Highlights

• During week no. 44, 2015;85% (402/343) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 79757 compared to 77583 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

• A total of 165 alerts were generated by eDEWS system in week 44, 2015; Of these 156 alerts were verified as true for further investigations with appropriate response.

• Altogether 40 alerts for Measles, 27 Dengue Fever, 24 Acute viral hepatitis, 17 Cut.Leishmaniasis, 13 each for Pertussis and Bloody diarrhea, 6 Acute Flaccid Paralysis, 5 Meningitis, 4 Schistosomiasis, 3 each for Viral hemorrhagic fever and Neonatal Tetanus, 1 Other acute diarrhea were received and responded in system generated.

• Online disease surveillance and response system was launched in 4 governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.

Sana'a, 8 November 2015 — 2 WHO chartered planes have arrived in Sana'a, carrying more than 76 tonnes of medicines and medical supplies as part of the response to cyclone Chapala and the ongoing conflict in Yemen.

The planes, which arrived last week, contain interagency emergency health kits and basic malaria medicines sufficient for 70 000 people for approximately 3 months, trauma kits for 6400 patients requiring surgical care and diarrhoeal diseases kits for more than 100 000 cases.

"The cyclone that made landfall in Yemen caused tremendous damage to households leaving hundreds of people exposed to unfavorable health conditions, including flooding and injuries which required medical support," said Dr Ahmed Shadoul, WHO Representative in Yemen.

"In addition to the ongoing crisis, the needs have become enormous, this medical aid is therefore timely and will enhance the health authorities' ability to respond to both emergencies."

Cyclone Chapala impacts

Supplies on the ground in YemenSince cyclone Chapala made landfall in Yemen on 3 November, 8 people have died, including 2 children, and over 60 have been injured in the areas affected by the cyclone. Over 44 000 people have also been displaced as a result of damage to property, crops, health facilities, ambulances and power supply lines in Socotra, Shabwah and Hadramaut governorates.

To ensure 24-hour emergency health service delivery, WHO and health partners have supported 8 hospitals in Hadramout and Mukalla with essential medicines and fuel needed to keep them functioning. Of these 4 hospitals are in Mukalla (2 public and 2 private) and 4 are in rural areas.

To minimize disease outbreaks in the affected areas, WHO is supporting health authorities to strengthen the disease surveillance system through intensified monitoring and reactivating the rapid response teams in the coastal areas of Mukalla, Al-Mahra, Shabwa, Socotra, Abyan, Hodeida and Aden.

With flooding, WHO and partners are concerned about the increased risk in vector-borne diseases, like dengue fever, malaria and chikungunya and waterborne and diarrhoeal diseases.

As of October 2015

69 TOTAL DAMAGED HEALTH FACILITIES

27 FULLY DAMAGED HEALTH FACILITIES

36 TOTAL DAMAGED HOSPITALS

10 FULLY DAMAGED HOSPITALS

13 TOTAL DAMAGED HEALTH CENTERS AND UNITS

20 HEALTH WORKERS INJURED

8 HEALTH WORKERS KILLED

27 HIT AMBULANCES

4 LOOTED VEHICLES

2 CAPTURED SURVEILLANCE VEHICLES

But, 2015 global milestones and measles elimination goals are off track

12 NOVEMBER 2015 | GENEVA– The number of measles-related deaths has decreased 79% from 546 800 at the beginning of the century to 114 900 in 2014. New data released by the World Health Organization (WHO) for the Measles & Rubella Initiative, estimates that 17.1 million lives have been saved since 2000, largely due to increased vaccination coverage against this highly contagious viral disease. Measles vaccination has played a key role in reducing child mortality and in progress towards Millennium Development Goal 4.

However, the new data published in this week’s edition of the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report and WHO’s Weekly Epidemiological Record shows that overall progress towards increasing global immunization coverage has recently stagnated. While coverage with the first dose of the measles vaccine increased globally from 72% to 85% between 2000 and 2010, it has remained unchanged the past four years.

“We cannot afford to drop our guard,” says Dr Jean-Marie Okwo-Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals. “If children miss routine vaccination and are not reached by national immunization campaigns, we will not close the immunization gap.”

Based on current trends of measles vaccination coverage and incidence, the 2015 global milestones and measles elimination goals set by WHO’s Member States will not be achieved on time.

Although all countries include at least one dose of measles-containing vaccine in their routine vaccination schedule, only 122 (63%) have met the target of at least 90% of children vaccinated with a first dose. Additionally, only half of the world’s children are receiving the recommended second dose of the vaccine.

Success of immunization campaigns

In 2014, mass vaccination campaigns led by country governments with support from the Measles & Rubella Initiative and Gavi, the Vaccine Alliance, reached approximately 221 million children. Twenty-nine countries supplemented their routine vaccination programmes with mass immunization campaigns, helping to reduce measles incidence in four out of six WHO regions last year.

Overall, since 2000, these campaigns have enabled 2 billion children to receive a supplemental dose of measles vaccine.

In the African Region, cases dropped from over 171 000 in 2013 to under 74 000 in 2014, likely due to campaigns in Democratic Republic of the Congo (DRC) and Nigeria. WHO’s Eastern Mediterranean, European and the South-East Asia regions also saw decreases in measles incidence in 2014.

Large-scale campaigns in 2014 included:
Bangladesh – more than 53.6 million children vaccinated
DRC – more than 18.5 million children vaccinated
Pakistan - more than 25 million children vaccinated
United Republic of Tanzania – more than 20.5 million children vaccinated
Yemen – more than 11.3 million children vaccinated
Viet Nam – more than 15.1 children vaccinated

“Last year, the Measles and Rubella Initiative supported campaigns in 29 high-risk countries to stop measles, including in Liberia where a serious outbreak occurred following the Ebola epidemic. Funding for many of the largest campaigns came from Gavi, the Vaccine Alliance. Gavi’s support for measles campaigns in large countries like DRC and Pakistan, and measles-rubella vaccine introduction through campaigns targeting children under 15 years of age, is providing a strong boost to measles control and elimination in those countries, ” says Dr Robert Linkins, Chief, Accelerated Disease Control and Surveillance Branch at the U.S. Centers for Disease Control and Prevention.

“Despite our success in these countries, globally over 100 000 children needlessly died from measles last year. That’s a tragedy which can be easily prevented if we intensify our measles surveillance and vaccination efforts,” Linkins concluded.

Measles outbreaks remain an issue

Measles outbreaks, which happen when there are gaps in vaccination programmes, continue to pose a serious challenge to meeting global targets. The Americas and Western Pacific regions saw increased numbers of cases in 2014, mostly due to large outbreaks in China, the Philippines, and Viet Nam. In other regions, although the overall number of cases fell, some individual countries still had large outbreaks, including Angola, Ethiopia, India, the Russian Federation and Somalia.

Accelerating Progress

Measles is highly infectious and strong, sustained efforts are needed to maintain the current level of control. Together with changes in policies and practices in high-burden countries, vaccination and surveillance efforts need to be funded, maintained and strengthened, WHO and its partners say.

“Despite the welcome reduction in measles deaths, this highly-infectious disease continues to take a terrible toll on the lives of children around the world,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “A coordinated approach that puts stronger routine immunization at its core will be central to getting measles under control and securing further reductions in mortality from this vaccine-preventable disease.”

Note to editors:

Please note these figures are from 2014 and do not include numbers from outbreaks in early 2015.

Measles

Measles is a highly contagious viral disease, which affects mostly children. It is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.

There is no specific treatment for measles and most people recover within 2–3 weeks. However, particularly in malnourished children and people with reduced immunity, measles can cause serious complications, including blindness, encephalitis, severe diarrhoea, ear infection, pneumonia and death. The Measles & Rubella Initiative

Launched in 2001, the Measles & Rubella Initiative is a global partnership led by the American Red Cross, United Nations Foundation, U.S. Centers for Disease Control and Prevention (CDC), UNICEF and WHO. The Measles & Rubella Initiative is committed to ensuring that no child dies from measles or is born with congenital rubella syndrome; reducing measles deaths by 95% by 2015; and achieving measles and rubella elimination in at least five WHO regions by 2020.

The latest data is published in this week’s WHO’s Weekly Epidemiological Report and in CDC’s Morbidity and Mortality Weekly Report.

About Gavi, the Vaccine Alliance

Gavi, the Vaccine Alliance is a public-private partnership committed to saving children’s lives and protecting people’s health by increasing access to immunisation in poor countries. The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. Gavi uses innovative finance mechanisms, including co-financing by recipient countries, to secure sustainable funding and adequate supply of quality vaccines. Since 2000, Gavi has contributed to the immunisation of an additional 500 million children and the prevention of approximately 7 million future deaths.

World Health Assembly agreed milestones

In 2010, the World Health Assembly established three milestones towards the future eradication of measles to be achieved by 2015:

increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district or equivalent administrative unit; reduce and maintain annual measles incidence to 95% from the 2000 estimate.

For media inquiries, please contact:

Christian Lindmeier
WHO Communications Officer
Telephone: +41 22 791 1948
Mobile: +41 79 500 65 52
Email: lindmeierch@who.int

Karen Mah Communications Specialist, UNICEF
Measles & Rubella Initiative
Telephone: +1 (917) 265 4603
Mobile: +1 (917) 412 6166
Email: kmah@unicef.org

Frédérique Tissandier
Senior Manager Communication
Gavi, The Vaccine Alliance
Telephone: +41 (0)22 909 2968
Mobile: +41 (0)79 300 8253
Email: ftissandier@gavi.org

Related Links

WHO’s Weekly Epidemiological Report
CDC’s Morbidity and Mortality Weekly Report
Measles fact sheet
The Measles & Rubella Initiative: http://www.measlesrubellainitiative.org/
Gavi, the Vaccine Alliance: www.gavi.org

Sana'a, 12 November 2015—The Ministry of Public Health and Population, in cooperation with WHO and UNICEF, this week concluded the second round of the national polio immunization campaign targeting 4 551 174 children under the age of 5 in 17 governorates.

The four-day campaign has succeeded in reaching 92 per cent of the children targeted, with around 40 000 health workers in fixed and mobile teams taking part in the campaign. Imams of mosques and officials of local councils have mobilized support for the campaign, which was accompanied by an intensive health education and advocacy campaign.

The campaign targeted high-risk groups such as marginalized communities, internally displaced persons, refugees and Bedouins.

WHO provided US$ 3.3 million to cover the operational costs, including incentives for vaccinators and the cost of micro-planning and supervision. "Despite huge security challenges, WHO is committed to supporting polio immunization campaigns and all activities of the expanded programme on immunization to maintain the polio-free status of Yemen," said Dr Ahmed Shadoul, WHO Representative in Yemen. “We will continue to make every endeavour to reach the global goal of eradicating polio. This campaign is a step towards this long-term and crucial goal.” The ongoing armed conflict in Yemen poses a threat to the expanded programme on immunization in the country. WHO has supported the Ministry of Public Health and Population to keep polio vaccines safe through providing fuel and generators to enable vaccine storage as well as cold chain transferring them from war-torn areas to safer places.

HIGHLIGHTS

• In response to Cyclone Chapala that made a landfall in Yemen, WHO delivered 35 metric tons of medical supplies to Hadromouth, Shabwa and Mahara Hadramout, Shabwa, Socotra and Al-Mahra to respond to any mass casualties needs. The supplies cover the needs of over 120 000 people.
  
• On 4 November, WHO chartered a plane containing 76 metric tons of medical supplies comprising Interagency Emergency Health Kits basic unit.The Malaria Module and Diarrhoea Disease Kits arrived at Sana’a to support the response to Cyclone Chapala and the ongoing emergency interventions.
  
