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Yellow fever in Côte d'Ivoire
25.01.2011 - WHO

On 3 January 2011, the Minister of Health in Côte d'Ivoire notified WHO of a yellow fever outbreak in the north of the country. As of January 17, 2011 a total of 12 cases tested IgM positive by ELISA at the Institut Pasteur of Abidjan and were subsequently confirmed positive for yellow fever by the regional reference laboratory, the Institut Pasteur of Dakar (by ELISA and PRNT). These cases originate from Béoumi and Katiola districts, in the Bandama Valley Region in the centre of the country, and Séguéla and Mankono in the Worodougou Region in the north of the country.

In response to this outbreak, a field investigation was conducted in Béoumi and Katiola districts from 10 to 15 January 2011 by the Ministry of Health with support from the WHO country office. During this investigation a total of 64 suspected cases, including 25 deaths, were identified. Further laboratory testing is on-going.

On 22 January, the Ministry of Health of Cote d'Ivoire started an emergency vaccination campaign targeting over 840,000 people aged nine months and older in Béoumi, Katiola, Mankono and Séguéla districts, with support from WHO and UNICEF. GAVI-funded vaccines released by the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG) for the 2010 country mass preventive campaign will be used. The four districts were part of the 61 districts chosen for the preventive campaign, which could not be conducted last year due to the political situation.

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (03)
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In this update:
Africa
[1] Cholera - Zimbabwe 2010
[2] Cholera - Zimbabwe (Masvingo)
[3] Cholera - Cote d'Ivoire (Lagunes)
[4] Cholera - Zambia (Southern province)
[5] Cholera - Mozambique (Nampula)
[6] Cholera - Nigeria (Jigawa)
[7] Cholera - Ghana (Greater Accra)

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[1] Cholera - Zimbabwe 2010
Date: Sat 22 Jan 2011
Source: ZimOnLine [edited]
<http://www.zimonline.co.za/Article.aspx?ArticleId=6532>


At least 21 people died from cholera in 2010 while nearly 1000 others
were affected by an outbreak of the disease that started last February
2010, the WHO said this week. According to the UN agency, the deaths
were part of the 951 cumulative cholera cases recorded between 4 Feb
and 19 Dec 2010.

"(Some) 951 cumulative cholera cases consisting of 835 suspect cases,
116 laboratory confirmed cases and 21 deaths had been reported by 19
Dec 2010 to the WHO through the Ministry of Health and Child Welfare's
National Health Information Unit," the WHO said in its latest
Epidemiological Bulletin.

The recorded cases and deaths were, however, a far cry from the 98 522
cumulative incidents and 4 282 fatalities that had been reported
during the comparative period in 2009.

Cholera has become a perennial disease in Zimbabwe where the water and
sanitation infrastructure has collapsed due to lack of maintenance.

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[2] Cholera - Zimbabwe (Masvingo)
Date: Thu 20 Jan 2011
Source: The Zimbabwean [edited]
<http://www.thezimbabwean.co.uk/index.ph ... &Itemid=30>


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, a 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. "I am told there was an
apostolic sect meeting held near Nyika growth point. The church
gathering went for 3 days. The people there had no toilets and [no]
clean source of water."

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[3] Cholera - Cote d'Ivoire (Lagunes)
Date: Thu 27 Jan 2011
Source: Canadian Press [edited]
<http://www.google.com/hostednews/canadi ... Id=5780623>

The head of UNICEF in Cote d'Ivoire says that a cholera outbreak in a
neighborhood of Abidjan killed at least 7 people and sickened 35
others. UNICEF country chief Sylvie Dossou says the fatality rate of
20 percent in the Adjame neighborhood is "unacceptably high."

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[4] Cholera - Zambia (Southern province)
Date: 25 Jan 2011
Source: Lusaks Times [edited]
<http://www.lusakatimes.com/2011/01/25/c ... inazongwe/>


More than 40 people have been admitted to Sinamalima clinic in
Sinazongwe district in Southern Province after suffering from cholera
in the past week. Sinazongwe District Health Medical Officer Elias
Chipandwe said 3 people out of the 44 that have suffered from cholera
in the past 8 days have since died.

Dr. Chipandwe told the District Epidemic Preparedness Committee
yesterday, 24 Jan 2011, that currently 20 people were still admitted
to Sinamalima clinic, which has been turned into a cholera center.

Dr. Chipandwe disclosed that 10 villages were affected in Malima.

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[5] Cholera - Mozambique (Nampula)
Date: Thu 20 Jan 2011
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/201101210155.html>


A cholera outbreak in Monapo district, in the northern Mozambican
province of Nampula, has claimed 4 lives over the past week, according
to a report in Thursday's [20 Jan 2011] issue of the Maputo daily
"Noticias."

