Week ending August 29, 2020 Epidemiological Week 35
WEEKLY EPIDEMIOLOGY BULLETIN NATIONAL EPIDEMIOLOGY UNIT, MINISTRY OF HEALTH & WELLNESS, JAMAICA
EPI WEEK 35
Dracunculiasis (Guinea-worm disease)
Key facts
• Dracunculiasis is a crippling parasitic disease on the verge of eradication, with 54 human
cases reported in 2019.
• From the time infection occurs, it takes between 10–14 months for the transmission cycle
to complete until a mature worm emerges from the body.
• The parasite is transmitted mostly when people drink stagnant water contaminated with
parasite-infected water fleas.
• Dracunculiasis was endemic in 20 countries in the mid-1980s.
• The total of 54 cases in 2019 were reported from four countries: Angola (1 case), Chad (48
cases), South Sudan (4 cases) and Cameroon (1 case, likely imported from Chad).
Dracunculiasis is rarely fatal, but infected people become non-functional for weeks. It affects people
in rural, deprived and isolated communities who depend mainly on open surface water sources such
as ponds for drinking water.
Scope of the problem: During the mid-1980s an estimated 3.5 million cases of dracunculiasis occurred
in 20 countries worldwide, 17 countries of which were in Africa. The number of reported cases fell to
fewer than 10 000 cases for the first time in 2007, dropping further to 542 cases (2012). Over the past
eight years, human cases have stayed at double digits (28 in 2018 and a slightly higher number of 54
human cases in 2019.
Transmission, life-cycle and incubation period: About a year after infection, a painful blister forms –
90% of the time on the lower leg – and one or more worms emerge accompanied by a burning
sensation. To soothe the burning pain, patients often immerse the infected part of the body in water.
The worm(s) then releases thousands of larvae (baby worms) into the water. These larvae reach the
infective stage after being ingested by tiny crustaceans or copepods, also called water fleas.
People swallow the infected water fleas when drinking contaminated water. The water fleas are killed
in the stomach but the ineffective larvae are liberated. They then penetrate the wall of the intestine
and migrate through the body. The fertilized female worm (which measures 60–100 cm long) migrates
under the skin tissues until it reaches its exit point, usually at the lower limbs, forming a blister or
swelling from which it eventually emerges. The worm takes 10–14 months to emerge after infection.
https://www.who.int/news-room/fact-sheets/detail/dracunculiasis-(guinea-worm-disease)
SYNDROMES PAGE 2
CLASS 1 DISEASES PAGE 4
INFLUENZA PAGE 5
DENGUE FEVER PAGE 6
GASTROENTERITIS PAGE 7
RESEARCH PAPER PAGE 8
Released September 11, 2020 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- 78 sites.
Automatic reporting
2
SENTINEL SYNDROMIC SURVEILLANCE Sentinel Surveillance in
Jamaica
Map representing the Timeliness of Weekly Sentinel Surveillance Parish Reports for the Four Most Recent Epidemiological Weeks – 32 to 35 of 2020 Parish health departments submit reports weekly by 3 p.m. on Tuesdays. Reports submitted after 3 p.m. are considered late.
FEVER Temperature of >380C /100.40F (or recent history of fever) with or without an obvious diagnosis or focus of infection.
KEY VARIATIONS OF BLUE SHOW CURRENT WEEK
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Weekly Visits to Sentinel Sites for Undifferentiated Fever All ages: Jamaica, Weekly Threshold vs Cases 2020
2020 <5 2020 ≥5 Epidemic Threshold <5 Epidemic Threshold >=5
A syndromic surveillance system is good for early detection of and response to public health events. Sentinel surveillance occurs when selected health facilities (sentinel sites) form a network that reports on certain health conditions on a regular basis, for example, weekly. Reporting is mandatory whether or not there are cases to report. Jamaica’s sentinel surveillance system concentrates on visits to sentinel sites for health events and syndromes of national importance which are reported weekly (see pages 2 -4). There are seventy-eight (78) reporting sentinel sites (hospitals and health centres) across Jamaica.
REPORTS FOR SYNDROMIC SURVEILLANCE
Released September 11, 2020 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- 78 sites.
Automatic reporting
3
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.
FEVER AND JAUNDICE Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting with jaundice. The epidemic threshold is used to confirm the emergence of an epidemic in order to implement control measures. It is calculated using the mean reported cases per week plus 2 standard deviations.
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Weekly Visits to Sentinel Sites for Fever and Neurological Symptoms 2019 and 2020 vs. Weekly Threshold: Jamaica
2019 2020 Alert Threshold Epidemic Threshold
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Weekly visits to Sentinel Sites for Fever and Haemorrhagic 2019 and 2020 vs Weekly Threshold; Jamaica
2019 2020 Alert Threshold Epidemic Threshold
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Fever and Jaundice cases: Jamaica, Weekly Threshold vs Cases 2019 and 2020
2019 2020 Alert Threshold Epidemic Threshold
Released September 11, 2020 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- 78 sites.
Automatic reporting
4
ACCIDENTS Any injury for which the cause is unintentional, e.g. motor vehicle, falls, burns, etc.
KEY VARIATIONS Of BLUE SHOW CURRENT WEEK
VIOLENCE Any injury for which the cause is intentional, e.g. gunshot wounds, stab wounds, etc.
GASTROENTERITIS Inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhoea.
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Weekly visits to Sentinel Sites for Accidents by Age Group 2020 vs Weekly Threshold; Jamaica
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Weekly visits to Sentinel Sites for Violence by Age Group 2020 vs Weekly Threshold; Jamaica
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Weekly visits to Sentinel Sites for Gastroenteritis All ages 2020 vs Weekly Threshold; Jamaica
2020 <5 2020 ≥5 Epidemic Threshold <5 Epidemic Threshold >5
Released September 11, 2020 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- 78 sites.
Automatic reporting
5
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.
______________
* Dengue
Hemorrhagic Fever
data include Dengue
related deaths;
** Figures include
all deaths associated
with pregnancy
reported for the
period. * 2019 YTD
figure was updated.
*** CHIKV IgM
positive
cases
**** Zika
PCR positive cases
CLASS 1 EVENTS CURRENT
YEAR 2020 PREVIOUS
YEAR 2019
NA
TIO
NA
L /
INT
ER
NA
TIO
NA
L
INT
ER
ES
T
Accidental Poisoning 5 48
Cholera 0 0
Dengue Hemorrhagic Fever* NA NA
Hansen’s Disease (Leprosy) 0 0
Hepatitis B 0 11
Hepatitis C 0 2
HIV/AIDS NA NA
Malaria (Imported) 0 0
Meningitis (Clinically confirmed) 1 17
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 Deaths** 29 44
Ophthalmia Neonatorum 23 161
Pertussis-like syndrome 0 0
Rheumatic Fever 0 0
Tetanus 0 0
Tuberculosis 6 33
Yellow Fever 0 0
Chikungunya*** 0 1
Zika Virus**** 0 0 NA- Not Available
Released September 11, 2020 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- 78 sites.
Automatic reporting
6
NATIONAL SURVEILLANCE UNIT
INFLUENZA REPORT EW 35
August 23, 2020 -August 29, 2020 Epidemiological Week 35
EW 35 YTD
SARI cases 10 420
Total
Influenza
positive Samples
0 69
Influenza A 0 45
H3N2 0 4
H1N1pdm09 0 38
Not subtyped 0 3
Influenza B 0 24
Parainfluenza 0 0
Epi Week Summary
During EW 35, 10 (ten) SARI
admissions were reported.
Caribbean Update EW 35
Caribbean: Influenza and other respiratory virus activity remained low in the subregion. In Haiti and Jamaica SARI activity continue at epidemic levels.
