Weekly Epidemiological Bulletin

Ministary of public Health Papulation Electronic Disease Early Warning and Response System Primary Health Care Sector DG for Disease Contraol Surveillance

Volume 03, Issue 50, Epi week 50, 7 - 13 Dec 2015

H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 50, 2015

96%97 % 100% 93% 94% 92%94 %94 %95 % 120,000 94% 93% 88%90 % 89% 94%92 % 9392%% 94%92 % 85% 85%86 % 90% 82%82 % 81% 80%82 % 81% • During week no. 50, 2015;95% (402/382) health facilities from 16 governorates provided 78% 79% 79% 100,000 80% 72% 74% 70% 68%70 %69 %68 % 70%70 % 64%66 %64 % 66% 64%64 % valid surveillance data. 70% 62% 62% 80,000 60% 54% 51% 50% 60,000 40%

30% 40,000 P e r c e n t a ge a t e n c r e P

• The total number of consultations reported during the week in 16 governorates was Co n s u l a i t t o ns 20% 20,000 95607 compared to 91402 the previous reporting week. Acute respiratory tract infections 10% 0% -

(ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of

Wk 1 Wk 5 Wk 7 Wk 9 Wk Wk3

Wk 13 Wk 15 Wk 21 Wk 23 Wk 27 Wk 29 Wk 31 Wk 35 Wk 37 Wk 39 Wk 43 Wk 45 Wk 47 Wk Wk17 Wk19 Wk25 Wk33 Wk41 Wk49 morbidity this week. Wk11 Reporting Rate Consultations

Distribution of Reporting Rates by Governorates (Epi-week 50, 2015)

100%

• A total of 173 alerts were generated by eDEWS system in week 50, 2015; Of these 168 80%

60%

% %

alerts were verified as true for further investigations with appropriate response. %

% 92

40% 96

100

100 96 100

20% 100 N o. H F R e p o r t t er o p o. N R F H s 0%

• Altogether 32 alerts for Measles, 31 Dengue Fever, 29 Acute viral hepatitis, 21 Bloody diarrhea, 16 Cut.Leishmaniasis, 14 Pertussis, 11 Acute Flaccid Paralysis, 7 Meningitis, 3 Reporting Rate Target Schistosomiasis, 2 Viral hemorrhagic fever, 1 each for Neonatal Tetanus and Diphtheria were received and responded in system generated. Note: The cause of reporting rates decline in Taiz are the armed conflict.

• Online disease surveillance and response system was launched in 4 governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.

Leading causes of morbidity and mortality in Epi-week 50, 2015 Suspected dengue outbreak in Abyan, Shabwah, Al-Hodaidah and Al-Mahra Gov., Epi a). Suspected dengue outbreak weeks 14 to 50, 2015

250 Suspected Dengue fever cases • 432 suspected dengue cases were reported in 10 governorates, out of these 157 cases Shabwah 200

reported from Abyan, 82 cases from Al-Hodaidah, 56 cases from Shabwah and 14 cases Al-Mahra from A-Mahra, 4 cases with hemorrhagic manifestations were reported in Abyan and 150 Aden governorate through the eDEWS sentinel sites.

100 NO. of cases

Wk 16 Wk 19 Wk 22 Wk 25 Wk 28 Wk 31 Wk 34 Wk 37 Wk 40 Wk 43 Wk 46 Wk 49 Wk Wk 15 Wk 17 Wk 18 Wk 20 Wk 21 Wk 23 Wk 24 Wk 26 Wk 27 Wk 29 Wk 30 Wk 32 Wk 33 Wk 35 Wk 36 Wk 38 Wk 39 Wk 41 Wk 42 Wk 44 Wk 45 Wk 47 Wk 48 Wk 50 Wk • Abyan, Shabwah, Al-Mahra and Al-Hodidah governorates having increase number of 14 Wk reporting DF cases. 600 Suspected Dengue fever cases Abyan 500 Al-Hodidah

400

• Surveillance is being intensified to ensure that the ongoing Dengue and Acute viral 300 NO. of cases hepatitis outbreak is effectively monitored and other priority communicable disease 200

are reported through alternative sources including private health facilities, mobile 100 clinics, NGO partners on the ground, health workers in the community, and the general 0

public

WK 2 WK 6 WK WK 3 WK 4 WK 5 WK 7 WK 8 WK 9

WK 1 WK

WK 10 WK 14 WK 15 WK 18 WK 19 WK 22 WK 23 WK 26 WK 27 WK 31 WK 35 WK 39 WK 43 WK 47 WK WK 11 WK 12 WK 13 WK 16 WK 17 WK 20 WK 21 WK 24 WK 25 WK 28 WK 29 WK 30 WK 32 WK 33 WK 34 WK 36 WK 37 WK 38 WK 40 WK 41 WK 42 WK 44 WK 45 WK 46 WK 48 WK 49 WK 50 WK

Leading causes of morbidity and mortality in Epi-week 50, 2015 Proportional morbidity of leading priority diseases, Epi weeks 1 to 50, 2015 b. Other leading priority diseases

25.0%

• URTI (16.4%), suspected malaria (3.3%), OAD (8.4%) and Pneumonia (5.5%) remain the 20.0% leading causes of morbidity representing a total of 33.6%. 15.0%

10.0%

5.0%

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% 0.0%

Wk 1 Wk 2 Wk 3 Wk 4 Wk Wk5 Wk6 Wk7 Wk8 Wk9

Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 27 Wk 28 Wk 29 Wk 30 Wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 Wk 43 Wk 44 Wk 45 Wk 46 Wk 47 Wk 48 Wk 49 Wk 50 Wk Wk11 Wk12 Wk13 Wk14 Wk15 Wk16 Wk17 Wk18 Wk19 Wk20 Wk21 of total morbidity in reporting period. Bloody diarrhea represented 0.2% of this morbidity. Wk10 DD URTI S.MAL Pneumonia

Pneu 5.5% • All diarrheal disease comprised 8.7% and Pneumonia 5.5% of total morbidity in Pilot URTI 16.5% OAD 8.5% Governorates this week. BD 0.3%

Sch 0.1%

S.Mal 3.3% • All diarrheal disease comprised 4.51% and Pneumonia 3.03% of total morbidity in the <5 Others 64.8% Rb 0.1% years age group. Cases (n=16,379) AVH 0.2%

URTI=Upper respiratory infections; Pneu=Pneumonia; OAD=Other acute diarrhea; BD=Bloody diarrhea; AWD=Acute Watery Diarrhea; Sch=Schistosomiasis; Mal=Malaria; Rb=Rabies; AVH=Acute viral hepatitis; Meng=Meningitis; DF=Dengue fever; VHF=Viral hemorrhagic fever; Meas=Measles; CL=Cutaneous Leishmaniasis; Pert=Pertussis; Diph=Diphtheria; NNT=Neonatal Tetanus

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 1 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 50 ( 7 - 13 Dec 2015 )

Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Pneumonia ( Epi week 1 to 50, 2015)

Diarrheal Diseases URTI Sus.Malaria Pneumonia 6.0% 25.0% 18.0% 8.0%

16.0% 7.0% 5.0% 20.0% 14.0% 6.0%

12.0% 4.0% 15.0% 5.0% 10.0% 4.0% 3.0% 8.0% 10.0% 3.0% 6.0% 2.0%

4.0% 2.0% 5.0% 1.0% 2.0% 1.0%

0.0% 0.0% 0.0% 0.0%

Wk Wk 1 Wk 3 Wk 5 Wk 7 Wk 9

Wk 3 Wk 9 Wk Wk 1 Wk 5 Wk 7 Wk

Wk Wk 3 Wk 5 Wk 7 Wk 9 Wk 1

Wk Wk 1 Wk 3 Wk 7 Wk 9 Wk 5

Wk 11 Wk 13 Wk 15 Wk 17 Wk 19 Wk 21 Wk 23 Wk 25 Wk 27 Wk 29 Wk 31 Wk 33 Wk 35 Wk 39 Wk 43 Wk 47 Wk 37 Wk 41 Wk 45 Wk 49

Wk 17 Wk 23 Wk 31 Wk 37 Wk 45 Wk Wk 11 Wk 13 Wk 15 Wk 19 Wk 21 Wk 25 Wk 27 Wk 29 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 47 Wk 49 Wk

Wk Wk 11 Wk 13 Wk 15 Wk 17 Wk 21 Wk 23 Wk 25 Wk 29 Wk 31 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 47 Wk 49 Wk 19 Wk 27 Wk 37 Wk 45

Wk 11 Wk 13 Wk 15 Wk 17 Wk 19 Wk 21 Wk 23 Wk 27 Wk 29 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 45 Wk 47 Wk 49 Wk 25 Wk 31 Wk 37

Age and Sex distribution of total consultations of leading diseases (Epi week 50, 2015) Cumulative number of major health events reported in Epi-weeks 1 to 50, 2015 (1st Jan 2015 to 13th Dec 2015)

