Africa: Outbreak Bulletins 2012, 2013

[Ronan Kelly]

Vol. 2 Issue 2, March 26, 2012
Content
Overview of reported outbreaks in the WHO African Region Cholera Meningitis
Ongoing outbreaks
Lassa Fever in Nigeria
Typhoid in Zimbabwe
Meningitis in Burkina Faso
Meningitis in Uganda
Meningitis in Ethiopia
Meningitis in Benin
Nodding Syndrome in Uganda
Meningitis in Cote d’Ivoire
Anthrax in Lesotho


Introduction
In this issue, a general overview of outbreaks that occurred within the WHO African Region between January and February 2012 is provided as well as a summary of ongoing outbreaks as reported by Member States.

...

Cholera
Between January and February 2012, a total of 10 691 cases and 178 deaths were reported from 13 countries resulting in a CFR of 1.7% (Table 1). DR Congo and Sierra Leone accounted for 86% of the total number of cases and 65% of the total number of deaths (Figs. 3 and 4).
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Meningitis
Between 01 January and 11 march 2012, a total of 6 634 cases and 646 deaths have been reported from 14 countries (Table 2). The overall CFR was 9.7%. 20 districts from 9 countries experienced meningitis epidemics during the period under review.
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Ongoing outbreaks
Lassa Fever in Nigeria
At the beginning of 2012, WHO was notified by The Federal Ministry of Health in Nigeria of an outbreak of Lassa fever. As of March 22, 2012, 623 cases, including 70 deaths (CFR 11.23%) have been recorded from 19 of the 36 States since the beginning of the year. Of these, 108 have been laboratory confirmed. Three doctors and four nurses were reported to be among the fatalities.
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Typhoid in Zimbabwe
Fig. 9. Distribution of typhoid cases by date of onset, 10 October 2011 - 12 March 2012
Since 10 October 2011, Harare City has been experiencing an outbreak of Typhoid Fever. Between 10 Oc-tober 2011 and 04 March 2012, a total of 3 772 cases have been reported without deaths. Since the beginning of 2012 till March 04, 2649 cases were recorded. On the reporting epidemiological week 9 (week ending 4 March 2012), 198 new cases were reported from Harare (n=177), Bindura (n=18) and Chegutu (n=3). The distribution of cases by places of residence and date of onset is shown in Figure 8 and 9, respectively.
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Meningitis in Burkina Faso
The Ministry of Health in Burkina Faso notified WHO on March 19, 2012 of a meningococcal meningitis epi-demic in Solenzo and Sindou districts. As of 11 March 2012, a total of 1966 cases and 212 deaths were re-ported resulting in a case fatality of 10.8%. The epidemic thresholds were crossed during epi week 8 (week ending 26 February 2012). Figures 10 and 11 show the geographic distribution of the ongoing meningitis out-break and the weekly distribution of meningitis cases in Burkina Faso, respectively. Preventive and control measures are ongoing.
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Meningitis in Uganda
The districts of Amuru and Kiryandongo are reporting suspected Meningitis epidemics. While the attack rates had reached the epidemic threshold in epi-weeks 8 and 9 in both districts, the number of cases has since re-duced to below alert thresholds. Laboratory analysis conducted in Lacor Hospital in Gulu district and Central Public Health Laboratory (CPHL) did not isolate any causative agents. Additional samples had been collected from the suspected cases to confirm the causative organism.

As of March 20, 2012, twenty six (26) suspected cases of meningitis from Amuru district with 5 deaths (CFR=19.23%) have been reported. The initial cases were reported in epidemiological week 5 and increased gradually, attaining a peak of 10 cases in epi weeks 8 and 9 - translating to an attack rate (AR) of 18.6 cases per 100,000 population. The cases have since then reduced to an average of 1 (or less) case per day. The disease has predominantly affected persons below the age of 45 years with the most affected age-group be-ing children 1-14 years.

