yemen: cholera outbreak weekly epidemiology bulletin · 2017-07-10 · 1 highlights • during week...
TRANSCRIPT
1
Highlights
• Duringweek26(from25Juneto1July2017),43282suspectedcholeracasesand147deathswerereportedinYemen.
• Sincethebeginningofthisoutbreaksecondwave(from27Aprilto2July2017),262,650suspectedcholeracases,and1587deaths(CFR:0.6%)havebeenreportedin21ofthecountry23governorates(91%),andin86%ofthedistricts(287/333).
• Forthefirsttimesincethebeginningoftheoutbreaksecondwave,twocaseswerereportedinMukkalagovernorate,andtestedpositivewithrapiddiagnostictests.
• Theapparentoveralldeclineofsuspectedcasesreportedinthelastweeklybulletinwasnotconfirmed,andtheapparentdeclineinthecurveshownfigure1shouldbeinterpretedwithcaution1.Butadeclineseemstohavestartedsinceweek25inthetwomostaffectedgovernorates,AmanatAlAsimahandAlHudaydah.
1Giventhehugenumberofbacklogcasesreportedeveryday
YEMEN:choleraoutbreakWeeklyepidemiologybulletinWeek26-2017
2
GeographicaldistributionofcasesThefourmostaffectedgovernorateswereAmanatAlAsimah,AlHudaydah,HajjahandAmranwith48.4%(127023/262650)ofthecasesreportedsince27April2017.Amrangovernoratehadthehighestattackrate(18.3‰),followedbyAlMahwitgovernorate(17.4‰)(seetable1andfigure2).Table1:Numberofcholeracasesandattackratebygovernorate,Yemen,27April–2July2017
Governorate Cases AttackRate(‰)AmanatAlAsimah 37981 11.5Al-Hudaydah 31889 9.5Hajjah 29095 13.1Amran 28058 18.3Sana'a 21157 16.9Ibb 19993 6.5Taizz 19079 6.3Dhamar 15443 7.3AlMahwit 13228 17.4AlDhale'e 12360 16.4AlBayda 8067 10.5Aden 7939 8.3Abyan 5976 9.8Raymah 4937 7.8Lahj 3597 3.4Al_Jawf 1933 3.0Ma'areb 1048 2.9Sa'ada 415 0.5ALMahrah 293 1.8Shabwah 160 0.2Moklla 2 0.0Total 262650 8.9Since27June2,29587suspectedcasesand103deathsofcholerawerereportedin20governoratesand259districts(seetable2).ThehighestnumbersofcaseswerereportedinAlHudaydahandAmrangovernorates,andinthedistrictsofAlHali(AlHudaydahgov.,928cases,2deaths),Kanfir(Abyangov.,796cases,1death)andUtmah(Dhamargov.,614cases,1death).2Previousweeklyepibulletinwasreleasedon26June
3
Table2:Numberofcholeracasesanddeathsbygovernorate,Yemen,27June–2July2017
Governorate Cases DeathsAl-Hudaydah 3208 19Amran 2964 2Dhamar 2954 12Ibb 2702 20Sana'a 2434 4AlDhale'e 2254 5Taizz 2230 13AmanatAlAsimah 1983 -AlMahwit 1766 4Abyan 1505 3Hajjah 1305 9Aden 1097 -AlBayda 867 1Raymah 779 8Lahj 504 2Al_Jawf 495 1Ma'areb 316 -Sa'ada 91 -ALMahrah 79 -Shabwah 54 -Total 29587 103
4
Thismapshowsthesuspectedcholeraattackrate(‰)perdistrict
Since27April86,2%ofalldistricts(287/333)havebeenaffected.Figure3showsthe45mostaffecteddistrictswhere52.9%(137941/260520)3ofthecaseshavebeenreported.ThehighestnumberofcaseswerereportedinAlHali(AlHudaydahgov.,11518cases,21deaths),BaniAlHarith(AmanatAlAsimahgov.,7464cases,10deaths)andMa’ain(AmanatAlAsimahgov.,7330cases,7deaths).ZulaymatHabur(Amrangov.)andAlHali(AlHudaydahgov.)hadthehighestattackrates(respectively50.3‰and45.7‰).
32130missingvalues
5
Figure4:Epidemiccurvesofmostaffectedgovernoratesanddistricts,Yemen,27April–2July2017
4
4Hajjahgovernorateanddistrictcurvesshouldbeinterpretedwithcautionsincethereareusuallyreportinglate
6
0
500
1000
1500
2000
2500
3000
3500
4000
17 18 19 20 21 22 23 24 25 26
Case
Week
Numberofsuspectedcholeracases,governorateofSana'a,Yemen,2017
7
Casefatalityratio,andageandsexdistributionTable3:Numberofcholeracasesandcasefatalityratio(CFR),Yemen,27April–2July2017
Governorate Numberofcases
Proportionofcases(%)
Numberofdeaths CFR(%)
AmanatAlAsimah 37981 14.5 53 0.1Al-Hudaydah 31889 12.1 184 0.6Hajjah 29095 11.1 288 1.0Amran 28058 10.7 144 0.5Sana'a 21157 8.1 103 0.5Ibb 19993 7.6 216 1.1Taizz 19079 7.3 134 0.7Dhamar 15443 5.9 109 0.7AlMahwit 13228 5.0 101 0.8AlDhale'e 12360 4.7 57 0.5AlBayda 8067 3.1 21 0.3Aden 7939 3.0 46 0.6Abyan 5976 2.3 25 0.4Raymah 4937 1.9 73 1.5Lahj 3597 1.4 16 0.4Al_Jawf 1933 0.7 11 0.6Ma'areb 1048 0.4 4 0.4Sa'ada 415 0.2 1 0.2ALMahrah 293 0.1 1 0.3Shabwah 160 0.1 - -Moklla 2 0.0 - -Total 262650 100.0 1587 0.6From27Aprilto2July,theoverallcasefatalityratio(CFR)was0.6%(1587/262650).ThehighestCFRwerestillreportedinRaymahandIbbgovernorates,respectively1.5%and1.1%,(seetable3andfigure5).
Since27June,theoverallCFRwas0.3%(103/29587)andwasthehighestinRaymahgovernorate(1.0%,8/779)(seefigure6).
8
Themale/femalesexratiowas0.9.Thehighestproportionofcaseswasstillseeninthe15-29yearagegroup(i.e.28.1%).Patientsagedunder18yearsoldwere46.7%ofthetotal.Peopleover60yearsoldweremoreatriskofdying(CFR:2.9%),followedbycasesinthe45-60yearagegroup(CFR:1.1%)(seetable4).CFRwasslightlyhigherinmalethaninfemalecases(respectively0.7%and0.6%).Table4:Distributionofcholeracasesanddeathsbyage,Yemen,27April–2July2017
Age(y.o.) Cases Deaths
Male Female Total* %ofcases Male Female Total** CFR(%)
<5 25858 21739 47597 18.2 142 104 246 0.55-14 31027 28129 59156 22.7 119 118 237 0.415-29 30199 43027 73226 28.1 59 87 146 0.230-44 17712 25299 43011 16.5 94 119 213 0.545-60 8807 11922 20729 7.9 121 108 229 1.1>60 7987 9282 17269 6.6 258 244 502 2.9Total 121590139398260988 100.0 793 780 1573 0.6*1662missingvalues **14missingvalues Forfurtherinformation:DrXavierdeRadiguèsC:[email protected]:Thisbulletinisnowreleasedonceaweek.Ashorterupdateisproposeddaily.YoucanfindthemonEMROwebsite.