• On 9 November, the second round of the National Immunization Campaign was launched in Yemen targeting 5 039 936 children under the age of 5 years for polio.WHO has provided US $ 3.3 million to cover the operational costs of the campaign.
  
• From 22 August to 31 October, the WHO and Field Medical Foundation (FMF) assisted 13 879 children under 5 years, pregnant women and mothers . in providing nutrition mobile clinic service in Aden, Lahj and Hadramout Governorates.

• 250 000 benefited Residual fumigation campaigns targeting 50 000 houses in coordination with National Malaria Programme

• I.V fluids sufficient for 300 000 people were provided in affected governorates.

• 380 health workers trained on case management for physicians and paramedics on dengue and malaria

Highlights

• During week no. 45, 2015;86% (402/345) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 74601 compared to 79757 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

A total of 172 alerts were generated by eDEWS system in week 45, 2015; Of these 167alerts were verified as true for further investigations with appropriate response.

• URTI (14.7%), suspected malaria (3.3%), OAD (10%) and Pneumonia (4.7%) remain the leading causes of morbidity representing a total of 32.7%.

• All diarrheal disease comprised 10.3% and Pneumonia 4.7% of total morbidity in Pilot Governorates this week.

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.3% of this morbidity.

• All diarrheal disease comprised 5.36% and Pneumonia 2.53% of total morbidity in the <5 years age group.

• Altogether 38 alerts for Measles, 27 Acute viral hepatitis, 23 Dengue Fever, 21 Pertussis, 19 Cut.Leishmaniasis, 18 Bloody diarrhea, 8 Acute Flaccid Paralysis, 5 Meningitis, 3 Viral hemorrhagic fever, 2 each for Schistosomiasis and Neonatal Tetanus, 1 Rabies were received and responded in system generated.

H i g h l i g h t s

During week no. 46, 2015;89% (402/357) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 75391 compared to 74601 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

• A total of 158 alerts were generated by eDEWS system in week 46, 2015; Of these 147 alerts were verified as true for further investigations with appropriate response.

• URTI (15%), suspected malaria (3.1%), OAD (9.4%) and Pneumonia (5.4%) remain the leading causes of morbidity representing a total of 32.9%.

• All diarrheal disease comprised 9.6% and Pneumonia 5.4% of total morbidity in Pilot Governorates this week.

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.3% of this morbidity.

• All diarrheal disease comprised 4.95% and Pneumonia 2.82% of total morbidity in the <5 years age group.

• Altogether 27 alerts each for Measles and Acute viral hepatitis, 19 each for Dengue Fever and Pertussis, 18 Bloody diarrhea, 15 Cut.Leishmaniasis, 9 Acute Flaccid Paralysis, 6 Meningitis, 3 Schistosomiasis, 2 Viral hemorrhagic fever, 1 each for Neonatal Tetanus and Pneumonia were received and responded in system generated.

Highlights

• During week no.47, 2015; 92% (402/368) health facilities from governorates provided valid surveillance data.

• The total number of consultations reported during the week in governorates was 83928 compared to 75391 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S. Mal) were the leading cause of morbidity this week.

• A total of 179 alerts were generated by eDEWS system in week 47, 2015; Of these 174 alerts were verified as true for further investigations with appropriate response .

• URTI (15.8%), suspected malaria (3.5%), OAD (9.1%) and Pneumonia (5.3%) remain the leading causes of morbidity representing a total of 33.7%.

• All diarrheal disease comprised 9.3% and Pneumonia 5.3% of total morbidity in Pilot Governorates this week.

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.2% of this morbidity.

• All diarrheal disease comprised 4.81% and Pneumonia 2.97% of total morbidity in the <years age group.

• Altogether alerts for Measles, Pertussis, Bloody diarrhea, Acute viral hepatitis, Dengue Fever, Cut. Leishmaniasis, each for Meningitis and Schistosomiasis, Acute Flaccid Paralysis, Neonatal Tetanus, Viral hemorrhagic fever, each for Other acute diarrhea and Diphtheria were received and responded in system generated.

