Wüstenschiff

MENINGITIS, MENINGOCOCCAL - UGANDA: (ARUA, HOIMA)
*************************************************
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 13 Jan 2009
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/18/667975>


The number of patients admitted in Hoima district with suspected meningitis
has increased to 34 since the outbreak was first reported last week [week
of 5 Jan 2009]. Paul Kaggwa, the assistant commissioner for health
education and promotion in the Ministry of Health, on Monday [12 Jan 2009]
said 27 cases were first reported last Monday [?Mon 5 Jan 2009] in
Kigorobya sub-county [the affected sub county in Hoima]. Kaggwa added that
3 cases had been confirmed to be meningitis, while 9 deaths had been reported.

He added that 42 people were admitted with meningitis in Arua district
[Dadama and Oluko are the affected sub counties of Arua according to
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>. -
Mod.ML]. Kaggwa said 2 cases were confirmed to be meningitis, while 9
deaths had occurred. He added, however, that the ministry could not confirm
whether the deaths were due to meningitis.

Last week, the health ministry identified the Hoima outbreak to be the
meningococcal meningitis, which is caused by a bacterium and is transmitted
from person-to-person through contact with throat secretions.

Meningitis is an inflammation of the meninges, which is the lining
surrounding the brain and spinal cord. The ministry said overcrowding,
keeping in close contact with patients, living in congested and poorly
ventilated premises aids the spread of the disease. Kaggwa said the
Ministry of Health had embarked on a mobilisation drive to sensitise the
communities in the 2 districts to avoid congestion within their homes. "We
are on an active surveillance and the situation is being observed
seriously," Kaggwa said.

Meningitis last broke out in Hoima in February 2008. During the last
outbreak, 6 people died and many people were admitted in hospitals.

[byline: Raymond Baguma]

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

[The following is extracted from Mod.ML's comments in a prior ProMED-mail
post [Meningitis, meningococcal - Uganda (Arua) 20071207.3954].

"Meningococcal meningitis occurs sporadically or as epidemics in
sub-Saharan Africa, which is known as the "Meningitis Belt", an area that
stretches from Senegal in the west to Ethiopia and Eritrea in the east and
that includes northern Uganda
(<http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx>). 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>).

"During the 1st 10 weeks of the 2006 meningitis season, outbreaks in
eastern Africa were mainly caused by _Neisseria meningitides_ serogroup
W-135, whereas in West Africa the outbreak was due to mainly serogroup A.
In the Gulu district of Uganda the predominant serogroup was W-135, but
serogroup A predominated in Uganda outside this district. Gulu is located
in the center of the northern region, bordering Sudan and east of Arua
(<http://www.ugpulse.com/images/articles/ ... 00_447.jpg>).

"In the Gulu district, the disease was noted in "Internally Displaced
Persons" camps. Overcrowded housing and large population displacements that
undoubtedly characterized these camps likely favored the transmission of
_N. meningitides_. At that time, the International Coordinating Group (ICG)
on Vaccine Provision for Epidemic Meningitis Control provided 360 000 doses
of trivalent vaccine (polysaccharide vaccine for serotypes A, C, and W135)
in an attempt to control the outbreak
(<http://www.who.int/csr/don/2006_03_21/en/index.html>).

"In January 2007, a meningitis outbreak was again reported in Uganda,
according to the WHO
(<http://mediaglobal.org/article/2007-01- ... gitis-belt>)
in an "area, which borders southern Sudan and the Democratic Republic of
Congo... [among] both refugees and nationals living in 'rural, densely
populated settlements." The most affected district was said to be Arua. At
the time, the meningitis outbreak in South Sudan was reportedly caused by
serotype A, but the serotype causing the meningitis outbreak in Uganda was
not given. The current outbreak is again occurring in the Arua district,
but "this time round, it is counties like Vurra in Arua, which were not
covered during the [prior] immunization [program].

"To control an outbreak, WHO recommends mass vaccination with the
appropriate vaccine, depending on availability, in every involved district
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/>). There are several
different types of meningococcal vaccines. Polysaccharide vaccines, which
have been available for over 30 years, exist against serogroups A, C, Y,
and W-135 in various combinations (such as, a bivalent AC, trivalent
ACW-135, and a tetravalent ACYW-135 polysaccharide vaccine). There is a
monovalent conjugate vaccine against serogroup C and a tetravalent against
serogroups A, C, Y and W-135. The conjugate vaccines are immunogenic for
children under 2 years of age whereas polysaccharide vaccines are not. All
these vaccines have been proven safe and effective with infrequent and mild
side effects. For both the meningococcal conjugate and the polysaccharide
vaccines, approximately 7-10 days are required following vaccination for
development of protective levels of anti-meningococcal antibodies."

According to another recent news release concerning the Ugandan current
meningitis outbreak date Jan 14 2009
(<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>),
the Ugandan Red Cross "discovered that the [meningitis] epidemic broke out
in an area with no history of vaccination for meningitis and that the case
fatality is high mainly due to the limited number of health units in the
area. It was also found that the affected homesteads are congested which
easily leads to the spread of the disease."

A map of Uganda showing the affected districts can be found at
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf> and a map of
the African bacterial meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>. - Mod.ML

The HealthMap/ProMED-mail interactive map of Uganda is available at
<http://healthmap.org/promed/en?g=443328 ... 7,33.083,6>. -
CopyEd.MJ]

MENINGITIS, MENINGOCOCCAL - UGANDA: (ARUA, HOIMA)
*************************************************
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 13 Jan 2009
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/18/667975>


The number of patients admitted in Hoima district with suspected meningitis
has increased to 34 since the outbreak was first reported last week [week
of 5 Jan 2009]. Paul Kaggwa, the assistant commissioner for health
education and promotion in the Ministry of Health, on Monday [12 Jan 2009]
said 27 cases were first reported last Monday [?Mon 5 Jan 2009] in
Kigorobya sub-county [the affected sub county in Hoima]. Kaggwa added that
3 cases had been confirmed to be meningitis, while 9 deaths had been reported.

He added that 42 people were admitted with meningitis in Arua district
[Dadama and Oluko are the affected sub counties of Arua according to
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>. -
Mod.ML]. Kaggwa said 2 cases were confirmed to be meningitis, while 9
deaths had occurred. He added, however, that the ministry could not confirm
whether the deaths were due to meningitis.

