Ygi;gyu Field Epidemiology and Disease Surveillance Division (FEDSD) National Institute of Health (NIH), Islamabad Phone: 051- 9255237, Email: [email protected] Weekly Bulletin: Integrated Disease Surveillance and Response (IDSR) 10th June 2021 Highlights of the week 22 (31st May – 06th June 2021) Figure 1: Most frequently reported cases during week 22, in comparison with pervious weeks, Pakistan Cumulative Information: 7,000 W20 W21 W22 5,977 6,000 Maximum cases reported were; ILI (n=5977), Acute Diarrhea (Non 5,000 4,327 Cholera) (n=4327), Malaria (n=1075), 4,000 ALRI< 5 years (n=898), SARI (n=592), B. Diarrhea (n=482), Typhoid (n=334), TB 3,000 (n=313), and suspected Cholera 2,000 (n=246). 1,075 898 1,000 592 482 In comparison with previous week i.e. Cases of Number 334 313 246 WK21, the cases of all above said 0 diseases decreased/ less reported. Cases of Acute Viral Hemorrhagic fever reported from Balochistan (n=15), Sindh (n=11), and KP (n=02). Cases of Chickenpox reported from Table 1: Province/Area wise distribution of most frequently reported cases during week 22, Pakistan Sindh (n=16) and Balochistan (n=02) Diseases AJK Baloch. GB KP ICT Sindh Total Cases of TB reported from Sindh (n=253), KP (n=58) and Balochistan ILI 3 1,847 24 550 50 3,503 5,977 (n=02) AD (Non-Cholera) 57 881 7 550 97 2,735 4,327 Malaria 3 424 0 345 0 303 1,075 ALRI < 5 years 0 157 26 60 0 655 898 SARI 0 54 1 500 0 37 592 B. Diarrhea 0 162 2 96 0 222 482 Typhoid 0 107 22 105 0 100 334 TB 0 2 0 58 0 253 313 S. Cholera 0 23 2 51 0 170 246 CL 0 127 0 10 0 0 137 VH(B, C & D) 0 9 0 0 0 127 136 Measles 0 31 0 4 1 6 42 AVH 0 15 0 2 0 11 28 Chickenpox 0 2 0 0 0 16 18 Point of Attention: Teleconference could not happen for the past 04 weeks due to involvement of IDSRS districts focal persons in COVID-19 tracing, response and vaccination activities. There is a need to verify the alerts for early detection and response activities by the IDSR teams and other concerned in their respective provinces and areas. Cases of Chicken reported more from Sindh which need to be verified, investigated, and responded. Acute viral hemorrhagic fever cases were reported more from Balochistan and Sindh. This need verification, outbreak investigation and response activities at earliest. Maximum Typhoid cases reported from Balochistan, KP, Sindh and GB. This need detailed investigation and classification (i.e. MDR or XDR) followed by response activities accordingly. Malaria cases reported from more from Balochistan, KP and Sindh. Verification, epidemiological investigation and response action is urgently required. It is proposed to enhance community awareness on water, sanitation and hygiene (WASH) practices especially for diarrheal diseases and typhoid affected districts. 1 | P a g e IDSR Weekly Epidemiological Bulletin Sindh Figure 2: Most frequently reported cases during week 22 in comparison with pervious weeks, Sindh 5,000 Sindh reported maximum cases of ILI 4,500 W20 W21 W22 (n=3,503) followed by AD (Non 4,000 3,503 Cholera) (n=2,735), ALRI< 5 Years 3,500 (n=655), Malaria (n=303), B. Diarrhea 3,000 2,735 (n=222), S. Cholera (n=170), VH (B, C & 2,500 D) (n=127), Typhoid (n=100), and SARI 2,000 (n=37) 1,500 Number of Cases of Number 1,000 District Ghotki reported the maximum 655 500 303 222 cases of ILI, AD (Non Cholera), ALRI <5 170 127 100 37 0 years, Malaria and B. Diarrhea. District Hyderabad reported maximum cases of ILI, AD (Non-Cholera), ALRI <5 years, and S. Cholera. From Karachi Malir maximum cases reported as AD (Non-Cholera), ILI and Table 2: District wise distribution of most frequently reported cases during week 22, Sindh ALRI <5 years. Karachi Karachi Shikarpur reported maximum cases of Diseases Ghotki Hyderabad Shikarpur Tharparkar Total AD (Non Cholera), and ALRI <5 years. East Malir From Tharparkar maximum cases of ILI 461 2727 0 186 0 129 3,503 ILI, AD (Non-Cholera) and Malaria. AD (Non- 684 977 136 615 165 158 2,735 Cholera) Decrease in case trend observed in ILI, ALRI < 5 years 192 184 0 118 115 46 655 AD (Non-Cholera) and ALRI <5 years. Malaria 132 25 12 30 10 94 303 Bloody Cases of Chickenpox, acute viral 133 32 4 27 2 24 222 hemorrhagic fever, Malaria and Diarrhea Mumps need immediate verification, S. Cholera 8 137 25 0 0 170 epidemiological investigations, and VH (B, C & D) 82 11 0 30 0 4 127 response activities. Typhoid 30 10 0 44 0 16 100 SARI 6 20 0 3 8 0 