Wüstenschiff

LEISHMANIASIS, VISCERAL - SUDAN: (SOUTHERN)
*******************************************
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 11 Mar 2011
Source: BBC News [edited]
<http://www.bbc.co.uk/news/health-12707330>


Leishmaniasis in southern Sudan
-------------------------------
The worst outbreak of "black fever" in nearly a decade has hit
Southern Sudan. Unless it's treated, kala azar -- also known as
visceral leishmaniasis -- kills nearly all of those infected. The
World Health Organization estimates that there are up to 500 000 new
cases every year.

Leishmaniasis is spread by sandfly bites and symptoms include
anaemia, nausea, and a swollen liver or spleen, where the parasites
multiply, overwhelming the immune system.

The commonest treatment is an antimonial drug from the 1930s, SSG
[sodium stibogluconate], which is very toxic and can itself kill.
Koert Ritmeijer, head of Medecins Sans Frontieres medical department
in Amsterdam, says at their clinic in Malakal they are now using a
shorter combination treatment which is less toxic.

[A woman] who has travelled from the village of Adong to get to the
clinic has 4 children, and 3 of them have had kala azar. She says many
families cannot afford the trip to the clinic even when their children
are very sick.

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

[The outbreak has probably been unfolding over several years.
ProMED-mail reported increasing numbers of patients already in 2002
and 2003 (see below). The present news release from the BBC underlines
that the control measures over the past 8 years have not succeeded.
Leishmaniasis is associated with malnutrition and HIV, and we have no
information on the HIV prevalence in patients with leishmania in the
area or the rate of malnutrition.

Maps of Sudan can be seen at
<http://www.unhcr.org/publ/PUBL/409224744.pdf> and
<http://healthmap.org/r/0Adg> - Mod.EP]

Sierra Leone - Gelbfieber
15.03.2011

Aus dem Bonthe Distrikt (Southern Province) werden zwei Fälle von bestätigtem Gelbfieber gemeldet. Der erste Fall trat bereits Mitte Januar, der zweite Mitte Februar auf. Es handelt sich um die ersten Fälle seit über 2 Jahren in Sierra Leone. Am 5. März wurde Vom Gesundheitsministerium von Sierra Leone daraufhin eine Impfkampagne im Bonthe Distrikt begonnen. / Quelle: crm

Burkina Faso - Meningokokken-Meningitis
28.03.2011

In den ersten 10 Wochen dieses Jahres wurden bereits 1.479 Fälle mit 279 Todesfällen gemeldet. Während der Trockenzeit (Dezember-April) kommt es in den Ländern des „Afrikanischen Meningitisgürtel“ regelmäßig zu Meningokokken-Epidemien. Während der Saison 2009 infizierten sich in Afrika fast 90.000 Personen, von denen mehr als 5.000 verstarben. Impfschutz (ACWY) beachten. / Quelle: crm

Madagaskar - Pest
01.04.2011

Seit Anfang Januar sind bereits mehr als 250 Menschen an der bakteriellen Infektion erkrankt; es gab 60 Todesfälle. Begonnen hat der Ausbruch im Nordwesten, inzwischen sind fast alle Regionen betroffen. Die von Rattenflöhen übertragene Infektion tritt regelmäßig in der Regenzeit auf. / Quelle: crm

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (05): 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>

In this update:
Africa
[1] Cholera - Ghana
[2] Cholera - Ghana (Greater Accra)
[3] Cholera - Zimbabwe (Manicaland)
[4] Cholera - Congo DR (Kisangani)
[5] Cholera - Burundi (Bururi)
[6] Cholera - Nigeria (Bauchi)
[7] Cholera - Somalia (Mogadishu)

*****
[1] Cholera - Ghana
Date: Thu 31 Mar 2011
Source: Ghana Broadcasting Corporation [edited]
<http://gbcghana.com/index.php?id=1.340472>


About 5614 cholera cases with 69 deaths have been recorded nationwide
by the Ghana Health Service (GHS). Of the number, 380 are recorded in
the 12 Municipalities and districts in the Eastern Region.

The Regional Disease Control Officer, Emelia Okai disclosed this to
GBC's Radio Ghana in Koforidua. She said New Juaben has the highest
number of 228 cases followed by Akwapim South with 61 cases. Mrs. Okai
said Birim Central recorded 33 cases while Kwaebibrem District has 1.

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

[The interactive HealthMap/ProMED map for Ghana is available at:
<http://healthmap.org/r/00IG> - CopyEd.EJP]

*****
[2] Cholera - Ghana (Greater Accra)
Date: Thu 31 Mar 2011
Source: Modern Ghana [edited]
<http://www.modernghana.com/news/322631/ ... accra.html>


Current statistical data on the cholera outbreak in the Greater Accra
Region indicates that 4190 cases had been recorded, with 36 deaths.
The breakdown shows the Accra Metropolis is leading with 3207 cholera
cases and 33 deaths, while the Ga East district comes 2nd with 473
reported cases and 1 death. Others include Ga South, with 119 cases
and a death; Ga West, 253 cases and a death.

Adentan, Ledzorkuku Krowor and Tema, recorded 38, 62 and 28 cases
respectively, with no deaths. Furthermore, the Dangbe West district
had 6 cases, followed by Ashaiman with 3 cases, while the Dangbe East
district, recorded only 1 case.

This became known when The [Ghanaian] Chronicle visited some selected
hospitals in Accra to find out the state of the epidemic. According to
Dr. Irene Agyepong Amarteyfio of the Greater Accra Regional Health
Directorate, her outfit had requested the various facilities in the
districts to check their summaries, in order to produce the final
report.

The Acting Metro Director of Health Services, Dr. George Mensah,
disclosed to The Chronicle that just 2 days ago, the Adabraka
Polyclinic's infirmary cholera record was approaching about 3008
cases, a number which spans January [2011] to date.

He explained further that the outbreak had become severe, because of
the way and manner people disposed off faeces in the environment. Also
at the La General Hospital on Monday [28 Mar 2011], cholera figures
were up to 357 in the 1st quarter of 2011. Out of the 357 cases,
January documented 49, with February recording 147, and in this month
of March alone, the number has increased to 161 cases.

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

[The interactive HealthMap/ProMED map for Greater Accra is available
at: <http://healthmap.org/r/0Ein> - CopyEd.EJP]

*****
[3] Cholera - Zimbabwe (Manicaland)
Date: Wed 30 Mar 2011
Source: AllAfrica [edited]
<http://allafrica.com/stories/201103310085.html>


One person has died while 70 others have been affected by cholera in
Chisumbanje after a sugarcane estate in the district reportedly failed
to provide adequate water and sanitary facilities.

This comes amid unconfirmed reports that at least 8 people could have
died of the disease in Chimanimani, where 11 cases have been reported.
The estate in Chisumbanje, formerly run by ARDA, employs nearly 5000
people from 5 districts of Manicaland province but has inadequate
sanitary facilities to cater for the huge numbers of people staying
there. Officials from the Ministry of Health and Child Welfare have
since intervened and are currently working with the estate management
to arrest the outbreak.

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

[The interactive HealthMap/ProMED map for Manicaland is available at:
<http://healthmap.org/r/0Eio> - CopyEd.EJP]

*****
[4] Cholera - Congo DR (Kisangani)
Date: Fri 1 Apr 2011
Source: AfriqueJet [edited]
<http://www.afriquejet.com/news/africa-n ... 17271.html>


A cholera epidemic claimed 36 lives, out of the 645 affected, between
27 Feb and 26 Mar 2011 in Kisangani, eastern Democratic Republic of
Congo (DRC), the UN Office for humanitarian affairs (OCHA) said. It
said new cases were being recorded, as preventive vaccines were not
available and drugs to treat those affected were scarce.

Because of the prevailing situation, the country's Public Health
minister, Victor Makweng Kaput, has since Wednesday [30 Mar 2011] been
visiting Kisangani, at the head of a high-powered delegation of
hospital and humanitarian staff, including representatives of the
World Health Organization (WHO) and UNICEF in DRC.

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

[The interactive HealthMap/ProMED map for Kisangani is available at:
<http://healthmap.org/r/0Eip> - CopyEd.EJP]

*****
[5] Cholera - Burundi (Bururi)
Date: Tue 22 Mar 2011
Source: XinHua [edited]
<http://www.mb.com.ph/articles/310792/ch ... wn-rumonge>


At least 13 persons suffering from cholera have been admitted to the
hospital of Rumonge in the province of Bururi, 75 km south of the
Burundian capital Bujumbura, a health official in the town told local
media on Mon 21 Mar 2011.

Charles Bikorimana, head of the Hygiene and Sanitation Service in
Rumonge, said the cholera epidemic broke out on 11 Mar 2011 during a
shortage of clean water in that town. "3 more persons were admitted
yesterday (20 Mar 2011) at Rumonge Hospital and they had cholera
symptoms. They are in addition to other 10 persons who were admitted
to Rumonge Hospital on 11 Mar 2011 and who had cholera-like symptoms,"
Bikorimana said.

Rumonge is a tourist town and is located on the shores of Lake
Tanganyika. It is Burundi's 4th town after Bujumbura, the central town
of Gitega and the northern town of Ngozi.

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

[The interactive HealthMap/ProMED map for Bururi is available at:
<http://healthmap.org/r/0Eiq> - CopyEd.EJP]

*****
[6] Cholera - Nigeria (Bauchi)
Date: Mon 21 Mar 2011
From: Dr.Yusuf Jibrin
<ybjibrin@yahoo.co.uk>


There are confirmed cases of Cholera in Bauchi Northeastern Nigeria.
So far we have admitted 22 cases in the last one week.

--
Dr. Yusuf Jibrin
ATBU Teaching Hospital
Bauchi, Northeast Nigeria

[ProMED thanks Dr. Jibrin for this firsthand report. - Mod.LL]

[The interactive HealthMap/ProMED map for Bauchi is available at:
<http://healthmap.org/r/0Eir> - CopyEd.EJP]

*****
[7] Cholera - Somalia (Mogadishu)
Date: Sat 12 Mar 2011
Source: Canadian Press [edited]
<http://www.google.com/hostednews/canadi ... Id=6226063<&>


A growing cholera outbreak in Somalia's war-ravaged capital has
killed more than 20 people and infected more than 2000, a doctor said
Sat 11 Mar 2011.

Dr. Lul Mohamed said that Banadir Maternity Hospital has seen more
than 2000 cholera patients since the beginning of February [2011] and
the disease is rapidly spreading. In the past 48 hours, she said, the
hospital has received 180 people affected by the highly contagious
disease whose symptoms include dehydration, nausea, vomiting and
diarrhea.

She said that the hospital is running low on supplies and cash to pay
health workers but volunteers are helping care for the sick. Mohamed
said many of patients are children from camps for displaced families,
some of whom fled after weeks of a government-led offensive against
insurgents.

[Byline: Abdi Guled]

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

[The interactive HealthMap/ProMED map for Mogadishu is available at:
<http://healthmap.org/r/01sN> - CopyEd.EJP]

LASSA FEVER, NOSOCOMIAL - NIGERIA: (ADAMAWA)
********************************************
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: Wed 6 Apr 2011
Source: Nigerian Tribune [edited]
<http://tribune.com.ng/index.php/news/20 ... in-adamawa>


Consultant medical doctor dies of Lassa fever in Adamawa
--------------------------------------------------------
Disaster struck in Adamawa State, as the outbreak of Lassa fever
claimed the life of a consultant medical doctor, working at the
Federal Medical Centre in Yola. 2 other persons are currently
receiving treatment at Irrua Specialist Centre for the Control of
Tropical and Infectious Diseases. Dr Aliyu Danburam, chief medical
director of the Federal Medical Centre, Yola, who confirmed the
outbreak, however, said that the epidemiological units of the Federal
Ministry of Health, and the Federal Medical Centre, Yola, were working
round the clock to contain the epidemic.

Dr Danburam said in early March [2011], it was noticed that a few
doctors at the medical centre developed symptoms of viral haemorrhagic
fever after treating a patient, and that since the disease was not
common in the environment, thus making the diagnosis difficult, they
were referred to the specialist centre for the control of tropical and
infectious diseases.

He stated that it was at the specialist centre that it was confirmed
that they had Lassa fever, adding that the consultant, who was the
index patient, eventually died while the 2 other doctors were still
undergoing treatment. He, however, disclosed that another person, a
senior laboratory technologist, who died during the same period, had
cardiac failure and not Lassa fever.

Dr Danburam said due to the highly infectious nature of Lassa fever,
which he said could be catastrophic if not urgently brought under
control, the federal epidemiological unit had established a
surveillance squad at the medical centre, to screen all cases that
could be remotely linked to the outbreak, while adequate medications
and equipment were being put in place to meet future challenges.

[Byline: Wale Akintunde]

--
Communicated by:
Shamsudeen Fagbo
<oloungbo@yahoo.com>

[Lassa haemorrhagic fever is an acute illness of 1-4 weeks duration
that occurs throughout West Africa. Though first 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 throughout 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.
There is no epidemiological evidence supporting airborne spread
between humans, but person-to-person transmission occurs in both
community and health care settings.

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
2010; 102(12): 1243-6; available at
<http://www.nmanet.org/images/uploads/Pu ... 43_dec.pdf>).

A map showing the location of Adamawa state in the east of the
country can be accessed at
<http://www.waado.org/nigerdelta/Maps/Ni ... tates.html>. The
HealthMap/ProMED-mail interactive map of Nigeria can be accessed at
<http://healthmap.org/r/01yX>. - Mod.CP]

FOODBORNE ILLNESS, FATAL - MADAGASCAR: (TOLIARA) FISH
*****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Wed 6 Apr 2011
Source: BigNewsNetwork.com [edited]
<http://feeds.bignewsnetwork.com/?sid=765874>


At least 14 people have died in Madagascar from poisoned fish. Around
120 other people are seriously ill, with some in hospitals, after
ingesting the toxic sardines which had been caught in the
south-western town of Toliara.

Samples of the fish have been sent for analysis.

In previous food poisoning incidents the contaminated sardines had
eaten poisonous seaweed, which now proliferates on local reefs.

Officials have blamed global warming and changed sea conditions for
the incident.

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

******
[2]
Date: Wed 6 Apr 2011
Source: BBC News Africa [edited]
<http://www.bbc.co.uk/news/world-africa-12993339>


At least 14 people have died in Madagascar after eating toxic
sardines. Officials say more than 120 people remain seriously ill
after the incident in the south-western town of Toliara.

The government sent its condolences to the victims' families,
promising to foot the medical bills of those being treated in
hospital.

Samples of the sardines have been sent for analysis. In previous
incidents, researchers said the contaminated sardines had eaten
poisonous seaweed. They say seaweed has proliferated among
Madagascar's coral reefs as global warming changes the sea
conditions.

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

[The toxin in the seaweed that the sardines may have eaten is not
known at the time of this writing.

Seaweed species such as _Porphyra_ and _Chondrus_ may be used as food
in many countries. Other uses may be as fertilizers and other
industrial uses.

Seaweed can be affected by viruses, bacteria, parasitic algae, and
fungal infections (for example _Pythium_, _Petersenia_, and
_Phycomelaina_ species). However, little is known about disease of
these plants.

As such, we do not know if the seaweed was affected by a disease that
then affected the sardines, or if the sardines have a disease of their
own.

We look forward to results of the sardine testing.

The city of Toliara can be located via the HealthMap/ProMED-mail
interactive map at <http://healthmap.org/r/0Fdt>.

A photo of a sardine may be found at
<http://www.pyroenergen.com/articles/sardines.htm> - Mod.TG]

MALARIA - SWAZILAND: (HHOHHO) ALERT
***********************************
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 8 Apr 2011
Source: Times of Swaziland [edited]
<http://www.times.co.sz/News/27508.html>


Malaria outbreak: more than 20 cases reported
---------------------------------------------
The National Malaria Control Programme (NMCP) has declared a malaria
outbreak in the Sidvwashini area of Northern Hhohho and surrounding
locations at Masutaneni, Nya-katfo, and Ngonini.

Simon Kunene, NMCP programme manager, said the epidemic was
discovered by malaria surveillance agents who were screening and
testing residents in the community after a case was reported by
Bhalekane Nazarene Clinic. The country defines a malaria outbreak, or
epidemic, as 5 or more locally transmitted cases in a community.

Since Tuesday [5 April 2011], over 20 malaria cases have been
detected in the area through community screening and have been
referred for treatment to the local health facility.

"Due to the country's disease notification hotline 977, the NMCP was
able to respond quickly and efficiently to the reported cases," Kunene
said, emphasising the important role health facilities and healthcare
workers have in the country. Kunene added that this was the 1st of its
kind in the area and thus a cause for concern.

The NMCP has trained healthcare workers in the country to test and
confirm malaria among patients showing signs and symptoms of the
disease. The main signs and symptoms of malaria are fever, fatigue,
severe headache, chills, and sweating. Malaria is a deadly disease and
anyone with these symptoms should be rushed to the nearest health
facility within 24 hours.

Although investigations are still ongoing, the outbreak was likely
due to someone who travelled outside the country and became infected
after being bitten by malarial mosquitoes. When the traveller returned
to the community, he/she was bitten by local mosquitoes, which
transmitted malaria to surrounding neighbors. Mosquitoes are common in
the Sidvwashini area due to stagnant water related to agricultural
operations.

The NMCP advises residents to avoid stagnant water and use personal
protection measures like sleeping under bed nets and accept indoor
residual spraying (IRS) every day during the malaria season. [Residual
spraying does not need to be repeated daily. - Mod.JW] The NMCP has
responded to the outbreak by applying IRS to houses to reduce mosquito
populations, distributing bed nets to protect the population, and
handing out health education materials about protection against
malaria.

"The NMCP will do everything in its power to prevent malaria
outbreaks in the country and eventually eliminate the disease
entirely. It is the responsibility of the community to do everything
they can to protect themselves against malaria," Kunene said.
Community residents can protect themselves and their neighbours by
taking prophylactic medication when travelling outside the country,
accepting house spraying when offered, sleeping under bed nets and
seeking treatment immediately if one feels sick.

[Byline: Winnie Ncongwane]

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

[Hhohho district is the northernmost region in Swaziland reached by a
road that follows the border with South Africa from Mbabane to Piggs
Peak, the main town in the region.

The area has a climate which supports endemic transmission of malaria
according the 2005 map of malaria risk in Swaziland by MARA (Mapping
Malaria Risk in Africa, <http://www.mara.org.za/>).

In the World Malaria Report 2010, reporting malaria in Swaziland for
2009, a total of 106 _P. falciparum_ cases autochthonous cases are
reported among 230 hospitalised cases with a total of 13 deaths
(<http://www.who.int/malaria/world_malari ... nnex7a.pdf>).

Thus, Swaziland has a climate and vector potential where imported
cases can easily start local transmission, and is located close to
Mozambique, which reported 4.3 million suspected malaria cases in 2009
with nearly 94 000 microscopy proven cases (World Malaria Report 2010,
see link above).

Maps of Swaziland can be seen at
<http://www.lib.utexas.edu/maps/africa/swaziland.gif> and
<http://healthmap.org/r/0G0F>. - Mod.EP]

LEISHMANIASIS, VISCERAL - SUDAN: (AL QADARIF)
*********************************************
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 8 Apr 2011
Source: Sudanjem.com (Sudan Justice and Equality Movement) [in
Arabic, trans. Corr.SB, edited]
<http://www.sudanjem.com/2011/04/>


Cases of visceral leishmaniasis on the rise in Al Qadarif state,
eastern Sudan
------------------------------------------------------------------------------
Cases of visceral leishmaniasis, or kala azar, in Gedaref [Al
Qadarif] state, have increased to more than 5550 cases. The total
number of deaths is now more than 142 a year, increasing by 10 to 15
deaths a month, and medical sources fear that the disease is turning
into a pandemic.

Medical sources familiar with Gedaref (Al Qadarif) state preferred to
withhold the name of the newspaper printing the information on the
campaign, saying they are classified sources. The campaign aims at
eradicating the [sand] flies that transmit the disease by the end of
May [2011], and is estimated to cost 71 000 [Sudanese] pounds [about
USD [27 000].

Er Rahad [in North Kurdufan state] is one of the areas hardest hit by
the disease, with 80 percent of the state of Gedaref's [Al Qadarif's]
total.

[The article] reports that the campaign will start with the
environmental sanitation situation, the eradication of stray dogs who
are [the redservoir of the disease], along with a campaign to cut
trees that create breeding areas for the [sand] flies.

[Translator notes:
Er Rahad is a town in North Kurdufan state in central Sudan, 30
kilometres [18.6 mi] south of El Obeid.
The state of Al Qadarif is right on the eastern border of the Sudan
with Ethiopia. - Corr.SB]

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

[_Leishmania_ is transmitted by the sandfly _Phlebotomus_ spp. The
state of Gedaref (Al Qadarif) is known as a highly endemic area for
_Leishmania_. A previous study from 1997-2000 found 658 cases of
visceral leishmaniasis (VL) in a population of about 4000 people
(Lambert M et al: The sandfly fauna in the visceral-leishmaniasis
focus of Gedaref, in the Atbara-River area of eastern Sudan. Ann Trop
Med Parasitol. 2002; 96(6): 631-6; abstract available at
<http://www.ncbi.nlm.nih.gov/pubmed/12396326>). The study also
reported that "_Phlebotomus orientalis_ could be responsible for the
indoor transmission of the parasites causing the local VL between
humans and between humans and local dogs (which have been found
infected by some of the _Leishmania zymodemes_ found in humans)."

Maps of the Sudan can be seen at
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf> with
former English names, and <http://healthmap.org/r/0G0w> & zoom in to
see Arabic & translated names. - Mod.EP]

Burundi - Darminfektionen
08.04.2011

Risiko für Durchfallerkrankungen landesweit, regional ist auch mit Cholera zu rechnen. In Rumonge, einer von Touristen häufig aufgesuchten Stadt am Tanganyika-See, sind nach einer vorübergehenden Knappheit an sauberem Wasser Mitte März 26 Patienten mit Cholera stationär behandelt worden. Nachdem das Land 10 Jahre poliofrei war, sind 2009 wieder zwei Fälle aufgetreten. Impfschutz und Hygiene beachten. / Quelle: crm

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (09): 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>

In this update:
[1] Cholera - Congo DR (Orientale)
[2] Cholera - Zimbabwe (Masvingo)
[3] Cholera - Zimbabwe (Manicaland)
[4] Cholera - Nigeria (Taraba)
[5] Cholera - Chad (Mayo-Kebbi Est)
[6] Cholera - Namibia

******
[1] Cholera - Congo DR (Orientale)
Date: Tue 12 Apr 2011
Source: The Guardian (UK), Guardian Development Network, UN
Integrated Regional Information Networks (IRIN) News report [edited]
<http://www.guardian.co.uk/global-develo ... a-outbreak>


An outbreak of cholera that has claimed 51 lives in the eastern
Democratic Republic of the Congo city of Kisangani [Orientale
province] since late February 2011 could worsen as heavy rains
threaten to undermine an emergency chlorination program, warned health
experts. The outbreak of _Vibrio cholerae_ serotype O1 Inaba has led
to the hospitalization of 913 people since it was first reported on 23
Feb 2011.

At present, the outbreak's spread is slowing: 11 new cases were
recorded on 6 Apr 2011 and the fatality rate fell from 14.4 to 5.5 per
cent over the previous 3 weeks. In mid-March 2011, 189 cases were
recorded in a single week in the city's Lubunga district.

It has also confined to Kisangani's 5 zones. Suspected cases some 125
km [78 mi] away from the city tested negative for cholera.

But the lack of a dramatic reduction in the caseload led Leen
Verhenne, who works with the Belgian branch of Medecins Sans
Frontieres, to be cautious. "This type of epidemic can stay around for
the long term and claim many victims," she told IRIN [UN Integrated
Regional Information Networks], adding that epidemiological data
suggested the principal transmission route was from person to person,
rather than via consumption of contaminated water, which generally
leads to steeper, shorter peaks in transmission rates.

Mystery still surrounds how the outbreak's patient zero, a 50 year
old woman who had never left Kisangani, became infected. 1st cases of
previous outbreaks tend to involve patients who had travelled from
cholera-endemic areas such as Katanga or the Kivu provinces.

Results of tests on 11 of Kisangani's water sources have yet to be
released. As a precautionary measure, municipal authorities
chlorinated all the city's main sources of water, distributed
purification tablets and increased public education about personal and
food hygiene.

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

[Kisangani can be located on the maps of Congo DR at
<http://healthmap.org/r/0IpM> and
<http://www.mapsofworld.com/democratic-r ... al-map.jpg>.
- Sr.Tech.Ed.MJ]

******
[2] Cholera - Zimbabwe (Masvingo)
Date: Sun 10 Apr 2011
Source: NewsDay Zimbabwe [edited]
<http://www.newsday.co.zw/article/2011-0 ... n-chiredzi>


A senior health official told NewsDay that 3 people died last week
following a fresh outbreak of cholera in Chiredzi's Sengwe and
Chilonga areas. Masvingo provincial medical director Robert
Mudyiradima said 2 adults and a child died from over 60 cholera cases
reported in the area since last week.

