Epidemiological Update on Public Health Emergencies WHO Country Office, Liberia 29 June 2018

Content Public Health Emergencies Ebola Virus Disease: DRC 1 Rift Valley Fever: Kenya 2 Cholera: Uganda 3 4 Cholera: Nigeria Public Health Emergencies Other Events Under Follow - up 5

Public Health Emergencies (AFRO) 10 Humanitarian Crises 44 Outbreaks 2 Grade 3 events 2 Grade 1 events 2 Grade 2 events 40 Ungraded events Health EMERGENCIES Program Source: WHE AFRO week 25 bulletin

Ebola Virus Disease: DRC Geographical distribution of the EVD cases in DRC, 24 June 2018 The MoH and WHO continue to closely monitor the EVD outbreak in the DRC Since 17 June 2018: No new confirmed case or death has been reported On 24 June 2018, two new suspected cases were reported in Bikoro Health Zone Since 4 April 2018: 55 cases including 28 deaths have been reported 38 confirmed, 14 probable 3 suspected CFR in confirmed and probable cases is 54% A total 24 case-patients with confirmed EVD have been cured and discharged 5 HCWs have been affected with two deaths 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 25 bulletin

Ebola Virus Disease: DRC The focus of the response remains on intensive surveillance, including active case finding, investigation of suspected cases and alerts and contact tracing. As of 23 June 2018, 172 contacts were under follow up and were expected to complete the mandatory monitoring on 27 June 2018. Implementation of ring vaccination protocol: a total of 3, 268 people have been vaccinated the target are front-line health professionals, people who have been exposed to confirmed EVD cases and contacts of these contacts A total of 60 children orphaned by EVD have been identified and cared for with food and medicines Source: WHE AFRO week 25 bulletin

Public Health Measures: DRC WHO is supporting neighboring countries to systematically assess and take action on Ebola preparedness, and develop national contingency response plans. A community dialogue about signs, mode of transmission, prevention measures and community involvement in EVD response was conducted 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

Rift Valley Fever: Kenya The RVF outbreak in Kenya continues to evolve, with two other counties reporting confirmed cases Since week 23, additional 44 cases including 6 deaths have been reported From 2 - 21 June 2018: 54 cases, including 11 deaths (CFR - 20.4%), have been reported from three counties As of 21 June 2018, three confirmed case-patients were in admission Of the 25 samples tested, nine were confirmed All the human cases are primarily herders who are epidemiologically linked to suspected RVF livestock cases Geographical distribution of RFT cases in Kenya, 2 - 21 June 2018 Public Health Measures: A national RVF TC chaired by the Director of Veterinary Services, has been constituted Meets weekly to review the situation and provide technical guidance to the counties. The MoH has activated the EOC For the past two months, the Ministry of Livestock has been reporting high numbers of deaths among animals, as well as abortions in camels and goats in four counties: Marsabit (bordering Ethiopia), Wajir (bordering Ethiopia and Somalia), Kitui (east of Nairobi) and Kadjiado (bordering Tanzania). These areas are known to be endemic for RVF. Source: WHE AFRO week 25 bulletin

Cholera: Uganda Kampala, has been experiencing an insidious cholera outbreak since the end of April 2018. On 20 June 2018, 16 new suspected cholera cases were admitted to the Cholera Treatment units Since 29, Apr 2018: a total of 92 suspected cholera cases and one death (CFR -1.1%) have been reported 26 specimens have cultured Vibrio cholerae sero type Ogawa This outbreak emerged when a 40-year-old woman presented to a public hospital with acute watery diarrhoea and vomiting and a stool specimen tested positive for Vibrio Cholera on 29 April 2018. Geographical distribution of cholera cases in Uganda, 29 April - 20 June 2018 Public Health Measures: A cholera task force has been activated Active surveillance is ongoing 139 zones across Kampala identified as hot spots for potential cholera transmissions. Assessments for compliance with standards carried out in public places and homes Source: WHE AFRO week 25 bulletin

Cholera : Nigeria The cholera outbreak in Adamawa State, north-east Nigeria continues In week 25 (ending 24 June 2018), 99 new suspected cholera cases and one death were reported, compared to 85 cases and four deaths reported in week 24. On 24, 2018: a total of 17 patients were admitted across three cholera treatments centres (CTCs). Since 12 May 2018: a total 1,412 cases and 25 deaths (CFR - 1.8%) have been reported, as of 24 June 2018. Of 68 stool samples collected and tested using cholera rapid diagnostic tests, 47 (69%) were positive for Vibrio Cholerae Geographical distribution of cholera cases in North - east Nigeria, 12 May - 24 June 2018 Public Health Measures: WASH: chlorination at water points, disinfection of latrines, hygiene promotion and education on the dangers of open defecation Active surveillance is ongoing Source: WHE AFRO week 25 bulletin

Other Events Under Follow-up Flood: Ivory Coast From June 18 - 19, 2018: Côte d’Ivoire suffered heavy rains which led to a great deal of material damage and loss of life. A total of 20 deaths has been reported and 115 wounded people hospitalized Dengue Fever: Ethiopia Since 8 June 2018: 52 cases in the flood affected Gode Zone of Somali Region have been confirmed by laboratory Cholera: DRC From week 1 to 23: 11,582 cases with 308 deaths (CFR-2.7%) has been reported in DRC. This has been graded 3 by WHO. Cholera: Zambia On 15 June 2018, the Zambian MoH officially declared the end of cholera outbreak in the country. The declaration came 14 days since the last confirmed cholera case was reported in the country. a total of 5, 935 cholera cases, with 114 deaths (CFR-1.9%), were reported. Monkey Pox: DRC Since week 1, 2018: 1,210 suspected cases of Monkeypox including 28 deaths), have been reported. 34 cases confirmed

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