Eiectronic Integrated Disease Early Warning and Response System Volume 08,Lssue08,Epi Week 08,(17-23 February,2020)

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 08,lssue08,Epi week 08,(17-23 February,2020)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-8,2020

% % %

96 96

100% 96 420000

96 96 90% 410000 •During week no.8,2020, %97(1991/1923) health facilites from 23 80% 70% 400000 Governorates provided valid surveillance data. 60% 390000 50% 380000

Percentage 40% 30% 370000 Consulttaions 20% 360000 10%

•The total number of consultation reported during the week in 23 0% 350000

Wk 2 Wk 3 Wk 4 Wk 5 Wk 6 Wk 7 Wk 8 Wk Governorates was 412575 compared to 411094 the previous reporting week 1 Wk

08. Acute respiratory tract infections lower Respiratory Infections (LRTI), Upper Reporting Rate Consultations Respiratory Infections (URTI), Other acute diarrhea (OAD) and Malaria (Mal) Distribution of Reporting Rates by Governoraes (Epi-Week 08,2020)

were the leading cause of morbidity this week. %

100

% %

100% %

98 99

% 100

90% 100

100

97 90

80% 93

90 95

70% 81 60% 50% 40% 30%

● A total of 1796 alerts were generated by eDEWS system in week 08, 2020, Of No. HF Reports 20% 10% these 1795 alerts were verified as true for further investigations with 0% appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 08,2020 Proportional morbidity of leading priority diseases, Epi week 08,2020

Guinea Worm ● (URTI) 15%, suspected Malaria (7.2%),(DD) (9.1%) and (LRTI) (5.6%)Remain the Scabies Chicken Pox leading causes of morbidity representing a total of (36.9%) Brucellosis HIV/ AIDS Tuberculosis RB CL ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than Sch VHF 1% of total morbidity in reporting period Bloody diarrhea represented 0.3% Of this DF Meng morbidity Mal Mumps AFP NNT AVH_B&C ● All diarrheal disease comprised 9.1% and LRTI 5.6% of total morbidity in pilot Governorates AVH_A&E Meas this week . Typhoid F OAD BD Pert SARI ILI ● All diarrheal disease comprised 9.1% and OAD 6.7% of total morbidity in all age group . LRTI URTI

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0%

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 النكاف :Mumps التيفوئيد أخرى :Typh أمراض أخرى :Others أنفلونزا على شكل وباء :ILI

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 08, (17-23 February,2020) Epidemiological Situation of Cholera and Diphtheria

GOV

Epidemiological curve of Diphtheria Cases with CFR% Overview of the Diphtheria From Wk1-WK8,2018,2019 and 2020 (Cumulative from WK1 ,2019 to WK8 ,2020)

Year2018 WK1-WK8 Year2019 ,WK1-WK8 Year2020 , WK1-WK8 المؤشر Indicator Suspected Cases 674 315 211 حاالت االشتباه Death Cases 22 17 16 حاالت الوفيات %CFR 3.20% 5.4% 8% معدل االماتة AR/10,000 0.2 0.1 0.01 معدل الهجمة/10,000 Confirmed cases 12 45 29 (from total tested(44) 43%from total tested(104) 59%from total tested(49%45 الحاالت المؤكدة بالمختبر Confirmed Death 0 1 2 (from tested total deaths(5) 40% from tested total deaths(5 %20 الوفيات المؤكدة بالمختبر Number of cases given Antitoxin 127 142 81 from total suspected 45% from total suspected 38% from total suspected %19 عدد الحاالت التي أعطيت مضاد السموم Affected Governorates 19Gov.(83%) 19 Gov.(83%) 19 Gov.(83%) المحافظات المتأثرة Affected Districts 141 Dist.(42%) 95 Dist.(29%) 81 Dist.(24%) المديريات المتأثرة Summary of Diphtheria indicators Distribution of Suspected and Death Diphtheria Cases by Age Group During Last 3 Weeks (6,7,8) Cases Death

50 3 8 4 40 0 30

20 53 50 44 1 39 10 0 0 15 0 3 7 (>50 Y) (36 - 50 Y) (26 - 35 Y) (16 - 25 Y) (11 - 15 Y) (6 - 10 Y)

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 08, (17-23 February,2020) Epidemiological Situation of Dengue Fever and SARI Overview of Dengue Fever From Wk1-WK8,2018,2019 and 2020 Epidemiological curve of Dengue Fever Cases with CFR% (Cumulative from WK1 ,2019 to WK8 ,2020)

Dengue IgM (Rapid Test) (Positivity Rate)2020 Distribution of Dengue Fever Death by Age group

Epidemiological curve of SARI Cases with CFR% Overview of SARI From Wk1-WK8,2018,2019 and 2020 (Cumulative from WK1 ,2019 to WK8 ,2020)

Deaths

Summary of SARI indicators Distribution of SARI Death cases by Age group from During Last 3 Weeks (6,7,8)

خالل الثالث األسابيع األخيرة During Last 3 Weeks المؤشر Indicator WK6-WK8,2020

Suspected Cases 400 حاالت اإلشتباة Death Cases 5 حاالت الوفيات CFR% 1.3% معدل اإلماتة Attack rate /10,000 0.1 معدل الهجمة / 10,000 Connfirmed Cases From all Lab Branches 0 الحاالت المؤكدة بالمختبر من جميع فروع المختبر Connfirmed Deaths 0 الوفيات المؤكدة بالمختبر Affected Governoate 10 Gov.(43%) المحافظات المتأثرة Affected Districts 29 Dist. (9%) المديريات المتأثرة

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-8 ,2020)

URTI LRTI mararia tested cases & confirmed 18.0% 7.0% 4000

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 1.0% 2.0%

wk1 wk3 wk4 wk5 wk6 wk8 wk7 0.0% 0.0% wk2

Rapid Test(Postive) Microscope(Postive)

WK2 WK3 WK4 WK5 WK6 WK7 WK1 WK8

WK1 WK2 WK3 WK4 WK6 WK7 WK5 WK8

Age and Sex distribution of total consultations of leading diseases (Epi week8,2020) Number of Alerts Received and Responded (Epi Weeks 5-8,2020)

100000

URTI LRTI Pert BD OAD Typhoid F 90000 86488 AFP Meas AVH_A&E AVH_B&C DF Meng 80000

Sch CL Chicken Pox Mal 70000 250

60000 56124 200 50000

39573 40000 38920 150 35462 33837 34394 33415

30000 28932

25587 100 No. of of No.Alerts

20000

50 10000

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 25587 34394 38920 56124 28932 Female 33837 35462 39573 86488 33415 Distribution of consultations of leading diseases by Governorates,Epi week 8-2020

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 3468 4479 1427 862 6397 1157 1160 1347 4983 2239 3157 2499 2349 4286 2877 4580 877 788 3137 3930 1627 89 4003 61718 LRTI 324 448 802 115 4964 225 238 753 1921 1069 1666 652 299 1973 1447 1401 269 162 612 1844 248 20 1785 23237 ILI 219 0 135 0 98 34 36 0 13 66 141 1 0 68 77 22 116 1 57 271 154 6 377 1892 SARI 0 0 4 0 1 0 0 0 20 0 72 0 0 0 3 0 0 0 3 0 0 0 0 103 Pert 1 3 0 0 0 16 6 5 3 9 4 1 5 0 1 9 2 0 10 3 2 0 11 91 BD 27 2 32 4 151 47 9 37 65 95 107 4 8 4 91 18 33 15 92 120 23 0 150 1134 OAD 1200 1643 753 618 1626 840 381 588 3101 1222 2383 866 467 1793 1565 1283 687 367 1370 2538 752 45 1495 27583 Typhoid F 47 42 255 8 366 120 18 149 618 262 1098 71 10 0 586 36 97 45 181 357 68 27 467 4928 Meas 0 17 1 2 3 0 1 6 17 5 1 6 2 10 5 2 2 3 4 0 8 0 7 102 AVH_A&E 7 7 4 1 1 2 1 2 111 10 27 30 7 1 21 13 0 4 12 18 11 0 23 313 AVH_B&C 5 1 4 0 0 1 0 1 75 11 9 3 1 4 26 0 3 0 1 1 15 0 12 173 NNT 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 AFP 0 0 0 0 3 0 0 0 3 0 0 0 0 1 4 0 0 1 0 1 0 0 3 16 375 28 1 8 44 43 1 13 10 25 17 9 7 األمراض المشتبهةMumps 11 24 5 7 6 8 0 20 54 7 27 Mal 59 546 3 3 19821 44 93 533 198 337 690 2 1 5167 398 81 6 246 541 173 4 0 945 29891 Meng 0 2 0 0 1 2 0 0 9 2 0 4 0 0 6 1 2 0 1 0 1 0 17 48 DF 14 324 4 7 1870 0 2 9 0 5 0 46 1 45 4 105 32 5 1 0 31 0 142 2647 VHF 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 Sch 1 0 0 16 5 17 0 25 66 53 29 7 2 104 7 5 0 18 38 38 2 0 33 466 CL 0 0 2 2 0 1 0 1 19 11 13 0 9 8 9 11 2 4 9 4 0 0 0 105 RB 0 0 33 0 7 2 0 25 115 29 88 3 3 6 73 2 0 1 1 5 0 0 6 399 Tuberculosis 2 4 1 1 10 0 2 1 8 0 9 0 0 3 9 2 0 1 1 9 0 0 3 66 HIV/ AIDS 0 0 0 0 0 0 0 0 4 0 0 1 1 0 0 0 0 0 0 0 1 0 0 7 Brucellosis 2 0 40 0 19 28 2 9 139 47 351 0 7 72 107 0 6 0 13 18 11 0 29 900 Chicken Pox 20 8 2 3 10 12 14 14 72 26 19 38 12 67 50 25 17 34 62 40 7 0 3 555 Scabies 13 1 1 0 34 0 1 12 26 30 20 1 2 27 0 2 7 7 39 26 1 2 3 255 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 4962 12543 5055 7967 16304 4120 2272 5601 54578 9359 19490 10833 4544 12918 14483 19081 4888 1192 6469 8727 5401 345 11552 242684 total_cons_disease 10433 20144 9140 9664 53016 6863 4241 9233 67561 16501 30625 15140 7736 27704 23433 26847 7094 3086 12917 19644 8363 535 22655 412575 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 08, (17-23 February,2020)

Alert Responded in Epi - Week 8,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Radfan Public H,Halimeen rural H,Almilah contact with the focal points, the cases of suspected cholera were diagenosed clinicaly according to Halimayn,Al Had,Al Musaymir,Radfan,Al Hospital,Almusaimeer H,Ibn Khaldoon Hospital,Habil case definition. Chol Lahj Hawtah,Al Maqatirah,Al Milah,Habil the cases reported immediatly to the operation room, recorded in the line list. 108 0 Aljubair ruralH,Tour Albaha Hospital, October public Jabr,Tur Al Bahah,Yaffa the cases treated by iv fluid, ors and antibiotic. H,Other the cases finaly left the health facility.

immediate reports was recived by the focal points, the cases of suspected pertussis were diagenosed clinicaly according to case definition. Pert Lahj Al Maflahy,Yahr,Yaffa,Radfan Makh Dispensary,Yaher rural H,Alhilal Dispensary 9 0 the cases reported immediatly to the operation room, recorded in the line list. the cases treated symptomaticaly and left the health facility.

