Eiectronic Integrated Disease Early Warning and Response System Volume 07,Lssue31,Epi Week 31,(29 July-04August,2019)

Ministary Of Public Health Papulation Epidemiological Bulletin Primary Heath Care Sector Weekly DG for Diseases Control & Surveillance Eiectronic Integrated Disease Early Warning and Response System Volume 07,lssue31,Epi week 31,(29 July-04August,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-31,2019

% %

% % % % % % % %

% % % % % % % % % %

% % %

97 97

96 96 96 96 96 96 96 96

95 95 95 95 95 95 95 95 95 95

94 94

100% 94 400000

93 93 90% 350000 80% 300000 70% •During week no.31,2019, %97(1991/1933) health facilites from 23 Governorates 60% 250000 provided valid surveillance data. 50% 200000

40% 150000 Percentage

30% Consulttaions 100000 20% 10% 50000

0% 0

Wk6 Wk7 Wk 1 Wk 2 Wk 3 Wk 4 Wk 5 Wk 8 Wk 9

Wk 15 Wk 16 Wk 24 Wk 25 Wk Wk 11 Wk 12 Wk 13 Wk 14 Wk 17 Wk 18 Wk 19 Wk 20 Wk 21 Wk 22 Wk 23 Wk 26 Wk 27 Wk 28 Wk 29 Wk 30 Wk 31 Wk •The total number of consultation reported during the week in 23 Governorates was 10 Wk 359305 compared to 364284 the previous reporting week 31 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 31,2019)

% %

100% %

% 90

Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of morbidity this %

100

100 91

90% 100

100

% 90

week. 80% 97

78 90 70% 60% 50% 40% 30%

20% No. HF Reports HF No. 10% ● A total of 1775 alerts were generated by eDEWS system in week31, 2019, Of these 0% 1774 alerts were verified as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 31,2019 Proportional morbidity of leading priority diseases, Epi week 31,2019

AVH_A&E; 0.1% AFP; 0.0% Typhoid F; 1.4% Mumps; 0.1% Mal; 4.3% DF; 0.1% ● (URTI) 13.5%, suspected Malaria (4.3%),(OAD) (9.2%) and (LRTI) (5.1%)Remain the AVH_B&C; 0.0% Sch; 0.1% Meas; 0.0% RB; 0.1% leading causes of morbidity representing a total of (46.8%) Meng; 0.0% Brucellosis; 0.3% Chicken Pox; 0.2% Scabies; 0.1% ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than CL; 0.0%

1% of total morbidity in reporting period Bloody diarrhea represented 0.4% Of this OAD; 9.2% morbidity

● All diarrheal disease comprised 14.7% and LRTI 5.1% of total morbidity in pilot Governorates BD; 0.4% SARI; 0.0% URTI; 13.5% this week . Pert; 0.0% ILI; 0.4% ● All diarrheal disease comprised 14.7% and OAD 9.2% of total morbidity in all age group . LRTI; 5.1%

Measles Situition in Yemen Distribution of Governorate Measles cases & Deaths , Epi weeks1- 31,2019 Epi Curve of Measles in Yemen During 2017,2018,2019

1000 900

900 800 800 700 700

600 600

500 500 400

300 400

200 300 100 200 0

100

wk1 wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9 wk10 wk11 wk12 wk13 wk14 wk15 wk16 wk17 wk18 wk19 wk20 wk21 wk22 wk23 wk24 wk25 wk26 wk27 wk28 wk29 wk30 wk31 wk32 wk33 wk34 wk35 wk36 wk37 wk38 wk39 wk40 wk41 wk42 wk43 wk44 wk45 wk46 wk47 wk48 wk49 wk50 wk51 wk52 0 2019 465 524 562 594 620 615 837 590 384 304 245 220 196 195 163 177 135 125 106 83 84 63 37 114 161 148 140 141 135 120 115 2018 241 218 357 349 377 328 384 459 427 512 532 722 733 820 763 844 631 625 673 451 500 492 394 210 374 348 494 442 482 465 420 438 337 253 369 439 404 428 501 404 451 524 434 489 416 470 427 455 414 494 468 442 No of cases No of Death 2017 80 127 145 166 179 146 178 166 143 174 129 122 123 82 137 90 81 72 98 85 54 53 44 31 19 33 87 74 58 95 91 95 75 91 21 66 80 89 76 109 131 92 97 91 67 130 136 105 103 123 114 116

النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا على شكل وباء :ILI التهاب تنفسي حاد وخيم:SARI التهاب الكبد :AVH الحصبة :Meas داء الكلب :RB التهاب السحايا :Men حمى الضنك :DF مالريا :Mal بلهارسيا :Sch اسهال مائي حاد :AWD التهاب الجهاز التنفسي السفلي:LRTI اسهال حاد اخرى :OAD اسهال مدمم :BD عدوى الجهاز التنفسي العلوي :URTI االيذز :HIV الجذري:CHICKEN دودة غينية:GUINEA حمى مالطيه:BRUCELLOSIS السل:TUPERCULOSIS This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 1 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019)

GOV

Distribution of suspected cholera cases by age group ( 1 Jan- 14 August 2019) Distribution of associated deaths by age group ( 1 Jan- 14 August 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601)

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 2 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019) Dengue Fever and Measles Outbreak SITUATION IN YEMEN

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Deaths Email ([email protected])

Deaths

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 3 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-31 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-31,2019

20.0% 8.0% 4500

18.0% 7.0% 4000

16.0% 3500 6.0% 14.0% 3000

5.0% 12.0% 2500

10.0% 4.0% 2000

8.0% 3.0% 1500

6.0% 1000 2.0% 4.0% 500

2.0% 1.0%

wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9

0.0% wk1

wk11 wk22 wk12 wk13 wk14 wk15 wk16 wk17 wk18 wk19 wk20 wk21 wk23 wk24 wk25 wk26 wk27 wk28 wk29 wk30 wk31

0.0% wk10

WK6 WK1 WK2 WK3 WK4 WK5 WK7 WK8 WK9

WK17 WK28 WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK18 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK26 WK27 WK29 WK30 WK31

WK1 WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK13 WK26 WK11 WK12 WK14 WK15 WK16 WK17 WK18 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK27 WK28 WK29 WK30 WK31 WK10 Rapid Test(Postive) Microscope(Postive)

Age and Sex distribution of total consultations of leading diseases (Epi week 31,2019) Number of Alerts Received and Responded (Epi Weeks 28-31,2019)

80000 75961 URTI LRTI Pert BD OAD Typhoid F

70000 AFP Meas AVH_A&E AVH_B&C DF Meng

60000 Sch CL Chicken Pox Mal 250

50000 48444

200 40000 35255 32655 32907 33514 150 30000 28683 25940 23201 22963 100 20000 Alerts of No.

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 23201 32655 33514 48444 25940 Female 22963 32907 35255 75961 28683 Distribution of consultations of leading diseases by Governorates,Epi week 31-2019

Hadramout Sanaa Suspected Disease Abyan Aden Al-Baidha Al-Dhale AlHodaidah Al-Jawf Al-Mahra Al-Mahweet Amana Amran Dhamar Hadramout Hajjah Ibb Lahj Mareb Rayma Sa'adah Shabwah Socotra Taiz Total wady Governorate URTI 2809 3435 1407 1123 5187 1063 473 896 4836 1637 2587 1343 1445 3508 2338 3378 567 510 2952 3034 1178 73 2834 48613 LRTI 314 366 829 189 4039 286 43 367 1856 804 1347 318 171 1496 1168 1160 173 98 667 1009 201 32 1265 18198 ILI 127 0 70 0 82 30 0 12 12 6 57 0 0 76 49 0 97 0 98 166 130 1 254 1267 SARI 0 0 1 0 0 0 0 0 4 3 63 0 0 1 0 0 0 0 22 0 0 0 4 98 Pert 4 1 0 0 3 8 0 4 2 5 6 0 0 1 1 2 8 0 1 2 8 0 5 61 BD 88 3 50 10 127 63 1 76 117 117 142 0 4 8 77 31 34 13 123 149 35 2 188 1458 OAD 1252 1497 1084 685 2113 1043 313 791 4558 1730 2672 565 383 2399 2096 1588 482 358 1971 2618 761 21 2065 33045 Typhoid F 46 44 285 13 525 172 11 146 649 258 751 38 7 0 617 41 72 52 206 344 69 39 483 4868 Meas 3 14 4 2 6 2 0 1 17 12 5 1 2 8 7 3 1 0 16 2 0 0 9 115 AVH_A&E 9 13 2 3 5 0 0 4 150 21 41 12 6 1 15 22 1 0 8 11 21 0 24 369 AVH_B&C 2 0 4 0 2 11 0 0 89 4 5 4 1 11 22 1 1 0 1 2 2 0 9 171 NNT 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 AFP 0 0 0 0 2 0 0 0 4 0 0 0 0 0 2 0 0 1 0 0 0 0 2 11 329 18 0 6 21 30 1 10 10 18 18 21 7األمراض المشتبهة Mumps 8 12 9 8 27 12 0 6 35 25 27 Mal 59 178 3 1 6778 124 29 512 232 432 472 4 0 4015 448 70 17 141 689 210 1 0 977 15392 Meng 0 1 0 0 2 0 0 0 9 3 2 3 0 0 11 0 0 0 0 0 0 0 13 44 DF 84 118 1 4 14 0 0 0 1 0 0 9 2 12 1 115 14 0 0 1 42 0 85 503 VHF 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 Sch 0 0 2 12 0 9 0 18 67 50 44 7 0 114 25 6 3 17 67 30 0 0 11 482 CL 0 0 0 2 0 1 0 3 9 14 9 0 2 3 2 2 4 0 5 6 1 0 1 64 RB 0 0 37 0 3 0 0 21 83 25 110 1 0 32 99 1 0 1 1 7 0 0 8 429 Tuberculosis 3 4 1 0 21 2 0 0 19 0 9 0 0 12 3 1 0 0 2 9 0 0 12 98 HIV/ AIDS 0 0 0 0 0 0 0 0 4 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 Brucellosis 2 0 77 1 11 188 0 2 161 58 217 0 6 157 91 0 5 1 31 17 14 0 31 1070 Chicken Pox 7 14 3 8 3 12 2 8 112 71 53 7 8 21 24 8 5 23 139 47 12 0 14 601 Scabies 20 0 2 0 55 0 0 4 20 4 11 1 0 33 2 0 0 13 38 22 1 1 9 236 Guinea Worm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 othr_disease 4323 9063 4613 7953 15709 3351 1905 4434 51439 6748 20636 7051 3814 10671 11809 11368 4658 976 6182 8878 4472 263 11044 211360 total_cons_disease 9244 15037 9325 10178 38560 6723 2795 7855 66887 12906 30587 9441 6527 24384 20919 18098 6255 2396 13971 19009 6979 432 20797 359305 This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 4 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019)

