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

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EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU

Tuesday 21 August 2018

The epidemiological situation of the Ebola Virus Disease dated August 20, 2018:

• A total of 102 cases of haemorrhagic fever were reported in the region, 75 confirmed and 27 probable.

• 9 suspected cases are under investigation.

• 6 new confirmed cases, including 4 in Mabalako, 1 in Beni and 1 in Oicha.

• 4 confirmed [deaths], including 3 in Mabalako and 1 in Beni.

[snip]

News of the response

* The Ethics Committee approved the use of four additional experimental therapeutic molecules, namely ZMapp, Remdesivir, Favipiravir and Regn3450 - 3471 - 3479. Ebola Treatment Centers (ETC) treatment and care teams will be able to use these molecules for the treatment of patients infected with Ebola virus disease.

* Since vaccination began on August 8, 2018, 1,693 people have been vaccinated , including 903 in Mabalako, 471 in Beni and 319 in Mandima.


Comment: 6 new cases from Monday to Tuesday.

[link to www.cidrap.umn.edu]

WHO: 13 health workers infected in DRC Ebola outbreak

[snip]

Tarik Jasarevic, a spokesperson with the World Health Organization (WHO), told CIDRAP News that 13 healthcare workers have tested positive for Ebola, a troubling development, because infected health workers were one of the main factors in the rapid spread of the disease during the 2013-2016 outbreak in West Africa.

Jasarevic also commented on a recent UNICEF report that said children were being infected at high rates during this outbreak.

[snip]

On Twitter, the WHO confirmed that 10 vaccination rings have been identified around the most recent 28 cases in the outbreak, leading to approximately 1,300 people being vaccinated with Merck's unlicensed Ebola vaccine.

[snip]

Although the previous outbreak was challenging because it took place in such a rural area, WHO and DRC officials emphasize the challenge is greater in the current outbreak, which is taking place in an eastern region riddled with as many as 130 rebel fighting groups.

Earlier today, Peter Salama, MD, the WHO's deputy director-general for emergency preparedness and response, tweeted that 41 case contacts in security "red zones" are being followed up daily by health workers from DRC and Doctors Without Borders.

Last week, WHO officials said in a press conference that the "red zones" were largely inaccessible to workers trying to complete vaccination chains, and were the most frightening aspect of the outbreak.


Last Edited by NawtyBits on 08/22/2018 11:19 AM

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As of 19 Aug 2018, 10 rings have been defined around 28 recently confirmed cases and approximately 1300 people have consented and been vaccinated.

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Bunia: 24 Red Cross rescuers trained on the burial of Ebola corpses

On 20-21 Aug 2018, 24 Red Cross volunteers from Bunia and Mambasa (Ituri) were trained on the burial of the bodies of those who died of the Ebola virus disease.

Comment: Too late? 50+ people have already died and been buried. Why wait a month in to the outbreak to teach people these things....ugh

[link to i59.photobucket.com]

Map of affected area.

[link to apps.who.int]

Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 3

Situation Overview

The Ministry of Health in the Democratic Republic of the Congo, WHO and partners are responding to an Ebola virus disease (EVD) outbreak since 1 August 2018, with the epicentre being Mangina town in Mabalako Health Zone, North Kivu Province, in the east of the country. Confirmed cases have also been reported from Beni Health Zone (North Kivu Province) and Mandima Health Zone (Ituri Province).

Since our last situation report on 14 August 2018 (External situation report 2), an additional 45 new confirmed EVD cases and 18 new deaths have been reported. Nine other suspected cases are under investigation to confirm or exclude EVD. By 20 August 2018, 39 case-patients were admitted in Ebola treatment centres (ETCs) in Mabalako (36) and Beni (3).

As of 20 August 2018, a total of 102 confirmed and probable EVD cases, including 59 deaths, have been reported. Of the 102 cases, 75 are confirmed and 27 are probable. Of the 59 deaths, 32 occurred in confirmed cases and 27 remain probable. A total of 13 cases have been reported among health workers, of which, 12 are confirmed and one has died. Since the onset of the outbreak, a total of 10 case-patients have recovered from the disease and were discharged and re-integrated into their communities.

Among the 88 cases out of the 102 confirmed and probable cases for which age and sex are known, the median age was 32 years (age range: 0-74), with the age group 30-39 being most affected, accounting for 28% (25/88) cases. Women accounted for 58% (51/88) of all cases.

The epicentre of the outbreak remains Mabalako Health Zone in North Kivu Province, reporting 80% (82) of all cases, including 61 confirmed and 21 probable cases. Additionally, four other health zones in North Kivu Province and one in Ituri Province have reported confirmed and probable cases (Table 1).

As of 20 August 2018, a total of 2,408 contacts were listed, of these, 637 completed their 21-day mandatory follow up period. A total of 1 782 are currently under surveillance, of which 1,686 (95%) were seen on the reporting day.

The Ministry of Health, WHO and partners are monitoring and investigating alerts in other provinces in the Democratic Republic of the Congo and in neighbouring countries. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo as well as in Uganda, Rwanda and the Central African Republic, and, to date, EVD has been ruled out in all these alerts.

Context

North Kivu and Ituri are among the most populated provinces in the Democratic Republic of the Congo. North Kivu shares borders with Uganda and Rwanda. The provinces have been experiencing intense insecurity and a worsening humanitarian crisis, with over one million internally displaced people and a continuous efflux of refugees to neighbouring countries, including Uganda, Burundi and Tanzania.

The Democratic Republic of the Congo is also experiencing multiple disease outbreaks, including three separate outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the provinces of Mongola, Maniema and Haut Lomami/Tanganyika/Haut Katanga/Ituri, cholera in 12 provinces, measles spread across the country, and monkeypox.

[snip]

The EVD outbreak in the Democratic Republic of the Congo has evolved rapidly in the last week, with several new cases and deaths being reported . It is likely that more new cases and deaths will occur in the coming days and weeks as people who were earlier exposed to infections will develop illness. This stage in the evolution of the outbreak is also the defining moment in the efforts to contain the outbreak, in terms of averting further exposures to infections. The topmost priority remains strengthening and improving effectiveness and
efficiency of all aspects of the response, especially identifying all potential contacts, closely following them up and immediately isolating those who develop symptoms, scaling up vaccination activities,as well as strengthening other response pillars. These efforts need to be sustained and further enhanced to help
interrupt transmission and contain the outbreak.

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EPIDEMIOLOGICAL SITUATION IN THE PROVINCE OF NORTH KIVU

Wednesday 22 August 2018

The epidemiological situation of the Ebola Virus Disease dated 21 August 2018:

• A total of 103 cases of haemorrhagic fever were reported in the region, 76 confirmed and 27 probable.

• 7 suspected cases are under investigation.

• 1 new case confirmed to Mabalako who is a care provider.

• 2 deaths of confirmed cases in Mabalako.

[snip]

Vaccination

• Immunization activities are continuing at the three sites of Mabalako, Beni and Mandima. Since vaccination began on August 8, 2018, 2,179 people have been vaccinated, including 1,178 in Mabalako, 552 in Beni and 449 in Mandima.

• The vaccination of contacts of the first confirmed case of Oicha began this Wednesday, August 22, 2018.

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Congo-Kinshasa: Experimental Ebola Treatments OK'd in DRC as Cases Top 100


The Ebola outbreak in North Kivu province, Democratic Republic of the Congo (DRC) shows no signs of slowing down, as health officials approved the use of four additional Ebola treatments at Ebola treatment centers (ETCs) in the eastern part of the country.

As of yesterday, the DRC's health ministry reported a total of 102 cases (6 new), with 75 confirmed; 59 people have died, and 9 additional cases are suspected.

The DRC also updated information regarding immunization: Since vaccination began on Aug 8, 1,693 people have been vaccinated: 903 in Mabalako, 471 in Beni, and 319 in Mandima health zones.


Four new treatments approved for use


Last week DRC officials begin using the experimental monoclonal antibody treatment mAb114 in Beni on 10 patients. Now, ZMapp, remdesivir, favipiravir, and Regn 3450-3471-3479 are also approved for use in ETCs, the country's health ministry said.

They are planning to cause an outbreak. Look out too many people. They are going to kill us.. pray against these evil snakes i

Thanks Nawty.

Seems like they are trying, it looks like its going to largely depend on those rebel fighting zones.

I wonder on the effectiveness of the vaccines on those who have already been exposed and are in the process of coming down with it.

Hi, Nawty.

Been wondering how much this current outbreak will accelerate due to people hiding cases, like what happened in West Africa the last time (2014). Then, it was largely an issue of proper burial procedures according to custom versus medically-approved burial procedures, causing the hiding. They believed that if you didn't bury a person properly, consequences would be dire. Perhaps they thought the person wouldn't move on but would stay and curse them, like Madagascar tradition.

The current outbreak is so different. Multiple armed groups vying for mineral-rich land, and a close border with Uganda and Rwanda, would indicate a rough area to hang out. Would some hide cases to prevent exposure of their military numbers and situation to authorities? Why, certainly!

Sounds more like Mad Max than the last big outbreak, 2014-16, which was more steeped in primitive superstitions and group bathing of corpses, as well as fear of hospitals.

Yikes! This has all the makings of a great novel, but I wouldn't want to live it.

Dont take it people

Mother Nature is more effective at protecting the planet than any human could ever be. When she's ready, she will kick our asses with little to no help from puny humans.

Don't say stupid stuff. If you live in the DRC, your life expectancy is already shockingly low. If you are exposed to ebola, or are a health care worker, take the fucking vax. You have nothing to lose, and everything to gain.

The vax *appears* to be very effective. The problem, as you stated, is the current state of unrest in the region. If ebola takes off, this will be the main reason.

The Red Cross was training people is safe burials this week. But, there are too many people whose deeply rooted traditions and superstitions that will do what they believe is best. And that is not going to help things. People will be hiding cases, stealing bodies, hiding bodies, etc. Factor in all the fighting factions, and the danger of just being there, and I can't see how anything good will come of this.

I hope we don't have to live it.

And if it come to the point where the vax is needed here in the US, we have much bigger problems than the vax itself.

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EPIDEMIOLOGICAL SITUATION IN NORTH KIVU PROVINCE

Thursday 23 August 2018

The epidemiological situation of the Ebola Virus Disease dated August 22, 2018:

• A total of 103 cases of haemorrhagic fever were reported in the region, 76 confirmed and 27 probable.

• Of the 76 confirmed cases, 36 died, 31 are hospitalized and 9 are cured.

• 13 suspected cases are under investigation.

• 2 deaths of confirmed cases in Mabalako.

[snip]

Vaccination

• Since vaccination began on 8 August 2018, 2,613 people have been vaccinated , including 1,311 in Mabalako, 632 in Beni, 626 in Mandima and 44 in Oicha.

[snip]

Port of entry monitoring

To date, 715,238 travelers have passed the sanitary control at the 28 entry points set up.


Comment: no new cases 8/21 and 8/22. 6 more suspects

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Patient diagnosed with first case of Mers virus in England since 2013

A person who was diagnosed with the first case of Middle East Respiratory Syndrome (Mers) in England since 2013 is said to be in a stable condition.

Public Health England (PHE) said the patient is a resident of the Middle East, where they are believed to have contracted the infection before travelling to the UK.

“While this is a serious infection for the individual, the risk of transmission to the general population from this case is very low,” a spokesman said.

He said the patient was initially admitted to a hospital in Leeds and then transferred to Liverpool hospital, an expert respiratory infectious disease centre, where they are stable and receiving appropriate treatment.

[snip]

As a precautionary measure, PHE experts are working closely with NHS colleagues to advise them on infection control measures and will be contacting people who might have been in close contact with the individual to monitor their symptoms and provide health advice.

This will include contacting passengers who travelled in close proximity to the patient on the same flight to the UK.

They said people without symptoms were not considered infectious but, as a precaution, those who have been in close proximity will be contacted and monitored to ensure that if they do become unwell they can be treated quickly.

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Russian bots were used to sow divisions on vaccines

By Helen Branswell

In the lead-up to the 2016 U.S. election, Russian bots and trolls took to Twitter and other social media platforms to try to turn Americans against one another. But in addition to spreading false information and interfering in the election, a new study reports, a significant number of these malevolent actors tried to sow discord over vaccines.

An analysis of Twitter accounts previously identified as having been operated by Russian bots and trolls found they dove into the vaccine debate as early as January 2015, the researchers reported. They did not take one side or the other, but seemed to tweet pro-vaccine and anti-vaccine messages in roughly equal measure.

On a variety of issues, the overall aim of the Russian campaign appeared to be to erode social cohesion and generate confusion by amplifying the number of voices taking part in these debates on social media. But in the case of vaccines, that could have increased the misperception that the science on their safety and effectiveness isn’t settled — as is the case — but rather that it is still subject to debate.

[snip]

Even though the division of pro- and anti-vacccine tweets was roughly equal, that still skewed the picture of views on vaccines on Twitter, he noted, pointing to data from the Pew Trust that shows the vast majority of Americans support vaccination.

“We’ve always been a little puzzled why social media looks like there are so many anti-vaxxers,” said Broniatowski. “So even if somebody’s posting 50-50, compared to the Pew data, there are going to be more anti-vaxxers.”

h/t shiloh

[link to www.cidrap.umn.edu]

WHO: 95% of Ebola case contacts in DRC now traced

As of Aug 20, 95% of case contacts in the latest Ebola outbreak in the Democratic Republic of the Congo (DRC) have been traced, according to a tweet today from Peter Salama, MD, the World Health Organization's (WHO's) deputy director-general for emergency preparedness and response.

In a graph showing the percentage of case contacts traced, Salama explained, "Dips in recent days show when work was needed to engage with communities before teams could access some areas. That work was done successfully. On 20 August, 95% of 1,782 contacts followed-up in 3 health zones."

Press Release. Not subject to 50% rule.

[link to www.gov.uk (secure)]

Public Health England (PHE) confirm that an individual has been diagnosed with Middle East Respiratory Syndrome (MERS) in England.

Published 23 August 2018

From:
Public Health England

MERS-Cov

The patient was initially admitted to a hospital in Leeds and was transferred to Royal Liverpool Hospital, an expert respiratory infectious disease centre, where they are stable and receiving appropriate treatment.

The patient is a resident of the Middle East, where they are believed to have contracted the infection, before travelling to the UK.

While this is a serious infection for the individual, the risk of transmission to the general population from this case is very low.

MERS-CoV (the virus that causes MERS) can be spread when someone is in close contact with a patient for a sustained period of time. This means there is a very low risk to the general population of becoming ill.

This is the fifth case of MERS diagnosed in England, with previous cases diagnosed in 2012 to 2013.

As a precautionary measure, PHE experts are working closely with NHS colleagues to advise them on infection control measures. They will be contacting people who might have been in close contact with the individual to monitor their symptoms and provide health advice. This will include contacting a number of passengers who travelled in close proximity to the patient on the same flight to the UK.

People without symptoms are not considered infectious but, as a precaution, those who have been in close proximity will be contacted and monitored to ensure that if they do become unwell they can be treated quickly.

If people show symptoms of MERS after travelling to the Middle East, our advice remains unchanged and they should contact health services through the usual routes – by calling their GP or NHS 111.

Typically MERS symptoms include fever, cough and shortness of breath.

Healthcare professionals are advised to remain vigilant for severe unexplained respiratory illness occurring in anyone who has recently travelled into the UK from the Middle East, particularly in light of increased travel associated with the Hajj.

Dr Jenny Harries, Deputy Medical Director at PHE, said:

A patient in hospital in Liverpool is being treated for Middle East Respiratory Syndrome coronavirus (Mers-CoV) infection. The patient is thought to have contracted the infection whilst in the Middle East before travelling to the UK.

Public Health England is following up those who have had close and sustained contact with the patient to offer advice and to monitor them as necessary.

It is important to emphasise that although a case has been identified, the overall risk of disease transmission to the public is very low.

As we’ve seen in previous cases, we have well established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed to minimise the risk of transmission.

Background

No further details about the patient will be provided due to patient confidentiality.
The patient was first assessed, diagnosed and treated at Leeds Teaching Hospitals NHS Trust before being transferred to the specialist unit in Liverpool. The NHS will not issue daily condition checks. An update will only be provided if there is a significant change to the patient’s condition.
The patient travelled on Saudi Arabian Airlines flight (number SV123) on 16 August 2018. Aircraft recycle and filter the air in the cabin and this is why contact tracing is usually restricted to 3 rows in front and 3 behind the case. If you have not been contacted then you are not considered at risk.
The total number of laboratory confirmed cases detected in the UK is now 5: the current case, 2 imported from the Middle East in 2012 to 13 and 2 as a result of onward transmission from one of the cases whilst in the UK. General travel health advice for travellers going to the Middle East is available from NaTHNaC’s website TravelHealthPro.
MERS guidance issued by PHE for clinicians can be accessed from the: Middle East respiratory syndrome coronavirus (MERS-CoV): clinical management and guidance.
Health advice posters are available here on the PHE website.
Typically MERS symptoms include fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhoea, have also been reported.

Public Health England press office

Email [email protected]

Telephone 020 7654 8400

h/t sharon sanders

These are the 5 MERS cases in UK.

The five cases:

#4 - Man, 49, onset date September 3 after travel from Saudi Arabia, hospitalized September 7 in Doha, Qatar, transported to the UK via air ambulance September 11 - Saudi Arabia Death note.

#10 - Man, 60, onset 26 January, hospitalized in ICU in UK, died March 19, travel history to Saudi Arabia Death note

#11 - Man, 38, onset February 6, died February 17, comorbidities, son of case #10 - United Kingdom Death note

#12 - A younger female family member, who only had exposure to Case 10 while he was in hospital. She became ill on February 5 with a typical influenza-like illness which did not require hospital admission. She has now fully recovered. - United Kingdom

#2238 - Patient, hospitalized in Leeds, England after arrival from the Middle East <--current case


Source: FluTrackers Cumulative Coronavirus MERS Case List

h/t crofsblog

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

Ebola: medics brace for new cases as DRC outbreak spreads

An outbreak of Ebola in the Democratic Republic of the Congo (DRC) has reached a pivotal moment and now endangers medical teams fighting to stop the spread of the disease, health workers have said.

Dr Peter Salama, the World Health Organisation’s emergencies chief, said there were 103 confirmed and probable cases in the outbreak, which is centred in the eastern province of North Kivu, and that another wave of cases was expected.

[snip]

Several cases of Ebola have already been identified in the city of Beni, raising fears of further infection in a crowded urban centre.

[snip]

Just as worrying, health workers said, was a new case in the town of Oicha, which is almost entirely surrounded by an Islamist militia based in Uganda that has been responsible for a series of bloody raids across the region.

North Kivu is one of the most violent parts of Congo, and is a base for dozens of armed groups that contest government authority and exploit mineral resources in the region.

The WHO said a doctor in Oicha had been hospitalised with Ebola, and 97 of his contacts had been identified. “It is the first time we have a confirmed case and contacts in an area of high insecurity. It is really the problem we were anticipating and at the same time dreading,” Salama said.

[snip]

We are worried that we are not seeing the suspect cases coming into our centres that we should be seeing. It is not a situation where we are confident that the outbreak is under control,” Huster said. “It is all about winning the trust of the community. It’s super important to come early when they are sick and people often come too late.”

