Global & Disaster Medicine

Archive for the ‘Ebola’ Category

Ebola virus disease – Democratic Republic of the Congo Disease outbreak news: Update (12 September 2019)

“……As of 10 September, a total of 3091 EVD cases were reported, including 2980 confirmed and 111 probable cases, of which 2074 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1737) were female, 29% (886) were children aged less than 18 years, and 5% (157) were health workers…….”

 


Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study

Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study

Published:September 04, 2019DOI:https://doi.org/10.1016/S1473-3099(19)30313-5

“Findings

….Of the 1270 survivors of Ebola virus disease who were discharged from Ebola treatment units in Guinea, information was retrieved for 1130 (89%). Compared with the general Guinean population, survivors of Ebola virus disease had a more than five-times increased risk of mortality up to Dec 31, 2015 (age-standardised mortality ratio 5·2 [95% CI 4·0–6·8]), a mean of 1 year of follow-up after discharge. Thereafter (ie, from Jan 1–Sept 30, 2016), mortality did not differ between survivors of Ebola virus disease and the general population. (0·6 [95% CI 0·2–1·4]). Overall, 59 deaths were reported, and the cause of death was tentatively attributed to renal failure in 37 cases, mostly on the basis of reported anuria. Longer stays (ie, equal to or longer than the median stay) in Ebola treatment units were associated with an increased risk of late death compared with shorter stays (adjusted hazard ratio 2·62 [95% CI 1·43–4·79]).

Interpretation

Mortality was high in people who recovered from Ebola virus disease and were discharged from Ebola treatment units in Guinea. The finding that survivors who were hospitalised for longer during primary infection had an increased risk of death, could help to guide current and future survivors’ programmes and in the prioritisation of funds in resource-constrained settings. The role of renal failure in late deaths after recovery from Ebola virus disease should be investigated….”

WHO: 5 new confirmed cases of Ebola, raising the outbreak total to 3,054, with 444 suspected cases under investigation plus there were also 5 additional deaths noted, raising the fatality total to 2,050.

WHO

 

 


WHO: 10 new cases of Ebola have been confirmed in the Democratic Republic of the Congo (DRC), raising the outbreak total to 2,852, and 380 suspected cases are still under investigation.

WHO


A trial of two Ebola drugs showed significantly improved survival rates

BBC

“……Four drugs were trialled on patients in the Democratic Republic of Congo, where there is a major outbreak of the virus.

More than 90% of infected people can survive if treated early with the most effective drugs…….”


The health minister in the Democratic Republic of Congo has resigned in protest at the handling of the Ebola outbreak

BBC

“……In his letter to Félix Tshisekedi, he criticised the decision to remove him as head of the Ebola response team, and replace him by a committee “under your direct supervision”.

He said members of that committee had interfered with his work in recent months.

He also condemned “strong pressure exercised in recent months” to use a new Ebola vaccine advocated by some aid agencies and donors……”

  • More than 2,500 people have been infected
  • 2/3 of them have died.
  • It took 224 days for the number of cases to reach 1,000
  • It took just 71 days to reach 2,000.
  • About 12 new cases are being reported every day.

Three previous Ebola outbreaks have demonstrated how a response can succeed — or how, in an atmosphere of suspicion, it can go badly wrong.

NYT

The Mbandaka outbreak: “The outbreak just before the current one ushered in a new era in the war against Ebola: a new Merck vaccine stopped the outbreak in just three months, after only 33 deaths……”

The West African outbreak: “History’s worst Ebola outbreak was the one that began in West Africa in late 2013 and whose last flare-ups were not snuffed out until early 2016. The outbreak infected over 28,000 people and killed over 11,000……”

The outbreak named ‘Ebola’:   The 1976 outbreak that gave the virus its name also created the air of otherworldly terror that surrounds it. Most of the 318 cases and 280 deaths were in Yambuku, in the north of what was then Zaire…..”


WHO’s director-general, Tedros Adhanom Ghebreyesus, PhD, declared that the Democratic Republic of the Congo’s Ebola outbreak is a public health emergency of international concern (PHEIC).

