Republic of Liberia Ministry of Health & Social Welfare Nimba County Health Team

Transcription

1 Republic of Liberia Ministry of Health & Social Welfare Nimba County Health Team WEEK: WEEK ENDING: 18 OCTOBER, 2015 WEEKLY SURVEILLNCE REPORT FOR EPI WEEK 31 TO 42, 2015 During the weeks under reviewed the following immediately reportable diseases, conditions and events were reported as follow: Acute Flaccid Paralysis (AFP) 3 Suspected Measles. 25 Maternal Mortality. 2 Neonatal Mortality.. 1 Suspected EVD. 1,351 Acute Watery Diarrhea Figure 1:- liness of reports from reporting Health Districts DISTRICTS WEEK CUMULATIVE % FOR WEEK Gbehlay-Geh T 91% Sanniquellie-Mah T 94% Tappita L 72% Yarwin Mehnsonnoh L 79% Zoe-Geh L 70% Saclepea-Mah T 90%

2 Legend This weeks On T Late L No report received NR % Cumulative 80% on % on 50% on DISEASE REPORTS: Figure 2: Table showing immediate reportable diseases for EPI weeks 31 to 42 of 2015, Nimba County DISEASES Weeks Cases Death CFR Acute Flaccid Paralysis (AFP) 3 0 0% Yellow Fever 0 0 0% Lassa Fever 0 0 0% Neonatal Tetanus 0 0 0% Cholera 0 0 0% Acute Watery Diarrhea % Bloody Diarrhea 0 0 0% Human Rabies 0 0 0% Meningitis 0 0 0% Measles % Suspected VHF/EVD 1, % Neonatal Mortality 1 Maternal Mortality 2 COMMENTS: Between week 31 and 42, three (3) cases of Acute Flaccid Paralysis (AFP), seven hundred eighty-two (782) Acute Watery Diarrhea (AWD), and twenty-five (25) cases of Measles were reported. There was no death among these cases reported.

3 % of timeliness of reports Also one thousand three hundred fifty-one (1,351) cases of suspected VHF/EVD with one hundred sixteen (116) community that were swab, two (2) maternal deaths and one (1) Neonatal death were reported. The case fatality rate for the suspected VHF/EVD is 8.6%. Figure 3: Graph showing the timeliness of Nimba County Health Districts reports for weeks of % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% CUMULATIVE % FOR WEEK COMMENTS: HEALTH DISTRICTS During these twelve (12) weeks, three (3) Health Districts met the 80% on time report indicator, while three (3) met the % on time report indicator. IDSR expected indicator for timeliness is 80% on time report.

4 No of Cases Figure 4: Graph showing number of cases and death reported per Health Districts for week 31 42, Cases death COMMENTS: Deaths of the suspected VHF/EVD are deaths that occurred in the communities and had to be swab for EVD testing. REPORT PREPARED BY: INTRODUCTION: ISAAC B. COLE COUNTY SURVEILLANCE OFFICER NIMBA COUNTY Acute Flaccid Paralysis (AFP) Summary Poliomyelitis is a highly contagious viral disease caused by infection with the poliovirus (serotypes 1, 2 and 3). The virus infects mostly children below the age of five years, and in up to 1% of those infected the virus invades the central nervous system leading to muscle weakness

5 and irreversible paralysis (usually in the lower limbs). This sometimes progress to breathing problems, and death. Incubation period is 7 to 14 days for paralytic cases with range of approximately 3 to 35 days. This Surveillance include immediate reporting any case of AFP < 15 years of age or case of any age in which a clinician suspects polio and followed by collection 2 stool specimens < 14 days of paralysis onset Performing virus isolation in a WHO-accredited laboratory and Classifying cases according to WHO scheme ('confirmed polio', 'non-polio', 'polio-compatible'). In Nimba County, there was an alert of three cases of AFP in week 40 (week beginning 28 th September and ending 4 th October, 2015). OBJECTIVES: To confirm the existence of the reported Acute Flaccid Paralysis (AFP) outbreak. To collect samples from patients who have paralysis. To identify and line list all affected persons. METHODS: Nimba County is situated on North-Eastern part of Liberia bordering two countries (Cote d Ivoire and Guinea). Nimba County has a population of 534,376 (2015 est. population) in 6 health districts namely Gbehlay-Geh, Sanniquellie-Mah, Tappita, Yarwin Mehnsonnoh, Zoe-Geh and Saclepea-Mah. The outbreak affected 2 of the 6 health districts catchment communities (Manbor in Gbehlay- Geh and Yekepa Area K in Sanniquellie-Mah). Case based forms for each of the cases were filled by the investigating team. The parents of each case were orally interviewed.

6 Specimens were collected and sent to LIBR for confirmation. RESULTS: A total of three (3) cases were reported, all of them are male. Median Age of AFP cases are 77 months (18-95). Case A: - is a 1 year 6 months old male child who presented on the 29 th September, 2015 at the YMCA Clinic in Sanniquellie-Mah with 8 days history of progressive flaccid paralysis and fever. Paralysis is asymmetrical and affects both lower limbs. Patient has received an extra dose of OPV apart from that which was received at birth. 2 stool specimens were collected 8 th and 9 th day after the onset of paralysis. Result of investigation is being awaited. Case B: - is a 7 year and 11 months old male child who presented on the 28 th September, 2015 at the Karnplay Health Center, Gbehlay-Geh District with 8 days history of progressive flaccid paralysis and fever. Paralysis is symmetrical and affects all limbs. Patient has received an extra dose of OPV apart from that which was received at birth. 2 stool specimens were collected 9 th and 10 th day after the onset of paralysis. Result of investigation is being awaited. Case C: - is a 6 years old male child who presented on the 30 th September, 2015 at the Karnplay Health Center, but lives in Sanniquellie-Mah with 7 days history of progressive flaccid paralysis and associated fever. Paralysis is asymmetrical and affects both lower limbs. Patient has received two extra doses of OPV apart from that which was received at birth. 2 stool specimens were collected 8th and 9 th day after the onset of paralysis. Result of investigation is being awaited.

7 # of cases Outbreak of Acute Flaccid Paralysis in Gbehlay- Geh and Sanniquelle-Mah Districts, Nimba County between 21st September and 1st of October, 2015 NO OF DAYS CONCLUSION: Two of the cases live in the same district and one live in a district very close to Guinea where there are confirmed cases of vaccine derived polio. The three cases had no travel history outside of their home towns since one year ago each. PUBLIC HEALTH ACTION: Parents were asked to take child the Health Center for management. Specimens were collected and sent to LIBR for confirmation.