Wüstenschiff

Experts mine bats in search of Marburg reservoir
WHO - 17.08.2007

Marburg haemorrhagic fever is a severe and highly fatal disease caused by a virus from the same family as the one that causes Ebola haemorrhagic fever. Both diseases are rare, but can cause dramatic outbreaks with high fatality. There is currently no specific treatment or vaccine. Two cases of Marburg virus infection have recently been reported in Uganda. One of the people, a miner, died in July.

An international team of scientists is working to identify the hosts of the virus and mode of its natural transmission in the environment. They are particularly focusing on the mines and surrounding area.

This week experts from the Centers for Disease Control and Prevention (CDC), the National Institute of Communicable Diseases (NICD) in South Africa and WHO entered a lead and gold mine in a remote forest reserve in western Uganda to search for bats, which are suspected to be the source of the latest Marburg outbreak.

This photo story documents their expedition into the mines.

MARBURG HEMORRHAGIC FEVER- UGANDA (05)
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Date: Fri 17 Aug 2007
Source: Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/L17781220.htm>


Uganda: Marburg outbreak in Uganda contained
-------------------------------------------
Uganda has contained an outbreak of Marburg disease among gold
miners, but contacts of the 2 known cases must now make sure they
don't spread the deadly virus through sex, the World Health
Organisation said on Fri 17 Aug 2007. WHO expert Pierre Formenty said
investigators had collected hundreds of bats from the mine, which
they suspect may be a possible reservoir of the disease.

A miner died on 14 Jul 2007 and another was confirmed this week
[13-17 Aug 2007] as having survived the rare viral haemorrhagic
disease, spread through blood or other body fluids including semen.
Closely related to Ebolavirus, it kills most of its victims.

"This outbreak is contained. But we need to follow up the survivors
and (contacts) need to have safe sex in the next 3 months at least,"
Formenty told reporters by telephone. "Survivors could eject virus in
semen." He was speaking from a laboratory near Kitaka mine in the
western Kamwenge district, some 250 km (155 miles) from the capital
Kampala.

A team of 8 international experts has gathered there to research how
the virus is transmitted to humans and to try to pin down its elusive
"natural reservoir." Active surveillance of the miners and nearby
population would continue to the end of August [2007], Formenty said.
"We should stay vigilant, other outbreaks will come," he added,
noting that there had been multiple outbreaks of both Marburg and
Ebola in Africa over the past decade.

A major outbreak of Marburg occurred among gold miners in the
Democratic Republic of Congo between 1998 and 2000, causing 128
deaths among 154 cases. An outbreak in Angola in 2004-2005 killed 150
people among 163 cases, according to the WHO. There is no vaccine or
specific treatment for the disease, which causes a severe headache
and fever followed by rapid debilitation. Death can follow within 8
to 9 days.

An outbreak is contained when 2 incubation periods, or 21 days, have
passed without any contacts developing symptoms. Experts from the
WHO, the U.S. Centers for Disease Control and Prevention and South
Africa's National Institute for Communicable Diseases have been
examining some 300 fruit- and insect-eating bats trapped when leaving
the mine. But Robert Swanepoel, a South African expert who has also
worked on previous outbreaks in Congo and Angola, said: "Finding the
virus doesn't prove that a species is in fact the key to the riddle
of where the virus remains or is perpetuated. The tragedy of this
disease ... is an outbreak goes by very quickly. You are looking for
something that is no longer there."

[Byline: Stephanie Nebehay]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[So far the investigation has shed little light on the source of the
outbreak virus. The WHO Weekly Epidemiological Record of Fri 17 Aug
2007
(<http://www.who.int/wer/2007/wer8233/en/index.html>) states that
interviews conducted with the mine authorities have identified one
additional suspected case and 2 individuals who were taken ill in
mid-June 2007 and have since recovered. These individuals are being
investigated as a matter of priority. All the miners under
investigation for Marburg hemorrhagic fever had been at the mine for
approximately 8 months with no movements outside the mining area
during that time. To date, there have been no reported cases among
health care workers.

The particular strain of Marburgvirus associated with this outbreak
appears to be not easily transmissible. - Mod.CP]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (27)
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In this update:
Africa
[1] Cholera - Guinea
[2] Cholera - Sudan (Gedaref)
[3] and [4] Cholera - Ghana (Northern Region)
[5] and [6] Cholera - Angola
[7] Cholera - Comoros Islands (Grand Comoros)

******
[1] Cholera - Guinea
Date: Tue 14 Aug 2007
Source: Reuters [edited]
<http://africa.reuters.com/wire/news/usnL1448707.html>


Cholera has killed dozens of people in Guinea since seasonal rains
arrived a few weeks ago, taking the death toll to 47 since the start
of 2007, the health ministry said.

Cholera is spread via water or food contaminated with feces and
becomes more common in West Africa's rainy season, during the
northern hemisphere's summer.

