WeeklyEpidemiological

Monitor ISSN 2224-4220 Volume 6 Issue 31/32 Sunday 11 August 2013

Current major event Map of : Affected Districts - August 2013 Monsoon and threats of dis- ease outbreaks in Pakistan Heavy monsoon rains have killed more than 154 people across Pakistan and displaced thousands and caused huge damage to properties and infrastructure since the beginning of August 2013. More monsoon rains are forecast later in the month. WHO Pakistan is responding to the health situations in flood affected areas. An Emergency Flood Operation Centre has been established. Six medical camps are working round the clock in rain affected areas in and Thatta. Alerts of acute watery diarrhea, measles, neonatal tetanus and Diphtheria List of floods in Pakistan 2003 - 2013 Update on outbreaks have been reported and responded to in Year Affected Prov- Reported Major Out- in the Eastern Mediterranean Region these areas. inces Deaths breaks Novel Coronavirus in Saudi Arabia, UAE & Editorial note 2003 484 Tunisia; Hepatitis E in South Sudan; Men- ingococcal meningitis in South Sudan; The monsoon season and the accompa- 2007 KP, Sindh & 967 Wild poliovirus in Somalia. nying flash floods has started and is al- Baluchistan ready causing devastations in parts of 2010 All Pakistan 2000 AWD, Den- Current public health events of Pakistan and Afghanistan. News sources gue international concern o have reported over 85 people killed in 2011 All Pakistan 361 AWD, Den- [cumulative N of cases (deaths), CFR %] gue, CCHF flash flooding in Afghanistan, and in Avian influenza Pakistan 154 deaths were reported . 2012 KP, Punjab & 455 AWD, CCHF, Egypt [173 (63), 36.4%] Many people are injured and homes, Sindh, Balochis- Measles, tan Pertussis, Indonesia [192 (160), 83.3 %] farmlands and infrastructure are de- Malaria stroyed. The affected populations are Viet Nam [125 (62), 49.6%] left without adequate shelter. This is just 2013 Karachi, Punjab, 154 Measles, [31 (27), 87.1%] KP, Balochistan CCHF, AWD, the beginning of the monsoon in both Dengue Global total [629 (375), 59.6%] countries and more heavy rains is fore- casted. following the 2011 flooding. Over 21580 Hepatitis E

In the last three years, the two Eastern confirmed cases including 317 deaths South Sudan [11,779 (219), 1.8%]# were reported from nationwide . Congo- Mediterranean countries have suffered Novel Coronavirus (MERS-CoV) some of the worst flooding in modern Crimean hemorrhagic fever (CCHF) also Saudi Arabia [75 (40), 53.3% ] history, with Pakistan being the most spread with displaced livestock and affected. Pakistan witnesses frequent caused outbreaks in new areas in 2010 [3 (0)] and 2011 floods. flooding but in the last three years the Jordan [2 (2), 100%] flooding has become more frequent, There is enough reason to worry about extensive and severe. In the aftermath of the prospects of disease outbreaks as the France [2 (1), 50%] these flooding caused by severe weather, current flooding season continues. UAE [7 (3), 42.8% ] Pakistan suffered some serious out- WHO/Pakistan has always taken a lead- breaks of water and vector borne dis- ing role in monitoring and responding to Tunisia [2 (0)] eases (see table right). A big outbreak of these outbreaks. The Disease Early Influenza A (H7N9) virus acute watery diarrhea with confirmed Warning and Response System (DEWS) [135 (44), 32.6%] cholera cases were reported from af- is the driving force behind the WHO/ Meningococcal meningitis fected provinces of Pakistan during the CO effort. It has provided effective 2011 floods. Another technical support in the Country South Sudan [196 (13), 6.6%]# that has followed flooding in Pakistan is (especially after the devolution of the Wild poliovirus dengue fever. A large outbreak of den- Ministry of Health). The three levels of Somalia [95 (0)] gue was reported from Karachi follow- WHO should be prepared to compli- CFR=Case-Fatality Rate; # Suspected cases ing the 2010 flooding and from Punjab ment the efforts of DEWS if needed.

Published by the World Health Organization (WHO), Eastern Mediterranean Regional Office (EMRO), Cairo, Egypt. For Correspondence: Tel + 20-2-22765273, Fax + 20-2-2765456. E-mail: [email protected] 31/32