orientation for goarn mission on aftermath of typhoon ketsana:

DOH National Epidemiology Center

Orientation for GOARN MissionOn aftermath of Typhoon Ketsana:Leptospirosis and other Health Effects

DOH National Epidemiology Center

DOH National Epidemiology Center

REGION ARI ILI PNEUMONIA DIARRHEA SARI

NCR 9068 1057 33 3150 28

III 939 177 1 295 21

IV-A 5442 237 9 671 4

TOTAL 15449 1471 43 4116 53

54% 5% 0% 14% 0%

Ondoy Syndromic Surveillance in Evacuation Centers as of October 14, 2009

DOH National Epidemiology Center

REGION FEBRILE ILLNESS SKIN INFECTIONS/WOUNDS TOTAL

NCR 1504 3811 18651

III 275 399 2107

IV-A 456 1146 7965

TOTAL 2235 5356 28723

8% 19% 100%

Ondoy Syndromic Surveillance in Evacuation Centers as of October 14, 2009

DOH National Epidemiology Center

NCR Top 5 Diseases

NCR OCT 7-9 0CT 8-10 OCT 9-11 OCT 10-12 OCT 11-13

ARI 437 588 762 1077 930

ILI 121 149 165 228 177

PNEUMONIA 1 1 0 1 4

DIARRHEA 432 131 174 257 250

SKIN INFXN 158 200 235 365 267

DOH National Epidemiology Center

REGION 4A OCT 7-9 OCT 8-10 OCT 9-11 0CT 10-12 OCT 11-13

ARI 317 631 931 1053 715

ILI 24 34 52 55 41

PNEUMONIA 1 0 0 0 0

DIARRHEA 28 52 106 151 122

SKIN INFXN 65 132 195 224 152

Region IV-A Top 5 Diseases

DOH National Epidemiology Center

•Lalaki•Lugar na may baha•Lumusong sa baha nang may mga sugat sa balat•Lagnat at pamumula/ paninilaw ng mata

LEPTOSPIROSIS

DOH National Epidemiology Center

DOH National Epidemiology Center

DOH National Epidemiology Center

DOH National Epidemiology Center

DOH National Epidemiology Center

DOH National Epidemiology Center

No. of Cases Previously FLOODED STILL FLOODED

Zero Passive Surveillance Active Surveillance

1-2 cases/week Active Surveillance Case Referral

>3 cases/week Case Referral Case Referral/TARGETED PROPHYLAXIS

OUTBREAK Outbreak Management

Outbreak Management/MASS PROPHYLAXIS

Targetted Interventions

DOH National Epidemiology Center

Parameters Rates/Proportions

Attack Rate 2.5%

Hospitalization Rate 20% of those who will be infected

Dialysis Rate 20% of hospitalized

Case Fatality Rate 20%

Population needing prophylaxis

5%

Assumptions

DOH National Epidemiology Center

Estimates Scenario NCR IV-A TOTAL

250/10,000 Will get infected 17,500 25,000 42,500

50/10,000 Will be hospitalized 3,500 5,000 8,500

10/10,000 Will need dialysis 700 1,000 1,700

5/10,000 Will Die 350 500 850

500/10,000 Will be given doxycycline as prophylaxis

35,000 50,000 85,000

DOH National Epidemiology Center

Review of Leptospirosis Deaths

• Males 16, Female 1• Age ranged from 23 years to 51 years (mean 40 years, median 44 years)• Final Diagnosis: Weil’s Disease 8, ARDS 3, Not Available 6• Interval from onset to hospitalization: 2-7 days (mean and median of 4 days)

DOH National Epidemiology Center

Review of Leptospirosis Deaths

• Direct admission to San Lazaro Hospital 10 From other hospitals 6 From physician 1 • Duration of Stay at SLH: 3-26 hours (median

16 hours)• Oliguria 15, Hemoptysis 6, Hypotension 5