Ethiopian Public Health Institute (EPHI) የኢትዮጵያ የህብረተሰብ ጤና ኢንስቲትዩት EPIDEMIOLOICAL BULLETIN Weekly Report/Vol. # /No.36 April 27, 2020

0 4 4 New event Ongoing events Outbreaks HIGHLIGHTS: WEEK 16, (13-19 April, 2020)  In the total number of confirmed COVID -19 cases raised to 123, Recoveries 41 and 3 deaths recorded as of 26th April, 2020.  People who were in close contact with the confirmed cases are being traced and quarantined.  The national surveillance completeness and timeliness rate were 80.5% and 79.3% respectively.  One new additional Human Guinea worm disease reported during the week, raised to total of 7 Human guinea worm.  Cholera outbreak ongoing in Somali, and SNNP regions: 43 new cases, 0 death reported during the week.  Measles outbreaks continued across the country with Oromia region affected most. A total of 575 suspected measles cases and 7 death were reported during the week.  A total of 10,915 confirmed and clinical malaria cases with 2 deaths were reported during the week.  A total of 2,298 SAM cases and 3 deaths reported, showed 1701(43%) cases decrement as compared to last week  A total of 24 Maternal deaths were reported during this week, showed 4(14%) decrement as compared to last week.  A total of 19 Suspected Anthrax cases and 2 deaths were reported during the week.  A total of 99 suspected rabies cases and 2 deaths were reported during week,  Response to the outbreak strengthened by the team deployed from the national and regional health bureau. Surveillance report Completeness and Timeliness The national surveillance data reporting completeness and timeliness rate were 80.5% and 79.3% respectively. Dire Dawa city, Afar, Somali and Gambella region didn’t submit the report during the week.

1 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

Cases By Date

Daily cases Cumulative

50 123 125 117 45 108 105 40 35 85 85 30 65 65 25

20 44 45

Daily Cases Cumulative Cumulative 15 29 25 10 15 9 5 5 0 -15

Date

Guinea worm: One new additional morphologically confirmed Human guineaworm cases reported during the week from the Gog woreda of Gambella region. As a response, abating of ponds, Detail case investigation, Active case search, case management, filter distribution, and health education are strengthened and well maitained to prevent other villagers from getting the diseas.

Cholera: is ongoing in SNNPR, Somali and Oromia region, a total of 43 suspected Cholera cases without deaths were reported during the week. The highest 38(88%) were reported from SNNPR followed by 5(12%) from Somali region and 2 (4.6%) from Oromia region.

AFP: No new suspected AFP cases and death reported during the week.

Anthrax: A total of 19 Suspected Anthrax cases and 2 deaths were reported during the week, which showed 7(36%) cases increment as compared to last week. Highest 13(68%) suspected cases were from Amhara region and 6(32%) were reported from Tigray region. Two deaths were reported from Gulomeheda woreda, Eastern Tigray of Tigray region.

Weekly Diseases Summary The weekly surveillance data received from regions is summarized in Table 1 below. 1 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

Table 1: Summary of surveillance data, Weeks 1-16, 2020, Ethiopia.

Week 16 Rates per S.No Disease Condition YTD (N) YTD (N) cases (N) 100,000 Pop 1 Malaria 10915 10.40 322905 2 Suspected Meningitis 30 0.03 1225 3 Dysentery 4195 4.00 87262 4 Typhoid Fever 15425 14.69 363491 5 Relapsing Fever 70 0.07 1027 6 Epidemic Typhus 7759 7.39 210015 7 SAM 2298 2.19 73905 8 Scabies 2396 2.28 98132 9 Suspected AFP 0 0.00 333 10 Suspected Anthrax 19 0.02 285 11 Suspected Cholera 43 0.04 3133 12 Suspected Measles 575 0.55 18418 13 Suspected N_ Tetanus 1 0.00 53 14 Suspected Rabies 99 0.09 2352 15 Maternal Deaths 24 0.02 299 16 Avian Influenza 0 0.00 0 17 SARS 0 0.00 0 18 Smallpox 0 0.00 0 19 Yellow Fever 0 0.00 82 20 VHF 0 0.00 0 21 Pandemic Influenza 0 0.00 0 N.B: There were zero cases of suspected Avian Influenza, SARS, small pox, yellow fever, VHF, Guinea worm and Smallpox during this week’s period.

Neonatal tetanus (NNT): One suspected Neonatal cases without death was reported nationally during the week, showed 3(75%) cases decrement as compared to last week.

Maternal Death: A total of 24 maternal deaths were reported nationally during this week, which showed 4(14%) maternal deaths decrement as compared to last week. Highest 9(38%) deaths were from Amhara region followed by 8(33%) from Oromia region and 3(13%) Addis Ababa city.

Rabies: Nationally 99 suspected rabies cases and 2 death were reported during the week, which showed 37(37%) increment of cases as compared to last week. Highest 67(67%) suspected rabies cases were from Tigray followed by 25(25%) from Amhara region and 5(5%) were from Addis Ababa city. Of two deaths reported, 1 death was

2 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

reported from Kutaber woreda South Wollo zone of Amhara region and 1 death was Ahiferom woreda, Central Tigray Zone of Tigray region.

Measles: During the week, a total of 575 suspected measles cases and 7 deaths were reported and showed 39(6.5%) cases decrement as compared to last week. The highest 364(63%) suspected measles cases were from Oromia region followed by 184(32%) from Amhara region and 18(3%) from Tigray region. All of deaths were from Oromia region, Tulo woreda of West Hararge zone reported five deaths, woreda of 1 and Gedo Hospital of reported 1 death. Figure 1: Distribution of Measles cases and Deaths by Epidemiological week as of week 16, 2020, Ethiopia.

3000 10 Sum of Measles_Cases Sum of Measles_Deaths 9 2500 8 7 2000 7 6 1500 5 4 1000

3 Number of measles Deaths Deaths Number measles of

Number of Measles cases Number cases Measles of 2 500 575 1 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Epi week

Malaria: During the week a total of 10,915 confirmed and clinical cases and 2 deaths were reported during the week, which showed 5862(35%) cases decrement as compared to the last week. Highest 3474(32%) cases were from Amhara region followed by 3384(31%) cases were from SNNP region and 1478(13.5%) cases from Oromia region. Two deaths were reported from Woreda 05, Kolfe Keraniyo Subcity of Addis Ababa city.

Meningitis: A total of 30 suspected meningitis cases and 1 death was reported during the week, which showed 35(54%) case decrement as compared to last week. The highest 14(47%) suspected cases were from Oromia, followed by 5(17%) cases were from Addis Ababa city and 4(13%) were reported from Amhara region. One death was reported from Humera town, Western Tigray of Tigray region.

3 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

Relapsing fever (RF): A total of 70 relapsing fever (RF) cases without death were reported during the week, showed 7(9%) cases decrement as compared to the last week. Highest 57(81%) RF cases were from Oromia region followed by 12(17%) cases from Addis Ababa city and 1(1.5%) were from Amhara region.

Severe Acute Malnutrition (SAM): During the week, a total of 2,298 SAM cases and 3 deaths were reported which showed 1701(43%) cases decrement as compared to last week. The highest 1508(66%) SAM cases were reported from Oromia followed by 347(15%) from SNNP region and 323(14%) from Amhara region. Of total three deaths reported, 2 SAM deaths were from Enkelo and woreda, Arsi zone of Oromia region and 1 death was from Kobo woreda, North Wollo zone of Amhara region. See figure below.

6000 SAM Cases SAM inpatient Deaths 20 18 5000 16 14 4000 12 3000 10 2298 8 2000

Number of cases SAM Number 6

4 of SAM Number deaths 1000 3 2 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Epi week

Scabies: A total of 2,396 scabies case were reported during the week, showed 293(12%) cases decrement as compared to the last week. Highest 1034(43%) scabies cases were from Amhara followed by 580(24%) cases were from Oromia and 300(13%) from SNNPR.

4 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

Figure 2: Summary of immediately reportable diseases reported from each region, week 16, 2020, Ethiopia.

* Each symbol represents the report of at least one case of the disease in the region in this week Figure 3: Summary of weekly reportable diseases reported from each region, week 16, 2020, Ethiopia.

*Each symbol represents the report of at least one case of the disease in the region in this week. 5 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue

Major Public health action

 Ethiopian Public Health Institute (EPHI), in collaboration with WHO and other health partners, are responding to the outbreak in the affected woredas.  Response Teams have been deployed to all affected woredas and continued remote support is being provided to all regions.

COVID-19: In Ethiopia the total number of confirmed COVID -19 raised to 123 cases, 41 Recoveries and 3 COVID-19 deaths recorded as of 26th April, 2020.

 All are now receiving their medical treatment and those who have been in contact with the case are identified.  Globally 2,995,244 confirmed COVID-19 cases and 207,009 deaths were reported as of 26th April, 2020, in a 210 countries/territories/ areas.

Major Public health actions in Ethiopia for 2019 novel coronavirus

 Contact identification, contact listing and follow-up of Confirmed cases strengthened and well maintained.  Rumor/Alert investigation, Infection prevention and Control and epidemiologically linking of contacts and confirmed cases are major activities ongoing.  Collecting sample and conducting the tests for the suspected cases are also ongoing.  Case Detection and testing of SARI and Pneumonia like illness from Hospitals are ongoing.  Case management of confirmed cases  Toll-free hotline (8335) and 952 was established to provide information to and receive alert from; the public.

The Epidemiological Bulletin is published by the Ethiopian Public Health Institute Editor in Chief: Mulugeta Asefa Public Health Emergency Management Center, Early Warning & Information System Management Directorate Address: P.O. Box 1242, Swaziland Street, Addis Ababa Telephone: +251-112-765-340, Toll Free: 8335/8665, Fax: +251-112-758-634 Website: www.ephi.gov.et

6 | P a g e EPI Bulletin/ April 27, 2020/Week 16 Ethiopian Public Health Institue