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C t it tiC t it tiCurrent situation of Rift Valley FeverCurrent situation
of Rift Valley Feverof Rift Valley Fever in Egypt
of Rift Valley Fever in Egypt
Dr. Amr KandeelUndersecretary for Preventive Affairs
Ministry of Health and PopulationE t
1
Egypt27-29 January,2009
OverviewOverview
• IntroductionIntroduction• Disease in humans
O tb k i E t• Outbreaks in Egypt• RVF surveillance activities/MOHP• Assessment of RVF preventive
activities/MOHP• Needs and researches
2
IntroductionIntroduction
Rift Valley Fever (RVF)Rift Valley Fever (RVF)is an arthropod-borne,
t f iacute, fever-causingviral disease of sheep,
goats, cattle and people
3
Disease in humansDisease in humans• Incubation period 2-6 days• Many are Inapparent, or have
mild flu-like symptomsy• Others may have fever,
headache, myalgia, nauseaheadache, myalgia, nausea and painful eyes
• Retinopathy(1-10%) loss of• Retinopathy(1-10%), loss of visual acuityRecovery 4 7 days4
• Recovery 4-7 days
Transmission to HumansTransmission to HumansVector
Bite of mosquito infected with RVFBite of mosquito infected with RVFDirect Contact
Tissues or body fluids of infected animalsinfected animals
Handling birthing tissues, meatAerosol
Breathing in the virus duringBreathing in the virus during slaughter of infected animals or duringthe birthing process
Oral; not very common- Drinking unpasteurized milk from an
infected animal
5Does not spread from person- to-person
RVF in EgyptRVF in Egyptgyp1977-2003
gyp1977-2003
6
Occurrence of RVFOccurrence of RVF
7
Number of positive (IgM) cases of Rift Valley Fever by Governorate ,Egypt 1993-2008
Number of positive (IgM) cases of Rift Valley Fever by Governorate ,Egypt 1993-2008
GovernorateNo. Of cases IgM +ve
Year
y , gypy , gyp
Aswan, Ismailia, Sharkia,Giza,Qena1281993
Dakahlia, Sharkia ,Damitta, cairo ,Aswan, Menofia, Behira, Kafrelshiekh, Qailiobia ,Giza
2231994
31995 31995
91996
71997
Dakahlia, Sharkia ,Ghabia,,Aswan, Menofia, Behira,K f l hi kh Q
1111998Kafrelshiekh ,Qena
441999
12000
62001
Aswan, Damitta ,Qena, Menofia182002
Behira, Kafrelshiekh, Dakahlaia1912003
42004
02005
8
02005
02006
02007
02008
Rift Valley Fever outbreak by Governorate Egypt 1977
Rift Valley Fever outbreak by Governorate Egypt 1977Egypt 1977Egypt 1977
9
- 18,000 cases- 598 deaths
Rift Valley Fever outbreak by Governorate Egypt 1993
Rift Valley Fever outbreak by Governorate Egypt 1993Egypt 1993Egypt 1993
10128 cases
Rift Valley Fever outbreak by Governorate Egypt 2003
Rift Valley Fever outbreak by Governorate Egypt 2003Egypt 2003Egypt 2003
11191 cases
Positive (IgM) cases of Rift Valley Fever by Month, Egypt 2003
Positive (IgM) cases of Rift Valley Fever by Month, Egypt 2003Month, Egypt 2003 Month, Egypt 2003
KaferElshiekh Behira Dakahlia
20
25 Total No.=191
15
No.
5
10
0
12
Month
August SeptemberJuly
Positive (IgM) cases of Rift Valley Fever by Outcome ,Egypt 2003
Positive (IgM) cases of Rift Valley Fever by Outcome ,Egypt 2003
180
Outcome ,Egypt 2003Outcome ,Egypt 2003
Total No. =191
153
120140160180 Total No. 191
80%
80100120
No.
80%
38
204060
20%
0
13outcome
Positive (IgM) cases of Rift Valley Fever by Governorate, Egypt 2003
Positive (IgM) cases of Rift Valley Fever by Governorate, Egypt 2003Governorate, Egypt 2003Governorate, Egypt 2003
No. of case Died
T t l N 19181
7270
80
90 Total No. =191
3840
50
60
No.
