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International Outbreak News

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1. Human infection with avian influenza A (H5N8) – the Russian Federation

   On 18 February 2021, the National IHR Focal Point for the Russian Federation notified WHO of detection of avian influenza A(H5N8) in seven human clinical specimens. These are the first reported detection of avian influenza A(H5N8) in humans. Positive clinical specimens were collected from poultry farm workers who participated in a response operation to contain an avian influenza A(H5N8) outbreak detected in a poultry farm in Astrakhan Oblast in the Russian Federation. The laboratory confirmation of the seven specimens were performed by the State Research Centre for Virology and Biotechnology VECTOR (WHO H5 Reference Laboratory). The age of seven positive cases ranged between 29 to 60 years and five were female.
   
   Between 3 and 11 December, a total of 101 000 of 900 000 egg laying hens on the farm died. This high mortality rate prompted an investigation. Samples were collected from these birds and an initial detection of avian influenza A(H5N8) was performed by the Russian regional veterinary laboratory. On 11 December, the outbreak was confirmed by the World Organisation for Animal Health (OIE) Reference laboratory, and the Federal Centre for Animal Health (FGBI-ARRIAH), in Vladimir, the Russian Federation. Outbreak containment operations started immediately and continued for several days due to the large size of the poultry farm.

2. Ebola virus disease – Guinea

   On 14 February 2021, the Ministry of Health (MoH) of Guinea informed WHO of a cluster of Ebola Virus

3. Rift Valley fever – Kenya

   Rift Valley fever (RVF) has been reported in Kenya in humans in Isiolo and Mandera counties and in

4. Ebola virus disease – Democratic Republic of the Congo

   On 7 February 2021, the Minister of Health of the Democratic Republic of the Congo declared an outbreak of Ebola Virus Disease (EVD) after the laboratory confirmation of one case in North Kivu Province. The case was an adult female living in Biena Health Zone. To date the source of infection is still under investigation.
   
   On 25 January 2021, the case presented with nasal bleeding. From 25 January to 1 February, she reportedly received outpatient care at a local health centre. From 1 to 3 February, she was admitted to a second health centre with signs of physical weakness, dizziness, joint pain, epigastric pain, liquid stools, headache and difficulty breathing. On 3 February, a blood sample was collected for EVD testing due to her epidemiological link with an EVD survivor. On the same day, she was referred to a hospital in Katwa Health Zone (part of Butembo city) following the deterioration of her condition. She was admitted to the intensive care unit the same day and died on 4 February. On 5 February, the body was buried in Musienene Health Zone, however not under safe burial practices.

5. Influenza A (H3N2) variant virus – United States of America

   On 13 January, 2021, a child under 18 years of age in Wisconsin developed respiratory disease. A respiratory specimen was collected on 14 January. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) testing conducted at the Wisconsin State Laboratory of Hygiene indicated a presumptive positive influenza A(H3N2) variant virus infection. The specimen was forwarded to the Influenza Division of the Centers for Disease Control and Prevention (CDC) on 21 January for further testing. On 22 January, CDC confirmed an influenza A (H3N2)v virus infection using RT-PCR and genome sequence analysis. Investigation into the source of the infection has been completed and revealed that the child lives on a farm with swine present. Sampling of the swine on the property for influenza virus has not yet been conducted but is planned. Five family members of the patient reported respiratory illness during the investigation and were tested for influenza; all tested negative. The patient was prescribed antiviral treatment and was not hospitalized and has made a full recovery. No human to human transmission has been identified associated with this investigation.
   
   Sequencing of the virus by CDC revealed it is similar to A (H3N2) viruses circulating in swine in the mid-western United States during 2019-2020. Viruses related to this A (H3N2)v virus were previously circulating as human seasonal A (H3N2) viruses until around 2010-2011 when they entered the USA swine population. Thus, past vaccination or infection with human seasonal A (H3N2) virus is likely to offer some protection in humans.

6. Middle East respiratory syndrome coronavirus (MERS-CoV) – The Kingdom of Saudi Arabia

   Between 1 June through 31 December 2020, the National IHR Focal Point of Saudi Arabia reported four additional cases of Middle East respiratory syndrome (MERS-CoV) with one associated death. The cases were reported from Riyadh (two cases), Taif (one case), and Al-Ahsaa (one case) Regions.
   
   The link below provides details of the four reported cases.

7. Cholera – Togo

   From 11 November to 28 December, 2020 a total of 67 suspected cholera cases presenting with diarrhea and vomiting, including two deaths a case fatality ratio (CFR: 3%) were reported from the municipalities “Golfe 1” and “Golfe 6” in Lomé, Togo. A total of four health areas (Katanga, Adakpamé, Gbétsogbé in Golfe 1, and Kangnikopé in Golfe 6) in the affected municipalities reported at least one case.
   
   On 17 November, cholera was confirmed by culture in the laboratory of the National Institute of Hygiene (INH) in Lomé, Togo and WHO was informed. On 19 November, the Minister of Health, Public Hygiene and Universal Access to Care of Togo issued a press release declaring a cholera outbreak and on 24 November WHO was officially notified. From 11 November to 28 December 2020, a total of 17 out of 41 stool samples tested positive for Vibrio cholerae O1 serotype Ogawa by culture in the National Institute of Hygiene (INH) in Lomé, Togo.