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]. • In the year 2011, total 95 districts including 2 agencies providing surveillance data to the DEWS on weekly basis from around 3,375 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC. • A total of 45,510,570 consultations were reported through DEWS of which 10,582,901 (23%) were acute respiratory infections (ARI); 4,445,752 (10%) were Skin disease; 4,029,210 (9%) were acute diarrhoea; and 2,882,775 (6%) were suspected malaria. • In year 2011, A total of 5,752 alerts with 1,053 outbreaks were reported: Altogether 1710 alerts for Measles; 1350 for AWD; 785 for Dengue fever; 333 for Neonatal tetanus and tetanus; 298 for Leishmaniasis; 287 for Pertussis; 131 for Malaria; 98 for Bloody diarrhoea; 51 for acute jaundice syndrome; while 709 for others communicable diseases. • In week 1, 2012, three new type‐1 polio cases were confirmed by the laboratory: two from FATA (Khyber agency) and one from Khyber Pakhtunkhwa (Tank district). As of 9 th January 2012, Pakistan has reported a total of 192 polio cases (190 type‐1 & 2 type‐3) for the year 2011 from 58 districts/towns/tribal agencies/areas. Highlights Disease early warning system and response in Pakistan 01 Volume 3, Issue 1, Tuesday 10 January, 2012 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)/ Sus- pected 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 Acute diarrhoea and ARI in Pakistan, 2010 and 2011. Disease Sindh KPK Punjab Balochistan Gilgit Baltistan AJ&K FATA ICT Bloody diarrhoea 134,362 (1%) 101,063 (1%) 1,838 (0.02%) 90,278 (3%) 8,850 (1%) 1,578 (0.15%) 5,122 (1%) 484 (0.45%) Total consultation 20,150,603 8,576,371 11,184,899 3,350,114 741,689 1,056,134 342,987 107,773 Skin diseases 2,764,929 (14%) 368,793 (4%) 1,005,588 (9%) 201,135 (6%) 45,801 (6%) 40,082 (4%) 16,290 (5%) 3,134 (3%) Acute respiratory infection 4,600,807 (23%) 2,543,511 (30%) 2,328,341 (21%) 704,630 (21%) 133,894 (18%) 166,158 (16%) 72,216 (21%) 33,344 (31%) Suspected malaria 1,924,519 (10%) 186,689 (2%) 310,454 (3%) 428,174 (13%) 971 (0.13%) 7,926 (1%) 23,105 (7%) 937 (1%) Acute diarrhoea 1,727,693 (9%) 933,676 (11%) 794,127 (7%) 358,984 (11%) 99,947 (13%) 65,281 (6%) 36,517 (11%) 12,985 (12%) • The above graph shows the weekly trend of acute diarrhoea and ARI as percentage of cases out of total consultations reported to DEWS in 2010 and 2011. • In 2010, DEWS expanded after the August Flood, and total consultations were 11,855,316. • In year 2011, approximately 45,510,570 patient consultations have been reported to the DEWS from all provinces, FATA and AJ&K with average weekly consultations at 875,204. • The above table provides the total consultations in 2011 in each province and the overall frequency and proportional morbidity of five disease syndrome by province. Proportional morbidity of ARI is highest in KP while acute diarrhoea is highest in KP and Balochistan. • Proportional morbidity of suspected malaria were very high for the year at 13% in Balochistan and 12% in Sindh. Table 1: Most common communicable diseases syndromes reported in 2011, by province 0 5 10 15 20 25 30 35 40 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 Percentage Epi‐week AD 2010 AD 2011 ARI 2010 ARI 2011 Special Issue ‐ Summary 2011
6
Embed
Weekly Epidemiological - World Health Organization...Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 2012) This weekly Epidemiological Bulletin is published jointly by
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
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].
• In the year 2011, total 95 districts including 2 agencies providing surveillance data to the DEWS on weekly basis from around 3,375 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.
• A total of 45,510,570 consultations were reported through DEWS of which 10,582,901 (23%) were acute respiratory infections (ARI); 4,445,752 (10%) were Skin disease; 4,029,210 (9%) were acute diarrhoea; and 2,882,775 (6%) were suspected malaria.
