Epidemiological Week 19 (Week ending 13th May, 2018)

Highlights Cumulative figures as of week 19 • 217 health facilities across submitted • 1,077,571 consultations from week 1 weekly reports of epidemic-prone diseases in the to week 19. electronic early warning disease surveillance • 3,280 cumulative cases of (EWARN) system in week 19, compared to 192 health facilities reported in Week 18. AWD/Cholera and 21 deaths since • Total number of consultations increased from December 2017. 50,411 in week 18 to 57,498 in week 19. • 6,156 Accumulative alerts were • A total of 4,221 alerts were received. Of these, 199 received, 217 of these, were 1 were confirmed as true alerts . confirmed as true alerts from week 1 • The highest numbers of diseases reported in week to week 19, 2018. 19 were other acute diarrhoeas (2,816 cases),

influenza like illness (1,729 cases) and severe acute • 5,398 cumulative cases of suspected respiratory illness (930 cases). measles cases since the beginning of 2018. • A total of 312 new cases of suspected AWD/cholera with 4 deaths were reported in week 19 compared • Of the 5,398 measles cases, 3,473 to 296 AWD cases with 4 deaths in week 18. (64%) are under 5 years while 1,925 • A cumulative total of 3,280 AWD/cholera cases2, (36%) are above 5 years. including 21 deaths have been reported since December 2017. • The number of reported measles cases decreased from 211 in week 18 to 126 cases in week 19.

Table 1. Summary of Alerts for epidemic prone diseases Disease Wk16 Wk17 Wk18 Wk19 Cumulative cases (Wk 1 – 19, 2018 2018 2018 2018 2018) Total consultations 55,439 51,937 50,411 57,498 1,077,571 Other Acute Diarrheas 2285 2,142 2,421 2816 41192 Influenza Like Illness 1401 1502 1493 1729 33,468 Severe Acute Respiratory Illness 1106 874 855 930 17,415 Suspected Measles 104 160 211 126 5398 Confirmed Malaria 236 254 300 314 4446 Acute Watery Diarrhoea 66 15 11 14 1154 Bloody Diarrhea 53 162 111 114 1266 Whooping Cough 56 25 56 41 850

1 These alerts are alerts from specific diseases of SARI, ILI, AWD, OAD, WC, Measles, Malaria, Falciprium Positive &RDT examined as auto-calculated by the system. 2 The Cases of AWD/Cholera in the eWARN system are collected from sentinel sites. while the cases of AWD/cholera in Sitrep are collected from temporary CTC sites which doesn't include the Sentinel sites

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Acute Jaundice 0 2 2 3 68 Disease Wk16 Wk17 Wk18 Wk19 Cumulative cases (Wk 1 – 19, 2018 2018 2018 2018 2018) Suspected Meningitis 6 1 2 6 55 Diphtheria 0 0 0 0 26 Neonatal Tetanus 0 0 1 1 19 Acute Flaccid Paralysis 0 0 0 0 2 Viral Hemorrhagic Fever 1 0 0 0 3

Total number of Consultations and Reporting sites Completeness of Reporting. Out of 265 health facilities expected to submit weekly reports of communicable diseases in the EWARN system across Somalia, 217 submitted reports in week 19, a completeness of reporting of 82%. A total of 57,498 consultations were recorded in week 19, 2018 (Fig 1). Fig 1: Consultations and reporting sites, week 1 to 19, 2018 70,000 250 60,000 200 50,000 40,000 150 30,000 100

20,000 Consultations

50 ReportingSites 10,000 - 0 WK8 WK9 WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK17 WK18 WK19 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018

Totoal Consultations Reporting Sites

Proportionate Morbidity As shown in figure 2; Other acute diarrhoeas (OAD), influenza like illness (ILI), severe acute respiratory illness (SARI), suspected measles and malaria are the commonest causes of morbidity across Somalia in 2018. In week 19, the highest numbers of diseases were other acute diarrhoeas (2,816 cases), influenza like illness (1,729 cases) and severe acute respiratory illness (930 cases). Fig. 2. Commonest Causes of Morbidity during Week 1 to 19

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other acute Diaria influence like illness Severe Acute Respiratory Illness Suspected Measles Confirmed Malaria

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Situation Update of AWD/Cholera

AWD/Cholera situation in different regions of Lower Jubba , Hiiran, and Banadir.

