Wüstenschiff

Kongo, Demokratische Republik
Ebola hämorrhagisches Fieber EHF
11.09.2007

Der seit Ende August aus der Provinz Kasai Occidental gemeldete regionale Ausbruch eines hämorrhagischen Fiebers hat sich nach Vorliegen der Untersuchungsergebisse als EHF erwiesen. Die Krankheit geht mit Fieber und Blutungen einher und endet in einem hohen Prozentsatz tödlich. Betroffen sind mehrere Dörfer in den Gebieten von Mweka und Luebo etwa 130 km nordwestlich der Provinzhauptstadt Kananga. Bis zum 10. September wurde von den örtlichen Behörden die Zahl der Erkrankten mit etwa 400 angegeben, von denen mehr als 160 verstorben sind. Das Infektionsgebiet im zentralen Südosten der DRC ist abgelegen und touristisch nicht erschlossen. Private Reisen dorthin sollten vorerst unterbleiben.

Quelle: crm

Uganda
Meningokokken-Krankheit
11.09.2007

Sieben Monate nach Abklingen der Krankheitswelle epidemischer Hirnhautentzündungen, die im 1. Quartal in der West Nile-Provinz (N) zu mehr als 3.000 Erkrankungen geführt hatte, wurden Anfang September erneut einige Erkrankungen und Todesfälle aus dem Arua-Distrikt gemeldet. Die Region ist von Einheimischen und Flüchtlingen dicht besiedelt, touristisch aber nicht erschlossen. Risiko-Reisende (z.B. Hilfseinsätze) in dieser Region sollten weiterhin geimpft sein. / Quelle: crm

Südafrika - Tollwut
12.09.2007

Wildtiertollwut ist landesweit verbreitet. Als Hauptreservoire bzw. Überträger gelten Hunde, Mungos, Schakale und Füchse. Die meisten menschlichen Erkrankungen gab es in den beiden Provinzen KwaZulu-Natal (O) und Limpopo (N): Dort wurden im vorigen Jahr 31, in diesem Jahr bisher 9 Todesfälle gemeldet. Nach verdächtigen Tierkontakten, vor allem nach Bissverletzungen, ist sofort ein Arzt aufzusuchen. Bei vorhersehbarem Risiko, besonders bei längeren Aufenthalten, ist eine vorbeugende Impfung anzuraten. / Quelle: crm

Tansania - Schistosomiasis
12.09.2007

17 israelische Touristen und eine deutsche Journalistin sind innerhalb der letzten Monate nach der Rückkehr aus Tansania an Bilharziose erkrankt. Alle hatten sich zuvor im Kisima Ngeda Safari-Camp am Lake Eyani im Westen der Arusha-Provinz aufgehalten und dort regelmäßig einen künstlich angelegten Badeteich benutzt, der offenbar durch wurmlarvenhaltiges Wasser gespeist wurde. Bilharziose, eine Wurmerkrankung, die den Darm, die Harnwege und die Leber beteiligen kann, ist in zahlreichen tansanischen Binnengewässern verbreitet, gelegentlich auch in ungewöhnlichen Biotopen; Süßwasserkontakte sind nach Möglichkeit zu vermeiden. / Quelle: crm

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (35)
************************************************
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:
Africa
[1] Cholera - Guinea (countrywide)
[2] Cholera - Swaziland (Shiselweni)

******
[1] Cholera - Guinea (countrywide)
Date: Tue 11 Sep 2007
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


At the weekly meeting of the National Crisis Committee on Epidemics
on 6 Sep 2007, the Secretary General of the Ministry of Public Health
noted that, in Guinea, there was a slight decrease in the number of
cholera cases compared to the previous week. Nevertheless the state
of alert should be maintained. With several weeks more to go before
the end of the rainy season, the number of cases and deaths is likely
to rise. In 2006, the month of November recorded the largest number of cases.

Between 27 Aug and 2 Sep 2007, 573 new cholera cases and 22 deaths
were reported in Guinea, 349 cases including 12 deaths in Conakry
alone. Other towns include Fria (an industrial city) with 70 cases
and 4 deaths, Coyah with 58 cases including 3 deaths, Kindia with 39
cases including 3 deaths, Dubreka with 34 cases, Forecariah, 14
cases, Gueckedou (Guinee Forestiere) 6 cases, and Boffa with 3 cases.

Since the beginning of 2007, more than 3847 cholera cases have been
reported in the country. The number of cases is more than twice as
high as it was this time in 2006, 1789. About 135 people have died
from cholera in Guinea in 2007 as compared to 148 in 2006.

In rural areas, other towns have reported cases of severe diarrhea,
including fatalities. The town of Telimele (135 km (84 mi) from
Kindia) reported 19 cases including 4 deaths and Banko, a village in
the town of Dabola, recorded 23 cases and 2 deaths. Stool samples
collected from patients are being sent to Conakry for confirmation of
cholera. Immediate measures are being taken to provide potable water
and adequate drugs to affected areas, which would help in preventing
the spread of the epidemic. New centers for the treatment of cholera
have been opened and a sensitization campaign launched in Telimele and Dabola.

--
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[A map of the country of Guinea, in West Africa, can be found at
<http://www.un.org/Depts/Cartographic/ma ... guinea.pdf>. Most
of the cases are reported from the western part of the country
(Guinee Maritime) in the regions of Kindia (where Conakry is) and
Boke, but other cases are more central in the Haute Guinee area
(Faranah region) as well as in southwestern Guinee Forestiere
(Nzerekore region). - Mod.LL]

******
[2] Cholera - Swaziland (Shiselweni)
Date: Tue 11 Sep 2007
Source: Reuters Foundation AlertNet, UN Integrated Regional
Information Networks (IRIN) report [edited]
<http://www.alertnet.org/thenews/newsdes ... dd1b1c.htm>


Swazis have become acquainted with the term "water rationing" as they
struggle to cope with one of the longest dry periods in memory.
"Water levels are down nationwide," said Jameson Mkhonta, public
relations officer for the Swaziland Water Services Corporation, the
parastatal water utility. "The drought ... [has affected the entire
country], and not just in the south and east where it is usually dry."

About 40 percent of Swaziland's one million people are facing acute
food and water shortages, according to UN agencies. Most of the water
cuts are unannounced, but when they last for several days the
government trucks in water to the affected communities.

The rapidly shrinking water sources have undoubtedly aggravated the
plight of the food insecure. "You wonder what people are doing with
the maize meal they receive as food aid when there is no water for
cooking?" asked a humanitarian relief worker in Manzini.

Families have resorted to drinking water from small local dams,
streams and rivers and even, in some cases, sharing dwindling water
supplies with livestock, sparking fears that waterborne diseases,
which have already occurred, could spread.

Hlatikhulu Government hospital, in the rural Shiselweni Region in the
south of the country, this week reported a substantial increase in
cases of cholera, an acute intestinal infection caused by
contaminated water or food.

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

[A map of Swaziland showing the southern location of the Shiselweni
Region having its southern border with South Africa can be seen at
<http://www.lib.utexas.edu/maps/africa/swaziland.gif>. - Mod.LL]

Botsuana - Milzbrand
12.09.2007

Die Tierkrankheit, die bei unmittelbaren Kontakten auf die Haut oder bei Verzehr unzureichend gegarten Fleisches auf den Darm übertragen werden kann, kommt landesweit bei Haus- und Wildtieren vor, auch in den touristisch frequentierten Nationalparks. Aktuell besteht der Verdacht bei tot aufgefundenen Elefanten, Giraffen und einem Büffel erneut im Chobe-Park, wo es bereits in den vorangegangenen Jahren größere Ausbrüche gab. Menschliche Erkrankungen kommen immer wieder bei Einheimischen vor. Hygiene beachten. Vorsicht beim Umgang mit kranken Tieren. / Quelle: crm

Swasiland - Cholera/Durchfallerkrankungen
13.09.2007

Klima/Wetter: Das gesamte Land wird derzeit von einer der schwersten und längsten Dürreperioden seiner Geschichte heimgesucht. Etwa die Hälfte der 1 Million Einwohner ist von akutem Trinkwasser- und Nahrungsmangel betroffen. Mit einer Entspannung der Situation ist nicht vor Einsetzen der Regenzeit im Oktober/November zu rechnen. Es besteht ein erhöhtes Risiko für Durchfallerkrankungen. Im staatlichen Krankenhaus von Shiselweni (S) wurde ein Anstieg von Cholera-Erkrankungen beobachtet, Fallzahlen wurden nicht genannt. Hygiene beachten. / Quelle: crm

Uganda - Malaria
14.09.2007

Nach Angaben örtlicher Gesundheitsdienste sind die Fallzahlen unter der Bevölkerung in den nördlichen und östlichen Landesteilen im Gefolge stärkerer Regenfälle in letzter Zeit stark angestiegen; in einigen Distrikten haben sie sich verdoppelt. Es handelt sich fast ausschließlich um Malaria tropica. Vorbeugungsmaßnahmen (Mückenschutz und Tabletteneinnahme) beachten. / Quelle: crm

LUNGENPEST - UGANDA (ARUA): FATAL, SUSPECTED
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International Society for Infectious Diseases
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Date: Thu 13 Sep 2007
Source: AllAfrica, The Monitor (Kampala) report [edited]
<http://allafrica.com/stories/200709130018.html>


Plague continues to cause anxiety in Aruu town. Medical reports from
Aruu health centers indicate that at least 20 people have been
infected by suspected plague. The report says 5 people have been
killed as a result of the outbreak.

The commissioner for Community Health, Dr Sam Okware said, "It
[plague] is endemic [in the region]. It happens at this time of the
year, especially when the rains start falling in June. It is caused
by rats that cross from DR Congo," he said.

Arua DDHS (Divisional Director of Health Services) Patrick Anguzu
told Daily Monitor yesterday, 12 Sep 2007, that a health team from
Arua has set up emergency plans to deal with suspected cases. The
infected area, 'Kampala', is a popular market that attracts traders
from West Nile and Congo for cross-border trade.

"Yes, there is that scare because it can spread faster in our places.
So our medical personnel have to be ready for any suspected cases
that may spill off to our area. That area (Kampala) is not far from
us in Arua," Dr Anguzu said.

[Byline: Warom Felix Okello]

--
Communicated by:
ProMED-mail
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[Formal documentation that these illnesses are plague is still
pending. But, as can be seen on a map, the Arua district of Uganda
and across the border from the Orientale (Eastern) province of Congo
DR are both areas where plague occurs
(<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>).

The manifestations of _Yersinia pestis_ infection in the cases are
unstated but, with a substantial fatality rate, more invasive forms
of the disease such as septicemic and pneumonic plague may be
present. It is the pneumonic form that can spread from
person-to-person. - Mod.LL]

Uganda - Malaria
14.09.2007

Nach Angaben örtlicher Gesundheitsdienste sind die Fallzahlen unter der Bevölkerung in den nördlichen und östlichen Landesteilen in Uganda im Gefolge stärkerer Regenfälle in letzter Zeit stark angestiegen; in einigen Distrikten haben sie sich verdoppelt. Es handelt sich fast ausschließlich um Malaria tropica. Vorbeugungsmaßnahmen (Mückenschutz und Tabletteneinnahme) beachten.

Quelle: crm

CHIKUNGUNYA - AFRIKA (GABUN)
***********************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 14 Sep 2007
From: Dr. Fred Eric Page
<imtssa.entomo@wanadoo.fr>


The medical entomology unit of the Institute for Tropical Medicine
(French military medical service) has conducted in July 2007 an
entomological study in Libreville, Gabon. The objective was to assess
the risk of chikungunya [virus] transmission during the dry season
for the French [armed] forces. BG-sentinel traps and a mosquito
magnet trap were used. We caught 965 _Aedes albopictus_ (716 females
and 249 males) and 80 _Aedes aegypti_ (71 females and 9 males) in 15
days. Our virology unit found 2 pools of _Aedes albopictus_ females
containing chikungunya virus. No dengue [virus-] infected [mosquito
pools] have been found in either species.

In Libreville, _Aedes albopictus_ seems to be the vector of the
chikungunya outbreak that occurred beginning in April [2007]. The
persistence of _Aedes albopictus_ [chikungunya virus] - infected
populations during the dry season is worrying. A resumption of the
outbreak could occur at the beginning of the rainy season.

--
Dr. Fred Eric Page
Medical Entomology Unit
Institute for Tropical Medicine
French Medical Service
IMTSSA- le Pharo BP 46
13 998 Marseille-Armees
France
<imtssa.entomo@wanadoo.fr>

[The Gabon Ministry of Health reported 5000 cases of suspected
chikungunya virus infection in Libreville in May 2007 (see ProMED
archive no. 20070519.1591). ProMED requests information about efforts
to control _Aedes_ mosquitoes there. ProMED thanks Dr. Page for this
latest report, and requests further information if further
entomological studies are done or should the chikungunya virus
outbreak resume when the rains begin.

A map of Gabon can be accessed at
<http://www.lib.utexas.edu/maps/africa/g ... l_2002.jpg> - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (37)
************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Shigellosis (Bakterielle Ruhr) - Demokratische Republik Kongo (Kasai Occidental)
Date: Wed 12 Sep 2007
Source: Agence France-Presse (AFP) [edited]
<http://afp.google.com/article/ALeqM5hHE ... yDKskgGSQA>


The WHO on Wed 12 Sep 2007 confirmed that a shigella strain of infectious
dysentery is present alongside the deadly Ebola virus in the central
Democratic Republic of Congo (DRC). Laboratory tests confirmed the presence
of _Shigella dysenteriae_ type 1 among some 372 suspected cases of Ebola in
the western Kasai region in the past 4 months, WHO spokeswoman Fadela Chaib
told AFP.

The DRC's Ministry of Health said earlier this week that the Ebola outbreak
has caused 166 deaths, but WHO said that laboratory tests have so far
confirmed just 5 Ebola deaths. The discovery of shigella is "further
complicating operations," said WHO.

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[_S. dysenteriae_ has a number of recognized serotypes, of which serotype 1
attracts special attention for its epidemic-causing potential, the Shiga
toxin it produces, and its association with most serious complications. The
location of western Kasai (Kasai Occidental) can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf>. - Mod.LL]

Uganda - Pest
19.09.2007

Ein aktueller Ausbruch wird aus dem Arua-Distrikt gemeldet. Bereits im Frühjahr gab es einen ähnlichen Ausbruch im Masindi-Distrikt; beide Gebiete liegen im Westen des Landes an der Grenze zur DRC. Der Erreger kann durch Rattenflöhe sowie direkt durch kranke Menschen übertragen werden. Rattenbiotope sowie Kontakte zu Kranken sind zu meiden. / Quelle: crm

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (38 )
************************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Diarrhea, dysentery - Zimbabwe (Matabeleland North)
Date: Mon 17 Sep 2007
Source: Zim Online [edited]
<http://www.zimonline.co.za/Article.aspx?ArticleId=2021>


A diarrhoea and dysentery outbreak has hit Bulawayo, Zimbabwe's 2nd largest
and water-starved city, amid reports that about 400 residents have been
treated for the diseases since August 2007. Bulawayo is facing a serious
water shortage that has seen residents go without water for periods of up
to 4 days.

Bulawayo City Council spokesman Phathisa Nyathi confirmed the outbreak of
the 2 diseases and warned residents against using water from unprotected
sources. "We have recorded high numbers of diarrhoea cases in the city
since we started experiencing water problems, and very recently, we also
got reports of cases of dysentery breaking out in the city," Nyathi said.

The outbreak of diarrhoea and dysentery in the city comes hardly a month
after the council warned residents of possible disease outbreaks due to the
water shortages.

Zimbabwe's 2nd city has faced perennial water problems for more than 2
decades, during which both residents and the city fathers have pinned their
hopes on an ambitious project to draw water from the Zambezi river.
Boreholes, which have been providing the residents with most of their water
needs, have also dried up in some parts, leading to the surfacing of black
market water dealers.

[byline: Nqobizitha Khumalo]

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

[This posting illustrates that the lack of water, in addition to flooding,
leads to waterborne diseases. The city and its province can be found on a
map at <http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>. -
Mod.LL]

Nach Ebola auch Typhus im Kongo ausgebrochen
21.9.2007

Kinshasa (dpa) - Nach Ebola ist im Kongo auch Typhus ausgebrochen. Bisher seien fünf Fälle bestätigt, sagte ein Vertreter der Weltgesundheitsorganisation. Die WHO untersucht im Kongo den vor zehn Tagen gemeldeten Ebola-Ausbruch. Die Behandlung der Patienten ist der Organisation zufolge schwierig, da häufig mehr als eine Krankheit zugrunde liege. Noch könne nicht angegeben werden, wie viele Menschen tatsächlich an Ebola erkrankt seien. Die Zahl von 375 Kranken und 167 Todesfällen durch Ebola wurde daher nicht bestätigt. / Quelle: Welt online