Epidemiological Week No. 30 (19 -25 July 08) Aug 9/ Vol. 140/ DEWS 2008-30

Muzaffarabad: Ghel Jabri Picture by Dr. Mazhar Iqbal Reporting Units ...... 2 Total number of consultations...... 2 DEWS Data, Epidemiological Week No. 30, 2008 ...... 3 DEWS Data, (Epidemiological Weeks No.27 – 30, 2008):...... 4 Acute Diarrhoea and suspected Cholera: ...... 5 Acute Respiratory Tract Infections: ...... 7 Upper and Lower Respiratory Tract Infection:...... 7 Other Conditions under Surveillance: ...... 8 Outbreak Alert and Response...... 8 Number of reported cases and deaths per District, AJK ...... 9 Number of reported cases and deaths per District, NWFP ... 10

ƒ In week 30, a total of 73,183 ƒ All the earthquake affected districts consultations were reported from 247 show an increase in the number of reporting units consultations for Acute Diarrhoea over the past few weeks

ƒ ARI remains the leading cause of ƒ Two alerts were received and consultation this week (18% of total investigated accordingly consultations) ƒ There was no outbreak reported from any District. ƒ Acute Diarrhoea was reported in 12% of all consultations, same percentage

The Weekly Morbidity and Mortality Report (WMMR) is published by the Ministry of Health of (MOH) and the World Health Organization (WHO). The WMMR is built on surveillance data that health service providers and NGOs transmit on a weekly basis from health facilities and hospitals in those areas affected by the earthquake that struck Pakistan on 8 October 2005.

The WMMR objectives are to monitor the trend of health conditions over a period of time and provide vital information to all health partners. The WMMR is only a snapshot of the health conditions in those facilities where events are registered and data collected and does not necessarily reflect the situation from other health facilities.

The WMMR is a publication that has been developed for emergencies and previously used in other areas such as the Darfur Crisis.

The WMMR is produced with the financial support of AAI Australia, Americares, CIDA, Denmark, DFID, ECHO, Ireland, Italy, Japan, Korea, Monaco, Norway, SIDA, Slovak Republic, Switzerland, Turkey, USAID

The WMMR is published by the World Health Organization (WHO), Health Emergency Operation Centre, National Park Road, Chak Shahzad, Islamabad, Pakistan. For More Information, please contact: Dr. Rayana Bouhaka, Manager Operations, WHO/EHA/Pakistan; [email protected] or Dr. Birjees Mazher Kazi, Chief, Public Health Laboratories Division, NIH MOH; [email protected] or WHO Webpage: http://www.whopak.org/disaster WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29

Reporting Units

During week 30, 2008, total 247 (74%) weekly reports were received from the DEWS reporting sites on due time. Compared to last week, the DEWS reporting have increased by 10% (64% and 74% respectively). The total number of reporting sites in the Earthquake affected districts remains 335 as of week 30, 2008. Table 1, summarizes the reporting by each earthquake affected district for the last 4 weeks.

Table1. Heath Facilities by district, reported from Earthquake Affected Areas, Pakistan, 28 June - 25 July 2008. Reporting Health Facilities 28June-4July 5-11 July 08 12-18 July 08 19-25 July 08 Area Population 08 Week-27 Week-28 Week-29 Week-30 Bagh 452,532 36 28 24 29 592,256 24 39 37 37 Mansehra 1,154,804 64 64 64 65 Muzaffarabad 770,000 70 54 36 45 Neelum 184,000 12 12 6 11 Poonch 633,712 60 58 46 60 Total 3,727,668 275 (82%) 255 (76%) 213(64%) 247(74%)

Total number of consultations

During week 30, total 73,183 patient consultations were reported, an increase of 8% compared to last week. Similar to the prior weeks, the district Muzaffarabad reports the highest proportion (27%) and Neelum reports the lowest proportion (3%) of the total consultation reported from all the earthquake affected districts. Neelum is the smallest district with the least number of DEWS reporting sites among all the districts in the earthquake affected area. Figure 1 depicts the pattern of weekly reporting units participating in the DEWS and the total number of weekly consultations reported from week 1, 2007 to week 30, 2008. Overall there seems to be a decline in consultations starting from week 49 onwards compared to the previous weekly pattern. This declining trend could be a result of people going to private clinics for health care which are now functional in the earthquake affected areas.

Figure1. Weekly trend of reporting units and total number of consultations, Earthquake Affected Areas, Pakistan, Week 1, 2007 – week 30 2008. # of Units Weekly pattern of reporting consultations # of Cns. 350 120000 Reporting Unit Consultations 300 100000 250 80000 200 60000 150 40000 100

50 20000

0 0 W04 W07 W10 W13 W16 W19 W22 W25 W28 W31 W34 W37 W40 W43 W46 W49 W52 W03 W06 W09 W12 W15 W18 W21 W24 W27 W30 Ep i- w e e k W01/07

2 WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29

DEWS Data, Epidemiological Week No. 30, 2008

During the Epidemiological week 30 (19th -25th July 2008), a total of 73,183 consultations were reported through DEWS. The distribution of consultations by age groups indicate that 19% are children less than 5 years of age, 21% are children 5-14 years of age, 40%, the majority, are adults 15-45 years of age, and 20% are adults above 45 years age. Of the total consultations reported for week 30, 52% were from female patients. The proportion for Upper Respiratory Tract Infection was 14%, Acute Diarrhoea 12%, Unexplained Fever 8%, Lower Respiratory Tract Infection 4% and Scabies 5% in all age groups and both sexes. Out of the total 73,183 reported consultation in all ages and both sexes, 55% (40,494) accounted for health problems other than the diseases reported above. See (Figure 2).

Figure 2.Distribution of reported consultations by disease/health event and age groups, 19-25 July 2008, Earthquake Affected Areas, Pakistan Distribution of consultations by age Distribution of consultations by diseases 45 40% URTI AD 14% 13% 40 LRTI 35 4% UF 30 9% 25 19% 21% 20% 20

consultations SCB

Percentage of all 15 5% 10 5 0 OTH <5 5-14 15-44 ≥45 55% Age-group

*OTH includes all other reportable conditions, plus all other consultations for conditions not under surveillance

Comparison of consultation by sex shows that in female patients, health events other than the five common communicable diseases are reported higher than males (58% and 54% respectively). In males, the proportion for Acute Diarrhoea, URTI and UF were higher than for females. The proportion of consultations for LRTI and Scabies are the same in both males and females. (Figure 3)

Figure 3.Distribution of reported consultations by disease/health event and age groups, 19 to 25 July 2008, Earthquake Affected Areas, Pakistan

Distribution of consultations (Male) Distribution of consultations (Female) URTI AD URTI AD 13% 12% 15% 13% LRTI LRTI UF 4% 4% UF 8% 9%

SCB SCB 5% 5%

OTH OTH 54% 58%

3 WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29

Disease Distribution by Age:

Acute Upper Respiratory Tract Infections (URTI) is the highest reported disease in all age groups during week 30. In children less than five years of age Acute Diarrhoea (AD) comprised 20% of the consultations followed by Upper Respiratory Tract Infection 19% of the consultations, Unexplained Fever 11%, Lower Respiratory Tract Infection (LRTI) 5%, Scabies 5% and other health problems 40%. In children 5 to 15 years of age Upper Respiratory Tract Infection was reported in 16% of the consultations followed by Acute Diarrhoea 14%, Unexplained Fever (UF) 10%, Scabies 6%, Lower Respiratory Tract Infection 4% and other health problems 47%. In both adult age groups, 15-45 years and above 45 years, the proportion of the other health problems is higher than reported for children. The proportion of the remaining reported communicable diseases in both adult groups is lower than reported in children. Figure 4 presents the comparisons of the reported consultation by age groups.

Figure4. Proportion of primary causes for all reported cases by age groups, 19 – 25 July 2008, Earthquake Affected Areas, Pakistan, SCB SCB AD MAL AD 5% 4% 9% <1% 20% LRTI 3% SCB AD MAL MAL URTI 5% 10% OTH SCB AD <1% <1% 12% LRTI 40% 6% 14% MAL LRTI 4% <1% UF 5% 7% URTI LRTI OTH 12% 4% 64% UF URTI 19% 11% URTI OTH 16% UF 60% < 5yrs (n=13,913) OTH ≥15 - ≤44yrs (n=29,493) 8% 47% UF 10% 5 - <15yrs (n=15,256) ≥ 45yrs (n=14,521)

*OTH includes all other reportable conditions, plus all other consultations for conditions not under surveillance

DEWS Data, (Epidemiological Weeks No.27 – 30, 2008):

During the period 28th June to 25th July, 2008 (Epidemiological weeks 27 to 30, 2008 both inclusive), a total of 288,368 were reported in the Earthquake affected areas. The proportion of the five common diseases under surveillance was, 45% (130,073) of the total consultations reported during this period. This proportion remains almost consistent for the last four weeks. During this period 14% (40,865) of consultations were due to Upper Respiratory Tract Infection (URTI), 8% (24,495) Unexplained Fever (UF), 13% (36,404) Acute Diarrhoea (AD), 4% (11,187) Lower Respiratory Tract Infection (LRTI), and 5% (14,079) due to Scabies (SCB). Acute Jaundice Syndrome was reported in 84 consultations and Bloody Diarrhoea was reported in 1,286 consultations during this period.

A total of 57 deaths were reported during the last four weeks period. Most (77%) of the total reported deaths were due to health events other than the diseases under weekly surveillance. Five deaths due to Lower respiratory tract infection and the total case fatality for LRTI over the past four weeks is 0.045%. Out of the total deaths in the last four week period, eight deaths were reported to be due to acute diarrhoea resulting in a case fatality for AD of 0.022%. No other deaths were reported from any of the other diseases under weekly surveillance during this four week period.

4 WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29 Table 2. Weekly distribution of reported cases, deaths and monthly Case Fatality Rate (CFR), Earthquake Affected Areas, Pakistan, Week 27 - 30, 2008. Week WEEK 27 WEEK 28 WEEK 29 WEEK 30 TOTAL CFR% Event C D C D C D C D C D AD 8956 1 9972 3 8364 4 9112 0 36404 8 0.022 SC 0 0 0 0 0 0 0 0 0 0 0.000 AFP 1 0 1 0 1 0 0 0 3 0 0.000 AJS 15 0 20 0 28 0 21 0 84 0 0.000 BD 352 0 332 0 321 0 281 0 1286 0 0.000 LRTI 2844 2 2652 1 2925 2 2766 0 11187 5 0.045 MAL 429 0 389 0 374 0 468 0 1660 0 0.000 MG 0 0 0 0 0 0 0 0 0 0 0.000 MS 5 0 2 0 3 0 0 0 10 0 0.000 OTH 40625 9 39223 11 37953 10 40494 14 158295 44 0.028 SCB 3618 0 3811 0 3100 0 3550 0 14079 0 0.000 UF 6497 0 6194 0 5586 0 6218 0 24495 0 0.000 URTI 11230 0 10477 0 8885 0 10273 0 40865 0 0.000 Total Cons. 74572 12 73073 15 67540 16 73183 14 288368 57 RU 275 255 213 247

Acute Diarrhoea and suspected Cholera:

During week 30, 2008, Acute Diarrhoea (AD) was reported in 9,112 patients accounting for 12% of the total consultation in all age groups. In children less than 5 years of age Acute Diarrhoea was reported in 20% of the total consultations the age group. In children 5 to 14 years of age, 14% of the consultations were for AD. In the adult age groups, 15-45 years and above 45 years of age, AD consultations were reported as 9% and 10% respectively, out of the total consultations in the respective age groups. From week 16 onwards, the proportion of Acute Diarrhoea weekly consultations are increasing gradually presenting the usual seasonal pattern of the disease in the area. The proportion of AD has slightly risen in week 29 compared to week 25. However, this year the trend of AD has been slightly lower than the previous two years, but generally, the weekly trend of AD from weeks 1 to 30 depicts a similar pattern for the last three years (Fig 6).

Figure 5: Trend in Acute diarrhoea as a percent of all consultations, weekly comparison by years, Earthquake Affected Areas, Pakistan, Weekly comparison of acute diarrhoea (Year 05, 06, 07 and 08) 18 16 14 12 10 8 6 consultations

Percentage of all all of Percentage 4 2 0 1 4 7 101316192225283134374043464952 Ep i- w e e k 2005 2006 2007 2008

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In general there is an increasing trend of Acute Diarrhoea in all districts depicted for the last few weeks. When comparing the trends of Acute Diarrhoea by district from Week 1 to 30, 2008, Battagram and Neelum report the highest proportion of AD throughout the period and present a fluctuating pattern of cases. However, for the last two epidemiological weeks district Poonch has the highest proportion due to a sudden increase in cases; yet, there is neither the indication of case clustering nor does the situation look like an epidemic reported from any part of the district. The districts of Bagh, Battagram, Muzaffarabad and Neelum have all depicted and increasing pattern and in week 30, these four districts along with Poonch have approximately the same percentage of consultations. District Neelum has shown an increase in cases during the last two weeks but this seems to be part of the normal fluctuation. Due to the current seasonal increase in diarrhoeal disease, indicated by the disease pattern, the health cluster partners are continuously taking measures and conduct activities on prevention and control of diarrhoeal diseases and are vigilantly monitoring the Acute Diarrhoea situation in their respective districts. (Fig 6) Figure 6: Trend in Acute diarrhoea as a percent of all consultations, comparison by districts weeks 1-30, 2008, Earthquake Affected Areas, Pakistan Weekly trend of acute diarrhoea by district 20 18 16 14 12 10 8

consultations 6 Percentage of all all of Percentage 4 2 0 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930 Ep i- w e e k BAGH BA TTA GRAM MA NSEHRA MUZAFFARABAD NEELUM POONCH

Bloody Diarrhoea:

During week 30 of 2008, a total of 281 cases of Bloody Diarrhoea were reported from all the districts, which is comparatively lower than the total BD consultations reported during the previous week. The overall proportion of reported Bloody Diarrhoea is very small for all the weekly consultations with a little weekly fluctuation. When comparing the weekly trend of the BD by districts, District Battagram, Muzaffarabad and Neelum report slightly higher proportion compared to other three districts with a weekly fluctuating pattern of the disease. Overall trend suggests that district Neelum has the highest proportion of BD consultations. The WHO team along with DoH and Health Partners have conducted a thorough assessment of the BD situation in these districts and preventive measures have been initiated. Although there is no clustering of cases in any one area but the sporadic cases are being reported continuously. The probable explanation for the relatively higher proportion in these three districts is the consumption of contaminated water and poor hygienic practices (Figure 7).

Figure 7: Trend in weekly Bloody diarrhoea as a percent of all consultations, comparison by district, Earthquake Affected Areas, Pakistan, Weekly trend of bloody diarrhoea by district 2.00 1.80 1.60 1.40 1.20 1.00 0.80

consultations 0.60 Percentage of all all of Percentage 0.40 0.20 0.00 123456789101112131415161718192021222324252627282930 Ep i- w e e k BAGH BATTAGRAM MA NSEHRA MUZA FFA RABAD NEELUM POONCH

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Acute Respiratory Tract Infections: During week 30, 2008, a total of 11,810 consultations for ARI (both Upper and Lower Respiratory Tract Infection) were reported. ARI accounts for 18% of the total consultations reported for the week (URTI 14% and LRTI 4%) and are still the leading cause of consultations for all age groups, among all the diseases under surveillance. For the current week, in children less than 5 years of age URTI was reported in 19% and LRTI in 5% of the consultations. In the 5 to 14 year age group URTI was reported in 16% and LRTI in 4% of the consultations. In the 15 to 45 year age group, URTI was reported for 12% and LRTI for 3% of the consultations. In the age group above 45 years URTI was reported for 12% and LRTI for 4% of the consultations. Overall, the proportion of ARI in male patients was reported to be higher compared to females. The weekly trend of ARI for the same weeks (from week 1 to 30) from the last two years display a similar trend to that of 2008. The overall ARI trend, from weeks 10 to 15 remain consistent with a little weekly fluctuation in the earthquake affected districts. The proportion of ARI from weeks 16 to 26 in 2008 remains slightly higher than the same period in 2006 and 2007, however, from weeks 27 onwards the trend has been declining and now is at the same level as the previous years (Fig 8). During week 30, 2008 there were 2,766 consultations for Lower Respiratory Tract Infection.

Figure 8: Comparison of ARI weekly trends of year 2005, 2006, 2007 and 2008, Earthquake affected districts Pakistan Weekly trend of ARI, comparison by year (05, 06, 07 and 08) 40 35 30 25 20 15 10 consultations

Percentage of all all of Percentage 5 0 1 4 7 101316192225283134374043464952 Ep i- w e e k 2005 2006 2007 2008

Upper and Lower Respiratory Tract Infection:

During week 30, 2008, 4% (2,766) of the consultations were for Acute Lower Respiratory Tract Infections and 14% (10,273) of cases were for Upper Respiratory tract Infections reported in all age groups through the DEWS system. The proportion of consultations for ARI remained almost consistent from week 10 to 15. However, there is an overall declining trend in both Upper and Lower Respiratory Tract Infection from week 16, 2008 onwards. (Figure10).

Figure 10: Weekly Proportion of URTI and LRTI as percentage of all consultations, (week 1 – 30, 2008) Earthquake Affected Areas, Pakistan Weekly proportion of ARI (Week 1-29, 2008) 30 LRTI 25 URTI

20

15

consultations 10 Percentage all of

5

0 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930 Ep i- w e e k

7 WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29

Suspected Malaria:

In week 30, 2008, there were 468 suspected cases of malaria reported. District Poonch remains the district with the highest reported number of suspected malaria cases compared to the other districts. In comparison to last week, the proportion of suspected malaria cases has slightly increased in the districts of Bagh, Battagram and Muzaffarabad. Districts Poonch and Mansehra have shown a slight decrease in consultations compared to week 29. There were no associated deaths due to suspected malaria reported from any district. Compared to the same weeks from the last two years, the percentage of malaria in 2008 is lower.

Figure 9: Weekly trends in Suspected Malaria as percentage of all consultations, comparison by district, Earthquake Affected Areas, Pakistan, weeks 1-30, 2008 Weekly trend of Malaria by district 2.5

2

1.5

1

consultations 0.5 Percentage all of

0 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930 Ep i- w e e k BAGH BA TTA GRA M MA NSEHRA MUZA FFA RA BAD POONCH

Other Conditions under Surveillance:

During this week, 40,494 (55%) consultations out of the total 73,183 consultations, in all ages and both sexes were for health problems other than the reportable diseases under weekly surveillance. There were 21 cases of suspected Acute Jaundice Syndrome reported from all the earthquake affected districts. Additionally, there were no cases of suspected Hemorrhagic Fever or Neonatal Tetanus reported from any district for week 30, 2008.

Outbreak Alert and Response1 During week 30, 2008, a total of 2 alerts were identified/ reported and were responded to accordingly.

Battagram:

Acute Diarrhoea

Alerts were received from , Koshgram, , and . Upon investigation, the cases were found to be sporadic and no clustering was seen. Booklets were distributed and water tanks were cleaned by WHO. Chlorine tablets were distributed.

Suspected Malaria

An alert of suspected Malaria was reported from THQ . The cases were not clustered and diagnosed clinically and found healthy when investigated by WHO surveillance team.

1 Outbreak Investigation and response of Suspected Viral Hepatitis, Malaria, and Bloody Diarrhoea and Watery Diarrhoea would only take place when a cluster of cases is identified or there is an increase in the incidence of the disease. (Note: Single death due to Diarrhoea and single case of reported severe dehydration among >5 years would be investigated) 8 WMMR Weekly Morbidity and Mortality Report Pakistan 4 Aug 2008 / Vol. 139/ DEWS 2008-29

Number of reported cases and deaths per District, AJK

Table 3. Number of reported cases and deaths, Bagh District*, Earthquake Affected Areas, Pakistan, 28 June – 25 July 2008.

AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 27 917 0 0 0 12 0 0 0 80 0 1239 0 51 0 0 0 0 0 0 0 266 0 169 0 1 0 5970 0 28 1263 0 0 0 55 0 0 0 100 0 869 0 37 0 0 0 0 0 0 0 343 0 182 0 1 0 5344 0 29 811 0 0 0 21 0 0 0 78 0 509 0 41 0 0 0 0 0 0 0 194 0 115 0 4 0 5168 0 30 1015 0 0 0 33 0 0 0 120 0 787 0 58 0 0 0 0 0 0 0 240 0 155 0 1 0 4478 0 Total 4006 0 0 0 121 0 0 0 378 0 3404 0 187 0 0 0 0 0 0 0 1043 0 621 0 7 0 20960 0

Table 4. Number of reported cases and deaths, Poonch District*, Earthquake Affected Areas, Pakistan, 28 June – 25 July 2008.

AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 27 1601 0 0 0 26 0 0 0 732 0 1554 0 172 0 1 0 0 0 0 0 485 0 1084 0 0 0 4406 0 28 1535 1 0 0 38 0 0 0 617 0 1445 0 168 0 0 0 0 0 0 0 461 0 860 0 0 0 4742 2 29 1418 0 0 0 26 0 0 0 548 0 1038 0 172 0 0 0 0 0 0 0 369 0 818 0 0 0 4131 4 30 1577 0 0 0 37 0 0 0 649 0 1558 0 148 0 0 0 0 0 0 0 463 0 1047 0 1 0 4838 4 Total 6131 1 0 0 127 0 0 0 2546 0 5595 0 660 0 1 0 0 0 0 0 1778 0 3809 0 1 0 18117 10

Table 5. Number of reported cases and deaths, Muzaffarabad District*, Earthquake Affected Areas, Pakistan, 28 June – 25 July 2008.

AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 27 3139 0 0 0 155 0 0 0 1566 1 4492 0 101 0 0 0 0 0 0 0 1235 0 3089 0 5 0 11136 7 28 3283 1 0 0 97 0 0 0 1306 0 4079 0 106 0 0 0 0 0 0 0 1291 0 3187 0 3 0 8768 4 29 2449 0 0 0 126 0 0 0 1716 0 3257 0 98 0 0 0 0 0 0 0 977 0 2442 0 0 0 7874 6 30 2398 0 0 0 70 0 0 0 1442 0 3647 0 182 0 0 0 0 0 0 0 1080 0 2720 0 4 0 8833 4 Total 11269 1 0 0 448 0 0 0 6030 1 15475 0 487 0 0 0 0 0 0 0 4583 0 11438 0 12 0 36611 21

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Number of reported cases and deaths per District, NWFP

Table 6. Number of reported cases and deaths, *, Earthquake Affected Areas, Pakistan, 28 June – 25 July 2008.

AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 27 1345 0 0 0 104 0 0 0 117 0 1483 0 104 0 4 0 0 0 0 0 519 0 918 0 5 0 4915 0 28 1588 0 0 0 88 0 0 0 177 0 1376 0 74 0 1 0 0 0 0 0 585 0 840 0 6 0 5583 0 29 1550 0 0 0 110 0 0 0 129 0 1545 0 59 0 3 0 0 0 0 0 588 0 933 0 17 0 5650 0 30 1452 0 0 0 87 0 0 0 78 0 1363 0 78 0 0 0 0 0 0 0 446 0 846 0 12 0 5850 0 Total 5935 0 0 0 389 0 0 0 501 0 5767 0 315 0 8 0 0 0 0 0 2138 0 3537 0 40 0 21998 0

Table 7. Number of reported cases and deaths, *, Earthquake Affected Areas, Pakistan, 28 June – 25 July 2008.

AD SC BD AFP LRTI URTI MAL MS MG AHF SCB UF AJS OTH Week C D C D C D C D C D C D C D C D C D C D C D C D C D C D 27 1748 1 0 0 24 0 1 0 178 1 2143 0 1 0 0 0 0 0 0 0 1029 0 1204 0 4 0 13044 2 28 1946 1 0 0 30 0 1 0 255 1 2129 0 4 0 1 0 0 0 0 0 961 0 1094 0 10 0 13445 5 29 2042 4 0 0 34 0 1 0 394 2 2391 0 4 0 0 0 0 0 0 0 943 0 1272 0 7 0 14479 0 30 2250 0 0 0 21 0 0 0 321 0 2569 0 2 0 0 0 0 0 0 0 1192 0 1402 0 3 0 15234 6 Total 7986 6 0 0 109 0 3 0 1148 4 9232 0 11 0 1 0 0 0 0 0 4125 0 4972 0 24 0 56202 13

10