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Pakistan Epidemiological Bulletins 2014

Ronan Kelly

Ronan Kelly

Retired 2020
Link to 2013 thread: http://www.flutrackers.com/forum/showthread.php?t=198201

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: eic.nih@gmail.com; WHO: Tel : +92-051-9255184-5, Fax : +92-051-9255083; E-mail: wr@pak.emro.who.int.

Volume 5, Issue 3, Wednesday 22 January 2014
Epidemiological week no. 3
(12 to 18 Jan 2014) *
Highlights

? Dengue*fever:*During*this*week,*16*Dengue*
fever* lab* confirmed* cases* have* been* re‐
ported*from*province* Sindh.*The*outbreaks*
are*being*responded*jointly.*
*
? In*this* week,* 76* districts* and* 2,340* health*
facilities* have* reported* to* Disease* Early*
Warning* System* (DEWS),* compared* to* 77*
districts* with* 2,287* health* facilities*shared*
weekly*data*in*week*2,*2014*to*the*DEWS.*
*
? Total* 761,666* patients* consultations* re‐
ported* this* week* 2,* 2014* compared* with*
772,014*consultations*in*week*2,*2014.**
*
? In*this*week,*a*total*of*75* alerts* identified*
and*timely*responded.*Altogether*33* alerts*
were*for*Measles;*15*for* Leishmaniasis;*13*
for* Typhoid;* 8* for* NNT;* 4* for* Diphtheria;*
while*1*each*for*AWD*and*Bloody*diarrhoea.*
...
Dengue
From*1st*to*18*January*2014,*a*total*of*85*lab*con‐
firmed*Dengue*fever*cases*were*reported,*out*of*them*84*posi‐
tive*cases*from*Sindh*province;*while*1*positive*case*was*re‐
ported*from*province*Punjab.* *

* In*year*2013*Dengue*fever*cases*are*reported*from*the*
less*endemic*areas.*A*huge*outbreak*is*confronted*in*district*
Swat*and*increasing*number*of*Dengue*fever*cases*are*re‐
ported*from*adjacent*district*also*and*cases*are*also*reported*
from*Gawadar*district*in*Balochistan*province*and*Karachi*in*
Sindh*province.**
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2012*and*2013*
* *
* In*this*week*3*(5*to*11*Jan*2014),*no*new*polio*case*was*reported.*The*total*
number*of*polio*cases*in*2013*remains*91*(as*compared*to*58*in*2012)*from*22*districts/
towns/tribal*agencies/*FR*areas*(as*compared*to*28*in*2012).** * *
* More*than*80%*of*total*polio*cases*are*from*Khyber*Pakhtunkhwa*(10*cases)*
and*FATA*(65*cases).*It*is*of*note*that*type‐1*wild*poliovirus*is*persistently*circulating*in*
Punjab*province*(after*being*introduced*from*central*Khyber*Pakhtunkhwa)*for*nearly*
three*months*indicating*substantial*immunity*gap.**
...
CCHF
In*week*3,*2014,*no*new*CCHF*cases*reported*from*any*district.*A*total*of*100*suspected,*64*confirmed*CCHF*cases*and*20*deaths*have*been*reported*country*wide*in*year*2013.**** * *
* In*year*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*Ba‐
lochistan;*7*from*Sindh;*6*from*Khyber*Pakhtunkhwa*and*5*from*Punjab.*Table*on*right*illustrates*situa‐
tion*of*CCHF*cases*in*2012‐13.** * *
* Approximately*all*the*cases*had*contact*history*with*animal*trading/handling,*tick*bite,*contact*
with*patient,*tannery*worker,*butcher/animals*slaughtering,*and*fresh*animal*skin.*There*is*ongoing*trade*
of*animals*and*animal*skins*with*movement*intra*Pakistan*and*between*neighboring*countries*
(Afghanistan*and*Iran).
...
Malaria:*
The*chart*at*below*(see link) shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*3,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*5,576*out*of*which*458*were*found*positive;*289*for*P.*Vivax;*82*for*P.*Falciparum;*while*87*for*Mixed*(SPR*=*8.21%;*F.R*=*
36.90%).*
...
http://reliefweb.int/sites/reliefwe...ekly-Epidemiological-Bulletin-03-22012014.pdf
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 5, Wednesday 5 February 2014

Epidemiological week no. 5
(26 Jan to 1 Feb 2014) *
? Dengue*fever:*During*this*week,*13*Dengue*
fever* lab* confirmed* cases* have* been* re‐
ported*from*province* Sindh.*The*outbreaks*
are*being*responded*jointly.*
*
? In*this* week,* 74* districts* and* 2,216* health*
facilities* have* reported* to* Disease* Early*
Warning* System* (DEWS),* compared* to* 73*
districts* with* 2,299* health* facilities*shared*
weekly*data*in*week*4,*2014*to*the*DEWS.*
*
? Total* 845,798* patients* consultations* re‐
ported* this* week* 5,* 2014* compared* with*
844,175*consultations*in*week*4,*2014.**
*
? In*this*week,*a*total*of*62* alerts* identified*
and*timely*responded.*Altogether*28* alerts*
were*for*Measles;*13*for* Leishmaniasis;*10*
for*NNT;*6*for*Typhoid;*2*each*for*Diphtheria*
and*Scabies;*while*1*for*Pertussis.*
...
Dengue
From*1st*January*to*1st*February*2014,*a*total*of*106*
lab*confirmed*Dengue*fever*cases*were*reported,*out*of*them*
105*positive*cases*from*Sindh*province;*while*1*positive*case*
was*reported*from*province*Punjab.*
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2012*and*2013*
* *
* In*this*week*5*(26*Jan*to*1*Feb*2014),*two*new*wild*type‐1*polio*cases*were*
reported*from*Federally*Administered*Tribal*Areas*(North*Waziristan*Agency)*with*date*
of*onset*of*paralysis*in*2014.*This*brings*the*total*number*of*polio*cases*in*2014*to*
seven,*all*from*North*Waziristan*Agency*in*FATA.**
* The*tribal*Agency*did*not*conduct*any*polio*supplementary*immunization*ac‐
tivities*(SIAs)*since*June*2012*leading*to*an*ongoing*explosive*polio*outbreak*with*35*
type‐1*wild*polio*cases*in*2013*and*seven*so*far*in*2014.
...
CCHF
In*week*5,*2014,*no*new*CCHF*cases*reported*from*
any*district.*A*total*of*100*suspected,*64*confirmed*CCHF*cases*
and*20*deaths*have*been*reported*country*wide*in*year*2013.*
...
Malaria:*
*
The*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*5,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*5,088*out*of*which*305*were*found*positive;*147*for*P.*Vivax;*116*for*P.*Falciparum;*while*42*for*Mixed*(SPR*=*5.99%;*F.R*=*
51.80%).
...
http://reliefweb.int/sites/reliefwe...ekly-Epidemiological-Bulletin-05-06022014.pdf
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 7, Wednesday 19 February 2014

Epidemiological week no. 7
(9 to 15 Feb 2014) *
? Dengue*fever:*During*this*week,*13*Dengue* fever* lab* confirmed* cases* have* been* re‐ ported*from*Sindh*province.**
*
? In*this* week,* 75* districts* and* 2,378* health* facilities* have* reported* to* Disease* Early* Warning* System* (DEWS),* compared* to* 79* districts* with* 2,330* health* facilities*shared* weekly*data*in*week*6,*2014*to*the*DEWS.*
*
? Total* 911,475* patients* consultations* re‐ ported* this* week* 7,* 2014* compare* to* 757,430*consultations*in*week*6,*2014.**
*
? In*this*week,*a*total*of*88* alerts* identified and*timely*responded.*Altogether*44* alerts* were*for*Measles;*13*for* Leishmaniasis;*11* for* NNT;* 6* for* Typhoid* fever;* 3* each* for** H1N1,*AWD*and*ARI;*2*for*Acute*diarrhoea;* while*1*each*for*MERS‐CoV,*Diphtheria*and* Scabies.
...
Dengue
From*1st*January*to*15th*February*2014,*a*total*of*130*
lab*confirmed*Dengue*fever*cases*were*reported,*out*of*them*
129*positive*cases*from*Sindh*province;*while*1*positive*case*
was*reported*from*Punjab*province.* *
* In*year*2013*Dengue*fever*cases*were*reported*from*
many*less*endemic*areas.*A*huge*outbreak*was*confronted*in*
district*Swat*and*increasing*number*of*Dengue*fever*cases*were*
reported*from*adjacent*district*also*and*cases*were*also*re‐
ported*from*Gawadar*and*Kech*districts*in*Balochistan*province*
and*Karachi*in*Sindh*province.**
...
MERS-COV
15‐Feb*MERS‐COV* Punjab* Rawalpindi*
Village*Nerian*Sharif,*
Tehsil*Tara*Khel,*Distt.*
Sadhnoti*AJK*

A*death*due*to*severe*Acute*Respiratory*Infection*was*reported*from*ICU,*MH*hospital*
Rawalpindi.*Patient*was*a*55*year*old*female*admitted*in*MH*due*to*SARI.*The*patient*
has*travel*history*to*Saudi*Arabia*for*Umrah*and*returned*1*week*back.*She*developed*
flu*like*symptoms*during*last*days*of*her*Umrah*and*symptoms*got*worsened*after*her*
arrival*home.*She*was*admitted*in*ICU,*MH*on*11th*February*and*specimen*were*tested*for*MERS-CoV*and*found*negative.*The*patient*was*a*known*case*of*Diabetes*and*
Hypertension.*The*close*contacts*in*the*family*were*given*awareness*regarding*the*
disease*and*educated*on*preventive*measures.
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
* In*this*week*7*(9*to*15*Feb*2014),*6*new*wild*type‐1*polio*cases*were*reported,*4*from*
the*Federally*Administered*Tribal*Areas*(North*Waziristan*and*Khyber*agencies)*and*2*from*Khyber*
Pakhtunkhwa*(Peshawar*and*Bannu*districts).*This*brings*the*total*number*of*polio*cases*in*2014*to*
15*(from*4*districts/agencies).** * *
* The*additional*polio*vaccination*round*(as*per*short*interval*additional*dose*strategy)*
has*been*completed*in*43*districts.*Charsadda,*Mardan*&*Nowshera*districts*in*Khyber*Pakhtunk‐
hwa*and*5*towns*of*Karachi*are*in*the*process*of*implementation,*whereas*5*towns*of*Karachi*(Bin*
Qasim,*Gadap,*Gulshan,*Landhi*and*Orangi)*could*not*start*the*vaccination*round*due*to*insecurity.*
While*north*and*south*Waziristan*tribal*agencies*in*FATA*remain*unreached*(since*June*2012).
...
CCHF
In*week*7,*2014,*no*new*CCHF*cases*reported*from*
any*district.*A*total*of*100*suspected,*64*confirmed*CCHF*cases*
and*20*deaths*have*been*reported*country*wide*in*year*2013.**** * *
* In*year*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*re‐
ported*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
...
Malaria:*
*
The*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*7,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*6,294*out*of*which*443*were*found*positive;*224*for*P.*Vivax;*81*for*P.*Falciparum;*while*138*for*Mixed*(SPR*=*7.04%;*F.R*=*
49.44%).*
...
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-07-19022014.pdf
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 8, Wednesday 26 February 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-08-26022014.pdf?ua=1

Epidemiological week no. 8
(16 to 22 Feb 2014) *
? Dengue*fever:*During*this*week,*11*Dengue* fever* lab* confirmed* cases* have* been* reported*from*Sindh*province.**
*
? In*this* week,* 80* districts* and* 2,519* health* facilities* have* reported* to* Disease* Early* Warning* System* (DEWS),* compared* to* 79* districts* with* 2,378* health* facilities*shared* weekly*data*in*week*7,*2014*to*the*DEWS.*
*
? Total* 994,040* patients* consultations* reported*in*week*8,*2014*compare*to*911,475* consultations*in*week*7,*2014.**
*
? In*this*week,*a*total*of*81* alerts* identified* and*timely*responded.*Altogether*31* alerts* were* for* Measles;* 14* for* Leishmaniasis;* 9* Typhoid*fever;* 8*for*NNT;* 7*for*ARI;* 4*for*
Diphtheria;*2*each*for*Pertussis*and*Scabies;*
while* 1* each* for* AWD,* Bloody* diarrhoea,* CCHF*and*Rubella.*
...
Dengue
From*1st*January*to*22nd*February*2014,*a*total*of*141*
lab*confirmed*Dengue*fever*cases*were*reported,*out*of*them*
140*positive*cases*from*Sindh*province;*while*1*positive*case*was*
reported*from*Punjab*province.* *
* In*year*2013*Dengue*fever*cases*were*reported*from*
many*less*endemic*areas.*A*huge*outbreak*was*confronted*in*dis‐
trict*Swat*and*increasing*number*of*Dengue*fever*cases*were*re‐
ported*from*adjacent*district*also*and*cases*were*also*reported*
from*Gawadar*and*Kech*districts*in*Balochistan*province*and*Ka‐
rachi*in*Sindh*province.**
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
* In*this*week*8*(16*to*22*Feb*2014),*six*new*wild*type‐1*polio*cases*were*reported,*five*
from*the*Federally*Administered*Tribal*Areas*(North*Waziristan*agency)*and*one*from*Khyber*
Pakhtunkhwa*(Peshawar*district).*This*brings*the*total*number*of*polio*cases*in*2014*to*twenty*one*
(compared*to*5*in*2013*till*this*time)*from*4*districts/agencies*(compared*to*5*in*2013*so*far).* *
* Second*round*of*National*Immunization*Days*(NIDs)*commenced*today*targeting*more*
than*34*million*children.*District*Swabi*and*Mardan*are*conducting*the*NIDs*with*a*phased*ap‐
proach*until*3rd*week*of*March.**
...
Malaria:*
*
*
The*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*8,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*6,238*out*of*which*431*were*found*positive;*249*for*P.*Vivax;*67*for*P.*Falciparum;*while*115*for*Mixed*(SPR*=*6.91%;*F.R*=*
42.23%).*
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 9, Wednesday 5 March 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-09-05032014.pdf?ua=1

Epidemiological week no. 9
(23 Feb to 1 Mar 2014) *
• Dengue*fever:* During*this*week,* 5*Dengue*
fever* lab* confirmed* cases* have* been* re‐
ported*from*Sindh*province.**
*
• In*this* week,* 78* districts* and* 2,500* health*
facilities* have* reported* to* Disease* Early*
Warning* System* (DEWS),* compared* to* 80*
districts* with* 2,519* health* facilities*shared*
weekly*data*in*week*8,*2014*to*the*DEWS.*
*
• Total* 933,313* patients* consultations* re‐
ported* in* week* 9,* 2014* compare* to*
1,008,938*consultations*in*week*8,*2014.**
*
• In*this*week,*a*total*of*84* alerts* identified*
and*timely*responded.*Altogether*30* alerts*
were* for* Measles;* 20* for* Leishmaniasis;* 9*
Typhoid*fever;*8*for*NNT;*6*each*for*H1N1*
and* ARI;* 2* each* for* Bloody* diarrhoea* and*
Pertussis;*while*1*for*Scabies.

Dengue

From*1st*January*to*1st*March*2014,*a*total*of*146*lab*con‐
firmed*Dengue*fever*cases*were*reported,*out*of*them*145*positive*
cases*from*Sindh*province;*while*1*positive*case*was*reported*from*
Punjab*province.* *
* In*year*2013*Dengue*fever*cases*were*reported*from*many*
less*endemic*areas.*A*huge*outbreak*was*confronted*in*district*Swat*
and*increasing*number*of*Dengue*fever*cases*were*reported*from*
adjacent*district*also*and*cases*were*also*reported*from*Gawadar*
and*Kech*districts*in*Balochistan*province*and*Karachi*in*Sindh*prov‐
ince.**
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
* *
* In*this*week*9*(23*Feb*to*1*Mar*2014),*three*new*wild*type‐1*polio*
cases*were*reported*from*the*Federally*Administered*Tribal*Areas*(two*from*
North*Waziristan*agency*and*one*from*FR*Bannu).*This*brings*the*total*number*
of*polio*cases*in*2014*to*24*(compared*to*5*in*2013*till*this*time)*from*5*dis‐
tricts/tribal*agencies*(compared*to*5*in*2013*till*this*time). **
...
Malaria:*
**
The*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*9,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*6,772*out*of*which*513*were*found*positive;*324*for*P.*Vivax;*73*for*P.*Falciparum;*while*116*for*Mixed*(SPR*=*7.58%;*F.R*=*
36.84%).*
...
Current*situation*of*H1N1*in*Pakistan:** *
* A*comparative*analysis*of*H1N1*cases*reported*through*DEWS*have*been*done*for*the*years*2013*and*2014.*In*2013*
total*9*cases*of*H1N1*have*been*reported,*(3*cases*from*Punjab*and*6*cases*from*Khyber*Pakhtunkhwa).*However,*in*2014*an*
increase*in*the*number*of*Influenza*cases*have*been*noted*in*some*parts*of*Punjab*province*in*Pakistan*in*a*month*period.

There*are*reports*of*critical*illness*and*deaths*in*young*and*middle*aged*adults.*So*far,*20*suspected*cases*have*been*
reported*from*Punjab*where*majority*(10)*of*the*cases*reported*from*Multan*whereas*4*cases*from*Khanewal*and*3*from*DG*
Khan.*Out*of*these*20*cases,*10*cases*were*laboratory*positive*for*H1N1,*4*cases*reported*as*SARI,*2*for*Hemophilus*influenza*
and*1*for*HIB.*Results*of*three*cases*with*ILI*are*still*awaited.*5*out*of*all*the*cases*were*died*due*to*the*severity*of*the*disease*
CFR=*25%.**
*
From*Khyber*Pakhtunkhwa*province*this*year*4*suspected*cases*have*been*reported*and*2*of*these*are*found*positive*
for*H1N1*and*1*each*positive*for*HIA*and*HIB*respectively.*So*far*no*other*case*reported*from*other*provinces*of*Pakistan.**
Despite*challenges,*there*is*much*that*the*public,*patients,*clinicians,*and*public*health*community*can*do*now*to*
reduce*the*influenza*impact.**
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 10, Wednesday 12 March 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-10-12032014.pdf?ua=1

Highlights

Epidemiological week no. 10
(2 to 8 Mar 2014) *
? Dengue*fever:* During*this*week,* 8*Dengue*
fever* lab* confirmed* cases* have* been* re‐
ported*from*Sindh*province.**
*
? In*this* week,* 78* districts* and* 2,554* health*
facilities* have* reported* to* Disease* Early*
Warning* System* (DEWS),* compared* to* 80*
districts* with* 2,500* health* facilities*shared*
weekly*data*in*week*9,*2014*to*the*DEWS.*
*
? Total* 933,452* patients* consultations* re‐
ported*in*week*10,*2014*compare*to*942,638*
consultations*in*week*9,*2014.**
*
? In*this*week,*a*total*of*67* alerts* identified*
and*timely*responded.*Altogether*31* alerts*
were* for* Measles;* 10* for* Leishmaniasis;* 9**
for*NNT;*6*for*ARI;*4*for*H1N1;*3*for*Scabies;*
2*for*bloody*diarrhoea;*while*1*for*Typhoid*
fever.*

Dengue
*
* From*1st*January*to*8th*March*2014,*a*total*of*154*lab*con‐
firmed*Dengue*fever*cases*were*reported,*out*of*them*153*positive*
cases*from*Sindh*province;*while*1*positive*case*was*reported*from*
Punjab*province.
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
* *
* In*this*week*9*(23*Feb*to*1*Mar*2014),*three*new*type‐1*wild*poliovirus*
cases*were*reported*from*the*Federally*Administered*Tribal*Areas*(two*from*
North*Waziristan*and*one*from*South*Waziristan*agency).*This*brings*the*total*
number*of*polio*cases*in*2014*to*27*(compared*to*5*in*2013*till*this*time)*from*6*
districts/tribal*agencies/areas*(compared*to*5*in*2013*till*this*time). *
...
Malaria:*
**
The*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*9,*2014.*Total*number*of*Malaria*cases*tested*in*
this*week*is*4,460*out*of*which*356*were*found*positive;*202*for*P.*Vivax;*71*for*P.*Falciparum;*while*83*for*Mixed*(SPR*=*7.98%;*F.R*=*
43.26%).
...
Current*situation*of*H1N1*in*Pakistan:** *
* A*comparative*analysis*of*H1N1*cases*reported*through*DEWS*have*been*done*for*the*years*2013*and*2014.*In*2013*
total*9*cases*of*H1N1*have*been*reported,*(3*cases*from*Punjab*and*6*cases*from*Khyber*Pakhtunkhwa).*However,*in*2014*an*
increase*in*the*number*of*Influenza*cases*have*been*noted*in*some*parts*of*Punjab*province*in*Pakistan*in*a*month*period.*
There*are*reports*of*critical*illness*and*deaths*in*young*and*middle*aged*adults.*So*far,*20*suspected*cases*have*been*
reported*from*Punjab*where*majority*(10)*of*the*cases*reported*from*Multan*whereas*4*cases*from*Khanewal*and*3*from*DG*
Khan.*Out*of*these*20*cases,*10*cases*were*laboratory*positive*for*H1N1,*4*cases*reported*as*SARI,*2*for*Hemophilus*influenza*
and*1*for*HIB.*Results*of*three*cases*with*ILI*are*still*awaited.*5*out*of*all*the*cases*were*died*due*to*the*severity*of*the*disease*
CFR=*25%.**
*
From*Khyber*Pakhtunkhwa*province*this*year*4*suspected*cases*have*been*reported*and*2*of*these*are*found*positive*
for*H1N1*and*1*each*positive*for*HIA*and*HIB*respectively.*So*far*no*other*case*reported*from*other*provinces*of*Pakistan.**
Despite*challenges,*there*is*much*that*the*public,*patients,*clinicians,*and*public*health*community*can*do*now*to*
reduce*the*influenza*impact.*
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 12, Wednesday 26 March 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-12-26032014.pdf?ua=1

Epidemiological week no. 12
(16 to 22 Mar 2014) *
• Dengue*fever:*During*this*week,*11*Dengue*
fever* lab* confirmed* cases* have* been* re‐
ported,*10* cases*were*from*Sindh*province*
and*1*case*was*from*Punjab*province.**
*
• In*this* week,* 81* districts* and* 2,465* health*
facilities* have* reported* to* Disease* Early*
Warning* System* (DEWS),* compared* to* 82*
districts* with* 2,577* health* facilities*shared*
weekly*data*in*week*11,*2014*to*the*DEWS.*
*
• Total* 1,022,196* patients* consultations* re‐
ported* in* week* 12,* 2014* compare* to*
1,059,885*consultations*in*week*11,*2014.**
*
• In*this*week,*a*total*of*66* alerts* identified*
and*timely*responded.*Altogether*23* alerts*
were*for*Measles;*16*for*Leishmaniasis;*7*for*
NNT;*5*for*H1N1;*4*for*Pertussis;*3*for*Ty‐
phoid*fever;*2*each*for*CCHF*and*ARI;*while*1*
each*for*acute*diarrhoea,*AJS,*Dengue*fever*
and*Scabies.*

Dengue
From*1st*January*to*15th*March*2014,*a*total*of*173*lab*
confirmed*Dengue*fever*cases*were*reported,*out*of*them*171*posi‐
tive*cases*were*from*Sindh*province;*while*2*positive*cases*were*
reported*from*Punjab*province.*
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
* In*this*week*12*(16*to*22*Mar*2014),*seven*new*wild*type‐1*polio*cases*
were*reported,*two*from*Khyber*Pakhtunkhwa*(one*each*from*Peshawar*and*
Bannu*districts)*and*five*from*Federally*Administered*Tribal*Areas*(North*Wa‐
ziristan*Agency).*This*brings*the*total*number*of*polio*cases*in*2014*to*36*(now - 40 - Ro)
(compared*to*6*in*2013*till*this*time)*from*7*districts/tribal*agencies*
...
Malaria:*
**
The*Table*and*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*12,*2014.*Total*number*of*Malaria*
cases*tested*in*this*week*is*6,421*out*of*which*526*were*found*positive;*310*for*P.*Vivax;*61*for*P.*Falciparum;*while*155*for*Mixed*(SPR*=*
8.19%;*F.R*=*41.06%).
...
Current*situation*of*H1N1*in*Pakistan:** *
* A*comparative*analysis*of*H1N1*cases*reported*through*DEWS*have*been*done*for*the*years*2013*and*2014.*In*2013*
total*9*cases*of*H1N1*have*been*reported,*(3*cases*from*Punjab*and*6*cases*from*Khyber*Pakhtunkhwa).*However,*in*2014*an*
increase*in*the*number*of*Influenza*cases*have*been*noted*in*some*parts*of*Punjab*province*in*Pakistan*in*a*month*period.
There*are*reports*of*critical*illness*and*deaths*in*young*and*middle*aged*adults.*So*far,*37*suspected*cases*have*been*
reported*from*Punjab*where*majority*(15)*of*the*cases*reported*from*Multan*whereas*6*cases*from*Khanewal*and*3*each*from*
DG*Khan*and*Lahore,*and*8*cases*were*reported*from*rest*of*Punjab*province.*One*case*from*district*Loralai*(Balochistan*prov‐
ince)*was*also*reported*from*Nishter*hospital.*Multan,*which*was*not*survived*and*died*o*the*date*of*admission.*Out*of*these*
37*cases,*21*cases*were*laboratory*positive*for*H1N1,*9*cases*reported*as*SARI,*2*for*Hemophilus*influenza*and*2*for*HIB.*Re‐
sults*of*one*case*with*ILI*are*still*awaited.*9*out*of*all*the*cases*were*died*due*to*the*severity*of*the*disease*CFR=*25%.** *
From*Khyber*Pakhtunkhwa*province*this*year*14*suspected*cases*have*been*reported*and*3*of*these*are*found*posi‐
tive*for*H1N1*and*1*each*positive*for*HIA*and*HIB*respectively.*Despite*challenges,*there*is*much*that*the*public,*patients,*cli‐
nicians,*and*public*health*community*can*do*now*to*reduce*the*influenza*impact.**
...
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-12-26032014.pdf?ua=1
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 13, Wednesday 2 April 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-13-02042014.pdf?ua=1

Epidemiological week no. 13
(23 to 29 Mar 2014)

? Dengue fever: During this week, 10 Dengue
fever lab confirmed cases have been reported,
8 cases were from Sindh province
and 2 case were from Punjab province.
? In this week, 82 out of 87 districts and 2,592
out of 2,700 health facilities have reported
to Disease Early Warning System (DEWS),
compared to 81 districts with 2,465 health
facilities shared weekly data in week 12,
2014 to the DEWS.
? Total 958,081 patients consultations reported
in week 13, 2014 compare to
1,051,989 consultations in week 12, 2014.
? In this week, a total of 55 alerts generated
and timely responded. Altogether 20 alerts
were for Measles; 18 for Leishmaniasis; 4 for
H1N1; 3 for Typhoid fever; 2 each for AJS
and NNT; while 1 each for Acute diarrhoea,
ARI, Bloody diarrhoea, Diphtheria, Pertussis
and Scabies.
? 6 outbreaks were identified and responded
and 1 ongoing outbreak monitored.

Dengue
From 1st January to 29th March 2014, a total of 182 lab confirmed
Dengue fever cases were reported, out of them 179 positive
cases were from Sindh province; while 3 positive cases were reported
from Punjab province.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 13 (23 to 29 Mar 2014), three new wild type‐1 polio cases
were reported from Federally Administered Tribal Areas (North Waziristan
Agency). This brings the total number of polio cases in 2014 to 39 (compared to
6 in 2013 till this time) from 7 districts/towns/tribal agencies/FR areas
(compared to 6 in 2013 till this time).
...
Malaria:
The Table and chart at below shows the Malaria slide positivity and Falciparum ratio in week 13, 2014. Total number of Malaria
cases tested in this week is 3,879 out of which 362 were found positive; 192 for P. Vivax; 46 for P. Falciparum; while 124 for Mixed (SPR =
9.33%; F.R = 46.96%).
...
Current situation of H1N1 in Pakistan:
From 1st January to 29th March 2014, a total of 64 suspected cases of H1N1 and SARI were reported in the country,
while an increase in the number of Influenza cases have been noted in southern parts of the Punjab province.
There are reports of critical illness and deaths in young and middle aged adults. So far, 50 suspected cases have been
reported from Punjab where majority (18) of the cases reported from Multan whereas 9 cases from Lahore, 6 from Khanewal,
3 from DG Khan, and 14 cases were reported from rest of Punjab province. One case from district Loralai (Balochistan province)
was also reported from Nishter hospital Multan, which was not survived and died on the date of admission. Out of these
50 cases, 25 cases were laboratory confirmed for H1N1. 9 out of all the lab confirmed cases were died due to the severity of
the disease (CFR= 36%).
From Khyber Pakhtunkhwa province this year 14 suspected cases have been reported and 3 of these are found positive
for H1N1 and 1 each positive for HIA and HIB respectively. There is much that the public, patients, clinicians, and public
health community can do to reduce the influenza impact.
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 14, Wednesday 9 April 2014
http://reliefweb.int/sites/reliefwe...ekly-Epidemiological-Bulletin-14-09042014.pdf

Epidemiological week no. 14
(30 Mar to 5 Apr 2014)
? Dengue fever: During this week, no Dengue fever lab confirmed cases have been reported from any province.
? In this week, 77 out of 87 districts and 2,448 out of 2,700 health facilities have reported to Disease Early Warning System (DEWS),
compared to 82 districts with 2,592 health facilities shared weekly data in week 13, 2014 to the DEWS.
? Total 846,666 patients consultations reported in week 14, 2014 compare to 960,672 consultations in week 13, 2014.
? In this week, a total of 72 alerts generated and timely responded. Altogether 29 alerts were for Measles; 21 for Leishmaniasis; 4
each for H1N1 and Typhoid fever; while 1 each for Acute diarrhoea, AJS, ARI, Bloody diarrhoea, Diphtheria, Meningitis, Pertussis and Scabies.
? 5 outbreaks were identified and timely responded.
...
Dengue
*
* From*1st*January*to*5th*April*2014,*a*total*of*182*lab*confirmed*
Dengue*fever*cases*were*reported,*out*of*them*179*positive*cases*were*
from*Sindh*province;*while*3*positive*cases*were*reported*from*Punjab*
province.*
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
*
* In*this*week*14*(30*Mar*to*5*Apr*2014),*four*new*wild*type‐1*polio*cases*were*
reported,*three*from*Federally*Administered*Tribal*Areas*(North*Waziristan*Agency)*and*
one*from*Khyber*Pakhtunkhwa*(Bannu*district).*This*brings*the*total*number*of*polio*
cases*in*2014*to*43*(compared*to*6*in*2013*till*this*time)*from*7*districts/towns/tribal*
agencies/FR*areas*(compared*to*6*in*2013*till*this*time).
...
Malaria:*
*
The*Table*and*chart*at*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*14,*2014.*Total*number*of*Malaria*
cases*tested*in*this*week*is*4,421*out*of*which*183*were*found*positive;*68*for*P.*Vivax;*46*for*P.*Falciparum;*while*102*for*Mixed*(SPR*=*
9.98%;*F.R*=*48.16%).
...
Current*situation*of*H1N1*in*Pakistan:**
*
*From*1st*January*to*5th*April*2014,*a*total*of*64*suspected*cases*of*H1N1*and*SARI*were*reported*in*the*country,*
while*an*increase*in*the*number*of*Influenza*cases*have*been*noted*in*southern*parts*of*the*Punjab*province.*
There*are*reports*of*critical*illness*and*deaths*in*young*and*middle*aged*adults.*So*far,*51*suspected*cases*have*been*
reported*from*Punjab*where*majority*(18)*of*the*cases*reported*from*Multan*whereas*9*cases*from*Lahore,*6*from*Khanewal,**
3*from*DG*Khan,*and*15*cases*were*reported*from*rest*of*Punjab*province.*One*case*from*district*Loralai*(Balochistan*prov‐
ince)*was*also*reported*from*Nishter*hospital*Multan,*which*was*not*survived*and*died*on*the*date*of*admission.*Out*of*these*
51*cases,*23*cases*were*laboratory*confirmed*for*H1N1.*11*out*of*all*the*lab*confirmed*cases*were*died*due*to*the*severity*of*
the*disease*(CFR=*47.82%).** *
From*Khyber*Pakhtunkhwa*province*this*year*14*suspected*cases*have*been*reported*and*3*of*these*are*found*posi‐
tive*for*H1N1*and*1*each*positive*for*HIA*and*HIB*respectively.*There*is*much*that*the*public,*patients,*clinicians,*and*public*
health*community*can*do*to*reduce*the*influenza*impact.**
...
http://reliefweb.int/sites/reliefwe...ekly-Epidemiological-Bulletin-14-09042014.pdf
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 16, Wednesday 23 April 2014

Epidemiological week no. 16
(13 to 19 Apr 2014) *
? Dengue*fever:*During*this*week,*no*Dengue* fever* lab* confirmed* cases* have* been* re‐ ported*from*any**province.** *
? In*this*week,*76*out*of*87*districts*and*2,436*out*of*2,700*health*facilities*have*reported*to* Disease* Early* Warning* System* (DEWS),*
compared*to*79*districts*with*2,604*health*facilities* shared* weekly* data* in* week* 15,*2014*to*the*DEWS.* *
? Total* 924,957* patients* consultations* reported* in* week* 16,* 2014* as* compared* to*1,037,561*consultations*in*week*15,*2014.**
*
? In*this*week,*a*total*of*55*alerts*generated*and*timely*responded.*Altogether*28* alerts*were*for*Measles;*10*for*Leishmaniasis;*5*for*NNT;*3*for*Acute*diarrhoea;*2*each*for*AJS,*ARI* and* Typhoid* fever;* while* 1* each* for*AWD,*H1N1*and*Diphtheria.*
? 2* outbreaks*were* identified* and*timely*responded.
...
Dengue
From*1st*January*to*19th*April*2014,*a*total*of*183*lab*confirmed*
Dengue*fever*cases*were*reported,*out*of*them*179*positive*cases*were*
from*Sindh*province;*while*4*positive*cases*were*reported*from*Punjab*
province.*
...
Distribution*of*Wild*Polio*Virus*cases*in*Pakistan*2013*and*2014*
*
* In*this*week*16*(13*to*19*Apr*2014),*two*new*type‐1*wild*polio*cases*have*been*
reported*in*the*country,*one*each*from*Federally*Administered*Tribal*Areas*(North*Wa‐
ziristan*agency)*and*Sindh*(Gaddap*Town*Karachi).*This*brings*the*total*number*of*polio*
cases*in*2014*to*49*(compared*to*6*in*2013*till*this*time)*from*9*districts/towns/tribal*
agencies/FR*areas*(compared*to*6*in*2013*till*this*time).
...
Malaria:*
**
The*Table*and*chart*given*below*shows*the*Malaria*slide*positivity*and*Falciparum*ratio*in*week*16,*2014.*Total*number*of*Malaria*
cases*tested*in*this*week*is*3,574*out*of*which*365*were*found*positive;*208*for*P.*Vivax;*74*for*P.*Falciparum;*while*83*for*Mixed*(SPR*=*
10.21%;*F.R*=*43.01%).*
...
Current*situation*of*H1N1*in*Pakistan:**
*
* From*1st*January*to*19th*April*2014,*a*total*of*71*suspected*cases*of*H1N1*and*SARI*were*reported*in*the*country,*
while*an*increase*in*the*number*of*Influenza*cases*have*been*noted*in*southern*parts*of*the*Punjab*province.*
There*are*reports*of*critical*illnesses*and*deaths*in*young*and*middle*aged*adults.*So*far,*57*suspected*cases*have*
been*reported*from*Punjab*where*majority*(32)*of*the*cases*reported*from*Multan*whereas*17*cases*from*Lahore,*while*2*
each*from*Rawalpindi*and*Islamabad.*One*case*from*district*Loralai*(Balochistan*province)*was*also*reported*from*Nishter*hos‐
pital*Multan,*which*did*not*survived*and*died*on*the*date*of*admission.*Out*of*these*57*suspected*cases,*27*cases*were*labora‐
tory*confirmed*for*H1N1.*18*out*of*all*the*lab*confirmed*cases*died*due*to*the*severity*of*the*disease*(CFR=*66.66%).** *
From*Khyber*Pakhtunkhwa*province*this*year*14*suspected*cases*have*been*reported*and*4*of*these*are*found*posi‐
tive*for*H1N1.*There*is*much*that*the*public,*patients,*clinicians,*and*public*health*community*can*do*to*reduce*the*influenza*
impact.
...
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-16-23042014.pdf?ua=1
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 17, Wednesday 30 April 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-17-30042014.pdf?ua=1

Epidemiological week no. 16 (20 to 26 Apr 2014)
? Dengue fever: During this week, no Dengue fever lab confirmed cases have been reported from any province.
? In this week, 73 out of 87 districts and 2,420 out of 2,700 health facilities have reported to Disease Early Warning System (DEWS),
compared to 76 districts with 2,436 health facilities shared weekly data in week 16, 2014 to the DEWS.
? Total 950,714 patients consultations reported in week 17, 2014 as compared to 928,030 consultations in week 16, 2014.
? In this week, a total of 46 alerts generated and timely responded. Altogether 17 alerts were for Measles; 9 for Leishmaniasis; 7 for
NNT; 4 for Acute diarrhoea; 3 for Scabies; 2 for Typhoid fever; while 1 each for AWD, BD, CCHF and H1N1.
? 2 outbreaks were also identified and timely responded.

Dengue

From 1st January to 26th April 2014, a total of 183 lab confirmed
Dengue fever cases were reported, out of them 179 positive cases were
from Sindh province; while 4 positive cases were reported from Punjab
province.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 17 (20 to 26 Apr 2014), five new type‐1 wild polio cases have been
reported in the country, four from Federally Administered Tribal Areas (three from North
Waziristan and one from South Waziristan agency) and one from Sindh (Gadap Town
Karachi). This brings the total number of polio cases in 2014 to 54 (compared to 8 in
2013 till this time) from 9 districts/towns/tribal agencies/FR areas (compared to 7 in
2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 17, 2014. Total number of Malaria
cases tested in this week is 4,181 out of which 526 were found positive; 324 for P. Vivax; 94 for P. Falciparum; while 108 for Mixed (SPR =
12.58%; F.R = 38.40%).
...
Current situation of H1N1 in Pakistan:
From 1st January to 26th April 2014, a total of 71 suspected cases of H1N1 and SARI were reported in the country,
while an increase in the number of Influenza cases have been noted in southern parts of the Punjab province.

There are reports of critical illnesses and deaths in young and middle aged adults. So far, 57 suspected cases have
been reported from Punjab where majority (32) of the cases reported from Multan whereas 17 cases from Lahore, while 2
each from Rawalpindi and Islamabad. One case from district Loralai (Balochistan province) was also reported from Nishter hospital
Multan, which did not survived and died on the date of admission. Out of these 57 suspected cases, 27 cases were laboratory
confirmed for H1N1. 18 out of all the lab confirmed cases died due to the severity of the disease (CFR= 66.66%).

From Khyber Pakhtunkhwa province this year 14 suspected cases have been reported and 4 of these are found positive
for H1N1. There is much that the public, patients, clinicians, and public health community can do to reduce the influenza
impact.
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 20, Wednesday 21 May 2014

Epidemiological week no. 20 (11 to 17 May 2014)
• Dengue fever: During this week, no Dengue fever lab confirmed case have been reported from any province.
• In this week, 73 out of 87 districts and 2,423 out of 2,700 health facilities have reported to Disease Early Warning System (DEWS), compared to 74 districts with 2,428 health facilities shared weekly data in week 19,
2014 to the DEWS.
• Total 952,827 patients consultations reported in week 20, 2014 as compared to 935,359 consultations in week 19, 2014.
• In this week, a total of 45 alerts generated and timely responded. Altogether 20 alerts were for Measles; 5 for Leishmaniasis; 4 for
CCHF; 3 each for AJS, Bloody diarrhoea and NNT; 2 each for Acute diarrhoea and Typhoid; while 1 each for AWD, ARI and Diphtheria.
• 13 outbreaks were also identified and timely responded.
...
Dengue
From 1st January to 17 May 2014, a total of 185 lab confirmed Dengue fever
cases were reported, out of these 179 positive cases were from Sindh province; while 6 positive cases were reported from Punjab province.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 20 (11 to 17 May 2014), five new type‐1 wild polio cases have
been reported in the country, all from Federally Administered Tribal Areas (3 from North
Waziristan agency, one each from South Waziristan and Khyber agencies). This brings the
total number of polio cases in 2014 to 66 (compared to 14 in 2013 till this time) from 9
districts/towns/tribal agencies/FR areas (compared to 8 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 20, 2014. Total number of Malaria
cases tested in this week is 3,413 out of which 406 were found positive; 286 for P. Vivax; 66 for P. Falciparum; while 54 for Mixed (SPR =
11.90%; F.R = 29.56%).
...
Current situation of H1N1 in Pakistan:
From 1st January to 17th May 2014, a total of 73 suspected cases of H1N1 and SARI were reported in the country,
while an increase in the number of Influenza cases have been noted in southern parts of the Punjab province.
There are reports of critical illnesses and deaths in young and middle aged adults. So far, 59 suspected cases have
been reported from Punjab where majority (32) of the cases reported from Multan whereas 18 cases from Lahore, while 2
each from Rawalpindi and Islamabad. One case from district Loralai (Balochistan province) was also reported from Nishter hospital
Multan, which did not survived and died on the date of admission. Out of these 59 suspected cases, 27 cases were laboratory
confirmed for H1N1. 18 out of all the lab confirmed cases died due to the severity of the disease (CFR= 66.66%).
From Khyber Pakhtunkhwa province this year 14 suspected cases have been reported and 4 of these are found positive
for H1N1. There is much that the public, patients, clinicians, and public health community can do to reduce the influenza
impact.
...
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-20-21052014.pdf?ua=1
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 21, Wednesday 28 May 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-21-28052014.pdf?ua=1

Epidemiological week no. 21 (18 to 24 May 2014)
• Dengue fever: During this week, no Dengue fever lab confirmed case have been reported from any province.
• In this week, 65 out of 87 districts and 2,365 out of 2,700 health facilities have reported to Disease Early Warning System (DEWS), compared to 73 districts with 2,423 health facilities shared weekly data in week 20, 2014 to the DEWS.
• Total 983,085 patients consultations reported in week 21, 2014 as compared to 976,770 consultations in week 20, 2014.
• In this week, a total of 51 alerts generated and timely responded. Altogether 33 alerts were for Measles; 4 each for CCHF and Leishmaniasis; 3 for AWD; 2 each for Acute diarrhoea and NNT; while 1 each for AJS,
Diphtheria and Typhoid.
• 10 outbreaks were also identified and timely responded.
...
Dengue
From 1st January to 24th May 2014, a total of 185 lab confirmed Dengue fever
cases were reported, out of these 179 positive cases were from Sindh province; while 6 positive
cases were reported from Punjab province.
...
CCHF
One case reported from isolation ward of FJCH. Investigation was done and
found history of developing high grade fever, thereafter bleeding per rectum
and gum. Case is a farmer by occupation and has contact with animals used
for farming. There was no travelling history. One blood sample collected and
result is awaited. Lab investigation reveals Hb 9.4 g/dl, platelets 19,000/cmm,
Urea 42 mg%, Creatinine 0.8 mg%, Malaria ‐ve and LFTs were deranged. Supportive
treatment along with 4 pints of FFPs was transfused. No other relative
found with same sign and symptoms. Family was sensitized regarding CCHF.
...
During last 2 weeks, 3 suspected CCHF cases were reported from PIMS. On 16
May a case was admitted at the hospital. The blood sample sent to NIH was
found positive for CCHF, the patient could not survive and died on same day.
Furthermore Two more deaths due to suspected CCHF were also reported
from the hospital, one was on 6 May from Kabul and other on 18 May from
Wah. On field investigation contact of the first case (CCHF positive) at village
SHAH Alladitta was found with symptoms of fever and vomiting, later he was
found positive for CCHF. He was admitted in PIMS with 18000 Platelets and
haematuria but absconded on same day. Health Department through local
live stock Department in Islamabad took action regarding Tick Survey and
measures for its control and prevention at Shah Alladitta village.
...
Suspected and confirmed CCHF cases are reported continuously from epidemiological week 8 2014. So far total 15 suspected
cases, 5 laboratory confirmed, and 5 deaths (4 due to positive CCHF) have been reported where most of the cases are from province Balochistan
Suspected cases = 9 (5 were from Afghanistan); Lab confirmed = 2, and 1 death. 4 suspected cases (1 from Afghanistan) reported
from Islamabad; 1 positive and 3 deaths. While 1 each case was reported from AJ&K (‐ve) and province Punjab (+ve and expired).
Approximately all the cases had contact history with animal trading/handling, tick bite, contact with patient, tannery worker,
butcher/animal slaughtering. There is ongoing trade of animals and animal skins with movement intra Pakistan and between neighboring
countries (Afghanistan and IRAN).
WHO team is supporting the provincial health departments in handling the situation. The WHO‐DEWS team conducts epidemiological
investigation and contacts tracing (active surveillance in the community and hospitals), sharing information with the stake holders
(DoH, Livestock Dept., hospitals and other partners). Give health education to family members and close contacts of the cases on preventive
measures and seeking immediate health care in case of fever/symptoms. Collect and transport blood samples to NIH for laboratory testing
and confirmation. Although joint efforts are being taken, however, more vigorous actions are required on the eradication of infected ticks in
the high risks areas and awareness raising in the population.
...

Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 21 (18 to 24 May 2014), one new type‐1 wild polio case
has been reported from Federally Administered Tribal Areas (FR Bannu). This
brings the total number of polio cases in 2014 to 67 (compared to 17 in 2013 till
this time) from 9 districts/towns/tribal agencies/FR areas (compared to 10 in
2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 21, 2014. Total number of Malaria
cases tested in this week is 2,300 out of which 233 were found positive; 189 for P. Vivax; 20 for P. Falciparum; while 24 for Mixed (SPR =
10.13%; F.R = 18.88%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 22, Wednesday 4 June 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-22-04062014.pdf?ua=1

Epidemiological week no. 22 (25 - 31 May 2014)
• Dengue fever: During this week, no Dengue fever lab confirmed case have been reported from any province.
• In this week, 69 out of 87 districts and 2,377 out of 2,700 health facilities have reported to Disease Early Warning System (DEWS), compared to 66 districts with 2,365 health facilities shared weekly data in week 21,
2014 to the DEWS.
• Total 969,449 patients consultations reported in week 22, 2014 as compared to 1,016,700 consultations in week 21, 2014.
• In this week, a total of 53 alerts generated and timely responded. Altogether 37 alerts were for Measles; 4 each for AWD and Leishmaniasis; 3 for CCHF; while 1 each for Naegleria Meningitis, Dengue fever, Diphtheria,
Pertussis and NNT.
• 10 outbreaks were also identified and timely responded.

Dengue
* From 1st January to 31st May 2014, a total of 185 lab confirmed Dengue fever
cases were reported, out of these 179 positive cases were from Sindh province; while 6
positive cases were reported from Punjab province.
...
CCHF
Two suspected CCHF cases reported from Fatima Jinnah Chest Hospital on
25th May, both are residents of Afghanistan. The first suspected patient was
15 year old female from Rozgan (Afghanistan) whereas the second patient, an
80 years old male from the same area. Both the patients had fever, headache
and body aches with bleeding from nose and mouth and had history of animal
contact. Lab investigations showed low platelet count whereas sample sent
for confirmation at NIH was found positive for CCHF for the male patient. For
both the patients’ symptomatic treatment, supportive fluids were started.
Awareness session was given to Patient’s families regarding the disease.

*Two suspected CCHF cases reported from Fatima Jinnah Chest Hospital on
29th of May, where one patient had a travel history of Afghanistan. The first
suspected case was a 16 years old male resident of Killi Landi, Kuchlak, District
Quetta whereas the second suspected patient was a 30 years old male patient,
resident of Saryaab Mill, Saryaab Road, District Quetta. Both the patients
had fever, headache and body aches with bleeding from nose and
mouth but only the first case had history of animal contact. Lab investigations
showed low platelet count whereas sample sent for confirmation at NIH was
found negative for CCHF for the first patient; lab test for second patient is
under process. For both the patients’ symptomatic treatment, supportive
fluids were started. Awareness session was given to Patient’s families regarding
the disease.

A 28 years old male patient belongs to Afghanistan is admitted in Hayat Abad
Medical Complex on 30 May2014 with history of Fever, Myalgia and Bruises/
Brown spots on the skin all over the body and his condition was not stable at
admission but started improving. Platelet count was only 9500/cmm. Patient
is shifted in Isolated room. Blood sample sent to NIH for Laboratory testing
and confirmation, and reported positive for CCHF. Ribavirine starts to the
patient and to the health personnel who attended him along with patient's
close contacts. Hospital staff requested to implement Infection Control Measures
and to practice Barrier Nursing and wear PPEs while attending the patient.
The patient has recovered and stable.
...
Suspected and confirmed CCHF cases are reported continuously from epidemiological week 8 2014. So far total 16 suspected
cases, 7 laboratory confirmed, and 5 deaths (4 due to positive CCHF) have been reported where most of the cases are from province Balochistan
Suspected cases = 9 (5 were from Afghanistan); Lab confirmed = 3, and 1 death. 4 suspected cases (1 from Afghanistan) reported
from Islamabad; 1 positive and 3 deaths. While 1 each case was reported from province Khyber Pakhtunkhwa (belongs to Afghanistan and
positive for CCHF) province Punjab (+ve and expired) and AJ&K (‐ve).
Approximately all the cases had contact history with animal trading/handling, tick bite, contact with patient, tannery worker,
butcher/animal slaughtering. There is ongoing trade of animals and animal skins with movement intra Pakistan and between neighboring
countries (Afghanistan and IRAN).
...

Naegleria Meningitis
DEWS team was informed about death due to Primary amebic
meningoencephalitis (PAM) reported from a private hospital.
The team visited the family of deceased. History revealed that
the patient had severe headache and Vomiting, he was treated
from nearby GP with different medicines but condition was still
detoriated and admitted to AKU but did not survive and died on
24th May. The Karachi Water and Sewerage Board (KWSB) have
been requested to chlorinate all major reservoirs. A joint committee
of health department officials, KWSB and Karachi Municipal
Corporation (KMC) officials has been set up which will monitor
water chlorination and take water samples on daily basis
from different towns and share reports with all the stakeholders.
Moreover, utilization of print and electronic media to create
awareness among people to prevent Naegleria infection is
planned.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 22 (25 to 31 May 2014), new type‐1 wild polio cases have been
reported in the country, two from Federally Administered Tribal Areas (North Waziristan
Agency) and one each from Khyber Pakhtunkhwa (Bannu district) and Sindh (SITE town
Karachi). This brings the total number of polio cases in 2014 to 71 (compared to 17 in
2013 till this time) from 10 districts/towns/tribal agencies/FR areas (compared to 10 in
2013 till this time).
...
Malaria:

The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 22, 2014. Total number of Malaria
cases tested in this week is 3,293 out of which 347 were found positive; 271 for P. Vivax; 36 for P. Falciparum; while 40 for Mixed (SPR =
10.54%; F.R = 21.90%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 23, Wednesday 4 June 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-23-11062014.pdf?ua=1

Epidemiological week no. 23
(1 - 7 June 2014)
? CCHF: During this week, 2 suspected CCHF cases have been reported from province Balochistan; laboratory results awaited.
? In this week, 73 out of 87 districts and 2,724 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS), compared to 69 districts with 2,377 health facilities shared weekly data in week 22, 2014.
? Total 1,234,518 patients consultations reported in week 23, 2014 as compared to 1,035,621 consultations in week 22, 2014.
? In this week, a total of 43 alerts generated and timely responded. Altogether 27 alerts were for Measles; 5 for Leishmaniasis; 4 for
AWD; 3 for NNT; 2 for CCHF; while 1 each for Bloody diarrhoea and Diphtheria.
? 8 outbreaks were also identified and timely responded.
...
Dengue
From 1st January to 7th June 2014, a total of 306 lab confirmed Dengue fever cases were reported, out of these 300
positive cases were from Sindh province; while 6 positive cases were reported from Punjab province.
...
CCHF
...
Suspected and confirmed CCHF cases are reported continuously from epidemiological week 8 2014. So far total 18 suspected
cases, 7 laboratory confirmed, and 5 deaths (4 due to positive CCHF) have been reported where most of the cases are from province Balochistan
Suspected cases = 11 (6 were from Afghanistan); Lab confirmed = 3, and 1 death. 4 suspected cases (1 from Afghanistan) reported
from Islamabad; 1 positive and 3 deaths. While 1 each case was reported from province Khyber Pakhtunkhwa (belongs to Afghanistan and
positive for CCHF) province Punjab (+ve and expired) and AJ&K (‐ve).

Approximately all the cases had contact history with animal trading/handling, tick bite, contact with patient, tannery worker,
butcher/animal slaughtering. There is ongoing trade of animals and animal skins with movement intra Pakistan and between neighboring
countries (Afghanistan and IRAN).
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 23 (1 to 7 June 2014), four new type‐1 wild polio cases have been
reported in the country, three from Federally Administered Tribal Areas (North Waziristan
Agency) and one from Khyber Pakhtunkhwa (Bannu district). This brings the total
number of polio cases in 2014 to 75 (compared to 18 in 2013 till this time) from 10 districts/
towns/tribal agencies/FR areas (compared to 10 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 23, 2014. Total number of Malaria
cases tested in this week is 2,483 out of which 365 were found positive; 217 for P. Vivax; 18 for P. Falciparum; while 30 for Mixed (SPR =
10.67%; F.R = 18.11%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 25, Wednesday 25 June 2014
http://www.emro.who.int/images/stor...Epidemiological-Bulletin-25-25062014.pdf?ua=1

Epidemiological week no. 25(15 - 21 June 2014)
? CCHF: During this week, 3 lab confirmed CCHF cases have been reported 2 from province Khyber Pakhtunkhwa (belongs to Afghanistan); while 1 positive case report from province Punjab (district Rawalpindi).
? In this week, 76 out of 87 districts and 2,770 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS),
compared to 73 districts with 2,477 health facilities shared weekly data in week 24, 2014.
? Total 1,099,762 patients consultations reported in week 25, 2014 as compared to 1,073,998 consultations in week 24, 2014.
? In this week, a total of 68 alerts generated and timely responded. Altogether 48 alerts were for Measles; 6 for Leishmaniasis; 4
each for Diphtheria and NNT; 3 for AWD; 2 for CCHF; while 1 for Bloody diarrhoea.
? 3 outbreaks were also identified and timely responded.

Dengue
From 1st January to 21st June 2014, a total of 306 lab confirmed Dengue fever cases were reported, out of these 300
positive cases were from Sindh province; while 6 positive cases were reported from Punjab province.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 25 (15 to 21 June 2014), one new type‐1 wild polio case
was reported, from Federally Administered Tribal Areas (North Waziristan
Agency). This brings the total number of polio cases in 2014 to 83 (compared to
19 in 2013 till this time) from 10 districts/towns/tribal agencies/FR areas
(compared to 10 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria slide positivity and Falciparum ratio in week 25, 2014. Total number of Malaria
cases tested in this week is 2,779 out of which 269 were found positive; 210 for P. Vivax; 26 for P. Falciparum; while 33 for Mixed (SPR =
9.68%; F.R = 21.93%).
...
CCHF

A 50 year old man was reported from DHQ Hospital Rawalpindi
as positive case of CCHF. Field investigations were conducted in
coordination with DSC Rawalpindi and patient was found in the
Emergency ward. The patient is a security guard by profession
and from past 5 days developed high grade fever, sore throat,
swollen foot and blood in vomits. Blood sample send to NIH
came positive for CCHF whereas dengue tests were negative,
Platelets count was 94000. Contacts were briefed about symptoms
and CCHF precautions. Patient is stable and recovering in
hospital. The detail Investigation and findings shared with EDO
(H) Rawalpindi.
...
Suspected and confirmed CCHF cases are reported continuously from epidemiological week 8 2014. So far total 25 suspected
cases, 14 laboratory confirmed, and 5 deaths (4 due to positive CCHF) have been reported where most of the cases are from province Balochistan
Suspected cases = 12 (6 were from Afghanistan); Lab confirmed = 5, and 1 death. 6 positive cases (5 positive from Afghanistan)
were reported from province Khyber Pakhtunkhwa. 4 suspected cases (1 from Afghanistan) reported from Islamabad; 1 positive and 3
deaths. 2 positive cases were reported from province Punjab (1 +ve was expired and other stable and discharged from hospital). While 1
suspected case was reported from province AJ&K district Sudhnuti and was negative for CCHF.
Approximately all the cases had contact history with animal trading/handling, tick bite, contact with patient, tannery worker,
butcher/animal slaughtering. There is ongoing trade of animals and animal skins with movement intra Pakistan and between neighboring
countries (Afghanistan and IRAN).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 26, Wednesday 2 July 2014
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-26-02072014.pdf

Epidemiological week no. 26
(22 - 28 June 2014)
? CCHF: During this week, 2 lab confirmed CCHF case have been reported from province Khyber Pakhtunkhwa (belongs to Afghanistan).
? In this week, 76 out of 87 districts and 2,751 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS), compared to 76 districts with 2,770 health facilities shared weekly data in week 25,
2014.
? Total 1,082,551 patients consultations reported in week 26, 2014 as compared to 1,153,036 consultations in week 25, 2014.
? In this week, a total of 42 alerts generated and timely responded. Altogether 26 alerts were for Measles; 5 for Leishmaniasis; 4 for
CCHF; 3 for Acute diarrhoea; while 1 each for Naegleria Meningitis, Diphtheria, NNT and Scabies.
? 3 outbreaks were also identified and timely responded.
...
Crimean Congo Haemorrhagic Fever
Crimean Congo Haemorrhagic Fever (CCHF) cases are reported continuously from epidemiological week 8 2014. So far total 32
suspected cases, 15 laboratory confirmed, and 9 deaths (of theses 4 Laboratory confirmed) have been reported. Most of the cases are from
Balochistan province 17 suspected (9 cases belongs to Afghanistan), 6 Laboratory confirmed and 1 death. 6 Laboratory confirmed (4 from
Afghanistan) were reported from Khyber Pakhtunkhwa province. 4 suspected cases (1 from Afghanistan), 1 Laboratory confirmed and 3
deaths (due to suspected CCHF) were reported from Islamabad. 2 Laboratory confirmed cases, 1 death reported from Punjab province.
While 1 suspected case was reported from district Sudhnuti (AJK) and was negative for CCHF.
The CCHF cases from Afghanistan are detected and reported from Quetta and Peshawar because the patients are referred for
treatment (mostly self referrals) to the Tertiary Care hospitals in both these cities.
...
23‐Jun CCHF Khyber Pakhtunkhwa
Peshawar
Behsud, Jalalabad,
Afghanistan
An alert for CCHF was received from Khyber Teaching Hospital
Peshawar. Investigations revealed a 58 years old patient
resident of Jalalabad, was brought to Khyber Teaching Hospital
Peshawar with fever, Body aches and Lethargy for one
week and bleeding from gums and mouth started in the
ward. He was admitted and then shifted to Isolation. Patient
is an animal dealer by occupation. His platelets were 98000
at the time of arrival. Sample was collected and sent to NIH
which was reported positive for CCHF PCR. The case is recovered
and discharged from hospital. Information shared with
DoH.

23‐Jun CCHF Khyber Pakhtunkhwa
Peshawar
Pull Akhishti, Kabul,
Afghanistan
An alert for CCHF, a male patient of 32 years age belonging
to Kabul Afghanistan was brought to Hayatabad Medical
Complex Peshawar having Fever, Myalgia, Headache and
Body ache for last 9 days and bleeding from Nose for 3 days.
He is a security guard by profession and have no history of
animal contact for last one month. His platelets count was
9000/cmm on admission. Blood sample was sent to NIH
which was found positive for CCHF. While all contacts (family
members and health care providers) were sensitized about
contagious nature of the disease and PPEs. The patient could
not survive and died on 25th June 2014.

...

Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 26 (22 to 28 June 2014), five new type‐1 wild polio virus (WPV)
cases were reported, three from Khyber Pakhtunkhwa (one each from Peshawar, Mardan
and Bannu districts) and one each from Federally Administered Tribal Areas (North
Waziristan Agency) and Sindh (Landhi Town Karachi). This brings the total number of
polio cases in 2014 to 88 (compared to 20 in 2013 till this time) from 12 districts/towns/
tribal agencies/FR areas (compared to 10 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria Slide Positivity and Falciparum Ratio in week 26, 2014. Total number of Malaria
cases tested in this week is 5,072 out of which 475 were found positive; 326 for P. Vivax; 72 for P. Falciparum; while 76 for Mixed (SPR =
9.37%; F.R = 31.37%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 27, Wednesday 9 July 2014
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-27-09072014.pdf

Epidemiological week no. 27
(29 June - 5 July 2014)
? CCHF: During this week, 6 lab confirmed CCHF cases have been reported 3 from Balochistan province (2 cases belongs to Afghanistan);
2 from Khyber Pakhtunkhwa province (both the cases belongs to Afghanistan); while 1 lab confirmed CCHF death was
from Punjab province. (4 out of 6 cases belongs to Afghanistan and were brought to Pakistan for treatment).
? In this week, 76 out of 87 districts and 2,925 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS),
compared to 76 districts with 2,751 health facilities shared weekly data in week 26,
2014.
? Total 987,644 patients consultations reported in week 27, 2014 as compared to 1,166,436 consultations in week 26, 2014.
? In this week, a total of 42 alerts generated and timely responded. Altogether 23 alerts were for Measles; 7 for CCHF; 5 for Leishmaniasis;
2 each for Typhoid fever and NNT; while 1 each for Acute Watery Diarrhoea,
Acute diarrhoea and Diphtheria.
...

Crimean Congo Haemorrhagic Fever
Crimean Congo Haemorrhagic Fever (CCHF) cases are reported continuously from epidemiological week 8 2014. So far total 38
suspected cases, 22 laboratory confirmed, and 10 deaths (of these 7 laboratory confirmed) have been reported. Most of the cases are from
Balochistan province 17 suspected (9 cases belongs to Afghanistan), 9 Laboratory confirmed and 1 death. 8 Laboratory confirmed (6 from
Afghanistan) were reported from Khyber Pakhtunkhwa province. 4 suspected cases (1 from Afghanistan), 2 Laboratory confirmed and 3
deaths (due to suspected CCHF) were reported from Islamabad. 4 suspected CCHF cases (3 Laboratory confirmed), 3 deaths (2 Lab confirmed)
reported from Punjab province. While 1 suspected case was reported from district Sudhnuti (AJK) and was negative for CCHF.

The CCHF cases from Afghanistan are detected and reported from Quetta and Peshawar because the patients are referred for
treatment (mostly self referrals) to the Tertiary Care hospitals in both these cities. The list of CCHF cases with addresses shared with concerned
person at the Ministry of Public Health Afghanistan for preventive measures at community level.
...
30‐Jun CCHF Balochistan Quetta FJCH (Killi Beraw,Saryab Road)

One CCHF case was reported from FJCH. Investigations revealed that the patient
is a dairy farmer and had usual contact with cattle. As per investigations patient
had developed rigors, headache, abdominal pain from last 10 days with complaints
of nasal / gum bleeding for 3 days. The lab results showed Hb 13.5 mg/dl,
platelets 12,000/cmm and also malaria was positive. Symptomatic treatment,
supportive fluids was started. There was no travelling history. Awareness session
was taken with family regarding CCHF disease. Blood sample collected and was
found positive for CCHF.

30‐Jun CCHF Balochistan QuettaFJCH (Killi Poroon, Anjeel District, Afghanistan)

One CCHF case reported from FJCH. Patient had high grade fever, headache,
body ache and nasal / gum bleeding. Patient is an animal trader by profession
and also had animals at home. The lab investigation showed Hb 13.4 mg/dl,
platelets 129,000/cmm, urea 48 mg%, Creatinine 0.8 mg% whereas Malaria and
Dengue were negative. Patient is living in an endemic area and travel to other
districts for trading. Supportive treatment and fluids intake started. Family was
sensitized about CCHF and case condition. Blood sample collected and was found
positive for CCHF.

2‐Jul CCHF Balochistan Quetta FJCH (Killi Pethaw Kholaw, District Malghao, Afghanistan)

One CCHF case was reported from FJCH. Case is an animal trader by profession.
Symptomatic history showed high grade fever with rigors and weakness in lower
limb from last 10 days and nasal/gum bleeding for last 3 days. The lab investigations
revealed Hb 15.5 mg/dl, platelets 61,000/cmm and blood sample send to
NIH came out positive whereas malaria and Dengue were negative. Symptomatic
treatment, supportive fluids was given. There was no travelling history neither
any such case at his family. Awareness session was taken on CCHF. Family was
sensitized for being isolated with the case and inform if any contact gets similar
sign and symptoms.

2‐Jul CCHF Khyber Pakhtunkhwa Peshawar Gadi Khana, Lahori Gate, Peshawar City

Information by DMS HMC about admission of a staff member of Emergency Department
who was involved in shifting of a Positive CCHF case to the Medical
Ward. Initially he was only treated for Fever but later on it was revealed that he
was exposed to the vomitus of the CCHF case. He developed Gums & Mouth
bleeding. Ribavirin was started along with supportive therapy. Blood sample sent
to NIH came positive for CCHF. The patient could not survive and expired.

4‐Jul CCHF Khyber Pakhtunkhwa Peshawar Mohallah Naranj Bagh, Jalal Abad, Afghanistan

An 18 years old female from Jalal Abad Afghanistan was suspected as a CCHF
case at Hayat Abad Medical Complex. Patient had history of fever, body aches
and hemorrhage from nose and mouth. Patient belongs to a family that deals
with domestic animals and butchers. Patient was isolated in a separate room and
investigations revealed that platelet count was 23000; blood sample sent to NIH
found positive for CCHF. Ribavirin treatment initiated to the patient as well as to
close contacts including health care providers that examined the patient.

29‐Jun CCHF Punjab Chakwal Village Jhatla Talagang Chakwal

A death due to CCHF was reported from Holy Family Hospital (HFH) Rawalpindi.
WHO responded with DDHO Chakwal by visiting the hospital and in the community.
Patient was consulted local doctors but later come to HFH OPD and was
given out patient prescription. Later started blood in vomit and was admitted in
Emergency ward under supervision of Medical ward specialist but could not
survive and expired on 30 June 2014. The deceased was farmer by profession,
with history of cattle handling. Blood sample send to NIH during admission,
came out positive, Platelets 17000 and Hb was 4.5. Field visit was arranged and
contacts were briefed about symptoms and CCHF. No family members found ill,
LHW were instructed to remain vigilant about any case in the area. Shared the
detail Investigation report with WHO Punjab, EDO(H) Chakwal and WHO DEWS
Islamabad. Deceased was buried with proper instructions from NIH.

1‐Jul CCHF Khyber Pakhtunkhwa Peshawar Tajkungan, Mazarshrif Afghanistan

A CCHF case was reported from Isolation Room of Khyber Teaching Hospital,
Peshawar. The patient was a 32 year old male, resident of Taj Kurghan, Mazar
Sharif, Afghanistan having fever, headache, body aches for the last 5 days,
bruises on hands for the last 4 days and bleeding from gums and rectum for the
last 2 days. By profession the patient is a butcher. The laboratory investigations
show low platelets (35,000/cmm). Sample was collected and was found positive
for CCHF. The patient did not survive and died on 2nd July 2014.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 27 (29 June to 5 July 2014), two new type‐1 wild polio virus
(WPV) cases were reported from Federally Administered Tribal Areas
(Khyber Agency). This brings the total number of polio cases in 2014 to 90
(compared to 22 in 2013 till this time) from 12 districts/towns/tribal agencies/
FR areas (compared to 11 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria Slide Positivity and Falciparum Ratio in week 26, 2014. Total number of Malaria
cases tested in this week is 3,067 out of which 343 were found positive; 238 for P. Vivax; 38 for P. Falciparum; while 67 for Mixed (SPR =
11.18%; F.R = 30.61%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 28, Wednesday 16 July 2014
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-28-16072014.pdf

Epidemiological week no. 28
(6 - 12 July 2014)
? CCHF: During this week, 2 laboratory confirmed CCHF cases (1 belongs to Afghanistan) and 2 deaths have been reported from Khyber Pakhtunkhwa province; (3 out of 7 suspected cases belongs to Afghanistan and
were brought to Pakistan for treatment).
? In this week, 75 out of 87 districts and 2,981 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS), compared to 76 districts with 2,925 health facilities shared weekly data in week 27, 2014.
? Total 1,081,287 patients consultations reported in week 28, 2014 as compared to 1,051,721 consultations in week 27, 2014.
? In this week, a total of 67 alerts generated and timely responded. Altogether 35 alerts were for Measles; 8 for Leishmaniasis; 7 for CCHF; 5 for NNT; 2 each for Acute diarrhoea, Dengue fever and Naegleria Meningitis;
while 1 each for Acute Watery Diarrhoea, Bloody diarrhoea, AJS, H1N1, Tetanus and Typhoid fever.

CCHF
Crimean Congo Haemorrhagic Fever (CCHF) cases are reported continuously from epidemiological week 8, 2014. So far total 42
suspected cases, 22 laboratory confirmed, and 11 deaths (of these 7 laboratory confirmed) have been reported. Most of the cases are from
Balochistan province 18 suspected (9 cases belongs to Afghanistan), 9 Laboratory confirmed and 2 deaths. 8 Laboratory confirmed (6 from
Afghanistan) were reported from Khyber Pakhtunkhwa province. 4 suspected cases (1 from Afghanistan), 2 Laboratory confirmed and 3
deaths (due to suspected CCHF) were reported from Islamabad. 4 suspected CCHF cases (3 Laboratory confirmed), 3 deaths (2 Lab confirmed)
reported from Punjab province. While 1 suspected case was from district Sudhnuti (AJK) and was negative for CCHF.
The CCHF cases from Afghanistan are detected and reported from Quetta and Peshawar because the patients are referred for
treatment (mostly self referrals) to the Tertiary Care hospitals in both these cities. The list of CCHF cases with addresses shared with concerned
person at the Ministry of Public Health Afghanistan for preventive measures at community level.
...
10‐Jul CCHF Khyber Pakhtunkhwa
Bannu
Mira Khel, Ghori Wala, Bannu

54 years old man, butcher by profession, belonged to Mira Khel, UC
Ghori Wala, district Bannu, became sick on 2nd July when he developed
fever, severe body aches and dehydration. He was treated at DHQ hospital
Bannu but not improved and was referred to Peshawar and got
admitted in Medical Ward of HMC in Isolation Room. He developed
Bruises under the skin all over the body. At the time of admission his
platelets were 12000. 1 blood sample taken and found positive for
CCHF. The patient could not survive and expired on 11‐7‐2014.

9‐Jul CCHF Khyber Pakhtunkhwa
Peshawar
Kundus, Near Mazare Shareef, Afghanistan

25 years old female patient was admitted in Hayatabad Medical Complex
with complaints of fever, generalized weakness admitted on 9‐7‐
2014. The patient belongs to Kundus, Afghanistan. Bleeding from gums
started for the last 2 days from date of admission. Positive contact history
with animals present in the home. Patient was put on Ribavirine
therapy along with supportive treatment. Platelets were 23000 on admission.
1 blood sample taken and sent to NIH found positive for CCHF.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In this week 28 (6 to 12 July 2014), four new type‐1 wild polio virus (WPV) cases
were reported, two from Federally Administered Tribal Areas (Khyber Agency) and one each
from Khyber Pakhtunkhwa (Peshawar) and Sindh (Sanghar). The polio case from Sanghar is
the first one reported in 2014 from outside the reservoir and outbreak areas. This brings the
total number of polio cases in 2014 to 94 (compared to 24 in 2013 till this time) from 13 districts/
towns/tribal agencies/FR areas (compared to 12 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria Slide Positivity and Falciparum Ratio in week 26, 2014. Total number of Ma‐
laria cases tested in this week is 4,083 out of which 543 were found positive; 375 for P. Vivax; 67 for P. Falciparum; while 101 for Mixed (SPR
= 13.30%; F.R = 30.94%).
...
 
Re: Pakistan Epidemiological Bulletins 2014

Volume 5, Issue 29, Wednesday 23 July 2014
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-29-23072014.pdf

Epidemiological week no. 29
(13 - 19 July 2014)
? CCHF: During this week, 4 suspected CCHF cases with 3 deaths have been reported 2 cases were Punjab province, while 1 each
from Balochistan and Khyber Pakhtunkhwa provinces; (1 out of 4 suspected cases belongs to Afghanistan and were brought to Pakistan for treatment).
? In this week, 75 out of 87 districts and 2,976 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS), compared to 75 districts with 2,981 health facilities shared weekly data in week 28,
2014.
? Total 1,098,835 patients consultations reported in week 29, 2014 as compared to 1,112,504 consultations in week 28, 2014.
? In this week, a total of 55 alerts generated and timely responded. Altogether 28 alerts were for Measles; 8 for NNT; 4 for CCHF; 2
each for AWD, Diphtheria and Typhoid fever; while 1 each for Dengue fever, Bloody diarrhoea and Naegleria Meningitis.
? Three outbreak were also identified and timely responded.

CCHF

Crimean Congo Haemorrhagic Fever (CCHF) cases are reported continuously from epidemiological week 8, 2014. So far total 54
suspected cases, 24 laboratory confirmed, and 17 deaths (of these 10 laboratory confirmed) have been reported. Most of the cases are from
Balochistan province 18 suspected (9 cases belongs to Afghanistan), 9 Laboratory confirmed and 2 deaths. 8 Laboratory confirmed (6 from
Afghanistan) were reported from Khyber Pakhtunkhwa province. 4 suspected cases (1 from Afghanistan), 2 Laboratory confirmed and 3
deaths (due to suspected CCHF) were reported from Islamabad. 4 suspected CCHF cases (3 Laboratory confirmed), 3 deaths (2 Lab confirmed)
reported from Punjab province. While 1 suspected case was from district Sudhnuti (AJK) and was negative for CCHF.
The CCHF cases from Afghanistan are detected and reported from Quetta and Peshawar because the patients are referred for
treatment (mostly self referrals) to the Tertiary Care hospitals in both these cities. The list of CCHF cases with addresses shared with concerned
person at the Ministry of Public Health Afghanistan for preventive measures at community level.
...
13‐Jul CCHF KhyberPakhtunkhwa Peshawar
RehmanMedical Institute
(VillageDhidana,Kabul, Afghanistan)

A 25 years old man residence of village Dhidana, Kabul was admitted
in Rehman Medical Institute (PVT), Hayat Abad Peshawar
emergency with history of Fever, Bleeding per rectum. He developed
haematemisis afterwards. He was investigated for hemorrhagic
fever from Agha Khan Laboratory and was reported Positive
for CCHF. He is a farmer by profession and was in good state of
health 10 days ago. WHO provided PPEs to RMI. The patient is
improving and still under treatment. Information shared with DHO.

15‐Jul CCHF Punjab ChakwalMohra Qazi,
PO‐ Karyala,Tehsil & District Chakwal

A death of 45 year old cattle handler was reported and was suspected
as Crimean Congo Hemorrhagic Fever by Holy Family Hospital
Rawalpindi. Verbal autopsy and retrograde investigations in
HF hospital was done. Patient was admitted in Emergency ward
under supervision of Medical specialist but expired on the same
evening. Platelets were 10,000 and Hemoglobin was 14.1. Patient
belongs to District Chakwal. The deceased developed high grade
fever and blood in vomitus from last 5 days. Treatment was provided
by various local doctors and DHQ hospital Chakwal but later
referred to Holy Family hospital. Blood sample sent to NIH came
positive for CCHF. Information and detail Investigation report was
shared with WHO Punjab, EDO(H) Rawalpindi and EDO(H) Chakwal.
Field investigation was done by DDHO Chakwal and entomologist
with live stock focal persons. No contact was found with complaints
or with any symptoms. All the necessary actions taken in
the area by veterinary staff to disinfect the area and cattle. LHWs
were sensitized to do further surveillance in the area.
...
Distribution of Wild Polio Virus cases in Pakistan 2013 and 2014
In week 29 (13 to 19 July 2014), five new type‐1 wild polio virus (WPV) cases were
reported, three from Federally Administered Tribal Areas (two from North Waziristan, one
from South Waziristan) and one each from Khyber Pakhtunkhwa (Lakki Marwat district) and
Sindh (Gadap town Karachi). This brings the total number of polio cases in 2014 to 99
(compared to 24 in 2013 till this time) from 14 districts/town/tribal agencies/FR areas
(compared to 12 in 2013 till this time).
...
Malaria:
The Table and chart given below shows the Malaria Slide Positivity and Falciparum Ratio in week 29, 2014. Total number of Malaria
cases tested in this week is 7,937 out of which 567 were found positive; 424 for P. Vivax; 68 for P. Falciparum; while 75 for Mixed (SPR =
7.14%; F.R = 25.22%).
...
 
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