Eiectronic Integrated Disease Early Warning and Response System Volume 08,Lssue17,Epi Week 17,(20-26 April,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,lssue17,Epi week 17,(20-26 April,2020)

Highlights eDEWS Reporting Rates vs Consultations in Govemorates,Epi Weeks 1-17,2020

% % %

% % % %

97 97 97

96 96 96 96

95 95 95 95

100% 94 450000

92 96 90% 400000 •During week no.17,2020, %92(1991/1822) health facilites from 23 80% 350000 70% 300000 Governorates provided valid surveillance data. 60% 250000 50% 200000

Percentage 40%

150000 Consulttaions 30% 20% 100000 10% 50000

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

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

Wk 16 Wk Wk 11 Wk 12 Wk 13 Wk 14 Wk 15 Wk 17 Wk Governorates was 295637 compared to 334727 the previous reporting week 10 Wk

17. 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 17,2020)

were the leading cause of morbidity this week.

% %

100% %

98 100

90% 100

100

% %

80% %

86 73

70% %

77 74

60% 76 69 50% 40% 30%

No.Reports HF 20% A total of 1332 alerts were generated by eDEWS system in week 17,2020, were 10% verified as true for further investigations with appropriate response 0%

Reporting Rate Target

Leading causes of morbidity mortality in Epi-Week 17,2020 Proportional morbidity of leading priority diseases, Epi week 17,2020

Guinea Worm ● (URTI) 14.1%, suspected Malaria (5.8%),(DD) (9.5%) and (LRTI) (5%)Remain the Scabies Chicken Pox leading causes of morbidity representing a total of (34.4%) 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 9.5% and LRTI 5% of total morbidity in pilot Governorates this AVH_A&E Meas week . Typhoid F OAD BD Pert SARI ILI ● All diarrheal disease comprised 9.5% and OAD 7.8% 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 17, (20-26 April,2020) Epidemiological Situation of Cholera and Diphtheria

GO Overview of the AWD/Cholera From Wk1-WK17,2018,2019 and 2020 Epidemiological curve of AWD/Cholera with CFR% V (Cumulative from WK1 ,2019 to WK17 ,2020)

RDTs Results (Positivity Rate) During 2020 Distribution of suspected & dead cases by age group(WK1-WK17/2020)

Overview of the Diphtheria From Wk1-WK17,2018,2019 and 2020 Distribution of Suspected and Death Diphtheria Cases by Age Group

Summary of Diphtheria indicators Suspected Cases by Vaccine Received and Weeks During 2020 During Last 3 Weeks (15,16,17)

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 17, (20-26 April,2020) Epidemiological Situation of Dengue Fever and SARI

Overview of Dengue Fever From Wk1-WK17,2018,2019 and 2020 Epidemiological curve of Dengue Fever Cases with CFR% (Cumulative from WK1 ,2019 to WK17 ,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-WK17,2018,2019 and 2020 (Cumulative from WK1 ,2019 to WK17 ,2020)

Deaths

Summary of SARI indicators During Last 3 Weeks (15,16,17)

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 17, (20-26 April,2020)

weekly trends of Upper Respiratory infections ,Lower Respiratory and mararia tested cases & confirmed (Epi weeks 1-17,2020)

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 wk5 wk6 wk7 wk8 wk9 wk3 wk4

0.0% 0.0% wk2

wk10 wk11 wk12 wk13 wk14 wk17 wk15 wk16

1 2 3 4 5 6 7 8 9

10 11 12 13 14 15 16 17

WK WK WK WK WK WK WK WK

WK Rapid Test(Postive) Microscope(Postive)

WK WK WK WK WK WK WK WK WK

WK WK WK WK WK WK WK WK

Age and Sex distribution of total consultations of leading diseases (Epi week17,2020) Number of Alerts Received and Responded (Epi Weeks 14-17,2020)

70000 65793 URTI LRTI Pert BD OAD Typhoid F

60000 AFP Meas AVH_A&E AVH_B&C DF Meng

Sch CL Chicken Pox Mal 50000 250

42043 40000 200

30000 29034 28059 150 24932 25046 24580 21228

20000 17487 17730 100 No. of Alerts of No.

