1. South Sudan Surveillance Highlights – IDSR & EWARN
Epidemiology update Week 47 of 2016
Bulletin available at:
CSR - DDC AFRO

2. Highlights week 47 of 2016 IDSR EWARN
System Performance
43% (27 counties attached target completeness of 80%)
Top Causes of Morbidity
Malaria (40%)
AWD (7%)
Top cause of mortality
S. Malaria 7/24 (29%)
EWARN
System Performance
67%
Top Causes of Morbidity
Malaria (20%)
ARI (27%)
AWD (7%)
Top causes of mortality
AWD - 3 deaths from Bentiu (2)& Juba 3 PoC (1)

3. IDSR completeness by week 2014 to 2016

4. EWARN reporting performance by partner in week 47 of 2016

5. Highlights Preparedness and response actions
Malaria
Malaria accounted for 40% and 27% of consultations in nonconflict-affected and IDP areas
Analysis of malaria trends at state hub level showed that malaria cases were within expected levels.
In the 26 (33%) affected counties; the malaria trends have either returned to normal or are slowly returning to normal
Malaria accounted for 29% of mortality in the non conflict areas & 4% deaths in IDPs.

6. Malaria trends for 2014 to 2016

7. Malaria trends by state as of week 47 of 2016

8. Malaria trends in the IDP sites as of week 47 of 2016
Malaria trend in IDPs within expected levels

9. Cholera
Cholera confirmed in nine states [Jubek, Terekeka, Jonglei, Imatong, Eastern Lakes; Western Bieh, Northern Liech; Southern Liech; & Eastern Nile states].
Cumulatively, 3,307 cholera cases including 58 deaths (24 facilities and 34 community) (CFR 1.75%) have been reported in South Sudan
Cumulatively 128 (34%) of the samples tested positive for Vibrio Cholerae in the NPHL
National and state level cholera taskforce committees are coordinating preparedness and response activities
Active transmission currently restricted to Bentiu PoC.

10. Epidemic curve for cholera cases in South Sudan, from 18 June - 1 December 2016

11. Cholera cases in South Sudan,18 June - 1 Dec 2016

12. Cholera Bentiu PoC - week 47, 2016
Most cases are <10 years [and in 2yrs)
<10 yrs - 64%
<2yrs - 36%
Most cases in sectors
Sect 3: 27%
Sect 2: 24%
Sect 1: 9%
Oral cholera vaccination
41 (91%) did not receive OCV

13. Laboratory Updates as of 1 Dec 2016
State
Culture results
New positives in week 47
Cumulative
Positive
Cumulative Negative
Total tested
Eastern Nile  0 5
Jonglei 1 4
Jubek 73
126
199
Terekeka 2
Eastern Lakes 17 38 55
Imatong 7 8
Fangak 13 26 39
Wau 6
Boma
Northern Liech 11 28
Southern Liech
Eastern Nile (Pigi) 00
128
241
369
128 confirmed cases in 9 states
11 confirmed cases in Northern Liech

14. Measles
New suspect measles cases reported in Aweil South (1); Wau (2); Gogrial West (6).
Recent outbreak confirmed in Wau; and a cumulative of 13 counties with confirmed measles in 2016.
Comprehensive response including reactive measles vaccination underway in Wau.
Since the beginning of 2016, a total of 1,851 suspect measles cases including at least 19 deaths (CFR 1.03%) have been reported countrywide
Continued vigilance - detect and test suspect measles cases as we head into the dry season during which transmission is expected to increase

15. HEV Mayom & Abyei
Two clusters of acute jaundice syndrome suspected to be due to HEV have been reported in Mayom [involving 27 cases including 9 deaths since 29/05/2016] and Abyei [involving 8 cases including 4 deaths [since 25 Oct 2016]. Four of 16 samples were PCR positive for HEV. Further laboratory testing is to date negative for Ebola; Marburg; RVF; & CCHF by PCR. Arboviral testing is underway.
Additionally, three of six samples tested in Geneva were HEV [PCR] and malaria positive. All six samples were positive for malaria

16. Preparedness and response actions
Integrated approach for cholera response including targeted vaccination with OCV in areas with active transmission
Cholera evaluation - updating EPR plan & guidelines
Enhanced measles surveillance and case based investigation
Enhanced surveillance for meningitis
Timely and consistent submission of weekly reports
Response to HEV cases in Abyei and Mayom

17. THANKS