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 32, Epi week 32, 8 - 14 Aug 2016

H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 32, 2016

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

% %

% % %

100% % 180,000

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

94 96

95 95 90% 94 81 160,000 • During week no. 32, 2016; 90% (1104/995) 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 143484 compared to 157849 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 32 , 2016) • A total of 1184 alerts were generated by eDEWS system in week 32, 2016; Of these 629 100%

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

% % % % % %

60% %

% %

% % % %

98 98

103

96 96 96 96

100 100 100 100 100 100

40% 100

76 62 • Altogether 92 alerts for Pertussis, 75 Lower Respiratory Infections, 70 each for Typhoid 20% 68 0%

and Paratyphoid Fever and Other acute diarrhea, 69 Bloody diarrhea, 54 Malaria, 50 Upper et F p o. N R r o H s Respiratory Infections, 39 Measles, 32 Dengue Fever, 21 Influeza Like Illness, 12 Mumps, 9 each for Acute Flaccid Paralysis and Schistosomiasis, 6 each for Severe Acute Respiratory

Infection and Meningitis, 5 Viral hemorrhagic fever, 4 Cut.Leishmaniasis, 3 Neonatal Reporting Rate Target Tetanus, 2 Acute viral hepatitis, 1 Rabies 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 32, 2016 Suspected dengue outbreak in Al-Hodaidah, Lahj,Shabwah & Aden Gov., Epi weeks 1 to a). Suspected dengue outbreak 32, 2016

Suspected Dengue fever cases • 357 suspected dengue cases were reported in 11 governorates, out of these 65 cases 600 reported from Al-Hodidah, 59 Cases from Shabwah, 57 Cases from Aden, and 18 Cases from Lahj, 4 cases with hemorrhagic manifestations were reported in Hadramout, 500

Shabwah, Al-Hodidah and Hadramout wady 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 32, 2016 Proportional morbidity of leading priority diseases, Epi weeks 1 to 32, 2016 b. Other leading priority diseases

20.0% 18.0% • URTI (14.3%), suspected malaria (3%), OAD (9.7%) and LRTI (5.8%) remain the leading 16.0% 14.0% causes of morbidity representing a total of 32.8%. 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 0.6% of this morbidity. DD URTI S.Malaria LRTI

LRTI 6.0% OAD 9.9% BD 0.6% • All diarrheal disease comprised 10.2% and LRTI 5.8% of total morbidity in Pilot URTI 14.6% Sch 0.2% Governorates this week. Mal 3.1% Rb 0.1% AVH 0.2% Other_Disease Tuberculosis 0.0% 62.9% Mumps 0.1% • All diarrheal disease comprised 10.2% and LRTI 5.8% of total morbidity in all age group. Chicken Pox 0.1% Brucellosis 0.3% 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 32 ( 8 - 14 Aug 2016 )

Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Lower Respiratory infections ( Epi week 1 to 32, 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 32, 2016) Vaccine preventable diseases in Epi-weeks 1 to 32, 2016 (28th Dec 2015 to 14th Aug 2016)

No.# of Cases Total No.# of Greater Than Total No.# of Diseases Less Than Five 35000 Wk-32 Cases Five Alerts

30000 Measles 91 1640 1017 623 1062

25000 Diphtheria 0 6 6 0 3 20000 Pertussis 453 5298 3487 1811 1459 15000

Number of Consultations of Number Acute Viral 10000 212 6133 2859 3274 226 Hepatitis (A & E)

5000 Acute Flaccid 11 367 194 173 226 Paralysis 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Meningitis 51 1506 947 559 171 Male 8690 12772 13890 21681 10813 Female 8421 11952 13911 29315 12571 Mumps 198 2004 950 1054 152

Distribution of consultations of leading diseases by Governorates, Epi week 32

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

Upper Respiratory Infections 648 2550 1180 1492 1336 1019 1795 1054 877 1235 658 711 701 335 726 1067 580 581 357 502 212 893 20509

Lower Respiratory Infections 234 403 490 970 347 420 1041 445 430 265 515 169 237 86 144 483 343 353 294 234 130 340 8373

Other Acute Diarrhea 368 1424 769 573 574 789 2180 802 588 773 627 570 448 283 272 545 488 400 329 359 186 522 13869

Bloody Diarrhea 13 4 33 4 21 58 123 19 11 32 39 10 34 2 14 18 75 51 101 57 42 68 829

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 4 11 5 30 17 14 22 9 0 0 0 6 0 4 28 26 20 13 214

Malaria 0 78 26 13 6 162 1982 1006 10 129 144 10 54 12 0 172 5 94 105 180 132 20 4340

