Cholera – Republic of the Sudan

On 8 September, Sudan’s Federal Ministry of Health (FMoH) notified WHO about a cholera outbreak in four localities in the Blue Nile State (BNS), south-eastern Sudan, bordering Ethiopia and South Sudan. The first case was detected on 28 of August 2019.

From 28 August through 8 October 2019, a total of 247 suspected cholera cases, including 8 deaths (case fatality ratio: 3.5 %), have been reported from four localities in Blue Nile State including Al Roseries (99), Ad Damazin (52), Wad Almahi (3) and Baw (2), and five localities in Sennar State including Abu Hugar (71), Singa (4), Alsoky (13), Aldaly wa Almzmom (2) and Sennar (1) . One hundred fifty cases were female (61%), and 238 (94.4%) were over 5 years of age.

Medical Product Alert N° 10/2019 (English version)

This Medical Product Alert relates to four confirmed falsified products: quinine sulphate circulating in Central African Republic and Chad and quinine bisulphate circulating in Uganda. It should be noted that this is the second WHO Medical Product Alert issued on the same batch number of falsified quinine bisulphate circulating in the African region. Please refer to the previous WHO Medical Product Alert N°2/2017 issued 27 July 2017. Quinine bisulphate and quinine sulphate are listed on the WHO Model List of Essential Medicines for management of severe malaria. This alert compiles details of four different falsified products that have been discovered at different times and locations over the past year. This repeated occurrence highlights the need for additional vigilance in Central and East Africa for such products that display common characteristics and distribution patterns.

WHO was informed by a non-governmental organization (NGO) that this falsified quinine sulphate was found at patient level in the Central African Republic. At this stage, testing has not yet been conducted. Product details are listed in Table 1 below.

Polio outbreak– The Philippines

On 19 September 2019, the Philippines declared an outbreak of polio. Two cases have been reported to date, both caused by vaccine-derived poliovirus type 2 (VDPV2). Environmental samples taken from sewage in Manila on 13 August and a waterway in Davao on 22 August have also tested positive for VDPV2.

The first case was confirmed on 14 September following testing by the National Polio Laboratory at the Research Institute for Tropical Medicine, the Japan National Institute of Infectious Diseases (NIID) and the United States Centers for Disease Control and Prevention (CDC). The case-patient is a 3-year-old girl from Lanao del Sur in the southern Philippines. The virus isolated is genetically linked to VDPV2 previously isolated from environmental samples in Manila and Davao. This indicates that the virus is circulating.

Cases of Undiagnosed Febrile Illness – United Republic of Tanzania

The following is a description of the current situation in the United Republic of Tanzania regarding unofficial reports of a number of cases of illness and a summary of WHO efforts to obtain information about this situation.

As specified in Article 9 of the International Health Regulations (IHR), WHO may take into account reports from sources other than notifications from Member States and shall assess these reports according to established epidemiological principles under the IHR.

Listeriosis– Spain

On 16 August 2019, Regional Health Authorities in Andalusia, Spain, reported an outbreak of listeriosis, caused by the bacteria Listeria monocytogenes (L. monocytogenes), associated with the consumption of a chilled roasted pork meat product manufactured in Spain by Magrudis Company Limited and sold under the brand name “La Mechá”. This outbreak was reported by Spanish Authorities to the World Health Organization, via the International Food Safety Authorities Network (INFOSAN), on 20 August 2019. On 23 August, a Food Safety Alert was issued by the Spanish Authorities, advising consumers to avoid any product sold under that brand and that a small amount of the implicated chilled roasted pork was also sold non-branded by another company.

From 7 July through 13 September , a total of 222 confirmed cases linked to this outbreak have been reported in five regions of Spain: Andalusia (214), Aragon (4), Extremadura (2), Castilla y Leon (1), and Madrid (1). Fifty-seven per cent of cases are women including 38 pregnant women and 24% of cases are 65 years old or above (24 men and 25 women). Three deaths have been reported among elderly persons who were ill with listeriosis at the time of death. Reportedly, six women had miscarriages linked to this outbreak. On 23 August 2019, France, through the European Commission Early Warning and Response System (EWRS), notified a travel related case in a foreign citizen with travel history to Andalusia who had consumed the implicated product. Only three cases of listeriosis have been recorded with a date of consumption after 17 August, but all the three bought the product before the food alert was launched.