Alhlal HC, Tur Sena'a Dispensary ,Halimeen rural eidews coordinator visited the health facility, the cases of suspected Dengue fever were diagenosed Radfan,Halimayn,Yaffa,Al clinicaly according to case definition. DF Lahj H,October public H,Ibn Khaldoon Hospital,Tour Albaha 105 0 Hawtah,Tuban,Tur Al Bahah Dengue igm were positive for7 cases Hospital The cases added to the line list, treared symptomaticaly and improved.

contact with the surveillance coordinator, the cases of suspected Diphtheria from the districts,the cases were diagenosed clinicaly according to case definition. Diph Lahj Al Had Alhaid rural H,Other the cases reported immediatly to the operation room, recorded in the line list. 14 0 the cases treated by antibiotic and improved. RRT supplayed contacts with erythromycin as prophlayxises

contact with the focal points, the cases of suspected measles were diagenosed clinicaly according to case definition. Meas Lahj Al Had Al Amal Health Center 2 0 the cases reported immediatly to the operation room, registerd in the line list. the cases treated symptomaticaly and left the health facility.

Aden German Hosp.,Almua'ala health complex,Al-Wali Al Mualla,Khur Maksar,Al Buraiqeh,Ash Hosp.,Al Ryadah Hosp.,Masafi Aden H,Alwahda eIDEWES team were contact by f.p, the cases were DF Aden Shaikh Outhman,AlMansura,Dar Sad, diagnostic clinically, treatment were given,The cases were different area 324 3 educational H,Durrat Aldar specialized H,Aden Sairah samples were not collected Investigation form were done,3 cases were dead Dispensary,Dar Saad Complex,Other

Alkalloa'a Complex.,Dar Saad Complex,Alwahda Al Mualla,Attawahi,Al Mansura,Dar eiDEWS team were contacted fp, the cases were diagnosed clinically,the cases were vaccination Meas Aden educational H,Khalefah Hospital,Albasateen medical except one case was un vaccination ,not samples were collected,treatment were given ,investigation 17 0 Sad,Sairah,Ash Shaikh Outhman center,Al Shifa'a HC,Maharik HC form were done.

eIDEWS team were contacted fp: The cases were diagnoses clinically ,investigation form were done,6 VHF Aden Al Mualla,Dar Sad Al Ryadah Hosp.,Durrat Aldar specialized H,Other 2 6 cases were dead

Pert Aden Ash Shaikh Outhman Alwahda educational H 3 1

Diph Aden Ash Shaikh Outhman Alwahda educational H 4 1

Chol Aden Dar Sad,Ash Shaikh Outhman Alwahda educational H 43 1

RRT in districts visited FP. in H and the suspected cases in villages to investigate the new cases of Mudiyah,khanfir,Rosod,AlMahfd,Sarar,Ah Mudiya Hosp.,Alrazi .H,Al Mahfad Hospital,Mahnf-Lwdr AWD there.all the cases from different villages of districts, the cases diagnosed clinically, RDT'S and Chol Abyan stool cultures didn't done or few cases negative by RDT, treatment were given, investigation forms were 49 0 war,Lawder,Jayshan Sibah H,Jishan HC,Spah HC done , the cases and their families received complete advices about the ways of prevention and management of cholera infection. the cases included in Cholera line list

RRT in Lawder district visited the Diphtheria case in Lawder H and investigated the Epi. situation in his village. The case was 1 male (Mosab Hussein Mohammed) 16 years old ,from Alsaeed Village (Amajel) Diph Abyan Lawder Al Azi Dispensary .He un-vaccinated. He received his management of Diphtheria in Alazi Dispensary and admitted in 1 0 Lawder H. as Antibiotic (P.Penicilline inj.) without Anti-toxoid (finished). The case diagnosed clinicaly and oral swab didn't collected, procain pencilline given in Diphtheria department

eIDEWS team contacted the FP. In Hospital. the cases diagnosed clinically (standard dengue case DF Abyan Rosod,Lawder Rassad H,Mahnf-Lwdr H definition), samples were not collected,RDT not done. treatment were given, investigation forms were 14 0 done

RRT visited the reported case in Lawdar city .the propable case was 1 male (Basheer Khaled Mohammed) 6 years old from Lawder city, he vaccinated. The case diagnosed clinically according to the Pert Abyan Lawder Mahnf-Lwdr H 1 0 standard case definition. he received antibiotics & regular interest . investigation form done , RRT in Lawdar district investigated the region for quick research on other new case

SabirAlMawadim,Maqbanah, Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al Sama,AtTaiziyah,AshShamayatayn,Hayfa Loqiah Hospital,Almsrakh Hospital,22 May Almodafar n, Jabal Habashy,Sharab ArRawnah, Chol Taiz HC,Mawih Hospital,Alnshmh H,MSF Hospital,Al Aroos 1515 1 AlMisrakh,Khadir,AlQahirah, AlMaafer, Hospital,22 MayHC,ArRomahcenter, Khalifa Mawiyah,AlMudhaffar, Salh,Sharab Hospital,Labs National Center,Other AsSalam,Dhubab

Pert Taiz Salh,At Taiziyah,Al Qahirah MSF Hospital,Yemeni - Suidi H 11 0

Al-Safwah Hosp.,Althwrh H,Mohammed Aldorah DF Taiz Salh,Sama,Jabal Habashy 142 1 HC,Other

Al Maafer,Jabal Habashy,Al Misrakh,At Meas Taiz Alsnh HC,Albrahat Mratibah HC,MSF Hospital,Other 7 0 Taiziyah,Salh

Jabal Habashy,Al Diph Taiz Albrahat Mratibah HC,Althwrh HC,Almkha Hospital,Other 13 1 Mudhaffar,AlMukha,Dhubab

AFP Taiz At Taiziyah,Al Qahirah,Salh MSF Hospital,Yemeni - Suidi H 3 0

Alshahr public H,Hajar aljoul rural H,Mifaa The EDEWS coordinator contacted the districts coordinator. The cases were diagnosed clinically by DF Hadramout Hajr,Broom,Ash Shahr,Al Mukalla City case definition. RDT were done. It were positive in 12 cases . the cases we're treated by supportive 46 0 HC,Hadramout modern hospital,Other treatment. all cases improved and discharged.

Ad Dis,Adh Dhlia'ah,Ghail Ba Wazir,Al The District RRT investigated the living area.The cases were diagnosed clinically by case definition the Meas Hadramout Alghurifatain HU,Shuhair HC,Other cases were vaccination except one case was un vaccination,blood samples were collected. 6 0 Mukalla City symptomatic treatment were given.

The district RRT visited the health facility. The case was diagnosed clinically. The case was vaccinated. Pert Hadramout Ash Shahr Al-Qods Dispensary 1 0 the case was treated by antibiotic.

Immediate report was sent by the EDEWS focal person. The cases were diagnosed clinically by case definition. the cases were from Hagr district. the cases were 2 males greater than 5 years. RDT was Chol Hadramout Al Mukalla City,Hajr Hajar aljoul rural H,Bin Sena'a educational H,Other 4 0 done. One was pisitive by RDT . one stool samples was collected and sent to central lab for culture. the result was negative. the cases were treated by fluids and ORS. the cases improved and discharged.

Alert Responded in Epi - Week 8,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

The EDEWS coordinator visited the health facility.The cases were diagnosed clinically by case definition. they study in the same school but in different clases. pseudomembrane were seen. no Bullneck . 2 Diph Hadramout Al Mukalla City Maternity and Childhood H - Mukalla 3 1 samples were collected and sent to central lab for culture. The result were negative. both cases were treated by antibiotic. the cases improved and discharged,one case was dead

Hubaysh,AsSaddah,FarAlUdayn,Ibb DhiAsSufal,ArRadmah,AlQafr,AlMakhadir YarimHospital,alHazmHospital,Alshaheed AsSayyani,AshShair,AnNadirah,Jiblah, AlbadaniHospital,AlradhmahH,AlmakhaderHC,AlqaidahH Immediate notification. eDEWS Coordinator visited hospital. the stool samples were collected 48 Chol Ibb positive by rapid test 861 0 AlDhihar AlUdayn,Yarim ,AlMashannah ,ALMzahanH,Yahsub Hospital,Aladin H,Mother and Child All cases were improved Mudhaykhirah,Badan, Hazm AlUdayn, H,Other AsSabrah

eDEWS focal points contacted.Information shared, Samples were Meas Ibb Al Udayn,Badan,Yarim,An Nadirah Aladin H,Yahsub Hospital,Other collected,the cases were vaccination except 2 cases were un vaccination 5 0

AlUdayn,AlMashannah,AlDhihar AFP Ibb Aladin H,Al Thawrah Hospital,Other Immediate notification, samples were collected and and send to sanaa,the cases were vaccination 4 0 AsSaddah

Immediate notification by focal point. Case was diagnosed clinically and treated accordingly. Case was Pert Ibb Yarim Yarim Hospital 1 0 not Vaccinated .

AlQanawis,AdDahi,AzZuhrah,Kamaran AlHawak,AlHali,AsSalif,AlMunirah Alhshm Center,Althawra public H,Almekhlaf HC,Alzaydia eDEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and AlMighlaf, AlGarrahi, Alluheyah Rural HAlsalakhana H,Alkanawes HC,Aldhahi Rural treated accordingly, isolation done , the cases take treatment and go out side hospital , Treatment use Chol AlHodaidah 1311 0 AsSukhnah,Zabid,AlMina,AlMarawiah H,Almansouria rural H,Bait Alfakih H,Alzaydia Rural WHO protocol DTC, cases done rapid test for sever cases (total rapid test done were 3 test, 10 test Bura,AlMansuriyah,AzZaydiyah,Bayt Al H,Aljarrahi rural H,Alluheyah HU,Other were positive Faqiah,Kamaran

Al Qanawis,Al Hali,AsSalif,Zabid, Al Hawak,Bayt AlFaqiah, AlMarawiah, AlkanawesHC,Alkanawes PrivateH, Aldhahi RuralH,Hais Focal points were contacted , they informed us that the suspected DF cases had a history of high fever AsSukhnah,AzZaydiyah,AlMina, rural Hospital,Hikmah hospital, Alsalif , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically. Medications have been DF AlHodaidah started, samples were collected in the lab of hospital for testing by serological test ( NS1) which this test 1870 6 AtTuhayat,Bura,AlMunirah,Alluheyah, Hospital,Alhodaidah Hospital,Al HabalHU,Almansouria measure the presence of dengue protein ( high sensitive & quality test) which detect the Antigen of virus Bajil, Ad Dahi,Al Mansuriyah,Az Zuhrah, rural H,Bajil Rural Hospital,Other that confirm the result,6 cases were dead Ad Durayhimi,Kamaran

eDEWS coordinator contacted the focal points, the cases were suspected measles which the cases Meas AlHodaidah Al Hawak, Az Zaydiyah Alhawk HC,Alzaydia Rural H were vaccination ,fever , rash recorded , the blood samples have been collected from the patient by 3 0 district coordinator and sent to the central laboratory in Sanaa.

