{ "version": "0.8", "date": "8 October 2026", "reference": 47.25, "hoursPerDay": 24, "profiles": [ { "id": "DEN", "name": "Dengue: other reported cases", "days": 5, "intensity": 3, "durationBasis": "The existing five-day acute course is retained for cases not reported dead at the snapshot cutoff. WHO gives a 2-7-day symptom window. Five days is a representative choice, not a measured mean or a survivor-specific estimate. Other cases include unresolved outcomes and severe cases not reported dead; no future deaths are imputed. Later fatigue is excluded. [S2]", "intensityBasis": "Fever, headache, body/joint aches and nausea support a meaningful acute symptom burden. Assigned intensity 3 is a working average across the whole day, including relief and sleep. It is lower than a severe-pain peak. WHO does not establish the value 3 or its ratio to the reference. [S2]", "excludes": "Later fatigue, prolonged recovery, a separate severity adjustment for other reported cases, caregiver distress, bereavement, unreported infections, death itself and lost life years.", "lowDays": 3, "lowIntensity": 2, "highDays": 7, "highIntensity": 4, "profileVersion": "1.1" }, { "id": "DIS", "name": "Flood displacement: initial distress", "days": 30, "intensity": 2, "durationBasis": "We assign the same 30-day initial course to each person in the selected flood-displaced cohort. Reports of continuing displacement and difficult living conditions support a multiweek scenario. None measures a 30-day cohort mean. This is a consistency choice, not evidence of equal recovery time or a month actually spent in a shelter. [S6, S10, S11, S12]", "intensityBasis": "WHO describes anxiety, sadness, sleep problems and other distress after emergencies. Assigned intensity 2 represents a modest whole-day average across the selected cohort, including relief and people with little distress. This provisional mapping to the pain reference is especially weak; WHO supplies no numeric conversion. [S7]", "excludes": "Injury and disease episodes, suffering before death, bereavement, later mental-health effects, distress outside the selected cohort and post-death loss.", "lowDays": 14, "lowIntensity": 1, "highDays": 60, "highIntensity": 3, "profileVersion": "1.0" }, { "id": "CHIK", "name": "Chikungunya: other reported cases", "days": 8, "intensity": 4, "durationBasis": "CDC describes acute symptoms typically resolving within 7-10 days. We retain eight days for cases outside the selected CHIKV-attributable fatal group. This is a representative choice, not an observed outbreak mean or proof of survival; unresolved outcomes and other-cause deaths are not reclassified. Persistent joint symptoms are excluded from this ordinary course. [S4]", "intensityBasis": "CDC describes potentially severe, debilitating joint symptoms; Paraguay's adult suspected-case definition included incapacitating joint pain or arthritis. These support testing a higher average than dengue. Assigned intensity 4, and the 4:3 ratio, remain model judgments rather than measured equivalence. [S3, S4]", "excludes": "Persistent or recurrent joint pain beyond the assigned course, extra severity profiles for other cases, caregiver distress, bereavement, unreported infections, death itself, lost life years and suffering after death.", "lowDays": 7, "lowIntensity": 3, "highDays": 10, "highIntensity": 5, "profileVersion": "1.1" }, { "id": "EBO", "name": "Bundibugyo Ebola: other reported cases", "days": 14, "intensity": 5, "durationBasis": "The original all-case assumption of 14 days is retained for cases not reported dead at the cutoff. Historical series reported courses around 9-10 days in Uganda and 15-18 days in Isiro. Fourteen days is a rounded choice, not a pooled mean, a survivor-specific estimate or an observed 2026 average. Unresolved cases remain in this group; no future deaths are imputed. [S14, S15]", "intensityBasis": "The studies describe headache, muscle and abdominal pain, gastrointestinal symptoms and marked weakness. We assign intensity 5 as a provisional combined whole-day average, allowing for treatment, relief and sleep. Neither study measured USU intensity. Choosing 5 rather than the dengue value 3 or chikungunya value 4 is a model judgment, not a demonstrated clinical ratio. [S14, S15]", "excludes": "Incubation without symptoms, persistent post-Ebola symptoms, caregiver distress, bereavement, unconfirmed or unreported illness, and post-death loss. Individual severity and time to death or recovery are not reconstructed.", "lowDays": 7, "lowIntensity": 3, "highDays": 21, "highIntensity": 7, "profileVersion": "1.0" }, { "id": "EBO-F", "name": "Bundibugyo Ebola: fatal illness", "days": 12, "intensity": 6, "durationBasis": "We select 12 days between the historical median onset-to-death durations of 9 days in Uganda and 15 days in Isiro. It represents the complete symptomatic course ending at death, not an extra terminal period. It is not a pooled mean or an observed 2026 average; the studies were small and treatment settings differed. [S14, S15]", "intensityBasis": "We assign intensity 6 as a combined time-average of pain and other acute distress over the whole fatal course, including relief, sleep and intervals without experience. This is a provisional judgment above the existing value 5, not a measured USU mapping. Concurrent symptoms are represented together and are not added again. No intensity is assigned after death or to known absence of experience. [S14, S15]", "excludes": "Incubation without symptoms, caregiver distress, bereavement, death itself, lost life years and suffering after death. Individual trajectories and conscious time are not measured.", "lowDays": 9, "lowIntensity": 6, "highDays": 15, "highIntensity": 6, "profileVersion": "1.0", "sensitivity": [ { "label": "Shorter fatal course", "days": 9, "intensity": 6 }, { "label": "Central assumption", "days": 12, "intensity": 6 }, { "label": "Longer fatal course", "days": 15, "intensity": 6 }, { "label": "Lower fatal intensity", "days": 12, "intensity": 5 }, { "label": "Higher fatal intensity", "days": 12, "intensity": 7 } ] }, { "id": "DEN-F", "profileVersion": "1.0", "name": "Dengue: fatal illness", "days": 7, "intensity": 5, "durationBasis": "Seven days is a provisional representative course from symptom onset to death. A Puerto Rico series of 58 fatal laboratory-positive cases reported a median of 7.1 days; in a Malaysian review of 322 deaths, 66.5% occurred on illness days 4-7. A Singapore series of 28 adults reported a longer median of 12 days. These differing populations support testing alternatives. Seven days is our choice, not a pooled mean or an observed average for the listed outbreaks. [S18, S19, S20]", "intensityBasis": "We assign intensity 5 as one combined average for pain and other experienced distress throughout the fatal illness. Clinical descriptions of abdominal pain, vomiting and breathing difficulty motivate testing a higher average than the ordinary value 3. The exact value 5 and its ratio to 3 are judgments, not measured USU conversions. This elapsed-time average allows for earlier milder illness, treatment, relief, sleep and periods without experience; it is not a constant severe-pain score. [S17]", "excludes": "Incubation without symptoms, death itself, lost life years, caregiver distress, bereavement and suffering after death. Individual symptom and consciousness trajectories are not measured; no extra terminal period is added.", "lowDays": 5, "lowIntensity": 5, "highDays": 12, "highIntensity": 5, "sensitivity": [ { "label": "Shorter fatal course", "days": 5, "intensity": 5 }, { "label": "Central assumption", "days": 7, "intensity": 5 }, { "label": "Longer fatal course", "days": 12, "intensity": 5 }, { "label": "Lower fatal intensity", "days": 7, "intensity": 4 }, { "label": "Higher fatal intensity", "days": 7, "intensity": 6 } ] }, { "id": "CHIK-F", "profileVersion": "1.0", "name": "Chikungunya: attributable fatal illness", "days": 28, "intensity": 5, "durationBasis": "A Ceará, Brazil series reported a mean onset-to-death interval of 28 days and a median of 15 days across 245 laboratory-confirmed deaths. We borrow the mean for this simple aggregate model. It includes later deaths and is not a measured Paraguay average. Differences in ages, care and death attribution limit transferability. The course represents the complete symptomatic illness ending at death, not an extra terminal period. [S21]", "intensityBasis": "We assign intensity 5 as a combined elapsed-time average, above the ordinary value 4. A Paraguay adult ICU study describes fever, gastrointestinal symptoms and neurological involvement, but does not measure USU intensity or a complete onset-to-death course. The exact value and 5:4 ratio are judgments, allowing for relief, sleep and intervals without experience. This is not a constant conscious pain score. No suffering is assigned after death. [S22]", "excludes": "Death itself, lost life years, caregiver distress, bereavement and suffering after death. No separate joint-pain or terminal-period allowance is added. Age-specific courses, symptom-free intervals and consciousness histories are not reconstructed.", "lowDays": 15, "lowIntensity": 5, "highDays": 42, "highIntensity": 5, "sensitivity": [ { "label": "Shorter course using the Brazilian median", "days": 15, "intensity": 5 }, { "label": "Central assumption using the Brazilian mean", "days": 28, "intensity": 5 }, { "label": "Longer course, an author-selected stress test", "days": 42, "intensity": 5 }, { "label": "Lower fatal intensity", "days": 28, "intensity": 4 }, { "label": "Higher fatal intensity", "days": 28, "intensity": 6 } ] }, { "id": "SAM-T", "name": "Treated severe acute malnutrition: early