Hey nawty, I have a separate thread about the difficulties regarding this particular outbreak so likely some overlap. I feel this is quite different compared to other outbreaks In the region. Since I know you and feisty and others frequent this thread

I will post here instead, as I know there are posters with a little bit more background and interest in science, as well as the difficulties on the ground,
Both politics and violence being the main themes. I posted many times as an AC back in the day in related threads and hopefully I can help keep the threads updated to this quickly growing problem, which could easily spill across borders..

As always I appreciate everyone's incite and getting the word out...

Thread: Ebola, Why this time it IS dirrent.

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

MPONDWE, Uganda — On Tuesdays and Fridays, an estimated 19,000 people stream down the hill from Congo’s North Kivu province to cross the border into this small town, many of them headed to a sprawling open-air market.

The current outbreak is still escalating, according to Redfield and workers at nongovernmental organizations that have rushed in to treat victims and interrupt the spread of the disease
“Really, in two weeks, we’ve gone from 24 cases to 105 cases,” Redfield said, mainly because many health workers at a hospital in the town of Mangina, where the outbreak began, became infected when they treated early patients without recognizing that they had Ebola and therefore did not take adequate precautions. The disease spreads through contact with the bodily fluids of victims, putting health workers and patients’ family members at greatest risk.
“In the next couple of weeks, we’ll have greater clarity” about the scope of the problem, Redfield said.
“The scary thing is that we are above 100 cases already,” said Michelle Gayer, director of emergency health for the International Rescue Committee, a nonprofit organization that is helping in the region. But she said it will be another week before health authorities can begin to assess fully how bad the outbreak may become.

It is accelerating quickly, and the numbers given so far are likely we'll behind the current stats due to reporting issues and violence.

This appears to me and many others to be a far worse situation than recent outbreaks given the conditions. They are having difficulty Reaching the contacts for contact tracing. Even at 95%, it still represents around 120 cases unaccounted for.

Time will tell, as such a quick rise occurred in only two weeks, the common incubation period.

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

An outbreak of Ebola in the Democratic Republic of the Congo (DRC) has reached a pivotal moment and now endangers medical teams fighting to stop the spread of the disease, health workers have said.

Dr Peter Salama, the World Health Organisation’s emergencies chief, said there were 103 confirmed and probable cases in the outbreak, which is centred in the eastern province of North Kivu, and that another wave of cases was expected.

The DRC’s Health Ministry has confirmed 36 deaths. Another 27 deaths were suspected to be from Ebola, it said. Salama said 14 healthcare workers had been infected so far, one of whom had died.

Several cases of Ebola have already been identified in the city of Beni, raising fears of further infection in a crowded urban centre.

Just as worrying, health workers said, was a new case in the town of Oicha, which is almost entirely surrounded by an Islamist militia based in Uganda that has been responsible for a series of bloody raids across the region.

North Kivu is one of the most violent parts of Congo, and is a base for dozens of armed groups that contest government authority and exploit mineral resources in the region.

The WHO said a doctor in Oicha had been hospitalised with Ebola, and 97 of his contacts had been identified. “It is the first time we have a confirmed case and contacts in an area of high insecurity. It is really the problem we were anticipating and at the same time dreading,” Salama said.

Karin Huster, coordinator for Médecins Sans Frontières in Mangina, the epicentre of the outbreak, said new patients were arriving at the emergency treatment units every day.

Obviously we are concerned. We are worried that we are not seeing the suspect cases coming into our centres that we should be seeing. It is not a situation where we are confident that the outbreak is under control,” Huster said. “It is all about winning the trust of the community. It’s super important to come early when they are sick and people often come too late.”

The insecurity in the region and a mobile population has made vaccination campaigns like the one that helped overcome an Ebola outbreak that killed 33 in the north-west of the DRC earlier this year less effective.

It's hard to believe that more are not following this...I guess they believe that every outbreak is the same. This has so many differences, and we have not even fully sequenced the virus that I am aware of. We still no very little, yet, the things we do know are troublesome