Eiectronic Integrated Disease Early Warning and Response System

Ministary Of Public Health Papulation Epidemiological Bulletin Primary Heath Care Sector Weekly DG for Diseases Control & Surveillance Eiectronic Integrated Disease Early Warning and Response System

Volume 09,lssue2,Epi week2,(11- 17 January,2021)

Highlights eDEWS Reporting Rates vs Consultations ,Epi Weeks 1-2,2021

100% % 268000

% 94 •During week no.2,2021, %94 health facilites provided valid surveillance data. 90% 94 267000 80% 70% •The total number of consultation reported during the week was 267700 266000 60% compared to 264321 the previous reporting week 2 Acute respiratory tract 50% 265000 infections lower Respiratory Infections (LRTI), Upper Respiratory Infections

40% Percentage (URTI), Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of 264000 Consulttaions 30% morbidity this week. 20% 263000 10%

● A total of 824 alerts were generated by eDEWS system in week 2- 2021, Of 0% 262000 Wk 2 Wk these 815 alerts were verified as true for further investigations with 1 Wk appropriate response Reporting Rate Consultations

Leading causes of morbidity mortality in Epi-Week 2,2021 Proportional morbidity of leading priority diseases, Epi week 2,2021

Scabies Chicken Pox ● (URTI) 17.1%, suspected Malaria (8.2%),(DD) (7.2%) and (LRTI) (7.4%)Remain the Brucellosis HIV/ AIDS leading causes of morbidity representing a total of (39.9%) Tuberculosis RB CL Sch VHF DF ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than Meng Mal 1% of total morbidity in reporting period Bloody diarrhea represented 0.4% Of this Mumps AFP morbidity NNT AVH_B&C AVH_A&E Meas Typhoid F ● All diarrheal disease comprised 7.2% and LRTI 7.4% of total morbidity in pilot OAD BD Governorates this week . Susp. Cholera Diph Pert SARI ILI ● All diarrheal disease comprised 7.2% and OAD 6.4% of total morbidity in all age group LRTI . URTI 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0%

التهاب:SARI التهاب الكبد :AVH الحصبة :Meas داء الكلب :RB التهاب السحايا :Men حىم الضنك :DF مالريا :Mal بلهارسيا :Sch اسهال ما يئ حاد :AWD التهاب الجهاز التنف يس السف يل:LRTI اسهال حاد اخرى :OAD اسهال مدمم :BD عدوى الجهاز التنف يس العلوي :URTI االيذز :HIV الجذري:CHICKEN دودة غينية:GUINEA حىم مالطيه:BRUCELLOSIS السل:TUPERCULOSIS النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا عل شكل وباء :ILI تنف يس حاد وخيم

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 1 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 2,(11- 17 January,2021) Epidemiological Situation of Dengue Fever and Diphtheria

GO V

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 2 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 2,(11- 17 January,2021)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-2,2021)

URTI LRTI mararia tested cases & confirmed 20.0% 8.0% 2000

18.0% 1800 7.0%

16.0% 1600

6.0% 1400 14.0%

1200 12.0% 5.0%

1000 10.0% 4.0% 800 8.0% 3.0% 600

6.0% 400 2.0% 4.0% 200

1.0%

2.0% 0

wk1 wk2 0.0%

0.0%

1 2 2

1 Rapid Test(Postive) Microscope(Postive)

WK WK

Age and Sex distribution of total consultations of leading diseases (Epi week 2,2021) Number of Alerts Received and Responded (Epi Weeks 1-2,2021)

60000

55400 URTI LRTI Pert BD OAD Typhoid F

50000 AFP Meas AVH_A&E AVH_B&C DF Meng

Sch CL Chicken Pox Mal 600 40000 36145 500

30000 26136 26576 400 24951 25103

21822 19553

20000 18846 18850 300 No. of Alerts of No.

200

10000 100

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 18846 24951 26136 36145 19553 Female 18850 25103 26576 55400 21822 Distribution of consultations of leading diseases by Governorates,Epi week 2-2021

Suspected Disease Al-Baidha AlHodaidah Al-Jawf Al-Mahweet Amana Amran Dhamar Hajjah Ibb Rayma Sa'adah Sanaa Governorate Taiz Total

