Eiectronic Integrated Disease Early Warning and Response System Volume 07,Lssue28,Epi Week 28,(08-14 July,2019)

Ministary Of Public Health Papulation Epidemiological Bulletin Primary Heath Care Sector Weekly DG for Diseases Control & Surveillance Eiectronic Integrated Disease Early Warning and Response System Volume 07,lssue28,Epi week 28,(08-14 July,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-28,2019

% % % % % %

% % % % % % % % % %

% % %

96 96 96 96 96 96

95 95 95 95 95 95 95 95 95 95

94 94

100% 94 400000

93 93 90% 350000 80% 300000 70% •During week no.28,2019, %96(1991/1920) health facilites from 23 Governorates 60% 250000 provided valid surveillance data. 50% 200000

40% 150000 Percentage

30% Consulttaions 100000 20% 10% 50000

0% 0

Wk 2 Wk 4 Wk Wk 1 Wk 3 Wk 5 Wk 6 Wk 7 Wk 8 Wk 9 Wk

Wk11 Wk13 Wk18 Wk20 Wk25 Wk27 Wk 12 Wk 14 Wk 15 Wk 16 Wk 17 Wk 19 Wk 21 Wk 22 Wk 23 Wk 24 Wk 26 •The total number of consultation reported during the week in 23 Governorates was Wk 10 364889 compared to 348989 the previous reporting week 28 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 28,2019)

% %

100% % %

Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of morbidity this %

100

100 100

90% 100

100

95 94

week. 80% 93

91 %

70% 87 60% 50% 40% 30%

20% No.HF Reports 10% A total of 1972 alerts were generated by eDEWS system in week 28, 2019, were verified 0% as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 28,2019 Proportional morbidity of leading priority diseases, Epi week 28,2019

AVH_A&E; 0.1% AFP; 0.0% Mumps; 0.1% Mal; 4.5% DF; 0.1% Typhoid F; 1.4% AVH_B&C; 0.0% ● (URTI) 13.5%, suspected Malaria (4.5%),(OAD) (9.8%) and (LRTI) (5.4%)Remain the Meas; 0.0% Sch; 0.1% RB; 0.1% leading causes of morbidity representing a total of (49.4%) Meng; 0.0% Brucellosis; 0.3% Chicken Pox; 0.2% Scabies; 0.1% ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than CL; 0.0%

1% of total morbidity in reporting period Bloody diarrhea represented 0.5% Of this OAD; 9.8% morbidity

● All diarrheal disease comprised 16.2% and LRTI 5.4% of total morbidity in pilot Governorates BD; 0.5% this week . SARI; 0.0% URTI; 13.5% Pert; 0.0% ILI; 0.4% ● All diarrheal disease comprised 16.2% and OAD 9.8% of total morbidity in all age group . LRTI; 5.4%

Measles Situition in Yemen Distribution of Governorate Measles cases & Deaths , Epi weeks1- 28,2019 Epi Curve of Measles in Yemen During 2017,2018,2019

1000 900

900 800 800 700 700

600 600

500 500 400

300 400

200 300 100 200 0

100

wk1 wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9 wk10wk11wk12wk13wk14wk15wk16wk17wk18wk19wk20wk21wk22wk23wk24wk25wk26wk27wk28wk29wk30wk31wk32wk33wk34wk35wk36wk37wk38wk39wk40wk41wk42wk43wk44wk45wk46wk47wk48wk49wk50wk51wk52 0 2019 465 524 562 594 620 615 837 590 384 304 245 220 196 195 163 177 135 125 106 83 84 63 37 114 161 148 140 141 2018 241 218 357 349 377 328 384 459 427 512 532 722 733 820 763 844 631 625 673 451 500 492 394 210 374 348 494 442 482 465 420 438 337 253 369 439 404 428 501 404 451 524 434 489 416 470 427 455 414 494 468 442 No of cases No of Death 2017 80 127 145 166 179 146 178 166 143 174 129 122 123 82 137 90 81 72 98 85 54 53 44 31 19 33 87 74 58 95 91 95 75 91 21 66 80 89 76 109 131 92 97 91 67 130 136 105 103 123 114 116

النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا على شكل وباء :ILI التهاب تنفسي حاد وخيم:SARI التهاب الكبد :AVH الحصبة :Meas داء الكلب :RB التهاب السحايا :Men حمى الضنك :DF مالريا :Mal بلهارسيا :Sch اسهال مائي حاد :AWD التهاب الجهاز التنفسي السفلي:LRTI اسهال حاد اخرى :OAD اسهال مدمم :BD عدوى الجهاز التنفسي العلوي :URTI االيذز :HIV الجذري:CHICKEN دودة غينية:GUINEA حمى مالطيه:BRUCELLOSIS السل:TUPERCULOSIS This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 1 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019)

GOV

Distribution of suspected cholera cases by age group (1 Jan- 23 July 2019) Distribution of associated deaths by age group (1 Jan- 23 July 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601)

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 2 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019) Dengue Fever and Measles Outbreak SITUATION IN YEMEN

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Deaths Email ([email protected])

Deaths

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 3 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-28 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-28,2019

20.0% 8.0% 4500

18.0% 4000 7.0%

16.0% 3500 6.0% 14.0% 3000

5.0% 12.0% 2500

10.0% 4.0% 2000

8.0% 3.0% 1500

6.0% 1000 2.0% 4.0% 500

2.0% 1.0%

wk2 wk3 wk4 wk5 wk6 wk7 wk8 wk9

0.0% wk1

wk20 wk25 wk11 wk12 wk13 wk14 wk15 wk16 wk17 wk18 wk19 wk21 wk22 wk23 wk24 wk26 wk27 wk28

0.0% wk10

WK2 WK1 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK10 WK11 WK12 WK13 WK14 WK15 WK16 WK17 WK18 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK26 WK27 WK28

WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK1 Rapid Test(Postive) Microscope(Postive)

WK15 WK10 WK11 WK12 WK13 WK14 WK16 WK17 WK18 WK19 WK20 WK21 WK22 WK23 WK24 WK25 WK26 WK27 WK28

Age and Sex distribution of total consultations of leading diseases (Epi week 28,2019) Number of Alerts Received and Responded (Epi Weeks 25-28,2019)

90000

URTI LRTI Pert BD OAD Typhoid F 80000 77847 AFP Meas AVH_A&E AVH_B&C DF Meng

70000 Sch CL Chicken Pox Mal 400 60000

350 50134 50000 300

40000 36590 250 33746 32194 33341 30000 29048 200 26050 22762 23162 No. of of No.Alerts 150 20000 100

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 22762 32194 33746 50134 26050 Female 23162 33341 36590 77847 29048 Distribution of consultations of leading diseases by Governorates,Epi week 28-2019

Hadramout Sanaa Suspected Disease Abyan Aden Al-Baidha Al-Dhale AlHodaidah Al-Jawf Al-Mahra Al-Mahweet Amana Amran Dhamar Hadramout Hajjah Ibb Lahj Mareb Rayma Sa'adah Shabwah Socotra Taiz Total wady Governorate URTI 2657 3761 1289 986 5567 1102 621 999 4962 1737 2536 1333 1638 3348 2398 3350 693 554 2895 2869 1147 76 2811 49329 LRTI 422 297 824 193 4347 399 41 425 1936 863 1471 311 230 1429 1319 1025 216 129 605 1098 235 61 1666 19542 ILI 127 0 47 0 112 96 0 6 14 46 74 5 0 410 83 0 65 0 81 86 140 3 201 1596 SARI 0 0 11 0 1 0 0 0 7 0 79 0 0 0 1 0 0 0 19 0 0 0 0 118 Pert 0 3 0 0 0 10 2 0 5 14 8 2 1 0 14 10 0 0 2 0 6 0 15 92 BD 65 6 32 2 120 120 0 111 129 193 170 12 5 3 113 25 30 26 180 156 45 0 208 1751 OAD 1022 1760 1223 684 2462 1125 367 648 5499 1816 2855 576 398 2947 2249 1667 512 488 1813 2569 831 27 2390 35928 Typhoid F 58 56 333 17 528 179 1 123 742 265 901 27 9 5 630 32 90 60 196 333 61 41 412 5099 Meas 0 12 4 4 3 3 1 0 13 15 2 7 3 3 12 7 0 5 24 4 9 0 10 141 AVH_A&E 8 10 4 0 1 1 0 1 125 9 41 20 7 0 17 11 5 2 4 14 20 0 14 314 AVH_B&C 4 1 4 2 0 0 0 1 76 2 8 9 0 7 30 1 6 0 1 3 1 0 11 167 NNT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AFP 1 0 0 0 0 0 0 0 2 1 0 1 0 3 1 0 0 2 1 2 0 0 0 14 337 12 1 8 29 16 0 24 12 11 42 9 10 األمراض المشتبه24ة Mumps 15 13 7 8 22 15 4 8 35 12 Mal 59 299 12 0 7045 164 15 531 234 448 592 2 1 3543 517 95 13 177 790 180 6 0 1607 16330 Meng 0 14 0 0 1 1 0 0 16 0 3 2 0 5 14 0 0 0 0 0 1 0 14 71 DF 156 116 0 2 39 0 0 0 0 0 0 16 5 2 0 67 33 0 0 0 43 0 63 542 VHF 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 Sch 0 0 1 23 2 21 0 19 69 85 25 5 3 98 13 9 3 4 64 24 0 0 12 480 CL 0 0 4 5 0 3 0 2 4 2 10 1 3 12 5 3 0 4 5 5 2 0 0 70 RB 0 0 2 1 4 0 0 5 85 4 92 1 0 20 26 0 0 0 2 6 0 0 8 256 Tuberculosis 10 5 0 0 2 3 0 1 19 1 8 1 0 4 4 3 0 0 3 6 1 0 8 79 HIV/ AIDS 0 0 0 0 0 0 0 0 4 0 0 1 0 2 0 0 0 0 0 0 0 0 0 7 Brucellosis 3 0 50 2 12 64 0 1 180 43 197 0 15 185 86 1 16 1 49 20 14 0 20 959 Chicken Pox 9 28 2 17 12 23 0 21 109 78 35 11 8 68 65 10 14 21 137 45 8 0 7 728 Scabies 16 1 0 0 69 7 0 8 31 4 9 2 1 33 2 1 0 17 39 28 2 0 9 279 Guinea Worm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 othr_disease 4964 10208 4422 6893 12366 3358 2217 4517 50773 4837 19722 6470 4187 9546 12673 10749 5122 1346 5667 7436 4548 239 10977 203237 total_cons_disease 9821 16675 9350 9193 36996 7131 3285 8185 68305 11871 31084 9906 6667 23903 22218 17864 6860 3139 13863 18120 7174 448 22831 364889 This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 4 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019)

Alert Responded in Epi - Week 28,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Radfan Public H, Tur Sena'a Dispensary ,Alwaht rural Radfan,Tuban,Yaffa,Halimayn,Al The focal points were contacted, information shared, the cases of suspected dengue fever were DF Lahj H,Tebah Dispensary,Almusaimeer H,Alhlal HC,Ibn diagenosed clinicaly according to case definition, Rapid test were positive. 67 0 Musaymir,Al Hawtah Khaldoon Hospital Cases added to the line list , treated symptomaticaly and improved.

