H5N1

WHO AFRO - Situation Report #33 - Ebola virus disease outbreak in DRC

WHO AFRO has published Situation Report - Ebola Virus Disease Outbreak in DRC - Sitrep 33 (2019).

The Ebola virus disease (EVD) outbreak in the North Kivu and Ituri provinces has recently shown an increase in the number of cases reported by week, after many weeks of overall decline. This rise is not unexpected and likely due, in part, to the recently increased security challenges, including direct attacks on treatment centres, and pockets of community mistrust, which slowed some response activities in affected areas for a few days. 

While Katwa and Butembo remain major hotspots, clusters of cases with onward transmission have been reported in other health zones such as Mandima, Masereka and Vuhovi, which is concerning. Response teams are working actively in these areas to limit local transmission. 

During the last 21 days (25 February – 17 March 2019), no new cases have been detected in nine of the 20 health zones that have been affected during the outbreak. Moreover, the outbreak is currently limited to 34 health areas within 11 health zones; 19% of the 128 health areas affected to date. During this period, a total of 86 confirmed cases were reported from Katwa (35), Butembo (13), Mandima (12), Masereka (8), Vuhovi (6), Kalunguta (5), Kyondo (2), Lubero (2), Kyaina (1), Mabalako (1) and Biena (1). 

As of 17 March 2019, a total of 960 EVD cases, including 895 confirmed and 65 probable cases, were reported. A total of 603 deaths were reported (overall case fatality ratio 63%), including 538 deaths among confirmed cases. Of confirmed and probable cases with reported age and sex, 57% (542/959) were female, and 30% (287/960) were children aged less than 18 years. 

Three additional healthcare worker infections were confirmed this week; cumulatively 77 healthcare worker infections have been reported, including 26 deaths. 

The Ministry of Health (MoH), WHO and partners continue to monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo and in neighbouring countries. To date, all reported alerts outside the outbreak affected areas have been investigated or laboratory tested to rule out EVD.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri to Tuesday March 19 2019

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri to Tuesday, March 19, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Tuesday, March 19, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 18, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 968, 903 confirmed and 65 probable. In total, there were 606 deaths (541 confirmed and 65 probable) and 315 people cured. 

• 234 suspected cases under investigation; 

• 8 new confirmed cases, including 4 in Masereka, 2 in Katwa, 1 in Kayina and 1 in Mandima;  

• 3 new deaths of confirmed cases, including 

º 2 community deaths: 1 in Katwa and 1 in Mandima; 

º 1 death at the CTE of Butembo; 

• 1 new patient cured out of CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas. 

News of the response   

Vaccination  

• Since the start of vaccination on 8 August 2018, 89,656 people have been vaccinated , including 22,470 in Katwa, 20,977 in Beni, 10,972 in Butembo, 6,109 in Mabalako, 2,985 in Kalunguta, 2,811 in Goma, 2,700 in Mandima, 2,317 in Komanda, 2.114 to Oicha, 1.430 to Kayina, 1.389 to Kyondo, 1.357 to Karisimbi, 1.315 to Bunia, 1.229 to Masereka, 1.124 to Vuhovi, 1.021 to Lubero, 831 to Biena, 806 to Musienene, 772 to Mutwanga, 690 to Rutshuru, 557 to Rwampara (Ituri), 527 to Nyankunde, 496 to Mangurujipa, 355 to Tchomia, 333 to Lolwa, 280 to Mambasa, 254 to Alimbongo, 250 to Mweso, 245 to Kibirizi, 207 to Kirotshe, 161 to Nyiragongo, 97 to Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri to Monday March 18 2019

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri to Monday, March 18, 2019. Not good: Nine new cases, and five deaths—four of them community deaths. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Monday, March 18, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 17, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 960, 895 confirmed and 65 probable. In total, there were 603 deaths (538 confirmed and 65 probable) and 314 people cured. 

• 172 suspected cases under investigation; 

• 9 new confirmed cases, including 3 in Katwa, 2 in Vuhovi, 2 in Masereka, 1 in Butembo and 1 in Kalunguta;  

• 5 new deaths of confirmed cases, including 

º 4 community deaths, including 3 in Katwa and 1 in Kalunguta; 

º 1 death at the CTE of Butembo; 

• 2 new patients recovered from CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health area. 

News of the response   

Vaccination  

• Since the start of vaccination on 8 August 2018, 89,173 people have been vaccinated , including 22,470 in Katwa, 20,956 in Beni, 10,972 in Butembo, 6,109 in Mabalako, 2,985 in Kalunguta, 2,811 in Goma, 2,700 in Mandima, 2,317 in Komanda, 2.114 to Oicha, 1.430 to Kayina, 1.389 to Kyondo, 1.357 to Karisimbi, 1.315 to Bunia, 1.229 to Masereka, 1.124 to Vuhovi, 1.021 to Lubero, 831 to Biena, 806 to Musienene, 772 to Mutwanga, 690 to Rutshuru, 557 to Rwampara (Ituri), 527 to Nyankunde, 496 to Mangurujipa, 355 to Tchomia, 333 to Lolwa, 280 to Mambasa, 254 to Alimbongo, 250 to Mweso, 245 to Kibirizi, 207 to Kirotshe, 161 to Nyiragongo, 97 to Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri to Sunday March 17 2019

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri to Sunday, March 17, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Sunday, March 17, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 16, 2019: 

•Since the beginning of the epidemic, the cumulative number of cases is 951, 886 confirmed and 65 probable. In total, there were 598 deaths (533 confirmed and 65 probable) and 312 people cured. 

• 231 suspected cases under investigation; 

• 8 new confirmed cases, including 3 in Katwa, 3 in Vuhovi, and 2 in Masereka;  

• 4 new confirmed case deaths, including 

º 2 community deaths, including 1 in Vuhovi and 1 in Katwa; 

º 2 deaths at the CTE, including 1 in Butembo and 1 in Beni (identification of the origin of the patient in progress); 

• 1 new patient cured out of CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas. 

News of the response 

Case clusters in Vuhovi and Masereka 

• The case cluster in Vuhovi is made up of family members who were reluctant to respond. After several days of refusing to vaccinate and follow up contacts, several members of this family became ill at the same time. Following the last community death in this family, several neighbors and other villagers moved and asked to be vaccinated. After discussions with the community engagement and psycho-social care teams, the family leaders themselves undertook, in a letter addressed to the coordination of the response, not to oppose to their activities. They asked that their sick relatives be transferred to the CTE and that the rest of the family be vaccinated. 

•  Masereka's cases are family members of another confirmed patient who died on March 4, 2019.  

Vaccination  

• Since vaccination began on August 8, 2018, 88,719 people have been vaccinated , including 22,412 in Katwa, 20,909 in Beni, 10,966 in Butembo, 6,109 in Mabalako, 2,985 in Kalunguta, 2,791 in Goma, 2,607 in Mandima, 2,317 in Komanda, 2,144 to Oicha, 1,389 to Kyondo, 1,380 to Kayina, 1,357 to Karisimbi, 1,315 to Bunia, 1,169 to Masereka, 1,064 to Vuhovi, 1,021 to Lubero, 806 to Musienene, 772 to Mutwanga, 771 to Biena, 690 to Rutshuru, 557 to Rwampara (Ituri), 527 to Nyankunde, 496 to Mangurujipa, 355 to Tchomia, 333 to Lolwa, 280 to Mambasa, 254 to Alimbongo, 250 to Mweso, 245 to Kibirizi, 207 to Kirotshe, 161 to Nyiragongo, 97 to Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Saturday March 16 2019

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 Saturday, March 16, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Saturday, March 16, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 15, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 943, of which 878 are confirmed and 65 are probable. In total, there were 594 deaths (529 confirmed and 65 probable) and 311 people healed. 

• 237 suspected cases under investigation; 

• 7 new confirmed cases, including 2 in Kyondo, 2 in Katwa, 1 in Butembo, 1 in Masereka and 1 in Vuhovi;  

• 3 new deaths of confirmed cases, including 

º 2 community deaths, including 1 in Masereka and 1 in Katwa; 

º 1 death at CTE Mabalako (this is a patient from Mandima); 

• 1 new patient cured out of CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas. 

