Weekly Epidemiological Bulletin Ministary of public Health Papulation Electronic Disease Early Warning and Response System Primary Health Care Sector DG for Disease Contraol Surveillance Volume 04, Issue 32, Epi week 32, 8 - 14 Aug 2016 H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 32, 2016 % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % 100% % 180,000 % 96 95 94 94 93 95 95 95 96 95 96 92 92 93 94 90 90 88 96 87 86 92 84 95 94 96 94 95 95 90% 94 81 160,000 • During week no. 32, 2016; 90% (1104/995) health facilities from 22 governorates 79 80% 140,000 provided valid surveillance data. 70% 120,000 60% 100,000 50% 80,000 40% 30% 60,000 P e r c e n t a g e g a t n e c r e P • The total number of consultations reported during the week in 22 governorates was 20% 40,000 C a i o n s u l t o n s t 143484 compared to 157849 the previous reporting week. Acute respiratory tract infections 10% 20,000 0% - Lower Respiratory Infections (LRTI), Upper Respiratory Infections (URTI), Other acute diarrhea (OAD) and Malaria (Mal) were the leading cause of morbidity this week. Reporting Rate Consultations Distribution of Reporting Rates by Governorates (Epi-week 32 , 2016) • A total of 1184 alerts were generated by eDEWS system in week 32, 2016; Of these 629 100% alerts were verified as true for further investigations with appropriate response. 80% % % % % % % % 60% % % % % % % % % % % % % % 98 98 97 103 96 96 96 96 100 100 100 100 100 100 40% 100 90 % % 85 84 80 76 62 • Altogether 92 alerts for Pertussis, 75 Lower Respiratory Infections, 70 each for Typhoid 20% 68 0% and Paratyphoid Fever and Other acute diarrhea, 69 Bloody diarrhea, 54 Malaria, 50 Upper et N o. F p H Ro r s Respiratory Infections, 39 Measles, 32 Dengue Fever, 21 Influeza Like Illness, 12 Mumps, 9 each for Acute Flaccid Paralysis and Schistosomiasis, 6 each for Severe Acute Respiratory Infection and Meningitis, 5 Viral hemorrhagic fever, 4 Cut.Leishmaniasis, 3 Neonatal Reporting Rate Target Tetanus, 2 Acute viral hepatitis, 1 Rabies were received and responded in system generated. • Online disease surveillance and response system was launched in 4 governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar).The last eDEWS expand in new 6 Governorates (Al- Baidha, Mareb, Al-Jawf, Al-Mahweet,Rayma and Al-Dhale). Leading causes of morbidity and mortality in Epi-week 32, 2016 Suspected dengue outbreak in Al-Hodaidah, Lahj,Shabwah & Aden Gov., Epi weeks 1 to a). Suspected dengue outbreak 32, 2016 Suspected Dengue fever cases • 357 suspected dengue cases were reported in 11 governorates, out of these 65 cases 600 reported from Al-Hodidah, 59 Cases from Shabwah, 57 Cases from Aden, and 18 Cases from Lahj, 4 cases with hemorrhagic manifestations were reported in Hadramout, 500 Shabwah, Al-Hodidah and Hadramout wady governorate through the eDEWS system. 400 300 NO. of cases 200 • Surveillance is being intensified to ensure that the ongoing dengue outbreak is 100 effectively monitored and other priority communicable disease are reported through alternative sources including private health facilities, mobile clinics, NGO partners on 0 the ground, health workers in the community, and the general public Aden Lahj AlHodaidah Shabwah Leading causes of morbidity and mortality in Epi-week 32, 2016 Proportional morbidity of leading priority diseases, Epi weeks 1 to 32, 2016 b. Other leading priority diseases 20.0% 18.0% • URTI (14.3%), suspected malaria (3%), OAD (9.7%) and LRTI (5.8%) remain the leading 16.0% 14.0% causes of morbidity representing a total of 32.8%. 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% • Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% 0.0% of total morbidity in reporting period. Bloody diarrhea represented 0.6% of this morbidity. DD URTI S.Malaria LRTI LRTI 6.0% OAD 9.9% BD 0.6% • All diarrheal disease comprised 10.2% and LRTI 5.8% of total morbidity in Pilot URTI 14.6% Sch 0.2% Governorates this week. Mal 3.1% Rb 0.1% AVH 0.2% Other_Disease Tuberculosis 0.0% 62.9% Mumps 0.1% • All diarrheal disease comprised 10.2% and LRTI 5.8% of total morbidity in all age group. Chicken Pox 0.1% Brucellosis 0.3% Guinea Worm 0.0% HIV/ AIDS 0.0% URTI=Upper respiratory infections; LRTI=Lower Respiratory Infections; ILI=Influeza Like Illness; OAD=Other acute diarrhea; BD=Bloody