Public Health Emergency of International Concern (PHEIC)
Polio this week as of 31 July 2019
:: July 2019 Polio News is available online for all the latest news, polio in numbers and the funding updates.

Summary of new viruses this week:
:: Afghanistan — one wild poliovirus type 1 (WPV1) case;
:: Pakistan— two WPV1-positive cases and eight WPV1-positive environmental samples;
:: Nigeria —one circulating vaccine-derived poliovirus type 2 (cVDPV2) case and one cVDPV2-positive environmental sample;
:: Democratic Republic of the Congo (DRC) — one cVDPV2 sample isolated from a contact case and one cVDPV2 community isolate;
:: Central African Republic — one cVDPV2-positive environmental sample and 13 cVDPV2 samples isolated from community;
:: Myanmar — one cVDPV type 1 case and five cVDPV1 samples isolated from a contact case.


Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Inter-Agency Statement on Ebola outbreak in the Democratic Republic of the Congo, one year on
Joint statement from WHO Director-General Dr Tedros Adhanom Ghebreyesus, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, UNICEF Executive Director Henrietta Fore, and World Food Programme Executive Director David Beasley
NEW YORK/GENEVA/KINSHASA/DAKAR/ROME, 31 July 2019 – “Tomorrow, 1 August, marks one year since the Government of the Democratic Republic of the Congo (DRC) declared an outbreak of the Ebola virus disease in North Kivu province of the DRC. Two weeks ago, it was declared a public health emergency of international concern.

“Just yesterday, a new case of the disease was confirmed in Goma, with the patient later dying – the second case to be confirmed this month in the city of around 1 million people. This latest case in such a dense population center underscores the very real risk of further disease transmission, perhaps beyond the country’s borders, and the very urgent need for a strengthened global response and increased donor investment.

“In the last year, there have been more than 2,600 confirmed cases, including more than 1,800 deaths in parts of Ituri and North Kivu provinces. Almost one in three ‘cases’ is a child. Every single ‘case’ is someone who has gone through an unimaginable ordeal. More than 770 have survived.

“The disease is relentless and devastating.

“Ebola passes from mother to child, husband to wife, patient to caregiver, from the dead body of a victim to the mourning relative. The disease turns the most mundane aspects of everyday life upside down — hurting local businesses, preventing children from going to school and hampering vital and routine health services. It is primarily a health crisis, but one that also critically impacts how people care for their family, view their neighbours and interact with their community.

“The challenges to stopping further transmission are indeed considerable. But none are insurmountable. And none can be an excuse for not getting the job done. The United Nations and partners are continuing to ramp up the response in support of the Government and to further bolster joint action. The UN is working to ensure an enabling environment for the public health response that its health agency supports, including appropriate security, logistics, political and community engagement, and action to address the concerns of affected communities. We commend the recent Government decision to take measures to ensure its efforts are further joined up.

“We also salute the heroic efforts of the mostly Congolese healthcare workers on the front line, the people of affected communities and partners. Despite their ceaseless work, the disease continues to spread. This outbreak is occurring in an active conflict zone which makes an effective response far more complicated because of insecurity, including armed attacks on health workers and facilities, and population displacement. In some of the affected areas, violence is preventing us from reaching communities and working with them to stop further transmission.

“We call on all parties to the violence to ensure that responders can do their work safely and that those seeking care can access it without fear of attacks.

“We are proud of the work that we and our partners have done so far, collaborating with communities in support of the Government-led response to protect those at risk and care for those affected:
:: Over 170,000 people vaccinated;
:: 1,300 people treated with investigational therapies across 14 treatment and transit centres;
:: 77 million screenings of national and international travelers;
:: 20,000 contacts visited daily to ensure they do not also become sick;
:: 3,000 samples tested in 8 laboratories every week;
:: More than 10,000 handwashing sites installed in critical locations;
:: More than 2,000 community engagement workers operating in affected – areas listening to concerns, gaining trust, and mobilizing local action;
:: Over 440,000 patients and contacts provided with food assistance, crucial to limiting movement among people who could spread the disease; and
:: Daily meals provided to 25,000 schoolchildren in Ebola-affected areas to help build trust within communities.

“Now we must build on those achievements, but to do so we urgently need far more support from the international community. The Government needs more support than ever before. The public health response to an Ebola outbreak requires an exceptional level of investment; 100 per cent of cases must be treated and 100 per cent of contacts must be traced and managed. We need air transport to get responders and critical equipment to some of the most remote areas and warehousing to safely store precious health supplies including vaccines. We will continue to accelerate our response, and we ask partners old and new to do the same.

“At this critical juncture, we reaffirm our collective commitment to the people of the DRC; we mourn for those we have lost; and we call for solidarity to end this outbreak.”


Rwanda’s border with DRC remains open
Kigali, August 1 2019 — The Ministry of Health confirms that Rwanda’s border with the Democratic Republic of Congo is open, following traffic slow-down this morning as measures were put in place to reinforce screening procedures and public safety at entry points.
To date, Rwanda remains Ebola free. The Ministry has advised against unnecessary travels to Goma-Eastern Congo, following increasing number of cases confirmed in DRC, and requested that individuals who have recently travelled to an Ebola affected area to report to the nearest screening station and to report any suspected Ebola cases via the Ministry of health toll-free lines 114, police number 112 or to community health workers or the nearest health centre…


Geneva Palais briefing note on the impact of the Ebola outbreak on children in the Democratic Republic of the Congo
Press release
This is a summary of remarks by Jerome Pfaffman, UNICEF Senior Health Specialist – to whom quoted text may be attributed – at today’s press briefing at the Palais des Nations in Geneva
…This Ebola response is far more complex because it is in an active conflict zone. People living in North Kivu and Ituri are facing a public health emergency and a humanitarian crisis at the same time.
Both provinces, for example, are also facing a major measles outbreak. In Ituri, about half of the health facilities have been damaged or destroyed during fighting over the past two years. There is mass displacement. We have just completed a first vaccination campaign in the provincial capital, Bunia, where we vaccinated more than 40,000 children against measles. But we need to vaccinate far more children, against the full array of diseases, in order to protect them from all the public health risks they are exposed to.
This is why the new strategic response plan includes both an intensification of the public health response, and a whole program to address acute humanitarian and social needs.
UNICEF will need to triple its budget to respond to this complex crisis. This includes about 70 million dollars for epidemic control activities, 30 million to build community capacities in at-risk areas, and another 70 million to deliver essential services.
Colleagues and communities are fighting the outbreak tirelessly but we desperately need the international community to back us up…


Press release
UNICEF ramps up Ebola prevention efforts as South Sudan assessed as ‘high-risk’ country
UN children’s agency reaches 3 million with Ebola prevention messages
…UNICEF South Sudan is focusing on and engaging populations that are most at risk in the states bordering DRC and Uganda. The UN children’s agency and its partners have trained 450 front-line mobilizers who are knocking on doors, organizing community meetings and engaging religious and local leaders to disseminate life-saving messages.
“Our teams and partners on the ground working in the communities confirm that an increasing number of people are now aware of Ebola, and the protection measures they can take to avoid infection,” said Ayoya, “The early detection and containment of the three Ebola cases in Uganda in June came as a result of increased public awareness and shows the true value of the prevention work and of working with communities. As long as Ebola remains on our doorstep, we cannot rest and must continue our efforts.”…


Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.
WHO Grade 3 Emergencies [to 3 Aug 2019]

Democratic Republic of the Congo
[See DRC Ebola+ above for detail]

Cyclone Idai – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified


WHO Grade 2 Emergencies [to 3 Aug 2019]

:: Libya: Five medical staff dead in latest attack on health facilities in Tripoli
Tripoli, 28 July 2019 – The World Health Organization strongly condemns yesterday’s attack on Az Zawiyah Field Hospital in the south of Tripoli. Five health workers were killed and eight were injured in the attack. The hospital was damaged and forced to suspend its services.

:: MERS-CoV global summary and assessment of risk – August 2018
pdf, 570kb

:: Bi‐weekly Situation Report 15 – 1 August 2019

Afghanistan – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017)
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified


WHO Grade 1 Emergencies [to 3 Aug 2019]

Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified


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 – No new digest announcements identified
Yemen – No new digest announcements identified


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified