Week ending October 21, 2017 Epidemiology Week 42 WEEKLY ... · FEVER AND JAUNDICE Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting

Released November 6, 2017 ISSN 0799-3927

NOTIFICATIONS-

All clinical

sites

INVESTIGATION

REPORTS- Detailed Follow

up for all Class One Events

HOSPITAL ACTIVE

SURVEILLANCE-30

sites*. Actively pursued

SENTINEL

REPORT- 79 sites*.

Automatic reporting

*Incidence/Prevalence cannot be calculated

1

Week ending October 21, 2017 Epidemiology Week 42

WEEKLY EPIDEMIOLOGY BULLETIN NATIONAL EPIDEMIOLOGY UNIT, MINISTRY OF HEALTH, JAMAICA

Weekly Spotlight Close to 3 million people access hepatitis C cure

EPI WEEK 42

Hosted by the Government of Brazil, the World Hepatitis Summit 2017 is being co-organized by WHO and the World Hepatitis Alliance. The Summit aims to encourage more countries to take decisive action to tackle hepatitis, which still causes more than 1.3 million deaths every year and affects more than 325 million people.

Many countries are demonstrating strong political leadership, facilitating dramatic price reductions in hepatitis medicines, including through the use of generic medicines—which allow better access for more people within a short time.

In 2016, 1.76 million people were newly treated for hepatitis C , a significant increase on the 1.1 million people who were treated in 2015. The 2.8 million additional people starting lifelong treatment for hepatitis B in 2016 was a marked increase from the 1.7 million people starting it in 2015. But these milestones represent only initial steps – access to treatment must be increased globally if the 80% treatment target is to be reached by 2030.

However, funding remains a major constraint: most countries lack adequate financial resources to fund key hepatitis services.

Downloaded from:http://www.who.int/mediacentre/news/releases/2017/hepatitis-c-

cure/en/

SYNDROMES

PAGE 2

CLASS 1 DISEASES

PAGE 4

INFLUENZA

PAGE 5

DENGUE FEVER

PAGE 6

GASTROENTERITIS

PAGE 7

RESEARCH PAPER

PAGE 8

http://www.google.com.jm/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&docid=Juz0TfK8UHFxbM&tbnid=kFpmxj0_4cgraM:&ved=0CAUQjRw&url=http://summitpediatrics.blogspot.com/2011/02/fever-friend-or-foe.html&ei=e0GlUofFHMXokQfS24CQAw&bvm=bv.57752919,d.eW0&psig=AFQjCNFhU0bYMgQWIDEj6PAPCGgii5YGGQ&ust=1386648250476674


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


2

REPORTS FOR SYNDROMIC SURVEILLANCE FEVER Temperature of >380C /100.40F (or recent history of fever) with or without an obvious diagnosis or focus of infection.

KEY RED CURRENT WEEK

FEVER AND NEUROLOGICAL Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person with or without headache and vomiting. The person must also have meningeal irritation, convulsions, altered consciousness, altered sensory manifestations or paralysis (except AFP).

FEVER AND HAEMORRHAGIC Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting with at least one haemorrhagic (bleeding) manifestation with or without jaundice.

50

500

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Epidemiology Weeks

Fever in under 5y.o. and Total Population 2017 vs Epidemic Thresholds, Epidemiology Week 42

Total Fever (all ages) Cases under 5 y.o.

<5y.o. Epi Threshold All Ages Epi Threshold

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Fever and Neurological Symptoms Weekly Threshold vs Cases 2017, Epidemiology Week 42

2017 Epi threshold

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Epidemiology Weeks

Fever and Haem Weekly Threshold vs Cases 2017, Epidemiology Week 42

Cases 2017 Epi threshold


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


3

FEVER AND JAUNDICE Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting with jaundice.

ACCIDENTS Any injury for which the cause is unintentional, e.g. motor vehicle, falls, burns, etc.

VIOLENCE Any injury for which the cause is intentional, e.g. gunshot wounds, stab wounds, etc.

The epidemic threshold is

used to confirm the

emergence of an epidemic

so as to step-up appropriate

control measures.

0

2

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12

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

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Epidemiology Weeks

Fever and Jaundice Weekly Threshold vs Cases 2017, Epidemiology Week 42

Cases 2017 Epi threshold

50

500

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

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Epidemiology Weeks

Accidents Weekly Threshold vs Cases 2017

≥5 Cases 2016 <5 Cases 2016 Epidemic Threshold<5 Epidemic Threshold≥5

1

10

100

1000

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Epidemiology Week

Violence Weekly Threshold vs Cases 2017

≥5 y.o <5 y.o <5 Epidemic Threshold ≥5 Epidemic Threshold


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


4

CLASS ONE NOTIFIABLE EVENTS Comments

CONFIRMED YTD AFP Field Guides

from WHO indicate

that for an effective

surveillance

system, detection

rates for AFP

should be

1/100,000

population under

15 years old (6 to 7)

cases annually.

