Going Viral-Ebola vaccine is having ‘major impact’ but Congo outbreak may still explode; pg12

Non, all previous outbreaks always occurred in remote areas. It's why WHO is calling it "game changer".

A good article about that : [link to www.theatlantic.com (secure)]

This thread needs to be pinned again.

[link to www.theguardian.com (secure)]

The new cases bring the total of confirmed cases to three in the city of 1 million people, raising the prospect of a wider outbreak than feared.

Prof Jean-Jacques Muyenbe, the director general of the DRC’s National Institute for Biomedical Research, told the Guardian on Friday that “the situation had evolved overnight with the confirmation of two new cases” in the Wangata neighbourhood of Mbandaka.

This is wrong: it reached Monrovia (capital of Liberia) and also Conakry I seem to remember!

[link to m.dw.com]

“From Guinea's border regions, the disease continued its spread towards neighboring countries Liberia and Sierra Leone. In Liberia, the virus reached the capital city Monrovia by mid-June. After an angry mob had attacked an isolation center for patients in the slum neighborhood of West Point on August 16, the government decided to put the whole area under quarantine and imposed nighttime curfews”

Hey France! A little help, please?

[link to www.liberation.fr]

Ebola en RDC: des habitants en colère, la décision de l’OMS attendue

Après l’apparition d’Ebola à Mbandaka, les habitants de cette ville de l’ouest de la RDC exprimaient leur colère contre l’inaction des autorités, alors que l’Organisation mondiale de la santé doit décider vendredi si l’épidémie constitue une urgence de «portée mondiale».

«Le directeur général de l’OMS a convoqué «un Comité d’urgence (...) le 18 mai pour fournir des conseils sur la question de savoir si l’épidémie actuelle constitue une urgence de santé publique de «portée mondiale».

Comment: I think it's about the WHO emergency meet today.

h/t crofsblog

[link to crofsblogs.typepad.com]

DR Congo: Nearly 300 people reportedly had contact with Ebola patients in Mbandaka

Thanks to Lucy Lecomte for sending the link to this report from VOAafrique: Nearly 300 people reportedly had contact with Ebola patients in Mbandaka. Excerpt from the Google translation and then a comment:

More than three hundred people reportedly had direct or indirect contact with Ebola patients in Mbandaka, a town of more than 1.2 million people in the Democratic Republic of the Congo won Thursday by panic.

Congolese government confirmed "two suspected cases of haemorrhagic fever" in Wangata health zone, Mbandaka, whose "one of two samples tested positive for Ebola virus disease", said the minister for Congolese Health, Oly Ilunga.

"We estimate more than 300 people who have been in direct or indirect contact with people infected with the Ebola virus in Mbandaka," told AFP a doctor at a general hospital in that city.


Hey France! This is the link to original story, if you could just check it out and see if google translate missed anything.

[link to www.voaafrique.com (secure)]

[link to www.washingtonpost.com (secure)]

Congo confirms first urban Ebola case, raising possibility of ‘explosive increase in cases’

[snip]

Ebola is much harder to contain in urban areas, so this development compounds the risk of contagion. The World Health Organization’s lead response official called the new confirmed case “a game changer.”

[link to www.msf.org]

At present, 514 people who may have been in contact with infected people have been notified by the national health authorities, and they’re currently under monitoring. To tackle the epidemic and limit as much as possible the risk of it spreading, Médecins Sans Frontières (MSF) is stepping up its response in the affected areas (Mbandaka and Bikoro).

People in Mbandaka are angry at the authorities inaction.

WHO raises Ebola health risk to 'very high' in DR Congo

[link to www.cnn.com (secure)]

The World Health Organization (WHO) has raised the Ebola health risk assessment to "very high" in the Democratic Republic of Congo, ahead of an emergency meeting Friday to discuss the worsening outbreak.

[snip]

While the WHO raised the national public health risk to 'very high," it said the global risk level is "currently low."

Comment: The regional risk was "high", too, I read somewhere. No link to that, sorry.

Thank you. Understandable.

[link to www.washingtonpost.com (secure)]

The World Health Organization says the ongoing Ebola outbreak in Congo does not yet warrant being declared a global health emergency.
For a health crisis to constitute a global health emergency it must meet three criteria stipulated by WHO: It must threaten other countries via the international spread of disease, it must be a “serious, unusual or unexpected” situation and it may require immediate international action for containment.

