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 42, Epi week 42, 12 - 18 Oct 2015

H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 42, 2015

96%97 % 100% 93% 94% 100,000 94% 94%92 %93 % 9392% % 94% 88% 90% 92% 82%82 % 85% 82% 90,000 ● During week no. 42, 2015;88% (402/354) health facilities from 16 governorates provided 78% 81% 80% 79% 81%79 %

80% 72% 74% 80,000 70% 68%70 %69 %68 % 70%70 % 66% 66% valid surveillance data. 70% 64% 64%62 % 64%64 % 62% 70,000 60% 54% 51% 60,000 50% 50,000 40% 40,000

30% 30,000 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 20% 20,000 Co n s u l a i t t o ns 72269 compared to 66933 the previous reporting week. Acute respiratory tract infections 10% 10,000 0% -

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

Wk 1 Wk 2 Wk 4 Wk 5 Wk 7 Wk 8 Wk Wk3 Wk6 Wk9

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Distribution of Reporting Rates by Governorates (Epi-week 42, 2015)

100% 80%

● A total of 137 alerts were generated by eDEWS system in week 42, 2015; Of these 129

60%

% %

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

% %

40%

100

64 100

100

100 100

20% 8

N o. H F R e p o r t t s r ope R F H o. N 0%

● Altogether 26 alerts for Acute viral hepatitis, 21 Measles, 19 Dengue Fever, 16 Bloody diarrhea, 12 Acute Flaccid Paralysis, 11 Pertussis, 10 Cut.Leishmaniasis, 6 Meningitis, 3 Reporting Rate Target Schistosomiasis, 2 Pneumonia, 1 each for Other acute diarrhea, Viral hemorrhagic fever and Note: The cause of reporting rates decline in Taiz and Sa'da are the armed conflict, as well as the reasons to Neonatal Tetanus were received and responded in system generated. the others ( Aden. Lahj, Abyan, Amran and Al-Mahrah); lack of electricity, fuels, and access to the net . Suspected Dengue outbreak

● 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 42, 2015 Suspected dengue outbreak in Shabwah, Al-Mahrah Gov., Epi weeks 14 to 42, 2015 a). Suspected dengue outbreak

250 DF - Shabwah Gov. • 158 suspected dengue cases were reported in 7 governorates, out of these 50 cases Cases 200 Death

reported from Shabwah and 56 cases from A-Mahra. 1 cases with hemorrhagic 150 manifestations were reported in Aden governorate through the eDEWS sentinel sites. 100

NO. of cases of NO. 50

• Shabwah and Al-Mahra governorates having increase number of reporting DF cases. Some

Wk14 Wk16 Wk18 Wk20 Wk21 Wk23 Wk25 Wk27 Wk29 Wk31 Wk34 Wk36 Wk38 Wk40 Wk42 Wk 15 Wk 17 Wk 19 Wk 22 Wk 24 Wk 26 Wk 28 Wk 30 Wk 32 Wk 33 Wk 35 Wk 37 Wk 39 Wk 41 governorates (especially Taiz) lost all communication tools and still its reporting rates is low. 70 60 Cases DF - Al-Mahra Gov. 50 Death

40 • Surveillance is being intensified to ensure that the ongoing dengue outbreak is effectively 30 20 monitored and other priority communicable disease are reported through alternative cases of NO. 10 sources including private health facilities, mobile clinics, NGO partners on the ground, 0

health workers in the community, and the general public

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Leading causes of morbidity and mortality in Epi-week 42 2015 Proportional morbidity of leading priority diseases, Epi weeks 1 to 42, 2015 b. Other leading priority diseases

25.0%

● URTI (13.9%), suspected malaria (2.7%), OAD (10.3%) and Pneumonia (4.7%) remain the 20.0% leading causes of morbidity representing a total of 31.6%. 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 6 Wk 7 Wk Wk 4 Wk 5 Wk 8 Wk 9 Wk

