Week 16 2019.Pdf

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,lssue16,Epi week 16,(15-21 April,2019)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-16,2019

% % % %

96 96 96 96

95 95 95 95

% 94

100% 94 400000

93 93 90% 350000 80% 300000 70% •During week no.16,2019, %95(1991/1882) 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 1 Wk 5 Wk 9 Wk Wk 2 Wk 3 Wk 4 Wk 6 Wk 7 Wk 8 Wk

Wk13 Wk14 Wk 11 Wk 12 Wk 15 Wk 16 •The total number of consultation reported during the week in 23 Governorates was Wk 10 3500062 compared to 379820 the previous reporting week 16 . Acute respiratory tract Reporting Rate Consultations

infections lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Distribution of Reporting Rates by Governoraes (Epi-Week 16,2019)

% %

100% %

100

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

100

100 100

90% 100

100

96 95

% 92

week. 80% %

83 89

70% 82 60% 50% 40% 30%

20% No.HF Reports 10% ● A total of 1947 alerts were generated by eDEWS system in week 16, 2019, Of these 0% 1946 alerts were verified as true for further investigations with appropriate response

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 16,2019 Proportional morbidity of leading priority diseases, Epi week 16,2019

AVH_A&E; 0.1% AFP; 0.0% Typhoid F; 1.4% Mumps; 0.2% Mal; 4.7% DF; 0.1% ● (URTI) 14.3%, suspected Malaria (4.7%),(OAD) (10.5%) and (LRTI) (5.8%)Remain AVH_B&C; 0.0% Sch; 0.2% Meas; 0.1% RB; 0.0% Meng; 0.0% Brucellosis; 0.3% the leading causes of morbidity representing a total of (53.7%) Chicken Pox; 0.3% 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 0.4% Of this OAD; 10.5% morbidity

● All diarrheal disease comprised 18.4% and LRTI 5.8% of total morbidity in pilot Governorates BD; 0.4% this week . SARI; 0.0% URTI; 14.3% Pert; 0.0%

ILI; 0.6% ● All diarrheal disease comprised 18.4% and OAD 10.5% of total morbidity in all age group . LRTI; 5.8%

Measles Situition in Yemen Distribution of Governorate Measles cases & Deaths , Epi weeks1- 16,2019 Epi Curve of Measles in Yemen During 2017,2018,2019,

800 900

700 800

600 700

500 600

400 500 300 400 200 300 100 200 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 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 16 (15-21 April,2019)

GOV

Distribution of suspected cholera cases by age group (1 Jan – 28 April 2019) Distribution of associated deaths by age group (1 Jan – 28 April 2019)

Maps Officer / Fawaz Al-Khalidi - Mobile (771422601) Distribution of suspected and deaths cases by age and sex From 1 Jan to 14 April 2019

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 16 (15-21 April,2019)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-16 ,2019)

URTI LRTI mararia tested cases & confirmed Epi weeks 1-16,2019

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% 0

0.0%

wk3 wk8 wk2 wk4 wk5 wk6 wk7 wk9

0.0% wk1

wk13 wk10 wk11 wk12 wk14 wk15 wk16

WK1 WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK10 WK11 WK12 WK13 WK14 WK15 WK16

WK2 WK3 WK4 WK5 WK6 WK7 WK8 WK9

WK1 Rapid Test(Postive) Microscope(Postive)

WK15 WK10 WK11 WK12 WK13 WK14 WK16

Age and Sex distribution of total consultations of leading diseases (Epi week 16,2019) Number of Alerts Received and Responded (Epi Weeks 13-16,2019)

80000

73103 URTI LRTI Pert BD OAD Typhoid F

70000 AFP Meas AVH_A&E AVH_B&C DF Meng

60000 Sch CL Chicken Pox Mal 300

50000 46855 250

40000 34808 33351 200 31460 32357 30000 28455 25531 150 22065 22077

20000 No.of Alerts 100

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 22065 31460 33351 46855 25531 Female 22077 32357 34808 73103 28455 Distribution of consultations of leading diseases by Governorates,Epi week 16-2019

