Wüstenschiff

MENINGITIS, MENINGOCOCCAL - CENTRAL AFRICAN REPUBLIC: 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: Mon 11 Feb 2008
Source: AllAfrica [edited]
<http://allafrica.com/stories/200802120003.html>


Up to one million people in the Central African Republic (CAR) are at
risk from a meningitis epidemic sweeping across the northwest of
their country, and overwhelmed local health authorities do not have
enough vaccine stocks to meet demands, the United Nations Office for
the Coordination of Humanitarian Affairs (OCHA) warned today [11 Feb 2008].

An outbreak was declared after numerous deaths were reported in the
districts of Ouham, Ouham Pende and Nana-Grebizi in the first 5 weeks
of this year, OCHA said in a press statement. UN agencies,
non-governmental organizations (NGOs) and the country's government
are working together to try to combat the epidemic. Following a
request from the World Health Organization (WHO), some USD 100 000
has been released from the UN's Emergency Response Fund (ERF) for the
CAR so that enough vaccines can be bought to protect about 80 000 people.

John Holmes, the Under-Secretary-General for Humanitarian Affairs and
Emergency Relief Coordinator, said that "protecting the people in the
north of the Central African Republic will prevent meningitis from
spreading to the rest of the country and into neighbouring Chad."

Toby Lanzer, the UN Humanitarian Coordinator in the country, said the
ERF injection has ensured that aid workers can immediately help many
of those who need vaccines. "We count on donors to continue
supporting our efforts so that more lives can be saved," he said.

The meningitis epidemic is the latest crisis to hit the CAR, which
has been buffeted by deadly fighting between government forces and
armed rebels and also by widespread bandit attacks against civilians.
Life expectancy in the impoverished, landlocked nation stands at just
43 [years].

--
Communicated by:
Coulibaly Sidi
<sidi_couly@yahoo.ca>

[The above news release presumably refers to a meningococcal
meningitis outbreak. According to a prior ProMED post, archive
number 20080125.0309, the WHO warned in October 2007 that 80 million
people out of roughly 350 million who live in 21 African countries
that constitutes the so-called meningococcal meningitis belt,
stretching from Ethiopia and Eritrea in the east to Senegal and
Mauritania in the west, might need to be vaccinated against the
bacterium, _Neisseria meningitides_, in 2008. The African
meningococcal meningitis belt includes the northern portion of the
Central African Republic (CAR). A map of the African bacterial
meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>.

Numerous cases of meningococcal meningitis are reported in this
region of Africa each year during the dry season, between December
and June, and every 6-12 years a large outbreak occurs
(<http://www.cdc.gov/ncidod/eid/vol9no10/03-0170.htm>).

WHO warned that meningitis could be especially severe in 2008 as the
region is anticipated to be heading toward the peak of a 6- to
12-year cycle of meningococcal meningitis (see ProMED post, archive
number 20080125.0309). Mass vaccination with the appropriate
serogroup-spcific meningococcal vaccine is used in involved districts
in an attempt to induce herd immunity (whereby transmission is
blocked when a critical percentage of the population have been vaccinated
(<http://www.who.int/mediacentre/factsheets/fs141/en/>). The
serogroups of _N. meningitides_ involved in the current outbreak in
the CAR are not specified in the above news release, although
outbreaks reported in surrounding countries have been due to
serogroups A and W135 (see prior ProMED posts below).

The CAR, a former French colony, is a sparsely populated (about 4.3
million people), landlocked country, bordered on the north and east
by Chad and Sudan, on the west by Cameroon and on the south by the
Democratic Republic of the Congo and the Republic of the Congo. The
CAR is one of the world's least developed countries, with a 2002
annual per capita income of USD 260; agriculture accounts for 55
percent of the country's gross domestic product (GDP), with most of
the population engaged in subsistence farming. There are more than 80
ethnic groups in the Central African Republic, each with its own
language. The CAR is beset by ethnic tensions and continued civil
unrest, as are its neighbors. The U.S. Department of State has
strongly advised American citizens not to travel to the CAR because
of heightened security concerns as a result of fighting between
rebels and government forces in the north prefectures of the country
(<http://www.travel.state.gov/travel/cis_ ... w_940.html>). - Mod.ML]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (10)
**********************************************
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 - Nigeria: (Cross River)
[2] Cholera - Uganda: (Kampala)
[3] Cholera - Angola
[4] Cholera - Congo DR: (Katanga)
[5] Diarrhea - Mozambique: (Tete)

******
[1] Cholera - Nigeria: (Cross River)
Date: Tue 12 Feb 2008
Source: AllAfrica, Leadership (Abuja) report [edited]
<http://allafrica.com/stories/200802120351.html>


Over 60 children between the ages of 1-2 have reportedly died of
cholera epidemic in northern Cross River state. The incident, which
occurred 3 weeks ago has been attributed to drinking of contaminated
water. The deaths occurred in Ogoja and its environs. The epidemic in
Yala, Obudu, Mbube, Bekwara, and Ogoja main towns is attributable to
shortage of water supply to the people resulting to the use of water
from ponds, streams, and gutters for domestic use and drinking.

Sources at the General Hospital, Ogoja confirmed that over 30
children have died in the hospital in the past 3 weeks, outside those
who could not make it to hospital. "We are losing an average of 5
kids a day here. When I was on duty, over 7 children have died," a
nurse at the hospital told our correspondent.

The Medical Superintendent of General Hospital, Ogoja, Dr Bart Egabe,
confirmed the epidemic.

[Byline: Edem Edem]

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

[The state of Cross River is in southeastern Nigeria and can be found
on a map at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf>. - Mod.LL]

******
[2] Cholera - Uganda: (Kampala)
Date: Sun 10 Feb 2008
Source: AllAfrica, New Vision (Kampala) report [edited]
<http://allafrica.com/stories/200802110991.html>


The Ministry of Health has confirmed that cholera has hit Kampala
district again. So far 6 patients have been admitted at the cholera
isolation camp in Mulago Hospital. There are no confirmed deaths. Dr
Mohamed Kirumira, the Kampala chief of health services said, 4
patients are undergoing treatment and other patients are reported to
be undergoing tests at Asumpta Clinic in Kamwokya.

Dr Sam Okware, the commissioner of health services, attributed the
outbreak to poor sanitation and lack of personal hygiene among the
masses and is not new.

"We have been having cholera for the last 2 to 3 years in western and
northern Uganda," he said. In 2005, an outbreak of cholera outbreak
killed at least 56 people and made more than 2000 others ill," says
the Ministry of Health.

[Byline: Frederick Womakuyu]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[These may be the same cases reported in a previous posting. Kampala
is in southern Uganda and can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>. - Mod.LL]

******
[3] Cholera - Angola
Date: Wed 6 Feb 2008
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=594011>


During the period from 28 Jan to 3 Feb 2008, cholera cases in Luanda,
the country's capital, dropped from 37 with one death to 30 cases
without any recorded deaths.

The reduction was due to the banned consumption of fish from Kilunda
lagoon and distribution of clean drinking water to residents of
Cacuaco district, ANGOP learned Wednesday [6 Feb 2008] in Luanda.
Speaking to ANGOP, the spokesperson of the National Commission of
Combat Against Cholera, Vita Vemba, said that awareness campaigns
directed to residents to avoid defecating neither next nor in the
lagoon has also contributed to the reduction of the number of cases.

The official added that last week [28 Jan-3 Feb 2008] Cacuaco
district recorded 35 cases against 27 registered on the previous
week. Sambizanga district reported 3 cases, one in the "Ossos" ward
and 2 in Porto Pesqueiro.

Precarious conditions of basic sanitation and the consumption of
untreated water in the above-cited localities were accounted for the
recorded cases, noted Vita Vemba, who added that during the 5th
epidemiological week of 2008 [28 Jan-3 Feb 2008], 200 cases with one
death were also registered. About 35 percent of the cases occurred in
Huila province, followed by provinces of Benguela, Cunene, Luanda,
Bie, and Kwanza Norte. Compared to the week before, there was a drop
from 233 with 3 deaths.

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

[A map of Angola showing the affected areas in the western part of
the country can be found at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod. LL]

******
[4] Cholera - Congo DR: (Katanga)
Date: Tue 12 Feb 2008
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://reliefweb.int/rw/RWB.NSF/db900SI ... enDocument>


A cholera outbreak in the southern Democratic Republic of Congo (DRC)
province of Katanga has spread, despite efforts to bring the epidemic
under control.

The disease has claimed the lives of 97 people and 4029 have been
infected since the 1st cases of the gastrointestinal illness were
reported in Katanga in September 2007, according to Francois Dumont,
spokesman for Medecins Sans Frontieres (MSF-Belgium). The disease has
spread quickly since the end of December 2007.

"What is remarkable is that the peak of the epidemic has not yet been
reached because the number of patients continues to grow," Dumont said.

Most of the cases have been reported in Lubumbashi, the provincial
capital, where the death toll stands at 49 and the number of
infections at 2543, and Likasi, nearly 100 km (62 mi) north of
Lubumbashi, where 48 people have died and 1486 cholera patients have
sought treatment.

The government and MSF-Belgium have set up 2 centers in Lubumbashi
where patients can seek treatment free of charge.

"Epidemiological data from the 1st week of February [2008] confirm an
upward trend (of the epidemic) in Likasi," said Dumont. He said 404
patients were registered in Likasi, with a population of about 350
000, at the beginning of February 2008, compared with 381 during the
last week of January 2008. "The rate of admissions remains very high,
almost 60 new patients a day," said Dumont.

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

[Likasi and Lubumbashi are located in the southern Congo DR province
of Katanga and can be seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf>. - Mod.LL]

******
[5] Diarrhea - Mozambique: (Tete)
Date: Tue 5 Feb 2008
Source: Agence France-Presse (AFP) [edited]
<http://afp.google.com/article/ALeqM5h52 ... 2VvBLgC0SQ>


An outbreak of diarrhea in a flood-hit city in central Mozambique has
claimed the lives of 64 people since early January 2008, the local
council said on Tuesday [5 Feb 2008]. The municipal authority in the
city of Tete said that a total of 835 people had contracted diarrhea
from contaminated water since the flooding began at the start of
2008. "64 of that total have not survived," the council's statement said.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Tete province in north western Mozambique. The state can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf>.
Cholera has been reported there this month - Mod.LL]

LUNGENPEST, FATAL - CONGO DR: (ORIENTALE), SUSPECTED
***********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 12 Feb 2008
Source: AllAfrica, Le Potentiel (Kinshasa) report [in French, trans.
Mod.MPP, edited]
<http://fr.allafrica.com/stories/200802120247.html>


An unknown disease similar to pneumonic plague has killed 5 persons
among the 20 cases reported since January [2008] in a locality of the
Northeast of the Democratic Republic of the Congo [DRC], according to
the Ministry of Health. "There is the suspicion of pulmonary plague
since the beginning of the month of January [2008] in Bolelole,"
Orientale province, located approximately 500 km (311 mi) to the
northeast of Kisangani, declared Dr Vital Mondonge, director of the
Department of Epidemics in the Ministry of Health.

According to the source, patient care has been provided by the local
structure of the Ministry of Health, assisted by a team from Medecins
Sans Frontieres (MSF) [Doctors Without Borders], said Dr Mondonge.

"The situation seems to be under control because, we have not
reported new cases in the past 2 weeks" he said, saying that disease
surveillance and public awareness were strengthened.

Samples taken from the cases in order to detect the responsible
[bacteria] have been sent to a laboratory in Bunia, approximately 200
km (125 mi) to the east.

"We are awaiting the results of the [laboratory] analyses, which can
take several weeks" said Dr Mondonge. In October 2006, the World
Health Organization [WHO] had reported a probable "outbreak."
Considered by the WHO to be a re-emerging disease, plague can be
extremely contagious, when transmitted by the respiratory route
[through inhalation] or through contact with secretions.

[Byline: Regine Kiala]

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

[Primary pneumonic plague (one percent of natural plague
presentations) arises as a result of inhalation of plague bacilli in
infectious aerosols, such as would be produced when there are
secondary pneumonic complications in bubonic/septicemic plague.

Primary plague pneumonia has a short incubation period of 1-3 days,
after which there is sudden onset of flu-like symptoms including
fever, chills, headache, generalized body pains, weakness, and chest
discomfort. A cough develops with sputum production, which may be
bloody, and increasing chest pain and difficulty in breathing. As the
disease progresses, hypoxia (low oxygen concentration in the blood)
and hemoptysis (coughing up blood) are prominent. The disease is
invariably fatal unless antimicrobial therapy commences within 24
hours of exposure.

Patients with primary pneumonic plague generate large quantities of
infectious aerosols that pose a significant risk to close contacts.
CDC (US Centers for Disease Control and Prevention) guidelines
identify contacts within 2 meters (6.5 ft) as being at greatest risk
and do not consider the organism likely to be carried through air
ducts or vents. Persons who have been in contact with pneumonic
plague patients or handling potentially infectious body fluids or
tissues without appropriate protection should receive preventive
antimicrobial therapy. The preferred antimicrobial agents for
prophylaxis are tetracyclines, quinolones, or chloramphenicol.

A map of Congo DR showing the northeast Orientale (also written
Oriental or Eastern) province can be found at
<http://www.lib.utexas.edu/maps/africa/c ... _pol98.jpg>. - Mod.LL]

IRIN hat geschrieben:KENYA: Cholera outbreak in Mandera

ISIOLO, 18 February 2008 (IRIN) - An outbreak of cholera in Kenya's northeastern district of Mandera has claimed the lives of six people, with the local hospital reporting that about 130 people had sought treatment at the facility during the past week.

About 60 patients have been admitted to the hospital, a medical officer from the Mandera District Hospital, who asked not to be named, said, adding that the hospital had asked for more cholera treatment drugs from Garissa, the provincial capital of the Northeastern Province where Mandera is situated.

Abukar Abdi, public health officer for Mandera, said the outbreak could be the result of general poor hygiene in Mandera town or the use of contaminated water from the nearby Dawa River, which forms part of the border between Kenya and Ethiopia.

He said his office had ordered 25 food kiosks in Mandera town to close down due to poor hygiene.

Cholera is a diarrhoeal illness caused by Vibrio cholerae. Between 10 and 20 percent of patients develop severe watery diarrhoea with vomiting. Treatment is mainly by rehydration and up to 80 percent of cholera cases can be treated successfully using only oral rehydration salts.

Quelle: http://www.irinnews.org

Grüsse
Alexander

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (11)
**********************************************
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], [2] Cholera - Kenya: (Northeastern)
[3] Diarrhea, fatal - Nigeria: (Anambra)
[4] Cholera - Zimbabwe: (Mashonaland East, Mashonaland Central)

*****
[1] Cholera - Kenya: (Northeastern)
Date: Mon 18 Feb 2008
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://www.irinnews.org/Report.aspx?ReportId=76804>


An outbreak of cholera in Kenya's Mandera district has claimed the
lives of 6 people, with the local hospital reporting that about 130
people had sought treatment at the facility during the past week
[11-17 Feb 2008]. About 60 patients have been admitted to the
hospital, a medical officer from the Mandera District Hospital, who
asked not to be named, said, adding that the hospital had asked for
more cholera treatment drugs from Garissa, the provincial capital of
the Northeastern Province, where Mandera is situated.

Abukar Abdi, public health officer for Mandera, said the outbreak
could be the result of general poor hygiene in Mandera town or the
use of contaminated water from the nearby Dawa River, which forms
part of the border between Kenya and Ethiopia. He said his office had
ordered 25 food kiosks in Mandera town to close down due to poor hygiene.

--
Communicated by:
Coulibaly Sidi
<sidi_couly@yahoo.ca>

******
[2] Cholera - Kenya: (Northeastern)
Date: Mon 18 Feb 2008
Source: Kenya Broadcasting Corporation [edited]
<http://www.kbc.co.ke/story.asp?ID=48267>


Since the outbreak was reported in January 2008, 8 people have died
from cholera in Mandera; 5 of the victims succumbed at Mandera
District Hospital while 3 others perished at Bulla Hawa Hospital on
the Kenya-Somalia border.

Northeastern provincial public health officer Dr Bernard Nyongesa
said the outbreak had spread to Elwak 175 km (109 mi) away. He said
it had become difficult to control the spread of the disease due to
lax immigration checks at Bula Hawa at the Kenya-Somalia and at Suftu
at the Kenya-Ethiopia borders. Dr Nyongesa said the situation was
made worse by the lack of health facilities in the area.

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

[The Northeastern Province can be found on a map of Kenya at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

[A similar article was submitted by ProMED-mail rapporteur Joseph
Dudley. - Mod.MPP]

******
[3] Diarrhea, fatal - Nigeria: (Anambra)
Date: Fri 15 Feb 2008
Source: Nigerian Tribune [edited]
<http://www.tribune.com.ng/15022008/news/news9.html>


Following an outbreak of diarrhea with vomiting, 5 children have been
reported dead and over 50 are receiving treatment in various
hospitals at Amafor West area of Nkpor, an outskirts of Onitsha, Anambra State.

A medical practitioner in the area, Ndubuisi Donatus Uzoigwe, who
confirmed the outbreak to newsmen, said there were no primary health
care center or health workers to enlighten the parents on the dangers
of the disease.

Uzoigwe, proprietor of Ndubuisi Health Care Services Centre, said he
had already drawn the attention of various government health agencies
at both local and state levels to the alarming rate of the endemic
outbreak of diarrhea with vomiting which hit the area since January 2008.

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

[The etiology of this outbreak is not stated but Anambra is located
in southern Nigeria not far from where outbreaks of cholera in the
Delta and Cross Rivers states have occurred. The states can be found
on a map of Nigeria at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf>. - Mod.LL]

******
[4] Cholera - Zimbabwe: (Mashonaland East, Mashonaland Central)
Date: Fri 15 Feb 2008
Source: AllAfrica, The Herald (Harare) report [edited]
<http://allafrica.com/stories/200802150292.html>


So far, 7 people from Nyamukuyo Village in Mudzi district,
Mashonaland East Province, have died of cholera. The minister of
Health and Child Welfare, Dr David Parirenyatwa, confirmed the
outbreak, which started 2 weeks ago.

