Weekly Epidemiological Bulletin

Ministary of public Health Papulation Electronic Disease Early Warning and Response System Primary Health Care Sector DG for Disease Contraol Surveillance

Volume 04, Issue 34, Epi week 34, 22 - 28 Aug 2016

H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 34, 2016

% % % % % % % % % % % % % % % % % % %

% %

% % %

100% % 180,000

96 95 94 94 93 95 95 95 96 95 96 92 92 93 94 90 90 92 90

94 96

95 95 90% 94 81 160,000 • During week no. 34, 2016; 90% (1105/998) health facilities from 22 governorates 79

80% 140,000

provided valid surveillance data. 70% 120,000 60% 100,000 50% 80,000 40%

30% 60,000 P e r c e n t a g e g a t n e c r e P • The total number of consultations reported during the week in 22 governorates was 20% 40,000 i a C l u s n o t s n o t 148402 compared to 147149 the previous reporting week. Acute respiratory tract infections 10% 20,000 0% - Lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of morbidity this week. Reporting Rate Consultations

Distribution of Reporting Rates by Governorates (Epi-week 34 , 2016) • A total of 966 alerts were generated by eDEWS system in week 34, 2016; Of these 493 100%

alerts were verified as true for further investigations with appropriate response. 80%

% % % % % % % % %

60%

% %

98 98

100 100 100 100 100 100 100 100 100 93

40% 92

88 88

79 80 20% %

• Altogether 97 alerts for Pertussis, 57 Other acute diarrhea, 49 each for Bloody diarrhea, 43 0%

Typhoid and Paratyphoid Fever and Measles, 43 Malaria, 37 Lower Respiratory Infections, et F p o. N R r o H s 34 Dengue Fever, 33 Upper Respiratory Infections, 11 each for Influeza Like Illness and Acute Flaccid Paralysis, 6 Meningitis, 4 each for Severe Acute Respiratory Infection and

Acute viral hepatitis, 3 each for Cut.Leishmaniasis and Mumps, 2 Schistosomiasis, 1 Reporting Rate Target Neonatal Tetanus were received and responded in system generated.

• Online disease surveillance and response system was launched in 4 governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar).The last eDEWS expand in new 6 Governorates (Al- Baidha, Mareb, Al-Jawf, Al-Mahweet,Rayma and Al-Dhale).

Leading causes of morbidity and mortality in Epi-week 34, 2016 Suspected dengue outbreak in Al-Hodaidah, Lahj,Shabwah & Aden Gov., Epi weeks 1 to a). Suspected dengue outbreak 34, 2016

Suspected Dengue fever cases • 446 suspected dengue cases were reported in 14 governorates, out of these 112 cases 600 reported from Al-Hodidah, 85 Cases from Shabwah, 32 Cases from Aden, and 22 Cases from Lahj, 1 cases with hemorrhagic manifestations were reported in Mareb 500

governorate through the eDEWS system. 400

300

NO. of cases 200 • Surveillance is being intensified to ensure that the ongoing dengue outbreak is 100 effectively monitored and other priority communicable disease are reported through

alternative sources including private health facilities, mobile clinics, NGO partners on 0 the ground, health workers in the community, and the general public

Aden Lahj AlHodaidah Shabwah

Leading causes of morbidity and mortality in Epi-week 34, 2016 Proportional morbidity of leading priority diseases, Epi weeks 1 to 34, 2016 b. Other leading priority diseases

20.0% 18.0% • URTI (13.6%), suspected malaria (3.2%), OAD (10.8%) and LRTI (5.8%) remain the leading 16.0% 14.0% causes of morbidity representing a total of 33.4%. 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% • Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% 0.0% of total morbidity in reporting period. Bloody diarrhea represented 0.5% of this morbidity. DD URTI S.Malaria LRTI LRTI 5.8% OAD 10.9% BD 0.6% • All diarrheal disease comprised 11.3% and LRTI 5.8% of total morbidity in Pilot URTI 13.7% Sch 0.2% Governorates this week. Mal 3.2% Rb 0.1% AVH 0.2% Other_Disease Tuberculosis 0.0% 63.0% Mumps 0.1% • All diarrheal disease comprised 11.3% and LRTI 5.8% of total morbidity in all age group. Chicken Pox 0.1% Brucellosis 0.2% Guinea Worm 0.0% HIV/ AIDS 0.0%

