Wüstenschiff

Kenia - Darminfektionen
17.11.2011

Risiko für Durchfallerkrankungen landesweit. Mit Cholera-Ausbrüchen ist regional zu rechnen. Im größten Flüchtlingslager der Welt, im Lager Dadaab im Nordosten des Landes, ist die Cholera ausgebrochen. Dort leben etwa eine halbe Million Flüchtlinge aus Somalia, darunter viele Kinder. Bislang soll es 60 Erkrankte und einen Todesfall geben. Nach UN-Angaben wurden bereits Behandlungsstationen eingerichtet. Auch Polio kommt seit 2009 wieder vor. In diesem Jahr gab es einen bestätigten Fall Ende Juli. Hygiene beachten, Impfschutz für Risikoreisende. / Quelle: crm

Gruß
Birgitt

YELLOW FEVER - AFRICA (22): GHANA
*********************************

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International Society for Infectious Diseases
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Date: Fri 18 Nov 2011
Source: Daily Graphic [edited]
http://www.graphic.com.gh/dailygraphic/ ... news=16689


Health authorities in the Northern Region have confirmed a new case of
yellow fever [YF] in the region. This follows laboratory findings that
attributed the death of a 16-year-old-boy from Dikatami in the
Sawla-Tuna-Kalba District to yellow fever [virus] infection.
Consequently, district and regional health facilities in the region
have been put on high alert to identify and manage effectively any
case of yellow fever.

Briefing the Daily Graphic, the Deputy Regional Director in Charge of
Public Health, Dr Jacob Mahama, said on 20 Aug 2011, the boy reported
at a clinic in the Sawla District with complaints of fever, chills,
vomiting and abdominal pains. He said after examinations, he was
referred to the Wa Hospital in the Upper West Region, where he died
the next day. "However, the blood sample of the patient was sent to
Accra and later to Dakar, Senegal, in September 2011, where it was
found to be positive for yellow fever," he noted.

Dr Mahama said following the confirmation of the yellow fever case, a
team from the Regional Health Directorate was dispatched to Sawla. The
team, he said, undertook a search for other cases, by reviewing the
records in all the facilities. He said the team found no other cases,
but sensitised the health staff in the district and the community
people on yellow fever, its symptoms and causes.

Dr Mahama said the World Health Organisation (WHO) had recommended
that there should be a reactive vaccination in various parts of the
country to prevent the spread of the disease. He said, in the Northern
Region, the vaccination would take place in 6 districts that have been
considered as high risk due to their proximity to Wa and Cote
d'Ivoire, where there has been an outbreak of yellow fever. The
districts are the Sawla-Tuna-Kalba, Bole, Central Gonja, West Gonja,
East Gonja and West Mamprusi. He said already the region had received
the vaccines and had distributed them to the districts, pending the
commencement of the vaccination exercise from 22 - 28 Nov 2011.

Yellow fever, as explained by Dr Mahama, is an acute viral fever with
symptoms that include fever, chills, vomiting and jaundice.

It is a disease prevalent in tropical Africa and South America,
because the _Aedes_ mosquito which transmits this virus breeds in the
tropics.

Of patients who suffer from severe yellow fever, 20-30 per cent lose
their lives.

The best ways to avoid yellow fever is through vaccination and by
avoiding the bite of a mosquito.

--
Communicated by:
ProMED-mail from HealthMap Alerts


[Unfortunately, it has taken 3 months to make the YF diagnosis, with
the risk of additional cases occurring during that time that could
have led to an outbreak. Fortunately, apparently no new cases have
occurred. It seems unusual that this report does not mention the 3
cases that occurred this year (2011) in the in Wa Municipality, Jirapa
and Wa East Districts of the Upper West Region (see ProMED-mail
archive number 20111112.3357). These isolated cases are probably due
to spill-over transmission from the sylvan (jungle or forest) YF virus
transmission cycle that involves wild primates.

The 17 Nov 2011 edition of Spy Ghana
(http://www.spyghana.com/health/health-n ... low-fever/)
quoted the Deputy Director in charge of surveillance at the Ashanti
Regional Health Services Directorate, Dr Asiedu Bekoe, who said a mass
YF vaccination exercise scheduled to kick start in 57 districts from
22-28 Nov 2011 was vital because 3 yellow fever cases [probably those
reported in ProMED-mail archive number 20111112.3357] have been
confirmed in some districts this year. Dr. Bekoe revealed that 17
districts in the Ashanti region would be covered for the exercise but
for the 1st phase, 3 districts namely Kumasi, Adansi South and Atwima
Mponua would be covered. Noting that the other 14 districts would have
their turn somewhere July next year [2012], Dr Bekoe said his unit was
targeting 1 325 201 in the 3 districts selected for the 1st phase.

The Ashanti Region is located in the south-central part of Ghana,
relatively far away from the locations where this year's (2011) YF
cases occurred. A map showing the administrative regions of Ghana can
be accessed at
http://www.lib.utexas.edu/maps/africa/g ... n_2007.jpg.

The Sawla-Tuna-Kalba District is one of the 18 districts in the
Northern Region of Ghana. Its capital is Sawla. A
HealthMap/ProMED-mail interactive map showing the location of
Sawla-Tuna-Kalba District can be accessed at
http://healthmap.org/r/1s3N - Mod.TY]

RABIES - GHANA: (WESTERN) CANINE, HUMAN
***************************************

A ProMED-mail post
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Date: Sun 20 Nov 2011
Source: Ghanamm.com, Ghana News Agency (GNA) report [edited]
http://www.ghanamma.com/2011/11/rabies- ... -district/


Rabies had killed 2 teenagers at Tikobo Number Two and Bonyere in the
Jomoro District [Western Region] after being bitten by dogs. Mr
Kenneth Addai Boadu, Jomoro District agricultural director, said this
when addressing the Jomoro District Assembly at its sitting at Half
Assini. He said the teenagers died at Effia Nkwanta Government
Hospital after referral from Half Assini Government Hospital between
September and October this year [2011].

Mr Boadu said in April this year, an anti-rabies campaign was
organised in the district but in some communities, instead of pet
owners bringing their animals for vaccination, they rather asked the
officials to chase them for the vaccination. This, he said, the
officers could not do due to the risk involved thus leaving some pets
unvaccinated at the end of the exercise.

He said the unfortunate incident, which resulted in the death of the 2
teenagers, had led to a re-vaccination exercise in those communities
since Mon 14 Nov 2011, by the Ministry of Food and Agriculture. Mr
Boadu said in both cases the animals concerned were killed and eaten
without the authorities examining them to ascertain whether they were
carriers of rabies or not. He therefore advised the general public not
to kill any dog after having bitten someone but chain it till 3 weeks
to ascertain whether it is a rabies carrier.

The Assembly advised the agricultural authorities to prosecute pet
owners who refused to vaccinate their animals.

--
Communicated by:
ProMED-mail from HealthMap alerts


[This unfortunate incident illustrates the difficulties encountered in
rabies control in rural Africa. Lack of diagnostic facilities and
incomplete vaccination coverage enables the virus to persist in the
domestic canine population and continue to threaten the human
community. The marking of vaccinated dogs might to some extent reduce
exposure of the human population by identifying unmarked dogs as
potential rabies virus carriers. The killing and eating of the
suspected rabid dog in this incident obscured the diagnosis, but it
would not have contributed to any extent to further spread of the
infection.

The Jomoro District is located in the Western Region of Ghana. The
HealthMap/ProMED-mail interactive map of Ghana is available at
http://healthmap.org/r/1smp. - Mod.CP]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (38): 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 - Djibouti
[2] Cholera - Kenya (North Eastern province), Somali refugees
[3] Cholera - Kenya (Rift Valley province)
[4] Cholera - Cameroon (Littoral province)
[5] Cholera - Congo DR
[6] Cholera - Congo DR (Equateur province)
[7] Cholera - Somalia (Middle Juba)
[8] Cholera - Uganda (Kasese)
[9] Cholera - Zambia (Northern Province)

*****
[1] Cholera - Djibouti
Date: Wed 23 Nov 2011
Source: IC Publications [edited]
http://www.africasia.com/services/news_ ... e23327.701

Authorities in Djibouti have reported a serious outbreak of a
potentially fatal diarrhea infection in the capital [Djibouti], with
2 deaths since October 2011 and 127 new cases this month [November
2011], the WHO said on Tuesday [22 Nov 2011]. WHO said 5000 cases of
acute watery
diarrhea (AWD) have already been reported this year [2011] compared
to 2000 in the Red Sea port in 2010.

Poor hygiene and sanitation along with recent rainfall in some areas
had led to the contamination of already limited and unsafe water
supplies, according to the UN health agency, which said the drought
in the Horn of Africa had exacerbated the situation.

"The effects of the recurring drought on several parts of Djibouti
and neighbouring countries have resulted in a malnourished, poorer
and more vulnerable population," a WHO statement said. [WHO] is
working with the Djibouti ministry of health to train health workers
and set up treatment centres.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[2] Cholera - Kenya (North Eastern province), Somali refugees
Date: Tue 15 Nov 2011
Source: Reuters [edited]
http://www.reuters.com/article/2011/11/ ... LD20111115

Cholera has broken out in the world's largest refugee camp in Kenya,
home to nearly 500,000 Somali refugees, the United Nations said on
Tuesday, 15 Nov 2011. Insecurity also continues to hamper aid efforts
following the kidnapping of Western aid workers from the sprawling
Dadaab complex of five camps, where 100 additional Kenyan police have
been deployed in the past month, it said.

"There are now 60 cholera cases in the camps, including 10
laboratory-confirmed cases and 1 refugee death," Andrej Mahecic,
spokesman of the U.N. High Commissioner for Refugees (UNHCR), told a
news briefing. The outbreak is believed to have started among newly
arrived refugees from Somalia, where the disease is endemic, who may
also have contracted it en route by drinking unsafe water from areas
flooded by heavy rains, he said.

The UNHCR and other aid agencies have set up cholera treatment centers
in the camp for severe cases and are promoting safe hygiene practices,
Mahecic said. Most cases can be managed by giving oral rehydration
solutions.

In all, some 220 Kenyan police are now deployed in Dadaab, which
consists of 5 camps spread across 50 square kilometers (19 square
miles), according to the UNHCR spokesman.

[Byline: Stephanie Nebehay]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[3] Cholera - Kenya (Rift Valley province)
Date: Mon 21 Nov 2011
Source:Nairobi Star (Nairobi) [edited]
http://allafrica.com/stories/201111220198.html

The government has confirmed an outbreak of dysentery and cholera in
parts of Turkana where 40 people have died in the last one month.
Turkana Central medical officer Joseph Epem said they had dispatched a
team of more than 50 medical officers and delivered drugs to help
combat the outbreak in Kerio division. However, Epem said the outbreak
had been compounded by famine in the area. More than 250 other victims
have been placed under treatment. "We treating the affected people to
ensure the diseases do not spread," Epem said.

Last week, medical teams had been sent to parts of Turkana to
investigate the cause of the deaths. Turkana Central district
commissioner Humphrey Nakitare said the teams have been working in
Kerio area where most of the victims are reported to have succumbed to
famine, malaria and diarrhea, among other ailments.

He said than 100 000 people still rely on relief food for survival in
the area where the famine situation worsened early in 2011, leading to
the Kenyans for Kenya Initiative through which more than Shs600
million [USD6550] was raised to aid the famine victims. Kerio division
Public Health officer Diana Rotich, said famine had contributed to the
deaths in the area.

[Byline: Mathews Ndanyi]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[4] Cholera - Cameroon (Littoral province)
Date: Non 28 Nov 2011
Source:Medecins Sans Frontieres (MSF) [edited]
http://www.msf.org/msf/articles/2011/11 ... rities.cfm

A cholera epidemic has spread across all districts of Cameroon’s
economic capital, Douala, home to 2.1 million people. The epidemic,
which was officially declared 14 months ago, in September 2010, has
peaked and troughed a number of times. In March and April 2011, during
the short rainy season, cholera peaked with an average of 120 cases
per week. But since September the number of cases has been increasing
further, with more than 400 cases per week reported in mid-October
2011.

“The existing health structures were no longer able to care for
patients adequately. We found 2 to 3 patients per bed, some lying on
the ground or on benches, in an appalling condition,” says Dr
Narcisse Wega, MSF’s emergency coordinator in Cameroon. “Health
facilities had reached their limit and were no longer able to cope
with the influx of patients.”

There has been a gradual decrease in registered cases of cholera in
the past few days, raising hopes that the current peak is over. During
the 3rd week of November 2011, 15 new admissions were registered per
day at the Laquintinie hospital treatment centre, compared with 40
daily admissions during the previous week. “This corresponds to the
rain having stopped in the past 10 days,” says Dr Wega.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[5] Cholera - Congo DR
Date: Wed 16 Nov 2011
Source: Alert Net [edited]
http://www.trust.org/alertnet/news/more ... esponse-un


Aid agencies in Democratic Republic of Congo are running short of
funds
to respond to a cholera outbreak that has hit 8 out of 11 provinces,
the
UN has said. Cholera has infected around 17 500 people and
killed 508 in the vast central African nation since the start of the
year [2011], according to the Congolese ministry of health and the
WHO.

With the epidemic yet to subside, humanitarian agencies estimate at
least USD 4 million is needed to maintain cholera response activities
in
the western provinces of Equateur, Bandundu and Kinshasa, and the
central-eastern Province Orientale, until next year [2012]. "We are in

the rainy season, a period which increases the risk of propagation. It

is, therefore, important that aid groups continue the response," said

Yvon Edoumou, spokesman for the U.N. Office for the Coordination of
Humanitarian Affairs (OCHA) in Congo.

There are have been more than 7500 cases in western provinces,
including
the capital Kinshasa, which had not experienced a cholera epidemic in
10
years. But the majority of cases, about 10 000, have been reported
in the restive eastern region, where waterborne diseases are endemic.

[Byline: George Fominyen]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[6] Cholera - Congo DR (Equateur province)
Date: Fri 18 Nov 2011
Source: XinHuaNet [edited]
http://www.coastweek.com/3446_congo_10.htm

At least 23 people have died from cholera which broke out in Equateur
province of the Democratic Republic of Congo (DR Congo), according to
local sources.

"Even though the epidemic seems to have reduced in Mbandaka, cholera
still affects some parts of the country especially in South Ubangi
area in Equateur province where 15 out of 119 cases that were reported
since 5 Nov 2011 have died; 8 other people died during the same period
in Basankusu health zone," the president of the local civil society
groups, Modeste Bonkengu, said on Tue, 15 Nov 2011.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[7] Cholera - Somalia (Middle Juba)
Date: Sun 13 Nov 2011
Source: Press TV [edited]
http://www.presstv.ir/detail/209864.html

At least 81 Somali women and children have died and nearly 670 others
[have been] hospitalized due to cholera in the famine-stricken African
country, Press TV reports. The 81 lost their lives in Jilib Town and
Hoomboy village in south Somalia in the last 24 hours Sat 12 Nov].

Somali doctors say that within the last 24 hours more than 670 Somali
children affected by cholera were rushed to medical centers in
Mareerey Village 15 km north east of Jilib.

Somalia has been the hardest-hit country in what is being described as
the worst drought in the Horn of Africa in 60 years. According to the
UN, a quarter of Somalia's 9.9 million population are either
internally displaced or living outside the country as refugees. The
UN has declared famine in 5 regions of Somalia and says that the
international humanitarian response to the crisis has been
insufficient.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[8] Cholera - Uganda (Kasese)
Date: Tue 8 Nov 2011
Source: The Monitor [edited]
http://allafrica.com/stories/201111080231.html

Authorities in Kasese District have ordered the closure of all eating
places that do not meet minimum health standards following a cholera
outbreak that has left 4 people dead and 50 others admitted to
hospital.

The district health officer Yusuf Baseka said, "The disease is
spreading very fast. It is now in Bukonzo West and East and Busongora
North and South constituencies; 4 people have died so far and by this
evening we have about 50 cases admitted at various health units in the
district." He said the disease was first reported in September 2011
in the Democratic Republic of Congo (DRC) fishing villages of
Kyavinyonge and Kasindi Pole along Lake Edward which are adjacent to
Kasese.

The two eastern DRC fishing villages correspond in cross-border
business with Uganda's fishing village of Kayanzi where the first
cases in Kasese were reported during the last week of October 2011.

