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,lssue23,Epi week 23,(03-09 Jun,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-23,2019

%

% % % %

%

%

% % % % % % % %

%

% % %

%

95

%

%

96 96 96 96

96

95

95 95 95 95 95 95 95 95

%

94

94 94

100% 94 400000

92

96

93 93 90% 350000 80% 300000 70% •During week no.23,2019, %94(1991/1875) health facilites from 23 Governorates 60% 250000 provided valid surveillance data. 50% 200000

40% 150000 Percentage

30% Consulttaions 100000 20% 10% 50000

0% 0

Wk 5 Wk 9 Wk Wk 1 Wk 2 Wk 3 Wk 4 Wk 6 Wk 7 Wk 8 Wk

Wk13 Wk14 Wk18 Wk22 Wk 11 Wk 12 Wk 15 Wk 16 Wk 17 Wk 19 Wk 20 Wk 21 Wk 23 •The total number of consultation reported during the week in 23 Governorates was Wk 10 213660 compared to 246575 the previous reporting week 23 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 23,2019)

%

%

95

%

%

%

%

% %

100% %

%

%

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

%

%

%

94

%

100

98

97

100

100

% 100

90% 100

%

90

100

%

100

98

97

93

%

94

%

90

% 93

week. 80% 90

%

89

75 87

70% 87 60% 50% 40% 30%

20% No.HF Reports 10% ● A total of 1449 alerts were generated by eDEWS system in week 23, 2019, were 0% verified as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 23,2019 Proportional morbidity of leading priority diseases, Epi week 23,2019

AVH_A&E; 0.1% AFP; 0.0% Typhoid F; 1.2% Mumps; 0.1% Mal; 3.5% DF; 0.1% ● (URTI) 14.1%, suspected Malaria (3.5%),(OAD) (10.9%) and (LRTI) (5.5%)Remain AVH_B&C; 0.0% Sch; 0.1% Meas; 0.0% RB; 0.0% the leading causes of morbidity representing a total of (53.3%) 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 0.6% Of this OAD; 10.9% morbidity

● All diarrheal disease comprised 19.3% and LRTI 5.5% of total morbidity in pilot Governorates BD; 0.6% SARI; 0.0% URTI; 14.1% this week . Pert; 0.0% ILI; 0.5% ● All diarrheal disease comprised 19.3% and OAD 10.9% of total morbidity in all age group . LRTI; 5.5%

Measles Situition in Distribution of Governorate Measles cases & Deaths , Epi weeks1- 23,2019 Epi Curve of Measles in Yemen During 2017,2018,2019

900 900

800 800

700 700 600 600 500

400 500

300 400

200 300 100 200 0

100

wk1 wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9 wk10wk11wk12wk13wk14wk15wk16wk17wk18wk19wk20wk21wk22wk23wk24wk25wk26wk27wk28wk29wk30wk31wk32wk33wk34wk35wk36wk37wk38wk39wk40wk41wk42wk43wk44wk45wk46wk47wk48wk49wk50wk51wk52 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 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 23 (03-09 Jun,2019)

GOV

Distribution of suspected cholera cases by age group (1 Jan- 18 June 2019) Distribution of associated deaths by age group (1 Jan- 18 June 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Distribution of suspected and deaths cases by age and sex From 1 Jan to 14 April 2019

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 23 (03-09 Jun,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-23 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-23,2019

20.0% 8.0% 4500

18.0% 4000 7.0%

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% 0

0.0%

wk7 wk2 wk3 wk4 wk5 wk6 wk8 wk9

0.0% wk1

wk10 wk11 wk12 wk13 wk14 wk15 wk16 wk17 wk18 wk19 wk20 wk21 wk22 wk23

WK1 WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK16 WK19 WK10 WK11 WK12 WK13 WK14 WK15 WK17 WK18 WK20 WK21 WK22 WK23

WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK1 Rapid Test(Postive) Microscope(Postive)

WK21 WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK17 WK18 WK19 WK20 WK22 WK23

Age and Sex distribution of total consultations of leading diseases (Epi week 23,2019) Number of Alerts Received and Responded (Epi Weeks 20-23,2019)