20000 Diseases No of Cases Percentage

18000

16000 Upper Respiratory Infections 388568 12.8%

14000

12000 Diarrheal Diseases 289664 9.5%

10000

8000 Suspected Malaria 102042 3.4%

Number of Consultations of Number 6000

4000 Pneumonia 142188 4.7%

2000

0 Total (All consultations) 3041811 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Male 5574 7662 9526 15398 7570 Female 5601 8234 9204 18393 8445 Leading Diseases by Governorate, Epi week 50

Distribution of consultations of leading diseases by Governorates, Epi week 50

Sana'a Hadramout Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Shabwah Al-Mahrah Dhamar Total Gov. wady Upper Respiratory Infections 958 2593 784 674 1230 831 821 565 1736 1354 528 515 546 1046 276 1222 15679

Pneumonia 245 283 450 164 109 594 626 250 465 329 658 180 145 275 62 404 5239

Other Acute Diarrhea 275 929 373 379 357 676 783 480 758 788 545 248 368 339 159 608 8065

Bloody Diarrhea 8 4 7 5 3 53 0 1 3 27 30 9 40 8 7 34 239

Acute Watery Diarrhea 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Schistosomiasis 1 1 2 5 2 5 1 4 24 25 15 2 1 0 0 5 93

Malaria 49 121 2 1 2 164 1506 954 6 72 119 21 30 3 3 97 3150

Meningitis 0 5 0 1 2 9 1 0 12 0 5 0 0 0 0 21 56

Dengue Fever 7 28 157 28 49 0 82 0 1 0 0 0 56 10 14 0 432

Viral Hemorrhagic Fever 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4

Rabies 0 0 0 1 0 3 0 4 44 1 23 0 0 2 0 44 122

Measles 4 7 0 2 2 0 0 4 15 1 0 1 5 1 0 4 46

Acute Viral Hepatitis (A & E) 15 18 4 18 3 38 5 2 70 2 10 2 8 5 2 32 234

Neonatal Tetanus 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3

Acute Flaccid Paralysis 0 2 0 3 0 1 0 3 2 0 1 0 0 1 0 1 14

Cutaneous Leishmaniasis 0 0 0 0 0 0 0 5 2 2 2 1 1 3 0 7 23

Diphtheria 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2

Pertussis 0 6 0 3 0 3 0 0 2 14 0 8 0 0 0 0 36

Other Un 8 0 19 0 6 0 235 5 8 16 0 15 0 4 4 10 330

Other Consultations 2131 5623 1838 5162 3215 4869 5396 1465 12962 2793 1832 1514 1357 2423 1016 8046 61642

Total Consultations 3700 9624 3638 6446 4900 7246 9459 3741 16110 5424 3765 2515 2557 4120 1543 10819 95607 A Number of alerts & outbreaks reported and investigated with appropriate response g Number of Alerts Received and Responded (Epi weeks 47 and 50, 2015) e 2015 Current week 50, 2015 System Gen. Alerts (week 50) Diseases S.Measles S.Pertussis AVH AFP NNT Meningitis Alers Outbreaks Alers Outbreaks TRUE FALSE S.Measles 1048 1 32 0 32 0 C.Leish Sch BD S.Dengue VHF Diph S.Pertussis 468 0 14 0 14 0 AVH 589 1 29 0 29 0 45 AFP 233 0 11 0 11 0 Pneu 39 0 0 0 0 0 40 NNT 48 0 1 0 1 0 35 Mal 20 0 0 0 0 0 Meningitis 234 0 7 0 7 0 30

C.Leish 575 0 17 0 16 1 25 المبلغة األنذارات عدد األنذارات المبلغة Sch 112 0 3 0 3 0 BD 724 0 24 0 21 3 20 OAD 27 0 0 0 0 0 15 S.Dengue 660 3 32 0 31 1 URTI 2 0 0 0 0 0 10 VHF 54 0 2 0 2 0 5 AWD 5 0 0 0 0 0 Diph 4 0 1 0 1 0 0

Rb 5 0 0 0 0 0

Wk48 Wk49 Wk50 Other Diseases 4 0 0 0 0 0 Wk47 Total 4851 5 173 0 168 5

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 2 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 50 ( 7 - 13 Dec 2015 )

Lahj Governorate

26 health facilities from 14 districts in Lahj governorate reported to eDEWS with a total of 3700 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 3 alerts each for Measles and Acute viral hepatitis, 1 Dengue fever were reported and responded.

