Yemen: Diphtheria Outbreak - Nov 2017Ongoing
Diphtheria is making an alarming comeback in the war torn country, with 189 clinically diagnosed cases and 20 deaths – mostly children and young adults – in the last three months. Most diphtheria cases and deaths have been reported in Ibb governorate but the outbreak is spreading fast, already affecting 13 governorates. The closest points of entry to Ibb are in Sana’a and Hodeida, making it crucial that Sana’a airport and the port of Hodeida remain open. (WHO, 27 Nov 2017)
By 4 December, 318 suspected cases of diphtheria and 28 deaths had been reported in 15 of Yemen’s 20 governorates. Half the suspected cases are children between the ages of 5 and 14, and nearly 95% of deaths are children under 15. Nearly 70% of all suspected cases are in Ibb governorate. (MSF, 12 Dec 2017)
312 suspected cases of diphtheria have been reported in Yemen between mid-August and 20 December. The outbreak has resulted in 35 deaths reported. At 11%, the case fatality rate (CFR) is high. 18 out of Yemen’s 22 governorates are affected, with Ibb having the majority of cases. (ACAPS, 22 Dec 2017)
As of 28 January 2018, Yemen is grappling with a spike in diphtheria, which has claimed 48 lives in the last two months. WHO reported on 11 January 2018 that diphtheria-related deaths had been recorded in 19 governorates. Across the country, 610 suspected cases have been reported. The diphtheria outbreak occurs against the backdrop of a cholera epidemic accounting for more than 2,200 lives lost and more than one million suspected cases reported, since April 2017. (OCHA, 28 Jan 2018)
WHO reports that, as of 15 February 2018, the cumulative number of suspected diphteria cases is 1,085 with 66 associated deaths. 20 governorates and 162 districts have reported suspected cases. Ibb and Al Hudaydah are the most affected governorates. Children under the age of five years account for 30 per cent of suspected cases and for 47 per cent of dipheria associated deaths. (OCHA, 18 Feb 2018)
As of 14 April 2018, the local health authorities reported a total of 1,584 suspected diphtheria cases including 85 associated deaths (CFR=5.4%). The diphtheria outbreak has affected 195 districts from 20 governorates. At governorate level, Ibb and Sana'a are the most affected governorates. Children (<5 years of age) represent 20% of suspected diphtheria cases and 38% of associated deaths. The most affected age group is 5-15 years old representing 44 % of the cases. A cumulative total of 6,842 diphtheria contacts have been given preventative antibiotics, 142 during week 15. (WHO/Gov't of Yemen, 14 Apr 2018)
As of 3 June 2018, a cumulative total of 1,850 suspected diphtheria cases have been reported including 98 associated deaths. The outbreak has affected 202 districts across 20 governorates with Ibb and Sana’a being the most affected. Children under 5 years represent 20 per cent of suspected diphtheria cases and 37 per cent of associated deaths. The most affected age group is 5 to15 years old, representing 44 per cent of all cases. A diphtheria vaccination campaign was launched in Sa’ada, covering only 34 per cent as too many people refused the vaccinations. (Relief and Development Peer Foundation, 30 Jun 2018)
Maps & Infographics
Most read reports
- Yemen: Humanitarian Response Plan January-December 2018 [EN/AR]
- UNICEF Yemen Humanitarian Situation Report (June 2018) [EN/AR]
- Yemen’s healthcare in crisis: a doctor speaks out
- Yemen Humanitarian Update Covering 12 June - 9 July 2018 | Issue 20
- Yemen Humanitarian Bulletin Issue 30 | 28 January 2018 [EN/AR]
“Here our job is human. I can’t leave it, I can’t stop.”
Dr Anisa, a doctor with British Red Cross partner the Yemen Red Crescent, speaks from a battered clinic in Sana’a, Yemen.
Once, she was a hospital specialist. The clinic was a thriving health centre for mothers and babies.
But now, Yemen is caught up in deadly conflict. Dr Anisa is now a GP working in one of the only clinics where people can get free healthcare. Patients travel for hours to see her every day.
Like many doctors in Yemen, she hasn’t been paid in two years.
A country at war
Despite so much natural beauty in Yemen there are always reminders that this is a country at war – a war which has been so devastating to 22 million people. There are regular reminders of the conflict at different points in the journey and, while our minds are focused very much on Hodeidah and a potential impending ground attack, it is also with the millions of children directly and indirectly affected by the horrendous conflict across Yemen.
Current major event
Emergency risk communication in outbreaks
To provide WHO Member States, partners and stakeholders involved in emergency preparedness and response with the most up-to-date best practices on Emergency Risk Communication, this year WHO published “Communicating risk in public health emergencies - A WHO guideline for emergency risk communication (ERC) policy and practice”.
• In June, the security situation in Al Hudaydah deteriorated as clashes erupted, leading to the displacement of more than 121,000 people. UNICEF continues to express its concern around child protection and the safety of civilians.
Acute diarrhoea in Deir-ez-Zor, Syria
An increase in number of cases of acute diarrhoea cases was reported from Deir- ez-Zor governorate in Syria since March 2018. As of 24th June 2018, a total of 578 cases including 12 related deaths (case fatality rate—CFR: 2.07%) were reported to WHO.
Daily Nutritional Services in Fara AlUdayn District.
Daily Nutritional Services in Mudhiakhera District.
CHVs Basic Training in Mudhiakhera District.
Daily Health Services in Fara AlUdayn District.
Daily Health Services in Mudhiakhera District.
UNOCHA & WFP Observation.
Emergency Water Supply.
Study on the Rehabilitation of Al-Hasha Well.
Hygiene Awareness – Raising.
• Conflict and port status: Military operations in Al Hudaydah have lessened recently, while sporadic shelling and airstrikes hit some districts, including Zabid and Bait Al Faqih. Clashes are raging in AlTohaita District. Several main roads in the city remain blocked, whereas the port is still operational.
Tarik Jašarevic, for the World Health Organization (WHO), said that conditions in Hudaydah, even before the escalation of the conflict, had been some of the direst in Yemen. Hudaydah had registered the highest incidences of suspected cholera cases (around 14 per cent of reported cases countrywide since the start of the epidemic in April 2017) and diphtheria (209 suspected cases). In addition, there had been 252 suspected cases of measles.
• Eleven people were killed by an airstrike in Sa’ada, including nine children, as violence continues in several governorates.
• The UN verified 842 cases of the recruitment and use of boys as young as 11 years old in 2017. Also verified was the killing and maiming of 1,316 children.
• Commodity imports improved in May, leading to better supply and availability in most local markets but prices remained high.
• The Yemen Humanitarian Fund (YHF) has completed a reserve allocation for US$90m.
Current major event
Upsurge of CCHF cases in Afghanistan
An upsurge in the number of the reported cases of Crimean Congo hemorrhagic fever (CCHF) from Afghanistan has been reported during 2018. The increase is mainly in Herat province in the western part of the country. As of week 25-2018, a total of 125 cases including 18 deaths (CFR=14.4%) have been reported countrywide.
The security situation in Yemen continued to deteriorate in May, especially along the West coast and around the city of Al Hudaydah. UNICEF is concerned around child protection and safety of civilians and civilian infrastructure.
New York 20 June 2018
• Humanitarian agencies are increasingly worried by the likely impact of a possible military assault on Al Hudaydah City which will impact hundreds of thousands of civilians.
• Prepositioning of aid supplies continues throughout the Governorate as aid organisations plan to stay and deliver • Forty-six migrants drown off the coast of Yemen
INCREASED CONCERNS AT A POSSIBLE MILITARY ASSAULT ON AL HUDAYDAH
Protection Needs Assessment for 222 HHs.
Nutritional Services in 7 health facilities in Ibb governorate.
CMAM Trainings for health workers and community health volunteers.
Medical Health Services in 7 health facilities in Ibb governorate.
Outreach (door-to-door) activities.
Water Tanks Installation.
Feasibility Study on Water Resources.
1000 Hygiene Kits & 2000 Jerry Water Cans for Fara Al-Udayn district.
Conflict intensifies in Al Hudaydah Governorate; humanitarian actors prepare for additional displacement
First containerized vessel delivers supplies to Al Hudaydah Port since November 2017 port closures
Health actors launch cholera and diphtheria vaccination campaigns in high-risk areas
329 Meeting of the Strategic Advisory Group of Experts on immunization, April 2018 – conclusions and recommendations
329 Réunion du Groupe stratégique consultatif d’experts sur la vaccination, avril 2018 – conclusions et recommandations
Health Cluster partners continue to provide health services by supporting 1,753 Health Facilities (16 Governorate Hospitals, 95 District Hospitals, 50 General Hospitals, 19 Specialized Hospitals, 456 Health Centers and 1,117 Health Units). The Health Cluster partners also support the GHO and DHO through paying incentives to health staff as well as administration / logistics support to local health authorities.