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 08,lssue40,Epi week40,(28 September -4 October,2020)

Highlights eDEWS Reporting Rates vs Consultations ,Epi Weeks 1-40,2020

% % %

%

% % % %

% % % %

%

%

% % %

%

% % %

97 97 97

95

%

%

% % % %

96 96 96 96

% % % %

100% % 350000

95 95 95 95

% % %

94

% %

96

93 93 93

%

96

92 92 92

91

%

96

91 91 91 91

90 90 90 90 90

89 89 89

88 88

•During week no.39,2020, %88 health facilites provided valid surveillance data. % 87

90% 86

82 300000 80% 70% 250000 •The total number of consultation reported during the week was 237918 60% compared to 226849 the previous reporting week 40 Acute respiratory tract 200000 infections lower Respiratory Infections (LRTI), Upper Respiratory Infections 50% 150000

Percentage 40%

(URTI), Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of Consulttaions morbidity this week. 30% 100000 20% 50000 10%

A total of 1017 alerts were Generated by eDEWS system in week 40,2020, were 0% 0

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

Wk 11 Wk 13 Wk 14 Wk 15 Wk 16 Wk 17 Wk 18 Wk 20 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 27 Wk 28 Wk 29 Wk 31 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 40 Wk Wk Wk 12 Wk 19 Wk 21 Wk 30 Wk 32 Wk 39 verified as true for further investigations with appropriate response Wk 10

Reporting Rate Consultations

Leading causes of morbidity mortality in Epi-Week 40,2020 Proportional morbidity of leading priority diseases, Epi week 40,2020

Scabies Chicken Pox ● (URTI) 12.6%, suspected Malaria (8.7%),(DD) (8.6%) and (LRTI) (5.5%)Remain the Brucellosis HIV/ AIDS leading causes of morbidity representing a total of (35.4%) 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 0.3% Of this Mumps AFP morbidity NNT AVH_B&C AVH_A&E Meas Typhoid F ● All diarrheal disease comprised 8.6% and LRTI 5.5% of total morbidity in pilot OAD BD Governorates this week . Susp. Cholera Diph Pert SARI ILI ● All diarrheal disease comprised 8.6% and OAD 7.3% 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%

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, - Epidemiological Week Number 40,(28 September -4 October,2020)

Epidemiological Situation of Cholera 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 40,(28 September -4 October,2020)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-40,2020)

URTI LRTI mararia tested cases & confirmed 16.0% 8.0% 3500

14.0% 7.0% 3000

12.0% 6.0% 2500

10.0% 5.0% 2000

8.0% 4.0% 1500

6.0% 3.0% 1000

4.0% 2.0% 500

2.0% 1.0%

0

wk2 wk4 wk7 wk9 wk1 wk3 wk5 wk6 wk8

wk11 wk12 wk14 wk16 wk17 wk19 wk21 wk23 wk24 wk26 wk28 wk29 wk31 wk33 wk36 wk38 wk40 wk10 wk13 wk15 wk18 wk20 wk22 wk25 wk27 wk30 wk32 wk34 wk35 wk37 wk39

0.0%

2 3 4 5 6 7 8 9

1 0.0%

12 13 14 15 16 29 30 31 32 33 34 10 11 17 18 19 20 21 22 23 24 25 26 27 28 35 36 37 38 39 40

1 3 6 8 2 4 5 7 9

11 13 16 18 21 23 26 28 31 33 36 38 10 12 14 15 17 19 20 22 24 25 27 29 30 32 34 35 37 39 40

WK WK WK WK WK WK WK WK

WK Rapid Test(Postive) Microscope(Postive)

WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK

WK WK WK WK WK WK WK WK WK

WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK

Age and Sex distribution of total consultations of leading diseases (Epi week 40,2020) Number of Alerts Received and Responded (Epi Weeks 37-40,2020)

60000

URTI LRTI Pert BD OAD Typhoid F

50066 50000 AFP Meas AVH_A&E AVH_B&C DF Meng

Sch CL Chicken Pox Mal 250 40000

32733 200 30000

22832 150 21611 20487 21015 20000 18931 17535

16213 16497 Alerts of No. 100

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 16213 20487 21611 32733 17535 Female 16497 21015 22832 50066 18931 Distribution of consultations of leading diseases by Governorates,Epi week 40-2020

Suspected Disease Al-Baidha AlHodaidah Al-Jawf Al-Mahweet Amana Amran Dhamar Mareb Rayma Sa'adah Governorate Total

URTI 1202 5166 1038 831 3459 2417 2287 3953 2343 725 582 1566 3730 749 30048 LRTI 599 3534 295 314 858 935 1090 1536 1313 304 97 377 1455 318 13025 ILI 50 68 97 0 17 0 35 61 66 145 0 13 209 71 832 SARI 0 0 0 0 2 2 38 0 0 0 0 6 0 0 48 Pert 0 2 1 0 7 5 1 0 0 0 0 2 0 4 22 BD 27 89 37 28 31 78 60 7 67 24 20 47 149 62 726 OAD 612 1593 787 507 2266 1695 2066 1721 1366 501 289 890 2568 412 17273 Typhoid F 195 538 180 95 613 288 893 4 569 90 66 75 386 152 4144 Meas 8 5 3 5 7 5 1 7 5 0 1 50 2 1 100 AVH_A&E 3 3 6 0 63 19 44 3 28 3 2 12 28 10 224 AVH_B&C 1 10 2 0 69 3 6 7 18 4 0 1 4 1 126 NNT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AFP 1 3 0 0 2 0 1 0 3 1 0 4 0 0 15 184 6 29 22 1 17 8 32 األمراض المشتبهة Mumps 2 10 3 7 26 5 16 Mal 5 11571 56 646 126 715 778 4886 342 44 324 416 261 470 20640 Meng 0 0 1 1 2 0 5 4 3 0 0 0 0 1 17 DF 7 49 1 67 1 1 0 261 0 121 1 5 0 60 574 VHF 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sch 0 8 6 28 33 83 30 129 14 2 24 31 52 14 454 CL 4 0 5 1 12 13 9 9 4 1 4 5 8 0 75 RB 29 1 0 7 75 15 59 0 53 0 0 0 2 0 241 Tuberculosis 1 0 0 3 4 0 5 6 8 3 0 0 4 5 39 HIV/ AIDS 0 0 0 0 4 0 0 0 1 0 0 0 0 0 5 Brucellosis 37 17 26 6 78 43 310 74 92 19 0 4 14 2 722 Chicken Pox 0 14 9 0 26 15 19 10 19 24 13 32 26 0 207 Scabies 0 11 0 5 11 3 13 36 46 0 8 10 23 2 168 Guinea Worm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 othr_disease 4650 17304 4624 4471 34417 10295 14654 13550 15152 5468 1529 3980 10028 4065 144187 total_cons_disease 7753 40396 7236 7128 43027 17165 22981 26409 21830 7521 2992 7694 19289 6497 237918 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 40,(28 September -4 October,2020)

Alert Responded in Epi - Week40,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

AtTaiziyah,Salh,Khadir,MawiyahHayfan,AsSil 22 May HC,Al Mashgab Hospital,Hifan H,Mawih Chol Taiz 92 0 w,SharabArRawnahSama Hospital,Other

Meas Taiz At Taiziyah Ar Romah center 1 0

Pert Taiz Salh Al-Safwah Hosp. 4 0

DF Taiz Salh,Al Qahirah Al-Safwah Hosp.,Al wahdah HC 60 0

Immediate notification by.eDEWS focal points ,samples were collected. ,the cases were vaccination, Meas Ibb As Saddah,Al Udayn Alsadah HU,Aladin H 5 0 They are from different areas.

AlUdayn,,Hazm,AlUdayn,AsSabrah AshShair,AnNadirah,Jiblah,ArRadmah Dar Al Sharq HC,Yarim Hospital,Alshaheed Albadani Immediate notification. eDEWS Coordinator visited hospital, some stool samples were collected and Chol Ibb AlMashannah,Hubaysh,AsSaddah,Far Hospital,Almakhader HC,Alqaidah H,Aladin H,Najd Hawshp result positive by rapid test for 3 cases and other were negative 231 1 AlUdayn,Ibb,DhiAsSufal,Badan,AlDhiharAlQ H,Aldhalmh HC,Other All cases were improved,one case was dead afr,AlMakhadir,AsSayyani Mudhaykhirah

Immediate notification by focal points, Cases were diagnosed clinically and treated accordingly and Diph Ibb Al Mashannah,As Saddah Alnassr H,Other 6 0 recieved anti-toxin, All cases were vaccinated,the cases from different area.

AFP Ibb Al Mashannah,Al Dhihar,Al Udayn Aladin H,Other Immediate notification.Patients,samples were collected and send to sanaa,the cases were vaccination 3 0

AlHawak,AlHali,Jabal Ras, Deir zblh H,AlMokarHC,Aldhahi Rural H,AlBaidha AlGarbiah eIDEWS coordinator contacted the focal points, information was shared. The cases were diagnosed AlGarrahi,Bura,AlMansuriyah, HC,Bait Alfakih H Almansouria rural H,Almughtaribeen clinically according to case definition, some cases were investigated by rapid test for vibrio cholera and Chol AlHodaidah AzZaydiyah,BaytAlFaqiah, 355 0 HC,AlhshmCenter,ZayedHC,Alkanawes HC,Alsalakhana result were positive for 3 cases, Appropriate treatment were given according to severity of symptoms AlQanawis,AzZuhrah,AlMina, , H,salamcenter,Alzaydia RuralH,Aljarrahi rural H Other and dehydration. Alluheyah

Focal points were contacted , the suspected DF cases had a history of high fever , retro- bulbar pain AlQanawis,AsSalif,AlHawak Alkanawes Private H,Alsalif Hospital,Alrasheed specialized DF AlHodaidah ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been started, ALL cases 49 0 Zabid,AlMarawiah,AdDurayhimiAl Hali H,Zabid ruralHospital,Alhodaidah Hospital,Other diagnosis depend on case definition and platelets counts

eIDEWS coordinator contacted the focal points, information was shared. The cases were diagnosed Meas AlHodaidah As Salif, Al Hawak,Bura,Bajil Alkarya HC,Althawra public H,Alzera'ai HU 5 0 clinically according to case definition, the cases were vaccination

Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane Diph AlHodaidah Al Munirah, Al Hawak Almuneera H,Althawra public H around tonsillitis , and sever inflammation, the some of patients vaccination ,the cases were diagnosed 2 0 clinically. Medications have been started, ALL cases only depend on case definition

eIDEWS coordinator contacted the focal points, information was shared,all cases were diagnosed Pert AlHodaidah Zabid, Az Zaydiyah Qadidah center,Alzaydia Rural H clinically according to cases definition, the cases were vaccinated against pertussis, the focal RRT was 2 0 send to investigate and treat any new cases

The eIDEWS coordinator contacted the contact, and the information was shared,The cases were AFP AlHodaidah Zabid, Al Hawak Qadidah center,Althawra public H diagnosed clinically according to the case definition,the cases were vaccinated against polio and 3 0 samples were sent to the central laboratory to confirm the diagnosis

