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.
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.
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.
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).
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).
Between 10 and 13 October 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The four cases are from the same compound in Riyadh city.
Contact tracing of household and healthcare contacts is ongoing for these cases.
Between 8 October and 16 October 2015, the National IHR Focal Points of Brazil and Colombia notified PAHO/WHO of cases of Zika virus infection.
In May 2015, the public health authorities of Brazil confirmed autochthonous transmission of Zika virus in the northeastern part of the country. As of 8 October, autochthonous cases of Zika virus had been detected in 14 states: Alagoas, Bahia, Ceará, Maranhão, Mato Grosso, Pará, Paraná, Paraíba, Pernambuco, Piauí, Rio de Janeiro, Rio Grande do Norte, Roraima, and São Paulo.
The Ministry of Health and Social Welfare (MOHSW) of the United Republic of Tanzania has notified WHO of new foci of cholera outbreaks in the country. As of 13 October, 13 regions have been affected, namely Dar es Salaam, Morogoro, Pwani, Kigoma, Kilimanjaro, Iringa, Dodoma, Geita, Mara, Singida, Shinyaga, Mwanza and Zanzibar. As of 19 October, the cumulative number of cases is 4,835 cases, including 68 deaths. The region of Dar es Salam accounts for 72% of all reported cases (3,460). Zanzibar has reported 140 cases.
The national task force led by the MOHSW continues to carry out activities aimed at controlling the outbreak. Water sanitation measures have been implemented alongside health education campaigns. The MOHSW, WHO, the US Centers for Disease Control (CDC) and the Field Epidemiology Program have joined forces to enhance surveillance and ensure a timely, coordinated response to alerts from the field.