11
24
310
20
30
13% 7.9%
33.3%
013% 7.9%
14 governeorate
Positive (IgM) cases of Rift Valley Fever by Age Group ,Egypt 2003
Positive (IgM) cases of Rift Valley Fever by Age Group ,Egypt 2003Age Group ,Egypt 2003Age Group ,Egypt 2003
Total No 191
40.3
354045
Total No .=191
20253035
%
11
17.815.7
13.6
101520
1.605
15age group
Positive (IgM) cases of Rift Valley Fever by Gender ,Egypt 2003
Positive (IgM) cases of Rift Valley Fever by Gender ,Egypt 2003Gender ,Egypt 2003Gender ,Egypt 2003
Total No. =191
Male
female40%
60%
16
RVF surveillance activities/ MOHPRVF surveillance activities/ MOHP
• RVF is one of the immediate notifiable diseases of the national communicable diseases surveillance system.y
• Encephalitis became one of the Immediate notifiable diseases nationwideImmediate notifiable diseases nationwide after RVF outbreak in 2003
• Both RVF and Encephalitis suspect cases• Both RVF and Encephalitis suspect cases are reported to MOHP on daily basis nationwide
17
nationwide.
Number of positive cases of Encephalitis by Outcome ,Egypt 2006,2007,2008
Number of positive cases of Encephalitis by Outcome ,Egypt 2006,2007,2008
no. of cases died
Outcome ,Egypt 2006,2007,2008Outcome ,Egypt 2006,2007,2008
17582000
1451
1758 1683
1200
1400
1600
1800
600
800
1000
1200No.
307 358 299
0
200
400
18 Year
RVF surveillance activities/ MOHP Cont’d
RVF surveillance activities/ MOHP Cont’d
• Promote surveillance in Fever and
Cont dCont d
Promote surveillance in Fever and ophthalmic hospitals for early case detectiondetection
• Training courses for health care providers on case definition earlyproviders on case definition, early detection, managementP id t t ll• Prepare rapid response teams at all governorate's levels
19
RVF surveillance activities/ MOHP Cont’d
RVF surveillance activities/ MOHP Cont’d
C t t i i f l b t di ti kit f RVF
Cont dCont d
• Constant provision of laboratory diagnostic kits of RVF• Serum testing for all suspect cases for IgG and IgM at
CPHL/MOHP• Monitoring and follow-up visits to fever and ophthalmic
hospitals• Develop a plan of action to evaluate the preventive• Develop a plan of action to evaluate the preventive
programs for RVF, nationwide• Collaboration with concerned parties eg. vector control
Dept local Administrative sector environment affairsDept., local Administrative sector, environment affairs• Collaboration with the Organization of Veterinary
Services/MOA
20
RVF surveillance activities/ MOHP Cont’d
RVF surveillance activities/ MOHP Cont’d
• Distribute printed materials;
Cont’dCont’d
Distribute printed materials;flyers, posters on RVF f h lth kfor health care workers
21
Reported number of Reported number of epo ted u be osuspect cases of RVF
epo ted u be osuspect cases of RVF
Egypt, 2004-2008Egypt, 2004-2008
22
Reported suspect cases of Rift Valley Fever Egypt 2004-2008
Reported suspect cases of Rift Valley Fever Egypt 2004-2008Fever, Egypt 2004 2008 Fever, Egypt 2004 2008
18892000
13291400
1600
1800
828
571689
600
800
1000
1200
No.
0
200
400
600
0
Year
23
Reported suspect cases of Rift Valley Fever by Month, Egypt 2007-2008
Reported suspect cases of Rift Valley Fever by Month, Egypt 2007-2008by Month, Egypt 2007 2008 by Month, Egypt 2007 2008
400 376
250300350400
112 108
172
93
168118
153113
215
125148
11791100
150200250
No.
5946 26 19 35
5727 37
76 93 9177
050
100
month
242007 2008
Reported suspect cases of Rift Valley Fever by Governorate, Egypt 2007-2008
Reported suspect cases of Rift Valley Fever by Governorate, Egypt 2007-2008by Governorate, Egypt 2007 2008 by Governorate, Egypt 2007 2008
No.
379352
324350
400
200
250
300
13412990 81 77
57 57 50 41100
150
50 41 32 24 20 20 15 14 12 6 2 6 4 10
50
25Governeorate
Assessment of RVF preventive activities Ministry of Health and Population (MOHP)Assessment of RVF preventive activities
Ministry of Health and Population (MOHP)
Conduction of field visits In 14
Ministry of Health and Population (MOHP)Ministry of Health and Population (MOHP)
governorates in 2007 - 2008 to: - Health Directorate, - Health districts, - Fever hospitals,p ,- Ophthalmic hospitals ,- Veterinarian Health Directorates,Veterinarian Health Directorates, - Villages
26
Results of assessment by Vaccination Status, Egypt 2007-2008
Results of assessment by Vaccination Status, Egypt 2007-2008
120
Status, Egypt 2007 2008Status, Egypt 2007 2008
97.8 9485
78 4 78 78
100
120
78.4 78 78 76.368.6
60.5 58.1 55.3 51.3 47.160
80
%
29.3
20
40
0
27 Governorate
Needs and researchesNeeds and researches
• Enhance entomology surveillancegy
• Upgrade Vector Control Department• Upgrade Vector Control Department- building capacity of personnel- Renovation of facilities at all levels- equipments/insecticides
28
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