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 2229 3627 1332 939 5554 1131 523 734 4916 1916 2416 1737 1716 3458 2241 3365 805 560 3199 3145 1123 85 3146 49897 LRTI 276 505 855 291 3930 387 50 425 1997 952 1346 386 291 1527 1368 1410 236 187 852 1243 342 32 1495 20383 ILI 381 1 79 0 228 62 0 20 24 34 111 0 0 453 112 0 115 0 59 116 203 4 240 2242 SARI 0 0 5 0 0 0 0 1 5 0 65 0 0 12 2 0 0 0 37 0 0 0 0 127 Pert 0 5 0 0 1 10 0 0 0 5 0 2 0 0 0 10 0 0 9 6 3 0 15 66 BD 60 34 47 20 93 88 0 87 77 172 126 1 7 5 102 30 47 17 92 158 47 0 150 1460 OAD 1248 1831 1276 596 1973 1116 347 756 6352 1700 2688 409 441 3222 2350 1500 465 440 1959 2701 689 32 2727 36818 Typhoid F 68 55 337 16 438 189 3 106 750 286 681 42 12 3 630 56 96 87 259 336 85 34 437 5006 Meas 6 16 1 5 7 8 2 0 8 15 2 8 8 17 3 7 1 0 24 20 1 0 18 177 AVH_A&E 15 28 3 2 3 3 0 5 111 5 49 14 10 0 15 14 0 0 0 16 12 0 17 322 AVH_B&C 3 0 1 0 2 3 0 0 41 0 6 1 0 12 23 0 3 0 0 1 1 0 12 109 NNT 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 3 AFP 0 1 0 0 0 0 0 1 3 0 1 0 1 2 1 0 0 0 1 0 1 0 2 14 545 47 0 17 23 38 2 8 12 16 49 72 42 األمراض المشتبه12ة Mumps 13 16 19 27 31 12 9 21 48 11 Mal 32 297 17 0 9117 155 6 493 110 341 456 1 0 2546 359 52 5 152 721 152 36 0 1234 16282 Meng 0 2 0 0 0 0 0 0 4 0 1 2 0 0 11 0 0 0 0 0 1 0 15 36 DF 39 101 0 3 91 0 0 1 0 0 0 75 1 1 0 50 44 0 0 0 20 0 20 446 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 2 0 0 25 7 15 0 29 52 81 34 5 2 138 14 5 0 12 72 41 0 0 16 550 CL 0 0 4 4 1 5 0 0 2 2 20 0 1 5 2 5 2 5 15 5 0 0 4 82 RB 0 0 2 0 1 0 0 3 63 0 67 1 2 7 10 1 0 0 0 4 0 0 8 169 Tuberculosis 8 2 0 0 2 4 0 1 5 2 7 0 0 6 7 1 2 0 2 2 0 0 9 60 HIV/ AIDS 0 0 2 0 0 0 0 1 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 Brucellosis 4 0 65 0 11 67 0 3 210 63 219 0 9 72 85 0 14 1 32 13 11 0 30 909 Chicken Pox 13 29 13 26 25 54 4 21 102 127 49 11 29 113 57 14 18 24 173 65 50 0 43 1060 Scabies 14 2 8 4 89 0 0 7 14 7 25 2 1 35 5 2 0 9 47 13 0 4 12 300 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 4302 11608 4562 5253 12126 2798 1384 2618 40510 5685 16703 5715 4343 8933 14264 6928 4092 856 5137 6772 4855 241 11454 181139 total_cons_disease 8793 18514 9800 8108 35351 6772 2351 6906 59301 13400 29306 10030 7024 23741 24266 14295 5887 2638 13901 18061 7590 432 23595 350062 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 16 (15-21 April,2019)

Alert Responded in Epi - Week 16,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Immediate report was recived by the FP , the Cases of suspected whooping cough were diagenosed clinicaly according to CD. Pert Lahj Radfan,Tuban,Al Milah Makah Clinic,Alsharif Health Center,Alraha HU 10 0 The Cases were un vaccinated except one case was vaccination Cases treated symptomaticaly and left the HF.

Eidews coordinator visited the HF , the cases of suspected cholera were diagenosed clinicaly according to CD. Al Milah,Al Maqatirah,Radfan,Al Had,Al Almilah Hospital,Najd Alkarba HU,Alanbwa HC,Radfan Public RDT Negative except 49 cases were positive Chol Lahj Maflahy,Yaffa,Halimayn,Tur Al Bahah,Habil H,October public H,Karesh Health Center,Tour Albaha 162 1 Cases reported immediately to OR , registerd in the LL. Jabr,Al Musaymir,Al Qabbaytah Hospital,Halimeen rural H cases treated by iv fluid ,ors and antibiotic. Finaly Cases discharged.one case was dead

Contact with the FP ,the cases of suspected measles , the cases were diagenosed clinicaly according to CD. Al Musaymir,Al Maqatirah,Radfan,Al Had,Al Meas Lahj Radfan Public H,MCH Hawtah,Halimeen rural H The cases were vaccinated except 2 cases were un vaccination 7 0 Hawtah,Halimayn Cases reported immediately , added to the LL. Cases treated symptomaticaly and left the HF.

The focal points contacted ; information shared , the cases of suspected Dengue fever , the cases were Alwaht rural H,Habil Aljubair rural H,Tour Albaha DF Lahj Habil Jabr,Tur Al Bahah,Tuban,Halimayn diagenosed clinicaly according to CD. 50 2 Hospital,Halimeen rural H,Other Cases recorded in the LL , treated symptomaticaly and improved, 2 cases were dead

eiDEWS team were contacted fh :The cases were diagnosis clinically, the cases were vaccination Pert Aden Ash Shaikh Outhman,Al Mansura,Al Mualla Alwahda educational H,Dr.Muna Clinic,Alburaihi H,Other unknown excpt one case was vaccinated and one case ather was un vaccination and the most samples 5 0 were unknown collected , treatment were given, investigation from were done.

eiDEWS team were contacted fh :The case was diagnosis clinically, vaccination unknown and sample, Diph Aden Ash Shaikh Outhman Alwahda educational H 1 0 treatment was given, investigation from was done.

eiDEWS team were contacted fh : the cases from different places, the cases were diagnosis clinically, 16 cases were vaccination and ather cases were vaccination unknown and 6 cases were positive by Chol Aden Ash Shaikh Outhman,Dar Sad,Al Mansura Alwahda educational H,Albasateen medical center 266 2 RT, the most samples were unknow collected, treatment were given, investigation from were done.2 cases were dead

Ash Shaikh Outhman,Al Alwahda educational H,Hashed Health Complex,Alkawd eiDEWS team were contacted fh :The cases were diagnosis clinically, the cases were vaccination Meas Aden Mansura,Attawahi,Al Buraiqeh,Sairah,Dar Alothmani Complex,Altwahi Health Complex,Alburaika Health unknown and samples but 8 cases were vaccinated , treatment were given, investigation from were 16 0 Sad Complex.,Babl Hospital done.

Alwahda educational H,Hwailat Dispensar,Masafi Aden H,Al- eiDEWS team were contacted fh : the cases from different places and ages, the cases were diagnosis Ash Shaikh Outhman,Al Buraiqeh,Al DF Aden Wali Hosp.,Khalefah Hospital,Aden German Hosp.,Babl clinically, the cases were vaccination unknown and samples, treatment were given, investigation from 101 0 Mualla,Al Mansura,Sairah,Dar Sad Hospital,Al Ryadah Hosp.,Durrat Aldar specialized H,Other were done.

eIDEWES team was contact fp, the case was diagnoses clinically, Sample was collected, vaccination AFP Aden Al Mansura Dr.Muna Clinic 1 0 was done, treatment was given, investigation form was done.

eIDEWES team were contact fp, the cases were diagnoses clinically, samples were collected, VHF Aden Al Mansura Alburaihi H 2 0 treatment were given, investigation form were done

eIDEWS team contacted the F.P. The cases were vaccination except 2 cases were un vaccination , Meas Abyan Zungobar,Sarar,Rosod,khanfir Mother and child HC,Sirar HC,Rassad H 6 0 Blood Samples collected and waiting for send to Sana,a city

eIDEWS team contacted the F.P. , the cases were diagnosed clinically, RDT'S were positive in 34 Al Al Mahfad Hospital,Mahnf-Lwdr H,Alrazi .H,Mudiya cases only, and stool cultur not done, treatment were given, investigation forms were done , the cases Chol Abyan Mahfd,Sarar,Ahwar,Zungobar,Rosod,Mudiya 80 2 Hosp.,Rassad H,Zunjopar H,Ahwr H,Sirar HC and their families received complete advices about the ways of prevention and management of cholera h,khanfir,Lawder,Jayshan infection. the cases included in Cholera line list,2 cases were dead

eIDEWS team contacted the FP.. all the patients came from different villages of district,the cases were DF Abyan Al Mahfd,Lawder Al Mahfad Hospital,Mahnf-Lwdr H diagnosed clinically (standard dengue case definition), samples were not collected, treatment were 39 0 given, investigation forms were done.

Sharab Ar Rawnah,Al Misrakh,Khadir,Al Qahirah,Al Maafer,Sama,Mawiyah,Al Rapid response team contacted also focal points by eIDEWS coordinator,cases diagnosed clinically Al Aroos Hospital,22 May HC,Ar Romah center,Almodafar according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Mudhaffar,Salh,Sharab As Chol Taiz Hospital,Aljoumhri H,Khalifa Hospital,Al Loqiah Hospital,22 labs)for confirmation. Supplements & antibiotics treatment were given(case management)all of them 1372 3 Salam,SabirAlMawadim May Almodafar HC,Mawih Hospital,Other were from taiz governorate &,the results of stool C/s still pending. .the details of rapid test results are in Maqbanah,AtTaiziyah,AshShamayatayn, the line list.There were collection & cluster of cases in the same Place, 3 cases were dead Hayfan,Jabal Habashy,AlMukha

eIDEWS coordinator contacted focal points and the coordinator of the directorate ,information's Al Mudhaffar,Al Qahirah,AlMukha,Al Al Loqiah Hospital,Al wahdah HC,MSF Hospital,Almsrakh Meas Taiz shared.Blood samples were collected from the cases and sent for lab confirmation & the cases were 18 0 Mawasit,Mashraa Wa Hadnan,Al Misrakh Hospital,Almkha Hospital,Other vaccination except one case was vaccination unknown All data in the line list.

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

Rapid response team and Focal points was contacted by eIDEWS coordinator ,,,, information's shared. AFP Taiz Al Qahirah Yemeni - Suidi H 2 0 samples were collected ,, and will be send to sana'a, the cases were vacination unknown

Focal points and the coordinator of the directorate were contacted ,, the suspected DF cases had a history of high fever , retro- bulbar pain ,myalgia and arthralgia, cases were diagnosed clinically.and by DF Taiz Al Qahirah 22 May H,Aljoumhri H,Mohammed Al-Dourah HC,Altawn H 20 0 blatelets 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..

