WEEK 08: 17Th-23Thfeb 2020

MINISTRY OF HEALTH THE WEEKLY EPIDEMIOLOGICAL BULLETIN WEEK 08: 17th-23thFeb 2020

Dear Reader, Current public health threats We are pleased to share our 8th weekly epidemiological bulletin for nCorona Viral Disease (COVID-19) the year 2020.  No case has been reported in Uganda This epidemiological bulletin serves to inform all stakeholders at  The National Task Force has been activated to district, national, and global levels on disease trends, public health enhance preparedness against COVID-19 surveillance and interventions undertaken in detecting, preventing  Points of entry have been activated and screen- ing is ongoing and responding to public health events in the country on a weekly  High risk travelers are being followed and alerts basis. verified

In this issue, we bring you the following among others  The nCorona surveillance strategy has been developed and disseminated (Annex ii)  National and district weekly surveillance reporting West Nile fever in Moyo  Suspected epidemic prone diseases.  One fatal case was confirmed in Moyo District  Ongoing (current) public health events (page 1) Measles Outbreak in Isingiro and Obong Dis-  Regional reporting rates trict  Public health events in border countries  144 measles cases have been managed at Nakivale HC IV For comments please contact: Dr. Allan Muruta, Commission- er, Department of Integrated Epidemiology, Surveillance and  6 measles cases confirmed in Obongi District Public Health Emergencies - MoH; P.O BOX 7272 Kampala, Tel: TB in Karamoja and Lango sub-regions 080010066 (toll free); Email: [email protected] or  TB has been declared as a national emergency [email protected]  Most affected areas are Acholi, Lango Karamoja Kampala sub-regions and Uganda prisons ser- vices and hence are prioritized for response Fig 1: Ongoing Public Health Events  Dashboards have been developed to effectively monitor targeted response activities

Yellow fever in Moyo, Maracha and Buliisa Districts  4 confirmed cases in Moyo  3 confirmed cases in Buliisa Districts  1 confirmed cases in Maracha  Outbreak response activities are on going RVF in Kampala and Kiboga Districts  The case in Naguru RRH was discharged after recovery  One case was confirmed in Kiboga District

Malaria Outbreak

(Refer to map on page 1)

Data source: PHEOC

Page 1

Priority Diseases Acute Flaccid Paralysis (AFP)  2 AFP cases were investigated during week 08 from The data shows high number of typhoid, measles, Malaria, Tororo and Adjumani Districts dysentery, SARI and animal bites in different parts of the  country. 33 districts have investigated at least 1 AFP

Table 1: Case Fatality Rate of Priority Diseases, week 08 Fig 3: Non Polio AFP rates by district, week 08 Conditions Cases Deaths CFR(%)

AFP 4 0 0.0 AEFIs 4 0 0.0 Animal bites 234 0 0.0 Bacterial Meningitis 1 0 0.0 Cholera 1 0 0.0 Dysentery 48 0 0.0 Guinea Worm 1 0 0.0 Malaria 168052 133 0.1

Hepatitis B 128 0 0.0 Measles 135 0 0.0

lab EPI Data source: NNT 0 0 0.0 Plague 0 0 0.0 Other Suspected 0 VHFs 0 0.0 SARI 265 0 0.0

Typhoid fever 1457 0 0.0

Yellow fever 0 0 0.0 Anthrax 0 0 0.0 Malaria Leprosy 0 0 0.0 T.B 4 0  62 Districts still experiencing malaria outbreak

Severe Acute Respiratory Infection (SARI), Viral Haemorrhagic Fevers (VHF), Data source: DHIS2 Fig 4: Distribution of Malaria outbreak, week 08 Measles (Confirmed cases)

 Nineteen (19) districts have detected and investigated at least one suspected measles case.  These are: Adjumani, Agago, Alebtong, Apac, Bugiri, Bushenyi, Hoima, Isingiro, Kakumiro, Kampala, Kanun- gu, Kasese, Kassanda, Kiboga, Kiryandongo, Kole, Kwan- ia, Lamwo, Lira, Moroto, Masindi, Mu- bende, Nakaseke Nakasongola, Otuke, Pader, Serere, Wakiso, and Yumbe.  144 cases have been recorded in Isingiro

Fig … : Epidemic Curve of measles outbreak in Isingiro Districts

15 Number of cases of Number

0 1 6 11 16 21 26 1 6 11 16 21 26 31 5 10 15 20 25 30 4 9 14 19 24 29 5 Nov Dec Jan Feb Mar

Onset Date Data source: DHIS2

Page 2 Human influenza surveillance

In week 08, A total of 45 specimens were collected from Mulago, Jinja and Gulu Referral Hospitals. The samples were tested for; A (H1), Pandemic A (H1N1), A (H3), A (H5), and B subtypes. In this week one specimen tested positive for subtype B.

Fig 5. Trends of maternal and perinatal Deaths week 25, 2019- week 08, 2020

Data source: Makerere University Walter Reed Project

Table 3: Public health events across the coun- Table 2: Distribution of maternal deaths (n=36) and perinatal deaths (n=160 , week 08) tries bordering Uganda, Feb 2020 Coun- Condition No. No. of Grading try of deaths cases South Measles 4732 26 Ungrad- ed Sudan Hepatitis E 167 2 Ungrad- ed DRC EVD 3432 2253 G3 Polio- 84 0 G2

mylites (cVDPV2) Measles 331,31 6302 G2

Monkey 5288 107 N/A

Cholera 2651 43 G3 Plague 51 8 No up-

Rwan- - - - Closed

Kenya Cholera 191 1 Ungrad-

Measles 198 5 Ungraded Leishmani- 38 0 Ungrad- asis ed Chikungu- 163 nya Tanza- - - - No up-

Data source: DHIS2

Page 3 Completeness of reporting Acknowledgement and Recommendations  The data shows that measles cases are reported in dis-  The reporting rates in week 6 are still affected by tricts that either host refugees or border districts. switch to the new systems DHIS2 & mTrac Pro Therefore these districts are urged to enhance immun- ization and nutrition interventions.  The reporting rates have improved compared to the last weeks following the switch.  Chief Administrative Officers and District Health Offic- ers (DHOs) should share situation reports of all public health events in their catchment areas. Fig 7; Completeness of reporting, week 08, 2020  Implementing Partners supporting surveillance activities in different districts across the country are request- ed to support improvement of surveillance data quality in their respective districts.  The timeline for EPI bulletin has been revised. This means that the bulletin will consist of only weekly data that is submitted on time (by Monday midday). Dis- tricts are encouraged to ensure timely reporting to enhance early detection and prompt response.  UNEPI reminds and encourages all the districts to carry out active search for AFP, NNT, EAFI and measles cases in their health facilities and communities.  Maternal deaths and perinatal deaths audits should be conducted to address issues surrounding excessive deaths of mothers and newborns especially for Kampa- la region.  Partners are urged to support districts that are current- ly affected by outbreaks Source: DHIS2 Annex I: Percentage of reporting per region, Epi week 08, 2020

Data source: DHIS2 source: Data

Editorial team :

Allan Muruta, Carol Kyozira, Godfrey Bwire , David Muwanguzi, Anne. Nakinsige, Eldard Mabumba, Benard Lubwama, Leocadia Kwagonza, Harriet Mayinja, Specioza Katusiime, Maureen Nabatanzi, Apolo Ayebale, Freda Aceng, Godfrey Ekuka, Emma Arinaitwe, Job K., Robert Kato, Joyce Nguna, Milton Wetaka, Joshua Kayiwa, Jayne Tusiime.

Remember, your feedback is important to us.

Page 4 Annex II: National surveillance strategy for 2019-nCoV Outbreak