Wüstenschiff

YELLOW FEVER - AFRICA (02): UGANDA (NORTH)
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Date: Mon 3 Jan 2011
Source: AllAfrica, The Monitor report (Uganda) [edited]
<http://allafrica.com/stories/201101030017.html>


Contrary to what government promised, the yellow fever [YF] vaccine
may take another 2 weeks before it can reach the country, further
delaying the mass vaccination against yellow fever in northern
Uganda. The health ministry had earlier said vaccination would
commence last Saturday [1 Jan 2011], but the director, Clinical and
Community Health Services, Dr Kenya Mugisha, yesterday [2 Jan 2011]
said the vaccine is limited in supply. "The medicine [sic; vaccine]
is scarce. There is a possibility of it having to be manufactured but
we are working with the International Coordinating Group (ICG) to see
that it is here as soon as possible." The ICG is the body charged
with distributing yellow fever vaccine worldwide.

The scarcity comes at a time when Cameroon is also battling yellow
fever and the available 1.5 million doses have to be shared between
the 2 countries. The vaccination targets 2.5 million people in 26 districts.

Dr Mugisha, who headed the National Task Force on Yellow Fever to
Northern Uganda, said the situation is now under control with no new
cases registered in recent days while most of those who were admitted
have been discharged from hospital. "The situation is calm, by Friday
[31 Dec 2010] , only 23 people were still contained in hospitals," he said.

The disease, which has killed 48 people and affected 190 others, is
prevalent in Abim, Agago, Lawo, Pader, Kitgum, Gulu, Arua, Kabong,
Kotido, and Lira. Dr Isa Makumbi, a health ministry official said
about 3 million Ugandans are at the risk of contracting the disease
if no immediate vaccination programme takes place across the region.

Yellow fever is a viral haemorrhagic disease that is transmitted by
female _Aedes_ mosquitoes. Symptoms include fever, nausea, bleeding,
and vomiting. If untreated, yellow fever may result into kidney
failure or death. The disease last hit the country in 1972.

[Byline: Flavia Lanyero, Cissy Makumbi]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Alas, the likely delay in obtaining YF vaccine that Mod.JW warned
about in the previous post [see ProMED-mail archive no.
20110102.0017] has come to pass. The encouraging news from the report
above is that no new cases have appeared recently, which may buy the
Ugandan health authorities some time as they await delivery of the
vaccine. There is no mention of any effort to reduce the vector
mosquito populations in the affected areas. One hopes that a vector
control effort has been initiated aggressively.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed
at <http://healthmap.org/r/0089>. The affected districts can be
located on the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>. - Mod.TY]

MALARIA - SOUTH AFRICA: (LIMPOPO)
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<http://www.promedmail.org>
ProMED-mail is a program of the
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Date: Tue 4 Jan 2011
Source: Times Live [edited]
<http://www.timeslive.co.za/africa/artic ... in-Limpopo>


Malaria reported from the Limpopo province, South Africa
-------------------------------------------------------
A pair of siblings died from malaria in Mopane at the weekend [1-2
Jan 2011], the Limpopo health department said on Monday [3 Jan 2011].

The pair were believed to be between 9-years-old and 13-years-old,
said spokesman Cecil Motsepe. "They were admitted into Malamulele
hospital over the weekend, diagnosed with malaria and treated... but
they sadly died." The gender of the siblings was not yet known. The
entire family was tested and found to be negative.

"We will be thoroughly investigating how they contracted the virus,"
said Motsepe. The department said it had seen a slight increase in
malaria cases in the province over the past week but could not
release any figures. It had been carrying out a provincial programme
to help prevent such diseases.

"We are carrying out a spray programme and have targeted 960 000
households to be sprayed," Motsepe said. So far, 40 000 homes had
been sprayed. "We are dispatching a team immediately to the area
where the siblings came from so that all the homes there can be
sprayed," said Motsepe.

"Malaria is treatable but 90 percent of the time people treat it too
late. So people must check for symptoms." Malaria is a mosquito-borne
disease which is transmitted through the bites of certain types of
mosquitoes. Flu-like symptoms, body aches and pains, nausea, vomiting
and diarrhoea are all symptoms of the disease.

