Wüstenschiff

Tschad - Polio
15.06.2010

Polio, zuvor bereits ausgerottet, wurde seit 2003 aus dem benachbarten Nigeria mehrfach importiert. 2007 waren es nach einem vorübergehenden Rückgang wieder 22 Erkrankungen durch Wildvirus Typ 1 und 3 in verschiedenen Landesteilen. 2008 wurden 37 Fälle gemeldet. 2009 erkrankten insgesamt 66 Menschen an Polio. Seit Beginn des Jahres wurden 14 Fälle gemeldet. Hygiene und Impfschutz (Polio) beachten. / Quelle: crm

Suspected Acute Haemorrhagic Fever in the Republic of the Congo
29.06.2010 - WHO

WHO has received preliminary reports of five suspected cases, including three deaths, with acute haemorrhagic fever from Mokouangonda, an isolated forest village of about 100 inhabitants in Mokoke district, Region of Sangha, in northern Republic of the Congo (Brazzaville).

The three deaths were among male forest hunters from Mokouangonda who presented similar symptoms of epistaxis (nose bleeds), bloody diarrhoea, cough and fever prior to deaths after a 1-2 week long hunting expedition in the Odzala National Park.

A joint Ministry of Health (MoH) and WHO team is currently in the field to assess the situation and to collect clinical samples for diagnosis. These will be tested by the Centre International de Recherches Médicales de Franceville (CIRMF) Gabon, and Institut National de Recherche Biomédicale à Kinshasa, DRC.

A Regional Coordination Committee to contain the outbreak has been established in Ouesso, Sangha Region, under the Direction Générale de la Santé, assisted by WHO and other international partners including Wildlife Conservation Society (WCS) in Congo and Museum National d'Histoire Naturelle in France. Measures to respond to the disease outbreak including epidemiological investigation, social mobilization and infection control are being implemented in the area.

DENGUE/DHF UPDATE 2010 (31)
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******
Cape Verde
Date: Sat 26 Jun 2010
Source: Afrique en ligne [in French, trans. Corr.SB., edited]
<http://www.afriquejet.com/afrique-de-l% ... 51785.html>


The government in the Cap Verde Islands has decided to allow absences
on Friday [2 Jul 2010] of officials and workers in the private sector
to enable them to participate in the national health campaign designed
to eliminate sources of mosquitoes to prevent the emergence of a new
epidemic of dengue in the archipelago, said official sources to PANA
[news agency] in Praia.

In 2009, Cape Verde had registered for the 1st time an epidemic of
dengue fever, which had killed 4 people out of a total of 21 304
cases. According to statistics compiled by health authorities this
year [2010], 305 cases of dengue have been reported, especially in the
islands of Fogo (161) and Santiago (115), without cases of hemorrhagic
disease or fatalities.

Announcing the launch of this campaign, the Cape Verde Minister of
Health, Basilio Ramos, revealed, after the completion of 2
entomological studies to assess the levels of infestation, that the
country's sanitation "was poor," hence the government's wish to
strengthen the risk-preventive measures. In this context, the
government, to prevent the situation from last year [2009] repeating
itself, raised awareness among populations about mosquito control.
Next Monday [28 Jun 2010], another campaign will commence spraying
houses and community structures in the islands at high risk, including
Santiago, Fogo and Maio.

The campaign on Friday [25 Jun 2010] called "Clean Cape Verde," will
be coordinated by the city councils of each district; however, the
government hopes for the involvement of the entire population, given
the risk of outbreaks of diseases transmitted by mosquitoes, such as
dengue, yellow fever and malaria, (which will occur) if the sanitation
of the country is not improved.

The Health Minister has given assurance, however, that unlike last
year [2009], when health authorities did not know how to respond to
dengue, Cape Verde is now prepared to face any outbreak of disease.
"We have a contingency plan, and health facilities will follow what is
already planned, and we are working to ensure that the situation does
not repeat itself," said Basilio Ramos, who warned that the greatest
challenge to prevent a new epidemic "will always be prevention."

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

[A HealthMap/ProMED-mail interactive map showing the location of Cape
Verde off of the coast of West Africa can be accessed at
<http://healthmap.org/r/00Xw>. - Mod.TY]

UNDIAGNOSED DISEASE - DEMOCRATIC REPUBLIC OF CONGO: (EQUATEUR) REQUEST FOR
INFORMATION
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Date: Sat 26 Jun 2010
Source: AfriScoop.com, Xinhua News Agency report [in French, trans., edited]
<http://www.afriscoop.net/journal/spip.php?breve3091>


Undiagnosed disease kills at least 15 in one week
-------------------------------------------------
According to local sources on Friday [25 Jun 2010], since the beginning of
this week [20 Jun 2010], some 20 cases and at least 15 deaths of an
unidentified disease have been reported in Songo, which is located 12 km
[7.5 mi] from Basankusu, the main town in the district of Equateur,
Equateur province, Democratic Republic of Congo. Sources from the Equateur
health district in Basankusu indicated that the disease is manifested by
fever, headache, abdominal cramps, and vomiting, without additional comment
for reasons of confidentiality.

