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S
Hub W#155, 2011
E
EPIDEMIOL
LOGICAL BULLETIN
B
: FLOOD RE
ESPONSE IN
I NORTHE
ERN SINDH
H
DEW
WS Highlights:
Priiority dise
eases
Und
der surveillance
in the fllood affec
cted areas
s
Acute Flaccid
d Paralysis (AFP
P)
Acute Jaundiice Syndrome (A
AJS)
Acute Respirratory Infections
(Upper and Low
wer) (ARI)
Acute Wateryy Diarrhoea/ (AW
WD)
Suspected Cholera
C
Acute Bloodyy Diarrhoea (BD))
Other Acute Diarrhoea (AD)
er (VHF)
Suspected Hemorrhagic Feve
M
(Mal)
Suspected Malaria
Suspected Measles
M
(Ms)
Suspected Meningitis
M
(Mg)
Skin diseases and others
54%
59%
48%
311%
19%
22%
23%
36%
W2
35%
36%
37%
W3
W4
W5
64%
%
60%
67%
67%
67%
72%
48%
25%
8%
W6
W7
W8
W9 W10 W1
11 W12 W13 W14 W15
Figure:2:Northern
nSindhDistrictsresponseinDEWSr
reporting(Week1
12to15,2011)
W12
120%
100%
W13
98%
%
95% 95%95%
955% 95%95%95%
85%
84% 82%82%
9
92%
84%
%
81% 80%
80%
70%
W15
73%
55%
60%
50%
40%
36%
33%
40%
32%28%
30%
27%
WHONortthernSindhresponded1stoutbreakkofAWDon
th
14 April2011,atUCAbranTaluka,Naushe
eraFeroze.
92%
888%
91% 87%
W14
88%
84
4% 84%86%
20%
9%
0%
Figurre:3:DEWSdiiseasesreporrted
du
uringthewee
ek#15(2011
1)
Sukkkur
Shikarpur
Larkana
Kambe
er
Kashmore
Jaaccobabad
Ghotki
Khairpur
N..Feroz
Figure:4:DEW
WSdiseasesrep
portedduringthe
eweek#15(20
011)
AD,9%
LRTI,5%
URTI,16%
UF,4%
AL,10%
MA
SCB,13%
OTH,40%
DISEASES
D
AD
AFP
AJS
AWD
BD
EYE
HF
LRTI
MAL
MG
MS
OTH
SCB
SNB
UF
URTI
GTTK
14%
%
0%
%
0%
%
0%
%
25%
%
10%
%
0%
%
15%
%
9%
%
0%
%
0%
%
10%
%
6%
%
0%
%
5%
%
10%
%
JCB
6%
0%
0%
200%
4%
20%
0%
6%
5%
0%
0%
13%
10%
0%
8%
5%
KMR
17%
0%
47%
0%
16%
9%
0%
21%
17%
0%
0%
16%
19%
20%
16%
14%
KSM
M
1%
%
0%
%
0%
%
0%
%
1%
%
1%
%
0%
%
1%
%
2%
%
0%
%
0%
%
1%
%
2%
%
0%
%
3%
%
1%
%
KHP
12%
0%
29%
0%
14%
11%
0%
10%
15%
0%
0%
8%
12%
5%
24%
12%
LRK
14%
0%
3%
0%
22%
11%
0%
18%
13%
100%
0%
12%
20%
0%
15%
14%
NFZZ
12%
%
0%
5%
0%
4%
12%
%
0%
11%
%
24%
%
0%
0%
14%
%
7%
25%
%
1%
12%
%
SKP
12%
0%
16%
0%
7%
14%
0%
11%
8%
0%
0%
14%
10%
30%
8%
15%
SUK
11%
0%
0%
0%
6%
12%
0%
6%
6%
0%
0%
12%
15%
20%
22%
16%
Pagee 1
Northern Sindh
Hub W#15, 2011
Alerts Highlights:
Atotalof24alertswerereceivedandrespondedbyalldistrictsduringweekNo.15Outof24reportedalerts;Measles(9),Pertussis(4),(3)eachforTetanusand
Death,AWD(2)and(1) caseeachforSnakebite,viralencephalitisandDengue,whileno anycaseofPolioreportedatNorthernSindhHubduringweek15
(2011).
Districtwise
AlertsofWeek15
Ghotki
Jacobabad
Kambar
Kashmore
Khairpur
Larkana
NFeroze
Shikarpur
Sukkur
Figure:5:AlertsreportedatSukkurHUBduringweek#14&15(2011)
43%
38%
Week#14
22%
0%
0%
AFP
9%
4%
4%
Dengue
13%
0%
CPox
Death
Alert
No.of
cases
District
Age/Sex
8-Apr-11
AD
Jacobabad
>5M
9-Apr-11
Pertussis
Ghotki
<5F
9-Apr-11
Measles
Ghotki
<5F
9-Apr-11
Measles
Khairpur
<5F
9-Apr-11
Measles
Sukkur
9-Apr-11
Measles
Jacobabad
<5M
<5F,>5
F
10-Apr-11
Measles
Kashmore
<5M
11-Apr-11
Tetanus
Ghotki
<5F
11-Apr-11
Measles
Ghotki
<5M
11-Apr-11
Measles
Jacobabad
>5M
12-Apr-11
12-Apr-11
Pertussis
Pertussis
1
1
Sukkur
Sukkur
<5M
<5F
12-Apr-11
Measles
Sukkur
<5M
13-Apr-11
Snake bite
13-Apr-11
13-Apr-11
13-Apr-11
Death
Death
Death
Viral
Encephlitis
1
1
1
14-Apr-11
Dengue
9%
Qambar
Shahdadkot
Shikarpur
Shikarpur
Shikarpur
MS
Ghotki
Naushahro
Feroze
<5M
Naushahro
Feroze
All
groups
>5F
14-Apr-11
Pertussis
Sukkur
<5F
14-Apr-11
Tetanus
Larkana
>5F
14-Apr-11
Measles
Shikarpur
<5M
14-Apr-11
Tetanus
<5M
40%
AllARI,36%
30%
Mal+UF+
HF,24%
Skin
Dis.,23%
All
Diarrhea,17
%
20%
10%
0%
W7
W8
W9
4%
0%
S.bite
CausativeAgent
Acute Diarrhoea
Pertussis
Suspected Measles
Suspected Measles
Suspected Measles
Suspected Measles
Suspected Measles
Tetanus
Suspected Measles
Suspected Measles
Suspected pertussis
Suspected pertussis
Suspected Measles
Snake bit
PatientisadmittedinCMCLarkana,TIGreceivedbypatientprovidedbyWHO,onseton1242011,reportedbySODEWSLarkana
50%
W6
HIV
Actiontaken/Notes
60%
W5
V.E
A32yearsoldmalediagnosedandreportedsuspectedcaseofAcuteDiarrhoea,reportedbySODEWSJacobabad.
1suspectedcase,collectedspecimenandsenttoNIH,gaveerythromycintocaseandcontacts,uponfieldinvestigationfoundmany
unimmunizedchildrenandoutreachvaccinationscheduledforcommunity.
suspectedcaseofmeaslesfoundintheweeklyDEWSdataofRHCjarwaruponfieldinvestigationthreeyearsagebabyboynamedKanwalS/O
Srichandwithpostmeaslescasewithoutanyrashnosamplewascollectednoanyothercasefoundduringactivesearch
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,childwasinvestigated,norashandnofever,babywassickbutnotaccordingtoMeaslescasedefinition.
3suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
SuspectedcaseofTetanuswasadmitedinMCHcentrenotifiedbypediatricianhospitalinvestigationcompleted.TIGwasgivenpatient.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,uponfieldinvestigationfoundfalsereoprtedcase.
1suspectedcase,uponfieldinvestigationfoundthatitwasacasedefinitionproblem,vaccinationscheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,patientisadmittedatMuhammadiMedicalCenterSukkur,reportedby
SODEWSSukkur.
Shahdadkot
Figure:6:ProportionatePrioritydiseasesreportedatSukkurHUB
W4
TET
A60yearslady,reporteddeathduetoRenalFailure,on13042011.
A7monthsoldbaby,reporteddeathduetoAnaemia,on13042011.
A12yearslady,reporteddeathduetoaroadaccident,on13042011.
A7yearsoldgirl,sufferingfromViralEncephlitis,herthreeothersistershaveexpiredduringlastsixmonthswithsimilarcomplaints.Reported
bySODEWSGhotki.
1suspectedcase,admittedtodaywithnegativeantidengueIGM,negativeMPtest,platelets24000,fromAghaKhanlab,nowcaseisreferredto
Sukkurhospital.CrossnotifiedbySODEWSKhairpur.BloodsampletakenatRanipur,on07042011.
6AWDcasesatDHQN/Feroze,ondated1442011,respondedImmediately,3weredehydrated,allwerefromsamefamily,2stoolsamples
weretakenandshippedtoNIH,Islamabad,WHOmedicine(DDK)suppliedtoDHQthroughEDOH,HealthhygienekitandAquqtabs:distributed
tothisfamily,Hypothesesdeveloped.Watersampleswerealsocollected.
1suspectedcase,specimennotcollectedaspatienthadtakenantibiotic,uponfieldinvestigationfoundmanyunimmunizedchildrenandhealth
educationforcommunitycompleted.
PatientisadmittedinCMCLarkana,TIGreceivedbypatientprovidedbyWHO,onseton0842011,reportedbySODEWSLarkana
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
W3
Pert
0%
>5F
<5M
>5F
AWD
W2
AWD
4%
4%
0%
CasecommunicatedwithEDOH,ASVadministrated,patientarenowimproving,reportedbySODEWSLarkana.
14-Apr-11
W1
0%
>5M
Qambar
MG
0%
Week#15
13%
9%
8%
0%
Dateofalert
14-Apr-11
17%
Renal Failure
Anaemia
Anaemia
Viral Encephlitis
Negative anti dengue
IGM
AWD
Suspected pertussis
Tetanus
Suspected Measles
Tetanus
Figure:7:ProportionatePrioritydiseasesreportedatSukkurHUB
Week#
W1
W2
W3
W4
W5
W6
W7
W8
W9
W10
W11
W12
W13
W14
W15
AllDiarrhoea
5684(11%)
6842(11%)
7072(11%)
7453(10%)
6998(10%)
8812(10%)
7940(10%)
13638(12%)
8668(11%)
14030(12%)
15327(13%)
15746(14%)
16710(15%)
17042(16%)
19700(17%)
AllARI
23466(45%)
29266(45%)
30103(46%)
34281(46%)
32765(48%)
40753(46%)
34716(46%)
52439(45%)
35746(46%)
50801(42%)
48096(41%)
43955(39%)
40881(38%)
39458(37%)
41933(36%)
Weekly Epidemiological Bulletin Data source; District health office, PPHI, Teaching hospitals and private partners.
For Correspondence: ghyder.shaikh@gmail.com
WHO Northern Sindh Hub Sukkur: Tel : +92-071-5932871, Fax : +92-071-5932871
Mal+UF+HF
12041(23%)
13945(22%)
13852(21%)
16243(22%)
13557(20%)
19195(22%)
15576(20%)
26324(23%)
17308(22%)
28632(24%)
29115(25%)
27614(25%)
26054(24%)
25957(24%)
27952(24%)
SkinDis.
10525(20%)
14283(22%)
14088(22%)
17298(23%)
14847(22%)
20076(23%)
17750(22%)
24181(21%)
15564(20%)
26448(22%)
25693(22%)
25259(22%)
24202(22%)
24491(23%)
27012(23%)
Page 2