Weekly Epidemiological Bulletin Electronic Disease Early Warning System & Response (eDEWS) in and FATA Epidemiological Week no. 22 (27 May to 02 Jun, 2012) Priority diseases under surveillance in eDEWS

Respiratory Diseases Acute (upper) respiratory infections

Pneumonia <5 years

Pneumonia > 5 years

Suspected Diphtheria

Suspected Pertussis Gastro Intestinal Diseases Acute Watery Diarrhea <5 year

Acute Watery Diarrhea > 5 year

Bloody Diarrhea <5 years

Bloody Diarrhea > 5 years

Other Acute Diarrhea < 5 years

Other Acute Diarrhea > 5 years

Suspected Enteric/Typhoid Fever Other Communicable Suspected Malaria

Suspected Meningitis

Suspected Dengue Fever Suspected Viral Hemorrhagic Fever

Pyrexia Of Unknown Origin Vaccine Preventable

Suspected Measles

Suspected Acute Viral Hepatitis

Highlights Chronic Viral Hepatitis

 18 districts and 3 agencies provided surveillance data to the eDEWS this week from 519 Neonatal Tetanus

health facilities. Acute Flaccid Paralysis  A total of 146,779 consultations were reported through eDEWS of which 18% or 25,866 cases Skin Disease were Acute Upper Respiratory Infection, is still the highest cause of morbidity of total Scabies consultations were showing 1% increase in percentage as compared to week 21.  Other Acute Diarrhoea shared 11% or 15,862 cases of the total consultations showing 1% Cutaneous Leishmaniasis increase in percentage as compared to previous week. Injuries /Poisoning  Pyrexia of Unknown Origin accounted for 5% or 7,288 cases out of total consultations. Injuries  Skin Infection (Skin Inf.) reported at 3% or 3,852 cases and suspected Typhoid Fever comprised Snake bite only 0.3% or 462 cases out of total consultations. Other unusual diseases  A total of 79 alerts including 4 outbreaks (3 for Measles and 1 for Falciparum Malaria) were received. 68 alerts for suspected Measles, 3 for AWD, 3 for NNT, 2 for BD while 1 each for Other unusual diseases Enteric Fever, Cutaneous Leishmaniasis and suspected Malaria were shared and responded.

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Compiled situation in Khyber Pakhtunkhwa & FATA Figure-1: Four years trend of Other Acute Diarrhea (OAD) in Khyber Pakhtunkhwa/FATA (2009, 2010, 2011 and 2012)

The above graph shows the trend of Other Acute Diarrhoea (OAD) cases out of total consultations reported to DEWS in 2009, 2010, 2011 and 2012 up until now. In this week 22, 2012 OAD consultations shows 11% or 15,862 cases of total cases which shows 1% increase in percentage as compared to week 21. During this week high percentage of OAD consultations were reported from district Hangu 20%, Kohistan 20%, Buner 17%, Swat 16%, Mohmand agency 16%, Malakand 15%, Haripur 13%, Lower Dir 13%, Charsadda 12% and D.I. Khan 10%. Figure-2: Alerts reported in Khyber Pakhtunkhwa/FATA (year 2011 and 2012 comparison)

The above graph shows the different reported alerts to DEWS from year 2011 and 2012. High number of alerts reported in year 2012 due to more active surveillance and response. A cumulative figure for the current year is 1,545 alerts (3,444 cases) including of 110 outbreaks were reported. Measles alerts are leading in Khyber Pakhtunkhwa and FATA with 1,170 alerts (2,036 cases) including 80 outbreaks. Followed by Leishmaniasis 170 alerts (544 cases) including 11 outbreaks, Neonatal Tetanus 87 alerts (89 cases), AWD 18 alerts (38 cases), Diphtheria 17 alerts (17 cases), suspected Typhoid 16 alerts (62 cases) including 4 outbreaks, Pertussis 11 alerts (21 cases) including 1 outbreak, Bloody diarrhoea 10 alerts (55 cases) including 4 outbreaks, AFP 8 alerts (8 cases), suspected Acute Viral Hepatitis 7 alert (58 cases) including 2 outbreaks, Scabies 6 alerts (308 cases) including 5 outbreaks, H1N1 5 alerts (11 cases) including 1 outbreak, Dengue Fever 4 alerts (4 cases), Tetanus 4 alerts (4 cases), Other Acute Diarrhoea 2 alert (164 cases), CCHF 2 alerts (3 cases), Chickenpox 2 alert (5 cases), Dengue Hemorrhagic Fever 1 alerts (4 cases), suspected DHF/CCHF 1 alert (1 case), Falciparum Malaria 2 alert (2 cases) including 1 outbreak, Unexplained Fever 1 alert (1 case) and Rabies 1 outbreak (9 cases) were shared.

