Weekly Epidemiological Bulletin

Transcription

1 Weekly Epidemiological Bulletin Disease early warning system and response in Pakistan Volume 3, Issue 6, Wednesday February, 212 Highlights Epidemiological week no. 6 ( to 11 February, 212) Priority diseases under surveillance in DEWS In week 6, 212, total 78 districts including 2 agencies provided surveillance data to the DEWS on weekly basis from around 1,736 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC. A total of 47,889 consultations were reported through DEWS of which 26% were acute respiratory infections (ARI); % were Skin disease; % were acute diarrhoea; and 4% were suspected malaria. A total of 1 alerts with 6 outbreaks were reported: Altogether 6 alerts for Measles; for Leishmaniasis; 12 for Pertussis; 11 for Neonatal tetanus; 9 for Typhoid; 4 for Bloody diarrhoea; 3 each for AWD and suspected Malaria; 2 each for AJS; Diphtheria; Scabies and Unexplained fever; while 1 each for AD, DF; ARI; Meningitis and Rabies. In week 6, 212, two new polio cases, 1 each reported from Khyber (FATA) and district Jhang (Punjab). As of 11th February, the total number of polio cases in 212 is 11; from 8 districts/towns/tribal agencies and areas. Acute (Upper) Respiratory Infection Pneumonia Suspected Diphtheria Suspected Pertussis Acute Watery Diarrhoea Bloody diarrhoea Other Acute Diarrhoea Suspected Enteric/Typhoid Fever Suspected Malaria Suspected Meningitis Suspected Dengue fever Suspected Viral Hemorrhagic Fever Pyrexia of Unknown Origin Suspected Measles Suspected Acute Viral Hepatitis Chronic Viral Hepatitis Neonatal Tetanus Acute Flaccid Paralysis Scabies Cutaneous Leishmaniasis Others Figure 1: Weekly trend of Acute diarrhoea, Bloody diarrhoea, ARI and Suspected malaria in Pakistan, Week 1, 211 to week 6, Table 1: Most common communicable diseases syndromes reported weekly Disease Wk-1 Wk-2 Wk-1 Wk-2 Wk-3 Wk-4 Wk- Wk-6 Acute respiratory infection 24,42 (29%) 2,219 (3%) 92,846 (27%) 11,49 (27%) 13,371 (%) 137,322 (26%) 114,319 (26%) 138,7 (%) Skin diseases 68,422 (8%),18 (8%) 19,973 (6%) 19,746 (%) 24,721 (%),639 (%) 22,2 (%) 26,786 (%) Acute diarrhoea 7,942 (7%) 49,44 (7%) 21,971 (6%) 24,322 (6%) 27,74 (%) 28,461 (%) 23,92 (%) 28,969 (%) Bloody diarrhoea 4,332 (.2%) 4,7 (.9%) 1,2 (.44%) 2,2 (.4%) 2,13 (.42%) 2,66 (.%) 2,19 (.%) 2,676 (.49%) Suspected malaria,48 (6%) 39,991 (6%) 13,97 (4%),113 (4%) 2,37 (4%) 19,817 (4%),82 (4%) 21,72 (4%) Total consultation 8,26 717,926 3,43 49,93 11,668 34, ,26 47,889 The above graph shows the weekly trend of ARI; Acute diarrhoea; Bloody diarrhoea and Suspected malaria as proportional morbidity (percentage of cases out of total consultations) reported to DEWS on weekly basis. The above table provides the total consultations for each of the last 8 weeks proportional morbidity of five disease syndrome. Proportional morbidity of ARI is highest in KP while acute diarrhoea is highest in and Balochistan (please see the graphs for every province in page 4 and ). For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int. 1

2 Special Bulletin: DEWS, Pakistan, Week no. 6 ( to 11 February, 212) Previous week's (/212) Outbreaks: Date Disease Province District Area <M >M <F >F Action Taken Alert for Cutaneous Leishmaniasis, 6 cases were reported and responded. Injection Glucantime was advised. Follow up 3 Feb Leishmaniasis Balochistan Lasbela Town Bela planned. 