LASSA FEVER - NIGERIA (03): (PLATEAU) FATALITIES
************************************************
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International Society for Infectious Diseases
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Date: Wed 30 Jan 2013
Source: English News, Xinhua [edited]
http://news.xinhuanet.com/english/healt ... 139763.htm
Two people lost their lives on Wednesday [30 Jan 2013] in a recent outbreak of Lassa fever in Nigeria's middle-belt Plateau state, according to an official. Plateau State Commissioner for Health Fom Dawak told reporters in Jos, the state capital, that a woman and a man died while receiving treatments at the state-run Jos University Teaching Hospital (JUTH) and Vom Christian Hospital, respectively.
"Also, 2 other persons are currently on admission at the Vom Christian Hospital and are responding to treatment for Lassa fever," the state official said, adding that the Ministry of Health had dispatched epidemiologists to communicate knowledge on how to contain the disease. There is a high possibility of treatment and survival after early diagnosis, he said.
Lassa virus is usually transmitted when the saliva, urine, and excreta of multi-mammalian rats come in contact with humans through their food or water. Dawak said another symptom of the deadly fever is bleeding, which is why it is usually referred to as haemorrhagic fever, associated with bleeding through the nose, gums and urine. "Aside from bleeding, people should watch out for the general symptoms of ill-health such as headaches and fever," he added.
In some cases, Lassa fever has similar symptoms to malaria, the commissioner for health cum medical doctor noted. "The symptoms could also vary, but we always use proper testing to ensure that the patient is adequately treated," he said, advising local residents to always cover their food and water properly, as well as pay attention to clean surroundings. When people have clean and less clustered surroundings so as to keep rats away, the possibility of contacting the fever would be lower, he said.
In 2012, Lassa fever claimed more than 40 lives in 12 states across the West African country. For this reason, the Nigerian government set up a Lassa Fever Rapid Response Committee to investigate, prevent, and control outbreaks of the disease.
[Byline: Hou Qiang]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[In the countries of Africa, such as Nigeria, where Lassa fever is endemic, the disease is a significant cause of morbidity and mortality. While Lassa fever infection is normally mild or has no observable symptoms in about 80 percent of people infected with the virus, the remaining 20 percent have a severe multi-system disease. Exceptionally, Lassa fever is associated with epidemics, during which the case-fatality rate can reach 50 percent. There is no preventative vaccine and treatment.
The antiviral drug ribavirin has been used with success in Lassa fever patients. It has been shown to be most effective when given early in the course of the illness. Patients should also receive supportive care consisting of maintenance of appropriate fluid and electrolyte balance, oxygenation and blood pressure, as well as treatment of any other complicating infections.
Lassa fever virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic. The reservoir, or host, of Lassa virus is a rodent known as the "multimammate rat" of the genus __Mastomys_. These rodents breed very frequently, produce large numbers of offspring, and are numerous in the savannas and forests of West, Central, and East Africa. In addition, _Mastomys_ generally readily colonize human homes. Lassa fever may also spread through person-to-person contact. This type of transmission occurs when a person comes into contact with virus in the blood, tissue, secretions, or excretions of an individual infected with the Lassa virus.
A HealthMap/ProMED-mail interactive map of Nigeria can be seen at http://healthmap.org/r/50T5. A map showing the location of Plateau state in central Nigeria can be accessed at: http://www.ialnigeria.com/home/index.ph ... Itemid=128. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1qGF.]
Aktuelle Epidemien in Afrika
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Hepatitis E in Südsudan
HEPATITIS E - SOUTH SUDAN: (MABAN) REFUGEE CAMPS
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Fri 1 Feb 2013
Source: Medecins sans Frontieres (MSF) [edited]
http://www.doctorswithoutborders.org/ne ... field-news
An epidemic of hepatitis E is escalating across refugee camps in South Sudan's Maban county. To date, Medecins Sans Frontieres (MSF) has treated 3991 patients in its health facilities in the camps and has recorded 88 deaths, including 15 pregnant women. Hepatitis E [virus] causes a liver disease and can lead to acute liver failure and death. It is particularly dangerous for pregnant women. Like cholera, the virus spreads in environments with poor sanitation and contaminated water. There is no cure, but its symptoms are treatable.
"We have been doing everything we can to care for people with hepatitis E [virus infection], but there is no treatment for the disease," says Dr. Jose-Luis Dvorzak, MSF Medical Coordinator in Maban County. "We suspect this outbreak is far from over, and many more people will die."
The 1st cases appeared in June 2012. Three camps -- Jamam, then Gendrassa and Batil -- have seen the most cases so far. Numbers still have not peaked in Batil camp, where death rates have steadily risen from one or 2 per week in November [2012] to 10 per week in January [2013]. Over the past 2 weeks, MSF has identified a further 41 suspected hepatitis E cases in Doro camp, 2 of whom have died, meaning that none of the camps in Maban County is free of the virus.
This hepatitis E outbreak was able to take hold because of poor water and sanitation conditions, such as inadequate distribution of clean water, limited access to functioning latrines, and too few hand-washing points in the Maban refugee camps, which host more than 110 000 Sudanese refugees. "The refugee camps should not only be a place of safety from conflict but also a place where refugees can stay alive and are safe from preventable diseases and outbreaks," said Laurence Sailly, MSF Emergency Coordinator in Doro camp.
Because of Maban county's geographical location, it is a flood plain in the rainy season and a parched wasteland in the dry season. The refugees in these camps are completely reliant on humanitarian assistance for the food, water, and healthcare they need to survive. While continuing to concentrate on the extremely heavy medical workload of caring for hepatitis E patients and treating all the other patients with other pathologies who present in our field hospitals, MSF teams are also carrying out emergency gap-filling activities, such as pumping, treating, and distributing around 2.5 million liters of water per week in Doro camp.
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[Hepatitis E is found worldwide, and different genotypes of hepatitis E virus determine differences in epidemiology. Genotypes 1 and 2 are usually seen in developing countries and cause community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Globally, 70 000 deaths and 3.4 million cases of acute hepatitis E are attributable to infection with hepatitis E virus genotypes 1 and 2. The highest seroprevalence rates are observed in regions where low standards of sanitation increase the risk for transmission of the virus. In Egypt, half the population aged above 5 years is serologically positive for hepatitis E virus (see: http://www.who.int/mediacentre/factshee ... index.html). The conditions in the refugee camps in South Sudan are such that, once established, the illness is difficult or impossible to control and eradicate, as described in the MSF statement above.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
An interactive HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/3q1_. - Mod.CP]
************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 1 Feb 2013
Source: Medecins sans Frontieres (MSF) [edited]
http://www.doctorswithoutborders.org/ne ... field-news
An epidemic of hepatitis E is escalating across refugee camps in South Sudan's Maban county. To date, Medecins Sans Frontieres (MSF) has treated 3991 patients in its health facilities in the camps and has recorded 88 deaths, including 15 pregnant women. Hepatitis E [virus] causes a liver disease and can lead to acute liver failure and death. It is particularly dangerous for pregnant women. Like cholera, the virus spreads in environments with poor sanitation and contaminated water. There is no cure, but its symptoms are treatable.
"We have been doing everything we can to care for people with hepatitis E [virus infection], but there is no treatment for the disease," says Dr. Jose-Luis Dvorzak, MSF Medical Coordinator in Maban County. "We suspect this outbreak is far from over, and many more people will die."
The 1st cases appeared in June 2012. Three camps -- Jamam, then Gendrassa and Batil -- have seen the most cases so far. Numbers still have not peaked in Batil camp, where death rates have steadily risen from one or 2 per week in November [2012] to 10 per week in January [2013]. Over the past 2 weeks, MSF has identified a further 41 suspected hepatitis E cases in Doro camp, 2 of whom have died, meaning that none of the camps in Maban County is free of the virus.
This hepatitis E outbreak was able to take hold because of poor water and sanitation conditions, such as inadequate distribution of clean water, limited access to functioning latrines, and too few hand-washing points in the Maban refugee camps, which host more than 110 000 Sudanese refugees. "The refugee camps should not only be a place of safety from conflict but also a place where refugees can stay alive and are safe from preventable diseases and outbreaks," said Laurence Sailly, MSF Emergency Coordinator in Doro camp.
Because of Maban county's geographical location, it is a flood plain in the rainy season and a parched wasteland in the dry season. The refugees in these camps are completely reliant on humanitarian assistance for the food, water, and healthcare they need to survive. While continuing to concentrate on the extremely heavy medical workload of caring for hepatitis E patients and treating all the other patients with other pathologies who present in our field hospitals, MSF teams are also carrying out emergency gap-filling activities, such as pumping, treating, and distributing around 2.5 million liters of water per week in Doro camp.
