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Bangladesh: Rohingya Emergency Response EWARS Epidemiological Bulletin W13 2018, 3 April 2018

Situation Report
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Epidemiological Highlights Week 13

To date, 155 health facilities out of 158 (98%) have been registered as EWARS sites.

•109 reported were received for week 13, with 9% timeliness and 69% completeness.

•In week 13, total of 79 alerts were triggered, of which 78 were verified (99%).

•Numerous activities are being undertaken by the WHO Health Emergency team as part of their monsoon preparedness activities to support the response in Cox’s Bazar. These include developing an outbreak investigation toolkit, EWARS health facility reporting guide and acute watery diarrhoea preparedness and response plan.

•Discussion on the design and implementation of community based surveillance is ongoing with partners.

•Weekly epidemiological bulletin, EWARS bulletin and diphtheria bulletins for week 13 are disseminated to all partners.


• From 8 November 2017, there were 6,460 diphtheria case-patients reported through EWARS. Week 13 cases include 169 new casepatients (an increase in 31 cases from week 12).

• Total of 40 deaths (case-fatality proportion <1.0%). Most recent death occurred during W12 2018 in a child aged 3 years.

• Majority cases (67, 57.5%) were in persons aged 5-14 years.

• In the host community, 58 diphtheria case-patients have been reported (Figure 3), of which 14 were laboratory-confirmed, 34 were probable cases and 10 were suspected cases. An additional, 61 case-patients were excluded following negative laboratory testing. No deaths have been reported within the host community.

• Diphtheria cases amongst the Forcibly Displaces Myanmar Nationals (FDMN) have declined since January 2018, ~100 cases per week continue to be reported. Further investigation is currently underway to understand transmission dynamics and design strategies for further reduction in cases.
W13 2018 | Highlights W13 2018 | Highlights Measles • In week 13, there were 43 new suspected measles cases compared to 50 cases in week 12. Since 31 December 2017, there were a total of 1105 suspected measles cases.

• To assess ongoing transmission and circulation of measles virus, a rapid sampling strategy has been designed to sample 25 patients over 3-4 days, with the possibility of extending sampling timeframes up to seven days.

Acute Jaundice Syndrome (AJS)

• In week 13, there were 133 new case-patients compared to 105 in week 12. Since 31 December 2017, there were total of 1591 AJS cases.

• Exhaustive sampling was conducted to determine the aetiological agent for AJS. AJS sampling ended on the 26 March 2018 with pending results.

Acute Watery Diarrhoea (AWD)

• In week 13, there were 3,889 AWD cases compared to 4,529 cases in week 12. Since 31 Dec 2017, there were total of 63,496 cases of AWD.

• An AWD Preparedness and Response Plan is currently being developed