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MENINGITIS, BACTERIAL - AFRICA (02): NIGERIA, WHO MENINGITIS REGION
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[1] Nigeria
[2] Africa: WHO Meningitis Region

******
[1]
Date: Thu 12 Mar 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/ar ... fZI38jb5vg>


A meningitis outbreak has killed 931 people [with a total of 13 516
cases affected] in 4 West African countries since January [2009],
with most deaths occurring in the continent's most populous nation
Nigeria, the United Nations said Wednesday [11 Mar 2009]. "Nigeria is
the most affected with 9086 cases and 562 deaths. Niger reports 2620
cases and 113 deaths. Burkina Faso reports 1756 cases and 250 deaths.
Mali reports 54 cases and 6 deaths."

UNICEF warned that the authorities in Nigeria, where public health
facilities are abysmal and poverty rampant despite its huge oil
riches, faced an uphill task in tackling the crisis. "In Nigeria,
case management and a mass vaccination campaign are underway. The
stock of vaccine may be insufficient regarding the epidemiological
trends, especially in the districts in the north," it warned.

Health authorities placed northern Nigeria on a state of high alert
in January [2009] following a meningitis outbreak in the town of
Zinder in neighbouring Niger. Nigeria's largest northern state of
Kano has been the worst hit thus far.

Meningitis causes inflammation of the lining of the brain and spinal
cord and has long wracked Africa, the world's poorest region.
According to UNICEF, it can spread through sneezing and coughing. The
disease mainly affects children and young adults aged 1-30, it said.
"The so-called African meningitis belt stretches from Mauritania in
the west to Ethiopia in the east and is home to about 350 million
people," UNICEF said. "Outbreaks occur every year between December
and May. The dry season, with strong dusty winds and cold nights make
people more prone to respiratory infections and facilitates the
spread of bacteria."

The biggest recorded outbreak of epidemic meningitis in Africa
occurred in 1996 with over 250 000 cases and 25 000 deaths. Even when
the disease is diagnosed early, 5 to 10 percent of patients die,
typically within one or 2 days of the onset of symptoms, according to
the World Health Organisation. Most victims suffer irreversible
neurological consequences.

The current WHO recommendation for outbreak control is to mass
vaccinate every district in an epidemic phase, as well as nearby
areas in alert phase. It estimates that a mass immunisation campaign
can avoid 70 percent of cases. Outbreak response also includes active
surveillance and case management and support to community awareness programmes.

Once the disease is contracted, it can be treated in its early stages
with antibiotics. WHO recommends oily chloramphenicol as the drug of
choice in areas with limited health facilities.

UNICEF said mass vaccination drives were currently underway in Niger
and Burkina Faso.

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

******
[2] Africa: WHO Meningitis Region
Date: Wed 11 Mar 2009
Source: WHO MDSC (Multidisease Surveillance Centre) Meningitis Weekly
Bulletin Week 08 2009 [edited]
<http://www.who.int/csr/disease/meningoc ... 009_S8.pdf>


Table 1: Epidemiological Situation Week 8 (16-22 Feb 2009)
Country / Case / Death / Lethality (percent) / District in alert /
District in epidemic / Complet (percent) / NmA / NmW135 / Other Nm /
Pneum / Hib
Benin / 11 / 0 / 0.0 / 0 / 0 / 98.7 / 0 / 0 / 0 / 3 / 0
Burkina Faso / 266 / 35 / 13.2 / 4 / 1 / 100.0
Cameroon / - / - / - / - / - / - / - / - / - / - / -
Central African Rep / - / - / - / - / - / - / - / - / - / - / -
Cote d'Ivoire / 7 / 0 / 0.0 / 0 / 0 / 86.0 / - / - / - / - / -
Ethiopia / - / - / - / - / - / - / - / - / - / - / -
Ghana / - / - / - / - / - / - / - / - / - / - / -
Guinea / - / - / - / - / - / - / - / - / - / - / -
Mali / - / - / - / - / - / - / - / - / - / - / -
Niger / 621 / 21 / 3.4 / 7 / / 6 / 100.0
Nigeria / 1817 105 / 5.8 / 29 / / 28 / 70.8 / 37 / 7 / 0 / 2 / 0
Congo DR** / - / - / - / - / - / - / - / - / - / - / -
Chad / 25 / 4 / 16.0 / 0 / 0 / 92.9 / - / - / - / - / -
Togo / 12 / 0 / 0.0 / 0 / 0 / 100.0 / - / - / - / - / -
Total / 2759 / 165 / 6.0 / 40 / 35 / 59.6 / 37 / 7 / 0 / 5 / 0
* identification by: PCR, latex, culture
** definition of alert/epidemic thresholds not applicable to this
country outside the meningitis belt.