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts . Information shared, It were diagnosed clinically according to standard definition For measles , the cases were vaccination except 2 Meas Hajjah Sharas,AlMahabishah,AlMiftah,Aslem Sharas HC,Almahabesha Public H,Other 7 0 cases were un vaccination Investigation form were Done. Appropriate treatment were given. The samples were collected and sent to the central laboratory AlMaghrabah,Wadhrah,AlMiftahAshShahil,Al Jamimah,Qafl Mabyan Hospital,Almahabesha Public H,Ash Shaghadira EIDEWS Coordinator Contact the district coordinator. Information has been shared. It have been Kuaydinah,Shamer,,Hajjah Health Center,Al Miftah HC,Almaghraba HC,Bani Alawam Chol Hajjah reported of cases suspected cholera were diagnosed clinically (acute watery diarrhea)the cases from 221 0 City,BaniAlAwam,Qarah,SharasAshShaghad HC,Abs Rural Hospital,Qafl Shamer Kufl-Shamar Rural different areas, they have been given appropriate treatment irahKushar,Haradh H,Public Republican Hospital,Other Hajjah,Khayran,AlMuharraq eDEWS coordinator contacted focal points, information shared, cases have been diagnosed clinically DF Hajjah Khayran Al Muharraq,Abs Martyr d. Yasser w Thab Hospital,Abs Rural Hospital .According to the standard definition DF , Some cases have been rapid test work the result were 261 0 positive, Appropriate treatment were given

EIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, Information shared . We received a report ,the cases (suspected diphtheria) The diagnosis were clinically (diphtheria)the cases Diph Hajjah Abs,Hajjah City,Kuhlan Affar Abs Rural Hospital,Public Republican Hospital,Kuhlan Afar HC 3 0 were un vaccination,The response team in the field investigated the cases and the contacts and the appropriate treatment were given

Rapid response team contacted focal points by eIDEWS coordinator & HF visited, cases diagnosed clinically according to case definition. Stool samples(C/S & serotyping) collected from cases & sent to Omar Al Mokhtar Complex,Ibn Khaldon HC,Arwdhah H,,22 lab (Central labs)for confirmation. Supplements & antibiotics treatment were given, Most of them were Bani AlHarith,Maain,Az'zal Chol Amana May Hospital Bni - Hwath HC,Jabr Bn Hyan Complex,Jddr from Amana governorate & a few of them from other governorates ,different districts of that 316 0 Aththaorah,Shu'Aub,AsSabain HC,Al Jraf Complex,Ottan Complex Gazah Complex,Other governorates. Rapid tests of cholera were negative for 2 watery stool samples & positive for 9 watery stool samples collected , so stool C/s done for 2 positive samples & the results of stool C/s still pending. There were a collection or cluster of cases seen in the same Place.

"eIDEWS coordinator contacted focal points, information's shared, then HF visited by eIDEWS coordinator,Blood samples were collected from the cases and sent for lab confirmation & the onset of Meas Amana AlWahdah,Shu'Aub,Maain Az'zal Klodia Vaian Complex,Alrazi HC,Other 7 0 fever, skin rash,the most cases were vaccinated against measles, Vit-A were given to the cases, in order to support their immunity against complications of measles.

eIDEWS coordinator contacted focal points, information shared, then HF visited by eIDEWS coordinator. The cases were diagnosed clinically according to the case definition. Antibiotics treatment Pert Amana AsSabain,Assafi'yah,AththaorahAt Tahrir AsSabin Hospital,Iraqi HC, Aljomhwri H 7 0 were given,The cases were unvaccinated against Pertussis & still alive under treatment. There were no collection of cases seen in the same place.

eIDEWS coordinator contacted focal points & DRRT, information shared, after that HF visited by eIDEWS coordinator,The cases were diagnosed clinically according to the case definition as possible diphtheria. Symptoms & signs of a case were, fever, sore throat, grey-whitish pseudo-membrane, As Sabin Hospital,Scinces and Tecnology H,Zaid bn Sultan Diph Amana As Sabain,Shu'Aub,Bani Al Harith,Maain swelling of neck lymph-nodes(Bull neck), difficulty of swallowing & breathing. Antibiotics treatment were 9 2 H,Alrafaa H,22 May Hospital,Other given & the case management done. Throat swab for culture, slides of smear fixed were taken & sent to Central Lab for microbiological confirmation (Albert stain, Gram stain & Diphtheria C/S) the cases were un vaccination except 3 cases vaccination,2 cases were dead

