Archive for the ‘Ebola’ Category
Ebola: “….If the outbreak goes unchecked, it could threaten the health and stability of neighboring countries: Uganda, Rwanda, and South Sudan. Such spread would lead to travel, trade, economic, and security implications reaching far beyond the region, which would exacerbate the toll of the outbreak and increase the cost of response…..”
Friday, November 30th, 2018“……We therefore believe that the U.S. government should allow CDC staff to return to the field for as long as the WHO and others deem necessary. Security arrangements should be made to ensure that any deployed teams could operate safely in affected areas. Options for the safe deployment of CDC personnel may include using existing security forces, such as the United Nations Organization Stabilization Mission in the DR Congo (MONUSCO), which is currently protecting WHO staff. Ideally, epidemic response agencies and organizations from other countries with Ebola experience that are not already engaged in the current response would similarly offer assistance to the WHO and the DRC.
The WHO has transformed its ability to respond to emergencies, but it remains dependent on international support, both technical and financial. It has requested that member states create a Contingency Fund for Emergencies (CFE) to support its work in responding to disease and other crises. To date, however, the CFE has received less than a third of its $100 million annual target. More support is clearly needed; it’s estimated that the response to the DRC Ebola outbreak alone will cost $44 million……”
DRC: Fighting Malaria and Ebola at the same time
Thursday, November 29th, 201828 November 2018 | BENI: A spike in malaria cases is threatening the health of people in parts of the eastern Democratic Republic of the Congo (DRC) where health workers are also battling an Ebola outbreak. In response, a four-day mass drug administration (MDA) campaign was launched today in the Northern Kivu province town of Beni, with a target to reach up to 450 000 people with anti-malarial drugs combined with the distribution of insecticide-treated mosquito nets.
The malaria control campaign is being led by the DRC National Malaria Control Programme, supported by the World Health Organization (WHO), UNICEF, the Global Fund and the United States President’s Malaria Initiative (PMI). The campaign is modelled after the campaign implemented in Sierra Leone during the 2014 Ebola outbreak in West Africa, which was instrumental in lowering illness and deaths from malaria in the areas reached.
“Controlling malaria is critical in areas like North Kivu, as it causes widespread disease and death, especially among the region’s children,” says Dr Yokouide Allarangar, WHO’s Representative to the DRC. “This anti-malaria campaign will also help reduce the pressure on the overall health system, which is currently striving to protect people from the ongoing Ebola threat in the region.”
One campaign impacting two diseases
North Kivu’s malaria outbreak has overburdened Ebola responders; many suspected cases of Ebola have turned out to be malaria, as early symptoms of both diseases are similar. Up to 50% of people screened in Ebola treatment centers have been found to only have malaria.
Therefore, the anti-malaria campaign has two main aims.
Firstly, the distribution of insecticide-treated mosquito nets will prevent malaria transmission and its accompanying health consequences, thus saving lives.
Secondly, the mass drug administration will treat people who have already contracted malaria and curtail transmission of malaria among Ebola-affected populations and health centres. Having fewer people present with malaria will lessen the workload on already stretched Ebola treatment centres.
DRC’s malaria challenge
From 2016-2017, DRC observed an estimated increase of more than half a million malaria cases (24.4 million to 25 million), according to the WHO World malaria report 2018. DRC is the second-leading country in the world for malaria cases, after Nigeria, accounting for 11% of the 219 million cases and 435 000 deaths from malaria in 2017.
In North Kivu province, the area experiencing the brunt of the Ebola outbreak, there has already been an up to eight-fold increase in malaria incidence as of early September 2018 (or approximately 2000 cases registered per week) compared to the same period in 2017.
Despite recent improvements in coverage of malaria interventions, DRC continues to experience challenges in access to preventive and curative malaria interventions, as well as an environment that supports very high transmission rates. Funding, infrastructure challenges and insecurity are all key obstacles to achieving the intervention coverage needed to protect populations at risk.
Ongoing Ebola outbreak in North Kivu Province
North Kivu province is the epicentre of an Ebola outbreak that was announced on 2 August and has caused more than 365 cases and 236 deaths. The town of Beni has been one of the most affected. Political instability, violence, and a refugee and internally-displaced people crisis have made the current Ebola outbreak one of the most complex and difficult public health challenges in recent history.
Ebola response in DRC: Stuck in first gear
Saturday, November 17th, 2018“…..Dr. Pierre Rollin is an expert on Ebola with the U.S. Centers for Disease Control and Prevention…..Rollin has been visiting for more than 20 years to respond to periodic Ebola outbreaks. And he says there’s a pattern to these eruptions.
“Usually you have one or two months before you detect it,” explains Rollin. By then enough cases start cropping up that one of them reaches a health worker who recognizes that it might be Ebola and orders up a test.
