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Weekly Epidemiological Bulletin Disease Early Warning System and Response in Pakistan

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Weekly Epidemiological Bulletin Disease Early Warning System and Response in Pakistan Weekly Bulletin Epidemiological Disease early warning system and response in Pakistan Volume 2, Issue 42, Monday 24 October, 2011 Highlights Priority diseases under surveillance Epidemiological week no. 42 (14 to 21 October, 2011) in DEWS Acute Flaccid Paralysis (AFP) • 79 districts and 2 agencies provided surveillance data to the DEWS this week from Acute Jaundice Syndrome (AJS) 2,551 health facilities. • A total of 886,224 consultations were reported through DEWS of which 210,475 (24%) Acute Respiratory Infections (Upper and Lower) (ARI) were acute respiratory infections (ARI), 80,944 (9%) were Skin disease, 73,343 (8%) were acute diarrhoea, and 68,059 (8%) were suspected Malaria. Acute Watery Diarrhoea (AWD)/ Suspected Cholera • A total of 145 alerts with 9 outbreaks were reported in week‐42, 2011: Altogether 56 Acute Bloody Diarrhoea (BD) alerts were for Dengue Fever, 27 for AWD, 19 for Measles, 14 for Neonatal tetanus, 11 for Leishmaniasis, 5 for Malaria, 4 for Pertussis, 2 each for Bloody diarrhoea and Diph‐ Other Acute Diarrhoeas (AD) theria, while 1 each for Acute jaundice syndrome, CCHF, Meningitis, Mumps and Food Suspected Viral Hemorrhagic poisoning . Fever (VHF) • National Polio Eradication Initiative reported fourteen new polio cases 7 from Sindh Suspected Malaria (Mal) (Thatta, Kamber and Karachi); 5 from FATA (Bajour, Waziristan South and Waziristan Suspected Measles (MS) st North), 2 from Balochistan (Quetta). As of 21 October, 2011, Pakistan has reported a Suspected Meningitis (MG) total 132 polio cases (130 type‐1 & 2 type‐3) from 41 districts/towns/tribal agencies/ Others areas. Figure‐1: Weekly trend of leading priority diseases in Pakistan, 29 July 2010 to 13 October 2011 (Epi week 31, 2010 to week 42, 2011) 35 AD BD ARI S. Malaria 30 25 20 Percentage 15 10 5 0 9 7 5 3 1 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 11 31 33 35 37 39 41 43 45 47 49 51 ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk wk Disease Wk-35 Wk-36 Wk-37 Wk-38 Wk-39 Wk-40 Wk-41 Wk-42 Acute respiratory infection 68,736 (18%) 158,580 (18%) 175,906 (19%) 193,771 (19%) 205,597 (21%) 209,436 (21%) 221,144 (22%) 210, 475 (24%) Acute diarrhoea 40,403 (10%) 96,128 (11%) 109,523 (12%) 110,835 (11%) 105,295 (11%) 97,007 (10%) 92,214 (9%) 73,343 (8%) Bloody diarrhoea 2,589 (0.66%) 7,387 (0.85%) 7,920 (0.85%) 8,676 (0.86%) 9,393 (0.94%) 8,075 (0.80%) 8,016 (0.78%) 6,007 (0.68%) Suspected malaria 22,729 (6%) 58,753 (7%) 64,766 (7%) 78,109 (8%) 83,684 (8%) 82,802 (8%) 85,698 (8%) 68,059 (8%) Total consultation 389,729 864,693 931,318 1,005,251 995,450 1,014,266 1,023,163 886,224 Since July 29, 2010, approximately 49,521,708 patient consultations have been reported to the DEWS from all provinces, FATA and AJ&K. While we still receive reports on about 1,000,000 consultations per week, there is a drop in timely reporting due to challenges in accessibility caused by floods, security and infrastructure. The above graph shows the weekly trend of four major diseases as percentage of cases out of total consultations reported to DEWS. From last 5 weeks (38 to 42, 2011) acute diarrhoea cases have been decreasing by 3%, while at the same time cases of ARI have been increasing by 5%. Suspected Malaria cases have also shown seasonal increase from week 35 especially from districts in Sindh and Balochistan. This weekly Epidemiological Bulletin is published jointly by the National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 01 Epidemiological Bulletin: DEWS, Pakistan, Week no. 42 (14 to 21 October, 2011) Current week's Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken 8 suspected cases of Bloody Diarrhea were reported from BHU Chamm. Village Khater‐Nar, Stool samples collected for lab confirmation and Shigella isolated. DHO‐H 18‐Oct BD AJK Hattian 2 2 4 0 U.C Chakhama informed. Active surveillance found no other cases, health education given to the community. A suspected case of Dengue Fever (19 years old female) admitted in KATH Mansehra with complaints of fever and body aches from last 7 days, rash Khyber Dabgran Near Sheik‐ present on the body, PLT counts were 98000, sample taken and sent to NIH 17‐Oct DHF Mansehra 