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Epidemiological Week 52 (Week Ending 31 December, 2017)

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Epidemiological Week 52 (Week Ending 31 December, 2017) Early Warning Disease Surveillance and Response Bulletin, Somalia 2017 Epidemiological week 52 (Week ending 31 December, 2017) Highlights Cumulative figures as of week 52 Reports were received from 268 facilities 1,851,018 total consultations reported in week 50, compared to 265 79,121 cumulative cases of reporting completeness in week 48. AWD/cholera in 2017. Total number of consultations decreased from Of the 78,842, 32,768 (41%) are 60,746 in week 52 to 53,631 in week 52. children less than 5 years while The highest number of consultations in week 52 46,397 (59%) are 5 years above. were for Other Acute Diarrhoea (OAD-1,645 1,159 cumulative deaths of cases), Influenza Like Illness (ILI-1,458 cases) AWD/Cholera in 2017 followed by Severe Acute Respiratory Illness 55 districts in 19 regions have (SARI-573 cases) reported AWD/Cholera cases AWD cases increased from 55 in week 51 to 108 22,657 cumulative cases of in week 52. suspected measles cases Most of the AWD Cases were reported from Of the 22,657 measles cases, Beletweyne district of Hirshabelle state where 11,753 (51%) are under 5 years there an active outbreak of cholera. while 10,933 (49%) are above 5 No AWD/cholera deaths reported in all districts years in the past 14 weeks The number of measles cases decreased from 415 in week 51 to 351 cases reported in week 52. Table 1. Summary of A Table 1. Summary of Alerts for epidemic prone diseases diseases Disease Week 51, 2017 Wk52 2017 Cumulative cases (Week 1 – 52) Total consultations 60746 53,631 1851018 Other Acute Diarrheas 2172 1645 77424 Influenza Like Illness 2004 1458 65264 Severe Acute Respiratory Illness 634 573 22669 Confirmed Malaria 328 254 14070 Suspected Measles 415 351 22657 Acute Watery Diarrhoea 55 108 79121 Bloody Diarrhea 42 26 2360 Whooping Cough 39 35 975 Suspected Meningitis 6 4 237 Viral Hemorrhagic Fever 5 8 149 Acute Jaundice 2 8 205 Page 1 of 10 Neonatal Tetanus 2 4 181 Diphtheria 0 4 242 Acute Flaccid Paralysis 0 4 141 Total number of Consultations and number of reporting sites, week 34 to 52, 2017. Total number of Consultations and number of reporting sites, week 34 to 52, 2017 800 90000 700 80000 600 70000 60000 500 50000 400 40000 300 30000 Consultations Reporting sites 200 20000 100 10000 0 0 WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Consultations Reporting sites Proportionate morbidity The commonest causes of morbidity during week 52 The commonest causes of morbidity during week 52 2500 2000 1500 1000 500 0 Other Acute Influenza Like Severe Acute Confirmed Suspected Acute Watery Diarrheas Illness Respiratory Malaria Measles Diarrhoea Illness Week 51, 2017 Week 52, 2017 Page 2 of 10 Situation update of AWD/Cholera Epidemic situation The number of AWD cases increased from 55 in week 51 to 108 in week 52 across Somalia (Table 1). However, in Beletweyene district of Hiraan region where new cholera cases have been reported, 8 cases tested positive for V. Cholerae, Ogawa, O1. No deaths have been reported. All new cases reported from 6 district 5 regions across the country. A total of 79,121 cases and 1,159 deaths (CFR 1.47%) have been reported in 55 districts in all the nineteen regions of Somalia. The most affected regions since the beginning of the outbreak include Bay, Banadir, Toghdeer, Bari and Mudug. Most of the affected populations live in IDP camps where access to safe water and sanitation is limited. Of the 55 affected districts, 34 of these have been classified as hard to reach or inaccessible. The Case Fatality Rate in inaccessible districts is 4 times as in other districts. Overall, children below 5 years constitute more than 58% of the total number of AWD/cholera cases reported since the beginning of year. AWD/Cholera Cases in Somali: Week 1-52 Epi_curve showing AWD cases in Somalia between week 1 - 52 (January and December), 2017 6,000 5.00 5,000 4.00 4,000 3.00 3,000 2.00 2,000 1,000 1.00 - - Week 1 Week 3 Week 5 Week 7 Week 9 Week 19 Week 11 Week 13 Week 15 Week 17 Week 21 Week 23 Week 25 Week 27 Week 29 Week 31 Week 33 Week 35 Week 37 Week 39 Week 41 Week 43 Week 45 Week 47 Week 49 Week 51 Jan Feb March April May June July Aug Sept Oct Nov Dec Total Cases Deaths CFR Page 3 of 10 Response activities implemented during the week Coordination and Leadership The Federal Ministry of Health, with the support of WHO, conducted weekly coordination meetings with Health and WASH cluster partners at national and sub-national levels. The Cholera treatment centre in Beletweyne was opened to manage AWD/Cholera cases with support from local NGOS Surveillance and Laboratory activities A total of 265 sentinel health facilities submitted reports to the