H5N1

DRC Ebola: CMRE update, December 1

CMRE has published Epidemiological situation of December 01, 2019. Excerpt from the Google translation:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT 30 NOVEMBER  2019 

Sunday, 01 December 2019   

Since the beginning of the epidemic, the cumulative number of cases is 3,313, of which 3,195 are confirmed and 118 are probable. In total, there were 2,203 deaths (2085 confirmed and 118 probable) and 1078 people healed. 

• 349 suspected cases under investigation;  

• 3 new confirmed cases, including: 

º 2 in North Kivu in Mabalako; 

º 1 in Ituri in Mandima;  

• 1 new death of confirmed cases, including: 

º No community deaths have been recorded; 

º 1 death of confirmed case in Ituri in Mandima; 

• No healed person came out of ETC; 

• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 163 (5% of all confirmed / probable cases), including 41 deaths; 

• Ebola response activities are paralyzed in the Mangina and Biakato sub-coordinations for security reasons.

 

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.

NEWS  

Arrival of the Director General of the World Health Organization in Goma 

 • The Director General of the World Health Organization (WHO), Dr. Tedros Ghebreysus arrived this Sunday 01 December 2019 in the evening in Goma; 

• He came to Goma with a dual purpose: to express his solidarity with the Congolese government, specifically the coordination of the response through his general coordinator, Prof. Steve Ahuka Mundeke, to the entire response team, including the WHO team. Secondly, its mission was to discuss with the coordination of the response in order to define the strategies to come to put an end to this epidemic. He also expressed his solidarity with the wounded of the attacks of the night from 27 to 28 November 2019 in Biakato in Ituri, which he visited at the Hospital before coming to meet the coordinator of the response and all the families who lost their lives. their; 

• "We were near the end of this epidemic with all the good results we had recently, unfortunately this security incident could take us back. We still have to put in place a certain strategy to continue this fight against Ebola," he said; 

• It was marked by the determination of the whole team of the response, including the commitment of everyone to want to continue this fight to end it. "Each of those who spoke expressed the need for security to be able to continue," said the WHO DG; 

• Long before, the WHO Director General had a closed meeting with the response coordinator and the only point discussed in their discussions was the safety of the response teams in order to continue the activities and put end this 10th epidemic; 

• "It is difficult to fight against Ebola under bullets, so I invite you to determination, courage and above all not to give in. Your pleas for safety have arrived and we promise you to do our best, under the leardship from the Congolese government, we will continue to fight to defeat the Ebola virus," said Dr. Tedros, nicknamed Dr. Paluku in North Kivu; 

• He shared a meal with the response teams in memory of those who lost their lives for the Ebola Virus Disease in Biakato and to comfort everyone who returned to Goma from Biakato, Mangina and Beni  

VACCINATION  

• 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;  

• 821 people were vaccinated, until Thursday, November 28, 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, 255,441 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. 

MONITORING AT ENTRY POINTS  

• Sanitary control activities are disrupted in the Beni and Mangina sub-coordinations in North Kivu, as well as Mambasa and Biakato in Ituri following the demonstrations of the population who decry the killings of civilians and the attacks of armed innocents who took target response teams; 

• Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 122,122,460 ;  

• To date, a total of 109 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

Samoa measles: 'The children are deteriorating in front of our eyes'

I'm rapidly learning that Radio New Zealand is a key source for news on this subject: Samoa measles: 'the children are deteriorating in front of our eyes'. This report dated November 30 conveys the impact of measles on the community. Excerpt:

"I took them to the hospital, the vaccine is very important." 

School teacher Fa'i Fruean was taking no risks with his two daughters after the death of a 15-month-old with measles in his village near Apia this week. 

"Measles is the virus inside our body and the vaccine is the key to protect," he said.  

Being a school teacher, education is important to him. Half way down the main road towards town is Leulumoega District Hospital, where there is a quiet lunch time lull, and Dr Scott Wilson is expecting a busy afternoon. 

He said there are 18 sick children in the ward, some in a very serious situation - he had to send one child to the main hospital in town as he could do no more to help. 

"The children are deteriorating in front of our eyes," he said.

The doctors and nurses are also tired and ready for a break. They will head back this weekend while backup arrives, following the foreign minister's announcement that 100,000 new vaccines and New Zealand doctors who speak Samoan were on the way. 

Dr Wilson was quick to point out that the local Samoan nurses and doctors have been working the hardest, and longest, and have been heroic.  

"We've been here for five minutes, they've been here for weeks, dealing with this," he said. 

"The amount of work they've managed to get through, the support they've provided us, they've embraced us and helped us, along the journey."  

And it's not just the doctors. The connected communities around the country have taken the initiative and organised food and parcels and hygiene kits.  

The Samoa Victims Support Group, which was established to care for women victims of domestic violence, has volunteers going out every day taking supplies and messages to families. 

The messages include the importance of household hygiene, how to care for traumatized children and parents, and of course, why you should get vaccinated. 

Every weekday there are mobile vaccination units leaving the Tupua Tamasese Meaole Hospital in Apia following a morning briefing.  

The lady with the microphone starts delivering reminders to the volunteers, asking one woman to stand up and turn around as an example to the rest about how to wear a mask properly.  

"There is no disease you can spread from under your chin, it's from your mouth and nose," she said.  

And there were clear instructions about how to treat the families in the village once they arrived. 

"Vaccinate the kids, but get parental consent," she said.

Samoa measles outbreak: Police urge public to keep to curfew

Via Radio New Zealand News: Samoa measles outbreak: Police urge public to keep to curfew.

Police in Samoa are warning people not to defy curfew orders under a state of emergency for the country's measles outbreak.

Some people continue to defy the orders by taking their children to public gatherings, including church services, the Samoa Observer reports.  

That is a breach of the state of emergency provisions for which people could find themselves charged or even arrested.  

Samoa's Deputy Police Commissioner Papalii Monalisa Tiai-Keti said arresting or charging would be a last resort in a bid to enforce the orders. 

But Papalii urged members of the clergy, as well as village leaders and parents to heed the order.  

She said police officers were explaining the orders to members of the public and issuing warnings if citizens were not obeying.  

The Church of Jesus Christ of Latter Day Saints is the only church that has closed all church meetings and gatherings until the state of emergency is lifted.  

Other denominations have continued their Sunday services but have asked people under 19 years of age to stay away.  

There have been another five deaths in Samoa's measles epidemic, bringing the toll to 53 today. 

It's the sixth day the death toll has risen, with children under the age of four making up almost all but five of the dead. 

The Ministry of Health said in the past 24 hours, there were another 198 cases of measles recorded, bringing the total to more than 3700.

See also this earlier RNZ report on the effect of the curfew on church attendance.

Samoa: Measles epidemic death toll climbs to 53

Via Talamua On-line News, which is becoming the most accessible local source for news: Measles epidemic death toll climbs to 53.

APIA, SAMOA – 02 DECEMBER 2019: The measles epidemic continues to grip the country with five (5) more fatalities in the last twenty four hours pushing the death toll to 53.  

Most of the deaths are children under 4 years old with 25 recorded deaths in the 1-4 years age group that also records the highest number of measles cases at 1181.  Fifteen (15) deaths are in the 6-11 months category and eight (8) deaths in the 0-5 months age group. 

The latest fatalities also recorded the first death in the 5-9 years age group.  

To date, admissions include 19 critically ill children in the ICU/HDU, 2 pregnant women and 1 postnatal at the Tupua Tamasese Meaole hospital at Moto’otua. 

The Ministry of Health confirms a total of 3,728 measles cases have been reported to the Disease Surveillance Team, since the outbreak started.  There were 198 recorded in the last 24 hours. 

There are currently 183 measles cases who are in-patients at all health facilities.  Of this, 155 are at the Tupua Tamasese Meaole Hospital (TTMH), 4 at Poutasi District Hospital, 1 at Lalomanu District Hospital, 18 at the Leulumoega Rural District Hospital, 3 at the Malietoa Tanumafili II Hospital (MTIIH), 1 at Sataua District Hospital and 1 at Safotu District Hospital.  Admissions include 19 critically ill children in ICU/HDU and 2 pregnant women and 1 postnatal at TTMH. 

The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,129.  Of that, 893 (79%) patients have been discharged. 

To date, 53 measles related deaths have been recorded, with 5 fatalities in the last 24 hours.

Measles across the Pacific

Samoa isn't happening in a vacuum, and other Pacific nations are scrambling to vaccinate people and screen travellers. Here's a very preliminary list of relevant websites with information on the issue:

American Samoa

Vax Before Travel: Information on Samoa, Fiji, and Tonga.

WHO Western Pacific Region

Radio New Zealand: Impressive coverage, focused on Samoa.

As happens all too often in a new outbreak of any kind, I'm finding that websites for the local ministries of health (or government) are nonexistent or woefully out of date. If you can provide me with better links, please email me at [email protected] or DM me on Twitter @crof.

Samoa measles: 3,728 cases, 53 deaths as of December 1

A tweet from the Government of Samoa (@samoagovt), posted at about 3:45 p.m. Pacific Coast time:

Latest update: 3,728 measles cases have been reported since the outbreak with 198 recorded in the last 24 hours. To date, 53 measles related deaths have been recorded. Since the Mass Vaccination Campaign on 20 Nov 2019, the Ministry has successfully vaccinated 58,150 individuals.

I believe a little over 30,000 Samoans were vaccinated before this outbreak began. The total population is about 200,000. So heroic efforts have protected somewhat less than 50% of the population, when 95% would grant the country herd immunity. Obviously, the campaign must go on.

WHO Director-General praises bravery of health workers during visit to eastern DR Congo following fatal attacks on Ebola responders

A news release: WHO Director-General praises bravery of health workers during visit to eastern Democratic Republic of Congo following fatal attacks on Ebola responders.

World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus today visited health workers affected by recent armed attacks on Ebola response staff that killed four outbreak responders and injured seven others in the eastern Democratic Republic of the Congo (DRC). Dr Tedros called for improved security in the region to protect health workers trying to contain Ebola. 

“I came here today to stand side by side with you, my sisters and brothers, and commend you all for your compassion and bravery in this most trying of times,” said Dr Tedros during a visit to Goma, the capital of North Kivu province. “You have put your lives on the line to protect the health and wellbeing of others.”   

“I have also come here to recommit my steadfast support, and that of the World Health Organization, to the affected communities of this region and to the government of the Democratic Republic of the Congo, to bring the Ebola outbreak under control.”  

Dr Tedros told responders that “ending the outbreak cannot be done without a much stronger effort to improve your security. We call on those responsible for security to recognize your extraordinary efforts by making a greater commitment to your security."   

On the night of 27 November, unidentified armed attackers launched two separate attacks on a camp housing Ebola outbreak response staff in Biakato Mines and on the Ebola coordination office in Mangina. These were the latest in a series of similar incidents this year, during which WHO has documented approximately 390 attacks on health facilities that have killed 11 and injured 83 health care workers and patients in DRC.  

But despite the disruptions, WHO and humanitarian partners in eastern DRC have committed to continue their Ebola response operations. Since the start of the outbreak in August 2018, over 3300 people have contracted Ebola, some 2100 of whom have died. In recent weeks, there has been an encouraging decline in the number of people confirmed with the virus.  

In Goma, Dr Tedros met and thanked Ebola responders who are in hospital recovering from injuries suffered in the 27 November attacks. "You are working to save lives and you get attacked -- this is wrong," he said.    

Dr Tedros also met with National Ebola Coordinator Steve Ahuka and expressed solidarity with and support for the Government and people of the DRC, noting, "We won't give up and we will finish the job."   

Later, Dr Tedros and Professor Ahuka met with DRC Ministry of Health, WHO and other responders, including those evacuated following the violence, paying tribute to their selflessness and persistence. Several responders recounted their experiences of being confronted by the attackers and stressed their commitment to working to end the Ebola outbreak in memory of their fallen colleagues. 

"You cannot face Ebola and bullets without commitment, and that's why I am so proud of you," Dr Tedros said. “Even though we shouldn't give up, your security must be ensured." Across the eastern DRC outbreak zone, WHO continues to support activities throughout the affected areas. 

“There can be no more callous act than to target health professionals working to heal the sick and care for those in need,” he added. “Every time an attack like this happens, it disrupts efforts to contain the Ebola outbreak and puts the health and wellbeing of local men, women and children at greater risk.”   

“Such senseless violence must stop.”