Wk 10 Wk 11 Wk 14 Wk 15 Wk 16 Wk 19 Wk 20 Wk 23 Wk 24 Wk 28 Wk 29 Wk 32 Wk 33 Wk 36 Wk 37 Wk 41 Wk 42 Wk Wk13 Wk17 Wk18 Wk21 Wk22 Wk25 Wk26 Wk27 Wk30 Wk31 Wk34 Wk35 Wk38 Wk39 Wk40 of total morbidity in reporting period. Bloody diarrhea represented 0.4% of this morbidity. Wk12 DD URTI S.MAL Pneumonia

Pneu 4.7% ● All diarrheal disease comprised 10.6% and Pneumonia 4.7% of total morbidity in Pilot URTI 14.0% OAD 10.3% Governorates this week. BD 0.4%

Sch 0.1% Others 67.0% S.Mal 2.7% ● All diarrheal disease comprised 5.54% and Pneumonia 2.64% of total morbidity in the <5 Rb 0.2% years age group. Cases (n=16,379) AVH 0.3%

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 42 ( 12 - 18 Oct 2015 )

Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Pneumonia ( Epi week 1 to 42, 2015)

Diarrheal Diseases URTI Sus.Malaria Pneumonia 6.0% 25.0% 16.0% 8.0%

14.0% 7.0% 5.0% 20.0% 12.0% 6.0% 4.0% 10.0% 5.0% 15.0%

8.0% 4.0% 3.0%

10.0% 6.0% 3.0% 2.0%

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

0.0% 0.0%

Wk 1 Wk 3 Wk 5 Wk 9 Wk Wk7

Wk 1 Wk 3 Wk 5 Wk 7 Wk 9 Wk

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

Wk 11 Wk 13 Wk 17 Wk 19 Wk 21 Wk 25 Wk 27 Wk 29 Wk 33 Wk 35 Wk 37 Wk 41 Wk Wk15 Wk23 Wk31 Wk39

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

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

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Age and Sex distribution of total consultations of leading diseases (Epi week 42, 2015) Cumulative number of major health events reported in Epi-weeks 1 to 42, 2015 (1st Jan 2015 to 18th Oct 2015)

16000 Diseases No of Cases Percentage

14000 Upper Respiratory Infections 287652 12.1% 12000

10000 Diarrheal Diseases 226157 9.5%

8000 Suspected Malaria 80552 3.4%

6000 Number of Consultations of Number 4000 Pneumonia 107666 4.5% 2000

0 Total (All consultations) 2376278 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Male 4579 5936 7057 11041 6282 Female 4157 5681 7001 14158 6377 Leading Diseases by Governorate, Epi week 42

Distribution of consultations of leading diseases by Governorates, Epi week 42

Hadramout Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Sana'a Gov. Shabwah Al-Mahrah Dhamar Total wady Upper Respiratory Infections 616 1465 622 93 833 646 553 350 1368 679 402 379 408 604 203 845 10066

Pneumonia 137 166 264 73 194 458 382 89 298 126 418 63 74 212 28 402 3384

Other Acute Diarrhea 306 742 418 103 319 859 693 462 1142 607 479 219 258 208 102 512 7429

Bloody Diarrhea 7 1 4 0 0 100 1 2 2 20 29 10 28 3 0 46 253

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

Schistosomiasis 0 0 3 0 4 3 0 3 14 6 17 3 1 0 0 6 60

Malaria 1 16 9 0 0 182 915 606 7 42 88 19 27 0 0 54 1966

Meningitis 0 3 0 0 0 8 2 2 3 0 6 0 0 0 0 14 38

Dengue Fever 4 16 21 0 7 0 4 0 0 0 0 0 50 0 56 0 158

Viral Hemorrhagic Fever 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1

Rabies 0 0 1 0 0 3 1 5 61 0 4 0 0 1 0 38 114

Measles 0 2 2 0 1 2 0 8 2 3 1 1 6 0 0 0 28

Acute Viral Hepatitis (A & E) 8 16 1 0 4 41 0 2 41 1 20 10 7 2 0 49 202

Neonatal Tetanus 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2

Acute Flaccid Paralysis 0 4 0 0 0 1 2 0 2 0 1 2 0 0 0 0 12

Cutaneous Leishmaniasis 0 0 0 0 0 2 0 0 1 3 4 0 0 4 0 1 15

Diphtheria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Pertussis 1 0 2 0 0 2 1 0 1 2 1 0 4 0 0 0 14

