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The number of reported cases of Ebola virus disease (EVD) consistently declined in recent weeks, with 14 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 30 September through 6 October (Figure 1).
On 29 August 2019, a suspected yellow fever case was reported from Kano state with a travel history to Yankari game reserve, Alkaleri Local Government Area (LGA), Bauchi state, Nigeria.

From 29 August through 22 September 2019, Nigeria reported an outbreak of yellow fever with an epi-centre in the Yankari game reserve of Alkaleri LGA, Bauchi state. According to Nigeria Centre for Disease Control (NCDC), 231 suspected cases have been reported in four states including Bauchi (110), Borno (109), Gombe (10), and Kano (2), of which there have been 13 presumptive positive by IgM testing and 24 cases positive by reverse-transcriptase polymerase chain reaction (RT-PCR) at national laboratories. Of 24 cases confirmed by RT-PCR (20 cases in Bauchi, three in Gombe and one in Kano state), six deaths were reported, all from Alkaleri LGA, Bauchi state, resulting in a case fatality ratio of 25% among the confirmed cases. The vaccination history for the 231 suspected yellow fever cases is not known, and the results of follow-up testing from regional reference laboratory Institute Pasteur Dakar (IPD) are not yet available.
The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues this week with 20 new confirmed cases reported in North Kivu and Ituri provinces from 25 September-1 October 2019, versus 29 in the previous week.
The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues this week with 29 new confirmed cases reported in North Kivu and Ituri provinces from 18-24 September 2019, versus 57 in the previous week.
On 16 July 2019, the Ebonyi State Ministry of Health received information about suspected yellow fever cases in Ndingele ward, Izzi Local Government Area (LGA), Nigeria. The cases had symptoms of fever and jaundice, reported with onset since May 2019. As of 30 August 2019, a total of 84 suspected yellow fever cases, including 26 deaths (case fatality ratio: 31 %), have been reported across nine LGAs within Ebonyi State. Of the suspected yellow fever cases, fifty-five per cent (46/84) are male. The most affected age group is 0-9 years (28 cases, 33%), followed by age groups 20-29 years and above 30 years each with 20 cases (24%). The 10-19 year age group has the least number of cases (16 cases, 19%). Seventy-nine per cent of suspected cases (66/84), including seven confirmed cases positive by real-time polymerase chain reaction (RT-PCR) are reported from Izzi LGA which is located in the north-eastern part of the State, bordered with Cross River State in the east, and Benue State in the north. One case has been confirmed in an international worker involved in the extractive industry in Izzi LGA, and residing in adjacent Abakiliki LGA (an urban centre in the State).

The assessment conducted by the LGA rapid response team (RRT) and national agencies found low vaccination coverage and poor routine immunization documentation. Community surveys were conducted and yellow fever vaccination coverage was estimated to be 56% (64% for children aged less than 5 years and 48% for those older than 5 years of age). Though Nigeria introduced routine vaccination for yellow fever into the immunization schedule in 2004, most adults remain susceptible and overall population immunity is low. Although no entomological studies were conducted at the time, the geography and vegetation of the affected state is compatible with the presence of the Aedes mosquitoes, as illustrated by the transmission patterns.
From 1 through 31 August 2019, the National IHR Focal Point of Saudi Arabia reported 6 additional laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection and one associated death. The cases were reported from Riyadh (3 cases), Taif (1 case), Quriyat (1 case), and Najran (1 case) regions. One of the cases reported (Case #4) is a household contact identified during the contact tracing investigation of Case #2.

The link below provides details of the 6 reported cases :
On 19 September 2019, the Philippines declared an outbreak of polio. Two cases have been reported to date, both caused by vaccine-derived poliovirus type 2 (VDPV2). Environmental samples taken from sewage in Manila on 13 August and a waterway in Davao on 22 August have also tested positive for VDPV2.

The first case was confirmed on 14 September following testing by the National Polio Laboratory at the Research Institute for Tropical Medicine, the Japan National Institute of Infectious Diseases (NIID) and the United States Centers for Disease Control and Prevention (CDC). The case-patient is a 3-year-old girl from Lanao del Sur in the southern Philippines. The virus isolated is genetically linked to VDPV2 previously isolated from environmental samples in Manila and Davao. This indicates that the virus is circulating.
The following is a description of the current situation in the United Republic of Tanzania regarding unofficial reports of a number of cases of illness and a summary of WHO efforts to obtain information about this situation.

As specified in Article 9 of the International Health Regulations (IHR), WHO may take into account reports from sources other than notifications from Member States and shall assess these reports according to established epidemiological principles under the IHR.
The intensity of the Ebola virus disease (EVD) transmission in the Democratic Republic of the Congo increased slightly from last week, with 57 new confirmed cases reported in North Kivu and Ituri provinces from 11-17 September 2019, versus 40 in the previous week.
On 16 August 2019, Regional Health Authorities in Andalusia, Spain, reported an outbreak of listeriosis, caused by the bacteria Listeria monocytogenes (L. monocytogenes), associated with the consumption of a chilled roasted pork meat product manufactured in Spain by Magrudis Company Limited and sold under the brand name “La Mechá”. This outbreak was reported by Spanish Authorities to the World Health Organization, via the International Food Safety Authorities Network (INFOSAN), on 20 August 2019. On 23 August, a Food Safety Alert was issued by the Spanish Authorities, advising consumers to avoid any product sold under that brand and that a small amount of the implicated chilled roasted pork was also sold non-branded by another company.

