The Ebola virus disease (EVD) outbreak is continuing with moderate intensity. Katwa and Butembo remain the major health zones of concern, while simultaneously, small clusters continue to occur in various geographically dispersed locations. During the last 21 days (30 January – 19 February 2019), 79 new cases have been reported from 40 health areas within 12 health zones (Figure 1), including: Katwa (46), Butembo (15), Kyondo (4), Vuhovi (4), Kalunguta (2), Oicha (2), Biena (1), Mabalako (1), Manguredjipa (1), Masereka (1), Mutwanga (1), and Rwampara (1).¹

No new cases have been reported from the Beni in the last three weeks. This is a significant achievement given the previous intensity of the outbreak in this area. Elsewhere, trends in the case incidence (Figure 2) have been encouraging; however, other indicators (such as the continued high proportion of community deaths, persistent delays in case detection, documented local travel amongst many cases, and relatively low numbers of cases among contacts under surveillance) suggest a high risk of further chains of transmission in affected communities. Response teams must maintain a high degree of vigilance across all areas with declining case and contact tracing activity, as with areas with active cases, to rapidly detect new cases and prevent onward transmission.

On 26 June 2018, an outbreak of circulating vaccine-derived poliovirus type 1 (cVDPV1) was declared in Papua New Guinea following laboratory confirmation of cVDPV1 isolation in two healthy community contacts of the index case. Since the declaration, a total of 26 confirmed cVDPV1 cases have been reported in the following nine provinces: Eastern Highlands (six), Enga (five), East Sepik (four), Madang (three), Morobe (three), Jiwaka (two), Gulf (one), Southern Highlands (one), and National Capital District (NCD) (one). The last laboratory-confirmed case reported having experienced the onset of paralysis in late October 2018. Environmental surveillance continues on a bimonthly basis in Port Moresby and Lae to complement active acute flaccid paralysis (AFP) case search efforts.

To date, there have been five rounds of Supplementary Immunisation Activities (SIA) conducted from July to December 2018. Consultants from WHO and UNICEF have been deployed to provide technical support during pre-campaign preparations and implementation to ensure high quality SIAs and improve AFP case detection. The first round of SIA targeted children under five years of age in three high-risk provinces. The second round included children under five years of age in all nine provinces. The third and fourth rounds of SIA included National Immunisation Days (NIDs) which were aimed at children less than 15 years of age and achieved a coverage of 93% and 97% respectively. The fifth round of SIA was a sub-national campaign conducted in four priority provinces (NCD, Central, Enga, and Angoram district in East Sepik province). Planning is currently ongoing for additional NIDs in 2019.

From 1 January through 31 January 2019, the International Health Regulations (IHR) National Focal Point of Saudi Arabia reported fourteen additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including three deaths.