40000 37631 URTI LRTI Pert BD OAD Typhoid F

35000 AFP Meas AVH_A&E AVH_B&C DF Meng 31846

30000 Sch CL Chicken Pox Mal 250

25000

20417 200 19665 20110 19978 20000 18625 17765 150 15000 13993 13780

100 10000 of No.Alerts

5000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 13993 19665 20110 31846 17765 Female 13780 18625 20417 37631 19978 Distribution of consultations of leading diseases by Governorates,Epi week 23-2019

Hadramout Suspected Disease Abyan Al-Baidha Al-Dhale AlHodaidah Al-Jawf Al-Mahra Al-Mahweet Amana Amran Dhamar Hadramout Lahj Mareb Rayma Sa'adah Shabwah Taiz Total wady Governorate URTI 1580 3008 944 612 2920 761 529 563 1937 1103 1700 1126 985 1755 1577 1716 585 349 1915 2203 760 58 1509 30195 LRTI 242 413 471 204 2344 237 52 286 773 580 1112 236 201 688 811 758 171 61 400 867 174 32 723 11836 ILI 323 0 40 0 27 18 0 0 12 21 50 0 0 76 79 0 132 0 0 69 83 13 156 1099 SARI 0 0 0 0 0 0 0 0 5 0 51 0 0 0 0 0 0 0 7 0 0 0 0 63 Pert 0 2 0 0 0 18 0 0 1 3 0 0 1 0 0 2 0 0 2 2 0 0 7 38 BD 60 0 43 12 102 43 1 67 46 136 207 3 6 2 77 6 33 18 113 156 34 0 110 1275 OAD 1057 1097 771 506 1231 812 251 815 2184 1381 2177 383 333 1718 1836 789 486 329 1196 2302 514 18 1209 23395 Typhoid F 30 33 246 11 276 115 10 77 259 128 501 13 3 9 279 31 41 38 91 213 34 30 150 2618 Meas 1 4 1 1 1 2 0 0 0 14 0 1 1 4 2 0 0 0 2 0 2 0 1 37 AVH_A&E 18 11 1 0 4 1 0 1 48 6 12 14 5 0 13 9 5 0 1 7 8 0 9 173 AVH_B&C 3 0 1 0 0 4 0 0 34 0 5 1 0 4 10 1 1 0 1 0 0 0 0 65 NNT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AFP 0 0 0 0 0 1 0 0 2 0 0 0 0 2 2 0 0 0 0 0 0 0 0 7 240 25 0 3 17 9 1 13 7 8 32 18 14األمراض المشتبهة Mumps 7 5 5 10 21 6 1 3 10 13 12 Mal 50 359 1 2 2930 189 2 248 87 236 315 1 0 1538 234 25 3 112 363 81 1 0 611 7388 Meng 0 0 0 0 0 0 0 0 4 0 3 5 0 0 3 0 0 0 0 0 0 0 2 17 DF 78 54 0 10 4 0 0 0 0 0 0 26 2 1 0 61 5 0 0 0 13 0 12 266 VHF 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Sch 0 0 0 6 2 13 0 15 6 48 18 5 0 62 10 2 0 4 51 19 1 0 10 272 CL 0 0 2 1 0 0 0 0 1 7 10 0 0 1 2 3 0 7 4 1 0 0 0 39 RB 0 0 0 0 1 0 0 9 0 0 52 0 1 5 9 0 0 0 0 6 0 0 5 88 Tuberculosis 5 0 1 0 1 6 0 0 0 1 7 3 0 1 2 0 1 1 0 1 0 0 2 32 HIV/ AIDS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Brucellosis 3 0 42 0 17 44 0 4 42 38 240 0 5 64 65 0 9 0 29 12 3 0 22 639 Chicken Pox 2 11 6 8 9 23 1 11 20 33 16 1 11 31 51 8 2 18 142 51 23 0 24 502 Scabies 10 0 0 0 77 0 0 2 14 0 8 0 1 15 0 0 0 10 8 12 0 0 2 159 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 2355 10600 2997 3635 5170 2048 1863 1983 20422 3361 10817 5584 3210 3694 9404 4397 3416 554 3956 5606 2991 198 6804 115065 total_cons_disease 5879 15509 6336 5641 17322 4764 2749 5260 27708 7992 19678 7418 4748 11927 15953 8438 4942 1679 8741 13666 4734 349 12227 213660 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 23 (03-09 Jun,2019)