0 0 0 1 Pakhtunkhwa habad Camp for confirmation, Nine cases admitted in hospital from same family with same complaints. EDO Health informed for necessary action and thermal fogging. Health Education session regarding prevention done. Alert for 9 cases of Leishmaniasis, training of health care providers for Kuch,Nasir Leishmaniasis treatment and prevention done by IRC, patients were 19‐Oct Leishmaniasis Punjab Mianwali abad,Potta,UC Kala 1 4 0 4 screened by DDOH for IM and IL injections, Malaria Program requested for Bagh,Issa Khel fogging and IRS of the area. Alert for AWD, 6 suspected cases with severe dehydration found in village Village Wahid Buksh with 3 deaths, village was 12 KM away from RHC and village surround by Mari, UC Isamail rain water. During investigation health education imparted, Aqua tabs, 17‐Oct AWD Sindh Mirpur Khas 2 1 1 2 Kumbhar, Taluka ORS, water filter, Jerry cans and Hygiene kits were distributed, EDO‐H Sindhri inform regarding the alert and deaths and 1 stool sample taken and sent to NIH for confirmation. Village Mir Muham‐ Alert for AWD, 6 cases from one village, active surveillance found no other 20‐Oct AWD Sindh Sanghar mad channa, UC Jaffer 4 2 0 0 cases, health education, Aqua tabs, Zinc tabs, ORS, Hygiene kits were dis‐ khan Laghari tributed, EDO‐H informed and 2 water samples collected. Alert for AWD, 11 cases from one village, investigation complete, health Village Mokhai, UC education provided, hand pump was the source of water, IV fluid, antibi‐ 14‐Oct AWD Sindh Tharparkar Mirwah, Taluka Na‐ 0 6 0 5 otic, Hygiene kit and ORS were distributed, EDO‐H informed. Active surveil‐ garparkar lance found no other cases. Village Ramzan Kho‐ Alert for AWD, 9 cases from one village, Hand pump was the source of 20‐Oct AWD Sindh Thatta man UC Kalri, taluka 1 4 0 4 water, health education, Aqua tabs, Zinc tabs, ORS, Filters and Jerry cans thatta were provided, EDO‐H informed. 2 water samples taken, under process. BHU Chawkandi and 22‐cases of Falciparum investigated, 11 confirmed by RDT (SPR = 50%; FR = 19‐Oct Malaria Sindh Dadu Village Wassei, UC 4 8 5 5 100%) , rain water stagnant near homes, health education imparted and Baid, Taluka KN Shah EDO‐H informed. Village Daro Machi, 23‐cases of Falciparum investigated, 17 confirmed by RDT (SPR = 74%; FR = 20‐Oct Malaria Sindh Dadu UC Kakar, Taluka KN 8 5 5 5 100%), rain water stagnant near homes, health education imparted, WHO Shah. and Merlin team jointly investigated the outbreak , EDO‐H informed. Current week's Alerts: Province Khyber Pakhtunkhwa Current week's Alerts: Province Balochistan Date Disease District Area <5M >5M <5F >5F Date Disease District Area <5M >5M <5F >5F 20‐Oct CCHF Haripur Makhan Colony 0 1 0 0 15‐Oct AJS Ziarat Sinjawi 0 0 0 0 Killi Jan Mohammad, CD Ameen Abad, UC 19‐Oct AWD Chagai 2 3 5 8 19‐Oct DHF Abbottabad Sherwan Abbottabad 0 1 0 0 Chagai village 21‐Oct DHF D. I. Khan Gur Wali, Kirri Shamozai, Tehsil Paroa 0 1 0 0 20‐Oct AWD Jaffarabad Karam Shah Muhalla, UC 1, Tehsil Jhat Pat 1 0 1 0 15‐Oct DHF Haripur Nawansher 0 1 0 0 19‐Oct DHF Jaffarabad Yaqoob Muhallah, Tehsil Usta Mohammad 0 1 0 3 17‐Oct DHF Quetta FJ Hospital 0 0 0 1 17‐Oct DHF Haripur Muhallah Golian Mera, Pind Hisham Khan 0 1 0 0 20‐Oct DHF Quetta FJ Hospital 0 1 0 0 18‐Oct DHF Haripur Panian Chawk Haripur city 0 1 0 0 17‐Oct DHF Ziarat Ziarat Town 0 1 0 0 17‐Oct DHF Mansehra Reerh Attershisha 0 1 0 0 20‐Oct Leishmaniasis Jaffarabad Bhati Muhallah, UC 1, Tehsil Jhat Pat 0 0 0 1 17‐Oct DHF Mansehra Dabgran Near Sheikhabad Camp 0 0 0 1 15‐Oct Leishmaniasis Jhal Magsi DHQ Hospital‐UC Gandawah City 1 0 1 0 19‐Oct Leishmaniasis Kalat Maoli, tehsil Surab 0 1 0 0 18‐Oct DHF Mansehra Shohal Maidan Balakot 0 1 0 0 15‐Oct Leishmaniasis Kech Haji Abdul Salam Mohalla‐ UC Turbat 0 1 0 0 16‐Oct Diphtheria Peshawar Village Lamda Jaba Cherat 0 0 1 0 20‐Oct Leishmaniasis Khuzdar Tehsil Khuzdar 0 3 0 0 Village Ajmaira, UC Ajmaira, Tehsil Bata‐ 20‐Oct Measles Battagram 0 1 0 0 19‐Oct Leishmaniasis Lasbela Jhaoo cross Bela 0 3 0 0 gram 20‐Oct Leishmaniasis Panjgur Union Council Kallag, Mohallah Simsori 0 0 0 1 18‐Oct Measles Charsadda Neher Koroona 1 0 0 0 new killi sulamankhail, sarana rd, Killi haikal‐ 20‐Oct Leishmaniasis Pishin 0 1 0 1 21‐Oct Measles D. I. Khan Arra, Tehsil & District D I Khan 1 0 0 0 zai 16‐Oct Leishmaniasis Sibi Sibi Bypass road, almadina hotel 0 1 0 0 21‐Oct Measles D.
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