diarrhea; Susp. Cholera; SARI=Severe Acute Respiratory Infection; Typh=Typhoid and Paratyphoid Fever; Mumps; Sch=Schistosomiasis; Mal=Malaria; Rb=Rabies; AVH=Acute viral hepatitis; Meng=Meningitis; DF=Dengue fever; VHF=Viral hemorrhagic fever; Meas=Measles; CL=Cutaneous Leishmaniasis; Pert=Pertussis; Diph=Diphtheria; NNT=Neonatal Tetanus This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 1 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 32 ( 8 - 14 Aug 2016 ) Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Lower Respiratory infections ( Epi week 1 to 32, 2015 & 2016) DD 2015 URTI 2015 S.MAL 2015 LRTI 2015 Diarrheal Diseases DD 2016 URTI Sus.Malaria LRTI URTI 2016 S.MAL 2016 LRTI 2016 25.0% 20.0% 8.0% 7.0% 18.0% 7.0% 6.0% 20.0% 16.0% 6.0% 14.0% 5.0% 5.0% 15.0% 12.0% 4.0% 10.0% 4.0% 3.0% 10.0% 8.0% 3.0% 6.0% 2.0% 2.0% 5.0% 4.0% 1.0% 2.0% 1.0% 0.0% 0.0% 0.0% 0.0% Age and Sex distribution of total consultations of leading diseases (Epi week 32, 2016) Vaccine preventable diseases in Epi-weeks 1 to 32, 2016 (28th Dec 2015 to 14th Aug 2016) No.# of Cases Total No.# of Greater Than Total No.# of Diseases Less Than Five 35000 Wk-32 Cases Five Alerts 30000 Measles 91 1640 1017 623 1062 25000 Diphtheria 0 6 6 0 3 20000 Pertussis 453 5298 3487 1811 1459 15000 Number of Consultations of Number Acute Viral 10000 212 6133 2859 3274 226 Hepatitis (A & E) 5000 Acute Flaccid 11 367 194 173 226 Paralysis 0 <1yr 1-4yr 5-14yr 15-44yr >45yr Meningitis 51 1506 947 559 171 Male 8690 12772 13890 21681 10813 Female 8421 11952 13911 29315 12571 Mumps 198 2004 950 1054 152 Distribution of consultations of leading diseases by Governorates, Epi week 32 Sana'a Hadramout Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Shabwah Al-Mahrah Dhamar Al-Baidha Mareb Al-Jawf Al-Mahweet Rayma Al-Dhale Total Gov. wady Upper Respiratory Infections 648 2550 1180 1492 1336 1019 1795 1054 877 1235 658 711 701 335 726 1067 580 581 357 502 212 893 20509 Lower Respiratory Infections 234 403 490 970 347 420 1041 445 430 265 515 169 237 86 144 483 343 353 294 234 130 340 8373 Other Acute Diarrhea 368 1424 769 573 574 789 2180 802 588 773 627 570 448 283 272 545 488 400 329 359 186 522 13869 Bloody Diarrhea 13 4 33 4 21 58 123 19 11 32 39 10 34 2 14 18 75 51 101 57 42 68 829 Susp. Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schistosomiasis 2 0 1 2 4 11 5 30 17 14 22 9 0 0 0 6 0 4 28 26 20 13 214 Malaria 0 78 26 13 6 162 1982 1006 10 129 144 10 54 12 0 172 5 94 105 180 132 20 4340 Meningitis 0 5 0 5 1 3 7 6 9 0 1 0 0 0 0 10 0 3 0 0 1 0 51 Dengue Fever 18 57 58 26 11 0 65 11 1 0 0 0 59 0 0 0 0 40 0 0 0 11 357 Viral Hemorrhagic Fever 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 5 Rabies 1 0 1 1 0 9 0 9 29 0 26 0 0 0 0 2 0 0 0 7 0 2 87 Measles 1 6 11 4 0 2 19 5 13 13 5 1 3 0 0 1 1 1 1 0 2 2 91 Acute Viral Hepatitis (A & E) 2 14 9 41 16 12 4 19 34 7 10 1 7 1 2 10 3 5 3 1 2 9 212 Neonatal Tetanus 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 Acute Flaccid Paralysis 0 1 0 2 0 2 1 1 1 0 0 1 0 0 1 1 0 0 0 0 0 0 11 Cutaneous Leishmaniasis 0 0 3 1 2 1 0 8 2 0 6 6 0 0 3 6 2 6 3 1 8 1 59 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pertussis 7 21 30 3 5 7 9 11 27 81 24 2 29 0 14 8 39 99 12 1 0 24 453 Influeza Like Illness 51 20 255 52 8 74 75 65 3 13 40 40 61 0 0 0 55 35 4 31 17 28 927 Severe Acute Respiratory Infection 0 0 7 3 1 0 8 27 0 0 4 0 0 0 1 47 7 3 0 0 5 0 113 Typhoid and Paratyphoid Fever 4 56 72 132 65 205 337 652 50 103 114 69 57 6 15 188 271 86 265 103 54 26 2930 Mumps 2 4 71 4 12 2 21 15 13 4 5 3 5 0 1 2 2 4 12 4 2 10 198 Tuberculosis 0 2 5 0 0 2 4 4 10 0 2 2 3 0 0 13 2 3 1 1 0 0 54 HIV/ AIDS 0 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 Brucellosis 0 0 0 0 2 7 8 56 10 0 7 0 10 0 2 21 72 74 112 4 1 0 386 Chicken Pox 0 11 4 0 6 2 11 6 3 0 5 1 1 0 0 1 0 15 0 9 10 14 99 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 Other_Disease 1959 7628 3037 6766 5682 4792 8190 2466 15198 3628 2504 1731 2942 988 2525 7795 1302 3102 778 1507 431 3465 88416 Total_Consultations 3310 12352 6062 9897 7944 7482 15584 7532 17719 6298 4758 3336 4642 1713 3721 10562 3388 4978 2405 3001 1351 5449 143484 Number of alerts & outbreaks reported and investigated with appropriate response Number of Alerts Received and Responded (Epi weeks 29 and 32, 2016) 2016 Current week 32, 2016 System Gen.