Week 26 2019.Pdf

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 07,lssue26,Epi week 26,(24-30 Jun,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-26,2019

% % % % %

% % % % % % % % % %

% % %

96 96 96 96 96

95 95 95 95 95 95 95 95 95 95

94 94

100% 94 400000

93 93 90% 350000 80% 300000 70% •During week no.26,2019, %96(1991/1912) health facilites from 23 Governorates 60% 250000 provided valid surveillance data. 50% 200000

40% 150000 Percentage

30% Consulttaions 100000 20% 10% 50000

0% 0

Wk 4 Wk 6 Wk Wk 1 Wk 2 Wk 3 Wk 5 Wk 7 Wk 8 Wk 9 Wk

Wk13 Wk15 Wk17 Wk24 Wk26 Wk 11 Wk 12 Wk 14 Wk 16 Wk 18 Wk 19 Wk 20 Wk 21 Wk 22 Wk 23 Wk 25 •The total number of consultation reported during the week in 23 Governorates was Wk 10 354760 compared to 351332 the previous reporting week 26 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 26,2019)

% %

100% % 100

Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of morbidity this %

% %

100

100 97

90% 100

100

96 95 94 %

week. 80% 92

91 78

70% 90 60% 50% 40% 30%

20% No.HF Reports 10% A total of 2250 alerts were generated by eDEWS system in week 26, 2019, were verified 0% as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 26,2019 Proportional morbidity of leading priority diseases, Epi week 26,2019

AVH_A&E; 0.1% AFP; 0.0% Mumps; 0.1% Mal; 4.5% DF; 0.2% Typhoid F; 1.4% AVH_B&C; 0.0% ● (URTI) 14.1%, suspected Malaria (4.5%),(OAD) (9.7%) and (LRTI) (5.2%)Remain the Meas; 0.0% Sch; 0.1% RB; 0.1% leading causes of morbidity representing a total of (50%) Meng; 0.0% Brucellosis; 0.3% Chicken Pox; 0.2% Scabies; 0.1% ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than CL; 0.0%

1% of total morbidity in reporting period Bloody diarrhea represented 0.5% Of this OAD; 9.7% morbidity

● All diarrheal disease comprised 16.5% and LRTI 5.2% of total morbidity in pilot Governorates BD; 0.5% SARI; 0.0% URTI; 14.1% this week . Pert; 0.0%

ILI; 0.6% ● All diarrheal disease comprised 16.5% and OAD 9.7% of total morbidity in all age group . LRTI; 5.2%

Measles Situition in Yemen Distribution of Governorate Measles cases & Deaths , Epi weeks1- 26,2019 Epi Curve of Measles in Yemen During 2017,2018,2019

900 900

800 800

700 700 600 600 500

400 500

300 400

200 300 100 200 0

100

wk1 wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9 wk10wk11wk12wk13wk14wk15wk16wk17wk18wk19wk20wk21wk22wk23wk24wk25wk26wk27wk28wk29wk30wk31wk32wk33wk34wk35wk36wk37wk38wk39wk40wk41wk42wk43wk44wk45wk46wk47wk48wk49wk50wk51wk52 0 2019 465 524 562 594 620 615 837 590 384 304 245 220 196 195 163 177 135 125 106 83 84 63 37 114 161 148 2018 241 218 357 349 377 328 384 459 427 512 532 722 733 820 763 844 631 625 673 451 500 492 394 210 374 348 494 442 482 465 420 438 337 253 369 439 404 428 501 404 451 524 434 489 416 470 427 455 414 494 468 442 No of cases No of Death 2017 80 127 145 166 179 146 178 166 143 174 129 122 123 82 137 90 81 72 98 85 54 53 44 31 19 33 87 74 58 95 91 95 75 91 21 66 80 89 76 109 131 92 97 91 67 130 136 105 103 123 114 116

النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا على شكل وباء :ILI التهاب تنفسي حاد وخيم:SARI التهاب الكبد :AVH الحصبة :Meas داء الكلب :RB التهاب السحايا :Men حمى الضنك :DF مالريا :Mal بلهارسيا :Sch اسهال مائي حاد :AWD التهاب الجهاز التنفسي السفلي:LRTI اسهال حاد اخرى :OAD اسهال مدمم :BD عدوى الجهاز التنفسي العلوي :URTI االيذز :HIV الجذري:CHICKEN دودة غينية:GUINEA حمى مالطيه:BRUCELLOSIS السل:TUPERCULOSIS 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 26 (24-30 Jun,2019)

GOV

Distribution of suspected cholera cases by age group (1 Jan- 10 July 2019) Distribution of associated deaths by age group (1 Jan- 10 July 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Distribution of suspected and deaths cases by age and sex From 1 Jan to 14 April 2019

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 26 (24-30 Jun,2019) Dengue Fever and Measles Outbreak SITUATION IN YEMEN

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Deaths Email ([email protected])

Deaths

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 26 (24-30 Jun,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-26 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-26,2019

20.0% 8.0% 4500

18.0% 4000 7.0%

16.0% 3500 6.0% 14.0% 3000

5.0% 12.0% 2500

10.0% 4.0% 2000

8.0% 3.0% 1500

6.0% 1000 2.0% 4.0% 500

2.0% 1.0%

wk9 wk2 wk3 wk4 wk5 wk6 wk7 wk8

0.0% wk1

wk10 wk11 wk13 wk14 wk15 wk16 wk17 wk18 wk19 wk20 wk21 wk22 wk23 wk24 wk25 wk26

0.0% wk12

WK6 WK1 WK2 WK3 WK4 WK5 WK7 WK8 WK9

WK22 WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK17 WK18 WK19 WK20 WK21 WK23 WK24 WK25 WK26

WK6 WK2 WK3 WK4 WK5 WK7 WK8 WK9

WK1 Rapid Test(Postive) Microscope(Postive)

WK17 WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK18 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK26

Age and Sex distribution of total consultations of leading diseases (Epi week 26,2019) Number of Alerts Received and Responded (Epi Weeks 23-26,2019)

80000

73501 URTI LRTI Pert BD OAD Typhoid F

70000 AFP Meas AVH_A&E AVH_B&C DF Meng

60000 Sch CL Chicken Pox Mal 400

50000 48059 350

40000 300 35305 35857 32224 32735 250 30000 28647 24742 200 22432 21698

20000 of No.Alerts 150

100 10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 22432 32224 35305 48059 24742 Female 21698 32735 35857 73501 28647 Distribution of consultations of leading diseases by Governorates,Epi week 26-2019

Hadramout Sanaa Suspected Disease Abyan Aden Al-Baidha Al-Dhale AlHodaidah Al-Jawf Al-Mahra Al-Mahweet Amana Amran Dhamar Hadramout Hajjah Ibb Lahj Mareb Rayma Sa'adah Shabwah Socotra Taiz Total wady Governorate URTI 2448 4304 1433 870 5674 970 615 941 4875 1783 2662 1454 1726 2985 2191 3618 677 580 2835 2899 1173 83 3065 49861 LRTI 275 426 793 210 3963 291 44 453 1946 927 1626 302 240 1324 1281 1034 201 123 538 1063 231 30 1287 18608 ILI 215 0 56 0 123 81 0 2 14 36 222 2 0 470 97 0 148 3 77 94 193 15 188 2036 SARI 0 0 9 0 0 0 0 0 6 0 70 0 0 2 1 0 0 0 29 0 0 0 0 117 Pert 2 2 0 0 11 8 0 0 0 30 0 4 4 2 23 3 0 0 7 6 1 0 15 118 BD 48 5 32 9 156 71 0 111 138 173 235 5 5 3 84 14 47 18 105 154 31 0 155 1599 OAD 1167 1774 1176 527 2342 1057 278 913 4602 1918 2469 566 386 3146 2196 1630 509 498 1806 2527 808 25 2161 34481 Typhoid F 40 55 316 12 522 208 0 157 678 252 857 33 4 0 549 57 72 88 215 260 68 29 409 4881 Meas 1 19 1 1 5 3 0 8 11 16 0 0 0 5 16 2 0 3 24 8 14 0 11 148 AVH_A&E 14 13 4 2 4 3 0 0 106 9 40 17 13 2 19 24 5 3 3 3 25 0 18 327 AVH_B&C 4 4 1 0 0 2 0 0 91 0 10 1 0 6 26 3 6 0 0 0 0 0 9 163 NNT 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 AFP 0 0 1 0 0 0 1 0 2 0 1 0 0 1 4 0 0 1 0 2 1 0 0 14 377 25 0 5 24 18 4 14 10 8 42 19 8 األمراض المشتبهةMumps 15 10 20 12 30 26 1 6 39 20 21 Mal 63 277 14 5 6751 162 42 594 190 459 468 1 1 3067 396 91 12 239 964 190 11 0 2118 16115 Meng 0 5 0 0 4 0 0 0 6 0 4 1 0 0 14 0 0 0 2 0 1 0 18 55 DF 145 110 0 5 37 0 0 0 0 0 0 15 4 2 0 94 26 0 0 0 22 0 76 536 VHF 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 Sch 0 0 1 19 0 15 0 14 59 75 28 4 0 105 17 5 0 15 60 21 0 0 9 447 CL 0 0 3 6 0 3 0 0 12 11 11 0 7 2 4 11 2 2 6 4 1 0 0 85 RB 0 0 0 0 2 2 0 6 71 0 58 0 1 11 23 0 0 0 0 5 0 0 11 190 Tuberculosis 2 5 2 0 2 0 0 1 14 1 6 1 1 5 7 1 0 1 3 2 2 0 4 60 HIV/ AIDS 0 0 0 0 0 0 0 0 3 0 1 0 1 2 0 0 0 0 1 0 0 0 0 8 Brucellosis 2 0 51 0 14 21 0 3 164 51 300 0 7 134 88 0 14 0 39 16 12 0 17 933 Chicken Pox 0 33 7 17 9 22 0 29 113 43 26 10 5 59 55 16 25 36 134 39 24 1 19 722 Scabies 24 0 0 0 109 7 0 9 31 3 12 1 0 42 0 0 0 19 23 14 0 0 0 294 Guinea Worm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 othr_disease 3950 8946 5565 6263 11886 3192 1766 3597 45847 4938 17702 7178 3885 7825 13489 12311 5093 1082 5351 8105 5042 275 11458 194746 total_cons_disease 9713 16452 10611 8267 36011 6716 2758 7719 61869 12310 30033 10288 6724 21744 22528 19219 6880 3078 13653 17273 7878 458 22578 354760 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]) 4 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 26 (24-30 Jun,2019)

Alert Responded in Epi - Week 26,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Tur Sena'a Dispensary ,Dar Almunasra HU,Alamal AlMilah,AlMusaymir,Halimayn,YaffaTur The focal points were contacted , information shared , the cases of suspected dengue fever were DF Lahj Halmien Dispensary,Halimeen rural H,October public diagenosed clinicaly according to case definition . 94 0 Al Bahah,Tuban H,Tour Albaha Hospital,Alwaht rural H,Alhlal HC Cases added to the line list , treated symptonaticaly and improved.