Other Un 2 28 8 0 0 12 217 3 6 28 0 0 0 1 8 4 317

Other Consultations 2164 3779 1968 171 2616 5016 4766 1467 9831 2405 2185 1442 1499 2125 815 5967 48216

Total Consultations 3246 6239 3323 440 3980 7335 7539 2999 12779 3922 3655 2148 2361 3160 1212 7931 72269 A Number of alerts & outbreaks reported and investigated with appropriate response g Number of Alerts Received and Responded (Epi weeks 39 and 42, 2015) e 2015 Current week 42, 2015 System Gen. Alerts (week 42) Diseases Alers Outbreaks Alers Outbreaks TRUE FALSE S.Measles S.Pertussis AVH AFP Pneu NNT Meningitis S.Measles 759 1 21 0 21 0 S.Pertussis 320 0 11 0 11 0 C.Leish Sch BD OAD S.Dengue VHF AVH 368 0 27 0 26 1 30 AFP 169 0 12 0 12 0 Pneu 33 0 2 0 2 0 25 NNT 30 0 1 0 1 0 Mal 20 0 0 0 0 0 Meningitis 182 0 6 0 6 0 20

C.Leish 435 0 12 0 10 2 المبلغة األنذارات عدد األنذارات المبلغة Sch 85 0 3 0 3 0 15 BD 537 0 20 0 16 4 OAD 25 0 1 0 1 0 10 S.Dengue 432 3 20 0 19 1 URTI 1 0 0 0 0 0 5 VHF 35 0 1 0 1 0 AWD 5 0 0 0 0 0 Diph 2 0 0 0 0 0 0

Rb 3 0 0 0 0 0

Wk40 Wk41 Wk42 Other Diseases 4 0 0 0 0 0 Wk39 Total 3445 4 137 0 129 8

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 42 ( 12 - 18 Oct 2015 )

Lahj Governorate

26 health facilities from 14 districts in Lahj governorate reported to eDEWS with a total of 3246 patients consultations in week 42, 2015. Total 3 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 2 alerts for Acute viral hepatitis, 1 Pertussis were reported and responded.

Aden Governorate

22 health facilities from 8 districts in Aden governorate reported to eDEWS with a total of 6239 patients consultations in week 42, 2015. Total 14 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 5 alerts for Dengue fever, 3 Acute viral hepatitis, 2 each for Measles and Acute Flaccid Paralysis, 1 each for Meningitis and Viral hemorrhagic fever were reported and responded.

Abyan Governorate

21 health facilities from 4 districts in Abyan governorate reported to eDEWS with a total of 3323 patients consultations in week 42, 2015. Total 5 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 3 alerts for Dengue fever, 1 each for Pertussis and Measles were reported and responded.

Taiz Governorate

3 health facilities from 9 districts in Taiz governorate reported to eDEWS with a total of 440 patients consultations in week 42, 2015. Total NO alert were reported and appropriate measures were taken in week 42, 2015.

Hadramout Governorate

22 health facilities from 7 districts in Hadramout governorate reported to eDEWS with a total of 3980 patients consultations in week 42, 2015. Total 1 alert were reported and appropriate measures were taken in week 42, 2015. Altogether 1 alert for Measles were reported and responded.