Meningitis 0 5 0 5 1 3 7 6 9 0 1 0 0 0 0 10 0 3 0 0 1 0 51

Dengue Fever 18 57 58 26 11 0 65 11 1 0 0 0 59 0 0 0 0 40 0 0 0 11 357

Viral Hemorrhagic Fever 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 5

Rabies 1 0 1 1 0 9 0 9 29 0 26 0 0 0 0 2 0 0 0 7 0 2 87

Measles 1 6 11 4 0 2 19 5 13 13 5 1 3 0 0 1 1 1 1 0 2 2 91

Acute Viral Hepatitis (A & E) 2 14 9 41 16 12 4 19 34 7 10 1 7 1 2 10 3 5 3 1 2 9 212

Neonatal Tetanus 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3

Acute Flaccid Paralysis 0 1 0 2 0 2 1 1 1 0 0 1 0 0 1 1 0 0 0 0 0 0 11

Cutaneous Leishmaniasis 0 0 3 1 2 1 0 8 2 0 6 6 0 0 3 6 2 6 3 1 8 1 59

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 21 30 3 5 7 9 11 27 81 24 2 29 0 14 8 39 99 12 1 0 24 453

Influeza Like Illness 51 20 255 52 8 74 75 65 3 13 40 40 61 0 0 0 55 35 4 31 17 28 927

Severe Acute Respiratory Infection 0 0 7 3 1 0 8 27 0 0 4 0 0 0 1 47 7 3 0 0 5 0 113

Typhoid and Paratyphoid Fever 4 56 72 132 65 205 337 652 50 103 114 69 57 6 15 188 271 86 265 103 54 26 2930

Mumps 2 4 71 4 12 2 21 15 13 4 5 3 5 0 1 2 2 4 12 4 2 10 198

Tuberculosis 0 2 5 0 0 2 4 4 10 0 2 2 3 0 0 13 2 3 1 1 0 0 54

HIV/ AIDS 0 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3

Brucellosis 0 0 0 0 2 7 8 56 10 0 7 0 10 0 2 21 72 74 112 4 1 0 386

Chicken Pox 0 11 4 0 6 2 11 6 3 0 5 1 1 0 0 1 0 15 0 9 10 14 99

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 1959 7628 3037 6766 5682 4792 8190 2466 15198 3628 2504 1731 2942 988 2525 7795 1302 3102 778 1507 431 3465 88416

Total_Consultations 3310 12352 6062 9897 7944 7482 15584 7532 17719 6298 4758 3336 4642 1713 3721 10562 3388 4978 2405 3001 1351 5449 143484

Number of alerts & outbreaks reported and investigated with appropriate response Number of Alerts Received and Responded (Epi weeks 29 and 32, 2016)

2016 Current week 32, 2016 System Gen. Alerts (week 32) Diseases Alers Outbreaks Alers Outbreaks TRUE FALSE S.Measles S.Pertussis AFP LRTI Mal Meningitis C.Leish S.Measles 1062 0 44 0 39 5 S.Pertussis 1459 0 103 0 92 11 Sch BD OAD S.Dengue URTI ILI SARI AVH 226 0 6 0 2 4 AFP 226 0 9 0 9 0 Typhoid F Mumps AVH NNT VHF Rb LRTI 1200 0 170 0 75 95 NNT 42 0 3 0 3 0 250 Mal 950 0 110 0 54 56 Meningitis 171 0 8 0 6 2 C.Leish 151 0 5 0 4 1 200

Sch 164 0 10 0 9 1 BD 903 0 91 0 69 22 OAD 1254 0 178 0 70 108 150 S.Dengue 1110 4 43 0 32 11

URTI 985 0 151 0 50 101 Alerts of No. VHF 81 0 5 0 5 0 100 Susp. Cholera 0 0 0 0 0 0 Diph 3 0 0 0 0 0 Rb 2 0 1 0 1 0 ILI 322 0 46 0 21 25 50 SARI 92 0 15 0 6 9 Typhoid F 2194 0 126 0 70 56 Mumps 152 0 21 0 12 9 0 Unusual_Disease 24 0 39 0 0 39 Other Diseases 0 0 0 0 0 0 Total 12773 4 1184 0 629 555

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 32 ( 8 - 14 Aug 2016 )

Reporting of health facilities , No.# of districts and patients consultations in week 32, 2016

Al- Al- Hadramout Sanaa Abyan Aden Al-Baidha AlHodaidah Al-Jawf Amana Amran Dhamar Hadramout Hajjah Ibb Lahj Mareb Rayma Sada Shabwah Taiz Al-Dhale Mahra 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-32 42 61 40 141 36 24 59 25 25 24 85 24 103 24 26 32 71 21 25 34 23 50

Patients Cons. 6062 12352 3388 15584 2405 1713 3001 17719 4758 10562 7944 3721 7532 7482 3310 4978 1351 6298 3336 4642 9897 5449

Alerts were reported and appropriate measures were taken in week 32, 2016.

True Alerts

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

Abyan 0 0 0 0 0 0 0 3 0 0 0 0 10 0 0 0 0 0 0 0 13

Aden 1 0 0 11 1 1 3 4 1 0 0 3 6 0 0 4 2 0 0 0 37

AlHodaidah 1 15 0 8 5 19 17 2 1 4 2 30 4 2 0 16 17 1 0 0 144

Al-Jawf 0 14 0 0 1 13 8 1 0 1 0 4 2 0 2 16 6 0 0 0 68

Al-Mahra 0 0 0 0 0 2 2 0 0 0 0 3 0 0 0 0 2 0 0 0 9

Al-Mahweet 0 5 0 0 1 7 7 0 0 0 0 7 1 0 1 4 9 0 0 1 43

Amana 1 1 0 0 0 4 1 7 1 2 0 0 8 0 1 1 1 0 1 0 29

Amran 0 0 0 0 0 0 0 2 0 0 0 0 5 0 2 0 0 0 0 0 9

Dhamar 1 2 1 0 0 2 2 1 2 0 1 1 3 0 0 8 0 0 1 0 25

Hadramout 0 3 0 1 0 0 1 0 0 1 0 0 5 0 0 3 0 1 0 0 15

Hadramout wady 1 0 0 0 0 0 0 0 0 0 0 1 3 0 0 0 1 1 0 0 7

Hajjah 1 0 1 2 0 0 0 4 1 3 0 0 2 0 1 0 0 0 0 0 15

Ibb 1 2 0 0 1 1 2 2 0 0 0 0 3 0 0 4 1 0 0 0 17

Lahj 0 0 0 2 0 0 0 1 0 0 0 3 3 0 0 0 0 0 0 0 9

Rayma 0 4 1 0 3 9 8 1 0 0 0 6 0 3 0 4 3 0 0 0 42

Sada 0 0 0 0 0 0 0 4 0 0 0 0 8 0 0 0 0 0 0 0 12

Sanaa Governorate 1 0 1 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 5

Shabwah 0 3 0 6 1 6 0 0 0 0 0 1 6 0 0 1 1 1 0 0 26

Taiz 1 0 0 0 0 0 0 4 0 0 0 0 1 0 0 0 0 0 0 0 6

Al-Baidha 0 10 0 0 4 4 1 1 0 0 0 2 12 1 0 8 2 0 0 0 45

Mareb 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1

Al-Dhale 0 10 0 2 4 7 2 1 0 1 0 8 9 0 1 1 5 1 0 0 52

Total 9 69 4 32 21 75 54 39 6 12 3 70 92 6 9 70 50 5 2 1 629

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 32 ( 8 - 14 Aug 2016 )

Alert Responded in Epi-week 32, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

DF Lahj Al Hawtah,Tuban Ibn Khaldoon Hospital,Saber HC Field investigation done and report of DF send 16 0

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

Al Madaribah Wa OAD Lahj Al Arah,Radfan, AlShat Hospital,Radfan Hospital,Alanad Field investigation and response is ongoing 96 0 Tuban

Alfayosh Health Unit.Alsharif Health Pert Lahj Tuban,Yaffa Focal point was contacted, case diagnosed clinically and treated by antibiotic 7 0 Center,October General Hosp.

eDEWS team contacted FP, 1 case was reported, 12m F from AL-daleh, onset before 3 month, AFP Aden Al Mansura Plastic Limbs Center 1 0 diagnosed as traumatic neuritis, AFP coordinator in aden informed

Al Masafi Hospital,Salah Adden Hospital,Al-Wali Hosp.Saber Al Buraiqeh, Al Hosp.,Aden Dispensary,Central Mansura, Ash eDEWS team contacted FP, cases were reported, diagnosed clinically ,samples were collected for DF Aden clinic,Al-Memdara Modern Center,Al- 48 0 Shaikh Outhman, 4 cases. Wahdah Hosp.,Shifa Aden Khur Maksar, Siera Dispensary,Al Jamhoria,Al Zahra'a Dispensary

Al Mansura,Khur eDEWS team contacted FP, 2 deaths were reported, , diagnosed clinically as case of cerebral Mal Aden Al Buraihi,Al Jamhoria 6 2 Maksar malaria, one case admitted on 3/8 and die on the next day in ICU (missed case in the week 30 )

Al Mansura, Ash Al Madena Center, Khalefah eDEWS team contacted FP, cases were reported, only one case was fully vaccinated, diagnosed Meas Aden Shaikh Outhman, Hospital,Children's Rights Clinic, Al- 6 0 clinically, sample was collected and investigation forum done Attawahi Qallooaa Pol. Cl.

Ash Shaikh eDEWS team contacted FP, 2 deaths were reported, all less than 5y , 1 case from aden , diagnosed Meng Aden Al-Wahdah Hosp. 3 2 Outhman clinically, admitted on 7/8 and die on 9/8 DDX ME , cerebral malaria, DF , the other case from yafae

Al Buraiqeh,Al Beer Ahmed MCH center,Dr.Muna eDEWS team contacted FP, cases were reported, , diagnosed clinically, fully vaccinated, field Mansura,Ash Clinic,Al Mansura New Dispensary,Al- Pert Aden investigation done before few weeks ago,epi coordinator of aden and health office in ALburaiqa both 21 0 Shaikh Outhman, Wahdah Hosp.,Al- Basateen Charitable informed Siera ,Dar Sad center,Al-Maidan Pol. Cl.

Khanfir, Rosod, MCH Ja'ar,Hamomah Health Unit,Sarar edews conected focal point .cases diagnosed by case defination .10 cases vaccinated,and samplse Meas Abyan 11 0 Sarar Heath Center collected for 2 cases and well be sent, no cluster of cases

Al Mahfad Hospital,Al Wadhea Al Mahfad,Al Hospital,Batis HC,Alrazi Wadhea,Khanfir,La Hospital,Lawdar Hospital,AlAin Health edews conected focal point. cases diagnosed clinically .18 cases vaccinated ,6 cases collected in Pert Abyan 30 0 wdar,Rosod, Unit,Rosod Hospital,Al Samim cluster in Al Wadhea. Sabah,Sarar Clinic,Dr.Shandhor Clinic,Sarar Heath Center

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

Al Udayn Hospital ,Dr. Waheeb Ata eDEWS focal point was contacted.After investigation were bloody diarrhea due to bacterial BD Ibb Al Udayn,Yarim 41 0 Hospital infections Cases from different areas

eDEWS focal point was contacted.Cases were diagnosed as upper respiratory infections and ILI Ibb Al Mashannah Naser Hospital 7 0 treated accordingly

Mal Ibb Al Qafr,Yarim Rihab Hospital,Yarim Hospital eDEWS focal point was contacted.clinically diagnosed and treated accordingly 2 0

eDEWS focal point and coordinator were contacted.Information shared. Samples were collected and Meas Ibb Al Dhihar,Al Udayn Al Amin Hospital,Al Udayn Hospital 2 0 will be send to central lab in Sanaa.Casse were vaccinated

Al Dhihar, Badan, Al Amin Hospital,Alshaheed Albadani eDEWS focal point was contacted.Cases were diagnosed clinically and treated accordingly.2 Cases Pert Ibb 7 0 Yarim Hospital,Dr. Waheeb Ata Hospital were vaccinated .

Al Mashannah,Al Naser Hospital,Al Udayn eDEWS focal point was contacted.Cases were diagnosed as typhoid fever by widal test and treated Typh Ibb Udayn,As Hospital,Abdulmoghni Hospital,Yahsob 158 0 accordinglly Saddah,Yarim Hospital

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

AlAksa Hospital,Althawrah Al Hawak,Al Hospital,Motherhood and Childhood Khawkhah,Al eDEWS coordinator contacted the hospital focal point, the cases were diagnosed suspected dengue DF AlHodaidah Center,Almeghlaf Hospital,Al Khubah 40 0 Mighlaf,Alluheyah,B and treated according dispensary,Bayt Al Faqiah Hospital,AL ayt Al Faqiah,Zabid moqer center

eDEWS coordinator contacted the focal point, the cases were suspected measles which was Meas AlHodaidah Az Zuhrah,Bajil Az Zuhrah Hospital,Bajel Hospital diagnosed clinically, samples have been collected from the patient by district coordinator and sent to 2 0 the central laboratory in Sanaa

Ad Dahi, Al Alkdn Center,Althawrah Hospital,Castle eDEWS coordinator contacted the hospital focal point, cases were diagnosed suspected Pret and Pert AlHodaidah Hawak, Al Mina, At 7 0 Center,Aziz dispensary treated accordingly Tuhayat

eDEWS coordinator contacted focal point,information shared. A 8 months old female frome hiran Khayran Al AFP Hajjah Altabuab Center district was diagnosed as suspected AFP. Field investigation was done and stool samples were 1 0 Muharraq collected and will be sent to the central lab. in sanaa

eDEWS coordinator contacted focal point, information shared, cases diagnosed clinically.Has been DF Hajjah Hajjah City,Najrah Saudi Hospital,Hakim Center 7 0 rapid examination for cases The result was positive for 3 cases.

Al Maghrabah,Al Adbaa Center,Al Mahabishah Mahabishah, eDEWS coordinator contacted focal point, information shared. Case were diagnosed clinically. Meas Hajjah Hospital,Al Jomhori Hospital,Health 5 0 Hajjah City, Blood sample was collected from the cases center Al-dhafeer Mabyan

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 32 ( 8 - 14 Aug 2016 )

Alert Responded in Epi-week 32, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Jomhori Hospital,Kushar Health eDEWS coordinator contacted focal point, information shared. Cases were diagnosed clinically. Pert Hajjah Hajjah City,Kushar 11 0 Center Cases treated with antibiotics

eDEWS coordinator contacted focal point, information shared . cases have been diagnosed Sch Hajjah Al Miftah Alsalam Center 5 0 clinically, appropriate treatment has been given.

Damaj Health Center,Nashor Health As Safra,Sa'da Focal point was contacted , blood samples were collected for 11 cases and will be sent to the central Meas Sada Center,Al Jomhori Hospital,Al Mahather 13 0 ,Sahar lab. in Sanaa Health Center

Nashor Health Center,Baqim As Safra,Baqim, Hospital,Haydan Hospital,Kitaf Haydan, Kitaf wa edews team contacted focal point cases were diagnosed clinically as suspected pert symptomatic Pert Sada hospital,An Ndhir Health Unit,Al 78 0 Al Boqee, Razih, treatment was given . 24 cases were not vaccinated ,vaccination status for rest is unknown . Jomhori Hospital,Al Mahather Health Sa'da, Sahar Center,Al-Amerah

Salamatak Private Clinici,Dar Aldawaa eDEWS team contact Edews focal point . cases diagnosis according to case defination as LRTI ( LRTI Al-Mahra Al Ghaydah 15 0 Private Clinic bronchitis ) Appropriate treatment wes given to cases

Salamatak Private Clinici,Al Ghaydah eDEWS team contact Edews focal point . cases diagnosis according to case defination and Lab Mal Al-Mahra Al Ghaydah,Sayhut 9 0 Center Hospita results (+ve MPS) Appropriate treatment wes given to cases

eDEWS team contact Edews focal point and visit health centre. cases diagnosis according to case Al Balsm Medical Centre ,Dar Aldawaa OAD Al-Mahra Al Ghaydah defination as diarhorea ,and by lab ( amebiasis and shigelosis ) . Appropriate treatment wes given to 62 0 Private Clinic,Modern medical clinic cases .

Dar Aldawaa Private Clinic,Modern eDEWS team contact Edews focal point . cases diagnosis according to case defination as URTI ( URTI Al-Mahra Al Ghaydah,Sayhut 77 0 medical clinic tonsilitis ,pharingitis , otitis media ) Appropriate treatment wes given to cases.

Al Hazm, Al Ynaba Unit,Hazm CentermAl Humaydat Humaydat, Al Center ,Al khalq Center,Al Maslub ,Khalq, Al Maslub, Center,Al Mariam Unit,Alkhair Edews team contact focal point. cases diagnosed clinically as suspected BD.4result Bacteriea 30 BD Al-Jawf Al Matammah, Al Center,Alashnan Center,Alkasspah 94 0 result amoebiea and Gairdiea Appropriate treatment was given Maton, Bart Al Unit,Almaton Center,Al Anan Hospital,Al Anan, Khabb wa Rahwb Center,Sooq Altalowt Unit,Al ash Sha'af Marashi Center

Edews team contact focal point. cases diagnosed clinically as suspected ILI.Appropriate treatment ILI Al-Jawf Al Matammah Al Mariam Unit 2 0 was given

Al Hazm, Al Ynaba Unit,Hazm Center,Alamomah Humaydat, Al Wltofola,Alamomah Wltofola,Al Hazm Khalq, Al Maslub, Hospital,Al Humaydat Center,Al khalq Edews team contact focal point. cases diagnosed clinically as suspected LRTI.Appropriate treatment LRTI Al-Jawf Al Matammah, Al Center,Al Maslub Cente,Al Mariam 188 0 was given Maton, Khabb wa Unit,Almaton Center,Sooq Altalowt ash Sha'af, Unit,Al Marashi Center,Maqam Al Rajuzah Ashwal Unit

Al Hazm, Al Maain Health Center,Al Hazm Maslub, Al Hospital,Al Maslub Center,Al Mariam Edews team contact focal point. cases diagnosed clinically as suspected Mal.Appropriate treatment Mal Al-Jawf Matammah, Unit ,Alashnan Center,Al Marashi 90 0 was given Kharab Al Marash, Center,Al Zalol Uni,Maqam Al Ashwal Rajuzah Unit

Edews team contact focal point. cases diagnosed clinically as suspected Meas.samples were Meas Al-Jawf Al Hazm Maain Health Center 1 0 collected to be send to contral .Lab in sana.a Appropriate treatment was given

Edews team contact focal point. cases diagnosed clinically as suspected Mumps.Appropriate Mumps Al-Jawf Al Maslub Al Maslub Center 9 0 treatment was given

Al Hazm, Al Al Hazm Hospital,Al Maslub Edews team contact focal point. cases diagnosed clinically as suspected OAD.Appropriate treatment OAD Al-Jawf Maslub, Al Maton, Center,Almaton Center,Ameen Nasher 87 0 was given Bart Al Anan Center

Edews team contact focal point. cases diagnosed clinically as suspected Pert.Appropriate treatment Pert Al-Jawf Al Hazm, Al Maslub Maain Health Center,Al Maslub Center 12 0 was given

Al Maton, Kharab Edews team contact focal point. cases diagnosed clinically as suspected Sch.Appropriate treatment Sch Al-Jawf Almaton Center,Al Marashi Center 14 0 Al Marashi was given

Al Hazm, Al Humaydat, Al Ynaba Unit,Hazm Center,Al Hazm Khalq, Al Maslub, Hospital,Al Humaydat Center ,Al khalq Al Matammah, Al Center,Al Maslub Center,Alkhair Edews team contact focal point. cases diagnosed clinically as suspected Typh.Appropriate treatment Typh Al-Jawf Maton, Az Zahir, Center,Almaton Center,Almarfek 329 0 was given Bart Al Anan, Center,Al Anan Hospital,Al Rahwb Khabb wa ash Center,Sooq Altalowt Unit,Al Marashi Sha'af, Kharab Al Center,Al Shara`a Unit,Rajuzah Hospital Marashi, Rajuzah

Edews team contact focal point. cases diagnosed clinically as suspected URTI.Appropriate treatment URTI Al-Jawf Al Hazm Ynaba Unit 124 0 was given

Al Naser Hospital,Al Fateh Dispensary,LKmat Salah Health Ad Dhale'e, Al Unit,Daglal Health Center,Hawrah Azariq, Al Husha, The communication with the surveillance officers , clinically diagnosed cases as defined by the case BD Al-Dhale Ghnyah Health Uni,Baldat Bani Ali 52 0 Ash Shu'ayb, and the laboratory , were given appropriate treatment. Health Unit,Dhawran Health Jahaf, Qa'atabah Center,Lodyh Health Center,Al Salqah Health Unit,Al Fakher Health Center

The communication with the surveillance officers, clinically diagnosed cases and laboratory as DF Al-Dhale Ash Shu'ayb Ash Shu'ayb Medical Dispensary 3 0 suspected dengue fever .

Ad Dhale'e ,Ad Al Tadhamon Privet Hospital,Al The communication with the surveillance officers , clinically diagnosed cases as defined by case as ILI Al-Dhale Dhale'e, Al Husha, Thawakhb Health Center,Lodyh Health 19 0 suspected Anflonza , were given appropriate treatment. Ash Shu'ayb, Dam Center,Hamah Alhab Health Unit

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] 5 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 32 ( 8 - 14 Aug 2016 )

Alert Responded in Epi-week 32, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Ad Dhale'e, Al Al Markolah Health Unit,Hawrah Azariq, Al Husha, Ghnyah Health Unit,Al Daqah Health The communication with the surveillance officers. Clinically diagnosed cases as defined by case as LRTI Al-Dhale 25 0 Al Hussein, Damt, Unit,Al Qobah Health Unit,Manqeer suspected lower respiratory inflammation . It was given the appropriate treatment Jahaf Health Center,Al Ozlah Health Unit

Al Azariq,Al Hawrah Ghnyah Health Unit,Al Qobah The communication with the surveillance officers , clinically diagnosed cases were reported as Mal Al-Dhale 16 0 Hussein Health Unit suspected Mlriae been given appropriate treatment.

