Health Information Update

Source: WHO, Event Information Site for IHR National Focal

Event Updates: 16 November 2019 to 20 November 2019

Event Updated Country Hazard Disease Event Description IHR Assessment
2019-11-20 Pakistan Infectious Acute Flaccid Paralysis Through national disease surveillance, an outbreak of cVDPV2 has been confirmed in Pakistan in 2019. Between 7 July and 5 November, seven children have been paralysed from cVDPV2 in northern Pakistan – four in Diamer district, Gilgit-Baltistan province, one in MCI Islamabad, one in Torghar and one in Kohistan, Khyber Pakhtunkhwa province. The cases have a date of onset of paralyses between 7 July and 6 October 2019. Moreover, the virus was also isolated in stool samples from three contacts of patients experiencing acute flaccid paralysis (two contacts from Diamir and one contact from Torghar), as well as in 16 healthy children from Diamer, Kohistan and Rawalpindi districts and in seven environmental samples from Rawalpindi and Lahore districts in Punjab province, Diamer and Gilgit districts in Gilgit-Baltistan province and Karachi district in Sindh province.

All environmental samples were collected between 21 August to 7 October 2019. The genetic sequencing confirms that the isolated VDPV2 from the environmental surveillance samples collected at the Safdarabad site in Rawalpindi district in August is linked to a virus isolated from Diamer environmental surveillance samples collected in August and September, which indicates a circulating VDPV2 outbreak.

Pakistan is classified as endemic for wild poliovirus and as of 13 November, there have been 82 cases of wild poliovirus type 1 (WPV1) reported in the country in 2019 compared to 12 cases in 2018. The last VDPV2 case in Pakistan was reported from Quetta city, Balochistan province in December 2016 and was classified as a cVDPV2.

WHO is currently assessing the risk of spread of cVDPV2 within the country as high due to the high population movement, strong connectivity across the country, and low population immunity against type 2 poliovirus 

WHO does not recommend any restriction on travel and/or trade to Pakistan based on the information available for the current polio outbreak.


Public Health Risk
2019-11-17 Japan Infectious Meningococcal Disease On 12 November 2019, Shizuoka City Public Health Centre (SCPHC), Shizuoka Prefecture, Japan, received a report of a confirmed case of invasive meningococcal disease (IMD) who was admitted to a local hospital. The case is a 55-year-old New Zealander who lives in Australia and travelled to Japan on 25 October. The patient watched four games of the 2019 Rugby World Cup at auditoriums in Yokohama (on 26, 27 October and 2 November) as well as in Tokyo (on 1 November). The case stayed in Tokyo until 9 November when he boarded together with his wife on a cruise ship at Yokohama and settled into the voyage to the Republic of Korea. This cruise ship accommodates more than 2000 passengers and nearly 1000 foreign workers. On 10 November, the patient developed a headache and was referred to a hospital close to Shimizu Port, Shizuoka Prefecture. IMD was diagnosed on 12 November (Neisseria meningitidis identified by culture of blood and cerebrospinal fluid – serogroup B genotype ST-213). The patient was in a critical condition in an isolated ward. After the treatment, he had recovered and been discharged from the local hospital on 14 November. He went back to Australia on 16 November. Epidemiological investigations and contact tracing are ongoing. Close contacts on the cruise ship were identified and were given  prophylaxis regardless of vaccination history. The cruise ship on which the patient was travelling has stopped at five ports in Japan and will stop at five additional ports in Japan and another port in the Republic of Korea. The spouse of the case is asymptomatic and as of 16 November 2019, there has been no additional notification of IMD cases realated to this case or to the 2019 Rugby World Cup.

WHO does not recommend any restriction on travel and trade to Japan on the basis of the information available on the current event.

Public Health Risk
2019-11-16 Venezuela (Bolivarian Republic of) Infectious Yellow Fever On 13 November 2019, the Venezuela IHR National Focal Point (NFP) and the Venezuela PAHO/WHO Country Office shared information regarding a confirmed case of yellow fever reported in the Bolivar State. The case corresponds to a 46-year-old male farmer, belonging to the Pemón ethnic group, resident of the Kamarata Sector in the municipality of Gran Sabana , Bolivar State, and who has been in the locality of Uriman, municipality of Gran Sabana within the 19 days prior to the onset of symptoms. Symptom onset was on 14 September 2019, and included fever, chills, nausea, vomit, epistaxis, petechiae, and diarrhoea. On 26 September 2019 the probable case sought medical attention at the Ruiz and Páez Hospital in the Municipality of Heres where the clinical condition deteriorated, with moderate dehydration, gingivorrhagia, jaundice, coluria, abdominal pain, and hepatomegaly. As of 13 November 2019, the patient remains hospitalized with a diagnosis of chronic renal failure and moderate anaemia. On 26 September 2019, the first serum sample has been taken and has been sent to the National Reference Laboratory, the National Institute of Hygiene “Rafael Rangel” (IHRR) in Caracas. On 13 November 2019 the first sample tested positive for yellow fever (RT-PCR ONE STEP) and on 14 November 2019 tested negative for dengue (RT-PCR real time). On 10 October 2019 a second serum sample has been taken, which was send to the IHRR, results are pending. 

WHO does not recommend any general travel or trade restrictions be applied to Venezuela based on the information available for this event.

Public Health Risk


  *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.