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DOH National Epidemiology Center
Orientation for GOARN MissionOn aftermath of Typhoon Ketsana:Leptospirosis and other Health Effects
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DOH National Epidemiology Center
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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
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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
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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
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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
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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
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DOH National Epidemiology Center
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DOH National Epidemiology Center
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DOH National Epidemiology Center
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DOH National Epidemiology Center
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DOH National Epidemiology Center
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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
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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
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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
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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)
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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