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 2 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Figure-3: Number of alerts and alert cases reported in Khyber Pakhtunkhwa/FATA (Week 22, 2012)

The above left side graph shows different alerts and their cases reported in KP/FATA and right side graph shows different alerts shared by district wise in week 22, 2012. In this week a total of 79 alerts (140 cases) including 4 outbreaks (3 for Measles and 1 for Falciparum Malaria) were reported and responded. Highest number of alerts reported from district Swat 16 suspected Measles alerts (20 cases) were shared, Followed by district Haripur 14 alerts including 11 suspected Measles while 1 each for Enteric fever, BD and Falciparum Malaria, Abottabad 9 suspected Measles, Bajaur agency 6 alerts including 4 suspected Measles and 2 NNT, D.I. Khan 6 suspected Measles, Mardan 4 alerts including 3 suspected Measles and 1 AWD, Shangla 4 alerts including 3 suspected Measles and 1 CL, Mansehra 4 suspected Measles, Swabi 3 suspected Measles, Battagram 2 suspected Measles, Charsadda 2 suspected Measles, Khyber agency 2 suspected Measles, Kohat 2 alerts including 1 each for AWD and BD, Malakand 2 suspected Measles, Bannu 1 NNT, FR Banuu 1 suspected Measles and Hangu 1 AWD were reported and responded.

 4 outbreaks (Measles 3 and Falciparum Malaria 1) were reported in this week.  1 Measles and 1 Falciparum Malaria were shared from district Haripur . A total of 9 suspected measles cases were reported from village Kotehra. Gave vitamin A. Field investigation found 7 childlren with no BCG scar and no routine immunization activity. Missed children sent to nearest health facility for vaccination. Outreach vaccination scheduled for current week. EDO Health and EPI coordinator informed about outbreak. . 1 cases of Falciparum malaria confirmed by both RDT and microscopy. Patient developed complications and referred to hospital where he was treated. No travel history to malaria endemic area. Active surveillance conducted in area. 8 cases with fever identified. Slides were taken for examination. Health session conducted for the affected family. Bed nets distributed by CHWs. Larvicidal activity in the camp carried out. Fog spray is planned for 2nd week of June.

 1 Measles outbreak was shared from district Mardan . A suspected Measles case was reported from MMC Mardan, case was investigation at hospital and received complete doses of routine vaccination. Active surveillance conducted in the area, surrounding houses were checked for identification of more cases and routine vaccination status, 5 more cases were identified in the family and surrounding. BCG coverage was 83% and Measles was 66% in the area. Vit-A was given, EPI team also requested for outreach immunization in the area. Blood Sample Collected for confirmation of antibodies, Health education session conducted with the family members and community, patient isolated, EDO-H Focal person & EPI Coordinator were informed.

 1 Measles outbreak was shared from district Swabi . A total of 5 suspected cases of Measles were reported from BUH Fazal Abad. Cases were investigated and responded in the presence of Health department personal. During investigation 4 more cases were found in the same locality. Vit.A given, health education sessions conducted, EDO H and EPI coordinator Informed, Measles Vaccination done in the relevant houses.

