Disease outbreaks

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Between 8 September and 24 November, 2020, the North-Central region of Burkina Faso reported a
Reports of a cluster of deaths from an undiagnosed disease were notified on 1 November 2020 through Event Based Surveillance in two states, Delta and Enugu, located in southern Nigeria.
On 18 November 2020, the Minister of Health of the Democratic Republic of the Congo declared the end of the Ebola Virus Disease (EVD) outbreak in Equateur Province.
The Ministry of Health in Lao People's Democratic Republic (PDR) reported a human case of infection with an avian influenza A(H5N1) virus. The case is a one-year-old female who developed symptoms of fever, productive cough, difficulty breathing and runny nose on 13 October 2020. She was hospitalized for her illness on 16 October and discharged on 19 October. As part of severe acute respiratory infection (SARI) sentinel surveillance, a specimen was collected on the date of hospitalization and confirmed to be positive for avian influenza A(H5N1) on 28 October by reverse transcription polymerase chain reaction (RT-PCR) at the National Centre for Laboratory and Epidemiology (NCLE).

Among the close contacts of the patient, one contact developed fever and cough after the onset of illness in the case. Specimens collected from all household contacts, including the symptomatic contact, were negative for influenza A viruses.
The Ministry of Health (MoH) notified WHO that between 13 September and 1 October 2020, eight cases of Rift Valley Fever (RVF) including seven deaths were confirmed in animal breeders. Districts affected include Tidjikja and Moudjéria (Tagant region), Guerou (Assaba region) and Chinguetty (Adrar region). Laboratory confirmation of RVF infection was performed using a reverse transcription polymerase chain reaction (RT-PCR) at the National Institute for Public Health Research (INRSP) in Nouakchott. The age of infected patients varied between 16 and 70 years old and included one woman and seven men. All seven deaths occurred among hospitalised patients with fever and haemorrhagic syndrome (petechia, gingivorrhagia) and vomiting.

Between 4 September to 7 November 2020, a total of 214 people were sampled and their samples have been sent to the INRSP for laboratory testing with a total of 75 testing positive for RVF (RT-PCR and serology by enzyme-linked immunosorbent assay (ELISA). Positive cases have been reported in 11 of 15 regions of the country: Brakna, Trarza, Gorgol, (on the border with Senegal), Adrar, Assaba, Hodh El Gharby, Hodh El Chargui, Guidimaka (on the border with Mali) and Nouakchott Sud, Nouakchott Ouest and Tagant. The Tagant region is the most affected (38/75, 51%) with principal hotspot districts being Tidjikja and Moudjeria. Thus far a total of 25 deaths have been reported from this outbreak.
Since June 2020, 214 human cases of COVID-19 have been identified in Denmark with SARS-CoV-2 variants associated with farmed minks, including 12 cases with a unique variant, reported on 5 November.
On 13 October 2020, the French health authorities officially reported 13 laboratory-confirmed cases of Mayaro fever in French Guiana, France.

In September 2020, the Institut Pasteur de la Guyane (IPG) (member of the French National Reference Laboratory for arboviruses) identified two cases of Mayaro virus infection (MAYV) confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and one probable case found positive for Mayaro antibodies. The case-patients presented dengue-like symptoms and joint pains, and tested negative for dengue by RT-PCR.
On 30 September 2020, the French Guiana Regional Health Agency (ARS) reported the first detection of Oropouche virus (OROV) in French Guiana. On 22 September 2020 the Pasteur Institute in Cayenne (a member of the French National Reference Laboratory for arboviruses) notified the France IHR National Focal Point of seven laboratory-confirmed cases of Oropouche virus infection in the village of Saül. These cases were identified following clinical investigations of an unusually high number of dengue-like illnesses in the village. Between 11 August and 25 September, there were 37 clinically-compatible cases of Oropouche virus disease identified in Saül. The results of serology for dengue, chikungunya, and Zika were negative, and seven of nine cases tested positive for OROV by reverse transcriptase polymerase chain reaction (RT-PCR).

Among the 37 clinically-compatible cases, most cases are male (60%) and the median age is 36 years (range 3-82 years). The most represented age range is 15 to 54-years-old (19 cases) followed by 0 to 14-years-old (10 cases). A peak of cases was observed in mid-September however, the outbreak investigation remains ongoing.
From 1 January through 13 September 2020, a total of 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio 3.7%), have been reported in 127 health zones from 17 out of 26 provinces in the Democratic Republic of the Congo. The first epidemic peak was observed at the beginning of March 2020 (epi week 10), with 136 cases reported weekly (Figure1). From 1 January through 7 August, the Institut National de Recherche Biomédicale (INRB) received 80 samples from suspected cases of monkeypox, of which 39 samples were confirmed positive by polymerase chain reaction. Four out of the 80 specimens were skin lesions (crusts/vesicles), the remaining samples were blood. There is no further information at this time regarding the outcome of these 80 patients whose samples were tested. Confirmatory testing remains ongoing.

During the same period in 2019, 3,794 suspected cases and 73 deaths (CFR 1.9%) were reported in 120 health zones from 16 provinces while a total of 2,850 suspected cases (CFR 2.1%) were reported in 2018.
On 28 August 2020, the National IHR Focal Point of Chad notified WHO of an outbreak of chikungunya in Abéché, eastern Chad.
Three months after the declaration of the eleventh Ebola virus disease (EVD) outbreak in Equateur Province, Democratic Republic of the Congo, the number of confirmed cases continues to increase, and the geographic spread of the outbreak continues to expand.

As of 1 September 2020, 110 cases (104 confirmed and six probable) including 47 deaths (case fatality ratio 43%) have been reported from 36 health areas in 11 health zones. In the past 21 days (12 August – 1 September 2020), 24 confirmed cases have been reported in 15 health areas across eight health zones. To date, three healthcare workers have been affected, making up 3% of all cases. In addition, 48 people have recovered from EVD to date.
On 9 August 2020, the Federal Ministry of Health, Sudan notified WHO of the detection of a

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