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On 31 May 2018, the State Ministry of Health (SMOH) of the Red Sea State in Sudan reported four suspected cases of chikungunya fever from Swakin locality, in Red Sea State. Among the signs and symptoms were sudden onset of fever, headache, joint pain and swelling, muscle pain and/or inability to walk.

The first suspected case of chikungunya in the neighboring Kassala State was reported on 8 August 2018, in a male travelling from the Red Sea State. Since then cases have been reported in three localities of the State (Kassala, West Kassala and Rural Kassala). On 10 August, among 24 collected blood samples, 22 samples tested positive for chikungunya by PCR and ELISA at the National Public Health Laboratory (NPHL) in Khartoum. On 9 September, an additional 100 samples were collected and pooled in batches of ten: 50% of pools tested positive for mixed chikungunya and dengue viruses, and all pools were positive for chikungunya virus.
The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is becoming increasingly undermined by security challenges in at-risk areas, particularly Beni. These incidents severely impact both civilians and frontline workers, forcing suspension of EVD response activities and increasing the risk that the virus will continue to spread. WHO continues to distinguish between the incidents of conflict between rebel and government forces, and pockets of community push-back on the response. A recent increase in the incidence of new cases (Figure 1) is the result of the multitude of challenges faced by response teams. This also reflects improved active surveillance and reporting from the community.

Since the last Disease Outbreak News (data as of 9 October), 29 new confirmed EVD cases were reported: 23 from Beni, four from Butembo, one from Mabalako, and one from Masereka Health Zones in North Kivu Province. Fifteen of these confirmed cases have been linked to known cases or were linked retrospectively through case to transmission chains within the respective communities, while fourteen recently reported cases remain under investigation.
Since the last Disease Outbreak News was published on 20 September (with data as of 15 September), an additional 4914 cases have been reported including 92 laboratory-confirmed cases (Figure 1).
On 15 July, the outbreak of cholera was officially declared by the Ministry of Public Health of Niger. The first three cases were residents of Nigeria from Jibiya Local Government Area (LGA) in Katsina State on the border with Niger. The cases were all from the same family and reportedly had an onset of symptoms in Jibiya LGA before seeking treatment on 5 July 2018 at a health facility in a bordering town in Niger. Vibrio cholerae serotype O1 Inaba was confirmed in stool samples from all three cases, one of which died within minutes of admission. In addition to these cases, six cases were reported in the following two days from villages in Niger located approximately 4km away from Jibiya LGA. Since then, the outbreak has continuously expanded geographically and in magnitude with peaks of around 400 cases reported in two weeks in August and in early September.
On 26 September 2017, WHO was alerted to a suspected outbreak of monkeypox in Yenagoa Local Government Area (LGA) in Bayelsa State, Nigeria. The index cluster was reported in a family. All of whom developed similar symptoms of fever and generalized skin rash over a period of four weeks. Epidemiological investigations into the cluster show that all infected cases had a contact with monkey about a month prior to onset.
The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. WHO faces a precarious situation given recent increases in insecurity, incidents of community mistrust, and increased geographical spread.
From 1 June through 16 September 2018, the International Health Regulations (IHR 2005) National Focal Point of Saudi Arabia reported 32 additional cases of Middle East Respiratory Syndrome (MERS), including 10 deaths.
The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. While substantial progress has been made, the situation is precarious given recent increases in insecurity, incidents of community reluctance and geographical spread.
The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo remains active. While substantial progress has been made to limit the spread of the disease to new areas and the situation in Mangina (Mabalako Health Zone) is stabilizing, the cities of Beni and Butembo have become the new hotspot. Response teams continue to enhance activities to mitigate potential clusters in these cities and prevent spread to other areas.
On 6 September 2018, a cholera outbreak in Harare was declared by the Ministry of Health and Child Care (MoHCC) of Zimbabwe and notified to WHO on the same day.
On 23 August 2018, the Algerian Ministry of Health (MoH) announced an outbreak of cholera in northern parts of the country, in and around the capital province Algiers.
Six weeks into the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo, the overall situation has improved since the height of the epidemic; however, significant risks remain surrounding the continued detections of sporadic cases within Mabalako, Beni and Butembo health zones in North Kivu Province.
On 8 September 2018, the International Health Regulations (IHR 2005) National Focal Point (NFP) of the Republic of Korea notified WHO of a laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV).
Yellow fever outbreak in Republic of the Congo 7 September 2018
Situation report on the Ebola outbreak in the Democratic Republic of Congo DRC 7 September 2018
Since March 2013, when the avian influenza A(H7N9) virus infection was first detected in humans, a total of 1567 laboratory-confirmed human cases, including at least 615 deaths, have been reported to WHO (Figure 1) in accordance with the International Health Regulations (IHR 2005). So far, all but three reported cases have occurred in China. In the latest wave (the sixth wave, which began in October 2017), only three human cases have been detected; meanwhile there have been fewer A(H7N9) virus detections in poultry and environment samples, according to reports from mainland and the Hong Kong Special Administrative Region China.
On 22 August 2018, the International Health Regulations (IHR 2005) National Focal Point for the United Kingdom of Great Britain and Northern Ireland notified WHO about a laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The patient is a resident of the Kingdom of Saudi Arabia who was visiting the United Kingdom of Great Britain and Northern Ireland.
The outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo is at a key juncture. Recent trends (Figure 1) suggest that control measures are working. Over the past week, contact follow-up rates have substantially improved, most patients recently admitted to Ebola treatment centres (ETC) received therapeutics within hours of being confirmed, and ring vaccination activities have scaled to reach contacts (and their contacts) of most confirmed cases reported in the last three weeks. However, the outbreak trend must be interpreted with caution. Since the last Disease Outbreak News on 24 August 2018, 13 additional confirmed and probable cases have been reported, the majority (n=8) were from the city of Beni. Moreover, substantial risks remain, posed by potential undocumented chains of transmission; four of the 13 new cases were not known contacts. Likewise, sporadic instances of high-risk behaviours in some communities (such as unsafe burials, reluctance towards contact tracing, vaccination an
Disease outbreak news for Yellow fever in French Guiana.
Disease outbreak news for EVD in DRC.

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