Last week, the health ministry identified the Hoima outbreak to be the
meningococcal meningitis, which is caused by a bacterium and is transmitted
from person-to-person through contact with throat secretions.

Meningitis is an inflammation of the meninges, which is the lining
surrounding the brain and spinal cord. The ministry said overcrowding,
keeping in close contact with patients, living in congested and poorly
ventilated premises aids the spread of the disease. Kaggwa said the
Ministry of Health had embarked on a mobilisation drive to sensitise the
communities in the 2 districts to avoid congestion within their homes. "We
are on an active surveillance and the situation is being observed
seriously," Kaggwa said.

Meningitis last broke out in Hoima in February 2008. During the last
outbreak, 6 people died and many people were admitted in hospitals.

[byline: Raymond Baguma]

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

[The following is extracted from Mod.ML's comments in a prior ProMED-mail
post [Meningitis, meningococcal - Uganda (Arua) 20071207.3954].

"Meningococcal meningitis occurs sporadically or as epidemics in
sub-Saharan Africa, which is known as the "Meningitis Belt", an area that
stretches from Senegal in the west to Ethiopia and Eritrea in the east and
that includes northern Uganda
(<http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx>). 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>).

"During the 1st 10 weeks of the 2006 meningitis season, outbreaks in
eastern Africa were mainly caused by _Neisseria meningitides_ serogroup
W-135, whereas in West Africa the outbreak was due to mainly serogroup A.
In the Gulu district of Uganda the predominant serogroup was W-135, but
serogroup A predominated in Uganda outside this district. Gulu is located
in the center of the northern region, bordering Sudan and east of Arua
(<http://www.ugpulse.com/images/articles/ ... 00_447.jpg>).

"In the Gulu district, the disease was noted in "Internally Displaced
Persons" camps. Overcrowded housing and large population displacements that
undoubtedly characterized these camps likely favored the transmission of
_N. meningitides_. At that time, the International Coordinating Group (ICG)
on Vaccine Provision for Epidemic Meningitis Control provided 360 000 doses
of trivalent vaccine (polysaccharide vaccine for serotypes A, C, and W135)
in an attempt to control the outbreak
(<http://www.who.int/csr/don/2006_03_21/en/index.html>).

"In January 2007, a meningitis outbreak was again reported in Uganda,
according to the WHO
(<http://mediaglobal.org/article/2007-01- ... gitis-belt>)
in an "area, which borders southern Sudan and the Democratic Republic of
Congo... [among] both refugees and nationals living in 'rural, densely
populated settlements." The most affected district was said to be Arua. At
the time, the meningitis outbreak in South Sudan was reportedly caused by
serotype A, but the serotype causing the meningitis outbreak in Uganda was
not given. The current outbreak is again occurring in the Arua district,
but "this time round, it is counties like Vurra in Arua, which were not
covered during the [prior] immunization [program].

"To control an outbreak, WHO recommends mass vaccination with the
appropriate vaccine, depending on availability, in every involved district
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/>). There are several
different types of meningococcal vaccines. Polysaccharide vaccines, which
have been available for over 30 years, exist against serogroups A, C, Y,
and W-135 in various combinations (such as, a bivalent AC, trivalent
ACW-135, and a tetravalent ACYW-135 polysaccharide vaccine). There is a
monovalent conjugate vaccine against serogroup C and a tetravalent against
serogroups A, C, Y and W-135. The conjugate vaccines are immunogenic for
children under 2 years of age whereas polysaccharide vaccines are not. All
these vaccines have been proven safe and effective with infrequent and mild
side effects. For both the meningococcal conjugate and the polysaccharide
vaccines, approximately 7-10 days are required following vaccination for
development of protective levels of anti-meningococcal antibodies."

According to another recent news release concerning the Ugandan current
meningitis outbreak date Jan 14 2009
(<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>),
the Ugandan Red Cross "discovered that the [meningitis] epidemic broke out
in an area with no history of vaccination for meningitis and that the case
fatality is high mainly due to the limited number of health units in the
area. It was also found that the affected homesteads are congested which
easily leads to the spread of the disease."

A map of Uganda showing the affected districts can be found at
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf> and a map of
the African bacterial meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>. - Mod.ML

The HealthMap/ProMED-mail interactive map of Uganda is available at
<http://healthmap.org/promed/en?g=443328 ... 7,33.083,6>. -
CopyEd.MJ]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (07)
**********************************************
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 - Zimbabwe: WHO
[2] Cholera - South Africa
[3] Cholera - Ghana (Volta State)
[4] Cholera - Mozambique (Nampula, Capo Delgado)
[5] Cholera - Nigeria (Ebonyi)

******
[1] Cholera - Zimbabwe: WHO
Date: Fri 16 Jan 2009
Source: Government of Zimbabwe; World Health Organization (WHO)
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... c=1&cc=zwe>


Zimbabwe: Daily cholera update and alerts, 15 Jan 2009
------------------------------------------------------
Highlights of the day:
- 689 cases and 24 deaths added today (compared with 1550 cases and 104
deaths yesterday)
- 37 per cent of the areas affected have reported today (21 out of 57
affected districts)
- 87 per cent of districts reported to be affected (54 districts/62)
- All 10 of the country's provinces are affected

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

[The total number of cases reported in the full report
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... report.pdf>
is now 42 675, and the total fatality count has risen to 2225. In the 3
days since ProMED-mail's last posting, the cases have risen by 2896 and the
fatalities by 201. The outbreak continues to spread to new areas and the
overall case fatality rate, reflecting the overall poor conditions in the
country, which has crept slightly higher to 5.2 per cent.

A map of Zimbabwe with provinces can be found at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>. The
HealthMap/ProMED-mail interactive map of Zimbabwe is available at
<http://healthmap.org/promed/en?v=-19,29.9,6>. - Mod.LL]

******
[2] Cholera - South Africa
Date: Thu 15 Jan 2009
Source: The Times [edited]
<http://www.thetimes.co.za/News/Article.aspx?id=919335>


Cholera is spreading in South Africa -- and fast. There have been more than
2000 infections in Limpopo, and Mpumalanga has recorded its 1st cholera
death. 9 new cholera infections were reported in Mpumalanga yesterday [14
Jan 2009]. This brings to 13 the number of people who have died from the
disease.

