Pakistan Epidemiological Bulletins 2012

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 29, Wednesday 25 July 2012

Highlights
? Measles: 142 alerts investigated this week, responding to 12 outbreaks involving 272 measles cases, 1 death.
? AWD: 22 alerts investigated this week and 3 outbreaks identified and appropriate measures were taken.
? Two new CCHF cases reported this week; In 2012, total of 23 confirmed cases have been reported throughout the country. Most of the cases (14)
directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab.
? No new polio case was reported in week 29, 2012; As of 21 July 2012, Pakistan has reported a total of 23 polio cases (20 type‐1, 2 type‐3 and 1 mixture type‐1 and 3) from 13 districts/ tribal agencies.
? 87 districts have reported to DEWS in week 29, 2012. 2,295 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 819,161 patients? consultations were reported in week 29 compared to 813,291 consultations reported on week 28, 2012.
? Total 220 alerts were investigated, while response provided to 21 outbreaks.
...

Volume 3, Issue 30, Wednesday 1 August 2012

Highlights
? Measles: 146 alerts investigated this week, responding to 13 outbreaks involving 259 measles cases, 2 deaths.
? AWD: 28 alerts investigated this week and 3 outbreaks identified and appropriate measures were taken.
? Two new CCHF cases reported this week; In 2012, total of 25 confirmed cases have been reported throughout the country. Most of the cases (16) directly reported from Balochistan, 4 each KPK and Sindh and 1 from Punjab.
? No new polio case was reported in week 30, 2012; As of 30 July 2012,
Pakistan has reported a total of 23 polio cases (20 type‐1, 2 type‐3 and 1
mixture type‐1 and 3) from 13 districts/ tribal agencies.
? 89 districts have reported to DEWS in week 30, 2012. 2,327 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 858,953 patients? consultations were reported in week 30 compared to
857,305 consultations reported on week 29, 2012.
? Total 240 alerts were investigated, while response provided to 24 outbreaks.
...
Follow up of CCHF, Measles and Dengue
CCHF:
CCHF is a serious viral hemorrhagic fever with up to 50% 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.
Two new cases of CCHF in week 30. In 2012, a total of 33 suspected cases have been reported throughout the country with 25 confirmed to date and 8 deaths; (CFR is 32.00%). 22 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).
Any contact of a CCHF patient should monitor his/her temperature for 14 days and see a doctor if fever develops. The anti viral medicine Ribavirin has been effective in saving lives of patients who report early to the health facility.

Measles:
As of 21 July 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 28 July (8,299 cases and 117 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 30 (22 ‐ 28 July, 2012).

Dengue:
The chart at right showing 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 79 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 and Falciparum rate reported in week 30, 2012. Total number of malaria cases tested in week 30, 2012 is 7394, out of which 1546 were found positive; 1249 for P. Vivax; 234 for P. Falciparum; while 63 for Mixed (SPR = 20.91%; F. R = 84.87%).

AWD:
1. The surveillance definition for a case of ?Acute Watery Diarrhoea? (AWD) or suspected cholera in an endemic area, is any case over age 2 years with severe dehydration or death due to diarrhoea of 3 or more stools in 24 hours.
2. An AWD outbreak is defined as a cluster of 6 or more cases of AWD or any number of cases with at least one confirmed case of Vibrio cholera.
3. Table at right summarizes the situation of AWD in week 30, (21 to 28 July) 2012. During the week, a total of 28 AWD alerts were reported and
3 out breaks were identified and were responded very efficiently and in systematic manner. Most of the alerts (16) were from Sindh; while Khyber Pakhtunkhwa, Balochistan and Punjab had 6, 4 and 1 AWD alerts respectively. This week 5 deaths were reported, all from Balochistan.
4. The Surveillance Officers of the respective districts with the close coordination of trained rapid response teams from Department of Health and partners address the outbreaks.
5. Notably the outbreak of cholera in a remote area of Gwadar district in Balochistan with 78 cases and 4 deaths had no further deaths after rapid response team arrived.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 33, Wednesday 22 August 2012

Highlights

Epidemiological week no. 33
(12 - 18 Aug 2012)
? Measles: 82 alerts investigated this week, responding to 10 outbreaks
involving 158 measles cases, no death.
? AWD: 24 alerts investigated this week and 5 outbreaks identified, involving
136 AWD cases, 2 deaths.
? One new CCHF cases reported this week; In 2012, a total of 37 suspected
cases have been reported throughout the country with 29 confirmed to date
and 9 deaths.
? No new polio case was reported in week 33, 2012; As of 18 August 2012,
Pakistan has reported a total of 29 polio cases (26 type‐1, 2 type‐3 and 1
mixture type‐1) from 16 districts/tribal agencies.
? 83 districts have reported to DEWS in week 33, 2012. 2,163 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 632,763 patients? consultations were reported in week 33 compared to
780,835 consultations reported on week 32, 2012.
? Total 163 alerts were investigated, while response provided to 24 outbreaks.
...
Follow up of CCHF, Measles and Dengue

CCHF:
...
One new suspected cases of CCHF in week 33. In 2012, a total
of 37 suspected cases have been reported throughout the country with
29 confirmed to date and 9 deaths; (CFR is 31.03%). 21 cases have been
reported from Balochistan; 6 from Sindh; 5 from Khyber Pakhtunkhwa
and 5 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 11 August 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 18 August (9,000 cases and 125 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 33 (12 to 18 August, 2012) (158 cases and no deaths - 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 right showing 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 89 in Sindh
and 82 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 and
Falciparum rate reported in week 32, 2012. Total number of malaria
cases tested in this week is 8636, out of which 1513 were
found positive; 1208 for P. Vivax; 251 for P. Falciparum; while 54
for Mixed (SPR = 17.52%; F. R = 20.16%).

AWD:
? The surveillance definition for a case of ?Acute Watery Diarrhoea? (AWD) or suspected cholera in an endemic area, is any case over
age 2 years with severe dehydration or death due to diarrhoea
of 3 or more stools in 24 hours.
? An AWD outbreak is defined as a cluster of 6 or more cases of
AWD or any number of cases with at least one confirmed case
of Vibrio cholera.
? The table at right summarizes the situation of AWD in last four
weeks, 22 July to 18 August 2012. During the period, a total of
111 AWD alerts were reported and 22 confirmed AWD out
breaks were identified and were responded very efficiently and
in systematic manner.
? The Surveillance Officers in the districts with the close coordination
of trained rapid response teams from Department of
Health and partners address the outbreaks.
? Notably the outbreak of cholera in Swabi district in Khyber
Pakhtunkhwa with 150 cases with 2 deaths had no further
deaths after a joint team (DOH; PPHI; WHO) arrived.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 34, Wednesday 29 August 2012

Highlights
Epidemiological week no. 34 (19 - 25 Aug 2012)
? Measles: 66 alerts investigated this week, responding to 4 outbreaks involving 137 measles cases, 3 deaths.
? AWD: 3 alerts investigated this week and 1 outbreak identified, involving 8 AWD cases, no deaths.
? Two new CCHF cases reported this week; In 2012, a total of 39 suspected
cases have been reported throughout the country with 29 confirmed to date
and 9 deaths.
? No new polio case was reported in week 34, 2012; As of 27 August 2012, Pakistan has reported a total of 29 polio cases (26 type‐1, 2 type‐3 and 1 mixture type‐1) from 16 districts/tribal agencies.
? 88 districts have reported to DEWS in week 34, 2012. 2,422 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 527,248 patients? consultations were reported in week 34 compared to
660,161 consultations reported on week 33, 2012.
? Total 98 alerts were investigated, while response provided to 5 outbreaks.

...
Follow up of CCHF, Measles and Dengue
CCHF
...
Two new suspected cases of CCHF in week 34. In 2012, a total of 39 suspected cases have been reported throughout the country with 28 confirmed to date and 9 deaths; (CFR is 31.04%). 23 cases have been reported from Balochistan; 6 from Sindh; 5 from Khyber Pakhtunkhwa and 4 from Punjab.
...
Measles:
As of 25 August 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 25 August; (9,155 cases and 130 deaths - Ro) and table 2 illustrates the alerts and outbreaks in week 34 (19 to 25 August, 2012) (137 cases and 5 fatalities - Ro).
...
Dengue
...
Total
number of confirmed dengue cases to date in 2012 is 92 in Sindh
and 84 in Punjab.
...
Malaria
...
Total number of malaria
cases tested in this week is 10108, out of which 1778 were
found positive; 1330 for P. Vivax; 312 for P. Falciparum; while 136
for Mixed (SPR = 17.59%; F. R = 25.20%).

AWD:
...
The table at right (673 cases and 6 fatalities - Ro) summarizes the situation of AWD in last four
weeks, 29 July to 25 August 2012. During the period, a total of
82 AWD alerts were reported and 13 confirmed AWD out
breaks were identified and were responded very efficiently and
in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 35, Wednesday 5 September 2012

Highlights

Epidemiological week no. 35 (26 Aug - 1 Sep 2012)
? Measles: 104 alerts investigated this week, responding to 20 outbreaks involving 257 measles cases, 4 deaths.
Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 19 alerts investigated this week and 4 outbreak identified, involving 173 AWD cases, 3 deaths. Outbreak was controlled by house to house
measures to disinfect drinking water and by case management and infection
control at health facilities (Page 7)
? Two new CCHF cases reported this week; 1 from Chakwal (Punjab) and 1 from Karachi (Sindh). (Page 6)
? No new polio case was reported in week 35, 2012; (Page 6)
? 87 districts have reported to DEWS in week 35, 2012. 2,095 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 722,965 patients? consultations were reported in week 35 compared to 531,963 consultations reported on week 34, 2012.
? Altogether 182 alerts were investigated and response was provided to 30 outbreaks.
...
Follow up of CCHF, Measles and Dengue
CCHF
...
Two new suspected cases of CCHF in week 35. One case was from Chakwal and treated in Rawalpindi but expired. Family and contacts are being monitored. Second case was from Karachi and is improving. In 2012, a total of 41 suspected cases have been reported throughout the country with 30 confirmed to date and 10 deaths; (CFR is 33.34%). 23 cases have been reported from Balochistan; 9 from Sindh; 5 from Khyber Pakhtunkhwa and 4 from Punjab.
...
Measles:
As of 25 August 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 1 September (9,425 cases and 135 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 35 (26 August to 1 September 2012)(257 cases and 4 deaths - Ro).
...
Dengue
Total
number of confirmed dengue cases to date in 2012 is 107 in
Sindh and 95 in Punjab. Month of peak incidence in 2010 was
November while peak incidence in 2011 was in September and
October.
...
Malaria:
...
Total number of malaria
cases tested in this week is 17320, out of which 3120 were
found positive; 2181 for P. Vivax; 686 for P. Falciparum; while
253 for Mixed (SPR = 18.01%; F. R = 30.10%).

AWD

Total 741 cases & 8 deaths in the past 4 weeks
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 39, Wednesday 3 October 2012

Epidemiological week no. 39
(23 - 29 Sep 2012)
? Measles: 71 alerts investigated this week, responding to 3 outbreaks involving 128 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 20 alerts investigated this week and 3 outbreaks identified, involving 38 AWD cases. Outbreaks were controlled by house to house measures to disinfect drinking water and by case management and infection control at
health facilities (Page 7)
? 6 new CCHF cases reported in week 39, 2012;
? 3 new polio cases were reported in week 39, 2012; (Page 6)
? 85 districts have reported to DEWS in week 39, 2012. 2,237 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 929,784 patients? consultations were reported in week 38 compared to
908,376 consultations reported in week 38, 2012.
? Altogether 179 alerts were investigated and response was provided to 18 outbreaks.
...
Follow up of CCHF, Measles and Dengue
CCHF:
...
6 new cases of CCHF in week 39. In 2012, a total of
51 suspected cases have been reported throughout the
country with 39 confirmed to date and 14 deaths; (CFR is
35.90%). 21 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5
from Punjab.
...
Measles:
As of 29 September 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 29 September (10,069 cases and 143 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 39 (23 to 29 September,
2012). (128 cases and 0 deaths - Ro)
...
Dengue:
The chart at right showing 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 167 in Sindh
and 273 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 and
Falciparum rate reported in week 39, 2012. Total number of malaria
cases tested in this week is 20859, out of which 3491 were
found positive; 2528 for P. Vivax; 781 for P. Falciparum; while 182
for Mixed (SPR = 16.74%; F. R = 27.59%).

AWD:
...
? The table at right summarizes the situation of AWD in last four
weeks, 3 to 29 September 2012. During the period, a total of 78
AWD alerts were reported and 12 confirmed AWD out breaks
were identified and were responded very efficiently and in
systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Reliefweb

Volume 3, Issue 40, Wednesday 10 October 2012

Highlights
Epidemiological week no. 40
(30 Sept - 6 Oct 2012)
? Measles: 68 alerts investigated this week, responding to 13 outbreaks involving 198 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 18 alerts investigated this week and 5 outbreaks identified, involving 168 AWD cases, 2 deaths. Outbreaks were controlled by house to house measures to disinfect drinking water and by case management and infection control at health facilities (Page 7)
? 1 new suspected CCHF case reported in week 40, 2012;
? 3 new polio cases were reported in week 40, 2012; (Page 6)
? 82 districts have reported to DEWS in week 40, 2012. 2,295 health facilities have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 890,297 patients? consultations were reported in week 40 compared to 960,498 consultations reported in week 39, 2012.
? Altogether 206 alerts were investigated and response was provided to 36 outbreaks.
...
Follow up of CCHF, Measles and Dengue
CCHF
...
1 new suspected case of CCHF in week 40. In 2012, a total of 52 suspected cases have been reported throughout the country with 39 confirmed to date and 14 deaths; (CFR is 35.90%). 21 confirmed cases have been reported from Balochistan; 7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from Punjab.
...
Measles:
As of 6 October 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 6 October (10,269 cases and 149 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 40 (198 cases and 6 deaths - Ro)
...
Dengue:
The chart at right showing 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 198 in Sindh and 298 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 and Falciparum rate reported in week 40, 2012. Total number of malaria cases tested in this
week is 21075, out of which 3369 were found positive; 2233 for P. Vivax; 930 for P. Falciparum; while 206 for Mixed (SPR = 15.99%; F. R = 33.72%).

AWD:
...
? The table at right summarizes the situation of AWD in last four weeks, 9 September to 6 October 2012. During the period, a total of 81 AWD alerts were reported and 14 confirmed AWD out breaks were identified and were responded very efficiently and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 41, Wednesday 17 October 2012

Highlights
Epidemiological week no. 41
(7 - 13 Oct 2012)
? Measles: 74 alerts investigated this week, responding to 10 outbreaks
involving 202 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 22 alerts investigated this week and 8 outbreaks identified, involving
106 AWD cases, 3 deaths. Outbreaks were controlled by house to house
measures to disinfect drinking water and by case management and infection
control at health facilities (Page 7)
? 2 new suspected CCHF case reported in week 41, 2012; (Page 6)
? 1 new polio cases were reported in week 41, 2012; (Page 6)
? 84 districts have reported to DEWS in week 41, 2012. 2,334 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 961,606 patients? consultations were reported in week 41 compared to
918,266 consultations reported in week 40, 2012.
? Altogether 201 alerts were investigated and response was provided to 31 outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 41, 2012 one new type‐1 polio cases was reported Federally Administered Tribal
Areas (Bajour Agency).
? As of 13 October 2012, Pakistan has reported a total of 44 polio cases including 41 type‐1,
2 type‐3 and 1 mixture type‐1 and 3 polio cases from 26 districts/tribal agencies.
...
CCHF:
...
2 new suspected cases of CCHF in week 41. In 2012, a
total of 54 suspected cases have been reported throughout the
country with 39 confirmed to date and 14 deaths; (CFR is
35.90%). 21 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from Punjab.
...
Measles:
As of 13 October 2012, more measles cases and deaths have been reported in Pakistan than in 12 months last year. Table 1 (10,485 cases, 153 deaths - Ro) summarizes
the situation of measles in 2012 up to 13 October; and table 2 (202 cases and 4 deaths - Ro) illustrates the alerts and outbreaks in week 41 (7 to 13 October, 2012).
...
Dengue:
The chart at right showing 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 233 in Sindh and 319 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 and Falciparum rate reported in week 41, 2012. Total number of malaria cases tested in this week is 19885, out of which 3573 were found positive; 2348 for P. Vivax; 938 for P. Falciparum; while 287 for Mixed (SPR = 17.97%; F. R = 34.28%).

AWD:
...
The table at right summarizes (366 cases and 5 deaths - Ro) the situation of AWD in last four
weeks, 16 September to 13 October 2012. During the period, a
total of 83 AWD alerts were reported and 27 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 42, Wednesday 24 October 2012

Highlights

? Measles: 74 alerts investigated this week, responding to 10 outbreaks
involving 163 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 7 alerts investigated this week and 2 outbreaks identified, involving
115 AWD cases, 2 deaths. Outbreaks were controlled by timely measures to
disinfect drinking water and by case management and infection control at
health facilities (Page 7)
? 1 new suspected CCHF case reported in week 42, 2012; (Page 6)
? 3 new polio cases were reported in week 42, 2012; (Page 6)
? 82 districts have reported to DEWS in week 42, 2012. 2,302 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 891,575 patients? consultations were reported in week 42 compared to
982,050 consultations reported in week 41, 2012.
? Altogether 157 alerts were investigated and response were provided to 18
outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 42, 2012 3 new type‐1 polio cases were reported; 2 from Khyber Pakhtunkhwa
(Swabi and Torghar districts) and 1 from Balochistan (Sherani district).
? As of 20 October 2012, Pakistan has reported a total of 47 polio cases including 44 type‐1,
2 type‐3 and 1 mixture type‐1 and 3 polio cases from 27 districts/tribal agencies.
...
CCHF:
...
1 new suspected cases of CCHF in week 42. In 2012,
a total of 55 suspected cases have been reported throughout
the country with 40 confirmed to date and 14 deaths; (CFR is
35.90%). 22 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5
from Punjab. Chart at right illustrates current situation of
CCHF cases in 2012.
...
Measles:
As of 20 October 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 20 October (10,704 cases and 157 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 42 (14 to 20 October, 2012; 163 cases and 3 deaths - Ro)
...
Dengue:
The chart at right showing 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 270 in Sindh and 327 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 and
Falciparum rate reported in week 42, 2012. Total number of malaria
cases tested in this week is 19880, out of which 3311 were found
positive; 2099 for P. Vivax; 966 for P. Falciparum; while 246 for Mixed
(SPR = 16.67%; F. R = 36.61%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 23 September to 20 October 2012. During the period, a
total of 70 AWD alerts were reported and 14 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Epidemiological week no. 43
(21 - 27 Oct 2012)
? Measles: 71 alerts investigated this week, responding to 12 outbreaks
involving 172 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 6)
? AWD: 7 alerts investigated this week and 1 outbreak identified, involving 15
AWD cases. Outbreak was controlled by timely measures and by case management and infection control at health facilities (Page 6)
? No new CCHF case reported in week 43, 2012; (Page 5)
? No new polio cases was reported in week 43, 2012; (Page 5)
? 65 districts have reported to DEWS in week 43, 2012. 1,789 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 563,695 patients? consultations were reported in week 43 compared to
930,263 consultations reported in week 42, 2012.
? Altogether 127 alerts were investigated and response were provided to 15 outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 43, 2012 no new polio case was reported from any area in the country.
? As of 27 October 2012, Pakistan has reported a total of 47 polio cases including 44 type‐1,
2 type‐3 and 1 mixture type‐1 and 3 polio cases from 27 districts/tribal agencies.
...

CCHF
...
No new case of CCHF in week 43. In 2012, So for a total
of 55 suspected cases have been reported throughout the country
with 40 confirmed to date and 14 deaths; (CFR is 35.90%). 22
confirmed cases have been reported from Balochistan; 7 from
Sindh; 6 from Khyber Pakhtunkhwa and 5 from Punjab.
...
Measles:
As of 20 October 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 27 October (10,905 cases and 161 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 43 (21 to 27 October, 2012) (172 cases and 2 deaths - Ro).
...

Dengue:
The chart at right showing 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 308 in Sindh and 331 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 and
Falciparum rate reported in week 43, 2012. Total number of malaria
cases tested in this week is 8,194, out of which 1182 were found
positive; 833 for P. Vivax; 316 for P. Falciparum; while 349 for Mixed
(SPR = 14.43%; F. R = 29.53%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 30 September to 27 October 2012. During the period, a
total of 58 AWD alerts were reported and 17 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Epidemiological week no. 44
(28 Oct to 3 Nov 2012)
 Measles: 61 alerts investigated this week, responding to 17 outbreaks
involving 242 measles cases. Vitamin A was provided to cases and EDOs-H took action to improve vaccination in affected areas (Page 7)
 AWD: 6 alerts investigated this week and 1 outbreak identified, involving
112 cases. Outbreak was controlled by timely measures and by case management and infection control at health facilities (Page 7)
 Two new suspected CCHF cases reported in week 44, 2012; (Page 6)
 One new polio cases was reported in week 44, 2012; (Page 6)
 82 districts have reported to DEWS in week 44, 2012. 2,323 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
 684,045 patients? consultations were reported in week 44 compared to
593,038 consultations reported in week 43, 2012.
 Altogether 122 alerts were investigated and response were provided to 22
outbreaks.
...
Polio
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
 In week 44, 2012 one new type-1 polio case was reported from Federally Administered
Tribal Areas (Bajour Agency).
 As of 3 November 2012, Pakistan has reported a total of 48 polio cases including 45 type-
1, 2 type-3 and 1 mixture type-1 and 3 polio cases from 26 districts/tribal agencies.
...
CCHF
Two new suspected cases of CCHF in week 44. In 2012, So
for a total of 57 suspected cases have been reported throughout the
country with 40 confirmed to date and 14 deaths; (CFR is 35.00%). 22
confirmed cases have been reported from Balochistan; 7 from Sindh;
6 from Khyber Pakhtunkhwa and 5 from Punjab.
...
Measles
As of 20 October 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 3 November (11,172 cases and 168 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 44 (242 cases and 7 deaths - Ro) (28 Oct to 3 Nov, 2012).
...
Dengue:
The chart at right showing 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 369 in Sindh and 338 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 and
Falciparum rate reported in week 44, 2012. Total number of malaria
cases tested in this week is 14,114, out of which 2022 were found
positive; 1307 for P. Vivax; 562 for P. Falciparum; while 153 for Mixed
(SPR = 14.33%; F. R = 35.36%).

AWD
...
The table at right summarizes the situation of AWD in last four
weeks, 7 October to 3 November 2012. During the period, a
total of 42 AWD alerts were reported and 18 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Epidemiological week no. 46
(11 - 17 Nov 2012)

? Measles: 99 alerts investigated this week, responding to 19 outbreaks
involving 290 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 5 alerts investigated this week, involving 7 cases. Alerts/Outbreaks
were controlled by timely measures and by case management and infection
control at health facilities (Page 7)
? One new suspected CCHF cases reported; (Page 6)
? 85 districts have reported to DEWS in week 46, 2012. 2,504 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 806,873 patients? consultations were reported in week 46 compared to
888,767 consultations reported in week 45, 2012.
? Altogether 207 alerts were investigated and response were provided to 26
outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? As of 17 November 2012, Pakistan has reported a total of 54 polio cases including
51 type‐1, 2 type‐3 and 1 mixture type‐1 and 3 polio cases from 27 districts/
tribal agencies.
...
CCHF:
...
On 15 November, 2012, one new suspected case
of CCHF was reported from Balochistan. In 2012, So for a
total of 60 suspected cases have been reported throughout
the country with 41 confirmed to date and 17 deaths; (CFR
is 36.96%). 23 confirmed cases have been reported from
Balochistan; 7 from Sindh; 6 from Khyber Pakhtunkhwa
and 5 from Punjab.
...
Measles:
As of 10 November 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 17 November (11,764 cases and 183 deaths -Ro); and table 2 illustrates the alerts and outbreaks in week 46 (11 to 17 Nov,2012) (290 cases and 5 deaths - Ro).
...
Dengue:
The chart at right (see link) showing 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 542 in Sindh and 350 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 (see link) shows the Malaria slide positivity and
Falciparum rate reported in week 46, 2012. Total number of malaria
cases tested in this week is 15,501, out of which 2159 were found
positive; 1223 for P. Vivax; 620 for P. Falciparum; while 316 for Mixed
(SPR = 13.93%; F. R = 43.35%).

AWD:

? The table at right (see link) summarizes the situation of AWD in last four
weeks, 20 October to 17 November 2012. During the period, a
total of 26 AWD alerts were reported and 3 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 48, Wednesday 5 December 2012

Epidemiological week no. 48
(25 Nov to 1 Dec 2012)

? Measles: 122 alerts investigated this week, responding to 31 outbreaks
involving 397 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 7)
? AWD: 4 alerts investigated this week, involving 9 cases. Alerts/Outbreaks
were responded timely and appropriate measures were taken on case management and infection control (Page 7)
? 88 districts have reported to DEWS in week 48, 2012. 2,517 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 868,251 patients? consultations were reported in week 48 compared to
762,234 consultations reported in week 47, 2012.
? Altogether 204 alerts were investigated and response were provided to 35 outbreaks.

...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 48, 2012, no new polio case was reported from any of the district.
? As of 1 December 2012, Pakistan has reported a total of 56 polio cases including 53 type‐1, 2 type‐3
and 1 mixture type‐1 and 3 polio cases from 28 districts/tribal agencies.
...
CCHF
...
In week 48, 2012, no new CCHF case was reported
from Balochistan. In 2012, So for a total of 61 suspected
cases have been reported throughout the country
with 42 confirmed to date and 17 deaths; (CFR is 40.48%).
24 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from
Punjab. Chart at right illustrates current situation of CCHF
cases in 2012.
...
Measles:
As of 10 November 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 1 December (12,512 cases and 208 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 47 (25 Nov to 1 Dec 2012)(397 cases and 15 deaths - Ro).
...
Dengue:
The chart at right showing 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 622 in Sindh and 353 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 and
Falciparum ratio reported in week 48, 2012. Total number of malaria
cases tested in this week is 13,495, out of which 1813 were found
positive; 1009 for P. Vivax; 627 for P. Falciparum; while 177 for
Mixed (SPR = 13.43%; F. R = 44.35%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 4 November to 1 December 2012. During the period, a
total of 26 AWD alerts were reported and 1 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 49, Wednesday 12 December 2012

Highlights

Epidemiological week no. 49
(2 to 8 Dec 2012)
? Measles: 130 alerts investigated this week, responding to 54 outbreaks
involving 665 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 8)
? AWD: 2 alerts investigated this week, involving 3 cases. Alerts/Outbreaks
were responded timely and appropriate measures were taken on case management and infection control (Page 8)
? 86 districts have reported to DEWS in week 49, 2012. 2,477 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 868,740 patients? consultations were reported in week 49 compared to
876,288 consultations reported in week 48, 2012.
? Altogether 208 alerts were investigated and response were provided to 58
outbreaks.

...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 49, 2012, no new polio case was reported from any of the district.
? As of 8 December 2012, Pakistan has reported a total of 56 polio cases including 53 type‐1, 2 type‐3
and 1 mixture type‐1 and 3 polio cases from 28 districts/tribal agencies.
...
CCHF:
...
In week 49, 2012, no new CCHF case was reported
from Balochistan. In 2012, So for a total of 61 suspected
cases have been reported throughout the country
with 42 confirmed to date and 17 deaths; (CFR is 40.48%).
24 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from
Punjab.
...
Measles:
As of 10 November 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 8 December (13,203 cases and 232 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 49 (2 ‐ 8Dec 2012) (665 cases and 24 deaths - Ro).
...
Dengue:
The chart at right (see link) showing 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 672 in Sindh and 353 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
and Falciparum ratio reported in week 49,
2012. Total number of malaria cases tested in this week is
7,049, out of which 757 were found positive; 511 for P.
Vivax; 226 for P. Falciparum; while 20 for Mixed (SPR =
10.74%; F. R = 32.50%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 11 November to 8 December 2012. During the period, a
total of 22 AWD alerts were reported and 4 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 4, Issue 50, Wednesday 19 December 2012

Highlights
Epidemiological week no. 50
(9 to 15 Dec 2012)
? Measles: 180 alerts investigated this week, responding to 52 outbreaks
involving 710 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 8)
? AWD: 3 alerts investigated this week, involving 39 cases. Alerts/Outbreaks
were responded timely and appropriate measures were taken on case management and infection control (Page 8)
? 82 districts have reported to DEWS in week 50, 2012. 2,380 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this
week
? 799,859 patients? consultations were reported in week 50 compared to
890,750 consultations reported in week 49, 2012.
? Altogether 246 alerts were investigated and response were provided to 58 outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? In week 50, 2012, no new polio case was reported from any of the district.
? As of 15 December 2012, Pakistan has reported a total of 56 polio cases including 53 type‐1, 2 type‐3
and 1 mixture type‐1 and 3 polio cases from 28 districts/tribal agencies.
...
CCHF:
...
In week 50, 2012, no new CCHF case was reported
from Balochistan. In 2012, So for a total of 61 suspected
cases have been reported throughout the country
with 42 confirmed to date and 17 deaths; (CFR is 40.48%).
24 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from
Punjab.
...
Measles:
As of 10 November 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 15 December (13,973 cases and 269 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 50 (9 ‐ 15 Dec2012) (710 cases and 35 deaths - Ro).
...
Dengue:
The chart at right showing 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 707 in Sindh and 353 in
Punjab. Month of peak incidence in 2010 was November
while peak incidence in 2011 was in September and
October. In 2012, the month of peak incidence September
for Punjab and November for Sindh.

Malaria:
The chart at right shows the Malaria slide
positivity and Falciparum ratio reported in week 50,
2012. Total number of malaria cases tested in this week
is 11154, out of which 1364 were found positive; 757
for P. Vivax; 460 for P. Falciparum; while 147 for Mixed
(SPR = 12.23%; F. R = 44.50%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 18 November to 15 December 2012. During the period,
a total of 19 AWD alerts were reported and 3 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2012

Volume 3, Issue 51, Wednesday 26 December 2012

Highlights

Epidemiological week no. 51 (16 to 22 Dec 2012)
? Measles: 162 alerts investigated this week, responding to 48 outbreaks
involving 695 measles cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in affected areas (Page 8)
? AWD: 1 alert investigated this week, involving 5 cases. Alerts/Outbreaks
were responded timely and appropriate measures were taken on case management and infection control (Page 8)
? 85 districts have reported to DEWS in week 51, 2012. 2,431 health facilities
have shared weekly data to the Disease Early Warning System (DEWS) in this week
? 841,982 patients? consultations were reported in week 51 compared to
822,939 consultations reported in week 50, 2012.
? Altogether 231 alerts were investigated and response were provided to 51
outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2011 and 2012
? As of 29 December 2012, Pakistan has reported a total of 58 polio cases including 55 type‐
1, 2 type‐3 and 1 mixture type‐1 and 3 polio cases from 28 districts/tribal agencies.
...
CCHF:
...
In week 51, 2012, no new CCHF case was reported from Balochistan. In 2012, So for a total of 61 suspected cases have been reported
throughout the country with 42 confirmed to date and 17 deaths; (CFR is 40.48%). 24 confirmed cases have been reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from Punjab.
...
Measles:
As of 10 November 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 22 December (14,687 cases and 304 deaths - Ro); and table 2 illustrates the alerts and outbreaks in week 51 (16 ‐ 22 Dec 2012) (695 cases and 35 deaths - Ro).
...
Malaria:
...
Total number of malaria cases tested in this week is
11239, out of which 1294 were found positive; 728 for P.
Vivax; 418 for P. Falciparum; while 148 for Mixed (SPR =
11.51%; F. R = 43.74%).

AWD:
...
The table at right summarizes the situation of AWD in last four
weeks, 26 November to 22 December 2012. During the period,
a total of 10 AWD alerts were reported and 1 confirmed AWD
out breaks were identified and were responded very efficiently
and in systematic manner.
...