Ebola Case in Large City of Goma and PHEIC Declared by WHO 7-17-19Jenny Abercrombie
IN THE NEWS
Ebola Case in Large City of Goma and PHEIC Declared by WHO 7-17-19
The WHO leadership was concerned about recent Ebola (EVD) news so the Emergency Committee was convened in Switzerland to determine if a Public Health Emergency of International Concern (PHEIC) should be announced. This was the fourth meeting of this type however, when considered on previous occasions, all the criteria had not been met. This time, it was decided that they would recommend the announcement and the WHO’s Director-General, Tedros Adhanom Ghebreyesus, declared it immediately on 7/17/19. The new rationale included the new case of Ebola in Goma, a large City which is considered a major hub and, as the Mr. Tedros stated, “the gateway to the rest of the DRC and the world”. Other factors included that the one year mark for this outbreak will be reached in the next month; the ongoing violence, including deaths last week, against EVD Responders and Health Care Workers that sometimes prevents rapid follow up to suspected or confirmed cases of Ebola; and the increase in cases in areas where new cases had declined or been halted.
This article contains information about two unrelated cases of EVD which have either crossed a border (Uganda) or been in a DRC (Democratic Republic of the Congo) city abutting the border with Rawanda. Details are included to best illustrate how further spread into neighboring countries can occur as well as all of the variables which lead to difficulty containing this outbreak. Goma is a hub for regional, national and international travel with ready air travel to many international countries including the U.S. A set of Maps of the areas mentioned are included in an attachment for persepective and a list of links to more info on this news is included in this document. A more comprehensive list of EVD topics will be included as an attachment.
DRC: 2512 cases; 2418 confirmed & 94 probable – 1676 deaths; 1582 confirmed & 94 probable; 703 have recovered
New Case Report (7/15/19) in Goma, DRC: On 7/12/19, a 46 y/o minister who had visited multiple churches and churchgoers, including those that were sick, reported feeling ill and was visited by a nurse before getting on a bus to travel the 200 kilometers to Goma from Butembo. Goma sits on the border of the DRC and Rwanda and is the Captial of the North Kivu Province with over 1 million residents, and a travel hub for many. The bus did follow a road with multiple health check-points but it is unclear if he didn’t report his symptoms (and none were obvious), or if he avoided being associated with his previously reported symptoms so he could continue to travel, since the DRC Ministry reports he used different names at each of the checkpoints. When he arrived in Goma, he went to a health care center because he felt unwell. The health care workers at the center quickly determined that his presentation was consistent with EVD and transferred him to the Ebola Treatment Center in Goma. Labs there confirmed Ebola infection. The risk for contact spread is considered low since he was rapidly identified and everyone with him on the bus, including two family members, were identified as contacts, vaccinated and will be monitored. The bus and health center were both decontaminated. He was safely transported back to Butembo for further care but died in transit. Goma has been preparing for cases and have personnel trained and supported by MSF (Doctors Without Borders).
Uganda: 3 cases; 3 confirmed –3 deaths confirmed from June 11 DRC to Uganda spread – no other positive cases in Uganda have been found in 34 days since the death of the last EVD confirmed case from that set of exposures.
New Case Report (7/16/19) in Bwera, Uganda: A 22 y/o woman traveled via an unmanned crossing path from the DRC to Uganda to buy fish (she was a known fishmonger and trader) at a market in Uganda on 7/11/19, and was symptomatic at that time, with 4 known episodes of vomiting in a food area. She went back to Beni, DRC the following day (7/12) and was admitted to the Beni Ebola Treatment Unit (ETU) and died 7/1519 with positive Ebola test results. Some, but not even close to all, contacts have been identified including those that may have come into contact with or cleaned up her vomitus. Identified contacts have been vaccinated and the search goes on for more contacts at the market, around where she stayed, or on the path(s) she took from one country to the other. This information was ascertained from the Situation Report #35 from the WHO African Field Office.
WHO Announcement that EVD Is Now a Public Health Crisis on International Concern:
WHO African Office Link to Ugandan Ebola Situation Reports (see # 35 & 36):
DRC Situation Report 7/17/19:
WHO Ebola Homepage with Links to Situation Updates, Announcements, Outbreak News, etc.
CDC Ebola in Eastern DRC – Outbreak Began August 1, 2019: