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Weekly Epidemiological Bulletin

This weekly Epidemiological Bulletin is published jointly by the 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. 46 (11 to 17 November, 2011)

• 80 districts and 2 agencies provided surveillance data to the DEWS this week from 2,636 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.

• A total of 816,850 consultations were reported through DEWS of which 203,121 (25%) were acute respiratory infections (ARI); 72,768 (9%) were Skin disease; 61,792 (8%) were acute diarrhoea; and 57,597 (7%) were suspected malaria.

• A total of 124 alerts with 10 outbreaks were reported in week‐46, 2011: Altogether 28 alerts for AWD, 23 for Measles; 22 for Neonatal tetanus and tetanus; 18 for Leishmaniasis; 7 for Pertussis; 6 each for Malaria and ARI; 4 each for DHF and Acute diarrhoea; 2 for AJS; while 1 each for CCHF, Diphtheria, Typhoid and unexplained fever.

• In this week nine new polio cases were confirmed by the laboratory, four from FATA (three from North Waziristan agency and one from Khyber agency); two each from Balochistan (Mastung and Barkhan districts) and Punjab (Vehari and Rahim Yar Khan districts); and one from Khyber Pakhtunkhwa (Lakki Marwat district). As of 21st November 2011, Pakistan has reported a total of 154 polio cases (152 type‐1 & 2 type‐3) from 48 districts/towns/tribal agencies and areas.

Highlights

Disease early warning system and response in Pakistan

01

Volume 2, Issue 46, Monday 21 November, 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 27 October 2011 (Epi week 31, 2010 to week 46, 2011)

Disease Wk-39 Wk-40 Wk-41 Wk-42 Wk-43 Wk-44 Wk-45 Wk-46

Acute diarrhoea 105,295 (11%) 97,007 (10%) 93,085 (9%) 74,189 (8%) 62,628 (8%) 65,701 (8%) 32,405 (8%) 61,792 (8%)

Total consultation 995,450 1,014,266 1,033,276 897,598 808,954 879,811 407,339 816,850

Suspected malaria 83,684 (8%) 82,802 (8%) 86,326 (8%) 68,441 (8%) 58,613 (7%) 69,408 (8%) 33,8869 (8%) 72,768 (9%)

Acute respiratory infection 205,597 (21%) 209,436 (21%) 223,902 (22%) 213,432 (24%) 193,863 (24%) 217,676 (25%) 101,386 (25%) 203,121 (25%)

Bloody diarrhoea 9,393 (0.94%) 8,075 (0.80%) 8,107 (0.78%) 6,089 (0.68%) 5,461 (0.68%) 5,289 (0.60%) 2,751 (0.68%) 5,706 (0.70%)

Skin diseases 105,912 (11%) 95,842 (9%) 94,167 (9%) 81,161 (9%) 69,393 (9%) 77,842 (9%) 33,869 (8%) 72,768 (9%)

Since July 29, 2010, approximately 52,456,152 patient consultations have been reported to the DEWS from all provinces, FATA and AJ&K. While we still receive reports on around 1,000,000 consultations per week, there is a drop in timely reporting due to EID holidays, challenges in accessibility caused by secu‐rity situation in some areas. The above graph shows the weekly trend of four major diseases as percentage of cases out of total consultations reported to DEWS. From last 8 weeks (39 to 46, 2011) acute diarrhoea cases have been decreased (From 11% to 8%), while at the same time cases of ARI have been increased (From 21% to 25%). A slight fluctuation in the suspected malaria cases have been seen recently after consistent seasonal increase from week 35 especially from districts in Sindh and Balochistan.

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AD BD ARI S. Malaria

Epidemiological Bulletin: DEWS, Pakistan, Week no. 46 (11 to 17 November, 2011)

This weekly Epidemiological Bulletin is published jointly by the 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, 02

Current week's Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

11‐Nov AWD KPK Lower Dir Village Gular, UC & Tehsil Samar Bagh 0 2 2 2

A Case of suspected AWD was reported, on active surveillance 5 more cases were found in same area with severe dehydration, all the patients were referred to DHQ Hospital for IV therapy, Stool samples collected for lab confirmation but both found negative for Cholera, Water Samples taken for any fecal contamination, ORS, Hygiene kits & Aqua tabs distributed, Health & Hygiene promotion Session conducted with family members.

