Global & Disaster Medicine

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DRC: April was the deadliest month of the 9-month long Ebola outbreak

CIDRAP

“…..April total: 406 cases, 308 deaths

Today’s cases raise the outbreak total to 1,495, of which 1,429 are confirmed and 66 are probable. There have been 984 deaths, and 306 suspected cases are still under investigation…..”


DRC: Ebola situation worsening

WHO

Total cases: 1480
– Confirmed cases: 1414
– Probable cases: 66

Deaths: 970
– Confirmed: 904
– Probable: 66

WHO Director-General Dr Tedros Adhanom Ghebreyesus and WHO Regional Director for Africa, Dr Matshidiso Moeti, have concluded a visit to Butembo, in the Democratic Republic of the Congo. It was in Butembo on 19 April that WHO epidemiologist Dr Richard Mouzoko was killed by armed men while he and colleagues were working on the Ebola response.

“Dr Mouzoko’s death moved me profoundly. On this mission, he was on my mind the whole time as we met with other dedicated colleagues. I am also profoundly worried about the situation. Cases are increasing because of violent acts that set us back each time. We have already begun to adjust our response.”

Dr Tedros and Dr Moeti traveled to Butembo to express their gratitude and show support to WHO and partner organization staff, while also assessing the next steps needed to strengthen both security and the Ebola response effort. They also met with local political, business and religious leaders, and called on them to accelerate their efforts to stabilize the surrounding environment.

They urged the international community to step up support to contain the Ebola outbreak, including filling the funding gap that threatens to stymie the Ebola response.

Most Ebola response activities, including community engagement, vaccination, and case investigation, have been re-launched following a slowdown in the wake of the attack that left Dr. Mouzoko dead and two people injured. However, they expressed deep concern that a rise in reported cases in recent weeks is straining resources even further.

“My pride and respect for my extraordinary colleagues has only grown,” said Dr Moeti. “They have been through something unimaginable and yet are willing to continue this vital work. We need the security situation to be under control for them and for the local people. During our mission, we had fruitful discussions with the partners who provide security cover to see what more could be done. Meanwhile, we will continue to work with various groups and embed our response at the community level.”

The delegation met the Mayor of Butembo, Sylvain Kanyamanda Mbusa, the US Ambassador, Michael A. Hammer, the Deputy Special Representative of the peacekeeping mission to the DRC (MONUSCO), David Gressly, and other UN partners, business, religious and political leaders, and NGOs active in the response.

“We are entering a phase where we will need major shifts in the response,” said Dr Tedros. WHO and partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap.”

Only half of the currently requested funds have been received, which could lead to WHO and partners rolling back some activities precisely when they are most needed.

“We will continue to adjust the response, as we have done for each context in each community,” said Dr Moeti. “This worrisome rise in cases is a further call to action. In the end, it is only through the ownership by all the affected communities that the outbreak will end. Some would have Ebola drive us apart. We can only defeat it if we all work together.”


The Democratic Republic of the Congo (DRC) recorded 27 new cases of Ebola, setting a new single-day record for this 9-month outbreak. The ministry also recorded 26 deaths—also the highest daily total to date


DRC: A hospital attack in Butembo took the life of a World Health Organization (WHO) epidemiologist deployed to the outbreak region.

CIDRAP

  • 1,340 cases of EBV, of which 1,274 are confirmed.
  • The number of deaths rose to 874.

“…….WHO Director-General Tedros Adhanom Ghebreyesus, PhD, tweeted the same day about the most recent attack.

“Appalled by another attack on health workers saving lives in DRC. The violence not only disrupts vital Ebola outbreak response but also creates risk of disease spread. Latest attack was 24 hours after Butembo and @WHO colleague’s death,” he said…..”

 


The Democratic Republic of the Congo (DRC): Ebola outbreak total = 1,302 and the death toll has now reached 843.


Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12th April 2019

WHO

12 April 2019

Statement
Geneva

The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding Ebola virus disease (EVD) in the Democratic Republic of the Congo took place on Friday, 12th April, 2019, from 13:00 to 17:20 Geneva time (CET).

Key Findings:

It was the view of the Committee the ongoing Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo does not constitute a Public Health Emergency of International Concern (PHEIC). However, the Committee wished to express their deep concern about the recent increase in transmission in specific areas, and therefore the potential risk of spread to neighbouring countries.

The Committee also wishes to commend the efforts of responders from the government of the Democratic Republic of Congo, the World Health Organization and partners to contain the outbreak in a complex and difficult setting.