There have been 176 diagnosed cases of the disease which, according to
Lidia Chongo, the Deputy National Director of Health, is particularly
severe in the communities of Nacuca and Carapira. The main reasons for
the spread of the disease in Monapo, she said, are the habit of
defecating in the open, and contamination of traditional, unprotected
wells used by the population.

Since Monapo lies on the Nacala rail corridor, there are fears that
the disease will spread to other parts of the province including the 2
main cities, Nampula and Nacala port. Cases of severe diarrhea have
been reported from Nampula, Mozambique Island and Ribaue and Murrupula
districts, but these have not yet been confirmed as cholera.

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[6] Cholera - Nigeria (Jigawa)
Date: Wed 19 Jan 2011
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/201101190595.html>


No fewer than 194 people were confirmed infected by cholera following
the outbreak of the disease in Hadejia, Jigawa State. A report from
the affected areas revealed that the outbreak of the disease started
last week and within a few days, spread all over the city, affecting
hundreds of people. No deaths have been recorded in the epidemic.

Confirming the outbreak of the disease, the Director State Primary
Health Care, Dr. Aminu Danmalam said as of yesterday, 18 Jan 2011,
reports have shown that 117 females and 77 males were infected by the
cholera disease in Hadejia.

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[7] Cholera - Ghana (Greater Accra)
Date: Tue 25 Jan 2011
Source: XinHuaNet [edited]
<http://english.cri.cn/6966/2011/01/25/2722s617261.htm>


2 deaths were recorded on Mon 24 Jan 2011, and more than 45 people
hospitalized after a cholera outbreak hit southern Ghana, officials of
the Ghana Health Service (GHS) told Xinhua.

The patients are receiving treatment in a number of health centers in
the capital Accra and other parts of the central region.

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Yellow fever in Côte d'Ivoire - update
01.02.2011 - WHO

More than 700,000 people were vaccinated against yellow fever in the recent emergency vaccination campaign in Côte d'Ivoire led by the Ministry of Health with support from WHO and UNICEF.

The campaign, conducted from 21 to 28 January 2011, reached 88% of the targeted population in the districts of Katiola, Beoumi (in the center of the country), Seguela, Mankono (in the North). The high vaccination coverage results were validated by a field survey conducted by WHO the next day following the campaign.

Suspected cases of yellow fever were notified by Côte d'Ivoire on 3 January, and 12 cases were laboratory confirmed on 17 January by the regional reference laboratory, Institut Pasteur in Dakar. The outbreak has affected the districts of Seguela (14 cases, including 10 deaths), Mankono (1 case), Beoumi (18 cases including 9 deaths) and Katiola (46 cases, including 16 deaths).

Burundi, Ruanda - Gelbfieber
01.02.2011

Aufgrund des Gelbfieber-Ausbruchs in Uganda haben die Länder der East African Community (Burundi, Kenia, Tansania, Ruanda und Uganda) beschlossen, den Nachweis einer Gelbfieber-Impfung stärker zu kontrollieren. Eine Impfung ist für alle Reisenden (auch bei Einreise aus Europa) vorgeschrieben. / Quelle: crm
__________________________

Côte d’Ivoire - Darminfektionen
01.02.2011

Risiko für Durchfallerkrankungen landesweit. Ende Januar wurde ein Cholera-Ausbruch aus Abidjan mit 35 Erkrankten und 7 Todesfällen gemeldet. Polio wurde im Dezember 2008 zum ersten Mal seit 5 Jahren wieder nachgewiesen. Bis Ende 2009 wurden 27 Erkrankungen registriert. Hygiene und Impfschutz (Polio) weiterhin beachten. / Quelle: crm
___________________________

Kenia - Gelbfieber
01.02.2011

Aufgrund des Gelbfieber-Ausbruchs in Uganda haben die Länder der East African Community (Burundi, Kenia, Tansania, Ruanda und Uganda) beschlossen, den Nachweis einer Gelbfieber-Impfung stärker zu kontrollieren. Genauere Angaben zur Umsetzung sind noch nicht bekannt. Um Schwierigkeiten bei der Einreise zu vermeiden sollten alle Reisenden, auch bei der Einreise aus Europa, einen gültigen Impfnachweis vorweisen können. Eine Impfung wird allen Reisenden empfohlen. / Quelle: crm
___________________________

Mosambik - Darminfektionen
01.02.2011

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 176 bestätigten Fällen unter Tausenden Erkrankten und bisher mindestens 17 Todesopfern gemeldet. Betroffen ist vor allem der Norden der Provinz Nampula (O). Durch anhaltende Regenfälle und das damit verbundene 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
___________________________

Tansania - Gelbfieber
01.02.2011

Aufgrund des Gelbfieber-Ausbruchs in Uganda haben die Länder der East African Community (Burundi, Kenia, Tansania, Ruanda und Uganda) beschlossen, den Nachweis einer Gelbfieber-Impfung stärker zu kontrollieren. Die Regierung Tanasanias hat an der Grenze zu Uganda Impfstationen eingerichtet um nicht geimpfte Reisende vor Ort impfen zu können. Die Kontrollen an allen Grenzübergängen und Flughäfen wurden verschärft. Laut Botschaftsangaben sollte auch bei Einreise aus Europa ein gültiger Impfnachweis vorhanden sein, Zwangsimpfungen oder die Verweigerung der Einreiseerlaubnis können nicht ausgeschlossen werden. Eine Impfung wird allen Reisenden empfohlen.