Following the heavy rains that have led to the floods in Districts Reporting Cases in Week 19 the Juba land and Shabelle basins, there has been an

observed increase in the number of new AWD/Cholera cases. The cholera outbreak that started in December 2017 in Beletweyne along river Shabelle has spread to Jowhar, Kismayo, Afgoye and Banadir. The cholera spread is expected to increase due to the floods that have led to contamination of water sources in the flood affected regions. Floods have also led to blockage of access of health services which will contribute to delayed health seeking by the affected populations with. Over the past 2 Weeks, there has been an increase in the number of AWD/Cholera cases reported in , Banadir and Lower Jubba; the regions that are affected by floods. In week ending 7th May, active transmission of AWD/cholera was reported in in Lower Jubba, Afgoye in Lower Shabelle as well as in 14 districts of Banadir region (Darkenly, Daynile, Hodan, Madina, Waberi, HamarWeine, Hamarjabjab, Heliwa, Waberi and Wardigley, Kaaran, Yaqshid, Howlwadag Shangani districts). In Kismayo, affected communities especially in Farjano IDP are reportedly using contaminated water from open water sources. The Oral Cholera Vaccination that was implemented in 11 high risk districts in 2017 of the central region has greatly contributed to the reduction in the number of new AWD/cholera cases.

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Fig 3. AWD/Cholera cases in Somalia May 2017-May 2018 3500 4.0

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Cases Total Deaths CFR (%)

Table 2. Summary of AWD/Cholera cases in different regions Week 18 Week 19 Cumulative as of Epi- Regions (30thApril -6thMay-2018) (07th -13thMay-2018) Week 49, 2017, Wk 19, States 2018 Cases Deaths CFR (%) Cases Deaths CFR (%) Cases Deaths CFR (%) Central Banadir 132 2 1.5 143 2 1.4 1,042 7 0.7

Jubba land L/ Jubba 127 2 1.6 149 2 1.3 1,186 11 0.9

South west L/ Shabelle 37 0 0.0 20 0 0.0 72 0 0.0

Hir-shabele M/Shabelle 0 0 0.0 0 0 0.0 4,15 2 0.5

Hiraan 0 0 0.0 0 0 0.0 565 1 0.2

Total 296 4 1.4 312 4 1.3 3,280 21 0.6

*The AWD/Deaths reported in this table have not been confirmed by stool analysis. Cholera Situation in Hiraan, Lower Jubba, Middle Shabelle and Banadir. • Banadir region which included Mogadishu city has one of the highest concentration of refugees where access to safe water and proper sanitation is limited. The AWD/Cholera outbreak in Banadir region started in January 2018 following reports of similar outbreak in Beletweyne district of Hiraan region. Of the 17 districts that make up Banadir region, 14 have so far reported cases which have been managed in Banadir CTC located in the capital Mogadishu. There has been an increase in the number of AWD/Cholera cases from 132 and 2 deaths to 143 cases and 2 deaths. More than 70% of the cholera cases reported in Banadir are children below 2 years of age. • In Lower Jubba, The current AWD/Cholera outbreak in Kismayo district started in week 5 of 2018 in the IDP communities of Farjano where access to safe water and sanitation is limited. The district is characterised by returnees from Kenya as well as those displaced by war in Middle Jubba. Currently Lower Jubba is one of the flood affected regions. The reported cases of AWD/Cholera did not receive OCV which was given in Kismayo in March 2017. The persons

