SRI LANKA Third Quarter 2014 EPIDEMIOLOGY UNIT A publication of the Epidemiology Unit Ministry Of Health No. 231, De Saram Place, Colombo.10 www.epid.gov.lk CONTENTS PAGE NO 1. Surveillance of Poliomyelitis 02 2. Surveillance of Measles 03 3. Surveillance of Cholera 03 4. Surveillance of Leptospirosis 03 5. Surveillance of Human Rabies & Control activities 04 6. Surveillance of Malaria 04 7. Surveillance of Viral Hepatitis 04 8. Surveillance of Enteric Fever 04 9. Surveillance of Dysentery 04 10. Surveillance of Japanese Encephalitis 04 11. Surveillance of Tetanus 04 12. Surveillance of Rubella and Congenital Rubella Syndrome 04 13. Surveillance of Dengue Fever 06 14. Surveillance of Tuberculosis 06 15. Surveillance report on AEFI 07 16. Surveillance at Sea Port 09 17. Surveillance at Air Port 09 18. Pattern of Enteric Pathogens isolated 09 19. Surveillance of Leprosy 10 20. Sexually Transmitted Diseases 11 21. Surveillance of Meningitis 12 22. Influenza Surveillance 12 23. Special Report Surveillance Report On Influenza 14 24. Summary of Notifiable Diseases 20 EPIDEMIOLOGICAL BULLETIN Volume 55 July to September 2014
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Third - Epidcases in the previous quarter and 1279 cases in the cor-responding quarter of 2013. Jaffna (165 cases ) and Bat-ticaloa (86 cases) reported the highest number of cases.
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SRILANKAThird Quarter 2014
EPIDEMIOLOGY UNIT A publication of the Epidemiology Unit Ministry Of Health No. 231, De Saram Place, Colombo.10 www.epid.gov.lk
CONTENTS PAGE NO
1. Surveillance of Poliomyelitis 02
2. Surveillance of Measles 03
3. Surveillance of Cholera 03
4. Surveillance of Leptospirosis 03
5. Surveillance of Human Rabies &
Control activities 04
6. Surveillance of Malaria 04
7. Surveillance of Viral Hepatitis 04
8. Surveillance of Enteric Fever 04
9. Surveillance of Dysentery 04
10. Surveillance of Japanese Encephalitis 04
11. Surveillance of Tetanus 04
12. Surveillance of Rubella and Congenital
Rubella Syndrome 04
13. Surveillance of Dengue Fever 06
14. Surveillance of Tuberculosis 06
15. Surveillance report on AEFI 07
16. Surveillance at Sea Port 09
17. Surveillance at Air Port 09
18. Pattern of Enteric Pathogens isolated 09
19. Surveillance of Leprosy 10
20. Sexually Transmitted Diseases 11
21. Surveillance of Meningitis 12
22. Influenza Surveillance 12
23. Special Report
Surveillance Report On Influenza 14
24. Summary of Notifiable Diseases 20
EPIDEMIOLOGICAL BULLETIN
Volum
e 55
July
to S
epte
mbe
r
201
4
Volume 55 3rd Quarter July-September
2
1. POLIOMYELITIS
Eighteen (18) Acute Flaccid cases were notified to the
Epidemiology Unit during the 3rd quarter 2014. This is
lower compared to reported AFP cases of 28 during the
3rd quarter 2013. Reported number of AFP cases for
the quarter is below the expected number of AFP cases
per quarter of the annual surveillance target of
2:100,000 under 15 - year age population, which is 24
according to the current census survey population. The
non-polio AFP rate for the third quarter of 2014 was
1.4:100,000 under 15 year age population.
Notification of AFP Cases from Hospitals
All hospitals where Consultant Paediatricians are availa-
ble, are considered as sentinel sites for AFP surveillance.
A total of 69 sentinel sites are currently functioning and
last updated in 2013. All sentinel sites are expected to
report immediately on AFP case admissions to the Epide-
miology Unit and to the Regional Epidemiologist of the
respective area of patient’s residence. Majority of the
cases (72%) were notified from the sentinel site hospitals
for AFP, the Lady Ridgeway Children’s Hospital (LRH),
Teaching Hospital (TH) Peradeniya and TH Karapitiya.
Particulars of all hospitals which reported AFP cases are
given below.
Table 01: Notification of AFP cases by sentinel hospitals - 3rd quarter 2014
Distribution of AFP Cases according to Provinces, Districts & MOH Areas
The highest number of cases (5) were reported from Galle
district. The complete list of distribution of AFP cases ac-
cording to the province, district and MOH area are given
below. Table 02.
Age and Sex Distribution of AFP Cases
Sex distribution of the cases were equal during the 3rd
quarter 2014 and this was different compared to the trend
reported during the 3rd quarter 2013 in which majority was
(75%) of boys in the reported AFP cases.
Seasonal Distribution of AFP Cases
Majority of AFP cases were reported during July-August
(89%) with similar no of cases in each month. This is
similar to the compatible quarter in 2013 which reported
the highest proportion in the month of August
Hospital No: of cases
reported
LRH 9
T.H.Peradeniya 2
T.H.Karapitiya 2
G.H.Badulla 1
SBSCH 1
GH Kegalle 1
G.H.Nuwara Eliya 1
DGH Vavuniya 1
Total 18
Majority (66.7%) of cases were between 1-9 years dur-
ing the 3rd quarter this year and the trend was more or
less similar compared to the compatible quarter in the
previous year.
The table 03 shows the age distribution in the 3rd quar-
ter 2014.
Table 02: Geographical distribution of AFP cases
3rd quarter 2014
Province District MOH Area
Num-ber of AFP
cases
Western Colombo Maharagama 1
Padukka 1
Nugegoda 1
Gampaha Divulapitiya 1
Southern Galle Bopepoddala 1
Hikkaduwa 1
MC Galle 1
Habaraduwa 1
Imaduwa 1
Central Kandy Manikhinna 1
Poojapitiya 1
Nawalapitiya 1
Nuwara Eliya Mathurata 2
Sabaragamuwa Ratnapura Nivithigala 1
Kegalle Dehiowita 1
North Central Anuradhapura Horowpathana 1
Uva Badulla Badulla 1
Total 18
Volume 55 3rd Quarter July-September
3
Table 03. Distribution of AFP cases by Age
3rd quarter 2014
Majority (61%) of the reported AFP cases were Guillain
Barre Syndrome (GBS) and diagnoses of all 18 cases of
AFP are given in Table 04.
Final diagnoses of AFP cases
Laboratory exclusion of poliomyelitis in AFP patients
Two stool samples collected within 14 days of onset of
paralysis are required at the Virology laboratory (Medical
Research Institute, WHO regional reference laboratory)
for exclusion of polio virus. According to WHO criteria
these samples should be of ‘good condition’ as well as
timely.
Being of correct quantity (8-10g), being sent in a leak
proof container with no evidence of spillage or leakage
and presence of ice in the container on receipt are the
criteria to be completed to make the samples of ‘good
condition’.
Out of all cases 12 AFP cases (67%) had both stool sam-
ples collected timely and sent to MRI for polio virology.
Age
< 1 year old 1
1-4 year old 4
5-9 year old 8
10–15 year old 5
Total 18
Total
Final Diagnoses Frequency
GBS 11
Encephalomyelitis 02
Facial Nerve Palsy 01
Brain Stem Encephalitis 01
Transverse Myelitis 01
Radiculopathy 01
Myalgia 01
Total 18
Table 04: Final diagnoses of AFP patients reported
during 3rd quarter 2014
2. MEASLES
Seven hundred and fourteen (714) suspected measles
patients were reported during the third quarter 2014 in
showing evidence of declining the outbreak situation
started since January 2013. Five hundred and forty four
(544) of them were clinically confirmed as measles as
compatible with clinical surveillance case definition of
“fever and maculopapular rash with one of the signs of
cough, coryza or conjunctivitis”.
Suspected measles for the compatible quarter, in the
previous year was 2103 and 1334 of them were clinically
confirmed as measles. Of the clinical cases 77% were
field investigated by the respective medical officers of
health (MOH) of the patients’ residential areas and spe-
cial field investigation reports have been sent to the Epi-
demiology Unit. Western province reported highest pro-
portion (28%) (Colombo 60%, Kalutara 35%, Gampaha
32%) followed by Southern province (20%) and North
Western province (13%).