Alert Responded in Epi - Week 23,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Contact with the surveillance coordinator of districts , the cases of suspected cholera were diagenosed clinicaly according to case definition,19 RDT positive and ather Al Maqatirah,Al Had,Tuban,Al Alhaid rural H,Karesh Health Center,Almusaimeer cases were negative. Chol Lahj MadaribahandRasAlara,Yahr Halimayn H,Yaher rural H,Halimeen rural H,Tour Albaha 114 0 the cases reported immediately to operation room, registerd in the line list. Tur Al Bahah,Al Qabbaytah,Al Musaymir Hospital,Other the cases treated by intravenous fluid , ors and antibiotic. Cases finally improved.

Alhabeel Health Unit,Alwaht rural H,Makh The focal points were contacted, information shared, the cases of suspected Dengue Tuban,Halimayn,Tur Al Bahah,Yaffa,Al DF Lahj Dispensary,Halimeen rural H,Tour Albaha Hospital,Alhlal fever were diagenosed clinicaly according to case definition, cases added to the line 61 0 Maflahy HC,Almaflehi rural Hospital list, treated symptonaticaly and improved.

Immediate report was recived , the cases of suspected whooping cough were diagenosed clinicaly according to case definition, Pert Lahj Radfan,Al Milah Radfan Public H,Alraha HU 2 0 the cases were vaccinated. the cases treated symptomaticaly and left the health facility.

eIDEWES team were contact fp, the cases were diagnoses clinically ,not samples Pert Aden Al Mansura,Ash Shaikh Outhman Dr.Muna Clinic,Alwahda educational H were collected, one case was vaccination unknown and one case ather was un 2 0 vaccination,investigation from were done

eIDEWES team were contact fp, the cases were different areas, the cases were Khur Maksar,Ash Shaikh Outhman,Dar Shifa Aden Dispensary,Aden German Hosp.,Alwahda DF Aden diagnoses clinically, not samples were collected, treatment were given, not 54 2 Sad,Al Mansura educational H,Al Ryadah Hosp.,Other investigation form were done,2 cases were dead

eIDEWS team was contacted RRT AlMualla distrect, the case was Abdulhadi KHasem Muhammed Ahmed,male 20yr old from SheekhOthman distrect,has bloody urine,and VHF Aden Al Mualla Other 1 0 fever, diagnosed clinically, rapid test was positive , treatment was given,and investigation form was done

eiDEWS team were contacted fh: the cases from different places and ages, the cases Chol Aden Ash Shaikh Outhman,Dar Sad Alwahda educational H,Albasateen medical center 51 0 were diagnosis clinically, treatment were given, investigation from were done.

eiDEWS team were contacted fh :The cases were diagnosis clinically, one case was vaccination unknown and one case ather was un vaccination but the last case was Meas Aden Ash Shaikh Outhman,Dar Sad Alwahda educational H,Durrat Aldar specialized H 4 0 vaccinated , the samples were unknown, treatment were given, investigation from were done.

RRT districts visited the suspected cases of Cholera , RDT were (-) and 3 cases were Jayshan,Al positive , stool for culture didn't collected, the cases were diagnosed clinically, Chol Abyan Al Mahfad Hospital,Mudiya Hosp.,Alrazi .H,Mahnf-Lwdr H 62 0 Mahfd,,khanfir,Lawder treatment were given, investigation form were done, the case included in Cholera line list.

eIDEWS team contacted the FP, the cases diagnosed clinically (standard dengue case Al Azi Dispensary,Mahnf-Lwdr H,Al Thuraya Clinic,Al DF Abyan Lawder,Sarar,khanfir,Al Mahfd definition), samples were not collected, treatment were given, investigation forms were 78 0 Mahfad Hospital done.

eIDEWS team contacted the F.P, the cases were un vaccination, Blood Samples Meas Abyan Mudiyah Mudiya Hosp. 1 0 collected and waiting for send to Sana,a city

