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Weekly Epidemiological Bulletin
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected].
Epidemiological week no. 14 (1 - 7 April 2011)
• 77 districts in 5 provinces and State of Azad Jammu and Kashmir (AJK) provided surveil-lance data to the DEWS. This system is gradually expanding to provide information about communicable disease threats in all parts of Pakistan.
• 2,821 fixed health facilities and 8 mobile medical outreach centres provided surveillance data for this week.
• A total of 816,788 consultations were reported through DEWS of which 25% were acute respiratory infections (ARI), 9% skin disease, 9% acute diarrhoea, and 6% were suspected Malaria.
• A total of 69 alerts were reported in week-14, 2011: Altogether 36 alerts were for Measles; 7 were for Pertussis, 6 were for meningitis, 5 were for acute Watery Diarrhoea, 4 were for Bloody diarrhoea, 3 each were for Chickenpox, and Leishmaniasis, while 1 each for Acute diarrhoea, Acute Jaundice Syndrome, Malaria, Mumps, and Typhoid.
• There was 1 polio case confirmed this week: from Killa Abdullah (Balochistan)
Highlights
Disease early warning system and response in Pakistan
01
Volume 2, Issue 14, Monday 11 April, 2011
Table-1: Priority diseases reported during the week 7 to week 14, 2011
Priority diseases under surveillance
in DEWS
Acute Flaccid Paralysis (AFP)
Acute Jaundice Syndrome (AJS)
Acute Respiratory Infections (Upper and Lower) (ARI)
Acute Watery Diarrhoea (AWD)/ Suspected Cholera
Acute Bloody Diarrhoea (BD)
Other Acute Diarrhoeas (AD)
Suspected Viral Hemorrhagic Fever (VHF)
Suspected Malaria (Mal)
Suspected Measles (MS)
Suspected Meningitis (MG)
Others
Figure-1: Weekly trend of leading priority diseases in Pakistan, 29 July 2010 to 7 April 2011 (Epi week 31, 2010 to week 14, 2011)
Diseases Wk-7 Wk-8 Wk-9 Wk-10 Wk-11 Wk-12 Wk-13 Wk-14
Skin Disease 56,464 (9%) 68,055 (9%) 61,675 (8%) 79,747 (9%) 82,310 (9%) 75,043 (9%) 78,277 (9%) 73,961 (9%)
ARI (URI and LRI) 201,493 (31%) 250,489 (30%) 217,495 (30%) 249,133 (29%) 261,405 (28%) 223,829 (27%) 225,256 (26%) 208,216 (25%)
Other Acute Diarrhoea (Not Watery) 39,728 (6%) 53,257 (6%) 46,412 (6%) 57,134 (7%) 65,107 (7%) 67,046 (8%) 74,382 (9%) 72,148 (9%)
Bloody Diarrhoea 4,437 (1%) 4,851 (1%) 4,862 (1%) 5,494 (1%) 5,990 (1%) 5,589 (1%) 6,594 (1%) 5,319 (1%)
Suspected Malaria 35,061 (5%) 46,665 (6%) 40,357 (6%) 52,266 (6%) 56,251 (6%) 52,712 (6%) 55,411 (6%) 52,977 (6%)
Total consultation 653,895 821,436 721,987 850,554 923,109 825,367 871,874 816,788
0
5
10
15
20
25
30
35
40
45
50
wk‐31
wk‐33
wk‐35
wk‐37
wk‐39
wk‐41
wk‐43
wk‐45
wk‐47
wk‐49
wk‐51
wk 1
wk 3
wk 5
wk 7
wk 9
wk 11
wk 13
Percentage
AD BD ARI S. Malaria
Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
Fig-2: Weekly number of reporting health units (Week 33-2010 to week 14-2011)
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 02
Table-2: Leading causes of seeking health care in the flood affected districts, 29 July 2010 to 7 April 2011
Focus on: Polio
Diseases Total Skin Diseases 2,501,904 (11%)
Acute Respiratory Infection 5,723,667 (25%) Other Acute Diarrhoea (Not Watery) 2,010,773 (9%)
Bloody Diarrhoea 195,982 (1%) Suspected Malaria 1,306,829 (6%) Unexplained Fever 906,013 (4%)
Total Consultations 22,635,188
Since July 29, 2010, a total of 2,010,773 acute diarrhea patient consultations have been reported to DEWS from the districts participating in DEWS in 5 provinces and the state of AJK.
In the graph at right, DEWS weekly reports received in 2011 are compared to the reports of 2010 and 2009 from disaster‐affected districts. This week, DEWS received 72,148 reports of acute diarrhea, 9% of total con‐sultations. This is same proportional morbidity than reported by DEWS in week‐14/2010, and in week‐14/2009.
Figure-4: Acute Diarrhea trends, Disaster affected districts, Pakistan 2009, 2010 and 2011
Since July 29, 2010, a total of 5,723,667 Acute Respiratory Infection (both Upper and Lower) patient consultations have been reported to DEWS from the districts participating in DEWS in 5 provinces and the state of AJK.
In the graph at right, DEWS weekly reports received for ARI in 2011 are com‐pared to the reports of 2010 and 2009 from disaster‐affected districts. This week, DEWS received 208,216 reports of Acute Respiratory Infection, 25% of total consultations, same proportional morbidity reported by DEWS in week‐14/2010, and in week‐14/2009.
Figure-3: Acute Respiratory Infection trends, Disaster affected districts, Pakistan 2009, 2010 and 2011
Here we are sharing a serious concern from the polio eradication program, during the last four weeks a total of 11 new cases of type‐1 polio cases (See table on the right) were confirmed by the laboratory. They include 4 cases from FATA (Khyber, Kurram, Lakki Marwat and FR Lakki) 2 cases from Sindh (Badin, TM Khan), 2 from Khyber Pakhtunkhwa (Peshawar, Nowshera), and 3 from Balochistan (Pishin, and Killa Abdulla). As of 7 April, Pakistan has reported a total of 26 polio cases (all type‐1) from 12 districts/tribal areas/agencies.
Clustering of type‐1 polio cases in south Sind is of serious concern and war‐rant aggressive response with appropriate oral polio vaccine. Four type‐1 polio cases have been reported in the past eight weeks from neighboring areas of three districts.
Technical Advisory Group for Polio Eradication in Pakistan and Afghanistan met this week on 24 and 25 March to review the current situation in both countries, evaluate impact of eradication activities and advise further guidance on strategies and activities employed for polio eradi‐cation as appropriate. This was followed by the inter‐country coordination meeting for polio eradication in Pakistan and Afghanistan on 26th March to further consolidate cross border collaboration for polio eradication.
Epi-week # Province / Agency District / Area Cases
Wk‐11
FATA Khyber 1
Sindh Badin 1
Sindh TM Khan 1
Khyber Pakhtunkhwa Peshawar 1
Khyber Pakhtunkhwa Nowshera 1
Wk‐12
FATA Kurram 1
FATA Lakki Marwat 1
Balochistan Pishin 1
Balochistan Killa Abdullah 1
Wk‐13 FATA FR Lakki 1
Wk‐14 Balochistan Killa Abdullah 1
0
5
10
15
20
25
30
35
40
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52
Percentage
Epi week
200920102011
0
2
4
6
8
10
12
14
16
18
20
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52
Percentage
Epi‐week
200920102011
597 702 826
788
758
745
715
655
575
509
439
502 88
1 125
911
3913
42 1627
1391 1960
185
6215
9229
521
9621
86
2192
2247
2377
239
924
01
254
6278
6274
029
03282
1
361375411
331400215192153
12810581 58
46
2626
11
812
8 11
1111 11 8 8 8
8 8 86
6 613 8
0
500
1000
1500
2000
2500
3000
3500
Wk 33
Wk 34
Wk 35
Wk 36
Wk 37
Wk 38
Wk 39
Wk 40
Wk 41
Wk 42
Wk 43
Wk 44
Wk 45
Wk 46
Wk 47
Wk 48
Wk 49
Wk 50
Wk 51
Wk 52
Wk 1‐11
Wk 2
Wk 3
Wk 4
Wk 5
Wk 6
Wk 7
Wk 8
Wk 9
Wk 10
Wk 11
Wk 12
Wk 13
Wk 14
Mobile Fixed
Table-3: Alerts reported in week 14 of 2011 Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 03
Date of alert
Disease Province District Location Male Female
Action taken / Notes <5 >5 <5 >5
1‐Apr‐11 AWD Balochistan Bolan Village Faqirabad, UC Mashkaf
0 2 0 0
Two suspected cases of AWD were reported from DHQ hospital Sibi. Patients belong to Vilage Faqirabad UC Mushkaf, district Bolan. Samples were found positive for VC. Both children were recovered. Hygiene sessions were conducted. Aqua tabs, hygiene kits, water storage buckets and Jerry canses were distributed. No new cases were found. Situation is under control.
7‐Apr‐11 Measles Balochistan Chagai Village Hassan abad, Nou‐kundi
0 3 1 3 7 cases identified on active surveillance. Only one child was vaccinated, catch‐up vaccination started in two villages and 227 children were vaccinated.
7‐Apr‐11 Malaria Balochistan Jaffarabad CD Manjhi Pur 0 0 0 0 EDO‐H is informed and requested for provision of antimalarial drugs and RDTs at the facility. 16 samples were collected and 11 found positive for Malaria (6 P.Falciparum, 2 P.Vivax & 3 mixed).
2‐Apr‐11 Measles ICT Islamabad CH PIMS (Badhana village); CH PIMS (Khanna, Shakrial, Badhana)
2 0 2 0 Vitamin A was given, field visit planned for active surveillance in the community.
4‐Apr‐11 BD Khyber Pakhtunkhwa
Haripur Khalabut township 2 1 4 0
Bloody Diarrhoea alert was generated from the weekly analysis for CD KTS3. Active surveillance conducted, stool samples were taken from 2 children and found positive for Shigella Sonnei. Water samples tested and bacterial contamination found. Health education session conducted in the area. IEC material and aqua tabs distrib‐uted in the affected houses. EDO Health office informed.
6‐Apr‐11 Measles Khyber Pakhtunkhwa
Haripur Muhallah Sayedan, Khalabut 0 1 0 0 Alert was received from CD KTS3. Active surveillance in the area carried out. No other cases found. Vaccine status of the area assessed. Child given VitA. Sample taken and sent to NIH. EDO and EPI coordinator informed.
6‐Apr‐11 Pertussis Khyber Pakhtunkhwa
Tank
(3 alerts)UC Shah Alam‐near Pirano Korona; Warannha‐UC Jattatar; Zaro Shah Korona and Mughziai
4 2 3 0
Hygiene session conducted with the households. Isolation of the cases advised. Pt. was already under treatment. Erythromycin syp. & tablets were given to the con‐tacts. Family informed about the communicability, EDO‐H and EPI Coordinator informed about the situation. Vaccination plan discussed with EPI coordinator.
7‐Apr‐11 Meningitis Punjab Jhang Mohallah Chanda wala, Bhakhar Road‐Sadar
0 0 0 1 Suspected case was reported. CSF was taken and sent to a private lab by the peadia‐trition. Field investigations continued. No other cases found.
7‐Apr‐11 Leishmaniasis Punjab Khushab RHC Padrad 0 2 0 1 EDO(H) Mianwali provided 100 injections for the treatment to the RHC and treat‐ment has been started. LHWs were motivated for follow‐up and recovery. Fogging was done in the affected areas.
5‐Apr‐11 Meningitis Punjab Layyah DHQ hospital Layyah ‐UC urban 2
0 0 0 Suspected case was reported from the health facility. CSF sample taken and sent to IPH. Investigations continued.
1‐Apr‐11 BD Punjab Layyah DHQ Layyah 1 0 0 0 Health education sessions conducted, 1 sample collected and sent to NIH but found negative. EDO H and EPI coordinator Informed, Active Surveillance done.
4‐Apr‐11 Chicken pox Punjab Multan Basti Khas‐UC Durana Langana
1 3 1 4 Health & Hygiene session conducted, information provided to the parents regarding the care of these children
7‐Apr‐11 BD Punjab Muzaffargarh BHU Muradabad‐Head Muradabad Khas
2 0 2 1 Stool sample was collected and sent to NIH for culture, Drinking water samples were collected from water source for analysis. Aqua tabs, Jerry cans, life straw were distributed. Health and hygene sessions were conducted.
4‐Apr‐11 Measles Punjab Rajanpur Basti Abdul Raheem‐UC Sikhani wala; Basti wahid bukhsh‐UC Rojhan Sharqi
0 2 4 0 2 alerts with 6 cases investigated, gave two doses of vitamin A, collected blood specimen, throat swab and sent to NIH, EDO(H) informed.
1‐7 Apr 2011
Measles Punjab Sargodha
Chak No. 101 NB Masjid wali street No. 10‐UC 121; Chak No. 107 NB‐UC 91; Remount Depot‐UC 117
2 0 2 0 3 alerts from different places investigated 4 suspected cases reported. Gave two doses of vitamin A, collected blood specimen, throat swab and sent to NIH, EDO(H) informed.
7‐Apr‐11 Measles Khyber Pakhtunkhwa
Upper Dir RHC Wari 1 0 0 0 Vit.A given, health education sessions conducted, EDO H and EPI coordinator In‐formed, Active Surveillance done. No other cases found. Patients isolated. Plan for strengthening of routine EPI developed by EDO‐H
1‐Apr‐11 BD Punjab Bahawalpur Lal Sohanra 1 2 0 0 Health education sessions conducted, 1 sample collected and sent to NIH but found negative. EDO H and EPI coordinator Informed, Active Surveillance done.
7‐Apr‐11 AD Punjab Bhakkar BHU Mullan wali, Basti Gamay wali; BHU Notak, Mohallah Kay Bi wala
8 11 8 10
2 alerts generated while data analysis. Upon field investigation mild cases were found in recovering stage. Conducted health and hygine sessions in the community, Life Straw filters, aquatabs, Jerry cans and soaps were distributed, assessment of essential medicines at the facility was also done.
5‐Apr‐11 Measles Punjab Bhakkar Mohallah Farookabad‐UC Darya Khan Urban II
0 1 0 0 Gave two doses of vitamin A, collected blood specimen, throat swab and sent to NIH, EDO(H) informed.
7‐Apr‐11 Measles Punjab D. G. Khan Basti shikari‐UC Nawan 1 0 2 0 Gave two doses of vitamin A to the patient, blood specimen and throat swab collected and sent to NIH. EDO(H) informed.
5‐Apr‐11 Leishmaniasis Punjab D. G. Khan Chah Jabooje wala‐UC Gadai 0 0 0 0 Suspected case was reported and sample was tested and found positive for LD+++. EDO(H) was informed, further field investigation is planned.
1‐Apr‐11 Meningitis Punjab D. G. Khan Khoo sujre wala shah wala‐Moza Khan pur
1 0 0 0 Sample was not taken in view of the condition of child. Hygiene sessions were conducted with parents, patient management reinforced.
6‐Apr‐11 Leishmaniasis Khyber Pakhtunkhwa
Lower Dir Village Bar Kallay‐UC Khall 0 16 4 13
Active surveillance done in surrounding areas. Line List was maintained for the cases. Required doses of Glucantime were provided. On job training of health staff was conducted for administration of Glucantime. RBM program coordinator was in‐formed and requested for residual spray. ITN’s were distributed in the affected families. Health education sessions conducted. EDO‐H and Focal person were informed about the situation. LHW are motivated to provide health education in the affected community.
6‐Apr‐11 Typhoid Khyber Pakhtunkhwa
Malakand Village Julagram 0 0 0 0
50 cases of suspected Typhoid fever were detected from the OPD record during visit to RHC Dheri Julagram. All cases belonged to Younas khel area of UC Dheri Julagram. Almost all cases are below 15 years age. 15 patients from the area were admitted in the DHQ hospital, also EDO (H) office informed and joint visit conducted in the area. Three Water samples were taken and sent by EDO (H) office to public health labora‐tory in Peshawar. LHWs , religious leaders were motivated to dessiminate health and hygeine messages in the affected community. One blood and two stool samples were collected from cases and sent to NIH.
1‐Apr‐11 Mumps Khyber Pakhtunkhwa
Swabi RHC Sheikh Jana‐Near Janaza Gah
0 1 0 0 Health education sessions conducted, sample collected and sent to NIH. EDO H and EPI coordinator Informed.
4‐Apr‐11 Pertussis Khyber Pakhtunkhwa
Tank Burki Abad & Gulabi Pump 1 1 0 0 EDO‐H informed, erythromycin given to patient and contacts, Isolation of the cases advised, Active surveillance done and preventive health session conducted.
7‐Apr‐11 Measles Khyber Pakhtunkhwa
Tank (2 alerts) Burki Abad‐UC Tank II, UC Maghziai; Gharbi Chakkar
4 0 0 0 Vit.A given, health education sessions conducted, EDO H and EPI coordinator In‐formed, <5 Measles Vaccination planned, but not in security compromised area. Isolation of the patient advised.
Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011) Table-4: Alerts reported in week 14 of 2011. (Cont’d)
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 04
Date of alert Disease Province District Location Male Female
Action taken / Notes <5 >
5 <5 >5
5‐Apr‐11 Measles Sindh Badin
Village Dyal Ghar‐UC Halepota; Village Mohummad laik lund‐UC Ghulamshah
2 0 3 2 2 alerts from different locations with 7 suspected cases investigated, Gave Vitamin A, isolation of cases, advocated for improving routine vaccination in town, health education.
6‐Apr‐11 Pertussis Sindh Dadu Village Din Mohd Shahani‐UC Monder
1 0 2 2 health education, case isolation, EOH informed of investigation
6‐Apr‐11 AWD Sindh Dadu Village Guhram Khan Gopang‐UC Dadu 4
0 1 0 0 Health education was given. Sample collected, EDOH informed, ORS, chlorine tabs distributed, active surveillance, sensitization of HCWs for prompt reporting
5‐Apr‐11 Measles Sindh Ghotki
Village Khair Muham‐mad Soomro‐UC Mithri; Village Mian Samo UC Umar daho
2 0 0 1 3 alerts from different sites with 3 suspected Measles case notified from MCH centre Ghotki. No any other case of suspected measles found. 1 blood speci‐men collected and sent to NIH. Vitamin A was given. Informed EDOH.
1‐Apr‐11 Pertussis Sindh Ghotki Village Laluwari UC Hussain Beli
1 0 1 0 Two suspected cases of pertusis were notified by pediatrician from MCH centre Ghotki. Patient treated at the hospital. Field investigation continued.
6‐Apr‐11 Measles Sindh Hyderabad UC Dhingano, Bozdar Village, Qaim Lashari
1 0 0 0 Gave Vitamin A dose, case isolation, health education, LHW 2nd vitmain A dose, reinforced case management, active surveillance
2‐Apr‐11 AJS Sindh Hyderabad Village Bacho Kaleri 0 1 1 5 health education, 2 water samples collected and sent to NIH, advocated immu‐nisation activity, informed EDOH. Further investigation in process.
6‐Apr‐11 Meningitis Sindh Mirpurkhas DHQ Mirpurkhas 2 0 0 0 ensure proper management, provided medicines and inject able case, isolated, health education, timely notifcations and case definitions
2‐Apr‐11 AWD Sindh Sukkur IDP camp at Rohri bypass
0 0 0 1 A 17 years old girl from Bagri family, original residence of Kandhkot expired due to acute diarrhea. No other cases found.
5‐Apr‐11 Measles Sindh Sukkur Memon colony near IBA; Village Sadiq Palh‐UC Trimoh
2 0 0 0 2 suspected Measles case was reported, upon field investigation first case was found mis‐diagnosed. For 2nd case vitamin A given, collected specimen and sent to NIH, outreach vaccination scheduled for community.
7‐Apr‐11 Meningitis Sindh Sukkur Village Bagh Pai Ameeran‐Taluka Pano Akil
0 2 0 0 2 suspected cases of meningitis, admitted in GMC hospital Sukkur, patients are improving now, final report in process after diagnoses. No other cases found in community.
1‐Apr‐11 Measles Sindh Tando Allahyar
UC 3 Lashari Gali Aman Shah Colony; UC Tando Soomro; UC3 Laghari Jali Amarullah Shah Story
1 1 0 2 3 alerts from different locations reported, Vitamin A dose given, case isolation, health education, LHW provided second dose, mop up vaccination requested, active case finding, reinforced case management
6‐Apr‐11 Measles Sindh Tharparkar Village Kapoosar‐UC Malanhore Veena
0 0 2 1 Gave Vitamin A, Isolation of cases, informed EDOH, advocated vaccination, health education and active case finding.
5‐Apr‐11 Chicken Pox Sindh Thatta Village Fateh Muham‐mad
1 1 2 1 Patient and attendants were given health education on the diseases and impor‐tance of isolation. They were encouraged for getting enough sleep, drink suffi‐cient water and frequent hand washing with soap.
6‐Apr‐11 Measles Sindh Thatta Village Saddique Lashari
2 2 0 0 Gave Vitamin A, Isolation of cases, EDO‐H ensure vaccination in the village , health education.
6‐Apr‐11 Measles Sindh Naushahro Feroze
Baban Shah Chowk‐UC Kandiaro; Village Alam ja Bhaan‐UC Mithiani
2 0 0 0 2 alerts investigated. Gave vitamin A to cases, collected specimen and sent to NIH, upon field investigation more cases found and outreach vaccination sched‐uled in community.
6‐Apr‐11 Pertussis Sindh Naushahro Feroze
Village Alam ja Bhaan‐UC Mithiani
1 0 0 0 Suspected five cases of Pertussis reported from flood affected area, informed DHMT for health promotion and control measures.
2‐Apr‐11 Chicken Pox Sindh Naushahro Feroze
Village Lal Bux Lund, near Civil hospital
1 0 1 1 3 suspected cases were reported from DHQ Naushero Feroze, health education given.
6‐Apr‐11 Measles Sindh Nawabshah Taj colony‐UC 6 0 1 0 0 Gave Vitamin A, Patient isolated, advocated for improving routine vaccination in town, health education.
6‐Apr‐11 Measles Sindh Qambar Shahdadkot
Village Daffar‐UC Bohar
1 0 0 0 Gave vitamin A, collected specimen and sent to NIH.
4‐Apr‐11 Measles Sindh Shikarpur Sukkur (Village Alam Khan‐Taluka Lakhi)
0 0 1 0 Gave vitamin A to suspected case, collected specimen and sent to NIH, out‐reach vaccination scheduled for community. Cross notified by Sukkur SO.
5‐Apr‐11 Meningitis Sindh Shikarpur Sukkur (Village Man‐grio Wahi‐Sultan kot)
1 0 0 0 1 Suspected cases of Meningitis admitted in GMC hospital Sukkur, community follow up done, diagnosed as case of suspected T.B Meningitis, cross notified by Sukkur SO.
6‐Apr‐11 Measles Sindh Jamshoro Village Jan Muham‐mad‐UC Amri
1 0 0 0 Gave Vitamn A, case isolation, health education, instruction to parents on 2nd Vitamin A dose
2‐Apr‐11 Measles Sindh Khairpur Village Shaikh Taib‐UC Kolab Jeal
0 0 1 0 Gave vitamin A, collected specimen and sent to NIH, upon field investigation more cases found and outreach vaccination scheduled for community.
1‐Apr‐11 Measles Sindh Matiari UC Taj Pur Near railway station, Allahdio Sand
0 1 0 0 Gave Vitamin A, isolation, advocated for strengthening routine vaccination in town, health education and active case finding
7‐Apr‐11 Measles Sindh Mirpur Khas
Umerkot (Village Abdul Shakoor Gish‐kori); Village Kachelo Farm‐UC Mir Imam Bux
5 2 7 0 2 alerts from different location investigated 1 from Umerkot and the other from Mirpukhas with 14 cases. Gave vitamin A drops, health education, informed EDOH, cross notification to Mirpurkhas
6‐Apr‐11 AWD Sindh Mirpurkhas Civil Hospital‐Pediatrics ward
0 3 0 0 cases line listed, proper case management ORS/aqua tabs provided, water samples and stool samples collected1 for investigation, further inforcement of WASH interventions. Continuation of previous AWD alert.
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 05
Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
Province Khyber Pakhtunkhwa • This week 18 districts reported to DEWS
from KP province, 611 health facilities reported 156,870 patients consultations to DEWS.
• ARI is the leading disease in KP province. ARI cases reported 50,966 (32%), an in-creasing by 1% in proportional morbidity as compared with last week.
• 12 alerts were reported in this week from Khyber Pakhtunkhwa, 4 each were for Measles, and Pertussis, while 1 each for Bloody Diarrhoea, Mumps, Typhoid, and Leishmaniasis.
Province Punjab • 12 districts reported data to DEWS from Punjab
province, 773 health centers reported a total of 203,526 patient consultations during this report-ing period
• ARI cases reported were 51,278 (25%), a decline by 1% in proportional morbidity as compared with last week.
• 18 alerts were reported in this week from Punjab; 7 were for Measles, 3 each were for Bloody diarrhoea, and Meningitis, 2 each were for Acute Diarrhoea, and Leishmaniasis, while 1 for Chicken pox.
• This week a total of 7,610 malaria samples were tested of which 125 were positive (slide positivity rate 1.6%, while falciparum rate was 47.2%).
Figure-5: Trend of priority communicable diseases, province KP (31-July 2010 to 7 April 2011)
Figure-6: Trend of priority communicable diseases, province Punjab (3 August 2010 to 7 April 2011)
Diseases Wk-11 Wk-14
Skin Diseases 7,836 (4%) 7,345 (5%)
ARI (URI and LRI) 61,398 (34%) 50,966 (32%)
Other Acute Diarrhoea (Not Watery) 13,664 (8%) 15,170 (10%)
Bloody Diarrhea 1,313 (1%) 1,192 (1%)
Total consultations 181,133 156,870
Suspected Malaria 2,219 (1%) 2,245 (1%)
Wk-12
7,478 (4%)
55,817 (33%)
13,577 (8%)
1,221 (1%)
1,959 (1%)
168,794
Wk-13
7,735 (4%)
53,810 (31%)
14,978 (9%)
1,408 (1%)
2,307 (1%)
174,222
Diseases Wk-11 Wk-12 Wk-13 Wk-14
Skin Diseases 17,224 (8%) 16,625 (9%) 17,309 (8%) 17,042 (8%)
ARI (URI and LRI) 56,139 (27%) 49,706 (26%) 52,369 (26%) 51,278 (25%)
Other Acute Diarrhoea (Not Watery) 12,418 (6%) 15,200 (8%) 16,753 (8%) 15,738 (8%)
Suspected Malaria 5,413 (3%) 6,684 (3%) 7,571 (4%) 7,475 (4%)
Total consultations 206,444 193,903 203,992 203,526
Unexplained Fever 5,882 (3%) 6,176 (3%) 7,050 (3%) 7,067 (3%)
0
5
10
15
20
25
30
35
40
45
50
wk 31
wk 33
wk 35
wk 37
wk 39
wk 41
wk 43
wk 45
wk 47
wk 49
wk 51
wk 1
wk 3
wk 5
wk 7
wk 9
wk 11
wk 13
Percentage
AD BD ARI S. Malaria
0
5
10
15
20
25
30
35
40
45
50
wk 31
wk 33
wk 35
wk 37
wk 39
wk 41
wk 43
wk 45
wk 47
wk 49
wk 51
wk 1
wk 3
wk 5
wk 7
wk 9
wk 11
wk 13
Percentage
AD BD ARI S. Malaria
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 06
Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
Province Sindh • This week 22 districts reported to DEWS from
Sindh province, and 996 health centers re-ported a total of 382,927 patient consultations during the reporting period of week 14, 2011.
• In Sindh, ARI cases reported were 88,577 (23%), 1% lower proportional morbidity as compared with last week.
• 34 alerts were reported from Sindh in this week: 22 were for Measles, 3 each were for Pertussis, Meningitis, and Acute Watery Diar-rhoea, 2 were for Chickenpox, while 1 was for Acute Jaundice syndrome.
Province Balochistan
• In this week, 16 districts reported to DEWS from Balochistan province. 388 fixed and 7 mobile medical outreach centers reported a total of 62,108 patient consultations.
• ARI reported in 13,873 (22%) of the total consulta-tions which is 2% lower proportional morbidity as compared with last week.
• 3 alerts were reported in this week from Balochistan, 1 each was for Acute Watery Diarrhoea, Measles, and Malaria.
• Malaria cases were reported from some of the districts in Balochistan. In week 14 a total of 862 malaria samples were tested of which 281 were positive and slide positivity rate was 32.6%, while falciparum rate was 61.5%.
Diseases Wk-11 Wk-14
Skin Diseases 53,708 (11%) 45,117 (12%)
ARI (URI and LRI) 127,894 (27%) 88,577 (23%)
Other Acute Diarrhoea (Not Watery) 33,711 (7%) 33,621 (9%)
Bloody Diarrhea 3,035 (1%) 2,277 (1%)
Total consultations 475,096 382,927
Suspected Malaria 42,099 (9%) 34,543 (9%)
Wk-12
46,530 (12%)
100,746 (25%)
31,947 (8%)
2,640 (1%)
36,933 (9%)
397,149
Wk-13
48,208 (11%)
101,954 (24%)
35,354 (8%)
2,952 (1%)
37,542 (9%)
424,185
Figure-7: Trend of priority communicable diseases, province Sindh (6 August 2010 to 7 April 2011)
Figure-8: Trend of priority communicable diseases, province Balochistan (6 August 2010 to 7 April 2011)
Diseases Wk-11 Wk-14
Skin Diseases 3,410 (6%) 3,897 (6%)
ARI (URI and LRI) 15,189 (27%) 13,873 (22%)
Other Acute Diarrhoea (Not Watery) 5,053 (9%) 6,729 (11%)
Bloody Diarrhea 1,607 (3%) 1,775 (3%)
Total consultations 57,068 62,108
Suspected Malaria 6,512 (11%) 8,667 (14%)
Wk-12
4,317 (7%)
15,927 (26%)
5,940 (10%)
1,665 (3%)
7,124 (12%)
61,597
Wk-13
4,429 (7%)
14,818 (24%)
6,741 (11%)
2,147 (3%)
7,979 (13%)
62,254
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Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
Islamabad Capital Territory
• This week Islamabad is reporting from four health facilities with a total of 1,398 patient consultations.
• ARI cases reported were 452 (32%), while Acute Diarrhoea (Not Watery) 139 (10%). Fluc-tuation in rates is due to difficulties in collect-ing reports as the system is being established.
• 2 alerts of Measles were received this week from Islamabad.
Figure-9: Trend of priority communicable diseases, Islamabad (1 January to 7 April 2011)
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 07
Diseases Wk-11 Wk-14
Skin Diseases 35 (2%) 21 (2%)
ARI (URI and LRI) 404 (25%) 452 (32%)
Other Acute Diarrhoea (Not Watery) 108 (6%) 139 (10%)
Bloody Diarrhea 16 (1%) 5
Total consultations 1,765 1,398
Suspected Malaria 3 2
Wk-12
25 (1%)
1,288 (51%)
200 (8%)
40 (2%)
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2,550
Wk-13
7 (1%)
102 (17%)
52 (9%)
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588
FATA
• This week FATA is reporting from one health center in IDP camp in Mohmand Agency, with a total of 1,457 patient consultations.
• ARI cases reported were 310 (21%), while Acute diarrhoea reported 230 cases (16%)
• No alert was received this week.
Diseases Wk-11 Wk-14
Skin Diseases 97 (6%) 117 (8%)
ARI (URI and LRI) 381 (24%) 310 (21%)
Other Acute Diarrhoea (Not Watery) 153 (10%) 230 (16%)
Bloody Diarrhea - -
Total consultations 1,603 1,457
Suspected Malaria 5 3
Wk-12
68 (5%)
345 (25%)
182 (13%)
1
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1,374
Wk-13
117 (8%)
340 (24%)
216 (15%)
1
10
1,415
Figure-9: Trend of priority communicable diseases, FATA (4 February to 7 April 2011)
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Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
Gilgit Baltistan • In this week, weekly report from 3 districts in
Gilgit Baltistan sent weekly report from 26 health centers with a total of 3,952 patient con-sultations.
• ARI cases reported were 1,617 (41%), while Acute Diarrhoea (Not Watery) 232 (6%). The DEWS network has been recently introduced in Gilgit Baltistan and is being established.
• No alert was received this week.
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 08
Diseases Wk-13
Skin Diseases 459 (10%)
ARI (URI and LRI) 1,647 (35%)
Other Acute Diarrhoea (Not Watery) 247 (5%)
Bloody Diarrhea 63 (1%)
Suspected Malaria 2
Total consultations 4,686
Wk-14
262 (7%)
1,617 (41%)
232 (6%)
46 (1%)
25 (1%)
3,952
Distribution of Wild Polio Virus cases Pakistan 2010 and 2011
Year 2010: The total num-ber of polio cases reported in 2010 is 144 including 120 type-1 cases and 24 type-3 from 40 infected districts/towns/agencies.
Year 2011: The total num-ber of new type-1 polio cases confirmed by the laboratory is 26 to date.
1 polio cases confirmed this week: from Killa Abdullah (Balochistan).
Province Cases 2010 Cases 2011
P1 P3 P1 P3
Punjab 6 1 - - Sindh 26 1 6 - Khyber Pakhtunkhwa 19 5 2 - FATA 63 11 13 - Balochistan 6 6 5 - AJK - - - - Gilgit‐Baltistan - - - - Islamabad - - - - Total 120 24 26 -
State of Azad Jammu and Kashmir • In this week, weekly report from 4 districts in
AJK received to DEWS system from twenty three (23) health centers with a total of 4,550 patient consultations.
• ARI cases reported were 1,143 (25%), while Acute diarrhoea reported 289 (6%) cases
• No alert was received this week.
Diseases Wk-13
Skin Diseases 13 (2%)
ARI (URI and LRI) 216 (40%)
Other Acute Diarrhoea (Not Watery) 41 (8%)
Bloody Diarrhea -
Suspected Malaria -
Total consultations 532
Wk-14
160 (4%)
1,143 (25%)
289 (6%)
6
17
4,550
Epidemiological Bulletin: DEWS, Pakistan, Week no. 14 (1 - 7 April 2011)
This weekly Epidemiological Bulletin is published jointly by the Federal Ministry of Health, Government of Pakistan, National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan . For Correspondence: NIH: [email protected]; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083, E-mail: [email protected]. 09
Confirmed Alerts (1st Dec 2010 to 8 April 2011)