Week 37 2019.Pdf

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,lssue37,Epi week 37,(9- 15 September,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-37,2019

% %

% % % % % % % % % %

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

% % % %

97 97

96 96 96 96 96 96 96 96 96 96

95 95 95 95 95 95 95 95 95 95 95 95

94 94 94

100% 94 400000

93 93 90% 350000 80% 300000 70% •During week no.37,2019, %94(1991/1873) 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 2 Wk 6 Wk 7 Wk Wk 1 Wk 3 Wk 4 Wk 5 Wk 8 Wk 9 Wk

Wk 11 Wk 16 Wk 21 Wk 26 Wk 30 Wk 31 Wk 35 Wk Wk 12 Wk 13 Wk 14 Wk 15 Wk 17 Wk 18 Wk 19 Wk 20 Wk 22 Wk 23 Wk 24 Wk 25 Wk 27 Wk 28 Wk 29 Wk 32 Wk 33 Wk 34 Wk 36 Wk 37 Wk •The total number of consultation reported during the week in 23 Governorates was 10 Wk 357422 compared to 356936 the previous reporting week 37 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 37,2019)

% %

100% %

% %

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

100

% 100

100 100

90% 97

100

% 98

week. 80% %

83 73

70% % 64 60% % 50% 48 40% 30%

20% No. HF Reports HF No. 10% A total of 1793 alerts were generated by eDEWS system in week 37 2019, were verified 0% as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 37,2019 Proportional morbidity of leading priority diseases, Epi week 37,2019

Guinea Worm Scabies ● (URTI) 13.5%, suspected Malaria (4.7%),(DD) (15.8%) and (LRTI) (5.1%)Remain the Chicken Pox Brucellosis leading causes of morbidity representing a total of (39.1%) HIV/ AIDS Tuberculosis RB CL Sch ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than VHF DF 1% of total morbidity in reporting period Bloody diarrhea represented 0.4% Of this Meng Mal morbidity Mumps AFP NNT AVH_B&C AVH_A&E ● All diarrheal disease comprised 15.8% and LRTI 5.1% of total morbidity in pilot Governorates Meas Typhoid F this week . OAD BD Pert SARI ILI LRTI ● All diarrheal disease comprised 15.8% and OAD 9.5% of total morbidity in all age group . URTI 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% Measles Situition in Yemen Distribution of Governorate Measles cases & Deaths , Epi weeks1- 37,2019 Epi Curve of Measles in Yemen During 2017,2018,2019

1200 900

800 1000

700 800 600 600 500

400 400

200 300

0 200

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 42 58 105 101 89 89 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 37 (9-15 September,2019)

GOV

Distribution of suspected cholera cases by age group ( 1 Jan- 27 September 2019) Distribution of associated deaths by age group ( 1 Jan- 27 September 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 37 (9-15 September,2019) Dengue Fever and Measles Outbreak SITUATION IN YEMEN

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) 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 37 (9-15 September,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-37 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-37,2019

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%

wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9

0.0% wk1

wk13 wk14 wk15 wk16 wk17 wk35 wk36 wk37 wk11 wk12 wk18 wk19 wk20 wk21 wk22 wk23 wk24 wk25 wk26 wk27 wk28 wk29 wk30 wk31 wk32 wk33 wk34

0.0% wk10

WK3 WK6 WK9 WK1 WK2 WK4 WK5 WK7 WK8

WK14 WK17 WK20 WK25 WK28 WK31 WK36 WK10 WK11 WK12 WK13 WK15 WK16 WK18 WK19 WK21 WK22 WK23 WK24 WK26 WK27 WK29 WK30 WK32 WK33 WK34 WK35 WK37

WK2 WK4 WK6 WK1 WK3 WK5 WK7 WK8 WK9

WK13 WK15 WK22 WK24 WK31 WK33 WK35 WK11 WK12 WK14 WK16 WK17 WK18 WK19 WK20 WK21 WK23 WK25 WK26 WK27 WK28 WK29 WK30 WK32 WK34 WK36 WK37 WK10 Rapid Test(Postive) Microscope(Postive)

Age and Sex distribution of total consultations of leading diseases (Epi week 37,2019) Number of Alerts Received and Responded (Epi Weeks 34-37,2019)

80000 74758 URTI LRTI Pert BD OAD Typhoid F

70000 AFP Meas AVH_A&E AVH_B&C DF Meng

60000 Sch CL Chicken Pox Mal 350

50000 48882 300

40000 250 34802 32472 32916 33227 200 30000 28344 25775 23486 22857 150

20000 of No.Alerts 100

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 23486 32472 33227 48882 25775 Female 22857 32916 34802 74758 28344 Distribution of consultations of leading diseases by Governorates,Epi week 37-2019

