Pathfinder
Editor, Senior Moderator
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 52: 19 to 25 December 2022
Data as reported by: 17:00; 25 December 2022
...
Yellow fever West, Central, and East Africa
455 cases
40 Deaths
11% CFR
EVENT DESCRIPTION
Yellow fever outbreaks have been reported from 12 countries
in the WHO African Region in 2022, namely Cameroon, Central
African Republic (CAR), Chad, Côte d’Ivoire, Democratic Republic
of Congo (DRC), Ghana, Kenya, Niger, Nigeria, Republic of Congo,
Sierra Leone and Uganda.
Of these, eight countries are experiencing continued transmission
since 2021 (Cameroon, CAR, Chad, Côte d’Ivoire, DRC, Ghana,
Nigeria, and Republic of Congo) and four countries have reported
confirmed cases only in 2022 (Kenya, Niger, Sierra Leone, and
Uganda). Gabon reported one confirmed case in 2021, but no
further cases were recorded in 2022, indicating the end of the
outbreak in this country.
Between 1 January 2021 and 19 December 2022, a total of 203
confirmed and 252 probable cases have been reported to WHO
from 13 countries in the WHO African Region, with 49 additional
plaque reduction neutralization test (PRNT)-positive samples
currently pending classification. Of the confirmed cases, 151
(74%) had symptom onset in 2021 while 52 (26%) in 2022.
Overall, 40 deaths have been reported from a total of 455
confirmed and probable cases (CFR 9%) including 23 deaths
among confirmed cases (CFR 11% among confirmed cases).
Overall CFR remained high among confirmed cases in 2022 (6
deaths, 12%) compared to 2021 (17 deaths, 11%), with several
countries reporting CFRs above 1%.
The majority of confirmed cases between 1 January 2021 and 19
December 2022 were reported in the last quarter of 2021, with
most occurring in Ghana (62 cases, 12 deaths), Cameroon (35
cases, 0 deaths), Chad (30 cases, 5 deaths), Nigeria (24 cases, 0
deaths), and CAR (23 cases, 3 deaths).
Other countries that reported confirmed cases during the twoyear
period were Côte d’Ivoire (8 cases, 0 deaths), DRC (6 cases,
1 death), Congo (4 cases, 0 deaths), Niger (4 cases, 1 death),
Kenya (3 cases, 0 deaths), Uganda (2 cases, 0 deaths), Gabon
(1 case, 0 deaths), and most recently Sierra Leone (1 case, 0
deaths). Countries including Burkina Faso, Senegal, and Togo
have reported probable cases that were later ruled out. A probable
case from Benin is currently pending classification.
Among confirmed cases, the male to female ratio was similar in
2021 and 2022 (1.3 and 1.6 respectively). The most affected age
group in 2021 was 10 years and below, while the most affected
age group in 2022 is 20-30 years. Overall, approximately 71% of
confirmed cases are 30 years old and younger, and children 10
years old and below appear to be particularly affected.
According to WUNIEC, country vaccination coverages for 2021
are as: Cameroon (54%), Central Africa Republic (41%), Chad
(45%), Congo (67%), Côte d’Ivoire (65%), Democratic Republic
of Congo (56%), Gabon (64%), Ghana (94%), Kenya (7%), Niger
(80%), Nigeria (63%) and Sierra Leone 85%, (Uganda NA).
.
PUBLIC HEALTH ACTIONS
WHO provides coordination and technical support to countries
in conducting comprehensive investigations and outbreak
response. Response measures by affected countries include:
Training of 51 personnel from at least 10 countries in the
investigation of confirmed or probable cases of yellow fever.
Reviewing case investigation reports and providing feedback
to field teams to assess disease exposure and risk of disease
amplification.
An innovative programme to enable international shipment
of YF samples to regional reference laboratories, as well as
laboratory testing and capacity building, has been initiated
with support from the EYE strategy.
WHO is engaged in ongoing activities to support countries
in YF laboratory diagnosis, including periodic accreditation
visits and capacity development.
Nine International Coordination Group (ICG) requests for
YF emergency vaccine provision have been funded and
vaccines were received by countries (2 Ghana, 2 Chad, 2
CAR, 1 Cameroon, 1 Kenya and 1 Niger). Since the beginning
of the current outbreak (2021 to 29 November 2022), a total
of 4 385 320 persons have been vaccinated in Ghana, Chad,
CAR, Kenya, and Cameroon as part of the ICG-supported
response.
Most priority countries have conducted a PMVC against
YF or are in process. Gabon, Kenya, and Niger have not
yet planned PMVCs. However, they are included in the EYE
strategy as priorities. Approximately 50 million people are
expected to be protected by PMVCs in 2022.
Chad submitted its application for a prevention mass
campaign. Weekly risk analysis sessions have been
conducted since 18 October 2022 to inform planning of
priority areas for the prevention mass campaign.
The Republic of the Congo: PMVC for YF & measles
integrated vaccination was organized from 5 to 14 August
2022 in 11 out of 12 departments with a coverage of 93%
for YF (preliminary report). The final report of the campaign
and the mandatory PCCS are pending.
The Democratic Republic of Congo: Eight provinces have
organized preventive campaigns in 2021 including Bas-Uele,
Equateur, Haut-Uele, Mongala, Nord-Ubangi, Sud-Ubangi,
Tshopo and Tshuapa. Three provinces have been scheduled
to conduct additional preventive campaigns as from end of
November through December 2022 and include Maniema,
Sankuru and Sud Kivu.
Uganda: The country introduced YF vaccination into routine
immunization in late October 2022. In addition, 10 of 13
million vaccine doses have been received for PMVC, the
rest had been expected by the end of November 2022 but
have not yet been received. PMVC has been planned for late
January 2023.
All 13 countries reporting confirmed cases of YF have
implemented proof of YF vaccination requirements as a
condition of entry. Ten countries require proof of yellow
fever vaccination for all travelers, regardless of travel origin,
while three countries (Chad, Kenya, and Nigeria) require
proof of yellow fever vaccination for travelers arriving from
countries with areas at risk for yellow fever transmission, as
determined by the WHO Secretariat.
SITUATION INTERPRETATION
The measles outbreak in South Africa which has been showing
an increasing trend in the past month has seen a decline in
the past seven days. Given the strong laboratory capacity in
country, all reported cases have been laboratory confirmed.
Case management tracking and follow up of cases and contacts
for vaccination is ongoing, however vaccination strengthening
efforts must continue to get the outbreak under control.
...
https://apps.who.int/iris/bitstream/handle/10665/365480/OEW52-1925120222.pdf
AND OTHER EMERGENCIES
Week 52: 19 to 25 December 2022
Data as reported by: 17:00; 25 December 2022
...
Yellow fever West, Central, and East Africa
455 cases
40 Deaths
11% CFR
EVENT DESCRIPTION
Yellow fever outbreaks have been reported from 12 countries
in the WHO African Region in 2022, namely Cameroon, Central
African Republic (CAR), Chad, Côte d’Ivoire, Democratic Republic
of Congo (DRC), Ghana, Kenya, Niger, Nigeria, Republic of Congo,
Sierra Leone and Uganda.
Of these, eight countries are experiencing continued transmission
since 2021 (Cameroon, CAR, Chad, Côte d’Ivoire, DRC, Ghana,
Nigeria, and Republic of Congo) and four countries have reported
confirmed cases only in 2022 (Kenya, Niger, Sierra Leone, and
Uganda). Gabon reported one confirmed case in 2021, but no
further cases were recorded in 2022, indicating the end of the
outbreak in this country.
Between 1 January 2021 and 19 December 2022, a total of 203
confirmed and 252 probable cases have been reported to WHO
from 13 countries in the WHO African Region, with 49 additional
plaque reduction neutralization test (PRNT)-positive samples
currently pending classification. Of the confirmed cases, 151
(74%) had symptom onset in 2021 while 52 (26%) in 2022.
Overall, 40 deaths have been reported from a total of 455
confirmed and probable cases (CFR 9%) including 23 deaths
among confirmed cases (CFR 11% among confirmed cases).
Overall CFR remained high among confirmed cases in 2022 (6
deaths, 12%) compared to 2021 (17 deaths, 11%), with several
countries reporting CFRs above 1%.
The majority of confirmed cases between 1 January 2021 and 19
December 2022 were reported in the last quarter of 2021, with
most occurring in Ghana (62 cases, 12 deaths), Cameroon (35
cases, 0 deaths), Chad (30 cases, 5 deaths), Nigeria (24 cases, 0
deaths), and CAR (23 cases, 3 deaths).
