NATIONAL EPIDEMIOLOGY UNIT, MINISTRY OF HEALTH, JAMAICA

Released January 22, 2016 ISSN 0799-3927

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*Incidence/Prevalence cannot be calculated

1

Week ending January 9, 2016 Epidemiology Week 1

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

Weekly Spotlight What is microcephaly?

EPI WEEK 1

Microcephaly is condition where a baby’s head is much smaller than expected. During pregnancy, a baby’s head grows because the baby’s brain grows. Microcephaly can occur because a baby’s brain has not developed properly

during pregnancy or has stopped growing after birth, which results in a smaller head size.

Microcephaly can be an

isolated condition, meaning that it can occur with no other major birth defects, or it can occur in combination with other major birth defects. Babies with microcephaly can have a range of other problems, depending on how severe their microcephaly is. Microcephaly has been linked with the following problems: Seizures Developmental delay, such as problems with speech or

other developmental milestones (like sitting, standing, and walking)

Intellectual disability (decreased ability to learn and function in daily life)

Problems with movement and balance Feeding problems, such as difficulty swallowing Hearing loss Vision problems These problems can range from mild to severe and are often lifelong. In some cases, these problems can be life-threatening. Because it is difficult to predict at birth what problems a baby will have from microcephaly, babies with microcephaly often need close follow-up through regular check-ups with a healthcare provider to monitor their growth and development. Source: http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html

SYNDROMES

PAGE 2

CLASS 1 DISEASES

PAGE 5

INFLUENZA

PAGE 7

DENGUE FEVER

PAGE 8

GASTROENTERITIS

PAGE 9

http://www.cdc.gov/ncbddd/actearly/milestones/index.html

http://www.google.com.jm/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&docid=Juz0TfK8UHFxbM&tbnid=kFpmxj0_4cgraM:&ved=0CAUQjRw&url=http://summitpediatrics.blogspot.com/2011/02/fever-friend-or-foe.html&ei=e0GlUofFHMXokQfS24CQAw&bvm=bv.57752919,d.eW0&psig=AFQjCNFhU0bYMgQWIDEj6PAPCGgii5YGGQ&ust=1386648250476674

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REPORTS FOR SYNDROMIC SURVEILLANCE GASTROENTERITS

Three or more loose

stools within 24 hours.

FEVER

Temperature of >380C

/100.40F (or recent

history of fever) with or

without an obvious

diagnosis or focus of

infection.

0

200

400

600

800

1000

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

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of

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Epi weeks

GE ≥5 Weekly Threshold vs Cases 2016, EW 1

2015 Cases 5 years and older

0

200

400

600

800

1000

1200

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Epi Weeks

GE <5 Weekly Threshold vs Cases 2016, EW 1

2016 Cases Epidemic Threshold

100

1000

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Nu

mb

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of

Cas

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Epidemiology Weeks

Fever in under 5y.o. and Total Population 2016 vs Epidemic Thresholds, EW 1

Total Fever (All Ages) Cases under 5 y.o.

<5y.o. Epidemic threshold Epidemic Threshold-Total Population


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REPORTS FOR SYNDROMIC SURVEILLANCE FEVER AND

RESPIRATORY


/100.40F (or recent

history of fever) in a

previously healthy

person with or without

respiratory distress

presenting with either

cough or sore throat.

FEVER AND

HAEMORRHAGIC


/100.40F (or recent


previously healthy

person presenting with

at least one

haemorrhagic

(bleeding)

manifestation with or

without jaundice.

FEVER AND

JAUNDICE


/100.40F (or recent


previously healthy

person presenting with

jaundice.

1

10

100

1000

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Nu

mb

er

of

Cas

es

Epi Weeks

Fever & Resp Weekly Threshold vs Cases 2016, EW 1

2016 <5 2016 ≥60

<5 year old's, Epidemic Threshold ≥60 year old's, Epidemic Threshold

0

5

10

15

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Nu

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of

Cas

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Epidemiology weeks

Fever and Haem Weekly Threshold vs Cases 2016, EW 1

Cases 2016 Epidemic Threshold

0

2

4

6

8

10

12

14

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

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of

Cas

es

Epi Weeks

Fever and Jaundice Weekly Threshold vs Cases 2016, EW 1

Cases 2015 Epidemic Threshold


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4

FEVER AND

NEUROLOGICAL


/100.40F (or recent


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).

ACCIDENTS

Any injury for which

the cause is

unintentional, e.g.

motor vehicle, falls,

burns, etc.

VIOLENCE

Any injury for which

the cause is intentional,

e.g. gunshot wounds,

stab wounds, etc.

0

10

20

30

40

50

60

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

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of

Cas

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Epi Weeks

Fever and Neurological Symptoms Weekly Threshold vs Cases 2016, EW 1

2016 Epidemic Threshold

50

500

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Nu

mb

er

of

Cas

es

Epidemiology Weeks

Accidents Weekly Threshold vs Cases 2016

≥5 Cases 2016 <5 Cases 2016 Epidemic Threshold<5 Epidemic Threshold≥5

1

10

100

1000

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Nu

mb

er

of

Cas

es

Epidemiology Week

Violence Weekly Threshold vs Cases 2016, EW 1

≥5 y.o <5 y.o


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sites

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5

CLASS ONE NOTIFIABLE EVENTS and LEPTOSPIROSIS 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.

______________

The TB case detection

rate established by

PAHO for Jamaica is

at least 70% of their

calculated estimate of

cases in the island, this

is 180 (of 200) cases

per year.

*Data not available

**Leptospirosis is

awaiting classification

as class 1, 2 or 3

______________

1 Dengue Hemorrhagic

Fever data include Dengue

related deaths;

2 Maternal Deaths include

early and late deaths.

CLASS 1 EVENTS CURRENT

YEAR PREVIOUS

YEAR

NA

TIO

NA

L /

INT

ER

NA

TIO

NA

L

INT

ER

ES

T

Accidental Poisoning 5 9

Cholera 0 0

Dengue Hemorrhagic Fever1 0 0

Hansen’s Disease (Leprosy) 0 0

Hepatitis B 0 1

Hepatitis C 0 0

HIV/AIDS - See HIV/AIDS National Programme Report

Malaria (Imported) 1 0

Meningitis 3 10

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 Deaths2 0 0

Ophthalmia Neonatorum 5 14

Pertussis-like syndrome 0 0

Rheumatic Fever 0 0

Tetanus 0 0

Tuberculosis 0 0

Yellow Fever 0 0

UNCLASSED** Leptospirosis 1 0


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NATIONAL SURVEILLANCE UNIT INFLUENZA REPORT EW 1

January 3– January 9, 2016 Epidemiology Week 1

January, 2016 Admitted Lower Respiratory Tract Infection and LRTI-related Deaths

Current year Previous year

Week 1

2016 YTD 2016

Week 1

2015

YTD

2015

Admitted Lower

Respiratory Tract

Infections

72 72 84 84

Pneumonia-related

Deaths 2 2 0 0

EW 1 YTD

SARI cases 28 28

Total Influenza

positive

Samples

1 1

Influenza A 1 1

H3N2 1 1

H1N1pdm09

0 0

Influenza B 0 0

Comments:

The percent positivity of influenza

viruses circulating among

respiratory samples tested in EW

1, 2016 was 33%. Influenza

A/H3N2 was the only virus

detected. This virus sub-type is

included in the annual influenza

vaccine. There has been no

detection of the influenza variant

A/H3 virus (A/H3N2v), influenza

Avian H5 or H7 viruses among

samples tested.

INDICATORS

Burden

Year to date, respiratory

syndromes account for 3.7% of

visits to health facilities.

Incidence

Cannot be calculated, as data

sources do not collect all cases of

Respiratory illness.

Prevalence

Not applicable to acute

respiratory conditions.

*Additional data needed to calculate Epidemic Threshold

0

50

100

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Epidemiology Week

2016 Cases of Admitted LRTI, SARI, Pneumonia related Deaths

Admitted LRTI 2016 No. of SARI cases for 2016

Pneumonia-related Deaths 2016 Mean of SARI cases 2010-2015*


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Dengue Bulletin January 3 –January 9, 2016 Epidemiology Week 1

DISTRIBUTION

Year-to-Date Suspected Dengue Fever

M F Total %

<1 0 0 0 0 1-4 1 0 1 33 5-14 1 0 1 33 15-24 0 1 1 34 25-44 0 0 0 0 45-64 0 0 0 0 ≥65 0 0 0 0

Unknown 0 0 0 0 TOTAL

2 1 3 100

Weekly Breakdown of suspected and

confirmed cases of DF,DHF,DSS,DRD

2016

2015YTD EW

1 YTD

Total Suspected

Dengue Cases 3 3 2

Lab Confirmed Dengue cases

0 0 0

CO

NFI

RM

ED

DHF/DSS 0 0 0

Dengue Related Deaths

0 0 0

0

100

200

300

400

500

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecN

o. o

f su

spec

ted

cas

esMonths

2016 Cases vs. Epidemic Threshold

2016 Epi threshold

0.6

0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

0.2

0.0

0.7

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

Inci

de

nce

(P

er

10

0,0

00

Po

pu

lati

on

)

Suspected Dengue Fever Cases per 100,000 Parish Population

0

1000

2000

3000

4000

5000

6000

7000

2004200520062007200820092010201120122013201420152016

Nu

mb

er

of

Cas

es

Years

Dengue Cases by Year: 2004-2016, Jamaica

Total confirmed Total suspected


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Gastroenteritis Bulletin January 3 –January 9, 2016 Epidemiology Week 1

Year EW 1 YTD

<5 ≥5 Total <5 ≥5 Total

2016 138 196 334 138 196 334

2015 386 301 687 386 301 687

Figure 1: Total Gastroenteritis Cases Reported 2014-2016

0

100

200

300

400

500

600

700

800

900

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

No

. o

f G

E C

as

es

EW

Total GE - 2014 Total GE - 2015 Total GE - 2016

KSA STT POR STM STA TRE STJ HAN WES STE MAN CLA STC

GE cases < 5yrs old YTD 53 0 4 12 15 2 6 4 4 5 13 7 13

GE cases ≥5yrs old YTD 28 3 9 21 16 5 13 14 10 11 26 21 19

Total GE cases YTD 81 3 13 33 31 7 19 18 14 16 39 28 32

0

10

20

30

40

50

60

70

80

90

Nu

mb

er

of

case

s

Total number of GE cases Year To Date by Parish, 2016

Weekly Breakdown of Gastroenteritis cases In Epidemiology Week 1, 2016,

the total number of reported GE

cases showed a 51% decrease

compared to EW 1 of the previous

year.

The year to date figure showed a

51% decrease in cases for the

period.

EW

1


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9

RESEARCH PAPER

Strengthening Health Care Systems for HIV and AIDS in Jamaica: A Programme of Research and Capacity

Building 2007-2012

N Edwards1, E Kahwa2, D Kaseje3, J Mill4, J Webber5, S Roelofs6, M Walusimbi7, H Klopper8, J Harrowing8

1University of Ottawa, Canada

2The UWI School of Nursing, Mona, University of the West Indies, Jamaica

3Great Lakes University of Kisumu, Kenya,

4University of Alberta, Canada

5Canadian Nurses’ Association, Canada,

6Mulago Hospital, Uganda

7University of Western Cape, South Africa,

8University of Lethbridge, Canada

Objectives: To contribute to health systems strengthening for HIV and AIDS care in Jamaica by fostering dynamic

and sustained engagement of nurses in the process of change through capacity building in research and policy.

Methods: This work was done as part of an international program of research which was implemented in Jamaica

and three African countries (Kenya, Uganda and South Africa). Using mixed methods and participatory action

research, we tested the “leadership hub model” to invigorate nurses’ involvement in policy and research and

improve nursing care. Data collection included cross sectional surveys of nurses on clinical practice, quality

assurance and stigma; an institutional assessment of workplace policies and the impact of the HIV epidemic on the

nursing workforce. Capacity building included training in the policy development process, training in research

skills including opportunities for collaborating on research projects, research grants for junior investigators, and

research internships for nurses.

Results: Three research projects were completed in Jamaica. Sixteen (16) Jamaican nurses participated in the

international research internship to build capacity for research. Frontline nurses, nurse researchers, and decision

makers improved capacity in using and leading research to influence policy. Three (3) research proposals by junior

nurse researchers and three (3) HIV policy evaluation proposals by leadership hubs were funded and successfully

completed.

Conclusions: This program of research built research and policy capacity among nurses for leadership roles in

improving equity, quality and efficiency of health systems for HIV and AIDS care. Findings from the three

interrelated research projects will be presented.

The Ministry of Health

24-26 Grenada Crescent

Kingston 5, Jamaica

Tele: (876) 633-7924

Email: [email protected]

mailto:[email protected]

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NATIONAL EPIDEMIOLOGY UNIT, MINISTRY OF HEALTH, JAMAICA