16‐Nov Pertussis KPK Lower Dir Village Sharmakhan‐Shontala, UC & Tehsil Samar Bagh

7 2 3 1

During active surveillance 2 cases of suspected Pertussis were found having typical Cough with vomiting, 11 more cases were found in the same area but most of them were unimmunized for routine vaccination. some were already recovered, Erythromycin was provided to all close contacts, Nasophyrangeal swab were taken from 2 cases for confirmation. Outreach Immunization activity was carried out by EPI team in the area. EDO was Informed.

15‐Nov AJS Sindh Badin Village Mian Pota, UC Talhar, Taluka Talhar 0 5 0 2 7 cases of suspected acute viral hepatitis investigated, health education imparted, one pregnant women

suspected case was give TT vaccine, informed MS RHC and DHMT and 3 blood sample taken and sent to NIH

16‐Nov AWD Sindh Mirpur Khas Baloch Mohalla, Old Wolcut Factory, UC # 6, Taluka Mirpurkhas

2 2 1 1 1 suspected case was found in hospital, on active surveillance 5 more cases with diarrhoea were found in the community. Contaminated water of hand pump was the possible source, health education imparted, Aqua tabs, Zinc tabs and ORS distributed, EDO‐H, DSM PPHI informed.

17‐Nov AWD Sindh Thatta Village Allo Tara, UC Sonda, Taluka Thatta. 3 2 6 5

3 Patient were admitted in Hospital, during active surveillance 13 more cases found, Canal was the source of drinking water, health education imparted, Aqua tabs, Zinc tabs, ORS, Jerry cans and water filter distributed, EDO‐H informed and 2 water sample taken.

16‐Nov Malaria Sindh Ghotki Village Muhammad Khan Shar UC Bairoota Taluka Daharki

10 23 8 25

Suspected Malaria Death reported by health technician at EDOH office Mirpur Mathelo. Field investigation done and WHO response, DEWS team performed MP tests on RDTs and found 30 positive cases (P. Falcipa‐rum 17, P. Vivax 3, Mixed 10) in the village. ACT & bed nets provided, Health education session conducted in the community, moreover informed EDOH for fumigation and resudal spray.

11‐Nov Malaria Sindh Thatta Village Pir Dino Khaskheli, UC Jhirk, Taluka Thatta 6 8 1 4 19‐cases of malaria (7 P. Falciparum and 2 Mix) found confirmed by RDT, health education imparted to family

members and other neighbor, Anti Malaria medicines and Bed Nets provided and EDO‐H informed.

16‐Nov Malaria Sindh Thatta Village Sheikh Muhammad Ismail, UC Jhirk, Taluka Thatta

2 8 4 11 25‐cases of malaria (8 P. Falciparum and 3 Mix) found confirmed by RDT, health education imparted to family members and other neighbor, Anti Malaria medicines and Bed Nets provided and EDO‐H informed.

14‐Nov Pertussis Sindh Tharparkar Village Bhoongrai Khosa, UC Mitho Dabhro, Taluka Diplo 1 4 2 8 15 Suspected case investigated, Throat Swab collected, sensitized regarding proper vaccination and Personal

Hygiene, informed EDO‐H, DSM PPHI, MS DHQ regarding the cases and Throat swab taken.

16‐Nov Pertussis Sindh Tharparkar Village Baando Kapri, UC Warawah, Taluka Nagar‐parkar

4 2 2 9 case of Pertussis were investigated, History of Patient was taken, Health education imparted regarding Vaccination and Proper health and Hygiene, Anti Biotic and Antipyratic tabs given, inform EDO‐H, DSM‐PPHI, MS THO.

Current week's Alerts: Province Sindh Date Disease District Area <5M >5M <5F >5F

17‐Nov AD Naushahro Feroze Baladi Mohalla, UC and taluka Kandiyaro 1 1 1 1

15‐Nov AJS Badin Village Mian Pota, UC Talhar, Taluka Talhar 0 5 0 2 15‐Nov AJS Benazirabad Police Line Dispensory, UC 1 2 0 1 0

12‐Nov AWD Badin Village Haji Channesar Jat, Dadar ko Farm, UC Rahuki 1 1 0 1

17‐Nov AWD Hyderabad Gayoosala, Usmanabad near Bilala Masjid, UC‐16, Taluka Hyderabad 0 0 0 3