Table-1: Leading causes of seeking health care in flood affected districts, compiled weekly reports

Total Consultations Disease name Week-19 Week-20 Week-21 Week-22 (1st Jan to 02nd Jun, 2012) Acute Diarrhoea 16,890 (11%) 17,861 (11%) 17,631 (10%) 15,862 (11%) 218,387 (7.4%) Bloody Diarrhoea 1,727 (1%) 1,379 (1%) 1,544 (1%) 1,068 (1%) 22,218 (1%) Suspected Malaria 3,350 (2%) 3,868 (2%) 4,098 (2%) 3,200 (2%) 44,705 (1.5%) Skin Diseases 4,464 (3%) 4,514 (3%) 4,639 (3%) 3,852 (3%) 79,641 (3%) Pyrexia of Unknown Origin 8,538 (5%) 8,213 (5%) 8,174 (5%) 7,288 (5%) 137,346 (5%) Acute Respiratory Infection 29,966 (19%) 29,947 (18%) 30,490 (17%) 25,866 (18%) 719,525 (24%) Total Consultations 159,890 161,900 176,830 146,779 2,946,630

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 3 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

The above table shows compiled communicable diseases cases from weekly reports and proportional morbidity through eDEWS reported. Since January 1, 2012, approximately 2,946,630 patient consultations have been reported to the eDEWS from Khyber Pukhtunkhwa province and Federal Administered Tribal Areas (FATA).

In this week 22, 2012 (27th May to 02nd Jun, 2012) reports were received from 519 health centres and the major causes for seeking health care by the communities in almost all of the regions were diarrhoeal diseases 15,862 cases or 11%, acute respiratory infections 25,866 cases or 18%, skin diseases 3,852 cases or 3% and suspected malaria 3,200 cases or 2%. Figure-4: Total number of HFs reported and consultations Figure‐5: Leading communicable diseases percentage trend in Khyber (Week no.1 to 22, 2012) Pakhtunkhwa and FATA (Week no.1 to 22, 2012)

Figure 4 shows the number of health facilities and total number of consultations reported. Figure 5 shows the weekly percentage trend of ARI, Other Acute Diarrhoea, suspected Malaria and Pyrexia of Unknown Origin in Khyber Pakhtunkhwa and FATA from week 1 to 22, 2012. ARI percentage is showing fluctuation since week 15 and OAD showing 1% increase in week 22 as compared to week 21.

Table-2: Respiratory Diseases situation in Khyber Pakhtunkhwa and FATA

Figure-6: Respiratory Diseases Week-21 Week-22

Upper Respiratory Infection 29,232 24,826

Pneumonia <5 663 537

Pneumonia >5 595 503

Table 2 shows the last two weeks Acute Respiratory Tract Infection (Upper Respiratory Tract Infection and Lower Respiratory Tract Infection (Pneumonia)) consultations comparison and figure 5 shows the last four weeks percentage situation of ARI.

Table-3: Gastro Intestinal Diseases situation in Khyber Pakhtunkhwa and FATA Figure-7: Gastro Intestinal Diseases Week-21 Week-22

Bloody Diarrhea <5 591 425 Bloody Diarrhea >5 953 642 Other Acute Diarrhea <5 9,298 8,407 Other Acute Diarrhea >5 8,333 7,455 Suspected Typhoid Fever 754 462

Table 3 shows the last two weeks cases of Gastro Intestinal Diseases and figure 6 shows the Gastro Intestinal Diseases percentage of last four weeks.