Other countries that reported confirmed cases during the twoyear
period were Côte d’Ivoire (8 cases, 0 deaths), DRC (6 cases,
1 death), Congo (4 cases, 0 deaths), Niger (4 cases, 1 death),
Kenya (3 cases, 0 deaths), Uganda (2 cases, 0 deaths), Gabon
(1 case, 0 deaths), and most recently Sierra Leone (1 case, 0
deaths). Countries including Burkina Faso, Senegal, and Togo
have reported probable cases that were later ruled out. A probable
case from Benin is currently pending classification.
Among confirmed cases, the male to female ratio was similar in
2021 and 2022 (1.3 and 1.6 respectively). The most affected age
group in 2021 was 10 years and below, while the most affected
age group in 2022 is 20-30 years. Overall, approximately 71% of
confirmed cases are 30 years old and younger, and children 10
years old and below appear to be particularly affected.
According to WUNIEC, country vaccination coverages for 2021
are as: Cameroon (54%), Central Africa Republic (41%), Chad
(45%), Congo (67%), Côte d’Ivoire (65%), Democratic Republic
of Congo (56%), Gabon (64%), Ghana (94%), Kenya (7%), Niger
(80%), Nigeria (63%) and Sierra Leone 85%, (Uganda NA).
.
PUBLIC HEALTH ACTIONS
WHO provides coordination and technical support to countries
in conducting comprehensive investigations and outbreak
response. Response measures by affected countries include:
Training of 51 personnel from at least 10 countries in the
investigation of confirmed or probable cases of yellow fever.
Reviewing case investigation reports and providing feedback
to field teams to assess disease exposure and risk of disease
amplification.
An innovative programme to enable international shipment
of YF samples to regional reference laboratories, as well as
laboratory testing and capacity building, has been initiated
with support from the EYE strategy.
WHO is engaged in ongoing activities to support countries
in YF laboratory diagnosis, including periodic accreditation
visits and capacity development.
Nine International Coordination Group (ICG) requests for
YF emergency vaccine provision have been funded and
vaccines were received by countries (2 Ghana, 2 Chad, 2
CAR, 1 Cameroon, 1 Kenya and 1 Niger). Since the beginning
of the current outbreak (2021 to 29 November 2022), a total
of 4 385 320 persons have been vaccinated in Ghana, Chad,
CAR, Kenya, and Cameroon as part of the ICG-supported
response.
Most priority countries have conducted a PMVC against
YF or are in process. Gabon, Kenya, and Niger have not
yet planned PMVCs. However, they are included in the EYE
strategy as priorities. Approximately 50 million people are
expected to be protected by PMVCs in 2022.
Chad submitted its application for a prevention mass
campaign. Weekly risk analysis sessions have been
conducted since 18 October 2022 to inform planning of
priority areas for the prevention mass campaign.
The Republic of the Congo: PMVC for YF & measles
integrated vaccination was organized from 5 to 14 August
2022 in 11 out of 12 departments with a coverage of 93%
for YF (preliminary report). The final report of the campaign
and the mandatory PCCS are pending.
The Democratic Republic of Congo: Eight provinces have
organized preventive campaigns in 2021 including Bas-Uele,
Equateur, Haut-Uele, Mongala, Nord-Ubangi, Sud-Ubangi,
Tshopo and Tshuapa. Three provinces have been scheduled
to conduct additional preventive campaigns as from end of
November through December 2022 and include Maniema,
Sankuru and Sud Kivu.
Uganda: The country introduced YF vaccination into routine
immunization in late October 2022. In addition, 10 of 13
million vaccine doses have been received for PMVC, the
rest had been expected by the end of November 2022 but
have not yet been received. PMVC has been planned for late
January 2023.
All 13 countries reporting confirmed cases of YF have
implemented proof of YF vaccination requirements as a
condition of entry. Ten countries require proof of yellow
fever vaccination for all travelers, regardless of travel origin,
while three countries (Chad, Kenya, and Nigeria) require
proof of yellow fever vaccination for travelers arriving from
countries with areas at risk for yellow fever transmission, as
determined by the WHO Secretariat.
SITUATION INTERPRETATION
The measles outbreak in South Africa which has been showing
an increasing trend in the past month has seen a decline in
the past seven days. Given the strong laboratory capacity in
country, all reported cases have been laboratory confirmed.
Case management tracking and follow up of cases and contacts
for vaccination is ongoing, however vaccination strengthening
efforts must continue to get the outbreak under control.
...
https://apps.who.int/iris/bitstream/handle/10665/365480/OEW52-1925120222.pdf