illness and recovery", "profileVersion": "1.0", "days": 42, "intensity": 2, "lowDays": 28, "lowIntensity": 1, "highDays": 56, "highIntensity": 3, "durationBasis": "We assign a six-week course after admission. Historical outpatient programmes in South Sudan, a different country, reported 2021 mean stays of 42.3, 43.2 and 46.3 days under three adapted protocols. These provide context for a multiweek window. Forty-two days is our rounded choice, not measured suffering duration in Sudan in 2026. Nutritional treatment can continue after clinical improvement; pre-admission suffering is excluded. [S26, S27]", "intensityBasis": "Malnutrition can involve physical discomfort, digestive problems and irritability, while children eligible for outpatient care may have good appetite and no acute problems requiring hospital care. We assign 2 as a combined average across people and elapsed time, including improvement, relief, sleep and intervals without experience. The value is below the ordinary dengue value 3 because this course averages over a longer recovery window. Both the value and this comparison are judgments, not validated ratios to kidney-stone pain. Concurrent symptoms are bundled once. [S27, S28]", "excludes": "Suffering before treatment admission, untreated children, moderate malnutrition, later or recurrent episodes outside the selected courses, long-term developmental harm, separate infection or injury burdens, broader conflict and displacement distress, caregiver distress, bereavement, death itself, lost life years and suffering after death." } ], "events": [ { "id": "E01", "name": "Brazil dengue outbreak", "short": "Brazil dengue", "period": "2024, epidemiological weeks 1-23", "count": 7866769, "unit": "reported cases", "profile": "DEN", "source": "S1", "scope": "Acute dengue illness partitioned into reported fatal cases and other reported cases", "countBasis": "PAHO/WHO, 18 June 2024, p. 6: 7,866,769 reported cases through EW 23. The regional surveillance series includes suspected cases; this is not a laboratory-confirmed-only count. No correction for missed or misclassified cases is applied.", "deaths": "3,643 reported fatal cases are used within the 7,866,769-case population to select a complete fatal illness course. Those cases are removed from the ordinary group, and the death count remains separately visible.", "cardNote": "Two shared dengue courses, with one course per case. Reported deaths identify the fatal group; death itself and bereavement are not assigned USU.", "slug": "brazil-dengue-2024", "location": "Brazil", "category": "Disease outbreak", "periodShort": "2024 · weeks 1–23", "dateKey": 20240608, "scopeShort": "Acute illness, including fatal cases", "deathCount": 3643, "deathNote": "Same reporting period", "countShort": "7.87 million", "unitShort": "reported cases", "included": "One complete acute illness course per reported case, combining pain and other acute distress. The 3,643 cases reported dead receive a seven-day, intensity-5 fatal course; the other 7,863,126 cases retain the five-day, intensity-3 assumption. Other cases include unresolved outcomes and severe cases not reported dead. They are not all known survivors or mild cases.", "takeaway": "About 59,974,296 USU is assigned to 7,866,769 reported cases in this snapshot. The estimate combines an ordinary acute course for 7,863,126 other reported cases with a complete fatal illness course for 3,643 reported deaths. All four dengue entries use the same two courses. Source coverage and the number of cases in each group still differ.", "related": "/events/methodology/#profile-den-f", "relatedTitle": "The shared fatal dengue course", "fatalCaseModel": { "profile": "DEN-F", "introducedInVersion": "0.5", "comparisonVersion": "0.4", "eligibilityStatus": "eligible", "eligibilityBasis": "PAHO country detail on page 6 reports 7,866,769 cases and 3,643 fatal cases through EW 23 of 2024, with the fatality rate using that case population. [S1]" }, "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each reported case receives exactly one course.", "coverageNote": "Fatal-case duration comes from historical studies in other settings, not measurements in this outbreak. The average intensity is an author-selected assumption. Clinical severity and conscious time are not reconstructed; persistent symptoms remain unestimated.", "components": [ { "id": "other-cases", "label": "Other reported cases", "count": 7863126, "profile": "DEN", "days": 5, "intensity": 3, "usuPerCourse": 7.619047619047619, "estimatedUSU": 59909531.428571425 }, { "id": "fatal-cases", "label": "Reported fatal cases", "count": 3643, "profile": "DEN-F", "days": 7, "intensity": 5, "usuPerCourse": 17.77777777777778, "estimatedUSU": 64764.444444444445 } ], "estimatedUSU": 59974295.87301587, "usuPerCourse": 7.6237519969146, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 59937287.61904762, "changeUSU": 37008.25396825373, "changePercent": 0.06174495950412809, "removedOrdinaryUSU": 27756.190476190477, "fatalSensitivity": [ { "label": "Shorter fatal course", "days": 5, "intensity": 5, "estimatedUSU": 59955791.746031746 }, { "label": "Central assumption", "days": 7, "intensity": 5, "estimatedUSU": 59974295.87301587 }, { "label": "Longer fatal course", "days": 12, "intensity": 5, "estimatedUSU": 60020556.19047619 }, { "label": "Lower fatal intensity", "days": 7, "intensity": 4, "estimatedUSU": 59961342.98412698 }, { "label": "Higher fatal intensity", "days": 7, "intensity": 6, "estimatedUSU": 59987248.76190476 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 3643, "treatment": "replacement", "basis": "PAHO country detail on page 6 reports 7,866,769 cases and 3,643 fatal cases through EW 23 of 2024, with the fatality rate using that case population. [S1]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E02", "name": "Rio Grande do Sul floods", "short": "Rio Grande do Sul floods", "period": "2024, displaced cohort reported 24 May", "count": 580000, "unit": "people displaced (approx.)", "profile": "DIS", "source": "S5", "scope": "Initial distress assigned to a reported displaced cohort", "countBasis": "UNHCR spokesperson, UN Geneva briefing, 24 May 2024: approximately 580,000 displaced people. The estimate uses the specific spoken figure rather than the rounded 600,000 headline. This is a dated population estimate, not new displacement episodes, an average daily population, or a final event total. People in shelters are a subset of this displaced cohort and are not added again.", "deaths": "163 deaths were cited in the 24 May briefing about floods and landslides. The source does not establish how many involved drowning or whether any selected suffering overlaps with the displacement allowance.", "cardNote": "30 days is an assumed course for the selected cohort, not measured person-time or the full flood burden.", "slug": "rio-grande-do-sul-floods-2024", "location": "Rio Grande do Sul, Brazil", "category": "Natural disaster", "periodShort": "24 May 2024 · cohort snapshot", "dateKey": 20240524, "scopeShort": "Initial displacement distress", "deathCount": 163, "deathNote": "Whole flood event, as of 24 May", "countShort": "About 580,000", "unitShort": "displaced people", "included": "One initial distress course for each person in the reported displaced cohort, combining anxiety, sadness and disrupted daily life.", "takeaway": "The model assigns about 30.5 USU per displaced person over an assumed 30-day course. Duration drives much of the estimate: a modest average intensity can accumulate over several weeks. This is a scenario for the named cohort; the source did not track each person for 30 days.", "related": "/reports/displacement-is-not-one-number/", "relatedTitle": "Displacement is not one number: understanding stocks and movements", "illustrativeFatalScenario": { "status": "Illustrative only; excluded from event estimatedUSU", "mechanism": "Conscious drowning experience", "minutes": 3, "intensity": 8, "eligibleCount": null, "actualAdditionalUSU": null, "revisedEventUSU": null, "hypotheticalCount": 163, "noOverlapAssumedForIllustration": true, "source": "S16", "countSource": "S5", "durationBasis": "Author-selected rounded three-minute window informed by surface struggle and time to unconsciousness; not a measured average for these deaths.", "intensityBasis": "Author-selected combined intensity 8 for air hunger, fear and pain; not an empirically established USU mapping.", "excluded": "Other fatal mechanisms, anticipation or entrapment before the selected window, injury outside it, later conscious suffering after resuscitation, and bereavement.", "hypotheticalUSUPerCourse": 0.008465608465608466, "hypotheticalAdditionalUSU": 1.37989417989418 }, "fatalSufferingReview": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The 24 May 2024 briefing reports 163 deaths across floods and landslides, without a cause-specific count aligned to its displaced population. A later official review covers 47 deaths in 14 Vale do Taquari municipalities, reporting 17% drowning, 32% burial and 51% trauma. Those regional percentages cannot be applied to the statewide 163-death snapshot, and they do not establish overlap with its displacement allowance. [S5, S23]", "nextRequirement": "A dated count for a specified fatal mechanism, its relation to this event snapshot, and a clear separation from the experience already included. A short representative course could then be assigned without reconstructing every person’s history.", "blockers": [ "mechanism_count", "snapshot_alignment", "overlap" ] }, "components": [ { "id": "included-course", "label": "Initial displacement distress", "count": 580000, "profile": "DIS", "days": 30, "intensity": 2, "usuPerCourse": 