eIDEWS coordinator & the survailance coordinator of Amana governoratecontacted a focal point ,then HF visited. Information shared. The number of cases were two,one female & one male. The 1st case his name Naji Ateeq Saleh Al-Ziyadi, his age 17 months,from Amana governorate, Assafi'yah district,Taiz street area.His stool specimen was collected from the 1st case on 29 - 09 - 2020 & the specimen sent to the National Polio Program for lab confirmation His date of onset of AFP was on 26 - 09 - 2020. He was AFP Amana As Sabain As Sabin Hospital 2 0 vaccinated against polio (2 doses).The 2nd case her name Jumana Jamil Shouei Tuhama, her age 9 months, from Amana governorate, Az'zal district, Noqum, Ghazal area. Her stool specimen collected from the 2nd case on 29 - 09 - 2020 & the specimen sent to the National Polio Program for lab confirmation. Her date of onset of AFP was on 29 - 09 - 2020. She was vaccinated against polio (3 doses). There were no collection of cases seen in the same place of both cases.

the e-DEWS focal points in the hospital were contacted, the reported case verified, the cases diagnosed Neshoor Health Center,Al Salam Hospital,Dr. Mosfir Clinic,Al clinically according to the standard case definition, the cases treated at the OPD in the health center, the Meas Sa'adah As Safra,Sa'da,AdhDhahir,Sahar 50 0 Jumhoori Hospital line list updated and the information shared. DRRT informed to perform field investigation and household response activities

edews focal points contacted , the cases were diagnosed clinically , no RDT performed and not samples Sharah Hosp.,uasnim HU,Qahza Health Center,Al Jumhoori Chol Sa'adah Razih,Baqim,Sa'da collected . the cases treated in the HC according to the management protocol the line list updated and 39 0 Hospital the information shared

the edews focal point contacted , the health facility visited and the investigation performed , the samples AFP Sa'adah Sa'da altakhasasy hospital,Al Jumhoori Hospital 4 0 collected and sent to the central lab , the RRT visit the patient home and perform the investigation

DF Sa'adah Sa'da altakhasasy hospital 5 0

the e-DEWS focal points contacted, the reported cases verified, the cases diagnosed clinically as alhamazat center,Al Jumhoori Hospital,Al Majazeen Health Diph Sa'adah Sahar,Sa'da,Haydan probable Diphtheira cases according to the SCD, the cases treated and the contact traced, the line list 24 0 Unit updated and the information shared

Pert Sa'adah Majz Majz Health hospital 2 0

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 40,(28 September -4 October,2020)

Alert Responded in Epi - Week40,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

AsSawd,AlMadan,,Habur Zulaymah,Kharif,AlAshah 22 May hospital,Al Sanaaniah Health Center,Harf Sufyan eIDEWS coordinator contacted focal points and the coordinator of surveillance in districts , the cases Chol Amran AsSudah,BaniSuraim,Amran H,Maswar Rural Hospital,Huth Health hospital,Al Madan were diagnoses clinically as suspected cholera ( AWD) according to case definition. all the cases 142 0 Raydah,Maswar Huth Dhi Bin,Harf Health hospital,Habur Health hospital,Other improved after taking the treatments proper Sufyan,Jabal Iyal Yazid,Suwayr

eIDEWS coordinator contacted focal points and the coordinator of surveillance in districts and visit health center, the cases were diagnoses clinically as suspected Measles. according to case Meas Amran Iyal Surayh,As Sawd,Thula,Harf Sufyan Dhaiaan Health Center,Harf Sufyan H,Other 5 0 definition.Blood samples were collected of cases and sent to central lab in sanaa for confirmation,the cases were vaccinated against

eIDEWS coordinator contacted focal points and the coordinator of surveillance in districts and visit Pert Amran Harf Sufyan,Amran,Khammer Harf Sufyan H,22 May hospital,Al Salam Khamir Hospital health hospital, The cases were diagnoses clinically as suspected pertussis.according to case 5 0 definition,the cases were un Vaccinated.

