Date: Sun, 29 Dec 2019 18:28:40 +0100 (MET)

Beni, DR Congo, Dec 29, 2019 (AFP) - A total of 2,231 people have died out of 3,373 declared cases of Ebola in the current epidemic in the DR Congo, according to the agency overseeing the response, health officials said Sunday.   Deadly unrest in the fragile state has hampered the fight against the disease during the latest epidemic, which broke out on August 1, 2018, with the eastern provinces of North Kivu and Ituri particularly badly hit.

Both areas, beset by violence for two decades, have seen repeated attacks on Ebola health workers by dozens of armed groups as well as on health sites set up to treat victims.   More than 200 civilians have been killed in the troubled east since November in clashes blamed on the Allied Democratic Forces (ADF), a militia group of Ugandan origin which officials blame for a string of massacres in recent weeks.

Health authorities meanwhile said Sunday that 341 suspected Ebola cases were being investigated, a day after the Multisectoral Committee for Epidemic Response (CMRE) monitoring the disease unveiled its latest batch of data Saturday.   The current epidemic is the tenth overall and the second deadliest on record since a 2014-16 outbreak struck west Africa, killing more than 11,300.
Date: Sat, 28 Dec 2019 10:13:40 +0100 (MET)

Tshikapa, DR Congo, Dec 28, 2019 (AFP) - Twenty bodies have been recovered from a river in the Democratic Republic of Congo after a ferry blaze, local officials said Saturday.   The boat, which was transporting dozens of passengers as well as goods, caught fire overnight Monday in Tshimbinda, a village near Tshikapa, the capital of the central province of Kasai.

A report by a naval force in charge of waterway security in the DRC said a member of the crew lit a cigarette just as his comrades were filling up the boat with fuel.   It said 17 bodies were found on Tuesday and another three on Friday along the Kasai river, a tributary of the Congo River.

Several other people suffered burns and a number remain missing, the report said, without giving the total number of people on board the boat at the time of the fire.   Lake and river transport is widely used in the vast country as the highway system is poor, but accidents are common, often caused by overloading and the unsafe state of vessels.
Date: Fri 20 Dec 2019
Source: MSF (Medecins Sans Frontieres) [edited]
<https://www.msf.org/efforts-tackle-deadly-drc-measles-epidemic-remain-insufficient>

Since January 2019, more than 288,000 people have contracted measles in the Democratic Republic of Congo (DRC) and more than 5700 have died from the disease. According to the World Health Organization (WHO), this is the largest measles epidemic in the world today and the largest recorded in DRC for decades. Efforts have been made at [the] national level, but more resources must be quickly committed and targeted to areas that are still suffering from this disease in order to stop this outbreak.

In areas with low immunisation coverage, vaccination can reduce infant mortality by 50%.

Several factors are contributing to the spread of the current epidemic in DRC. There is extremely low immunisation coverage in some regions of the country due to the lack of vaccines, vaccinators, or access to health structures.

On top of this, there are stockouts [shortages] of the measles vaccine in the country, difficulties in keeping the vaccine at the right temperature until injection (which reduces its effectiveness), and logistical difficulties in getting the vaccines to their final destinations. The needs are enormous, and the national vaccination programme cannot keep up. In 2019, measles spread to all 26 provinces of the country.

The epidemic is showing no signs of abating: 9605 new cases were reported in the last week of November [2019], the highest number since the start of the year. The fatality rate this year [2019], over 2%, is twice as high as in previous years. Nearly three-quarters (73%) of deaths are children under the age of 5.

In addition, measles cases remain underreported across the country. We have set up surveillance strategies to identify new areas affected by the epidemic in order to start interventions as soon as possible. For example, in Viadana, in the province of Bas-Uele, a small team went to assess the situation following a rapid increase in the number of cases notified in early December [2019].

What they found there far exceeded the data they had received. In a single school of about 300 children, more than 100 students were ill with measles. This assessment enabled us to immediately start medical activities for these children and organise a vaccination campaign.

A similar system has been set up in the 4 provinces of ex-Katanga, in the southeast of the country, where MSF has created "sentinel" sites. In October 2019, MSF put in place a decentralised laboratory in order to quickly analyse suspected cases of measles and rubella. Prior to that, the samples would have had to be sent all the way to Kinshasa for analysis, which took several months.