Ibb Governorate

25 health facilities from 15 districts in Ibb governorate reported to eDEWS with a total of 7335 patients consultations in week 42, 2015. Total 15 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 3 alerts each for Acute viral hepatitis and Bloody diarrhea, 2 each for Cut.Leishmaniasis, Pertussis, Measles and Meningitis, 1 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 7539 patients consultations in week 42, 2015. Total 6 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 2 alerts for Acute Flaccid Paralysis,1 each for Dengue fever, Pertussis,Pneumonia and Neonatal Tetanus were reported and responded.

Hajjah Governorate

24 health facilities from 22 districts in Hajjah governorate reported to eDEWS with a total of 2999 patients consultations in week 42, 2015. Total 4 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 4 alerts for Measles were reported and responded.

Amana Governorate

25 health facilities from 10 districts in Amana governorate reported to eDEWS with a total of 12779 patients consultations in week 42, 2015. Total 12 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 6 alerts for Acute viral hepatitis, 2 Acute Flaccid Paralysis, 1 each for Measles, Pertussis, Cut.Leishmaniasis and Schistosomiasis were reported and responded.

Sa'da Governorate

16 health facilities from 15 districts in Sa'da governorate reported to eDEWS with a total of 3922 patients consultations in week 42, 2015. Total 7 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 3 alerts for Measles, 2 Bloody diarrhea, 1 each for Pertussis and Schistosomiasis were reported and responded.

Amran Governorate

25 health facilities from 20 districts in Amran governorate reported to eDEWS with a total of 3655 patients consultations in week 42, 2015. Total 17 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 5 alerts for Bloody diarrhea, 4 Acute viral hepatitis, 3 Cut.Leishmaniasis, 1 each for Measles, Pertussis, Schistosomiasis, Meningitis and Acute Flaccid Paralysis were reported and responded.

Sana'a Governorate

24 health facilities from 16 districts in Sana'a governorate reported to eDEWS with a total of 2148 patients consultations in week 42, 2015. Total 3 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 1 alert each for Acute viral hepatitis, Measles and Acute Flaccid Paralysis were reported and responded.

Shabwah Governorate

25 health facilities from 17 districts in Shabwah governorate reported to eDEWS with a total of 2361 patients consultations in week 42, 2015. Total 17 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 6 alerts for Dengue fever, 5 Measles, 3 Bloody diarrhea, 2 Pertussis, 1 Acute viral hepatitis were reported and responded.

Al-Mahrah Governorate

24 health facilities from 9 districts in Al-Mahrah governorate reported to eDEWS with a total of 1212 patients consultations in week 42, 2015. Total 4 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 4 alerts for Dengue fever were reported and responded.

Hadramout Al-wady

25 health facilities from 9 districts in Hadramout Al-wady governorate reported to eDEWS with a total of 3160 patients consultations in week 42, 2015. Total 4 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 3 alerts for Cut.Leishmaniasis, 1 Acute Flaccid Paralysis were reported and responded.

Dhamar

23 health facilities from 12 districts in Dhamar governorate reported to eDEWS with a total of 7931 patients consultations in week 42, 2015. Total 17 alerts were reported and appropriate measures were taken in week 42, 2015. Altogether 6 alerts for Acute viral hepatitis, 3 Bloody diarrhea, 2 each for Meningitis and Acute Flaccid Paralysis, 1 each for Cut.Leishmaniasis, Pertussis, Other acute diarrhea and Pneumonia 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 42 ( 12 - 18 Oct 2015 )

Alert Responded in Epi-week 42, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Labos Hospital/October Pert Lahj Labos/Yaffa Focal point contacted, case diagnosed clinically and treated by antibiotic. 1 0 General Hosp.

Labos Hospital/October The AVH cases were diagnosed clinically, no further information available, further AVH Lahj Labos/Yaffa, Al Milah General Hosp., Alkashaa 8 0 gathering of information is ongoing. Health Unit

eDEWS team contacted FP, 5 cases were reported , 2 females and 3 males , 4 cases AVH Aden Al Mualla Al-muala Pol. Clinic 5 0 from AL-mualla and 1 case from qallooa ,all cases treated symptomatically

eDEWS team contacted FP, cases were reported and one death case, all were adults , Al Buraihi , Al-Wali Hosp., Al- 2 cases from lahj and 1 case from abyan. The death case was a 20y old Female from Al Mansura, Ash DF Aden Wahdah Hosp., Al-Saeed Abyan referred from other private hospital , no sample collection, no investigation 16 2 Shaikh Outhman, Hosp., Saber Hosp. form. another death case was reported, it was a 156m Female from AL-mansura. 2 hours after admission patient died , no sample ,no investigation form.

eDEWS team contacted FP, 3 cases were reported. Cases were diagnosed clinically as Meng Aden Al Mansura Al-Saeed Hosp. Meningitis. Patient ages were 72m,36m,60m respectivly ,no further information about 3 0 them.

eDEWS team contacted FP, 3 cases were reported , 2 females and 1 male . 1st case was a 17m fmale from darsad ,vaccinated ,investigation form was done ,2 stool Ash Shaikh Outhman Al-Wahdah Hosp., Al-Wali AFP Aden samples were collected from the patient and 3 samples for the contacts. 2nd case was 4 0 , Al Mansura, Hosp. a 120m Male from dalehe ,vaccination status unknown , investigation form was done , still waiting for the samples . 3rd case was a 96m Female from Lahj

eDEWS team contacted FP, case was reported aged 66m, and 96mths, from Crater and Al-Maidan Pol. Cl., Hawilat Meas Aden Siera, Al Mansura, bureqa , vaccinated single dose , blood sample was collected ,investigation form was 2 0 Dispensary, done

Hashed Pol.Cl, Al-Maidan Pol. eDEWS team contacted FP, cases were reported , most of them were adults, 3children AVH Aden Al Mansura, Siera, 8 0 Cl., Al-Wali Hosp. less than 5 yrs. cases from different areas.

Focal point was contacted, the cases were diagnosed as suspected dengue fever by DF Abyan Zingibar Zingibar 5 0 case definition. Blood samples were collected for confirmation.

Focal point contacted, cases was diagnosed by case definition, vaccination status Meas Abyan Zingibar Zingibar 2 0 unknown, blood samples will be collected and send to Sanaa central lab

Focal point was contacted, the cases were diagnosed as suspected dengue fever by Alrazi Hospital , Lawdar DF Abyan Khanfir، Lawdar case definition. Blood samples were collected for confirmation. One case died befor 14 1 Hospital confirmation.

Focal point was contacted, the cases diagnosed clinically at outpatient clinic and Pert Abyan Lawdar Lawdar Hospital 2 0 treated accordingly, vaccination state is nil.

The suspected measles case was diagnosed by case definition,no blood sample was Meas Hadramout Al Mukalla City MCH Mukalla 1 0 collected , symptomatic treatment was given

Yahsob Hospital, Alkaida CL Ibb Yarim, Dhi As Sufal, eDEWS focal point was contacted. Case was clinically diagnosed and treated accordingly 2 0 Hospital

Alshaheed Albadani Hospital, eDEWS focal point contacted,the case was clinically dignosed and treated Pert Ibb Badan, Al Dhihar, 2 0 Dar AlShifa Hospital, accordinglly.Case was vaccinated.

Al Thawrah Hospital, Alnor eDEWS focal point was contacted. All cases were investigated by LP, the result was Meng Ibb Al Dhihar 7 0 Hospital, (no growth of bacteria). Cases were treated and improved

eDEWS focal point and coordinator were contacted.Information shared.Stool samples AFP Ibb Al Dhihar Al Thawrah Hospital were collected (2 samples from child,3 samples from contact children)and send to 1 0 central lab in Sanaa.Child and contact all were vaccinated

Dr. Waheeb Ata Hospital, Dar eDEWS focal point was contacted.After lab investigation all cases were positive AVH AVH Ibb Yarim, Al Dhihar AlShifa Hospital, Alnor 25 0 cases and treated accordinglly.Cases were from different areas Hospital,

Al Udayn, Al Dhihar, Al Udayn Hospital, Dar AlShifa eDEWS focal point was contacted.After investigation the cause of bloody diarrhea was BD Ibb 12 0 Dhi As Sufal Hospital, Dhi As Sufal Hospital due to amoeba and bacterial infections

eDEWS focal point and coordinator were conacted.Information shared.Sample was Dhi As Sufal, Al Dhi As Sufal Hospital, Meas Ibb collected and will be send to central lab in sanaa.case not vaccinated becaus her age 3 2 0 Makhadir Balfakeeh Hospital month

eDEWS coordinator contacted focal point, The suspected AFP cases from Al Marawiah Almarawea Hospital, Zabid AFP AlHodaidah Al Marawiah, Zabid, and zabid districts , samples were collected from the patient and his close contacts by 2 0 Hospital district coordinator and sent to the Central laboratory in Sana a.

Focal point was contacted , the suspected DF cases were diagnosed clinically. DF AlHodaidah Al Hawak AlAksa Hospital Medications have been started, samples were collected and will be sent to the 3 0 National lab in Sanaa

eDEWS coordinator contacted the hospital focal point, the case was diagnosed Pneu AlHodaidah Al Hawak Althawrah Hospital Pneumonia and treated accordingly, case died due to severe complications(Neglected 20 1 case).

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 42 ( 12 - 18 Oct 2015 )

Alert Responded in Epi-week 42, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eDEWS coordinator contacted the hospital focal point, the case was diagnosed Pert AlHodaidah Al Hawak Althawrah Hospital 1 0 suspected pertusis and treated accordingly.

eDEWS coordinator contacted the focal point. The suspected NNT case was diagnosed NNT AlHodaidah Al Hawak Althawrah Hospital clinically , complaining of fever , convulsion , inability to breast feed(sucking) , the case 2 0 still in Hospital under treatment.

Al Miftah Health Center, Qafl Al Miftah, Qafl eDEWS coordinator contacted focal points and informations were shared. The Shamer Hospital, Al Jomhori Meas Hajjah Shamer, Hajjah City suspected cases were diagnosed clinically. Blood samples have been collected and will 8 0 Hospital and Bani Qais Health and Bani Qais be sent to the central Lab. in Sana'a Center

Main Health Center, Old City, Al Wahdah, Alshaheed Center, Althawra eDEWS team contacted focal points and informations were shared. Cases were AVH Amana Assafiyah, Shuaub Hospital, Alrazi Health Center, diagnosed clinically in OPD, no lab confirmation for all cases. Appropriate treatment 31 0 and Aththaorah AlGoraf Complex and Shuaub was given, patients families educated about ways to avoid infection Complex

eDEWS team contacted focal point, the case was a 3 years, vaccinated , diagnosed Pert Amana As Sabain As Sabin Hospital 1 0 clinically . Antibiotic treatment was given

eDEWS team contacted focal point. Cases were diagnosed clinically and by lab. Sch Amana At Tahrir AlGomhori Hospital 14 0 Treatment was given. cases came from different areas

eDEWS team contacted focal points and informations were shared. Field investigation AlGomhori Hospital and AFP Amana At Tahrir and Maain was done and stool samples from cases and close contacts were collected for 2 0 Science University Hospital confirmation

eDEWS team contacted focal point, field investigation done. The suspected cases were Meas Amana Maain Main Complex diagnosed clinically, blood samples were collected from the cases and sent to central 2 0 lab for confirmation

eDEWS team contacted focal point. Case was diagnosed clinically and by lab. CL Amana Assafiyah Althawra Hospital 1 0 Treatment was given .

