Somalia: Measles Outbreak - Dec 2016Ongoing
Since September, 419 measles cases have been officially recorded, 302 of which are children under five. (UNICEF, 13 Dec 2016)
This week IOM...launched a mass public health campaign to contain an ongoing measles outbreak in Kismayo...Through TV and radio, IOM, the Somali government and health partners are disseminating a series of public messages about measles...The six-day campaign is estimated to reach over 2,000 people in the most affected communities, as well as surrounding areas. (IOM, 16 Dec 2016.)
UNICEF and partners are aiming to vaccinate 54,000 children under 10 in Kismayo...There have been over 704 cases of fever and rashes in Kismayo, the majority of them children...Most were not vaccinated against measles although there are 16 free vaccination posts in Kismayo. (UNICEF, 16 Dec 2016.)
Drought conditions have increased the spread of epidemic-prone diseases such as acute watery diarrhoea, cholera and measles. In the first 7 weeks of 2017, over 6000 cases and 65 deaths by acute watery diarrhoea/ cholera have been reported, and a total of 2578 cases of suspected measles were reported as of September 2016. (WHO, 27 Feb 2017)
Cases of suspected measles continue to rise across Somalia. A total of 7,694 cases have been reported nationwide, far exceeding the 5, 657 total cases recorded for all last year. The need for non-essential life-saving health services have increased and more affected areas are in dire need of urgent assistance. (OCHA, 16 May 2017)
Somalia is also facing its worst measles outbreak in 4 years, with over 14,823 suspected cases reported in 2017 (as of 31 July), compared to 5,000-10,000 cases per year since 2014. The situation is especially critical for millions of under-vaccinated, weak and hungry children who are more susceptible to contracting infectious diseases. More than 80% of those affected by the current outbreak are children under 10 year of age. In early 2017, WHO and partners, in collaboration with national health authorities, vaccinated almost 600,000 children aged 6 months to 5 years for measles in hard-to-reach and hotspot areas across the country. (WHO, 15 Aug 2017)
The numbers of cases of measles remain at epidemic levels with more than 1,491 cases being recorded in August. (Health Cluster, 29 Sep 2017)
Over 1469 suspected measles cases were reported in September. The numbers of cases of measles remain at epidemic levels with more than 18,000 cases so far recorded from January to end of September. Although there has been a decline in recent months, the number of cases is 4 times as those reported in 2015 and 2016. A nationwide campaign to vaccinate all 4.2 million children in the country between the ages of 6 months and 10 years will begin in November/December 2017. (Health Cluster, 19 Oct 2017)
Measles cases reported continue to be very high, increasing every month from all areas of the country with more than 19,316 cases being recorded since January 2017. Although there has been a decline in recent months, the number of cases is 4 times as high as those reported in 2015 and 2016. (Health Cluster, 19 Nov 2017)
The Ministry of Health of the Federal Government of Somalia, in partnership with WHO and UNICEF, has today concluded a five-day national measles campaign, targeting 1 million children aged 6 months to 10 years in Puntland, and 4.2 million across the country. In 2017, amidst a drought emergency, a total of 23,002 suspected measles cases were reported, which is alarmingly high compared to previous years. Among these cases, 83 per cent were children under 10 years of age. (WHO/UNICEF, 07 Jan 2018)
As part of the ongoing national measles vaccination campaign, after successful completion of the campaign in Puntland in January, UNICEF and partners conducted measles campaigns in March in central and southern regions of Somalia, and Somaliland. 2,734,941 children between six months and 10 years were vaccinated (102 per cent of the targeted 2,693,928). Since the start of the year, 4,067 suspected measles cases were reported – 72 percent being children under-five. (UNICEF, 31 Mar 2018)
Since the beginning of the year, a total of 5,242 suspected cases of measles was reported, with the overall trend decreasing from 2016-17. Surveillance is based on signs of high fever and rash, providing high sensitivity to identify measles. The declining trends reflects the completed measles vaccination campaign in February and March that reached 94% of children under-10 years old (UNICEF/WHO). (Health Cluster, 30 Apr 2018)
Of the 6,311 suspected cases of measles reported since January, the majority are children under the age of 5. The highest number of cases have been seen in Banadir region and South West and Galmudug states. In 2017, 12,336 cases were reported. Humanitarian partners have attributed the low number of reported AWD/cholera and measles cases to vaccination campaigns conducted in all states of Somalia in January and March, which reached 4.4 million (94 per cent) of the targeted children under age 5. Meanwhile, no cases of wild-polio have been detected following laboratory tests by the polio surveillance network. A supplementary immunization for polio is underway across southern and central Somalia. Two vaccination rounds are planned for July, following last year’s successful campaigns in Banadir region and, Hirshabelle and South West states. (OCHA, 5 July 2018)
Maps & Infographics
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A new VDPV2 isolated from a contact (EPID SOM/GDO/DLO/18/002-C1) from Dolo district in Gedo region of South zone. It has 38 nucleotide differences from Sabin2. The VP1 sequence shows it has no close genetic link to previously sequenced cVDPV2s; it is classified as VDPV2 and represents a VDPV2 event that has not previously been identified.
The contact sample is collected from an IDP camp called KABASA
217 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 26.
Total number of consultations increased from 55,256 in week 25 to 55,343 in week 26.
A total of 284 alerts were received. 42 of these alerts were confirmed as true alerts in week 26.
Children at grave risk as violations spike.
Interview with outgoing DHC.
The Gu rainy season ends, but needs remain high.
Humanitarians step up vaccination campaigns.
Lack of funding hampers aid operation.
# of people in need 5.4m
# of people in humanitarian emergency and crisis (IPC Phases 3 &4) 2.m
# of people Emergency (IPC Phase 4) 0.5m
Food security has improved significantly in many of the areas worst-affected by the 2016/17 drought, thanks to large-scale humanitarian assistance and improvement in seasonal performance1. Some 2.6 million people are now estimated to be internally displaced. Nearly 2,700 households are displaced following the armed standoff between the Somaliland and Puntland in Tukaraq, Sool region.
In March and April 2018, health cluster partners provided consultation services to 559,772 individuals in 263 health facilities (including mobile health units). This includes 326,358 females and 219,131 children under five.
Health cluster partners participated in the mass measles vaccination. A total of 3.6M children were vaccinated against measles. The campaign started in February in Puntland where 933,406 children were vaccinated.
219 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 25.
Total number of consultations increased from 44,883 in week 24 to 55,256 in week 25.
A total of 341 alerts were received. 50 of these alerts were confirmed as true alerts.
- VDPV type 2 and type 3 were detected from 2 AFP cases, 3 Contacts and 3 Community samples collected from Bulloburti, Warshakeh and Jemmame West districts of Central and South Somalia. • EPID no: SOM/HRN/BBT/18/002 and the 3 contacts have cVDPV3
Location of case: JAMECO MUBARAK village –BULO BURTI District -Hiran Region - Central zone
• PV2-VDPV and PV3-VDPV isolated from AFPs, contacts and Community samples collected from Lower Jubba,
Hiran and Middle Shabelle regions of Central and South Zones
• Discussion on progress with team to conduct detail investigation and active search of in these areas
• 459 contact samples and 263 community samples from healthy children collected
• A total of 125 community samples were collected from 5 inaccessible districts in Middle and Lower Shaballe regions
No cVDPV2 or cVDPV3 detected from an AFP case, contact or healthy children
5 ES samples with suspected PV were sent for sequencing. Samples were collected in week 18, 19,20 and 21 from KAWMA (n=3 samples) and 21 October (n=2 sample)
Additional 25 community samples collected this week from healthy children in Kurtunware district (inaccessible area) in Lower Shabelle region; It was scheduled to collect 25 stool samples from healthy children living in access-compromised districts of central and south zones.
• 216 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 22.
• Total number of consultations decreased from 62,876 in week 21 to 59,673 in week 22.
• A total of 4,231 alerts were received. 159 of these alerts were confirmed as true alerts1 .
The humanitarian situation in Somalia remains challenging in 2018. After a prolonged drought in 2016 and 2017, the above-average Gu rains have had devastating impact in some parts of the country. Flash floods and riverine flooding has been reported in several areas, including the Banadir region, Hirshabelle, Jubaland, Galmuduug, and the South West states. Evictions of IDPs are on the rise, while the benefits of the rainy season are yet to translate into a significantly improved food security situation across the country.
• 228 health facilities across Somalia submitted weekly reports of epidemic-prone diseases in the electronic early warning disease surveillance (EWARN) system in week 21.
• Total number of consultations increased from 50,749 in week 20 to 62,876 in week 21.
• A total of 4,449 alerts were received. 303 of these alerts were confirmed as true alerts1 .
No cVDPV2 or cVDPV3 reported from any human stool sample in 2017 or 2018
3 PV3 isolated from 3 ES samples collected in week 18, 19 and 20 from KAWMA (n=2 samples) and 21 October (n=1 sample) ES sites with EPID number (ES/SOM/BAN/HDN/EGH/18/019, ES/SOM/BAN/HMW/KAWMA-1/18/018 and ES/SOM/BAN/HMW/KAWMA-1/18/020). Samples are undergoing sequencing
KAWMA ES site catchment area house-to-house survey completed. Further investigations ongoing in selected HH with suspected AFPs and sickly children reported.
Over 770,000 people have been affected and 230,000 displaced due to ongoing severe floods along the Juba and Shabelle river basins. The floods have critically impacted crops, shelters and critical service infrastructure, including water, health, nutrition and education facilities. The increased risk of water-borne communicable diseases remains a major threat, especially acute watery diarrhoea (AWD)/cholera.
29 May 2018 – Key stakeholders joined hands to draft a 5-year plan to reduce the incidence and mortality of measles and rubella in Somalia at a 3-day planning workshop convened by WHO from 22 to 24 May 2018.
Measles is currently a leading cause of death for children in Somalia. Less than half of children under 12 months were vaccinated through routine immunization services in 2017, which means Somali children are still bearing the burden of preventable diseases.
- No PV2 or PV3 isolated from any AFP or ES sample this week.
- KAWMA ES site catchment area house to house survey on progress using standard questionnaire developed on ODK.
- The main Objective is: Further understand characteristics of the populations in the catchment area, profiling populations based on using sewage system, understand pattern of populations movement, immunity profile of all Under 5 children and whether or not the children took mOPV2 vaccine from the 3 recent campaign, searching for AFP cases.