10000 50

0 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Male 17487 24932 28059 42043 21228 Female 17730 25046 29034 65793 24580 Distribution of consultations of leading diseases by Governorates,Epi week 17-2020

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 3220 2588 1158 816 2117 1000 706 880 3589 1938 2292 1772 1527 2842 1767 3598 704 453 1425 3075 1227 55 2818 41567 LRTI 315 305 734 73 1365 405 174 470 1164 874 1265 406 204 1118 937 1083 235 103 344 1234 233 17 1663 14721 ILI 198 0 65 0 33 88 9 0 44 4 75 84 0 36 42 0 127 4 0 173 148 0 237 1367 SARI 0 0 5 0 0 0 0 0 13 0 85 0 0 0 0 0 0 0 0 0 0 0 2 105 Pert 5 2 0 0 3 8 0 0 4 7 5 4 5 0 3 1 0 0 0 0 3 0 5 55 BD 53 0 33 6 53 86 7 24 83 61 71 9 3 2 65 8 73 18 71 108 25 0 158 1017 OAD 1067 944 578 633 884 784 188 672 2562 1299 2225 714 477 1502 1294 1186 485 308 929 2134 754 20 1422 23061 Typhoid F 67 25 234 5 145 146 7 145 617 251 1064 33 6 2 372 54 80 74 95 324 64 19 342 4171 Meas 4 4 1 1 6 0 0 3 3 7 1 1 0 7 0 3 6 0 3 2 3 0 3 58 AVH_A&E 3 10 1 0 1 1 1 3 74 6 16 16 8 1 10 3 2 0 2 8 17 0 19 202 AVH_B&C 2 13 7 0 1 0 0 0 53 8 11 3 0 2 23 4 1 0 2 5 4 0 14 153 NNT 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 3 AFP 0 2 0 0 1 0 0 0 4 0 0 0 0 5 0 0 0 0 0 0 0 0 0 12 263 11 4 3 33 14 2 7 8 22 17 2 2األمراض المشتبهة Mumps 10 4 4 6 13 6 5 11 39 9 31 Mal 21 267 1 0 10131 97 25 476 156 346 731 1 0 3498 276 56 31 161 310 145 7 0 509 17245 Meng 1 0 0 0 1 0 0 0 15 1 1 6 0 0 5 0 0 1 2 0 0 0 8 41 DF 7 80 1 5 555 0 4 5 3 0 0 85 2 4 0 21 4 0 0 0 35 0 45 856 VHF 0 13 0 0 2 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 21 Sch 0 0 0 8 0 23 0 33 80 50 19 3 0 81 11 4 3 7 13 36 2 0 29 402 CL 0 0 6 1 0 2 0 1 19 9 1 0 0 6 1 13 4 4 1 5 0 0 0 73 RB 1 0 0 0 0 0 0 5 102 9 69 2 1 0 53 3 0 0 0 5 0 0 4 254 Tuberculosis 2 1 2 0 6 1 0 1 3 0 10 0 1 1 4 1 0 0 2 3 0 0 3 41 HIV/ AIDS 0 1 0 0 0 0 0 0 10 0 0 1 0 0 0 0 0 0 0 0 0 0 0 12 Brucellosis 2 0 29 0 2 19 2 8 115 69 380 0 5 59 57 0 11 3 21 15 3 1 12 813 Chicken Pox 2 11 9 3 16 12 7 5 67 24 28 32 24 28 39 10 7 22 30 56 7 0 7 446 Scabies 21 1 0 0 34 0 0 3 16 5 5 0 0 24 2 1 4 22 3 19 0 1 1 162 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 5019 6443 5015 7331 7137 2985 1626 4689 35237 9503 18070 9296 4282 9116 12025 9633 4658 1274 2670 8760 4792 310 10427 180298 total_cons_disease 10029 11438 8390 8777 23146 5885 3034 8103 45004 14903 26890 13811 6568 18604 17445 15739 6457 2541 6232 16671 7344 432 18194 295637 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 17, (20-26 April,2020)

