WEEKLY BULLETIN ON OUTBREAKS AND OTHER EMERGENCIES Week 14: 29 March to 4 April 2021 Data as reported by: 17:00; 4 April 2021 REGIONAL OFFICE FOR Africa WHO Health Emergencies Programme 0 116 103 13 New event Ongoing events Outbreaks Humanitarian crises 117 622 3 105 Algeria ¤ 36 13 110 0 5 420 164 Mauritania 7 2 10 501 392 110 0 7 0 Niger 17 927 449 Mali 3 334 10 567 0 6 0 2 079 4 4 595 165 Eritrea Cape Verde 38 520 1 037 Chad Senegal 4 918 185 59 0 Gambia 27 0 3 0 17 125 159 9 761 45 Guinea-Bissau 796 17 7 0 Burkina Faso 225 46 215 189 2 963 0 162 593 2 048 Guinea 12 817 150 12 38 397 1 3 662 66 1 1 23 12 Benin 30 0 Nigeria 1 873 71 0 Ethiopia 420 14 481 5 6 188 15 Sierra Leone Togo 3 473 296 53 920 779 52 14 Ghana 5 245 72 Côte d'Ivoire 10 098 108 14 484 479 63 0 40 0 Liberia 17 0 South Sudan Central African Republic 916 2 45 0 25 0 19 670 120 43 180 237 90 287 740 Cameroon 7 0 28 676 137 5 330 13 138 988 2 224 1 952 87 655 2 51 22 43 0 112 12 6 1 488 6 3 988 79 11 187 6 902 102 Equatorial Guinea Uganda 542 8 Sao Tome and Principe 32 11 2 042 85 41 016 335 Kenya Legend 7 100 90 Gabon Congo 18 504 301 Rwanda Humanitarian crisis 2 212 34 22 482 311 Measles 18 777 111 Democratic Republic of the Congo 9 681 135 Burundi 2 964 6 Monkeypox Ebola virus disease Seychelles 27 930 739 1 525 0 420 29 United Republic of Tanzania Lassa fever Skin disease of unknown etiology 189 0 4 084 20 509 21 Cholera Yellow fever 1 349 5 6 257 229 22 631 542 cVDPV2 Dengue fever 88 930 1 220 Comoros Angola Malawi COVID-19 Chikungunya 33 661 1 123 862 0 3 719 146 Zambia 133 0 Mozambique 2 952 40 Anthrax Leishmaniasis 2 0 464 1 25 572 454 Avian influenza Plague Zimbabwe 68 119 782 Madagascar Crimean-Congo haemorrhagic fever Mauritius Malaria 36 923 1 525 10 227 66 40 878 591 Hepatitis E Rift Valley fever 1 112 12 Namibia Cases West Nile fever Botswana Deaths Countries reported in the document 44 790 537 Eswatini Countries outside WHO African Region 17 352 668 WHO Member States with no reported events South Africa Lesotho Not applicable 10 686 315 1 552 416 52 995 Graded events † “The boundaries and names shown and the designations used on this map do not imply the expression of any (2) opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate borderlines for which there may not yet be full agreement.” 0 410 820 Kilometers 50 19 3 Grade 3 events Grade 2 events Grade 1 events 36 22 30 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 116 events in the region. This week’s articles cover: 1 Overview COVID-19 across the WHO African region Ebola virus disease in Guinea 2 -5 Ongoing events Ebola virus disease in Democratic Republic of the Congo Summary of major 6 For each of these events, a brief description, followed by public health measures issues, challenges implemented and an interpretation of the situation is provided. and proposed actions A table is provided at the end of the bulletin with information on all new and ongoing 7 All events currently public health events currently being monitored in the region, as well as recent events that being monitored have been controlled and closed. Major issues and challenges include: The African Region continues to experience a fall in both weekly cases and deaths. Ethiopia (14 626; 30.7%), Kenya (8 774; 18.4%), South Africa (6 533; 13.7%), Madagascar (1 603; 3.4%) and Côte d’Ivoire (1 569; 3.3%) reported the highest numbers of new cases. Among the top five reporting countries, only Ethiopia registered a significant increase of 10.8% during this reporting period. However, the continued spread of the virus means that the region needs to remain observant to new cases, and strengthen all active surveillance and response measures. Guinea has reported a new confirmed case on day 35 of the countdown to the end of the pandemic, which has changed the response dynamic. In addition, community resistance in the area where the last new confirmed cases and probable cases were reported has temporarily stopped response activities in the region. A serious gap in funding for the response also threatens to overturn all measures that have been taken to date. These issues require urgent intervention from authorities and partners. There have been no new Ebola virus disease cases in Democratic Republic of the Congo for 34 days. However, there are challenges with contact follow-up, difficulties with feedback from health zones and inadequate funding for all response pillars. Additionally, there are security problems that have prevented response measures by some partners. These issues need urgent attention and adequate funding needs to be provided to ensure a robust response to prevent resurgence of the outbreak. 1 Health Emergency Information and Risk Assessment Health Emergency Information and Risk Assessment 157 3 089 961 78 369 2.5% Coronavirus disease 2019 African region Cases Deaths CFR In the past seven days (29 March - 4 April 2021), the African number of COVID-19 related deaths per million population. Region reported 47 626 new cases, a 17.7% decrease compared Zimbabwe (0.8/million population) Ethiopia (0.8/million), Nigeria to the previous week. Thirty-two (69.6%) countries showed (0.7/million), Madagascar (0.4/million) and South Africa (0.4/ a fall in new cases, while 13 (28.3 %) had an increase in new million) have the lowest number of COVID-19 related deaths per daily cases. Ethiopia (14 626; 30.7%), Kenya (8 774; 18.4%), million population. South Africa (6 533; 13.7%), Madagascar (1 603; 3.4%) and As health workers continue being at the frontline of the pandemic, Côte d’Ivoire (1 569; 3.3%) reported the highest numbers of COVID-19 infections among them are on the increase. To-date new cases. Among the top five reporting countries, only Ethiopia 105 734 (3.4% of all cases) health worker infections have been registered a significant increase of 10.8% during this reporting reported from 46 countries in the region. South Africa (54 984, period. This overall fall in new cases could result in complacency 52.0%), Algeria (11 936, 11.3%) and Ghana (4 763, 4.5%), have around COVID-19 response measures in regional populations, recorded the highest number of health worker infections among with resultant non-adherence to preventive measures, already countries. Zimbabwe (11.4%), Liberia (11.0%), and Guinea- seen in many countries. Therefore, these trends need to be Bissau (10.3%), have the highest country specific proportion carefully monitored. of health worker infections. Only Eritrea has not reported any A decrease (25.1%) in daily deaths has also been observed, with healthcare worker infections. 935 deaths reported last week. These are encouraging trends as The total number of confirmed COVID-19 cases in the African we start to monitor the impact of vaccine rollout. The new deaths continent is over 4.3 million. Total death counts now stand at were reported by 44 countries in the past 7 days with an average 114 361 deaths (case fatality ratio 2.7%), and more than 3.8 of 134 deaths per day; including 324 (34.7%) in South Africa, million people have recovered. 162 (17.3%) in Ethiopia, and 107 (11.4%) in Kenya. Currently, the total number of confirmed cases in the WHO African Region is over 3 million, including 78 369 deaths (case fatality ratio 2.5%), accounting for 2.4% of global cases and 2.8% The weekly distribution of confirmed cases of COVID-19 of global deaths. At this time, there are more than 2.7 million in the WHO African Region by reporting date, recoveries in the WHO African Region, giving a recovery rate of 25 February 2020 – 4 April 2021 (n = 3 089 961) 90.0% of confirmed case patients. The top five countries reporting the highest case numbers include South Africa (1 551 964 cases, 50.2%), Ethiopia (215 189 cases, 6.9%), Nigeria (163 195 cases, 5.3%), Kenya (138 988 cases, 4.5%) and Algeria (117 524 cases, 3.8%), accounting for 2 186 860 (70.8%) of all cases. The United Republic of Tanzania has reported no new confirmed cases in our database in the last 334 days. The average cumulative attack rate (number of cases per million) in the African region is estimated at 2 832/million population, ranging from 9/million to 43 985 million. Seychelles (43 985 cases/million population), Cabo Verde (32 497 cases/million), South Africa (26 503 cases/million), Namibia (17 956 cases/ million) and Botswana (16 687 cases/million), are the five countries with the highest attack rate in the region.