H5N1

DRC Ebola: 9 cases on August 17, 8 deaths, 10 recoveries

The Technical Secretariat has published updates for August 17 and 18. Here is an excerpt from the Google translation of the August 18 update:

Date: Sunday, August 18, 2019

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT AUGUST 17, 2019.

Since the beginning of the epidemic, the cumulative number of cases is 2,877, of which 2,783 are confirmed and 94 are probable. In total, there were 1,934 deaths (1,840 confirmed and 94 probable) and 862 people healed.

• 387 suspected cases under investigation;

• 9 new confirmed cases, including 5 in North Kivu, including 2 in Katwa, 1 in Kayna, 1 in Musienene and 1 in Pinga, 3 in Ituri, Mandima and 1 in South Kivu in Mwenga;

• A new health zone has been assigned to North Kivu, the details of which will be provided in our next newsletters;

• 8 new confirmed deaths, including 5 in North Kivu;

º 3 community deaths, including 2 in North Kivu, including 1 in Katwa and 1 in Musienene and 1 in Ituri in Mandima;

º 4 deaths in CTEs in North Kivu, including 2 in Beni, 1 in Butembo and 1 in Katwa;

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

• 10 healed people released from CTEs in North Kivu, including 6 in Mabalako, 3 in Beni and 1 Katwa;

• 1 health worker, living and vaccinated, is one of Kayna's new confirmed cases. The cumulative number of confirmed/probable cases among health workers is 154 (5% of all cases confirmed/probable), 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.

VACCINATION

• Since the beginning of vaccination on August 8, 2018, 197,172 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.

MONITORING AT ENTRY POINTS

• Participation in the motorized caravan in the city of Beni to raise public awareness about health control activities in PoE/PoC with the theme: "Fight against ebola and community involvement." Since the beginning of the epidemic, the accumulation of travelers monitored (temperature measurement) at sanitary control points until 16 August 2019 86,102,617;

• To date, a total of 98 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.

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.

WHO AFRO: Ebola external situation report 54, August 13

WHO AFRO has published External Situation Report: 13 August 2019. Excerpt:

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in Democratic Republic of the Congo (DRC) continues. In the past week, 68 new confirmed EVD cases with an additional 43 deaths have been reported from 13 health zones across the two affected provinces. Most (59%) of the new cases reported in the past seven days were from Beni (n=29) and Mandima (n=11) Health Zones.

Data from a randomized clinical trial were announced this week. The data show, for the first time, that Ebola treatments improve survival rates. Two of the four drugs trialled were found to have the most efficacy, and as a result, changes have been made to the treatment of Ebola patients in the Democratic Republic of the Congo. This should encourage communities to seek care early and is an important step to finding an effective treatment for Ebola. More information is available in the following article, "Update on Ebola drug trial: two strong performers identified".

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. The two remaining cases in Goma city, who were infected via direct contact with the case reported on 30 July, are being discharged from the hospital today. A total of 232 contacts (including 114 high risk contacts) of the Nyiragongo cases remain under surveillance. Ongoing vaccination activities have reached the majority (98%) of eligible contacts, and 1314 contacts, contacts-of-contacts and frontline workers have been vaccinated to date.

A case was confirmed in the 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-patient travelled from Mandima to Lolwa, where symptoms started. Currently, there is no evidence of local transmission of EVD in this health zone. Close follow up and identification of contacts is ongoing to minimize the chance of local transmission.

Of the eight cases reported in Mambasa Health Zone in the past 21 days, the majority have epidemiological links to Somé Health Area, with limited local transmission in Mambasa thus far. On 10 August 2019, a case was detected in Butembo Health Zone who had a protracted travel history from Mongbwalu Health Zone, via Beni. If the date of onset and symptoms is confirmed, this would be the first instance of a case originating from this Health Zone. In depth investigations are ongoing to establish any epidemiological links to this case that can reveal more detail as how and where the case-patient became infected.

In the 21 days from 22 July through 11 August 2019, 69 health areas within 17 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces. During this period, a total of 237 confirmed cases were reported, with the majority coming from the health zones of Beni (43%, n=103) and Mandima (21%, n=50).

As of 11 August 2019, a total of 2831 EVD cases were reported, including 2737 confirmed and 94 probable cases, of which 1892 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases with reported sex and age, 57% (1601) were female, and 29% (810) were children aged less than 18 years. Cases continue to be reported among health workers, with the cumulative number infected rising to 151 (5% of all confirmed and probable cases).

DRC Ebola: 15 new cases on August 11, 4 deaths, no recoveries

I'm happy to say that the Technical Secretariat is now sending out its updates in more usable form. So here is an excerpt from the update for today:

MULTISECTORAL NATIONAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE

TECHNICAL SECRETARIAT

SUBJECT: EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT AUGUST 11, 2019.
Date: Monday, August 12, 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,831, 2,737 confirmed and 94 probable. In total, there were 1,892 deaths (1,798 confirmed and 94 probable) and 833 people healed.

• 334 suspected cases under investigation;

• 15 new confirmed cases, including 14 in North Kivu, including 6 in Beni, 2 in Butembo, 2 in Katwa, 1 in Kalunguta, 1 in Kayna, 1 in Mabalako, 1 in Musienene and 1 in Ituri in Mandima;

• 4 new deaths of confirmed cases in North Kivu:

º 3 community deaths in North Kivu, including 1 in Beni, 1 in Butembo and 1 in Kayna;

º 1 death in CTEs in North Kivu in Butembo;

• No cured person has emerged from CTEs;

• 1 health worker is among the new confirmed cases of Mabalako. 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.

*Vaccination*

• Since vaccination began on August 8, 2018, 191,237 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

• Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 84,128,451.
• To date, a total of 98 PoEs and PoCs have been established in North Kivu and Ituri Provinces to protect prevent the spread of the epidemic in neighboring countries.

DRC Ebola: 15 new cases on August 10, 9 deaths (6 in community), 20 recoveries

The Technical Secretariat has just published updates for August 10 and 11, with tables for both dates—except that they're both for December 12, 2018. I have no idea what the problem is. Well, for what it's worth, here's an excerpt from today's Google-translated report on August 10:

Sunday, August 11, 2019

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 10, 2019.

Date: Sunday, August 11, 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,816, of which 2,722 confirmed and 94 probable. In total, there were 1,888 deaths (1,794 confirmed and 94 probable) and 833 people cured.

• 326 suspected cases under investigation;

• 15 new confirmed cases, including 11 in North Kivu, including 6 in Beni, 2 in Butembo, 1 in Katwa, 1 in Mutwanga and 1 in Vuhovi and 4 in Ituri, including 3 in Mambasa and 1 in Mandima;

• 9 new confirmed deaths, including 6 in North Kivu and 3 in Ituri:

º 6 community deaths, including 3 in North Kivu, including 1 in Beni, 1 in Katwa and 1 in Vuhovi, and 3 in Ituri, including 2 in Mambasa and 1 in Mandima;

º 2 deaths in CTEs in North Kivu, 1 in Beni and 1 in Mabalako;

º 1 death at the CT of Beni;

• 20 people healed out of the CTE of Beni;

• 1 health worker is among the new confirmed cases of Mutwanga. The cumulative number of confirmed/probable cases among health workers is 151 (5% of all confirmed/probable cases), including 41 deaths.

The update also reports 190,787 persons vaccinated and 83,587,883 persons monitored through 98 checkpoints.

Ebola in eastern DRC

Via The Lancet Infectious Diseases, a devastatingly critical comment by Pierre E. Rollin: Ebola in eastern DRC.

When the current Ebola outbreak was declared on Aug 1, 2018, in North Kivu, Democratic Republic of the Congo (DRC), confidence was high that the hundreds of experienced responders and the new therapeutics and vaccines would be able to quickly stop this tenth outbreak in DRC. As of July 28, 2019, 2671 probable and confirmed cases and 1790 probable and confirmed deaths have been reported. Leadership and coordination shortfalls, increased insecurity, mistrust, and denial from both the community and the responders are now hallmarks of the response. 

The ineffectiveness of the collection, analysis, and diffusion of epidemiological data, the centrepiece of any response, is predictive of the situation worsening. The different and mainly incomplete databases combined with the absence of accurate and up-to-date chains of transmission makes case counts, monitoring, and intervention difficult or even impossible. 

Many cases of Ebola virus disease are identified late, with many previous transits through unprepared health-care facilities, or are detected as community deaths. Most of the probable cases (death without laboratory confirmation) are not recorded. Research activities are following a parallel agenda, which often differs from timely intervention goals, with numerous data collections kept for exclusive scientific publications and to advance personal careers. 

Laboratory diagnosis is done at multiple sites by the Institut National de Recherches Biologiques. This achievement is tempered by an overconfidence in the capabilities of the laboratories, incomplete sharing of results with patient providers, low quality-control procedures, and unjustified fear of losing control. Rapid field molecular typing of the virus and bedside rapid diagnostic assays, both seen as a crucial support for the control of the 2014–16 west Africa outbreak, are not done to inform the response. 

Early in the outbreak, new therapeutics were made available first under a monitored emergency use of unregistered and investigational interventions (MEURI) protocol, then through a randomised controlled trial supported by the US National Institutes of Health, the Institut National de Recherches Biologiques, and the DRC Ministry of Health. As of July 30, 2019, 682 patients were recruited under the MEURI and 621 patients under the randomised controlled trial protocol. Late admission of cases due to fear from the community or ineffective follow-up of contacts has complicated the use of therapeutics and vaccines and analyses. 

Ring vaccination of contacts and contacts of contacts of confirmed Ebola cases using rVSV-ZEBOV was rapidly implemented. As of July 27, 2019, 178 121 people have been vaccinated, 31 016 of whom were frontline workers, the rest being contacts and contacts of contacts of Ebola cases. The epidemiological data generated by the vaccination and the contact tracing teams are mostly not shared. As a result, daily field reports have noted at least 651 identified contacts of confirmed cases who were not vaccinated and became cases (among them 205 deaths) between Dec 31, 2018, and July 30, 2019. Vaccination coverage among health-care workers is high but incomplete. 

The initial response should be to generate, maintain, and constantly update the primary databases, then sharing them among all players. Parallel databases should not exist. Because of the field difficulties and the inadequate personnel resources, a single team staffed by the most experienced partners should oversee this task. During the autumn of 2014, a Conakry informal taskforce, consisting of one member from each main partner (Guinea Ministry of Health, WHO, Médecins Sans Frontières, Centers for Disease Control and Prevention) met at least once a week, allowing real fact-based understanding and management of the Ebola situation. This approach needs to be replicated for this outbreak at each level. 

Laboratory support from national and external partners is needed and should provide timely support for clinical management of patients receiving experimental therapeutics or difficult epidemiological investigations, such as cases with multiple or unknown origins. As in the west African outbreak, point-of-care rapid diagnostic tests should be fielded, at least as an evaluation of community deaths. 

The existing vaccination strategy and implementation on the ground, should be drastically changed. A single combined team should follow and vaccinate contacts and contacts of contacts. This policy, combined with a rapid and complete inclusion of all high-risk contacts, should reduce, or at least improve the outcome of, secondary Ebola cases and affect the transmission curve. 

Even if the infection prevention and control efforts have yielded some progress, the relatively large proportion of cases due to reuse of material (eg, syringes, needles, and perfusion tubes) is unacceptable. More emphasis on the multiple risks of this practice should be advertised among the care providers and the population. 

Helping the existing local health-care providers to regain the population's confidence is crucial. This should be done by introducing a comprehensive health system with actions that encompass the health-related problems encountered daily by the population—eg, malaria, vaccine-preventable diseases, childbirth, and quality of care. 

Together with the presence of violence and insecurity, Ebola virus disease has a real chance of becoming endemic in this part of DRC. Only multiple and immediate changes, starting within the leadership and coordination of all the partners involved through inclusive, flexible, and unified response efforts, will be able to reverse the trend.

WHO: Ebola virus disease – DR 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 86 cases per week (range 80 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. 

In the 21 days from 17 July through 6 August 2019, 65 health areas within 16 health zones reported new cases (Table 1, Figure 2). During this period, a total of 257 confirmed cases were reported, with the majority coming from the health zones of Beni (46%, n=119) and Mandima (23%, n=58). The majority of recent cases in Mandima Health Zone were reported from the northern health areas of Somé (n=39) and Mayuano (n=8). Of the eight cases reported in Mambasa Health Zone in the past 21 days, the majority have epidemiological links to Somé Health Area, with limited local transmission in Mambasa thus far.  

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. Of the four cases, two have died and two are in an Ebola Treatment Centre(ETC). On 3 August, all 256 contacts related to the first confirmed case in Goma Health Zone (reported 14 July), finished their 21-day follow up period. A total of 232 contacts (including 114 high risk contacts) of the Nyiragongo cases remain under surveillance. Ongoing vaccination activities have reached the majority (98%) of eligible contacts, and 1314 contacts, contacts of contacts and frontline workers vaccinated to date.  

New infections continue to be reported among personnel working in community health posts and other facilities. In the last 21 days, 14 new cases were reported among health workers from Mandima (n=5), Beni (n=4), and one each in Katwa, Mambasa, Masereka, Oicha, and Vuhovi. Cumulatively, 149 (5%) healthcare workers have been infected to date.  

As of 6 August, a total of 2781 EVD cases were reported, including 2687 confirmed and 94 probable cases, of which 1866 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1572) were female, and 28% (791) were children aged less than 18 years.

DRC Ebola: External Situation Report 53: 6 August 2019

WHO AFRO has published External Situation Report 53: 6 August 2019. Excerpt:

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in Democratic Republic of the Congo continues at a similar transmission intensity to previous weeks. Since our last external situation report, with data reported up to 28 July 2019, 92 new confirmed EVD cases with an additional 59 deaths have been reported across the two affected provinces. There are currently no confirmed cases of EVD outside the Democratic Republic of the Congo.

Hotspots continue to be the source of cases in other areas through the movement of suspected and confirmed cases and their contacts. This was observed on 30 July 2019 when a confirmed case was reported in Nyiragongo Health Zone on the outskirts of Goma city. This case-patient was a miner in Ituri and travelled to Goma through several hotspot areas. Two family members of the case-patient, a child and his spouse, have tested positive and are receiving care in the Goma Ebola Treatment Centre (ETC). There is currently no indication of an epidemiological link between these cases and the first case identified in Goma on 14 July 2019. All 256 contacts related to the confirmed case, who was reported on 14 July in Goma, finished their 21-day follow up period on 3 August 2019.

In the 21 days from 15 July through 4 August 2019, 68 health areas within 16 health zones reported new cases, representing 10% of the 664 health areas within North Kivu and Ituri provinces. During this period, a total of 260 confirmed cases were reported, with the majority coming from the health zones of Beni (46%, n=120) and Mandima (21%, n=54). The number of cases reported from Somé Health Area in Mandima Health Zone continues to increase, with 74% (n=40) of the total cases observed in this health zone in the last 21 days. The response in Somé Health Area was challenging for several weeks due to tension between local communities and Ebola response teams. The situation has recently improved following dialogues with community leaders to understand the community’s perspective and to define common ground for collaboration.

As of 4 August 2019, a total of 2763 EVD cases were reported, including 2669 confirmed and 94 probable cases, of which 1849 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases with reported sex and age, 57% (1562) were female, and 28% (787) were children aged less than 18 years. Cases continue to be reported among health workers, with the cumulative number infected rising to 149 (5% of all confirmed and probable cases).

1 August 2019 marked one year since the Government of the Democratic Republic of the Congo declared the Ebola outbreak. UN partners reaffirmed our collective commitment to the people of the Democratic Republic of the Congo, and called for solidarity to end the outbreak.

DRC Ebola: 10 new cases, 6 deaths (1 in community), 1 recovery

We're now getting the daily update, but in a new format that's going to involve a lot of extra work to put it into readable form here. Here's my first shot at it, Google translated:

Monday, August 05, 2019

MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE 

TECHNICAL SECRETARIAT                                      

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI AT AUGUST 04, 2019.

Monday, August 5th, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 2,763, of which 2,669 confirmed and 94 probable. In total, there were 1,849 deaths (1,755 confirmed and 94 probable) and 797 people healed. 

• 282 suspected cases under investigation;

• 10 new confirmed cases, including 7 in North Kivu, including 3 in Katwa, 2 in Beni and 2 in Butembo and 3 in Ituri in Mandima;

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

º 1 community deaths in North Kivu in Beni;

º 5 deaths in CTEs, including 4 in North Kivu, including 2 in Beni, 1 in Butembo and 1 in Mabalako, and 1 in Ituri in Komanda;

º No TB deaths;

• 1 person cured out of Butembo CTE;

• 1 health worker is one of the new confirmed cases in Katwa. The cumulative number of confirmed / probable cases among health workers is 150 (5% of all confirmed / probable cases), including 41 deaths.

• Recovery of cases: 1 case of Kalunguta and 1 case of Masereka have been reclassified in their respective Detection Health Zone, notably in Katwa and Butembo.

/! \ 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

Interim Minister of Health's ground trip to Goma

• Interim Health Minister Pierre Kangudia Mbay arrived on Monday, August 5, 2019 in Goma, North Kivu Province, to take stock of the situation of the response to the Ebola Virus Disease. He commended the efforts of all the teams working for the EVD response in the provinces of North Kivu and Ituriri, in particular the technical secretary of the National Multisectoral Committee for the Response to Ebola Virus Disease Teacher. Dr. Jean-Jacques Muyembe;

• His visit is also to prepare a roadmap to be proposed in Rwanda, where will be held from Tuesday, August 06, 2019 a large meeting on the EVD in order to quickly end this disease;

• The situation of the fight against Ebola Virus Disease, which is of the utmost concern to the entire authority of the Democratic Republic of the Congo, especially the Head of State, President Félix Antoine Tshisekedi, also concerns all the neighbors of the DRC, as well as the international community.

Vaccination

• Since the start of vaccination on August 8, 2018, 185,289 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

• Support by Republican Guard elements to GOMA PoE / PoC sanitary control activities.

• Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 81,769,759.

• To date, a total of 98 entry points (PoE) and sanitary control points (PoCs) have been established 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.