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Zimbabwe Weekly Epidemiological Bulletin

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Zimbabwe Weekly Epidemiological Bulletin Zimbabwe Weekly Epidemiological Bulletin Number 160 Epidemiological week 16 (week ending 22 April 2012) Highlights: Week 16 (16– 22 April 2012) Bindura 0 69 (2.04) 69 (1.51) 33 typhoid cases reported Chirumhanzu 0 1 (0.03) 1 (0.02) 12621 malaria cases and 11 deaths reported Chitungwiza 0 2 (0.06) 2 (0.04) Chegutu 0 16 (0.47) 16 (0.35) Contents Harare 1079(90.14) 3080 4159 (90.9) A. General context (91.04) B. Epidemic prone diseases Harare 0 8 (0.24) 8 (0.17) Central C. Events of public health importance in the region Hospitals D. Completeness and timeliness of the national data E.Acknowledgments F.Annexes From 26 October 2011 to date, 67 samples were 1. Classification of events that may constitute a laboratory confirmed to be, 67 were confirmed Public Event of International Concern S.typhi of which 63 were from Harare and 4 2. Standard case definitions from Bindura. 3. Alert/action epidemic thresholds This week, a total of 52 cases were reportedconsisting of 33 cases for week 16 all A. General Context from Harare and late reporting of 19 cases of week 15. In the previous week 65 cases hadbeen Typhoid outbreak in Harare is still on-going reported countrywide. Since week 52 of 2011, a since October 10, 2011. The disease has spread decrease in the number of cases reported weekly to other provinces. However the weekly number has been observed as is shown in the epidemic- of cases has declined. curve. Since the beginning of 2012, a total of 3383 No reports of cholera, influenza A and measles cases have been reported. outbreaks countrywide. The map (Figure 2) below shows the B. Epidemic prone diseases distribution of cumulative cases by place of residence in Harare City since the beginning Typhoid outbreak of the outbreak to date Table 2: Distribution of typhoid cases by Since 10 October 2011, Harare City has been place of residence, Harare City, 16-22 Apr experiencing an outbreak of Typhoid Fever. The 2012 disease has also spread to Chitungwiza City, Mashonaland Central Province (Bindura Suburb Frequency district) and Mashonaland West Province n=33 (%) (Zvimba and Chegutu districts). As of 22 April Kuwadzana 16 (48.5%) 2012, a total of 4572 cases were reported. The distribution of the cumulative cases is as shown Dzivaresekwa 9 (27.3%) in table 1 below. Whitecliffe 3 (9.1%) Tynwald 2 (6.1%) Table 1: Distribution of typhoid cases by Snake park 1 (3%) place of treatment, Zimbabwe, 10 October 2011-22 April 2012 Crowborough 1 (3%) Warren Park 1 (3%) Place of 10 Oct-31 1 Jan-22 Total treatment Dec 2011 April 2012 n=4572 n=1197 (%) n=3383 (%) (%) Zvimba 118 (9.86) 207 (6.12) 325 (7.11) This weekly Epidemiological Bulletin is published jointly by the Ministry of Health and Child Welfare, Zimbabwe and the World Health Organization. 1 For correspondence: Email: [email protected] and [email protected] or call: +263772104257 or +263772277893 Zimbabwe Weekly Epidemiological Bulletin Figure 1: Harare and Bindura Typhoid Epidemic Curve, 10 October 2011 – 22 April 2012 Anthrax 120 No cases of anthrax have been reported this week. The cumulative figure for anthrax is 17. 100 80 Malaria 60 This week, a total of 12621 cases and 11 deaths 40 were reported as compared with 13967 cases Number Cases of Number 20 and 13 deaths in the previous week. The following districts are the most affected: 0 Table 3: Top 10 Malaria Affected Districts in 2011/09/18 2011/09/25 2011/10/02 2011/10/09 2011/10/16 2011/10/23 2011/10/30 2011/11/06 2011/11/13 2011/11/20 2011/11/27 2011/12/04 2011/12/11 2011/12/18 2011/12/25 2012/01/01 2012/01/08 2012/01/15 2012/01/22 2012/01/29 2012/02/05 2012/02/12 2012/02/19 2012/02/26 2012/03/04 2012/03/11 2012/03/18 2012/03/25 2012/04/01 2012/04/08 2012/04/15 2012/04/22 Week 16, Zimbabwe Date of onset Response activities District Frequency n=12621 (%) Coordination meetings with the Mutoko 1870 (14.8%) thematic committees involving Harare Mt Darwin 1381 (10.9%) City Health authorities and Partners Nyanga 795 (6.3%) (WHO, UNICEF, CDC, NGOs) every 2 Mbire 711 (5.6%) weeks Hurungwe 693 (5.5%) Chipinge 863 (5.4%) Social mobilization activities Mutare 637 (5.1%) Case management, and investigation Chimanimani 562 (5.02%) Active contact tracing Mudzi 571 (4.5%) Water quality monitoring Makonde 563(4.5%) Bucket chlorination at water points Since the beginning of 2012, a total of 137302 Figure 2: Map of the distribution of typhoid cases and 106 deaths (CFR= 0.08%) has been cases by place of residence, Harare City, 10 reported. Oct 2011- 22 April 2012 Response Activities: Outbreak Verification Assessment conducted by MOHCW with support from GOAL in Makonde district Health promotion campaigns Challenges: late submission of statistics by the village health workers to Clinics Figure 3: Comparison of national malaria cases 2012 vs. 2011 and epidemic threshold This weekly Epidemiological Bulletin is published jointly by the Ministry of Health and Child Welfare, Zimbabwe and the World Health Organization. 