2018 Équateur province Ebola outbreak: Difference between revisions

Coordinates: 0°45′S 18°07′E / 0.750°S 18.117°E / -0.750; 18.117
From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
→‎Background: ==Previous outbreaks==
No edit summary
Tags: Visual edit Mobile edit Mobile web edit
Line 18: Line 18:
| data5 = 25<ref name="who6">{{cite web |title=Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 6 |url=https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-4 |website=ReliefWeb |accessdate=30 May 2018 |language=en}}</ref>
| data5 = 25<ref name="who6">{{cite web |title=Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 6 |url=https://reliefweb.int/report/democratic-republic-congo/democratic-republic-congo-ebola-virus-disease-external-situation-4 |website=ReliefWeb |accessdate=30 May 2018 |language=en}}</ref>
}}
}}
On 8 May 2018, it was reported that 17 people were suspected of having died from [[Ebola virus disease]] (EVD) near the town of [[Bikoro]] in the [[Province of Équateur]] in the north-west of the [[Democratic Republic of the Congo]] (DRC).<ref name="gua">{{cite news|url=https://www.theguardian.com/world/2018/may/08/drc-confirms-two-cases-of-ebola-in-north-western-town|title=DRC: at least 17 people dead in confirmed Ebola outbreak|date=8 May 2018|work=The Guardian|accessdate=9 May 2018|agency=[[Reuters]]|language=en}}</ref> The [[World Health Organization]] declared the outbreak after two people were confirmed as having the disease.<ref name="who">{{cite news|url=http://www.who.int/news-room/detail/08-05-2018-new-ebola-outbreak-declared-in-democratic-republic-of-the-congo|title=New Ebola outbreak declared in Democratic Republic of the Congo|last=|first=|date=8 May 2018|work=World Health Organization|accessdate=9 May 2018}}</ref><ref>{{Cite news|url=https://www.cbsnews.com/news/congo-ebola-cases-confirmed-new-outbreak-2018-08-05/|title=New Ebola outbreak hits Africa as 2 cases confirmed in Congo|date=8 May 2018|work=CBS News|access-date=9 May 2018|agency=[[Associated Press]]|language=en}}</ref>
[http://snip.ly/jts8yd On 8 May 2018, it was reported that 17 people were suspected of having died from Ebola virus disease (EVD) near the town of Bikoro in the Province of Équateur in the north-west of the Democratic Republic of the Congo (DRC).]<ref name="gua">{{cite news|url=https://www.theguardian.com/world/2018/may/08/drc-confirms-two-cases-of-ebola-in-north-western-town|title=DRC: at least 17 people dead in confirmed Ebola outbreak|date=8 May 2018|work=The Guardian|accessdate=9 May 2018|agency=[[Reuters]]|language=en}}</ref> [http://snip.ly/jts8yd The World Health Organization declared the outbreak after two people were confirmed as having the disease.]<ref name="who">{{cite news|url=http://www.who.int/news-room/detail/08-05-2018-new-ebola-outbreak-declared-in-democratic-republic-of-the-congo|title=New Ebola outbreak declared in Democratic Republic of the Congo|last=|first=|date=8 May 2018|work=World Health Organization|accessdate=9 May 2018}}</ref><ref>{{Cite news|url=https://www.cbsnews.com/news/congo-ebola-cases-confirmed-new-outbreak-2018-08-05/|title=New Ebola outbreak hits Africa as 2 cases confirmed in Congo|date=8 May 2018|work=CBS News|access-date=9 May 2018|agency=[[Associated Press]]|language=en}}</ref>


The virus was first confirmed in the [[inland port]] city of [[Mbandaka]] on 17 May, causing the WHO to raise its assessment of the national risk level to "very high",<ref name=who-2018-05-17/><ref name=":0" /> but the organization decided on 18 May that the outbreak did not pose sufficient risk of spreading internationally to constitute an [[Public Health Emergency of International Concern|international public health emergency]].<ref>{{Cite news|url=http://www.bbc.co.uk/news/world-africa-44164027|title=Ebola in DR Congo 'not yet global crisis'|date=18 May 2018|work=BBC News|access-date=19 May 2018|language=en-GB}}</ref> It is the largest outbreak of Ebola since the [[West African Ebola virus epidemic|West African epidemic]] of 2013–16,<ref name= "patient zero" /> but as of 27 May, it still remains confined to the Équateur province.<ref name="who6"/>
[http://snip.ly/jts8yd The virus was first confirmed in the inland port city of Mbandaka on 17 May, causing the WHO to raise its assessment of the national risk level to "very high",]<ref name=who-2018-05-17/><ref name=":0" /> [http://snip.ly/jts8yd but the organization decided on 18 May that the outbreak did not pose sufficient risk of spreading internationally to constitute an international public health emergency.]<ref>{{Cite news|url=http://www.bbc.co.uk/news/world-africa-44164027|title=Ebola in DR Congo 'not yet global crisis'|date=18 May 2018|work=BBC News|access-date=19 May 2018|language=en-GB}}</ref> [http://snip.ly/jts8yd It is the largest outbreak of Ebola since the West African epidemic of 2013–16,]<ref name= "patient zero" /> [http://snip.ly/jts8yd but as of 27 May, it still remains confined to the Équateur province.]<ref name="who6"/>


==Virology==
==Virology==

Revision as of 12:29, 4 June 2018

2018 Democratic Republic of the Congo Ebola outbreak
Initial case April 2018(?)[1][2]
Map showing the location of the Province of Équateur in the Democratic Republic of the Congo
Location of the Province of Équateur in the Democratic Republic of the Congo
Map showing the location the Democratic Republic of the Congo in Africa
Location of the Democratic Republic of the Congo in Africa
Confirmed cases37[3]
Probable cases13[3]
Suspected cases7[4]
Deaths25[5]

On 8 May 2018, it was reported that 17 people were suspected of having died from Ebola virus disease (EVD) near the town of Bikoro in the Province of Équateur in the north-west of the Democratic Republic of the Congo (DRC).[6] The World Health Organization declared the outbreak after two people were confirmed as having the disease.[1][7]

The virus was first confirmed in the inland port city of Mbandaka on 17 May, causing the WHO to raise its assessment of the national risk level to "very high",[8][9] but the organization decided on 18 May that the outbreak did not pose sufficient risk of spreading internationally to constitute an international public health emergency.[10] It is the largest outbreak of Ebola since the West African epidemic of 2013–16,[11] but as of 27 May, it still remains confined to the Équateur province.[5]

Virology

Zaire ebolavirus, which has been identified in this outbreak,[12] is included in genus Ebolavirus, family Filoviridae,[13] which are negative-sense single-stranded RNA viruses.[14]

The virus was named for the Ebola River, which runs as a tributary of the Congo River in the Democratic Republic of the Congo; it was first identified in 1976 in Yambuku.[15][16]

Epidemiology

Map
About OpenStreetMaps
Maps: terms of use
100km
62miles
none
Wangata
Wangata
Iboko
Iboko
Bikoro
Bikoro
Location of suspected cases reported

The earliest cases are believed to have occurred in early April 2018.[17]

The suspected index case was a police officer, who died in a health center in the village of Ikoko-Impenge, near the market town of Bikoro in Équateur province, according to the International Federation of the Red Cross and Red Crescent Societies.[11] After his funeral, eleven family members became ill, and seven of them died. All of the seven deceased had attended the man's funeral or cared for him while he was sick.[11] The identification of this individual as the index case has not yet been confirmed.[18]

Équateur province's Provincial Health Division reported 21 cases with symptoms consistent with Ebola virus disease, of whom 17 had died, on 3 May 2018.[12] Of these, eight cases have subsequently been shown not to have been Ebola-related.[19] The outbreak was declared on 8 May after samples from two of five patients in Bikoro tested positive for the Zaire strain of the Ebola virus.[1][12][6] On 10 May, the World Health Organization (WHO) stated that the Democratic Republic of the Congo had a total of 32 cases of EVD,[2] and a further two suspected cases were announced the following day, bringing the total cases to 34, all located in the Bikoro area.[20]

Timeline of reported cases and deaths[21]
Date Cases Deaths CFR Contacts
Confirmed Probable Suspected Total
2018-05-11[22] 2 18 14 34 18 52.9% 75
2018-05-14[23] 2 22 17 41 20 48.8% 432
2018-05-18[12] 14 21 10 45 25 55.6% 532
2018-05-20[18] 28 21 2 51 27 52.9% 628
2018-05-23[19] 31 13 8 52 22* 42.3%* >600[24]
2018-05-27[5] 35 13 6 54 25 46.3% 906
2018-05-30[25] 37 13 0 50* 25 50% >900[26]

* numbers are subject to revision both up, when new cases are discovered, and down, when tests show cases were not Ebola-related.