Baqim Hospital and At Talh BD Sada Baqim and Sahar Investigation on goining 13 0 Hospital

At Talh Hospital, Majz Health Focal points were contacted. The suspected cases were diagnosed as suspected Meas Sada Sahar, Majz and Sa'da 3 0 Center and Al Jomhori Hospital measles clinically. Symptomatic treatment was given.

Pert Sada Majz Majz Health Center Focal point contacted, case was diagnosed clinically, antibiotic treatment was given. 2 0

Sch Sada Majz Majz Health Center Focal point contacted, cases diagnosed clinically and treated accordingly. 6 0

Al Hekmah Dispensary, Thula eDEWS team contacted focal points and informations were shared. Cases were Raydah, Thula and AVH Amran Hospital, Al Rayan Dispensary diagnosed clinically in OPD, no lab confirmation for all cases. Appropriate treatment 20 0 Amran and Amran General Hospital was given, patients families educated about ways to avoid infection.

eDEWS team contacted focal point and informations were shared. Cases were Sch Amran Al Qaflah Al Qaflah Hospital 5 0 diagnosed clinically. Appropriate treatment was given.

eDEWS contacted focal point and informations were shared. The suspected cases Meas Amran Maswar Maswar Hospital diagnosed clinically using case difenation. Blood sample was collected. Appropraite 1 0 treatment was given

eDEWS contacted focal point and informations were shared. The suspected cases Pert Amran Amran Amran General Hospital 1 0 diagnosed clinically using case difenation. Appropraite treatment was given.

Amran General Hospital, Al Amran, Al Madan, Madan Hospital, Al Gnaya eDEWS contacted focal points and informations were shared. The suspected cases BD Amran Suwayr, Khamir and 20 0 Center, Al Salam Hospital and diagnosed clinically using case difenation. Appropraite treatment was given Huth Huth Hospital

Amran General Hospital, Amran, Raydah and eDEWS team contacted focal points. Cases were diagnosed clinically and by lab. CL Amran Raydah Hospital and Al 4 0 Al Madan Treatment was given Madan Hospital

eDEWS team contacted focal point and informations were shared. Stool samples were AFP Amran Amran Amran General Hospital 1 0 collected from the cases, and sent for confirmation

eDEWS contacted focal points and informations were shared. The suspected cases Meng Amran Khamir Al Salam Hospital 4 0 diagnosed clinically using case difenation. Appropraite treatment was given

Sanaa eDEWS Focal point was contacted after investigation all cases are positive for AVH. AVH Hamdan Shamlan Hospital 5 0 Governorate Cases were from different areas

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 42 ( 12 - 18 Oct 2015 )

Alert Responded in Epi-week 42, 2015

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

eDEWS contacted focal point and informations were shared. The suspected case Sanaa Meas Jihanah Al Dhwra Shaheed Hospital diagnosed clinically using case difenation. Blood sample was collected. Appropraite 1 0 Governorate treatment was given

Sanaa eDEWS team contacted focal point and informations were shared. Stool samples were AFP Bani Hushaysh Bait Al Hanmi Center 2 0 Governorate collected from the cases, and sent for confirmation

eDEWS contacted focal points and informations were shared. The suspected cases Teab Al Atfal Clinic and Al Pert Shabwah Ataq diagnosed clinically using case difenation. Appropraite treatment was given. Cases 4 0 Awal Medical Complex from differant areas

Teab Al Atfal Clinic, alkhor eDEWS contacted focal points and informations were shared. The suspected cases Ataq and Merkhah Al BD Shabwah health center and Al Awal diagnosed clinically using case difenation. Appropraite treatment was given. Cases 15 0 Ulya Medical Complex from differant areas