Aden Governorate

25 health facilities from 8 districts in Aden governorate reported to eDEWS with a total of 6924 patients consultations in week 50, 2015. Total 15 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 3 alerts each for Measles, Dengue fever and Pertussis, 2 Acute viral hepatitis, 1 each for Viral hemorrhagic fever, Meningitis, Acute Flaccid Paralysis and Diphtheria were reported and responded.

Abyan Governorate

23 health facilities from 4 districts in Abyan governorate reported to eDEWS with a total of 3638 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 5 alerts for Dengue fever, 1 each for Bloody diarrhea and Viral hemorrhagic fever were reported and responded.

Taiz Governorate

18 health facilities from 9 districts in Taiz governorate reported to eDEWS with a total of 6446 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 2 alerts each for Acute viral hepatitis and Acute Flaccid Paralysis, 1 each for Dengue fever, Measles and Pertussis were reported and responded.

Hadramout Governorate

21 health facilities from 7 districts in Hadramout governorate reported to eDEWS with a total of 4900 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 5 alerts for Dengue fever, 2 Measles were reported and responded.

Ibb Governorate

25 health facilities from 15 districts in Ibb governorate reported to eDEWS with a total of 7246 patients consultations in week 50, 2015. Total 14 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 6 alerts for Acute viral hepatitis, 4 Bloody diarrhea, 2 Pertussis, 1 each for Meningitis and Acute Flaccid Paralysis were reported and responded.

Hodaidah Governorate

25 health facilities from 22 districts in Hodaidah governorate reported to eDEWS with a total of 9459 patients consultations in week 50, 2015. Total 6 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 5 alerts for Dengue fever, 1 Neonatal Tetanus were reported and responded.

Hajjah Governorate

24 health facilities from 22 districts in Hajjah governorate reported to eDEWS with a total of 3741 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 3 alerts each for Measles and Acute Flaccid Paralysis, 1 Cut.Leishmaniasis were reported and responded.

Amana Governorate

25 health facilities from 10 districts in Amana governorate reported to eDEWS with a total of 16110 patients consultations in week 50, 2015. Total 28 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 11 alerts for Measles, 10 Acute viral hepatitis, 2 each for Pertussis and Cut.Leishmaniasis, 1 each for Meningitis, Acute Flaccid Paralysis and Schistosomiasis were reported and responded.

Sa'da Governorate

23 health facilities from 15 districts in Sa'da governorate reported to eDEWS with a total of 5424 patients consultations in week 50, 2015. Total 10 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 5 alerts for Pertussis, 2 Cut.Leishmaniasis, 1 each for Measles, Bloody diarrhea and Schistosomiasis were reported and responded.

Amran Governorate

24 health facilities from 20 districts in Amran governorate reported to eDEWS with a total of 3765 patients consultations in week 50, 2015. Total 10 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 4 alerts for Bloody diarrhea, 2 Acute viral hepatitis, 1 each for Acute Flaccid Paralysis, Cut.Leishmaniasis, Schistosomiasis and Meningitis were reported and responded.

Sana'a Governorate

24 health facilities from 16 districts in Sana'a governorate reported to eDEWS with a total of 2515 patients consultations in week 50, 2015. Total 4 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 1 alert each for Bloody diarrhea, Pertussis, Measles and Cut.Leishmaniasis were reported and responded.

Shabwah Governorate

25 health facilities from 17 districts in Shabwah governorate reported to eDEWS with a total of 2557 patients consultations in week 50, 2015. Total 17 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 7 alerts for Dengue fever, 5 Bloody diarrhea, 3 Measles, 1 each for Acute viral hepatitis and Cut.Leishmaniasis were reported and responded.

Al-Mahrah Governorate

25 health facilities from 9 districts in Al-Mahrah governorate reported to eDEWS with a total of 1543 patients consultations in week 50, 2015. Total 4 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 3 alerts for Dengue fever, 1 Bloody diarrhea were reported and responded.

Hadramout Al-wady

24 health facilities from 9 districts in Hadramout Al-wady governorate reported to eDEWS with a total of 4120 patients consultations in week 50, 2015. Total 7 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 2 alerts each for Cut.Leishmaniasis and Bloody diarrhea, 1 each for Acute Flaccid Paralysis, Dengue fever and Measles were reported and responded.

Dhamar

25 health facilities from 12 districts in Dhamar governorate reported to eDEWS with a total of 10819 patients consultations in week 50, 2015. Total 18 alerts were reported and appropriate measures were taken in week 50, 2015. Altogether 6 alerts for Cut.Leishmaniasis, 3 each for Measles, Meningitis and Acute viral hepatitis, 2 Bloody diarrhea, 1 Acute Flaccid Paralysis were reported and responded.

