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WHO: Ebola outbreak in Congo is stabilizing

WHO

 


WHO: List of Blueprint priority diseases (i.e. diseases and pathogens to prioritize for research and development in public health emergency contexts)

WHO

2018 annual review of the Blueprint list of priority diseases

For the purposes of the R&D Blueprint, WHO has developed a special tool for determining which diseases and pathogens to prioritize for research and development in public health emergency contexts. This tool seeks to identify those diseases that pose a public health risk because of their epidemic potential and for which there are no, or insufficient, countermeasures. The diseases identified through this process are the focus of the work of R& D Blueprint. This is not an exhaustive list, nor does it indicate the most likely causes of the next epidemic.

The first list of prioritized diseases was released in December 2015.

Using a published prioritization methodology, the list was first reviewed in January 2017.

February 2018 – Second annual review

The second annual review occurred 6-7 February, 2018. Experts consider that given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated research and development for*:

  • Crimean-Congo haemorrhagic fever (CCHF)
  • Ebola virus disease and Marburg virus disease
  • Lassa fever
  • Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
  • Nipah and henipaviral diseases
  • Rift Valley fever (RVF)
  • Zika
  • Disease X

Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible.

A number of additional diseases were discussed and considered for inclusion in the priority list, including: Arenaviral hemorrhagic fevers other than Lassa Fever; Chikungunya; highly pathogenic coronaviral diseases other than MERS and SARS; emergent non-polio enteroviruses (including EV71, D68); and Severe Fever with Thrombocytopenia Syndrome (SFTS).

These diseases pose major public health risks and further research and development is needed, including surveillance and diagnostics. They should be watched carefully and considered again at the next annual review. Efforts in the interim to understand and mitigate them are encouraged.

Although not included on the list of diseases to be considered at the meeting, monkeypox and leptospirosis were discussed and experts stressed the risks they pose to public health. There was agreement on the need for: rapid evaluation of available potential countermeasures; the establishment of more comprehensive surveillance and diagnostics; and accelerated research and development and public health action.

Several diseases were determined to be outside of the current scope of the Blueprint: dengue, yellow fever, HIV/AIDs, tuberculosis, malaria, influenza causing severe human disease, smallpox, cholera, leishmaniasis, West Nile Virus and plague. These diseases continue to pose major public health problems and further research and development is needed through existing major disease control initiatives, extensive R&D pipelines, existing funding streams, or established regulatory pathways for improved interventions. In particular, experts recognized the need for improved diagnostics and vaccines for pneumonic plague and additional support for more effective therapeutics against leishmaniasis.

The experts also noted that:

  • For many of the diseases discussed, as well as many other diseases with the potential to cause a public health emergency, there is a need for better diagnostics.
  • Existing drugs and vaccines need further improvement for several of the diseases considered but not included in the priority list.
  • Any type of pathogen could be prioritised under the Blueprint, not only viruses.
  • Necessary research includes basic/fundamental and characterization research as well as epidemiological, entomological or multidisciplinary studies, or further elucidation of transmission routes, as well as social science research.
  • There is a need to assess the value, where possible, of developing countermeasures for multiple diseases or for families of pathogens.

The impact of environmental issues on diseases with the potential to cause public health emergencies was discussed. This may need to be considered as part of future reviews.

The importance of the diseases discussed was considered for special populations, such as refugees, internally displaced populations, and victims of disasters.

The value of a One Health approach was stressed, including a parallel prioritization processes for animal health. Such an effort would support research and development to prevent and control animal diseases minimising spill-over and enhancing food security. The possible utility of animal vaccines for preventing public health emergencies was also noted.

Also there are concerted efforts to address anti-microbial resistance through specific international initiatives. The possibility was not excluded that, in the future, a resistant pathogen might emerge and appropriately be prioritized.

 

*The order of diseases on this list does not denote any ranking of priority.

 


Statement on the 1st meeting of the IHR Emergency Committee regarding the Ebola outbreak in 2018

WHO

18 May 2018

Statement

The 1st meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the Ebola Virus Disease (EVD) outbreak in the Democratic Republic of the Congo took place on Friday 18 May 2018, from 11:00 to 14:00 Geneva time (CET).

