Young people’s views guide WHO advice on HIV prevention and care for those most at risk

17 Jul, 2014

reference: http://www.who.int/features/2014/hiv-prevention/en/

Sex workers, drug users, men who have sex with men and transgender people are at higher risk of HIV than the general population – a risk that is heightened if the person is young. WHO has produced specific guidance on how best to provide support and treatment for young people under 24 in these vulnerable groups, drawing heavily on young people’s own views.

“You have triple stigma if you are young, a sex worker and transgender,” said a young person in Asia. This was one of many comments gathered during a range of community consultations by WHO partner organizations* to learn about the barriers such young people face in accessing health services.

“In many countries, these young key populations are not even spoken about, much less provided for. But changes that happen in adolescence can add complications to already complicated lives,” says Alice Armstrong of WHO’s HIV Department, who coordinated this work. The consultations examined the experiences across the world of young men who have sex with men (MSM), young people who sell sex, those who inject drugs and those who are transgender.

The findings helped to shape WHO’s “Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations,” as well as a series of discussion briefs developed with other UN agencies and community organization partners on how to provide services, programmes and support for these key groups.

Expelled, ashamed, abused

More than 5 million people overall aged 10 to 24 are living with HIV. Those aged 15 to 24 years were estimated in 2012 to account for 39% of all new infections worldwide in people over 15 years of age.

There is a dearth of reliable health data about young people but it is recognised that discrimination and stigma, violence and alienation from families and friends are factors that can lead them, willingly or not, to engage in behaviours, such as unprotected sex and the sharing of needles and syringes, that put them at risk of HIV and hepatitis B and C infections.

“I was expelled from school and abandoned by my own family when they found out I was taking some [non-injecting] drugs. So I thought, why not go all the way,” said a young Indonesian.

“Clients are too ashamed to purchase a condom and we are too scared to buy a condom,” a young male sex worker in Pakistan said.

Police respond with abuse when you try to report abuse by clients, a young sex worker in Kenya recounted, “telling us [we should instead] be selling potatoes in the market”.

Listen and learn

Legal barriers, such as age of consent to accessing health services, can also pose huge problems.

“It’s not helpful to tell a young person go away, we can’t give you a condom now, come back when you are 18,” says Dr Rachel Baggaley of WHO’s HIV Department. “For young men who have sex with men, for example, this is a period when they are often really at risk of HIV. If we can support them through this time to develop the knowledge and skills to protect themselves from HIV this could have an important impact.”

“We hope that these new guidelines and discussion briefings will serve as an exchange of information for groups working in all these areas, stimulate discussion and raise awareness of how these young people need more attention, in particular from health services,” says Ms Armstrong.

That includes listening to what young people themselves say. “Young people don’t want to be lectured at, yet we doctors love telling people what to do,” adds Dr Baggaley. “One group during the survey consultations drew a picture of their ideal health worker. It had huge ears – and a tiny mouth.”


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* Partners included: United Nations Populations Fund, Youth Voices Count, HIV Young Leaders Fund and Youth Research Information Support Education (YouthRISE), Youth LEAD

Measles: know the risks, check your status, protect yourself

22 Apr, 2014

reference : http://www.who.int/features/factfiles/measles/en/

Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.

It remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 122 000 people died from measles in 2012 – mostly children under the age of five.

This fact file on measles has been created for World Immunization Week (24-30 April). This year the slogan for the week is “Immunize for a healthy future: Know, Check, Protect”.

Facts about measles vaccination (HTML)

World Malaria Day 2014: WHO helps countries assess feasibility of eliminating malaria

24 Apr, 2014

reference : http://www.who.int/mediacentre/news/notes/2014/world-malaria-day/en/

 On World Malaria Day (25 April), WHO is launching a manual to help countries to assess the technical, operational and financial feasibility of moving towards malaria elimination.

WHO’s new guide, “From malaria control to malaria elimination: a manual for elimination scenario planning”, will provide these countries with a comprehensive framework to assess different scenarios and timelines for moving towards elimination, depending on programme coverage and funding availability.

“Increased political commitment and the expansion of global malaria investments have saved some 3.3 million lives since 2000,” says Dr Margaret Chan, Director-General at WHO. ”Countries where malaria remains endemic now want to build on this success.”

