Disease outbreak news

From 11 November to 28 December, 2020 a total of 67 suspected cholera cases presenting with diarrhea and vomiting, including two deaths a case fatality ratio (CFR: 3%) were reported from the municipalities “Golfe 1” and “Golfe 6” in Lomé, Togo. A total of four health areas (Katanga, Adakpamé, Gbétsogbé in Golfe 1, and Kangnikopé in Golfe 6) in the affected municipalities reported at least one case.

On 17 November, cholera was confirmed by culture in the laboratory of the National Institute of Hygiene (INH) in Lomé, Togo and WHO was informed. On 19 November, the Minister of Health, Public Hygiene and Universal Access to Care of Togo issued a press release declaring a cholera outbreak and on 24 November WHO was officially notified. From 11 November to 28 December 2020, a total of 17 out of 41 stool samples tested positive for Vibrio cholerae O1 serotype Ogawa by culture in the National Institute of Hygiene (INH) in Lomé, Togo.

On 15 December 2020, the Brazil Ministry of Health reported the second confirmed human infection with influenza A(H1N2) variant virus [A(H1N2)v] in Brazil in 2020.

SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally; infecting a large number of people; causing severe disease and associated long-term health sequelae; resulting in death and excess mortality, especially among older and vulnerable populations; interrupting routine healthcare services; disruptions to travel, trade, education and many other societal functions; and more broadly having a negative impact on peoples physical and mental health. Since the start of the COVID-19 pandemic, WHO has received several reports of unusual public health events possibly due to variants of SARS-CoV-2. WHO routinely assesses if variants of SARS-CoV-2 result in changes in transmissibility, clinical presentation and severity, or if they impact on countermeasures, including diagnostics, therapeutics and vaccines. Previous reports of the D614G mutation and the recent reports of virus variants from the Kingdom of Denmark, the United Kingdom of Great Britain and Northern Ireland, and the Republic of South Africa have raised interest and concern in the impact of viral changes.

A variant of SARS-CoV-2 with a D614G substitution in the gene encoding the spike protein emerged in late January or early February 2020. Over a period of several months, the D614G mutation replaced the initial SARS-CoV-2 strain identified in China and by June 2020 became the dominant form of the virus circulating globally. Studies in human respiratory cells and in animal models demonstrated that compared to the initial virus strain, the strain with the D614G substitution has increased infectivity and transmission. The SARS-CoV-2 virus with the D614G substitution does not cause more severe illness or alter the effectiveness of existing laboratory diagnostics, therapeutics, vaccines, or public health preventive measures.

From October to December 2020, a total of seven confirmed cases of yellow fever (YF) have been reported from four health districts in three regions in Senegal.

Between 6 November and 15 December 2020, 52 suspected cases of yellow fever (YF), including 14

On 14 December 2020, authorities of the United Kingdom (UK) reported to WHO that a new SARS-CoV-2 variant was identified through viral genomic sequencing. This variant is referred to as SARS-CoV-2 VUI 202012/01 (Variant Under Investigation, year 2020, month 12, variant 01).

Since June 2020, Danish authorities have reported an extensive spread of SARS-CoV-2, the virus that causes COVID-19, on mink farms in Denmark.

Between 8 September and 24 November, 2020, the North-Central region of Burkina Faso reported a

Reports of a cluster of deaths from an undiagnosed disease were notified on 1 November 2020 through Event Based Surveillance in two states, Delta and Enugu, located in southern Nigeria.

On 18 November 2020, the Minister of Health of the Democratic Republic of the Congo declared the end of the Ebola Virus Disease (EVD) outbreak in Equateur Province.

The Ministry of Health in Lao People's Democratic Republic (PDR) reported a human case of infection with an avian influenza A(H5N1) virus. The case is a one-year-old female who developed symptoms of fever, productive cough, difficulty breathing and runny nose on 13 October 2020. She was hospitalized for her illness on 16 October and discharged on 19 October. As part of severe acute respiratory infection (SARI) sentinel surveillance, a specimen was collected on the date of hospitalization and confirmed to be positive for avian influenza A(H5N1) on 28 October by reverse transcription polymerase chain reaction (RT-PCR) at the National Centre for Laboratory and Epidemiology (NCLE).

Among the close contacts of the patient, one contact developed fever and cough after the onset of illness in the case. Specimens collected from all household contacts, including the symptomatic contact, were negative for influenza A viruses.

The Ministry of Health (MoH) notified WHO that between 13 September and 1 October 2020, eight cases of Rift Valley Fever (RVF) including seven deaths were confirmed in animal breeders. Districts affected include Tidjikja and Moudjéria (Tagant region), Guerou (Assaba region) and Chinguetty (Adrar region). Laboratory confirmation of RVF infection was performed using a reverse transcription polymerase chain reaction (RT-PCR) at the National Institute for Public Health Research (INRSP) in Nouakchott. The age of infected patients varied between 16 and 70 years old and included one woman and seven men. All seven deaths occurred among hospitalised patients with fever and haemorrhagic syndrome (petechia, gingivorrhagia) and vomiting.

Between 4 September and 7 November 2020, a total of 214 people were sampled and their samples have been sent to the INRSP for laboratory testing with a total of 75 testing positive for RVF (RT-PCR and serology by enzyme-linked immunosorbent assay (ELISA). Positive cases have been reported in 11 of 15 regions of the country: Brakna, Trarza, Gorgol, (on the border with Senegal), Adrar, Assaba, Hodh El Gharby, Hodh El Chargui, Guidimaka (on the border with Mali) and Nouakchott Sud, Nouakchott Ouest and Tagant. The Tagant region is the most affected (38/75, 51%) with principal hotspot districts being Tidjikja and Moudjeria. Thus far a total of 25 deaths have been reported from this outbreak.

Since June 2020, 214 human cases of COVID-19 have been identified in Denmark with SARS-CoV-2 variants associated with farmed minks, including 12 cases with a unique variant, reported on 5 November.

On 13 October 2020, the French health authorities officially reported 13 laboratory-confirmed cases of Mayaro fever in French Guiana, France.

In September 2020, the Institut Pasteur de la Guyane (IPG) (member of the French National Reference Laboratory for arboviruses) identified two cases of Mayaro virus infection (MAYV) confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and one probable case found positive for Mayaro antibodies. The case-patients presented dengue-like symptoms and joint pains, and tested negative for dengue by RT-PCR.

On 30 September 2020, the French Guiana Regional Health Agency (ARS) reported the first detection of Oropouche virus (OROV) in French Guiana. On 22 September 2020 the Pasteur Institute in Cayenne (a member of the French National Reference Laboratory for arboviruses) notified the France IHR National Focal Point of seven laboratory-confirmed cases of Oropouche virus infection in the village of Saül. These cases were identified following clinical investigations of an unusually high number of dengue-like illnesses in the village. Between 11 August and 25 September, there were 37 clinically-compatible cases of Oropouche virus disease identified in Saül. The results of serology for dengue, chikungunya, and Zika were negative, and seven of nine cases tested positive for OROV by reverse transcriptase polymerase chain reaction (RT-PCR).

Among the 37 clinically-compatible cases, most cases are male (60%) and the median age is 36 years (range 3-82 years). The most represented age range is 15 to 54-years-old (19 cases) followed by 0 to 14-years-old (10 cases). A peak of cases was observed in mid-September however, the outbreak investigation remains ongoing.