Epidemiological Week No. 25 (14 -20 June 08) July 8/ Vol. 135/ DEWS 2008-25
Bagh: WHO Surveillance officer during investigation of AWD alert in Thub, Bagh. Picture credit: Dr. Majid Bhatti Reporting Units ...... 2 Total number of consultations...... 2 DEWS Data, Epidemiological Week No. 25, 2008 ...... 3 DEWS Data, (Epidemiological Weeks No.22 – 25, 2008):...... 4 Acute Diarrhoea and suspected Cholera: ...... 5 Acute Respiratory Tract Infections: ...... 7 Upper and Lower Respiratory Tract Infection:...... 7 Other Conditions under Surveillance: ...... 8 Outbreak Alert and Response...... 8 Number of reported cases and deaths per District, AJK ...... 10 Number of reported cases and deaths per District, NWFP ... 11
In week 25, a total of 73,132 All the earthquake affected districts consultations were reported from 278 reported higher proportion of reporting units consultations for Acute Diarrhoea
Seven alerts were received and ARI remains the leading cause of investigated accordingly consultation this week and the weekly trend is on decline None of the alerts was found to be an outbreak Acute Diarrhoea was reported in 11% of all consultations, similar to reports from last week.
The Weekly Morbidity and Mortality Report (WMMR) is published by the Ministry of Health of Pakistan (MOH) and the World Health Organization (WHO). The WMMR is built on surveillance data that health service providers and NGOs transmit on a weekly basis from health facilities and hospitals in those areas affected by the earthquake that struck Pakistan on 8 October 2005.
The WMMR objectives are to monitor the trend of health conditions over a period of time and provide vital information to all health partners. The WMMR is only a snapshot of the health conditions in those facilities where events are registered and data collected and does not necessarily reflect the situation from other health facilities.
The WMMR is a publication that has been developed for emergencies and previously used in other areas such as the Darfur Crisis.
The WMMR is produced with the financial support of AAI Australia, Americares, CIDA, Denmark, DFID, ECHO, Ireland, Italy, Japan, Korea, Monaco, Norway, SIDA, Slovak Republic, Switzerland, Turkey, USAID
The WMMR is published by the World Health Organization (WHO), Health Emergency Operation Centre, National Park Road, Chak Shahzad, Islamabad, Pakistan. For More Information, please contact: Dr. Rayana Bouhaka, Manager Operations, WHO/EHA/Pakistan; [email protected] or Dr. Birjees Mazher Kazi, Chief, Public Health Laboratories Division, NIH MOH; [email protected] or WHO Webpage: http://www.whopak.org/disaster WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Reporting Units
During week 25, 2008, total 278 (83%) weekly reports were received from the DEWS reporting sites on the due time. Compared to last week, the DEWS reporting has increased by 2% this week (81% and 83% respectively). The total number of reporting sites in the Earthquake affected districts remains 335 as of week 25, 2008. Table 1, summarizes reporting by each earthquake affected district for the last 4 weeks.
Table1. Heath Facilities by district, reported from Earthquake Affected Areas, Pakistan, 24May -20 June 2008. Reporting Health Facilities 31May-6June 14-20 June 24-30 May 08 7-13 June 08 Area Population 08 08 Week-22 Week-23 Week-24 Week-25 Bagh 452,532 36 33 35 36 Battagram 592,256 32 30 33 36 Mansehra 1,154,804 65 62 64 64 Muzaffarabad 770,000 73 70 65 71 Neelum 184,000 19 19 17 15 Poonch 633,712 63 63 57 56 Total 3,727,668 288(86%) 277(83%) 271(81%) 278(83%)
Total number of consultations
During week 25, a total 73,132 patient consultations were reported, an increase by 7% compared to last week. Similar to the prior weeks, the district Muzaffarabad reports the highest proportion (35%) and Neelum reports the lowest proportion (3%) of the total consultation reported from all the earthquake affected districts. Neelum is the smallest district with the least number of DEWS reporting sites among all the districts in the earthquake area. Figure 1 depicts the pattern of weekly reporting units participating in the DEWS and the total number of weekly consultations reported from week 1, 2007 to week 25, 2008. Overall there seems to be a decline in consultations starting from week 49 onwards compared to the previous weekly pattern. This decline in trend could be a result of several reasons which are being investigated.
Figure1. Weekly trend of reporting units and total number of consultations, Earthquake Affected Areas, Pakistan, Week 1, 2007 – week 25 2008. # of Units Weekly pattern of reporting consultations # of Cns 350 120000 Reporting Unit Consultations 300 100000 250 80000 200 60000 150 40000 100
50 20000
0 0 W05 W09 W13 W17 W21 W25 W29 W33 W37 W41 W45 W49 W05 W09 W13 W17 W21 W25
W01/07 Epi-week W01/08
2 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
DEWS Data, Epidemiological Week No. 25, 2008
During the Epidemiological week 25 (14 – 20 June, 2008), a total of 73,132 consultations were reported through DEWS. The distribution of consultations by age groups indicate that 19% are children less than 5 years of age, 20% are children 5-14 years of age, 41%, the majority, are adults 15-45 years of age, and 20% are adults above 45 years age. Of the total consultations reported for week 25, 53% were from female patients. The proportion for Upper Respiratory Tract Infection was 15%, Unexplained Fever 9%, Acute Diarrhoea 11%, Lower Respiratory Tract Infection 4% and Scabies 5% in all age groups and both sexes. Out of the total 73,132 reported consultation in all ages and both sexes, 55% (40,529) accounted for health problems other than the diseases reported above. See (Figure 2).
Figure 2.Distribution of reported consultations by disease/health event and age groups, 14 to 20 June 2008, Earthquake Affected Areas, Pakistan Distribution of consultations by age Distribution of consultations by diseases 45 AD BD 40 11% 41% URTI <1% LRTI 35 15% 4% 30 MA L UF <1% 25 9% 20 19% 20% 20% 15 SCB consultations Percentage of 10 5% 5 0 <5 5-14 15-44 ≥45 OTH 55% Age-group
*OTH includes all other reportable conditions, plus all other consultations for conditions not under surveillance
Comparison of consultation by sex shows that in female patients, health events other than the five common communicable diseases are reported higher than males (58% and 52% respectively). In males, the proportion for Acute Diarrhoea and URTI and Scabies were higher than for females. The proportion of consultations for UF, LRTI and Malaria are the same in both males and females. (Figure 3)
Figure 3.Distribution of reported consultations by disease/health event and age groups, 14 to 20 June 2008, Earthquake Affected Areas, Pakistan
Distribution of consultations (Male) Distribution of consultations (Female) AD AD BD URTI 12% URTI 10% BD LRTI <1% LRTI 16% 14% <1% 4% 4% MAL MAL UF <1% UF <1% 9% 9% SCB SCB 4% 5%
OTH OTH 52% 58%
3 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Disease Distribution by Age:
Acute Upper Respiratory Tract Infections (URTI) is the highest reported disease in all age groups during week 25. In children less than five years of age Upper Respiratory Tract Infection was reported in 21% of the consultations, followed by Acute Diarrhoea (AD) 20%, Unexplained Fever 10%, Lower Respiratory Tract Infection (LRTI) 4%, Scabies 4% and other health problems 39%. In children 5 to 15 years of age Upper Respiratory Tract Infection was reported in 18% of the consultations followed by Acute Diarrhoea 12%, Unexplained Fever (UF) 10%, Scabies 6%, Lower Respiratory Tract Infection 5% and other health problems 47%. In both adult age groups, 15-45 years and above 45 years, the proportion of the other health problems is higher than reported for children, followed by URTI. The proportion of the remaining reported communicable diseases in adults is lower than reported in children. Figure 4 presents the comparisons of the reported consultation by age groups.
Figure4. Proportion of primary causes for all reported cases by age groups, 14 – 20 June 2008, Earthquake Affected Areas, Pakistan,
SCB AD SCB AD MAL 4% 20% MAL LRTI 4% 7% <1% <1% 3% LRTI OTH 4% URTI SCB AD MAL SCB AD MAL 39% 12% 4% 7% M<1%LRTI 6% 12% <1% LRTI 5% 5% UF URTI URTI OTH 7% 12% URTI 21% 66% UF 18% 10% OTH UF OTH 59% < 5yrs (n=14,247) 47% ≥15 - ≤44yrs (n=29,730) 11% UF 10% 5 - <15yrs (n=14,313) ≥ 45yrs (n=14,842)
*OTH includes all other reportable conditions, plus all other consultations for conditions not under surveillance
DEWS Data, (Epidemiological Weeks No.22 – 25, 2008):
During the period 24 May to 20 June, 2008 (Epidemiological weeks 22 to 25, 2008 ), a total of 286,885 consultations were reported in the Earthquake affected areas. The proportion of the five common diseases under surveillance was, 46% (131,031) of the total consultations reported during this period. This proportion remains almost consistent for the last four weeks. During this period 16% (46,956) of consultations were due to Upper Respiratory Tract Infection (URTI), 9% (26,703) Unexplained Fever (UF), 10% (28,804) Acute Diarrhoea (AD), 4% (12,488) Lower Respiratory Tract Infection (LRTI), and 5% (13,340) due to Scabies (SCB). Acute Jaundice Syndrome was reported in 58 consultations and Bloody Diarrhoea was reported in 1215 consultation during this period.
A total of 84 deaths were reported during this period. Most (85%) of the total reported deaths were due to health events other than the diseases under weekly surveillance. Nine deaths due to Lower respiratory tract infection, all under five years age, were reported in last four weeks, four from Mansehra, two from Muzaffarabad, three from Poonch, and one from Bagh district; resulting in a total LRTI case fatality of 0.072%. Four deaths were reported due to acute diarrhoea during the last four week period and the total case fatality for AD stands at 0.014%. No deaths were reported from any other disease under weekly surveillance during this four week period.
4 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Table 2. Weekly distribution of reported cases, deaths and monthly Case Fatality Rate (CFR), Earthquake Affected Areas, Pakistan, Week 21 - 24, 2008. Week WEEK 22 WEEK 23 WEEK 24 WEEK 25 TOTAL CFR% Event C D C D C D C D C D AD 7227 1 6853 2 6832 0 7892 1 28804 4 0.014 SC 0 0 0 0 0 0 1 0 1 0 0.000 AFP 2 0 0 0 0 0 0 0 2 0 0.000 AJS 19 0 9 0 14 0 16 0 58 0 0.000 BD 313 0 310 0 281 0 311 0 1215 0 0.000 LRTI 3596 0 3136 2 2904 4 2852 3 12488 9 0.072 MAL 354 0 392 0 333 0 383 0 1462 0 0.000 MG 0 0 0 0 1 0 0 0 1 0 0.000 MS 0 0 0 0 1 0 0 0 1 0 0.000 OTH 38533 11 39036 17 37756 20 40529 23 155854 71 0.046 SCB 3429 0 3268 0 3267 0 3376 0 13340 0 0.000 UF 6758 0 7024 0 6296 0 6625 0 26703 0 0.000 URTI 13334 0 11573 0 10902 0 11147 0 46956 0 0.000 Total Cons. 73565 12 71601 21 68587 24 73132 27 286885 84 RU 288 277 271 278
Acute Diarrhoea and suspected Cholera:
During week 25, 2008, Acute Diarrhoea was reported in 7,892 patients accounting for 11% of the total consultation in all age groups. In children less than 5 years of age Acute Diarrhoea was reported in 20% of the total consultations, a less than 1% change compared to week 24. In children 5 to 14 years of age, 12% of the consultations were for AD. In the adult age groups, 15- 45 years and above 45 years of age, AD consultations were reported as 7% for each group, out of the total consultations. From week 16 onwards, the proportion of Acute Diarrhoea weekly consultations are increasing gradually, representing the usual seasonal pattern of the disease in the area. In week 25 the proportion of AD has risen slightly compared to week 24. Generally, the weekly trend of AD from weeks 1 to 25 depicts a similar pattern as the last three years (Fig 6). There was one suspected case of suspected cholera reported from Bagh district.
Figure 5: Trend in Acute diarrhoea as a percent of all consultations, weekly comparison by years, Earthquake Affected Areas, Pakistan, Weekly comparison of acute diarrhoea (Year 05, 06, 07 and 08) 18 16 14 12 10 8 6 consultations
Percentage of all 4 2 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Epi-week 2005 2006 2007 2008
5 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25 In general there is an increasing trend of Acute Diarrhoea in all districts depicted for the last few weeks. When comparing the trends of Acute Diarrhoea by district from Week 1 to 25, 2008, Battagram and Neelum report the highest proportion of AD throughout the period and present a fluctuating pattern of cases. However, there is neither the indication of case clustering nor does the situation look like an epidemic reported from any part of the districts. Due to the seasonal increase in diarrhoeal disease, indicated by the disease pattern, the health cluster partners have started to take measures and conduct activities on prevention and control of diarrhoea diseases and are vigilantly monitoring the Acute Diarrhoea situation in their respective districts. (Fig 6)
Figure 6: Trend in Acute diarrhoea as a percent of all consultations, comparison by districts weeks 1-25, 2008, Earthquake Affected Areas, Pakistan Weekly trend of acute diarrhoea by district 16 14 12 10 8 6 consultations
Percentage of all 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Epi-week BAGH BATTAGRAM MA NSEHRA MUZAFFARABAD NEELUM POONCH
Bloody Diarrhoea:
During week 25 of 2008, total 311 cases of Bloody Diarrhoea were reported from all the districts, which is comparatively higher than the total BD consultation reported during the previous week. The overall proportion of reported Bloody Diarrhoea is very small for all the weekly consultations with a little weekly fluctuation. When comparing the weekly trend of the BD by districts, District Battagram, Muzaffarabad and Neelum report slightly higher proportion compared to other three districts with a weekly fluctuating pattern of the disease. The WHO team along with DoH and Health Partners have conducted a thorough assessment of the BD situation in these districts and preventive measures have been initiated. The probable explanation for the relatively higher proportion in these three districts is the consumption of contaminated water and poor hygienic practices (Figure 7).
Figure 7: Trend in weekly Bloody diarrhoea as a percent of all consultations, comparison by district, Earthquake Affected Areas, Pakistan, Weekly trend of bloody diarrhoea by district 2.00 1.80 1.60 1.40 1.20 1.00 0.80
consultations 0.60 Percentage of all 0.40 0.20 0.00 12345678910111213141516171819202122232425 Epi-week BAGH BATTAGRAM MA NSEHRA MUZAFFARABAD NEELUM POONCH
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Acute Respiratory Tract Infections: During week 25, 2008, a total of 13,999 consultations for ARI (both Upper and Lower Respiratory Tract Infection) were reported. ARI accounts for 19% of the total consultations reported for the week (URTI 15% and LRTI 4%) and are still the leading cause of consultations for all age groups, among all the diseases under surveillance. For the current week, in children less than 5 years of age URTI was reported in 21% and LRTI in 4% of consultations. In the 5 to 14 year age group URTI was reported in 18% and LRTI in 5% of consultations. In the 15 to 45 year age group URTI was reported for 12% and LRTI for 3% of consultations. In the age group above 45 years URTI was reported for 12% and LRTI for 5% of consultations. Generally, children experience more URTI than adults. Additionally, the proportion of ARI in male patients was reported higher compared to females. The weekly trend of ARI for the same weeks (from week 1 to 25) from the last two years display a similar trend to that of 2008. The overall ARI trend, from weeks 10 to 18 remain consistent with a little weekly fluctuation in the earthquake affected districts. However, the proportion of ARI from weeks 12 to 25 in 2008 remains slightly higher than the same period in 2006 and 2007 (Fig 8). During week 25, 2008 there were 2,852 consultations for Lower Respiratory Tract Infection.
Figure 8: Comparison of ARI weekly trends of year 2005, 2006, 2007 and 2008, Earthquake affected districts Pakistan Weekly ARI trend, comparison by year (05, 06, 07 and 08) 40 2005 2006 2007 2008 35 30 25 20 15 consultations
Percentage of all 10 5 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Epi-week
Upper and Lower Respiratory Tract Infection:
During week 25, 2008, taking into account all of the age groups reported through the DEWS system, 4% (2,852) of the consultations were for Acute Lower Respiratory Tract Infections and 15% (11,147) were for Upper Respiratory tract. The proportion of consultation for ARI remained almost consistent from week 10 to 15. However, there is an overall declining trend in both Upper and Lower Respiratory Tract Infection from week 16, 2008 onwards. (Figure10).
Figure 10: Weekly Proportion of URTI and LRTI as percentage of all consultations, (week 1 – 25, 2008) Earthquake Affected Areas, Pakistan Weekly proportion of ARI (Week 1-25, 2008) 30 LRTI URTI 25
20
15
10 consultations
Percentage of all 5
0 12345678910111213141516171819202122232425 Epi-week
7 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Malaria: In week 25, 2008, there were 383 suspected cases of malaria reported. District Poonch remains the district which reports the highest number of suspected malaria case compared to the other districts. In comparison to last week, the proportion of suspected malaria cases has increase in the district of Bagh, however, there has been a decrease in cases in the districts of Poonch and Battagram (Fig 9). There were no associated deaths due to suspected malaria reported from any district. Compared to the same weeks in the last two years, the percentage of malaria cases in 2008 is lower.
Figure 9: Weekly trends in Suspected Malaria as percentage of all consultations, comparison by district, Earthquake Affected Areas, Pakistan, weeks 1-25, 2008 Weekly trend of Malaria by district 1.8 1.6 1.4 1.2 1 0.8 0.6 consultations
Percentage of all 0.4 0.2 0 12345678910111213141516171819202122232425 Epi-week BAGH BATTAGRAM MA NSEHRA MUZAFFARABAD POONCH
Other Conditions under Surveillance:
During this week, 40,529 (55%) consultations out of the total 73,132 consultation, in all ages and both sexes, were for health problems other than reportable diseases under weekly surveillance. There were 16 cases of Acute Jaundice Syndrome and no cases of suspected AFP reported from any district. Additionally, there were no cases of suspected Hemorrhagic Fever or Neonatal Tetanus reported from any district for week 25, 2008.
Outbreak Alert and Response1
During week 25, 2008, a total of 7 alerts were identified/ reported and were responded to accordingly.
Bagh:
Suspected Cholera
CD Thub, Bagh reported one case of suspected Cholera. WHO surveillance team investigated the case, the patient is a 50 year old male resident of village Khissa Farooqabad, Bagh, who developed sudden onset of profuse watery diarrhoea, nausea and vomiting one day prior to admission. The patient was referred to DHQ hospital Bagh for further management. WHO surveillance team visited the village for active surveillance and water quality testing was done of all the water sources which were open unprotected natural springs. On active surveillance no more cases were identified in the family or community.
1 Outbreak Investigation and response of Suspected Viral Hepatitis, Malaria, and Bloody Diarrhoea and Watery Diarrhoea would only take place when a cluster of cases is identified or there is an increase in the incidence of the disease. (Note: Single death due to Diarrhoea and single case of reported severe dehydration among >5 years would be investigated) 8 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Battagram
Acute Watery Diarrhoea
An increase in number of acute diarrhoea cases was reported from health facilities from Battagram and Shangla. Although acute diarrhoea has slightly declined since last week , these particular sites have shown an increase in the number of cases. .However, all the cases were sporadic. Health education sessions were conducted within the community and aqua tabs were distributed as a precautionary measure. The problem lies with the open water sources and the storages. After each rainfall, it becomes muddy and the cases were increase. The issue was discussed with the EDOH and he assured to further increase the health education messages regarding clean drinking water practices through the LHW programme.
Mansehra
Two cases of suspected Malaria and one case of suspected bloody diarrhoea were reported this week from Mansehra district. There is no clustering of cases and there is no outbreak from any disease.
Muzaffarabad
Three alerts received from district Muzaffarabad this week.
One alert of acute diarrhoea / suspected cholera was received from Muzaffarabad General Hospital. This alert was due to possible contamination of the spring source during the rains. All the suspected cases have recovered and there were no more cases in the community.
Meningitis
Four cases of suspected meningitis were reported by AIMS hospital. All the cases were found to be sporadic with no clustering. Of the four cases, two of them were male and two female. The two female patients expired, their CSF was drawn and lab results are suggestive of tuberculosis meningitis. The other two patients were treated successfully and discharged.
Measles
One case of suspected measles was reported by BHU Patikka. WHO surveillance team investigated the case, collected sample and sent it to NIH for laboratory testing. Mopping of the area was done by the DoH through EPI staff.
9 WMMR Weekly Morbidity and Mortality Report Pakistan 8 July 2008 / Vol. 135/ DEWS 2008-25
Number of reported cases and deaths per District, AJK
Table 3. Number of reported cases and deaths, Bagh District*, Earthquake Affected Areas, Pakistan, 14 -20 June 2008.
AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 22 657 0 0 0 18 0 0 0 115 0 1405 0 76 0 0 0 0 0 0 0 253 0 242 0 1 0 5747 0 23 444 0 0 0 22 0 0 0 32 0 907 0 28 0 0 0 0 0 0 0 173 0 131 0 0 0 3921 1 24 561 0 0 0 19 0 0 0 46 0 937 0 66 0 0 0 1 0 0 0 196 0 138 0 0 0 4326 0 25 710 0 1 0 26 0 0 0 48 0 1121 0 50 0 0 0 0 0 0 0 235 0 133 0 0 0 5352 0 Total 2372 0 1 0 85 0 0 0 241 0 4370 0 220 0 0 0 1 0 0 0 857 0 644 0 1 0 19346 1
Table 4. Number of reported cases and deaths, Poonch District*, Earthquake Affected Areas, Pakistan, 14 -20 June 2008.
AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 22 931 0 0 0 13 0 0 0 871 0 1807 0 140 0 0 0 0 0 0 0 421 0 1235 0 0 0 4430 5 23 930 1 0 0 17 0 0 0 732 0 1538 0 146 0 0 0 0 0 0 0 458 0 1104 0 0 0 4695 1 24 974 0 0 0 21 0 0 0 710 0 1545 0 110 0 0 0 0 0 0 0 488 0 879 0 0 0 4057 6 25 1100 0 0 0 22 0 0 0 618 0 1503 0 107 0 0 0 0 0 0 0 430 0 1029 0 0 0 4805 3 Total 3935 1 0 0 73 0 0 0 2931 0 6393 0 503 0 0 0 0 0 0 0 1797 0 4247 0 0 0 17987 15
Table 5. Number of reported cases and deaths, Muzaffarabad District*, Earthquake Affected Areas, Pakistan, 14 -20 June 2008.
AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 22 2513 0 0 0 98 0 0 0 1637 0 4902 0 40 0 0 0 0 0 0 0 1327 0 3402 0 2 0 10689 0 23 2554 0 0 0 124 0 0 0 1766 0 4937 0 102 0 0 0 0 0 0 0 1269 0 3452 0 0 0 10616 0 24 2306 0 0 0 131 0 0 0 1591 2 4200 0 93 0 1 0 0 0 0 0 1210 0 3337 0 1 0 10426 6 25 2940 0 0 0 119 0 0 0 1760 0 4614 0 106 0 0 0 0 0 0 0 1330 0 3323 0 0 0 11170 14 Total 10313 0 0 0 472 0 0 0 6754 2 18653 0 341 0 1 0 0 0 0 0 5136 0 13514 0 3 0 42901 20
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Number of reported cases and deaths per District, NWFP
Table 6. Number of reported cases and deaths, Battagram District*, Earthquake Affected Areas, Pakistan, 14 -20 June 2008.
AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 22 1217 0 0 0 116 0 0 0 160 0 2115 0 81 0 0 0 0 0 0 0 487 0 646 0 11 0 4999 0 23 1095 0 0 0 94 0 0 0 94 0 1502 0 106 0 0 0 0 0 0 0 472 0 975 0 8 0 5119 0 24 1139 0 0 0 76 0 0 0 74 0 1543 0 49 0 0 0 0 0 0 0 492 0 674 0 11 0 4383 0 25 1344 0 0 0 97 0 0 0 98 1 1482 0 89 0 0 0 0 0 0 0 576 0 1031 0 11 0 5481 0 Total 4795 0 0 0 383 0 0 0 426 1 6642 0 325 0 0 0 0 0 0 0 2027 0 3326 0 41 0 19982 0
Table 7. Number of reported cases and deaths, Mansehra District*, Earthquake Affected Areas, Pakistan, 14 -20 June 2008.
AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 22 1398 1 0 0 35 0 2 0 369 0 2204 0 6 0 0 0 0 0 0 0 762 0 1206 0 4 0 10762 6 23 1398 1 0 0 22 0 0 0 169 1 1992 0 7 0 0 0 0 0 0 0 775 0 1336 0 1 0 12874 8 24 1425 0 0 0 19 0 0 0 183 2 2032 0 5 0 0 0 0 0 0 0 742 0 1220 0 2 0 12433 8 25 1491 1 0 0 20 0 0 0 167 2 2031 0 19 0 0 0 0 0 0 0 714 0 1071 0 5 0 12260 6 Total 5712 3 0 0 96 0 2 0 888 5 8259 0 37 0 0 0 0 0 0 0 2993 0 4833 0 12 0 48329 28
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