• Online disease surveillance and response system was launched in governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in Governorates (Sana'a City, Hodaidah,
Hajjah, Ibb, Al-Mukalla and Sa'da) in November 2013. The next expansion phase has Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl-wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.

At a glance

• Continuing conflict may result in the complete collapse of Yemen’s health system.

• More than 15.2 million people lack access to health services.

• For the past 10 months, partners have been increasingly reliant on the World Health Organization (WHO) as one of the sole providers of medical supplies in the country.

Situation update

The intensification of conflict in Yemen since March 2015 has pushed Yemen’s already weakened health system to the brink of collapse.
Insecurity, power shortages and a lack of fuel (for generators and ambulances) have led to the closure of almost one in four health facilities. Not only are health workers among the 2.3 million people displaced, but the procurement and distribution of medicines and medical supplies has been disrupted. In addition, economic factors are taking a toll on the Ministry of Health’s ability to fund the continued operation of health facilities and individuals’ ability to pay to access them.

As a result, 15.2 million people currently lack access to health care and the conflict looks unlikely to abate any time soon. A one-two punch of successive cyclones has also added to the strain, displacing an extra 44 000 people and increasing the risk of vector-borne diseases such as dengue fever and malaria.

GENEVA, 15 December 2015 – The World Health Organization and health partners are appealing for US$ 31 million to ensure the continuity of health services for nearly 15 million people in Yemen affected by the ongoing conflict. Funding is urgently needed as the Yemeni health system has collapsed, leaving millions of vulnerable people without the care and medications they urgently need.

“WHO is appealing to donors to help us meet the urgent, immediate humanitarian needs of the injured, pregnant women, malnourished children and elderly who are bearing the brunt of a collapsing health system,” says Dr Ala Alwan, WHO Regional Director for the WHO Eastern Mediterranean. “We should not allow this to continue. With sufficient funds, we can reduce the risk of disease outbreaks, provide life-saving medications and vaccinate children to reduce avoidable deaths.”

Currently, WHO and health partners are providing essential medicines, supporting health services and providing mental health psychosocial support in hard-to-reach areas through mobile clinics and primary health care centres. However, more funding is required to ensure that disrupted services are restored. “The funding requested will help WHO and our partners support vital health services in 3 major areas: casualty management for those injured due to the conflict, treatment for patients with chronic diseases, and disease surveillance and vaccination activities to prevent outbreaks,” says Dr Ahmed Shadoul, WHO Representative to Yemen.

The health and humanitarian situation for the civilian population in Yemen has reached catastrophic levels. The situation in some governorates is especially critical: 100% of the population of the Aden governorate and more than three quarters in the Taiz governorate are in need of humanitarian assistance. Since September, fighting has intensified in Taiz, and almost 240 000 vulnerable civilians are living under a virtual state of siege. In other parts of the country, the conflict has crippled the health system, making the delivery of health services and supplies extremely challenging. Almost 70 health facilities and 27 ambulances have been damaged, and there is a shortage of health workers, limiting access to health care.

Compounding the situation, fuel shortages have made it impossible for many major hospitals and health facilities to function optimally, while lack of fuel for ambulances has crippled the referral process. Surgical operations, including caesarian sections, have been disrupted. Patients whose treatment requires constant power supply are also at risk. Fuel shortages are also are creating severe challenges for the transportation of food, water, and medical supplies, and the operation of water pumps and generators. In response to this, WHO has supplied over one million litres of fuel to health facilities and ambulances to keep them functional. Support has also been provided for the delivery of water purification tablets and over 19 million litres of water to camps and areas hosting internally displaced persons.

Over the past 9 months, WHO has distributed over 250 tonnes of life-saving medical supplies to Yemeni health authorities and international, and local nongovernmental organizations, serving more than 7 million beneficiaries. Together with health partners, WHO has vaccinated 4.6 million children against polio and 1.8 million against measles in high-risk areas.

