DR Congo: Ebola Outbreak - May 2018Ongoing
The Government of the [DRC] declared a new outbreak of Ebola virus disease (EVD) in Bikoro in Equateur Province today...The outbreak declaration occurred after laboratory results confirmed two cases of EVD. (WHO, 8 May 2018)
From 4 April through 9 May 2018, a total of 32 [EVD] cases (among which two are confirmed, 18 probable and 12 suspected cases) were reported from Bikoro health zone, Equateur province, including 18 deaths. Three of the 32 cases were among healthcare workers...All cases were reported from the catchment area of the Ikoko-Impenge health facility, located 30 km from the central health zone office of Bikoro, which is 280 km by road from Mbandaka, the capital of Equateur province. Of the 21 initially reported cases on 8 May 2018, 17 had epidemiological links (potential contacts with another suspect case). (WHO, 10 May 2018)
As of 11 May 2018, there are a total of 34 cases, with 18 deaths (case fatality rate 52.9%), among which two cases are confirmed, 14 suspected and 18 probable. Three health workers have been affected, with two suspected cases and a probable case who died. (WHO, 11 May 2018)
The affected community, Ikoko Impenge, is situated in the Bikoro Health Zone of the Equateur province of the DRC. The epicentre is a very remote village; Ikoko Impenge health area is not covered by mobile telephone networks but is accessible by road (though access is difficult especially with the ongoing rainy season). There are currently suspected 10 cases in treatment in two different facilities. Ikoko Impenge health area covers 15km and includes 5 villages, all of which have reported suspected cases. This area of DRC has not suffered previous documented Ebola outbreaks before the current outbreak. (IFRC, 14 May 2018)
One new case of [EVD] has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people in Equateur Province. (WHO, 17 May 2018)
The 1st meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding [EVD] outbreak in [DRC] took place on...18 May 2018...It was the view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have not currently been met. (WHO, 18 May 2018)
On 15 June 2018, five new suspected EVD cases were reported in Bikoro Health Zone. Six laboratory specimens (from suspected cases reported previously) tested negative. No new confirmed EVD cases and no new deaths were reported on the reporting date. Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case-patient in Iboko Health Zone developed illness on 2 June 2018 and was confirmed 6 June 2018. To date, a total 24 case-patients with confirmed EVD have been cured since the onset of the outbreak. Since the beginning of the outbreak (on 4 April 2018), a total of 57 EVD cases and 28 deaths (case fatality rate 49.1%) have been reported, as of 15 June 2018. (WHO, 15 Jun 2018)
On 27 June 2018, all the people who were exposed to the last confirmed EVD case-patient completed their mandatory 21-day follow up without developing symptoms. This is an important milestone. The last confirmed EVD case in Equateur Province was cured and discharged from the Ebola treatment centre (ETC)[.] (WHO, 3 Jul 2018)
On 3 July 2018, WHO reviewed the level of public health risk associated with the current outbreak. The latest assessment concluded that the current [EVD] outbreak has largely been contained, considering that over 21 days (one maximum incubation period) have elapsed since the last laboratory-confirmed case was discharged and that contact tracing activities ended on 27 June 2018. However, there remains a risk of resurgence from potentially undetected transmission chains and possible sexual transmission of the virus by male survivors. It is therefore, critical to maintain all key response pillars until the end of the outbreak is declared. (WHO, 6 Jul 2018)
Appeals & Response Plans
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25-28 June 2018, Morogoro: As part of ongoing efforts to prepare countries in the African Region to respond effectively to disease outbreaks and humanitarian disasters, the World Health Organization in collaboration with the Ministry of Health and President’s Office President's Office Regional and Local Government authorities (PORALG) organized a training of national rapid response teams on Ebola virus disease (EVD) to ensure that the country has the people with the skills and expertise to prevent and respond to EVD.
GENEVA — The World Health Organization says it expects the Ebola outbreak in the Democratic Republic of Congo to be over on July 24. That will mark 42 days, two incubation periods of 21 days each, since the last patient infected with the Ebola virus was released from care.
The countdown toward the end of the Ebola outbreak in the DRC started on June 12. If no other cases of this fatal disease are identified by July 24, the DRC’s Ministry of Health will announce the end of the disease the following day in an elaborate ceremony in the capital, Kinshasa.
Les autorités congolaises se préparent à déclarer dans une semaine la fin de l’épidémie d’Ebola à l’Equateur. Depuis le 12 juin, aucun cas positif n’a été observé en République démocratique du Congo (RDC), a dit mardi devant la presse à Genève une porte-parole de l’Organisation mondiale de la santé (OMS). « Suivant les recommandations de l’OMS, le Ministère de la Santé de la République Démocratique du Congo a entamé un compte rebours jusqu’au 24 juillet pour marquer la fin de l’épidémie d’Ebola » a ajouté Fadela Chaib.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 58 events in the region. This week’s edition covers key new and ongoing events, including:
Humanitarian crisis in Ethiopia
Humanitarian crisis in in the Democratic Republic of the Congo
Hepatitis E outbreak in Namibia
Cholera outbreak in Cameroon
Ebola virus disease in the Democratic Republic of the Congo.
The Logistics Cluster was activated in the Democratic Republic of Congo in 2008 in response to one of the world’s most complex and longest-standing humanitarian crises.
Conflict, insecurity and Ebola have all affected the humanitarian situation. Every day, the cluster seeks solutions to logistics challenges across some of the country’s most remote and diverse landscapes to ensure responding agencies in the field can reach those in need.
Half way into the year, humanitarian organizations have only received 35 per cent of the money needed for relief worldwide. "Our humanitarian relief is a matter of life or death in many horrific war and disaster zones. The lack of funding leaves many desperate families without assistance. Mothers are forced to cut back on food for already malnourished children. Girls and boys are deprived of education and hope," warned Secretary General of the Norwegian Refugee Council, Jan Egeland.
By Mirabelle Enaka Kima, IFRC
Democratic Republic of the Congo’s traditional leaders, the main influencers and keepers of ancestral customs, are the key to community safety and surveillance against the ongoing outbreak of Ebola.
In this context, heightened surveillance is undeniably the ultimate step leading to the adoption of safe practices and considerations. In most affected areas, engaging community leaders as key decision-makers has been essential to ensuring openness of communities and effective behaviour change.
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 8-14 July 2018 and includes updates on carbapenemase-producing (OXA-48) Klebsiella pneumoniae, dengue, Ebola virus disease, poliomyelitis, MERS-CoV, mass gathering monitoring (FIFA Men's Football World Cup), measles, poliovirus type 2, rubella, Vibrio growth in the Baltic Sea, and West Nile virus.
Since he was a teenager, Didier Ipete wanted to run his own store. He would have liked to have studied at university but he didn’t have that opportunity. Nevertheless, he was happy to build up his business until it was one of the most popular shops at the market in Itipo, a small community in Equateur province in the Democratic Republic of the Congo.
The WHO Health Emergencies Programme is currently monitoring 57 events in the region. This week’s edition covers key ongoing events, including:
Rift Valley fever in Uganda
Ebola virus disease in the Democratic Republic of the Congo
Lassa fever in Liberia
Humanitarian crisis in South Sudan
Humanitarian crisis in north-east Nigeria.
For each of these events, a brief description, followed by public health measures implemented and an interpretation of the situation is provided.
1. Situation update
The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in Équateur Province, the Democratic Republic of the Congo. Until the outbreak is declared over, intensive surveillance, survivor monitoring and other response activities are ongoing to prevent, promptly detect and respond to potential resurgences of the virus.
The Early Warning Early Action initiative has been developed with the understanding that disaster losses and emergency response costs can be drastically reduced by using early warning analysis to act before a crisis escalates into an emergency.
Early actions strengthen the resilience of at-risk populations, mitigate the impact of disasters and help communities, governments and national and international humanitarian agencies to respond more effectively and efficiently.
José Graziano da Silva, FAO Director-General
Ebola epidemics are unlike anything seen before: The virus spreads rapidly, the disease is infectious and has a high mortality rate, and often there are widespread rumors, misconceptions and misinformation about the disease and how to prevent it are widespread.
Psychosocial support is vital to ensure the well-being of the affected population, and also to counter-act the threats to public health and safety that fear, stigmatization and misconception poses.
Miriam Alía, an MSF vaccination expert, has just returned from Equateur province in the Democratic Republic of Congo (DRC). Miriam worked as a medical referent in the area of Itipo, the epicentre of the recent outbreak. She explains how MSF took part in the ring vaccination against the disease and tells of her personal experience working with Congolese health workers.
Le Ministère de la santé et l’OMS continuent de suivre de près la flambée épidémique de maladie à virus Ebola (MVE) en République démocratique du Congo.
Les activités de recherche et de suivi des contacts se sont achevées le 27 juin, après que les derniers sujets potentiellement exposés au virus sont parvenus au terme de leur période de suivi de 21 jours sans avoir présenté de symptômes. Tout au long de la flambée, l’équipe de terrain a réalisé plus de 20 000 visites chez des contacts.
Avec une population estimée à 1 626 606 habitants et une densité de 16 habitants/km2 , elle a pour chef-lieu Mbandaka qui est la plus grande ville. L'Équateur est depuis 2015 l’une des 26 provinces de la République démocratique du Congo (RDC).
Les localités de Wangata, Iboko et Bikoro sont trois (03) des dix-huit (18) zones de santé (ZS) de cette province affectées par l’épidémie actuelle de la maladie à virus Ebola (MVE). Voir les différentes populations des localités affectées dans le Tableau I.
Current major event
Cholera situation in Eastern Mediterranean Region 2017
Cholera remains a threat to public health and claims lives in the countries of Eastern Mediterranean Region (EMR). During 2017, a total of 1,108,584 suspected cases of cholera including 3,273 related deaths (case fatality rate—CFR: 0.30%) were reported to WHO by seven Member States in the EMR.
A group of independent scientific experts convened by the WHO for the purpose of evaluating investigational therapeutics for Ebola virus disease (EVD) during the current outbreak, 17 May 2018