Contact with the focal points , the cases of suspected cholera were diagenosed clinicaly according to case definition. Radfan,AlHad,AlMilah,AlMaqatirah,Halim Radfan Public H,Rayshan HU,October public H,Tour 32 RDT positive and ather cases Chol Lahj ayn,Yaffa,TurAlBahah,AlHawtah Albaha Hospital,Almusaimeer H,Alwaht rural H,Yaher negative. 221 0 AlQabbaytah,Tuban,Yahr, Al Musaymir rural H,Other the cases reported immediatly to the operation room , registred in the line list the cases treated by iv fluid, ors and antibiotic. the cases finaly improved and left the health facility.

Contac with the focal point , 2 cases of suspected measles were diagenosed clinicaly according to case Meas Lahj Al Had Aljanab HU definition. 2 0 Cases added to the line list,treated symptomaticaly and left the health facility.

Eidews coordinator visited the health facility , the cases of suspected whooping cough were diagenosed Pert Lahj Tuban,Radfan Al Hakmah Center clinicaly according to case definition. 3 0 The cases treated symptomaticaly and left the health facility.

Alburaihi H,Aljumhuria educational H,Masafi Aden Khur Maksar,Al Buraiqeh,Ash Shaikh eIDEWES team were contact fp, the cases were different areas, the cases were diagnoses clinically, DF Aden H,Alwahda educational H,Aden German Hosp.,Al-Wali the most samples were collected, treatment were given, the most cases investigation form were done, 110 1 Outhman,Al Mualla,Al Mansura,Dar Sad Hosp.,Al Ryadah Hosp.,Other one case was dead

eIDEWES team were contacted fp : the cases were diagnosis clinically, treatment were given, Chol Aden Dar Sad,Ash Shaikh Outhman Albasateen medical center,Alwahda educational H 93 0 investigation from were done.

Almua'ala health complex,Dar Saad Complex,Alwahda Dar Sad,Sairah,Ash Shaikh Outhman,Al eIDEWES team were contact fp, the cases were diagnoses clinically, treatment were given, sampls Meas Aden educational H,Al Ryadah Hosp.,Madinat Alsha'ab health were collected, the cases were un vaccination except 5 cases were vaccination unknown and one case 19 0 Buraiqeh,Al Mualla,Al Mansura complex,Other was vaccination

eDEWS team contacted RRT, the cases were diagnoses clinically, the cases were un-vaccinated , Pert Aden Al Mansura,Sairah Alnakib H,Almaidan health complex 2 0 treatment were given, samples were not collected and investigation form were done.

eIDEWS team were contacted , rapid test were positive,samples were collected,treatment were given , VHF Aden Al Mualla,Al Mansura Al-Wali Hosp.,Other 2 0 investigation form were done.

khanfir,Al Mahfd,Lawder,Al Al Thuraya Clinic,Amajl HC,Al Azi Dispensary,Al Mahfad eIDEWS team contacted the FP, the cases were diagnosed clinically (standard dengue case definition), DF Abyan 145 0 Wade'a,Ahwar Hospital,Mahnf-Lwdr H,Alwadhee H,Ekhlas Clinic samples were not collected, treatment were given, investigation forms were done.

RRT in districts visited the suspected cases of Cholera, RDT were (+) and stool for culture didn't Chol Abyan Al Mahfd,Mudiyah,khanfir,Lawder Al Mahfad Hospital,Mudiya Hosp.,Alrazi .H,Mahnf-Lwdr H collected,the cases were diagnosed clinically, treatment were given, investigation form were done, the 86 1 cases included in Cholera line list, one case was dead

eIDEWS team contacted the F.P. in Mudiyah H. the case was 1 male ( Azzam Basel Azzam Ahmed) 8 months old. from Mudiyah city. the case didn't received any doses of MR vaccine during either the Meas Abyan Mudiyah Mudiya Hosp. 1 0 routine or campaign vaccination of measles and rubella. investigation done in 26 June. and Blood Sample collected and waiting for send to Sana,a city

eIDEWS team visited the focal point in Mahnf H, the suspected cases were 1 female >5 years old,(Nora Raid Qasem), 9 years old from Lawdar city and her brother (Ali Raid Qasem) 3 years old. both cases Pert Abyan Lawder Mahnf-Lwdr H were unimmunized and diagnosed clinically according to the standard case definition. all of them 2 0 admitted in the hospital and take antibiotics & regular interest till complete recovery . investigation form done , RRT IN Lawdar district investigated the region for quick research on other new cases.

Sharab Ar Rawnah,Al Misrakh,Khadir,Al Al Aroos Hospital,22 May HC,Ar Romah Qahirah,Al Maafer,Sama,Mawiyah,Al Rapid response team contacted also focal points by eIDEWS coordinator,cases diagnosed clinically center,Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Chol Taiz Mudhaffar,Salh,Sharab As 1499 2 Loqiah Hospital,22 May Almodafar HC,Mawih labs)rapid test :129 cases were positive &,the results of stool C/s still pending,There were collection & Salam,SabirAlMawadim,Maqbanah,AtTai Hospital,Other cluster of cases in the same Place,2 cases were dead ziyah,AshShamayatayn Hayfan

Al Mudhaffar,Al Qahirah,Sharab Ar 22 May Almodafar HC,Al wahdah HC,Abduljalil Nassr eIDEWS coordinator contacted focal points and the coordinator of the directorate ,information's Meas Taiz Rawnah,MashraaWaHadnan,Salh Al shared.Blood samples were collected from the cases and sent for lab confirmation & the cases were 11 0 Hoapital,Alfath HC,Other Mawasit vaccinated ,All data in the line lis.