Additionally, the Committee has provided the following public health advice:

  • The committee advises to redouble efforts to detect cases as early as possible, identify and follow up all contacts, ensure the highest level of coverage vaccination of all contacts and contacts of contacts.
  • Sustained efforts must be made to prevent nosocomial transmission and to shorten time between onset of disease and access to high standards of care and therapeutics at Ebola treatment units.
  • Special emphasis should be placed on addressing the rise in case numbers in the remaining epicentres, notably Butembo, Katwa, Vuhovi, and Mandima.
  • The Committee advises WHO and all partners to identify, target, and scale up community dialogue and participation, engagement of traditional healers, and other community engagement tactics to strengthen and broaden community acceptance.
  • The Committee also noted the need to follow the recommendations of SAGE with regards to the vaccination strategy provided at its latest meeting.
  • The safety of responders should be prioritized, while avoiding the securitization of the response.
  • Because there is a very high risk of regional spread, neighbouring countries should continue to accelerate current preparedness and surveillance efforts, including vaccination of health care workers and front-line workers in surrounding countries.
  • Cross-border collaboration should continue to be strengthened, including timely sharing of data and alerts, cross-border community engagement and awareness raising. In addition, work should be done to better map population movements and understand social networks bridging national boundaries.
  • The Committee maintains its previous advice that it is particularly important that no international travel or trade restrictions should be applied. Exit screening, including at airports, ports, and land crossings, is of great importance; however, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.
  • The committee strongly emphasized the critical need to strengthen current efforts in both preparedness and response. This will require substantial, immediate and sustained additional financial support.
  • While there is no added benefit to declaring a PHEIC at this stage, there was concern about current levels of transmission requiring close attention to the evolving situation. The committee advised the WHO Director General to continue to monitor the situation closely and reconvene the Emergency Committee as needed.

The W.H.O. says once again that the Ebola epidemic does not meet the criteria for declaring an international public health emergency.

NYT


The recent escalation in the number of Ebola virus disease (EVD) cases continues in the Democratic Republic of the Congo

WHO

April 9

“….This past week saw 65 new confirmed cases reported in the last seven days….”

WHO

“……Knowledge gained following the 2014–16 West Africa Ebola outbreak identified a number of challenges survivors face, including reduced or blurred vision stemming from inflammation of their eyes…..Next steps will be to continue to follow up with survivors, at the clinics held each month, where they are provided medical, biological and psychological care. There are currently over 300 survivors registered in the follow-up programme……”

mohindo baby eye test by dr drc ebola


The Democratic Republic of the Congo closed out March with an ongoing spate of cases over the weekend: 23 in eight locations.

DRC

SITUATION ÉPIDÉMIOLOGIQUE DANS LES PROVINCES DU NORD-KIVU ET DE L’ITURI

Dimanche 31 mars 2019

  La situation épidémiologique de la Maladie à Virus Ebola en date du 30 mars 2019 :

  • Depuis le début de l’épidémie, le cumul des cas est de 1.082, dont 1.016 confirmés et 66 probables. Au total, il y a eu 676 décès (610 confirmés et 66 probables) et 331 personnes guéries.
  • 279 cas suspects en cours d’investigation ;



The Democratic Republic of the Congo (DRC) saw no let-up in Ebola cases with the health ministry reporting six more cases.

DRC

SITUATION ÉPIDÉMIOLOGIQUE DANS LES PROVINCES DU NORD-KIVU ET DE L’ITURI

Mardi 26 mars 2019

  La situation épidémiologique de la Maladie à Virus Ebola en date du 25 mars 2019 :

  • Depuis le début de l’épidémie, le cumul des cas est de 1.022, dont 957 confirmés et 65 probables. Au total, il y a eu 639 décès (574 confirmés et 65 probables) et 324 personnes guéries.
  • 161 cas suspects en cours d’investigation 
    (Informations indisponibles pour les zones de santé couvertes par la sous-coordination de Butembo à cause d’un problème de connexion internet)
  • 6 nouveaux cas confirmés, dont 2 à Katwa, 2 à Mandima, et 2 à Vuhovi ; 
  • 5 nouveaux décès de cas confirmés, dont
    • 4 décès communautaires, dont 2 à Katwa et 2 à Mandima ;
    • 1 décès au CTE de Butembo ;
  • 3 nouveaux patients guéris sortis du CTE de Butembo.

/!\ Les données présentées dans ce tableau sont susceptibles de changer ultérieurement, après investigations approfondies et après redistribution des cas et décès dans leurs zones de santé respectives.


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