30.476190476190474, "estimatedUSU": 17676190.476190474 } ], "aggregation": "One representative course per source-defined case or person.", "estimatedUSU": 17676190.476190474, "usuPerCourse": 30.47619047619047, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "fatalSufferingCoverage": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The 24 May 2024 briefing reports 163 deaths across floods and landslides, without a cause-specific count aligned to its displaced population. A later official review covers 47 deaths in 14 Vale do Taquari municipalities, reporting 17% drowning, 32% burial and 51% trauma. Those regional percentages cannot be applied to the statewide 163-death snapshot, and they do not establish overlap with its displacement allowance. [S5, S23]", "nextRequirement": "A dated count for a specified fatal mechanism, its relation to this event snapshot, and a clear separation from the experience already included. A short representative course could then be assigned without reconstructing every person’s history.", "blockers": [ "mechanism_count", "snapshot_alignment", "overlap" ], "label": "Fatal suffering unestimated", "eligibleCount": null, "treatment": null } }, { "id": "E03", "name": "Paraguay chikungunya outbreak", "short": "Paraguay chikungunya", "period": "1 October 2022 - 11 March 2023", "count": 81037, "unit": "suspected, probable or confirmed cases", "profile": "CHIK", "source": "S3", "scope": "Acute courses for other cases and complete courses for CHIKV-attributable fatal cases", "countBasis": "Torales et al., CDC MMWR, 9 June 2023: 81,037 suspected, probable or confirmed cases during 1 October 2022-11 March 2023. Discarded negative-tested cases are excluded by the source. This is an interim outbreak count, not the final 2023 total.", "deaths": "52 CHIKV-attributable deaths among 47,116 probable or confirmed cases within the broader 81,037-case total. The death count remains separate from USU and identifies the cases receiving a complete fatal course.", "cardNote": "Other cases retain an eight-day acute course; the 52 attributable fatal cases receive one complete 28-day course. Persistent joint symptoms beyond assigned courses remain unestimated.", "slug": "paraguay-chikungunya-2022-2023", "location": "Paraguay", "category": "Disease outbreak", "periodShort": "1 Oct 2022 – 11 Mar 2023", "dateKey": 20230311, "scopeShort": "Acute illness and fatal courses", "deathCount": 52, "deathNote": "Attributable; probable / confirmed subset", "countShort": "81,037", "unitShort": "reported cases", "included": "80,985 other cases receive an eight-day course at intensity 4. The 52 CHIKV-attributable fatal cases receive a complete 28-day course at intensity 5 in place of that allowance. Concurrent symptoms are combined, and each case receives one course.", "takeaway": "The estimate is about 1.32 million USU. Most comes from the ordinary acute courses; the separate fatal course changes the previous estimate by about 0.22%. This modest change reflects the small selected fatal group, not the importance of the lives lost.", "related": "/usu-research/", "relatedTitle": "Explore the USU research background", "coverageNote": "The fatal course is provisional and borrowed from another setting. Paraguay’s 52 attributable deaths include eight neonates and 32 adults aged 60 or older. One shared course simplifies these very different experiences; it is not validated for each age group. Persistent joint symptoms outside the assigned courses remain unestimated.", "aggregation": "One course per case: ordinary acute allowance for count minus the attributable death count, plus a complete fatal course for the selected attributable deaths. No extrapolation from the mortality subset.", "fatalCaseModel": { "profile": "CHIK-F", "introducedInVersion": "0.6", "comparisonVersion": "0.5", "eligibilityStatus": "eligible", "mortalitySubsetCount": 47116, "fatalLabel": "CHIKV-attributable fatal cases", "otherLabel": "Other cases in the reported total", "otherCaseMeaning": "“Other” means cases outside the selected attributable fatal group. It includes unresolved outcomes and cases whose deaths were assigned another cause; it does not mean known survivors or mild cases. We do not infer additional deaths from the subset.", "eligibilityBasis": "MMWR places 52 CHIKV-attributable deaths within 47,116 probable or confirmed cases, themselves part of the 81,037 suspected, probable or confirmed cases reported through 11 March 2023. We replace the allowance for those 52 only. Deaths attributed to other causes and deaths pending review do not receive this replacement. The report does not provide one complete all-age count for those other categories. No fatality rate is extrapolated to suspected cases. [S3]" }, "components": [ { "id": "other-cases", "label": "Other cases in the reported total", "count": 80985, "profile": "CHIK", "days": 8, "intensity": 4, "usuPerCourse": 16.253968253968253, "estimatedUSU": 1316327.619047619 }, { "id": "fatal-cases", "label": "CHIKV-attributable fatal cases", "count": 52, "profile": "CHIK-F", "days": 28, "intensity": 5, "usuPerCourse": 71.11111111111111, "estimatedUSU": 3697.777777777778 } ], "estimatedUSU": 1320025.3968253967, "usuPerCourse": 16.28916910578374, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 1317172.8253968253, "changeUSU": 2852.571428571362, "changePercent": 0.21656774066166803, "removedOrdinaryUSU": 845.2063492063492, "fatalSensitivity": [ { "label": "Shorter course using the Brazilian median", "days": 15, "intensity": 5, "estimatedUSU": 1318308.5714285714 }, { "label": "Central assumption using the Brazilian mean", "days": 28, "intensity": 5, "estimatedUSU": 1320025.3968253967 }, { "label": "Longer course, an author-selected stress test", "days": 42, "intensity": 5, "estimatedUSU": 1321874.2857142857 }, { "label": "Lower fatal intensity", "days": 28, "intensity": 4, "estimatedUSU": 1319285.8412698412 }, { "label": "Higher fatal intensity", "days": 28, "intensity": 6, "estimatedUSU": 1320764.9523809522 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 52, "treatment": "replacement", "basis": "MMWR places 52 CHIKV-attributable deaths within 47,116 probable or confirmed cases, themselves part of the 81,037 suspected, probable or confirmed cases reported through 11 March 2023. We replace the allowance for those 52 only. Deaths attributed to other causes and deaths pending review do not receive this replacement. The report does not provide one complete all-age count for those other categories. No fatality rate is extrapolated to suspected cases. [S3]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E04", "name": "Peru dengue outbreak", "short": "Peru dengue", "period": "2024, epidemiological weeks 1-23", "count": 249843, "unit": "reported cases", "profile": "DEN", "source": "S1", "scope": "Acute dengue illness partitioned into reported fatal cases and other reported cases", "countBasis": "PAHO/WHO, 18 June 2024, p. 4: 249,843 reported cases through EW 23. The Andean series is described as suspected cases. No correction for missed or misclassified cases is applied.", "deaths": "207 reported fatal cases are used within the 249,843-case population to select a complete fatal illness course. Those cases are removed from the ordinary group, and the death count remains separately visible. The country detail uses 207 deaths; the same source summary uses 203. The main calculation retains 207, and the report shows the effect of the alternative figure.", "cardNote": "Two shared dengue courses, with one course per case. Reported deaths identify the fatal group; death itself and bereavement are not assigned USU.", "slug": "peru-dengue-2024", "location": "Peru", "category": "Disease outbreak", "periodShort": "2024 · weeks 1–23", "dateKey": 20240608, "scopeShort": "Acute illness, including fatal cases", "deathCount": 207, "deathNote": "Source discrepancy: summary says 203", "countShort": "249,843", "unitShort": "reported cases", "included": "One complete acute illness course per reported case, combining pain and other acute distress. The 207 cases reported dead receive a seven-day, intensity-5 fatal course; the other 249,636 cases retain the five-day, intensity-3 assumption. Other cases include unresolved outcomes and severe cases not reported dead. They are not all known survivors or mild cases.", "takeaway": "About 1,905,669 USU is assigned to 249,843 reported cases in this snapshot. The estimate combines an ordinary acute course for 249,636 other reported cases with a complete fatal illness course for 207 reported deaths. All four dengue entries use the same two courses. Source coverage and the number of cases in each group still differ.", "related": "/events/methodology/#profile-den-f", "relatedTitle": "The shared fatal dengue course", "fatalCaseModel": { "profile": "DEN-F", "introducedInVersion": "0.5", "comparisonVersion": "0.4", "eligibilityStatus": "eligible", "eligibilityBasis": "PAHO country detail on page 4 reports 249,843 cases and 207 fatal cases through EW 23 of 2024. Its 0.083% case-fatality rate matches 207 divided by 249,843. We retain this country detail over the conflicting summary figure of 203. [S1]" }, "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each reported case receives exactly one course.", "coverageNote": "Fatal-case duration comes from historical studies in other settings, not measurements in this outbreak. The average intensity is an author-selected assumption. Clinical severity and conscious time are not reconstructed; persistent symptoms remain unestimated.", "alternativeDeathCounts": [ { "count": 203, "basis": "PAHO summary on page 1, contrasted with country detail on page 4. [S1]", "estimatedUSU": 1905627.9365079366, "changeFromMainUSU": -40.63492063479498 } ], "components": [ { "id": "other-cases", "label": "Other reported cases", "count": 249636, "profile": "DEN", "days": 5, "intensity": 3, "usuPerCourse": 7.619047619047619, "estimatedUSU": 1901988.5714285714 }, { "id": "fatal-cases", "label": "Reported fatal cases", "count": 207, "profile": "DEN-F", "days": 7, "intensity": 5, "usuPerCourse": 17.77777777777778, "estimatedUSU": 3680.0 } ], "estimatedUSU": 1905668.5714285714, "usuPerCourse": 7.627464333315608, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 1903565.7142857143, "changeUSU": 2102.857142857043, "changePercent": 0.11046937476734865, "removedOrdinaryUSU": 1577.142857142857, "fatalSensitivity": [ { "label": "Shorter fatal course", "days": 5, "intensity": 5, "estimatedUSU": 1904617.1428571427 }, { "label": "Central assumption", "days": 7, "intensity": 5, "estimatedUSU": 1905668.5714285714 }, { "label": "Longer fatal course", "days": 12, "intensity": 5, "estimatedUSU": 1908297.1428571427 }, { "label": "Lower fatal intensity", "days": 7, "intensity": 4, "estimatedUSU": 1904932.5714285714 }, { "label": "Higher fatal intensity", "days": 7, "intensity": 6, "estimatedUSU": 1906404.5714285714 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 207, "treatment": "replacement", "basis": "PAHO country detail on page 4 reports 249,843 cases and 207 fatal cases through EW 23 of 2024. Its 0.083% case-fatality rate matches 207 divided by 249,843. We retain this country detail over the conflicting summary figure of 203. [S1]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E05", "name": "Bangladesh dengue outbreak", "short": "Bangladesh dengue", "period": "1 January – 7 August 2023", "count": 69483, "unit": "laboratory-confirmed cases", "profile": "DEN", "source": "S9", "scope": "Acute dengue illness partitioned into reported fatal cases and other reported cases", "countBasis": "WHO reported 69,483 laboratory-confirmed cases from 1 January to 7 August 2023. The surveillance system is hospital-based. This is an interim snapshot, not a full-year count or an estimate of all infections.", "deaths": "327 reported fatal cases are used within the 69,483-case population to select a complete fatal illness course. Those cases are removed from the ordinary group, and the death count remains separately visible.", "cardNote": "Two shared dengue courses, with one course per case. Reported deaths identify the fatal group; death itself and bereavement are not assigned USU.", "slug": "bangladesh-dengue-2023", "location": "Bangladesh", "category": "Disease outbreak", "periodShort": "1 Jan – 7 Aug 2023", "dateKey": 20230807, "scopeShort": "Acute illness, including fatal cases", "deathCount": 327, "deathNote": "Same reporting period", "countShort": "69,483", "unitShort": "lab-confirmed cases", "included": "One complete acute illness course per reported case, combining pain and other acute distress. The 327 cases reported dead receive a seven-day, intensity-5 fatal course; the other 69,156 cases retain the five-day, intensity-3 assumption. Other cases include unresolved outcomes and severe cases not reported dead. They are not all known survivors or mild cases.", "takeaway": "About 532,716 USU is assigned to 69,483 reported cases in this snapshot. The estimate combines an ordinary acute course for 69,156 other reported cases with a complete fatal illness course for 327 reported deaths. All four dengue entries use the same two courses. Source coverage and the number of cases in each group still differ. This is a hospital-based, laboratory-confirmed snapshot, not the full outbreak burden.", "related": "/events/methodology/#profile-den-f", "relatedTitle": "The shared fatal dengue course", "fatalCaseModel": { "profile": "DEN-F", "introducedInVersion": "0.5", "comparisonVersion": "0.4", "eligibilityStatus": "eligible", "eligibilityBasis": "WHO explicitly reports 69,483 cases including 327 related deaths from 1 January to 7 August 2023, within the same hospital-based surveillance snapshot. [S9]" }, "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each reported case receives exactly one course.", "coverageNote": "Fatal-case duration comes from historical studies in other settings, not measurements in this outbreak. The average intensity is an author-selected assumption. Clinical severity and conscious time are not reconstructed; persistent symptoms remain unestimated.", "components": [ { "id": "other-cases", "label": "Other reported cases", "count": 69156, "profile": "DEN", "days": 5, "intensity": 3, "usuPerCourse": 7.619047619047619, "estimatedUSU": 526902.8571428572 }, { "id": "fatal-cases", "label": "Reported fatal cases", "count": 327, "profile": "DEN-F", "days": 7, "intensity": 5, "usuPerCourse": 17.77777777777778, "estimatedUSU": 5813.333333333334 } ], "estimatedUSU": 532716.1904761905, "usuPerCourse": 7.666856504126053, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 529394.2857142857, "changeUSU": 3321.9047619048506, "changePercent": 0.6274916166544503, "removedOrdinaryUSU": 2491.4285714285716, "fatalSensitivity": [ { "label": "Shorter fatal course", "days": 5, "intensity": 5, "estimatedUSU": 531055.2380952381 }, { "label": "Central assumption", "days": 7, "intensity": 5, "estimatedUSU": 532716.1904761905 }, { "label": "Longer fatal course", "days": 12, "intensity": 5, "estimatedUSU": 536868.5714285715 }, { "label": "Lower fatal intensity", "days": 7, "intensity": 4, "estimatedUSU": 531553.5238095238 }, { "label": "Higher fatal intensity", "days": 7, "intensity": 6, "estimatedUSU": 533878.8571428572 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 327, "treatment": "replacement", "basis": "WHO explicitly reports 69,483 cases including 327 related deaths from 1 January to 7 August 2023, within the same hospital-based surveillance snapshot. [S9]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E06", "name": "Pakistan floods", "short": "Pakistan floods", "period": "2022 floods, displaced population reported 7 October", "count": 7900000, "unit": "people displaced (approx.)", "profile": "DIS", "source": "S10", "scope": "Initial distress assigned to a reported displaced cohort", "countBasis": "UNHCR’s 7 October 2022 briefing reported approximately 7.9 million people displaced. We assign one initial course to that source-defined population. It is not measured person-time or a count of new daily movements. The nearly 600,000 people in relief sites are a subset and are not added again.", "deaths": "At least 1,700 deaths were cited in the 7 October briefing for the flood event as a whole. This is a reported threshold, not an exact final death count; it is separate from USU.", "cardNote": "30 days is an assumed course for the selected cohort, not measured person-time or the full flood burden.", "slug": "pakistan-floods-2022", "location": "Pakistan", "category": "Natural disaster", "periodShort": "7 Oct 2022 · population snapshot", "dateKey": 20221007, "scopeShort": "Initial displacement distress", "deathCount": 1700, "deathNote": "Whole flood event, as reported 7 Oct", "countShort": "About 7.9 million", "unitShort": "displaced people", "included": "One initial distress course for each person in the reported displaced cohort, combining anxiety, sadness and disrupted daily life.", "takeaway": "Applying the same initial displacement course used for Rio Grande do Sul gives about 30.5 USU per person. The large population drives the result. Injury, disease and lasting psychological effects remain outside this estimate; 30 days is assumed, not observed follow-up.", "related": "/reports/displacement-is-not-one-number/", "relatedTitle": "Displacement is not one number: understanding stocks and movements", "deathDisplay": "At least 1,700", "fatalSufferingReview": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The selected UNHCR briefing reports at least 1,700 deaths for the whole flood event and about 7.9 million displaced people. It does not separate the deaths by mechanism or link them to the modeled displacement course. The mortality threshold is not an eligible drowning count. [S10, S24]", "nextRequirement": "A source-aligned count for a specified fatal mechanism and an explicit overlap decision. Any addition would cover only that defined experience; it would not convert the entire death toll into one generic course.", "blockers": [ "mechanism_count", "overlap" ] }, "components": [ { "id": "included-course", "label": "Initial displacement distress", "count": 7900000, "profile": "DIS", "days": 30, "intensity": 2, "usuPerCourse": 30.476190476190474, "estimatedUSU": 240761904.76190475 } ], "aggregation": "One representative course per source-defined case or person.", "estimatedUSU": 240761904.76190475, "usuPerCourse": 30.476190476190474, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "fatalSufferingCoverage": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The selected UNHCR briefing reports at least 1,700 deaths for the whole flood event and about 7.9 million displaced people. It does not separate the deaths by mechanism or link them to the modeled displacement course. The mortality threshold is not an eligible drowning count. [S10, S24]", "nextRequirement": "A source-aligned count for a specified fatal mechanism and an explicit overlap decision. Any addition would cover only that defined experience; it would not convert the entire death toll into one generic course.", "blockers": [ "mechanism_count", "overlap" ], "label": "Fatal suffering unestimated", "eligibleCount": null, "treatment": null } }, { "id": "E07", "name": "Mexico dengue outbreak", "short": "Mexico dengue", "period": "2024, epidemiological weeks 1-23", "count": 83997, "unit": "reported cases", "profile": "DEN", "source": "S1", "scope": "Acute dengue