Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 27 July 2018

Content Ebola Virus Disease: DRC Cholera: Niger Measles: Mauritius cVDPV2: DRC Other Events Under Follow - up

Public Health Emergencies (AFRO) 9 Humanitarian Crises 45 Outbreaks 2 Grade 3 events 4 Grade 1 events 36 Ungraded events 2 Grade 2 events Health EMERGENCIES Program

Ebola Virus Disease: DRC On 24 July 2018, the Min. of Health, Dr Oly declared the end of the ninth outbreak of EVD in the country. The announcement comes 42 days (two incubation periods) after blood samples from the last confirmed Ebola patient twice tested negative for the disease WHO Director-General, Dr Tedros and RD for Africa, Dr. Moeti, commend the country and partners in the response against the outbreak while urging them to extend this success to combatting other diseases in the DRC The outbreak was contained due tireless efforts of local teams, support of partners, the generosity of donors, and the effective leadership of the MoH From 20 - 21 July 2018, WHO supported the harmonization and validation of the wide range of data arising from the outbreak response As of 24 July 2018: 54 suspected cases including 33 deaths have been reported (CFR – 61%) 38 confirmed, 16 probable Geographical distribution of EVD cases, DRC, 5 April – 24 July 2018 As part of the next phase of the Ebola virus disease response, WHO will support the Government to undertake an After-Action Review with partners and donors to review lessons learned and to determine how best to leverage resources and knowledge from the first two phases of the response to strengthen health systems and national resilience under a National Action Plan for Heath Security.

Measles: Mauritius Geographical distribution of measles cases in Mauritius, 21 Mar- 17 Jul 2018 Since 21 March 2018: Mauritius has been reporting measles cases on an increased trend A peak was observed in week 24 (ending 17 June 2018) when more than 80 cases were reported. As of 8 July 2018, a total of 435 cases, including three deaths (CFR - 0.7%) have been reported from nine districts. The three deaths had unknown vaccination status, with ages of 29 and 31 years. All 435 cases have been confirmed by the virology laboratory of Candos Vaccination status as of the reporting date: 29% were vaccinated 45% were not vaccinated 26% had unknown vaccination status. PUBLIC HEALTH ACTIONS Strengthening active search case affected areas. Isolation and management of cases in different Vaccination sessions scheduled on Saturdays for adults age 15- 45 yrs who have not been vaccinated

Distribution of cVDPV2 cases, DRC, 13 Feb - 25 July, 2018 cVDPV2: DRC Distribution of cVDPV2 cases, DRC, 13 Feb - 25 July, 2018 Since 13 February 2018, the ongoing outbreak of the cVDPV2 was declared a national public health emergency A cumulative total of 29 confirmed cVDPV2 cases have been reported from six provinces, with no death Ituri, the most recent affected area, when an AFP case with onset of paralysis on 5 May 2018 was reported from Gethy close to the border with Uganda Circulation of the strain was confirmed when the same strain was isolated in stool specimens from two healthy community contacts. WHO assessed the overall public health risk National level - very high International spread - high Public Health Measures: The national poliomyelitis outbreak plan has been adopted AFP surveillance Strengthen Vaccination of travelers against polio

Geographical distribution of cholera cases in Niger, 5 - 17 July 2018 Cholera: Niger On 13 July 2018: MoH notified WHO of an outbreak of cholera involving 23 cases including three deaths in Maradi Region on the border with Nigeria The first three case patients, aged 1, 3, and 6, belonging to the same family from Nigeria, that were admitted to a local hospital in Niger on 5 July 2018. As of 17 July 2018, a total of 123 suspected cases with four deaths (CFR - 3.3%) have been reported from ten villages in Madarounfa district, Maradi region on the border with Nigeria Nineteen of the cases are reportedly from the Nigerian side of the border. So far, the peak in incidence was on 15 July 2018, when 24 new cases were reported Geographical distribution of cholera cases in Niger, 5 - 17 July 2018 PUBLIC HEALTH ACTIONS Strengthening the surveillance system and active search case affected areas. Management of cholera cases in different CTU WASH & IPC practices are being improved

Geographical distribution of cholera cases, DRC wk 29, 2018 Cholera: DRC Geographical distribution of cholera cases, DRC wk 29, 2018 The cholera outbreak continues to evolves with 513 new cases including 24 deaths (CFR - 4.7%) reported in week 28, 2018. Since January 2018, a total of 13,777 cholera cases with 432 deaths (CFR – 3.1%), has been reported Fourteen of 26 provinces reported at least one cholera case during the reporting week The Kasai region remains the most affected, with 50% of cases reported in week 28. Generally, there is an increased trend in the number of cases across the country. PUBLIC HEALTH ACTIONS Strengthening the surveillance system and active search case affected areas. Management of cholera cases in different CTU IPC practices are being improved through use of PPE

Other Events Under follow -Up Hepatitis E (HEV) : South Sudan Since 3 January 2018, a total of 116 suspected cases have been reported Of these, 16 have been confirmed by Laboratory. Use of stagnant water for domestic or recreation purposes is likely to be source of infection. Hepatitis E (HEV) : Namibia From Jan 2018, a total of 1,915 cases including 17 deaths (CFR - 0.9%) 178 laboratory confirmed 1,355 have epidemiological Lassa Fever: Nigeria Six new confirmed cases were reported in wk 28 Since week 1, 2018: 2,201 suspected cases including 116 (CFR-25.3%) Of these, 459 cases Lab confirmed Rift Valley Fever: Uganda Since 29 June 2018, 8 suspected cases including 2 deaths have been reported 4 Lab confirmed (CFR – 50%) 4 Suspected 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) Measles: Ethiopia During week 28, 2018, 56 new cases were reported. Since week 1, 2018, a total of 2,625 suspected cases have been reported across the country of which 699 have been Laboratory confirmed

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