• In year 2011, A total of 5,752 alerts with 1,053 outbreaks were reported: Altogether 1710 alerts for Measles; 1350 for AWD; 785 for Dengue fever; 333 for Neonatal tetanus and tetanus; 298 for Leishmaniasis; 287 for Pertussis; 131 for Malaria; 98 for Bloody diarrhoea; 51 for acute jaundice syndrome; while 709 for others communicable diseases.
• In week 1, 2012, three new type‐1 polio cases were confirmed by the laboratory: two from FATA (Khyber agency) and one from Khyber Pakhtunkhwa (Tank district). As of 9th January 2012, Pakistan has reported a total of 192 polio cases (190 type‐1 & 2 type‐3) for the year 2011 from 58 districts/towns/tribal agencies/areas.
Highlights
Disease early warning system and response in Pakistan
01
Volume 3, Issue 1, Tuesday 10 January, 2012
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)/ Sus-pected 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 Acute diarrhoea and ARI in Pakistan, 2010 and 2011.
• The above graph shows the weekly trend of acute diarrhoea and ARI as percentage of cases out of total consultations reported to DEWS in 2010 and 2011.
• In 2010, DEWS expanded after the August Flood, and total consultations were 11,855,316. • In year 2011, approximately 45,510,570 patient consultations have been reported to the DEWS from all provinces, FATA and AJ&K with
average weekly consultations at 875,204. • The above table provides the total consultations in 2011 in each province and the overall frequency and proportional morbidity of five
disease syndrome by province. Proportional morbidity of ARI is highest in KP while acute diarrhoea is highest in KP and Balochistan. • Proportional morbidity of suspected malaria were very high for the year at 13% in Balochistan and 12% in Sindh.
Table 1: Most common communicable diseases syndromes reported in 2011, by province
Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 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
Distribution of Wild Polio Virus cases Pakistan 2010 and 2011
Year 2011: As of 9th January, 2012, the total number of polio cases confirmed by the laboratory is 192 (190=type‐1, and 2=type‐3) from 58 districts/towns/tribal agencies and areas.
Province Cases 2010 Cases 2011
P1 P3 P1 P3
Punjab 6 1 8 ‐
Sindh 26 1 32 ‐
Khyber Pakhtunkhwa 19 5 22 ‐
FATA 63 11 55 2
Balochistan 6 6 72 ‐
AJ&K ‐ ‐ ‐ ‐
Gilgit‐Baltistan ‐ ‐ 1 ‐
Islamabad ‐ ‐ ‐ ‐
Total 120 24 190 2
Current week's (1/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken
5‐Jan Leishmaniasis Balochistan Nasirabad Abro Mohla & Bhangar Mohla town area 1 3 2 0
Outbreak of 6 cases of Leishmaniasis from one location. Inj Glucantime was provided and health education was given.
6 new cutaneous Leishmaniasis cases were attended in continuation of previous Cases. Treat‐ment started through MC supported Program. Till date a total of 66 cases reported from this center.
7‐Jan Malaria Balochistan Lasbela Civil Hospital Bela 0 0 0 0 58 cases of suspected Malaria reported from Hospital out of which 24 were positive for P. Falciparum and 7 were P. Vivax (SPR=54%). The treatment was provided to all patients. Infor‐mation was shared with DHO for necessary action.
7‐Jan Malaria Balochistan Lasbela RHC Lakhra 0 0 0 0 17 cases of suspected Malaria reported from RHC out of which 11 were positive 9 for P. Falciparum and 2 for mix (SPR=65%). Treatment was provided to all patient as per WHO protocol. All the information was shared with DHO for necessary action.
5 cases of acute vomiting were reported from RHC and BHU from village Kundi. On investiga‐tion there were 14 more cases in that area presented with severe vomiting and dizziness without diarrhoea or any other complaint. These cases belonged to one family and were in 4 adjacent houses sharing a single source of water which is a well. There is no history of com‐munal or shared food. 5 cases were severely dehydrated and were given IV fluids. Water samples were taken from source and water tanks and sent to NIH. Water from tanks was contaminated while source had no bacterial growth. Blood samples were taken and showed raised ALT, serum urea and eosinophils. 2 out of three samples also showed thrombocyto‐penia. Serology for Hep A was negative. Patients were treated symptomatically and are stable. Families informed to avoid source of water and use another source. Hygiene session held. EDO health was informed of the outbreak.
3‐Jan Measles KPK Lower Dir Village Navagai, UC Rabat, Tehsil Balmbat 5 1 2 0
Alert for measles, during active surveillance 7 more cases were found, routine outreach vacci‐nation conducted in the area by EPI Team, Vit‐A was given, Blood Sample Collected for confir‐mation of antibodies, Health education session conducted with the family members and community, patient isolated, EDO‐H & EPI Coordinator were informed.
4‐Jan Measles KPK Lower Dir Village Shagai, UC Rabat, Tehsil Balmbat 3 2 1 0
Alert for Measles, during active surveillance 5 more cases were found, routine outreach vaccination conducted in the area by EPI Team, 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.
5‐Jan Measles KPK Lower Dir Village Ttoru, UC Drangal, Tehsil Samar Bagh 1 0 0 0
Alert for Measles, during active surveillance no more cases found, routine outreach vaccina‐tion conducted in the area by EPI Team, Vit‐A was given, Blood Sample Collected for confirma‐tion of antibodies, Health education session conducted with the family members and commu‐nity, patient isolated, EDO‐H & EPI Coordinator were informed.
5‐Jan Measles KPK Upper Dir Lower Dir (Village Warri Payeen, UC & Tehsil Warri)
1 0 0 0 Suspected Measles case reported from OPD‐DHQ Hospital belongs to Upper Dir. The concern S.O informed for active surveillance. Blood Sample collected and sent to NIH, Health educa‐tion session conducted with the family members.
Alert for Hepatitis C generated through media, report about unusually high number of Chronic Hepatitis cases and deaths in Rajanpur. Report was shared with the EDOH Rajanpur. Joint investigation and response team including SO DEWS Rajanpur, DDHO Rajanpur, DMS DHQ hospital and National Hepatitis Control Program focal person along with outreach team members including MO, LHS and vaccinator of BHU Kotla Naseer visited more than 100 household in 7 bastis. 21 cases of Hepatitis C had lab reports indicating. 2 deaths were reported in last 2 months. One at THQ Rojhan diagnosed with Hepatoma. The second death at DHQ hospital Rajanpur was 15 years old boy with confirmed Hepatitis C at the time of death. DMS DHQ hospital and National Hepatitis control program focal person provided awareness sessions and shared with the community about availability of free of charge services for diagnosis and treatment of everyone irrespective of any bias os cast, color, creed and socio‐economic status. Further investigation planned.
3‐Jan Pertussis Sindh Dadu Village Kaloo Khan Karmani, near Wapda colony
2 1 2 1
Suspected case of Pertussis found in hospital, during active surveillance 5 more cases found, Child was not vaccinated, 9 out of 15 children were vaccinated in the community, health education imparted, Erythromycin provided, EDOH, THO, DSM, EPI FP inform and 1 throat sample taken.
Suspected cases of Pertussis reported in Village, Active surveillance done, Throat sample taken, vaccination status was not good, 8 out of 20 children were vaccinated in the area, health education session was conducted, Erythromicine provided, EDOH, THO, DSM, EPI FP inform and request for immunization.
Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 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]. 03
Current week's Alerts: Province Balochistan Date Disease District Area <5M >5M <5F >5F
7‐Jan AJS Chagai Gharib Abad UC Nokundi 0 2 0 1
7‐Jan Leishmani‐asis
Jaffara‐bad
Shaheed Murad Colony, Tehsil Dera Allah Yar 0 2 0 0
7‐Jan Leishmani‐asis
Jhal Magsi
Bhanry Pat Kar‐ra, UC Mir Pur, DHQ Hospital Gandawah 1 1 2 0
Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 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]. 04
Province Khyber Pakhtunkhwa (2011): • 1,007 health facilities from 20 districts from Khyber Pakhtunk-
hwa were reported to DEWS on weekly basis with a total of 8,576,371 patients consultations in year 2011.
• A total of 1,377 alerts were reported in the same time period; Altogether 535 for Measles; 352 for AWD; 233 for Dengue fever; 41 for Pertussis; 35 for Leishmaniasis; 22 for Bloody diarrhoea; 19 for Neonatal tetanus and tetanus; 11 for AJS; while 129 for other communicable diseases.
• 299 outbreaks were reported during the year; out of which 189 for AWD; 35 for Dengue fever; 12 for Measles; 11 for Bloody diarrhoea; 8 for AJS; 7 for Leishmaniasis; 6 for Pertussis; while 31 for other communicable diseases.
Figure-3: Trend of priority communicable diseases, province KPK
Province Sindh (2011):
• 1,086 health facilities from 19 districts in Sindh were reported on weekly basis to DEWS with a total of 20,150,603 patient consultations in 2011.
• 2,089 alerts were reported from Sindh in 2011; out of which 718 for AWD; 588 for Measles; 251 for Neonatal tetanus and teta-nus; 147 for Dengue fever; 129 for Pertussis;53 for Malaria; 21 for Bloody diarrhoea; 11 for Leishmaniasis; 6 for AJS; while 165 for other communicable diseases.
• 391 outbreaks were also received and appropriate response were taken; out of which 212 for AWD; 61 each for Measles and Pertussis; 28 for Malaria; 13 for Dengue fever; 2 each for AJS and Bloody diarrhoea; 1 for Leishmaniasis; while 11 for other communicable diseases.
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 Current Week (1, 2012) Total A O A O A O A O
Figure‐2: Weekly number of reporting health facilities (Week 1 to 52, 2011)
2262
2349
2255
2199
2251
2322
2450
2466
2404
2547 2785
2745
2909
2935
2982
3120
3021
3022
3058
3196
3250
3215
3259
3354
3375
3363
3234
3259
3251
3142
3329
3156
3109
2752
1488
2522
2564
2532
2648
2671
2716
2597
2550
2706
2477 2743
2777
2846
2930
2764
2766
2535
11 11 11 8 8 8 8 8 8 66 6 13 8 6 6 7 7 7
8 7 73 6 6 6
2 2
0
500
1000
1500
2000
2500
3000
3500
4000
Wk 1‐11
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
Epi‐week
Number of HFs
Mobile Fixed
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
Percentage
AD BD ARI S. Malaria
0
5
10
15
20
25
30
35
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
Percentage
AD BD ARI S. Malaria
Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 2012) Province Punjab (2011): • Around 800 health facilities from 8 districts reported data to
DEWS from 12 districts in Punjab province in 2011 with a total of 11,184,899 patient consultations.
• A total of 1,106 alerts were reported in 2011 from Punjab, 369 for Dengue fever; 194 for Measles; 153 for AWD; 40 for Leishmaniasis; 38 for Bloody diarrhoea; 26 for Pertussis; 13 for malaria; 8 for AJS; while 265 for Other communicable dis-eases.
• 161 outbreaks were also received and appropriate response were taken; Altogether 73 for AWD; 61 for dengue fever; 9 for Leishmaniasis; 6 for Measles; 2 for Pertussis; 1 each for Bloody diarrhoea and Malaria; while 8 for other communica-ble diseases.
Figure-5: Trend of priority communicable diseases, province Punjab
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]. 05
State of Azad Jammu and Kashmir (2011):
• 127 health facilities from 10 districts were reported from AJ&K were reported to DEWS in year 2011 on weekly basis with a total of 1,056,134 patient consultations.
• 104 alerts with 33 outbreaks were reported from AJ&K; altogether 41 for Measles; 32 for AWD; 13 for Dengue fever; 6 for AJS; 4 for Bloody diarrhoea; 3 for Leishmaniasis; 2 for Pertussis; while 3 for other com-municable diseases.
• 73 health facilities in 3 agencies reported from FATA in year 2011, with a total of 342,987 patient consultations.
• 99 alerts with 16 outbreaks were reported in 2011; Altogether 41 for Measles; 20 for Neonatal tetanus and tetanus; 14 for AWD; 5 for Leishmaniasis; 4 for Dengue fever; 3 for Pertussis; 2 for bloody diar-rhoea; 1 for Malaria; while 9 for other communicable diseases.
Province Gilgit Baltistan (2011):
• 82 health facilities from 7 districts in Gilgit Baltistan were reported to DEWS in year 2011 on weekly basis with a total of 741,689 patient consultations.
• 164 alerts were reported in year 2011 from Gilgit and Baltistan; Altogether 99 for Measles; 17 for AWD; 9 for Pertussis; 8 for bloody diarrhoea; 6 for Dengue fever; 5 for Leishmaniasis; 4 for AJS; 3 for Malaria; while 13 for other communicable dis-eases.
• 21 outbreaks were also received and appropriate response were provided; Altogether 8 for AWD; 3 for Pertussis; 1 each for AJS; Bloody diarrhoea; Dengue fever; Measles and Leishmaniasis; while 5 for other communicable diseases.
Figure-7: Trend of priority communicable diseases, Gilgit Baltistan
FATA (2011):
Province Balochistan (2011):
• 525 health facilities from 20 districts in Balochistan were re-ported to DEWS in year 2011 on weekly basis, with a total of 3,350,114 patient consultations.
• 771 alerts were reported in year 2011 from Balochistan; Alto-gether 198 for Leishmaniasis; 191 for Measles; 76 for Pertussis; 61 for Malaria; 51 for AWD; 42 for Neonatal tetanus and teta-nus; 16 for AJS; 13 for Dengue fever; 3 for Bloody diarrhoea; while 120 for others communicable diseases.
• 123 outbreaks were also received and appropriate response were provided; Altogether 58 for Malaria; 29 for AWD; 9 for Pertussis; 8 each for Measles and Leishmaniasis; 10for bloody diarrhoea; while 10 for other communicable diseases.
Figure-6: Trend of priority communicable diseases, province Balochistan
0
5
10
15
20
25
30
35
40
45
50
wk 14
wk 15
wk 16
wk 17
wk 18
wk 19
wk 20
wk 21
wk 22
wk 23
wk 24
wk 25
wk 26
wk 27
wk 28
wk 29
wk 30
wk 31
wk 32
wk 33
wk 34
wk 35
wk 36
wk 37
wk 38
wk 39
wk 40
wk 41
wk 42
wk 43
wk 44
wk 45
wk 46
wk 47
wk 48
wk 49
wk 50
wk 51
wk 52
Percentage
AD BD ARI S. Malaria
05
101520253035404550
wk 14
wk 15
wk 16
wk 17
wk 18
wk 19
wk 20
wk 21
wk 22
wk 23
wk 24
wk 25
wk 26
wk 27
wk 28
wk 29
wk 30
wk 31
wk 32
wk 33
wk 34
wk 35
wk 36
wk 37
wk 38
wk 39
wk 40
wk 41
wk 42
wk 43
wk 44
wk 45
wk 46
wk 47
wk 48
wk 49
wk 50
wk 51
wk 52
Percentage
AD BD ARI S. Malaria
0
10
20
30
40
50
wk 7
wk 8
wk 9
wk 10
wk 11
wk 12
wk 13
wk 14
wk 15
wk 16
wk 17
wk 18
wk 19
wk 20
wk 21
wk 22
wk 23
wk 24
wk 25
wk 26
wk 27
wk 28
wk 29
wk 30
wk 31
wk 32
wk 33
wk 34
wk 35
wk 36
wk 37
wk 38
wk 39
wk 40
wk 41
wk 42
wk 43
wk 44
wk 45
wk 46
wk 47
wk 48
wk 49
wk 50
wk 51
wk 52
Percentage
AD BD ARI S. Malaria
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
Percentage
AD BD ARI S. Malaria
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
Percentage
AD BD ARI S. Malaria
Special Bulletin: DEWS, Pakistan, Week no. 1 (1 to 7 January, 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]. 06