Republic of the Philippines Leptospirosis Department of Health Monthly Surveillance Report No.3 Kagawaran ng Kaluougan March, 2019 Leptospirosis Leptospirosis is a group of zoonitic bacterial diseases with variable manifestations. Disease transmission may be through: contact of skin, especially if abraded, or of mucous membranes with moist soil, vegetation contaminated with urina with infected animals or contaminated water as swimming, wading in flood waters, accidental immersion or occupational abrasion; direct contact with urine or tissues of infected animals. Table 4, Leptospirosis Cases in the Philippines, 2019* vs 2018 Er) Par) Cote eed Ce ee ieee PIDSR Case Definition for Leptospirosis EDITORIAL BOARD ‘A person who developed acute febrile illness Suspected | with headache, myalgia and prostation Case: associated with any of the following possibly after exoosure to infected animals or an environment contaminated with animal urine FERCHITO INO, MD, MPH, PHSAE + Congunetival suffocation -ChprGe, Epidemiology Bureau ‘+ Meningeal irtation + Anutia or Oliguria andi or proteinuria + Jaundice + Hemormiages (from intestines or lungs) + Cardiac arthythmia oF faire 2 Skin rash Probable ‘A suspected case in an ongoing epidemic or Hae Case an environment contaminated wth animal richentd HABELLERA, RN Urine (0.9, wading in water floods. ric folds, Nurse V drainage) JEZZA JONAH T: ACLAN, RN, MPH lurse Il Confirmed | A suspected case that is laboratory Case confirmed, Case counts reported here do NOT represent the il number and ore subject to change after inclusion of deloyed reports and review of cases A POF fle ofthis report avaliable a wnrw.doh av phistatsies Percentage Total may not equa to 100 due to rounding off gues Page 8Republic ofthe Philippines Leptospirosis Department of Health Monthly Surveillance Report No.3 Kagawaran ng Kalueugan Een = ease eu March, 2019 |. Trend in the Philippines A total of 384 leptospirosis cases were reported nationwide from January 1 to March 30, 2019 [Figure 1]. This is ‘58% lower compared to the same time pariod last yoar (837) [Table 2]. Figure 1. Reported Leptospirosis Cases by Morbidity Week (N=354) Philippines, January 1 to March 30, 2019 Alort and Epidemic Threshold Morwiy Wook Geographic Distribution of Cases Most of the cases were from the following regions: REGION V (76, 21%), NCR (74, 21%], REGION VI (49, 14%) REGION Il (26, 7%) and REGION IV-A (21, 6%) (Table 2} Table 2. Reported Leptospirosis Cases by Region, Philippines, March 2019* (N=354) vs. March 20187 L w ul VA MIMAROPA Vv vi Vil Vl 1K x XL Xi ARMM. CAR CARAGA 3 NCR 74 eleleis alels|aia|ziSle|_lelale 3 3 2 5 1 3 5 3 41 3 0 2 0 0 1 0. as feo }oo| || fo| | =lerftglno| us| fe slelelelelelelelelele|a}elelelele| | tom period of January f fo March 30,2019 “From prod of Jury 1 fo Maren 30,2078 Case counts reported ere do NOT represent the finl number and are subject tochonge after inclusion of delayed reports and evew of cases ‘APOF file ofthis report i avalableat mv. doh gow phstatisies Percentage Tota may not equal to 100 due ro roundng-of figures Pme 28Repu of the Philipines Leptospirosis Department of Health Monthly Surveillance Report No.3 aganran ng Kaheogan ST Pern Il, Profile of Cases ‘Age of cases ranged from 3 years to 88 years (median = 34 years) [Figure 2]. Majority (304, 86%) of cases were male. Most (52, 15%) of the cases belonged to the age group of 20-24 years old, There were 42 deaths (CFR. 11.86%), Figure 2. Reported Leptospirosis Cases by Age Group and Sex (N=354) Philippines, March 2019 Male Female = i =| a] ‘Age Group (Years) i 55 60 45 40 35 90 2 20 15 10 5 0 5 10 15 20 25 90 a5 40 45 50 55 No. of Cases IV, Laboratory Status of Leptospirosis Cases Out of the 354 reported leptospirosis cases, there were 91 cases (26%) tested for laboratory confirmation. Out of the tested, 22 cases (24%) yielded for positive results, 33 cases. (36%) yiolded negative results, while there were 36 cases (40%) awaiting laboratory results [Figure 3) Figure 3. Laboratory Status of Reported Leptospirosis Cases, Philippines, March 2019" 364 reported leptospirosis cases 91 (26%) cases tested for laboratory ‘confirmation i ~orincmesrocme cee | (TREE) [senna en “From poi of Sanuney 19 Mor 9, 2019 ‘case counts reported here do NOT represent the fina number and are subject to change afte inlsion of delayed reports ond review of cases. A POF feof this reports avalooie a wanv.deh aon phic, Percentage Total may not equal 2100 due to rounding of ures Page 28Republic of the Philippines Leptospirosis Department of Health Monthly Surveillance Report No.3 Kagpvaran og Kater March, 2019 V. Profile of Confirmed Leptospirosis C: ‘Out ofthe 354 reported leptospirosis cases, a total of 22 confirmed leptospirosis cases were reported nationwide from January 1 to March 30, 2019 [Figure 4] Figure 4. Confirmed Leptospirosis by Morbidity Week (n=22) Philippines, March 2019° Ne. of Coes 5 6 7 8 oe. 2 8 3 ° 1 ° ° 2 1 2 ° Merity Weak VL. Geographic Distribution of Confirmed Leptospirosis Cases ‘Most of the confirmed leptospirosis cases were from the following regions: NCR (12, 55%), REGION VI (4, 16%) and REGION IV-A (3, 14%). Among the reported confirmed leptospirosis cases, 1 death was noted from NCR (CFR 4.55%) Table 3. Confirmed Leptospirosis Cases by Region (n=22) Philippines, March. 2019 L 4 0 0.00 VA, 3 0 0.00) v 4 o 0.00 vi 4 0 0.00. vill 1 o 0.00 NCR 2 4 8.33 “From poi of Saousry fo March 30,2019 ‘Case counts reported here do NOT represent the fil number and are subject change after incision of delayed cepts and review of cases ‘POF file ofthis report vaible of suv. 0h ace antics Percentage Toto! may not equa e100 due to rounding off figures Page 48pubic ofthe Philipines Leptospirosis Department of Health Monthly Surveillance Report No.3 Kagan ng Kahan Epidemiology Bureau eer GAIL use eee Vil. Sex and Age Group of Confirmed Leptopsirosis Casos ‘Ago of confirmed leptospirosis cases ranged from 15 years to 49 years {median = 25 years). Majority (19, 86%) ‘of confirmed cases were male. Most (6, 27%) of the confirmed leptospirosis cases belonged to the age group of 45.49 years old (Figure 5 Figure 5. Confirmed Leptospirosis Cases by Age Group and Sex (n=22) Philippines, March 2019" Male @Female 260 jm 55.59 [9 5084 |" asag |" 4o4a |" 35.39 |= 30-34 |? 25.29 20-24 16-19 (5 10-14 |@ pee 7 ‘Age Group (Years) ‘he. of Contes Leptospexs "From pore of anu $0 March 30, 2019 ose counts repored here do NOT represent te ial number and ore subject o change afte inclusion ef Seloyed reports and evew of coses A POF ie of ths reports ovtiable ot wiv. doh.gou hse. Percentage Total may net equa to 100 6ve to rounding of favre —Republic of the Philippines Department of Health agaaran ng Kahzogan Epidemiology Bureau files erty ic Leptospirosis Monthly Surveillance Report No.3 March, 2019 Figures 6-22. Leptospirosis Alert and Epidemic Thresholds per Region as of March, 2019 Fig. 6 Reported Leptospirosis Cases by Morbidity Week Region I, as of January 1-March 30, 2019 (n=11) Fig. 8 Reported Leptospirosis Cases by Morbidity Wook Region Ill as of January 1-March 30, 2019 (n=18) Fig. 10 Reported Leptospirosis Cases by Morbidity Week Region MIMAROPA, as of January 1-March 30, 2019 (n=4) Fig. 7 Reported Leptospirosis Cases by Morbidity Week Region Il, a of January 1-March 30, 2019 (n=26) Fig. 9 Reported Leptospirosis Cases by Morbidity Week Region IV-A, as of January 1-March 30, 2019 (n=21) ase counts reported here do NOT represent the final number and are subject to change afte inclusion of deleyed reports and review of cose, 4 POE file ofthis report is ovolbleot wis coh dou physi Percentage Tota mey not equal 0100 dve to rounding of figures: OseanRepublic of the Philippines Department of Health Kegewaran ng Kakusugan Ee ee ieee aetna ion Leptospirosis Monthly Surveillance Report No.3 a) Figures 6-22. Leptospirosis Alert and Epidemic Thresholds per Region as of March, 2019 Fig. 12 Reported Leptospirosis Cases by Morbidity Week Region VI, as of January 1-March 30, 2019 (n=49) Fig. 14 Reported Leptospirosis Cases by Morbidity Week Region Vill, as of January 1-March 30, 2019 (n=12) Fig. 16 Reported Leptospirosis Cases by Morbidity Week of January {-March 30, 2019 (n=7) Region X, Fig. 13 Reported Leptospirosis Cases by Morbidity Week Region Vil, as of January 1-March 30, 2019 (n=13) Fig. 15 Reported Leptospirosis Cases by Morbidity Week. Region IX, as of January 1-March 30, 2019 (n=11) a A Fig. 17 Reported Leptospirosis Cases by Morbidity Week Region XI, as of January 1-March 30, 2019 (n=18) (Case counts reported here do NOT represent the fine number and are subject to change afer inclusion of delayed repors and review of cases. ‘POF file ofthis report i ovolble of nun dh gov cities Percentage Tota! may not equa to 100 duet runing of figures ‘aki waeRepublic ofthe Philippines Leptospirosis Department of Health Monthly Surveillance Report No.3 Kaganaran ng Kanan March, 2019 Figures 6-22. Leptospirosis Alert and Epidemic Thresholds per Region as of March, 2019 Fig, 18 Reported Leptospirosis Cases by Morbidity Week Fig. 19 Reported Leptospirosis Cases by Morbidity Week. Region XU, as of January 1-March 30, 2019 (n=2) Region ARMM, as of January 1-March 30, 2019 (n=2) WA A_MIVA_AA_ Fig. 20 Reported Leptospirosis Cases by Morbidity Week — Region CAR, as of January 1-March 30, 2019 (n=8) Fig. 21 Reported Leptospirosis Cases by Morbidity Week Region CARAGA, as of January 1-March 30, 2019 (n=3) re, Fig. 22 Reported Leptospirosis Cases by Morbidity Week Region NCR, as of January 1-March 30, 2019 (n=74) ose counts reported here de NOT represent the final number nd ore subject o change ate clusion of Stayed reports and evew of cose ‘A POF fle ofthis report avaible a wv doh.gou pst Percentage Tol may rot eal 100 due torounding of gues Pane Pt