Pakistan Epidemiological Bulletins 2012

[Ronan Kelly]

Epidemiological week no. 4 (22 to 28 January, 2012)
? In week 4, 2012, total 77 districts including 1 agency provided surveillance data to the DEWS on weekly basis from around 1,618 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.**
? A total of 530,151 consultations were reported through DEWS of which 26% were acute respiratory infections (ARI); 5% were Skin disease; 5% were acute diarrhoea; and 4% were sus‐ pected malaria.** *
? A total of 140 alerts with 9 outbreaks were reported: Altogether 48 alerts for Measles; 21 for Leishmaniasis; 14 for Neonatal tetanus and tetanus; 14 for Pertussis; 9 for AWD; 7 each for ARI and Typhoid; 5 for Acute diarrhoea; 4 each for Bloody diarrhoea and Influenza; 2 each for Acute Jaundice syndrome, Malaria and Scabies; while 1 for unexplained fever.**
? In week 4, 2012,**four new type‐1 polio cases from Khyber Pakhtunkhwa (districts Peshawar, Kohat, Lakki Marwat and DI Khan). As of 28th January, the total number of polio cases in 2012 is 7; from 6 districts/towns/tribal agencies and areas.

see link for maps, details, graphs, trends; http://reliefweb.int/sites/reliefweb...eport_3487.pdf

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Weekly Epidemiological Bulletin
Disease early warning system and response in Pakistan
This weekly Epidemiological Bulletin is published jointly by the National Institute of Health, Islamabad and World Health Organization (WHO), Pakistan.
For Correspondence: NIH: eic.nih@gmail.com; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083; E-mail: wr@pak.emro.who.int.
Volume 3, Issue 6, Wednesday 15 February, 2012

Highlights
Disease early warning system and response in Pakistan
Volume 3, Issue 6, Wednesday 15 February, 2012
? In week 6, 2012, total 78 districts including 2 agencies provided surveillance data to the DEWS on weekly basis from around 1,736 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.
? A total of 547,889 consultations were reported through DEWS of which 26% were acute respiratory infections (ARI); 5% were Skin disease; 5% were acute diarrhoea; and 4% were suspected malaria.
? A total of 135 alerts with 6 outbreaks were reported: Altogether 65 alerts for Measles; 15for Leishmaniasis; 12 for Pertussis; 11 for Neonatal tetanus; 9 for Typhoid; 4 for Bloody diarrhoea; 3 each for AWD and suspected Malaria; 2 each for AJS; Diphtheria; Scabies and Unexplained fever; while 1 each for AD, DF; ARI; Meningitis and Rabies.
? In week 6, 2012, two new polio cases, 1 each reported from Khyber (FATA) and district Jhang (Punjab). As of 11th February, the total number of polio cases in 2012 is 11; from 8 districts/towns/tribal agencies and areas.

...

http://www.who.int/hac/crises/pak/sitreps/pakistan_epi_15february2012.pdf

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Bulletin archive: http://www.who.int/hac/crises/pak/si.../en/index.html

Volume 3, Issue 13, Wednesday 4 April 2012

Highlights
Epidemiological week no. 13 (25 to 31 March 2012)
? In week 13, 2012, total 87 districts including 3 agencies provided surveillance data to the DEWS on weekly basis from around 1,881 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.
? A total of 755,137 consultations were reported through DEWS of which 20% were acute respiratory infections (ARI); 7% were acute diarrhoea; 4% were suspected malaria; while 4% were Skin disease.
? A total of 164 alerts with 17 outbreaks were reported/identified in week 13, 2012: Altogether 93 alerts for Measles; 22 for Leishmaniasis; 13 for Typhoid; 9 for ARI; 6 for NNT; 5 for Pertussis; 4 for AWD; 2 each for Acute diarrhoea, Bloody diarrhoea, AJS, Scabies and Chicken Pox; while 1 each for Diphtheria and Dengue Fever.
? In this week no new polio cases was reported. As of 2 April 2012, the total number of polio cases confirmed by the laboratory is 15 from 10 districts/towns/tribal agencies and areas.