eIDEWS team contacted focal point and The coordinator of surveillance in district Huth and visit health hospital case were diagnosis Diph Amran Huth Huth Health hospital 1 0 clinically as probable diphtheria.The response team in district the field investigated case and the contacts and the appropriate treatment were given.case not Vaccinated. case from district Huth

AlHaymahAdDakhiliy,Jahanh, BiladArus,Attyal,BaniHushayshSa'fan,Nahm, Alshe'eb Alaswad HC,Al wheda Manakha rural eDEWS coordinator contacted focal points, The cases were diagnosed suspected cholera(AWD) some Chol Khwlan,ManakhahHamdan,Bani Hospital,Walan Hospital,Bait Alhenami HC,Bait Al Shatarah cases were tested by rapid test and result 6 cases was positive ,the cases were treated at the health 290 1 Matar,Sanhan,Al Haymah Al Kharijiyah,Bani Hu,Hamdan Hospital,Other facility and received treatment Dhabyan

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Meas Sanaa Governorate Manakhah,Hamdan Al wheda Manakha rural Hospital 2 0 definition, Skin rash started ,the cases were vaccination, blood samples were collected.

AsSawadiyah,Radman AlAwad AlQuraishyah,AlBayda City Hospital,Mother and child HC,Dthran HC,Alshriah eIDEWS team contacted focal points, the cases were diagnosed clinically as suspected cholera using Chol Al-Baidha Sabah,AtTaffah,Naman Sare H,Althwrh Hospital,Al-Taffah Center,Dar Najd 318 0 case definition, Mukayras,DhiNa'im,ALSharyahAlMalagim,N HealthOther ati,Rada',Az-Zahir

At Taffah,Naman,Al Malagim, Dhi IDEWS team contacted focal points, the cases diagnosed clinically according to case definition Meas Al-Baidha Al-Taffah Center,Araa health center,Other 8 0 Na'im,Radman Al Awad Antibiotics treatment were given, samples were collected, the cases were vaccination against measls

eIDEWS team contacted focal point the cases were diagnosed clinically as suspected cholera using DF Al-Baidha Naman Araa health center 7 0 case definition the cases 3 male and 3 femal

eIDEWS team contacted and visit focal point information shared field investgation done stool sample were collected from the case and close contactes in 27/9/2020 samples were sent for confirmation the AFP Al-Baidha Al Quraishyah Dar Najd Health date of onse of AFP in /9/2020 the case was one femal his name was Arwa Mohammed Ahmed Ahmed 1 0 Alahmdi this age 96 Monthes she was from AlQuraishyah from Alroaq village and the she was non vaccinated

eDEWS coorinator contacted focal point theIDEWS team contacted point information was non collected Samples the a case diagnosed clinically As suspected Diphtheria using case definition the onset in 1/10/2020 was given Antibiotic management the number of caes were Diph Al-Baidha Al Bayda City Althwrh Hospital one 2 0 male and one femal ther ages were 6 years and 9 years the cases was greater than the name his Raid Saleh Hussain Alahmadi and Saidah Salaah Ahmed Alahmadi from Gaahri village and non vaccination. agianst Dephtheri

Dawran Hospital,Dheba HC,Souk Aleffa HC,Zeraja rural Mayfa'at Anss,Jahran Dhamar City,Dawran H,Aljarf HC,Alhumyat HC,Kharbah Abuyabes HC,Rsabh Chol Dhamar Aness, Maghirib Anss,Wusab AlAli,AlHada 203 0 Hospital,Dhamar public H,Alwahda university H,Ezzan Utmah,Anss,AlManar,Wusab AsSafil Center,Other