Focal points were contacted , the suspected Diphtheria cases had a history of pseudo membrane Diph AlHodaidah Al Hawak Althawra public H around tonsillitis , and sever inflammation, the patient vaccination , was diagnosed clinically. Medications 7 0 have been started, ALL cases only depend on case definition,refer to ALthwora

eDEWS coordinator contacted focal point, The suspected AFP 3 child femels,first femel 5 month from –al Aldhahi have 3 doses of vaccine , Hospital recorded 18/2/2020 , secand femel 8 month from Hali have 3 doses of vaccine , Hospitalrecorded 17/2/2020 , Third femel 6 month frome Al marrawa have 3 AFP AlHodaidah Al Hawak Althawra public H doses of vaccine, Hospital recorded 18/2/2020 3 0 , stool samples were collected from the patient and his close contacts by district coordinator and sent to the Central laboratory in Sanaa

AflahAlYaman,HajjahCity,Najrah, Aljawana HU,Kadam HC,Ibn Roshd Dispensary Meas Hajjah KhayranAlMuharraq,AlMahabishah 10 0 ,Almahabesha Public H,Hajja Dispensary,Other Hajjah City,Qafl Shamer

AlMahabishah,KuhlanAffar,Mustaba BaniAlAwam,Kuhlan,AshSharaf Almahabesha Public H,Alshahel Rural AlMaghrabah,KhayranAlMuharraq Hospital,Almaghraba HC,Public Republican eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts. Information shared .It have Chol Hajjah AshShaghadirah,Najrah,AshShahil Hospital,Khatwah HC,Qafl Shamer Kufl-Shamar Rural been reported cases of suspected cholera , The cases were diagnosed clinically (Acute watery 558 0 AlMiftah,QaflShamer,BaniQais,Aslem,AlJ H,Bani Chamakh HC,Bani Qais Health Center,Mabyan diarrhea)It were given the appropriate treatment amimahMabyan,Abs,Hajjah Hospital,Kuhlan Afar HC,Other Kuaydinah,Aflah AshShawm

eDEWS coordinator contacted focal points, information shared, cases have been diagnosed clinically DF Hajjah Hajjah City,Abs Sauid Hospital in Hajja,Other .According to the standard definition DF ,the Cases from different areas , Some cases have been rapid 45 1 test work the result were positive Appropriate treatment were given

eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared . We received a report from Hospital, cases (suspected diphtheria) The diagnosis were clinically Diph Hajjah Abs,Al Mahabishah,Al Maghrabah AbsRuralHospital,AlmahabeshaPublicH,Other 3 0 (diphtheria),the cases were un vaccination,The response team in the field investigated the cases and the contacts and the appropriate treatment were given

AFP Hajjah Aslem Aslam HC 1 0

eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Aththaorah,Az'zal,Assafi'yah,AsSabain,M Al Mithaq Complex,ALRAHBI COMPLEX,Gazah case and sent for lab confirmation & the onset of fever,skin rash,the cases were unvaccinated against Meas Amana 17 0 aain,Shu'Aub Bani Al Harith,At Tahrir Complex,Maain Complex,Alrwdh HC,Aljomhwri H measles. Vit-A were given to the cases in order to support their immunity against complications of measles.

Rapid response team contacted focal points by eIDEWS coordinator,cases diagnosed clinically Alwahda Health Center,Arwdhah H,As Sabin Hospital,22 according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central AlWahdah,Aththaorah,Shu'Aub May Hospital,Jabr Bn Hyan Complex,Ottan Complex,Al labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most of them Chol Amana AsSabain,Assafi'yah,BaniAlHarith,MaainA were from Amana governorate & a few of them from other governorates from different districts of that 743 1 Jraf Complex,Omar Al Mokhtar Complex,Bni - Hwath z'zal,AtTahrir, Sana'aOld governorates,the results of stool C/s still pending. .Rapid tests of cholera were negative for most HC,Other collected specimens, so stool C/s not done for that samples.There were no collection or cluster of cases in the same Place,one case was dead

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,Zaid bn Sultan H 8 1 of neck lymph-nodes(Bull neck) & difficulty of swallowing & breathing. Antibiotic treatment was given & case management done.Throat swabs taken into Central Lab for confirmation(Albert stain,Gram stain & Diphtheria C/S)the cases were vaccination,one case was dead

eIDEWS coordinator contacted focal points,then HF visited. Information shared.Stool samples collected AFP Amana Maain,Assafi'yah Scinces and Tecnology H,Althwrh H 3 0 from the cases & sent for lab confirmation, the cases were unvaccinated against polio.

eIDEWS coordinator contacted focal points,information shared,then HF visited by eIDEWS coordinator.The cases diagnosed clinically according to the case definition. Antibiotics treatment were Pert Amana As Sabain,Shu'Aub As Sabin Hospital 3 0 given,the cases were unvaccinated against Pertussis. There were no collection of cases seen in the same place.