Sharab Ar Rawnah,Al Misrakh,Khadir,Al Rapid response team contacted also focal points by eIDEWS coordinator,cases Qahirah,Al Maafer,Sama,Mawiyah,Al Al Aroos Hospital,22 May HC,Ar Romah diagnosed clinically according to case definition.Stool samples(C/S & serotyping) Mudhaffar,Salh,Sharab As center,Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al collected from cases & sent to lab (Central labs)for confirmation. Supplements & Chol Taiz 718 0 Salam,SabirAlMawadim Loqiah Hospital,22 May Almodafar HC,Mawih antibiotics treatment were given(case management)rapid test :39 cases positive &,the Maqbanah,AtTaiziyah,AshShamayatayn, Hospital,Other results of stool C/s still pending. .There were collection & cluster of cases in the same Hayfan,Jabal Habashy,AlMukha Place.

We was communicating with the coordinator of edews in the facility we found these cases of suspicion of pertussis,the cases were from different areas. .. Action :these Pert Taiz At Taiziyah MSF Hospital 7 0 cases were treated at home . Advices have been given to their parents to follow up and review

Focal point,and the coordinator of the directorate were contacted ,, the suspected DF cases had a history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by blatelets counting, ,rapid test of dengue virus was DF Taiz Al Qahirah Mohammed Al-Dourah HC 12 0 done for some of cases ,,which were positive,, Medications have been given,,,there is cluster of cases in some areas. There are 11 cases ,,7 male, 4 female. All from .. All data in the line list..

eIDEWS coordinator contacted focal point,and the coordinator of the directorate ,information's shared.Blood samples was collected from the case and sent for lab Meas Taiz Sharab Ar Rawnah Abduljalil Nassr Hoapital 1 0 confirmation & .There is one female ,, less than 5 years old, vaccinated ,, from taiz governorate ,,. . All data in the line lis.

The EDEWS coordinator contacted the focal person. The cases are diagnosed clinically by case definition as suspected df. The cases were from Aleleeb area . 3 DF Hadramout Qhail Ben Yameen Alaleeb HC blood samples were collected and tested for df by df NS1 RDT All cases were 26 0 negative for df antigen. All cases were treated by symptomatic treatment All cases improved.

Immediate report was sent by the EDEWS district coordinator. The case is 72 monnths male from Fowa Alkadeema area in AlMukalla city. The case is diagnosed clinically by Meas Hadramout Al City Fawa alkadima HC 1 0 case definition. Skin rash started in 7th of June 2019. The case is vaccinated. blood sample was collected. Symptomatic treatment was given.

Immediate report was sent by the EDEWS focal person,the cases were diagnosed clinically by case definition as suspected cholera. RDT were positive for 2 and Cultuer Chol Hadramout Hajr,Al Mukalla City Hajar aljoul rural H,Bin Sena'a educational H 2 0 swap were cllected and sent to central lab. The result are pending. IV fluid and cover antibiotic were given,the cases improved and discharged.

Al Udayn,,AlMashannah Hubaysh,As Saddah, Far Al Immediate notification. eDEWS Coordinator visited hospital, stool samples were Udayn,Ibb,DhiAsSufal AL Mzahan H,Yahsub Hospital,Aladin H,Mother and Child collected and positive by rapid test for 75 Chol Ibb ArRadmah,Mudhaykhirah Badan,Hazm H,Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani 1477 1 Al Udayn,As Sabrah,AlQafr,AsSayyani Hospital,Alradhmah H,Almakhader HC,Alqaidah H,Other All cases were improved, one case was dead ,AshShair,AnNadirah,Jiblah,Al Dhihar,Al Makhadir

eDEWS focal points contacted.Information shared, Samples were collected the Meas Ibb As Saddah,An Nadirah Alsadah HU 2 0 cases were vaccinated

Immediate notification.Patient ,samples were collected and send to sanaa, the cases AFP Ibb Ibb,Al Dhihar Hrd.H.U,specialist Medical Clinic 2 0 were vaccination

Immediate notification by focal point. Cases were diagnosed clinically and treated accordingly and recieved anti-toxin Rapid response team visited village of infected Diph Ibb Al Mashannah Alnassr H 2 0 persons for reaserch another cases ,treated contact persones,and health education. 2 Cases were un Vaccinated

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 23 (03-09 Jun,2019) Alert Responded in Epi - Week 23,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Bura,Al Mansuriyah,AzZaydiyah,Bajil,Bayt Al eDEWS coordinator contacted the hospital focal points, the cases were diagnosed Alsalakhana H,Alhshm Center,Alkanawes HC,salam Faqiah,Al Qanawis, Ad Dahi,Az Zuhrah, suspected AWD and treated accordingly, isolation done , the cases take treatment and Chol AlHodaidah center,Aldhahi Rural H,Almansouria rural H,Bait Alfakih 2126 2 Al Hawak,Al Hali, Al Mina, As Salif,Al go out side hospital , Treatment use WHO protocol ORC, cases done rapid test for H,Alzaydia Rural H Munirah,Alluheyah,Al Hajjaylah,Al sever cases, positive send for confirmation Mighlaf,,Al Garrahi, Jabal Ras

eDEWS coordinator contacted the focal point, the case was suspected measles which case was females un vaccination from has ,fever , rash recorded in 6/5,Hospital Meas AlHodaidah As Salif Alsalif Hospital 1 0 recorded in 12/6, the blood sample have been collected from the patient by district coordinator and sent to the central laboratory in Sanaa. Focal points were contacted , the suspected DF cases had a history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically. Medications DF AlHodaidah Zabid Al Mokar HC 4 0 have been started, ALL cases diagnosis depend on case definition and platelets counts, no cluster of three cases in same place Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane around tonsillitis , and sever inflammation, the cases were un vaccination , Diph AlHodaidah Al Hawak Althawra public H 3 0 the cases were diagnosed clinically. Medications have been started, ALL cases only depend on case definition

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts . Khayran Al Muharraq,Mabyan,Kuhlan Information shared.It were diagnosed clinically according to standard definition For Meas Hajjah Almuharak HC,Kuhlan Alsharaf Dispensary 4 0 Ash Sharaf measles , the cases wereVaccinated , Investigation form were Done.Appropriate treatment were given. The samples were collected and sent to the central laboratory

Najrah,AshShahil,QaflShamer,BaniQais, AlMiftah,Qarah,Aslem,AlJamimah,AflahA Mabyan Hospital,Public Republican Hospital,Khatwah eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts, Information shShawm,Mabyan,HajjahCity,,Harad HC, Bani Chamakh HC,Bani Qais Health Center,Kuhlan shared .We received a report of cases suspected cholera , The cases were diagnosed h,Hajjah,Kuaydinah,Al Chol Hajjah Afar HC,Almahabesha Public H,Alshahel Rural clinically (Acute watery diarrhea). Rapid Test were done for some cases the result 2225 2 Mahabishah,Kuhlan Affar,Mustaba,Bani Hospital,Almaghraba HC,Qafl Shamer Kufl-Shamar were positive in the some cases .The Cases from different areas. It were given the Al Awam,Kuhlan Ash Sharaf,Al Rural H,Other proper treatment of cases Maghrabah,KhayranAlMuharraq, AshShaghadirah

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts . Information shared.It was diagnosed clinically according to standard definition For AFP, AFP Hajjah Al Miftah,Mustaba Alsalam Center,Other 2 0 Investigation form was Done. Appropriate treatment was given. The sample was collected and sent to the central laboratory

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central labs)for confirmation. Aththaorah,Shu'Aub,Assafi'yah,BaniAlHar Omar Al Mokhtar Complex,Alkwit educational H,Arwdhah Supplements & antibiotics treatment were given(case management)Most of them were Chol Amana ith,AsSabain,MaainAz'zal,At H,22 May Hospital,As Sabin Hospital,Ibn Khaldon HC,Al 1678 1 from Amana governorate & a few of them from other governorates ,different districts of Tahrir,Sana'a Old,AlWahdah Jraf Complex,Other that governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most 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.

eIDEWS coordinator contacted focal points,information shared.the cases diagnosed clinically according to the case definition. Antibiotic treatment was given,the cases were Pert Amana Al Wahdah Almutwkl H 1 0 unvaccinated against pertussis. There were no collection of cases seen in the same place.

eIDEWS coordinator contacted focal points,then HF visited. Information shared.Stool AFP Amana Shu'Aub,Assafi'yah ALGOHALLY HOSPITAL,Althwrh H samples collected from the cases and sent for lab confirmation, the cases were un 2 0 vaccination

eIDEWS coordinator contacted focal points,informations shared,after that HF visited by eIDEWS coordinator.The cases diagnosed clinically according to the case definition as suspected diphtheria.Symptoms & signs of a cases were,fever,sore throat,grey-whitish Diph Amana As Sabain,Maain As Sabin Hospital pseudo-membrane ,swelling of neck lymph-nodes(Bull neck) & difficulty of swallowing 3 0 & breathing. Antibiotic treatment were given & cases management done.Throat swabs taken into Central Lab for confirmation(Albert stain,Gram stain & Diphtheria C/S,the cases were vaccination

the surveillance team contacted , the cases presented to Gohzah DTC from different Sahar,Razih,Majz,Adh alhamazat center,Sharah Hosp.,Al Jumhoori area ,the cases diagnosed clinically according to the SCD, the cases were tested by Chol Sa'adah Dhahir,Baqim,Sa'da Hospital,Monabbih Rural Hospital,Ghamer Health RDT , 13 cases were positive by RDT , not samples were collected for confirmation by 354 0 ,Munabbih,Ghamir,Al Hishuah,Qatabir Center,Other cultures ,the details included in the line list and the information shared , the Districts RRT informed to respond

eIDEWS contacted to respond to 2 suspect measles , the HF visited the cease, all Meas Sa'adah Sa'da Al Jumhoori Hospital ceases dignosed callinically most cease were api linked ,the supportive mangmant,al 2 0 casesl Un vacetinted

eIDEWS coordinator contact the focal point after reporting of 2 suspected whooping cough the cases was diagnosed clinically according to the case definition and all cases Pert Sa'adah Kitaf wa Al Boqee Aal Shueeb Health Unit 2 0 was treated in outpatient the RRT contacted to perform the investigation and related activities

As Al Qaflah Rural Hospital,As Sawd Health Sudah,Huth,Suwayr,KhammerShaharah,I hospital,Raydah Health hos.,Al Ashah Health yal Surayh,Harf Sufyan Habur Eidews Team contacted Focal points, the cases were diagnosed as clinically as hospital,Harf Sufyan H,Al Sanaaniah Health Center,Al Chol Amran Zulaymah,Dhi suspected cholera Treatment were given ORS and intravenous fluid and antibiotics 895 0 Salam Khamir Hospital,Huth Health hospital,Kharif Rural Bin,AlAshah,Amran,Raydah ,Bani All the cases improved After Taking The Treatments Hospital,Amran General Hospital,Thula Health Suraim,Kharif,Jabal Iyal Yazid,Al hospital,Habur Health hospital,Other Madan,Al Qaflah,As Sawd,Maswar

Eidews Team Contacted Focal Points. Cases Were Diagnosed Clinically as Suspected Meas Amran Thula,Harf Sufyan,Khammer Al Salam Khamir Hospital,Other 14 0 Measles. One case was Under age Vaccinated and ather cases were un vaccination

Eidews team contacted focal point. The cases were diagnosed clinically as suspected Pert Amran Khammer Al Salam Khamir Hospital pertussis .according to definition case. Treatment were given antibiotic all cases 3 0 improved after taking the treatments

eidews team contacted focal point . and Rapid response Team visit Health Hospital case were diagnosed Diph Amran Amran Other 1 0 clinically probable diphtheria. the case treated with antibiotics and anti toxin . case from district Ryadah

Al Husn,Nahm,BaniDhabyan, Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital Khwlan,Manakhah,Hamdan,BaniMatar,Al ,Almarbak HC,Almanar Hospital,Bait Alrejal HC,Walan Rapid Response team visited area according to cases definition suspected cholera Chol HaymahAlKharijiyah,Jahanh,BiladARus,A Hospital, Bani Mansour HC,Al wheda Manakha rural and result rapid test cholera 22 cases positive and ather cases Not done or negatitve 2045 0 rhab,Sa'fan,Attyal,Sanhan,Bani Hospital ,Awmara H,22 May Hospital ,Ka'a Alreka and cases are recoreded in line list and cases deifferant area Hushaysh,Al Haymah Al Kharijiyah, HC,Sa'afan HC,Other

The EDEWS coordinator contacted the focal person. The cases was diagnosed Pert Sanaa Governorate Arhab Alhayfa HC clinically by case definition. Unknown vaccination status. The cases was treated with 2 0 antibiotic.

eIDEWS coordinator visited the health facilities , the cases suspected of measles, the cases were diagnosed clinically according to case definition, one case was un Meas Shabwah ,Osailan Outpatient Clinics/ Ataq Hosp.,Usaylan Hospital 2 0 vaccinated and one case ather was vaccinated , the samples were collected, the cases were treated and improved.

eIDEWS coordinator visited the health facilities , the cases suspected of cholera, the cases from different areas, the cases were diagnosed clinically according to case Chol Shabwah Ataq,Baihan Emergency/Ataq Hospital,Bayhan Hospital 88 0 definition, rapid test were negative but 55 cases were positive, the cases were collected ,all cases received their best treatment and improved. 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 23 (03-09 Jun,2019)

Alert Responded in Epi - Week 23,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eIDEWS coordinator visited the health facilities , the cases suspected of dengue DF Shabwah Rodhoom Al Wafa Clinic fevere, the cases were diagnosed clinically according to case definition, rapid test were 13 0 negative, the cases collected in all cases received their best treatment and improved

ALSharyah,AlMalagim,AlA'rshRada',Rad eIDEWS team contacted focal point the cases were diagnosed clinically as suspected man Al Awad,Al Quraishyah,Al Alarsh center,Alqrishih HU,Althwrh Hospital,Alswadih cholera using case definition , the rapid test 100 positive and the main saing watery Chol Al-Baidha BaydaCity,ArRyashyyah HC,Al-Taffah Center, Hospital,Alswmah HC,Thi 764 0 diarrhea &vomting some dehydration the paitnts ademittedt and with ORS and IV AsSawadiyah,AtTaffah,Naman,Mukayras, - Naem HC,Areeb HC,Other fluid in good condation Wald Rabi',Sabah,Nati,Dhi Na'im

IDEWS team contacted points information shared blood saeIDEWS team contacted Meas Al-Baidha At Taffah Al-Taffah Center focal point the case diagnosed clinically according to case definition Antibiotics 1 0 treatment was given, the case was vaccinated

EDEWS team contact Edews focal points, the cases diagnosis according to case Chol Al-Mahra ,Qishn Al Ghaydah Center Hospital ,Qishn Country Hospital defination , susspected Cholera case in line listing and send daily to central level 39 0 ,Cholera rapid test were +ve ,then samples send to culture , treatment were given

edews team contact focal points , the case was diagnosed clinically as suspected (pert) using case definition , name: - Btul Ahmed Abdul Rahim bin Saad, age 96 m vaccine : 3 Pert Hadramout wady Sayun Tarebatalbelad HU 1 0 dose protective therapy given to contact and health education for the family . symptomatic treatment was prescribed

edews team contact focal points , the cases was diagnosed clinically as suspected (meas) using case definition , (1) name: Ayman Mujahid Ali Ahmed, age 36 m , vaccine, zero doses fever onset Meas Hadramout wady Rumah Ramah Clinic 1 0 01/06/2019, blood sample collected symptomatic treatment was prescribed

Bani hutam HC,Wathan HU,Dheba HC,A Unity Centre Wusab As Safil,Mayfa'at (residential),bny salamh Unite,Kharbah Abuyabes Anss,JabalAshsharq Edews coordinator contacted focal points, they found cases diagnosed suspected HC,Alhumyat HC, AlMasli Hospital,Alwahda university Chol Dhamar AlManar,Jahran,Anss Chol(Acut watery diarrhoea and dyhadretion ) the cases tested by rapid test And result 1630 5 H,Zeraja rural H,Hamam Ali Hospital,Taibah MaghiribAns,AlHada Utmah,DhamarCity were postive for 214, all cases received treatment ,5 cases were dead hospital,Alkharba rural H,Almajel HC,Aljarf HC,Dawran Dawran Aness,Wusab Al Ali Hospital,Dhamar public H, Other

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed clinically according to case definition.Stool samples collected Al Kari Hospital,Al vatha HC,Medghal Rural Hospital,Bid from cases for screening test only . Supplements & antibiotics treatment were Chol Mareb Al wadi,Madkhal, City,Bid Bidah 39 0 Bidah Hospital given(case management)the results of stool Rapid tests of cholera 7 positive and the most cases not done .There were a no collection or cluster of cases seen in the same Place

we contacted the contact and told us that suspected dengue cases, the cases had a history of high fever, back pain, muscular pain, and arthralgia. The samples were DF Mareb Al wadi Al Kari Hospital collected at the hospital's laboratory for serological testing (NS1). This test measures 5 1 the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result,one case was dead

Al Maton Health Center,Bart Rajuzah Hospital,Al Khalq Rajuzah,Al Maslob,Al The EDEWS Coordinator received a report from the control officer that there were Health Center,Al Hazm Hospital,Al Marashi Health Matammah,Kharab Al Marashi,Bi'rat Al cases of the doctor's diagnosis. It were cholera., 16 cases positive rapid test , from Chol Al-Jawf Center,Al Humaydat Health Center,Al Ghail Health 373 1 Anan,Khob Wa Asha'af,Al Hamidat,Al different areas,Treatments were treated according to the treatment plan,one case was Center,Al Shifa Center,Hosoon Aal Shanan Health Ghayl,Al Matun,Al Hazm dead Center,Other

Zahlool Health Unit,Al Kasmi (Al Marfaqi Aal Qassim) EDEWS team contacted focal points, the Cases diagnosed clinically as suspected Pert Al-Jawf Rajuzah,Az Zahir,Bi'rat Al Anan 18 0 Health Unit,Other pert,treatments were given cases un vaccines

The EDEWS coordinator has contacted the coordinator. The condition were diagnosed clinically by definition of the condition. The number of cases were 2 from different Meas Al-Jawf Al Matun Al Qasabah Health Unit districts and villages. Number of Male 1 and 1 cases femal number of cases . Blood 2 0 samples were not collected. Symptom therapy and antibiotic giving were given and vitamin A

Contact the EDEWS team for the contact. The case clinically diagnosed as suspected in the AFP field was diagnosed. The name.zuhara' trky dahas . Age: 11 months. Not a AFP Al-Jawf Al Matun Al Qasabah Health Unit 1 0 restaurant. Node locality Fecal samples were collected from the cases and close contact was sent to the Central Laboratory in Sana'a.

eIDEWS coordinator contacted focal points, information were shared. all cases were Al Khabt,Ar Rujum,At Tawilah,Al Al Arkob HC,Hufash H,Alrujm Hospital,Lahbol Health diagnosed clinically according to case definition, the cases were investigated by rapid Chol Al-Mahweet Mahwait City,Milhan,Shibam Unit,Swaq Alahd HU,Numan HU,Bani Sa`d test for vibrio cholera, 18 cases were positive and ather cases were negative. 1176 2 Kawkaban,Hufash,Bani Sa'd,Al Mahwait Hospital,Altawilh HC,Aljoumhwri H,Shbam H,Other appropriate treatment were given according to severity of symptoms and dehydration,2 cases were dead

eDEWS coordinator contacted the hospital focal points, the cases were diagnosed BiladAtTa'am,AsSalafiyah Chol Rayma Bany Alwahdy Center ,Althulaia H,Wadi Alarid HC,Other suspected AWD and treated accordingly, isolation done , the cases take treatment 176 1 Kusmah,AlJabin,AlJafariyah Mazhar and go out side hospital , Treatment use WHO protocol ORC, one case was dead

Ad Dhale'e,Al Azariq,Al Dhwran HC,Alfakhr HC,22 May Hospital,Damt eDEWS team contacted FP, the cases were diagnosed according to case definition, Chol Al-Dhale 609 0 Husha,AlHussein,Damt,Juban,Qa'atabah HC,Alnassr H,Other all included in updated daily line listing

eIDEWS team were contacted fp: the cases were diagnoses clinically, vaccination Meas Al-Dhale Al Hussein Alhassin HC were done, samples were collected , treatment were given, investigation form were 1 0 done.

eDEWS team conted focal points, information shared inve stigation forms and lab and DF Al-Dhale Ash Shu'ayb Alshaib Dispensary waiting for samples results cases opriate treatment were appro , they came from ather 10 0 governorates

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