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Published Date: 2019-03-14 14:05:08
Subject: PRO/AH/EDR> Ebola update (28): Congo DR (NK,IT) cases, law, research
Archive Number: 20190314.6366412
EBOLA UPDATE (28): DEMOCRATIC REPUBLIC OF CONGO (NORTH KIVU, ITURI) CASES, LAW, RESEARCH
****************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Case updates
- Epidemiological situation report, 13 Mar 2019, DRC Ministry of Health
- Epidemiological situation report, 11 Mar 2019, DRC Ministry of Health
- Biena: new case after 30 days
- Ituri: Byakato and Lwemba: 2 active outbreaks
[2] Summaries
- CIDRAP (Center for Infectious Disease Research and Policy) 13 Mar 2019 update
- CIDRAP 11 Mar 2019 update
- WHO/AFRO External situation report 32
[3] Announcements
- Public health enforcement law adopted Mukwege: "Ebola is not a false epidemic"
- Mukwege: "Ebola is not a false epidemic"
[4] Research: Sequencing

******
[1] Case updates
- Wed 13 Mar 2019. Epidemiological situation report, DRC Ministry of Health
[in French, machine trans., abridged, edited]
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=1135a99949

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 12 Mar 2019:
- Since the beginning of the epidemic, the cumulative number of cases is 927, of which 862 are confirmed and 65 are probable. In total, there have been 584 deaths (519 in confirmed and 65 in probable cases) and 308 people have recovered;
- 193 suspected cases under investigation;
- 2 new confirmed cases, including 1 in Mandima and 1 in Kalunguta;
- no new confirmed case deaths.

News of the response
Vaccination
-----------
Since vaccination began on 8 Aug 2018, 87 668 people have been vaccinated. [See URL for number of vaccines in each location.]

--
communicated by:
ProMED-mail rapporteur Mary Marshall

- Mon 11 Mar 2019. Epidemiological situation report, DRC Ministry of Health
[in French, machine trans., abridged, edited]
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=ad8e2a185f

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 10 Mar 2019:
- Since the beginning of the epidemic, the cumulative number of cases is 923, of which 858 are confirmed and 65 are probable. In total, there have been 582 deaths (517 in confirmed and 65 in probable cases) and 308 people have recovered.
- 150 suspected cases under investigation;
- 2 new confirmed cases, including 1 in Butembo and 1 in Biena;
- No new case deaths confirmed.

News of the response
- The coordinator of the Butembo sub-coordination, Dr Jean-Christophe Shako, made a mission to Kighali (health zone of Lubero), a village located 45 km [28 mi] from Lubero center, on Mon 11 Mar 2019. The mission in this village was risky because it is surrounded by hills from which armed groups monitor any movement of vehicles and people.
- The aim of the response team was to remove community reluctance against vaccination and household decontamination following the detection of a confirmed case and possible probable cases in the village. The confirmed case is a woman, a known but reluctant contact, who fled Butembo to seek refuge in Kighali. In order to limit the risk of spread of the virus in this village, it was important to carry out all the response activities around the case, namely the listing of contacts, vaccination, the decontamination of households and health facilities, the establishment of the 21-day tracking system, as well as food distribution for all contacts.
- The day before, a team of 3 epidemiologists had entered the village to investigate. On site, they had met with fierce reluctance from the community and were seriously injured by the angry mob. On Monday [11 Mar 2019], Dr Shako managed to remove this reluctance, thanks to the involvement of local leaders including the mwami, the group leader, the priest, the territory administrator and the zone chief medical officer.
- A large crowd gathered to listen to the speeches of all the speakers. They spoke in turn about the importance of hosting response teams, not attacking them, being vaccinated, and respecting all other preventive measures. These words seem to have convinced the population, in particular about 60 contacts who have quickly registered to benefit from the vaccination and start the 21-day follow-up program. A call has been made to other contacts who are still hidden.

Vaccination
-----------
- Since the start of vaccination on 8 Aug 2018, 86 951 persons have been vaccinated. [See URL for number of vaccines in each location.]

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[The good news is that there have been no new deaths reported. The bad news is that attacks continue to occur, but the good news is that some communities apparently are listening and actually responding to the call to be supportive of the effort to control Ebola. - Mod.LK]

- Biena: new case after 30 days
Tue 12 Mar 2019. Lubero / Territory: Biena records new Ebola case after 30 days without reported case
[Rafio Moto Butembo-Beni, machine trans., abridged, edited]
http://radiomotofm.info/lirearticle.php?billet=5540

The Biena health zone registered a new case after 30 days passed without any case notified in this country. The case was recorded on Sun 10 Mar [2019] at Mambowa hospital.

The patient is a 2 year old child who had been in contact with his father who died of Ebola in Butembo 2 weeks ago. On the morning of Mon 11 Mar [2019], the coordination of the Ebola response team in the Biena health zone confirms the transfer of this case to the Ebola treatment center [ETC] Butembo. The district medical officer indicates that efforts are being made in terms of vaccination of contacts of the confirmed case.

Note that the week before 10 Mar [2019], in the awareness mission against Ebola, the sensitization team was invaded by residents from Katanga to Vuyinga. One of the sensitizers was heavily beaten and remains interned in a health facility of the place.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

- Ituri: Byakato and Lwemba: 2 active outbreaks
Sat 9 Mar 2019. Ituri: Byakato and Lwemba, 2 active Ebola outbreaks with multiple contact cases
[Radio Moto Butembo-Beni, machine trans., abridged, edited]
https://protect2.fireeye.com/url?k=1d085220-412c5369-1d0aab15-0cc47aa8d394-48841c0c8e965b44&u=http://radiomotofm.info/lirearticle.php?billet=5528

Ebola virus disease is still confirmed to be dangerous in Mandima rural health zone in Mambasa territory in Ituri province. The localities of Byakato and Lwemba are now considered active foci of this disease and [contain] several cases of contact.

In these 2 localities, some already confirmed cases were sent to the Mangina Ebola treatment center in Beni territory. Fearing new contaminations or the reappearance of this epidemic in his jurisdiction, the delegated official of the state assigned to Mangina has called the population of his entity to great vigilance and strict observance of hygiene measures. Kasereka Kandondo Ephrem made this call this weekend in an exclusive interview: "Ebola was mastered in Mangina because the population quickly understood the danger of the said disease and respected the preventive measures to fight against this epidemic. Now that Byakato and Lwemba has become a big focus for this epidemic, we must be vigilant to avoid new contaminations, because several cases' contacts are now around," he said. "Ebola is a very serious disease, dangerous, very contagious, because it can empty an entire community, a nation. We must be careful in respecting the rules of hygiene."

--
communicated by:
ProMED-mail rapporteur Mary Marshall

******
[2] Summaries
- Wed 13 Mar 2019. DRC reports 2 new Ebola cases; study notes seroprevalence in region
[CIDRAP (Center for Infectious Disease Research and Policy), abridged, edited]
http://www.cidrap.umn.edu/news-perspective/2019/03/drc-reports-2-new-ebola-cases-study-notes-seroprevalence-region
[byline: Lisa Schnirring]

The Ebola total in the Democratic Republic of the Congo (DRC) grew by 2 today, and a new serologic study from 5 central African countries, including the DRC, found a low prevalence, hinting that exposure to the virus is probably rare outside of outbreaks. The 2 latest cases were reported in Mandima in Ituri province, which has reported a handful of recent cases, and from Kalunguta in North Kivu province, an insecure area where vaccination teams were recently held by an armed group.

The number of people vaccinated continued to rise, with 87 668 people immunized. Nearly 1/4 of them have been in Katwa, one of the current main hot spots.

Seroprevalence in central Africa
-------------------------------
For the study, an international team of researchers, hoping to get a better handle on serologic prevalence of Ebola and the geographic range of hemorrhagic fever viruses, tested 2430 blood samples that had been collected from 1997-2012 for other studies. The countries are the Republic of Congo, the DRC, Uganda, Ghana, and Cameroon. The team published its findings yesterday [Tue 12 Mar 2019] in Emerging Infectious Diseases.

The experts screened the samples for antibodies using a microneutralization assay and a new luciferase immunoprecipitation system assay. Samples that were positive for Ebola antibodies were confirmed by enzyme-linked immunosorbent assay (ELISA).

For the Republic of Congo and the DRC -- both of which have reported Ebola outbreaks -- serologic prevalence was 2%-3.5%, generally consistent with earlier studies. Higher prevalence rates were seen in samples from rural areas compared with urban areas.

They also found a 1.3% prevalence in southern Cameroon, an area thought to be at risk for the spread of Marburg virus, another viral hemorrhagic fever pathogen. The country hasn't reported any Ebola cases, and the authors said the findings suggests a low risk of exposure. A 1983 serologic survey for different parts of the country had found a 3%-14.5% seroprevalence.

Taken together, the team said evidence of past Ebola exposure in different parts of central Africa might be explained by migration of people from known exposure areas or where the virus hasn't been detected yet. The authors added that some areas might be at increased risk of human exposure because of Ebola or related viruses, owing to environmental, societal, and behavioral practices.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[ref: Steffen I, et al. Serologic prevalence of Ebola virus in equatorial Africa. Emerg Infect Dis. 2019; 25 (5). doi: 10.3201/eid2505.180115.
There appears to be low risk of exposure to Ebola virus outside an outbreak. - Modd.LK]

- Mon 11 Mar 2019. New attack, case in high-risk village among latest Ebola perils
[CIDRAP (Center for Infectious Disease Research and Policy), abridged, edited]
http://www.cidrap.umn.edu/news-perspective/2019/03/new-attack-case-high-risk-village-among-latest-ebola-perils
[byline: Lisa Schnirring]

An armed group 2 days ago struck the same ETC in Butembo in the Democratic Republic of the Congo (DRC) that sustained an earlier attack, killing a police officer as the security team repelled the attackers. Alongside the fresh violence, the DRC health ministry reported 5 new cases in updates over the weekend and through today [Mon 11 Mar 2019], and an outbreak response team made headway tracking a transmission chain in a high-risk village south of Butembo.

The health ministry said in its 9 Mar [2019] update that early that morning, heavily armed men attempted to attack the Butembo ETC. But officials had been informed of a possible attack, and security forces had positioned themselves around the treatment center, which helped repel the attackers and save lives. Officials said a policeman protecting the treatment center died in the gun battle and that several assailants were captured. The health ministry was in contact with medical staff, who were on hand to calm patients who remained in their isolation rooms.

Attackers included Mai Mai militia, and the attack also wounded health workers, according to a 9 Mar [2019] report from Reuters. North Kivu is one of the DRC provinces that is home to different Mai Mai militia groups, which reportedly align themselves with a variety of domestic, foreign, and guerilla groups with different objectives, some political.

The treatment center was attacked by an unknown group on 27 Feb [2019], which -- along with an earlier attack on another facility in Katwa -- prompted Doctors Without Borders (MSF) to withdraw its staff from the outbreak's epicenter. The Butembo location quickly reopened, staffed by local health workers.

The Saturday [9 Mar 2019] attack came just hours before a visit from World Health Organization (WHO) leadership, accompanied by senior US officials. During a 3-day mission, the group met with the DRC's president, government officials, partner organizations, and local responders.

WHO director-general Tedros Adhanom Ghebreyesus, said the attacks aren't by the community; they are perpetrated on the community by groups exploiting a desperate situation for their own purposes. He said people in Ebola-hit communities want and deserve a place to receive care and a chance to survive the disease. "They do not deserve to suffer in their homes while infecting their loved ones; they do not deserve to suffer in inadequately resourced health centers while infecting health workers."

He said that WHO has asked for and received more support from the UN and local police to protect the treatment centers, and he emphasized that battling Ebola requires striking a delicate balance between providing accessible care, maintaining the neutrality of the response, and protecting patients and staff from attacks by armed groups.

In other outbreak developments, in daily updates over the weekend and through today [Mon 11 Mar 2019], the health ministry reported 5 more cases, including 3 in Butembo, 1 in Katwa, and 1 in Biena. Four more people died from their infections, all from Butembo, boosting the fatality count to 582. One death occurred in the community, and 3 patients died in the city's ETC.

In today's [Mon 11 Mar 2019] update, the DRC health ministry said health officials from the Butembo outbreak response office today made a risky mission to a village named Kighali in Lubero health zone, located south of Butembo. It said the trek is dangerous, because armed groups monitor the movement of vehicles and people from hills surrounding the village. Yesterday, 3 epidemiologists who entered the village to investigate a confirmed case there in a woman who fled Butembo, were seriously injured by an angry mob.

Today's mission was designed to address community reluctance against vaccination and household decontamination and to pave the way for other response steps, including contact tracing, establishing a 21-day tracking system, and distributing food to all contacts. The health ministry said local leaders, including the priest, territory administrator, and health zone chief medical officer, helped outbreak coordinator Jean-Christophe Shako engage with the local population. It said a large crowd gathered to listen to speeches from the speakers, who emphasized the importance of hosting response teams, being vaccinated, and respecting other prevention steps. So far, about 60 contacts there have registered for vaccination and 21-day follow up.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

- Wed 13 Mar 2019. Democratic Republic of Congo: Ebola virus disease outbreak - External situation report 32
[WHO Health Emergencies Information and Risk Assessment, 12 Mar 2019, abridged, edited]
http://newsletters.afro.who.int/outbreak-dashboards/130adq3fn2yq720bx6nkml?email=true&a=11&p=54683561

Situation update; data as reported by Tue 12 Mar 2019
-----------------------------------------------------
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo (DRC), is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern. Simultaneously, relatively small clusters of cases have been observed in other areas of North Kivu and Ituri provinces, which stem from chains of transmission in Katwa and Butembo, but these clusters have largely been contained to limited local transmissions.

Over the last 21 days, no new cases have been detected in 11 of the 20 health zones affected to date, and within the recently affected health zones, transmission has been limited to 34 out of 154 health areas. The response has had traction in these places, despite the challenges of community mistrust engendered by the years of conflict they have endured. The risk of further chains of transmission and spread, however, remain high, as demonstrated by the recent spread to Lubero health zone and the reintroduction to Biena health zone following a prolonged period without new cases.

These events highlight the importance of the response teams remaining active and vigilant across all areas, including those with lower case incidence, to rapidly detect new cases and prevent onward transmission.

As of 10 Mar 2019, a total of 923 EVD cases, including 858 confirmed and 65 probable cases, were reported from 20 health zones in the North Kivu and Ituri provinces. Overall, cases have been reported from 125 of 319 health areas across 20 health zones. A total of 582 deaths were reported (overall case fatality ratio 63%), including 517 deaths among confirmed cases. Of confirmed and probable cases with reported age and sex, 57% (523/922) were female, and 30% (279/923) were children aged less than 18 years. The cumulative total of confirmed and probable cases among health workers is 74, including 26 deaths.

Nine of the 20 health zones (45%) that have reported at least one case of EVD to date have active virus transmission, reporting at least one confirmed case in the last 21 days (18 Feb to 10 Mar 2019). Conversely, there are 11 health zones (55%) where no cases of EVD have been reported in the last 21 days. In total 34 (22%) health areas in the 9 zones reported one or more cases.

A total of 80 confirmed cases were reported from Katwa (45), Butembo (18), Mandima (7), Kalunguta (3), Kyondo (2), Masereka (2), Lubero (1), Beni (1), and Biena (1). Most cases were reported in Katwa and Butembo, accounting for 79% (63/80) of cases reported in the last 3 weeks. A new health zone, Lubero, has reported a confirmed case for the 1st time, with links to a confirmed case in Butembo.

The Ministry of Health (MoH), WHO, and partners continue to monitor and investigate all alerts in affected areas in other provinces in the DRC and in neighbouring countries. To date, all reported alerts outside the outbreak affected areas have been investigated or laboratory tested to rule out EVD.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

******
[3] Announcements
- Wed 13 Mar 2019. Public health enforcement law adopted
[Ebola: MoH press release 13 Mar 2019, abridged, edited]
https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=0779c370e7

Entry into force of the law on the organization of public health in the DRC
----------------------------------------------------
Adopted on 13 Dec 2018, Law no. 18/035 lays down the fundamental principles relating to the organization of public health [and] comes into force on 13 Mar 2019.

"It has been nearly 20 years since the DRC has waited for this law," said minister of health Dr Oly Ilunga Kalenga. "The coming into force of the Public Health Organization Act marks an important turning point in our journey towards achieving universal health coverage in the DRC. I am pleased to be able to count this legislation among the achievements of my mandate. But I must also acknowledge the contribution of all the ministers of health who preceded me."

The right to health is a fundamental right of the Congolese citizen and a state duty.

It had become imperative to adopt, at the national level, a comprehensive, integrated, and innovative text, which was adapted to the realities of the moment, while opening a new path for the future.

The new law sets out the rights and duties of patients, healthcare providers, and institutions in order to bring the administration of patients and the patients closer to the healthcare decision-making and distribution centers to which they are entitled. It is based on the principle of "health for all and by all".

This law applies to health personnel, care recipients, health services, institutions, and enterprises, as well as any natural or legal person considered as a partner in the administration of healthcare.

In addition to incorporating provisions of international legal instruments related to the guarantee of health into the Congolese legal arsenal, the law introduces major innovations including:

1. institutionalization of the organization and functioning of the national public health system;
2. reproductive health as an effective and efficient means of reducing child and maternal mortality;
3. mandatory vaccination;
4. financing the health system;
5. the penalization of the abuses related to the non-observance of the provisions of this law.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

- Wed 13 Mar 2019. Mukwege: "Ebola is not a false epidemic, to refuse to consider this danger is to open the door to decimate us"
[Actualite, machine trans., abridged, edited]
https://actualite.cd/index.php/2019/03/13/mukwege-aux-habitants-de-butembo-beni-ebola-nest-pas-une-fausse-epidemie-refuser-de

Nobel Peace Prize laureate Denis Mukwege on Tuesday [12 Mar 2019] called on the people of Butembo-Beni to take an active role in fighting the Ebola epidemic that has plagued this region of North Kivu since August 2018. In his message to Actualite.CD, the gynecologist reassures that Ebola really exists and that it must be combated: "As a doctor, I tell you that Ebola is not a false epidemic. It is real and deserves our attention to all, as well as our very committed struggles to put an end to it. To refuse to consider this danger is to open the door to decimate the insulation. We must avoid locking ourselves in ourselves. We must break this isolation to engage together in other struggles for peace in our region," Dr Denis Mukwege advised.

The doctor's call from the Panzi hospital comes as teams in the Far North (Butembo, Beni, Lubero), engaged in the response to the Ebola outbreak, are facing cases of community resistance from residents who do not believe in the existence of the Ebola epidemic. For Dr Denis Mukwege, denying the existence of this disease may "help the macabre plan of those who want to make us disappear".

"Let us unite and support each other to protect our medical centers and our doctors, our nurses. Let's refuse their destruction. [For] we will definitely need all these centers when Ebola will be defeated. Do not blindly reject drugs, vaccines, care, other preventive measures that we are offered. It would be isolating us more. I call on religious leaders, community leaders, civil society, and the entire population to appropriate this awareness campaign to protect our population. It is you who will lead the Congo to its restoration, and for this, each of you is important," Dr Denis Mukwege urged.

[byline: Claude Sengenya]

--
communicatd by:
ProMED-mail rapporteur Mary Marshall

******
[4] Research: sequencing
Date: Wed 13 Mar 2019
From: Gustavo Palacios <gustavo.palacios@gmail.com>, director, Center for Genome Sciences, USAMRIID [edited]

The Institut National de Recherche Biomedicale (INRB), in conjunction with the partners listed below, has been sequencing samples during the ongoing Nord-Kivu/Ituri EVD outbreak in the Democratic Republic of the Congo (DRC).

