0 jan 12 jan 19 jan 26 feb 2 ewarn weekly summary … causes of morbidity include acute respiratory...

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EWARN Weekly Summary Report Early Warning Alert and Response Network

Jan 12 Jan 19 Jan 26 Feb 2

FMT 1 2 2 0

Mobile Clinic 0 1 2 1

Evacuation Centre 0 0 0 0

FMT Hospital 2 1 1 0

Hospital 26 26 25 24

RHU 50 48 48 50

BHS 5 9 7 4

0102030405060708090

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SPEED Reporting facilities by type and week

HIGHLIGHTS

This week, 79 health facilities reported 16,483 total consultations in typhoon-affected areas of Region VI and VIII by SPEED

Acute respiratory infection accounted for 33% of total consultations, most among SPEED conditions reported in the current reporting period

Measles cases continue to be reported from Region VIII. A total of 93 suspected measles cases with 1 death had been reported from 1-26 January 2014. Among the cases under 5 years of age, 66% were not vaccinated. A measles immunization campaign is still on-going in the Region.

OVERALL SPEED REPORTING FROM TYPHOON-AFFECTED AREAS

Overall, the number of facilities reporting decreased in the current week, with 79 facilities reporting this week from 85 last week. However, total consultations increased by 4%, from 15,869 last week to 16,483 this week.

Total consultations by municipality: REGION VI (Western Visayas): Capiz: Dao (228), Jamindan (28), Mambusao (754), Panitan (83), Roxas City (477), Sapi-An (163), Sigma (272); Iloilo: Barotac Viejo (27), Iloilo City (167), Janiuay (29), Sara (72) REGION VIII (Eastern Visayas): Biliran: Biliran (104), Cabucgayan (221), Naval (144); Eastern Samar: Balangiga (471), Balangkayan (38), City of Borongan (175), General Macarthur (359), Giporlos (46), Guiuan (734), Hernani (182), Lawaan (217), Llorente (348), Maydolong (17), Mercedes (43), Quinapondan (199), Salcedo (287); Leyte: Alangalang (170), Albuera (305), Babatngon (86), Barugo (13), Burauen (188), Calubian (70), Capoocan (86), Carigara (261), Dulag (430), Isabel (545), Jaro (262), Julita (241), Kananga (556), La Paz (367), Leyte (287), Merida (844), Ormoc City (3067), Palo (291), Palompon (270), Pastrana (176), San Isidro (65), Santa Fe (123), Tabango (234), Tacloban City (738), Tolosa (39), Villaba (661), City of Baybay (145); Western Samar: Marabut (78) The proportion of consultations due to acute respiratory infection increased from 30% to 33% over this reporting week (2-8 Feb) and is still the leading cause of consultation amongst the SPEED conditions. Fever and rash and acute hemorrhagic fever remained at less than 1%. Acute watery diarrhea increased from 2% to 3% in the current week. SPEED Syndrome ARI = Acute respiratory infection AWD = Acute watery diarrhea AHF = Acute hemorrhagic fever

Areas reporting to SPEED in current week Region VI

Capiz

Iliolo Region VIII

Biliran

Eastern Samar

West Samar

Leyte

Post-Typhoon Yolanda Week 13 | Epidemiological Week No. 8 | 2nd to 8th February 2014

EWARN weekly summary| 2nd to 8th February 2014

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FMT 0 0 0 0




Hospital 1 1 1 1

RHU 3 3 3 3

BHS 0 0 0 0

0

1

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SPEED reporting facilities by type and week, Biliran

PROVINCIAL SUMMARIES (SOURCES INCLUDE: EVENT-BASED SURVEILLANCE, PIDSR, SPEED)

REGION VI – WESTERN VISAYAS

CAPIZ PROVINCE


FMT 0 1 1 0




Hospital 5 5 3 2

RHU 8 8 8 5

BHS 0 0 0 0

0

2

4

6

8

10

12

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SPEED reporting facilities by type and week, Capiz

Reporting: Reporting in Capiz included 5 Rural Health Units and 2 Hospitals in the current reporting week (2 Feb -8 Feb). Consultations: The total number of SPEED consultations decreased from 2,464 to 2,005 over the past week. Leading causes of morbidity include acute respiratory infection (19%), high blood pressure (3.5%), fever (3.5%), animal bites (3%) and skin diseases (2%). Alerts: No alerts reported for the week 2-8 February 2014.

ILOILO PROVINCE


FMT 1 1 1 0




Hospital 2 1 3 1

RHU 2 2 1 3

BHS 0 0 0 0

0

1

2

3

4

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SPEED reporting facilities by type and week, Iloilo

Reporting: Reporting from Iloilo included 3 Rural Health Units and 1 Hospital. Consultations: The total number of SPEED consultations increased from 238 to 295 over the past week. Leading causes of morbidity include acute respiratory infection (37%), hypertension (12%), wounds (8%), fever (7.5%) and acute diarrhea (6%). Alerts: No alerts were reported for the week 2-8 February 2014.

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 slightly decreased from 484 last week to 469 during the current reporting week. Leading causes of morbidity include acute respiratory infection (53%), high blood pressure (14%), skin diseases (9.5%), acute watery diarrhea (9%) and wounds (7%). Alerts: For this week, 6 fever and rash cases were reported from Cabucgayan Rural Health Unit (2), Biliran Provincial Hospital (2) and Naval Main Health Center (2). Measles immunization was done for children six months to less than 10 years old. One case of suspect Acute Hemorrhagic Fever (AHF) was reported from Biliran Provincial Hospital and another one from Cabucgayan RHU. These were referred to Provincial Health Office for further investigation. Diarrhea cases were also reported from Cabucgayan RHU (22) and Biliran Provincial Hospital (9).


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WESTERN SAMAR PROVINCE


ARI 58% 48% 56% 45%

Fever and Rash 0% 0% 0% 0%

AWD 6% 3% 0% 4%

AHF 0% 0% 0% 0%

0%

10%

20%

30%

40%

50%

60%

70%

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Proportionate morbidity of select epidemic-prone conditions by week

Reporting: One Rural Health Unit reported from Western Samar this week. Consultations: The total number of SPEED consultations was 78. Leading causes of morbidity include acute respiratory infection (45%), high blood pressure (20.5%), wounds (9%), skin diseases (8%), fever (6%) and acute watery diarrhea (4%). Alerts: No alerts were reported for the week 2-8 February 2014. Event-based Surveillance: reported 5 suspect measles cases from Barangay Sto.Niño, Villareal, Samar from 23 January 2014. Age of cases ranged from 4 months to 68 years old (Median: 2 years old). RESU is following-up on the cases and will conduct investigation.

EASTERN SAMAR PROVINCE


FMT 0 0 0 0




Hospital 8 8 7 8

RHU 14 14 13 14

BHS 0 5 2 0

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SPEED reporting facilities by type and week, Eastern Samar

Reporting: 22 Health Facilities reported from Eastern Samar including 14 Rural Health Units and 8 Hospitals. Consultations: The total number of SPEED consultations declined by 11% during the current reporting week (from 3,492 last week to 3,116). Leading causes of morbidity were acute respiratory infection (27%), high blood pressure (4%), wounds (4%), skin diseases (2.5%) and acute watery diarrhea (1%). Alerts: There were 4 SPEED reports of fever with rash from Lawaan (Lawaan Main Health Center), one from Hernani (Hernani RHU), one from Guiuan RHU and one from Our Lady of Guadalupe Hospital in Guiuan. Cases were investigated by the Provincial Health Office. Suspect cases of Acute Hemorrhagic Fever (AHF) were reported by Albino Duran Memorial Hospital of Balangiga (4), Felipe Abrigo Memorial Hospital of Guiuan (3), Agpalo Hospital (3) in Guiuan and 1 case from Lawaan Main Health Center. 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 in barangays with cases.

LEYTE PROVINCE


FMT 0 0 0 0




Hospital 10 11 11 12

RHU 22 20 22 24

BHS 5 4 5 4

0

5

10

15

20

25

30

35

40

45

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SPEED reporting facilities by type and week, Leyte

Reporting: Reporting from Leyte included 24 RHUs, 12 hospitals, 4 BHS and 1 mobile clinic. Consultations: The total number of SPEED consultations increased from 8,563 to 10,520 over the past week. Leading causes of morbidity were acute respiratory infection (36%), wounds (7%), high blood pressure (5.5%), fever (3%) and animal bites (3%).


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Alerts: Alerts of fever and rash were reported from Tacloban City (4 - Eastern Visayas Regional Medical Center and 2 - Masa Health service Unit), Jaro (3 - Jaro MHO), Palo (3 - Leyte Provincial Hospital), Alangalang (1 – Alangalang MHO), Calubian (1 – Northwestern Leyte District Hospital), Carigara (1 – Carigara MHO), Kananga (1 Kananga District Hospital), Ormoc City (1 – Ormoc District Hospital), Palompon (1 - Dr. Manuel B. Veloso Memorial Hospital), Santa Fe (1 – Santa Fe MHO) and Tabango (1 - Tabango MHO). A measles immunization campaign is being conducted in the Region. Meanwhile, 19 consultations for suspect AHF were reported from Ormoc City (11 - Clinica Gatchalian and Hospital and 8 - Ormoc District Hospital), seven in Leyte (7 Leyte Provincial Hospital in Palo) and one in Tacloban City (Eastern Visayas Regional Medical Center).

Suspect Measles in Region 8 :

The Regional Epidemiology and Surveillance Unit reported a total of 93 suspect measles cases from 1-26 January 2014. One death due to pneumonia was reported in a 1 year old child from Mapanas, Northern Samar on 14 January 2014. Most of the cases occurred in the provinces of Biliran (35%) and Leyte (31%). Among the less than 5 years old cases, 66% were not vaccinated. Blood samples were taken for laboratory examination. A measles immunization campaign is on going in the region.

MAPS

Location of SPEED notifications of fever with rash, 2nd

to 8th

February 2014, Regions VI and VIII (red=hospital blue=other facility

Location of SPEED notifications of acute hemorrhagic fever, 2nd

to 8

th February 2014, Regions VI and VIII (red=hospital

blue=other facility)


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FOCUS ON: HIGH BLOOD PRESSURE (HYPERTENSION)

KEY FACTS

Worldwide, it is estimated that high blood pressure causes 51% of deaths due to stroke and 45% due to heart disease

Hypertension is a major risk factor for cardiovascular disease. Metabolic risk factors such as diabetes, high blood cholesterol and obesity, increase the risk of complications from high blood pressure, including heart disease, stroke, kidney failure and blindness

Treating hypertension results in a 40% decrease in the risk of stroke and 15% decrease in risk of MI

SIGNS AND SYMPTOMS

Hypertension is referred to as the “silent killer” since most individuals do not manifest symptoms

Hypertension is defined as a blood pressure: ≥140 systolic /90 diastolic (or ≥130 or ≥80 among people with diabetes or renal disease)

WHO IS AT RISK?

Certain behaviors and lifestyle choices are risk factors for hypertension and cardiovascular disease (in “Prevention” below)

Proportion of people with hypertension increases with age: 1 in 10 people in their 20s -30s; 5 in 10 people in their 50s

In the Western Pacific Region (WPR), 37% of adults older than 24 have high blood pressure

In the Philippines, 25% of adults 21 years old and above have high blood pressure

HYPERTENSION REPORTED IN TYPHOON YOLANDA

Overall there have been over 14,000 consultations for hypertension in these areas. The following charts and tables show information from SPEED consultations in select typhoon-affected areas (Regions VI and VIII) from 10 Nov 2013 – 8 Feb 2014. Results shown are dependent upon facility reporting which varied over time.

REGION VI

In Region VI, there have been 3,829 consultations for hypertension reported through SPEED, mostly from the Capiz province. Hypertension consultations in Capiz and Iloilo peaked in the second week of December. As a proportion of all consultations, however, Antique spiked in the last week of November while Iloilo spiked in the last week of January.

REGION VIII

In Region VIII, there have been 10,481 consultations for hypertension reported through SPEED, mostly from Leyte province. Hypertension consultations in Leyte appeared to increase and plateau from the time of the typhoon until mid December and decrease by the end of December. This was however, a reflection of total consultations in that time period.


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PREVENTION

Measures to Prevent Cardiovascular Events in Hypertensive Patients:

Stop Smoking o In Western Pacific Region (WPR), 25% of adults >15 yrs

smoke tobacco daily o In the Philippines, 28.3% of population aged 15 years

old and over currently smoke tobacco.

Control blood sugar if diabetic

Treat dyslipidemia (high cholesterol)

Reduce intake of sodium and diet rich in fat o Consume a diet rich in vegetables, fruit, and low fat

dairy products.

Maintain a body mass index (BMI) between 18.5-24.9 kg/m2. o In Western Pacific region (WPR), 25.4% adults >20 are overweight. In the Philippines, 27% adults >20 are overweight and

obese.

Engage in regular aerobic exercise or do brisk walking at least 30 minutes a day o In Western Pacific region (WPR), 33.2% of people over 15 yrs have insufficient physical activity o In the Philippines, high levels of physical inactivity is also reported among adults >20 at work (76%), non-work (76%), travel

(94%), and leisure (93%).

Limit alcohol intake to less than 1 oz/day of ethanol (24oz of beer, 8oz wine, or 2oz 80 proof whiskey).

TREATMENT1

Hypertension:

ALL cases should be seen by a healthcare provider

Oral anti-hypertensive medication should be administered

Most patients will need at least 2 agents to attain blood pressure targets. Less than half will meet their target with monotherapy. Over 30% need ≥ 3 agents to meet their goal.

For more information, go to: http://www.who.int/cardiovascular_diseases/guidelines/hypertension/en/

_____________________________________ 1 “Manual on Treatment Protocols of Common Communicable Diseases and Other Ailments During Emergencies and Disasters”, Second Edition, 2013

This weekly EWARN Summary is published by the World Health Organization (WHO), Philippines. It is based on preliminary surveillance data from multiple sources, including the Surveillance in Post-Extreme Emergencies and Disasters (SPEED) system, the Philippines Integrated Disease Surveillance and Response System (PIDSR), and event-based reporting system. WHO surveillance contact: [email protected] Weekly Summaries are available at:http://www.wpro.who.int/philippines/typhoon_haiyan/en/index.html

http://www.who.int/cardiovascular_diseases/guidelines/hypertension/en/

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