Disease outbreaks

WHO disease outbreak news
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This week, the case incidence continued to be low in the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (Figure 1). From 5 to 11 February, three new confirmed cases were reported in Beni Health Zone, North Kivu Province. All three cases have epidemiological links to a transmission chain originating in Aloya Health Area, Mabalako Health Zone, with possible nosocomial exposure in Beni. The most recent case reported from Beni Health Zone on 11 February was isolated one day after symptom onset. Early detection of cases reduces the probability of transmission of EVD in the community and significantly improves the clinical outcome for the patients.

In the past 21 days (22 January to 11 February 2020), 12 confirmed cases, including three community deaths, were reported from four health areas within two active health zones in North Kivu Province (Figure 2, Table 1): Beni (n=11) and Mabalako (n=1). It has been 42 days since Katwa Health Zone has reported new cases. The continued reduction of geographic spread of EVD cases and the declining trend in case incidence observed in the past 21 days are encouraging; however, these improvements remain fragile and should not be interpreted as an indication that response efforts can be reduced. Continued vigilance is essential to improve infection prevention and control in health care facilities, as well as ensuring early identification and follow up of cases and contacts.
From 29 January to 4 February four new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.
On 9 and 13 January 2020, the National IHR Focal Point of the United Arab Emirates (UAE) reported an additional two (2) laboratory-confirmed cases of Middle East respiratory syndrome Coronavirus (MERS-CoV) to WHO.

The link below provides details of the 2 reported cases:
From 22 to 28 January five new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.
Nine new confirmed cases were reported from 15 to 21 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.
On 20 January 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of novel coronavirus in the Republic of Korea. The case is a 35-year-old female, Chinese national, residing in Wuhan, Hubei province in China.

The case-patient had developed fever, chill, and muscle pain on 18 January while in Wuhan. She visited a local hospital in Wuhan and was initially diagnosed with a cold. On 19 January , the case-patient was detected with fever (38.3 °C) upon arrival at the Incheon International Airport. The case-patient was transferred to a national designated isolation hospital for testing and treatment. She was tested positive for pancoronavirus reverse transcriptase-polymerase chain reaction (RT-PCR) assay, and subsequently was confirmed positive for novel coronavirus (2019-nCoV) on 20 January by sequencing at the Korea Centers for Disease Control and Prevention (KCDC). Upon detection, the patient had chills, runny nose, and muscle pain.
On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The case-patient is male, between the age of 30-39 years, living in Japan.
Fourteen new confirmed cases were reported from 8 to 14 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.
On 13 January 2020, the Ministry of Public Health (MoPH), Thailand reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The case is a 61-year-old Chinese woman living in Wuhan City, Hubei Province, China. On 5 January 2020, she developed fever with chills, sore throat and headache. On 8 January 2020, she took a direct flight to Thailand from Wuhan City together with five family members in a tour group of 16 people. The traveler with febrile illness was detected on the same day by thermal surveillance at Suvarnabhumi Airport (BKK), Thailand, and was hospitalized the same day. After temperature check and initial assessment, she was transferred to the hospital for further investigations and treatment.
On 13 January 2020, the Thailand’s Ministry of Public Health (MoPH) reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The case is a 61-year-old Chinese woman living in Wuhan City, Hubei Province, China. On 5 January 2020, she developed fever with chills, sore throat and headache. On 8 January 2020, she took a direct flight to Thailand from Wuhan City together with five family members in a tour group of 16 people. The traveler with febrile illness was detected on the same day by thermal surveillance at Suvarnabhumi Airport (BKK), Thailand, and was hospitalized the same day. After temperature check and initial assessment, she was transferred to the hospital for further investigations and treatment.
On 11 and 12 January 2020, WHO received further detailed information from the National Health Commission about the outbreak.

WHO is reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly.
From 1 January through 19 December 2019, a total of 124 laboratory confirmed cases of measles, including two deaths, were reported in the Gaza Strip (case fatality ratio=1.6%). Of the confirmed cases, forty-nine cases (40%) were hospitalized, 12 were among health care workers, and seventy-five (60%) were males. Gaza Strip has an estimated population of 1.99 million (Palestinian Central Bureau of Statistics-2019).

In addition, of the confirmed cases, 57 cases (46%) were un-vaccinated, of which 28 (23%) were among infants between 6 months to one year old, and 29 (23%) among age groups higher than 30 years old. Between 2009 and 2018, the median administrative immunization coverage for the second dose of measles-containing-vaccine (MCV2) was 97%.
Twelve new confirmed cases were reported from 1 to 7 January in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri Provinces.
On 29 December 2019, the National IHR Focal Point of the United Arab Emirates (UAE) reported one laboratory-confirmed case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) to WHO.

The case is a 74-year-old male national who owns a camel farm located in Al Ain City, Abu Dhabi region in UAE where he is living. He developed fever, cough and sore throat on 8 December 2019 and was admitted to hospital on 10 December, then transferred to ICU on 16 December. A nasopharyngeal aspirate was collected and tested positive for MERS-CoV by reverse transcription polymerase chain reaction (RT-PCR) (UpE and Orf1a genes) on 16 December by the Shiekh Khalifa Medical Center laboratory. He has underlying comorbidities including hyperkalemia, diabetes mellitus with diabetic nephropathy, heart disease, asthma and hypertension. He has a history of close contact with dromedary camels and sheep at his farm in the 14 days prior to the onset of symptoms. He has no history of recent travel and has not been involved in slaughtering animals. Currently, the patient is in stable condition in intensive care unit isolation.
On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. As of 3 January 2020, a total of 44 patients with pneumonia of unknown etiology have been reported to WHO by the national authorities in China. Of the 44 cases reported, 11 are severely ill, while the remaining 33 patients are in stable condition. According to media reports, the concerned market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection.

The causal agent has not yet been identified or confirmed. On 1 January 2020, WHO requested further information from national authorities to assess the risk.
Since the last disease outbreak news published on 19 December 2019, 29 new confirmed cases were reported from 18 to 31 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu province. The confirmed cases in this week were reported from eight health areas in four health zones: Mabalako (62%, n=18), Butembo (14%, n=4), Kalunguta (17%, n=5), and Katwa (7%, n=2). Three of the four cases reported in Butembo in the past fourteen days are linked to a transmission chain of more than 50 people that originated in Aloya Health Area, Mabalako Health Zone. One individual classified as a relapse case of EVD, infected several other individuals within the family and through nosocomial transmission (for more information, please see the disease outbreak news published on 19 December 2019). In Kalunguta Health Zone, the five cases reported between 24 and 28 December 2019, are a distinct epidemiologically linked chain of transmission, although the source of exposure is currently under investigation.

In the past 21 days (11 December to 31 December), 40 confirmed cases were reported from 10 health areas within five neighbouring active health zones in North Kivu province (Figure 2, Table 1): Mabalako (68%, n=27), Butembo (13%, n=5), Kalunguta (13%, n=5), Katwa (5%, n=2), and Biena (3%, n=1). The majority of the cases (75%, n=30) are linked to known chains of transmission.
On 5 December 2019, the National IHR Focal Point for Qatar reported three laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection to WHO.

The first case-patient (case #1) is a 67-year-old female from Doha, Qatar. She developed fever, cough, shortness of breath and headache on 23 November 2019, and presented to a hospital on 25 November. On 27 November, she went to the same hospital for follow up. However, on 28 November, her condition worsened and she was admitted to the hospital. A nasopharyngeal swab was collected on 28 November and tested positive for MERS-CoV by reverse-transcriptase polymerase chain reaction (RT-PCR) on 29 November. The patient had underlying medical conditions, and passed away on 12 December 2019. The source of her infection is under investigation. The patient had neither a history of contact with dromedary camels nor recent travel. Follow up and screening of seven household contacts and 40 healthcare worker contacts is ongoing and two asymptomatic secondary cases have been identified so far.
From 3 November through 8 December 2019, three laboratory confirmed cases of yellow fever including two deaths (case fatality rate = 67%) were detected through the national surveillance system in Mali. The first case-patient was a 15-year-old girl from a village in Kati district, Koulikoro region, Mali. The second and third case were in 17 and 25-year-old men, nationals from Cote d'Ivoire, living in the district of Bouguimi, Sikasso region, Mali. All three cases tested positive for yellow fever by Immunoglobulin M (IgM) and reverse-transcriptase polymerase chain reaction (RT-PCR) on 3 December 2019 at Institute Pasteur Dakar (IPD). The first case was not vaccinated against yellow fever and had no travel history outside of Kati District. Meanwhile, the vaccination status for the other two cases was unknown.

Additionally, there were nine suspected and three probable cases reported from the Bouguimi district, including three deaths among the probable cases.
Eleven new confirmed cases were reported from 11 to 17 December in the ongoing Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces.
From 1 through 30 November 2019, the National IHR Focal Point of Saudi Arabia reported 10 additional cases of Middle East respiratory syndrome (MERS-CoV) infection and one associated deaths. The cases were reported from Riyadh (4), Madinah (2), Al-Qassim (1), Assir (1), Taif (1), and Makkah (1) regions.

The link below provides details of the 10 reported cases:

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