Weekly Epidemiological - WHO€¦ · Haripur Vilage Bandi, UC Kothera, Tehsil Ghazi 2 8 3 12 A suspected outbreak of AWD was reported from RHC Ghazi from village Bandi, UC Kothera

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. 34 (19 - 25 August, 2011) • 82 districts and 3 agencies provided surveillance data to the DEWS this week from 2,736

health facilities.

• A total of 872,608 consultations were reported through DEWS of which 18% were acute respiratory infections (ARI), 12% skin disease, 11% acute diarrhoea, and 7% suspected Malaria.

• A total of 168 alerts with 29 outbreaks were reported in week-34, 2011: Altogether 65 alerts were for AWD; 25 for Measles; 19 for DHF; 11 for Neonatal Tetanus and Tetanus; Ten for Pertussis; Nine for Leishmaniasis; Eight for Suspected Malaria; seven for Acute diarrhoea; Six for Bloody diarrhoea; Three for Chicken pox; Two for Typhoid; while one each for Meningitis, Mumps and Scabies.

• National Polio Eradication Initiative reported five new type-1 confirmed polio cases this week: These include two cases from Federally Administered Tribal Areas (Khyber agency), one case from Khyber Pakhtunkhwa province (Peshawar district) and two cases from Ba-lochistan province (Quetta and Killa Abdullah districts). Wild poliovirus type-1 was also isolated from a healthy child in Balochistan province (Quetta district). As of 28th August, Pakistan has reported a total of 77 polio cases (76 type-1 cases & 1 type-3 case) from 28 districts/towns/tribal agencies/areas.

Highlights

Disease early warning system and response in Pakistan

01

Volume 2, Issue 34, Monday 29 August, 2011

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)/ Suspected 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: Three years trend of Acute diarrhoea in Pakistan (2009, 2010, and 2011)

Disease Wk-27 Wk-28 Wk-29 Wk-30 Wk-31 Wk-32 Wk-33 Wk-34

Acute Diarrhoea 100,320 (10%) 104,413 (10%) 107,861 (10%) 103,098 (10%) 109,255 (10%) 106,918 (10%) 101,174 (10%) 93,312 (11%)

Total consultation 994,345 1,025,647 1,037,391 1,019,120 1,078,912 1,040,292 988,119 872,608

Since July 29, 2010, approximately 42,404,056 patient consultations have been reported to the DEWS from five provinces and three agencies and state of AJK. In this week 34, 2011 (19 to 25 August, 2011) reports were received from 2,736 health centers and the major causes for seek‐ing health care by the communities in almost all of the provinces were diarrheal diseases 93,312 (11%), acute respiratory infec‐tions 158,253 (18%), skin diseases 106,261 (12%) and suspected malaria 60,122 (7%). The above graph shows the trend of acute diarrhoea cases out of total consultations reported to DEWS in 2009, 2010 and 2011 up until now.

0

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16

20

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52

Percentage

Epi‐week

2009 2010 2011

Epidemiological Bulletin: DEWS, Pakistan, Week no. 34 (19 to 25 August, 2011)

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 Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

22‐Aug BD AJK Muzaffarabad Village Sarar, UC Gojra , Tehsil Muzaffarabad 3 4 0 0 Cluster of suspected cases of BD were reported from village Sarar Hassanabad. Stool sample collected and sent to NIH. DHO Muzaffarabad informed. Active surveillance found no other cases.

23‐Aug Malaria Balochis‐tan

Chagai BHU Sargesha 0 0 0 0 Malaria alert was reported. The case were examined clinically and patients were treated. 17 test were positive out of 30 (P.Vivax 10, P.Falciparium 7) SPR = 56.6%, while FR = 41.1%. DHO was informed and requested to provide RDTs, ACT andas Bed nets for further prevention.


Jaffarabad BHU Cattle form 11 21 9 23 An alert of Malaria was investigated for 64 reported cases. The cases were examined and slides test was taken. 10/17 of the slides verified positive ( P.Falciparium 5, P.Vivax 3, mixed 2) SPR = 58.8%, while FR = 70%. Medicines was provided. DHO was requested to provide bednets to the said location as a preventive measures.


Jhal Magsi RHC Jhal Magsi 8 33 7 15 Malaria alert was reported. Field investigation including RDTs test for suspected cases. 63 cases were reported, 53 samples were collected and 33 came out positive (P. Falciparum 10, P. Vivax 22, mixed 1) SPR = 66%, while FR = 33.3%. DHO and representative of malaria control program was informed and requested to take preventive measures.


Kharan BHU Sarawan 0 0 0 0 Malaria alert was reported. Field investigation was done via DEWS focal person. The case were examined clinically and blood test was taken. 20 test came positive out of 38 (9 P.Vivax, 7 P.Falciparium, 4 mixed) patients were treated, SPR = 52.6%, while FR = 65%. DHO was requested to provide RDTs, ACT and Bednets for prevention.


Nasirabad BHU Allah Dad Umrani, Tehsil Manjhi Shoorti

8 14 11 19 An alert of Malaria was investigated for 52 reported cases. Health facility was visited 15/22 (68%) found positive, (P.Falciparium 10, P.Vivax 4, Mixed 1) SPR = 68.18%, while FR = 73.3%. DHO and Merlin representative was informed and requested for distribution of bed nets to the affected community.

26‐Aug AWD Gilgit‐Baltistan

Ghizer

Village Bubar Khutum UC Bubar Tehsil Punial; Village Golodas near govt schoolTehsil Ishko‐man

0 1 0 1

Two cases of AWD were reported from Aga Khan Health Center Singal. Stool samples taken, Culture sensitivity done and found positive for V.c. Ogawa ,DHO Ghizer and area Medical Officer informed, Immediate case management procedures were adopted and patient recovered from acute stage on rehydration, active surveillance done in the area and no other cases were found. Health education session conducted with the patient, family and community notables for better hygienic practices. Aqua tab were distributed to the community, drinking water samples from different sources were collected and sent to Environmental Protection lab.

23‐Aug Visceral Leishma‐niasis

Gilgit‐Baltistan

Diamir Hudur Valley 0 0 4 0 DHQ hospital Chilas received four patients of suspected visceral Leishmaniasis which were later confirmed on bone marrow biopsy. On field investigation no other case found. Health education session conducted.EDO health and DSM PPHI informed about the patients. Glucantime treatment to start.

19‐Aug AWD Khyber Pakhtunk‐hwa

Haripur Village Pakh Shahi, UC Muslimabad

6 11 17 12

A suspected outbreak of AWD was reported from RHC Khanpur from village Pakh Shahi, Muslimabad as 8 cases were admit‐ted with AWD from same village. On active case finding 38 more patients were identified. 2 Stool samples were taken and sent to NIH which came back positive for V.c. Ogawa. Water samples were taken which also came back positive for contami‐nation. Aqua tabs, ORS and soaps were distributed. All the cases with AWD were treated and managed on the same day. Health and Hygiene session was conducted for the affected community. EDO Health was informed of the AWD cases.


Haripur Vilage Bandi, UC Kothera, Tehsil Ghazi

2 8 3 12

A suspected outbreak of AWD was reported from RHC Ghazi from village Bandi, UC Kothera as 9 cases were admitted with AWD from same village. On active case finding 16 more patients were identified. Stool samples was taken and sent to NIH. Water samples were also taken which came back positive for contamination. Aqua tabs, ORS and soaps were distributed house to house. All the cases with AWD were treated and managed on the same day. Health and Hygiene session was conducted for the affected community. EDO Health was informed of the suspected cases


Lower Dir Village Audigram, Maniyal, UC Lal Qilla, Tehsil Balmbat

1 2 1 0 AWD alert reported, Four cases identified, active surveillance done, stool sample collected and found positive for V.c. Ogawa. Water Samples taken for any fecal contamination, ORS, Hygiene kits & Aqua tabs distributed, Health & Hygiene promotion Session conducted with family members, EDO‐H was informed.


Lower Dir Village Kass Kandao, UC Lajbook, Tehsil Balmbat.

1 7 4 4 AWD alert reported, 16 cases identified. Active surveillance done, stool sample collected and sent to NIH. Water Samples taken for fecal contamination, ORS, Hygiene kits, Aqua tabs distributed, health and hygiene promotion session conducted with family members, EDO‐H was informed, WASH partners were requested for water Source protection.


Lower Dir Village Shahikoto, UC Koto, Tehsil Balmbat

4 17 4 21

AWD case was notified from DHQ Timergrah. Active surveillance done in area, 46 cases identified and investigated, stool sample collected for lab confirmation, Water Samples taken for fecal contamination, ORS, hygiene kits and Aqua tabs distributed, health and hygiene promotion session conducted with family members, EDO‐H was informed, HRDS was also involved during response, other wash partners were requested for interventions.


Lower Dir

Village Parpety, Gombaty, UC Kotkay, Tehsil Lal Qilla.

3 0 4 12 AWD alert reported, active surveillance done, 19 cases identified on active surveillance and investigated, stool sample collected for lab confirmation, Water samples taken for any fecal contamination, ORS, Hygiene kits and Aqua tabs were distributed, Health and hygiene promotion session conducted with family members, EDO‐H was informed.


Nowshera

Mohallah Moham‐madi Khel, Village Mian Essa, UC Mughalki

0 0 5 6

Elders of Mian Essa Village met the Deputy EDO Health & informed him about a number of diarrhea cases in their village. Suspected cases were investigated by WHO in collaboration with DoH. Sample taken & sent to NIH for confirmation. 11 cases of Acute Diarrhea found in the area. LHW's asked to cover the whole Union Council in two days for delivering hygiene related messages, stressing use of boiled water and distribution of Aqua tabs and ORS. Aqua tabs and ORS provided to LHW's. Diarrhea related medicines provided to the health facility. Medical camp being held in the village.

