Two separate circulating vaccine-derived poliovirus type 2s (cVDVP2s) have been confirmed.  The first cVDPV2 strain has been isolated from two acute flaccid paralysis (AFP) cases from two districts in Haut-Lomami province, with onset of paralysis on 20 February and 8 March 2017.  The second cVDPV2 strain has been isolated from Maniema province, from two AFP cases (with onset of paralysis on 18 April and 8 May) and a healthy contact in the community.

Outbreak response plans are currently being finalized, consisting of supplementary immunization activities (SIAs) with monovalent oral polio vaccine type 2 (mOPV2), in line with internationally-agreed outbreak response protocols.  Surveillance and immunization activities are being strengthened in neighbouring countries. 

WHO advice

WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel. 

As per the advice of an Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC).  Countries affected by poliovirus transmission are subject to Temporary Recommendations. 

To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers. 

(PHR)

A 69 year-old male, non-national, works as a farmer and living in Al Ain, UAE. He has frequent contact with dromedaries. The patient is currently in critical condition admitted to ICU on ECMO.

A 45 year-old male, non-national, works as a butcher and living in Al Ain, UAE. The case is asymptomatic and was identified during the tracing of case 1 (please see above).   He has frequent contact with dromedaries. The case is currently asymptomatic in stable condition admitted to negative pressure isolation room on a ward.

Globally, 1980 laboratory-confirmed cases of infection with MERS-CoV including at least 699 related deaths have been reported. 

 WHO advice:

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

(PHR)

Twelve (12) of the twenty five (25) reported cases during this time period were associated with 3 simultaneous, yet unrelated clusters of MERS cases. The Ministry of Health is evaluating each case and their contacts and implementing measures to limit further human-to-human transmission. Description of the three clusters is shown below, followed by individual descriptions of each laboratory-confirmed case reported to WHO, starting from the newly reported cases:

Cluster 1

A cluster of cases has been identified at a hospital in Bisha city, Assir Region. Fifty (50) healthcare contacts and eighteen (18) household contacts were listed for follow up. Of which, fifteen (15) contacts have, so far, been tested by PCR and results were positive for MERS-CoV by PCR (UpE and Orf1a genes) for two (2) contacts and negative for the rest

Cluster 2

A cluster of cases has been identified in a hospital in Riyadh city, Riyadh Region.  Thirty four (34) healthcare contacts and twelve (12) household contacts were listed for follow up. Of which, twenty nine (29) contacts were tested by PCR and results were positive for MERS-CoV by PCR (UpE and Orf1a genes) for four (4) contacts and negative for the rest.

Cluster 3

A third cluster was detected at a hospital in Wadi Aldwaser city, Riyadh Region. This outbreak is believed to be over based on the follow-up period of all contacts.  In total, twenty one (21) healthcare contacts and five (5) household contacts were listed for follow-up, of which, four (4) were positive for MERS-CoV by PCR (UpE and Orf1a genes)

WHO advice:

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

(PHR)

WHO advice:

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

(PHR)