Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 06 April 2018

Content Public Health Emergencies 1 Cholera : Angola 2 Cholera: Mozambique 3 Cholera : Tanzania 4 Monkey Pox: Central African Republic Other Events Under Follow - up 5 Public Health Emergencies

Public Health Emergencies (AFRO) 57 Events 9 Humanitarian Crises 44 Outbreaks 2 Grade 3 events 8 Grade 1 events 5 Grade 2 events 34 Ungraded events Source: WHO Health Emergencies AFRO week 13 bulletin on outbreaks and public health emergencies

Geographical distribution of cholera cases, Angola, 25 – 30 March 2018 Cholera: Angola Angola is experiencing cholera outbreaks in two of its eight provinces: Uíge: in the north-western Cabinda: an exclave province between DRC and the Republic of Congo. Uíge Accounts for (805 cases and 12 deaths) 56.3% of suspected cases reported using wells (cacimba) as their main source of drinking water As of 26 January 2018: 819 cases including 13 deaths (CFR – 1.6%) In both outbreaks, samples from reported cases tested positive for Vibrio cholerae 01 by stool culture at the National Public Health Laboratory (INSLP). Geographical distribution of cholera cases, Angola, 25 – 30 March 2018 PUBLIC HEALTH ACTIONS Surveillance and active case finding activities are ongoing in high risk areas. Risk communication is being conducted by the Angola FETP and the NRC in neighborhoods of Uíge. Angola is experiencing cholera outbreaks in two of its eight provinces: Uíge, which is located in the north-western part of the country, and Cabinda, which is an exclave province located between the Democratic Republic of the Congo and the Republic of Congo. The outbreak in Uíge was notifed on 21 December 2017 and has been ongoing for 14 weeks with a clear downward trend in the last 11 weeks. Source: WHO Health Emergencies AFRO week 13 bulletin on outbreaks and public health emergencies

Cholera: Mozambique The cholera outbreak in northern Mozambique is ongoing in two adjacent provinces: Nampula and Cabo From Mid August 2017 – March 25, 2018: 2, 285 cases including 5 deaths (CFR – 0.2%) As of 25 March 2018: four districts and two cities are actively reporting cholera cases The main hotspots of the outbreak are Memba district (848 cases) and Pemba city (352 cases). Laboratory specimens collected in Nampula during a rapid assessment tested positive Epi curve of Cholera cases in Mozambique, Week 47, 2017 - Week 13, 2018 PUBLIC HEALTH ACTIONS WHO is supporting multi-sectoral coordination and response activities cholera treatment centres (CTCs) have been established in affected districts Provision of technical support in surveillance, case management, contact tracing, community awareness Nampula (1,642 cases and 2 deaths) Cabo Delgado (643 cases and 3 deaths). Source: WHO Health Emergencies AFRO week 13 bulletin on outbreaks and public health emergencies

Cholera : Tanzania The cholera outbreak in Tanzania is showing a declining trend overall, despite an increase in week 12 of five cases This is a significant reduction in case incidence as compared to 321 cases and 7 deaths reported in week 9 Bulletin Three regions have been the hotspot for the outbreak in 2018: Dodoma, Rukwa and Ruvuma, while In 2017 the hotspot regions were: Songwe, Mbeya, Dodoma, Ruvuma, Morogoro, Iringa and Kigoma Geographical distribution of cholera cases in Tanzania, week 11 - week 12, 2018 A total of 1, 445 Cases including 27deaths (1.9%) has been reported Public Health Measures The WASH component of the Cholera Elimination Plan, is expected to be launched in May or June 2018. WASH interventions are ongoing in affected and non-affected areas Source: WHO Health Emergencies AFRO week 13 bulletin on outbreaks & PHE

Monkey Pox: CAR On 17 March 2018: the MOH officially declared an outbreak of Monkey pox in Bambara district On 2 March 2018: the index case developed symptoms, while on 16 March 2018: the last suspected case was notified. Four of the eight cases (50%) were male; all cases were over 5 years of age while three patients were hospitalized. As of 25 March 2018: 8 cases with zero deaths (CFR - 0%) 6 confirmed cases One contact of a case developed suspicious lesions and laboratory confirmation is pending Geographical distribution of monkey pox cases in CAR, 15 Feb - 21 Mar 2018 PUBLIC HEALTH ACTIONS The response plan to Monkeypox is being updated. Free healthcare is being offered Regular follow-up of contacts of confirmed cases is ongoing Source: WHO Health Emergencies AFRO week 13 bulletin on outbreaks & PHE

Other Events Under Follow-up Cholera: Republic of Congo: (New event) As of 25 March 2018: 32 suspected cases of cholera including 1 death were reported in the departments of Mongolo (28 suspected) and Liranga (4 suspected) near the Congo River. Measles: Algeria From January 25 – March 13, 2018: 2 320 cases including 5 deaths have been reported from 13 wilayas Cholera : DRC From week 1 to 8 of 2018: 6 080 cases including 140 deaths(CFR: 2.3%) In week 8, 571 new cases and 22 deaths reported, Nationwide: 60, 492 cases including 1, 288 deaths (CFR; 2.1%) have been reported Measles: DRC This is an ongoing outbreak since the beginning of 2017. As of week 8 in 2018: 48, 326 cases including 563 deaths (CFR 1.2%) Since 2018: 3, 404 cases including 30 deaths (0.9%) were reported.

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