20‐Aug DHF Khyber Pakhtunk‐hwa

Haripur

Babu Muhallah; Village Jab, UC Jab; Chakaai Chappr Road

0 2 0 1

Three suspected cases of DF were reported by DHQ from different locations. Lab investigations revealed thrombocytopenia and leucopenia. Blood sample was taken and sent to NIH which came back positive for IgM Dengue. No more cases were found on active surveillance. A session on DF spread and prevention was conducted for the affected household. EDO Health was informed of the outbreak. Fog spray in the area is underway.

19‐Aug DHF Khyber Pakhtunk‐hwa

Peshawar Old Bara Road, Near Thana Kababi, University Town.

0 1 0 0 A suspected case of Dengue was reported from KTH, Peshawar. The Isolated patient was investigated & sample sent to NIH for confirmation which was found positive for Dengue, Relatives of the patients were educated.. The patient had a travel history to Lahore for his business there before his illness.

23‐Aug AWD Punjab Mianwali Mohallah Shareef Kheel no2,Daudkheel

2 2 2 5

Health facility reported that there are 11 patients of AWD with varying severity from same family. Stool sample taken from the patient admitted in Health Facility. Water sample was taken for water quality testing. Education about hygiene and health given to community, Medicine supplied to near health facility, aqua tabs, soaps and ORS distributed to patients families. Filters and water purification methods are also conveyed.

21‐Aug AWD Punjab Muzaffargarh

Basti jak Jhanboo, Moza Old Qureshi, UC Van Patafi; Basti Kot Lashari, Moza Gul qaim Mastoi, UC KD qureshi

2 5 3 9

AWD alert from two different locations. ERT had visited the area & suspect's stool swab sample was collected & sent to NIH. In the locality/area 20 households were interviewed and 4 more case of simple diarrhea were found & referred to health facility for treatment. Health education to family members in households visited. Distribution of water filters, buckets, soaps, Aqua Tabs, ORS & IEC among them. Nearest RHC Basera SMO joined investigation & was given briefing on the situa‐tion, control measures & importance of awareness among general masses about safe drinking water, food & personal hygiene.

19‐Aug AWD Sindh Karachi Radho Jokhio goth Gadap tawn

0 5 2 9 16 AWD cases reported and 2/3 stool sample taken found positive for V.c. Ogawa. Reinforced case management, Active surveillance done, Ringer lactate, Novadit, Flagyl inj provided Health education, EDO‐H informed.

20‐Aug AWD Sindh Larkana Village gabar UC Lashari ratodero

0 1 1 11 13 AWD cases reported, health and hygiene sessions done aqua tabs ,ORS, life straw, IEC, jerry cane distributed, stool and water samples collected, follow up done reports shred with EDO‐H. Referrals were arranged for severe cases. Environmental Health unit arranged chlorination of water source or other appropriate intervention.

22‐Aug AWD Sindh Mirpur Khas Village Deh‐164 A, UC Paban taluka Digri

1 2 2 4 AWD alert, reinforced case management, Active surveillance done, Aqua tabs, Life straw filters, Jerry cans, Bed nets and IEC Material provided Health education EDO‐H informed, 3 cases and 1 stool sample collected

25‐Aug AWD Sindh Nawabshah Village Wali Muham‐mad Mirasi, UC Sun, Taluka Qazi Ahmed

2 6 3 7 AWD alert, reinforced case management, Active surveillance done, Aqua tabs, Zinc tabs and ORS distributed Health educa‐tion, EDO‐H informed, 18 cases, 2 Stool and 5 Water sample collected in H2S Bottle.

21‐Aug Malaria Sindh Larkana Village mangria Talka bakrani

2 4 2 2 Malaria alert, 10 samples were collected and 8 found positive for Malaria (P. falciparum 1, 7 Mix) SPR = 80%, while FR = 100%. Investigation done record verified of facility foud correct response is planned for village reported to EDOH.

24‐Aug Malaria Sindh Thatta Village Khameeso samejo

2 4 4 8 27 suspected malaria cases were reported, 27 Blood sample collected out of them 18 were positive (P.Falciparium 16, P. Vivax 1, Mixed 1) SPE = 66.6%, while Fr = 94.4%. Active surveillance done, Health education and EDO‐H, DSM(PPHI) and Malaria Supervisor informed. Bed nets were distributed, Kerosene oil was sprayed on surrounding stagnant water.



Province Khyber Pakhtunkhwa:

• This week 20 districts reported to DEWS from 700 health facilities with a total of 153,418 patients con-sultations.

• AD cases reported were showing a consistent upward trend and between for 15% - 16% of the total consul-tations in last 4 weeks.

• 44 alerts were reported in this week, 24 were for

AWD, 14 for DHF and six for measles.

Figure-3: Three years trend of Acute diarrhoea, province KPK

Province Sindh:

• This week 21 districts reported to DEWS from 931 health centers with a total of 411,372 patient consul-tations during the reporting period of week 34, 2011.

• In Sindh, AD cases reported were 40,510 (10%), same proportional morbidity as compared with last week.

• 49 alerts were reported from Sindh in this week: 25 were for AWD; Eight were for Measles; Six for NNT and Tetanus; Two each for DHF, Leishmaniasis, Ma-laria and Pertussis; while one each for Bloody diar-rhoea and Chicken pox.

Figure-4: Three years trend of Acute diarrhoea, province Sindh

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

Post Flood 2010 2011 (up till wk 33) Total

A O A O A O A O

Acute Watery Diarrhoea 209 85 705 320 65 16 979 421

Bloody Diarrhoea 10 1 64 12 6 1 80 14

Measles 48 6 1269 80 25 ‐ 1342 86

Pertussis 1 ‐ 197 21 10 ‐ 208 21

Malaria 12 7 56 39 8 7 76 53

Leishmaniasis 1 ‐ 93 21 9 1 103 22

Others 156 43 451 47 34 4 641 94

Total 447 144 3012 552 168 29 3627 725

Current Week (34)

Acute Jaundice Syndrome 5 2 36 12 ‐ ‐ 41 14

NNT + Tetanus 5 ‐ 141 ‐ 11 ‐ 157 ‐

Table‐1: Leading causes of seeking health care in flood affected districts, 29 July 2010 to 25 August 2011, compiled from weekly reports

Diseases Total

Skin Diseases 4,606,062 (11%)

Acute Respiratory Infection 9,573,311 (23%)

Acute Diarrhoea 4,014,012 (9%)

Bloody Diarrhoea 362,297 (1%)

Suspected Malaria 2,492,717 (6%)

Unexplained Fever 1,620,532 (4%) Total Consultations 42,404,056

Figure‐2: Weekly number of reporting health facilities (Wk 33/2010 to Wk 34/2011)

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Epidemiological Bulletin: DEWS, Pakistan, Week no. 34 (19 to 25 August, 2011) Province Punjab: • 8 districts were reported data to DEWS from Punjab

province, 455 health facilities reported a total of 278,184 patient consultations during this reporting period

• AD cases reported were 13,973, and stabilized be-tween 7% - 8% from last four weeks.

• 26 alerts were reported in this week from Punjab; Nine for AWD; Six for AD; Four for NNT; Two each for Bloody diarrhoea and DHF; while one each for Measles, Pertussis and Scabies.

Figure-5: Trend of acute diarrhoea, province Punjab (3 August 2010 to 25 August 2011)


State of Azad Jammu and Kashmir:

• In this week, weekly report received from 82 health centers from 7 districts, with a total of 30,686 patient consultations.

• ARI cases reported were 3,504 (11%), while Acute diarrhoea re-ported 2,036 (7%) cases.

• Six alerts were received and responded this week; Two were for Measles, while one each for AWD, BD, DHF and Chicken pox.

• This week 53 health centers in 3 agencies reported from FATA, with a total of 8,272 patient consultations.

• ARI cases reported were 1,406 (16%), while Acute diarrhoea re-ported 1,055 cases (13%)

• One alert for AWD received and responded this week.

Gilgit Baltistan:

• In this week, 71 health centers from 7 districts in Gilgit Baltistan sent weekly report with a total of 23,546 patient consultations.

• ARI cases reported were 2,786 (12%), while Acute Diarrhoea 4,307 (18%).

• Nine alerts received and responded this week, Three for AWD; Two for BD, while one each for AD, Leishmaniasis, Malaria and Meningitis.

Figure-7: Trend of priority communicable diseases, Gilgit Baltistan (25 March to 25 Aug 2011)

FATA:

Province Balochistan:

• In this week, 17 districts reported to DEWS from Balochistan province. 429 health centers reported a total of 68,087 patient consultations.

• AD reported in 8,196 (12%) of the total consulta-tions, same proportional morbidity as compared with last week.

• 24 alerts were reported in this week from Balochis-tan, nine were for Leishmaniasis; Four each were for AWD and Pertussis; Three for measles, while one each for chicken pox, malaria, meningitis and Ty-phoid.

Figure-6: Three years trend of Acute diarrhoea, province Balochistan

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Current week's Alerts: Province Balochistan Date Disease District Area <5M >5M <5F >5F