Comments
--------
Burkina Faso:
- district in alert: Toma, Titao, and Ziniare
- district in epidemic: Solenzo
Niger:
- district in alert: Gaya, Loga, Guidan-Roumdji, Magaria, Mirriah,
Keita, and Zinder
- district in epidemic: Bilma, Dogon-Doutchi, illela, Matameye
Madarounfa, and Tessaoua
Nigeria: 28 LGAs [local government areas] in epidemic and 29 LGAs in
alert (see details on page 3 of the original at the source URL). The
7 cases of NmW135 have been isolated in Adamawa State where no LGA
reached alert or epidemic threshold as of week 8 [16-22 Feb 2009]

Table 2. Synthesis of the Epidemiological Situation 2009 (reported weeks 1-8)
Country / Case / Death / Lethality (percent) / District in alert /
District in epidemic / Reported weeks / In districts (percent) / In
weeks (percent)
Benin / 109 / 15 / 13.8 / 1 / 0 / 01-08 / 98.7 / 100.0
Burkina Faso / 1514 / 213 / 14.1 / 7 / 3 / 01-08 / 100.0 / 100.0
Cameroon / - / - / - / - / - / - / - / -
Central African Rep / 41 / 17 / 41.5 / 1 / 0 / 01-07 / 100.0 / 100.0
Cote d'Ivoire / 120 / 27 / 22.5 / 0 / 0 / 01-08 / 90.0 / 90.0
Ethiopia / 32 / 6 / 18.8 / 0 / 0 / 01-07 / -
Ghana / 61 / 13 / 21.3 / 0 / 0 / 01-06 / - / -
Guinea / - / - / - / - / - / - / - / -
Mali / 31 / 2 / 6.5 / 0 / 0 / 01-04 / 100.0 / 100.0
Niger / 1897 / 84 / 4.4 / 6 / 7 / 01-08 / 100.0 / 100.0
Nigeria / 5323 / 333 / 6.3 / 37 / 52 / 01-08 / 70.8 / 99.9
Congo DR **/ - / - / - / - / - / - / - / -
Chad / 259 / 33 / 12.7 / 2 / 0 / 01-08 / 108.9 / 95.9
Togo / 105 / 16 / 15.2 / 1 0 / 01-08 / 100.0 / 99.3
Total / 9492 / 759 / 8.0 / 55 / 62 / 01-08 / 65.0 / 99.5
** definition of alert/epidemic thresholds not applicable to this
country outside the meningitis belt

Comments
--------
The epidemic trend is on the rise in Nigeria and Niger. The ascending
trend of the epidemic curve is still above those of 2007 and 2008. As
opposed to 2008 where the epidemic was located in northern West of
Nigeria, the epidemic of 2009 is mainly located in the Northern
Central region with eastward extension. The case fatality rates are
however low in the 2 countries. If in Niger the vaccine is still
available, in Nigeria, the 1st supplies of vaccines have just arrived
this week 8 [16-22 Feb 2009]. WHO missions are on the ground in
Nigeria to support local authorities.

