Date: 4 -10 May 2014 Epidemiological Weekly Bulletin EPI Week NO. 19 EWARN Highlights EWARN coverage

ACU EWARN covers 71/150 sub-District in7 governorate.The total population ● During Epi-week no 19, 2014; 91.4% (138/151) of the health facilities currently under surveillance is about 7.189.528 across 7 Governorates provided surveillance data 91.4% of reporting sites submitted the weekly reports on time. ● The total number of consultations reported during the reporting week was 43118 (including 40.1% children under the age of five) compared to 45821 consultations during week 18. The leading cause of morbidity was FUO (Fever of Unknown Origin), with over 562 cases (1.23%). ● Ongoing measles outbreak in all governorate except (310 cases of suspected measles). ● As of week 19, 2 new AFP (Acute Flaccid Paralysis) cases reported, 21 AFP cases reported in 2014 up to date. See weekly Poliomyelitis outbreak report for more details. ● Common disease reported under others were URTI (upper respiratory tract infection), acute bronchiolitis, whooping cough, acute diarrhea, Brucellosis and Cutaneous leishmaniasis.

Number of sentiel sites and Total Number of Consultations per Completeness and timelines Governorate No of No of Governorate Reporting Sentinels 100% sentinels consultations

80% 37 33 89.2% 8771 AL-HASSAKA 5 3 60.0% 566 60% AR- 26 30 115.4% 11831 37 34 91.9% 10272 40% DEIR-EZ-ZOR 7 7 100.0% 1151 20% IDLEB 36 29 80.6% 12955 LATTAKIA 3 2 66.7% 275 0% 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Grand total 151 138 91.4% 45821

Proportion of morbidities among >5Y Proportion of morbidities among<5Y

.ADB .ADB .AWD .FUO 8% 10% .AWD 0% 13% .AJS .UXD 1% 10% 0% .UCE .AJS 8% 13%

.SARI .MEN 8% 3% .FUO .AFP 53% 0%

.MEA .SARI 12% 16%

.MEN .AFP .UCE 1% .MEA .UXD 0% 8% 36% 0%

Trends for Leading Priority Diseases in 7 Governorates – Epi week 47, 2013 to Epi week 19 2014

0.015

0.01

0.005

0 13 47 13 48 13 49 13 50 13 51 13 52 14 1 14 2 14 3 14 4 14 5 14 6 14 7 14 8 14 9 14 10 14 11 14 12 14 13 14 14 14 15 14 16 14 17 14 18 14 19

.AJS .SARI .MEA .FUO .ADB Proportional Morbidity of suspected Measles by Governorate, Epi Week 19 2014

0.06 0.05 0.04 0.03 0.02 0.01 0 13 47 13 48 13 49 13 50 13 51 13 52 14 1 14 2 14 3 14 4 14 5 14 6 14 7 14 8 14 9 14 10 14 11 14 12 14 13 14 14 14 15 14 16 14 17 14 18 14 19

Aleppo Al-Hassakeh Ar-Raqqa Deir-ez-Zor Hama Idleb Lattakia (blank)

Number of cases (n) and propotional morbidity(%) by Epi week and leading priority Syndrom1 for governorate.Epi week 18 , 19

week 18 week 19 Governorate FUO AJS ABD MEA SARI Total* FUO AJS ABD MEA SARI Total* NO. 38 47 20 56 8 51 63 32 74 15 Aleppo 8680 8771 % 0.44% 0.54% 0.23% 0.65% 0.09% 0.58% 0.72% 0.36% 0.84% 0.17% NO. 5 1 7 30 7 5 0 6 16 4 Al-hassaka 552 566 % 0.91% 0.18% 1.27% 5.43% 1.27% 0.88% 0.00% 1.06% 2.83% 0.71% NO. 122 35 47 43 11 136 40 48 73 22 Ar-rqqa 9723 11831 % 1.25% 0.36% 0.48% 0.44% 0.11% 1.15% 0.34% 0.41% 0.62% 0.19% NO. 133 25 40 65 51 172 21 24 53 56 Deir-ez-zor 11137 10272 % 1.19% 0.22% 0.36% 0.58% 0.46% 1.67% 0.20% 0.23% 0.52% 0.55% NO. 7 15 9 21 12 3 10 12 12 10 Hama 1176 1151 % 0.60% 1.28% 0.77% 1.79% 1.02% 0.26% 0.87% 1.04% 1.04% 0.87% NO. 139 35 10 65 35 189 32 7 82 53 Idleb 11418 12955 % 1.22% 0.31% 0.09% 0.57% 0.31% 1.46% 0.25% 0.05% 0.63% 0.41% NO. 11 8 0 0 0 6 0 0 0 0 Lattakia 432 275 % 2.55% 1.85% 0.00% 0.00% 0.00% 2.18% 0.00% 0.00% 0.00% 0.00% <5 90 58 68 173 53 17821 72 72 54 201 90 18708 TOTAL >5 365 108 65 107 71 26260 490 94 75 109 70 27113 NO. 455 166 133 280 124 562 166 129 310 160 Grand total 43118 45821 % 1.06% 0.38% 0.31% 0.65% 0.29% 1.23% 0.36% 0.28% 0.68% 0.35%

Alerts/Outbreak Investigated and Response Activity in Epi-week 19 2014

Alert #HF reach The most affected Disease # Cases Response Activity / Actions Taken* comments threshold threshold communities[1] Zarba Our DLOs collected the stool samples despite of the jebel Saman AFP 1 2 2 difficulty.our lab expert distributed special kits to collect stool samples. Hama:latamna Line list collected in all HFs to identify the most affected age MEA 1 67 310 Ar-raqqa :Maadan Idleb:Atama,Darkosh group. Aleppo:Iss,Dayr Hafir Aleppo:Iss Line list collected in some HFsIdleb & Deir Ez-Zor. The AJS 5 5 166 Lattakea result will declared soon. FUO (typhoid Ar-raqqa :Maadan increaseHepatitis number A confirmed of cases in somein Idleb cases. and Deir-Ez-Zor,we 5 22 562 Deir-ez-zor:Sbekan fever) Lattakia coordinate with WASH experts to response ABD 5 5 129 Aleppo:Iss

SARI 5 1 160 Idleb:Darkosh

MEN UCE (Scabies) in all camps We distribute the treatment in Hom and Aleppo rural

UCE (Whooping cough)

ABD=Acute Bloody Diarrhea AWD=Acute Watery Diarrhea AFP=Acute Flaccid Paralysis AJS=Acute Jaundice Syndrome SARI= Severe Acute Respiratory Illness UXD=Unexplained Death FUO=Fever Of Unknown Origin MEA=suspected Measles MEN= suspected Meningitis UCE=Unexplained Cluster Of Health Events For any queries: please do not hesitate to contact the EWARN Unit at the [email protected] Epidemiological Weekly Bulletin- Syria EWARN- Epi week 18