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Outbreak update – Dengue in Pakistan, 1 December 2019

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3 December 2019 – The Ministry of National Health Services, Regulations and Coordination (MNHSR&C) of Pakistan reported 998 new cases of dengue fever during epidemiologic week 48 (25 November – 1 December) of 2019. Out of these new cases, 789 (79%) were reported from Sindh and 209 (20%) from the rest of the regions in Punjab, Islamabad, Khyber Pakhtunkhwa (KP), Baluchistan, Azad Jammu and Kashmir (AJK) and tribal districts of KP. Within Sindh, 14 443 (93%) of the total 15 521 cases are reported from Karachi alone. Cases reported from the twin cities of Islamabad and Rawalpindi now stand at 20 980 – 40% of the national tally – with 47 new cases reported this week.

The total number of reported dengue cases this year is 52 485 including 91 associated deaths (giving a case fatality ratio, CRF, of 0.17%) from all the provinces and AJK except for Gilgit-Baltistan. The highest number of deaths during 2019 have been reported from Sindh (42, CFR 0.27%) followed by Punjab (23, CFR 0.22%) and Islamabad (22, CFR 0.16%). The districts reporting most of the dengue cases include Islamabad Capital Territory (ICT), Karachi, Peshawar, Rawalpindi, Lasbela and Muzaffarabad.

Data reported by the MNHSR&C for the past four epidemiologic weeks (Week 45–48) show a declining trend in the number of new dengue cases. During week 45, the total number of new cases in all regions was 2935 compared to 2395 new cases in week 46 and 998 cases in week 48. This shows that outbreak surveillance, prevention and control measures are bringing positive results. The start of the winter season in most parts of the country has also contributed as it creates a less favourable environment for vector breeding.

The federal ministry and provincial health departments are implementing control measures with the support of WHO and other partners to limit this outbreak, which has spread rapidly across the country. At the federal level, an Emergency Operations Center (EOC) at the National Institute of Health (NIH) is monitoring the disease situation on a daily basis. Standard guidelines for case management have been shared with all healthcare providers and both formal and informal training is being conducted. Extensive social mobilization, community engagement and vector control activities are being undertaken in all the affected and neighbouring areas with the involvement of relevant line departments and stakeholders.

WHO continues to provide leadership and support to health authorities and partners while conducting activities to mitigate the outbreak and reduce disease morbidity and mortality. WHO and the MNHSR&C continue to monitor outbreak trends in various regions to promptly investigate and respond to any alert and sustain control of the disease.