Volume 1, Issue 2 Sultanate of Oman Ministry of Health
Apr-Jun 2017
Inside this issue:
Launching of the 1 e-surveillance Hand Hygiene Day 4
World Day for Safe- 7 ty and Health at Work
Proposal for mater- 9 nal Tdap vaccine Measles-Rubella 10 surveillance: Q1 Launching of the e-Surveillance
National ARI 11 The National Electronic Public Health nologies are providing a promising envi- surveillance: Q1 Surveillance System (NEPHSS) ronment for launching surveillance sys- tems in a digital platform and providing Q1 (Jan-Mar 2017) 12 – he Ministry of Health has initiated the real time data for action. Similarly the Communicable 15 T first steps towards a national elec- electronic real time data from environ- Disease Surveil- tronic surveillance (E-Surveillance) of dis- lance data ment monitoring agencies for climate, eases and events of public health concern water quality etc. are increasingly being by launching of the Electronic notification rd shared on the public domains. So also the system on 3 May 2017. E-surveillance has evolution of remote sensing systems com- Editorial Board been initiated with the main objective of bined with the geographical information Executive Editor: utilizing information technology tools to systems have been contributing to the Dr Seif Al Abri achieve the stated objectives of public public health surveillance systems. All Director General, DGDSC health surveillance addressing the current these informations from various sources and the future challenges. Editor: along with the disease data can be opti- Dr Shyam Bawikar Background mised into a single interoperable digital platform. The layers of Board of Directors The development in information help in (Departments) information technol- ‘Tarassud’ (e-Surveillance) interpretation of dis- Surveillance ogy and communica- ease data and public Communicable Diseases tion sectors have health management in Central Public Health opened several ave- context with environ- Laboratory nues that could be ment in far broader Infection Prevention and effectively utilised and efficient way than Control for enhancing the Environment and Occu- the traditional way. pational Health public health surveil- The public health lance functions “informatics” expert through use of elec- should be able to sup- Contributors: tronic health rec- port the public health Dr Padmamohan Kurup ords, interconnected Ms Najla Al Zadjali decisions at the local or Dr Fatma Al Hikmani record sharing plat- national level by facili- Dr Shyam Bawikar forms, and web tating the availability Dr Prakash Patel based applications ARI, EPI and IPC team of timely, relevant, and etc. Thus such tech- Public Health Bulleti n
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high-quality information. In other words, public health surveillance systems into a such systems should always be able to pro- single multi layered IT platform. vide direction on methods for achieving Description of E-Notification system public health goals faster, and more effi- ciently at a lower cost by the integrated All the major hospitals have the electronic information technology. health records system (Al Shifa 3+) and are connected to the central data warehouse The Vision currently. There is an on-going ambitious A National Electronic Public Health Surveil- plan to connect all polyclinics and primary lance System (NEPHSS) is envisioned as a health care facilities in the country to the set of software applications, databases, network. The Al Shifa-3+ is an in-house elec- and data within intranet that allows users tronic patient records system developed by the Directorate General of Information Schematic layers of the surveillance Technology (DGIT) in the Ministry of Health. platform within NEPHSS In line with this the E-surveillance (Tarassud) “The objective is is also developed by the IT directorate and is to bring about the customized for public health surveillance functions and hierarchy in the country. It is sequential developed as a flexible web based system which enables it to be comparable to any replacement and similar surveillance software available in the integration of market and is significantly cheaper. The sys- tem is developed in such a way that it is the existing stand-alone most user friendly method to notify diseas- of computerized medical records to report es. The following are the simple steps: public health communicable diseases and other public The notifications are available as part of surveillance systems health events more efficiently as well as to the patient’s electronic health record. provide an IT platform to support web into a single multi The user just has to click open the rele- based public health surveillance functions vant notification form from drop down layered IT with capacity and scope of qualitative and list of electronic notifications. The form quantitative expansion in future. platform.” will fetch personal particulars and con- Objective of current phase tact information from the patient’s rec- ord. The option of automatic pop-up To bring about the sequential replacement once the specific diagnostic International and integration of existing stand-alone Classification of Diseases (ICD) code is
1. Users complete computerized medical record linked notifica- tion and submits 2. Data transferred to central server 3. Data are pushed to the web based system (Intranet only) at this phase 4. Data accessed using username and password by other stakeholders 5. Assigned administration level controls
Volume 1, Issue 2
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entered is also available. ysis, and reporting process. The disease details are filled up by the 3. Improves reporting timeliness and com- notifying doctor through various pleteness of data dropdown/selection menus on the notifi- 4. Better feedback to data providers. cation embedded in Al Shifa 3+ system. 5. Improved efficiency of system mainte- Some fields in the form will be mandato- nance and improved documentation with ry such as immunization details for a vac- clear monitoring. cine-preventable disease. Way Forward This system has the option to generate an alert for notification transmitted to the Specific questions related to usage, ac- registered mobile phones/email to con- cess, interoperability, analysis, quality, cerned public health unit. validation, storage, privacy, security, The electronic notification will be accessi- and liability have come up and each are being addressed. ble to the data manager at the gover- To develop a web-enabled system se- norate and national level through differ- “The way forward is ent levels of permission online with a time cured and protected for use only by pre- gap of few hours. This is made available authorized personnel (Internet based). to have smartphone through a web based application current- Such an online system accessible and web based ly made available through MoH intranet through internet from anywhere in the applications to National and Regional Directorates of country will make available e-notification Disease Surveillance and Control. system to all health institutions including reporting by private and non-MoH governmental The regional Focal Points would access organizations with or without Al Shifa- different the password protected website and veri- 3+ system. fy/update/complete data entry online. It stakeholders that Developing tools to utilize optimally the is envisaged that up-to-date data on would enrich the communicable disease would be availa- electronic health records (Al Shifa-3+) ble to all concerned in real time thus ful- maintained by MoH that would tap big surveillance data for further analytics. filling the important criteria of an ideal database.” surveillance system. Smartphone applications and web based reporting by different stakeholders that Challenges would enrich the surveillance database and help in more meaningful analysis The following issues remain critical and also and predictions. pose challenges in the evolution of this initi- ative: 1. Change management 2. Designing surveillance, data collection, data management, analysis, interpreta- tion, dissemination. 3. High volume heterogeneous information that is distributed widely. 4. Data quality and changing systems 5. Data sharing and privacy issues
Benefits of the System 1. Simplifies routine public health surveil- lance processes and add additional func- tionality that is not provided by the cur- rent systems. 2. Streamlines disease data collection, anal- Public Health Bulleti n
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Hand Hygiene Project: Celebration of HH Day (Part-1)
and hygiene is the act of cleaning Safer Care’ launched in 2005. The aim of H hands with the use of soap and wa- the campaign was to advance the goal of ter or with the use of alcohol-based hand maintaining a high global profile on the rub in order to remove soil, dirt and espe- importance of hand hygiene in health care. cially the microorganisms. Hand hygiene Thus globally to 'bring people together' in can prevent or minimize the spread of in- support of the hand hygiene improvement. fections. According to WHO every year Global hand hygiene day 2017 hundreds of millions of patients around the world are affected by the healthcare asso- This year the WHO theme for the hand ciated infections. The latest statistics indi- hygiene day was “Fight Antibiotic Re- cates that more than 3.5 million children all sistance – it’s in your hands”. This theme is over the world die due in harmony with the Booklet published on HH day 2017 national theme of “Role to transmission of “Every year on 5th of diseases like diar- model in hand hy- giene”. It focuses on May the World Health rhoea, acute respira- tory infection and the importance of the Organization (WHO) more than 40% of best practices of hand encourages member these diseases can be hygiene to prevent the controlled by proper spread of antimicrobial states to celebrate hand hygiene either resistance (AMR). Thus ‘Hand Hygiene Day’ to using soap and water draws attention of the higher authorities, poli- empathize and or using alcohol. cymakers, hospital advocate the essential These infections could managers, administra- be prevented by care- benefits of hand tors, infection preven- givers properly clean- tion and control lead- hygiene .” ing their hands at the ers and the healthcare key moments in pa- workers to the link be- tient care. Moreover tween AMR and the the practice of ‘Hand practice of hand hy- hygiene’ is the first giene. important step for reducing the inci- National celebration dence of health care- of hand hygiene day associated infection 2017 and thus promote pa- The World Hand Hy- tient safety. giene Day was celebrated on 4th May 2017 by the Ministry of Health represented by Every year on 5th of May the World Health the Central Department of Infection Pre- Organization (WHO) encourages member vention and Control (CDIPC) under the Di- states to celebrate ‘Hand Hygiene Day’ to rectorate General of Diseases Surveillance empathize and advocate the essential ben- and Control (DGDSC). Around 200 efits of hand hygiene as well as to demon- healthcare workers from different hospitals strate the world's commitment to this pri- and other government health sectors in the ority area of health care. Sultanate took part in this event. In 2009, the annual global campaign of The national theme of this year for hand ‘SAVE LIVES: Clean Your Hands’ was hygiene day was “Role model in hand hy- launched. It was a natural extension of the giene”. In the event the main topic of dis- WHO’s global priority action theme of (Continued on page 6) ‘Patient Safety Challenge: Clean Care is Volume 1, Issue 2
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The Project Plan
‘Role Model ... in Hand Hygiene’
Objectives To encourage leaders to be hand hygiene role model To emphasizes role of leaders to enhance hand hygiene performance among healthcare workers Improve compliance in hand hygiene practice among healthcare workers Preparatory-phase Planning the process of the project Selected four hospitals for hand hygiene pro- ject “The national Selected focal point for each hospital Selected four wards/units in each hospital theme of this year Involve leaders to be hand hygiene role model for hand hygiene Arranged posters to hand hygiene role model Selected external auditors day was “Role Training of focal points and external auditors model in hand Adopted WHO hand hygiene checklist for assessment hygiene” and the Provided hand hygiene education materials main topic of the for each hospital event was First-phase (pre-assessment) Pre-assessment of selected wards/units by external auditors in each hospital discussion on the Data collection pre-assessment project.” Second phase (intervention) Role of focal person Monthly rounds with hospital DG to enhance hand hygiene performance Encourage Leaders to motivate HCWs to improve hand hygiene practice Involve leaders to be role model Display posters of leaders performing hand hygiene Provided hand hygiene education and training in selected wards/units Role of wards/units Nominate weekly hand hygiene role model Nominated hand hygiene role model involve in education of other HCWs Provided hand hygiene badge for each role model Role of hand hygiene role model Motivate other HCWs to conduct hand hygiene activities Enhance hand hygiene practice among other healthcare workers Third-phase (post-assessment) Post-assessment of selected wards/units by external auditors in each hospital Data collection and analyze of pre and post hand hygiene audit Evaluate the outcome of results based on interventions Dissemination of the results to be utilized for future planning Public Health Bulleti n
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cussion was the project on role model of display the posters of as reminders to per- hand hygiene. The focus of the project form hand hygiene. Every week the leaders was on the leaders as role models within select and nominate a staff as role model in the health institutions in promoting hand hygiene. The third phase was the post healthcare workers' compliance with the -assessment after these interventions. hand hygiene practices. Conclusion The project of ‘Role model in hand hy- This project demonstrated that the pres- giene’ was conducted in four tertiary ence of role model in hand hygiene and healthcare hospitals in the Muscat gover- their advocacy and education awareness norate. Its main objective was to assess drive has a positive impact on the hand hy- impact of role model on the compliance giene compliance of staff. to hand hygiene among healthcare work- ers. The project was implemented In summary hand hygiene is an essential practice not only for the health care work- through three phase which was pre- “Hand hygiene is an assessment, intervention and post- ers in the medical field but also an im- assessment. portant preventive exercise for the general essential practice public. People can become frequently in- The first phase focused on pre- not only for the fected if they do not follow this simple yet a assessment of selected four wards/units major infection prevention and control pro- health care by external auditors in each hospital. The cedure. second phase was implementation of the Everyone therefore shares the responsibil- workers in the interventions which mainly delegated to ity equally to increase the awareness and the leaders in order to motivate HCWs medical field but practice of hand hygiene. hand hygiene compliance. The interven- also an important tions included several activities such as (Results of the Hand Hygiene Project will be pub- selecting key staff leaders as role models. lished as Part-2 in the next issue of the Public preventive exercise They were required to motivate and en- Health Bulletin) for the general courage other health care workers by providing education and awareness public.” about the essentials of hand hygiene,
The CDIPC staff at the celebration function on Hand Hygiene Day 2017 Volume 1, Issue 2
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World Day for Safety and Health at Work
he International Labour Organisation World Day for Safety and Health at Work T (ILO) celebrates the World Day for Safety and Health at Work annually on the 28 April to promote the prevention of oc- cupational accidents and diseases globally. This campaign aims to increase awareness on emerging trends in the field of occupa- tional safety and health and on the magni- tude of work-related injuries, diseases and fatalities worldwide. The ILO’s campaign for the year 2017 focuses on the critical need for countries to improve their capaci- ty to collect and utilize reliable occupation- al safety and health (OSH) data.
The Department of Environmental and “The exhibition in Occupational Health participated in the Occupational Safety and Health exhibition general did spread from 27-30 April 2017 at Muscat Grand Mall messages on which was organized by Ministry of Man- tervention of occupational injuries? power, represented by the General Direc- awareness of torate of Labour Welfare and was under 4. Do you know your legal rights towards occupational safety the patronage of His Excellency Salim Bin injuries at work? Nasser Al Awfi, Undersecretary of the Min- 5. Do you believe that you need to report to all segments of istry of Oil and Gas. injuries at work? society.” The exhibition in general did spread mes- 6. Do you think you need to report simple sages on awareness of occupational safety injuries which only need first aid treat- to all segments of society. Furthermore, ment? we had the opportunity to convey the mes- 7. Have you ever reported a near miss sage of importance of notification of occu- injury at your work? pational injury and death by employee and 8. Is there a system of reporting occupa- employers, as a starting point to reduce the tional injuries in your workplace? burden of it in the future and strengthening the capacity to collect and utilizes the data 9. Have you ever had an injury at work and by the country. have not reported it? The Department of Environmental and Total 741 participants participated in the Occupational Health planned three themes survey during the 4 days exhibition. for the exhibition. The first one was 35% of them did have occupational injury through conducting a web survey to the but majority (59%) of participants didn’t exhibition visitors which viewed the know their post injury legal rights. Report- general public awareness on the work re- ing all types of injury is important, even lated injuries. We obtain the public aware- simple injuries that only need first aid ness by asking the following nine ques- treatment. Unfortunately in our survey tions: 62% of responders thought there was no 1. Have you ever tripped/fallen at your need to report. 37% of the workers didn’t work? have a reporting system of occupational injury at their workplace and 22% who had 2. Do you think sitting on your chair at injury at work didn’t report it to the admin- work can cause injury? istration. 3. Is road traffic accident while going or (Continued on page 8) returning from work are within the in- Public Health Bulleti n
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Poster to promote health at the place of work
“Primary prevention through reporting near miss and hazard at work place and secondary prevention, by reporting an occupational injury to prevent future accidents through risk assessment and management.”
The majority (94%) of the participants be- hazard at work place and secondary pre- lieved it is important to report work injury, vention, by reporting an occupational inju- 69% of responders felt sitting long hours ry to prevent future accidents through risk on the chair can cause injury while 65% assessment and management. Finally, the considered road traffic accident while go- third theme was through distributing ing to or returning from work was an occu- health education material on stretching pational injury. exercise for sedentary type of work. The The second theme was through designing exercise only take 2-3 minutes and it is rec- a poster for promoting workers health ommend to repeat it every hour while sit- through early occupational injury notifica- ting at work to prevent work related mus- tion. The poster demonstrates two types of culoskeletal disease. prevention in public health. Primary pre- vention through reporting near miss and Volume 1, Issue 2
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MoH proposal to introduce maternal Tdap vaccination
he Ministry of Health is contemplat- pertussis. The cocooning programs have T ing introduction of Tdap vaccine dur- achieved moderate postpartum coverage ing pregnancy to prevent pertussis infec- among mothers. However had limited suc- tion in the new born. Especially life threat- cess in vaccinating other family members ening during the first two months of life. impeding program expansion and sustaina- The National Immunization Technical Advi- bility. Moreover the delay in immune re- sory Group (NITAG) in the Ministry of sponse in vaccinated with Tdap after an Health has made strong recommendations infant's birth may offer insufficient protec- to that effect. tion to infants during the first weeks of life. The Tdap, then will be the second vaccine Thus it was concluded that cocooning administered to mother during pregnancy alone is an insufficient strategy to prevent to prevent a serious infectious disease in pertussis morbidity and mortality in new- the newborn. In the past the strategy of born infants. maternal tetanus toxoid (TT5) was success- The blunting effect fully implemented leading to the elimina- “Cord blood from tion of neonatal tetanus in Oman. The last Concerns were case was reported from Mussana in South raised about the newborn infants Batinah governorate in the year 1995. possible blunting effect. Blunting whose mothers
Strategy for prevention of pertussis refers to the inter- received Tdap ference of mater- in early infancy during pregnancy nal antibodies (in Transplacental maternal antibodies response to vac- or before had cination of Tdap The transplacentally transferred maternal higher antibodies provide protection against per- during pregnancy) with the infant tussis in early life and before starting the concentrations of immune response primary series of pertussis vaccination. pertussis Several studies provide evidence support- to primary vac- cination at 2, 4 ing the existence of efficient transplacental antibodies.” and 6 months. As a result the infant may transfer of pertussis antibodies. The half- life of transferred maternal pertussis anti- carry a higher risk of acquiring pertussis later in infancy. bodies is approximately 6 weeks. However the clinical evidence of blunting After receipt of Tdap, boosted pertussis- specific antibody levels peak after several of an infant's immune response is unclear suggesting such effect if at all would be weeks, followed by a decline over several short-lived due to rapidly declining mater- months. To optimize the concentration of maternal antibodies transferred to the foe- nal antibodies. The published literature suggests a short duration of blunting of the tus, ACIP concluded that unvaccinated infant response and that the potential ben- pregnant women should receive Tdap, preferably in the third or late second tri- efit of protection from maternal antibodies in newborn infants far outweighs the po- mester (after 20 weeks gestation). tential risk for shifting disease burden to
Cocooning later period in infancy.
Cocooning practice was recommended by Policy on Tdap ACIP since 2005. It is defined as the strate- Global evidence indicates that the infants gy of vaccinating pregnant women imme- of women who received the Tdap pertussis diately during postpartum and to vaccinate booster vaccine during pregnancy, the risk all other close contacts of infants with Tdap to reduce the risk for transmission of (Continued on page 16) Public Health Bulleti n
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Measles and Rubella Surveillance: Jan-Mar 2017
man is in the phase of measles and rubella elimination since late nineties. The cas- O es reported in the country are either imported or importation related. In the first quarter of 2017 total 56 IgM positive and one clinical case of measles was reported. While 8 vaccine associated measles and rubella cases were discarded based on the WHO crite- ria. 'zero’ rubella cases were reported. The chain of transmission in Dhofar is ongoing since week #36 (Sep) of 2016. To maintain the status of elimination of measles in Oman the chain should be interrupted within 12 months. A mass vaccination campaign with MMR is being planned. Following tables summarises measles data and final classification of cases in Q1:
Measles case categories: Week #1 to 13, 2017 (n=57)
Measles case categories # cases “In Oman in the Measles cases due to local endemic genotype 0 first quarter of Laboratory confirmed measles cases, unknown source (% positivity) 56 (8.9%) Clinically compatible measles case 1 2017 total 56 lab- Discarded: Vaccine related (based on WHO criteria) 8 confirmed and 1 Discarded: All laboratory tests negative 563 Total reported cases of Fever and Rash syndrome in Q1 628 clinical case of measles was Measles genotypes in Dhofar and other Governorates: Week #1 to 13, 2017 (n=57) reported while Classification Cases Genotype Wilayat Case classification Genotype Dhofar cluster Barka Isolated case, unknown source - 34 B3 rubella cases were #3 Rustaq Isolated case, unknown source D8 Dima Tayin Isolated case, unknown source - 'zero’ . Eight Dhofar cluster 5 B3* Ibra Isolated case, unknown source D8 Imported vaccine associated 2 B3* Saham Isolated case, unknown source (Yemen) Liwa Imported case D4 measles cases were Imported 1 B3* Buraimi Imported case B3 (Pakistan) Buraimi Importation related B3 discarded.” Total 42 Seeb Isolated case, unknown source - Mutrah Isolated case, unknown source - *Note: Two phylogenetically different Bawsher ?Link to Dhofar-3 cluster B3 variants of genotype B3 and D8 were BB Ali Isolated case, unknown source - reported in Oman during 1st quarter Izki Family cluster - 3 cases -
Final classification of confirmed measles cases: Week #1 to 13, 2017 (n=57)
Final classification of confirmed measles cases Cases Genotype Measles cases due to local endemic genotype 0 No endemic genotype Isolated, source unknown, no epi-link, no secondary cases 8 D8*, B3 Isolated, source unknown, clinically compatible case 1 - Imported, Pakistan (2), Yemen (2), travel related (1) 5 B3*, D4 Importation related, epi-linked to imported case 1 B3* Dhofar measles cluster #3 39 B3, B3* Izki family cluster 3 - Total confirmed measles cases 57 Volume 1, Issue 2
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National ARI Surveillance: Jan-Mar 2017
National Acute Respiratory Infections (ARI) Rate (Week 27, 2016 to Week 13, 2017)
Note: ARI rate is calculated as a ratio of admissions due to severe acute respiratory illness over total admissions at the sentinel site hospitals in Oman
Influenza viruses by subtypes: Week #1 to week #13, 2016 and 2017 Public Health Bulleti n
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Communicable Disease Surveillance Data: By Governorates FIRST QUARTER Data: January—March 2017
North South Communicable Diseases and North South Mu- Al Muscat Dhofar Dakhliyah Sharqi- Sharqi- Dhahira Buraimi Total Batinah Batinah sandam Wustah Syndromes yah yah Group A Diseases Cholera 0 Yellow fever Never reported Plague Never reported Novel Influenza A virus Infection 0 Crimean-Congo Haemorrhagic Fever 9 1 1 2 1 3 1 Dengue fever 2 1 1 Pneumococcal invasive disease 0 Haemophilus influenzae type B 0 Meningococcal infection 5 2 1 1 1 Tuberculosis, pulmonary 43 15 5 4 6 4 2 2 3 1 1 Tuberculosis, extra pulmonary 34 7 11 4 6 2 1 3 Malaria 125 28 13 18 15 5 9 8 13 13 2 1 Rabies 0 Group A Syndromes Acute Flaccid Paralysis surveillance 7 1 3 1 1 1 Fever & Rash-Illness surveillance 628 39 99 154 126 54 41 39 41 34 1
Measles (IgM positive) + Clinical 56 + 1 3 42 2 2 3 2 1 (Clin.) 2 Rubella (IgM positive) 0 Congenital Rubella Syndrome (CRS) 0 Acute Haemorrhagic Fever Syndrome 2 1 1 Coronavirus Respiratory Syndromes 0 Food Poisoning (Infectious origin) 119 1 40 14 5 12 21 6 2 18 Group B Diseases and Syndrome Acute Viral Hepatitis (Total) 604 23 54 22 8 4 60 413 2 6 12 Acute Viral Hepatitis A 457 14 7 16 4 37 362 6 11 Acute Viral Hepatitis B 7 1 1 1 2 1 1 Acute Viral Hepatitis C 2 1 1 Acute Viral Hepatitis D (in B pos) 0 Acute Viral Hepatitis E 0 Acute Viral Hepatitis unspecified 138 8 46 5 4 1 23 51 Typhoid fever 4 1 2 1 Pertussis 168 6 55 27 24 25 23 8 Brucellosis 123 3 110 4 1 4 1 Leishmaniasis 0 Schistosomiasis, intestinal 0 HIV/AIDS 25 10 1 7 2 2 3 Mumps 220 3 4 97 60 4 12 16 22 2 Varicella 5,824 585 169 991 926 1369 490 715 316 117 41 105 Acute Encephalitis Syndrome 0 Other Meningitis Syndrome 11 1 8 1 1 Common note for all data tables: The category of ‘Tuberculosis, pulmonary’ includes sputum positive and negative forms HIV [AIDS] data are for nationals only Volume 1, Issue 2
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Communicable Disease Surveillance Data: By Weeks (1 to 13) FIRST QUARTER Data: January—March 2017
Priority Communicable Diseases Wk Wk Wk Wk Wk Wk Wk Wk Wk Wk Wk Wk Wk Total and Syndromes 01 02 03 04 05 06 07 08 09 10 11 12 13 Group A Diseases Cholera 0 Yellow fever Never reported Plague Never reported Novel Influenza A virus Infection 0 Crimean-Congo Haemorrhagic Fever 9 2 1 2 4 Dengue fever 2 1 1 Pneumococcal invasive disease 0 Haemophilus influenzae type B 0 Meningococcal infection 5 1 1 1 2 Tuberculosis, pulmonary 43 2 3 5 4 2 5 3 3 4 3 2 2 5 Tuberculosis, extra pulmonary 34 2 4 3 1 2 2 2 2 4 3 4 5 Malaria 125 12 10 15 12 10 8 13 4 11 5 4 8 13 Rabies 0 Group A Syndromes Acute Flaccid Paralysis surveillance 7 2 1 1 1 2 Fever & Rash-Illness surveillance 628 64 47 51 37 36 38 44 40 53 56 59 54 49 Measles (IgM positive)+ Clinical 56 + 1 6 4 11 5 6+1 1 1 3 2 8 3 6 Rubella (IgM positive) 0 Congenital Rubella Syndrome (CRS) 0 Acute Haemorrhagic Fever Syndrome 2 1 1 Coronavirus Respiratory Syndromes 0 Food Poisoning (Infectious origin) 119 16 17 3 4 8 4 5 5 8 43 1 5
Group B Diseases and Syndromes Acute Viral Hepatitis (Total) 604 40 34 31 23 30 56 44 34 61 80 59 51 61 Acute Viral Hepatitis A 457 30 25 22 19 21 41 29 26 45 62 48 38 51 Acute Viral Hepatitis B 7 1 2 2 1 1 Acute Viral Hepatitis C 2 1 1 Acute Viral Hepatitis D (in B pos) 0 Acute Viral Hepatitis E 0 Acute Viral Hepatitis unspecified 138 9 9 9 4 9 15 13 6 15 16 10 13 10 Typhoid fever 4 1 2 1 Pertussis 168 10 9 8 13 14 14 20 17 10 19 16 12 6 Brucellosis 123 20 6 7 7 5 6 6 11 14 11 11 11 8 Leishmaniasis 0 Schistosomiasis, intestinal 0 HIV/AIDS 25 1 3 3 5 2 1 3 2 2 3 Mumps 220 21 16 20 15 12 21 20 13 13 17 15 18 19 Varicella 5,824 331 391 401 347 385 393 498 476 485 462 526 507 622 Acute Encephalitis Syndrome 0 Other Meningitis Syndrome 11 2 1 2 1 1 3 1 Public Health Bulleti n
Page 14 Communicable Disease Surveillance Data: Wilayat Distribution FIRST QUARTER Data: January—March 2017 Measles Rubella Menin. Pertus- HIV TB Pulm Brucel- Governorate Wilayat AFP IgM+ IgM+ infection HepA HepB Malaria sis [AIDS] Total TB losis CCHF Muscat 2 1 1 1 Muscat Mutrah 1 1 1 9 4 3 3 Bawsher 4 10 1 1 3 2 Seeb 7 7 10 7 Al Amerat 2 1 1 2 1 4 2 Qurayat 3 1 1 1 Salalah 1 33+1* 1 6 1 12 45 1 13+2* 3+1* 47 1 Dhofar Taqah 1 28 Mirbat 1 1 1 1 14 Thumrait 4 10 Sadha 3 2 3 Rakhyut 2 5 Dhalkut 2 Shaleem Muqshan Mazyoona 5 1 1 Sohar 1 4 6 5 3 2 1 4 North Suwaiq 7 1 4 5 3 1 Batinah Saham 1 1 4 2 4 1 1 Shinas 1 2 9 1 1 Liwa 1 4 5 1 3 1 Khaburah 1 1 Rustaq 1 2 5 16 4 2 South Batinah Barka 1 1 5 4 5 2 Musanah 1 3 2 2 2 1 Nakhl Wadi Maawil 1 2 1 1 Al Awabi 1 Nizwa 1 2 2 1 1 1 1 Dakhliyah Samail 1 15 2 2 Bahla 1 1 1 2 1 1 1 1 Izki 3 1 3 Adam Al Hamra 1 Manah Bidbid 1 1 Ibra 2 North Mudaibi 2 5 18 Sharqiyah Bidiyah 1 15 1 2 1 1 Al Qabil 1 2 1 Dima Wa Al Tayeen 1 5 1 1 Wadi Bani Khalid 19 Sur 1 8 8 South Jalan Bani Bu Ali 186 3 2 1 Sharqiyah Jalan Bani Bu Hassan 98 2 1 Al Kamil Wa Al Wafi 70 1 Masirah 1 Ibri 1 11 8 2 2 4 3 Dhahira Yankul 1 1 1 Dhank 1 Buraimi 1 2 1 6 13 2 1 1 Buraimi Mahda Sunaina Khasab 1 3 Musandam Daba Al Baya Bukha 1 1 1 Madha Haima 1 Al Wustah Duqum 4 Mahoot 7 1 Al Jazer 1 TOTAL 7 56+1 0 5 455 7 125 168 25 77 43 123 9 Volume 1, Issue 2
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Communicable Disease Surveillance Data: Age Distribution FIRST QUARTER Data: January—March 2017
Communicable Diseases and Total <1 y 1-4 y 5-9 y 10-14 y 15-19 y 20-24 y 25-34 y 35-44 y ≥ 45 y Syndromes Group A Diseases Cholera 0 Yellow fever Never reported Plague Never reported Novel Influenza A virus Infection 0 Crimean-Congo Haemorrhagic Fever 9 1 1 3 4 Dengue fever 2 1 1 Pneumococcal invasive disease 0 Haemophilus influenzae type B 1 Meningococcal infection 5 1 2 1 1 Tuberculosis, pulmonary 43 1 3 13 7 19 Tuberculosis, extra pulmonary 34 1 1 6 8 18 Malaria 125 1 1 4 32 60 16 11 Rabies 0 Group A Syndromes Acute Flaccid Paralysis surveillance 7 2 4 1 Fever & Rash-Illness surveillance 628 172 321 78 7 3 7 28 7 5 Measles (IgM positive) + Clinical 56 + 1 29+1 13 1 1 1 2 5 3 1 Rubella (IgM positive) 0 Congenital Rubella Syndrome (CRS) 0 Acute Haemorrhagic Fever Syndrome 2 1 1 Coronavirus Respiratory Syndromes 0 Food Poisoning (Infectious origin) 112 9 12 13 9 21 31 13 4
Group B Diseases and Syndromes Acute Viral Hepatitis (Total) 604 3 176 298 73 16 9 12 8 9 Acute Viral Hepatitis A 457 2 149 228 51 13 6 5 1 2 Acute Viral Hepatitis B 7 1 3 2 1 Acute Viral Hepatitis C 2 1 1 Acute Viral Hepatitis D (in B pos) 0 Acute Viral Hepatitis E 0 Acute Viral Hepatitis unspecified 138 1 27 70 22 3 2 3 5 5 Typhoid fever 4 1 1 1 1 Pertussis 168 125 28 4 5 1 2 2 1 Brucellosis 123 1 8 8 6 14 11 43 18 14 Leishmaniasis 0 Schistosomiasis, intestinal 0 HIV/AIDS 25 5 13 4 3 Mumps 220 8 101 39 18 7 18 20 5 4 Varicella 5,824 347 755 1829 1050 523 518 585 170 47 Acute Encephalitis Syndrome 0 Other Meningitis Syndrome 11 2 4 1 1 3
Note Note: Leprosy and Dracunculiasis have been eliminated as a public health problem in Oman. Category of Tuberculosis, pulmonary includes While 'Zero' cases of following diseases formerly under surveillance were reported in the first sputum positive and negative forms HIV [AIDS] data are for nationals only quarter of 2017 viz. Anthrax, Diphtheria, Acute Poliomyelitis, Louse borne Typhus, Neonatal Tetanus and Lymphatic Filariasis. “The wisest mind has something yet to learn.”
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The statements of facts and opinions expressed of contracting pertussis was reduced by an estimated 91% during the in the articles of this newsletter are solely those of the respective authors and or contributors. first two months of life. This period is considered critical because the infants are yet to receive their first childhood pertussis vaccination. In February 2013, the CDC and ACIP recommended Tdap vaccination during pregnancy, preferably between 27 and 36 weeks gestation to maximize the antibody transfer to the newborn.
In summary Postpartum Tdap administration is NOT optimal Cocooning alone may NOT be effective and is difficult to imple- ment The short duration of blunting of the immune response of the in- fant is NOT significant Tdap in pregnancy is safe and has NO associated serious adverse events and risk to the foetus
Thus maternal Tdap vaccination during pregnancy benefits the moth- er and infant by providing earlier protection to the mother, thereby protecting the infant at birth; and vaccination during late pregnancy maximizes transfer of maternal antibodies to the infant, likely provid- ing direct protection to the infant for a period after birth. This quarterly news bulletin is published by the Directorate General for Disease Surveillance Source: The Advisory Committee on Immunization Practices (ACIP) and Control, Ministry of Health, Oman recommendations https://www.cdc.gov/pertussis/pregnant/hcp/ pregnant-patients.html ©Ministry of Health, Oman