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WHO AFRO Outbreaks and Other Emergencies, Week 15: 08 - 14 April 2019; Data as reported by 17:00; 14 April 2019

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South Sudan
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WHO
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This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 67 events in the region. This week’s edition covers key ongoing events, including:
- Humanitarian crises in South Sudan Humanitarian crises in North East Nigeria
- Ebola virus disease outbreak in the Democratic Republic of the Congo
- Cholera outbreak in Kenya
- Measles outbreak in Madagascar.

For each of these events, a brief description, followed by public health measures implemented and an interpretation of the situation is provided.

A table at the end of the bulletin gives detailed information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have been controlled and thus closed.

Major issues and challenges include:

Disease outbreaks within humanitarian contexts are highlighted in both north-east Nigeria and South Sudan this week. Both countries have successfully established early warning alert and response surveillance systems over the last few years which has enabled these outbreaks to be reported and responded to in a rapid manner. In north-east Nigeria, the low rates of immunisation within the population that are internally displaced have created conditions ideal for the transmission of measles. Additionally, in South Sudan ten counties have ongoing measles outbreaks although the reported leading cause of morbidity is currently malaria. It is key that reactive measles vaccination campaigns continue to be undertaken in a timely manner to reach the highest possible coverage in order to bring these outbreaks to a close.

In recent weeks the number of new cases of Ebola virus disease has increased although the geographic spread of the disease continues to be limited to two provinces and the disease not spread to neighbouring countries. On 12 April 2019, the WHO Director General convened a meeting of the International Health Regulations (IHR) Emergency Committee for Ebola Virus Disease in the Democratic Republic of Congo to determine whether the outbreak constitutes a Public Health Emergency of International Concern (PHEIC). The Emergency Committee concluded that the ongoing outbreak does not constitute a PHEIC. However, the committee expressed their deep concern about the recent increase in transmission in specific areas, and the potential risk of spread to neighbouring countries and, therefore provided public health advice.