Epidemiological Updates Week 29, (12-19 July 2015)

Transcription

1 Weekly EV Situational Report Kambia istrict, Sierra Leone: July 1 Epidemiological Updates Week 29, (12-19 July 1) 1. Epidemiological Highlights - There were no new EV confirmed cases reported in Week 29 (13-19 July, 1). - A total of n=1 samples (19 blood and 101 swabs) were tested for EV during the week. - A total of n=114 alerts were generated and responded to during the reporting week; v n=100 death alerts were reported from all seven chiefdoms. v n=14 live alerts were reported from five chiefdoms. 2. Alerts A total of 114 alerts were reported from all chiefdoms. The live alerts were reported from Samu(6), Magbema(3), Tonko Limba(2), Mambolo(1) and Gbinleh- ixon(2), while Bramaia and Masungbala did not report any live alerts. On the other hand, the death alerts were reported from Samu(23), Magbema(29), Tonko Limba(18), Mambolo(13), Masungbala(7), Gbinleh- ixon (11) and Bramaia(13). The alerts are presented by chiefdom in the following figure (Fig. 1). Figure 1: Number of alerts by chiefdom, week 29, 1, Kambia istrict, Sierra Leone

2 The trend of alerts has been consistent for the last four Epi Weeks (26-29). The number of death alerts is increasing, as shown in the following chart (Fig. 2). Most of the alerts were from Magbema (29). Generally, death alerts have been increasing in the two chiefdoms of Magbema and Samu as compared with previous week. However, a significant decline in the death alerts has been observed in Masungbala. 140 Number of alerts eath Alerts Live Alerts Total Alerts Figure 2: Number of death and live alerts reported by week, Weeks 1-29, 1, Kambia, Sierra Leone Expected and reported death alerts A total of 111 death alerts are expected in the district based on the national mortality rate under normal circumstances. As evident from the following figure (Fig. 3), each chiefdom should report at least the expected number of deaths. However, if the number of death alerts reported is lower, it may indicate the occurrence of secret burials, which requires additional attention.

3 30 140% 130% % 1% Number of death alerts % % 9 8% % 7 22 % % 80% 60% 40% % % of reported deaths 0 Magbema Bramaia Tonko- Limba Gbinleh ixon Samu Masungbala Mambolo 0% Expected eaths / week eath Alerts Reported % deaths reported Figure 3: Expected and reported death alerts by chiefdom, Week 29, 1, Kambia, Sierra Leone The number of death alerts increased compared to last week. Masungbala and Mambolo are reporting below the expected number of deaths at 8% and % respectively. Magbema, Bramaia and Tonko Limba are reporting over 100%. 3. EV cases A total of 82 non- cases (negative), 34 suspected, and 0 probable or EV- confirmed cases were reported within the reporting week. The trend of cases based on laboratory classification by week is presented in the following figure (Fig. ) Not a case Excluded Suspect Probable Confirmed Figure 4: Trend of sample test outcomes (Confirmed, Probable, Suspect and Not a case) from Week 23, 14 Week 29, 1

4 There was no confirmed EV case in Epi Week 29. Within the last seven days, the highest rate of infection was recorded during Epi Week 24, 1, from then the trend has been on a decline reaching zero for the first time since May 31 st. The trend of EV confirmed cases is shown as follows by week and chiefdom (Fig. 6). Figure : Confirmed Cases in Kambia by Chiefdom since Jan. 1, 1 Most of the EV confirmed cases reported in the past few weeks (22-28) originated from the Tonko- Limba, Samu and Magbema chiefdoms. In fact, the two active transmission chains within the district were primarily occurring within the Tonko- Limba and Samu chiefdoms. Chiefdoms ate since last case Masungbala 22/01/1 182 Mambolo 07/02/1 166 Gbingleh- ixon 01/0/1 83 Bramaia 01/07/1 Magbema 0/07/1 16 Tonko Limba 07/07/1 14 Samu 10/07/1 9 istrict 10/06/1 9 No. of days without a case Table 1: ate of last EV case reported and number of days since last case reported by chiefdom, as of 19 July 1, Kambia

5 As of 21 July, the district had gone 10 days without a case. However, three chiefdoms had gone fewer than 21 days without a confirmed case, namely: Bramaia (), Magbema (16), Tonko- Limba (14), and Samu (9). Epidemiological link of confirmed cases There was no EV confirmed case in Epi Week 29. There are two active transmission chains in the district (Fig. 7). Figure 7: EV transmission chains, as of July 19, 1, Kambia Kaffubulom- Royenke- Rosino- Laya TRANSMISSION CHAIN AS AT 10 TH JULY 1 Mamusa, Marampa Royenke, BKM daugther SK 40M IGS 28F EB days F Barmoi Luma SK24 F HJ 2F Rosino amd Layah Samu sisterin law Ya IK?F MK 9F Pa MK 44M MK 27M OS 22M daugther, close contact IB?24F breastfed AK 11moF son SS1 M MK 10M 03- May 1- May 01- Jun 04- Jun 09- Jun 1- Jun 19- Jun 22- Jun 10- Jul diagose while alive, index case First Generation Second Generation Third Generation Fourth Generation Secret burial diagnosed after death R=Recovered =ead fifth generation KAMBA- KAALO- KAGBOTO TRANSMISSION CHAIN AS of 7th July 1 Karmanko Bramaia Kamba Magbema Kadalo- Kagboto, Tonkolimba AB 39M MB 29F SB 2M AB 10 P AT 80M MK 2M FB 28F IB 29M wife, applied herbs aughter IB 14moF close contact R YK 2F AT 4M AK 6F YK 60F G/aughter shared bed MB 6F neigbhor/ close friend - Apr 30- Apr - May 31- May 01- Jun 09- Jun 1- Jun 22- Jun 28- Jun 29- Jun 01- Jul 07- Jul diagose while alive, index case First Generation Second Generation Third Generation Fourth Generation Fifth Generation Secret burial diagnosed after death R=Recovered =ead MBS 60F step /aughter R shared bed MK 4F KS 7F AS 44M AS 22M Niece A household contact, care M 60M

6 However, the Epi- Link for the confirmed Health care Worker infection (Kambia ETC) from Week 27, 1 has not been determined and investigations are on going. 3. Laboratory investigation A total of 1 lab samples (19 blood and 101 swabs) were investigated for EV during this week. The number of samples and those testing EV positive during this week is presented by date as follows (Fig. 8). Figure 6: Total Blood and Swab samples tested by date, Week 28, 1, Kambia, Sierra Leone In addition, the number of samples tested over the past three (3) months is presented by week as shown below (Fig. 9). The trend shows that the number of samples being tested is increasing consistently with the number of alerts reported.

7 Fig.7: Number of Alerts, Samples Tested and EV- positive samples, Weeks 17-29, 1, Kambia, Sierra Leone 4. Cross Border Surveillance Figure 10: Spot Map of EV affected bordering areas in Samu chiefdom (Kambia, Sierra Leone) and Benty sous- préfecture (Forécariah, Guinea) The Spot map (figure 10) shows the villages in Samu chiefdom (Kambia district) and the neighboring Benty sub- préfecture (Forécariah prefecture) which has had high case load in the previous weeks. Cases occurring within this region have accounted for 81% of the total EV- positive caseload in Forecariah for the last 21 days.

8 Figure 11: Spot Map of EV- affected areas in Kambia district (Sierra Leone) and Forécariah prefecture (Guinea) Partner Organizations Kambia EV Weekly Situational Report