Monthly Communicable Disease Surveillance Report (Summary of reporting % for P, L, S included)
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1 Integrated Diseases Surveillance Project Monthly Communicable Disease Surveillance Report Monthly Communicable Disease Surveillance Report (Summary of reporting % for P, L, S included) MONTH: JUNE 2014 Prepared by: State Surveillance Unit, IDSP State Health Society, Bihar 1
2 LETTER OF TRANSMITTAL MONTH: JUNE 2014 The monthly communicable disease surveillance report contains an early source of infectious disease surveillance data for Bihar. These data are important for monitoring early trends of notifiable infectious diseases and for targeting prevention and control efforts. Early detection is essential to the control of emerging, reemerging, and novel infectious diseases. Containing the spread of such a disease in a profoundly interconnected world requires active vigilance for signs of an outbreak, rapid recognition of its presence, and diagnosis of its microbial cause, as well as strategies and resources for an appropriate and efficient response. The purpose of this document is to summarize important information to data users who should know about the report to facilitate proper analysis and interpretation. This report comprises compilation, analysis and interpretation of data reported under Integrated Disease Surveillance Project (IDSP), Bihar. The diseases reportable may increase or decrease over time. These data are subject to change, reflecting recent entry of information received from reporting sources. The report contains interpretation of monthly communicable disease trend, outbreak analysis as well as reporting percentage of Presumptive (P), Laboratory (L) and Syndromic (S) forms through which the data on diseases are reported. Analysis and interpretations on above have been done both at State and District level for decentralized control efforts. The report is expected to generate Early Warning Signals (EWS) of impending disease outbreaks and help in early preparedness for control and management of communicable diseases in the State. It is also expected to provide help to all the SPOs & DPOs involved in Disease Control Programme and other Officials, institutions etc involved in disease surveillance and its control. The Action Points for control and management of various diseases have been attached as Annexure with this Monthly Report for ready reference and to plan for subsequent interventions in case of any unusual increase in the number of cases/outbreaks if any. Data contained within this monthly report is based on information recorded under IDSP as on 30th June Majority of the diseases reported in P, L and S forms show rising trend in June when compared to May But the incidence of Acute Diarrhoea, Bacillary Dysentery, Viral Hepatitis, Enteric fever, PUO, ARI, Pneumonia, Dog bite, Snake bite, Kala-azar and Filaria as reported in P form; Typhoid, Malaria & TB as reported in L form and Cough with or without fever (<2 weeks), Loose Watery Stool, Jaundice and Fever cases as reported in S form is more in June. The rising trends of these diseases have to be closely monitored & appropriate action should be undertaken accordingly. In June 2014, total 43 outbreaks involving 578 cases and 18 deaths were reported in Bihar. Out of these outbreaks, 25 outbreaks of Chicken Pox involving 367 cases were reported from 6 districts viz: Gopalganj, Gaya, Kishanganj, Rohtas, Madhubani & Saran. 7 outbreaks of Diarrhoea involving 160 cases & 1 death were reported from 6 districts viz: Aurangabad, Nawada, Gaya, Lakhisarai, Madhubani & Sheikhpura. Besides these, 11 outbreaks of AES involving 51 cases & 17 deaths were reported from 6 districts viz: Aurangabad, Gaya, Jahanabad, Muzaffarpur, Samastipur & Nawada. The districts are expected to keep a close eye on the trend of above diseases, especially on Enteric, Food & Water-borne as well as Vector-borne diseases on account of prevailing Monsoon Season. Outbreak & Self preventive measures for various diseases have been incorporated in Summer, Monsoon & Winter Alerts. Soft copies of all these documents along with Action Points for control and management of various diseases can be downloaded from state website: Hope that the report helps attaining the goal to promote healthier lives among citizens of Bihar. (Anand Kishor) Executive Director State Health Society 2