URTI=Upper respiratory infections; LRTI=Lower Respiratory Infections; ILI=Influeza Like Illness; OAD=Other acute diarrhea; BD=Bloody diarrhea; Susp. Cholera; SARI=Severe Acute Respiratory Infection; Typh=Typhoid and Paratyphoid Fever; Mumps; Sch=Schistosomiasis; Mal=Malaria; Rb=Rabies; AVH=Acute viral hepatitis; Meng=Meningitis; DF=Dengue fever; VHF=Viral hemorrhagic fever; Meas=Measles; CL=Cutaneous Leishmaniasis; Pert=Pertussis; Diph=Diphtheria; NNT=Neonatal Tetanus

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 1 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 34 ( 22 - 28 Aug 2016 )

Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Lower Respiratory infections ( Epi week 1 to 34, 2015 & 2016)

DD 2015 URTI 2015 S.MAL 2015 LRTI 2015 Diarrheal Diseases DD 2016 URTI Sus.Malaria LRTI URTI 2016 S.MAL 2016 LRTI 2016 25.0% 20.0% 8.0% 7.0%

18.0% 7.0% 6.0% 20.0% 16.0% 6.0% 14.0% 5.0% 5.0% 15.0% 12.0% 4.0% 10.0% 4.0% 3.0% 10.0% 8.0% 3.0% 6.0% 2.0% 2.0% 5.0% 4.0% 1.0% 2.0% 1.0%

0.0% 0.0% 0.0% 0.0%

Age and Sex distribution of total consultations of leading diseases (Epi week 34, 2016) Vaccine preventable diseases in Epi-weeks 1 to 34, 2016 (28th Dec 2015 to 28th Aug 2016)

No.# of Cases Wk- Total No.# of Greater Than Total No.# of Diseases Less Than Five 35000 34 Cases Five Alerts

30000 Measles 91 1817 1151 666 1162

25000 Diphtheria 0 8 7 1 4 20000 Pertussis 446 6163 4075 2088 1649 15000

Number of Consultations of Number Acute Viral 10000 241 6638 3084 3554 233 Hepatitis (A & E)

5000 Acute Flaccid 16 389 208 181 243 Paralysis 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Meningitis 62 1623 1021 602 182 Male 9308 12779 15087 22478 11327 Female 9168 12607 13925 30368 12481 Mumps 136 2300 1091 1209 165

Distribution of consultations of leading diseases by Governorates, Epi week 34

Sana'a Hadramout Al- Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Shabwah Al-Mahrah Dhamar Al-Baidha Mareb Al-Jawf Rayma Al-Dhale Total Gov. wady Mahweet

Upper Respiratory Infections 678 2621 843 1457 1272 905 2231 1036 945 936 600 614 627 337 643 1227 581 605 455 436 246 910 20205

Lower Respiratory Infections 232 464 297 879 339 376 1426 496 454 207 509 183 259 105 81 588 314 292 304 221 114 407 8547

Other Acute Diarrhea 474 1602 503 914 730 739 3763 954 631 560 644 576 492 210 328 595 391 402 368 327 199 553 15955

Bloody Diarrhea 5 1 22 7 29 52 140 38 4 31 53 13 54 5 2 19 44 67 57 66 32 71 812

Susp. Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Schistosomiasis 2 0 1 2 3 4 4 60 31 6 19 5 2 0 0 9 2 0 35 22 27 22 256

Malaria 5 93 6 7 4 168 2292 945 9 67 146 28 53 3 0 243 2 77 162 302 105 30 4747

Meningitis 0 6 0 6 2 1 1 1 15 0 2 0 0 0 0 12 2 11 1 0 2 0 62

Dengue Fever 22 32 76 50 6 0 112 5 0 0 0 1 85 0 3 0 1 44 0 0 2 7 446

Viral Hemorrhagic Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1

Rabies 0 0 2 2 0 12 0 4 39 0 18 0 0 0 0 30 6 0 0 3 0 5 121

Measles 1 6 0 4 2 4 1 9 13 13 6 3 1 1 1 1 3 0 8 1 5 8 91

Acute Viral Hepatitis (A & E) 6 11 1 64 8 9 5 14 42 0 13 4 7 0 4 18 14 5 2 1 2 11 241

Neonatal Tetanus 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1

Acute Flaccid Paralysis 0 4 0 1 0 1 1 0 4 0 1 1 0 0 0 1 0 0 0 0 1 1 16

Cutaneous Leishmaniasis 5 0 0 2 2 2 2 7 3 4 8 4 0 0 2 2 4 0 5 1 8 5 66

Diphtheria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Pertussis 7 16 7 4 10 6 17 9 18 62 17 0 18 0 7 25 14 109 40 3 0 57 446

Influeza Like Illness 27 4 135 99 12 11 92 78 1 0 42 46 40 0 0 0 73 46 4 29 12 44 795

Severe Acute Respiratory Infection 0 0 0 0 0 0 14 65 0 2 0 0 0 0 0 51 1 16 0 0 4 3 156

Typhoid and Paratyphoid Fever 28 47 31 103 46 190 329 657 90 49 115 154 58 6 2 393 244 47 251 107 66 23 3036

Mumps 3 12 0 3 4 5 21 19 14 2 2 1 9 0 0 8 2 11 13 0 5 2 136

Tuberculosis 1 15 7 0 0 0 4 8 1 0 4 2 3 0 0 18 3 1 2 1 0 2 72

HIV/ AIDS 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2

Brucellosis 0 12 0 0 0 10 4 23 3 0 24 2 13 0 0 8 65 26 142 6 8 0 346

Chicken Pox 0 21 8 0 6 0 19 15 2 0 0 0 3 0 0 5 7 3 7 3 16 10 125

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

Other_Disease 1950 8419 1945 8418 6198 4942 8510 2497 15647 2979 2512 1742 3247 947 2285 9465 1394 3400 941 1220 369 3481 92508

Total_Consultations 3447 12724 3883 12023 8902 7437 18620 7132 18073 4944 4738 3379 4971 1614 3358 12274 3268 5173 2730 2704 1366 5642 148402

Number of alerts & outbreaks reported and investigated with appropriate response Number of Alerts Received and Responded (Epi weeks 31 and 34, 2016)

2016 Current week 34, 2016 System Gen. Alerts (week 34) Diseases Alers Outbreaks Alers Outbreaks TRUE FALSE S.Measles S.Pertussis AFP LRTI Mal Meningitis C.Leish S.Measles 1162 0 50 0 49 1 S.Pertussis 1649 0 97 0 97 0 Sch BD OAD S.Dengue URTI ILI SARI AVH 233 0 7 0 4 3 AFP 243 0 11 0 11 0 Typhoid F Mumps AVH VHF NNT LRTI 1278 0 111 0 37 74 NNT 43 0 1 0 1 0 250 Mal 1032 0 91 0 43 48 Meningitis 182 0 6 0 6 0 C.Leish 158 0 6 0 3 3 200

Sch 173 0 8 0 2 6 BD 1006 0 98 0 49 49 OAD 1385 0 131 0 57 74 150 S.Dengue 1175 4 40 0 34 6

URTI 1048 0 91 0 33 58 No.of Alerts VHF 82 0 0 0 0 0 100 Susp. Cholera 0 0 0 0 0 0 Diph 4 0 0 0 0 0 Rb 2 0 0 0 0 0 ILI 341 0 28 0 11 17 50 SARI 100 0 12 0 4 8 Typhoid F 2296 0 123 0 49 74 Mumps 165 0 11 0 3 8 0 Unusual_Disease 24 0 44 0 0 44 Other Diseases 0 0 0 0 0 0 Total 13781 4 966 0 493 473

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 2 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 34 ( 22 - 28 Aug 2016 )

Reporting of health facilities , No.# of districts and patients consultations in week 34, 2016

Al- Hadramout Sanaa Abyan Aden Al-Baidha AlHodaidah Al-Jawf Al-Mahra Amana Amran Dhamar Hadramout Hajjah Ibb Lahj Mareb Rayma Sada Shabwah Taiz Al-Dhale Mahweet wady Governorate

No.# Of Districts 11 8 20 26 12 8 9 10 20 10 12 10 31 15 14 14 7 13 16 17 14 9

No.# Of Reps. Wk-34 29 61 40 141 36 22 59 25 25 25 85 23 113 22 26 35 72 20 25 37 27 50

Patients Cons. 3883 12724 3268 18620 2730 1614 2704 18073 4738 12274 8902 3358 7132 7437 3447 5173 1366 4944 3379 4971 12023 5653

Alerts were reported and appropriate measures were taken in week 34, 2016.

True Alerts

Governorate AFP BD CL df ILI LRTI Mal Meas Meng Mumps NNT OAD Pert SARI Sch Typh URTI AVH Total

Abyan 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 3

Aden 1 0 0 6 0 0 1 5 1 0 0 1 8 0 0 2 0 0 25

AlHodaidah 1 18 0 10 4 17 15 0 0 1 0 31 5 3 0 8 12 0 125

Al-Jawf 0 0 0 0 0 0 0 2 0 0 0 0 6 0 0 0 0 0 8

Al-Mahra 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2

Al-Mahweet 0 10 0 0 1 4 7 1 0 0 0 3 2 0 0 3 6 0 37

Amana 2 0 0 0 0 1 1 9 2 2 0 3 7 0 0 7 1 2 37

Amran 1 0 1 0 0 0 0 4 0 0 0 1 5 0 0 2 0 0 14

Dhamar 1 2 0 0 0 1 3 1 2 0 0 0 4 0 0 10 1 1 26

Hadramout 0 4 0 1 0 0 1 2 0 0 0 2 4 0 0 3 0 0 17

Hadramout wady 0 0 0 0 0 0 0 1 0 0 0 0 3 0 0 0 0 0 4

Hajjah 0 0 1 0 0 0 0 8 0 0 0 1 7 0 1 0 0 0 18

Ibb 1 1 0 0 0 0 1 3 0 0 0 0 4 0 0 5 0 0 15

Lahj 0 0 0 3 0 0 2 1 0 0 0 0 6 0 0 1 1 0 14

Rayma 1 1 1 0 3 7 6 2 0 0 0 9 0 0 0 1 7 0 38

Sada 0 0 0 0 0 0 0 3 0 0 0 0 6 0 0 0 0 0 9

Sanaa Governorate 1 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 4

Shabwah 0 0 0 13 0 0 0 1 0 0 0 0 4 0 0 0 0 0 18

Taiz 1 0 0 0 0 0 1 1 1 0 1 0 1 0 0 0 0 0 6

Al-Baidha 0 10 0 0 3 7 2 1 0 0 0 6 4 1 0 7 5 1 47

Mareb 0 1 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 12

Al-Dhale 1 1 0 0 0 0 3 0 0 0 0 0 8 0 1 0 0 0 14

Total 11 49 3 34 11 37 43 49 6 3 1 57 97 4 2 49 33 4 493

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 3 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 34 ( 22 - 28 Aug 2016 )

Alert Responded in Epi-week 34, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Ibn Khaldoon Hospital,Saber HC,Tur DF Lahj Hawtah,Tuban,Tur Field investigation done and report of DF send 21 0 Albaha Hospital Al Bahah

eDEWS coordinator visited focal point, information shared; the case was diagnosed clinically using Meas Lahj Al Milah Alraha Health Unit 1 0 case definition ,blood sample was collected & send to sana,a Lab

Ibn Khaldoon Hospital,Almilah Al Hawtah,Al Hospital,Alfayosh Health Unit,Alsharif Pert Lahj eDEWS coordinator visited focal point,case diagnosed clinically and treated by antibiotic 7 0 Milah,Tuban,Yaffa Health Center,Saber HC,October General Hosp.

Ash Shaikh eDEWS team contacted FP, 4 cases were reported, 3 of them less than 5y, 2 of them from aden, AFP Aden Al-Wahdah Hosp. 4 0 Outhman samples were collected for the PT and contacts in aden , AFP coordinater in lahj and abyan informed

Al Buraiqeh,Al Al Masafi Hospital,Salah Adden Mansura,Ash Hospital,Aden Dispensary,Al-Wali eDEWS team contacted FP, cases were reported .diagnosed clinically, samples were collected for 5 DF Aden Shaikh 20 0 Hosp.,Al-Memdara Modern Center,Al cases . Outhman,Khur Jamhoria Maksar

Ash Shaikh Al-Wahdah Hosp.,Dar Saad Pol. Outhman,Dar eDEWS team contacted FP, cases were reported, sample was collected for 4 cases ,one case fully Meas Aden Cl.,,Khor-Maksar Pol. Cl.,Al Shifa'a,Al 6 0 Sad..Khur vaccinated . Zahra'a Dispensary Maksar,Siera

Aden Dispensary,Dr.Muna Clinic,Al Al Mansura,Ash Naqeeb Hospital,Khalefah Hospital,Kod Pert Aden Shaikh Al-Othman Cl.Al-Memdara Modern eDEWS team contacted FP, cases were reported , diagnosed clinically ,2 cases vaccinated . 15 0 Outhman,Dar Sad Center,Al-Wahdah Hosp.,Dort Al-Dar Hosp.,

Alrazi Hospital,Lawdar Hospital,AlAin edews team contacted focal point ,cases diagnosed clinically ,4 cases vaccinated ,rest cases state of Pert Abyan Khanfir,Lawdar 7 0 Health Unit, vaccination is unknown .

eDEWS focal point and coordinator were contacted.Information shared.Samples were collected (2 AFP Ibb Al Udayn Al Udayn Hospital from case and 3 from contacted child) and will be send to central lab in Sanaa.Case wasnot 1 0 vaccinated and child contact were vaccinate

Al Mashannah ,Al Naser Hospital,Al Udayn Hospital, Jibla eDEWS focal point and coordinator were contacted.Information shared. Samples were collected and Meas Ibb 4 0 Udayn, Jiblah Hospital will be send to central lab in Sanaa.Cases were vaccinated and cases from different areas

Rihab Hospital ,Al Razi Health Center Al Qafr ,Dhi As eDEWS focal point was contacted.Cases were diagnosed clinically and treated accordingly 3cases Pert Ibb ,Yarim Hospital , Dr. Waheeb Ata 6 0 Sufal, Yarim vaccinated rest .Cases were not vaccinated and from different areas Hospital

eDEWS coordinator contacted focal point , stool samples were collected from the patient and his close AFP AlHodaidah At Tuhayat Suwaiq center 1 0 contacts by district coordinator and sent to the Central laboratory in Sana a

Al Hawak, Al Mina AlAksa Hospital ,AlAmal Hospital ,Aman , Az Zaydiyah ,Al Center ,Az Zaydiyah Hospital Khawkhah ,Al ,ALlageuin center ,Motherhood and eDEWS coordinator contacted the hospital focal point, cases were diagnosed suspected dengue and DF AlHodaidah 96 0 Qanawis,Alluheyah Childhood Center ,Al Qanawis Hospital treated accordingly ,As Sukhnah ,Bayt ,Al Khubah dispensary ,As Sukhnah Al Faqiah . Hospital ,Bayt Al Faqiah Hospital

