weekly epidemiological - who · 24‐maymeasles kpk haripur khanpur city, uc khanpur, dhq 0 2 1 2 2...

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. 21 (20 to 26 May 2012)

• Measles: 213 alerts investigated, respond‐ing to 14 outbreaks involving 433 measles cases.

• CCHF: 3 new cases including one death posi‐tive 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 re‐ported over the week 21 compared to 811,059 consultations reported on week 20, 2012.

Highlights

Disease early warning system and response in Pakistan

01

Volume 3, Issue 21, Wednesday 30 May 2012

• The graph (Figure‐1) shows the weekly trend of ARI; Acute diarrhoea; Bloody diarrhoea and Suspected malaria as propor‐tional morbidity (percentage of cases out of total consultations) reported to DEWS on weekly basis.

• Proportional morbidity of ARI is highest in Khyber Pakhtunkhwa, Sindh and Balochistan, while acute diarrhoea is highest in Khyber Pakhtunkhwa, FATA, Punjab, Sindh and Balochistan (please see the graphs for every province in page 4 and 5).

Disease # of Cases Percentage

Acute diarrhoea 965,582 7%

Bloody diarrhoea 64,150 0.48%

ARI 2,833,808 21%

S. Malaria 583,191 4%

Skin Diseases 593,789 4%

Unexplained fever 463,306 3%

Total (All consultations) 13,485,871

Disease # of Cases Percentage

Acute diarrhoea 74,618 9%

Bloody diarrhoea 3,834 0.47%

ARI 122,053 15%

S. Malaria 42,218 5%

Skin Diseases 33,800 4%

Unexplained fever 28,107 3%

Total (All consultations) 809,858

Figure‐2: Weekly trend of Acute diarrhoea, Bloody diarrhoea, ARI and Suspected malaria in Pakistan Week‐1, 2011 to week‐21, 2012.

Figure‐1: 88 districts reported to DEWS in week 21, 2012.

Priority diseases under surveillance

in DEWS

Pneumonia Acute Watery Diarrhoea

Bloody diarrhoea Other Acute Diarrhoea

Suspected Enteric/Typhoid Fever Suspected Malaria

Suspected Meningitis Suspected Dengue fever

Suspected Viral Hemorrhagic Fever Suspected Measles

Suspected Diphtheria Suspected Pertussis

Suspected Acute Viral Hepatitis Neonatal Tetanus

Acute Flaccid Paralysis Scabies

Cutaneous Leishmaniasis Others Major health events reported during the

Epi‐week ‐ 21 (20 ‐ 26 May 2012)

Cumulative number of selected health events reported in Epi‐week 1 ‐ 21 (1 Jan ‐ 26 May 2012)

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AD BD ARI S. Malaria

Weekly Bulletin: DEWS, Pakistan, Week no. 21 (20 to 26 May 2012)

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 (21/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

24‐May Measles AJK Poonch Village Pothi UC Town Tehsil Rawala‐kot

1 0 4 1

Alert for suspected measles case was reported. Upon field investigation 5 more sus‐pected cases were found. Blood sample collected for lab testing. Vit. A drops was given to active cases and contacts. Immunization status were assessed in 12 households and found poor. Situation was discussed with DOH and intensified outreach activity planned for whole village. Health education imparted. Follow up planned.

21‐May Malaria Balochistan Awaran Village Jibri, Tehsil Mashkai 19 21 15 8

63 suspected Malaria cases were reported. 43 slides were tested and 30 were positive (SPR 70%). PF=1 (FR 3%) , PV=11, Mix=18. Treatment was given through antimalarial drugs. Information shared with DHO for bed nets and other necessary action.

21‐May Malaria Balochistan Awaran Camp Jhaoo Tehsil Jhal Jhaoo 12 31 12 12

67 suspected Malaria cases were reported and 35 samples were tested by RDT. 30 veri‐fied positive (SPR 86%) of PF=2, PV=14, Mix=14 (FR 53%). all the cases were from same location. Treatment was provided. All information was shared with DHO for bed net dis‐tribution to affected community.

21‐May Malaria Balochistan Bolan RHC Haji Shehr (Haji Shehr) 22 57 12 32

Outbreak for Malaria was reported from RHC. 123 samples were tested on microscope and RDTs out of which 71 were positive (SPR 58%). PF=1, PV= 41, M=29 (FR 42%). ACTs and RDTs provided. All information was shared with district malaria control program to take intervention.

23‐May Malaria Balochistan Harnai Nakus, UC Nakus, Tehsil Harnai 0 6 1 3

Alert for Malaria was received. Total 15 slides were tested out of which 10 came out positive for PV. SPR was 60%. Merlin is functional in the district. Matter was discussed with Merlin FP. DHO was informed. Patients are under treatment.

21‐May Malaria Balochistan Jhal Magsi BHU Sarangani (Sarangani UC Jhal Magsi)

5 3 7 8

23 suspected Malaria cases were reported including one death. out of which 12 positive cases (SPR 52%) with 7 Falciparum(30% FR). Investigation was made on call. All the cases were from one location. Antimalaria medicine+ RDTs were sent through Focal Person to BHU for further intervention.

21‐May Malaria Balochistan Lasbela Bela town, UC Bela 10 19 12 15

53 suspected Malaria cases reported from Civil Hospital Bela. All cases tested and 30 found positive (SPR 57%), PF=9 (FR=17%), PV=21. Anti malarial drugs were used for treat‐ment. All information was shared with DHO and Malaria control program representative and requested for interventions.

24‐May Malaria Balochistan Naseerabad

BHU Sabz Ali Umrani (Goth Sabz Ali Umrani, UC Judair South)

5 4 15 7 31 cases of suspected malaria were reported including 2 deaths. 20 Falciparum slides were positive out of 36 (FR 55%). All the cases were from same location. Anti Malarial medicine + RDTs were supplied. Information shared with DHO

25‐May Malaria Balochistan Naseerabad CD Qadir Abad (Goth Qadir Abad UC Ali Abad)

2 2 6 5

15 suspected Malaria cases were reported. All the cases were Falciparum Positive and belonging to same village. 15 slides were tested and all were positive of Falciparum. Alert was late investigated due to coordination meeting at Quetta. Anti Malarial medicine + RDTs were supplied. Information was shared with DHO.

25‐May Measles Balochistan Pishin Village & Killi New Abad Batezai 5 6 2 2

15 suspected cases of measles including one death due to measles was reported. All patients were given symptomatic treatment. 15 children were assessed for routine immu‐nization out of which 5 cases found vaccinated with BCG and none of the child were vac‐cinated against measles. Informed EDOH.

24‐May Leishmani‐asis FATA Khyber

Agency Village Rikalay,Tehsil Jamrud 1 7 2 10

Leishmaniasis cases were reported by medical Technician while he was conducting free medical camp. An investigation visit was arranged next day by WHO EHA team. The area was searched for new cases. Total of 20 cases were detected. Health education imparted. Patients were advised to visit CH Jamrud for injection Glucantime treatment.

22‐May Measles ICT Islamabad Rati Kasi Tarnol 3 0 2 1

6 suspected cases of measles were reported, all of the suspected cases found unvacci‐nated. In house to house cluster, 40 children were assessed for routine immunization, out of them 16(40%)were found totally unvaccinated,outreach vaccination activity carried out in the locality.

22‐May Leishmani‐asis KPK Kohat Village Barh, UC

Nasrat Khel 2 8 3 7

Cutaneous Leishmaniasis outbreak notified. On field visit 20 patients were found with history of sleeping outside and also not using Bednet. EHA‐Team provided Inj Glucantime for the patients and requested BHU Barh staff for keeping the line‐list and records of patients for epidemiological investigations. District team requested for bednets.

24‐May Leishmani‐asis KPK Kohat

Mohallah HakeemA‐bad, UC Billitang (Kot & Kharmatuu road)

2 5 2 6

Cutaneous Leishmaniasis outbreak notified. EHA Team kohat went for the detail investi‐gation to the area. Total of 15 cases were found with multiple lesions mostly on the foot , hands, eyelids, face etc. Infected patients were keeping animals like goats, sheeps and cows and they use to take them out for feeding to the nearby mountains. Sleeping out‐side and without the use of Bednet. EHA‐Team provided 4 boxes of Inj Glucantime to the patients.

24‐May Measles KPK Haripur Khanpur city, UC Khanpur, DHQ 0 2 1 2

2 suspected measles cases was notified, vitamin A drops provided . With these 2 cases total of 5 cases have reported with measles in past month. Outbreak has been declared in Khanpur city. Line list is maintained. Outreach vaccination is scheduled subject to avail‐ability of vaccine

24‐May Measles KPK Mardan Village Ashraf Abad, UC Kot Jungara, Tehsil Takht Bhai

6 1 8 4

Measles outbreak reported from BHU, active surveillance was carried out jointly in the area. 18 suspected cases with 2 deaths were identified in two adjacent areas. Routine immunization status of the area was confirmed through a cluster and found BCG ‐ 12 (61%) and Measles ‐3 (18%). Outreach activity was conducted by EPI Team and vacci‐nated 90 children in the area. Vit‐A was given, Blood Sample Collected for confirmation. Health education imparted, EDO‐H Focal person & DSM PPHI were informed & requested for regular outreach immunization in the area and surrounding.



Cont’d current week's (21/2012) Outbreaks: Date Disease Province District Area <5M >5M <5F >5F Action Taken

21‐May Measles Punjab Bhakkar

Mohallah Tayyab Sultan, UC Daggar Aolakh, Tehsil Bhakkar.

3 2 3 1

6 Suspected cases of measles reported from one locality. On active surveillance 03 more suspected cases were found. All cases were found totally unvaccinated. Vit A drops provided. 30 Children in the location ( apart from Suspects ) were assessed for vaccination ( BCG+ Measles). 85 % were found vaccinated. The families with measles cases were refusals. 5 Blood samples were collected for lab confirmation. Health education session conducted for highlighting the importance of vaccination of their children against all the EPI diseases. General hygiene and isolation measures were demonstrated to the community. EDO‐H informed.

21‐May Measles Sindh Badin Village Yousuf Chang, UC and taluka Golarchi

1 3 1 1

Alert for measles case was reported from hospital, during active surveillance 5 more cases were found, Vitamin (A)drops were given, health education imparted, immunization status was checked for 7 children where BCG= 3 (43%), Penta1=2 (29%) and rest of the children found totally unvaccinated. All suspected cases found unvaccinated for measles 1 & 2. Information shared with DSC and DHMT and intensified outreach vaccination activity in the area. 2 Blood samples were collected for lab testing.

24‐May Measles Sindh Ghotki Police Quarters UC I 3 1 2 0 Alert for Measles was notified. On field investigation 5 more cases were found from same house. Vitamin (A) drops were given to all cases, blood sample collected and sent to NIH for lab confirmation, informed DHMT for intensified outreach activity in the area.

22‐May Measles Sindh Hyderabad

Multan Khan Gali, near Government school, SITE areMur‐shidabad

4 5 2 3

14 suspected measles cases with 2 deaths reported, Vitamin(A) drops were given to all cases, health education imparted, vaccination status of 18 children were assessed where 4 children were vaccinated against BCG and rest of the children found totally unvaccinated. Information shared with DHO and DSC and request for intensified outreach in the area. 11 Blood samples were collected for lab confirmation.

21‐May Measles Sindh Karachi

Toti rehman pani wali Gali, Islamia colony, Qasba colony, UC‐9, SITE Town

4 0 7 0

Responding to measles alert DEWS team visited area for active search, 1 death due to measles and 11 suspected cases of Measles were found, health education imparted regarding importance of vaccina‐tion, 27 children were assessed for their routine immunization status, BCG= 11(41%), Penta1= 13(47%), Penta2= 11(41%), Penta3= 8(30%), Measles1= 2(9%) and Measles2 is 0). Information shared with PEI WHO and THMT and intensified outreach in the area.

24‐May Measles Sindh Larkana Village Kandero Mugheri, UC Rato‐kot, taluka Larkana

3 1 1 7

Alert for suspected measles was reported, during active surveillance 11 more suspected cases were found, cluster of routine immunization were assessed for 12 children where none of the child found vaccinated against measles, Vitamin(A) drops given to all cases, health education imparted, informa‐tion shared with EDOH. 12 Blood samples were collected for lab confirmation.

20‐May Measles Sindh Qambar Shahdadkot

UC Qubosaeedkhan , Taulka Qubosaeedkhan

5 0 1 0

Alert for suspected measles was reported, on active surveillance 5 more suspected cases were found. Vitamin(A) drops were given, health education imparted,6 children were assessed for routine immuni‐zation in house to house cluster where all of the children found totally unvaccinated, informed DHMT and 5 Blood samples were collected for lab confirmation.

24‐May Measles Sindh Qambar Shahdadkot

Ismail Chutto, UC Abad, taluka Warah 6 1 `1 0

Alert for suspected measles was reported from Larkana SO, On active search 7 more cases were found, Vitamin(A) drops provided, health education imparted, 8 children were assessed for the routine immu‐nization where 2 (20%) found vaccinated for measles 1. Informed DHMT and 6 Blood samples col‐lected.

25‐May Measles Sindh Sukkur Shaikh community, village Nasirabad, UC Tamachani

3 1 1 0

Alert for suspected Measles was cross notified by SO DEWS Khairpur, upon field investigation 4 more cases were found, 5 blood samples collected for lab testing. Vitamin (A) drops given to the cases. A total of 24 children were assessed for routine immunization and none of the child were found vacci‐nated,20 to 30 houses of community were refusals for vaccines, sensitized the villagers on importance of routine immunization & prevention of Measles. Information shared with DHMT.

25‐May Pertussis Sindh Ghotki Village Abdul Raz‐zaque Chachar, UC Ranwatti

0 5 5 3

Alert for probable Pertussis was notified. upon field investigation 12 more cases of Pertussis were found. Complete dose of Erythromycin provided to the patients. 21 children were assessed for routine immunization where 13 children were found vaccinated against BCG and rest of the children found totally unvaccinated. informed DHMT for intensified outreach vaccination activity in the area.

22‐May Pertussis Sindh Khairpur Village Ghulam M. Chang, UC. Razaa‐bad, taluka Faiz Gunj

7 5 5 3

Alert for probable Pertussis case was reported. On active search total 20 suspected cases were found, health education imparted, Erythromycin tabs provided to all cases and contacts, immunization status was assessed for 20 children where none of the child was found vaccinated. Information shared with DHMT.

22‐May Pertussis Sindh Khairpur

Village faqeer Azizullah Rajper, UC Razaabad, taluka Faiz Gunj

0 1 4 0

Alert for probable Pertussis case was reported from community, on active search total 5 cases were found, health education imparted, Erythromycin tabs were distributed to all cases, immunization status was checked for the cases where none of the child was found vaccinated. Information shared with DHMT.

22‐May Pertussis Sindh Khairpur Village M. Urs Chang, UC Razaabad taluka Faizgunj

8 3 6 3

Alert for probable Pertussis case was notified, field investigation done and found total of 20 suspected cases, health education imparted, Erythromycin tabs were distributed, immunization status was as‐sessed for 20 children where none of the child was found vaccinated. Information shared with DHMT, intensified outreach activity planned.

21‐May Pertussis Sindh Sukkur Village Badshah dino, UC Tarai, taluka Salehpat

2 1 4 0

4 suspected cases of Pertussis reported from BHU Gagro, during field investigation 3 more suspected cases were found, 4 Nasopharyngeal swabs collected for lab testing, syrup Azomax given to all cases & tab erythromycin provided to contacts. A total of 09 children were checked for routine immunization out of 9, BCG 5 (55%)while rest of the children found unvaccinated. Information shared with DHMT, DSC & DPEO.

25‐May Pertussis Sindh Tando Allahyar

Village Kamaro Shareef, UC Pak Singhar, taluka Tando Allahyar

0 0 3 3

Alert for probable Pertussis case was reported from community, On active search found total of 6 cases, health education imparted, Erythromycin tabs were distributed, vaccination status were as‐sessed for 6 children where BCG= 2(30%), Penta= 1(20%). EDOH informed and 2 Nasal Swab collected for lab testing.

25‐May Pertussis Sindh Tando Allahyar

Village Pir Ghulam Muhammad Qure‐shi, UC Pak Singhar taluka Tando Alla‐hyar

3 2 3 3 Alert for probable Pertussis case was reported, on active search found 10 more suspected cases, health education imparted, Erythromycin tabs distributed, vaccination status assessed for 11 children where BCG= 7 (60%), Penta= 3 (30%), Measles= 2 (20%). Information shared with EDOH.



Province Khyber Pakhtunkhwa: 481 health facilities from 17 districts of Khyber Pakhtunkhwa reported to DEWS with a total of 151,832 patients consultations reported in week 21, 2012. Total 100 alerts were received while 4 outbreaks were identified and appropriated measures were taken in week 21, 2012. Altogether 91 alerts for Measles; 3 for Leishmaniasis; 2 for Dengue fever while 1 each for AJS, AWD, Scabies and Typhoid.

Figure-5: Trend of priority communicable diseases, province KPK

Province Sindh:

Figure‐3: Number of alerts received and responded, week 21, 2012 Figure‐4: Number of consultations by age and gender, week 21, 2012

Province Punjab:

Figure-6: Number of alerts received and responded week 20, 2012, province KPK

Figure-7: Trend of priority communicable diseases, province Sindh

655 health facilities from 23 districts in province Sindh were reported to DEWS with a total of 327,157 patients consultations in week 21, 2012. Total 96 alerts received while 15 outbreaks were identified and appropriate measure were taken in week 21,2012. Altogether 64 alert for Measles; 11 for Pertussis; 8 for AWD; 5 for Scabies; 4 for Typhoid; 2 for Dengue fever; while 1 each for NNT and Food poisoning.

Figure-8: Number of alerts received and responded week 20, 2012, province Sindh

Figure-9: Trend of priority communicable diseases, province Punjab Figure-10: Number of alerts received and responded week 20, 2012, province Punjab

392 health facilities from 8 districts in province Punjab reported to DEWS with a total of 197,594 patients consultations in week 21, 2012. Total 47 alerts were received while 1 outbreak was identified and appropriate measures were taken in week 21,2012. Altogether 24 alerts for Measles; 7 for Acute diarrhoea; 5 for Typhoid; 3 each for Dengue fever and ARI; 2 each for Bloody diarrhoea and Scabies; while 1 for NNT.

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< 1 yr 1‐4 yr 5‐14 yr 15‐50 yr 50 + yr

Male 27671 64262 83396 127449 57241

Female 26197 61137 85336 211562 65607

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State of Azad Jammu and Kashmir:

Province Gilgit Baltistan:

FATA:

Province Balochistan:

Figure-11: Trend of priority communicable diseases, province Balochistan Figure-12: Number of alerts received and responded week 20, 2012, province Balochistan

458 health facilities from 23 districts in province Balochistan reported to DEWS with a total of 71,918 patients consultations in week 21, 2012. Total 31 alerts reported while 9 outbreaks were identified in week 21, 2012. Altogether 10 alerts for Measles; 8 for Malaria; 7 for Leishmaniasis; 3 for CCHF; while 1 each for AWD, Tetanus and Scabies.

34 health facilities from 4 districts in Gilgit Baltistan reported to DEWS with a total of 15,137 patients consultations in week 21, 2012. Total 6 alerts were reported in week 21, 2012; Altogether 4 alerts for Measles; while 1 each for Leishmaniasis and Pertussis.

Figure-13: Trend of priority communicable diseases, province Gilgit Baltistan Figure-14: Number of alerts received and responded week 20, 2012, Gilgit Baltistan

Figure-15: Trend of priority communicable diseases, FATA

54 health facilities from 3 agencies in FATA reported to DEWS with a total of 15,711 patients consultations in week 21, 2012. Total 11 alerts reported while 1 outbreak identified in week 21, 2012. Altogether 7 alerts for Measles; 3 for NNT and tetanus; while 1 for Leishmaniasis were reported and appropriated measures were taken.

Figure-16: Number of alerts received and responded week 20, 2012, FATA

Figure-17: Trend of priority communicable diseases, AJ&K Figure-18: Number of alerts received and responded week 20, 2012, AJ&K

123 health facilities from 9 districts in AJ&K reported to DEWS with a total of 29,715 patients consultations in week 21, 2012. Total 16 alerts reported while 1 outbreak was identified in week 21, 2012. Altogether 11 alerts were for Measles; while 5 for Leishmaniasis were reported and appropriate measures were taken.

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Distribution of Wild Polio Virus cases Pakistan 2011 and 2012

In this week 21, 2012, no new polio case was reported. As of 28 May 2012, the total number of polio cases confirmed by the laboratory is 16 from 10 districts/towns/tribal agencies and areas.

Province Cases 2011 Cases 2012

P1 P3 P1 P1+P3

Punjab 9 ‐ 1 ‐

Sindh 33 ‐ 2 ‐

Khyber Pakhtunkhwa 23 ‐ 4 ‐

FATA 57 2 4 1

Balochistan 73 ‐ 2 ‐

AJ&K ‐ ‐ ‐ ‐

Gilgit‐Baltistan 1 ‐ ‐ ‐

Islamabad ‐ ‐ ‐ ‐

Total 196 2 13 1

P3

‐

‐

‐

2

‐

‐

‐

‐

2

Table‐1: Total number of alerts and outbreaks reported and investigated with appropriate response Disease

2011 2012 (up till week 20) Current week 21, 2012

A O A O A O A O

Acute watery diarrhoea 1350 543 163 11 10 0 173 11

Acute jaundice syndrome 51 17 60 7 1 0 61 7

Bloody diarrhoea 98 20 65 6 2 0 67 6

Dengue fever 785 111 36 2 7 0 43 2

Measles 1708 110 1942 154 213 14 2155 168

Pertussis 287 81 235 88 12 7 247 95

NNT + tetanus 399 0 249 0 6 0 255 0

Malaria 131 88 39 17 8 8 47 25

Leishmaniasis 298 33 400 35 17 3 417 38

Others 645 69 653 48 33 0 686 48

Total 5752 1072 3842 368 309 32 4151 400

Total for 2012 (week 1‐21, 2012)

The chart below and table to the right show the weekly number of con‐firmed 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 54 in Sindh and 57 in Punjab. Month of peak incidence in 2010 was November while peak incidence in 2011 was in September and October.

Distribution of Dengue cases in Pakistan, 2012

Epi‐week Punjab Sindh 1 0 2 2 0 1 3 0 4 4 0 5 5 1 1 6 2 1 7 3 5 8 5 3 9 4 3 10 8 4 11 3 1 12 1 2 13 2 1 14 7 1 15 5 4 16 5 3 17 4 3 18 3 1

Weekly reported Dengue cases

19 2 0 20 1 8

TOTAL 57 54 21 1 1

0

2

4

6

8

10

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

# 0f cases

Epi wk

Trend of positive dengue cases, wk‐1 to wk‐21, 2012

Punjab Sindh



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.

In response to the measles out‐

breaks in Sindh, meeting regarding the constitution of the ‘Provincial Task Force for improvement of Routine immunization was held on 26 May 2012 at PD‐EPI office, Sindh under the leadership of Prof. Dr. Iqbal Memon President PPA. The main objectives of the meeting were to discuss the Measles Situation analysis in Sindh including Karachi and formation of Provin‐cial Measles Task Force. The meeting was attended by members of the Pediatric as‐sociation, PD‐EPI, UNICEF and WHO Polio and DEWS.

After the detailed discussion by each member, they decided the following actions points for the Task Force for mea‐sles response in Sindh.

1. Each district will constitute a District task force committee, which will be responsible for planning to improve the rou‐

tine immunization including outreach in their respective district, and will report on weekly progress. 2. Target age group for measles vaccine will be from age of 6‐months to‐5‐years. 3. UNICEF would take responsibility to prepare communication strategy and prepare messages for community and par‐

ents regarding routine vaccine. These messages in the form of Handbills, Flyers or posters will be distributed through the Polio teams and through leading NGOs of the areas. It will be also disseminated through FM‐Radio, Cable TV and schools and through Mosque announcement.

4. PD‐EPI Office would instruct all districts that two days/week will be fixed for Measles and BCG vaccine, and these days will be Uniform for whole province for instance Monday for BCG and Measles, and Thursday for Measles.

5. Prof. Dr. Iqbal Memon President PPA offered that he will disseminate the message for Routine Immunization (RI) to more than 500 Pediatrician all over the Sindh on the behalf of the Pakistan Pediatric Association (PPA).DEWS team also prepare a SMS for VPD case notification for Pediatricians, that will also send to all pediatrician on the platform of PPA.

6. All stakeholders would be attending regular meetings on every Wednesday at 9‐30 am at PD‐EPI office.

Table‐1

# of Alerts # of Outbreaks # of Cases # of Deaths

AJ&K 28 2 47 0

Balochistan 153 29 665 5

FATA 66 11 207 4

Gilgit Baltistan 7 0 8 0

ICT 5 1 15 0

Khyber Pakhtunkhwa 838 37 1501 13

Punjab 256 12 446 6

Sindh 589 62 1482 21

Total 1942 154 4371 49

Epi‐week 1 ‐ 20, 2012

Province

Table‐2

# of Alerts # of Outbreaks # of Cases # of Deaths

AJ&K 11 1 18 0

Balochistan 10 1 36 1

FATA 7 0 8 0

Gilgit Baltistan 4 0 4 0

ICT 2 1 12 0

Khyber Pakhtunkhwa 91 2 158 5

Punjab 24 1 40 0

Sindh 64 8 157 6

Total 213 14 433 12

Epi‐week 21, 2012

Province

0

100

200

300

400

500

w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21

Jan Feb March April May

2011 2012



Alerts and outbreaks, week 21, 2012

weekly epidemiological - who · 24‐maymeasles kpk haripur khanpur city, uc khanpur, dhq 0 2 1 2 2...

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