Immediate report was sent by the EDEWS focal person. The diagnosis are made by clinical Ghail Ba Wazir,Al Mukalla City,Qhail Ben University Hospital,Ad Dis Al-Shrgyah Hospital,Ghail manifestation according to case definition. The cases were vaccinated but 2 cases were un vaccination Meas Hadramout 8 0 Yameen,Ad Dis Bawazeer H and one case ather was vaccination unknown . blood samples were collected. Symptomatic treatment were given

The district RRT investigated the living area. . The cases are diagnosed clinically as AWD. The cases were in moderate dehydration. RDT were done 3 cases were positve. Stool culture were collected by Chol Hadramout Ad Dis,Al Mukalla City Maternity and Childhood H - Mukalla,Bin Sena'a educational H 4 0 Carry_Blair media and sent to central lab. The result is pending. The cases were admitted to the isolated room. IV flid,cover antibiotic and ORS were given.

Radfan HU,Bin Sena'a educational H,Hadramout modern The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case DF Hadramout Ghail Ba Wazir,Broom,Al Mukalla City 75 0 hospital,Al-Hayath Dispensary,Other definition. . All cases were treated by symptomatic treatment All cases improved.

The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically as suspected Pert Hadramout Al Mukalla City University Hospital pertusis (by pediatric specialist). The cases one male (2) months and one female(60) months. The 2 0 cases came from different areas. Both cases are un vaccinated. Antibiotic treatment were given.

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 16 (15-21 April,2019) Alert Responded in Epi - Week 16,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Al Udayn,Yarim,AlMashannah Hubaysh,As Saddah, Far Al Udayn,Ibb,DhiAsSufal Immediate notification. eDEWS Coordinator visited hospital. stool samples were collected 166 positive AL Mzahan H,Yahsub Hospital,Aladin H,Mother and Child ArRadmah,Mudhaykhirah Badan,Hazm Al and ather samples were negative by rapid test . Chol Ibb H,Yarim Hospital,al-Hazm Hospital,Alshaheed Albadani 2608 9 Udayn,As Sabrah,AlQafr,AlMakhadirAs Hospital,Alradhmah H,Almakhader HC,Alqaidah H,Other Sayyani,Ash Shair,An Nadirah,Jiblah,Al All cases were improved,9 cases were dead Dhihar

eDEWS focal point contacted.Information shared Meas Ibb As Saddah,Al Dhihar Swadah HC,Other 3 0 . Samples were collected . the Cases were vaccinated

Immediate notification by focal points. Case was diagnosed clinically and treated accordingly Rapid response team visited village of infected persons for reaserch another cases ,treated contact Diph Ibb As Saddah Other 1 0 persones,and health education. case was unVaccinated

Immediate notification.Patient name Nabil Mohammed Ahmed Alsari. 18 months ,old male.From

AFP Ibb Yarim Yahsub Hospital 1 0 Yarim /-Rebate Alqla'a - Bani Monabh - Date of notification 21/4/2019.Date onset of symptoms 19/4/2019.samples ( 2 from case ,and send to sanaa,number of vaccinated 5 doses

Bura,Al Mansuriyah,AzZaydiyah,Bajil,Bayt Alsalakhana H,Alhshm Center,Alkanawes HC,salam Al Faqiah,Al Qanawis, Ad Dahi,Az Zuhrah, Chol AlHodaidah center,Aldhahi Rural H,Almansouria rural H,Bait Alfakih 1468 1 Al Hawak,Al Hali, Al Mina, As Salif,Al H,Alzaydia Rural H Munirah,Alluheyah,Al Hajjaylah,Al Mighlaf

Alzaydia Rural H,Zabid rural Hospital,Althawra public DF AlHodaidah Az Zaydiyah, Al Hawak,Al Hali,Zabid,Bajil 91 0 H,Alamal Hospital

Diph AlHodaidah Al Hali, Al Hawak Shamsan Center,Althawra public H 5 0

Meas AlHodaidah Al Hali, Al Hawak Almughtaribeen HC,Althawra public H,Alhawk HC 7 0

Pert AlHodaidah Al Hawak Althawra public H 1 0

Najrah,AshShahil,QaflShamer,BaniQais,AlMi ftah,Qarah,Aslem,AlJamimah,AflahAshShaw Mabyan Hospital,Public Republican Hospital,Khatwah HC, eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared .We m,Mabyan,HajjahCity,Abs,Haradh,Hajjah,Ku Bani Chamakh HC,Bani Qais Health Center,Kuhlan Afar received a report of cases suspected cholera , The cases were diagnosed clinically (Acute watery Chol Hajjah aydinah,Al Mahabishah,Kuhlan HC,Almahabesha Public H,Alshahel Rural 3023 10 diarrhea). Rapid Test were done for some cases, the result were positive .The Cases from different Affar,Mustaba,Bani Al Awam,Kuhlan Ash Hospital,Almaghraba HC,Qafl Shamer Kufl-Shamar Rural areas. It were given the proper treatment of cases,10 cases were dead Sharaf,Al Maghrabah,KhayranAlMuharraq, H,Other AshShaghadirah