Department of health spokesman Fidel Hadebe said: "We are dealing with a
communicable disease. People are traveling from Zimbabwe [and] moving into
Gauteng and Western Cape." He said health workers "are working flat out.
Sometimes people seek help too late when they have complicated symptoms. We
are dealing with a complicated problem and we just cannot quarantine people."

An Mpumalanga health department spokesman, Mpho Gabashane, said the
province was on high alert after laboratory tests confirmed that a South
African woman who died on 5 Jan 2009 had succumbed to cholera after
visiting Zimbabwe with her husband. 9 other cholera cases were recorded at
Mpumalanga clinics and hospitals. Gabashane said the provincial health
department was monitoring the rivers in all the areas in which cholera had
been reported.

A spokesman for the Limpopo health department, Phuthi Seloba, said [the
number of] cholera infections in the province had reached 2023, with 49 new
cases confirmed yesterday [14 Jan 2009]. All the patients are South African.

Western Cape health department's spokesman Eric Ntabazalila said there had
been 7 cholera infections to date.

In KwaZulu-Natal, the department of health's spokesman, Leon Mbongwa, said
only 2 cholera cases had been confirmed in the province. 4 suspected cases
had been incorrectly diagnosed.

Gauteng has 33 cholera infections confirmed, and it is suspected that 173
people have contracted the disease, health department spokeswoman Phumelele
Kaunda said.

Both North West and Eastern Cape have been relatively unscathed by the
disease, but isolated cases of cholera infection have been reported.

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

[Most of the new cases are likely to be locally acquired and not directly
from Zimbabwe. The areas mentioned in the postings regarding South Africa
can be found on a map of the country at
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf>. Limpopo is
called the Northern Province on this map. The HealthMap/ProMED-mail map of
South Africa is available at <http://healthmap.org/promed/en?v=-29,25.1,5>.
- Mod.LL]

******
[3] Cholera - Ghana (Volta State)
Date: Fri 16 Jan 2009
Source: Ghanaian Chronicle [edited]
<http://www.ghanaian-chronicle.com/thest ... TY%3C/b%3E>


A cholera outbreak has hit the Anyako community in the Keta Municipality of
the Volta Region, a development that has created fear and anxiety and panic
among residents. The Keta municipal director of health services, Dr Atsu
Seake, who briefed the Chronicle, said that 8 out of the 249 affected
people had already died. He said those who had been admitted to hospital
and clinics in the municipality are responding to treatment.

According to Dr Seake, the problem began on 12 Dec 2008, and he blamed the
situation on poor environment and sanitation practices in the community. He
disclosed that out of the 8 reported deaths, 7 of them died at home, while
only one died at the hospital.

[byline: Samuel Agbewode]

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

[The Volta State is in south eastern Ghana. To its south west is Greater
Accra, where cholera has been recently reported, and to the east is
southern Togo, where cholera has also occurred. The area can be seen on a
map at <http://www.un.org/Depts/Cartographic/ma ... /ghana.pdf>. - Mod.LL]

******
[4] Cholera - Mozambique (Nampula, Capo Delgado)
Date: Wed 14 Jan 2009
Source: African Press Agency [edited]
<http://www.apanews.net/apa.php?page=sho ... icle=85654>


Mozambique's new cholera outbreak in the northern region of Nampula has
killed 40 people. More than 60 others are seeking medical treatment daily,
health officials said here Wednesday [13 Jan 2009].

Nampula health director Flavio Wate told APA in an interview that most of
the densely populated suburbs in the provincial capital of Nampula
contracted the preventable disease after drinking contaminated water and
for practising poor hygiene. "We recorded 16 deaths as of January 2009 and
the rest died in the month of December 2008. We are working with the
communities in our efforts to reduce the consequences, should it continue
raining in the next few weeks," he said.

Radio Mozambique reported on Wednesday that 3 people died this week in the
neighboring province of Cabo Delgado out of the 60 cases reported this
month in the area. The health ministry said 103 people have died from the
epidemic from 10 200 cases registered since March 2008.

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

[Nampula and Cabo Delgado provinces are located in north eastern Mozambique
bordering the Indian Ocean and can be seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf>. - Mod.LL]

******
[5] Cholera - Nigeria (Ebonyi)
Date: Wed 15 Jan 2009
Source: Daily Sun [edited]
<http://www.sunnewsonline.com/webpages/n ... 009-16.htm>


No fewer than 27 children between the ages of 4 and 10 years were reported
dead on Tuesday [14 Jan 2009] at Ndiagu-Anagu in Ikwo Local Government Area
of Ebonyi State as a result of suspected outbreak of severe
gastroenteritis, otherwise known as cholera.

According to a reliable source, the mysterious deaths which started few
weeks ago have ravaged the rural community where children between the ages
of 1 to 10 years were said to have been affected and are in critical condition.

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

[Ebonyi State is an inland south eastern state of Nigeria and is one of the
6 new states in Nigeria created in 1996; Ebonyi was created from the of old
Abakaliki division of Enugu State and old Afikpo division of Abia State.

The area of Nigeria mentioned can be found on a map at
<http://en.wikipedia.org/wiki/Ebonyi_State>. The outbreaks reported in this
update can also be found on the HealthMap/ProMED-mail interactive map at
<http://www.healthmap.org/promed>. - Mod.LL]

ANTHRAX, HUMAN, LIVESTOCK - ZIMBABWE
************************************
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: 13 Jan 2009
Source: SW Radio Africa/Physicians for Human Rights [edited]
<http://www.swradioafrica.com/pages/phys ... 130109.htm>


Current health crisis: anthrax
------------------------------
The World Health Organization (WHO) has reported some 200 human cases of
anthrax since November 2008 with 8 confirmed deaths. These cases were
attributed to the ingestion of animals (cattle and goats) that had died of
anthrax. Zimbabweans avoid eating animals that have died of disease, but
these cases appear to [have] occurred in starving rural people scavenging
carrion.

Physicians for Human Rights (PHR) was told that veterinary anthrax control
programs in Zimbabwe, which had included regular monthly control programs,
have been dramatically curtailed in the economic collapse. The surviving
herds are now much more vulnerable to infectious diseases.

