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Surveillance and Disease Intelligence Unit Zambia National Public Health Institute

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Citation Style For This Article: Surveillance and Disease Intelligence Unit. Intergrated Disease Surveillance and Response. Health Press Zambia Bull. 2020; 4(3); pp 3-6

Weekly Summary

Current outbreaks and public health threats

 COVID-19 (Coronavirus): 96 confirmed cases were reported in the week under review. Cumulatively as of the 31st of May, a total of 1,089 confirmed cases,7 deaths and 912 recoveries have been recorded.

 cVDPV Outbreak: No new confirmed cases were recorded this week.

 Measles Outbreak: No new suspected cases were reported in the week under review from the resurgence of the outbreak in Lunte district of Northern Province.

Immediately notifiable diseases

 COVID-19 (Coronavirus): The country has recorded a cumulative total of 1089 confirmed cases from Muchinga (557), Lusaka (384), Copperbelt (77),Central (36), Eastern (6), Northern (6), Northwestern (6) Southern (5) and Luapula (5) provinces.

 Acute Flaccid Paralysis (AFP): Two cases were reported in the week under review in Central (1) and Northern (1) provinces.

 Maternal Deaths: Fifteen maternal deaths were recorded in Northern (4), Lusaka (2), Central (2), Western (2), Luapula (2) Southern (2) and Copperbelt (1) provinces.

Other diseases/events

 Rabies: One suspected rabies death was recorded in the week under review from Serenje district of Central province.

 Mumps: 140 suspected cases were reported in the week under review from Southern (35), Central (27), Eastern (27), Copperbelt (26), North western (14), Western (7) and Lusaka (4) provinces.

Paper and Electronic Timeliness and Completeness, Health Facility Level

Provincial Report Timeliness

Summary Report Priority Diseases, Conditions and Events (Week 22)

Maternal Deaths

Week 22

Cumulative Number of Maternal Deaths by Province

 Fifteen maternal deaths were registered in the week under review.

 Obstetric hemorrhages and Indirect causes continue to be the leading causes of maternal deaths.

 Lusaka province (66) has cumulatively recorded the highest number of maternal deaths.

 In total, 278 maternal deaths have been recorded from Epi week 1 to Epi week 22 of the year 2020.

Vaccine Preventable Diseases

AFP Surveillance

Districts with reported AFP Cases Week 1-22 2020

Week 22

 Two cases of AFP were reported in the week under review from Mumbwa (1) district in Central province and Senga (1) district in Northern province.

 All samples have been collected and sent for laboratory investigation

 Cumulatively, 81 AFP cases have been recorded from 42 districts country wide.

 As a result of the cVDPV outbreak, non-AFP target rate has been increased to 4/100, 000 population below 15.

 All results received from specimens submitted to the regional lab came out negative for cVDPV

 The risk of cVDPV2 transmission in Zambia is high in districts that are: 1) Silent, 2) Not attaining NonPolio AFP Rates of 4/100,000 or 80% stool adequacy, 3) Neighboring to countries with active outbreaks and 4) Having low IPV vaccination coverages.

Poliovirus Environmental Surveillance (ES)

Measles Outbreak

 The 2nd episode of the outbreak in Lunte district of Northern province was confirmed in the previous epidemiological reporting week.

 No new suspected cases were reported in the week under review,

 The cumulative number of cases recorded since the resurgence of the outbreak, now stands at six suspected cases and One IgM confirmed.

 The affected health facility in the district is Mulenga Mapesa.

Measles & Rubella surveillance

 No new suspected measles cases were reported in the week under review.

 Measles suspected cases are sent for laboratory investigations.

 Cumulatively, 103 suspected measles cases , 15 measles Igm confirmed cases and 6 confirmed measles rubella cases have been recorded.

COVID-19

 96 confirmed cases and 0 death of COVID–19 were reported in the week under review from Lusaka (35), Muchinga (27), Copperbelt (21), Southern (5), Eastern (6) and Luapula (2) provinces. Cumulatively, 1,089 confirmed cases have been recorded, 7 deaths and 912 recoveries.

 The confirmed cases are distributed across Muchinga (557), Lusaka (384), Copperbelt (77), Central (36), Northwestern (6),Eastern (6), Southern (5), Luapula (5), and Northern (5) provinces.

 The University Teaching Hospital Virology Lab (UTHVL), the School of Veterinary Medicine (UNZAVET) and Tropical Diseases Research Centre (TDRC) are conducting tests for suspected cases.

Week 22

Non-Bloody Diarrhoea

 Cumulatively, 274,598 cases of non-bloody diarrhea were reported (week 1 to week 22).

 The highest number of cases reported are from Central province representing 14.97% (42,297).

 The highest cumulative incidence reported is from Central province at 2,438 per 100,000 of the population at risk.

 A downwards trend in the cumulated number of non-bloody diarrhea cases reported has been

Global/Regional/Public Health Events (Cases/Case Fatality Rate)

Ebola	Measles	Cholera	Poliovirus (c VDPD)	CoronaVirus (COVID 19)
DRC : 3,463 CFR 65.80%	DRC: 369,520 CFR 1.80%	DRC: 9,630 CFR 1.20% Moz: 2,305 CFR 0.80%	Angola: 121 CFR 0.0% DRC: 113 CFR 0.0%	Global:6,255,533CFR5.99% Africa: 102,133 CFR 2.6%

COVID-19 WHO African Region

 The coronavirus disease 2019 (COVID-19) pandemic continues to evolve rapidly in the WHO African Region since Countries in the WHO African Region, with all 47 Member States reporting confirmed cases

 23,133 new confirmed cases and 515 deaths of COVID-19 were reported across all affected countries in the current reporting week.

 Cumulatively, a total of 102,133 confirmed cases and 2,614 deaths have been reported in the African region.

 Of the 102,133 confirmed COVID-19 cases reported, 45,925 (45%) cases have been documented as recovered. A total of 2,380(2.33%) health care workers have been infected by the pandemic.

Ebola Virus, DRC 2018-2020

 There has been no new confirmed EVD cases in the week under review. This is the 27th successive day with zero reported confirmed EVD cases since the resurgence of the outbreak on 10 April 2020.

 Cumulatively, 3,463 suspected cases, 3,317confirmed cases, 145 probable cases and 2,280 deaths (CFR is 66%) have occurred since the outbreak started earlier in 2018.

 The total number of health workers affected remains at 171, representing 5% of confirmed and probable cases. ***For more information look up the WHO Weekly Bulletin on Outbreaks and Other Emergencies and for Global updates on the coronavirus COVID 19 look up John Hopkinsdashboard on

Public Health Actions

Circulating Vaccine Derived Poliovirus Outbreak

 All provinces are further encouraged to strengthen AFP surveillance using available technological tools and geo code all cases detected.

 The national annualized Non Polio AFP detection rate has increased to 4 cases /100,000 of children detected under 15 years for provinces.

 Note all AFP cases are immediately notifiable and require immediate investigation with new case investigation forms.

 All districts are expected to conduct health facilities integrated supervisory active searches at priority sites as per recommended schedule.

 Provinces to ensure silent districts not reporting AFP/measles cases are supported for active surveillance of AFP cases.

Ebola Virus Disease Preparedness

 All provinces to strengthen EVD surveillance among all health care providers and raise community awareness of EVD prevention.

 Provide weekly reports in IDSR reports of active searches including zero reporting in at risk districts, including ports of entry.

 Ensure epidemic preparedness measures for detecting cases, sample testing/transportation and managing cases are effected.

 All border districts to strengthen point of entry EVD screening including facilitation of cross boarder monitoring and reporting of suspected EVD cases.

Heightened Surveillance in COVID– 19 High Risk Districts

 Surveillance (including Event Based Surveillance) is being actively conducted at POEs, health facilities, and sentinel sites.

 Screening facilities have been set up at POEs; additionally, screening is being done at the dry port in Makeni for all buses coming in from outside the country.

 Additional thermal scanners to be procured and placed at the POEs to avoid over-crowding and enhance social distancing; set up/identification of designated quarantine facilities to enforce guidelines on quarantine.

 Isolation facilities have also been set up in all high risk districts across the ten provinces;

 Provincial epidemic preparedness committees to engage all relevant government stakeholders and multisector partners required to prevent, control and stop transmission of COVID– 19.

Global Alert of the Coronavirus & Preparedness

 Orientation of staff at points of entry on COVID-19 in all provinces is being conducted in cascade

 Screening at all points of entry to be strengthened especially at international points of entry.

 Circulation of awareness materials to the public and health personnel is being done.

 Report all suspected patients to higher authority immediately.

 Daily monitoring & 14 day quarantine of all travelers from high risk countries is mandatory.  Strengthen surveillance for all Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI)

 Case definitions to be made available and other IEC materials in health facilities and public places.

 A call centre has been established at ZNPHI and all queries should be channeled to the following numbers: 909/+260 96 4638726/+260 974493553/+260 95 3898941.

Reported by Surveillance and Disease Intelligence Unit: Muzala Kapin’a, Nkomba Kayeyi, Moses Banda, Mazyanga M Liwewe, Victor Mukonka and Zambia National Public Health Institute (ZNPHI)