3 Feb Pertussis Khairpur 3 Feb Pertussis 4 Feb Measles 31 Jan Measles 2 Feb Measles 2 Feb Measles Current week's (6/212) Outbreaks: Date Disease Province District Area <M >M <F >F Action Taken 9 Feb Measles 1 Feb Typhoid 11 Feb Measles Balochistan Khuzdar 7 Feb Pertussis Dadu 8 Feb Pertussis Dadu 11 Feb Typhoid Khyber Pakhtunkhwa Qambar Shahdadkot Balochistan Lasbela Khyber Pakhtunkhwa Khyber Pakhtunkhwa Lower Dir Shangla Qambar Shahdadkot Qambar Shahdadkot S. Benazirabad Village Sobhdar Lashari, taluka Gambat Village Allah Dino Chandio, UC Kot Ghulam Shah Imam Bakhish Goth UC Sakran Village Matako, UC Khazana, Tehsil Munda. Village Alagram, UC Puran Village Punah Mugheri, UC Behram Soorghar UC Ornach Tehsil Nall Faqeer ai Chandio Near meeran Machi, UC Hazarwah Village Lashkar khan Burguri, UC put Gul Muhammad Village Bug, UC Bug Burrira, Taluka K.N Shah Dubai Banglow colony, UC Daur, Taluka Daur Haripur Village Kothra, UC Kothra Distribution of Wild Polio Virus cases Pakistan 211 and 212 As of 11 February, 212, the total number of polio cases confirmed by the laboratory is 9 (type 1) from 8 districts/towns/tribal agencies and areas. Suspected Pertussis outbreak reported, upon field investigation 17 cases found, erythromycin provided to cases and contacts, health & hygiene session conducted, special outreach activity for routine immunization will be conducted as soon as possible. Alert for probable Pertussis, upon field investigation found 24 cases of suspected Pertussis, Erythromycin provided to all cases as per protocol of WHO, cases line listed and information shared with DHMT for immunization follow up. Alert for 2 suspected cases of measles, during field investigation more cases were found. Vit A and symptomatic treatment was given. 1 blood sample was collected and found positive. Information was shared with district health team, outreach vaccination planned. Alert for suspected Measles, during active surveillance 4 cases were found. outreach immunization activity conducted, Vit A given, blood sample collected and found positive, health education session conducted in the community, EDO H informed. Alert for suspected measles reported from THQ hospital, 3/4 samples taken found positive for Measles. Vitamin A was given and active surveillance conducted with DOH team and Environmental engineer, found 9 more cases in the nearby houses, Outbreak was declared and EDOH along with EPI and Hub office WHO was informed. Local measles vaccination campaign started along with polio campaign. Follow up is planned in 4 weeks time however close monitoring has been established by converting ARI center's reception counter to observational cell for the next week. Alert for 1 suspected case of Measles, during field Investigation found more suspected cases Vitamin (A) given to all, health education imparted regarding isolation and prevention of measles. 1 sample collected and found positive for Measles. Alert for Measles reported by DHO, on field investigation in remote area found 14 clinical Measles cases. Health and Hygiene education with symptomatic treatment given along with Vit A, collected one blood sample & sent to NIH. Un immunized childrenin the community were immunized. Alert for 7 cases of suspected Enteric fever were reported from BHU. On active case finding in village 1 more cases were found with positive clinical sign and symptoms with positive Widal tests. Blood sample was taken from 2 patients and both came positive for IgM typhoid. Water sample results are awaited. Health and hygiene sessions were conducted for community. Hygiene kits and aqua tabs were also distributed in the affected community. Follow up visited is planned for the coming week. Alert for one suspected cases of Measles. Upon field investigation found 14 more clinical cases of measles Vit. A. given to all the patients, health education imparted regarding isolation and immunization for measles. 1 probable case of Pertussis was reported, on active surveillance more cases were found, cases were not vaccinated, out of 1 children only 1 had BCG scar, Health education session was conducted, Erythromycin was given, EDO H, THO and EPI focal person informed and request for Immunization. Probable cases of Pertussis were investigated, during active surveillance more cases were found, health education was imparted, 8 (%) out of 23 had BCG scars, Erythromycin given to cases, EDOH, THO, EPI FP and MO BHU informed and request for immunization, 1 Throat swab was collected. Suspected case of Typhoid found in the village, 2 out of 7 were Widal +ve, on active surveillance done, health and Hygiene session were conducted in the village, underground water was the suspected source, Aqua tabs were distributed, EDOH, DOH informed and 2 water samples were taken. Province Cases 211 Cases 212 P1 P3 P1 P3 Punjab Khyber Pakhtunkhwa 23 4 FATA Balochistan 73 2 AJ&K Gilgit Baltistan 1 Islamabad Total For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int. 2

3 Special Bulletin: DEWS, Pakistan, Week no. 6 ( to 11 February, 212) Current week's Alerts: Province Khyber Pakhtunkhwa Current week's Alerts: Province Date Disease District Area <M >M <F >F Date Disease District Area <M >M <F >F 1 Feb Leishmaniasis Bannu Village Taji Kala 1 7 Feb Leishmaniasis Lower Dir A/R Taimar Camp, Timargara Feb Measles Battagram Village Bandigo colony, UC Ajmaira 1 7 Feb Measles Buner kohi dera near cheena tehsil gagra Feb Measles Buner Village Char Katkala,UC Jawar 1 1 Feb Measles Buner Village mollator near elai tehsil dagar 1 11 Feb Measles Buner Village maradoo tehsil chagharzai 1 7 Feb Measles Charsadda Gulbahar 1 7 Feb Measles Charsadda Zahidabad 1 8 Feb Measles Charsadda Gul Lala kallay 1 8 Feb Measles Charsadda Hisara Kallay 1 8 Feb Measles Charsadda Mutabar Kallay 1 9 Feb Measles Charsadda Turlandi 1 6 Feb Measles D. I. Khan Mangal, Kirri Shamozai, Tehsil Paroa 1 6 Feb Measles D. I. Khan Zafar Abad Colony, UC Lachra 1 7 Feb Measles D. I. Khan Mandhra Kalan Feb Measles Haripur Khalabut Township 1 9 Feb Measles Haripur Shah Maqsood 1 1 Feb Measles Haripur Wapda colony, Ghazi city, Tehsil Ghazi Feb Measles Haripur Village Chinari Near Tanaka Shareef 1 7 Feb Measles Kohat Darra Bazaar, Darra Adam Khel 1 7 Feb Measles Kohat KDA Gate No Feb Measles Lower Dir Village Shekaoly, UC Toor Mang 2 1 Feb Measles Lower Dir Village Gombat Talash, UC Shahikhail Feb Measles Nowshera Mohalla Nader Khel Village 1 1 Feb Measles Nowshera Village Pabbi 1 7 Feb Measles Shangla Village Kotkay Sharona 1 8 Feb Measles Shangla Village Basi Feb Measles swabi Private Clinic, Faqeer Abad Feb Measles Swabi BHU Sard China, Khwar 1 7 Feb Measles Swat Village & UC Balogram 1 7 Feb Measles Swat Village Barikot Attaullah Korona 1 7 Feb Measles Swat Village Guluno Shah Devlai 1 7 Feb Measles Swat Village Qamber Mohallah Pir Khel 1 8 Feb Measles Swat Village Bandaan Parona, UC Jambel 1 8 Feb Measles Swat Village Bishband 1 8 Feb Measles Swat Village Goda Manai, UC Tall 1 8 Feb Measles Swat Village Tor Qamar, UC Islampur 1 9 Feb Measles Swat Village Baba G Mohallah 1 9 Feb Measles Swat Village Banju Kishawra 1 9 Feb Measles Swat Village Dadahara Mianz Palao 1 9 Feb Measles Swat Village Mega Galoch, UC Kalkaley 1 9 Feb Measles Swat Village Sirsenai Chowk 1 8 Feb Pertussis Mansehra Mohallah Kangar Garhi Habibullah Feb Scabies Lower Dir Village Golar Shontala Feb Typhoid Haripur Village Kothra, UC Kothra Current week's Alerts: Province Balochistan Date Disease District Area <M >M <F >F 9 Feb BD Khuzdar Dozzan Baggi Soorghar UC Ornach Tehsil Nall Feb Leishmaniasis Bolan Village Lundi Khosa 1 7 Feb Leishmaniasis Bolan Village Mashkaf 1 9 Feb Leishmaniasis Bolan Dhadar city 1 11 Feb Leishmaniasis Jaffarabad BHU Sohbat Pur, Tehsil Sohbat Feb Leishmaniasis Kalat Hajika UC, Tehsil Surab 1 8 Feb Leishmaniasis Khuzdar Malghozar UC Lizo, Taj Abad 3 7 Feb Leishmaniasis K Saifullah Killa Saifullah 3 8 Feb Leishmaniasis K Saifullah Muslim Bagh 1 9 Feb Leishmaniasis Sibi DHQH Sibi Feb Malaria Jaffarabad CD Goth Ghulam Mohammad Jamali Feb Measles Awaran Camp Jhaoo, Tehsil Jhal Jhaoo Feb Measles kharan killi qadirabad, Sarawan Feb Measles Khuzdar Soorghar UC Ornach Tehsil Nall Feb Measles Lasbela Daroo hotel UC Baroot 1 1 Feb Measles Lasbela Jam Yousuf colony UC Pathra HUB Feb Measles Lasbela Shaikh Abad Gadani 1 8 Feb Pertussis Chagai Girdi jungle refugee camp Feb Pertussis Khuzdar Kapparo Soorghar UC Ornach Tehsil Nall Feb Rabies Harnai UC Harnai Feb AWD Mirpur Khas Street # 1, ward #1 1 7 Feb AWD Tharparkar Village Rajoro, UC Rajoro, Taluka Chachro 2 6 Feb BD Larkana Village Bhasham ji wandh Feb BD Qambar Village Abbas Lahar, UC Warah Feb BD Benazirabad Village Mashak, UC Bhoora Feb Leishmaniasis Shikarpur Village Pathan Kot, taluka Khanpur Feb Measles Ghotki Near Bilal Masjid, UC I Ghotki City 1 11 Feb Measles Ghotki Village Gullan Laghari, UC Bandh 1 7 Feb Measles Jamshoro Muhajir colony taluka Kotri Feb Measles Larkana Bhains colony Muhalla larkano 1 1 Feb Measles Larkana Rahmat pur muhalla UC Feb Measles Qambar Village Faqeer Ali Sher Baig Chandio 1 8 Feb Measles Qambar Kamboh Mohalla, Shahdadkot, UC II 1 8 Feb Measles Qambar Sultan Ahmed Khuwar Mohalla Feb Measles Qambar Faqeer ai Chandio Near meeran Machi Feb Measles Qambar Shah Mohammad Chandio Feb NNT Larkana Village Ali Bagh 1 7 Feb NNT Benazirabad Village Dilawar Daeper, UC Ghupchani 1 6 Feb NNT Sanghar Village Gul sher wassan, Deh Shahsi 1 7 Feb NNT Shikarpur Village Amanullah, UC Chak 1 1 Feb NNT Thatta Village Muhammad Ali Khoso 1 7 Feb Pertussis Badin Village Haji Muhammad Bhatti Feb Pertussis Badin Village Haji Khan Khoso, UC Saeedpur Feb Pertussis Dadu Village Lashkar khan Burguri Feb Pertussis Dadu Village Bug, UC Bug Burrira Feb Pertussis Hyderabad Al Fazal town, Phulelli taluka hyderabad 1 11 Feb Pertussis Matiari Kachi Paro Mohalla, City Matiari 3 11 Feb Pertussis Sukkur Jamali Mohalla, Bachal Shah Miyani Feb Pertussis Thatta Village Nazir Ahmed shah 3 8 Feb Tetanus TM Khan Goth Baqir nizamani 1 11 Feb Typhoid Larkana Village Hussain abad Khoso Feb Typhoid Mirpur Khas Chaudhary Mola Buksh Colony Feb Typhoid Benazirabad Village ghulam Hussain Heral Feb Typhoid Benazirabad Village Mashak, UC Bhoora Feb Typhoid Benazirabad Village Ramzan Dahri Feb Typhoid Benazirabad Asif Colony, UC Kazi Ahmed Feb Typhoid Benazirabad Dubai Banglow colony Current week's Alerts: Province Punjab Date Disease District Area <M >M <F >F 11 Feb AD Layyah BHU Shahpur, UC Shahpur, Tehsil Karoor Feb AJS Lahore Gul Street Colony, Sadar Feb ARI Mianwali BHU Tolla Bangi Kheel Feb AWD Layyah BHU Bakhri Ahmed Khan, UC B. A. Khan Feb DHF Lahore Badami bagh, Ravi town 1 1 Feb Malaria Mianwali THQ Issa Kheel Feb Malaria Muzaffargarh Basti Mithoo Wala, UC Taleri Feb Measles Bhakkar Nazir Town, UC Bhakkar Urban II 1 9 Feb Measles D. G. Khan Bangalwali Sokar UC Sokar Feb Measles Multan Asti Jhand wala, UC Jhangerabad Feb Measles Muzaffargarh DHQ Housing Colony, City Feb Meningitis Multan Jhoke lashker pur, Kho tinday wala 1 9 Feb NNT Multan Basti Khanbela Jalalpur peer wala 1 9 Feb Pertussis Rajanpur Basti Lanjwani, Moza Munno Wah 1 11 Feb Scabies Mianwali RHC Tabiser Feb Tetanus D. G. Khan Uroo shareef uc Fazla Katch 1 1 Feb Tetanus Lahore Rana Town shadhra 1 9 Feb Typhoid Layyah BHU Jharkal, UC Samtia, Tehsil Karoor Feb UXF Mianwali THQ Issa Kheel Feb UXF Muzaffargarh Basti Choohar pur, UC Garey Wahin For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int. 3