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 3 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 50 ( 7 - 13 Dec 2015 )

Alert Responded in Epi-week 50, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eDEWS team contacted focal points and informations were shared. Cases were diagnosed Tuban, Al Milah and Al Alanad, Alkashaa Health Unit Meas Lahj clinically as suspected Meas. Blood samples were collected from cases and sent to central lab in 4 0 Hawtah and MCH Hawtah Sana'a

Alkashaa Health Unit, Alhad Al Milah, Al Had and eDEWS team contacted focal points and informations were shared. Cases were diagnosed AVH Lahj Hospital and October General 11 0 Yaffa clinically and by lab as suspected AVH. Further investigation is ongoing. Hospital

eDEWS focal point was contacted. Cases were diagnosed clinically as suspected DF. Cases were DF Lahj Tuban Saber HC 3 0 not collected in a cluster

eDEWS team contacted focal points. Cases were diagnosed clinically and by lab as suspected Al-Qateea Pol. Clinic and AVH Aden Siera and Al Mansura AVH. Appropraite treatment was given and families of cases were educated about infection 10 0 Hashed Pol.Clinic control measusres

Al Buraihi, Al-Wali Hospital eDEWS team contacted focal points. Cases were diagnosed clinically as suspected DF. Cases DF Aden Al Mansura 23 0 and Saber Hospital were from different areas

Al-muala Pol. Clinic, Dort Al- Al Mualla, Dar Sad and eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Cases Pert Aden Dar Hospital and Al-Wahdah 6 0 Ash Shaikh Outhman were vaccinated Hospital

eDEWS team contacted focal points. Cases were females presented with fever and vaginal VHF Aden Al Mansura Al-Wali Hospital 2 0 bleeding and diagnosed clinically as suspected VHF

Al Mansura, Dar Sad Hashed Pol.Cl, Dort Al-Dar eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Meas. Blood Meas Aden and Ash Shaikh Hospital and Al-Wahdah samples were collected from only two cases and sent to central lab in Sana'a. Immunization 7 0 Outhman Hospital program was informed

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected Diph. Cases Diph Aden Ash Shaikh Outhman Al-Wahdah Hospital were brothers fully vaccinated from Aldalhe. Throat swab for culture was done at district level 1 1 and both cases were admitted on 7/12/2015, then one of them died on 13/12/2015

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected Meng. Cases Meng Aden Ash Shaikh Outhman Al-Wahdah Hospital 4 0 were from different areas

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected AFP. One case AFP Aden Ash Shaikh Outhman Al-Wahdah Hospital 2 0 was not vaccinated. One case from Lahij and AFP coordinator of Lahij was informed

Mudiya Hospital, Shokra HC, Mudiyah, Khanfir, eDEWS team contacted focal points. Cases were diagnosed clinically as suspected DF. DF Abyan Zingibar Hospital, Almsaimir 154 0 Zingibar and Lawdar Incecticide sprying will be conducted this week to affected areas HU and Lawdar Hospital

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as bacterial BD Abyan Zingibar Zingibar Hospital 4 0 infection. Cases not collected in cluster

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected VHF. VHF Abyan Lawdar Lawdar Hospital 2 0 Appropriate treament was given

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected Pert. Cases Pert Taiz Salh Labs National Center 3 0 were not vaccinated

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected Meas. Blood Meas Taiz Salh Labs National Center 2 0 samples were collected from cases to be send to the central lab in Sana'a

Labs National Center and Al- eDEWS team contacted focal points and informations were shared. Cases were diagnosed AVH Taiz Salh 11 0 Refaee Hospital clinically and by lab as suspected AVH

Al-Wehda Health Center and eDEWS team contacted focal point. Cases were diagnosed clinically as suspected AFP. Stool AFP Taiz Al Qahirah and Hayfan 3 0 Hayfan Hospital samples were collected from cases to be send to the central lab in Sana'a

DF Taiz Salh Al-Thawrah Hospital eDEWS team contacted focal point. Cases were diagnosed clinically as suspected DF 19 0

Ash Shihr General Hospital, Ibn Sina Hospital, Ghayl Ba eDEWS team contacted focal points. Cases were diagnosed clinically as suspected DF. Ash Shihr, Al Mukalla DF Hadramout Wazir Hospital, University Preventive intervension was conducted by malaria progaram (insecticide spray) and further 45 0 City and Ghayl Ba Wazir Hospital and Algarah Health intervension is ongoing Center

Al Mukalla City and Ar An Nour Medical Center and eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Meas. No Meas Hadramout 2 0 Raydah Wa Qusayar Qusayar Health Center blood sample was collected. Symptomatic treatment was given

Al Udayn and Dhi As Al Udayn Hospital and Al Razi eDEWS focal points were contacted. Cases were diagnosed clinincally as pert. Appropriate Pert Ibb 3 0 Sufal Health Center treatement. Cases from different areas

Al Udayn Hospital, Al Amin Hospital, Dar AlShifa Hospital, eDEWS team contacted focal points. Cases were diagnosed clinically and by lab as suspected Al Udayn, Al Dhihar, AVH Ibb Dr. Waheeb Ata Hospital, AVH. Appropraite treatment was given and families of cases were educated about infection 32 0 Yarim and Al Qafr Rihab Hospital and Alnor control measusres. Cases from different araes Hospital

Dar AlShifa Hospital, Rihab eDEWS team contacted focal points. Cases were diagnosed clinically and by lab as bacterial BD Ibb Al Dhihar and Al Qafr Hospital, Alkhansa Health 16 0 infection. Appropraite treatment was given. Cases from different areas Center and Alnor Hospital

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected Meng. Meng Ibb Al Dhihar Al Thawrah Hospital 6 0 Investigation form, LP and CSF were tested with no bacterial growth

eDEWS team contacted focal point and informations were shared. The case was diagnosed AFP Ibb Al Mashannah MCH Almashannah clinically as suspected AFP. Stool samples were collected from cases and contact to be send to 1 0 the central lab in Sana'a

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 4 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 50 ( 7 - 13 Dec 2015 )

Alert Responded in Epi-week 50, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease Ad Durayhimi, AlAksa Ad Durayhimi, Al Focal points were contacted. The suspected DF cases were diagnosed clinically. Medications Hospital, Bajel Hospital, Az DF AlHodaidah Hawak, Bajil and Az have been started,. Samples were collected in their lab and diagnosed by serological ( detection 81 0 Zaydiyah Hospital and AlAmal Zaydiyah of antibodies ). No cluster of three cases in one location was reported Hospital

eDEWS coordinator contacted the focal point. The suspected NNT case was diagnosed clinically, NNT AlHodaidah Al Hawak Althawrah Hospital One case was a 7 days female child ,from Alshaharia admitted to hospital and die due to sever 3 1 complicated.

Ash Shaghadira Health eDEWS coordinator contacted focal points and informations were shared.Cases were Ash Shaghadirah, Abs AFP Hajjah Center, Abs Hospital and diagnosed as suspected AFP. Complete vaccination. Field investigation was done and stool 3 0 and Kuhlan Affar Kuhlan Affar Health Center samples were collected and will be send to the central lab. in sanaa

Kuhlan Ash Sharaf, Kuhlan Ash Sharaf Health eDEWS coordinator contacted focal points and informations were shared.Cases were Meas Hajjah Mabyan and Ash Center, Mabyan Hospital and diagnosed as suspected Meas. Blood samples have been collected and will be send to the 4 0 Shaghadirah Ash Shaghadira Health Cente central Lab. in Sana'a

eDEWS coordinator contacted focal point and informations were shared. The suspected cases CL Hajjah Hajjah City Saudi Hospital were diagnosed clinically. The work of the lab tests were positive. Appropriate treatment has 3 0 been given

Main Complex, Science University Hospital, Alshaheed Center, AlMethak Maain, Al Wahdah, Health Center, Azzal Complex, eDEWS team contacted focal points. The suspected cases were diagnosed clinically. Field Aththaorah, Azzal, As Meas Amana As Sabin Hospital, Main investigation was done. Blood samples collected from the cases and sent to central lab for 15 0 Sabain, Old City and At Health Center, AlKuwait confirmation Tahrir Hospital, Ghaza Complex, Az Zubairi Health Center and German Modern Hospital

Main Complex, Science University Hospital, Maain, Al Wahdah, Alshaheed Center, Cludia Fain eDEWS team contacted focal points and informations were shared. Cases were diagnosed Azzal, Aththaorah, Health Center, Azzal Complex, AVH Amana clinically in OPD as suspected AVH and confirmed by lab. Appropriate treatment was given and 59 0 Assafiyah, Old City and AlGoraf Complex, Althawra patients families were educated about ways to avoid infection Shuaub Hospital, Iraqi Health Center, Az Zubairi Health Center and Shuaub Complex

As Sabin Hospital and eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Amana As Sabain and At Tahrir 2 0 AlKuwait Hospital Antibiotic treatment was given

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected meningitis. Meng Amana Assafiyah Althawra Hospital Investigation form, LP and CSF were collected and wating for result. Cases came from different 5 0 areas

Althawra Hospital and eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was CL Amana Assafiyah and At Tahrir 2 0 AlGomhori Hospital given

eDEWS team contacted focal point and informations were shared. Field investigation was done. AFP Amana Assafiyah Althawra Hospital Stool samples from cases and close contacts were collected to be send to the central lab in 2 0 Sana'a

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was Sch Amana At Tahrir AlGomhori Hospital 20 0 given. Cases came from different areas.

An Ndhir Health Unit, Fawt Razih, Saqayn, Majz Health Center, Majz Health eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Sada 14 0 and Sa'da Center, Al Jomhori Hospital Antibiotic treatment was given and Shaara Hospital

Focal point contacted. The case was diagnosed clinically as suspected Meas. Symptomatic Meas Sada Al-Hashwah Noman Health Center 1 0 treatment was given.

eDEWS coordinator was contacted. Cases clinically diagnosed clinically as suspected BD. No BD Sada Ghamr Ghamr Health Center 3 0 cluster collection.

Ghamr Health Center and eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was CL Sada Ghamr and Razih 2 0 Shaara Hospital given

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was Sch Sada Sa'da Al Jomhori Hospital 9 0 given. Cases came from different areas.

eDEWS team contacted focal point and informations were shared. The case was diagnosed AFP Amran Iyal Surayh Sahab Hospital clinically as suspected AFP. Stool samples were collected from cases and contacts to be send to 1 0 the central lab in Sana'a

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was CL Amran Raydah Al Hekmah Dispensary 2 0 given

eDEWS team contacted focal points and informations were shared. Cases were diagnosed Al Hekmah Dispensary and Al AVH Amran Raydah and Amran clinically in OPD as suspected AVH and confirmed by lab. Appropriate treatment was given and 8 0 Rayan Dispensary patients families were educated about ways to avoid infection

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Treatment was Sch Amran Al Qaflah Al Qaflah Hospital 6 0 given. Cases came from different areas.

Al Rayan Dispensary, Al Amran, Suwayr, Al eDEWS team contacted focal points. Cases were diagnosed clinically and by lab as bacterial BD Amran Gnaya Center, Al Madan 19 0 Madan and Khamir infection. Appropraite treatment was given Hospital and Al Salam Hospital

This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 5 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 50 ( 7 - 13 Dec 2015 )

Alert Responded in Epi-week 50, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eDEWS team contacted focal point. Cases were diagnosed clinically as suspected meningitis. Meng Amran Khamir Al Salam Hospital Investigation form, LP and CSF were collected and wating for result. Cases came from different 3 0 areas

Sanaa Al Haymah Ad eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as bacterial BD Al Salaf Health Center 4 0 Governorate Dakhiliyah infection. Appropraite treatment was given

Sanaa eDEWS team contacted focal points. Cases were diagnosed clinically as suspected Pert. Pert Jihanah Al Dhwra Shaheed Hospital 8 0 Governorate Antibiotic treatment was given

eDEWS team contacted focal point. The suspected case was diagnosed clinically. Field Sanaa Meas Jihanah Al Dhwra Shaheed Hospital investigation was done. Blood sample was collected from the case and sent to central lab for 1 0 Governorate confirmation

Sanaa Lamdha Center ( Bait Al eDEWS team contacted focal point. The case was diagnosed clinically and by lab as CL. CL Bani Dhabyan 1 0 Governorate hamam ) Appropraite treatment was given

Khorah Medical Clinic, Al Karmom Nisab Hospital, Teab Merkhah As Sufla, eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as bacterial BD Shabwah Al Atfal Clinic, Dr Saleh 33 0 Nisab, Ataq and Arma infection. Appropraite treatment was given Abdurahman Medical clinic and Al Mafod Hospital

eDEWS team contacted focal point. Cases were diagnosed clinically in OPD as suspected AVH AVH Shabwah Merkhah As Sufla Khorah Medical Clinic and confirmed by lab. Appropriate treatment was given and patients families were educated 4 0 about ways to avoid infection

Al Karmom Nisab Hospital, Ar eDEWS team contacted focal points. The suspected cases were diagnosed clinically. Field Nisab, Ar Rawdah and Meas Shabwah Rawdah Hospital and Ain investigation was done. Blood samples were collected from the cases and will be send to central 5 0 Ain Hospital lab in Sana'a. Appropraite treatment was given