Emergency Committee conclusion

It was the view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have not currently been met.

Meeting

Members and advisors of the Emergency Committee met by teleconference. Presentations were made by representatives of the Democratic Republic of the Congo on recent developments, including measures taken to implement rapid control strategies, and existing gaps and challenges in the outbreak response. During the informational session, the WHO Secretariat provided an update on and assessment of the Ebola outbreak.

The Committee’s role was to provide to the Director-General their views and perspectives on:

  • Whether the event constitutes a Public Health Emergency of International Concern (PHEIC)
  • If the event constitutes a PHEIC, what Temporary Recommendations should be made

Current situation

On 8 May, WHO was notified by the Ministry of Health of the Democratic Republic of the Congo of two lab-confirmed cases of Ebola Virus Disease occurring in Bikoro health zone, Equateur province. Cases have now also been found in nearby Iboko and Mbandaka. From 4 April to 17 May 2018, 45 EVD cases have been reported, including in three health care workers, and 25 deaths have been reported. Of these 45 cases, 14 have been confirmed. Most of these cases have been in the remote Bikoro health zone, although one confirmed case is in Mbandaka, a city of 1.2 million, which has implications for its spread.

Nine neighbouring countries, including Congo-Brazzaville and Central African Republic, have been advised that they are at high risk of spread and have been supported with equipment and personnel.

Key Challenges

After discussion and deliberation on the information provided, the Committee concluded these key challenges:

  • The Ebola outbreak in the Democratic Republic of the Congo has several characteristics that are of particular concern: the risk of more rapid spread given that Ebola has now spread to an urban area; that there are several outbreaks in remote and hard to reach areas; that health care staff have been infected, which may be a risk for further amplification.
  • The risk of international spread is particularly high since the city of Mbandaka is in proximity to the Congo river, which has significant regional traffic across porous borders.
  • There are huge logistical challenges given the poor infrastructure and remote location of most cases currently reported; these factors affect surveillance, case detection and confirmation, contact tracing, and access to vaccines and therapeutics.

However, the Committee also noted the following:

  • The response by the government of the Democratic Republic of the Congo, WHO and partners has been rapid and comprehensive.
  • Interventions underway provide strong reason to believe that the outbreak can be brought under control, including: enhanced surveillance, establishment of case management facilities, deployment of mobile laboratories, expanded engagement of community leaders, establishment of an airbridge, and other planned interventions.
  • In addition, the advanced preparations for use of the investigational vaccine provide further cause for optimism for control

In conclusion, the Emergency Committee, while noting that the conditions for a PHEIC are not currently met, issued Public Health Advice as follows:

  • Government of the Democratic Republic of the Congo, WHO, and partners remain engaged in a vigorous response – without this, the situation is likely to deteriorate significantly. This response should be supported by the entire international community.
  • Global solidarity among the scientific community is critical and international data should be shared freely and regularly.
  • It is particularly important there should be no international travel or trade restrictions.
  • Neighbouring countries should strengthen preparedness and surveillance.
  • During the response, safety and security of staff should be ensured, and protection of responders and national and international staff should prioritised.
  • Exit screening, including at airports and ports on the Congo river, is considered to be of great importance; however entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.
  • Robust risk communication (with real-time data), social mobilisation, and community engagement are needed for a well-coordinated response and so that those affected understand what protection measures are being recommended;
  • If the outbreak expands significantly, or if there is international spread,  the Emergency Committee will be reconvened.

The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of this advice.

Based on this advice, the reports made by the affected States Parties, and the currently available information, the Director-General accepted the Committee’s assessment and on 18 May 2018 did not declare the Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern (PHEIC). In light of the advice of the Emergency Committee, WHO advises against the application of any travel or trade restrictions. The Director-General thanked the Committee Members and Advisors for their advice.

 


Ebola, the Democratic Republic of the Congo (DRC), and The WHO

WHO

The World Health Organization (WHO) and a broad range of partners are in the Democratic Republic of the Congo (DRC) working with the Government to contain an outbreak of Ebola virus disease (EVD) in Bikoro health zone, Equateur Province. The outbreak was declared three days ago.  WHO Director-General Dr Tedros Adhanom Ghebreyesus will travel to the DRC over the week-end to take stock of the situation and direct the continuing response in support of the national health authorities.

As of 11 May, 34 Ebola cases have been reported in the area in the past five weeks, including 2 confirmed, 18 probable (deceased) and 14 suspected cases. Five samples were collected from 5 patients and two have been confirmed by the laboratory. Bikoro health zone is 250 km from Mbandaka, capital of Equateur Province in an area of the country that is very hard to reach.

“WHO staff were in the team that first identified the outbreak. I myself am on my way to the DRC to assess the needs first-hand,” said Dr Tedros. “I’m in contact with the Minister of Health and have assured him that we’re ready to do all that’s needed to stop the spread of Ebola quickly. We are working with our partners to send more staff, equipment and supplies to the area.”

A multidisciplinary team including WHO experts, along with staff from the Provincial Division of Health and Médecins Sans Frontières (MSF), arrived in Bikoro on 10 May. This first group of responders is now gathering more data to understand the extent and drivers of the epidemic. The team will also set up an active case search and contact tracing, establish Ebola treatment units to care for patients, set up mobile labs, and engage the community on safe practices. WHO will also work with national authorities in planning further public health measures such as vaccination campaigns.

“WHO is supporting the Government of the Democratic Republic of the Congo in coordinating this response; this is the country’s ninth Ebola outbreak and there is considerable expertise in-country,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “However, any country facing such a threat may require international assistance. WHO and its partners including MSF, World Food Programme (WFP), UNICEF, International Federation of Red Cross and Red Crescent Societies (IFRC) and the Congolese Red Cross, UNOCHA and MONUSCO , US Centers for Disease Control and Prevention (US-CDC), the International Organization for Migration (IOM), are all stepping up their support.”

The response plan to the outbreak includes surveillance, case investigation, and contact tracing; community engagement and social mobilization; case management and infection prevention and control; safe and dignified burials; research response including the use of ring vaccination and antivirals; and coordination and operations support.

“It is too early to judge the extent of this outbreak,” said Dr Peter Salama, WHO Deputy Director-General for Emergency Preparedness and Response. “However, early signs including the infection of 3 health workers, the geographical extent of the outbreak, the proximity to transport routes and population centres, and the number of suspected cases indicate that stopping this outbreak will be a serious challenge. This will be tough and it will be costly. We need to be prepared for all scenarios.”

In its latest Disease Outbreak News, WHO lists the risks to surrounding countries as moderate. WHO has however, already alerted those countries and is working with them on border surveillance and preparedness for potential outbreaks. WHO does not at this time advise any restrictions on travel and trade to the Democratic Republic of the Congo.

ENDS

Note to editors:

Current operations:

The first multidisciplinary team comprised of experts from WHO, Médecins Sans Frontières and the Provincial Division of Health arrived in Bikoro on 9 May to strengthen coordination and investigations. More deployments of epidemiologists, logisticians, clinicians, infection prevention and control experts, risk communications experts and vaccination support teams should arrive in Bikoro on Saturday.

WHO is working with Government and key partners – including Médecins Sans Frontières, World Food Programme, the International Federation of the Red Cross, UNICEF and US-CDC – to strengthen coordination of the EVD response at the national level and in the affected Bikoro health zone and is calling on its development partners to ensure a strong, comprehensive and rapid response to support the DRC Government to prevent and control the spreading of the disease.

Two mobile labs are planned to be deployed on 12 May.

Current bed capacity includes 15 beds in Bikoro. MSF is currently establishing isolation on site and has also deployed four mobile isolation units (5 beds each).

WHO is coordinating a major flight plan with UNHAS/WFP to deploy experts, equipment and materials to the field and is working closely with other health partners to prevent further geographical spread, improve surveillance data and reduce deaths by improving treatment of Ebola patients in Bikoro and the epicentre of Ikoko-Impenge.  The cost of the air bridge for 3 months is estimated at US$ 2.4 million.

A logistician is expected to arrive in Bikoro this afternoon/evening to arrange accommodation/staff logistics. Additional information on access, transportation, and logistics requirements will be communicated tomorrow.

WHO is in the process of sending (Saturday) medical supplies to Bikoro to support the Ebola response, including:

  • Personal Protective Equipment kits (PPE)
  • Interagency Emergency Health Kit (IEHK)
  • boxes for transportation
  • body bags

WHO is helping with surveillance of cases by setting up community-based data collection to complement information provided by health facilities.

WHO has alerted neighbouring countries and is supporting the Central African Republic and Republic of Congo to strengthen surveillance in case of cross-border spread of the outbreak.

Funding requirements

WHO released US$ 1 million from its Contingency Fund for Emergencies to kick start the rapid response. Based on current assessment and response needs the estimated budget for the international response is US$ 18 million for a 3-month operation. Wellcome Trust and UK Department for International Development (DFID) announced a commitment of up to £3 million to support a rapid response to the outbreak.


New anti-malarial netting: A long-lasting insecticidal net that incorporates a synergist piperonyl butoxide (PBO) and a long-lasting indoor residual spraying formulation of the insecticide pirimiphos-methyl.

NY Times

The Lancet

“……The PBO long-lasting insecticidal net and non-pyrethroid indoor residual spraying interventions showed improved control of malaria transmission compared with standard long-lasting insecticidal nets where pyrethroid resistance is prevalent……”

Health workers demonstrating the use of a LLIN in Kisumu, Kenya

“….The new nets contain pyrethroids, a class of chemicals used in nets for over a decade, along with the newer compound, piperonyl butoxide, which blocks mosquitoes’ ability to break down pyrethroids.….”

Net with Anopheles mosquito

 


Two million people in five African countries to be vaccinated against cholera

WHO

A spate of cholera outbreaks across Africa has prompted the largest cholera vaccination drive in history, with more than two million people across the continent set to receive oral cholera vaccine (OCV).

 

The vaccines, funded by Gavi, the Vaccine Alliance, were sourced from the global stockpile and are being used to carry out five major campaigns in Zambia, Uganda, Malawi, South Sudan and Nigeria. The campaigns, which will be completed by mid-June, are being implemented by the respective Ministries of Health supported by the World Health Organization (WHO) and partners of the Global Task Force on Cholera Control (GTFCC), and mostly in reaction to recent cholera outbreaks.

 

In the 15 years between 1997 and 2012 just 1.5 million doses of cholera vaccines were used worldwide. In 2017 alone almost 11 million were used, from Sierra Leone to Somalia to Bangladesh. In the first four months of 2018 over 15 million doses have already been approved for use worldwide.

 

“This is an unprecedented response to a spike in cholera outbreaks across Africa,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “We have worked hard to ensure there is now enough vaccine supply to keep the global stockpile topped up and ready for most eventualities. However with more and more people now succumbing to this terrible, preventable disease, the need for improved water and sanitation – the only long-term, sustainable solution to cholera outbreaks – has never been clearer.”

 

Through its Regional Office for Africa, WHO regularly provides technical and operational support to countries often affected by cholera in Africa. In particular, since the beginning of 2018 WHO has led on providing technical expertise and guidance, working closely with Ministries of Health in the five countries to plan and implement the campaigns with different partners. This is part of a global push to reduce cholera deaths by 90 percent by 2030.

 

“Oral cholera vaccines are a key weapon in our fight against cholera,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But there are many other things we need to do to keep people safe. WHO and our partners are saving lives every day by improving access to clean water and sanitation, establishing treatment centres, delivering supplies, distributing public health guidance, training health workers, and working with communities on prevention.”

 

The burden of cholera remains high in many African countries. As of 7 May many countries are facing cholera outbreaks, with at least 12 areas or countries reporting active cholera transmission in sub-Saharan Africa. Recent developments in the use of OCVs show that the strong mobilisation of countries and partners can effectively tackle the disease when tools for prevention and control are readily available.

 

“Every rainy season, cholera springs up and brings devastation to communities across Africa,” said Dr Matshidiso Moeti, WHO’s Regional Director for Africa. “With this historic cholera vaccination drive, countries in the region are demonstrating their commitment to stopping cholera from claiming more lives. We need to build on this momentum through a multisectoral approach and ensure that everyone has access to clean water and sanitation, no matter where they are located.”

 

The five African campaigns are:

 

  • Nigeria
    1.2 million doses will protect around 600,000 people to contain an emerging cholera outbreak in Bauchi state, where more than 1700 cases have been reported.
  • MalawiOne million doses of cholera vaccine will protect over 500,000 people in Lilongwe to combat an outbreak which has infected more than 900 people across the country.
  • Uganda360,000 doses of cholera vaccine have been shipped to Uganda to protect 360,000 people in Hoima District, Western Uganda, after an outbreak in Kyangwali refugee camp hospitalized more than 900 people. The country is also now engaging in long-term cholera control planning to vaccinate over 1.7 million people in the coming months.
  • Zambia667,100 doses of cholera vaccine are being delivered as part of the second round of vaccination to the Lusaka slums after a major outbreak infected over 5700 people, killing more than 100. Zambia is also engaging on long term cholera control and planning vaccination in additional hotspots.
  • South Sudan

113,800 doses have been shipped as a preventative measure ahead of the war-torn country’s rainy season. These extra doses will complement doses remaining from previous campaigns to target Panyijiar. Over 2.6 million doses of OCV have been administered in South Sudan since 2014.

 

Oral Cholera Vaccine is recommended to be given in two doses. The first gives protection for six months, the second for three to five years. All five campaigns should have completed their second round of vaccinations by mid-June.

 

A resolution on cholera will be proposed by Zambia and Haiti at this month’s World Health Assembly, calling for renewed political will and an integrated approached to eliminate cholera, including investment in clean water, sanitation and hygiene (WASH).

 

The global cholera vaccine stockpile is managed by the Global Task Force on Cholera Control (GTFCC), which decides on OCV use in non-emergency settings, and the International Coordinating Group (ICG), which decides on outbreak response and features representatives from WHO, UNICEF, the International Federation of the Red Cross and Red Crescent Societies (IFRC) and Medecins Sans Frontières (MSF). The stockpile is funded in full by Gavi, the Vaccine Alliance, which is a GTFCC partner and has an observer status on the ICG.

 


Lassa Fever: A WHO Review

WHO

Key Facts

  • Lassa fever is an acute viral haemorrhagic illness of 2-21 days duration that occurs in West Africa.
  • The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces.
  • Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures.
  • Lassa fever is known to be endemic in Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, and Nigeria, but probably exists in other West African countries as well.
  • The overall case-fatality rate is 1%. Observed case-fatality rate among patients hospitalized with severe cases of Lassa fever is 15%.
  • Early supportive care with rehydration and symptomatic treatment improves survival.
Background

Though first described in the 1950s, the virus causing Lassa disease was not identified until 1969. The virus is a single-stranded RNA virus belonging to the virus family Arenaviridae.

About 80% of people who become infected with Lassa virus have no symptoms. 1 in 5 infections result in severe disease, where the virus affects several organs such as the liver, spleen and kidneys.

Lassa fever is a zoonotic disease, meaning that humans become infected from contact with infected animals. The animal reservoir, or host, of Lassa virus is a rodent of the genus Mastomys, commonly known as the “multimammate rat.” Mastomys rats infected with Lassa virus do not become ill, but they can shed the virus in their urine and faeces.

Because the clinical course of the disease is so variable, detection of the disease in affected patients has been difficult. When presence of the disease is confirmed in a community, however, prompt isolation of affected patients, good infection prevention and control practices, and rigorous contact tracing can stop outbreaks.

Lassa fever is known to be endemic in Benin (where it was diagnosed for the first time in November 2014), Ghana (diagnosed for the first time in October 2011), Guinea, Liberia, Mali (diagnosed for the first time in February 2009), Sierra Leone, and Nigeria, but probably exists in other West African countries as well.

Symptoms of Lassa fever

The incubation period of Lassa fever ranges from 6–21 days. The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow. In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop.

Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages. Deafness occurs in 25% of patients who survive the disease. In half of these cases, hearing returns partially after 1–3 months. Transient hair loss and gait disturbance may occur during recovery.

Death usually occurs within 14 days of onset in fatal cases. The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80% of cases during the third trimester.

Transmission

Humans usually become infected with Lassa virus from exposure to urine or faeces of infected Mastomys rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of a person infected with Lassa fever. There is no epidemiological evidence supporting airborne spread between humans. Person-to-person transmission occurs in both community and health-care settings, where the virus may be spread by contaminated medical equipment, such as re-used needles. Sexual transmission of Lassa virus has been reported.

Lassa fever occurs in all age groups and both sexes. Persons at greatest risk are those living in rural areas where Mastomys are usually found, especially in communities with poor sanitation or crowded living conditions. Health workers are at risk if caring for Lassa fever patients in the absence of proper barrier nursing and infection prevention and control practices.

Diagnosis

Because the symptoms of Lassa fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease. Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever.

Definitive diagnosis requires testing that is available only in reference laboratories. Laboratory specimens may be hazardous and must be handled with extreme care. Lassa virus infections can only be diagnosed definitively in the laboratory using the following tests:

  • reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • antibody enzyme-linked immunosorbent assay (ELISA)
  • antigen detection tests
  • virus isolation by cell culture.
Treatment and prophylaxis

The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness. There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever.

There is currently no vaccine that protects against Lassa fever.

Prevention and control

Prevention of Lassa fever relies on promoting good “community hygiene” to discourage rodents from entering homes. Effective measures include storing grain and other foodstuffs in rodent-proof containers, disposing of garbage far from the home, maintaining clean households and keeping cats. Because Mastomys are so abundant in endemic areas, it is not possible to completely eliminate them from the environment. Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons.

In health-care settings, staff should always apply standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions.

On rare occasions, travellers from areas where Lassa fever is endemic export the disease to other countries. Although malaria, typhoid fever, and many other tropical infections are much more common, the diagnosis of Lassa fever should be considered in febrile patients returning from West Africa, especially if they have had exposures in rural areas or hospitals in countries where Lassa fever is known to be endemic. Health-care workers seeing a patient suspected to have Lassa fever should immediately contact local and national experts for advice and to arrange for laboratory testing.

Lassa Fever in Sierra Leone


WHO: Global Burn Registry

WHO

The Global Burn Registry is based upon a brief data collection form that has been developed by WHO and a global network of experts and widely pilot tested. It provides the opportunity to move from a range of fragmented approaches to an improved, standardized, and global data collection system for this important public health problem.

Registering to participate in the Global Burn Registry is straight forward and carried out through this website on the pages that follow. Upon registration, the data collection form and guidance on how to use it are sent to the focal person who registered the health facility to participate. The form is available in English, French and Spanish and takes approximately 5 minutes to complete or upload.

Data can be accessed through the online Global Burn Registry interface maintained by WHO. The interface allows users to view data from their health facility as well as all other participating health facilities. The data gives health facilities a clear picture of the major risk factors and populations at risk for burns in their setting, as well as how these compare and contrast with other settings. This information is key to identifying and prioritizing programmes to prevent burn injuries. Data can be viewed online or exported for further analysis.

WHO recommends that all persons interested in either accessing and using the data in the Global Burn Registry, or registering their health facility to participate in the Global Burn Registry, should first read a brief Frequently Asked Questions (FAQ) document which provides answers to the most commonly asked questions about the Global Burn Registry. At the bottom of the FAQ there is a link for those who wish to register their health facility to participate in the Global Burn Registry as well as a link for those persons who wish to know more about accessing and using the data in the Global Burn Registry.

 

 

 


Donors pledge over US$15 million to WHO’s Contingency Fund for Emergencies

WHO

WHO

27 March 2018 – Donors have pledged an additional US$15.3 million to support quick action by the World Health Organization to tackle disease outbreaks and humanitarian health crises through its emergency response fund in 2018, the Contingency Fund for Emergencies (CFE).

Canada, Denmark, Estonia, Germany, the Republic of Korea, Kuwait, Luxembourg, Malta, Netherlands, Norway, and the United Kingdom of Great Britain and Northern Ireland announced contributions ranging from US$20,000 to US$5.6 million at a conference hosted at WHO headquarters in Geneva, Switzerland on Monday (March 26) – increasing CFE funding levels to US$23 million.

This will enable the rapid financing of health response operations in the coming months – filling that critical gap between the moment the need for an emergency response is identified and the point at which funds from other sources can be released. WHO will seek to secure further donor commitments to achieve its US$100 million funding target for the 2018/2019 biennium.

First-time pledges were made by Denmark, Kuwait, Luxembourg, Malta and Norway. The UK has increased its overall commitment to the fund from US$10.5 million to US$16 million, making it the second largest donor after Germany.

“For the UK, the CFE is an extraordinarily good investment. We are convinced it has a vital and unique role to play in the global effort to prevent and mitigate health emergencies. Today we pledge an additional £4 million (US$5.6 million) for the Contingency Fund and pledge to work with WHO to better profile to a wider audience the huge value it brings. The G7 and the G20 share the UK’s desire for an adequately funded CFE. We urge our fellow Member States and donors to heed WHO’s call and to step forward to provide financial support for the Contingency Fund for Emergencies,” said Alistair Burt, UK Minister of State for International Development.

The CFE’s ability to release funds within 24 hours sets it apart from complementary financing mechanisms that have different funding criteria and slower disbursement cycles. While other funding mechanisms allow for the scale up of response operations, none are designed to deliver an immediate and early response. The CFE has demonstrated that a small investment can save lives and dramatically reduce the direct costs of controlling outbreaks and responding to emergencies.

“Without the CFE, recent outbreaks of Ebola in DRC, Marburg virus Disease in Uganda and pneumonic plague in Madagascar could have gotten out of control. By acting decisively and quickly, we can stop disease outbreaks and save thousands of lives for a fraction of the cost of a late response. The CFE has proven its value as a global public good that should be underwritten by long term investment,” said Dr Peter Salama, WHO Deputy Director General for Emergency Preparedness and Response.

Since 2015, the CFE has enabled WHO, national authorities and health partners to get quick starts on more than 50 disease outbreaks, humanitarian crises and natural disasters, allocating more than US$46 million. It has supported the rapid deployment of experts; better disease detection and reporting; the delivery of essential medicines, supplies and personal protective equipment; the strengthening of surveillance and vaccination; improved access to water, sanitation and health services; community engagement; and more.

Madagascar’s health minister Dr Lalatiana Andriamanarivo called for increased support for the CFE, saying it was instrumental to containing an unprecedented outbreak of pneumonic plague that rapidly spread across the island nation in 2017.

“We call on our international partners to support the Contingency Fund for Emergencies to enable WHO to respond to outbreaks everywhere across the world, and to reinforce national capacities to manage health emergencies in the future,” said Dr Andriamanarivo.

In 2017, the CFE provided nearly US$21 million for operations in 23 countries, with most allocations released within 24 hours. Over half (56%) of allocations funded responses in the WHO Africa region, with 28% going to responses in countries in the WHO Eastern Mediterranean Region and 11% to the South East Asia Region.

Note to editors

The WHO Health Emergencies Programme has three funding categories: the core budget that covers essential functions; the appeals budget that covers the additional work done in response to acute and protracted health emergencies; and the WHO Contingency Fund for Emergencies.

The Contingency Fund for Emergencies is replenished through donor contributions outside of the WHO Health Emergencies Programme core budget. Contributions are pooled and flexible, rather than earmarked for specific activities.

For more information, please contact:

Tarik Jašarević
Communications Officer
Telephone : +41 22 791 5099
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

Pledges announced at the CFE Pledging Conference 26 March 2018


OpenWHO is WHO’s new interactive, web-based, knowledge-transfer platform offering online courses to improve the response to health emergencies.

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