Spread to Mbandaka

On 14 May suspected cases were reported in the Iboko and Wangata areas in Équateur province, in addition to Bikoro. Wangata is a district of the city of Mbandaka, the capital of Équateur province, which lies around 100 miles north of Bikoro.[11][23] WHO reported on 17 May 2018 that one of the cases in the Wangata district of Mbandaka city had been confirmed,[8] the first case of this outbreak to be confirmed in an urban area.[11] Mbandaka is a busy, densely populated port on the Congo River with a population of 1.2 million,[27] making the risk of spreading high.[12][11] The following day, WHO raised the health risk in DRC to "very high" because it has spread to an urban area.[9] The DRC government is particularly concerned about boat transport along the Congo between Mbandaka and the capital, Kinshasa.[28] WHO also considers that there is a high risk of the outbreak spreading within the region,[12] since the Republic of the Congo and Central African Republic, which border the affected region,[28] as well as seven other nearby countries at particular risk.[27] As of 23 May, 4 cases of EVD have been confirmed in Mbandaka.[19]

On 20 May, the focus of the outbreak was still the Bikoro area, where 56.9% of the total cases and 81.5% of the fatalities have been located.[18] As of 23 May, the focus of the outbreak is split between Bikoro and Iboko; Iboko has 55% of the confirmed cases of EVD.[19] The cases in the Bikoro health zone are located in Ikoko Impenge (12), Bikoro (6), Momboyo (1) and Moheli (1); those in the Iboko health zone are located in Itipo (13), Mpangi (2), Wenga (1) and Loongo (1).[19] No cases have yet been reported from new areas.[19]

According to the fifth situation report released by WHO the case fatality rate (CFR) is 42.3%.[19] Demographics have been reported for 44 cases as of 22 May; there are 26 cases of EVD in men and 18 in women; 7 cases are in children 14 years and under, and 9 are in those over 60 years.[19] As of 23 May, there have been 5 reported cases in health-care workers, including two who died.[19] Contact tracing is being employed to identify contacts with infected individuals.[18][29] On 29 May, it was reported that 800 contacts were identified in the city of Mbandaka;[30] the next day it was reported that 500 people in the city had been vaccinated.[31]

Cases and deaths by health zone
As of 30 May 2018[25]
Health
zone		 Cases Deaths CFR
Confirmed Probable Suspected Total
Bikoro 10 11 0 21 17 80.9%
Iboko 23 2 0 25 5 20.0%
Wangata 4 0 0 4 3 75.0%
Total 37 13 0 50 25 50%

Further preparation

On 29 May, the World Health Organization indicated that nine neighbouring countries have been alerted for being at high risk of spread of EVD,[32]

Containment challenges

The Bikoro area has three hospitals, but the area's health services are described by WHO as predominantly having "limited functionality";[12] they receive supplies from international bodies but experience frequent shortages. More than half of the Bikoro area cases are in Ikoko-Impenge, a village not connected to the road system.[12][19] Bikoro lies in dense rain forest,[11] and the area's remoteness and inadequate infrastructure are hindering treatment of EVD patients, as well as surveillance and vaccination efforts.[27]

Another challenge is adherence: on 20–21 May, three individuals with EVD in an isolation ward of a treatment center in Mbandaka fled; two later died after attending a prayer meeting, at which they might have exposed 50 other attendees to the virus.[33][34][35][36] Bushmeat is believed to be one vector of infection, but bushmeat vendors at the Mbandaka market told reporters that they did not believe Ebola was real or serious.[37]

Hostility to health workers has also been reported.[38]On 29 May the WHO forecast somewhere between 100-300 cases before the end of July.[39]

Response

Médecins Sans Frontières (MSF) has established treatment centers in Bikoro, Ikoko and Wangata.[19] WHO sent an expert team to Bikoro on 8 May,[1] and on 13 May, WHO Director-General Tedros Adhanom Ghebreyesus visited the town.[40] As of 24 May, WHO had sent 138 technical personnel to the three affected areas; the Red Cross has sent more than 150 people, and UNICEF personnel are also active.[19] Other international agencies sending teams include the UK Public Health Rapid Support Team[41] and the Africa Centres for Disease Control and Prevention.[42] The Wellcome Trust has donated £2 million towards the DRC outbreak.[43] Merck is donating its experimental vaccine and Gavi, the Vaccine Alliance is helping to support vaccination operations.[44] Several tons of supplies have been shipped to the DRC, including protection and disinfection kits and palliative drugs.[11] After the virus spread to the city of Mbandaka, DRC health minister Oly Ilunga Kalenga announced that healthcare would be provided free for those affected.[45][46]

On 18 May, the WHO IHR committee met for the first time to consider the outbreak, and decided against declaring a Public Health Emergency of International Concern; if the outbreak expands or spreads internationally, the committee will reassess the situation.[27]