"In the last few days, there have been several deaths from cholera,"
Dr Emmanuel Rolland Malano, head of the health ministry's cholera
unit, told Reuters. "Of 1240 cases registered in hospitals and health
centres in Guinea (since 1 Jan 2007), there have been 47 deaths," he said.

The worst hit locations were the southeastern area around the remote
town of Gueckedou, where 17 people had died, and the coastal capital
Conakry, some 800 km (500 miles) away, where the disease claimed 14 lives.

Most of Guinea's 10 million people scrape by in poverty despite
living on top of 1/3rd of the world's known reserves of bauxite, the
ore used to make aluminum.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[A map of the country of Guinea can be found at:
<http://www.un.org/Depts/Cartographic/ma ... guinea.pdf>.
Conakry can be found in Kinida, in the southwest, and Gueckedou in
Nzerekore, in the southeast. - Mod.LL]

******
[2] Cholera - Sudan (Gedaref)
Date: Tue 14 Aug 2007
Source: Reuters [edited]
<http://africa.reuters.com/wire/news/usnL14783281.html>


A cholera outbreak in eastern Sudan, which has spread due to
devastating floods across the region, has killed 49 people and
affected some 710 others, a World Health Organisation (WHO) official
said on Tue 14 Aug 2007.

In 2006, a cholera outbreak throughout Sudan killed 700 people and
affected 25 000. It was the 1st time in many years the waterborne
disease had been reported in Africa's largest country.

WHO official Mohamed Abder Rab said all the recent cases had been
reported in the eastern Gedaref state and Kassala town, with the 1st
reported on 19 Apr 2007.

"The situation in Gedaref is not yet under control ... Flooding is
spreading the waterborne disease," Rab told Reuters before traveling
to the east to verify conditions in the region hit by the worst
flooding in living memory in Sudan. "Latrines are flooded ... houses
are destroyed. People are living on the fringes. They don't have
proper drinking water or latrine facilities, and hygiene is
compromised," he added.

Rab said Sudan's government had been reluctant to announce the
outbreak. "Historically most governments don't want to admit cholera
because of the international ramifications and local ramifications,"
he said, adding it could affect tourism.

The little tourism Sudan has is mainly to its Red Sea diving resorts
in the east or for Sudanese honeymooners to the picturesque Kassala town.

He said governments are required to report contagious diseases such
as cholera. "There are certain diseases that have a potential for
international spread, cholera being one of them, and they have to be
reported," he added. Sudan borders 9 African countries, with Eritrea
and Ethiopia to the east.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

A map of Sudan showing the eastern state of Gedaref can be found at:
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf>.
In 2006, many of the cholera cases were in the southern states. - Mod.LL]

******
[3] Cholera - Ghana (Northern Region)
Date: Tue 14 Aug 2007
Source: My Joy Online [edited]
<http://www.myjoyonline.com/health/200708/7598.asp>


13 people in the Nalong electoral area in the Tamale metropolis are
reported dead following a suspected outbreak of cholera. An Assistant
Director at the Tamale metropolitan assembly, Iddrisu Karim, who
disclosed this to Joy News says the victims experience vomiting and
diarrhea in 3 areas of the metropolis: Bayon-Waya, Lamashegu and Nalong.

Mr Karim said the assembly was liaising with the metropolitan health
directorate to deal with the problem and has also informed Ministry
of Health in Accra for assistance.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The city of Tamale is the capital of the Northern Province of Ghana
and can be found on a map of the country at:
<http://www.un.org/Depts/Cartographic/ma ... /ghana.pdf>.
- Mod.LL]

******
[4] Cholera - Ghana (Northern Region)
Date: Fri 17 Aug 2007
Source: The Statesman [edited]
<http://www.thestatesmanonline.com/pages ... 4476§ion=1>


A cholera outbreak has been detected at Nalon Fong, a suburb of the
Tamale metropolis in the Northern Region. 19 people have died so far,
2 yesterday [16 Aug 2007], since the outbreak was reported last week.

According to the Acting Northern Director of the Ghana Health
Service, Seidu Kokor, poor environmental management compounded by the
recent rains in the metropolis caused the outbreak. He noted that,
for the past months pipes in the area have been locked, therefore the
people depend on an unhygienic source of water located in the area
for various usages, including drinking and cooking, among others.

Meanwhile, residents in the outbreak area, who attributed the cause
of deaths to witchcraft, nearly lynched an alleged witch to death.
The woman (name withheld), believed to be in her 50s, was found
unconscious when the Assemblyman and other residents intervened.

[Byline: Hamza Lansah Lolly]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

******
[5] Cholera - Angola
Date: 14 Aug 2007
Source: AllAfrica.com and Angola Press Agency [edited]
<http://allafrica.com/stories/200708141003.html>


Nine cases of cholera and 4 deaths were registered last week in the
provinces of Luanda, Malanje and Benguela, ANGOP has learned from a
document of the Health Ministry. According to the communication, 78
percent of the cases were registered in the southern Benguela
province, while 22 percent were shared by the northern provinces of
Luanda and Malanje.

According to the document, there was a reduction of cases compared to
the previous week.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The mentioned provinces can be found on a map of the country of Angola at:
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>.
- Mod.LL]

******
[6] Cholera - Angola
Date: Mon 13 Aug 2007
Source: News24 [edited]
<http://www.news24.com/News24/Africa/New ... 90,00.html>


Almost 420 people have been killed by cholera in Angola since the
start of 2007, according to figures released on Mon 13 Aug 2007 by
the World Health Organization (WHO) in Luanda.

A total of 16 320 cases were reported in 16 out of the country's 18
provinces, with Luanda, the nation's capital, recording the highest
figure of 6692 cases, followed by Benguela and Cabinda provinces,
which recorded 3681 and 1721 cases respectively, the WHO said.

The highest number of deaths, 102, was recorded in Kwanza Sul
province, followed by Luanda with 77 and Malange with 46.

The easily treatable waterborne disease broke out in Luanda's
northern slum of Boa Vista in February 2006. It then spread across a
country whose infrastructure has been ravaged by civil war and where
drinking water and proper sanitation are luxuries.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The mentioned provinces can be found on a map of the country of Angola at:
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>.
- Mod.LL]

******
[7] Cholera - Comoros Islands (Grand Comoros)
Date: Mon 13 Aug 2007
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://allafrica.com/stories/200708131151.html>


Until the traditional wedding season kicked off in July 2007 on Grand
Comore, largest of the 3 islands that make up the Comoros
archipelago, cholera was almost under control.

"This is an outbreak; we have seen over 800 cases, and 14 people have
died since February 2007," Josefa Marrato, country representative for
the UN's children fund (UNICEF), told IRIN. Grand Comore, with 300
000 people, is home to almost half the Indian Ocean archipelago's
total population.

Cholera is not new to the Comoros: there were epidemics in 1975, 1998
and 2000, said Abderamane Maiga, Officer in Charge at the World
Health Organisation (WHO) on Grand Comore (or Grand Comoros), adding
that since the current outbreak started in February 2007, July and
August have seen a dramatic spike in new cases.

Poor sanitation, crumbling sewage systems, streets filled with
garbage and a lack of potable water are the root causes of the
outbreak, but food served at traditional wedding parties has been
blamed for spreading the disease so rapidly.

"Cases have gone up due to the festivities; people get together, eat
together, but are not taking the appropriate hygiene measures," said
Marrato. "Cholera had been almost under control until July 2007, when
the 'Grand marriage' festivities started."

Elaborate and expensive public weddings marked by copious consumption
take place throughout the islands during July and August. The timing
coincides with the European holiday season when the Comoran diaspora
-- mainly resident in France -- returns for 'Grand Marriage,'
literally, 'great wedding'. The county's economy is heavily dependent
on migrant remittances from the 150 000 Comorans estimated to be living abroad.

Cholera had been almost under control until July, when the 'Grand
marriage' festivities started.

Having a 'Grand Marriage', which can cost up to 30 000 USA dollars
and last from one to 3 weeks, is usually reserved for the wealthy but
is attended by all, and the host family often feeds entire
communities. "They involve the whole village and the neighboring
villages," Maiga said.

In a communication last week, the government warned of the
significance of the Grand Marriage festivities and their apparent
link to the outbreak. "The government asked people not to have them
[festivities] and to restrain from eating together," Marrato said.

But calling off or postponing a traditional occasion that has
required years of planning and a lifetime of scrimping and saving is
often not considered an option.

Measures have also been taken to ensure that the disease does not
spread to the other islands, Anjouan and Moheli, by informing
travelers about the disease and the hygiene measures they can take to
protect themselves.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[Grand Comoros is the largest and most northern and western of this
island nation, which is located in the Indian Ocean between
Madagascar and the African continent. The islands can be seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... omoros.pdf>.
- Mod.LL]

Poliomyelitis in der Demokratischen Republik Kongo - update
WHO - 21.08.2007

As of 14 August 2007, one new case of polio was reported from Bandundu province of the Democratic Republic of the Congo, bringing the total number of cases in the country this year to 27. The most recent onset of paralysis was 22 June 2007. The last supplementary immunization activities (SIA's) in this area was on 25 July; the next is scheduled to start 6 September.