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

[Seen against the larger canvas the anthrax problem is trivial unless one
accepts that with the breakdown of human and veterinary health services the
available data is but a fraction of reality; in the late 1970s there were
some 10 000 human cases of anthrax in the country due to wet weather and a
breakdown in the delivery of veterinary services thanks to the civil
insurgency.

The above came from the PHR Executive Summary of the report. Other links:
<http://physiciansforhumanrights.org/lib ... 01-13.html>
<

A search of the PHR full report (see pages 31-32)
<http://physiciansforhumanrights.org/lib ... m-full.pdf>
revealed the the following comment in WHO source document below from which
the PHR segment was based:

"According to WHO figures, there have been 200 human cases of anthrax
reported since November 2008, with 8 deaths. Consumption of contaminated
meat is a possible cause." ex WHO Zimbabwe Health Cluster Bulletin No 2 -
12 December 2008
<http://www.who.int/hac/crises/zmb/sitre ... ec2008/en/>.

PHR also comments: "PHR was also told that veterinary anthrax control
programs in Zimbabwe, which had included regular monthly dipping programs
for cattle, have been dramatically curtailed in the economic collapse. The
results in the veterinary sector are that dipping and vaccination of
livestock have largely ceased and the surviving herds are much more
vulnerable to infectious diseases." There is little that one can add.

The OIE Timelines information only covers 2005 & 2007:
<http://www.oie.int/wahis/public.php?pag ... _timelines> - Mod.MHJ]

RABIES, CANINE, HUMAN - SOUTH AFRICA: (EASTERN CAPE) 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: Fri 16 Jan 2009
Source: Independent online, SAPA report [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 170C530026>


Suspected rabies outbreak in Eastern Cape
-----------------------------------------
The Eastern Cape Department of Health officials were attending to a
suspected rabies outbreak in Mgwenyane village near Libode on Friday 16 Jan
2009, the department said. Spokesperson Sizwe Kupelo said the department
had dispatched an outbreak team to the village after at least 8 people were
bitten by 2 dogs in the village.

One of the dogs attacked its owner and then bit 5 other people before
running away. The other dog bit 2 people and also ran away. The dogs were
believed to have fled into a nearby forest. All the people who had been
bitten were identified and taken to a nearby hospital where they were being
treated for dog bites and receiving anti-rabies medication.

The outbreak team was on the scene informing people to treat all dogs in
the area with suspicion. "We are urging those who had been bitten to come
forward and be treated with immediate effect," Kupelo said. The suspected
outbreak was reported to the Eastern Cape Department of Agriculture. The
Department was responsible for immunising dogs in the area and would help
with further investigations. Kupelo said that the Department only suspected
that the dogs suffered from rabies but that further investigation would
reveal the facts. The ages of the people bitten ranged from 4 to 66 years old.

In an unrelated incident, the Department of Health dispatched an ambulance
to the village of Mhlanganisweni near Libode after receiving a report that
5 boys were in a critical condition after being initiated. The report from
a member of the community said that the boys needed urgent medical
attention. They would be taken to a nearby hospital. Since last December
[2008], 12 boys had died from botched circumcisions and "thousands" had
been rescued by police and health officials over the last few months,
Kupelo said.

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[Although the diagnosis of rabies virus infection has not been confirmed by
laboratory tests, it is highly probable that the diagnosis will be
confirmed in view of the frequency of reports of rabies from this province
of South Africa. That said, this report suggests that the risk of
contracting rabies virus infection from feral dogs may be of no greater
concern than some of the social practices prevalent in the region.

The HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/promed/en?v=-29,25.1,5>. A map showing the provinces
of south Africa can be accessed at
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>, and the
location of the city of Libode can be found at
<http://www.fallingrain.com/world/SF/1/Libode.html>. - Mod.CP]

PLAGUE, FATAL - ALGERIA
************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 19 Jan 2009
Source: United Press International [edited]
<http://www.upi.com/Top_News/2009/01/19/ ... 232390982/>


A number of al-Qaida militants in training have been killed by
plague, the disease believed to have ravaged Europe in the Middle
Ages. At least 40 al-Qaida followers have died since the disease
swept through a training camp in Algeria, as was reported on Monday
[19 Jan 2009]. The deaths became known when security forces found a
body beside a road.

The victims were associated with "al-Qaida in the Land of the Islamic
Maghreb," the largest and most powerful al-Qaida group outside the
Middle East. Al-Qaida leaders said they fear the plague has spread to
other cells or to Taliban fighters in Afghanistan. The epidemic began
in the hideouts of AQLIM (al-Qaida in the Land of the Islamic
Maghreb) in Algiers, sources said. The group fled to Bejaia and Jijel
provinces.

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ProMED-mail <promed@promedmail.org>

[Whether person-to-person spread of _Y. pestis_ via pneumonic plague,
the only form of human plague transmissible between people, has
occurred is not clear.

The outbreak has been reported to have occurred in Tizi Ouzou
province, 150 km east of the capital Algiers. In June 2003, an
outbreak of plague emerged in the Oran area of Algeria. During the
following weeks, a total of 11 confirmed and 7 suspected cases of
plague were reported from the same area. All cases were bubonic
plague; septicemia and coma later developed in 2 patients. According
to national health records, the last outbreak in Oran was in 1946,
and the last human cases of plague occurred in Algeria in 1950 (1).

The 2003 outbreak brought to mind the novel written by Nobel
Prize-winning novelist Albert Camus, "The Plague," which chronicled a
1940s plague outbreak in Oran, Algeria, which began with a rat
die-off in and around the apartment building of the protagonist Dr.
Bernard Rieux.

Reference:
1. Bitam I, Baziz B, Rolain J-M, et al: Zoonotic focus of Plague,
Algeria. Emrg Infect Dis 2006; 12: 1975-1977.

G Bennett-Williams, Ch Akula and ProMED Rapporteur Susan Baekeland
contributed versions of this ongoing story. - Mod.LL]

For maps of Algeria, see
<http://www.lib.utexas.edu/maps/africa/algeria_pol01.jpg> and
<http://www.lib.utexas.edu/maps/africa/a ... dmin01.jpg>.

