Public Health Emergency of International Concern (PHEIC)
Polio this week as of 21 February 2018 [GPEI]
:: New on http://polioeradication.org/: Ending polio and yellow fever in Nigeria, and why the polio vaccine must be delivered multiple times.
::  Our brand new animation on the two polio vaccines has been released, available in English, French, and Arabic.
:: In response to recent cases, the government of the Democratic Republic of the Congo (DRC) has announced the circulating vaccine-derived poliovirus 2 (cVDPV2) outbreak ongoing in the country as a Public Health Emergency of National Concern. Since the outbreak began, the Ministry of Health, supported by WHO and partners of the Global Polio Eradication Initiative, has implemented four monovalent oral polio vaccine 2 (mOPV2) supplementary immunization campaigns and one mop-up campaign to prevent virus spread. They have worked hard to strengthen surveillance and routine immunization in the outbreak zones and across the country, and are fully committed to ending the outbreak. The total number of officially reported cVDPV2 cases in the DRC in 2017 is 21. No cases of cVDPV2 with onset in 2018 have so far been reported.
:: Summary of newly-reported viruses this week: No new viruses reported.

Syria cVDPV2 outbreak situation report 35, 20 February 2018
Situation update 20 February 2018
[Editor’ text bolding]
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 74. The most recent case (by date of onset of paralysis) is 21 September 2017 from Boukamal district, Deir Ez-Zor governorate.
:: An inactivated polio vaccine (IPV) immunization round has successfully concluded in Damascus, Hasakah, parts of Aleppo governorates, and Jurmana district of rural Damascus as part of the second phase of the outbreak response. IPV vaccination is continuing in accessible parts of Aleppo governorate.
:: Reportedly, a total of 233 518 children aged 2–23 months received IPV, representing 71% of the estimated target.
:: Post campaign monitoring of the IPV campaign has concluded in Damascus, Hasakah and parts of Aleppo governorate that completed the implementation. Overall, post campaign monitoring indicates 81% vaccination rates by parental/caregiver recall and 77% by finger marking.
:: Post campaign monitoring particularly focused on the internally displaced persons (IDP) camps; the data indicates 91% vaccination rates by parental/caregiver recall and 89% by finger marking.
:: A nationwide immunization round utilizing bivalent OPV (bOPV) is planned for March. The campaign will target all children aged less than 5 years.


WHO Grade 3 Emergencies  [to 24 February 2018]
The Syrian Arab Republic
:: Syria cVDPV2 outbreak situation report 35, 20 February 2018
[See Polio above for detail]

Weekly cholera bulletins
:: Weekly epidemiology bulletin, 5–11 February 2018
Cumulative figures
-The cumulative total from 27 April 2017 to 11 Feb 2018 is 1,059,970 suspected cholera cases and 2,258 associated deaths, (CFR 0.21%), 1104 have been confirmed by culture.
– 59.3 % of death were severe cases at admission
– The total proportion of severe cases among the suspected cases is 16%
– The national attack rate is 382.7 per 10,000. The five governorates with the highest cumulative attack rates per 10,000 remain Amran (894), Al Mahwit (857), Al Dhale’e (644), Hajjah (520) and Sana’a (515).
– Children under 5 years old represent 28.8% of total suspected cases.
– In total, 29,629 rapid diagnostic tests (RDT) have been performed which represents 28 % coverage.
– 2,732 cultures have been performed which represents 22.3% coverage.
– The last positive culture was on 4 Feb 2018 in Al Harith district in Amant Al Asimah
– 182 districts are still reporting suspected cholera cases since last 3 weeks
– 123 districts (out of 305 affected districts) did not report any suspected cases for the last three consecutive weeks
Governorate and District level
– At governorate level, the trend from W4 –W6 decrease or was stable in all governorates except (Aden governorate)
– The weekly number of cases is decreasing for the 22 consecutive weeks.
– The weekly proportion of severe cases has significantly decreased representing now 9% of the admitted cases.
Week 6 2018
– 3,886 suspected cases and 3 associated deaths were reported
– 9 % are severe cases
– 589 RDTs were performed, 131 were positive
– No culture test was performed this week

WHO Grade 2 Emergencies  [to 24 February 2018]
Bangladesh/Myanmar: Rakhine Conflict 2017
[See WHO announcement in Milestones/Perspectives above]

Democratic Republic of the Congo 
:: Read the health situation report in French pdf, 4.28Mb, February 2018

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: 23 Feb 2018   UN chiefs call for stepped-up support for vulnerable Syrians, refugees and host communities, amid escalating violence inside Syria

:: 20 Feb 2018  Yemen Humanitarian Update Covering 12 – 18 February 2018