Public Health Emergency of International Concern (PHEIC)
Polio this week as of 7 June 2017
:: In Syria, a circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been confirmed. The virus strain was isolated from two cases of acute flaccid paralysis (AFP) and one healthy contact, from Deir-Ez-Zor governorate. See the ‘Syrian Arab Republic’ section below for more information.
:: The final decision made by the World Health Assembly on 29 May on polio transition planning is now available online. The decision follows extensive discussions by Member States on the need to address the challenge of scaling down the polio programme as eradication comes closer, including the potential impact on achieving and sustaining a polio-free world, on health system programmes and on systems currently supported by polio assets. Delegates welcomed existing efforts to plan for the post-polio world, and stressed the importance of careful, considered and strategic approaches to the transition of polio assets, requesting the Director-General to prepare a detailed transition action plan.
:: Summary of newly-reported viruses this week: Syria – two new circulating vaccine-derived poliovirus type 2 (cVDPV2) isolated from acute flaccid paralysis (AFP) cases and one cVDPV2 isolated from a healthy contact; and, Pakistan – four new environmental sample positive for wild poliovirus type 1 (WPV1).
Weekly country updates as of 7 June 2017
Syrian Arab Republic
:: In Syria, a circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been confirmed. The virus strain was isolated from two cases of acute flaccid paralysis (AFP) and one healthy contact (collection date: 25 April 2017), from Deir-Ez-Zor governorate. The cases had onset of paralysis on 5 March and 6 May.
:: No case of WPV1 has been reported in Syria since 21 January 2014.
:: Outbreak response plans are being finalized, in line with internationally-agreed outbreak response protocols. Although access to Deir-Ez-Zor is compromised due to insecurity, the Governorate has been partially reached by several vaccination campaigns against polio and other vaccine-preventable diseases since the beginning of 2016. Most recently, two campaigns have been conducted in March and April 2017 using the bivalent oral polio vaccine (OPV). However, only limited coverage was possible through these campaigns.
WHO Grade 3 Emergencies [to 10 June 2017]
Overview of WHO operations in north eastern Nigeria
June 2017 —WHO has decided to adopt a sub-regional approach across the four Lake Chad basin affected countries, to increase its interventions, which will address the health needs of the displaced populations and host communities alike.
Iraq – No new announcements identified.
South Sudan – No new announcements identified.
The Syrian Arab Republic – No new announcements identified
Yemen – No new announcements identified.
[see UNICEF reports below]
WHO Grade 2 Emergencies [to 10 June 2017]
WHO opened a field office in Maroua to support the emergencies in the north.
2 June 2016 — The WHO Country Office in Cameroon is strengthening the emergency response in the North Region. It has opened a field office in Maroua, capital of the Region, located 1153 km from Yaounde.
Central African Republic – No new announcements identified. [see UNICEF reports below]
Democratic Republic of the Congo – No new announcements identified.
Ethiopia – No new announcements identified.
Libya – No new announcements identified.
Myanmar – No 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. 36 (29 May to 4 June 2017) [EN/KU]
:: 9 Jun 2017 Palais briefing notes on cholera in Yemen and circulating vaccine-derived poliovirus in Syria
:: Yemen Humanitarian Bulletin Issue 24 | 07 June 2017
[see UNICEF reports below]
UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
DRC (Kasai crisis)
:: Complex Emergency in the Kasai region DR Congo Situation Report No.7 (31 May 2017)
Nigeria – No new announcements identified.
UNICEF [to 10 June 2017]
82 June, 2017
Number of suspected cholera cases reaches 100,000 in Yemen
SANA’A, Yemen, 8 June 2017 – The number of suspected cholera cases in Yemen continues to rise, reaching 101,820 with 791 deaths as of 7 June 2017. Worst affected are the country’s most vulnerable: children under the age of 15 account for 46 per cent of cases, and those aged over 60 represent 33 per cent of fatalities.
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) are honing in on areas reporting the highest number of cases to stop the disease from spreading further.
“These cholera ‘hot spots’ are the source of much of the country’s cholera transmission,” said Dr Nevio Zagaria, the head of WHO’s office in Yemen. “Stamp out cholera in these places and we can slow the spread of the disease and save lives. At the same time, we’re continuing to support early and proper treatment for the sick and conducting prevention activities across the country.”