Surveillance and prevention of transmission

Surveillance of travelers at Mbandaka's port and airport is ongoing.[12] The DRC Ministry of Health has identified 115 areas where movement of people increases the risk of virus transmission, including 83 river ports, 9 airports and 7 bus stations, as well as 16 markets.[18] José Makila, the DRC minister of transport, has stated that the Navy will be used to surveil river traffic on the Congo.[28] On 10 May, the Nigerian Ministry of Health reported it would start screening at its borders,[47] and as of 18 May, a total of 20 countries have instituted screening of travelers coming from the DRC.[12] WHO has sent teams to 8/9 of the neighboring countries to assess their capability to deal with EVD spread and facilitate their surveillance.[19] The DRC Ministry of Health is working with surveyors and cartographers from UCLA and OpenStreetMap DRC to improve mapping of the affected area.[48] A laboratory has been operational in Bikoro since 16 May, enabling local testing of patient samples for Ebola virus.[18]

Burials are being organized by MSF and the Red Cross of the Democratic Republic of the Congo to minimize the risk of transmission.[12] The United Nations Radio is broadcasting EVD awareness information, and posters and leaflets are being prepared and distributed.[12] UNICEF has warned 143 churches across Mbandaka of the risks of prayer meetings.[19]

Ring vaccination with rVSV-ZEBOV

Ebola and contact tracing

Health authorities including DRC's Ministry of Public Health are using recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV) vaccine – a recently developed experimental Ebola vaccine, produced by Merck – to try to suppress the outbreak. This live-attenuated vaccine expresses the surface glycoprotein of the Kikwit 1995 strain of Zaire ebolavirus in a recombinant vesicular stomatitis virus vector.[49] rVSV-ZEBOV was trialed in Guinea and Sierra Leone during the West African epidemic of 2013–16, with 5837 people receiving the vaccine; the trial authors concluded that rVSV-ZEBOV provided "substantial protection" against EVD,[50] but subsequent commentators have questioned the degree of protection obtained.[51] As the vaccine has yet to be approved by any regulatory authority, it is being used in DRC under a compassionate use trial protocol.[17]

A ring vaccination strategy is ongoing, which involves vaccinating only those most likely to be infected: direct contacts of infected individuals, and contacts of those contacts.[11][52][53][54][55] Other groups targeted include health workers, laboratory personnel, surveillance workers and people involved with burials.[44][56] People who have been vaccinated will be followed up for 84 days to assess whether they are protected from infection and to monitor any adverse events.[17] A total of 4,320 doses of the rVSV-ZEBOV vaccine were delivered to DRC's capital Kinshasa by WHO on 16 May, and a further 3,240 doses arrived three days later;[18] another 8,000 doses will also be made available.[57] The vaccine must be transported and stored at between −60 and −80 °C.[44] A cold chain was established in Kinshasa by 18 May and has been extended to Mbandaka. WHO plans to concentrate on vaccinating three sets of contacts of confirmed EVD cases, two in Bikoro and one in Mbandaka.[12]

Vaccination started on 21 May among health workers in Mbandaka,[46] with 7,560 vaccine doses ready for immediate use, according to WHO.[18][44] The DRC health minister Oly Ilunga Kalenga stated that vaccination of health workers and Ebola case contacts in the Wangata and Bolenge areas of Mbandaka would take five days, after which vaccination would start in Bikoro and Iboko.[46] As of 24 May, 154 people in Mbandaka have been vaccinated, and preparations have started for vaccinating in Bikoro and Iboko.[19] Up to 1,000 people are expected to have been vaccinated by 26 May, according to WHO.[18] It is the first time that vaccination has been attempted in the early stages of an Ebola outbreak.[17]

Experimental therapeutic agents

Chemical formula for Favipiravir

Health officials are exploring the idea of trialing experimental treatments, including the antiviral agents favipiravir and GS-5734, and the antibody ZMapp. All three agents were given to patients during the West African epidemic, but none has yet been proved to be effective.[58] The DRC Ministry of Health has also requested that the US trial mAb114 treatment in the current outbreak. The mAb114 monoclonal antibody has been developed by Jean-Jacques Muyembe at the National Institute for Biomedical Research, and is derived from an EVD survivor of the 1995 Kikwit outbreak who still had circulating anti-Ebola antibodies 11 years later; it has been tested in macaques but not in humans.[36][59][60]

The ZMapp cocktail was assessed by the World Health Organization for emergency use under the MEURI ethical protocol. The panel agreed that "the benefits of ZMapp outweigh its risks" while noting that it presented logistical challenges, particularly that of requiring a cold chain for distribution and storage.[61] Four alternative therapies (Remdesivir, REGN3470-3471-3479, Favipiravir, and mAb114) were also considered for use under some circumstances, but they are at earlier stages of development.[61][62]