...

http://www.who.int/hac/crises/pak/sitreps/pakistan_epi_4april2012.pdf

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 14, Wednesday 14 April 2012

Highlights
Epidemiological week no. 14 (1 to 7 April 2012)
? In week 14, 2012, total 82 districts including 3 agencies provided surveillance data to the
DEWS on weekly basis from around 1,973 health facilities. Data from mobile teams is reported
through sponsoring BHU or RHC.
? A total of 621,004 consultations were reported through DEWS of which 20% were acute
respiratory infections (ARI); 8% were acute diarrhoea; 4% were suspected malaria; while 4% were
Skin disease.
? A total of 226 alerts reported while 23 outbreaks were identified in week 14, 2012: Altogether
131 alerts for Measles; 16 for Leishmaniasis; 14 Pertussis; 12 for Typhoid; 11 for NNT and
Tetanus; 9 for ARI; 8 each for Acute diarrhoea and Scabies; 6 for AWD; 5 for Bloody diarrhoea; 3
for AJS; 2 for Dengue fever; while 1 for Unexplained fever.
? In this week no new polio cases was reported. As of 9 April 2012, the total number of polio
cases confirmed by the laboratory is 15 from 10 districts/towns/tribal agencies and areas.
...

Volume 3, Issue 15, Wednesday 18 April 2012

Highlights
Epidemiological week no. 15 (8 to 14 April 2012)
? In week 15, 2012, total 82 districts including 3 agencies provided surveillance data to the
DEWS on weekly basis from around 2,010 health facilities. Data from mobile teams is reported
through sponsoring BHU or RHC.
? A total of 684,278 consultations were reported through DEWS of which 19% were acute
respiratory infections (ARI); 8% were acute diarrhoea; 4% were suspected malaria; while 4% were
Skin disease.
? A total of 247 alerts reported while 27 outbreaks were identified in week 15, 2012: Altogether
142 alerts for Measles; 30 for Leishmaniasis; 16 for NNT and Tetanus; 12 for Typhoid; 11
for Pertussis; 9 for acute diarrhoea; 7 for Scabies; 5 for ARI; 4 for Acute jaundice syndrome; 3 for
AWD; 2 each for Bloody diarrhoea and Diphtheria; while 1 each for CCHF, HF, Food poisoning and
Chicken Pox.
? In this week no new polio cases was reported. As of 16 April 2012, the total number of polio
cases confirmed by the laboratory is 15 from 10 districts/towns/tribal agencies and areas.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

CCHF outbreak from Week 15 report above;

13‐Apr CCHF; District: D. I. Khan; Area: Village Malana, Pakka Malana; Cases: 2 (males aged above 5)

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012 - CCHF outbreak in DI Khan District

Congo suspects in Dera
From the Newspaper | Our Correspondent | 15th April, 2012

DERA ISMAIL KHAN, April 14: Two suspected patients of Congo virus have been admitted in the isolation ward of District Headquarters Hospital Dera Ismail Khan, said MS Dr Khalid Aziz on Saturday.

He said the blood samples of the two patients had been sent to the National Institute of Health, Islamabad, for verification.
They were identified as Tariq and Ghulam Shabbir, residents of Malana area of Dera Ismail Khan.

Another doctor of the hospital told Dawn on condition of anonymity the patients seemed to have contracted the Congo virus as both suffered high fever and bleeding from their noses. The two patients are stated to be shepherds.

http://dawn.com/2012/04/15/congo-suspects-in-dera/

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012 - CCHF outbreak in DI Khan District

