Congo approves more experimental Ebola treatments as cases rise

FILE PHOTO: Congolese health workers prepare the Ebola treatment centre in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland

KINSHASA (Reuters) – Democratic Republic of Congo has approved four more experimental treatments against the deadly Ebola virus, the health ministry said as it raced to contain an outbreak in its violence-torn east.

Health authorities last week started administering the U.S.-developed mAb114 treatment to Ebola patients, the first time such a treatment had been used against an active outbreak.

The health ministry said in a daily bulletin late on Tuesday that the 10 patients who received mAb114 since Aug. 11 have experienced a “positive evolution”, but the outbreak has continued to grow.

The four additional treatments approved by Congo’s ethics committee are Remdesivir, made by Israel’s Gilead Sciences; ZMapp, an intravenous treatment made by San Diego’s Mapp Pharmaceutical; Japanese drug Favipiravir; and one referred to as Regn3450 – 3471 – 3479.

Remdesivir was administered to its first patient in the town of Beni on Tuesday, who is doing well, the ministry said in its bulletin.

Six new cases and four new deaths have been confirmed from the haemmorhagic fever, which causes vomiting and severe diarrhea, the ministry said.

That brings the total number of deaths to 59 and confirmed cases to 75 since last month.

Congo, whose heavily forested interior makes its a natural home for Ebola, is at the forefront of a global campaign to combat the virus, which killed more than 11,000 people when it swept through West Africa from 2013-2016.

The Central African country has experienced ten Ebola outbreaks since the virus was discovered in northern Congo in 1976 – more than twice as many as any other country – and 33 people died in a flare-up in the northwest that ended last month.

In addition, a vaccine manufactured by Merck, which proved effective against the earlier outbreak in northwestern Congo, has been administered to 1,693 health workers and contacts of Ebola patients.

Insecurity in Congo’s eastern borderlands with Uganda has continued to complicate the response, with some contacts of Ebola patients located in so-called “red-zones”, which are off limits to emergency responders due to militia activity.

Instead, local health workers in those areas are monitoring the contacts and no Ebola cases have yet been confirmed there.

(Reporting By Amedee Mwarabu and Fiston Mahamba; Writing by Aaron Ross; Editing by Andrew Heavens)

Congo starts vaccinating health workers against Ebola

A Congolese health worker checks the temperature of a woman before the launch of vaccination campaign against the deadly Ebola virus near Mangina village, near the town of Beni, in North Kivu province of the Democratic Republic of Congo, August 8, 2018. REUTERS/Samuel Mambo

By Fiston Mahamba

MANGINA, Congo (Reuters) – Congolese officials and the World Health Organization began vaccinating health workers against the deadly Ebola virus on Wednesday, to try to halt an outbreak in Congo’s volatile east.

A Reuters witness on a visit to Mangina, the village in eastern Democratic Republic of Congo where the epidemic was declared, saw health workers in protective suits administering the injections.

So far 43 people are believed to have been infected in North Kivu and Ituri provinces, including 36 who have died, the health ministry said on Tuesday.

“We are putting all our energy and all our expertise to quickly control this epidemic,” Health Minister Oly Ilunga told journalists at the start of the vaccination campaign.

“All the measures of prevention are in place. The vaccination is the last phase. It will enable us to break the chain of transmission of this epidemic.”

More than 900 contacts of those infected have been identified for monitoring, although security is an issue in the area where militia groups operate, WHO said.

The disease, which causes fever, vomiting, and diarrhea, is spread through direct contact with body fluids.

“Around 40 health workers are expected to be vaccinated today; by end of the week, once all the necessary steps are in place, vaccination of community contacts and their contacts will commence,” WHO spokesman Tarik Jasarevic said.

WHO has said that analysis of genetic sequencing showed it was a separate outbreak from the one 2,500 km (1,500 miles) away in the northwest that ended less than two weeks ago after killing 33 people — but the same Zaire strain.

This is Congo’s 10th Ebola outbreak since the virus was first identified near northern Congo’s Ebola river.

“There is a huge fear among the local population,” Kaswera Mathumo, a medical worker at a clinic in Mangina, where the vaccinations were taking place, said.

The experimental vaccine being used, which is manufactured by Merck, proved successful during its first wide-scale usage against the previous outbreak in Equateur Province.

More than 3,000 doses remain in stock in the capital Kinshasa, allowing authorities to deploy them quickly to affected areas.

But they face security challenges in eastern Congo, a region bubbling with conflicts over land and ethnicity stoked by decades of on-off war.

Local authorities announced on Tuesday that 14 bodies had been discovered in the town of Tubameme, about 40 km (25 miles) northeast of the epicenter of the outbreak in the town of Mangina, suspected to have been killed by a militia group.

(Additional reporting by Tom Miles in Geneva; Writing by Tim Cocks and Stephanie Nebehay; Editing by Richard Balmforth)

WHO says Ebola team arrives in Congo

FILE PHOTO: Medecins Sans Frontieres (MSF) workers talk to a worker at an isolation facility, prepared to receive suspected Ebola cases, at the Mbandaka General Hospital, in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe

By Tom Miles and Fiston Mahamba

GENEVA/GOMA (Reuters) – An international delegation has arrived in the town of Beni in Democratic Republic of Congo, 30 km (18 miles) from where an Ebola outbreak was declared, the World Health Organization and Congolese officials said on Thursday.

Officials from the United Nations, the World Bank, the WHO and Democratic Republic of Congo’s Ministry of Health, including Health Minister Oly Ilunga, will support a team already on the ground.

Congo declared the new outbreak on Wednesday, just days after another outbreak that had killed 33 people in the northwest was declared over.

Twenty people have died from haemorrhagic fevers in and around Mangina, a densely populated town in North Kivu province about 30 km (18 miles) southwest of the city of Beni and 100 km from the Ugandan border.

The ministry has not made public when the deaths occurred. Another six who are still living are showing signs of fever, of which four tested positive.

“The Government-Partner delegation is holding its first meeting to organize the response,” North Kivu governor Julien Paluku tweeted. “Already a … team from Kinshasa is installing a laboratory and a single coordination center.”

But eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

(Writing by Tim Cocks; editing by Matthew Mpoke Bigg)

WHO says Congo faces ‘very high’ risk from Ebola outbreak

FILE PHOTO: Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe/File Photo

By Tom Miles and Fiston Mahamba

GENEVA/KINSHASA (Reuters) – Democratic Republic of Congo faces a “very high” public health risk from Ebola because the disease has been confirmed in a patient in a big city, the World Health Organization (WHO) said on Friday, raising its assessment from “high” previously.

The risk to countries in the region was now “high”, raised from “moderate”, but the global risk remained “low”, the WHO said.

The reassessment came after the first confirmed case in Mbandaka, a city of around 1.5 million on the banks of the Congo River in the northwest of the country.

The case raised concerns that the virus, previously found in more rural areas, would be tougher to contain and could reach downstream to the capital Kinshasa, which has a population of 10 million.

It also followed the announcement by Congo’s health ministry of 11 newly confirmed cases in the smaller town of Bikoro, near the northwest village where the virus was first detected.

“The confirmed case in Mbandaka, a large urban center located on major national and international river, road and domestic air routes, increases the risk of spread within the Democratic Republic of the Congo and to neighboring countries,” the WHO said.

WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama had told reporters on Thursday that the risk assessment was being reviewed.

“Urban Ebola is a very different phenomenon to rural Ebola because we know that people in urban areas can have far more contacts so that means that urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Later on Friday, the WHO will convene an Emergency Committee of experts to advise on the international response to the outbreak, and decide whether it constitutes a “public health emergency of international concern”.

The nightmare scenario is an outbreak in Kinshasa, a crowded city where millions live in unsanitary slums not connected to a sewer system.

Jeremy Farrar, an infectious disease expert and director of the Wellcome Trust global health charity, said the outbreak had “all the features of something that could turn really nasty”.

“As more evidence comes in of the separation of cases in space and time, and healthcare workers getting infected, and people attending funerals and then traveling quite big distances – it’s got everything we would worry about,” he told Reuters.

WHO spokesman Tarik Jasarevic said on Friday that Congo’s Ministry of Health had provided updated figures: 45 cases overall since April 4, including 14 confirmed, 10 suspected and 21 probable. There had been 25 deaths, but no new infections among healthworkers, Jasarevic told reporters.

The WHO is sending 7,540 doses of an experimental vaccine to try to stop the outbreak in its tracks, and 4,300 doses have already arrived in Kinshasa. It will be used to protect health workers and “rings” of contacts around each case.

The vaccine supplies will be enough to vaccinate 50 rings of 150 people, the WHO said. Each ring represents the number of people including health workers who may have come into contact with an Ebola patient.

As of 15 May, 527 contacts had been identified and were being followed up and monitored.

(This story corrects to clarify location of Mbandaka.)

(Additional reporting by Kate Kelland in London; Writing by Tom Miles and Edward McAllister; Editing by Matthew Mpoke Bigg)

Congo bars tourists from national park after kidnapping

Britons Robert Jesty and Bethan Davies are seen in this undated photograph received via the Foreign and Commonwealth Office, in London, Britain May 14, 2018. Foreign and Commonwealth Office/Handout via Reuters

ABIDJAN (Reuters) – Rangers said on Tuesday they had stopped tourists entering Democratic Republic of Congo’s Virunga National Park during investigations into the kidnapping of two Britons there last week.

Gunmen ambushed Robert Jesty, Bethan Davies and their driver in Congo’s volatile eastern borderlands on Friday and released them three days later.

Park ranger Rachel Makissa Baraka, 25, was killed trying to defend them.

“The suspension of tourism is being undertaken as an additional precautionary measure whilst an investigation is undertaken surrounding the recent events,” the park said in a statement.

It said the suspension would remain in place until June 4.

Eastern Congo has seen successive waves of violence over the past quarter century and was at the epicentre of two wars between 1996 and 2003 that killed millions, mainly through hunger and disease.

Rebel groups and militias still control large swathes of the territory. More than 175 rangers have died protecting the park, which is in the rugged mountains and volcanic plains adjacent to Rwanda and Uganda.

FILE PHOTO: A mountain gorilla looks out of a clearing in Virunga national park in the Democratic Republic of Congo, near the border town of Bunagana October 21, 2012. REUTERS/James Akena/File Photo

FILE PHOTO: A mountain gorilla looks out of a clearing in Virunga national park in the Democratic Republic of Congo, near the border town of Bunagana October 21, 2012. REUTERS/James Akena/File Photo

Since tourism was relaunched in 2014, Virunga National Park – Africa’s oldest national park – has received more than 17,000 visitors, keen to see its rare mountain gorillas or climb the active Nyiragongo volcano.

(Reporting by Joe Bavier; Editing by Andrew Heavens)

WHO says 19 dead, 39 infected so far in Congo Ebola outbreak

A health worker is sprayed with chlorine after visiting the isolation ward at Bikoro hospital, which received a new suspected Ebola case, in Bikoro, Democratic Republic of Congo May 12, 2018. REUTERS/Jean Robert N'Kengo

GENEVA (Reuters) – Democratic Republic of Congo reported 39 suspected, probable or confirmed cases of Ebola between April 4 and May 13, including 19 deaths, the World Health Organization said on Monday.

It said 393 people who identified as contacts of Ebola patients were being followed up. Information about the outbreak in Bikoro, Iboko and Wangata health zones in Equateur province was still limited, the WHO said in a statement.

At present the outbreak did not meet the criteria for declaring a “public health event of international concern”, which would trigger the formation of an emergency WHO committee.

(Reporting by Tom Miles, Editing by William Maclean)

Seventeen deaths reported in Congo as Ebola outbreak confirmed

FILE PHOTO: A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa October 21, 2014. REUTERS/Media Coulibaly

By Benoit Nyemba and Fiston Mahamba

KINSHASA (Reuters) – At least 17 people have died in an area of northwestern Democratic Republic of Congo where health officials have now confirmed an outbreak of Ebola, the health ministry said on Tuesday.

It is the ninth time Ebola has been recorded in the central African nation, whose eastern Ebola river gave the deadly virus its name when it was discovered there in the 1970s, and comes less than a year after its last outbreak during which eight people were infected, four of whom died.

“Our country is facing another epidemic of the Ebola virus, which constitutes an international public health emergency,” the ministry said in a statement.

“We still dispose of the well trained human resources that were able to rapidly control previous epidemics,” it said.

Ebola is believed to be spread over long distances by bats, which can host the virus without dying, as it infects other animals it shares trees with such as monkeys. It often spreads to humans via infected bushmeat.

Before the outbreak was confirmed, local health officials reported 21 patients showing signs of hemorrhagic fever around the village of Ikoko Impenge, near the town of Bikoro. Seventeen of those later died.

Medical teams supported by the World Health Organization and medical charity Medecins Sans Frontieres were dispatched to the zone on Saturday and took five samples from suspected active cases.

Two of those samples tested positive for the Zaire strain of the Ebola virus, the ministry said.

“Since notification of the cases on May 3, no deaths have been reported either among the hospitalized cases or the healthcare personnel,” the statement said.

After Congo’s last Ebola flare-up, authorities there approved the use of a new experimental vaccine but in the end did not deploy it owing to logistical challenges and the relatively minor nature of the outbreak.

The worst Ebola epidemic in history ended in West Africa just two years ago after killing more than 11,300 people and infected some 28,600 as it rolled through Guinea, Sierra Leone and Liberia.

Despite regular outbreaks every few years, death tolls in Congo have been significantly lower.

“Our top priority is to get to Bikoro to work alongside the Government of the Democratic Republic of the Congo and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak,” said Dr Peter Salama, WHO Deputy Director-General, Emergency Preparedness and Response.

“Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.”

Health experts credit an awareness of the disease among the population and local medical staff’s experience treating for past successes containing its spread.

Congo’s vast, remote geography also gives it an advantage, as outbreaks are often localized and relatively easy to isolate.

Ikoko Impenge and Bikoro, however, lie not far from the banks of the Congo River, an essential waterway for transport and commerce.

Further downstream the river flows past Democratic Republic of Congo’s capital Kinshasa and Brazzaville, capital of neighboring Congo Republic – two cities with a combined population of over 12 million people.

(Writing by Tim Cocks and Joe Bavier; Editing by Richard Balmforth)

Two million children in Congo at risk of starvation, U.N. warns

GENEVA (Reuters) – More than 2 million children in the Democratic Republic of Congo are estimated to be at risk of dying from severe acute malnutrition if they do not get the aid they need, the United Nations warned on Friday.

U.N. humanitarian chief Mark Lowcock will meet donors next week in the country where conditions in many areas are worsening, U.N. spokesman Jens Laerke told a Geneva briefing.

“We have a great responsibility in the DRC…now is the time to stay the course,” Laerke said.

The 2 million children at risk of starvation include some 300,000 children in the Kasai region, Bettina Luescher of the U.N.’s World Food Programme (WFP) said.

(Reporting by Stephanie Nebehay, editing by Tom Miles)

WHO confirms second Ebola case in Congo outbreak

FILE PHOTO: A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa October 21, 2014. REUTERS/Media Coulibaly

By Aaron Ross

KINSHASA (Reuters) – The World Health Organization (WHO) confirmed on Sunday a second case of Ebola in Democratic Republic of Congo after an outbreak this week of 17 other suspected cases.

Health officials are trying to trace 125 people thought to be linked to the cases identified in the remote northeastern province of Bas-Uele province in northeastern Congo near the border with Central African Republic, WHO’s Congo spokesman Eugene Kabambi said.

Three people have so far died among the 19 suspected and confirmed cases, he added.

It was not immediately clear how the first victim, a deceased male, caught the virus, although past outbreaks have been linked to contact with infected bush meat such as apes.

The outbreak comes just a year after the end of an epidemic in West Africa killed more than 11,300 people mostly in Guinea, Sierra Leone and Liberia.

However, Congo, whose dense forests contain the River Ebola near where the disease was first detected in 1976, has experienced many outbreaks and has mostly succeeded in containing them without large-scale loss of life.

The GAVI global vaccine alliance said on Friday some 300,000 emergency doses of an Ebola vaccine developed by Merck <MRK.N> could be available in case of a large-scale outbreak and that it stood ready to support the Congo government on the matter.

(Reporting by Aaron Ross; Writing by Emma Farge; Editing by Louise Ireland and Gareth Jones)

Mass graves in central Congo bear witness to growing violence

A red headband, worn by Kamuina Nsapu militia fighters, is seen at a mass grave discovered by villagers in Tshimbulu near Kananga, the capital of Kasai-central province of the Democratic Republic of Congo, March 11, 2017.

TSHIMBULU, Democratic Republic of Congo (Reuters) – The increasingly brutal nature of fighting in central Congo between the army and local militia is on vivid display in the village of Tshienke, where the bodies of rebel fighters were dumped into a mass grave last month following intense clashes.

A visit to this site this month was the first time that journalists including Reuters have been able to see the toll that the Congolese military has exacted on fighters of the Kamuina Nsapu militia, whose insurgency poses the most serious threat to the rule of President Joseph Kabila.

Reuters was unable to determine the exact number of bodies in eight mass graves dug in January and February in Congo’s Kasai-Central province. The graves were also confirmed by nine local witnesses.

The United Nations said it suspects that Congolese forces killed 84 militia members close to the town of Tshimbulu between Feb. 9-13.

The government denies its soldiers used disproportionate force and says they have recovered automatic weapons from militia fighters after clashes.

Government spokesman Lambert Mende told Reuters that the bodies in the mass graves were those of Kamuina Nsapu fighters and it was the group who had buried them, not the army.

“I don’t see why the soldiers would hide the fact, that after clashing with the terrorists, the terrorists died,” he said, confirming that the army killed militia fighters in the clashes.

Leaders of Kamuina Nsapu could not be reached for comment.

BONE SHARDS

At one grave site at Tshimbulu, a human femur poked out of the dirt and shards of bone dotted the perimeter.

“We saw arms and legs. There were … people who were entirely exposed because they hadn’t been buried well,” said one man who found the mass grave last month with fellow farmers.

He, like about a dozen witnesses Reuters interviewed, spoke on condition of anonymity for fear of reprisals from the army.

Two km (1 mile) away in Tshienke, another farmer pointed out two more mass graves she said contained bodies dumped by an army truck between 8 p.m. and 11 p.m. on the night of Feb. 12, following intense clashes on Feb. 9 and 10.

A red headband of the kind worn by members of the Kamuina Nsapu militia was wedged in the grass near the graves.

In a statement to Reuters, the U.N. peacekeeping mission in Congo said it informed the government earlier this month of three alleged mass grave sites in Tshimbulu and, in December, of seven more in the village of Nkoto, about 150 km (90 miles) northwest. The government says the graves were dug by the militia.

Kabila’s decision not to step down when his presidential mandate expired in December was followed by a wave of killings and lawlessness across the vast central African nation.

Kabila has said he is committed to respecting the constitution but an election to choose his successor cannot take place until a lengthy voter registration process is completed.

However, the rebellion that began in Kasai-Central has spread to five of Congo’s 26 provinces and resulted in hundreds of deaths.

VIOLENCE

Kabila’s opponents have used violence to exploit the uncertainty caused by his decision to stay on. Last August, a local chief known as Kamuina Nsapu after his native village, was killed in a clash with soldiers.

He had rejected the authority of the central government in Kasai-Central and demanded that government forces leave. Since then, Kamuina Nsapu militants do not appear to have a leader and some of the latest violence appears to be ethnic score-settling.

But they have also demanded that the government move to implement a deal signed on Dec. 31 requiring Kabila to step down after an election this year.

“It has taken on a political dimension because the aim is now to see Kabila no longer at the head of the country,” said Alphonse Mukendi, a human rights activist in the provincial capital Kananga.

More than 60 local leaders connected to the militia, including Kamuina Nsapu’s brother, began arriving in Kananga on Sunday for negotiations with the government, provincial vice governor Justin Milonga told Reuters.

The government hopes that conciliatory gestures, including suggestions it is prepared to return Kamuina Nsapu’s body to his family, can ease tensions, though Milonga cautioned that many in the decentralized rebellion hope to see it continue.

Kamuina Nsapu’s tactics have alienated many, according to local residents, who say it uses child soldiers, some as young as 10.

It has attacked schools and churches, institutions it sees as oppressive, and executed police officers, soldiers and rival chiefs.

Mende, the government spokesman, said Congolese forces also suffered casualties at the hands of the group, including about 30 police officers killed last August.

But in battles with the military, the militia has faced machine gun fire while its fighters are armed with machetes, batons and home-made rifles.

After a video appearing to show soldiers massacring militia members was posted on social media, the United Nations called on Congo’s government to end “human rights violations, including apparent summary executions, by the … armed forces”.

The military’s top prosecutor, Major General Joseph Ponde, announced on Saturday that seven soldiers had been charged in connection with the video, including for the war crimes of murder and mutilation.

Ponde also said investigators plan to exhume two graves discovered near where the video was shot in neighboring Kasai-Oriental province.

(Editing by Tim Cocks and Giles Elgood)