Al Maflahy,Yaffa,Al Had,Al Immediate report were recived by the focal points , the cases of suspected whooping cough were Pert Lahj Alhilal Dispensary,Al Amal Health Center,Alraha HU diagenosed clinicaly according to case definition. 10 0 Milah,Tuban,Habil Jabr The cases were treated symptomaticaly and left the health facility.

Contact with the focal points , the cases of suspected measles were diagenosed clinicaly according to Abrbadr HU,Alwaht rural H,Balla Health Unit,Lbaos case definition. Meas Lahj Tuban,Habil Jabr,Al Milah,Yaffa 7 0 ALSalem Hospital The cases were vaccinated except one case was un vaccination , the cases recorded in the line list , treated symptomaticaly and left the health facility.

Yaffa,Tur AlBahah,Yahr Contact with the focal points , the cases of suspected cholera were diagenosed clinicaly according to AlHawtah,Tuban,AlHad Al October public H,Tour Albaha Hospital,Ibn Khaldoon case definition, 24 RDT positive and ather cases were negative, cases reported immediatly to operation Chol Lahj 168 0 Qabbaytah,Radfan Al Maqatirah,Al Hospital,Rayshan HU,Yaher rural H,Other room , recorded in the line list , cases treated by iv fluid , ors and antibiotic, cases finaly lmproved and Had left the health facility.

Alburaihi H,Aden German Hosp.,Maharik HC,Shifa Aden Khur Maksar,Ash Shaikh Outhman,Al Dispensary,Aljumhuria educational H,Alwahda eIDEWES team were contact fp, the cases were different areas, diagenosed clinically,not samples were DF Aden 116 0 Mualla,Dar Sad,Al Mansura educational H,Durrat Aldar specialized H,Al-Wali collected, treatment were given, investigation form were done. Hosp.,Other

Attawahi,Sairah,Ash Shaikh Alwahda educational H,Albasateen medical eDEWS team contacted RRT, The cases were diagnosed clinically,6 cases were un vaccination and one Meas Aden 12 0 Outhman,Dar Sad,Al Mansura center,Hashed Health Complex case was vaccination ,treatment were given, samples were collected, investigation form were done.

eiDEWS team were contacted fh :The cases diagnosis clinically, the cases were vaccination unknown Pert Aden Ash Shaikh Outhman,Al Mansura Alwahda educational H,Khalefah Hospital,Alnakib H 3 0 and samples also, treatment were given, investigation from were done.

eiDEWS team was contacted fh :The case was kadriah Abdullah Ahmad /female age 78m, from Diph Aden Ash Shaikh Outhman Alwahda educational H Almoalla /diagnosis clinically, unknown vaccination and sample, treatment was given, investigation from 1 0 was done.

eIDEws team were contacted fp, the cases were diagnoses clinically from Albasteen plok 7,11,4,2,9,1 Chol Aden Dar Sad,Ash Shaikh Outhman Albasateen medical center,Alwahda educational H and one case from ather aree, the samples were collected , treatment were given, investisgtion form 78 0 were done

eIDEWS team were contacted fp, the cases were diagnoses clinically, Not samples were collected, VHF Aden Dar Sad Albasateen medical center,Al Ryadah Hosp. 6 1 treatment were given, investiagtion were done, one case was dead

Al Thuraya Clinic,Zunjopar H,Al Mahfad Hospital,Amajl Zungobar,Rosod,AlMahfd,Sibah eIDEWS team contacted the FP, the cases were diagnosed clinically (standard dengue case definition), DF Abyan HC,Rassad H,Alwadhee H,Ekhlas Clinic,Mahnf-Lwdr 156 0 Lawder,khanfir Al Wade'a,Ahwar samples were not collected, treatment were given, investigation forms were done. H,Alkafah HU

eIDEWS team visited the F.P,the case was vaccination, investigation form was done , stool Sample AFP Abyan khanfir Mother and child HC 1 0 collected and sent to Sana,a city

RRT in Almahfed district visited FP, the cases were diagnosed clinically, RDT'S were positive in 3 cases AlMahfd,Jayshan,RosodMudiyah,khanfir, , and stool culture not done. treatment were given, investigation forms were done , the cases and their Chol Abyan Al Mahfad Hospital,Rassad H,Mudiya Hosp.,Alrazi .H 41 0 Lawder families received complete advices about the ways of prevention and management of cholera infection. the cases included in Cholera line list,one case was dead

Sharab Ar Rawnah,Al Al Aroos Hospital,22 May HC,Ar Romah Rapid response team contacted also focal points by eIDEWS coordinator,cases diagnosed clinically Misrakh,Khadir,AlQahirahAlMaafer,Sama, center,Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Chol Taiz MawiyahAlMudhaffarSalh,SharabAsSala labs)for confirmation. Supplements & antibiotics treatment were given(case management)rapid test :66 1661 1 Loqiah Hospital,22 May Almodafar HC,Mawih m,SabirAlMawadimMaqbanah,AtTaiziyah cases positive,the results of stool C/s still pending,There were collection & cluster of cases in the same Hospital,Alnshmh H,MSF Hospital,Other AshShamayatayn Hayfan Place, one case was dead

Al Mudhaffar,Al Maafer,Mashraa Wa 22 May Almodafar HC,Alnshmh H,Abduljalil Nassr eIDEWS coordinator contacted focal points, the coordinator of the directorate ,information's Meas Taiz Hadnan,Sama,Sharab Ar Rawnah,Al shared.Blood samples were collected from the cases and sent for lab confirmation & the cases were 10 0 Hoapital,Other Mawasit vaccination except one case was un vaccination All data in the line list

Focal point,and the coordinator of the directorate were contacted ,the suspected DF cases had a history Althwrh H,Aljoumhri H,Mohammed Al-Dourah HC,Altawn of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by blatelets DF Taiz Al Qahirah,Al Mudhaffar,Salh 63 0 H counting, ,rapid test of dengue virus was done for some of cases ,,which were positive,, Medications have been given,,,there is cluster of cases in some areas, All data in the line list..

Al Qahirah,Sabir Al Mawadim,At the communicating with the coordinator of edews in the facility we found these cases of suspicion of Pert Taiz Yemeni - Suidi H,Al-Safwah Hosp.,Al Aroos Hospital pertussis,the cases were from different areas. .. Action :these cases were treated at home, Advices 15 0 Taiziyah,Salh have been given to their parents to follow up and review..

We were receiving an immediate report from the coordinator of edews in the facility about this case of suspicion of diphtheria ,the cases were diagnosed clinically as a suspected case of diphtheria,we write all data about the case in the line list .. action :we inform the Rapid response team to visit the facility Diph Taiz At Taiziyah,Sharab Ar Rawnah Abduljalil Nassr Hoapital,Other 2 0 which receive the cases and they found data recorded in the hospital and the case was complained of fever and membrane in the throat and difficulty of swallowing,after that the team have been visit the house of the patient and they take all data about the cases and their contacts..all that's in the line lis..

Immediate report were sent by the EDEWS focal person, The cases were diagnosed clinically by case Ad Dis Al-Shrgyah Hospital,Mifaa HC,Hajar aljoul rural definition. AWD started , RDT were done it were positve. stool culture were collected and sent to central Chol Hadramout Ad Dis,Broom,Hajr 25 0 H,Other lab. the result is pending. the case reffered to AlMukalla city. the case was admitted to the DTC. iv fluid ,ORS and erythromycin antibiotic were given

Immediate report was sent by the EDEWS focal person. the case is 24 months female from Hadhathm area in Arraida district. the case is diagnosed clinically as suspected AFP. paralysis of the lower limb AFP Hadramout Ar Raidah and Qosaiar Hadhathm HC started post IM injection . the case is fully vaccinated. the RRT visited the living area. 2 stool samples 1 0 were collected and sent to the GOV level. the case was treated by supporive treatment. the polio coordinator was informed.

Al Mukalla City,Daw'an,Ghail Ba immediate report were sent by the EDEWS focal person, the cases were diagnosed clinically as Meas Hadramout Bdiree HC,Mukaibel Balhji H suspected measles, the cases came from different areas , the cases were vaccination , blood samples 7 0 Wazir,Adh Dhlia'ah were collected by the district RRT. all cases were treated with supportive treatment all cases improved.

immediate report was sent by the EDEWS focal person. the cases were diagnosis clinical , the cases Pert Hadramout Adh Dhlia'ah,Al Mukalla City Aldhulaia'a HC,Al-Madinah Dispensary 2 0 were un vaccinated,the cases were treated with antibiotic

The EDEWS coordinator contacted the focal person. the cases were diagnosed clinically as suspected DF Hadramout Qhail Ben Yameen,Ad Dis Raydat Jawheen HC,Halfon HC df,blood samples were collected and tested for df by using df NS1 RDT.all cases were treated with 16 0 supportive treatment. all cases improved.

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 5 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019) Alert Responded in Epi - Week 28,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Udayn,Yarim,AlMashannah Hubaysh,As Saddah, Far Al Udayn,Ibb,DhiAsSufal AL Mzahan H,Yahsub Hospital,Aladin H,Mother and Child ArRadmah,Mudhaykhirah Badan,Hazm Immediate notification. eDEWS Coordinator visited hospital, stool samples were collected and positive Chol Ibb H,Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani by rapid test for78 cases 1813 0 Al Udayn,As Hospital,Alradhmah H,Almakhader HC,Alqaidah H,Other All cases were improved Sabrah,AlQafr,AlMakhadirAs Sayyani,Ash Shair,An Nadirah,Jiblah,Al Dhihar

Ash Shair,As Sayyani,As Saddah,Al Immediate notification by eDEWS focal points , samples were collected and sent to Sanaa and gave Meas Ibb Mashannah,Al Al Saleh hospital,Alnssr H,Aladin H,Other 12 0 suspected cases vit A,the most cases were Vaccinated Dhihar,AlMakhadir,YarimAl Udayn

Immediate notification by focal points, the Cases were diagnosed clinically and treated accordingly, the Pert Ibb Ar Radmah,Al Makhadir alkair alhadidy Dispensary 14 0 cases were un vaccination except 2 cases were vaccination

Immediate notification.Patient name Abdullazez Ahmed Hamed AFP Ibb Al Mashannah Mother and Child H 30 months ,old male.From ALdhihar- -Jabel Alshga - Date of notification 27/6/2019.Date onset of 1 0 symptoms 25/6/2019. samples 2 from case ,and send to sanaa,number of vaccinated 7 doses

Bura,AlMansuriyah AzZaydiyah,BaytAlFaqiahAl Qanawis, Ad Alsalakhana H,Alkanawes HC,Aldhahi Rural Dahi,Az Zuhrah, Al Hawak,Al Hali As eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and H,Almansouria rural H,Bait Alfakih H,Alzaydia Rural treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use Chol AlHodaidah Salif,Al Munirah,Al Mighlaf,AlGarrahi 4136 1 H,Aljarrahi rural H,Alluheyah HU,Alhshm WHO protocol ORC, cases done rapid test for sever cases, positive send for confirmation, one case Alluheyah,Kamaran, Jabal Ras,As Center,Althawra public H,Almekhlaf HC,Other was dead Sukhnah,Zabid, Al Mina,Al Garrahi

eDEWS coordinator contacted the focal points, the cases were suspected measles , the cases were un Meas AlHodaidah Al Hali, As Salif,Bajil Al Kadaf HC,Alsalif Hospital,Other vaccination , fever , rash recorded, the blood samples have been collected from the patient by district 3 0 coordinator and sent to the central laboratory in Sanaa.

Focal points were contacted , they informed us that the suspected DF cases had history of high fever , Alaksa specialized H,Hais rural Hospital,D.abdh Faqih retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been DF AlHodaidah Al Hawak,Hays,Zabid,Bayt Al Faqiah started, samples were collected in the lab of hospital for testing by serological test ( NS1) which this test 39 0 HC,Hikmah hospital measure the presence of dengue protein ( high sensitive & quality test) which detect the Antigen of virus that confirm the result. No cluster of three

Focal point were contacted , the suspected Diphtheria cases had a history of pseudo membrane around Diph AlHodaidah Al Hawak,Bajil Althawra public H,Cement Center tonsillitis , and sever inflammation, the cases were un vaccination , the cases were diagnosed clinically. 2 0 Medications have been started, ALL cases only depend on case definition,one case from alhawak

Najrah,AshShahil,QaflShamerBaniQais,A lMiftah,Qarah Aslem,AlJamimah Public Republican Hospital,Khatwah HC,Qafl Shamer AflahAshShawm,Mabyan,HajjahCity,Abs, Kufl-Shamar Rural H,Bani Chamakh HC,Bani Qais Haradh,Hajjah Kuaydinah,AlMahabishah eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared .It have Chol Hajjah Health Center,Mabyan Hospital,Kuhlan Afar been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea) 2183 2 Kuhlan Affar,Mustaba,Bani Al HC,Almahabesha Public H,Alshahel Rural the cases from different area. It were given the appropriate treatment,2 cases were dead Awam,Kuhlan Ash Sharaf Al Hospital,Almaghraba HC,Other Maghrabah KhayranAlMuharraq AshShaghadirah

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts . Information shared.It were diagnosed clinically according to standard definition For measles , the cases were un Meas Hajjah Mabyan,Aflah Al Yaman Almaefri HU,Other 3 0 vaccination,Investigation form were done,Appropriate treatment were given,The samples were collected and sent to the central laboratory

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts. Information shared . We Hajjah City,Aslem,Kuhlan Ash Sharaf,Al Public Republican Hospital,Bani Zyad HU,Almahabesha received a report from Private clinic , the cases (suspected diphtheria) The diagnosis were clinically Diph Hajjah 5 0 Mahabishah Public H,Other (diphtheria) ,2 cases were un vaccination and 3 cases ather were vaccination,The response team in the field investigated the cases and the contacts and the appropriate treatment were given

eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts. Information shared.It were AFP Hajjah Hajjah City,Bani Qais,Qafl Shamer Public Republican Hospital,Other diagnosed clinically according to standard definition For AFP, Investigation form were Done. Appropriate 3 0 treatment were given,The samples were collected and sent to the central laboratory

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Omar Al Mokhtar Complex,Bni - Hwath HC,Arwdhah clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab Aththaorah,Shu'Aub,Assafi'yah,BaniAlHar H,As Sabin Hospital,Jddr HC,22 May Hospital,Alwahda (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana ith,AsSabain,MaainAz'zal,At of them were from Amana governorate & a few of them from other governorates ,different districts of that 3244 3 Health Center,Alrazi HC,Al Jraf Complex,Jabr Bn Hyan Tahrir,Sana'a Old,AlWahdah governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most Complex,Gazah Complex,Other collected specimens,so stool C/s not done for that negative samples.There were a collection or cluster of cases seen in the same Place,3 cases were dead

Azal Complex,Omar Al Mokhtar Complex,Gazah Sana'a Old,Az'zal,Al Wahdah,Maain,As eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Meas Amana Complex,ALSONINH COMPLEX,22 May Hospital,As cases and sent for lab confirmation ,the cases were un vaccination, Vit-A were given to the cases,in 13 0 Sabain,Shu'Aub Sabin Hospital order to support hese immunity against complications of measles.

eIDEWS coordinator contacted focal points,information shared,then HF visited by eIDEWS Pert Amana At Tahrir,Bani Al Harith Alkwit educational H,Zaid bn Sultan H coordinator.The cases diagnosed clinically according to the case definition. Antibiotics treatment were 5 0 given,the cases were un vaccination,There were no collection of cases seen in the same place.

eIDEWS coordinator contacted focal poinst,then HF visited. Information shared.Stool samples collected AFP Amana At Tahrir Alkwit educational H 2 0 from the case and sent for lab confirmation, the case was un vaccinated against polio.

