C. Groeneveld, M. Banda, N. Kayeyi, ML. Mazaba, M. Kapina
Surveillance and Disease Intelligence Unit
Zambia National Public Health Institute
Weekly Report
- Current outbreaks
- Cholera: Six suspected cases tested negative for Vibrio Cholreae tested negative for cholera
- Ebola Virus Disease: Zero cases were reported
Immediately notifiable
Acute Flaccid Paralysis (AFP): No cases were reported in the week under review.
Measles: A total of nine cases were reported this week from Lusaka (2), Northern (4), North Western (2) and Luapula (1) provinces. Three specimens were investigated for measles.
Maternal Deaths: Countrywide nine maternal deaths were registered from Lusaka (3), Eastern (2), Southern (1), North Western (1), Copperbelt (1) and Luapula (1) provinces.
Dengue: One case was confirmed from Lusaka province from a person who recently travelled West Africa
Other diseases
Dysentery: Nationwide 841 of cases of dysentery were recorded this week. Of the twelve samples tested 1 was positive for S. dysenteriae
Regional Public Health Events
NATIONAL IDSR HEALTH FACILITY REPORTING RATES, WEEK 29 2019
OUTBREAKS
Cholera Outbreak
Cumulatively, 435 suspected cases of cholera were recorded from Lusaka and Northern provinces (Nsama, and Mpulungu districts) since week 1.
VACCINE PREVENTABLE DISEASES
AFP Surveillance
Only 44% of the 92 reported case have had complete OPV vaccinations ( ≥ 3 or more doses)
Stool from the 83 adequate specimens were discarded for polioviruses, 7 are pending results
AFP Surveillance
The sensitivity of environmental surveillance poliovirus detection remains adequate with ≥50% isolation of Non-Polio Enteroviruses; while the isolation rate among AFP cases is 7.6% (7/92).
No wild type polioviruses or circulating vaccine-derived polioviruses have been isolated from week 1 to 30.
Measles and Rubella
26% (target 80%) of the reported IDSR have been cases laboratory tested
Positivity among the 154 tested cases for measles IgM is 22% (target 10%) and 1.3% for rubella
Only 20% of the tested have a history of vaccination
HIGH BURDEN DISEASES
HIV
Lusaka and Central provinces have cumulatively reported high numbers of new cases from week 1.
TB
Cumulatively, Muchinga province has recorded the highest confirmed incidence of TB from weeks
Maternal Deaths
Obstetric hemorrhages continue to be the leading cause of death.
Dog Bites
Cumulatively, Central province has recorded the highest number of cases (1560) since week1.
18 fatal rabies deaths have bee recorded to date.
Malaria
Central and Lusaka provinces recorded the highest cumulative incidence of malaria cases from week 1 to 30.
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
81 new confirmed cases and 45 new deaths were reported in the current week.
Cumulative cases stand at of 2659 which 2565 are confirmed and 1,688 deaths occurred (CFR is 66%).
Active transmission is ongoing with 13 of the 23 health reporting zones confirming cases in the last 7 days; .
The regional risk of spread re- mains 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.
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 reposting 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
Vaccine-Preventable Disease Surveillance in Silent Districts
Provinces to ensure silent districts not reporting AFP cases are supported for active surveillance
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.
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
Reported by: Surveillance and Disease Intelligence Unit
Writers: Chanda Groeneveld, Muzala Kapin’a, Moses Banda, Nkomba Kayeyi, Mazyanga M Liwewe, Victor Mukonka and Zambia National Public Health Institute (ZNPHI)