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2020
From 1 through 29 February 2020, the National IHR Focal Point of Saudi Arabia reported 18 additional cases of MERS-CoV infection, including five associated deaths. The cases were reported from Riyadh (seven cases), Hafer Albatin (two cases), Najran (two cases), Eastern (two cases), Aljouf (one case), Makkah (one case), Hail (one case), Taif (one case) and Jeddah (one case) regions. Among reported cases of MERS-CoV infection, majority (16 cases) were male, and only two cases were female. The age of reported cases ranged from 34 to 81 years. No cases were reported among healthcare workers. The link below provides details of the 18 reported cases.
Since 17 February 2020, no new cases have been reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. While this is a positive development, there is still a high risk of re-emergence of EVD given the current challenges related to limited resources amidst other local and global emergencies, continued insecurity and population displacement in previous hotspots, and limited access to some affected communities. It is therefore critical to maintain surveillance and response operations in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak. Ongoing outbreak response efforts continue, which include investigating and validating new alert cases, supporting appropriate care and rapid diagnosis of suspected cases (which continue to be detected), supporting survivors through a multi-disciplinary programme, and strategically transitioning activities. From 24 to 31 March, an average of 4082 alerts were reported and investigated daily. Of these alerts, 274 were validated as suspected cases, requiring specialized care and laboratory testing to rule-out EVD. From 23 to 29 March, 2376 samples were tested including: 1322 blood samples from alive, suspected cases; 365 swabs from community deaths; and 689 samples from re-tested patients. Overall, laboratory activity decreased by 14% compared to the prior week.
No new cases have been reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo since 17 February 2020 (Figure 1).
There have been no new cases of Ebola virus disease (EVD) reported in the ongoing outbreak in the Democratic Republic of the Congo since 17 February 2020. However, because there is still a risk of re-emergence of EVD, it is critical to maintain surveillance and response operations until and after the end of outbreak declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak. Unfortunately, the response faces increasing limitations that could result in delayed detection and control of flare-ups. These limitations include a funding shortfall, ongoing insecurity and lack of access to some areas, and limited staffing and resources amidst other local and global emergencies.
On 18 February 2020, the National IHR Focal Point for Qatar reported one laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus infection (MERS-CoV) to WHO.
It has been over 21 days since the last confirmed case of Ebola virus disease (EVD) has been reported (Figure 1). On 9 March, the last 46 contacts finished their follow-up. These are important milestones in the outbreak as over one maximum incubation period has passed without any confirmed cases of EVD. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak. Extensive surveillance, pathogen detection, clinical management and other response activities are currently ongoing. These include, but are not limited to, investigating and validating new alert cases, supporting appropriate care and rapid diagnostics of suspected cases which continue to be detected each day, and supporting survivors through a multi-disciplinary programme to help mitigate potential risks of re-emergence. Over the course of the past week (4–10 March 2020), over 32 000 alerts were reported and investigated, and 2584 alerts were validated as suspected cases; requiring specialized care and laboratory testing to rule-out EVD. From 2 to 8 March, 2818 samples were tested including: 1574 blood samples from alive, suspected cases; 376 swabs from community deaths; and 868 samples from re-tested patients. Overall, this was a 16% decrease in testing compared to the previous week.
On 12 February 2020, the European Centre for Disease Prevention and Control (ECDC) reported an increase in the number of cases of dengue infection in French Guiana, Guadeloupe, Martinique, and Saint-Martin. In January 2020, health authorities in the region declared a dengue epidemic in Guadeloupe and Saint-Martin and indicated that Martinique is also at-risk of an epidemic. Dengue epidemics in these territories usually occur when there is a shift in the predominant circulating DENV serotype, and non-immune populations (e.g., tourists, new immigrants, or people not previously exposed to the circulating serotypes) are exposed to the new serotype through human movements within the territories or across neighboring countries. Local transmission occurs through the Aedes mosquito vector present on the islands and in French Guiana.
No new cases of Ebola virus disease have been reported since 17 February, and on 3 March, the only person confirmed to have EVD in the last 21 days (Figure 1) was discharged from an Ebola Treatment Centre after recovering and testing negative twice for the virus. This is an important milestone in the outbreak. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak. As of 3 March 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1, Figure 2), including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (n=1927) were female, 28% (n=973) were children aged less than 18 years, and 5% (n=171) were health care workers.
The Central African Republic (CAR) has experienced an upsurge in measles cases as a result of outbreaks since 2019.
From 19 to 25 February, no new confirmed cases of Ebola virus disease (EVD) were reported. This was the first time since the beginning of the response that no new confirmed cases were reported over a seven-day period (Figure 1). The most recent case was reported in Beni Health Zone, North Kivu Province on 17 February. While the lack of new confirmed cases reported in the last seven days is a major achievement, the outbreak remains active and risk of additional cases emerging remains high. In the past 21 days (5 to 25 February 2020), four confirmed cases were reported from two health areas in Beni Health Zone in North Kivu Province (Figure 2, Table 1). Even with strengthened surveillance operations, transmission of Ebola virus outside of groups currently under surveillance cannot be excluded. Ebola virus also persists in some survivors’ body fluids, with potential to infect others. In at least one instance during this outbreak, relapse – in which a person who has recovered from EVD develops symptoms again – was observed, sparking a new chain of transmission which has taken several months to interrupt. To mitigate a potential resurgence of the outbreak, it is critical to maintain response capacities to rapidly detect and respond to any new cases, and to prioritize survivor support and monitoring and the maintenance of cooperative relationships with the survivors’ associations. Substantial surveillance, pathogen detection, and clinical management activities are currently ongoing, including validating alerts, following remaining contacts who were potentially exposed to the virus, supporting rapid diagnostics of suspected cases, and working with community members to strengthen surveillance on people who pass away in the communities. As of 25 February, 510 contacts are currently under surveillance, of which 97% were followed daily in the last seven days. In the last seven days, more than 5100 alerts per day were reported and investigated, of which over 400 alerts (including ~70 community deaths) were validated as suspected EVD cases; requiring laboratory testing and specialized care within the established Ebola treatment and transit centres. On average, suspect cases stay in these facilities for three days before EVD can be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 operational laboratories deployed in cities that have been affected by the outbreak. From 17 to 23 February, more than 3600 samples were tested.