H5N1

Ebola DRC: A bad day for the response

The Ministry of Health has published EBOLA DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Tuesday January 22 2019. Yesterday was bad: 10 new cases, 11 deaths (4 in the community) and case total now at 699. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Tuesday, January 22, 2019   

The epidemiological situation of the Ebola Virus Disease  dated 21 January 2019:   

• Since the beginning of the epidemic, the cumulative number of cases is 699, of which 650 confirmed and 49 probable. In total, there were 433 deaths (384 confirmed and 49 probable) and 246 people healed. 

• 252 suspected cases under investigation. 

• 10 new confirmed cases, including 7 in Katwa, 2 in Vuhovi and 1 in Oicha. 

• 11 new confirmed case deaths, including 

º 4 community deaths in Katwa 

º 7 deaths in CTEs: 3 in Katwa, 3 in Butembo and 1 in Beni 

• 1 new person healed out of Butembo CTE.

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

News of the response   

Dignified and secure burials 

• Further strengthening the commitment of the Catholic Church in the response to the Ebola epidemic, Bishop Melchizedek Sikuli Paluku, the Bishop of the Diocese of Butembo-Beni, asked the priests, religious, pastoral agents and faithful of his diocese to strictly adhere to a series of measures in relation to the celebration of Christian funerals. 

• Henceforth, the celebration of funerals in parish churches is subject to the presentation of a certificate of medical examination, also called "SWAB". This involves taking a saliva sample from the deceased person who is then tested in the laboratory to determine if the person was contaminated with the Ebola virus.  

• The accompaniers of patients who carry the Blessed Sacrament to their homes or health facilities must ensure the condition of the sick and take all necessary measures to prevent the administration of the Blessed Sacrament from being a source of contamination or propagation of the epidemic.    

• If there is resistance from a family or a neighborhood to these new measures, the pastoral service will be temporarily suspended, as has already happened in some parishes.   

• As a reminder, Monsignor Melchizedek Sikuli Paluku launched last December the campaign "Family Without Ebola", a project that is part of the citizen campaign "Ebola Pas Chez Moi".   

Safety incident in Komanda 

• On Sunday, January 20, 2019, an altercation broke out between a motorcyclist and health workers placed at a health checkpoint in the Komanda Health Zone. After refusing to wash his hands and submit to temperature control, the rider tried to attack the health workers. The police officers present at the scene then arrested the biker. In protest, a group of bikers decided to attack the health checkpoint, the home base of the response agents and the Komanda response coordination office. Fortunately, thanks to the rapid intervention of the police, the property damage is minimal with a few broken chairs at the coordination office. In total, two agents of the response were slightly injured.    

Vaccination 

• Since the beginning of vaccination on August 8, 2018, 64,403  people have been vaccinated , including 20,116 in Beni, 13,969 in Katwa, 7,414 in Butembo, 5,866 in Mabalako, 2,506 in Kalunguta, 2,080 in Komanda, 1,911 in Goma, 1,663 in Mandima, 1,477 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 789 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 358 in Kayina, 355 in Tchomia, 334 in Biena, 167 in Nyankunde, 127 at Kirotshe, 125 at Nyiragongo, 114 at Alimbongo and 13 at 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.

Branswell: Ebola vaccine supplies are expected to last

Via STAT, Helen Branswell writes: A spot of good news in Ebola crisis: Vaccine supplies are expected to last. Excerpt:

There’s some good news related to an Ebola crisis that has offered very little up until now. The World Health Organization now predicts there are adequate supplies of an experimental Ebola vaccine to control the outbreak in the Democratic Republic of the Congo. 

“I believe we will have enough vaccine to stop this outbreak unless something very dramatic changes,” Dr. Peter Salama, WHO’s deputy director-general of emergency preparedness and response, told STAT. 

And while an ongoing clinical trial of the vaccine may not be complete for some time, preliminary analyses suggest it is working. 

Salama said the evidence the WHO has been gathering in North Kivu — where nearly 64,000 doses have been administered — point to the vaccine being “highly, highly efficacious.” That conclusion, he said, is based on how the vaccine has performed in the people who have received it, on three modeling studies, and on an earlier study of the vaccine conducted in West Africa.  

