Notifiable Diseases Summary Report for July 2015

Disease ReportedTotal Cases
Scrub Typhus4
Typhoid Fever2

FluView_ILI & SARI Surveillance Report for Week 26, 2015

The incidence of ILI and SARI for the week was 23/1000 outpatient visits and 10/100 hospitalized patients respectively. The highest incidence of ILI and SARI cases were reported from Paro and Mongar Hospital respectively. The ILI cases were commonly observed among age group 15-29 years while SARI cases were observed among 0-1 years age group. From 14 samples received and tested by Real-Time RT-PCR, positivity rate was 7.14%.

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Laboratory Testing for Middle East Respiratory Syndrome Coronavirus Interim guidance

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ILI/SARI Surveillance Intensified Across Both Sentinel and Non-Sentinel Sites for Early Detection of MERS CoV

PHL has initiated scaling up ILI/SARI surveillance across the sentinel and non-sentinel sites (all district hospitals) with an objective to detect MERS CoV for early containment of the disease. Therefore, all the district hospitals are required to send sample from symptomatic individual with travel history to one of the countries: Thailand, South Korea and Middle East. It is also mandatory to send samples from all SARI cases irrespective of travel history and any issues on logistic and supplies should be discussed with PHL.

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Quarterly Disease Surveillance Bulletin, Volume 1, January - March, 2015

Public Health Laboratory (PHL) is pleased to launch its first Quarterly Disease Surveillance Bulletin for 2015 and henceforth the bulletin will be produced regularly at the end of every quarter. The aim of the bulletin is to provide insight and regular update on various disease surveillance conducted by Public Health Laboratory to policy makers in the Ministry of Health, health professionals and relevant stakeholders. The current bulletin covers disease surveillance data from January to March, 2015.

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Release Order for In-country Training on Water Quality Testing and Reporting

The laboratory staffs of Yebilaptsa Hospital, Zhemgang BHU-I,Gedu Hospital,Phuntsholing Hospital,Sibsoo Hospital,Trashiyangtse Hospital,Samdrupcholing BHU-I,Rangjung BHU-I,Samtse Hospital,Sarpang Hospital,Tsimalakha Hospital,Pemagatshel Hospital,Gelephu CRRH,Gomtu Hospital,Chukha BHU-I,Dagapela Hospital,Paro Hospital,Panbang BHU-I,Lhuntse Hospital and Kanglung BHU-I can download the Release Order for attending "In-country Training on Water Quality Testing and Reporting" from the given link

Click Here to Download Release Order

Monthly Notifiable Disease Surveillance Report(Reporting Center Wise) for March, 2015

NDS Reporting Center wise Report

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Monthly Notifiable Disease Surveillance Summary Report for March, 2015

NDS Summary Reporting Report

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A Prospective Hospital-based Surveillance to Estimate Rotavirus Disease Burden in Bhutanese Children under 5 Years of Age

As part of efforts to develop an informed policy for rotavirus vaccination, this prospective study was conducted to estimate the burden of rotavirus diarrhea among children less than 5 years old attended to the Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extending from February....

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ARI Outbreak status- Reported since 4th February - 15th March, 2015 from various part of the Country, Bhutan.

A total of five ARI Outbreaks were reported from the following various places

  1. Gaybakha, Wangdue Phodrang,dated 4-6th Feb, 2015 (Influenza A/pdmH1)
  2. Ramjar Middle school, Trashi Yangtse, dated 02-Mar-2015 (Influenza A/H3)
  3. Yurung Locality, Pema Gatshel, dated 04-Mar-2015 (Influenza A/pdmH1)
  4. Mukhung Community Pry School, Mongar, dated: 05-Mar-2015 (Influenza A/pdmH1)
  5. Phochu Dumra Lobdra, Punakha, dated 12-Mar-2015 (Influenza A/pdmH1)

Outbreaks were investigated immediately by respective District Health Officials with... Read More

User Manuals for PHL Online Systems

Public Health Laboratory has developed user manual for following online systems:

  1. Bhutan Diarrheal Study Information System (BDSIS)
  2. National Notifiable Disease Surveillance Information System & Event Reporting Information System (NNDSIS/ERIS)
  3. Bhutan ILI AND SARI Information System (ILI-SARI)
  4. Tuberculosis Information & Surveillance System (TBISS)
  5. Water Quality Monitoring Information System (WQMIS)

Please click here to view/download the manuals.

Training of health workers on Revised ILI and SARI surveillance guidelines, web-based reporting and sample shipment as per IATA regulation from 28th – 30th January 2015, Gelephu

Workshop Resolution

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Outbreak Investigation Report On Scrub Typhus In Singye Namgyel Primary School, Wangduephodrang, 3rd-4th October 2014

Following the death of a 17 years old female student from Singye Namgyel Primary school Migtena village, Athang geog under Wangduephodrang district on 28/08/14 at JDWNR Hospital with provisional diagnosis of viral encephalitis, a rapid response team from Wangduephodrang visited the area and mitigation measures were implemented. Another 8 years old female student expired on 28/09/2014 from same school (referred from Punakha Hospital). She was suspected of meningococcal-meningitis. Similarly, a 10 years old female student from same school was referred from Punakha Hospital on 29/09/2014 with similar sign and symptoms to that of the deceased. These numbers of similar cases following the death of two school children has alerted the public health department and mandated to intervene.

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Dominance of Emerging G9 and G12 Genotypes and Polymorphism of VP7 and VP4 of Rotaviruses from Bhutanese Children with Severe Diarrhea Prior to the Introduction of Vaccine

Bhutan is a small landlocked country located between India and China. Part of the population is concentrated in the capital Thimphu, but most are scattered sparsely throughout the country. Diarrhea is a major cause of illness and death in Bhutanese children, and the morbidity rate from diarrhea in ,5 years old children is 314.6/1,000 population [1,2], while 13% of deaths are attributable to diarrhea [3]. Approximately 83% of the population have access to safe drinking water and 91% have access to sanitary toilets [1]. A shift from bacterial to possibly viral diarrhea has been observed, although information regarding childhood diarrhea is...

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National Workshop on Severe Acute Respiratory Infections (SARI) Surveillance,Bumthang,1-3 October,2014

The SARI surveillance system is one of the important surveillance systems in the country which was established for monitoring trends in respiratory illnesses and to understand the epidemiology of influenza viruses and other respiratory pathogens by Public Health Laboratory.

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Preliminary Report on Surveillance for Diarrhea Etiologic Agents at Public Health Laboratory in Stool Specimens from Children in Bhutan, from July 2013 to August 2014

After the successfully completion of two years collaborative Surveillance between the Public Health Laboratory and the Department of Enteric Diseases, AFRIMS, Bangkok on Diarrhea Etiologic Agents in Stool Samples from Children Attending Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, the collaborative surveillance on diarrhea etiologic agents has been extended to Eastern Regional Referral Hospital (Mongar), Central Regional Referral Hospital (Gelephu) and Phuntsholing General Hospital in July 2013 to further understand the epidemiology of diarrhea etiologic pathogens among the Bhutanese children for another two years.

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Ebola virus Disease Update

New cases and deaths attributable to EVD continue to be reported by the Ministries of Health in Guinea, Liberia, Nigeria, and Sierra Leone. Between 12 and 13 August 2014, 152 new cases (laboratory-confirmed, probable, and suspect cases) of EVD and 76 deaths were reported from the four countries as follows: Guinea, 9 new cases and 3 deaths; Liberia, 116 new cases and 58 deaths; Nigeria, 0 new cases and 1 death; and Sierra Leone, 27 new cases and 14 deaths.

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Centers for Disease Control and Prevention(CDC) Review Report on Influenza Laboratory Capacity in PHL

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Centers for Disease Control and Prevention(CDC) Review Report on Surveillance System in the Country

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Applications Invited for One Health Postgraduate Study Fellowships

Massey University is seeking applicants for One Health Postgraduate Study Fellowships as part of a 3-year program ‘Integrating Education and Action for One Health’ in Afghanistan, Bhutan, Nepal and Bangladesh. The program is funded by the European Commission under the One Health Program in Asia, and runs from 2014–2017.

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Report on Entomological investigation of Malaria outbreak in Khawrong, Langchenphu, Jomotshangkha (3rd June 2013 to 9th June 2014)

The first two malaria cases were reported from a couple, Mr. TshetenDorji and Mrs. Tsheltrim Zangmo, who had seeked treatment in India. They are nomadic herders;they had cited that, since, treatment at Basic Health Unit required hospitalization, they preferred to get treated in India. No medical prescription was available with them, though, it was most likely that, they were treated by......

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Report on Malaria Case follow up at Changray village Trongsa Dzongkhag

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Epidemiology of dog bites and Rabies post exposure prophylaxis in Bhutan, 2009–2012.(Article under peer review)

Dog bites in human and expenses incur on anti-rabies treatment is a public health problem in Bhutan. In this study we describe the epidemiology of dog bites and the use of human rabies postexposure prophylaxis (PEP) vaccine in Bhutan for a period of four years (2009-2012). Dog bites and PEP treatment data (18,813 patients’) were retrieved from 34 health centres and performed descriptive and logistic regression analyses.

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Novel Human Bufavirus Genotype 3 in Children with Severe Diarrhea Bhutan(Published Article)

We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs.

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Multidrug-resistant Tuberculosis Patients in Bhutan, August 2011 to July 2012(Published Article)

This study aimed to describe the factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan. The study covered all MDR-TB patients admitted to Gidhakom Hospital, Thimphu from August 2011 to July 2012. Data were collected from MDR-TB registers, laboratory registers and inpatient records as well as from interview with patients about demographic characteristics, history of previous anti-TB treatment, compliance and contact history. There were total 19 MDR-TB patients. Majority of the patients were males (63%). Median age was 25 years for males and 30 years for females.

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Molecular Characterization and PCR-based Replicon Typing of Multiple Resistant Shigella sonnei Isolates from Bhutan(Published Article)

During a diarrhea surveillance study in Bhutan 2011, Shigella sonnei were isolated more frequently than expected. Twenty-nine S. sonnei isolated from Bhutan were characterized for antimicrobial susceptibility, integrons, gyrA gene mutation, replicon typing, plasmid and PFGE analysis.

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Rotavirus burden 2013 manuscript(Article under peer review)

During the study period, a total of 284 children (1 in 45) were hospitalized, and 2,220 children (1 in 6 children) attended the outpatient clinic with diarrhea. Group A rotavirus was detected in 5% of the stool samples from the hospitalized children with diarrhea.

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Influenza surveillance from November 2008 to 2011;including pandemic influenza A(H1N1)pdm09 in Bhutan(Published Article)

The first case of A(H1N1)pdm09 infection was detected in Bhutan in July 2009, 3 months after the virus was first reported in Mexico in April 2009. During the official WHO pandemic period( 11 June 2009 to 8 August 2010), a total of 2149 samples were collected and tested by RT-PCR of which 22.7% (487) were confirmed A(H1N1)pdm09;H3N2,H1N1 and B positive in 2.2%, 1.1% and 7.2%, respectively.

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Chikungunya Fever Outbreak,Bhutan, 2012(Published Article)

In 2012, chikungunya virus (CHIKV) was reported for the first time in Bhutan. IgM ELISA results were positive for 36/210 patient samples; PCR was positive for 32/81. Phylogenetic analyses confirmed that Bhutan CHIKV belongs to the East/Central/South African genotype. Appropriate responses to future outbreaks require a system of surveillance and improved laboratory capacity

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Strengthening the One Health Hub Bhutan

A One Health approach involving joint activities amongst human, animal and environmental sectors for the control of zoonoses has received increasing attention in recent years given the high proportion of emerging infectious diseases originating from animal species,such as avian influenza (H5N1, H1N1), Severe Acute Respiratory Syndrome (SARS), antimicrobial resistance, Nipah virus and others.

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One Health Hub Bhutan Membership Registration

To register as a One Health Hub Bhutan member, please download the Membership Registration Form and email the completed form to or