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[Hepatitis E is found worldwide, and different genotypes of hepatitis E virus determine differences in epidemiology. Genotypes 1 and 2 are usually seen in developing countries and cause community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Globally, 70 000 deaths and 3.4 million cases of acute hepatitis E are attributable to infection with hepatitis E virus genotypes 1 and 2. The highest seroprevalence rates are observed in regions where low standards of sanitation increase the risk for transmission of the virus. In Egypt, half the population aged above 5 years is serologically positive for hepatitis E virus (see: http://www.who.int/mediacentre/factshee ... index.html). The conditions in the refugee camps in South Sudan are such that, once established, the illness is difficult or impossible to control and eradicate, as described in the MSF statement above.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
An interactive HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/3q1_. - Mod.CP]
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Lassa-Fieber in Nigeria - Ebonyi
LASSA FEVER - NIGERIA (04): (EBONYI) FATAL
******************************************
A ProMED-mail post
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International Society for Infectious Diseases
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Date: Tue 5 Feb 2013
Source: The Global Times, Xinhua News Agency report [edited]
http://www.globaltimes.cn/content/760253.shtml
Fresh outbreak of Lassa fever claims 2 lives in Nigeria
-------------------------------------------------------
Ebonyi State in eastern Nigeria on Monday [4 Feb 2013] confirmed a fresh outbreak of Lassa fever, saying that 2 people had died from the disease and 4 others were on the danger list. The permanent secretary in the state ministry of health, Hyacinth Oteh, announced the development while receiving the health emergency response team from the Federal Ministry of Health. Oteh said the outbreak of the disease was reported on 1 Feb 2013 and confirmed that 2 of the 6 patients infected with the disease had died while the other 4 were critical.
He regretted the absence of a virology laboratory in the state to aid early diagnosis and treatment of the disease, adding that some deaths had been recorded earlier when the disease was first reported in the state in 2005. The permanent secretary advocated for the establishment of a virology laboratory in each of the geo-political zones to help contain the spread of the disease through early diagnosis and treatment. He said medical doctors and other health workers involved in the fight against the disease should emphasize contact tracing in order to isolate people identified with the disease. According to him, the state government had commenced an enlightenment campaign on the resurgence of the disease and the need for members of the public to protect themselves.
Jerry Kehinde, the leader of the team, said 9 states, including Ebonyi, had been identified as Lassa fever prone and maintained that the Federal Ministry of Health was doing everything to contain the spread. He said the virus was being spread by a specie of rats known as [_Mastomys natalensis_]. He said the states affected were those ravaged by the 2012 flood disaster and warned the people to avoid contacts with rats. Kehinde said the team would identify the source of the infection and create public awareness about it.
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[In the countries of central Africa, such as Nigeria, where Lassa fever is endemic, the disease is a significant cause of morbidity and mortality. While Lassa fever infection is normally mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. The antiviral drug ribavirin has been used with success in Lassa fever.
Lassa fever virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic. The reservoir of Lassa fever virus is a rodent known as the multimammate rat of the genus __Mastomys_. These rodents produce large numbers of offspring, and are numerous in the savannahs and forests of West, Central, and East Africa. In addition, _Mastomys_ generally readily colonize human homes. Lassa fever may also spread through person-to-person contact. A case of nosocomial infection of a doctor in Ebonyi state was recorded last year [Lassa fever - Nigeria: (EB) nosocomial 20120119.1015405]. This type of transmission occurs when a person comes into contact with virus in the blood, tissue, secretions, or excretions of an individual infected with the Lassa fever virus.
A photo of the Natal multimammate mouse (_Mastomys natalensis_) can be seen at http://www.arc.agric.za/uploads/images/ ... oucha_.gif. Images of other _Mastomys_ rodents can be viewed at http://www.google.co.uk/search?q=Mastom ... 96&bih=410.
A map showing the location of Ebonyi state in south eastern Nigeria can be accessed at http://www.ialnigeria.com/home/index.ph ... Itemid=128. A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/r/5evZ. - Mod.CP]
******************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Tue 5 Feb 2013
Source: The Global Times, Xinhua News Agency report [edited]
http://www.globaltimes.cn/content/760253.shtml
Fresh outbreak of Lassa fever claims 2 lives in Nigeria
-------------------------------------------------------
Ebonyi State in eastern Nigeria on Monday [4 Feb 2013] confirmed a fresh outbreak of Lassa fever, saying that 2 people had died from the disease and 4 others were on the danger list. The permanent secretary in the state ministry of health, Hyacinth Oteh, announced the development while receiving the health emergency response team from the Federal Ministry of Health. Oteh said the outbreak of the disease was reported on 1 Feb 2013 and confirmed that 2 of the 6 patients infected with the disease had died while the other 4 were critical.
He regretted the absence of a virology laboratory in the state to aid early diagnosis and treatment of the disease, adding that some deaths had been recorded earlier when the disease was first reported in the state in 2005. The permanent secretary advocated for the establishment of a virology laboratory in each of the geo-political zones to help contain the spread of the disease through early diagnosis and treatment. He said medical doctors and other health workers involved in the fight against the disease should emphasize contact tracing in order to isolate people identified with the disease. According to him, the state government had commenced an enlightenment campaign on the resurgence of the disease and the need for members of the public to protect themselves.
Jerry Kehinde, the leader of the team, said 9 states, including Ebonyi, had been identified as Lassa fever prone and maintained that the Federal Ministry of Health was doing everything to contain the spread. He said the virus was being spread by a specie of rats known as [_Mastomys natalensis_]. He said the states affected were those ravaged by the 2012 flood disaster and warned the people to avoid contacts with rats. Kehinde said the team would identify the source of the infection and create public awareness about it.
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[In the countries of central Africa, such as Nigeria, where Lassa fever is endemic, the disease is a significant cause of morbidity and mortality. While Lassa fever infection is normally mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. The antiviral drug ribavirin has been used with success in Lassa fever.
Lassa fever virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic. The reservoir of Lassa fever virus is a rodent known as the multimammate rat of the genus __Mastomys_. These rodents produce large numbers of offspring, and are numerous in the savannahs and forests of West, Central, and East Africa. In addition, _Mastomys_ generally readily colonize human homes. Lassa fever may also spread through person-to-person contact. A case of nosocomial infection of a doctor in Ebonyi state was recorded last year [Lassa fever - Nigeria: (EB) nosocomial 20120119.1015405]. This type of transmission occurs when a person comes into contact with virus in the blood, tissue, secretions, or excretions of an individual infected with the Lassa fever virus.
A photo of the Natal multimammate mouse (_Mastomys natalensis_) can be seen at http://www.arc.agric.za/uploads/images/ ... oucha_.gif. Images of other _Mastomys_ rodents can be viewed at http://www.google.co.uk/search?q=Mastom ... 96&bih=410.
A map showing the location of Ebonyi state in south eastern Nigeria can be accessed at http://www.ialnigeria.com/home/index.ph ... Itemid=128. A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/r/5evZ. - Mod.CP]
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Lassa-Fieber in Nigeria - Plateau
LASSA FEVER - NIGERIA (05): (PLATEAU)
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A ProMED-mail post
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Date: Wed 6 Feb 2013
Source: This Day Live [edited]
http://www.thisdaylive.com/articles/las ... rt/138646/
A medical consultant with the Jos University Teaching Hospital (JUTH), Professor Chika Ogbonna, has said that over 5000 people die of Lassa fever yearly and that over 300 000 others get infected with the disease in the country yearly. He disclosed this on Wednesday [6 Feb 2013] in Jos, the Plateau state capital, during a sensitisation workshop on Lassa fever in the state. The professor, who described the disease as very deadly, said the patient experiences symptoms 2-3 weeks after infection.
Meanwhile, the federal government has said that it is determined to nip [it] in the bud to stop the spread of the fever in the country. The minister of health, Professor Onyebuchi Chukwu, added that the government is working toward bringing assistance to the general public and to prevent further mortality arising from the disease in the state and the country in general.
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communicated by:
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[Lassa fever is an acute viral illness that occurs in West Africa. The illness was discovered in 1969 when 2 missionary nurses died in Nigeria, West Africa. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the 1st cases originated. The virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic, or animalborne. In areas of Africa where the disease is endemic, Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. Lassa fever is also associated with occasional epidemics, during which the case fatality rate may reach 50 per cent.
According to the CDC Special Pathogens website (http://www.cdc.gov/ncidod/dvrd/spb/mnpa ... lassaf.htm): "The number of Lassa virus infections per year in West Africa is estimated at 100 000 to 300 000, with approximately 5000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the disease is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10-16 per cent of people admitted to hospitals have Lassa fever, which indicates the serious impact of the disease on the population of this region."
While the figures for case numbers and fatalities in Plateau state of Nigeria seem very large, they are not unexpected, since Plateau state is one of the mid-belt states of Nigeria reporting high incidence of Lassa fever. An accurate account of the numbers of Lassa fever cases in Plateau state and other mid-belt states supported by laboratory diagnostics would be welcomed.
A HealthMap/ProMED-mail interactive map of Nigeria can be seen at http://healthmap.org/r/50T5. A map showing the location of Plateau state in central Nigeria can be accessed at http://www.ialnigeria.com/home/index.ph ... Itemid=128. - Mod.CP]
*************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 6 Feb 2013
Source: This Day Live [edited]
http://www.thisdaylive.com/articles/las ... rt/138646/
A medical consultant with the Jos University Teaching Hospital (JUTH), Professor Chika Ogbonna, has said that over 5000 people die of Lassa fever yearly and that over 300 000 others get infected with the disease in the country yearly. He disclosed this on Wednesday [6 Feb 2013] in Jos, the Plateau state capital, during a sensitisation workshop on Lassa fever in the state. The professor, who described the disease as very deadly, said the patient experiences symptoms 2-3 weeks after infection.
