Outbreak Tracker

No new cases of Ebola virus disease have been reported since 17 February, and on 3 March, the only person confirmed to have EVD in the last 21 days (Figure 1) was discharged from an Ebola Treatment Centre after recovering and testing negative twice for the virus. This is an important milestone in the outbreak. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.

As of 3 March 2020, a total of 3444 EVD cases were reported from 29 health zones (Table 1, Figure 2), including 3310 confirmed and 134 probable cases, of which 2264 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (n=1927) were female, 28% (n=973) were children aged less than 18 years, and 5% (n=171) were health care workers.

The Central African Republic (CAR) has experienced an upsurge in measles cases as a result of outbreaks since 2019.

From 19 to 25 February, no new confirmed cases of Ebola virus disease (EVD) were reported. This was the first time since the beginning of the response that no new confirmed cases were reported over a seven-day period (Figure 1). The most recent case was reported in Beni Health Zone, North Kivu Province on 17 February. While the lack of new confirmed cases reported in the last seven days is a major achievement, the outbreak remains active and risk of additional cases emerging remains high. In the past 21 days (5 to 25 February 2020), four confirmed cases were reported from two health areas in Beni Health Zone in North Kivu Province (Figure 2, Table 1). Even with strengthened surveillance operations, transmission of Ebola virus outside of groups currently under surveillance cannot be excluded. Ebola virus also persists in some survivors’ body fluids, with potential to infect others. In at least one instance during this outbreak, relapse – in which a person who has recovered from EVD develops symptoms again – was observed, sparking a new chain of transmission which has taken several months to interrupt. To mitigate a potential resurgence of the outbreak, it is critical to maintain response capacities to rapidly detect and respond to any new cases, and to prioritize survivor support and monitoring and the maintenance of cooperative relationships with the survivors’ associations.

Substantial surveillance, pathogen detection, and clinical management activities are currently ongoing, including validating alerts, following remaining contacts who were potentially exposed to the virus, supporting rapid diagnostics of suspected cases, and working with community members to strengthen surveillance on people who pass away in the communities. As of 25 February, 510 contacts are currently under surveillance, of which 97% were followed daily in the last seven days. In the last seven days, more than 5100 alerts per day were reported and investigated, of which over 400 alerts (including ~70 community deaths) were validated as suspected EVD cases; requiring laboratory testing and specialized care within the established Ebola treatment and transit centres. On average, suspect cases stay in these facilities for three days before EVD can be definitively ruled out (i.e. after two negative polymerase chain reaction tests 48 hours apart), while care is provided for their illness under isolation precautions. Timely testing of suspected cases continues to be provided across 11 operational laboratories deployed in cities that have been affected by the outbreak. From 17 to 23 February, more than 3600 samples were tested.

From 1 December 2019 through 31 January 2020, the National IHR Focal Point of Saudi Arabia reported 19 additional cases of MERS-CoV infection, including 8 associated deaths.

On 7 February 2020, the Chile IHR National Focal Point informed the Pan American Health Organization / World Health Organization (PAHO/WHO) of the detection of three confirmed cases of autochthonous dengue fever reported on Easter Island.

From 4 November through 14 February 2020, eight laboratory confirmed cases of yellow fever in Buliisa (3), Maracha (1) and Moyo (4); including four deaths (CFR 50%), were detected through the national surveillance system.

During the past week, the incidence of new Ebola virus disease (EVD) cases has remained low (Figure 1). From 12 to 18 February, one new confirmed case was reported. The case was reported in Beni Health Zone, North Kivu Province and had an epidemiological link to a confirmed case reported on 5 February. As the case was alerted and transferred to an Ebola Treated Centre four days after symptom onset, there remains a risk that onward transmission to contacts may have occurred, and further cases may be expected from the currently active chain of transmission. Ebola virus may also persist in some survivors’ body fluids for several months, and in a limited number of instances, transmissions from exposure to body fluids of survivors have been documented during this outbreak. The ongoing programme for survivor care helps mitigate the risks of re-introduction events.

To maintain operations and prevent re-emergence of the outbreak, WHO is requesting funding. Under the Strategic Response Plan (SRP 4.1), WHO’s financial need for the Ebola Response from January to June 2020 is US $83 million. Thanks to the generosity of many donors during 2019, WHO has some carry-over funding, which has been applied to maintain operations through February 2020. USD $40 million is currently needed to ensure continuity of response and preparedness activities to bring the case incidence to zero, and continue building strong, resilient health systems.

From 1 January through 9 February 2020, 472 laboratory confirmed cases including 70 deaths (case fatality ratio= 14.8%) have been reported in 26 out of 36 Nigerian states and the Federal Capital Territory.

This week, the case incidence continued to be low in the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (Figure 1). From 5 to 11 February, three new confirmed cases were reported in Beni Health Zone, North Kivu Province. All three cases have epidemiological links to a transmission chain originating in Aloya Health Area, Mabalako Health Zone, with possible nosocomial exposure in Beni. The most recent case reported from Beni Health Zone on 11 February was isolated one day after symptom onset. Early detection of cases reduces the probability of transmission of EVD in the community and significantly improves the clinical outcome for the patients.

In the past 21 days (22 January to 11 February 2020), 12 confirmed cases, including three community deaths, were reported from four health areas within two active health zones in North Kivu Province (Figure 2, Table 1): Beni (n=11) and Mabalako (n=1). It has been 42 days since Katwa Health Zone has reported new cases. The continued reduction of geographic spread of EVD cases and the declining trend in case incidence observed in the past 21 days are encouraging; however, these improvements remain fragile and should not be interpreted as an indication that response efforts can be reduced. Continued vigilance is essential to improve infection prevention and control in health care facilities, as well as ensuring early identification and follow up of cases and contacts.

From 29 January to 4 February four new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.

On 9 and 13 January 2020, the National IHR Focal Point of the United Arab Emirates (UAE) reported an additional two (2) laboratory-confirmed cases of Middle East respiratory syndrome Coronavirus (MERS-CoV) to WHO.

The link below provides details of the 2 reported cases:

From 22 to 28 January five new confirmed cases were reported in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.

Nine new confirmed cases were reported from 15 to 21 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.

On 20 January 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of novel coronavirus in the Republic of Korea. The case is a 35-year-old female, Chinese national, residing in Wuhan, Hubei province in China.

The case-patient had developed fever, chill, and muscle pain on 18 January while in Wuhan. She visited a local hospital in Wuhan and was initially diagnosed with a cold. On 19 January , the case-patient was detected with fever (38.3 °C) upon arrival at the Incheon International Airport. The case-patient was transferred to a national designated isolation hospital for testing and treatment. She was tested positive for pancoronavirus reverse transcriptase-polymerase chain reaction (RT-PCR) assay, and subsequently was confirmed positive for novel coronavirus (2019-nCoV) on 20 January by sequencing at the Korea Centers for Disease Control and Prevention (KCDC). Upon detection, the patient had chills, runny nose, and muscle pain.

On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The case-patient is male, between the age of 30-39 years, living in Japan.

The Japanese Ministry of Health, Labour and Welfare, today informed the World Health Organization (WHO) of a confirmed case of a novel coronavirus (2019-nCoV) in a person who travelled to Wuhan, China. This is the second confirmed case of 2019-nCoV that has been detected outside of China, following confirmation of a case in Thailand on 13 January. Considering global travel patterns, additional cases in other countries are likely.

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome. 2019-nCoV is a new strain that has not been previously identified in humans.

Fourteen new confirmed cases were reported from 8 to 14 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo.

On 13 January 2020, the Ministry of Public Health (MoPH), Thailand reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The case is a 61-year-old Chinese woman living in Wuhan City, Hubei Province, China. On 5 January 2020, she developed fever with chills, sore throat and headache. On 8 January 2020, she took a direct flight to Thailand from Wuhan City together with five family members in a tour group of 16 people. The traveler with febrile illness was detected on the same day by thermal surveillance at Suvarnabhumi Airport (BKK), Thailand, and was hospitalized the same day. After temperature check and initial assessment, she was transferred to the hospital for further investigations and treatment.

On 11 and 12 January 2020, WHO received further detailed information from the National Health Commission about the outbreak.

WHO is reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly.

From 1 January through 19 December 2019, a total of 124 laboratory confirmed cases of measles, including two deaths, were reported in the Gaza Strip (case fatality ratio=1.6%). Of the confirmed cases, forty-nine cases (40%) were hospitalized, 12 were among health care workers, and seventy-five (60%) were males. Gaza Strip has an estimated population of 1.99 million (Palestinian Central Bureau of Statistics-2019).

In addition, of the confirmed cases, 57 cases (46%) were un-vaccinated, of which 28 (23%) were among infants between 6 months to one year old, and 29 (23%) among age groups higher than 30 years old. Between 2009 and 2018, the median administrative immunization coverage for the second dose of measles-containing-vaccine (MCV2) was 97%.