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 2592 3172 1272 981 5461 954 600 907 4802 2008 2560 1482 1605 3646 2266 3880 532 582 2947 3224 1185 60 1427 48145 LRTI 256 323 771 176 4301 328 53 392 1905 951 1331 328 245 1375 1187 1240 145 132 590 1141 257 33 626 18086 ILI 180 0 16 0 90 42 0 0 9 21 48 5 0 61 29 1 96 1 50 164 125 3 82 1023 SARI 0 0 13 0 0 0 0 0 1 13 79 0 0 0 0 0 0 0 19 0 8 0 0 133 Pert 1 2 0 0 0 23 0 0 2 6 3 4 0 0 11 7 0 0 5 6 0 0 1 71 BD 51 4 57 10 140 48 2 81 86 155 113 8 2 2 69 26 18 10 138 135 41 0 75 1271 OAD 1236 1928 1160 658 3380 1043 390 699 4477 1940 2563 673 421 2752 1971 1727 468 387 1690 2477 833 13 984 33870 Typhoid F 36 43 326 11 429 159 12 94 579 271 826 28 9 8 513 35 63 64 191 325 73 25 141 4261 Meas 1 17 4 4 3 2 0 0 11 1 5 1 1 5 10 0 1 0 13 4 2 0 4 89 AVH_A&E 9 12 2 2 2 0 1 1 117 13 49 19 8 7 21 30 0 1 5 16 20 0 19 354 AVH_B&C 3 1 3 0 2 2 0 0 69 7 11 7 1 4 16 0 0 0 3 1 5 0 5 140 NNT 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 2 AFP 0 1 0 0 0 1 0 0 4 1 0 0 0 0 1 0 0 0 0 0 0 0 3 11 247 7 2 7 24 15 1 2 11 14 14 6 5 األمراض المشتبه10ة Mumps 15 8 6 10 17 16 0 2 37 18 Mal 34 141 1 0 8181 81 29 490 217 571 498 3 1 3657 398 70 36 241 826 218 1 0 1282 16976 Meng 0 0 0 0 3 1 0 0 11 2 1 1 0 0 9 0 0 0 2 0 0 0 17 47 DF 159 85 0 8 11 0 0 0 0 0 0 8 5 37 2 86 14 0 0 0 30 0 230 675 VHF 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 Sch 1 0 1 17 1 16 0 25 32 91 31 10 0 91 10 1 1 11 44 28 0 0 12 423 CL 0 0 2 3 0 2 0 0 3 2 14 1 1 2 1 12 0 3 7 5 0 0 6 64 RB 0 0 28 0 1 0 0 6 87 32 104 0 1 10 87 0 0 1 0 11 0 0 4 372 Tuberculosis 1 6 0 1 9 2 1 0 11 0 3 0 0 4 5 2 0 0 2 4 0 0 4 55 HIV/ AIDS 0 0 0 0 0 0 0 0 4 1 0 3 0 0 2 0 0 0 0 0 8 0 0 18 Brucellosis 2 0 62 0 11 58 0 5 166 41 185 0 11 140 54 0 8 0 16 18 12 0 7 796 Chicken Pox 3 19 2 7 8 8 2 4 60 56 33 11 1 22 35 11 1 14 103 48 8 0 2 458 Scabies 24 1 0 0 52 0 1 3 9 6 12 0 0 32 3 1 0 21 30 17 0 0 5 217 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 3946 7988 5451 7880 13701 3291 1995 4392 52293 6256 20905 7092 4366 10624 11712 11171 5352 1182 6325 9091 4688 257 4347 204305 total_cons_disease 8583 14163 10041 9864 41596 6467 3090 7810 67074 15676 31330 10031 6694 24297 20429 18445 6973 2933 13501 19627 7215 393 11190 357422 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 37 (9-15 September,2019)

Alert Responded in Epi - Week 37,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Eidews coordinator visited the health facility, the cases of suspected cholera were diagenosed clinicaly according to case definition. Yaffa,Al Maqatirah,Al Had,Radfan,Al Alhaid rural H,Radfan Public H,Ibn Khaldoon RDT 96 positive, cases reported immediatly to the operation room, recorded in the line Chol Lahj 159 0 Hawtah,Al Qabbaytah,Tur Al Bahah Hospital,Karesh Health Center,Tour Albaha Hospital list. the cases treated by iv fluid, ors and antibiotic. the cases finaly improved and left the health facility.

Alhlal HC, Tur Sena'a Dispensary ,Radfan Public Tuban,Yaffa,Radfan,Halimayn,Al Eidews coordinator visited the health facility, the cases of suspected Dengue fever were diagenosed DF Lahj H,Halimeen rural H,Almilah Hospital,Habil Aljubair rural clinicaly according to case definition. 86 0 Milah,Habil Jabr,Tur Al Bahah H,Tour Albaha Hospital The cases added to the line list , treated symptomaticaly and improved.

Immediate reports were recived by the focal point , the cases of suspected whooping cough were Pert Lahj Yaffa,Tuban October public H,Alsharif Health Center diagenosed clinicaly according to case definition. 7 0 The cases registerd in the line list, treated symptomaticaly and left the health facility.

Contact with the surveillance coordinator of the district, 2 cases of suspected Diphtheria from bany baker area were diagenosed clinicaly according to case definition. Cases reported immediatly to the operation room , added to the line list. Diph Lahj Al Had Alhaid rural H 2 0 Cases treated by penicillin and recoverd. RRT Visited that area , supported vaccination camp for children and contact supplyed by erythromycin for 14 days.

