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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 3, Issue 27, Wednesday 27 June 2012 Highlights Figure‐1: 86 districts reported to DEWS in week 25, 2012. Epidemiological week no. 25 (17 - 23 June 2012) • Measles: 173 alerts investigated, responding to 27 outbreaks involving 418 measles cases. • CCHF: In 2012, total of 21 confirmed cases have been reported throughout the country. Most of the cases (12) directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab. • 2 AWD outbreaks identified in 2 districts of Sindh and responded few confirmed cases in localities. • Acute diarrhoea: Trend of acute diarrhoea is stable in all provinces. Districts in Sindh and Khy‐ ber Pakhtunkhwa are investigating alerts for acute watery diarrhoea/suspected cholera. • No new polio case was reported; As of 25 June Priority diseases 2012, Pakistan has reported a total of 22 polio Cumulative number of selected health events reported in under surveillance Epi‐week 1 ‐ 25 (1 Jan ‐ 23 June 2012) cases (19 type‐1, 2 type‐3 and 1 mixture type‐1 in DEWS and 3) from 13 districts/tribal agencies. Pneumonia Disease # of Cases Percentage Acute Watery Diarrhoea Bloody diarrhoea Acute diarrhoea 1,269,435 8% • 86 districts have reported in week 25, 2012, Other Acute Diarrhoea Suspected Enteric/Typhoid Fever Bloody diarrhoea 80,391 0.48% Please see map. 2,260 health facilities have Suspected Malaria shared weekly data to the Disease Early Warning Suspected Meningitis ARI 3,320,196 20% System (DEWS) in this week Suspected Dengue fever Suspected Viral Hemorrhagic Fever Suspected Measles S. Malaria 755,999 5% Suspected Diphtheria • 812,072 patients’ consultations were reported in Suspected Pertussis Skin Diseases 736,469 4% week 25 compared to 833,414 consultations Suspected Acute Viral Hepatitis Neonatal Tetanus Unexplained fever 581,072 3% reported on week 24, 2012. Acute Flaccid Paralysis Scabies Total (All consultations) 16,721,988 Cutaneous Leishmaniasis Others Major health events reported during the Epi‐week ‐ 25 (17 ‐ 23 June 2012) Figure‐2: Weekly trend of Acute diarrhoea in Pakistan Week‐1, 2011 to week‐25, 2012. Disease # of Cases Percentage 20 Acute diarrhoea 75,793 9% 2011 2012 15 Bloody diarrhoea 4,127 0.51% ARI 118,507 15% 10 S. Malaria 45,515 6% Percentage 5 Skin Diseases 36,707 5% 0 Unexplained fever 29,687 4% 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 Epi‐week Total (All consultations) 812,072 • The graph (Figure‐1) shows the comparison of weekly trend of Acute diarrhoea as proportional morbidity (percentage of cases out of total consultations) reported to DEWS each week in year 2011 and 2012. • The overall weekly trend of acute diarrhoea remained stable during the last 4 week, however in KP the weekly propor‐ tional morbidity of AD shows an upward trend in all the provinces. 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 Weekly Bulletin: DEWS, Pakistan, Week no. 25 (17 to 23 June 2012) Current week's (25/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken Muslim Bagh town 12 suspected cases of Leishmaniasis were reported. Patients were investigated and found lesions on Leishma‐ 21‐Jun Balochistan Killa Saifullah area, Tehsil 0 6 0 6 face, nose, arms and legs. No travel history have seen in these patient. Treatment as per WHO protocol niasis Muslim Bagh was given. Leishma‐ Village Kolak, UC 6 suspected cases of Leishmaniasis were reported. Patients have history of disease since one year but no 19‐Jun Balochistan Pishin 0 0 0 6 niasis Oramzai improvement after treatment. Treatment has provided to the patients. Mungli, UC Par‐ 21 cases of malaria were reported and tested for confirmation.11 found positive (SPR=52%) of P.F=2 19‐Jun Malaria Balochistan Awaran war, Tehsil Mash‐ 2 6 5 8 (FR=55%), P. V=5, Mix=4. Anti malarial treatment provided. Information shared with DHO and requested kai for bed nets and fogging in the locality. BHU Padag, Killi 30 cases of suspected malaria were reported. 30 slides were tested where 19 verified positive (SPR=63%) 19‐Jun Malaria Balochistan Chagai Mohammad Jhan 3 5 10 12 of pf=8 (FR=42%),pv=11. RDTs and antimalarial medicines were provided. Bed nets not available in the Amuri, UC Padag district. 17 cases for suspected malaria were reported. 12 slides were tested using RDTs and all verified positive Goth Mohammd 18‐Jun Malaria Balochistan Jaffarabad 3 5 3 6 (SPR 100%). Antimalarial drug provided for treatment. Bed nets and insecticides not available in the Amin Kanadrani district. Suspected cases of malaria were reported from village. 21 slides tested out of which 14 were found Village Khichi, UC 22‐Jun Malaria Balochistan Jhal Magsi 4 12 3 16 positive (SPR=67%) of pf=7 (FR=48%), pv=4, Mix=3. Information shared with DHMT and requested to take Barija necessary action. ACTs supplied for proper treatment of the patients. DHQ Hospital, 60 cases of Malaria were reported. 25 slides tested where 13 were positive (SPR=52%) pf=7 (FR=54%), 18‐Jun Malaria Balochistan Lasbela 12 9 15 24 Tehsil Uthal pv=6. Patients were treated with antimalarial drugs. Information shared with DHO for necessary action. 2 suspected cases of measles were reported. During field investigation 4 more suspected cases were Jamadar Ayoob found. 23 children were assessed for routine immunization out of which 3 (13%) were not vaccinated 19‐Jun Measles Balochistan Kech 1 0 3 2 ward, UC Absar against any antigen. Health education session conducted regarding importance of routine immunization. Information shared with DHO. 2 suspected cases of measles were reported through community. During field investigation 3 more Suthkalbazaar, UC suspected cases were found.Vit A drops were given to the cases and health education imparted in the 20‐Jun Measles Balochistan Kech 2 0 3 0 Koshkalat community regarding routine immunization. 58 children were assessed for routine immunization out of which 5 were found totally unvaccinated against measles. Information shared with DHO. An alert of suspected measles was reported. On field investigation 12 more suspected cases were found. Baleena Rodeni, Vit A drops were given to the cases. Cases were assessed for the routine immunization but none of child 17‐Jun Measles Balochistan Khuzdar UC and Tehsil 6 2 1 4 found vaccinated against measles. Information shared with DHMT and requested for intensified out‐ Surab reach activity in the locality. Health education imparted regarding the routine immunization. 2 blood samples were taken for confirmation. Alert reported through LHW. investigation was done. Patients were presented with typical signs & symp‐ toms and had no immunization history. Vit A provided to all suspects. One blood sample was collected Sat Marlla, UC and sent to NIH. community was told about routine immunization importance and requested take their 18‐Jun Measles Balochistan Khuzdar Zereena Kattan, 1 2 3 1 Tehsil Khuzdar children to nearby EPI centre for routine immunization. Information shared with DHO and EPI team. 9 children less then 5 years were checked, 2 confirmed through EPI card while others partially immunized. Measles one dose coverage was 37.5% while second dose was zero. 6 suspected cases of measles were reported. Vit A drops provided. None of the case were found vacci‐ Killi Alozai, UC nated against measles. Immunization status of the community was not satisfactory because outreach 20‐Jun Measles Balochistan Killa Saifullah Akhterzai, Tehsil 2 0 3 1 Killa Saifullah activity has not been done due to compromised security in the area. DHO was informed about the situa‐ tion. An alert of measles were reported. During field investigation, 4 more suspected cases were found. Vit A Mohalla Shapatan, 22‐Jun Measles Balochistan Panjgur 4 0 1 0 drops were given to the cases. Health education imparted. 5 children were assessed for routine immuni‐ UC Chitkan zation out of which 4 (80%) were found vaccinated against measles. 4 suspected cases and 1 death due to measles were reported. All the cases were found unvaccinated. Vit Killi samkhail, UC A drops provided and health education imparted. 35 children were checked for routine immunization 18‐Jun Measles Balochistan Pishin 4 1 0 0 Saranan and all of them were found unvaccinated against measles. Vaccination done on spot by the support of EPI team. An outbreak of measles was reported from HF. Vit A drops were provided and health education was Village killi Baran‐ imparted in the community. During house to house survey, 73 children were assessed for routine immu‐ 21‐Jun Measles Balochistan Pishin 8 3 0 0 zai, UC Gulistan. nization and none of them were found vaccinated against measles. Vaccinated these children on spot by the support of EPI team. An alert of suspected measles were reported. On active search 4 more suspected cases were found. None of the case were found vaccinated against measles. Vit A drops provided to all cases. Blood sample 17‐Jun Measles Balochistan Ziarat Mana, UC Zindra 1 3 1 0 was collected and sent to NIH for lab confirmation. Health education imparted. 9 children were assessed for routine immunization where 2 children found completely vaccinated while rest of them were par‐ tially vaccinated. 3 children were found vaccinated with Measles 1 (37%). An alert of suspected measles was reported. On active search 6 more suspected cases were found.
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