"When an epidemic is declared, medical care and vaccination must be combined to stop the spread of the disease," said Alex Wade, MSF head of mission in DRC. "Since mid-November [2019], the Congolese health authorities started measles supplementary immunization activities in the whole country.

"Meanwhile we continue to provide free quality medical care to patients," said Wade. "But for now, the epidemic is still several steps ahead of the medical-humanitarian response."

[MSF is] also active in the province of Kongo Central. To support the Congolese health authorities, on 13 Dec 2019 we opened a treatment centre for complicated measles cases in the general hospital in Matadi, capital of the province and the country's main port. A week earlier, another team had opened a similar facility a few hours' drive west, in the coastal town of Muanda. These treatment centres were overloaded within a few days after their opening, and teams had to relocate to larger structures.

In these treatment centres, MSF teams give specific attention to other illnesses associated with measles, such as malaria and malnutrition, which greatly increase the risk of death. But they also support the treatment of measles in the surroundings of these health zones by distributing treatment kits and strengthening surveillance and detection of new cases. They also provide free transport for patients who need to be transferred to clinics and hospitals.

Since 2018, MSF teams have been working to provide measles patients with appropriate care and undertake vaccination in various provinces of the country, including Ituri, Haut and Bas-Uele, Tshopo, Kasai, Mai-Ndombe, Kwilu, and Sud Ubangi. Between January 2018 and October 2019, a total of 46,870 patients were treated and 1,461,550 children were vaccinated by our teams in 54 health zones.

In collaboration with the Congolese Ministry of Health, [MSF] also helped to strengthen measles vaccination activities in areas where the Ebola outbreak continues to spread and, as a result, where vaccination coverage for other diseases has dropped dramatically. Unfortunately, many regions are still not vaccinated.

"Supplementary immunisation activities have been launched by the Congolese Ministry of Health, but there are still many health zones where the outbreak continues," says Wade. "We must wait until the end of these vaccinations to have a better understanding of the evolution of the epidemic.

"However, the current implementation of this campaign suggests that needs will persist, especially for children over the age of 5 who will not have been vaccinated during this period," Wade continues. "It will then be essential that humanitarian organisations and other responders pool all possible efforts to help the Congolese Ministry of Public Health to overcome this measles outbreak. Too many children have died from this easily preventable disease."
Date: Wed, 18 Dec 2019 18:46:21 +0100 (MET)

Goma, DR Congo, Dec 18, 2019 (AFP) - Nearly 700,000 people have been displaced by violence in eastern Democratic Republic of Congo, Doctors Without Borders (MSF) said on Wednesday, pointing to "worrying" cases of malnutrition and sexual violence.   In a press release, it said more than 687,500 displaced people were now living in camps or with host families.

Between January and September, MSF treated at least 11,220 children suffering from malnutrition, 2,310 victims of sexual violence and 1,980 wounded, it said.   The agency highlighted the territories of Masisi, Rutshuru and Walikale in the southern part of North Kivu province.   "We have treated twice as many victims of sexual violence as last year," Ewald Stals, MSF's health coordinator in Masisi, said.

North Kivu province, which borders Rwanda and Uganda, is one of the most dangerous zones in Africa's Great Lakes region.   Militia groups have controlled much of the province since the Congo Wars of the 1990s, killing civilians and fighting over resources.
Date: Tue 10 Dec 2019
Source: Outbreak News Today [abridged, edited]
<https://tinyurl.com/vs5rdkq>

In a follow-up on the world's largest measles outbreak, the World Health Organization (WHO) reports that the Democratic Republic of the Congo (DRC) measles outbreak continues to grow and expand.

Since the beginning of the year through 2 Dec [2019], a total of 269 079 suspected measles cases, including 5430 deaths (CFR 2%), have been reported from all 26 provinces in the DRC.

Since 11 Nov [2019], 53 new health zones have confirmed epidemics.

This outbreak has already caused more deaths compared to the ongoing Ebola virus disease outbreak.

WHO notes that in addition to DRC, several other countries in the African region are also experiencing measles outbreaks. The underlying factor for the measles outbreaks in the African region is the inability of the vaccine administration systems to reach vulnerable children, rather than low uptake of the vaccines by the recipients, an increasing phenomenon seen in the developed world.

Some of the reasons for the low immunization coverage in the African region include inadequacies in the healthcare systems and social dislocation due to armed conflicts, poverty, other disasters, etc.
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