Volume 3, Issue 16, Wednesday 25 April 2012

Epidemiological week no. 16 (15 to 21 April 2012)
? In week 16, 2012, total 85 districts including 3 agencies provided surveillance data to the
DEWS on weekly basis from around 1,958 health facilities. Data from mobile teams is reported
through sponsoring BHU or RHC.
? A total of 690,808 consultations were reported through DEWS of which 18% were acute
respiratory infections (ARI); 9% were acute diarrhoea; 4% were suspected malaria; while 4% were
Skin disease.
? A total of 243 alerts reported while 23 outbreaks were identified in week 16, 2012: Altogether
133 alerts for Measles; 21 for AWD; 19 for acute diarrhoea; 14 each for Leishmaniasis and
Typhoid; 13 for NNT and tetanus; 9 for Pertussis; 6 for ARI; 4 each for Malaria and Scabies; 2 for
acute jaundice Syndrome; while 1 each for Bloody diarrhoea, CCHF, DF and Food poisoning.
? In this week no new polio cases was reported. As of 23 April 2012, the total number of polio
cases confirmed by the laboratory is 15 from 10 districts/towns/tribal agencies and areas.
...
18‐Apr CCHF Sindh Karachi
NIBD (National Institute
of Blood Disease), Gulshan‐
e‐Iqbal Town
0 1 0 0
1 confirmed case of CCHF was reported from NIBD, EDO representative accompanied during
investigation, case belongs to quetta, initially case was suspected for Malaria and anti Malarial
treatment given.Later on CCHF diagnosed by lab test. Platelets count reduced to 10,000,
patient attendent were sensitized regarding proper Hygiene, brief about the mode of transmission,
advised to use insect repellents and information shared with SO DEWS Quetta.
...

Volume 3, Issue 17, Wednesday 2 May 2012

? In week 17, 2012, total 87 districts including 2 agencies provided surveillance data to the
DEWS on weekly basis from around 1,958 health facilities. Data from mobile teams is reported
through sponsoring BHU or RHC.
? A total of 758,579 consultations were reported through DEWS of which 17% were acute
respiratory infections (ARI); 9% were acute diarrhoea; 5% were suspected malaria; while 4% were
Skin disease.
? A total of 246 alerts reported while 25 outbreaks were identified in week 17, 2012: Altogether
130 alerts for Measles; 25 for Leishmaniasis; 18 each for AWD and Typhoid; 17 for Acute
diarrhoea; 11 for NNT and tetanus; 9 for Pertussis; 8 for Bloody diarrhoea; 3 each for acute jaundice
syndrome and Scabies; 2 for DF; while 1 each for Malaria and ARI.
? In this week no new polio cases was reported. As of 30 April 2012, the total number of polio
cases confirmed by the laboratory is 15 from 10 districts/towns/tribal agencies and areas.
...
24‐Apr ARI Layyah BHU 136,UC Mandi Town <5M:13; >5M: 17; <5F: 20; >5F: 35
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 18, Wednesday 9 May 2012

Epidemiological week no. 18 (29 April to 5 May 2012)
• In week 18, 2012, total 86 districts including 3 agencies provided surveillance data to the
DEWS on weekly basis from around 1,998 health facilities. Data from mobile teams is reported
through sponsoring BHU or RHC.
• A total of 612,300 consultations were reported through DEWS of which 18&#37; were acute
respiratory infections (ARI); 10% were acute diarrhoea; 5% were suspected malaria; while 4%
were Skin disease.
• A total of 228 alerts reported while 26 outbreaks were identified in week 18, 2012: Altogether
128 alerts for Measles; 23 for acute diarrhoea; 14 for Leishmaniasis; 12 for Typhoid; 10 for
NNT and tetanus; 9 for AWD; 6 each for Bloody diarrhoea and Scabies; 5 for Pertussis; 4 for Dengue
fever; 3 for CCHF; while 2 each for Acute jaundice syndrome, Diphtheria, Malaria and ARI.
• In this week one polio case (type‐3) was confirmed by the laboratory from Federally Administered
Tribal Areas (Khyber Agency). As of 7th May 2012, Pakistan has reported a total of 16 polio
cases (13 type‐1, 2 type‐3 , 1 mix type‐1 and 3) from 10 districts/tribal agencies
...
30‐Apr CCHF Balochistan Quetta Fatima Jinnah Chest and
General Hospital Male aged above 5
One case of suspected CCHF was reported. Sample sent to NIH for lab testing and it came out positive confirms
an outbreak. On field investigation no more case was found. THQ Hospital Khanozai provided PPE kit
and Ribovarin. Resprestative from live stock took on board for taking intervention regarding disinfecting
Animals. Pateint's family was breifed regarding the disease and its prevention and in case if anybody develop
similar symptoms inform DEWS SO. District and Provincial health authorties was informed
...
Current Situation of CCHF:
In Pakistan, incidence peaks typically in June and September and as
thought to reflect the animal migrations with mixing of susceptible animals
and immune animals carrying infected ticks. However, it seems this year
the incidence is peaking early as ten suspected cases including four deaths
have been reported with date of onset from 5 April to 30 April 2012.
In 2012, 11 alerts/outbreaks have been notified by the DEWS teams. The
outbreaks reported from Punjab, KPK and Balochistan. Most of the cases
have history of close contacts with animals in Balochistan.
Table given at right briefs the situation of CCHF outbreaks in 2012
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 19, Wednesday 16 May 2012

Epidemiological week no. 19 (6 to 12 May 2012)
? In week 19, 2012, total 86 districts including 3 agencies provided surveillance data to the DEWS on weekly basis from around 2,148 health facilities. Data from mobile teams is reported through sponsoring BHU or RHC.
? A total of 735,567 consultations were reported through DEWS of which 17% were acute respiratory infections (ARI); 10% were acute diarrhoea; 5% were suspected malaria; while 4% were Skin disease.
? A total of 239 alerts reported while 26 outbreaks were identified in week 19, 2012: Altogether 143 alerts for Measles; 22 for Typhoid; 19 for Leishmaniasis; 11 for Pertussis; 9 for acute diarrhoea; 7 each for Malaria and AWD; 6 for Bloody diarrhoea; 5 for Scabies; 3 for CCHF; 2 each for AJS and Diphtheria; while 1 each for ARI, DF and Tetanus.
? In this week no new polio case was reported. As of 14 May 2012, Pakistan has reported a total of 16 polio cases (13 type‐1, 2 type‐3 , 1 mix type‐1 and 3) from 10 districts/tribal agencies
...
Focus on: Measles
In this week, DEWS team successfully responded 143 alerts and 13 outbreaks for measles. Increase in the number of cases this year compare to last year indicates that the children are not vaccinated against measles as no such campaigns have been planned this year. However, last year measles immunization campaign was organized in Feb 2011 which had reduced the significant number of cases.
Measles is a killer childhood disease. One in 15 people have complications with measles, and one in 1000 will die of it, but two doses of measles vaccine will protect people against the disease. WHO has set the target for measles elimination for 2015 which would require that more than 95% of the world children are covered by two doses of measles vaccine.
In 2011, 1708 alerts and 110 outbreaks had investigated by WHO‐DEWS team with the collaboration with department of health. 3890 measles cases and 64 deaths due to measles had been reported; while up till 12 May 2012, a total of 1787 alerts reported and 142 outbreaks identified in which 4047 cases and 48 deaths had been reported.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 20, Wednesday 23 May 2012

Epidemiological week no. 20 (13 to 19 May 2012)
? 86 districts have reported in week 20, 2012, Please see map.
? 2,137 health centres have reported to the Disease Early Warning System (DEWS) in week 20, 2012
? 790,282 patients? consultations were reported over the week 20 compared to 756,457 consultations reported on week 19, 2012.
? Measles: 145 alerts investigated, responding to 10 outbreaks involving 272 measles cases. The most explosive outbreak is in Karachi.
? CCHF: 3 new cases including one death positive for CCHF from Quetta, bringing total to 11 cases and four deaths.
? Acute diarrhoea: Trend of acute diarrhoea in on the rise in all provinces. Districts in Sindh and Punjab are investigating alerts for acute watery diarrhoea/suspected cholera.
? No new polio case was reported in week 20, 2012.
...
15‐May CCHF Balochistan Quetta
Jinnah town; Satelite
town; Kharotabad;
Khuchlak
5 females under 5, 1 female over 5
6 new suspected cases of CCHF reported from Quetta, 3 cases including one death confirmed positive by PCR, while 3 samples pending. Two of the suspected cases are contacts of confirmed cases and all others have history of handling animals or skins.
...
Focus on: Measles
...
In Pakistan, measles is an important cause of childhood morbidity and mortality. Measles outbreaks have been increasingly common in the country.
From 1st January to 19th May 2012, DEWS team have reported 1937 Alerts and identified and responded to 156 outbreaks (clustering of more than 5 cases in a locality) of Measles. During this period 4324 clinical cases and 49
deaths due to Measles have been reported.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 21, Wednesday 30 May 2012