20‐Aug AWD Quetta BMCH, Brewery Road 2 0 1 0

25‐Aug Chicken Pox Sibi Village pozak, Bakhara 3 0 1 0

19‐Aug Leishmaniasis Khuzdar Chandni Chaowk UC Faiz Abad 0 0 0 1

23‐Aug Leishmaniasis Khuzdar Natwani UC Baghbana Tehsil Khuzdar 0 1 0 0

24‐Aug Leishmaniasis Khuzdar Faiz Abad Chandni Chaowk Khuzdar 0 1 0 0

24‐Aug Leishmaniasis Khuzdar Norgama Tehsil Zehri 1 0 0 0

22‐Aug Leishmaniasis Lasbela Winder Town 0 2 0 0

24‐Aug Leishmaniasis Panjgur Union Council ,Bonistan Mohallah Madresa 0 1 0 0

23‐Aug Measles Quetta BMCH, Brewery Road 0 0 1 0

20‐Aug Measles Sibi Village Dehpal kolan 1 0 1 0

24‐Aug Pertussis Jaffarabad Ghot Ali Jamali, U/C Sameji, Tehsil U.M 2 0 0 0

24‐Aug Pertussis Nasirabad Ghot Mir Mohammad Bugti, Tehsil DMJ 2 0 1 0

25‐Aug Pertussis Nasirabad Ghot Sawali Khan Bugti, Tehsil DMJ 0 2 0 1

23‐Aug Pertussis Panjgur Union Council Chitkan ,Mohallah Taar 0 0 0 1

23‐Aug Pertussis Panjgur Washbood, Mohallah Madresa/serdar 0 1 1 8

24‐Aug Pertussis Panjgur Union Council Sordo ,Mohallah brohi 0 0 1 0

22‐Aug Pertussis Ziarat Ziarat town 1 0 0 0

19‐Aug Typhoid Chagai Killi Dilmurad cha padag 0 2 0 2

25‐Aug Typhoid Chagai Zahoor Colony Dalbandin 0 2 0 2

24‐Aug Measles Khuzdar Moza Gul Bhit UC Zeedi Tehsil Khuzdar 1 0 0 0

24‐Aug Measles Lasbela Mazar goth Beroot 5 1 1 1

24‐Aug Measles Panjgur UC Chitkan, Mohalla Taar office 0 1 0 0

23‐Aug Mumps Ziarat Ziarat, Cheena, Pechi 0 3 0 0

23‐Aug NNT Nasirabad Nursery ward of DHQ‐ Hospital D.M.J 2 0 0 0

23‐Aug Malaria Chagai BHU Sargesha 0 0 0 0

25‐Aug Malaria Jaffarabad BHU Cattle form 11 21 9 23

19‐Aug Malaria Jhal Magsi RHC Jhal Magsi 8 33 7 15

24‐Aug Malaria Kharan BHU Sarawan 0 0 0 0

25‐Aug Malaria Nasirabad BHU Allah Dad Umrani, Tehsil Manjhi Shoorti

8 14 11 19

23‐Aug Measles Khuzdar Civil colony Khuzdar 2 0 1 0

23‐Aug Measles Khuzdar Pat Mai UC Baghbana Tehsil Khuzdar 0 0 1 0

Current week's Alerts: AJK; FATA; GB and ICT Date Disease District Area <5M >5M <5F >5F

23‐Aug AWD Hattian Village Cham , P.O Chanari, Tehsil Hattiyan Bala

0 1 0 1

22‐Aug BD Muzaffara‐bad

Village Sarar, UC Gojra , Tehsil Muzaffara‐bad

3 4 0 0

24‐Aug Chicken Pox Kotli chak nasru sersawa kotli 0 2 0 0

25‐Aug DHF Bhimber DHQ Bhimber‐Kot Jamel Barnala 0 2 0 1

22‐Aug Measles Bagh vill chalandrat UC Rangla tehsil Dhirkot 0 0 1 0

24‐Aug Measles Bagh Vill Saliyan UC Dharay Tehsil Bagh 0 2 0 1

23‐Aug AWD Bajaur Agency

village Jabbare, Manu dherai Tehsil Ut‐mankhel

1 0 0 0

24‐Aug AD Diamir Civil hospital Darrel 30 62 36 55

26‐Aug AWD Ghizer Village Bubar Khutum UC Bubar Tehsil Punial; Village Golodas near govt schoolTehsil Ishkoman

0 1 0 1

25‐Aug AWD Gilgit Gilgit Town area 0 1 0 1

23‐Aug BD Ghanche Village Surmo UC Gorsy Khaplu 0 0 0 1

22‐Aug BD Skardu Village GhaziAbad Kachura 0 0 0 1

23‐Aug Leishmani‐

asis Diamir Hudur Valley 0 0 4 0

24‐Aug Malaria Diamir FAP Gayyal 3 2 4 1

22‐Aug Meningitis Skardu Village Sadat colony Gamba 0 1 0 0

23‐Aug AWD Islamabad FG Polyclinic 0 1 0 1

19‐Aug Measles Islamabad CH PIMS (bari Imam) 1 0 1 0

Current week's Alerts: Province Punjab Date Disease District Area <5M >5M <5F >5F

23‐Aug AD Bhakkar Mullan Wali City,Tehsil Bhakkar 0 8 0 5

22‐Aug AD Layyah chak no 91 ml, u/c 90 ml tehsil karoor 15 12 16 12

24‐Aug AD Rahim Yar Khan

Adam Wali, UC Akramabad, Tehsil Ra‐himyarkhan

7 8 6 5


Saadi Sultan, UC Rasoolpur, Tehsil Rahim Yar Khan

6 5 4 7


chak 92 P, UC 228 P, Tehsil Rahimyar Khan 4 8 5 12

25‐Aug AD Rajanpur RHC Kot Mithan; UC kot Mithan, Tehsil Rajanpur

40 39 18 26

23‐Aug AWD Mianwali Mohallah Shareef Kheel no2,Daudkheel 2 2 2 5

22‐Aug AWD Multan Khan Pur Qazi UC chack R/S, tehsil Shujabad 0 0 0 1

21‐Aug AWD Muzaffargarh Basti jak Jhanboo, Moza Old Qureshi, UC Van Patafi; Basti Kot Lashari, Moza Gul qaim Mastoi, UC KD qureshi

2 5 3 9

24‐Aug AWD Muzaffargarh Basti Kikryan Wala, UC Bhuttapur 0 0 0 2

24‐Aug AWD Muzaffargarh Basti Qazi Wala, Moza Laang Malana, UC City‐3

1 0 1 1

24‐Aug AWD Muzaffargarh Mohallah Khurshid Abad, UC Lutkeran 0 0 0 1

25‐Aug AWD Rahim Yar Khan

Basti Maharan, Mouza chak 92 P, UC 228P Tehsil Rahimyar Khan

0 1 0 0

25‐Aug AWD Rajanpur Jaafria Colony, House no. 5, Near Imam Bargaah, UC Rajanpur Gharbi

0 1 0 0

23‐Aug BD Layyah Moaza Dollo nasheeb U/c Lohanch nasheeb 0 2 0 1

24‐Aug BD Layyah Moaza jhakar U/c Jhakar pakka 1 0 2 0

22‐Aug DHF Multan Nishter Hospital; Y Block Multan, Chowk Ghanta Ghar

0 5 0 0

22‐Aug DHF Rahim Yar Khan

Sh. Zayed Hospital‐Church Road RY Khan & Jetha Bhutta

0 2 0 0

23‐Aug Measles D. G. Khan UC Urban 3 0 1 0 0

24‐Aug NNT D. G. Khan Ban Dhola uc Fazla Kach tehsil Tribal 1 0 0 0

25‐Aug NNT D. G. Khan Chabree Bala uc Yaroo 1 0 0 0

25‐Aug NNT Layyah U/c Shergarh tehsil choubhara 1 0 0 0

24‐Aug NNT Multan Lutfabad, Mouza Jarh 0 0 1 0

25‐Aug Pertussis D. G. Khan Basti Gadi Shumali uc Sokar tehsil Taunsa 1 0 0 0

25‐Aug Scabies Bhakkar Sial city, UC Sial, Tehsil Bhakkar 2 10 1 7



Current week's Alerts: Province Khyber Pakhtunkhwa Date Disease District Area <5M >5M <5F >5F

20‐Aug AWD Buner Chamo u/c sorray tehsil chagharzai 1 0 0 0

26‐Aug AWD Charsadda Najeemabad 0 1 0 1

19‐Aug AWD Haripur Village Pakh Shahi, UC Muslimabad 6 11 17 12

22‐Aug AWD Haripur Peshawar Adda, Near Afaq Hotel 0 0 1 0

22‐Aug AWD Haripur Village Razayaian, Bagra#2, UC Bagra 0 1 1 0

23‐Aug AWD Haripur Vilage Bandi, UC Kothera, Tehsil Ghazi 2 8 3 12

19‐Aug AWD Lower Dir Village Audigram, Maniyal, UC Lal Qilla, Tehsil Balmbat

1 2 1 0

23‐Aug AWD Lower Dir Village Kass Kandao, UC Lajbook, Tehsil Balmbat.

1 7 4 4

24‐Aug AWD Lower Dir Village Shahikoto, UC Koto, Tehsil Balmbat 4 17 4 21

25‐Aug AWD Lower Dir Village Parpety, Gombaty, UC Kotkay, Tehsil Lal Qilla.

3 0 4 12

25‐Aug AWD Nowshera Mohallah Mohammadi Khel, Village Mian Essa, UC Mughalki

0 0 5 6

24‐Aug AWD Shangla Village Basi Bagh/ Tehsil Alpurai 0 2 0 1

19‐Aug AWD Swabi RHC Yar Hussain, Mohallah Shaheen Abad. 1 3 0 2

24‐Aug AWD Swabi RHC Yar Hussain, Village Qadame, Yar Hussain 0 1 0 0

19‐Aug AWD Swat Village and UC Chuprial, Tehsil Matta 0 1 0 0

19‐Aug AWD Swat Village Shank Madyan, UC Chail, Tehsil Bahrain

0 0 0 1

19‐Aug AWD Swat Village Zor Kale, UC and Tehsil Bahrain 0 0 0 1

20‐Aug AWD Swat Village Chatai Kale Fazal Abad, UC & Tehsil Matta

0 0 0 1

20‐Aug AWD Swat Village Kala Kale Mehak Road, UC Kala Kale, Tehsil Kabal

1 0 0 0

22‐Aug AWD Swat Village and UC Kuz Shawar, Tehsil Matta 0 0 0 1

22‐Aug AWD Swat Village Barthana near Mosque, UC Barthana, Tehsil Matta

0 0 0 1

22‐Aug AWD Swat Village Kuz Shawar Saland, UC Kuz Sha‐war,Tehsil Matta

0 0 0 1

23‐Aug AWD Swat Village Sambat, UC Baidara, Tehsil Matta 0 1 0 0

24‐Aug AWD Swat Mohala Madai, Village and UC Shakardara, Tehsil Matta

0 0 1 0

19‐Aug DHF Abbotta‐bad

Banda Saad, UC Dhamtor 0 1 0 0

24‐Aug DHF Abbotta‐bad

Village: Akora, Qalandarabad 0 1 0 0

25‐Aug DHF Battagram Village Jahangirabad 0 0 0 1

20‐Aug DHF Haripur Awan Colony Near Afaq Hotel 0 0 0 1

20‐Aug DHF Haripur Babu Muhallah; Village Jab, UC Jab; Chakaai Chappr Road

0 2 0 1

22‐Aug DHF Haripur Near Poly Technique college, saraiSaleh UC Sarai saleh

0 1 0 0

22‐Aug DHF Haripur Railway Line New Abbadi Kangra Colony UC Panian

0 1 0 0

23‐Aug DHF Haripur Village Alam, UC Dheenda 0 1 0 0

24‐Aug DHF Haripur BHU Mang, UC Mang 0 1 0 0

24‐Aug DHF Haripur Choar Shareef 0 1 0 0

26‐Aug DHF Haripur KTH Peshawar (House No 15, Sector 2, Kan‐graa Colony)

0 1 0 0

19‐Aug DHF Peshawar Old Bara Road, Near Thana Kababi, University Town.

0 1 0 0

25‐Aug Measles Abbotta‐bad

Village Samlala, UC Langra 1 0 0 0

23‐Aug Measles Buner bagra village gokand dagar 4 3 0 0

22‐Aug Measles Charsadda Ahmad Ustaaz Kalllay 1 0 0 0

22‐Aug Measles Charsadda Ocha Muslimabad 0 1 0 0

23‐Aug Measles Charsadda Qalarai Kallay 1 0 0 0

25‐Aug Measles Haripur Afgha Refugee Camp Padhinna 0 0 0 1

Current week's Alerts: Province Sindh Date Disease District Area <5M >5M <5F >5F

22‐Aug AWD Badin Taluka Tando Bago 0 0 1 0

19‐Aug AWD Ghotki Village Walaidino Khawara UC Daidlai Taluka Pano Akil

0 0 0 1

22‐Aug AWD Ghotki Village Budho Bozdar UC jarwar 0 1 0 0

19‐Aug AWD Hyderabad Hali road Sabzi Mandi, Near BHU Hali road 1 0 2 0

24‐Aug AWD Hyderabad Latifabad 0 1 0 0

24‐Aug AWD Hyderabad Noorani Basti near Mustafa Park 0 0 0 1

22‐Aug AWD Jamshoro Railway colony Kotri 0 0 1 0

22‐Aug AWD Jamshoro Telegraph colony Kotri 1 0 1 0

19‐Aug AWD Karachi Radho Jokhio goth Gadap tawn 0 5 2 9

22‐Aug AWD Mirpur Khas Village Deh‐164 A, UC Paban taluka Digri 1 2 2 4

23‐Aug AWD Mirpur Khas Village Khaskheli mohalla, UC Girhore Sharif Taluka Digri

0 0 0 0

23‐Aug AWD Naushahro Feroze

Village Darya Khan Jalbani 2 0 0 0

25‐Aug AWD Nawabshah Village Wali Muhammad Mirasi, UC Sun, Taluka Qazi Ahmed

2 6 3 7

19‐Aug AWD Shikarpur Balouch Mohalla Pipal wala Khanpur 0 1 0 0

19‐Aug AWD Sukkur Village wali Dhino khooharo, UC Dadloi Talluka Panoakil

0 1 0 2

22‐Aug AWD Tando Allah Yar

Village Bado Machi, UC 1 Taluka Chamber 0 1 0 0

22‐Aug Measles Thatta Village Sirdar Shoro, UC Jhampir 1 0 1 1

24‐Aug Measles Thatta Village Hussain Mirbahar 3 0 1 1

24‐Aug Measles Thatta Village Soomar Meerbahar 4 0 0 0

25‐Aug Measles Thatta Abdullah Gandro 0 1 3 2

24‐Aug NNT Ghotki Village Pathan Mahar UC Bhaitoor 1 0 0 0

22‐Aug NNT Jacobabad Village Sargani near Jhal Magsi 1 0 0 0

25‐Aug NNT Karachi Neonatal ICU, NICH 1 0 1 0

22‐Aug NNT Khairpur Village Tando Shah UC & taluka Kot Diji 1 0 0 0

21‐Aug NNT Thatta Shedi Mohalla, Chohar Jamali 1 0 0 0

24‐Aug Pertussis Mirpur Khas Villaage Dharam Kohli, UC Makhan Samoo taluka Mirpurkhas

2 0 4 1

22‐Aug Pertussis Tharparkar Village Jetrar, UC Tar ajmed Taluka Chachro 2 0 2 1

19‐Aug Tetanus Shikarpur Shahi Bagh 0 1 0 0

20‐Aug AWD Larkana Village gabar UC Lashari ratodero 0 1 1 11

19‐Aug AWD Mirpur Khas IDP Camp, Village Daulat Laghari 0 0 0 0

19‐Aug AWD Mirpur Khas Village daulat Laghari, Khaskheli Mohalla, UC Daulatpur

0 0 0 0

22‐Aug AWD Tando Allah Yar

Village Bahar khan mirjat, UC Tando Soomro 1 0 0 0

19‐Aug AWD Tharparkar IDP Camp behind Naukot forte, UC Mohrano, Taluka Mithi

0 1 0 0

19‐Aug AWD Tharparkar IDP Camp, Naukot qila, UC Mahrano Taluka Mithi

0 1 0 0

20‐Aug AWD Tharparkar Village Diplo tawn, UC & Taluka Diplo 0 1 0 0

22‐Aug AWD Thatta Village Haji Abbas charan, UC Qadin dino shah, Taluka Shah Bundar

0 0 0 1

25‐Aug AWD Thatta Haji Muhammad Ali Chandio 2 0 1 1

20‐Aug BD Badin IDP Camp GD & UC Shadi Lodge 0 2 0 2

21‐Aug Chicken Pox

Thatta Chuk‐153 Gul Muhad Baran Jati 1 1 0 0

19‐Aug DHF Badin Army Welfare Sugar mill 0 1 0 0

19‐Aug DHF Ghotki Village Gul Baig Gadani UC Dhangro Taluka Mirpur Mathelo

0 0 1 0

20‐Aug Leishma‐niasis

Larkana Allah abad muhalla goli mar street larkana 0 1 0 0

22‐Aug Leishma‐niasis

Qambar Shahdadkot

Village bhuthi behram talka Miro khan 0 1 0 0

21‐Aug Malaria Larkana Village mangria Talka bakrani 2 4 2 2

24‐Aug Malaria Thatta Village Khameeso samejo 2 4 4 8

22‐Aug Measles Ghotki Village Chaglani UC bereri 0 1 0 0

24‐Aug Measles Ghotki Langah Muhalla village chaglani UC bereri 0 0 1 0

25‐Aug Measles Karachi Shershah Kemari tawn 1 0 0 1

24‐Aug Measles Mirpur Khas Village Kot Mirs 0 1 0 0



Distribution of Wild Polio Virus cases Pakistan 2010 and 2011

Year 2010: The total number of polio cases reported in 2010 is 144 includ‐ing 120 type‐1 cases and 24 type‐3 from 40 infected districts/towns/agencies. Year 2011: The total number of polio cases confirmed by the laboratory is 77 (76=type‐1, and 1=type3) till date from 28 districts.

Focus on:

While March and April are usually the months for pertussis outbreaks and more pertussis cases were reported from Sindh during this time, outbreaks of pertussis have continued in Sindh throughout 2011 up until now. Please see chart at right. Outbreaks of pertus‐sis started in KP and Balochistan in May and have also continued up until now. Punjab has had scattered cases since May and Gilgit‐Baltistan had an outbreak of 30 cases in August. Prevention of pertussis depends on main‐tenance of high coverage of routine immunization of all children under age one year. Pertussis, or whooping cough, is caused by bacteria called Bordatella pertussis and B parapertussis that live in the mouth, nose, and throat and spread very easily from child to child in droplets produced by coughing or sneezing. Following an incubation period of 9–10 days (range 6‐20 days), patients develop runny nose and cough. In the course of 1–2 weeks, coughing paroxysms ending in the characteristic whoop occur and may last four to eight weeks. The disease is most dangerous in infants, who should be hospitalized to ensure adequate oxygenation and nutrition. Estimates from WHO suggest that, in 2008, about 16 million cases of pertussis occurred worldwide, 95% of which were in developing countries, and that about 195,000 children died from the disease.

Pertussis is prevented by vaccination with at least 3 primary doses of pentavalent vaccine (DPT‐HepB‐Hib), given by the intramuscular route at ages 6 weeks, 10 weeks and 14 weeks in the EPI Pakistan sched‐ule.

Province Cases 2010 Cases 2011 P1 P3 P1 P3

Punjab 6 1 - -

Sindh 26 1 14 -

Khyber Pakhtunkhwa 19 5 7 -

FATA 63 11 23 1

Balochistan 6 6 31 -

AJK - - - -

Gilgit‐Baltistan - - 1 -

Islamabad - - - -

Total 120 24 76 1

0

10

20

30

40

50

60

70

80

Wk‐01

Wk‐03

Wk‐05

Wk‐07

Wk‐09

Wk‐11

Wk‐13

Wk‐15

Wk‐17

Wk‐19

Wk‐21

Wk‐23

Wk‐25

Wk‐27

Wk‐29

Wk‐31

Wk‐33

# of cases

Epi‐week

Province wise number of Pertussis cases by week,Pakistan (Wk 1 ‐ 34, 2011)

Sindh Balochistan Khyber Pakhtunkhwa Gilgit‐Baltistan Punjab



Alerts and outbreaks, week 34, 2011

Documents

Weekly Epidemiological - WHO€¦ · Haripur Vilage Bandi, UC Kothera, Tehsil Ghazi 2 8 3 12 A suspected outbreak of AWD was reported from RHC Ghazi from village Bandi, UC Kothera