The communication with the liaison officers were clinically diagnosed case of measles as suspected Meas Al-Dhale Qa'atabah Al Salam Hospital 2 0 Done samples collected and sent to the central level Sanaa

The communication with the surveillance officers , have been reported cases, clinically diagnosed Mumps Al-Dhale Ad Dhale'e Al Mokhtar Dispensary 7 0 as suspected mumps , was given the appropriate treatment

Al Aqabah Health Unit,Dr. Ahmed Alabgr Dispensary,Al Markolah Health Ad Dhale'e, Al Unit,Hawrah Ghnyah Health The communication with the surveillance officers , cases diagnosed clinically as defined by the case OAD Al-Dhale Azariq, Al Husha, 88 0 Uni,Dhawran Health Center,Sahoor and the laboratory . It was given appropriate treatment Damt, Jahaf Health Unit,Manqeer Health Center,Al Shaymah Health Unit

Al Dhale Privet Hospital ,Al Tadhamon Ad Dhale'e, Al Privet Hospital,LKmat Salah Health Azariq, Ash Unit,Daglal Health Center,Al Shuhada The communication with the liaison officers were clinically diagnosed case as suspected Pertussis . Pert Al-Dhale 24 0 Shu'ayb, Jahaf, Altlathah Hospital,Al Shaymah Health Give them appropriate treatment. Juban, Qa'atabah Unit,Al Sarar Health Center,22 May Hospital,Al Salam Hospital

The communication with the surveillance officers , clinically diagnosed cases in the laboratory , were Sch Al-Dhale Jahaf Al Ozlah Health Unit 5 0 given appropriate treatment.

All cases were diagnosed clinically depending on widal test on diagnosis. No culture was done. Typh Al-Dhale Qa'atabah Al Salam Hospital 17 0 Cases were treated by antibiotics

Al Aqabah Health Unit,Bani Sabh Ad Dhale'e, Al Health Center,Al Shaymah Health Edews team contact focal point. cases diagnosed clinically as suspected URTI.Appropriate treatment URTI Al-Dhale 30 0 Husha, Jahaf Unit,Al Sarar Health Center,Al Ozlah was given Health Unit

The communication with the surveillance officers , clinically diagnosed cases as suspected VHF Al-Dhale Ad Dhale'e Al Tadhamon Privet Hospital 1 0 hemorrhagic fever .

Sharab Ar Al-Shaheed Abdul-Galeel Hoapital, Al- Rawnah, Al Meas Taiz Tawon Hospital, Al-Sharq Hoapital and Samples were taken from the patient and send it to sana'a 4 0 Qahirah and Hayfan Hospital Hayfan

eDEWS team contacted focal point. The case was diagnosed clinically as suspected Pert. The case Pert Taiz Salh Al-Safwah Hospital 1 0 is not received. Appropriate treatment was given

eDEWS team contacted focal point. The case was diagnosed clinically as suspected AFP. Samples AFP Taiz Al Qahirah Alrawda Hospital 1 0 were collected and sent to central level in Sana'a

Main Complex, Alshaheed Center, Maain, Al Azzal Complex, Science University eDEWS team contacted focal points, information was shared . Cases were diagnosed clinically as Wahdah, Azzal, Meas Amana Hospital, Cludia Fain Health Center, suspected Meas. Blood samples and swabs were collected from the case and sent for lab 13 0 Assafiyah and At Althawra Hospital and Alolofi Health confirmation . Cases were vaccinated against measles Tahrir Center

Bani Al Harith, Zaid Hospital, Ghaza Complex, Maain, Al Alshaheed Center, Azzal Complex, As Wahdah, Azzal, eDEWS team contacted focal points. Cases diagnosed clinically as suspected Pert. Antibiotics Pert Amana Sabin Hospital, AlKuwait Hospital, 27 0 As Sabain, At treatment was given. Cases were vaccinated Althawra Hospital and Az Zubairi Health Tahrir, Assafiyah Center and Old City

eDEWS team contacted the focal point. Cases were diagnosed clinically in OPD and confirmed by Sch Amana At Tahrir AlGomhori Hospital lab as suspected Sch. Appropriate treatment was given. Cases came from different districts and 15 0 areas of Sanaa governorate

eDEWS team contacted the focal point, information shared. The case was diagnosed clinically as AFP Amana Assafiyah Althawra Hospital suspected AFP. Field investigation was done. Stool samples were collected from the case and close 1 0 contacts and sent for confirmation. The case was vaccinated against polio

Amran and Bani Family Health Center and Al Sanania eDEWS team contacted focal points. Case were diagnosed clinically as suspected Meas. Samples Meas Amran 5 0 Suraim Center were collected to be send to central lab in sana'a. Som cases were vaccinated

Al Qaflah, Khamir, Al Qaflah Hospital, Al Salam Hospital, Al Amran, Harf eDEWS team contacted focal points. Cases were diagnosed clinically as suspected pertussis. Pert Amran Rayan Dispensary, Harf Sufyan 24 0 Sufyan and Bani Appropriate treatment was given. cases from different areas. Cases were vaccinated Hospital and Al Sanania Center Suraim

Al Qaflah and eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as suspected sch. Sch Amran Al Qaflah Hospital and Al Gnaya Center 12 0 Suwayr Appropriate treatment was given.

Sanaa eDEWS team contacted focal points. Cases were diagnosed clinically as suspected pertussis. Pert Hamdan 22 May Hospital 2 0 Governorate Appropriate treatment was given. Cases were vaccinated

Sanaa eDEWS team contacted focal points. Cases were diagnosed clinically as suspected CL. Appropriate CL Hamdan 22 May Hospital 5 0 Governorate treatment was given

Sanaa eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as suspected sch. Sch Arhab Awmara Hospital 7 0 Governorate Appropriate treatment was given

Sanaa eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Jihanah Al Dhwra Shaheed Hospital 1 0 Governorate Samples were collected to be send to central lab in sana'a

Sanaa Edews team contacted focal point information shared stool sample we're collected from the case and AFP Jihanah Al Dhwra Shaheed Hospital 1 0 Governorate sent to the central lab.and case vaccinated

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] 6 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 32 ( 8 - 14 Aug 2016 )

Alert Responded in Epi-week 32, 2016

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Awal Medical Complex, Habban Ataq, Habban, Hospital, Salem Bahaj Clinic, Azan eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Shabwah 19 0 Mayfaa Hospital, Teab Al Atfal Clinic, Hantwsh Appropriate treatment was given Clinic

Al Awal Medical Complex, Hatib Health Ataq, Hatib, Center, Habban Hospital, Azan eDEWS team contacted focal points. Cases were diagnosed clinically as suspected DF. Appropriate DF Shabwah Habban, Mayfaa 36 0 Hospital, Bayhan Hospital and Al-Salam treatment was given and Bayhan Dispensary

eDEWS team contacted the focal point. The cases was diagnosed clinically as suspected VHF. VHF Shabwah Ataq Al-Salam Dispensary 1 0 Appropriate treatment was given

eDEWS team contacted focal points. The case was diagnosed clinically as suspected Meas Meas Al-Baidha Rada' Al Salaam Hospital 1 0 Appropriate treatment was given

Areeb Health Center, Alamal Hospital, Mukayras, Rada', Marthaàh Unit, Radaà Hospital Al A'rsh, Al Bayda, Alnmodgy, Al Zahraà Hospital, Barkan eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Al-Baidha Naman, Az Zahir, Unit, Naman Center, AZ Zahir Health 39 0 Appropriate treatment was given Maswarah and As Center, Al Heah Hospital, Dathran Unit, Sawma'ah and Nati As Sawmaàh Health Center and Algailah Health Center

Sayun public Hospital , Al Ahkaf eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Hadramout wady Sayun and Tarim 9 0 Dispensary and Tarim Hospital Appropriate treatment was given

eDEWS team contacted the focal point, information shared. The case was diagnosed clinically as AFP Hadramout wady Tarim Tarim Hospital suspected AFP. Field investigation was done. Stool samples were collected from the case and close 1 0 contacts and sent for confirmation

eDEWS team contacted focal points. Cases were diagnosed clinically as suspected VHF. VHF Hadramout wady Sayun Al Ahkaf Dispensary 1 0 Appropriate treatment was given and health education was done

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Dhamar Jahran Maabr Dispensary 1 0 Samples were collected to be send to central lab in sana'a

General Dhamar Hospital Authority, Dhamar City and eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Dhamar Maabr University Hospital and Taibah 8 0 Jahran Appropriate treatment was given. Cases from different areas Dispensary

eDEWS team contacted the focal point, information shared. The case was diagnosed clinically as AFP Dhamar Dhamar City General Dhamar Hospital Authority suspected AFP. Field investigation was done. Stool samples were collected from the case and close 1 0 contacts and sent for confirmation

eDEWS team contacted focal point. The cases was diagnosed clinically as suspected Pert. Pert Al-Mahweet Bani Sa'd Gomah Sareh Health Center 1 0 Appropriate treatment was given was vaccinated against pertussis

eDEWS team contacted the focal point. Cases were diagnosed clinically and by lab as suspected Sch Al-Mahweet Shibam Kawkaban Alahjor Center 5 0 Sch. Appropriate treatment was given

eDEWS team contacted the focal point. The case was diagnosed clinically as suspected Meas. Meas Rayma Mazhar Aljalal Dispensary 2 0 Samples were collected to be send to central lab in sana'a

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.