Previous outbreaks

The Democratic Republic of the Congo (formerly Zaire) has had eight previous EVD outbreaks, with the earliest being in 1976.[63][64] All have been located in the west or north of the country,[57] with three previous outbreaks (in 1976, 1977 and 2014) occurring in the former province of Équateur, of which the current Équateur province forms part.[2] The most recent outbreak occurred in the northern Congo area in 2017,[65] with 8 confirmed or probable cases including 4 deaths.[66] The DRC regulatory authorities approved use of the experimental rVSV-ZEBOV vaccine, but logistical issues delayed implementation until the outbreak was already under control.[17][58][67]

DRC lags behind the rest of Africa in health expenditure, at Intl$ 32 per head in 2014.[68][69] Shortly before the first cases of the ongoing Ebola outbreak, the country experienced a widespread cholera epidemic (June 2017 – spring 2018), which was the most serious in the country since 1994.[70][71][72]

Timeline of Ebola outbreaks in the Democratic Republic of the Congo (formerly Zaire) since 1976
V・T
Date		 Country Major location Outbreak information Source
Strain Cases Deaths CFR
Aug 1976 Zaire Yambuku EBOV 318 280 88% [73]
Jun 1977 Zaire Tandala EBOV 1 1 100% [64][74]
May–Jul 1995 Zaire Kikwit EBOV 315 254 81% [75]
Aug–Nov 2007 Democratic Republic of the Congo Kasai-Occidental EBOV 264 187 71% [76]
Dec 2008–Feb 2009 Democratic Republic of the Congo Kasai-Occidental EBOV 32 14 45% [77]
Jun–Nov 2012 Democratic Republic of the Congo Orientale BDBV 77 36 47% [64]
Aug–Nov 2014 Democratic Republic of the Congo Tshuapa EBOV 66 49 74% [78]
May–Jul 2017 Democratic Republic of the Congo Likati EBOV 8 4 50% [79]
Apr–Jul 2018 Democratic Republic of the Congo Équateur Province EBOV 54 33 61% [80]
Aug 2018–June 2020 Democratic Republic of the Congo Kivu EBOV 3,470 2,280 66% [81]
June–Nov 2020 Democratic Republic of the Congo Équateur Province EBOV 130 55 42% [82]
Feb 2021–May 2021 Democratic Republic of the Congo North Kivu EBOV 12 6 50% [83]
April 2022 Democratic Republic of the Congo Équateur Province EBOV 5 5 100% [84][85]
August 2022 Democratic Republic of the Congo North Kivu EBOV 1 1 100% [86]

See also

References

  1. ^ a b c d "New Ebola outbreak declared in Democratic Republic of the Congo". World Health Organization. 8 May 2018. Retrieved 9 May 2018.
  2. ^ a b c "Ebola virus disease – Democratic Republic of the Congo". World Health Organization. 10 May 2018. Retrieved 11 May 2018.
  3. ^ a b "EBOLA RDC - Evolution de la riposte de l'épidémie d'Ebola au Vendredi 01 juin 2018". us13.campaign-archive.com. Retrieved 2 June 2018.
  4. ^ "EBOLA RDC - Evolution de la riposte de l'épidémie d'Ebola au Samedi 02 juin 2018". us13.campaign-archive.com. Retrieved 3 June 2018.
  5. ^ a b c "Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 6". ReliefWeb. Retrieved 30 May 2018.
  6. ^ a b "DRC: at least 17 people dead in confirmed Ebola outbreak". The Guardian. Reuters. 8 May 2018. Retrieved 9 May 2018.
  7. ^ "New Ebola outbreak hits Africa as 2 cases confirmed in Congo". CBS News. Associated Press. 8 May 2018. Retrieved 9 May 2018.
  8. ^ a b "WHO concerned as one Ebola case confirmed in urban area of Democratic Republic of the Congo". World Health Organization. Retrieved 17 May 2018.
  9. ^ a b McKirdy, Euan; Senthilingam, Meera (18 May 2018). "WHO raises Ebola health risk to 'very high' in DRC". CNN. Retrieved 18 May 2018.
  10. ^ "Ebola in DR Congo 'not yet global crisis'". BBC News. 18 May 2018. Retrieved 19 May 2018.
  11. ^ a b c d e f g h i Bearak, Max (17 May 2018). "First confirmed urban Ebola case is a 'game changer' in Congo outbreak". The Washington Post. ISSN 0190-8286. Retrieved 17 May 2018.
  12. ^ a b c d e f g h i j k l m "Ebola Virus Disease: Democratic Republic of the Congo: External Situation Report 3" (PDF). World Health Organization. 18 May 2018. Retrieved 18 May 2018. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  13. ^ Kuhn, Jens H.; Becker, Stephan; Ebihara, Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka, Yoshihiro; Lipkin, W. Ian; Negredo, Ana I.; Netesov, Sergey V. (2010). "Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations". Archives of virology. 155 (12): 2083–2103. doi:10.1007/s00705-010-0814-x. PMC 3074192. PMID 21046175.
  14. ^ Mühlberger, Elke (2007). "Filovirus replication and transcription". Future virology. 2 (2): 205–215. doi:10.2217/17460794.2.2.205. ISSN 1746-0794. PMC 3787895. PMID 24093048.
  15. ^ "How Ebola got its name". The Spectator. 25 October 2014. Retrieved 20 May 2018.
  16. ^ Newman, Patricia (2015). Ebola: Fears and Facts. Lerner Publishing Group. p. 4. ISBN 9781467792400. Retrieved 20 May 2018.
  17. ^ a b c d e Jon Cohen (15 May 2018). "Hoping to head off an epidemic, Congo turns to experimental Ebola vaccine". Science. doi:10.1126/science.aau1857.
  18. ^ a b c d e f g h i "Ebola Virus Disease: Democratic Republic of the Congo: External Situation Report 4" (PDF). World Health Organization. 20 May 2018. Retrieved 23 May 2018. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  19. ^ a b c d e f g h i j k l m n o "Democratic Republic of the Congo Ebola virus disease" (PDF). World Health Organization. 25 May 2018. Retrieved 26 May 2018.
  20. ^ "WHO and partners working with national health authorities to contain new Ebola outbreak in the Democratic Republic of the Congo". World Health Organization. Retrieved 11 May 2018.
  21. ^ "Ebola situation reports: Democratic Republic of the Congo". WHO.
  22. ^ "EBOLA VIRUS DISEASE, Democratic Republic of Congo, External Situation Report 1" (PDF). WHO. 11 May 2018.
  23. ^ a b "EBOLA VIRUS DISEASE, Democratic Republic of Congo, External Situation Report 2" (PDF). WHO. 14 May 2018.
  24. ^ News, ABC. "Ebola vaccinations begin in rural Congo on Monday: Ministry". ABC News. Retrieved 26 May 2018. {{cite web}}: |last1= has generic name (help)
  25. ^ a b "Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 7". ReliefWeb. Retrieved 2 June 2018.
  26. ^ "The Fight to Get a Vaccine to Center of Ebola Outbreak". The New York Times. 1 June 2018. Retrieved 2 June 2018.
  27. ^ a b c d "Statement on the 1st meeting of the IHR Emergency Committee regarding the Ebola outbreak in 2018". World Health Organization. Retrieved 18 May 2018.
  28. ^ a b c "Congo at a knife edge as number of cases of Ebola continues to rise". The Daily Telegraph. 23 May 2018. Retrieved 23 May 2018. {{cite news}}: Cite uses deprecated parameter |authors= (help)
  29. ^ "Congo, U.N. deploy specialists to tackle Ebola epidemic". Reuters. 13 May 2018. Retrieved 13 May 2018.
  30. ^ CNN, Meera Senthilingam,. "Congo Ebola outbreak: 5 experimental drugs to be tried". CNN. Retrieved 31 May 2018. {{cite web}}: |last1= has generic name (help)CS1 maint: extra punctuation (link) CS1 maint: multiple names: authors list (link)
  31. ^ "Nearly 700 get Ebola vaccine in Congo; more cases possible". Fox News. 1 June 2018. Retrieved 1 June 2018.
  32. ^ "Ebola virus disease – Democratic Republic of the Congo". World Health Organization. Retrieved 3 June 2018.
  33. ^ "Two infected Ebola patients flee treatment center in Congo". CBS news. Retrieved 23 May 2018.
  34. ^ "Ebola outbreak in DR Congo: Patients 'taken to church'". BBC. 23 May 2018. Retrieved 23 May 2018.
  35. ^ Nebehay, Stephanie. "Infection alert after dying Ebola patients taken to Congo prayer..." U.S. Retrieved 24 May 2018.
  36. ^ a b "ProMED-mail post". www.promedmail.org. Retrieved 25 May 2018.
  37. ^ Louise Dewast (31 May 2018). "At the center of Ebola in the Congo, worry and indifference coexist".
  38. ^ Aaron Ross (25 May 2018). "Fear and suspicion hinder Congo medics in Ebola battle". Reuters. Retrieved 28 May 2018.
  39. ^ Miles, Tom. "WHO's Congo Ebola plan assumes 100-300 cases over three months". U.S. Retrieved 29 May 2018.
  40. ^ "WHO Director General visits Ebola-affected areas in DR Congo". World Health Organization. Retrieved 14 May 2018.
  41. ^ "Ebola outbreak: UK Public Health Rapid Support Team deploys to DRC". GOV.UK. Retrieved 21 May 2018.
  42. ^ Patient Ligodi (22 May 2018). "Two more die of Ebola in Congo; seven new cases confirmed". Reuters. Retrieved 22 May 2018.
  43. ^ "Wellcome pledges £2m after new Ebola outbreak confirmed | Wellcome". wellcome.ac.uk. Retrieved 11 May 2018.
  44. ^ a b c d "WHO supports Ebola vaccination of high risk populations in the Democratic Republic of the Congo". World Health Organization. Retrieved 21 May 2018.
  45. ^ Jason Burke (18 May 2018). "Ebola: two more cases confirmed in Mbandaka in DRC". The Guardian. Retrieved 22 May 2018.
  46. ^ a b c Saleh Mwanamilongo (21 May 2018). "Congo Ebola vaccination campaign begins with health workers". Washington Post. Retrieved 22 May 2018.
  47. ^ Adebayo, Bukola (10 May 2018). "Ebola: Nigeria begins screening of travelers from high-risk countries". CNN. Retrieved 11 May 2018.
  48. ^ Ed Yong (21 May 2018). "Most Maps of the New Ebola Outbreak Are Wrong". The Atlantic. Retrieved 21 May 2018.
  49. ^ "A Recombinant Vesicular Stomatitis Virus Ebola Vaccine". New England Journal of Medicine. 376 (4): 330–41. 2017. doi:10.1056/NEJMoa1414216. {{cite journal}}: Cite uses deprecated parameter |authors= (help)
  50. ^ "Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!)". Lancet. 389 (10068): 505–18. 2017. doi:10.1016/S0140-6736(16)32621-6. {{cite journal}}: Cite uses deprecated parameter |authors= (help)
  51. ^ "Questionable efficacy of the rVSV-ZEBOV Ebola vaccine". Lancet. 391 (10125): 1021. 2018. doi:10.1016/S0140-6736(18)30560-9. {{cite journal}}: Cite uses deprecated parameter |authors= (help)
  52. ^ "Ebola Erupts Again in Africa, Only Now There's a Vaccine". The New York Times. 11 May 2018. ISSN 0362-4331. Retrieved 11 May 2018.
  53. ^ Aizenman, Nurith (15 May 2018). "Can The New Ebola Vaccine Stop The Latest Outbreak?". NPR.org. Retrieved 16 May 2018.
  54. ^ "WHO planning for 'worst case scenario' over DRC Ebola outbreak". www.aljazeera.com. Retrieved 14 May 2018.
  55. ^ "19 dead in latest Congo Ebola outbreak: WHO". Reuters. 14 May 2018. Retrieved 14 May 2018.
  56. ^ "Ebola outbreak: Experimental vaccinations to begin in DR Congo". BBC. 21 May 2018. Retrieved 21 May 2018.
  57. ^ a b "Ebola virus disease – Democratic Republic of the Congo, Disease outbreak news". WHO. 23 May 2018.
  58. ^ a b Erika Check Hayden (18 May 2018). "Experimental drugs poised for use in Ebola outbreak". Nature. 557 (7706): 475. doi:10.1038/d41586-018-05205-x.
  59. ^ Erika Check Hayden (25 February 2016). "Ebola survivor's blood holds promise of new treatment". Nature. doi:10.1038/nature.2016.19440.
  60. ^ "Protective monotherapy against lethal Ebola virus infection by a potently neutralizing antibody". Science. 351 (6279): 1339–42. 2016. doi:10.1126/science.aad5224. {{cite journal}}: Cite uses deprecated parameter |authors= (help)
