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WEEKLY BULLETIN on OUTBREAKS and OTHER EMERGENCIES Week 42: 12 - 18 October 2020 Data As Reported By: 17:00; 18 October 2020

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WEEKLY BULLETIN on OUTBREAKS and OTHER EMERGENCIES Week 42: 12 - 18 October 2020 Data As Reported By: 17:00; 18 October 2020 WEEKLY BULLETIN ON OUTBREAKS AND OTHER EMERGENCIES Week 42: 12 - 18 October 2020 Data as reported by: 17:00; 18 October 2020 REGIONAL OFFICE FOR Africa WHO Health Emergencies Programme 0 118 106 12 New event Ongoing events Outbreaks Humanitarian crises 54 402 1 856 Algeria 36 13 3 649 118 1 0 733 2 7 550 163 Gambia 7 0 1 379 93 1 201 69 1 0 Mauritania 80 0 Mali 3 286 132 Senegal 2 079 4 3 425 0Eritrea 15 094 312 Niger 8 494 39 1 0 Burkina Faso 35 109 1 7 752 86 1 0 134 1 1 0 Guinea 10 0 119 15 Chad Cabo Verdé 2 381 65 55 0 89 137 1 352 6 038 14 11 0 60 266 1 115 1 1 10 0 29 0 Nigeria 11 518 70Côte d’Ivoire South Sudan 1 873 895 15 4 856 62 337 2 1 109 241 21 570 425 14 728 257 Guinea-Bissau Ghana 17 0 1 843 0 29 0 Central African 29 0 Liberia 20 301 121 23 0 2 787 55 Benin Cameroon Republic 916 2 Ethiopia 2 389 41 47 232 310 420 14 4 0 Sierra léone Togo 28 676 137 Uganda 1 846 79 Democratic Republic 48 21 805 3 198 5 1 868 13 529 2 44 881 832 1 940 49 of Congo 2 300 72 Congo 9 801 93 3 1 Gabon 1 488 6 Kenya 128 53 1 380 82 711 13 Legend 2 496 41 293 7 71 0 8 881 54 70 899 1 026 Rwanda Measles Humanitarian crisis 4 896 31 5 156 92 16 043 253 Burundi 929 15 147 0 Monkeypox Hepatitis E 549 1 Sao Tome 11 051 303 Seychelles 159 0 Tanzania 989 0 Lassa fever Yellow fever and Principe 509 21 124 17 Dengue fever Cholera 1 312 5 4 594 171 5 070 83 Angola Ebola virus disease cVDPV2 Comoros Equatorial 5 857 181 502 7 2 0 Chikungunya Guinea 133 0 862 0 Floods Malawi 7 622 247 Zambia Mozambique COVID-19 Leishmaniasis 15 458 336 Zimbabwe 2 625 21 Madagascar Anthrax Plague Namibia 338 1 Malaria Crimean-Congo haemorrhagic fever Botswana 8 011 230 395 10 Cases 16 810 238 Acute Jaundice Syndrome Mauritius Deaths 10 072 65 10 001 71 Rift Valley fever 5 242 20 Countries reported in the document 11 936 128 Eswatini N Non WHO African Region W E WHO Member States with no reported events 3 0 LesothoLesotho5 780 116 692 471 17 780 South Africa 20 0 S South Africa1 833 42 Graded events † 49 19 2 Grade 3 events Grade 2 events Grade 1 events 40 22 20 31 Ungraded events ProtractedProtracted 3 3 events events Protracted 2 events ProtractedProtracted 1 1 events event Health Emergency Information and Risk Assessment Overview Contents This Weekly Bulletin focuses on public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 118 events in the region. This week’s main articles cover the following events: 1 Overview Coronavirus disease 2019 (COVID-19) in Togo 2 -4 Ongoing events Measles in Chad Ebola virus disease (EVD) in Équateur Province, Democratic Republic of the Congo. 5 Summary of major issues, challenges For each of these events, a brief description, followed by public health measures implemented and and proposed actions an interpretation of the situation is provided. A table is provided at the end of the bulletin with information on all new and ongoing public health 6 All events currently events currently being monitored in the region, as well as recent events that have largely been being monitored controlled and thus closed. Major issues and challenges include: Togo is one of the least affected countries in the African region and is to be commended on their efficient and systematic response to the outbreak. However, the country has challenges around funding, poor access to personal protective equipment, evidenced by their relatively high numbers of health workers affected, and only centralized testing capacity. Case management is also a potential problem, with shortages of the medication and equipment required to manage severe cases of the disease. These issues need to be addressed in order to allow authorities in Togo to continue effective management of the COVID-19 response. The measles outbreak in Chad, ongoing since the beginning of 2020, is continuing to decline. However, a measles risk assessment shows that the country is still at very high risk of measles transmission during the remaining quarter of 2020 and the first six months of 2021, due to poor monitoring, low vaccine coverage by routine immunization programmes and the absence of a second dose of the vaccine. This is compounded by issues with response coordination and financial management and lack of current vaccine stocks. There have been no new confirmed cases of EVD in Équateur Province, Democratic Republic of the Congo for the past 19 days. This is a very welcome development. However, challenges remain around known confirmed cases still living in the community and contacts lost to follow- up. Lack of funding for the response continues, with inadequate human resources for risk communication and community engagement in affected health zones and hotspots. Strong and robust surveillance systems need to be sustained in order to detect, isolate, test and treat new suspected cases as early as possible. 1 Health Emergency Information and Risk Assessment Health Emergency Information and Risk Assessment Ongoing events 157 2 049 51 2.5% Coronavirus disease 2019 Togo Cases Deaths CFR EVENT DESCRIPTION Geographical distribution of cumulative number of confirmed cases of Togo remains one of the least affected countries in the African region, coronavirus 19 in Togo as of 16 October 2020. with around half of the country’s cases reported in Gulf Préfecture, (1 032; 50.4%), followed by Agoe Préfecture (242; 11.8%), both in Greater Lomé. However, all 39 préfectures have been affected. As of 16 October 2020, there has been a cumulative total of 2 049 cases reported, with 51 deaths (case fatality ratio 2.5%). Of the confirmed cases, 130 (including 11 active cases) are health workers, with 114 health professionals and 16 support staff. The total number of cases that have recovered is 1 517 (74%), which is lower than the regional average of 85%. Contact tracing is ongoing, with a total of 17 424 contacts identified, 173 of which were new on 16 October 2020 and 17 086 have self- isolated and been followed-up during the course of the outbreak. A total of 106 500 tests have been carried out, which is 138 tests per 10 000 population. Males are more affected than females, with a sex ratio of (M/F) 1.8 (1 323/726). The median age affected is 34, with age groups 15-24, The distribution of confirmed COVID-19 cases and deaths in Togo, 25-34 and 35-44 most affected. Most deaths are in the age groups 5 March to 16 October 2020. 45-54 (10 deaths), 55-64 (10 deaths) and 65-74 (13 deaths). Of the deaths, 36 have been in males and 15 in females. Of those who died, 22 had one comorbidity, 14 had two comorbidities, four had three comorbidities and 11 had no comorbidities. Hypertension was the most common comorbidity, followed by diabetes, obesity and tuberculosis. PUBLIC HEALTH ACTIONS Meetings of the Health Sectoral Response Unit for Response Management are held on Monday, Wednesday and Friday each week. There is ongoing data collection on monitoring of compliance Confirmation of COVID-19 infection is by PCR at the national with barrier measures in all health centres in the Kara region health laboratory at the regional office in Kara and at Dapaong with support from partners; continuation of local awareness- and Sokodé regional health centres and the Sylvanus Olympio raising by NGOs, préfects and local elected officials and university hospital. watch committees; community outreach sessions are given Work on nine isolation sites in different regions is ongoing, by community health workers and community relays; there along with equipping the seven regional centres identified for is dissemination of awareness-raising messages in radio and COVID-19 care. television broadcasts and constant management of rumours including in districts and regions. SITUATION INTERPRETATION Infection prevention and control measures are being evaluated Togo is to be commended on its efficient and organized approach to in Plateau region, along with ongoing training for workers managing the COVID-19 outbreak, which has affected all regions of in regional care centres on management of severe cases of the country, with relatively good testing levels and contact tracing and COVID-19. follow-up. However, challenges remain in funding, a requirement for continued case management training and improvements needed in Active cases are cared for in specific centres and cured cases materials and equipment availability and supply. Personal protective are reintegrated into their communities. equipment is required, as seen by the relatively high proportion of Points of entry are monitored by central, regional and district health worker infections among the total number of cases, and there monitoring teams; travellers are recorded at the Sanvi Condji is a shortage of the medications required to treat COVID-19 cases. and Noépé points of entry and travellers entering through the Testing capacity needs to be increased throughout the country, main airport are screened using a COVID-19 mobile biological since it is currently confined to a few centres, and collaboration and diagnostic laboratory, as well as those travellers who have exchange between districts needs to be improved.
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