Ar Rawdah Hospital, Bayhan Hospital, Rudum Hospital, Ar Rawdah, Bayhan, eDEWS team contacted focal points. The suspected cases were diagnosed clinically. Blood Habban Hospital, Azan DF Shabwah Rudum, Habban, samples were collected from the cases and will be send to central lab in Sana'a. Appropraite 53 0 Hospital, Baer Ali Medical Mayfaa and Ataq treatment was given Center and Al Rebath Medical Clinic

Dr Saleh Abdurahman eDEWS team contacted focal point. The case was diagnosed clinically and by lab as CL. CL Shabwah Ataq 1 0 Medical clinic Appropraite treatment was given

eDEWS team contact with eDEWS focal point , the case diagnosis clinical according to case BD Al-Mahra Hat Hat Health Centre 3 0 definition and diagnosed by lab as (shigelosis )and ( amebiasis), medical treatment are give

Modern medical clinic, Al eDEWS team contacted eDEWS focal point , the case clinically diagnosed according to case DF Al-Mahra Sayhut and Al Ghaydah Amal Clinic and Salamatak definition, and we have complete line list for these suspected cases, appropriate treatment was 7 0 Private Clinici give

eDEWS team contact focal point. The cases were diagnosed cliniclly CL according to case Hadramout CL Tarim Al gharf, Tarim Health Centers definition. Samples were not collected . The cases from endemic area. Symptomatic treatment 3 0 wady prescribed

Hadramout AL Akad, Al Radod Health eDEWS coordinator contact focal points.The cases were diagnosed BD and lab results are BD Al Qatn, Tarim 7 0 wady Centers shiglosis. Appropretiate treatment prescribed

eDEWS contact focal point.The case was suspeceted cliniclly AFP according to case definition. Hadramout AFP Sayun Madudh Health Center Two stool samples collected from the case, and 3 stool samples from contacts and sent to the 1 0 wady central lab .Sypotmatic treatment prescribed

eDEWS coordinator contact focal point. The cases were suspeceted cliniclly DF using case Hadramout DF Sayun Bin Zulia Hospital difination. The main symptoms headache ; pain behind eyes and muscles pain. The cases were 6 0 wady from ALmuklla city. lab results are postive IgM . sypotmatic treatment prescribed

Hadramout eDEWS coordinator contact focal point.the case was suspeceted cliniclly measles by using case Meas Alsoum Alsoum Health center 1 0 wady definition . blood sample collected and sent to central lab. Sypotmatic treatment prescribed

26 September hospital, Al Helal AlAhmer Center, Utmah, Dhamar City eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as CL. CL Dhamar General Dhamar Hospital 5 0 and Jahran Appropraite treatment was given Authority and Ma`abr University Hospital

Al Helal AlAhmer Center, eDEWS team contacted focal points. Cases were diagnosed clinically in OPD as suspected AVH AVH Dhamar Dhamar City AlMasli Hospital and Dr. and confirmed by lab. Appropriate treatment was given and patients families were educated 26 0 Khaled BaWazir Clinic about ways to avoid infection

Madeena Alsharq Hospital, Jabal Ash sharq, eDEWS team contacted focal point. The suspected case was diagnosed clinically. Blood sample General Dhamar Hospital Meas Dhamar Dhamar Cityand was collected from the case and sent to the central lab in Sana'a. Appropraite treatment was 4 0 Authority and AlAqwa`a Dawran Aness given Dispensary

eDEWS team contacted focal points. Cases were diagnosed clinically as suspected meningitis. General Dhamar Hospital Meng Dhamar Dhamar City Investigation form, LP and CSF were collected and there were three cases postive for 17 0 Authority and AlMasli Hospital s.pnumoniea. Appropritae treatmentwas given

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab as bacterial BD Dhamar Dhamar City AlMasli Hospital 18 0 infection. Appropraite treatment was given

The objective of this weekly epidemiological bulletin is to provide a snap shot on selected health events reported from the eDEWS surveillance system in all governorates (Aden, Abyan, Lahj, Taiz, Hadramout, Ibb, Hodidah, Hajjah , Al-Amana, Amran, Sana'a Gov., Shabwah, Al-Mahrah, Hadramout Al-Wady and Dhamar) of Yemen. While every attempt is made to present the weekly trends of epidemic prone diseases, the information presented in the bulletin needs to be interpreted in the context that precise information on the reference populations is not always available. The bulletin also includes information collected by the eDEWS teams. The primary focus of DEWS is early detection of epidemic prone desease, to facilitate a rapid public health response.