worsen ‘a nightmare’

Via The New York Times: In Zimbabwe, the Water Taps Run Dry and Worsen ‘a Nightmare’. Excerpt:

HARARE, Zimbabwe — It had been five days since water had stopped flowing out of the taps at Eneres Kaitano’s bungalow in southern Harare, Zimbabwe’s modern and tidy capital city. Five days since she had done any laundry. Five days since she had forbidden her children from using the toilet more than once a day.  

On the sixth day, she again rose at 3 a.m. to fetch water from a communal borehole. By the early afternoon, she was still waiting her turn at the tap with her six buckets and cans.  

Much of the city had the same idea. More than half of the 4.5 million residents of Harare’s greater metropolitan area now have running water only once a week, according to the city’s mayor, forcing them to wait in lines at communal wells, streams and boreholes.  

“It is causing us serious problems,” said Ms. Kaitano, a 29-year-old jeans wholesaler who was down to her last clean outfit last week. “We have to stop ourselves from going to the toilet.”

Zimbabwe’s acute water shortage is a result of a particularly bad drought this year, a symptom of climate change. Poor water management has wasted much of the water that remains. Two of Harare’s four reservoirs are empty from lack of rain, but between 45 and 60 percent of the water that’s left is lost through leakage and theft, said Herbert Gomba, the mayor of Harare.

But the water crisis is only a microcosm of Zimbabwe’s malaise. Years of mismanagement under Robert Mugabe, who governed Zimbabwe for 37 years until he was finally ousted in 2017, have left the economy in tatters. Residents are battling daily blackouts that last between 15 and 18 hours; shortages of medicine, fuel and bank notes; and inflation of more than 175 percent.

DRC Ebola: We took steps to secure the city - Dr. Muyembe

Via provinces26cd.net: DRC: We took steps to secure the city - Dr. Muyembe (Goma-Ebola). The Google translation:

After the death on Wednesday, July 31, of the second confirmed case of Ebola in Goma (North Kivu), Dr. Jean-Jacques Muyembe, who heads the technical secretariat of the response to the Ebola virus disease, was reassured about the work which is done. 

"We have taken steps to secure the city with respect to transmissions. We are here to prevent this disease from continuing for a second year." 

He said he understood the exasperation of the population in relation to the duration of this epidemic. 

"One year is already too much. Previous epidemics lasted only three or four months," he added. 

The first challenge of his action is to control this epidemic.  

"We will do everything possible to ensure that this epidemic is contained, without risk of overflow," he said.

Dr Jean-Jacques Muyembe, who heads the technical secretariat for the Ebola response, the death of the second confirmed case in Goma (North Kivu). 

"We must not be surprised to see a new case or a third case. This reflects the quality of our interventions, especially the quality of the work done on surveillance. We have to prepare for that," he said in his interview. 

This second confirmed case was diagnosed on Tuesday, July 30th. He died on Wednesday morning. He was cared for at the Ebola Treatment Center (ETC) at the Goma General Referral Hospital, supported by Médecins Sans Frontières (MSF).

DRC Ebola: Introducing a new vaccine would compromise the actions of the response (Civil society)

Via Topcongofm.net: Introducing a new vaccine would compromise the actions of the response (Civil society). The Google translation:

"Introducing a new vaccine would increase mistrust and suspicion, which could further complicate the actions of the response," said Wednesday, July 31, TOP CONGO, Omar Kavota, coordinator of this structure, which recommends to the authorities "let the current vaccine be consumed and new experiments postponed." 

In one year of the most devastating epidemic in the DRC, affecting North Kivu and Ituri, this committee is not very appreciative of the response.

"The Ebola Response Support Committee bitterly notes the existence of pockets of resistance in some communities, but it is also undeniable that in the first five months the signals were towards the end of this epidemic,"  says Omar Kavota. 

The civil society of North Kivu believes that  "it is not impossible that we finish with Ebola in this part of the country" , recommending the Prime Minister to  "kindly bet on certain resources which, beyond the considerations of politicians, have the necessary expertise and the perfect mastery of the context and also a person whose expertise is proven in the control of epidemics". 

Since the outbreak of this epidemic in the two eastern provinces of the Congolese territory, two cases have been detected in the city of Goma, in the space of a few days, with no apparent link, both victims who died during their charge. 

Shortly before the death of the second victim, the health authorities had cordoned off the port entrance to the city of Bukavu, looking for a person suspected of being "high risk" from Goma. Boats and other boats from North Kivu were held for several hours to facilitate these investigations.  

For its part, Médecins Sans Frontières believed that the detection of the second victim is  "another worrying sign that the epidemic is not under control".

WHO: At Ebola's 1-year mark, we mourn the lives lost, and call for solidarity

A statement from WHO/OCHA/UNICEF, and WFP: At 1-year mark, we mourn the lives lost, and call for solidarity. Excerpt:

“Tomorrow, 1 August, marks one year since the Government of the Democratic Republic of the Congo (DRC) declared an outbreak of the Ebola virus disease in North Kivu province of the DRC. Two weeks ago, it was declared a public health emergency of international concern. 

“Just yesterday, a new case of the disease was confirmed in Goma, with the patient later dying – the second case to be confirmed this month in the city of around 1 million people. This latest case in such a dense population center underscores the very real risk of further disease transmission, perhaps beyond the country’s borders, and the very urgent need for a strengthened global response and increased donor investment.   

“In the last year, there have been more than 2,600 confirmed cases, including more than 1,800 deaths in parts of Ituri and North Kivu provinces. Almost one in three ‘cases’ is a child. Every single ‘case’ is someone who has gone through an unimaginable ordeal. More than 770 have survived.  

“The disease is relentless and devastating. “Ebola passes from mother to child, husband to wife, patient to caregiver, from the dead body of a victim to the mourning relative. The disease turns the most mundane aspects of everyday life upside down — hurting local businesses, preventing children from going to school and hampering vital and routine health services. It is primarily a health crisis, but one that also critically impacts how people care for their family, view their neighbours and interact with their community. 

 “The challenges to stopping further transmission are indeed considerable. But none are insurmountable. And none can be an excuse for not getting the job done. The United Nations and partners are continuing to ramp up the response in support of the Government and to further bolster joint action. The UN is working to ensure an enabling environment for the public health response that its health agency supports, including appropriate security, logistics, political and community engagement, and action to address the concerns of affected communities. We commend the recent Government decision to take measures to ensure its efforts are further joined up.  

“We also salute the heroic efforts of the mostly Congolese healthcare workers on the front line, the people of affected communities and partners. Despite their ceaseless work, the disease continues to spread. This outbreak is occurring in an active conflict zone which makes an effective response far more complicated because of insecurity, including armed attacks on health workers and facilities, and population displacement. In some of the affected areas, violence is preventing us from reaching communities and working with them to stop further transmission.  

“We call on all parties to the violence to ensure that responders can do their work safely and that those seeking care can access it without fear of attacks.