--
Communicated by:
Dr Mandy Kader Konde
Director
WHO-Multidisease Surveillance Center (MDSC)
WHO-Meningitis Vaccine Project (MVP) Focal Point
1473 Avenue Naba Zombre, 01 BP 549 Ouagadougou 01
Burkina Faso
<kondek@oncho.afro.who.int>

[ProMED-mail thanks Dr Kader Konde of the WHO Multidisease
Surveillance Centre (MDSC) in Ouagadougou (Burkina Faso) for alerting
ProMED to the latest WHO data on bacterial meningitis in countries
under enhanced surveillance of meningitis in the WHO Africa Region.

The meningococcal meningitis epidemic in Nigeria and Niger continues
to expand, but the 1st supplies of meningococcal vaccines have just
arrived in Nigeria in week 8 (16-22 Feb) of 2009. The serogroups
covered by the meningococcal vaccine are not specified in the reports
above; in Nigeria, both serogroup A and W135 are involved.

Table 1 above is a summary of the reports on cerebrospinal meningitis
received by country for week 8 of 2009. Table 2 above is a summary of
the reports received on meningitis activity by country for weeks 1-8 of 2009.

The HealthMap/ProMED-mail interactive map of Nigeria is available at
<http://healthmap.org/promed/en?v=9.6,6.1,6>.
A map of the African bacterial meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>. - Mod.ML]

DENGUE/DHF UPDATE 2009 (12)
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******
Cote d'Ivoire (Elfenbeinküste)
Date: Fri 13 Mar 2009
Source: World Health Organization Weekly
Epidemiological Record No. 11/12 [edited]
<http://www.who.int/wer/2009/wer8411_12.pdf>


An alert was issued following the diagnosis of an
acute infection caused by dengue virus 3 (DENV3)
in one Japanese tourist and one French
expatriate, both of whom were hospitalized (in
Tokyo and Marseille, respectively) upon their
return from Abidjan; their visits occurred
between May and July 2008. The virus isolate was
similar to the DENV-3 genotype that had been
circulating in Saudi Arabia in 2004.
Additionally, the Centre National de Reference
des Arbovirus in Paris also identified positive
anti-dengue immunoglobulin M (IgM) in 7 of 14
specimens collected from suspected dengue cases
occurring in travellers returning from Abidjan
between 1 May 2008 and 31 Aug 2008. Further
analysis by reverse-transcriptase polymerase
chain reaction (RT-PCR) identified additional
cases who were positive for DENV-3.

In 2008, reports from the Institut de Veille
Sanitaire in Paris also identified a sharp
increase in imported cases of dengue in
travellers returning from Cote d’Ivoire; of 12
cases reported between 1 Jan 2006 and 31 Aug
2008, 8 were reported in 2008, 3 in 2007 and one
in 2006. In 2008, Cote d’Ivoire was faced with
the co-circulation of yellow fever virus and
DENV-3 in Abidjan city and the surrounding
suburban areas. This raises questions of whether
there was an urban transmission cycle for dengue
in Abidjan and whether it was caused by an
emerging serotype since DENV-3 has never been
reported in west Africa. To better assess the
extent of the epidemic and the risk of dengue in
Abidjan, a team from WHO and the Ministry of
Health followed up with an investigation in
Abidjan during 2­16 Sep 2008. The yellow fever
surveillance system helped the follow-up team to
obtain specimens from humans, mosquitoes and
monkeys. The investigation team also collected
mosquito and serum specimens from around the
residences of confirmed dengue cases (where this
information was available) and established an
active case-finding system in health-care centres
in districts reporting confirmed cases of yellow fever.

The surveillance systems established in
health-care centres by the Ministry of Health
identified many cases of suspected classical
dengue but did not detect any severe cases or
deaths. However, specimens were not collected and
laboratory diagnosis was not available. DENV-3
was confirmed by RT-PCR in 2 specimens collected
as part of routine surveillance during week 19 (1
from Cocody Bingerville and 1 from Adzope). The
vector and larval indices were high and above the
threshold of 5 percent in these areas.

Additionally, a sylvatic transmission cycle has
been documented in west Africa, where DENV-2 has
been found circulating among _Erythrocebus patas_
monkeys and various sylvatic _Aedes_ species,
including _Ae. taylori_, _Ae. furcifer_, and _Ae. luteocephalus_.