illness partitioned into reported fatal cases and other reported cases", "countBasis": "PAHO/WHO, 18 June 2024, pp. 2–3: 83,997 reported cases through EW 23. The regional surveillance series includes suspected cases; it is not laboratory-confirmed only. No correction for missed or misclassified cases is applied.", "deaths": "26 reported fatal cases are used within the 83,997-case population to select a complete fatal illness course. Those cases are removed from the ordinary group, and the death count remains separately visible.", "cardNote": "Two shared dengue courses, with one course per case. Reported deaths identify the fatal group; death itself and bereavement are not assigned USU.", "slug": "mexico-dengue-2024", "location": "Mexico", "category": "Disease outbreak", "periodShort": "2024 · weeks 1–23", "dateKey": 20240608, "scopeShort": "Acute illness, including fatal cases", "deathCount": 26, "deathNote": "Same reporting period", "countShort": "83,997", "unitShort": "reported cases", "included": "One complete acute illness course per reported case, combining pain and other acute distress. The 26 cases reported dead receive a seven-day, intensity-5 fatal course; the other 83,971 cases retain the five-day, intensity-3 assumption. Other cases include unresolved outcomes and severe cases not reported dead. They are not all known survivors or mild cases.", "takeaway": "About 640,241 USU is assigned to 83,997 reported cases in this snapshot. The estimate combines an ordinary acute course for 83,971 other reported cases with a complete fatal illness course for 26 reported deaths. All four dengue entries use the same two courses. Source coverage and the number of cases in each group still differ.", "related": "/events/methodology/#profile-den-f", "relatedTitle": "The shared fatal dengue course", "fatalCaseModel": { "profile": "DEN-F", "introducedInVersion": "0.5", "comparisonVersion": "0.4", "eligibilityStatus": "eligible", "eligibilityBasis": "PAHO country detail across pages 2-3 reports 83,997 cases and 26 fatal cases through EW 23 of 2024, with a corresponding case-fatality rate of 0.031%. [S1]" }, "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each reported case receives exactly one course.", "coverageNote": "Fatal-case duration comes from historical studies in other settings, not measurements in this outbreak. The average intensity is an author-selected assumption. Clinical severity and conscious time are not reconstructed; persistent symptoms remain unestimated.", "components": [ { "id": "other-cases", "label": "Other reported cases", "count": 83971, "profile": "DEN", "days": 5, "intensity": 3, "usuPerCourse": 7.619047619047619, "estimatedUSU": 639779.0476190476 }, { "id": "fatal-cases", "label": "Reported fatal cases", "count": 26, "profile": "DEN-F", "days": 7, "intensity": 5, "usuPerCourse": 17.77777777777778, "estimatedUSU": 462.22222222222223 } ], "estimatedUSU": 640241.2698412698, "usuPerCourse": 7.622192100209172, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 639977.1428571428, "changeUSU": 264.1269841269823, "changePercent": 0.04127131524538546, "removedOrdinaryUSU": 198.0952380952381, "fatalSensitivity": [ { "label": "Shorter fatal course", "days": 5, "intensity": 5, "estimatedUSU": 640109.2063492063 }, { "label": "Central assumption", "days": 7, "intensity": 5, "estimatedUSU": 640241.2698412698 }, { "label": "Longer fatal course", "days": 12, "intensity": 5, "estimatedUSU": 640571.4285714285 }, { "label": "Lower fatal intensity", "days": 7, "intensity": 4, "estimatedUSU": 640148.8253968253 }, { "label": "Higher fatal intensity", "days": 7, "intensity": 6, "estimatedUSU": 640333.7142857142 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 26, "treatment": "replacement", "basis": "PAHO country detail across pages 2-3 reports 83,997 cases and 26 fatal cases through EW 23 of 2024, with a corresponding case-fatality rate of 0.031%. [S1]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E08", "name": "Rasuwa floods, Nepal", "short": "Nepal floods", "period": "26 August 2026 floods; displacement-site population in the 4-9 September situation report", "count": 3629, "unit": "people in 37 displacement sites", "profile": "DIS", "source": "S11", "scope": "Initial distress assigned to the reported displacement-site cohort", "countBasis": "UNFPA Nepal reported 3,629 people in 37 displacement sites in its 4-9 September 2026 situation report. We use that fixed site population, not the much broader affected population, all people ever displaced, or a cumulative count of movements. The source does not measure person-days; a standard course is assigned to the selected cohort. Later changes in site occupancy do not revise this dated snapshot.", "deaths": "The same report gives 1,367 confirmed deaths across the broader flood event. These are not deaths among the selected 3,629 site residents. Missing people are not added to the death count; mortality is separate from USU.", "cardNote": "Only people in the reported displacement sites are modeled. It is not an estimate for everyone affected by the floods.", "slug": "nepal-rasuwa-floods-2026", "location": "Rasuwa flood response, Nepal", "category": "Natural disaster", "periodShort": "4–9 Sep 2026 · site snapshot", "dateKey": 20260909, "scopeShort": "Distress in displacement sites", "deathCount": 1367, "deathNote": "Broader flood event, same report", "countShort": "3,629", "unitShort": "people in 37 sites", "included": "One initial distress course for each person in the reported displacement-site cohort, using the same duration and intensity as the other flood entries. People staying outside these sites are outside the calculation.", "takeaway": "The shared flood template gives about 30.5 USU per person, or about 111,000 USU for this site population. The scope is narrow: it covers distress assigned to the 3,629 people in the reported displacement sites, not the full human impact of the floods.", "coverageNote": "This estimate covers the reported site residents only. A smaller result than another flood entry can reflect narrower population coverage, not a less severe disaster.", "related": "/reports/displacement-is-not-one-number/", "relatedTitle": "Displacement is not one number: understanding stocks and movements", "heroScope": "Initial distress among people living in 37 reported displacement sites.", "fatalSufferingReview": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The 1,367 deaths refer to the broader flood event, while this estimate covers 3,629 residents of 37 displacement sites. The report does not identify fatal cases within that site cohort or supply a cause-specific count for a separately defined fatal experience. Subtracting the broader death toll from site residents would mix populations. [S11]", "nextRequirement": "Define the fatal-experience population separately and obtain a dated mechanism-specific count. Any broader addition would need a visible scope change and an overlap check, rather than treating site residents as an illness case total.", "blockers": [ "population_mismatch", "mechanism_count", "overlap" ] }, "components": [ { "id": "included-course", "label": "Distress in displacement sites", "count": 3629, "profile": "DIS", "days": 30, "intensity": 2, "usuPerCourse": 30.476190476190474, "estimatedUSU": 110598.09523809524 } ], "aggregation": "One representative course per source-defined case or person.", "estimatedUSU": 110598.09523809524, "usuPerCourse": 30.476190476190474, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "fatalSufferingCoverage": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The 1,367 deaths refer to the broader flood event, while this estimate covers 3,629 residents of 37 displacement sites. The report does not identify fatal cases within that site cohort or supply a cause-specific count for a separately defined fatal experience. Subtracting the broader death toll from site residents would mix populations. [S11]", "nextRequirement": "Define the fatal-experience population separately and obtain a dated mechanism-specific count. Any broader addition would need a visible scope change and an overlap check, rather than treating site residents as an illness case total.", "blockers": [ "population_mismatch", "mechanism_count", "overlap" ], "label": "Fatal suffering unestimated", "eligibleCount": null, "treatment": null } }, { "id": "E09", "name": "DR Congo: Bundibugyo Ebola outbreak", "short": "DR Congo Ebola", "period": "2026 outbreak, cumulative confirmed cases through 7 September", "count": 6757, "unit": "confirmed cases", "profile": "EBO", "source": "S13", "scope": "Acute illness courses partitioned into reported fatal cases and other reported cases", "countBasis": "WHO reported 6,757 confirmed cases in DR Congo through 7 September 2026, including two cases diagnosed there and subsequently treated in Germany. We retain WHO’s country attribution. Cases reported in Uganda and France, contacts under monitoring, and suspected or unreported cases are excluded. This is a cumulative outbreak snapshot, not the number currently ill. Some outcomes were still unresolved at the cutoff.", "deaths": "WHO reported 3,267 deaths among the 6,757 confirmed cases attributed to DR Congo through 7 September 2026. These deaths identify the cases assigned a fatal illness course. They are removed from the ordinary group and are not added as extra cases. The mortality count remains visible as a separate measure.", "cardNote": "Reported fatal cases receive a complete fatal course in place of the ordinary allowance. Other cases include unresolved outcomes.", "slug": "dr-congo-ebola-2026", "location": "Democratic Republic of the Congo", "category": "Disease outbreak", "periodShort": "Through 