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Weekly visits to Sentinel Sites for Influenza-like Illness (ILI) All ages 2020 vs Weekly Threshold; Jamaica
2020 2020 2020
Epidemic Threshold <5 Epidemic Threshold 5-59 Epidemic Threshold ≥60
Epidemiologic week
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Epidemiological Week
Jamaica: Percentage of Hospital Admissions for Severe Acute Respiratory Illness (SARI 2020) (compared with 2011-2019)
SARI 2020 Alert Threshold
Average epidemic curve (2011-2019) Seasonal Threshold
Epidemic Threshold
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A(H1N1)pdm09 A not subtyped A no subtypable A(H1)A(H3) Parainfluenza RSV AdenovirusMethapneumovirus Rhinovirus Coronavirus BocavirusOthers Flu B Positives % Positives
Released September 11, 2020 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- 78 sites.
Automatic reporting
7
Dengue Bulletin August 23, 2020 - August 29, 2020 Epidemiological Week 35 Epidemiological Week 35
Reported suspected and confirmed dengue
with symptom onset in week 35 of 2020
2020
EW 35
YTD
Total Suspected Dengue
Cases 0** 747**
Lab Confirmed Dengue cases
0** 1**
CONFIRMED Dengue Related Deaths
0** 1**
Points to note:
• ** figure as at September 9 , 2020
• Only PCR positive dengue cases
are reported as confirmed.
• IgM positive cases are classified
as presumed dengue.
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2018 suspected dengue 2019 Suspected Dengue 2020
Epidemic threshold Alert Threshold Monthly mean
Released September 11, 2020 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- 78 sites.
Automatic reporting
8
RESEARCH PAPER
Abstract Knowledge and Practice Related to Lifestyle Among Adults with Diabetes and Hypertension
Colleen Campbell1, Delani Campbell1, Khadijah Estick1, Mario McCallum1, Martin McIntosh1, Jourdain Masters1, Alliyah
Mentor1, Yakeev Morris1, Ta’Mal Phillip1, Gabriella Ranjit1, Orlando Smith1, Gayan White,1 Norman Waldron2
1MBBS Class of 2020, Department of Community Health and Psychiatry, Faculty of Medical Sciences, The University of the West
Indies, Mona, Jamaica 2Department of Community Health and Psychiatry , Faculty of Medical Sciences, The University of the West Indies, Mona,
Jamaica
Aim: To determine the level of knowledge and assess the lifestyle practices of adult patients with Diabetes
and/or Hypertension attending the primary health care clinics in Jamaica.
Background: Diabetes and Hypertension are among the leading causes of preventable morbidity and related
disability worldwide. The shift in disease burden from infectious diseases to non-communicable diseases has
been attributed to dietary and physical activity changes.
Method: In this cross-sectional study using 150 randomly selected adults from primary health care centres
in seven parishes of Jamaica. A 69-item interviewer-administered questionnaire was used. The questions
measured knowledge and lifestyle practices related to diet, smoking, exercise and alcohol consumption.
Results: The majority (%) of the sample was female (76%) and most persons were within the age group of
56 years or over (68.6%). The mean knowledge score of exercise was 4.7 (SD 1.2) with a score range of 1 to
6. No statistical differences presented in mean knowledge of exercise by socioeconomic and demographic
characteristics. Nine of the ten questions assessing knowledge of diet were answered correctly by the
majority (50.7% - 93.3%).
The mean knowledge score for alcohol consumption and smoking was 5.5 (SD 0.9) and 2.9 (SD 0.3),
respectively. Just over a half (52.3%) of the sample reported exercising (52.3%) and consuming sugar-
sweetened beverages (53%). Very little reported drinking alcohol in the last three months (10.7%) and a
minority (4.7%) of the sample reported that they are currently smoking.
Conclusion: Mean knowledge scores for exercise, alcohol consumption and smoking were relatively high,
while lifestyle practices among participants was relatively low. We recommend further research to assess the
facilitators and barriers to adopting lifestyle changes among Jamaican adults.
Keywords: Knowledge, Lifestyle, Practice, Diabetes, Hypertension
____________________________________________________________________________________
The Ministry of Health and Wellness
24-26 Grenada Crescent
Kingston 5, Jamaica
Tele: (876) 633-7924
Email: [email protected]