2 For correspondence: Email: [email protected] and [email protected] or call: +263772104257 or +263772277893 Zimbabwe Weekly Epidemiological Bulletin Cabo Delgado: 404 cases and 4 deaths 2011 threshold 2012 (CFR: 1.0%) 18000 16000 Niassa: 243 cases and 3 deaths (CFR= 14000 1.0%). 12000 Social mobilisation activities are ongoing. 10000 Cases 8000 6000 Tanzania – Suspected Anthrax 4000 2000 As of 11 March 2011, a total 12 suspect anthrax 0 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 cases and 1 death (CFR= 8.3%) were Week number reported. Median age (IQR) was 30 years (Q1= 2 years, Q2= 54 years). Age group 40-49 years constituted 34% of the cases. C. Completeness and timeliness of the National data E. Acknowledgements o National data reported in week n 16 All health workers, operating at different levels Completeness decreased from 84% to of the health system, providing information are 83% greatly acknowledged. In addition, special Timeliness decreased from 82% to 66% thanks to Health and WASH cluster members for sharing their data with our team. D. Events of public health importance within SADC MOHCW is grateful to all Partners including UN family and NGOs for their support. Mozambique: cholera outbreak Information on events of public health importance occurring within SADC is As of epidemiological week 15, a total of 647 consolidated from the WHO daily summary of cholera cases and 7 deaths (CFR: 1.1%) have health events. been reported from 2 provinces: This weekly Epidemiological Bulletin is published jointly by the Ministry of Health and Child Welfare, Zimbabwe and the World Health Organization. 3 For correspondence: Email: [email protected] and [email protected] or call: +263772104257 or +263772277893 Zimbabwe Weekly Epidemiological Bulletin Annex 1: Classification of Events that may constitute a Public Health Emergency of International Concern There are three groups of events if detected by the national surveillance system should trigger the use of the IHR (2005) Decision Instrument to be notified as they may constitute Public Health Emergencies of International Concern. These are: 1. A case of unusual or unexpected diseases which may have serious public health impact: smallpox, poliomyelitis due to wild-type poliovirus, human influenza caused by a new subtype and SARS. 2. Any event of potential international public health concern including events of unknown causes or sources and those involving other events or diseases: environmental health emergencies (natural events, chemical and radio-nuclear events, technological incidents, complex emergencies and deliberate events) Food borne diseases Zoonotic diseases or other infectious diseases. 3. Any of following diseases that have demonstrated the ability to cause serious public health impact and spread rapidly and internationally: Cholera, pneumonic plague, yellow fever, viral haemorrhagic fevers, West Nile Fever, other diseases that are of special national or regional concern e.g. dengue, RVF and meningococcal disease. This weekly Epidemiological Bulletin is published jointly by the Ministry of Health and Child Welfare, Zimbabwe and the World Health Organization. 4 For correspondence: Email: [email protected] and [email protected] or call: +263772104257 or +263772277893 Zimbabwe Weekly Epidemiological Bulletin Annex 2: Standard Case Definitions Diseases Standard Case Definitions Cholera Suspected case In an area where there is no cholera outbreak, any person aged five years or more, presenting with severe dehydration or death from acute watery diarrhoea In an area where there is a cholera outbreak, any person aged two years or more presenting with acute watery diarrhoea, with or without vomiting Confirmed case A suspected case in which Vibrio cholerae sero-groups O1 or O139 has been isolated in the stool. Note All suspected cases under the age of two years must be confirmed. The inclusion of all ages in the case definition somewhat reduces specificity, that is, inclusion of more non-cholera childhood diarrhoea cases (mainly those below 5years). It does not impede meaningful interpretation of trends. Teams should monitor any shift in the age distribution of cases, which might indicate a changing proportion of non- cholera cases among patients seen. Malaria Suspected uncomplicated malaria Any person living in a malaria area or history of travelling in a malaria area within the last 6 weeks, presenting with fever, malaise, chills, and rigors, without signs of severe disease such as vital organ dysfunction Confirmed uncomplicated malaria Is suspected uncomplicated malaria with laboratory diagnosis by malaria blood slide or RDT for malaria parasites Confirmed severe malaria A patient hospitalized with P.
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