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 08, (17-23 February,2020) Alert Responded in Epi - Week 8,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

the edews focal points contacted , the cases were diagnosed clinically according to the standard case Diph Sa'adah Majz,As Safra,Sa'da Dhian HC,Damaj Hospital,Al Jumhoori Hospital definition ,the cases referred to the Diphtheria isolation in hospital , the cases receive the proper 8 0 management , the contacts traced by the district RRT , the line list updated and the information shared

Meas Sa'adah Saqayn,Majz,Kitaf wa Al Boqee Saqayn Hospital,Majz Health hospital 4 0

Pert Sa'adah Saqayn,Majz,Ghamir,Haydan Foot HC,Ghamer Health Center,Haydan Hospital 10 0

Munabbih,Shada,Ghamir,Sa'da Monabbih Rural Hospital,Ghamer Health Center,Ghafira edews focal point contacted , the cases was diagnosed clinically , no RDT performed and no samples Chol Sa'adah collected . the cases treated in the HC according to the management protocol the line list updated and 99 0 ,AdhDhahir,Razih Unit,Other the information shared

Thula Health hospital,Habur Healthhospital, Al Abraq JabalIyalYazid,AsSudah,Huth,Suwayr, Health Unit,Al Qaflah Rural Hospital,As Sawd Health Raydah, Thula,Sufyan,Habur Zulaymah, hospital,Raydah Health hos.,Al Ashah Health eidews Coordinator Contacted focal points , The cases were diagnoses clinically as suspected cholera. Chol Amran BaniSuraim,Khammer,Shaharah,Harf 232 0 hospital,Harf Sufyan H,Al Salam Khamir Hospital,Kharif according to case definition. All The cases improved After Taking The Treatments proper DhiBin,AlAshah,Amran,Kharif,AlMadan, Rural Hospital,Amran General Hospital,Huth Health Al Qaflah, AsSawd,Maswar hospital,Other

Eidews Coordinator Contacted focal points and Coordinator of Surveillance in districts , the s Were diagnoses clinically as suspected Measles. according to case definition. Blood Samples Were Collected Meas Amran Amran,Jabal Iyal Yazid,Thula,Maswar Hababah Health Center,Maswar Rural Hospital,Other 5 0 Of case and Sent to Central Lab in Sanaa for confirmation,the cases were vaccination except 2 Cases were under age Vaccinated

Eidews Coordinator Contacted focal points and Coordinator of Surveillance in district and visit health hospital Maswar and Rapid Response team district visit cases and investigation the Cases Were Pert Amran Maswar,Khammer Maswar Rural Hospital,Al Salam Khamir Hospital diagnoses clinically as suspected whooping cough.according to case definition. All The cases improved 9 0 After Taking The Treatments proper .All the cases were un Vaccinated except 2 cases were vaccination un known

Eidews Coordinator Contacted focal point and Coordinator of Surveillance in district and visit health hospital 22may the Cases Were diagnoses clinically as suspected Diphtheria . according to case Diph Amran Amran 22 May hospital 3 0 definition. Rapid response Team visit the contacts and gives antibiotics. The two cases improved After Taking The Treatments. and one case were transfer to the sanaa. the cases not Vaccinated

Eidews Coordinator Contacted focal point and visit health hospital 22may the Cases Were diagnoses clinically as suspected dengue fevere .according to case definition. Rapid Test were done for some DF Amran Amran 22 May hospital 5 0 cases the result were positive All The cases improved After Taking The Treatments proper. the cases from different areas

Sanhan,BaniHushays,AlHaymah Walan Hospital,22 May Hospital,Alar rural H,Awmara AdDakhiliyah,AlHusn,Nahm,Bani H,Alshaeed MohamedAldurraHospital,Alhanak HU,Bait eDEWS coordinator contacted focal points,The cases were diagnosed suspected cholera(AWD) cases Chol Sanaa Governorate Dhabyan,Khwlan,Manakhah,Hamdan, Alsaid HC,Almarbak HC,Hamdan Hospital, Bani Mansour 1348 0 tested by rapid test 83 case positive and cases were treated at the health facility and received treatment BaniMatar,AlHaymahAlKharijiyah,Jahanh, HC,Bait Alhenami HC,Qaa Al Sook Hu,Alshe'eb Alaswad Bilad Arus,Arhab,Sa'fan,Attyal HC,Other

The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case Pert Sanaa Governorate Arhab, Al Haymah Al Kharijiyah,Sanhan Alhayfa HC,July 17 Hospital 3 0 definition,the cases were vaccination unknown, The cases were treated with antibiotic.

The district RRT visited the health facility. The case was 168 months female The case was diagnosed AFP Sanaa Governorate Arhab Awmara H clinically by case definition. paralysis started in 17_2_2020. The case vaccinated 7 dose stool sample 1 0 was collected and sent to central lab

The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case Diph Sanaa Governorate Attyal,Jahanh Shawban HU definition.one case was vaccination and one case other was vaccinatioin unknown, The cases were 2 0 treated with antibiotic.

Teab Al Atfal Clinic,Salem Bahaj Clinic,Emergency/Ataq eIDEWS team were contacted with health facilities found suspected of measles,the cases were Meas Shabwah As sa,aid,Ar-rawdah,Ataq,Baihan diagnosed clinically according to case definition,the cases were un vaccination except 2 cases were 8 0 Hospital,Bayhan Hospital vaccination, samples were collection,the cases were received their best treatment and improvement

eIDEWS team were contacted with health facilities found the cases suspected of dengue fever from Al shareef Usaylan Clinic,Al Wafa Clinic,Rudum Rural different areas ,the cases were diagnosed clinically according to case definition rapid test were done for DF Shabwah Rodhoom,Osailan 31 0 Hospital,Usaylan Hospital some cases and rusalt one case was positive, all cases were received their best treatment and general condition improvement

eIDEWS team were contacted with health facilities found one suspected cases of pertussis the cases Pert Shabwah Ar-rawdah,Arma Al Redha Clinic,Arma Hospital were diagnosed clinically according to case definition,the cases were vaccination , cases were received 2 0 her best treatment and general condition were improvement

Emergency/Ataq Hospital,Al Talh Health Center,Bayhan eIDEWS team were contacted with health facilities found three suspected cases of cholera ,the cases Chol Shabwah Ataq,At'talih,Baihan were diagnosed clinically according to case definition, rapid test were positive for 3 cases, all cases were 8 0 Hospital received their best treatment and improvement

Sabah,AtTaffah,Naman,Mukayras, DhiNa'im,ALSharyah,AlMalagim,Radman Althwrh Hospital,Al-Taffah Center,Alshriah Sare H,Qaea eIDEWS team contacted focal points, the cases were diagnosed clinically as suspected cholera using case definition, rapid test 41 positive the main saing watery diarrhea &vomting some dehydration the Chol Al-Baidha AlAwad,AlQuraishyah,AlBaydaCity, Rada Center,Mother and child HC,Mukayras 576 0 paitnts ademittedt in the Centers and with ORS and IV fluid in good condation the cases from deferrnt Rada',WaldRabi',Nati,AzZahir,As Hospital,Other organ Sawadiyah, Ar Ryashyyah

IDEWS team contacted point intformation shared blood saeIDEWS team contacted focal point the cases diagnosed clinically according to case definition Antibiotics treatment were given the number of Meas Al-Baidha Sabah Zkhm HC cases were and one femal less than 5 years he ages 5 monthe and Apear skin rash in 18/2/2020 and 1 0 the fever in 16/2/2020 in respectively the case from Zkhm from ALhager villages and there are was collction of cases samples was cases and their are was vaccination against measls

eDEWS coorinator contacted focal point theIDEWS team contacted point information was non collected Samples the a case diagnosed clinically As suspected Diphtheria using case definition the onset in 14/2/2020 was given Antibiotic management the number of caes were one male ther ages Diph Al-Baidha Al Bayda City Althwrh Hospital 1 1 were 16 years the case was greater than 5 years the name he Ali Seif Saleh Aldbani the case from Albaydah he was non vaccination. agianst Dephther refer to Snaa and dead in 17/2/2020 in Nor Alhiah hospital

EDEWS team contact Edews focal points in Central Hospital ,the cases diagnosis according to case Pert Al-Mahra Al Ghaydah,Sayhut Al Ghaydah Center Hospital ,Sayhut Country Hospital defination , susspected Pertusus,the cases were un vaccination,treatment were given and RRT visit 6 0 cases and treatment all contact

EDEWS team contact Edews focal points in Central Hospital , the cases diagnosis according to case defination , susspected Diphtheria,the cases were un vaccination, treatment were given and send to Diph Al-Mahra Al Ghaydah,Sayhut Al Ghaydah Center Hospital 2 0 culture result were +ve RRT visst cases and treatment all contact

Alert Responded in Epi - Week 8,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

EDEWS team contact Edews focal point in `AlGhaydhah Central Hospital . cases from Qishen District Chol Al-Mahra Al Ghaydah Al Ghaydah Center Hospital ,cases diagnosis according to case defination , susspected Cholera case was in line list ,Cholera rapid 3 0 test was -ve ,treatment was given and send 1 sample to culture but result was -ve

EDEWS team contact Edews focal point in `AlAis Health Centre . case from AlMasilah District ,case diagnosis according to case defination , suspected Measles case was females (18) Meas Al-Mahra Al Masilah,Tarim Al Ais Health Centre,Bakhmais Clinic 3 0 months vaccinated only one dose of measles ,treatment was given , and serum sample was teken and send to central level ,

edews team contact focal points , the cases were diagnosed clinically as suspected (meas) using case definition , (1) name : Moed Sami Saeed Basaida .age 6 m , uder age vaccine . Fever onset 13/02/2019, blood sample collected Meas Hadramout wady Tarim Bakhmais Clinic (2) name: Khadija Mohamed Hussein, age 18 m , vaccine 2 dose,fever onset 16/02/2019, blood sample 2 0 collected Vit A provided . . symptomatic treatment were prescribed

edews team contact focal points , the cases were diagnosed clinically as suspected (pert) using case definition the cases were un vaccination except 2 cases were vaccination Pert Hadramout wady Sayun,Al Qatn,Tarim Al wady Health Unit ,Alkarya HC investigation and action by RRT 5 0 . symptomatic treatment were prescribed

Dawran Hospital,Alhumyat HC,Dhamar public H,A Unity AlManar,Jahran,Dhamar City,Dawran Centre (residential),Zeraja rural H,Meshrafa HC,Alrabo'o Aness,Anss Maghirib Ans EdeWS coordinator contacted focal points he found cases diagnosed suspected Chol(Acut watery Chol Dhamar banighulais HC,Althalouth HC,Rsabh Hospital ,Alkharba diarrhoea and dyhadretion) some cases tested by rapid test and result were postive for 21 cases - 564 0 AlHada,Utmah,Wusab AlAli,Wusab rural H,Aljarf HC,Kharbah Abuyabes HC,Alwahda cases were treated at the health facility and received treatment AsSafil Mayfa'at Anss,Jabal Ashsharq university H,Other

Pert Dhamar Jahran,Dhamar City Alwahda university H,Ezzan Center 4 0

Meas Dhamar Dhamar City A Unity Centre (residential) 1 0

contacted the contact and told us that suspected dengue cases had a history of high fever, back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for serological DF Mareb Harib,Sirwah,Marib City Harib Hospital,Al ghurairy center ,alhayat dispensary 32 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