eIDEWS coordinator contacted focal points,informations shared,after that HF visited by eIDEWS coordinator.The case diagnosed clinically according to the case definition as suspected diphtheria.Symptoms & signs of a case were,fever,sore throat,grey-whitish pseudo-membrane,swelling Diph Amana Maain,As Sabain,Bani Al Harith 22 May Hospital,As Sabin Hospital 4 0 of neck lymph-nodes(Bull neck) & difficulty of swallowing & breathing. Antibiotic treatment was given & case management done.Throat swab & fixed slides were taken into Central Lab for confirmation(Albert stain,Gram stain & Diphtheria C/S)the cases were vaccination

Al Barakat Health Unit,Al Jumhoori Hospital,Monabbih Razih,Sa'da,AdhDhahir Rural Hospital,Ghafira Unit,Sudan Health Unit,Qatabir edews focal points were contacted , the cases all diagnosed clinically , all are RDT positive for 47 Chol Sa'adah Sahar,Baqim,Qatabir Majz,Ghamir,Al 796 1 Health Center,Majz Health hospital ,Ghamer Health cases ,the cases were treated , the information shared and the line list updated,one case was dead Hishuah Center,Other

Al Jumhoori Hospital,Al Khawalid Health Unit,Haydan Sa'da,AsSafra,Saqayn elDEWS team contacted focal points,information shared, blood samples were not collected from the Meas Sa'adah Hospital,Majz Health hospital ,Ghamer Health Center,Al - cases, the onset of fever,skin rash and other information were recorded in the line list ,the cases were 24 0 Qatabir,Haydan,Majz Ghamir,Sahar Talh Hospital un vaccination

the edews focasl in hospital and the surveillance team were contacted , the cases were diagnosed Diph Sa'adah Sa'da ,Majz Al Jumhoori Hospital,Dhian HC clinically according to the case definition , the cases isolated and treated , the RRT contacted to trace 7 0 contacts the samples sent to CPHL for confirmation

edews coordinator conduct the focal, after report of cases pertusess cases , the cases were diagnsed Pert Sa'adah Haydan,Qatabir Khamis Marran Health Center 2 0 clinically and treated in the health cente

the edews focal point contacted , the health facility visited and the investigation performed. the patient AFP Sa'adah Majz Majz Health hospital name is shhad shnter 30 months old ,from magz district ,. the samples collected and sent to the central 1 0 lab , the RRT visit the patient home and perform the investigation

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 6 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019)

Alert Responded in Epi - Week 28,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

As Al Qaflah Rural Hospital,As Sawd Health Sudah,Huth,Suwayr,KhammerShaharah,I hospital,Raydah Health hos.,Al Ashah Health yal Surayh,Harf Sufyan Habur Eidews Coordinator Contact the Coordinator of Surveillance in Districts , The cases were diagnosed hospital,Harf Sufyan H,Al Sanaaniah Health Center,Al clinically as suspected cholera, according to case definitio, Rapid Test were done for some cases the Chol Amran Zulaymah,Dhi 794 1 Salam Khamir Hospital,Huth Health hospital,Kharif Rural result were positive and some cases negative, All The cases improved After Taking The Treatments Bin,AlAshah,Amran,Raydah Thula,Bani Hospital,Amran General Hospital,Thula Health proper,one case was dead Suraim,Kharif,Jabal Iyal Yazid,Al hospital,Habur Health hospital,Other Madan,Al Qaflah,As Sawd,Maswar

Iyal Dhaiaan Health Center,Raydah Health hos.,Al Salam Eidews Coordinator Contact the Coordinator of Surveillance in Districts, The cases Were Diagnosed Meas Amran Surayh,Raydah,Shaharah,Khammer,Hab Khamir Hospital,Habur Health hospital,Kharif Rural clinically as suspected Measles, According to Case Definition, Blood Samples Were Collected Of 15 0 ur Zulaymah,Kharif,Thula Hospital,Thula Health hospital,Other Patient and Sent To Central Lab in Sanaa, the cases were vaccinated Against Measles

Eidews Coordinator Contact the Coordinator of Surveillance in District khammer The cases were Pert Amran Khammer,Al Ashah,Suwayr Al Salam Khamir Hospital,Other diagnosed clinically as suspected pertussis. according To case definition,the cases Improved After 14 0 Taking the Treatments Antibiotics

Eidews Team Contacted Focal Point. and visit health hospital amran and investigation. Case Were AFP Amran Amran Amran General Hospital Diagnosed Clinically as Suspected AFP. according to definition case. stool sample Collected and Sent 1 0 To Central Lab in Sanaa, the case was vaccinated, the Case from Governorate Hagah

Eidews team contacted focal point. and Rapid response Team visit Health Hospital 22 case were diagnosed Diph Amran Amran Other 1 0 clinically probable diphtheria. the case treated with antibiotics and anti toxin. case from distric khamer

Bani Hushaysh,Al Haymah Al Bani Mansour HC,Al wheda Manakha rural Hospital Kharijiyah,AlHusn,Nahm,BaniDhabyan,K ,Awmara H,22 May Hospital ,Ka'a Alreka HC,Sa'afan Rapid Response team visited area according to cases definition suspected cholera , 393 cases were Chol Sanaa Governorate hwlan,Manakhah,Hamdan HC,Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital positive rapid test and ather cases were negative ,cases are recoreded in line list , the cases from 2670 1 BaniMatar,AlHaymahAlKharijiyah,Jahanh, ,Almarbak HC,Almanar Hospital,Bait Alrejal HC,Walan deifferant area BiladARus,Arhab,Sa'fan,Attyal,Sanhan Hospital,Other

The EDEWS coordinator contacted the focal person, The cases were diagnosed clinically by case Meas Sanaa Governorate Bani Matar,Al Husn 26September H in Matna 4 0 definition,. Skin rash started ,The cases were vaccinated, blood samples were collected.

