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The Ministry of Health of the Democratic Republic of the Congo (DRC) has notified WHO of ongoing outbreaks of cholera across the country. Although the overall trend is decreasing, there are still areas reporting a high number of cases. Since the beginning of the year, 19,705 cases have been reported in DRC. As of 29 November, the following provinces had reported cases: South Kivu (4,906), ex-Katanga (4,565), Maniema (3,971), North Kivu (3,294) and ex-Oriental (2,969). A high number of cases are still reported in the province of South Kivu where the situation is particularly worrying because of the presence of camps hosting refugees from Burundi. Furthermore, there are concerns that the epidemic in Maniema could spread to other provinces of the country as observed during the 2011 cholera epidemic when areas of Kinshasa were also affected. View the full article

On 8 December 2015, the Ministry of Health (MoH) of Brazil provided PAHO/WHO with an update regarding the unusual increase in the number of cases of microcephaly among newborns in the northeast of Brazil. As of 5 December, 1,761 suspected cases of microcephaly, including 19 deaths, have been identified. The cases are distributed across 422 municipalities of 14 federal units. Pernambuco and Paraíba are the most affected states with 804 and 316 cases, respectively. Fatal cases were reported in Rio Grande do Norte (7), Sergipe (4), Bahia (2), Rio de Janeiro (2), Ceará (1), Maranhão (1), Paraíba (1) and Piauí (1). Investigations are ongoing.View the full article

On 2 December 2015, the National IHR Focal Point (NFP) of Panama notified PAHO/WHO of the first 3 laboratory-confirmed cases of Zika virus disease. On 27 November, the Ministry of Health (MoH) of Panama was informed of 68 patients with fever and exanthema in Ustupu island, Alligandi district, Guna Yala province. Serum samples were taken from 43 patients, 30 of whom were symptomatic, and sent for testing to the Commemorative Gorgas Institute for Health Studies. All samples, which were analyzed using the algorithm proposed by PAHO/WHO (see related links), resulted negative for dengue and chikungunya. Out of the samples taken from the 30 symptomatic patients, 3 tested positive for Zika virus by reverse transcription polymerase chain reaction (RT-PCR). The 3 laboratory-confirmed cases are females aged 29, 48, and 58 years old. View the full article

Between 2 and 27 November 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 3 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 2 deaths. The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 3 MERS-CoV cases that were reported in previous DONs on 13 November (case no. 4 and 5) and on 27 September (case no. 7).View the full article

On 27 November 2015, the National IHR Focal Point of Paraguay notified PAHO/WHO of 6 laboratory-confirmed autochthonous cases of Zika virus infection in the city of Pedro Caballero, which is located in the northeast of the country and shares borders with Brazil. The diagnoses were made by the national reference laboratory, the Central Public Health Laboratory of the Ministry of Health, through reverse transcription polymerase chain reaction (RT-PCR) technique. Cases were identified from clusters of febrile patients whose samples tested negative for dengue and chikungunya. They presented with fever, headache, myalgia, arthralgia, retroocular pain and nausea. Their age ranges from 14 to 45 years old, and half of them are female. Cases have been managed on an outpatient basis in different health care services of the health care network. Investigations are ongoing.View the full article

On 26 November 2015, national health authorities in Mexico notified PAHO/WHO of 3 cases of Zika virus infection, including two autochthonous cases (residents of Nuevo León and Chiapas) and one imported case (with history of travel to Colombia). The diagnoses were made by the national reference laboratory using reverse transcription polymerase chain reaction (RT-PCR). Mexican health authorities are implementing the corresponding prevention and control measures. Investigations are ongoing. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

On 27 November 2015, the National IHR Focal Point of Venezuela received notification of 7 suspected cases of Zika virus infection. The diagnoses were made by the national reference laboratory, the "Rafael Rangel" National Institute of Hygiene. Four samples tested positive for Zika virus by reverse transcription polymerase chain reaction (RT-PCR). The results were re-confirmed by Colombia’s National Institute of Health (INS). The cases, whose age ranges from 40 to 55 years old, are all women from areas that border Brazil. Venezuelan health authorities are implementing prevention and control measures. Investigations are ongoing. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

On 24 November, the National IHR Focal Point of El Salvador notified PAHO/WHO of 3 laboratory-confirmed autochthonous cases of Zika virus infection. The preliminary confirmation was provided by the national reference laboratory and has since been confirmed by the United States Centers for Disease Control and Prevention (CDC) in Fort Collins. Salvadoran health authorities are implementing the corresponding prevention and control activities. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

On 24 November, the National IHR Focal Point of El Salvador notified PAHO/WHO of 3 laboratory-confirmed autochthonous cases of Zika virus infection. The preliminary confirmation was provided by the national reference laboratory and has since been confirmed by the United States Centers for Disease Control and Prevention (CDC) in Fort Collins. Salvadoran health authorities are implementing the corresponding prevention and control activities. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

PAHO/WHO has received notification of a laboratory-confirmed autochthonous case of Zika virus infection in Guatemala. The case, who is a resident of the Zacapa department, developed symptoms on 11 November. An investigation is being carried out to detect further cases. The confirmatory testing was performed at the United States Centers for Disease Control and Prevention (CDC) in Fort Collins. Guatemalan health authorities are implementing the corresponding prevention and control activities. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

PAHO/WHO has received notification of a laboratory-confirmed autochthonous case of Zika virus infection in Guatemala. The case, who is a resident of the Zacapa department, developed symptoms on 11 November. An investigation is being carried out to detect further cases. The confirmatory testing was performed at the United States Centers for Disease Control and Prevention (CDC) in Fort Collins. Guatemalan health authorities are implementing the corresponding prevention and control activities. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

The Ministry of Health (MoH) of Brazil has provided PAHO/WHO with an update regarding the unusual increase in the number of cases of microcephaly among newborns in the northeast of Brazil. As of 21 November, a total of 739 cases of microcephaly were being investigated in nine states in the northeast of Brazil. The distribution of the cases was as follows: Pernambuco (487 cases), Paraíba (96 cases), Sergipe (54 cases), Rio Grande do Norte (47 cases), Piauí (27 cases), Alagoas (10 cases), Ceará (9 cases), Bahia (8 cases) and Goiás (1 case). One fatal case was reported in the state of Rio Grande do Norte.View the full article

The Ministry of Health (MoH) of Brazil has provided PAHO/WHO with an update regarding the unusual increase in the number of cases of microcephaly among newborns in the northeast of Brazil. As of 21 November, a total of 739 cases of microcephaly were being investigated in nine states in the northeast of Brazil. The distribution of the cases was as follows: Pernambuco (487 cases), Paraíba (96 cases), Sergipe (54 cases), Rio Grande do Norte (47 cases), Piauí (27 cases), Alagoas (10 cases), Ceará (9 cases), Bahia (8 cases) and Goiás (1 case). One fatal case was reported in the state of Rio Grande do Norte.View the full article

WHO received notification from the National IHR Focal Point of Iraq of additional laboratory-confirmed cases of cholera. As of 22 November, a total of 2,810 laboratory-confirmed cases of Vibrio cholerae 01 Inaba had been confirmed at the Central Public Health Laboratory in Baghdad, and only 2 deaths related to cholera were reported. These cases were reported from 17 Governorates of the country, namely Baghdad (940 cases), Babylon (675 cases), Qadisiyyah (442 cases), Muthanna (287 cases), Karbala (157 cases), Basra (102 cases), Wassit (68 cases), Najaf (46 cases), Thyqar (20 cases), Missan (21 cases), Dahuk (16 cases), Kirkuk (19 cases), Erbil (10 cases) Diyala (3 cases), Salaheddine (2 cases) Sulaimanneya (1 case) and Ninewa (1 case). View the full article

WHO received notification from the National IHR Focal Point of Iraq of additional laboratory-confirmed cases of cholera. As of 22 November, a total of 2,810 laboratory-confirmed cases of Vibrio cholerae 01 Inaba had been confirmed at the Central Public Health Laboratory in Baghdad, and only 2 deaths related to cholera were reported. These cases were reported from 17 Governorates of the country, namely Baghdad (940 cases), Babylon (675 cases), Qadisiyyah (442 cases), Muthanna (287 cases), Karbala (157 cases), Basra (102 cases), Wassit (68 cases), Najaf (46 cases), Thyqar (20 cases), Missan (21 cases), Dahuk (16 cases), Kirkuk (19 cases), Erbil (10 cases) Diyala (3 cases), Salaheddine (2 cases) Sulaimanneya (1 case) and Ninewa (1 case). View the full article

The Ministry of Health and Social Welfare (MOHSW) of Tanzania has notified WHO of additional laboratory-confirmed cases of cholera. Across the country, at least 9,871 cases have been reported, including 150 deaths. As of 25 November, the following regions had reported cases: Dar es Salaam (4,482 cases), Tanga (1,398 cases), Singida (861 cases), Mwanza (504 cases), Mara (436 cases), Kigoma (353 cases), Dodoma (284 cases), Morogoro (248 cases), Arusha (239 cases), Pwani (222 cases), Kagera (128 cases), Shinyanga (96 cases), Lindi (78 cases), Geita (48 cases), Rukwa (28 cases), Manyara (25 cases), Tabora (12 cases), Iringa (2 cases) and Kilimanjaro (2 cases).View the full article

The Ministry of Health and Social Welfare (MOHSW) of Tanzania has notified WHO of additional laboratory-confirmed cases of cholera. Across the country, at least 9,871 cases have been reported, including 150 deaths. As of 25 November, the following regions had reported cases: Dar es Salaam (4,482 cases), Tanga (1,398 cases), Singida (861 cases), Mwanza (504 cases), Mara (436 cases), Kigoma (353 cases), Dodoma (284 cases), Morogoro (248 cases), Arusha (239 cases), Pwani (222 cases), Kagera (128 cases), Shinyanga (96 cases), Lindi (78 cases), Geita (48 cases), Rukwa (28 cases), Manyara (25 cases), Tabora (12 cases), Iringa (2 cases) and Kilimanjaro (2 cases).View the full article

In October 2015, the Ministry of Health (MoH) of Brazil notified PAHO/WHO of an unusual increase in the number of cases of microcephaly among newborns in the state of Pernambuco, northeastern Brazil. As of 17 November, a total of 399 cases of microcephaly were being investigated in seven states in the northeast of Brazil. Most of the cases were registered in Pernambuco state (268). Other states that reported microcephaly cases are Sergipe (44), Rio Grande do Norte (39), Paraiba (21), Piaui (10), Ceara (9) and Bahia (8).View the full article

On 29 October 2015, the National IHR Focal Point of the Republic of Korea notified WHO of a cluster of cases with respiratory symptoms in Seoul. Between 19 and 29 October, 3 people who work in the same facility developed symptoms of pneumonia. From 22 to 24 October, they were admitted to hospital. On 27 October, the hospital isolated the patients and alerted local health authorities, which then informed the Korean Centers for Disease Control and Prevention (KCDC).View the full article

On 12 November 2015, the National IHR Focal Point of Suriname notified PAHO/WHO of 4 additional cases of Zika virus infection. The cases were laboratory confirmed by the Caribbean Public Health Agency (CARPHA). Furthermore, one of two previously reported cases (see DON published on 11 November) was also re-confirmed by CARPHA. Given the increased transmission of Zika virus in the Region of the Americas, PAHO/WHO recommends that its Member States establish and maintain the capacity to detect and confirm cases of Zika virus infection, prepare their health services for a potential additional burden at all levels of health care, and implement an effective public communications strategy to reduce the mosquitoes that transmit this disease, particularly in areas where this vector is present. The complete set of recommendations is available in the latest Epidemiological Update (see related links).View the full article

On 11 November 2015, the National Health and Family Planning Commission (NHFPC) of China notified WHO of 2 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus. The Chinese Government has taken the following surveillance and control measures:View the full article

Between 26 October and 1 November 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 7 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Contact tracing of household and healthcare contacts is ongoing for these cases.View the full article

On 27 October 2015, the National IHR Focal Point of Egypt notified WHO of an outbreak of Dengue fever in a village in the Dayrout District of Assiut Governorate. Between 1 and 31 October 2015, a total of 253 cases were admitted to the Dayrout Fever Hospital due to acute febrile illness. Patients developed fever, headache, general body aches and abdominal pain with occasional vomiting and/or diarrhea but experienced no further complications or fatalities. They have been responding to the given medical care. Some of the cases come from the same household. View the full article

Between 17 and 24 October 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Contact tracing of household and healthcare contacts is ongoing for these cases.View the full article

On 12 October 2015, the National IHR Focal Point of the Republic of Korea provided follow-up information on a previously reported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The patient, who was discharged from hospital on 3 October following two consecutive negative PCR tests for MERS-CoV, was readmitted to hospital with fever on 11 October and tested again positive for MERS-CoV on 12 October. The patient, a 35-year-old male, developed symptoms on 11 October and visited a hospital. He was transferred to another hospital for isolation. The patient, who has comorbidities, tested positive for MERS-CoV on 12 October. As of 14 October, his condition was reported to be improving. Contact tracing of household and healthcare contacts is ongoing.View the full article