1. Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 16 March 2018

2. Content Public Health Emergencies 1 2 3 4 Lassa Fever: Nigeria
Rift Valley Fever: South Sudan 3
Meningitis: AFRO Region 4
Listeriosis: South Africa
Public Health Emergencies

3. Public Health Emergencies (AFRO)
9 Humanitarian Crises
41 Outbreaks 1
Protracted Grade 2 event 2
Protracted Grade 3 events 9
Grade 1 events 2
Grade 3 events 31
Ungraded events 5
Grade 2 events
Source: WHO Health Emergencies AFRO week 10 bulletin on outbreaks and public health emergencies

4. Lassa Fever: Nigeria
Week 10: 12 new confirmed cases, including 4 deaths (CFR – 33.3%) reported from 7 states
From 1 January to 11 March 2018: 1,386 suspected cases and 114 deaths (CFR – 8.2%) reported from 19 states
Laboratory: 1,362 cases tested were positive while 9 cases were classified as probable.
CFR (confirmed and probable) -24.7% (72/374)
A total of 3,323 contacts have been identified and 1,150 (34.6%) are still under follow up
Public Health Response
National Lassa fever EOC continues to coordinate response
A comprehensive incident action plan developed
National Rapid Response Teams deployed
Dedicated Lassa fever treatment units established and ribavirin is available for treatment
NCDC teams deployed to four Benin Republic border states
Risk communication
Geographical distribution of Confirmed Lassa Fever cases in Nigeria as at 11th March, 2018
Confirmed (365) and Probable (9) Cases of Lassa fever by epidemiological week in Nigeria week 50, 2017 to week 10, 2018
Source: NCDC week 10, 2018 Situation report on Lassa fever

5. Rift Valley fever: South Sudan
Week 10: Eight new suspected cases reported
Yirol East (5) and Yirol West (3)
As of 9 March 2018: a total of 40 cases and four deaths have been reported.
Confirmed (6), probable(3), negative(19), and 12 suspect RVF cases (with pending laboratory results)
Women (57.1%); aged years (72.2%)
Since the beginning of the outbreak, a total of 28 animal samples have been tested
9 RVF positive (three IgM and six IgG), 6 suspected RVF (based on IgG and IgM serological titres), and 13 RVF negative.
PUBLIC HEALTH ACTIONS
Joint Ministry of Health and Ministry of Livestock and Fisheries press briefing
Coordination of response by a multi-sectoral task force at the national and sub-national (Yirol East) levels.
Surveillance for suspected human and animal cases by community workers
Social mobilization and awareness
Development of multisector RVF preparedness and response framework

6. Meningitis: AFRO Region
Week 7: 625 new cases with 44 deaths reported from 18 countries
From week 1 to 8, a cumulative total of 4,173 suspected meningitis cases with 310 deaths have been reported by countries of the belt under enhanced surveillance (CFR 7.4%).
A total of 1,561 samples have been tested out of 4,173 cumulative suspected cases. (37.4%).
Spn remains the dominant germ with 105/177 (59%) of positive results.
At week 8, two districts, one in Ghana and one in South Sudan reached the epidemic threshold
Map of Meningitis main pathogens reported weeks 01 – 08, 2018
Source: WHO IST West Africa Week 7 Meningitis Bulletin

7. Listeriosis: South Africa
From 1 January 2017 to 8 March 2018: 967 laboratory-confirmed cases reported
183 deaths reported out 669 confirmed cases with outcome data available (CFR %)
Gauteng Province has reported the most cases (59.1%; 572/967)
Source of the outbreak has been identified to be an Enterprise food production facility in Polokwane, Limpopo Province
PUBLIC HEALTH ACTIONS
Recall of Enterprise’s entire domestic and international distribution networks
The registration for exports temporarily suspended
An investigation of the RCL Wolwehoek production facility is underway.
Risk communication messages have been issued advising the public not to eat all processed meat products that are sold as ready-to-eat
On 12 January 2018, nine children under the age of 5 years from the same crèche presented to Chris Hani Baragwanath Hospital in Johannesburg with febrile gastroenteritis. A food-borne illness was suspected, with listeriosis as a possible cause. Environmental Health Practitioners (EHPs) visited the crèche and obtained samples from two unrelated brands of polony (Enterprise and Rainbow Chicken Limited (RCL)), which were submitted for testing. Listeria monocytogenes was isolated from the stool of one ill child and from both polony specimens. Whole genome sequencing and genomic analysis by the NICD Centre for Enteric Diseases confirmed the ST6 sequence type on all three isolates on 27 January Whole genome sequencing analysis was performed on environmental samples collected from the Enterprise factory, confirming the outbreak strain ST6, and showing the source of the outbreak to be the Enterprise food production facility in Polokwane, Limpopo Province.

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