Hamdan,Khwlan, Al 22 May Hospital ,Alshaeed Mohamed Aldurra The EDEWS coordinator contacted the focal person, The cases were diagnosed clinically by case Diph Sanaa Governorate HaymahAlKharijiyah,Jahanh,Bani definition, the cases were vaccination unknown except 3 cases were vaccination,The cases treated 9 0 Hospital,Unit Kulasay Health,Bait Alrejal HC Matar,Sa'fan with antibiotic.

The district RRT visited the health facility, The cases were diagnosed clinically by case definition, AFP Sanaa Governorate Bilad Ar Rus,Al Haymah Ad Dakhiliyah Walan Hospital,Kuwait Center 2 0 paralysis started , The cases were vaccinated samples were collected and sent to central lab

Maqbelah Health Center,Outpatient/Al Ain Clinic,Bin eIDEWS coordinator contacted the health facilities found , suspected cases of dengue fever, the cases DF Shabwah As sa,aid,Ain,Ataq were diagnosed clinically according to case definition, all cases were received their treatment and 43 0 Salmeen Clinic,Emergency/Ataq Hospital improvement.

eIDEWS coordinator visited the health facilities found the cases were suspected cases of measles, the Meas Shabwah Markhah Al Alya,Osailan,Ain,Ataq alkhor health center,Usaylan Hospital cases were diagnosed clinically according to case definition, vaccination were not done,blood samples 9 0 were collected , all cases were received their treatment and improvement.

eIDEWS team contacted the health facilities found suspected cases of cholera, the cases from different areas, the cases were diagnosed clinically according to case definition, rapid test were not Chol Shabwah Baihan,Ataq,Rodhoom Bayhan Hospital,Emergency/Ataq Hospital 38 0 done because not available except one case was positive, all cases were received their best treatment and improvement.

Salem Bahaj Clinic,Usaylan Hospital,Dr Saleh eIDEWS coordinator visited the health facilities found suspected case of pertussis , the cases were Pert Shabwah Ataq,Osailan diagnosed clinically according to case definition, vaccination were not done except one case was 6 0 Abdurahman Medical clinic vaccination,the cases were treated and improved.

AsSawadiyah,AtTaffah,Naman,Mukayras, Wald Rabi',Sabah,Nati,Dhi Alswmah HC,Thi - Naem HC,Areeb HC,Alarsh Na'im,ALSharyah,AlMalagim eIDEWS team contacted focal points, the cases were diagnosed clinically as suspected cholera using Chol Al-Baidha center,Althwrh Hospital,Al-Taffah Center,Mukayras case definition, rapid test 129 positive the main saing watery diarrhea &vomting some dehydration the 1058 0 AlA'rsh,Radman Al Awad,Al Hospital,Other paitnts ademittedt and with ORS and IV fluid in good condation the cases from deferrnt organ Quraishyah,Al BaydaCity,ArRyashyyah ,Maswarah

IDEWS team contacted point information shared blood saeIDEWS team contacted, the cases diagnosed clinically according to case definition Antibiotics treatment were given , Apear skin rash and Meas Al-Baidha At Taffah,Dhi Na'im,Sabah,Wald Rabi' Al-Taffah Center,Thi - Naem HC,Almnash HC 4 0 the fever in respectively the cases there are were non collction of cases samples were cases and their are un vaccination except one case was vaccination against measls

EDEWS team contact Edews focal points in `Hospital ,the cases diagnosis according to case defination Chol Al-Mahra Qishn,Huswain,Al Ghaydah Qishn Country Hospital,Al Ghaydah Center Hospital , susspected Cholera cases in line listing and send daily to central level ,Cholera rapid test were +ve 16 0 ,then samples send to culture , treatment were given to cases

EDEWS team contact Edews focal point in Aamal Clinic . 2 case from Sayhut District )( Rakhut vilage ) Pert Al-Mahra Sayhut Al Amal Clinic the cases diagnosis according to case defination , susspected Pertusis cases were 2 females age 4,2 2 0 mounths , the cases un vaccinated , treatment were given to cases

EDEWS team contact Edews focal point in `Aamal Clinic .case diagnosis according to case defination , Meas Al-Mahra Sayhut Al Amal Clinic susspected measles case was female 21years, vaccinated 1 doses ,serum sample taken from cases 1 0 ,treatment was given to cases

edews team contact focal points , the cases were diagnosed clinically as suspected (meas) using case definition , the cases were vaccination except one case was under vaccination age , blood samples were collected Meas Hadramout wady Sayun,Shibam,Wadi Al Ayn Tarebah Health Center ,Wadi Bani Ali HC, Babkr H Vit A provided . 3 0 investigation done by RRT . symptomatic treatment were prescribed

edews team contact focal points , the case was diagnosed clinically as suspected (pert) using case definition , name: - Aisha Walid Qandous, age 144 m vaccine : 3 Pert Hadramout wady Sayun Bour Health Center dose 1 0 protective therapy given to contact and health education for the family . symptomatic treatment was prescribed

This weekly epidemiological leaflet is issued by the National Early Warning and Response Program of the Ministry of Public Health and Population. For Correspondence: Dr. Rema Al-Yousfi, Mobile (713228999, e-mail: [email protected]), Yahya Amer-Mobile (777553779, e-mail [email protected]) 7 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 28 (08-14 July,2019)

