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OPT: Epidemiological bulletin for Gaza Strip vol 1, issue 15

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Epidemiological weeks 46-49 of 2009

N. of Reporting Units 17/17

Population under surveillance 869 375

- The number of people under surveillance for this reporting period is 869 375 out of 1 073 303 (81%) Palestine refugees registered with UNRWA in the Gaza Strip. This number corresponds to beneficiaries accessing UNRWA health services in 2008;

- The reporting completeness for epiweeks 46-49 of 2009 was 100%;

- The number of consultations in the period 46-49 weeks was going with the usual trend except in weeks 46 and 48 because of holidays and Aladha feast.

- Watery diarrhoea as well as acute bloody diarrhoea and viral hepatitis remain the major causes of morbidity among reportable infectious diseases in the refugee population of the Gaza Strip. During weeks forty six-forty nine, the morbidity trend of acute bloody diarrhoea showed a fluctuating trend with a noticeable increase in week forty nine that will be monitored closely in coming weeks, Watery diarrhoeas in the <3 years, watery diarrhoeas in the >3 years showed a fluctuating trend. Acute hepatitis manifested a decreasing trend all through. Typhoid fever shows a fluctuating pattern.

- Alert/alarm thresholds were not breached for any of the major diseases in the reporting period. During epi-weeks forty six-forty nine, the morbidity trend of acute bloody diarrhoea, watery diarrhoeas in the <3 years, watery diarrhoeas in the >3 years, acute hepatitis and typhoid fever shows a fluctuating trend with a noticeable increase in week forty nine for the acute bloody diarrhoea, watery diarrhoeas in the <3 years, watery diarrhoeas in the >3 years. This will be monitored closely in coming weeks. Neither alert nor alarm thresholds were breached during the reporting period.

Priority Class-A Diseases

Class A diseases are reported within 24 hours in order to produce a rapid alert and initiate necessary actions to confirm or not a potential outbreak.

In the reporting period, one case of viral meningitis was reported from Maghazi HC. The patient was a 2 months old boy. A case of bacterial meningitis of a 12 year old boy was reported from Bureij HC. All needed public health measures including isolation and health education were taken.

What is new is the appearance of cases of influenza A H1N1in Gaza starting from 6 December 2009. 153 cases of influenza A H1N1 have been confirmed in the Gaza Strip as of 18 December 2009. 11 people have died due to influenza A H1N1 but all had additional risk factors. The number of confirmed cases presented in this report surely underestimates the actual number of people affected by influenza A H1N1.

Class-B Diseases

During the reporting period, only one case of mumps was reported from Nusierat HC. She is a 5 years girl who was immunized at 15 months. All needed management and public health measures were taken (isolation, health education was provided to contacts).

The majority of non vaccine preventable Class B diseases (54%), were attributed to watery diarrhea among children under three years of age. Other leading causes of morbidity were watery diarrhea in the refugee population above three years (34%) followed by acute bloody diarrhea (11%). Cases of acute hepatitis (acquired through syndromic surveillance) accounted for 1% of the proportional morbidity.