WHO Grade 3 Emergencies [to 1 April 2017]
Iraq: Within hours of opening its doors, Athbah trauma field hospital treats casualties from west Mosul
29 March 2017 – Mosul, Iraq — With medical capacities to treat severely wounded people significantly reduced due to conflict and coupled with the increased trend of traumatic injuries among civilians, the World Health Organization, the Federal Ministry of Health and Ninewa Department of Health has opened a trauma field hospital in Athba.

South Sudan
WHO’s famine response plan in South Sudan focuses on working with partners to prevent spread of diseases amongst people weakened by food insecurity
Juba, 30 March 2017 – The World Health Organization (WHO) continues to scale up its response to reduce preventable deaths and diseases, and provide health services in famine-affected areas of South Sudan. In February 2017, famine was declared in the former Unity State, where 100 000 people face starvation and another 1 million are on the brink of famine.

WHO joins partners at South Sudan’s National Health Summit to build a resilient health system and attain greater access to health services
Juba, 27 March 2017— The third National Health Summit for South Sudan opened today with some 500 participants coming together to consider the challenges and opportunities of delivering health in South Sudan, and to establish a clear vision for health in the years ahead.

The Syrian Arab Republic
Addressing the silent impact of war: WHO expands mental health care services across Syria 27 March 2017

Nigeria – No new announcements identified
YemenNo new announcements identified


WHO Grade 2 Emergencies [to 1 April 2017]
Central African Republic  – No new announcements identified.
Democratic Republic of the CongoNo new announcements identified.
EthiopiaNo new announcements identified.
LibyaNo new announcements identified.
MyanmarNo new announcements identified.
Niger  – No new announcements identified.
Ukraine  – No new announcements identified.


UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises.
:: Iraq: Mosul Humanitarian Response Situation Report No. 26 (20-26 March 2017) [EN/AR/KU]

:: 31 Mar 2017 Syria: US $3.4 billion needed to provide life-saving assistance for 13 million people
:: 30 Mar 2017 Statement to the Security Council on the humanitarian situation in Syria

:: Humanitarian coordinator in Yemen, Jamie McGoldrick, statement on the humanitarian situation in Yemen two years into the escalation of the conflict [EN/AR]
Sana’a, 28 March 2017
Two years of relentless conflict in Yemen have devastated the lives of millions of people. An alarming 18.8 million of them- almost two thirds of the population- need some kind of humanitarian or protection support. This man-made disaster has been brutal on civilians. Some seven million women, children, and men could risk famine in 2017.
:: Under-Secretary General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O’Brien – Statement on Yemen 26 Mar 2017


POLIO [to 1 April 2017]
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 29 March 2017
:: This week, synchronized polio campaigns were conducted across 13 countries in west and central Africa including Nigeria, Chad, Cameroon, Guinea, Mali, and Niger. Over 190 000 vaccinators aimed to immunize more than 116 million children over the course of the campaign.

Country Updates [Selected Excerpts]
New cases or environmental samples reported across the monitored country/region settings: Afghanistan, Pakistan, Nigeria, Lake Chad Basin. Guinea and West Africa, and Lao People’s Democratic Republic have been removed from the monitored geographies list.
:: One new wild poliovirus type 1 (WPV1) case was reported in the past week, from Kunduz province, with onset of paralysis on 21 February. It is the most recent case in the country, and brings the total number of WPV1 cases for 2017 to three. For 2016, the case count remains 13.
:: One new WPV1 environmental positive sample was reported in the past week, from Kandahar, collected on 26 January.
:: Two new WPV1 positive environmental samples were reported in the past week, from Killa Abdullah and Pishin, Balochistan, collected on 1 and 2 March, respectively.


Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

Zika virus [to 1 April 2017]
WHO podcast episodes 2017
Zika virus has been reported in dozens of countries around the world from 2015 onwards. WHO’s experience over 2016 has shown that Zika virus and the associated neurological complications represent a long-term public health challenge.
In a series of 5 podcasts on Zika, we bring you stories of Evidence in action.