Alert Responded in Epi - Week 31,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Radfan Public H, Tur Sena'a Dispensary ,Halimeen rural Radfan,Halimayn,Al Maqatirah,Al The focal points were contacted, information shared, the cases of suspected Dengue fever were DF Lahj H, AL jamaheer Dispensary,October public H,Tour diagenosed clinicaly according to case definition , the most cases were Rapid test positive. 115 0 Musaymir,Yaffa,Tur Al Bahah,Tuban Albaha Hospital,Sabr Health Center,Alwaht rural H,Other Cases added to the line list , treated symptomaticaly and improved.

Contact with the focal points of the health facility, the cases of suspected cholera were diagenosed Yaffa,Al Maqatirah,Al Qabbaytah,Al October public H,Alswaleha HU,Ibn Khaldoon clinicaly according to case definition. Hawtah,Al Musaymir,Tur Al 21 RDT positive and ather cases were negative Chol Lahj Hospital,Tour Albaha Hospital,Alwaht rural H,Radfan 92 0 Bahah,Tuban,Habil Jabr,Radfan,Yahr,Al the Cases reported lmmediatly to operation room, recorded in the line list. Public H,Yaher rural H,Alhasn HU,Other Had,Halimayn the Cases treated by iv fluid , ors and antibiotic. Cases finaly left the health facility.

Contact with the focal points , the cases of suspected measles were diagenosed clinicaly according to case definition. Meas Lahj Radfan,Tuban,Al Hawtah Radfan Public H,Alwaht rural H,Ibn Khaldoon Hospital 3 0 the Cases were vaccinated unknown except one case was vaccination the Cases added to the line list , treated symptomaticaly and left the health facility.

Immediate reports were recived by the focal points, the cases of suspected whooping cough were Pert Lahj Yaffa October public H diagenosed clinicaly according to case definition. 2 0 Cases registerd in the line list, treated symptomaticaly and left the health facility.

Contact with the surveillance coordinator , 3 cases of suspected Diphtheria were diagenosed clinicaly according to case definition. The membrane was clear, coverd the tonsills . Diph Lahj Al Had Alhaid rural H Cases were not vaccinated. 3 0 Cases treated by penicilline, reported immediatly to the operation room, recorded in the line list , contact also recorded in the line list , treated by erythromycine. RRT visited the area , vaccinated all missed children, Health education about the disease.

Khur Maksar,Dar Sad,Ash Shaikh Shifa Aden Dispensary,Al-Wali Hosp.,Alwahda eIDEWES team were contact by f.p, the cases were diagnostic clinically and investigation were done, treatment were given, most sampls were not collected,2 cases were dead DF Aden Outhman,Khur Maksar,Al Mualla,Al educational H,Aljumhuria educational H,Al Noor Hosp.,Al- 118 2

Mansura Salam Hosp.,Aden German Hosp.,Other

Al Mualla,Dar Sad,Ash Shaikh Albasateen medical center,Alwahda educational H,Al- eIDEWS team were contacted FP : rapid test were positive for 11 cases ,samples were collected for Chol Aden culture which were positive for one case 98 1 Outhman,Khur Maksar,Al Mansura Wali Hosp. treatment were given,one case was dead

eIDEWES team were contact fp, the case was diagnosed clinically, not sample was collected, treatment Pert Aden Al Mansura Dr.Muna Clinic 1 0 was given, investigation form was done

Al Mansura,Attawahi,Ash Shaikh Dr.Muna Clinic,Dar Saad Complex,Alwahda educational eIDEWES team were contact fp, the cases were diagnoses clinically,samples were collected, treatment Meas Aden 14 0 Outhman,Dar Sad,Al Buraiqeh,Sairah H,Albasateen medical center,Al Ryadah Hosp. were given , investgation form were done.

eiDEWS team were contacted fh :The cases were diagnosis clinically, treatment were given, Diph Aden Ash Shaikh Outhman,Sairah Alwahda educational H,Almaidan health complex 4 0 investigation from were done.

eIDEWES team were contact fp the cases were diagnosed clinically, no samples were collected, VHF Aden Al Mansura Aden German Hosp.Al-Wali Hosp.,Other 2 1 treatment were given,one case was dead

eIDEWS team contacted the F.P, 2 cases were vaccination and ather cases were un Meas Abyan khanfir,Sarar,Lawder Razi Medical Dispensary,Alhtat HU 3 0 vaccination,investigation done , Blood Samples collected and waiting for send to Sana,a city

Zunjopar H,Al Azi Dispensary,Al Mahfad Hospital,Amajl eIDEWS team contacted the FP, the cases diagnosed clinically (standard dengue case definition), the DF Abyan Zungobar,Lawder,Al Mahfd,khanfir 84 0 HC most samples were not collected, treatment were given, investigation forms were done

