133-690: Walikale is a town in the North Kivu Province of the Democratic Republic of the Congo (DRC). It is the administrative center of the Walikale Territory . Walikale is home to the largest tin deposits in the Congo and to some very large gold mines, as well. In particular, the Bisie mine is supposed to account for somewhere between 50 and 80% of tin exports from North Kivu. The control of Bisie mine
266-412: A coma near the end of life. Those who survive often have ongoing muscular and joint pain, liver inflammation , and decreased hearing, and may have continued tiredness, continued weakness, decreased appetite, and difficulty returning to pre-illness weight. Problems with vision may develop. It is recommended that survivors of EVD wear condoms for at least twelve months after initial infection or until
399-427: A septic state . EBOV is thought to infect humans through contact with mucous membranes or skin breaks. After infection, endothelial cells (cells lining the inside of blood vessels), liver cells, and several types of immune cells such as macrophages, monocytes , and dendritic cells are the main targets of attack. Following infection, immune cells carry the virus to nearby lymph nodes where further reproduction of
532-507: A "war effort tax", which escalated alongside coltan prices. RCD-Goma also held a controlling 75% interest in the Société Minière des Grands Lacs (SOMIGL), which held a temporary monopoly on coltan exports, generating immediate revenue surges. In December 2000, the 112 tonnes of exported coltan brought in over $ 1.1 million in taxes; however, none of these funds were allocated toward public services like healthcare or education. The monopoly
665-528: A Territorial Administrator supported by two Assistant Territorial Administrators, who facilitate the effective governance of vast regions, often remote or rural. Appointed by the Ministry of the Interior and Security , territorial officials are part of the state's official budget. They are responsible for implementing state policies at the local level, under the oversight of the provincial governor , who serves as both
798-737: A bridge over the Osso River. On 25 February 2003, RCD-Goma forces orchestrated a massacre in Bushimoo and Kailenge, killing at least 44 civilians. The attack was deceitfully executed under the guise of a community meeting meant to introduce a new village leader—an ex-Mayi-Mayi who had defected to RCD-Goma. The atrocities extended into the Walikale region. In April 2003, RCD-Goma forces killed five civilians and tortured two women near Kabusa, approximately ten kilometers from Walikale. In June 2003, seven inhabitants of Lukweti were executed with bayonets, and their village
931-466: A brutal regime, characterized by arbitrary detention, torture, and summary executions . Civilians were often confined in inhumane conditions, including detention in muddy pits several meters deep. North of Kanyabayonga , the FDLR targeted civilians across several villages, including Kayna, Mayene, Nyamindo, Kisandja, and Kiteka. The attacks often involved killings, harassment, and forced displacement. During
1064-476: A child and an employee of the international NGO Save the Children , were killed in the village of Karuba. In November 1996, Walikale Territory became a critical transit point and deadly trap for Rwandan refugees fleeing the advancing AFDL and RPA. Refugees arrived in the area via three routes: one from Bukavu through Bunyakiri ; another through the dense forests of Kahuzi-Biéga National Park and Nyabibwe; and
1197-662: A focal point for intense military operations and humanitarian crises . The war marked the beginning of a campaign by the newly formed Alliance of Democratic Forces for the Liberation of Congo (AFDL), led by Laurent-Désiré Kabila , and the Rwandan Patriotic Army (RPA), under Paul Kagame , to depose Mobutu Sese Seko 's regime in Zaire (present-day DRC). While the AFDL and RPA justified their incursion by accusing Mobutu of marginalizing
1330-477: A locality between Hombo and Walikale. Hundreds of refugees were executed as part of a broader system of targeted extermination. A similar system was implemented in Itebero, where special units systematically hunted down refugees throughout December 1996. In Mutiko locality, refugees intercepted at checkpoints were transported to Mukito village under the pretense of being prepared for UNHCR-assisted repatriation. However,
1463-565: A makeshift camp at Rukwi, killing an indeterminate number of refugees in a protracted series of raids that spanned weeks and months. In late November, atrocities were reported in Miandja, where AFDL/RPA units killed approximately 50 civilians, including 40 Rwandan refugees and 10 local Hutu Banyarwanda . Refugees who had established settlements at Karunda in Kirumbu village and on the Nyabura plantation in
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#17328523784421596-476: A person who has developed symptoms of the disease. Body fluids that may contain Ebola viruses include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine and semen . The WHO states that only people who are very sick are able to spread Ebola disease in saliva , and the virus has not been reported to be transmitted through sweat. Most people spread the virus through blood, feces and vomit. Entry points for
1729-422: A priority of Doctors Without Borders . Ebolaviruses can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for five minutes). To disinfect surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants may be used at appropriate concentrations. Education of
1862-452: A proper protective barrier between the dead body and the living. Social anthropologists may help find alternatives to traditional rules for burials. Transportation crews are instructed to follow a certain isolation procedure, should anyone exhibit symptoms resembling EVD. As of August 2014 , the WHO does not consider travel bans to be useful in decreasing spread of the disease. In October 2014,
1995-561: A rapid antigen test which gives results in 15 minutes was approved for use by WHO. It is able to confirm Ebola in 92% of those affected and rule it out in 85% of those not affected. Early symptoms of EVD may be similar to those of other diseases common in Africa, including malaria and dengue fever . The symptoms are also similar to those of other viral haemorrhagic fevers such as Marburg virus disease , Crimean–Congo haemorrhagic fever , and Lassa fever . The complete differential diagnosis
2128-429: A reservoir. Traces of EBOV were detected in the carcasses of gorillas and chimpanzees during outbreaks in 2001 and 2003, which later became the source of human infections. However, the high rates of death in these species resulting from EBOV infection make it unlikely that these species represent a natural reservoir for the virus. Deforestation has been mentioned as a possible contributor to recent outbreaks, including
2261-563: A rich fish population, forming a vital economic resource for surrounding communities. Lake Kivu, the highest lake in Central Africa , sits at an elevation of 1,460 meters, with a Congolese surface area of 2,700 square kilometers and an average depth of 285 meters. However, its fish diversity is relatively limited compared to Lake Edward. Additionally, the Mokotos Lakes—Ndalaha, Lukulu, Mbalukia, and Mbila—occupy 86 square kilometers in
2394-414: A secreted glycoprotein , small soluble glycoprotein (sGP or GP) is synthesised. EBOV replication overwhelms protein synthesis of infected cells and the host immune defences. The GP forms a trimeric complex , which tethers the virus to the endothelial cells. The sGP forms a dimeric protein that interferes with the signalling of neutrophils , another type of white blood cell. This enables the virus to evade
2527-540: A share of profits in exchange for their protection. Although some coltan passed through local trading houses, the majority was flown directly to Rwanda, bypassing the DRC's export system. Rwandan military officers and entrepreneurs linked to the government were prominently represented as directors and stakeholders in key trading houses in Goma and Bukavu, such as Grands Lacs Metals and Rwanda Metals. These trading houses collaborated with