Since 2000, there has been a 42% reduction in malaria mortality rates globally, and a 49% decline in the WHO African Region. This progress has led some malaria-endemic countries, even those with historically high burdens of malaria, to start exploring the possibility of elimination.

But although many countries have the political will to commit to elimination, technical, operational and financial obstacles remain, particularly in countries that have a high disease burden.

From control to elimination

The WHO manual will help countries assess what resources they need to reduce malaria transmission to very low levels, i.e. the point at which focused elimination programmes can start in earnest. It will also help them consider appropriate timelines and provide them with essential knowledge for long-term strategic planning for malaria programmes.

“This long-term view on malaria is critical: it is vital to plan for the period after elimination,” says Dr John Reeder, Director of WHO’s Global Malaria Programme. “If interventions are eased or abandoned, malaria transmission can re-establish relatively quickly in areas that are prone to the disease, leading to a resurgence in infections and deaths.”

Countries nearing elimination

Having reduced malaria transmission to very low levels and re-oriented their malaria programme activities, 19 countries are currently classified by WHO as being in the “pre-elimination or elimination phase”. Seven more countries have reduced transmission to zero and are in the “prevention of re-introduction phase”.

In recent years, the WHO Director-General has certified four countries malaria-free: the United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010) and Armenia (2011).

World Malaria Day 2014

World Malaria Day was instituted by WHO Member States during the 2007 World Health Assembly. It is an occasion to highlight the need for continued investment and sustained political commitment for malaria control and elimination. The theme for the 2013-2015 campaign is: “Invest in the future. Defeat malaria.”

There were an estimated 207 million cases of malaria in 2012, causing over 600 000 deaths. Malaria transmission occurs in 97 countries and territories around the world, inflicting the heaviest toll on countries of sub-Saharan Africa.

For more information please contact:

Mr Tarik Jasarevic
WHO, Geneva
Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 79367 6214 
E-mail: jasarevict@who.int

7 million premature deaths annually linked to air pollution

25 March, 2014

reference : http://www.who.int/mediacentre/news/releases/2014/air-pollution/en/

In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.

New estimates

In particular, the new data reveal a stronger link between both indoor and outdoor air pollution exposure and cardiovascular diseases, such as strokes and ischaemic heart disease, as well as between air pollution and cancer. This is in addition to air pollution’s role in the development of respiratory diseases, including acute respiratory infections and chronic obstructive pulmonary diseases.

The new estimates are not only based on more knowledge about the diseases caused by air pollution, but also upon better assessment of human exposure to air pollutants through the use of improved measurements and technology. This has enabled scientists to make a more detailed analysis of health risks from a wider demographic spread that now includes rural as well as urban areas.

Regionally, low- and middle-income countries in the WHO South-East Asia and Western Pacific Regions had the largest air pollution-related burden in 2012, with a total of 3.3 million deaths linked to indoor air pollution and 2.6 million deaths related to outdoor air pollution.

“Cleaning up the air we breathe prevents non-communicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly…”

Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health

“Cleaning up the air we breathe prevents noncommunicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly,” says Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health. “Poor women and children pay a heavy price from indoor air pollution since they spend more time at home breathing in smoke and soot from leaky coal and wood cook stoves.”

Included in the assessment is a breakdown of deaths attributed to specific diseases, underlining that the vast majority of air pollution deaths are due to cardiovascular diseases as follows:

Outdoor air pollution-caused deaths – breakdown by disease:

  • 40% – ischaemic heart disease;
  • 40% – stroke;
  • 11% – chronic obstructive pulmonary disease (COPD);
  • 6% – lung cancer; and
  • 3% – acute lower respiratory infections in children.

Indoor air pollution-caused deaths – breakdown by disease:

 

  • 34% – stroke;
  • 26% – ischaemic heart disease;
  • 22% – COPD;
  • 12% – acute lower respiratory infections in children; and
  • 6% – lung cancer.

The new estimates are based on the latest WHO mortality data from 2012 as well as evidence of health risks from air pollution exposures. Estimates of people’s exposure to outdoor air pollution in different parts of the world were formulated through a new global data mapping. This incorporated satellite data, ground-level monitoring measurements and data on pollution emissions from key sources, as well as modelling of how pollution drifts in the air.

