Weekly Epidemiological - WHO...Ghazi City, UC Ghazi, RHC Ghazi 1 3 1 2 7 suspected Enteric Fever cases were reported. Blood samples were tested and Typhidot IgM found positive for

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. 24 (10 - 16 June 2012)

• Measles: 170 alerts investigated, respond‐ing to 23 outbreaks involving 410 measles cases.

• CCHF: In 2012, total of 20 confirmed cases have been reported throughout the coun‐try. Most of the cases (11) directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab.

• Acute diarrhoea: Trend of acute diarrhoea is on the rise in all provinces. Districts in Sindh and Khyber Pakhtunkhwa are investi‐gating alerts for acute watery diarrhoea/suspected cholera.

• No new polio case was reported; As of 18 June 2012, Pakistan has reported a total of 22 polio cases (19 type‐1, 2 type‐3 and 1 mixture type‐1 and 3) from 13 districts/tribal agencies.

• 88 districts have reported in week 24, 2012, Please see map. 2,283 health facilities have shared weekly data to the Disease Early Warning System (DEWS) in this week

• 824,292 patients’ consultations were re‐ported in week 24 compared to 770,838 consultations reported on week 23, 2012.

Highlights

Disease early warning system and response in Pakistan

01

Volume 3, Issue 24, Wednesday 20 June 2012

• The graph (Figure‐1) shows the comparison of weekly trend of Acute diarrhoea as proportional morbidity (percentage of cases out of total consultations) reported to DEWS each week in year 2011 and 2012.

• The overall weekly trend of acute diarrhoea remained stable during the last 4 week, however in KP the weekly propor‐tional morbidity of AD shows an upward trend and much stable in Punjab, Sindh and Balochistan.

Disease # of Cases Percentage

Acute diarrhoea 1,192,426 8%

Bloody diarrhoea 76,222 0.48%

ARI 3,199,529 20%

S. Malaria 710,292 4%

Skin Diseases 699,091 4%

Unexplained fever 550,779 3%

Total (All consultations) 15,900,063

Disease # of Cases Percentage

Acute diarrhoea 76,201 9%

Bloody diarrhoea 4,041 0.49%

ARI 122,595 15%

S. Malaria 44,667 5%

Skin Diseases 36,628 4%

Unexplained fever 30,382 4%

Total (All consultations) 824,292

Figure‐2: Weekly trend of Acute diarrhoea in Pakistan Week‐1, 2011 to week‐24, 2012.

Figure‐1: 88 districts reported to DEWS in week 28, 2012.

Priority diseases under surveillance

in DEWS

Pneumonia Acute Watery Diarrhoea

Bloody diarrhoea Other Acute Diarrhoea

Suspected Enteric/Typhoid Fever Suspected Malaria

Suspected Meningitis Suspected Dengue fever

Suspected Viral Hemorrhagic Fever Suspected Measles

Suspected Diphtheria Suspected Pertussis

Suspected Acute Viral Hepatitis Neonatal Tetanus

Acute Flaccid Paralysis Scabies

Cutaneous Leishmaniasis Others Major health events reported during the

Epi‐week ‐ 24 (10 ‐ 16 June 2012)

Cumulative number of selected health events reported in Epi‐week 1 ‐ 24 (1 Jan ‐ 16 June 2012)

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Weekly Bulletin: DEWS, Pakistan, Week no. 24 (10 to 16 June 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 (24/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

12‐Jun Measles Balochistan Kech BHU Jusak (Muhallah Ghulam Rasool)

1 3 1 2

An alert of suspected measles was reported. On active search 6 more suspected cases were found. Vit A drops were given to the cases. In house to house cluster, 39 children were assessed for routine immuni‐zation, 100% found unvaccinated. Health education imparted regarding the routine immunization and parents were advised to visit nearest EPI centre for vaccination of their children.

12‐Jun Measles Balochistan Pishin village killi Torashah, UC Batazai

8 3 8 1

Suspected cases of meales were reported from Health Facility. During active surveillance, 20 more sus‐pected cases were found out of which 5 were totally vaccinated while rest of them were found unvacci‐nation against all antigens. Vit A drops were given. 65 children were assessed for routine vaccination and none of the child was found vaccinated against measles. Children were vaccinated against measles on the spot.

13‐Jun Measles Balochistan Pishin Killi sulamanzai, UC saranan 3 1 2 1

An alert of suspected measles was reported. During field investigation 6 more suspected cases were detected. 3 cases were found vaccinated while rest were totally unvaccinated. Vit A drops were given to the cases. 45 childern were assessed for routine immunization and all of them were unvaccinated. Chil‐dren were vaccinated against measles on the spot.

14‐Jun Measles Balochistan Nushki DHQ Hospital 2 3 0 0

An alert of suspected measles were reported from DHQ‐Hospital. On field visit, 4 more suspected cases were found. Out of 5 children, 2 children found vaccinated against measles. Vit A drops provided. Health education imparted. Further plan was made with DHO for the intensified outreach vaccination for the children between 9 months‐ 11 years.

14‐Jun Measles Balochistan Nushki Killi Surkhab,UC Ahmed Wal 4 3 1 2

An alert of suspected measles was reported. On active search 9 more suspected cases were found. Vit A drops provided and health education imparted regarding routine immunization. Intensified outreach vaccination activity planned.

14‐Jun Measles Balochistan Panjgur Mohalla Dumb, UC Tasp 4 3 4 2

13 suspected cases of measles were reported. All cases were not vaccinated as they were refusals. Vit A drops were provided. 2 blood samples were taken and sent to NIH for lab confirmation. Health education session conducted about the importance of routine immunization. DHO was informed.

14‐Jun Measles FATA Khyber Agency

Village Shagai,UC Lala China,Tehsil Jamrud

1 1 2 2

An alert of suspected measles was reported. On active surveillance total 6 suspected cases were found. Blood sample collected and sent to NIH for lab confirmation. Vitamin A drops were given to suspects. Health education imparted. A total of 50 children vaccinated for measles. Report shared with Agency Surgeon and FSMO.

11‐Jun Measles Khyber Pakhtunk‐hwa

Mansehra Batpara Neelor Khaki UC Bherkund 1 1 1 2

An alert of suspected Measles was reported. On active search total of 5 suspected cases of Measles were found and out of them 3 cases were totally unvaccinated. Vitamin A drops were given to the cases, two oral swabs and one blood sample collected for lab confirmation, House cluster was taken and 17 children <7 yrs of age were assessed for routine immunization and get vaccinated against Measles by EPI technician.


Mardan Village Ajab Gul, UC Gumbat, 1 2 1 2

An alert for suspected Measles was reported. On field investigation 5 more clinical cases were found. Vitamin A drops were given to cases. During field visit 18 children were checked for routine immuniza‐tion; 16 (89%)children were found not vaccinated for measles 1, 18 (100%) were unimmunized for mea‐sles 2. EPI team vaccinated 97 children under 5 years of age with measles vaccine. Health education sessions conducted with the LHW's, family members and community. EDO‐H Focal person, EPI Coordina‐tor and LHS were informed.

12‐Jun Typhoid Khyber Pakhtunk‐hwa

Haripur Ghazi City, UC Ghazi, RHC Ghazi 1 3 1 2

7 suspected Enteric Fever cases were reported. Blood samples were tested and Typhidot IgM found positive for S.Typhi. On field investigation contaminated water supply found as possible source of infec‐tion. Water samples from source, homes were taken and assessed for contamination. Health and hy‐giene sessions were conducted for affected families. Environmental interventions will be carried out depending on water sample results. Aqua tabs were distributed. EDO health informed.


D. I. Khan Kamran Colony, Daraban Kalan 2 0 2 1

2 suspected cases of Measles were found on active surveillance visit to hospital. Both of the suspected cases belonged from the same area. On field visit, 3 more suspected cases were found. All were unvacci‐nated against measles. A total of 17 children below 13 yrs were vaccinated against measles.


Haripur Village Khoi Dara, UC Kotehra, BHU Amgah

4 3 3 6

An alert of suspected measles case was reported. On active surveillance 15 more suspected cases were found. Vitamin A drops were given to the cases. None of the child was found completely vaccinated against measles. 11 (73%) children without BCG scar. No routine immunization activity in the area had been conducted by government. No EPI tech in the adjacent health facility. Outbreak declared in the area. Outreach vaccination is planned in the affected locality.


Mardan Village Shakar‐dand, UC Fathma 3 2 2 5

An alert of suspected Measles was reported. On active search 11 more suspected cases were found. 23 children were assessed for routine immunization out of which 19 (83%) children were found unvacci‐nated for measles 1 and 23 (100%) for measles 2 vaccine. During outreach vaccination by EPI team 110 children under 5 years were vaccinated. Vit‐A drops provided. Session was conducted with 23 LHW's of entire UC on importance of routine vaccination. Health education session conducted with the family members and community, EDO‐H Focal person & EPI Coordinator were informed.


Swabi BMC Swabi, Qibla Cham Bazar Kale Tordher

1 1 1 2

An alert of suspected Measles was reported. During field investigation 4 more suspected cases were found. EPI Card was not available with all cases. proper information regarding routine immunization was also not available. Vit. A drops were given to the cases, health education imparted, EDO H and EPI coor‐dinator Informed and requested for outreach vaccination in the affected area.


Abbottabad Riyala, Dalola 2 0 1 3

An alert of suspected measles was reported. On active search 5 more suspected cases were found. Vitamin A drops were given to the cases. House cluster was taken and 13 children <5 years assessed for routine immunization out of which 7 children found completely unvaccinated. Vaccination was done on the spot. EDO‐H and EPI coordinator were informed.

16‐Jun AWD Khyber Pakhtunk‐hwa

Haripur Village Amgah, UC Kotehra 1 5 0 3

9 suspected AWD were reported from BHU Amgah. Epidemiological and environmental assessments were carried out. Assessment indicated all the cases were liked with history of shared food. Active surveillance done, 2 other case found. Stool sample was taken and sent to NIH for lab testing and confir‐mation. Water samples were taken awaited for results. Rx given, Aqua tabs, ORS and filters distributed. Health education sessions conducted to the family as well as in the community. EDO Health informed.



Cont’d current week's (24/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

10‐Jun Measles Punjab Bhakkar

Mohallah Nawab Shah, UC Bhakkar Urban I, Tehsil Bhakkar.

0 2 3 2

2 suspected cases of measles were reported. On active surveillance 5 more suspected cases were found. All the suspects were found un vaccinated. 51 Children in the locality were checked for vaccination (BCG+ Measles) and out of which 44 (86 %) were found vaccinated. Vit A drops provided to the cases. Health education imparted about the importance of vaccination of their children against all the EPI diseases. Families and community was provided awareness about importance of isolation of the cases from healthy children to halt the spread of disease . Blood samples were collected and sent to NIH for lab conformation.

13‐Jun Measles Punjab Muzaf‐fargarh

Basti Machi, UC Beer Band, Jatoi 3 1 1 3

Two deaths reported due to suspected measles. Parents confirmed that their children were not vaccinated against any antigen. On active search, 6 more suspected cases were found. During survey, 8 children were assessed for routine immunization, 5 (64%) children were having BCG scar & 4(49%) had received Measles1 vaccine. During intensified outreach activity BCG 13, OPV 13, Penta 13, Measles 165 shots were delivered. Blood samples were drawn & sent to NIH for lab confirmation. Health education imparted.

11‐Jun Measles Sindh Ghotki Bagri Muhalla Mathelo Phatak UC I Ghotki City

3 1 1 0 An alert of suspected measles was notified, upon field investigation 4 more suspected cases were found. Vitamin A drops were given to all the cases. Blood samples collected and sent to NIH for lab confirmation. Informed DHMT for routine immunization in the locality.

11‐Jun Measles Sindh Matiari

Village Jamal Ni‐zamani, UC K.K Nizamani, taluka Hala

4 5 1 7

1 Death and 2 cases of Measles were reported from LUMHS, during field investigation 14 more suspected cases were found, Vitamin (A) dose was given, health education imparted. Immuni‐zation status was assessed for 17 children where none of the child were found vaccinated against measles, EDOH informed and 5 Blood samples collected for lab confirmation.

11‐Jun Measles Sindh Qambar Shahdad‐kot

Deera , UC Ber‐sharif , Taulka Kambar

3 2 0 1

An alert of suspected measles was reported. During field investigation 5 more suspected cases were found and also 1 death due to Measles, Vitamin (A) drops were given to all cases, health education imparted, 10 children were assessed for routine immunization out of which 2(20%) children found vaccinated against measles1 and 2 (20%) found vaccinated for measles 2.

12‐Jun Measles Sindh Karachi

Fida hussain Shaikh road, Daryaabad, near Memon hotel, Lyari town

3 1 1 0

An alert of suspected measles case was reported. During field visit 4 more suspected cases were found, cases were not vaccinated against Measles1 , Vitamin (A) drops were given, health education imparted, vaccination status was assessed out of which 55% were vaccinated against measles 1 and 53% for measles 2 vaccine. Informed THMT and 1 Blood sample collected for lab confirmation.


Abdul Khalique Chandio, UC Khandu, taluka Warah

5 1 2 1

An alert of suspected Measles was reported. During field investigation total 9 suspected cases were found, Vitamin (A) drops provided, health education imparted, 10 children were assessed for routine immunization and none of the child found vaccinated against measles. DHMT in‐formed and 9 Blood samples were collected for lab confirmation.


Gorgage, UC Khandu, taluka Warah

1 0 5 0

An alert of suspected Measles was reported. During field investigation 5 more suspected cases were found, Vitamin (A) drops were given to the cases, health education imparted, 10 children were assessed for routine immunization where 2 (20%) children were vaccinated against mea‐sles 1 and 2(20%) for measles 2 vaccine. DHMT informed and 5 Blood samples collected for lab testing.

12‐Jun Pertussis Sindh Sanghar Village Nazar Ali Bugti, UC Mian, taluka Sanghar

5 12 13 37

3 suspected cases of Pertussis were reported from community, during field investigation 60 more cases were found, Erythromycin tabs provided to all cases and contacts, health education imparted, immunization status was assessed for 67 patients where BCG=33 (50%) and Penta= 27 (40%) were found vaccinated, EDOH informed and 3 Naso Pharyngeal swab collected for lab testing. Laboratory results revealed growth of H. parainfluenza in one of the samples.

13‐Jun AWD Sindh

Tando Muham‐mad Khan

Bnear Hali Jhirk, UC Bulri Shah Karim, 1 2 0 3

3 cases of AWD were found on active surveillance visit to hospital. On field investigation, 3 more cases were found, Dug well was the source of water, Aqua tabs distributed, health educa‐tion imparted, EDOH informed, 1 Stool and 2 water sample collected for lab confirmation.

13‐Jun AWD Sindh

Tando Muham‐mad Khan

Kanji Kohli, UC Tando Ghulam Haider, taluka Tando Ghulam Hayder

1 2 0 3 5 cases of AWD were reported, Hand Pump was the source of water, Aqua tabs distributed, health education imparted, EDOH and LHW informed about the cases, 1 Stool and 2 water sample collected for lab confirmation.

13‐Jun Measles Sindh Khairpur Village Shehmeer, Photo Gopang 6 0 3 1

1 Post Measles case was reported. On field investigation total 10 suspected cases were found, Vitamin (A) drops provided. Information was shared with DHMT and intensified outreach vacci‐nation activity planned.

14‐Jun Pertussis Sindh Shikar‐pur

Village Sher dil Jatoi, UC karan 3 4 7 2

An alert of suspected Pertussis case was reported, during field investigation 13 more suspected cases were found, 29 children were assessed for routine immunization out of which 9(31%) found partially vaccinated, health education imparted, Erythromycin tabs provided to the cases and contacts, DHMT informed and 2 Naso Pharyngeal swabs were collected for lab confirma‐tion.

15‐Jun Pertussis Sindh Shaheed Benazir Abad

Village Habibullah Dahri 0 0 3 2

An alert of suspected Pertussis was notified, during field investigation 4 more suspected cases were found. House cluster was taken where 14 children were assessed for routine immuniza‐tion out of which BCG= 9(81%), Penta1=8(72%), Penta2=6(54%), Penta3=6(54%). Information share with DHMT.

15‐Jun Pertussis Sindh Shaheed Benazir Abad

Village Hakim Dahri 0 0 7 3

An alert of Pertussis was notified. During field investigation total 10 suspected cases were found, Cluster for routine immunization was taken from 10 houses where 11 children were assessed, BCG=8(72%), Penta1=6(54%), Penta2=6(54%), Penta3=5(45%). Information share with DHMT.



Province Khyber Pakhtunkhwa: 446 health facilities from 17 districts of Khyber Pakhtunkhwa reported to DEWS with a total of 128,792 patients consultations reported in week 24, 2012. Total 62 alerts were received while 9 outbreaks were identified and appropriate measures were taken. Altogether 53 alerts for Measles; 3 each for Leishmani‐asis; 2 for Typhoid; while 1 each for AWD, DF, NNT and Pertussis. Acute diarrhoea shows a slightly upward trend in KP.

Figure-5: Trend of acute diarrhoea diseases, province KPK

Province Sindh:

Figure‐3: Number of alerts received and responded, week 24, 2012 Figure‐4: Number of consultations by age and gender, week 24, 2012

Province Punjab:

Figure-6: Number of alerts received and responded week 21 - 24, 2012, province KPK

Figure-7: Trend of trend of acute diarrhoea, province Sindh

719 health facilities from 23 districts in province Sindh were reported to DEWS with a total of 352,625 patients consultations in week 24, 2012. Total 77 alerts received while 13 outbreaks were identified and appropriate measure were taken. Altogether 55 alerts for Measles; 10 for AWD; 5 for Pertussis; 4 for NNT; while 1 each for Acute diarrhoea, Typhoid and Scabies.

Figure-8: Number of alerts received and responded week 21 - 24, 2012, province Sindh

Figure-9: Trend of acute diarrhoea, province Punjab Figure-10: Number of alerts received and responded week 21 - 24, 2012, province Punjab

408 health facilities from 8 districts in province Punjab reported to DEWS with a total of 193,837 patients consultations in week 24, 2012. Total 54 alerts were received while 2 outbreaks were identified and appropriate measures were taken. Altogether 37 alerts for Measles; 5 for Acute diarrhoea; 3 each for AJS and Typhoid; 2 each for DF and Scabies; while 1 each for AWD and ARI. A slightly decline noted in the proportion of AD consultation in Punjab.

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< 1 yr 1‐4 yr 5‐14 yr 15‐50 yr 50 + yr

Male 27994 65528 83121 129836 60629

Female 27174 61040 86720 214745 67505

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State of Azad Jammu and Kashmir:

Province Gilgit Baltistan:

FATA:

Province Balochistan:

Figure-11: Trend of acute diarrhoea, province Balochistan Figure-12: Number of alerts received and responded week 21 - 24, 2012, province Balochis-

492 health facilities from 23 districts in province Balochistan reported to DEWS with a total of 80,992 patients consultations in week 24, 2012. Total 21 alerts reported while 6 outbreaks were identified and appropriate measures were taken in week 24, 2012. Altogether 10 alerts for Measles; 7 for Leishmaniasis; 3 for CCHF; while 1 for Scabies.

32 health facilities from 4 districts in Gilgit Baltistan reported to DEWS with a total of 17,418 patients consultations in week 24, 2012. 4 alerts were reported and appropriate response were taken in week 24, 2012; 2 alerts for Measles; while 1 each for Leishmaniasis and Pertussis.

Figure-13: Trend of acute diarrhoea, province Gilgit Baltistan Figure-14: Number of alerts received and responded week 21 - 24, 2012, Gilgit Baltistan

Figure-15: Trend of acute diarrhoea, FATA

51 health facilities from 3 agencies in FATA reported to DEWS with a total of 16,019 patients consultations in week 24, 2012. Total 7 alerts reported in week 24, 2012. Altogether 5 for Measles; while 2 for Leishmaniasis were reported and appropriated measures were taken.

Figure-16: Number of alerts received and responded week 21 - 24, 2012, FATA

Figure-17: Trend of acute diarrhoea, AJ&K Figure-18: Number of alerts received and responded week 21 - 24, 2012, AJ&K

118 health facilities from 9 districts in AJ&K reported to DEWS with a total of 30,069 patients consultations in week 24, 2012. Total 10 alerts reported in week 24, 2012. Altogether 8 alerts were for Measles; while 2 for Leishmaniasis were reported and appropriate measures were taken.

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Distribution of Wild Polio Virus cases Pakistan 2011 and 2012

• In week 24, 2012 no new type‐1 polio case was reported.

• As of 18 June 2012, Pakistan has reported a total of 22 polio cases (19 type‐1, 2 type‐3 and 1 mixture type‐1 & 3) from 13 districts/tribal agen‐cies.

Province Cases 2011 Cases 2012

P1 P3 P1 P1+P3

Punjab 9 ‐ 2 ‐

Sindh 33 ‐ 3 ‐

Khyber Pakhtunkhwa 23 ‐ 4 ‐

FATA 57 2 8 1

Balochistan 73 ‐ 2 ‐

AJ&K ‐ ‐ ‐ ‐

Gilgit‐Baltistan 1 ‐ ‐ ‐

Islamabad ‐ ‐ ‐ ‐

Total 196 2 19 1

P3

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‐

2

‐

‐

‐

‐

2

Table‐1: Total number of alerts and outbreaks reported and investigated with appropriate response Disease

2011 2012 (up till week 23) Current week 24, 2012

A O A O A O A O

Acute watery diarrhoea 1350 543 199 14 12 3 211 17

Acute jaundice syndrome 51 17 63 7 3 0 66 7

Bloody diarrhoea 98 20 74 5 0 0 74 5

Dengue fever 785 111 49 2 3 0 52 2

Measles 1708 110 2532 224 170 23 2702 247

Pertussis 287 81 262 105 7 4 269 109

NNT + tetanus 399 0 268 0 5 0 273 0

Malaria 131 88 66 40 0 0 66 40

Leishmaniasis 298 33 448 39 15 0 463 39

Others 645 69 743 60 20 1 763 61

Total 5752 1072 4704 496 235 31 4939 527

Total for 2012 (week 1‐24, 2012)

CCHF: CCHF is a serious viral hemorrhagic fever with up to 50% case fatality rate, caused by an RNA virus of family Bunyaviridae, genus

Nairovirus, carried by Hyalomma species of ticks. Human beings become infected by tick bites or crushing the ticks, which are usually found on sheep, cattle, goats or camels, and their slaughtered skins. They may also be exposed to the virus in blood or tissues of a viremic animal during its slaughter and butchering; or by contact with infected blood or secretions of acute human cases in home or hospital setting.

In Pakistan, the first known CCHF outbreak occurred during January 1976 at Rawalpindi General Hospital (RGH) among a surgical team. After above scenario, outbreaks were reported mostly from Balochistan province during 1978, 1987, 1994, 1995 and 1999 involving 4 to 9 cases per year.

In 2012, total of 26 suspected cases have been reported throughout the country with 20 confirmed to date and 6 deaths; (CFR is 30%). 15 cases have been reported from Balochistan; 4 each from KP and Sindh and 3 from Punjab. Chart at right illus‐trates current situation of CCHF cases in 2012.

Approximately all the cases have contact history with animal trading/handling, tick bite, contact with patient, tannery worker,

butcher/animals slaughtering, a traditional practice of wearing fresh animal skin (posti) to treatment ailment. These animals and their skins have continuous movement!intra Pakistan and between neighboring countries (Afghanistan and Iran).

Follow up of CCHF, Measles and Dengue

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Number of CCHF cases reported (Week 1 ‐ 24, 2012) Pakistan

Cases +ve Deaths



Table‐1

# of Alerts # of Outbreaks # of Cases # of Deaths

AJ&K 71 4 115 0

Balochistan 213 48 939 8

FATA 97 15 276 4

Gilgit Baltistan 14 0 15 0

ICT 10 2 38 0

Khyber Pakhtunk‐hwa 1110 56 2018 23

Punjab 370 21 661 12

Sindh 817 101 2038 36

Total 2702 247 6100 83

2012 (Week 1 ‐ 24)

Province

Table‐2

# of Alerts # of Outbreaks # of Cases # of Deaths

AJ&K 8 0 10 0

Balochistan 10 6 69 0

FATA 5 1 12 0

Gilgit Baltistan 2 0 2 0

ICT 0 0 0 0

Khyber Pakhtunk‐hwa 53 7 123 0

Punjab 37 2 60 3

Sindh 55 7 134 3

Total 170 23 410 6

Epi‐week 24, 2012

Province

Measles: As of 16 June 2012, more measles cases and deaths have been reported in Pakistan than in 12 months last year. Table 1 updates the situation of measles in 2012 up to 16 June; and table 2 illustrates about the alerts and outbreaks in week 24 (10‐16 June, 2012). As it is shown in the above table that majority of the measles cases have been reported from Sindh and Khyber Pakhtunkhwa provinces. Both of these provinces have announced the EPI facilities will be providing measles vaccine twice a week for all children under age 5. Dengue:

The chart at below show the weekly number of confirmed Dengue cases reported by surveillance focal points in the Departments of Health in Sindh and Punjab in 2012. Total number of confirmed dengue cases to date in 2012 is 61 in Sindh and 66 in Punjab. Month of peak incidence in 2010 was November while peak incidence in 2011 was in September and Octo‐ber.

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Trend of positive dengue cases, wk‐1 to wk‐24, 2012

Punjab Sindh



Alerts and outbreaks, week 24, 2012

Documents

Weekly Epidemiological - WHO...Ghazi City, UC Ghazi, RHC Ghazi 1 3 1 2 7 suspected Enteric Fever cases were reported. Blood samples were tested and Typhidot IgM found positive for