H5N1

DRC Ebola: 7 new cases on August 16, 37 this week, 2,868 total

The MoH/WHO AFRO Ebola DRC KIVU 2018 Dashboard reports 7 new cases on August 16, making 37 this week, 229 in the past 21 days, and 2,868 since the outbreak was declared. Of those cases, 1,921 have died and 849 have survived. Out of 16,900 contacts, 2,500 are not being traced.

DRC Ebola: August 16 update, with details on the South Kivu cases

The Technical Secretariat has emailed its August 16 update. Excerpt from the Google translation and then some comments:

MULTISECTORAL NATIONAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE

TECHNICAL SECRETARIAT

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT AUGUST 15, 2019.

Date: Friday, August 16, 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,861, of which 2,767 confirmed and 94 probable. In total, there were 1,921 deaths (1,827 confirmed and 94 probable) and 849 people cured.

• 360 suspected cases under investigation;

• 9 new confirmed cases, including 5 in North Kivu, including 3 in Beni, 1 in Kalunguta and 1 in Musienene, 2 in Ituri in Mambasa and 2 in South Kivu in Mwenga;

• 8 new confirmed deaths, including 5 in North Kivu, 1 in Ituri and 1 in South Kivu:

º 5 community deaths, including 3 in North Kivu, including 2 in Beni and 1 in Kalunguta, 1 in Ituri in Mambasa and 1 in South Kivu in Mwenga;

º 3 deaths in CTEs, including 2 in North Kivu in Beni and 1 in Ituri in Komanda. 

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

• No health worker is among the new confirmed cases. The cumulative number of confirmed/probable cases among health workers is 153 (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.

News

New health zone affected by EVD in South Kivu

• A new health zone has been affected by Ebola Virus Disease in South Kivu Province;

• This is a 24 year old woman and her 7 month old son. On the mother's side, symptoms of EVD began to appear on August 4, 2019 in Beni, but she died on August 14 in Mwenga after consulting two health facilities, namely the Kangolo and Kilingutu Health Center;

• The sample taken from the deceased was tested positive on August 15, 2019 and her son was confirmed positive case MVE August 15, 2019. He is placed in isolation and will be put on treatment;

• According to initial investigations, the woman from Bukavu was living with a host family at the Mabolio Health Area in the Beni Health Zone in North Kivu Province. She was listed as a high-risk contact around a member of this family, confirmed MVE on July 25, 2019;

• On the twelfth day of her follow-up, on 06 August 2019, there was an alert about her move to Bukavu by the teams of the response and she was found accompanied by her two children (5 years and 7 months) at the Point of entry (PoE) from Kasindi, bordering Uganda;

• During her return to Beni, she escaped the response teams and continued her way from Kasindi to Beni, Butembo, Goma, Bukavu to Mwenga.

• During her journey, she escaped the vigilance of the various entry points and control points following a change of identity 4 times;

• Some actions have already been implemented around these two cases, including the dignified and safe burial (EDS) of the 24-year-old female body, the deployment of a multidisciplinary team of rapid intervention and the isolation of the baby, who has already started to be cared for. A recovered EVD patient is also part of the team deployed to care for the infant;

• The team's mission is to support the Mwenga health zone, the DPS and the South Kivu Province for one week in order to quickly circumscribe the home;

• A total of 120 contacts have already been listed around these two cases.

I'm greatly encouraged by the reliance of the response on Ebola survivors to care for current patients and children.

This is a good time to mention how to get Secretariat updates directly: Write to bulletinquotidien.ebola10@gmail.com and ask to be put on the mailing list. You can expect to get a Word document in French (easily converted to English with Google Translate), several graphs, and the daily table. 

If you don't to get any more email than you already have, just follow the new Twitter account of the Comité Multisectoriel de la Riposte à la Maladie à Virus Ebola. They've just started up, and I have the pleasure of being their #3 follower. They're tweeting links to their updates  and other news as well.

DRC Ebola: 9 new cases on August 15, 30 this week, 2,861 total

The MoH/WHO AFRO Ebola DRC KIVU 2018 Dashboard report 9 new cases on August 15, making it 30 so far this week, with 230 cases in the past 21 days and 2,861 since the outbreak was declared.

The dashboard includes the 2 new cases in Mwenga (click on the Health Zones menu at the top and scroll down to Mwenga). However, it doesn't list the death of the 24-year-old woman, which may have occurred after the dashboard was updated.

The dashboard also reports 1,913 deaths and 846 recoveries. Out of 16,700 contacts, 2,500 are going untraced at the moment.

DR Congo Ebola outbreak spreads to new province as epidemic continues to spiral

Via The Guardian: Congo Ebola outbreak spreads to new province as epidemic continues to spiral. Excerpt:

The year-long Ebola outbreak in the Democratic Republic of the Congo has spread to a new province, with two cases – one of them fatal – confirmed in South Kivu.  