37 Chickenpox 4 5 0 2 2 2 15 Mumps 0 0 0 3 1 0 4 Figure 3: Week wise reported cases of AD (Non-Cholera), ILI, Malaria, Sindh 7000 AD (Non Cholera) ILI ALRI < 5years 6000 5000 4000 Number Number of Cases 3000 2000 1000 0 W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 2 | P a g e IDSR Weekly Epidemiological Bulletin Balochistan Figure 4: Most frequently reported cases during week 22, in comparison with previous weeks, Baluchistan 1,800 W20 W21 W22 From Balochistan overall ILI (n=1560), 1,560 AD (Non Cholera) (n=748), Malaria 1,600 1,400 (n=400), ALRI <5 years (n=156), B. 1,200 Diarrhea (n=136), CL (n=127), Typhoid 1,000 (n=91), SARI (n=52), S. Cholera (26), 800 748 and Measles (n=24) remained at 600 maximum. Number of Cases 400 400 156 200 136 127 91 52 26 24 District Kech reported maximum cases 0 for ILI, AD (Non-Cholera), Malaria, and ALRI <5 years District Killa Abdullah reported maximum cases for ILI, AD (Non- Cholera), and CL Table 3: District wise distribution of most frequently reported cases during week 22, Baluchistan District Lasbella reported maximum Diseases Kech (Turbat) Killa Abdullah Lasbella Pishin Quetta Total cases for Malaria followed by SARI, and ALRI <5 years. ILI 287 288 2 180 803 1560 AD (Non- 121 239 30 101 257 748 District Pishin reported more cases for Cholera) ILI, AD (Non-Cholera), and B. Diarrhea Malaria 87 33 247 21 12 400 District Quetta reported maximum ALRI < 5 years 90 0 42 24 0 156 cases for ILI followed by AD (Non- B. Diarrhea 23 0 4 78 31 136 Cholera). CL 0 80 12 8 27 127 In week22, increase trend observed Typhoid 0 7 9 47 28 91 for ILI, AD (Non-Cholera) and Malaria SARI 1 2 49 0 0 52 Cases of Leprosy, NNT, and Pertusis S. Cholera 0 0 8 16 2 26 need immediate verification, epidemiological investigation and Measles 0 11 0 5 8 24 response actions. Pertussis 0 0 4 9 0 13 NNT 0 0 2 5 0 7 Leprosy 4 0 0 0 0 4 Figure 5: Week wise reported cases of AD (Non-Cholera), ILI, Malaria, Baluchistan 1800 ILI AD (Non Cholera) Malaria 1600 1400 1200 1000 800 Number of Cases 600 400 200 0 W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 3 | P a g e IDSR Weekly Epidemiological Bulletin Khyber Pakhtunkhwa Figure 6: Most frequently reported cases during week 22, in comparison with pervious weeks, KP 1000 KP reported the maximum AD (Non W20 W21 W22 Cholera) (n=393), ILI (n=383), SARI 900 (n=342), Malaria (n=315), Typhoid 800 (n=96), ALRI <5years (n=57), B. 700 Diarrhea (n=46), S. Cholera (n=19), CL 600 (n=10) and Meningitis (n=06). 500 393 383 400 342 315 District Kohat remained the most Number of Cases 300 affected district and reported 200 96 maximum cases of all diseases except 100 57 46 19 10 6 Measles which remained same. 0 AD (Non ILI SARI Malaria Typhoid ALRI < 5 B. Cholera CL Meningitis District Haripur reported 96 cases of Cholera) years Diarrhea SARI this week. Table 4: District wise distribution of most frequently reported cases during week 22, KP Weekly cases of AD (Non Cholera), ILI, SARI decreased in comparison with the previous week. Diseases Haripur Kohat Total AD (Non-Cholera) 0 393 393 Cases of Meningitis need immediate verification, epidemiological ILI 0 383 383 investigation and response actions SARI 96 246 342 Malaria 0 315 315 Typhoid 0 96 96 ALRI < 5 years 0 57 57 B. Diarrhea 0 46 46 Cholera 0 19 19 CL 0 10 10 Meningitis 0 6 6 Measles 2 2 4 Figure 7: Week wise reported cases of SARI, AD(Non-Cholera), ILI & Malaria, KP 1600 AD (Non Cholera) ILI SARI 1400 1200 1000 800 600 Number of Csses 400 200 0 W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 4 | P a g e IDSR Weekly Epidemiological Bulletin Islamabad (ICT) Figure 8: Most frequently reported cases during week 22, in comparison with pervious weeks, ICT Form ICT, most frequent diseases were 120 W20 W21 W22 ARI (69) followed by AWD <5 years 100 (n=50), ILI (n= 50), and AWD >5 years (n=47) 80 69 In WK22 decrease in trend observed 60 for ARI, and AWD (both <5 & >5 years 50 47 50 40 Number of Cases 20 0 ARI AWD < 5years AWD > 5years ILI Figure 9: Week wise reported cases of ARI and AWD, ICT 700 ARI AWD < 5years AWD > 5years 600 500 400 300 Number Number of Cases 200 100 0 Gilgit Baltistan W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 Figure 10: Most frequently reported cases during week 22, in comparison with pervious weeks, GB From Gilgit Baltistan, maximum cases 40 reported were ALRI<5 years, Typhoid, W20 W21 W22 ILI, AD (Susp.