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It were Mabyan,AshShaghadirah, Ash Shaghadira Health Center,Public Republican diagnosed clinically according to standard definition For measles, the cases were un Vaccinated, Meas Hajjah HajjahCity,KuhlanAshSharaf 17 0 Hospital,Kuhlan Alsharaf Dispensary,Abs Rural Hospital,Other Investigation form wereDone,Appropriate treatment were given. The samples were collected and sent to ,KhayranAlMuharraq,Abs ,Aslem the central laboratory

eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared. We received a report from Abs Rural Hospital , the cases (suspected diphtheria) The diagnosis was clinically Diph Hajjah Abs,Washhah Abs Rural Hospital,Other 7 0 (diphtheria). Males 3 cases, and 3 females. All cases more than five years . Cases from different districts , the cases were un vaccinated, Appropriate treatment were given

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It were Abu Hadi Specialized Poly in Souk Alaman,Sauid Hospital in AFP Hajjah Najrah,Hajjah City diagnosed clinically according to standard definition For AFP, Investigation form were Done. Appropriate 2 0 Hajja treatment were given. The samples were collected and sent to the central laboratory

Rapid response team contacted focals by eIDEWS coordinator & HF visited,cases diagnosed clinically Alkwit educational H,Alshaheed Complex,Altabri HC,Alraisi according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab (Central Aththaorah,Shu'Aub,Assafi'yah,BaniAlHarith, HC,Jabr Bn Hyan Complex,Omar Al Mokhtar Complex,Jddr labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most of them Chol Amana AsSabain,MaainAz'zal,At Tahrir,Sana'a HC,Azal Complex,Ibn Khaldon HC,Al Jraf Complex,As Sabin were from Amana governorate & a few of them from other governorates ,different districts of that 3942 7 Old,AlWahdah Hospital,22 May Hospital,Shaheed Abdo Qader Ali Hilal governorates,the results of stool C/s still pending. Rapid tests of cholera were negative for most Complex,Gazah Complex,Scinces and Tecnology H,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.7 cases were 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 As Sabain,Maain,Bani Al Harith,Aththaorah As Sabin Hospital,ALIRAQ HEALTH CENTER,Other 5 0 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 vaccinated

eIDEWS coordinator contacted focal points,then HF visited. Information shared,Stool samples collected AFP Amana As Sabain As Sabin Hospital from the cases and sent for lab confirmation.The date of onset of AFP, the cases were 3 0 vaccinated,There were no collection of cases seen in the same place.

eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the Aththaorah,Az'zal,Al Al Jraf Complex,Azal Complex,Almutwkl H,Iraqi HC,Alrazi cases and sent for lab confirmation . the cases were unvaccinated except one case was vaccinated Meas Amana 8 0 Wahdah,Assafi'yah,Shu'Aub HC,Other against measles. Vit-A was given to the cases,in order to support had immunity against complications of measles.

As the edews focal points contacted . the cases were diagnosed clinically and treated in the HF. Safra,Majz,Munabbih,Qatabir,Baqim,Ghamir Dhian HC,Monabbih Rural Hospital,Al Ghabir Health the RDT performed for cases all of them were negative except 31 cases were positive Chol Sa'adah 930 0 ,Razih,Sahar,Sa'da ,Kitaf wa Al Boqee,Adh Unit,Ghamer Health Center,alhamazat center,Other . Dhahir the RRT health and wash contacted to respond and perform their activities

Sudan Health Unit,Dr. Mosfir Clinic,Majz Health hospital eIDEWS contacted to respond to cases suspect measles , the HF visited the cease, all ceases Meas Sa'adah Sahar,Sa'da ,Al Hishuah,Majz,As Safra 24 0 ,Dhian HC,Wadeah HC,Al -Talh Hospital,Other dignosed callinically , the cases were un vaccination except one case was vaccinated

the edews focal points contacted . the case diagnosed clinically (patient name :Kamal Ali Saleh )5 years old male patient , unvaccinated . Diph Sa'adah Sa'da Al Jumhoori Hospital 1 0 the case was isolated and recive treatment by antitoxine and suportive care in Aljumhori hospital . the contact traced by Haydan district RRT . the line list updated and sheared

edews coordinator conduct the focal in dahyan after report of cases pertusess cases , the cases were Pert Sa'adah Majz,Haydan Dhian HC,Khamis Marran Health Center,Other 9 0 diagnsed clinically and treated in the health center

the edews focal point contacted , the health facility visited and the investigation performed. the patient name is Aminah Mahdi Saleh ,144 months old ,from Sehar district AFP Sa'adah Sa'da Al Jumhoori Hospital ,. 1 0 the samples collected and sent to the central 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]) 5 Weekly Bulletin: Electornic Integrated Disease Early Warinig & Response System, Yemen - Epidemiological Week Number 16 (15-21 April,2019)