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

[Although this report mainly focuses on past
dengue cases in Cote d'Ivoire, since information
about dengue cases coming out of West Africa is
so little, it is valuable to know what has been
going on in the recent past. It would be of
interest to know if dengue virus can be
maintained in wild primates and the _Aedes_
species mentioned above, alone, in the absence of
human cases. A HealthMap/Promed-mail interactive
map of the Cote d'Ivoire can be accessed at
<http://healthmap.org/promed/en?v=7.6,-5,5>. - Mod.TY]

RABIES, CANINE, HUMAN - ANGOLA (06): (LUANDA)
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Date: Fri 13 Mar 2009
From: Ellicott McConnell
<eck@intercom.net>


A comment
---------
I don't know whether or not it is of importance in the recent
outbreak in Angola, but in many parts of the developing world there
are a number of often bizarre "remedies" for rabies. It is my
understanding that only about half of rabid dogs shed the virus from
the salivary glands. Thus, half the time the remedies "work," not a
bad average for home remedies, so their use persists. Unfortunately,
by the time the failures get to valid medical assistance, it's too late!

--
Ellicott McConnell, Ph.D.
<eck@intercom.net>

Angola - Tollwut
16.03.2009

Der Tollwut-Ausbruch in der Hauptstadt Luanda hält weiter an. Bis Mitte Februar sind bisher 93 Personen an der Tollwut verstorben. Bei der Mehrzahl handelt es sich um Jungen die von streunenden Hunden gebissen worden sind. Die Regierung startete im Januar eine großangelegte Aktion zur Impfung bzw. Keulung von Hunden in Luanda. Bei entsprechenden Kontakten sofort einen Arzt aufsuchen, bei vorhersehbarem Risiko und längerem Aufenthalt wird eine vorbeugende Impfung empfohlen. / Quelle: crm
______________________________

Südafrika - Darminfektionen
16.03.2009

Risiko für Durchfallerkrankungen landesweit. Cholera: Aus dem Nachbarland Simbabwe wurde Cholera Anfang Dezember importiert. Die meisten der bisher über 12.000 Erkrankungen und 59 Todesfälle traten in Limpopo und Mpumalanga auf; auch Kwazulu-Natal, Western Cape und Gauteng sind betroffen. Aktuell ist die Zahl der wöchentlichen Neuinfektionen wieder rückläufig. Hygiene beachten. Das Risiko für Reisende ist gering. / Quelle: crm

Namibia - Schon 25 Malariatote im Norden
19.03.2009 - AZ online

Personen und Vorräte werden von Ondangwa in Krisengebiete geflogen
Fast 8000 Menschen sind bereits an Malaria erkrankt und einige an der gefürchteten Krankheit gestorben. Hubschrauber brachten auch gestern wieder Nahrungsmittel in entlegene Gebiete. In Zeltlagern müssen sich die Familien selbst versorgen ... mehr

Gruß
Birgitt

LASSA FEVER - NIGERIA (07)
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Date: Thu 19 Mar 2009
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/200903170204.html>


More than 55 persons have died so far from the Lassa fever epidemic
between January 2008 and February 2009, out of the over 390 patients
admitted as a result of the illness. More than 51 million Nigerians
are at risk, with the annual number of illnesses estimated at 3
million and with the number of deaths estimated at about 58 330.

This disclosure came as the Guild of Medical Directors yesterday [18
Mar 2009] in Abuja demanded an adequate supply of Ribavirin (the
antiviral drug for the treatment of Lassa fever) in the Federal
Capital Territory (FCT) and its environs. Chief Medical Director of
the Irrua Specialist Teaching Hospital, Irrua Edo State, Prof. George
Akpede, made the disclosure yesterday on the occasion of the
commissioning of the Lassa Fever Diagnostic and Research Laboratory,
Institute of Lassa Fever Research and Control at the Irrua
Specialists Teaching Hospital, Irrua, Edo State. He said the Lassa
fever epidemic was no longer limited to some states as it was thought
but had assumed virtually a country-wide dimension.

The outbreak of Lassa fever has been confirmed in the FCT and its
environs, and out of the 12 cases reported since February [2009], 5
patients have died.

Meanwhile, in a presentation on Lassa fever during the monthly
meeting of the Abuja Chapter of the Guild, the National President, Dr
Charles Cudjoe, called for more rapid diagnostic test centres for
Lassa fever. "The Guild did a survey at the outbreak of this disease,
and, disturbingly, we discovered that there was not enough Ribavirin.
We discovered that the drug that is in stock in some pharmaceutical
stores would expire this month [March 2009]. That is a bit of a
problem, because we need to tackle this as quickly as possible. All
hands must be on deck to import these drugs from the companies that
make them. Even if the epidemic does not expand, we should be able to
handle the few cases that come in," he said.

The News Agency of Nigeria (NAN) discovered that a pack of 45 tablets
of Ribavirin 400 mg is sold for 115 pounds sterling [USD 167] in the
UK, while 84 tablets of the same drug went for 274 pounds sterling
[USD 398]. A survey had shown that Roche and Swipha are the 2
companies that manufacture this drug. In Abuja, 45 tablets of
Ribavirin 400 mg went for Naira 25 000 [USD 169] for a stock that is
due to expire this month [March 2009], while the cost for the same
drug with a later expiration date is about Naira 120 000 [USD 807].
Cudjoe expressed reservation over the handling of the epidemic that
was 1st discovered in the town of Lassa in Borno.

--
Communicated by:
ProMED-mail Rapporteur A-Lan Banks

[Since January 2008, Lassa fever virus infection has affected more
than 390 people and been responsible for 55 deaths in Nigeria. Since
February 2009, there have been 12 additional cases and 5 deaths in
the proximity of the Federal Capital Territory. From these figures,
it is difficult to predict the future course of the epidemic.

Ribavirin is an anti-viral drug indicated for severe respiratory
syncytial virus infections (individually), hepatitis C infection
(used in conjunction with peginterferon alfa-2b) and other viral
infections. It has been used successfully in hospitals in the
treatment of Lassa fever virus infection. Ribavirin is a prodrug,
which, when metabolized, resembles purine RNA nucleotides. In this
form, it interferes with RNA metabolism required for viral
replication. How it exactly affects viral replication is unknown.
Multiple mechanisms may be responsible for its actions. The primary
observed serious adverse side-effect of Ribavirin is hemolytic
anemia. Ribavirin is also a teratogen in some animal species and thus
poses a theoretical reproductive risk in humans, remaining a hazard
as long as the drug is present, which can be as long as 6 months
after a course of the drug has ended (see:
<http://en.wikipedia.org/wiki/Ribavirin>).

The HealthMap/ProMED-mail interactive map of Nigeria is available at
<http://healthmap.org/promed/en?v=9.6,6.1,6>.
- Mod.CP]

Namibia - Tollwut
23.03.2009

In Swakopmund wurde ein Mann von einem tollwütigem Schakal gebissen. Eine Postexpositionsprophylaxe wurde eingeleitet. Bereits im Februar wurden aus der Hauptstadt Windhoek eine ungewöhnliche Häufung von Tollwut-Fällen bei Hunden gemeldet. Nach Angaben des veterinärmedizinischen Instituts erkrankten in den letzten Wochen fast 50 Hunde an der Tollwut. Eine groß angelegte Impfkampagne wurde eingeleitet. Nach verdächtigen Tierkontakten ist sofort ein Arzt aufzusuchen. Da eine adäquate postexpositionelle Versorgung in Afrika nicht immer gewährleistet ist, sollten Risiko-Reisende prophylaktisch geimpft sein. / Quelle: crm

Namibia - Malaria
23.03.2009

Während der Regenzeit, die im November beginnt und bis April/Mai andauert, muss in den ausgewiesenen Malariagebieten mit einem zunehmenden Übertragungsrisiko gerechnet werden. Im Norden des Landes kam es aufgrund der starken Regenfälle der letzten Wochen zu fast 8.000 Malariaerkrankungen und 25 Todesfällen. Malaria-Chemoprophylaxe und Schutz vor nachtaktiven Stechmücken beachten. / Quelle: crm

Meningitis kills over 1,100 West Africans - WHO

GENEVA, March 27 (Reuters) - One third of the world's stockpiled meningitis vaccine doses have been dispatched to West Africa where an outbreak has killed more than 1,100 people since January, the World Health Organisation (WHO) said on Friday.
mehr....

Quelle:af.reuters.com

€4.7 million to fight meningitis epidemic in Niger and Nigeria

The Commission has responded rapidly to the major meningitis epidemic affecting Nigeria and Niger, allocating €4.7 million to support efforts to contain the epidemic and treat those affected. The outbreak has already claimed more than 1,800 lives in the region The number of declared cases is estimated at more than 32,000, (22,500 in Nigeria and 5 700 in Niger). It is feared that the situation will worsen in the coming weeks as the epidemic season is just beginning. The number of cases in Nigeria and Niger are high enough for the outbreak to be considered a major epidemic....mehr...
Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.


Quelle:European Commission Humanitarian Aid department (ECHO)

Kinderlähmung breitet sich in Afrika aus

Die weitgehend eingedämmt geglaubte Kinderlähmung ist in Afrika wieder auf dem Vormarsch. Seit vergangenem Jahr habe sie sich von Nigeria und vom südlichen Sudan aus ausgebreitet, teilte das Internationale Komitee vom Roten Kreuz (IKRK) am Mittwoch in Genf mit. mehr...

Grüsse
Alexander

IRIN hat geschrieben:BURKINA FASO: Meningitis - fewer cases, but more deadly

OUAGADOUGOU, 7 April 2009 (IRIN) - Though Burkina Faso has half as many meningitis infections as of 22 March than in the same period last year, the mortality rate is higher. More than 13 percent of the 2,760 infected people have died in 2009, versus the fewer than 10 percent of 6,604 who died last year, according to the Ministry of Health.

The UN World Health Organization (WHO) defines successful epidemic control as keeping the mortality rate below 10 percent.

"We have had a higher mortality rate because the majority of the infections [this year] have been caused by [the bacteria] pneumococcus, for which there is no vaccine," Ousmane Badolo, chief epidemiologist for meningitis control at the Ministry of Health, told IRIN.

Though vaccines are available in rich countries for diseases caused by this bacteria - which commonly show up in Africa as pneumonia and meningitis - vaccine development has lagged in developing countries. WHO in 2008 approved a pneumococcal vaccine that The Global Alliance for Vaccines and Immunization (GAVI) is expected to introduce later this year in The Gambia and Rwanda.

When asked how Burkina Faso has been able thus far to limit the meningitis outbreak as compared to Nigeria and Niger, which have together reported almost 30,000 infections according to the European Commission's Humanitarian Aid Department (ECHO), Badolo said each country goes through cycles. "Two years ago it was bad in Burkina [Faso] when it was calm in Niger."

The mortality rate in Nigeria and Niger thus far in 2009 is about five percent, according to WHO.

Badolo told IRIN health workers have conducted vaccination campaigns in Burkina Faso the past three years for the types of meningitis that can be prevented - even if only short-term. The vaccine currently available in Africa offers protection for at most five years against four strains of meningitis.

Burkina Faso turned to the WHO-administrated free emergency meningitis vaccine stock in 2001, 2006, 2007 and 2008.

The Health Ministry's Badolo said a vaccination campaign has begun in the central district Zignaré, which was placed on alert because it has at least five infections per 100,000 residents. He added the infection there is caused by the "A" bacteria strain for which the country has more than one million vaccines.

Burkina Faso is expected to be the first country in the world's highest-risk meningitis zone to start a mass vaccination campaign later this year with a new vaccine promising long-term protection against the most common form of meningitis in Africa - strain "A".

But in the country's northern Titao district, home of this year's deadly pneumococcus infections, Badolo said health workers can only treat patients with antibiotics and "hope for the best".

Even with early diagnosis and treatment up to 10 percent of meningitis patients die, according to WHO.

http://m.irinnews.org


Grüsse
Alexander

Meningococcal Disease: situation in the African Meningitis Belt
25.03.2009 - WHO

During the first 11 weeks of 2009 (January 1- March 15), a total of 24 868 suspected cases, including 1 513 deaths (1), have been reported to WHO by countries of the meningitis belt. More than 85% of the cases have occurred in one epidemic foci, encompassing Northern Nigeria and Niger (see below) and are characterized by the predominance of Neisseria meningitidis (Nm) serogroup A.
Niger

The Ministry of Health of Niger has reported 4 513 suspected cases of meningococcal disease including 169 deaths (case-fatality rate of 3.7%) from January 1 to March 15 2009. So far 20 of Niger's 42 districts have crossed the alert or the epidemic threshold. In the last week alone, 1 071 suspected cases including 30 deaths (case-fatality rate of 2.8%) have been reported, with 10 districts crossing the epidemic threshold, and 10 the alert threshold.

Cerebrospinal fluid specimens tested by PCR and/or culture positive have confirmed the large predominance of Neisseria meningitidis serogroup A.
Nigeria

The Ministry of Health of Nigeria has reported 17 462 suspected cases of meningococcal disease, including 960 deaths, (case-fatality-rate of 5.5% from January 1 to March 15). In the last week alone, 4 164 suspected cases with 171 deaths were reported, with 66 Local Government Area's (LGAs) having crossed the epidemic threshold while 30 had crossed the alert threshold. Cases originate from 16 Northern states, with states of the North East (Bauchi, Gombe and Yobe) being the most affected in the final week of the period. As in the preceding weeks, Katsina and Jigawa states are seriously affected as well.

Cerebrospinal fluid specimens have tested positive for Neisseria meningitidis serogroup A by latex test and/or culture. Mass vaccination has been implemented by the Federal Ministry of the Health, with the support of Médecins sans Frontières, UNICEF and WHO. Although vaccination strategy across the states varies, WHO has made recommendations to standardize vaccine strategy and the rational use of vaccine.
WHO support

WHO is supporting the Nigerian Federal and National Ministry of Health to strengthen disease surveillance, laboratory diagnosis, case management and in defining adapted vaccination strategies. Technical experts from WHO have been supporting the Federal Ministry of Health in Nigeria since mid February 2009.

The International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control (ICG) have released 2.3 million doses of polysaccharide vaccines to Nigeria and 1.9 million doses of vaccine to Niger. (ICG partners include WHO, International Federation of Red Cross and Red Crescent Societies, United Nations Children Fund, Médecins sans Frontières). The stockpile of the ICG for this epidemic season was set at 12.97 million doses. The emergency stockpile has been established with the support of Global Alliance for Vaccines and Immunization (GAVI) and EU Humanitarian Aid Office (ECHO). (1) Data for week 11 for Burkina Faso, Niger and Nigeria only. However other countries are reporting less than 50 cases a week so far.

(1) Data for week 11 for Burkina Faso, Niger and Nigeria only. However other countries are reporting less than 50 cases a week so far.

Vorsicht vor Malaria
Höhepunkt der Erkrankungen Ende des Monats erwartet – Prophylaxe ratsam
06.04.2009 - AZ online

Die Zahl der Malariaerkrankungen in den Hochwassergebieten wird bis Ende des Monats noch ansteigen. Ärzte raten Reisenden, die den Norden besuchen, eine Prophylaxe zu nehmen. Die Möglichkeit, dass infizierte Moskitos in zentrale Gebiete gebracht werden, ist nicht ausgeschlossen ... mehr

Gruß
Birgitt

Mosambik - Darminfektionen
06.04.2009

Risiko für Durchfallerkrankungen landesweit. Der aktuelle Cholera-Ausbruch hält weiterhin mit unveränderter Intensität an. Dieses Jahr wurden bisher 13.000 Erkrankungen und 140 Todesfälle gemeldet. Hygiene beachten, Risikoreisende sollten geimpft sein. / Quelle: crm