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WHO, Event Information Site for IHR National Focal

Event Updates: 10 February 2020 to 17 February 2020

Event Updated Country Hazard Disease Event Description IHR Assessment
2020-02-17 Saudi Arabia Infectious Coronavirus Infection (MERS-CoV) Between 1 and 31 January 2020, the National IHR Focal Point of Saudi Arabia reported 15 additional cases of MERS-CoV infection, including 5 associated deaths.

 

Since 2012 until 31 January 2020, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2519 with 866 associated deaths.

 Public Health Risk
Details of the case/s:
The cases were reported from Madinah (1 case), Riyadh (5 cases), Al-Qassim (2 cases), Aseer (6 cases), Aljouf (1 case) regions. A hospital outbreak was reported in Aseer region with a cluster of 6 cases. Three of the cases were health care workers (cases #5, #6, #8, two were patients (case #11, #15) and one was visitor (cases #14). One of the cases (case #15) died.
Risk Assessment:
All cases reported between 1 to 31 January 2020 are locally acquired. However WHO expects that additional cases of MERS-CoV infection imported by travelers from the Middle East affected countries after exposure to animals, animal products (for example contact with camels) or humans (for example in a health care setting) will be reported from other countries.
Interference with travel and trade:
No
2020-02-14 China Zoonosis Influenza due to identified avian or animal influenza virus (A/H9N2) On 7 February 2020, a case of avian influenza (H9) infection was reported to WHO from Hong Kong SAR, China, in a child who visited his grandparents’ home in Shenzhen City, Guangdong Province. The virus was subsequently identified to be influenza A(H9N2). Public Health Risk
Details of the case/s:
The case is a 7-year-old boy with underlying medical conditions who had symptom onset on 4 February 2020. The next day he received medical care and was placed in isolation. On 7 February 2020, his nasopharyngeal swab tested positive for the influenza A (H9) virus. Subtyping results revealed that the virus was H9N2. As of 12 February, the case is in a stable condition and no symptoms have been detected in his contacts.

The case had visited his relatives’ home in Shenzhen city, Guangdong Province, during the incubation period, where backyard poultry was kept. However, he did not have direct contact with poultry or consume undercooked poultry.
Risk Assessment:
There has been no evidence of international disease spread by travellers. Thus far, the virus does not seem to transmit easily between humans and therefore the likelihood of community-level spread is low.
Interference with travel and trade:
No
2020-02-14 Uganda Infectious Yellow Fever From 4 November 2019 through 4 February 2020, there were six laboratory confirmed cases of yellow fever including four deaths detected through the national surveillance system On 10 December 2019, MoH was notified of a confirmed case of yellow fever following testing of a sample from a patient in Buljisa General Hospital.

 

On 22 January 2020, the laboratory, the Uganda Virus Research Institute (UVRI), notified the Ministry of Health of a second positive case of yellow fever in Buliisa with connection to the index case and with similar occupation.

 

Two other confirmed cases of yellow fever were identified in Moyo district in West Nile region.

 

On 23 January 2020 the Minister of Health of the Government of Uganda declared an outbreak of Yellow Fever.

 Public Health Risk
Details of the case/s:
Case in Buljisa in Hoima region:  A 37-year-old male suspected viral haemorrhagic fever (VHF) admitted at Buliisa Health Centre. He was a cattle farmer trading in milk between Uganda and the Democratic Republic of Congo, from Kizikya cell, Buliisa district. On 30 October 2019, he visited Buliisa General Hospital with complaints of fever and headache which had lasted five days. He later developed epistaxis and died on 4 November 2019.

The investigation team collected and sent eight blood samples from family members and neighbours for laboratory testing for yellow fever. One sample confirmed to have yellow fever while the other samples were negative.

Cases in Moyo district: The two cases were males aged 18 and 21 years who were dealing in cutting and trading timber between Uganda and South Sudan. The two men fell ill on 3 January 2020 and were admitted at Logoba Health Center in Moyo District. They were later referred to Moyo General Hospital with symptoms of fever, vomiting, diarrhoea, fatigue, headache, abdominal and joint pains, confusion and unexplained bleeding. They deteriorated and died in Moyo General Hospital on the 5 and 6 of January 2020. Results from UVRI confirmed Yellow Fever infection.

Subsequently, Moyo notified a second cluster of suspect and confirmed yellow fever infection in a different village. The confirmed case was a 59-year-old man who presented with symptoms including unexplained bleeding and fever on 22 January and died on the 23 January 2020. A blood sample collected from him tested positive for yellow fever by yellow fever Polymerase Chain Reaction (PCR) test. His death was preceded by the death of two of his family members both died in early January with similar symptoms.
Risk Assessment:
There is risk for further amplification and international spread because of frequent population movements to and from South Sudan and DRC, coupled with the low population immunity in the cross-border areas.
Interference with travel and trade:
No
2020-02-14 Central African Republic Infectious Measles The Central African Republic has experienced an upsurge in confirmed measles outbreaks since 2019. 

 

From 1 January 2019 to 2 February 2020, a total of 5,392 suspected cases including 82 deaths were reported. The distribution of cases by age group is 72% for those under 5 years old and 18% for 5 to 10 years old. Among the suspected cases 180 cases were confirmed IgM + for measles after analyzes at the reference laboratory of the Institut Pasteur in Bangui.

 Public Health Risk
Risk Assessment:
WHO estimates the overall risk for the CAR from the current measles outbreak to be high.  Risk at the regional level is assessed as moderate given the large cross border movements of populations to and from neighbouring countries including Chad, RDC and Cameroon both for security reasons and commercial activities. The risk is considered low at the global level.
WHO Recommendations
Measles is a vaccine-preventable disease and two doses of MCV are recommended to ensure immunity. 
Interference with international travel or trade:
No
2020-02-12 Philippines (the) Infectious Coronavirus Infection (COVID-19) As of 8 February 2020, there have been three confirmed cases of COVID-19 in the Philippines. On 30 January 2020, the Philippines Department of Health (DOH) confirmed the first case of COVID-19 in the Philippines and on 1 February 2020, they announced the death of a second case. Both cases were a couple from Wuhan, China, which arrived in the Philippines via Hong Kong on 21 January 2020. On 3 February 2020, a third case with travel history from Wuhan, China was confirmed.

 

As of 8 February 2020, the Epidemiological Surveillance Units (ESUs) throughout the country as a result of event-based surveillance have reported a total of 267 PUIs for COVID-19 monitoring and testing. Of this there have been 3 confirmed cases, 86 have tested negative and 178 have pending results.

 

 

 

 

 

 

 

 

 

 Public Health Risk
Details of the case/s:
First case:  38-year-old female Chinese whose samples tested positive for COVID-19 at the Victorian Infectious Disease Reference Laboratory (VIDRL), Melbourne, Australia on 30 January 2020. She sought consultation at the Adventist Medical Center in Manila on 25 January and was referred to San Lazaro Hospital (the dedicated infectious disease hospital in the capital) that same day for pneumonitis.

 

Second Case: 44-year-old male travel companion of the 1st case  who developed fever on 18 January 2020 and was admitted to San Lazaro hospital in Manila on 25 January after experiencing fever, cough and sore throat. Over the course of the patient’s admission, he developed severe pneumonia due to COVID-19 and other viral and bacterial infections (S. pneumoniae and Influenza B). In his last few days, the patient was stable and showed signs of improvement, however, the condition of the patient deteriorated in the last 24 hours before his death on 1 February 2020.

 

Third Case: 60-year-old female who was a patient under investigation (PUI). The patient arrived in Cebu City, Philippines, from Wuhan, China, via Hong Kong SAR, China, on 20 January 2020, and traveled to Bohol, Philippines, thereafter. On January 22, the patient consulted a private hospital in Bohol after experiencing fever and coryza. A sample taken from the patient 24 January and tested at the Victorian Infectious Diseases Reference Laboratory in Australia and the Research Institute for Tropical Medicine (RITM). Results from said tests came back negative on 29 and 30 January 2020, and upon recovery of the patient, she was discharged and allowed to return to China via Cebu 31 January 2020. However, on 3 February, the Department of Health was notified by RITM that a sample taken on 23 January had tested positive for COVID-19 making this patient the third confirmed case in the Philippines.

 

 

 
Risk Assessment:
These are the first three case of COVID-19 infection diagnosed in Philippines. 

 

The rapid spread within China and the exportation of cases to several countries demonstrates the potential for international spread.  Exported COVID-19 cases are expected to occur, particularly given the degree of international travel from China. Human to human transmission has been described, thus further spread of the disease cannot be excluded.
WHO advice/recommendations:
On 30 January 2020, WHO Director General declared the current outbreak of COVID-19 a public health emergency of international concern (PHEIC), with temporary recommendations issued for all countries.

 

It is important to remind populations and health workers of the basic principles to reduce the general risk of transmission of acute respiratory infections.  WHO does not recommend any specific health measures for travellers
Interference with International travel or trade:
No

 
 

 

 

 

 

 

 

 

2020-02-11

  

 

 

 

 

 

 

 

Nigeria

  

 

 

 

 

 

 

 

Infectious

  

 

 

 

 

 

 

 

Lassa Fever

 From 1 January to 2 February 2020, 365 laboratory confirmed cases including 47 deaths have been reported in 23/36 Nigerian States and the Federal Capital Territory.  Ten confirmed cases have been reported among health care workers with 1 death in confirmed and 1 probable case. While the twenty-three states have reported at least one confirmed case, 278 of all the cases are from three states, namely Edo (128), Ondo (129) and Ebonyi (21). The other States affected are: Enugu, Kano, Borno, Nasarawa, Kogi, Rivers, Abia, Adamawa, Benue, Kaduna, Delta, Taraba, Plateau, Bauchi, Osun, Ogun, Kebbi, Anambra, Gombe and FCT.   

 

 

 

 

 

Public Health Risk
Risk Assessment:
Lassa fever is known to be endemic in Benin, Guinea, Ghana, Liberia, Mali, Sierra Leone and Nigeria, but may exist in other West African countries.In Nigeria, the peak of outbreaks is usually observed in the dry season (December–April); therefore, the number of cases is expected to increase.   The current overall risk is considered moderate at national level.  The overall regional and global risk is considered low due to minimal number of suspected cross-border transmission from Nigeria to neighbouring countries. 

 
Interference with International travel or trade:
No

 
 

 

 

2020-02-11

 Chile Infectious Dengue Fever (Imported cases of DENV 2) On 7 February 2020, the Chile IHR National Focal Point informed PAHO/WHO of the detection of 3 confirmed cases of autochthonous dengue fever reported on Easter Island, all of them have been diagnosed by PCR (on 6 February) and serotype 2 (DENV 2 by PCR ) has been identified in 2 cases.  The identification of the third case serotype is pending.  No travel history reported.  

Public Health Risk
Risk Assessment:
Easter Island has weekly air transport connections with French Polynesia, where an ongoing dengue outbreak with predominant DENV 2 circulation is happening. Additionally, due to the presence of the competent vector and, given that Easter Island is a popular tourist destination, the risk of spread to neighboring islands and countries cannot be ruled out.
Interference with International travel or trade:
No

 
2020-02-11 India Infectious Coronavirus Infection (2019-nCoV) Up to 10 February 2020, India has reported three 2019-nCoV confirmed cases. All of them are medical students studying in Wuhan and are currently Kerala State. As per 10 February, the three cases are in isolation ward and in stable condition. Public Health Risk
Details of the case/s:
·         Case 1: The case is a 21-year-old student who studies in Wuhan University and returned to Kochi, Kerala, from Wuhan via Kolkata on 24 January 2020. On 25 January 2020, as per the directives of the Kerala govt. for travellers coming from China to report to the nearest health facility, she presented to the nearest Primary Health Centre. She was advised to do self-monitoring and to report back in case of development of symptoms. On 27 January, she presented to the Thrissur General Hospital with symptoms (fever, chills, cough, sore throat), after which she was admitted in an isolation ward. Her samples tested positive for 2019-nCoV by PCR at The National Institute of Virology (NIV), Pune on 30 January 2020. The patient did not report having visited any health care facility or having had contact with any known 2019-nCoV case.

·          

·          Case 2: The second case confirmed in India was a 23-years-old male reported on 1 February 2020 from Alappuzha, Kerala. He had travelled from Wuhan back to India in the same flight as the case number 1.

·          

·          Case 3: On 3 February 2020 the third 2019-nCoV confirmed case was reported from Kasargod, Kerala. He is a 23-year-old male who travelled from Wuhan to India on 25 January 2020.

 
·         Risk Assessment:
These are the first diagnosed cases of 2019-nCoV infection in Kerala, India.

 

·         The rapid spread within China and the exportation of cases to several countries demonstrates the potential for international spread.  Additional cases of 2019-nCoV infection imported by travellers are reported by other countries. Exported 2019-nCoV cases are expected to occur, particularly given the degree of international travel to and from China. Human to human transmission has been described, thus further spread of the disease cannot be excluded.
·         WHO advice/recommendations:
On 30 January 2020, WHO Director General declared the current outbreak of COVID-19 a public health emergency of international concern (PHEIC), with temporary recommendations issued for all countries.

 

·         It is important to remind populations and health workers of the basic principles to reduce the general risk of transmission of acute respiratory infections.  WHO does not recommend any specific health measures for travellers
·         Interference with International travel or trade:
·         No

·          
 

 

 

 

2020-02-10

  

 

 

Nepal

  

 

 

Infectious

  

 

 

 

Coronavirus Infection (2019-nCoV)

 Details of the case/s:  

 

 

Public Health Risk
On 9 January 2020, a 32-year-old male Nepalese citizen with good health record and a student at Wuhan Technical University travelled to Nepal.

As per patient statement, he had developed non-productive cough since 3 January 2020. He visited the Sukraraj Infectious and Tropical Disease Hospital (STIDH) at Kathmandu on 13 January 2020, to seek medical attention since his cough had not improved and he was also having malaise. Given his travel history, he was admitted for observation in the isolation unit of the hospital. No signs were detected during the physical examination although the patient developed a mild fever the night of admission and complained of mild difficulty in breathing when febrile. On 13 January 2020, the laboratory results for Influenza virus tested negative at the National Influenza Center (NIC), the National Public Health Laboratory (NPHL). The chest x-ray did not reveal any abnormality and routine blood test parameters were normal except for a suggestion of lymphopenia. The patient was started on antipyretics and antibiotics. Tests for dengue, brucellosis and scrub typhus were negative; Acid- Fast Bacilli (AFB) smear was negative, urine microscopy and Liver function tests (LFT) parameters were within normal limits and blood culture did not show any growth. The case developed intermittent fever during the second and third days of admission and the maximum temperature recorded was 102°F.  Chest X-ray was repeated, and the findings were inconclusive. As the patient showed clinical improvement, he was discharged on 17 January 2020 after he remained afebrile for 24 hours.

Further testing of throat/oropharyngeal swab and serum samples of the patient (both collected on 13 January 2020) was facilitated by WHO at School of Public Health, University of Hong Kong at Hong Kong.

On 23 January 2020, samples were tested by two RT-PCR assays (N for screening and ORF1b for confirmation; Hong Kong University protocol).  The respiratory sample was positive in both assays, whereas the serum sample was not. The respiratory sample was positive in the repeated test and declared positive for 2019-nCoV and subsequently reported through appropriate channels. The Hong Kong University laboratory was  in the process of getting partial sequences for acquiring additional information from this sample. The case is currently in stable condition with no clinical symptoms and preliminary inquiries revealed that he has been living temporarily with his brother, his sister and her family (including her husband and daughter) and his mother in Kathmandu. No family member has developed any symptoms to date. According to the case, he has neither visited any health care facilities, nor the seafood market at Wuhan during the incubation period. He did not have any exposure to wild animals or poultry or contacted any patients with symptoms of pneumonia or respiratory tract infections. Nevertheless, he had visited a supermarket near his university dormitory to buy groceries and watch a movie in the same complex on 31 December 2010 – the last time he was out in the public sphere before departing to the Wuhan airport on 9 January 2020.
Risk Assessment:
This is the first case of 2019-nCoV infection diagnosed in Nepal.

The rapid spread within China and the exportation of cases to several countries demonstrates the potential for international spread.  Additional cases of 2019-nCoV infection imported by travellers are reported by other countries. Exported 2019-nCoV cases are expected to occur, particularly given the degree of international travel to and from China. Human to human transmission has been described, thus further spread of the disease cannot be excluded.

 
WHO advice/recommendations:
On 30 January 2020, WHO Director General declared the current outbreak of COVID-19 a public health emergency of international concern (PHEIC), with temporary recommendations issued for all countries.

 

It is important to remind populations and health workers of the basic principles to reduce the general risk of transmission of acute respiratory infections.  WHO does not recommend any specific health measures for travellers
Interference with International travel or trade:
No

*A public health risk is something that is (or is likely to be) hazardous to human health or could contribute to a disease or an infectious condition in humans.