ProMED Disease Outbreak Update

Ebola in the Democratic Republic of Congo, Middle East Respiratory Syndrome in Saudi Arabia, Lassa fever in Nigeria.

Information available within this Disease Outbreak Update is produced by Program for Monitoring Emerging Diseases (ProMED).

Ebola

Location

Outbreak in North Kivu and Ituri provinces, Democratic Republic of Congo, Ebola preparedness efforts in Uganda
 

Outbreak Update

Thu 2 May 2019. Epidemiological situation report, DRC Ministry of Health

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 1 May 2019:

Since the beginning of the epidemic, the cumulative number of cases is 1510, of which 1444 are confirmed and 66 are probable. In total, there were 994 deaths (928 confirmed and 66 probable) and 421 people cured.
 

• 286 suspected cases under investigation;
• 15 new confirmed cases, including 7 in Katwa, 3 in Musienene, 2 in Butembo, 2 in Mandima, and 1 in Mabalako;
• 10 new deaths of confirmed cases, including 7 community/hospital deaths -- 2 in Katwa, 2 in Butembo, 2 in Musienene, and 1 in Mabalako; and 3 ETC/TC deaths -- 2 in Butembo and 1 in Katwa;
• 6 new recoveries released from ETCs -- 4 in Butembo and 2 in Beni;
• 2 health workers, including one in Katwa and one in Musienene, are among the new confirmed cases. The cumulative number of confirmed/probable cases among health workers is 94 (6.2% of all confirmed/probable cases), including 33 deaths.

The latest WHO external situation report (30 April 2019) is available here.

As it stands, the current outbreak is the world's 2nd largest, and the DRC's 10th since 1976, when the disease was first recorded.
 

Outbreak Preparation and Response

Community Response 

Risk Communication and Community Engagement teams on the ground have been working closely with Infection Prevention and Control teams this week in support of the Safe Injection Campaign, an initiative aimed at encouraging the safer use of needles and injections in homes as a means of reducing EVD transmission risks. The campaign will commence on 5 May 2019, alongside activities for the World Hand Hygiene Day.

As part of the continued efforts to empower communities to be more actively engaged in the EVD response, requests received from the numerous dialogues with local residents are being reviewed to aid the transfer of the response ownership back to the community. Further plans are currently being drafted on who will deliver these feedback to the communities in a timely manner. Lastly, Risk Communication and Community Engagement teams are also working closely with other WHO partners to bring about a new mass communications campaign to comprehensively promote key messages to the affected communities from all outbreak response pillars. See more here.

The Paul G Allen Family Foundation named the WHO, Red Cross, and UNICEF as recipients of the Ebola Response Accelerator Challenge, funding projects that aim to end this outbreak quickly. The Red Cross project will track community data for response workers, while the WHO's project aims to train Congolese medical students and youth leaders about Ebola. The grant allows UNICEF to establish a new text message system.

Vaccination 

As of 2 May 2019 - since vaccination began on 8 Aug 2018, 109 844 people have been vaccinated [total numbers of people vaccinated in North Kivu, Ituri, Tshopo, and Haut-Uele provinces can be seen here. Preliminary data from the World Health Organization (WHO) released last month show the vaccine is 97.55% effective against the virus — see here. An article in Axios also explored the preliminary findings looking at the effectiveness of the vaccination programme currently in place within the DRC.

Preparedness in neighbouring countries 

Uganda has also increased its ebola preparedness efforts, recently completing an Ebola simulation exercise. In addition, the International Rescue Committee (IRC), in collaboration with the Ministry of Health and Kagadi district, is to establish Ebola screening points at points of entry into the country on the shores of Lake Albert. The Infectious Diseases Institute (IDI), as an implementing partner in the district, has been providing vehicles to enable the district Ebola task force go to hard-to-reach areas down the escarpment.
 

Disease Research

A new paper in PNAS assesses the effectiveness of the vaccination programme that was implemented in the May-July 2018 Ebola outbreak in the Democratic Republic of Congo.

Using a spatial model that incorporates human mobility, poverty, and population density, the researchers assessed the effectiveness of the vaccination program that was implemented during the 2018 Ebola outbreak. Their results demonstrate that even modest delays in initiating vaccination would have markedly eroded the impact of the program. The methodology used has applicability for identifying areas at risk during outbreaks of other emerging and reemerging diseases.

See the full ProMED post here.

 

MERS-CoV

Location

Riyadh, Saudi Arabia
 

Outbreak Update

Information from Saudi Ministry of Health Report 27 April — 5 May 2019:

In the 9 days since the last update [26 Apr 2019], there has been 1 newly confirmed case of MERS-CoV reported by Saudi Arabia and 2 outcomes - 1 fatal and 1 recovery - of previously confirmed cases.

NEW CONFIRMED CASE (See here)

Date of confirmation report: 4 May 2019
Case No: 19-1913
MERS in Riyadh city: 59-year-old male in Riyadh city, Riyadh region
Contact with camels: Unknown
Case classification: Primary
Current status: Active

NEWLY REPORTED FATALITY (See here)

Case No: 19-1894, Date of confirmation report: 4 Apr 2019. A 59-year-old male from Al Khafji, Ash Sharqiyah [Eastern] region. Classified as a secondary case. Date of outcome report: 27 Apr 2019. Outcome: fatal.

NEWLY REPORTED RECOVERY (See here)

Case No: 18-1911. Date of confirmation report: 22 Apr 2019. A 56-year-old male from Madinah city, Al Madinah region. Classified as a primary case with high risk exposure not identified. Date of outcome report: 28 Apr 2019. Outcome: recovered.

The total number of cases confirmed since 1 Jan 2019 is now 137, including 30 deaths. Reported case fatality rate 21.9 percent.

See the full ProMED post here

 

Lassa Fever

Location

Nigeria
 

Outbreak Update

Information from Nigeria Center for Disease Control Situation Reportv (Sun 28 Apr 2019):
 

• In the reporting week 17 (22-28 Apr 2019), 8 new confirmed cases were reported from 4 states -- Ondo (4), Taraba (1), Plateau (1) and Kebbi (2) -- with one new death in Ondo State.
• From 1 Jan to 28 Apr 2019, a total of 2323 suspected cases have been reported from 21 states. Of these, 554 were confirmed positive, 15 probable and 1754 negative (not a case).
  
  - Since the onset of the 2019 outbreak, there have been 124 deaths in confirmed cases. The case fatality rate in confirmed cases is 22.4%
• A total of 21 states have recorded at least one confirmed case across 82 local government areas.
• 92% of all confirmed cases are from Edo (36%), Ondo (28%), Ebonyi (8%), Bauchi (8%), Taraba (7%) and Plateau (6%) states
• Predominant age-group affected is 21-40 years (range, older than 1 month to 89 years; median age, 32 years).
• The male-to-female ratio for confirmed cases is 1.2:1.
• In the reporting week 17, one new healthcare worker was affected in Kebbi State. A total of 18 healthcare workers have been infected since the onset of the outbreak in 9 states.

Outbreak Response

• 13 patients are currently being treated at various treatment centres across the country: Irrua Specialist Teaching Hospital (ISTH) treatment Centre (1), Federal Medical Centre Owo (6), Taraba (3), Kebbi (2) and Plateau (1)
• A total of 7219 contacts have been identified from 20 states. Of these, 680 (9.4%) are currently being followed up, 6475 (90%) have completed 21 days of follow-up, while 8 (0.1%) were lost to follow-up. In addition, 116 (1.6%) symptomatic contacts have been identified, of which 56 (0.8%) have tested positive.
• The National Lassa fever multi-partner, multisectoral Emergency Operations Centre (EOC) continues to coordinate the response activities at all levels.

See the full ProMED post here


Information available within this Disease Outbreak Update is produced by Program for Monitoring Emerging Diseases (ProMED).

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