H5N1

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Saturday, December 15, 2018

The Ministry pf Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Saturday, December 15, 2018. More bad news: eight new cases and five new deaths, four of them in the community. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Saturday, December 15, 2018   

The epidemiological situation of the Ebola Virus Disease  dated 14 December 2018:   

• Since the beginning of the epidemic, the cumulative number of cases is 529, 481 confirmed and 48 probable. In total, there were 311 deaths (263 confirmed and 48 probable) and 183 people cured. 

• 96 suspected cases under investigation.  

• 8 new confirmed cases, including 4 in Mabalako, 2 in Katwa, 1 in Kalunguta, and 1 in Komanda. 

• 5 new confirmed deaths, including 2 in Mabalako, 1 in Komanda, 1 in Katwa and 1 in Beni. All are community deaths, except that of Beni. 

• 1 new person healed out of CTE in Beni.

   

 /! \  The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

News of the response 

Campaign "Family Without Ebola" 

• Bishop Sikuli Paluku, the bishop of the Butembo-Beni diocese, launched the "Family Without Ebola" campaign throughout the district of Butembo-Beni. This project is part of the "Ebola Pas Chez Moi" citizen campaign launched by Beni students last October.  

• In a statement issued Friday, December 14, 2018, the bishop calls all Catholic faithful to protect themselves to protect their neighbors and their community. He particularly emphasized the importance of youth engagement in the Ebola response. Inspired by the passage in the first letter of St. Paul the Apostle to Timothy, chapter 4, verse 12, he reminded the youth that they are not only the future of the country. They are present. The bright future of the DRC will not happen without them. 

• Bishop Sikuli Paluku also invited all the priests and other religious leaders to increase awareness during liturgical and pariturgical celebrations. He regretted that, despite the efforts of the response teams, the epidemiological situation remained alarming and the epidemic continued to spread because of the members of the population who refused to apply the hygienic prescriptions. He strongly condemned "the inhuman and cruel mischief" of all those who verbally or physically attacked the response teams and the pastoral agents involved in the outreach. He also denounced those who desecrated the graves by digging up people who had died of Ebola and some of whom ended up being infected.  

• Religious leaders in the affected areas have been involved in sensitizing the population since the beginning of the epidemic. Monsignor Sikuli Paluku has personally engaged in sensitizing the population by agreeing to be vaccinated and regularly denouncing the hostile behavior that has caused the spread of the epidemic.     

Vaccination 

• Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). 

• Continued immunization of primary care providers in the Goma Health Zone.  

• Since the start of vaccination on 8 August 2018, 46,887  people have been vaccinated , including 18,855 in Beni, 8,438 in Katwa, 5,036 in Mabalako, 4,606 in Butembo, 2,178 in Kalunguta, 1,663 in Mandima, 791 in Vuhovi, 750 in Masereka. , 724 in Komanda, 700 in Lubero, 627 in Oicha, 599 in Mutwanga, 511 in Kyondo, 434 in Bunia, 355 in Tchomia, 344 in Musienene, 117 in Goma, 70 in Biena, 63 in Alimbongo, 13 in Karisimbi and 13 in Kisangani. 

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Friday, December 14, 2018

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Friday, December 14, 2018. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Friday, December 14, 2018   

The epidemiological situation of the Ebola Virus Disease  dated 13 December 2018:   

• Since the beginning of the epidemic, the cumulative number of cases is 521, 473 confirmed and 48 probable. In total, there were 306 deaths * (258 confirmed and 48 probable) and 182 people healed. 

• 97 suspected cases under investigation.  

• 3 new confirmed cases, including 1 in Beni, 1 in Kalunguta, and 1 in Komanda. 

• 3 reports of confirmed cases from December 12, 2018, including 2 in Komanda and 1 in Beni, for which the laboratory results were released late in the evening.   

• 2 new confirmed deaths, including 1 in Kalunguta and 1 in Komanda. Both are community deaths. 

• 3 new people healed out of the CTE of Beni.  

