Public Health Emergency of International Concern (PHEIC)
Polio this week as of 12 June 2018 [GPEI]
:: Following unconfirmed reports on 8 June of suspected polio re-emergence in Venezuela, final laboratory testing has confirmed the cause of the paralysis is not wild poliovirus or vaccine-derived poliovirus. The full statement from the Global Polio Eradication Initiative may be read here.
:: World leaders at the G7 summit affirmed continued commitment to global polio eradication in the summit communique: “We reconfirm our resolve to work with partners to eradicate polio and effectively manage the post-polio transition”. [See Milestones above] for text]

Summary of newly-reported viruses this week:
Pakistan: One new wild poliovirus type 1 (WPV1) case reported.

Update on suspected polio case in Venezuela
Following unconfirmed reports on 8 June of suspected polio re-emergence in Venezuela, final laboratory testing has confirmed the cause of the paralysis is not wild poliovirus or vaccine-derived poliovirus.
15/06/2018 – Statement from the Global Polio Eradication Initiative
A 34-month old child had presented with symptoms of acute flaccid paralysis (AFP) on 29 April, from a community with low vaccination coverage in Orinoco delta, Delta Amacuro state.
A Sabin type 3 poliovirus was isolated from stool samples of the child. Isolation of Sabin type 3 poliovirus can be expected in children and communities immunized with bivalent oral polio vaccine, which contains attenuated (weakened) type 1 and type 3 Sabin strains.  Final laboratory analysis received today has confirmed that the AFP symptoms are not associated with wild or vaccine-derived poliovirus.
A number of conditions or infections can lead to AFP, poliovirus being just one of them.  As part of global polio surveillance efforts, every year more than 100 000 AFP cases are detected and investigated worldwide. Clinical evaluation of the child is underway to determine the cause of the paralysis. The most important point is that the child should be provided with appropriate care and support.
While wild and vaccine-derived polio have both been ruled out as the cause of this child’s symptoms, this area of Venezuela is experiencing vaccination coverage gaps. It is critical that countries maintain high immunity to polio in all communities, and strong disease surveillance, to minimize the risk and consequences of any eventual poliovirus re-introduction or re-emergence.
The partners of the Global Polio Eradication Initiative (GPEI) – WHO, the US Centers for Disease Control and Prevention, Rotary International, UNICEF and the Bill & Melinda Gates Foundation – will continue to support national and local public health authorities in these efforts, together with the Pan American Health Organization…


WHO Grade 3 Emergencies  [to 16 Jun 2018]
:: WHO and partners working with national health authorities to contain disease outbreaks
13 June 2018 – Infectious disease outbreaks are a serious public health concern, posing a direct threat to families, especially children, in every home in Yemen. Emergency preparedness and response structures could mean the difference between life and death for many people. Through the quick mobilization of readily available teams, the number of people affected could be reduced and the spread of deadly diseases controlled.
In the midst of war and faced with a collapsing health system, WHO, national health authorities, along with local and international partners, have scaled-up their operations, through the establishment of rapid response teams (RRTs) in the fight against disease outbreaks. These teams are critical; investigating outbreaks and ensuring that prevention and control measures are rapidly executed to contain any infectious disease threat.
These multi-disciplinary teams comprise health care professionals each with a specific skillset, designed to rapidly detect and contain a potential outbreak before it has a chance to spiral out of control.
…The fight against cholera 
As Yemen faces what is now known as the world’s largest cholera outbreak, these dedicated RRTs ensure that laser-focus on early detection, or the early identification of suspected cholera cases, and the investigation of the source are top priorities. The national epidemiological surveillance programme and WHO utilized the already established electronic integrated disease early warning system (eIDEWS) to support the early detection of suspected cholera. eIDEWS was initiated in 2013 as a pilot in 4 governorates (Aden, lahj, Abyan and Taiz) with a total 98 selected sites.
The eIDEWS is a surveillance and data collection program designed to rapidly detect potential outbreaks and public health threats at the earliest possible stages. The program then generates an alert in order to facilitate timely interventions and prompt response to help prevent or reduce the spread of the disease. These findings influence the response plan at district level, using essential findings from rapid assessments to formulate an informed and effective outbreak response.
The fight against cholera also resulted in the request of national health authorities for a way in which they could increase the mobility of RRTs to reach otherwise inaccessible areas in order to investigate and respond to reported outbreaks. This resulted in the procurement and planned distribution of 1000 motorbikes in Yemen.
“With disease outbreaks threatening the lives of millions of Yemeni people, an effective response relies heavily on the ability of RRTs to rapidly detect and investigate potential outbreaks. Early detection leads to timely interventions that save lives,” said Dr Zagaria.
:: Weekly epidemiology bulletin, 28 May–3 June 2018

WHO Grade 2 Emergencies  [to 16 Jun 2018]
[Several emergency pages were not available at inquiry]

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. 
:: Yemen Humanitarian Update Covering 4 – 11 June 2018 | Issue 19
:: Yemen: Al Hudaydah Update Situation Report No. 1, 14 June 2018
…Heavy fighting in Al Hudaydah put hundreds of thousands of civilians at risk;
…Al Hudaydah port remains open and food is being offloaded from vessels;
…Humanitarian organizations continue to provide life-saving assistance to displaced and vulnerable people despite a deterioration in the security situation;

Syrian Arab Republic 
:: Syrian Arab Republic: Humanitarian situation update in Afrin District and for IDPs in surrounding communities (as of 15 June 2018)


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.
:: OCHA Flash Update #4 Tropical Cyclone Sagar | 14 June 2018