1. Epidemiological Update on Public Health Emergencies
WHO Country Office, Liberia 13 July 2018

2. Content Rift Valley Fever: Uganda cVDPV2: DRC Ebola Virus Disease: DRC
Lassa Fever: Nigeria
Other Events Under Follow - up

3. Public Health Emergencies (AFRO)
11 Humanitarian Crises
46 Outbreaks 2
Grade 3 events 4
Grade 1 events 39
Ungraded events 2
Grade 2 events
Health
EMERGENCIES
Program

4. Rift Valley Fever: Uganda
Geographical distribution of RVF cases in Uganda, 29 Jun – 9 Jul, 2018
On 29 June 2018, the Uganda MoH notified WHO of RVF outbreak in Isingiro and Kasese districts.
Two unrelated simultaneous cases were confirmed by RT-PCR on 28 June 2018 and both died while at hospitals in Mbarara and Kasese districts
The first case-patient was a 47-year-old male whose main occupation was as a butcher and died at home with blood oozing from orifices.
Since 29 June 2018, 8 suspected cases including 2 deaths have been reported
4 Lab confirmed (CFR – 50%)
4 Suspected
Additionally, 55 animal specimens were collected from the farm where one of the confirmed cases worked
PUBLIC HEALTH ACTIONS
A national RRT have been deployed to affected districts
Active surveillance is being enhanced in affected districts.
IPC practices are being improved through use of PPE

5. Distribution of cVDPV2 cases
cVDPV2: DRC
Distribution of cVDPV2 cases
1 Jan - 29 June, DRC
In DRC, three different (cVDPV2) outbreaks have been detected of acute flaccid paralysis (AFP) cases since February 2018.
In June 2018, the last confirmed case from Ituri Province close to the border with Uganda, from an AFP case with onset of paralysis on 5 May 2018 was reported.
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
This risk is magnified by known population movements between the affected area of DRC, Uganda, CAR and South Sudan, and the upcoming rainy season which is associated with increased intensity of virus transmission.
WHO Advice
Countries with frequent travel with DRC
should strengthen AFP surveillance
travelers be fully vaccinated against polio
WHO assessed the overall public health risk at the national level to be very high and the risk of international spread to be high due to the proximity of the recent detection of the AFP case in Ituri which is close to an international border and with known population movement.
WHO assessed the overall public health risk at the national level to be very high and the risk of international spread to be high. This risk is magnified by known population movements between the affected area of Democratic Republic of the Congo, Uganda, Central African Republic and South Sudan, and the upcoming rainy season which is associated with increased intensity of virus transmission.

6. Ebola Virus Disease: DRC
Geographical distribution of the EVD cases in DRC, 10 June 2018
The MoH and WHO continue to closely monitor the EVD outbreak in the DRC
on 27 June, 2018, Contact tracing activities concluded after the last people with potential exposure to the virus completed 21-day follow-up
On 12 June, the last confirmed Ebola virus disease was discharged following two negative tests
A period of 42 days (2 incubation periods) must elapse before the outbreak can be declared over.
Since 4 April 2018:
55 suspected cases including 29 deaths have been reported
38 confirmed, 14 probable
CFR in confirmed and probable cases is 55%
5 suspected cases are awaiting lab results
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.
The review included the development of a 90-day enhanced surveillance and response plan for the continuation of core activities after the end of the outbreak, as well as planning for sustaining local and national capacities for to ongoing health emergency response across the Democratic Republic of the Congo
On 3 July 2018, WHO reviewed the level of public health risk associated with the current outbreak. The latest assessment concluded that the current Ebola virus disease outbreak has largely been contained, considering that over 21 days (one maximum incubation period) have elapsed since the last laboratory-confirmed case was discharged and that contact tracing activities ended on 27 June However, there remains a risk of resurgence from potentially undetected transmission chains and possible sexual transmission of the virus by male survivors. It is therefore, critical to maintain all key response pillars until the end of the outbreak is declared. Strengthened surveillance mechanisms and a survivor monitoring program are in place to mitigate, rapidly detect and respond to respond to such events. Based on these factors, WHO considers the public health risk to be moderate at the national level.
Risk Assessment:
National level: High
resurgence from potentially undetected transmission chains and possible sexual transmission of the virus by male survivors
Regional level: Low
At global level: Low

7. Epi curve of Lassa fever cases in Nigeria week 1- 27, 2018
Lassa Fever: Nigeria
During week 27 (July 2-8, 2018) seven new confirmed cases including three deaths were reported
From 1 January – July 8, 2018:
2,115 suspected cases have been reported
Of the total cases reported
Confirmed – 446 cases including 115 deaths
Probable - 10
CFR in confirmed cases is 25.4%
21 states have reported at least one confirmed
15 states have exited the active phase
81% of confirmed cases are from Edo state
Four cases are currently in T unit
A total of 5,713 contacts
156(2.7%) are currently being followed up,
5547 (97.1%) have completed 21 days
10(0.2%) were lost to follow
85 symptomatic contacts, 29 (34%) tested positive
Geographical Distribution of Confirmed Lassa Fever cases in Nigeria as at 8 July, 2018
Epi curve of Lassa fever cases in Nigeria week 1- 27, 2018

8. Strong Winds: Guinea Bissau
On 27 June 2018, the country was hit by strong winds at the speed of 80 to 150 km/h,
according to the National Meteorological Agency.
This resulted in hundreds of houses, social infrastructure (schools, hospitals, roads, etc.) to be destroyed in the capital city.
As of reporting day, a total of 2,000 families and 11,000 people have been affected including 6 deaths.

9. Other Events Under follow -Up
Rabies: DRC
A total of 100 cases with 18 deaths (CFR- 18%) have been reported from week 1 to 25, 2018.
Monkey Pox: DRC
Since week 1, 2018: 2,924 suspected cases of Monkeypox including 36 deaths (CFR – 1.2%), have been reported. 34 cases confirmed
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: Uganda
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
Cholera: Nigeria
In week 27, 140 new suspected cholera cases and one death were reported, compared to 99 cases and one death reported in week 24
Since 12 May 2018: 1,583 cases and 26 deaths (CFR - 1.6%) have been reported, as of 6 July 2018.
47 specimen have been tested positive for Vibrio Cholerae
Rift Valley Fever: Kenya
From May 21 – 4 July 2018:
94 cases, including 10 deaths (CFR - 11%), have been reported from three counties
cVDPV2: Papua New Guinea
On 21 May 2018, the regional polio reference laboratory reported to WHO the isolation of VDPV1 from a child with AFP in Papua New Guinea

10. THANK YOU