H5N1

MSF: Urgent humanitarian response needed to unprecedented crises in northeast DR Congo

MSF.org has published Urgent humanitarian response needed to unprecedented crises in northeast Democratic Republic of Congo.

KISANGANI/GENEVA – Multiple humanitarian crises are unfolding in Ituri province, northeastern Democratic Republic of Congo, and hundreds of thousands of people are in urgent need of humanitarian assistance, according to Médecins Sans Frontières (MSF). 

The recent upsurge in violence across the regions of Djugu, Mahagi and Irumu have forced thousands to flee their homes. Despite MSF’s repeated calls on international aid organisations to scale up humanitarian aid, the majority of the displaced still haven’t received even the most basic assistance.

“Unfortunately, this is not the first time there are important humanitarian needs in the country,” explains Dr Moussa Ousman, MSF Head of Mission in the Democratic Republic of Congo. “This time we are seeing not only mass displacement due to violence but also a rapidly spreading measles outbreak and an Ebola epidemic that shows no signs of slowing down, all at the same time. This is unprecedented.”

Intercommunal violence has been increasing in Ituri since December 2017, and the large majority of people displaced as a result have been in urgent need of humanitarian assistance, some for more than a year. Since October 2018, MSF has conducted three mortality surveys in the locations of Drodro, Nizi and Angumu. All showed that the mortality rates in these communities were far above emergency levels. 

“Our surveys show that people are mainly dying from preventable diseases such as malaria, measles and diarrhoea,” says Dr Ousman. “That is very worrying. Especially as it has not yet been possible to vaccinate against measles because of the ongoing Ebola outbreak, and the fear of Ebola further spreading. Together with the ministry of health, we are looking at what innovative strategies we can implement given the circumstances, but more help is urgently needed here to prevent more deaths.”

MSF is supporting the local ministry of health to provide medical care and respond to the most acute needs of the displaced in Drodro, Nizi and Bunia. Our teams are also providing clean water, distributing relief items and constructing showers and latrines. Nevertheless, the most urgent needs of thousands of families remain unmet. 

MSF urges for an immediate scale up of long-term humanitarian assistance, to prevent the loss of more lives and to ensure decent living conditions for all those who have been forced to flee.

Kenya: Ebola scare in Karatina as two patients isolated

Thanks to Craig Wilson for catching my mistake; I first posted this as a Uganda story. Via The Standard: Ebola scare in Karatina as two patients isolated.

A suspected Ebola case has caused scare at Karatina Hospital in Nyeri County after two patients exhibited Ebola related symptoms. 

The two male patients are said to have presented haemorrhagic fever and were admitted in the isolation unit. 

According to a community health worker at the hospital who declined to be mentioned over sensitivity of the matter told The Standard that the two patients were admitted on Tuesday. 

“The two were bleeding from the ears and nose. They have been isolated in one ward and no one is allowed to be go near them. The ward has been sprayed and any items they use remain in that ward,” said the officer.

Nyeri health Chief Officer Newton Wambugu confirmed that the two were admitted to the hospital but he did not reveal report that blood samples were taken to Kenya Medical Research Institute (Kemri) laboratory in Nairobi for further testing. 

The chief officer however said the two tested positive for malaria. 

The two businessmen from Mathira are said to had traveled through Uganda from Democratic Republic of Congo for a business trip. 

A week ago a patient suspected to have had Ebola virus in Kericho tested negative after blood samples were taken to Kemri laboratory.

DR Congo: A doctor researcher pleads for the cultivation of Artemisia

Via mediacongo.net, a report from The Tropical Storm: Malaria: A doctor researcher pleads for the cultivation of the plant "Artemisia". The Google translation: 

On April 25, humanity celebrated World Malaria Day under the theme: "Zero Malaria! I'm in ". In the Democratic Republic of Congo, at least 15 million people affected by this disease have been registered, especially among children, in 2017. This was stated by the doctor researcher, Dr. Pika Longila, citing as source the Organization World Health Organization (WHO).  

In the face of the challenge of malaria, Dr. Longila pleads for the cultivation of the plant "Artemisia", which is a credible alternative for the developing country. "Even people who are in remote areas can grow at home at home for treatment," he told the newspaper The Storm of the Tropics. This natural remedy against malaria plays a dual role: preventive and curative. 

"We want to give every family the opportunity to have a garden of Artemisia, but people must first be trained in culture," said the representative of Artemisia House in Kinshasa.  

Integrate Artemisia into the pharmacopoeia 

According to this researcher, Artemisia is effective, inexpensive and accessible to everyone. Favoring the Artemisia herbal tea in the case of simple malaria allows patients to escape the influx of fake drugs. This allows those living in remote areas to have this molecule allowing, these days, to overcome many malaria situations around the world. Especially that access to health care and treatment for malaria, including the distribution of insecticide-treated mosquito nets are difficult for many people living in these lost areas. 

According to him, it is necessary to work for the promotion of the tea Artemisia in order to integrate it in the pharmacopoeia and the care of the malaria in the DRC. Dr. Longila supports this approach following comparative scientific research conducted on a sample of 1,000 people in the country, and the results have demonstrated the effectiveness of this plant in the management of malaria with a success of 98%. Thanks to these studies conducted at the University of Paris, some African countries are interested in this plant, including Nigeria, Senegal, Niger, Cameroon, Chad, Burundi, Rwanda, Congo-Brazza and Madagascar. 

No adverse effects  

Generally, this product has no adverse effects except in some patients who do not support its bitter taste, informs the doctor. This product helps post-consumer patients to destroy female Anopheles cells and to fight severe malaria. 

Also, it was pointed out that the scientific studies conducted on this plant distinguish them from charlatans, the case of traditional practitioners. Thus the researchers on this plant sensitize the community in the churches, schools, companies ... through the projection of films in order to favor its appropriation. 

It is since 2015 that the house Artemisia works in the DRC, but very active in the provinces of South Kivu, North Kivu and Kongo-Central. There is also a representation in Kinshasa, in Lubumbashi as well as in other cities of the country. 

As a reminder, the latest report of the World Health Organization (WHO), the number of deaths caused by malaria in 2017, is estimated at 435,000, a figure virtually unchanged from the previous year. This is why the urgency of WHO is to relaunch the global action against malaria, before asking the countries most affected by this disease to appropriate this challenge.

DR Congo: Over 18,000 persons died of malaria in 2018

Via mediacongo.net: WMD 2019: Over 18,000 dead of malaria in 2018. Excerpt from the Google translation:

On the occasion of the commemoration of the 12th JMP 2019, the Minister of Public Health announced that the DRC has recorded more than 18 million cases of malaria in 2018, of which more than 16 million cases of simple malaria and 1.8 million cases of severe malaria. Of this number, 18 thousand people died. 

Placed this year under the theme "Zero Malaria. I commit myself ", the 12th World Malaria Day (JMP 2019) was celebrated yesterday Thursday, April 25th by the international community. In Kinshasa, the Minister of Public Health and the actors of the fight against malaria met on the campus of the Academy of Fine Arts (ABA), in Kinshasa / Gombe, to commemorate and prepare the state of play against the scourge of malaria in the DRC. On this occasion, the Minister of Public Health declared that the celebration of this 12th JMP reminds the suffering conveyed by malaria with its cohort of expenses and deaths unacceptable, because avoidable.  

Malaria, he said, is the leading cause of morbidity, hospitalization and mortality in the country. Thus, this pathology killed silently during the year 2018, more than 18 thousand people in the DRC on more than 18 million cases of malaria, including 16 million cases of simple malaria and more than 1.8 million severe malaria, or nearly 10%. These figures are staggering and must appeal to the national community. 

