Wüstenschiff

Kamerun - Gelbfieber:
15.10.2007

Ein 19-jähriger Student aus Zoetele, Süd-Provinz, ist im September an Gelbfieber verstorben. Es ist der neunte Gelbfieberfall, der innerhalb der letzten fünf Jahre im Land bekannt wurden. Impfschutz beachten; eine gültige Gelbfieber-Impfung ist bei Einreise ohnedies vorgeschrieben. / Quelle: crm

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 ( 49 )
***********************************************
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 - Somalia
[2] Cholera - Angola (Kwanza Sul)
[3] Cholera, diarrhea - Nigeria (Bauchi)

******
[1] Cholera - Somalia
Date: Mon 15 Oct 2007
Source: United Nations [edited]
<http://www.un.org/apps/news/story.asp?N ... 3&Cr=&Cr1=>


The United Nations World Health Organization (WHO) has warned of an
imminent risk of cholera in southern Somalia. Seven new cases have
been confirmed so far in the capital, Mogadishu, as well as in
Berdale and Burhakaba.

WHO says the new cases represent an even more serious threat than the
outbreak that occurred 3 months ago and which affected more than 37
000 people and led to over 1100 deaths. The UN Children's Fund
(UNICEF) has begun delivering cholera kits and oral re-hydration
therapy supplies to the area.

The UN Office for the Coordination of Humanitarian Affairs (OCHA)
reports that the flood alert was raised from moderate to high on the
Shabelle and Juba rivers following significant rainfall in South
Somalia and the Ethiopian highlands where the 2 rivers originate. An
inter-agency mission to assess the situation and possible
interventions are being planned. Meanwhile, the UN High Commissioner
for Refugees (UNHCR) reports that, in a 2-way flow of displaced
persons, nearly 31 000 people have fled ongoing insecurity, sporadic
violence and looting in Mogadishu since the beginning of September
2007, while nearly 800 internally displaced persons (IDPs) returned
to the Somali capital. In addition, nearly 7300 residents and IDPs
have been evicted from their homes in government and public buildings
since June 2007, according to UNHCR's Population Movement Tracking.

Somalia, which has had no functioning central government since the
regime of Muhammad Siad Barre was toppled in 1991, has seen renewed
fighting since the beginning of 2007, after the Ethiopian-backed
Transitional Federal Government (TFG) drove the Union of the Islamic
Courts (UIC) out of Mogadishu and most of the rest of the country in
December 2006. Since the onset of fighting in January 2007, UNHCR
reports that between February and May 2007, about 400 000 IDPs moved
from Mogadishu, with about 125 000 returning between April and June
2007. Since June 2007, nearly 85 000 people have moved from the
capital.

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

[A map of Somalia can be found at:
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>.
Mogadishu, the national capital, can be found on the eastern coast.
Burhakaba is located in the Bay region, north and west of Mogadishu,
and Berdale (Berdaale on the map) is in the more northern region of
Mudug. - Mod.LL]

*****
[2] Cholera - Angola (Kwanza Sul)
Date: Mon 15 Oct 2007
Source: AllAfrica.com and Angola Press Agency (Luanda) [edited]
<http://allafrica.com/stories/200710151840.html>


34 cases of cholera, resulting in 10 deaths were reported over the
last 10 days in Wako-Kungo region, Cela district, in the coastal
Kwanza Sul province. According to the balance report of the municipal
health division, made available to ANGOP this Mon 15 Oct 2007, the
cases were registered in the outskirts of Wako-Kungo city.

The note also stated that local health officials are actively engaged
in tracking down cholera cases in the region, conducting house to
house distribution of calcium hypochlorite, sensitizing the
communities on the dangers of the epidemic disease, as well as
holding some upgrading courses to benefit technicians, chieftains and
religious authorities, among others.

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

[A map of the west African country of Angola showing Kwanza Sul
(spelled Cuanza Sul on the map) can be found at:
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>.
- Mod.LL]

******
[3] Cholera, diarrhea - Nigeria (Bauchi)
Date: Wed 17 Oct 2007
Source: The Vanguard [edited]
<http://www.vanguardngr.com/index.php?op ... &Itemid=47>


About 7 people have died in Bauchi State owing to a gastroenteritis
outbreak, while over 60 people are currently infected with the
disease in the state. This was disclosed by the Secretary of Nigeria
Red Cross Society Bauchi State Chapter, Alhaji Adamu Abubakar. He
stated further that those infected with the deadly disease are
receiving treatment in various health institutions in the state as a
result, a development which, according to him, can degenerate into
cholera if not taken care of quickly [Does this imply that it is
already cholera? - Mod.LL].