Out of the all field investigated clinically confirmed cases
69% were among below 1 year or above 28 years who
were not due for measles vaccination. Only 5% were
with a history of receiving at least a measles vaccine
dose and the remaining the history was not known for
measles vaccination.
Laboratory investigations of suspected measles or rubella
patients (494) from July to September who were with
fever and maculopapular rash with one of cough, coryza
or conjunctivitis were investigated in the WHO accredited
virology laboratory at the Medical Research Institute
(MRI) and identified 388 cases were serology positive for
Measles IgM antibodies. Outbreak of measles was con-
sidered as declining during the third quarter.
3. CHOLERA
No confirmed cases of cholera were reported to the Epide-
miology Unit during the 3th Quarter 2014. Last case of
cholera was reported in the country in January 2003
4. LEPTOSPIROSIS
During the 3rd quarter 2014, 601 cases and 10 deaths
(CFR 1.66 %) due to Leptospirosis were notified to the
Epidemiology Unit compared to 509 cases and 5 deaths in
the previous quarter and 788 cases and 14 deaths during
corresponding quarter of 2013.
Volume 55 3rd Quarter July-September
4
11. TETANUS
Three cases of clinically confirmed tetanus were reported
in the third quarter. Galewela, Kopay, Thanamalwila
MOOH of RDHS areas of Matale, Jaffna and Moneragala
respectively reported one case each.
12. RUBELLA AND CONGENITAL RUBELLA
SYNDROME (CRS)
During the whole quarter 7 suspected Rubella disease
cases were reported but none of them were confirmed as
Rubella infection in field level investigation or by the la-
boratory investigations. No CRS cases were reported
during the quarter and not detected at the laboratory dur-
During the 3rd quarter of 2014, 12383 cases of DF/DHF
and 24 deaths were reported (0.19% CFR) when com-
pared to 12710 cases of DF/DHF and 38 deaths (0.29 %
CFR) reported during the 2nd quarter of 2014. Proportion
of cases notified in July, August and September were
46.20%, 32.48%, and 21.32% respectively. Table 09
shows the distribution of DF/DHF cases and deaths in
the RDHS divisions during the 3rd quarter of 2014.
Special surveillance data on 1132 confirmed cases
were received and analyzed for the 3rd quarter of
2014. Age distribution of reported cases were <4 years
of age in 63 (5.50%), 5- 9 years of age in 89(7.80%),
10 - 14 years of age in 100 (8.80%), 15 – 19 years of
age in 107 (9.40%), 20 - 24 years of age in 196
(17.30%), 25 - 29 years of age in 145 (12.80%), 30 - 34
years of age in 105 (9.27%), 35 - 39 years of age in 78
(6.80%), 40 - 44 years of age in 60 (5.30%), 45 - 49
years of age in 59 (5.21%), 50 – 54 years of age in 38
(3.35%), 55 - 59 years of age in 35 (3.09%), >60 years
of age in 46 (4.06%) .
According to the clinical findings majority of the reported
cases 1055 (93.36%) were classified as dengue fever,
6.10% were classified as Dengue haemorrhagic fever
without shock , 0.176% were Dengue haemorrhagic fe-
ver with shock while 0.088% falling into unusual dengue
category.
During the 3rd quarter of 2014, 1198 blood samples
were tested using IgM capture ELISA test at the De-
partment of Virology, MRI. From the total, 601
(50.16%) samples were confirmed as positive (Table
10).
.
14. TUBERCULOSIS
A total of 2506 TB patients were notified to the NPTCCD by
H816A, and 2449 patients were registered at chest clinics
for the 3rd Quarter 2014.Out of this 2449 TB patients,
2245 (91.7%) were New TB Cases,118 (4.8%) were Re–
treatment Cases and 86 (3.5%) were Other Cases. Out of
New TB cases 1140 (50.8%) were New Smear Positive
TB, 484 (21.6%) were New Smear Negative TB and 621
(27.7%) were New Extra Pulmonary TB Cases. A total of
1926 TB patients were screened for HIV, out of them Eight
patients were found positive. Three Multi Drug Resistant
TB patients were detected during above quarter. Distribu-
tion of TB Patients by RDHS division is given in the Table
11.
Table 11: Tuberculosis Patients by RDHS divisions
- 3rd quarter 2014
RDHS
DIVISION
New Retreat‐ment & other PTB
sp+ve PTB sp‐ve
EPTB Total
Colombo 302 95 149 546 77 623
Gampaha 146 58 73 277 22 299
Kalutara 81 25 53 159 12 171
Kandy 64 47 62 173 14 187
Matale 19 08 12 39 02 41
Nuwara Eliya 23 10 14 47 03 50
Galle 49 30 25 104 03 107
Matara 39 18 26 83 03 86
Hambantota 15 07 16 38 00 38
Jaffna 20 11 15 46 05 51
Vavuniya 10 04 00 14 01 15
Batticaloa 31 12 13 56 06 62
Ampara 06 04 02 12 03 15
Kalmunai 17 10 05 32 03 35
Trincomalee 12 06 08 26 04 30
Kurunegala 64 46 31 141 24 165
Puttalam 22 07 14 43 00 43
Anuradhapura 37 05 11 53 04 57
Polonnaruwa 25 07 07 39 02 41
Badulla 35 11 11 57 04 61
Monaragala 10 06 04 20 00 20
Rathnapura 55 31 43 129 06 135
Kegalle 46 20 17 83 04 87
Mannar 06 01 06 13 02 15
Mulathivu 04 03 01 08 00 08
Kilinochchi 02 02 03 07 00 07
Total 1140 484 621 2245 204 2449
Total
PTB-Pulmonary Tuberculosis EPTB– Extra Pulmonary Tuberculosis SP + ve - Sputum Positive SP – ve - Sputum Negative Data from Central TB Register Source - National TB Register
Volume 55 3rd Quarter July-September
7
.
15. SURVEILLANCE REPORT ON AEFI Surveillance of Adverse Events Following Immuniza-
tion (AEFI) effectively continued in the 3rdQuarter of
2014 has reached 94.0% of completeness of re-
ports, while only 32.7% reports were received in
time at the Epidemiology Unit. Badulla, Mannar,
Matara, Monaragala, Mullaitivu, Ratnapura and
Vavuniya were able to send all reports. The best
timeliness was reported from the Gampaha district
(56.8%) followed by Monaragala(51.5%), and
Kegalle (50.0%).(Table 11) Overall performance of
timeliness of monthly AEFI surveillance reports has
dropped and needs more attention by Medical Offic-
ers of Health.
The highest percentage of nil reports were received
from Ampara(60.0%), while for the country it was
38.7%. Jaffna district has the lowest ‘Nil return’ of
8.6%,followed by Kilinochchi(11.1%) indicating the
good surveillance system in place. The highest rate
(469.6 per 100,000 immunizations) of AEFI was
reported from Jaffna district, while Colombo reported
the highest number of 189 AEFI cases in the third
quarter 2014.
For the third quarter, the highest number of AEFI
(n=1016) was reported against Pentavalent vaccine,
where as the highest rate of AEFI (546.4/100,000
doses administered) was reported against DTP vac-
cine. The rate of AEFI for Pentavalent (01st, 02nd&
03rd dose) is 391.4per 100,000 doses administered.
High Fever (660), Nodule (282) and Allergic Reac-
tion (280) are the leading AEFI reported. Highest
numbers of fever cases reported were following
Pentavalent (380 cases: 146.4 per 100,000 doses
administered) and DPT (204 cases: 238.2 per
100,000 doses administered) vaccines. For Allergic
reactions, it was largely due to PVV (74 cases: 28.5
per 100,000 doses administered), DTP (63 cases;
73.6 per 100,000 doses administered)and LJE (56
cases: 41 per 100,000 doses administered). Highest
numbers of cases with nodules reported were fol-
lowing Pentavalent (219 cases: 84.4 per 100,000
doses administered). There were 3 cases of HHE
reported following Pentavalent vaccine, but the re-
ported rates of 1.3 per 100,000 doses have not ex-
ceeded the expected rates of HHE for Pentavalent
vaccine.