“WHO and health partners call on all donors to urgently fill this funding gap and ensure continuity of life-saving and essential health services,” says Dr Shadoul.

Listen to the press briefing by Dr Ahmed Shadoul, WHO Representative in Yemen.

For more information contact:

WHO Geneva
Tarik Jašarević
Media Spokesperson
Email: jasarevict@who.int
Tel: +41 22 791 5099
Mob: +41 793 676 214.

WHO Yemen
Sadeq Hasan
Media Relations
Email: hasansa@who.int
Tel : + 967 733096603

WHO Regional Office
Rana Sidani
Media Relations
Email: sidanir@who.int
Tel: +20-222-765-552 Mob: +20-109-975-6506

H i g h l i g h t s

• During week no. 48, 2015;94% (402/376) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 87264 compared to 83928 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

• A total of 188 alerts were generated by eDEWS system in week 48, 2015; Of these 166 alerts were verified as true for further investigations with appropriate response.

• URTI (16.2%), suspected malaria (3.3%), OAD (9.2%) and Pneumonia (5.1%) remain the leading causes of morbidity representing a total of 33.8%.

• All diarrheal disease comprised 9.5% and Pneumonia 5.1% of total morbidity in Pilot Governorates this week.

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.3% of this morbidity.

• All diarrheal disease comprised 4.81% and Pneumonia 2.78% of total morbidity in the <5 years age group.

• Altogether 33 alerts each for Dengue Fever and Measles, 25 Acute viral hepatitis, 19 Bloody diarrhea, 18 Cut.Leishmaniasis, 15 Pertussis, 9 Acute Flaccid Paralysis, 7 Meningitis, 3 each for Schistosomiasis and Viral hemorrhagic fever, 1 Pneumonia were received and responded in system generated.

• Online disease surveillance and response system was launched in 4 governorates (Aden,
Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov.,
HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.

H i g h l i g h t s

• During week no. 49, 2015;94% (402/378) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 91402 compared to 87264 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

A total of 204 alerts were generated by eDEWS system in week 49, 2015; Of these 185 alerts were verified as true for further investigations with appropriate response.

• URTI (16.2%), suspected malaria (3.3%), OAD (9.2%) and Pneumonia (5.1%) remain the leading causes of morbidity representing a total of 33.8%.

• All diarrheal disease comprised 9.4% and Pneumonia 5.1% of total morbidity in Pilot Governorates this week.

• Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.3% of this morbidity.

• All diarrheal disease comprised 4.83% and Pneumonia 2.73% of total morbidity in the <5 years age group.

• Altogether 38 alerts for Measles, 31 Dengue Fever, 28 Acute viral hepatitis, 24 Bloody diarrhea, 20 Cut.Leishmaniasis, 18 Pertussis, 8 Acute Flaccid Paralysis, 7 Meningitis, 4 Schistosomiasis, 3 each for Neonatal Tetanus and Viral hemorrhagic fever, 1 Pneumonia were received and responded in system generated.

• Online disease surveillance and response system was launched in 4 governorates (Aden,
Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov.,
HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.

24 December 2015, Sana’a, Yemen -- The World Health Organization (WHO) has delivered more than 100 tonnes of medicines and medical supplies for more than one million beneficiaries in 8 districts of Taiz governorate, where more than 3 million people, including 392,000 internally displaced persons, are in dire need of humanitarian assistance.

The health supplies, which were delivered following the announcement of the ceasefire, consist of urgently needed oxygen cylinders, medicines and medical devices, including surgical supplies and equipment for the management of trauma cases. These supplies have been distributed to 13 hospitals and health centres, and have replenished the local health department’s contingency stock for future needs.

“The health situation in Taiz has increasingly deteriorated. Shortages in health staff, medicines and fuel, as well as limited access by the humanitarian community due to the insecurity, have caused many health facilities in the governorate to shut down," said WHO Representative in Yemen Dr Ahmed Shadoul. "We are calling on all parties to guarantee unrestricted, long term delivery of humanitarian aid and unconditional movement of health workers."