Alburaihi H,Alwahda educational H,Aljumhuria eIDEWES team were contact by f.p, the cases were diagnostic clinically, treatment were given. Ash Shaikh Outhman,Khur Maksar,Dar samples were not collected DF Aden educational H,Al Ryadah Hosp.,Al-Wali Hosp.,Aden 85 0 Sad,Al Mansura Investigation form German Hosp. were done.

eIDEWES team were contact by f.p, the cases were diagnostic clinically, treatment were given,the Khur Maksar,Sairah,Al Mualla,Al Khor-Maksar Complex.,Babl Hospital,Almua'ala health cases were Vaccinated except 3 cases were un vaccination Meas Aden Buraiqeh,Ash Shaikh Outhman,Al complex,Alwahda educational H,Hashed Health 17 0 samples were not collected Mansura,Dar Sad Complex,Durrat Aldar specialized H Investigation form were done

Shifa Aden Dispensary,Almua'ala health Al Buraiqeh,Sairah,Khur Maksar,Al eIDEWES team were contact by f.p, the cases were Chol Aden complex,Albasateen medical center,Alwahda educational 180 0 Mualla,Dar Sad,Ash Shaikh Outhman diagnostic clinically, treatment were given,4 cases were positive by RDT H

eDEWS team contacted RRT. The cases were diagnosed clinically, one case was vaccination and one AFP Aden Sairah,Ash Shaikh Outhman Almaidan health complex,Alwahda educational H case other was un vaccination , treatment were given, samples were collected and investigation form 1 0 were done.

eiDEWS team were contacted fh :The cases were diagnosis clinically, treatment were given, Pert Aden Ash Shaikh Outhman,Dar Sad Alwahda educational H,Al Ryadah Hosp. 2 0 investigation from were done.

eiDEWS team were contacted fh :The cases were diagnosis clinically, the cases were vaccination Diph Aden Ash Shaikh Outhman Alwahda educational H 3 0 unknown and samples, treatment were given, investigation from were done.

RRT in Mudiyah district visited FP, the cases were diagnosed clinically, RDT'S were positive in some samples and stool culture didn't done, treatment were given, investigation forms were done , the cases Chol Abyan Mudiyah,khanfir,Lawder,Al Mahfd Mudiya Hosp.,Alrazi .H,Mahnf-Lwdr H,Al Mahfad Hospital 31 0 and their families received complete advices about the ways of prevention and management of cholera infection. the cases included in Cholera line list.

Al Azi Dispensary,Mahnf-Lwdr H,Al Samim Clinic,Spah eIDEWS team contacted the FP,the cases were diagnosed clinically (standard dengue case definition) DF Abyan Lawder,Jayshan,Sibah,Al Mahfd 159 0 HC,Al Mahfad Hospital,Alkafah HU samples were not collected, treatment were given, investigation forms were done

eIDEWS team visited the focal points , The suspected case diagnosed clinically according to the standard case definition, the case admitted in the hospital and take antibiotics & regular interest till Pert Abyan Lawder Mahnf-Lwdr H 1 0 complete recovery , investigation form done , RRT in districts investigated the region for quick research on other new cases.

eIDEWS team contacted the F.P,the case was un vaccination,Blood Sample collected and waiting for Meas Abyan Lawder Mahnf-Lwdr H 1 0 send to Sana,a city

RRT in Lawder district visited the FP. In Mahnf-Lawdar Hospital. the cases were 2 females , all the cases were > 5 years old ( khalood Esam AlAolagi) 12 years old from Zarah village and ( Sema Alkhader VHF Abyan Lawder Mahnf-Lwdr H 2 0 Magda) 13 years old from Alnagdah villag. the cases diagnosed clinically (standard dengue case definition), samples were not collected, treatment were given, investigation forms were done

Sharab Ar Rawnah,Al Misrakh,Khadir,AlQahirah,AlMaafer,Mawi Al Aroos Hospital,22 May HC,Ar Romah Rapid response team contacted also focal point by eIDEWS coordinator,cases diagnosed clinically yah,AlMudhaffarSalh,SharabAsSalam, center,Almodafar Hospital,Aljoumhri H,Khalifa according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Chol Taiz 1832 2 SabirAlMawadim,Maqbanah, Hospital,Al Loqiah Hospital,22 May Almodafar HC,Mawih labs)for confirmation. Supplements & antibiotics treatment were given(case management)rapid test : 168 AtTaiziyah,AshShamayatayn Hospital,Alnshmh H,MSF Hospital,Other cases were positive&the results of stool C/s still pending,There were collection & cluster of cases in the Hayfan,Jabal Habashy same Place,2 cases were dead

the communicating with the coordinator of edews in the facility we found these case of suspicion of Pert Taiz Salh Al-Safwah Hosp. 1 0 pertussis, Action :these case was treated at home

Labs National Center,22 May Almodafar HC,Alhikma Focal point,and the coordinator of the directorate were contacted , the suspected DF cases had a history Al Mudhaffar,AlMukha,Al of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by blatelets DF Taiz Hospital,AlmodafarHospital, Althwrh H,Aljoumhri 230 0 Qahirah,Khadir,Salh counting, ,rapid test of dengue virus was done for some of cases ,,which were positive,, Medications H,Almkha Hospital,Other have been given,there is cluster of cases in some areas, All from taiz governorate, All data in the line list..

