Floods in Venezuela Situation Report 28 Dec 1999

GENERAL HEALTH SITUATION
EPIDEMIOLOGICAL SURVEILLANCE

1. Current Situation

In the organization of epidemiological surveillance to confront the disaster, the following has been considered:

• Surveillance of the population located in shelters.
• Surveillance of the affected population (not in shelters).
• Surveillance of the rest of population.

Surveillance of the population located in shelters

Some information is available from the states that have population located in shelters. This surveillance is in the development phase. Based on the information that has been received and consolidated, trauma and wounds are defined as the leading cause of morbidity, followed by diarrheal diseases, and the third cause is fever and cough. According to daily reports, morbidity from trauma and wounds is declining, while morbidity from diarrheal diseases and fever and cough is on the rise.

Surveillance in the affected population (not in shelters) and in the rest of the population.

The available information corresponds to the epidemiological week No. 50 (from 12 to 18 December 1999), except for cholera, which corresponds to week No. 51. The latter is obtained through the habitual Epidemiological Surveillance System.

Dengue: For week No. 50, there were 396 reported cases, 89 fewer than the same week in 1998, the cumulative of cases is smaller than that during the same period in 1998, but the incidence is located in the alarm zone of the endemic channel. A rise is reported in the Aedex index to houses and a decline in deposits.

The states in an epidemic situation are Anzoategui, Carabobo, Mérida, and Zulia, and in alarm situation, the state of Falcon. Of these five states, four have been affected by the disaster and have population in shelters.

Cholera: Regional Epidemiology Department of the state of Sucre reports that for week No. 51 there were fourteen (14) confirmed cases of cholera, with a national total of 221 cases, 178 more than in the same period in 1998.

The total number of cases in the nation is 355, a figure that represents 42 cases more than in the same period in 1998. The affected states are Sucre, Delta Amacuro, New Esparta, Monagas, and Miranda. In Miranda the cholera outbreak is under control. As of today (27-Dec-99), there have been a total of 7 reported cases.

Malaria: In week No. 50, 537 cases were reported, which is 232 more than in the same week of 1998. The cumulative number of cases is located in the safety zone of the endemic channel. States in epidemic are Amazonas, Anzoategui, Portuguese and Zulia, in alarm Miranda and Sucre. Of these six states, four have been affected by the disaster.

An approximation to the definition of the states that require priority for support in its Plan of Action are Miranda, Vargas (it is rebuilding its surveillance system), Sucre, New Esparta, Zulia, and Anzoategui.

Morbidity reported in the shelters
according to affected federal entities
week 5, from 19 to 25 Dec.

The following table reports morbidity according to federal entities. Below are the leading causes of epidemiological interest, excluding from the analysis the causes grouped into other disorders.

In the state of Aragua, of 894 medical visits, 89 correspond to trauma and wounds, occupying the leading cause of attention, (without considering other disorders). This figure represents 13% of all visits, followed by the Diarrheal Syndrome with 87 cases (10%), and in the third place fever with 1.2%.

In the state of Carabobo of 4,073 medical cases, 380 correspond to trauma and wounded, occupying the leading cause of attention, (without considering the other causes), this figure represents 10%, followed by the Diarrheal Syndrome with 203 cases (5%) and in the third place fever with 3%.

In the state of Miranda, of 1,021 medical visits, 143 correspond to Diarrheal Syndrome, occupying first place (without considering other causes). This figure represents 14.1% of all medical visits, followed by fever with 5% and in the third place fever and cough, with 4.3%. During week 5, cases of cholera were officially reported (01 in Inawa).

In the state of Yaracuy, 219 medical visits correspond to dermatosis, occupying first place. This figure represents 40% of all medical visits, followed by Diarrheal Syndrome with 23.2%, and in the third place fever, with 14%.

In the Federal District, of 279 medical visits, 43 correspond to fever, occupying first place (without considering other causes). This figure represents 15% of all medical visits, followed by Diarrheal Syndrome with 14%, followed by injuries and wounds with 12%. The weekly report of the Federal District is consolidated, which means that this report contains preliminary data.

All the states affected are reporting daily cases and outbreaks reportable diseases and of immediate report: in shelters, in affected population, and in the rest of the population. The daily surveillance report defined for disaster situations is being activated and consolidated (systematized).

With the information from the States who have consolidated their information, a first analysis of problems was carried out (enclosed table), which indicates as problem number 1 trauma and wounds, problem 2 diarrheal diseases and as problem 3, fever and cough. According to the daily report, injuries and wounds are under control, but diarrheal diseases and fever and cough are on the rise.

MORBIDITY REPORTED IN THE SHELTERS BY FEDERAL ENTITIES, WEEK OF 19 TO 25-12-99 - VENEZUELA

EPIDEMIOLOGICAL SURVEILLANCE, BUREAU OF EPIDEMIOLOGY AND STRATEGIC ANALYSIS.
MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT

HEALTH PROBLEMS - POPULATION IN SHELTERS
REPORTING ENTITIES AFFECTED FROM 19 TO 25/12/99

REPORT AVERAGE
(PERCENTAGES ACCORDING TO CAUSES FOR MEDICAL CARE)

2. PAHO/WHO Support

Support for standardizing morbidity reports of the population located in shelters by diarrheal, respiratory, febrile, jaundiced, and dermatological syndromes.

Sending this information to all Health Departments of the states in alert on leptospirosis, due to the possibility of outbreaks.

Organization of epidemiological surveillance in the state of Vargas.

Programming a technical meeting in the state of Miranda, with the state's technical team, Chief of Epidemiological Surveillance of the Ministry of Health and Social Development (MSDS) and PAHO, for the purpose of strengthening surveillance and organization of a Plan of Action (Wednesday 29-12-99).

Realization today of a technical meeting with the Chief of Epidemiology of the Federal District in order to support the implementation of a Plan of Action and determination of needs.

3. Requirements

• Strengthening of epidemiological surveillance in shelters and in affected areas, to strengthen the operational and field work (to define human resource needs, mobilization of personnel, etc.).
• Strengthen the regular epidemiological surveillance system.
• Guarantee timely reports.
• Intensify actions in order to guarantee sanitary drinking water to the population.
• Intensify the monitoring and control of vectors and rodents.
• Guarantee support of laboratory diagnosis (to define needs for inputs, reagents, culture media, etc).
• Produce useful information at the different levels for decision-making (daily reports, weekly reports, informative bulletins for medical teams, etc).
• Carry out control measures for risks and outbreaks (to define human resource needs and materials, drugs for foci control, mobilization of personnel, larvicides, pesticides, etc).
• Define needs for training in the different technical areas and levels.

DRUGS

1. Current Situation

Support for the classification of humanitarian assistance has been ongoing since the day of the emergency. The institutions in charge of the management of incoming relief supplies of the states of Aragua and Lara set upthe installations of the SUMA system and have monitored the donations received in each state and at points of distribution.

2. PAHO/WHO Support

PAHO has mobilized personnel of the region and has installed the SUMA system in the SEFAR (Pharmaceutical Service of the Ministry of Health), the Ministry of the Environment, the Division of Health of the Armed Forces, the main reception center of Civil Defense supplies, the reception warehouse of the Red Cross, the Center of National Collection of the Red Cross and the drug store room of this same institution. If necessary, additional Venezuelan emergency personal will be mobilized, who have been previously trained and have supported in missions outside the country. Computer equipment has been delivered to manage the large influx of donations to the Division of Health of the National Armed Forces and to the Red Cross.

3. Requirements

Basic Sanitation:

• Latrines

Supplies:

• Plastic Containers for storage
• Chlorination equipment
• Contribution of human resources in the areas of Mental Health, Epidemiology, and Chemical Safety.

WATER AND ENVIRONMENT

1. Current Situation

There is progress in rehabilitating the water services, although in the affected rural and urban areas, the water distribution problems are on the rise. Simultaneously, there is progress in the installation of Hompks water treatment units and in recovery of damaged wells and systems.

2. Support of PAHO/WHO

• The development of national environmental diagnosis (area affected) in Health Systems and Services is activated.
• The development of an emergency shelter is activated in the National Water Committee and in the office of the Ministry of Health and Social Development.
• The development of technical actions is activated in the professional group of the School of Emergencies by rehabilitation activities.

3. Requirements

• Support for the mobilization of personnel in 1 state of the country in order to apply the diagnosis of Services.
• Support for the installation of an emergency shelter in the Ministry of Health and Social Development and in Hidroven.
• Support for the responses to the problems of hazardous materials in the Port of Guaira.