3 JUNE MONTHLY COMMUNICABLE DISEASE SURVEILLANCE REPORT (IDSP) Data contained within this monthly report is based on information reported by DSU (IDSP), Bihar as on 30 th June 2014 in prescribed Presumptive, Laboratory and Syndromic forms Objective: The basic objective behind the compilation of Monthly Communicable Disease Surveillance Report is to keep an eye on diseases that show rising trend and take appropriate measures promptly for their control and management. A detailed guideline on actions/interventions to be taken on any unusual increase in disease incidence and outbreaks has been attached as enclosure with this document. Soft copies of this document can be downloaded from website: Reference: The report has been compiled & interpreted by Dr. Ragini Mishra (State Epidemiologist, IDSP, State Health Society, Bihar). Any suggestions and feedback can be mailed on ragini330@gmail.com Table of contents 1. Key reportable disease trend (State level) summary in June 2014 Pg Outbreak summary, June 2014 Pg 5 3. Data tables Pg 6 4. State & District wise monthly disease trends Pg Outbreak Analysis (June 2014) Pg District wise average monthly reporting % of P, L, S forms Pg Annexure (SHEET A-Z & A'-B'') 3
4 1. Key Reported Disease trend: Monthly trend of diseases (on the basis of Monthly trend of diseases (on the basis of LAB presumptive surveillance) surveillance) Sl No Disease May-14 Jun-14 Trend Sl No Disease May-14 Jun-14 Trend Acute Diarrhoea Bacillary Dysentery Viral Hepatitis Dengue Chikungunya 0 0 Monthly Trend of diseases (on the basis of Syndromic surveillance) Sl No Disease May-14 Jun-14 Trend Fever<7 days with bleeding Enteric fever Malaria Dengue 0 2 Chikungunya JE Meningococcal Meningitis Typhoid Cough with or without fever(<2 WEEKS) 3 Cough with or without fever(>2 WEEKS) AES 0 15 Meningitis Diphtheria Loose Watery Stool (<2 weeks) with some/much dehydration Measles Diphtheria 5 15 Pertussis Chicken Pox Fever of Unknown Origin (PUO) ARI Pneumonia Leptospirosis 12 1 AFP Dog bite Cholera Shigella Vir Hep A Vir Hep E Leptospirosis Malaria Pv Malaria Pf Loose watery stool (<2 weeks) with no dehydration 6 Loose watery stool (<2 weeks) with blood Jaundice < 4 weeks AFP less than 15 Years age Unusual Symptoms leading to death or hospitalization Fever<7 days only fever Snake bite Unusual syndrome Kala-azar TB Kala-azar TB HIV Fever<7 days with rash 12 Fever<7 days with daze or semiunconsciousness HIV Filaria Filaria Fever>7 days
5 Note* declining trend rising trend Constant Note: The above summary is based after analyzing disease trend at State level. However, district wise variance in disease trend is seen which have been interpreted in subsequent pages. Districts are accordingly required to go through the report and undertake subsequent action for control and management of diseases that show a rising trend. Due to greater file size, only graphical representation of diseases trend have been incorporated in this report. Annexure containing data can be downloaded from website: 3. Outbreaks Summary of Outbreaks in June 2014 in Bihar Disease outbreak District No of outbreaks Total No of Cases Total No of Deaths Chicken Pox Gopalganj Chicken Pox Gaya Chicken Pox Kishanganj Chicken Pox Rohtas Chicken Pox Madhubani Chicken Pox Saran Diarrhoea Aurangabad Diarrhoea Nawada Diarrhoea Gaya Diarrhoea Lakhisarai Diarrhoea Madhubani Diarrhoea Sheikhpura AES Aurangabad AES Gaya AES Jahanabad AES Muzaffarpur AES Samastipur AES Nawada TOTAL
6 4. Data Table: 6 Disease (P form) Current Year ¹ Cumulative total Jun 2014 Cases Jan 13- Jun 2014 Previous year-2013 Cumulative total Jun 2013 Cases since Jan-Jun 2013 Acute Diarrhoeal Disease Bacillary Dysentery Viral Hepatitis Enteric fever Malaria Dengue Chikungunya AES Meningitis Measles Diphtheria Pertussis CHK Pox PUO ARI Pneumonia Leptospirosis AFP Dog bite Snake bite Unusual syndrome Kala-azar TB HIV Filaria Disease (L form) Dengue Chikungunya JE Meningococcal Meningitis Typhoid Diphtheria Cholera Shigella Vir Hep A Vir Hep E Leptospirosis Malaria Pv Malaria Pf Kala-azar TB HIV Filaria *NA=Not Available National Disease Surveillance Data, IDSP, June 2014
7 Trend of Diseases based on Presumptive Surveillance (State level) 7
8 8
9 9
10 Trend of Diseases based on Laboratory Surveillance (State wise analysis) 10
11 11
12 Trend of Diseases based on Syndromic Surveillance (State level Analysis) 12
13 13
14 District wise trend of Diseases based on Presumptive Surveillance (District wise analysis) 14
15 15
16 16
17 17
18 18
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20 20
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24 24
25 25
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27 27
28 28
29 29
30 30
31 31
32 32
33 33
34 34
35 35
36 36
37 37
38 38
39 39
40 District wise trend of Diseases on the basis of Laboratory Surveillance 40
41 41
42 42
43 43
44 44
45 45
46 46
47 47
48 48
49 49
50 50
51 51
52 52
53 53
54 54
55 55
56 56
57 57
58 District wise trend of Diseases/Illnesses on the basis of Syndromic Surveillance (District Wise Analysis) 58
59 59
60 60
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63 63
64 64
65 65
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71 71
72 OUTBREAK ANALYSIS 72
73 GRAPHICAL REPRESENTATION OF OUTBREAKS BY TYPES REPORTED & RESPONDED BY THE DISTRICTS (in June 2014) 73
74 MONTHLY AVERAGE REPORTING PERCENTAGE OF P,L & S FORMS UNDER IDSP 74
75 *Note: Due to IDSP Portal updation at Govt. of India level, average monthly reporting% of Reporting Units has been affected in June
76 76 DISTRICT WISE & MONTH WISE AVG REPORTING % OF P, L & S FORMS (IDSP) IN BIHAR IN 2014 District Wise Monthly Average Reporting Percentage for P, L & S forms, Bihar for Months Jan to June 2014 FORM-P FORM-P FORM-P FORM-P FORM-P FORM-P FORM-L FORM-L FORM-L FORM-L FORM-L FORM-L FORM-S FORM-S FORM-S FORM-S FORM-S FORM-S SNo District Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Avg Blocks Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % Reporting % (Jan) (Feb) (Mar) (Apr) (May) (Jun) (Jan) (Feb) (Mar) (Apr) (May) (Jun) (Jan) (Feb) (Mar) (Apr) (May) (Jun) 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA W.CHAMPARAN PATNA E.CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL * Note: Due to IDSP Portal rectification at Govt. of India level, Avg reporting % has considerably dropped in June
77 OUTBREAK INVESTIGATION (Trigger and Response Mechanisms) Level 1 (ANM/ MPW) Serial Syndrome Trigger event Action taken no 1 1 Acute watery stools More than 5 cases in 1000 population 1. Treat with appropiate antibiotics. 2. Treat with ORS 3. Refer to PHC if dehydration is severe. 4. Inform MO PHC 5. Collect water samples and send to PHC for analysis. 6. OT testing 7. Check TCL stock (bleeching powder) 8. Train the local person about chlorination of water. 9. IEC for Community awareness about safe water and personal hygene. 2 A ) Fever < 7 days duration a) Only fever b) With rash 5 cases in 1000 population. Even single in the village 1.Slides for MP with presumptive /RT for malaria 2. Inform MOPHC. 3. IEC for community awareness. 1. Collect slide for MP. 2. Refer the case to PHC 3. Inform MOPHC 4. Give vitamin A 5. Give paracetamol. 6. Check immunisation 7. Surveillance for Aedes Egypti Larvae in the house. a. Containers b. Coolers, etc c) Altered consciousness d) Fever with bleeding Even single case in the village Even single case in the village 1. Collect slide for MP. 2. Refer the case to CHC/DH 3. Antipyretics 4. Inform to PHC 5. Vector surveillance 6. IEC 1. Refer the case to CHC/DH 2. Inform to PHC 3. Vector surveillance 4. IEC
78 e) Fever with convulsions B) Fever more than 7 days Even single case in the village above 5 years of age group More than 2 cases in 1000 population 3 Jaundice More than 2 cases in 1000 population. 4 Unusual event More than 2 deaths or hospitalization 1. Refer the case to CHC/DH 2. Inform to PHC 3. Vector surveillance 4. IEC 1. Give paracetamol. 2. Collect slide for MP. 3. Give anti malarial treatment. 4. Inform to PHC. 5. OT testing of drinking water. 6. Collect water sample and send it to PHC for analysis. 7. Check TCL stock. 8. Train local person about water Chlorination. 9. Community awareness about safe water and Personal hygene. 1. Refer to PHC 2. Inform MOPHC 3. Search for antenetal cases with jaundice in 2 nd /3 rd trimester. 4. Collect water samples for analysis and send it to PHC 5. OT testing. 1. Inform MOPHC 2. Community awareness
79 Level 2 Medical Officer Level (PHC/CHC) Serial no Probable Diagonosis Trigger event Action taken 1 Acute watery diarrhoea/cholera >5 cases in 1000 population for some geographical area 2 Typhoid More than 2 cases for some geographical area Verify the information from ANM. Confirmation of the outbreak. Active search of cases with standard case definition. Standard case management. Stool sample collection for Cholera. Ensure safe water supply. Inform district authority and ask for help SOS. IEC. Documentation. Ensure buffer stock. Verify the information from ANM Confirmation of the outbreak Active search of cases with standard core definition Stool sample collection Standard case management Ensure safe water supply Inform district authority and ask for help SOS IEC Documentation Ensure buffer stock Blood culture for S typhi.
80 3 Viral hepatitis 2 cases or more of jaundice from one geographical area. 4 Measles Even a single suspected case 5 Japanese Encephelitis Even a single suspected case. 7 DF/DHF Even a single case of suspected DF/DHF from a community of 1000 population. Clinical verification. Standard case management. Active search of cases. Ensure Safe Water supply. Stool samples for virus isolation. Serological investigation. Active search for 2 nd /3 rd trimester cases with jaundice and keep them under observation with referral to district hospital SOS. Investigation of water Treatment Plant/ pipeline Leakages. Verify the case through clinical manifestation. Send samples for laboratory testing. Standard case management. Active search of cases. Ring vaccination. IEC Vitamin A. Verify the information. Clinical confirmation. Standard case management. Active search of cases with standard case definition. Vector surveillance and control. IEC Vaccination as a preventive measure. Subsequently inform to higher authority. Isolation of virus. Sero-diagnosis Referral of serious cases to district hospital. Verify the information. Suspect if clustering of fever cases with M.P. negative slides are found. Confirmation of outbreak. Standard case management. Active search of cases with standard case definition. House-to-house vector surveillance for A.. Egypti Larvae. Fogging/spraying if necessary. Inform the DHO. IEC Empty the coolers, vessels and keep them dry for 24 hours at least once in a week. Remove garbage.(containers etc.) Laboratory confirmation.
81 8 Malaria Even single case is found malaria + ve in an area where malaria was not present for minimum three months. SPR rise more than double over last three months. Single death from malaria (clinical /microscopically). Single PF case of indigenous origin. 9 Unusual syndromes causing death or hospital admission Hospitalization or death of minimum two cases of similar illness from same geographical area. Mass survey for fever cases. Microscopic examination within 24 hours Start CRT to all fever cases/all contacts of + ve cases and all migratory population. (in case of single PF case of indigenous origin is found) Focal spraying with synthetic pyrethyroid Fogging daily X 3 days followed by biweekly for 3 weeks. Larvicidal application Elimination of mosquitogenic places by tempting of water tables, land filling, chanalizing the drains. Activate DDC/FTD Involve local bodies and community by IEC. Daily surveillance for 3 to 4 weeks. Verification of the rumor. Clinical verification of cases. Basic Life Support and emergency medical care. Refer to appropriate hospital if necessary. Active search of cases. Autopsy and preservation of body fluid and tissues of vital organs for laboratory diagnosis. IEC to avoid panic. Reporting to the higher authority.
82 Level 3 District Level/Medical College Serial no Confirmed Diagnosis Trigger event Action taken 1 Acute watery diarrhea/ cholera. >5 cases in 1000 population from same geographical area. 1 District Nodal Officer Verifies the information from Medical Officer PHC/CHC 2 Confirmation of the outbreak with the help of data analysis 3 Analysis of laboratory sample if any. 4 Rapid Response team Visit to the site Confirm the outbreak Std. Case management Active search of cases with standard case definition Stool sample collection Ensure availability of essential drugs and establish Depot center. Ensure safe water supply. Inform State authority and ask for help SOS. IEC. Documentation. Feedback 2 Typhoid More than 2 cases for some geographical area 1 District Nodal Officer Verifies the information from Medical Officer PHC/CHC 2 Confirmation of the outbreak by data analysis 3 Analysis of laboratory sample if any. 4 Rapid Response team Visit to the site. Confirm the outbreak Std. Case management Active search of cases with standard case definition Ensure safe water supply Inform State authority and ask for help SOS IEC Documentation Feedback
83 3 Viral hepatitis 2 cases or more of jaundice from one geographical area. 4 Measles Even a single suspected case District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic. Standard Case Management. Find out source of infection. Active search of cases. Ensure safe water supply. Stool samples for virus isolation. Serological investigation. Active search for 2 nd /3 rd trimester cases with jaundice and keep them under observation with referral to Medical college hospital SOS. Investigation of water Treatment Plant/ pipeline Leakages. Inform State authority and ask for help SOS IEC Documentation Feedback District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic. Ring immunization and effective containment. Send samples to reference laboratory. Standard management of complicated cases. IEC Vitamin A prophylaxis Feedback
84 6 Japanese Encephalitis Even a single suspected case. 7 DF/DHF Even a single case of suspected DF/DHF from a community of 1000 population. District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic. Clinical confirmation. Standard case management. Active search of cases with standard case definition. Vector surveillance and control. IEC Vaccination as a preventive measure. Subsequently inform to higher authority and ask for help sos. Laboratory specimen to reference laboratory for Virus Isolation. Sero-diagnosis IEC Documentation Feedback District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic. Standard management of complicated cases. Active search of cases with standard case definition. Intensified Vector surveillance house-tohouse Foggy/spraying if needed. IEC Empty the coolers, vessels and keep them dry for 24 hours at least once in a week. Sero-diagnosis IEC Documentation Feedback.
85 8 Malaria Even single case is found malaria + ve in an area where malaria was not present for minimum three months. SPR rise more than double over last three months. Single death from malaria (clinical/microsc opically). Single PF case of indigenous origin. 9 Unusual syndromes causing death or hospital admission Hospitalization or death of minimum two cases of similar illness for same geographical area. District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic Mass survey for fever cases. Microscopic examination within 24 hours Start CRT to all fever cases/all contacts of + ve cases and all migratory population. (in case of single PF case of indigenous origin is found) Focal spraying with synthetic pyrethyroid Fogging daily X 3 days followed by biweekly for 3 weeks. Larvicidal application Elimination of mosquitogenic places by tempting of water tables, land filling, chanalizing the drains. Activate DDC/FTD Involve local bodies and community by IEC. Daily surveillance for 3 to 4 weeks. District Nodal Officer Verifies the information from Medical Officer PHC/CHC Confirmation of the outbreak by data analysis Analysis of laboratory sample if any. RRT investigation to confirm epidemic Basic Life Support and emergency medical care. Refer to appropriate hospital. Active search of case. Autopsy and preservation of body fluid and tissues of vital organs for laboratory diagnosis. IEC to avoid panic. Reporting to the higher authority. Documentation Feedback.
86 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET A STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Acute Diarrhoeal Disease (including acute gastroenteritis FOR PRESUMPTIVE SURVEILLANCE-P) Acute Diarrhoeal Disease YEAR 2014 SL NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
87 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET B STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Bacillary Dysentery FOR PRESUMPTIVE SURVEILLANCE-P Bacillary Dysentery YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
88 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET C STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Viral Hepatitis FOR PRESUMPTIVE SURVEILLANCE-P Viral Hepatitis Year 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
89 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET D STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Enteric Fever FOR PRESUMPTIVE SURVEILLANCE-P Enteric Fever YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
90 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-E STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Malaria FOR PRESUMPTIVE SURVEILLANCE-P S.NO DISTRICT YEAR 2014 JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL Malaria
91 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-F STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Dengue FOR PRESUMPTIVE SURVEILLANCE-P Dengue / DHF / DSS YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
92 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-G STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Chikungunya FOR PRESUMPTIVE SURVEILLANCE-P Chikungunya YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
93 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-H STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF AES FOR PRESUMPTIVE SURVEILLANCE-P Acute Encephalitis Syndrome YEAR 2013 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
94 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-I STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Meningitis FOR PRESUMPTIVE SURVEILLANCE-P Meningitis YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
95 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-J STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Measles FOR PRESUMPTIVE SURVEILLANCE-P Measles YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
96 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-K STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Diphtheria FOR PRESUMPTIVE SURVEILLANCE-P Diphtheria YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
97 Ministry of Health & Family Welfare(IDSP),Government of India; SHEET-L STATE HEALTH SOCIETY, BIHAR MONTH WISE CASE OF Pertussis FOR PRESUMPTIVE SURVEILLANCE-P Pertussis YEAR 2014 S.NO DISTRICT JAN FEB MAR APR MAY JUNE 1 ARARIA AURANGABAD ARWAL BANKA BEGUSARAI BHABHUA BHAGALPUR BHOJPUR BUXAR DARBHANGA GOPALGANJ GAYA JAHANABAD JAMUI KHAGARIA KISHANGANJ KATIHAR LAKHISARAI MADHUBANI MADHEPURA MUNGER MUZAFFARPUR NAWADA NALANDA WEST CHAMPARAN PATNA EAST CHAMPARAN PURNIA ROHTAS SAHARSA SHEKHPURA SHEOHAR SITAMARHI SAMASTIPUR SARAN SUPAUL SIWAN VAISHALI TOTAL
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