Whole of Syria - Disease Early Warning Snapshot May 2019 Epidemiological Summary Aleppo W 18 - 22 During weeks 18-22 (May) 2019, weekly cases of influenza-like illness con�nued Weekly cases of acute diarrhea to decline na�onally at even higher rates than the previous month – case rates Northwest W 18 - 22 rose nearly 400% in Dayr Har sub-district and more than 130% reduced by 26%, represen�ng an overall decrease of 43% since February from As a result of increased hostilities in northwest Syria in May, an estimated 24 in Mare sub-district while typhoid approximately 53,000 cases per week to 30,000 cases per week. Severe Acute surveillance sites were damaged, case rates increased 82% in the Respiratory Illness (SARI) weekly case rates were at their lowest in 2019, suspended or changed lines of control – governorate overall declining 35% since April. The an�cipated seasonal increase in acute diarrhea 15 in Idleb, 8 in Hama and 1 in Aleppo. cases con�nued to be observed with weekly cases rates rising by 14% and Al-Hasakeh increases seen in 13 out of the 14 governorates. Acute diarrhea case rates rose more than 100% in the governorates of As-Sweida, Damascus, Dar’a, La�akia, Aleppo Quneitra, and Tartous. For the fourth month in a row, Hepa��s A case rates Idleb Ar-Raqqa con�nued to decline in May by 3% though increases were reported in Damas- cus (13%), Deir-ez-Zor (14%), Aleppo (18%), and Rural Damascus (48%). Meningi�s weekly cases increased na�onally by 21% with the greatest increases Lattakia Deir-ez-Zor observed in Ar-Raqqa (47%), Deir-ez-Zor (58%), and Aleppo (121%). Finally, for the second month in a row, weekly cases of typhoid increased na�onally, rising Hama by 30% since April and 48% since March. Aleppo, Deir-ez-Zor and Al-Hasakeh Tartous governorates all experienced an increase in case rates of 35% or more. Homs Deir-ez-Zor W 18 - 22 Typhoid weekly cases rose by 39% in the Lattakia & Tartous W 18 - 22 governorate with 4 sub-districts seeing a Numbers Key Total PHC Consultations 30-50% increase and 3 sub-districts Weekly case rates of acute diarrhea seeing a 51-91% increase with Al-Mayadin experiencing the largest rise 1,968,551 increased in Lattakia and Tartous by 133% and 176% respectively. Damascus Reported Cases by age Weeks 18 - 22 : Total Consultations # of Reporting Quneitra weeks 18 - 22 Sites 51% 49% above 5 under 5 1 - 25,000 1 - 25 As-Sweida Dar'a 25,001 - 50,000 26 - 50 Average # of Reporting Sites Quneitra W 18 - 22 50,001 - 100,000 (Weeks 18 -22) 1,500 Case rates of acute diarrhea increased More than 100,000 51 - 75 by 103% from an average of 32 cases per week in April to an average of 65 Subdistricts without More than 75 Reporting Completeness 89.1 % cases per week in May reporting capacity Trends for top 3 morbidities Total number of cases by morbidity,Week 18-22 (May) Consultations/Reporting Sites 60,000 600,000 1,600 Influenza Like Illness 50,000 149,632 Acute Diarrhea 109,965 500,000 40,000 Suspected Leishmaniasis 10,658 1,540 Suspected Typhoid 5,319 400,000 30,000 Sites Repor�ng Suspected Hepa��s (Jaundice) 3,527 300,000 1,500 20,000 SARI 2,902 10,000 Acute bloody diarrhea 1,574 200,000 1,440 0 Suspected Meningi�s 697 100,000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Suspected Measles and Rubella 249 Acute Flaccid Paralysis 42 0 1,400 EPI weeks 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 EPI weeks Acute Diarrhea Influenza Like Illness Suspected Leishmaniasis Consula�ons Repor�ng sites For inquires please contact Christina Bethke [email protected] Production Date: 18 July 2019 Data is consolidated from EWARS and EWARN databases Mohammad Bawaneh [email protected] © WHO 2019. All rights reserved. .