Table 12 : Completeness and timeliness of monthly re-porting and receipt of “NIL” reports of AEFI by RDHS divi-sions - 3rd quarter 2014
DP
DH
S
%
com
pleten
ess
%
Tim
ely return
s
%
Nil R
eturn
s
No
. of
AE
FI
AE
FI R
ate
(100,000 va
ccine d
oses)
Colombo 94.1 47.9 33.3 189 148.0
Gampaha 97.8 56.8 38.6 80 61.4
Kalutara 87.2 14.7 38.2 56 72.7
Kandy 90.3 30.8 49.2 117 108.9
Matale 94.9 45.9 45.9 53 136.5
Nuwara Eliya 87.2 32.4 35.3 75 128.6
Galle 95.0 31.6 52.6 54 85.3
Hambantota 97.2 14.3 40.0 92 193.2
Matara 100.0 49.0 31.4 72 132.3
Jaffna 97.2 25.7 8.6 156 469.6
Kilinochchi 75.0 11.1 11.1 22 289.0
Mannar 100.0 6.7 53.3 16 219.6
Vavuniya 100.0 8.3 58.3 17 139.4
Mullativu 100.0 0.0 50.0 19 257.9
Batticaloa 97.6 41.5 36.6 84 220.3
Ampara 71.4 20.0 60.0 7 37.1
Trincomalee 97.0 21.9 15.6 73 229.2
Kurunegala 96.3 46.2 34.6 157 146.1
Puttalam 88.9 12.5 56.3 31 53.6
Anuradhapura 80.7 10.9 32.6 83 122.1
Polonnaruwa 95.2 25.0 45.0 34 112.4
Badulla 100.0 45.8 31.3 140 204.0
Moneragala 100.0 51.5 39.4 54 149.7
Ratnapura 100.0 13.0 50.0 68 92.9
Kegalle 97.0 50.0 21.9 71 90.1
Kalmunai 94.9 35.1 48.6 44 133.4
Sri Lanka 94.0 32.7 38.7 1864 131.8
Volume 55 3rd Quarter July-September
8
Table 13: Number of Selected Adverse Events by Vaccines – 3rd quarter 2014
Note: The total number of AEFI reported in monthly returns include all vaccines in use, where as this table shows only selected vaccines. Therefore the total numbers of AEFI in these two tables are not the same.
BCG OPV PVV DPT MMR LJE DT TT aTd
Total num-ber of AEFI re-
ported
Total Number of AEFI Report-ed
AEFI reporting rate/100,000 doses administered
06 1016 468 115 109 92 17 27 1850
7.4
391.4
546.4
60.7
79.8
103.6
21.5
43.3
High Fever (>39oC)
Reporting rate/100,000 doses administered
2 380 204 28 28 17 01 660
2.5 146.4 238.2 14.8 21.8 20.5 1.6
Allergic reactions
Reporting rate/100,000 doses administered
74 63 56 56 18 08 05 280
28.5 73.6 29.5 41.0 20.3 10.1 8.0
Severe local reactions
Reporting rate/100,000 doses administered
66 22 05 02 05 100
25.4 25.7 2.6 1.5 5.6
Seizure (Febrile/Afebrile)
Reporting rate/100,000 doses administered
16 20 02 4.0 42
6.2 23.3 1.1 2.9
Nodules
Reporting rate/100,000 doses administered
219 50 04 02 05 02 282
84.54 58.4 2.1 3.2 5.6 3.2
Injection site abscess
Reporting rate/100,000 doses administered
4 100 19 1 1 7 2 134
4.9 38.5 22.2 0.5 0.7 7.9 3.2
HHE
Reporting rate/100,000 doses administered
3 03
1.2
Volume 55 3rd Quarter July-September
9
Total
A. Yellow fever 1150
B. Meningococcal meningitis 276
C. Oral polio 195
17. SURVEILLANCE AT AIRPORT
Surveillance activities carried out at the Inter
national Airport, Katunayake during the 3rd Quarter
2014 is given below.
1. Yellow Fever Surveillance
a. No. with valid certificate - 252
b. No. without valid certificate & De-ported
- 00
c. No. without valid certificate & Isolat-ed
- 00
a No. Of passengers Arrived - 970160
b No.of Passengers Departures - —
4. Release of Human Remains
a. No. of human Remains released - 108
b. No. of released to J.M.O. For post-mortern
- 07
c. No. Alleged suicide - 03
5
Surveillance of other infectious diseases
-
Nil
6 Airport Sanitation
a No of sanitary inspections carried out including Food establishment
- 14
2. Disinsection of Aircrafts
a No. of flights arrived - 7131
b No. of flights has to be disinsected - 5151
c No. of flights disinsected - 4814
3. Passenger Arrivals & departures
b No. Of food samples taken under Food Act
- 00
c No. Found defective - 00
d No. of court cases / prosecuted / Warned
- 00
7 Other Health Activities a Polio Vaccination No - of doses
given - 00
b Health talk given to staff - 14
8 a. No. of water samples taken for Bacteriological Analysis
- 03
b. No. Reported Contaminated - 00
Details of the vaccinations carried out by the Assistant
Port Health Office during the 3rd quarter 2014, is as
follows;
16. SURVEILLANCE AT SEA PORT 18. BACTERIOLOGY REPORT, MEDICAL RESEARCH INSTITUTE
Table 14
JUL AUG SEP
(A) CHOLERA
No. of stool specimens Examined 144 119 59
No. of positives 0 0 0
(B) SALMONELLA
No of blood specimens examined
S.typhi
S.paratyphi A
No of stools specimens examined 164 131 88
S.typhi 0 0 0
S.paratyphi A 0 0 0
Others 7 1 5
(C) SHIGELLA
No of stool specimens examined 164 131 88
Sh.flexneri 1 0 0 0
Sh.flexneri 2 0 0 0
Sh.flexneri 3 0 0 0
Sh.flexneri 4 0 0 0
Sh.flexneri 5 0 0 0
Sh.flexneri 6 0 0 0
(D) ENTERO PATHOGENIC E.COLI
No of stool specimens examined 1 3 2
No of positive 0 0 0
(E) CAMPYLOBACTER
No of stool specimens examined 17 12 35
No of Positives 0 0 0
(F) ISOLATES
Clinical 11 15 17
S. Typhi 0 1 0
S. Paratyphi A 0 1 0
Other Salmonella 5 2 7
Shigella spp 0 1 1
Sh.sonnei 0 0 0
Volume 55 3rd Quarter July-September
10
19. LEPROSY
Table 15: quarterly return of Leprosy statistics –3rd quarter 2014
1. National
At the end of the quarter Cumulative for end of the quarter 3rd
QTR,2014 3rd
QTR,2013 Diff (%) 2014 2013 Diff (%)
New patients detected 558 502 11.15 1732 1554 11.45
Children 53 44 20.45 164 139 17.98
Grade 2 Deformities 36 31 16.12 136 102 33.33
Multi-Bacillary 272 261 4.21 843 770 9.48
Females 226 203 11.33 668 645 3.56
2. Districts
District New patients G2-Deformity Children MB Females
Central 22 02 02 12 07
Kandy 16 01 01 08 05
Matale 05 01 01 03 02
Nuwara Eliya 01 00 00 01 00
Eastern 59 05 12 19 31
Ampara 09 01 01 02 05
Batticaloa 23 01 06 09 13
Kalmunai 24 02 05 07 11
Trincomalee 03 01 00 01 02
Northern 24 00 04 15 10
Jaffna 14 00 00 09 05
Mannar 01 00 00 01 00
Mulathivu 02 00 00 01 02
North Central 48 04 03 23 14
Anuradhapura 25 01 02 11 07
Pollonnaruwa 23 03 01 12 07
North Western 47 08 04 24 15
Kurunegala 27 05 01 15 10
Puttalam 20 03 03 09 05
Sabaragamuwa 55 02 04 30 24
Kegalle 13 01 02 10 04
Rathnapura 42 01 02 20 20
Southern 80 02 03 38 26
Galle 32 00 01 10 11
Hambanthota 21 01 00 14 07
Matara 27 01 02 14 08
Uva 09 00 01 05 01
Baddulla 05 00 01 02 00
Monaragala 04 00 00 03 01
Western 214 13 20 106 98
Colombo 108 08 11 54 50
Gampaha 61 04 06 35 24
Kalutara 45 01 03 17 24
Sri Lanka 558 36 53 272 226
Vauniya 07 00 04 04 03
Source : Anti Leprosy Campaign
Volume 55 3rd Quarter July-September
11
20. SEXUALLY TRANSMITTED DISEASES
Table 16: New episodes of STD/HIV/AIDS reported or treated at STD clinics in Sri Lanka –3rd quarter 2014
Disease
New cases or new disease episodes during the quarter
Total new cases or new episodes for the calendar year up to end of the quarter **
Male Female Total Male Female Total
HIV positives1 43 16 59 113 48 161
AIDS 14 04 18 36 12 48
Early Syphilis2 55 22 77 134 56 190
Syphilis Late Syphilis3 213 108 321 601 313 914
Congenital Syphilis4 11 03 14 12 09 21
Gonorrhoea5 120 25 145 353 82 435
Ophthalmia Neonatorum6 00 00 00 01 01 02
Non specific cervicitis/urethritis 168 400 568 459 1088 1547
Genital Herpes 357 429 786 968 1224 2192
Genital Warts 279 206 485 805 596 1401
Chancroid 00 00 00 02 00 02
Trichomoniasis 01 22 23 05 77 82
Candidiasis 219 365 584 634 1079 1713
Bacterial Vaginosis 00 334 334 02 892 894
Other sexually transmitted diseases7 104 32 136 317 97 414
Chlamydial infection 00 00 00 00 00 00
Non venereal 1074 570 1644 2966 1556 4522
Source: NSACP
(Includes cases diagnosed and reported to the Central STD clinic Colombo and Peripheral STD clinics of Na-tional STD/AIDS Control Programme of Sri Lanka)
** - Includes adjustments for revised diagnosis, reporting delays or any other amendments
1 - Includes AIDS cases 2 - Diagnosed within 2 years of infection and considered to be infectious 3 - Diagnosed after 2 years of infection and considered to be non-infectious 4 - Includes both early and late cases
5 - Includes presumptive Gonorrhoea
6 - Includes both gonococcal and chlamydial conjunctivitis in neonatal period
7
8
-
-
Includes Lymphogranuloma venerium, Granuloma inguinalae, Molluscum contagiosum, Scabies, Tinea, Hepatitis B etc. Number of STD clinic attendees who were not having sexually transmitted diseases.
Volume 55 3rd Quarter July-September
12
21. SURVEILLANCE OF MENINGITIS–
3rd quarter 2014
Meningitis is a notifiable disease condition in Sri Lanka
since year 2005. During the 3rd quarter 2014, 356 cases
of suspected meningitis cases were reported to the
Epidemiology Unit through the routine disease notifica-
tion system .
Out of this,286 cases were clinically confirmed by the
Public Health Inspectors during their field investigations.
Highest number of meningitis cases were reported from
the Kegalle district (31) followed by Badulla (29) and
Kurunagalla (20) districts.
Thirty five percent of the clinically confirmed meningitis
cases belonged to the age group less than one year,
another 25% belonged to the age group 1-5 years and
19% belonged to age group 6 – 15 years. Sixty two per-
cent of the clinically confirmed cases were males and
38% were females.
Table 17: Summary findings for special investiga-tions carried out for clinically confirmed cases of Meningitis from 1st January to 30th September 2014
CSF Culture Report
CSF Culture Number (%)
CSF results available
No Growth
Grouup B streptococci
Haemophillus influenza
Streptococcus Pneu-moniae
Culture results not known
Not done
Total
166
(155)
(08)
(02)
(01)
224
07
398
45%
53%
02%
100%
Final outcome of the patient
Outcome Number (%)
Cured
Died
Information not available
Total
373
08
17
398
94%
02%
04%
100%
Final Diagnosis (based on clinical and lab find-ings)
Diagnosis Number (%)
Culture confirmed
Probable bacterial meningitis
Probable viral meningitis
Suspected Meningitis
Total
11
39
32
317
398
03%
10%
08%
80%
100%
22. INFLUENZA SURVEILLANCE
Human Influenza surveillance
Human Influenza surveillance comprises of 2 components;
Influenza like illness (ILI) surveillance and Severe
DR. P. PALIHAWADANA CHIEF EPIDEMIOLOGIST EPIDEMIOLOGY UNIT 231, DE SARAM PLACE COLOMBO 10. ISSN NO: 2345-9360
No polio cases. (from AFP surveillance system).
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