The confirmed cases were reported in the Mwenga area, some way south of the city of Bukavu, which sits on the country’s eastern border with Rwanda.  

The latest cases, which have been concentrated around the cities of Beni and Butembo, follow recent deaths from the disease in the major city of Goma. 

The Ebola outbreak in eastern DRC has killed 1,808 people out of 2,765 confirmed cases, according to the ministry of health. The current outbreak, which started in August last year, is the second largest in history.  

One of the two new cases was a 24-year-old woman who had already had been identified last month as a high-risk contact of another Ebola case in Beni, more than 700km north, according to a government statement issued on Friday.  

She travelled by bus, boat and road with her two children to Mwenga, in South Kivu, where she died on Tuesday night, according to a slide from a presentation by health officials. 

Most of the cases reported outside the area of the immediate outbreak, including across the border in Uganda, have involved patients who have travelled from the area at the centre of the outbreak in North Kivu.  

“Two cases which tested positive for Ebola were confirmed overnight in South Kivu, in Lwindi district in the Mwenga region,” the health ministry said in a statement.  

The new cases are “a 24-year-old woman and her seven-month-old child,” said Dr Jean-Jacques Muyembe, the director of DRC’s National Institute for Biomedical Research, in a statement released on Friday. The child is being treated.  

The woman had received the experimental vaccine that has been used widely to inoculate contacts. However, the vaccine is not infallible, although it is believed to protect about 97% of those who have received it. 

The new cases will again raise serious questions about whether the large-scale, international-led health response to the Congolese Ebola crisis is capable of containing the outbreak, which has been described by some officials as the most complex public health emergency in history.

Ebola in South Kivu: Governor Theo Kasi hails 'the vigilance of the response teams' and reassures neighboring countries

Via 7sur7.cd, news of an unwelcome development: Ebola in South Kivu: Governor Theo Kasi hails "the vigilance of the response teams" and reassures neighboring countries. As the map shows, Mwenga is 400 km by road from Goma. The Google translation:

In a message to the people of his jurisdiction after the confirmation of the Ebola virus cases in the Mwenga territory, the governor of South Kivu province, Theo Ngwabidje Kasi, salutes the vigilance of the response teams committed in this territory that have "rapidly detected and isolated" cases.  

On Friday, Aug. 16, Theo Ngwabidje chaired a meeting with public health experts to discuss steps that will need to be taken to strengthen surveillance at entry and exit points to prevent further spread.  

He announced that national coordination teams are already deployed in the region.  

"Thanks to the vigilance of our response teams, two cases of importation of Ebola virus disease have been confirmed in the Mwenga territory more than 100 kilometers from Bukavu." National coordination teams came to support to effectively contribute to the fight against this epidemic," he said.  

Theo Ngwabidje announced the vaccination of already listed contacts.  

"At the moment, all cases of contact are being listed for daily monitoring, this is the vaccine and we are happy to have it here, and I urge people to trust the politico-administrative authorities. who have made all the necessary arrangements," he concluded.

DRC Ebola: 10 new cases on August 14, 8 deaths, 4 recoveries

The Technical Secretariat did not send out its August 15 update until late last night. Here is an excerpt from the Google translation:

MULTISECTORAL NATIONAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE

TECHNICAL SECRETARIAT

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT AUGUST 14, 2019.

Date: Thursday, August 15, 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,852, of which 2,758 confirmed and 94 probable. In total, there were 1,913 deaths (1,819 confirmed and 94 probable) and 848 people healed.

• 353 suspected cases under investigation;

• 10 new confirmed cases, including 9 in North Kivu, including 4 in Beni, 3 in Kalunguta, 2 in Katwa and 1 in Ituri in Mandima;

• 8 new confirmed deaths, including 7 in North Kivu and 1 in Ituri:

º 2 community deaths, including 1 in North Kivu in Kalunguta and 1 in Ituri in Mandima;

º 5 deaths in CTEs in North Kivu, including 3 in Beni, 1 in Katwa and 1 in Mabalako;

º 1 death in the CT in North Kivu in Beni;

• 4 cured people released from CTEs, including 3 in North Kivu in Beni and 1 in Ituri in Komanda;

• One health worker, living and vaccinated, is one of the new confirmed cases in Katwa. The cumulative number of confirmed/probable cases among health workers is 153 (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.

News

Closing in Goma of the cross-border meeting between Rwanda, Uganda, South Sudan and the DRC on the MVE

• The cross-border meeting on the EVD, which brought together the DRC, Rwanda, Uganda, Burundi and South Sudan, ended on Thursday, August 15, 2019. From this meeting, several recommendations emerged from which the establishment bilateral collaboration with the DRC and sharing of expertise, development of memoranda of understanding, protocols and standard operating procedures to guide areas for such collaboration, establishment of common cross-border monitoring and joint response between DRC, Rwanda, Uganda, Burundi and South Sudan, as well as the acceleration of emergency health expert travel and joint assessments to consolidate lessons learned and make recommendations. according to the IHR at the end of the epidemic;

• In addition, WHO and other partners will provide technical and financial assistance to countries to monitor and implement the recommendations, convene a high-level political meeting and follow up on the implementation of the recommendations;

• This two-day meeting brought together health experts from four countries and different stakeholders in the response. It was organized by WHO to respond to its July 2019 decision in Geneva to place the 10th EVD epidemic in the DRC as a health emergency of international concern. However, WHO has recommended that all neighboring DRC countries prepare to effectively treat potential cases of Ebola and other health emergencies;

• It aimed to discuss measures to strengthen cross-border collaboration between the DRC and these three countries with Ebola response preparedness as a first priority. Participants discussed, in turn, several themes, including the situation of the EVD outbreak in the DRC, the status of activities and emergency preparedness capacities in the districts bordering the DRC. DRC, the overview of the fourth edition of the Strategic Response Plan, strengthening the functions and operational framework of the mandatory and optional National Focal Points (NFPs) of the IHR and improving cross-border collaboration in the context of the HIV / AIDS epidemic. EVD in the DRC.

• Next steps will be the development and finalization of the bilateral roadmaps for the implementation of the above recommendations with concrete timelines and resources, as well as the organization of a high-level political meeting to encourage political ownership and mobilization of domestic resources.

Organization of a press conference on the success of two out of four molecules used against EVD in the provinces of North Kivu and Ituri

• The Technical Secretary of the multisectoral committee against Ebola Prof. Dr. Jean-Jacques Muyembe announced this Thursday, August 15, 2019 the victory of two effective molecules to cure Ebola Virus Disease;

• These are mAb114 and Regeneron, two of the most advanced molecules among the four molecules, whose protocol is applied under the acronym MEURI (Mab114, Regeneron, ZMapp and Remdesivir) set up as soon as this 10th epidemic is declared by the Expert Committee convened by WHO;

• Mab114 is a monoclonal antibody isolated from the blood of a survivor of the Ebola outbreak in Kikwit. This is the result of a study conducted for a decade by the National Institute of Biomedical Research (INRB) in collaboration with the United States National Institute of Health (NIH);

• The therapeutic efficacy of these two molecules was confirmed by a randomized, controlled study initiated since November 20, 2018 by the INRB in collaboration with NIH and some international NGOs, including Médecins sans frontières (MSF) and the Alliance for International Medical Action (ALIMA), coordinated by WHO with the approval of the Ethics Committees of the DRC School of Public Health and the US NIH;

• "These very encouraging results allow us to say that Ebola is no longer a non-incurable disease, but today there are drugs, one of which is a product of collaboration with Congolese scientists," said Muyembe.

• The press conference was held in front of Health Secretary Sylvain Yuma Ramazani, Health Minister Mukengeshay Kupa's Office Director, and US Ambassador Michael A. Hammer, as well as several researchers from the Ministry of Health.

WHO: Ebola virus disease – Democratic Republic of the Congo

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

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks, with an average of 81 cases per week (range 68 to 91 cases per week) in the past six weeks (Figure 1). There are currently no confirmed cases of EVD outside of the Democratic Republic of the Congo. 

This week, initial data from a randomized clinical trial (RCT) of EVD therapeutics were announced. The data showed that two of the four treatments trialled were more effective in treating EVD. As a result, patients in the four Ebola treatment centres that participated in the RCT will now be randomized to receive the two better performing treatments. Patients in treatment centres not participating in the RCT will continue to be able to access those treatments under a compassionate use protocol. This change will help ensure that every treatment centre patient receives the best possible treatment with the greatest chance of survival, based on the most recent evidence. 

The data indicates that when people are willing and able to access care soon after the onset of symptoms, they have an increased chance of survival. Providing each patient with optimal supportive care, closely monitoring their progress, and addressing any other health issues has saved lives and will continue to be a top priority. More information is available in the following update and press release.  

No new confirmed cases have been reported in Goma city since our last report, with a total of four confirmed cases reported from Goma (n=1) and Nyiragongo (n=3) health zones to date. Two cases, who were infected via direct contact with the case reported on 30 July, received treatment at an Ebola Treatment Centre in Goma city and were discharged on 13 August. A total of 203 contacts of the Nyiragongo cases remain under surveillance.  

In the 21 days from 24 July through 13 August 2019, 66 health areas within 17 health zones reported new cases (Table 1, Figure 2). During this period, a total of 228 confirmed cases were reported, with the majority coming from the health zones of Beni (42%, n=96) and Mandima (20%, n=46). A case was confirmed in Lolwa Health Zone, which is the first confirmed case in that health zone to date, bringing the total number of affected health zones over the course of the outbreak to 27. The case travelled from Mandima to Lolwa, where they became symptomatic. Currently, there is no evidence of local transmission of EVD in this health zone. Close identification and follow up of contacts is ongoing to minimize the chance of local transmission. 

New infections continue to be reported among personnel working in community health posts and other facilities. In the last 21 days, 11 new cases were reported among health workers from Beni (n=3), Mandima (n=2), and one each in Katwa, Mabalako, Mambasa, Masereka, Mutwanga, and Vuhovi. Cumulatively, 151 (5%) health workers have been infected to date.  

As of 13 August, a total of 2842 EVD cases were reported, including 2748 confirmed and 94 probable cases, of which 1905 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 57% (1608) were female, and 29% (815) were children aged less than 18 years.

DRC Ebola: 10 new cases on August 14, 21 this week, 2,758 total

The MoH/WHO AFRO Ebola DRC KIVU 2018 Dashboard reports 10 new cases on August 14, making 21 so far this week, 228 in the past 21 days, and 2,852 since the outbreak began. Deaths are now at 1,905 and 842 have recovered.

DRC Ebola: 5 new cases on August 13, 7 deaths, 9 recoveries

Via email, the Technical Secretariat has published the August 14 update, with numbers up to August 13:

MULTISECTORAL NATIONAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE

TECHNICAL SECRETARIAT

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT AUGUST 13, 2019.

Date: Wednesday, August 14, 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,842, 2,748 confirmed and 94 probable. In total, there were 1,905 deaths (1,811 confirmed and 94 probable) and 844 people healed.

• 380 suspected cases under investigation;

• 5 new confirmed cases, including 4 in North Kivu, including 2 in Beni, 1 in Butembo, 1 in Kalunguta and 1 in Ituri in Komanda;

• 7 new confirmed deaths, including 5 in North Kivu and 2 in Ituri:

º 2 community deaths, including 1 in North Kivu in Kalunguta and 1 in Ituri in Komanda;

º 4 deaths in CTEs, including 3 in North Kivu, including 1 in Butembo, 1 in Katwa and 1 in Mabalako and 1 in Ituri in Komanda;

º 1 death in the CT in North Kivu in Beni;

• 9 people healed from ETCs in North Kivu, including 4 in Katwa, 3 in Beni and 2 in Goma;

• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 152 (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.

*News*

Cross-border meeting between Rwanda, Uganda, Burundi, South Sudan and the DRC_ held in Goma

• The World Health Organization (WHO) is organizing a trans-boundary meeting between Rwanda, Uganda, Burundi, South Sudan and the DRC from 14 to 15 August 2019 in Goma, North Kivu Province. This meeting is part of the reinforcement of collaboration between the different countries in order to put an end to the Ebola virus epidemic that has been raging since 1 August 2018 in the DRC, precisely in the provinces of North Kivu and Ituri;

• Indeed, the cross-border meeting between these different countries

• follows the decision of WHO to place this 10th epidemic as a health emergency of international concern;

• Several stakeholders took part in this meeting, including the North Kivu Provincial Minister of Health, the Secretary General for Health, the representatives of the Technical Secretariat of the Multisectoral Committee for the Ebola Virus Disease Response (CMRE), including Prof. Stève Ahuka, members of the response coordination, representatives of WHO, IOM, CDC Atlanta and Africa, UNICEF and Ocha.

A dignified and safe burial team threatened in Nyiragongo

• A dignified and secure burial team (EDS) was threatened by stone throwing at the HERI clinic in the Ngangi 3 health area in the Nyirangongo Health Zone. The perpetrators of this incivic act are, in particular some members of the community not yet identified,

• Another DHS team was assaulted by Mai Mai in the Kalunguta Health Zone at the Kivetya Health Zone. The balance is three stolen phones. This behavior justifies the failure of the DHS of a positive body, manipulated and buried by the family in this country.

Vaccination

• Since vaccination began on August 8, 2018, 193,246 people have been vaccinated.

• 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 20 May 2018.

Surveillance at points of entry 

• Disruption of activities at the KANGOTE checkpoint (PoC) in BUTEMBO Following a rumor that the Mai-Mai were around the PoC.

DRC Ebola: 5 new cases, 11 this week, 2,842 total

The MoH/WHO AFRO Ebola DRC KIVU 2018 Dashboard reports 5 new cases on August 13, making 11 so far this week. The last 21 days have seen 238 cases, and 2,842 since the outbreak began. Deaths now total 1,898 and 833 have recovered. Out of 16,400 contacts, 2,100 are going untraced.