DEWS-WER-19-2012 (English)

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May 14, 2012
DISEASES EARLY WARNING SYSTEM
WER-19 (6th Yr)
DEWS WEEKLY EPIDEMIOLOGICAL REPORT
EPREPORT
SUMMARY:
 This report includes surveillance data from 5th April to 11th May 2012.
 Out of 300 functional Sentinel sites(SS), 300 (100%) have sent their reports in Week-19 of 2012;
 Out of total 305,799 events recorded in week-19 of 2012, 97,562227 (31.9%) consultations were reported due to
DEWS target diseases.
 Main causes of consultations this week are Acute Respiratory Infections/ARI (20.1%) and Acute Diarrheal
Diseases/ADD (10.6%) from total clients in a continuing trend from the week before.
 33 deaths caused due to Pneumonia, Diarrheal diseases and Meningitis/Severely ill children, so that 14 deaths due
to pneumonia, 6 deaths due to diarrheal diseases and 13 deaths reported due to Meningitis and Severely Ill
Children.
 In this reporting week, eight Measles outbreaks reported and investigated in Bamyan, Daykundi, Hilmand Takhar,
Hirat, and Khost provinces.
 Three poisoning in Balkh and Bamyan, one Pertussis outbreaks in Badakhshan and one Darmatitis outbreaks in
Kandahar reported and investigated.
REPORTS RECEIVED FROM REPORTING SITES:
As of May 11, 2012, 300 sentinel sites were functioning in eight epidemiological regions, in 34 provinces of
Afghanistan. In this reporting week, all 3 sentinel sites have sent their reports on new cases of DEWS target
diseases, recorded during the reporting. Out of all events recorded in DEWS sentinel sites, 15 target diseases
(priority diseases) are included in DEWS weekly epidemiological reports.
35
30
300
50
30
48
36
34
37
35
30
300
Page 1 of 10
Total
37
South
East
34
East
36
South
48
West
30
North
East
50
North
Central
West
No. of Expected
Reports from
Sentinel Sites
No. of Reports
Received in this
week
Central
East
Table-1: Status of Reports Rec00eived from DEWS Regions during Epidemiological week-19,
2012
DEWS Sentinel Sites:
Table-2
DEWS Epidemiological Regions and types of Sentinel Sites in
Out of total 305,799 clients recorded in week-19 of 2012, 17.2%
(52484) of consultations were reported due to cough and cold and
2.9% (8922) of consultations were reported due to pneumonia. In
the same reporting period, 10.6% or 32,445 events were reported
due to diarrheal illnesses (7.3% due to Acute Watery Diarrhea,
2.4% due to Bloody Diarrhea and 0.9% due to acute watery
diarrhea with dehydration). In comparison with previous week
(W18 of 2012) the percentage of ARI diseases has decreased by
0.8% to 20.1%, whereas the percentage of Acute Diarrheal
diseases increased by 1.6% to 10.6%.This variation can be due to
changes in temperature /weather during the reporting
week.Figure-2 above shows the percentages of DEWS target
diseases by age groups in week-19 of 2012.
Page 2 of 10
30%
25%
20%
15%
10%
5%
0%
Total
South
East
East
South
West
North
East
Centr
al
West
North
Centr
al East
Figure-1(Map)
shows
the
Week-18, 2012
distribution of DEWS sentinel sites,
already established in the relevant
Type of
SS
regions/provinces till May 11, 2012
by type of health facilities. Data on
19
33 25
20 28 25
22
194
CHC/BHC 22
15 DEWS target diseases are being
12
7
10 7
9
4
7
4
60
collected from these sentinel sites DH
4
5
4
4
5
3
4
43
PH/RH/SH 14
(SS).The symbols on the map show
0
0
0
1
0
0
0
3
the number of sentinel sites in each Poly Clinic 2
Total
50
30
48
36
34
37
35
30
300
region/province,
and
do
not
CHC=Comprehensive Health Center, DH=District hospital, PH=provincial
indicating the GPS of the SS
hospital, RH= Regional hospital, SH= specialized hospital
locations.
DEWS Data in Epidemiological Week-19 of 2012
Fig-2: Percentages of DEWS Target
Diseases by age Group in W19 of 2012
ARI ARI
AwD
C&C Pn
BD
AwD Men AVH Mea Mala Typh
w /SIC ep sle ria Fev
U5% 25%
7%
15%
4%
2%
0%
0%
0%
0%
0%
O5% 14%
1%
4%
2%
1%
0%
0%
0%
0%
1%
Tot% 17.2% 2.9% 7.3% 2.4% 0.9% 0.1% 0.1% 0.1% 0.4% 0.5%
Percentage of ARI by weeks and by Age Groups
In the epidemiological week-19, a total of 61,406 events of ARI were reported. 25 % of total clients less than 5 years of
age were cough & Cold patients and 14% among the age group 5 years and over. The percentage of C&C (<5 years)
Table-4: Percentages of ARI Diseases during 11 recent weeks by age groups and by weeks
Disease
Age
ARI- C&C
Week
09-12
(%)
<5 Yr.
5+
<5 Yr.
>=5 Yr
ARIPneumonia
Week
10-12
(%)
34.4
19.3
11.3
2.5
Week
11-12
(%)
32.4
17.9
11.6
2.1
Week
12-12
(%)
31.6
18.0
10.2
2.1
29.1
17.2
9.7
2.1
Week
13-12
(%)
30.3
16.3
9.2
1.9
Week
14-12
(%)
28.3
14.6
9.0
1.8
Week
15-12
(%)
27.1
15.0
8.6
1.7
Week
16-12
(%)
27.6
14.3
8.0
1.4
Week
17-12
(%)
27.8
14.6
7.5
1.5
Week
18-12
(%)
25.6
14.5
6.7
1.4
Week
19-12
(%)
25
14
7
1
consultations in week-09, in comparison with the percentage of C&C in week-19 of 2012, decreased by 9.4%, whereas in
case of 5 years and above decreased by 5.3% to14% in this reporting week. The trend of ARI diseases in last 11 weeks
can be read in table-4. The percentages of consultations on Pneumonia cases of age group less than 5 years decreased by
4.3% in last 11 weeks, whereas the percentage of age group 5 years and over decreased by 1.5% to 1% in last 11 weeks.
In the reporting week-19 of 2012, the highest percentage of Cough & Cold has been recorded in Kapisa and Logar
provinces with 28% and 25 respectively, whereas the lowest percentages of C&C were reported from Farah province with
9 %. The highest percentages of Pneumonia reported from Sar-i- Pul and Jawzjan provinces with 9% and 8%
respectively, whereas the lowest percentage was recorded in Zabul province with less than1%. (Fig-3)
Percentages of ARI from Total Clients in week-19 of 2012
35%
30%
25%
20%
15%
10%
5%
0%
BDS BAL
Pneumonia
BA
GH
JO
KH
NA
SA
WA
BD
GH
UR
NU
DAY FYB
HEL HER
KAN
KDZ LOG
PKA PIA PAR
SAR TAK
ZAB KAB BGL
FRA
KAP PAN NIM
KNR LAG
M
A
W
O
N
M
R
G
O
U
R
4% 4% 6% 3% 2% 2% 2% 1% 8% 1% 1% 3% 3% 2% 2% 1% 1% 4% 9% 3% 5% 0% 3% 6% 1% 1% 5% 2% 2% 0% 1% 2% 2% 4%
Cough&Cold 13% 23% 17% 25% 25% 20% 14% 18% 18% 12% 24% 17% 25% 19% 16% 21% 20% 17% 14% 16% 21% 11% 13% 16% 11% 9% 16% 28% 17% 17% 10% 24% 9% 23%
Percentages of Diarrheal Diseases by weeks and by Age Groups
The table-5 below shows the percentages of diarrheal diseases (Acute watery Diarrhea, Bloody Diarrhea and Acute watery
Table-5: Percentages of Diarrheal Diseases from Total Clients during 11 recent weeks by age groups.
Disease
Age
Week
0912(%)
Wee
(10-12
(%)
Week
11-12
(%)
Week
12-12
(%)
Week
13-12
(%)
Week
14-12
(%)
Acute Watery
Diarrhea
<5 Years
>= 5 Years
<5 Years
>=5 Years
<5 Years
≥5 Years
5.9
1.7
1.9
1.0
0.6
0.1
6.5
1.8
2
1
0.6
0.2
6.3
1.9
2.1
1.0
0.6
0.2
7.2
2.2
2.0
1.1
0.7
0.2
7.7
2.2
2.2
1.1
0.7
0.2
9.3
2.4
2.5
1.1
1.0
0.2
Bloody Diarrhea
Acute W. Diarrhea
with Dehydration
Week
15-12
(%)
10.6
2.7
2.6
1.2
1.1
0.2
Week
16-12
(%)
Week
17-12
(%)
Week
18-12
(%)
Week
19-12
(%)
13.2
3.1
3.0
1.3
1.5
0.3
13.6
3.2
2.6
1.2
1.7
0.3
13.6
3.4
3
1.3
1.6
0.4
15
4
4
2
2
1
diarrhea with dehydration) from week-09 to week-19 of 2012, from total clients. Acute watery diarrhea among children
less than five years has been increased from 5.9% in week-09 to 15% in the reporting week, whereas acute watery
diarrhea among age group 5 years and above has increased by 2.3% to 4%.(Please refer to Table-5, above).Bloody
diarrhea, in age group less than 5 years increased by 2.1% in last 11 weeks, while in case of age group 5 years and above
increased by 1% in the same period. Acute watery diarrhea with dehydration in age group less than 5 years increased by
1.4%, in case of five years and above increased by 0.9% in last 11 weeks.
Page 3 of 10
20%
Percentages of Diarrheal Diseases from Total Clients in week-19 of 2012
AWDwD
15%
BD
AWD
10%
5%
0%
Percentages of suspected Meningitis/SIC, Malaria and Typhoid Fever by Region:
Fig -5: Percentages of Men/SIC Malaria & Typhoid
1.6% Fever from Total Clients in Week-19 of 2012 by Region
1.4%
1.2%
1.0%
0.8%
0.6%
0.4%
0.2%
0.0%
North
Centra
Centra
North
West
South
East
l West
l East
East
South
East
Men/SIC
0.1%
0.2%
0.1%
0.1%
0.1%
0.1%
0.0%
0.0%
Malaria
0.1%
0.2%
0.1%
0.1%
0.1%
0.4%
1.6%
0.9%
Typhoid Fev 0.6%
0.4%
0.5%
0.3%
0.3%
0.8%
0.7%
0.8%
Diphtheria
Vaccine Preventable Diseases
1.8%
Pertussis
In the epidemiologic week-19 of 2012, a total of 224
suspected cases of Meningitis/Sever Ill Child were
reported from all regions and the highest percentage was
recorded in North region. In the same reporting week,
from all regions 1327 consultations were reported by
Sentinel Sites to be malaria and the highest percentage of
Malaria cases were reported from East region with 1.6%.
Out of the total clients, 1500 cases or 0.5% in national
level were reported to be suspected Typhoid Fever and the
highest percentage of Typhoid Fever was reported from
South and South East region with 0.8% each and followed
by East regions with 0.7%.
Page 4 of 10
Acute
Flaccid
Paralysis
Tetanus
/New Natal
Tetanus
Measles
Viral
Hepatitis
Meningitis/
Sever Ill
Child
In DEWS target diseases (priority diseases) seven
vaccine preventable diseases are included,
so that their occurrences are changing by Table-6: Suspected Cases of Vaccine Preventable Diseases in
W19 of 2012 by Region
seasonal variations. Among these diseases
Meningitis/severely ill child is being
reported mostly in North region, in this
Regions
week out of total 224 cases in country
level, 78 cases have been reported from
North region and 55 cases were recorded in
25
7 29
0
0
0
0
North East
central east region.
78
6 51
3
0
0
2
In general the highest number of cases of North
13
5 20
0
0
0
1
viral hepatitis being reported from East, Central West
south East and central east regions, so that West
19
9
6
0
0
0
0
in the reporting week out of total 290 Central East
55 169 70
4
0
1
1
cases, 51 cases from east, 36 cases from South
16
7 18
1
0
1
3
South-east and 169 cases from Central East
13
51 136
0
0
2
1
East
region were reported. From total 343
5
36 13
0
0
0
0
Measles cases reported in the reporting South East
224 290 343
8
0
4
8
week, 136 cases were recorded in East Total
region, while 70 cases recorded in Central East region.
Percentages of ARI & Diarrheal Diseases by Epidemiological Weeks(from W22 of 2011 to W19 of 2012)
Among the DEWS target diseases, Acute Respiratory Infections (ARI) and Acute Diarrheal Diseases (ADD) as leading causes of morbidity and mortality,
having the highest frequency of consultations. The following Line-Chart shows the trend of ADD and ARI from week-22 of 2011 to week-19 of 2012. In week22 of 2011, the ARI and ADD curves crossed each other, so that ARI started decreasing and ADD changed its course to increase. By the end of Summer season
of 2011 these curves crossed one another again in week-37 and from that time to week 6 of 2012, in general the percentage of ARI was increasing, while the
percentages of ADD were falling /decreasing, but week-09 of 2012 was a turning point for both categories of ARI and Diarrheal diseases i.e. ARI started
decreasing, while ADD started increasing. In this week (Week-19 of 2012) in comparison with previous week, ARI decreased by 0.8% to 20.1%, while the
percentage of ADD increased by 1.6% to 10.6%.
35
Trend of ARI/ADD as Propotion of Total Clients From Week-22 of 2011 to Week-19 of 2012
30
28.1 28
25
20
15
10
5
26.125.7
23.2
22
21.8
17.1
20.7
16.2 16.116.8 16 15.916.215.816.115.8
20
15.315.5 15.8
15
18.8
14.1
17.9
13.5
13.3 17.6
12.4
16.3
15.4 11.1
14.9
14.3
10.110.1
13.813.913.4 13.6 13.2 13.8
9.2
13
12.9 12.812.413.412.8 12.8
8.5 8.2
11.5
7 7.3
ARI
26.926.8
25.3
24.4
22.5 22.421.521.7
20.9
20.1
10.6
8.5 8.6 9
7.2
6.6 6.2
6.3
5.7 5.5
5.6
5.5
4.9 4.9 4.6 4.7 4.5 4.3 4.4
4.9
4.2 4.0 4.4 4.7
ADD
0
W22-11
W23
W24
W25
W26
W27
W28
W29
W30
W31
W32
W33
W34
W35
W36
W37
W38
W39
W40
W41
W42
W43
W44
W45
W46
W47
W48
W49
W50
W51
w52
W-1-12
W2-12
W3-12
W4-12
W5-12
W6-12
W7
w8
W9
w10
W11
W12
W13
W14
W15
W16
W17
W18
W19
P
e
r
c
e
n
t
a
g
e
s
31.2
30.5 31.530.830.529.9
29.529.9
29.328.9
Weeks of the Year
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal outbreaks of avian influenza, anthrax, brucellosis or other
zoonoses should be reported immediately to the DEWS team in the relevant province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO
CSR/DEWS Technical Officer, 0708811856,[email protected]
Mortality:
Type of outbreak
Pertussis
Avian/Swine Flu
ARI
Measles
Diarrhea
Meningitis
Hepatitis
Malaria
Typhoid
CCHF
Bl. Diarrhea
Chickenpox
Other
Total
Total
South
East
East
South
Central
East
West
Central
West
North
North
East
Among
DEWS
target
Table-7: Deaths by Main Causes of Mortality and by Region in W19 of 2012
diseases
Pneumonia,
Diarrheal diseases and Main
Meningitis/ Severely Ill Causes of
Children (SIC) are main Deaths
causes of mortality which
make in general more than Pneumonia
1
4
4
0
0
1
1
3
14
95% of total deaths of
surveillance target diseases. Diarrheal
3
0
0
0
0
2
1
0
6
Usually deaths due to Diseases
diarrheal diseases increases Meningitis
3
5
0
3
0
1
1
0
13
during summer season,
while the number of deaths due to Pneumonia increases during cold period/Winter Season. In this week out of
33 deaths reported from all regions, 14 deaths caused by Pneumonia, 13 deaths caused by Meningitis/severely
ill children and 6 deaths were caused by diarrheal diseases. (Table-7)
Number of Outbreaks investigated in 2012 with details of W18/W19
Reported outbreaks since first week of 2012 to date
Investigated
Rumor
Clinic-ally/lab
13
1
12
7
116
3
7
113
2
2
2
2
15
155
2
6
13
149
Epidemiological week-18


Suspected Measles Outbreak: reported from Kandi villages of Khaiderkhil Mandozi district
of Khost province on April 28 /2012, the team investigated the area on the same day and
during the investigation there were suspected measles cases , the team collected the specimens
and send it to CPHL , the cases treated and the vaccination campaign conducted in surrounding
villages, the team is investigating for further case
Suspected Measles Outbreak: reported from Dowaba villages of Gardez district of Paktya
province on April 29 /2012, the team investigated the area on the following day and during the
investigation there were 14 suspected measles cases , the team collected the specimens and send
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal
outbreaks of avian influenza, anthrax, brucellosis or other zoonoses should be reported immediately to the DEWS team in the relevant
province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO CSR/DEWS
Technical Officer, 0708811856,[email protected]





it to CPHL , the cases treated and the vaccination campaign conducted in surrounding villages,
the team is investigating for further case
Suspected Measles Outbreak: reported from Sabar villages of Sarhawza district of Paktika
province on April 30 /2012, the team investigated the area on the following day and during the
investigation there were 16 suspected measles cases , the team collected the specimens and send
it to CPHL , the cases treated and the vaccination campaign conducted in surrounding villages,
the team is investigating for further case
Suspected Measles Outbreak: reported from Penja villages of Shor -tepa district of Balkh
province on May 02 /2012, the team investigated the area on the following day and during the
investigation there were 11 suspected measles cases , the team collected the specimens and send
it to CPHL , the cases treated and the vaccination campaign conducted in surrounding villages,
the team is investigating for further case
Suspected Measles Outbreak: reported from Sayed Bacha villages of Panjab district of
Bamyan province on April 28 /2012, the team investigated the area on the following day and
during the investigation there were 7 suspected measles cases , the team collected the
specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the outbreak is controlled .
Suspected Measles Outbreak: reported from Naway Dag villages of Goshta district of
Nangarhar province on April 29 /2012, the team investigated the area on the following day and
during the investigation there were 5 suspected measles cases , the team collected the
specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the outbreak is controlled.
Suspected Measles Outbreak: reported from Shahrak –e- khatumul anbia of Guzara district of
Hirat province on April 29 /2012, the team investigated the area on the following day and
during the investigation there were 15 suspected measles cases , the team collected the
specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the team is investigating for further case
Epidemiological week-19




Suspected Measles Outbreak: reported from Jawpalal, Tagab ghar villages of Waras district of
Bamyan province on May 08 /2012, the team investigated the area on the following day and
during the investigation there were 24 suspected measles cases with no death , the team
collected the specimens and send it to CPHL , the cases treated and the vaccination campaign
conducted in surrounding villages, the team is investigating for further case
Suspected Measles Outbreak: reported from Mangor of Sharestan district of Daikondi
province on May 06 /2012, the team investigated the area on the following day and during the
investigation there were 15 suspected measles cases , the team collected the specimens and send
it to CPHL , the cases treated and the vaccination campaign conducted in surrounding villages,
the outbreak is controlled .
Suspected Poisoning : reported from Sherenehazara girl school of Center of bamyan city
of
Bamyan province on May 05 /2012, the team investigated the area on the following day and
during the investigation there were 45 suspected poisoning cases which unconsciousness and
lethargy , the team collected the specimens and send it to CPHL , the cases treated and health
education sessions conducted in school, the outbreak is controlled .
Rumor of Suspected Poisoning : reported from Shah foladi boy high school of Center of bamyan
city of Bamyan province on May 09 /2012, the team investigated the area on the same day
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal
outbreaks of avian influenza, anthrax, brucellosis or other zoonoses should be reported immediately to the DEWS team in the relevant
province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO CSR/DEWS
Technical Officer, 0708811856,[email protected]









and during the investigation there were no suspected poisoning cases , it was a rumor not an
outbreak.
Suspected Measles Outbreak: reported from kofaka villages of Nadali district of Helmand
province on May 04 /2012, the team investigated the area on the following day and during the
investigation there were 5 suspected measles cases with no death , the team collected the
specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the team is investigating for further case
Suspected Measles Outbreak: reported from Kala kohna villages of Lashkargha district of
Helmand province on May 05 /2012, the team investigated the area on the following day and
during the investigation there were 7 suspected measles cases with no death , the team collected
the specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the team is investigating for further case
Suspected Dermatitis Outbreak: reported from Sopanzai villages of Arghestan district of
Kandahar province on May 08 /2012, the team investigated the area on the Same day and
during the investigation there were 27 suspected dermatitis cases , the cases treated and health
education sessions conducted in surrounding villages, the outbreak is controlled .
Suspected Pertussis Outbreak: reported from Gurgkush village of Yaftal district of
Badakhshan province, on May 06 /2012 and investigated on the same day, during the
investigation there were 6 suspected cases of Pertussis with no death and specimen collected
and send to CPHL, and patients treated, the team is investing for further cases.
Suspected Pertussis Outbreak: reported from Khasar village of Shahribuzurg district of
Badakhshan province, on May 10 /2012 and investigated on the same day, during the
investigation there were 27 suspected cases of Pertussis with no death and specimen collected
and send to CPHL, and patients treated, the outbreak is controlled .
Suspected Measles Outbreak: reported from Cheshma i-garmac villages of Farkhar district of
Takhar province on May 11 /2012, the team investigated the area on the following day and
during the investigation there were 5 suspected measles cases with no death , the team collected
the specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the team is investigating for further case
Suspected Measles Outbreak: reported from Chah Azadi Zooriha, Chah Azadi Helalzaiha,
Chah Arab villages of Zinda Jan district of Hirat
province on May 06 /2012, the team
investigated the area on the following day and during the investigation there were 8 suspected
measles cases with no death , the team collected the specimens and send it to CPHL , the cases
treated and the vaccination campaign conducted in surrounding villages, the outbreak is
controlled.
Suspected poisoning : reported from Ahmad shah Masood girls school at Mazar city of Balkh
province on May 09 /2012 and investigated on the same day, and the health team investigated the
affected area and they found 30 cases of fainting and generalized agitation with no deaths case
and the patients treated and health education and hygiene session conducted for students,
outbreak is under control,
Suspected Measles Outbreak: reported from Sorokhil and Hashikhil villages of Jajimedan district
of Khost province on May 04 /2012, the team investigated the area on the following day and
during the investigation there were 30 suspected measles cases with no death , the team
collected the specimens and send it to CPHL , the cases treated and the vaccination campaign
conducted in surrounding villages, the outbreak is controlled
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal
outbreaks of avian influenza, anthrax, brucellosis or other zoonoses should be reported immediately to the DEWS team in the relevant
province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO CSR/DEWS
Technical Officer, 0708811856,[email protected]

Suspected Measles Outbreak: reported from Sorbani villages of Matoon district of Khost
province on May 07 /2012, the team investigated the area on the same day and during the
investigation there were 23 suspected measles cases with no death , the team collected the
specimens and send it to CPHL , the cases treated and the vaccination campaign conducted in
surrounding villages, the team is investigating for further case.
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal
outbreaks of avian influenza, anthrax, brucellosis or other zoonoses should be reported immediately to the DEWS team in the relevant
province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO CSR/DEWS
Technical Officer, 0708811856,[email protected]
ANNEX:
Mapping of Percentages/Cases of Selected Diseases in Week-19 of 2012 by Province
All cases of suspected measles, pertussis, diphtheria, meningitis, or cholera, and unusual increases in incidence of any disease, and animal
outbreaks of avian influenza, anthrax, brucellosis or other zoonoses should be reported immediately to the DEWS team in the relevant
province or the national focal point – "Director Surveillance"<[email protected]> 0700290955 or the WHO CSR/DEWS
Technical Officer, 0708811856,[email protected]
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