On 27 September 2024, Rwanda reported its first Marburg virus disease outbreak (MVD), see also previous EpiNews.

• The highest number of new confirmed cases were reported in the first two epidemiological weeks of the outbreak with 26 cases reported in epidemiological week 39 (23 to 29 September 2024) and 23 cases in week 40 (30 September to 6 October). This was followed by a sharp decline in weeks 41 and 42, with 12 and one case reported respectively.
  
• As of 29 October 2024, 65 cases of MVD have been reported, including 15 deaths (23%); 3 patients are in isolation. So far, 47 patients have recovered. For updates, see LINK.
  
• Most of the people infected are health workers, particularly those who work in intensive care units.
  
• Contact tracing is ongoing, with 1’146 contacts under follow-up as of 20 October 2024.
  
• Based on available updates from the outbreak investigation, the index case was a male between 20 and 30 years old with a history of exposure to bats in a cave.
  

According to WHO, between 2 to 29 September 2024 (week 36 to 36), 17 countries shared their meningitis epidemiological data.

Epidemic:

• Benin: Zoe region (Abdomey health district, crossed epidemic threshold on weeks 33 and 34), remaining in epidemic phase on week 36

Alert:

• Benin: Alibori region, Atacora region, Bargou region, Collines region
  
• Mali: Bamako region

For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch.

The World Health Organization (WHO) has certified Egypt as malaria-free, marking a significant public health milestone for a country with more than 100 million inhabitants. The achievement follows a nearly 100-year effort by the Egyptian government and people to end a disease that has been present in the country since ancient times.

Ethiopia is facing a significant malaria crisis, reporting a total of 5’723’754 cases from 1 January to 15 September 2024. Four regions of Oromia, Amhara, Southwest, and South Ethiopia Regional State comprise 80.0% of all cases. The resurgence of Malaria in Ethiopia is exacerbated by the suspension of malaria control programs, especially in conflict-affected regions, which has created vulnerable living conditions due to displacement, among others.

In Epidemiological Week 36 alone, there were 227’675 malaria cases and 18 deaths. A significant proportion of the cases (over 81.0%) came from four regions: Oromia (440%), Amhara (18.0%), Southwest (12.0%), and South Ethiopia Regional State (7.0%). Of the cases in week 36, 98.0% were confirmed through laboratory testing, and Plasmodium falciparum accounted for 62.0%

Dengue is currently emerging as a public health problem in most states of Sudan. According a source at the Ministry of Health, Kassala state has recorded an unprecedented increase in dengue fever cases and deaths, especially among the internally displaced population, and the emergency department of one Kassala hospital is receiving between 50 and 60 cases of dengue per day. Three doctors from the same hospital have died due to dengue fever.

The number of malaria cases in the Dominican Republic has increased by 300% with 842 confirmed cases compared to the same period last year [2023], when there were only 213 cases.

According to the WHO, the circulating poliovirus type 3 (cVDPV3) has been detected in three environmental samples in the arrondissement of Cayenne since May 2024. No cases of acute flaccid paralysis or polio in humans have been detected. The last case of wild poliovirus in French Guiana occurred in 1983; cVDPV had not previously been detected.

On 28 October 2024, the US Center of Disease Control and Prevention reported a suspected imported case of Lassa fever in an Iowa resident. The case recently to West Africa (country unspecified) in early October 2024 and became ill upon return and was isolated in a hospital where he died end of October.

Lassa fever is endemic in West Africa with 100’000 to 300’000 cases reported each year.

Sporadic cases have been reported among returning travellers: In the past 10 years, EU/EEA countries have reported seven Lassa fever cases to ‘The European Surveillance System’ (TESSy). Two cases were reported by the UK (ex-Nigeria and ex-Mali) in 2009, one by Sweden (ex-Liberia) in 2016, two by Germany (ex-Togo and a secondary case infected in Germany) in 2016 and two by the Netherlands (ex-Sierra Leone) in 2019. In the USA, there have been nine imported Lassa fever cases since 1969.

The NHS has sounded an alarm with a 10-day COVID warning, calling for vigilance as the number of cases climbs. According to recent figures released by the UK Health Security Agency (UKHSA), there's been a 17.8% week-on-week increase in COVID infections in England and a sharp 27.3% rise in related fatalities.

In the EU/EEA, there has been a downward trend of COVID-19 activity since the peak in July 2024, including in most of the countries that experienced a later epidemic during the summer. People aged 65 years and above continue to represent the main age group at risk of hospitalization and severe outcomes due to COVID-19.