"3 people have succumbed to cholera detected in Chiredzi,"
Mudyiradima said. He said the source of the resurgent outbreak was
neighboring Manicaland Province where the disease has been detected in
the last few months.

"The disease originated from Chisumbanje, which is why the areas
affected are those bordering Manicaland. As you are aware, efforts to
contain the disease in Manicaland have been underway since February
[2011]," he said.

Since February 2011, Masvingo recorded at least 20 cholera-related
deaths and 1064 cases were reported from Bikita, Mwenezi, and Zaka
districts.

[byline: Tatenda Chitagu]

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

[Masvingo province can be located on the maps of Zimbabwe at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf> and
<http://healthmap.org/r/0IpN>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Zimbabwe (Manicaland)
Date: Mon 11 Apr 2011
Source: AllAfrica, The Herald (Zimbabwe) report [edited]
<http://allafrica.com/stories/201104120099.html>


A total of 8 people, 6 from the same family, have died of cholera
while another 8, all members of the Johanne Marange Apostolic Sect,
were hospitalized in Chimanimani [Manicaland province]

All the cases were recorded from Rusitu District of Chimanimani,
which was hit by a cholera outbreak in Mar 2011.

Director of Epidemiology and Disease Control in the Ministry of
Health and Child Welfare, Dr Portia Manangazira, said they were
continuing dialogue with members of the sect so that they can consider
accessing health care facilities. "We are still making dialogue with
members of the Marange Apostolic sect so that they can access
treatment at health care facilities," said Dr Manangazira.

She said the 16 cases from Rusitu were detected early in March 2011
but were only attended to later in the month as the sect members were
allegedly hiding the sick from members of the public.

28 districts in Manicaland, Masvingo, and Mashonaland West provinces
have been trained to deal with disease outbreaks.

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

[Manicaland province can be located on the maps of Zimbabwe at
<http://www.un.org/Depts/Cartographic/ma ... mbabwe.pdf> and
<http://healthmap.org/r/0IpO>. - Sr.Tech.Ed.MJ]

******
[4] Cholera - Nigeria (Taraba)
Date: Fri 8 Apr 2011
Source: The Guardian (Nigeria) [edited]
<http://www.ngrguardiannews.com/index.ph ... Itemid=559>


No fewer than 24 people have died in Donga Local Council Area of
Taraba State following an outbreak of a disease suspected to be
cholera. Apart from the death toll, over 60 people are reportedly
lying critically ill in various hospitals in the council as a result
of the epidemics. The development has forced residents of the council
to take refuge in other areas of the state.

Confirming the report to The Guardian, the commissioner for health,
Mohammed Bose, however, said preventive measures have been put in
place by the state government to halt the spread of the disease.
Though he could not authenticate the type of disease ravaging the
council, the commissioner, however, said its symptoms were close to
those of cholera, which recently struck in nearby Bantaji village of
Wukari Local Council. His words: "There was an outbreak of cholera in
Bantaji village of Wukari. It was the spillover that got to Donga
Local Council."

Doctors Across Borders [Medecins sans Frontieres], according to the
commissioner, was currently on ground in the council attending to
persons suffering from the ailment. "Though it is not yet confirmed
that the disease is cholera, with the symptoms on ground, one would
believe that it is cholera," Bose added.

[byline: Charles Akpeji and Ali Garba]

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

[Taraba state can be located on the maps of Nigeria at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf> and
<http://healthmap.org/r/0FxR>. - Sr.Tech.Ed.MJ]

******
[5] Cholera - Chad (Mayo-Kebbi Est)
Date: Tue 5 Apr 2011
Source: Google, Agence France-Presse (AFP) report [edited]
<http://www.google.com/hostednews/afp/ar ... .692381365>


The International Federation of Red Cross and Red Crescent Societies
(IFRC) said the situation was further exacerbated in the impoverished
Bongor region [Mayo-Kebbi Est region], "where a serious cholera
epidemic left 1500 people ill and 30 confirmed dead."

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

[Bongor can be located on the maps of Chad at
<http://www.un.org/Depts/Cartographic/ma ... e/chad.pdf> and
<http://healthmap.org/r/0IpP>. - Sr.Tech.Ed.MJ]

******
[6] Cholera - Namibia
Date: Sun 20 Mar 2011
Source: Thomson Reuters Foundation AlertNet [edited]
<http://www.trust.org/alertnet/news/nami ... age-crops/>


Floods in northern Namibia have displaced thousands of people, spread
cholera and ravaged food crops, which are also being hit by
fast-breeding army worms.

With damage to roads cutting many people off from health services,
the Namibian government has declared a state of emergency and appealed
to the international community for assistance.

The worst-affected areas are Caprivi, Oshana, Omusati, Ohangwena, and
Oshikoto, aid agencies and local officials say.

The Namibian authorities and humanitarian organisations are concerned
about the spread of waterborne disease. They report an outbreak of
cholera, with 123 suspect cases, according to WHO, at least 4 of which
have been confirmed. 2 people have died.

[byline: Alex Klaushofer]

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

[Maps of Namibia can be seen at <http://healthmap.org/r/009K> and
<http://www.maplibrary.org/stacks/Africa ... /index.php>. -
Sr.Tech.Ed.MJ]

MALARIA - ZIMBABWE: (GOROMONZI)
*******************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 18 Apr 2011
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/201104180191.html>


Zimbabwe: Malaria Outbreak in Goromonzi
---------------------------------------
A total of 11 people have died of malaria while 846 others have been
treated for the killer disease in Goromonzi West.

According to reports 909 cases have been recorded so far. The
affected areas are Maiden of Svisva, Svisva 1 and 2 and Chabwino
compound in Goromonzi West Constituency.

Councillor Miriam Chipunza yesterday said health facilities are too
far from their area and they are appealing for mobile facilities to
rescue them. Clr Chipunza said the villagers were concerned that the
outbreak could claim more victims before the necessary steps are taken
to arrest it.

Dr Steven Karima, the district medical officer for Goromonzi,
confirmed the outbreak. "I can confirm that there is a malaria
outbreak in Goromonzi and we have since responded to 909 cases. We
have treated 846 patients and 178 of them were positive meaning they
had malaria parasites," he said.

Dr Karima said mobile clinics were visiting the area everyday. "We
have sent a proposal to the province so as to launch a full programme
supplying treated nets, spraying as well as biolarvicide for
prevention." Dr Kurima said

Goromonzi used to be a malaria free zone but it shares borders with
Mudzi, Shamva and Murehwa that are confirmed malaria zones. "Villagers
now fear that the malaria zone extending into their area would claim
lives hence there is need for the responsible authorities to react
immediately," he said.

National malaria control manager in the Ministry of Health and Child
Welfare, Dr Joseph Mberikunashe, also confirmed the outbreak in
Mashonaland East. "Yes there is malaria outbreak in Goromonzi, Mudzi,
Mutoko and UMP and we have received the death cases but it is now
under control since our team is now on the ground.

"Goromonzi was once a malaria free zone but zones change due the
climate change and travelling," he said. Dr Mberikunashe added that 60
000 cases of malaria have been detected in the country since the end
of last year up to date.

Areas above 1500 meters [4921 feet] such as Harare are usually
malaria free, while areas below 900 meters [2953 feet] are normally a
high risk to malaria, particularly in the north of the altitude is
between 900 - 1500 meters.

After HIV/AIDS, malaria is the biggest killer of children under 5 in
Zimbabwe and pregnant women as well as newborns.

According to research, the main challenge to the spread of malaria is
because there is no single way of preventing malaria and mosquitoes.
Malaria is increasingly becoming resistant to existing drugs. Efforts
have been made to introduce an effective vaccine and the most
effective way to reduce malaria so far is prevention through use of
insecticide-treated nets.

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

[It is correct that Goromonzi, about 20 miles [32 km] east of Harare,
previously was considered malaria free. Whether the introduction of
malaria is due to climate change or travelers -- as suggested here --
remains conjectual. Alternative explanations are reduced focus on
control measures like reduction of possible breeding sites and
insufficient use of impregnated bed nets.

The interactive HealthMap/ProMED map is available at
<http://healthmap.org/r/0IVA>
â&#128;&#147; Mod.EP]

Tschad - Infektionskrankheiten
18.04.2011

Risiko für Durchfallerkrankungen landesweit. In der Regenzeit 2010 wurden viele Ernten vernichtet und einige Dörfer von der Außenwelt abgeschnitten. Daher gab es wesentlich mehr Cholera–Fälle als in den Vorjahren. Seit Beginn des Ausbruchs im vergangenen Jahr wurden über 8.000 Fälle mit mindestens 220 Toten berichtet. Aus dem verarmten Bongor im Süden des Landes wird im April ein Ausbruch mit 1.518 Fällen und 30 Toten gemeldet. Dieser wird von vielen Masern-Fällen in nahezu derselben Region begleitet. Polio, zuvor bereits ausgerottet, wurde seit 2003 aus dem benachbarten Nigeria mehrfach importiert. In diesem Jahr wurden bereits 16 Fälle gemeldet; der letzte Patient erkrankte am 20. Februar 2011. 2010 wurden 19 Fälle gemeldet. Hygiene und Impfschutz (Polio, Masern) beachten. / Quelle: crm

CHIKUNGUNYA (10): MADAGASCAR & SEYCHELLES
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 18 Apr 2011
Source: Midi Madagasikara [in French, trans. Laurence Mialot,
edited]
<http://www.midimadagasikara.mg/index.ph ... =3:societe>


Several cases of chikungunya [virus infection] were detected in the
Seychelles and in Madagascar. In Grand Isle, tests have confirmed the
presence of the virus among 4 people, and 102 cases are believed to be
suspicious. The risks that chikungunya [virus] transmitted by the
mosquito _Adedes abopictus_ will come back are real, particularly
during this season, which is favorable to tropical diseases. The
growing number of people who have been bitten and have contracted the
disease in Seychelles the past few weeks have put the population and
the people in charge of public health on high alert.

Vigilance is in order. Since the virus came back, the inter-regional
cell of the epidemiology of the Indian Ocean (CIRE) considers that the
return of chikungunya [virus] in the department is possible. The
climatic conditions of the past weeks have promoted multiplication of
the mosquitoes.

Travelers going to the islands in the Indian Ocean are warned and
should take precautions. Local populations are advised to get rid of
stagnant water around the house after downpours at least once a week.
In case of signs or symptoms such as headaches, muscular pains, nausea
and rash, people are strongly advised to go and see their doctor.

[byline: Anjara Rasoanaivo]

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

[Madagascar has had periodic cases of chikungunya virus infection for
several years (see archives below), so it is not surprising that cases
are occurring again in 2011. The Seychelles, however, have not
reported a major chikungunya outbreak since 2006, when nearly 2000
cases occurred.

A HealthMap/ProMED-mail interactive map showing the location of the
Seychelles in the Indian Ocean can be accessed at
<http://healthmap.org/r/0JpV>. A HealthMap/ProMED-mail interactive map
showing the location of Madagascar off the east coast of Africa can be
accessed at <http://healthmap.org/r/00ae>. - Mod.TY]

YELLOW FEVER - AFRICA (14): KENYA (BARINGO), SUSPECTED, 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: Sun 24 Apr 2011
Source: Sunday Nation [edited]
<http://www.nation.co.ke/News/Yellow+fev ... index.html>


Health personnel in Baringo are on high alert after a 50 year old man
succumbed to a condition suspected to be yellow fever [YF] in Kapluk
area. Baringo North District medical officer of health Felix Atisa,
however, dismissed the claim that the man was killed by yellow fever.
"A blood specimen taken to the Kenya Medical Research Institute
(KEMRI) did not reveal any traces of yellow fever, but he may have
died of haemorrhagic fever," said Dr Atisa. Addressing the press in
Kabarnet on Saturday [23 Apr 2011], Dr Atisa said a team of disease
surveillance officials had been deployed to the area to monitor the
situation.

"We urge the locals who develop symptoms of the disease like
headache, joint aches, and fever to seek medical attention
immediately," said the medical officer, who added that all health
facilities had been stocked with enough drugs in case of any
emergency. He said that a mass vaccination programme will soon be
rolled out in the area. The last time such an exercise was carried out
in Baringo and Elgeyo Marakwet was in 2001.

Dr Atisa's sentiments contradicted those of Kabarnet District
Hospital medical superintendent Robert Pukose, who said the man died
from haemorrhagic fever "which is common among patients with yellow
fever." Addressing the press in his office, Dr Pukose said that a
postmortem examination at Moi Teaching and Referral Hospital in
Eldoret confirmed the cause of death to be yellow fever. Dr Pukose
said investigations on another person who died on Friday last week
indicated that he suffered from hepatitis B, which co-exists with
yellow fever.

Yellow fever is an acute viral haemorrhagic disease transmitted by
infected mosquitoes. The "yellow" in the name refers to the jaundice
that affects some patients. According to the World Health
Organization, there is no cure for yellow fever. Treatment aims at
reducing the symptoms for the comfort of the patient. Vaccination is
the most important preventive measure against the disease. Yellow
fever vaccines provide immunity for a period of 10 years.

Residents of Salawa, Kapluk, Barwessa, and Seretunin claimed 5 people
have died within the last 5 months with yellow fever-related symptoms.
But Dr Pukose dismissed the claim, saying that they were based on
hearsay. "The victim from Seretunin died after taking rat poison and a
child from Salawa died from severe malaria; there is no evidence that
they died from yellow fever," said the medic.

Dr Pukose said the lower regions of Baringo and Elgeyo Marakwet were
particularly prone to yellow fever and appealed to the government to
conduct another mass vaccination against the disease this year. He
advised the residents to ensure that bushes and empty cans around
their compounds were cleared since they were conducive environments
for the breeding of mosquitoes.

According to Dr Pukose, yellow fever symptoms include fever,
headache, backache, joint and muscle pains and yellowness of the eyes
in severe cases.

--
communicated by:
ProMED-EAFR

[This situation is not clear. The diagnostic tests used by KEMRI (a
WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference
and Research) that discarded YF as the etiologic agent in this case
are not specified, nor is the basis on which the postmortem
examination at Moi Teaching and Referral Hospital confirmed YF virus
infection. ProMED-mail would be interested in receiving additional
information about this case, or any new hemorrhagic fever cases, as it
becomes available.

In any event, given that this is an area subject to sporadic YF
outbreaks, a vaccination campaign is prudent, especially if the last
campaign was 10 years ago, and children born since then, as well as
those missed by that earlier campaign, are at risk of YF virus
infections.

A HealthMap interactive map of Kenya showing the location of Baringo
district can be accessed at <http://healthmap.org/r/0JN_> - Mod.TY]