Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 21 June 2018

Content Public Health Emergencies Ebola Virus Disease: DRC 1 Ebola Virus Disease: DRC Hepatitis E: Namibia 2 Lassa Fever: Nigeria 3 Other Events Under Follow - up 4 Public Health Emergencies

Public Health Emergencies (AFRO) 9 Humanitarian Crises 46 Outbreaks 2 Grade 3 events 2 Grade 1 events 5 Grade 2 events 38 Ungraded events Health EMERGENCIES Program Source: WHE AFRO week 24 bulletin

Ebola Virus Disease: DRC The EVD outbreak in Equateur Province, DRC is still active Since 06 June 2018: No new confirmed or death has been reported On 15 June 2018, five new suspected cases were reported in Bikoro Health Zone Since 4 April 2018: 62 suspected cases, including 28 deaths (CFR 49.1%) 38 cases confirmed 14 probable 10 suspected 62 % (23) of the confirmed cases from Iboko 5 HCWs have been affected with two deaths Geographical distribution of the EVD cases DRC, Week 24, 2018 Risk Assessment: National level: Very high Regional level: High At global level: Low Risk Assessment: National level: very high due to the serious nature of the disease Regional level: High confirmed case in Mbandaka, located on a major national and international river, increases the risk for further spread to neighboring countries. At global level: Risk is currently considered low. Source: WHE AFRO week 24 bulletin

Ebola Virus Disease: DRC The outbreak remains localized to the three health zones initially affected. 52% from Iboko (27), 40% from Bikoro (21), 8% from Wangata (4) The primary focus of response has moved from urban areas to most remote and hard to reach places (Iboko) A total of 289 contacts are under follow up, while 1,417 have completed the 21-day follow-up Implementation of ring vaccination protocol: a total of 3,017 people have been vaccinated (including HCWs and people exposed to confirmed EVD cases) Risk Assessment: National level: very high due to the serious nature of the disease Regional level: High confirmed case in Mbandaka, located on a major national and international river, increases the risk for further spread to neighboring countries. 1199 vaccinated At global level: Risk is currently considered low. Source: WHE AFRO week 24 bulletin

Public Health Measures: DRC WHO continues to support neighboring countries to enhance their preparedness and readiness to detect and contain EVD should it be introduced A community dialogue about signs, mode of transmission, prevention measures and community involvement in EVD response was conducted with 37 local leaders Ongoing risk communication and social mobilization activities: mass awareness campaign through TV, radio, and social mobilization teams are on going Risk Assessment: National level: very high due to the serious nature of the disease Regional level: High confirmed case in Mbandaka, located on a major national and international river, increases the risk for further spread to neighboring countries. At global level: Risk is currently considered low. Source: WHE AFRO week 24 bulletin

Hepatitis E: Namibia The Hepatitis outbreak in Namibia has shown an increased trend in the last two weeks In week 23, a total of 61 new suspected cases were reported, compared to 59 in week 22 Since week 36 2017: 1,524 suspected cases and 16 deaths (CFR -1.0%) have been reported 113 cases confirmed 1137 epidemiologically linked 207 suspected Six of the deaths occurred in pregnant women 76% of the most affected age group is between 20 and 39 years While 59% of cases are male. Geographical distribution of hepatitis E cases in Namibia, Week 24, 2018 Public Health Measures: The National HEMC continues to coordinate response interventions WASH implementation activities are ongoing Active surveillance is ongoing Risk Assessment: National level: very high due to the serious nature of the disease Regional level: High confirmed case in Mbandaka, located on a major national and international river, increases the risk for further spread to neighboring countries. At global level: Risk is currently considered low. Source: WHE AFRO week 24 bulletin

Lassa Fever: Nigeria In Week 24 (ending June 17, 2018): One new confirmed case was reported from Ondo state. From January – June 17, 2018: a total of 2,022 suspected cases have been reported from 21 states Of these: 438 were confirmed including 109 deaths (CFR – 24.9%), 10 are probable, 38 health care workers have been affected including 9 deaths Five states remain in active outbreak phase A total of 5,595 contacts have been identified 5341(95.5%) have completed 21 days 244 (4.4%) contacts are still under follow up Epi curve of Lassa fever Confirmed (438) and Probable (10) Cases in Nigeria week 1- 24, 2018 PUBLIC HEALTH ACTIONS: National Lassa fever After Action Review report produced Active case search ongoing National Lassa fever multi-sectorial EOC TWG continues to coordinate the response activities at all levels Source: NCDC week 24 bulletin

Other Events Under Follow-up Measles: Sierra Leone From June 4 - 14, 2018: 19 confirmed cases have been reported Koinadugu district on the border with Guinea; cases were reportedly from unvaccinated children who sought care in nearby health facilities close to the border. Lassa fever : Sierra Leone Since 2018: A total of 16 confirmed cases including 6 deaths have been reported from Bo (2) and Kenema (14) districts Monkey Pox: Cameroon Since 26 May 2018: 19 suspected cases, including 8 deaths (CFR- 42%). Lassa Fever: Nigeria From January – June 20, 2018: a total of 2,022 suspected cases have been reported from 21 states Of these: 438 were confirmed including 109 deaths (CFR – 24.9%), Measles: Guinea Since week 8, 2018: 1,113 including 9 deaths (0.8%) 267 samples tested IGM positive. 76% were not vaccinated for measles despite vaccination campaign efforts in 2017 following a large epidemic Measles: DRC As of week 24, 2018: 3,404 cases including 30 deaths (0.9%), have been reported.

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