Alert Responded in Epi - Week 16,2019

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

As Al Qaflah Rural Hospital,As Sawd Health hospital,Raydah Sudah,Huth,Suwayr,Khammer,Shaharah,Iyal Health hos.,Al Ashah Health hospital,Harf Sufyan H,Al Eidews team contacted focal point The cases were diagnosed as clinically as suspected cholera. Surayh,Harf Sufyan Habur Zulaymah,Dhi Chol Amran Sanaaniah Health Center,Al Salam Khamir Hospital,Huth treatment were given such as intravenous fluid and o. r. s. all the cases improved after taking the 1740 4 Bin,AlAshah,Amran,Raydah,Thula,Bani Health hospital,Kharif Rural Hospital,Amran General treatments,4 cases were dead Suraim,Kharif,Jabal Iyal Yazid,Al Madan,Al Hospital,Thula Health hospital,Habur Health hospital,Other Qaflah,As Sawd,Maswar

Eidews team contacted focal points and rapid response team visit health center .and visit area and Dhaiaan Health Center,Adan Health Center,Hababah Health invstagation . cases were diagnosed clinically as suspected measles. according to case definition. Meas Amran Iyal Surayh,Habur Zulaymah,Thula,Raydah 15 0 Center,Raydah Health hos.,Other blood samples were collected and sent to the central lab in sanaa .cases were vaccinated against measles.

Eidews coordinator contacted focal point The cases were diagnosed clinically as suspected pertussis Pert Amran Suwayr,Khammer Al Gnaya Center,Al Salam Khamir Hospital 5 0 cases treated with antibiotics

Eidews team contacted focal point. and rapid response team visit health hospital and visit area and invstagation. case was diagnosed Diph Amran Amran Other clinically.prospect diphtheria. the case treated with antibiotics. and anti toxin case vaccinated against 1 0 diphtheria. case from district jabl iyal yazed

Al Husn,Nahm,BaniDhabyan, Bait Alsaid HC,Bait Alhenami HC,July 17 Hospital ,Almarbak Khwlan,Manakhah,Hamdan,BaniMatar,AlHa HC,Almanar Hospital,Bait Alrejal HC,Walan Hospital, Bani Edews team contacted focal points, The cases diagnosed clinically suspected cholera and The cases Chol Sanaa Governorate ymahAlKharijiyah,Jahanh,BiladARus,Arhab, 3189 4 Mansour HC,Al wheda Manakha rural Hospital ,Awmara H,22 are recoreded in line list and cases deifferant area,4 cases were dead Sa'fan,Attyal,Sanhan,Bani Hushaysh,Al May Hospital ,Ka'a Alreka HC,Sa'afan HC,Other Haymah Al Kharijiyah,

Rapid Respose team visited area according to cases definition suspected measles the most cases Meas Sanaa Governorate Bani Matar,Bilad Ar Rus Bait Alrejal HC,Walan Hospital,Other 20 0 were un vaccinated .Blood samples collected and sent to central lab

The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case Pert Sanaa Governorate Arhab D /Hassan Tamah Center,Alhayfa HC 6 0 definition. The cases were vaccination unknown. The cases were treated with antibiotic.

eIDEWS team visited the HF, the cases of suspected cholera, the cases were diagnosed clinically Chol Shabwah Baihan,Ataq,Ain Bayhan Hospital,Emergency/Ataq Hospital 85 0 according to case definition,rapid test were positive for 63 cases ,the cases treated and improved

eIDEWS coordinator contacted the HF, the cases suspected of pert, the cases were diagnosed clinically Pert Shabwah Ataq Salem Bahaj Clinic 3 0 according to case definition, all cases were unvaccination , treatment were given for all cases

eIDEWS coordinator contacted the HF, the case was diagnosed clinically according to case definition, AFP Shabwah Ataq Ataq Central Hospital vaccination was done , sample was collected and send to the central level , the case was treated and 1 0 improve

eIDEWS team contacted the HF, the cases suspected of dengue fever , the cases were diagnosed DF Shabwah Ataq,Ain,Rodhoom Ataq Central Hospital,Outpatient/Al Ain Clinic,Al Wafa Clinic 20 0 clinically according to case definition, rapid test were positive , all cases treated and improved

eIDEWS team contacted the HF , the case suspected of measles, the case was diagnosed clinically Meas Shabwah Ar-rawdah Ar Rawdah Hospital 1 0 according to case definition ,vaccination was done,sample was collected ,he case treated and improved

eIDEWS coordinator visited the HF, the case probable of diphtheria , the case name Diala Mohamed Ali Diph Shabwah Rodhoom Al Wafa Clinic female age 5 years from Almshhara village , the case was diagnosed clinically according to case 1 0 definition , the case was un vaccination done, treatment was given and improve

AL Sharyah,As Sawma'ah,Al Malagim,Al A'rsh,Rada',Radman Al Awad,Al Alarsh center,Alqrishih HU,Althwrh Hospital,Alswadih HC,Al- eIDEWS team contacted focal points, the cases were diagnosed clinically as suspected cholera using Quraishyah,Al Bayda Chol Al-Baidha Taffah Center,Mukayras Hospital,Alswmah HC,Thi - Naem case definition, rapid test 215 positive the main saing watery diarrhea &vomting some dehydration the 1172 0 City,ArRyashyyah,AsSawadiyah,At HC,Areeb HC,Other paitnts ademittedt and with ORS and IV fluid in good condation the cases from deferrnt organ Taffah,Naman,Mukayras,Wald Rabi',Sabah,Nati,Dhi Na'im

IDEWS team contacted point information shared blood saeIDEWS team contacted focal point the case diagnosed clinically according to case definition Antibiotics treatment was given,one male less than 4 Meas Al-Baidha Az-Zahir Alzahr HC monthe he ages 6 months thehe name Abdulkhalk Ali Abdullah Abdullrab and Apear skin rash in 1 0 15/4/2019 and the fever in 12/4/2019 in respectively the case from Alzahr from Al Bormaan and there are was non collction of cases sample was case and their are was un vaccination against measls

EDEWS team contact Edews focal point in `Sayhut Country Hospital .case diagnosis according to case Meas Al-Mahra Sayhut Sayhut Country Hospital defination , susspected measles case was female age 48mounths case vaccinated and other case was 2 0 male 558 mounths un vaccinated ,serum sample taken from cases ,treatment was given to cases

EDEWS team contact Edews focal points in Health centres, the cases were diagnosis according to case Chol Al-Mahra Huswain,Qishn Saqar Health Centre,Qishn Country Hospital defination , susspected Cholera case in line listing and send daily to central level ,Cholera rapid test was 23 0 +ve ,then samples send to culture ,one case was +ve by culture , treatment were given

edews team contact focal points , the case was diagnosed clinically as suspected (AFP) using case definition , AFP Hadramout wady Tarim Bin Salm Clinic (1) name: altaaf birak 'ahmad biahmish, age 144 m , date onset 19/04/2019 Vaccine dose : 5 dose 1 0 Primary diagnosis G B S Stool samples: two stool samples collected symptomatic treatment was prescribed

edews team contact focal points , the cases were diagnosed clinically as suspected (meas) using case definition , the cases were un vaccinated except 4 cases were vaccinated and one case was under ega Meas Hadramout wady Al Qatn,Shibam,Amd,Sayun,Huraidhah Alkutn Public H,Huraidha rural H,Other vaccination, blood samples collected 8 0 Vit A provided . . symptomatic treatment were prescribed

Chol Hadramout wady Sayun Sayo'on Public H 1 0

Bani hutam HC,Wathan HU,Dheba HC,A Unity Centre Wusab As Safil,Mayfa'at (residential),bny salamh Unite,Kharbah Abuyabes EdeWS coordinator contacted focal points, he found cases diagnosed suspected Chol(Acut watery Anss,JabalAshsharq AlManar,Jahran,Anss HC,Alhumyat HC, AlMasli Hospital,Alwahda university Chol Dhamar diarrhoea and dyhadretion )cases tested by rapid test And result were negtive except 291cases were 2550 3 MaghiribAns,AlHada Utmah,DhamarCity H,Zeraja rural H,Hamam Ali Hospital,Taibah postive - all cases received treatment,3 cases were dead Dawran Aness,Wusab Al Ali hospital,Alkharba rural H,Almajel HC,Aljarf HC,Dawran Hospital,Dhamar public H, Other

Edewds coordinator contacted of the focal points and he found that the cases were diagnosed according Meas Dhamar Dhamar City Dhamar public H 2 0 to the standard definition of Meas, the cases were un vaccination - Samples collected from the cases

EIDEWS coordinator contacted coordinator district he found tow case diagnosed suspected Diph according to the standard definitions from Dhamar district -Al saada schooll area- Rathwan AGBAT - Diph Dhamar Dhamar City Taibah hospital 1 0 17 years old -not dosage taken - The beginning of the symptoms 7/4/2019/) - , Reporting date 18/4/2019 -(Note: there not have other case of this same neighbor and other injuries in the remaining contacts .

EdeWS team visted focal point and he found the case diagnosed according to case definition as suspected AFP Flaccid Paralysis- Weakness - ) -Patient data:Mhmed Jabr Almkdshe (60 mounth - AFP Dhamar Dhamar City Al Mogalee & ALGumah Dispensary From Mefah Anss district - Alkwalh area - dosage taken - The beginning of the symptoms 17 /4/2019- 1 0 Reporting date 19/4/2019. All samples from the patient and contact the patient were delivered to the coordinatori of paralyss

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 16 (15-21 April,2019)

Alert Responded in Epi - Week 16,2019 Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed clinically according to case definition.Stool samples collected from cases for screening test only . Alwadi,Harib,Madkhal,Majzar,Sirwah,Bid Al Kari Hospital,( al Wahdah ) Hospital,Alateer Hospital ,AL Chol Mareb Supplements & antibiotics treatment were given(case management)the results of stools Rapid tests of 178 1 Bidah,Marib City Askary Hospital cholera 41 positive .There were a no collection or cluster of cases seen in the same Plac, one case was dead

we contacted the contact and told us that suspected dengue cases cases had history of high fever, back pain, muscular pain, and arthralgia. The samples were collected at the hospital's laboratory for DF Mareb Harib,Al wadi Harib Hospital,( al Wahdah ) Hospital,Alateer Hospital 44 0 serological testing (NS1). This test measures the presence of dengue protein (high sensitivity and quality test) which detects the virus antigen .that confirms the result

eIDEWS coordinator contacted focal points,information's shared,then HF,case visited by eIDEWS Meas Mareb Raghwan Raghwan Hospital coordinator & . Blood samples was collected from the case and sent for lab confirmation & the onset of 1 0 fever , skin rash, the case was vaccinated

Al Maton Health Center,Bart Rajuzah Hospital,Al Khalq Health The coordinator of the EDEWS received a report from the surveillance officer at the Center for the Rajuzah,Al Maslob,Al Matammah,Kharab Al Center,Al Hazm Hospital,Al Marashi Health Center,Al treatment of the existence of a number of 30 cases in which the doctor suspected that cholera had been Chol Al-Jawf Marashi,Bi'rat Al Anan,Khob Wa Asha'af,Al 632 1 Humaydat Health Center,Al Ghail Health Center,Al Shifa taken to the health facility and verifying the authenticity of the communication. The cases were Hamidat,Al Ghayl,Al Matun,Al Hazm Center,Hosoon Aal Shanan Health Center treated,one case was dead

Al Kasmi (Al Marfaqi Aal Qassim) Health Unit,Al Masloob EDEWS team contacted focal points. the Cases were diagnosed clinically as suspected pert.treatments Pert Al-Jawf Az Zahir,Al Maslob,Al Matun 10 0 Health Center,Al Shifa Center,Other were given, the cases were un vaccines

The EDEWS coordinator has contacted the coordinator. The condition was diagnosed clinically by Al Shifa Center,Al Marashi Health Center,Hosoon Aal Shanan Meas Al-Jawf Al Matun,Kharab Al Marashi,Al Matammah definition of the condition. Blood samples were not collected. Symptom therapy and antibiotic giving 8 0 Health Center were given and vitamin A.

eIDEWS coordinator contacted focal point, information was shared. all cases was diagnosed clinically Al Khabt,Ar Rujum,At Tawilah,Al Mahwait Al Arkob HC,Hufash H,Alrujm Hospital,Lahbol Health according to case definition, same case were investigated by rapid test for vibrio cholera and 53 cases Chol Al-Mahweet City,Milhan,Shibam Kawkaban,Hufash,Bani Unit,Swaq Alahd HU,Numan HU,Bani Sa`d Hospital,Altawilh 1549 3 were positive . appropriate treatment were given according to severity of symptoms and dehydration,3 Sa'd,Al Mahwait HC,Aljoumhwri H,Shbam H,Other cases were dead

Bassam Hamid Saleh Alfarkh ,120 month's from Bani Saad , Bani Alshdiad village. eIDEWS coordinator contacted focal point, information was shared. The case was diagnosed clinically according to case AFP Al-Mahweet Al Mahwait City Aljoumhwri H definition. the left lower limb flaccid paralysis start at April 17 , 2019 and the case reported at April 20 , 1 0 2019. he was vaccination against polio ( 6 doses ), the stools samples was collected at April 20 , 2019.the samples was send to central lab

As Salafiyah,Al Jabin,Bilad At Nawm HU,rabouw Almasjedeen Hospital ,Kusmah DEWS coordinator contacted the hospital focal points, the cases were diagnosed suspected AWD and Chol Rayma 294 3 Ta'am,AlJafariyah,Mazhar, Kusmah HC,Althulaia H,Almithaq H,Bni Musap HC,Other treated accordingly, isolation done , the cases take treatment and go out side hospital,3 cases were dead

Juban,Al Husha,Damt,Ad Dhale'e,Al 22 May Hospital,Damt HC,Alfakhr HC,Alnassr H,Alslam H eDEWS team contacted FP , the cases were reported , all cases were diagnosed according to case Chol Al-Dhale 855 1 Azariq,Al Hussein,Qa'atabah ,Other definition, all included in updated daily line listing ,one case was dead

eIDEWS team was contacted fp: the cases were diagnoses clinically, vaccination were done, samples Meas Al-Dhale Al Husha,Ad Dhale'e,Al Hussein,Ash Shu'ayb Bni Ssubh HC,Alnassr H,Alhassin HC 5 0 were collected , treatment were given, investigation form were done.

eIDEWS team was contacted fp: The case was female age: 9 y from ,diagnoses clinically , vaccination Diph Al-Dhale Ad Dhale'e Alnassr H was done, sample was collacted , treatment was given, investigation form was done. 1 0