Meanwhile, the federal government has said that it is determined to nip [it] in the bud to stop the spread of the fever in the country. The minister of health, Professor Onyebuchi Chukwu, added that the government is working toward bringing assistance to the general public and to prevent further mortality arising from the disease in the state and the country in general.
--
communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[Lassa fever is an acute viral illness that occurs in West Africa. The illness was discovered in 1969 when 2 missionary nurses died in Nigeria, West Africa. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the 1st cases originated. The virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic, or animalborne. In areas of Africa where the disease is endemic, Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. Lassa fever is also associated with occasional epidemics, during which the case fatality rate may reach 50 per cent.
According to the CDC Special Pathogens website (http://www.cdc.gov/ncidod/dvrd/spb/mnpa ... lassaf.htm): "The number of Lassa virus infections per year in West Africa is estimated at 100 000 to 300 000, with approximately 5000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the disease is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10-16 per cent of people admitted to hospitals have Lassa fever, which indicates the serious impact of the disease on the population of this region."
While the figures for case numbers and fatalities in Plateau state of Nigeria seem very large, they are not unexpected, since Plateau state is one of the mid-belt states of Nigeria reporting high incidence of Lassa fever. An accurate account of the numbers of Lassa fever cases in Plateau state and other mid-belt states supported by laboratory diagnostics would be welcomed.
A HealthMap/ProMED-mail interactive map of Nigeria can be seen at http://healthmap.org/r/50T5. A map showing the location of Plateau state in central Nigeria can be accessed at http://www.ialnigeria.com/home/index.ph ... Itemid=128. - Mod.CP]
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Gelbfieber im Tschad
YELLOW FEVER - AFRICA (09): CHAD
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Date: Thu 14 Feb 2013
Source: Afrique Jet [edited]
http://www.afriquejet.com/201302141919/ ... break.html
The Ministry of Health of Chad is launching an emergency mass-vaccination campaign against yellow fever from 22 Feb 2013, following laboratory confirmation of 2 cases in the country in December 2012, the World Health Organisation (WHO) said in a dispatch obtained by PANA Thursday [14 Feb 2013].
The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda, and Adre, targeting over a million people, including inhabitants of refugee camps in the area.
The campaign is supported by the Chad's Ministry of Health, the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11), and GAVI Alliance.
The 2 cases from Goz Beida and Guereda districts were confirmed by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal.
They were identified through the national surveillance programme for yellow fever following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudan's Darfur region.
The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths.
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[It is not clear why this announcement was so late in coming out, given that the cases occurred in December 2012. Also, it is not clear whether the 139 suspected cases and 9 fatal cases were contracted in the same area of Chad, along the Darfur border, as the 2 fatal cases reported above. These cases are very likely spill-over from the YF outbreak in western or northern Darfur. The gold mines in Darfur had workers from other countries, most likely some from Chad, that might have contracted YF virus infections and returned home and died there.
A HealthMap/ProMED-mail map of Chad can be accessed at http://healthmap.org/r/5nRk. - Mod.TY]
********************************
A ProMED-mail post
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International Society for Infectious Diseases
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Date: Thu 14 Feb 2013
Source: Afrique Jet [edited]
http://www.afriquejet.com/201302141919/ ... break.html
The Ministry of Health of Chad is launching an emergency mass-vaccination campaign against yellow fever from 22 Feb 2013, following laboratory confirmation of 2 cases in the country in December 2012, the World Health Organisation (WHO) said in a dispatch obtained by PANA Thursday [14 Feb 2013].
The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda, and Adre, targeting over a million people, including inhabitants of refugee camps in the area.
The campaign is supported by the Chad's Ministry of Health, the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11), and GAVI Alliance.
The 2 cases from Goz Beida and Guereda districts were confirmed by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal.
They were identified through the national surveillance programme for yellow fever following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudan's Darfur region.
The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths.
--
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ProMED-mail <promed@promedmail.org>
[It is not clear why this announcement was so late in coming out, given that the cases occurred in December 2012. Also, it is not clear whether the 139 suspected cases and 9 fatal cases were contracted in the same area of Chad, along the Darfur border, as the 2 fatal cases reported above. These cases are very likely spill-over from the YF outbreak in western or northern Darfur. The gold mines in Darfur had workers from other countries, most likely some from Chad, that might have contracted YF virus infections and returned home and died there.
A HealthMap/ProMED-mail map of Chad can be accessed at http://healthmap.org/r/5nRk. - Mod.TY]
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Verdacht auf Gelbfieber in Nigeria
YELLOW FEVER - AFRICA (10): NIGERIA, SUSPECTED
***********************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Fri 8 Feb 2013
Source: Weekly Epidemiological Report, Nigerian Centre for Disease Control, Federal Ministry of Health [edited]
http://www.fmh.gov.ng
Cumulative data for 2013 as of 8 Feb 2013 [summarized from a table]. Cases by state:
Abia 1
Adamawa 6
Akwa Ibom 2
Bayelsa 1
Benue 6
Gombe 3
Imo 3
Kano 12
Ondo 2
Sokoto 2
Total 38
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ProMED-mail
<promed@promedmail.org>
[The report above indicates the numbers of suspected cases without specifying how many were fatal. The small numbers of cases scattered geographically indicate that these were most likely sylvan (jungle or forest) cases from wild primates to mosquitoes and then to people, and not urban transmission from human to mosquito to human, with the possible exception of Kano state if the 12 cases occurred in one locality. Unless the situation has changed recently, Nigeria is at risk for yellow fever outbreaks because it is the only country among 13 in West Africa yet to conduct mass vaccination as was indicated in a ProMED-mail post of 24 Oct 2012 (archive no. 20121026.1366454). A recent problem in Nigeria has been the sale of fake yellow fever vaccination cards, which would complicate matters should an outbreak occur.
A map of Nigeria showing the locations of the states can be accessed at http://www.lib.utexas.edu/maps/africa/nigeria_pol93.jpg. - Mod.TY
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1qGF.]
***********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 8 Feb 2013
Source: Weekly Epidemiological Report, Nigerian Centre for Disease Control, Federal Ministry of Health [edited]
http://www.fmh.gov.ng
Cumulative data for 2013 as of 8 Feb 2013 [summarized from a table]. Cases by state:
Abia 1
Adamawa 6
Akwa Ibom 2
Bayelsa 1
Benue 6
Gombe 3
Imo 3
Kano 12
Ondo 2
Sokoto 2
Total 38
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The report above indicates the numbers of suspected cases without specifying how many were fatal. The small numbers of cases scattered geographically indicate that these were most likely sylvan (jungle or forest) cases from wild primates to mosquitoes and then to people, and not urban transmission from human to mosquito to human, with the possible exception of Kano state if the 12 cases occurred in one locality. Unless the situation has changed recently, Nigeria is at risk for yellow fever outbreaks because it is the only country among 13 in West Africa yet to conduct mass vaccination as was indicated in a ProMED-mail post of 24 Oct 2012 (archive no. 20121026.1366454). A recent problem in Nigeria has been the sale of fake yellow fever vaccination cards, which would complicate matters should an outbreak occur.
A map of Nigeria showing the locations of the states can be accessed at http://www.lib.utexas.edu/maps/africa/nigeria_pol93.jpg. - Mod.TY
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1qGF.]
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Birgitt
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Meningitis - Meningokokken in Äthiopien
MENINGITIS, MENINGOCOCCAL - ETHIOPIA: (SOUTHERN NATIONS, NATIONALITIES, AND PEOPLES REGION)
*******************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 24 Jan 2013
Source: Foreign & Commonwealth Office (FCO)/Health [edited]
http://www.fco.gov.uk/en/travel-and-liv ... a/ethiopia
The Ethiopian government and the World Health Organisation have reported an outbreak of meningococcal meningitis around Arba Minch and Shebdino, in southern Ethiopia. There has been one reported case in Arba Minch town.
--
Communicated by:
Cathy Travis
Information Manager
InterHealth Worldwide
http://www.interhealth.org.uk/
[We are not told in the above report about the number of cases or the meningococcal serogroups that are causing the meningococcal meningitis outbreak in Southern Ethiopia.
Ethiopia is one of the countries in the "meningitis belt" stretching from Senegal in West Africa to the Horn of Africa that is plagued yearly by large epidemics of meningococcal meningitis (http://www.cdc.gov/ncidod/eid/vol9no10/03-0170.htm). The meningitis outbreaks occur in the dry season (December to April) and end at the onset of the rainy season (from May to June). Larger outbreaks occur every 8-12 years (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx). Attack rates during these cyclic epidemics of meningitis range from 100 to 800 per 100 000 population, but individual communities have reported rates as high as 1000 per 100 000 (World Health Organization (WHO): Meningococcal meningitis fact sheet: http://www.emro.who.int/sudan/pdf/FactS ... ngitis.pdf).
To control an outbreak, WHO recommends mass vaccination with the appropriate meningococcal vaccine in every involved district in an attempt to induce herd immunity, whereby transmission is blocked when a critical percentage of the population has been vaccinated (see http://www.who.int/mediacentre/factsheets/fs141/en/). Meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains.
There are at least 13 serogroups of _Neisseria meningitidis_, the cause of meningococcal meningitis, based on the antigenic specificity of their capsular polysaccharides; disease is most commonly due to serogroups A, B, C, Y, and W135. All these serogroup polysaccharides except B are immunogenic in humans; serogroup B is poorly immunogenic, presumably because serogroup B polysaccharide resembles the human neural cell adhesion molecule.
While effective capsular polysaccharides-based vaccines exist against serogroups A, C, W135, and Y, no similar vaccine is available against disease caused by serogroup B strains. A new protein-based, 4-component meningococcal serogroup B (4CMenB) vaccine has been developed that is hoped will be a broad-spectrum B vaccine (Cohn AC, Messonnier ME. Inching Toward a Serogroup B Meningococcal Vaccine for Infants. JAMA 2012;307(6):614-615.; and Stephens DS. Comment. Prevention of serogroup B meningococcal disease. Lancet 2012;379(9816):592-594).
Rarely, outbreaks of meningococcal meningitis have been related to other serogroups, such as type X, which has occurred in Niger in 2006 and Burkina Faso in 2010.
Arba Minch is a city with a population of 95 373 (2012) located in the Gamo Gofa Zone of the Southern Nations, Nationalities, and Peoples Region of southern Ethiopia, about 500 km (310 miles) south of the Ethiopian capital, Addis Ababa (http://en.wikipedia.org/wiki/Arba_Minch). Shebedino, with a population of 233 922 (2007), is one of the "woredas" (districts) in the Southern Nations, Nationalities and Peoples Region of Ethiopia (http://en.wikipedia.org/wiki/Shebedino).
A map of the African bacterial meningitis belt can be found at http://www.medic8.com/images/map4-9.gif. The HealthMap/ProMED-mail interactive map of this region is available at http://healthmap.org/r/1Ahu. - Mod.ML]
*******************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 24 Jan 2013
Source: Foreign & Commonwealth Office (FCO)/Health [edited]
http://www.fco.gov.uk/en/travel-and-liv ... a/ethiopia
The Ethiopian government and the World Health Organisation have reported an outbreak of meningococcal meningitis around Arba Minch and Shebdino, in southern Ethiopia. There has been one reported case in Arba Minch town.
--
Communicated by:
Cathy Travis
Information Manager
InterHealth Worldwide
http://www.interhealth.org.uk/
[We are not told in the above report about the number of cases or the meningococcal serogroups that are causing the meningococcal meningitis outbreak in Southern Ethiopia.
Ethiopia is one of the countries in the "meningitis belt" stretching from Senegal in West Africa to the Horn of Africa that is plagued yearly by large epidemics of meningococcal meningitis (http://www.cdc.gov/ncidod/eid/vol9no10/03-0170.htm). The meningitis outbreaks occur in the dry season (December to April) and end at the onset of the rainy season (from May to June). Larger outbreaks occur every 8-12 years (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx). Attack rates during these cyclic epidemics of meningitis range from 100 to 800 per 100 000 population, but individual communities have reported rates as high as 1000 per 100 000 (World Health Organization (WHO): Meningococcal meningitis fact sheet: http://www.emro.who.int/sudan/pdf/FactS ... ngitis.pdf).
To control an outbreak, WHO recommends mass vaccination with the appropriate meningococcal vaccine in every involved district in an attempt to induce herd immunity, whereby transmission is blocked when a critical percentage of the population has been vaccinated (see http://www.who.int/mediacentre/factsheets/fs141/en/). Meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains.
There are at least 13 serogroups of _Neisseria meningitidis_, the cause of meningococcal meningitis, based on the antigenic specificity of their capsular polysaccharides; disease is most commonly due to serogroups A, B, C, Y, and W135. All these serogroup polysaccharides except B are immunogenic in humans; serogroup B is poorly immunogenic, presumably because serogroup B polysaccharide resembles the human neural cell adhesion molecule.
While effective capsular polysaccharides-based vaccines exist against serogroups A, C, W135, and Y, no similar vaccine is available against disease caused by serogroup B strains. A new protein-based, 4-component meningococcal serogroup B (4CMenB) vaccine has been developed that is hoped will be a broad-spectrum B vaccine (Cohn AC, Messonnier ME. Inching Toward a Serogroup B Meningococcal Vaccine for Infants. JAMA 2012;307(6):614-615.; and Stephens DS. Comment. Prevention of serogroup B meningococcal disease. Lancet 2012;379(9816):592-594).
Rarely, outbreaks of meningococcal meningitis have been related to other serogroups, such as type X, which has occurred in Niger in 2006 and Burkina Faso in 2010.
Arba Minch is a city with a population of 95 373 (2012) located in the Gamo Gofa Zone of the Southern Nations, Nationalities, and Peoples Region of southern Ethiopia, about 500 km (310 miles) south of the Ethiopian capital, Addis Ababa (http://en.wikipedia.org/wiki/Arba_Minch). Shebedino, with a population of 233 922 (2007), is one of the "woredas" (districts) in the Southern Nations, Nationalities and Peoples Region of Ethiopia (http://en.wikipedia.org/wiki/Shebedino).
A map of the African bacterial meningitis belt can be found at http://www.medic8.com/images/map4-9.gif. The HealthMap/ProMED-mail interactive map of this region is available at http://healthmap.org/r/1Ahu. - Mod.ML]
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Birgitt
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Gelbfieber im Tschad
Yellow fever in Chad
14.02.2013 - WHO
The Ministry of Health of Chad is launching an emergency mass-vaccination campaign against yellow fever from 22 February 2013, following laboratory confirmation of two cases in the country in December 2012.
The two cases from Goz Beida and Guereda districts, were laboratory confirmation by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal. They were identified through the national surveillance programme for yellow fever, following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudan’s Darfur region. The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths.
The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda and Adré, targeting over a million people, including inhabitants of refugee camps in the area. The campaign is supported by the Chad’s Ministry of Health, the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11), and GAVI Alliance.
____
1 The YF-ICG is a partnership that manages the stockpile of yellow fever vaccines for emergency response on the basis of a rotation fund. It is represented by United Nations Children's Fund (UNICEF), Médecins Sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO, which also serves as the Secretariat. The stockpile is supported by GAVI Alliance.
Gruß
Birgitt
14.02.2013 - WHO
The Ministry of Health of Chad is launching an emergency mass-vaccination campaign against yellow fever from 22 February 2013, following laboratory confirmation of two cases in the country in December 2012.
The two cases from Goz Beida and Guereda districts, were laboratory confirmation by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal. They were identified through the national surveillance programme for yellow fever, following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudan’s Darfur region. The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths.
The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda and Adré, targeting over a million people, including inhabitants of refugee camps in the area. The campaign is supported by the Chad’s Ministry of Health, the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG11), and GAVI Alliance.
____
1 The YF-ICG is a partnership that manages the stockpile of yellow fever vaccines for emergency response on the basis of a rotation fund. It is represented by United Nations Children's Fund (UNICEF), Médecins Sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO, which also serves as the Secretariat. The stockpile is supported by GAVI Alliance.
Gruß
Birgitt
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Birgitt
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Hepatitis E in Südsudan
HEPATITIS E - SOUTH SUDAN (02): REFUGEE CAMPS, FATALITIES
*********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 15 Feb 2013
Source: Adelaide now, AAP report [edited]
http://www.adelaidenow.com.au/news/brea ... 6579175818
Deadly hepatitis E outbreak hits South Sudan
--------------------------------------------
The United Nations says an outbreak of hepatitis E has killed 111 refugees in camps in South Sudan since July [2012]. UN refugee agency spokesman Adrian Edwards says the influx of people to the camps from neighbouring Sudan is believed to be one of the factors in the rapid spread viral disease of the liver. Edwards said on Friday [15 Feb 2013] that 6017 cases had been diagnosed.
The virus is spread through contaminated food and water.
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[The hepatitis E death toll has increased from the 88 recorded on 1 Feb 2013 by Medecins sans Frontieres and is likely to increase further in view of the congestion and lack of resources in these camps in South Sudan.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
An interactive HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/3q1_. - Mod.CP]
*********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 15 Feb 2013
Source: Adelaide now, AAP report [edited]
http://www.adelaidenow.com.au/news/brea ... 6579175818
Deadly hepatitis E outbreak hits South Sudan
--------------------------------------------
The United Nations says an outbreak of hepatitis E has killed 111 refugees in camps in South Sudan since July [2012]. UN refugee agency spokesman Adrian Edwards says the influx of people to the camps from neighbouring Sudan is believed to be one of the factors in the rapid spread viral disease of the liver. Edwards said on Friday [15 Feb 2013] that 6017 cases had been diagnosed.
