Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Tag: Health

Random Analytica: Mefloquine – Colonels & Generals

Mefloquine wasn’t just given to Diggers [Australian slang for Other Ranks]. Colonels and Generals got it too. They get sick and they die. They don’t believe the diagnostic overshadowing of PTSD makes any sense either. Some are even voicing their concerns.

Here is a list of Colonels and Generals who either received Mefloquine on Operations OR (more telling) refused to take it. Correct as at 20th October 2019. I’ll update accordingly.

 

Confirmed Mefloquine Exposure and Symptomology

18th October 2019 (Canada): Lieutenant-General Roméo Antonius Dallaire. UNAMIR (Rwanda 1993/94). Via W5. Romeo Dallaire joining lawsuit against government over anti-malaria drug. Excerpt:

In a W5 exclusive, Dallaire announced that he is joining a lawsuit against the Canadian government and Defence Department over an anti-malaria drug that he, and other soldiers , were forced to take on missions to Rwanda, Somalia and Afghanistan.

Dallaire, who led the international peacekeeping mission in Rwanda in 1994, has become the highest ranking soldier to join an unprecedented legal action by veterans over the use of the anti-malaria drug Mefloquine. He joins nearly 900 other veterans who claim the Canadian government and Department of National Defence “willfully ignored and concealed the risks” of the drug, which is marketed under the brand name Lariam.

Dallaire has been hailed a hero, both for his attempts to stop the genocide in Rwanda, but also for his outspoken admission that he struggles with Post-Traumatic Stress Disorder.

30th January 2019: Colonel Timothy Dunn (USA). Deployed (Sep – Dec 2006). Via the Military Times. ‘I plead with you to look at this very closely,’ retiree tells panel studying health effects of anti-malarial drugs. Excerpt:

Timothy Dunn, a retired Marine Corps colonel, was among those who told the committee they’d be willing to provide information.

” I open my self, my heart and soul and medical records to you,” Dunn said. “You have to do something to look at this closely and make a fair and just determination … there are many more than I who have had this problem.”

Dunn said he still suffers from insomnia, anxiety, depression, ringing in the ears, and dizziness.

22nd May 2016 (UK): General David Julian Richards. Operation Pallisar (2000). Via the Independent. British armed forces set to ban most prescriptions of controversial anti-malarial drug Lariam. Excerpt:

Lady Caroline Richards, the General’s wife, had also taken a keen interest in matter for a long time. She added “Wives and partners of people who had been affected by the use of Lariam approached me and described what had happened. There were some terrible, sad stories of trauma, of relationships ending, psychological problems. We heard about other forces which have stopped using Lariam, so this is obviously something which needed looking into.”

23rd November 2015 (UK): Major-General Alistair Duncan. Sierra Leone (1999). Via the Daily Mail. Has this highly decorated hero been driven mentally ill by an anti-malaria drug tourists are still given? Excerpt:

Today, however, he is locked up in a secure psychiatric unit near his home in Somerset. Tragically diminished, he has been incarcerated for ten months. He has lost the capacity to read and write; outbursts of aggression are punctuated by periods of torpor. He can be sweet-tempered and affectionate; remote and belligerent by turns. His wife, and a growing body of expert medical opinion, believe his psychiatric disorder has been caused, in part, by the controversial anti-malarial drug mefloquine, or Lariam, which he was given for six months in 1999 before being deployed to West Africa.

The Abstainers

31st August 2016 (UK): General Francis Richard Dannatt. Refused Mefloquine. Via The Guardian. Ex-army chief apologises to troops over anti-malaria drug. Excerpt:

Lord Dannatt, who was chief of the general staff between 2006 and 2009, told BBC2’s Victoria Derbyshire programme he would not take the drug because of his son’s experience with it.

Dannatt said his son Bertie had suffered mental health problems after taking two doses of Lariam before visiting Africa in the late 1990s. He was not in the armed forces at the time but had been prescribed the drug by his father’s army doctor.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

10. Mefloquine Dispatches: Acceptance, 2019

My acceptance story actually started a month ago when I penned my first letter. My Request to Darren Chester. I’m not sure if he read it or not. I honestly don’t care. I laugh and I cry as I write my stories. I write for myself.

I have some AMAZING people helping me with this.

I used to hate the RSL. I didn’t understand the sub-branch setup when I first go in. I got dragged in by a job services provider. I had slept in my car the night before. I was so embarrassed by my situation I didn’t return for a year. I was off the grog by then. Was holding down a part-time job in a bottle-shop. Lived by myself in a cabin. Was restoring my relationship with my kids.

My RSL advocate is an ex-Navy man. He was on the HMAS Melbourne after it had sunk two of our own ships. The HMAS Melbourne was indirectly linked to 161 allied sailor deaths. Plus all the trauma afterwards. His hands shake. He has a condition which makes him shake to some degree all the time. Yet, he chooses to come in and help out veterans like me. He takes extra time too. All of his folders are fatter than other advocates because he does the due diligence. After I first meet him I kick-off in his small office. He still invites me back again. The second time I’m shaking like a leaf. It’s my pattern. He gets it.

Then there is my GP. She is an older lady. Has an amazing brain and a thousand stories. She is still a country GP in a world that doesn’t respect the connectivity that a Doctor can have with a community. She first worked with veterans in the 1970s before there was even a DVA. One of her first patients was gassed in the trenches of WWI. Changes of light would kick him off. He died screaming because the systems we have were set up for the projection of war power, not the assistance required for the men and women who stand on the wall. She has had her own struggles. She gets it.

She points me toward a Psychologist. I didn’t go to him for help on this. I thought I might have some PTSD but I’m unsure. He listens quietly at times. Interjects with his own stories as well. He sees the PTSD but also something deeper. The second time I see him I am shaking so much it takes me an hour to calm down. He is like me but older. He flew into Vietnam as a specialist at the end of that war. He jumps out of a chopper on a hill and still carries the bursitis today. He has a girl’s name! Everyone mistakes him for a girl when they first write it down. Think on that for a moment. He soldiered in Vietnam with a girl’s name! How tough is this guy.

When I finally pinpoint the Mefloquine I immediately admit myself to the local ER [Emergency Room]. I’m ready for the long sleep but I’ve made a promise to be there for the kids. My ER doctor is a combat veteran. What are the chances! Of all the doctors I get when I find out about this I get a combat vet. I tell him my suspicions. He takes me seriously. He shipped into Timor Leste in 2006 with Op ASTUTE. I know nothing about this operation. I avoid all things East Timor. He tells me they dropped mefloquine in 03’ because it was sending everyone crazy. That line alone saves me. I start to dig. Then I start to dig deeper.

My psychologist points me toward a psychiatrist. We don’t know who to choose because my thing is a bit of an outlier. I get an older gent who moves heaven and earth to get me a bed. When we first talk I’m on a different planet. I look at the puzzles he has adorning his rooms in fascination. At a much later date I meet another psychiatrist. He is originally from Pakistan but calls Australia home now. He takes the time to read my stuff. Talks me down. Explains why it is important to accept that my condition has a mental health element. They are both the smartest men in the room and yet they don’t get it, not yet anyway.

Yesterday I sat down with my first ever Occupational Therapist. She is young but not too young. She is professional. Her partner is an ex-AJ [Army Jerk]. His time was spent in the Sands. Didn’t do the malarial zones. Has had his battles too. I tell her I’m glad. It means I don’t have to explain absolutely everything. She writes copious amounts of notes as I rattle of my disjointed tale. She explains the process, where we go from here. We agree to not use the word rehabilitation. There is no cure for what I have. It’s all management from here.

I’ve accepted that I won’t be cured. The disease has already done too much damage to the person I once was. The person it has created is interesting though. He can be intense, he can talk too much. When he kicks off he can be a terror but most of the time he just quietly sits at the back of the room or at home when he muses and writes. He has accepted the disconnection. Enjoys the silence. Or the music when he has the headphones on. I think I can do something important with this. I don’t know what it is yet but I don’t want to go to the grave SCREAMING. Not like my old troop sergeant. He was such a good bloke.

I don’t want to be one of those veterans who screams at the injustice of it all. Hell, when I signed up possibly dying for your country was part of the GIG.

It’s been a long time since I signed that paperwork in 1989.

I know everyone’s experience with quinoline is different. There are no first prizes here for suffering. We are all on our own journey and doing the best we can.

My new journey started this week. I have stopped screaming. I have accepted my fate and will make the best of what I have left.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: A ‘Soldiers-Five’ [trans. Basic Reading Guide] on Mefloquine

An old ‘soldiers-five’ on Mefloquine. When I first thought I was given Mefloquine I wasn’t sure where to look first. I initially got some good and some bad information. I’m not the tree of knowledge on Mefloquine but here is a suggested reading list and resource guide concerning Mefloquine. I’ve focused on veterans because that is my lived experience. Remember, this is a guide only. Consult your doctor.

Last updated 7th October 2019

World Health Organisation

8th August 1989: World Health Organisation. The original warning from WHO way back in 1989.

Consumer Medicine Information

9th October 2017: The Consumer Medicine Information guide for Lariam (linked here: 171009_ConsumerMedicineInformation_Roche_Lariam). A veteran mate has underlined the important health warnings.

Mefloquine Articles (non-specific)

27th April 1996: New Scientist.  Malaria pill stands accused – Lariam fends off malaria more effectively than any other drug, but growing evidence of disturbing side effects may soon land its manufacturer in court (via 960427_Article_NewScientist_Mefloquine). Thanks to the veteran mate who sent this through. He was given Lariam in 1994 and 1999 without the serious side-effects.

Mefloquine Articles for Veterans

27th January 2003: CBS News. The Dark Side Of Lariam. How Dangerous Is It? One of the first ‘deep-dives’ into mefloquine by a news outlet. Discusses the Fort Bragg suicide cluster where mefloquine was a factor.

19th September 2013: CBS News. Elite Army units to stop taking anti-malarial drug. The US Army’s Special Forces banned from using mefloquine in 2013.

25th September 2013: Huffpost. Mefloquine: The Military’s Suicide Pill. Dr Remington Nevin writes about mefloquine including the 2013 FDA’s ‘black-box’ warning. The world is waking up to the dangers of mefloquine. Dr Nevin is one of the leading experts in the field.

12th October 2014: Army Technology. Mefloquine – the military’s deadly malaria treatment. Dr Remington Nevin discusses the downside to mefloquine including his own personal deployment experience with the drug.

11th August 2016: Military Times. Malaria drug causes brain damage that mimics PTSD: case study. A different take on mefloquine exposure from the USA.

22nd August 2016: Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. One of the first articles I read. Also includes a link to a 2016 7.30 Report about the Australian mefloquine/tafenoquine trials.

30th August 2018: The Irish Times. Vivid nightmares and suicidal thoughts – ex-soldiers blame drug for destroyed lives. An Irish perspective. With a standing Army of approximately 10,000 they have still administered Lariam to approx. 5,500 – 6,000 over the years.

Podcasts

12th June 2019: The Medical Republic. TMR podcast: Can this anti-malarial drug really cause “brain damage”? Thanks to my GP, Dr Mary Lamond for sending this to me. Along with other subjects the podcast covers mefloquine/tafenoquine exposure and its risks in simple language.

Books

23rd January 2014: ‘The Answer to the Riddle Is Me’ by David Stuart MacLean. The Washington Post book review can be found here.

Official Mefloquine Sites (Information & Policy)

Last accessed 7th October 2019: Department of Defence (Australia). Mefloquine. An excellent resource. One of the first sites I visited. Mefloquine Loading Doses are also explained.

Experts

Dr Remington Nevin (USA). Possibly the leading expert in the field of Quinism in 2019 when I suspected my exposure. US Army (Major – Retired). A Vermont-based physician epidemiologist and expert consultant in the adverse effects of antimalarial drugs, particularly mefloquine and tafenoquine.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: Mefloquine Use by the Australian Defence Force (1990s)

I’m ready to heal yet I still need to count the cost. Others have made the attempt and fallen short. It might be my most important piece of epidemiology to date. It might pan out to be nothing. At least now I can do it systemically and at a slower pace.

It’s personal for me.

191112_MefloquineUseByADF90s (UPD)

The chart above is still a work in progress. I’m starting to get some good feedback from other veterans… If you want to add to this chart please reach out.

Last updated 12th November 2019

Notes:

191112_MefloquineNotes (UPD)

 

990910_Photo_JMolan_OpSpitfire

10th September 1999. Brigadier Jim Molan & Ian Martin directing the evacuation of Dili, East Timor. Source: Twitter (John L. Gould)

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

6. Mefloquine Dispatches: @WHO, 8th August 1989

When it was issued by the World Health Organisation I was still at school. I wasn’t interested in global issues. I should have read it but I don’t. I’m getting my final paperwork ready for the Army. I’m failing school. The Army accepts Year 10 and I have good grades to that point. School seems so pointless. Something is kicking off in the Middle East. We are going to smash Saddam Hussein in the fucking teeth. I don’t want to miss out on any action. I’m still too young in 1989 but I am slotted in for Basic Training early next year. I am 16-years old. I am so Green.

I’m good judoka. I’m not interested in black belts, I just love the training. I train twice during the week and on weekends if we get enough interest. My Sensei is amazing. He is a psychiatric nurse. He is tough. We laugh as he tells us the story of the bloke who tried to jump him in the supermarket. It supposed to be a joke but W* throws him. The checkout chick is terrified. It’s a great story. I meet him a year or two later. I’m home on leave. I’ve put on 15kg and I’m Army tough. As we train one of the kids clumsily kicks me in the balls as we practice sacrifice throws. It’s an accident but I’m in agony. W* tells the story to the other bouncers at the nightclub he is working at part-time that night. I’m still tender. We laugh. I get free entry and a drink voucher. I feel like a God in the early 90s but that hasn’t happened yet.

I’m working in a greasy Indian restaurant on weekends. The Indian family who own it treat me like one of their own. I get paid $10 per hour cash-in-hand (which is big money back then). I smell like sauce as I go to school on Mondays. The smell lingers till Wednesday. Indian food smells when you do the dishes. It takes me years to get coached into an Indian restaurant with my best friend and his girl. The food is amazing. I’m catching up with another friend and her man next week. We are eating Indian.

I’m so busy. I’ve been training for years to get this far. I’m an accomplished Venturer. I teach others how to abseil, orient a map or whatever. My Venturer leader is an amazing soldier. He is old but still fit. He smokes constantly. Under the stars one night he tells me how he started smoking. He is on patrol in Malaysia back in the day when his best mate cops the full blast of something. He is covered in his blood. Bits of flesh drip off him. When he gets in front of a medic they think he might be damaged. His mate cops the full blast, he walks away without a scratch. The medic puts a cigarette in his mouth and lights it. That was his first smoke. I’m sixteen and this amazing man is sharing his real story. We have a moment. I’ll meet other amazing soldiers in the future. Men and Women. We will share moments. I’ll forget it all.

It’s been 30-years since the World Health Organisation issued their warning.

1989_WHO_Mefloquine

I wonder why they never followed up on it?


WHO~Mefloquine

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Mefloquine and Tafenoquine use by the Australian Defence Force 1990 – 2017

Mefloquine and Tafenoquine are two different types of anti-malarial drugs that have been in use potentially as far back as 1990 but trialled extensively by the Australian Defence Force at the turn of the century. From 2016 via the Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. Excerpt:

The Australian Defence Force has acknowledged it accidentally exposed one of its soldiers to controversial anti-malarial drugs during trials in East Timor, despite the soldier having a medical history of mental illness which should have precluded his involvement.

The soldier, Chris Salter, developed chronic depression and psychosis after inclusion in the Timor trials of psychoactive drugs mefloquine and tafenoquine.His illness has led to repeated suicide attempts and more than a dozen stays in psychiatric hospitals. He is unable to work or care for his family.

Since the trials, which included thousands of Australian soldiers between 2001 and 2003, a small group of veterans have developed severe mental illnesses. They believe the ADF erred by giving them the drugs even though there was a significant body of research which pointed to the drugs’ side effects, which in some cases are permanent.

I just wanted to get a chart posted which highlighted the use of Mefloquine and Tafenoquine in Australian soldiers over the past 30-years. Currently most of the documentation concentrates on the trials conducted between 1998 – 2002, however there is some evidence that groups of soldiers were subjected to trials of mefloquine as far back as 1992 during Operation SOLACE (Somalia). I’ll update the chart as new information comes to hand.

Mefloquine~TafenoquineUsebyADF1990-2017

Explanatory Notes:

1992-93: Somalia – Awaiting more information
1993: Cambodia – Awaiting more information
1994-96: Rwanda – One confirmed mefloquine dosage. Awaiting more info
1997: PNG – One confirmed mefloquine dosage. Awaiting more info
1998: Bougainville – Peace Monitoring Group – 201 troops given Tafenoquine (note: Stuart McCarthy’s notes state 374 troops were given Tafenoquine).
2000: East Timor – 639 troops given Tafenoquine during trials.
2000: East Timor – 162 troops given Mefloquine during the Double-Blind trial
2000: East Timor – 492 troops given Tafenoquine during the Double-Blind trial
2001: Australia – 31 troops given Tafenoquine to test for Relapse Prevention
2001: East Timor – 1,157 troops given Mefloquine during the last major trial of the drug

An excellent resource for understanding the trial intensity of both anti-malarial drugs is Stuart McCarthy’s Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002. See attached:

150724_Summary_SMcCarthy_ClinicalTrials

Data Sources

  1. Mefloquine http://www.defence.gov.au/Health/HealthPortal/Malaria/Anti-malarial_medications/Mefloquine/default.asp
  2. Randomized, double-blind study of the safety, tolerability, and efficacy of tafenoquine versus mefloquine for malaria prophylaxis in nonimmune subjects https://www.ncbi.nlm.nih.gov/pubmed/19995933
  3. Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002 https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Foreign_Affairs_Defence_and_Trade/Mefloquine/Submissions
  4. TGA Approvals for Australian Defence Force Use of Mefloquine in Townsville (Queensland) and Somalia, 1992-93 https://www.righttoknow.org.au/request/tga_approvals_for_australian_def

Measles in Australia (as at 18th April 2019)

I’ve been watching the news about various measles outbreaks across the globe and wondered how badly Australia had been impacted (or infected). After reading a few articles it dawned on me that no single entity looked after the data as it was a state or territory issue and each state reported infectious diseases differently. Not best practice for highly infectious diseases.

In terms of the measles numbers for Australia. I have put a tentative number of 109 across all states and territories. That eclipses last year’s total of 103 cases and the 81 cases recorded in 2017.

190418_Infographic_Measles_Australia

The State by State breakdown with links

If we have broken the measles record for recent years in the first four months one can only guess at the eventual total. One to watch…

Ebola in the Democratic Republic of Congo 4 April – 22 May 2018

The World Health Organisation updated its Ebola virus disease – Democratic Republic of the Congo Disease Outbreak News on Wednesday with numbers to Tuesday. The DR Congo Ministry of Health updated its numbers today with data to Wednesday presenting some new numbers including the invalidation of eight previously reported community deaths which occurred pre-outbreak.

Ian Mackay has broken down the numbers for us in an easy tweet. They are:

#Ebola numbers for 22MAY2018 from DRC MOH…

  • total: 58 (+0 from last report)
  • confirmed: 30 (+2)
  • suspect: 14 (+5)
  • probable: 14 (-7)
  • fatal: 22 (38%; -5)
  • Wangata: 10 (+3 suspect; +2 deaths)
  • Iboko: 24 (+6 suspect)
  • Bikoro: 24 (+3 suspect)

Those numbers in a infographic which details the cases/fatalities by territory (rather than Health Zone). Iboko Health Zone lies within Bikoro Territory:

180524_Infographic_EbolaInDRC

The World Health Organisation data via its latest Disease Outbreak News. Ebola virus disease – Democratic Republic of the Congo. Excerpt:

On 8 May 2018, the Ministry of Health (MoH) of the Democratic Republic of the Congo declared an outbreak of Ebola virus disease (EVD). This is the ninth outbreak of Ebola virus disease over the last four decades in the country, with the most recent outbreak occurring in May 2017.

Since the last Disease Outbreak News on 17 May 2018, an additional fourteen cases with four deaths have been reported. On 21 May 2018, eight new suspected cases were reported, including six cases in Iboko Health Zone and two cases in Wangata Health Zone. On 20 May, seven cases (reported previously) in Iboko Health Zone have been confirmed. Recently available information has enabled the classification of some cases to be updated.

As of 21 May 2018, a cumulative total of 58 Ebola virus disease (EVD) cases, including 27 deaths (case fatality rate = 47%), have been reported from three health zones in Equateur Province. The total includes 28 confirmed, 21 probable and 9 suspected cases from the three health zones: Bikoro (n=29; ten confirmed and 19 probable), Iboko (n=22; fourteen confirmed, two probable and six suspected cases) and Wangata (n=7; four confirmed and three suspected case). Of the four confirmed cases in Wangata, two have an epidemiological link with a probable case in Bikoro from April 2018. As of 21 May, over 600 contacts have been identified and are being followed-up and monitored field investigations are ongoing to determine the index case. Three health care workers were among the 58 cases reported.

Ebola in the Democratic Republic of Congo 4 April – 15 May 2018

The World Health Organisation has updated its Ebola virus disease – Democratic Republic of the Congo Disease Outbreak News which include Epidemic Curve chart and a map illustrating the Health Zones impacted.

Currently there are 40-cases in Bikoro Territory (2-confirmed, 20-probable & 18-suspect) and I’ve assumed that all 23 reported fatalities have occurred in that territory based on the most recent reporting although this has not been confirmed by the WHO in this update.

Note: If all the 23 fatalities have occurred in Bikoro Territory that puts the CFR at 57.5%. However, if all the fatalities have occurred in the smaller Bikoro Health Zone the CFR then spikes to 65.7%. There have also been four cases reported in Wangata Territory including two brothers who travelled to Bikoro for a wedding. This places those four within the environs of Mbandaka, a city of 1.2 to 1.5-million.

WHO are also reporting three Health Care Workers among the 44 infected without providing any further information.

All the cases to date have occurred in Equateur Province which is represented in the infographic below:

180515_Infographic_EbolaInDRC

The World Health Organisation data via Ebola virus disease – Democratic Republic of the Congo. Excerpt:

Since the last Disease Outbreak News on 14 May 2018, an additional five cases, including one laboratory-confirmed case from the city of Mbandaka, Wangata health zone, have been notified by the country’s Ministry of Health. Wangata health zone is one of three health zones in Mbandaka City, which has a population of approximately 1.5 million people. Recently available information has enabled the classification of some cases to be updated1.

From 4 April through 15 May 2018, a cumulative total of 44 Ebola virus disease (EVD) cases including 23 deaths (CFR = 52%) have been reported from three health zones in Equateur Province. The total includes three confirmed, 20 probable and 21 suspected cases from the three health zones, Bikoro (n=35; two confirmed, 18 probable and 15 suspected cases), Iboko (n=5; two probable and three suspect cases) and Wangata (n=4; one confirmed, and three suspect cases). Of the four cases in Wangata, two have an epidemiological link with a probable case in Bikoro from April 2018. As of 15 May, 527 contacts have been identified and are being followed-up and monitored. Three health care workers were among the 44 cases reported. Figure 1 shows the date of notification (date of illness onset not yet available for most cases) for 27 cases with available data from 5 May through 15 May 2018. Figure 2 shows the location of cases by health zone.

Ebola in the Democratic Republic of Congo 4 April – 13 May 2018

The World Health Organization has updated its Disease Outbreak News (DON) on the Ebola outbreak which has data updated to the 13th May 2018. I missed the initial DON but the most recent news is both good and bad. Good in that WHO has immediately ramped up efforts to stem this latest outbreak including deploying the Ebola vaccine but also bad because the two probable cases in the Wangata territory are on the outskirts of a large population centre (Mbandaka – population 1.2-million).

The DON breaks down the cases by Health Zones. Currently those cases listed in Bikoro and Ikoko Health Zones lie within Bikoro Territory while the Wangata Territory encompasses the city of Mbandaka and surrounds. The Case Fatality Rate for Bikoro Territory is 51.3%. All the cases so far have occurred in Equateur Province. Infographic below:

180513_Infographic_EbolaInDRC

The data for this infographic was supplied by the World Health Organization via Disease Outbreak News 14 May 2018 – Ebola virus disease – Democratic Republic of the Congo. Excerpt:

Since the publication of the first Disease Outbreak News on the Ebola outbreak in Equateur province, Democratic Republic of the Congo on 10 May 2018, an additional seven suspected cases have been notified by the country’s Ministry of Health. Importantly, since the last update, cases have been reviewed and reclassified, and some discarded.

From 4 April through 13 May 2018, a total of 39 Ebola virus disease cases have been reported, including 19 deaths (case fatality rate = 49%) and three health care workers. Cases were reported from the Bikoro health zone (n=29; two confirmed, 20 probable and 7 suspected cases), Iboko health zone (n=8; three probable and five suspected cases) and Wangata health zone (n=2; two probable cases). To date, 393 contacts have been identified and are being followed-up. Wangata health zone is adjacent to the provincial port city of Mbandaka (population 1.2 million). Response teams on the ground are in the process of verifying information on reported cases. Case numbers will be revised as further information becomes available.