The race to contain the cholera outbreak will not be won easily. The country’s health system has been nearly destroyed by more than two years of intense conflict. Less than half of the country’s health centres are fully functional. Medical supplies are flowing into the country at a third of the rate that they were entering Yemen before March 2015. Important infrastructure has been damaged by the violence, cutting 14.5 million people off from regular access to clean water and sanitation. Health and sanitation workers have not received their salaries in more than eight months.
“The cholera outbreak is making a bad situation for children drastically worse. Many of the children who have died from the disease were also acutely malnourished”, said Dr Meritxell Relano, UNICEF’s Representative in Yemen. “Today, life for children in Yemen is a desperate struggle for survival, with cholera, malnutrition and the relentless violence constantly sounding a death knell at their doorsteps,” she said.
UNICEF, WHO, along with their partners, are working on a war footing to respond to this latest outbreak. Nearly 3.5 million people across the country have been reached by disinfecting water tanker filling stations, chlorinating drinking water, restoration of water treatment plants, rehabilitation of water supply systems, providing household water treatments and distributing hygiene kits (soaps and washing powders). UNICEF and WHO are both providing support and medical supplies to Oral Rehydration Centres and Diarrheal treatment centres across the country where patients are being screened and provided immediate medical support. All this is done along with disseminating hygiene awareness to the affected populations.
The total funding needed for the joint response activities of health, water and sanitation partners comes to US$ 66.7 million for six months. While donors have been generous to date, more funding is still required, particularly for water and sanitation interventions. The biggest need, however, is for an increased number of partners in the field across the country, including in areas with poor access due to conflict.
EBOLA/EVD [to 10 June 2017]
Ebola Situation report: 09 June 2017
09 June 2017
WHO, UN Agencies, international organizations, non-governmental organizations (NGOs) and partners continue to support the Ministry of Health (MoH) in the Democratic Republic of the Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province in the north-east of the country.
On 08 June 2017, no new confirmed, probable or suspected EVD cases were reported. The last confirmed case was isolated on 17 May 2017 and tested negative for EVD by PCR for the second time on 21 May 2017.
There are currently a total of five confirmed and three probable cases. Of these, four survived and four died, resulting in a case fatality rate of 50%. The confirmed and probable cases were reported from Nambwa (four confirmed and two probable), Ngayi (one probable) and Mabongo (one confirmed) in Likati Health Zone. All contacts completed the follow up monitoring period. Active case search is ongoing and thirteen community alerts were reported and investigated, none of which fulfilled the criteria to be a suspect case.
Modelling suggests the risk of further cases is currently low but not negligible, and decreases with each day without new confirmed/probable cases. As of the reporting date, 83% of simulated scenarios predict no further cases in the next 30 days.
All seven response committees are maintaining functionality at the national level, namely monitoring, case management, water sanitation and hygiene (WASH) and biosafety, laboratory and research, pyscho-social management, logistics, and communication. A response team will remain in the affected areas until the declaration of the end of the outbreak.
Current risk assessment
The previous risk assessment was re-evaluated by WHO in light of the evolution of the outbreak and the available information.
- :: The overall risk at the national level has been revised to moderate due to the fact that a rapid response team was deployed, field investigation identified cases and contacts and all contacts completed their 21 day monitoring period. A response team remains in the field and treatment units are established.
- :: The risk at the regional and global level is low as no cases have been reported outside of Likati health zone and the area is remote with limited access and transport to/from the affected area.
- :: The protocol for a possible ring vaccination has been formally approved by the national regulatory authority and Ethics Review Board of the Democratic Republic of the Congo Vaccine…
- :: International vaccine deployment and cold chain shipment to DRC is not advised at this point.
WHO responds to Ebola in Democratic Republic of the Congo
6 June 2017 – Multidisciplinary teams face numerous challenges as they respond to an outbreak of Ebola virus disease in the remote, forested regions of the Democratic Republic of the Congo. WHO and partners are supporting the country’s Ministry of Health in all aspects of the response, including epidemiological investigation, surveillance, logistics and supplies, communications, and community engagement.
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.
Zika virus [to 10 June 2017]
[No new digest content identified]
MERS-CoV [to 10 June 2017]
DONs- Disease Outbreak News
Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia, United Arab Emirates, and Qatar
6 June 2017
Between 21 April and 29 May 2017, the National IHR Focal Point of Saudi Arabia reported 25 additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection including six fatal cases. On 16 May 2017, the IHR NFP of the United Arab Emirates reported two (2) additional case of MERS-CoV. On 23 May 2017, the National IHR Focal Point of Qatar reported one additional case of MERS-CoV…
Yellow Fever [to 10 June 2017]
[No new digest content identified]