This statement is from a public orginization in the public domain, and is therefore presented in full.

[link to www.who.int]

Statement on the 1st meeting of the IHR Emergency Committee regarding the Ebola outbreak in 2018

18 May 2018 Statement


The 1st meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the Ebola Virus Disease (EVD) outbreak in the Democratic Republic of the Congo took place on Friday 18 May 2018, from 11:00 to 14:00 Geneva time (CET).

Emergency Committee conclusion

It was the view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have not currently been met.

Meeting

Members and advisors of the Emergency Committee met by teleconference. Presentations were made by representatives of the Democratic Republic of the Congo on recent developments, including measures taken to implement rapid control strategies, and existing gaps and challenges in the outbreak response. During the informational session, the WHO Secretariat provided an update on and assessment of the Ebola outbreak.

The Committee’s role was to provide to the Director-General their views and perspectives on:

*Whether the event constitutes a Public Health Emergency of International Concern (PHEIC)
*If the event constitutes a PHEIC, what Temporary Recommendations should be made

Current situation

On 8 May, WHO was notified by the Ministry of Health of the Democratic Republic of the Congo of two lab-confirmed cases of Ebola Virus Disease occurring in Bikoro health zone, Equateur province. Cases have now also been found in nearby Iboko and Mbandaka. From 4 April to 17 May 2018, 45 EVD cases have been reported, including in three health care workers, and 25 deaths have been reported. Of these 45 cases, 14 have been confirmed. Most of these cases have been in the remote Bikoro health zone, although one confirmed case is in Mbandaka, a city of 1.2 million, which has implications for its spread.

Nine neighbouring countries, including Congo-Brazzaville and Central African Republic, have been advised that they are at high risk of spread and have been supported with equipment and personnel.

Key Challenges

After discussion and deliberation on the information provided, the Committee concluded these key challenges:

The Ebola outbreak in the Democratic Republic of the Congo has several characteristics that are of particular concern: the risk of more rapid spread given that Ebola has now spread to an urban area; that there are several outbreaks in remote and hard to reach areas; that health care staff have been infected, which may be a risk for further amplification.
The risk of international spread is particularly high since the city of Mbandaka is in proximity to the Congo river, which has significant regional traffic across porous borders.
There are huge logistical challenges given the poor infrastructure and remote location of most cases currently reported; these factors affect surveillance, case detection and confirmation, contact tracing, and access to vaccines and therapeutics.

However, the Committee also noted the following:

The response by the government of the Democratic Republic of the Congo, WHO and partners has been rapid and comprehensive.
Interventions underway provide strong reason to believe that the outbreak can be brought under control, including: enhanced surveillance, establishment of case management facilities, deployment of mobile laboratories, expanded engagement of community leaders, establishment of an airbridge, and other planned interventions.
In addition, the advanced preparations for use of the investigational vaccine provide further cause for optimism for control

In conclusion, the Emergency Committee, while noting that the conditions for a PHEIC are not currently met, issued Public Health Advice as follows:

Government of the Democratic Republic of the Congo, WHO, and partners remain engaged in a vigorous response – without this, the situation is likely to deteriorate significantly. This response should be supported by the entire international community.
Global solidarity among the scientific community is critical and international data should be shared freely and regularly.
It is particularly important there should be no international travel or trade restrictions.
Neighbouring countries should strengthen preparedness and surveillance.
During the response, safety and security of staff should be ensured, and protection of responders and national and international staff should prioritised.
Exit screening, including at airports and ports on the Congo river, is considered to be of great importance; however entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.
Robust risk communication (with real-time data), social mobilisation, and community engagement are needed for a well-coordinated response and so that those affected understand what protection measures are being recommended;
If the outbreak expands significantly, or if there is international spread, the Emergency Committee will be reconvened.

The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of this advice.

Based on this advice, the reports made by the affected States Parties, and the currently available information, the Director-General accepted the Committee’s assessment and on 18 May 2018 did not declare the Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern (PHEIC). In light of the advice of the Emergency Committee, WHO advises against the application of any travel or trade restrictions. The Director-General thanked the Committee Members and Advisors for their advice.


Comment: We aren't there yet.

PHEIC=Public Health Emergency of International Concern

What is a public health emergency of international concern?

A PHEIC is defined in the IHR (2005) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”. This definition implies a situation that is:

*serious, sudden, unusual or unexpected;
*carries implications for public health beyond the affected State’s national border; and
*may require immediate international action.

The impression I'm getting from various places is that WHO believes that the rapid vax intervention in contacts should stop that particular circle of infection.

So, we wait. And watch.

Yes I got the same impression. They seem very confident and said they learned from the last outbreak.

Hey France! Can you see if there's anything earth shattering here?

[link to us13.campaign-archive.com (secure)]

It's a daily communication from the health minister, with the official figures.
In the commentaries it says that no new health professional has been infected.
It also says that they didn't found the patient zero yet.

SO good news..the vax seems to be holding and HCWs aren't getting sick.

Not so good news, P0 is unknown.

Good news, P0 is probably in the middle of nowhere.


Thanks!!

Well, nobody is rushing to globalization on this issue. So now the waiting game is when the virus is found through out the globe it can then be labeled as a 'pandemic'. Pandemic means prevalent over the whole country or the whole world.

WHO has laid down the parameters. From now on the news story will be measured as such. Trump better have the balls to call it for what it is, or we will suffer consequences beyond heartbreaking. Building that wall takes on a whole new meaning and purpose.

h/t tetano

[link to www.theguardian.com (secure)]

Ebola: two more cases confirmed in Mbandaka in DRC

Two more cases of Ebola have been confirmed in the north-western city of Mbandaka in the Democratic Republic of the Congo, health officials have said.

The report brings to three the number of confirmed cases in the city of 1 million people, raising the prospect of a wider outbreak than feared.

[snip]

Muyembe said laboratory results released late on Thursday had confirmed the two new cases. He was unable to give any further details about whether the individuals knew each other. The aid agency Médecins san Frontières, however, said it was aware of only one new laboratory-based confirmation from Mbandaka.

[link to reliefweb.int (secure)]

1. Situation update

Grade 3
Cases 45
Deaths 25
CFR 56%

I'm on the road today, driving from Hilton Head Island to Nashville. Will update as I can.

[link to times.cd]


"In connection with the consequences that the Ebola epidemic could cause in the supply of the city of Kinshasa, a consultation meeting is convened on Monday."

(Crossroads of several rivers including the Congo River and Oubangui River, Mbandaka supplies fish and meat to Kinshasa by the river. Boat and canoe traffic is intense between the two cities.)

Three confirmed cases in the city of a million? Yikes!

There must be thousands of contacts, many of which were anonymous. People on a bus, next to the patients at a vendor's table in a market, etc. Reminds me of how uneasy I'd get when someone I didn't know would do a wet sneeze on the subway back east, and sit there just hoping that this wasn't a major infection I'd been bathed in.

One could imagine that could go like the opening scene of the movie Contagion... but movie doom is cool while real world doom, not so much.

That's it! Doom on guys, this is what we have all been waiting for all these years. Personally I would have prefered thermo-nukes but Ebola will do the job. Was great knowing you all and thanks GLP for providing me the platform to speak.

Tedros Adhanom Ghebreyesus, chief executive of WHO, quoted by Agence France Presse (AFP), confirmed that teams are preparing to administer by Sunday, May 20, a vaccine to medical personnel deployed on the front line.

But this represents a major logistical challenge, as the vaccine must be kept at -51 degrees Celsius and the DRC is a tropical country where electricity supply is uncertain.

However, WHO warns about the risk of spreading the Ebola outbreak which is now considered "very high" at the national level and "high" for neighboring countries.

An alert made after reviewing his assessment of this epidemic in the province of Ecuador.

Nine neighboring DRC countries, including Congo-Brazzaville and the Central African Republic, have been informed that they are at high risk of spread, WHO said.

For its part, the International Organization for Migration (IOM) has announced the deployment of epidemiologists and medical staff in Kinshasa and 16 entry points on the DRC's borders to try to prevent the spread of Ebola .

[link to www.radiookapi.net (secure)]

W.H.O. Says New Ebola Outbreak Is Not Yet a Top Health Emergency

"Although Ebola’s presence in Mbandaka has made the risk of an international spread of the disease “particularly high,” the emergency committee said there should be no restrictions on travel or trade and instead urged stronger surveillance and preparations for dealing with the disease."

[link to www.nytimes.com (secure)]