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.

Influenza A(H1N2) variant virus – Brazil

On 22 June 2020, the International Health Regualtions (IHR) Focal Point (FP) of Brazil shared a preliminary report with the Panamerican Health Organization, the WHO Regional Office for the Americas of a human infection with Influenza A(H1N2) variant virus (A(H1N2)v). According to the report, the patient, a 22-year-old female, with no comorbidities, worked in a swine slaughterhouse in Ibiporã Municipality, Paraná State, and developed an influenza-like illness on 12 April 2020. The patient initially sought medical care on 14 April and a respiratory specimen was obtained on 16 April as part of routine surveillance activities. The patient was treated with oseltamivir, was not hospitalized and has recovered.

A real-time RT-PCR test conducted at the public health laboratory identified a non-subtypable influenza A virus. In May 2020, the specimen was forwarded to the Laboratory of Respiratory Virus and Measles, Oswaldo Cruz Institute (FIOCRUZ per its acronym in Portuguese), a national influenza reference laboratory, in Rio de Janeiro. On 22 June, genetic sequencing characterized this virus as an influenza A(H1N2)v virus.

Yellow fever – Gabon

On 15 April 2020, WHO received information regarding a confirmed case of yellow fever in Magandi village, Tchibanga city in Nyanga Province of southern Gabon, 590 km from the capital, Libreville.

The case is an 83-year-old male with no known vaccination history for yellow fever. He had onset of symptoms on 30 January 2020 and presented to a health facility on 2 February 2020 with abdominal pain and jaundice. Between 2 February and 9 April, he consulted the Urban Health Centre in Tchibanga, the Christian Alliance Hospital in Bongolo and the University hospital in the capital Libreville where the case received anti-malarial treatment and remained hospitalized until his death on 9 April 2020. On 14 April 2020, the laboratory results received from the WHO Regional Reference Laboratory at the Institute Pasteur in Dakar, Senegal, confirmed yellow fever infection, by seroneutralisation test. The additional differential diagnostic tests performed were negative for dengue, West Nile fever, chikungunya, Crimean-Congo Haemorrhagic fever, Zika and Rift Valley fever.

Yellow fever – Togo

On 20 April 2020, WHO received information regarding a confirmed yellow fever case in Galangashie health area, located 30 km from Mango village, Oti district, Savanes region in the northern part of Togo.

The case is a 55-year-old woman with no vaccination history for yellow fever. She had onset of symptoms on 31 January 2020 and presented to a health facility on 3 February 2020 with fever and aches. The following day she developed jaundice and a blood sample was taken. On 7 February , the blood sample was transported to the national laboratory. On 10 February , the sample from the case was received at the national laboratory and test results on 17 March were Immunoglobulin M (IgM) positive for yellow fever. The positive yellow fever result was confirmed by the Institute Pasteur in Dakar Senegal, a yellow fever reference laboratory on 14 April 2020 by seroneutralisation.

Measles – Burundi

Burundi has been experiencing an increase in the number of confirmed cases of measles since November 2019. This outbreak initially started in a refugee transit camp (Centre de transit de Cishemere, Cibitoke Health district), whose inhabitants had arrived from measles-affected provinces of the Democratic Republic of Congo. Refugees spend 21 days in the Transit Camp of Cishemere before they are sent to permanent camps in Nyankanda and Bwagiriza refugee camps in Butezi, Kavumu camp of Cankuzo, Garsowe camp of Muyinga and Mulumba camp at Kiremba.

The outbreak was identified when suspected measles cases had been reported by the local residents in the surrounding areas, highlighting pockets of under-vaccinated populations. According to WHO/UNICEF 2018 estimates, measles first dose vaccination coverage is relatively high (88%), and slightly lower for the second dose (77%). However, this does not reflect the vaccination coverage of incoming refugees.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

From 1 through 31 March 2020, the National IHR Focal Point of Saudi Arabia reported 15 additional cases of MERS-CoV infection, including five associated deaths. The cases were reported from Riyadh (7 cases), Makkah (4 cases), Najran (3 cases), and Al Qassim (1 case) regions.

The link below provides details of the 15 reported cases.

Measles – Mexico

Mexico is experiencing a measles outbreak. Between 1 January and 2 April 2020, 1,364 probable1cases of measles were reported, of which 124 were laboratory confirmed, 991 were discarded and 328 remain under investigation. The age of the confirmed measles cases ranged from three months to 68 years (median=20 years), and 59% were male. Analysis conducted by the National Reference Laboratory (InDRE) identified the genotype D8 (similar to other countries in the Region), linage MVs/GirSomnath.IND/42.16/ for 17 of the confirmed cases.

Of the 124 confirmed cases, 105 were in Mexico City, 18 in Mexico State, and one in Campeche State; the following is a summary of the epidemiological situation in each: