Weekly Epidemiological Bulletin Electronic Disease Early Warning and Response System

Volume 02, Issue 5, Epi week 5, 27 Jan. - 2 Feb. 2014

H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 5, 2014

100% Consultations Reporting Rate 75,000 ● During week no 5, 2014; 96% (236/247) health facilities from 10 governorates 96% 90% 96% 96% 95% 96% 70,000 65,000 provided valid surveillance data. 80% 60,000 70% 55,000 50,000 ● The total number of consultations reported during the week in 10 60% 45,000 50% 40,000 governorates was 71794 compared to 70778 the previous reporting week. 35,000

40% 30,000 P e r c e n t a g e g at nc e r e P

Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected 30% 25,000 s n i oat l t u os n C 20,000

malaria (S.Mal) were the leading cause of morbidity this week. 20% 15,000

10% 10,000

1 2 3 4 5

Wk Wk Wk Wk Wk ● A total of 111 alerts were generated by eDEWS system in week 5, 2014; Of Wk these, 83 alerts were verified as true for further investigations with appropriate response. Distribution of Reporting Rates by Governorates (Epi-week 5, 2014) ● Altogether 41 alerts Measles, 14 Petrussis, 9 C.Leishmaniasis, 6 AVH, 3 each

100%

for Acute Flaccid Paralysis, NNT and Meningitis, 2 Dengue fever, 1 each for

% %

80% %

% % Bloody Diarrhea and OAD were received and responded. 100

60% 100

100

100 92 40% 84 20% ● Online disease surveillance and response system was launched in 4

N o H F R e p o r t s o t r p R eF H o N 0% governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has started in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb, Al- Mukalla and Sa'da) in November 2013. Ongoing on site trainings to improve Reporting Rate weekly reporting and immediate notification are underway in all governorates. Target

Leading Priority Diseases - 10 Governorates (Epi-week 5, 2014) 124 districts from 10 Governorates reported to eDEWS in week 5, 2014 ● URTI (13.5%), suspected malaria (2.6%), OAD (7%) and Pneumonia (4.1%) remain the leading causes of morbidity representing a total of 27.2%.

● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.4% of this morbidity.

● All diarrheal disease comprised 7.5% and Pneumonia 4.1% of total morbidity in All Governorates this week. ● All diarrheal disease comprised 4.3% and Pneumonia 2.3% of total morbidity in the <5 years age group.

Trends for Leading Priority Diseases in 10 Governorates - Epiweeks 1 to 5, 2014 Proportional Morbidity for Leading Priority Diseases - Epiweek 5, 2014

18.0% Pneu, 4.1% DD URTI S.MAL Pneumonia 16.0% OAD, 7.0%

14.0% BD, 0.4% URTI, 13.5% 12.0% Sch, 0.1% 10.0%

8.0% S.Mal, 2.6%

6.0% Others, 71.6% Rb, 0.2% 4.0% AVH, 0.1% 2.0%

0.0% Wk1 Wk2 Wk3 Wk4 Wk5

*Acute Diarrhea=OAD; Bloody Diarrhea=BD; S.Malaria=Mal; Acute Respiratory Infections=ARI Cases (n=71,794)

URTI=Upper respiratory infections; Pneu=Pneumonia; OAD=Other acute diarrhea; BD=Bloody diarrhea; AWD=Acute Watery Diarrhea; Sch=Schistosomiasis; Mal=Malaria; Rb=Rabies; AVH=Acute viral hepatitis; Meng=Meningitis; DF=Dengue fever; VHF=Viral hemorrhagic fever; Meas=Measles; CL=Cutaneous Leishmaniasis; Pert=Pertussis; Diph=Diphtheria; NNT=Neonatal Tetanus

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 715 695 482; WHO/EHA Office; Email: [email protected] 1

Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodaidah Hajjah Amana Sa'da Total URTI 567 1881 999 833 615 763 571 403 1328 1711 9671 Pneumonia 115 157 305 204 53 733 611 308 318 117 2921 OAD 234 687 166 318 153 739 506 389 917 939 5048 BD 3 8 2 13 1 162 108 2 4 10 313 AWD 0 0 0 0 0 0 0 0 0 0 0 Schistosomiasis 1 0 1 5 1 5 0 7 28 9 57 Malaria 5 56 29 43 4 92 825 693 12 136 1895 Meningitis 0 4 0 43 0 1 4 2 3 1 58 Dengue Fever 0 2 0 1 0 0 19 0 0 0 22 Viral Hemorrhagic Fever 0 0 0 0 0 0 0 0 0 0 0 Rabies 2 0 1 28 0 2 3 2 71 0 109 Measles 11 12 0 6 10 7 11 0 17 24 98 Acute Viral Hepatitis (A & E) 4 14 1 29 2 14 6 0 16 1 87 Neonatal Tetanus 1 0 0 2 0 0 2 0 0 0 5 Acute Flaccid Paralysis 1 0 0 1 0 0 1 2 1 0 6 Cutaneous Leishmaniasis 1 0 0 1 0 0 1 5 29 12 49 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 Pertussis 3 1 0 0 4 7 2 0 2 6 25 OtherUn 2 8 1 2 0 0 25 0 13 0 51 Other Consultations 2299 4319 2584 5915 2361 6099 9285 1469 13248 3800 51379 Total Consultations 3249 7149 4089 7444 3204 8624 11980 3282 16007 6766 71794

2013 - 2014 Current week 5, 2014 System Gen. Alerts ( week 5) Diseases Alerts Outbreaks Alerts Outbreaks TRUE FALSE AWD 0 0 0 0 0 0 Pertussis 337 7 14 0 14 2 Measles 817 0 41 0 41 4 AFP 90 0 3 0 3 3 Schistosomiasis 28 0 0 0 0 1 Bloody Diarrhie 29 0 1 0 1 14 AVH 190 2 6 0 6 1 Denque fever 125 0 2 0 2 0 Meningitis 97 0 3 0 3 0 CL 138 1 9 0 9 3 NNT 36 0 3 0 3 0 OAD 15 0 1 0 1 0 VHF 4 0 0 0 0 0 Pneumonia 27 0 0 0 0 0 Total 1933 10 83 0 83 28

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease eDEWS team contact focal point, surveillance coordinator was informed, cases were diagnosed Pertussis Lahj Labaos Labaos Hospital clinically using case definition by doctor in clinic, cases were treated as per standard protocol for 3 0 Pertussis. The case was reported by eDEWS focal point in Laboose Hospital, the case admitted to hospital on 27/2/2014 were it was diagnosed by a pediatric specialist as NNT. The case died on the second day. NNT Lahj Labaos Labaos Hospital 1 1 The director of reproductive health program was informed where she contact the DG of the district. A full report with further investigation will be conducted. Saber,alhwatah,Alana Tuban, Alhwatah, .eDEWS team contact focal point, information shared; the case was diagnosed clinically using case Measles Lahj d,alarah,alsharif,al- 12 0 alarah,Al - had definition, blood samples were collected from just 8 cases. hadHFS eDEWS team contact focal point, cases were diagnosed clinically using case definition, after further AVH Lahj Radfan Radfan Hospital 3 0 investigation, there was no cluster of cases. All patients were treated adequately.

Al Meidan,Ash Shaab Craiter,Al Muala,At Charitable,Al By cotact with eDEWS focal point we were informed that 3 cases were detected by duty doctor, Measles Aden Tawahi,Ash Shaikh Muala,At Tawah,Kod investigation forms were filled and blood sample was collected from just 4 cases . Both investigation 9 0 Outhman, Al Othmani and Al forms and blood sample were sent to Sanaa at 04/02/2014 Wahdah HFS

By contact with eDEWS focal point we were informed that 2 cases were reported by duty doctor and Al Bureiqa and Ash Ash Shaab and Al Pertussis Aden one case by OPD , the cases were diagnosed by case definition. all cases were treated according to the 3 0 Shaikh Outhman Wahdah HFS. standard protocol of pertussis. Ash Shaikh By cotact with eDEWS focal point we were informed that the case was seen by duty doc.,investigation AVH Aden Al Wahdah Hosp. 4 0 Outhman form was filled and blood saple wasn't taken . The informations obtained from focal point indicate that 3 cases were admitted and underwent the Ash Shaikh Meningitis Aden Al Wahdah Hosp. measures of Meningitis surveillance programme in the hospital by filling investigation forms and LP 4 0 Outhman investigation, one case was seen in OPD. The cases come from two different governorates.

22 May Hospital,Al- At Taiziyah,Salh,Al Wehda,Al- Focal point contacted, information shared, sample was collected , and will be send to the centrla lab. Measles Taiz Misrakh and Al 6 0 Thawrah,Al Misrakh In Sanaa. Qahirah and Sweden HFS

HF was visited ,, information shared , samples were sent to the HF lab. With negative results (No Meningitis Taiz Al Qahirah Sweden Hospital 43 0 growth) ,, only 33 samples recorded at the HF lab. 3 samples test results were positive for Hepatitis A, patients are from different areas (No alert AVH Taiz Al Qahirah Sweden Hospital 16 0 threshold = collection of 3 cases from the same area) The suspected NNT death case aged 10 days male child from Demnat Khadier brought to hospital NNT Taiz Al Qahirah Sweden Hospital on: 1/02/2014 . C/O fever convulsion and inability to breast feed(sucking) , he was admitted into 0 1 hospital , anti-tetanus toxoid doses , antibiotic therapy and I.V fluids have been give , date of death: 4/02/2014. eDEWS team contact focal point, the cases were diagnosed clinically using case definition. blood Alridh Qosear and Alridh and alhamy Measles Hadramut samples were collected from 6 cases will be sent to surveillance central lab for confirmation . The 10 0 alshaher HFS surveillance coordinator was informed. addes alshargeh,Alridh addes,Gosear,Univers eDEWS team contact focal point, the cases were diagnosed clinically using case definition. Antibiotic Pertussis Hadramut 4 0 Qosear,MUKALLA ty and algarh HFS treatment was given to the patients. and gail bawaser Adhi harand AL thawrah,MCH and Focal point and coodinator were contacted, information shared, samples were collected , and will be Measles Ibb 6 0 Almashanah. Nase HFS. send to the central lab. In Sanaa. Focal point and doctor were contacted, investigation showed high WBC , the suspected Pertussis case Dr.waheeb ata and is 7 years old female child from small village named Alsanaa-Alqafr district , apprporiate treatment was Pertussis Ibb Yarim and Al qafr 7 0 Al rihab HFS given , the father told the doctor that his other 2 daughters and 2 children nex door have the same complian , we couldn't conduct a field visit due to security issues. appropriate treatment was given. AVH Ibb Al shaheed albadani Focal point was contacted.,No investigation done,.patients are from deferent areas. 3 0 Badan Focal point contacted , information shared , patients were diagnosed clincially only (Elisa test wasn’t AL Hawak and Al AlAksa and Al DF Hodaidah done) , four samples collected from pateints stay in hosp , referrance pateint to Hodaidah national 13 0 Qanawis. Qanawis HFS . lab for confirmation, patients from diferent area. eDEWS coordinator contacted focal point, cases were suspected AFP, sample was collected from AFP Hodaidah Alluheyah Alluheyah Hosp. 1 0 patient by district coordinator ,send to laboratory in Sanaa. Al Garrahi,At Al Garrahi,At Tuhayat,Hays,Az eDEWS coordinator contacted focal point, cases were suspected Measles , samples were collected Measles Hodaidah Tuhayat,Hays,Az 11 0 Zuhrah and Ad Dahi from just 3 cases ,clinicaly diagnosis only.. Zuhrah and Ad Dahi. HFS. eDEWS team contacted focal point. The cases confirmed to be NNT , and cases were death due to NNT Hodaidah AL Hawak Althawrah Hosp. 2 2 sever complicated. Al Qanawis and AL Al Qanawis and eDEWS coordinator contacted focal point. The cases confirmed to be Pret , and treated Pertussis Hodaidah 2 0 Hawak Althawrah HFS. appropriately.. eDEWS coordinator contacted meningitis focal point, cases diagnosed as meningitis and treated Meningitis Hodaidah AL Hawak AlAksa Hosp. 4 0 appropriately. eDEWS coordinator contacted focal point, the cases confirmed to be Acute diarrhea and treated OAD Hodaidah AL Hawak Althawrah Hosp. 44 1 appropriately, one cases death due to sever complicated . AVH Hodaidah Ad Dahi Ad Dahi Hosp. eDEWS coordinator contacted meningitis focal point, cases diagnosed as AVH and treated 3 0 kuhlan ash sharaf Kuhlan ash sharaf eDEWS was contacted focal point, and information shared.Case was diagnosed by the standard 2 0 AFP hajjah and hajjah city. and SAUDI HFS. definition samples were collected and sent to sanaa. AL-Thwra,Iraqi,Al- Assafia,Al-sabin,Old Sabin,Main,AL- city,AL- eDEWS team contact focal point, information shared blood samples were collected from case and Measles Amana Methak,Shuaub,Al- 13 0 Thawra,Shuaub,Azz sent for lab confirmation . razi ,Azzal,and AL- al,and AL-Wahda. Saheed HFS eDEWS team contact focal point,Tow month feamal from Amana dignosid clinically using case Pertussis Amana Old city AL-Zubairi HC 1 0 definition. Antibiotic treatment was given. eDEWS team contact focal point,most cases have been laboratory comfirmed ,Four cases from the AVH Amana Assafia Iraqi HC district ,the rest from different regions, apropraite treatment was given to the patients..parents of the 9 0 cases were educated about the importance of following the rules of genral hygiene.