CHOLERA, DIARRHEAAND DYSENTERY UPDATE 2007 ( 28 )
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In this update:
Africa
[1] Cholera - Guinea
[2] Diarrhea, dysentery - Zimbabwe (Harare)

******
[1] Cholera - Guinea
Date: Mon 20 Aug 2007
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/200708201410.html>


Almost 1800 people have been affected by a cholera outbreak in
Guinea, which has caused 67 deaths, according to the UN Office for
the Coordination of Humanitarian Affairs (OCHA) in Conakry. In the
same period in 2006, just 30 cases of cholera were reported,
resulting in no deaths, according to OCHA.

"The epidemic is quite serious this year [2007], but the government
and humanitarian partners are doing everything they can to treat
cases and prevent the spread of the disease in Guinea," Madeleine
Maka Kaba, OCHA spokesperson told IRIN.

The seafront capital Conakry where 2 million people live, many of
them packed close together in squalid slums without running water or
sanitation, is being hit hardest. 370 of the cases and 18 deaths have
been recorded there.

The epidemic is also hitting hard in other towns and cities around
the country, many of which have had neither piped water, nor
sanitation, nor electricity for several years. In Kindia, 135 km
(about 84 mi) east from Conakry, 46 cases and 6 deaths have been
reported since Sat 18 Aug 2007, when a woman infected with the
disease traveled there from Conakry, according to the Ministry of Health.

Agencies working to prevent the spread of cholera in Guinea include
the Guinean Ministry of Health, OCHA, the World Health Organisation
(WHO), the International Committee of the Red Cross (ICRC), Medecins
sans Frontieres (MSF), the UN Children's Fund (UNICEF), and local
organisations.

In Conakry, the Ministry of Health has set up 3 cholera treatment
centres, with help from UNICEF and MSF, according to Sergio Martin
Esteso, who supervises the centres for MSF. "The Donka centre, the
biggest treatment center in Conakry, has seen 115 cases since 18 Aug
2007," Esteso said.

UNICEF is currently working with the local Conakry government, ICRC
and the Faculty of Medicine at the University of Conakry to
distribute 17 000 bottles of 'Sur Eau,' a water treatment product for
use in individual households, to sections of the city most affected
by the outbreak. UNICEF has made the antimicrobial agent doxycycline
available to the Ministry of Health as well as a ton of disinfectant.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[A map of the country of Guinea can be found at
<http://www.un.org/Depts/Cartographic/ma ... guinea.pdf>. - Mod.LL]

******
[2] Diarrhea, dysentery - Zimbabwe (Harare)
Date: Mon 20 Aug 2007
Source: International Herald Tribune, Associated Press report [edited]
<http://www.iht.com/articles/ap/2007/08/ ... rtages.php>


Cases of diarrhea and dysentery have soared to 900 a day in the
Zimbabwean capital with health authorities blaming water shortages,
according to a report Mon 20 Aug 2007, in the official newspaper.

City health director Dr Prosper Chonzi said each of Harare's 60
public clinics were treating an average of 15 water-related
complaints a day, with private doctors dealing with many more, the
Herald newspaper said. No deaths were reported.

State radio said taps ran dry in impoverished townships around Harare
for up to 3 days at a time, forcing householders to search for water
in drains and wells contaminated by collapsing sewerage facilities.

The northern Hatcliffe district, where basic houses were built after
a widely criticized slum clearance operation in 2005, rarely had
running water, according to city health authorities.

Chonzi said 2 years ago that diarrhea cases were uncommon in the city
of 1.5 million people.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[A map of Zimbabwe showing the location of Harare can be found at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>. - Mod.LL]

HANTAVIRUS INFECTION- ALGERIA (SIDI BEL ABBES): REQUEST FOR INFORMATION
************************************************************************
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Date: Sat 25 Aug 2007
Source: El Khabar, Algeria [edited]
<http://www.elkhabar.com/FrEn/lire.php?ida=79110&idc=52>


The health status of the infected people in Abdelkader Hassani
Hospital in Sidi Bel Abbes province is quite like Hantaan virus
[hantavirus] symptoms, spreading in the early 30s in Asia and Eastern
Europe as a result of poverty in prevailing in Central Asia and a set
of Eastern European countries then, a medical source told El Khabar.

According to the sources, the virus hits peasants living in rural
areas carried by the striped field mouse who contaminate men through
the air or water. Hantaan virus infectious disease symptoms,
characterised mainly by fever and renal failure, are quite like those
hitting Sidi Bel Abbes province citizens.

The Sidi Bel Abbes Health director [refused to give details on the
nature and the origin of this contagion, insisting on the] need to
wait for the final results of medical tests done on 12 Aug 2007, the
date on which the 1st case was reported.

--
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley, PhD

[Further information on the nature of this reported resurgence of
Hantaan hemorrhagic fever would be welcomed. - Mod.CP

Sidi Bel Abbes, in northwest Algeria, may be located on the map at
<http://www.lib.utexas.edu/maps/africa/algeria_pol01.jpg>. - CopyEd.MJ]
...................................cp/mj/dk

IRIN hat geschrieben:GUINEA: Cholera cases still rising

DAKAR, 28 August 2007 (IRIN) - At least 800 more people have been infected with cholera over the last week, bringing the total number of reported cases to 2,500 since January out of which 90 people have died, according to the Guinean Ministry of Health.

"The number of people infected by the disease in Conakry has considerably increased since July," said Sergio Martin Esteso, programme head for Medecins Sans Frontieres (MSF) in Guinea, in a statement. "Of the 1,260 patients treated in the three centres where MSF works, more than 1,000 have been in the past three weeks."

"Once again, health facilities weren't well enough prepared to cope with this emergency," Esteso said.

The disease has spread rapidly despite sensitization efforts including a national radio campaign organised by the government, the Guinean Red Cross and UNICEF, emphasizing the importance of clean water and proper hygiene.

According to MSF, many Guineans cannot afford to purchase clean drinking water, limiting the impact of any prevention messages, and efforts to battle the disease are further hampered by a lack of trained medical staff at treatment centres, MSF said.

Since the arrival of rains in late May, cholera cases recorded by the Guinean Ministry of Health have multiplied exponentially with each passing week. From 13 to 19 August, the Ministry recorded 723 cases.

The capital city Conakry has borne the brunt of the outbreak, accounting for 1,260 of the 2,496 total cases recorded to date.

Cholera is caused by the bacteria Vibrio cholerae and typically contracted by eating food or drinking water contaminated by the faeces of an infected person. Outbreaks occur frequently in countries with inadequate access to clean water, lack of proper sanitation, and overcrowding.

Quelle: http://www.irinnews.org

Grüsse
Alexander

VIRALES HÄMORRHAGISCHES FIEBER - DEMOKRATISCHE REPUBLIK KONGO (WEST KASAI): SUSPECTED
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Date: 29 Aug 2007
From: ProMED-mail <promed@promedmail
Source: Evening Echo Ireland [edited]
<http://www.eveningecho.ie/news/bstory.a ... n=14974284>


Haemorrhagic feverkills more than 100
-----------------------------------
More than 100 people have died in a remote part of the Democratic
Republic of Congo, the result of a suspected haemorrhagic fever
epidemic, local health officials said today.

People began dying of the suspected fever 2 weeks ago near Mweka, an
area in the province of Kasai Occidental, said Jean-Constatin Kanow,
the chief medical inspector for the province. "We began by suspecting
typhoid fever, but now we believe it's haemorrhagic fever," said Kanow.

The DRC has in the past seen large outbreaks of Marburg and Ebola,
both haemorrhagic fevers caused by viruses that in severe cases attack
the central nervous system and cause bleeding from the eyes, ears and
other parts of the body.

The deaths began following the funeral of 2 village chiefs. "Everyone
that attended those funerals is now dead," said the medical inspector.
According to Kanow, haemorrhagic fever is transmitted by contact
with an infected person.

In all, 4 villages are affected and 217 people have come down with the
illness.
Of the 103 recorded deaths, 100 were adults and 3 were children, said Kanow.

--
Communicated by ProMED-mail
<promed@promedmail.org>

[A map of the DRC, showing Kananga, capital of Kasai Occidental
province, near the Angolan border, can be seen at
<http://kids.mapzones.com/world/democrat ... go/drc.jpg>

The small number of children could be explained by the fact that
children normally take no part in nursing the sick, nor in touching
the bodies of the dead when preparing them for burial, so do not come
into close contact with infectious material. - Mod.JW]

TYPHUS: ALGERIEN
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IAlgeria (Djelfa)
Date: Sat 25 Aug 2007
Source: Echorouk Online [edited]
<http://www.echoroukonline.com/english/m ... e&sid=7343>


The epidemiological report issued by local health authorities in
Djelfa province, 300 km (186 mi) south of Algiers, continue to raise
concern among the local population after [typhoid has been confirmed
in] 8 patients. The figure came after a check-up of 26 patients on
Tue 29 Aug 2007, [raising] the number of typhoid confirmed [cases] to
36 since the epidemic broke out last week.

According to the Health Director (HD) of Djelfa province, "The
average of 2 confirmed cases per day is not alarming compared to the
number admitted and not confirmed." [sic]

[Byline: Reda Bouzouina]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Most outbreaks of typhoid fever are caused by water contaminated by
human feces.

The area involved can be found on a map of Algeria at
<http://content.answers.com/main/content ... Djelfa.png>.
- Mod.LL]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (30)
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In this update:
Africa
[1] Cholera - Guinea (Conakry)
[2] Cholera - Tanzania (Manyara)

******
[1] Cholera - Guinea
Date: Tue 28 Aug 2007
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/200708281040.html>


At least 800 more people have been infected with cholera over the
last week, bringing the total number of reported cases to 2500 since
January 2007. [According to the Guinean Ministry of Health, 90 of the
2500 cases have been fatal.]

"The number of people infected by the disease in Conakry has
considerably increased since July 2007," said Sergio Martin Esteso,
program head for Medecins Sans Frontieres (MSF) in Guinea, in a
statement. "Of the 1260 patients treated in the 3 centers where MSF
works, more than 1000 have been in the past 3 weeks."

"Once again, health facilities weren't well enough prepared to cope
with this emergency," Esteso said.

Since the arrival of rains in late May 2007, cholera cases recorded
by the Guinean Ministry of Health have multiplied exponentially with
each passing week. From 13 to 19 Aug 2007, the Ministry recorded 723
cases. The capital city Conakry has borne the brunt of the outbreak,
accounting for 1260 of the 2496 total cases recorded to date.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[A map of the country of Guinea showing the location of Conakry can be found at
<http://www.un.org/Depts/Cartographic/ma ... guinea.pdf>. - Mod.LL]

******
[2] Cholera - Tanzania
Date: Thu 30 Aug 2007
Source: Independent Online [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 954C438949>


Health officials said on Wednesday [29 Aug 2007] 2 Tanzanians have
died as a result of a new cholera outbreak in the north of the country.

"Since the beginning of this week, the hospital has attended to 31
people who had contracted the disease," Kiteto district chief medical
officer Moses Halelwa told reporters by telephone from Kibaya
hospital. He said 2 of the patients had died.

Halelwa said district authorities had set up a public awareness
campaign urging all residents to drink boiled water and seek
treatment immediately upon detecting the symptoms.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Kiteto is one of the 5 districts of the Manyara region of Tanzania,
which can be located on the map at
<http://en.wikipedia.org/wiki/Manyara_Region>. - CopyEd.MJ]

NAMIBIA: Meningitis-Warnung
Internationaler Personenverkehr birgt Risiko
31.08.2007

Windhoek – Nach etlichen Fällen der Meningitis in der Region Oshikoto im Norden hat die Weltgesundheitsorganisation (WHO) eine Warnung an die Öffentlichkeit gerichtet, dass die Fälle derzeit „in beispiellosem Tempo“ vorkämen. Anfang des Monats wurde der Tod des Jungen Lukas Akapa aus dem Dorf Omakunde im Wahlkreis Eengodi gemeldet.

Die WHO betont, dass die Volksgesundheit mehr denn je auf internationale Kooperation angewiesen sei. Gehirnhautentzündung könne leicht Grenzen überschreiten. Obwohl die WHO eine Reihe einleuchtender Empfehlungen zur Anhebung des Gesundheitsniveaus verbreitet hat, räumt die Organisation gleichzeitig ein, dass der zahlenmäßig hohe internationale Personenverkehr das Risiko für die Verbreitung ansteckender Krankheiten gewaltig erhöhe. Die Fluglinien befördern jährlich mittlerweile zwei Milliarden Menschen. Das entspricht einem Drittel der Weltbevölkerung.

Die Zielsetzung der Weltgesundheitsorganisation schreibt genau vor, welche Schritte ein jedes Land beim Ausbruch einer gefährlichen ansteckenden Krankheit zu befolgen hat. Darin nimmt der Austausch von Information und Sachkenntnis einen hohen Stellenwert ein, weil kein Land seine Bürger in der Isolierung schützen könne.

Quelle: Allgemeine Zeitung Namibia

Fieber im Kongo ausgebrochen
30.08.2007

Kongo, bei Mweka, Provinz Kasai-Occidental: Es ist noch nicht klar, welches hämorrhagisches Fieber es ist, möglicherweise Ebola oder das Marburg-Fieber. Klar ist - nach letzten Meldungen sind Hunderte im abgelegenen Kernland des Kongo von der Krankheit befallen, 103 Menschen bereits tot und bisher vier Dörfer von der Seuche betroffen. "Zuerst hielten wir es für ein Typhus-Fieber, aber jetzt denken wir, es ist ein hämorrhagisches Fieber," so Provinz-Doktor Jean-Constatin Kanow laut Medienberichten. Laut Kanow sind 4 Dörfer betroffen, Kampungu, Makonono, Kaluamba and Mombo.

Die Weltgesundheitsorganisation WHO hat seltsamerweise bisher noch nicht eingegriffen, man warte noch auf "Testergebnisse", heisst es. Die Behörden des Kongos wollten nicht, dass die Sache bekannt werde. In den 4 Dörfern leben 30.000 Menschen, in der Region ungefähr 140.000 Personen. Der Vize-Gesundheitsminister Ferdinand Ntua sagte, man habe "ein Team von Doktoren und Forschern" entsandt, man müsse erst die Laborergebnisse abwarten.

1995 hatte ein Ebola-Ausbruch in der kongolesischen Stadt Kikwit (Provinz Bandundu) 250 Todesopfer gefordert, in den Städten Watsa and Durba war es bereits früher zu Ausbrüchen des Marburg-Fiebers gekommen.
Zu der Masseninfektion soll es nun angeblich bei einer Beerdigung von 2 Dorfvorstehern gekommen sein, bei denen die Leichen mit der Hand gewaschen wurden ... mehr

Unknown illness in the Democratic Republic of the Congo
WHO - 31.08.2007

An outbreak of an unknown illness with a high mortality has been reported from the province of Kasai Occidental, in the Democratic Republic of the Congo. The exact number of cases and deaths is unknown at this time. The clinical features in the majority of cases include fever, headache, diarrhoea or colicky abdominal pain, and vomiting. Over 50% of cases have been in children under 10 years of age.

An investigation team from the Provincial and National Health Ministries, the Institut National de Recherches Biologiques (INRB) and WHO is in the field, and has taken clinical samples for laboratory testing. WHO is mobilizing support for the epidemiological investigation and logistics, including supplies, and water and sanitation and technical partners in the Global Outbreak Alert and Response Network (GOARN) have offered to provide support to the MoH if required.

At the present time, the etiological agent is unknown but the national health authorities have taken a precautionary approach and are implementing measures to improve hygiene, ensure the safety of the water supply, promote safe burial practices and strengthen infection control.

MENINGITIS - NAMIBIA (NORTH): REQUEST FOR INFORMATION
************************************************
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 5 Sep 2007
Source: The Namibian (Windhoek) [edited]
<http://allafrica.com/stories/printable/ ... 50453.html>


New Suspected Meningitis Cases
-----------------------------------
A total of 9 people with suspected meningitis are reportedly being
treated at the Onandjokwe Lutheran Hospital, The Namibian has learnt
from reliable sources. Health authorities did not want to confirm or
deny the report yesterday. "What I am sure of is, that apart from the
3 old cases that were reported in Onandjokwe Hospital earlier, there
are 6 new cases, but there might be more than that even," said a source.

Another reliable source who informed The Namibian about the new cases
could not say which villages the patients were from. "Yes, I received
a report of alleged new meningitis cases at Onandjokwe, but I was
also informed that these alleged cases of meningitis have still to be
investigated and verified to determine whether they are really
meningitis or not," the Permanent Secretary of Health, Kahijoro
Kahuure, told The Namibian late yesterday afternoon [4 Sep 2007].

When approached for comment, hospital superintendent Dr. Fillemon
Amaambo told The Namibian that he was busy with a meeting. The matron
of the hospital, Monika Shilongo, referred the reporter to the
Onandjokwe Hospital's chief administrator, Julius Mtuleni, and the
control register nurse, Penina Akudhenga. Both of these officials
referred questions to the Director of Health, Maria Kavezimbi, who in
turn referred the reporter to the Permanent Secretary of Health and
Social Services.

Last Wednesday [29 Aug 2007], the Regional Councillor of Eengodi
Constituency, Walde Sheyavali, announced on the NBC's Oshiwambo radio
service that several cases of the disease had been reported at
Onamakulikwa and Ohambala villages in Eengodi Constituency that week
and that he had asked the Onandjokwe health workers to go and
familiarise themselves with the situation. At that time Matron
Shilongo at the Onandjokwe Hospital said they were treating children
from Onamakulikwa, Ohambala, Onkumbula and Ohashipepe villages for meningitis.

She said a boy from Omakunde village died of the disease at the
beginning of last month [August 2007]. Matron Shilongo also said then
that health workers had been sent to those villages to investigate
the disease and give information to the villagers. Regional Health
Director Kavezimbi had confirmed to The Namibian that 3 children were
then being treated for meningitis at the Onandjokwe Hospital.

[Byline: Oswald Shivute]

--
Communicated by:
Coulibaly Sidi
<sidi_couly@yahoo.ca>
(by way of Larry Madoff)

[A prior outbreak of meningitis that was presumed to be due to the
meningococcus at the time was reported in a ProMED posting in 2000
(Meningitis - Namibia (North) 20001214.2182). For a discussion of
meningitis in Namibia, please see that report. ProMED requests
further information on the current outbreak [including identification
of the strain involved].

For a map of Namibia, please see
<http://www.lib.utexas.edu/maps/africa/namibia.gif>. - Mod.ML]

[Locator map:
<http://www.localization-translation.com ... amibia.jpg>
Map of African bacterial meningitis belt:
<http://www.medic8.com/images/map4-9.gif>

Namibia is nowhere near the ill-famed bacterial meningitis belt of
Africa -- see map above -- but nevertheless reports a few cases
nearly every year. - Mod.JW]

EBOLA FIEBER - DEMOKRATISCHE REPUBLIK KONGO
****************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Mon 10 Sep 2007
Source: Guardian Unlimited [edited]
<http://www.guardian.co.uk/worldlatest/s ... 79,00.html>


KINSHASA, Congo (AP) - Lab results have confirmed a deadly illness
outbreak in southeastern Congo as Ebola fever, officials said Monday
[10 Sep 2007].

The Center for Disease Control in Atlanta and another lab in Gabon
confirmed the disease as a hemorrhagic fever, and specifically as
Ebola, Health Minister Makwenge Kaput said on national television.
More than 100 people have died of illness in the affected region
since late August [2007].


--
Communicated by:
ProMED-mail <promed@promedmail.org>

******
[2]
Date: 10 Sep 2007
Source: Yahoo News Canadian Press [edited]
<http://ca.news.yahoo.com/s/capress/0709 ... ongo_ebola>


Congo confirms Ebola outbreak; more than 100 have died since late August [2007]
---------------------
Lab results have confirmed a deadly illness outbreak in southeastern
Congo is Ebola fever.

Congo Health Minister Makwenge Kaput says the U-S Centers for Disease
Control and Prevention in Atlanta and another lab in Gabon have
confirmed the disease as a hemorrhagic fever and specifically Ebola.

Provincial chief medical inspector Jean-Constatin Kanow says more
than 160 people have died of the illness in the affected region since
late August [2007] and nearly 400 have been infected.

He says the infections are mostly in 2 areas, Mweka and Luebo and the
majority of the deaths occurred at the beginning of the outbreak.

Makwenge did not say whether the outbreak has been contained.

Spokesperson Kelly Keith confirms hemorrhagic fever experts at
Canada's National Microbiology Laboratory in Winnipeg have been
following the situation and are prepared to deploy a team to the area
if requested.

Experts from the Winnipeg laboratory - which is part of the Public
Health Agency of Canada - are often tapped by the World Health
Organization's Global Outbreak Alert and Response Network to help
contain these types of outbreaks.

The special pathogens team has developed a portable lab that can be
safely operated in remote locations with few resources. Being able to
accurately identify cases early has been critical to containment
efforts, because the initial symptoms of hemorrhagic fevers are
similar to those of other diseases which commonly strike in affected areas.

Medical inspectors had previously said people began dying after
high-profile funerals of 2 village chiefs in the region where
relatives usually wash the bodies of the deceased by hand.

Ebola is spread through direct contact with the blood or secretions
of an infected person, or objects that have been contaminated with
infected secretions. It is not known where the initial infection came
from, though medical researchers say it is likely from contact with
an infected animal.

In the past, Congo has seen large outbreaks of Marburg and Ebola,
both hemorrhagic fevers caused by viruses that, in severe cases,
attack the central nervous system and cause bleeding from the eyes,
ears and other parts of the body.

By the end of August [2007], 4 villages had been affected and 217
people had come down with the illness, including 103 who died. About
140 000 people live in the Mweka area.

Congo's last major Ebola outbreak struck in Kikwit in 1995, killing
245 people. Kikwit is about 300 kilomertres from the site of the
current purported outbreak.

--
Communicated by:
Pierre Bigras
<pierre-bigras@sympatico.ca>

[Ebola virus, a filovirus, has one of the highest case fatalities (up
to 80 percent) of any viral disease except rabies. ProMED-mail
requests further information about the actual numbers of people
infected and fatalities, as well as the specific location and
circumstances of the outbreak in the southeastern part of the
DRC. One hopes that this is not part of the eastern DRC that has
been torn by civil strife and violence, preventing intervention that
would further describe the outbreak and work with local inhabitants
to prevent spread from infected individuals to those in contact,
through exposure to bodily fluids.

A map of the Democratic Republic of the Congo can be accessed
at: <http://encarta.msn.com/map_701511809/Congo_(DRC).html> - Mod. TY]

[It is curious that according to the above mentioned newswire, the
case fatality rate (CFR) of this outbreak seems to be fairly low for
Ebola hemorrhagic fever with the report of 103 deaths out of 217
cases (CFR 47.5 percent) by the end of August, and now approximately
160 deaths and 400 cases (CFR 40 percent). One is curious to know
the true numbers of cases and deaths, and if information on the viral
strain is available. For a good summary of prior outbreaks of Ebola
hemorrhagic fever outbreaks see the WHO Ebola outbreak chronology
table available at:
<http://www.who.int/mediacentre/factshee ... ndex1.html>.
Outbreaks of Ebola-Sudan virus have had lower CFRs as a rule than
Ebola-Zaire virus associated outbreaks.

For a map of the DRC highlighting urban areas that includes the 2
above mentioned affected areas of Mweka and Luebo, see
<http://www.reliefweb.int/rw/fullMaps_Af ... penElement>
(the areas are visible if resolution of the map is increased. One
can also see where they are in relation to Kikwit where the above
mentioned outbreak occurred in 1995. - Mod.MPP]