4 Table 1: Leading causes of seeking health care in districts, Wk 31, 21 to Wk 6, 212, compiled from weekly reports Diseases Number of Consultations Acute respiratory infection 13,829,1 (23%) Skin diseases 6,14,216 (1%) Acute diarrhoea,472,461 (9%) Special Bulletin: DEWS, Pakistan, Week no. 6 ( to 11 February, 212) Figure 2: Number of alerts by disease, week 6, Bloody diarrhoea 481,931 (1%) Suspected malaria 3,671,969 (6%) Unexplained fever 2,271,972 (4%) Total consultations 6,4,448 Table 2: Total number of alerts and outbreaks reported and investigated with appropriate response Disease (up till week 6) Total A O A O A O A O Acute watery diarrhoea Acute jaundice syndrome Bloody diarrhoea Dengue fever Measles Pertussis NNT + tetanus Malaria Leishmaniasis Others Total Province Khyber Pakhtunkhwa: 433 health facilities from 16 districts of Khyber Pakhtunkhwa reported to DEWS on weekly basis with a total of 18,17 patients consultations in week alerts were reported in this week; Altogether 41 for Measles; 2 for Leishmaniasis; while 1 each for Pertussis, Typhoid and Scabies. 1 outbreak for Typhoid received this week and appropriate measure was taken. Figure-3: Trend of priority communicable diseases, province KPK Province : 2 health facilities from 23 districts in reported on weekly basis to DEWS with a total of 213,23 patient consultations in this week. Figure-4: Trend of priority communicable diseases, province 4 37 alerts were reported; Altogether 1 for Measles, 8 for Pertussis; 7 for Typhoid; 6 for NNT; 3 for Bloody diarrhoea; 2 for AWD; while 1 for Leishmaniasis outbreaks, 2 for Pertussis; and 1 each for Measles and Typhoid were received and appropriate measure were taken For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int. 4

5 Province Punjab: 314 health facilities from 8 districts reported data to DEWS in Punjab with a total of 1,134 patient consultations. A total of 2 alerts were reported in in this week; Altogether 4 for Measles; 3 for NNT; 2 for Malaria and unexplained fever; while 1 each for AD; AJS; ARI; AWD; DF; Meningitis; Pertussis; Scabies and Typhoid. No outbreaks from any area of Punjab was received. Special Bulletin: DEWS, Pakistan, Week no. 6 ( to 11 February, 212) Figure-: Trend of priority communicable diseases, province Punjab Province Balochistan: 372 health facilities from 18 districts in Balochistan reported to DEWS, with a total of 9,897 patient consultations. 2 alerts were reported in this week from Balochistan; Altogether 9 for Leishmaniasis; 6 for Measles; 2 for Pertussis; while 1 each for BD; Malaria and Rabies. 1 outbreak for Measles was received and appropriate measure was taken. Figure-6: Trend of priority communicable diseases, province Balochistan Province Gilgit Baltistan: 9 health facilities from 2 districts in Gilgit Baltistan reported to DEWS in this week; with a total of 1,81 patient consultations. 1 alert for Leishmaniasis was reported this week and appropriate measure was taken. No outbreak for any disease received this week from any area from Gilgit Baltistan. Figure-7: Trend of priority communicable diseases, Gilgit Baltistan wk 2 wk 22 wk 24 wk 26 wk wk 4 wk 42 wk 44 wk 46 wk wk 2 wk 4 wk 6 State of Azad Jammu and Kashmir: 124 health facilities from 9 districts reported to DEWS in this week with a total of 23,468 patient consultations. 2 alerts for Leishmaniasis were received and appropriate measures were taken. FATA: 32 health facilities from 2 agencies reported from FATA in this week, with a total of,86 patient consultations. 8 alerts; 4 for Measles; while 2 each for NNT and Diphtheria were reported this week and appropriate measure were taken wk 2 wk 22 wk 24 wk 26 wk wk 4 wk 42 wk 44 wk 46 wk wk 2 wk 4 wk wk wk 2 wk 22 wk 24 wk 26 wk wk 4 wk 42 wk 44 wk 46 wk wk 2 wk 4 wk 6 For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int.

6 Alerts and outbreaks, week 6, 212 Special Bulletin: DEWS, Pakistan, Week no. 6 ( to 11 February, 212) For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : , Fax : ; wr@pak.emro.who.int. 6