Al-jumhory,At Talh, eDEWS team contact focal point, information shared; cases were diagnosed clinically using case Saada,Sehar, Measles Saada Qatabir,Majz Health definiton, blood samples were collected from the cases and will be sent to central lab in sanaa for 22 0 Qatabir and Majz. and Dahyan HFS confirmation.

Diarrheal Diseases URTI Sus.Malaria Pneumonia 10.0% 18.0% 3.5% 7.0%

9.0% 16.0% 3.0% 6.0% 8.0% 14.0% 7.0% 2.5% 5.0% 12.0% 6.0% 10.0% 2.0% 4.0% 5.0% 8.0% 4.0% 1.5% 3.0% 6.0% 3.0% 4.0% 1.0% 2.0% 2.0% 2.0% 1.0% 0.5% 1.0%

0.0%

1 2 3 4 5

0.0%

1 2 3 4 5

Wk Wk Wk Wk Wk

0.0% 0.0%

1 2 3 4 5

Wk Wk Wk Wk Wk

Cumulative number of major health events reported in Epi-weeks 10, 2013 to 5, 2014 (1st March Age and Sex distribution of total consultations of leading diseases (Epi week 5, 2014) 2013 to 2nd Feb. 2014) 18000 Diseases No of Cases Percentage

16000 Upper Respiratory Infections 219824 16.1% 14000 12000 Diarrheal Diseases 110157 8.1% 10000 Suspected Malaria 25553 1.9% 8000 6000 Pneumonia 57316 4.2% 4000 Others 952324 69.8% Number of Consultationsof Number 2000 0 Total (All consultations) 1365174 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Leading Diseases by Governorate, Epiweek 5 Male 4208 5835 6956 10444 5650 ● URTI was highest in Governorate Aden (26.3%) this week. Female 3805 5698 6637 15589 6961 ● Diarrheal Disease was highest in Governorate Saada (14%) this week. Distribution of consultations of leading diseases by Governorates, Epiweek 5 Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodaidah Hajjah Amana Sa'da Total URTI 567 1881 999 833 615 763 571 403 1328 1711 9671 Pneumonia 115 157 305 204 53 733 611 308 318 117 2921 OAD 234 687 166 318 153 739 506 389 917 939 5048 BD 3 8 2 13 1 162 108 2 4 10 313 AWD 0 0 0 0 0 0 0 0 0 0 0 Schistosomiasis 1 0 1 5 1 5 0 7 28 9 57 Malaria 5 56 29 43 4 92 825 693 12 136 1895 Meningitis 0 4 0 43 0 1 4 2 3 1 58 Dengue Fever 0 2 0 1 0 0 19 0 0 0 22 Viral Hemorrhagic Fever 0 0 0 0 0 0 0 0 0 0 0 Rabies 2 0 1 28 0 2 3 2 71 0 109 Measles 11 12 0 6 10 7 11 0 17 24 98 Acute Viral Hepatitis (A & E) 4 14 1 29 2 14 6 0 16 1 87 Neonatal Tetanus 1 0 0 2 0 0 2 0 0 0 5 Acute Flaccid Paralysis 1 0 0 1 0 0 1 2 1 0 6 Cutaneous Leishmaniasis 1 0 0 1 0 0 1 5 29 12 49 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 Pertussis 3 1 0 0 4 7 2 0 2 6 25 OtherUn 2 8 1 2 0 0 25 0 13 0 51 Other Consultations 2299 4319 2584 5915 2361 6099 9285 1469 13248 3800 51379 Total Consultations 3249 7149 4089 7444 3204 8624 11980 3282 16007 6766 71794 A Number of Alerts Received and Responded (Epiweeks 2 to 5, 2014) Number of alerts & outbreaks reported and investigated with appropriate response g 2013 - 2014 Current week 5, 2014 System Gen. Alerts ( week 5) e Diseases 50 Alerts Outbreaks Alerts Outbreaks TRUE FALSE 44 Wk2 Wk3 Wk4 Wk5

AWD 0 0 0 0 0 0 45 41

Pertussis 337 7 14 0 14 2 40 Measles 817 0 41 0 41 4 35 30 AFP 90 0 3 0 3 3 30 28 Schistosomiasis 28 0 0 0 0 1 25 Bloody Diarrhie 29 0 1 0 1 14 20 15 AVH 190 2 6 0 6 1 14 13 15 11 12 Denque fever 125 0 2 0 2 0 9 10 7 6 7 7 Meningitis 97 0 3 0 3 0 5 4 4 5 4 4 4 4 3 2 2 3 2 3 2 3 CL 138 1 9 0 9 3 5 0 1

NNT 36 0 3 0 3 0 0

Number of Number Reported Alerts

OAD 15 0 1 0 1 0 BD AFP VHF 4 0 0 0 0 0 AVH

Pneumonia 27 0 0 0 0 0 C.Leish

S.Dengue

S.Measles Meningitis Total 1933 10 83 0 83 28 S.Pertussis

eDEWS team contact focal point,surveillance coordinator was informed,cases were diagnosed cliniclly Al-jumhory and AL Pertussis Saada Saada and Sehar. using definiton by doctor in clinic.on job training of doctor about investigaton was 4 0 mahather HFS. conducted.Reported cases were treatad as per standard protocol for pertussis Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodaidah Hajjah Amana Sa'da Total URTI 567 1881 999 833 615 763 571 403 1328 1711 9671 Pneumonia 115 157 305 204 53 733 611 308 318 117 2921 OAD 234 687 166 318 153 739 506 389 917 939 5048 BD 3 8 2 13 1 162 108 2 4 10 313 AWD 0 0 0 0 0 0 0 0 0 0 0 Schistosomiasis 1 0 1 5 1 5 0 7 28 9 57 Malaria 5 56 29 43 4 92 825 693 12 136 1895 Meningitis 0 4 0 43 0 1 4 2 3 1 58 Dengue Fever 0 2 0 1 0 0 19 0 0 0 22 Viral Hemorrhagic Fever 0 0 0 0 0 0 0 0 0 0 0 Rabies 2 0 1 28 0 2 3 2 71 0 109 Measles 11 12 0 6 10 7 11 0 17 24 98 Acute Viral Hepatitis (A & E) 4 14 1 29 2 14 6 0 16 1 87 Neonatal Tetanus 1 0 0 2 0 0 2 0 0 0 5 Acute Flaccid Paralysis 1 0 0 1 0 0 1 2 1 0 6 Cutaneous Leishmaniasis 1 0 0 1 0 0 1 5 29 12 49 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 Pertussis 3 1 0 0 4 7 2 0 2 6 25 OtherUn 2 8 1 2 0 0 25 0 13 0 51 Other Consultations 2299 4319 2584 5915 2361 6099 9285 1469 13248 3800 51379 Total Consultations 3249 7149 4089 7444 3204 8624 11980 3282 16007 6766 71794

Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 5 (27 Jan. - 2 Feb. 2014)

Lahj Governorate

25 health facilities from 13 districts in Lahj governorate reported to eDEWS with a total of 3249 patients consultations in week 5, 2014. Total 10 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 6 Alerts Measles and 1 each for Pertussis, AVH, NNT and C. Leishmaniasis were reported and responded.

Aden Governorate

23 health facilities from 8 districts in Aden governorate reported to eDEWS with a total of 7149 patients consultations in week 5, 2014. Total 11 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 6 alerts Measles, 2 Pertussis, and 1 each for Meningitis, AVH and Bloody Diarrhea were reported and responded.

Abyan Governorate

22 health facilities from 4 districts in Abyan governorate reported to eDEWS with a total of 4089 patients consultations in week 5, 2014. No alert were reported and appropriate measures were taken in week 5, 2014.

Taiz Governorate

21 health facilities from 8 districts in Taiz governorate reported to eDEWS with a total of 7444 patients consultations in week 5, 2014. Total 8 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 5 alerts Measles, and 1 each for AVH, Meningitis and NNT were reported and responded.

Hadramout Governorate

25 health facilities from 7 districts in Hadramout governorate reported to eDEWS with a total of 3204 patients consultations in week 5, 2014. Total 6 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 4 alerts Pertussis and 2 Measles were reported and responded.

Ibb Governorate

24 health facilities from 15 districts in Ibb governorate reported to eDEWS with a total of 8624 patients consultations in week 5, 2014. Total 6 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 3 alerts Measles, 2 Pertussis, and 1 AVH were reported and responded.

Hodaidah Governorate

25 health facilities from 22 districts in Hodaidah governorate reported to eDEWS with a total of 11980 patients consultations in week 5, 2014. Total 15 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 5 alerts Measles, 2 each for Dengue Fever and Pertussis, and 1 each for AVH, C.Leishmaniasis, Acute Flaccid Paralysis, Meningitis, NNT and OAD were reported and responded.

Hajjah Governorate

24 health facilities from 23 districts in Hajjah governorate reported to eDEWS with a total of 3282 patients consultations in week 5, 2014. Total 4 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 2 alerts each for Acute Flaacid Paralysis and C. Leishmaniasis were reported and responded.

Amana Governorate

24 health facilities from 10 districts in Amana governorate reported to eDEWS with a total of 16007 patients consultations in week 5, 2014. Total 11 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 9 alerts Measles, and 1 each for Pertussis and AVH were reported and responded.

Sa'da Governorate

23 health facilities from 15 districts in Sa'da governorate reported to eDEWS with a total of 6766 patients consultations in week 5, 2014. Total 12 alerts were reported and appropriate measures were taken in week 5, 2014. Altogether 5 alerts each for C.Leishmaniasis and Measles, and 2 Pertussis were reported and responded.

Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 5 (27 Jan. - 2 Feb. 2014) Alerts / Outbreaks Investigated and Responded in Epi-week 5, 2014 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease eDEWS team contact focal point, surveillance coordinator was informed, cases were diagnosed Pertussis Lahj Labaos Labaos Hospital clinically using case definition by doctor in clinic, cases were treated as per standard protocol for 3 0 Pertussis. The case was reported by eDEWS focal point in Laboose Hospital, the case admitted to hospital on 27/2/2014 were it was diagnosed by a pediatric specialist as NNT. The case died on the second day. NNT Lahj Labaos Labaos Hospital 1 1 The director of reproductive health program was informed where she contact the DG of the district. A full report with further investigation will be conducted. Saber,alhwatah,Alana Tuban, Alhwatah, .eDEWS team contact focal point, information shared; the case was diagnosed clinically using case Measles Lahj d,alarah,alsharif,al- 12 0 alarah,Al - had definition, blood samples were collected from just 8 cases. hadHFS eDEWS team contact focal point, cases were diagnosed clinically using case definition, after further AVH Lahj Radfan Radfan Hospital 3 0 investigation, there was no cluster of cases. All patients were treated adequately.

The objective of this weekly epidemiological bulletin is to provide a snap shot on selected health events reported from the eDEWS surveillance system in All governorates (Aden, Abyan, Lahj, Taiz, Hadramout, Ibb, Hodaidah, Hajjah and Al-Amana) of Yemen. While every attempt is made to present the weekly trends of epidemic prone diseases, the information presented in the bulletin needs to be interpreted in the context that precise information on the reference populations is not always available. The bulletin also includes information collected by the eDEWS teams. The primary focus of DEWS is early detection of epidemic prone desease, to facilitate a rapid public health response.