WHO

17 July 2019

News release
Geneva

WHO Director-General Dr. Tedros Adhanom Ghebreyesus today declared the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) a Public Health Emergency of International Concern (PHEIC).

“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Dr. Tedros. “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders — coming from not just WHO but also government, partners and communities — to shoulder more of the burden.”

The declaration followed a meeting of the International Health Regulations Emergency Committee for EVD in the DRC. The Committee cited recent developments in the outbreak in making its recommendation, including the first confirmed case in Goma, a city of almost two million people on the border with Rwanda, and the gateway to the rest of DRC and the world.

This was the fourth meeting of the Emergency Committee since the outbreak was declared on 1 August 2018.

The Committee expressed disappointment about delays in funding which have constrained the response. They also reinforced the need to protect livelihoods of the people most affected by the outbreak by keeping transport routes and borders open. It is essential to avoid the punitive economic consequences of travel and trade restrictions on affected communities.

“It is important that the world follows these recommendations. It is also crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region,” said Professor Robert Steffen, chair of the Emergency Committee.

Since it was declared almost a year ago the outbreak has been classified as a level 3 emergency – the most serious – by WHO, triggering the highest level of mobilization from WHO. The UN has also recognized the seriousness of the emergency by activating the Humanitarian System-wide Scale-Up to support the Ebola response.

In recommending a PHEIC the committee made specific recommendations related to this outbreak.

“This is about mothers, fathers and children – too often entire families are stricken. At the heart of this are communities and individual tragedies,” said Dr. Tedros. “The PHEIC should not be used to stigmatize or penalize the very people who are most in need of our help.”


Finally, the year-old Ebola epidemic in the Democratic Republic of Congo is now considered a global health emergency

NYT

‘……“This is still a regional emergency and by no way a global threat,” said Robert Steffen of the University of Zurich, chairman of the W.H.O. emergency committee that recommended the declaration.

But the panel was persuaded by several factors that have made combating the epidemic more urgent in recent weeks: The disease reached Goma, a city of nearly two million people; the outbreak has raged for a year; the virus has flared again in spots where it had once been contained; and the epidemic hot zone has geographically expanded in northeastern Congo near Rwanda and into Uganda……’

“…..The W.H.O. said it had received $49 million from international donors from February to July, only half the money it needs. Officials who have visited the region say supplies are running short, including the protective gear that health workers need to avoid becoming infected. At a United Nations meeting about the outbreak on Monday, one official said he had seen syringes and gloves being reused because equipment was becoming scarce.….”


Three more health workers infected in Ebola outbreak in DRC

WHO

Disease outbreak news: Update
11 July 2019

The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues this past week with a similar transmission intensity to the previous week. While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, there has been an increase in cases in Beni, and a high incidence of cases continues in parts of Mabalako Health Zone. In addition to these re-emerging hotspots, there are a large number of people with confirmed and probable infections moving to other health zones, with the greatest number coming from Beni Health Zone. The movement of cases causes the outbreak to spread to new health zones and re-emerge in health zones with previously controlled infections. Overall, this underscores the importance of robust mechanisms for listing and following up contacts and understanding the motivations for peoples’ decisions to move.

After the first reported case in the Ariwara Health Zone on 30 June, no new cases have been observed in that health zone. A response team deployed to that zone continues to identify contacts, engage the community, and vaccinate individuals at risk. Response personnel from the bordering countries of Uganda and South Sudan continue to support operational readiness activities. Resources are being dedicated to monitoring the Uganda-Democratic Republic of the Congo border in that area.

In the 21 days from 19 June through 9 July 2019, 72 health areas within 22 health zones reported new cases, representing 11% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 247 confirmed cases were reported, the majority of which were from the health zones of Beni (41%, n=101), Mabalako (19%, n=48), Lubero (6%, n=16), and Mandima (5%, n=13). As of 09 July 2019, a total of 2437 EVD cases, including 2343 confirmed and 94 probable cases, were reported (Table 1). A total of 1646 deaths were reported (overall case fatality ratio 68%), including 1552 deaths among confirmed cases. Of the 2437 confirmed and probable cases with known age and sex, 57% (1384) were female, and 29% (704) were children aged less than 18 years.


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