YELLOW FEVER - AFRICA (12): UGANDA (NORTH)
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Date: Thu 27 Jan 2011
Source: Allvoices [edited]
<http://www.allvoices.com/contributed-ne ... s-caused-5>


Health officials in Uganda have launched a yellow fever [YF]
vaccination drive in the north where an outbreak of the disease has
caused 53 deaths and 224 infections in 10 districts since late 2010.
Almost a million people are expected to be vaccinated in the campaign,
launched by Health Minister Richard Nduhura on 23 Jan [2011]. The
outbreak of yellow fever last year [2010] was so mysterious because
the disease was first thought to be [an] Ebola[virus infection] and
then pneumonic plague, and then later on it was identified by the
Ministry of Health as yellow fever.

The disease first hit Abim and Agago districts, but later on spread
to Kitgum and other 10 districts in northern Uganda. Nathan
Kenya-Mugisha, the acting Director General of Health Services and
experts from the Ministry of Health, the World Health Organization,
and the Centers for Disease Control positively confirmed the disease.
A total of 174 people have been affected by yellow fever. Of these, 45
people died in 10 districts of Northern Uganda that include Abim,
Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong, Nebbi, Agago, and Lira
districts.

Yellow fever, which had not been seen in Uganda for about 40 years,
has claimed the lives of 48 individuals in the north of the country,
sending 187 others to hospital.

Doctors and local leaders in northern Uganda worked tirelessly to
find the true cause and prevent the spread of the unknown disease at
the time. Radio announcements and other means of sensitization were
used by the government of Uganda and the World Health Organization.
Residents were advised that anybody who presents suffering high
fevers, muscle and back pain, headache, shivering, loss of appetite
abdominal pain, vomiting, and diarrhea, should report to the nearest
health facility for treatment.

Meanwhile, the ministry of health has also disclosed plans to carry
out yellow fever vaccination in northern Uganda. The plans for the
vaccination came out because of the many deaths and continued spread
of infections in the districts of Kitgum, Abim, Agago, Lamwo, Pader,
Gulu, Arua, and Kaabong.

All foreign diplomatic services are advising their citizens to avoid
traveling to northern Uganda unless vaccinated. And today [27 Jan
2011], as the vaccination is going on, local leaders say they fear
there may not be sufficient medicine as people are coming from far and
wide.

John Bosco Ogwok, Kitgum district local council chairman, said they
were vaccinating people from the neighboring country, Sudan, who were
coming for the exercise. Vaccination points, Ogwok said, especially
those near the border with Southern Sudan, have registered large
numbers of Sudanese, while Ugandans from neighboring districts such as
Gulu and Lira have also turned up for vaccination. Grace Ogwang, a
nursing officer in Kitgum district coordinating outpost vaccination
points, said that health officials were vaccinating everyone who
turned up. "Our ethics in the practice of medicine is
non-discrimination; whether you are from Kitgum or not, we don't
discriminate," Ogwang said. "We are vaccinating everybody coming to
the vaccination point, so long as you are above 6 months of age."

Kitgum is one of the 5 districts where the 1st phase of vaccination
is taking place in northern Uganda. The others are Pader, Lamwo,
Agago, and Abim. Health Minister Nduhura said the remaining districts
in the north would begin the programme during a 2nd phase whose start
date depended on resolving funding issues.

In Africa, World Health Organization [WHO] estimates 508 million
people in 32 countries (including Uganda) are at risk. The number of
yellow fever cases has increased over the past 2 decades due to
declining population immunity to infection, deforestation,
urbanization, population movements, and climate change.

In the case of Uganda, the genomic sequencing of the virus strain
responsible for the current yellow fever outbreak is 98 percent
identical to the East African Couma-Ethiopia genotype, according to a
WHO brief. This is an indication that the virus has been circulating
in the region.

Kenya, the Democratic Republic of Congo, and Sudan reported yellow
fever outbreaks in 1992-1993. A recent outbreak occurred in Sudan in
2003.

Côte d’Ivoire - Gelbfieber
08.02.2011

Seit Dezember starben mindestens 35 Menschen aus den Regionen Seguela, Mankono, Katiola und Beoumi (Zentral-Nord).Insgesamt 79 Menschen sind erkrankt. Trotz unsicherer politischer Lage wurde im Januar eine Impfkampagne durchgeführt. Diese hat ca. 70.000 Menschen erreicht. Impfschutz beachten! / Quelle: crm
______________________

Uganda - Gelbfieber
08.02.2011

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. Am 22. Januar begann die erste Impfphase; jeder, der über sechs Monate alt ist, kann sich in den Stationen impfen lassen. Es kommen auch viele Menschen aus den umliegenden Regionen und aus dem benachbarten Sudan.