Alert Responded in Epi - Week 17,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

contact with the focal points, the cases of suspected measles were diagenosed clinicaly according to Al Madaribah and Ras case definition. Meas Lahj Al Madarebah HU,Al Hakmah Center 3 0 Alara,Radfan,Tuban The cases reported immediatly to the operation room, recorded in the line list. the cases treated symptomaticaly and left the health facility.

immediate report were recived by the focal points, the case of suspected perttusis was diagenosed Pert Lahj Yaffa Bin Dayan Dispensary clinicaly according to case defintion. 1 0 The case added to the line list, treated symptomaticaly and left the health facility.

contact with the focal points,the cases of suspected cholera were diagenosed clinicaly according to case Al Maqatirah,Radfan,Al definition. Chol Lahj Radfan Public H,Alhaid rural H,Other the cases reported immediatly to the operation room, recorded in the line list. 17 0 Had,Halimayn,Yaffa the cases treated by iv fluid, ors and antibiotic. the cases finaly left the health facility

contact with the focal points, the cases of suspected Diphtheria were diagenosed clinicaly according to case definition. Diph Lahj Yaffa,Al Had Dar Alhikma Dispensary,Other 5 0 The cases reported immediatly to the operation room, registerd in the line list. The cases treated by antibiotic and improved.

Dar Alhikma Dispensary,Ibn Khaldoon Hospital,October the focal points were contacted, information shared the cases of suspected Dengue fever were DF Lahj Al Hawtah,Yaffa diagenosed clinicaly according to case definition. 21 0 public H The cases added to the line list, treated symptomaticaly and improved.

eiDEWS team were contacted fp,the cases were diagnosis clinically,samples were collected,treatment VHF Aden Al Mansura,Al Mualla Hashed Health Complex,Khalij Aden Hospital 13 0 were given,investigation form were done.

Sairah,Khur Maksar,Al Buraiqeh,Al Alburaihi H,Babl Hospital,Alwahda educational H,Al eDEWS team contacted RRT. All cases were diagnosed clinically, treatment were given, samples were DF Aden Mualla,Ash Shaikh Outhman,Dar Sad,Al 80 2 Ryadah Hosp.,Al-Wali Hosp. collected and investigation forms were done,2 cases were dead Mansura

Diph Aden Attawahi Alkalloa'a Complex. 1 0

Ash Shaikh Outhman,Dar Sad,Khur Alwahda educational H,Al Ryadah Hosp.,Kuwait Medical Pert Aden 2 0 Maksar Center

eiDEWS team were contacted fp,the cases were diagnosis clinically,vaccination were done,samples Meas Aden Ash Shaikh Outhman,Al Mualla,Dar Sad Alwahda educational H,Almua'ala health complex 4 0 were collacted,treatment were given,investigation form were done.

AFP Aden Ash Shaikh Outhman Alwahda educational H 2 0

Chol Aden Ash Shaikh Outhman,Dar Sad Alwahda educational H 11 0

RRT visited the reported cases, 2 cases were un vaccination and 2 cases other were vaccination,The Meas Abyan Zungobar,khanfir,Ahwar ,Lawder Mother and child HC,Ahwr H,Al Azi Dispensary cases were diagnosed clinically according to the standard case definition. He received antibiotics & 4 0 regular interest . investigation form done

RRT visited the reported cases in districts , the cases diagnosed clinically according to the standard Pert Abyan Lawder,khanfir Amajl HC,Dr.Fadaq Clinic case definition. they received antibiotics & regular interest . investigation form done , RRT in districts 5 0 investigated the region for quick research on other new cases

RRT in districts visited FP the cases diagnosed clinically, RDT and stool cultures didn't done but RDT'S was negative in 1 case . treatment were given, investigation forms were done , the cases and their Chol Abyan khanfir,Al Mahfd,Ahwar,Sibah Alrazi .H,Ahwr H,Al Mahfad Hospital 9 0 families received complete advices about the ways of prevention and management of cholera infection. the cases included in Cholera line list

AshShamayatayn,Jabal HabashySharab Almodafar Hospital,Aljoumhri H,Khalifa Hospital,Al ArRawnah AlMisrakh,Khadir,AlQahirah Loqiah Hospital,Almsrakh Hospital,22May Mawiyah,AlMudhaffar,Sharab Chol Taiz AlmodafarHC,Mawih Hospital, Alnshmh H,MSF 454 0 AsSalam,Sabir AlMawadim Hospital,Al Aroos Hospital,22 MayHC,ArRomahcenter, Maqbanah,AtTaiziyah,Hayfan, Khalifa Hospital,Labs National Center,Other Salh,AlMaafer

Al-Safwah Hosp.,Al wahdah HC,Mohammed Aldorah DF Taiz AlQahirah,JabalHabashy,Salh 45 0 HC,Althwrh H

Pert Taiz Al Qahirah,At Taiziyah Yemeni - Suidi H,MSF Hospital 5 0

Meas Taiz Sharab Ar Rawnah,At Taiziyah Abduljalil Nassr Hoapital,MSF Hospital 3 0

Diph Taiz At Taiziyah MSF Hospital 1 0

Meas Hadramout Al Mukalla City Shab al badiah HC 1 0

Chol Hadramout Hajr,Al Mukalla City Hajar aljoul rural H 11 0

VHF Hadramout Al Mukalla City Hadramout modern hospital 6 0

Broom,Ghail Ba Wazir,Ash Alshahr public H,Ghail Bawazeer H,Alborj Hospital,Bin DF Hadramout Shahr,ArRaidah and Qosaiar Al Mukalla 85 0 Sena'a educational H,Hajar aljoul rural H City,Hajr

Diph Hadramout Al Mukalla City Al Kazan HC 1 0

Pert Hadramout Qhail Ben Yameen,Al Mukalla City Alborj Hospital,Raydat Jawheen HC 4 0

AlMakhadir,AsSayyani,AshShairAnNadira h,Jiblah,AlDhihar AlUdayn,AlMashannah YarimHospital,alHazmHospital,Alshaheed Mudhaykhirah,Badan,Hazm AlbadaniHospital,AlradhmahH,AlmakhaderHC,AlqaidahH Immediate notification. eDEWS Coordinator visited hospital,some stool samples were collected. and Chol Ibb positive by rapid test for 12 samples 437 0 AlUdayn,AsSabrah,Hubaysh, ,ALMzahanH,Yahsub Hospital,Aladin H,Mother and Child All cases were improved AsSaddah,FarAlUdayn,Ibb H,Other DhiAsSufal,ArRadmah,Yarim, AlQafr

Immediate notification by focal points. Cases were diagnosed clinically and treated accordingly.2 Cases Pert Ibb Al Udayn Aladin H 3 0 Vaccinated .

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 17, (20-26 April,2020)

Alert Responded in Epi - Week 17,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

AsSukhnah,Zabid,AlMina ,AlMarawiah,Bura,AlMansuriyah,AzZaydiy Almansouria rural H,Bait Alfakih H,Alzaydia Rural ah,Bayt AlFaqiah H,Aljarrahi rural H,Alluheyah HU,Alhshm Chol AlHodaidah AlQanawis,AdDahi,AzZuhrah 637 0 Center,Althawra public H,Almekhlaf HC,Alzaydia Rural AlHawak,AlHali,AsSalif, HAlsalakhana H,Alkanawes HC,Aldhahi Rural H,Other AlGarrahi,AlMunirah AlMighlaf Alluheyah , Ad Durayhimi

AFP AlHodaidah As Sukhnah Shgenh HU 1 0

AlQanawis,AlHali,AsSalif,Zabid Aldhahi RuralH,Hais rural Hospital,Hikmah hospital, AlHawak,Bayt AlFaqiah Alsalif Hospital,Alhodaidah Hospital,Al AzZuhrahAlMunirah,AlMarawiahAdDahi,A DF AlHodaidah HabalHU,Almansouria rural 555 0 sSukhnah,AzZaydiyahBajil,AlMansuriyah, H,BajilRuralHospital,AlkanawesHC, Alkanawes PrivateH, AlMina,Bura,At Other Tuhayat,Alluheyah,Kamaran

