Dr. NAVJOT KHOSA I.A.S District Collector & District Magistrate COLLECTORATE, CIVIL STATION KUDAPPANAKUNNU THIRUVANANTHAPURAM Phone : +91 471 2731177 Message I am happy to note that District Surveillance Unit of Trivandrum is publishing its Surveillance Report for the last 6 years. The present publication will act as a strong basis for many policy decisions. Arogya Jagratha, the strategy for control of Communicable diseases, declared by Government of Kerala for the coming years has its roots in the Surveillance data. In this Covid 19 pandemic situation the surveillance team of entire district has been doing commendable work by extensive compilation of data and field studies and activities. The analysis and data presented here is a sworn statement to the strength of Thiruvananthapuram Communicable Disease Surveillance System. I appreciate the sincere efforts of all the Officers involved in generating and maintaining such a valuable treasure, not only for current use, but also for use in years to come. Dr. NAVJOT KHOSA Dr. SHINU K.S District Medical Officer DISTRICT MEDICAL OFFICE(HEALTH) RED CROSS ROAD THIRUVANANTHAPURAM Phone : +91 471 2473257 Message A sensitive disease surveillance system is the stepping stone for an effective response to any public health challenge. The huge database of IDSP in our state has been of immense help in specific disease control measures in general and in formulating Annual Epidemic Preparedness Plan in particular and I am pleased to know that the district surveillance unit of IDSP has prepared a first volume of consolidated surveillance data, well analyzed, for the past 6 years. The report showcases the time trend of important epidemic prone diseases highlighting major associated events. I congratulate the District Surveillance Officers and all other officers involved in generating such a quality reference document useful for policy makers, researchers and students of public health at all levels. I wish IDSP Trivandrum all success in controlling the Communicable Disease in future. Dr. SHINU K.S Dr. VINAY GOYAL I.A.S District Development Commissioner COLLECTORATE, CIVIL STATION KUDAPPANAKUNNU THIRUVANANTHAPURAM Phone : +91 471 2731177 Message Surveillance is the back bone of any disease control Programme. Kerala has one of the best Surveillance Programmes among the Indian States. Capital City Thiruvananthapuram, is doing an Excellent Surveillance System and it have been proved in the ongoing Covid Pandemic crisis. Systematic and rapid outbreak investigation, committed and knowledgeable work force, robust management of database, accurate and timely reporting, organized Rapid Response Team for promptly controlling outbreak, inter sectoral co-ordination – all activities earned a high level of respect for IDSP, Trivandrum. I wholeheartedly appreciate the DSO and all other officers those who have spent this time and energy for materializing this report. Best wishes to IDSP Trivandrum. Dr. VINAY GOYAL Dr. JOSE D’CRUZ Additional District Medical Officer DISTRICT MEDICAL OFFICE(HEALTH) RED CROSS ROAD THIRUVANANTHAPURAM Phone : +91 471 2473257 Message I am extremely proud and pleased to know that IDSP Trivandrum is publishing its Surveillance report for the period, 2015-2020. This report highlights the special status of the District Surveillance Unit. The past year has been eventful in all aspects. Disease Surveillance has touched new heights and program coverage has extended to new areas. The robust database maintained at various levels is a public health treasure awaiting exploration by researchers. I congratulate all staff of IDSP and COVID Control Room of Trivandrum district for their commendable contributions and my colleagues for immense support extended all along. Dr. JOSE D’CRUZ Dr. ARUN P.V District Programme Manager DISTRICT PROGRAMME OFFICE THYCADU, TRIVANDRUM THIRUVANANTHAPURAM Phone : +91 471 2321288 Message The reliable and valid surveillance data is the key for planning prevention and control strategies for epidemic prone diseases. It is expected that all the field functionaries study the data and analyze. Based on the analysis the required policy initiatives as well as actions are taken. The surveillance team has been doing compilation of data and field studies. This will be of help to the health functionaries as well as to the academia. I am sure that this publication will be a valuable reference material for the future. I congratulate all the health care staff involved in this exercise and I also congratulate the District NHM functionaries for supporting the Programme Officers and staff along. Dr. ARUN P.V From the Editorial Desk Dr.Dhanuja V.A Acknowledgement A well-functioning disease surveillance programme is a sine qua non for effective management of public health. This has been proved in our ability to successfully manage the epidemic that threatened Kerala since the last few years. Rather than something becoming active during a crisis disease surveillance must develop the sensitivity to be alert to any emerging epidemic. Retrospective analysis of surveillance data allows us to draw conclusions which help us to be more alert in the future. It is my pride and pleasure to publish the first report of Surveillance activity of IDSP Trivandrum for the previous 6 years, 2015-2020. ▪ On behalf of IDSP wing District Medical Office(Health) Trivandrum, we acknowledge the effort of Dr.Shinu K.S, the District Medical Officer for his constant support and guidance on bringing out this bulletin. ▪ We are grateful to Dr.Jose D’Cruz, Additional District Medical officer, DMO(H), Trivandrum, who led the editorial board of this bulletin. We are thankful to Dr.Sukesh Raj, the Deputy DMO, DMO(H), Trivandrum, for guiding us throughout the process of preparing this bulletin . ▪ We are thankful to State IDSP Surveillance Officer Dr.Meenakshy and entire State IDSP Unit for the immense support for preparing this bulletin. ▪ Dr.Swathi Augustine former Epidemiologist, Dr.Lakshmi G.G Assistant Surgeon, Mudakkal, Dr.Sarath Veterinary Consultant, State IDSP, Dr.Arun P Assistant Surgeon Karakulam needs special mention for their commendable work in preparing the formats, conducting and coordinating the bulletin preparation works. ▪ At this point it is necessary to mention the name of Dr.Hyma M.S, Medical officer, IDSP, Trivandrum and Mr.Aneesh Raj T, Senior Data Entry Operator, IDSP Cell, Trivandrum for their relentless efforts towards bringing out this bulletin. ▪ We are thankful to Dr.Arun P.V (District Programme Manager), Dr.Ajesh (Assistant Aadram Nodal officer), Dr.Joy John (Training Team Leader), Dr.Sunitha (Control Room Nodal Officer), Dr.Arnold Deepak(Covid Control-Election Nodal Officer)for their whole hearted support. ▪ We also offer our sincere gratitude to the entire team of staff across different sections of District Medical Office for their contribution to the bulletin. ▪ We are extremely indebted to the staff of NHM, District TB cell, RCH officer and all other Programme officers for their contribution. ▪ We are thankful to Covid 19 Control Cell and War Room, Trivandrum who led the Technical Team for providing continuous support by giving inputs regarding the content of this bulletin. ▪ Last but not the least we also express our utmost regards to all Medical officers, staffs and other field level workers, ASHA workers of Thiruvananthapuram District for their dedicated work in the periphery and consistent reporting without which this bulletin would not have been possible. Dr.Dhanuja V.A District Surveillance Officer II IDSP, Thiruvananthapuram Editorial Team 1. Dr. Shinu K S District Medical Officer DMO (H), Trivandrum 2. Dr. Jose D’Cruz District Surveillance Officer DMO (H), Trivandrum 3. Dr.Sukesh Raj Dy.DMO DMO(H), Trivandrum 4. Dr. Dhanuja V A District Surveillance Officer II DMO (H), Trivandrum 5. Dr. Swathi Augustine Epidemiologist IDSP, Trivandrum 6. Dr. Hyma M S Medical Officer IDSP, Trivandrum 7. Dr.Arun P Asst.Surgeon, Karakulam 8. Mr. Aneesh Raj T Senior Data Entry Operator IDSP Cell, Trivandrum Contents 1. Introduction 1 2. Demography of Trivandrum district 3 3. IDSP a) Introduction 4 b) District Surveillance Unit Organogram 5 c) Functions of DSU 6 4. Chikungunya 7 5. Dengue 10 6. Leptospirosis 13 7. H1N1 17 8. Varicella Zoster 19 9. Hepatitis a) Hepatitis A 20 b) Hepatitis B 21 c) Hepatitis C 22 10. Mumps 24 11. Measles 25 12. Malaria a) Falciparum Malaria 26 b) Vivax Malaria 27 c) Mixed Malaria 28 13. Filariasis 30 14. Typhoid 31 15. Scrub Typhus 32 16. Animal Bite a) Dog 35 b) Cat 36 c) Snake 37 17. Leprosy 38 18. COVID 19 45 a) Baseline data 50 b) HR Cell 62 c) Deaths 66 d) Post COVID clinics 72 e) Psychological Intervention 74 f) Election activities regarding Covid 19 80 19. Annexure I 83 20. Annexure II 91 21. Annexure III 94 1. Introduction Thiruvananthapuram District Profile Thiruvananthapuram District is the southernmost district of the state of Kerala. The district was formed in 1956, with its headquarters in the city of Thiruvananthapuram (Trivandrum), which is Kerala's capital. The district covers an area of 2,192 square kilometers (5, 41,655 acres). In the 2011 census, district had a population of 33, 01,427 making it the second most populous district in the state after Malappuram district. The population density of the district is the highest in Kerala, with the number of 1,509 inhabitants per square kilometer (3,910/sq mi). The district is divided into six taluks ie. Thiruvananthapuram, Chirayinkeezhu, Neyyattinkara, Nedumangadu, Varkala and Kattakada. The urban bodies in the district are: Thiruvananthapuram Corporation, Varkala, Neyyattinkara, Attingal and Nedumangad municipalities. The southern border of the district, Kaliyikkavila is 54 kilometres (34 miles) away from Kanyakumari, which is the southernmost point on the Indian peninsula. Geography of District Thiruvananthapuram is built on seven hills by the sea shore and is located at 8.5°N 76.9°E on the west coast, near the southern tip of mainland India. The city is situated on the west coast of India and is bounded by the Laccadive Sea to its west and the Western Ghats to its east.