More Ebola in DRC as nurse's murder halts efforts in Vuhovi

The Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo (DRC) grew by 5 cases today, according to the daily update from the country's ministry of health.

There are now 853 cases (788 confirmed and 65 probable), including 531 deaths, and 177 cases are still under investigation. The new confirmed cases include three in Katwa and one each in Kyondo and Kalunguta.

Also reported today were two community deaths in confirmed cases in Katwa. Community deaths raise the risk of transmission.

The ministry of health also detailed the temporary halting of surveillance activities in Vuhovi, after a nurse from the Bisongo health center was abducted and murdered. Officials said a group of unidentified people carried out the attack.

"Contrary to certain information that has circulated, the patients of the Vuhovi General Reference Hospital have not been hunted, and they continue to be cared for on site," the health ministry said, adding that it is encouraging health workers to resume outbreak activities.

New vaccination campaign

Today front-line workers in the Lolwa health zone, which lies between Komanda and Rwampara on the road connecting Beni to Bunia, were vaccinated in a preventive effort, the ministry said.

Since August, 82,144 people in the DRC and surrounding countries have been vaccinated with Merck’s rVSV-ZEBOV vaccine. About half of those vaccinations have taken place in Katwa and Beni.

Today the World Health Organization (WHO) published an outbreak update and noted that Katwa and Butembo remain the areas of concern.

No new cases have been recorded in Beni for more than 3 weeks, but, from Jan 30 to Feb 19, 40 health areas in 12 health zones recorded 79 cases: Katwa (46), Butembo (15), Kyondo (4), Vuhovi (4), Kalunguta (2), Oicha (2), Biena (1), Mabalako (1), Manguredjipa (1), Masereka (1), Mutwanga (1), and Rwampara (1).

"Trends in the case incidence have been encouraging; however, other indicators (such as the continued high proportion of community deaths, persistent delays in case detection, documented local travel amongst many cases, and relatively low numbers of cases among contacts under surveillance) suggest a high risk of further chains of transmission in affected communities," the WHO said.

"Response teams must maintain a high degree of vigilance across all areas with declining case and contact tracing activity, as with areas with active cases, to rapidly detect new cases and prevent onward transmission."

The WHO said the case-fatality rate for the outbreak is 62%.

Survival trend for favipiravir recipients

In research news, today the Journal of Infectious Diseases published a retrospective study on survival rates of Ebola patients who received favipiravir in Guinea during the West African Ebola outbreak in 2015.

Favipiravir, also known as T-705 or Avigan, is an experimental antiviral drug manufactured by Toyama Chemical of Japan.

In the study, the case-fatality rate in favipiravir-treated patients was lower than in untreated patients (31/73 [42.5%] vs 52/90 [57.8%], P = 0.053 in univariate analysis), but the authors write that the effect did not reach statistical significance.

See also:

Feb 21 DRC report

Feb 21 WHO update

Feb 21 J Infect Dis study

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