For the interactive HealthMap/ProMED map with links to recent ProMED
postings on events in Algeria and neighboring countries, see
<http://healthmap.org/promed/en?v=28.2,2.6,5>. - Mod.MPP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (08 )
**********************************************
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 - Zimbabwe: WHO
[2] Cholera - South Africa (Limpopo)
[3] Cholera - South Africa (Mpumalanga)

******
[1] Cholera - Zimbabwe: WHO
Date: Mon 19 Jan 2009
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Government of Zimbabwe; WHO report [edited]
<http://reliefweb.int/rw/rwb.nsf/db900SI ... enDocument>


Zimbabwe: daily cholera update and alerts, 19 Jan 2009
------------------------------------------------------
Highlights of the day:
- 1900 cases and 137 deaths added today (in comparison 434 cases and
11 deaths yesterday [19 Jan 2009])
- 58.6 percent of the districts affected have reported today (34 out
of 55 affected districts)
- 88.7 percent of districts reported to be affected (55 districts/62)
- newly affected areas: Svisvi, Zhamba, and Musita (Gokwe South)

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

[The total number of cases reported in the full report
<http://reliefweb.int/rw/rwb.nsf/db900si ... report.pdf>
is now 46 606, and the total fatality count has risen to 2484. In the
4 days since ProMED-mail's last posting, the cases have risen by 3931
and the fatalities by 259. The outbreak continues to spread to new
areas and the overall case fatality rate, reflecting the overall poor
conditions in the country, which has again crept slightly higher to
5.3 percent.

A map of Zimbabwe with provinces can be found at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>.
The HealthMap/ProMED-mail interactive map of Zimbabwe is available at
<http://healthmap.org/promed/en?v=-19,29.9,6>. - Mod.LL]

******
[2] Cholera - South Africa (Limpopo)
Date: Mon 19 Jan 2009
Source: Sowetan [edited]
<http://www.sowetan.co.za/News/Article.aspx?id=920901>


68 new cases of cholera were reported in Limpopo yesterday [18 Jan
2009]. This brings to 2348 the total number of cases throughout South
Africa that have been reported since the outbreak of the disease in
November 2008.

Department of Health and Social Development spokesman Phuti Seloba
said that they were concerned at the rate at which the disease was
spreading in the province.

Cholera was 1st diagnosed when Zimbabwean victims of the water-borne
disease crossed the border to seek treatment.

Seloba said they were continuing with the campaign to educate
communities to ensure that people know what measures to take to deal
with the disease.

[Byline: Frank Maponya]

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

[Most of the new cases are likely to be locally acquired and not
directly from Zimbabwe. The areas mentioned in the postings regarding
South Africa can be found on a map of the country at
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf>.
Limpopo is called the Northern Province on this map. The
HealthMap/ProMED-mail map of South Africa is available at
<http://healthmap.org/promed/en?v=-29,25.1,5>. - Mod.LL]

******
[3] Cholera - South Africa (Mpumalanga)
Date: Mon 19 Jan 2009
Source: AllAfrica, BuaNews (Tshwane) report [edited]
<http://allafrica.com/stories/200901191459.html>


A total of 49 cases of cholera and 19 deaths have been confirmed in
Mpumalanga. Speaking to BuaNews on Monday [19 Jan 2009], provincial
Department of Health spokesperson Mpho Gabashane said 49 cases were
confirmed while 142 diarrhoea cases had been reported at clinics. A
total of 139 have been hospitalized.

Mr Gabashane also said tests done at the Maribi River had showed the
presence of _Vibrio cholerae_, which is the bacterium which causes
cholera. Residents from affected areas, including Bushbuckridge, Dr
JS Moroka, Mbombela, and Thaba Choeu, have been urged to refrain from
using water from nearby rivers and streams.

[Byline: Gabi Khumalo, Nthambeleni Gabara]

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

MENINGITIS, MENINGOCOCCAL - UGANDA (02): (MASINDI)
**************************************************
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 19 Jan 2009
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/13/668614>


The health ministry has reported an outbreak of meningitis in Masindi
district, a week after the deadly disease was reported in Hoima and
Arua districts. The director of clinical services in the ministry, Dr
Kenya Mugisha told The New Vision yesterday [19 Jan 2009] that 15
cases of meningitis had been reported in Masindi, with 4 deaths. He
said the outbreak had affected Pakanyi sub-county. "There are fears
that it may be spreading to Kigumba," said Mugisha. He said rapid
tests had been carried out on patients, which confirmed meningitis.

The outbreak in Masindi follows reported outbreaks in Dadama and
Oluko sub-counties in Arua and Kigorobya sub-county in Hoima. Mugisha
said the ministry was preparing to carry out a mass vaccination
exercise in the affected districts.

The ministry identified the outbreak to be the meningococcal
meningitis, which is caused by bacteria transmitted from
person-to-person through contact with throat secretions.

Meningitis is an inflammation of the meninges, which is the lining
surrounding the brain and spinal cord. The disease is also spread by
being in close contact with a patient. Living in congested and poorly
ventilated premises with an infected person increases the risk of the
spread of the disease. The most common symptoms of bacterial
meningitis are fever, headache, neck stiffness, sensitivity to light,
mental confusion, and vomiting.

Dr John Turyagaruka, the Masindi district health officer, said the
district lies in the meningitis belt that covers the areas of
southern Sudan and northern Uganda and outbreaks are normally
anticipated during this time of the year. He also said the district
was using stocks of drugs that were earlier dispatched to the
district following a meningitis scare in November [2008]. The
district health department is carrying out public sensitisation on
the outbreak.

[Byline: Raymond Baguma]

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

[The Ugandan meningococcal meningitis outbreak continues to spread,
now involving the Masindi district, which lies between the Arua
district to the north and the Hoima district to the south, where the
disease was previously reported. The meningococcal serogroups causing
this outbreak have not as yet been specified.

A map of Uganda showing the affected districts can be found at
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf> and a
map of the African bacterial meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>.

The HealthMap/ProMED-mail interactive map of Uganda is available at
<http://healthmap.org/promed/en?g=443351 ... 7,33.083,6>. - Mod.ML]

PLAGUE, FATAL - ALGERIA (02): UNCONFIRMED, 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: Tue 20 Jan 2009
Source: Dr Saada Chougrani <labsis@gmail.com>


The information (rumor) about the outbreak occurred in mountainous
borders between Tizi Ouzou and Bejaia was given by the daily paper in
Arabic language "Echorouk" in its on-line edition of 6 Jan 2009
<http://www.echoroukonline.com/ara/national/31104.html>. No serious
source, health professionals, even more the reference laboratory for
plague in Oran (Laboratory for the Plague of the Institute Pasteur of
Algeria in Oran) or that of in Algiers (medical bacteriology) had to
take seriously these rumors.