The distribution of an additional 22 tonnes of medical aid to 5 health facilities in Sala, Al-Qahera and Al-Mudhaffar districts of Taiz City is on hold due to access issues. WHO is negotiating with all parties to the conflict and advocating for unconditional access of medicines and supplies to these three districts, where 400 000 people are in critical need of humanitarian assistance.

“WHO is deeply concerned about the continuous lack of humanitarian access to Taiz City, depriving people from basic health care and violating their essential human rights. WHO re-emphasizes the crucial need for uninterrupted delivery of health services and calls upon all concerned parties to respect the basic rights of all Yemenis to access health care services,” said Dr Shadoul.

HIGHLIGHTS

• The second round of the national polio immunization campaign has been concluded in all governorates with 5 039 936 children (96% of target) vaccinated.

• The fourth round of outreach activities has been launched in all governorates targeting more than 300 000 children under the age of one. WHO has funded the activities with US$ 450,000 for operational costs, including field visits, supervision and transportation costs.

• To integrate and strengthen meningitis surveillance in the six governorates of Sana'a, Aden, Taiz, Hodeida, Ibb and Hajjah, WHO supported the Ministry of Health to conduct training of 92 surveillance coordinator s and health officials.

• A three-day training workshop on infection control measures under pandemic influenza preparedness (PIP) was held on 23 November targeting 90 physicians, paramedics and nurses from Sana'a Governorate.

Situation update

• The health situation in conflict-affected areas continues to deteriorate due to shortages of health workers and restricted access for the health sector. In Taiz Governorate, access to the only cancer treatment center for patients from Taiz , Ibb, Lahj, Hodeida and Al-Dhalea governorates is limited mainly due to ongoing violence. The center, which receives an average of 50 patients per day, is facing shortages of health workers and medical supplies due to the insecurity.

• As of 15 November, health facility reports indicate 33 350 casualties, including 5 798 deaths and 27 552 injuries in conflict-affected governorates. The number of deaths is believed to be higher given that these reports only capture health facility-reported deaths. From 3-7 November 2015, there were an additional 26 deaths and 204 injuries in Hadramout, Socotra and Shabwa Governorates as a result of cyclones Chapala and Megh.

• With the onset of winter and cold-related illnesses such as pneumonia, measles and acute respiratory infections (ARIs), an estimated 2.3 mil lion internally displaced Yemenis are at increased risk. Limited access by displaced populations and host communities to health services will increase susceptibility to diseases, with the most vulnerable groups such as children, elderly and chronic disease patients especially at risk.

• According to a recent humanitarian needs overview issued by OCHA, it is estimated that more than 19 million people lack access to safe water an d sanitation; more than 14 million people are food insecure, including 7.6 million who are severely food insecure; and nearly 320,000 children are severely acutely malnourished.

• Since the beginning of the crisis, nine health workers have been killed and 17 injured as a direct result of the conflict. Additionally, 99 health facilities have been affected (see table 1).

Highlights

• During week no. 50, 2015;95% (402/382) health facilities from 16 governorates provided valid surveillance data.

• The total number of consultations reported during the week in 16 governorates was 95607 compared to 91402 the previous reporting week. Acute respiratory tract infections (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this week.

• A total of 173 alerts were generated by eDEWS system in week 50, 2015; Of these 168 alerts were verified as true for further investigations with appropriate response • Altogether 32 alerts for Measles, 31 Dengue Fever, 29 Acute viral hepatitis, 21 Bloody diarrhea, 16 Cut.Leishmaniasis, 14 Pertussis, 11 Acute Flaccid Paralysis, 7 Meningitis, 3 Schistosomiasis, 2 Viral hemorrhagic fever, 1 each for Neonatal Tetanus and Diphtheria were received and responded in system generated.

• Online disease surveillance and response system was launched in 4 governorates (Aden,
Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov.,
HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates.