Monday, February 25, 2019

Katwa town now a hot spot leads to spike in DRC Ebola cases and deaths

By Esther Nakkazi

Katwa, a town in North Kivu province is now the main focus and a hotspot of the Ebola Virus Disease epidemic. In the last 21 days, 86 new confirmed cases were reported in the Democratic Republic of Congo (DRC), of which 49 (57%) were reported in Katwa.

North Kivu of DRC, which is affected by the outbreak of EVD, is among the most populated provinces, with eight million inhabitants. The region has been experiencing intense insecurity and worsening humanitarian crisis.

From the DRC Ministry of Health's Ebola updates Katwa surpassed Beni in terms of the number of cases and deaths. To date, Beni has reported 235 cases (226 confirmed and 9 probable) and 127 deaths while Katwa is 239 cases (228 confirmed and 11 probable) and 182 deaths.

The mortality rate is also higher in Katwa. The mortality rate in Beni is 54% while it is 76% in Katwa.

According to the DRC Ministry of Health, the high mortality rate in Katwa can be explained by the fact that contacts of confirmed cases who refused vaccination and follow-up of contacts are not found until after their death in the community.

Thus, the percentage of community deaths in Katwa is much higher than in other health zones. The high number of community deaths remains a concern as they are an important source of spread of the epidemic.

This situation demonstrates the importance of increasing community engagement and active case finding in the community and health facilities in Katwa, officials from the Ministry said.

Ebola Vaccinations
Since the beginning of vaccination on 8 August 2018, 83,118 people have been vaccinated, including 21,230 in Katwa, 20,593 in Beni, 10,091 in Butembo, 6,109 in Mabalako, 2,746 in Kalunguta, 2,551 in Goma, 2,317 in Komanda, 2,084 in Oicha.

1,813 in Mandima, 1,357 in Karisimbi, 1,325 in Kyondo, 1,283 in Kayina, 1,094 in Bunia, 1,064 in Vuhovi, 920 in Masereka, 772 in Mutwanga, 767 in Biena, 700 in Lubero, 590 in Rutshuru, 583 in Musienene, 527 in Nyankunde, 496 in Mangurujipa, 426 in Rwampara (Ituri), 355 in Tchomia, 333 in Lolwa, 280 in Mambasa, 254 in Alimbongo, 207 in Kirotshe, 141 in Nyiragongo, 97 in Watsa (Haut-Uélé), and 13 in Kisangani.

The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

But as of 20th February 2019, the Strategic Advisory Group of Experts (SAGE) on Immunization has reviewed data on all Ebola candidate vaccines currently undergoing clinical evaluation. There are three candidate vaccines other than the rVSV-ZEBOV-GP vaccine, that are in advanced stages of clinical evaluation or have been licensed.

Two of them are licensed in their country of origin (Ad5-EBOV, monovalent Zaire Makona, licensed in China; and GamEvac-Combi, monovalent Zaire Makona, licensed in Russia). A third vaccine candidate (Ad26.ZEBOV & MVA-BN-Filo, based on a prime/boost strategy using a multivalent, Zaire Mayinga, Sudan, Tai Forest and Marburg,) will be submitted for approval under the United States Food and Drug Administration (US FDA) Animal Rule.


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