Epidemiological week no. 21 (20 to 26 May 2012)
? Measles: 213 alerts investigated, responding to 14 outbreaks involving 433 measles cases.
? CCHF: 3 new cases including one death positive for CCHF from Quetta, bringing total to 12 cases and four deaths in last four weeks.
? Acute diarrhoea: Trend of acute diarrhoea in on the rise in all provinces. Districts in Sindh and Punjab are investigating alerts for acute watery diarrhoea/suspected cholera.
? No new polio case was reported in week 21, 2012.
? 88 districts have reported in week 21, 2012, Please see map.
? 2,202 health centres have reported to the Disease Early Warning System (DEWS) in week 21, 2012
? 809,858 patients? consultations were reported over the week 21 compared to 811,059 consultations reported on week 20, 2012.

...
Focus on: Follow up of Measles
Measles cases are drastically increasing in 2012 in all over the country especially in Sindh and Khyber Pakhtunkhwa.
Measles data of 2012 by each province / territory is shown in table 1, while table 2 illustrates the province wise distribution of measles alerts and outbreaks, numbers of cases and deaths in week 21, 2012.

(433 cases and 12 fatalities were reported this week bringing the totals to 4,804 cases and 61 fatalities. - Ro)

...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 23, Wednesday 13 June 2012

Epidemiological week no. 23 (3 - 9 June 2012)
? Measles: 168 alerts investigated, responding to 31 outbreaks involving 415 measles cases.
? CCHF: two new cases reported in week 23; In 2012, total of 27 cases have been reported throughout the country.
? Acute diarrhoea: Trend of acute diarrhoea in on the rise in all provinces. Districts in Sindh and Khyber Pakhtunkhwa are investigating alerts for acute watery diarrhoea/ suspected cholera.
? Five new polio cases were reported; As of 11 June 2012, Pakistan has reported a total of 22 polio cases (19 type‐1, 2 type‐3 & 1 mixture type‐1 & 3) from 13 districts/tribal agencies.
? 87 districts have reported in week 23, 2012, Please see map. 2,251 health centres have reported to the Disease Early Warning System (DEWS) in week 23, 2012
? 732,614 patients? consultations were reported over the week 23 compared to 792,763 consultations reported on week 22, 2012.
...
Follow up of CCHF, Measles and Dengue
CCHF:
CCHF is a serious viral hemorrhagic fever with up to 70% mortality 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 22 suspected cases have been reported throughout the country with 15 confirmed to date and 5 deaths. Out of 15 cases with linked history of Balochistan, 13 cases have been reported from Quetta. Chart at right illustrates current situation of CCHF cases in 2012. CFR is 33%.


Measles:
As of 9 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 and table 2 illustrates about the alerts and outbreaks in week 23 up to 9 June. [415 cases and 11 deaths are reported for week 23 bringing the total to 5,663 cases and 77 fatalities - Ro]

...
Dengue:
The chart to the right 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 60 in Sindh and 64 in Punjab. Month of peak incidence in 2010 was November while peak incidence in 2011 was in September and October.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 24, Wednesday 20 June 2012

Epidemiological week no. 24
(10 - 16 June 2012)
• Measles: 170 alerts investigated, responding to 23 outbreaks involving 410 measles cases.
• CCHF: In 2012, total of 20 confirmed cases have been reported throughout the country. 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 investigating 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 reported in week 24 compared to 770,838 consultations reported on week 23, 2012.
...
Follow up of CCHF, Measles and Dengue
CCHF:
CCHF is a serious viral hemorrhagic fever with up to 50&#37; 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 illustrates 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).
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). (6100 cases and 83 fatalities - Ro)
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 October.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 25, Wednesday 27 June 2012

Highlights
Epidemiological week no. 25
(17 - 23 June 2012)
? Measles: 173 alerts investigated, responding to 27 outbreaks involving 418 measles cases.
? CCHF: In 2012, total of 21 confirmed cases have been reported throughout the country. Most of the cases (12) directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab.
? 2 AWD outbreaks identified in 2 districts of Sindh and responded few confirmed cases in localities.
? Acute diarrhoea: Trend of acute diarrhoea is stable in all provinces. Districts in Sindh and Khyber Pakhtunkhwa are investigating alerts for acute watery diarrhoea/suspected cholera.
? No new polio case was reported; As of 25 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.
? 86 districts have reported in week 25, 2012, Please see map. 2,260 health facilities have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 812,072 patients? consultations were reported in week 25 compared to 833,414 consultations reported on week 24, 2012.
...
Follow up of CCHF, Measles and Dengue
CCHF:
...
In 2012, total of 28 suspected cases have been reported throughout the country with 21 confirmed to date and 6 deaths; (CFR is 30%). 17 cases have been reported from Balochistan; 4 each from KP and Sindh and 3 from Punjab. Chart at right illustrates 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).

Measles:
As of 23 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 23 June; (6530 cases and 93 fatalities - Ro)

Dengue:
The chart at right show the weekly number of confirmed Dengue cases reported by surveillance focal points from the Departments of Health in Sindh and Punjab in 2012. Total number of confirmed dengue cases to date in 2012 is 67 in Sindh and 72 in Punjab.
Month of peak incidence in 2010 was November while peak incidence in 2011 was in September and October.

Malaria:
The chart at right shows the malaria slide positivity rate and Falciparum rate reported in week 25, 2012. Total number of malaria cases tested in week 25, 2012 is 18995, out of which 4030 were found positive.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 26, Wednesday 4 July 2012

Highlights
Epidemiological week no. 26 (24 - 30 June 2012)
? Measles: 146 alerts investigated this week, responding to 23 outbreaks involving 382 measles cases, 8 deaths.
? AWD: 12 alerts investigated this week and 6 outbreaks identified in 5 districts of Sindh with 41 cases and 1 death; 1 outbreak in Thatta with confirmed V. c. Ogawa, 1 in Badin with V. c. Inaba, while 4 outbreaks are pending for labs result.
? No new CCHF case reported this week; In 2012, total of 21 confirmed cases have been reported throughout the country. Most of the cases (12) directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab.
? No new polio case was reported; As of 2 July 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 to DEWS in week 26, 2012, Please see map. 2,270 health facilities have shared weekly data to the Disease Early Warning
System (DEWS) in this week
? 835,476 patients? consultations were reported in week 26 compared to 838,795 consultations reported on week 25, 2012.
? Total 209 alerts were investigated, while response provided to 39 outbreaks.

...
Follow up of CCHF, Measles and Dengue

CCHF:
...
In 2012, total of 28 suspected cases have been reported throughout the country with 21 confirmed to date and 6 deaths; (CFR is
30%). 17 cases have been reported from Balochistan; 4 each from
KP and Sindh and 3 from Punjab.
...
Measles:
As of 30 June 2012, more measles cases and deaths have been reported in Pakistan than in 12 months last year. Table 1 summarizes the situation of measles in 2012 up to 30 June (6940 cases and 101 fatalities - Ro); and table 2 illustrates the alerts and outbreaks in week 26 (24‐30 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 right show the weekly number of confirmed Dengue cases reported by surveillance focal points from the Departments of Health in Sindh and Punjab in 2012. Total number of confirmed dengue cases to date in 2012 is 68 in Sindh and 72 in Punjab. Month of peak incidence in 2010 was November while peak incidence in 2011 was in September and October.

Malaria:
The chart at right shows the malaria slide positivity rate and Falciparum rate reported in week 26, 2012. Total number of malaria cases tested in week 26,
2012 is 20013, out of which 3812 were found positive; 2858 for P. Vivax; 598 for P. Falciparum; while 356 for Mixed (SPR = 19.05%; F. R = 25.03%)
...