The secretary further warned the Bauchi state government to stand
against the spread of cholera in the state in order to avoid the 2005
experience that led to the loss of many people in the state and much
suffering.

[Byline: Patience Ogbodo]

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

[ProMED ( in update 48 ) has already posted on the spread of cholera in
Bauchi state. Whether the 7 deaths include the 5 previously noted is
not clear.

A map of Nigeria showing the state and city of Bauchi in the
northeast can be found at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf>.
- Mod.LL]

GELBFIEBER - SUDAN: SUSPECTED, 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: Fri 19 Oct 2007
Source: Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/L19741476.htm>


The World Health Organisation (WHO) said on Friday [19 Oct 2007] it
was investigating a suspected outbreak of yellow fever in Sudan,
which has killed nearly 30 people.

The viral disease, which causes jaundice in some patients, is
transmitted by mosquitoes but can be confused with malaria, typhoid,
viral haemorrhagic fevers, and hepatitis.

"We have 31 suspect cases including 28 deaths. Samples are being
tested, we should know early next week whether it is yellow fever or
not," said WHO spokesman Gregory Hartl. The outbreak was near the
Nile about 3 hours from Khartoum and the samples were being sent to a
laboratory in Cairo for analysis, he said.

Yellow fever symptoms include fever, muscle pain, nausea, and
vomiting, but most patients improve after 3-4 days, according to the
United Nations health agency.

Some 15 percent of patients enter a "toxic phase" within 24 hours,
with bleeding from the mouth, nose, eyes, or stomach as kidney
function deteriorates. Half die within 2 weeks. There is no specific
treatment -- except for oral rehydration salts and paracetamol -- for
the disease, which has caused large epidemics in Africa and the
Americas.

Intensive care may save the most seriously ill patients, but it is
rarely available in the poorest countries. Vaccination is important
for rapid control of outbreaks, according to the WHO.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Unfortunately, this report does not indicate the exact location
where the suspected yellow fever (YF) cases occurred. If it is in
South Kordofan, it might be in the same or nearby area where the
previous YF virus outbreak took place in 2005. ProMED-mail requests
additional information confirming (or not) this outbreak as YF, and
if so, about the mosquito vectors involved and emergency control
measures being taken to halt virus transmission.

Concerning likely vectors, in ProMED-mail archive no. 20051223.3665
Dr. Alan Kemp wrote about YF virus vectors in Sudan, "_Aedes
(Stegomyia) aegypti_ played a minor role in the 1940 outbreak while
_Aedes (Fredwardsius) vittatus_ and _Aedes (Diceromyia) furcifer/
taylori_ (may have included _Ae. (Dic.) cordellieri_, which was
described long afterwards) were believed to be responsible for most
of the transmissions.

Zoomable maps of Sudan can be accessed through the URL of the source
of this report, above, and at
<http://healthmap.org/promed?v=13.8,30,5>. - Mod.TY]

Sudan - Gelbfieber
22.10.2007

Nach Pressemeldungen unter Berufung auf die WHO gibt es einen neuen Gelbfieber-Ausbruch am Nil "3 Stunden (südlich?) von Khartoum" - eine genaue Ortsangabe fehlt. Die letzten größeren Ausbrüche im südlichen Sudan datieren aus den Jahren 2003 und 2005. Impfschutz beachten. / Quelle: crm

MILZBRAND - ZIMBABWE (MAZOWE): 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: 20 Oct 2007
Source: IOL [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 904C972938>


Seven people have been sent to hospital in Zimbabwe with potentially
lethal anthrax poisoning following an outbreak of the animal-borne
disease in a private game park north of the capital, reports said on
Sat 20 Oct 2007. The 7 have been admitted to hospital in the northern
town of Concession, said the state-controlled Herald newspaper.

The outbreak of anthrax -- which is normally caught by humans if they
eat the meat of infected cattle -- occurred at Manzou Game Park in
Mazowe, said the paper.

There are sporadic outbreaks of anthrax in Zimbabwe. Last December
[2006], 3 people died in Goromonzi district, east of the capital,
from anthrax, which they were suspected to have caught after either
eating or handling infected meat.

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

["Poisoning" suggests gastro-enteric anthrax, but, knowing the
inaccuracies implicit in newspaper reports, it could be either
cutaneous or both. This disease is now widespread in Zimbabwe and
enzootic. It has long been a disease of nature parks in Africa
because of the problems inherent in controlling it in wildlife. That
it is on a private park might exclude the possibility that it was
initially in cattle brought without permission into the park by
neighboring villagers, a constant problem in national parks
throughout East Africa. Clarification is being sought from contacts
in country. - Mod.MHJ]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 ( 50 )
**********************************************
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 - Senegal
[2] Cholera - Angola (Benguela)

******
[1] Cholera - Senegal
Date: Mon 22 Oct 2007
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/200710221888.html>


As the number of cholera cases in Senegal in 2007 tops 2000, Red
Cross and UN officials say not enough has changed since a huge
epidemic 2 years ago that affected more than 30 000 people and killed 450.

According to the International Federation of the Red Cross (IFRC), 12
deaths and 2231 cases of cholera have been registered since the
beginning of August 2007 in 6 regions of the country. "Every day,
we're getting new cases. Before, it was one or 2 cases a day. Now,
it's 60 or 70. It's alarming," said Mamadou Sonko, head of operations
for the Senegalese Red Cross.

The Red Cross will train 240 volunteers who will lead awareness
activities in different communities. It will also distribute
disinfectant, antimicrobial soap, bowls, buckets, and measuring cups
to families in Diourbel, Dakar, Louga, Saint Louis, Fatick, and
Kaolack, where cases have emerged.

According to Aissa Fall Gueye, IFRC's regional health manager for
Sahel countries, cholera cases appeared only sporadically and were
easily contained until the rainy season began in July [2007] and
floodwaters began pouring down on Senegal and other West African
nations. "It's during that period that we saw a big peak," Gueye
said. "The rainy season certainly had an impact."

The movement of people across cities and regions was another
important factor. Sonko said the 1st cases of cholera appeared in
Touba, the religious center of the country. One week after it rained
in Touba, and sewer waters overflowed onto the streets, a large
religious gathering took place in Saint Louis, on the northeastern
coast hundreds of kilometers away. "Within 3 days, the 1st cases
appeared in Saint Louis."

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

[The mentioned areas can be found on a map of Senegal at
<http://www.un.org/Depts/Cartographic/ma ... enegal.pdf>. - Mod. LL

The Sahel is the boundary zone in Africa between the Sahara to the
north and the more fertile region to the south. The countries of the
Sahel today include Senegal, Mauritania, Mali, Burkina Faso, Niger,
Nigeria, Chad, Sudan, and Eritrea, which can be located on the map at
<http://www.un.org/Depts/Cartographic/ma ... africa.pdf> - CopyEd.MJ]

******
[2] Cholera - Angola (Benguela)
Date: Fri 19 Oct 2007
Source: AllAfrica, Angola Press Agency (ANGOP, Luanda) report [edited]
<http://allafrica.com/stories/200710190721.html>


One person died of cholera in Balombo, southwestern Benguela
Province, out of the 14 cases recorded in this district, in the last
6 days, ANGOP has learned. In the mentioned period, 9 patients were
discharged and others are still in hospital under medical care.

At least 8 people died out of the 188 cases recorded between 6 Sep
2006 and 15 Oct 2007, informed a source with the local health authorities.

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

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

[The outbreaks discussed in this update can be located on the
HealthMap/ProMED-mail interactive map at
<http://www.healthmap.org/promed>. - CopyEd.MJ]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (51)
**********************************************
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 - West Africa
[2] Cholera - Mozambique: (Zambezia)
[3] Cholera - Congo DR: (Congo DR-Uganda border)

******
[1] Cholera - West Africa
Date: Tue 23 Oct 2007
Source: Voice of America [edited]
<http://www.voanews.com/english/2007-10-23-voa43.cfm>


Nearly 300 people have died in a cholera epidemic in West Africa, and
thousands of others have been infected. Outbreaks this year [2007]
have left more than 250 dead in Guinea and 30 dead in Sierra Leone.

In Senegal, more than 2000 cases of cholera have been reported, says
Red Cross Health Manager for West and Central Africa, Aissa Fall
Gueye. This is a very high infection rate, she says, but not
exceptional for the West African country. Only 12 cases have been
fatal. She says Senegal has done a good job of responding to this
year's [2007] crisis. But she says the disease will continue to
plague the region if international donors and governments do not
shift their focus from disaster relief to long-term prevention.

It can also pass from person to person, which becomes a serious
problem as people move around the country. For example, in Senegal,
this year's [2007] first major outbreak was reported in Touba, after
rains caused the sewers to overflow. One week later, there was an
outbreak hundreds of kilometers away in Saint Louis, after a
religious gathering that was attended by many from Touba.

Gueye says health organizations and ministries need to stop acting
like firefighters, who wait to respond until the situation is already
in crisis. She says they need to be more proactive and they need
donor support to help them focus more strongly on prevention.

But community level action is not enough, says Belgium's Doctors
Without Borders West Africa Operational Coordinator, Sebastien Roy.
"The biggest increase of cases is probably linked to structural
reasons. Bad sanitation conditions, problems with the water supply
for the population, and with wide urbanization of the city," he noted.

In 2005, more than 1200 died in a massive outbreak that infected more
than 75 000 across West Africa.

[Byline: Naomi Schwarz]

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

[A map of West Africa showing the countries involved can be found at
<http://www.un.org/Depts/Cartographic/ma ... africa.pdf>. - Mod.LL]

******
[2] Cholera - Mozambique: (Zambezia)
Date: Tue 23 Oct 2007
Source: Independent Online [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 309C189263>


A cholera outbreak in Mozambique's central province of Zambezia
reported this week has resulted in the death of 2 people and the
hospitalisation of another 6.

Radio Mozambique reported on Thu 25 Oct 2007 that the outbreak in the
rural district of Morrumbala near the Malawian border was due to the
consumption of contaminated water. The station said out of the 29
cases reported in that province this week, 6 people who remained in
hospital were in a stable condition.

Cholera outbreaks are often reported in Mozambique's rural and urban
centres during the rainy season, which began this month [October 2007].

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

[A map of Mozambique in showing the province of Zambezia in this
southeastern African nation can be found at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf>. - Mod.LL]

******
[3] Cholera - Congo DR: (Congo DR-Uganda border)
Date: Wed 24 Oct 2007
Source: Independent Online [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 660C352343>


The latest clashes in the Democratic Republic of Congo have driven 33
000 more people from villages in Nord-Kivu province and a cholera
outbreak is suspected, UN agencies reported on Wed 24 Oct 2007. About
25 000 people have been uprooted in the rugged Rutshuru highlands
about 50 kilometers (30 miles) north of the provincial capital Goma
and 8000 others have fled over the border into Uganda, UN officials estimated.

At Bunagana, a settlement on the border, officials had noted 2 cases
of suspected cholera, a fast-spreading water-borne disease, leading
the UN HCR [UN High Commissioner for Refugees - Mod.LL] to urge
people to move out of the zone to the "transit center with adequate
health facilities." HCR workers and Medecins Sans Frontieres (MSF -
Doctors without Borders) at Nyankabanda have finished building "7
collective shelters for 1500 people." MSF staff were vaccinating
children under 5 and the UN Children's Fund provided 2 10 000-liter
fresh water tanks.

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

[A map of Congo DR showing the location of Nord-Kivu in the east of
the country can be found at
<http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf> - Mod.LL]

POLIOMYELITIS - WORLDWIDE (09): SUDAN, CHAD, DEMOCRATIC
REPUBLIC OF THE CONGO
***********************************************
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] Sudan (Darfur)
[2] Chad
[3] Democratic Republic of the Congo

******
[1] Sudan (Darfur)
Date: 23 Oct 2007
Source: All Africa [edited]
<http://allafrica.com/stories/200710230914.html>


UN agencies and Sudanese health officials began a 2-day countrywide
polio immunisation campaign on [23 Oct 2007], following reports of a
new case of the disease in Darfur.

No polio cases had been reported in Sudan since August 2005, granting
the country WHO certification as polio-free. The new case, which was
confirmed in a boy from South Darfur, may have spread from
neighbouring Chad, the health agency said.

"Sudan will implement coordinated and cross-border outbreak response
activities as Chad synchronizes its response in the next 2 months,"
Mohamed Abdurrab, WHO representative in Sudan said.

Some villages in Darfur could not reached by vaccinators during a
3-day campaign in August 2007 due to insecurity in the war-torn
region. That campaign also followed reports of polio in Chad.

Officials said more vaccinations would be administered in November [2007].

A highly infectious viral disease, polio invades the nervous system
and can cause total paralysis in a matter of hours.

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

[According to the most recent update on the polio eradication
website, the date of onset of the above mentioned case in Sudan was
10 Sep 2007. The poliovirus type involved is type-1 (also referred to
as wild poliovirus type 1 or WPV-1; see
<http://www.polioeradication.org/content ... ecount.pdf>).

The wild poliovirus worldwide update provided information on the
origin of the virus, presumably based on results of genetic typing of
the poliovirus isolate involved. "In Sudan, in response to the recent
confirmation of a polio case in South Darfur (linked to virus
circulating in Chad), NIDs (National Immunization Days) were launched
on 23 Oct 2007. Further NIDs will be conducted in November [2007] in
synchronization with Chad. The activities are part of an urgent and
ongoing outbreak response to minimise the risk of further
international spread, which is compounded by large population
movements across the region during the upcoming Hajj season.
Insecurity in both Sudan and Chad continues to be of major concern to
the quality of outbreak response activities" (see
<http://www.polioeradication.org/casecount.asp#details>).

From the monthly situation report available at
<http://www.polioeradication.org/content ... sitrep.asp>,
there is the following background information: "In Sudan, the 1st
polio identified in Sudan since June 2005 was confirmed in southern
Darfur in an area close to a known transmission zone in Chad. The
case is a 30-month old child from a nomadic group traveling across
southern Darfur. The detection of 6 cases in Chad this year (2007)
underlines the ongoing threat of re-infection from endemic areas. The
risk of further spread to the east remains high and is further
compounded by large population movements across the region for the
upcoming Hajj season. Sudan has been conducting preventive polio
campaigns since confirmation of polio in Chad earlier this year. An
emergency outbreak response campaign will now be held on 23 Oct 2007
in synchronization with Chad." - Mod.MPP]

******
[2] Chad
Date: 23 Oct 2007
Source: Polio eradication wild poliovirus weekly update [edited]
<http://www.polioeradication.org/casecount.asp#details>


In Chad, advance notification of 5 new cases (WPV1s) was received.
The cases are in previously infected areas in the west of the country
bordering Nigeria, and in the east bordering Sudan, and in a
newly-infected area in the south-central part of the country.

In response, Chad is synchronizing immunization activities with
neighbouring countries, notably with Nigeria in the west and with
Sudan in the east.

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

[According to the polio eradication website, as of 23 Oct 2007 there
have been 6 cases of polio confirmed in Chad, with date of onset of
the most recent WPV-1 isolate on 31 Aug 2007, but as stated above,
there has been advance notification of 5 more recent cases according
to the weekly update. Reviewing the annual case counts reported from
Chad in 2000, there were 4 cases; in 2001 and 2002 there were no
cases reported, and Chad was considered to have interrupted
transmission of WPV in the country. In 2003, there were 25 cases; in
2004 there were 24 cases; in 2005, there were 2 cases; and in 2006,
there was one case reported. All reported cases from 2003 until the
present are considered to be importation related
(<http://www.polioeradication.org/content ... ecount.pdf>).
- Mod.MPP]

******
[3] Democratic Republic Congo
Date: 23 Oct 2007
Source: Polio eradication wild poliovirus weekly update [edited]
<http://www.polioeradication.org/casecount.asp#details>


In DR Congo, advance notification of 2 new cases (WPV1s) was received
from Orientale province. The outbreak in Orientale is continuing to
spread, as one of the 2 new cases is from previously polio-free
Kisangani district, further along the Congo river. Efforts must now
focus on stopping this outbreak once and for all in Orientale. The
next SIAs are planned for [25 Oct 2007].

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

[According to the polio eradication website, as of 23 Oct 2007, there
have been a total of 32 cases of wild poliovirus-associated paralytic
disease reported from the DR Congo, not including the above mentioned
2 cases of WPV-1 from Orientale province. Historically, in 2000 there
were 28 cases of polio reported; there were no cases reported during
the period 2001 through 2005; and in 2006, there were 13 cases
reported. As with Chad, all cases reported since 2003 have been
considered importation-related (presumably this conclusion is based
upon genetic typing of poliovirus isolates demonstrating their recent
linkage to ongoing poliovirus circulation in other known infected countries
(<http://www.polioeradication.org/content ... ecount.pdf>).

More information comes from the monthly situation report of the polio
eradication initiative for September/October 2007, available at
<http://www.polioeradication.org/content ... sitrep.asp>:
"In 2007, the polio outbreak following a 4th importation is
continuing in Equateur Province and has spread into neighbouring
Orientale Province. 32 cases have been reported this year (2007), the
highest number of cases of all the re-infected countries. Although a
number of SIAs have been conducted throughout the year in the
affected areas, several operational challenges affect the quality of
the campaigns, including availability of petrol for transport and
adequate micro-planning to reach all populations along the Congo
River. Emphasis on upcoming campaigns is to urgently address these
operational issues." - Mod.MPP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (52)
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Cholera - Senegal
Date: Fri 26 Oct 2007
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA),
ReliefWeb, Int. Fed. of Red Cross and Red Crescent Societies report (IFRC)
[edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Cholera is an endemic illness in Senegal, hitting the population
particularly hard during the rainy season. From 3 Aug 2007 to 14 Oct 2007,
2144 cholera cases were registered with 11 deaths, a lethality rate of 0.51
per cent. The 1st case of the current outbreak was officially declared by
the Ministry of Health on 3 Aug 2007 in the district of Touba, Diourbel
Region. Following a request from the Senegalese Red Cross Society (SRCS),
the CHF 40 000 (USD 34 500) allocated from the Federation's DREF (Disaster
Relief Emergency Fund) will support their efforts to respond. The SRCS, as
an auxiliary to the government health authorities, is assisting the
Ministry of Health (MoH) to control the epidemic. This operation is
expected to be implemented over 3 months, and will therefore be completed
by January 2008; a final report will be made available by April 2008 (3
months after the end of the operation).

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

[A map of Senegal can be found at
<http://www.un.org/Depts/Cartographic/ma ... enegal.pdf>.

The outbreaks discussed in this update can be located on the
HealthMap/ProMED-mail interactive map at <http://www.healthmap.org/promed>.
- Mod.LL]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 ( 53 )
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>


Cholera, refugee camps - Congo DR: (North Kivu)
Date: Thu 1 Nov 2007
Source: AllAfrica, Reuters Africa report [edited]
<http://africa.reuters.com/wire/news/usnL01449778.html>


A cholera outbreak in Congo's eastern city of Goma is raising fears of an
epidemic among tens of thousands of refugees in camps, aid workers said on
Thursday [1 Nov 2007]. Fighting between government soldiers, Tutsi
insurgents, Rwandan Hutu rebels, and local Mai Mai militia has forced more
than 370 000 to flee villages in North Kivu province in 2007 alone.

More than 45 000 displaced people now live in 5 overcrowded camps on the
edge of Goma where aid agencies are struggling to maintain minimum hygiene
standards.

The medical charity Medecins Sans Frontieres (MSF) said it recorded 533
cases of cholera at health centers it supports, in both the camps and Goma,
over the past 6 weeks.

"The main crisis is in the camps around Goma," said Patrick Lavand'homme,
head the UN Office for the Coordination of Humanitarian Affairs in Goma.
Some 189 cases were reported between 24 and 28 Oct 2007, mostly in the
camps for the displaced, he said. 3 people have died from the disease so
far, MSF said.

Leo Jansen, MSF-France's head of mission in eastern Congo, said that while
the outbreak was manageable, it could soon flare out of control because
refugees continue to flood in. "They're in a bad situation. They're
susceptible to cholera. We've seen the number of cases double inside
Mugunga (camp) in recent weeks," he told Reuters. "We are fearing that the
outbreak could be bigger than in other years."

In 1994, nearly one million mainly Hutu refugees fled to Goma from Rwanda
fearing reprisals following a genocide that killed some 800 000 Tutsis and
moderate Hutus. The sudden influx provoked a major humanitarian disaster
and more than 50 000 people died after a cholera epidemic swept through the
camps.

[byline: Joe Bavier]

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

[A map of the Democratic Republic of the Congo showing the location of Goma
in North Kivu can be found at
<http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf>. The
outbreaks discussed in this update can also be located on the
HealthMap/ProMED-mail interactive map at <http://www.healthmap.org/promed>.
- Mod.LL]

RIFT-TAL-FIEBER -SUDAN
************************

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 2 Nov 2007
Source: Reuters Africa [edited]
<http://africa.reuters.com/top/news/usnBAN255064.html>


Rift Valley Fever kills 60 people in Sudan
-------------------------------------------------
An outbreak of Rift Valley fever in Sudan has struck at least 125 people,
killing 60 of them, the World Health Organization (WHO) said on Friday [2
Oct 2007]. The United Nations health agency said 2 weeks ago that it was
investigating a deadly outbreak in Sudan suspected to be yellow fever [see:
ProMED-mail post "Yellow fever - Sudan: susp., RFI 20071020.3419"], but
laboratory tests have shown it was Rift Valley fever, WHO spokesman John
Rainford said.

"There are 125 human cases and 60 deaths," he told Reuters. More
investigation was needed into the outbreak, which had erupted in White
Nile, Sennar, and Jazeera provinces in central and eastern Sudan, including
the exact timing of the first cases, Rainford said. "Right now we don't
have a clear picture." [A map of Sudan and its constituent provinces can be
accessed at <http://www.rightsmaps.com/html/sudmap1.html>. - Mod.CP]

Rift Valley fever virus, transmitted by contact with the blood or organs of
infected animals, can also be carried by mosquitoes, according to the WHO.
Herders, farmers, veterinarians and slaughterhouse workers are deemed at
higher risk of infection from the disease, which can devastate livestock.

While most human cases are relatively mild, a small percentage of patients
develop a much more severe haemorrhagic form which can cause them to vomit
blood or pass it in their faeces. Bleeding from the nose or gums can also
occur.

The nearly 50 per cent fatality rate was "very high" compared to the usual
expectations for Rift Valley fever, but it was likely that many more mild
cases have not been detected in Sudan, according to Rainford. "The Sudanese
government has been highly cooperative and transparent in sharing
information," Rainford said. WHO officials were in the area of the outbreak
and the United States Naval Medical Research Unit NAMRU-3 laboratory in
Cairo had helped with the laboratory analysis, he added.

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

[Rift Valley fever virus is a member of the genus _Phlebovirus_ (family
_Bunyaviridae_). The virus was 1st identified in 1931 during an
investigation into an epidemic among sheep on a farm in the Rift Valley of
Kenya. Since then, outbreaks have been reported in sub-Saharan and North
Africa. In 1997-98, a major outbreak occurred in Kenya, Somalia, and
Tanzania and again in September 2000, and more recently mainly affecting
livestock in 2006/2007, Rift Valley fever cases have been confirmed also in
Saudi Arabia and Yemen (see references below), being the first reported
occurrence of the disease outside the African continent. A map of the
distribution of endemic and sporadic Rift valley fever can be accessed at
<http://www.cdc.gov/ncidod/dvrd/spb/mnpa ... rvfmap.htm>.

The vast majority of human infections result from direct or indirect
contact with the blood or organs of infected animals. The virus can be
transmitted to humans through the handling of animal tissue during
slaughtering or butchering, assisting with animal births, conducting
veterinary procedures, or from the disposal of carcasses or fetuses.
Certain occupational groups such as herders, farmers, slaughterhouse
workers and veterinarians are therefore at higher risk of infection. The
virus infects humans through inoculation, for example via a wound from an
infected knife or through contact with broken skin, or through inhalation
of aerosols produced during the slaughter of infected animals. The aerosol
mode of transmission has also led to infection in laboratory workers. There
is some evidence that humans may also become infected with Rift Valley
fever by ingesting the unpasteurized or uncooked milk of infected animals.

Human infections have also resulted from the bites of infected mosquitoes,
most commonly the _Aedes_ mosquito. Transmission of Rift Valley fever virus
by hematophagous (blood-feeding) flies is also possible. To date, no
human-to-human transmission of Rift Valley fever has been documented.

Illness in humans is usually mild. However, in some patients the illness
can progress to hemorrhagic fever (which can lead to shock or hemorrhage),
encephalitis (inflammation of the brain, which can lead to headaches, coma,
or seizures), or ocular disease (diseases affecting the eye).

The interactive HealthNet map of Sudan is available at
<http://healthmap.org/promed?v=13.8,30,5>. - Mod.CP]

Rift-Tal-Fieber in Sudan
WHO - 05.11.2007

On 18 October 2007, the Federal Ministry of Health (FMoH), Sudan, requested WHO support to investigate and control a suspected haemorrhagic fever outbreak in White Nile and Sinnar States.

WHO has mobilized technical and logistics support for a joint Federal Ministry of Health and Ministry of Animal Resources and Fisheries field investigation. The field team included staff from the Food and Agriculture Organization (FAO) and field diagnostics capacity from the U.S. Naval Medical Research Unit No.3 (NAMRU-3), a WHO Collaborating Centre for Emerging Infectious Diseases based in Cairo, Egypt.

The joint field team arrived in Kosti, White Nile State on 24 October, and investigated reports of human and animal illness in the surrounding area. The team implemented outbreak response activities, including intensified surveillance and case management, social mobilization and outbreak communications. The investigation team reported its findings and recommendations to the FMoH in Khartoum on 28 October, at which point, the FMoH requested additional WHO support for controlling an outbreak of Rift Valley Fever (RVF).

As of 2 November, 125 cases including 60 deaths have been reported from more than 10 localities of White Nile, Sinnar, and Gezira states. Young adult males are predominantly affected. More than 25 human samples have been found positive for RVF by PCR or ELISA.

Samples from animals have been sent to the Central Veterinary Research Laboratory, Khartoum for analysis, but results are not yet available. Efforts are ongoing to intensify surveillance, case management, health education and vector control in the affected areas. WHO is working with the FMoH on an outbreak response plan of action and to identify the priority technical and operational support needed.

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (54)
**********************************************
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 - Uganda: (Nebbi)
[2] Diarrhea - South Africa: (Mpumalanga)

******
[1] Cholera - Uganda: (Nebbi)
Date: Mon 5 Nov 2007
Source: The Monitor [edited]
<http://www.monitor.co.ug/news/reg11055.php>


A fresh outbreak of cholera has hit 3 Nebbi subcounties of Panyimur,
Parombo, and Akworo and has left 42 infected.

The Nebbi District health educator, Mr Obima Kits told Daily Monitor on Fri
2 Nov 2007, that a soldier from Angumu detach in Panyimur and a Congolese
national were the 1st victims of the outbreak. "These sub counties have
poor sanitation, that is why the disease keeps on causing havoc. The only
way is to improve on the sanitation and hygiene if we are to contain the
disease," Mr Obima said. He said the most affected parishes include Parwo
and Pangere in Parombo, Uguta and Kituna in Akworo.

[byline: Warom Felix Okello]

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

[The Nebbi district of Uganda in the northwest, bordering on Congo DR, can
be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... ganda1.pdf>. - Mod.LL]

******
[2] Diarrhea - South Africa: (Mpumalanga)
Date: Fri 2 Nov 2007
Source: Mail & Guardian [edited]
<http://www.mg.co.za/articlePage.aspx?ar ... _national/>


A total of 150 people were treated for diarrhea in the Nkangala area in
Delmas since the outbreak last week, Mpumalanga provincial minister of
health and social services Sipho Lubisi said on Fri 2 Nov 2007. "150 cases
have been reported to outpatient facilities for treatment. At this point in
time, no deaths linked to diarrhea have been reported."

Addressing journalists, Lubisi said that since the outbreak of diarrhea was
noted, various laboratory tests had been carried out to identify the
presence of any bacteria that might be responsible for the disorder. The
area was hit by a typhoid outbreak in September 2005 and 4 people died as a
result. However, the provincial minister said the current situation could
not be linked to the previous one. He said, however, that if such evidence
was obtained through various tests currently under way, the public would be
informed.

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[Mpumalanga province is located in the northeastern part of the country and
can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf>.

The outbreaks discussed in this update can also be located on the
HealthMap/ProMED-mail interactive map at <http://www.healthmap.org/promed>.
- Mod.LL]

Südafrika - Darminfektionen
06.11.2007

Risiko für Durchfallerkrankungen landesweit. Ein Ausbruch wässriger Diarrhoen wird seit Ende Oktober aus dem Gebiet von Nkangala im Delmas-Bezirk der Mpumalanga-Provinz, östlich von Johannesburg, berichtet. Cholera wurde in letzter Zeit nicht gemeldet. Hygiene beachten. / Quelle: crm

Sudan - Rift Valley-Fieber (RVF)
06.11.2007

Aus den drei südlich der Hauptstadt Khartoum gelegenen Provinzen White Nile, Sennar und Jazeera werden aktuelle Ausbrüche dieser Viruskrankheit bei der ländlichen Bevölkerung gemeldet. Ausbrüche dieser Tierseuche mit menschlichen Erkrankungen, die mit Fieber und Allgemeinerscheinungen einhergehen und zu Kompliaktionen an Inneren Organen, Hirn, Augen sowie Blutungen führen können, gab es in Ostafrika bereits öfter. Schutz vor Überträgermücken (vorwiegend tagaktiv) sowie Nahrungshygiene (Fleisch, Milch) beachten, Kontakte zu Tieren (Rinder, Schafe, Ziegen, Kamele) sind zu meiden. / Quelle: crm