Furthermore, I would remind you of another bibliographical reference
on the plague epidemic of 2003: Bertherat E, Bekhoucha S, Chougrani
S, et al: Plague reappearance in Algeria after 50 years, 2003. Emerg
Infect Dis. 2007 Oct [20 Jan 2009]. Available from
<http://www.cdc.gov/EID/content/13/10/1459.htm>.

--
Dr Saada Chougrani
University of Oran, Algeria
<labsis@gmail.com>

[ProMED-mail thanks Dr Chougrani for his comments regarding the
report of an outbreak of _Yersinia pestis_. It is certainly possible
that this is not a plague outbreak. ProMED would certainly like to
have more information regarding the etiology of this reported
cluster, whether naturally occurring or not. - Mod.LL]

[For maps of Algeria, see:
<http://www.lib.utexas.edu/maps/africa/algeria_pol01.jpg> and
<http://www.lib.utexas.edu/maps/africa/a ... dmin01.jpg>.

For the interactive HealthMap/ProMED map with links to recent ProMED
postings on events in Algeria and neighboring countries, see
<http://healthmap.org/promed/en?v=28.2,2.6,5>. - Mod.MPP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (09 )
**********************************************
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 - Zimbabwe: WHO
[2] Cholera - South Africa (Limpopo)
[3] Cholera - Zambia (North-Western province)
[4] Cholera - Mozambique (Tete)

******
[1] Cholera - Zimbabwe: WHO
Date: Wed 21 Jan 2009
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Government of Zimbabwe; WHO report [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... c=1&cc=zwe>


Zimbabwe: daily cholera update and alerts, 21 Jan 2009
------------------------------------------------------
Highlights of the day:
- 1125 cases and 38 deaths added today (in comparison 894 cases and
37 deaths yesterday [20 Jan 2009])
- 53.4 percent of the districts affected have reported today (31 out
of 58 affected districts)
- 88.7 percent of districts reported to be affected (55 districts/62)
- 1 case denotified for Hurungwe after data cleaning
- daily institutional case fatality rate 1.6 percent

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

[The total number of cases reported in the full report at
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... report.pdf>
is now 48 623, and the total fatality count has risen to 2755. In the
2 days since ProMED-mail's last posting, the cases have risen by 2017
and the fatalities by 271. The outbreak continues to spread to new
areas and the overall case fatality rate, reflecting the overall poor
conditions in the country, which has again crept now substantially
higher to 5.7 percent.

A map of Zimbabwe with provinces can be found at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>. The
HealthMap/ProMED-mail interactive map of Zimbabwe is available at
<http://healthmap.org/promed/en?v=-19,29.9,6>. - Mod.LL]

******
[2] Cholera - South Africa (Limpopo)
Date: Wed 21 Jan 2009
Source: IOL (Independent Online, South Africa) [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 738C533559>


A 10th person has died of cholera in Limpopo, the provincial health
department said on Wednesday [21 Jan 2009]. Spokesperson Phuti Seloba
said another 2650 people were confirmed to have the waterborne
disease since November 2008. He said a total of 102 new cases were
recorded by Wednesday afternoon [21 Jan 2009] with Sekhukhune and
Capricorn accounting for the highest number at 65.

Last week [week of 12 Jan 2009], the Greater Sekhukhune District
Municipality allocated [ZAR] 18 million [approx. USD 1.78 million] to
the fight against the spread of cholera in the region. Municipality
spokesperson Sizwe Yende said on Tuesday [20 Jan 2009] that
Sekhukhune, which has been mostly affected by the cholera outbreak,
planned to intensify efforts to provide clean water and fight the
spread of the disease. He said this was to be done by speedily
repairing all water infrastructures that had broken down in the
affected areas and to continue to supply water tankers to places
without proper infrastructure.

Yende said the municipality would continue conducting health and
hygiene awareness campaigns and double efforts in places that were
not yet affected by cholera. He attributed the breakdown of water
infrastructure in Sekhukhune to theft of parts or the whole machines
that pumped water to the area's reservoirs.

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

[Most of the new cases are likely to be locally acquired and not
directly from Zimbabwe.

Limpopo can be found on a map of the country at
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf>.
Limpopo is called the Northern Province on this map. The
HealthMap/ProMED-mail map of South Africa is available at
<http://healthmap.org/promed/en?v=-29,25.1,5>. - Mod.LL]

******
[3] Cholera - Zambia (North-Western province)
Date: Wed 21 Jan 2009
Source: Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009- ... 697917.htm>


Another case of suspected cholera has been recorded in Solwezi at
Songisa Village in Mushitala area near Solwezi River in [the
North-Western province of] Zambia, bringing the number of patients to
3, Zambia News and Information Services (ZANIS) reported on Wednesday
[21 Jan 2009].

Solwezi District Medical Doctor, Harrison Ng'uni confirmed that the
patient was taken to Kimasala cholera isolation center for treatment
at 6 p.m. local time (1600 GMT) on Tuesday [20 Jan 2009], ZANIS said.

Ng'uni said the 1st 2 cholera patients, both of one family, who were
admitted to the isolation center, are responding to treatment and
they will be discharged in 2 days.

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

[Maps of Zambia can be found at
<http://www.un.org/Depts/Cartographic/ma ... zambia.pdf> and the
HealthMap/ProMED-mail interactive map at
<http://healthmap.org/promed/en?g=897041&v=-14.417,26,6>. - Mod.LL]

******
[4] Cholera - Mozambique (Tete)
Date: Wed 21 Jan 2009
Source: The Earth Times [edited]
<http://www.earthtimes.org/articles/show ... to-84.html>


At least 13 people have died of cholera in Mozambique's northwestern
Tete province, bringing to 84 the number of people in the country
bordering Zimbabwe to have succumbed to the disease since October
2008, state radio reported Wednesday [21 Jan 2009]. The deaths were
recorded in the districts of Moatize, Changa, and Tete town, where
over 1000 people in total have been diagnosed with cholera.

Health authorities in Tete attribute the increase in infections to
the heavy rains that are pounding the region and surrounding
countries, namely Zambia, Zimbabwe, and Malawi.

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

[Tete province in northwestern Mozambique can be seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf>
The HealthMap/ProMED-mail interactive map of Mozambique is available
at <http://healthmap.org/promed/en?g=102601 ... 6,33.587,5>. - Mod.LL]

LASSA FEVER - UNITED KINGDOM ex NIGERIA
***************************************
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 23 Jan 2009
Source: Channel 4 News, PA News [edited]
<http://www.channel4.com/news/articles/s ... er/2909847>


Africa traveller has Lassa fever
--------------------------------
A patient is being treated in hospital for Lassa fever, which can
cause deafness [among other things], a health watchdog said. The
patient travelled in Nigeria before returning to the United Kingdom
(UK) and is now being treated at the high security infectious
diseases unit at the Royal Free Hospital in north London. The Health
Protection Agency (HPA) said the patient, whose gender is not being
disclosed, represented an isolated case and there was no risk to the
general public.

Lassa fever is caused by Lassa virus and is endemic in Nigeria,
Sierra Leone, Liberia, Guinea and the Central African Republic.
Hundreds of thousands of people are infected in these countries each
year and isolated cases have been seen in Europe and the US [imported
from Africa - Mod.CP]. Infection also occurs in other African
countries including Mali, Senegal and the Democratic Republic of Congo.

Around 8 in 10 people infected with Lassa virus develop mild or no
symptoms, but in 20 percent of cases people will have severe illness.
Symptoms include fever, headache, sore throat, a cough, nausea,
vomiting, diarrhoea and muscle pain. Around 2 percent of all patients
die from the illness and death rates are particularly high in women
in the final months of pregnancy. A common complication of Lassa
fever is deafness.

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

[Lassa viral haemorrhagic fever is an acute illness of 1-4 weeks
duration that occurs in West Africa. Though 1st described in the
1950s, the virus causing the disease was not identified until 1969.
The virus is a single-stranded RNA virus belonging to the virus
family _Arenaviridae_. Lassa fever is known to be endemic in Guinea
(Conakry), Liberia, Sierra Leone and parts of Nigeria, but probably
in other West African countries as well.

Lassa fever is a zoonotic disease, meaning that humans become
infected from contact with infected animals. The animal reservoir of
Lassa virus is a rodent of the genus _Mastomys_, commonly known as
the "multimammate rat." Mastomys infected with Lassa virus do not
become ill, but they can shed the virus in their excreta (urine and faeces).

Lassa fever occurs in all age groups and in both men and women.
Persons at greatest risk are those living in rural areas where
Mastomys are usually found, especially in areas of poor sanitation or
crowded living conditions. Health care workers are at risk if proper
barrier nursing and infection control practices are not maintained.

Family members and health care workers should always be careful to
avoid contact with blood and body fluids while caring for sick
persons. Routine barrier nursing precautions probably protect against
transmission of Lassa virus in most circumstances. However, for added
safety, patients suspected to have Lassa fever should be cared for
under specific "isolation precautions," which include the wearing of
protective clothing such as masks, gloves, gowns, and face shields,
and the systematic sterilization of contaminated equipment. The
antiviral drug ribavirin is effective treatment for Lassa fever if
given early on in the course of clinical illness.

Further information can be obtained from the World Health
Organisation Web site at:
<http://www.who.int/mediacentre/factshee ... index.html>. - Mod.CP]

[A map showing the countries in West Africa mentioned above is
available at:
<http://everythingspossible.files.wordpr ... africa.jpg>
- Copyed.EJP]

LASSA FEVER - UNITED KINGDOM ex NIGERIA
***************************************
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 23 Jan 2009
Source: Channel 4 News, PA News [edited]
<http://www.channel4.com/news/articles/s ... er/2909847>

Africa traveller has Lassa fever
--------------------------------
A patient is being treated in hospital for Lassa fever, which can
cause deafness [among other things], a health watchdog said. The
patient travelled in Nigeria before returning to the United Kingdom
(UK) and is now being treated at the high security infectious
diseases unit at the Royal Free Hospital in north London. The Health
Protection Agency (HPA) said the patient, whose gender is not being
disclosed, represented an isolated case and there was no risk to the
general public.

Lassa fever is caused by Lassa virus and is endemic in Nigeria,
Sierra Leone, Liberia, Guinea and the Central African Republic.
Hundreds of thousands of people are infected in these countries each
year and isolated cases have been seen in Europe and the US [imported
from Africa - Mod.CP]. Infection also occurs in other African
countries including Mali, Senegal and the Democratic Republic of Congo.

Around 8 in 10 people infected with Lassa virus develop mild or no
symptoms, but in 20 percent of cases people will have severe illness.
Symptoms include fever, headache, sore throat, a cough, nausea,
vomiting, diarrhoea and muscle pain. Around 2 percent of all patients
die from the illness and death rates are particularly high in women
in the final months of pregnancy. A common complication of Lassa
fever is deafness.

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

[Lassa viral haemorrhagic fever is an acute illness of 1-4 weeks
duration that occurs in West Africa. Though 1st described in the
1950s, the virus causing the disease was not identified until 1969.
The virus is a single-stranded RNA virus belonging to the virus
family _Arenaviridae_. Lassa fever is known to be endemic in Guinea
(Conakry), Liberia, Sierra Leone and parts of Nigeria, but probably
in other West African countries as well.

Lassa fever is a zoonotic disease, meaning that humans become
infected from contact with infected animals. The animal reservoir of
Lassa virus is a rodent of the genus _Mastomys_, commonly known as
the "multimammate rat." Mastomys infected with Lassa virus do not
become ill, but they can shed the virus in their excreta (urine and faeces).

Lassa fever occurs in all age groups and in both men and women.
Persons at greatest risk are those living in rural areas where
Mastomys are usually found, especially in areas of poor sanitation or
crowded living conditions. Health care workers are at risk if proper
barrier nursing and infection control practices are not maintained.

Family members and health care workers should always be careful to
avoid contact with blood and body fluids while caring for sick
persons. Routine barrier nursing precautions probably protect against
transmission of Lassa virus in most circumstances. However, for added
safety, patients suspected to have Lassa fever should be cared for
under specific "isolation precautions," which include the wearing of
protective clothing such as masks, gloves, gowns, and face shields,
and the systematic sterilization of contaminated equipment. The
antiviral drug ribavirin is effective treatment for Lassa fever if
given early on in the course of clinical illness.

Further information can be obtained from the World Health
Organisation Web site at:
<http://www.who.int/mediacentre/factshee ... index.html>. - Mod.CP]

[A map showing the countries in West Africa mentioned above is
available at:
<http://everythingspossible.files.wordpr ... africa.jpg>
- Copyed.EJP]

RABIES, CANINE, HUMAN - ANGOLA: (LUANDA)
****************************************
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 20 Jan 2009
Source: Diario Digital [trans. by Mod.MPP, edited]
<http://diariodigital.sapo.pt/news.asp?s ... ews=368927>


Outbreak of rabies has killed 42 children in Luanda
---------------------------------------------------
An outbreak of rabies in the Angolan capital has resulted in the
death of 42 children since October [2008], Luis Bernadino, the
Director General of the Pediatric Hospital of Luanda, revealed today
[20 Jan 2009]. The Health Services of the Provincial Government of
Luanda has not yet provided data on the total number of cases,
including adults.

Luis Bernardino told the Lusa News Agency that the number of deaths
[42] refers to the total number of children admitted to the hospital
that were infected with rabies virus. The doctor stated that that the
majority of victims are male children, between 4 and 10 years old.
According to the Director General of the Luanda Pediatric Hospital,
the high number of [cases], is due to the fact that they are admitted
'too late' when it is no longer possible to save lives. "The vaccines
are only effective if administered within 24 hours after infection
[the bite]," he stressed. The report advises that, 'when there is the
knowledge that a child (and perhaps also adults), has been bitten by
animals -- mostly dogs, cats or monkeys -- the child she should be
taken immediately to a medical post so they can be vaccinated and monitored.'

To combat the rabies outbreak, during the past 12 days, the Luanda
Provincial Government has implemented a campaign involving mass
vaccination of animals and collection of strays. This campaign ends
next Friday [?23 Jan 2009] and data currently indicate that more than
50 thousand animals have been vaccinated. In statements to Lusa, the
Provincial Director of Agriculture and Rural Development, Maria
Galeia da Paz, said that the campaign is going well, having already
vaccinated in 8 days, the number of animals that, in normal years,
took 45 days to vaccinate. A total of 25 brigades, with 100
vaccinators for each municipality were formed, with the exception of
the municipality of Maianga which has only 80 vaccinators. Luanda has
9 municipalities. There are already 9 cars, one for each municipality
that are being used for the collection of animals. Each municipal
government has the task of preparing a place where the animals can be
held temporarily pending identification by owners. "People have no
more than 24 hours to make the claims, so after that period [24
hours] animals that have not been claimed by owners will be killed,"
he stressed.

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

[The HealthMap/ProMED-mail interactive map of Angola is available at:
<http://healthmap.org/promed/en?v=-12.3,17.5.5>. The capital, Luanda,
is situated on the northern coast of Angola, some 200 miles to the
north of Huambo where a similar large scale outbreak of rabies
occurred in 2007. The authorities in Luanda appear to be responding
with vigor to control the domestic and feral dog population, but the
balance between vaccination and killing is not clear from the
report. - Mod.CP]

LASSA FEVER - UNITED KINGDOM ex NIGERIA (02)
********************************************
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 23 Jan 2009
Source: Sky News Online [edited]
<http://uk.news.yahoo.com/5/20090123/tuk ... dbed5.html>


UK man under quarantine with Lassa fever
----------------------------------------
The 66-year-old man is suffering from Lassa fever, an infection
[Lassa fever] which comes from the same family as the deadly Ebola
virus. [This statement is incorrect. These viruses are unrelated.
Lassa fever virus belongs the _Arenaviridae_ family of viruses, and
the various species of Ebola virus are classified in the family
_Filoviridae_. - Mod.CP] The patient is being treated at the Royal
Free Hospital, where doctors describe his situation as "stable." It
has been confirmed that the man had recently been travelling in Nigeria.

Lassa fever is endemic in parts of Africa, where it is spread in the
droppings of infected [multimammate] rats. Although 80 percent of
cases produce no symptoms, the remainder develop a severe
multi-system disease affecting several organs in the body, such as
the liver, spleen and kidneys. The onset of the disease is gradual.
The Health Protection Agency (HPA) are stressing that this is an
isolated case and there is no risk to the general public.

The patient in question returned to the UK on 6 Jan 2009 and was
admitted to the Homerton University Hospital 2 days later. Doctors
moved him to the Hospital for Tropical Diseases, University College
Hospital on Thursday [?14 Jan 2009], where he was diagnosed as having
Lassa fever. Once that discovery was made he was quickly transported
to Royal Free Hospital where experts could provide the appropriate treatment.

Dr Dilys Morgan, from the HPA, said, "The infection is not easily
spread to others and then only by direct contact with bodily fluids.
The usual incubation period for Lassa fever is 7-10 days. We are
working closely with Homerton University Hospital and the Hospital
for Tropical Diseases, University College Hospital to identify any
members of staff who may have been involved in the care of this
patient, and who came into contact with their bodily fluids. These
people will be provided with information about Lassa fever and asked
to get in contact with us should they develop any symptoms. Patients
and visitors to the hospital are not at risk."

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[This report supplements the preceding report with the dates of
transfer of the patient and the identity of the hospitals concerned.
Detailed information regarding Lassa fever can be obtained from the
World Health Organisation Web site at:
<http://www.who.int/mediacentre/factshee ... index.html>. - Mod.CP].

PLAGUE, FATAL - ALGERIA (03): UNCONFIRMED
*****************************************
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: Sun 25 Jan 2009
From: Martin Dirksen-Fischer <MartinDirksenFischer@gmx.de>


An article [<http://www.echoroukonline.com/eng/algeria/4667.html>]
from Echorouk News (the paper that published the article about the
plague outbreak a couple of days ago) quotes the leader of the
Salafist Group of Preaching and Combat (GSPC) named Droudkel. He
denies the plague rumor.

--
Dr Martin Dirksen-Fischer
Public Health Officer
Grindelberg
Germany
<MartinDirksenFischer@gmx.de>

[ProMED-mail thanks Dr Dirksen-Fischer for his contribution. There
may have been political motivation behind the original newswire and
the information may well have been false. - Mod.LL]