News of the response     

Vaccination  

• Since vaccination began on August 8, 2018, 88,533 people have been vaccinated , including 22,403 in Katwa, 20,882 in Beni, 10,966 in Butembo, 6,109 in Mabalako, 2,985 in Kalunguta, 2,771 in Goma, 2,575 in Mandima, 2,317 in Komanda, 2,084 in Oicha, 1,389 in Kyondo, 1,357 in Karisimbi, 1,340 in Kayina, 1,315 in Bunia, 1,169 in Masereka, 1,064 in Vuhovi, 1,021 in Lubero, 806 in Musienene, 772 in Mutwanga, 771 in Biena, 690 in Rutshuru, 529 in Rwampara (Ituri), 527 in Nyankunde, 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri to Friday March 15 2019

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri to Friday, March 15, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Friday, March 15, 2019   

The epidemiological situation of the Ebola Virus Disease dated 14 March 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 936, 871 confirmed and 65 probable. In total, there were 591 deaths (526 confirmed and 65 probable) and 310 people cured. 

• 240 suspected cases under investigation; 

• 4 new confirmed cases, including 1 in Mandima, 1 in Katwa, 1 in Butembo and 1 in Kayina;  

• 4 new confirmed case deaths, including 

º 2 community deaths, including 1 in Mandima and 1 in Butembo; 

º 2 deaths at CTE, including 1 Mabalako and 1 in Beni (these are 2 cases notified to Mandima reported in the bulletin of Thursday, March 14, 2019); 

• 1 new patient cured out of CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas.

News of the response     

Vaccination  

• Since the start of vaccination on 8 August 2018, 88,360 people have been vaccinated , including 22,391 in Katwa, 20,857 in Beni, 10,966 in Butembo, 6,109 in Mabalako, 2,935 in Kalunguta, 2,731 in Goma, 2,575 in Mandima, 2,317 in Komanda, 2,084 to Oicha, 1,389 to Kyondo, 1,357 to Karisimbi, 1,340 to Kayina, 1,315 to Bunia, 1,169 to Masereka, 1,064 to Vuhovi, 985 to Lubero, 806 to Musienene, 772 to Mutwanga, 771 to Biena, 690 to Rutshuru, 527 in Nyankunde, 519 in Rwampara (Ituri), 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

EBOLA DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Thursday March 14 2019

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 Thursday, March 14, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Thursday, March 14, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 13, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 932, of which 867 are confirmed and 65 are probable. In total, there were 587 deaths (522 confirmed and 65 probable) and 309 people cured. 

• 210 suspected cases under investigation; 

• 5 new confirmed cases, including 3 in Mandima, 1 in Kalunguta and 1 in Lubero;  

• 3 new deaths of confirmed cases, including 

º 1 community death in Mandima; 

º 2 deaths at Butembo CTE; 

• 1 new patient cured out of CTE Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas.

News of the response    

Incident at Biena 

• The Mambowa Transit Center, in the Biena Health Zone, was ransacked by the mob following the refusal of the population to allow a team to retake a sample from the body of a man suspected of having died of Ebola in a local health center. The crowd also attacked Biena's General Reference Hospital, including a newly rehabilitated building. 

• The police intervened to disperse the crowd. Unfortunately, one young man died after being hit by a stray bullet and another was injured. All response activities were suspended for the day.  

• A delegation consisting of the administrator of the territory and several notables of the region will go to Biena from Friday, March 15, 2019 to discuss with the population to appease the situation. The Ministry of Health has asked the Ministry of the Interior to open an investigation into the incidents that occurred during the day.   

Vaccination  

• Since vaccination began on August 8, 2018, 87,985 people have been vaccinated , including 22,336 in Katwa, 20,849 in Beni, 10,939 in Butembo, 6,109 in Mabalako, 2,935 in Kalunguta, 2,683 in Goma, 2,453 in Mandima, 2,317 in Komanda, 2,084 to Oicha, 1,389 to Kyondo, 1,357 to Karisimbi, 1,340 to Kayina, 1,315 to Bunia, 1,136 to Masereka, 1,064 to Vuhovi, 957 to Lubero, 772 to Mutwanga, 767 to Biena, 756 to Musienene, 690 to Rutshuru, 527 in Nyankunde, 519 in Rwampara (Ituri), 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 250 in Mweso, 245 in Kibirizi, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

Ebola DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Wednesday March 13 2019

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, March 13, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Wednesday, March 13, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 12, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 927, of which 862 are confirmed and 65 are probable. In total, there were 584 deaths (519 confirmed and 65 probable) and 308 people healed. 

• 193 suspected cases under investigation; 

• 2 new confirmed cases, including 1 in Mandima and 1 in Kalunguta;  

• No new confirmed case deaths. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas.

News of the response     

• Vaccination  

Since vaccination began on August 8, 2018, 87,668 people have been vaccinated , including 22,275 in Katwa, 20,839 in Beni, 10,908 in Butembo, 6,109 in Mabalako, 2,935 in Kalunguta, 2,643 in Goma, 2,413 in Mandima, 2,317 in Komanda, 2,084 at Oicha, 1,389 at Kyondo, 1,357 at Karisimbi, 1,340 at Kayina, 1,315 at Bunia, 1,109 at Masereka, 1,064 at Vuhovi, 920 at Lubero, 772 at Mutwanga, 767 at Biena, 706 at Musienene, 690 at Rutshuru, 527 in Nyankunde, 519 in Rwampara (Ituri), 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 250 in Mweso, 224 in Kibirizi, 207 in Kirotshe, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

Ebola DRC - Evolution of the response to the Ebola outbreak in North Kivu and Ituri on Tuesday March 12 2019

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri to Tuesday, March 12, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Tuesday, March 12, 2019   

The epidemiological situation of the Ebola Virus Disease  dated March 11, 2019: 

• Since the beginning of the epidemic, the cumulative number of cases is 925, of which 860 are confirmed and 65 are probable. In total, there were 584 deaths (519 confirmed and 65 probable) and 308 people healed. 

• 170 suspected cases under investigation; 

• 2 new confirmed cases, including 1 in Mandima and 1 in Masereka;  

• 2 new deaths of confirmed cases, including 

º 1 community death in Masereka; 

º 1 death at the CTE of Butembo. 

/! \  The data presented in this table are subject to change later, after extensive investigations and after redistribution of cases and deaths in their health areas.

 

News of the response     

Vaccination  

• Since the start of vaccination on 8 August 2018, 87,390 people have been vaccinated , including 22,191 in Katwa, 20,829 in Beni, 10,908 in Butembo, 6,109 in Mabalako, 2,935 in Kalunguta, 2,633 in Goma, 2,399 in Mandima, 2,317 in Komanda, 2,084 in Oicha, 1,370 in Kyondo, 1,357 in Karisimbi, 1,340 in Kayina, 1,315 in Bunia, 1,081 in Masereka, 1,064 in Vuhovi, 857 in Lubero, 772 in Mutwanga, 767 in Biena, 706 in Musienene, 690 in Rutshuru, 527 in Nyankunde, 519 in Rwampara (Ituri), 496 in Mangurujipa, 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 250 in Mweso, 207 in Kirotshe, 174 in Kibirizi, 161 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.  

• 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 19 May 2018.

A systematic review of MERS seroprevalence and viral RNA prevalence in dromedary camels

Via bioRxiv: A systematic review of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) seroprevalence and viral RNA prevalence in dromedary camels: implications for animal vaccination. The abstract and then a comment:

Human infection with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is driven by recurring dromedary-to-human spill-over events, leading decision-makers to consider dromedary vaccination. Dromedary vaccine candidates in the development pipeline are showing hopeful results, but gaps in our understanding of the epidemiology of MERS-CoV in dromedaries must be addressed to design and evaluate potential vaccination strategies. 

We systematically reviewed the published literature reporting seroprevalence and/or prevalence of active MERS-CoV infection in dromedary populations from both cross-sectional and longitudinal studies, including 60 studies in our qualitative syntheses. 

MERS-CoV seroprevalence increased with age up to 80-100% in adult dromedaries supporting geographically wide spread endemicity of MERS-CoV in dromedaries in both the Arabian Peninsula and countries exporting dromedaries from Africa. The high prevalence of active infection measured in juveniles and at sites where dromedary populations mix should guide further investigation – particularly of dromedary movement – and inform vaccination strategy design.

Mike Coston at Avian Flu Diary has been doing an extraordinary job of covering MERS for years, and never more so than in this year's outbreak. By all means check his posts for both breaking news and the detailed background he provides.