Alert Responded in Epi - Week 28,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

EdeWS coordinator contacted focal points,they founds cases diagnosed suspected Chol(Acut watery Chol Dhamar Maghirib Ans Dheba HC diarrhoea and dyhadretion ) the cases tested by rapid test And result were postive for 110, all cases 1067 0 received treatment

Edewds coordinator contacted of the focal points and they founds that the cases were diagnosed Meas Dhamar Anss,Dhamar City Kharbah Abuyabes HC,Taibah hospital 2 0 according to the standard definition of Meas, the cases were un vaccination, Samples collected

Edewds coordinator contacted of the focal points and they founds that cases were diagnosed according Pert Dhamar Dawran Aness,Jahran Bin alakwa'a Dispensary,Alwahda university H 8 0 to the standard definition of pert ,the cases from different area , the cases were un vaccination

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed AlJubah,Majzar,Alwadi clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb May 22 Hospital,Al Kari Hospital,Qaniah Health CENTER 27 0 Sirwah,Mahliyah,Bid Bidah Supplements & antibiotics treatment were given ,the results of stool Rapid tests of cholera 7 positive and the same cases not done ,There were a no collection or cluster of cases seen in the same Place

the contacted the contact and told us that suspected dengue , cases had history of high fever, back pain, muscular pain, and arthralgia,The samples were collected at the hospital's laboratory for serological DF Mareb Al Jubah,Al wadi May 22 Hospital,( al Wahdah ) Hospital,Al Kari Hospital 33 0 testing (NS1). This test measures the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result

EDEWS team contacted focal points, the Cases were diagnosed clinically as suspected pert,treatments Pert Al-Jawf Al Hazm,Al Matun,Rajuzah AL Nile Dispensary,Al Shifa Center,Bart Rajuzah Hospital 10 0 were given,the cases were un vaccines

Khob Wa Asha'af,Al Hamidat,Al Ghayl,Al Al Maton Health Center,Al Hazm Hospital,Al Humaydat Matun,Al Hazm,Rajuzah,Al Maslob,Al Health Center,Bart Rajuzah Hospital,Bart Al Anan Rural The EDEWS Coordinator received a report from the control officer that there were cases of the doctor's Chol Al-Jawf diagnosis. It were cholera,without a suspicious examination from different areas,After 437 0 Matammah,Kharab Al Marashi,Bi'rat Al Hospital,Al Marashi Health Center,Hosoon Aal Shanan validation,Treatments were treated according to the treatment plan Anan Health Center,Other

The EDEWS coordinator have contacted the coordinator, The condition were diagnosed clinically by Meas Al-Jawf Al Hazm,Al Matun Al Hazm Hospital,Al Qasabah Health Unit definition of the condition, Blood samples were not collected, Symptom therapy and antibiotic giving were 3 0 given and vitamin A

Altawilh HC,Bni Alhmadi HU,Mlhan Health Center,Alrujm Shibam Kawkaban,Hufash,Bani Sa'd,Al eIDEWS coordinator contacted focal points, information were shared, all cases were diagnosed clinically Hospital,Bani Sa`d Hospital,Shbam H,Alrujm according to case definition,the cases were investigated by rapid test for vibrio cholera and the result Chol Al-Mahweet MahwaitAl, Khabt,Ar Rujum,At 736 0 Hospital,Alkhpt H,Hufash H,Alahjer HC,Swaq Alahd were positive for22 and some cases were not investigated by rapid test, appropriate treatment were Tawilah,Al Mahwait City,Milhan, HU,Other given according to severity of symptoms and dehydration

eIDEWS coordinator contacted focal points, information were shared. the cases were diagnosed Diph Al-Mahweet Al Mahwait City,Milhan Aljoumhwri H,Other 2 0 clinically according to case definition, the cases were vaccinated against diphtheria and treated

Mazhar, Kusmah,As Salafiyah,Al Althulaia H,Al Arkob HC,Wadi Alarid HC,Almithaq eIDEWS coordinator contacted focal points, information were shared, the cases were diagnosed Chol Rayma clinically according to case definition,appropriate treatment were given according to severity of 225 1 Jabin,Bilad At Ta'am,AlJafariyah H,Alqssia HC,Alathneen Alrahb Center ,Other symptoms, one case was dead

eIDEWS coordinator contacted focal points, information were shared, the cases were diagnosed AFP Rayma Bilad At Ta'am,Al Jabin Althulaia H clinically according to case definition, stool samples collected and sent at or lab confirmation, the cases 2 0 were vaccination

The EDEWS coordinator contacted the focal person,The cases were diagnosed clinically by case definition, blood samples were collected. Symptomatic treatment and cover antibiotic were given, the Meas Rayma Al Jabin Althulaia H 5 0 cases were vaccination except 2 cases were un vaccination

Al Azariq,Al Husha,Ad Dhale'e,Damt,Ash Daglal Health Center,Ghnih Hourh HU,Damt HC,22 May eDEWS team contacted FP ,all cases were diagnosed according to case definition, all included in Chol Al-Dhale Shu'ayb,Juban,Al 294 0 Hospital,Alfakhr HC,Alnassr H,Dhwran HC,Other updated daily line listing Hussein,Qa'atabah,Jahaf

eIDEWS team was contacted fp: The cases were diagnoses clinically, vaccination were done, samples Meas Al-Dhale Jahaf,Ash Shu'ayb,Al Husha,Al Azariq Alshaib Dispensary,Daglal Health Center 4 0 were collected , treatment were given, investigation form were done.