Health Action in Nepal Health Newsletter Ministry of Health and Population, Department of Health Services, Epidemiology and Disease Control Division World Health Organization-Emergency and Humanitarian Action - Issue II, October 2005 N Headlines O I N G NEPAL E M R ID • Laboratory Confirmed N - R W E HUMLA ES T TE S R KATHMANDU Poliomyelitis Case Recently E DARCHULA N W R R BAJHANG E APU R G A KT A IO B H Detected In Nepal F BAITADI BAJURA MUGU N RA HU LD W DE K JUMLA E K A DOTI AL S LALITPUR A D ACHHAM IKO DOLPA T N T E C R H A MUSTANG N N R P DAILEKH U E Highlights R JAJARKO T G KAILALI IO N RUKUM MANANG C SURKHET E • Japanese Encephalitis in NT BARDIYA MYAGDI RA SALYAN BA L ROLPA GL GORKHA R U T KASKI N G E Nepal A LAM J UN G G B IO R RASUW A N BANKE PYUTHAN GULMI A P A G EA GJ STERN N IN REGION • Influenza Pandemic Y A D DANG S TANAHU A H SINDHU D NUW AKOT PALCHOK PALPA A U I K H SOLU Preparedness ST S A A I A L SANKHUWA L B H AR DO P KHUMBU P I DE P A K A N A L H SABHA PA W CHITW AN H TAPLEJUNG U A MAKW ANPUR KAVRE C R N E • Floods and Landslides M A R OKHAL A R S SINDHULI DHUNGA NG U A R A T P R R A T O A H H A K J A E I H R T M P U T H H O H A I TH C A A H N Lymphatic Filariasis B • R A A U T L B DHAN P TERAI A D S A U R T Y KUTA U A A A T P ILAM N U S R O R I HILL A H SIRAHA Elimination Program in R H A A D M S MOUNTAIN N SAPTARI JHAPA U Nepal S MO RANG EDCD News update • Workshop on Outbreak Laboratory Confirmed Poliomyelitis Case Recently Detected In Nepal Preparedness & Response to Dr. Ganga Ram Choudhary Influenza like illness for Surveillance Coordinator, IPD/WHO Rapid Response Teams Nepal remains at high risk of poliomyelitis because of continued virus • Workshop for the reduction transmission in the Indian states of Uttar Pradesh and Bihar. The border of outbreaks from food and between Nepal and India is porous with people from either country freely water borne communicable moving back and forth. diseases In Nepal, there were two laboratory confirmed cases of poliomyelitis in 1999 • Rabies Awareness program and four cases in 2000. All cases were identified in the districts bordering • Emergency Preparedness in India. Since the last case in 2000, Nepal has remained polio free until recently. Sindhupalchowk District initiated by the District The most recent case in Nepal was a 2-year-old male child from Sarlahi Disaster Relief Committee district in the Central Region of Nepal. The case was recorded by Sadar th Forth coming News Hospital, Sitamani, India on 9 August 2005. The child was presented to the hospital with complaints of weakness in all four limbs for three days. The case • National Annual Review was investigated by the Surveillance Medical Officer (SMO), Sitamani India. Meeting for the Fiscal Year 2004/05, from November 13- A single stool sample was collected on 10th August 2005 and was sent to the 15 2005 in Kathmandu referral laboratory for further investigation as a suspected Poliomyelitis case. The patient could not move, sit, stand, and hold his head. No association of fever, common cold, muscle pain, diarrhea or vomiting was noted. There is no record of second sample being collected by SMO Sitamani. The case was notified to Nepal on 20th September 2005. To be continued second page Health Action in Nepal (Monthly Health News Letter, Issue II, October 2005) Page No. Page # 1 of 5 Laboratory Confirmed Japanese Encephalitis in Nepal (JE kills over 300 in 2005) Poliomyelitis Case Recently Detected in[[ Nepal cont. The immunization record from the Map of Nepal Village Health Worker of the Japanese Encephalitis cases and deaths, 25 October 2005 child’s VDC (Phari Parsa VDC of HUMLA Sarlahi district) showed that the DARCHULA BAJHANG MUGU BAITADI 12 child had received three doses of BAJURA KATHMANDU DADEL- JUMLA 0 BHAK OPV during routine immunization. DHURA DOTI ACHHAM KALIKOT DOLPA 106 MUSTANG By verbal history, he had also KANCHAN- LALIT PUR DAILEKH 366 JAJARKOT 14 KAILALI 3 RUKUM MANANG received four or more doses of 69 SURKHET 57 1 MYAGDI SALYAN BARDIYA OPV during Supplementary B GORKHA ROLPA AG KASKI 6 LU LAMJUNG NG 498 PARBAT RASUWA Immunization Activity (SIA). BANKE 202 PYUT- HAN GULMI 85 DANG ARGHAK SYANGJA TANAHU SINDHU- 34 HACHI NUWAKOT PALCHOK Although the clinical findings were 4 PALPA 0 DOLAKHA 1 DHADING KATHM KAPIL- 14 396 NAWAL BHAK SULUK- BASTU RUPAN- PARASI HUMBU DEHI P SANKHUWA- TAPLEJUNG not suggestive of poliomyelitis, the 3 1 MAKAWAN- LALIT KAVRE A H SABA CHITWAN H 52 PUR C E M A 35 R OKHAL- DHUNGA first stool specimen collected on 11 PARSA SINDHULI 1 KHOTANG TERHA- R 5 A 6 BHOJ- THUM TH BARA E RAUT- H PUR C 0 AHAT UDAYAPUR DHAN- PA Aug 2005 in India showed that the SARLAHI MAHO- KUTA 2 TARI 42 DHA ILAM NUSA SIRAHA 6 15 child was excreting wild poliovirus 6 4 SUNSARI MORANG 7 SAPTARI JHAPA type 1.The second specimen was 0 29 104 37 Total Cases=1916 collected in Nepal after 52 days of Total Deaths=307 onset, and laboratory result also JE Affected Districts Source; DoHS, EDCD revealed wild poliovirus Type 1. During the follow-up examination on 25 September 2005, it was Until the end of October 2005, there were altogether 1916 Japanese found that the child had residual Encephalitis cases reported to EDCD from 19 districts. Out of that 1609 paralysis but was improving. (84%) patients were cured and 309 (16%) died. Compared to September 2005, 37 additional cases were detected from the Eastern Region and Among five contacts specimens Mid- Western Region of Nepal and out of these 9 died in the month of collected from this case during October 2005. investigation, one contact specimen collected from the patient's elder sister showed that News update in October 2005 the child was also infected with wild poliovirus Type 1. However, “Workshop for reduction of food and water-borne the child is symptom less. By communicable disease outbreak in the Western Region verbal history, this child had received only two doses of OPV For “the reduction of food and water borne communicable disease outbreak”, a and one or more doses during 2-day workshop was held in Palpa, Western Region of Nepal from 2-3 October Supplementary Immunization 2005. The participants came from the Municipality, Office of the Drinking Activity. Water, NGO/INGO, Veterinary and Agricultural Development Office, and the District Public Health Office (DPHO). Staff from the Mission Hospital, Palpa Response Plan: Nepal has and teachers from Government Schools also attended. After the workshop, planned to conduct three rounds of participants will play an active role for creating awareness at the grass roots mopping up in response to this level and then assist in prevention and control of outbreak from food and water wild poliovirus case. The campaign borne communicable diseases. will cover five districts urgently including the affected district and 2 Day Orientation on Vector Control (Malaria) in Central its surrounding districts i.e. Sarlahi, Region, from 29-30 October 2005 Mahottari, Rauthat, Sindhuli, and Makawanpur in the Central The 2-day orientation program on vector control especially on essential Region. According to the plan, the malariology for Vector Control Assistants (VCA) and Malaria Inspectors was first round of mop up was held in VBDRTC (Vector Borne Disease Research and Training Center) in the conducted successfully within 14 Central Region. Altogether 30 Vector Control Assistants (VCA), Malaria days of the laboratory confirmed Inspectors and representatives from the Regional Health Directorate from 21 poliomyelitis case. In addition, districts of five regions participated actively. 14 districts of especially Terai Sub-National Immunization Days and inner Terai are highly affected by Malaria. The objective of this two day (SNID) will be conducted for the program was to discuss the existing malaria information system and identify remaining Terai districts and areas to improve, to improve the reporting system for outbreaks of malaria and Kathmandu valley in December to discuss monitoring and supervision of malaria prevention and control 2005 and January 2006. activities. Health Action in Nepal (Monthly Health News Letter, Issue II, October 2005) Page No. Page # 2 of 5 News update in October 2005 Influenza Pandemic Preparedness in Nepal Workshop on Outbreak Preparedness and Response The National Task Force is working to finalize the National training for Influenza-like Influenza Pandemic Preparedness and Response Plan for Nepal. illness for Rapid Response Teams in the Central and Mid- The plan aims to facilitate and coordinate the implementation of the Western Region activities of both the health and agricultural sectors to prevent and contain Avian Influenza in poultry and humans, and to reduce the There are Rapid Response team for risk and mitigate the impact in the event of an Influenza pandemic. outbreak preparedness and immediate response in all 75 districts. The workshop was held in Kavre in the Under the leadership of the Ministry of Health and Population Central Region and Nepalgunj in the (MOHP) and the Ministry of Agriculture and Cooperatives Mid-Western Region of Nepal from (MOAC), with technical support from WHO, this plan was further 6-7 October and 24-25 October 2005 developed in September 2005 with the participation of different respectively with the support of constituencies from the private and public sector.