___________

Pertussis-like

syndrome and

Tetanus are

clinically

confirmed

classifications.

______________

The TB case

detection rate

established by

PAHO for Jamaica

is at least 70% of

their calculated

estimate of cases in

the island, this is

180 (of 200) cases

per year.

______________

1 Dengue Hemorrhagic

Fever data include

Dengue related deaths;

2 Maternal Deaths

include early and late

deaths.

Hep B increase for wk

29, 2017 due to results

received from

NBTS/NPHL

CLASS 1 EVENTS CURRENT

YEAR PREVIOUS

YEAR

NA

TIO

NA

L /

INT

ER

NA

TIO

NA

L

INT

ER

ES

T

Accidental Poisoning 95 128

Cholera 0 0

Dengue Hemorrhagic Fever1 0 3

Hansen’s Disease (Leprosy) 0 2

Hepatitis B 42 26

Hepatitis C 9 4

HIV/AIDS - See HIV/AIDS National Programme Report

Malaria (Imported) 6 2

Meningitis ( Clinically confirmed) 35 63

EXOTIC/ UNUSUAL Plague 0 0

H I

GH

MO

RB

IDIT

/

MO

RT

AL

IY

Meningococcal Meningitis 0 0

Neonatal Tetanus 0 0

Typhoid Fever 0 0

Meningitis H/Flu 0 0

SP

EC

IAL

PR

OG

RA

MM

ES

AFP/Polio 0 0

Congenital Rubella Syndrome 0 0

Congenital Syphilis 0 0

Fever and

Rash

Measles 0 0

Rubella 0 0

Maternal Deaths2 35 23

Ophthalmia Neonatorum 282 343

Pertussis-like syndrome 0 0

Rheumatic Fever 3 6

Tetanus 1 0

Tuberculosis 46 49

Yellow Fever 0 0

Chikungunya 0 4

Zika Virus 0 162


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


5

NATIONAL SURVEILLANCE UNIT INFLUENZA REPORT EW 42

October 15-21, 2017 Epidemiology Week 42

October 2017

EW 42 YTD

SARI cases 0 308

Total Influenza

positive Samples

2 26

Influenza A 0 0

H3N2 0 0

H1N1pdm09 0 0

Not subtyped 0 0

Influenza B 4 26

Other 0 0

Comments: During EW 41, the proportion of SARI

hospitalizations among all

hospitalizations slightly decreased and

remained below the average epidemic

curve and the alert threshold as

compared to previous weeks.

During EW 39, the number of

pneumonia cases increased below the

alert threshold and was higher than the

previous seasons for the same period.

During EW 41, ARI cases remained at

similar levels as compared to previous

weeks, and was similar to levels

observed in previous season for the

same period.

INDICATORS

Burden

Year to date, respiratory

syndromes account for 4.4% of

visits to health facilities.

Incidence

Cannot be calculated, as data

sources do not collect all cases of

Respiratory illness.

Prevalence

Not applicable to acute

respiratory conditions.

0

500

1000

1500

2000

2500

3000

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Epi Weeks

Fever and Respiratory 2017

<5 5-59≥60 <5 years epidemic threshold5 to 59 years epidemic threshold ≥60 years epidemic threshold

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

0

1

2

3

4

5

6

1 3 5 7 9 111315171921232527293133353739414345474951

Per

cen

tage

of

po

siti

ves

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osi

tive

sam

ple

s

Distribution of Influenza and other respiratory viruses among SARI cases by EW surveillance EW 34, 2017, NIC Jamaica

A(H1N1)pdm09 A not subtyped A no subtypable A(H1)A(H3) Flu B Parainfluenza RSVAdenovirus Methapneumovirus Rhinovirus CoronavirusBocavirus Others % Positives

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

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

Per

cen

tage

of

SAR

I cas

es

Epidemiological Week

Jamaica: Percentage of Hospital Admissions for Severe Acute Respiratory Illness (SARI 2017) (compared with 2011-2016)

Average epidemic curve (2011-2016)

Alert Threshold

SARI 2017

Seasonal Threshold


NOTIFICATIONS-

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sites

INVESTIGATION



HOSPITAL ACTIVE

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SENTINEL

REPORT- 79 sites*.

