WHO

CDC

Crowe SJ, Maenner MJ, Kuah S, Erickson BR, Coffee M, Knust B, et al. Prognostic indicators for Ebola patient survival. Emerg Infect Dis. 2016 Feb [date cited]. http://dx.doi.org/10.3201/eid2202.151250

“….Time from symptom onset to healthcare facility admission was not associated with survival, but viral load in the first Ebola virus–positive blood sample was inversely associated with survival: 52 (87%) of 60 patients with a C_t of >24 survived and 20 (22%) of 91 with a C_t of <24 survived. C_t values may be useful for clinicians making treatment decisions or managing patient or family expectations….”

Note:  Cycle threshold (C_t) can serve as an approximation of viral load.

NY Times

**   “…..today, at least 10 percent of Egyptians, nearly nine million people, are chronically infected, the highest rate in the world….

**  “….Mr. Ellabbad…was finally cured of hepatitis this spring. An air-conditioning repairman, he took a three-month regimen that included sofosbuvir, first of the new generation of miracle drugs. The pills would have cost more than $84,000 in the United States.  He got them free from the Egyptian government, which paid about $900…..”

History

USGS

Three Main Shocks

1. December 16, 1811 – Magnitude ~7.5
2. January 23, 1812 – Magnitude ~ 7.3
3. February 7, 1812 – Magnitude ~ 7.5

WHO

The Ministry of Health of the Democratic Republic of the Congo (DRC) has notified WHO of ongoing outbreaks of cholera across the country. Although the overall trend is decreasing, there are still areas reporting a high number of cases.

Since the beginning of the year, 19,705 cases have been reported in DRC. As of 29 November, the following provinces had reported cases: South Kivu (4,906), ex-Katanga (4,565), Maniema (3,971), North Kivu (3,294) and ex-Oriental (2,969). A high number of cases are still reported in the province of South Kivu where the situation is particularly worrying because of the presence of camps hosting refugees from Burundi. Furthermore, there are concerns that the epidemic in Maniema could spread to other provinces of the country as observed during the 2011 cholera epidemic when areas of Kinshasa were also affected.

Public health response

In response to the outbreaks, the government of DRC, together with WHO and partner organizations, has intensified surveillance, case management and health promotion activities in the affected areas. Moreover, cholera treatment centres have been strengthened at selected sites.

Water sanitation and hygiene activities, such as water chlorination, are being implemented. Communication and health education activities are also continuing.

The MoH and WHO conducted joint risk assessment missions in South Kivu, Maniema and Kisangani. Following their recommendations, an updated control and response plan was developed. WHO also provided technical support and coordination for the implementation of prevention and control measures. The implementation of oral cholera vaccine campaigns is being discussed with national authorities.

WHO advice

WHO does not recommend any travel or trade restriction to DRC based on the current information available.

Hawaii Department of Health

As of December 15, 2015*:

Of the confirmed cases, 136 are Hawaii Island residents and 17 are visitors.
120 cases have been adults; 33 have been children (<18 years of age). Onset of illness has ranged between 9/11/15 – 12/8/15.

Washington Post

CNN