Yellow Fever [to 1 April 2017]
March 28, 2017
Brazil Works to Control Yellow Fever Outbreak, with PAHO/WHO support
Washington, D.C., (PAHO/WHO)—Brazil is carrying out mass vaccination campaigns for yellow fever in the states of Minas Gerais, Espirito Santo, Sao Paulo, Rio de Janeiro and Bahia, while strengthening surveillance and case management throughout the country since an outbreak of sylvatic yellow fever began in January. More than 18.8 million doses of vaccine have been distributed, in addition to routine immunization efforts.
The Pan American Health Organization/World Health Organization (PAHO/WHO) is providing specialized technical cooperation to the federal authorities managing the outbreak and has mobilized more than 15 experts, including experts from the Global Outbreak Alert and Response Network (GOARN), in disease control, surveillance, virology, immunization and other fields to collaborate with health officials in the affected states. These experts have been operating with field teams in surveillance, response, and control operations in Minas Gerais, Espirito Santo and Rio de Janeiro States…

Disease outbreak news
Yellow fever – Suriname
28 March 2017
On 9 March 2017, the National Institute for Public Health and the Environment (RIVM) in the Netherlands reported a case of yellow fever to WHO. The patient is a Dutch adult female traveller who visited Suriname from the middle of February until early March 2017. She was not vaccinated against yellow fever…

EBOLA/EVD [to 1 April 2017]
No new digest content identified for this edition.

MERS-CoV [to 1 April 2017]
No new digest content identified for this edition.


Meningococcal disease – Nigeria
Disease outbreak news – 24 March 2017
As of 19 March 2017 (epidemiological week 11), a total of 1407 suspected cases of meningitis and 211 deaths (case fatality rate: 15%) have been reported from 40 local government areas (LGAs) in five states of Nigeria since December 2016. Zamfara, Katsina and Sokoto account for 89% of these cases. Twenty-six LGAs from all five states reported 361 cases in epidemiological week 11 alone. Twenty-two wards in 15 LGAs have crossed the epidemic threshold. Three of these LGAs share borders with Niger. NmC is the predominant serotype in this outbreak.

The most affected age group is 5 to 14 year olds and they are responsible for about half of reported cases. Both sexes are almost equally affected.

Public health response
WHO and partners including National Primary Health Care Development Authority, UNICEF, Nigeria Field Epidemiology and Laboratory Training Program, eHealth Africa, Médecins Sans Frontières, Rotary International, Nigeria Centre for Disease Control, and Gavi, the Vaccine Alliance (Gavi) are providing support to this outbreak.*

The following measures are being implemented:
:: Nigeria Centre for Disease Control, with support from the WHO, is taking the overall lead in coordinating the response at the national level.
:: Daily coordination meetings are being held at the state and LGA levels.
:: The rapid response teams are conducting active case finding, performing lumbar puncture of suspect cases and training local staff on case management.
:: Case management is being carried out at the public health centres at the LGA level.
:: 19,600 persons were vaccinated with the meningococcal ACWY vaccine in Gora ward in Zamfara state.
:: 500,000 doses of Gavi-supported meningococcal AC PS vaccines and injection supplies were approved by the International Coordination Group (ICG) for use in Zamfara State and arrived on 27 March 2017.**
;; Katsina state is preparing an ICG request for submission.

WHO risk assessment
The successful roll-out of MenA conjugate vaccine has resulted to the decreasing trend of meningitis A, however, other meningococcal serogroups are still causing epidemics. The most recent outbreak that has been reported was in Togo due to Neisseria meningitidis serogroup W (see Disease Outbreak News as published by WHO on 23 February 2017).

WHO advice
The outbreak response consists of appropriate case management with reactive mass vaccination of populations. Promptness of the reactive campaign is essential, ideally within four weeks of crossing the epidemic threshold.
WHO does not recommend any travel or trade restriction to Nigeria based on the current information available on this outbreak.


WHO & Regional Offices [to 1 April 2017]

WHO launches global effort to halve medication-related errors in 5 years
29 March 2017 – WHO today launched a global initiative to reduce severe, avoidable medication-associated harm in all countries by 50% over the next 5 years.

Marshall Islands triumphs against lymphatic filariasis
1 April 2017 – The country is the latest to join six others in WHO’s Western Pacific Region: Cambodia, China, Cook Islands, Niue, the Republic of Korea and Vanuatu are already validated for eliminating the disease as a public health problem. In 2016, WHO validated the Maldives and Sri Lanka – both from the South East-Asia Region – for having achieved elimination. Lymphatic filariasis is a mosquito-borne disease that damages the lymphatic system, leading to severe disfigurement, pain and disability.

Depression tops list of causes of ill health
31 March 2017 – WHO’s World Health Day campaign, the high point of which is 7 April, is themed “Depression: let’s talk”. The campaign’s aim is to have more people with depression, in all countries, both seek and get help. According to the latest WHO estimates, more than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015.


WHO’s famine response in South Sudan focuses on working with partners to prevent spread of diseases
April 2017 – WHO continues to scale up its response to reduce preventable deaths and diseases, and provide health services in famine-affected areas of South Sudan. Currently 100,000 people in the region face starvation and another 1 million are on the brink of famine.

France to recommend colour-coded nutrition labelling system
March 2017 – France has decided to recommend an easy to read labelling system that uses colour codes to guide consumers on the nutritional value of food products. The Nutri-Score system can help limit the consumption of foods high in energy, saturated fats, sugar or salt.

10th meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases
March 2017 – The meeting, taking place on 29–30 March 2017, will cover issues on Global Vector Control Response, examination of dossiers requesting the potential inclusion of diseases as NTDs, gaps in disease elimination, eradication of dracunculiasis, integrated data management, and the 2nd WHO NTD Global Partners’ Meeting.

Global Health Sector Strategy on Viral Hepatitis
March 2017 – Worldwide, approximately 240 million people have chronic hepatitis B infection and 80 million people have chronic hepatitis C infection. A dedicated portal has been developed for the first ever Global Health Sector Strategy on Viral Hepatitis 2016–2021.

Weekly Epidemiological Record, 31 March 2017, vol. 92, 13 (pp. 145–164)
:: Epidemic meningitis control in countries of the African meningitis belt, 2016
:: Ensuring the timely supply and management of medicines for preventive chemotherapy against neglected tropical diseases

IVB Announcements
:: STI vaccine consultant pdf, 224kb 28 March 2017
Deadline for application: 21 April 2017

:: WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
No new digest content identified.

WHO Region of the Americas PAHO
:: Brazil Works to Control Yellow Fever Outbreak, with PAHO/WHO support (03/28/2017)

WHO South-East Asia Region SEARO
:: Saima Wazed Hossain is WHO Champion for Autism in South-East Asia Region 1 April 2017

WHO European Region EURO
:: Helping Syrians cope with depression 30-03-2017
:: Feeling low in adolescence 29-03-2017
:: New report offers in-depth analysis of health situation in Republic of Moldova 27-03-2017
:: Measles outbreaks across Europe threaten progress towards elimination
Copenhagen, 28 March 2017
Over 500 measles cases were reported for January 2017 in the WHO European Region. Measles continues to spread within and among European countries, with the potential to cause large outbreaks wherever immunization coverage has dropped below the necessary threshold of 95%.
“With steady progress towards elimination over the past 2 years, it is of particular concern that measles cases are climbing in Europe,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “Today’s travel patterns put no person or country beyond the reach of the measles virus. Outbreaks will continue in Europe, as elsewhere, until every country reaches the level of immunization needed to fully protect their populations.”
Two-thirds of the Region’s 53 countries have interrupted endemic transmission of measles; however, 14 remain endemic, according to the Regional Verification Commission for Measles and Rubella Elimination (RVC)…
“I urge all endemic countries to take urgent measures to stop transmission of measles within their borders, and all countries that have already achieved this to keep up their guard and sustain high immunization coverage. Together we must make sure that the hard-earned progress made towards regional elimination is not lost,” continues Dr Jakab…

WHO Eastern Mediterranean Region EMRO
:: Within hours of opening, Athbah trauma field hospital treats casualties from west Mosul
Mosul, Iraq 29 March 2017

WHO Western Pacific Region
:: Republic of the Marshall Islands eliminates lymphatic filariasis as a public health problem
MANILA, 30 March 2017


CDC/ACIP [to 1 April 2017]

MMWR Weekly March 31, 2017 / No. 12
:: Zika Virus Transmission — Region of the Americas, May 15, 2015–December 15, 2016
:: Yellow Fever Outbreak — Kongo Central Province, Democratic Republic of the Congo, August 2016
:: Evaluation of Automated Molecular Testing Rollout for Tuberculosis Diagnosis Using Routinely Collected Surveillance Data — Uganda, 2012–2015
:: Notes from the Field: Adverse Events Following a Mass Yellow Fever Immunization Campaign — Kongo Central Province, Democratic Republic of the Congo, September 2016