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Epidemiological Update onPublic Health Emergencies WHO Country Office, Liberia10August 2018
Content Ebola Virus Disease: DRC Guinea Worm: South Sudan Hepatitis E: Namibia Other Events Under Follow - up Cholera: Niger
Public Health Emergencies (AFR) 2 Grade 3 events 4 Grade 1 events 10 Humanitarian Crises 36 Ungraded events 3 Grade 2 events 47 Outbreaks Health EMERGENCIES Program
Ebola Virus Disease: DRC • On 1 August 2018: the MoH of DRC notified WHO of a new outbreak in North Kivu Province, in the eastern part of the country • hosts over 1 million displaced people. • shares borders with Rwanda and Uganda with cross border movement due to the trade activities • The announcement was issued little more than a week after the MoH declared the end of an outbreak in Equateur Province some 2500 km from North Kivu • Since 28 July 2018: a total of 43suspected cases including 34 deaths (CFR -79%) reported • 16tested positive for EVD • 27 probable • 31 suspected • A total of two health workers have been affected with CFR of 50% Geographical distribution of EVD cases, DRC, 28 July - 3 August 2018 • Geographically, all the cases are currently localized to five health zones in North Kivu Province • Current Risk Assessment: • National Level : High • Regional Level: High • Global Level: Low
Ebola Virus Disease: DRC • The majority of the cases are in the Mangina health area: • an active conflict zone. • The major barrier will be safely accessing the affected population • As of 5 August 2018, 966 contacts have been registered and follow up • A total of 28 key PoEs have been identified to strengthen surveillance capacity to rapidly detect and respond to potential new Ebola cases • There are 3,220 doses of vaccine available in Kinshasa and the MOH started vaccination of contacts and front-line workers on 8 August 2018 • WHO recommends • Strengthening multi-sectoral coordination of the response, • Enhanced surveillance (active case finding, Case investigation, Contact tracing and surveillance at Points of Entry) • IHR travel measures and cross border health • WHO advises against any restriction of travel and trade to the DRC based on the currently available information • As investigations continue to establish the full extent of this outbreak, it is important for neighboring
Guinea Worm: South Sudan Geographical distribution of GW disease cases South Sudan, 27 May - 23 Jul 2018 • On 23 July 2018, the South Sudan MoH declared the outbreak in Western Lakes State, located in the central part of the country • Between May and July 2018: 3 out of 25 worm specimens tested positive for Guinea Worm at US CDC Laboratory • The confirmed cases, two females and one male aged 14, 17 and 25 years, respectively, are all cattle keepers by occupation • Until this event, the last case of Guinea worm in South Sudan was confirmed in December 2016 • Detailed investigations are ongoing to ascertain the • source of disease, close contacts • and the open water sources visited by the cases after the worms emerged
Cholera: Niger Geographical distribution of cholera cases in Niger, 5 July - 5 August 2018 • On 13 July 2018, the Niger MoH notified WHO of a cholera outbreak in Madarounfa District, Maradi Region at the border with Nigeria • In epi-week 31(ending 5 August 2018), 129 new suspected cases were reported compared to 322 including two deaths during week 30, 2018 • Since 5July 2018: a total of 739 suspected cases Including 11 deaths (CFR - 1.5%) have been reported. • 54% of the suspected cases are between 2 and 14 years, while 46% are 15 years and above. • The outbreak has remained localized to Madarounfa District • The initial case-patients were found to have epidemiological links to Nigeria • PUBLIC HEALTH ACTIONS • Active surveillance has been strengthened • Management of cholera cases in different CTUs • WASH & IPC practices are have been initiated in affected communities
Hepatitis E: Namibia Geographical distribution of hepatitis E cases in Namibia, 27 May - 18 July 2018 • The outbreak of hepatitis E in Namibia continues to evolve, with one new region being affected • In epi-week 31(ending 5 August 2018), 520 new suspected cases with one death reported • As of 29July 2018: a total of 2,435 suspected cases Including 20 deaths (CFR - 0.8%) have been reported • Of the 2, 435 cases, 250 have been laboratory confirmed by IgM ELISA. • Of the 20 deaths, 50% occurred in women during pregnancy or post-delivery • Four regions are currently experiencing the disease outbreaks • PUBLIC HEALTH ACTIONS • Active case search ongoing in affected regions • Health education materials and case management posters have been distributed. • Repair of water taps and sanitation facilities is ongoing
Lassa Fever: Nigeria Geographical distribution of confirmed Lassa fever cases in Nigeria as of 5 August, 2018 • During week 31 (ending August 5, 2018) • nine new confirmed cases were reported with two new deaths • From January – 5 August 2018: • a total of 2,334 s suspected cases have been reported from 22 states • Of these: 481 were confirmed including 123 deaths (CFR – 25.6%), • 10 are probable, • 1844 negative • 39 health care workers have been affected • Ten patients are currently being managed at treatment Centres • A total of 6,383 contacts have been identified • 439(6.9%) are being followed up, 5846 (91.6%) have completed 21 days • 88 symptomatic contacts of which 30 (34%) have tested positive • PUBLIC HEALTH ACTIONS • Lassa fever TWG continues to coordinate the response activities at all levels • Enhanced surveillance scaled up across the country • Harmonization of laboratory and surveillance data ongoing
Other Events Under follow -Up • Monkey Pox: CAR: • Cumulatively, since 2 March 2018: • 29 cases of Monkeypox including one death (CFR -3.4%) have been reported 11 cases laboratory confirmed • RVF and CCHF: Uganda • As of 9 July 2018, 8 suspected cases of RVF, • 4 laboratory confirmed including 2 deaths (CFR - 50%) • cVDPV2: DRC • A cumulative total of 29 confirmed cVDPV2 cases have been reported from six provinces, with no death • Dengue : Ethiopia • since 19 January, A total of 125 cases have been reported. The outbreak was due in Gode Zone of Somali Region • Measles : Mali: • Since week 1 of 2018, a total of 1,136 suspected cases with zero deaths have been reported • Of these, 265 have been confirmed (IgM-positive) • cVDPV2: Nigeria: • From 30 January through 23 May 2018: ten environmental samples collected from two collection sites tested positive for genetically-related VDPV2 viruses • Nipah virus: India: • As of 17 July 2018: a total of 19 Nipah virus (NiV) cases, including 17 deaths, were reported from Kerala State. • Cholera: Nigeria • As of 18 July 2018: a total of 16,892 suspected cases Including 201 deaths (CFR - 1.2%) have been reported from 17 states