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Al Jubah,Al wadi,Marib City,Harib Al May 22 Hospital,( al Wahdah ) Hospital,Harib Al clinically according to case definition.Stool samples collected from cases for screening test only . Chol Mareb 35 0 Qaramish,Raghwan,Bid Bidah Qaramish Hospital,Bid Bidah Hospital,Raghwan Hospital Supplements & antibiotics treatment were given(case management),the results of stool Rapid tests of cholera 7 positive .There were a no collection or cluster of cases seen in the same Place

The surveillance officer was contacted and it was confirmed that the diagnosis was based on the Pert Mareb Al wadi Al Kari Hospital definition of the case, where the number of suspected pertussis was 2 cases were investigated and 2 0 treated. all inlaid

eIDEWS coordinator contacted focal points,information's shared,then HF,cases visited by eIDEWS coordinator &Blood samples were collected from the cases and sent for lab confirmation, the onset of Meas Mareb Al wadi,Harib Al Qaramish Al Kari Hospital,Harib Al Qaramish Hospital 2 0 fever , skin rash ,one case was vaccination and one case other was vaccination unknown, & Vit-A were given to the suspected cases, in order to improve their immunity against complications of measles

EDEWS team contacted focal points,the Cases were diagnosed clinically as suspected pert.treatments Pert Al-Jawf Az Zahir,Al Matun Al Shifa Center,Al Qasabah Health Unit,Other 16 0 were given,the cases were un vaccines

Al Khalq,AlGhayl,Bi'rat Al Anan, Al Bart Al Anan Rural Hospital,Al Shifa Center,Al Khalq The EDEWS Coordinator received a report from the control officer that there were cases of the doctor's Chol Al-Jawf Maslob,Al Hazm,Kharab Al Marashi,Al diagnosis. It were cholera,the cases without a suspicious examination from different areas. After 131 0 Health Center,Al Marashi Health Center,Al Hazm Hospital Matun,Az Zahir validation. Treatments were treated according to the treatment plan

Milhan,AlMahwait,alKhabt Ar Rujum eIDEWS coordinator contacted focal points, information was shared.all cases were diagnosed clinically AljoumhwriH,AlArkobHC,HufashH,BaniSa`d according to case definition, few cases were investigated by rapid test for vibrio cholera and the result Chol Al-Mahweet Hufash,Shibam Kawkaban,Bani 95 0 Hospital,NumanHU,Hospital, Other were positive for 3 cases. appropriate treatment were given according to severity of symptoms and Sa'd,AtTawilah,AlMahwait City dehydration

eIDWES coordinator contacted focal points, information was shared.The cases were diagnosed clinically Meas Al-Mahweet Al Khabt,Shibam Kawkaban,Ar Rujum Alwast HU,Alahjer HC,Alrujm Hospital,Other according to case definition,,skin rash were appear, the cases were vaccinationa except one case was 4 0 un vaccination and one case other was vaccination unknownt ,the cases were collected and send to lab

eIDEWS coordinator contacted focal points, information was shared. all cases were diagnosed clinically Pert Al-Mahweet Hufash Hufash H according to cases definition. 3 cases were males and 2 cases were females . all cases were vaccinated 5 0 against pertussis, the focal RRT were send to investigate and treat any new cases

eIDEWS coordinator contacted focal points,information was shared. all cases were diagnosed clinically according to case definition. 2 cases were females and one case was male. all cases were not DF Al-Mahweet Al Khabt Bani Amarh HU 9 0 investigated by RDT for dengue fever. appropriate treatment were given according to severity of symptom

AlJabin,AlJafariyah,AsSalafiyah,Mazhar,K Alhadiah HC,Az Zilh HC,Althulaia H,Almithaq H,Wadi eIDEWS Coordination contact focal points in health centre,the cases were diagnosed according to case Chol Rayma definition as Acute Watery Diahorea cases, 193 0 usmah,Bilad AtTa'am, Alarid HC,Other ) most cases treatment at home

eIDEWS coordinator contacted focal points, all cases were diagnosed clinically according to cases Meas Rayma Al Jafariyah,Kusmah Kusmah HC,Other 3 0 definition,the cases were vaccination,.

DF Rayma Al Jabin Althulaia H eIDEWS team contacted focal points, the cases were diagnosed clinically using case definition 5 0

case -Lamia Yahya Ahmed Mohamed appat Date of paralysis 15 /2 /2020 -age 14 mmont - / 13/ AFP Rayma Mazhar Az Zilh HC 2/2020 coordinater contact wth focal point stool sample collected 14/2 / 2020 and sent at or lab 1 0 confirmation the last how v acented poillo many 3 dos

Al Azariq,Juban,Qa'atabah,AlHussein, eDEWS team contacted FP,all cases were diagnosed according to case definition, all included in Chol Al-Dhale Aamwr HU,Alfakhr HC,Damt HC,Alnassr H,Other 69 0 Ad Dhale'e,Damt updated daily line listing

eIDEWS team were contacted fp: diagnoses clinically, vaccination were done, samples were collected , Meas Al-Dhale Juban,Qa'atabah 22 May Hospital,Alslam H 2 0 treatment were given, investigation form were done.

eDEWS team conted focal point information shared inve stigation forms and lab samples and waiting for DF Al-Dhale Ash Shu'ayb, Alshaib Dispensary results cases opriate treatment was appro cases were 5 males their given were Greater than 5 years 7 0 ages they came from other they governorates