Ebola Hemorrhagic Fever - Congo Republic: Suspected

[Reasonable Rascal]

Interesting note derived from the report: native superstition/distrust of outsiders causes them to believe that medical researchers bring infections (illness) with them as opposed to their merely responding to reports of existing infections. Needless to say this can have a very serious hampering effect on research and determining the extent of the geographical tange of the infectious spread. In this matters are no different than when medical researchers and missionaries first started visiting 3rd world well over 100 years ago.

RR
-----------------------

EBOLA HEMORRHAGIC FEVER - CONGO REP. (04): SUSPECTED
************************************************** **
A ProMED-mail post

Date: Wed 12 Feb 2003 09:23:37 -0000
From: Pablo Nart
Source: BBC, Brazzaville Tue 11 Feb 2003, 18:12 GMT [edited]
<http://news.bbc.co.uk/go/em/-/1/hi/world/africa/2750017.stm>


38 people have died in a suspected outbreak of the Ebola virus in the north of Congo-Brazzaville, near the border with Gabon
----------------------------------------------
The Congolese Ministry of Health says the people died in the villages of Kelle and Mbou, about 800 kilometres north of Brazzaville, in the Region known as Cuvette West.

The authorities were first alerted to a possible outbreak of Ebola when a clan of gorillas in the region began to die in December [2002]. Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, which has now claimed more than 80 percent of that gorilla clan.

The Ministry of Health suspects that the current outbreak was caused by villagers eating primates that were already infected with Ebola. But confirmation that the virus is responsible for the recent human deaths has not yet been possible because local inhabitants are refusing to cooperate with teams of Ministry of Health workers and World Health Organisation specialists who have gone to the region to study and contain the outbreak.

The villagers of Kelle and Mbou have so far refused to give blood samples needed to test for the virus, and have become hostile towards the visiting medical teams. They claim it is the medical workers who bring the virus to the region.

The local inhabitants, who are mostly Pygmies, were badly mistreated by Gabonese troops who came to the area to contain an Ebola outbreak in 1996 and 1997, and this may be the reason why the local population
is fearful.

Since an outbreak in the same area in June last year [2002], the Congolese ministries of Forestry and the Environment have had teams of workers in the region trying to raise the awareness of the local population to the dangers of eating gorillas and chimps, particularly those which they find already ill or dead. But they admit it is an uphill struggle in a region where bush meat has been a staple of the local diet for centuries.

[Byline: Pascale Harter]

[Reasonable Rascal]

http://news.bbc.co.uk/2/hi/africa/2750017.stm

Tuesday, 11 February, 2003, 18:12 GMT

Ebola outbreak 'may spread' in Congo

Thirty-eight people have died in a suspected outbreak of the Ebola virus in the north of Congo-Brazzaville, near the border with Gabon.

The Congolese authorities say they are concerned that the virus might spread.

Ebola is spread through contact with small amounts of body fluids.

Little more is known about the virus, which causes its victims to die from internal bleeding.

Bush meat

The Congolese health ministry says the people died in the villages of Kelle and Mbou, about 800 kilometres north of Brazzaville, in the region known as Cuvette West.

The authorities were first alerted to a possible outbreak of Ebola when a clan of gorillas in the region began to die in December.

Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, which has now claimed more than 80% of that gorilla clan.

For the authorities, the Ebola virus is the stuff of nightmares.

Spread almost as easily as the flu but far more deadly, Ebola can result in the death of 95% of its victims.

The Congolese practice of washing the body before burial is just one of the factors that makes the virus so difficult to contain.

The health ministry suspects that the current outbreak was caused by villagers eating primates in the area who were already infected with Ebola.

Hostile

But confirmation that the virus is responsible for the recent human deaths has not yet been possible.

This is because local inhabitants are refusing to co-operate with teams of health ministry workers and World Health Organisation specialists who have gone to the region to study and contain the outbreak.

The villagers of Kelle and Mbou have so far refused to give blood samples needed to test for the virus, and have become hostile towards the visiting medical teams.

They claim it is the medical workers who bring the virus to the region.

The local inhabitants, who are mostly Pygmies, were badly mistreated by Gabonese troops who came to the area to contain an Ebola outbreak in 1996 and 97.

And this may be the reason why the local population is fearful.

Since an outbreak in the same area in June last year, the Congolese ministries of forestry and the environment have had teams of workers in the region trying to raise the awareness of the local population to the dangers of eating gorillas and chimps, particularly those which they find already ill or dead.

But they admit it is an uphill struggle in a region where bush meat has been a staple part of the local diet for centuries.

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (05): SUSPECTED
************************************************** **
A ProMED-mail post

[1]
Date: Wed 12 Feb 2003 5:09 PM
From: Marianne Hopp
Source: WHO Disease Outbreak Reported 12 Feb 2003 [edited]
<http://www.who.int/csr/don/2003_02_12b/en/>

Suspected acute haemorrhagic fever syndrome in the Republic of the Congo - Update 2
-------------------------------------------------
As of 12 Feb 2003, 61 suspected cases of acute haemorrhagic fever syndrome have been reported in the districts of Mbomo (7 cases, 4 deaths) and Kelle (54 cases, 44 deaths) in Cuvette Ouest Region (see previous report: <http://www.who.int/csr/don/2003_02_10/en/>)

A team is in the field and clinical samples have been collected. These will be tested by the Centre International de Recherches Medicales de Franceville (CIRMF), Gabon. Volunteers from the national Red Cross Society are informing and mobilizing communities in the region. A National Coordination Committee to contain the outbreak has been established in Brazzaville under the Direction Generale de la Sante, assisted by WHO and other international partners.

******
[2]
Date: Thu, 13 Feb 2003 05:04:53 -0500 (EST)
From: Pablo Nart
Source: Kenya Broadcasting Corporation online 13 Feb 2003 [edited]
<http://www.kbc.co.ke/story.asp?id=15504&categoryid=2>

At least 48 people are now known to have died in a suspected outbreak of Ebola in the north of Congo-Brazzaville, near the border with Gabon. The authorities in Brazzaville have not yet been unable to confirm that the virus is the cause of the deaths.

At first, inhabitants of the villages of Kelle and Mbomo, where people have been dying daily in recent weeks, refused to cooperate with emergency teams from the ministry of health and the World Health Organisation (WHO) sent to investigate a possible Ebola outbreak. Instead they accused the health teams of bringing the virus to the area themselves, and refused to give blood samples from their dead. But the ministry of health says it has now obtained blood samples from 5 of the deceased. The samples have been sent from Kelle and Mbomo, 800 kilometres north of the capital, Brazzaville, to a laboratory in Libreville, Gabon, and results of the Ebola tests are expected within the next 5 days.

In the meantime, the ministry of health and the WHO are treating the deaths as a confirmed Ebola outbreak and taking measures to contain the spread of the virus, which is easily passed by contact with body fluids and between humans and animals. The ministry says its emergency teams have now succeeded in convincing inhabitants of the area to stay away from church and not to travel. The teams are also trying to stop people in the region from eating wild game such as gorilla, gazelle, and antelope. These are among the animals that have been dying off in the surrounding forest and have already tested positive for Ebola.

Ebola killed 43 people in Congo and 53 others in neighbouring Gabon between October 2001 and February 2002. The WHO says more than 1000 people have died of Ebola since the virus was first identified in 1976 in western Sudan and in a nearby region of Congo.

--
ProMED-mail
<promed@promedmail.org>

[This is an increase of 10 suspected Ebola virus deaths in the 2 days since the last report -- see ref. below. The reference to gazelle is probably to a small, dog-sized antelope also known as duiker, nowhere near as fast a runner as the East and South African gazelles. As noted in the 2001 ref. below, these are caught and eaten by chimpanzees, but gorillas do not eat meat, so their source of infection must be something else -- termites or insect larvae have been postulated. - Mod.JW]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (07): SUSPECTED
************************************************** **
A ProMED-mail post

Date: Sun 16 Feb 2003
From: "Pablo Nart"
Source: Health 24, South Africa, Sun 16 Feb 2003 [edited]
<http://www.health24.co.za/news.asp?action=art&SubContentTypeId=0&ContentID=
21002>

Suspected Ebola Fever Outbreak: Death Toll Reaches 51
-----------------------------------------------------
Villagers in a remote northern area of the Republic of Congo ran away from health workers trying to contain a suspected outbreak of the deadly Ebola [fever] as three further deaths boosted the toll to 51, the country's health ministry said on Fri 14 Feb 2003.

In reports monitored in Nairobi, Ebola [virus] has not yet been confirmed as the cause of the deaths in the districts of Kelle and Mbomo, about 800 kilometres north of the capital Brazzaville. But the authorities suspect the virus because of the symptoms and because several gorillas died from Ebola recently and gorilla meat is a key part of the diet of people in the area. Ebola is a viral hemorrhagic fever that causes massive bleeding. It is spread by contact with bodily fluids. There is no known cure. Blood samples from six of the 51 victims were being tested in neighboring Gabon with the assistance of the World Health
Organization (WHO) to confirm if the cause is Ebola [virus].

A year ago, 62 people died in a confirmed Ebola outbreak in northern Congo and across the border in Gabon, according to the WHO. In 1999, 170 people died in an Ebola fever outbreak in northern Uganda and in 1995, the disease killed 265 in the town of Kikwit in the Democratic Republic of Congo, then known as Zaire.

******
[2]
Date: Sat 15 Feb 2003
From: "Pablo Nart"
Source: IRIN news.org, (UN Office for the Coordination of Humanitarian
Affairs), Sat 15 Feb 2003 [edited]
<http://www.irinnews.org/report.asp?ReportID=32314&SelectRegion=Great_Lakes&
SelectCountry=CONGO>

Suspected Ebola Outbreak: 38 of 51 Deaths Occurred in Village of Ebelangoy
--------------------------------------------------------------------------
BRAZZAVILLE: The government of the Republic of Congo on Thu 13 Feb 2003 quarantined the Cuvette-Ouest Region due to an outbreak of hemorrhagic fever, suspected to be Ebola [fever]. "We are still waiting for lab confirmation, but it looks almost certain that this is an outbreak of Ebola," Iain Simpson, responsible for media relations and communications at the Communicable Diseases Programme of the World Health Organization (WHO), told IRIN from Geneva on Fri 14 Feb 2003. "We are moving forward as though this is confirmed, assembling a team including case management experts and epidemiologists to travel to Congo as soon as practicable."

The epidemic has already caused 51 deaths, Minister of Health and Population, Alain Moka, told a news conference in the capital, Brazzaville, on Thu 13 Feb 2003. The districts of Mbomo and Kelle have been the hardest hit. The village of Ebelangoy, where 38 deaths have already been recorded, is nearly deserted, as residents have fled towards Kelle and the surrounding area. "The conditions are ripe for a rapid, large-scale spread of the disease, and we have the worst to fear," said Moka.

--
ProMED-mail
<promed@promedmail.org>

[These two reports indicate that the death toll in the suspected Ebola hemorrhagic fever outbreak in the Cuvette-Ouest Region of the Republic of Congo has increased by one since the last WHO update dated Thu 13 Feb 2003 (see: Ebola hemorrhagic fever - Congo Rep. (06): suspected 20030215.0398), and identify the village of Ebelangoy as the putative center of the outbreak. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (08): CONFIRMED
************************************************** **
A ProMED-mail post

Date: Tue 18 Feb 2003
From: ProMED-mail <promed@promedmail.org>
Source: World Health Organisation (WHO), Disease Outbreaks Report, Tue 18
Feb 2003 [edited]
<http://www.who.int/csr/don/2003_02_18/en/>


Ebola Hemorrhagic Fever in The Republic of the Congo - Who Update 4
--------------------------------------------------
As of Tue 18 Feb 2003, a total of 73 suspected cases and 59 deaths of Ebola hemorrhagic fever has been reported in the districts of Mbomo and Kelle in Cuvette Ouest Region [see: Ebola hemorrhagic fever - Congo Rep. (06): suspected 20030215.0398].

The Government of the Republic of the Congo has officially declared the epidemic as due to Ebola hemorrhagic fever. Laboratory testing carried out at the Centre International de Recherches Medicales de Franceville (CIRMF), Gabon has confirmed the diagnosis of Ebola virus in clinical samples.

The government has requested the assistance of WHO in controlling the outbreak. A team including epidemiologists and social mobilization experts from WHO and the Global Outbreak Alert and Response Network have arrived in the Cuvette Ouest Region. Experts in clinical management will be joining them in the area shortly.

--
ProMED-mail
<promed@promedmail.org>

[This report is the first official confirmation of diagnosis of the disease as Ebola hemorrhagic fever by laboratory testing. Since the previous WHO update dated Thu 13 Feb 2003, the number of cases has increased by 12 and the number of deaths by 9. - Mod.CP]

[Reasonable Rascal]

Congolese kill teachers accused of Ebola spell

http://www.reutershealth.com/archive/2003/02/21/eline/links/20030221elin030.html

Last Updated: 2003-02-21 11:59:50 -0400 (Reuters Health)

BRAZZAVILLE (Reuters) - Congolese villagers have stoned and beaten to death four teachers accused of casting an evil spell to cause an outbreak of the deadly Ebola disease that has killed nearly 70 people, a local official said Friday.

The outbreak of Ebola in the districts of Kelle and Mbomo near the central African country's northern border with Gabon is thought by scientists to have been caused by the consumption of infected monkey meat.

But many locals believe occult forces are at work.

"In Kelle, people continue to believe that the Ebola disease is a spell that has been cast on them by witches, and four teachers accused of being the cause of the disease have been beaten and stoned to death," said Dieudonne Hossie, a local official. He did not say when the teachers were killed.

"We call on the people of Kelle to be calm. It is the Ebola virus which is raging in the area. It is not an evil spell, it is a scientifically proven virus," Hossie, who was speaking on the official Radio-Congo, said.

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (10)
*****************************************
A ProMED-mail post

Date: Tue 25 Feb 2003
From: A-Lan Banks <A-Lan.Banks@derwent.co.uk>
Source: CNN online, Reuters report, Tue 25 Feb 2003 [edited]
<http://www.cnn.com/2003/WORLD/africa/02/25/congo.ebola.reut/>


Republic of the Congo: Ebola Fever Outbreak Death Toll Now 75
-------------------------------------------------
The toll from the Ebola outbreak in Congo has risen to 75 deaths among 93 cases, but is believed to be under control, the World Health Organization (WHO) said on Tue 25 Feb 2003. The outbreak in the Kelle and Mbomo districts near the central African country's border with Gabon is thought by scientists to have been caused by the consumption of infected monkey meat. The WHO last Wednesday put the death toll at 64.

Ebola killed at least 73 people in Congo and Gabon in an epidemic from October 2001 to February 2002. It is passed on by infected body fluids, and certain strains can kill between 50 and 90 percent of its victims through massive internal bleeding.

The number of victims in the current outbreak exceed those reported from Congo and Gabon a year ago and came from an investigating team of WHO and government experts deployed in the remote northwest area. "It would be unrealistic to say that we've seen all the cases, but it is realistic to say that we have seen most," WHO spokesman Ian Simpson told Reuters. "An isolation ward has been set up in Kelle hospital where people are coming to be treated. That is real progress," he added. "Up to now it was a question of trying to persuade people that they needed medical intervention." Local officials said last week that many villagers believed occult forces were at work, leading some to stone and beat to death 4 teachers accused of casting an evil spell to cause the outbreak.

--
A-Lan Banks
<A-Lan.Banks@derwent.co.uk>

[These figures represent an increase in 7 deaths since the last Reuters report dated Fri 21 Feb 2003, and 20 cases since the last WHO update dated Thu 13 Feb 2003. It may be premature to suggest that the outbreak is being contained. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (11)
*****************************************
A ProMED-mail post

Date: Wed 26 Feb 2003
From: Marianne Hopp <mjhopp12@yahoo.com>
Source World Health Organisation(WHO) CSR Disease Outbreak News, Wed 26 Feb
2003 [edited]
<http://www.who.int/csr/don/2003_02_26/en/>


Ebola hemorrhagic fever in the Republic of the Congo - WHO Update 5
-------------------------------------------------
As of Wed 25 Feb 2003, a total of 5 laboratory-confirmed and 90 probable cases, including 77 deaths (case fatality rate 81 percent) from Ebola hemorrhagic fever, has been reported in the districts of Mbomo and Kellé in Cuvette Ouest Region (see previous report: <http://www.who.int/csr/don/2003_02_18/en/>).

Experts in clinical management and a logistician have joined the international team from the Global Outbreak Alert and Response Network, the Congolese Ministry of Health and WHO. Isolation wards have been set up in Kelle and Mbomo Hospitals, and are receiving patients. <http://www.who.int/csr/outbreaknetwork/en/>

--
Marianne Hopp
<mjhopp12@yahoo.com>

[Since the previous WHO Update 4 released on Tue 18 Feb 2003 (see Ebola hemorrhagic fever - Congo Rep. (08): conf 20030218.0420), the number of probable and confirmed cases of Ebola hemorrhagic fever has increased by 22, and the number of deaths by 18. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (12)
*****************************************
A ProMED-mail post

Date: Thu 27 Feb 2003
From: Pablo Nart <p.nart@virgin.net>
Source: UN Integrated Regional Information Networks, via allAfrica.com, Wed
26 Feb 2003 [edited]
<http://allafrica.com/stories/200302260256.html>


Republic of the Congo: A Total of 149 Contacts under Surveillance
--------------------------------------------------
As of Wed 26 Feb 2003, 95 cases of Ebola fever have been confirmed in the Cuvette-Ouest Region of the Republic of Congo (ROC), resulting thus far in 77 deaths, the World Health Organisation (WHO) reported [see: Ebola hemorrhagic fever - Congo Rep. (11) 20030226.0484]. WHO further reported that it had identified 149 other individuals who had been in contact with people suffering from the highly contagious haemorrhagic fever, which has been concentrated in the remote forest districts of Etoumbi, Mbomo, and Kelle, near the border with Gabon.

The ROC Red Cross, which has 62 volunteers trained in techniques to combat Ebola fever, has been involved in assessing the situation on the ground together with the Health Ministry, the WHO and other agencies. They have been attempting to heighten awareness of the disease, identify suspected cases, enforce isolation and infection control measures, and promote good practices among the local population, including not eating bushmeat or touching dead animals, and adopting safe practices during funeral rites.

Meanwhile, the International Federation of Red Cross and Red Crescent Societies on Wednesday launched an appeal for US $130 000 to help the ROC Red Cross to monitor some 50 000 people for 3 months in remote parts of the country. "Ebola is devastating and terrifying. It can kill those who care for the sick, and those who perform funeral rites," said the International Federation's senior epidemiologist, Dr Bernard Moriniere, in a Federation statement issued on Monday. "Enforcing effective control measures while establishing trust and respecting the fears, traditions, and beliefs of the community is very difficult in a context of death and despair," Moriniere added. "Community-based Red Cross volunteers can play a crucial role as a trusted bridge that is often lacking in such situations."

The Federation said that Ebola was characterised by fever, diarrhoea, severe blood loss, and intense fatigue, and transmitted through direct contact with body fluids of infected persons or other primates. There is no cure, and between 50 percent and 90 percent of victims die. The best way of halting its spread was through prevention and prompt detection and isolation of suspected cases, the Federation added. Accordingly, the
Brazzaville government quarantined the Cuvette-Ouest Region on 13 Feb 2003. However, WHO said on Wednesday that the movement of people trying to escape the epidemic had remained a source of concern.

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (13)
*****************************************
A ProMED-mail post

Date: Fri 28 Feb 2003
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organisation (WHO) CSR, Disease Outbreak News, Fri 28
Feb 2003 [edited]
<http://www.who.int/csr/don/2003_02_28/en/>


Ebola hemorrhagic fever in the Republic of the Congo - WHO Update 6
-------------------------------------------------
As of Thu 27 Feb 2003, a total of 5 laboratory-confirmed and 92 probable cases, including 80 deaths, from Ebola haemorrhagic fever, has been reported in the districts of Mbomo and Kelle in Cuvette Ouest Region (see previous report: <http://www.who.int/csr/don/2003_02_26/en/> ).

The Congolese government has sent food for the communities in these districts. The Ministry of Health, WHO and the international team from the Global Outbreak Alert and Response Network are training local health workers in clinical management of the disease; carrying out active case finding and contact tracing; and providing protective clothing and essential medical equipment: <http://www.who.int/csr/outbreaknetwork/en/>

They are also developing public health education messages about Ebola fever with local leaders through the local radio and print media, and, with volunteers from the national Red Cross Society, working to increase community awareness and understanding of Ebola fever.

--
Marianne Hopp
<mjhopp12@yahoo.com>

[These figures represent an increase of 2 cases and 3 deaths in the 48 hours since Wed 25 Feb 2003. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (14)
*****************************************
A ProMED-mail post

Date: Fri 28 Feb 2003
From: Pablo Nart <p.nart@virgin.net>
Source: Europa Press, Fri 29 Feb 2003 (translated by Maria Jacobs,
ProMED-ESP) [edited]
<http://www.europapress.es/europa2001/abierto/noticia.asp?cod=20030228182117>


Republic of the Congo: Ebola Fever Death Toll Rises to 81
---------------------------------------------------------
According to the data published today by the Congolese Ministry of Health, at least 81 persons have died as a result of the epidemic of Ebola hemorrhagic fever in the Cuvette Ouest Region (northwest Congo), on the border with Gabon. The Ministry of Health information bulletin indicates that the district of Kelle, 430 miles northwest of Brazzaville, where the main focus of the epidemic is located, registered 72 deaths, while the neighboring district of Mbomo, almost 500 miles further north, reported 9 victims since the disease appeared on 4 Jan 2003. In 1996, a similar epidemic caused the death of hundreds of people in the Democratic Republic of Congo (DRC).

Shortly before, WHO spokesperson Fadela Chaib had stated that in Cuvette Ouest, 80 of the 97 cases of Ebola hemorrhagic fever registered had died. According to the WHO data, 72 of the 85 cases registered in Kelle died, as did 8 of the 12 cases registered in Mbomo. According to Chaib, local communities have begun to have a better understanding of this highly contagious disease, and have less fear, thanks in part to the medical and expert teams that have arrived and who are instructing them to not eat dead monkeys found in the forest, as well as to change their burial rites.

--
ProMED-mail
<promed@promedmail.org>

[The Ministry of Health report increases the number of death reported by WHO by one. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (15)
*****************************************
A ProMED-mail post

Date: Tue 4 Mar 2003
From: A-Lan Banks <A-Lan.Banks@derwent.co.uk>
Source: Reuters AlertNet, Tue 4 Mar 2003 [edited]
<http://www.alertnet.org/thenews/newsdesk/L04518549>


Republic of the Congo: Ebola Cases Now Number 108 with 88 Deaths
--------------------------------------------------
Nearly 90 people have been killed by Ebola virus in the remote forests of the Republic of the Congo since the latest outbreak of the disease hit this central African country just over a month ago. Congo's Health Ministry said on Tue 4 Mar 2003 that 88 people out of the 97 who have so far contracted the disease have died, and another 130 people suspected of contact with Ebola fever sufferers were under surveillance. Ebola virus, which is passed on by infected body fluids, kills between 50 and 90 percent of its victims through massive internal bleeding, depending on the strain of the [virus].

The Ebola outbreak surfaced in the Kelle and Mbomo districts near Congo's border with Gabon, some 700 km (440 miles) north of the country's capital, Brazzaville. The World Health Organisation (WHO) said on Tue 4 Mar 2003 it had recorded 86 deaths from the disease out of 108 cases, of which 94 were in Kelle and the rest in Mbomo. "The isolation wards and other preventive measures are working very well. So again, we're seeing a slight decline in new cases but (remain) certainly very much on the alert, watching for more," WHO spokeswoman Christine McNab told reporters. "The new case count has somewhat slowed...The WHO and global response unit are still there very much in action, assisting with case detection and case management," she said.

A government and parliamentary delegation was due to visit the afflicted region, known as Cuvette-Ouest. Ebola experts from around the world were also due to meet in Brazzaville on Tuesday to discuss the outbreak. Scientists believe this outbreak was triggered by the consumption of infected monkey meat. Bush meat is a staple among remote forest communities and deemed a delicacy in many cities. Primates started dying in large numbers towards the end of last year and Congo launched an appeal to the international community on Mon 2 Mar 2003 to help protect central Africa's primates, especially gorillas, who are being decimated by the disease.

Ebola killed 73 people in Congo and Gabon in an epidemic from October 2001 to February 2002. The disease takes its name from a river in neighbouring Democratic Republic of Congo where Ebola was discovered in 1976. The worst outbreak was in that country in 1995 when more than 250 people died.

[Byline: Christian Tsoumou]

--
A-Lan Banks
<A-Lan.Banks@derwent.co.uk>

[Combining the Ministry of Health and the WHO figures, the total number of Ebola fever cases appears now to be to 108, with 88 deaths. This represents an increase of 11 cases and 7 deaths since Fri 28 Feb 2003. Another 130 contacts are still under surveillance. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (16)
*****************************************
A ProMED-mail post

[1]
Date: Fri 7 Mar 2003
From: A-Lan Banks <A-Lan.Banks@derwent.co.uk>
Source: AllAfrica.com, Fri 7 Mar 2003 [edited]
<http://allafrica.com/stories/200303060184.html>


Republic of the Congo: Ebola Fever Case Number Reaches 110 with 89 Deaths
--------------------------------------------------
As at Wed 5 Mar 2003, 110 cases of Ebola virus infection had been confirmed in the Cuvette-Ouest Region of the Republic of Congo (ROC), resulting in 89 deaths so far, the World Health Organisation (WHO) reported. 79 of the deaths occurred in the district of Kelle, while another 10 occurred in Mbomo District. WHO further reported that another 86 individuals who had been in contact with people suffering from the highly contagious haemorrhagic fever were being monitored.

Meanwhile, scientists meeting in the capital, Brazzaville, at a conference to discuss the current outbreak and means of fighting the disease in the future, said they had not yet identified the reservoir of the Ebola virus -- a critical element needed in planning more effective strategies to combat the disease. "That's the fundamental question. We must come up with answers to this question, because the entire world is awaiting our findings," Christophe Boesch, an independent researcher, was quoted by Agence France Presse (AFP) as saying on Wednesday. The meeting, which began on Tuesday and was due to end on Thursday, was being attended by some 70 medical researchers, anthropologists, virologists, doctors, veterinarians, and representatives from tropical disease research centres in Europe, the US, and from the UN, according to AFP.

Ebola is characterised by fever, diarrhoea, severe blood loss, and intense fatigue, and is transmitted through direct contact with body fluids of infected persons or of other primates. There is no cure, and between 50 percent and 90 percent of victims die. The best way of halting its spread is through prevention and prompt detection and isolation of suspected cases.

Authorities were first alerted to a possible Ebola outbreak in late 2002 when a band of gorillas in the region began dying. Tests carried out on the bodies confirmed that they had died of Ebola. The current outbreak is believed to have been caused by villagers eating primates infected by Ebola.

--
A-Lan Banks
<A-Lan.Banks@derwent.co.uk>

******
[2]
Date: Fri 7 Mar 2003
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organisation (WH0), CSR, Disease Outbreak News,
Fri 7 Mar 2003 [edited]
<http://www.who.int/csr/don/2003_03_7/en/>


Ebola hemorrhagic fever in the Republic of the Congo - WHO Update 7
------------------------------------------------
As of Fri 7 Mar 2003, a total of 5 laboratory-confirmed and 105 probable cases, including 89 deaths have been reported from Ebola haemorrhagic fever, in the districts of Mbomo and Kelle in Cuvette Ouest Region (see previous report:
<http://www.who.int/csr/don/2003_02_28/en/>).

The Ministry of Health, WHO and the international team continue to train health workers in the treatment of Ebola, carry out contact tracing, and provide essential medical equipment. Experts from the Global Outbreak Alert and Response Network who have been working to contain outbreak include those from Bernhard-Nocht-Institut, Hamburg, Germany, Centers for Disease Control and Prevention, Atlanta, United States, Institute of Tropical Medicine, Antwerp, Belgium and the London School of Hygiene and Tropical Medicine, London, England.
(<http://www.who.int/csr/outbreaknetwork/en/>)

The national Red Cross Society is assisting with social mobilization activities to increase awareness and understanding of Ebola in the community.

--
Marianne Hopp
<mjhopp12@yahoo.com>

[Since the Reuters report dated Tue 4 Mar 2003 (see: Ebola hemorrhagic fever - Congo Rep. (15) 20030304.0543), the number of confirmed cases of Ebola fever has increased by 2 and deaths by one,
whereas the number of contacts under surveillance has decreased by 44. Although consumption of bushmeat has been suggested as a possible source of the outbreak, the report of the proceedings of the conference in Brazzaville suggests that human and non-human primates can contract infection from the same source and that the identity of this reservoir of Ebola virus remains unknown. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (18)
*****************************************
A ProMED-mail post


Date: Tue 11 Mar 2003
From: Pablo Nart <p.nart@virgin.net>
Source Yahoo! news, Reuters report, Tue 11 March 2003 [edited]
<http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030311/sc_nm/health_congo_ebola_dc_1>


Republic of the Congo: Death Toll Reaches 100
---------------------------------------------
The deadly Ebola virus has killed 100 people in the remote forests of Congo Republic and wiped out nearly 2/3 of the gorillas in a reserve. "We have reached the fateful figure of 100 dead," Congo's Health Minister Alain Moka said on Tue 11 Mar 2003 at a ceremony to accept donations to help fight the outbreak. The latest Ebola epidemic to hit the central African country struck in January 2003 in the dense forest region of Cuvette-Ouest about 440 miles north of the capital Brazzaville. "The government has already spent 300 million CFA francs (USD 507 000) to put in place the logistics needed to help stricken people but the state alone cannot help," Moka said. "We must have the support of everybody and the international community."

Monkeys, chimpanzees, and gorillas started dying in large numbers toward the end of 2002, and primatologists say the impact has been devastating on the Lossi park in Cuvette-Ouest. At an Ebola conference in Brazzaville last week, primatologist Bermejo Magdalena told Reuters that gorillas had been disappearing at an alarming rate where she works in the Lossi sanctuary, which covers 123 square miles. "In the sanctuary of about 1200 gorillas we are now down to just 450 gorillas. We have recorded the disappearance of 600 to 800 gorillas," she said, adding the outbreak could spread to the nearby Odzala park and might then contaminate forests in Gabon. "If Odzala is also contaminated by the epidemic, that's nearly 20 000 gorillas under threat. That's very serious, catastrophic," she said.

Ebola killed 73 people in Gabon and the same area of Congo in an epidemic from October 2001 to February 2002, but experts fear this outbreak is more virulent. The disease takes its name from a river in the Democratic Republic of Congo where Ebola was discovered in 1976. The worst outbreak was there in 1995 when more than 250 people died.

[Byline: Christian Tsoumou]

--
ProMED-mail
<promed@promedmail.org>

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (19)
*****************************************
A ProMED-mail post


Date: Fri 14 Mar 2003
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organisation (WHO), CSR, Disease Outbreaks News, Fri
14 Mar 2003 [edited]
<http://www.who.int/csr/don/2003_03_14/en/>


Ebola Hemorrhagic Fever in the Republic of the Congo - WHO Update 8
--------------------------------------------------
As of Fri 14 March 2003, the Ministry of Health of the Republic of the Congo has reported 118 cases, (13 laboratory-confirmed and 105 epidemiologically linked), including 106 deaths in the districts of Mbomo and Kelle in Cuvette Ouest Departement. Laboratory confirmation was made by the Centre International de Recherche Medicale a Franceville (CIRMF), Gabon. (see previous report: <http://www.who.int/csr/don/2003_03_7/en/>)

In the Cuvette Ouest Departement, the Ministry of Health, WHO and the international team continue to train health workers in the treatment of Ebola fever, to carry out contact tracing and provide essential medical equipment. In Brazzaville, a workshop has been organized for training physicians and nurses working in the capital for clinical management of viral haemorrhagic fever patients.

The team of experts from the Global Outbreak Alert and Response Network assisting the Ministry of Health in controlling the outbreak, include: the Bernhard- Nocht-Institut, Hamburg, Germany; Centre National de la Recherche Scientifique et Museum National dHistoire Naturelle, Paris, France; Centers for Disease Control and Prevention, Atlanta, United States; Institute of Tropical Medicine, Antwerp, Belgium; the London School of Hygiene and Tropical Medicine, London, England; Medecins sans Frontieres (MSF, Holland), and the Washington State University, United States. The national Red Cross Society is assisting with social mobilization, surveillance and case management activities.
(<http://www.who.int/csr/outbreaknetwork/en/>)

--
ProMED-mail
<promed@promedmail.org>

[Since the WHO Update No.7 released one week ago, the number of cases has increased from 110 (5 laboratory-confirmed) to 118 (13 laboratory-confirmed) and the number of deaths from 89 to 106. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (20)
*****************************************
A ProMED-mail post


Date: Sun 16 Mar 2003
From: Pablo Nart <p.nart@virgin.net>
Source: Jornal Publico (Portugal), Sun 16 Mar 2003 [in Portuguese, summarized by Mod.JW]
<http://jornal.publico.pt/publico/2003/03/16/Sociedade/S21.html>


The Republic of the Congo: Number of Ebola Cases Now 120 with 108 Deaths
---------------------------------------------
The latest official figures for the Ebola hemorrhagic fever outbreak, published yesterday, are 120 cases and 108 deaths since January 2003, all in the Cuvette Ouest Departement, in the northwest of the Republic of the Congo.

--
ProMED-mail
<promed@promedmail.org>

[Since the WHO Update No.8 released Fri 14 Mar 2003, the number of cases has increased by 2 from 118 to 120 and the number of deaths by 2 from 106 to 108. - Mod.CP]

[Reasonable Rascal]

EBOLA HEMORRHAGIC FEVER - CONGO REP. (21)
*****************************************
A ProMED-mail post

Date: Mon 24 Mar 2003
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organisation (WHO), CSR, Disease Outbreaks News, Mon
24 Mar 2003 [edited]
<http://www.who.int/csr/don/2003_03_24a/en/>


Ebola Hemorrhagic Fever in the Republic of the Congo - WHO Update 9
---------------------------------------------------
As of Sun 23 Mar 2003, the Ministry of Health of the Republic of the Congo has reported 123 cases, (13 laboratory-confirmed and 110 epidemiologically linked), including 113 deaths in the districts of Mbomo and Kelle in Cuvette Ouest Departement [see: Ebola hemorrhagic fever - Congo Rep. (19)
20030314.0629]. 79 contacts are being followed up.

The new team of 3 physicians and 7 nurses from the Ministry of Health and the Service de Sante des Armees was trained in clinical management and safe burial practices last week. A mobile team is visiting each village on the Entsiami-Kelle road weekly, carrying out control activities and surveillance.

Social mobilization activities involving community leaders are also continuing.

--
Marianne Hopp
<mjhopp12@yahoo.com>

[Since the WHO Update No.8 released over a week ago, on Fri 14 Mar 2003, the number of cases of Ebola fever has increased by 5 from 118 (13 laboratory-confirmed) to 123 (13 laboratory-confirmed) and the number of deaths by 7 from 106 to 113. - Mod.CP]