AFP Dhamar Dawran Aness Dawran Hospital 1 0

Pert Dhamar Dawran Aness Bin alakwa'a Dispensary 1 0

Meas Dhamar Al Hada Zrajah HC 1 0

the contacted the contact and told us that suspected dengue, the cases had a history of high fever, Alateer Hospital,Harib Hospital,( al Wahdah ) Hospital,AL back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for DF Mareb Harib,Al wadi, City 121 0 Askary Hospital serological testing (NS1)these test measures the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb Al wadi,Al Jubah ( al Wahdah ) Hospital,Al Kari Hospital,Al Khaithlah Hospital 25 0 Supplements & antibiotics treatment were given, the results of stool Rapid tests of cholera 3 positive .There were a no collection or cluster of cases seen in the same Place

eIDEWS coordinator contacted focal point,then HF visited(Nabil Alsharabi center). Information shared.Stool sample collected from the case in 1/10/2020 & the sample sent for lab confirmation.The AFP Mareb Al wadi Other date of onset of AFP was in 9/10/2020.The case was one male,his name Awad Ahmed Hassan ,his age 1 0 10 month ,from Mareb governorate,Alwadi district, Jaw alnassem area.He was vaccinated against polio(1 doses)

The eIDEWS Coordinator received a report from the control officer that there were cases of the doctor's Al Maslob,Bi'rat Al Anan,Kharab Al Bart Al Anan Rural Hospital,Al Shifa Center,Al Maton Health Chol Al-Jawf diagnosis. It were cholera,the cases without suspicious examination from different areas. After validation. 63 0 Marashi,Al Matun,Al Khalq Center Treatments were treated according to the treatmen plan

The eIDEWS coordinator has contacted the coordinator. The condition were diagnosed clinically by Meas Al-Jawf Al Maslob,Bi'rat Al Anan,Kharab Al Marashi Al Masloob Health Center,Al Marashi Health Center definition of the condition, Blood samples were not collected. Give antibiotics and vitamin A 3 0

Pert Al-Jawf Al Matun Al Shifa Center 1 0

eIDEWS coordinator contacted the focal points, information was shared, The cases were diagnosed AlMahwait,alKhabt ,ArRujum clinically according to case definition,some cases were investigated by rapid test for vibrio cholera and Chol Al-Mahweet Hufash,Shibam Kawkaban,Bani Alkhpt H,Aljoumhwri H,Numan HU,Other 104 0 the result were negative except one case was positive, Appropriate treatment were given according to Sa'd,AtTawilah,AlMahwait City ,Milhan severity of symptoms and dehydration.

eIDEWS coordinator contacted the focal points, information was shared. The cases were diagnosed Diph Al-Mahweet Hufash,Milhan Hufash H,Other clinically according to case definition,one case was un vaccination and one case other was vaccinatioin 2 0 unknown against diphtheria

eIDWES coordinator contacted focal points, information was shared.The cases were diagnosed clinically Meas Al-Mahweet Shibam Kawkaban,Milhan,Bani Sa'd Alahjer HC,Bani Sa`d Hospital,Other according to case definition ,skin rash were appear and the fever,2 cases were vaccination and 2 cases 5 0 other were un vaccination but the last case was vaccination unknown

eIDEWS coordinator contacted the focal points,information was shared. All cases were diagnosed clinically according to case definition. 34 cases were males and 33 cases were females, 2 cases were DF Al-Mahweet Bani Sa'd Bani Sa`d Hospital 67 0 investigated by RDT for dengue fever and one result was positive. Appropriate treatment were given according to severity of symptoms.

eIDEWS coordinator contacted the focal points, information was shared, The cases were diagnosed clinically according to case definition, some cases were investigated by rapid test for vibrio cholera and Chol Rayma Kusmah,Mazhar,Al Jabin Althulaia H,Az Zilh HC 32 0 result one positive, Appropriate treatment were given according to severity of symptoms and dehydration eIDWES coordinator contacted focal points, information was shared.The case was diagnosed clinically Meas Rayma Bilad At Ta'am Almithaq H according to case definition,skin rash and fever were appear , blood samples were collected and send 1 0 to central Lab in Sanaa eIDEWS coordinator contacted the RRT, information was shared. The case was diagnosed clinically Diph Rayma Mazhar Nawm HU according to case definition,the case was vaccination 1 0

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