Aufgrund des Gelbfieber-Ausbruchs haben die Länder der East African Community (Burundi, Kenia, Tansania, Ruanda und Uganda) beschlossen, den Nachweis einer Gelbfieber-Impfung stärker zu kontrollieren. Genauere Angaben zur Umsetzung sind noch nicht bekannt. Um Schwierigkeiten bei der Einreise zu vermeiden sollten alle Reisenden, auch bei der Einreise aus Europa, einen gültigen Impfnachweis vorweisen können. / Quelle: crm

Mehr als 20 Menschen fallen Cholera-Ausbruch in Somalia zum Opfer

Mogadischu. Nach einem Cholera-Ausbruch in der somalischen Hauptstadt Mogadischu sind nach Angaben von Ärzten bereits mehr als 20 Menschen an der Infektionskrankheit gestorben. mehr...

Grüsse
Alexander

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (04)
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In this update:
Africa
[1] Cholera - Zambia
[2] Cholera - South Africa
[3] Cholera - Ghana (Greater Accra)
[4] Cholera - Cote d'Ivoire (Lagunes)
[5] Cholera - Nigeria (Kogi)
[6] Cholera - Nigeria (Kano)

******
[1] Cholera - Zambia
Date: Sat 19 Feb 2011
Source: Lusaka Times [edited]
<http://www.lusakatimes.com/2011/02/19/d ... nd-clinic/>


Dr Mbewe has disclosed that one person has died of cholera in Lusaka's
Chipata Compound while 14 cholera cases are under treatment. He says
the affected areas include Lusaka's Matero Compound, Sinamalima area
in Sinazongwe district in Southern Province, and Nsumba village in
Northern Province.

Dr Mbewe disclosed that the Ministry has continued with its programme
of disinfecting the toilets and testing water collecting points in
cholera-prone areas.

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******
[2] Cholera - South Africa
Date: Thu 17 Feb 2011
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA),
ReliefWeb, Government of Belgium report [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>


As a consequence of "La Nina", the southern part of Africa has had an
exceptional amount of rainfall since December 2010, which has led to
heavy flooding.

In South Africa, approximately 20 000 people throughout 9 South
African provinces have been heavily affected, with a total of 70
deaths already. The floods damage infrastructure and the harvests, and
increase the risk of illnesses that are borne by the contaminated
water. For example, there are reports of cholera in the province of
Limpopo. Many of the affected people are living in temporary
settlements where basic facilities are either totally missing or
scarcely available. The most vulnerable groups need long-term aid for
health care, hygiene and clean water.

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[With the severe flooding, more cholera is expected to be reported
throughout the southern part of Africa. - Mod.LL]

[The HealthMap/ProMED-mail interactive map South Africa can be seen at
<http://healthmap.org/r/00vd>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Ghana (Greater Accra)
Date: Fri 11 Feb 2011
Source: Ghana New Agency (GNA) [edited]
<http://www.ghananewsagency.org/s_health/r_25317/>


The Regional Health Directorate of Ghana Health Service (GHS) on Fri
11 Feb 2011, cautioned residents to observe personal hygiene and
adhere to advice provided by health professionals as the number of
deaths from the cholera outbreak in Accra rose to 6.

Speaking to the GNA in Accra, the deputy regional director of public
health, Dr Edward Antwi, said so far 505 cases had been recorded. The
Health Directorate has also expressed worry at the turn of events due
to the increase in the number of cases after the 1st case was reported
on 10 Jan 2011 and reiterated its warning to residents to take
precautionary measures to avoid contamination.

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******
[4] Cholera - Cote d'Ivoire (Lagunes)
Date: Mon 31 Jan 2011
Source: UN Integrated Regional Information Networks (IRIN) News [edited]
<http://www.irinnews.org/Report.aspx?ReportID=91784>


Health experts and residents say poor hygiene exacerbated by growing
piles of rubbish is largely to blame for a dry-season cholera outbreak
in Cote d'Ivoire's main city of Abidjan, which has killed 8 people of
61 infected.

The diarrhoeal disease, contracted through contaminated food or water,
generally occurs during the rainy season when flooding can contaminate
water sources, according to the WHO. But outbreaks can also occur in
the dry season, WHO says.

The initial case, in Abidjan's Adjame District (a poor neighborhood
that has seen severe post-election violence in recent weeks), was
registered in mid-January 2011; the major rains ended in November
2010. Cholera has also affected the district of Williamsville.

"Across this region [West Africa] there are pockets of poverty where
hygiene is poor and we see occasional outbreaks," Mamadou D Ball, WHO
representative in Cote d'Ivoire, told IRIN. "The cholera bacterium is
always present."