Each year, more than 250 million cases of malaria are reported
worldwide, killing between one and 3 million people, the majority of
whom are young children. 90 percent of malaria-related deaths, which
is commonly associated with poverty, take place in sub-Saharan
Africa. In 2010, 9 people died of malaria out of 450 cases reported in Gauteng.

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

[ProMED reported on malaria in Limpopo province in January 2010
(Malaria - South Africa: (LP) 20100106.0060). A map of malaria in
Limpopo and neighboring province Mpumalanga can be found on page 40
at the following link:
<http://www.doh.gov.za/docs/factsheets/g ... ention.pdf>.
It will be seen that the risk is high in the areas bordering Zimbabwe
and Mozambique. The latest official data on malaria in South Africa
according to the province is from 2007, where 499 cases were reported
with 3 deaths
(<http://www.doh.gov.za/issues/malaria/annauldata.pdf>) compared to
2004 where 4899 cases with 50 deaths were reported from Limpopo
province. - Mod.EP]

YELLOW FEVER - AFRICA (03): COTE D'IVOIRE, CENTRAL
***********************************************
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Date: Wed 5 Jan 2010
Source: IRIN [edited]
<http://www.irinnews.org/Report.aspx?ReportID=91530>


Unrest following Cote d'Ivoire's presidential election is blocking a
nationwide vaccination drive against yellow fever [YF], a fatal
mosquito-borne disease that is affecting people throughout the
country. In the past month, 11 people have died in the centre-north
departments of Seguela, Katiola, and Beoumi; 2 cases of yellow fever
have been confirmed, and there are a further 21 suspected cases in
those departments and in nearby Mankono, according to local health
workers and the World Health Organization (WHO). Health officials are
still investigating the suspected cases, some of which could be
dengue, WHO said.

A yellow fever immunization drive initially planned for the end of
November [2010] as part of a worldwide WHO and UN Children's Fund
initiative has been postponed twice due to the current political situation.

Rivals Alassane Ouattara and incumbent Laurent Gbagbo claim the
presidency and have formed governments. There have been violent
clashes, particularly in the west; in the commercial capital Abidjan
pro-Gbagbo, youth have attacked UN personnel and vehicles. The UN
says it recognizes Ouattara as president. "[The vaccination drive]
was set again for 10-15 Jan [2011], but now again it looks like that
won't be possible due to the insecurity," John Mulangu, WHO-Africa
emergency and humanitarian action adviser, told IRIN.

Nationwide campaigns imply that UN and local health workers go to
communities in teams over a period of days, but WHO workers said this
was currently not feasible. Another problem is that many district
health directors who travelled to Abidjan to vote have not made it
back to their posts because of insecurity on the roads and severely
limited bus services.

Yellow fever has no cure; it causes severe illness and kills about
half of its victims, mostly due to lack of treatment for symptoms
like dehydration. WHO says the single most important preventive
measure is vaccination.

WHO and local health officials told IRIN that people were being
vaccinated on a small scale but said it was critical to cover the
entire country. Coulibaly Seydou, Seguela health district director,
said health workers were able to vaccinate people in some affected
villages there on 26-28 Dec [2010]. "But given that yellow fever is
transmitted by mosquitoes, it spreads easily; it doesn't stop at a
village or district boundary," Coulibaly told IRIN. "It is important
that the vaccination campaign be conducted in all targeted regions of
the entire country," WHO's Mulangu said. "If we do not do this, we
might see a spread of the disease with high morbidity and high mortality."

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Other countries in the past have managed to arrange truce days
during civil wars in order to carry out mass vaccination against
epidemics. Perhaps the people with experience in negotiating such
truces could help to organize one in this situation. - Mod.JW]

[Prior to this report, the most recent YF outbreak was in July 2010
in Abidjan in the far south of Cote d'Ivoire, distant from the areas
of the reported cases in the central part of the country. This new
situation is a sad illustration of how political conflict leads to
insecurity and inability of the public health sector to function in
the face of a serious threat of epidemic YF spread. One hopes that
the political situation will stabilize quickly to permit the
vaccination campaign to move ahead before more cases spread. One
hopes that there will be an adequate supply of YF virus vaccine,
given the demand currently for vaccines to counter YF outbreaks in
Cameroon and northern Uganda.

Seguela, Katiola, and Beoumi 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/promed/index.php?v=7.6,-5,5>. - Mod.TY]

YELLOW FEVER - AFRICA (04): UGANDA, NORTH
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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: Wed 5 Jan 2011
Source: International Rescue Committee [edited]
<http://www.rescue.org/news/irc-responds ... ganda-9956>


The International Rescue Committee (IRC) is responding to a rare
outbreak of yellow fever which has so far claimed almost 50 lives in
northern Uganda. To help curb the spread of the disease and treat
those already infected, the IRC is training Ugandan health workers
and community volunteers in the northern districts of Kitgum and
Lamwo to detect, refer and treat the disease and is providing drugs,
disinfectants, and protective gear including gloves and masks.

The IRC will also assist in a government-run vaccination campaign
that that will reach 2.5 million people in Uganda's northern
districts. Meanwhile, an IRC ambulance is carrying patients from
isolated communities to hospitals. When the vaccination campaign
begins later this month [January 2011], IRC health teams will help
transport vaccines from storage facilities to inoculation sites.

Dr. Alex Opio Chono, who directs the IRC's health programs in Uganda,
said that the IRC is now focused on promoting preventative hygiene,
bringing information to the public, and strengthening community
involvement in detecting and reporting symptoms of yellow fever. "Our
teams are travelling around the countryside, informing people about
yellow fever and where they can receive inoculations," Dr. Chono
said. "In collaboration with the district health authorities, we are
also launching an information campaign with posters, radio spots,
radio talk shows and community meetings."

Yellow fever, [caused by a virus] transmitted by infected mosquitoes,
was last recorded in Uganda almost 40 years ago, according to health
officials. The disease has a wide range of symptoms from nausea and
vomiting to jaundice, bleeding and kidney failure. About half of
those who develop severe symptoms and are untreated die from the disease.

The outbreak is affecting an area still recovering from 2 decades of
civil war between the rebel Lord's Resistance Army and the Ugandan
government. "The war destroyed many health facilities, and there is a
severe shortage of trained medical staff, making this area
particularly ill-equipped to handle an outbreak of such a serious
disease," said Cristine Betters, the IRC director in Uganda.

[Byline: Peter Biro]

--
Communicated by:
T J Allen <tjallen@pipeline.com>

[The disruption of medical services and lack of trained personnel may
account for the difficulty experienced in making a valid diagnosis
early in this outbreak. The above report does not indicate when the
vaccination campaign will begin. The IRC's transportation of the
vaccine, when it does become available, should insure proper handling
of it so that it retains its potency. Meanwhile, one hopes that
efforts to implement preventive measures, especially elimination of
_Aedes aegypti_ vector mosquito breeding sites, will significantly
reduce the risk of yellow fever virus transmission.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed
at <http://healthmap.org/r/0089>. The affected districts can be
located on the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011
***********************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
Africa
[1] Cholera - Zambia
[2] Cholera - Zimbabwe


******
[1] Cholera - Zambia
Date: Sat 8 Jan 2011
Source: Times of Zambia [edited]
<http://www.zamnet.zm/newsys/news/viewne ... 1294482767>


The Ministry of Health (MoH) has recorded 21 cholera cases
countrywide as of 5 Jan 2011. MoH spokesperson Kamoto Mbewe confirmed
the new cholera cases yesterday, 7 Jan 2011.

Dr Mbewe said the ministry recorded 5 new admissions, 7 discharges
and 9 under treatment, but no deaths had occurred. He said of the 5
new admissions, one was from Lusaka in Chawama compound and 4 from
Mpulungu in the Northern Province. Dr Mbewe also said 151 cholera
cases have been recorded since November 2010.

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

******
[2] Cholera - Zimbabwe
Date: Mon 3 Jan 2011
Source: Newsday [edited]
<http://www.zimdiaspora.com/index.php?op ... &Itemid=18>


A cholera outbreak has been detected in one of Harare's oldest
suburbs, Majubheki in Mbare, with at least 20 households having
reportedly been affected. This has raised concern over the spread of
the infamous epidemic that claimed over 4000 lives and affected
thousands more countrywide in 2008.

Chairman of the Harare Residents Trust in Majubeki Samuel Mapurisa
said affected residents were taken to Matapi (Mbare) Poly Clinic
after suffering from severe stomachaches, diarrhea and vomiting.

The Epidemiology and Disease Control director in the Ministry of
Health, Dr Portia Mananganzira, could neither confirm nor deny the
Harare outbreak but said the probability of such an outbreak was high.

"I cannot confirm the outbreak, but I would not be surprised, because
cholera cases have recently been reported in Manicaland and
Mashonaland West provinces. Going into 2011, 69 cases of cholera had
been reported in Mashonaland West," she said.

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

[It should be noted that the current cholera epidemic in Haiti is
rapidly approaching the numbers recorded in the 2008 horrific
Zimbabwe outbreak, which spread across land borders to several
neighboring countries. - Mod.LL]

YELLOW FEVER - AFRICA (05): UGANDA (NORTH)
******************************************
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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 10 Jan 2011
Source: AllAfrica, The Monitor (Uganda) report [edited]
<http://allafrica.com/stories/201101100006.html>


Close to 50 people have died [from yellow fever virus infections; YF] with
another 190 infected in the past couple of weeks since the disease was
first detected.

Even as Uganda struggles to cope with an outbreak of yellow fever, some
conmen are selling vaccination cards to people who have not been
vaccinated, a Daily Monitor investigation has shown. At the South African
embassy for example, 6 out of 10 yellow cards presented as part of
requirements for visa applications, are found to be fake --creating the
risk of the disease being spread to countries not infected. At Kampala City
Council Hospital, just next to the imposing White Hall that houses the
council's offices, the illegal trade in yellow fever cards is lucrative and
bustling. The "hawkers", casually dressed unlike their tattered-trouser
donning counterparts downtown, are busy; hovering in the hospital compound
on the look out for clients to buy the vaccination cards at a give-away
price. Under normal circumstances, vaccination and a card for proof costs
Shs 46 000 [USD 19.64] at this facility - -but if you bargain with these
"hawkers", you could get one for as low as Shs 15 000 [USD 6.40], without
even being vaccinated. Our reporter was charged Shs 25 000 [USD 10.57] for
the card.

The South African high commissioner to Uganda, Mr Jon Qwelane, says the
black market in vaccination cards is a serious problem. He does not just
fear the spread of the disease to his country but the blatant abuse of
ethical standards of disease control.

Of the 53 countries in Africa, 39 are at a high risk of transmitting yellow
fever [virus], including Uganda.

[byline: Flavia Lanyero]

--
communicated by:
Thomas James Allen
<tjallen@pipeline.com>

[The 31 Dec 2010 edition of The Monitor
(<http://allafrica.com/stories/201012310008.html>) indicated that there
were 12 new YF cases (dates not given), with no deaths, bringing the total
number of YF cases to 190 with deaths remaining at 48. This is not good
news. When the 2-week delay in the delivery of vaccine was first announced
recently, no new cases were reported. Apparently, and not surprisingly,
transmission of YF virus continues, making the initiation of the
vaccination campaign more urgent than ever. The only immediate good news
coming out of the outbreak is that it continues to be confined to 10
districts in northern Uganda. With ongoing YF virus transmission and the
large proportion of African countries at risk should the virus be
introduced, the selling of fake YF vaccination cards raises the specter of
spread through movement of viremic individuals, putting large populations
of susceptible people at risk in an environment where YF vaccine is already
in short supply. One hopes that Uganda officials will crack down
immediately on the sale of fraudulent cards and that health and immigration
officials in other countries are vigilant for holders of these fake cards
by passengers arriving from Uganda.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<http://healthmap.org/r/0089>. The districts can be seen on the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>. - Mod.TY]

Uganda - Gelbfieber
11.01.2011

Die seit Ende Oktober gemeldete unklare Erkankung konnte als Gelbfieber indentifiziert werden. Im Norden des Landes sind im Norden des Landes mindestens 191 Erkrankungs- und 49 Todesfälle aufgetreten. Die Krankheit ist in Uganda seit 40 Jahren nicht mehr gemeldet worden, die Immunität der Bevölkerung ist dementsprechend schlecht. Nun eilt es, mit den Impfkampagnen zu beginnen, damit sich die Erkrankung nicht noch weiter ausbreitet. Reisende sollten unbedingt geimpft werden. / Quelle: crm

MONKEYPOX - DEMOCRATIC REPUBLIC OF CONGO: (EQUATEUR)
****************************************************
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ProMED-mail is a program of the
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Date: Wed 12 Jan 2011
Source: Radio Okapi [in French, trans. Mod.MPP, edited]
<http://radiookapi.net/actualite/2011/01 ... -a-bikoro/>


Equateur province: 114 cases with 5 deaths due to monkeypox reported in Bikoro
-----------------------------------------------------------
The disease [known as] monkeypox, also known as monkey variola, has raged
in the north and south of Equateur province. At least 3 health zones are
affected. For example, in the Bikoro health zone, 114 people have
contracted the disease and 5 have died.

According to the WHO Equateur provincial branch, the Bikoro health zone has
broken the record with 114 cases. Most of the cases have been reported in
the Mooto health area, about 82 kilometers [51 mi] from Mbandaka.

Two weeks ago, medical authorities suspected the presence of a similar
disease in the Gbadolite health zone. According to the WHO/Equateur
regional medical officer, Louis Pia, laboratory tests on specimens from
patients that were sent to the INRB (National Institute for Biomedical
Research) in Kinshasa, confirmed that the cause was monkeypox virus.

The disease has been reported also in Boende health zone. The same
confirmation has been made on specimens taken from patients [in Boende]. It
is still unclear how many have been infected [overall in Equateur].

To deal with this epidemic, medical advice is for observation of hygiene
rules. The medical officer also asked farmers in the affected health zones
not pick up dead animals in the forest, including monkeys, squirrels, and
pangolins that transmit this disease to humans.

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

[A recent investigation suggests that monkeypox virus, to which the
smallpox vaccine also provides immunity, is now at least 20 times as common
as it was shortly after the eradication of smallpox and the relaxation of
immunisation. (For a detailed discussion see ProMED-mail Monkeypox,
increased incidence - Congo DR 20100901.3124, and AW Rimoina et al. Major
increase in human monkeypox incidence 30 years after smallpox vaccination
campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci
USA. 2010; 107(37): 16262-7. <http://www.pnas.org/content/107/37/16262.long>.)

Whereas monkeypox virus infection is somewhat less serious than smallpox,
it can still scar and even kill its victims. And in contrast to smallpox,
monkeypox is not only able to jump between humans, but can infect through
contact with the small animals that harbor the virus (such as rodents,
squirrels, and monkeys). As a result, its control may be more difficult to
achieve.

The virus species _Monkeypox virus_ is a member of the genus
_Orthopoxvirus_. Monkeypox virus can cause a disease in humans that is
clinically similar to smallpox and outbreaks in central Africa have been
associated with significant mortality (such as reported above), although
none occurred in an outbreak in the USA in 2003 associated with introduced
African rodents. An important difference between monkeypox virus and
smallpox virus (variola virus) is that monkeypox virus so far has not
transmitted from person-to-person as efficiently as variola virus. Indeed
monkeypox virus is normally resident in rodents and squirrels but can be
transmitted to other species as zoonoses. Phylogenetically the species
_Monkeypox virus_ is among the most divergent viral species from the
species _ Variola virus_. In fact variola virus is more closely related to
camelpox virus than to monkeypox virus. Consequently evolution of monkeypox
virus into a variola-like virus by mutation and selection is improbable.
Nonetheless it has potential to cause significant disease in the human
population and might require in limited situations reuse of vaccinia virus
vaccine.

The HealthMap/ProMED-mail interactive map of the Democratic Republic of
Congo can be accessed at <http://healthmap.org/r/0m0C>. - Mod.CP]

CHIKUNGUNYA (03): FRANCE ex BENIN
*********************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Tue 18 Jan 2011
From: Marie-Catherine Receveur
<marie-catherine.receveur@chu-bordeaux.fr> [edited]


An imported case of acute chikungunya fever virus infection returning
[to France] from Benin was serologically confirmed at the University
Hospital of Bordeaux, France. The patient's trip was planned from 20
Oct - 2 Dec 2010, and shortened because of an acute algo-febrile
presentation on 30 Nov [2010]. On 20 Dec [2010], he was admitted in
our unit because of persistent asthenia and severe incapacitating
arthralgia mainly located on neck, elbows, and wrists and was
subsequently investigated for the condition.

--
MC Receveur, E Boidin, D Malvy
Le Centre hospitalier universitaire de Bordeaux
France
<marie-catherine.receveur@chu-bordeaux.fr>

[Although chikungunya virus (CHKV) was transmitted in southern France
during warm weather following importation of the virus in 2010 (see
ProMED-mail archive number 20100926.3495), there was no risk of
ongoing CHIKV transmission in Bordeaux at the season of the year of
the imported case above. This report is of interest because
ProMED-mail receives few reports of CHKV infections in Africa, where
it is endemic. This is the 1st report of CHKV transmission in Benin.
Drs Receveur, Boidin, and Malvy are thanked for this first-hand
report. It will be interesting to learn how long the patient's
arthralgia persists. A recent study reported that on average, 2 years
after infection 43 per cent to 75 per cent of CHKV-infected people
reported prolonged or late-onset symptoms (arthralgia) highly
attributable to infection by this virus (see ProMED-mail archive
number 20110115.0178).

A HealthMap/ProMED-mail interactive map showing the location of Benin
in West Africa can be accessed at
<http://healthmap.org/r/016m>. - Mod. TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (02)
************************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
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In this update:
Africa
[1] Cholera - Nigeria (Niger state)
[2] Cholera - Mozambique
[3] Cholera - Zimbabwe (Masvingo)

*****
[1] Cholera - Nigeria (Niger state)
Date: Thu 13 Jan 2011
Source: Leadership (Abuja) [edited]
<http://allafrica.com/stories/201101130777.html>


The death toll from cholera outbreak in Lavun and Edati Local
Government Area of Niger State has now risen from 8 to 13. Leadership
gathered that 7 out of the victims were from Tama-Nku, a village in
Edati Local Government where the outbreak was first noticed late on
Tue 11 Jan 2011.

It was further gathered that 5 are from Saachi Village while one is
from Danchitagi Village all in Lavun Local Government Area of the state.

The Director Primary Health Care in the area, Alhaji Zakeri Saba said
that the River Kaduna, which is their main source of water, might be
responsible for the outbreak, and appealed to the communities along
the rivers to always treat and boil their water before use.

[Byline: Abu Nmodu]

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

[Maps of Nigeria can be seen at
<http://en.wikipedia.org/wiki/States_of_Nigeria> and
<http://healthmap.org/r/0msN>. - Sr.Tech.Ed.MJ]

******
[2] Cholera - Mozambique
Date: Mon 17 Jan 2011
Source: AllAfrica, Mozambique News Agency (AIM) report [edited]
<http://allafrica.com/stories/201101180160.html>


So far this rainy season [2010-2011], cholera outbreaks have been
recorded in 3 of Mozambique's 11 provinces, with a total of 126 cases
diagnosed, reports this issue of the independent daily "O Pais",
citing the deputy national director of public health, Leonardo Chavane.

By last Thu 13 Jan 2011, 54 cases had been reported in the northern
province of Cabo Delgado, in the provincial capital, Pemba, and in
the districts of Ancuabe, Chiure, Montepuez, and Pemba-Metuge. In
Nampula province, 45 cases of cholera were diagnosed in Memba,
Mogincual, Nacaroa, and Meconta districts, while in Chimoio, capital
of the central province of Manica, 27 cases of the disease were
confirmed. In none of the 3 provinces concerned have any deaths from
cholera been reported.

Chavane warned that the heavy rains occurring over much of the
country, plus defective drainage systems, could lead to further
outbreaks of cholera

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

[Maps of Mozambique can be seen at
<http://www.un.org/Depts/Cartographic/ma ... zambiq.pdf> and
<http://healthmap.org/r/0mRJ>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Zimbabwe (Masvingo)
Date: Tue 18 Jan 2011
Source: Radio Voice of the People (VOP) Zimbabwe [edited]
<http://www.radiovop.com/national-news/5 ... ikita.html>


A fresh cholera outbreak which has seen 60 people infected with the
disease and 4 people dead has been reported in Bikita. Masvingo
Provincial Medical Director Dr Robert Mudyiradima said tests had
confirmed that the deaths of 2 children, one man, and a woman from
Nyika Growth Point were caused by cholera.

"We have dispatched our health teams to assess the situation and
raise more awareness on the disease," Dr Mudyiradima said. He said
the recent rains and a recent meeting of the Apostolic Faith members
could have contributed to the resurgent outbreak.

In 2008, 4000 people countrywide died of cholera according to the WHO.

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

[Maps of Zimbabwe can be seen at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf> and
<http://healthmap.org/r/0mRK>. - Sr.Tech.Ed.MJ]

YELLOW FEVER - AFRICA (06): UGANDA (NORTH)
******************************************
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 14 Jan 2011
Source: AllAfrica, The Monitor (Uganda) [edited]
<http://allafrica.com/stories/201101140034.html>


After long weeks of waiting, the yellow fever [YF] vaccine finally
arrived in the country with 5 districts -- Abim, Agago, Pader,
Kitgum, and Lamwo -- set to receive the drug first. One million doses
arrived on Wednesday [12 Jan 2011] and if all goes as planned,
vaccination is to start on 22 Jan [2011] targeting all people above 6
months. The amount of drugs received is, however, less than the 2.5
million doses that the ministry had earlier said it needed to carry
out a mass vaccination in 26 districts in northern Uganda.

While addressing the press in Kampala yesterday [13 Jan 2011], the
assistant commissioner National Disease Control Dr Issa Makumbi, said
the country will only require more drugs if the disease is confirmed
in the remaining 5 districts that were feared to have the disease.
These are Gulu, Arua, Kaabong, Kotido, and Lira. "We are still
carrying out tests in the other districts. Once the laboratory tests
confirm yellow fever, we shall mobilise for more drugs," Dr Makumbi
said. He said if there is need for more vaccination, the surrounding
districts to the 5 will be the next in line.

The vaccination exercise is budgeted to cost USD 3.5 million; yet to
be released to the ministry. Junior health minister Richard Nduhura
said the public should be calm and follow advice to avoid contracting
the disease.

[Byline: Flavia Lanyero, Mercy Nalugo]

--
Communicated by:
Thomas James Allen
<tjallen@pipeline.com>

[This report does not mention the occurrence of new cases. A report
on 10 Jan 2011 indicated that close to 50 people died from YF virus
infections with another 190 infected in the previous 2 weeks (see
ProMED-mail archive no 20110111.0123), indicating that active
transmission of YF virus was ongoing at that time. The arrival of the
YF vaccine is good news, although less than earlier vaccine needs
estimates indicated. One hopes that intensive YF surveillance in all
10 districts will be carried out, with rapid response by the
vaccination teams if and when new cases are detected.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<http://healthmap.org/r/0089>.
The districts can be seen on the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>. - Mod.TY]

Yellow fever in Uganda
19.01.2011 - WHO

On 23 December 2010, the Minister of Health in Uganda reported 3 laboratory confirmed cases of yellow fever, detected through a special investigation following an outbreak in the country in October 2010. The cases were reported in 3 districts of Abim, Agago and Kitgum near the border with South Sudan.

In total, five cases have been laboratory confirmed for yellow fever by the US Centers for Disease Control and Prevention (3 by RT-PCR, 1 by ELISA method and 1 by histopathology). A total of 226 cases compatible with the clinical case definition including 53 deaths have been reported by 12 districts in northern Uganda.

Following field investigations by the Ministry of Health with the support of WHO, Médecins Sans Frontières (MSF), the US and others partners, a decision was made to conduct a reactive mass vaccination campaign in 5 districts (Abim, Agago, Kitgum, Lamwoo and Pader). On 31 December 2010, WHO deployed three additional experts to support risk assessment, and planning and implementation of control measures which include strengthening of the surveillance system and the vaccination campaign.

A request for one million doses of vaccine was submitted to the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG) on 4 January 2011 and the vaccine from the GAVI funded emergency stockpile was shipped to the country on 11 January 2011. The vaccination campaign will start on 22 January 2011, targeting a population of over 905,000 people.

Uganda - Gelbfieber
21.01.2011

Die seit Ende Oktober gemeldete unklare Erkankung konnte als Gelbfieber indentifiziert werden. Im Norden des Landes sind mindestens 226 Erkrankungs- und 53 Todesfälle aufgetreten. Die Krankheit ist in Uganda seit 40 Jahren nicht mehr gemeldet worden, die Immunität der Bevölkerung ist dementsprechend schlecht. Inzwischen sind 1Mio Impfdosen verfügbar, die Impfungen sollen am 22.Januar beginnen. Es werden die Menschen in Gulu, Arua, Kaabong, Kotido, und Lira geimpft. Reisende sollten unbedingt geimpft werden. / Quelle: crm

YELLOW FEVER - AFRICA (08 ): COTE D'IVOIRE, CENTRAL
**************************************************
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 21 Jan 2011
Source: Voice of America [edited]
<http://www.voanews.com/english/news/afr ... 66179.html>


The United Nations Children's Fund is kicking off a yellow fever [YF]
vaccination campaign in Cote d'Ivoire despite growing [political]
instability and hostility to U.N. staff following a disputed
presidential election in November [2010]. UNICEF plans to vaccinate
more than 800 000 adults and children in north-central Cote d'Ivoire
against YF over the next week. Health workers will target 4 rural
districts, including Katiola and Beoumi where 66 cases of the
mosquito-borne illness have been recorded since November [2010],
including 25 deaths. UNICEF says just one case of the highly deadly
disease constitutes an epidemic.

UNICEF spokesman in Cote d'Ivoire, Louis Vigneault-Dubois, said the
vaccination campaign was delayed by the tense political gridlock that
has gripped the country since a 28 Nov [2010] presidential poll. "Now
it has reached a point where it is urgent to vaccinate the people, to
stop the epidemic in the 4 districts that are concerned by the
current campaign and to make sure that the disease does not spread
further beyond the 4 districts that are concerned," said Vigneault-Dubois.

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

[The YF outbreak situation in the Cote d'Ivoire grows of increasing
concern. The 5 Jan 2011 report (ProMED-mail archive number
20110105.0048) stated that there were 21 suspected YF cases and 11
deaths. Now, there are 66 cases and 25 deaths. It is difficult to
predict if the political conflicts and attacks on UN personnel will
become a major obstacle in mounting this urgent vaccination campaign.
One hopes that no interference will occur. The virus will not await a
political resolution, and more cases and deaths will occur if that
resolution is not accomplished.

Seguela, Katiola, and Beoumi 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/promed/index.php?v=7.6,-5,5>. - Mod.TY]

Mosambik - Darminfektionen
24.01.2011

Risiko für Durchfallerkrankungen landesweit. Während der Regenzeit kommt es immer wieder zu lokal begrenzten Cholera-Ausbrüchen. In dieser Regensaison (2010/2011) wird im Januar ein Ausbruch mit „tausenden“ Erkrankten und bisher mindestens 13 Todesopfern gemeldet. Betroffen ist vor allem der Norden der Provinz Nampula. Durch anhaltende Regenfälle und dem damit verbundenen Hochwasser wird die Lage verschärft; in Gebieten nahe der großen Staudämme wie dem Cahora Bassa Damm mussten schon einige Dämme geöffnet werden, viele Menschen müssen ihre Häuser verlassen. Die Hochwasser führenden Flüsse sind stark verunreinigt, den Menschen fehlt der Zugang zu sauberem Trinkwasser. Hygiene beachten, Risikoreisende sollten geimpft werden. / Quelle: crm