2660-540: A sudden influenza -like stage characterised by fatigue , fever , weakness , decreased appetite , muscular pain , joint pain , headache, and sore throat. The fever is usually higher than 38.3 °C (101 °F). This is often followed by nausea, vomiting, diarrhoea , abdominal pain, and sometimes hiccups . The combination of severe vomiting and diarrhoea often leads to severe dehydration . Next, shortness of breath and chest pain may occur, along with swelling , headaches , and confusion . In about half of
2793-555: A third from North Kivu, passing through southern Masisi Territory and the towns of Busurungi and Biriko. While armed men in these groups often managed to escape, the slowest refugees—mainly women, children, and the elderly—became the primary targets of the AFDL/RPA's systematic attacks. On 9 December 1996, the AFDL/RPA forces unleashed one of their deadliest massacres at the Hombo Bridge, where they shot dead several hundred refugees. Many of
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#17328523784422926-521: Is a main source of contention within the Congolese army, as it provides for upwards of $ 100,000 a month in taxes for local soldiers. This does not include the individual pits that some commanders control and or the kickbacks they get from trading houses. North Kivu Province North Kivu ( Jimbo la Kivu Kaskazini in Swahili ) is a province bordering Lake Kivu in the eastern Democratic Republic of
3059-414: Is able to survive on objects for a few hours in a dried state, and can survive for a few days within body fluids outside of a person. The Ebola virus may be able to persist for more than three months in the semen after recovery, which could lead to infections via sexual intercourse . Virus persistence in semen for over a year has been recorded in a national screening programme. Ebola may also occur in
3192-446: Is confirmed by isolating the virus, detecting its RNA or proteins, or detecting antibodies against the virus in a person's blood. Isolating the virus by cell culture , detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) are methods best used in the early stages of the disease and also for detecting the virus in human remains. Detecting antibodies against
3325-620: Is confirmed by testing blood samples for the presence of viral RNA , viral antibodies or the virus itself. Control of outbreaks requires coordinated medical services and community engagement, including rapid detection, contact tracing of those exposed, quick access to laboratory services, care for those infected, and proper disposal of the dead through cremation or burial. Prevention measures involve wearing proper protective clothing and washing hands when in close proximity to patients and while handling potentially infected bushmeat , as well as thoroughly cooking bushmeat. An Ebola vaccine
3458-691: Is considered evidence that these bats are a reservoir species of EBOV. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo , immunoglobulin G (IgG) immune defense molecules indicative of Ebola infection were found in three bat species; at various periods of study, between 2.2 and 22.6% of bats were found to contain both RNA sequences and IgG molecules indicating Ebola infection. Antibodies against Zaire and Reston viruses have been found in fruit bats in Bangladesh , suggesting that these bats are also potential hosts of
3591-902: Is considered low. Usually when someone has symptoms of the disease, they are unable to travel without assistance. Dead bodies remain infectious; thus, people handling human remains in practices such as traditional burial rituals or more modern processes such as embalming are at risk. Of the cases of Ebola infections in Guinea during the 2014 outbreak, 69% are believed to have been contracted via unprotected (or unsuitably protected) contact with infected corpses during certain Guinean burial rituals. Health-care workers treating people with Ebola are at greatest risk of infection. The risk increases when they do not have appropriate protective clothing such as masks, gowns, gloves and eye protection; do not wear it properly; or handle contaminated clothing incorrectly. This risk
3724-763: Is extensive and requires consideration of many other infectious diseases such as typhoid fever , shigellosis , rickettsial diseases , cholera , sepsis , borreliosis , EHEC enteritis , leptospirosis , scrub typhus , plague , Q fever , candidiasis , histoplasmosis , trypanosomiasis , visceral leishmaniasis , measles , and viral hepatitis among others. Non-infectious diseases that may result in symptoms similar to those of EVD include acute promyelocytic leukaemia , haemolytic uraemic syndrome , snake envenomation , clotting factor deficiencies/platelet disorders, thrombotic thrombocytopenic purpura , hereditary haemorrhagic telangiectasia , Kawasaki disease , and warfarin poisoning. An Ebola vaccine , rVSV-ZEBOV ,
3857-491: Is greatly influenced by altitude. Temperatures decrease with elevation: areas below 1,000 meters average 23°C, while those at 2,000 meters average 15°C. Rainfall varies from 1,000 to 2,000 millimeters annually, with drier periods in January-February and July-August. The region experiences four distinct seasons: two wet seasons (mid-August to mid-January, mid-February to mid-July) and two short dry seasons. According to
3990-638: Is home to the Rwenzori Mountains , part of the Albertine Rift , which serves as a key freshwater source and supports a diverse ecosystem . North Kivu also hosts Virunga National Park , a UNESCO World Heritage Site home to endangered mountain gorillas . Demographically, North Kivu is ethnically diverse, predominantly inhabited by Bantu -speaking people, including the Nande, Mbuba, Hunde , Lese, Talinga, Hutu , Tutsi , and Batwa ( pygmies ). However,
4123-412: Is important for the infected and infection control People who care for those infected with Ebola should wear protective clothing including masks, gloves, gowns and goggles. The U.S. Centers for Disease Control (CDC) recommend that the protective gear leaves no skin exposed. These measures are also recommended for those who may handle objects contaminated by an infected person's body fluids. In 2014,
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4256-534: Is not known. Plants, arthropods , rodents , and birds have also been considered possible viral reservoirs. Bats were known to roost in the cotton factory in which the first cases of the 1976 and 1979 outbreaks were observed, and they have also been implicated in Marburg virus infections in 1975 and 1980. Of 24 plant and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected. The bats displayed no clinical signs of disease, which
4389-692: Is often due to shock from fluid loss , and typically occurs between six and 16 days after the first symptoms appear. Early treatment of symptoms increases the survival rate considerably compared to late start. An Ebola vaccine was approved by the US FDA in December 2019. The virus spreads through direct contact with body fluids , such as blood from infected humans or other animals, or from contact with items that have recently been contaminated with infected body fluids. There have been no documented cases, either in nature or under laboratory conditions, of spread through
4522-603: Is organized into chiefdoms , known as collectivités , and sectors . These entities represent traditional forms of authority, where leadership is often determined by ethnic customs and later formalized by the state. The head of a chiefdom holds the title "mwami" (paramount customary chief). Chiefdoms and sectors are divided into groupements , which further subdivide into villages. Village heads and chiefs manage governance within these smaller divisions. Some notable chiefdoms and sectors in North Kivu include: The frontiers of
4655-543: Is particularly common in parts of Africa where the disease mostly occurs and health systems function poorly. There has been transmission in hospitals in some African countries that reuse hypodermic needles. Some health-care centres caring for people with the disease do not have running water. In the United States the spread to two medical workers treating infected patients prompted criticism of inadequate training and procedures. Human-to-human transmission of EBOV through
4788-544: Is the most dangerous of the known EVD-causing viruses, and is responsible for the largest number of outbreaks. The fifth and sixth viruses, Reston virus (RESTV) and Bombali virus (BOMV), are not thought to cause disease in humans, but have caused disease in other primates. All six viruses are closely related to marburgviruses . Ebolaviruses contain single-stranded, non-infectious RNA genomes . Ebolavirus genomes contain seven genes including 3'-UTR - NP - VP35 - VP40 - GP - VP30 - VP24 - L - 5'-UTR . The genomes of
4921-399: Is the nucleoprotein, whose concentration in the host cell determines when L switches from gene transcription to genome replication. Replication of the viral genome results in full-length, positive-strand antigenomes that are, in turn, transcribed into genome copies of negative-strand virus progeny. Newly synthesised structural proteins and genomes self-assemble and accumulate near the inside of
5054-565: Is theoretically possible due to the presence of Ebola virus particles in saliva, which can be discharged into the air with a cough or sneeze, but observational data from previous epidemics suggests the actual risk of airborne transmission is low. A number of studies examining airborne transmission broadly concluded that transmission from pigs to primates could happen without direct contact because, unlike humans and primates, pigs with EVD get very high ebolavirus concentrations in their lungs, and not their bloodstream. Therefore, pigs with EVD can spread
5187-530: Is thought to begin with a virion attaching to specific cell-surface receptors such as C-type lectins , DC-SIGN , or integrins , which is followed by fusion of the viral envelope with cellular membranes . The virions taken up by the cell then travel to acidic endosomes and lysosomes where the viral envelope glycoprotein GP is cleaved. This processing appears to allow the virus to bind to cellular proteins enabling it to fuse with internal cellular membranes and release
5320-432: Is unclear whether they played a role in spreading the disease to people. The natural reservoir for Ebola has yet to be confirmed; however, bats are considered to be the most likely candidate. Three types of fruit bats ( Hypsignathus monstrosus , Epomops franqueti and Myonycteris torquata ) were found to possibly carry the virus without getting sick. As of 2013 , whether other animals are involved in its spread
5453-671: The AFDL . By late 1997, tensions mounted as Kabila faced allegations of marginalizing Tutsi factions in his government and favoring his Katangan affiliates. Other reports suggested that the United States provided military assistance to Rwanda in the lead-up to the war, ostensibly motivated by access to Congo's vast natural resources. A U.S. Army Rwanda Interagency Assessment Team (RIAT) was deployed to Rwanda in July 1998 to train Rwandan units. The presence of U.S. forces sparked controversy, as it coincided with
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5586-671: The ALiR ( Armée pour la Libération du Rwanda ) also attacked civilians in Walikale Territory and Masisi Territory. In January 2000, ALiR forces killed approximately 100 civilians in the village of Luke, Walikale Territory, accusing them of collaborating with RCD-Goma and RPA forces. Most of the victims were killed with machetes or shot . On 9 July 2000, ALiR attacked a displaced persons' camp in Sake , killing 34–42 civilians, mostly women and children of Hunde and Tembo ethnicity. On 7 August 1998,
5719-547: The Bashali Chiefdom . The provincial river system includes the Rutshuru , Rwindi, Semliki, Osso, and Lowa rivers. Volcanic soils , derived from recent lava flows, dominate areas near active volcanoes; these soils, while fertile in older flows, are less suitable for agriculture in recent deposits. Between Goma and Rutshuru, volcanic soils are fertile yet shallow, conducive to agriculture. Alluvial soils are common in
5852-625: The Congo Free State were defined by the Neutrality Act during the 1885 Berlin Conference , in which the European powers staked out their territorial claims in Africa. The Congo Free State's northeastern boundary was defined in 1885 as "a straight line coming from the northern end of Lake Tanganyika and ending at a point located on the 30th east meridian and at 1° 20' south latitude; further north,
5985-522: The DRC Mapping Exercise Report , many of the victims' hands were bound, and bodies were often discovered in public pit latrines . By 1 November 1996, all refugee camps between Goma and Rutshuru had been dismantled. The Kibumba camp's survivors moved toward Mugunga, while those from Kahindo and Katale were scattered into the dense forests of Virunga National Park . Attempting to evade interception by AFDL/RPA forces, refugees wandered through
6118-807: The Lowa River . Victims were killed either by gunfire or by brutal methods involving hammers and hoes . Deceptively lured with promises of UNHCR assistance for repatriation, most of the victims' bodies were discarded in the Lowa River. By mid-December 1996, AFDL/RPA forces advanced on the makeshift camps in Biriko, located in the Walowa-Luanda groupement . Refugees here were surrounded by soldiers from Ziralo and Bunyakiri in South Kivu and Ngungu in North Kivu. Hundreds of refugees, including women and children, were killed in
6251-1008: The Masisi Territory became a critical theater of pursuit and systematic violence as the AFDL and RPA advanced in their campaign. Their primary targets were refugees—mainly Rwandans—and ex-FAR/Interahamwe combatants fleeing westward towards Walikale. These columns of escapees, slowed by exhaustion and the harsh terrain, established temporary camps in villages across Masisi Territory, including Osso, Kinigi, Katoyi, Kilolirwe, Ngandjo, Nyamitaba, Miandja, Nyaruba, Kirumbu, and Kahira. Survivors from decimated camps such as Mugunga, Kibumba, Kahindo, and Katale were disproportionately represented among these disparate groups. The assault on refugees and Internally displaced persons escalated on 19 November 1996, when Mayi-Mayi fighters aligned with AFDL/RPA forces attacked Ngungu village. Backed by artillery , they indiscriminately slaughtered an estimated several hundred refugees and ex-FAR/Interahamwe combatants. Reports from
6384-741: The Ruwenzori Mountains , also committed widespread atrocities in Beni. In 2000, ADF-NALU forces kidnapped, enslaved, and killed hundreds of civilians. In January, they abducted over 100 people in Mutwanga, and in April, they attacked surrounding villages, forcibly recruiting children and enslaving women. Many victims endured malnutrition , physical abuse , and execution during captivity, with some forced to carry looted property over long distances. In November 2002, RCD-Goma launched an assault on Bushimoo village in
6517-846: The Tutsi population and harboring perpetrators of the 1994 Rwandan genocide , alternate reports, including those from the United Nations Security Council , implicated both factions in the systematic looting of Zaire 's mineral wealth and perpetrating massacres throughout the conflict. At the onset, North Kivu hosted a significant population of Rwandan refugees, estimated by the United Nations High Commissioner for Refugees (UNHCR) to number 717,991 in October 1996. Refugee camps , including Kibumba (194,986), Katale (202,566), and Kahindo (112,875), were strategically situated along
6650-795: The Uganda People's Defence Force (UPDF) took control of Beni without opposition. However, this occupation provoked substantial local resistance, with youth in Beni and Lubero joining the Mayi-Mayi groups. Strengthened by financial and military support from the Kinshasa government, the Mayi-Mayi launched attacks on UPDF convoys and engaged in violent confrontations with Ugandan forces. These clashes were further compounded by internal rivalries within Mayi-Mayi factions, notably between Chief Lolwako Poko Poko's Vurondo Mayi-Mayi and Chief Mudohu's forces. Efforts by
