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Weekly Epidemiological Bulletin Disease Early Warning System and Response in Pakistan

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Weekly Epidemiological Bulletin Disease Early Warning System and Response in Pakistan Weekly Bulletin Epidemiological Disease early warning system and response in Pakistan Volume 2, Issue 30, Monday 1 August, 2011 Highlights Priority diseases under surveillance Epidemiological week no. 30 (22 - 28 July, 2011) in DEWS Acute Flaccid Paralysis (AFP) • 88 districts and 3 agencies provided surveillance data to the DEWS this week Acute Jaundice Syndrome (AJS) from 3,092 health facilities. Acute Respiratory Infections (Upper and Lower) (ARI) • A total of 1,010,892 consultations were reported through DEWS of which 17% were acute respiratory infections (ARI), 12% skin disease, 10% acute diar- Acute Watery Diarrhoea (AWD)/ Suspected Cholera rhoea, and 6% suspected Malaria. Acute Bloody Diarrhoea (BD) • A total of 131 alerts with 20 outbreaks were reported in week-30, 2011: Alto- Other Acute Diarrhoeas (AD) gether 50 alerts were for AWD; 38 for Measles; Eight for Neonatal tetanus Suspected Viral Hemorrhagic and Tetanus; Seven for Pertussis; Four for Leishmaniasis; Three for Malaria; Fever (VHF) Two for Acute jaundice syndrome; One for Bloody diarrhoea, and 18 were Suspected Malaria (Mal) for other suspected diseases. Suspected Measles (MS) Suspected Meningitis (MG) • National Polio Eradication Initiative reported no new confirmed polio case this week. Total 60 (59=type1, and 1=type3) confirmed polio cases have been Others reported in 2011 from 25 districts. Figure‐1: Three years trend of Acute diarrhoea in Pakistan (2009, 2010, and 2011) 20 2009 2010 2011 16 12 Percentage 8 4 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Epi‐week Disease Wk-23 Wk-24 Wk-25 Wk-26 Wk-27 Wk-28 Wk-29 Wk-30 Other Acute Diarrhoea (Not Watery) 100,753 (10%) 102,217 (10%) 103,978 (10%) 107,924 (10%) 100,320 (10%) 104,413 (10%) 107,861 (10%) 103,341 (10%) Total consultation 1,009,254 1,028,090 1,019,724 1,087,368 994,345 1,025,647 1,034,504 1,010,892 Since July 29, 2010, approximately 38,413,010 patient consultations have been reported to the DEWS from the five provinces and three agencies and state of AJK. In this week 30, 2011 (22 to 28 July, 2011) reports were received from 3,092 health centers and the major causes for seeking health care by the communities in almost all of the provinces were diarrheal diseases, acute respiratory infections 172,676 (17%), skin diseases 123,139 (12%) and suspected malaria 57,544 (6%). The above graph shows the trend of acute diarrhoea cases out of total consultations reported to DEWS in 2009, 2010 and 2011 up until now. This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 01 Epidemiological Bulletin: DEWS, Pakistan, Week no. 30 (22 - 28 July, 2011) Previous week's Outbreaks: Date Disease Province District Area <M >M <F >F Action Taken Balochis‐ Village Kud Sayan‐UC AWD outbreak comprising of 35 cases. 2 stool sample collected and found positive for V.c. Ogawa, 4 water sample were also 16‐Jul AWD Lasbela 7 9 4 15 tan Kathore, Tehsil Bela collected for quality test. AWD outbreak reported in media. Cases investigated with collaboration with DHO and health authorities staff, house to Balochis‐ Kehn, Barani Bhaint, UC 17‐Jul AWD Khuzdar 6 24 2 21 house survey revealed cases with typical sign and symptoms. Two stool and two water samples were collected and sent to tan Ornach, Tehsil Nall NIH. Health education session conducted, water filters, aqua tabs, hygiene kits were distribute in the community. Union Council Tasp Balochis‐ During NID, AWD alert was reported, area visited, 12 patients found. Early response team meeting was conducted with DHO 21‐Jul AWD Panjgor Sarekalat, Mohalla 5 4 1 2 tan and health authorities. DTC established in BHU Tasp Bazar. Medicine, Health education sessions provided. Johan Dun 4 suspected AD cases with moderate dehydration were reported and 23 more found during active surveillance in village Barkot, Haripur. The patients presented with moderate dehydration. Initial epidemiological investigation suggested contami‐ nated water was the source. Stool sample was taken sent to NIH and found positive for V.c. Ogawa. Environmental assess‐ 15‐Jul AWD KPK Haripur Village Bagra, UC Bagra 6 8 2 13 ment was carried out water samples were taken and found contaminated. 6 cases with moderate dehydration were admit‐ ted in different health facilities. Aqua tabs, ORS and soap were distributed. Door to door by LHW during the polio campaign. Health and Hygiene session conducted for the affected community. Water tank was cleaned with the help of local commu‐ nity. EDO Health was informed. AWD alert was reported from DHQ hospital Mardan. The case was investigated and sample taken and found positive for V.c. Mohalla Sharif Abad, Ogawa. EDO Health, DSM of PPHI, MS of DHQ and EPI Coordinator informed. On active surveillance in the area one more 16‐Jul AWD KPK Mardan 0 0 0 0 Takht Bai patient recovered from diarrhea was found. Water samples taken and being tested. Health Education conducted with households and community. IEC material, soap and aqua tabs were distributed. Hasan Garha UC Mera Two AWD cases were reported form Akora Khattak, Nowshera. 1/2 samples collected was found positive for V.c. Ogawa. 15‐Jul AWD KPK Nowshera Akora Khattak Now‐ 0 1 0 1 Hygiene sessions were conducted, Filters and IEC material distributed. No more cases were found during field surveillance. shera Alert for BD was reported by BHU Muslimabad. 6 cases were reported from a poultry farm in the village. On active case finding 15 more diarrhoea cases were found having abdominal cramps and some with bloody diarrhoea. All these cases are Village Muslimabad, UC resident employees of same poultry farm. Stool sample was taken and sent to NIH. Environmental assessment was carried 16‐Jul BD KPK Haripur 0 21 0 0 Muslimabad out and water samples were taken from 2 sources and 1 found contaminated. Management of the poultry farm were advised to use the safe water source. Health and hygiene session was conducted for the staff. Aqua tabs, soap and ORS were distributed. Follow up visit was made on 20th July. No new cases were reported. EDO health was informed. One AWD case reported from Nishter hospital, sample taken and found positive for V.c. Ogawa, the area was visited jointly by the SO,EHE and DEWS FP. House to house survey conducted no other cases found in the locality. Area was assessed for Mohalla Koharay Wala, 21‐Jul AWD Punjab Multan 0 1 0 0 the WASH. Health education session conducted, health hygiene kits (Aqua tabs, Jerry cans, Multi purpose soap, Antiseptic Ghazia Abad Chowk soap, Buckets and water filter) distributed. LHWs mobilized to conduct HE sessions on hygiene in the other areas of the whole UC. shared the line list with EDO(H). Chah Mithoo Wala, Near by Four AWD cases from four different locations were reported, 4/4 samples found positive for V.c. Ogawa. In the locality/area Sardar Koorey Khan School; 10 households on each side were interviewed but no more similar case or suspect was found. Health education to family 15‐Jul Khoo M. Hussain Wala, Near members in households visited. Distribution of soap, Aqua Tabs, jerry cans, buckets, water filters and IEC among them. by Taleri Nehar, UC Taleri; AWD Punjab Muzaffargarh Basti Babrey, Moza Chah 0 0 1 3 Nearest BHU Doaba was visited and MO was given briefing on the situation, control measures and importance of awareness among general masses about safe drinking water, food and personal hygiene, it was also suggested to advise LHWs, CDC 19‐Jul Godhar, UC Van Patafi; Dera Murad Wala, Chah Pir Wala, supervisor & School Health & Nutrition Supervisor to impart above said information among community while conducting UC Bhutta Pur their HE sessions in the catchment area. EM & EH assessment was also done at BHU. Village Ali junejo,Deh Alert for 4 cases of AWD. Reinforced case management, active surveillance done, Health education, ORS, Aqua tabs and Zinc 18‐Jul AWD Sindh TM Khan jaith,UC Dhando,Taluka 1 0 2 1 Tando ghulam haider tabs Provided, DMT & EDO‐H informed, 1 stool sample collected and found positive for V.c. Ogawa, 2 Water samples taken. Tando Allah Village Azizullah memon Alert for 24 cases suspected Pertussis. Reinforced case management, active surveillance done, Health education, Erythromy‐ 21‐Jul Pertussis Sindh 6 3 12 3 Yar farm cin provided for cases, 3 throat swab samples taken. Current week's Outbreaks: Date Disease Province District Area <M >M <F >F Action Taken Village Muri, Town An alert for AWDin two villages of Muzaffarabad was responded in a medical camp where 130 cases from one village and 50 Committee Ghari cases from another village were treated. There was one death was reported from RHC Ghari Dupatta, one sample (was 24‐Jul AD AJK Muzaffarabad 24 34 64 58 Dupatta; Village Khutti, found positive for V.c. Ogawa. Community awareness session conducted, IEC material distributed. DHO was informed about Muzaffarabad situation. 54 suspected malaria cases were reported. 22 samples were taken and 13 verified positive (P. Falciparum 7, P.Vivax 4, mixed Balochis‐ BHU Noor Mohammad 28‐Jul Malaria Jaffarabad 0 0 0 0 2); SPR=59%, while FR=69%. The patients were treated and DHO is informed and requsted for distribution of bednets to the tan Jamali location. Balochis‐ Positive malaria cases were reported where 10 were positive for P.Vivax and 11 for P.
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