In Kiryandongo district a cumulative of 44 suspected cases, with six 6 deaths (CFR 13.6%) have been report-ed between January 28 and March 20, 2012. Most of the cases have been recorded in the 15-29 year age-group but significantly high numbers have been reported in the 1-14 year and 30-44 years age-groups.
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Meningitis in Ethiopia
The National Public Health Emergency Management Center of Ethiopian Health and Nutrition Research Insti-tute received reports of an increased number of suspected meningitis cases from Kemata Tembaro, Wolyita, Hadya Zones and Halaba Special districts (locally called Woredas ) of the Southern Nations Nationalities and Peoples (SNNPR) Region since the 6th of February 2012. As of 8th March 2012, a total of 58 suspected cas-es with 0 death were reported from 12 woredas and 3 administrative towns. The suspected cases were dis-tributed over different places at different times and hence do not constitute outbreak but most of them (54%) are reported from Kachabira Woreda of Kembata Tembaro Zone. In Kachabira woreda with population of 133,304, the suspected meningitis cases started to increase from the 4th epi week and reached peak in the 6th epi week indicating that it is an outbreak. The cases start declining from the 7th epi week on wards. The most affected age group is 2 - 30 Years (65%). Due to late prepositioning of Rapid Diagnostic Test (Pastorex), only 5 samples were collected and tested using RDT and three out of the 5 samples tested posi-tive for meningococcal meningitis serogroup B (further laboratory investigation is being undertaken to validate and document the finding)

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Meningitis in Benin
The Ministry of Health of Benin notified WHO of an outbreak on meningitis during the epi-week 7 (week end-ing on 19 February 2012. As of 11 March 2012, a total of 381 cases and 38 deaths (CFR 10%) were reported from the following three districts in epidemic: Nikki (70 cases and 6 deaths, CFR:8.6%), Tanguieta (57 cases and 7 deaths, CFR: 12.3% ) and Perere district (44 cases and 4 deaths, CFR: 9% ). The Districts of Cobly, Natitingou, Kalale, Materi, Matitingou and Sinende are in alert.

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Nodding Syndrome in Uganda
The Uganda Ministry of Health reported a mysterious disease condition, referred to as “Nodding Syndrome”, being reported in the Northern Uganda districts of Kitgum, Pader and Lamwo. The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunted growth. The investigations revealed that the disease was a new type of epi-lepsy that was reported to have affected at least 3,000 children in the districts of Kitgum, Lamwo and Pader in Northern Uganda. As of February 14, it is estimated that a total of 3,094 suspected cases with 170 deaths have occurred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. The disease presentation suggests that this is possibly a new type of epilepsy that is characterized by head nod-ding episodes that consist of repetitive dropping forward of the head. There is deterioration of brain function in some of the victims, and malnutrition with growth retardation; many children have dropped out of school.

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Meningitis in Cote d’Ivoire
An ICG request submitted by national authorities for 300,000 doses of Meningitis Vaccine W135 (including devices) has been approved and mass vaccination campaigns in the 2 epidemic districts i.e. Tengréla (total population - 93,583) and Kouto (total population – 121,897) were conducted.
WHO Country Office has been working with the health authorities in strengthening epidemiological surveil-lance; distribution of supplies, refresher training of health workers on case management and sensitization of the population
Fig. 16. Geographic distribution of meningitis in Cote d’Ivoire, 11 March 2012
Affected districts
The Ministry of Health in Cote d’Ivoire has reported an outbreak of meningococcal meningitis in Central and Northern parts of the country. As of 11 March 2012, a total of 281 cases including 39 deaths were reported .
The Institut Pasteur in Abidjan confirmed the presence of Neisseria meningitidis W135 from samples collect-ed in Tengréla and Kouto districts; while streptococcus pneumoniae was isolated in samples from Bouaké northeast. More laboratory samples are being tested from districts reporting suspected cases for characteri-sation.
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Anthrax in Lesotho
On 06 March 2012, one of the local radio stations in Lesotho reported an event where people seemed to be having sores on their body after eating meat of animals that died in their villages and skinning of dead ani-mals. It was reported that many animals such as cows and donkeys had died. Around 300 suspected human cases with 3 deaths were reported from three villages (Masaleng Ha Janki, Ha Popa and Mampusi villages) of Berea district. Out of 98 suspected cases in Masaleng Ha Janki, 58 presented with signs and symptoms of Anthrax.
Cases presented with painless black eschar skin lesions/blisters, swelling below the jaws and neck and swelling of the limbs especially hands and arms, abdominal pains, fever and diarrhea.
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http://reliefweb.int/sites/reliefweb...-26mar2012.pdf

[Ronan Kelly]

Africa Outbreak Bulletin
Vol. 2 Issue 3, April 30, 2012



Cholera
Between January and March 2012, a total of 15 270 cases and 268 deaths were reported from 15 countries
resulting in a CFR of 1.8% (Table 2). DR Congo and Sierra Leone accounted for 83% of the total number of
cases and 67% of all deaths Figures 2 and 3 show the geographic distribution of cholera cases by country
and the weekly distribution of cholera cases and deaths in DRC respectively.

Meningitis
Between 01 January and 08 April 2012, a total of 13 169 cases and 1 178 deaths were reported by 14 countries (Table 3). The overall CFR was 8.9%. 42 districts in 10 countries crossed the epidemic threshold as shown in Fig 5.
The most prevalent pathogens identified in the districts that had crossed the epidemic threshold were Neisseria meningitidis (67%) and Streptococcus pneumoniae (31%). Out of the 461 confirmed Neisseria meningitides samples , the most frequent serogroup was Nm W135 (77%, n=356) as shown in Figure 4.
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Ongoing outbreaks

1. Lassa Fever in Nigeria
At the beginning of 2012, WHO was notified by The Federal Ministry of Health of an outbreak of Lassa fever. As of April 08, 2012, 818 cases, including 84 deaths (CFR 10.3%) were reported from 19 out of the 36 States as shown in Fig 6 and 7, since the beginning of the year. Only 131 cases (16%) have been laboratory confirmed. Three doctors and four nurses were reported to be among the fatalities.
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2. Typhoid in Zimbabwe

Since 10 October 2011, Harare City has been experiencing an outbreak of Typhoid Fever ( see Fig 8). The disease has also spread to Chitungwiza City, Mashonaland Central Province (Bindura district) and Masho-naland West Province (Zvimba and Chegutu districts). Figure 9 shows the typhoid epidemic curve in Zimba-bwe. As of 08 April 2012, a total of 4 177 cases had been reported. Of these, 4064 cases and 2 deaths (CFR= 0.05%) were from Harare City, 69 cases from Bindura, 25 cases from Zvimba, 15 cases from Chegutu, Chitungwiza 2 cases and Chirumanzu 1 case. Of the total samples collected for laboratory confir-mation from 26 October 2011 to date, 52 were confirmed S.typhi.
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3. Meningitis in Burkina Faso
The Ministry of Health notified WHO on 19 March 2012 of a meningococcal meningitis epidemic in Solenzo and Sindou districts. As of 15 April 2012, a total of 4 811 cases and 503 deaths with a case fatality of 10.5%were reported. The epidemic thresholds were crossed during the epidemiological week ending 26 February 2012. Figures 10 and 11 show the geographic distribution of the ongoing meningitis outbreak and the distri-bution of meningitis cases by week respectively. Preventive and control measures are ongoing.
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4. Cholera in Ghana
Fig. 12. Geographic distribution of Cholera in Ghana as of 11 April 2012
On 11 April 2012, the Ministry of Health notified WHO of a cholera outbreak in the Greater Accra Region which began during the first week of 2012. A total of 996 cases and 15 deaths were reported from 13 districts. Of these, Accra district reported 59% of the cases and 87% of the deaths. Weekly reported cases have ranged from 12 to 27. However in weeks 12 and 13, there was an upsurge in the number of cases to 67 and 267 respectively. Of those affected, 59% are males with the 20-29 year age group being the most affected accounting for 43% of all cases.
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5. Meningitis in Chad
The Ministry of Health reported an outbreak of meningococcal meningitis which started during the 2nd week of January 2012. As of 15 April 2012, a total of 2 828 cases and 135 deaths were reported from 49 districts with 12 districts having crossed the epidemic threshold (Figure 11).
Laboratory results confirmed Neisseria meningitis A as the predominant pathogen (83%) in all the districts which crossed the epidemic and alert thresholds.
...
6. Cholera in Uganda
The Ministry of Health reported cholera epidemics in 6 districts across the country as shown in figure 14. The districts affected are Mbale, Sironko and Bududa in the Eastern region; Kasese and Buliisa districts in the West and South Western regions; and Nebbi district in the West Nile sub-region (Northern Uganda). Between February and March 2012, a cumulative number of 358 cases including 18 deaths (CFR = 5.0%) were report-ed from the districts of Mbale, Sironko, Buliisa, Bududa and Nebbi. In Kasese district a cumulative number of 366 cases including 10 deaths (CFR = 2.7%) were reported as of March 2012. The causative agent for the cholera epidemics was confirmed by the Central Public Health Laboratory (CPHL) as Vibrio cholerae O1 bio-type El Tor serotype Inaba.
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7. Meningitis in Benin
The Ministry of Health notified WHO of an outbreak of meningitis during the week ending 19 February 2012. As of 15 April 2012, a cumulative number of 717 cases and 69 deaths (CFR: 9.6%) were reported from the following five districts that had crossed the epidemic threshold: Nikki (120 cases and 16 deaths, CFR: 11.7%), Tanguieta (119 cases and 11 deaths, CFR: 9.2%), Materi (107 cases and 6 deaths, CFR: 5.7% ), Cobly (67 cases and 7 deaths, CFR: 10.4%) and Perere districts (53 cases and 5 deaths, CFR: 9.4%). Figure 15 shows the geographical distribution of the affected districts.
...
8. Nodding Syndrome in Uganda
The Ministry of Health reported a mysterious condition, referred to as “Nodding Syndrome”, in the northern districts of Kitgum, Pader and Lamwo (Figure 16). The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunted growth. As of February 14, it is estimated that a total of 3 094 suspected cases with 170 deaths have occurred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. There is deterioration of brain function in some of the victims and malnutrition with growth retardation. Many affected children have dropped out of school.
...

[Ronan Kelly]

Africa Outbreak Bulletin
Vol. 2 Issue 4, 26 May 2012



Cholera
Between January and April 2012, a total of 25 856 cases and 538 deaths were reported from 20 countries resulting in a CFR of 2.1% (Table 2). DR Congo, Ghana, Uganda and Sierra Leone accounted for 84% of the total number of cases and 73% of all deaths. Figure 2 shows the geographic distribution of cholera cases by country and Figure 3 the weekly distribution of cholera cases and deaths in DR Congo.
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Meningitis
Between January and April 2012, a total of 16 199 cases and 1 398 deaths were reported by 16 countries (Table 3). The overall CFR was 8.6%. A total of 44 districts in 11 countries crossed the epidemic threshold as shown in Fig 5.
The most prevalent pathogens identified in the districts that had crossed the epidemic threshold were Neisseria meningitidis (66%) and Streptococcus pneumoniae (27%). Out of the 619 confirmed Neisseria meningitidis samples, the most frequent serogroup was Nm W135 (79%, n=486) as shown in Figure 4.
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Ongoing outbreaks

1. Cholera in Ghana
On 11 April 2012, the Ministry of Health notified WHO of a cholera outbreak in the Greater Accra Region. Be-tween January and 6 May 2012, a total of 3 216 cases and 28 deaths were reported from 20 districts. The CFR is 0.9%. Accra district reported 53% of the cases and 87% of the deaths. Geographic distribution of cas-es is shown in figure 6. Weekly reported cases have ranged from 12 to 27. However in weeks 12 - 18, there was an upsurge in the number of cases (Figure 7).
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2. Cholera in Mozambique
As of 13th May 2012, a total of 647 cases and 7 deaths (CFR: 1.1 %) were reported from two provinces namely Cabo Delgado ( affected districts are Pemba and Montepuez with a total of 404 cases and 4 deaths; CFR: 1.0%) and Niassa province (affected districts are Cuamba and Mecanhelas) with a total of 243 cases and 3 deaths; CFR:1.0%). Between weeks 15 and 19, no cases and deaths have been notified from the two provinces.
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3. Cholera in Uganda
The Ministry of Health reported a cholera outbreak in eight districts across the country (figure 10). Between 01 January 2012 and 04 May 2012, a total of 2 544 cases and 48 deaths (CFR = 1.9%) were reported from the eight districts. The distributions of the cases and deaths by districts are as follows: Nebbi (813 cases and 16 deaths); Mbale (270 cases and 11 deaths); Buliisa (575 cases and 6 deaths); Bududa (127 cases/ 6 deaths); Sironko (20 cases and 2 deaths); Hoima (287 cases and 6 death); Kasese (319 cases and 0 deaths); Kibaale district (133/ 2 deaths). The causative agent for the cholera epidemics was confirmed by the Central Public Health Laboratory (CPHL) as Vibrio cholerae O1 bio-type El Tor serotype Inaba.
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4. Cholera in Zimbabwe
A cholera alert was received from Old Boli Clinic in Chiredzi District, Masvingo province on the 5th of May 2012 (figure 11). The suspected cases were from Matibi 11, Njinga and Manyise Villages. A total of 16 chol-era cases and 0 deaths with 6 vibrio cholerae positive laboratory samples were reported from the 3rd to the 17th of May. The first suspected cholera case presented at the clinic on the 2nd of May 2012, followed by a second suspect on the 3rd of May 2012. Stool samples were collected by the investigation team and submit-ted for laboratory analysis. The sample from the first suspected case, who had received antibiotics, was neg-ative; the sample from the second suspected case, who had received ORS, was positive for vibrio cholerae Inaba.
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5. Meningitis in Benin
The Ministry of Health notified WHO of an outbreak of meningitis during the epidemiological week 7 (week ending at 19 February 2012). As of 13 May 2012, a cumulative number of 800 cases and 78 deaths (CFR: 9.8%) were reported from 23 districts. The following six districts had crossed the epidemic threshold: Nikki (125 cases and 14 deaths, CFR: 11.2%), Tanguieta (138 cases and 14 deaths, CFR: 10%), Materi (114 cases and 6 deaths, CFR: 5.3% ), Cobly (73 cases and 7 deaths, CFR: 9.6%), Perere districts (54 cases and 5 deaths, CFR: 9.3%) and Natitingou (46 cases and 2 deaths, CFR: 4.3%). Figure 12 shows the geographical distribution of the affected districts.
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6. Meningitis in Burkina Faso
The Ministry of Health notified WHO of a meningococcal meningitis epidemic in Solenzo and Sindou districts on 19 March 2012. As of 13 May 2012, a total of 5 558 cases and 590 deaths have been reported (CFR: 10.6%). The epidemic threshold was crossed during the epidemiological week 8 (week ending at 26 February 2012). Figures 13 and 14 show the geographic distribution of the ongoing meningitis outbreak and the distri-bution of meningitis cases by week respectively. Preventive and control measures are ongoing. Reactive vac-cination with polysaccharide ACYW135 was conducted in 3 of the affected districts.
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7. Meningitis in Chad
The Ministry of Health reported an outbreak of meningococcal meningitis which started during the 2nd week of January 2012. As of 13 May 2012, a total of 3 636 suspected cases and 154 deaths were reported from 49 districts. A total of 12 districts crossed the epidemic threshold (Figure 15).
Laboratory results confirmed Neisseria meningitis A as the predominant pathogen (83%) in all the districts which crossed the epidemic thresholds.
...
8. Lassa Fever in Nigeria
At the beginning of 2012, WHO was notified by The Federal Ministry of Health of an outbreak of Lassa fever. Between 1 January and 6 May 2012, 869 cases including 92 deaths (CFR 10.6%) were reported from 22 out of the 36 States as shown in Fig 16 and 17. 82% of the cases and 37% of the deaths were reported from Edo state. A total of 143 cases (16%) have been laboratory confirmed. Three doctors and four nurses were report-ed to be among the dead.
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9. Typhoid in Zimbabwe
Fig. 19. Distribution of typhoid cases by date of onset, 10 October 2011 - 8 May 2012
Since 10 October 2011, Harare City has been experiencing an outbreak of Typhoid Fever. The disease has also spread to Chitungwiza City, Mashonaland Central Province (Bindura district) and Mashonaland West Province (Zvimba and Chegutu districts). Figure 18 shows the typhoid epidemic curve in Zimbabwe. As of 10 May 2012, a total of 4 266 cases had been reported. Out of the samples collected for laboratory confir-mation from 26 October 2011 to date, 67 were confirmed S.typhi.
...
10. Nodding Syndrome in Uganda
The Ministry of Health reported a mysterious condition, referred to as “Nodding Syndrome”, in the northern districts of Kitgum, Pader and Lamwo (Figure 20). The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunt-ed growth. As of February 14, it is estimated that a total of 3 094 suspected cases with 170 deaths have oc-curred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. There is deterioration of brain function in some of the victims and malnutrition with growth retardation. Many affected children have dropped out of school.
...
11. Yellow Fever in Togo
Between January and April 2012, a total of 10 cases of Yellow Fever have been reported from the following five districts: Tone (3 cases), Oti (4cases), District II (1 case), Doufelgou (1 case) and Vo (1 case). Laborato-ry samples submitted to the Pasteur Institute have been confirmed as IgM positive. Figure 21 shows the geo-graphic distribution of the Yellow Fever cases.
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[Ronan Kelly]

Africa Outbreak Bulletin
Vol. 2 Issue 6, 13 September 2012

Content
 Overview of reported outbreaks in the WHO African Region
Cholera
 Ongoing outbreaks
 Cholera in Sierra Leone,
Guinea and Liberia
Cholera in DR Congo
Cholera in Zambia
Ebola in DR Congo
Ebola in Uganda


...
Cholera
Between 01 January and 01 September 2012, a total of 62 106 cases and 1 246 deaths were reported from
23 countries resulting in a CFR of 2.0% (Table 2). DR Congo, Sierra Leone, Guinea, Uganda, Ghana and
Niger accounted for 92% of the total number of cases and 88% of all deaths. Figure 2 shows the geographic
distribution of cholera cases by country and
Figure 3 the distribution of cholera cases and
deaths by country in the region.
In response to cholera outbreaks, support was provided to the respective Ministries of Health in the areas of
surveillance, case management, sensitization of the population and data management. WHO AFRO deployed
international and regional experts, cholera supplies and other supplies to the affected countries.
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Ongoing outbreaks

1. Cholera in Sierra Leone, Guinea and Liberia
Sierra Leone: The Ministry of Health in Sierra Leone declared an outbreak of cholera in 12 out of 13 dis-tricts: Bo, Bombali, Bonthe, Kambia, Kono, Moyamba, Port Loko, Pujehun, Tonkolili, Kenema, Koinadugu and Western Area (that includes Freetown the capital city). The Government declared the cholera outbreak as a “humanitarian crisis”.
As of the 06 September 2012, a total of 16 884 cases with 257 deaths (CFR=1.5%) had been reported.
Guinea: Between 02 February and 01 September 2012, 5 523 cases and 105 deaths (CFR: 1.9%) had been reported from 10 districts.
Liberia: The last confirmed cholera cases were reported on 25 March 2012.
Additional information on cholera outbreaks in Guinea, Sierra Leone and Liberia is given in the following tables, maps and graphs.
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2. Cholera in DR Congo
DR Congo continues to experience a cholera outbreak. Between 01 January and 26 August 2012, a total of 22 792 cases with 512 deaths (CFR: 2%) were reported from 8 out of 11 provinces as shown in table 5.
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3. Cholera in Zambia
Zambia is experiencing a cholera outbreak in the district of Mpulungu in northern Province since 03 August 2012. As of 27 August 2012, a total of 153 cases and 2 deaths (CFR: 1.3%) had been reported. The majority (54%) of the patients are below 15 years of age.
Of the 33 stool samples collected, 22 tested positive for Vibrio cholerae. Currently the disease is confined to Mpulungu District though it has the potential of spreading since the district has inadequate access to clean water due to a water supply system breakdown.
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4. Ebola in DR Congo
The Ministry of Health (MoH) of the Democratic Republic of Congo (DRC) declared an outbreak of Ebola on 17 August 2012. As of 8 September 2012, a total of 29 (15 suspected, 6 probable and 8 confirmed) cases and 15 deaths had been reported from Haute Uelé district in Province Orientale. The reported cases and deaths have occurred in 2 health zones i.e. 19 cases and 12 deaths in Isiro and 10 cases and 3 deaths in Vi-adana. The fatal cases in Isiro include three health-care workers. There have been no confirmed cases of Ebola reported outside Haute Uelé district.
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5. Ebola in Uganda
On 24 July 2012, the Ministry of Health (MoH) of Uganda notified WHO of an outbreak of Ebola haemor-rhagic fever from Kibaale district, mid-western Uganda.
A total of 24 probable and confirmed cases including 17 deaths have been reported since the beginning of the outbreak. Of these, 11 cases were laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe. The last confirmed case was discharged on 24 August 2012. There have been no new con-firmed cases of Ebola haemorrhagic fever reported in Kibaale district, Uganda, since 3 August 2012.
All contacts of probable and confirmed cases have been followed up daily and have completed the recom-mended 21 days of monitoring for any possible signs or symptoms of Ebola.
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[Ronan Kelly]

Africa Outbreak Bulletin
Vol.2 Issue 9, 21 December 2012

The PDF seems to be copy-protected - some extracts below - follow the link to read in full.

[gsgs]

unusual H3N2 outbreak in Zimbabwe, July 2012
low mortality

http://crofsblogs.typepad.com/h5n1/2...influenza.html

[Ronan Kelly]

Africa Outbreak Bulletin
Vol. 2 Issue 10, 07 February 2013

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Cholera
Between January and December 2012, a total of 94 553 cases and 1 834 deaths were reported from 25 countries resulting in a CFR of 1.9%. DR Congo, Sierra Leone, Ghana, Guinea, Uganda and Niger account-ed for 90% (85 293 / 94 553) of the total number of cases and 70% (1 596 / 1 834) of all deaths. The distri-bution of cholera cases and deaths is shown in Table 1 and Figures 3 and 4.
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Meningitis
Between January and December 2012, a total of 28 351 meningitis cases and 2 468 deaths were reported from 18 countries (Table 3). The Case Fatality Ratio was estimated at 8.7%. A total of 46 districts in 12 countries crossed the epidemic threshold as shown in Table 3 and Figure 5.
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Viral Hemorrhagic Fever
Between January and December 2012, seven countries experienced Viral Hemorrhagic Fever (VHF) out-breaks. Ebola outbreaks were reported from DR. Congo and Uganda Lassa Fever in Nigeria Marburg in Uganda , Rift Valley Fever in Mauritania and yellow fever in Cote d’Ivoire, Ghana and Togo. The distribution of VHF by country is shown in table 5 and figure 7.
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[Ronan Kelly]

Outbreak Bulletin - Vol. 3 Issue 3, 26 April 2013

The PDF seems to be copy-protected - some extracts below - follow the link to read in full.