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Published Date: 2012-08-31 10:37:42
Subject: PRO/AH/EDR> Ebola virus disease - Congo DR (07): (OE) WHO
Archive Number: 20120831.1275094

EBOLA VIRUS DISEASE - DEMOCRATIC REPUBLIC OF CONGO (07): (ORIENTALE) WHO
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Date: Thu 30 Aug 2012
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2012_08_30/en/index.html

Ebola outbreak in Democratic Republic of Congo (DRC) - update
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The Ministry of Health (MoH) of the Democratic Republic of Congo (DRC) continues to work with partners to control the outbreak of Ebola virus disease. As of 28 Aug 2012, a total of 24 (6 probable, 6 confirmed and 12 suspected) cases and 11 deaths had been reported from Province Orientale. The reported cases and deaths occurred in 3 health zones as follows: 17 cases and 9 deaths in Isiro; 6 cases and 2 deaths in Viadana; 1 case and 0 deaths in Dungu. The fatal cases in Isiro include 3 health-care workers. All alerts have been investigated and so far there has been no Ebola suspected or confirmed cases reported from outside Province Orientale.

Initial samples were tested by Uganda Virus Research Institute (UVRI) in Entebbe, Uganda, and 3 samples taken from 2 patients were confirmed for Ebola virus (Ebola subtype Bundibugyo).

The US Centers for Disease Control and Prevention (CDC) has established a field laboratory in Isiro to support case management and epidemiological investigations. A National Task Force convened by the Congolese Ministry of Health is working with several partners including WHO, Medecins Sans Frontieres (MSF), International Federation of Red Cross and Red Crescent Societies (IFRC), CDC, [and the USAID PREDICT project] to control the outbreak.

A joint MoH, WHO, and MSF emergency response team is in the field to conduct a detailed epidemiological investigation and case management. WHO has deployed epidemiologists and logisticians from AFRO regional office (including the Inter-country Support team) and WHO headquarters to support the MoH and is working closely with partners in the areas of coordination, surveillance, epidemiology, logistics for outbreak, public information, and social mobilization.

WHO's Global Outbreak Alert and Response Network (GOARN) has deployed an anthropologist from the National Museum of Natural History (MNHN), France, to assist with a clearer understanding of the social and anthropological issues among the affected population that could impact the ongoing response efforts. Control activities that are being carried out include active case finding and contact tracing, enhanced surveillance, case management, public information, and social mobilization and reinforcing of infection control practices.

WHO does not recommend that any travel or trade restrictions be applied to Democratic Republic of Congo. There is currently no indication that this Ebola virus disease outbreak is related to the recent Ebola outbreak in Uganda occurring in Kibaale district.

General information on Ebola subtypes
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There are 5 identified subtypes of ebolavirus. The subtypes have been named after the location where they were first detected in outbreaks. 3 of the 5 subtypes have been associated with large Ebola virus disease outbreaks in Africa. Ebola-Zaire, Ebola-Sudan, and Ebola-Bundibugyo. Ebola virus disease is a febrile [sometimes] haemorrhagic illness, which causes death in 25-90 percent of all cases. The Ebola-Reston subtype, found in the Philippines, can infect humans, but no illness or death in humans has been reported to date.

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Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[Previously the WHO reported that at least 10 people in Orientale Province had died from suspected Ebola virus disease by 20 Aug 2012. WHO first reported the outbreak on 17 Aug 2012. Local sources say the 1st symptoms were spotted about a month ago. 9 of the deaths -- which included 3 health workers -- occurred in the district of Isiro, and one occurred in Dungu district. Of the 15 cases so far, 13 are probable and 2 confirmed. The death case in Dungu was a hunter.

As of 28 Aug 2012, WHO now reports a total of 24 cases (6 probable, 6 confirmed, and 12 suspected) and 11 deaths had been reported from Province Orientale. The reported cases and deaths occurred in 3 health zones as follows: 17 cases and 9 deaths in Isiro; 6 cases and 2 deaths in Viadana; 1 case and 0 deaths in Dungu. The fatal cases in Isiro include 3 health-care workers.

Thus the number of suspected cases has increased from 13 to 24, the number of confirmed cases from 2 to 6, and the number of fatalities from 9 to 11. It remains to be resolved whether these increases represent continued spread of the outbreak, or the result of enhanced surveillance.

The HealthMap/ProMED-mail interactive map of the Democratic Republic of the Congo can be accessed at http://healthmap.org/r/35-r. A map of the provinces of DRC is available at http://www.mapsofworld.com/democratic-republic-of-congo/democratic-republic-of-congo-political-map.html. - Mod.CP]

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