  61. ^ a b "Notes for the record: Consultation on Monitored Emergency Use of Unregistered and Investigational Interventions for Ebola Virus Disease (EVD)" (PDF). World Health Organization. 17 May 2018. Retrieved 25 May 2018.
  62. ^ "NIH begins testing Ebola treatment in early-stage trial". National Institutes of Health (NIH). 23 May 2018. Retrieved 25 May 2018.
  63. ^ Rosello, Alicia; Mossoko, Mathias; Flasche, Stefan; Van Hoek, Albert Jan; Mbala, Placide; Camacho, Anton; Funk, Sebastian; Kucharski, Adam; Ilunga, Benoit Kebela; Edmunds, W John; Piot, Peter; Baguelin, Marc; Muyembe Tamfum, Jean-Jacques (2015). "Ebola virus disease in the Democratic Republic of the Congo, 1976-2014". ELife. 4: e09015. doi:10.7554/eLife.09015. ISSN 2050-084X. PMC 4629279. PMID 26525597.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  64. ^ a b c "Years of Ebola Virus Disease Outbreaks". www.cdc.gov. 18 May 2018. Retrieved 22 May 2018.
  65. ^ Beavers, Olivia (14 May 2017). "Second Ebola case in Congo confirmed". The Hill. Retrieved 9 May 2018.
  66. ^ "Situation Report" (PDF). WHO.org. World Health Organization. Retrieved 9 May 2018.
  67. ^ "Ebola virus disease: Democratic Republic of the Congo: External Situation Report 22" (PDF). WHO. 8 June 2017. Retrieved 21 May 2018.
  68. ^ "Democratic Republic of the Congo". World Health Organization. Retrieved 24 May 2018.
  69. ^ "Democratic Republic of the Congo: WHO statistical profile" (PDF). World Health Organization. January 2015. Retrieved 24 May 2018.
  70. ^ "DRC: MSF Treats 17,000 People in One of the Largest National Cholera Outbreaks Ever". Médecins Sans Frontières. 27 September 2017. Retrieved 24 May 2018.
  71. ^ "DRC: Fighting the Country's Worst Cholera Epidemic in Decades". Médecins Sans Frontières. 25 January 2018. Retrieved 24 May 2018.
  72. ^ "Cholera – Kinshasa, Democratic Republic of the Congo". World Health Organization. 25 January 2018. Retrieved 24 May 2018.
  73. ^ Report of an International Commission (1978). "Ebola haemorrhagic fever in Zaire, 1976". Bulletin of the World Health Organization. 56 (2): 271–293. ISSN 0042-9686. PMC 2395567. PMID 307456.
  74. ^ Heymann, D. L.; et al. (1980). "Ebola Hemorrhagic Fever: Tandala, Zaire, 1977–1978". Journal of Infectious Diseases. 142 (3): 372–76. doi:10.1093/infdis/142.3.372. PMID 7441008.
  75. ^ Khan, A. S.; Tshioko, F. K.; Heymann, D. L.; Le Guenno, B.; Nabeth, P.; Kerstiëns, B.; Fleerackers, Y.; Kilmarx, P. H.; Rodier, G. R.; Nkuku, O.; Rollin, P. E.; Sanchez, A.; Zaki, S. R.; Swanepoel, R.; Tomori, O.; Nichol, S. T.; Peters, C. J.; Muyembe-Tamfum, J. J.; Ksiazek, T. G. (1999). "The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995". The Journal of Infectious Diseases. 179 Suppl 1: S76–86. doi:10.1086/514306. ISSN 0022-1899. PMID 9988168. S2CID 12364499.
  76. ^ "Outbreak news. Ebola virus haemorrhagic fever, Democratic Republic of the Congo--update". Relevé Épidémiologique Hebdomadaire. 82 (40): 345–346. 5 October 2007. ISSN 0049-8114. PMID 17918654.
  77. ^ "WHO | End of Ebola outbreak in the Democratic Republic of the Congo". www.who.int. Retrieved 22 May 2018.
  78. ^ "Congo declares its Ebola outbreak over". Reuters. 15 November 2014. Retrieved 22 May 2018.
  79. ^ "Democratic Republic of the Congo Ebola virus" (PDF). World Health Organization. Retrieved 22 May 2018.
  80. ^ "Ebola virus disease – Democratic Republic of the Congo: Disease outbreak news, 25 July 2018". ReliefWeb. Retrieved 26 July 2018.
  81. ^ "DR Congo's deadliest Ebola outbreak declared over". BBC News. 25 June 2020. Retrieved 25 June 2020.
  82. ^ "UNICEF welcomes end of Ebola outbreak in the Equateur Province of the DRC". www.unicef.org. Retrieved 18 November 2020.
  83. ^ "European Centre for Disease Prevention and Contro" (PDF). COMMUNICABLE DISEASE THREATS REPORT Week 18, 2-8 May 2021. Retrieved 20 June 2021.
  84. ^ "Five Ebola virus patients in DR Congo reported dead: WHO". BERNAMA. 25 May 2022. Retrieved 13 June 2022.
  85. ^ "5 Ebola virus patients in DR Congo reported dead: WHO". www.aa.com.tr. Retrieved 13 June 2022.
  86. ^ "The Democratic Republic of the Congo declares Ebola resurgence in North Kivu". WHO | Regional Office for Africa. Retrieved 7 April 2023.

Further reading

External links

0°45′S 18°07′E / 0.750°S 18.117°E / -0.750; 18.117

Retrieved from "https://en.wikipedia.org/w/index.php?title=2018_Équateur_province_Ebola_outbreak&oldid=844362404"