VHF AlHodaidah Al Hawak,Bajil Alamal Hospital,Alesra'a Specialized H 2 0

Pert AlHodaidah Az Zaydiyah Alzaydia Rural H 3 0

Meas AlHodaidah Zabid,Bajil Zabid rural Hospital,Aziz HC 6 0

Diph AlHodaidah Al Hawak Althawra public H 1 0

AlMiftah,Najrah,AshShaghadirah,AshSha hil,QaflShamer, Qafl Shamer Kufl-Shamar Rural H,Bani Chamakh BaniQais,AlJamimah,Mabyan, HC,Bani Qais Health Center,Mabyan Hospital,Kuhlan eIDEWS Coordinator contacted the Coordinator of Surveillance in Districts. Information shared .It have Chol Hajjah Abs,Hajjah,Kuaydinah,Aflah Afar HC,Almahabesha Public H,Alshahel Rural been reported case of suspected cholera , The cases were diagnosed clinically (Acute watery diarrhea 393 0 AshShawm,AlMahabishah Hospital,Almaghraba HC,Public Republican )Itwere given the appropriate treatment ,KuhlanAffar,Mustaba,Bani Hospital,Khatwah HC,Other AlAwam,KuhlanAshSharaf

eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared, the cases (suspected diphtheria) The diagnosis were clinically (diphtheria) 3 cases were un vaccination ,The Diph Hajjah Abs,Hajjah City Abs Rural Hospital,Public Republican Hospital 4 0 response team in the field investigated the cases and the contacts and the appropriate treatment were given

KhayranAlMuharraq,Najrah, eIDEWS Coordinator contacted the Coordinator of Surveillance in District. Information shared.It were AFP Hajjah Abu Hadi Specialized Poly in Souk Alaman,Other diagnosed clinically according to standard definition For AFP , Investigation form were Done. Appropriate 5 0 Mustaba,AlMahabishah, Hajjah City treatment were given, The samples were collected and sent to the central laboratory

DF Hajjah Hajjah City Sauid Hospital in Hajja 4 0

eIDEWS Coordinator contacted the Coordinator of Surveillance in District . Information shared.It were Mabyan,Sharas,Najrah Kuhlan Ash Mabyan Hospital,Kuhlan Ash Sharaf HC,Sharas diagnosed clinically according to standard definition For measles ,the cases from Districts different Meas Hajjah 7 0 Sharaf HC,Other areas . the cases were vaccination except 2 cases were un vaccination,.Appropriate treatment were given. The samples were collected and sent to the central laboratory

Rapid response team contacted focal points by eIDEWS coordinator & HF visited,cases diagnosed Ottan Complex,Al Jraf Complex,Omar Al Mokhtar clinically according to case definition.Stool samples(C/S & serotyping) collected from cases & sent to lab BaniAlHarith,AsSabain, Complex,Bni - Hwath HC,Alwahda Health (Central labs)for confirmation. Supplements & antibiotics treatment were given(case management)Most Chol Amana Assafi'yah,AlWahdahAththaorahShu'Aub, of them were from Amana governorate & a few of them from other governorates ,different districts of that 335 0 Center,Arwdhah H,As Sabin Hospital,22 May MaainAz'zal governorates,the results of stool C/s still pending.Rapid tests of cholera were negative for most collected Hospital,Jabr Bn Hyan Complex,Other specimens,so stool C/s not done for that negative samples.There were a collection or cluster of cases seen in the same Place.

eIDEWS coordinator contacted focal points,then HF visited. Information shared.Stool samples collected AFP Amana Maain,Aththaorah,AtTahrir As Sabain Al Thawrah Complex,Aljomhwri H,As Sabin Hospital 4 0 from the cases & sent for lab confirmation,the cases were unvaccinated against polio.

eIDEWS coordinator contacted focal points,information's shared.Blood samples were collected from the cases and sent for lab confirmation & the onset of fever,skin rash, the cases were unvaccinated against Meas Amana Aththaorah,Shu'Aub,Az'zal Al Mithaq Complex,Omar Al Mokhtar Complex 3 0 measles. Vit-A were given to the cases in order to support her immunity against complications of measles.

eIDEWS coordinator contacted focal point,information shared,then HF visited by eIDEWS coordinator.The cases diagnosed clinically according to the case definition. Antibiotics treatment was given.The number of cases were 3,2 females & one male.For the 1st case,the date of illness onset was on 06\11\2018 & the date of case admission on 09\11\2018.The case was one male,his name MAJDI MANEH KHALED AL-ABBASSI,his age 1.1 month.The case from Amana governorate,Ma'ain district,Al- Sonainah area.The case was unvaccinated against Pertussis. For the 2nd case,the date of illness onset Pert Amana As Sabain As Sabin Hospital was on 07\11\2018 & the date of case admission on 10\11\2018.The case was one female,her name 4 0 RUKEYAH HUSSEIN WATHAB,her age 2 months.The case from Amana governorate,Assafi'yah district,Khawlan street.The case was unvaccinated against Pertussis. For the 3rd case,the date of illness onset was on 07\11\2018 & the date of case admission on 09\11\2018.The case was one female,her name ASMAA JOBRAN ALI AISHAN,her age 2 months.The case from Amran governorate,Harf Sufyan district.The case was unvaccinated against Pertussis. There were no collection of cases seen in the same place.

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 As Sabin Hospital 2 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 vaccination

Monabbih Rural Hospital,Qahza Health Center,Al Chol Sa'adah Majz,Munabbih,Adh Dhahir,Baqim,Sa'da 76 0 Jumhoori Hospital,Other

Meas Sa'adah Sahar,Al Hishuah Al Mahather Health Center 3 0

Diph Sa'adah Sa'da Al Jumhoori Hospital 2 0

JabalIyalYazid,Huth,Raydah, Thula,HarfSufyan,Habur 22 May hospital,Kharif Rural Hospital,Huth Health eidews Coordinator Contacted focal points and The Coordinator of Surveillance in districts And visit Chol Amran Zulaymah,BaniSuraim hospital,Thula Healthospital,Habur Health hospital, health hospital . The cases were diagnoses clinically as suspected cholera. according to case 162 0 Khammer,DhiBin,Amran,KharifAlMadan, Raydah Health hos.,Other definition All the cases improved After taking The Treatments prope Maswar

Eidews Coordinator Contacted focal points The Coordinator of Surveillance in districts and visit health hospital, the Cases Were diagnoses clinically as suspected Measles. According to Case definition. Meas Amran Thula,Raydah,AlAshah,Huth,Harf Sufyan Thula Health hospital,Raydah Health hos.,Other 7 0 Blood Samples Were Collected Of cases and Sent to Central Lab in Sanaa for confirmation.The Cases Vaccinated except one case was un vaccination Against Measles

Eidews Coordinator Contacted focal points and Contacted The Coordinator of Surveillance in districts, Pert Amran Al Qaflah,Khammer,Huth Al Qaflah Rural Hospital,Al Salam Khamir Hospital,Other the cases were diagnosed clinically as suspected pertusis. according to case definition. Case 7 0 Improved After gave the Treatments Antibiotics proper

AlHaymahAdDakhiliyah,AlHusnNahm,Ba AwmaraH,Alshaeed Mohamed Aldurra niDhabyan,Khwlan Hospital,AlhanakHU,BaitAlsaidHC,Almarbak ManakhahHamdan,BaniMatar AlHaymah eDEWS coordinator contacted focal points, The cases were diagnosed suspected cholera(AWD) cases Chol Sanaa Governorate HC,Hamdan Hospital, Bani Mansour HC,Bait Alhenami 529 0 AlKharijiyah,Jahanh Bilad Arus tested by rapid test 15 cases positive and cases were treated at the health facility and received treatment HC,Alshe'eb Alaswad HC,Walan Hospital,22 May Arhab,Sa'fan,Attyal Sanhan,Bani Hospital,Alar rural H,Other Hushays

The EDEWS coordinator contacted the focal person. The cases were diagnosed clinically by case Meas Sanaa Governorate Jahanh,Attyal Alshaeed Mohamed Aldurra Hospital 2 0 definition. Skin rash started,the cases were vaccination,blood samples were collected.

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 17, (20-26 April,2020)

Alert Responded in Epi - Week 17,2020

Suspected Governorate District HFs Actions Taken / Notes Cases Deaths Disease

Arrawdah,Mayfa'ah,Ain Dr.Ba Masli Clinic,Rudum Rural Hospital,Beer Ali Health eIDEWS team were contacted with health facilities found cases suspected cases of dengue fever from DF Shabwah different areas were collected,the cases were diagnosed clinically according to case definition, rapid test 35 0 Habban,Rodhoom Center,Habban Health Unit were done three cases were positive, all cases were cured and discharge

Al Talh Health Center,Waset Hospital,Jardan Rural eIDEWS team were contacted with health facilities found the cases suspected case of measles, the Meas Shabwah At'talih,Jirdan,Markhah Assufla cases were diagnosed clinically according to case definition, vaccination were done full doses, samples 3 0 Hospital were collected

eIDEWS team were contacted with health facilities found cases suspected cases of pertussis ,the Pert Shabwah Mayfa'ah,Ataq Al-Ahmadi Clinic,Dr Saleh Abdurahman Medical clinic cases were diagnosed clinically according to case definition, vaccination were not don for all cases was 3 0 cured and discharge

Habban Hospital,Emergency/Ataq Hospital,Bayhan eIDEWS team were contacted with health facilities found the cases suspected case of cholera,the cases Chol Shabwah Habban,Mayfa'ah,Ataq,Baihan 6 0 Hospital were diagnosed clinically according to case definition, rapid test were positive for 2 cases

Sabah,AtTaffah,Naman Mukayras,DhiNa'im,ALSharyah Althwrh Hospital,Al-Taffah Center,Al nasefa Chol Al-Baidha AlMalagim,RadmanAlAwad 506 0 Hospital,Mother and child HC,Mukayras Hospital,Other AlBaydaCity,AzZahir, As Sawadiyah,Rada'

Diph Al-Baidha Al Bayda City Althwrh Hospital 1 0

Meas Al-Baidha Mukayras Mukayras Hospital 1 0

EDEWS team contact Edews focal point in `AlGhaydhah Central Hospital .case from Alghaydha n Chol Al-Mahra Al Ghaydah Al Ghaydah Center Hospital District ,cases diagnosis according to case defination , susspected Cholera case was in line listing s 5 0 ,Cholera rapid test was +ve ,treatment was given

DF Al-Mahra Al Ghaydah Al Ghaydah Center Hospital 4 0

edews team contact focal points , the cases were diagnosed clinically as suspected (pert) using case definition , Pert Hadramout wady Sah,Tarim,Al Qatn Sah HC,Bin Salm Clinic 5 0 the cases were un vaccination except one case vaccination

AlManar,Jahran,Dhamar City,Dawran Rsabh Hospital ,Kharbah Abuyabes HC,Dhamar public Aness,Anss Maghirib Ans,AlHada,Utmah H,Souk Aleffa HC,Alhumyat HC,Hamam Ali Eidews coordinator District contacted focal point he found cases diagnosed suspected Chol(Acut watery Chol Dhamar 272 0 Wusab AlAli,Wusab AsSafil Mayfa'at Hospital,Alahad rural H,Meshrafa HC,Aldan rural diarrhoea and dyhadretion ) Anss,Jabal Ashsharq H,Dheba HC,Aljarf HC,Dawran Hospital,Other

Pert Dhamar Wusab As Safil,Jahran,Dawran Aness Dawran Hospital,Alwahda university H,alfadly Clinic 5 0

Meas Dhamar Dhamar City alhelal alnmothgi Desbonsry 1 0

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 . Chol Mareb Sirwah,Al wadi,Marib City mgmah al chahuad Complex,(alWahdah ) Hospital,Other 42 0 Supplements & antibiotics treatment were given(case management) ,the results of stool Rapid tests of cholera 3 positive .There were a no collection or cluster of cases seen in the same Place

eIDEWS coordinator contacted focal points,information's shared,then HF,cases visited by eIDEWS Marib City,Harib AlQaramish Harib,Al Al Kari Hospital,Harib Al Qaramish Hospital,Harib coordinator & .Blood samples were collected from the cases and sent for lab confirmation & the onset of Meas Mareb fever , skin rash ,the cases were unvaccinated against measles .All possible actions done by RRT of 6 0 wadi Hospital,( al Wahdah ) Hospital districts done,in order to control the infection to other close contacts & Vit-A were given to the suspected cases, in order to improve their immunity against complications of measles

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 Harib Hospital,Other 4 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

Al Khalq,Az Zahir,Al Hazm AlMatun,Bi'ratAlAnan Al Khalq Health Center,Al Hazm Hospital,Al Shifa The EDEWS Coordinator a report from the control officer that there were cases of the doctor's Chol Al-Jawf AlMatammah,Kharab Center,Bart Al Anan Rural Hospital,Al Marashi Health diagnosis. It were cholera,the cases without a suspicious examination from different areas. After 182 0 AlMarashi,AlGhayl,Rajuzah Al Center,Al Maton Health Center,Other validation. Treatments were treated according to the treatment plan Maslob,Khob Wa Asha'af

EDEWS team contacted focal points,the Cases diagnosed clinically as suspected pert.treatments were Pert Al-Jawf Kharab Al Marashi,Al Matun Al Marashi Health Center,Al Shifa Center 8 0 given,the cases were un vaccines

BaniSa'd,AtTawilah,ArRujum eIDEWS coordinator contacted the focal points, information was shared. The cases were diagnosed AljoumhwriH,AlArkobHC,HufashH,NumanHU,Bani Sa`d clinically according to case definition,some cases were investigated by rapid test for vibrio cholera, and Chol Al-Mahweet Hufash,Shibam Kawkaban 81 0 Hospital,Other the result were positive for 2 cases. Appropriate treatment were given according to severity of symptoms AlMahwaitCity,Milhan,AlMahwaitalKhabt and dehydration.

eIDEWS coordinator contacted the focal points,information was shared. All cases were diagnosed clinically according to case definition, The cases were not investigated by RDT for dengue fever and DF Al-Mahweet Bani Sa'd,Milhan Bani Sa`d Hospital,Other 5 1 positive for one case, appropriate treatment were given according to severity of symptom,one case was dead

eIDEWS coordinator contacted the focal points, information was shared. The case was diagnosed clinically according to case definition. Bador Ahmed Saleh Kahla 27 years old from Altawilla,Bani Alhaiat Diph Al-Mahweet At Tawilah Altawilh HC 1 0 Madam village. She was vaccinated against diphtheria(3 dose). Focal RRT was visit village and treated the contact persons with the affected person. People were also educated in this village

eIDWES coordinator contacted the focal points, information was shared.The cases were diagnosed clinically according to case definitiont, investigated and collected blood samples at Apr 23,2020 ,skin Meas Al-Mahweet At Tawilah,Al Mahwait Altawilh HC rash were appear at Apr 18 ,2020 and the fever appear at Apr 19 ,2020 . they were un vaccinated 3 0 except one case was vaccination against measles. The blood samples were send to central Lab in Sanaa for investigation. .. .

Kusmah,AsSalafiyah,Mazhar,Al eIDEWS Coordination contact focal point in health centre, the cases were diagnosed according to case Chol Rayma Kusmah HC,Az Zilh HC,Althulaia H,Almithaq H 67 0 Jabin,Bilad At Ta'am definition as Acute Watery Diahorea cases from ) most cases treatment at home

eDEWS team contacted FP, all diagnosed according to case definition, all included in updated daily line Chol Al-Dhale Qa'atabah,AlHusha,AdDhale'e Alfakhr HC,Alnassr H,Other 17 0 listing

eIDEWS team were contacted fp: The case was male, then 1 (less than 5 year), diagnoses clinically, Meas Al-Dhale Jahaf Other 1 0 vaccination was done, sample was collected , treatment was given, investigation form was done.