Mashraa Wa Hadnan,Al Mudhaffar,Al eIDEWS coordinator contacted focal points and the coordinator of the directorate ,information's Meas Taiz Althwrh HC,Other shared.Blood samples were collected from the cases and sent for lab confirmation &the cases were 4 0 Mawasit unvaccinated ,All data in the line lis

We was receiving an immediate report from the coordinator of edews in the facility about this case of suspicion of diphtheria which was one male , Age : 11 years old . Residence : taiz governorate,,almodaffer district,. .. the case was diagnosed clinically as a suspected case of diphtheria,, ,,..we write all data about the case in the line list .. action :we inform the Rapid response team to visit the Diph Taiz Al Mudhaffar Althwrh HC 1 0 facility which receive the cases and they found data recorded in the hospital and the case was complained of fever and membrane in the throat and difficulty of swallowing,,after that the team has been visit the house of the patient and they take all data about the case and her contacts..all that's in the line lis..

Rapid response team and Focal point was contacted by eIDEWS coordinator ,,,, information's shared. samples were collected ,, and will be send to sana'a, , There are 3 suspected case one of them was dead case which was : Mohammed abdulmoeen ahled ,, Age :144 months. Sex :male . . Residence : taiz governorate ,,almisrakh district ,,Date ofonset :5/8.. AFP Taiz Al Qahirah Yemeni - Suidi H 3 1 Vaccination:unknowndoses.. The other cases were 1.name :nashwan abdulmoeen. .Age :144 months Residence :almisrakh district /taiz. Date of onset :5/8Vaccination :unknown ..

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 37 (9-15 September,2019) Alert Responded in Epi - Week 37,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

The EDEWS coordinator contacted the focal person, the cases were diagnosed clinically by case Pert Hadramout Ash Shahr Al-Qods Dispensary 1 0 definition, the cases were vaccinated, antibiotic treatment were given.

The EDEWS coordinator visited the health facility, the cases were diagnosed clinically by case Maternity and Childhood H - Mukalla,Alsadara HC,Hajar definition,RDT were done and positive in 29 cases, stool culture were collected. the result is pending, all Chol Hadramout Al Mukalla City,Hajr,Ghail Ba Wazir 90 0 aljoul rural H,Other cases were treated in the DTC. IV fluids, ORS and antibiotic were given, all cases improved and discharged.

Immediate report were sent by the EDEWS focal person,the case was un vaccinated. not blood sample Meas Hadramout Adh Dhlia'ah Aldhulaia'a HC 1 0 was collected,symptomatic treatment was given.

Ad Dis Al-Shrgyah Hospital,Bin Sena'a educational The EDEWS coordinator contacted the focal person, the cases were diagnosed clinically by case DF Hadramout Ad Dis,Al Mukalla City,Al Mukalla definition, all cases were treated by symptomatic treatment,all cases improved and discharged, one case 8 1 H,Other was dead

Immediate report was sent by the EDEWS focal person. the case was 7 years old female from AlMukalla city. the case was diagnosed clinically by case definition. on examination. pseudomembrane with neck swelling was seen. the pt was irritable. sever dysphagia and DOB. 2 pharyngeal swaps were Diph Hadramout Al Mukalla City Maternity and Childhood H - Mukalla 1 0 collected and sent to central lab. the result is positive for bacillus of Diphitheria. DAT with cover antibiotic were given. the case is not vaccinated. the district RRT investigated the living area. vaccination, health education was performed. cover antibiotic was given to the contacts.

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,AlMakhadir AsSayyani,Ash Hospital,Alradhmah H,Almakhader HC,Alqaidah H,AL by rapid test for 120 samples , the cases were treatment, some stool samples sent for culture. Chol Ibb 1998 0 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 Saddah, Far Al Udayn,Ibb,DhiAsSufal

Badan,AlUdayn,AsSaddah, Alshaheed Albadani Hospital,Aladin H,specialist Medical eDEWS focal points contacted.Information shared , Samples were collected ,the cases were Meas Ibb AlQafr,AnNadirah,Yarim, Hubaysh,Al 10 0 Clinic,Aldhalmh HC,Other vaccination except 3 cases were un vaccination Mashannah,Al Dhihar

Immediate notification by focal point. Cases were diagnosed clinically and treated accordingly. 6 cases Pert Ibb Yarim Yarim Hospital 11 0 were Vaccinated and from different areas

Immediate notification by focal points, the cases were diagnosed clinically and treated accordingly and Diph Ibb Al Mashannah,Al Dhihar Alnassr H,Al Thawrah Hospital 6 0 recieved anti-toxin,5 cases were vaccination unknown,the cases from different areas

Immediate notification.Patient name Abdo Mohammed Ali Heder 60 months ,old male.From Taizz_Maqbanah-Albarh -Ankadhah Date of notification 9/9/2019.Date onset of symptoms AFP Ibb Al Mashannah Alnassr H 1 1 4/9/2019.Sample (one)From case ,number of vaccination 2 doses but He died in 10/9/2019 in Naser Hospital.