Dr Parirenyatwa said a woman who had visited Mozambique was suspected
to have carried the disease to the village. This is the 2nd reported
cholera outbreak in February 2008 after a similar outbreak in
Muzarabani [in Mashonaland Central Province - Mod.LL], where 4 people
died last week [4-10 Feb 2008]. In a separate interview, principal
director for preventive services in the Ministry of Health, Dr Gibson
Mhlanga, attributed the increase of cholera and diarrhea cases in the
country to unsafe water and inadequate sanitation.

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

[The 2 provinces are in the northern part of Zimbabwe and can be seen
bordering on Mozambique on a map at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>.

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

MASERN - KENYA: (NAIROBI), REFUGEES
************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 18 Feb 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, African Medical and Research Foundation (AMREF)
report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


A measles outbreak is feared in the Kibera slum in the heart of Nairobi
-----------------------------------------------------------------------
At least 12 suspected cases of measles -- a most contagious disease
that can also become a leading cause of death especially in children
already suffering other infections -- were reported at the weekend
[16-17 Feb 2008] by AMREF's mobile clinic team in Kibera. A week
earlier, 3 other cases had been diagnosed by another AMREF medical
team at the Highrise Estate camp for persons displaced from Kibera in
the post-election violence in Kenya.

AMREF is working with the Kenya Medical Research Institute following
the clinical diagnosis of measles. A measles outbreak is expected to
touch off an immunisation drive in the extensive slum through
combined efforts by the Ministry of Health and other health-related
organisations and UN agencies. Certainly, the post-election strife
has set the stage for outbreak of diseases such as measles. In areas
experiencing or recovering from war, civil strife, or natural
disasters, infection rates have been known to soar because of the
poor state of infrastructure and health services, which interrupt
routine immunisation. Also, overcrowding in camps for refugees and
internally displaced people greatly increases the risk of infection.
During a recent clinic session in Kibera, AMREF found that the
majority of nearly 800 patients suffered respiratory infections,
followed by rheumatism and joint pains, intestinal worms, diarrhoeal
diseases, and skin infections in that order.

AMREF's Dr Khisa Wakasiaka said AMREF treated 306 children and 438
adults in one day. Notably, Dr Khisa said, women had borne the brunt
of the violence and suffered far greater trauma compared with their
male counterparts. They were victims of sexual violence and witnessed
their kith and kin being killed or brutalised. Many had lost property
to looters and arsonists.

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

[A map of Kenya is available at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>, and a
map of Nairobi (the capital city) showing the location of Kibera,
reputed to be Africa's largest slum, can be found at
<http://www.maplandia.com/kenya/nairobi/kibera/>.

Kenya has achieved considerable success in the elimination of measles
infection through development of a programme of comprehensive
vaccination (see ProMED-mail Measles - Kenya: 2002-2007 update
20070921.3137). In the past problems have arisen by influx of
refugees from outside the country. Now Kenya has to deal with the
consequence of disruption of the vaccination programme by internal
unrest, which may be a more intractable problem. - Mod.CP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (12)
**********************************************
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 - Kenya: (Northeastern)
[2] Cholera - Congo DR: (Katanga)
[3] Cholera - Uganda: (Arua)
[4] & [5] Cholera - Mozambique

*****
[1] Cholera - Kenya: (Northeastern)
Date: Sat 23 Feb 2008
Source: AllAfrica.com & The East African Standard (Nairobi) [edited]
<http://allafrica.com/stories/200802221231.html>


Five more people have died from cholera at various health centers in
Mandera District. This brings the death toll to 10 in 3 weeks.
Already, more than 200 people have been admitted in hospitals with
various complaints.

Confirming the latest deaths, area Medical Officer of Health Dr.
Bonface Musila said new cases of the outbreak were also reported at
Arabia Secondary School. He said 20 students were among 40 new cases
of the contagious disease at the Arabia division some 65km from Mandera town.

[Byline: Adow Jubat]

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

[The Northeastern Province where the Mandera district is located can
be found on a map of Kenya at:
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

*****
[2] Cholera - Congo DR: (Katanga)
Date: Fri 22 Feb 2008
Source: Int Fed of Red Cross And Red Crescent Societies [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


The DRC's Katanga Province continues to be affected by a cholera
epidemic that started in mid-December 2007. To date, about 19 health
zones out of 67 are affected. In 2007, the total population in the
affected communities was 9 629 888 people. Health Ministry and WHO
reports show that the epidemic is extending in many big cities of the
province. 110 deaths are reported out of more than 4000 cases
registered in Lubumbashi, Haut Lomami, Likasi, Tanganyika, and Haut Katanga.

According to the WHO, the DRC (especially in the East) is one of the
5 countries in the world where serious cholera epidemics have
periodically occurred (1981, 2002-2003, 2004, 2006, 2007-2008) in
Katanga, South Kivu and Eastern Kasai.

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

[The southern Congo DR province of Katanga and can be seen on a map
at <http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf>. - Mod.LL]

*****
[3] Cholera - Uganda: (Arua)
Date: 21 Feb 2008
Source: AllAfrica & The Monitor (Kampala) [edited]
<http://allafrica.com/stories/200802201030.html>


Arua District has registered 23 cases of cholera since the disease
broke out last week. The District Health Officer, Dr. Patrick Anguzu,
told Daily Monitor that 1 person had died. He said the disease has
spread to Oli Division where 16 cases have been reported.

According to the latest statistics, 7 cases have been reported within
the municipality. Dr. Anguzu attributed the outbreak to communities
using unclean water drawn especially from River Enyau. "The number of
latrines and water supply are insufficient. People are easing
themselves around the water points, while others fetch from them," he said.

[Byline: Warom Felix Okello and Proscovia Acan]

[The location of Arua bordering on Congo DR in northwestern Uganda
can be found on a map at:
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>. - Mod.LL]

*****
[4] Cholera - Mozambique
Date: Wed 20 Feb 2008
Source: Independent Online [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 633C729600>


Eight of Mozambique's 11 administrative provinces, including the city
of Maputo, have been hit by a cholera epidemic which has claimed 50
lives, state media reported on Wednesday [20 Feb 2008]. Health
minister Ivo Garrido was quoted by the daily Noticias as saying that
the spread of the disease worried health authorities.

Currently the provinces of Maputo, Maputo city, Manica, Sofala, Tete,
Cabo Delgado, Gaza and Zambezia have registered cases of the highly
contagious disease. Only the provinces of Inhambane, Niassa and
Nampula have not recorded any cases of cholera.

Health authorities attributed the spreading of the disease to poor
hygiene practices and the flooding in the central provinces.

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

[See the next posting for a map of Mozambique. - Mod.LL]

*****
[5] Cholera - Mozambique
Date: Tue 19 Feb 2008
Source: Agence France-Presse (AFP) [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


At least 72 people have died of cholera and other intestinal diseases
brought on by floods that have ravaged central Mozambique since the
beginning of January 2008, medical staff said Tuesday [19 Feb 2008].

"Of the 450 cholera patients we have treated in areas affected by the
floods, 8 have died," global humanitarian organisation Doctors
without Borders said in a statement. "This figure is added to the 64
other deaths ... from diarrhea in the single village of Tete reported
by municipal authorities 2 weeks ago."

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

[Exactly where the cases are being reported from is not clear. The
following is taken from a ProMED posting about 1 month ago (Cholera,
diarrhea & dysentery update 2008 (05) 20080118.0227):

"Since the [cholera] outbreak began in November 2007, over 1000 cases
have been diagnosed, and over 80 percent of these are in Maputo and
Matola [in Maputo province]. The cholera treatment center for the 2
cities has been set up in Maputo's Mavalane hospital, which is seeing
between 5 and 10 new patients a day, said Garrido, cited in the
Tuesday [15 Jan 2008] issue of the Maputo daily "Noticias." However,
the situation in the southern province of Gaza is also becoming
alarming. The disease has been reported from the provincial capital
Xai-Xai, and the districts of Chokwe and Guija. Garrido said that
between 10 and 20 new cases are being reported every day."

Given this statement, one would think that there would be more than
450 cases overall. Maputo and Gaza provinces are located in the south
of the country. Cases were also reported from Manica in the central
part of the country, Tete in the northwest and Capo Delgado in the
northeast. The areas can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf>. The
outbreaks discussed in this update can also be found on the
HealthMap/ProMED-mail interactive map at
<http://www.healthmap.org/promed>. - Mod.LL]

Burkina Faso, Demokratische Republik Kongo, Nigeria - Meningokokken-Krankheit
25.02.2008

Nach dem Einsetzen der Trockenzeit hat in den Ländern Afrikas, in denen diese sog. "epidemische Hirnhautentzündung" verbreitet ist, die diesjährige Erkrankungssaison begonnen. Erste Auftritte wurden aus Burkina Faso, Nigeria und der Demokratischen Republik Kongo bekannt. Reisende sollten sich vor einer Reise in die betreffenden Länder durch einen erfahrenen Arzt beraten lassen und mit einem sog. "Vierfachimpfstoff" geimpft sein, vor allem bei Kontakten zur einheimischen Bevölkerung. / Quelle: crm

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 ( 13 )

**********************************************
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 - Kenya (North Eastern)
[2] Cholera - Somalia (Gedo)
[3] Cholera - Zambia
[4] Cholera - Angola (Huila)

******
[1] Cholera - Kenya (North Eastern)
Date: Fri 29 Feb 2008
Source: Reuters Africa [edited]
<http://africa.reuters.com/top/news/usnBAN948438.html>


Cholera has killed 43 people in the last 2 weeks along the remote
border between Kenya and Somalia, officials in both nations said on
Friday [29 Feb 2008].

Abubakar Abdi, a public health official in Kenya's Mandera District
[in the North Eastern Province of Kenya, bordering Somalia -
CopyEd.MJ], said 30 people, including at least 6 children, had died
there from the water-borne disease in a fortnight [14 days]. Meat
exports to Somalia and Ethiopia were banned, he said.

On the Somali side of the border, a staff member with the Irish
charity Trocaire said 13 people had died from 676 suspected cases,
257 of which had needed hospital treatment.

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

[A map of Eastern Africa showing the Somalia-Kenya border can be found at
<http://www.un.org/Depts/Cartographic/ma ... astafr.pdf>. - Mod.LL
Mandera in the North Eastern Province can be located on the map of Kenya at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - CopyEd.MJ]

******
[2] Cholera - Somalia (Gedo)
Date: Tue 26 Feb 2008
Source: BBC News [edited]
<http://news.bbc.co.uk/2/hi/africa/7265443.stm>


About 70 people have died in a severe outbreak of cholera in southern
Somalia, close to the Kenyan border town of Mandera, reports say. At
least 400 people have been affected and drought conditions are
aggravating the problem.

People affected on the Kenyan side of the border are getting medical
aid but almost none is available in Somalia, says the BBC's reporter
in the region. Local non-government organisations have appealed for
international help.

The crisis is affecting Somalia's Gedo region, where people interact
with their Kenyan neighbors across the border in Mandera, the BBC's
Bashkash Jugsodaay says.

Health personnel are helping sufferers on the Kenyan side and
spreading information about how the illness can be contracted from
dirty water. However, in Gedo, the lack of medical facilities is
making the situation unbearable, our reporter says. The handful of
NGOs in the area are unable to provide enough support and fear the
situation might get out of control, he adds.

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

[A map of the area can be found at the source URL. A map of Somalia
showing the Gedo region can be found also at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[3] Cholera - Zambia
Date: Thu 28 Feb 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, United Nations Children's Fund (UNICEF) report
[edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


The cholera situation in Mwense district of Luapula Province is under
control. No new patients have been recorded since 15 Feb 2008. Lusaka
District continues to report cases of cholera in high-density
settlements (Chipata Overspill, Chaisa, George (Zone 3), and Matero).
Cumulatively 71 patients have been treated for cholera in Lusaka in
the last 30 days; no deaths have been recorded. In Kitwe district
(Copperbelt Province), 35 cases of watery diarrhea have been recorded
with 6 confirmed as cholera.

UNICEF is responding to all 3 cholera zones by supporting MOH
(Ministry of Health) assessments and providing zinc tablets,
ciprofloxacilin, sodium lactate, glucose hyperton, ORS (oral
rehydration solution), cannulas, and latex examination gloves to
District Epidemic Preparedness Committees.

Although heavy rains are forecast until end March [2008] in the
northern part of Zambia, floodwaters are receding in the Southern
parts of the country, raising the risk of disease outbreaks,
diarrhea, cholera, and malaria, especially from highly contaminated
water sources and standing water.

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

[A map of Zambia showing the areas mentioned can be found at
<http://www.un.org/Depts/Cartographic/ma ... zambia.pdf>. - Mod.LL]

******
[4] Cholera - Angola (Huila)
Date: Wed 27 Feb 2008
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=598792>


In the past 24 hours, 10 new cholera cases were detected by the
Services of Public Health and Control to Endemic Diseases in southern
Huila province, in Lubango city and in Quipungo district, without any
deaths.

ANGOP learnt of the fact from the head of the referred division,
Bernabe Lemos, who informed that from the cases 9 were diagnosed in
Lubango and one in Quipungo, whilst the localities of Chibia and
Matala, other regions of the province greatly affected by the
disease, did not report any new cases.

Bernabe Lemos stated that at the moment 31 patients have been
hospitalized with the disease: 27 at the Treatment Centre of
the Central Hospital of Lubango Dr Agostinho Neto, 3 in Matala, and
one in Quipungo.

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

[Huila is a land-locked province in southwestern Angola and can be
found on a map at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

IRIN hat geschrieben:WEST AFRICA : Region 'well-prepared' to meet Meningitis outbreak

DAKAR, 29 February 2008 (IRIN) - Meningitis is spreading across the region with the death toll reaching 422 since the beginning of 2008 yet, contrary to several recent reports, a World Health Organization (WHO) official said the figures are lower than previous years and that West Africa is well-prepared to contain the disease.

"The International Coordination Group (ICG) is well-stocked with seven million vaccine doses at the ready to supplement existing government stocks if needed," Katya Fernandez-Vegas, technical officer for WHO in Geneva told IRIN. The ICG was set up in 1995 to ensure meningitis vaccines are used where they are most needed.

"We were expecting 2008 to be a big epidemic year," Fernandez-Vegas added, "but so far it has not been as bad as the last two years' outbreaks."

In October 2007 the WHO said that 80 million people out of roughly 350 million in 21 African countries might need to be vaccinated against the bacterium in 2008.

Meningitis is a potentially fatal infection that affects the thin lining surrounding the brain and spinal cord.

According to WHO meningitis has broken out in Benin, Burkina Faso, Cote d'Ivoire Ghana, Mali, Niger, Nigeria and Togo with a total of 3,420 suspect cases and a fatality rate of 12.9 percent.

Burkina Faso

The vast majority of cases so far have been in Burkina Faso. Some 308 people have died from the infection there with a total of 2,513 cases.

Seven health districts have reached epidemic levels. The WHO sets the epidemic threshold for meningitis at 10 cases per 100,000 inhabitants per week in a health district.

"Burkina is the hardest hit but it is also the best-prepared," Fernandez-Vegas said. "They have had epidemics in recent years so this year they are ready."

Fernandez-Vegas said the country has 800,000 vaccine doses available and UNICEF will be providing one million more in early March. The government and WHO have so far fully vaccinated three of the districts with epidemic levels.

Ousamen Badolo, head of epidemiologic surveillance at the ministry of health, told IRIN "We continue to send requests to mobilise more vaccine doses and to vaccinate all districts that could enter the epidemic threshold."

The sub-region

Outbreaks have occurred elsewhere in the sub-region since the beginning of 2008, according to ministries of health that IRIN contacts spoke to, at least 26 people have died of meningitis in Mali, 65 in Cote d'Ivoire and 16 in Benin.

No epidemics have yet been reported in Benin, yet researchers there have recently detected a particularly dangerous meningitis sero-group known as W135, which caused an epidemic in Burkina Faso in 2002.

W135 requires a special vaccine which only ICG can provide.

Several different bacteria can cause meningitis. The Neisseria sero-group is one of the most important to watch because it often leads to epidemics, experts say.

Meningitis has reached epidemic levels in one district in Mali, and two in Cote d'Ivoire.

"Mali is well-prepared with one million vaccines at the ready and strong epidemiological surveillance in place," Toumani Sidibé the national director of health told IRIN.

"Mali has taken the lead to build stocks since August 2007," he said. "We can cope with the situation in case of an epidemic."

Cote d'Ivoire

For Fernandez-Vegas, Cote d'Ivoire is the one country in the sub-region where vaccinating could pose a problem, as epidemic levels have been found in northern districts where there has been insecurity. "This makes it harder to reach affected people," she said.

The country is also low on vaccines. At least 600,000 vaccines are still needed, according to WHO technical officer Kouadio Aka Tanoh Bian.

But Ferandez-Vegas said ICG should be able to make up the shortfall. "At the moment our biggest concern is confirming the sero-group when a meningitis outbreak occurs," she said.

Quelle: http://www.irinnews.org

Grüsse
Alexander

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (14)
**********************************************
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 - Congo DR (Katanga)
[2] Cholera - Zimbabwe (Mashonaland East)
[3] Cholera - Kenya (Northeastern)
[4] Acute watery diarrhea - Somalia (Gedo)
[5] Cholera - Angola (Cunene)

******
[1] Cholera - Congo DR (Katanga)
Date: Mon 3 Mar 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb [in French, trans. & summ. Mod.LL, edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Since the end of September 2007, the province of Katanga has faced a
recrudescence of cases of cholera. On 17 Dec 2007, the epicenter of
the cholera epidemic developed in the town of Likasa, an important
crossroads between various urban centers.

For weeks one to 7 of this year [2008], 5483 cases of cholera were
declared in Katanga and 120 deaths occurred (2.18 percent). Since
week 7, the epidemiologic curve tended to fall to Lubumbashi and
Likasi.

To date, cholera activity has concentrated especially around 2 urban
centers (Lubumbashi and Likasi). However the propagation of the
disease continues and 5 health zones (Fungurume, Kabondo-Dianda,
Kapolowe, Manika, and Panda) have a curve of ascending evolution of
the epidemic.

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

[The southern Congo DR province of Katanga and can be seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... rcongo.pdf>. - Mod.LL]

******
[2] Cholera - Zimbabwe (Mashonaland East)
Date: Tue 4 Mar 2008
Source: AllAfrica, The Herald (Harare) report [edited]
<http://allafrica.com/stories/200803040232.html>


At least 14 cases of the deadly cholera have been reported in Harare
in the past 2 weeks, the Minister of Health and Child Welfare, Dr
David Parirenyatwa, has said. So far, 9 cases were reported at the
Waterfalls Refugee Transit Camp while another 5 were reported in
Epworth. Dr Parirenyatwa said no deaths had been recorded so far.

Investigations are underway to establish the origins of the cholera
cases at the Waterfalls camp. "We want to establish the route
traveled by the refugees," he said.

The minister said the 5 cases in Epworth were traced to Mudzi, which
was recently hit by an outbreak that claimed 7 lives in Nyakuyo
Village. A woman who visited Mozambique was suspected to have brought
the disease.

In February 2008, another 9 cases were reported in Kairezi and
Chadereka villages in Mashonaland Central. One person died.

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

[Harare, the capital, is in Mashonaland East and can be found on a
map of the country at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>. - Mod.LL]

******
[3] Cholera - Kenya (Northeastern)
Date: Sun 2 Mar 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, World Health Organization (WHO) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


In Mandera (Northeastern province), cholera is spreading and is
threatening refugees and host populations. A total of 392 suspected
cases of cholera and 7 deaths have been reported including 12 in
Mandera Triangle on 26 and 27 Feb 2008.

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

[The Northeastern province where the Mandera district is located can
be found on a map of Kenya at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

******
[4] Acute watery diarrhea - Somalia (Gedo)
Date: Fri 29 Feb 2008
Source: UN Integrated Regional Information Networks (IRIN) report [edited]
<http://reliefweb.int/rw/RWB.NSF/db900SI ... enDocument>


An outbreak of acute watery diarrhea (AWD) in and around the town of
Belet Hawo, southwestern Somalia, has killed at least 11 people in
the past 3 weeks, medical sources said on 28 Feb 2008. "11 people
have so far died in Belet Hawo hospital and the villages around it,"
Saaid Mohamed Samatar, a doctor with the Gedo Health Consortium
(GHC), said.

The district commissioner of Belet Hawo, Ahmed Mohamed Burkuus, said
a taskforce had been set up 2 weeks ago to deal with the outbreak,
mounting a campaign to warn people against drinking water that had
not been chlorinated. "We are using radio to inform people on what to
do to fight the spread of the disease," he said. "We have managed to
put chlorine in all the water wells."

Samatar said 263 cases of acute watery diarrhea had been reported
since the end of January 2008. He said the highest number of cases
was 80 per week but that was now declining. "This week we only
registered 15 cases."

In a report issued on 28 Feb 2008, the World Health Organization
(WHO) confirmed the cases of suspected AWD reported from Belet Hawo
in Gedo region.

Belet Hawo is close to the Kenya-Somalia border, not far from Mandera
town (northeastern Kenya), with frequent movement between the 2
towns. A recent outbreak of cholera in Mandera may be contributing to
the outbreak in Belet Hawo, said Samatar of the GHC.

Burkuus said there was a serious water shortage in the area and
people were drinking water "that they normally would not." He said
people and livestock were coming to the town in search of water.
"Livestock has started dying due to a lack of water and pasture."

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

[A map of Somalia showing the Gedo region can be found at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[5] Cholera - Angola (Cunene)
Date: Fri 29 Feb 2008
Source: UN ReliefWeb, Int Fed of Red Cross & Red Crescent Societies
report [edited]
<http://reliefweb.int/rw/RWB.NSF/db900SI ... enDocument>


Cholera is on the increase in Cunene Province in the South of Angola.
Since January 2008, due to heavy rainfall resulting in floods, some
12 980 people have been displaced in the village of Sangongo and the
provincial capital Ondgiva. 5 to 7 new cholera cases are reported
daily, 82 people have already died.

Angolan Red Cross (ARC) volunteers are working together with local
communities to take precautions. "The construction of latrines is
urgently needed," said Walter Bombo Guange Quifica, Red Cross
secretary general based in Angola's capital Luanda. The ARC formed
partnerships with other agencies to respond to the crisis and 100
latrines in the affected area have already been built in cooperation
with Oxfam.

This year's [2008] floods have also affected Moxico province in East
Angola and the northern province of Uige. While Angola in 2007
experienced the worst floods around Moxico, currently the most
affected area is the south of the country around Cunene Province.

[Byline: Martina Schwikowski]

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

[Cunene province can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

EBOLA HEMORRHAGIC FEVER - UGANDA (05): (BUNDIBUGYO), SUSPECTED
**************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 3 Mar 2008
Source: AllAfrica, New Vision (Kampala) report [edited]
<http://allafrica.com/stories/200803040095.html>


The Ministry of Health is investigating 2 suspected Ebola deaths in
Bundibugyo, a week after the country was declared free of the
disease. The victims who were residents of Bwera in Kasese but
working in Bundibugyo, died last week. The primary health care state
minister, Emmanuel Otaala, said: "It may or may not be Ebola. We
cannot tell now. We need to get the results and see what to do next."
He said a team of investigators had been sent to Bundibugyo.

Dr Monica Musenero, an epidemiologist at the Health Ministry, said
the samples were expected at the Uganda Virus Research Institute in
Entebbe, later yesterday [Sun 2 Mar 2008]. "We cannot dismiss the
possibility of Ebola, but we have to be patient and wait for the
results," she said.

A teacher at Bundikeki Primary School, succumbed to the disease on
Sunday afternoon [2 Mar 2008] after being admitted to hospital on
Tuesday [26 Feb 2009]. Health officials say he was complaining of
pain in joints and headache. He had been sharing a bed with a teacher
of Bukangama Primary School, who passed away a week earlier after
showing similar symptoms. [These are the 2 individuals referred to in
the opening sentence].

The New Vision has learnt that there is also growing panic by several
people that were in contact with the deceased. But Otaala urged
residents to be calm. "We should not panic. It is not yet confirmed
that this is Ebola and we have enough manpower to handle all
situations." Samuel Kazinga, the resident district commissioner, also
allayed fears that the strange disease was Ebola.

The World Health Organization (WHO) and the Ministry of Health
declared Uganda Ebola-free on 22 Feb 2008. The Ebola Virus struck
Bundibugyo in November last year [2007] leaving more than 40 people
dead.

[Byline: Conan Businge]

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

[Although the soundness of the preliminary diagnosis of Ebola
hemorrhagic fever cannot be judged from the scant information
contained in this report, it may be that the announcement of the end
of the Ebola fever outbreak by WHO and the Ugandan Ministry of Health
was premature. A clear account of the outbreak in Bundibugyo and the
final death toll has still to be published. Further developments are
awaited.

[An interactive map of the Bundibugyo region of Western Uganda is available at
<http://www.maplandia.com/uganda/bundibugyo/>. - Mod.CP]

HEPATITIS E VIRUS - UGANDA
**************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 3 Mar 2008
Source: ReliefWeb, The International Federation of Red Cross And Red
Crescent Societies [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Hepatitis E Virus Epidemic in Uganda
------------------------------------
The Ugandan Ministry of Health (MoH) and the World Health
Organization (WHO) in Uganda have confirmed an outbreak of Hepatitis
E in Madi Opei Sub-county in Lamwo County, Kitgum District of
Northern Uganda neighbouring the South of Sudan. A total of 314 cases
with 11 deaths have been registered since the epidemic began to
spread in November 2007 and the outbreak in Madi Opei has shown
minimal reduction in its trend of progression. About 75 percent of
the cases are between the age group of 15 and 44 years. Meanwhile,
about 60 percent (186/314) of the cases are females. The risk factors
responsible for this continued transmission of HEV have been
discovered to be extremely low latrine coverage, contamination of
water at household levels and poor hygiene practices in the affected
IDP camps.

According to findings of a situational analysis carried out in 25
villages located in Madi Opei, an average of 112 people share one
latrine facility within the IDP camp. This is almost 6 times above
the standard requirement of 20 people per latrine facility.
Furthermore, most villages are lacking latrines and thus the
communities have formed the habits of open defecation. Most of the
available latrines are not being maintained, making their use
difficult. This also encourages open air defecation.

Hygiene practices at household levels such as routine washing hands
with soap after visiting the toilet or before meals are hardly
practiced. Despite the fact that soaps were distributed to the
community, there are no indications to show that soap was being used
for hand washing at all. Water samples (from pots and buckets)
collected from households showed heavy presence of coli
micro-organisms giving the indication that contamination of water is
taking place at household levels, attributed to the use of pots and
poor personal hygiene practices.

Madi Opei IDP camp has a total of 19 functional boreholes that supply
optimal amount of water to the community. Bucket chlorination is
being conducted at all water sources in Madi Opei and the
surrounding. It was established that there were occasional
interruption in the supply of chlorine tablets, resulting into
erratic discontinuation in chlorination of water at source. This was
largely attributed to weak supervisory/oversight role provided to the
chlorination activity.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Hepatitis E is a liver disease caused by hepatitis E virus (HEV)
which is transmitted in much the same way as other enteric viruses.
Hepatitis E outbreaks have occurred world-wide in recent years (see
references below). The signs and symptoms of HEV infection are loss
of appetite, nausea, vomiting, discoloured urine, jaundice and
abdominal pain. However, there is no chronic (long-term) infection.
Hepatitis E is more severe among pregnant women, especially in the
3rd trimester. HEV is found in the feces of persons and animals with
hepatitis E. HEV is spread by eating or drinking contaminated food or
water. Transmission from person to person may occur.

It seems likely in view of the deficiencies in basic sanitation
pertaining in rural Uganda that other enteric agents in addition to
HEV are contributing to the epidemic situation described above.

The map of Uganda accompanying this report is available at
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>. - Mod.CP]

Uganda - Hepatitis E
05.03.2008

Ein Ausbruch dieser oral übertragenen Form der infektiösen Gelbsucht wird aus dem Kitgum-Distrikt im Norden des Landes gemeldet. Seit November vorigen Jahres wurden übber 300 Erkrankungen mit 11 Todesfällen bei Einheimischen registriert. Gefährdet für schwere Verläufe und Todesfälle sind besonders Schwangere. Als Ursache des Ausbruchs wird eine Verunreinigung von Trinkwasser mit Abwässern angegeben. Hygiene beachten. / Quelle: crm

UNDIAGNOSED DEATHS, HUMAN - SENEGAL, RFI
***********************************
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: 7 Mar 2008
Source: AFP Google [edited]
<http://afp.google.com/article/ALeqM5j6h ... 6diHJOul5g>


Probe into mysterious child deaths in Senegal
---------------------------------------------
Health authorities in Senegal are looking into the unexplained deaths
of about 20 small children in a poor suburb of Dakar, a regional
medical chief said Friday [7 Mar 2008].

"Investigations have begun to find out how many (children) and what
happened," Khemes Ngom told AFP, confirming press reports that 18 to
20 children, aged 3 to 5, died in the fishing district of Thiaroye-sur-Mer.

"People reported symptoms such as convulsions, vomiting and
diarrhea," she said, "but after tests, pediatricians and doctors have
ruled out diseases such as cerebral malaria, typhoid fever,
meningitis and cholera."

Ngom said that samples -- including ones from car batteries -- had
been gathered in Thiaroye-sur-Mer to be sent to health ministry laboratories.

The private weekly L'Observateur reported that the children might
have been poisoned by lead from car batteries left on a public waste
tip, because "people living in poverty fetch them to resell them."

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

[Although this could be a case of lead poisoning from the lead in the
batteries, it would be nice to know the general nutrition and health
of the children that died. It would also be helpful to know for how
long these children were ill before they died. Are these deaths
limited to just this fishing village or have there been other deaths
in other fishing villiages.

Symptoms of lead poisoning in children mimic other diseases with
complaints associated with stomachache, irritability, decreased
appetite, hyperactivity and sleep problems, lethargy, nervousness and
others. With such non-specific signs it is easy to attribute this to
a host of other childhood aliments. Convulsions, coma and death may
occur from lead poisoning.

This article does not tell us what samples were taken or how long
this condition has been ongoing. If anyone has more definitive
information we would appreciate it if you would share with us. - Mod.TG]