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INTEGRATED DISEASE SURVEILLANCE AND RESPONSE (IDSR) WEEK 30 15-21 JULY 2019

C. Groeneveld, M. Banda, N. Kayeyi, ML. Mazaba, M. Kapina

Surveillance and Disease Intelligence Unit

Zambia National Public Health Institute

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Weekly Report

  • Current outbreaks
  • Cholera: Four suspected cholera cases from Mpulungu district tested negative for V. Cholerae Immediately notifiable
  • Acute Flaccid Paralysis (AFP): Five cases from Eastern and Southern provinces are undergoing laboratory investigation for polioviruses
  • Measles: A total of six cases were reported this week from Copperbelt (1), Lusaka (4) and Muchinga (1) province (1). Five specimens are being tested for measles and rubella
  • Maternal Deaths: Countrywide six maternal deaths were registered from Lusaka (2), Southern, Northern (2) and Central (1) provinces
  • Clustering of Illness: 817 respiratory tract infections were reported in Chipata district, no fatalities
  • Other diseases

Typhoid: Seven cases were reported this week from Lusaka (1) province. Dysentery: the suspected cases of dysentery increased from 557 to 722 in this week compared to the previous week. Only Nine samples tested positive for Shigella dysenteria in the week.

Weekly Summary

NATIONAL IDSR HEALTH FACILITY REPORTING RATES, WEEK 29 2019


OUTBREAKS

Cholera Outbreak, Mpulungu District, Northern Province

• No cases of cholera were reported this week; the last reported cases was on the 5th June 2019
• Cumulatively 439 suspected cases have been reported from Lusaka, Nsama, Mpullungu districts from week 1, positivity
• The second round of the reactive Oral Cholera Vaccination (OCV) campaign converge is currently underway Mpulungu district.

VACCINE PREVENTABLE DISEASES
Cholera Outbreak, Mpulungu District, Northern Province
AFP Surveillance


Five cases from Eastern and Southern provinces are undergoing laboratory investigation for polioviruses

Only 44% of the laboratory tested cases have complete OPV vaccination ( ≥ 3 or more doses).

Stool from the 83 adequate specimens were discarded for polioviruses, 7 are pending results.

Environmental Polio Surveillance

The scheduled collections from the four sites in Ndola, Kitwe, Mufuiria and Chililabombwe

The sensitivity of environmental for poliovirus detection remains adequate with ≥50% isolation of Non-Polio Enteroviruses; while the isolation rate among AFP cases is 7..7% (7/90)

No wild type polioviruses or circulating vaccine-derived polioviruses have been isolated from week 1 to 25.

Measles and Rubella


A total of six cases were reported this week from Copperbelt (1), Lusaka (4) and Muchinga (1) province (1). Five specimens are being tested for measles and rubella.

Cumulatively 25.7% (152) of the 585 suspected cases have been laboratory investigated for measles IgM,19% have a history of vaccination.

HIGH BURDEN DISEASES

HIV


Nationwide week 35,056 cases were tested for HIV . The positivity rate among those tested cases was 5.11%

Lusaka and Central provinces have cumulatively reported high numbers of new cases from week 1.

TB

This week, 8.2 % of the 2877 suspected cases of TB were confirmed positive.

Cumulatively, Muchinga province has recorded the highest confirmed incidence of TB from weeks

Maternal Deaths

Countrywide six maternal deaths were registered from Lusaka (2), Southern, Northern (2) and Central (1) provinces

Obstetric hemorrhages continue to be the leading cause of death.

Lusaka, Western, and Eastern provinces have cumulatively recorded the highest number of deaths since week 1.

Dog Bites

283 cases of dog bites were recorded nation- wide.

Cumulatively, Central province has recorded

the highest number (1503) of cases dog bites from week 1 .

18 fatal rabies deaths have been recorded to date.

Malaria

112,001 suspected malaria cases were notified compared to 116,862 within week 28.

The confirmed incidence this week is 2.2/1000; the positivity rate for the confirmed cases this week was 51%.

North-western, Eastern and Luapula provinces recorded the highest cumulative incidence of malaria cases

EARLY WARNING DISEASES
Ebola Virus, DRC and Uganda , 2018-2019

93 new confirmed cases and 72 new deaths were reported in the current week.

Cumulative cases stand at of 2578 which 2484 are confirmed and 1737 deaths occurred (CFR is 66%).

Active transmission is ongoing with 19 of the 23 health reporting zones confirming cases in the last 21 days; 138 health workers have been infected or 5% of the total confirmed and probable cases.

169 976 people have been vac- cinated since the beginning of the outbreak

Regional risk of spread remains high

PUBLIC HEALTH ACTIONS

General Recommendations

All provinces and districts affected by the outbreaks should conduct laboratory tests on suspect- ed cases to confirm the outbreak. Samples from suspected outbreaks must be tested in the appropriate district or provincial laboratory and at a national reference laboratory.

Regional level

Provide technical guidance for outbreak investigation and response to affected regions.

Support the distribution of epidemic preparedness consumables to affected areas.

Vaccine-Preventable Disease Surveillance in Silent Districts

Provincial health offices to ensure sub regional attainment of the Non-Polio AFP rate of 2 cases per 100,000

Prioritize sample referral of suspected cases to the national reference laboratory

All suspected measles /AFP cases to be given a provisional clinical diagnosis before blood/stool samples are sent to the national reference laboratory for tests.

Districts to promote health worker & community awareness of VPDs and usage of immunization services

All provinces should geocode reported AFP cases

Active Surveillance in Cholera Hotspots

Known cholera prone regions to access risks and ensure epidemic preparedness and response measures in place for cholera prevention and control.
Regions that have reported Cholera outbreaks should conduct public education on preventative measures and work all relevant stakeholders to prevent cholera outbreaks