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

Ebola Outbreak in DRC 64: 22 October 2019
1. Situation update
In the past week, from 14 to 20 October, 21 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. The incidence of new confirmed EVD cases remains substantial in parts of North Kivu and Ituri provinces – in particular in the Biakato Mine Health Area, Mandima Health, with the majority (76%) of newly confirmed cases linked to this health area.

The deployment of additional support to the Biakato Mine Health Area has led to improvements in response efforts. The proportion of confirmed cases listed as contacts has increased in the past week from 13% to 57%. This increase was similarly witnessed in confirmed cases with a known epidemiological link to a case which augmented from 47% to 90% in the past week. While this is encouraging, there remain notable challenges in accessing and mounting the full range of public health activities in some areas.

In the 21 days from 30 September to 20 October, the number of affected health areas has decreased, with 20 health areas and nine health zones reporting new cases (Table 1, Figure 2). During this period, a total of 50 confirmed cases were reported, with the majority coming from the health zones of Mandima (54%; n=27 cases) and Mambasa (10%; n=5 cases). While many cases detected outside of these zones have travelled from these hotspots, onward local transmission has been observed in Kalunguta and Mabalako health zones, highlighting the high risk of resurgence and redispersion of cases.

As of 20 October 2019, a total of 3243 EVD cases were reported, including 3127 confirmed and 116 probable cases, of which 2171 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1821) were female, 28% (923) were children aged less than 18 years, and 5% (163) were healthcare workers…

Implementation of ring vaccination protocol
As of 20 October 2019, 240,824 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola vaccine.
The Democratic Republic of the Congo health authorities have endorsed the use of a second investigational Ebola vaccine, manufactured by Johnson & Johnson. This vaccine, which is administered as a two-dose course, 56 days apart, will be circulated in at-risk populations in areas that do not have active EVD transmission. Regular vaccination activities in EVD-affected areas will continue. The Merck/MSD vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola…


Public Health Emergency of International Concern (PHEIC)

Polio this week as of 23 October 2019
:: Wild poliovirus type 3 (WPV3) has been declared as globally eradicated. At an event held on World Polio Day 2019, Professor David Salisbury, chair of the independent Global Commission for the Certification of Poliomyelitis Eradication (GCC), presented the official certificate of WPV3 eradication to WHO Director General Dr Adhanom Ghebreyesus. Read more about this landmark declaration.
[See Milestones above for detail]
:: Polio eradication efforts do not only involve providing vaccines. For one Abdullahi Mahamed Noor, basketball is his way of bringing people together to raise awareness about the devastating disease. Read about his journey on using the sport to combat polio in Somalia.

Summary of new viruses this week:
:: Afghanistan— two WPV1 cases and six positive environmental samples;
:: Pakistan— four WPV1 cases and six WPV1-positive environmental samples;
:: Nigeria— two cVDPV2 positive environmental samples.
:: Chad— one cVDPV2 case;
:: Benin— one cVDPV2 case;
:: the Democratic Republic of the Congo— one cVDPV2 case;
:: Ghana— one cVDPV2 case and three cVDPV2 positive environmental samples;
:: Ethiopia— one cVDPV2 case:
:: Togo— one cVDPV2 case:
:: Zambia— one cVDPV2 case.


Philippines: Red Cross triples polio vaccination target
25 October 2019 IFRC
The Philippine Red Cross is more than tripling the number of children it aims to vaccinate in a door-to-door polio vaccination campaign, the Red Cross and the International Federation of Red Cross and Red Crescent Societies (IFRC) said today.

On 1 October 2019, the Red Cross announced support for a Department of Health campaign by activating volunteers in parts of Mindanao and Metro Manila to vaccinate 30,000 children in the hardest-to-reach communities. In fact, the Philippine Red Cross has reached nearly 60,000 children. Today, the target was increased to 100,000.

Announcing the increase, Philippine Red Cross Chairman Richard Gordon said:
“We’re particularly worried about children under five in urban slums, rural areas, migrant families and indigenous communities who have missed out on life-saving vaccinations. It’s simply not right that these children are at risk of death or lifelong disability in the 21st century. The tripling of our target reflects the commitment of Red Cross volunteers and staff, who are literally climbing mountains and crossing rivers to ensure no child is left behind. What’s more, they will do this again in a month when children need a booster, and a month after that too.”

Apart from low immunization rates, factors that contribute to the spread of polio, dengue and measles include low health literacy, unsafe water, poor sanitation, poor living conditions, high rates of chronic childhood malnutrition and poor access to healthcare. The Red Cross is also planning to reach 1 million people with life-saving health, hygiene and sanitation information…