Pakistan Epidemiological Bulletins 2013

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 23, Wednesday 12 June 2013
Epidemiological week no. 23
(2 to 8 June 2013)

? Measles: This week a total of 66 alerts investigated. 430 measles
cases were reporting from 27 districts. Vitamin‐A drops provided to
all the suspected cases and district health teams took action to improve
vaccination in affected areas.
? 73 districts and 2105 health facilities have reported to DEWS this
week 23, compared with 73 districts with 2099 health facilities
shared weekly data in week 22, 2013 to the Disease Early Warning
System (DEWS).
? 785,730 patients? consultations were reported in week 23, 2013
compared to 827,517 consultations reported in week 22, 2013.
? Altogether 104 alerts were investigated and response were provided
to 5 outbreaks.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 23, 2013, 4 new type‐1 wild polio cases were reported from Federally Administered
Tribal Areas (FATA; 3 from Khyber agency and 1 from FR Bannu), bringing the total
number of polio cases to 14 in 2013 (compared to 22 during the same time period last
year) from 8 districts/towns/tribal agencies /areas (compared to 13 during the same time
period last year).
...
CCHF
...
In week 23, 2013, 1 new CCHF case was reported from
Islamabad resident of district Killa Abdulla, Balochistan (Lab result
Positive for CCHF). The case is 45 years old female (housewife)
found clear contact history with animals, admitted at Shifa Int?l
Hospital, Islamabad for treatment. Platelets count was 17000 at
the time of admitting in the hospital and now improving. While
the 2nd case (Lab result awaiting) reported from same district Killa
Abdulla, Province Balochistan, a 28 year old male, labor by profession
found no contact history with animals (but have animals
around his working place), Platelets count was 34000 at the time
of admitting in the hospital. The total 16 CCHF cases have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week
23 (8 June 2013). (12,951 cases & 290 fatalities - Ro)
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 24, Wednesday 19 June 2013
Epidemiological week no. 24
(9 to 15 June 2013)

? Measles: This week a total of 97 alerts investigated. 457 measles
cases were reported from 35 districts.
Vitamin‐A drops provided to the suspected cases and district
health teams were contacted to improve vaccination in affected areas.

? 71 districts and 2020 health facilities have reported to Disease Early
Warning system (DEWS) this week 24, compared to 73 districts with
2105 health facilities shared weekly data in week 23, 2013 to the DEWS.

? 810,623 patients consultations were reported in week 24, 2013
compared to 792,860 consultations reported in week 23, 2013.

? Altogether 137 alerts were investigated and 2 new outbreaks along
with 4 ongoing outbreaks were responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 24, 2013, 2 new wild polio cases (type‐1) were reported 1 each from Federally
Administered Tribal Areas (Khyber agency) and Punjab province (Mandi Bahauddin district),
bringing the total number of polio cases in 2013 to 16 (compared to 23 during the
same time period last year) from 9 districts/towns/tribal agencies /areas (compared to 13
during the same time period last year) .
...
CCHF
...
In week 24, 2013, 4 new suspected CCHF cases
with 1 deaths were reported from Quetta, Balochistan. 3
out of 4 cases were male (30yrs‐Butcher; 50yrs‐Laborer;
and 57yrs‐animal handler) all having history of animal
contact. While the 4th case is 20 years old female
(housewife) with a history of contact animals at home.
Total 24 suspected, 13 confirmed CCHF cases and 8
deaths have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week
24 (15 June 2013) (13,445 cases & 295 fatalities - Ro).
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 25, Wednesday 26 June 2013
Epidemiological week no. 25
(16 to 22 June 2013)

? Measles: This week a total of 93 alerts investigated. 491 measles
cases were reported from 35 districts. Vitamin‐A drops provided to
the suspected cases and district health teams were contacted to
improve outreach vaccination in affected areas.

? 69 districts and 1986 health facilities have reported to Disease Early
Warning system (DEWS) this week 25, compared to 71 districts with
2105 health facilities shared weekly data in week 24, 2013 to
the DEWS.

? Total 848,574 patients consultations reported this week compared
to 847,362 consultations in week 24, 2013.

? Altogether 134 alerts were investigated and 7 outbreaks were identified
and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 24, 2013, 1 new type‐1 wild polio case was reported from the Federally Administered
Tribal Areas (Khyber agency), bringing the total number of polio cases to 17 in 2013
(compared to 24 during the same time period last year) from 9 districts/towns/tribal agencies
/areas (compared to 13 during the same time period last year).
...
CCHF
...
In week 25, 2013, 1 new suspected CCHF case
reported from Quetta, Balochistan. The case is male (18yrs
‐Tannery worker) having history of animal contact. Total 24
suspected, 13 confirmed CCHF cases and 8 deaths have
been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week
25 (22 June 2013). (13,947 cases and 300 fatalities - Ro)
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 26, Wednesday 26 June 2013
Epidemiological week no. 26
(23 to 29 June 2013)

? Measles: This week a total of 96 alerts investigated. 430 measles
cases were reported from 24 districts. Vitamin‐A drops provided to
the suspected cases and district health teams were contacted to
improve outreach vaccination in affected areas.
? 76 districts and 2081 health facilities have reported to Disease Early
Warning system (DEWS) this week 26, compared to 69 districts with
1986 health facilities shared weekly data in week 25, 2013 to
the DEWS.
? Total 833,036 patients consultations reported this week compared
to 890,309 consultations in week 25, 2013.
? Altogether 143 alerts were investigated and 5 outbreaks were identified
and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 26, 2013, one new type‐1 wild polio case was reported from Federally Administered
Tribal Areas (North Waziristan agency), bringing the total number of polio cases to
18 in 2013 (compared to 24 during the same time period last year) from 10 districts/
towns/tribal agencies /areas (compared to 13 during the same time period last year).
...
CCHF
...
In week 26 and 27 (23 Jun ‐ 6 July), 2013, 7 new suspected
CCHF case reported, 4 from district Quetta; 1 from Sibi; 1
from Killa Abdullah in province Balochistan; while 1 case reported
from Afghanistan admitted in Fatima Jinnah Chest Hospital,
Quetta. 6 out of 7 suspected CCHF cases were admitted in Fatimah
Jinnah Chest hospital, Quetta; while 1 cases belongs to district
Sibi is admitted in Sandeman hospital, Quetta. All the laboratory
results were awaiting. All the suspected cases having history
of animal contact. Total 32 suspected, 13 confirmed CCHF cases
and 8 deaths have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week 26 (29 June
2013). (14,395 cases and 301 fatalities - Ro)
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 28, Wednesday 17 July 2013
Epidemiological week no. 28

? Measles: This week a total of 65 alerts investigated. 287 measles
cases were reported from 27 districts. Vitamin‐A drops provided to
the suspected cases and district health teams were contacted to
improve outreach vaccination in affected areas.
? 81 districts and 2154 health facilities have reported to Disease Early
Warning system (DEWS) this week 28, compared to 76 districts with
2039 health facilities shared weekly data in week 27, 2013 to
the DEWS.
? Total 852,087 patients consultations reported this week compared
to 796,799 consultations in week 27, 2013.
? Altogether 93 alerts were investigated and 9 outbreaks were identified
and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 28, 2013, 3 new wild polio cases (type‐1) were reported in the country; 2 from
Federally Administered Tribal Areas (Khyber and North Waziristan Agencies) and 1 from
Khyber Pakhtunkhwa (Peshawar district) bringing the total number of polio cases to 21 in
2013 (compared to 27 during the same time period last year) from 11 districts/towns/
tribal agencies /areas (compared to 15 during the same time period last year).
...
CCHF
In last 2 weeks (week 28 and ongoing week 29), 2013, 5
suspected and 1 positive CCHF cases were reported. 4 suspected
cases including 1 death were from province Balochistan 2 each
from districts Quetta and Pishin; while 1 suspected case belongs
to Afghanistan (admitted in hospital in Quetta). All the cases
having history of contacts with animals at home and their products
(Boucher by profession). All the laboratory results were
awaiting. And 1 positive CCHF case reported from district Karachi,
province Sindh , a 50 years old female patient found with history
of contact with animals at home. Total 40 suspected, 14 confirmed
CCHF cases and 9 deaths have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week 28 (13 July
2013) (15,080 cases with 312 fatalities - Ro).
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 30, Wednesday 31 July 2013
Epidemiological week no. 30

http://www.emro.who.int/images/stories/pakistan/documents/pak_documents/DEWS/Weekly-Epidemiological-Bulletin-30-31072013.pdf

? CCHF: In week 30, 2013, 3 positive CCHF cases were reported from district Quetta Balochistan. All the cases are relatives and having history of
contact with animals and fresh animal products (meat, skin). Epidemiological investigation conducted and treatment initiated (Page 5).
? Measles: This week a total of 70 alerts investigated. 227 measles cases were reported from 27 districts. Vitamin‐A drops provided to the suspected
cases and district health teams were contacted to improve outreach vaccination in affected areas (Page 6).
? 78 districts and 2174 health facilities have reported to Disease Early Warning system (DEWS) this week 30, compared to 79 districts with 2216
health facilities shared weekly data in week 29, 2013 to the DEWS.
? Total 830,782 patients consultations reported this week compared to 867,029 consultations in week 29, 2013.
? Altogether 124 alerts were investigated and 10 outbreaks were identified and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 30, 2013, one new wild polio case was reported from Federally
Administered Tribal Areas (Khyber agency); This bring the total number
of polio cases to 22 in year 2013 (compared to 29 during the same time
period last year) from 11 districts/towns/tribal agencies/areas
(compared to 16 during the same time period last year).
...
CCHF
In the last 2 weeks (week 30 and 31), 2013, 7
suspected CCHF cases were reported. 4 cases including
3 positive CCHF cases were from district Quetta. While
1 each from districts Pishin, Kalat and Killa Abdullah. All
the cases having history of contacts with animals at
home and their products (Boucher by profession). A
total of 47 suspected, 30 confirmed CCHF cases and 10
deaths have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week 29 (20 July
2013). (15,621 cases and 317 fatalities - Ro)
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 32, Wednesday 14 August 2013
Epidemiological week no. 32
(4 to 10 Aug 2013)

http://www.emro.who.int/images/stories/pakistan/documents/pak_documents/DEWS/Weekly-Epidemiological-Bulletin-32-14082013.pdf

?CCHF: In week 32 and 33, 2013, a total of 4 suspected CCHF cases were reported, 2 from districts Quetta and Killasaifullah in Balochistan; while 1
each from district Chakwal (Punjab) and district Poonch (AJK). Epidemiological investigation conducted
and treatment initiated (Page 5).
? Measles: This week a total of 17 alerts investigated. 42 measles cases were reported from 9 districts. Vitamin‐A drops provided to the suspected
cases and district health teams were contacted to improve outreach vaccination in affected areas (Page 6).
? Due to EID holidays this week 32, 2013, 66 districts and 1690 health facilities have reported to Disease Early Warning system (DEWS), compared
to 72 districts with 1974 health facilities shared weekly data in week 31, 2013 to the DEWS.
? Total 414,759 patients consultations reported this week compared to 720,698 consultations in week 31, 2013.
? Altogether 42 alerts were investigated and 4 outbreaks were identified and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
In week 32, 2013, two new type‐1 wild polio cases were reported in the country,
one each from Sindh (Gadap town Karachi) and Federally Administered Tribal
Areas (North Waziristan Agency). This brings the total number of wild polio
cases to 24 in 2013 (compared to 32 during the same time period last year) from
12 districts/towns/tribal agencies/areas (compared to 19 during the same time
period last year).
...
CCHF

In week 32 and 33, 2013, a total of 4 suspected CCHF cases were reported, 2 from districts Quetta and Killasaifullah in Balochistan; while 1 each from district Chakwal (Punjab) and district Poonch (AJK). A total of 52 suspected, 35 confirmed CCHF cases and 10 deaths have been reported in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week 32 (10 August
2013) (15,762 cases and 319 fatalities - Ro).
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 33, Wednesday 21 August 2013
Epidemiological week no. 33
(11 to 17 Aug 2013)

http://www.emro.who.int/images/stories/pakistan/documents/pak_documents/DEWS/Weekly-Epidemiological-Bulletin-33-21082013.pdf

? CCHF: In week 33, 2013, 2 suspected CCHF cases were reported 1 each from districts Quetta and
Killasaifullah in Balochistan. Epidemiological investigation conducted and treatment initiated (Page 5).
? Measles: This week a total of 21 alerts investigated. 35 measles cases were reported from 14 districts. Vitamin‐A drops provided to the suspected
cases and district health teams were contacted to improve outreach vaccination in affected areas (Page 6).
? In this week (33, 2013), 79 districts and 2122 health facilities have reported to Disease Early Warning system (DEWS), compared to 66 districts
with 1690 health facilities shared weekly data in week 32, 2013 to the DEWS.
? Total 748,823 patients consultations reported this week compared to 433,038 consultations in week 32, 2013.
? Altogether 62 alerts were investigated and 2 outbreaks were identified and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In week 33, 2013, no new wild polio case was reported in the country.
? The total number of wild polio cases remain 24 in 2013 (compared to 32 during
the same time period last year) from 12 districts/towns/tribal agencies/areas
(compared to 19 during the same time period last year).
...
CCHF
In week 33, 2013, 2 suspected CCHF cases were reported, 2 from districts Quetta and Killasaifullah in Balochistan.
Cases were farmer and labour by profession with clear contact history with animal. Samples were collected
and result is awaited. The A total of 52 suspected, 35 confirmed CCHF cases and 10 deaths have been reported
in year 2013.
...
Measles
...
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in
2013 up till week 33 (17 August 2013). (15,797 cases and 319 fatalities - Ro)
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 34, Wednesday 28 August 2013
Epidemiological week no. 34
(18 to 24 Aug 2013)

? Dengue fever: 445 cases of Dengue fever have
been reported from district Swat and the outbreak
is being responded jointly.
? CCHF: In week 34, 2013, 2 suspected CCHF cases
were reported 1 each from district Quetta, Balochistan;
and district Attock in Punjab. Epidemiological
investigation conducted and treatment
initiated (Page 5).
? Measles: This week a total of 28 alerts investigated.
45 measles cases were reported from 13
districts. Vitamin‐A drops provided to the suspected
cases and district health teams were contacted
to improve outreach vaccination in affected
areas (Page 6).
? In this week (34, 2013), 73 districts and 1934
health facilities have reported to Disease Early
Warning system (DEWS), compared to 79 districts
with 2122 health facilities shared weekly data in
week 33, 2013 to the DEWS.
? Total 784,993 patients consultations reported this
week compared to 740,459 consultations in week
33, 2013.
? Altogether 85 alerts were investigated and 7 outbreaks
were identified and timely responded.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In this week 34, 2013, one new type-1 wild polio case was reported in the country
from Federally Administered Tribal Areas (FR Bannu). This brings the total
number of wild polio cases to 25 in 2013 (compared to 37 during the same time
period last year) from 12 districts/towns/tribal agencies/areas (compared to 22
during the same time period last year). The polio outbreak in FATA continues,
bringing the total number of wild polio cases from the region to 15 (60% of the
total wild polio cases in the country during 2013 so far).
...
CCHF
In week 34, 2013, 2 suspected CCHF cases were reported, 1 each from district Quetta, province Balochistan (Lab result
negative for CCHF); and district Attock in Punjab (Lab result Awaited). Total of 52 suspected, 35 confirmed CCHF cases and 10
deaths have been reported in year 2013.
...
Measles
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week
33 (24 August 2013). (15,850 cases & 320 fatalities - Ro)
...

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-34-28082013.pdf

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 35, Wednesday 4 September 2013
Epidemiological week no. 35 (25 to 31 Aug 2013)

? Dengue fever: During the week, a total of 592, positive cases of Dengue fever have been reported from 6 districts in Pakistan. The highest
number of DF cases (1,125 Dengue Lab confirmed) cases have been reported from district Swat, KP. The outbreak in Swat is being responded jointly.
? CCHF: In week 35, 2013, 2 suspected CCHF cases were reported 1 each from district Quetta, and Killa Abdullah Balochistan; While 2 other cases reported belongs to Afghanistan district Hilmand and Qandahar. Epidemiological investigation conducted and treatment initiated (Page 5).
? Measles: This week a total of 34 alerts investigated. 65 measles cases were reported from 19 districts. Vitamin‐A drops provided to the suspected cases and district health teams were contacted to improve outreach vaccination in affected areas (Page 6).
? In this week (35, 2013), 73 districts and 2019 health facilities have reported to Disease Early Warning system (DEWS), compared to 73 districts
with 1925 health facilities shared weekly data in week 34, 2013 to the DEWS.
? Total 843,047 patients consultations reported this week compared to 825,828 consultations in week 34, 2013.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In this week 35, 2013, 2 new wild polio cases (type‐1) were reported in
the country from Federally Administered Tribal Areas (North Waziristan
Agency). This brings the total number of wild polio cases to 27 in 2013
(compared to 39 during the same time period last year) from 12 districts/
towns/tribal agencies/areas (compared to 22 during the same
time period last year).
...
CCHF
In week 35, 2013, 2 confirmed and 2 suspected CCHF cases were reported and investigated. 1 each from district
Quetta (Negative), and Killa Abdullah (Positive), province Balochistan; while 2 cases belongs to Afghanistan, districts Hilmand
(Positive) and Qandahar (Lab result Awaited). All the cases were reported in Quetta. Total of 59 suspected, 37 confirmed CCHF
cases and 10 deaths have been reported country wide in year 2013.
...
Dengue
From January to 2nd September 2013 total 2,140 Dengue fever cases have been reported country wide. There are continuous
emergence of cases from Karachi throughout the year. This year higher number of cases of Dengue fever have been reported from the previously
les endemic areas. A huge outbreak is encountered in district Swat and case are also reported from district Mardan in Khyber
Pakhtunkhwa. First time this season Dengue fever cases have also been reported from district Gwadar Balochistan province.

From 7 August to 2nd September total 1,125 cases reported from 9 union councils of district Swat with the maximum cases reported
from Tehsil Babuzai. Most of the water samples collected from tyre shops for Aedes larva have been found positive. DCO Swat has
notified Dengue Task Force and Dengue Response Cell has been established at the EDO Health Office Swat. Joint outbreak control activities
have been started in the district by all partners and the concerned line departments. Epidemiological surveillance for case reporting, vector
and larvae surveillance have been enhanced in the district. Health care provider and health workers have been trained on prevention and
control of Dengue fever. Blood samples are being sent to NIH for genotyping also.
...
Measles
Table at the bottom summarizes the situation of measles in year 2012; and illustrates the alerts and outbreaks in 2013 up till week
35 (31 August 2013) (15,922 cases & 321 fatalities - Ro)
...

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-35_0.pdf

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 37, Wednesday 18 September 2013
Epidemiological week no. 37 (8 to 14 Sept 2013)

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-37-18092013.pdf

? Dengue fever: During this week, 1,952 Dengue fever cases have been reported. The highest number of DF cases 1,808 reported from district Swat,
Khyber Pakhtunkhwa. The outbreak in Swat is being responded jointly.
? CCHF: In week 37, 2013, 4 deaths (2 confirmed for CCHF) reported from district Abbottabad, Khyber Pakhtunkhwa province, all 4 cases belongs to the
same family living in a village in Tehsil Havellian, Abbottabad, and butcher by profession; while 4 more CCHF cases, 2 confirmed from district Killa
Abdullah; and 2 suspected cases reported from districts Loralai and Musa Khail in Balochistan province. Epidemiological investigation conducted
and treatment initiated (Page 5).
? In this week, 72 districts and 2047 health facilities have reported to Disease Early Warning system (DEWS), compared to 73 districts with 1872
health facilities shared weekly data in week 36, 2013 to the DEWS.
? Total 893,698 patients consultations reported this week compared to 840,660 consultations in week 36, 2013.
...
Dengue
In 2013 Dengue fever outbreaks reported from the less endemic areas in Pakistan. A huge Dengue fever outbreak is
being confronted in district Swat of Khyber Pakhtunkhwa province. In district Swat from 7th August to 19th September total
5,194 Dengue fever cases and 14 deaths have been reported. Rapid diagnostic Test Kits are used for diagnosis locally, and selected
numbers of samples are also sent to NIH Islamabad reference Laboratory for confirmation and Sero typing. 15 samples
tested at NIH revealed that three types of virus (DNV‐1; DNV‐2; DNV‐3) were detected in different patients from Swat. This
year few cases of Dengue fever have been diagnosed in Gawadar with no travel history out of the district (most probably the
infection was acquired locally).

District administration Swat has notified Dengue Task Force and Dengue Response Cell has been established at the
EDO Health Office Swat. Joint outbreak control activities are carried in the district by all partners and the concerned line departments.
From 1st January to 14 September 2013, Sindh reported 1,170, Punjab 119, and Balochistan 6 Dengue fever cases.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In this week 37, 2013, no new wild polio case was reported from
any part of the country. The total number of wild polio cases is 28 in
2013 (compared to 39 during the same time period last year) from 13
districts/towns/tribal agencies/areas (compared to 22 during the same
time period last year).
...
CCHF
In week 37, 2013, 4 deaths (2 confirmed for CCHF) reported from district Abbottabad, Khyber Pakhtunkhwa province,
all 4 cases belongs to the same family living in Abbottabad, Khyber Pakhtunkhwa, and Butcher by profession; while 4 more
CCHF cases, 2 confirmed from district Killa Abdullah; and 2 suspected cases reported from districts Loralai and Musa Khail in
Balochistan province were reported in this week 37, 2013. So for total of 72 suspected, 48 confirmed CCHF cases and 16 deaths
have been reported country wide in year 2013.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 38, Wednesday 25 September 2013
Epidemiological week no. 38 (15 to 21 Sept 2013)

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-38-25092013.pdf

? Dengue fever: During this week, 2,139 Dengue fever cases have been reported. The highest number of DF cases 1,759 reported from district Swat,
Khyber Pakhtunkhwa. The outbreak in Swat is being responded jointly.
? CCHF: In week 38, 2013, 2 new suspected CCHF cases reported, both the cases belongs to Afghanistan and admitted at hospital in Quetta,
both the cases having history of contact with animals (taking care at home). While on 24th September, 3 more suspected CCHF cases were
reported 1 each from districts Quetta, Killa Abdullah and Zhob. Epidemiological investigation conducted and treatment initiated (Page 5).
? In this week, 73 districts and 2192 health facilities have reported to Disease Early Warning system (DEWS), compared to 73 districts with 2047
health facilities shared weekly data in week 37, 2013 to the DEWS.
? Total 923,417 patients consultations reported this week compared to 934,448 consultations in week 37, 2013.
? Altogether 101 alerts were investigated and 11 outbreaks were identified and timely responded.
...
Dengue
In 2013 Dengue fever outbreaks reported from the less endemic areas in Pakistan. A huge Dengue fever outbreak is
being confronted in district Swat of Khyber Pakhtunkhwa province. In district Swat from 7th August to 25th September total
6,376 Dengue fever cases and 23 deaths have been reported. Rapid diagnostic Test Kits are used for diagnosis locally, and selected
numbers of samples are also sent to NIH Islamabad reference Laboratory for confirmation and Sero typing. 15 samples
tested at NIH revealed that three types of virus (DNV-1; DNV-2; DNV-3) were detected in different patients from Swat. This
year few cases of Dengue fever have been diagnosed in Gawadar with no travel history out of the district (most probably the
infection was acquired locally).

District administration Swat has notified Dengue Task Force and Dengue Response Cell has been established at the
EDO Health Office Swat. Joint outbreak control activities are carried in the district by all partners and the concerned line departments.
From 1st January to 25th September 2013, Sindh reported 1,472, Punjab 196, and Balochistan 8 Dengue fever
cases.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
? In this week 38, 2013, no new wild polio case was reported from
any part of the country. The total number of wild polio cases is remain
28 in 2013 (compared to 43 during the same time period last year) from
13 districts/towns/tribal agencies/areas (compared to 24 during the
same time period last year).
...
CCHF
In week 38, 2013, 2 new suspected CCHF cases reported, both the cases belongs to Afghanistan and admitted at hospital
in quetta, both the cases having history of contact with animals (taking care at home). While on 24th September 3 more
suspected CCHF cases were reported 1 each from districts Quetta, Killa Abdullah and Zhob (Died on same day, lab result
awaited) in Balochistan province. from So for total of 77 suspected, 48 confirmed CCHF cases and 17 deaths have been reported
country wide in year 2013.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 40, Wednesday 9 October 2013
Epidemiological week no. 40 (29 Sept to 5 Oct 2013)

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-40-09102013.pdf

? Dengue fever: During this week, 1,736 Dengue fever cases have been reported. The highest number of DF cases 898 reported from district Swat,
Khyber Pakhtunkhwa. The outbreak in Swat is being responded jointly.
? MERS‐CoV: An alert for the Middle East Respiratory Syndrome Chorona Virus was reported. The laboratory tests for the suspected case reported
negative. The tests were repeated and found negative.
? CCHF: In week 40, 2013, no new CCHF case was reported from any district (Page 5).
? In this week, 70 districts and 2059 health facilities have reported to Disease Early Warning system (DEWS), compared to 73 districts with 2071
health facilities shared weekly data in week 39, 2013 to the DEWS.
? Total 742,392 patients consultations reported this week compared to 867,073 consultations in week 39, 2013.
? 109 alerts investigated and 10 outbreaks identified and timely responded.
...
Dengue
An ongoing Dengue fever outbreak is being confronted in district Swat of Khyber Pakhtunkhwa province. In
district Swat total 8,083 Dengue fever cases and 23 deaths have been reported from 7th August to 5th October.
Three Sero types ( DNV‐1; DNV‐2;DNV‐3) of Dengue virus have been found in different patients in district Swat.
Samples for Sero typing are tested at National Institute of Health (NIH) Islamabad, and Institute of Public Health
(IPH), Lahore. The other districts in Khyber Pakhtunkhwa where Dengue fever cases reported are Mardan, Shangla
and Lower Dir.
District administration Swat has notified Dengue Task Force and Dengue Response Cell has been established
at the EDO Health Office Swat. Joint outbreak control activities are carried in the district by all partners and
the concerned line departments. From 1st January to 5th October 2013, Sindh reported 2,403, Punjab 315, and Balochistan 8 Dengue fever cases.
...
Distribution of Wild Polio Virus cases Pakistan 2012 and 2013
In week 40, 2013, seven new wild polio cases were reported in the country, six from
Federally Administered Tribal Areas (three each from North Waziristan and Khyber Agencies)
and one from Khyber Pakhtunkhwa (Peshawar). This brings the total number of wild polio cases
to 39 all type1 in 2013 (compared to 47 during the same time period last year) from 14 districts/
towns/tribal agencies/areas (compared to 25 during the same time period last year).
Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa have reported
87% (33/39) of the total wild polio cases this year so far.
...
CCHF
In week 40, 2013, no new CCHF case was reported from any district. So for total of 77 suspected, 48 confirmed CCHF
cases and 15 deaths have been reported country wide in year 2013.
In 2012, a total of 62 suspected cases were reported
throughout the country with 41 cases confirmed
and in total 18 deaths; of which 13 deaths (CFR is 31.7%)
are reported of the lab confirmed cases and 5 deaths are
reported as suspected CCHF cases. 23 confirmed cases
were reported from Balochistan; 7 from Sindh; 6 from Khyber
Pakhtunkhwa and 5 from Punjab.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 44, Wednesday 6 November 2013
Epidemiological week no. 44 (27 Oct to 2 Nov 2013)

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-44-06112013.pdf

? Dengue fever: During this week, 1237 Dengue fever cases have been reported. The highest number of DF cases 690 reported from Sindh. The
outbreaks are being responded jointly.
? CCHF: No new confirmed CCHF case was reported in week 44, 2013. (Page 5).
? In this week, 69 districts and 1,961 health facilities have reported to Disease Early Warning system (DEWS), compared to 72 districts with 2,049
health facilities shared weekly data in week 43, 2013 to the DEWS.
? Total 738,465 patients consultations reported this week compared to 896,122 consultations in week 43, 2013.
? 87 alerts investigated and 9 outbreaks identified and timely responded. Altogether 25 alerts were for Dengue fever; 14 for Measles; 11 for Leishmaniasis; 10 each for NNT and Typhoid; 4 each for
ARI and CCHF; 3 for Acute diarrhoea; 2 each for AWD and Scabies; while 1 each for Diphtheria and Malaria.
...
Dengue (See also Pakistan: 2013 Dengue cases - Ro)
An ongoing Dengue fever outbreak is being confronted in district Swat of Khyber Pakhtunkhwa province. In
district Swat total 8,963 Dengue fever cases and 36 deaths have been reported from 7th August to 2nd November
2013. Three Sero types ( DNV‐1; DNV‐2;DNV‐3) of Dengue virus have been found in different patients in district
Swat. Samples for Sero typing are tested at National Institute of Health (NIH) Islamabad, and Institute of Public
Health (IPH), Lahore. The other districts in Khyber Pakhtunkhwa where Dengue fever cases reported are Mardan,
Shangla and Lower Dir.
District administration Swat has notified Dengue Task Force and Dengue Response Cell has been established
at the EDO Health Office Swat. Joint outbreak control activities are carried in the district by all partners and
the concerned line departments. From 1st January to 2nd November 2013, Khyber Pakhtunkhwa reported 9,321;
Sindh 3,889, Punjab 1,103, and Balochistan 15 Dengue fever cases.
...
Distribution of Wild Polio Virus cases in Pakistan 2012 and 2013 (see also Pakistan Polio 2013- 63 cases to date - Ro)
In week 44 2013, 3 new wild polio cases (type‐1) have been reported; 2 from Federally
Administered Tribal Areas (North Waziristan Agency) and 1 from Khyber Pakhtunkhwa (Peshawar).
This brings the total number of wild polio cases to 56 in 2013 as compared to 54 in 2012 (point in
time) from 16 districts/ towns / tribal agencies / areas compared to 27 (point in time) last year.

It is important to mention that 87% (49/56) of the total wild polio cases this year have
been reported from Federally Administered Tribal Areas (40) and Khyber Pakhtunkhwa (09).
...
CCHF (See also Pakistan CCHF 2013 - Ro)
In week 44, 2013, no new CCHF case was reported from any area, but the result of 1 case reported previously from district Rawalpindi
found positive for CCHF. The patient is a staff nurse. So for total of 86 suspected, 58 confirmed CCHF cases and 18 deaths have been
reported country wide in year 2013.
...

[Ronan Kelly]

Re: Pakistan Epidemiological Bulletins 2013

Volume 4, Issue 52, Wednesday 1 January 2014
Epidemiological week no. 52
(22 to 28 Dec 2013)

? Dengue fever: During this week, 90 Dengue fever cases have been reported, out of them 80 from province Sindh and 10 from province
Punjab. The outbreaks are being responded jointly.
? In this week, 74 districts and 2,242 health facilities have reported to Disease Early Warning System (DEWS), compared to 78 districts with 2,278 health facilities shared weekly data in week 51, 2013 to the DEWS.
? Total 722,830 patients consultations reported this week 52, 2013 compared with 820,695 consultations in week 51, 2013.
? 30 alerts investigated and 2 outbreaks identified and timely responded. Altogether 7 alerts were for Leishmaniasis; 6 for Measles; 5 for NNT; 4 each for Typhoid and ARI; 2 for Diphtheria; while 1 each for Bloody diarrhoea
and Scabies.
...
Distribution of Wild Polio Virus cases in Pakistan 2012 and 2013
In this week 52, 2013, six new type‐1 wild polio cases have been reported in the country,
five from Federally Administered Tribal Areas (North & South Waziristan agencies) and one from
Punjab (Toba Tek Singh district). This brings the total number of polio cases this year to 83 as compared
to 58 last year, the number of infected districts/towns/tribal agencies/ FR areas in the country
are 21 as compared to 28 last year.
It is important to mention that 83% of total polio cases (69 cases) are from Khyber
Pakhtunkhwa (10 cases) and FATA (59 cases). North Waziristan Agency in FATA, alone has reported
31/59 (53%) Wild Polio cases indicating very intense viral circulation in the tribal agency.
...
Follow up of CCHF
In week 52, 2013, no new CCHF cases reported from any district. So for total of 100 suspected, 64
confirmed CCHF cases and 20 deaths have been reported country wide in year 2013.
In 2012, a total of 62 suspected cases were reported throughout the country with 41 cases confirmed
and in total 18 deaths; of which 13 deaths (CFR is 31.7%) are reported of the lab confirmed cases
and 5 deaths are reported as suspected CCHF cases. 23 confirmed cases were reported from Balochistan;
7 from Sindh; 6 from Khyber Pakhtunkhwa and 5 from Punjab. Table on right illustrates situation of CCHF
cases in 2012‐13.
...
Focus on Dengue fever:
...
In 2013 Dengue fever cases are reported from the less endemic areas also. A huge outbreak is confronted in district Swat and increasing
number of Dengue fever cases are reported from adjacent district also and cases are also reported from Gawadar district in Balochistan
province and Karachi in Sindh province. There is no vaccine available against dengue, and there are no specific medications to treat
a dengue infection. This makes prevention the most important step, and prevention means avoiding mosquito bites if you live in or travel to
an endemic area.
...
Malaria:
The chart at below shows the Malaria slide positivity and Falciparum ratio in week 52, 2013. Total number of Malaria cases tested
in this week is 6,023 out of which 540 were found positive; 279 for P. Vivax; 165 for P. Falciparum; while 96 for Mixed (SPR = 8.97%; F.R =
48.33%).
...

http://reliefweb.int/sites/reliefweb.int/files/resources/Weekly-Epidemiological-Bulletin-52-01012014.pdf