Federal Disease Surveillance and Response Unit Field ... · Disease Surveillance Division (FEDSD)...

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Provincial Technical Officers and fellows of FELTP assigned at the Disease Surveillance, Response Units

(DSRU’s) are working with provincial, and district health authorities on event based disease surveillance and

outbreak response. DSRUs are sharing the disease surveillance data, outbreak reports and activities of FELTP

fellows to the Federal Disease Surveillance and Response Unit (FDSRU) at the Field Epidemiology and

Disease Surveillance Division (FEDSD) National Institute of Health (NIH) Islamabad on weekly basis.

COVID-19 Surveillance

PDSRUs in Provinces are working with the

provincial department of health on COVID-19

surveillance, response and contact tracing since

February, 2020 in Pakistan. FELTP fellows Alumni

are actively involved in COVID-19 Surveillance

throughout Pakistan. Data is being shared with

FDSRU on daily basis and a SITRIP is being issued

by FEDSD National Institute of Health Islamabad

FDSRU has developed a mechanism for tracking of

travelers from other countries to Pakistan since 02

February 2020. Daily flights data from international

airports in Pakistan is being shared by the Central

Health establishment (CHE) Islamabad with FDSRU

teams who conduct daily calls on given contact

numbers of the travelers to ask about their health

status, advise them for immediate contact at the

nearest designated hospital in case of COVID-19

symptoms. Total 53,643 travelers have been traced

and contacted by Jul 12, 2020.

Table-1: Weekly Surveillance data COVID-19 by Jul 12, 2020

Province/

Region

Suspected cases

reported at

hospitals

Lab Update Hospital Update

Cumulative tests performed

(Cumulative)

Tested positive

cases

(Cumulative)

Still

admitted

Discharged/Recovered Expired

AJK 19,262 19,637 1,564 87 942 43

Baluchistan 46,049 53,258 11,157 20 7,421 126

GB 12,660 14,223 1,658 90 1,316 36

Islamabad 145,716 147,633 14,023 183 10,645 152

KP 138,570 173,873 30,078 595 20,762 1,087

Punjab 616,495 589,523 86,556 1,510 55,175 2,006

Sindh 553,676 564,491 103,836 1,667 60,439 1,747

Total 1,532,428 1,562,638 248,872 4,152 156,700 5,197

PDSRU SINDH

Total 103,836 confirmed COVID-19 cases were

reported from Sindh until Jul 12,2020. Most of these

cases were reported from Karachi District

(n=79,338) followed by District Hyderabad

(n=3778), District Sukkur (n=3184) and District

Ghotki (n=2818). Age group 50-59 has the highest

attack rate (512/100,000) followed by 60-69 years

age group (429/100,000), 30-39 years age group

(412/100,000), 70+ years’ age group (409/100,000)

and 40-49 years age group (380/100,000).

Federal Disease Surveillance and Response Unit

Field Epidemiology & Disease Surveillance Division

National Institute of Health (NIH) Islamabad

WEEKLY FIELD EPIDEMIOLOGY REPORT

Volume 2-- Issue 26 Jul 05-12, 2020 Date: Jul 13, 2020

Volume02 -- Issue 26 Jul 05- 12, 2020 Date: Jul 13, 2020

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Figure-1: Sindh - District-wise distribution of COVID-19 cases (Jul 12, 2020)

Figure-2: Sindh – Age group-wise Attack Rates /100,000 population (Jul 12, 2020)

PDSRU Punjab

PDSRU Punjab has reported total 616,495 suspected

cases of COVID-19 and out of these 86,556 were lab

confirmed COVID-19 cases up to Jul 12, 2020 while

results of 187 suspects were awaited. District Lahore

has the highest number of confirmed cases

(n=44810) followed by District Rawalpindi

(n=6791), District Multan (n=5529), District

Faisalabad (n=5444) and Gujranwala (n=3052)

respectively. Age group 31-45 years has the highest

number of cases (n=24700) followed by age group

16-30 (n=22928) and age group 46-60 years

(n=17295).

