Posted on 24TH MAY 2017
tagged Ebola, Worldwide

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

In this update:
[1] News
- African response to outbreak
- 4th case fatality DR Congo
- South Sudan: borders closed
- Nigeria: seaports
- EU [European Union] humanitarian air service
[2] Research
- International responders
[3] Vaccine

[1] News
21 May 2017 DRC: WHO optimistic on controlling DRC Ebola outbreak
[The World Health Organization's [WHO's] regional chief for Africa says prospects for rapidly controlling the spread of the deadly [Ebola virus disease (EVD)] in Democratic Republic of Congo are good. WHO reports 29 suspected cases, including 3 deaths since the outbreak was discovered in a remote region of DRC on [22 Apr 2017].

WHO's regional director for Africa does not underestimate the difficulties that lie ahead in bringing this latest outbreak of [EVD] in Democratic Republic of Congo to an end. Matshidiso Moeti notes the outbreak is centered in a remote area where it is difficult to operate and to bring in the personnel and material needed to contain this deadly disease. But, she tells VOA she is very encouraged by the speed with which the government and its national and international partners have responded to this crisis.

Moeti continues, "But, I am quite optimistic because this is a government that is experienced at this and which has got off to a very quick start and we are already on the ground with the partners," she said. "We are getting logistic support from WFP [World Food Program] and from the U.N. mission. So, I am quite optimistic."

Moeti calls the remoteness of the area a mixed blessing. "It is, of course, an area from which we are not expecting rapid expansion of the outbreak to other localities due to population movement as happened in West Africa. Although we are keeping a close eye on the Central African Republic...where we are concerned that there is insecurity there. There is some population movement there," she said.

Moeti says it is difficult to operate and carry out surveillance or investigations in this area because roads for car traffic do not exist. She says the government has fixed up a landing strip to enable helicopters to fly in the experts and material needed to combat this deadly disease."]

20 May 2017 DRC: African countries on alert over DR Congo Ebola outbreak
[African countries, including Rwanda, Uganda, Ghana, Kenya and Nigeria, have heightened surveillance measures at borders following an outbreak of the deadly [Ebola virus disease (EVD)] in the Democratic Republic of Congo (DR Congo).

Rwanda has kicked off new screening measures at its official border posts with DR Congo in order to detect [EVD]. Anyone entering Rwanda via official border posts with the DR Congo in Rubavu and Rusizi districts will go through temperature screening procedures, said a statement released by the Rwanda ministry of health on Fri [19 May 2017].

Uganda's minister of state for health Sarah Opendi told Xinhua that the country's National Health Task Force has been reactivated. She said health workers in Uganda's western border districts have been put on alert to monitor people coming in from DR Congo. "We have written to all District Health Officers to increase on surveillance, raise public awareness and alert the people about the Ebola outbreak" in DR Congo, said Opendi.

In Ghana, the Ghana Health Service (GHS) on Fri [19 May 2017] issued an alert on [EVD], calling on regional directors to enhance their preparedness.

Kenya's Director of Medical Services at the Ministry of Health Jackson Kioko said the government has reactivated the rapid response teams for enhanced surveillance and follow up of travelers with elevated body temperatures and asymptomatic cases with history of travel from DR Congo. "We wish to assure Kenyans that there is no suspected case of [EVD] in the country and they should remain vigilant, look out for any such illnesses and report to the nearest health facility without delay for immediate verification and investigation," Kioko said.

Tanzania has dispatched a team of medical experts in 6 regions in an effort to improve detection and information systems against outbreak of [EVD].

Health authorities in Zambia have also intensified surveillance in areas bordering DR Congo. Minister of Health Chitalu Chilufya said the government has put in place intervention measures to ensure that the disease does not enter Zambia.]

22 May 2017 DRC: 4th person succumbs to Ebola in Congo - WHO
[A 4th person is suspected to have died after succumbing to [Ebola virus disease (EVD) in the Democratic Republic of (DRC) Congo.
The World Health Organization (WHO) said on Sun [21 May 2017] that the person had died in a remote part of north-eastern DRC, bringing the total number of cases in Africa to 37.

Two of the 37 cases were confirmed as [Ebola virus disease, EVD], while 3, including the latest death, are considered probable of being [EVD], and 32 were suspected, WHO's Congo spokesperson Eugene Kabambi told the media.

Mobile laboratories have been dispatched to the zone where the disease is prevalent by the health authorities who are monitoring 416 people who had come into contact with sufferers, Kabambi added.]

22 May 2017 DRC: Gbudue, Tombura States [South Sudan] close borders with DRC in fear of Ebola virus disease (EVD) spread
[Tombura Deputy Governor, Lino Utu said the decision to close the 2 borders is a primary preventive measure the 2 States have taken following a report of 2 [Ebola virus disease (EVD)] death cases on 11 May 2017 and 29 suspected. The move comes a day when Gbudue State formed a task force monitoring committee to monitor the border over reports of a 2nd pandemic [EVD] outbreak in DRC since the first of 1976 near the Ebola River in the DRC.] ...more

[Gbudwe State is one of the 28 states of South Sudan created on 2 Oct 2015. It is located in the Equatoria region of South Sudan, and borders DR Congo. - Mod.LK]

23 May 2017 Nigeria: Govt unveils plans to check Ebola at seaports
[The Federal Government has instituted measures to ensure that the deadly [Ebola virus disease (EVD)] does not find its way back to the country through the seaports. Consequently, government is deploying officials of Port Health Services and Nigerian Ports Authority, NPA, to achieve the containment.

Speaking to newsmen in Lagos weekend, Port Manager of Lagos Port Complex, Apapa, Hajia Aisha Ali-Ibrahim, said all hands were on deck to intensify screening of seafarers coming into the country through the waterways and also ensure appropriate screening at all entry points into the port. She also said NPA was giving all necessary support to the Port Health Services to ensure there were no loopholes in carrying out the checks.] ...more

23 May 2017 DRC: Stylianides announces first EU airlift for Ebola outbreak in DR Congo
[The EU today [23 May 2017] announced its 1st tranche of aid in the fight against the Ebola outbreak in DR Congo. The announcement in Brussels came as the beleaguered country announced the 4th suspected death from the disease. Some 37 cases have now been reported in the north east of the gigantic but impoverished and politically unstable former Belgian colony.

Speaking in Brussels, Crisis Management Commissioner Christos Stylianides said: "It's vital to reach the affected areas and support early efforts in tackling the latest Ebola outbreak in the Democratic Republic of Congo. The EU's humanitarian air service will help get specialized personnel and medical supplies to the northeast of the country."] ...more

[2] Research
16 May 207. CF Houlihan, McGowan CR, Dicks S et al. Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014-2016: A cross-sectional study. PLoS Medicine 14(5): e1002300.
https://doi.org/10.1371/journal.pmed.1002300 [edited]

Healthcare and other front-line workers are at particular risk of infection with Ebola virus (EBOV). Despite the large-scale deployment of international responders, few cases of Ebola virus disease have been diagnosed in this group. Since asymptomatic or pauci-symptomatic infection has been described, it is plausible that infections have occurred in healthcare workers but have escaped being diagnosed. We aimed to assess the prevalence of asymptomatic or pauci-symptomatic infection, and of exposure events, among returned responders to the West African Ebola epidemic 2014-2016.

This is the 1st study, to our knowledge, of the prevalence of EBOV infection in international responders. More than 99 percent had clear negative results. Sera from 2 individuals had discordant results on the different assays; both were negative on the competitive assay, suggesting that prior infection was unlikely. The finding that a significant proportion experienced "near miss" exposure events, and that most of those who experienced symptoms did not get tested for EBOV at the time, suggests a need to review and standardise protocols for the management of possible exposure to EBOV, and for the management of illness, across organisations that deploy staff to outbreaks.]

[The authors conclude from their study that protocols for the management of possible exposure to Ebola virus and for the management of illness should be reviewed and standardised across organisations that deploy staff to outbreaks. - Mod.LK]

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[3] Vaccine
22 May 2017 DRC: WHO ready to deploy [Ebola virus disease (EVD) vaccine in disease outbreak.
[For the 1st time during a live outbreak of [Ebola virus disease (EVD)], a vaccine could be used to stop the spread of the disease, the World Health Organization [WHO] has said. In a press briefing on 18 May 2017, WHO said that it had been in discussions with the government of the Democratic Republic of Congo (DRC) about deploying the vaccine to combat the outbreak of the disease declared on 12 May 2017. As of 17 May there have been 20 cases of Ebola in the country [now 37, see above. - Mod.LK], 2 of which have been laboratory confirmed. A total of 4 people have died in the outbreak, which is centered in the Likati area in the north of the] ...more
(Gulland A. BMJ 2017;357:j2454)

[compiled by: Celeste Whitlow ]

Communicated by:

- 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]

See Also
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