Dr Saleh Abdurahman Medical Ataq, Ar Rawdah, clinic, Ar Rawdah Hospital, eDEWS contacted focal points and informations were shared. The suspected cases Meas Shabwah Bayhan, Hatib and Bayhan Hospital, Hatib Health 6 0 diagnosed clinically using case difenation. Appropraite treatment was given Merkhah As Sufla Center and Al hageer Medical Center

eDEWS team contacted focal point and informations were shared. Cases were AVH Shabwah Merkhah As Sufla Khorah Medical Clinic diagnosed clinically in OPD, and by lab confirmation for all cases. Appropriate 7 0 treatment was given and patients families educated about ways to avoid infection

Azan Hospital, Habban Mayfaa, Habban, Hospital, Bayhan Hospital, eDEWS contacted focal points and informations were shared. The suspected cases DF Shabwah Bayhan, Jardan and Jardan Hospital, Al Rebath 42 0 diagnosed clinically using case difenation. Appropraite treatment was given Ataq Medical Clinic and Ataq Public Hospital

Salamatak Private Clinici, Al Ghaydah Center Hospital, Al eDEWS contacted focal points and informations were shared. The suspected cases DF Al-Mahra Al Ghaydah 34 0 Balsm Medical Centre and Ba diagnosed clinically using case difenation. Appropraite treatment was given Kreet Clinic

Al Ahkaf Dispensary, Sayun eDEWS team contacted focal points. Cases were diagnosed clinically and by lab. CL Hadramout wady Sayun and Tarim public Hospital and Thabe 4 0 Treatment was given Health Center

The case was reported in the last week ,he was died in the in sayeun hospital intensive AFP Hadramout wady Sayun Sayun public Hospital 0 1 department

eDEWS coordintor visted sentinel site after disuction whith physican about case and seen patient in same time and diagnosied clinicl ly as 1.after couphing Pert Dhamar Dhamar City Dr. Khaled BaWazir Clinic 1 0 vomiting.2.apnea.3.cyanosis.4.subcongunctive hemorrhage and all vaccine taken and from out Ibb and approprirae treatment has been started

،Dr. Khaled BaWazir Clinic Theba Dispensary، Al Helal eDEWS COORDINTOR contact and visted sentinel site after disuction whith physican AlAhmer Center، General AVH Dhamar Dhamar City about cases he found all cases diagnosief clinicaly and nd tested inlab all famaly patient 51 0 ،Dhamar Hospital Authority educated to avoid infection and approprirae treatment has been started .. AlMasli Hospital, Dr/Mohamed Mayas clinic

.Jabal Ash sharq، Madeena Alsharq Hospital، eDEWS coordintor contact focalpoint .patient is diagnosied AFP AFP Dhamar 2 0 Dhamar City Theba Dispensary all information is collected and sample from patient and contact .

eDEWS coordintor contact and visted sentenal site. after discution whith phesican and AlMasli Hospital , Dr. Khaled looking at file hefound allcases diagnosied clinicaiiy and some cases enter lab to tested BD Dhamar Dhamar City BaWazir Clinic, Dr/Mohamed 38 0 all result is sever infection bactreiea and amobae apprpritae treatment has been Mayas clinic started as metrinadizol and antibiotic

eDEWS coordintor visted sentinel site after disuction whith physican about cases he AlMasli Hospital ، General Meng Dhamar Dhamar City found all cases diagnosied cliniclly and high level WBC above 20000 and approprirae 14 0 Dhamar Hospital Authority treatment has been started as antibioti

eDEWS coordintor contact focal point .is case is male about 26yeares diagnosied CL Dhamar Utmah AlMedan Center 1 0 clinicaly and tested in lab is positive appropritae treatment has been started

eDEWS coordintor contact with this physcin who treat this case is femal2year when OAD Dhamar Jahran Ma`abr University Hospital enter site case is asever dehydretion.and stay for about 4 day all treat ment as 28 1 cefatroxen.ors..decinien.gentamysen all these not helpful. and death in 18-10- 15

eDEWS coordintor contact focal point case is male 8month death in same Time when Pneu Dhamar Al Hada Albaradouny hospital 3 1 enter site all treatment not helpful as sefatoxem .ivfluied.oxygen..

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.