6783-504: The West African Ebola virus epidemic . Index cases of EVD have often been close to recently deforested lands. Like other filoviruses , EBOV replicates very efficiently in many cells , producing large amounts of virus in monocytes , macrophages , dendritic cells and other cells including liver cells , fibroblasts , and adrenal gland cells . Viral replication triggers high levels of inflammatory chemical signals and leads to
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#17328523784426916-675: The World Health Organization , there were 24 outbreaks of Ebola resulting in a total of 2,387 cases, and 1,590 deaths . The largest Ebola outbreak to date was an epidemic in West Africa from December 2013 to January 2016, with 28,646 cases and 11,323 deaths. On 29 March 2016, it was declared to no longer be an emergency. Other outbreaks in Africa began in the Democratic Republic of the Congo in May 2017, and 2018. In July 2019,
7049-556: The Zairean Red Cross documented the mass burials of victims to prevent outbreaks of epidemics. From 2–30 November, 2,087 bodies were buried in and around the Kibumba camp. Between 30 November 1996, and 26 January 1997, an additional 1,919 bodies were buried in the same area. At Kahindo Camp, 281 bodies were buried between 1–25 December 1996. At Katale Camp, 970 bodies were buried between 1 December 1996, and 18 January 1997. According to
7182-840: The alluvial plains of Semliki and Rwindi - Rutshuru , stretching from Lake Edward 's northern to southern shores. The steep Kabasha escarpment rises from Lake Edward's western bank, extending toward the Rwindi-Rutshuru plain, which is flanked by the massive Ruwenzori range (5,119 meters) to the east. Further south, the plain merges into volcanic lava fields leading to the Virunga Mountains , with prominent active volcanoes Nyamulagira (3,056 meters) and Nyiragongo (3,470 meters). The province features two major lakes: Lake Edward and Lake Kivu . Lake Edward, covering 2,150 square kilometers with 1,630 square kilometers in Congolese territory, reaches an average depth of 30 meters. It supports
7315-423: The cell membrane . Virions bud off from the cell, gaining their envelopes from the cellular membrane from which they bud. The mature progeny particles then infect other cells to repeat the cycle. The genetics of the Ebola virus are difficult to study because of EBOV's virulent characteristics. It is believed that between people, Ebola disease spreads only by direct contact with the blood or other body fluids of
7448-457: The execution of civilians . Detainees were often held in inhumane conditions, such as being confined in deep holes exposed to the elements. Protests against these abuses were met with lethal force, such as in March 2000, when UPDF soldiers killed four civilians during a demonstration in Beni. The Allied Democratic Forces–National Army for the Liberation of Uganda (ADF-NALU), an armed group based in
7581-535: The AFDL, while also issuing an order for the Rwandan Patriotic Army (RPA) soldiers to withdraw from Congolese territory. These actions provoked Rwanda and Uganda to support a new rebellion aimed at removing Kabila from power. On 2 August 1998, a mutiny within the Congolese military, the Forces Armées Congolaises (FAC), was announced on Radio-Télévision Nationale Congolaise (RTNC) in Goma . The mutiny led to
7714-533: The Bashali-Mokoto groupement faced a similar fate. In April 1997, AFDL/RPA forces attacked a school in the village of Humule, near Karuba—roughly fifty kilometers from Goma—killing 53 refugees. Further violence followed in May 1997 when AFDL/RPA units intercepted a group of refugees heading to the Karuba UNHCR transit center, where they hoped to facilitate their return to Rwanda. On 29 May, four people, including
7847-789: The Bashali-Mokoto groupement , killing an unverified number of people from the Hunde ethnic group. During the same period, Mayi-Mayi forces under Hunde's leadership retaliated by torching multiple Nyanga villages in the same region, resulting in further casualties and displacement. The cycle of violence intensified in January 2003, as RCD-Goma forces conducted coordinated attacks on the villages of Bushimoo, Kauli, and Binyungunyungu. Over three days (21–23 January), RCD-Goma troops indiscriminately killed civilians, set villages ablaze, and committed acts of sexual violence. A particularly egregious attack occurred on 22 January when approximately 15 civilians were executed on
7980-600: The Belgians occupied the post. After a series of incidents, the boundaries of the Congo, Uganda and Rwanda were settled in May 1910, with the eastern part of Kivu assigned to Uganda and the German colony of Rwanda. Kivu District was created by an arrêté royal of 28 March 1912, which divided the Congo into 22 districts. By 1954, Kivu District had been split into Sud-Kivu District and Nord-Kivu District . The First Congo War , which began in mid-October 1996, saw North Kivu become
8113-586: The Biriko camps through shootings or by being bludgeoned with hoes. Locals were forced to bury some of the victims, while others were discarded in the Nyawaranga River. The violence then spread to nearby villages, including Kilambo, Busurungi, Nyamimba, and Kifuruka. In Kifuruka, located 10 kilometers from Biriko, several hundred refugees were reportedly killed in December 1996. During the third week of December 1996, AFDL/RPA units committed mass killings in Musenge,
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#17328523784428246-664: The CDC began recommending that medical personnel receive training on the proper suit-up and removal of personal protective equipment (PPE); in addition, a designated person, appropriately trained in biosafety, should be watching each step of these procedures to ensure they are done correctly. In Sierra Leone, the typical training period for the use of such safety equipment lasts approximately 12 days. In 2022 in Uganda, lighter personal protection equipment has become available as well as possibilities to monitor and communicate with patients from windows in
8379-405: The Congo . The capital city is Goma . Spanning approximately 59,483 square kilometers with a population estimate of 8,147,400 as of 2020, it is bordered by Ituri Province to the north, Tshopo Province to the northwest, Maniema Province to the southwest, and South Kivu Province to the south, as well as Uganda and Rwanda to the east. North Kivu's administrative history traces back to
8512-705: The FAC in May 1999 targeted Goma neighborhoods, including Mukosasenge in Karisimbi , resulting in civilian casualties. Around 8 August 1999, RCD-Goma and RPA killed at least 17 civilians in the village of Otobora in Walikale Territory , many of whom were displaced persons from the neighboring village of Hombo. On 12 August 1999, RCD-Goma and RPA killed 44 civilians in the village of Miano in Masisi Territory , predominantly women and children of Tembo ethnicity. Victims were targeted based on their ethnic origin. Around 23 November 1999, RCD-Goma and RPA killed an unknown number of civilians in
8645-539: The Köppen-Geiger classification, North Kivu has a warm oceanic climate , with an annual average temperature of 18°C and average precipitation of 363.6 millimeters. Approximate correspondence between historical and current province North Kivu Province is systematically organized into a hierarchy of administrative divisions, which include territories , cities , chiefdoms ( collectivités ), sectors , groupements (groupings), and villages ( localités ). North Kivu comprises six territories. These territories are led by
8778-428: The Mutura border, according to UNHCR records. However, this exodus was perilous, with numerous reports of intimidation, coercion, and outright killings by AFDL/RPA soldiers targeting those seeking assistance. The scale of the violence against refugees became evident through reports from local organizations. NGOs such as the Équipe d'urgence de la biodiversité (EUB), the Association des Volontaires du Zaïre (ASVOZA), and
8911-426: The President's and Ministry's representative within the province. The territories in North Kivu include: The province consists of three cities— Goma , Butembo , and Beni . Each city is a decentralized administrative entity with official legal status and is led by a mayor appointed by a presidential decree on the advice of the Minister of the Interior and Security. The traditional governance of North Kivu
