Eiectronic Integrated Disease Early Warning and Response System Volume 07,Lssue42,Epi Week 42,(14- 20 October,2019)

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,lssue42,Epi week 42,(14- 20 October,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-42,2019

% %

% % % % % % % % % % % %

% % % % % % % % % % % % % %

% % % % %

97 97

96 96 96 96 96 96 96 96 96 96 96 96

95 95 95 95 95 95 95 95 95 95 95 95 95 95

94 94 94 94 94

100% % 400000

93 93 90% 350000 80% •During week no.42,2019, %96(1991/1907) health facilites from 23 300000 70% Governorates provided valid surveillance data. 60% 250000 50% 200000

Percentage 40% 150000 30% Consulttaions 100000 20% 10% 50000

•The total number of consultation reported during the week in 23 0% 0

Wk2 Wk5 Wk8 Wk 1 Wk 3 Wk 4 Wk 6 Wk 7 Wk 9

Wk 11 Wk 14 Wk 17 Wk 27 Wk 30 Wk 33 Wk 36 Wk 39 Wk 42 Wk Wk 12 Wk 13 Wk 15 Wk 16 Wk 18 Wk 19 Wk 20 Wk 21 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 28 Wk 29 Wk 31 Wk 32 Wk 34 Wk 35 Wk 37 Wk 38 Wk 40 Wk 41 Wk Governorates was 372271 compared to 370470 the previous reporting week 10 Wk

42. Acute respiratory tract infections lower Respiratory Infections (LRTI), Upper Reporting Rate Consultations Respiratory Infections (URTI), Other acute diarrhea (OAD) and Malaria (Mal)

Distribution of Reporting Rates by Governoraes (Epi-Week 42,2019)

% %

were the leading cause of morbidity this week. % %

100% %

99 %

100

100 100

90% 100

100

% 83

80% 93

88 89 70% 93 60% 50% 40% 30% 20% ● A total of 1820 alerts were generated by eDEWS system in week42, 2019, Of Reports HF No. 10% these 1819 alerts were verified as true for further investigations with 0% appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 42,2019 Proportional morbidity of leading priority diseases, Epi week 42,2019

Guinea Worm ● (URTI) 15.2%, suspected Malaria (4.8%),(DD) (13.2%) and (LRTI) (5.4%)Remain the Scabies Chicken Pox leading causes of morbidity representing a total of (38.6%) Brucellosis HIV/ AIDS Tuberculosis RB CL ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than Sch VHF 1% of total morbidity in reporting period Bloody diarrhea represented 0.3% Of this DF Meng morbidity Mal Mumps AFP NNT AVH_B&C ● All diarrheal disease comprised 13.2% and LRTI 5.4% of total morbidity in pilot Governorates AVH_A&E Meas this week . Typhoid F OAD BD Pert SARI ILI ● All diarrheal disease comprised 13.2% and OAD 8.9% 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%

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 النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا على شكل وباء :ILI

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 42 (14- 20 October,2019) Epidemiological Situation of Cholera

GOV

Distribution of suspected cholera cases by age group ( 01 Jan- 01 November 2019) Distribution of associated deaths by age group ( 01 Jan- 01 November 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601)

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 42 (14- 20 October,2019) Epidemiological Situation of Dengue Fever and Diphtheria

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

Deaths

Distribution of Suspected Diphtheria Cases by Vaccine Status Distribution of Death Diphtheria Cases by Vaccine Status Distribution of Confirmed Diphtheria Cases by Vaccine Status (from 1 January to 29 October 2019) (from 1 January to 29 October 2019) (from 1 January to 29 October 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]) 3 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 42 (14- 20 October,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-42 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-42,2019

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%

wk1 wk2 wk9 wk4 wk5 wk6 wk7 wk8

0.0% wk3

wk10 wk16 wk17 wk24 wk25 wk32 wk33 wk39 wk40 wk12 wk13 wk14 wk15 wk18 wk19 wk20 wk21 wk22 wk23 wk26 wk27 wk28 wk29 wk30 wk31 wk34 wk35 wk36 wk37 wk38 wk41 wk42

0.0% wk11

WK1 WK8 WK2 WK3 WK4 WK5 WK6 WK7 WK9

WK10 WK15 WK17 WK24 WK31 WK33 WK38 WK40 WK11 WK12 WK13 WK14 WK16 WK18 WK19 WK20 WK21 WK22 WK23 WK25 WK26 WK27 WK28 WK29 WK30 WK32 WK34 WK35 WK36 WK37 WK39 WK41 WK42

WK1 WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK15 WK16 WK17 WK18 WK31 WK32 WK33 WK34 WK11 WK12 WK13 WK14 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK26 WK27 WK28 WK29 WK30 WK35 WK36 WK37 WK38 WK39 WK40 WK41 WK42 WK10 Rapid Test(Postive) Microscope(Postive)

Age and Sex distribution of total consultations of leading diseases (Epi week 42,2019) Number of Alerts Received and Responded (Epi Weeks 39-42,2019)

90000

URTI LRTI Pert BD OAD Typhoid F 80000 78691 AFP Meas AVH_A&E AVH_B&C DF Meng

70000 Sch CL Chicken Pox Mal 250 60000

50670 50000 200

40000 35364 35634 33835 34317 150 29449 30000 26242 24273 24229

100 No.of Alerts 20000

50 10000

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 24273 33835 35364 50670 26242 Female 24229 34317 35634 78691 29449 Distribution of consultations of leading diseases by Governorates,Epi week 42-2019

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 2932 4202 1462 989 6474 1064 521 1361 5621 2316 3202 1596 1970 3641 2333 4837 821 810 2374 3576 1287 76 3261 56726 LRTI 295 397 759 156 4769 331 40 528 1962 1053 1420 363 236 1186 1295 1367 255 166 557 1275 250 53 1547 20260 ILI 134 0 80 0 99 88 0 0 16 21 51 0 0 90 52 9 157 0 110 215 172 2 321 1617 SARI 0 0 4 0 0 0 0 0 6 0 53 0 0 0 0 0 0 0 15 0 0 0 0 78 Pert 0 2 0 0 1 7 0 3 0 3 17 1 6 0 0 8 0 0 8 7 1 0 17 81 BD 38 3 58 13 149 87 6 51 68 117 68 7 2 0 70 41 33 14 101 121 50 0 154 1251 OAD 1584 2474 994 658 2473 1096 350 801 3748 1745 2412 576 406 2353 1669 2223 483 395 1445 2495 971 28 1664 33043 Typhoid F 38 31 265 11 408 128 19 107 602 251 799 36 6 7 542 54 96 72 164 353 51 47 408 4495 Meas 0 5 2 3 0 0 0 0 13 4 2 3 4 1 7 1 6 0 10 2 3 0 5 71 AVH_A&E 5 19 8 2 0 1 3 5 104 10 34 13 4 3 23 21 8 0 11 34 19 0 35 362 AVH_B&C 4 0 2 0 0 2 0 0 99 3 10 9 0 7 18 0 6 1 2 5 3 0 10 181 NNT 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 AFP 0 1 1 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 5 250 14 1 4 20 14 1 10 12 9 17 11 7 األمراض المشتبه17ة Mumps 9 7 4 10 5 14 0 4 46 14 Mal 40 194 1 2 8918 112 36 487 213 462 643 3 0 4394 366 55 15 343 341 182 0 0 1163 17970 Meng 0 0 0 0 2 1 0 0 21 1 2 0 0 0 4 0 0 0 0 0 1 0 17 49 DF 40 64 4 6 256 0 0 1 2 0 1 2 4 422 0 90 21 0 0 0 31 0 392 1336 VHF 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sch 1 0 0 11 0 7 0 31 71 78 22 15 4 139 16 5 7 9 46 40 0 0 23 525 CL 0 0 1 0 0 2 0 1 13 6 19 0 0 2 2 5 3 5 9 9 1 0 2 80 RB 0 0 28 0 2 0 0 6 74 10 93 0 1 3 101 1 0 0 0 18 0 0 11 348 Tuberculosis 2 2 0 0 9 0 0 0 19 1 21 0 0 7 5 2 0 0 2 6 1 0 4 81 HIV/ AIDS 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 10 Brucellosis 3 0 61 0 13 38 0 4 130 50 241 0 8 53 62 0 10 0 12 11 10 0 15 721 Chicken Pox 2 9 5 0 1 6 1 11 54 21 13 6 4 15 30 3 2 25 59 47 2 0 17 333 Scabies 11 1 2 0 36 4 1 4 11 8 19 0 0 28 1 2 0 28 30 22 0 4 0 212 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 3864 9020 4461 7625 13863 3585 2090 5141 53037 8318 19448 7592 4179 10234 13211 12310 5626 1255 5767 8984 4613 330 10472 215025 total_cons_disease 9271 16614 9002 9473 40515 6862 3071 9152 67227 15220 30396 11063 7009 23851 21301 21212 7576 3351 11473 19324 7500 541 21267 372271 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 42 (14- 20 October,2019)

Alert Responded in Epi - Week 42,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Yaffa,Radfan,Halimayn, Tur Al Bahah,Al Alhlal HC, Tur Sena'a Dispensary ,Radfan Public Eidews coordinator visited the health facility, the cases of suspected Dengue fever were diagenosed DF Lahj clinicaly according to case definition. 90 0 Madaribah and Ras Alara,Tuban H,Halimeen rural H,Tour Albaha Hospital,Alfayosh HU The cases added to the line list , treated symptomaticaly and improved.

Tuban,Yaffa,Radfan,Al October public H,Radfan Public Contact with the focal points , the cases of suspected cholera were diagenosed clinicaly according to Hawtah,AlMaqatirah, Halimayn,Al H,IbnKhaldoonHospital,Halimeen rural H,Almilah case definition,89 cases were positive by Chol Lahj RDT 150 0 Milah,Tur Al Bahah,Al Qabbaytah,Al Hospital,Balla Health Unit,Tour Albaha Hospital,Karesh the cases reported immediatly to the opration room, recorded in the line list , the cases treated by iv fluid, Musaymir Health Center,Other ors and antibiotic ,the cases finaly left the health facility.

Immediate report was recived by the focal points , the cases of suspected whooping cough were diagenosed clinicaly according to case definition,the Pert Lahj Yaffa,Tuban,Radfan October public H,Radfan Public H 8 0 cases reported immediatly to the operation room , registerd in the line list ,the cases treated symptomaticaly and left the health facility.

Eidews coordinator visited the health facility , the cases of suspected Diphtheria ,the cases were Diph Lahj Yaffa,Al Had Makh Dispensary,Alhaid rural H 15 0 diagenosed clinicaly ,all contact recorded in the line list

Contact with the focal point , 1 case of suspected measles was diagenosed clinicaly according to case definition. Meas Lahj Radfan Al Hakmah Center 1 0 Case reported immediatly to the operation room , recorded in the line list, case treated symptomaticaly and left the health facility.

AlMansura,AlBuraiqeh,Dar Sad,Ash Aden German Hosp.,Al-Wali Hosp.,Alwahda educational eIDEWS team were contacted fp: the cases were different area, the cases were diagnosis DF Aden 64 1 Shaikh Outhman H,Al Ryadah Hosp. clinically,samples were collected, treatment were given, investigation form were done,one case was dead

Al Buraiqeh,Ash Shaikh Outhman,Al eiDEWS team were contacted fp,the cases were diagnosed clinicaly, rapid test were positive by 6 cases Chol Aden Albasateen medical center,Alwahda educational H,Other ,stool samples were collected for culture from both cases,treatment were given ,investigation form were 183 1 Mualla,Dar Sad done,one case was dead

eIDEWES team were contact by f.p, the cases were KhurMaksar,DarSad, AshShaikh Khor-Maksar Complex.,Al Basateen Al Tahri Center,Al diagnostic clinically, investigation were done, treatment were given, samples were collected from most Meas Aden cases 5 0 Outhman, Attawahi Ryadah Hosp.,Alwahda educational H Investigation form were done ,the cases were vaccination except one case was un vaccination

eIDEWES team were contact fp, the cases were diagnoses clinically,the cases were collected, treatment Pert Aden Al Mansura,Ash Shaikh Outhman Alnakib H,Alwahda educational H 2 0 were given , investgation form were done

eiDEWS team was contacted fh :The case was Abobakar Abdulgani Ali, age 21m/from the Aldalea AFP Aden Ash Shaikh Outhman Alwahda educational H 1 0 /diagnosis clinically, unknown vaccination and sample /, investigation from was done.

Zunjopar H,Alrahmah Clinic,Al Mahfad Hospital,Mahnf- eIDEWS team contacted the FP, the cases were diagnosed clinically (standard dengue case definition), DF Abyan Zungobar,Sibah,Lawder, Al Mahfd,Ahwar 40 0 Lwdr H samples were not collected, treatment were given, investigation forms were done

RRT in districts visited FP. , the cases were diagnosed clinically, RDT'S were positive in 16 cases and Mudiyah,Lawder,Al stool culture didn't done, treatment were given, investigation forms were done , the cases and their Chol Abyan Mudiya Hosp.,Alrazi .H,Al Mahfad Hospital,Mahnf-Lwdr H 63 0 Mahfd,khanfir,Jayshan families received complete advices about the ways of prevention and management of cholera infection. the cases included in Cholera linelist

SabirAlMawadim,Maqbanah,Sama,AtTaiz Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al iyah, Rapid response team contacted also focal points by eIDEWS coordinator,cases diagnosed clinically Loqiah Hospital,Almsrakh Hospital,22 May Almodafar AshShamayatayn,Hayfan,JabalHabashy, according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Chol Taiz HC,Mawih Hospital,Alnshmh H,MSF Hospital,Al Aroos labs)for confirmation. Supplements & antibiotics treatment were given(case management)rapid test :106 1695 2 Sharab ArRawnah,AlMisrakh, Hospital,22 MayHC,ArRomahcenter, Khalifa cases were positive &,the results of stool C/s still pending. .There were collection & cluster of cases in Khadir,AlQahirah,AlMaafer,Mawiyah,AlMu Hospital,Labs National Center,Other the same Place,2 cases were dead dhaffar, Salh,Sharab AsSalam,

the communicating with the coordinator of edews in the facility we found these cases of suspicion of Pert Taiz SabirAlMawadim,Sama, Salh,At Taiziyah Al Aroos Hospital,Al Qatab HU,MSF Hospital pertussis,the cases were from different areas,Action :these cases were treated at home ., Advices have 17 0 been given to their parents to follow up and review.

Aljoumhri H,Mohammed Al-Dourah HC,Altawn Rapid response team were contacted, information shared, facilities has been visited the suspected DF cases had a history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed DF Taiz Al Qahirah,Al Mudhaffar,Salh,Khadir H,Alhikma Hospital,Labs National Center,Al-Riyad 392 0 clinically.and by blatelets counting, ,rapid test of dengue virus was done for some of cases, All from taiz Hospital,Althwrh H,Other governorate.. All data in the line list..

Rapid response team contacted, information shared.. Diph Taiz At Taiziyah,Maqbanah MSFHospital,HjdahHospital, Other These cases of suspicion of diphtheria are from districts , 9 1 All data about the cases in the line list,one case was dead

Mashraa Wa Hadnan,Sabir Al eIDEWS coordinator contacted focal points and the coordinator of the directorate ,information's Meas Taiz Alfath HC,Other shared.Blood samples were collected from these cases and sent for lab confirmation & the cases were 5 0 Mawadim,Al Qahirah vaccinated , All data in the line lis

Hajar aljoul rural H,Maternity and Childhood H - The EDEWS coordinator contacted the focal person,the cases were diagnosed clinically by case Chol Hadramout Hajr,Broom,Al Mukalla City definition,the cases came from different areas, RDTwere positive in 8 cases. no stool culture was done. 22 0 Mukalla,Bin Sena'a educational H the cases were treated by iv fluids ORS and antibiotic. the cases improved and discharged.

immediate report was sent by the EDEWS focal person. The case is 9 months female from Adhlaiaa area. the case was diagnosed clinically by case definition. symptoms started before 45 days. the case is Pert Hadramout Adh Dhlia'ah Aldhulaia'a HC 1 0 partially immunized.( PENTA 2) only. the case was treated by antibiotic. the district RRT investigated the living area. no cases with suspected pertusis was detected in the contacts.

The district RRT investigated the living area. the cases were diagnosed clinically by case definition,the Meas Hadramout Adh Dhlia'ah,Al Mukalla City Aldhulaia'a HC,30 Nobamber HC 3 0 cases were vaccinated not blood samples were collected. Symptomatic, treatment were given

The EDEWS coordinator visited the health facility. the case was 8 years old male from AlMukalla city. the case was diagnosed clinically. pseudomembrane was seen. no LN enlarged. 2 pharyngeal swaps Diph Hadramout Al Mukalla City Maternity and Childhood H - Mukalla were collected and sent to central lab by Ameis media. the result of culture was negative.no bacillus of 1 0 diphitheria was seen. the case is vaccinated. DAT with crystalline penicillin was given. the case admitted to the isolation word. the case improved and discharged.

AlQafr,AlMakhadir AsSayyani,Ash Shair,An Nadirah,Jiblah,AlDhihar, Almakhader HC,Alqaidah H,AL AlUdayn,Yarim,AlMashannah MzahanH,YahsubHospital,Aladin H,Mother and Child Immediate notification. eDEWS Coordinator visited hospital, the stool samples were collected and Chol Ibb Hubaysh,As Saddah, FarAlUdayn,Ibb, positive by rapid test for 48 cases 1374 1 H,Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani DhiAsSufal,ArRadmah, All cases were improved,2 cases were dead Hospital,Alradhmah H,Other MudhaykhirahBadan, HazmAlUdayn, AsSabrah

Alsadah HU,Albait Aljadid HC,Alshaheed Albadani eDEWS focal points contacted.Information shared , Samples were collected,the cases were vaccinated Meas Ibb Badan,As Saddah, Far Al Udayn 7 0 Hospital except one case was vaccination unknown

Immediate notification by focal points, the cases were diagnosed clinically and treated accordingly,the Ar Radmah,Al Mashannah,Yarim,Al Al Nukhbah dispensary,Alnassr H,Yarim cases were vaccination unknown except one case was vaccination,3 cases were dead Diph Ibb 19 3 Dhihar Hospital,ALhamd Hospital

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 42 (14- 20 October,2019)

Alert Responded in Epi - Week 42,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

,AlQanawis,AdDahi, AzZuhrah,AlHawak, AlHali,AsSalif,AlMunirah, Alhshm Center,Althawra public H,Almekhlaf HC,Alzaydia AlMighlaf,AlGarrahi, eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Rural HAlsalakhana H,Alkanawes HC,Aldhahi Rural treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use Chol AlHodaidah Alluheyah,JabalRas, AsSukhnah, 3025 0 H,Almansouria rural H,Bait Alfakih H,Alzaydia Rural WHO protocol DTC, cases done rapid test for sever cases (total rapid test done were cases test,16 test Zabid,Al Mina, Al Marawiah,Al H,Aljarrahi rural H,Alluheyah HU,Other were positive and other test were negtive, positive test send for confirmation, , Hajjaylah,Al Khawkhah ,Kamaran,Bura, AlMansuriyah,AzZaydiyah,Bayt Al Faqiah

Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane around tonsillitis , and sever inflammation, the cases were diagnosed clinically. Medications have been Diph AlHodaidah Bayt Al Faqiah, Al Hawak Alsa'adya HU,Althawra public H 10 0 started, ALL cases only depend on casses definition,one case was vaccination and one case other was un vaccinatiion but 8 cases were vaccination unknown

Alkanawes HC,Alkanawes PrivateH,HaisruralHospital, Focal points were contacted , the suspected DF cases had a history of high fever , retro- bulbar pain DF AlHodaidah Al Qanawis,Al Hali, As Salif,Hays,Zabid ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been started, ALL cases 256 0 Hikmah hospital,Alsalif Hospital diagnosis depend on case definition and platelets counts

Coordinator contacted the hospital focal point, the case was diagnosed suspected Pret and treated Pert AlHodaidah As Salif Alsalif Hospital 1 0 accordingly

Hajjah City,Qafl Hajar center,Public Republican Hospital,Al Matlai eDEWS coordinator contacted focal points, information shared, cases have been diagnosed clinically DF Hajjah Shamer,Kuaydinah,Aslem,Khayran,AlMu Center,Martyrd.YasserwThabHospital,Almedhbar .According to the standard definition, Cases from different areas Some cases have been rapid test work 422 0 harraq,Bani Qais HU,Other the result were positive, Appropriate treatment were given

,AlMahabishah,KuhlanAffar, Mustaba,Bani AlAwam, Kuhlan Bani Chamakh HC,Bani Qais Health Center,Mabyan AshSharaf, AlMaghrabah,Khayran Hospital,Kuhlan Afar HC,Almahabesha Public AlMuharraq,AshShaghadirah,Najrah,Ash eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts. Information shared .It have Chol Hajjah H,Alshahel Rural Hospital,Almaghraba HC,Public been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea) 1227 3 Shahil, AlMiftah,QaflShamer, Republican Hospital,Khatwah HC,Qafl Shamer Kufl- the cases from different area. It were given the appropriate treatment,3 cases were dead BaniQais,QarahAslem, Shamar Rural H,Other AlJamimah,Mabyan ,Abs,HajjahKuaydinah,Aflah AshShawm

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It was diagnosed clinically according to standard definition For measles, female A 24 months. Layan yusef ali al Meas Hajjah Sharas Sharas HC 1 0 sheali - from Sharas District sharas al aala village. vaccinated 2 dos. 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 District. Information shared . We received a report from Almuharak HC , 1 case (suspected diphtheria) The diagnosis was clinically Diph Hajjah Khayran Al Muharraq Almuharak HC (diphtheria) male A 8 years - Zaid mohammed hasen from Khayran Al Muharraq District not vaccinated 1 0 .The response team in the field investigated the case and the contacts and the appropriate treatment was given

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed 22 May Hospital,Jabr Bn Hyan Complex,Ottan clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab Az'zal,AtTahrir,Sana'aOld,AlWahdah,Atht Complex,Al Jraf Complex,Ibn Khaldon HC,Omar Al (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana haorah, Shu'Aub,AsSabain, of them were from Amana governorate & a few of them from other governorates ,different districts of that 1258 1 Mokhtar Complex,Bni - Hwath HC,Alwahda Health Assafi'yah,BaniAlHarith Maain governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most Center,Arwdhah H,As Sabin Hospital,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,2 cases were dead

AlWahdah,AtTahrir,BaniAlHarith,Assafi'ya Alshaheed Complex,Alrwdh HC,QUEEN SABA eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Meas Amana cases and sent for lab confirmation,the cases were unvaccinated against measles. Vit-A were given to 13 0 h,Shu'Aub,As Sabain,Maain CENTER,Shu'aub(Hae Alsjn) Complex,Alzhrawi HC the case,in order to support her immunity against complications of measles.

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 22 May Hospital,Alharamin H,As Sabin Hospital,Almalik 2 diphtheria.Symptoms & signs of a case were,fever,sore throat,grey-whitish pseudo-membrane,swelling Diph Amana Maain,Shu'Aub,As Sabain,Bani Al Harith 8 0 Hospital,Arwdhah H 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 the cases were vaccination

eIDEWS coordinator contacted focal point,then HF visited. Information shared.Stool sample collected from the case in 16/06/2019 & the sample sent for lab confirmation.The date of onset of AFP was in AFP Amana Assafi'yah Althwrh H 10/06/2019.The case was one male,his name BASHEER SALEH MOHAMMED MAKKY,his age 144 1 0 months,from Hajjah governorate, Bani Qais district, Al-Waha village.He was non-vaccinated against polio.

Al Mahather Health Center,Qatabir Health Majz,Sa'da the edews focal points contacted , the cases were diagnosed clinincally according to the SCD , the Chol Sa'adah Center,Monabbih Rural Hospital,Al Abqoor Health cases treated at the health facility according to the management protocol , the line list updated and the 326 1 ,Qatabir,Munabbih,Sahar,Baqim UnitMajz Health hospital ,Other information shared,5 cases were positive by RDT,one case was dead

Dr. Mosfir Clinic,Sudan Health Unit,uasnim HU,Al eDEWS coordinator contact the focal points , the cases were diagnosed clinically according to the case Meas Sa'adah AsSafra,Sa'da,Sahar, Baqim,Al Hishuah definition and treated in outpatient seeting the vaccination state of patient is unvaccinated the 10 0 Jumhoori Hospital serviullance team conducted to tack samples

Haydan,Sa'da ,Baqim,Kitaf wa Al Haydan Hospital,Al Jumhoori Hospital,Dhian HC,Al -Talh the edews focal points contacted , the cases were diagnosed clinically according to the standard case Diph Sa'adah 15 0 Boqee,Majz,Sahar Hospital,Other definition , the contacts traced by the district RRT , the line list updated and the information shared

Pert Sa'adah Saqayn,Majz Dhian HC,Foot HC,Majz Health hospital 8 0

Bani Suraim,Kharif,Al Kharif Rural Hospital,Amran General Hospital,Thula Madan,AlQaflah,AsSawd,Maswar,JabalIy Health hospital,Habur Healthhospital, Al Abraq Health Eidews Coordinator Contacted The Coordinator of Surveillance in Districts, The cases were diagnosed alYazid, AsSudah,Huth,Suwayr Unit,Al Qaflah Rural Hospital,As Sawd Health clinically as suspected cholera. According To case Definition , Rapid Test were done for some cases Chol Amran 728 0 Khammer,Shaharah, Harf hospital,Raydah Health hos.,Al Ashah Health the Result were positive and some cases negative , All The cases improved After Taking The Sufyan,HaburZulaymah, hospital,Harf Sufyan H,Al Salam Khamir Hospital,Huth Treatments proper DhiBin,AlAshah,Amran Raydah,Thula Health hospital,Other

Raydah Health hos.,Al Osrah Health Center,Hababah Eidews Coordinator Contacted The Coordinator of Surveillance in Districts,the cases were diagnosed Meas Amran AlMadan,Raydah,Amran, Thula clinically as suspected Measles, According to Case definition, the cases were Vaccinated except one 4 0 Health Center case was under age vaccination

eidewsTeam contacted focal points . And RRT visit Health Hospital 22 may and Visit the contacts and gives antibiotics case was diagnosed Diph Amran Amran 22 May hospital 1 0 clinically probable diphtheria . case Treated with antibiotics and anti toxin case from district iyal surayh

eidews Coordinator Contacted The Coordinator of Surveillance in District khammer and visit Al salam Pert Amran Khammer Al Salam Khamir Hospital khammer hospital The cases were diagnosed clinically as suspected pertusis. according To case 3 0 definition. The Cases Improved After gave the Treatments Antibiotics . The cases from districts others

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 42 (14- 20 October,2019)

Alert Responded in Epi - Week 42,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Manakhah,Hamdan Bani Alhanak HU,Bait Alsaid HC,Almarbak HC,Hamdan Matar,AlHaymah AlKharijiyah,Jahanh Hospital, Bani Mansour HC,Bait Alhenami HC,Qaa Al Bilad eDEWS coordinator contacted focal points, The cases were diagnosed suspected cholera(AWD) cases Chol Sanaa Governorate Sook Hu,Alshe'eb Alaswad HC,Walan Hospital,22 May tested by rapid test 163 cases positive and cases were treated at the health facility and received 1855 0 ARus,ArhabSa'fan,Attyal,Sanhan,BaniHu Hospital,Alar rural H,Awmara H,Alshaeed treatment shaysh, AlHaymahAlKharijiyah, MohamedAldurraHospital,Other AlHusn,NahmBani Dhabyan,Khwlan

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Pert Sanaa Governorate Arhab, Al Haymah Al Kharijiyah,Sanhan Alhayfa HC,Souk Alsabt HC 7 0 definition, the cases were vaccination unknown and appropriate treatment given to cases.

The EDEWS coordinator contacted the focal person, The cases were diagnosed clinically by case Meas Sanaa Governorate Sanhan Wadi Alajbar HC,Bahran HC definition,Skin rash started, one case was vaccination and one case other was un vaccination , blood 2 0 samples were collected.

The EDEWS coordinator contacted the focal person. The case was diagnosed clinically by case Diph Sanaa Governorate Jahanh Alshaeed Mohamed Aldurra Hospital 1 0 definition. Unknown vaccinated The case was treated with antibiotic.

Usaylan Hospital,Bayhan Hospital,Emergency/Ataq eIDEWS coordinator was contacted with health facilities found cases suspected case of cholera ,the Chol Shabwah Osailan,Baihan,Arma,Ataq,Ain cases were diagnosed clinically accord to case definition, rapid test were negative except one case was 8 0 Hospital positive,the cases received her best treatment and improvement.

eIDEWS coordinator was contacted with health facilities found cases suspected cases of dengue from different areas ,the cases were diagnosed clinically accord to case definition rapid test were positive for DF Shabwah Baihan,Habban Bayhan Hospital,Habban Health Unit,Habban Hospital 31 0 13 cases and other three cases were negative or not done by RDT, all cases were received their best treatment and improvement.

eIDEWS coordinator was contacted with the health facilities found cases suspected cases of measles, Meas Shabwah Ain,Ataq Outpatient/Al Ain Clinic,Al Awal Medical Complex 3 0 the cases wereun vaccination , samples were collected ,the cases were treated and improve

eIDEWS coordinator was contacted with health facilities found one suspected case of pertussis Nora Pert Shabwah Ain Ain General Hospital Abdalrab Ahamed female age 24 month from Alkethy village case diagnosed clinically accord to case 1 0 definition vaccination was not done case was received her best treatment and improvement.

Sabah,AsSawadiyah, AtTaffah,Naman,MukayrasDhiNa'im,ALS Alshriah Sare H,Qaea Rada Center,Mother and child eIDEWS team contacted focal points the cases were diagnosed clinically as suspected cholera using case definition , the rapid test 76 cases positive and the main saing watery diarrhea &vomting some Chol Al-Baidha haryah, AlMalagim,Radman HC,Mukayras Hospital,Althwrh Hospital,Al-Taffah 800 0 dehydration the paitnts ademittedt in HC with ORS and IV fluid in good condation the cases from AlAwad,AlQuraishyah Center,Other deferrnt organ AlBaydaCity,Rada',Wald Rabi',Al A'rsh

IDEWS team contacted points information shared blood saeIDEWS team contacted focal point the Meas Al-Baidha Mukayras,As Sawadiyah Mukayras Hospital,Other cases diagnosed clinically according to case definition Antibiotics treatment were given , Apear skin rash 2 0 and the fever ,one case was un vaccination and one case other was 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 17/10/2019 samples were sent for confirmation the AFP Al-Baidha Mukayras Mukayras Hospital 1 0 date of onse of AFP in 15/10/2019 the case was one male his name was Abdullah Salem Abdullah Algroi this age 72 Monthes he was from Mukayras from Mashabah village and the he was vaccinated 8

EDEWS team contact Edews focal point in `Qishn Country Hospital .case from Qishin District ,case Chol Al-Mahra Qishn Qishn Country Hospital diagnosis according to case defination , susspected Cholera cases send daily in line listing to central 4 0 level , rapid test was +ve ,treatment was given

edews team contact focal points , the cases were diagnosed clinically as suspected (cholera) using case Chol Hadramout wady Al Qatn Alkutn Public H,Alakkad HC definition , 2 0 Treatment : ORS, iv fluid , anti biotic.

edews team contact focal points , the case were diagnosed clinically as suspected (pert) using case definition , the cases were vaccination except one case was un vaccination and the last case was Pert Hadramout wady Sayun,Rakhyah Tarebatalbelad HU,Other vaccination unknown , 6 0 investigation done by RRT in the area . symptomatic treatment were prescribed

edews team contact focal points , the cases wereas diagnosed clinically as suspected (meas) using case definition , 2 cases were under age vaccine and 2 cases other were Meas Hadramout wady Sayun,Shibam,Alsoum Sayo'on Public H,Other 4 0 vaccination blood sample were collected . symptomatic treatment were prescribed

Zeraja rural H,Meshrafa HC,Alrabo'o banighulais Dhamar City,Dawran Aness,Wusab AlAli, HC,Althalouth HC,Rsabh Hospital ,Alkharba rural H,Aljarf Wusab AsSafil ,Mayfa'at Anss, Jabal EideWS coordinator contacted focal point he found cases diagnosed suspected Chol(Acut watery Chol Dhamar HC,Kharbah Abuyabes HC,Alwahda university H,Dawran diarrhoea and dyhadretion )some cases tested by rapid test and result were postive for 44 cases, all 1090 0 Ashsharq AlManar,Jahran, Anss Hospital,Alhumyat HC,Dhamar public H,A Unity Centre cases received treatment Maghirib Ans AlHada,Utmah (residential),Other

Eidewds coordinator contacted of the focal points and he found that cases were diagnosed according to Meas Dhamar Mayfa'at Anss,Al Manar Al JrashhHC,Hamam Ali Hospital 2 0 the standard definition of Meas, the cases were Vaccination ,samples were collected

Alwahda university H,Bin alakwa'a Dispensary,AL-Amal Eidewds coordinator contacted of the coordinator district and he found that cases was diagnosed Pert Dhamar Jahran,Dawran Aness,Dhamar City according to the standard definition of pert - cases from different area, the cases were un vaccination, 17 0 Center treatment and education health given

EdeWS team visted focal point and he found the case diagnosed according to case definition as suspected AFP Flaccid Paralysis- Weakness - ) -Patient data:yahy Asaad Alkhazy and Zyaad Mraad AFP Dhamar Dhamar City Al Mogalee & ALGumah Dispensary ALkrby (18 mounth - From Myfaa anss and Anss district - dosage taken - The beginning of the 2 0 symptoms 25 /10/2019- Reporting date 18/10/2019. All samples from the patient and contact the patient were delivered to the coordinatori of paralyss