Currently, the hospital in Songo is treating 6 cases, 2 of whom are
children under 10 years of age. Other cases have sought refuge in local
churches believing that cause of the illness is witchcraft because of the
rapidity of death of the victims. Boniface Awenze, the Equateur District
commissioner stated, however, that medical teams had been dispatched to the
area to investigate the situation. "We are adopting 2 approaches. The 1st
is a legal approach to investigate the allegations of witchcraft, and the
2nd is to mobilize a medical team comprising the area medical officer and
the nurses in the area already treating the patients to carry out the
medical investigation and determine whether it is an epidemic." He added
that until the investigation has been completed, people should observe the
advice of the medical team now deployed in the field in order to prevent
the spread of the disease to other localities.

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

[Further information from the area would be appreciated. The description of
the illness does not allow a diagnosis, but suggests that it is not an
outbreak of the hemorrhagic fevers which have afflicted this region in the
past.

A map of the Democratic Republic of Congo, showing the location of Equateur
province can be accessed at
<http://www.mapsofworld.com/democratic-r ... al-map.jpg>.
The HealthMap/ProMED-mail interactive map of the Congo DR can be accessed
at <http://healthmap.org/r/01Cq>. - Mod.CP]

Suspected Acute Haemorrhagic Fever in the Republic of the Congo update
02.07.2010 - WHO

Blood samples taken from one of the suspected cases in Sangha Region, Republic of Congo, tested negative for several viral haemorrhagic fevers (Ebola, Marburg, CCHF, Arenavirus). Additional laboratory investigations are ongoing. The tests were carried out by the Centre International de Recherches Médicales de Franceville (CIRMF) in Gabon. Samples from the other three suspected fatal cases could not be obtained .

The negative laboratory findings from this suspected case do not exclude that an acute haemorrhagic fever outbreak has occurred, or is still ongoing. The Ministry of Health, WHO and other partners continue to strengthen surveillance activities in humans and the wild life sector, and to implement control measures including active case search, infection control, and social mobilization.

More than 40 people who have had direct contact with the suspected cases will continue to be monitored for a period of 21 days from the last date of their exposure (19 June).

DENGUE - ITALY ex TANZANIA
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Date: Fri 9 Jul 2010
From: Giuseppe Ippolito [edited]
<giuseppe.ippolito@inmi.it>


A case of dengue-3 [virus] infection was recently diagnosed at the
Spallanzani National Institute for Infectious Diseases in Rome,
Italy. A traveller who had returned from Zanzibar on 24 Jun 2010,
Tanzania, developed symptoms 3 days later and was admitted to the
tropical diseases ward (Director: Pasquale Narciso).

Virologists of the Institute (Maria Rosaria Capobianchi and Antonino
DiCaro) were able to detect the virus by RT-PCR in a serum sample
collected on 30 Jun [2010]; the Dengue [virus] serotype was confirmed
by sequencing of the NS5 gene. E gene sequencing is ongoing, for
further molecular characterization.

This finding confirms previous PROMED-mail postings reporting the
existence of dengue infection in Tanzania, and in Zanzibar in
particular (ProMED Archive number 20100517.1620), and supports the
hypothesis that Dengue-3 [virus] is circulating in Africa (Franco L.
et al, Recent expansion of Dengue virus serotype 3 in West Africa,
Euro-surveill. 2010;15:19490).

--
Giuseppe Ippolito MD
Scientific Director
National Institute for
Infectious Diseases Lazzaro Spallanzani
Via Portuense, 29200149 Rome
Italy

[ProMED thanks Dr. Ippolito for this 1st-hand report. As he points
out, this provides addition evidence for the ongoing circulation of
dengue virus-3 in Tanzania. ProMED receives only sporadic reports on
dengue virus transmission in Africa, suggesting that these types of
reports represent the tip of a very large dengue virus African
iceberg. ProMED archive number 20100517.1620 reported 17 dengue cases
in Dar es Salaam, Tanzania on 15 May 2010. On 9 Feb 2010 and 10 Mar
2010, 2 imported dengue virus-3 cases from Tanzania were confirmed in
Japan (see ProMED archive no. 20100323.0922).

A HealthMap/ProMED-mail interactive map showing the location of
Tanzania in East Africa can be accessed at
<http://healthmap.org/promed/en?v=-6,35,5>. - Mod.TY]

Yellow feverin the Democratic Republic of the Congo
19.07.2010 - WHO

On 25 June 2010, Medecins sans Frontieres (MSF) reported a suspected case of Yellow fever in Titule, Base Ouele district of Orientale province (northern part of the country). Between March and June, 11 other suspected cases were reported, including two deaths.

The index case was identified as a 43 year-old male farmer who presented with clinical symptoms of fever, jaundice and haematuria (blood in urine). The onset date of his illness was 15 March 2010 and he died a few days later. He had no history of yellow fever vaccination. Laboratory tests conducted by the Institut National de Recherche Médicale (INRB) in Kinshasa showed IgM positive by ELISA test and was confirmed by the regional reference laboratory for yellow fever at the Institut Pasteur in Dakar, Senegal with more specific tests (plaque reduction neutralization test or PRNT).

