1. Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 01 June 2018

2. Content Public Health Emergencies Ebola Virus Disease: DRC1
Ebola Virus Disease: DRC
Lassa Fever: Nigeria 2 3
Anthrax: Uganda 4
Cholera: Tanzania 5
Other Events Under Follow - up
Public Health Emergencies

3. Public Health Emergencies (AFRO)
10 Humanitarian Crises
54 Outbreaks 2
Grade 3 events 5
Grade 1 events 5
Grade 2 events 43
Ungraded events
Health
EMERGENCIES
Program
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

4. Ebola Virus Disease: DRC
The EVD outbreak in Equateur Province, Democratic Republic of Congo is still active
On 27 May 2018: One new suspected EVD case was reported. There were no new confirmed cases and Deaths
Since 4 April 2018:
56 suspected cases, including 25 deaths (CFR 46.9%).
35 cases confirmed
13 probable (deaths for which specimens were not obtained)
3 remain suspected
5 HCWs have been affected with two deaths
A total of 906 contacts have been recorded and are being followed up actively
Geographical distribution of EVD in DRC 4 Apr - 27 May 2018
The index case in this outbreak has not yet been identified and epidemiologic investigations are ongoing, including laboratory testing.
The outbreak is still localized to the three health zones initially affected: Iboko (27 cases and 6 deaths), Bikoro (22 cases and 16 deaths) and Wangata (5 cases and 3 deaths)
Risk Assessment:
National level: very high
Regional level: High
At global level: Risk is currently considered low
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

5. Public Health Measures
WHO recommends the implementation of proven strategies for the prevention and control of the Ebola outbreak.
Strengthening the multi -sectorial coordination
Enhanced surveillance
Strengthening diagnostic capabilities
A total of 426 people have been vaccinated in two rings in Mbandaka
since the launch of the ring vaccination exercise on 21 may 2018
WHO and partners have completed
Assessment of EVD readiness in six neighboring countries:
Burundi, CAR, Congo, Rwanda, South Sudan and Tanzania.
Cross border surveillance at POEs has been strengthened
According to the advice of the IHR Emergency Committee (EC), which was convened by the WHO Director-General on 18th May 2018, WHO currently advises against the application of any travel or trade restrictions to Democratic Republic of the Congo. In addition, the EC advised that exit screening at airports and ports on the Congo River is considered to be of great importance to detect probable cases and to prevent the international spread of Ebola; entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value. The IHR Emergency Committee advised that currently the outbreak does not meet the criteria for a Public health emergency of international concern, but the vigorous response of the Government should continue to be supported by the international community.
As of 28 May, 23 countries have implemented entry screening for international travellers coming from Democratic Republic of the Congo, but there are currently no restrictions of international traffic in place. WHO continues to monitor travel and trade measures in relation to this event. WHO is working with partners on the ground (IOM and CDC) to map the points of entry in airports, ports and ground crossings, and to set up or further strengthen appropriate screening systems at strategic points of entry.
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

6. Lassa fever: Nigeria From January - 31 May 2018:
Epicurve of Lassa fever Confirmed (431) and Probable (10) Cases in Nigeria week 1- 21, 2018
From January - 31 May 2018:
a total of 1,968 s suspected cases have been reported from 21 states
Of these: 431 were confirmed including 108 deaths (CFR – 25.%),
10 are probable,
1,523 negative and 4 pending
38 health care workers have been affected
A total of 5,327 contacts have been identified
55(1%) are being followed up, 5261(98.8%) have completed 21 days
11(0.2%) lost to follow up.
82 symptomatic contacts of which 28 (36%) have tested positive
PUBLIC HEALTH ACTIONS
National Lassa fever After Action Review Meeting (AARM) scheduled for of June 2018
National intensive clinical workshop on diagnosis, management and control of Lassa Fever in scheduled for June 2018
National Lassa fever multi-sectorial EOC TWG continues to coordinate the response activities at all levels
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

7. Human Anthrax: Uganda Since February 2018:
Uganda has been experiencing recurrent outbreaks of anthrax with four districts being affected
As of 30 May 2018:
83 human cases
10 cases confirmed
7 probable
In-depth epidemiologic and ecological investigations are ongoing
Geographical distribution of anthrax cases in Uganda, 3 February - 23 May 2018
PUBLIC HEALTH MEASURES:
Active surveillance is ongoing for humans and animal cases
Communication and social mobilization
Case management is ongoing in the local health facilities.
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

8. Weekly trend of cholera cases in Tanzania Mainland,
Cholera: Tanzania
Weekly trend of cholera cases in Tanzania Mainland,
Week 1, 2018 – week 21, 2018
The cholera outbreak in Tanzania has escalated in recent weeks
In week 20:
249 new suspected cholera cases with eight deaths (CFR - 3.2%) have been reported,
compared to 44 cases reported in week 19.
As of 29, May 2018:
2,105 suspected cholera cases, including 44 deaths (CFR-2%)
Three out of 26 regions currently have active transmission,
PUBLIC HEALTH MEASURES:
Active Surveillance for AWD ongoing
WASH activities are ongoing
Risk communication and social mobilization
The outbreak of cholera in Tanzania Mainland is getting worse, with
a rapid increase in the number of new cases seen in recent weeks.
The ongoing heavy seasonal rain is facilitating the transmission of
infection, unhindered by any concrete response on the ground
Source: WHO Health Emergencies AFRO week 21 bulletin on outbreaks and public health emergencies

9. Other Events Under Follow-up
Cholera: Zimbabwe:
Since 23 March 2018: a total of 64 suspected cases with three deaths (CFR %) have been reported, as of 16 May 2018.
Of these, 22 cases have been confirmed, two cases classified as probable and 38 cases remained suspected
Measles: Guinea
A total of 1, 113 suspected cases including nine deaths
267 samples tested IGM positive.
76% were not vaccinated for measles despite vaccination campaign efforts in 2017
Listeriosis : South Africa
As of 29 May 2018:
1, 033 confirmed cases, including 204 deaths (CFR %) have been reported
Gauteng Province has been the most affected, with 59% of the total caseload
Monkey Pox: CAR
On 20 May 2018: 20 cases including one death have been reported.
Nine samples have tested positive for Monkey Pox
Measles: Algeria
A total of 2, 320 cases including 5 deaths have been reported

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