Bura,AlMansuriyah AzZaydiyah,BaytAlFaqiah Alsalakhana H,Alkanawes HC,Aldhahi Rural AlQanawis,AdDahi,AzZuhrahAlHawak,Al eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and H,Almansouria rural H,Bait Alfakih H,Alzaydia Rural treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use Chol AlHodaidah Hali,AsSalif AlMunirah,AlMighlaf 5744 0 H,Aljarrahi rural H,Alluheyah HU,Alhshm WHO protocol DTC, some cases done rapid test were positive for101 cases, positive test send for AlGarrahi,Alluheyah Center,Althawra public H,Almekhlaf HC,Other confirmation, , JabalRas,AsSukhnah,Zabid,Al Mina, Al Marawiah,Al Hajjaylah

Bayt Al Faqiah,Al Hali, Ad Durayhimi, Ad Bait Alfakih H,Al Hawak HC,Aldhahi Rural H,Althawra Focal point were contacted , the suspected Diphtheria cases had a history of pseudo membrane around Diph AlHodaidah tonsillitis , and sever inflammation, cases were vaccination and diagnosed clinically, Medications have 25 1 Dahi, Al Hawak,Bura public H,Other been started, ALL cases only depend on case definition.

Focal point was contacted , the suspected DF cases had a history of high fever , retro- bulbar pain DF AlHodaidah Al Qanawis Alkanawes Private H ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been started, ALL cases 11 0 diagnosis depend on case definition and platelets counts, no cluster of three cases in same place

eDEWS coordinator contacted the focal point, the cases were suspected measles the cases were none Meas AlHodaidah Al Hali Shamsan Center vaccination their from has ,fever , rash recorded in ,Hospital recorded the blood samples have been 3 0 collected from the patient by district coordinator and sent to the central laboratory in Sanaa.

Najrah,AshShahil,AlMiftah QaflShamer, BaniQais,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 District. Information shared .It has Chol Hajjah Health Center,Mabyan Hospital,Kuhlan Afar been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea) 1792 5 Kuhlan Affar,Mustaba,Bani Al HC,Almahabesha Public H,Alshahel Rural the cases from different area, It were given the appropriate treatment,5 cases were dead Awam,Kuhlan Ash Sharaf Hospital,Almaghraba HC,Other AlMaghrabah,Khayran AlMuharraq,AshShaghadirah

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts,Information shared , We received a report from Hospital , the cases (suspected diphtheria) The diagnosis were clinically Diph Hajjah Hajjah City,Khayran Al Muharraq,Abs Public Republican Hospital,Abs Rural Hospital 13 0 (diphtheria) the cases were vaccination except one case was un vaccination,The response team in the field investigated the cases and the contacts and the appropriate treatment were given

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It were Mabyan,Kuhlan Ash Sharaf,Al diagnosed clinically according to standard definition For measles, the cases were vaccination except 2 Meas Hajjah Mabyan Hospital,Aflah Al Yaman Health Center,Other 5 0 Mahabishah,Aflah Al Yaman cases were un vaccination, Investigation form were done,Appropriate treatment were given,The samples were collected and sent to the central laboratory

eDEWS coordinator contacted focal points, information shared, cases have been diagnosed clinically DF Hajjah Khayran Al Muharraq,Bani Qais Martyr d. Yasser w Thab Hospital,Bani Qais Health Center ,According to the standard definition, Cases from different areas , Some cases have been rapid test 37 0 work the result were positive Appropriate treatment were given

eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Aththaorah,Az'zal,Maain,As cases and sent for lab confirmation& the onset of fever,skin rash, the cases were unvaccinated against Meas Amana Azal Complex,Gazah Complex,Alzhrawi HC,Other 11 0 Sabain,Shu'Aub measles,Vit-A were given to the cases in order to support their immunity against complications of measles

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,AsSabain,Assafi'yah, Complex,Bni - Hwath HC,Arwdhah H,As Sabin (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana BaniAlHarith Maain 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 1962 1 ,Az'zal,AtTahrir,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

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 Maain,Bani Al Harith,Aththaorah,As 22 May Hospital,Bni - Hwath HC,Al Jraf Complex,As diphtheria.Symptoms & signs of a case were,fever,sore throat,grey-whitish pseudo-membrane ,swelling Diph Amana 12 0 Sabain Sabin Hospital,Zaid bn Sultan H of neck lymph-nodes(Bull neck) & difficulty of swallowing & breathing. Antibiotic treatment was given & case management done.Throat swabs taken into Central Lab for confirmation(Albert stain,Gram stain & Diphtheria C/S)the cases were vaccination

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 37 (9-15 September,2019)

Alert Responded in Epi - Week 37,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eIDEWS coordinator contacted focal points,then HF visited, Information shared.Stool samples collected AFP Amana As Sabain,Bani Al Harith,At Tahrir As Sabin Hospital,Aljomhwri H 4 0 from the cases and sent for lab confirmation,the cases were un vaccination against polio.

eIDEWS coordinator contacted focal point,information shared,then HF visited by eIDEWS coordinator.The cases diagnosed clinically according to the case definition. Antibiotics treatment was given.The number of cases were 3,2 females & one male.For the 1st case,the date of illness onset was on 06\11\2018 & the date of case admission on 09\11\2018.The case was one male,his name MAJDI MANEH KHALED AL-ABBASSI,his age 1.1 month.The case from Amana governorate,Ma'ain district,Al- Sonainah area.The case was unvaccinated against Pertussis. For the 2nd case,the date of illness onset Pert Amana Bani Al Harith Zaid bn Sultan H was on 07\11\2018 & the date of case admission on 10\11\2018.The case was one female,her name 3 0 RUKEYAH HUSSEIN WATHAB,her age 2 months.The case from Amana governorate,Assafi'yah district,Khawlan street.The case was unvaccinated against Pertussis. For the 3rd case,the date of illness onset was on 07\11\2018 & the date of case admission on 09\11\2018.The case was one female,her name ASMAA JOBRAN ALI AISHAN,her age 2 months.The case from Amran governorate,Harf Sufyan district.The case was unvaccinated against Pertussis. There were no collection of cases seen in the same place

