week ending august 29, 2020 epidemiological week 35 …...during ew 35, 10 (ten) sari admissions...

Week ending August 29, 2020 Epidemiological Week 35

WEEKLY EPIDEMIOLOGY BULLETIN NATIONAL EPIDEMIOLOGY UNIT, MINISTRY OF HEALTH & WELLNESS, JAMAICA

EPI WEEK 35

Dracunculiasis (Guinea-worm disease)

Key facts

• Dracunculiasis is a crippling parasitic disease on the verge of eradication, with 54 human

cases reported in 2019.

• From the time infection occurs, it takes between 10–14 months for the transmission cycle

to complete until a mature worm emerges from the body.

• The parasite is transmitted mostly when people drink stagnant water contaminated with

parasite-infected water fleas.

• Dracunculiasis was endemic in 20 countries in the mid-1980s.

• The total of 54 cases in 2019 were reported from four countries: Angola (1 case), Chad (48

cases), South Sudan (4 cases) and Cameroon (1 case, likely imported from Chad).

Dracunculiasis is rarely fatal, but infected people become non-functional for weeks. It affects people

in rural, deprived and isolated communities who depend mainly on open surface water sources such

as ponds for drinking water.

Scope of the problem: During the mid-1980s an estimated 3.5 million cases of dracunculiasis occurred

in 20 countries worldwide, 17 countries of which were in Africa. The number of reported cases fell to

fewer than 10 000 cases for the first time in 2007, dropping further to 542 cases (2012). Over the past

eight years, human cases have stayed at double digits (28 in 2018 and a slightly higher number of 54

human cases in 2019.

Transmission, life-cycle and incubation period: About a year after infection, a painful blister forms –

90% of the time on the lower leg – and one or more worms emerge accompanied by a burning

sensation. To soothe the burning pain, patients often immerse the infected part of the body in water.

The worm(s) then releases thousands of larvae (baby worms) into the water. These larvae reach the

infective stage after being ingested by tiny crustaceans or copepods, also called water fleas.

People swallow the infected water fleas when drinking contaminated water. The water fleas are killed

in the stomach but the ineffective larvae are liberated. They then penetrate the wall of the intestine

and migrate through the body. The fertilized female worm (which measures 60–100 cm long) migrates

under the skin tissues until it reaches its exit point, usually at the lower limbs, forming a blister or

swelling from which it eventually emerges. The worm takes 10–14 months to emerge after infection.

https://www.who.int/news-room/fact-sheets/detail/dracunculiasis-(guinea-worm-disease)

SYNDROMES PAGE 2

CLASS 1 DISEASES PAGE 4

INFLUENZA PAGE 5

DENGUE FEVER PAGE 6

GASTROENTERITIS PAGE 7

RESEARCH PAPER PAGE 8

Released September 11, 2020 ISSN 0799-3927

NOTIFICATIONS-

All clinical

sites

INVESTIGATION

REPORTS- Detailed Follow

up for all Class One Events

HOSPITAL

ACTIVE

SURVEILLANCE-30 sites. Actively pursued

SENTINEL

REPORT- 78 sites.

Automatic reporting

2

SENTINEL SYNDROMIC SURVEILLANCE Sentinel Surveillance in

Jamaica

Map representing the Timeliness of Weekly Sentinel Surveillance Parish Reports for the Four Most Recent Epidemiological Weeks – 32 to 35 of 2020 Parish health departments submit reports weekly by 3 p.m. on Tuesdays. Reports submitted after 3 p.m. are considered late.

FEVER Temperature of >380C /100.40F (or recent history of fever) with or without an obvious diagnosis or focus of infection.

KEY VARIATIONS OF BLUE SHOW CURRENT WEEK

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Epidemiologic week

Weekly Visits to Sentinel Sites for Undifferentiated Fever All ages: Jamaica, Weekly Threshold vs Cases 2020

2020 <5 2020 ≥5 Epidemic Threshold <5 Epidemic Threshold >=5

A syndromic surveillance system is good for early detection of and response to public health events. Sentinel surveillance occurs when selected health facilities (sentinel sites) form a network that reports on certain health conditions on a regular basis, for example, weekly. Reporting is mandatory whether or not there are cases to report. Jamaica’s sentinel surveillance system concentrates on visits to sentinel sites for health events and syndromes of national importance which are reported weekly (see pages 2 -4). There are seventy-eight (78) reporting sentinel sites (hospitals and health centres) across Jamaica.

REPORTS FOR SYNDROMIC SURVEILLANCE


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

3

FEVER AND NEUROLOGICAL Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person with or without headache and vomiting. The person must also have meningeal irritation, convulsions, altered consciousness, altered sensory manifestations or paralysis (except AFP).

FEVER AND HAEMORRHAGIC Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting with at least one haemorrhagic (bleeding) manifestation with or without jaundice.

FEVER AND JAUNDICE Temperature of >380C /100.40F (or recent history of fever) in a previously healthy person presenting with jaundice. The epidemic threshold is used to confirm the emergence of an epidemic in order to implement control measures. It is calculated using the mean reported cases per week plus 2 standard deviations.

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Epidemiologic week

Weekly Visits to Sentinel Sites for Fever and Neurological Symptoms 2019 and 2020 vs. Weekly Threshold: Jamaica

2019 2020 Alert Threshold Epidemic Threshold

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Weekly visits to Sentinel Sites for Fever and Haemorrhagic 2019 and 2020 vs Weekly Threshold; Jamaica


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Fever and Jaundice cases: Jamaica, Weekly Threshold vs Cases 2019 and 2020



NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

4

ACCIDENTS Any injury for which the cause is unintentional, e.g. motor vehicle, falls, burns, etc.

KEY VARIATIONS Of BLUE SHOW CURRENT WEEK

VIOLENCE Any injury for which the cause is intentional, e.g. gunshot wounds, stab wounds, etc.

GASTROENTERITIS Inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhoea.

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Weekly visits to Sentinel Sites for Accidents by Age Group 2020 vs Weekly Threshold; Jamaica

≥5 Cases 2020 <5 Cases 2020 Epidemic Threshold<5 Epidemic Threshold≥5

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100

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Weekly visits to Sentinel Sites for Violence by Age Group 2020 vs Weekly Threshold; Jamaica

≥5 y.o <5 y.o <5 Epidemic Threshold ≥5 Epidemic Threshold

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Epidemiologic Week

Weekly visits to Sentinel Sites for Gastroenteritis All ages 2020 vs Weekly Threshold; Jamaica

2020 <5 2020 ≥5 Epidemic Threshold <5 Epidemic Threshold >5


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

5

CLASS ONE NOTIFIABLE EVENTS Comments

Confirmed YTD AFP Field Guides

from WHO indicate

that for an effective

surveillance system,

detection rates for

AFP should be

1/100,000

population under 15

years old (6 to 7)

cases annually.

___________

Pertussis-like

syndrome and

Tetanus are

clinically confirmed

classifications.

______________

* Dengue

Hemorrhagic Fever

data include Dengue

related deaths;

** Figures include

all deaths associated

with pregnancy

reported for the

period. * 2019 YTD

figure was updated.

*** CHIKV IgM

positive

cases

**** Zika

PCR positive cases

CLASS 1 EVENTS CURRENT

YEAR 2020 PREVIOUS

YEAR 2019

NA

TIO

NA

L /

INT

ER

NA

TIO

NA

L

INT

ER

ES

T

Accidental Poisoning 5 48

Cholera 0 0

Dengue Hemorrhagic Fever* NA NA

Hansen’s Disease (Leprosy) 0 0

Hepatitis B 0 11

Hepatitis C 0 2

HIV/AIDS NA NA

Malaria (Imported) 0 0

Meningitis (Clinically confirmed) 1 17

EXOTIC/

UNUSUAL Plague 0 0

H I

GH

MO

RB

IDIT

/

MO

RT

AL

IY

Meningococcal Meningitis 0 0

Neonatal Tetanus 0 0

Typhoid Fever 0 0

Meningitis H/Flu 0 0

SP

EC

IAL

PR

OG

RA

MM

ES

AFP/Polio 0 0

Congenital Rubella Syndrome 0 0

Congenital Syphilis 0 0

Fever and

Rash

Measles 0 0

Rubella 0 0

Maternal Deaths** 29 44

Ophthalmia Neonatorum 23 161

Pertussis-like syndrome 0 0

Rheumatic Fever 0 0

Tetanus 0 0

Tuberculosis 6 33

Yellow Fever 0 0

Chikungunya*** 0 1

Zika Virus**** 0 0 NA- Not Available


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

6

NATIONAL SURVEILLANCE UNIT

INFLUENZA REPORT EW 35

August 23, 2020 -August 29, 2020 Epidemiological Week 35

EW 35 YTD

SARI cases 10 420

Total

Influenza

positive Samples

0 69

Influenza A 0 45

H3N2 0 4

H1N1pdm09 0 38

Not subtyped 0 3

Influenza B 0 24

Parainfluenza 0 0

Epi Week Summary

During EW 35, 10 (ten) SARI

admissions were reported.

Caribbean Update EW 35

Caribbean: Influenza and other respiratory virus activity remained low in the subregion. In Haiti and Jamaica SARI activity continue at epidemic levels.

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Weekly visits to Sentinel Sites for Influenza-like Illness (ILI) All ages 2020 vs Weekly Threshold; Jamaica

2020 2020 2020

Epidemic Threshold <5 Epidemic Threshold 5-59 Epidemic Threshold ≥60

Epidemiologic week

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Epidemiological Week

Jamaica: Percentage of Hospital Admissions for Severe Acute Respiratory Illness (SARI 2020) (compared with 2011-2019)

SARI 2020 Alert Threshold

Average epidemic curve (2011-2019) Seasonal Threshold

Epidemic Threshold

0%10%20%30%40%50%60%70%80%90%100%110%

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D I S T R I B U T I O N O F I N F L U E N Z A A N D O T H E R R E S P I R A T O R Y V I R U S E S I N S U R V E I L L A N C E B Y E W

A(H1N1)pdm09 A not subtyped A no subtypable A(H1)A(H3) Parainfluenza RSV AdenovirusMethapneumovirus Rhinovirus Coronavirus BocavirusOthers Flu B Positives % Positives


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

7

Dengue Bulletin August 23, 2020 - August 29, 2020 Epidemiological Week 35 Epidemiological Week 35

Reported suspected and confirmed dengue

with symptom onset in week 35 of 2020

2020

EW 35

YTD

Total Suspected Dengue

Cases 0** 747**

Lab Confirmed Dengue cases

0** 1**

CONFIRMED Dengue Related Deaths

0** 1**

Points to note:

• ** figure as at September 9 , 2020

• Only PCR positive dengue cases

are reported as confirmed.

• IgM positive cases are classified

as presumed dengue.

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Dengue Cases by Year: 2004-2020, Jamaica

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Suspected dengue cases for 2018, 2019 and 2020 versus monthly mean, alert, and epidemic thresholds

2018 suspected dengue 2019 Suspected Dengue 2020

Epidemic threshold Alert Threshold Monthly mean


NOTIFICATIONS-

All clinical

sites

INVESTIGATION



HOSPITAL

ACTIVE


SENTINEL

REPORT- 78 sites.

Automatic reporting

8

RESEARCH PAPER

Abstract Knowledge and Practice Related to Lifestyle Among Adults with Diabetes and Hypertension

Colleen Campbell1, Delani Campbell1, Khadijah Estick1, Mario McCallum1, Martin McIntosh1, Jourdain Masters1, Alliyah

Mentor1, Yakeev Morris1, Ta’Mal Phillip1, Gabriella Ranjit1, Orlando Smith1, Gayan White,1 Norman Waldron2

1MBBS Class of 2020, Department of Community Health and Psychiatry, Faculty of Medical Sciences, The University of the West

Indies, Mona, Jamaica 2Department of Community Health and Psychiatry , Faculty of Medical Sciences, The University of the West Indies, Mona,

Jamaica

Aim: To determine the level of knowledge and assess the lifestyle practices of adult patients with Diabetes

and/or Hypertension attending the primary health care clinics in Jamaica.

Background: Diabetes and Hypertension are among the leading causes of preventable morbidity and related

disability worldwide. The shift in disease burden from infectious diseases to non-communicable diseases has

been attributed to dietary and physical activity changes.

Method: In this cross-sectional study using 150 randomly selected adults from primary health care centres

in seven parishes of Jamaica. A 69-item interviewer-administered questionnaire was used. The questions

measured knowledge and lifestyle practices related to diet, smoking, exercise and alcohol consumption.

Results: The majority (%) of the sample was female (76%) and most persons were within the age group of

56 years or over (68.6%). The mean knowledge score of exercise was 4.7 (SD 1.2) with a score range of 1 to

6. No statistical differences presented in mean knowledge of exercise by socioeconomic and demographic

characteristics. Nine of the ten questions assessing knowledge of diet were answered correctly by the

majority (50.7% - 93.3%).

The mean knowledge score for alcohol consumption and smoking was 5.5 (SD 0.9) and 2.9 (SD 0.3),

respectively. Just over a half (52.3%) of the sample reported exercising (52.3%) and consuming sugar-

sweetened beverages (53%). Very little reported drinking alcohol in the last three months (10.7%) and a

minority (4.7%) of the sample reported that they are currently smoking.

Conclusion: Mean knowledge scores for exercise, alcohol consumption and smoking were relatively high,

while lifestyle practices among participants was relatively low. We recommend further research to assess the

facilitators and barriers to adopting lifestyle changes among Jamaican adults.

Keywords: Knowledge, Lifestyle, Practice, Diabetes, Hypertension

____________________________________________________________________________________

The Ministry of Health and Wellness

24-26 Grenada Crescent

Kingston 5, Jamaica

Tele: (876) 633-7924

Email: [email protected]

week ending august 29, 2020 epidemiological week 35 …...during ew 35, 10 (ten) sari admissions...

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