12‐Nov AWD Mirpur Khas Rajar Colony, UC #5, Taluka Mirpurkhas 1 2 0 0

16‐Nov AWD Mirpur Khas Village Junejo Colony, near Bus Trrminal Mirpurkhas, UC Turk Ali Mari 0 1 0 0

16‐Nov AWD Mirpur Khas Opposite Bhittai hospital, Baloch Colony, UC #5 Taluka Mirpurkhas 1 0 0 1

16‐Nov AWD Mirpur Khas Village Faiz Muhammad Laghari, near Jamrau Mori, UC Doulat Pur 0 1 0 0

16‐Nov AWD Mirpur Khas Village Haji Mubarak Khaskheli, Kapri Mo‐halla, UC Mir Ghulam Hussain Talpur 0 1 0 0

16‐Nov AWD Mirpur Khas Baloch Mohalla, Old Wolcut Factory, UC # 6, Taluka Mirpurkhas 2 2 1 1

12‐Nov AWD Qambar Shahdadkot Village Norang UC Jean abro 2 1 0 0

17‐Nov AWD Sanghar Village Khairo Kaloi, Taluka Shahdadpur 2 1 0 0

11‐Nov AWD Tando Allah Yar

Ashfaq Tawn, UC Pak Singhar, Taluka Tando Allahyar 0 1 0 0

11‐Nov AWD Tando Allah Yar Madina Colony Taluka Tando Allahyar 0 1 0 0


Village Sultan Abad, UC Sheikh Musa, Taluka Tando Allahyar 0 0 0 1


Village Maqbool memon (Hingorja Mohalla), UC Missan 0 4 0 0

11‐Nov AWD Tharparkar Village Bachal Shah Colony UC Mithi 0 1 0 0

11‐Nov AWD Tharparkar Village Sukhpur, UC Nagarparkar, Taluka Nagarparkar 1 0 0 0

12‐Nov AWD Tharparkar Village Kuwara, UC Pithapur, taluka Nagar‐parkar 1 0 0 0

13‐Nov AWD Tharparkar IDP Tent city Naukot, UC Mahrano, Taluka Mithi 0 0 2 0

15‐Nov AWD Tharparkar Village Edani, Peer Mohalla, UC Dhaheli, Taluka Chachro. 0 1 0 0

15‐Nov AWD Tharparkar Village Jarelo, Rind Mohalla, UC Tar Ahmed, Taluka Chachro. 0 1 0 0

14‐Nov AWD Thatta Sonda Citu UC Sonda 0 1 0 0 16‐Nov AWD Thatta Village Allah Buksh Tara, UC Sonda 0 1 0 0 16‐Nov AWD Thatta Village Moosa Merbahar, UC Sonda 1 0 1 1

16‐Nov AWD Thatta Village Saleh Muhammad Sheikh, Taluka Shah Bundar. 1 1 1 1

17‐Nov AWD Thatta Village Allo Tara, UC Sonda, Taluka Thatta. 3 2 6 5

15‐Nov AWD Umer Kot Khoso Paro, near Ali Nawaz Khaskheli house, UC 2, Taluka Umerkot 1 1 1 0

15‐Nov AWD Umer Kot Village Waryam Rajar, Bheel Paro, UC Atta Muhammad Pali 0 1 0 2

Cont’d: Province Sindh Date Disease District Area <5M >5M <5F >5F

14‐Nov Diphtheria Dadu Najab shah Mohalla, UC and Taluka Johi 0 1 0 0

16‐Nov Malaria Ghotki Village Muhammad Khan Shar UC Bairoota Taluka Daharki 10 23 8 25

11‐Nov Malaria Thatta Jhirck City, Mallah Mohalla, UC Jhirk Taluka Thatta 1 4 0 3

15‐Nov Measles Jamshoro Ameer complex UC Nagoline Taluka Kotri 0 0 1 0

15‐Nov Measles Jamshoro Near SDA office, Khuda Ki Basti # 3 UC Sonowaller 0 0 1 0

17‐Nov Measles Jamshoro Village Shah Paro, near G. High school, UC Nagoline 0 0 0 1

14‐Nov Measles Karachi Siddique Akbar Mohalla, near Al Khidmat hospital, sector 5‐E, SITE 1 1 2 0

