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*{{cite book |last1=Division |first1=Health and Medicine |last2=Health |first2=Board on Global |last3=Threats |first3=Forum on Microbial |title=The Ebola Epidemic in West Africa: Proceedings of a Workshop |date=2016 |publisher=National Academies Press |isbn=9780309450065 |url=https://books.google.com/books?id=aYCPDgAAQBAJ&printsec=frontcover&dq=ebola+congo&hl=en&ppis=_c&sa=X&ved=2ahUKEwiRiMytpffkAhVDPawKHQyBDDwQ6AEwBXoECAEQAg#v=onepage&q=ebola%20congo&f=false |accessdate=30 September 2019 |language=en}}
*{{cite book |last1=Division |first1=Health and Medicine |last2=Health |first2=Board on Global |last3=Threats |first3=Forum on Microbial |title=The Ebola Epidemic in West Africa: Proceedings of a Workshop |date=2016 |publisher=National Academies Press |isbn=9780309450065 |url=https://books.google.com/books?id=aYCPDgAAQBAJ&printsec=frontcover&dq=ebola+congo&hl=en&ppis=_c&sa=X&ved=2ahUKEwiRiMytpffkAhVDPawKHQyBDDwQ6AEwBXoECAEQAg#v=onepage&q=ebola%20congo&f=false |accessdate=30 September 2019 |language=en}}
*{{cite journal |last1=Ousman |first1=Kevin |last2=Kabego |first2=Landry |last3=Talisuna |first3=Ambrose |last4=Diaz |first4=Janet |last5=Mbuyi |first5=John |last6=Houndjo |first6=Bienvenu |last7=Ngandu |first7=Jean-Paul |last8=Omba |first8=Gaston |last9=Aruna |first9=Aaron |last10=Mossoko |first10=Mathias |last11=Djingarey |first11=Mamadou Harouna |last12=Balde |first12=Thierno |last13=Abok |first13=Patrick |last14=Diallo |first14=Boubacar |last15=Dovlo |first15=Delanyo |last16=Yao |first16=Michel |last17=Fortin |first17=Anne |last18=Formenty |first18=Pierre |last19=Fall |first19=Ibrahima Soce |title=The impact of Infection Prevention and control (IPC) bundle implementationon IPC compliance during the Ebola virus outbreak in Mbandaka/Democratic Republic of the Congo: a before and after design |journal=BMJ open |date=5 September 2019 |volume=9 |issue=9 |pages=e029717 |doi=10.1136/bmjopen-2019-029717 |url=https://www.ncbi.nlm.nih.gov/pubmed/31492782 |accessdate=30 September 2019 |issn=2044-6055}}
*{{cite journal |last1=Ousman |first1=Kevin |last2=Kabego |first2=Landry |last3=Talisuna |first3=Ambrose |last4=Diaz |first4=Janet |last5=Mbuyi |first5=John |last6=Houndjo |first6=Bienvenu |last7=Ngandu |first7=Jean-Paul |last8=Omba |first8=Gaston |last9=Aruna |first9=Aaron |last10=Mossoko |first10=Mathias |last11=Djingarey |first11=Mamadou Harouna |last12=Balde |first12=Thierno |last13=Abok |first13=Patrick |last14=Diallo |first14=Boubacar |last15=Dovlo |first15=Delanyo |last16=Yao |first16=Michel |last17=Fortin |first17=Anne |last18=Formenty |first18=Pierre |last19=Fall |first19=Ibrahima Soce |title=The impact of Infection Prevention and control (IPC) bundle implementationon IPC compliance during the Ebola virus outbreak in Mbandaka/Democratic Republic of the Congo: a before and after design |journal=BMJ open |date=5 September 2019 |volume=9 |issue=9 |pages=e029717 |doi=10.1136/bmjopen-2019-029717 |url=https://www.ncbi.nlm.nih.gov/pubmed/31492782 |accessdate=30 September 2019 |issn=2044-6055}}
*{{cite web |title=Genomic epidemiology of the 2018-19 Ebola epidemic |url=https://nextstrain.org/community/inrb-drc/ebola-nord-kivu |website=nextstrain.org |accessdate=9 November 2019}}
<small>{{Note2}}due to the increase in cases 250/140 death<sup>approx.</sup> per [https://mailchi.mp/sante.gouv.cd/ebola_kivu_16oct?e=2bde1f126a MOH] & [https://www.aljazeera.com/news/2018/10/ebola-spread-uganda-rwanda-warns-181011141950957.html WHO warns:] infobox, page move graph,table might need to be changed.</small>
<small>{{Note2}}due to the increase in cases 250/140 death<sup>approx.</sup> per [https://mailchi.mp/sante.gouv.cd/ebola_kivu_16oct?e=2bde1f126a MOH] & [https://www.aljazeera.com/news/2018/10/ebola-spread-uganda-rwanda-warns-181011141950957.html WHO warns:] infobox, page move graph,table might need to be changed.</small>



Revision as of 14:15, 9 November 2019

Extended content
Extended content
Extended content
Extended content
Nord-Kivu DRC, is where the outbreak started, it spread to South Kivu and Ituri, as well as, the country of Uganda(there are rumored cases in Tanzania per WHO[1]).

Epidemiology(other factors)

This particular outbreak started on August 1, just a few days after the prior 9th outbreak[2].Some factors that are different from the 2018 Équateur province Democratic Republic of the Congo Ebola virus outbreak are the following:

  1. While the Équateur outbreak occurred in 3 zones[3], this new EVD incident is occurring in almost a dozen zones(and 2 provinces)[4].
  2. There is an armed military conflict[5] that is impeding health workers(vaccination)[6][7]
  3. Finally, there is a mass refugee movement into Uganda from the DRC[8]

If the EVD lingers long enough due to military conflict and the high number of zones(area) affected,[9] Uganda and the millions of entering refugees could become a major problem[10]Currently there are 160 cases and almost 100 deaths, as of 23 September in DRC[11]Peter Salama of the World Health Organization on 25 September, indicated that insecurity is obstructing efforts to stop the virus and believes a combination of factors could establish conditions for an epidemic[12] On 24 November, it was reported that the current EVD outbreak would become the second biggest ever in history.[13] Uganda would eventually declare 4 cases, all died of EVD.[14]

Tanzania

The WHO stated on 21 September that "to date, the clinical details and the results of the investigation, including laboratory tests performed for differential diagnosis of these patients, have not been shared with WHO. The insufficient information received by WHO does not allow for a formulation of a hypotheses regarding the possible cause of the illness".[15][16][17] On 27 September, the CDC and U.S. State Department alerted potential travellers to the possibility of unreported EVD cases within Tanzania,[18] one day later the United Kingdom began indicating to potential travelers to Tanzania, the undiagnosed death of an individual and the WHO, 21 September statement on the issue.[19]

Treatment

Ebola virus from blood sample

Monitored Emergency Use of Unregistered Interventions has been used by the World Health Organization in this outbreak.WHO indicated that favipiravir is the most uncertain in terms of benefits/risks[20]

As a recent article indicates transparency is very important[21]; in the use of treatment options in this outbreak 35 individuals have been treated, 16 were discharged, 11 are still in the hospital and 8 died.[22]On 12 August, for the first time, two clinical trial medications were found to improve the rate of survival in those infected by EVD. They are REGN-EB3, a cocktail of three monoclonal Ebola antibodies, and mAb114. These two will be further used in therapy, ZMapp has been discontinued.[23][24][25][26]

ref

  1. ^ "U.S. alerts travelers to Tanzania about possible unreported Ebola". STAT. 27 September 2019. Retrieved 30 September 2019.
  2. ^ Mahamba, Fiston. "Congo declares new Ebola outbreak in eastern province". U.S. Retrieved 23 September 2018.
  3. ^ "Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 17: Declaration of End of Ebola Virus Disease Outbreak - Democratic Republic of the Congo". ReliefWeb. Retrieved 23 September 2018.
  4. ^ "EBOLA RDC - Evolution de la riposte contre l'épidémie d'Ebola dans la province du Nord Kivu au Samedi 22 septembre 2018". mailchi.mp. Retrieved 23 September 2018.
  5. ^ "Rebel Attack in Congo Ebola Zone Kills at Least 14 Civilians". VOA. Retrieved 23 September 2018.
  6. ^ "Ebola In A Conflict Zone". NPR.org. Retrieved 23 September 2018.
  7. ^ "WHO calls for free and secure access in responding to Ebola outbreak in the Democratic Republic of the Congo - Democratic Republic of the Congo". ReliefWeb. Retrieved 23 September 2018.
  8. ^ "Fleeing DRC to Uganda: Africa's other refugee crisis". www.aljazeera.com. Retrieved 23 September 2018.
  9. ^ "DR Congo: "Triple threat" of conflict, community resistance and increasing Ebola cases complicates response to outbreak - Democratic Republic of the Congo". ReliefWeb. Retrieved 23 September 2018.
  10. ^ "Uganda: Ebola Preparedness Emergency Plan of Action (EPoA) - DREF Operation n° MDRUG041 - Uganda". ReliefWeb. Retrieved 23 September 2018. outbreak of Ebola will be detected with transmission to many districts with potential of international spread. It is assumed that asymptomatic cases from DRC passed the Points of Entry undetected. Additionally, transmission with be propagated due to poor health seeking behaviours, preference for traditional healer, fear and distance to Ebola treatment centres. This will leave potentially hundreds of people exposed, thus allowing the disease to spread further into the communities, including outside the current at-risk districts, with contacts spread in refugee settlement, across the country, and potentially cross over to neighbouring countries
  11. ^ "EBOLA RDC - Evolution de la riposte contre l'épidémie d'Ebola dans la province du Nord Kivu au Samedi 22 septembre 2018". mailchi.mp. Retrieved 23 September 2018.
  12. ^ Schlein, Lisa. "WHO Warns Ebola Spreading in Eastern DR Congo". VOA. Retrieved 25 September 2018. A perfect storm of active conflict limiting our ability to access civilians, distress by segments of the community already traumatized by decades of conflict and of murder, driven by a fear of a terrifying disease
  13. ^ "Congo's Ebola outbreak almost second highest ever". Axios. Retrieved 26 November 2018.
  14. ^ "Ebola Virus Disease Outbreak Uganda Situation Reports". WHO | Regional Office for Africa. Retrieved 9 October 2019.
  15. ^ "WHO | Cases of Undiagnosed Febrile Illness – United Republic of Tanzania". WHO. Retrieved 22 September 2019.
  16. ^ "WHO accuses Tanzania of withholding information about suspected Ebola cases". Washington Post. Retrieved 22 September 2019.
  17. ^ "Tanzania not sharing information on suspected Ebola cases: WHO". www.aljazeera.com. Retrieved 22 September 2019.
  18. ^ "U.S. alerts travelers to Tanzania about possible unreported Ebola". STAT. 27 September 2019. Retrieved 27 September 2019.
  19. ^ "Health - Tanzania travel advice". GOV.UK. Retrieved 28 September 2019.
  20. ^ "Notes for the record: Consultation on Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) for Ebola Virus Disease (EVD)" (PDF). World Health Organization. Retrieved 23 September 2018.
  21. ^ Singh, Jerome Amir (24 February 2015). "Humanitarian Access to Unapproved Interventions in Public Health Emergencies of International Concern". PLoS Medicine. 12 (2). doi:10.1371/journal.pmed.1001793. ISSN 1549-1277. Retrieved 23 September 2018.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  22. ^ "Democratic Republic of Congo: Ebola Virus Disease - External Situation Report 7 - Democratic Republic of the Congo". ReliefWeb. Retrieved 23 September 2018.
  23. ^ Branswell, Helen (12 August 2019). "For the first time, clinical trial data show Ebola drugs improve survival rates". STAT. Retrieved 12 August 2019.
  24. ^ Boseley, Sarah (12 August 2019). "Ebola now curable after trials of drugs in DRC, say scientists". The Guardian. Retrieved 12 August 2019.
  25. ^ McNeil Jr., Donald G. (12 August 2019). "A Cure for Ebola? Two New Treatments Prove Highly Effective in Congo". The New York Times. Retrieved 12 August 2019. The two new therapies were among four that were tested in a trial that has enrolled almost 700 patients since November. The two worked so well that a committee meeting on Friday to look at preliminary results in the first 499 patients immediately recommended that the other two treatments, ZMapp, made by Mapp Biopharmaceutical, and remdesivir, made by Gilead Sciences, be stopped. All patients will now be offered either the Regeneron or the Biotherapeutics drug.
  26. ^ Maxmen A (12 August 2019). "Two Ebola drugs show promise amid ongoing outbreak". Nature. doi:10.1038/d41586-019-02442-6. ISSN 0028-0836.

information Note:due to the increase in cases 250/140 deathapprox. per MOH & WHO warns: infobox, page move graph,table might need to be changed.

  • - -            see above


















































*NPR medical article           *(in the future)may place copy peer reviews WikiJournal of Medicine here