The virus is spread through contaminated food and water.
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[The hepatitis E death toll has increased from the 88 recorded on 1 Feb 2013 by Medecins sans Frontieres and is likely to increase further in view of the congestion and lack of resources in these camps in South Sudan.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
An interactive HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/3q1_. - Mod.CP]
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Birgitt
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- Kontaktdaten:
Unbekanntes Krankheitssyndrom in Ghana
UNDIAGNOSED SYNDROME - GHANA: HUMAN
***********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sat 22 Feb 2013
Source: World health Organization Africa [edited]
http://www.afro.who.int/en/clusters-a-p ... -news.html
Outbreak of a "strange" phenomenon reported in Ghana
-----------------------------------------------
On 8 Feb 2013, health authorities in Ghana received reports of the sudden outbreak of a "strange" phenomenon affecting people along the coastline of Aflao, near the country's boarder with Togo.
Affected patients reported acute onset of cough, sneezing and chest pain. About 28 persons reported that they had experienced these symptoms which resolved on self-medication and/or when they left the coastline. No severe cases or deaths have been reported.
Unconfirmed reports also have it that the phenomenon was widespread along the immediate coastline of Togo, affecting mostly fishermen. Similar reports point to possibility of chemical waste dumped into the sea being the cause of the symptoms.
Health authorities in Ghana are investigating the "strange" phenomenon and have directed that all patients reporting to the health facilities in the affected areas with sneezing, coughing and running nose be thoroughly investigated.
Radio announcements are on-going for people with symptoms of the "strange" phenomenon to report at the Municipal Hospital for management and investigation. All health facilities in the district have been requested to record and report cases with the symptoms to the district authorities. Health staff at the Aflao port have been sensitized on the symptoms and advised to report suspected cases. Since that day and as at 19 Feb 2013 no other cases have been reported.
The WHO Country Office in Ghana is liaising closely with the Ministry of Health in the investigation and follow up. It is also sharing investigation findings with the WHO Regional Office for Africa (AFRO) so that appropriate support can be provided.
AFRO is liaising with the WHO Inter-country support team for West Africa and WCO/Ghana, both of which are closely monitoring the situation.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This sounds like "red tide."
Red tide is caused by several toxic algae. Depending upon the toxin, it is also known as paralytic shellfish poisoning (PSP), because it causes shellfish to be toxic for consumption.
The _Alexandrium_ genus is found in coastal waters high in nitrogen content. These organisms produce a neurotoxin, like many of the organisms capable of causing paralytic shellfish poisoning (PSP). The neurotoxin is potentially fatal for humans consuming contaminated shellfish and may be dangerous to humans and animals who swim in waters that are "blooming" with the organisms. Ocean spray containing the organisms may also cause illnesses, including rashes and eye irritation in people. Some species of this genus are capable of causing "red tide" that may be visible for long distances along a coastline.
PSP is a significant problem in several geographic areas, especially on both the east and west coasts of the USA. Produced by several closely related species in the genus _Alexandrium_, PSP toxins are responsible for persistent problems due to their accumulation in filter-feeding shellfish, but they also move through the food chain, affecting zooplankton, fish larvae, adult fish, and even birds and marine mammals.
Alexandrium blooms generally do not involve large-cell accumulations that discolor the water and may instead be invisible below the water surface. Low-density populations can cause severe problems due to the high potency of the toxins produced. Furthermore, _Alexandrium_ spp. can grow in relatively pristine waters, and it is difficult to argue that anthropogenic nutrient inputs are stimulating the blooms. These characteristics are important when considering mitigation and control strategies.
Often PSP is associated with red tides or algal blooms. Red tide is caused by an organism called _Karenia brevis_, which in high concentration can make the water look red. The organism releases a toxin that paralyzes the respiratory system of fish and other marine life.
Airborne toxins, water spray, and splashes in an outbreak have kept people from beaches while leaving others with irritated eyes and throats. Red tide irritates the skin of people exposed to it and can cause itchy eyes, scratchy throats, and coughs. Harvesting from affected areas for personal consumption is discouraged. Red tide poisoning symptoms include nausea and dizziness and may last for several days.
Previously, the one of the organism causing red tide was known as _Gymnodinium breve_, but it has been reclassified in the taxonomy of dinoflagellates. Its new name -- _Karenia brevis_, or _K. brevis_ -- was chosen in honor of Dr Karen Steidinger, a prominent red tide scientist from the Florida Marine Research Institute in St. Petersburg, Florida (http://www.mote.org/index.php?src=gendo ... toxicology).
Shellfish that have caused this disease include mussels, cockles, clams, scallops, oysters, crabs, and lobsters. Symptoms begin anywhere from 15 minutes to 10 hours after eating the contaminated shellfish, although usually within 2 hours. Symptoms are generally mild, and begin with numbness or tingling of the face, arms, and legs. This is followed by headache, dizziness, nausea, and muscular incoordination. Patients sometimes describe a floating sensation. In cases of severe poisoning, muscle paralysis and respiratory failure occur, and in these cases death may occur in 2 to 25 hours.
Ghana may be found on the HealthMap/ProMED-mail interactive map at: http://healthmap.org/r/1jUt - Mod.TG]
***********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sat 22 Feb 2013
Source: World health Organization Africa [edited]
http://www.afro.who.int/en/clusters-a-p ... -news.html
Outbreak of a "strange" phenomenon reported in Ghana
-----------------------------------------------
On 8 Feb 2013, health authorities in Ghana received reports of the sudden outbreak of a "strange" phenomenon affecting people along the coastline of Aflao, near the country's boarder with Togo.
Affected patients reported acute onset of cough, sneezing and chest pain. About 28 persons reported that they had experienced these symptoms which resolved on self-medication and/or when they left the coastline. No severe cases or deaths have been reported.
Unconfirmed reports also have it that the phenomenon was widespread along the immediate coastline of Togo, affecting mostly fishermen. Similar reports point to possibility of chemical waste dumped into the sea being the cause of the symptoms.
Health authorities in Ghana are investigating the "strange" phenomenon and have directed that all patients reporting to the health facilities in the affected areas with sneezing, coughing and running nose be thoroughly investigated.
Radio announcements are on-going for people with symptoms of the "strange" phenomenon to report at the Municipal Hospital for management and investigation. All health facilities in the district have been requested to record and report cases with the symptoms to the district authorities. Health staff at the Aflao port have been sensitized on the symptoms and advised to report suspected cases. Since that day and as at 19 Feb 2013 no other cases have been reported.
The WHO Country Office in Ghana is liaising closely with the Ministry of Health in the investigation and follow up. It is also sharing investigation findings with the WHO Regional Office for Africa (AFRO) so that appropriate support can be provided.
AFRO is liaising with the WHO Inter-country support team for West Africa and WCO/Ghana, both of which are closely monitoring the situation.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This sounds like "red tide."
Red tide is caused by several toxic algae. Depending upon the toxin, it is also known as paralytic shellfish poisoning (PSP), because it causes shellfish to be toxic for consumption.
The _Alexandrium_ genus is found in coastal waters high in nitrogen content. These organisms produce a neurotoxin, like many of the organisms capable of causing paralytic shellfish poisoning (PSP). The neurotoxin is potentially fatal for humans consuming contaminated shellfish and may be dangerous to humans and animals who swim in waters that are "blooming" with the organisms. Ocean spray containing the organisms may also cause illnesses, including rashes and eye irritation in people. Some species of this genus are capable of causing "red tide" that may be visible for long distances along a coastline.
PSP is a significant problem in several geographic areas, especially on both the east and west coasts of the USA. Produced by several closely related species in the genus _Alexandrium_, PSP toxins are responsible for persistent problems due to their accumulation in filter-feeding shellfish, but they also move through the food chain, affecting zooplankton, fish larvae, adult fish, and even birds and marine mammals.
Alexandrium blooms generally do not involve large-cell accumulations that discolor the water and may instead be invisible below the water surface. Low-density populations can cause severe problems due to the high potency of the toxins produced. Furthermore, _Alexandrium_ spp. can grow in relatively pristine waters, and it is difficult to argue that anthropogenic nutrient inputs are stimulating the blooms. These characteristics are important when considering mitigation and control strategies.
Often PSP is associated with red tides or algal blooms. Red tide is caused by an organism called _Karenia brevis_, which in high concentration can make the water look red. The organism releases a toxin that paralyzes the respiratory system of fish and other marine life.
Airborne toxins, water spray, and splashes in an outbreak have kept people from beaches while leaving others with irritated eyes and throats. Red tide irritates the skin of people exposed to it and can cause itchy eyes, scratchy throats, and coughs. Harvesting from affected areas for personal consumption is discouraged. Red tide poisoning symptoms include nausea and dizziness and may last for several days.
Previously, the one of the organism causing red tide was known as _Gymnodinium breve_, but it has been reclassified in the taxonomy of dinoflagellates. Its new name -- _Karenia brevis_, or _K. brevis_ -- was chosen in honor of Dr Karen Steidinger, a prominent red tide scientist from the Florida Marine Research Institute in St. Petersburg, Florida (http://www.mote.org/index.php?src=gendo ... toxicology).
Shellfish that have caused this disease include mussels, cockles, clams, scallops, oysters, crabs, and lobsters. Symptoms begin anywhere from 15 minutes to 10 hours after eating the contaminated shellfish, although usually within 2 hours. Symptoms are generally mild, and begin with numbness or tingling of the face, arms, and legs. This is followed by headache, dizziness, nausea, and muscular incoordination. Patients sometimes describe a floating sensation. In cases of severe poisoning, muscle paralysis and respiratory failure occur, and in these cases death may occur in 2 to 25 hours.
Ghana may be found on the HealthMap/ProMED-mail interactive map at: http://healthmap.org/r/1jUt - Mod.TG]
-
Birgitt
- Moderator
- Beiträge: 35386
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Gelbfieber im Tschad
YELLOW FEVER - AFRICA (11): CHAD
********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 22 Feb 2013
Source: Radio Dabanga [edited]
http://www.radiodabanga.org/node/43627
Following the emergence of yellow fever cases in the town of Goz Beida in Chad, a vaccination campaign against the disease was launched in the close by Djabal camp for Sudanese refugees in the east of the country.
Djabal's health official Adam Hassan told Radio Dabanga the campaign was launched on Thursday [21 Feb 2013] and it will last for 4 days and target 17 375 residents.
He added the vaccines are provided by Medecins Sans Frontieres and urged Djabal's population to "rush" to vaccination centers.
The town of Goz Beida is located about 2 kilometers [slightly more than one mile] from Djabal camp.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The yellow fever (YF) vaccination campaign in Chad has been initiated on 22 Feb 2013 as planned. It is in response to the occurrence of 2 yellow fever virus infections in eastern Chad in Goz Beida and Guereda districts in December 2012. These cases were doubtless spill-over from the YF outbreak in Darfur, Sudan.
There are several Sudanese refugee camps in Chad due to the violence in the Darfur states. It is highly likely that there is a certain amount of movement across the Chad/Darfur porous border. The above report does not indicate if there have been additional YF cases beyond those 2 reported in December 2012.
One hopes that a brief 4 day vaccination campaign is sufficient to provide the coverage indicated. ProMED-mail would appreciate receiving additional information about the vaccination campaign and any additional cases that might occur.
A HealthMap/ProMED-mail map of Chad can be accessed at http://healthmap.org/r/5nRk. - Mod.TY]
********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 22 Feb 2013
Source: Radio Dabanga [edited]
http://www.radiodabanga.org/node/43627
Following the emergence of yellow fever cases in the town of Goz Beida in Chad, a vaccination campaign against the disease was launched in the close by Djabal camp for Sudanese refugees in the east of the country.
Djabal's health official Adam Hassan told Radio Dabanga the campaign was launched on Thursday [21 Feb 2013] and it will last for 4 days and target 17 375 residents.
He added the vaccines are provided by Medecins Sans Frontieres and urged Djabal's population to "rush" to vaccination centers.
The town of Goz Beida is located about 2 kilometers [slightly more than one mile] from Djabal camp.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The yellow fever (YF) vaccination campaign in Chad has been initiated on 22 Feb 2013 as planned. It is in response to the occurrence of 2 yellow fever virus infections in eastern Chad in Goz Beida and Guereda districts in December 2012. These cases were doubtless spill-over from the YF outbreak in Darfur, Sudan.
There are several Sudanese refugee camps in Chad due to the violence in the Darfur states. It is highly likely that there is a certain amount of movement across the Chad/Darfur porous border. The above report does not indicate if there have been additional YF cases beyond those 2 reported in December 2012.
One hopes that a brief 4 day vaccination campaign is sufficient to provide the coverage indicated. ProMED-mail would appreciate receiving additional information about the vaccination campaign and any additional cases that might occur.
A HealthMap/ProMED-mail map of Chad can be accessed at http://healthmap.org/r/5nRk. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35386
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Denguefieber in Nord-Kenia und Somalia
DENGUE/DHF UPDATE (16): AFRICA
*********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
*****
Kenya (North Eastern province)
Date: Tue 19 Feb 2013
Source: UN Integrated Regional Information Networks (IRIN) News [edited]
http://www.irinnews.org/Report/97506/Ne ... ya-s-north
An outbreak of dengue fever in northern Kenya is drawing attention to the need for improved health services in some of the country's most remote communities.
Health officials report the dengue fever outbreak is taking place in Mandera District [North Eastern province], along the Ethiopian and Somali borders. Local health workers say there have been some 300 cases since the outbreak began in January [2013]. 3 suspected dengue deaths have been recorded, and there are fears that more cases have gone unreported.
"We can't term it as a big outbreak now, but we have sent a disease surveillance and response team there to help the facilities there and to also take specimen for further tests," said Ian Njeru, director of disease surveillance and response at the Ministry of Public Health and Sanitation. "Some 100 specimens we collected tested negative for malaria, and we have started to diagnose to see if they can be dengue fever infections."
"Most of the patients are seeking treatment in private clinics," said one official. "The district hospital is not treating the matter seriously. The poor are suffering, and they are the most affected." A nurse at a government hospital told IRIN that they lacked the antibiotics and fluids needed to help manage the dengue outbreak. "No intervention measures are in place now. No special team has been formed to deal with the dengue cases since an outbreak was reported mid-last month [January 2013]," she said. "An anaemic and expectant [mother] died at a clinic in town; she had both malaria and dengue. A police sergeant based in Elwak [a town in Mandera] died on 29 Jan 2013, while another man who contracted the disease died in Mandera last week [week of 11 Feb 2013]."
In 2011, an outbreak of dengue fever infected up to 5000 people.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[ProMED-mail receives very few reports of dengue outbreaks in Africa. The scarcity of reports has raised the question of whether this is due to few cases or to lack of adequate surveillance, laboratory support, and reporting. The 2011 report of the dengue outbreak, and now the current one above, with deaths, clearly indicate that dengue virus is circulating in northern Kenya. ProMED would appreciate receiving reports of the dengue virus types currently circulating, and news of any additional cases that might occur.
Maps of Kenya can be accessed at http://www.ogiek.org/photo-gallery/kenya-map-big.jpg and http://healthmap.org/r/1iSI. - Mod.TY]
*****
Somalia (Mogadishu city)
21 Feb 2013.
Dengue as of 27 Jan 2013, 28 cases. http://spanish.china.org.cn/internation ... 013545.htm [in Spanish]
[A HealthMap/ProMED-mail interactive map showing the location of Mogadishu in Somalia can be accessed at http://healthmap.org/r/1gIF. - Mod.TY]
*********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
*****
Kenya (North Eastern province)
Date: Tue 19 Feb 2013
Source: UN Integrated Regional Information Networks (IRIN) News [edited]
http://www.irinnews.org/Report/97506/Ne ... ya-s-north
An outbreak of dengue fever in northern Kenya is drawing attention to the need for improved health services in some of the country's most remote communities.
Health officials report the dengue fever outbreak is taking place in Mandera District [North Eastern province], along the Ethiopian and Somali borders. Local health workers say there have been some 300 cases since the outbreak began in January [2013]. 3 suspected dengue deaths have been recorded, and there are fears that more cases have gone unreported.
"We can't term it as a big outbreak now, but we have sent a disease surveillance and response team there to help the facilities there and to also take specimen for further tests," said Ian Njeru, director of disease surveillance and response at the Ministry of Public Health and Sanitation. "Some 100 specimens we collected tested negative for malaria, and we have started to diagnose to see if they can be dengue fever infections."
"Most of the patients are seeking treatment in private clinics," said one official. "The district hospital is not treating the matter seriously. The poor are suffering, and they are the most affected." A nurse at a government hospital told IRIN that they lacked the antibiotics and fluids needed to help manage the dengue outbreak. "No intervention measures are in place now. No special team has been formed to deal with the dengue cases since an outbreak was reported mid-last month [January 2013]," she said. "An anaemic and expectant [mother] died at a clinic in town; she had both malaria and dengue. A police sergeant based in Elwak [a town in Mandera] died on 29 Jan 2013, while another man who contracted the disease died in Mandera last week [week of 11 Feb 2013]."
In 2011, an outbreak of dengue fever infected up to 5000 people.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[ProMED-mail receives very few reports of dengue outbreaks in Africa. The scarcity of reports has raised the question of whether this is due to few cases or to lack of adequate surveillance, laboratory support, and reporting. The 2011 report of the dengue outbreak, and now the current one above, with deaths, clearly indicate that dengue virus is circulating in northern Kenya. ProMED would appreciate receiving reports of the dengue virus types currently circulating, and news of any additional cases that might occur.
Maps of Kenya can be accessed at http://www.ogiek.org/photo-gallery/kenya-map-big.jpg and http://healthmap.org/r/1iSI. - Mod.TY]
*****
Somalia (Mogadishu city)
21 Feb 2013.
Dengue as of 27 Jan 2013, 28 cases. http://spanish.china.org.cn/internation ... 013545.htm [in Spanish]
[A HealthMap/ProMED-mail interactive map showing the location of Mogadishu in Somalia can be accessed at http://healthmap.org/r/1gIF. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35386
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Lassa-Fieber in Nigeria
LASSA FEVER - NIGERIA (06)
**************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Distribution
[2] Case-fatality ratio
******
[1] Distribution
Date: Thu 14 Feb 2013
Source: This Day Live [edited]
http://tribune.com.ng/news2013/index.ph ... 2%80%94don
Eleven people were killed by Lassa fever in the country between 1 Jan-4 Feb 2013, this year. The former Vice-Chancellor of Ambrose Alli University (AAU), Ekpoma, Professor Dennis Agbonlahor, made the declaration on Wednesday [13 Feb 2013] in Benin City, Edo State capital shortly after delivering a lecture at the College of Medical Sciences of the University of Benin entitled "Lassa Fever: A 44-year-old deadly public health burden in Nigeria."
Agbonlahor announced that a Lassa fever pandemic [has] spread to 22 local government areas in 9 states of the federation, including Edo, Benue, Delta, Nasarawa, Taraba, and Plateau states, between 1 Jan-4 Feb 2013. In his lecture, Agbonlahor, who is a professor of microbiology, said that 23 states in the country were affected by Lassa fever in 2012 and that 87 deaths were recorded.
[Byline: Banji Aluko]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
******
[2] Case-fatality ratio
Date: Fri 8 Feb 2013
Source: Weekly Epidemiological Report, Nigerian Centre for Disease Control, Federal Ministry of Health [edited]
http://www.fmh.gov.ng
Cumulative data for the period 1 Jan 2013 to 8 Feb 2013:
Year / No. of cases / No. of deaths / Case-fatality ratio
2012 / 278 / 26 / 9.4
2013 / 232 / 15 / 6.5
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[This information indicates that, currently, 9 of the 36 states of Nigeria have already reported outbreaks of Lassa fever. The case-fatality ratio calculated from data for the 1st 5 weeks of 2012 and 2013 provide a mean value of 7.95% for the case-fatality.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1qGF. - Mod.CP]
**************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Distribution
[2] Case-fatality ratio
******
[1] Distribution
Date: Thu 14 Feb 2013
Source: This Day Live [edited]
http://tribune.com.ng/news2013/index.ph ... 2%80%94don
Eleven people were killed by Lassa fever in the country between 1 Jan-4 Feb 2013, this year. The former Vice-Chancellor of Ambrose Alli University (AAU), Ekpoma, Professor Dennis Agbonlahor, made the declaration on Wednesday [13 Feb 2013] in Benin City, Edo State capital shortly after delivering a lecture at the College of Medical Sciences of the University of Benin entitled "Lassa Fever: A 44-year-old deadly public health burden in Nigeria."
Agbonlahor announced that a Lassa fever pandemic [has] spread to 22 local government areas in 9 states of the federation, including Edo, Benue, Delta, Nasarawa, Taraba, and Plateau states, between 1 Jan-4 Feb 2013. In his lecture, Agbonlahor, who is a professor of microbiology, said that 23 states in the country were affected by Lassa fever in 2012 and that 87 deaths were recorded.
[Byline: Banji Aluko]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
******
[2] Case-fatality ratio
Date: Fri 8 Feb 2013
Source: Weekly Epidemiological Report, Nigerian Centre for Disease Control, Federal Ministry of Health [edited]
http://www.fmh.gov.ng
Cumulative data for the period 1 Jan 2013 to 8 Feb 2013:
Year / No. of cases / No. of deaths / Case-fatality ratio
2012 / 278 / 26 / 9.4
2013 / 232 / 15 / 6.5
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[This information indicates that, currently, 9 of the 36 states of Nigeria have already reported outbreaks of Lassa fever. The case-fatality ratio calculated from data for the 1st 5 weeks of 2012 and 2013 provide a mean value of 7.95% for the case-fatality.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1qGF. - Mod.CP]
-
Birgitt
- Moderator
- Beiträge: 35386
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Hepatitis E in Südsudan
HEPATITIS E - SOUTH SUDAN (03): REFUGEE CAMP, FATAL
***************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 4 Mar 2013
Source: Radio Tamazuj [edited]
http://radiotamazuj.org/en/article/over ... -doro-camp
Over 88 cases of hepatitis E have been reported in Doro Camp of Upper Nile State, according to a medical source. The health worker reported that in a period of 27 days the camp has reported 88 cases of hepatitis E virus infection, explaining that 5-6 cases per day are reported to various units in the camp. "We have 88 cases with 3 death cases," he said. The officer added that the 3 deceased were all women, 2 of whom were pregnant. The medical officer said that patients suffering from the disease display signs like yellow urine and eyes, joint pains, and general body weakness.
There has been much confusion in the camp because many people want treatment but there is no medical treatment available for the disease; it is a preventable but not treatable disease. One camp resident told Radio Tamazuj: "We resort to traditional treatment because there is no treatment available to us." He described the traditional treatment as involving the use of fire to burn the affected part, which exposes the victim to more pain.
The medical aid organisation Medecins Sans Frontieres has embarked on an awareness campaign in Doro since last year [2012] when hepatitis E broke out in other nearby camps in Maban County inhabited by refugees from Blue Nile State. The affected camps are Jammam, Jandrassa, Yusif Batil, and Doro. The outbreak spread to the latter camp, the largest one, as a result of contact of the residents with affected people from the other camps.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[A hepatitis E death toll of 88 cases was recorded on 1 Feb 2013 by Medecins Sans Frontieres and was reported subsequently to have risen to 11 cases (ProMED-mail postings Hepatitis E - South Sudan (02): refugee camps, 20130216.1545704) and may now have increased further. This report is posted because it contains additional information regarding the refugee camps affected and the responses to the outbreak.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
A map showing the locations of the refugee camps in South Sudan can be accessed at http://www.unhcr.org/pages/4e43cb466.html. An interactive HealthMap/ProMED-mail map can be accessed at http://healthmap.org/r/5PMQ. - Mod.CP]
***************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 4 Mar 2013
Source: Radio Tamazuj [edited]
http://radiotamazuj.org/en/article/over ... -doro-camp
Over 88 cases of hepatitis E have been reported in Doro Camp of Upper Nile State, according to a medical source. The health worker reported that in a period of 27 days the camp has reported 88 cases of hepatitis E virus infection, explaining that 5-6 cases per day are reported to various units in the camp. "We have 88 cases with 3 death cases," he said. The officer added that the 3 deceased were all women, 2 of whom were pregnant. The medical officer said that patients suffering from the disease display signs like yellow urine and eyes, joint pains, and general body weakness.
There has been much confusion in the camp because many people want treatment but there is no medical treatment available for the disease; it is a preventable but not treatable disease. One camp resident told Radio Tamazuj: "We resort to traditional treatment because there is no treatment available to us." He described the traditional treatment as involving the use of fire to burn the affected part, which exposes the victim to more pain.
The medical aid organisation Medecins Sans Frontieres has embarked on an awareness campaign in Doro since last year [2012] when hepatitis E broke out in other nearby camps in Maban County inhabited by refugees from Blue Nile State. The affected camps are Jammam, Jandrassa, Yusif Batil, and Doro. The outbreak spread to the latter camp, the largest one, as a result of contact of the residents with affected people from the other camps.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[A hepatitis E death toll of 88 cases was recorded on 1 Feb 2013 by Medecins Sans Frontieres and was reported subsequently to have risen to 11 cases (ProMED-mail postings Hepatitis E - South Sudan (02): refugee camps, 20130216.1545704) and may now have increased further. This report is posted because it contains additional information regarding the refugee camps affected and the responses to the outbreak.
Hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes include foodborne transmission from ingestion of products derived from infected animals and vertical transmission from a pregnant woman to her fetus. Currently, there is no vaccine available for control of hepatitis E virus infection. Hepatitis E virus infection is self-limiting in normal conditions, and fulminant hepatitis is rare, with only pregnant women being at increased risk. In environments such as the refugee camps in South Sudan, the outcomes are much more serious, especially for pregnant women.
A map showing the locations of the refugee camps in South Sudan can be accessed at http://www.unhcr.org/pages/4e43cb466.html. An interactive HealthMap/ProMED-mail map can be accessed at http://healthmap.org/r/5PMQ. - Mod.CP]
-
Birgitt
- Moderator
- Beiträge: 35386
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Histoplasmose in UK ex Uganda in 2011
HISTOPLASMOSIS, RESEARCHERS - UK: ex UGANDA, 2011
*************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 11 Mar 2013
Source: Journal of Travel Medicine [edited]
http://onlinelibrary.wiley.com/doi/10.1 ... 2/abstract
ref: Cottle LE, Gkrania-Klotsas E, Williams HJ, et al. A multinational outbreak of histoplasmosis following a biology field trip in the Ugandan rainforest. J Travel Med 2013; 20(2): 83-7.
Abstract
--------
Outbreaks of histoplasmosis have been increasingly reported in association with travel to endemic areas. Multiple outbreaks have been reported following travel to the Americas, but reports of pulmonary histoplasmosis in short-term immunocompetent travelers to Africa are rare.
A biology student was referred to our unit with suspected pulmonary histoplasmosis following her return from a field trip in the Ugandan rainforest. The patient informed us that several of her multinational student colleagues on the same expedition had developed a similar illness. Using an alert in ProMED-mail and a questionnaire forwarded to each of the symptomatic students, we accumulated data on the other cases involved in this apparent outbreak of pulmonary histoplasmosis.
Of 24 students 13 developed respiratory symptoms following the expedition. Chest X-ray appearances were often suggestive of miliary tuberculosis but in most cases a final diagnosis of histoplasmosis was made (confirmed with serology in 5 cases, clinically diagnosed in 6, and retrospectively suspected in 2). Detailed questioning indicated that the likely source was a large hollow bat-infested tree within the rainforest.
This is an unusual outbreak of histoplasmosis following short-term travel to Africa. Pulmonary histoplasmosis should always be considered in the differential diagnosis of an acute febrile respiratory illness in travelers returning from endemic areas or reporting activities suggesting exposure.
--
communicated by:
Shamsudeen Fagbo
<oloungbo@yahoo.com>
[As noted in the abstract, the original alert regarding this outbreak was posted on ProMED-mail and written by Lucy Cottle, the 1st author on this paper. We appreciate Dr Cottle using us as an alert vehicle and crediting ProMED-mail for its help.
As a review, the following was obtained from Medscape (http://emedicine.medscape.com/article/2 ... ew#showall):
"_Histoplasma capsulatum_ is a dimorphic fungus that remains in a mycelial form at ambient temperatures and grows as yeast at body temperature in mammals. Infection causes histoplasmosis. Although the fungus that causes histoplasmosis can be found in temperate climates throughout the world, it is endemic to the Ohio, Missouri, and Mississippi River valleys in the United States. Internationally, the fungus is predominantly found in river valleys in North and Central America, eastern and southern Europe, and parts of Africa, eastern Asia, and Australia.
"The soil in areas endemic for histoplasmosis provides an acidic damp environment with high organic content that is good for mycelial growth. Highly infectious soil is found near areas inhabited by bats and birds. Birds cannot be infected by the fungus and do not transmit the disease; however, bird excretions contaminate the soil, thereby enriching the growth medium for the mycelium. In contrast, bats can become infected, and they transmit histoplasmosis through droppings. Contaminated soil can be potentially infectious for years. Outbreaks of histoplasmosis have been associated with construction and renovation activities that disrupt contaminated soil. In addition, travelers to endemic areas are at risk for histoplasmosis because airborne spores can travel hundreds of feet.
"Most individuals with histoplasmosis are asymptomatic. Those who develop clinical manifestations are usually immunocompromised or are exposed to a high quantity of inoculum. _Histoplasma_ species may remain latent in healed granulomas and recur, if there is impairment of cell-mediated immunity.
"Approximately 90 per cent of patients are asymptomatic. If symptoms develop, onset occurs 3-14 days after exposure. Fever, headache, malaise, myalgia, abdominal pain, and chills are common symptoms; usually, histoplasmosis is self-limited. Individuals exposed to a large inoculum may develop severe dyspnea resulting from diffuse pulmonary involvement. Joint pain and skin lesions occur in 5-6 per cent of patients, mostly in females. Enlarged hilar and mediastinal lymph nodes are present in 5-10 per cent of patients. Cough, hemoptysis, dyspnea, and/or chest pain may be present and are related to the degree of compression on the pulmonary airway and circulation. Paratracheal involvement may cause cough or dyspnea because of compression on the trachea or bronchi."
African histoplasmosis is a systemic infection caused by the fungus _Histoplasma capsulatum_ var. _duboisii_ which occurs, with very few exceptions, only on the central part African continent, most commonly in west and central Africa, particularly Nigeria, Senegal, the Democratic Republic of Congo, and Angola. The _duboisii_ variety has yeast cells that average about twice the size of _H. capsulatum_ var. _capsulatum_. In general, the _duboisii_ variant is recognized when presenting with dissemination to skin, bone, and lymph node rather than the primary lung form. Both variants are more likely to disseminate in the presence of immune suppression.
A HealthMap/ProMED-mail interactive map of Uganda can be seen at http://healthmap.org/r/1wa6. - Mod.LL]
*************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 11 Mar 2013
Source: Journal of Travel Medicine [edited]
http://onlinelibrary.wiley.com/doi/10.1 ... 2/abstract
ref: Cottle LE, Gkrania-Klotsas E, Williams HJ, et al. A multinational outbreak of histoplasmosis following a biology field trip in the Ugandan rainforest. J Travel Med 2013; 20(2): 83-7.
Abstract
--------
Outbreaks of histoplasmosis have been increasingly reported in association with travel to endemic areas. Multiple outbreaks have been reported following travel to the Americas, but reports of pulmonary histoplasmosis in short-term immunocompetent travelers to Africa are rare.
A biology student was referred to our unit with suspected pulmonary histoplasmosis following her return from a field trip in the Ugandan rainforest. The patient informed us that several of her multinational student colleagues on the same expedition had developed a similar illness. Using an alert in ProMED-mail and a questionnaire forwarded to each of the symptomatic students, we accumulated data on the other cases involved in this apparent outbreak of pulmonary histoplasmosis.
Of 24 students 13 developed respiratory symptoms following the expedition. Chest X-ray appearances were often suggestive of miliary tuberculosis but in most cases a final diagnosis of histoplasmosis was made (confirmed with serology in 5 cases, clinically diagnosed in 6, and retrospectively suspected in 2). Detailed questioning indicated that the likely source was a large hollow bat-infested tree within the rainforest.
This is an unusual outbreak of histoplasmosis following short-term travel to Africa. Pulmonary histoplasmosis should always be considered in the differential diagnosis of an acute febrile respiratory illness in travelers returning from endemic areas or reporting activities suggesting exposure.
--
communicated by:
Shamsudeen Fagbo
<oloungbo@yahoo.com>
[As noted in the abstract, the original alert regarding this outbreak was posted on ProMED-mail and written by Lucy Cottle, the 1st author on this paper. We appreciate Dr Cottle using us as an alert vehicle and crediting ProMED-mail for its help.
As a review, the following was obtained from Medscape (http://emedicine.medscape.com/article/2 ... ew#showall):
"_Histoplasma capsulatum_ is a dimorphic fungus that remains in a mycelial form at ambient temperatures and grows as yeast at body temperature in mammals. Infection causes histoplasmosis. Although the fungus that causes histoplasmosis can be found in temperate climates throughout the world, it is endemic to the Ohio, Missouri, and Mississippi River valleys in the United States. Internationally, the fungus is predominantly found in river valleys in North and Central America, eastern and southern Europe, and parts of Africa, eastern Asia, and Australia.
"The soil in areas endemic for histoplasmosis provides an acidic damp environment with high organic content that is good for mycelial growth. Highly infectious soil is found near areas inhabited by bats and birds. Birds cannot be infected by the fungus and do not transmit the disease; however, bird excretions contaminate the soil, thereby enriching the growth medium for the mycelium. In contrast, bats can become infected, and they transmit histoplasmosis through droppings. Contaminated soil can be potentially infectious for years. Outbreaks of histoplasmosis have been associated with construction and renovation activities that disrupt contaminated soil. In addition, travelers to endemic areas are at risk for histoplasmosis because airborne spores can travel hundreds of feet.
"Most individuals with histoplasmosis are asymptomatic. Those who develop clinical manifestations are usually immunocompromised or are exposed to a high quantity of inoculum. _Histoplasma_ species may remain latent in healed granulomas and recur, if there is impairment of cell-mediated immunity.
"Approximately 90 per cent of patients are asymptomatic. If symptoms develop, onset occurs 3-14 days after exposure. Fever, headache, malaise, myalgia, abdominal pain, and chills are common symptoms; usually, histoplasmosis is self-limited. Individuals exposed to a large inoculum may develop severe dyspnea resulting from diffuse pulmonary involvement. Joint pain and skin lesions occur in 5-6 per cent of patients, mostly in females. Enlarged hilar and mediastinal lymph nodes are present in 5-10 per cent of patients. Cough, hemoptysis, dyspnea, and/or chest pain may be present and are related to the degree of compression on the pulmonary airway and circulation. Paratracheal involvement may cause cough or dyspnea because of compression on the trachea or bronchi."
African histoplasmosis is a systemic infection caused by the fungus _Histoplasma capsulatum_ var. _duboisii_ which occurs, with very few exceptions, only on the central part African continent, most commonly in west and central Africa, particularly Nigeria, Senegal, the Democratic Republic of Congo, and Angola. The _duboisii_ variety has yeast cells that average about twice the size of _H. capsulatum_ var. _capsulatum_. In general, the _duboisii_ variant is recognized when presenting with dissemination to skin, bone, and lymph node rather than the primary lung form. Both variants are more likely to disseminate in the presence of immune suppression.
A HealthMap/ProMED-mail interactive map of Uganda can be seen at http://healthmap.org/r/1wa6. - Mod.LL]