Following identification of the index case (the 43 year old male), an investigation is being conducted in the town inhabited by some 17,000 people for the purpose of determining the scope of the outbreak response and prepare for emergency vaccination.

The Democratic Republic of Congo (DRC) is among Africa's yellow fever endemic countries and, in 2003, introduced yellow fever vaccine in the Expanded Programme on Immunization (EPI) for all children at 9 months of age. The DRC has not yet benefitted from preventive vaccination campaigns.

Angola - Darminfektionen
26.07.2010

Risiko für Durchfallerkrankungen landesweit. Epidemische Ausbrüche von Cholera gab es seit 2006 in zahlreichen Provinzen einschließlich der hygienisch schlecht versorgten Viertel der Hauptstadt Luanda mit einem Gipfel jeweils während der Regenzeit, dies ist auch in 2010 nicht anders zu erwarten. Polio zirkuliert nach einer Pause von 4 Jahren durch Reimporte erneut im Lande. 2007 wurden 8 Erkrankungen nachgewiesen, 2008 stieg die Zahl auf insgesamt 28 Erkrankungen an. Für 2009 wurden 29 Fälle gemeldet. Seit Februar 2010 sind 15 Erkrankungen aufgetreten, alle Fälle wurden aus der Hauptstadt Luanda oder aus zuvor poliofreien Provinzen (Bie, Bengo, Huambo, Lunda Norte und Lunda Sul) gemeldet. Hygiene und Impfschutz (Polio) beachten. / Quelle: crm

YELLOW FEVER - AFRICA (06): COTE D'IVOIRE (ABIDJAN)
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<http://www.isid.org>

Date: Thu 29 Jul 2010
Source: Romandie News, Agence France-Presse (AFP) report
[in French, trans. Corr.SB, edited]
<http://www.romandie.com/infos/news2/100 ... nt0f33.asp>


Since 3 May 2010 an epidemic of yellow fever [YF] has killed 2 persons
in Abidjan with at least 19 cases reported, said the Ivorian Minister
of Health Aouel Aka, on Thursday [29 Jul 2010], when announcing a
vaccination campaign. "Since May, cases of hemorrhagic fever
[presumably YF] were registered in the health districts of Abidjan,
Grand Bassam (near Abidjan, the economic capital) [Sud-Comoe region]
and Bouake (center) [Vallee du Bandama region]," he said to the press.
In Abidjan alone, 2 people have died from yellow fever, with 8 cases
reported. A case of yellow fever has also been confirmed in
Grand-Bassam. The Minister has not clarified the situation in Bouake,
a town held by former rebels since the failed coup d'etat of 2002.

"A vaccination campaign is due to start Friday [30 Jul 2010] in the 3
affected towns," he added.

The last epidemic of yellow fever in Cote d'Ivoire was in December
2009, said a medical source, and it killed about 15 people people.
Yellow fever is transmitted to humans by the bite of a mosquito.

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

[The last YF cases reported in Abidjan occurred 2 years ago (2008) --
the outbreak in 2009 was elsewhere in the country. One hopes that
previous and current YF virus vaccination campaigns have provided
sufficient herd immunity to prevent a major outbreak.

Abidjan has an international sirport from which Emirates airlines
flies to Indian cities within 36 hours, connecting in Abu Dhabi. If
an unvaccinated, YF-infected passenger in the incubation period of the
disease were to embark in Abidjan he could arrive apparently healthy
in India -- or elsewhere in Asia -- and set off an epidemic there.
One hopes that destination cities in Asia are carefully checking the
vaccination status of passengers arriving from Abidjan.

Grand Bassam and Bouake can be located on the map of Cote d'Ivoire in
West Africa at
<http://lib.utexas.edu/maps/africa/ivory_coast_pol88.jpg>.
The HealthMap/ProMED-mail interactive map of Cote d'Ivoire can be accessed at
<http://healthmap.org/r/00*w>. - Mod.TY/JW]

Kap Verde - Dengue
02.08.2010

Seit der Epidemie 2009, bei der 21.304 Menschen erkrankten und 4 verstarben, besteht ein erhöhtes Dengue-Übertragungsrisiko. Bei dem Ausbruch 2010 auf den Inseln Brava, Fogo, Maio, Sal und Santiago wurde Dengue Serotyp 3 nachgewiesen. Insgesamt wurden dieses Jahr 305 Fälle gemeldet. Schutz vor überwiegend tagaktiven Stechmücken beachten. / Quelle: crm
_______________________

Simbabwe - Masern
02.08.2010

Bei dem seit September letzten Jahres bestehenden Masern-Ausbruch sind 9.455 Verdachtsfälle und 517 Todesfälle gemeldet worden. Bis auf Bulilima sind alle Distrikte betroffen. Die massiven Impfkampagnen zeigen bereits Wirkung. Nach Beendigung der Impfmaßnahmen sind bisher nur ca. 303 Erkrankungsfälle aufgetreten, Todesfälle gab es nicht mehr. Nach dem deutschen Impfkalender sind 2 MMR-Impfungen für alle Kinder vorgesehen. Ein fehlender Impfschutz kann auch später jederzeit, z.B. anlässlich einer Reise, nachgeholt werden. / Quelle: crm

DENGUE/DHF UPDATE 2010 (40)
***************************
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<http://www.promedmail.org>
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International Society for Infectious Diseases
<http://www.isid.org>

******
Cote d'Ivoire
Date: Thu 29 Jul 2010
Source: Romandie News [in French, trans. Corr.SB, edited]
<http://www.romandie.com/ats/news/100729 ... nt0f33.asp>


Since 3 May 2010 an epidemic of dengue has killed one person in
Abidjan, with 10 cases reported, said the Ivorian Minister of Health
Aouel Aka, on Thursday [29 Jul 2010]. In Abidjan alone, one person
has died from dengue with 10 cases recorded.

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

[This report is of particular interest, since ProMED receives so few
reports of dengue cases in Africa.

A HealthMap/ProMED interactive map showing the location of the Cote
d'Ivoire on the west coast of Africa can be accessed at
<http://healthmap.org/promed/en?v=7.6,-5,5>. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (13): AFRICA
********************************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Cholera - Cameroon (Far North)
[2] Cholera - Angola
[3] Cholera - Nigeria (Bauchi)
[4] Cholera - Somalia (Bay)
[5] Cholera - Somalia (WHO report May 2010)
[6] Cholera - Kenya
[7] Cholera - Guinea Bissau (Bafata)
[8] Cholera - Zimbabwe (Manicaland)

*****
[1] Cholera - Cameroon (Far North)
Date: Fri 6 Aug 2010
Source: UN ReliefWeb, Int Fed of Red Cross And Red Crescent Societies
(IFRC) report [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... report.pdf>


Since May 2010, the Far North Region of Cameroon has experienced a
severe cholera outbreak, the country's biggest outbreak in the last
10 years. As far as epidemiology is concerned, the Far North Region
of Cameroon is a high risk area. The last cholera outbreak occurred
in October 2009, recording 366 cases, 44 deaths, and affected 11
health districts in the region. The last cholera case was reported in
December 2009.

On 6 May 2010, the chief of the health service at Makary district
reported cases of diarrhea and vomiting, which were investigated at
the Ngouna Integrated Health Center (IHC). The IHC confirmed the 1st
cholera case on 6 May 2010. Until May 28 2010, all the cases
registered were in the Makary and Mada health districts of Far North
Region, which were not affected during the 2009 outbreak. Since then,
Mogode and Kousseri have also been affected. On 12 Jul 2010, 8 health
districts were already affected by cholera, while 4 new health
districts were affected as from 13 Jul 2010, namely Hina, Kolofata,
Roua, and Kay-hay health districts.

By 1 Aug 2010, 14 health districts out of the 28 that make up the Far
North Region of Cameroon were affected. A total of 456 cases of
cholera and 109 deaths have been registered, with a 7.5 percent case
fatality rate (CFR).

A cholera outbreak is current in Mogode, Kousseri, Makary, Meri,
Guere, Mokolo, Kolofata, Koza, Hina, Roua, Kay-hay, Mada, Yagoua, and
Tokombere health districts of the Far North Region of Cameroon.

So far, a total of 1456 cases of cholera and 109 deaths have already
been registered. Since the start of the operation, the cholera
outbreak has spread over the Far North Region of Cameroon, making the
entire population of that region extremely vulnerable. This
population is estimated at 3 480 000 people.

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

[A map showing the regions of Cameroon can be accessed at
<http://www.lib.utexas.edu/maps/africa/c ... _pol98.jpg>. The
HealthMap/ProMED mail interactive map of the country can be seen at
<http://healthmap.org/r/00Yv>. - Sr.Tech.Ed.MJ]

******
[2] Cholera - Angola
Date: Thu 5 Aug 2010
Source: Angola Press Agency (Angop) [edited]
<http://www.portalangop.co.ao/motix/en_u ... 6112a.html>


At least 1477 cholera cases were reported in the country, according
to information released by the Processing Centre of Epidemiologic
Data of the National Management of Public Health.

This information comes expressed in an assessment report of the
institution released to Angola Press this Thursday [5 Aug 2010], and
mentions that in the 1st half of 2010 an increase of 218 cases of
cholera was reported, against 1240 patients notified in 2009.

According to the document, among the notified cases, 34 resulted in death.

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

[Maps of Angola are available at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf> and the
HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BZ>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Nigeria (Bauchi)
Date: Mon 26 Jul 2010
Source: Nigerian Bulletin, Daily Independent (Nigeria) report [edited]
<http://nigerianbulletin.com/2010/07/26/ ... dependent/>


So far, 6 people have been confirmed dead and at least 160 infected
following the outbreak of diarrhea due to cholera in some parts of
Bauchi metropolis. This was disclosed by the Commissioner of Health,
Mohammed Yahaya Jalam, to Sunday Independent in his office on Fri 23
Jul 2010. According to him, out of the 160 people infected, 100 have
been treated at the Abubakar Tafawa Balewa Teaching Hospital, Bauchi,
and discharged while the remaining 60 are still receiving treatment.

A South African company, Zenith Water Projects, has donated cholera
eradication materials to Adamawa and Taraba states to curtail the
spread of the disease. Chief executive officer of the company,
Nicholas Igwe, presented the items to the minister of Water
Resources, Obadiah Ando, in Abuja.

[Byline: Bunmi Awolusi]

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

[A map showing the states in Nigeria can be seen at
<http://en.wikipedia.org/wiki/States_of_Nigeria>. The
HealthMap/ProMED mail interactive map of Nigeria can be accessed at
<http://healthmap.org/r/01MI>. - Sr.Tech.Ed.MJ]

******
[4] Cholera - Somalia (Bay)
Date: Wed 21 Jul 2010
Source: Suna Times [edited]
<http://www.sunatimes.com/view.php?id=279>


A total of 7 children under the age of 10 are reported to have died
in the Labatan Jirow district in the Bay region of southern Somalia.
It is believed that an outbreak of cholera has caused the death of
the minors. 12 other children are currently suffering from the
waterborne disease in the same district. The deaths have been
reported and recorded in the last 12 hours [21 Jul 2010] only.

Sheikh Hassan Abdi Nur, who is the district commissioner of Labatan
Jirow, told the press in Baidabo that the number of people affected
by cholera in the district is increasing. He said the outbreak of the
disease has become a great worry for both residents and his administration.

Sheikh Hassan, who is also known as Sheikh Saydheelow, also said that
there are no medical facilities and services in the district. Most of
the patients, who are mainly children, have been taken to the Baidabo
General Hospital for treatment.

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

******
[5] Cholera - Somalia (WHO report May 2010)
Date: 20 May 2010
Source: WHO Eastern Mediterranean Regional Office (EMRO) [edited]
<http://www.emro.who.int/somalia/pdf/Som ... 202010.pdf>


In epidemiological weeks 18-20 (3-23 May 2010), 204 sentinel sites of
the Communicable Diseases Surveillance and Reporting Network (CSR)
throughout Somalia reported 3103 AWD [acute watery diarrhea - Mod.LL]
cases including 76.6 percent children and 14 deaths (CFR 0.45
percent). South Central Zone alone accounted for 97 percent (3025) of
all AWD cases.

The integrated disease surveillance and response system (IDSR) in 7
districts of Lower and Middle Jubba reported 4252 consultations from
14 health facilities for 14 health events under surveillance. AWD
cases accounted for 833 consultations (76 percent of them children)
of all the consultations. Afmadow district accounted for 199 AWD
cases, Hagar (61), Kismaayo (233), Badhaadhe (58 ), Bu'aale (57),
Sakoow (61), and Salagle (57), Jilib (107). The data were not
available from Jamaame (Lower Jubba) during the reporting period due
to access challenges due to insecurity in the area.

On 20 May 2010, WHO received reports of an AWD outbreak in Jowhar
town in Middle Shabelle Region with a total of 8 cases including 6
adults and 2 deaths of patients under 5 years (CFR 25 percent). WHO
team visited Jowhar hospital where the cases had been referred.
Retrospective data of all AWD cases attended at the hospital from 8 -
24 May indicated that a total of 134 cases had been seen at the
hospital including (93) children under the age of 5 years and 2
deaths; one under the age of 5 (CFR 1.49). The rumored cases had not
been seen at the hospital as reported. Although the trends depicted
by the data collected do not necessarily describe an outbreak, Jowhar
is a high risk area for AWD outbreaks owing to the high population
density and IDPs in the area and the proximity to the Shabelle River,
which is also a major water source for residents. The number of cases
above 5 years is on the increase, a cause for vigilance. WHO is
therefore asking partners in the district to be alert and respond to
the situation as it evolves. Currently, there have been no samples
obtained from patients in Middle Shabelle Region.

In epidemiological weeks 18-21, Banadir Hospital (Mogadishu) reported
465 cases of cholera, including 84 percent (390) children. Of the 15
reported deaths (CFR 3.22), 10 were children. In week 13, WHO
received confirmation that 8 out of 19 samples (42 percent) tested
positive for _Vibrio cholerae_, serotype Inaba. During follow up
samples testing all 15 samples collected during week 20 tested
negative for cholera. Current trends indicate that the number of
reported cholera cases is still high and WHO continues top monitor
trends with view to revise the outbreak status.

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

[As a short review, the flagellar (H) antigens of _V. cholerae_ are
shared with many water vibrios and, therefore, are of no use in
distinguishing strains causing epidemic cholera. The O (somatic)
antigens, however, do distinguish strains of _V. cholerae_ into 139
known serotypes. Almost all of these strains of _V. cholerae_ are
nonvirulent. Until the emergence of the Bengal (O139) strain (which
is "non-O1"), a single serotype, designated O1, has been responsible
for epidemic cholera.

There are 3 distinct O1 biotypes, named Ogawa, Inaba, and Hikojima,
each of which may display the "classical" or El Tor phenotype. The
biotypes are distinguished by their expression of surface antigens A,
B, and C. Ogawa contains antigens A and B; Inaba antigens A and C;
and Hikojima antigens A, B, and C. The latter serotype is relatively
rare. - Mod.LL]

[Maps of Somalia can be seen at
<http://en.wikipedia.org/wiki/Regions_an ... of_Somalia> and
the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00aM>. - Sr.Tech.Ed.MJ]

******
[6] Cholera - Kenya
Date: Fri 9 Jul 2010
Source: UN ReliefWeb, Ministry of Public Health and Sanitation
(Kenya) report [edited]
<http://www.reliefweb.int/rw/RWFiles2010 ... report.pdf>


Beginning January 2010, outbreaks of cholera have cumulatively
affected 34 districts nationwide, causing a total of 3188 cases and
63 deaths (CFR o 2 percent). So far, the outbreaks have been
controlled in 29 districts. No new cases have been reported in the
month of July [2010] from the districts of Langata, Kilifi, Nakuru,
Kaloleni, and East Pokot, where cases have been reported in recent
weeks. In the last week [week ending 11 Jul 2010], no district has
reported new cases.

[The full report is available at the source URL above.]

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

[The areas mentioned can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. The
HealthMap/ProMED-mail interactive map of Kenya can be accessed at
<http://healthmap.org/r/019e>. - Sr.Tech.Ed.MJ]

******
[7] Cholera - Guinea Bissau (Bafata)
Date: Thu 8 Jul 2010
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/201007080597.html>


Staff from NGOs and the health authorities are going house-to-house
to distribute thousands of bottles of bleach to residents in the
Bafata area of central Guinea-Bissau to prevent another cholera
outbreak. An epidemic in 2008 claimed at least 225 lives and infected
more than 13 000 people.

"We're doing everything possible to prevent a cholera outbreak this
year [2010]. The joint effort of communities and local authorities
has prevented many cases of cholera in the past, and efforts have
once again been stepped up," said Ingrid Kuhfeldt, country director
of Plan International, which works to alleviate child poverty.

Cholera is a waterborne disease that usually occurs during the rainy
season and spreads quickly in rural areas like the Bafata region,
where most people fetch their water from wells that are easily
contaminated, and it is not always stored in hygienic conditions.

This year [2010], the 1st rains fell in early June 2010, but so far,
no cholera cases have been recorded anywhere in Guinea-Bissau.
Kuhfeldt told IRIN this was partly the result of careful planning by
the government and aid agencies, a repetition of the strategy
implemented in 2009, when Bafata had no confirmed cases.

Plan International's cholera prevention methods include distributing
medical and cleaning supplies, like bleach and oral rehydration
sachets, sinking wells and building toilets.

An epidemic in 2005 infected 25 000 people, followed by an epidemic
in 2008, which prompted the Ministry of Health to swiftly order
laboratory tests for suspected cases of cholera this month [July
2010], but they proved negative.

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

[Maps of Guinea Bissau can be seen at
<http://en.wikipedia.org/wiki/Regions_of_Guinea-Bissau> and the
HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/01Qd>. - Sr.Tech.Ed.MJ]

******
[8] Cholera - Zimbabwe (Manicaland)
Date: Fri 9 Jul 2010
Source: eFood Alert, The Herald (Zimbabwe) report [edited]
<http://efoodalert.blogspot.com/2010/07/ ... -2010.html>


A total of 4 cholera cases have been confirmed in Chiadzwa this week
[week ending 11 Jul 2010], with the victims reported to be panners
who had sneaked into the diamond fields. Officials from the Civil
Protection Unit and the Ministry of Health and Child Welfare
confirmed the outbreak on Wednesday [7 Jul 2010].

Some of the victims are said to be from Harare. CPU Manicaland
provincial head Mr Fungai Mbetsa said the 4 cases were reported on 28
Jun [2010] and confirmed on Monday [5 Jul 2010]. "The infected
people, who we believe to be panners, are being treated at Chishingwi Clinic.

"We are worried that some people are still finding their way into the
Chiadzwa diamond fields, which are a protected area." No deaths have
been recorded, and personnel from the Ministry of Health and Child
Welfare and other stakeholders are on the ground monitoring the situation.

Cholera cases were reported in Buhera and Mutambara earlier this year
[2010]. At least 25 cases and one death were confirmed in Buhera,
while 9 students from Lydia Chimonyo High School were treated at
Mutambara Mission Hospital after contracting the disease.

[Byline: Cletus Mushanawani]

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

[A map showing the administrative regions of Zimbabwe can be accessed at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf>.
The HealthMap/ProMED-mail interactive map of Zimbabwe can be seen at
<http://healthmap.org/r/01Qe>. - Sr.Tech.Ed.MJ]

LEISHMANIASIS, VISCERAL - SUDAN: (JONGLEI)
******************************************
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: Sat 7 Aug 2010
Source: Sudan Tribune [edited]
<http://www.sudantribune.com/spip.php?article35888>


Officials in Jonglei state have reported an outbreak of the deadly
Kala azar disease in the area. The disease which struck this week
[week of 2 Aug 2010] has already left 48 people dead and more than
130 people hospitalized, with the fear that the death toll could get higher.

Reaching many areas in rainy season in Jonglei state is difficult.
According to the minister for law enforcement in the state, Gabriel
Duop Lam, the victims were having difficulty accessing areas where
they could receive medical treatment.

Mr Duop who returned from Ayod town on Thursday [5 Aug 2010] added
that many patients are locked up in villages due to lack of transport
and heavy flooding in the area, thus making it difficult for them to
access health units.

In Ayod, 48 people died and 138 people are admitted, Duop said,
adding that it was not possible to evaluate fatalities in areas
inaccessible by road from Ayod County center.

Fangak and Pigi Counties have also reported kala azar cases according
to Radenta Ayen, Jonglei state minister of health, who described the
development in Ayod as "the worse."

Ayen said health facilities will be sent to the area immediately. She
swiftly called for international humanitarian organization for
assistance. Kala azar, also known as visceral leishmaniasis, is
common in northern Counties of Jonglei state.

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

[Kala azar is endemic in Jonglei State but numbers have been
decreasing from nearly 6000 in 2003 to less than 2000 in 2006
(Kolaczinski JH et al: Kala-azar Epidemiology and Control, Southern
Sudan. Emerg Infect Dis 2008; 14(4): 664-6; available at
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570907/>).

Available background data on leishmaniasis in Sudan as well as
HIV-leishmania co-infection is found in the ProMED posting from 7 Nov
2009 (Leishmaniasis - Sudan: (southern) 20091107.3851).

Jonglei state is situated in Southern Sudan and is bordering
Ethiopia. It can be located on the map at
<http://en.wikipedia.org/wiki/Jonglei>.
The HealthMap/ProMED-mail interactive map of Sudan is available at
<http://healthmap.org/r/01*0>. - Mod.EP]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (16)
************************************************
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 (Bauchi, Borno)
[2] Cholera - Cameroon (Far North region)

******
[1] Cholera - Nigeria (Bauchi, Borno)
Date: Mon 16 Aug 2010
Source: Google News, Agence France-Presse (AFP) report [edited]
<http://www.google.com/hostednews/afp/ar ... HZn5GiynBA>


A cholera outbreak in Nigeria has killed 87 people during the past
month while 1315 others have been infected, official figures showed
Mon 16 Aug 2010.

The outbreak in the northern states of Bauchi and Borno was believed
to be because of poor sanitation and the contamination of wells,
while Nigeria's rainy season often sees a surge in cholera cases.

Bauchi State has recorded 47 deaths and 1200 infections in the past
month, state health commissioner Mohammed Yahaya Jalem told AFP by
telephone from the state capital.

Borno State health commissioner Abdurrahman Terab told AFP on Thu 12
Aug 2010 that 40 people had died from cholera in the state within the
previous week while 115 others were infected.

Jalem attributed the outbreak to poor sanitation and the
contamination of open wells on which rural communities largely depend
as major water source. "We have mobilised health personnel and drugs
in the affected areas and we have stepped up... campaigns on how
people can guard against cholera and other water-related infections
especially in the rainy season," he said.

Health experts say a surge in cholera outbreaks is noticeable in
Nigerian villages in the rainy season when rain water washes dirt
into open wells and ponds.

More than 260 people died of cholera in 4 northern states in the last
quarter of 2009.

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

[Maps of Nigeria are available at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf> and
<http://healthmap.org/r/01Q4>. - Sr.Tech.Ed.MJ]

******
[2] Cholera - Cameroon (Far North)
Date: Thu 12 Aug 2010
Source: CNN [edited]
<http://edition.cnn.com/2010/WORLD/afric ... &wom=false>


Cholera has killed 200 people in the west African nation of Cameroon,
the government said Thu 12 Aug 2010, and aid agencies feared the
outbreak could spread to neighboring regions and nations. Another
2500 cases of cholera, a deadly water-borne disease, have been
diagnosed in Cameroon since an outbreak warning in June 2010.

About 70 percent of people living in the country's far north
[Extreme-Nord] region, bordering Nigeria and Chad, do not have access
to potable water, according to a Ministry of Water and Energy official.

Sanitation is also limited in the area and recent flooding has
aggravated the situation. UNICEF said it has dispatched emergency
medical kits containing surgical gloves, water treatment tablets,
cholera medicine, oral rehydration salts and educational materials.
The United Nations children's agency said the outbreak could be
devastating for children, who are especially vulnerable.

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

[Maps of Cameroon are available at
<http://www.lib.utexas.edu/maps/africa/c ... _pol98.jpg> and
<http://healthmap.org/r/02SZ>. - Sr.Tech.Ed.MJ]

CONJUNCTIVITIS - UGANDA AND SOUTHERN SUDAN
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Uganda & Southern Sudan
Date: Fri 20 Aug 2010
Source: MMWR Weekly, Volume 59, No. 32 [edited]
<http://www.cdc.gov/mmwr/preview/mmwrhtm ... mm5932a4_e>


Acute Hemorrhagic Conjunctivitis Outbreaks Caused by Coxsackievirus
A24v --- Uganda and Southern Sudan, 2010
---------------------------------------------
CDC [Centers for Disease Control and Prevention] was contacted on 22
Jun 2010 by the Ugandan Ministry of Health (MoH)/Uganda Virus
Research Institute and on 11 Jul 2010 by the Government of Southern
Sudan (GOSS) via the CDC Global Disease Detection Regional Center in
Kenya to perform diagnostic laboratory testing on conjunctival swabs
from persons with "red eye syndrome." Widespread, ongoing outbreaks
of acute hemorrhagic conjunctivitis (AHC) have been observed in
Uganda and Southern Sudan since spring 2010.

AHC becomes a reportable condition in outbreak settings. Case numbers
were estimated in Uganda after MoH confirmation of reported cases
from district health facilities and, in Southern Sudan, after a
medical record review in 6 health facilities. To date, 6818 cases
from 26 districts in Uganda, and 428 cases in Juba, Southern Sudan
have been counted; however, because most cases are not reported,
these totals are considered underestimates.

Conjunctival swabs were tested by reverse transcription-polymerase
chain reaction (RT-PCR) for enterovirus RNA. Enterovirus-positive
swabs were further characterized, and enterovirus-negative swabs were
tested by PCR for adenovirus. Of 29 conjunctival swabs tested from
Uganda, 13 (45 percent) were identified as coxsackievirus A24 variant
(CA24v), one (3 percent) as enterovirus 99, and 15 (52 percent) were
negative; of 6 conjunctival swabs tested from Southern Sudan, 3 (50
percent) were identified as CA24v, and 3 (50 percent) were negative.
All 18 enterovirus- negative swabs tested negative for adenovirus.

AHC epidemics, caused predominantly by enterovirus 70, CA24v, or
adenovirus, have occurred worldwide in predominantly tropical and
subtropical regions, typically last several months and affect large
populations (e.g., over 10 000-200 000) (1,2). Negative laboratory
results are common and can be attributed to multiple factors,
including timing of specimen collection. Symptoms (e.g.,
subconjunctival hemorrhage, foreign-body sensation, photophobia, and
discharge) usually resolve within 1-2 weeks. Treatment for AHC is
symptomatic; however, if secondary bacterial infection is suspected,
patients should seek medical care. AHC is highly contagious and could
spread to neighboring areas and countries; prevention (e.g., hand
washing and proper hygiene) is essential for control.* Control
measures instituted by the Ugandan and GOSS MoHs have included
developing investigation and response guidelines and issuing health
alerts via media channels to increase awareness concerning symptoms, tra!
nsmission, treatment, and prevention.

* CDC prevention recommendations are available at
<http://www.cdc.gov/cleanhands> and <http://www.cdc.gov/conjunctivitis>.

References
(1) CDC. Acute hemorrhagic conjunctivitis outbreak caused by
coxsackievirus A24---Puerto Rico, 2003. MMWR 2004;53:632--4.
(2) Tavares FN, Costa EV, Oliveira SS, Nicolai CC, Baran M, da Silva
EE. Acute hemorrhagic conjunctivitis and coxsackievirus A24v, Rio de
Janeiro, Brazil, 2004. Emerg Infec Dis 2006;12:495--7.

[Interested readers should consult the original MMWR text to identify
the large number of collaborators contributing to this survey. - Mod.CP]

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

[Conjunctivitis is an inflammation or infection of the thin layer
(conjunctiva) that lines the inside of the eyelid and covers the
white part of the eye. Inflammation can cause blood vessels in the
eye to become larger, and that can make the white of the eye look
pink or red. Thus, conjunctivitis is often called "pink eye" or "red
eye." Viral infection is the most common cause of conjunctivitis.

The acute hemorrhagic conjunctivitis observed in Uganda and Southern
Sudan -- a type of conjunctivitis that is sometimes accompanied by
nervous system involvement -- has previously been associated with
enterovirus 70 and coxsackievirus A24, and a variant of
coxsackievirus A24 appears to have been responsible for the current
outbreak in Uganda and Southern Sudan.

The HealthMap/ProMED-mail interactive map of Uganda at
<http://healthmap.org/r/0089>, and that of Southern Sudan at
<http://healthmap.org/r/00_c>. - Mod.CP]

[Regarding the containment of viral conjunctivitis, "Sneezing into
the hands" is not the way to go. We preach sneezing or coughing into
the inside of the elbow is better if there is no tissue to sneeze
into. Every thing/one the hands touch will become contaminated. - Mod.DK]