Mohammed Al-Dourah HC,Alrwdh H,Altawn H,Aljoumhri Focal points and the coordinator of the directorate were contacted , the suspected DF cases had a DF Taiz Al Qahirah,Al Mudhaffar,Salh history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by 76 0 H,Alhikma Hospital,Althwrh H blatelets counting, ,rapid test of dengue virus were done for some of cases ,which were positive, Medications have been given,,,there is cluster of cases in some areas, All data in the line list..

the communicating with the coordinator of edews in the facility we found these cases of suspicion of pertussis,the cases were from different areas. .. Action :these cases were treated at home . Advices Pert Taiz At Taiziyah MSF Hospital 15 0 have been given to their parents to follow up and review.. These cases from different areas ..

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case DF Hadramout Ad Dis Ad Dis Al-Shrgyah Hospital definition,The cases came from different areas , blood samples were collected, All cases were treated by 15 0 symptomatic treatment and improved.

The district RRT investigated the living area,The cases were diagnosed clinically by case definition, RDT Chol Hadramout Hajr,Al Mukalla City,Broom Hajar aljoul rural H,Mifaa HC were positive for 2 only,Stool culture were collected and sent to central lab, health education activities in 5 0 the area.

Immediate report was sent by the EDEWS focal person. The cases were diagnosed clinically by case Al-Madinah Dispensary,Maternity and Childhood H - definition. One case was from Shabowa gov(Azzan area). The 2nd case from AlMukalla city. The cases Pert Hadramout Al Mukalla City 4 0 Mukalla were 2 females less than 5years. Both cases were unvaccinated. Antibiotic treatment were given in the outpatient clinic.

The died case is 4 years old female from AlMukalla city. The case c/o low grade fever, defficult sawllwing,barking cough and stridor. Pseudomembrane was seen. It was thick adher to both tonsil. No Bull neck. This case is not vaccinated. Symptoms started in 20_6_2019(before 3 days of admission). Culture swap was collected. Diphitheria bacilli was seen. The case recieved DAT and cover antibiotic. Diph Hadramout Al Mukalla City Maternity and Childhood H - Mukalla 0 1 The case detriorated and admitted in bad general condition. O2 saturation decreased. The pt gone apnea. ENT consultation was done. Tracheostomy was not done. The case died in 25_6_2019. The RRT visited the living area. Cover the contacts with azithromycine. The area is included in the outreach activities .

Al Udayn,Yarim,AlMashannah Hubaysh,As Saddah, Far Al Udayn,Ibb,DhiAsSufal AL Mzahan H,Yahsub Hospital,Aladin H,Mother and Child Immediate notification. eDEWS Coordinator visited hospital, the stool samples were collected,85 cases ArRadmah,Mudhaykhirah Badan,Hazm were positive by rapid test . Chol Ibb H,Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani 1878 0 Al Udayn,As Hospital,Alradhmah H,Almakhader HC,Alqaidah H,Other Sabrah,AlQafr,AlMakhadirAs All cases were improved Sayyani,Ash Shair,An Nadirah,Jiblah,Al Dhihar

HazmAlUdayn,AsSayyani,Yarim As Alsadah HU,Jplh .H,al-Hazm Hospital,Al Saleh eDEWS focal points contacted.Information shared , Samples were collected, the cases were Meas Ibb Saddah,Al Makhadir,Jiblah,Al Udayn,Al hospital,Japal Pahri HU,Yahsub Hospital,Mother and 16 0 vaccinated except 2 cases were un vaccination Mashannah Child H,Aladin H,Other

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]) 5 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 26 (24-30 Jun,2019) Alert Responded in Epi - Week 26,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Immediate notification by focal points, the Cases were diagnosed clinically and treated accordingly, the Pert Ibb Al Mashannah,Yarim Mother and Child H,Other 23 0 cases were Vaccinated except one case was un vaccination

Far Al Udayn,Al Makhadir,Al Dhihar,Al Immediate notification,samples were collected from cases and send to sanaa, the cases were AFP Ibb AL Mzahan H,Belfaqih H,Other 4 0 Mashannah vaccination except one case was un vaccination

Bura,Al Mansuriyah,AzZaydiyah,Bayt Al Alsalakhana H,Alhshm Center,Alkanawes HC,salam eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Faqiah,Al Qanawis, Ad Dahi,Az Zuhrah, treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use Chol AlHodaidah center,Aldhahi Rural H,Almansouria rural H,Bait Alfakih 4365 3 Al Hawak,Al Hali, As Salif,Al Munirah,Al WHO protocol ORC, cases done rapid test for sever cases, positive send for confirmation,3 cases were H,Alzaydia Rural H,Aljarrahi rural H,Alluheyah HU,Other Hajjaylah,Al Mighlaf,Al Garrahi,Alluheyah dead

Coordinator contacted the hospital focal points, the cases were diagnosed suspected Pret and treated Pert AlHodaidah As Salif Alsalif Hospital accordingly, some cases have been two doses and the other have completed doses of vaccine , no 11 0 cluster of three cases in same place

Focal points were contacted , the suspected DF cases had a history of high fever , retro- bulbar pain DF AlHodaidah As Salif,Al Hali,Zabid, Al Hawak Alsalif Hospital,Zayed HC,Althawra public H ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been started, ALL cases 37 0 diagnosis depend on case definition and platelets counts, no cluster of three cases in same place

Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane Diph AlHodaidah Al Hawak Althawra public H around tonsillitis , the cases were un vaccination , the cases were diagnosed clinically,Medications 8 0 have been started, ALL cases only depend on case definition, refer to Althowra

Al Hawak,At Tuhayat,Al Hali, Az eDEWS coordinator contacted the focal points, the cases were suspected measles, the cases were un Meas AlHodaidah Alrabsa HC,Alzaydia Rural H,Other vaccination ,fever , rash recorded , the blood samples have been collected from the patient by district 5 0 Zaydiyah coordinator and sent to the central laboratory in Sanaa.

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts,Information shared . We Wadhrah,Hajjah City,Washhah,Kuhlan received a report from HC, the cases (suspected diphtheria) The cases were diagnosis clinically, the Diph Hajjah Public Republican Hospital,Other cases were unvaccination,The response team in the field investigated the cases and the contacts , the 4 0 Ash Sharaf appropriate treatment were given

Najrah,AshShahil,QaflShamerBaniQais,A lMiftah,Qarah Aslem,AlJamimah Public Republican Hospital,Khatwah HC,Qafl Shamer AflahAshShawm,Mabyan,HajjahCity,Abs, Kufl-Shamar Rural H,Bani Chamakh HC,Bani Qais Haradh,Hajjah Kuaydinah,AlMahabishah eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, Information shared .It have Chol Hajjah Health Center,Mabyan Hospital,Kuhlan Afar been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea) 2498 4 Kuhlan Affar,Mustaba,Bani Al HC,Almahabesha Public H,Alshahel Rural the cases from different area. It were given the appropriate treatment,4 cases were dead Awam,Kuhlan Ash Sharaf Al Hospital,Almaghraba HC,Other Maghrabah KhayranAlMuharraq AshShaghadirah

eIDEWS Coordinator contacted the Coordinator of Surveillance in District. The cases were diagnosed Pert Hajjah Hajjah City Public Republican Hospital 2 0 clinically according to the standard definition, and appropriate treatment was given to the cases

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It was diagnosed clinically according to standard definition For AFP, male A 72 Months, Bashar khali dsalih , AFP Hajjah Hajjah City Public Republican Hospital 1 0 from Ash Shaghadirah District bani seraa village , Investigation form was Done. Appropriate treatment was given. The sample was collected and sent to the central laboratory

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts,Information shared.It were diagnosed clinically according to standard definition For measles , the cases were un vaccination, Meas Hajjah Mabyan,Sharas,Aslem Mabyan Hospital,Other 5 0 Investigation form were Done,Appropriate treatment were given,The samples were collected and sent to the central laboratory

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Omar Al Mokhtar Complex,Bni - Hwath HC,Arwdhah clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab Aththaorah,Shu'Aub,Assafi'yah,BaniAlHar H,As Sabin Hospital,Jddr HC,22 May Hospital,Alwahda (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana ith,AsSabain,MaainAz'zal,At of them were from Amana governorate & a few of them from other governorates ,different districts of that 2529 0 Health Center,Alrazi HC,Al Jraf Complex,Jabr Bn Hyan Tahrir,Sana'a Old,AlWahdah governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most Complex,Gazah Complex,Other collected specimens,so stool C/s not done for that negative samples.There were a collection or cluster of cases seen in the same Place

eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Al Wahdah,Az'zal,Aththaorah,Sana'a Klodia Vaian Complex,Azal Complex,Alraisi cases and sent for lab confirmation , the cases were unvaccinated except 2 cases were vaccination Meas Amana 11 0 Old,Shu'Aub,Maain,Assafi'yah HC,Shu'aub(Hae Alsjn) Complex,Maain Complex,Other against measles, Vit-A were given to the cases in order to support their immunity against complications of measles.

eIDEWS coordinator contacted focal points,then HF visited. Information shared.Stool samples collected AFP Amana Assafi'yah,Aththaorah Althwrh H,AL ATRAF HC 2 0 from the cases and sent for lab confirmation, the cases were un vaccination

eIDEWS coordinator contacted focal points,informations shared,after that HF visited by eIDEWS coordinator.The case diagnosed clinically according to the case definition as suspected diphtheria.Symptoms & signs of a case were,fever,sore throat,grey-whitish pseudo-membrane,swelling Diph Amana As Sabain,Maain As Sabin Hospital,ALIRAQ HEALTH CENTER,Azal H 4 0 of neck lymph-nodes(Bull neck) & difficulty of swallowing & breathing. Antibiotic treatment was given & case management done.Throat swab & fixed slides were taken into Central Lab for confirmation(Albert stain,Gram stain & Diphtheria C/S)the cases were vaccination

Razih,Sa'da,Baqim,AdhDhahir Al Ghabir Health Unit,Al Jumhoori Hospital,Al Barakat eIDEWS focal points contacted . the DTCs recived cases suspected cholera cases comming from different ,all cases are diagnosed clinincally , the cases were tested by RDT ,12 cases were positive by Chol Sa'adah Sahar,MajzMunabbih,Qatabir Ghamir,Al Health Unit,uasnim HU,Monabbih Rural Hospital,Qatabir 1038 2 RDT , not samples were collected for culture . the health and wash RRT were contacted . the line list Hishuah Health Center,Ghamer Health Center,Other updated and the information shared,2 cases were dead

Khamis Marran Health Center,Haydan Hospital,Al -Talh eIDEWS coordinator contact the focal points after reporting of cases suspected whooping cough, the Pert Sa'adah Haydan,Sahar cases were diagnosed clinically according to the case definition and all cases were treated in outpatient 7 0 Hospital the RRT contacted to perform the investigation and related activities

Saqayn Hospital,Dr. Mosfir Clinic,Haydan Hospital,Al the e-DEWS focal points contacted ,all cases diagnosed clinically as suspected measles cases Meas Sa'adah Saqayn,Sa'da ,Haydan,Sahar according to the standard cases definition ,all cases receive the supportive management in the HU,the 24 0 AlAmri HU,Al Jumhoori Hospital,Al Salam Hospital cases were un vaccination except 2 cases were vaccination

the edews focal in hospital and the surveillance team were contacted , the cases were diagnosed clinically according to the case definition , , the cases isolated and treated , the RRT contacted to trace Diph Sa'adah Sa'da ,Majz Al Jumhoori Hospital,Dhian HC 6 1 contacts the samples sent to CPHL for confirmation, one case was dead

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]) 6 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 26 (24-30 Jun,2019)

Alert Responded in Epi - Week 26,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

As Al Qaflah Rural Hospital,As Sawd Health Sudah,Huth,Suwayr,KhammerShaharah,I hospital,Raydah Health hos.,Al Ashah Health yal Surayh,Harf Sufyan Habur hospital,Harf Sufyan H,Al Sanaaniah Health Center,Al Eidews Coordinator Contacts the Coordinator of Surveillance in Districts, The cases were diagnosed Chol Amran Zulaymah,Dhi clinically as suspected cholera., according to case definition. All The cases improved After Taking The 881 1 Salam Khamir Hospital,Huth Health hospital,Kharif Rural Bin,AlAshah,Amran,Raydah Thula,Bani Treatment,one case was dead Hospital,Amran General Hospital,Thula Health Suraim,Kharif,Jabal Iyal Yazid,Al hospital,Habur Health hospital,Other Madan,Al Qaflah,As Sawd,Maswar

Iyal Al Salam Khamir Hospital,Raydah Health hos.,Al Osrah Eidews Team Contacted Focal Points, the cases Were Diagnosed clinically as suspected Measles. Meas Amran Surayh,Khammer,Thula,Raydah,Amran, Health Center,Al Hajr Health Center,Gaar allah 16 0 According to Case Definition, the Cases Vaccinated Against Measles Shaharah,Al Ashah,Dhi Bin clinic,Other

Khammer,Habur Zulaymah,Dhi Al Salam Khamir Hospital,Amran General Hospital,Ayesh Eidews Coordinator Contact the Coordinator of Surveillance in Districts, the cases were diagnosed Pert Amran clinically as suspected pertussis, according to cases definition. The Cases Improved After Taking the 30 0 Bin,Amran,Raydah Dispensary,Other Treatments Antibiotics.cases from districts others

Eidews team contacted focal point . and Rapid response Team district amran visit Health Hospital cases were diagnosed Diph Amran Amran Other 1 0 clinically probable diphtheria. the case treated with antibiotics and anti toxin . case from district amran

Bani Hushaysh,Al Haymah Al Bani Mansour HC,Al wheda Manakha rural Hospital Kharijiyah,AlHusn,Nahm,BaniDhabyan,K ,Awmara H,22 May Hospital ,Ka'a Alreka HC,Sa'afan Rapid Response team visited area according to cases definition suspected cholera , 524 cases were Chol Sanaa Governorate hwlan,Manakhah,Hamdan HC,Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital positive by rapid test cholera and ather cases were negative and cases are recoreded in line list and 2372 0 BaniMatar,AlHaymahAlKharijiyah,Jahanh, ,Almarbak HC,Almanar Hospital,Bait Alrejal HC,Walan cases deifferant area BiladARus,Arhab,Sa'fan,Attyal,Sanhan Hospital,Other

The district RRT visited the health facility, the cases were vaccination, the cases were diagnosed AFP Sanaa Governorate Bani Matar 26September H in Matna 2 0 clinically by case definition, stool samples were collected and sent to central lab

Bani Matar,Jahanh,Manakhah,Al Bait Alrejal HC,Al wheda Manakha rural Hospital Rapid Respose team visited area according to case definition suspected measles, the cases were Meas Sanaa Governorate 8 0 Husn,Hamdan ,Shamlan Hospital vaccination but one case was un vaccination ,Blood sample collected cases and sent to central lab

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Pert Sanaa Governorate Al Haymah Ad Dakhiliyah,Arhab Kuwait Center,Alhayfa HC 6 0 definition,Unknown vaccination status,The cases were treated with antibiotic.

