General Context
There is maximum alert and global mobilization in all the member states of the WHO African region following the swine flu epidemic in Mexico and some other countries. There are no official reports of the disease from any of the AFRO countries so far. Other major concerns are the ongoing outbreaks of diseases notably meningitis in the meningitis belt.
Countries Situations
Acute crises
Angola: Floods have subsided but the aftermaths continue to hit the affected areas. According to the local authorities in Cunene, the situation is under control. WHO has been granted CERF funds to support in the mitigation of these aftermaths. From January to April 19th 563 cholera cases and 2 deaths were reported (CFR: 0.4%).
CAR: Security concerns have continued, particularly in the north. Clashes have been reported on the 18th of April in Kabo (North) between the elements of FACA (National Army) and the FDPC (rebels) spilling refugees into Chad. Health consequences are so far unknown since humanitarian flights to these areas have suspended.
Chad: The security situation is still unpredictable. Many security incidents are still being reported in the East. The numbers of central African refugees continue to rise, with 17,379 registered by the UNHCR as of April 22nd in six sites in Salamat region. Their health condition is good but there are some concerns because of the withdrawal of MSF before the rainy season that is expected soon. Meningitis outbreak: From 1st January to 19th April 2009, a total of 1,072 cases with 121 deaths (CFR: 11.3%) were reported.
DRC: Ongoing civilian attacks by FDLR rebels in North Kivu. The MONUC continues its logistic support to the FARDC (National Army) fighting the FDLR rebels. Cholera outbreak still ongoing, in Katanga, 57 new cases 1 death in week 16 with a cumulative 1,534 cases and 40 deaths (CFR: 2.6%) from week 1 to week 16. In South Kivu, 62 new cases 2 deaths in week 16 making a cumulative 2,622 cases with 22 deaths (CFR: 0.8%) from week 1 to week 16.
Ethiopia: Food security in parts of the country is threatened by a delayed start of the rains which if remains poor, will result in a second consecutive below-average harvest. According to official reports from the Federal MoH, 472 cases of AWD and 17 deaths (CFR 3.6%) have been reported from Somali, Oromiya and SNNP Regions from 9th March to 19th April 2009. Two new cases of meningitis have been reported from Medebay zana and Tahetaye koraro woredas this week. As of 23rd March, 8 cases and 0 death of meningitis have been reported from Tigray region.
Kenya: There is an increase in crime within the Nairobi metropolitan. The drought and its effects are deteriorating in most parts of northern Kenya. Malnutrition rates continue to rise and there is shortage of water for animals and domestic use. A total of 2,612 cholera cases have been reported so far with 58 deaths (CFR 2.2%) across twenty districts.
Madagascar: Political violence continues in the capital city. The final death toll of the tropical storm Jade stands at 15 deaths with 10 people injured and a total of 60,818 people affected. The authorities fear outbreaks of water borne disease following the floods that occurred. According to the humanitarian community, the country was already facing an extremely worrisome drought in the south, to which has been added the effects of cyclones and tropical storms all aggravating the food insecurity situation.
Niger: Meningitis outbreak is still of high concern. There was a slight decrease in the number of cases in week 16 compare to week 15. In week 16, a total of 1,036 cases with 39 deaths were reported. The total number of cases is now 11,085 with 442 deaths (CFR of 4%) since January 1st, 2009. WHO and health partners (UNICEF, MSF-B, MSF-E, MSF-S) are supporting mass vaccination campaign in 22 districts.
Zimbabwe: Cholera: the epidemic has started to stabilize and decline since week12. The bulk (83%) of cases reported from three provinces (Mashonaland West, Harare and Manicaland). Harare and Mashonaland West account for 67% of the cases. A total of 97,185 cases and 4,244 deaths (CFR: 4.4%) have been reported as of 25th April 2009.
Countries Under Surveillance
Burkina Faso: Meningitis, from week 1 to 16 in 2009, a total of 3,390 suspect cases with 438 deaths (CFR: 12.92%) have been reported. Three districts (Kongoussi, Barsalhogo and Seguenega) are in alert while one district (Titao) is in the epidemic. Vaccination campaign in 3 districts and 521,724 doses of vaccines were dispensed.
Burundi: The situation of Rain-induced floods seems under control and awaiting the complete return of normalcy. Assistance has been provided by humanitarian partners.
Congo: We are monitoring the situation ahead of the July presidential election.
Guinea: The political atmosphere has become a bit tense. In week 16, four new suspected meningitis cases with 0 death were reported bringing the total to 92 with 8 deaths (CFR: 8.6%) since week 1. Five new suspected of yellow fever cases with 0 death were reported. The total cases since week 1 are 41 with 0 death.
Liberia: Outbreak of yellow fever from Lofa County. Preparation of a yellow fever vaccination campaign in the affected districts with technical support from WHO.
Mozambique: Cholera outbreak, the number of cases is decreasing since week 9. From January 1st to April 18th 2009, a total of 16,424 cases and 133 deaths (CFR: 0.8%) were reported.
Namibia: Threat of cholera outbreak after floods that affected about 220,000 people. WHO is monitoring the situation and some NGOs are helping to prevent an outbreak.
Nigeria: Meningitis outbreak (No new update), 39,841 cases have been reported from week 1 to week15 of 2009, with 1,886 deaths (CFR: 4.7%). 59 districts in 8 states are in epidemic and 18 districts are in alert.
Uganda: In Karamoja sub-region incidences of cattle raid are still reported. The pursuit of the LRA rebels in DRC continues. Hepatitis E: Kitgum district, the epicenter of the epidemic registered 43 new cases in week 16.
Zambia: Floods continue in the west and northwest affecting 700,000 people.
For more information please contact: Dr Omar Khatib, Programme Manager, EHA/AFRO email: khatibo@afro.who.int
MAP: Africa: Weekly Emergency Situation Update (as of 27 Apr 2009)