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may have been absent during the OCV campaign. Over the past week, the number of AWD/Cholera cases increased from 127 and 1 death to 149 and 2 deaths that have been reported in Farjano CTC and Kismayo General Hospital CTU. More than 68% of the cholera cases reported from Lower Jubba are children below 2 years. • The AWD/Cholera outbreak in Lower Shabelle region started in week 17 of 2018, as a result of displacement of people due to floods that have been reported in this regions. Afgoye is the most affected district and cases are being managed in Marka General hospital. More than 35% of the cases reported in Afgoye are children below 5 years. AWD/Cholera cases and floods Following heavy rains in Ethiopia and Somalia, flash floods have been reported in the basins of Juba and Shabelle in 4 states. An estimated 718,000 people have been affected of which 220,000 have been displaced3. Floods contribute to contamination of water sources as well as disruption of health services which are precursors of cholera outbreaks. Of the flood affected regions, cholera cases have been reported in Kismayo (1,186 cases) and Afgoye (72 cases) as shown in table 3. Even when Jowhar and Beletweyne reported cases prior to the floods, no new cases have been reported from these districts following the floods.

Table 3. Distribution of AWD cholera cases in different districts Region District Week 19 Cumulative Week 49/17-week Cases Live Deaths 19/18 <2 yrs ≥2 yrs <2 yrs ≥2 yrs cases Deaths CFR (%) Banadir Darkenley 13 12 0 0 161 0 0 Daynile 14 6 0 1 181 4 2.2 HamarJabja 3 3 0 0 50 0 0 Hawlwadag 2 4 0 0 34 0 0 Hodan 12 6 0 1 263 1 0.4 Karaan 0 0 0 0 18 0 0 Madina 9 2 0 0 190 1 0.5 waberi 0 2 0 0 44 1 2.3 Shibis 1 0 0 0 6 0 0 Shingani 0 0 0 0 1 0 0 HamarWeine 2 1 0 0 19 0 0 Heliwaa 0 0 0 0 11 0 0 Wardigley 6 0 0 0 41 0 0 Yaqshid 0 2 0 0 23 0 0 M/Shabelle× Jowhar 0 0 0 0 415 2 0.5 Hiran× Beletweyne 0 0 0 0 522 1 0.2 BuloBarde 0 0 0 0 43 0 0 L/Shabelle× Afgoye 0 7 0 0 72 0 0 L/Jubba× Kismayo 72 30 0 2 1,186 11 0.9 Total 134 75 0 4 3,280 21 0.6 × regions currently affected by floods. Cases include deaths.

3 OCHA Flood Flash update|15th May 2018 Page 5 of 14

AWD/Cholera Response Activities Implemented During Week 19

Coordination and Leadership. • Coordination meetings were conducted in the flood affected districts. The coordination meetings are coordinated by Federal Ministry and State level MoH in coordination with health cluster partners

Case management • On job training was conducted for the health workers working in cholera treatment centres in Kismayo and Banadir and Afgoye Hospital CTCs • Management of cholera cases is being conducted in Banadir hospital CTC, Kismayo hospital CTU, Marka hospital CTU and Farjano CTU Surveillance and Laboratory Investigations • Routine line listing of cases including data analysis and risk assessment for cholera hotspots • Investigation and verification of rumours in flood affected regions • Stool sample collection and analysis in the WHO supported NPHL in Mogadishu

Water Sanitation, Hygiene and risk communication

• Hygiene promotion of AWD prevention and control mechanism is on-going in Farjano and Dalxiska • ARC is chlorinating 40 shallow wells as well as distribution of hygienic kits in Dalxiska camp,Farjano, Bula-ablika, Marina and surrounding areas • ARDI started chlorination of shallow wells in Farjano village have been started mainly in Bula- ablika, marine and Dabyanbo and distribution of aqua tabs • SRCS is distributing hygiene kits in all IDP households • ADRA is supporting hygiene promoters • SIF is conducting water tracking in some IDP camps

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Measles Situation

Districts Reporting Measles Case: Week 19 The number of suspected measles cases increased from 211 cases in week 18 to 126 cases in week 19. Cumulatively, 5,398 cases of suspected measles have been reported across Somalia since the beginning of 2018. Of the 5,398 measles cases, 3,473 (64%) are under 5 years while 1,925 (36%) are above 5 years. The most affected regions include Galgadud (1,063 cases), Bay (808 cases) Banadir (846 cases), (507 cases), and Sool (359 cases).

As shown in fig 4, the trends of measles have continued to decrease in all the regions following the successful implementation of measles vaccination campaign

Fig4: Measles Situation in Somalia from Week 1 to Week 19 2018

700 600 500 400 300 200 100 0 Wk1 Wk2 Wk3 Wk4 Wk5 Wk6 Wk7 Wk8 Wk9 Wk10Wk11Wk12Wk13Wk14Wk15Wk16Wk17Wk18Wk19 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018

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Table 4: Summary of Suspected measles cases by region week 1 - 19, 2018

Wk16 Wk17 Wk18 Wk19 Cumulative cases Region 2018 2018 2018 2018 (Wk 1 – 19)

Awdal 0 1 0 0 12 1 0 0 0 117 Banadir 17 9 54 0 846 Bari 1 1 - - 92 Bay 8 33 65 53 808 Galgaduud 0 11 0 0 1063 - - - - 18 Hiraan 4 2 8 1 101 12 6 4 33 200 Lower Shabelle 16 10 16 4 274 9 5 12 6 115 Middle Shabelle 3 59 4 0 130 Mudug 13 5 35 14 507 Nugaal - - 0 - 183 Sanaag 0 0 0 0 150 Sool 1 1 3 1 359 Togdher 11 9 6 7 196 Waqoyi Galbed 8 8 4 7 227 Grand Total 104 160 211 126 5398 Dash means there is no weekly Data/report submitted on the system during the specified reporting period.

Measles Outbreak Response Activities • The Federal Ministry of Health in collaboration with WHO, UNICEF and other partners launched the measles vaccination campaign in Mogadishu and Somaliland on 11th March 2018 to vaccinate 3.7 million children aged 6 months to 10 years in South Central and Somaliland. • The measles vaccination campaign was also conducted in Puntland in January 2018. 933,690 children aged 6 months to 10 years were vaccinated. • There has been a reduction in the number of measles cases reported from all the states following the vaccination campaign (fig 6&7)

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Fig6: Measles Trends after implementing Measles vaccination in Somaliland & South and Central

500 450 Measles 400 vaccination 350 implemente 300 d 250 200 150 100 50 0 Wk1 Wk2 Wk3 Wk4 Wk5 Wk6 Wk7 Wk8 Wk9 Wk10Wk11Wk12Wk13Wk14Wk15Wk16Wk17Wk18Wk19 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018

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Fig7: Measles trends after implementing Measles vaccination in Puntland

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Malaria Situation in Somalia The number of Malaria cases increased from 300 cases in week 18 to 314 cases in week 19. Cumulatively, 4,446 cases of Malaria cases have been reported across Somalia since the beginning of 2018. Of the 4,446 measles cases, 1,947 (44%) are under 5 years while 2,499 (56%) are above 5 years. The most affected regions include Bay (951 cases), Galgadud (679 cases), Banadir (623 cases) Lower Shabelle (489 cases), Bakol (389 cases), and Middle Shabelle (254 cases)

Fig8: Malaria Situation in Somalia from Week 1 to Week 19, 2018

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Table 5. Cumulative Summary of Epidemic-prone Diseases in different Districts of Somalia as of Week 1-19, 2018

Regions District SARI ILI AWD BD OAD DIPH WC MEAS NNT AFP AJS VHF MAL MENG OC Total_cons

Awdal Total 0 6290 11 89 2657 0 0 12 0 0 0 0 15 2 23969 33074 Baki 0 775 0 37 183 0 0 0 0 0 0 0 0 0 2204 3199 Borama 0 3925 11 49 1839 0 0 8 0 0 0 0 8 0 15628 21496 Lughaya 0 144 0 2 153 0 0 0 0 0 0 0 0 0 1270 1569 Zeila 0 1446 0 1 482 0 0 4 0 0 0 0 7 2 4867 6810 Bakool Total 114 54 0 50 344 0 15 117 0 0 0 0 389 2 42328 43413 Elberde 0 13 0 0 80 0 0 0 0 0 0 0 0 0 7405 7498 Huddur 5 5 0 13 61 0 0 1 0 0 0 0 121 0 6386 6592 Tayeeglow 25 14 0 0 38 0 0 6 0 0 0 0 45 2 961 1091 Waajid 84 22 0 37 165 0 15 110 0 0 0 0 223 0 27576 28232 Banadir Total 4420 7000 727 51 10644 0 9 846 0 1 0 0 623 12 284156 308489 Abdiaziz 0 81 0 0 76 0 0 0 0 0 0 0 0 0 6599 6756 Boondhere 0 0 18 0 192 0 0 23 0 0 0 0 0 0 5619 5852 Dayniile 14 99 0 0 180 0 0 7 0 0 0 0 1 0 10209 10510 Dharkinley 470 1015 0 0 1610 0 0 51 0 0 0 0 0 0 16812 19958 Hamar Jab Jab 171 418 0 2 390 0 1 7 0 0 0 0 1 0 9937 10927 Hamar Weyne 78 272 0 0 786 0 0 10 0 0 0 0 0 0 8346 9492 Hodan 3 22 5 0 41 0 0 0 0 0 0 0 6 0 6779 6856 Howl-wadaag 0 0 0 0 0 0 0 6 0 0 0 0 1 0 29000 29007 Huruwaa 1298 3090 15 5 3023 0 0 454 0 1 0 0 3 12 32207 40108 Kaaraan 10 69 0 0 46 0 0 1 0 0 0 0 0 0 14440 14566 Kahda 56 470 0 0 262 0 0 1 0 0 0 0 0 0 1289 2078 Shangani 26 17 0 0 12 0 0 0 0 0 0 0 0 0 89 144 Shibis 0 0 0 0 416 0 0 8 0 0 0 0 2 0 5761 6187 Waberi 0 0 0 0 33 0 0 0 0 0 0 0 0 0 13954 13987 Wadajir 1297 1358 689 5 1892 0 2 225 0 0 0 0 595 0 72137 78200 Wardhigley 18 0 0 22 1064 0 6 34 0 0 0 0 14 0 34421 35579 Yaqshid 979 89 0 17 621 0 0 19 0 0 0 0 0 0 16557 18282 Bari Total 81 1020 5 10 584 0 0 92 0 0 0 0 335 0 34401 43069 Banderbayla 35 153 1 0 20 0 0 1 0 0 0 0 0 0 746 956 Bossaso 46 847 3 0 345 0 0 28 0 0 0 0 331 0 19007 27126 Carmo 0 6 0 0 4 0 0 0 0 0 0 0 2 0 634 668 Page 11 of 14

Hafun 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1553 1577 Iskushuban 0 7 0 1 5 0 0 0 0 0 0 0 0 0 614 627 Qardho 0 0 0 9 127 0 0 45 0 0 0 0 2 0 6616 6799 Rakko 0 0 1 0 55 0 0 18 0 0 0 0 0 0 2311 2385 Ufeyn 0 7 0 0 2 0 0 0 0 0 0 0 0 0 374 383 Waciya 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2546 2548 Bay Total 409 1407 31 404 1005 9 13 447 0 0 1 0 951 0 63699 68462 Baidoa 383 970 23 239 756 9 7 270 0 0 1 0 769 0 55624 59137 Berdale 0 63 6 15 24 0 6 26 0 0 0 0 141 0 3034 3315 Burhakaba 26 175 1 150 161 0 0 149 0 0 0 0 41 0 3253 3956 Qansahdere 0 70 0 0 43 0 0 0 0 0 0 0 0 0 529 642 Qasax dhere 0 129 1 0 21 0 0 2 0 0 0 0 0 0 1259 1412 Galgadud Total 3049 1013 1 4 781 0 164 1424 0 0 3 0 679 8 41641 48767 Abudwak 1125 264 0 0 185 0 26 709 0 0 0 0 165 4 9129 11607 Adado 637 315 0 1 219 0 53 270 0 0 3 0 222 1 8211 9932 Balanbale 200 116 0 1 37 0 11 129 0 0 0 0 59 0 2149 2702 Dhuusamarreeb 567 146 1 2 97 0 16 157 0 0 0 0 100 0 11648 12734 El Bur 24 6 0 0 38 0 0 34 0 0 0 0 17 0 533 652 El Dere 351 103 0 0 153 0 22 61 0 0 0 0 65 3 7869 8627 Gelinsor 145 63 0 0 52 0 36 64 0 0 0 0 51 0 2102 2513 Gedo Total 36 1011 0 0 207 0 0 18 0 0 0 0 222 0 13517 15011 B/hawo 22 237 0 0 48 0 0 9 0 0 0 0 59 0 3369 3744 Doolow 8 280 0 0 53 0 0 4 0 0 0 0 52 0 3164 3561 Garbahaarey 1 184 0 0 36 0 0 0 0 0 0 0 38 0 2775 3034 Luuq 5 310 0 0 70 0 0 5 0 0 0 0 73 0 4209 4672 Hiraan Total 5241 3028 198 2 4328 0 12 101 0 0 0 0 111 2 49505 62528 Belet Weyne 2987 2205 192 0 2717 0 2 81 0 0 0 0 110 1 28938 37233 Bulo Burto 1433 391 6 2 1125 0 0 20 0 0 0 0 1 1 9793 12772 Jalalaqsi 681 113 0 0 374 0 0 0 0 0 0 0 0 0 1681 2849 Matabaan 86 240 0 0 82 0 0 0 0 0 0 0 0 0 4925 5333 Maxaas 54 79 0 0 30 0 10 0 0 0 0 0 0 0 4168 4341 Lower Total 1014 15 44 113 1052 3 18 200 0 0 0 0 126 0 52203 54788 Juba Afmadow 322 0 28 44 213 0 0 0 0 0 0 0 4 0 7074 7685 Hagar 77 5 0 6 93 2 1 38 0 0 0 0 0 0 2565 2787 Jamaame 78 0 6 7 114 0 0 44 0 0 0 0 60 0 5687 5996

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Kismayo 537 10 10 56 632 1 17 118 0 0 0 0 62 0 36877 38320 Lower Total 467 377 31 9 4564 4 10 274 0 0 0 0 489 0 85467 91692 Shabelle Afgoi 32 81 0 0 181 0 0 27 0 0 0 0 5 0 14653 14979 Kurtunwarey 19 1 0 0 844 0 0 26 0 0 0 0 28 0 9832 10750 Marka 190 2 31 6 2560 4 10 175 0 0 0 0 396 0 51047 54421 Qoryooley 53 0 0 0 600 0 0 40 0 0 0 0 53 0 8879 9625 Wanla Weyn 173 293 0 3 379 0 0 6 0 0 0 0 7 0 1056 1917 Middle Total 52 0 0 55 421 5 199 122 0 0 0 0 122 0 7590 8566 Juba Bu'ale 14 0 0 14 99 0 47 27 0 0 0 0 0 0 1533 1734 Jilib 29 0 0 25 253 5 113 73 0 0 0 0 122 0 4804 5424 Salagle 9 0 0 16 69 0 39 22 0 0 0 0 0 0 1253 1408 Middle Total 237 304 71 72 2087 0 1 123 0 0 0 0 254 0 61280 64429 Shabelle Adale 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3505 3505 Bal'ad 195 276 19 20 430 0 1 103 0 0 0 0 161 0 25485 26690 Jowhar 32 0 52 45 1355 0 0 20 0 0 0 0 73 0 17633 19210 Mahaday 2 16 0 7 95 0 0 0 0 0 0 0 10 0 4645 4775 Warsheikh 8 12 0 0 207 0 0 0 0 0 0 0 10 0 10012 10249 Mudug Total 228 36 12 25 2333 3 122 507 19 0 25 0 9 9 88350 91678 Galdogob 9 0 1 0 127 0 0 9 0 0 1 0 0 0 6573 6720 Galkacyo 191 0 11 19 1373 1 101 365 2 0 1 0 5 9 58893 60971 Harardere 28 36 0 1 146 0 12 29 0 0 0 0 4 0 3307 3563 Hobyo 0 0 0 0 632 2 8 94 17 0 22 0 0 0 9368 10143 Jariiban 0 0 0 5 55 0 1 10 0 0 1 0 0 0 10209 10281 Nugaal Total 72 771 6 0 428 1 6 183 0 0 0 0 0 0 11165 12632 Burtinle 1 148 0 0 108 0 0 29 0 0 0 0 0 0 2197 2483 Dangorayo 1 28 0 0 34 1 0 0 0 0 0 0 0 0 1333 1397 Eyl 12 213 0 0 84 0 0 44 0 0 0 0 0 0 3111 3464 Garoowe 58 382 6 0 202 0 6 110 0 0 0 0 0 0 4524 5288 Sanaag Total 840 382 17 0 583 1 76 150 0 0 0 0 22 1 16945 19151 Badhan 288 100 10 0 187 0 1 132 0 0 0 0 20 0 3568 4313 Baran 4 8 0 0 37 0 0 0 0 0 0 0 0 0 474 523 Dhahar 246 1 2 0 43 0 3 3 0 0 0 0 2 0 1476 1776 Eil-afweine 251 143 5 0 221 1 0 7 0 0 0 0 0 0 5704 6376 Erigavo 51 130 0 0 95 0 72 8 0 0 0 0 0 1 5723 6163 Sool Total 38 2860 0 5 2209 0 31 359 0 0 0 0 37 0 26148 31687

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Bocame 0 0 0 0 5 0 0 2 0 0 0 0 0 0 222 229 Hudun 0 496 0 0 294 0 1 14 0 0 0 0 0 0 2589 3394 Lasacanod 38 2147 0 5 1814 0 30 341 0 0 0 0 37 0 21471 25883 Taleex 0 217 0 0 96 0 0 2 0 0 0 0 0 0 1866 2181 Togdher Total 219 1734 0 178 1969 0 30 189 0 0 5 0 2 10 19756 24092 Ainabo 1 81 0 37 115 0 0 0 0 0 0 0 0 0 1419 1653 Buhodle 23 103 0 55 123 0 0 13 0 0 0 0 0 0 2210 2527 Burao 169 1363 0 67 1578 0 30 176 0 0 5 0 2 10 14464 17864 Odwayne 26 187 0 19 153 0 0 0 0 0 0 0 0 0 1663 2048 Waqoy Total 898 6166 0 199 4996 0 144 234 0 1 34 1 60 9 43301 56043 Galbed Ballayabane 138 201 0 21 166 0 24 9 0 0 0 0 0 1 1778 2338 Berbera 220 2222 0 2 1618 0 81 101 0 1 34 1 3 1 12743 17027 Gabiley 209 1790 0 78 1384 0 5 21 0 0 0 0 27 0 4804 8318 Hargeisa 194 1390 0 98 1422 0 32 90 0 0 0 0 30 7 20571 23834 Sheikh 137 563 0 0 406 0 2 13 0 0 0 0 0 0 3405 4526 Grand Total 17415 33468 1154 1266 41192 26 850 5398 19 2 68 1 4446 55 965421 1077571 SARI-Severe Acute respiratotyIllness,ILI-Influenza Like Illness, AWD-Acute Watery Diarrhoea,BD-Bloody Diarrhoea, Diph-Diptheria,WC-Whooping cough, Meas-Fever With Rash/Measles,NNT-Neonatal Tetanus,AJS-Acute Jaundice Syndrome, VHF-Viral Heamorrhagic Fever,Mal-Confirmed Malaria, Men-Bacterial Meningitis

For inquires please contact the Surveillance team, Ahmed Moallim Mohamed, Emergency & Surveillance Coordinator FMoH, [email protected] and WHO country office in Somalia or Dr Mutaawe Lubogo, Epidemiologist, [email protected]

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