Weekly Epidemiological - WHO · Weekly Epidemiological Bulletin This weekly Epidemiological Bulletin is published jointly by the National Institute of Health, Islamabad and World

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. 10 (4 to 10 March 2012)

• In week 10, 2012, total 84 districts including 2 agencies provided surveillance data to the DEWS on weekly basis from around 1,878 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.

• A total of 672,038 consultations were reported through DEWS of which 23% were acute respiratory infections (ARI); 6% were acute diarrhoea; 4% were suspected malaria; while 5% were Skin disease.

• A total of 203 alerts with 12 outbreaks were reported in week 10, 2012: Altogether 94 alerts for Measles; 22 for Leishmaniasis; 17 for Typhoid; 14 for Pertussis; 12 for ARI; 11 for NNT and Tetanus; 9 for AWD; 8 for Scabies; 5 for AD; 3 for Bloody diarrhoea; while 2 each for AJS, DF, Diptheria and Malaria.

• As of 10 March 2012, the total number of polio cases confirmed by the laboratory is 13 from 10 districts/towns/tribal agencies and areas.

Highlights

Disease early warning system and response in Pakistan

01

Volume 3, Issue 10, Wednesday 14 March 2012

Priority diseases under surveillance

in DEWS

Acute (Upper) Respiratory Infection Pneumonia

Suspected Diphtheria Suspected Pertussis

Acute Watery Diarrhoea Bloody diarrhoea

Other Acute Diarrhoea Suspected Enteric/Typhoid Fever

Suspected Malaria Suspected Meningitis

Suspected Dengue fever Suspected Viral Hemorrhagic Fever

Pyrexia of Unknown Origin Suspected Measles

Suspected Acute Viral Hepatitis Chronic Viral Hepatitis

Neonatal Tetanus Acute Flaccid Paralysis

Scabies Cutaneous Leishmaniasis

Others

Figure‐1: Weekly trend of Acute diarrhoea, Bloody diarrhoea, ARI and Suspected malaria in Pakistan, Week‐1, 2011 to week‐10, 2012.

• The above graph shows the weekly trend of ARI; Acute diarrhoea; Bloody diarrhoea and Suspected malaria as proportional morbidity (percentage of cases out of total consultations) reported to DEWS on weekly basis.

• The above table provides the total consultations for each of the last 8 weeks proportional morbidity of five disease syn‐drome. Proportional morbidity of ARI is highest in KP and FATA while acute diarrhoea is highest in Balochistan and Sindh (please see the graphs for every province in page 5 and 6).

Table 1: Most common communicable diseases syndromes reported weekly

Disease Wk-3 Wk-4 Wk-5 Wk-6 Wk-7 Wk-8 Wk-9 Wk-10

Acute diarrhoea 27,574 (5%) 28,461 (5%) 23,902 (5%) 28,969 (5%) 30,607 (5%) 31,551 (5%) 34,668 (5%) 37,812 (6%)

Total consultation 511,668 534,412 439,260 547,889 605,633 649,508 671,023 672,038

Suspected malaria 20,375 (4%) 19,817 (4%) 15,582 (4%) 21,752 (4%) 22,883 (4%) 23,482 (4%) 28,261 (4%) 29,388 (4%)

Acute respiratory infection 130,371 (25%) 137,322 (26%) 114,319 (26%) 138,507 (25%) 159,074 (26%) 152,681 (24%) 157,106 (23%) 152,988 (23%)

Bloody diarrhoea 2,130 (0.42%) 2,665 (0.50%) 2,195 (0.50%) 2,676 (0.49%) 2,730 (0.45%) 2,765 (0.43%) 3,056 (0.46%) 2,756 (0.41%)

Skin diseases 24,721 (5%) 25,639 (5%) 22,020 (5%) 26,786 (5%) 29,199 (5%) 28,796 (4%) 29,346 (4%) 30,514 (5%)

0

5

10

15

20

25

30

35

40

45

50

wk 1

wk 3

wk 5

wk 7

wk 9

wk 11

wk 13

wk 15

wk 17

wk 19

wk 21

wk 23

wk 25

wk 27

wk 29

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

Percentage

AD BD ARI S. Malaria

Special Bulletin: DEWS, Pakistan, Week no. 10 ( 4 to 10 March 2012)

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]. 02

Current week's (10/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

7‐Mar Leishmaniasis AJK Mirpur Village Khaliqabad 3 7 20 45 Outbreak for Leishmaniasis identified at Khaliqabad and adjacent area. Registration found total 75 patients with lesions from one week to one year. DHO and ADHO CDC were informed. Health education sessions held at schools. Healthcare providers trained on treatment guidelines.

5‐Mar AWD Balochistan Bolan Village Brahim bani 4 4 2 6 Alert for AWD, 16 cases were reported and investigated at DHQ hospital Dhadar. During field investigation along with district health team found no more suspected cases. 1 stool swab and 4 water samples were collected and sent to NIH. Aqua‐tabs distributed in the community.

6‐Mar Leishmaniasis Balochistan Lasbela Village Winder & Uthal, Tehsil Uthal 1 4 0 1

Alert for suspected Leishmaniasis, 6 cases were reported from two different locations. Patients have no traveling history. Lesions were mostly on legs. No any other case was found during active search. Patients were advised to take proper and regular treatment. Health and hygiene session was conducted with patient family member and community. DHO informed and requested to conduct household spraying.

9‐Mar AWD Sindh Tando Allah Yar

Village Ahmed khan lashari, UC Pak Singhar taluka Tando Allahyar

0 2 0 4 6 cases of AWD were reported from hospital, active surveillance conducted and 2 stool and 4 water samples taken, hand pump was the source of suspect, Aqua tabs, Zinc tabs and ORS distributed in the community, EDOH informed.

7‐Mar Measles Sindh Thatta Village Adam Mallah UC Mugal Bin taluka jati district thatta

6 2 6 0 Alert for 14 cases of Measles, during active surveillance Vitamin (A) given to children, none had been vacci‐nated for measles. Health education imparted regarding routine immunization, EDOH informed and re‐quested for mop‐up; 8 Blood samples were collected and sent to NIH.

7‐Mar Pertussis Sindh Ghotki Village Khuda Buksh Mangrio; Village Abdul Ghani Bozdar

13 6 15 8 42 probable Pertussis cases were investigated in 2 different locations. During active surveillance 57 contact children found in community out of them only 4 were having BCG Scar. Health education given; Erythromycin given to cases and contacts. 3 throat swabs were taken and sent to NIH. DHO and DSV were informed.

7‐Mar Pertussis Sindh Hyderabad GOR Colony, Latifabad # 01 1 3 1 1

Probable Pertussis case was reported and investigated in Shah Bhitai hospital. During active surveillance cluster of 10 houses was taken and found 11 children, out off them 2 were unvaccinated, health education regarding proper hygiene and importance of immunization was imparted, Erythromycin was given and 2 throat swabs were taken and sent to NIH.

7‐Mar Pertussis Sindh Sanghar Village Chak # 23, UC Gujri taluka Sanghar 0 9 3 6

Probable Pertussis case investigated, during active surveillance in the village, cluster of houses was checked and found 22 children none of them were vaccinated, Erythromycin given to the cases, health education was imparted regarding importance of vaccination, EDOH informed and requested for mop‐up the area and 1 throat swab collected and sent to NIH.

8‐Mar Pertussis Sindh Thatta Village Khameeso Khan Pathan UC Ali Bahar Sujawal

2 3 8 2

Two Probable Pertussis cases were reported from DHQ Sujawal. Active surveillance conducted and found 13 more cases, majority of the children received Anti biotic medicine, four throat samples were taken, health education imparted, routine immunization of the area was checked and found <70%, Erythromycin syrup given to cases; EDOH informed.

7‐Mar Typhoid Sindh Tharparkar Village Sajaee, UC Sob‐hiar, Taluka Diplo 0 4 1 1

Alert for Typhoid, 1 suspected case admitted in THQ hospital, during active search 5 more suspected Typhoid cases were found, out of them 1 was Widal positive; Health education imparted, rain water was the source of suspect; Aqua tabs distributed in the community; while 3 water samples collected and sent to NIH.

Current week's (9/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

27‐Feb Leishmaniasis Balochistan Lasbela Mosiani,UC Welput North, Tehsil Bela 2 3 0 1

6 case of suspected Leishmaniasis were reported. Patients have no traveling history. Lesions were mostly on legs. No other case was found during active search, Inj Glucantime provided to health facility incharge and advised to give proper treament and if new case will report then inform. The outbreak was discussed with DHO and requested to distribute bed nets and conduct household spraying.

27‐Feb Typhoid Balochistan Ziarat RHC Ahmadon, UC Kach, Tehsil Ziarat 1 4 0 2

Alert of 7 cases TF was received through weekly DEWS report. On investigation found that the cases are from the same locality, and the water source is the surface water from the dam which they keep in resorvior at home. Laboratory testing showed 4 were positive for typhoid 3 cases results were pending. Shortage of medicine and laboratory facility is felt in the whole UC. Matter was discussed with DHO and RHC incharge. Follow up visit was planned next week.

27‐Feb Measles KPK Lower Dir Village Kolalano Cham, UC Asbanrd, Tehsil Adenzai

1 5 1 1

Alert for Measles, active surveillance conducted, remote area with total population of 150 houses, 7 more cases were found in the surrounding and 4 recovered cases were also identified, routine outreach vaccination conducted in the area by EPI Team and vaccinated 40 children for routine immunization, Vit‐A was given, Blood Sample Collected for confirmation of antibodies, Health education session conducted with the family members and community, patient isolated, EDO‐H & EPI Coordinator were informed.

1‐Mar Measles KPK Lower Dir Village Anderey, UC Kotto, Tehsil Balmbat 7 0 1 0

Alert for Measles, active surveillance conducted, remote area with total population of 150 houses, 7 more cases were found in the surrounding, routine outreach vaccination conducted in the area by EPI Team and vaccinated 33 children for measles, Vit‐A was given, Blood Sample Collected for confirmation of antibodies, Health education session conducted with the family members and community, patient isolated, EDO‐H & EPI Coordinator were informed.

27‐Feb Pertussis Sindh Tando Allah Yar

Village Ahmed Khan Lund, Taluka Chambar 4 4 4 2

Case of probable Pertussis was investigated in hospital. During active surveillance in community found 13 more cases. In cluster of 30 houses found 16 children, out of them 9 were unvaccinated, Syp Erythrocin given for treatment and health and hygiene education was given, EDOH informed and 3 Throat swab collected.

28‐Feb Pertussis Sindh Qambar Shahdadkot

Village Lakhtia, UC Boohar, Taluka Kambar 7 11 8 8

34 probable Pertussis cases were investigated, during active surveillance, SO visited health facility to check EPI center and found 2 days vaccination was available for community, immunization status was 20%, health education was imparted regarding importance of vaccination, Erythromycin given and EDOH informed.

1‐Mar Pertussis Sindh Dadu

Village Ehsan ali Baladi, K.N Shah; Village Ghulam Rasool Khushk; Village Bahawalpur Sekhani; Village Hafiz Babar, taluka Johi

14 9 6 14

43 probable Pertussis cases were investigated in 4 different locations in district Dadu. During active surveil‐lance 45 contact children found in community out of them 21 were vaccinated; health education given; Erythromycin given to cases and contacts. 4 throat swabs were taken and sent to NIH. EDOH, focal person EPI were informed.

1‐Mar Measles Sindh Karachi

Village Hashim Khaskheli, Hyderi Mohalla, UC Murad Memon, Gaddap town

11 5 5 1 Alert for Measles, suspected case was admitted in hospital, Vitamin (A) given, health education was imparted, case was not vaccinated, during active surveillance in community found 22 children none of them was vacci‐nated, information share with THO and request for Mop‐up the area and 1 Blood sample collected.

2‐Mar AJS Sindh Shikarpur Village saen bux jaffri UC jamra taluka lakhi 2 12 0 4

AJS alert: BHU jamro Medical officer reported AJS cases from same location, team was comprised as SO DEWS, MO PPHI, EM & vaccinator. During investigation 18 cases were found & line listed. All cases were referred by MO PPHI for laboratory investigation to DHQ lab. IEC material distributed & health promotion session was conducted. community was sensitized on hygiene & safe drinking water.



Distribution of Wild Polio Virus cases Pakistan 2011 and 2012

As of 10 March 2012, the total number of polio cases confirmed by the labo‐ratory is 13 from 10 districts/towns/tribal agencies and areas.

Province Cases 2011 Cases 2012

P1 P3 P1 P1+P3

Punjab 9 ‐ 1 ‐

Sindh 33 ‐ 2 ‐

Khyber Pakhtunkhwa 23 ‐ 4 ‐

FATA 57 2 3 1

Balochistan 73 ‐ 2 ‐

AJ&K ‐ ‐ ‐ ‐

Gilgit‐Baltistan 1 ‐ ‐ ‐

Islamabad ‐ ‐ ‐ ‐

Total 196 2 12 1

Number o alerts by province, week 10, 2012

Province Khyber Pakhtunkhwa Date Disease District Area <5M >5M <5F >5F

6‐Mar AWD Hangu Village Muhammad Khawaja, UC Muhammad Khawaja 3 1 0 1

9‐Mar AWD Kohat Mohallah Taj Gul, Village Barh, Union Council Nasrat Khel 0 3 0 2

9‐Mar Diphtheria Charsadda Shekhabad 1 0 0 0

5‐Mar Diphtheria Nowshera Village Kana Khel Mandkay Shareef 0 1 0 0

8‐Mar Leishmaniasis Buner village khananoderai tehsil mandan 1 3 0 1

6‐Mar Leishmaniasis Nowshera Jabatar, Saleh Khana 1 0 0 1

6‐Mar Leishmaniasis Nowshera Shakot Bala, Saleh Khana 0 0 0 4

6‐Mar Leishmaniasis Nowshera Shakot Payan, Saleh Khana 0 0 0 5

6‐Mar Leishmaniasis Nowshera Zao Kalay, Saleh Khana 1 0 0 0

8‐Mar Leishmaniasis Nowshera Kuja Khel, Kahi 0 1 0 0

8‐Mar Leishmaniasis Nowshera Mohallah Khwaja khel, Kahi 0 0 0 1

8‐Mar Leishmaniasis Nowshera Mohallah: Kareem Khel, Kahi 0 0 0 1

8‐Mar Leishmaniasis Nowshera Nasu Khel, Kahi 0 1 0 0

8‐Mar Leishmaniasis Nowshera Shaheen Abad, Kahi 0 0 0 1

8‐Mar Leishmaniasis Nowshera Shawa Khan Korona, Maira Misri Banda 0 1 0 0

6‐Mar Measles Bannu Village Sra Darga 1 0 0 0

5‐Mar Measles Battagram Lower Dir (Village Tangrey Mousa, Battagram, Tehsil Warri) 0 1 1 0

9‐Mar Measles Buner village ghazi khanay tehsil dagar 0 1 0 0

9‐Mar Measles Buner village sowarai tehsil gagra 0 0 1 0

10‐Mar Measles Charsadda Charsadda 1 0 0 0

10‐Mar Measles Charsadda Mechanay Shabqadar 1 0 0 0

7‐Mar Measles D. I. Khan Potah, Tank Road, D I Khan 0 0 1 0

7‐Mar Measles D. I. Khan Village Cheena, Tank Road 1 0 0 0

9‐Mar Measles D. I. Khan Garah Haya 0 1 0 0

9‐Mar Measles D. I. Khan Lahore City Colony 1 0 0 0

9‐Mar Measles D. I. Khan Nasir Abad Colony 0 1 2 0

8‐Mar Measles Dir Upper Village Rokhan, UC Dir urban 1 0 1 0

6‐Mar Measles Hangu Mir Khanan Mohallah Karegar jhandi, Union Council Darsamand 1 0 0 0

6‐Mar Measles Hangu Zair Khawari banda, Union Council Darsamand 0 0 2 0

4‐Mar Measles Haripur Village Bandi Sher Khan 0 0 1 0

6‐Mar Measles Haripur Muhallah Iryar, Sikandarpur 1 0 0 0

6‐Mar Measles Haripur Village Rata, Bana, Bagra 1 0 0 0

7‐Mar Measles Haripur Toheedabad, Sarai Saleh 1 0 0 0

Cont’d Province Khyber Pakhtunkhwa Date Disease District Area <5M >5M <5F >5F

10‐Mar Measles Haripur Afghan Refugee Camp 4 3 1 4 3

8‐Mar Measles Kohat Mohallah Aimal Khel, Village Shaikhaan, Pindi Road Kohat 1 0 0 0

6‐Mar Measles Lower Dir Village Jaggal, UC Lajbook, Tehsil Balmbat 0 0 2 0

7‐Mar Measles Lower Dir Village Barirai, UC Drangal, Tehsil Samar Bagh 1 0 3 0

7‐Mar Measles Lower Dir Village Kaer Darra, Bebiyour 0 2 0 0

8‐Mar Measles Lower Dir Village Gujarano Cham, Kandaona, UC Asbanrd, Tehsil Adenzai 1 0 0 0

9‐Mar Measles Malakand Alladand 0 0 1 0

9‐Mar Measles Malakand Batkhela 0 0 1 0

10‐Mar Measles Malakand Mehrdai 1 0 1 1

9‐Mar Measles Nowshera Near Sheikhano Jumat, Mohallah Landay Khel, UC Rashakai 1 0 2 0

9‐Mar Measles Nowshera Phase 05, Sector E, Block 07, Tent 101, Jalozai IDP's Camp 0 0 1 0

10‐Mar Measles Nowshera Near Zait ur Rahman shop, Mohallah Mandoori, UC Khweshgi Bala 0 0 3 0

7‐Mar Measles Peshawar Pakha Ghulam 1 0 0 0

10‐Mar Measles Peshawar Kohat Road 1 0 1 0

10‐Mar Measles Peshawar Latifabad 1 0 0 0

10‐Mar Measles Peshawar Yakatoot 0 1 0 0

7‐Mar Measles Swabi BHU Beka 1 0 0 1

8‐Mar Measles Swabi CD Bada, Village Pola 1 0 0 2

4‐Mar Measles Swat Village Parona Chinar near BHU Meragai, UC Kokarai, Tehsil Babuzai 1 0 0 0

5‐Mar Measles Swat Village & UC Rang Mohallah,Tehsil Ba‐buzai 0 0 1 0

5‐Mar Measles Swat Village Lovi Ban Panar, UC Sangota, Tehsil Babuzai 1 0 0 0

6‐Mar Measles Swat Village Malam khas kasoona, UC Ki‐shawra, Tehsil Charbagh 0 0 1 0

7‐Mar Measles Swat Village Obo tangay chinargay Pararai, UC and Tehsil Barikot 0 1 0 0

8‐Mar Measles Swat Village and UC Allah Abad, Tehsil Char‐bagh 0 0 0 1

8‐Mar Measles Tank Abizari 0 0 1 0

8‐Mar Measles Tank ShahZamani 0 1 0 0

5‐Mar NNT Bannu Village Kinger 1 0 0 0

9‐Mar NNT Bannu Village Zindi Falak Sher Sra Darga 1 0 0 0

9‐Mar Pertussis Swabi BMC Swabi, Dwa Jangi, Bachai 1 0 0 0

5‐Mar Scabies Nowshera CAMP Health Post Catchment area 0 0 0 0



Province Balochistan Date Disease District Area <5M >5M <5F >5F

5‐Mar ARI Harnai Harnai city, UC Harnai Urban 2 6 3 4 5‐Mar ARI Ziarat Poi, UC Poi, Tehsil Sinjavi 2 0 3 0 5‐Mar AWD Bolan Village Brahim bani 4 4 2 6 5‐Mar BD Harnai Shahrig, UC Shahrig, Tehsil Harnai 2 11 1 5 7‐Mar Leishmaniasis Killa Saifullah DHQ Killa Saifullah 0 1 0 0 8‐Mar Leishmaniasis Killa Saifullah Haji Bhang Burma & Kili Barowala 0 0 1 1 6‐Mar Leishmaniasis Lasbela Village Winder & Uthal, Tehsil Uthal 1 4 0 1 10‐Mar Leishmaniasis Panjgur Village Tasp UC Tasp Bazar 0 1 0 0 10‐Mar Leishmaniasis Panjgur Villagea Kalla Kore UC Parome 0 1 0 0 10‐Mar Leishmaniasis Quetta BHU New Pashtoon Abad 0 0 0 0 6‐Mar Leishmaniasis Ziarat Village Shotcut, UC & Tehsil Sinjavi 0 0 1 0 5‐Mar Malaria Harnai Khidrani, UC Harnai Urban 4 3 2 3 5‐Mar Malaria Harnai Killi Shore, UC Shahrig 4 2 1 3 7‐Mar Measles Bolan Village Mashkaf 1 0 0 0 8‐Mar Measles Chagai Village Toheedabad, girdi jungle 1 0 0 0 7‐Mar Measles Gwadar Village Nawabad UC & Tehsil Gwadar 0 2 3 3 6‐Mar Measles Jaffarabad Town area of Usta Mohammad 2 0 0 0 4‐Mar Measles Kech Village Shahitump, UC Gokdan 0 1 0 0 6‐Mar Measles Khuzdar Masjid road UC Lizo Tehsil Khuzdar 0 0 1 0 7‐Mar Measles Khuzdar killi Sher jan, UC & Tehsil Wadh 1 0 0 0 5‐Mar Typhoid Ziarat Jungle Bandat, UC Kach, Tehsil Ziarat 0 2 0 1

Alerts: Province Punjab Date Disease District Area <5M >5M <5F >5F

6‐Mar AD Bhakkar BHU Hassan Shah, UC Angra 14 6 13 7

5‐Mar AD Layyah DHQ Layyah, UC Urban2, Tehsil Layyah. 0 27 0 20

5‐Mar AD R Y Khan Nawazabad, Tehsil Sadiqabad 6 11 7 16

7‐Mar AD R Y Khan Dera Faridi, Tehsil Liaqatpur 10 14 9 18

7‐Mar AD R Y Khan Zamin Shah, Tehsil Liaqatpur 6 10 7 13

5‐Mar AJS Lahore Ghamay Shah Ravi Town Lahore 0 1 0 2

7‐Mar AJS Lahore Walton Road Lahore 0 2 0 1

6‐Mar ARI Bhakkar BHU Barkat Wala, UC Daggar Qureshi 1 22 3 17

6‐Mar ARI Mianwali BHU Toll Bangi Kheel 33 11 49 17

8‐Mar ARI Mianwali BHU Shadia 21 9 29 7

9‐Mar ARI Muzaffargarh Qandrani Mohallah, Dasti Wala 11 26 8 19

5‐Mar ARI R Y Khan Ahmedpur Lamma, Tehsil Sadiqabad 51 45 43 68

5‐Mar ARI R Y Khan Nawazabad, Tehsil Sadiqabad 52 112 67 98

6‐Mar ARI R Y Khan Chak 1 P , Jetha Bhutta, Tehsil Khanpur 34 67 45 78

6‐Mar ARI R Y Khan Chak 94 NP, Tehsil Khanpur 33 41 36 39

7‐Mar ARI R Y Khan Chak 25 A, Tehsil Liaqatpur 32 24 25 48

7‐Mar ARI Rajanpur THQ Jampur, UC Jampur Urban 189 41 173 33

5‐Mar AWD Layyah BHU Lohanch Nasheeb 2 3 2 1

7‐Mar BD Mianwali RHC Daudkheel 4 0 4 0

8‐Mar DHF Lahore Iqbal Town 0 1 0 0

9‐Mar DHF Rajanpur Band Road Rajanpur, UC Rajanpur 0 0 0 1

6‐Mar Leishmaniasis Mianwali BHU Vanjaree 1 2 0 4

7‐Mar Measles Chakwal LRH Peshawar (Village Chungi Jhelum) 1 0 0 0

6‐Mar Measles D. G. Khan Block 16 Urban DGKhan 0 1 0 0

8‐Mar Measles D. G. Khan Chanan Cowk Block 45 uc 1 1 0 1 2

8‐Mar Measles D. G. Khan Shahzada Sultan Town uc 2 1 1 1 2

9‐Mar Measles D. G. Khan opposite Generation school uc 2 1 0 0 0

4‐Mar Measles Lahore Village Hanjarwal Multan Road Lahore 0 1 0 0

8‐Mar Measles Mianwali Shahnawaz wala, Chashma 1 0 0 0

8‐Mar Measles Muzaffargarh Cheena Basti, Near Fareed Acedamy 0 1 0 0

8‐Mar Measles Muzaffargarh Farid Colony, Near Boys Degree College 0 0 0 1

8‐Mar NNT Lahore Kot lakhPat Lahore 1 0 0 0

9‐Mar NNT Multan Ranawhain basti people wali 1 0 0 0

8‐Mar NNT Rajanpur Basti Abdul Karim mazari 1 0 0 0

9‐Mar Pertussis D. G. Khan Basti Litra uc Litra 1 0 0 0

6‐Mar Scabies Muzaffargarh Mohallah Shah Wala, UC Daira Din Panah 4 23 7 12

5‐Mar Scabies R Y Khan Ahmedpur Lamma, Tehsil Sadiqabad 9 19 13 26

6‐Mar Scabies R Y Khan Chak 25 A, Tehsil Liaqatpur 6 11 5 13

6‐Mar Tetanus Lahore Youhanabad Lahore 0 1 0 0

6‐Mar Typhoid Layyah RHC Chowk Azam, UC Chowk Azam City 0 0 0 3

5‐Mar Typhoid Mianwali RHC Kammar Machani 20 25 18 21

7‐Mar Typhoid Mianwali BHU Thathi 0 3 0 1

7‐Mar Typhoid Mianwali RHC Daudkheel 3 4 3 4

6‐Mar Typhoid Muzaffargarh THQ Kotaddu, Tehsil Kotaddu 0 1 0 1

7‐Mar Typhoid Muzaffargarh Basti Bakhshey Wala, UC Rohilanwali 1 1 0 1

7‐Mar Typhoid Muzaffargarh Near Jamia Masjid, Urban Seerpur 0 2 0 1

7‐Mar Typhoid Muzaffargarh Rohilanwali Adda, Khangarh, MZG 0 1 0 1

7‐Mar Typhoid Rajanpur THQ Jampur, UC Jampur Urban 0 2 0 4

Province Sindh Date Disease District Area <5M >5M <5F >5F

7‐Mar AWD Matiari Kachi Paro Mohalla, city Matiari 0 1 0 0

5‐Mar AWD Tando Allah Yar Mansoor colony city Tando Allahyar 0 0 0 1

9‐Mar AWD Tando Allah Yar Madina Colony, UC 3 0 0 0 1

9‐Mar AWD Tando Allah Yar Village Ahmed khan lashari 0 2 0 4

6‐Mar AWD Tharparkar Village Salar ji Dhani, UC Vajiar 0 1 0 0

6‐Mar BD Q Shahdadkot Allah Rakhio Junejo, UC Dostly 0 0 0 3

5‐Mar Leishmaniasis S Benazirabad village Allah Bux Lashari 0 0 0 1

9‐Mar Leishmaniasis S Benazirabad Village Long khoso 0 0 0 1

8‐Mar Measles Dadu Soorajabad Muhalla 1 0 0 0

9‐Mar Measles Ghotki Kolachi Muhalla, UC I 2 0 0 0

9‐Mar Measles Ghotki Mehran colony near Subzi Mandi 1 0 0 0

5‐Mar Measles Hyderabad Sachal Sarmast colony, Behar Colony 1 0 0 0

7‐Mar Measles Hyderabad Block C, Latifabad # 07 0 0 1 0

8‐Mar Measles Hyderabad Block B, Latifabad #7 0 0 1 0

6‐Mar Measles Jamshoro Maskeen colony UC Sonowaller 2. 0 1 0 0

8‐Mar Measles Jamshoro Gharibabad KotriTaluka Kotri 0 0 1 0

8‐Mar Measles Jamshoro Village Palandi, site area, UC A.B Shoro 0 1 0 0

5‐Mar Measles Karachi daryaabad, near Noorani Masjid 1 1 0 0

6‐Mar Measles Karachi Gali Number 1, Kumhar waro 1 0 0 0

6‐Mar Measles Karachi Hazara Colony, Lyari town 1 0 0 0

7‐Mar Measles Karachi Masjid Quarter, Tall wali gali 0 0 1 0

8‐Mar Measles Karachi Hill area, Chanesar goth, Jamshed town 0 1 2 0

6‐Mar Measles Larkana Nazar Muhalla near Police Chawki 1 0 0 0

10‐Mar Measles Larkana Ali abad Muhalla 0 0 1 0

8‐Mar Measles Matiari Village Ghulam Ali Laghari 1 1 0 0

10‐Mar Measles Mirpur Khas Village Darya khan kaloi 3 0 0 1

9‐Mar Measles N Feroze Village ghulam Abas solangi 0 1 0 0

5‐Mar Measles Q Shahdadkot Bhatti Mohalla behind Wapda office 1 0 0 0

8‐Mar Measles Q Shahdadkot Nomades, behind Lalu Raunk 2 3 1 0

9‐Mar Measles Q Shahdadkot Taqee Imam bargha Mohalla 0 2 0 0

6‐Mar Measles Sukkur BHU newpind & Haidery muhalla 0 0 4 0

7‐Mar Measles Sukkur BHU newpind & Chacher muhalla 0 1 0 0

5‐Mar Measles T M Khan Village Fateh khan Lund 1 0 0 0

7‐Mar Measles T M Khan Dars Muhalla, Rajo Khanani 1 0 0 0

7‐Mar Measles Thatta Village Adam Mallah 6 2 6 0

8‐Mar Measles Thatta Kachi Abadi Near Badshahi Masjid 1 1 0 1

9‐Mar Measles Thatta Village Ahmed Amdani 0 0 1 3

9‐Mar Measles Thatta Village Juho UC Gahro taluka Ghorabari 1 0 1 0

4‐Mar NNT Ghotki village Abdullah Ghoto UC Hussain Beli 1 0 0 0

8‐Mar NNT Ghotki Village Jumo Bhutto 0 0 1 0

9‐Mar NNT Ghotki village Jamal chachar 1 0 0 0

9‐Mar NNT Q Shahdadkot Village Jarwar Ghulam Mustafa 1 0 0 0

7‐Mar NNT Shikarpur Village chohaan uc chak taluka lakhi 1 0 1 0

9‐Mar Pertussis Dadu Ground Makhdoon talib Moula School 0 1 1 0

9‐Mar Pertussis Dadu Village Chutto Mastoi, Dadu 0 1 1 2

7‐Mar Pertussis Ghotki Village Khuda Buksh Mangrio 10 5 10 8

8‐Mar Pertussis Ghotki Village Abdul Ghani Bozdar 3 1 5 0

8‐Mar Pertussis Ghotki Village Abdul Mir Bahar 0 3 1 0

7‐Mar Pertussis Hyderabad GOR Colony, Latifabad # 01 1 3 1 1

10‐Mar Pertussis Matiari Piyaro Lund city taluka Jhando Mari 0 0 1 0

9‐Mar Pertussis Q Shahdadkot Muskeen Shahd Mohalla 0 0 3 0

7‐Mar Pertussis Sanghar Village Chak # 23 0 9 3 6

7‐Mar Pertussis Sukkur GMC Hospital 2 0 1 0

7‐Mar Pertussis Thatta Village Haji Rasool Bux Brohi 0 0 1 3

8‐Mar Pertussis Thatta Village Khameeso Khan Pathan 2 3 8 2

6‐Mar Scabies Badin Village Muhammad Sadiq Jat 0 8 1 8

7‐Mar Scabies Badin Village Murad Ali Shah 3 15 3 21

8‐Mar Scabies Q Shahdadkot Village Gogharo , UC Gogharo 1 8 0 9

5‐Mar Scabies Umer Kot Karia Para, UC Nabisar 2 5 4 3

6‐Mar Typhoid Hyderabad Latiabadabad Unit#08 0 0 2 1

6‐Mar Typhoid Larkana Village Mithal Chandio, UC Akil 0 0 0 2

9‐Mar Typhoid Larkana Ayoob colony City Larkana 0 2 0 1

9‐Mar Typhoid Larkana Village sultan shaikh 0 1 0 1

7‐Mar Typhoid Tharparkar Village Sajaee, UC Sobhiar 0 4 1 1

5‐Mar Typhoid Umer Kot Al Faisal colony, UC Nasibar 1 0 1 1

5‐Mar Typhoid Umer Kot Prem Nagar colony, UC Nasiber 0 0 0 3



Province Khyber Pakhtunkhwa:

• 448 health facilities from 17 districts of Khyber Pakhtunkhwa reported to DEWS on weekly basis with a total of 114,325 patients consultations in week 10, 2012.

• 63 alerts were reported in week 10; Altogether 44 for Measles; 11 for Leishmaniasis; 2 each for AWD, Diph-theria and NNT; while 1 each for Pertussis and Sca-bies.

• No outbreak for any disease was identified from any area in Khyber Pakhtunkhwa.

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

Province Sindh:

• 437 health facilities from 23 districts in Sindh reported on weekly basis to DEWS with a total of 249,642 patient consultations in week 10, 2012.

• 66 alerts were reported; Altogether 30 for Measles, 12 for Pertussis; 7 for Typhoid; 5 each for AWD and NNT; 4 for Scabies; 2 for Leishmaniasis; while 1 for Bloody diarrhoea.

• 7 outbreaks, 4 for Pertussis; while 1 each for Measles, AWD and Typhoid were identified and appropriate measures were taken.

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

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

2010 2011 2012 (up till week 10) Total A O A O A O A O

Acute watery diarrhoea 209 85 1350 543 63 2 1622 630 Acute jaundice syndrome 5 2 51 17 30 2 86 21 Bloody diarrhoea 10 1 98 20 27 3 135 24 Dengue fever 81 32 785 111 12 1 878 144 Measles 48 6 1710 91 664 19 2422 116 Pertussis 1 0 287 81 143 47 431 128 NNT + tetanus 5 0 399 0 158 0 562 0 Malaria 12 7 131 88 15 4 158 99 Leishmaniasis 1 0 298 33 197 22 496 55 Others 75 11 643 69 255 33 973 113 Total 447 144 5752 1053 1564 133 7763 1330

Table‐1: Leading causes of seeking health care in districts, Wk‐31, 2010 to Wk 10, 2012, compiled from weekly reports

Diseases Number of Consultations

Acute respiratory infection 14,454,927 (23%)

Skin diseases 6,258,590 (10%) Acute diarrhoea 5,607,572 (9%) Bloody diarrhoea 493,251 (<1%) Suspected malaria 3,776,062 (6%) Unexplained fever 2,359,656 (4%) Total consultations 62,764,062

Figure‐2: Number of alerts by disease, week 10, 2012

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Special Bulletin: DEWS, Pakistan, Week no. 10 ( 4 to 10 March 2012) Province Punjab: • 394 health facilities from 8 districts reported data to

DEWS in Punjab with a total of 197,626 patient con-sultations.

• A total of 48 alerts were reported in in this week; Alto-gether 10 for ARI; 9 each for Measles and Typhoid; 5 for AD; 4 for NNT and tetanus; 3 Scabies; 2 each for AJS and DF; while 1 each for AWD, BD, Leishmaniasis and Pertussis.

• Alerts were investigated on time and no outbreak of any disease was identified from any area in province Punjab.

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


State of Azad Jammu and Kashmir:

• 128 health facilities from 10 districts reported to DEWS in this week with a total of 25,149 patient consultations.

• 1 alert/outbreak for Leishmaniasis was identified and appro-priate measures were taken.

• 43 health facilities from 3 agencies reported from FATA in this week, with a total of 8,111 patient consultations.

• 3 alerts for Measles were reported this week and appropriate measures were taken.

Province Gilgit Baltistan:

• 33 health facilities from 4 districts in Gilgit Baltistan reported to DEWS in week 10, with a total of 12,251 patient consultations.

• No alert was received for any disease from any area in Gilgit Baltistan.

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

FATA:

Province Balochistan:

• 394 health facilities from 18 districts in Balochistan reported to DEWS, with a total of 62,470 patient con-sultations.

• 21 alerts were reported in week 10 from Balochistan; Altogether 7 each for Leishmaniasis and Measles; 2 each for ARI and Malaria; while 1 each for AWD, BD and Typhoid.

• 3 outbreaks, 2 for Leishmaniasis; while 1 for AWD were identified and appropriate measures were taken.

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

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Alerts and outbreaks, week 10, 2012

Weekly Epidemiological - WHO · Weekly Epidemiological Bulletin This weekly Epidemiological Bulletin is published jointly by the National Institute of Health, Islamabad and World

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