Al Hawak , Al Althawrah Hospital ,Castle Center eDEWS coordinator contacted the hospital focal point, cases were diagnosed suspected Pret and Pert AlHodaidah Mina ,Al Hali ,salam center ,Shamsan Center 16 0 treated accordingly ,Alluheyah ,Naharih dispensary

Aflah Al Yaman ,Al Mogbal Dispensary ,Al Mahabishah Mahabishah ,Al Hospital ,Al Miftah Health Center Miftah ,Ash eDEWS coordinator contacted focal point, information shared. Cases were diagnosed clinically. Blood Meas Hajjah ,Alsalam Center ,Uni Al Algareb ,Al 9 0 Shaghadirah sample were collected from 8 cases . Jomhori Hospital ,Kuhlan Affar Health ,Hajjah City Center ,Kuhlan Affar

Aflah Al Yaman ,Al Unit Bani Falah ,Unit ALQlaah ,AL Jamimah ,Ash Shifaa Dispensary ,Aslem Health eDEWS coordinator contacted focal point, information shared. Cases were diagnosed clinically. Pert Hajjah Shaghadirah 9 0 Center ,Al Jomhori Hospital ,Hajjah Cases treated with antibiotics ,Aslem ,Hajjah City Dispensary . .

Kitaf wa Al Boqee Al Salem ,Al Jomhori Hospital ,Saqayn focal point was contacted blood samples were collected for 9 cases ,and will be sent to the central lab Meas Sada 10 0 ,Sa'da ,Saqayn . Hospital . in sanaa

As Safra ,Baqim Nashor Health Center ,Unit Ysnm edews team contacted focal point cases were diagnosed clinically as suspected pert symptomatic Pert Sada ,Haydan ,Razih ,Haydan Hospital ,An Ndhir Health Unit 60 0 treatment was given ,9 cases were not vaccinated. Cases were from different areas . ,Sa'da ,Sahar . ,Al Jomhori Hospital ,Al-Amerah .

eDEWS team contact Edews focal point and visit hospital , case diagnosis according to case Meas Al-Mahra Al Ghaydah Al Ghaydah Center Hospital defination , susspected Measles , case is female 4 years , vaccinated , Appropriate treatment was 1 0 given to case

Al Khalq ,Kharab edews team contect focal point. Cases were diagnosed clinically as suspected meas.samples were Meas Al-Jawf Al khalq Center ,Al Marashi Center 8 0 Al Marashi collected from 7 cases to besend to central labin sana.a appropriate treatment was given

Al Humaydat ,Al Al Humaydat Center ,Alslal Unit ,Al Khalq ,,Al Maslub edews team contect focal point. Cases were diagnosed clinically as suspected Pert.appropriate Pert Al-Jawf khalq Center ,Al Maslub Center ,Alkhair 36 0 ,Al Matammah treatment was given Center ,Rajuzah Hospital . ,Rajuzah .

eDEWS team contact focal point,information shared,field investigation done.stool samples were AFP Al-Dhale Ad Dhale'e Al Aqabah Health Unit collected from the case and close contacts.Samples.Were sent for confirmation the case isfemale,her 1 0 age is 6 months.she is from alddalie governorate and vaccinated.against polio

Al Fateh Dispensary ,Al Mokhtar Dispensary ,Al Tadhamon Privet Ad Dhale'e ,Al Hospital ,Daglal Health Center ,Baldat eDEWS team contacted focal point,the cases diagnosed clinically according to case Pert Al-Dhale Azariq ,Ash 41 0 Bani Ali Health Unit ,Al Waleed Clinic definnition.antibiotics treatment were given. Shu'ayb ,Jahaf . ,Al Shuhada Altlathah Hospital ,Al Shaymah Health Unit

eDEWS team contacted the focal point.The case was diagnosed clinically as suspected Pert. The died Pert Taiz Al Qahirah Sweden Hospital 0 1 due to severe complications

eDEWS team contacted the focal point, information was shared. Cases were diagnosed clinically as Meas Taiz Salh MSF Hospital 2 0 suspected Meas. Blood samples and swab were collected from cases and sent for lab confirmation

eDEWS coordintor the contacted focal point. The case was diagnosied clinically as suspected AFP. AFP Taiz Salh MSF Hospital 1 0 Samples were not collected

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 4 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 34 ( 22 - 28 Aug 2016 )

Alert Responded in Epi-week 34, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Azzal Complex, AlMethak Health Azzal, Aththaorah, Center, Ghaza Complex, Main Health Maain, Old City, Al eDEWS team contacted focal points, information was shared. Cases were diagnosed clinically as Center, Alshaheed Center, Alrawda Meas Amana Wahdah, Bani Al suspected Meas. Blood samples and swab were collected from cases and sent for lab confirmation. 13 0 Hospital, Alolofi Health Center, Alrazi Harith, At Tahrir Case are vaccinated against measles Health Center and Science University and Shuaub Hospital

Maain, As Sabain, Ghaza Complex, As Sabin Hospital, At Tahrir, Bani Al AlKuwait Hospital, Zaid Hospital, Az eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Antibiotics Pert Amana 18 0 Harith, Old City Zubairi Health Center, Althawra Hospital treatment was given. Cases were vaccinated against Pert. and Assafiyah and SGH

eDEWS team contacted focal points, information was shared. Cases were diagnosed clinically as As Sabain and AFP Amana As Sabin Hospital and Althawra Hospital suspected AFP. Field investigation was done. Stool samples were collected from cases and close 4 0 Assafiyah contacts and sent for confirmation. Cases were vaccinated

Thula, Khamir, Thula Hospital, Al Salam Hospital, eDEWS team contacted focal points. Case were diagnosed clinically as suspected Meas. Blood Meas Amran Maswar and Harf Maswar Hospital and Harf Sufyan 6 0 samples were collected and to be send to central lab sanaa confirmation Sufyan Hospital

Al Qaflah, Kharif, Al Qaflah Hospital, Kharif Hospital, Al Khamir, Bani eDEWS coordinator contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Amran Salam Hospital, Al Sanania Center and 17 0 Suraim and Harf Appropriate treatment was given Harf Sufyan Hospital Sufyan

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected AFP. Field AFP Amran Khamir Al Salam Hospital investigation was done. Stool samples were collected from the case and close contacts and sent for 1 0 confirmation the case is vaccinated against polio

Sanaa Sanhan and Al Amal Center, Al wheda Hospital and eDEWS team contacted focal points. Case were diagnosed clinically as suspected Meas. Blood Meas 3 0 Governorate Manakhah Althaher Hospital samples were collected and to be send to central lab sanaa confirmation

Sanaa eDEWS team contacted the focal point. The case was diagnosed clinically as suspected AFP. Stool AFP Manakhah Al wheda Hospital 1 0 Governorate samples were collected from the case and close contacts and sent for confirmation

Al Awal Medical Complex, Habban Ataq, Habban and eDEWS coordinator contacted and visit focal points. Cases were diagnosed clinically as suspected Pert Shabwah Hospital, Salem Bahaj Clinic and Ain 18 0 Ain Pert. Some cases are not vaccinated. Appropraite treatment was given Hospital

Al Awal Medical Complex, Azan Hospital, Habban Hospital, Dr Saleh Ataq, Mayfaa, Abdurahman Medical clinic, Al-Ahmadi Habban, Hatib, Ar Clinic, Ataq Public Hospital, Hatib eDEWS coordinator visited focal points. Cases were diagnosed clinically as suspected DF. Blood DF Shabwah 78 0 Rawdah and Health Center, Al-Shifa Hospital, Teab samples were not collected. Symptomatic treatment was given Bayhan Al Atfal Clinic, Ar Rawdah Hospital, Al Redha Clinic, Bayhan Hospital and Al- Salam Dispensary

eDEWS coordinator contacted the focal point.The case was diagnosed clinically as suspected Meas. Meas Shabwah Ataq Teab Al Atfal Clinic 1 0 The case is not vaccinated. Appropraite treatment was given

eDEWS coordintor vist and contacted the focal point. Cases were diagnosed clinically as suspected Meas Al-Baidha Al A'rsh Al Arsh AlRural center 3 0 Meas. Appropriate treatment has been started