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******
[5] Cholera - Nigeria (Kogi)
Date: Thu 3 Feb 2011
Source: AllAfrica, Daily Trust report [edited]
<http://allafrica.com/stories/201102030334.html>


Residents of Ette community in Kogi Local Government Area of Kogi
State say they have lost 10 persons to a cholera epidemic since the
weekend [29-30 Jan 2011]. But the member representing Kogi/Kotonkarfe
Constituency in the state House of Assembly, Alhaji Abdulrahman Ndako,
told our correspondent yesterday, 2 Feb 2011, in a telephone interview
that he could only confirm 3 deaths.

The lawmaker, who added that 23 persons were also currently afflicted
with the disease in the area, said the epidemic had already spread to
several other communities like Edekakpo, Edegaki, Koton-Karfe, Ikumo,
and Edeha. He expressed concern that if urgent steps were not taken,
more people would be affected.

[Byline: Isiaka Wakili]

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[The state of Kogi is in central Nigeria while Kano (see below) is
among the northern states hit by cholera in the fall of 2010. - Mod.LL]

******
[6] Cholera - Nigeria (Kano)
Date: Wed 2 Feb 2011
Source: AllAfrica, Daily Trust report [edited]
<http://allafrica.com/stories/201102020770.html>


A cholera outbreak has hit Kano as 30 cases have been recorded at the
Infectious Disease Hospital (IDH) alone, Kano state commissioner for
health Hajia A'ishatu Isyaku Kiru said yesterday, 1 Feb 2011. Daily
Trust gathered that the cases were also recorded in many other
hospitals across the state, and according to a source at the Murtala
Mohammed General Hospital, Kano Municipal Local Government is the
worst hit.

[Byline: Jaafar Jaafar]

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LASSA FEVER - NIGERIA: (EBONYI)
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Date: Wed 23 Feb 2011
Source: The Compass Newspaper [edited]
<http://www.compassnewspaper.com/.../ind ... -in-ebonyi>


At least one person has been confirmed dead following an outbreak of
a haemorrhagic viral infection (otherwise known as Lassa fever) in
Abakaliki, the Ebonyi State capital. Although unconfirmed, reports
claim that 3 other persons believed to be residing at the military
cantonment have also died of the disease. The Commissioner for Health
and Environment in the state, Dr. Sunday Nwangele, who confirmed the
outbreak of the disease, said, however, that the state Ministry of
Health is on top of the situation.

The disease was 1st reported in the state in 2008, which then claimed
the lives of some people, including 2 medical doctors and other health
workers.

The Nigerian Compass newspaper gathered that the victim of the recent
incident resided at the Military Cantonment, Nkwegu, near Abakaliki.
Another woman in the same cantonment, who has also been diagnosed with
the disease, is said to be receiving treatment at the Ebonyi State
University Teaching Hospital.

According to the commissioner, epidemiologists from the ministry have
been deployed to the affected area and other parts of the state to
check the possible spread of the disease. Nwangele said the ministry
has sent protective kits to the state's teaching hospital for the
safety of health personnel.

The Chief Medical Director of the teaching hospital, Dr. Akuma Aja,
narrated how the victims were brought to the health facility. He said
the hospital took samples from neighbours and relatives, who had close
contacts with them, as well as health personnel who attended to them
while on admission, stressing that some of the results tested positive
to the disease.

Aja advised people in the state to keep their environment clean and
avoid contact with rodents and rats, which have been identified to be
responsible for the transmission of the disease.

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[Lassa haemorrhagic fever is an acute illness of 1-4 weeks duration
that occurs in West Africa. Though 1st described in the 1950s, the
virus causing the disease was not identified until 1969. The virus is
a single-stranded RNA virus belonging to the virus family
_Arenaviridae_. Lassa fever is known to be endemic in Guinea, Liberia,
Sierra Leone and parts of Nigeria but probably exists in other West
African countries as well. About 80 percent of human infections are
asymptomatic; the remaining cases have severe multi-system disease,
where the virus affects several organs in the body, such as the liver,
spleen and kidneys. The incubation period of Lassa fever ranges from
6-21 days.

Lassa fever is a zoonotic disease. The animal reservoir of Lassa
virus is a rodent of the genus _Mastomys_, commonly known as the
"multimammate rat." _Mastomys_ infected with Lassa virus do not become
ill, but they can shed the virus in their urine and faeces. (An image
of a multimammate rat can be viewed at:
<http://www15.bni-hamburg.de/bni/bni2/ne ... &pid=21232>).

Lassa fever can affect all age groups. Persons at greatest risk are
those living in rural areas where _Mastomys_ are usually found,
especially in areas of poor sanitation or crowded living conditions
such as, in the present instance, military encampments. There is no
epidemiological evidence supporting airborne spread between humans,
but person-to-person transmission occurs in both community and health
care settings.