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 4 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Province Khyber Pakhtunkhwa: Figure-8: Distribution of consultations by Figure-9: Weekly diseases (ARI, OAD, MAL and PUO) percentage trend communicable diseases

Figure 8 shows distribution of consultations by communicable diseases in week 22, 2012 and figure 9 shows weekly percentage trend of ARI, OAD, MAL and PUO from week 1 to 22, 2012. This week 18 districts reported to eDEWS from 468 health facilities with a total of 132,764 patients’ consultations. Acute Respiratory Tract Infection 24,113 cases reported were showing no change in percentage as compared to week 21 patients’ visits and accounted for 18% of the total consultations. Other Acute Diarrhea cases 14,455 or 11% showing 1% increase in percentage as compared to previous week and suspected Malaria 2,245 cases or 2% were reported. While Pyrexia of Unknown Origin cases 6,963 or 5% showing 0.4% increase. Suspected Typhoid Fever (TF) cases 409 or <1% and Scabies cases 3,499 or 3% were reported. Figure-10: ARI, OAD, MAL and PUO percentage situation of Khyber Pakhtunkhwa district wise in week 22, 2012

The above figure shows ARI, OAD, MAL and PUO percentage situation district wise in week 22, 2012. During this week high percentage of OAD consultations were reported from district Hangu 20% (197 cases), followed by district Kohistan 20% (112 cases), Buner 17% (1,321 cases), Swat 16% (2,624 cases), Malakand 15% (1,234 cases), Haripur 13% (1,325 cases), Lower Dir 13% (659 cases),Charsadda 12% (1,123 cases) and D.I. Khan 10% (931 cases). Similarly high percentage of ARI cases were reported from district Buner 29% (2,302 cases), Swat 28% (4,691 cases), Shangla 25% (1,276 cases), Kohistan 23% (129 cases) and Hangu 21% (209 cases). High percentages of suspected Malaria were reported from district Lower Dir 6% (313 cases), Bannu 5% (105 cases) and Mardan 4% (245 cases). High percentage of Pyrexia of Unknown Origin (PUO) consultations were reported from district Bannu 11% (232 cases), Lower Dir 11% (547 cases), D.I. Khan 10% (916 cases), Kohat 8% (914 cases), Charsadda 8% (730 cases), Shangla 7% (366 cases) and Mardan 6% (319 cases).

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 5 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Current week’s Alert/Outbreak in Khyber Pakhtunkhwa:  A total of 70 alerts including 4 outbreaks (3 for Measles and 1 for Falciparum Malaria) were received. 61 alerts for suspected Measles, 3 for AWD, 2 for BD while 1 each for NNT, Enteric Fever, Cutaneous Leishmaniasis and suspected Malaria were shared and responded. S. Date Suspected <5 >5 <5 >5 District Location Sample Positive Cases Death No. Investigated Disease M M F F 1 26-May-12 Measles Abbottabad FF Centre, Cant ATD 0 0 1 0 0 r 1 0

2 26-May-12 Measles Abbottabad Bandi Attai Khan, Havallian 1 0 0 0 0 r 1 0

3 28-May-12 Measles Abbottabad Lamba Mara, Jhangi 1 0 0 0 0 r 1 0

4 29-May-12 Measles Abbottabad Sultanpur, Cant Havalian 1 0 0 0 0 r 1 0

5 30-May-12 Measles Abbottabad Mohalla Bilal, Havalian City 1 0 0 0 0 r 1 0

6 30-May-12 Measles Abbottabad Afridi Road Sultanpur, Cant Havalian 0 1 0 0 0 r 1 0

7 31-May-12 Measles Abbottabad Mohalla Sheikhsn, Havalian City 0 0 0 1 0 r 1 0

8 31-May-12 Measles Abbottabad Mohabatan, Jhangra 1 0 0 0 0 r 1 0

Mohalla Naryan, Jadoon Caloney, St 9 01-Jun-12 Measles Abbottabad 2 0 0 1 0 r 3 0 1, Cant ATD

10 28-May-12 NNT Bannu Village Kotka Zabta Khan 0 0 1 0 0 r 1 0

Village Batamori, UC Batamori, 11 31-May-12 Measles Batagram 0 0 0 1 1 r 1 0 Tehsil and District Batagram Village Bier Jozz, UC Batamori, Tehsil 12 31-May-12 Measles Batagram 0 1 0 0 1 r 1 0 and District Batagram

13 30-May-12 Measles Charsadda Sir Piraan Kallay 0 0 1 0 1 r 1 0

14 31-May-12 Measles Charsadda village Wardaga 0 0 0 1 1 r 1 0

15 27-May-12 Measles D. I. Khan Tariq Abad UC City 2 0 1 1 1 0 r 3 0

16 27-May-12 Measles D. I. Khan Qureshi Morr, UC Muryali 1 0 0 1 0 r 2 0

17 28-May-12 Measles D. I. Khan Kirri Shamozai, Tehsil Paroa 1 0 1 0 0 r 2 0

18 29-May-12 Measles D. I. Khan Muryali, Multan Road 0 0 2 0 0 r 2 0

Kot Saggu (Saggu South), Tehsil 19 30-May-12 Measles D. I. Khan 2 0 0 0 0 r 2 0 Daraban

20 31-May-12 Measles D. I. Khan Zafar Abad Colony, UC Lachra 1 0 1 0 0 r 2 0

21 29-May-12 AWD Kohat Village Kachai, UC Usterzai 0 2 0 2 0 r 4 0

22 30-May-12 BD Kohat Union Council Usterzai 0 3 1 2 0 r 6 0

23 31-May-12 AWD Hangu BHU Sarozai, UC Serozai 0 0 0 0 0 r 0 0

24 30-May-12 Measles Haripur Villager Alloli, Haripur, DHQ 0 0 1 1 0 r 2 0

25 26-May-12 Measles Haripur Village Halli, UC Barkot, RHC Halli 1 0 0 0 0 r 1 0 Khanpur city, UC Khanpur, RHC Khan 26 28-May-12 Measles Haripur 2 0 0 0 0 r 2 0 Pur 27 28-May-12 Measles Haripur Darband Muhallah, UC Tarbella 1 0 0 0 0 r 1 0 Khalabut Township, Sector 3, UC 28 29-May-12 Measles Haripur 1 0 0 0 0 r 1 0 Khalabut, CD KTS3 Khalabut Township, Sector 4, UC 29 29-May-12 Measles Haripur 2 1 1 0 0 r 4 0 Khalabut, CD KTS4 Village Chaintree, UC Luder Mang, 30 31-May-12 Measles Haripur 0 1 0 0 0 r 1 0 DHQ

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 6 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Muhallah Darwesh Station, Nai 31 01-Jun-12 Measles Haripur 0 1 0 0 0 r 1 0 Abadi, Haripur city. Falciparum 32 30-May-12 Haripur Afghan Refugee camp, BHU STC5 0 1 0 0 2 r 1 0 Malaria

33 30-May-12 Measles Haripur Afghan Refugee camp 21 1 0 0 0 0 r 1 0

34 31-May-12 Enteric Fever Haripur Afghan Refugee camp Bassu Mera 0 2 0 0 2 r 1 0

35 31-May-12 BD Haripur Afghan Refugee camp Bassu Mera 1 0 2 0 0 r 3 0

Village Kotehra, UC Kotehra, BHU 36 28-May-12 Measles Haripur 3 1 3 2 0 r 9 0 Kotehra

37 01-Jun-12 Measles Haripur Village Neelor, Pind Hashim Khan 2 0 0 0 0 r 2 0

38 31-May-12 Measles Malakand Mayyan 1 0 0 0 1 r 1 0

39 30-May-12 Measles Malakand Sharbatay 2 0 0 0 2 r 2 0 Village & UC Baghdada, Tehsil 40 28-May-12 AWD Mardan 0 1 0 0 1 r 1 0 Mardan Khalid Afridi Quarters, Bypass Road, 41 29-May-12 Measles Mardan 0 2 0 0 1 r 2 0 Mardan Khas Village Dheri Korona(Akhon Baba), 42 30-May-12 Measles Mardan 0 1 2 3 0 r 6 0 UC Dagai, Tehsil Mardan Village Kandaro, UC Shiekh Yousaf, 43 31-May-12 Measles Mardan 0 0 1 0 0 r 1 0 Tehsil Mardan 44 29-May-12 Measles Shangla Village Lelonai 0 0 0 1 1 r 1 0

45 30-May-12 Measles Shangla Village Banjaro Brabroo 1 0 0 0 1 r 1 0

46 30-May-12 Measles Shangla Village Bengalay UC Bengalay 1 0 0 0 1 r 1 0

47 31-May-12 Leishmaniasis Shangla Munz Kele Sarkool 0 4 0 2 0 r 6 0 Village Sangota near Shingrai Road, 48 28-May-12 Measles Swat 0 0 0 1 1 r 1 0 UC Sangota, Tehail Babuzai Village Gulkada No.3 near Mosque, 49 28-May-12 Measles Swat 1 1 0 0 1 r 2 0 UC , Tehsil Babuzai Village Mera, UC Bara Dureshkhela, 50 28-May-12 Measles Swat 1 0 0 0 1 r 1 0 Tehsil Matta Village and UC Kota, Mohalla Bacha 51 29-May-12 Measles Swat 0 0 1 0 1 r 1 0 Palao, Tehsil Village and UC Tindodag, Tehsil 52 29-May-12 Measles Swat 0 0 0 1 1 r 1 0 Babuzai Village Gumbat Mera, UC Mlauk 53 29-May-12 Measles Swat 0 1 0 0 1 r 1 0 Abad, Tehsil Babuzai Village Sangota near Spring, UC 54 29-May-12 Measles Swat 0 0 0 1 1 r 1 0 Sangota, Tehsil Babuzai Village Sam Shin, UC Shin, Tehsil 55 29-May-12 Measles Swat 0 0 1 0 1 r 1 0 Village Alam Ganj, UC Guli Bagh, 56 29-May-12 Measles Swat 0 0 1 0 1 r 1 0 Tehsil Charbagh Village Chalyar, UC & Tehsil 57 30-May-12 Measles Swat 0 1 0 0 1 r 1 0 Khwazakhela Village Qilla, UC & Tehsil 58 30-May-12 Measles Swat 0 1 0 0 1 r 1 0 Khwazakhela Village Soye Gale Loy Band, UC Koz 59 30-May-12 Measles Swat 1 0 1 0 1 r 2 0 Aba Khel, Tehsil Kabal Village Sirsenai Nadir Khan 60 30-May-12 Measles Swat Mohallah, UC Bar Aba Khel, Tehsil 0 0 0 1 1 r 1 0 Kabal Village Galoch, UC Kala Kale, Tehsil 61 30-May-12 Measles Swat 0 0 1 0 1 r 1 0 Kabal

62 30-May-12 Measles Swat Village and UC Kanju, Tehsil Kabal 0 0 0 1 1 r 1 0

Village Shah Dand Galoch, UC Kala 63 30-May-12 Measles Swat 0 1 0 2 1 r 3 0 Kale, Tehsil Kabal

64 29-May-12 Measles Swabi BHU Fazal Abad 3 1 1 0 1 r 5 0

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 7 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

65 30-May-12 Measles Swabi BMC Swabi, Arib khan kale 0 0 1 0 0 r 1 0

66 01-Jun-12 Measles Swabi Private Clinic, Gaar Munara 0 3 1 1 1 r 5 0

67 29-May-12 Measles Mansehra Sheikh Abad Camp Mansehra 1 0 0 0 0 r 1 0

Near Noghazi Tomb Noghazi 68 29-May-12 Measles Mansehra 0 1 0 0 0 r 1 0 Mansehra

69 30-May-12 Measles Mansehra Village Kanait UC Hamshirian 0 0 1 0 0 r 1 0

70 28-May-12 Measles Mansehra Village Gheerwal UC Dhodial 0 1 0 0 0 r 1 0

Federal Administered Tribal Areas (FATA): Figure-11: Two years trend of Other Acute Diarrhoea in FATA

DEWS was started in FATA three agencies (Bajaur, Khyber, Mohmand) since February, 2011 during FATA IDPs crisis. Figure 11 shows 2 years weekly percentage trend of OAD percentage trend. In week 22 OAD 1,407 cases or 10% were shared showing no change in percentage as compared to previous week.

