EWARN Weekly Summary Report Early Warning Alert and Response Network

Transcription

1 EWARN Weekly Summary Report Early Warning Alert and Response Network Post-Typhoon Yolanda Week 10 Epidemiological Week No th January to 18 th January 2014 HIGHLIGHTS This week, 79 health facilities reported 16,018 total consultations through SPEED Acute respiratory infection accounted for 28% of total consultations, most among SPEED conditions reported in the current reporting period. Training on acute watery diarrhea, dengue, and measles preparedness and response is ongoing in Tacloban City. This will be repeated in the succeeding weeks. Participants are DOH Representatives, Provincial and City Health Office staff including surveillance and HEMS staff and hospital staff from Tacloban City, Ormoc City, Guiuan and Balangiga of Eastern Samar, Basey of Western Samar and Palompon, Palo, Calubian, Carigara, Abuyog and Burauen of Leyte. There were 84 cases of dengue fever in Ormoc City in January, which exceeded the alert threshold for the area. OVERALLSPEED REPORTING FROM TYPHOON-AFFECTED AREAS Overall, the number of facilities reportingremained relatively stable in the current week, with 79 facilities reporting this week and 75 last week. Total consultations declined by 9%, from 17,634 last week to 16,018 this week. Biliran in Eastern Visayas started reporting this week. Areas reporting to SPEED in current week Region VI Capiz Iliolo Region VIII Biliran Eastern Samar Leyte Total consultations by municipality: REGION VI (Western Visayas): Capiz: Dao(198), Ivisan (116), Jamindan (180), Mambusao (685), Panay (22), Panitan (48), Roxas City (619), Sigma (200),Tapaz (88); Iloilo: Ajuy (22), Iloilo City (124), Janiuay (33) REGION VIII (Eastern Visayas): Biliran: Biliran (102), Cabucgayan (86), Naval (203); Eastern Samar: Balangiga (530), Balangkayan (134), City Of Borongan (67), General Macarthur (237), Giporlos (115), Guiuan (490), Hernani (150), Lawaan (191), Llorente (137), Maydolong (282), Mercedes (174), Quinapondan (410), Salcedo (270); Leyte: Alangalang (107), Albuera (159), Babatngon (24), Barugo (110), Burauen (127), Calubian (16), Carigara (292), Dulag (48), Isabel (372), Kananga (90), La Paz (155), Leyte (218), Macarthur (31), Matag-Ob (168), Merida (498), Ormoc City (3011), Palo (405), Pastrana (107), San Miguel (40), Tabango (52), Tacloban City (581), Tolosa (209), Tunga (28), Villaba (447) The proportion of consultations due to acute respiratory infection decreased in this reporting week (12 Jan 18 Jan) from 33% to 28%, but it remained the leading cause of consultation amongst the SPEED conditions. Fever and rash and AHF remained at less than 1%. SPEED Syndrome ARI = Acute respiratory infection AWD = Acute watery diarrhea AHF = Acute hemorrhagic fever Proportion of total consult. Proportionate morbidity of select epidemic-prone conditions by week 35% 30% 25% 20% 15% 10% 5% 0% 22 Dec 29 Dec 5 Jan 12 Jan ARI 29% 26% 33% 28% Fever and Rash 0% 0% 0% 0% AWD 3% 3% 3% 3% AHF 0% 0% 0% 0% Page 1 of 5

2 PROVINCIAL SUMMARIES (SOURCES INCLUDE: EVENT-BASED SURVEILLANCE, PIDSR, SPEED) REGION VI WESTERN VISAYAS CAPIZ PROVINCE Reporting: Reporting in Capiz has declined, from 14 total health facilities in the week beginning with 22 Dec to 10 facilities in the current reporting week (12-18 Jan). Consultations: The total number of SPEED consultations declined from 3,156 to 2,156 over the past week. Leading causes of morbidity include acute respiratory infection (22%), high blood pressure (6%), wounds (5%),fever with other symptoms (3%)and fever (2%). Almost half of the consultations were others (56%). There were 12consultations for acute watery diarrhea, one for acute bloody diarrhea and one for acute jaundice syndrome. Alerts: There was one reported case of acute malnutrition. ILIOLO PROVINCE Reporting: Reporting from Iloilo included 2 Rural Health Units, 2 Hospitals, and 1 Foreign Medical Team Consultations: The total number of SPEED consultations declined from 634 to 188 over the past four weeks. Leading causes of morbidity include acute respiratory infection (27%), fever (19%), wounds (18%), hypertension (9.5%) and acute watery diarrhea (9%). Alerts: Iloilo Mission Hospital in Iloilo City reported alert of 1 case of acute flaccid paralysis (AFP). Stool specimen will be collected from the patient and sent to RITM for laboratory confirmation. Likewise the hospital also reported 1 case of fever and rash. One case of suspect leptospirosis was reported by Dart Canadian Military in Iloilo. All alerts were reported to RESU for further investigation. REGION VIII EASTERN VISAYAS BILIRAN PROVINCE Reporting: Reporting from Biliran included 3 Rural Health Units and 1 Hospital, Consultations: The total number of SPEED consultations is 391. Leading causes of morbidity include acute respiratory infection (61%), high blood pressure (7%), acute watery diarrhea (7%), wounds (6%) and fever and rash (4%). Acute hemorrhagic fever was <1% of consultations. Alerts: Seventeen fever and rash alerts were reported from the municipalities of Naval (Biliran Provincial Hospital, Naval Main Health Center), Biliran (Biliran RHU) and Cabugcayan (Cabugcayan RHU). Blood samples were sent to the RTM for measles confirmation. Measles immunization was done for children six months to less than 10 years old. Page 2 of 5