Sahar,Baqim,Qatabir,Majz, Monabbih Rural Hospital,Ghafira Unit,Dhian HC,Al the e-DEWS coordinator contact the e-DEWS focal points in the center, all cases were diagnosed clinically according to the SCD,The information shared and the cases were treated in the hospital Chol Sa'adah Saqayn,Sa'da,AdhDhahir, Jumhoori Hospital,Al Ghabir Health Unit,Al AlAmri 500 0 according to the management protocol the district rapid response team contacted to perform the Razih,Munabbih HU,Qatabir Health Center,Other investigation in the field

Haydan Hospital,Qatabir Health Center,Majz Health elDEWS team contacted focal points,information shared, blood samples were not collected from the Meas Sa'adah Sahar,Haydan,Qatabir,Sa'da Majz,Sahar cases and the onset of fever,skin rash , the cases were unvaccinated against measles. Not blood 13 0 hospital samples

Pert Sa'adah Haydan Haydan Hospital eDEWS coordinator contact the focal points ,the cases were un vaccination 5 0

Al Jumhoori Hospital,Amlah Noman Health Center,Majz the edews focal points contacted , the cases were diagnosed clinically according to the standard case Diph Sa'adah Haydan,Sa'da ,Al Hishuah,Majz,Sahar definition ,the cases were referred to the Diphtheria isolation in the cases receive the proper 7 0 Health hospital management , the contacts traced by the district RRT , the line list updated and the information shared

AsSudah,Huth,Suwayr Al Qaflah Rural Hospital,As Sawd Health Khammer,Shaharah, Harf hospital,Raydah Health hos.,Al Ashah Health Sufyan,HaburZulaymah eidews Coordinator Contact the Coordinator of Surveillance in Districts , The cases were diagnosed hospital,Harf Sufyan H,Al Salam Khamir Hospital,Huth clinically as suspected cholera . According to case definition, Rapid Test were done for some cases Chol Amran DhiBin,AlAshah,Amran Raydah 845 1 Health hospital,Kharif Rural Hospital,Amran General the result were positive and some Negative , All The cases improved After Taking The Treatments ,Thula,Bani Suraim,Kharif,Al Hospital,Thula Health hospital,Habur Health hospital,Al proper,one case was dead Madan,AlQaflah,AsSawd,Maswar,Jabal Abraq Health Unit,Other Iyal Yazid

eidews Coordinator Contact the Coordinator of Surveillance in Districts and visit health hospital ,The Pert Amran Raydah,Khammer Raydah Health hos.,Al Salam Khamir Hospital cases were diagnosed clinically as suspected pertusis, according To case definition,The Cases 6 0 Improved After Taking the Treatments Antibiotics

eidews Coordinator Contact the Coordinator of Surveillance in Districts and visit health hospital and investigation,the case was diagnosed clinically as suspected Measles. According to Case Definition, Meas Amran Raydah Raydah Health hos. 1 0 Blood Sample was Collected Of Patient and Sent To Central Lab in Sanaa,the Case was Vaccinated Against Measles

Eidews Team contacted focal points,and RRT visit Health Hospital and Visit the contacts and gives Diph Amran Thula,Amran Thula Health hospital,22 May hospital antibiotics cases transfer to health hospital , the Cases were diagnosed 5 0 clinically probable diphtheria . the cases Treated with antibiotics and anti toxin

eidews Team Contacted Focal Point. and Coordinator Surveillance district khamer visit Health Hospital AFP Amran Khammer Al Salam Khamir Hospital and investigation. Case Were Diagnosed Clinically as Suspected AFP. according to definition case. 1 0 stool sample Collected and Sent To Central Lab in Sanaa. Case from District suwer

BaniHushaysh,AlHaymahAlKharijiyah,AlH Bani Mansour HC,Al wheda Manakha rural Hospital usn,Nahm BaniDhabyan,Khwlan ,Awmara H,22 May Hospital ,Ka'a Alreka HC,Sa'afan Manakhah,Hamdan eDEWS coordinator contacted focal points,The cases were diagnosed suspected cholera(AWD) cases Chol Sanaa Governorate HC,Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital tested by rapid test 322 cases positive ,the cases were treated at the health facility and received 2479 0 BaniMatar,AlHaymah ,Almarbak HC,Almanar Hospital,Bait Alrejal HC,Walan treatment AlKharijiyah,Jahanh BiladARus,Arhab Hospital,Other Sa'fan,Attyal,Sanhan

Awmara H,Alja'ara HU,Alshaeed Mohamed Aldurra The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Meas Sanaa Governorate Arhab,Attyal,Jahanh,Manakhah definition, Skin rash started , The cases were un vaccinated except one case was vaccination ,blood 4 0 Hospital samples were collected.

Al wheda Manakha rural Hospital , D /Hassan Tamah Rapid Respose team visited area according to case definition suspected Diphteria,the cases were Diph Sanaa Governorate Manakhah,Arhab,Attyal,Bani Hushaysh 4 0 Center,Bait Alhenami HC vaccinated except 2 cases were vaccination unknown ,appropriate treatment given to cases

Al Haymah Ad Dakhiliyah, Al Haymah Al The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case Pert Sanaa Governorate Kuwait Center, Bani Mansour HC 6 0 Kharijiyah definition.,Unknown vaccination status,The cases were treated with antibiotic.

Yashbem Health Center,Rudum Rural Hospital,Shnidof eIDEWS coordinator were contacted with the health facilities they founds,suspected cases of dengue DF Shabwah Assa,aid,Rodhoom, Ataq fever, the cases were diagnosed clinically according to case definition, rapid test were not done, all 30 0 HC cases were treated and improved.

eIDEWS coordinator was contacted with the health facilities,he found suspected case of diphtheria, Diph Shabwah Ataq Teab Al Atfal Clinic 1 0 the case diagnosed clinically according to case definition,the case was un vaccination

eIDEWS team were contacted with the health facilities, they found suspected cases of cholera, the Chol Shabwah Rodhoom,Ataq,Baihan Rudum Rural Hospital,Emergency/Ataq Hospital cases were diagnosed clinically according to case definition,the rapid test were positive for 3 cases ,the 22 0 cases were received their best treatment and improvement.

eIDEWS coordinator was contacted with the health facilities he found suspected case of measles, the Meas Shabwah Ar-rawdah,Jirdan Al Redha Clinic,Jardan Rural Hospital cases were diagnosed clinically according to case definition,one case was vaccination and one case 2 0 other was un vaccination,samples were collected , the cases were treated and improved.

AsSawadiyah,AtTaffah, eIDEWS team contacted focal points the cases were diagnosed clinically as suspected cholera using Naman,Mukayras Sabah,DhiNa'im, Mother and child HC,Althwrh Hospital,AlTaffahCenter case definition and rapid test were positive for 90 cases and the main saing watery diarrhea &vomting Chol Al-Baidha 862 1 ALSharyah,AlMalagim, RadmanAlAwad, Mukayras Hospital,Other some dehydration the paitnts ademittedt in HC and with ORS and IV fluid in good condation the cases AlQuraishyah AlBaydaCity,Rada' from deferrnt organ,one case was dead

eDEWS coorinator contacted focal points theIDEWS team contacted point information was not Diph Al-Baidha At Taffah,Al Bayda Al-Taffah Center,Other collected Samples the cases diagnosed clinically As suspected Diphtheria using case definition the 2 0 onset were given Antibiotic , the cases were vaccination agianst Dephtheri

IDEWS team contacted points information shared blood saeIDEWS team contacted focal point the Meas Al-Baidha Sabah,Dhi Na'im,Al Quraishyah Zkhm HC,Dar Najd Health ,Other cases diagnosed clinically according to case definition Antibiotics treatment were given ,the cases were 4 0 un vaccination except one case was vaccination

EDEWS team contact Edews focal points in Health centre,the cases were diagnosis according to case Chol Al-Mahra Huswain,Al Ghaydah,Qishn Al Ghaydah Center Hospital ,Qishn Country Hospital 4 0 defination , susspected Cholera ,Cholera rapid test 2 positive ,treatment were given

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 37 (9-15 September,2019)

Alert Responded in Epi - Week 37,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

edews team contact focal points , the cases were diagnosed clinically as suspected (DF) using case definition , 5 male reported from Madwda health center main sign : fever , headache ,muscles pain, joint pain ,stomach , watery diarrhea. Vomiting DF Hadramout wady Sayun Madwda HC 5 0 lab result: 3 case negative , 2 cases no sample Investigation done by district RRT in the home and area Address: Sayoun, district , Madwda

edews team contact focal points , the cases was diagnosed clinically as suspected (meas) using case definition , Meas Hadramout wady Sayun Alghurfa HC 1 0 (1) name: Mohamed Shaaban Ahmed Masoud, age 9 m , under age vaccine fever onset 9/09/2019, blood sample collected. symptomatic treatment was prescribed

Taibah hospital,Alkharba rural H,Almajel HC,Aljarf Utmah,DhamarCity Dawran HC,Dawran Hospital,Dhamar public H, Bani hutam Aness,Wusab AlAli,WusabAsSafil HC,Wathan HU,Dheba HC,A Unity Centre EideWS coordinator contacted focal points he found cases diagnosed suspected Chol(Acut watery Chol Dhamar Mayfa'atAnss JabalAshsharq diarrhoea and dyhadretion )the cases tested by rapid test And result were postive for 80 cases , all 1232 0 (residential),bny salamh Unite,Kharbah Abuyabes AlManar,Jahran, Anss Maghirib Ans, cases received treatment HC,Alhumyat HC, AlMasli Hospital,Alwahda university AlHada H,Zeraja rural H,Hamam Ali Hospital, Other

Edewds coordinator contacted of the focal points and he found that the cases were diagnosed according Meas Dhamar Mayfa'atAnss,Jahran Al Hada Alkharba rural H,Zeraja rural H to the standard definition of Meas( fever -rash )the cases were vaccination except one case was un 5 0 vaccination, Samples were collected

Edewds coordinator contacted of the coordinator districts and he found that cases were diagnosed Pert Dhamar Dawran Aness Bin alakwa'a Dispensary according to the standard definition of pert , different area,the cases were un vaccination, treatment and 3 0 education health given

EIDEWS coordinator contacted coordinator district he found cases diagnosed suspected Diph Diph Dhamar Dhamar City Dhamar public H,Alhumyat HC according to the standard definitions Patient ,.Treatment have been given as antibiotic and toxin , Throat 3 0 swab not taken ,the cases were vaccination unknown except one case was un vaccination

eIDEWS coordinator contacted focal point,information's shared,then HF visited by eIDEWS coordinator.The number of cases were 1 male .Blood sample was collected from the case and sent for lab confirmation in 8 - 9 -2019 & the onset of fever,skin rash in 7 - 9 - 2019.His name Hashed Meas Mareb Al Abdiyah ALShahud Ali Abdul Hospital 1 0 Abdalwahed Almaarathi ,his age 3 years.He was from Mareb governorate,Bid Bidah district,Bani Maarath area.He was vaccinated against measles only one does. Vit-A was given to the cases,in order to improve their immunity against complications of measles

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Bid Bidah Hospital,Al vatha HC,Harib Hospital,May 22 clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb Harib,AlJubah,Alwadi,Bid Bidah,Sirwah 18 0 Hospital Supplements & antibiotics treatment were given(case management) ,the results of stool Rapid tests of cholera 5 positive .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 5 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 May 22 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

Al Maton Health Center,Al Hazm Hospital,Al Humaydat Al Hamidat,AlGhayl AlMatun,AlHazm 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 AlMaslob,AlMatammah,KharabAlMarashi diagnosis, they were cholera,without a suspicious examination from different areas. After validation,13 273 1 Hospital,Al Marashi Health Center,Hosoon Aal Shanan Bi'rat Al Anan cases positive for rapid test, Treatments were treated according to the treatment plan,one case was dead Health Center,Other

Contact the EDEWS team for the contact. The cases clinically diagnosed as suspected in the AFP field AFP Al-Jawf Al Khalq Al Khalq Health Center were diagnosed. Not a restaurant. Node locality Fecal samples were collected from the cases and close 1 0 contact was sent to the Central Laboratory in Sana'a.

Maain Health Center,Al Shifa Center,Hosoon Aal Shanan EDEWS team contacted focal points,the cases diagnosed clinically as suspected pert,treatments were Pert Al-Jawf AlHazm,AlMatammah,Az Zahir,Al Matun Health Center,Ard Alganateen Clinic,Al Kasmi (Al Marfaqi 25 0 given,the cases un vaccines Aal Qassim) Health Unit

1 The EDEWS coordinator have contacted the coordinator,The condition were diagnosed clinically by Meas Al-Jawf Al Hamidat,Bi'rat Al Anan Al Humaydat Health Center definition of the condition, Blood samples were not collected,Symptom therapy and antibiotic giving were 2 0 given and vitamin A

Shibam Kawkaban Hufash,Bani Sa'd Altawilh HC,Bni Alhmadi HU,Mlhan Health Center,Alrujm eIDEWS coordinator contacted focal point, information was shared. all cases were diagnosed clinically according to case definition,the cases were investigated by rapid test for vibrio cholera and the results Chol Al-Mahweet Al Mahwait,alKhabt Ar Rujum,AtTawilah Hospital,Bani Sa`d Hospital,Shbam H,Alkhpt H,Hufash 702 0 were positive for26 cases, appropriate treatment were given according to severity of symptoms and Al MahwaitCity,Milhan H,Alahjer HC,Swaq Alahd HU,Other dehydration

As Salafiyah,Bilad At Ta'am,Al Wadi Alarid HC,Altkarir HU,Almithaq H,Alhadiah eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Chol Rayma treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use 232 2 Jafariyah,Al Jabin,Kusmah,Mazhar HC,Althulaia H,Other WHO protocol ORC,2 cases were dead

eIDEWS Coordination contact focal point the suspected diphtheria had a history of pseudo tonsillitis s and seve inflammation cases were diagnosed clinically medication have been started v accented The Diph Rayma Al Jafariyah Almhil HC contact was vaccinated and the antibiotic was given to the appropriate patients and contacts and the 1 0 situation improved and we continue to communicate with the quick response What are the procedures performed for each

eIDEWS team was contacted fp: The cases were diagnoses clinically, vaccination were done, samples Meas Al-Dhale Ad Dhale'e,Jahaf,Al Husha,Qa'atabah Alznd HU,Other 4 0 were collected , treatment were given, investigation form were done.

AlAzariq,Qa'atabah, Daglal Health Center,Alfakhr HC,Aamwr HU,Dhwran eDEWS team contacted FP, the cases were diagnosed according to case definition, all included in Chol Al-Dhale AlHusha,AshShu'ayb,Ad Dhale'e,Al 146 0 HC,Alnassr H updated daily line listing Hussein,Damt

eDEWS team conted focal point information shared inve stigation forms and lab samples and waiting for DF Al-Dhale Ad Dhale'e Other results cases opriate treatment were appro cases were 5 males 5 their given were Greater than 5 years 8 0 ages they came from other they governorates