URTI 1592 7452 1354 1402 4959 3735 3413 6068 3328 1020 5135 4823 1572 45853 LRTI 966 5197 467 632 1639 1500 1691 2546 1883 142 812 1979 392 19846 ILI 139 159 89 15 73 1 554 58 59 4 134 234 116 1635 SARI 0 0 0 0 22 4 46 0 9 0 3 1 2 87 Pert 2 3 0 0 7 9 0 1 0 0 10 3 0 35 BD 37 141 127 49 51 95 77 77 77 13 106 138 92 1080 OAD 505 1776 727 433 1971 1511 1778 2357 1363 343 1710 2114 536 17124 Typhoid F 234 454 154 97 565 286 808 21 574 41 203 408 169 4014 Meas 10 8 4 1 10 8 0 6 2 0 80 6 1 136 AVH_A&E 4 0 4 2 76 4 36 2 33 0 2 8 3 174 AVH_B&C 0 0 2 0 74 7 4 8 35 0 0 3 5 138 NNT 0 0 0 0 2 0 0 0 0 0 0 0 0 2 AFP 1 0 0 1 3 0 0 1 2 0 0 2 0 10 233 4 23 24 2 30 45 األمراض المشتبهة Mumps 3 18 5 17 17 16 29 Mal 4 12608 41 641 109 465 705 6451 652 229 949 262 675 23791 Meng 0 0 0 0 11 0 0 2 1 0 1 0 0 15 DF 2 104 0 2 0 0 0 8 0 0 0 0 0 116 VHF 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sch 0 7 22 21 18 124 25 204 24 36 38 53 48 620 CL 0 0 11 4 11 10 4 2 3 5 2 6 4 62 RB 39 17 2 11 77 19 18 15 55 0 0 4 4 261 Tuberculosis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 HIV/ AIDS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Brucellosis 32 7 46 12 44 39 249 72 75 3 5 24 9 617 Chicken Pox 8 21 15 8 16 12 11 19 16 3 44 26 0 199 Scabies 0 21 0 10 11 23 13 21 4 9 55 30 6 203 Guinea Worm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 othr_disease 5054 25561 4881 5474 40129 11818 15738 22711 17818 1668 11388 9674 5036 176950 total_cons_disease 8741 40991 7916 8156 49709 18936 24264 33543 24963 3311 19783 19363 8024 267700 This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 3 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 2,(11- 17 January,2021)

Alert Responded in Epi - Week2,2021

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Surveillance coordinatore contacted focal points information shared , the case was diagnosed clinically AFP Al-Baidha At Taffah Al-Taffah Center 1 0 according to case definition, samples were collected from the case and send

AlQuraishyah,AsSawadiyah Althwrh Hospital,Al-Taffah Center,Zkhm HC,Alshriah Sare H,Thi - eIDEWS coordinator the focal points information was shared, the cases were diagnosed clinically acoording to Chol Al-Baidha ,DhiNa'im,Rada',Sabah, 113 0 Naem HC,Dar Al Najd HC,Other case definiaton, treatment were given ALSharyah,AtTaffah,Radman AlAwad,Wald Rabi'

Surveillance coordinatore contacted focal points information shared , the cases were diagnosed clinically MEAS Al-Baidha Radman Al Awad,Mukayras,Dhi Na'im Abdrabh Saleh Almhamdi HC,Other according to case definition, Antibiotics treatment were given,Apear skin rash and fever , one case was 10 0 vaccination and 4 cases were un vaccination against measls, samples were collected from the cases

eIDEWS team contacted focal points, the cases diagnosed clinically according to case definition, the cases were PERT Al-Baidha At Taffah Al-Taffah Center 2 0 unvaccination

AlHawak,AlHali,Jabal Ras,AlGarrahi,Bura AlmughtaribeenHC,Alhshm eIDEWS coordinator contacted the focal points, information was shared,The cases were diagnosed clinically AzZuhrah,Zabid,AlMansuriyah AzZaydiyah,Bayt Center,ZayedHC,AlkanawesHC,AlsalakhanaHsalamcenter,Alzaydia according to cases definition,some cases were investigated by rapid test for vibrio cholera and result were Chol AlHodaidah AlFaqiah,AlQanawis 245 0 RuralH,Aljarrahi rural H,Deir zblh H,AlMokarHC,Aldhahi Rural positive for 17 and 32 cases were negative, Appropriate treatment were given according to severity of AlMina,AlMarawiah,AlMighlaf,AsSalif H,AlBaidha AlGarbiah HC,Bait Alfakih HAlmansouriaruralH,Other AdDurayhimi,AsSukhnah,At Tuhayat symptoms and dehydration.

Surveillance coordinator contacted HFs focal points information were shared, the cases were clinically MEAS AlHodaidah Al Hali,Al Marawiah,At Tuhayat,As Sukhnah Al Baidha Al Garbiah HC,Alkhalifa HC,Almudmn HU 8 0 diagnosed according to the case definition. the samples were collected and sent

eIDEWS coordinator contacted the focal point, information was shared. all cases were diagnosed clinically PERT AlHodaidah Az Zaydiyah Alzaydia Rural H according to cases definition. 1 case was male and 1 case was female,the cases were vaccinated against 3 0 pertussis, the focal RRT was send to investigate and treat any new cases

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,the cases were diagnosed clinically according to case definition. NO Stool samples(C/S & serotyping) collected from cases . Supplements Chol Al-Jawf Al Matun,Bi'rat Al Anan,Rajuzah Al Maton Health Center,Bart Al Anan Rural Hospital,Other 6 0 & antibiotics treatment were given,Rapid tests of cholera was positive for 1 watery from some cases, stool samples doesnot collected ,There were no a collection or cluster of cases seen in the same Place.

Surveillance coordinator contacted HFs focal points, information's shared. Blood samples were not collected Al Hazm,Khob Wa Asha'af,Al Maslob,Kharab Al Al Hazm Health Center,Al Marashi Health Center,Al Masloob Health MEAS Al-Jawf from the cases and doesnot sent for lab confirmation . the onset of fever, skin rash.the cases were vaccinated 4 0 Marashi Center except one case was unvaccination against measles . Vit-A were given to the cases

The surveillance coordinator of the governorate called the focal points of the health facility and the information was exchanged over the phone and it became clear that the case conformed with the standard definition and the health facility was visited the investigation form was written for the case 4 stool samples were requested for the cases within a 24-hour interval which was taken for the acute flaccid paralysis surveillance program and AFP Amana Aththaorah,Maain AL ATRAF HC,Scinces and Tecnology H 3 0 the focal point of the health facility contact An immediate report was made in the eIDEWS system.The cases data has also been entered in the list of cases of acute flaccid paralysis in the eIDWS system and the case is reported in the daily report and submitted to the operations of the Health Office and surveillance operations in the Ministry of Public Health and Population

The eIDEWS coordinator and the DRRT contacted the focal points at the health facility by phone to ensure that Omar Al Mokhtar Complex,22 May Hospital,Jabr Bn Hyan the cases conformed with the standard case definition of cholera , The cases data were also uploaded to the Chol Amana Aththaorah,AsSabain,Shu'Aub Bani AlHarith Complex,As Sabin Hospital,Jddr HC,Al Jraf Complex,Ottan data entrants The cases data were entered in the line list of suspected cholera cases and submitted to the 95 0 Complex,Other central level of the program in the eIDEWS system there is no collection of cases in the same place ,some cases tested by rapid test and result negative except 2 cases were positive

The eIDEWS coordinator and the DRRT contacted the focal points at the health facility by phone to ensure that the case conformed with the standard case definition of diphtheria , The cases data were also uploaded to the data entrants by DRRT The cases data were entered in the line list of suspected diphtheria cases and submitted to the central level of the program in the eIDEWS system the focal points sent an immediate notification to the eIDEWS system there is no collection of cases in the same place. The cases were reported in the daily reports DIPH Amana Maain,Shu'Aub,As Sabain 22 May Hospital,As Sabin Hospital,Alrazi HC and communications to the governorate operations the ministry of health and the eIDEWS program The DRRT 6 0 collect a throat swab sent to the central labs for confirmation by CS The cases were given anti-toxin against diphtheria and the patient is still under treatment and the rapid response team took the necessary measures including taking a throat swab writing an investigation form and doing health education for contacts and later came to contacts at home and gave them preventive medicines and educational instructions to prevent the spread of the disease among them

The surveillance coordinator in the governorate contacted the focal points at the health facility the information was exchanged by phone and it became clear that the cases conformed with the standard definition the focal Aththaorah,Shu'Aub,At Tahrir,As Al Jraf Complex,Al Mithaq Complex,Alulfi HC,As Sabin Hospital,Azal MEAS Amana points made an immediate notification in the eIDEWS system ,the cases were unvaccinated against measles 10 0 Sabain,Az'zal,Maain,Bani Al Harith Complex,Other The cases were given vitamin A to enhance the childs immunity and to avoid any complications of the disease There are no collection cases seen of adjacent to the case

The eIDEWS coordinator and the DRRT contacted the focal points at the health facility by phone to ensure that the cases conformed with the standard case definition of pertussis then the HF visited , The cases data were As Sabin Hospital,Azal Complex,Omar Al Mokhtar PERT Amana AsSabain,Bani AlHarith,Shu'Aub Az'zal also uploaded to the data entrants The cases data were entered in the line list of suspected pertussis cases and 7 0 Complex,Phalastain Hospital submitted to the central level of the program in the eIDEWS system there is no collection of cases in the same place treatment by antibiotics were done, All cases were unvaccinated against pertussis

AlMadan,BaniSuraim,Amran, Raydah Health hos.,Habur Health hospital,22 May hospital,Al eIDEWS Coordinator Contacted focal points, districts coordinator Information was shared, the cases were Chol Amran Raydah,HaburZulaymah,Kharif,AsSudah,Maswar Sanaaniah Health Center,Maswar Rural Hospital,Huth Health diagnosed clinically as suspected cholera, according to case definition, Rapid Test were done for some cases 101 0 Huth,Dhi Bin,JabalIyalYazid,AsSawd,Al Ashah hospital,Al Madan Health hospital,Other and the result were two positive and other cases were negative, they were given appropriate treatments

Surveillance coordinator contacted HFs focal points, Information was shared, visit health hospital,the cases were diagnosed clinically as suspected Measles,according to case definition, Blood samples were collected of MEAS Amran Amran,Khammer,Raydah Al Hekmah dispensaryRaydah Health hos.,Al Salam Khamir Hospital 8 0 cases and sent to lab central in sanaa for confirmation,the cases were unvaccination except one case was vaccination and one case other was under age vaccination

eIDEWS coordinator contacted focal points, districts coordinator Information was shared,the cases were Al Ashah Health hospital,Al Salam Khamir Hospital,Huth Health PERT Amran Al Ashah,Huth,Khammer diagnosed clinically as suspected pertussis, according to Case definition. Antibiotics appropriate Treatments 9 0 hospital were given,The cases were unvaccinated against Pertussis

Utmah,Anss,AlManar ,Wusab AlAli eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and treated Rsabh Hospital,Dhamar public H,Alwahda university H,Ezzan Chol Dhamar AlHada,Jahran,Wusab accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use WHO protocol 47 0 Center,Souk Aleffa HC,Zeraja rural H,Aljarf HC,Other AsSafil,Mayfa'atAnss,Dhamar City ORC , rapid test not done .

eIDEWS coordinator contacted focal points, information shared, after that HFs visited by eIDEWS coordinator, The cases were diagnosed clinically according to the case definition as probaple diphtheria. Symptoms & signs DIPH Dhamar Jahran Alwahda university H of a cases were, fever, sore throat, grey-whitish pseudo-membrane, swelling of neck lymph-nodes(Bull neck) & 5 0 difficulty of swallowing & breathing., Antibiotic treatment were given except one case was under age Antibiotic , the cases were unvaccination

ArRadmah,AlMashannah,AsSaddah,AlMakhadir,A Almakhader HC Alqaidah H,Aladin H,Aldhalmh HC,Dar Al Sharq Immediate notification EDEWS coordinator Visited hospital , some stool samples were collected and negative Chol Ibb 72 0 sSabrah AshShair,Jiblah,AlUdayn,YarimIbb,Badan HC,Yarim Hospital,Alshaheed Albadani Hospital,Alradhmah H,Other by rapid test, they were given appropriate treatments

Surveillance coordinatore contacted the District Focal Points, Sample was collected at 17/1/2021,the case was MEAS Ibb Al Udayn Blad- Almuliki HC 2 0 unvaccinated.

eIDEWS coordinator contacted the focal points, information was shared,the cases were diagnosed clinically Chol Rayma Al Jabin,Bilad At Ta'am,Mazhar Althulaia H,Az Zilh HC according to case definition,two cases were investigated by rapid test for vibrio cholera and the result negative 40 0 . Appropriate treatment were given

eIDEWS coordinator contacted the focal point, information was shared. the case was diagnosed clinically according to case definition.Ghazi Ali Dawood Ismail 20 years old fromAljaferia brown Aljad village. he was DIPH Rayma Al Jafariyah Alhadiah HC 1 0 admitted t Apr 2 ,2020 with symptoms and signs of suspected diphtheria since 3 day's, he was refer to . he was unvaccinated against diphtheria

Surveillance coordinator contacted HFs focal points,The coordinator survey visited the health facility. The case AFP Sanaa Governorate Al Haymah Ad Dakhiliyah Kuwait Center was 48 months' male The case was diagnosed clinically by case definition. The Paralysis started in 12_1_2021. 2 0 The case was vaccinated 5 dose. stool sample was collected and sent to central lab.

Jahanh,BiladArus,Attyal, AlHaymah EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case definition(AWD) Walan Hospital,Bait Al Shatarah Hu,Hamdan Hospital,Alshe'eb Chol Sanaa Governorate AdDakhiliy,Bani Matar,AlHaymahAlKharijiyah, suspected cholera ,some cases tested by rapid test and result 4 cases positive, the cases were treated at the 217 0 Alaswad HC,22 May Hospital,Other Nahm,Khwlan,Hamdan health Facility and received treatment.

Surveillance coordinator contacted HFs focal points,The cases were diagnosed clinically by case definition,skin 22 May Hospital,26September H in Matna,Alshaeed Mohamed MEAS Sanaa Governorate Hamdan,Sanhan,Jahanh,Bani Matar rash started ,The cases were vaccinated except 3 cases were unvaccination , blood samples were collected and 6 0 Aldurra Hospital sent to central lab

The EDEWS coordinator contacted the focal person, The cases were diagnosed clinically by case definition, the PERT Sanaa Governorate Al Haymah Ad Dakhiliyah Kuwait Center 3 0 cases were vaccination unknown,The cases were treated with antibiotic.