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Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26)

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Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Country Population: 4,373,279 l Volume 06, Issue 08, 20 – 26 Feb. 2017 l Data Source: CSOs from 15 Counties and Lab Highlights Figure 1. Public Health Events Reported in Epi-week 8 Keynotes and Events of Public Health Significance 99.9% completeness in reporting coverage. 99% timeliness (4 facilities in Gbarpolu and 2 facilities in Nimba reported late). Annual review meeting ongoing in Bong County. One attributable measles death was reported, among 40 suspected cases. Ten suspected measles cases reported from Counties bordering Guinea. Reporting Coverage Table 1. Weekly IDSR Reporting Coverage, Liberia, Epi-week 8, 2017 Number of Number Expected of Number 760 (99.9%) Report from Reports Received Completeness Timeliness Health facilities County Health Facility Received on Time (%) (%) out of 761 Bomi 23 23 23 100 100 reported IDSR Bong 55 55 55 100 100 data Gbarpolu 15 15 11 100 73 Grand Bassa 33 33 33 100 100 Grand Cape Mount 32 32 32 100 100 Grand Gedeh 24 24 24 100 100 90 (100%) Grand Kru 19 19 19 100 100 Health districts out of 90 Lofa 59 59 59 100 100 reported IDSR Margibi 44 44 43 100 100 data Maryland 25 25 25 100 100 Montserrado 284 284 284 100 100 Nimba 75 74 73 98.7 98.6 Rivercess 19 19 19 100 100 99% Health Facility River Gee 19 19 19 100 100 timeliness for Sinoe 35 35 35 100 100 weekly IDSR Liberia 761 760 754 99.9 99 reporting Legend ≥80 ≤80 The national target for weekly IDSR reporting is 80%. IDSR Weekly Epidemiology and Surveillance Bulletin Page 1 Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Vaccine Preventable Diseases Measles Figure 2. Comparison of Suspected Cases of Measles Figure 3. Distribution of Suspected Measles Cases Re ported, Liberia, Epi-week 1- 8, 2016 & 2017 Reported, Liberia, Epi-week 8, 2017 Heighten Surveillance due to Guinea Outbreak Forty (40) suspected cases were reported. Montserrado (14), Grand Cape Mount (7), Bomi (6), Bong (5), Lofa (3), Nimba (2), Grand Gedeh (1), Grand Bassa (1) and Maryland (1). One attributable death reported from Suakoko district, Bong County. Compared to the same week in 2016, there is an observed 6% decrease in the number of suspected cases reported. All the seven (7) cases reported from Grand Cape Mount County came from Bo-Waterside Community, Tewor District. Three (3) positive results received, of which two were reported for week 8 (Montserrado) and one for week 7 (Rive Gee). Of the forty (40) cases, two (2) tested positive, nineteen (19) negative and nineteen (19) pending laboratory confirmation. Of the forty (40) suspected cases, 16 (40%) were reported to have been previously vaccinated, 21 (52.5%) had unknown status and 3 (7.5%) were not vaccinated. Fifteen (37.5%) of the suspected cases were < 5 years and 25 (62.5%) were ≥ 5 years. Cumulatively since Epi-week 1, two hundred twenty-seven (227) suspected cases have been reported, of which ten (10) tested positive, one hundred fifty-one (151) negative, seven (7) equivocal, and twelve (12) pending laboratory confirmation. Acute Flaccid Paralysis (Polio) Four (4) cases were reported. Nimba (2), Grand Gedeh (1) and Lofa (1). Specimens were collected for all cases. All samples are pending laboratory confirmation. Cumulatively since Epi-week 1, thirty (30) cases have been reported, of which twenty-one (21) have been tested negative for poliovirus and nine (9) pending laboratory confirmation. ***Note: According to the laboratory data, 3 of the cases from Rivercess County had inadequate stool and one (1) case from Maryland County has date of onset in 2016. This affected the cumulative result from 32 to 30. IDSR Weekly Epidemiology and Surveillance Bulletin Page 2 Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Table 2: Non-polio AFP rate/100,000 <15yrs, Liberia, Epi weeks 1 - 8, 2017 Non- # of cases <15 % of Reported Polio <14 days # of % of County years stool AFP specimen NPENTs NPENT pop <14days Rate collected Bomi 45639 3 42.7 3 100 0 0 Bong 180932 1 3.6 1 100 0 0 Gbarpolu 45243 0 0 0 0 0 0 Grand Bassa 120281 2 10.8 2 100 2 100 Grand Cape Mount 68945 1 9.4 1 100 0 0 Grand Gedeh 67959 3 28.7 3 100 0 0 Grand Kru 31421 0 0 0 0 0 0 Lofa 150214 4 17.3 4 100 0 0 Margibi 113895 8 45.7 8 100 2 25 Maryland 73754 0 0 0 0 0 0 Montserrado 606708 0 0 0 0 0 0 Nimba 250675 5 13.0 5 100 1 20 Rivercess 36237 3 53.8 3 100 1 33 River-Gee 38798 0 0 0 0 0 0 Sinoe 55553 0 0 0 0 0 0 Liberia 1886254 30 9.3 30 100 6 20 Non-Polio AFP <2 Stool <80% Non-Polio <10% Silent Rate ≥2 Adequacy ≥80% Enterovirus ≥10% Neonatal Tetanus One (1) case was reported from Bong County. Cumulatively since Epi-week 1, three (3) cases have been reported. Viral Hemorrhagic Diseases Ebola Virus Disease (EVD) Four (4) suspected cases were reported. Bong (1), Grand Cape Mount (1), River Gee (1) and Nimba (1). Specimens were collected from all and samples that were pending laboratory confirmation have been tested Cumulatively since Epi-week 1, two hundred forty-eight (248) suspected cases have been reported and all tested negative. Lassa fever Zero suspected cases were reported. Cumulatively since Epi-week 1, twelve (12) suspected cases have been reported, of which, three (3) tested positive, and eight (8) negative. Yellow fever Two (2) suspected cases were reported from Grand Cape Mount (1) and Nimba (1). Specimens were collected from all of the suspected cases and are pending laboratory confirmation. Cumulatively since Epi-week 1, forty-two (42) suspected cases have been reported, of which, twenty- three (23) tested negative and nineteen (19) pending laboratory confirmation. IDSR Weekly Epidemiology and Surveillance Bulletin Page 3 Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Meningitis One (1) suspected case was reported from Bomi County. Cumulatively since Epi-week 1, five (5) suspected cases have been reported. Events of Public Health Importance Maternal Mortality Figure 4. Weekly Distribution of Maternal Death Table 3. Primary Causes of Maternal Death, Reported, Liberia, Epi-week 8, 2017 Liberia, Epi-week 1 - 8, 2017 (n=40) Maternal Death Proportion Percentage Post-partum hemorrhage 12 30 Sepsis 6 15 Congestive Heart failure 3 7.5 Anemia 5 12.5 Renal failure 2 5 Multiple organ failure (herbal ingestion-1) 2 5 Pre-eclampsia 2 5 Ruptured uterus 2 5 Dissimilated intravascular coagulation 1 2.5 Amniotic fluid embolism 1 2.5 Cardiac pulmonary failure 1 2.5 Respiratory Distress 1 2.5 Abruptio placenta 1 2.5 Umbilical Hernia (Omphalocele) 1 2.5 Total 40 100 Six (6) maternal deaths were reported. Montserrado (2), Lofa (2), Bong (1) and River Gee (1). Primary causes of death were postpartum hemorrhage (2), sepsis (2), anemia, and abruptio placenta. (see Figure 4). All of the deaths were reported to have occurred in health facilities. Cumulatively since Epi-week 1, forty (40) deaths have been reported. Neonatal Mortality Fifteen (15) neonatal deaths were Figure 6. Primary Causes of Neonatal Death, Liberia, Epi-week 1 - 8, 2017 (n=85) reported. Montserrado (4), Nimba (4), Bong (2), Rivercess (2), Maryland (1), Grand Bassa (1), and Lofa (1). Reported causes of deaths were birth asphyxia (10), neonatal sepsis (4), and preterm. Cumulatively, since Epi-week 1, eighty-five (85) neonatal deaths have been reported. (see Figure 6) IDSR Weekly Epidemiology and Surveillance Bulletin Page 4 Liberia IDSR Epidemiology Bulletin 2017 Epi Week 08 (February 20 – 26) Table 4. Counties Reporting Neonatal Death in Liberia, Epi-week 8, 2017 County(n=31) Number of Deaths Rate of deaths/100,000 live births Montserrado 4 7 Nimba 4 17 Bong 2 12 Rivercess 2 58 Maryland 1 14 Grand Bassa 1 9 Lofa 1 7 Total 15 100 Human Exposure to Animal Bites (Suspected Rabies) Forty-nine (49) reports of animal bites were reported. Montserrado (26), Nimba (7), Rivercess (4), Grand Bassa (4), Margibi (2), Grand Gedeh (2), Bomi (2), Bong (1) and Lofa (1). Two specimens were collected from Rivercess County. All of the persons bitten were given anti-rabies vaccine. Cumulatively since Epi-week 1, three hundred (300) reports of animal bites have been documented. Bloody Diarrhea (Shigellosis) Nine (9) cases were reported from Sinoe (2), Bomi (1), Grand Kru (1), Nimba (1), Grand Gedeh (1), Margibi (1), Rivercess (1) and Grand Bassa (1). Specimens were collected from all cases. Five (5) of the cases were reported during week 8, of which one (1) case from District #4, Grand Bassa County was confirmed for shigellosis while eight (8) tested negative (some of these samples were collected during previous weeks). Cumulatively since Epi-week 1, forty-nine (49) cases of bloody diarrhea have been reported. Severe Acute Watery Diarrhea (Cholera) Three (3) suspected cases were reported from Grand Bassa (1), Grand Gedeh (1) and Sinoe (1) Counties. Specimens were collected from all three (3) cases and pending laboratory confirmation. Cumulatively since Epi-week 1, fifteen (15) suspected cases of cholera have been reported. Public Health Measures National level Nineteen suspected measles cases reported from six i. Follow up with Counties to verify received reports/data. counties. ii. Laboratory testing of IDSR priority specimens ongoing at the National Reference Laboratory. Ten neonatal deaths reported from six counties.
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