Avian Influenza A(H5N1)- Lao People’s Democratic Republic

The Ministry of Health in Lao People’s Democratic Republic (PDR) reported a human case of infection with an avian influenza A(H5N1) virus. The case is a one-year-old female who developed symptoms of fever, productive cough, difficulty breathing and runny nose on 13 October 2020. She was hospitalized for her illness on 16 October and discharged on 19 October. As part of severe acute respiratory infection (SARI) sentinel surveillance, a specimen was collected on the date of hospitalization and confirmed to be positive for avian influenza A(H5N1) on 28 October by reverse transcription polymerase chain reaction (RT-PCR) at the National Centre for Laboratory and Epidemiology (NCLE).

Among the close contacts of the patient, one contact developed fever and cough after the onset of illness in the case. Specimens collected from all household contacts, including the symptomatic contact, were negative for influenza A viruses.

Rift Valley Fever – Mauritania

The Ministry of Health (MoH) notified WHO that between 13 September and 1 October 2020, eight cases of Rift Valley Fever (RVF) including seven deaths were confirmed in animal breeders. Districts affected include Tidjikja and Moudjéria (Tagant region), Guerou (Assaba region) and Chinguetty (Adrar region). Laboratory confirmation of RVF infection was performed using a reverse transcription polymerase chain reaction (RT-PCR) at the National Institute for Public Health Research (INRSP) in Nouakchott. The age of infected patients varied between 16 and 70 years old and included one woman and seven men. All seven deaths occurred among hospitalised patients with fever and haemorrhagic syndrome (petechia, gingivorrhagia) and vomiting.

Between 4 September to 7 November 2020, a total of 214 people were sampled and their samples have been sent to the INRSP for laboratory testing with a total of 75 testing positive for RVF (RT-PCR and serology by enzyme-linked immunosorbent assay (ELISA). Positive cases have been reported in 11 of 15 regions of the country: Brakna, Trarza, Gorgol, (on the border with Senegal), Adrar, Assaba, Hodh El Gharby, Hodh El Chargui, Guidimaka (on the border with Mali) and Nouakchott Sud, Nouakchott Ouest and Tagant. The Tagant region is the most affected (38/75, 51%) with principal hotspot districts being Tidjikja and Moudjeria. Thus far a total of 25 deaths have been reported from this outbreak.

Mayaro virus disease – French Guiana, France

On 13 October 2020, the French health authorities officially reported 13 laboratory-confirmed cases of Mayaro fever in French Guiana, France.

In September 2020, the Institut Pasteur de la Guyane (IPG) (member of the French National Reference Laboratory for arboviruses) identified two cases of Mayaro virus infection (MAYV) confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and one probable case found positive for Mayaro antibodies. The case-patients presented dengue-like symptoms and joint pains, and tested negative for dengue by RT-PCR.

Oropouche virus disease – French Guiana, France

On 30 September 2020, the French Guiana Regional Health Agency (ARS) reported the first detection of Oropouche virus (OROV) in French Guiana. On 22 September 2020 the Pasteur Institute in Cayenne (a member of the French National Reference Laboratory for arboviruses) notified the France IHR National Focal Point of seven laboratory-confirmed cases of Oropouche virus infection in the village of Saül. These cases were identified following clinical investigations of an unusually high number of dengue-like illnesses in the village. Between 11 August and 25 September, there were 37 clinically-compatible cases of Oropouche virus disease identified in Saül. The results of serology for dengue, chikungunya, and Zika were negative, and seven of nine cases tested positive for OROV by reverse transcriptase polymerase chain reaction (RT-PCR).

Among the 37 clinically-compatible cases, most cases are male (60%) and the median age is 36 years (range 3-82 years). The most represented age range is 15 to 54-years-old (19 cases) followed by 0 to 14-years-old (10 cases). A peak of cases was observed in mid-September however, the outbreak investigation remains ongoing.

Monkeypox – Democratic Republic of the Congo

From 1 January through 13 September 2020, a total of 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio 3.7%), have been reported in 127 health zones from 17 out of 26 provinces in the Democratic Republic of the Congo. The first epidemic peak was observed at the beginning of March 2020 (epi week 10), with 136 cases reported weekly (Figure1). From 1 January through 7 August, the Institut National de Recherche Biomédicale (INRB) received 80 samples from suspected cases of monkeypox, of which 39 samples were confirmed positive by polymerase chain reaction. Four out of the 80 specimens were skin lesions (crusts/vesicles), the remaining samples were blood. There is no further information at this time regarding the outcome of these 80 patients whose samples were tested. Confirmatory testing remains ongoing.

During the same period in 2019, 3,794 suspected cases and 73 deaths (CFR 1.9%) were reported in 120 health zones from 16 provinces while a total of 2,850 suspected cases (CFR 2.1%) were reported in 2018.

Chikungunya – Chad

On 28 August 2020, the National IHR Focal Point of Chad notified WHO of an outbreak of chikungunya in Abéché, eastern Chad.

Yellow fever – French Guiana, France

On 23 July 2020, the France IHR National Focal Point reported a confirmed autochthonous (locally acquired) case of yellow fever in a 14-year-old male in French Guiana. On 17 July 2020, the case was laboratory confirmed at the French National Reference Centre for arboviruses, Institute Pasteur Cayenne.

The case-patient had severe disability, and developed dengue-like symptoms on 12 July. On 16 July, he was hospitalized in an intensive care unit in Cayenne, French Guiana, with consciousness disorders and acute liver failure, and died on 19 July.

Plague – Democratic Republic of the Congo

The health zone of Rethy in Ituri province, the Democratic Republic of the Congo, has seen an upsurge of plague cases since June 2020. The first case, a 12-year-old girl, reported to a local health centre on 12 June experiencing a headache, fever, cough, and an enlarged lymph node. She died on the same day and further deaths from the community due to suspected cases of plague were subsequently reported.

From 11 June though 15 July, six out of 22 health areas have been affected within Rethy health zone (11 villages), with a total of 45 cases including nine deaths (case fatality rate: 20%). All nine (9) cases who died presented with signs of headache, high fever, and painful nodes; four (4) out of the nine (9) cases had cough.