Risks factors are greater than expected

“The risks from air pollution are now far greater than previously thought or understood, particularly for heart disease and strokes,” says Dr Maria Neira, Director of WHO’s Department for Public Health, Environmental and Social Determinants of Health. “Few risks have a greater impact on global health today than air pollution; the evidence signals the need for concerted action to clean up the air we all breathe.”

After analysing the risk factors and taking into account revisions in methodology, WHO estimates indoor air pollution was linked to 4.3 million deaths in 2012 in households cooking over coal, wood and biomass stoves. The new estimate is explained by better information about pollution exposures among the estimated 2.9 billion people living in homes using wood, coal or dung as their primary cooking fuel, as well as evidence about air pollution’s role in the development of cardiovascular and respiratory diseases, and cancers.

In the case of outdoor air pollution, WHO estimates there were 3.7 million deaths in 2012 from urban and rural sources worldwide.

Many people are exposed to both indoor and outdoor air pollution. Due to this overlap, mortality attributed to the two sources cannot simply be added together, hence the total estimate of around 7 million deaths in 2012.

“Excessive air pollution is often a by-product of unsustainable policies in sectors such as transport, energy, waste management and industry. In most cases, healthier strategies will also be more economical in the long term due to health-care cost savings as well as climate gains,” says Dr Carlos Dora, WHO Coordinator for Public Health, Environmental and Social Determinants of Health. “WHO and health sectors have a unique role in translating scientific evidence on air pollution into policies that can deliver impact and improvements that will save lives.”

 

The release of today’s data is a significant step in advancing a WHO roadmap for preventing diseases related to air pollution. This involves the development of a WHO-hosted global platform on air quality and health to generate better data on air pollution-related diseases and strengthened support to countries and cities through guidance, information and evidence about health gains from key interventions.

Later this year, WHO will release indoor air quality guidelines on household fuel combustion, as well as country data on outdoor and indoor air pollution exposures and related mortality, plus an update of air quality measurements in 1600 cities from all regions of the world.

Down to zero: Nigeria stops guinea-worm disease in its tracks

31 March, 2014

reference : http://www.who.int/features/2014/nigeria-stops-guinea-worm/en/

From more than 650 000 cases in 1988 to zero today, Nigeria has successfully stopped transmission of guinea-worm disease, also known as dracunculiasis. Thousands of volunteer polio vaccinators helped to check every household nationwide to ensure that there were no remaining cases before the country could be certified free of guinea-worm disease in December 2013.

Members of the international certification team speak to health workers in Ebonyi, Nigeria

WHO/G Biswas

“When my elder brother Moses had guinea worm, I was not surprised because he used to pilfer fish from our mother’s pot and small yams from our father’s barn,” says Samuel Alo, today a community leader of Ejine Amagu, Ikwo Community in Ebonyi State, in south-east Nigeria. As a child in primary school, Samuel was told that guinea worm was a punishment for naughty children.

“Little did I know that the source of the worm was the pond from which we fetched water for drinking and cooking,” says Alo.

A crippling, parasitic disease

Guinea-worm disease (dracunculiasis) is almost exclusively found in poor, rural communities in low-income countries. It is a crippling, parasitic disease caused by a thread-like worm that grows up to 100cm long and migrates inside the body. Transmission occurs when people drink water contaminated with parasite-infected water fleas. Around one year after infection, one or more worms emerge from the skin through a painful blister, often on the leg. To soothe the excruciating pain, people often immerse the infected area in water. The worms then re-infect the water with thousands of larvae that are ingested by water fleas and the life cycle starts again.

There is no vaccine or treatment for this disease. The primary way to prevent guinea-worm infection is to provide a safe water supply, treat contaminated water and educate people to change their behaviour.

In 1988, when Nigeria reported more than 650 000 cases of guinea-worm disease, the Government launched an eradication programme following a World Health Assembly Resolution that called for the disease’s global eradication. The country could only be certified guinea-worm free when no cases were detected for 3 years.

Polio vaccinators help search house-to-house

One of the cardinal strategies for guinea-worm eradication in Nigeria has been active case search – a surveillance programme that used thousands of village volunteers to conduct house-to-house search for disease. Polio vaccinators helped to support surveillance during this final stage of eradication. In every house they entered during each polio vaccination round, the volunteers were trained to ask about guinea-worm disease, using a pictorial to demonstrate signs of the disease.

A cash reward provided an incentive for members of the public to report cases

WHO/G.Biswas

The last person known to have had guinea-worm disease in Nigeria was Grace Otubo, a 58-year-old migrant farmer from the remote rural village of Ezza Nwukbor in eastern Nigeria.

“Twenty five years ago, Mrs Otubo would have been just one of more than 650 000 victims of guinea-worm disease,” says Dr Rui Gama Vaz, WHO Representative in Nigeria. “The fact that she can be specifically identified as the final victim of the disease in her country is due to this successful system of surveillance.”

Combined effort and continued vigilance

Eradication efforts from WHO and partners, including the Yakubo Gowon Centre, The Carter Center, the Government of Japan and UNICEF, have included improving safe water supply, education and disease awareness, supporting behaviour change and training health workers to recognize and report suspected cases of guinea-worm disease. A cash reward provided an incentive for members of the public to report cases too.

In December 2013, on the recommendation of the WHO certification commission, Director-General, Dr Margaret Chan declared Nigeria free of guinea-worm disease. Dr Chan highlights the successful integration of guinea-worm surveillance into the disease surveillance and polio immunization campaigns: “This is the kind of joined-up effort that makes the most effective use of our human and financial resources, and has a dramatic and measurable impact.”

Since neighbouring countries (Chad, Ethiopia, Mali and South Sudan) still have on-going transmission of guinea-worm disease, Nigeria continues to remain vigilant for cases that might cross the border. Eradicating the disease, which incapacitates infected people for 3 weeks on average, has made an enormous contribution to Nigeria’s social and economic advancement.

[WHO]Meningococcal disease: 2013 epidemic season in the African Meningitis Belt

Reference :

http://www.who.int/csr/don/2013_06_06_menin/en/

Jun, 6  2013 –

  From 1 January to 12 May 2013 (epidemiologic week 19), 9 249 suspected cases of meningitis, including 857 deaths,  with a case fatality ratio of 9.3 percent, have been reported from 18 of the 19 African countries under enhanced  surveillance1 for meningitis. The number of cases reported so far are the lowest recorded during the epidemic season in the last ten years2.

Outbreaks of the meningococcal disease have been confirmed in Guinea and South Sudan, where 404 suspected cases3 (38 deaths) and 196 suspected cases (13 deaths) have respectively been notified.

In Guinea a small outbreak at the sub-district level was reported in Siguiri district, predominantly due to Neisseria meningitidis serogroup W135 (Nm W135). Upon request from the Ministry of Health of Guinea, the International Coordinating Group (ICG)4 on Vaccine Provision for Epidemic Meningitis Control released 63 075 doses of ACW polysaccharide vaccines. A reactive vaccination campaign targeting the affected population was conducted by the Ministry of Health from 2-7 May 2013.

In South Sudan an outbreak of Neisseria meningitidis serogroup A (Nm A) was confirmed in Malakal county, in the Upper Nile state.  The ICG  released 198 770 doses of Meningococcal A conjugate vaccine to implement a reactive vaccination campaign from 15-24 May 2013, which was led by the Ministry of Health of South Sudan with the support of WHO and partners. 

Additionally, outbreaks of  meningitis  were reported in Benin (1 district),  Burkina Faso (1 district), and Nigeria (3 districts). These outbreaks were of short duration and the predominance of the Nm bacteria was not confirmed. The ministries of health of affected areas implemented a series of preventive and control measures which include reinforcement of surveillance, case management and sensitization of the population.

The decrease in the number of cases of meningitis reported during the period under review is thought to be due to the progressive introduction of the newly developed Meningococcal A conjugate vaccine in countries of the African Meningitis Belt since 20105. The introduction of this first meningococcal vaccine available for preventive purposes in Africa has enabled the immunization of over 100 million people from 10 countries6  in the Meningitis Belt in the past three years (2010-2012). The reduced case load and epidemic activity observed this year, adds to the evidence on the impact of the introduction of this vaccine, which is expected to eliminate epidemics of Nm A, which is the predominant cause of the disease in Africa.   Given that large-scale epidemics in the African Meningitis Belt appear to occur in waves of 4 to 10 years, close surveillance for meningitis remains essential. 

Meningitis outbreaks are detected as part of the enhanced meningitis surveillance system introduced in 2002, whereby participating countries collect and send weekly, district level data to the WHO African Regional Office Inter-Country support team of Ouagadougou, which compiles and disseminates this data through a weekly regional bulletin. This allows for timely detection of outbreaks at district level, as well as monitoring of the situation at a regional level, enabling the identification of cross border, multi-country epidemics and a coordinated response.

WHO continues to monitor the epidemiological situation closely, in collaboration with partners and ministries of health in the affected countries.


1 The countries with enhanced surveillance for meningococcal disease include Benin, Burkina Faso, Cameroon, the Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, the Gambia, Ghana, Guinea, Mali, Mauritania, Niger, Nigeria, Senegal, South Sudan, Sudan and Togo. For 2013, no reports were available for Ethiopia. For Central African Republic reports were available up to epidemiologic weeks 10 and for Ghana and Guinea up to epidemiologic week 18.

2 WHO Weekly Epidemiological Record, 22 March 2013

3 Data up to epidemiologic week 18.

4 The ICG is a partnership between WHO, International Federation of Red Cross and Red Crescent Societies (IFRC), United Nations Children Fund (UNICEF), and Médecins Sans Frontières (MSF ) which manages an emergency vaccine stockpile, established with the support of the Global Alliance for Vaccines and Immunization (GAVI).

5 The new vaccine MenAfriVac® is manufactured by Serum Institute of India Ltd. and was developed for the meningitis belt through the Meningitis Vaccine Project, a partnership between WHO and PATH, funded by the Bill & Melinda Gates Foundation.

6 Burkina Faso (2010), Mali (2010–2011), Niger (2010–2011), Cameroon (2011–2012), Chad (2011–2012), Nigeria (2011- ), Ghana (2012), Benin (2012), Senegal (2012), Sudan (2012– ). Campaigns’ beginning and end years are indicated in parentheses; a single date indicates that the campaign was conducted during 1 year, an open date indicates the campaigns have not yet ended. Guinea and South Sudan preventive campaigns are planned for 2014.

 

[PSS]Dengue Alert

Reference :

http://www.pss.org.sg/whats-happening/pharmacy-news/dengue-alert

Jun ,17 2013

 

Dengue Alert

Dengue is a mosquito-borne disease caused by viruses. Infected person may present with high fever, headache, joint pain and rashes. In severe cases, the person may need hospitalization. 

National Environment Agency (NEA) updates the number of dengue cases in Singapore frequently.  As of 10May 2013, there are a total of 6396 dengue cases in this year alone.

[Click link to get most updated dengue number of cases]

Dengue

Dengue is a mosquito-borne disease caused by any one of  four closely related dengue viruses (DENV-1,-2, -3, -4).  These four type of dengue viruses are circulating around the globe.  A person infected with dengue fever can be infected as many as four times because infection with any type of DENV provides immunity to that particular type of virus for life, but confers only partial and transient protection against subsequent infection by the other three.

Transmission of Dengue Virus

Dengue viruses are transmitted between people by mosquitoes (Aedes aegypti and Aedes albopictus).  Dengue does not spread from person to person.  In order for transmission to occur the mosquito must feed on a person during the first 5-days (after being infected by dengue virus) when large of amount of viruses are in the blood.

Potential breeding sites of Aedes mosquitoes include flower pot plates/trays, toilet bowls, hardened soil in plants and domestic containers.

Signs and symptoms

  • High fever
  • Severe headache
  • Severe pain behind the eyes
  • Joint pain
  • Muscle and bone pain
  • Rash
  • Mild bleeding (e.g nose and gums bleed, easy bruising)

Symptoms of dengue are usually self-limiting and will clear within two weeks with plenty of rest, drinking lots of fluids and also taking medication to reduce pain and fever. However, with more severe symptoms, patients may need hospitalization and also fluids and electrolyte replacement. 

What you can do to stop dengue? Let’s fight dengue together!

For dengue, prevention is the most important step because there is no vaccine available against it. Prevention of dengue means avoiding mosquito bites and also preventing the breeding of its vector, the Aedes mosquito. Prevention of dengue can be divided into  measures to prevent mosquito breeding/ feeding anduse of mosquito repellents.

Measures to prevent mosquito breeding/ feeding Before we can eliminate dengue, we must first learn to identify the potential breeding sites of Aedes Mosquito. Aedes mosquito likes to lay its eggs in stagnant water making areas around our home. Examples of some mosquito breeding sites in our homes are flower pots, flower vases, roof gutter, drain, collar of toilet bowl and air conditioner tray.

After learning about Aedes mosquitoes breeding sites, in order to curb dengue, there are many things we can do.

  1. We must always turn over or cover any water storage containers (empty barrels, unused flower pots, bamboo poles container) when not in use.
  2. Change vase or flower pots water on alternate days. Clean and scrub the plate thoroughly to remove any mosquito eggs. Wash roots of flowers in vase thoroughly as mosquito eggs can stick on them easily.
  3. Clear any drain blockages and fallen leaves that can collect water.
  4. Loosen soil from potted plants to prevent stagnant water from forming.
  5. Spray insecticides in dark corners like behind curtains, under sofas/ bed and also in roof gutters.
  6. Avoid going out during early morning before day break and late afternoon after dark because this is the time mosquitoes are most active.
  1. Make sure windows and door screens are secured properly and without holes.
  2. Use air conditioner when possible.
  3. Sleep under a mosquito bed net.
  4. Wear long-sleeved shirt and long pants.
  5. Be co-operative when there is any government body who wants to inspect your house or when they come for fogging.

Use of mosquito repellents

Using the right insect repellent is important for ensuring protection against Aedes mosquitoes. There are many types of insect repellents that are available in Singapore and they also come in many forms like patches, sprays, wipes, lotions, bands and also candles. The usual ingredients in mosquito repellents are DEET (N.N Diethyl-meta-toluamide), Icaridin/Picaridin, Ethyl Butylacetylamino-propionate and Citronella.

Points to note when selecting a mosquito repellent are:

  • Length of time you need protection and
  • Also the active ingredients and its percentage.

Centres for Disease Control (America) believe that DEET and Picaridin provide longer lasting protection than other repellents. The length of protection correlates with the concentration of the active ingredients meaning the more concentrated the active ingredient a product contains, the longer it provides protection from mosquitoes. However, actual protection varies widely and maybe affected by factors such as temperature, perspiration, water exposure and abrasive removal. DEET is the most common ingredient in repellent products but should not be used in infants less than 2 months old. DEET is the usual choice for adults and for small children; parents can also opt for a safer alternative like Citronella.

Precautions to take when using repellent:

  • Always follow the recommendations/ instructions on product labels.
  • Apply repellent when you are going to be outdoors. Reapply when necessary.
  • Use sufficient repellent to cover only exposed skin or clothings. Spread evenly to all exposed areas. Do not use repellents under clothing. If repellent is applied to clothings, wash treated clothings before wearing again.
  • Do not apply repellent to cuts, wounds or irritated skin. If skin rash or irritation occurs, discontinue use and wash the area quickly with water and soap. Consult a doctor if necessary.
  • Do not put repellent directly on your face. Put on palm first and then apply on face. Avoid eyes and mouth.
  • After returning indoors, wash skin thoroughly with water and soap.
  • Do not let children handle the product and help them to apply. Avoid applying on their palm to prevent accidental ingestion of the repellent.

References and for further updates on dengue, you may wish to access the following sites:

[Uganda]Global Alert and Response (GAR)-Ebola in Uganda – update

Global Alert and Response (GAR)

Ebola in Uganda – update

30 NOVEMBER 2012 – As of 28 November 2012, the Ministry of Health in Uganda reported 7 cases (6 confirmed, 1 probable) with Ebola haemorrhagic fever in Luweero and Kampala districts. Of these cases, 4 died.