Rapid Respose team visited area according to case definition suspected Diphteria , the cases were Diph Sanaa Governorate Jahanh,Khwlan Qaa Al Sook Hu,Alshaeed Mohamed Aldurra Hospital vaccination unknown except 3 cases were vaccination eappropriate treatment given to case and contact 7 0 of cases

Al Redha Clinic,Dr Saleh Abdurahman Medical eIDEWS coordinator visited the health facilities found the cases suspected of measles, the cases were Meas Shabwah Ar-rawdah,Jirdan,Ataq,Ain 14 0 clinic,Jardan Rural Hospital,Ataq Central Hospital diagnosed clinically according to case definition, the cases were vaccination, samples were collected

eIDEWS coordinator visited the health facilities, the case was diagnosed clinically according to case AFP Shabwah Ar-rawdah Al Redha Clinic definition, vaccination was done, sample was collected and send to the central laboratory,case was 1 0 treated and improved.

eIDEWS coordinator contacted the health facilities, the case was diagnosed clinically according to case Diph Shabwah Ataq Teab Al Atfal Clinic 1 0 definition, the case was un vaccination

eIDEWS team contacted the health facilities found three suspected cases of dengue fever from DF Shabwah Ataq,Rodhoom,Markhah Assufla Rudum Rural Hospital,Waset Hospital different districts , the cases were diagnosed clinically according to case definition,all cases treated and 22 0 improved.

Emergency/Ataq Hospital,Beer Ali Health Center,Bayhan eIDEWS coordinator visited the health facilities found suspected cases of cholera , the cases diagnosed Chol Shabwah Ataq,Rodhoom,Baihan 44 0 Hospital clinically according to case definition.rapid test were not done, all cases were treated and improved.

eIDEWS coordinator visited the health facilities found , the suspected case of pertusses, the case was Pert Shabwah Ataq Salem Bahaj Clinic diagnosed clinically according to case definition, the case was un vaccination, sample was collected, the 1 0 case was treated and improved.

eDEWS coorinator contacted focal point theIDEWS team contacted point information was not collected Samples the a case diagnosed clinically As suspected Diphtheria using case definition the Diph Al-Baidha At Taffah Al-Taffah Center onset in 25/6/2018 was given Antibiotic management the number of caes was one femal ther ages 1 0 were 8 years the case was greater than 5 years his she name Aroaa Abdullah Salim Almsawdi the case from Altffah and vaccination. agianst Dephtheri

AsSawadiyah,AtTaffah,Naman,Mukayras, Wald Rabi',Sabah,Nati,Dhi Alswmah HC,Thi - Naem HC,Areeb HC,Alarsh eIDEWS team contacted focal points the cases were diagnosed clinically as suspected cholera using case definition , Chol Al-Baidha Na'im,ALSharyah,AlMalagim center,Alqrishih HU,Althwrh Hospital,Alswadih HC,Al- 1125 0 rapid test 165 positive the main saing watery diarrhea &vomting some dehydration the paitnts AlA'rsh,Radman Al Awad,Al Taffah Center,Mukayras Hospital,Other ademittedt in Center and with ORS and IV fluid in good condation the cases from deferrnt organ Quraishyah,Al BaydaCity,ArRyashyyah

IDEWS team contacted point information shared blood saeIDEWS team contacted focal point the cases diagnosed clinically according to case definition Antibiotics treatment was given the number of Meas Al-Baidha Sabah Zkhm HC case was and one mael greater than 5 years he ages 62 months and Apear skin rash in 27/6/2019 and 1 0 the fever in 25/6/2019 in respectively the case there are was non collction of case sample was cases and their are was un vaccination against measls

eIDEWS team contacted and visit focal point information shared field investgation done stool sample were collected from the case and close contactes in 29/6/2019 samples were sent for confirmation the date of onset of AFP in 25/6/2019 the case was one mael the he name was Abrahim kasim Mohammed AFP Al-Baidha Al Bayda Thi - Win HU 1 0 Abdubah he age 26 Monthes he was from Thi-Win village

he vaccinated 5

EDEWS team contact Edews focal point in Alghaydha Central Hospital .case from Hat District case AFP Al-Mahra Al Ghaydah Al Ghaydah Center Hospital diagnosis according to case defination , susspected A.F.P case was male age 4- mounths , case 1 0 vaccinated ,stool sample taken and send to central level and treatment was given to case

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]) 7 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 26 (24-30 Jun,2019)

Alert Responded in Epi - Week 26,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

edews team contact focal points , the cases were diagnosed clinically as suspected (cholera) using case definition ,

main sign : diarrhea. no dehydration , vomiting , Chol Hadramout wady Alsoum,Amd,Tarim Alsawm HC,Tarim H the case admitted in alsoom HC 3 0 Lab : Rapid test negative , investigation done

Treatment : ORS, iv fluid , anti biotic.

edews team contact focal points , the cases were diagnosed clinically as suspected (pert) using case definition , the cases were vaccination unknown Pert Hadramout wady Tarim,Al Qatn Aedeed Dispensary ,Alaneen HU 4 0 . symptomatic treatment were prescribed

Taibah hospital,Alkharba rural H,Almajel HC,Aljarf Utmah,DhamarCity Dawran HC,Dawran Hospital,Dhamar public H, Bani hutam Aness,Wusab Al Ali,Wusab As HC,Wathan HU,Dheba HC,A Unity Centre EdeWS coordinator contacted focal points they founds cases diagnosed suspected Chol(Acut watery Chol Dhamar Safil,Mayfa'at Anss,JabalAshsharq diarrhoea and dyhadretion )the cases tested by rapid test And result were postive for 128 cases - all 1629 1 (residential),bny salamh Unite,Kharbah Abuyabes AlManar,Jahran,Anss cases received treatment,one case was dead HC,Alhumyat HC, AlMasli Hospital,Alwahda university MaghiribAns,AlHada H,Zeraja rural H,Hamam Ali Hospital, Other

EideWS team visted focal point and he found the case diagnosed according to case definition as suspected AFP ( Flaccid Paralysis- Weakness - ) -Patient data: : Dafh Jabr Ahmed Kelan (48 mounth AFP Dhamar Dhamar City Al Mogalee & ALGumah Dispensary - From Myfah Anss district - Mram village- all dosage taken - The beginning of t he symptoms20 1 0 /6/2019- Reporting date30/6/2019. All samples from the patient and contact the patient were delivered to the coordinator of paralyses in the province

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Al Jubah,Harib Al Qaramish,Bid May 22 Hospital,Ahmed Hajer Hospital ,( al Wahdah ) clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb 29 0 Bidah,Alwadi,Sirwah,Madkhal Majzar Hospital,Al Majzaa Health Unit Supplements & antibiotics treatment were given(case management)There were a no collection or cluster of cases seen in the same Place

the contacted the contact and told us that suspected dengue the cases had history of high fever, back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for DF Mareb Al Jubah,Al wadi May 22 Hospital,( al Wahdah ) Hospital 26 0 serological testing (NS1). This test measures the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result

EDEWS team contacted focal points,Cases diagnosed clinically as suspected pert.treatments were Pert Al-Jawf Al Matun Imam Ali Center,Aal Qassim Health Unit,Al Shifa Center 8 0 given, the cases un vaccines

The EDEWS coordinator has contacted the coordinator,the condition were diagnosed clinically by Meas Al-Jawf Al Maslob,Kharab Al Marashi Al Masloob Health Center,Al Marashi Health Center definition of the condition, Blood samples werer not collected, Symptom therapy and antibiotic giving 3 0 were given and vitamin A

Khob Wa Asha'af,Al Hamidat,Al Ghayl,Al Al Maton Health Center,Al Hazm Hospital,Souq Al The EDEWS Coordinator received a report from the control officer that there were cases of the doctor's Matun,Al Hazm,Rajuzah,Al Maslob,Al diagnosis. It was a cholera, the cases were negative by rapid test , the cases without a suspicious Chol Al-Jawf Thalooth Health Unit,Al Humaydat Health Center,Bart 572 0 Matammah,Kharab Al Marashi,Bi'rat Al examination from different areas. After validation. Treatments were treated according to the treatment Rajuzah Hospital,Other Anan plan

eIDWES coordinator contacted focal points, information was shared. The cases were diagnosed Al Khabt,Ar Rujum,Bani Sa'd,Shibam clinically according to case definition, ,skin rash were appear,the cases were vaccination except 2 cases Meas Al-Mahweet Alrujm Hospital,Autmah HU,Alahjer HC,Other 8 0 Kawkaban,Milhan were un vaccination and one case was vaccination unknown , the blood samples collected and send to central lab for confirm diagnosis

Shibam Kawkaban,Hufash,Bani Sa'd,Al Altawilh HC,Bni Alhmadi HU,Mlhan Health Center,Alrujm eIDEWS coordinator contacted focal points, information were shared. all cases were diagnosed clinically Chol Al-Mahweet MahwaitAl, Khabt,Ar Rujum,At according to case definition, the cases investigated by rapid test for vibrio cholera and the result were 875 0 Hospital,Other Tawilah,Al Mahwait City,Milhan, positive for 29 cases, treatment were given according to severity of symptoms and dehydration

Wadi Alarid HC,rabouw Almasjedeen Hospital Althulaia Mazhar, Kusmah,As Salafiyah,Al IDEWS coordinator contacted focal points, information were shared, all cases were diagnosed clinically Chol Rayma H,Al Arkob HC,Swaq Alahd HU,Wadi Ghzwan according to case definition,all cases were connected to the confirmed cases of cholera,appropriate 221 1 Jabin,Bilad At Ta'am,AlJafariyah HU,Aljoumhwri H,Shbam H,Numan HU,Other treatment were given according to severity of symptoms and dehydration, one case was dead

The EDEWS coordinator contacted the focal person , the cases were diagnosed clinically by case Meas Rayma Bilad At Ta'am Alhurih HU definition blood samples were collected, the cases were vaccination,Symptomatic treatment and cover 3 0 antibiotic were given,

case -name Morsi Adel Ahm tahani - Al - Azi Ahmed Al - Zubai rappat Date of paralysis 20 /6/2019- AFP Rayma As Salafiyah rabouw Almasjedeen Hospital age84 mmonth esx meale -26 / 6 /2019 coordinater contact wth focal point stool sample collected 266 1 0 2019 and sent at26/6 /2019 or lab confirmation the last how v acented poillo many 9 dos

AlHusha,Damt,Qa'atabah,Juban Ad Dhwran HC,Hushb HC,Alfakhr HC,Alnassr H,Daglal eDEWS team contacted FP , all cases were diagnosed according to case definition, all included in Chol Al-Dhale 315 0 Dhale'e,Al Azariq,Al Hussein Health Center,Other updated daily line listing

eIDEWS team was contacted fp: 1 The cases, were 1 cases male, then 1 (less (less than 5 years), Meas Al-Dhale Jahaf Almdad HU diagnoses clinically, vaccination was done, sample was collected , treatment was given, investigation 1 0 form was done.

eDEWS team conted focal point information shared inve stigation forms and lab samples and waiting for DF Al-Dhale Ash Shu'ayb Althlathah Alshuhdaa Alauapl H results cases opriate treatment was appro cases were 3 males & female 1 their given were Greater than 5 0 5 years ages they came from other they governorates