* 1 hospital death occurring on December 11 in Beni was added after database review and validation.

 

 /! \  The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

News of the response 

Vaccination 

• Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). 

• Launch of the vaccination of front-line providers in the Goma health zone. A new vaccination ring was also opened in the community around Beni's contacts who had traveled to the South Mabanga district of Karisimbi, the second health zone in Goma City. These people of Karisimbi are vaccinated as contacts.  

• Since vaccination began on August 8, 2018, 46,047  people have been vaccinated , including 18,785 in Beni, 8,298 in Katwa, 4,985 in Mabalako, 4,316 in Butembo, 2,138 in Kalunguta, 1,663 in Mandima, 791 in Vuhovi, 750 in Masereka, 700 in Lubero, 685 in Komanda, 627 in Oicha, 599 in Mutwanga, 434 in Bunia, 421 in Kyondo, 355 in Tchomia, 344 in Musienene, 63 in Alimbongo, 40 in Biena, 27 in Goma, 13 in Karisimbi and 13 in Kisangani. 

WHO: Ebola virus disease – Democratic Republic of the Congo

WHO has published its weekly Ebola DON: Ebola virus disease – Democratic Republic of the Congo. Excerpt:

The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is occurring in an unforgiving context. Non-engagement from communities and conflict continue to hamper response activities in some affected areas. Moreover, poor infection prevention and control (IPC) practices across numerous private and public health centers remain a major source of amplification of the outbreak and risk to health and other frontline workers. 

Despite these challenges, substantial progress has been made on multiple fronts to address the situation, and daily successes are being observed in the implementation of proven public health measures alongside newer tools, such as vaccination and novel therapeutics. 

Together with the Ministry of Health (MoH) and our partners, WHO is further scaling up our response to the developing situation. WHO especially emphasizes the need to continuously improve quality, judiciously deploy new tools at our disposal, and sustain international commitment to response efforts well into 2019. Nonetheless, we remain confident the outbreak can be brought to a conclusion.  

During the reporting period (5 through 11 December 2018), 37 new cases were reported from 10 health zones in North Kivu and Ituri provinces: Katwa and Butembo (18), Beni (seven), Mabalako (four), Oicha (three), as well as one case each in Komanda, Kyondo, Mandima, Musienene and Vuhovi. 

Four new infections of health workers have been reported in Musienene, Katwa and Butembo health zones. In total, 51 (49 confirmed and two probable) health workers have been infected to date, of whom 17 have died. Twenty-three additional survivors were discharged from Ebola treatment centres (ETCs) and reintegrated into their communities. A total of 177 patients have recovered to date.  

As of 11 December, 505 EVD cases (457 confirmed and 48 probable), including 296 deaths, have been reported in 12 health zones in North Kivu Province and three health zones in Ituri Province (Figure 1). These zones represent a mix of densely populated urban areas and remote villages, each bringing a variety of factors driving transmission and posing different challenges. Trends in case incidence (Figure 2) reflect the continuation of the outbreak across these geographically dispersed areas, with an average of 33 new cases reported each week since mid-October. 

Although there has been a general decrease in the intensity of transmission in Beni in recent weeks, the outbreak is intensifying in Butembo and Katwa, and new clusters are emerging elsewhere. At present, the situation remains concerning.  

The very high risk of further geographical spread of the outbreak was highlighted this week by the movement of several contacts of confirmed cases from Beni to Kisangani and Goma. All of these contacts were rapidly traced, and have since returned to Beni where they will complete their 21 day follow-up. Several alerts of potential cases were also received from Goma, and towns between Goma and Butembo. These individuals were promptly isolated, reported and tested negative for EVD. 

Preparedness and operational readiness activities in other areas of North Kivu and Ituri provinces, other provinces of the Democratic Republic of the Congo, and neighbouring counties, must continue to be upscaled to rapidly detect and respond to any potential cases.

Ebola DRC: Bad news, but a miracle baby (updated)

I posted this item but found Typepad's editing function wasn't working. So here is the complete post, with today's table and a very nice photograph.

The Ministry of Health has published EBOLA RDC - Evolution de la riposte contre l'épidémie d'Ebola dans les provinces du Nord Kivu et de l'Ituri au Jeudi 13 décembre 2018. The bad news: Ten new cases and seven deaths—six of them in the community. The good news: A baby whose Ebola-positive mother died in childbirth has recovered. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Thursday 13 December 2018   

The epidemiological situation of the Ebola Virus Disease  dated December 12, 2018:   

• Since the beginning of the epidemic, the cumulative number of cases is 515, of which 467 are confirmed and 48 are probable. In total, there were 303 deaths * (255 confirmed and 48 probable) and 179 people cured. 

• 96 suspected cases under investigation.  

• 10 new confirmed cases, including 4 in Kyondo, 2 in Mabalako, 2 in Komanda, 1 in Kalunguta and 1 in Beni.  

º The new case confirmed Mabalako reported in the bulletin of 12 December 2018 lives in the health area near Biena, where he began to have symptoms of Ebola. The patient was contaminated by a confirmed case who lived in Aloya City, Mabalako Health Zone, and died at the Ebola Treatment Center on December 3, 20018.  

• 7 new confirmed deatha, including 2 in Kyondo, 2 in Katwa, 1 in Beni, 1 in Mabalako and 1 in Komanda. All are community deaths, except that of Beni.  

• 4 new healed people, including 3 exits from the CTE of Beni and 1 from the CTE of Butembo.  

*  Review of the list of confirmed cases of death in Beni in progress.  

 

/! \  The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

News of the response 

The miraculously young Beni 

Credit: DRC MOH

• The youngest Ebola healed came out of the Beni Ebola Treatment Center this Wednesday, December 12, 2018. This miraculously young, born October 31, 2018, was admitted at the age of 6 days to CTE after her mother , a confirmed case of Ebola, died during childbirth. Throughout his hospitalization, pediatricians, resuscitators and nannies of CTE took turns at his bedside 24 hours a day to give him every chance to survive. Nannies are former CTE patients who have recovered from Ebola and are able to care for sick children by wearing lighter protective gear. They play a fundamental role in caring for sick children who need more attention and a reassuring presence at their side during treatment.   

Vaccination 

• Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). Since the start of vaccination on 8 August 2018, 45,647  people have been vaccinated , including  18,726 in Beni, 8,084 in Katwa, 4,950 in Mabalako, 4,276 in Butembo, 2,108 in Kalunguta, 1,663 in Mandima, 791 in Vuhovi, 750 in Masereka, 700 in Lubero, 633 in Komanda, 627 in Oicha, 599 in Mutwanga, 434 in Bunia, 381 in Kyondo, 355 in Tchomia, 314 in Musienene, 63 in Alimbongo, and 13 in Kisangani.

Update: The little girl is named Benedicte, and The Washington Post has more details about her story. 

Ebola in the DRC: Expert sets out critical lessons learned in Liberia

Via MedicalXpress.com: Ebola in the DRC: Expert sets out critical lessons learned in Liberia. Excerpt:

Ebola in the Democratic Republic Congo (DRC) has now spread to urban areas. The Conversation Africa's Moina Spooner spoke to Mosoka Fallah who was head of case detection during Liberia's ebola outbreak in 2014 and 2015 about his experience, and what lessons that experience offers. 

What can you tell us about the spread of Ebola in the DRC?  

The situation is very serious. So far there have been 458 cases, including 271 deaths, in two of the country's provinces. This could get much worse. In Liberia's case, over two years, 4810 people lost their lives to ebola. 

I think it could be a matter of days before DRC's epidemic spreads to more urban centres or spills over into neighbouring countries. 

I say this because of how the outbreak is unfolding. 

First, health care workers are being infected. In our experience in Liberia, and in most outbreaks, infected health care workers can be super spreaders. They can infect the people they treat or those taking care of the sick.  

Second, there are now cases (live and dead) reported in communities that were not on the contact list. This is a list of people that may have come into contact with an infected person. If there are people that are infected who weren't on the list, it means that proper tracking isn't happening. It also implies that people don't trust, or are afraid, of the ebola response and are turning to home treatments, including traditional remedies or prayers. These could expose a larger population to infection.  

To contain an ebola outbreak, it's crucial that 100% of the contact list is documented and tracked. If this is broken, then a spread should be expected.  

Why has the country been unable to contain the spread this time round? 

The failure to control this outbreak is due to a variety of factors. 

Because of the civil war and with huge numbers of people living in abject poverty – as was the case in Liberia – there is widespread distrust in the government and its institutions. This means it will be hard for people to trust the Ebola response team. 

This is a major problem because Ebola containment is based on trust. Response workers can't be in every house and so they rely on individuals in communities to alert them. But if they're not trusted, cases won't be reported. Mistrust can also lead to violence – as we've seen in the frequent attacks against response workers in the DRC. These attacks delay response when speed is critical. 

These reactions are because the Ebola response goes against the normal tendency for families and friends to take care of their sick. Instead they are isolated and kept away. To help people accept this requires them to trust the health workers. People who are very poor, and have been neglected by the state, don't trust the authorities. And they aren't likely to accept the radical changes required. This, in turn, results in resistance and violence.  

What steps need to be taken immediately? 

The first steps must be to address some of the fundamental needs of the people. For example, at risk communities should be provided with food and useful tools and services – like water pumps and functional clinics. But these must be distributed through locally trusted leaders. 

Second, some of the Ebola response must go to the local community. The first step would be to identify key, trusted leaders who can lead the response. They can also be invited to propose solutions, and be supported in getting these implemented. In addition, local youths and religious and traditional leaders need to drawn in and paid to do active surveillance and community sensitisation.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Wednesday, December 12, 2018

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Wednesday, December 12, 2018. A bad day: five new cases in scattered locations, and nine deaths—eight of them in the community. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Wednesday, December 12, 2018   

The epidemiological situation of the Ebola Virus Disease  dated 11 December 2018:   

• Since the beginning of the epidemic, the cumulative number of cases is 505, of which 457 are confirmed and 48 are probable. In total, there were 298 deaths (250 confirmed and 48 probable) and 175 people healed. 

• 100 suspected cases under investigation.  

• 5 new confirmed cases, including 2 in Katwa, 1 in Komanda, 1 in Musienene and 1 in Mabalako.  

• 9 new confirmed cases, including 6 in Beni, 1 in Butembo, 1 in Katwa (community deaths) and 1 in Mabalako.  

• 3 new people healed out of Butembo CTE.

   

 /! \  The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

News of the response 

Alerts Notification in Goma 

• An alert has been notified to the Rutshuru General Referral Hospital. The victim died in hospital after presenting bleeding signs. A sample was taken and the result of the laboratory test was negative.   

• Contacts of a confirmed case of Beni traveling to Goma: The surveillance teams in Goma were looking for six people, three adults and three children, who had been in contact with a confirmed case of Beni. Before receiving the results of the laboratory tests of their deceased relative in Beni these six contacts had started for Goma, traveling in two separate groups. They had to go to relatives living in Mabanga South, a district of Goma. A mother and her two children were found at Kanyabayonga on Tuesday, December 11, 2018, and agreed to return to Beni to complete their 21-day follow-up period. The second group of travelers, consisting of the other two adults with the third child, arrived in South Mabanga on the night of Tuesday, December 11th. The child had a fever and the three people were immediately transferred to the Goma Ebola Treatment Center to perform the necessary tests. The laboratory test was negative.   

Vaccination

•  Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). 

• Since the start of vaccination on August 8, 2018, 45,020  people have been vaccinated , don t 18,638 in Beni, 7,765 in Katwa, 4,930 in Mabalako, 4,276 in Butembo, 2,108 in Kalunguta, 1,663 in Mandima, 791 in Vuhovi, 750 in Masereka , 700 in Lubero, 633 in Komanda, 627 in Oicha, 599 in Mutwanga, 434 in Bunia, 361 in Kyondo, 355 in Tchomia, 314 in Musienene, 63 in Alimbongo, and 13 in Kisangani.  

SENSITIZATION   

Beyond the medical arsenal, the Ministry of Health recalls that the response against Ebola is above all community.  Since the beginning of the epidemic, the city of Goma is an exposed area in the same way as the cities of Bunia and Kisangani because of the regular displacements of the population between the zones currently affected by the Ebola epidemic and these three big ones. urban centers.    

If all the inhabitants of these cities respect the sanitary measures recommended by the Ministry of Health, it is possible to ensure that, even if an Ebola case arrives in the city, it would be a sporadic case would not lead to a new outbreak.     

As a reminder, the recommendations of the Ministry of Health  are as follows: 

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes; 

2. If an acquaintance from an epidemic zone comes to visit you and is ill, do not touch her and call directly the North Kivu civil protection hotline; 

3. If you are identified as an Ebola patient contact, agree to be vaccinated and followed for 21 days; 

4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination. 

5. For all health professionals, observe the hygiene measures in the health centers and declare any patient with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).  

CIDRAP: Ebola count in DRC hits 500 in growing outbreak

Via CIDRAP, Stephanie Soucheray writes: Ebola count in DRC hits 500 in growing outbreak. Excerpt:

The world's second-largest Ebola outbreak hit another milestone today, as the Democratic Republic of the Congo (DRC) recorded 2 new cases, raising outbreak totals to 500, including 289 deaths. 

Of the four new deaths recorded today, two are community deaths in Beni and Mabalako, which took place outside a hospital or Ebola treatment center, raising the risk of transmission, the DRC said. 

There are also 80 people currently under investigation for suspected infections, the DRC's health ministry said in its daily update. 

Unknown transmission chains 

According to the latest weekly update from the World Health Organization's (WHO's) African regional office, among the 500 cases are 3 healthcare workers who have been infected since Dec 1. Since August, when the outbreak began, 49 healthcare workers have been infected, and 15 of those have died.  

While vaccination and case contact tracing are under way, there are still unknown transmission chains in North Kivu and Ituri provinces, the WHO said. On Dec 8, for example, the agency said five new cases were identified, yet only two of the cases were known contacts.  

"Contact tracing is still of concern due to insecurity and continuing pockets of community resistance. The number of contacts being followed as of 8 December 2018 was 6,417, of whom 5,812 had been seen in the previous 24 hours, representing 92%," the WHO regional office said. 

As of today, the DRC said 44,447 people have been vaccinated with Merck's unlicensed Ebola vaccine. The WHO said the remaining stock of vaccine in Beni is 4,290 doses.  

Katwa hospital burned 

The WHO said Beni, Katwa and Kalunguta are the hot spots of the outbreak, representing 30%, 27%, and 17% of the 119 confirmed and probable cases reported from Nov 18 to Dec 8.  

The WHO also said Komanda is an area of concern owing to surveillance challenges. The organization also said two healthcare posts and the Hope Health Centre in Katwa were burned by community members, another example of ongoing resistance in the volatile region. 

"Particular challenges lie in investigating new confirmed cases without clear epidemiological links to other cases, the need to strengthen contact monitoring in Beni and Komanda and the need to intensify community engagement in Katwa. In addition, the potential implication of the upcoming elections bringing large numbers of people together remains an issue," the WHO said.

WHO AFRO: Week 49 Ebola update

Thanks to Helen Branswell for tweeting from WHO AFRO's week 49 update. Excerpt from the section on Ebola:

As of 8 December 2018, there have been a total of 494 EVD cases, including 446 confirmed and 48 probable cases. To date, confirmed cases have been reported from 15 health zones: Beni (203), Mabalako (72), Katwa (53), Kalunguta (31), Butembo (30), Masereka (7), Oicha (7), Vuhovi (7), Kyondo (4), Mutwanga (3) and Musienene (2) in North Kivu Province; and Mandima (16), Komanda (8), Tchomia (2) and Mambasa (1) in Ituri Province. Twelve of the 15 affected health zones reported at least one new confirmed case in the previous 21 days (29 November-8 December 2018). A total of 283 deaths were recorded, including 235 among confirmed cases, resulting in a case fatality ratio among confirmed cases of 53% (235/446).