DRC Ebola: Dr. Muyembe deplores suspension of response activities in Biakato

Via provinces26rdc.net: DRC Ebola: Dr. Muyembe deplores suspension of response activities in Biakato. The Google translation: 

The technical secretary of the multisectoral committee for the response to Ebola, Dr. Jean Jacques Muyembe regretted Saturday, November 30, the suspension of activities to respond to the Ebola virus disease in Biakato (Ituri), while one was "two fingers within the end of this epidemic in this medium." These activities were suspended after the attack on the local treatment center during the night of November 28-29 by suspected Mai-Mai.  

During this armed attack, "there were three deaths and several injuries, and the center was burned and burned. And so, most of our activities have been suspended. The wounded were brought to Goma," lamented Dr. Muyembe.  

"We condemn all of us, all Congolese citizens condemn such acts, because we can not enter a treatment center for such a dangerous disease, to go kill, murder the health staff, who come to the aid of the sick and you kill them. It's not normal!" he continued.

DRC Ebola: 3 new cases on November 30, 10 this week, 3,313 total

The MoH/WHO AFRO Ebola DRC KIVU 2018 Dashboard reports 3 new cases on November 30, making 10 for epidemiological week 48, 24 in the past 21 days, and 3,313 since the outbreak was declared. Out of 2,700 contact, 800 are going untraced.

DRC Ebola: CMRE update, November 30

CMRE has published Situation épidémiologique du 30 novembre 2019. Excerpt from the Google translation: 

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AT NOVEMBER 29, 2019 

Saturday, November 30, 2019   

• Since the beginning of the epidemic, the cumulative number of cases is 3,310, of which 3,192 are confirmed and 118 are probable. In total, there were 2,202 deaths (2084 confirmed and 118 probable) and 1078 people healed. 

• 341 suspected cases under investigation; 

• 1 new case confirmed in North Kivu in Mabalako; 

• 1 new death of confirmed cases, including: 

o 1 community death in Ituri in Biakato; 

o No deaths among confirmed cases;  

• 1 person cured out of CTE in North Kivu in Beni;  

• 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; 

• Ebola response activities are paralyzed in the Mangina and Biakato sub-coordinations for security reasons.

  

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.

NEWS  

Funeral mass in memory of the agent of the response deceased following the attacks of Biakato in Ituri 

 • A Thanksgiving Mass was organized this Saturday, November 30, 2019 at the Saint Joseph Cathedral in Goma, capital of North Kivu Province in memory of the Biakato Mines Subcommittee on Immunization Commission logistician in Ituri, Belinda Kasongo Kasonzo, who died as a result of the attacks that took place on the night of 27 to 28 November 2019; 

• The General Coordinator for the Ebola Response to the Ebola Virus Disease, Prof. Steve Ahuka Mundeke, who presented the biography of the famous disappeared, pointed out that the logistician who leaves the land of humans at the age of 30, is a graduate in computer science management of the Higher Institute of Statistics "ISS Lubumbashi "and spent most of her childhood in Lubumbashi. She arrived in Kinshasa in 2018, where she was hired as a vaccine stock manager for the Expanded Program on Immunization (EPI), but long before she worked as an investigator at the World Health Organization (WHO) and as a Data Controller. manager at the Provincial Health Inspectorate of Upper Katanga; 

• For the partners in the response, including WHO and UNICEF, Belinda Kasongo was a brave, courageous and above all determined woman. She fell to the front, but the fight will continue until the end. They expressed the wish to see the authorities put an end to this unjustified violence; 

• The coordinator of the Biakato sub-coordination, Fabrice Kadima, and all the teams returning from this part of the Democratic Republic of Congo, for this purpose, testified to the conviviality in which they lived with Mrs. Belinda; 

• At the end of the Mass, the remains were taken to Goma airport and repatriated to Kinshasa for the funeral of the family. 

VACCINATION  

• 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;  

• 821 people were vaccinated, until Thursday, November 28, 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, until November 27, 2019, 255,381 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. 

MONITORING AT ENTRY POINTS  

• Sanitary control activities are disrupted in the Beni and Mangina sub-coordinations in North Kivu, as well as Mambasa and Biakato in Ituri following the demonstrations of the population who decry the killings of civilians and the attacks of armed innocents who took target response teams; 

• Since the beginning of the epidemic, the total number of travelers checked (temperature measurement ) at the sanitary control points is 122,099,389 ;  

• To date, a total of 109 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.