“So a lot of pieces of evidence that point in absolutely the same direction,” Salama said.

The vaccine is known by a provisional name, V920, and is made by Merck. It was first shown to be protective in people in a landmark clinical trial in Guinea toward the end of the massive West African Ebola crisis of 2014-2016.  

That study tested the vaccine in an approach that is being used in the current outbreak, a ring-vaccination strategy. People who have been in contact with a case — and then all of their contacts — are offered vaccine. People on the front lines of the response — health workers, people who conduct safe burials — are also offered the chance to be vaccinated. 

Salama said the vaccine efficacy rate in the current outbreak is well above 90 percent. He acknowledged there have been a few infections in people who were vaccinated, but said the number — which he declined to specify — is low. “There are very few breakthrough cases,” he said.  

Salama credits the vaccine for the fact that transmission at Beni — a major hot spot for several months — appears to be coming under control, even though the outbreak response teams have had a difficult time there tracing the chains of transmission and recurring violence has hampered their efforts.

Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Monday January 21 2019

The Ministry of Health has published Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Monday January 21 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Monday, January 21, 2019   

The epidemiological situation of the Ebola Virus Disease  dated January 20, 2019:   

• Since the beginning of the epidemic, the cumulative number of cases is 689, of which 640 are confirmed and 49 are probable. In total, there were 422 deaths (373 confirmed and 49 probable) and 245 people cured. 

• 141 suspected cases under investigation. 

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

• 3 new deaths of confirmed cases, including 

º 2 community deaths: 1 in Mabalako and 1 in Katwa 

º 1 at the CTE of Beni.

 

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

News of the response     

Vaccination 

• Since vaccination began on 8 August 2018, 63,750  people have been vaccinated , including 20,094 in Beni, 13,639 in Katwa, 7,314 in Butembo, 5,822 in Mabalako, 2,463 in Kalunguta, 2,080 in Komanda, 1,871 in Goma, 1,663 in Mandima, 1,477 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 789 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 355 in Tchomia, 320 in Biena, 298 in Kayina, 167 in Nyankunde, 127 at Kirotshe, 125 at Nyiragongo, 114 at Alimbongo and 13 at 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 epidemic in North Kivu and Ituri on Sunday January 20 2019

The Ministry of Health has published Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Sunday January 20 2019. Some encouragement: No new cases, and no community deaths. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Sunday 20 January 2019   

The epidemiological situation of the Ebola Virus Disease  dated 19 January 2019:   

• Since the beginning of the epidemic, the cumulative number of cases is 685, of which 636 are confirmed and 49 are probable. In total, there were 419 deaths (370 confirmed and 49 probable) and 245 people cured. 

• 191 suspected cases under investigation. 

• 0 new confirmed case. 

• 3 new deaths of confirmed cases, 2 of which at Butembo CTE and 1 at CTE de Beni. 

• 1 new person healed out of Butembo CTE.

    

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

News of the response     

Vaccination 

• Since vaccination began on August 8, 2018, 63,061  people have been vaccinated , including 20,042 in Beni, 13,449 in Katwa, 7,143 in Butembo, 5,822 in Mabalako, 2,433 in Kalunguta, 2,080 in Komanda, 1,811 in Goma, 1,663 in Mandima, 1,477 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 774 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 355 in Tchomia, 260 in Biena, 238 in Kayina, 167 in Nyankunde, 127 at Kirotshe, 125 at Nyiragongo, 63 at Alimbongo and 13 at 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.

Lassa fever: The question no one could answer

Via healthnews.ng, an important article: Lassa fever: The question no one could answer.

Last week was a big deal in Abuja as Nigeria’s capital city hosted the Lassa Fever International Conference which coincided with the 50th anniversary of the viral hemorrhagic fever that was described for the first time in Nigeria.  

For me, it was also my first time in Abuja in 2019 and I became very curious to know the latest developments in Lassa fever research and truth be told, the conference did not disappoint. 

Researchers and experts in the field of Lassa fever from across the world lived up to expectations. They shared preliminary results of numerous ongoing studies even as regulators expressed their commitment towards ensuring that effective interventions are not delayed unnecessarily. 

But on the sidelines of the conference, I was busy with something else. 

I was having discussions with the various stakeholders in the field of Lassa fever in Nigeria. From the country representative (Nigeria) of the World Health Organisation (WHO) to last-mile project managers in Edo and Ebonyi, everyone exuded confidence in the ability of their ongoing intervention programs to bring about the much needed succor and end to the scourge.   

But I noticed a trend, no one would tell me when they believe the Lassa fever outbreak will end. I asked the question — how soon will Nigeria stop recording new cases? 

Then I began to ponder. If what these people were telling me were sincerely true, why can’t they give a rough estimate of when they expect the country to be declared free of Lassa fever? 

Throughout the first day of the conference, I was scratching for answers. But when the guest speaker at the opening ceremony, Prof Oyewale Tomori, began to speak, I began to realise why no one wanted to tell me in affirmative terms when they believe Lassa fever would leave Nigeria. 

According to him, most of what he said at the conference were taken from his presentation at a similar event to mark the 35th (or thereabout) anniversary of Lassa fever in Nigeria. He said nothing much has changed. He made several compelling arguments that were impossible to dispel and I had to catch up with him the next day to get a much clearer picture of what is truly happening. 

For over one hour, the Nigerian professor of virology told me how things deteriorated and Nigeria made itself more welcoming for Lassa fever. He gave several instances where the same sets of recommendations were given but were not implemented — even those that were provided at the same venue but years apart. 

Prof Tomori who is a regular reader of this editorial drew a connection between Nigeria’s struggle to control Lassa fever and the unending Ebola outbreak in DR Congo.  

When I read the headlines of media coverage on the conference, they largely focused on the Lassa fever vaccine projects which were largely presented as the final nail to the coffin of Lassa fever in Nigeria. But the various vaccine candidates are still far from completing the clinical trials.  

Furthermore, the vaccines are expected to encounter numerous regulatory hurdles since several of them are combining three or more components that will address different processes.   

Even when the vaccines are available, Nigeria’s current vaccine coverage indicates that not everyone will have access to the vaccines. But there is an intervention that everyone can do and is effective. Hygiene. 

Infection prevention and control (IPC) has proven effective in preventing exposure of health workers to Lassa fever at Irrua Specialist Teaching Hospital although health workers in Ebonyi and several other locations ravished by Lassa fever continue to be exposed. 

“It is highly suicidal for healthcare workers to be infected with the Lassa fever.” 

Instead of waiting for vaccines, IPC should be propagated, enforced and domesticated. It is only when these have been achieved that anyone can start talking about when the Lassa fever scourge can end. The good thing about IPC is the fact that it confers protection on individuals against numerous deadly diseases, not just Lassa fever.

Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Saturday January 19 2019

The Ministry of Health has published Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Saturday January 19 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Saturday, January 19, 2019   

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

• Since the beginning of the epidemic, the cumulative number of cases is 685, of which 636 are confirmed and 49 are probable. In total, there were 416 deaths (367 confirmed and 49 probable) and 244 people cured. 

• 142 suspected cases under investigation. 

• 5 new confirmed cases, including 4 in Katwa and 1 in Beni. 

º The case of Beni is the 19-day-old baby of the confirmed case reported in the bulletin of January 18, 2019. 

• 2 new deaths of confirmed cases (all community deaths) in Katwa. 

• 1 new person healed out of Butembo CTE.

    

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

News of the response   

Epidemiological situation in Katwa 

• The health zones of Katwa and Butembo are the main current outbreaks of the epidemic, which reported 65% of new confirmed cases recorded in the last 21 days (58/89).  

• The main difficulty in Katwa is the reluctance of relatives of confirmed cases. The majority of new confirmed cases identified in Katwa are reluctant contacts who have refused vaccination and follow-up of contacts. Thus, the last 10 confirmed cases of Katwa, in the Muchanga health area, have family or neighborhood links.

 

Vaccination 

• Since the beginning of vaccination on 8 August 2018, 62,261  people have been vaccinated , including 20,012 in Beni, 13,269 in Katwa, 6,986 in Butembo, 5,768 in Mabalako, 2,433 in Kalunguta, 2,080 in Komanda, 1,751 in Goma, 1,663 in Mandima, 1,466 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 774 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 355 in Tchomia, 167 in Nyankunde, 127 in Kirotshe, 125 in Nyiragongo, 120 in Biena, 70 in Kayina, 63 in Alimbongo 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 epidemic in North Kivu and Ituri on Friday January 17 2019

The Ministry of Health has published Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Friday January 17 2019. It's alarming to see 12 new confirmed cases and three more community deaths. Excerpt from the Google translation: 

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Friday 18 January 2019   

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

• Since the beginning of the epidemic, the cumulative number of cases is 680, of which 631 are confirmed and 49 are probable. In total, there were 414 deaths (365 confirmed and 49 probable) and 243 people cured. 

• 209 suspected cases under investigation. 

• 12 new confirmed cases, including 6 in Katwa, 2 in Butembo, 1 in Musienene, 1 in Kayina, 1 in Kyondo and 1 in Beni. 

• 4 new deaths of confirmed cases including 

º 3 community deaths in Katwa and  

º 1 hospital death in Beni. 

• 1 new person healed out of Butembo CTE.

 

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

News of the response    

Medical care 

• On Thursday, January 17, 2019, the Governor of Ituri Province, Pacific Keta, inaugurated a new Ebola Treatment Center (ETC) and a laboratory in Makayanga (Komanda). This is the ninth CTE built during this tenth Ebola epidemic after those of Beni, Bunia, Butembo, Goma, Katwa, Mandima, Mangina and Tchomia. This new 28-bed CTE, the third in the province of Ituri, is designed to treat and isolate confirmed and suspected cases of Ebola from the Komanda Health Zone and surrounding areas.  

Vaccination 

• Since the start of vaccination on 8 August 2018, 61,682  people have been vaccinated , including 20,012 in Beni, 13,123 in Katwa, 6,796 in Butembo, 5,751 in Mabalako, 2,433 in Kalunguta, 2,080 in Komanda, 1,751 in Goma, 1,663 in Mandima, 1,406 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 774 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 355 in Tchomia, 167 in Nyankunde, 120 in Biena, 99 in Nyiragongo, 63 in Alimbongo, 57 in Kirotshe 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 January 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 on Thursday, January 17, 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Thursday, January 17, 2019   

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

• Since the beginning of the epidemic, the cumulative number of cases is 668, of which 619 are confirmed and 49 are probable. In total, there were 410 deaths (361 confirmed and 49 probable) and 242 people cured. 

• 136 suspected cases under investigation. 

• 5 new confirmed cases, including 3 in Kayina, 1 in Katwa and 1 in Mangurujipa. 

• 3 new deaths of confirmed cases (all community deaths), 2 in Kayina and 1 in Katwa. 

• 5 new people healed, including 2 exits from Butembo CTE, 2 from Katwa CTE and 1 from CTE in Beni.

  

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

News of the response    

New health zone affected: Kayina 

• Three new confirmed cases, including two community deaths, were detected in the same family in the Kayina Health Zone. This is the 18th health area affected by the Ebola epidemic. The central office of the Kayina Health Zone was alerted to the presence of people with Ebola-compatible symptoms in their territory. A registered nurse visited the home concerned on 13 January 2019 and made three samples that were sent to Butembo. The three samples returned positive and two of the three patients died meanwhile on January 14, 2019.  

• Investigations are underway to determine the health zone in which the three people were infected and to identify the chain of transmission. 

• A joint team of epidemiologists, communicators, vaccinators and WASH experts (prevention and control of infections) arrived in Kayina to launch priority actions to contain the epidemic in this area. A reinforcement of the teams at the health zone of Lubero is also planned. 

Vaccination 

• Since the start of vaccination on 8 August 2018, 61,201  people have been vaccinated , including 19,990 in Beni, 12,815 in Katwa, 6,796 in Butembo, 5,741 in Mabalako, 2,433 in Kalunguta, 2,080 in Komanda, 1,751 in Goma, 1,663 in Mandima, 1,406 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 750 in Masereka, 735 in Kyondo, 700 in Lubero, 599 in Mutwanga, 442 in Musienene, 434 in Bunia, 355 in Tchomia, 167 in Nyankunde, 120 in Biena, 63 in Alimbongo, 54 to Nyiragongo and 13 to 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.

WHO AFRO: Ebola update, week 2

WHO AFRO has published its Weekly Bulletin on Outbreaks and Other Emergencies for week 2 (January 5-11 2019). Excerpt:

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo persists and continues to be closely
monitored. Since the last report on 4 January 2019 (Weekly Bulletin 1),twenty new confirmed and one new probable EVD cases have been reported. During this period there have also been an additional 16 deaths.

On 12 January 2019, nine new confirmed cases were confirmed from Butembo (1) and Katwa (8), of which one was a known contact of a
confirmed case. A probable case was reported from Kalunguta on the same; it was an 8-years old child who died on 2 January 2019 and had been in contact with a confirmed case prior to his death. On 12 January 2019, five deaths were reported among confirmed cases in the Ebola Treatment Centre (ETC) in Beni (1) and in the community in Butembo (1) and Katwa (3). An additional healthcare worker has been infected since the last weekly report, bringing the number of infected healthcare workers to 56, with 18 deaths.

As of 12 January 2019, there have been a total of 644 EVD cases, including 595 confirmed and 49 probable cases. To date, confirmed cases have
been reported from 16 health zones: Beni (218), Biena (2), Butembo (47), Kalunguta (40), Katwa (98), Kyondo (8), Mabalako (89), Masereka (7),
Musienene (4), Mutwanga (3), Oicha (25), and Vuhovi (9) in North Kivu Province; and Komanda (24), Mandima (17), Nyankunde (1), and Tchomia
(2) in Ituri Province. Nine of the 16 affected health zones reported at least one new confirmed case in the previous 21 days (23 December 2018 to 12 January 2019). A total of 390 deaths were recorded, including 343 among confirmed cases, resulting in a case fatality ratio among confirmed cases of 58% (343/595).

Butembo, Katwa, and Oicha are the hot spots of the outbreak, reporting respectively 20% (n=13), 36% (n=23), and 17% (n=11) of the 64 confirmed cases reported in the previous 21 days (23 December 2018 to 12 January 2019). No additional cases have been reported from Beni since 31 December 2018.

Contact tracing is ongoing in 13 health zones; however, it remains challenging due to insecurity and continuing pockets of community
reluctance. The number of contacts being followed as of 12 January 2019 was 4 937, of whom 4 318 (87%) had been seen in the previous 24 hours. The proportion of contacts seen in health zones varied between 32% (in Biena) and 100%. An additional 156 new contacts were registered on 12 January 2019.

Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Wednesday January 16 2019

The Ministry of Health has published Ebola DRC - Evolution of the response to the Ebola epidemic in North Kivu and Ituri on Wednesday January 16 2019. Excerpt from the Google translation:

EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI 

Wednesday, January 16, 2019   

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

• Since the beginning of the epidemic, the cumulative number of cases is 663, of which 614 confirmed and 49 probable. In total, there were 407 deaths (358 confirmed and 49 probable) and 237 people cured. 

• 123 suspected cases under investigation. 5 new confirmed cases, 2 in Katwa, 1 in Butembo, 1 in Kyondo and 1 in Oicha. 

• 5 new deaths of confirmed cases, including:  

º 3 community deaths, including 1 in Katwa, 1 in Butembo, and 1 in Kyondo. 

º 2 at the Butembo CTE.

  

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

News of the response 

Vaccination 

• Since the start of vaccination on 8 August 2018, 60,715  people have been vaccinated , including 19,970 in Beni, 12,590 in Katwa, 6,746 in Butembo, 5,741 in Mabalako, 2,433 in Kalunguta, 2,023 in Komanda, 1,665 in Goma, 1,663 in Mandima, 1,406 in Oicha, 1,157 in Karisimbi, 877 in Vuhovi, 750 in Masereka, 735 in Kyondo, 700 in Lubero, 599 in Mutwanga, 434 in Bunia, 394 in Musienene, 355 in Tchomia, 167 in Nyankunde, 120 in Biena, 63 in Alimbongo, 54 to Nyiragongo and 13 to 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.