It is therefore in this sense that we must inscribe the manifestation of the day that encourages awareness and urgent action. It is precisely because of the need to act against this pathology that the Government of the Republic has committed, through the Ministry of Health, to guarantee universal access to key interventions in the fight against malaria for all inhabitants. from the country.

WHO: Malaria vaccine pilot launched in Malawi

A WHO news release: Malaria vaccine pilot launched in Malawi. Excerpt:

WHO welcomes the Government of Malawi’s launch of the world’s first malaria vaccine today in a landmark pilot programme. The country is the first of three in Africa in which the vaccine, known as RTS,S, will be made available to children up to 2 years of age; Ghana and Kenya will introduce the vaccine in the coming weeks. 

Malaria remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250 000 children die from the disease every year. Children under 5 are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435 000 people a year, most of them children.  

“We have seen tremendous gains from bed nets and other measures to control malaria in the last 15 years, but progress has stalled and even reversed in some areas. We need new solutions to get the malaria response back on track, and this vaccine gives us a promising tool to get there,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The malaria vaccine has the potential to save tens of thousands of children’s lives.”  

An innovation milestone, three decades in development 

Thirty years in the making, RTS,S is the first, and to date the only, vaccine that has demonstrated it can significantly reduce malaria in children. In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria  

“Malaria is a constant threat in the African communities where this vaccine will be given. The poorest children suffer the most and are at highest risk of death,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We know the power of vaccines to prevent killer diseases and reach children, including those who may not have immediate access to the doctors, nurses and health facilities they need to save them when severe illness comes.” 

“This is a day to celebrate as we begin to learn more about what this tool can do to change the trajectory of malaria through childhood vaccination,” she added.  

The pilot programme is designed to generate evidence and experience to inform WHO policy recommendations on the broader use of the RTS,S malaria vaccine. It will look at reductions in child deaths; vaccine uptake, including whether parents bring their children on time for the four required doses; and vaccine safety in the context of routine use.  

The vaccine is a complementary malaria control tool – to be added to the core package of WHO-recommended measures for malaria prevention, including the routine use of insecticide-treated bed nets, indoor spraying with insecticides, and the timely use of malaria testing and treatment.

Europe at risk from spread of tropical insect-borne diseases

Via The Guardian: Europe at risk from spread of tropical insect-borne diseases. Excerpt:

Insect-borne diseases such as dengue fever, leishmaniasis and encephalitis are on the rise and are now threatening to spread into many areas of Europe, scientists have warned.  

Outbreaks of these illnesses are increasing because of climate change and the expansion of international travel and trade, the European Congress of Clinical Microbiology and Infectious Diseases was told in Amsterdam on Saturday. 

Even previously unaffected areas in higher latitudes and altitudes, including some parts of northern Europe, are at risk of outbreaks unless action is taken to improve surveillance and data sharing, the researchers said. An adult female mosquito seen under a microscope. 

“Climate change is not the only, or even the main, factor driving the increase in vector-borne diseases across Europe, but it is one of many factors alongside globalisation, socioeconomic development, urbanisation and widespread changes to land use which need to be addressed to limit the importation and spread,” said the lead author Professor Jan Semenza, of the European Centre for Disease Prevention and Control in Stockholm. 

This point was backed by Giovanni Rezza, of the Istituto Superiore di Sanità in Rome. “Lessons from recent outbreaks of the West Nile virus in North America and the chikungunya virus in the Caribbean and Italy highlight the importance of assessing future vector-borne disease risks,” he said.  

Global warming has allowed mosquitoes, ticks and other disease-carrying insects to proliferate, adapt to different seasons and invade new territories across Europe over the past decade, with accompanying outbreaks of dengue in France and Croatia, malaria in Greece, West Nile fever in south-east Europe and chikungunya in Italy and France. 

Worryingly, the authors said, this might only be the tip of the iceberg. “Mediterranean Europe is now a part-time tropical region, where competent vectors like the tiger mosquito are already established,” added Rezza. And in future, hotter and wetter weather could provide ideal conditions for the Asian tiger mosquito, which spreads the viruses that cause dengue and chikungunya, to breed and expand across large parts of Europe, including the south and east of the UK and central Europe.

Venezuela: UN should lead full-scale emergency response

A news release from Human Rights Watch: Venezuela: UN Should Lead Full-Scale Emergency Response. Excerpt:

The combination of severe medicine and food shortages within Venezuela, together with the spread of disease across the country’s borders, amounts to a complex humanitarian emergency that requires a full-scale response by the United Nations secretary-general, researchers from Johns Hopkins Bloomberg School of Public Health and Human Rights Watch said in a report released today. The Venezuelan authorities during the presidency of Nicolás Maduro have proven unable to stem the crisis, and have in fact exacerbated it through their efforts to suppress information about the scale and urgency of the problems.

The 71-page report, “Venezuela’s Humanitarian Emergency: Large-Scale UN Response Needed to Address Health and Food Crises,” documents increased numbers of maternal and infant deaths; the unchecked spread of vaccine-preventable diseases, such as measles and diphtheria; and sharp increases in the transmission of infectious diseases such as malaria and tuberculosis in Venezuela. Available data shows high levels of food insecurity and child malnutrition, as well as of hospital admissions of malnourished children.  

“No matter how hard they try, Venezuelan authorities cannot hide the reality on the ground,” said Shannon Doocy, Ph.D., associate professor of International Health at Johns Hopkins Bloomberg School of Public Health, who conducted research at Venezuela’s border. 

“Venezuela’s health system is in utter collapse, which, combined with widespread food shortages, is piling suffering upon suffering and putting even more Venezuelans at risk. We need UN leadership to help end this severe crisis and save lives.”

Cyclone Idai: ECDC joins emergency response as more cases of cholera and waterborne diseases expected

Via ECDC: Cyclone Idai: ECDC joins emergency response as more cases of cholera and waterborne diseases expected. Excerpt:

Thousands of people are currently displaced in Mozambique, Malawi and Zimbabwe as a consequence of the tropical cyclone Idai, which hit southern Africa on 15 March 2019. The cyclone caused hundreds of fatalities so far and an upsurge of infectious diseases such as cholera. 

According to the World Health Organization (WHO) and as of 30 March, more than 500 deaths have been reported in Mozambique, 172 in Zimbabwe and 59 in Malawi as a result of this cyclone. Cholera cases continue to rise: over 1428 cases and 1 death reported in Mozambique, with 89 people still in treatment centres, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). UN OCHA estimates that 1.6 million people have been affected by cyclone Idai in the three countries, as thousands of houses have been destroyed or flooded.  

Heavy rains, floods, the shortage of portable water, disruption of healthcare services and overcrowding are major factors known to increase the risk of waterborne infections such as cholera and typhoid, but also malaria and measles. 

The areas affected by the cyclone will likely experience infectious disease outbreaks and the number of related deaths is expected to increase in the coming days. A cholera vaccination campaign with 900 000 doses of oral vaccines from the global emergency stockpile has already started this week. 

ECDC has deployed an epidemiologist under the EU Civil Protection Mechanism to assist in the emergency response in Mozambique. The mission will support the humanitarian response with public health assessments and epidemiological advice. ECDC is also producing a risk assessment on the health risks related to this event.

Canadian Red Cross sends team of health workers to Mozambique amid humanitarian crisis

Via The Globe and Mail, Geoffrey York writes: Canadian Red Cross sends team of health workers to Mozambique amid humanitarian crisis. Excerp:

The Canadian Red Cross is sending an emergency field hospital and a team of 25 Canadian health workers to battle a growing humanitarian crisis in Mozambique after a devastating cyclone. 

There are fears of cholera outbreaks and rising malaria infections from the massive flooding in the wake of Cyclone Idai. Stagnant water stretches across 3,000 square kilometres of the country. Several hundred thousand people have lost their homes in the biggest humanitarian disaster in Mozambique’s recent history, and an estimated 1.8 million people need urgent aid, according to the United Nations. 

About 55 health centres in the country have been severely damaged, the World Health Organization said Tuesday. The WHO is sending 900,000 doses of cholera vaccines and 900,000 bed nets to Mozambique to prepare for an expected surge in cholera and malaria cases. Some cholera cases have already been reported.  

Senior UN officials have said the cyclone and flooding may have been the worst weather-related disaster ever to hit the southern hemisphere. The Red Cross has warned that the threat of water-borne diseases such as cholera and malaria is a “ticking bomb” for the region. 

The Canadian Red Cross field hospital, including 53,000 kilograms of medical supplies and three Land Cruisers for mobile health delivery, was flown out of Canada on a Boeing 747 cargo airplane Tuesday and will arrive in Mozambique on Wednesday, along with the 25 health workers and other aid workers. 

Their goal is to help restore medical care in a country where basic services have been drastically disrupted, many clinics do not have electricity and the threat of water-borne diseases is looming.  

“We want to prevent a second disaster from happening,” said Chiran Livera, operations manager at the Canadian Red Cross. 

Mozambique’s doctors and nurses have been working non-stop and are suffering a “tremendous strain,” the Red Cross said.

WHO: Cyclone Idai briefing

WHO has published a Cyclone Idai briefing by Dr. Djamila Cabral, WHO representative in Mozambique:

Last Friday I visited Beira, one of the worst-affected areas that was hit by Tropical Cyclone Idai.  

The devastation is enormous 

More than 100 000 people have lost their homes and all of their possessions. Families, pregnant women, babies are living in temporary camps in horrific conditions, without secure food supplies, or safe drinking water and sanitation. 

Around 55 health centres have been severely damaged. I visited the central hospital in Beira where I saw the direct impact of the cyclone. The flooding had damaged essential equipment and the facility is unable to receive patients during this crucial time. As an example, surgical theatre and nursery completely damaged.  

Official death toll is more than 446 but we expect the real numbers to be much higher. 1.8 million people in Mozambique need urgent humanitarian assistance. 

For WHO, health is our number one priority now 

We must not let these people suffer a second disaster through a serious disease outbreak or inability to access essential health services. They have suffered enough. 

WHO’s Director General, Dr Tedros has called for a "no regrets" approach - this means that we are doing whatever it takes to address the crisis, investing all the available resources now to save lives and protect health.  

We are building up a surge team of over 40 staff from across the Organization, with expertise in logistics, epidemiology, and outbreak prevention and response. 

We have a number of key priorities right now. First to set up an early warning disease detection system so that we can respond rapidly as soon as an outbreak is suspected. Then we need to ensure that, as resources come in, they are immediately put to work.  

There is increased risk of diseases 

We know that after an event like this, there is extremely high risk of diarrhoeal diseases like cholera. WHO is positioning supplies to prepare to treat diarrhoeal diseases – lifesaving intravenous fluids, diagnostic tests, 900 000 doses of oral cholera vaccines are on their way from the global emergency stockpile. We are providing our expertise to set up 3 cholera treatment centres, including an 80-bed treatment centre in Beira.  

We are also preparing for a spike in malaria in the coming weeks by procuring 900 000 insecticide-treated bednets to protect all affected families, and ensure rapid diagnostic tests and antimalarials are positioned to high-risk areas.  

And we are working at top speed to ensure that the people of Mozambique can access essential health services during this crisis to ensure that:  

• people with HIV, TB or diabetes continue to receive their medications 

• thousands of pregnant women are able to receive care for safe childbirth 

• children receive treatment for common infections and are screened (and treated if needed) for acute malnutrition

 • people in need receive psycho-social support and protection from gender-based violence. 

The coming weeks are crucial for WHO in Mozambique. The health sector needs at least $38 million over the next 3 months for the health response to this humanitarian crisis.