As of 8 December 2018, a total of 132 patients were hospitalized in ETCs and transit centres, of which 37 are confirmed cases. All confirmed cases are on compassionate therapy.

Beni, Katwa and Kalunguta remain the main hot spots of the outbreak, with, respectively, 30% (n=36), 27% (n=32) and 17% (n=20) of the 119 confirmed and probable cases reported in the last 21 days (from 18 November-8 December 2018). Komanda is also an area of concern.

Contact tracing is still of concern due to insecurity and continuing pockets of community resistance. The number of contacts being followed as of 8 December 2018 was 6 417, of whom 5 812 had been seen in the previous 24 hours, representing 92%. Twelve health zones have contacts identified during follow-up.

PUBLIC HEALTH ACTIONS

• Two health posts and the Hope Health Centre in Katwa were burnt by the community.

• All surveillance activities continue, including case investigations, active case finding in health facilities and in the communities, and identification and listing of contacts around the latest confirmed cases. There are continued efforts to strengthen surveillance in Komanda, with continuation of listing activities and contact follow-up in those health zones that reported the most recent confirmed cases.

• The laboratory in Butembo received two additional staff and three new GeneXpert testing devices. The EVD laboratory in Bunia has been moved from the Ituri Provincial Laboratory to a position next to the Bunia General Reference Hospital.

• As of 6 December 2018, a total of 237 319 travellers were screened and vehicles decontaminated at 67 of 71 Points of Entry (PoE) and Points of Control (PoC). An alert received from the PoC Public Port/Goma was investigated and validated.

• On 5 December 2018, a total of 733 new people were vaccinated in 17 rings, bringing the cumulative numbers vaccinated to 41 226. The current stock of vaccine in Beni is 4 290 doses. Targeted vaccination continues in all affected health zones.

• There are continued community reintegration activities for patients discharged from ETCs, along with psychoeducation sessions to strengthen community engagement and collaboration in the response.

• Infection prevention and control (IPC) and water, sanitation and hygiene (WASH) activities continue, with decontamination of households and health facilities; distribution of personal protective equipment; and briefing of 37 traditional healers in basic IPC.

• Community awareness and mobilization sessions continue, with educational talks; youth awareness through a football tournament; continuing daily door-to-door outreach activities in households in affected areas; and continuation of awareness activities through the involvement of community leaders and local media.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Monday, December 10, 2018

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Monday, December 10, 2018. Excerpt from the Google translation of a long update:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Monday, December 10, 2018   

The epidemiological situation of the Ebola Virus Disease  dated December 9, 2018:   

• Since the beginning of the epidemic, the cumulative number of cases is 498, of which 450 confirmed and 48 probable. In total, there were 285 deaths (237 confirmed and 48 probable) and 167 people cured. 

• 73 suspected cases under investigation.  

• 4 new confirmed cases, including 3 in Katwa and 1 in Vuhovi. 

• 2 new deaths from confirmed cases (all community deaths), including 1 in Katwa and 1 in Vuhovi.  

• 2 new healed people, including 1 exit from the CTE of Beni and 1 from the CTE of Butembo.

   

 /! \  The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas. 

News of the response 

Focusing 

• Some media reported that the Ebola outbreak had just reached the town of Butembo. However, the Ministry of Health recalls that the first case of Ebola was identified in the town of Butembo on September 4, 2018. This was a high-risk contact of a confirmed case deceased from the Ndindi district, in the city of Beni, who refused the vaccination and fled to Butembo to escape the monitoring teams. The Minister of Health, Dr. Oly Ilunga Kalenga, visited Butembo on September 6, 2018 to oversee the response activities in this major commercial city of North Kivu. A few days later, the emergency operations center and the Ebola treatment center were fully operational.  

