Global & Disaster Medicine

Archive for the ‘Ebola’ Category

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.


DRC: Ebola outbreak total up to 2,277

WHO

Kampala, 26 June 2019 – After assessing one of the high-risk districts for Ebola virus disease in western Uganda today, Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa, commended the corps of health workers and Health Ministry officials for their sharpened preparedness to respond to an outbreak.

Dr Moeti toured the Kasese border area with the Minister of Health of Uganda, Dr Jane Ruth Aceng, who thanked WHO for the support the organization has provided both in preparing the country for Ebola and in responding to the recent confirmed cases.

“WHO has provided crucial support to Uganda in fighting Ebola,” said Dr Aceng. “I am glad to see how my teams on the ground have responded quickly and effectively.”

Prime Minister, Right Honourable Ruhakana Rugunda also expressed his commitment to the Ebola response during a meeting with Dr Moeti and senior governmental officials in Kampala.

Since 11 June, when Uganda declared the Ebola virus disease outbreak, there have been three confirmed cases, all of whom had travelled to the neighbouring Democratic Republic of the Congo (DRC). Uganda shares a nearly 900-kilometre long, often porous border with the DRC, where the disease has claimed more than 1 400 lives since August 2018.

More than 100 people who had contacts with the confirmed cases are being monitored. Since the outbreak was declared, 1063 high risk individuals have been vaccinated. This vaccination of contacts and contacts of contacts, known as ring vaccination, has showed good results in the DRC and other countries in West Africa. There are currently no new, confirmed cases of Ebola in Uganda.

“I commend Uganda for its quick response to the Ebola outbreak,” Dr Moeti said. “During my visit to the Kasese area, I spoke with health authorities who told me how the training they had received in detecting the disease meant they were on high alert for patients with any signs of infection. They were able to move swiftly when the first Ebola cases arrived in their health facility and to restrict possible exposure to relatively few health workers.”

During her two-day visit, Dr Moeti travelled to Bwera Hospital, near the border with the DRC where two of the three people who had the infection had died. A further three suspected cases are being treated at the hospital. Due to its investment into preparedness, the hospital can now obtain presumptive results to tests for the Ebola Zaire strain within two hours.

With support from WHO and partners, Uganda has trained more than 16 000 community leaders and volunteers in remote border areas to spot the symptoms, provide medical attention to potential patients and to alert the authorities. The local teams serve as the eyes and ears of the district and national emergency systems that cover surveillance, infection prevention and control, patient care, cross-border activities and coordination with communities.

“People are aware of the problem, how to protect themselves and where to report for action and support,” Dr Moeti pointed out.

Cross-border surveillance and collaboration between Uganda and DRC health authorities facilitated the early detection and response in Kasese where the cases were confirmed. Rapid reporting by DRC counterparts led to the easy tracing of the cases by Ugandan health authorities.

Since the first outbreak in the DRC in 2018, Uganda has trained more than 9 000 of its health workers to spot the signs of Ebola and vaccinated nearly 5 000 of them against the disease.

“The cost of preparedness is cheaper than response,” Dr Moeti added at the conclusion of her visit, adding donors and partners in her praise of the extensive preparedness activities. “It is the contribution of donors that has enabled us to help countries prepare and, as we have seen in Uganda, prevent the tragedy of an outbreak escalating to unimaginable numbers.”


Ebola Map of Uganda- 6/21/19

20190621_DailyMap_DRC_NordKivu_Ebola.png

ERCC


WHO Director-General: Though the spread of Ebola to Uganda is a new development, it doesn’t signal a shift in outbreak dynamics.

WHO

14 June 2019

Thank you, Dr Aavitsland,

Good evening from DRC.

I would like to thank Dr Aavitsland for his leadership of the Emergency Committee, and all the members of the committee, as well as the advisors and those who made presentations.

As you have heard, the Emergency Committee has recommended for a third time, and I have agreed, that the current Ebola outbreak in DRC does not constitute a public health emergency of international concern.

Although the outbreak does not at this time pose a global health threat, I want to emphasise that for the affected families and communities, this outbreak is very much an emergency.

Today I have been in Kinshasa to discuss the current Ebola outbreak with the Prime Minister of DRC, the Minister of Health, opposition leaders, donors and others.

Tomorrow I will travel to Goma and Butembo, to meet with our incredible staff and partners who are on the frontline of this outbreak.

I will also be traveling to Uganda to assess the situation.

Since the outbreak started last August, there have been 2108 cases of Ebola, and 1411 deaths. This is tragic.

Although the spread of Ebola to Uganda is tragic, it is not a surprise. We have said since the beginning of the outbreak that the risk of cross-border spread was very high, and it remains very high.

The fact that it has taken this long is a testament to the incredible work of all partners on both sides of the border.

I particularly want to commend the Government of Uganda for the way it has responded. So far, the investments they have made and the plans they have put in place to prepare for Ebola are paying off.

The spread of Ebola to Uganda is a new development, but the fundamental dynamics of the outbreak haven’t changed.

We have the people, the tools, the knowledge, and the determination to end this outbreak.

We need the sustained political commitment of all parties, so we can safely access and work with communities.

We also need the international community to step up its financial commitment to ending the outbreak.

WHO’s current funding needs for the period from February to July are 98 million U.S. dollars, of which 43.6 million dollars has been received, leaving a gap of 54 million dollars. We call on all our partners to fill this gap as soon as possible.

I will not hesitate to convene it again if needed.

Thank you.

DRC:

Total cases: 2108
– Confirmed cases: 2014
– Probable cases: 94

Deaths: 1411
– Confirmed: 1317
– Probable: 94


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