31

89

346

412380

512

429409

0

80

160

240

320

400

480

560

1-9 Y 10-19 Y 20-29 30-39 40-49 50-59 60-69 > 70

Att

ack

Rat

e/10

0,0

00

Age Groups


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Figure-3: Geographical Distribution of COVID-19 Cases in Punjab Province (Cumulative up to week 28)

Figure-4: Age wise distribution of COVID-19 cases in Punjab up to Jul 12, 2020

PDSRU - Baluchistan province

The department of Health Baluchistan has reported

11,157 positive cases of COVID-19 and 126 deaths

till Jul 12, 2020. 7,598 cases have recovered. District

Quetta has the highest number of confirmed

cases(n=8420) followed by District Killa Saifullah

(n=911), District Jaffarabad (n=328) and District

Mastung (n=224). Age group 30-44 has the highest

attack rate per 100000 Population (AR=3775)

followed by 15-29 age group (AR=3033) and 45-59

age group (AR=2032).

3785

2292824700

17295

8386

1480

0

5000

10000

15000

20000

25000

30000

1-15y 16-30 31-45 46-60 61-75 >75

No

. o

f C

ases

Age Groups


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Figure-5: Geographical Distribution of COVID-19 Cases in Baluchistan Province (Cumulative up to Week 28)

Figure-6: Baluchistan –Attack rates /100,000 population in different age groups (up to Jul 12,2020)

PDSRU- Gilgit-Baltistan (GB)

PDSRU GB has reported total 12,755 suspected

cases of COVID-19 and out of these 346 were lab

confirmed COVID-19 cases up to Jul 12, 2020 while

results of 245 suspected cases are still awaited.

12,290 samples were processed and 10,619 suspects

were declared negative for COVID-19. 1319 cases

recovered from COVID-19 while 36 cases expired.

District Skardu has the highest number of cases

(n=80) followed by District Hunza (n=68) and

District Astore (n=50).

1163

3033

3775

2032

947

0

800

1600

2400

3200

4000

<1-14 15-29 30-44 45-59 60+

Att

ack R

ate

/100000

Age Groups


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Table -2 Detail of number of samples, confirmed Covid-19 cases & Deaths in GB up to Jul 12, 2020

District

Number of

Samples

Negative Total Samples

Processed

Positive

Awaited

Recovered

Expired

Samples

Discarded

Astore 2574 2237 2558 50 10 266 05 06

Diamer 491 396 489 35 01 55 03 01

Ghanche 988 833 886 12 32 45 01 70

Ghizer 647 571 640 41 07 27 01 00

Gilgit 3284 2677 3169 49 44 437 16 71

Hunza 1099 869 1080 68 15 141 02 04

Kharmang 228 184 201 00 13 17 00 14

Nagar 932 762 929 26 01 144 02 02

Shigar 394 332 364 00 07 29 03 23

Skardu 2118 1758 1974 65 115 158 03 29

Grand Total 12755 10619 12290 346 245 1319 36 220

Figure-7: GB-District-Wise distribution of confirmed COVID-19 cases up to Jul 12, 2020

PDSRU-AJK

PDSRU AJK has reported total 19,262 suspected

cases of COVID-19 and out of these 1599 were lab

confirmed COVID-19 up to Jul 12, 2020 while

results of 173 suspected cases still awaited. 978 cases

have recovered from COVID-19 and 44 cases

expired due to COVID-19. District Muzaffarabad

has the highest number of cases (n=529) followed by

District Mirpur (n=336), District Bhimber (n=203)

and District Kotli (n=201).

Table -3: Distribution of suspected and confirmed Covid-19 cases in AJK up to Jul 12,2020

Figure-8: AJK-District-Wise distribution of confirmed COVID-19 cases up to Jul 12, 2020

50

80

7

41 39

68

1

21

35

0

15

30

45

60

75

90

Astore Skardu Ghanche Ghizer Gilgit Hunza Kharmang Nagar Diamer

No

. of

Cas

es

Districts

529

33

201

99 97

17

62

336

203

0

80

160

240

320

400

480

560

Muzaffarabad Hattian Bala Kotli Poonch Bagh Havaili Pallandri Mirpur Bhimber

No

. o

f C

ases

Districts

Total Suspected Cases Lab Tests Conducted Lab Confirmed Cases Lab Results Awaited Active Cases Recovered

19,262 19,969 1599 173 517 978


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PDSRU-KPK

PDSRU KPK has reported total 136,062 suspected

cases of COVID-19 and out of these 30,486 were lab

confirmed COVID-19 up to Jul 12, 2020 while 1019

patients expired. District Peshawar has the highest

number of cases (n=10957) followed by District

Swat (n=2692), District Malakand (n=1417) and

District Mardan (n=1174). Age group 30-39 years

has the highest attack rate/100,000 (AR=7316)

followed by 20-29 years age group (AR=5853) and

40-49 years age group (AR=5797).

Figure-9: Geographical Distribution of COVID-19 Cases in KPK Province (Cumulative up to Week 28)

Figure 10: KPK –Attack rates /100,000 population in different age groups (up to Jul 12, 2020)

1371

2164

5853

7316

5797

3963

2194

1310

518

0

1000

2000

3000

4000

5000

6000

7000

8000

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 Above 80

Att

ack

Rate

/10

0,0

00

Age groups


PDSRU Merged Areas KPK

PDSRU Merged Areas KPK has reported total

16,457 suspected cases of COVID-19 and out of

these 2085 were lab confirmed COVID-19 up to Jul

12, 2020 while results of 127 suspected cases still

awaited. District Khyber has the highest number of

confirmed COVID-19 cases (n=1036) followed by

District Bajour (n=466) and District Kurram

(n=391). In all the districts cases declined from week

24 onwards. Age group 26-50 years has the highest

number of cases (n=1185) followed by 0-25 years

age group (n=495).

Figure-11: Week-wise comparison of COVID-19 Cases - Districts of Merged Area KPK (up to Week 28)

Figure-12: Age wise distribution of Covid-19 cases in Merged Areas, KP (Jul 12, 2020)

Communicable Disease Surveillance

Influenza Suspected/Confirmed:

In 2018, total 3221 and in 2019 total 100

Suspected/confirmed Influenza cases reported from

PDSRUs/RDSRUs. In week 28, no suspected cases

were reported.

Diphtheria Surveillance:

During 2018 total 464 and during 2019 total 614-

suspected cases of Diphtheria were reported. In week

28, 05 cases were reported from Punjab & KPK.

Dengue Surveillance:

In 2018, total 3204 Dengue cases reported from

Sindh Total 24,610 cases reported which includes 48

new case reported from Baluchistan. In week 28, no

cases reported from Punjab, Merged Areas, ICT,

Sindh, KP, AJK & Baluchistan

CCHF Surveillance: In 2018, total 63 CCHF

(suspected and confirmed) cases were reported from

DSRUs and 75 cases have been reported in 2019.

No new case reported in this wee

31 33 40 4663

10 19 17

8455 45 39

24

815 8

1

5 20

5730

35 90

31

97

0

0

6 22

1

06

11

22

3 7

1

1

0

4

70

0 6

0

0

40

80

120

160

200

week 20 week 21 week 22 week 23 week 24 week 25 week 26 week 27

No

. o

f C

ases

BAJOUR KHYBER MOHMAND ORAKZAI KURRAM NORTH WAZIRISTAN SOUTH WAZIRISTAN

495

1185

401

0

300

600

900

1200

1500

0 to 25 years 26 to 50 years 51 years & above

No

. of

Cas

es

Age Groups


Table-4: Weekly and Cumulative Diseases Updates Jul 12, 2020

Table 5: Dengue cases reported in 2017, 2018, month-wise distribution in 2019 & current week (All provinces and regions)

Month KPK Sindh AJK ICT TDs - KP Baluch Punjab Total

Jan–Dec 2017

18,857 2,884 6 120 406 86 579 22,938

Jan-Dec 2018 332 2088 1 0 175 69 539 3204 Jan-Dec 2019 5214 2937 506 2847 1484 2841 8826 24547

Total 24403 7909 513 2967 2065 3057 9944 50750

12-07-2020 0 0 0 0 0 0 0 0 Total (2020) 03 0 0 0 02 185 10 200

Extensive drug Resistant (XDR) Typhoid Fever Surveillance in Sindh Province

In Karachi total 12,746 cases of extensive drug

resistance typhoid fever were reported from January

01, 2017 to Jul 12, 2020. During current week total

30 cases of XDR typhoid fever were reported from

different hospitals in Karachi. The XDR Typhoid

cases were reported mostly among the children and

maximum number of XDR cases 7799 (40%) were

reported in the age group 0-4 years. The overall

attack rate was 63/100,000. The age group 0-4 years

was the most affected age group (attack rate

192/100,000) followed by age group 5-9 years (AR

138/100,000). Females have higher attack rate

71/100,000 compared to Males

Table-6: Number of XDR Typhoid fever cases Karachi from January 1, 2017 to Jul 12, 2020 Year Year XDR Cases

Jan to December 2017 175



January 01, to Jul 12 ,2020 2020 1771

Total 12746

Figure 13: Week-wise number of XDR Typhoid fever cases in Karachi, from January 1, 2017 to Jul 12, 2020

0

50

100

150

200

250

300

Week

1

Week

4

Week

7

Week

10

Week

13

Week

16

Week

19

Week

22

Week

25

Week

28

Week

31

Week

34

Week

37

Week

40

Week

43

Week

46

Week

49

Week

52

Week

3

Week

6

Week

9

Week

12

Week

15

Week

18

Week

21

Week

24

Week

27

Week

30

Week

33

Week

36

Week

39

Week

42

Week

45

Week

48

Week

51

WE

EK

2

WE

EK

5

WE

EK

8

WE

EK

11

WE

EK

14

WE

EK

17

WE

EK

20

WE

EK

23

WE

EK

26

Jan FebMarApr MayJuneJuly Aug SeptOct Nov Dec Jan FebMarAprilMayJuneJulyAugustSept Oct Nov Dec Jan Feb Mar AprMayJuneJuly

2018 2019 2020

No.

of

case

s

Epidemiological Months and Weeks

Disease Total Cases in 2019 June 28-Jul 04, 2020 Total Cases in 2020

1 CCHF 75 0 03 2 Varicella 1,264 1 206 3 Dengue 24,547 0 200 4 Chikungunya 0 0 0 5 Measles 6,781 45 1191

6 Diphtheria 614 5 106 7 Suspected / confirmed Seasonal

Influenza 100 0 9


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XDR Typhoid Surveillance Data Sindh-Province (Excluding Karachi)

Total 6461 Salmonella Typhoid cases reported from

the November 2016 to Jul 12, 2020 from different

districts of Sindh province (excluding Karachi).

Among these cases 4961 were Extensive Drug

Resistant cases. Out of these cases, 70.1% (n=3470)

reported from District Hyderabad. The most affected

age group was 0 to 4 years (n=1341) with attack rate

45.4 per/10000 population followed by 5-9 years of

age group (n= 995) with attack rate 34/10000

population. Over all attack rate is 15.9/10000

population (n=3470).

Table 7: Extensive drug Resistant (XDR) Typhoid Fever Surveillance Hyderabad and other districts

Figure 14:XDR Typhoid Cases District Hyderabad Nov-2016 to Jul 12, 2020

Year Hyderabad Other District Total

2016 12 0 12

2017 485 4 489

2018 891 207 1098

2019 1645 998 2643

January 01 – July 04, 2020

418 260 678

Current week (Jul 05-12, 2020) 19 22 41

Total 3470 1491 4961

0

50

100

150

200

250

N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J

Year-16

Year-17 Year -18 Year-19 Year-20

No

. o

f cases

Month wise cases

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