Dr. Mohammed al-Qaisi Hospital, Al eDEWS coordinator contacted and visit focal points. Cases were diagnosed clinically as suspected Pert Al-Baidha Al Bayda Andalus, Dar Al Shefa`a and Al 10 0 Pert. Appropraite treatment was given Zahra`a Hospital

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Hadramout wady Tarim Aedeed Dispensary 1 0 Appropriate treatment has been started with vit. A. Blood sample collected and sent for confirmation

Al Ahkaf Dispensary, Ba Bakr Sayun and Wadi eDEWS coordinator contacted and visit focal points. Cases were diagnosed clinically as suspected Pert Hadramout wady philanthropic Hospital and Sayun public 7 0 Al Ayn Pert. Appropraite treatment was given. Some cases are not vaccinated Hospital

General Dhamar Hospital Authority, eDEWScoordintor contacted focal points. Cases were diagnosied clinicaly as suspected Pert. Cases Pert Dhamar Dhamar City Dar AlShefa Hospital, Ibn Alnafess 25 0 from different area. Some cases are vaccinated. Appropraite treatment was given Dispensary and Taibah Dispensary

eDEWS coordintor the contacted focal point. The case was diagnosied clinically as suspected AFP. AFP Dhamar Dhamar City Al Mogalee & ALGumah Dispensary 1 0 Samples were not collected

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Dhamar Dhamar City Al Helal AlAhmer Center 1 0 Appropriate treatment has been started. Blood sample collected and sent for confirmation

Shami Medical Center, Alataba Al Harib, Jabal Ravey Hospital, Alwahdah Hospital, Al Murad, Al wadi, Huia Marib Hospital, Areef Alyafea eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Antibiotics Pert Mareb Marib City, 35 0 Clinic, center al Regio, Mahliyah treatment was given Mahliyah and Al Hospital, 22 May Hospital, Cree Jubah Hospital and Alkhtla Hospital

eDEWS team contacted the focal point, information was shared. Cases were diagnosed clinically as DF Mareb Harib Areef Alyafea Clinic suspected DF. Investigation forms and lab samples were collected from cases and waiting for results. 4 0 Appropriate treatment was given

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Al-Mahweet Milhan Lahbol Health Unit 1 0 Appropriate treatment has been started. Blood sample collected and sent for confirmation

Al Mahwait City Alhelal Center and Gomah Sareh eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Antibiotics Pert Al-Mahweet 2 0 and Bani Sa'd Health Center treatment was given. Cases are vaccinated against pertussis

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected AFP. Stool AFP Rayma As Salafiyah Alaramea Dispensary 1 0 samples were collected from the case and close contacts and sent for confirmation

Al Jabin and Althlaya General Hospital and Merhab eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Rayma 5 0 Mazhar Dispensary Appropriate treatment has been started. Blood sample collected and sent for confirmation

The objective of this weekly epidemiological bulletin is to provide a snap shot on selected health events reported from the eDEWS surveillance system in all governorates (Aden, Abyan, Lahj, Taiz, Hadramout, Ibb, Hodidah, Hajjah , Al-Amana, Amran, Sana'a Gov., Shabwah, Al-Mahrah, Hadramout Al-Wady, Dhamar Al-Baidha, Mareb, Al-Jawf, Al-Mahweet,Rayma and Al-Dhale) of Yemen. While every attempt is made to present the weekly trends of epidemic prone diseases, the information presented in the bulletin needs to be interpreted in the context that precise information on the reference populations is not always available. The bulletin also includes information collected by the eDEWS teams. The primary focus of DEWS is early detection of epidemic prone desease, to facilitate a rapid public health response.