EIDEWS coordinator contacted coordinator district he found 4 cases diagnosed suspected Diph according to the standard definitions - Cases from different districts have been communicating with the Diph Dhamar Dhamar City Dhamar public H 4 0 rapid response teams for descent, treatment, examination and health education of the risks of infection, among these cases one case of the province of Albetha

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,Harib,Madkhal,Al Jubah Al vatha HC,Harib Hospital,Medghal Rural Hospital 17 0 Supplements & antibiotics treatment were given(case management),the results of stool Rapid tests of cholera 4 cases were positive ,.There were a no collection or cluster of cases seen in the same Place

eIDEWS coordinator contacted focal points,information's shared,then HF,cases visited by eIDEWS coordinator & RRT of Raghwan district, Blood samples were collected from the case and sent for lab Raghwan,Jabal Murad,Sirwah,Bid Raghwan Hospital,Alataba Al Ravey Hospital ,Bid Bidah confirmation & the onset of fever , skin rashthe,the cases were vaccinated except 2 cases were un Meas Mareb 6 0 Bidah,Madkhal Hospital vaccination against measles, All possible actions done by RRT of Raghwan district done,in order to control the infection to other close contacts & Vit-A were given to the suspected cases, in order to improve their immunity against complications of measles

the contacted the contact and told us that suspected dengue cases had a history of high fever, back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for DF Mareb Marib City,Al Jubah mgmah al chahuad Complex,May 22 Hospital 21 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

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 42 (14- 20 October,2019)

Alert Responded in Epi - Week 42,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Maslob,Al Khalq,Az Zahir,Al Al Humaydat Health Center,Al Masloob Health The EDEWS Coordinator received a report from the control officer that there were cases of the doctor's Chol Al-Jawf Hazm,Rajuzah,Al Matun,Bi'rat Al Center,Unit,Al Khalq Health Center,Bart Rajuzah diagnosis. It were cholera, 17 cases were positive by rapid test, the cases from different areas, After 289 0 Anan,Al Matammah,Al Hamidat Hospital,Al Shifa Center,Al Hazm Hospital,Other validation,Treatments were treated according to the treatment plan

EDEWS team contacted focal points, the Cases diagnosed clinically as suspected pert.treatments were Pert Al-Jawf Az Zahir,Rajuzah,Al Matammah Bart Rajuzah Hospital,Other 7 0 given,the cases were un vaccines

AlMahwait,alKhabt, ArRujum Bni Alhmadi HU,Alrujm ,Mlhan Health Center,Bani Sa`d eIDEWS coordinator contacted focal points, information were shared. all cases were diagnosed clinically according to case definition, some cases were investigated by rapid test for vibrio cholera and the result Chol Al-Mahweet ,Hufash,Shibam Kawkaban,BaniSa'd Hospital,Aljoumhwri H,Al Arkob 602 0 were positive, for 15 cases appropriate treatment were given according to severity of symptoms and ,AtTawilah,AlMahwait City ,Milhan HC,HufashH,NumanHU,Hospital,Other dehydration

eIDEWS coordinator contacted focal point, information were shared. all cases was diagnosed clinically according to case definition. one case was female and 2 cases were males . the cases was arrived to Pert Al-Mahweet Hufash Hufash H 3 0 Hufash hospital with symptoms and signs of suspected Whooping cough more than 15 day's . all cases were vaccinated against pertussis. the focal RRT were send to investigate and treat new cases

eIDEWS coordinator contacted focal points, information were shared. the cases were diagnosed Diph Al-Mahweet Al Mahwait City,Milhan Aljoumhwri H,Other clinically according to case definition ,the cases were un vaccinated against diphtheria 3 0

Al Jafariyah,Al Jabin,Kusmah,Mazhar,As Almithaq H,Aden HC,Wadi Alarid HC,Althulaia H,Az Zilh DEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Chol Rayma 206 0 Salafiyah,Bilad At Ta'am HC,Other treated accordingly, isolation done , the cases take treatment and go out side hospital

Al Azariq,Juban,Ash Daglal Health Center,Dhwran HC,22 May eDEWS team contacted FP, all cases were diagnosed according to case definition, all included in Chol Al-Dhale Shu'ayb,AlHusha,Qa'atabah,Ad 78 0 Hospital,Alnassr H,Other updated daily line listing Dhale'e,Damt

eIDEWS team was contacted fp: The cases were diagnoses clinically, vaccination were done, samples Meas Al-Dhale Al Azariq,Jahaf,Damt Daglal Health Center,Damt HC 3 0 were collected , treatment were given, investigation form were done.

eIDEWS team was contacted fp: The case was female age: 34 y from ,diagnoses clinically , vaccination Diph Al-Dhale Al Husha Other 1 0 was done, sample was collacted , treatment was given, investigation form was done.