RRT in district visited the suspected cases of Cholera ,8 cases were positive by RT the cases diagnosed clinically, treatment were given, investigation form were done, the patient and their family Chol Abyan khanfir,Mudiyah,Sarar,Lawder,Al Mahfd Mahnf-Lwdr H,Al Mahfad Hospital,Mudiya Hosp.,Alrazi .H 43 1 received complete advices about the ways of prevention and management of cholera infection. the case included in Cholera line list, one case was dead

eIDEWS team visited the focal points,the cases were diagnosed clinically according to the standard Pert Abyan Lawder Al Azi Dispensary,Mahnf-Lwdr H case definition. all of them admitted in the hospital and take antibiotics & regular interest till complete 4 0 recovery, investigation form done

Sharab Ar Rawnah,Al Misrakh,Khadir,AlQahirahAlMaafer,Sama, Al Aroos Hospital,22 May HC,Ar Romah Rapid response team contacted also focal points by eIDEWS coordinator,cases diagnosed clinically Mawiyah ,AlMudhaffar center,Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Chol Taiz labs)for confirmation. Supplements & antibiotics treatment were given & RT were positive for 80 cases, 1377 2 ,Salh,SharabAsSalam,SabirAlMawadim Loqiah Hospital,22 May Almodafar HC,Mawih the results of stool C/s still pendingThere were collection & cluster of cases in the same Place,2 cases ,Maqbanah,AtTaiziyah AshShamayatayn Hospital,Alnshmh H,MSF Hospital,Other were dead Hayfan,AlMukha

Sabir Al Mawadim,Al Mudhaffar,Al eIDEWS coordinator contacted focal points and the coordinator of the directorate ,information's Meas Taiz Qahirah,Ash Shamayatayn,Sharab Ar Al Aroos Hospital,22 May H,Althwrh HC,Almkha Hospital shared,Blood samples were collected from the cases and sent for lab confirmation & 5 cases were 9 0 Rawnah,AlMukha vaccinated, All data in the line lis.

Focal points and the coordinator of the directorate were contacted ,, the suspected DF cases had a Althwrh H,Altawn H,Aljoumhri H,Mohammed Al-Dourah history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by DF Taiz Al Mudhaffar,Salh,Khadir,Al Qahirah blatelets counting, ,rapid test of dengue virus were done for some of cases ,,which were positive,, 85 1 HC Medications have been given,there are cluster of cases in some areas,All data in the line list,one case was dead

communicating with the coordinator of edews in the facility we founds these cases of suspicion of Pert Taiz Al Qahirah,Salh,At Taiziyah Yemeni - Suidi H,Al-Safwah Hosp.,MSF Hospital pertussis,the cases were from different areas. .. Action :these cases were treated at home . Advices 5 0 have been given to their parents to follow up and review..

receiving an immediate report from the coordinator of edews in the facility about these cases of Al Qahirah,Sharab Ar Rawnah,At suspicion of diphtheria ,the cases were diagnosed clinically as a suspected cases of diphtheria,we write Diph Taiz Yemeni - Suidi H,MSF Hospital all data about the case in the line list .. action :we inform the Rapid response team to visit the facility 4 0 Taiziyah which receive the cases and they found data recorded in the hospital and the cases were complained of fever and membrane in the throat and difficulty of swallowing,,after that the team have been visit the house of the patient and all that's in the line lis..

Rapid response team and Focal points were contacted by eIDEWS coordinator ,,,, information's shared, AFP Taiz Al Qahirah,Al Waziyah Mohammed Al-Dourah HC,Other samples were collected and will be send to sana'a, one case was vaccination and one case ather was 2 1 vaccination unknown,one case was dead

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 5 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019) Alert Responded in Epi - Week 31,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

The district RRT investigated the living area. The cases were diagnosed clinically by case definition as Bin Sena'a educational H,Hajar aljoul rural H,Alsadara suspected cholera. the cases were 3 brothers living in Almahatta zone in Maifaa area. Al cases were Chol Hadramout Broom,Al Mukalla City,Hajr males aged 13, 18 &23 years. RDT was done. it was negative in all of the 3 stool samples collected. no 26 0 HC,Other culture was done. All cases were treated by iv fluids, ORS and antibiotic. All cases improved. the cases drink from a follow water before onset of symptomes. The WASH RRT informed.

The EDEWS coordinator visited the health facility. The cases were diagnosed clinically by case definition. the cases were greater than5 years. one male and 3 females. The cases came from different DF Hadramout Al Mukalla City Bin Sena'a educational H 9 0 areas. RDT was done. it was negative in all of the samples collected. all cases were admitted to the hospital and treated with symptomatic treatment. all cases improved and discharged.

Immediate report was sent by the EDEWS focal person. The case was 11 months male from AlMukalla city. the case is diagnosed clinically as suspected measles. skin rash started in29_7_2019. the case is Meas Hadramout Al Mukalla City Al-ShishanHealth Center 1 0 vaccinated by age group(recieved the MR1 dose). no blood sample was collected. symptomatic treatment was given.

ArRadmah,Mudhaykhirah Badan,HazmAlUdayn,AsSabrah Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani Immediate notification. eDEWS Coordinator visited hospital, stool samples were collected and positive AlQafr,AlMakhadirAs Sayyani,Ash Hospital,Alradhmah H,Almakhader HC,Alqaidah H,AL by rapid test for 103 samples Chol Ibb 1882 5 Shair,An Nadirah,Jiblah,Al Dhihar Al Mzahan H,Yahsub Hospital,Aladin H,Mother and Child Udayn,Yarim,AlMashannah Hubaysh,As H,Other All cases were improved ,5 cases were dead Saddah, Far Al Udayn,Ibb,DhiAsSufal

Immediate notification by.eDEWS focal points,samples were collected,the Cases were Vaccinated Meas Ibb As Saddah,Yarim,Badan,Al Udayn Alsadah HU,Aladin H,Yahsub Hospital 7 0 ,They are from different areas.

Immediate notification by focal point. Case was diagnosed clinically and treated accordingly.case was Pert Ibb Yarim Yarim Hospital 1 0 Vaccinated

Immediate notification, samples were collected from cases and send to sanaa, the cases were AFP Ibb Al Dhihar,Jiblah Al Thawrah Hospital 2 0 vaccination

Immediate notification by focal point. Case were diagnosed clinically and treated accordingly and 2 case were recieved anti-toxin. one case was not Vaccinated .3 cases Unknown Vaccinated One cas wase Diph Ibb Al Mashannah Alnassr H 4 1 dead her nsme Wazerah Abdulkareem HAMOOD Saleh 48 months old from Al Dhale- Al Hasha. date onset of symptoms 31/7/2019 date of death 3/8/2019.Case wase Unknown vaccinatedd

Bura,AlMansuriyah AzZaydiyah,BaytAlFaqiahAl Qanawis, Ad Alsalakhana H,Alkanawes HC,Aldhahi Rural Dahi,Az Zuhrah, Al Hawak,Al Hali As H,Almansouria rural H,Bait Alfakih H,Alzaydia Rural eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Chol AlHodaidah treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use 3772 0 Salif,Al Munirah,Al Mighlaf,AlGarrahi H,Aljarrahi rural H,Alluheyah HU,Alhshm WHO protocol ORC, cases done rapid test for cases 78 cases positive Alluheyah,Kamaran, Jabal Ras,As Center,Althawra public H,Almekhlaf HC,Other Sukhnah,Zabid, Al Mina,Al Hajjaylah

eDEWS coordinator contacted the focal points, the cases were suspected measles the cases were un Meas AlHodaidah Al Hawak,Al Hali,Ad Durayhimi Ghalel HC,Alhodaidah Hospital,Althawra public H vaccination ,fever , rash recorded , the blood samples have been collected from the patient by district 6 0 coordinator and sent to the central laboratory in Sanaa.

Focal points were contacted , he informed us that the suspected DF cases had history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been DF AlHodaidah Al Qanawis,Hays Alkanawes Private H,Hikmah hospital started, samples were collected in the lab of hospital for testing by serological test ( NS1) which this test 14 0 measure the presence of dengue protein ( high sensitive & quality test) which detect the Antigen of virus that confirm the result. No cluster of three

Coordinator contacted the hospital focal points, the cases were diagnosed suspected Pret and treated Pert AlHodaidah Alluheyah Dir Yaseen HU accordingly, some cases have been two doses and the other have completed doses of vaccine , no 3 0 cluster of three cases in same place

Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane Diph AlHodaidah Ad Dahi, Al Hawak Aldhahi Rural H,Althawra public H around tonsillitis , and sever inflammation, the cases were un vaccination , the cases were diagnosed 10 0 clinically. Medications have been started, ALL cases only depend on case definition,

DEWS coordinator contacted focal points, The suspected AFP ,the cases were vaccination , stool AFP AlHodaidah Zabid,Hays Qadidah center,Hais rural Hospital 2 0 samples were collected and sent to the Central laboratory in Sanaa

Al Jamimah,Abs,Khayran Al eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, Information shared , The Muharraq,Hajjah Aldebh HU,Khatwah HC,Abs Rural Hospital,Public diagnosis were clinically (diphtheria) The response team in the field investigated the case and the Diph Hajjah City,Mabyan,Mustaba,Aflah Ash contacts and the appropriate treatment were given,the most cases were un vaccination,2 cases were 26 2 Republican Hospital,Aslam HC,Other Shawm,Aslem,Kuhlan Ash dead Sharaf,Mustaba,Kushar

Najrah,AshShahil,QaflShamerBaniQais,A lMiftah,Qarah Aslem,AlJamimah Public Republican Hospital,Khatwah HC,Qafl Shamer AflahAshShawm,Mabyan,HajjahCity,Abs, Kufl-Shamar Rural H,Bani Chamakh HC,Bani Qais Haradh,Hajjah Kuaydinah,AlMahabishah eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, Information shared .It have Chol Hajjah Health Center,Mabyan Hospital,Kuhlan Afar been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea) 1761 1 Kuhlan Affar,Mustaba,Bani Al HC,Almahabesha Public H,Alshahel Rural the cases from different area. It were given the appropriate treatment,one case was dead Awam,Kuhlan Ash Sharaf Al Hospital,Almaghraba HC,Other Maghrabah KhayranAlMuharraq AshShaghadirah

Wadhrah,Abs,Khayran Al eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts . Information shared,It were Aldwalia HU,Dr.Abdalh Assar Center ,Kuhlan Afar diagnosed clinically according to standard definition For measles , the cases were un vaccination except Meas Hajjah Muharraq,Mabyan,Aflah Al 8 2 HC,Other 2 cases were vaccination, Investigation form were Done.Appropriate treatment were given. The samples Yaman,Kuhlan Affar were collected and sent to the central laboratory,2 cases were dead

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, The case was diagnosed Pert Hajjah Ash Shaghadirah Alghareb HU 1 0 clinically according to the standard definition, and appropriate treatment was given

eDEWS coordinator contacted focal point, information shared, cases have been diagnosed clinically DF Hajjah Khayran Al Muharraq Martyr d. Yasser w Thab Hospital .According to the standard definition, Cases from different areas , Some cases have been rapid test 12 0 work and the result were positive

eIDEWS coordinator contacted focal points,informations shared,after that HF visited by eIDEWS coordinator.The case diagnosed clinically according to the case definition as suspected Almjd H,Jabr Bn Hyan Complex,As Sabin Hospital,22 diphtheria.Symptoms & signs of a case were,fever,sore throat,grey-whitish pseudo-membrane,swelling Diph Amana Shu'Aub,As Sabain,Maain,Bani Al Harith 7 1 May Hospital,Zaid bn Sultan H of neck lymph-nodes(Bull neck) & difficulty of swallowing & breathing. Antibiotic treatment was given & case management done.Throat swab & fixed slides were taken into Central Lab for confirmation,the cases were vaccination,one case was dead

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Thi - Yzan for mother and child center ,Omar Al Mokhtar clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab Aththaorah,Shu'Aub,Assafi'yah,BaniAlHar Complex,Bni - Hwath HC,Arwdhah H,As Sabin (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana ith,AsSabain,MaainAz'zal,At Hospital,Jddr HC,22 May Hospital,Alwahda Health of them were from Amana governorate & a few of them from other governorates ,different districts of that 2128 1 Tahrir,Sana'a Old,AlWahdah Center,Alrazi HC,Al Jraf Complex,Jabr Bn Hyan governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most Complex,Gazah Complex,Other collected specimens,so stool C/s not done for that negative samples.There were a collection or cluster of cases seen in the same Place,one case was dead

Omar Al Mokhtar Complex,ALSONINH eIDEWS coordinator contacted focal point,information's shared,then HF,then cases visited by eIDEWS Shu'Aub,Az'zal,Assafi'yah,Maain,Bani Al coordinator & Blood samples were collected from the cases and sent for lab confirmation & the onset of Meas Amana COMPLEX,Gazah Complex,Jddr HC,Alrwdh 17 0 Harith,Al Wahdah,As Sabain fever,skin rash,the cases were un vaccination, & Vit-A were given to the suspected cases,in order to HC,Alshaheed Complex,Other improve their immunity against measles.

eIDEWS coordinator contacted focal point,information shared,The cases diagnosed clinically according Pert Amana At Tahrir Alkwit educational H,Aljomhwri H to the case definition. Antibiotic treatment were given,the cases were unvaccinated against Pertussis. 2 0 There were no collection of cases seen in the same place.

eIDEWS coordinator contacted focal points,then HF visited. Information shared,Stool samples collected AFP Amana Assafi'yah,As Sabain Althwrh H,As Sabin Hospital from the cases and sent for lab confirmation,the cases were vaccination,There were no collection of 4 1 cases seen in the same place,one case was dead This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 6 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019)

Alert Responded in Epi - Week 31,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

the edews focal points contacted , the cases were diagnosed clinically according to the standard case Diph Sa'adah Majz,Sa'da ,Haydan Al Jumhoori Hospital,Haydan Hospital definition ,the cases referred to the Diphtheria isolation, the cases receive the proper management , the 9 0 contacts traced by the district RRT , the line list updated and the information shared

Munabbih,Razih,Adh Dhahir,Sa'da Monabbih Rural Hospital,Ghafira Unit,Al Jumhoori eIDEWS focal points contacted , all cases are diagnosed clinincally ,the cases were tested by RDT ,10 Chol Sa'adah Qatabir,Baqim,Al Hospital,Qatabir Health Center,Ghamer Health cases were positive by RDT . not samples were collected for culture the line list updated and the 511 0 Hishuah,Majz,Sahar,Ghamir Center,Other information shared

Pert Sa'adah Majz Majz Health hospital 1 0

Majz Health hospital ,Saqayn Hospital,Al Jumhoori eIDEWS contacted to respond to cases suspect measles , the HF visited the cease, all ceases Meas Sa'adah Majz,Saqayn,Sa'da 16 0 Hospital dignosed callinically ,the cases were un vaccination

As Sudah,Thula,Kharif,Dhi Bin,Iyal Kharif Rural Hospital,Thula Health hospital,Al Salam Eidews Coordinator Contact the Coordinator of Surveillance in Districts ,The cases were diagnosed Chol Amran clinically as suspected cholera. according to case definition Rapid Test were done for some cases 701 0 Surayh,Raydah Khamir Hospital,Raydah Health hos.,Other the result were positive and some cases negative . All The cases improved After Taking The Treatments

Bani Eidews Coordinator Contact the Coordinator of Surveillance in Districts and visit health center Raydah Health hos.,Al Salam Khamir Hospital,Hababah damag.and investigation, the Case Were diagnosed clinically as suspected Measles, According to Case Meas Amran Suraim,Raydah,Thula,Shaharah,Khamm 12 0 Health Center,Other Definition, Blood Samples Were Collected Of Patient and Sent To Central Lab in Sanaa,the Cases were er,Jabal Iyal Yazid Vaccinated except 2 cases were un vaccination Against Measles.

Eidews Coordinator Contact the Coordinator of Surveillance in Districts and visit health hospital and Pert Amran Khammer,Huth Al Salam Khamir Hospital,Huth Health hospital investigation, The cases were diagnosed clinically as suspected pertussis. according To case 5 0 definition,The Cases Improved After Taking the Treatments Antibiotics.the cases from districts others

Bani Hushaysh,Al Haymah Bani Mansour HC,Al wheda Manakha rural Hospital AlKharijiyah,AlHusn,Nahm ,Awmara H,22 May Hospital ,Ka'a Alreka HC,Sa'afan BaniDhabyan,Khwlan Rapid Response team visited area according to cases definition suspected cholera, 383 cases were Chol Sanaa Governorate HC,Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital 2478 0 Manakhah,Hamdan positive rapid test cholera and cases are recoreded in line list ,the cases from deifferant area ,Almarbak HC,Almanar Hospital,Bait Alrejal HC,Walan BaniMatar,AlHaymahAlKharijiyah,Jahanh, Hospital,Other BiladARus,Arhab Sa'fan,Attyal,Sanhan

22 May Hospital ,Al wheda Manakha rural Hospital Rapid Respose team visited area according to case definition suspected Diphteria ,2 cases were Diph Sanaa Governorate Hamdan,Manakhah,Bani Matar vaccinated and one case was un vaccination but one case ather was vaccination unknown,appropriate 4 0 ,26September H in Matna treatment given to cases

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Pert Sanaa Governorate Al Haymah Ad Dakhiliyah Kuwait Center 2 0 definition,the cases were vaccination unknown, The cases were treated with antibiotic.

The EDEWS coordinator contacted the focal person, The cases were diagnosed clinically by case Meas Sanaa Governorate Bilad Ar Rus,Al Haymah Ad Dakhiliyah Walan Hospital,Alar rural H definition. Skin rash started , one case was vaccinated and one case ather was un vaccination,blood 2 0 samples were collected.

Hateeb,Habban,Mayfa'ah,Ataq,Rodhoom eIDEWS coordinator were contacted the health facilities, they founds cases suspected case of Chol Shabwah Al-Noor Clinic,Emergency/Ataq Hospital,Bayhan Hospital cholera,the cases were diagnosed clinically according to case definition, the most cases were rapid test 25 0 ,Baihan ,one case was positive byRT,treatment and improvement

Bayhan Hospital,Rudum Rural Hospital,Al Wafa eIDEWS coordinator was contacted the health facilities,they founds cases suspected cases of dengue DF Shabwah Baihan,Rodhoom,Ain,Ataq fever,the cases from different areas, the cases were diagnosed clinically according to case definition, 42 1 Clinic,Ain General Hospital rapid test were positive,the cases were treated and improved,one case was dead

eIDEWS coordinator was contacted the health facilities, theys founds suspected cases of pertussis, the Pert Shabwah Ataq,Rodhoom, Azal HC,Rudum Rural Hospital,Al Wafa Clinic cases were diagnosed clinically according to case definition,the cases were un vaccinatiin, all cases 8 0 were received their best treatment and improvement.

AsSawadiyah,AtTaffah Mukayras,WaldRabi',SabahNati,DhiNa'im Alswmah HC,Thi - Naem HC,Areeb HC,Alarsh eIDEWS team contacted focal points, the cases were diagnosed clinically as suspected cholera usin77 Chol Al-Baidha ,ALSharyah AlMalagim AlA'rsh,Radman center,Althwrh Hospital,Al-Taffah Center,Mukayras positive the main saing watery diarrhea &vomting some dehydration the paitnts ademittedt in Centers 841 1 Al Awad,Al Quraishyah,Al Hospital,Other and with ORS and IV fluid in good condation the cases from deferrnt organ,one case was dead BaydaCity,ArRyashyyah Maswarah

IDEWS team contacted points information shared , the cases were diagnosed clinically according to Meas Al-Baidha AlBaydaCity,DhiNa'im, Naman Althwrh Hospital,Thi - Naem HC 4 0 case definition, Antibiotics treatment were given,the cases were un vaccination

DEWS team contact Edews focal points in ` Country Hospital ,the cases were diagnosis according to Chol Al-Mahra Qishn,Huswain,Al Ghaydah Qishn Country Hospital,Al Ghaydah Center Hospital case defination , susspected Cholera cases in line listing and send daily to central level ,Cholera rapid 18 0 test was +ve ,then sample send to culture , treatment were given to cases

edews team contact focal points , the cases were diagnosed clinically as suspected (meas) using case definition , Meas Hadramout wady Al Qatn,Sayun Alkutn Public H the cases were vaccination, blood samples collected 2 0 . symptomatic treatment were prescribed

Taibah hospital,Alkharba rural H,Almajel HC,Aljarf Utmah,DhamarCity Dawran HC,Dawran Hospital,Dhamar public H, Bani hutam Aness,Wusab Al Ali,Wusab As HC,Wathan HU,Dheba HC,A Unity Centre Edews coordinator contacted focal points, they found cases diagnosed suspected Chol(Acut watery Chol Dhamar Safil,Mayfa'at Anss,JabalAshsharq diarrhoea and dyhadretion) 61 cases tested by rapid test And result were postive - all cases received 1251 0 (residential),bny salamh Unite,Kharbah Abuyabes AlManar,Jahran,Anss treatment HC,Alhumyat HC, AlMasli Hospital,Alwahda university MaghiribAns,AlHada H,Zeraja rural H,Hamam Ali Hospital, Other

Pert Dhamar Wusab Al Ali,Dawran Aness AlRa'adi HU,Bin alakwa'a Dispensary Edews coordinator contacted focal points, they found cases diagnosed suspected pert 6 0

Edewds coordinator contacted of the focal points and they founds that the cases were diagnosed according to the standard definition of Meas, the cases were un vaccination Meas Dhamar Al Hada,Dawran Aness Zeraja rural H 5 0

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 7 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 31 (29 July-04August,2019)

Alert Responded in Epi - Week 31,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Al Jubah,Al wadi,Sirwah,Bid May 22 Hospital,Qaniah Health CENTER,Bid Bidah clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb 27 0 Bidah,Mahliyah,Madkhal Hospital Supplements & antibiotics treatment were given,,the results of stool Rapid tests of cholera 8 positive ,.There were a no collection or cluster of cases seen in the same Place

the contacted the contact and told us that suspected dengue cases had a history of high fever, back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for DF Mareb Al Jubah,Al wadi May 22 Hospital,( al Wahdah ) Hospital 14 0 serological testing (NS1). This test measures the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result

Meas Mareb Harib Al Qaramish Harib Al Qaramish Hospital 1 0

Khob Wa Asha'af,Al Hamidat,Al Ghayl,Al Al Maton Health Center,Al Hazm Hospital,Al Humaydat Matun,Al Hazm,Rajuzah,Al Maslob,Al Health Center,Bart Rajuzah Hospital,Bart Al Anan Rural The EDEWS Coordinator received a report from the control officer that there were cases of the doctor's Chol Al-Jawf diagnosis. It were cholera, the cases negative by rapid test but 14 cases positive , the cases from 323 0 Matammah,Kharab Al Marashi,Bi'rat Al Hospital,Al Marashi Health Center,Hosoon Aal Shanan different areas, Treatments were treated according to the treatment plan Anan Health Center,Other

EDEWS team contacted focal points ,the Cases diagnosed clinically as suspected pert,treatments were Pert Al-Jawf Rajuzah,Al Hazm Bart Rajuzah Hospital,Other 8 0 given, the cases were un vaccines

Al Khalq Health Center,Al Kasmi (Al Marfaqi Aal Qassim) The EDEWS coordinator has contacted the coordinator, The condition were diagnosed clinically by Meas Al-Jawf Al Khalq,Az Zahir definition of the condition, Blood samples were not collected,Symptom therapy and antibiotic giving were 2 0 Health Unit given and vitamin A

Altawilh HC,Bni Alhmadi HU,Mlhan Health Center,Alrujm Shibam Kawkaban,Hufash,Bani eIDEWS coordinator contacted focal points, information were shared. the cases were diagnosed Hospital,Bani Sa`d Hospital,Shbam H,Alrujm clinically according to case definition,the cases were investigated by rapid test for vibrio cholera and the Chol Al-Mahweet Sa'd,AlMahwaitAl,Khabt,ArRujum,At 482 0 Hospital,Alkhpt H,Hufash H,Alahjer HC,Swaq Alahd result were positive for 6 cases, appropriate treatment were given according to severity of symptoms Tawilah,Al Mahwait City,Milhan, HU,Other and dehydration

eIDEWS coordinator contacted focal points, information were shared. the cases were diagnosed Pert Al-Mahweet Hufash,Shibam Kawkaban Hufash H,Shbam H 4 0 clinically according to case definition,the cases were un vaccination but one case was vaccination

eIDWES coordinator contacted focal points, information were shared. The cases were diagnosed Meas Al-Mahweet Al Mahwait Al Arkob HC clinically according to case definition, investigated and collected blood samples ,skin rash were appear, 1 0 the cases were vaccination

Mazhar, Kusmah,As Salafiyah,Al Althulaia H,Al Arkob HC,Wadi Alarid HC,Almithaq eIDEWS coordinator contacted focal points, information were shared. all cases were diagnosed clinically Chol Rayma according to case definition, appropriate treatment were given according to severity of symptoms and 159 1 Jabin,Bilad At Ta'am,AlJafariyah H,Alqssia HC,Alathneen Alrahb Center ,Other dehydration,one case was dead

case -nameNawaf Nabil Ali Hassan Abubaker appat Date of paralysis 28 /2019 -age36 maont - / 15 8 AFP Rayma Bilad At Ta'am Ruas HC /2019 coordinater contact wth focal point stool sample collected 20/8/ 2019 and sent at or lab 1 0 confirmation,the case was vaccination

Al Azariq,Juban,Al Husha,Damt,Ad Aamwr HU,22 May Hospital,Daglal Health eDEWS team contacted FP , all diagnosed according to case definition, all included in updated daily line Chol Al-Dhale 166 0 Dhale'e,Al Hussein,Qa'atabah Center,Alnassr H,Other listing

eIDEWS team were contacted fp: The cases were diagnoses clinically, vaccination were done, Meas Al-Dhale Jahaf,Ash Shu'ayb Alazlh HC,Other 2 0 samples were collected , treatment were given, investigation form were done.