Data are being released on virological.org (http://virological.org/t/drc-2018-viral-genome-characterization/230). Preliminary sequences are available at the link below and will be released on GenBank.
https://drive.google.com/open?id=1_1c3lIukzMFXwiAdVv_nd1_7UGzGzZ9M

A POPArt haplotype network analysis of the sequence data is also available at the above links, along with a flipbook separating the network by week, to add a time aspect to the analysis. All data have been shared and approved for release by the DRC Ministry of Health (MoH).
We are also releasing the data in a Nextstrain instance that allows the exploration of genomic sequence data and transmission patterns. The live community build can be found here: https://nextstrain.org/community/inrb-drc/ebola-nord-kivu and will be updated as new data are being generated, after approval by the DRC MoH in accordance with the principles of the Nagoya Protocol. The build is maintained at https://github.com/inrb-drc/ebola-nord-kivu.

POPArt: http://popart.otago.ac.nz. Bandelt H, Forster, P, Rohl A. Median-joining networks for inferring intraspecific phylogenies. Mol Biol Evol. 1999; 16(1): 37-48.

Nextstrain: https://nextstrain.org. Hadfield, et al. Nextstrain: real-time tracking of pathogen evolution. Bioinformatics. 2018; 34(23): 4121-4123.

Partners and collaborators
---------------------
This work is part of ongoing research collaborations between several partners:
Institut National de Recherche Biomedicale (INRB)
US Army Medical Research Institute of Infectious Diseases (USAMRIID)
University of Nebraska Medical Center (UNMC)
Institut Pasteur de Dakar, Dakar, Senegal (IPD)
TransVIHMI (IRD, INSERM, University of Montpellier)

Data statement
---------------
Genome sequences for all samples have been shared with all local and international partners working in the DRC. The information reported here is being shared pre-publication to help the research and public health communities respond to the current Ebola virus disease outbreak. Please note though that this data is still based on work in progress and should be considered preliminary. INRB will distribute these data to any entity or collaborator that needs it. Please communicate with Drs Muyembe-Tamfum and Ahuka-Mundeke for further coordination.

Prof Jean-Jacques Muyembe Tamfum (INRB, School of Medicine Kinshasa University)
Prof Steve Ahuka-Mundeke (INRB, School of Medicine Kinshasa University)
Dr Placide Mbala (INRB, School of Medicine Kinshasa University)
Dr Gustavo Palacios (USAMRIID)
Catherine Pratt (USAMRIID)
Dr Michael Wiley (USAMRIID)
Avenue de la Democratie No. 5345 - Kin/Gombe - B.P. 1197 - Kinshasha 1 - Tel. 898949 289 - 9913614 - 99 23123 - 081 5144285 email: <inrbrdc@yahoo.fr>, website: <www.inrb.cd>

[The haplotype networks are recommended for examination to help understand transmission chains. - Mod.LK

HealthMap/ProMED-mail map of DR Congo: http://healthmap.org/promed/p/194.]

See Also

Ebola update (27): Congo DR (NK, IT) cases, Butembo, summary, WHO, research 20190310.6360031
Ebola update (26): Congo DR (NK, IT) cases, summary, WHO, response 20190308.6356987
Ebola update (25): Congo DR (NK, IT) cases, summary, response, research 20190305.6350567
Ebola update (24): Congo DR (NK, IT) cases, attacks 20190303.6346910
Ebola update (23): Congo DR (NK,IT) cases, WHO, violence 20190301.6343087
Ebola update (22): Congo DR (NK,IT) cases, WHO, response 20190226.6336700
Ebola update (21): Congo DR (NK, IT) cases, summaries, vaccine, WHO, reading 20190223.6332712
Ebola update (20): Congo DR (NK, IT) cases, summary, vaccine, response 20190221.6328121
Ebola update (19): Congo DR (NK, IT) cases, summaries, news, UNICEF 20190218.6323083
Ebola update (18): Congo DR (NK, IT) cases, summaries, vaccine RFI, research 20190215.6319043
Ebola update (17): Congo DR (NK, IT) cases, summaries, research, response 20190213.6314580
Ebola update (16): Congo DR (NK, IT) cases, vaccine, South Sudan, local news 20190211.6310161
Ebola update (15): Congo DR (NK, IT) cases, summaries, local news 20190209.6307023
Ebola update (14): Congo DR (NK, IT) cases, summaries, WHO, Lancet 20190206.6299325
Ebola update (13): Congo DR (NK, IT) cases, summary, assessment, preparedness 20190202.6292000
Ebola update (12): Congo DR (NK, IT) cases, summaries, preparedness, treatment 20190131.6287934
Ebola update (11): Congo DR (NK,IT) cases, problems, education 20190128.6280966
Ebola update (10): Zaire ebolavirus detected, greater long-fingered bat, Liberia 20190124.6275982
Ebola update (09): Congo DR (NK, IT) cases, diagnostics, prevention, concerns 20190123.6273621
Ebola update (08): Congo DR (NK, IT) cases, prevention, spread, research 20190120.6268120
Ebola update (07): Congo DR (NK, IT) cases, summaries, prevention, research 20190118.6264739
Ebola update (06): Congo DR (NK, IT) cases, prevention, challenges 20190115.62596752018
Ebola update (05): Congo DR (NK, IT) cases, challenges, diagnostics, news 20190114.6256926
Ebola update (04): Congo DR (NK, IT) cases, WHO, travel, treatment 20190111.6252695
Ebola update (03): Congo DR (NK, IT) cases, summaries 20190109.6249090
Ebola update (02): Congo DR (NK, IT) cases, summaries 20190105.6243451
Ebola update (01): Congo DR (NK, IT) cases, summaries, Uganda 20190103.6241326
2018
---
Ebola update (158): Congo DR (NK, IT) cases, summary, response 20181231.6236998
Ebola update (157): Congo DR (NK, IT) cases, summaries, response, USA (NE) 20181229.6227661
Ebola update (156): DR Congo (NK, IT) cases, unrest 20181228.6225680
Ebola update (155): Congo DR (NK, IT) cases, response 20181226.6223997
Ebola update (154): Congo DR (NK, IT) cases, election, women 20181224.6221521
Ebola update (153): Congo DR (NK,IT) vaccine 20181222.6219516
Ebola update (152): Congo DR (NK, IT) 20181220.6217243
Ebola update (151): Congo DR (NK, IT) cases, background 20181219.6214793
Ebola update (150): Congo DR (NK, IT) cases, summary, Guinea 20181215.6211011
Ebola update (149): Congo DR (NK, IT) cases, summaries, WHO, accounts 20181214.6209571
Ebola update (148): Congo DR (NK, IT) cases, summaries, WHO, outbreak, children 20181212.6205250
Ebola update (147): Congo DR (NK, IT) cases, preparedness 20181210.6202858
Ebola update (146): Congo DR (NK, IT) cases, summary, commun., situation, women 20181208.6193146
Ebola update (145): Congo DR (NK, IT) cases, response, life in DRC 20181205.6181942
Ebola update (144): Congo DR (NK, IT) cases, summary, concerns 20181204.6179592
Ebola update (143): Congo DR (NK, IT) cases, response 20181202.6176037
Ebola update (142): Congo DR (NK, IT) cases, summary, WHO, suspect, response 20181130.6172738
Ebola update (141): Congo DR (NK, IT) cases, summary, WHO, challenges, response 20181128.6169448
Ebola update (140): Congo DR (NK, IT) cases, summary, preparedness 20181127.6167727
Ebola update (139): Congo DR (NK, IT) cases, WHO, news, control 20181124.6163036
Ebola update (138): Congo DR (NK, IT) cases, response, vaccine RFI 20181123.6160726
Ebola update (137): Congo DR (NK, IT) cases, summary, response 20181120.6156862
Ebola update (136): Congo DR (NK, IT) cases, response 20181119.6154485
Ebola update (135): Congo DR (NK, IT) cases, security 20181118.6152384
Ebola update (134): Congo DR (NK, IT) cases, challenges 20181117.6150791
Ebola update (133): Congo DR (NK, IT) cases, international 20181116.6149045
Ebola update (132): Congo DR (NK, IT) cases, vaccine, plans 20181115.6146562
Ebola update (131): Congo DR (NK, IT) cases, trial, prospects 20181114.6143952
Ebola update (130): Congo DR (NK, IT) cases, control 20181112.6141091
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