| No images? Click here  Friday, 1 November 2024 Joint statement by WHO and UNICEF Polio vaccination campaign to resume in northern Gaza1 November 2024 -- Jerusalem/Amman/Geneva/New York -- A third phase of the polio vaccination campaign is set to begin tomorrow in part of the northern Gaza Strip after being postponed from 23 October 2024 due to lack of access and assured, comprehensive humanitarian pauses, intense bombardment, and mass evacuation orders. These conditions made it impossible for families to safely bring their children for vaccination and to organize campaign activities. "The humanitarian pause necessary to conduct the campaign has been assured; however, the area of the pause has been substantially reduced compared to the first round of vaccination in northern Gaza, conducted in September 2024. It is now limited to just Gaza City. Though in the past few weeks, at least 100 000 people have been forced to evacuate from North Gaza towards Gaza City for safety, around 15 000 children under ten years in towns in North Gaza like Jabalia, Beit Lahiya and Beit Hanoun still remain inaccessible and will be missed during the campaign, compromising its effectiveness. To interrupt poliovirus transmission, at least 90% of all children in every community and neighborhood must be vaccinated. This will be challenging to achieve given the situation. The final phase of the campaign had aimed to reach an estimated 119 000 children under ten years old in northern Gaza with a second dose of novel oral polio vaccine type 2 (nOPV2). However, achieving this target is now unlikely due to access constraints. Despite the lack of access to all eligible children in northern Gaza, the Polio Technical Committee for Gaza, including the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners has taken the decision to resume the campaign. This aims to mitigate the risk of a long delay in reaching as many children as possible with polio vaccine and the opportunity to vaccinate those recently evacuated to Gaza City from other parts of North Gaza. To overcome challenges posed by the volatile security situation and constant population movement, robust micro plans have been developed to ensure the campaign is responsive to the significant population shifts and displacement in the north, following the first round in September. The campaign will be delivered by 216 teams across 106 fixed sites, 22 of which have been added to ensure increased availability of vaccination in areas where recently displaced people are seeking refuge. Two hundred and nine social mobilizers will be deployed to engage communities and raise awareness around vaccination efforts. The time period for the humanitarian pause has been extended by two hours and is expected to run from 6am to 4pm daily. As in the first two phases, vitamin A will also be co-administered to children between two to ten years in the north to help boost overall immunity. The campaign in northern Gaza follows the successful implementation of the first two phases of the second round in central and southern Gaza, which reached 451 216 children – 96% of the target in these areas. A total of 364 306 children aged between 2 and 10 years have received vitamin A so far in this round. Despite the challenges, WHO and UNICEF urge for the humanitarian pauses to be respected to ensure the successful delivery of this second round of the polio vaccination campaign. This is crucial to help curb the spread of polio in Gaza and neighboring countries.  WHO media contact:  You are receiving this NO-REPLY email because you are included on a WHO mail list.  |
Friday, November 1, 2024
Joint statement by WHO and UNICEF: Polio vaccination campaign to resume in northern Gaza
Disease Outbreak News: Marburg virus disease - Rwanda - 1 November 2024
| No images? Click here  Friday, 1 November 2024 Disease Outbreak NewsMarburg virus disease - Rwanda1 November 2024 Marburg virus disease – Rwanda Situation at a glanceIt has been over a month since the declaration of the Marburg virus disease (MVD) outbreak in Rwanda on 27 September 2024. As of 31 October 2024, 66 confirmed cases, including 15 deaths (CFR: 23%), have been reported including two new confirmed cases since the previous Disease Outbreak News report. WHO continues to support the Government of Rwanda in responding to the outbreak. Enhanced surveillance, contact tracing and infection prevention and control measures must be maintained until the outbreak is declared over. Description of the situationSince the last Disease Outbreak News on this event was published on 25 October 2024, two additional laboratory-confirmed cases of Marburg virus disease (MVD) were reported in Rwanda on 26 and 30 October respectively. These cases are known contacts of a previously confirmed case and are currently in isolation and receiving treatment. As of 31 October 2024, 66 confirmed cases, including 15 deaths (CFR: 23%), have been reported. Excluding the four recently reported confirmed cases, 70% of confirmed cases are males, and 48% are adults between 30 and 39 years of age. Health workers from two health facilities in Kigali account for almost 80% of all confirmed cases. Most cases are reported from the three districts in Kigali city. The highest number of new confirmed cases were reported in the first two epidemiological weeks of the outbreak with 26 cases reported in epidemiological week 39 (23 to 29 September 2024) and 23 cases in week 40 (30 September to 6 October). Following just one case reported in epidemiology week 42 (14 to 20 October), three cases were reported in epidemiology week 43 (21 to 27 October) and one case in week 44 (reported on 30 October). Since the declaration of the outbreak by the Government of Rwanda on 27 September and as of 31 October, 49 confirmed cases have recovered, and two cases are still receiving care at the designated Marburg treatment center. As of 31 October 2024, 6099 tests for Marburg virus have been conducted, with approximately 100-350 samples being tested daily at the Rwanda Biomedical Center. Contact tracing is ongoing, with 559 contacts listed under follow-up as of 31 October 2024. WHO continues to support the Government of Rwanda to respond to the ongoing outbreak. Enhanced surveillance, contact tracing and infection prevention and control measures must be maintained until the outbreak is declared over. EpidemiologyMVD is a highly virulent disease that can cause haemorrhagic fever and is clinically similar to Ebola virus disease. Marburg and Ebola viruses are both members of the Filoviridae family (filovirus). People are infected with Marburg virus when they come into close contact with Rousettus bats, a type of fruit bat, that can carry the Marburg virus and are often found in mines or caves. Marburg virus then spreads between people via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Health workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg virus. The incubation period varies from two to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Although not all cases present with haemorrhagic signs, severe haemorrhagic manifestations may appear between five and seven days from symptoms onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock. There is currently no approved treatment or vaccine for MVD. Some candidate vaccines and therapeutics are currently under investigation. Seventeen outbreaks of MVD have previously been reported globally. The most recent outbreaks were reported in Equatorial Guinea and the United Republic of Tanzania between February and June 2023. Additional countries that previously reported outbreaks of MVD in the African Region include Angola, the Democratic Republic of the Congo, Ghana, Guinea, Kenya, South Africa, and Uganda. Public health response
WHO risk assessmentMarburg virus disease (MVD) is caused by the same family of viruses (Filoviridae) that causes Ebola virus disease. MVD is an epidemic-prone disease associated with high CFR (24-88%). In the early course of the disease, MVD is challenging to distinguish from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Epidemiologic features can help differentiate between viral hemorrhagic fevers (including history of exposure to bats, caves, or mining) and laboratory testing is important to confirm the diagnosis. With 66 confirmed cases reported, this is the third largest MVD outbreak reported to date, with almost 80% of confirmed cases reported among health workers. Healthcare-associated infections (also known as nosocomial infections) of this disease can lead to further spread if not controlled early. The importance of screening all persons entering health facilities as well as inpatient surveillance for prompt identification, isolation, provision of care and notification cannot be overemphasized. This is in addition to the importance of contact identification and listing and daily follow-up of all contacts. Based on the outbreak investigation which included record review in health facilities, review of epidemiological data, serology and genomic sequencing, as well as environmental and animal testing, the source of the outbreak is reported to be of zoonotic origin, linked to exposure in a cave inhabited by fruit bats. However, the dates of symptom onset of cases are still unknown to WHO. On 30 September, WHO assessed the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level. However, based on the evolution of the outbreak and ongoing investigations, this risk assessment may be revised. MVD is not easily transmissible (i.e. in most instances it requires contact with the body fluids of a sick patient presenting with symptoms or with surfaces contaminated with these fluids). In addition, there are ongoing public health measures in place, including active surveillance in facilities and communities, testing suspected cases, isolation and treatment of cases and contact tracing. WHO adviceMVD outbreak control relies on using a range of interventions, including prompt isolation and case management; surveillance including active case search, case investigation and contact tracing; a laboratory service; infection prevention and control, including prompt safe and dignified burial; and social mobilization – community engagement is key to successfully controlling MVD outbreaks. Raising awareness of risk factors for Marburg virus infection and protective measures that individuals can take is an effective way to reduce human transmission. WHO advises the following risk reduction measures as an effective way to reduce MVD transmission in healthcare facilities and in communities:
Based on the current risk assessment, WHO advises against any travel restrictions or any trade restrictions with Rwanda at this time. For further information, please see WHO advice for international traffic in relation to the Marburg virus disease outbreak in Rwanda. Further informationCitable reference: World Health Organization (1 November 2024). Disease Outbreak News; Marburg virus disease in Rwanda. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON543
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