ProMED Disease Outbreak Update

Nipah bats

Outbreaks of Ebola in DRC and Uganda, MERS in Saudi Arabia, Nipah in India.

Information available within this Disease Outbreak Update is produced by Program for Monitoring Emerging Diseases (ProMED).

Note: Content may be edited for style and length.



Democratic Republic of Congo and Uganda

Outbreak Update

Mon 17 Jun 2019. Epidemiological situation report, DRC Ministry of Health

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 16 Jun 2019:
Since the beginning of the epidemic, the cumulative number of cases is 2168, 2074 confirmed and 94 probable. In total, there were 1449 deaths (1355 confirmed and 94 probable) and 596 people cured;
297 suspected cases under investigation;
20 new confirmed cases, including 14 in Mabalako [North Kivu], 1 in Musienene [North Kivu], 1 in Beni [North Kivu], 1 in Bunia [Ituri], 1 in Rwampara [Ituri], 1 in Kalunguta [North Kivu], and 1 in Kyondo [North Kivu];
9 new deaths of confirmed cases, including 4 community deaths -- 3 in Mabalako and 1 in Kalunguta; 5 ETC/TC deaths -- 3 in Mabalako, 1 in Katwa [North Kivu], and 1 in Bunia;
8 new recoveries released from ETCs -- 6 in Mabalako and 2 in Butembo [North Kivu];
the 3 Ebola cases tested in Uganda were reclassified to the Mutwanga health zone [North Kivu] after extensive investigations revealed that this is the area in which their symptoms started after their stay in Mabalako.

Outbreak Response

135 951 vaccinated persons
556 people vaccinated on 16 Jun 2019;
persons vaccinated by health zone: 34 159 in Katwa, 26 408 in Beni, 18 496 in Butembo, 12 077 in Mabalako [total number of people vaccinated can be seen at the source URL above];
66 724 495 controlled people;
80 entry points (PoE) and operational health checkpoints (OHC);
118 contaminated health workers;
the cumulative number of confirmed/probable cases among health workers is 118 (5.5% of all confirmed/probable cases), including 39 deaths.

News Articles

How Africa's porous borders make it difficult to contain Ebola — The Conversation, 15 June 2019

Ebola case counts spike again in DRC — CIDRAP, 17 June 2019

Disease Research

Estimating undetected Ebola spillovers — PloS Neglected Tropical Disease, 13 June 2019

Author summary

Emerging infectious diseases are often not investigated in rural Africa unless outbreaks involve a sizeable number of cases. A number of different Ebola virus disease (EVD) outbreaks have been reported in the literature and in surveillance reports since its discovery in 1976. The majority of the reports are of large outbreaks. Given the low reported rate of transmission of Ebola, and the high frequency with which cases infect no one else, one might expect most outbreaks to be very small (less than 5 people). This is the 1st study to the authors' knowledge that quantitatively estimates the number of undetected EVD outbreaks or probabilities of EVD outbreak detection by outbreak size. Although the total amount of evidence in this area is still limited, this study's main result -- that at least half of EVD outbreaks go undetected -- is consistent under many different sets of assumptions. This is the most thorough estimation of EVD outbreak detection to date and corroborates the majority of more qualitative work on EVD surveillance, suggesting greater investment in primary health care and local surveillance will be important to detect EVD outbreaks early and consistently.

See full paper here.

See full ProMED post here



Kerala, India

Outbreak Update

India TV News, Sat 15 June 2019

After one positive case and over 300 suspects, the scare of the 2nd attack of Nipah virus in Kerala is over, state Health Minister K.K. Shailaja told the media on Saturday [15 Jun 2019].

"Even though the Nipah scare is over, and there is no need for complete surveillance, the situation will be under observation till the middle of next month [July 2019]," Shailaja said.

See full ProMED post here



Eastern Mediterranean Regional Office

Outbreak Update

WHO/EMRO Epidemic and pandemic-prone diseases

At the end of May 2019, a total of 2442 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 842 associated deaths (case fatality rate: 34.5%), were reported globally; the majority of these cases were reported from Saudi Arabia (2051 cases, including 765 related deaths with a case fatality rate of 37.3%). During the month of May [2019], a total of 14 laboratory-confirmed cases of MERS were reported globally. All 14 cases were reported from Saudi Arabia with 4 associated deaths.

This month [May 2019], Saudi Arabia has not reported any new cases related to the Al-Khafji city outbreak. The outbreak has presumed to have stopped due to the effective response measures taken by Saudi Arabia. This month [May 2019], one household cluster was reported from Al-Kharj city, including 2 symptomatic national females aged 22 and 44. One 23-year-old national female healthcare worker was also infected this month [May 2019] in Riyadh. All 4 cases that died this month [May 2019] were symptomatic males with one or more co-morbidities.

Laboratory-confirmed cases reported since April 2012: 2442
Deaths reported since April 2012 globally: 843
Number of countries that have reported cases since April 2012: 27
Number of countries in the Eastern Mediterranean Region that have reported cases since April 2012: 12
13 laboratory-confirmed cases reported linked to an outbreak in Saudi Arabia in April [2019]
The age group 50-59 years continues to be at highest risk for acquiring infection of primary cases. The age group 30-39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50-59 years for primary cases and 70-79 years for secondary cases.

For more information on MERS epidemiology, outbreak and response, see here

See the full ProMED post here

Information available within this Disease Outbreak Update is produced by Program for Monitoring Emerging Diseases (ProMED).

Note: Content may be edited for style and length.