Automatic reporting


6

Dengue Bulletin October 15-21, 2017 Epidemiology Week 42

DISTRIBUTION

Year-to-Date Suspected Dengue Fever

M F Un-know

n

Total %

<1 2 0 0 2 2.9

1-4 4 1 0 5 7.1

5-14 6 11 0 17 24.3

15-24 7 8 0 15 21.4

25-44 14 6 1 21 30

45-64 4 4 0 8 11.4

≥65 0 0 0 0 0 Unknown 1 1 0 2 2.9 TOTAL 38 31 1 70 100

Weekly Breakdown of suspected and

confirmed cases of DF,DHF,DSS,DRD

2017

2016 YTD EW

42 YTD

Total Suspected

Dengue Cases 0 70 1823

Lab Confirmed Dengue cases

0 14 153

CO

NFI

RM

ED

DHF/DSS 0 0 3

Dengue Related Deaths

0 0 0

0

50

100

150

200

1 3 5 7 9 111315171921232527293133353739414345474951N

o. o

f C

ases

Epidemeology Weeks

2013 2014 2015 2016 2017

0.0 0.0

0.5

0.0

1.0

0.0 0.1

0.50.9 0.9

0.30.0

2.2

0.0

0.5

1.0

1.5

2.0

2.5

Susp

ect

ed

Cas

es

(Pe

r 1

00

,00

0 P

op

ula

tio

n)

Suspected Dengue Fever Cases per 100,000 Parish Population

0

1000

2000

3000

4000

5000

6000

7000

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Dengue Cases by Year: 2007-2017, Jamaica

Total Suspected Confirmed DF


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


7

Gastroenteritis Bulletin October 15-21, 2017 Epidemiology Week 42

Year EW 42 YTD

<5 ≥5 Total <5 ≥5 Total

2017 112 169 281 6,699 8,516 15,215

2016 94 169 263 5,439 8,977 14,416

Figure 1: Total Gastroenteritis Cases Reported 2016-2017

0

200

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1200

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Gastroenteritis Epidemic Threshold vs Cases 2017

<5 Cases ≥5 Cases Epi threshold <5 Epi threshold ≥5

0

10

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30

40

50

60

70

80

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

Westmoreland GE <5

2017 2016 Epi threshold <5 Alert Threshold

EW

42 Weekly Breakdown of Gastroenteritis cases Gastroenteritis:

In Epidemiology Week 42, 2017, the total

number of reported GE cases showed a 12% decrease compared to EW 42 of the

previous year.

The year to date figure showed an 8%

increase in cases for the period.


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL ACTIVE

SURVEILLANCE-30


SENTINEL

REPORT- 79 sites*.

Automatic reporting


8

RESEARCH PAPER

Strengthening Health Care Systems for HIV and AIDS in Jamaica: A Programme of Research and Capacity

Building 2007-2012

N Edwards1, E Kahwa2, D Kaseje3, J Mill4, J Webber5, S Roelofs6, M Walusimbi7, H Klopper8, J Harrowing8

1University of Ottawa, Canada

2The UWI School of Nursing, Mona, University of the West Indies, Jamaica

3Great Lakes University of Kisumu, Kenya,

4University of Alberta, Canada

5Canadian Nurses’ Association, Canada,

6Mulago Hospital, Uganda

7University of Western Cape, South Africa,

8University of Lethbridge, Canada

Objectives: To contribute to health systems strengthening for HIV and AIDS care in Jamaica by fostering dynamic

and sustained engagement of nurses in the process of change through capacity building in research and policy.

Methods: This work was done as part of an international program of research which was implemented in Jamaica

and three African countries (Kenya, Uganda and South Africa). Using mixed methods and participatory action

research, we tested the “leadership hub model” to invigorate nurses’ involvement in policy and research and

improve nursing care. Data collection included cross sectional surveys of nurses on clinical practice, quality

assurance and stigma; an institutional assessment of workplace policies and the impact of the HIV epidemic on the

nursing workforce. Capacity building included training in the policy development process, training in research skills

including opportunities for collaborating on research projects, research grants for junior investigators, and research

internships for nurses.

Results: Three research projects were completed in Jamaica. Sixteen (16) Jamaican nurses participated in the

international research internship to build capacity for research. Frontline nurses, nurse researchers, and decision

makers improved capacity in using and leading research to influence policy. Three (3) research proposals by junior

nurse researchers and three (3) HIV policy evaluation proposals by leadership hubs were funded and successfully

completed.

Conclusions: This program of research built research and policy capacity among nurses for leadership roles in

improving equity, quality and efficiency of health systems for HIV and AIDS care. Findings from the three

interrelated research projects will be presented.

The Ministry of Health

24-26 Grenada Crescent

Kingston 5, Jamaica

Tele: (876) 633-7924

Email: [email protected]

Documents

Week ending October 21, 2017 Epidemiology Week 42 WEEKLY ... · FEVER AND JAUNDICE Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting