Ebola – Democratic Republic of the Congo

Milestones :: Perspectives

Ebola – Democratic Republic of the Congo
Children account for more than one third of Ebola cases in eastern Democratic Republic of the Congo – UNICEF
Press release
KINSHASA, DAKAR, NEW YORK, GENEVA, 11 December 2018 – Children now account for more than one third of the Ebola cases in affected regions of the eastern Democratic Republic of the Congo (DRC), UNICEF said today. The UN children’s agency also reported that one in ten Ebola cases is under five-years-old, while children who contract the Ebola virus are at higher risk of dying from the disease than adults.

“We are deeply concerned by the growing number of children confirmed to have contracted Ebola,” said UNICEF’s Regional Director for West and Central Africa, Marie-Pierre Poirier, returning this week from Beni, one of the current epicentres of the Ebola outbreak. “The earlier children infected with Ebola receive treatment in a specialized health facility, the greater their chances of survival. Community mobilization and public awareness activities are also crucial to ensuring early detection and quick referral of suspected cases to Ebola treatment centres.”

Continued efforts are needed to raise awareness of prevention methods and promote early access to treatment which dramatically improves survival rates.

The impact of the disease on children goes beyond those who have been infected. When parents or caregivers with the disease are taken to treatment centres or pass away, some children are left on their own. UNICEF and its partners have so far identified more than 400 children who have been orphaned or left unaccompanied because of the virus. The growing number of separated children is linked to the high caseload of patients in the Ebola treatment centres of Beni and Butembo, the current epicentres of the disease.

UNICEF provides Ebola-infected children, orphans and unaccompanied children with appropriate assistance, including nutritional care and psychosocial and educational support. Together with its partners, UNICEF has opened a kindergarten next to the Ebola treatment centre of Beni to assist the youngest children whose parents are isolated in the centre. The creche has taken care of more than 20 separated infants and young children, aged up to eight years, since its opening early November.

Marie-Pierre Poirier met in Beni with national authorities, who are leading the Ebola-response, along with UN agencies and NGO partners. “Children are suffering a lot because of this epidemic – both those who have lost parents or caregivers as well as those who have been infected themselves,” said Poirier. “That’s why it’s imperative that children are put at the heart of the Ebola response.”

Since the start of the response to the latest Ebola outbreak in the DRC, UNICEF and its partners have:
Ø Provided psycho-social and material assistance to 520 affected families with children;
Ø Provided psychosocial support to 421 children in the Ebola Treatment Centers;
Ø Sensitized more than 91,000 children with Ebola prevention messages in schools;
Ø Briefed 4,310 teachers in schools on Ebola;
Ø Equipped 444 schools in high risk areas with hand-washing facilities;
Ø Reached more than 6,753,000 people with Ebola-prevention messages;
Ø Provided access to water to 889,440 people in the affected areas.

With more than 50 specialists in the impacted regions, UNICEF is operating out of Beni, Butembo, Mangina and Komanda.

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19: Situation report on the Ebola outbreak in North Kivu 
12 December 2018
[Excerpts]
…Case Management
:: On 24 November 2018, MoH announced the launch of a randomized control trial for Ebola therapeutics. This first ever multi-drug randomized control trial within an outbreak setting is an important step towards finding an effective treatment for Ebola. The trial is coordinated by WHO and led and sponsored by the DRC’s National Institute for Biomedical Research (INRB) which is the principal investigator. The trial has begun in the ALIMA facility in Beni, where patients are briefed on the trial and given the choice to participate.

:: Other ETCs continue to provide therapeutics under the MEURI (compassionate use) protocol, in collaboration with the MoH and the INRB, together with supportive care measures. WHO is providing technical clinical expertise on-site and is assisting with the creation of a data safety management board. UNICEF is providing nutritional treatment and psychological support for all hospitalized patients.

:: New patients continue to be treated in transit centres and ETCs. Over the reporting period, bed occupancy varied from 0% in Goma and Tchomia to 90% in Beni ETC.

: On 9 December 2018, a total of 131 patients were hospitalised in transit centres and ETCs, of whom 39 were laboratory confirmed.

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DONs Ebola virus disease – Democratic Republic of the Congo
13 December 2018
[Excerpt]
…WHO risk assessment
This outbreak of EVD is affecting north-eastern provinces of the country bordering Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include: travel between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities. WHO’s risk assessment for the outbreak is currently very high at the national and regional levels; the global risk level remains low. WHO continues to advice against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.

As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond…

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South Sudan set to vaccinate targeted healthcare and frontline workers operating in high risk states against Ebola

Juba 8 December, 2018 – The Ministry of Health of the Republic of South Sudan with support from the World Health Organization (WHO), DFID, GAVI vaccine alliance and other partners, is set to vaccinate targeted healthcare and frontline workers operating in high risk states bordering the Democratic Republic of Congo (DRC) against Ebola virus disease (EVD) as part of national preparedness efforts.

To facilitate the process, a training for the Vaccination team was incorporated into the micro plan developed by the vaccine technical working group (TWG). The members of the TWG among others include MoH, UNICEF, CDC, WHO, MSF, Health Cluster and others.  Accordingly, a four days training for 60 participants drawn from the states of Juba, Yei, Yambio and Nimule on Good Clinical Practice (GCP) course (4-7 December, 2018) in Juba.

The vaccination team members selected by their respective State Ministry of Health included representatives from health facilities, private sector and Civil Society Organizations. Each state vaccination team comprised of 15 members including vaccinators, clinicians, social mobilizers, and logisticians.

The GCP training is mandatory prior to the administration of the vaccine. Participants were equipped with knowledge and skills on Ebola vaccine (rVSV-ZEBOV) administration including vaccination techniques, and exposed through a simulation exercise.

Through this training, the vaccination team members were GCP certified and are now ready to conduct the Ebola vaccination scheduled to start with Juba on 19 December, 2018, and follow up the vaccinated individuals for a period of 21 days as the minimum standard of care.

The Ministry of Health, with technical support from the Vaccine Technical Working Group of the National EVD Task Force, the states, and NGOs operating in health care facilities in the respective States will coordinate the administration of the Ebola vaccine.

With support from GAVI vaccine alliance, 2,160 doses of the Ebola vaccine (rVSV-ZEBOV) have been allocated to South Sudan and will be administered to protect against Ebola virus-Zaire, the strain that is confirmed in the current outbreak in DRC. Although this vaccine is not yet licensed, it is being used under the compassionate-use guidelines in response to the ongoing Ebola outbreak in DRC as recommended by the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE)…

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