• In the past six weeks, a significant increase in Ebola cases and deaths has been observed in Butembo and Katwa, mainly due to the reluctance of the population, the destruction of health infrastructure and physical aggression toward the response teams. At a press conference in Kinshasa on December 6, 2018, the Minister of Health had described the increase as disturbing. Despite the difficulties, additional teams are being sent to Butembo and neighboring health zones on a daily basis to strengthen all pillars of the response in these areas.  

• Although this epidemic of Ebola, the most serious in the history of the Democratic Republic of Congo, attracts the attention of the world, it is important to remain factual, scientific, and avoid "sensationalizing" a situation already extremely complex and unique. The DRC is the only country in the world facing an epidemic of one of the most deadly diseases in such a difficult and unpredictable environment.  

• The Ministry of Health is already working with the best Congolese and international experts from WHO, UNICEF, the African Union, Médecins Sans Frontières (MSF), Alima, the Red Cross, and many other organizations. Congolese providers stood out for their courage and dedication. During this epidemic, they realized what no one else had ever done, such as negotiating with Mai-Mai leaders to access their village and vaccinate whole communities against Ebola. They are driven by a remarkable sense of responsibility and duty towards their country and their fellow citizens. This epidemic has also given new meaning to the concept of international cooperation. Strong links have been created between Congolese and international experts by spending so much time together in a difficult environment. They work not only together but they also support and encourage each other. This collaboration between Congolese and international teams is exemplary.  

• The Ministry of Health remains open to any expert and any organization with proven expertise in a specific area of ​​the response. Despite the fact that they did not have security clearances to travel to Ebola-affected areas, US experts from the  US Centers for Disease Control and Prevention  (CDC) and the US Agency for Development USAID have been involved in the response since August. They bring their expertise from Kinshasa and Goma, and make the connection with Washington DC and Atlanta.  

Vaccination 

• Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). 

• Since the start of vaccination on August 8, 2018, 43,944  people have been vaccinated , including  18,500 in Beni, 7,176 in Katwa, 4,836 in Mabalako, 4,176 in Butembo, 2,108 in Kalunguta, 1,663 in Mandima, 769 in Vuhovi, 750 in Masereka, 700 in Lubero, 633 in Komanda, 627 in Oicha, 599 in Mutwanga, 434 in Bunia, 355 in Tchomia, 314 in Musienene, 241 in Kyondo, and 63 in Alimbongo. 

LUBERO: The aggressive population against the Ebola response team

Via Radio Moto Butembo-Beni: LUBERO: the aggressive population against the Ebola response team. The Google translation:

The rural commune of Lubero was overheated the day of Saturday, December 08, 2018. All started from a refusal of the population to welcome the Ebola response team for taking samples from a body. The target body was that of a 3rd year student at the MULO Institute. 

The girl died the night from Friday to Saturday, December 08 in a health facility offering traditional health care in Lubero. The illness of which she died was manifested by signs similar to those produced by Ebola. 

No agreement was found for taking samples at the deceased's home. The crowd wanted to unload on the Lubero Rural Health Zone Chief Medical Officer who was in the delegation of the Ebola Response Team. He was saved thanks to the intervention of the elements of the order who shot bullets in the air. But Doctor MUMBERE MUSIVIRWA Cyril had some injuries.  

The protesters had already destroyed the home of Dr. MUMBERE MUSIVIRWA Cyrille. Windows in his house, appliances and furniture were damaged. His jeep also suffered from the protestors' anger. Other members who were in the response team delegation were also affected. But our sources do not give details about them.  

The authorities of Lubero condemn this popular behavior which does not allow the easy fight against Ebola virus disease and the organization of dignified and safe burials. Finally, the girl's body was taken to her last home in Kipese late in the afternoon of Saturday, December 08, 2018. 

The return of the funeral, there was another misfortune. A young man fell from a FUSO vehicle carrying him with the others. He suffered serious injuries in his thigh where the femur was crushed by the rear tire of the vehicle. He continues in care at the reference hospital in Lubero.