17‐Nov Measles Shikarpur Qazi Mohalla, Shikarpur City 0 1 0 0

12‐Nov NNT Badin Village Potho, Ali Mirshah, UC Kario Ganwer, Taluka Golarchi 1 0 0 0

17‐Nov NNT Dadu Village Hiro Khan Laghari, UC Pat Gul Mu‐hammad, Taluka Johi 1 0 0 0

16‐Nov NNT Ghotki Village Waryam Chachar UC Mithri Taluka Khan Garh 0 0 1 0

15‐Nov NNT Karachi Neonatal ICU, NICH/Sec 48‐B, Korangi # 2, Korangi Tawn 0 0 1 0

17‐Nov NNT Karachi Kachi Abadi, Bhains colony Bin Qasim Town 1 0 0 0

14‐Nov NNT Khairpur Village Gazi Khan buledi UC Kalar Talka Kamber 0 0 1 0

14‐Nov NNT Khairpur Village Muhammad Murad Rind UC Nizamani 1 0 0 0

15‐Nov NNT Khairpur Village Haji Maheral Alamani UC Kot mir Muhammad Taluka Kingri 1 0 0 0

16‐Nov NNT Khairpur Village Haji Khair Muhammad Bhambhro UC Sikanderabad Taluka Nara 1 0 0 0

16‐Nov NNT Khairpur Village Mohabat khan UC Chondiko Taluka Nara 1 0 0 0

17‐Nov NNT Khairpur Village Khuda Bux Brohi, UC Hingoja, taluka Sobho Dero 1 0 0 0

16‐Nov NNT Larkana Village Gull Mohammed Tunio Taluka Bakrani 1 0 0 0

14‐Nov NNT Qambar Shahdadkot

Village Gazi Khan buledi UC Kaler talka Kamber 0 0 1 0

17‐Nov NNT Sanghar Daper Colony, UC‐2, Taluka Sanghar 1 0 0 0

14‐Nov Pertussis Tharparkar Village Bhoongrai Khosa, UC Mitho Dabhro, Taluka Diplo 1 4 2 8

16‐Nov Pertussis Tharparkar Village Baando Kapri, UC Warawah, Taluka Nagarparkar 4 1 2 2

11‐Nov Malaria Thatta Village Pir Dino Khaskheli, UC Jhirk, Taluka Thatta 6 8 1 4

16‐Nov Malaria Thatta Village Sheikh Muhammad Ismail, UC Jhirk, Taluka Thatta 2 8 4 11

17‐Nov Measles Jacobabad Channa Mohalla, UC Jaffarabad 0 0 1 0


This weekly Epidemiological Bulletin is published jointly by the 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, 03

Current week's Alerts: Province Balochistan Date Disease District Area <5M >5M <5F >5F

11‐Nov Leishmani‐asis Khuzdar UC Zereena Kattan & UC Khand 0 3 0 0

12‐Nov Leishmani‐asis Khuzdar Rabat, UC Goani Grehsa; Lope; Kanak,

UC Gazgi 0 3 0 0

12‐Nov NNT Quetta Bolan Medical Complex Hospital 0 0 1 0

12‐Nov Tetanus Quetta Bolan Medical Complex Hospital 1 0 0 0

14‐Nov Pertussis Khuzdar Nawa, UC Baleena Kattan, Tehsil Khuzdar 1 0 0 0

15‐Nov Typhoid Chagai Killi georgage, Girdi jungle Refugee camp 0 2 0 3

15‐Nov Pertussis Kharan Wapda road, UC Northern town 0 1 1 1

15‐Nov Leishmani‐asis Kalat Chashma, UC Lakhorian, Tehsil Surab 1 0 0 0

16‐Nov NNT Nasira‐bad DHQ‐Dera Murad Jamali 1 0 0 0

16‐Nov Leishmani‐asis Bolan Mohalla Ghulam Bolak, Dhadar 0 0 1 0

16‐Nov CCHF Quetta Fatima Jinnah Chest Hospital 0 2 0 0

16‐Nov Leishmani‐asis

Jaffara‐bad Cattle farm colony, Tehsil Jhat Pat 0 1 0 0

17‐Nov Pertussis Kech Khuda Yousuf Mahallah, UC Absar 0 1 0 0

17‐Nov Measles Quetta Bolan Medical Complex Hospital 0 1 1 2

17‐Nov Leishmani‐asis Kech Akram Ward, UC Absar 0 1 0 0

17‐Nov Leishmani‐asis Lasbela Mangya UC Sheh Tehsil Lakhra 0 1 1 1

17‐Nov Leishmani‐asis Panjgur UC Khudabadan East, Mohallah Sara‐

wan 0 1 0 0

17‐Nov Leishmani‐asis Panjgur UC Washbood, Mohallah Faqeer Abad 1 0 0 0

17‐Nov Leishmani‐asis pishin Grid colony, UC bazar e khona 0 1 0 0

17‐Nov Leishmani‐asis Quetta Hazara town, Brewery road 0 2 1 2

17‐Nov Leishmani‐asis Quetta Pashtoon Abad 0 1 0 0

17‐Nov Leishmani‐asis Sibi Mohala Allabad, UC 3 & Ghareebabad 0 0 0 2

17‐Nov Pertussis Ziarat Kawas sharki 0 2 0 1

17‐Nov Leishmani‐asis Ziarat Pasara, Cheena 0 1 0 0

Current week's Alerts: AJK; FATA; GB and ICT Date Disease District Area <5M >5M <5F >5F

15‐Nov NNT Bajaur Agency village rashakai, tehsil Nawagai 0 0 1 0

17‐Nov Measles Mohmand Agency Kasai 1 0 0 0

17‐Nov NNT Bajaur Agency village gabaray, tehsil Mamoond 1 0 0 0

Current week's Alerts: Province Punjab Date Disease District Area <5M >5M <5F >5F

11‐Nov DHF Bhakkar DHQ Bhakkar‐Mohallah Jhakkar Alamabad‐ Chak 217/TDA 0 2 0 0

11‐Nov Leishma‐niasis D. G. Khan Mohala Duleani Tiba near CH Sakhi

Sarwar 0 1 0 0

11‐Nov NNT Rajanpur Faisal Colony, Choti Road, UC Basti Rindan 0 0 1 0

11‐Nov NNT Rajanpur THQ Jampur, Basti Mushtaq Khosa, UC Basti Foja 1 0 1 0

12‐Nov DHF Mianwali Nai Abadi Kotchandna, Isa Kheel 0 1 0 0

14‐Nov Leishma‐niasis

Rahim Yar Khan

Basti Ahmed abad, Malik pur, UC Jaja Abasian, tehsil Khanpur 0 1 0 0

14‐Nov Leishma‐niasis

Rahim Yar Khan UC Khanbela, Tehsil Liaqatpur 0 1 0 0

14‐Nov ARI Rahim Yar Khan

BHU Allah Jiwaya Lar, Tehsil Liaqat‐pur 7 18 11 23

14‐Nov ARI Rahim Yar Khan RHC Zahir Pir, Tehsil Khanpur 3 9 5 13

15‐Nov AD Mianwali BHU PaiKheel 3 5 4 3

15‐Nov ARI Rahim Yar Khan BHU 87/A, Tehsil Liaqatpur 4 7 6 10

15‐Nov ARI Rahim Yar Khan BHU Haroonabad, Tehsil Liaqatpur 2 7 3 8

15‐Nov Malaria Muzaffar‐garh RHC Sinanawan 40 31 33 16

15‐Nov DHF Vehari Moza Dharam Pura, Inshallah Nurs‐ery, Gali No. 2, Tehsil Mailsi 0 1 0 1

16‐Nov Leishma‐niasis Khushab Village Payel, Khushab 0 2 0 3

17‐Nov NNT D. G. Khan Gohra, UC Tuman Qaisrani 0 0 1 0

17‐Nov ARI Rahim Yar Khan

BHU 5/NP, Roshan Bhait, Tehsil Sadiqabad 4 3 6 9

17‐Nov ARI Rahim Yar Khan BHU Bhong, Tehsil Sadiqabad 26 98 31 67

12‐Nov AD Muzaffar‐garh

Basti New Qadir Pur & Thatha Sharif, UC Qadirpur Chajra 16 10 9 12

14‐Nov UXF Mianwali BHU Chak 5‐6 ml, piplan 0 5 1 4

14‐Nov AD Muzaffar‐garh

Basti Darkhan Wala, BHU Usman Koria, UC Kharak 6 4 9 7

14‐Nov Malaria Muzaffar‐garh BHU Usman Koria 5 7 4 3

14‐Nov DHF Pakpattan Chak No. 79/EB, Darya Ding, Tehsil Arif 0 2 0 0

Current week's Alerts: Province Khyber Pakhtunkhwa Date Disease District Area <5M >5M <5F >5F

11‐Nov AWD Lower Dir Village Gular, UC & Tehsil Samar Bagh 0 2 2 2

11‐Nov Measles Swat Village & UC Kabal, Tehsil Kabal 0 0 0 1

11‐Nov Measles Swat Village Mehak UC Kala Kale, Tehsil Kabal 0 0 1 0

12‐Nov Measles Lower Dir Village Sabar Shah & Serai, UC Tazagram, Tehsil Adenzai 4 1 5 2

12‐Nov Measles Lower Dir Village Shirkhanai, UC Hayaserai, Tehsil Balmbat. 0 0 1 0

14‐Nov Measles Charsadda Azizkhel 0 0 1 0 14‐Nov Measles Swat Village Chinar Baba Khwazakhela 0 0 1 0

14‐Nov Measles Swat Village Dherai, Mohallah Alfalah, UC Kanju, Tehsil Kabal 1 0 0 0

15‐Nov Measles Charsadda Dab Kallay 1 0 0 0 15‐Nov Measles Charsadda Munda camp 1 0 0 0 15‐Nov Measles Swabi Private Clinic, Narangi 2 0 1 0

15‐Nov Measles Swat Village & UC Shahderai,mohallah thana, Tehsil Kabal 1 0 0 0

16‐Nov Measles Haripur Tarbella Cant, tehsil Ghazi 1 0 0 0

16‐Nov Measles Lower Dir Village Shontala, UC & Tehsil Samar Bagh 3 0 2 0

16‐Nov Measles Swabi BHU Fazal Abad, Tel Banda 0 0 1 0

16‐Nov Pertussis Lower Dir Village Sharmakhan‐Shontala, UC & Tehsil Samar Bagh 7 2 3 1

11‐Nov Measles Swabi BMC Swabi, Kadi and Baja 2 0 0 0


This weekly Epidemiological Bulletin is published jointly by the 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

Province Khyber Pakhtunkhwa:

• This week 607 health facilities from 16 districts reported to DEWS with a total of 138,635 patients consultations.

• The proportional morbidity of AD dropped by 1% as com-pared with last week.

• 17 alerts were reported in this week, 15 were for Measles; while 1 each for AWD and Pertussis.

• 2 outbreaks, 1 each for AWD and Pertussis both were from Lower Dir were received and responded this week.

Figure-3: Trend of priority communicable diseases, province KPK

Province Sindh:

• This week 882 health facilities from 23 districts reported a total of 360,852 patient consultations.

• In Sindh, AD cases reported were 28,686 (8%), 1% lower pro-portional morbidity as compared with last week.

• 57 alerts were reported from Sindh in this week: 27 were for AWD; 14 for Neonatal tetanus; 6 for Measles, 4 for Malaria, 2 each for Pertussis and AJS, while 1 each for AD and Diphthe-ria.

• 9 outbreaks, 3 for Malaria, while 2 each for AWD and Pertus-sis, while 1 for AJS were received and responded this week.

Figure-4: Trend of priority communicable diseases, province Sindh

Table‐2: Total number of alerts and outbreaks reported and investigated with appropriate response Disease

Post Flood 2010 2011 (up till wk 45) Current Week (46) Total A O A O A O A O

Acute watery diarrhoea 209 85 1261 533 28 3 1498 621 Acute jaundice syndrome 5 2 42 14 2 1 49 17 Bloody diarrhoea 10 1 91 19 0 0 101 20 Dengue fever 81 32 774 111 4 0 859 143 Measles 48 6 1490 88 23 0 1561 94 Pertussis 1 ‐ 244 61 7 3 252 64 NNT + tetanus 5 ‐ 299 22 0 326 0 Malaria 12 7 103 69 6 3 121 79 Leishmaniasis 1 ‐ 210 28 18 0 229 28 Others 75 11 518 60 14 0 607 71 Total 447 144 5032 983 124 10 5603 1137

Table‐1: Leading causes of seeking health care in flood affected districts, 29 July 2010 to 10 November 2011, compiled from weekly reports

Diseases Number of Consultations

Acute respiratory infection 11,740,063 (22%)

Skin diseases 5,598,514 (11%) Acute diarrhoea 4,964,185 (9%) Bloody diarrhoea 439,816 (1%) Suspected malaria 3,254,132 (6%) Unexplained fever 1,185,306 (4%) Total consultations 52,456,152

Figure‐2: Weekly number of reporting health facilities (Wk 33/2010 to Wk 46/2011)

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Epidemiological Bulletin: DEWS, Pakistan, Week no. 46 (11 to 17 November, 2011) Province Punjab: • This week 484 health facilities from 8 districts reported data to

DEWS from Punjab province with a total of 195,835 patient consultations.

• AD cases reported were 11,974 (6%) and showing 1% higher proportional morbidity as compared with last week .

• 23 alerts were reported in this week from Punjab; 6 were for ARI; 4 each for DHF and Leishmaniasis; 3 each for AD and NNT; 2 for Malaria; while 1 for unexplained fever.

• No outbreak for any disease was received this week.

Figure-5: Trend of priority communicable diseases, province Punjab


State of Azad Jammu and Kashmir:

• In this week, reports were received from 118 health facilities from 10 districts with a total of 26,151 patient consultations.

• ARI cases reported were 5,313 (20%), while Acute diarrhoea reported 969 (4%) cases.

• No alerts or outbreak was received this week from any area of AJ&K.

• This week 39 health facilities in 2 agencies reported from FATA, with a total of 6,858 patient consultations.

• ARI cases reported were 1,695 (25%), while Acute diarrhoea was reported 512 cases (7%)

• 3 alerts, 2 for Neonatal tetanus and 1 for Measles were received and responded this week.

Province Gilgit Baltistan:

• In this week, 47 health centers from 5 districts in Gilgit Baltistan sent weekly report with a total of 16,668 pa-tient consultations.

• ARI cases reported were 2,760 (17%), while Acute diar-rhoea were 1,297 (8%).

• No alert or outbreak was received in this week from any area of Gilgit Baltistan.

Figure-7: Trend of priority communicable diseases, Gilgit Baltistan

FATA:

Province Balochistan:

• In this week, 18 districts reported to DEWS from Ba-lochistan province. 459 health centers reported a total of 71,851 patient consultations.

• AD reported in 6,761 (9%) of the total consultations, 2% lower proportional morbidity as compared with the last week.

• 24 alerts were reported in this week from Balochistan, 14 for Leishmaniasis; 4 for Pertussis; 3 for Neonatal tetanus and tetanus; while 1 each for CCHF, Measles and Typhoid.

Figure-6: Trend of priority communicable diseases, province Balochistan

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Distribution of Wild Polio Virus cases Pakistan 2010 and 2011

Year 2010: The total number of polio cases reported in 2010 is 144 including 120 type‐1 cases and 24 type‐3 from 40 in‐fected districts/towns/agencies. Year 2011: As of 18 November, 2011, the total number of polio cases confirmed by the laboratory is 154 (152=type‐1, and 2=type3) from 48 districts.

Pakistan Dengue Situation, 5th November 2011 Since the beginning of the year and as of Week 46th 2011; 554,663 cases of suspected dengue fever cases and 23,019

Lab confirmed cases were reported across the country with 356 deaths (CFR = 1.55%). Over 90% of cases were reported in Punjab province.

Provinces 2011

Suspected Confirmed Deaths

Punjab 551663 21177 331

Sindh 1400 980 17

Islamabad 980 620 2

Khyber Pakhtunkhwa 502 210 6

AJK 99 21 0

FATA 7 6 0

Balochistan 6 3 0

Gilgit Baltistan 6 2 0

Total 554663 23019 356

Province Cases 2010 Cases 2011 P1 P3 P1 P3

Punjab 6 1 4 - Sindh 26 1 29 -

Khyber Pakhtunkhwa 19 5 13 -

FATA 63 11 44 2

Balochistan 6 6 61 -

AJ&K - - - -

Gilgit‐Baltistan - - 1 -

Islamabad - - - -

Total 120 24 152 2



Alerts and outbreaks, week 46, 2011

weekly epidemiological - who · epidemiological bulletin: dews, pakistan, week no. 46 (11 to 17...

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