Lassa virus was named after the town of Lassa in northeastern
Nigeria, where the 1st known patient contracted this infection in
1969. Lassa viral infection may affect between 2 to 3 million people
each year in certain portions of the West African region, causing a
mortality of about 10 000. Lassa fever is one of the endemic zoonoses
in Nigeria, with a high probability for nosocomial transmission due to
several health care sector challenges. Although treatment is available
for Lassa fever, early diagnosis is still difficult in almost all
Nigerian health care institutions. (For a recent review, see, V.
Idemyor, Lassa virus infection in Nigeria: clinical perspective
overview. J Natl Med Assoc 102(12):1243-6, 2010).

A map showing the location of Ebonyi state can be accessed at:
<http://en.wikipedia.org/wiki/File:Niger ... te_map.png>. The
HealthMap/ProMED-mail interactive map of Nigeria can be accessed at:
<http://healthmap.org/r/007*>. - Mod.CP]

Madagaskar - Pest
01.03.2011

Seit Anfang Januar sind bereits 45 Menschen an der bakteriellen Infektion erkrankt und 23 gestorben. Die meisten Fälle traten in Ambilobe, Manambato und Ambarakaraka im Nordwesten auf; Straßensperren sollen helfen, eine weitere Ausbreitung zu verhindern. Die von Rattenflöhen übertragene Infektion tritt regelmäßig in der Regenzeit auf. / Quelle: crm
_____________________

Nigeria - Lassa-Fieber
01.03.2011

Aus Ebonyi (SO) wurde Ende Februar ein bestätigter Fall des hämorrhagischen Fiebers gemeldet. Der Patient verstarb; bei drei weiteren Verstorbenen wird dieselbe Diagnose vermutet. Die Bevölkerung ist aufgerufen, ihre Umgebung sauber zu halten und sich von Ratten und anderen Nagetieren, die für die Übertragung verantwortlich sind, fernzuhalten. / Quelle: crm
_____________________

Südafrika - Cholera
01.03.2011

Nachdem es im südlichen Afrika aufgrund des Wetterphänomens „el nina“ zu heftigen Regenfällen und Überschwemmungen gekommen ist, wurden nun die ersten Cholera-Fälle gemeldet. Es gibt Berichte aus Limpopo im Norden des Landes, aber auch in anderen Regionen soll es Fälle gegeben haben. Hygiene beachten, ggf. Impfung. / Quelle: crm

HEPATITIS B - UGANDA: (MOYO), REQUEST FOR INFORMATION
*****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 4 Mar 2011
Source: Daily Monitor [edited]
<http://www.monitor.co.ug/News/National/ ... index.html>


Hepatitis B continues to kill people in Moyo
--------------------------------------------
Despite efforts by health officials in Moyo District to check the
spread of Hepatitis B that broke out last year, more people have
continued to die from the deadly disease. Now, health officials have
confirmed that 4 people have so far died of the virus with 74
infections since last year [2010].

The district disease surveillance officer, Mr Simon Amudra, said many
of the cases are not reported in the health facilities. He said more
intensive sensitisation on the signs and symptoms like general body
weakness, fever, diarrhea, abdominal discomfort, loss of appetite and
vomiting needs to be increased in the communities.

The newly infected 24 cases admitted to isolation ward at Moyo
hospital since January this year have been discharged after
improvement to avoid further infections.

Hepatitis B virus mainly affects the liver.

[Byline: Martin Okudi]

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

[The outbreak of blood-borne hepatitis B virus infection in Moyo
District of Uganda has not been reported previously in ProMED-mail,
whereas outbreaks of the water/fecal borne hepatitis E virus infection
have been frequent. Further information concerning this hepatitis
outbreak in Moyo District is required.

Moyo District is a district in northern Uganda that can be located in
the map of Uganda at:
<http://en.wikipedia.org/wiki/Moyo_District>. The
HealthMap/ProMED-mail interactive map of Uganda can be accessed at:
<http://healthmap.org/r/0089>. - Mod.CP]

LEPROSY - GHANA: (VOLTA) CASES INCREASE
***************************************
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 5 Mar 2011
Source: Ghana News Agency (GNA) [edited]
<http://www.ghananewsagency.org/s_health/r_26282/>


Mr Anthony Adjavor, chief technical officer of the Ho Leprosarium, on
Friday [4 Mar 2011], reported an increase in leprosy cases, in the
Volta Region, from 73 in 2009 to 120 in 2010. He said the situation
had presented a challenge to the disease control officers to institute
extensive outreaches, to educate the public on the disease.

Mr Adjavor was speaking at a ceremony in Ho, when staff of the Armed
Forces Pay Office in Accra, presented assorted items to cured lepers,
living in clusters around the Ho Polyclinic, which was in the past
essentially a leper clinic. He said it was important that individuals
reported strange patches and abrasions on their skin to health
institutions for examination. Mr Adjavor said there could be people
with the disease, who were unknowingly infecting others.

The items presented include bags of maize, rice, cooking oil,
detergents, beverages, canned fish, disinfectants, toilet rolls and
loaves of bread, estimated at GHC [Ghana Cedi] 5000 [about USD 3300]
a[nd] cash of GHC 500 [about USD 330]. Lt Col Anthony Dzisi,
commanding officer, said the overture formed part of the Pay Office's
corporate social responsibility policy of contributing to the needs of
the disadvantaged in the society. He said the unit's activities, which
had been concentrated in Accra, were now being decentralized to affect
those in the regions as well. The officers and men joined the civilian
employees of the unit on the trip, and together with cured lepers,
danced and made merry after the presentation.

Donors, including some international non-governmental organizations,
have over the years, supported the cured lepers with health care
facilities and accommodation. Shunned by society, dejected cured
lepers from across the country, after their discharge, settled on the
fringes of the leprosarium (now Polyclinic) and christened the
flagship settlement "Freetown", which had since expanded into other
clusters.

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

[The news release makes it apparent that, despite being cured of
leprosy, people who once had this disease cannot return to a normal
way of life, but continue to live separate from the rest of their
society, and entirely dependent on the beneficence of others
(<http://allafrica.com/stories/201003180681.html>).

The following is extracted from the WHO Leprosy fact sheet no. 101
(<http://www.who.int/mediacentre/factsheets/fs101/en/>):

Leprosy is a chronic disease caused by a bacillus, _Mycobacterium
leprae_, an acid-fast, rod-shaped bacillus. _M. leprae_ multiplies
very slowly and the incubation period of the disease is about 5 years,
but symptoms can take as long as 20 years to appear. Leprosy is not
highly infectious. It is transmitted via droplets, from the nose and
mouth, during close and frequent contacts with untreated cases.
Untreated, leprosy can cause progressive and permanent damage to the
skin, nerves, limbs, and eyes. Leprosy is curable with multidrug
therapy (MDT) and treatment provided in the early stages averts
disability. MDT (dapsone, rifampicin, and clofazimine), which has been
available free of charge to all patients worldwide since 1995, remains
the key in eliminating the disease as a public health concern.

In 1991, WHO resolved to eliminate leprosy as a public health problem
by the year 2000. Elimination of leprosy as a public health problem is
defined as a prevalence rate of less than one case per 10 000 persons.
Ghana reported in 2005 that it achieved the leprosy elimination target
in most parts of the country with a prevalence rate of 0.36 per 10 000
population; at the time, leprosy was considered endemic in only 6
districts, where the prevalence rate was more than one per 10 000
(<http://www.modernghana.com/news/82523/1 ... prosy.html>).
Ghana reported a total of 734 cases at the end of October 2006
(<http://www.modernghana.com/news/121589/ ... arget.html>).
In 2010 it was reported that Ghana had a prevalence rate of 0.29 per
10 000
(<http://www.ghanaweb.com/GhanaHomePage/h ... ?ID=178169>),
which calculates to be 703 cases for its population of 24 233 431
(<http://en.wikipedia.org/wiki/Ghana>).

Currently, even with 120 cases of leprosy and a population of 1 635
421, the Volta region, one of 10 administrative regions in Ghana, has
a prevalence rate of 0.73 per 10 000, less than the leprosy
elimination target. Whether the increase in cases reported in the
Volta Region is the result of enhanced case-finding or ongoing
transmission of leprosy is not known. Leprosy among children would be
an indication of ongoing transmission in the community.

The Volta Region is located along the southern half of the eastern
border of Ghana, which it shares with the Republic of Togo
(<http://www.modernghana.com/GhanaHome/re ... 33&gender=>).
The city of Ho in southeast Ghana is the capital of the Volta Region
(<http://en.wikipedia.org/wiki/Ho,_Ghana>). Ho has one of the only 3
ultra modern hospitals in the country
(<http://www.modernghana.com/GhanaHome/re ... 33&gender=>).

For a map of the administrative regions of Ghana, see
<http://www.lib.utexas.edu/maps/africa/ghana_pol96.jpg>. For a map of
Ghana, see the interactive HealthMap/ProMED map at
<http://healthmap.org/r/0zcV>. - Mod.ML]

Meningococcal disease in Chad
08.03.2011 - WHO

From 1 January to 6 March 2011, the Ministry of Health of Chad reported 923 suspected cases of meningococcal disease including 57 deaths (case-fatality rate: 6.2%). So far, five districts primarily in the region of Logone Occidental experience an epidemic (Benoye, Kello, Laokassy, Melfi and Moundou ) while two others are in alert (Boussou and Sarh).

The predominance of Neisseria meningitidis A in epidemic districts has been laboratory-confirmed by latex agglutination test, with no other Neisseria meningitidis serogroup being identified in these areas.

The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control has provided 752,000 doses of bivalent polysaccharide AC vaccine for a mass vaccination campaign in affected areas of Benoye, Kello, Laokassy, Melfi and Moundou. Vaccines are being provided with the support of the Global Alliance for Vaccines and Immunization (GAVI) and Médecins sans Frontières.

WHO, UNICEF, Médecins sans Frontières and the International Federation of Red Cross (IFRC) are working with the Ministry of Health, Chad, to implement the vaccination campaigns as well as other emergency control measures, including case management and enhanced surveillance in neighbouring districts.

LASSA FEVER, IMPORTED - SWEDEN: (LINKOPING) ex WEST AFRICA
**********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 8 Mar 2011
Source: The Local (Swedish News in English) [edited]
<http://www.thelocal.se/32470/20110308/>


A Swedish woman is being treated at the intensive care unit of
Linkoping University Hospital in eastern Sweden after being diagnosed
with the deadly disease Lassa fever. The woman was infected in West
Africa, where she had been working for a humanitarian aid
organization. She is the 1st patient ever to be treated for Lassa
fever in Sweden.

The woman's condition is stable, but she will remain isolated for
another few weeks, according to infectious disease specialist Britt
Akerlind. The woman, who is in her 30s, was flown home on a medical
transport flight and arrived in Sweden on Monday [7 Mar 2011] morning.
"She tested positive for the disease in Africa. We have since
conducted some tests here, but the results are not in yet. We are
treating this as a serious illness," Akerlind told news agency TT.

The symptoms of Lassa fever, which infects between 300 000 and 500
000 people annually, include a high temperature and internal
haemorrhaging, but the majority of those that contract the disease
make a full recovery. "Only about one per cent of those infected
become seriously ill, and it is impossible to know in advance who will
be affected worse than others," Akerlind told TT.

Rodents are often carriers of Lassa fever, and the disease is spread
through contact with their faeces. Between humans, the disease is
passed through the exchange of bodily fluids. How the Swedish woman
caught the disease is unknown.

According to Akerlind there is no risk that Lassa fever, which claims
around 5000 lives annually, will spread in Sweden.

"There is no threat to the public whatsoever," she told TT.

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

[Importation of Lassa fever from West Africa into Europe and the
United States has occurred occasionally in the past. In this case, the
infection was diagnosed in West Africa (country not stated) and the
patient transferred to Linkoping University Hospital in eastern Sweden
for treatment. Linkoping is a city in southern Sweden, and the capital
of Ã&#150;stergotland County. Its location is shown in the map at:
<http://en.wikipedia.org/wiki/Link%C3%B6ping>.

Lassa haemorrhagic fever is an acute illness of 1-4 weeks duration
that occurs throughout West Africa. Though 1st described in the 1950s,
the virus causing the disease was not identified until 1969. The virus
is a single-stranded RNA virus belonging to the virus family
_Arenaviridae_. Lassa fever is known to be endemic in Guinea, Liberia,
Sierra Leone and parts of Nigeria but probably exists in other West
African countries as well. About 80 per cent of human infections are
asymptomatic; the remaining cases have severe multisystem disease,
where the virus affects several organs in the body, such as the liver,
spleen, and kidneys. The incubation period of Lassa fever ranges from
6-21 days.

Lassa fever is a zoonotic disease. The animal reservoir of Lassa
virus is a rodent of the genus _Mastomys_, commonly known as the
"multimammate rat." _Mastomys_ infected with Lassa virus do not become
ill, but they can shed the virus in their urine and faeces. (An image
of a multimammate rat can be viewed at
<http://www15.bni-hamburg.de/bni/bni2/ne ... &pid=21232>).

Lassa fever can affect all age groups. Persons at greatest risk are
those living in rural areas where _Mastomys_ are usually found,
especially in areas of poor sanitation or crowded living conditions.
There is no epidemiological evidence supporting airborne spread
between humans, but person-to-person transmission occurs in both
community and health care settings. - Mod.CP]

Yellow fever in Sierra Leone
11.03.2011 - WHO

On 8 February 2011, the Ministry of Health in Sierra Leone notified WHO of two cases of yellow fever in Jahun village in Bonthe district, Southern province.

The index case was a 40 year old female, who developed symptoms on 17 January 2011 and tested positive for IgM by ELISA test conducted by Institut Pasteur in Abidjan on 1 February 2011. The WHO reference laboratory for Yellow Fever at the Institut Pasteur in Dakar confirmed the case on 8 February 2011.

The second case was an 18 year old male identified during an outbreak investigation between 11-14 February. The case tested positive for IgM by ELISA test conducted by the Institute Pasteur in Abidjan.

None of the cases had a history of yellow fever vaccination.

On 5 March 2011, the Ministry of Health of Sierra Leone began a response vaccination campaign targeting 144,479 people aged nine months and above, excluding pregnant women in Bonthe district.

Sierra Leone benefited from a yellow fever preventive mass vaccination campaign in 2009, which covered 11 out of 13 districts in the country, excluding Bonthe and Bombali districts.