electronic disease surveillance systems in all regions. This is in addition to AWD/cholera reports received from cholera treatment facilities. The 8 stool samples collected from Banadir region were all negative for cholera AWD/Cholera alerts were received from Balad district in Middle Shabelle in the EWARN system and were confirmed as negative alerts for cholera. Water Sanitation and Hygiene Community education and mobilisation has been conducted in AWD/Cholera affected communities in Beletweyne and Balad district of Middle Shabelle 400 hygienic kits were distributed to affected communities in Beletweyne district Mobile vans have been deployed to sensitise communities on hygienic behaviour in Beletweyne Mobile teams have been deployed in high risk villages of Beletweyne district Community education and mobilisation was done in all regions affected by AWD. Essential Medicines and supplies Medical supplies and Integrated Health Kits were prepositioned in Baidoa,Hudur,Beletweyne,Kismayo and Banadir hospital . Suspected Measles Cases The number of suspected measles cases decreased from 415 cases in week 51 to 351 cases in week 52. A total of 23,353 cumulative cases of suspected measles have been reported from all the nineteen regions since the beginning of the year. Of the 23,353 measles cases, 15,846 (51%) are under 5 years while 7,507 (67%) are above 5 years. The most affected regions include Banadir (5,617 cases) Togdher (2,787 cases), Mudug (2566 cases) Lower Shebelle (2,050 cases), and Bari (1,968) (See Table 2). Page 4 of 10 Suspected Measles Cases in 2017: Week 1-52 Somalia, Suspected Measles Cases as of Week 1 - 25 800 700 600 500 400 300 Measles Measles Cases 200 100 0 W1 W3 W5 W7 W9 W11 W13 W15 W17 W19 W21 W23 W25 W27 W29 W31 W33 W35 W37 W39 W41 W43 W45 W47 W49 W51 Week Measles outbreak response Table 2: Summary of Suspected measles cases by region week 50, 51 and 52, 2017 Cumulative cases Region Week 50 Week 51 Week 52 (Wk 1 – 52) Awdal 0 0 1 105 Bakool 0 4 4 99 Banadir 82 69 67 5617 Bari 34 27 28 1968 Bay 9 36 25 654 W/Galbeed 1 3 3 758 Galgadud 6 5 7 625 Gedo 0 0 0 241 Hiraan 10 30 28 1461 Lower Juba 13 28 22 468 Lower Shabelle 29 36 36 2106 Middle Shabelle 16 11 12 716 Middle Juba 0 0 0 62 Mudug 67 65 63 2566 Nugal 58 49 45 2050 Sanag 0 0 0 259 Sool 17 25 0 698 Togdher 7 27 10 2900 Grand Total 349 415 351 23,353 WHO in collaboration with the Federal Ministry of Health have started preparatory activities for the upcoming mass nationwide measles campaigns in November 2017 targeting 4,278,083 (6 months- 10 years) children. Vaccines have been delivered to the state hubs. Page 5 of 10 Technical and coordinating structures set up, with weekly meetings at country office and zonal offices. Additionally, to micro planning and TOT trainings have been conducted in South-Central and Puntland. Puntland completed their district microplanning exercise and planning to implement campaign in first week of January 2018, targeting around one million children from 6 months to 10 years of age. Trainings for district microplans are planned in January 2018 in south central zone. Somaliland started preparation for measles campaign. ToT for microplanning is planned in January 2018. Page 6 of 10 Table 4. Summary of epidemic prone diseases and syndromes in different districts of Somalia as of week 52 Region/District SARI ILI AWD BD OAD Diph WC Meas NNT AFP AJS VFS MAL Men total_cons Baki 0 1468 0 130 533 0 0 6 0 0 0 0 8 0 3346 Borama 0 8343 1190 108 4112 0 0 33 0 0 0 0 69 0 23791 Lughaya 0 411 0 10 356 0 0 0 0 0 0 0 0 0 1896 Zeila 0 2030 16 26 1217 0 0 7 0 0 0 0 36 0 6962 Awdal 0 12252 1206 274 6218 0 0 46 0 0 0 0 113 0 35995 Elberde 1 0 0 0 124 0 0 3 0 0 0 0 0 0 21566 Huddur 12 0 0 2 91 0 16 16 0 0 0 0 134 0 8009 Tayeeglow 0 0 0 0 0 0 0 0 1 0 0 0 10 0 163 Wajid 20 0 0 38 266 0 100 237 0 0 0 0 135 0 52200 Bakool 33 0 0 40 481 0 116 256 1 0 0 0 279 0 81938 Abdiaziz 464 291 260 123 208 124 131 121 172 132 120 132 127 132 7488 Boondhere 0 0 0 0 274 0 0 43 0 0 0 0 0 0 5883 Dayniile 0 0 9 0 156 0 0 7 0 0 0 0 0 0 10719 Dharkinley 659 1729 0 0 1879 0 0 80 0 0 0 0 3 0 23045 Hamar Jab Jab 276 718 0 0 478 0 1 21 0 0 0 0 3 0 14265 Hamar Weyne 204 231 20 0 793 3 1 46 0 0 0 0 1 0 10085 Hodan 8 0 0 0 93 0 0 1 0 0 0 0 2 0 8390 Howl-wadaag 0 0 0 0 12 0 0 5 0 0 0 0 1 0 18435 Huruwaa 2631 4572 21 4 3757 0 1 871 0 0 0 0 8 2 58416 Kaaraan 1 0 0 0 14 0 0 0 0 0 0 0 5 0 16456 Kahda 13 144 0 0 104 0 0 0 0 0 0 0 0 0 3914 Shibis 75 0 0 1 541 0 0 25 0 0 0 0 17 0 8589 Waberi 0 0 0 0 88 0 0 7 0 0 0 0 1 0 15900 Wadajir 1128 1026 761 1 1843 0 18 182 3 0 0 0 845 0 86886 Wardhiigley 0 0 0 0 146 0 0 3 0 0 0 0 3 0 8052 Warta-nabadda 7 0 51 0 673 0 0 38 0 0 0 0 10 0 28430 Yaqshid 680 205 0 0 650 0 0 17 0 0 0 0 2 0 27648 Banadir 6146 8916 1122 129 11709 127 152 1467 175 132 120 132 1028 134 352601 Banderbayla
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