9044-941: The RCD-ML (Rally for Congolese Democracy–Liberation Movement) to incorporate these groups into its armed wing, the Armée Patriotique Congolaise (APC), failed, leading to intensified violence. In August 2000, confrontations between Vurondo Mayi-Mayi fighters and APC/UPDF troops in Lubero resulted in dozens of deaths, including civilians. Reports indicate that 17 civilians were killed, and seven Mayi-Mayi prisoners were summarily executed. In retaliation for Mayi-Mayi ambushes, UPDF forces launched indiscriminate attacks on villages suspected of harboring Mayi-Mayi fighters. These operations frequently involved mass civilian killings, destruction of property, and other acts of brutality. On 1 November 2000, UPDF soldiers reportedly executed between 7 and 11 civilians in Maboya and Loya, 16 kilometers north of Butembo , while setting ablaze 43 houses. Victims were either shot or burned alive. On 8 November 2000, close to
9177-643: The RCD-ML's control, its armed wing, the Armée Populaire Congolaise (APC), was implicated in atrocities targeting civilian populations. In Kiantsaba, a village near Beni, APC forces killed at least five civilians and razed homes. Meanwhile, APC troops, in coordination with the UPDF, clashed with Mayi-Mayi militias in the village of Irango. During these confrontations, the UPDF reportedly committed mass killings , sexual violence against young girls , and extensive property destruction, including arson and looting. The UPDF's presence in Beni extended beyond military confrontations. For several years, Ugandan forces established
9310-421: The Rutshuru corridor north of Goma. Additional camps, such as Mugunga (156,115) and Lac Vert (49,449), were located westward on the Sake route. These camps, positioned near critical transit routes and the Rwandan border, became focal points of military confrontation. On the evening of 27 June 1996, a clandestine Rwandan unit allegedly infiltrated the Kibumba refugee camp in Nyiragongo Territory , resulting in
9443-417: The Rwandan government's Congo Desk, facilitating the direct export of coltan to international markets. Despite the eventual downturn in coltan prices, military transfers persisted, as illustrated by the 5 October 2002, seizure of 36 tonnes of coltan belonging to Rwanda Metals in Tanzania. The DRC government accused Rwanda Metals of looting resources from the DRC, though the company contested the claim, asserting
9576-733: The Second Congo War, military control over natural resources , particularly coltan , became a lucrative enterprise for the Rwandan-backed rebel group RCD-Goma . Although a decline in coltan prices led to a reduction in direct Rwandan army management of certain mining sites, their vested interest in the coltan trade remained high, with RCD-Goma and other political entities actively participating. RCD-Goma facilitated substantial revenue flows from coltan; however, even greater profits were channeled to Rwanda, as military officials and Rwandan authorities diverted significant quantities of coltan across
9709-567: The Semliki plains, originating from lacustrine and fluvial deposits, while older, humus -rich soils are found in regions with deeper, clayey substrates, abundant in organic matter. Savannas dominate the alluvial plains of Semliki and Rutshuru, while shrubby , sclerophyllous formations are found on the lava plains north of Lake Kivu. Mountain rainforests grow primarily in the Rwenzori and Virunga massifs, while equatorial forests are extensive in
9842-458: The US it was ~18%, possibly due to improved prevention of disseminated intravascular coagulation . Recovery may begin between seven and 14 days after first symptoms. Death, if it occurs, follows typically six to sixteen days from first symptoms and is often due to shock from fluid loss . In general, bleeding often indicates a worse outcome, and blood loss may result in death. People are often in
9975-464: The United Nations and local witnesses indicate that no effort was made to distinguish civilians from combatants, with women and children among the fatalities. The following days saw continued massacres. In Osso, an improvised refugee camp adjacent to a local farm became a site of mass killing. Eyewitness accounts documented the presence of 20 to 100 bodies in the aftermath, though the actual death toll
10108-655: The Virunga National Park, an atrocity echoed in September 2003 in the nearby village of Mudja. Both incidents were marked by degrading treatment and indiscriminate abuse. In 2001, the Beni and Lubero regions in North Kivu became entrenched battlegrounds as various factions, including RCD-ML, Mayi-Mayi groups, UPDF, and elements of the FDLR, fought for territorial control. These conflicts were characterized by widespread violence against civilians, including extrajudicial killings , sexual violence , and systemic looting. Under
10241-542: The World Health Organization declared the Congo Ebola outbreak a world health emergency . The length of time between exposure to the virus and the development of symptoms ( incubation period ) is between 2 and 21 days, and usually between 4 and 10 days. However, recent estimates based on mathematical models predict that around 5% of cases may take longer than 21 days to develop. Symptoms usually begin with
10374-493: The air between humans or other primates . After recovering from Ebola, semen or breast milk may continue to carry the virus for anywhere between several weeks to several months. Fruit bats are believed to be the normal carrier in nature ; they are able to spread the virus without being affected by it. The symptoms of Ebola may resemble those of several other diseases, including malaria , cholera , typhoid fever , meningitis and other viral hemorrhagic fevers. Diagnosis
10507-463: The air has not been reported to occur during EVD outbreaks, and airborne transmission has only been demonstrated in very strict laboratory conditions, and then only from pigs to primates , but not from primates to primates. Spread of EBOV by water, or food other than bushmeat, has not been observed. No spread by mosquitos or other insects has been reported. Other possible methods of transmission are being studied. Airborne transmission among humans
10640-542: The assault. By 31 October, AFDL and RPA forces had reportedly executed hundreds of refugees who remained in Kahindo Camp. The United Nations Special Rapporteur on human rights violations in Zaire, Roberto Garretón, later estimated 143 deaths at Katale Camp and between 100 and 200 deaths at Kahindo Camp. As the AFDL/RPA offensive escalated, fear and desperation prompted some refugees to attempt repatriation to Rwanda. Between 26–31 October, approximately 900 refugees crossed
10773-706: The border is formed by the 30th meridian east." On this basis, all of Lake Kivu and both banks of the Ruzizi River were in the Free State. In June 1909, John Methuen Coote started the Kivu frontier incident when he travelled southwest from the British Uganda Protectorate and established fortified camps at Burungu and Rubona on Lake Kivu. British troops under Coote withdrew from the Rubona post on 29 June 1909, and
10906-565: The border. From January to October 2000, coltan exports from Rwandan-controlled eastern Democratic Republic of the Congo exceeded 445 tonnes , according to RCD-Goma's records. In late 2000, the organization implemented an export monopoly and declared 208 tonnes of coltan exports over the next two months. Accounting for both formal and clandestine transfers to Rwanda, annual production in the Kivu provinces likely reached between 1,400 and 1,700 tonnes in 2000. Estimates suggested that more than $ 60 million
11039-405: The breast milk of women after recovery, and it is not known when it is safe to breastfeed again. The virus was also found in the eye of one patient , in 2014, two months after it was cleared from his blood. Otherwise, people who have recovered are not infectious. The potential for widespread infections in countries with medical systems capable of observing correct medical isolation procedures
11172-524: The cases, the skin may develop a maculopapular rash , a flat red area covered with small bumps, five to seven days after symptoms begin. In some cases, internal and external bleeding may occur. This typically begins five to seven days after the first symptoms. All infected people show some decreased blood clotting . Bleeding from mucous membranes or from sites of needle punctures has been reported in 40–50% of cases. This may cause vomiting blood , coughing up of blood , or blood in stool . Bleeding into
11305-471: The cells' ability to produce and respond to interferon proteins such as interferon-alpha , interferon-beta , and interferon gamma . The VP24 and VP35 structural proteins of EBOV play a key role in this interference. When a cell is infected with EBOV, receptors located in the cell's cytosol (such as RIG-I and MDA5 ) or outside of the cytosol (such as Toll-like receptor 3 (TLR3) , TLR7 , TLR8 and TLR9 ) recognise infectious molecules associated with
11438-470: The colonial era when it was initially part of the Stanley Falls District within the Congo Free State . Following a series of territorial reorganizations, North Kivu became incorporated into Orientale Province , with Stanleyville (modern-day Kisangani ) as the provincial capital. The area gained provincial status in 1962 but was demoted to a district under Mobutu Sese Seko 's regime in 1965. It
11571-566: The coltan was mined domestically. Although the Tanzanian High Court dismissed the case, the provenance of the seized coltan remains uncertain. RCD-Goma, despite its self-appointed administrative authority, lacked the logistical and military resources necessary for extensive control over mining areas, as exercised by the Rwandan army. Nevertheless, it capitalized on the coltan trade by imposing numerous taxes and fees, including mining license charges, non-refundable deposits, export taxes, and
11704-717: The committee received 20% of the sale price, with RCD-Goma providing security. Ebola Ebola , also known as Ebola virus disease ( EVD ) and Ebola hemorrhagic fever ( EHF ), is a viral hemorrhagic fever in humans and other primates , caused by ebolaviruses . Symptoms typically start anywhere between two days and three weeks after infection. The first symptoms are usually fever , sore throat , muscle pain , and headaches . These are usually followed by vomiting , diarrhoea , rash and decreased liver and kidney function, at which point some people begin to bleed both internally and externally. It kills between 25% and 90% of those infected – about 50% on average. Death
11837-728: The deaths of three refugees, two soldiers from the Contingent Zaïrois pour la Sécurité des Camps (CZSC), and three Red Cross wardens. By October, the AFDL and RPA intensified their offensive, bombarding the Kibumba camp with heavy artillery on the night of 25–26 October, leaving an indeterminate number of refugees dead and obliterating the camp's hospital. Over 194,000 survivors fled toward Mugunga, while simultaneous assaults decimated Katale Camp despite initial resistance from Forces Armées Zairoises (FAZ)/CZSC personnel, ex- FAR combatants, and Interahamwe militias. Reports indicate several dozen refugees and one CZSC soldier were killed during
11970-501: The disease through droplets in the air or on the ground when they sneeze or cough. By contrast, humans and other primates accumulate the virus throughout their body and specifically in their blood, but not very much in their lungs. It is believed that this is the reason researchers have observed pig to primate transmission without physical contact, but no evidence has been found of primates being infected without actual contact, even in experiments where infected and uninfected primates shared
12103-441: The five different ebolaviruses (BDBV, EBOV, RESTV, SUDV and TAFV) differ in sequence and the number and location of gene overlaps. As with all filoviruses , ebolavirus virions are filamentous particles that may appear in the shape of a shepherd's crook, of a "U" or of a "6," and they may be coiled, toroid or branched. In general, ebolavirions are 80 nanometers (nm) in width and may be as long as 14,000 nm. Their life cycle
12236-574: The formation of the Rassemblement Congolais pour la Démocratie (RCD-Goma), a Tutsi-dominated rebel group supported by Rwanda. On the same day, the city of Goma fell into the hands of RCD-Goma and RPA without significant resistance. Goma remained under rebel control for nearly three years, from August 1998 to January 2001. On 25 February 1999, RCD-Goma and RPA forces massacred 45 civilians in Lukweti, Masisi Territory . Subsequent airstrikes by
12369-440: The former Kibumba camp. One of the most harrowing incidents occurred in April 1997 near Mwaro, close to the village of Kibumba. On 9 April AFDL/RPA soldiers intercepted refugees attempting to return to Rwanda. The victims were imprisoned in a mosque and a former farm building before being killed on 11 April. The number of victims is unknown, but accounts suggest the massacre claimed several hundred lives. In mid-November 1996,
12502-550: The general public about the risk factors for Ebola infection and of the protective measures individuals may take to prevent infection is recommended by the World Health Organization . These measures include avoiding direct contact with infected people and regular hand washing using soap and water. Bushmeat , an important source of protein in the diet of some Africans, should be handled and prepared with appropriate protective clothing and thoroughly cooked before consumption. Some research suggests that an outbreak of Ebola disease in
12635-441: The immune system by inhibiting early steps of neutrophil activation. Furthermore, the virus is capable of hijacking cellular metabolism. Studies have shown that Ebola virus-like particles can reprogram metabolism in both vascular and immune cells. Filoviral infection also interferes with proper functioning of the innate immune system . EBOV proteins blunt the human immune system's response to viral infections by interfering with
12768-504: The intercellular structure and causes liver damage, leading to improper clotting . The widespread bleeding that occurs in affected people causes swelling and shock due to loss of blood volume . The dysfunctional bleeding and clotting commonly seen in EVD has been attributed to increased activation of the extrinsic pathway of the coagulation cascade due to excessive tissue factor production by macrophages and monocytes. After infection,
12901-464: The legal ownership of the Canadian -based gold exploration and development company Banro Corp or the DRC government. In February 2001, an RCD-Goma committee awarded Medival Minerals Ltd., a Swiss company, an 18-month contract for cassiterite extraction in various concessions. In eastern DRC, coltan is often mislabeled as cassiterite to circumvent higher tantalum -related duties. Under this arrangement,
13034-453: The liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST); and abnormalities in blood clotting often consistent with disseminated intravascular coagulation (DIC) such as a prolonged prothrombin time , partial thromboplastin time , and bleeding time . Filovirions such as EBOV may be identified by their unique filamentous shapes in cell cultures examined with electron microscopy . The specific diagnosis of EVD
13167-546: The mineral. Return flights often carried arms and equipment back into the DRC. Civilian flights, which previously allowed local miners to sell coltan to local trading houses , were halted by military authorities to consolidate control over the trade. Civilians in military-controlled mining areas were frequently coerced into forced labor, and even paid miners had to sell their output to army officials at considerably reduced rates. Additionally, Rwandan soldiers served as private security for foreign-owned mining concessions, receiving
13300-640: The most recent in August 2022) and was the epicenter of the 2018–2020 Kivu Ebola outbreak, which was the second largest in history, resulting in over 3400 cases and 2200 deaths, following the 2014–2016 West Africa Ebola outbreak. Situated along the equator, North Kivu spans latitudes from 0° 58' north to 2° 03' south and longitudes from 27° 14' west to 29° 58' east. Its topography ranges from less than 800 meters to peaks exceeding 5,000 meters in altitude, comprising diverse formations including plains , plateaus , and mountainous regions. Notable lowland areas include
13433-480: The outbreak of hostilities in the DRC. American photojournalist and war correspondent Keith Harmon Snow asserted that Roger Winter, a key figure in the U.S. Committee for Refugees and Immigrants , orchestrated U.S.-endorsed insurgencies in Congo and neighboring states, including Rwanda, Sudan , and Uganda. In July 1998, driven by fears of a coup d'état , President Laurent-Désiré Kabila relieved Rwandan General James Kabarebe of his position as Chief of Staff of
13566-733: The park's inhospitable terrain for weeks. The volcanic landscape, marked by lava fields , offered little access to drinking water , leading to deaths from thirst and starvation . AFDL/RPA forces maintained relentless pressure on refugees. Checkpoints established between Mount Nyiragongo and Mugunga became sites of mass killings . Survivors reported that refugees intercepted at the park's exit were sorted by age and gender, with adult males systematically executed. The violence extended to makeshift camps within Virunga National Park, where refugees who sought temporary shelter were targeted. By February 1997, reports from local witnesses indicated that bodies of newly deceased refugees were discovered daily near
13699-461: The production of interferon-beta. By inhibiting these immune responses, EBOV may quickly spread throughout the body. When EVD is suspected, travel, work history, and exposure to wildlife are important factors with respect to further diagnostic efforts. Possible non-specific laboratory indicators of EVD include a low platelet count ; an initially decreased white blood cell count followed by an increased white blood cell count ; elevated levels of
13832-465: The province is confronted with ongoing security challenges stemming from armed groups , resource-related conflicts , and ethnic tensions . The Rwandan-backed M23 rebel group has been a significant source of instability . As of early 2024, M23-related violence had displaced approximately 1.7 million people, accounting for nearly 14% of North Kivu's population. North Kivu has also been the site of multiple outbreaks of Ebola virus disease (including
13965-491: The same air. Although it is not entirely clear how Ebola initially spreads from animals to humans, the spread is believed to involve direct contact with an infected wild animal or fruit bat. Besides bats, other wild animals that are sometimes infected with EBOV include several species of monkeys such as baboons , great apes ( chimpanzees and gorillas ), and duikers (a species of antelope ). Animals may become infected when they eat fruit partially eaten by bats carrying
14098-507: The semen of a male survivor tests negative for Ebola virus on two separate occasions. Survivors develop antibodies against Ebola that last at least 10 years, but it is unclear whether they are immune to additional infections. EVD in humans is caused by four of six viruses of the genus Ebolavirus . The four are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV) and one simply called Ebola virus (EBOV, formerly Zaire Ebola virus). EBOV, species Zaire ebolavirus ,
14231-455: The signalling proteins STAT1 and STAT2 are activated and move to the cell's nucleus . This triggers the expression of interferon-stimulated genes , which code for proteins with antiviral properties. EBOV's V24 protein blocks the production of these antiviral proteins by preventing the STAT1 signalling protein in the neighbouring cell from entering the nucleus. The VP35 protein directly inhibits
14364-456: The skin may create petechiae , purpura , ecchymoses or haematomas (especially around needle injection sites). Bleeding into the whites of the eyes may also occur. Heavy bleeding is uncommon; if it occurs, it is usually in the gastrointestinal tract . The incidence of bleeding into the gastrointestinal tract was reported to be ~58% in the 2001 outbreak in Gabon, but in the 2014–15 outbreak in
14497-735: The territories of Lubero , Masisi , Walikale , and Beni . Human activities have markedly influenced the province's vegetation, particularly through establishing single-species plantations , mainly comprising Eucalyptus saligna and Grevillea robusta . These plantations, alongside community-operated village plantations, constitute the principal legitimate wood-energy sources for populations proximate to Virunga National Park. Additional species, such as Acacia mearnsii , are also cultivated, often interplanted with food crops to provide supplementary revenue streams for local populations. These monoculture plantations, extending over approximately 11,200 hectares, play an indispensable role in meeting
14630-598: The treatment tents until it is necessary to enter if e.g. a patient's oxygen levels drop. The infected person should be in barrier-isolation from other people. All equipment, medical waste, patient waste and surfaces that may have come into contact with body fluids need to be disinfected . During the 2014 outbreak, kits were put together to help families treat Ebola disease in their homes, which included protective clothing as well as chlorine powder and other cleaning supplies. Education of caregivers in these techniques, and providing such barrier-separation supplies has been
14763-457: The victims were instead led to their deaths, being killed with sticks, hammers, and axes. Indigenous residents were coerced into participating in the killings and were later forced to bury the bodies. In the Nyarusukula district of Walikale , which had been transformed into a restricted military zone, hundreds of refugees were killed. Civilians were prohibited from entering the area, and most of
14896-424: The victims were women and children. In the following days, soldiers committed further atrocities near Kampala, a town close to Hombo. Refugees were burned alive along the road, while many women were subjected to sexual violence before being killed. In Chambucha , four kilometers from Hombo, soldiers intercepted several hundred refugees, including a significant number of women and children, and executed them near
15029-545: The victims' bodies were disposed of in the Lowa River and its tributaries. In early 1997, more killings were reported at the Kariki makeshift camp, 13 kilometers from Walikale. Refugees who sought safety here became easy targets for the AFDL/RPA forces, and most of the victims' bodies were left unburied. The Second Congo War profoundly affected North Kivu, as conflict erupted due to deteriorating relations between President Laurent-Désiré Kabila , Rwanda, and Tutsi soldiers within
15162-423: The village of Butuhe, 10 kilometers north of Butembo, Vurondo Mayi-Mayi attacked a UPDF convoy escorting lorries transporting minerals . Similarly, on 9 November 2000, UPDF soldiers attacked the village of Kikere, close to Butuhe, killing 36 civilians with rifles and rocket launchers and systematically destroying homes and livestock . The UPDF's reign of terror in Beni included arbitrary arrests , torture , and
15295-471: The village of Ngenge in Walikale Territory, indiscriminately opening fire on residents. On 24 November, RCD-Goma and RPA soldiers beat a group of senior figures in the village to death. The same soldiers "killed civilians in the neighboring villages of Kangati and Kaliki". On 5 February 2000, at least 30 people were killed by RCD-Goma and RPA forces in the village of Kilambo, Masisi Territory. A local NGO identified 27 victims. During this period, members of
15428-414: The viral nucleocapsid . The Ebolavirus structural glycoprotein (known as GP1,2) is responsible for the virus' ability to bind to and infect targeted cells. The viral RNA polymerase , encoded by the L gene, partially uncoats the nucleocapsid and transcribes the genes into positive-strand mRNAs , which are then translated into structural and nonstructural proteins. The most abundant protein produced
15561-597: The virus and that the filoviruses are present in Asia. Between 1976 and 1998, in 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from regions of EBOV outbreaks, no Ebola virus was detected apart from some genetic traces found in six rodents (belonging to the species Mus setulosus and Praomys ) and one shrew ( Sylvisorex ollula ) collected from the Central African Republic . However, further research efforts have not confirmed rodents as
15694-399: The virus include the nose, mouth, eyes, open wounds, cuts and abrasions. Ebola may be spread through large droplets ; however, this is believed to occur only when a person is very sick. This contamination can happen if a person is splashed with droplets. Contact with surfaces or objects contaminated by the virus, particularly needles and syringes, may also transmit the infection. The virus
15827-572: The virus is most reliable in the later stages of the disease and in those who recover. IgM antibodies are detectable two days after symptom onset and IgG antibodies can be detected six to 18 days after symptom onset. During an outbreak, isolation of the virus with cell culture methods is often not feasible. In field or mobile hospitals, the most common and sensitive diagnostic methods are real-time PCR and ELISA. In 2014, with new mobile testing facilities deployed in parts of Liberia, test results were obtained 3–5 hours after sample submission. In 2015,
15960-428: The virus takes place. From there the virus can enter the bloodstream and lymphatic system and spread throughout the body. Macrophages are the first cells infected with the virus, and this infection results in programmed cell death . Other types of white blood cells , such as lymphocytes , also undergo programmed cell death leading to an abnormally low concentration of lymphocytes in the blood. This contributes to
16093-434: The virus. Fruit production, animal behavior and other factors may trigger outbreaks among animal populations. Evidence indicates that both domestic dogs and pigs can also be infected with EBOV. Dogs do not appear to develop symptoms when they carry the virus, and pigs appear to be able to transmit the virus to at least some primates. Although some dogs in an area in which a human outbreak occurred had antibodies to EBOV, it
16226-459: The virus. On TLR activation, proteins including interferon regulatory factor 3 and interferon regulatory factor 7 trigger a signalling cascade that leads to the expression of type 1 interferons . The type 1 interferons are then released and bind to the IFNAR1 and IFNAR2 receptors expressed on the surface of a neighbouring cell. Once interferon has bound to its receptors on the neighbouring cell,
16359-422: The weakened immune response seen in those infected with EBOV. Endothelial cells may be infected within three days after exposure to the virus. The breakdown of endothelial cells leading to blood vessel injury can be attributed to EBOV glycoproteins . This damage occurs due to the synthesis of Ebola virus glycoprotein (GP), which reduces the availability of specific integrins responsible for cell adhesion to
16492-432: The wild animals used for consumption may result in a corresponding human outbreak. Since 2003, such animal outbreaks have been monitored to predict and prevent Ebola outbreaks in humans. If a person with Ebola disease dies, direct contact with the body should be avoided. Certain burial rituals , which may have included making various direct contacts with a dead body, require reformulation so that they consistently maintain
16625-511: The wood-energy demands of North Kivu's residents, particularly in Goma. In 2011, the EcoMakala project emerged as a geographically integrated REDD+ initiative to mitigate emissions from deforestation and forest degradation . Between 2020 and 2021, EcoMakala+ secured USD 1.3 million in funding, allowing North Kivu to become the first province in the Democratic Republic of the Congo to capitalize on carbon credit sales. North Kivu's climate
16758-462: Was approved by the US FDA in December 2019. While there is no approved treatment for Ebola as of 2019 , two treatments ( atoltivimab/maftivimab/odesivimab and ansuvimab ) are associated with improved outcomes. Supportive efforts also improve outcomes. These include oral rehydration therapy (drinking slightly sweetened and salty water) or giving intravenous fluids , and treating symptoms. In October 2020, atoltivimab/maftivimab/odesivimab (Inmazeb)
16891-671: Was approved for medical use in the United States to treat the disease caused by Zaire ebolavirus . Ebola was first identified in 1976, in two simultaneous outbreaks, one in Nzara (a town in South Sudan ) and the other in Yambuku ( the Democratic Republic of the Congo ), a village near the Ebola River , for which the disease was named. Ebola outbreaks occur intermittently in tropical regions of sub-Saharan Africa . Between 1976 and 2012, according to
17024-499: Was approved in the United States in December 2019. It appears to be fully effective ten days after being given. It was studied in Guinea between 2014 and 2016. More than 100,000 people have been vaccinated against Ebola as of 2019 . The WHO reported that approximately 345,000 people were given the vaccine during the Kivu Ebola epidemic from 2018 to 2020. Community awareness of the benefits on survival chances of admitting cases early
17157-1061: Was directed to local trading houses ( comptoirs ) during the peak months of the trade, while the Rwandan army reportedly accrued upwards of $ 250 million over an 18-month period from coltan exported to Rwanda. These profits largely benefitted Rwandan and RCD-Goma military elites, business figures, and other individuals with ties to the Rwandan government . The Rwandan army's extraction and transfer operations were organized and controlled by senior commanders stationed in key territories such as Walikale and Masisi . Checkpoints were established to monitor and restrict civilian access to mining areas, while major towns and airstrips became stockpiling sites for coltan awaiting air or road transport. To facilitate these operations, new airstrips were built, and military helicopters, along with contracted companies such as Swala Express, Bukavu Air Transport , and Kivu-Air , transported coltan from remote mining zones directly to Rwanda, where state-operated facilities were used to store
17290-477: Was dissolved in April 2001 due to the Rwandan army's disregard for RCD-Goma's control, withholding of stocks by trading houses, and a decline in tantalum prices. Letters from RCD-Goma officials expressed concern over revenue losses due to direct coltan exports to Rwanda by Rwandan forces. Monthly exports, estimated at 46 tonnes and valued at up to $ 21 million on the global market. RCD-Goma also capitalized on its authority by selling coltan concessions, even those under
17423-491: Was formally reinstated in 1988 under Ordinance-Law No. 88/1976 and Ordinance-Law No. 88-031, which redefined the previous Kivu Province into tripartite separate provinces: North Kivu, South Kivu, and Maniema. Presently, North Kivu comprises three cities— Goma , Butembo , and Beni —and six territories : Beni , Lubero , Masisi , Rutshuru , Nyiragongo , and Walikale . A 2013 decree also proposed city status for Kasindi , Oïcha , and Luholu. The province's eastern border
17556-559: Was likely higher. In early December 1996, AFDL/RPA forces attacked a makeshift camp in Mbeshe Mbeshe, Katoyi Chiefdom, killing hundreds of refugees and Zaireans indiscriminately. Survivors recalled the brutal nature of these assaults, with camps turned into death traps as soldiers opened fire on unarmed civilians. On 8 November 1996, survivors from Kahindo and Katale camps settled in Bashali Chiefdom , only to face renewed attacks by AFDL/RPA soldiers. Around 18 November, these forces stormed
17689-599: Was systematically looted. The indigenous Twa communities in North Kivu suffered disproportionately during this period. Accused of collaborating with various armed factions, the Twa people were subjected to repeated attacks by both RCD-Goma soldiers and FDLR. Crimes against the Twa people included rape , arbitrary detention , and other inhumane acts rooted in both ethnic prejudice and superstitious beliefs. In March 2003, RCD-Goma forces gang-raped numerous Twa women in Mubambiro, near
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