7 Sep 2026", "dateKey": 20260907, "scopeShort": "Acute illness, including fatal cases", "deathCount": 3267, "deathNote": "Confirmed-case population", "countShort": "6,757", "unitShort": "confirmed cases", "included": "One complete acute illness course per confirmed case, combining pain, gastrointestinal symptoms and other acute distress. The 3,267 cases reported dead receive a 12-day, intensity-6 fatal course; the other 3,490 cases retain the 14-day, intensity-5 assumption. These are disjoint groups, not extra cases. Other reported cases include unresolved outcomes and are not all known survivors.", "takeaway": "About 243,568 USU is assigned to the 6,757 confirmed cases in this snapshot. The estimate combines ordinary illness allowances for 3,490 other reported cases with complete fatal illness courses for 3,267 reported deaths. This models suffering before death. It does not assign a value to death itself or to lost life years.", "coverageNote": "This template draws on small studies of earlier Bundibugyo-virus outbreaks. It does not use patient-level duration or pain measurements from the 2026 outbreak. Persistent symptoms after the acute illness are unestimated.", "related": "/events/methodology/#before-death", "relatedTitle": "How suffering before death is included", "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each confirmed case receives exactly one course.", "fatalCaseModel": { "profile": "EBO-F", "introducedInVersion": "0.4", "comparisonVersion": "0.3", "eligibilityStatus": "eligible", "eligibilityBasis": "WHO identifies the 3,267 deaths within the same 6,757 confirmed cases attributed to DR Congo through 7 September 2026. [S13]" }, "components": [ { "id": "other-cases", "label": "Other reported cases", "count": 3490, "profile": "EBO", "days": 14, "intensity": 5, "usuPerCourse": 35.55555555555556, "estimatedUSU": 124088.88888888889 }, { "id": "fatal-cases", "label": "Reported fatal cases", "count": 3267, "profile": "EBO-F", "days": 12, "intensity": 6, "usuPerCourse": 36.57142857142857, "estimatedUSU": 119478.85714285713 } ], "estimatedUSU": 243567.74603174604, "usuPerCourse": 36.04672873046412, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "previousEstimatedUSU": 240248.88888888888, "changeUSU": 3318.8571428571595, "changePercent": 1.3814245544303332, "removedOrdinaryUSU": 116160.0, "fatalSensitivity": [ { "label": "Shorter fatal course", "days": 9, "intensity": 6, "estimatedUSU": 213698.03174603175 }, { "label": "Central assumption", "days": 12, "intensity": 6, "estimatedUSU": 243567.74603174604 }, { "label": "Longer fatal course", "days": 15, "intensity": 6, "estimatedUSU": 273437.4603174603 }, { "label": "Lower fatal intensity", "days": 12, "intensity": 5, "estimatedUSU": 223654.6031746032 }, { "label": "Higher fatal intensity", "days": 12, "intensity": 7, "estimatedUSU": 263480.8888888889 } ], "fatalSufferingCoverage": { "status": "included", "label": "Includes fatal illness", "eligibleCount": 3267, "treatment": "replacement", "basis": "WHO identifies the 3,267 deaths within the same 6,757 confirmed cases attributed to DR Congo through 7 September 2026. [S13]", "nextRequirement": null, "reviewedOn": "2026-10-08" } }, { "id": "E10", "name": "Mozambique floods", "short": "Mozambique floods", "period": "January 2026 floods; accommodation-centre population as of 29 January", "count": 100730, "unit": "people in 112 temporary accommodation centres (reported as over 100,730)", "profile": "DIS", "source": "S12", "scope": "Initial distress assigned to the reported accommodation-centre cohort", "countBasis": "UNICEF Flash Update #2, published 2 February 2026, reports over 100,730 displaced people in 112 temporary accommodation centres as of 29 January. We use 100,730 as the arithmetic anchor because a more precise count is not supplied, and retain the qualifier in the displayed population. This excludes people displaced outside those centres. The broader affected population is not substituted or added. Occupancy is a dated population, not measured person-time.", "deaths": "The selected UNICEF Flash Update #2 does not supply a mortality total aligned to its 29 January population snapshot. Its external-news list is not treated as an aligned UNICEF count. Mortality therefore remains unavailable, rather than zero or a count imported from a different period or event definition.", "cardNote": "Uses the same flood course, applied to an accommodation-centre population. The source’s over qualifier is preserved.", "slug": "mozambique-floods-2026", "location": "Mozambique", "category": "Natural disaster", "periodShort": "29 Jan 2026 · centre snapshot", "dateKey": 20260129, "scopeShort": "Distress in accommodation centres", "deathCount": null, "deathDisplay": "Not available", "deathNote": "No aligned total in selected report", "countShort": "Over 100,730", "unitShort": "people in 112 centres", "included": "One initial distress course for each person represented by the 100,730-person arithmetic anchor, using the same duration and intensity as the other flood entries. People outside the selected centres are not modeled.", "takeaway": "The shared flood template gives about 30.5 USU per person. Applied to an arithmetic anchor of 100,730 centre residents, the result is about 3.1 million USU. The source reports more than that many residents; neither the exact population nor its actual duration of distress is known from this report.", "coverageNote": "This estimate covers the selected accommodation-centre population only. It is not the full flood burden, and the source’s population threshold does not make the USU result a guaranteed lower bound.", "related": "/reports/displacement-is-not-one-number/", "relatedTitle": "Displacement is not one number: understanding stocks and movements", "heroScope": "Initial distress among people living in 112 temporary accommodation centres.", "fatalSufferingReview": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The selected UNICEF report gives an accommodation-centre population as of 29 January but no mortality total aligned to that snapshot. Its list of external news headlines is not an aligned UNICEF mortality figure. Neither an eligible fatal count nor overlap with the centre cohort is established. [S12]", "nextRequirement": "An aligned mortality source, a specified fatal mechanism and its eligible count, plus a defined population and overlap decision. Missing mortality remains unavailable, not zero.", "blockers": [ "aligned_mortality_count", "mechanism_count", "overlap" ] }, "components": [ { "id": "included-course", "label": "Distress in accommodation centres", "count": 100730, "profile": "DIS", "days": 30, "intensity": 2, "usuPerCourse": 30.476190476190474, "estimatedUSU": 3069866.6666666665 } ], "aggregation": "One representative course per source-defined case or person.", "estimatedUSU": 3069866.6666666665, "usuPerCourse": 30.476190476190474, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "fatalSufferingCoverage": { "status": "not_estimated", "reviewedOn": "2026-10-08", "basis": "The selected UNICEF report gives an accommodation-centre population as of 29 January but no mortality total aligned to that snapshot. Its list of external news headlines is not an aligned UNICEF mortality figure. Neither an eligible fatal count nor overlap with the centre cohort is established. [S12]", "nextRequirement": "An aligned mortality source, a specified fatal mechanism and its eligible count, plus a defined population and overlap decision. Missing mortality remains unavailable, not zero.", "blockers": [ "aligned_mortality_count", "mechanism_count", "overlap" ], "label": "Fatal suffering unestimated", "eligibleCount": null, "treatment": null } }, { "id": "E11", "name": "Sudan: severe child malnutrition", "short": "Sudan: severe child malnutrition", "period": "Admissions reported from 1 January to 30 June 2026; full representative post-admission courses may extend beyond June", "periodShort": "Jan-Jun 2026 · treatment admissions", "dateKey": 20260630, "count": 174737, "unit": "reported admissions for severe acute malnutrition treatment", "profile": "SAM-T", "source": "S25", "additionalSources": [ "S29" ], "scope": "Representative early treatment and recovery course for reported severe acute malnutrition admissions", "scopeShort": "Early treatment and recovery", "countBasis": "UNICEF reports 174,737 severe acute malnutrition admissions in the nutrition narrative for January-June 2026. Its headline rounds this to 174,700, while its results table lists 238,099. We select the narrative figure because it agrees with the headline and the stated 28% of the annual target; this does not establish that the table is wrong. The discrepancy remains unresolved. No averaging, summing or extrapolation to untreated children is applied. The report does not establish unique-child deduplication or how repeat admissions and transfers are counted. We assume one eligible course per reported admission. The conflicting table defines its indicator as ages 6-59 months; that exact age restriction is not independently verified for the selected narrative count. [S29]", "countReview": { "status": "source_discrepancy", "label": "Provisional admission count", "basis": "The narrative gives 174,737 admissions and the headline rounds it to 174,700. The results table gives 238,099 for the same reporting period. We retain the narrative figure provisionally and show the alternative; neither averaging nor adding the counts would resolve this conflict. [S25, S29]" }, "alternativeCounts": [ { "label": "UNICEF results table", "count": 238099, "basis": "Use the results-table figure on printed p. 11, keeping the duration and intensity fixed. This is an alternative input for the same entry, not another population to add. [S25]", "estimatedUSU": 10158890.666666666, "changePercent": 36.261352775886046 } ], "deaths": "No death count aligned with these treatment admissions was identified in the reviewed report. Mortality stays unavailable. No national conflict death toll or borrowed case-fatality rate is substituted. The representative model includes admissions with unknown outcomes; it does not establish survival or actual person-time.", "cardNote": "Provisional narrative admission count. The conflicting annex count and its effect on USU are visible in the report.", "slug": "sudan-child-malnutrition-2026", "location": "Sudan", "category": "Malnutrition", "deathCount": null, "deathDisplay": "Not available", "deathNote": "No matched cohort death count", "countShort": "174,737", "unitShort": "reported treatment admissions", "included": "One representative six-week early treatment and recovery course for each reported admission. Combined experienced discomfort and associated distress are counted once, allowing for improvement and relief. The reporting dates identify admissions; complete modeled courses can extend beyond June. The number is not a calendar-period total or a full course from first onset.", "takeaway": "The working model assigns about 42.7 USU per reported admission. Applied to 174,737 admissions, it gives about 7.5 million USU. This describes a selected treatment cohort under simple assumptions, not all suffering from malnutrition or conflict in Sudan.", "coverageNote": "This provisional estimate excludes suffering before admission and children who did not receive treatment. Duration and intensity are assumptions, not measured Sudan averages. Access to treatment and reporting practices affect the count; more recorded admissions can reflect improved access rather than worsening suffering.", "related": "/series/child-wasting-2024/", "relatedTitle": "Child wasting: background statistics and definitions", "heroScope": "Early treatment and recovery among reported severe acute malnutrition admissions. Suffering before admission and untreated children are outside this estimate.", "aggregation": "One representative early course per reported admission. Unique-child deduplication and actual outcome-specific person-time are not established.", "fatalSufferingReview": { "status": "not_estimated", "reviewedOn": "2026-10-08", "scopeNote": "This estimate assigns a representative early treatment and recovery course to admissions with unknown outcomes. A separate fatal course is unestimated; this does not establish zero deaths, survival or actual person-time for each child.", "basis": "No matched death count or outcome breakdown for the selected admission cohort was identified in the reviewed UNICEF report. We do not import a national war death toll or estimate deaths from a case-fatality rate borrowed from another population. [S25]", "nextRequirement": "A death count aligned with the selected admissions, plus evidence for the corresponding admission-to-death course. Replace the ordinary allowance for those cases, keeping the same post-admission time scope; never add a terminal period on top. Suffering before admission would require a separately defined extension.", "blockers": [ "aligned_mortality_count", "matched_fatal_course" ] }, "components": [ { "id": "included-course", "label": "Early treatment and recovery", "count": 174737, "profile": "SAM-T", "days": 42, "intensity": 2, "usuPerCourse": 42.666666666666664, "estimatedUSU": 7455445.333333333 } ], "estimatedUSU": 7455445.333333333, "usuPerCourse": 42.666666666666664, "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.", "fatalSufferingCoverage": { "status": "not_estimated", "reviewedOn": "2026-10-08", "scopeNote": "This estimate assigns a representative early treatment and recovery course to admissions with unknown outcomes. A separate fatal course is unestimated; this does not establish zero deaths, survival or actual person-time for each child.", "basis": "No matched death count or outcome breakdown for the selected admission cohort was identified in the reviewed UNICEF report. We do not import a national war death toll or estimate deaths from a case-fatality rate borrowed from another population. [S25]", "nextRequirement": "A death count aligned with the selected admissions, plus evidence for the corresponding admission-to-death course. Replace the ordinary allowance for those cases, keeping the same post-admission time scope; never add a terminal period on top. Suffering before admission would require a separately defined extension.", "blockers": [ "aligned_mortality_count", "matched_fatal_course" ], "label": "Fatal suffering unestimated", "eligibleCount": null, "treatment": null } } ], "sources": [ { "id": "S1", "title": "PAHO/WHO. Epidemiological Update: Increase in dengue cases in the Region of the Americas. 18 June 2024, pp. 2–4 and 6.", "url": "https://www.paho.org/sites/default/files/2024-06/2024-june-18-phe-epi-update-dengue-en2.pdf", "role": "Reported cases, deaths and coverage for Brazil, Peru and Mexico. These counts do not establish USU intensities." }, { "id": "S2", "title": "WHO. Dengue. Fact sheet, 21 August 2025, Symptoms section.", "url": "https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue", "role": "Acute symptom descriptions and 2-7-day duration context; does not estimate an average USU intensity." }, { "id": "S3", "title": "Torales M et al. Chikungunya Outbreak - Paraguay, 2022-2023. CDC MMWR 2023;72:636-638. 9 June 2023.", "url": "https://www.cdc.gov/mmwr/volumes/72/wr/mm7223a5.htm", "role": "81,037 reported cases, reporting dates and case definitions; mortality subset distinction." }, { "id": "S4", "title": "CDC. Clinical Signs and Symptoms of Chikungunya Virus Disease. 15 May 2024.", "url": "https://www.cdc.gov/chikungunya/hcp/clinical-signs/index.html", "role": "Severe/debilitating joint symptoms and typical 7-10-day acute course; no USU conversion." }, { "id": "S5", "title": "UN Geneva / UNHCR-WMO. Brazil floods briefing. 24 May 2024, UNHCR spokesperson soundbite.", "url": "https://www.unognewsroom.org/story/en/2183/brazil-floods-unhcr-wmo/6577", "role": "Approximately 580,000 displaced people and 163 deaths reported on 24 May 2024. Uses the specific spoken population rather than the rounded headline. Deaths cover floods and landslides; no mechanism-specific count or overlap information is supplied." }, { "id": "S6", "title": "UNICEF. Brazil Humanitarian Situation Report No. 1, Rio Grande do Sul Floods. 26 June 2024, pp. 1-2 and 9.", "url": "https://www.unicef.org/documents/brazil-humanitarian-situation-report-rio-grande-do-sul-floods-26-june-2024", "role": "Continuing displacement and delayed returns support investigating a multiweek window, not a measured mean duration." }, { "id": "S7", "title": "WHO. Mental health in emergencies. Fact sheet, 6 May 2025.", "url": "https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies", "role": "Qualitative basis for distress inclusion. Neither numeric intensity nor transfer from pain is established; conflict-specific disorder prevalence is not used." }, { "id": "S8", "title": "WSI event catalogue v0.8: USU reference convention (unchanged from v0.1).", "url": "/events/methodology/#reference", "role": "Stipulated six-hour kidney-stone reference: 47.25 modeled intensity-hours, with linear weighting. This convention defines the unit; it is not a measured equivalence between conditions." }, { "id": "S9", "title": "WHO. Disease Outbreak News: Dengue: Bangladesh. 11 August 2023.", "url": "https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON481", "role": "69,483 laboratory-confirmed cases and 327 related deaths, 1 January–7 August 2023. Describes hospital-based surveillance." }, { "id": "S10", "title": "UNHCR. Appeal for communities devastated by Pakistan floods. Briefing note, 7 October 2022.", "url": "https://www.unhcr.org/au/news/briefing-notes/unhcr-urgently-seeks-us-66-million-communities-devastated-pakistan-floods", "role": "Approximately 7.9 million people displaced and at least 1,700 deaths. Describes continuing disruption; no measured average duration or intensity." }, { "id": "S11", "title": "UNFPA Nepal. Situation Report on Nepal Floods, 4-9 September 2026.", "url": "https://www.unfpa.org/resources/situation-report-nepal-floods-4-%E2%80%93-9-september-2026", "role": "3,629 people in 37 displacement sites and 1,367 deaths across the broader flood event. Site residents are a selected population, not all affected or displaced people." }, { "id": "S12", "title": "UNICEF Mozambique. Flood Response, Flash Update #2. 2 February 2026, p. 1; population as of 29 January.", "url": "https://www.unicef.org/mozambique/en/media/9901/file/Floods_Flash-Update-2_02022026.pdf.pdf", "role": "Over 100,730 people in 112 temporary accommodation centres. We retain 100,730 as the arithmetic anchor and preserve the qualifier. No mortality total is aligned to this population snapshot; external press headlines are not used as such a total." }, { "id": "S13", "title": "WHO. Ebola disease caused by Bundibugyo virus: Democratic Republic of the Congo. Disease Outbreak News, 10 September 2026.", "url": "https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON617", "role": "6,757 confirmed cases and 3,267 deaths in DR Congo through 7 September 2026. Country count includes two cases diagnosed there and subsequently treated in Germany; excludes Uganda and France." }, { "id": "S14", "title": "Roddy P et al. Clinical manifestations and case management of Ebola haemorrhagic fever caused by a newly identified virus strain, Bundibugyo, Uganda, 2007-2008. PLOS ONE 2012;7:e52986.", "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0052986", "role": "Small historical clinical series: median onset-to-death duration 9 days in 11 fatal cases, range 3-20. Informs a representative fatal course; it does not establish a 2026 mean or USU intensity." }, { "id": "S15", "title": "Kratz T et al. Ebola virus disease outbreak in Isiro, Democratic Republic of the Congo, 2012: signs and symptoms, management and outcomes. PLOS ONE 2015;10:e0129333.", "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129333", "role": "Small historical clinical series: median onset-to-death duration 15 days, range 4-28. Documentation and setting limitations restrict transfer to 2026; it does not calibrate USU intensity." }, { "id": "S16", "title": "Tipton MJ, Montgomery H. The experience of drowning. Medico-Legal Journal 2022;90:17-26.", "url": "https://doi.org/10.1177/00258172211053127", "role": "Review with survivor accounts and video evidence about surface struggle and time to unconsciousness. Supports examining a short conscious-experience window, not a measured three-minute flood-death average or intensity 8." }, { "id": "S17", "title": "CDC. Clinical Features of Dengue. 24 February 2026.", "url": "https://www.cdc.gov/dengue/hcp/clinical-signs/index.html", "role": "Describes febrile and critical phases, abdominal pain, vomiting, respiratory distress and severe complications. Does not establish a USU intensity or complete fatal-course average." }, { "id": "S18", "title": "Tomashek KM et al. Enhanced Surveillance for Fatal Dengue-Like Acute Febrile Illness in Puerto Rico, 2010-2012. PLOS Neglected Tropical Diseases 2016;10:e0005025.", "url": "https://doi.org/10.1371/journal.pntd.0005025", "role": "58 fatal laboratory-positive cases; median onset-to-death interval 7.1 days, range 1.2-28.4. Historical duration context; comorbidities and some coinfections limit attribution and transfer to other outbreaks." }, { "id": "S19", "title": "Woon YL et al. A Two-Year Review on Epidemiology and Clinical Characteristics of Dengue Deaths in Malaysia, 2013-2014. PLOS Neglected Tropical Diseases 2016;10:e0004575.", "url": "https://doi.org/10.1371/journal.pntd.0004575", "role": "National retrospective review of 322 deaths; 66.5% occurred on illness days 4-7. Supports a roughly week-long scenario, not a universal duration or USU mapping." }, { "id": "S20", "title": "Leo YS et al. Confirmed adult dengue deaths in Singapore: 5-year multi-center retrospective study. BMC Infectious Diseases 2011;11:123.", "url": "https://doi.org/10.1186/1471-2334-11-123", "role": "28 adult fatal cases; median onset-to-death duration 12 days, range 2-38. Provides a longer-course contrast and motivates a duration alternative; selected hospital population with frequent comorbidity." }, { "id": "S21", "title": "Simião et al. (2019). A major chikungunya epidemic with high mortality in northeastern Brazil. Rev Soc Bras Med Trop 52. DOI: 10.1590/0037-8682-0266-2019", "url": "https://www.scielo.br/j/rsbmt/a/HK3MkR57y63cmjyq5Xsz5Rb/?lang=en", "role": "Historical duration evidence for the provisional fatal course. The study reports 245 deaths across 2016-2018; its abstract gives 244 for 2016-2017. Neither establishes a Paraguay-specific duration or an intensity conversion." }, { "id": "S22", "title": "Añazco et al. (2026). Clinical characteristics and mortality of critically ill patients with chikungunya infection: a multicenter study in Paraguay. BMC Infectious Diseases 26, 867. DOI: 10.1186/s12879-026-13023-0", "url": "https://link.springer.com/article/10.1186/s12879-026-13023-0", "role": "Clinical context from 34 adult ICU patients during January-June 2023. Not the March surveillance cohort, not neonatal evidence and not a source for this event’s death count. ICU stay is not total symptom duration; the study could not reliably recover the illness day at ICU admission." }, { "id": "S23", "title": "Ministério Público do Rio Grande do Sul. Civil Defence review of deaths in Vale do Taquari during the 2024 floods. 7 May 2025.", "url": "https://www.mprs.mp.br/noticias/62601/", "role": "Retrospective regional review of 47 deaths in 14 municipalities, based on family interviews and autopsy records: 17% drowning, 32% burial and 51% trauma. These regional percentages are not a statewide breakdown of the 163 deaths in the 24 May 2024 snapshot. Used to explain why the whole toll cannot be treated as drowning." }, { "id": "S24", "title": "UN Geneva. Bi-Weekly Press Briefing, 7 October 2022: UNHCR statement on Pakistan floods.", "url": "https://www.unognewsroom.org/teleprompter/en/1324/bi-weekly-press-briefing-07-october-2022/4709", "role": "Official account of the same UNHCR briefing, confirming the reported displacement and mortality figures. It supplies no mechanism-specific fatal count or overlap information for this calculation." }, { "id": "S25", "title": "UNICEF Sudan Humanitarian Mid-Year Situation Report 2026, No. 44. 7 August 2026. Reporting period: 1 January to 30 June 2026.", "url": "https://www.unicef.org/sudan/media/20026/file/Sudan%20Mid-year%20SitRep%202026.pdf.pdf", "role": "The nutrition narrative on printed p. 4 gives 174,737 SAM admissions, with 174,700 in the headline. The results table on p. 11 gives 238,099 for severe wasting admissions; p. 12 identifies the same reporting period. We select the narrative count provisionally and show the alternative. Deduplication and aligned cohort outcomes are not established." }, { "id": "S26", "title": "Simplified treatment protocols improve recovery of children with severe acute malnutrition in South Sudan: results from a mixed methods study. Journal of Health, Population and Nutrition (2024). DOI: 10.1186/s41043-024-00518-2", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10835937/", "role": "Historical outpatient programme data. The Length of stay section reports 2021 means of 42.3, 43.2 and 46.3 days under adapted protocols. These are treatment stays in South Sudan, not suffering durations in Sudan. The study excluded stays longer than 120 days. It does not measure USU intensity." }, { "id": "S27", "title": "WHO guideline on prevention and management of wasting and nutritional oedema (2023), recommendation B2.", "url": "https://www.ncbi.nlm.nih.gov/books/NBK601655/table/ch4.tab14/", "role": "Outpatient eligibility can include good appetite and absence of acute problems requiring inpatient care. Indexed recommendation text was reviewed; the direct page encountered a browser check. This cautions against inferring uniform severe pain from a severe wasting diagnosis. It supplies no USU calibration." }, { "id": "S28", "title": "UNICEF USA. Symptoms of Malnutrition in Children. Accessed 9 October 2026 UTC.", "url": "https://www.unicefusa.org/what-unicef-does/childrens-health/nutrition/symptoms-malnutrition", "role": "General descriptions of low energy, digestive and appetite problems, irritability and lethargy. These are possible symptoms, not a measured Sudan cohort average or a numerical USU conversion." }, { "id": "S29", "title": "UNICEF Sudan Humanitarian Mid-Year Situation Report 2026: report landing page. August 2026.", "url": "https://www.unicef.org/sudan/reports/unicef-sudan-humanitarian-mid-year-situation-report-2026", "role": "Confirms the January-June reporting period and rounded headline of 174,700 treated children. This summarizes the same report, so it is not independent confirmation and does not resolve the annex discrepancy." } ], "revisionDate": "2026-10-08", "siteVersion": "2.16.0", "mortalityPolicy": { "deathItselfUSU": null, "deathItselfTreatment": "Not assigned USU; reported deaths remain a separate measure.", "bereavement": "Excluded and unestimated.", "fatalIllnessRule": "Replace the ordinary allowance for the same case with one complete fatal illness course. Never add both.", "eligibilityRule": "A separate fatal experience requires a source-supported mechanism-specific count and no duplicated experience or person-time. Unknown eligibility remains null, not zero.", "coverage": "USU describes experienced suffering during lived time. No suffering is assigned after death or to known absence of experience. Full representative courses may extend beyond source cutoff dates. No future deaths are imputed.", "floodReview": "The four flood snapshots retain displacement distress only. Cause, source population, reporting cutoff and overlap must support any added fatal experience. Regional cause percentages are not extrapolated to a broader event death toll.", "treatedMalnutritionReview": "Sudan treatment admissions retain one representative post-admission course with unknown outcomes. A separate fatal course is unestimated because no aligned cohort death count was identified. An eventual replacement must retain the same post-admission scope." }, "calculationSchema": "event-components-v2", "calculationSchemaNote": "For fatalCaseModel entries, deathCount is the single fatal count input. The builder derives disjoint other and fatal components from count and deathCount. profile identifies the ordinary course; fatalCaseModel.profile identifies the complete fatal course. estimatedUSU is the sum of components. An optional mortalitySubsetCount records a narrower mortality-review population and must lie between deathCount and count. It does not replace the modeled count or imply extrapolation. Optional labels and otherCaseMeaning preserve source-specific attribution distinctions. fatalSufferingCoverage is derived from the fatalCaseModel or an explicit fatalSufferingReview. Unestimated eligible counts remain null and never create a zero-valued fatal component. Optional countReview records a source conflict. For single-course entries, alternativeCounts derives alternative totals with the same course; these do not enter estimatedUSU." }