Figure-12: Distribution of consultations by Figure-13: Weekly diseases (ARI, OAD, MAL and PUO) percentage trend communicable diseases

Figure 12 shows distribution of consultations by communicable diseases in week 22, 2012 and figure 13 shows weekly percentage trend of ARI, OAD, MAL and PUO from week 1 to 22, 2012. This week, 51 health facilities reported from 3 agencies to eDEWS with a total of 14,015 patients’ consultations. Acute Respiratory Tract Infection (ARI) 1,753 cases reported were showing 1% decrease in percentage as compared to week 21 patients’ visits and accounted for 13% of the total consultations. Other Acute Diarrhea (OAD) 1,407 cases or 10% were showing no change in percentage as compared to week 21 and suspected Malaria (Mal) 955 cases or 7% were shared. While Pyrexia of Unknown Origin (PUO) shared 325 cases or 2% which shows 1% decrease in percentage as This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 8 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

compared to previous week , suspected Typhoid Fever (TF) 53 cases or <1% and Scabies 353 cases or 3% were reported. Figure-14: ARI,OAD, MAL and PUO percentage situation of Federal Administered Treaty Agency (FATA) in last four weeks

The above figure 14 shows ARI, OAD, MAL and PUO percentage situation in FATA three agencies. During week 22, 2012 high percentage of ARI consultations were reported as compared to other diseases. In this week high percentage of Other Acute Diarrhoea consultations were reported from Mohmand as compared to Bajaur and Khyber agency. In this week OAD 16% or 388 cases, 10% or 507 cases and 8% or 512 cases were shared respectively from Mohmand, Bajaur and Khyber agencies. Similarly ARI 20% or 472 cases, 11% or 553 cases and 11% or 728 cases respectively from Mohmand, Bajaur and Khyber agencies. Pyrexia Unknown Origin (PUO) cases percentage were reported 3% or 76 cases, 2% or 113 cases and 2% or 136 cases respectively from Mohmand, Bajaur and Khyber agencies were reported. Suspected Malaria were shared 11% or 543 cases from Bajaur, 5% or 302 cases from Khyber and 5% or 110 cases from Mohmand agency.

Current week’s Alert/Outbreak in FATA:  A total of 9 alerts (7 for suspected Measles and 2 for NNT) were reported and responded in this week. S. Date Suspected <5 >5 <5 >5 Agency Location Sample Positive Cases Death No. Investigated Disease M M F F Bajaur village Sha dhand-Koohi, Tehsil 1 28-May-12 NNT 1 0 0 0 0 r 1 0 Agency Salarzai Bajaur 2 28-May-12 NNT village Balam Khar, Tehsil Salarzai 0 0 1 0 0 r 1 0 Agency Bajaur 3 29-May-12 Measles village Gat-Agra, Tehsil Mamoond 2 0 0 1 1 r 3 0 Agency Bajaur 4 29-May-12 Measles village Paja, Tehsil Khar 2 0 0 0 1 r 2 0 Agency Bajaur 5 29-May-12 Measles village Maina, Tehsil Mamoond 0 1 1 0 0 r 2 0 Agency Bajaur village Mandal-Manogai, Tehsil 6 29-May-12 Measles 1 0 0 0 0 r 1 0 Agency Salarzai

7 29-May-12 Measles FR Bannu Village Mamand Khel 1 0 0 0 1 r 1 0

Khyber Village Barra Dara,UC Kambila, Tehsil 8 30-May-12 Measles 0 1 1 0 1 r 2 0 Agency Mulagori Khyber Village New Abadi Shahzad Gul 9 31-May-12 Measles 0 0 1 0 0 r 1 0 Agency killi,Godar,Tehsil Jamrud

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 9 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page:

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012)

Figure-15: Total number of alerts/outbreak situation in Khyber Pakhtunkhwa & FATA through eDEWS System (Week 22, 2012)

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 10 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page: