Wüstenschiff

Südafrika - Gelbfieber
06.06.2011

Nach Angaben des Gesundheitsministeriums und der South African Society of Travel Medicine wird vorrausichtlich zum 30. Juni 2011 eine Verpflichtung zur Geldfieberimpfung bei der Einreise aus Sambia eingeführt. Um Schwierigkeiten bei der Einreise zu vermeiden, sollten alle Reisenden bei der Einreise aus Sambia bereits jetzt einen gültigen Impfnachweis vorweisen können. / Quelle: crm

Es ist zwar noch nicht bestaetigt, doch wird der erste EHEC-Fall in Aegypten angenommen. Ein deutscher Urlauber wurde mit Beschwerden zurueck nach Deutschland geflogen. Das aegyptiche Gesundheitsministerium ist zur Vorbeugung im Gebiet des Roten Meeres in Alarmbereitschaft gegangen!

Egypt reports its first suspected case of E. coli infection

http://www.almasryalyoum.com/en/node/465820

Es war doch kein EHEC. Die Proben in Hurghada waren negativ - allhamdullilah!

HEPATITIS E VIRUS - UGANDA: KARAMOJA
************************************
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 8 Jun 2011
Source: Outbreak News [edited]
<http://outbreaknews.com/2011/06/08/ugan ... districts/>


With the [ebolavirus] issue appearing to be over, health authorities
are battling at least one, maybe 2 different outbreaks [of hepatitis
E] in Karamoja.

The Ministry of Health yesterday [7 Jun 2011] confirmed an outbreak
of the viral liver disease where cases had been confirmed in Kaabong,
Moroto, and Kotido districts of the Karamoja sub-region of Uganda.

According to Kaabong district health officer Dr James Kisambu, a
total of 908 cases of hepatitis E had been reported in the affected
districts and were admitted at Kaabong Hospital.

Medical teams have been dispatched to the region to provide support,
and samples were taken from several suspected cases for testing at the
Uganda Virus Research Institute in Entebbe.

In addition to the outbreak above, New Vision reports that the
ministry was also investigating reports of a suspected outbreak of
yellow fever in Karamoja.

The clinical course of hepatitis E is similar to that of hepatitis A,
with no chronic form of the disease. Jaundice, fever, loss of
appetite, and lethargy are common symptoms.

People get infected primarily through the fecal-oral route, usually
through contaminated water or food. There have been several cases of
hepatitis E infection in France due to eating raw figatellu [a fresh
sausage], which is made from pig liver.

Much like hepatitis A, the fatality rate is low, with the exception
of pregnant women, where it can reach 20 percent among those infected
in the 3rd trimester. Liver failure is a frequent outcome with
pregnant women.

Hepatitis E is found endemically in countries that have inadequate
environmental sanitation. It is most frequently seen in Asia, Africa,
Central America, and the Middle East.

[Byline: Robert Herriman]

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

[Outbreaks of hepatitis E virus infection have been reported in
Karamoja region since early last year (2010) (see ProMED EAFR report
20100227.205783). The outbreaks at the time were attributed to
inappropriate disposal of faecal matter in the region and inadequate
access to safe water. The resurgence of these cases in the region is
an indication that the underlying risk factors have not been
addressed, and, therefore, a decisive response is still pending.

This report also mentions the possibility of a yellow fever outbreak
in the region. Clinically, yellow fever and acute viral hepatitis are
almost indistinguishable. However, the epidemiological investigations
commissioned by the national authorities should be able to determine
whether there is another outbreak in the region in addition to that of
hepatitis E virus.

It is, however, unlikely that up to 908 cases are admitted in
hospital, as the disease is largely a mild infection except in
pregnant women infected in the 3rd trimester; hence, during outbreaks,
most patients will not require admission.

A map showing the regions of Uganda can be seen at
<http://www.unicef.org/hac2011/images/HA ... Uganda.jpg>. The
districts in the Karamoja sub-region, which is located in northeastern
Uganda, can be seen on the map at
<http://reliefweb.int/sites/reliefweb.in ... 66-map.pdf>.
The HealthMap/ProMED-mail interactive map of Uganda is available at
<http://healthmap.org/r/017y>. A map showing the areas endemic for
hepatitis E virus can be seen at
<http://outbreaknews.com/wp-content/uplo ... ndemic.jpg>. -
Mod.JFW]

[Outbreaks of hepatitis E virus infections are usually due to fecal
contamination of water rather than of food stuffs, which would more
likely result in more isolated cases. Proper disposal of fecal matter
is a challenge in situations where facilities and local customs do not
support it. Public health education is needed. - Mod.TY]

CHIKUNGUNYA - AFRICA: REPUBLIC OF THE CONGO
*******************************************
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: 12 Jun 2011
Source: Xinhuanet [in French, trans. Mod.MPP, edited]
<http://french.news.cn/afrique/2011-06/12/c_13924610.htm>


More than 480 cases of chikungunya [virus infections] have been
reported over the past several days in the southern districts of
Brazzaville, the Congo [Brazzaville] Director General of Health,
Professor Alexis Elira Dokekias, said Saturday [11 Jun 2011] on
Radio-Congo.

"Of the more than 480 cases we identified, there have not been any
deaths; there are patients who have major, intermediate symptoms,"
said Professor Dokekias, calling on the population to remain calm and
not to yield to panic, because a "mechanism has been developed so that
people can easily access treatment."

Patients are presenting with skin lesions and complain of headaches,
muscle aches or joint pain and show a general fatigue," said Professor
Dokekias, stating that it is a question not of a "robust malaria," as
was the rumor spread in the city, but rather "a viral infection with
the chikungunya virus, a microbe from a variety of mosquito that
thrives in an environment where there is stagnant water" [This is not
malaria. The regional laboratory was able to identify chikungunya
virus in specimens that were taken as part of the investigation of the
increase in cases. - Mod.TY].

"We are facing an epidemic. Treatment is based primarily on the use
of paracetamol, the hydration of patients, and above all, we recommend
NOT to use certain medicines such as aspirin and anti-inflammatories,
which may facilitate a hemorrhagic form of the disease," he said,
announcing an upcoming campaign for "mosquito reduction" in the city,
using a substance not harmful to human beings.

Mosquito reduction and sanitation of the environment are the
preventive measures recommended by Professor Dokekias to counter the
epidemic of chikungunya that has already affected "several African
countries, including Mali, Senegal, Cote d'Ivoire, Cape Verde and,
very close to us, Gabon."

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

[This is the 1st report of a chikungunya [CHIK] outbreak in the
Republic of the Congo posted by ProMED-mail. There was a report of
CHIK virus outbreaks in Senegal in 1966, 1977, 1975, 1983, 1988,
1990,1992, 1996 and 1997 in many areas including the Dakar area.
Outbreaks were reported in neighboring Gabon in 2007, 2008 and 2010,
so an outbreak in the Republic of Congo is not surprising. ProMED
would be interested in receiving reports of CHIK virus infections in
Mali, Cote d'Ivoire, and Cape Verde, as ProMED-mail has never received
information from these countries, although they are mentioned in the
above report.

A HealthMap interactive map showing the location of Brazzaville can
be accessed at <http://healthmap.org/r/0hT9>. - Mod.TY]

Kongo, Republik - Chikungunya
14.06.2011

Mitte Juni wurde ein Ausbruch mit über 480 bestätigten Fällen innerhalb weniger Tage aus Brazzaville im Süden des Landes gemeldet. Schutz vor tag- und nachtaktiven Mücken wird empfohlen. / Quelle: crm

Gruß
Birgitt

CHIKUNGUNYA - AFRICA (02): REPUBLIC OF CONGO
********************************************
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 15 Jun 2011
Source: UN Integrated Regional Information Networks (IRIN) News
[edited]
<http://www.irinnews.org/Report.aspx?ReportID=92989>


Outbreak of chikungunya [virus infection] in the Republic of the
Congo
----------------------------------------------------------------------
Almost 1000 suspected cases of chikungunya, a mosquito-borne viral
disease that causes fever and severe joint pain, have been recorded
in the Republic of Congo's capital [Brazzaville] over the past 2
weeks.

"More than 900 people are showing symptoms of chikungunya, which is
transmitted by mosquito," Director-General of Health Alexis Elira
Dokekias told a news conference on 14 Jun 2011.

The disease's symptoms include muscle pain, headache, nausea,
fatigue, and rash, and are similar to those of dengue fever. There is

no known cure; treatment consists of relieving the symptoms.

Dokekias said the 1st cases appeared in early June 2011 in the poor
neighbourhoods of Bacongo and Makelekele in the south of
Brazzaville.

Of 48 samples analysed in a laboratory in neighbouring Gabon, just
over half tested positive for the virus, he said.

Dokekias urged anyone showing symptoms of the disease to report to
the nearest medical centre, and called on all citizens to clean up
potential mosquito habitats.

Chikungunya takes its name from a word in the Kimakonde language
meaning "to become contorted" -- a reference to the stooped
appearance of those infected.

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

[[Cases of chikungunya were reported around the same time last year
[2010] from South Eastern Gabon as part of a mixed chikungunya/dengue
outbreak.

This new outbreak in Brazzaville is an indication that the risk of
transmission is still high in the region. Chikungunya is an arboviral
disease transmitted by mosquitoes, commonly _Aedes aegypti_ and _Aedes
albopictus_. The poor neighborhoods affected in Brazzaville are
therefore particularly at risk if there are environmental conditions
that favor breeding of mosquitoes.

During outbreaks, it is recommended that affected communities be
mobilised to initiate interventions to halt community transmission.
Such measures include reducing the number of natural and artificial
water-filled container habitats that support the breeding of the
mosquitoes. Complementary measures may include: use of insecticides;
clothing which minimizes skin exposure; repellents that contain DEET
(N, N-diethyl-3-methylbenzamide), IR3535
(3-[N-acetyl-N-butyl]-aminopropionic acid ethyl ester), or icaridin
(1-piperidinecarboxylic acid, 2-(2-hydroxyethyl)-1-methylpropylester)
and can be applied to exposed skin; and insecticide treated mosquito
nets for those who sleep during the day time (see
<http://www.who.int/mediacentre/factsheets/fs327/en/>).

The HealthMap/ProMED-mail interactive map of the Republic of Congo is
available at <http://healthmap.org/r/0ZpI>. An administrative map
showing the 12 departments in the country can be seen at
<http://en.wikipedia.org/wiki/Department ... _the_Congo>.
- Mod.JFW]

[The number of cases has climbed dramatically from over 480 reported
on 11 Jun 2011 to over 900 just 3 days later on 14 Jun 2011,
indicating an accelerating outbreak. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (15): 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 - Cameroon
[2] Cholera - Nigeria (Adamawa)
[3] Cholera - Zimbabwe (Manicaland)
[4] Cholera - Uganda (Hoima)
[5] Cholera - Chad

******
[1] Cholera - Cameroon
Date: Fri 10 Jun 2011
Source: Reuters [edited]
<http://www.trust.org/alertnet/news/deat ... -epidemic/>


The death toll and the number of reported cases of cholera continue
to rise across Cameroon: nearly 7718 cases reported in 9 out of 10
regions and 256 deaths attributed to the epidemic. Cameroonians
continue to struggle in containing this killer disease.

Plan [a children's organisation working with communities in 48
developing countries to alleviate child poverty] in Cameroon has been
deploying teams of community volunteers "cholera soldiers" in its 7
operational regions: Centre, South West, North West, West, Littoral,
North, and Far North. The Centre region with more than 2558 cases
reported is hardest hit, although in part through the efforts of Plan,
the number of new cases being reported there has slowed to almost
none.

"This outbreak has been lingering for the past 2 years. The defenses
of those particularly vulnerable to the disease, small children under
5 and women, are low," said Plan Cameroon country director Famari
Barro. "Plan programs in the region are underpinned by the importance
of clean, potable water and basic hygiene and sanitation to prevent
the spread of disease."

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

[The HealthMap/ProMED-mail of Cameroon can be seen at
<http://healthmap.org/r/05Xt>. - Sr.Tech.Ed.MJ]

******
[2] Cholera - Nigeria (Adamawa)
Date: Thu 9 Jun 2011
Source: This Day Live [edited]
<http://www.thisdaylive.com/articles/ada ... ist/92889/>


An outbreak of cholera has claimed over 30 lives, mostly women and
children, in Mubi South and Maiha local government councils of Adamawa
State, while another 200 are still hospitalized in critical condition
in various medical establishments in the area.

To date, 19 deaths have been reported in Mubi South local government,
while another 17 persons have also been confirmed dead of similar
ailment in Maiha local government, resulting in serious tension and
general apprehension in the affected communities.

Mr Mathias Gumpi, a medical officer in one of the government health
centres in Mubi South local government council, told correspondents
that the council would not be certain that the sickness killing the
people was cholera until the results of medical tests of some of the
samples collected were out. The 2 local councils have been subjected
to repeated occurrences of cholera.

[Byline: Matthew Onah]

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

[The HealthMap/ProMED-mail of Nigeria can be seen at
<http://healthmap.org/r/0Yr_>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Zimbabwe (Manicaland)
Date: Thu 9 Jun 2011
Source: UN (OCHA) ReliefWeb, The Zimbabwean report [edited]
<http://reliefweb.int/node/406671>


Chipinge is the new epicentre of Zimbabwe's latest cholera outbreak,
according to the latest WHO epidemiological report. It showed that the
eastern Manicaland province accounted for about 95 percent of all
incidents reported since the beginning of 2011. More than 573 cholera
cases had been reported in Chipinge by the end of May [2011], nearly
63 percent of the 936 incidents recorded countrywide since January
[2011].

The Zimbabwean reported in March [2011] that a cholera time-bomb was
ticking at ARDA [Agriculture & Rural Development Authority] Estate in
Chipinge where the state-owned company was allegedly supplying
untreated water from the river straight to taps. More than 3000
households in Chipinge were at risk of contracting cholera,
particularly in Ward 26 at ARDA Estates where farm workers are being
provided with raw water from a nearby river.

Cholera has become a perennial disease in Zimbabwe where the water
and sanitation infrastructure has collapsed due to lack of
maintenance. It claimed more than 4200 lives in an outbreak between
September 2008 and July 2009 that also infected nearly 100 000 people.
According to the WHO report, the cholera death toll has risen to more
than 40 since the beginning of 2011.

A total of 936 cumulative cholera cases had been reported by the 3rd
week of May 2011, a 24 percent rise in the number of cases since the
end of April [2011] when 755 cases were recorded in 10 of Zimbabwe's
62 districts. The death toll stood at 25 at the end of April.

At least 886 or 95 percent of the current cases were reported from
the eastern Manicaland province which is also home to the
controversial Marange fields where artisan miners are digging for
alluvial diamonds.

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

[The HealthMap/ProMED-mail of Zimbabwe can be seen at
<http://healthmap.org/r/0Ypr>. - Sr.Tech.Ed.MJ]

******
[4] Cholera - Uganda (Hoima)
Date: Sun 5 Jun 2011
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/18/756682>


To date, 8 suspected cases of cholera have been reported in Nkondo
Parish, in Kabwoya sub-county in Hoima district. The district health
inspector, Frederick Byenume, told journalists that 8 people had been
admitted to Sebigoro Health Centre III in Kabwoya sub-county. However,
Byenume said no deaths had been recorded and 4 patients had been
discharged. The rest, he added, are undergoing treatment and showing
signs of improvement.

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

[The HealthMap/ProMED-mail of Uganda can be seen at
<http://healthmap.org/r/0XrF>. - Sr.Tech.Ed.MJ]

******
[5] Cholera - Chad
Date: Fri 3 Jun 2011
Source: TopNews New Zeland [edited]
<http://topnews.net.nz/content/215532-ou ... olera-chad>


An outbreak of cholera has been reported from Chad with the onset of
the rainy season. A health ministry official revealed that so far 102
people have died from the disease and the number is expected to go
up.

Country Director of aid group Oxfam, Abakar Mahamat, said that the
cholera outbreak is reported from Chad in the rainy season because
during this time, latrines flood and contaminated water collects in
stagnant pools.

According to the government, only 0.6 percent of households use
proper latrines, while 88 percent of the households use open spaces.
Another reason for cholera in the country is that the majority of
Chad's population drinks water from open wells or rivers. This water
is not safe for drinking due to the risk of [fecal] contamination and
various waterborne diseases.

[Byline: Neeraj Shahane]

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

[The HealthMap/ProMED-mail of Chad can be seen at
<http://healthmap.org/r/0YDB>. - Sr.Tech.Ed.MJ]

CHIKUNGUNYA - AFRICA (03): REPUBLIC OF CONGO
********************************************
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 17 Jun 2011
From: Marc Grandadam [edited]
<marc.grandadam@pasteur.fr>


In June 2011, 480 cases of chikungunya virus infections have been
reported in a southern district of Brazzaville, Republic of Congo
(ProMED-mail archive number 20110613.1806). Positive markers for
chikungunya virus infection were found by the regional reference
laboratory confirming the etiology of the outbreak. To complete these
data, we report an imported case in metropolitan France with a
positive diagnosis for chikungunya virus infection. The patient, who
is living in Brazzaville, arrived in France on 3 May [2011] and
immediately declared fever, severe arthralgia, myalgia and ankle
oedema.

A blood sample taken on 5 May [2011] was found positive by
chikungunya RT-PCR and the virus could be isolated on Vero cells.
Sequence analysis of E1 protein revealed that this isolate belongs to
the East-Central South Africa (ECSA) genotype of chikungunya [virus]
and more precisely to the Central Africa subgroup, clustered with
isolates from Cameroon in 2006 and from Gabon in 2007. The E1-A226V
mutation, associated to an adaptation to _Aedes albopictus_, has been
evidenced in this strain, which also exhibited 100 per cent nucleotide
identity with the Gabon isolate. Such type of isolates were known to
circulate in Central Africa and Western Africa at least since 2006
(Peyrefitte et al, Emerg Inf Dis. 2007;13(5) : 768-771 and Peyrefitte
et al. J. Med. Virol. 2008;80:430 433). The presence of _Ae.
albopictus_ in the Republic of Congo is not documented yet but its
formal identification in countries bordering the Republic of Congo
raise the question of the participation of this vector species in the
present outbreak. Thus it is critical to obtain entomologic
information in Brazzaville especially because of the genomic markers
that may potentiate chikungunya virus [transmission] in Brazzaville.

--
Dr Marc Grandadam, Dr Philippe Despres,
National Reference Centre for Arboviruses, Institut Pasteur, Paris,
France.
Dr Olivier and Dr Tetart
Hospital St Roch, Nice, France.
Valerie Caro, Genotyping of pathogens and public health
Institut Pasteur Paris, France.

[ProMED thanks Dr. Grandadam and colleagues for this valuable
followup report on the chikungunya outbreak in the RC, along with
their genetic assessment placing the virus in the Central African
subgroup.

It will be of interest to know if _Aedes albopictus_ is present in
Brazzaville in numbers sufficient to support the outbreak, or if the
vector involved is _Ae. aegypti_ or another mosquito species. The
Institut Pasteur group and colleagues are to be congratulated for
their timely studies and willingness to share their information so
quickly.

A HealthMap interactive map showing the location of Brazzaville can
be accessed at
<http://healthmap.org/r/0hT9>. - Mod.TY]

RABIES, ANIMALS, HUMAN - ANGOLA (03)
************************************
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 17 Jun 2011
Source: Agencia AngolaPress -- ANGOP [in Portuguese, trans. Mod.TY,
edited]
<http://www.portalangop.co.ao/motix/pt_p ... c6030.html>


The number of people bitten by dogs in Cabinda increased, reaching
405, of whom 12 died since 25 Jan of this year [2011], stated the
provincial public health and epidemic control official, Antinio Gomes
Tati. In statements to ANGOP, Antonio Tati considered the rabies
outbreak in the province alarming, judging by the daily average of dog
bite cases -- 6 per day.

Because of this, a meeting between health authorities, the Cabinda
municipal administration and veterinary services is scheduled for
Monday [20 Jun 2011] to draw up another strategy to reverse this
picture. This refers to circulating to collect stray dogs, cats and
monkeys to hold in kennels, for sacrifice of those [animals] whose
owners do not show up at the established time.

Antonio Tati stated that as for [human post-exposure treatment]
rabies vaccines, only 50 doses remain in the province, a fact that
intensifies concern of the authorities.

The Cabinda municipality is the most affected with 390 bite cases and
10 deaths, Buco Zau 11 bite cases and one death and Cacongo 4 [bite]
cases an one death, with Belize as the only municipality in the
province without registering any rabies cases.

The official indicated their concern about the fact that there have
been people who died 24 hours after having been bitten by dogs, given
that the rabies incubation period is from 45 days to 2 years on
average.

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

[If deaths are occurring 24 hours following dog bites, the deaths are
not due to rabies from that bite. It might be possible that these
individuals were bitten and infected several days before their deaths,
on an earlier occasion. There is no information indicating that these
cases were laboratory confirmed as rabies virus infections.
Alternatively, their deaths may have been due to something else.

The lack of rabies vaccine is a serious concern. Elimination of
un-owned stray dogs may exacerbate the outbreak, as new, stray
individual dogs move into the vacated territory and fight with
neighboring dogs. Vaccination of all dogs will be a more effective way
to halt the outbreak.

Rabies is a problem currently in other provinces in Angola. The 18
May 2011 ProMED-mail post (archive no. 20100519.1655) indicated that
human cases occurred in the provinces of Kwanza Sul, (4 cases),
Benguela (2), Kwanza Norte (2), Cunene (2) and Uige (1). The above
report indicates that the problem is present in Cabinda province, an
enclave in Angola's far north, as well. One wonders what may be going
on with rabies in neighboring areas of the Democratic Republic of the
Congo.

A map showing the boundaries of the provinces of Angola can be
accessed at:
<http://www.mapsofworld.com/angola/angol ... l-map.html>. The
HealthMap/ProMED-mail interactive map of Angola showing the location
of Cabinda province can be accessed at: <http://healthmap.org/r/0ZM>.
- Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (16): 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 - Congo DR (Bandundu)
[2] Cholera - Niger (Southern Region
[3] Cholera - Cote d'Ivoire (Abidjan)

******
[4] Cholera - Congo DR (Bandundu)
Date: Sat 18 Jun 2011
Source: AFP (Agence France-Presse) [edited]
<http://www.google.com/hostednews/afp/ar ... f84543e.91>


At least 29 people have been killed in an outbreak of cholera in the
western Bolobo region of the Democratic Republic of Congo since the
end of May 2011, health authorities said on Wednesday 15 Jun 2011.

The fatalities formed part of a total of 483 cholera cases which have
been registered in Bolobo since 31 May 2011, said Delly Mangombo, the
chief medical officer for the region in Bandundu province.

"Bolobo has an ongoing problem with its drinking water," Mangombo
told AFP. "The whole population gets its water from the river (Congo)
and whenever there is low water of the river, there is always
diarrhea," he said, adding that it was the 5th major outbreak in the
region in 50 years.

A team from the Belgian branch of Medecins Sans Frontiers
(MSF/Doctors Without Borders) is currently in the city of Bolobo to
help local medical teams cope with the outbreak, Mangombo said.

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

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

******
[5] Cholera - Niger (Southern Region)
Date: Sat 18 Jun 2011
Source: The Vanguard [edited]
<http://www.vanguardngr.com/2011/06/chol ... -in-niger/>


Cholera has killed at least 6 of the 347 known cases in Niger,
particularly in Niamey and Tillabery, the Nigerien minister of health,
Soumana Sanda, has said.

Several isolation camps for patients have been built in the Gamkalle
district of Niamey, in the rural town of Libore and N'Dounga, the
areas most affected by the disease.

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

[The interactive HealthMap/ProMED map for Niger is available at
<http://healthmap.org/r/008b> - CopyEd.EJP]

******
[6] Cholera - Cote d'Ivoire (Abidjan)
Date: Tue 21 Jun 2011
Source: Associated Press [edited]
<http://ca.news.yahoo.com/un-says-thousa ... 51343.html>


The United Nations says flooding around the Cote d'Ivoire's
commercial capital [Abidjan] is threatening at least 27 646 people,
and dozens of cholera cases have been reported.

The Office for the Coordination of Humanitarian Affairs (OCHA) said
on Tuesday [21 Jun 2011] that UN, Red Cross, and government officials
are trying to find ways to relocate people from flooded homes in a
dozen communities around Abidjan.

Spokeswoman Elisabeth Byrs said there is enormous need for new
shelter and other items as her agency prepares to help up to 10 000
families, while authorities look for longer-term solutions.

Byrs, speaking in Geneva, said the country's health officials had
confirmed 42 cases of cholera in the Koumassi district, including 10
cases in the past week [week ending 19 Jun 2011].

--
communicated by:
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CHIKUNGUNYA - AFRICA (04): REPUBLIC OF CONGO
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Date: Mon 13 Jun 2011
Source: Mwinda.org [in French, trans. Mod.LM, edited]
<http://www.mwinda.org/index.php?option= ... 01:article>


Close to 900 cases of chikungunya have already been counted in
Brazzaville, especially in the southern neighborhoods of the capital.
The 1st district of the capital, Makelekele, is the most affected.
Mfilou and Bacongo are also hit. For the moment, the authorities have
reported no deaths.

Nevertheless, people are worried; they compare the disease to a
"strong malaria" because of its symptoms -- high fever, muscle pain,
and headache.

Like malaria, chikungunya virus is transmitted to humans by a
mosquito, _Aedes (Stegomyia) albopictus_, or the "tiger mosquito".

Chikungunya causes high fever, joint pain (wrists, fingers, ankles,
feet, knees), muscle pain, headache, rash, nausea, and fatigue.

According to the Pasteur Institute: "The disease evolves rapidly
towards a quick improvement, with disappearance of fever in 1-10 days,
skin rash in 2 to 3 days, joint and muscle pain in a few weeks. The
disease is not usually known to be responsible for direct deaths, but
an investigation is currently under way at La Reunion to determine
whether the virus is responsible directly or indirectly for several
dozen deaths that have occurred in a context of acute infection."

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[The number of chikungunya virus infection cases remains essentially
the same as reported in a previous ProMED-mail post (see archive no.
20110616.183). However, this is the 1st report of the identity of the
vector mosquito, _Aedes albopictus_. The control of this mosquito will
be quite difficult, as it is not as closely dependent on human
habitations for its breeding habitats as the other common vector of
chikungunya virus, _Ae. aegypti_.

A HealthMap interactive map showing the location of Brazzaville can
be accessed at <http://healthmap.org/r/0hT9>. - Mod.TY]

RABIES, ANIMALS, HUMAN - ANGOLA (04): (BIE)
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Date: Fri 1 Jul 2011
Source: Jornal de Angola [in Portuguese, trans. Mod.TY, edited]
<http://jornaldeangola.sapo.ao/14/9/surt ... calussinga>


The most recent rabies outbreak in the Calussinga, Bie community
caused the deaths of 3 people between May and June [2011]. The Chief
of the Calussinga Health Center, Pedro Suende, yesterday [30 Jun 2011]
told the Jornal de Angola that the situation is of concern to the
local health authorities, so they are asking the public to join the
anti-rabies campaign.

"We are working to inform the public so that people will bring dogs
to the vaccination posts to help avoid unusual situations such as
bites from dogs that could be rabid," he said.

The responsible official of the Calussinga Health Center considers
the current situation to be serious and said that recently more than
30 people with dog bites were attended to in the Calussinga Health
Center. The head of the Andulo health section, Francisco Chiquete,
said that to counteract the outbreak of new cases, they are taking
measures, but lamented the lack of cooperation from the people during
the domestic animal vaccination campaign. "The local population does
not collaborate with the sanitary authorities, providing unjustified
arguments for not having their animals vaccinated," he added.

[Byline: Jose Chaves]

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[Previous cases were reported in Cabinda province, an enclave in far
northwestern Angola. The cases above, in Bie province, occurred in the
central part of the country. Rabies cases appear to be more widely
spread than before -- a cause for real concern that illustrates the
need for public education and an aggressive campaign to vaccinate
dogs.

A map showing the boundaries of the provinces of Angola can be
accessed at
<http://www.mapsofworld.com/angola/angol ... l-map.html>.
The HealthMap/ProMED-mail interactive map of Angola showing the
location of Bie province can be accessed at
<http://healthmap.org/r/0*I3>. - Mod.TY]

CHIKUNGUNYA - AFRICA (05): REPUBLIC OF CONGO
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Date: Fri 1 Jul 2011
Source: IRIN News [edited]
<http://www.irinnews.org/report.aspx?reportid=93112>


An epidemic of chikungunya, a mosquito-borne virus [disease], which
began in early June [2011] in Congo's capital Brazzaville, has spread
to the neighbouring Pool region, according to the World Health
Organization (WHO).

Between 1-23 Jun [2011], there were 7014 cases in Brazzaville and 460
in Pool, but no deaths, according to the WHO. In Pool, which endured a
series of civil wars between 1998 and 2003, damaging the local health
infrastructure, only the towns of Goma Tse Tse and Kinkala, the
regional capital, are affected.

In Brazzaville, the disease is concentrated in southern districts,
including Makelekele and Bacongo.

The disease's symptoms include muscle pain, headache, nausea, fatigue
and rash, and are similar to those of dengue fever. There is no known
cure; treatment consists of relieving the symptoms.

"Today we find that chikungunya is a problem for the city," Alexis
Elira Dokekias, director-general of health, told IRIN. "There are
patients who complain of chikungunya [virus infection] symptoms, but
do not show up in hospitals. These are hard to track... What is
encouraging is the fact that we have not seen any deaths. Patients who
show up are treated properly because the drugs are available."

Health Ministry specialists have identified the [_Aedes] aegypti_ and
[_Ae.] albopictus_ mosquito species as being responsible for the
outbreak [virus transmission]. Chikungunya [virus] was 1st confirmed
after an analysis of samples by the Franceville laboratory in Gabon.

To counter the disease, the authorities are urging people to clean up
possible breeding sites such as old containers, tyres or empty cans.
The spraying of insecticides to kill the mosquitoes would begin "next
week," said Dokekias.

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[This appears to be an explosive epidemic of chikungunya virus
infection. The 13 Jun 2011 ProMED post (archive no. 20110625.1942)
indicated that there were close to 900 cases. In the above report, the
figure has jumped to 7074 in just 2 weeks, including 460 cases in a
new area. One hopes that the cleanup campaign will reduce the vector
mosquito population and slow or halt this outbreak.

There is a map showing the location of the Pool area in the above
URL. A HealthMap interactive map showing the location of Brazzaville
can be accessed at
<http://healthmap.org/r/0hT9>. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (19): AFRICA
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******
[1] Diarrhea, fatal - Nigeria (Kano)
Date: Mon 4 Jul 2011
Source: Vanguard [edited]
<http://www.vanguardngr.com/2011/07/chol ... -hospital/>


Four people died, while 8 others were hospitalised in Kano and Takai
(65 km north of Kano metropolis) due to the outbreak of
gastroenteritis at the weekend. Meanwhile, health authorities in the
state have embarked on sanitization of open wells and other sources of
drinking water in the area. The officials who went round the town and
other surrounding hamlets offered curative attention to the victims to
forestall the spread of the disease.

The primary healthcare coordinator of the council, Malam Mansur
Abdulkadir, told reporters that the outbreak of the disease did not,
however, reach a "crisis stage", adding that the situation was under
control.

[byline: Abdulsalam Muhammad]

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[2] Cholera - Nigeria (Plateau)
Date: Fri 1 Jul 2011
Source: Vanguard [edited]
<http://www.vanguardngr.com/2011/07/chol ... -infected/>


Mr Jacob Wongdem, the permanent secretary in the Plateau State
Ministry of Health, has announced the outbreak of cholera in some
parts of the state. Wongdem, who earlier denied the outbreak of the
disease, said in Jos on Thu 30 Jun 2011 that it had killed 10 people.

He added that 370 people had also been infected by the disease,
reported in Jos South, Jos North, Mangu, Shendam, Barkin Ladi and
Pankshin local government areas.

"It is a bad situation, but the ministry is already doing everything
to control and stem the ailment," the permanent secretary said. He
attributed the outbreak to poor sanitary conditions and the
consumption of contaminated fruits and unwashed vegetables.

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[3] Cholera - Congo DR (Kinshasa)
Date: Mon 27 Jun 2011
Source: Radio Okapj [trans. edited]
<http://radiookapi.net/actualite/2011/06 ... -kinshasa/>


Four new cases of cholera were reported in Kinshasa on Mon 27 Jun
2011. This figure given by WHO brings the number of cholera cases to 7
in the Congolese capital. The outskirts are the most affected by the
disease.

The Public Health Ministry recommends the population to observe
strict individual and collective hygiene measures.

The director of the fight against the disease at the Ministry of
Health, Dr Benoit Kebela Ilunga, advised people to wash their hands
carefully after coming back from the bathroom, before eating, and
before preparing food. He also forbids them to drink water sold in
plastic bags. He explained that in some areas of Kinshasa where there
is no public restroom, people defecate in plastic bags that they throw
into the street. Dr Benoit Kebela condemns this practice. He asks
people who live in neighborhoods without access to water provided by
Regideso to boil water before drinking.

[byline: John Bompengo]

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