As soon as the case is identified as Ebola, response teams flood into the outbreak zone. They isolate those who are already sick and identify anyone who has had contact with them — and any contacts of those contacts – so they can be monitored and, if necessary, isolated in turn. Within a short time the outbreak is quashed. “Three, four months maximum,” says Rollin.
But that’s how long the current outbreak has been spreading through DRC. And Rollin says by many measures this time around it’s as if they’re stuck at square one.
“It’s as if we’re just starting now when in fact we started three months ago,” says Rollin. “We’re not making any progress.”…..”
Eight United Nations peacekeepers and at least 12 Congolese soldiers were killed in a joint military operation against rebels in the northeast of the Democratic Republic of Congo, which is facing a deadly Ebola outbreak.
Saturday, November 17th, 2018“……Rebel attacks have forced suspension of efforts to contain the Ebola outbreak in some areas.
Dr. Peter Salama, the emergencies chief for the World Health Organization, predicted Tuesday that Congo’s Ebola outbreak, which has killed more than 200 people, will last at least six more months.
The outbreak is “arguably the most difficult context that we’ve ever encountered,” Dr. Salama said, pointing to activities of the armed rebel groups in the region……”
8 new cases along with 4 more deaths from EBV: 3 health zones in the Democratic Republic of Congo (DRC) reported their first confirmed Ebola cases
Wednesday, November 14th, 2018
Democratic Republic of Congo: The current Ebola outbreak is the most severe in the country’s history with 319 confirmed and probable cases and at least 198 dead.
Tuesday, November 13th, 2018“…..efforts to contain the deadly outbreak have been thwarted by violence against health officials and civilians as militant groups battle for control in the affected region. The minister said two health workers were killed in one attack……”
FDA authorizes emergency use of first Ebola fingerstick test with portable reader
Tuesday, November 13th, 2018FDA authorizes emergency use of first Ebola fingerstick test with portable reader
For Immediate Release
November 9, 2018
Release
Today, the U.S. Food and Drug Administration announced that an emergency use authorization (EUA) has been issued for a rapid, single-use test for the detection of Ebola virus (Zaire ebolavirus). This is the second Ebola rapid antigen fingerstick test available under EUA, but the first that uses a portable battery-operated reader, which can help provide clear diagnostic results outside of laboratories and in areas where patients are likely to be treated.
The test, called the DPP Ebola Antigen System, is used with blood specimens, including capillary “fingerstick” whole blood, from individuals with signs and symptoms of Ebola virus disease (EVD) in addition to other risk factors, such as living in an area with large numbers of EVD cases and/or having contact with other individuals exhibiting signs and symptoms of EVD.
“The scourge of Ebola tragically demonstrates that we’re a global community when it comes to public health protection. Infectious disease doesn’t recognize nation states. Bacteria and viruses don’t respect territorial boundaries. It takes a sustained, robust and globally coordinated effort to protect our nation and the global community from various infectious disease threats. We’re all in this together. To that end, our FDA team of experts in drugs, vaccines and diagnostics continue to collaborate with our Federal, international and industry partners to employ our collective expertise, experiences from previous incidents, and resources to assist in the global response to the Ebola outbreak in the Democratic Republic of Congo,” said FDA Commissioner Scott Gottlieb, M.D. “This EUA is part of the agency’s ongoing efforts to help mitigate potential, future threats by making medical products that have the potential to prevent, diagnosis or treat available as quickly as possible. We’re committed to helping the people of the DRC effectively confront and end the current Ebola outbreak. By authorizing the first fingerstick test with a portable reader, we hope to better arm health care providers in the field to more quickly detect the virus in patients and improve patient outcomes.”
The FDA’s EUA authority allows the agency to authorize the use of an unapproved medical product, or the unapproved use of an approved medical product when, among other circumstances, there are no adequate, approved and available alternatives. When circumstances exist justifying authorization, the EUA becomes an important mechanism that allows broader access to medical products that have not been FDA cleared or approved and are instead only authorized for use for the duration of an emergency declaration. The FDA’s criteria for issuing an EUA for a diagnostic test includes making an assessment that it is reasonable to believe, based on the totality of evidence available to the agency, that the test may be effective and the known and potential benefits of using the test outweigh its known and potential risks.
In 2014, during the Ebola outbreak in West Africa, an emergency was declared by the Secretary of Health and Human Services. While that outbreak has ended, ongoing, smaller Ebola outbreaks have continued, and the emergency declaration is still in place. Recent outbreaks in remote areas with limited resources can benefit from rapid diagnostic tools, and the issuance of an EUA for the DPP Ebola Antigen System is an important step in addressing these outbreaks.
The DPP Ebola Antigen System provides rapid diagnostic results with tests that can be performed in locations where a healthcare provider does not have access to authorized Ebola virus nucleic acid tests (PCR testing), which are highly sensitive but can only be performed in certain laboratory settings that are adequately equipped. The DPP Ebola Antigen System has been authorized for use with capillary “fingerstick” whole blood, ethylenediaminetetraacetic acid (EDTA, an anticoagulant added to whole blood to prevent coagulation) venous whole blood and EDTA plasma. The DPP Ebola Antigen System should only be run in facilities, including treatment centers and public health clinics where patients are likely to be treated, and laboratories that are adequately equipped, trained and capable of such testing.
While today’s action will increase access to diagnostic tools for healthcare providers who may not have otherwise been equipped to perform tests, it is important to note that a negative result from the DPP Ebola Antigen System, especially in patients with signs and symptoms of EVD, should not be used as the sole basis for patient management decisions. The diagnosis of EVD must be made based on multiple factors such as, history, signs, symptoms, exposure likelihood and other laboratory evidence in addition to the detection of Ebola virus.
The FDA remains committed to using its authorities and resources to advance the development of countermeasures to address emerging threats and recently outlined its efforts to help address Ebola virus outbreaks. The FDA will continue to work with its federal partners and potential commercial product manufacturers in the most expedited manner to increase the availability of authorized diagnostic tests for Ebola virus disease for emergency use during this and any future outbreak.
With the issuance of the EUA for the DPP Ebola Antigen System to Chembio Diagnostic Systems Inc., the FDA has now issued EUAs for nine nucleic acid tests and two rapid diagnostic tests for Ebola virus detection in human specimens.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
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319 confirmed or probable cases, of Ebola in DRC
Saturday, November 10th, 2018Ebola virus disease – Democratic Republic of the Congo
As the Ebola virus disease (EVD) outbreak enters the fourth month since declaration, and case numbers surpass 300, substantial progress has been achieved in all aspects of the response. Nevertheless, there remains a challenging road ahead to control intense transmission in the city of Beni and emerging hotspots in villages around Beni and Butembo. Security incidents and pockets of community resistance continue to impact civilians and frontline workers, requiring the response to continually adapt to the situation. The UN is committed to staying and supporting the Ministry of Health (MoH), and confident that the outbreak can be contained. This week, the WHO Director-General, UN Under-Secretary-General for peacekeeping, and WHO Deputy Director-General (DDG) Emergency Preparedness and Response travelled to the Democratic Republic of the Congo to review how further support can be offered to strengthen the response.
Over the past week (31 October – 6 November), 29 new confirmed EVD cases were reported: 15 from Beni, seven from Butembo, four from Kalunguta, two from Mabalako, and one from Vuhovi. The two cases reported in Mabalako were a mother and her new-born child, residing and infected in Beni, but sought treatment at the Mabalako Ebola treatment centre (ETC). Three health workers from health posts in Beni and Kalunguta were among the newly infected; 28 health workers have been infected to date. Ten additional survivors were discharged from the Beni ETC and reintegrated into their communities; 88 patients have recovered to date.
As of 6 November, 308 EVD cases (273 confirmed and 35 probable), including 189 deaths (154 confirmed and 35 probable)1, have been reported in eight health zones in North Kivu Province and three health zones in Ituri Province (Figure 1). While fewer cases were reported from Beni this week, new cases continue to be detected daily here and elsewhere, and delays in case detection persist; therefore, trends in weekly incidence must be interpreted cautiously (Figure 2).
The risk of the outbreak spreading to other provinces in the Democratic Republic of the Congo, as well as to neighbouring countries, remains very high. Over the course of the past week, alerts have been reported from the South Sudan, Uganda and Yemen; EVD has been ruled out for all alerts to date. Uganda (geographically closest to outbreak affected areas), continues to intensify preparedness activities, and this week began to vaccinate health and frontline workers at priority health facilities.
Figure 1: Confirmed and probable Ebola virus disease cases by health zone in North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 6 November 2018 (n=308)
Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset, data as of 6 November 2018 (n=303)*
Uganda is to administer an experimental Ebola vaccine for health workers in high-risk areas bordering the Democratic Republic of the Congo
Wednesday, November 7th, 2018“……Uganda is the first country in the world to give the vaccine without an active outbreak of the disease, but is judged to be at very high risk……The vaccine, developed by Merck, is not licensed but proved effective during limited trials in west Africa……”
Over the weekend and today, 13 more cases and 5 more deaths from Ebola were reported in the Democratic Republic of the Congo.
Tuesday, November 6th, 2018- Au total, 300 cas de fièvre hémorragique ont été signalés dans la région, dont 265 confirmés et 35 probables.
- Sur les 265 confirmés, 151 sont décédés et 88 sont guéris. Les autres sont hospitalisés dans les différents Centre de Traitement d’Ebola (CTE) installés.
- 41 cas suspects en cours d’investigation.
- 2 nouveaux cas confirmés, dont 1 à Beni et 1 à Kalunguta.
- Aucun nouveau décès de cas confirmé rapporté ce jour.
- 7 nouveaux guéris à Beni…..”