Posted on 15TH MAY 2017
tagged Ebola, Democratic Republic of Congo; Nigeria

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1-3] Democratic Republic of Congo
[4 & 5] Nigeria

[1] Democratic Republic of Congo
Date: 13 May 2017
Source: Digital Journal [edited]

In a statement dated 13 May 2017, the World Health Organization announced it is now investigating 3 Ebola cases in The Democratic Republic of Congo (DRC), with the 1st case possibly being the "index case." The 2 additional suspected cases were identified after the Ebola outbreak was declared on 12 May 2017, according to Reuters. Government and WHO health care workers reached the remote area in Bas-Uele province in northeastern Congo, on the border with Central African Republic on Sat [12 May 2017].

The health teams will begin their field investigation with the hope of quickly identifying, testing, isolating, and treating any suspected cases. "The 1st case and possibly the index case, a 39-year-old male, presented onset of symptoms on 22 Apr 2017 and was deceased on arrival at the health facility," the WHO said in a statement. Bas-Uele province has a population of around 900 000 people, with most of the inhabitants belonging to the Baboa ethnic group. People in the province engage primarily in subsistence farming, hunting, and a little river commerce. The affected region is about 1300 km (808 miles) from the country's capital, Kinshasa. According to WHO spokesman Christian Lindmeier, out of 9 cases so far, 3 have died. "We need to take this very seriously," he added.

Al Jazeera quoted Lindmeier: "It's very important to find all the possible contacts of people who have been infected or been in contact, and to see whether there is a possible continuation of infection, and limit it as much as possible."

Communicated by:

[There are now 11 cases, with 3 deaths. Two cases have been confirmed.

- Democratic Republic of Congo (4o 18′ 38″ S, 15o 17′ 22″ E)
- Democratic Republic of the Congo (2o 52′ 34″ S, 23o 39′ 18″ E)

A map of the affected area can be seen at https://www.independent.co.ug/ebola-in-drc/ and a HealthMap/ProMED-mail map of the DRC at http://healthmap.org/promed/p/194. - Mod.LK]

[2] Democratic Republic of Congo: 2nd case confirmed
Date: Sun 14 May 2017
Source: Reuters [edited]

The World Health Organization (WHO) confirmed on Sun [14 May 2017] a 2nd case of Ebola in Democratic Republic of Congo after an outbreak this week of 17 other suspected cases.

Health officials are trying to trace 125 people thought to be linked to the cases identified in the remote northeastern province of Bas-Uele province in northeastern Congo near the border with Central African Republic, WHO's Congo spokesman Eugene Kabambi said. Three people have so far died among the 19 suspected and confirmed cases, he added.

It was not immediately clear how the 1st victim, a deceased male, caught the virus, although past outbreaks have been linked to contact with infected bush meat such as apes.

The outbreak comes just a year after the end of an epidemic in West Africa that killed more than 11 300 people, mostly in Guinea, Sierra Leone and Liberia.

However, Congo, whose dense forests contain the River Ebola near where the disease was 1st detected in 1976, has experienced many outbreaks and has mostly succeeded in containing them without large-scale loss of life.

The GAVI global vaccine alliance said on Friday [12 May 2017] that some 300 000 emergency doses of an Ebola vaccine developed by Merck (MRK.N) could be available in case of a largescale outbreak and that it stood ready to support the Congo government on the matter.

[Byline: Aaron Ross]

Communicated by:

[The MRK.N vaccine is rVSV-ZEBOV, which was shown to be highly protective against Ebola in clinical trials published in December 2016. See ProMED post "Ebola update (18): Congo DR, vaccine 20170513.5034029." - ModLK]

[3] Democratic Republic of Congo: WHO Regional Director visit
Date: Sat 13 May 2017
Source: WHO [edited]

The WHO Regional Director for Africa, Dr. Matshidiso Moeti, today [13 May 2017] visited Kinshasa (DR Congo) to discuss with national authorities and partners ways to mount a rapid, effective and coherent response in order to stop the ongoing Ebola outbreak.

The visit follows notification by the DRC Government of an outbreak of Ebola virus disease in Likati health zone, Bas Uele Province, in the northern part of the country bordering Central African Republic. The Likati health zone is around 1400 km from the capital. As of today [13 May 2017], 11 suspected cases including 3 deaths have been reported.

Speaking at the meeting, Dr Moeti said: "I am here to assure the government of DR Congo that, in collaboration with the UN system and other partners, we will work together to respond to this outbreak. WHO has already mobilized technical experts to be deployed on the ground and is ready to provide the leadership and technical expertise required to mount a coordinated and effective response. I encourage to public to work with the health authorities and take the necessary preventive measures to protect their health."

On 10 May 2017, a multidisciplinary team led by the Ministry of Health (MoH) and supported by WHO, under the new WHO Emergency Programme, and partners, was deployed to the Likati health zone, Bas Uele Province to conduct an in-depth field investigation. The health zone is situated in the remote, isolated and hard-to-reach northern part of the country, with limited transport and communication networks, factors that all impeded transmission of information about the suspected outbreak. Currently, it takes about 2-3 days to reach the epicenter from Kinshasa.

The Global Outbreak Alert and Response Network (GOARN) has been activated to provide additional support if required. Reinforcement of epidemiological surveillance, contact tracing, case management, and community engagement are underway.

"We are grateful to WHO and other partners for the swift support in carrying out investigations that led to the confirmation of this outbreak," said Dr. Oly Ilunga Kalenga, the Minister of Health of DR Congo. "A strong multi-sectoral response, better coordination, public awareness, community engagement and adequate resources will be critical in our efforts to stop the outbreak," he added.

The 1st case occurred on 22 Apr 2017 in a 45-year-old male. He was transported by taxi to hospital and was dead on arrival. The driver also fell ill and later died. A 3rd person who cared for the 1st case also became ill and has subsequently died. At present, 25 contacts of the 2nd patient who died are being followed. Of the cases and deaths, one has been tested PCR-positive for Ebola [Now 2 cases have been confirmed; see above. - Mod.LK].

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[4] Nigeria
Date: Sat 13 May 2017
Source: Premium Times [edited]

The management of the Federal Airports Authority of Nigeria (FAAN) has assured Nigerians of adequate surveillance at the nation's airports following the outbreak of Ebola virus in the Democratic Republic of Congo.

The World Health Organization (WHO) declared an Ebola outbreak in the Democratic Republic of Congo on Friday [12 May 2017], saying that at least one person had been confirmed dead due to the virus in the country's northeast.

Henrietta Yakubu, FAAN's Acting General Manager, Corporate Affairs, spoke to the News Agency of Nigeria (NAN) on Sat [13 May 2017], saying that there was no direct flight from Congo to Nigeria.

Ms. Yakubu also said that all the preventive measures being put in place at the airports were still in place. She said that the Port Health officials were at alert at all airports, adding that the authority had also informed them of the need to increase surveillance.

"We don't have direct flights from Congo; we only have them from Rwanda, but I want to assure members of the public that we still have all preventive measures in place at our airports. There are sanitizers at our arrivals with the scanning apparatus called Thermal scanners being installed by the Port Health Services. The scanners have camera monitors that display pictures aside the capturing of temperature."

Communicated by:

[Nigeria experienced Ebola virus in July 2014 when a Liberian-American who had the disease flew from Liberia to the Murtala Muhammed International Airport, Lagos and died 5 days later.

In response, "the Federal Government observed all of [this person's] contacts for signs of infection and increased surveillance at all entry points to the country. Nigeria was able to curtail the disease and was subsequently declared Ebola free by WHO."
From http://allafrica.com/stories/201705130233.html.

A HealthMap/ProMED-mail map of Nigeria can be found at http://healthmap.org/promed/p/62. - Mod.LK

[5] Nigeria
Date: 14 May 2017
Source: Punch Nigeria [edited]

According to the Minister of Health, Prof. Isaac Adewole, who said in a statement by the Director of Media and Public Relations, Mrs. Boade Akinola, on Sat [23 May 2017] the Federal Government has asked every health official in the country to test every fever patient showing symptoms of bleeding for the Ebola virus disease (EVD). It also asked all port health officials to step up inspection of all persons coming into the country.

The statement came less than 24 hours after the World Health Organization declared the outbreak of Ebola in DR Congo, describing the outbreak as "a public health crisis of international importance."

The ministry of health said: "The health minister directs all Nigerian health workers to maintain a high index of suspicion by screening all hemorrhagic fever patients for Ebola. Similarly, the minister encourages members of the public to observe a high level of personal hygiene, which includes regular hand washing and to also report all cases of fever to the nearest health facility."

The minister said he had directed health workers to increase efforts at ports of entry, and added that "The Federal Government, in response to the announcement by the WHO on confirmed cases of Ebola in the Democratic Republic of Congo, has directed port health officials to step up inspection activities and to report any sick person or suspects to ensure that epidemiologists in the states conduct relevant tests."

The FG also said: "The symptoms to look out for include fever, fatigue, weakness, dizziness and muscle aches. Patients with more severe cases show bleeding under the skin, internal organs or even from bodily orifices like mouth, nose and ears."

He added, "The Federal Government in response to the announcement by the WHO on confirmed cases of Ebola in the Democratic Republic of Congo [DRC], has directed port health officials to step up inspection activities and to report any sick person or suspects to ensure that epidemiologists in the states conduct relevant tests."

The minister also urged Nigerians not to panic as the Nigerian Center for Disease Control is on the ground and equipped to secure the health of citizens.

He said the CDC had for awhile been strengthening states' capacities to detect, manage and respond to hemorrhagic fevers, including Lassa fever.

Adewole called on states to begin social mobilization and media awareness efforts via television, radio, print and social media.

Meanwhile, the Nigerian Medical Association has called on doctors nationwide to immediately report suspicious cases to the Federal Government.

Speaking with Sunday Punch on Sat [13 May 2017], the President of the NMA, Prof. Mike Ogirima, said doctors across the nation should begin to take precautions and report suspicious cases. He said: "The Federal Government already has adequate experience on dealing with this because of the 1st outbreak, so we advise them to consolidate. We also want to advise them to quickly set up and put in measures in place to prevent any case, and even if by chance we have any case within the country, we should control the spread. We advise Nigerians to take care and stick to universal basic precautions, such as regular washing of hands, avoid overcrowding, and reporting of suspicious cases immediately to the nearest health center. We also advise our members all over the country to be on the alert and to make sure that they are well prepared and have the proper supplies to face any challenge." more...

[Byline: Eniola Akinkuotu]

[Compiled by: Celeste Whitlow]

Communicated by:

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