Field teams continue to investigate cases alerted to them from the communities. The major challenge faced in some communities is the belief that witch-craft and not Ebola was the cause of deaths, despite ongoing intensive awareness campaigns. Social mobilization teams are working closely with traditional healers and religious leaders to raise awareness on prevention and control of the disease.

WHO and partners, including the US Centers for Disease Control and Prevention (CDC), Médecins Sans Frontières (MSF), the Uganda Red Cross (URCS), African Field Epidemiology Network (AFENET) and Plan Uganda continue to support the national authorities in the response to the outbreak. Through WHO, an expert on infection prevention and control has been deployed to the field.

With respect to this event, WHO does not recommend that any travel or trade restriction be applied to Uganda.

Note: The total number of cases reported on 23 November2012 was 10 (6 confirmed, 4 probable) Probable cases that tested negative for Ebola have been classified as Non-Cases and excluded from the case counts.

[Sudan]Global Alert and Response (GAR)-Yellow fever in Sudan – update

Global Alert and Response (GAR) 

Yellow fever in Sudan – update

6 DECEMBER 2012 – As of 4 December, a total of 732 suspected cases of yellow fever, including 165 deaths have been reported in 33 out of 64 localities in Darfur. Laboratory results have confirmed yellow fever by IgM ELISA test and PCR in 40 clinical samples. Tests were conducted at the National Public Health Laboratory in Khartoum, with support from the US Naval Medical Unit 3 (NAMRU-3), WHO Collaborating Center for Emerging Infectious Diseases.

Currently, the Federal Ministry of Health is organizing an emergency mass vaccination campaign against yellow fever. The first phase of the campaign began on 21 November 2012, to cover 2.2 million people, and the second phase of the campaign is planned for this month, to cover an additional 1.2 million at risk population.

The vaccination campaign is being supported by the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG1), GAVI Alliance, ECHO, Central Emergency Response Fund (CERF), Sudan Common Humanitarian Fund (CHF), and non-governmental organizations working where the campaign is being carried out.

A comprehensive assessment of the outbreak is ongoing, to obtain additional epidemiological, laboratory and entomological information to understand the evolution of the outbreak and the risk of the epidemic.

WHO has activated the Global Outbreak Alert and Response Network (GOARN) and is deploying additional experts including an entomologist, virologists and an epidemiologist to support the ongoing response in the country.


1 The YF-ICG is a partnership that manages the stockpile of yellow fever vaccines for emergency response on the basis of a rotation fund. It is represented by United Nations Children’s Fund (UNICEF), Médecins Sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO, which also serves as the Secretariat. The stockpile was created by GAVI Alliance.

[Saudi Arabia]Global Alert and Response (GAR)-Novel coronavirus infection – update

Global Alert and Response (GAR)

Novel coronavirus infection – update

30 NOVEMBER 2012 – In addition to the fatal case of novel coronavirus in Saudi Arabia reported to WHO on 28 November, two fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to nine.

The latest confirmed case from Saudi Arabia occurred in October 2012 and is from the family cluster of the two cases confirmed earlier.

The two cases from Jordan occurred in April 2012. At that time, a number of severe pneumonia cases occurred in the country and the Ministry of Health (MOH) Jordan promptly requested a WHO Collaborating Centre for Emerging and Re-emerging Infectious Diseases (NAMRU – 3) team to immediately assist in the laboratory investigation. The NAMRU-3 team went to Jordan and tested samples from this cluster of cases.

On 24 April 2012 the NAMRU-3 team informed the MOH that all samples had tested negative for known coronaviruses and other respiratory viruses. As the novel coronavirus had not yet been discovered, no specific tests for it were available.

In October 2012, after the discovery of the novel coronavirus, stored samples were sent by MOH Jordan to NAMRU-3. In November 2012 NAMRU-3 provided laboratory results that confirmed two cases of infection with the novel coronavirus.

The MOH Jordan has requested WHO assistance in investigating these infections. A mission from WHO Eastern Mediterranean Regional Office (EMRO) and headquarters arrived in Amman on 28 November 2012 to assist in further epidemiological surveillance and to strengthen the sentinel surveillance systems for severe acute respiratory infections (SARIs).

In summary, to date a total of nine laboratory-confirmed cases of infection with the novel coronavirus have been reported to WHO – five cases (including 3 deaths) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.