Infectious Disease Surveillance & Epidemic Preparedness Unit
24 reports were received for week 44, but TimorAid and Philippine Humanitarian Mission still have not given data for week 44, and Oikos have still not given any reports since the beginning of the surveillance system.
Points for discussion: Malaria transmission in Dili, dengue fever in Dili and Los Palos, and measles in Dili and elsewhere, and Acute Flaccid Paralysis.
Dili seems to have a disproportionate notification - 78% of cases are there, against 59% of consultations. (This was most marked in week 42.) Movement of people makes it difficult to know why such a rise and drop over two weeks.
Dili has 73% of cases (59% of consultations), but weekly case numbers go up and down without a clear pattern.
A total of 4547 cases since week 39 (when reporting began), which makes this the second most common diagnosis on our list. Dr Chevalier has a document from a pre-crisis malaria survey, noting 55% parasite prevalence in Dili. An informal report from the UN clinic notes expatriates based in Dili with positive response to malaria treatment. It seems highly likely that there is transmission of malaria in Dili, and that this will get worse during the wet season.
It is important to note that dengue fever will also be recorded in this category in the current system. The Australian Military Hospital has given an informal report of some 15 cases of dengue confirmed by a rapid serology test (though we do not know the dates or locations). MDM-Portugal also reports suspected dengue in expatriate staff in Dili, and another informal report via the Baucau Medical Coordination Meeting notes several suspected cases in expatriate staff in Los Palos.
Dr Odete (the Timorese doctor stationed in Viqueque for the past two years) gives an informal report that there was a lot of dengue in Timor last year, but not before then.
UPPER RESPIRATORY TRACT INFECTION (including suspicion of TB):
There have been 7291 cases notified, making this the most common diagnosis on our list. The geographical distribution is fairly even, and the weekly numbers show no particular pattern.
LOWER RESPIRATORY TRACT INFECTION:
Dili has 72% of cases (59% of consultations), but weekly case numbers go up and down without a clear pattern.
There have now been 32 cases notified from Dili, (80% of the total) with 20 in week 43 and 12 in week 44. One death was reported in week 44 (Dili). There have also been 4 cases in Maliana, 2 cases in Liquica and 2 in Ermera. 7 of the Dili cases were from Lahane.
An informal report from Dr Odete in Viqueque notes that there have been no cases of measles there for at least two years.
A total of 1130 cases of scabies have been reported. Dili has reported 34% of the total (against 59% of consultations). There is no obvious pattern in the weekly totals.
Three cases have been reported, up to week 43 (2 in Baucau Hospital). No further information is available.
Seventeen (17) cases have been reported, with 3 in week 44 (all from Dili).
ACUTE FLACCID PARALYSIS:
A total of 7 cases have been reported, with the latest in week 42. Five of the total occurred in Dili. No samples have yet been collected for analysis.
Despite having been in Dili little more than a week, we have established an effective team, and have made some strong progress towards our general objectives. Within the next month we expect to have a useful basic service in place.
However, our efforts have been considerably hampered by the lack of budgetary and logistic support to the Dili operation of WHO.
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