3 EASTERN SAMAR PROVINCE Reporting:Reporting from Eastern Samar included 21 Health Centers including 13 Rural Health Units, 7 Hospitals, and 1 Foreign Medical Team. Consultations: The total number of SPEED consultations declined from 3,812 to 3,187 over the past four weeks. Leading causes of morbidity were acute respiratory infection (27.2%), skin diseases (4.7%), hypertension (4.6%), wounds (3.2%), and acute watery diarrhea (2.8%). Alerts: There were 4 SPEED reports of fever with rash from Quinapondan(2), Hernani(1) and Salcedo(1). Cases were investigated by the Provincial Health Office and DOH Regional Office VIII. Serology with the use of Dried Blood Spot was taken and samples were submitted to RITM.Event based surveillance also reported 4 cases of suspect measlesfrom Oras Western Samar. RESU and PHO investigated the cases. Blood samples were taken for laboratory examination. Albino Duran Memorial Hospital of Balangiga reported thru SPEED seven cases of suspect acute hemorrhagic fever (AHF) while Felipe Abrigo Memorial Hospital of Guiuan reported 1 suspect AHF case. These cases were investigated by the staff of Provincial Epidemiology and Surveillance Unit. They conducted information and education campaign on the prevention and control of Dengue and started with fogging operations on barangays with cases.1 case of suspect Leptospirosis was also reported from Balangiga. The case was referred to another hospital in Tacloban City for further evaluation and management. LEYTE PROVINCE Reporting: Reporting from Leyte included 21RHUs, 10 hospitals, 5 BHS and 1 hospital ran by Foreign Medical Team (in Tolosa). Consultations: The total number of SPEED consultations declined from 11,144 to 5,259 over the past four weeks but slightly increased to 7,295 in the current reporting period (12 Jan). Leading causes of morbidity were acute respiratory infection (28%), wounds (10%), high blood pressure (6%), skin diseases, fever (4%) and acute watery diarrhea (3%). Fourteen consultations of fever and rash were reported from Tacloban City (Bethany Hospital, Eastern Visayas Regional Medical Center), Ormoc City (Ormoc District Hospital), Palo (Leyte Provincial Hospital) and Calubian (Northwestern Leyte District Hospital). Meanwhile, 29 consultations for suspect AHF were reported from Tacloban City (Bethany Hospital, Eastern Visayas Regional Medical Center), Ormoc City (Ormoc District Hospital, Ormoc Doctor s Hospital, Clinica Gatchalian and Hospital) and Palo (Leyte Provincial Hospital). Alerts: The Ormoc City Epidemiology and Surveillance Unit has already reported 84 dengue cases this month of January which has already exceeded the alert threshold level. Majority of the cases are in the age group. The cases are in the districts of Cogon, Linao, Valencia, Curva, Ipil and San Pablo. The city is currently doing the control and containment of cases in Cogon District which has 51% of all reported cases. Fogging, larviciding, intensive clean-up drive and advocacy campaign are now being undertaken in collaboration with international partners. Meanwhile, there were 15 alerts for AHF in Bethany Hospital in Tacloban City Page 3 of 5

4 during the current reporting period (12 Jan). Ten of which had positive Dengue Rapid Test results. Most of the patients were from Tacloban City and three were from Palo, Alangalang and Villaba, Leyte. There were also five fever and rash alerts from 12 January to 18 January. Reports came from Eastern Visayas Regional Medical Center, Schistosomiasis Research and Training Hospital, Carigara District Hospital, Villaba RHU and Carigara RHU. A mass immunization campaign was conducted last November and December 2013 and a special measles immunization campaign is planned for vulnerable children (six months to 59 months and those who missed the immunization last November and December) in areas where clustering and confirmed measles cases are found. MAPS Location of SPEED notifications of fever with rash 12 th to 18th Jan 2014, Region VIII (red=hospital blue=other facility) Location of SPEED notifications of acute hemorrhagic fever12 th to 18th Jan 2014, Region VIII (red=hospital blue=other facility) Page 4 of 5

5 FOCUS ON: MEASLES KEY FACTS Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. In 2011, there were measles deaths globally about 430 deaths every day or 18 deaths every hour. More than 95% of measles deaths occur in low-income countries with weak health infrastructures. SIGNS AND SYMPTOMS The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts (see picture), usually on the face and upper neck then spreads to the trunk and limbs over 3-4 days. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 21 days). Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases. Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five. The most complications include ear infections, pneumonia, and diarrhea. Serious complications include blindness and encephalitis (an infection that causes brain swelling). As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care. WHO IS AT RISK? Unvaccinated young children are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected. Measles outbreaks can be particularly deadly in countries recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection. TRANSMISSION The highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions. The virus remains active and contagious in the air or on infected surfaces for up to two hours. It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts. TREATMENT No specific antiviral treatment exists for measles virus. Isolate those infected with measles in the evacuation center. Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia. All children in developing countries diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%. PREVENTION Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 40 years. It is safe, effective and inexpensive. It costs less than one US dollar to immunize a child against measles. Every child should receive 2 documented doses of measles-containing vaccine to ensure protection. Susceptible individuals who have been exposed to patients with measles must be referred to health authorities for immunization. Cover mouth and nose when coughing or sneezing. For more information, go to: Page 5 of 5