From 7 July through 13 September , a total of 222 confirmed cases linked to this outbreak have been reported in five regions of Spain: Andalusia (214), Aragon (4), Extremadura (2), Castilla y Leon (1), and Madrid (1). Fifty-seven per cent of cases are women including 38 pregnant women and 24% of cases are 65 years old or above (24 men and 25 women). Three deaths have been reported among elderly persons who were ill with listeriosis at the time of death. Reportedly, six women had miscarriages linked to this outbreak. On 23 August 2019, France, through the European Commission Early Warning and Response System (EWRS), notified a travel related case in a foreign citizen with travel history to Andalusia who had consumed the implicated product. Only three cases of listeriosis have been recorded with a date of consumption after 17 August, but all the three bought the product before the food alert was launched.
Ebola virus disease (EVD) transmission in the Democratic Republic of the Congo continued to ease this past week, with 40 new confirmed cases reported in North Kivu and Ituri provinces; this is the lowest weekly incidence since March 2019. While these signs are promising, it remains too soon to tell if this trend will persist. Emerging hotspots continue to pose challenges in terms of accessibility, insecurity, and violence. Surveillance indicators highlight that public health risks of further spread remain very high.

During the past 21 days (from 21 August through 10 September 2019), a total of 157 confirmed cases were reported form 15 health zones (Table 1, Figure 2), with the majority coming from the health zones of Kalunguta (19%, n=30), Beni (18%, n=28), Mambasa (16%, n=25), and Mandima (13%, n=20). Alimbongo, Oicha, and Pinga health zones recently passed 21 days without a new confirmed case of EVD.
In Nigeria and West Africa, a cVDPV2 outbreak originating from Jigawa state, Nigeria, continues to spread. In Ghana, cVDPV2 was isolated from an acute flaccid paralysis (AFP) case in Ando-Nyamanu, Chereponi district, Northern Region, bordering Togo. The case was a two-year old girl who had experienced onset of paralysis on 27 July 2019. Stool samples were taken on 27 and 28 July 2019, and sent to the National Polio Laboratory at the Noguchi Memorial Institute for Medical Research for further laboratory investigations. The sample tested positive for cVDPV2 on 17 August 2019. Sequencing of the sample from the AFP case revealed 25 nucleotide differences compared to the reference Sabin 2 and 6 nucleotides, with the closest sequencing match made with an AFP case originating from Jigsaw state, Nigeria from 2018. Earlier, a related cVDPV2 strain had been isolated from an environmental sample, collected on 11 June 2019, from Northern Region in Ghana. Both isolated viruses were linked to an outbreak originating in Jigawa, Nigeria, in 2018. In the past, this same strain had spread within Nigeria, and internationally to the Republic of Niger, Benin, and Cameroon.

The last indigenous wild poliovirus was reported in 2000. This is the first ever reported cVDPV2 outbreak reported in the country.
The intensity of Ebola virus disease (EVD) transmission in the North Kivu, South Kivu, and Ituri provinces remains substantial, with 57 new cases reported since the last EVD in the Democratic Republic of the Congo Disease Outbreak News Update on 29 August.
The Ebola virus disease (EVD) outbreak in North Kivu, South Kivu, and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to the previous six weeks, with an average of 77 cases per week (Figure 1).
From 1 through 31 July 2019, the National IHR Focal Point of Saudi Arabia reported 9 additional laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection and 4 associated deaths. The cases were reported from Riyadh (5 cases), Najran (3 cases), Al-Qassim (1 case) regions. There were no clusters of cases reported during this time period.

The link below provides details of the 9 reported cases :
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity (Figure 1).
On 23 June 2019, a vaccine-derived poliovirus type 1 (VDPV1) was isolated from a two -year- old child with acute flaccid paralysis (AFP), with onset of paralysis on 22 May 2019 from Kayin state, Myanmar. Subsequently, on 11 July 2019, a genetically linked VDPV1 was isolated from the same state from a 5-year 6-month-old child with AFP, with date of onset of paralysis on 14 June, and it was classified as circulating VDPV1 (cVDPV1) on 12 July 2019. On 25 July 2019, cVDPV1 was isolated from a third AFP case from the same state, with date of onset of paralysis on 23 May 2019. Subsequently, on 19 August 2019, a fourth case of VDPV1 has been confirmed in a six-year-old child, with onset of paralysis on 23 July 2019. The child has no history of vaccination with OPV. In addition, the virus has also been isolated from seven healthy community contacts. These linked viruses have 25 to 31 nucleotide changes from Sabin 1. All cases and contacts are from Hpapun township of Kayin state, Myanmar.

Myanmar’s routine immunization coverage is estimated at 91% for three doses of bivalent oral polio vaccine (bOPV) in 2018. Neighbouring countries including Thailand and other countries in South East Asia have been informed of the confirmed cVDPV1, and subnational surveillance is being strengthened across the region. In 2018, Myanmar and Kayin state met certification standards for AFP surveillance with non-polio AFP rate of 3.45, and stool adequacy rate of 100% for Kayin state.
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks, with an average of 81 cases per week (range 68 to 91 cases per week) in the past six weeks (Figure 1).
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks with an average of 86 cases per week (range 80 to 91 cases per week) in the past six weeks (Figure 1).
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity to recent weeks, with an average of 85 cases per week (range 79 to 91 cases per week) in the past six weeks (Figure 1).

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