[Byline: Enid Ninsiima]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*****
[9] Cholera - Zambia (Northern Province)
6 Nov 2011
http://ukzambians.co.uk/home/2011/11/06 ... n-mpulungu

Cholera has again broken out in Mpulungu district in Northern Province
barely a month after the Ministry of Health contained the disease. So
far 5 people from Muzabwera village have been infected with the water
borne disease and are receiving treatment at Mpulungu rural health
centre.

Northern Province Permanent Secretary, Emmanuel Mwamba confirmed the
latest outbreak of cholera in a media statement. He says the
provincial administration has since dispatched a team of health
personnel led by Northern Province Medical Officer
Jelita Chinyonga to Mpulungu to assess the impact of the outbreak.

[Byline: Dorothy Mainza]

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

Yellow Fever in Senegal
01.12.2011 - WHO

The Ministry of Health in Senegal notified the WHO of three cases of yellow fever in Kédougou and Saraya Health districts, near the border with Mali and Guinea Conakry on 26 October 2011.

The index case was a 25 year-old female who developed symptoms of fever, headache and vomiting, with no history of yellow fever vaccination. She consulted the health military post of Kédougou on 23 July 2011. The case was detected as part of a surveillance project for dengue and chikungunya conducted in the region. The WHO reference laboratory for Yellow Fever at the Institut Pasteur in Dakar confirmed the case (IgM by ELISA test and Plaque Reduction Neutralization Test or PRNT) on 10 October 2011.

Two other cases - 29 year-old female and 3 year-old male - were reported on 10 and 11 August 2011. All three cases have fully recovered. An outbreak investigation team assessed the situation in the Kédougou and Saraya districts from 8 to 29 August 2011, where a total of 76 people (suspected cases and their contacts, including 10 deaths) were identified. Laboratory tests conducted showed no evidence of recent yellow fever infection among the 76 people. However, the tests (IgG) indicated that 20 of them had previously been exposed to yellow fever virus or yellow fever vaccine.

The health districts of Kédougou and Saraya benefited from a preventive mass vaccination campaign in December 2007, where the vaccination coverage was 94.9% and 94.8% respectively.

The Ministry of Health of Senegal plans to organize a vaccination campaign in mid-December 2011, targeting the non-vaccinated individuals aged nine months and above, excluding pregnant women in Kédougou, Saraya and Salémata health districts. The mass vaccination campaign aims to protect the susceptible population living in the area, which appears to have increased due to recent migration from neighboring countries. A total of 159,626 doses of vaccine from the GAVI-funded yellow fever emergency vaccine stockpile has been released by the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG) for the campaign.

Quelle: WHO

Gruß
Birgitt

Kamerun - Darminfektionen
05.12.2011

Risiko für Durchfallerkrankungen landesweit. Auch Cholera-Ausbrüche kommen ganzjährig vor, insbesondere im Norden des Landes (Grenzgebiet zum Tschad). Seit Jahresbeginn bis Mitte August gab es insgesamt landesweit etwa 14.700 Fälle, 554 Erkrankte sind gestorben. Auch die größte Stadt und Wirtschaftsmetropole des Landes Douala, am atlantischen Ozean gelegen, ist betroffen. Seit September steigen dort die Anzahl der wöchentlichen Neuerkrankungen aufgrund der klimatischen Bedingungen kontinuierlich an. Hygiene beachten, bei Reisen in besonders gefährdete Regionen ist eine Impfung zu empfehlen. Letztes Jahr wurden zum ersten Mal seit 2007 wieder 3 Polio-Erkrankungen diagnostiziert. Hygiene und Impfschutz (Polio) beachten. / Quelle: crm
__________

Kenia - Dengue
05.12.2011

Nachdem aus der Ortschaft Mandera im Nordosten des Landes (Grenzgebiet zu Äthiopien und Somalia) Ende September die ersten Dengue-Fälle gemeldet wurden, ist die Zahl der Erkrankten innerhalb kurzer Zeit auf 5.000 angestiegen. Es gab mindestens 10 Todesfälle. Dengue ist in den Sub-Sahara-Ländern endemisch, genaue Erkrankungszahlen sind kaum verfügbar aufgrund des Fehlens von effektiven Überwachungssystemen. Außerdem ähnelt die Infektion klinisch der Malaria, so dass Symptome fehlinterpretiert werden können. / Quelle: crm
__________

Kongo, Demokratische Republik - Cholera
05.12.2011

Hohes Risiko für Darminfektionen, speziell Durchfallerkrankungen einschließlich Ruhr und Cholera landesweit. Die seit Ende Februar herrschende Cholera-Epidemie breitet sich weiter aus. 8 der insgesamt 11 Provinzen des Landes sind betroffen. Insgesamt gab es bis Mitte November etwa 17.500 Erkrankte und etwa 508 Todesfälle. Auch das Nachbarland Republik Kongo ist betroffen. Medikamente zur Behandlung der Cholera sind nur begrenzt erhältlich. Internationale Organisationen intensivieren ihre Überwachungsmaßnahmen und errichten neue Behandlungszentren, allerdings fehlen ausreichend finanzielle Mittel. / Quelle: crm
__________

Sambia - Darminfektionen
05.12.2011

Risiko für Durchfallerkrankungen landesweit; Cholera tritt während der Regenzeit (Oktober bis März) regelmäßig auf. Im Mpulungu Distrikt (Grenze zu Tansania) sind Anfang November erneut Cholera-Fälle aufgetreten, nur knapp einen Monat, nachdem dort die Infektion eingedämmt werden konnte. Hygiene beachten. / Quelle: crm
__________

Simbabwe - Typhus
08.12.2011

Pressemeldungen zufolge gibt es in der Hauptstadt Harare im Dezember einen Typhus-Ausbruch, innerhalb von 14 Tagen soll die Zahl der Erkrankten von 100 auf 500 angestiegen sein. Hygiene und Impfschutz beachten. / Quelle: crm


Gruß
Birgitt

UNDIAGNOSED CEREBRAL DISEASE - UGANDA: (PADER) NODDING DISEASE
**************************************************************

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: Thu 15 Dec 2011
Source: All Africa [edited]
http://allafrica.com/stories/201112080449.html


Uganda: Nodding Disease Death Toll in Pader At 66
-------------------------------------------------
As health experts remain puzzled about the mode of controlling the
spread of the nodding disease that has been devastating Pader
District, at least 66 children have been reported dead, leaving about
1500 others out of school in just 6 months.

A report by Trans-Cultural Psychosocial Organisation, an
non-governmental organization (NGO), reported that at least 1800 new
cases of the disease are reported after every 3 months, putting lives
of more children in the district at risk.

Nodding disease is a peculiar health problem that was 1st reported in
the district in 2008 and is characterised by head nodding, mental
retardation, stunted growth, blindness, body stiffness, endless
running nose and saliva, occasional defecation and urination during
attack of the infected person.

Many of the affected children are malnourished because eating food
seems to spark bouts of nodding and sometimes seizures. Epilepsy drugs
have been used to control the attacks but they do not cure the
disease, which has left many people perplexed, including medical
officers.

A 48-year-old woman of Atanga Sub-county, who has so far lost 2
children to the disease, said she fears that her only remaining
11-year-old child, who is also infected, could die soon.

Pader District Health Officer Janet Oola on Tuesday said the spread of
the disease is a great concern because it spreads so fast that about
1400 to 1600 infections were registered per day since August.

"The disease is so intense especially among children aged between 3-18
years and has spread to at least all sub-counties," Dr Oola said,
adding that despite using preventive drugs to treat the disease, more
infections continue to emerge.

According to Dr Oola, the disease has no known drugs but medicines
like Phenobarbitoin and Carbamaxpine that are used to treat its signs
and symptoms are expensive for the district to adequately supply to
the affected persons. She also noted that the disease can be prevented
by observing hygiene.

Pader LC5 Chairman Alfred Akena, however, said the district is in the
process of developing a paper that will help reduce the prevalence of
the disease. "We have called for regional meetings with all the
leaders in the region because the disease is a regional threat that
needs joint effort to kick it out."

The nodding disease is said to have 1st emerged in Sudan in the 1980s
and is currently restricted to small regions in South Sudan, Tanzania
and Uganda

--
Communicated by:
Mary Marshall


[In 1962, several children with attacks of "nodding head" were
described in Mahenge, a village of southern Tanzania (Aall L. Epilepsy
in Tanganyika. Transcult Res Mental Hlth Prob 1962;13:54-7). Possible
causes have remained obscure, but over 40 percent of those with HN
seemed to have cognitive impairment (Winkler AS et al. Clinical
characteristics of people with head nodding in southern Tanzania. Trop
Doct. 2010;40:173-5).

Nodding Disease has been linked to onchocerciasis (Kipp W et al.
(1994) Onchocerciasis and epilepsy in Uganda. Lancet 1994;343:183-4;
and Kipp W et al. Improvement in seizures after ivermectin. Lancet
1992;340:789-790). However, a review of available studies concluded
that there was no solid evidence linking epilepsia to onchocerciasis
(Druet-Cabanac M et al. Review of epidemiological studies searching
for a relationship between onchocerciasis and epilepsy.
Neuroepidemiology. 2004;23:144-9).

A study which includes MRI results on 7 patients with Nodding Disease
(Head Nodding Syndrome) reported that 4 had a normal scan. Of the
rest, one had frontal release signs and the other three patients
showed hippocampus pathologies were seen (2 bilateral). In 2 patients,
there were additional gliotic lesions. Another study using
computerized tomography found evidence of neurocysticercosis as a
major course of epilepsia in a rural area of Tanzania (Winkler AS et
al. Epilepsy and neurocysticercosis in rural Tanzania-An imaging
study. Epilepsia. 2009;50:987-93).

Thus the disease remains elusive. However, looking at the present
outbreak both neurocysticercosis and onchocerciasis seems unlikely.
Both of these infections have long incubation periods and the parasite
burden slowly builds up and this does not fit with the present rapid
spreading outbreak.

An infectious disease seems unlikely. Rather a food borne illness for
instance caused by a toxin would present. Several toxins produce
encephalopathies in which myoclonus can be a prominent feature. These
include intoxications with bismuth, methyl bromide, cooking oil
containing anilines, and tetraethyl lead. The clinical features in
many cases resemble the action myoclonus syndrome of posthypoxic
encephalopathy (Obeso JA et al. Toxic myoclonus. Adv Neurol.
1986;43:225-30), and the Spanish Oil Syndrome also come into mind
(Fournier E et al. Spanish adulterated oil matter. An important
discovery by Spanish toxicologists: the toxicity of anilides of
unsaturated fatty acids. Toxicol Eur Res. 1982;4:107-12).

ProMED will be happy to post data on the patients line cerebral scans,
results of lumbar puncture and we hope the authorities will perform a
detailed case control investigation of relevant factors like food and
environmental exposures. HealthMap location:
http://healthmap.org/r/1xMp - Mod.EP]

LASSA FEVER - GHANA: (ASHANTI, EASTERN), SUSPECTED
**************************************************

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 19 Dec 2011
Source: Citi FM Online [edited]
http://www.citifmonline.com/index.php?id=1.706389


The Public Health Directorate at the Ghana Health Service (GHS) has
set up a committee to investigate an outbreak of a disease known as
Lassa fever in the Eastern and Ashanti regions.

Lassa fever is an acute viral haemorrhagic illness caused by Lassa
haemorrhagic fever virus [species _Lassa virus_, genus _Arenavirus_,
family _Arenaviridae_.] It is transmitted to humans through contact
with food or household items contaminated with rodent [principally
_Mastomys natalensis_] excreta.

In an interview with Citi News, the National Coordinator for Public
Health at the GHS, Dr. Joseph Amankwa, said: "We're trying to find out
what's happening; there is a committee for Lassa fever which is
working on it."

He added: "We are going to do the investigation; it's not only in the
Ashanti region but in the Eastern region as well."

--
Communicated by:
George A. Robertson, PhD
Senior Technical Advisor
Vaccine Development Global Program
PATH
455 Massachusetts Ave NW, Suite 1000
Washington, DC 20001 USA


[Lassa fever is an acute viral zoonotic illness caused by Lassa virus,
an arenavirus known to be responsible for a severe haemorrhagic fever
characterised by fever, muscle aches, sore throat, nausea, vomiting,
and chest and abdominal pain. The virus exhibits persistent,
asymptomatic infection with profuse urinary virus excretion in the
ubiquitous rodent vector, _Mastomys natalensis_. Lassa fever is
endemic in West Africa and has been reported from Sierra Leone,
Guinea, Liberia, and Nigeria, but not previously from Ghana. Some
studies indicate that 300 000 to 500 000 cases of Lassa fever and 5000
deaths occur yearly across West Africa. (From: Lassa fever in West
African sub-region: an overview. Ogbu O, Ajuluchukwu E, Uneke CJ. J
Vector Borne Dis. 2007 Mar;44(1):1-11).

Lassa virus infection has not been not recorded previously in Ghana,
but the lesser prevalence of Lassa fever in Ghana was predicted by a
spatial-climatic analysis of Lassa fever data from human cases and
infected rodent hosts in West Africa during the period 1965-2007 (See:
Risk maps of Lassa fever in West Africa. PLoS Negl Trop Dis.
2009;3(3):e388)
http://www.plosntds.org/article/info%3A ... 95CF9E71CB
and also the ProMED-mail archived report: Lassa fever, predictive maps
- West Africa 20090428.1605). In this survey, information on
contemporary environmental conditions (temperature, rainfall,
vegetation) was derived from the NASA Terra MODIS satellite sensor
data and other sources and for elevation from the GTOPO30 surface for
the region from Senegal to the Congo. All multi-temporal data were
analysed using temporal Fourier techniques to generate images of
means, amplitudes and phases, which were used as the predictor
variables in 3 different models. In addition, meteorological rainfall
data collected between 1951 and 1989 were used to generate a synoptic
rainfall surface for the same region.

Lassa fever-favourable areas predicted by 3 different models covered
approximately 80 percent of each of Sierra Leone and Liberia, 50
percent of Guinea, 40 percent of Nigeria, 30 percent of each of Cote
d'Ivoire, Togo and Benin, and 10 percent of Ghana. This environmental
analysis accounts in some part for the previous absence of reports of
Lassa virus infection in Ghana.

A map of the regions of Ghana, showing the locations of the Ashanti
and Eastern regions, can be accessed at:
http://www.ghanaweb.com/GhanaHomePage/g ... region.php. -
Mod.CP]

UNDIAGNOSED ILLNESS - KENYA: (NAIROBI), EBOLA SUSPECTED
*******************************************************

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: Thu 22 Dec 2011
Source: Daily Nation [edited]
http://www.nation.co.ke/News/Woman+dies ... gljh7kz/-/

Health probe as Ebola scare woman dies
----------------------------------
Scientists are waiting for results of tests to confirm if a woman who
bled to death on Thursday died of Ebola [haemorrhagic fever]. Three
people who took the woman to hospital were also put in an isolation
ward at the Kenyatta National Hospital (KNH). They are being checked
for the deadly virus that is highly contagious.

The patient was said to have been bleeding from all openings and was
declared death on arrival.
“She had what looked like suspicious sudden onset of bleeding and as
part of our public health concern we have to investigate and find out
what caused it,” said Dr Masika Wafula, a consultant at the
Infectious Diseases Unit. Preliminary results from tests by the Kenya
Medical Research Institute and the Centre for Disease Control (CDC)
are expected on Friday [23 Dec 2011 afternoon. Dr Wafula declined to
speculate the cause of the death, saying the bleeding could have been
as a result of multiple conditions.

The woman’s father, her friend and a taxi driver were first
quarantined at the tents usually used for blood donation for several
hours. Their car was also detained. They were later moved to a ward
where they will be kept in isolation until doctors determine the cause
of the woman'sMuthoni’s death. Experts from the Ministry of Public
Health, Division of Disease Surveillance and Response are reported to
have taken over the investigation.

The 29-year-old wman was said to have been in good health when she
reported to work yesterday morning at the Timboroa Hotel in downtown
Nairobi. “She even went to the market and was going about her duties
at work when she started bleeding,” said persister. “When it
increased, the manager called our father who went to pick her up.”

Dr Ashford Parantai, who was among the experts who received the body
at the hospital, said incubation period for haemorrhagic fever is
18-48 hours. “The disease is spread by coming into contact with an
infected person or body secretions,” Dr Parantai said.

(By Lilian Onyango)

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

[There have been no recent reports of Ebola haemorrhagic fever in
urban areas of Kenya.
The sudden onset of the condition is unusual. Further information is
awaited. - Mod.CP


A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/r/1zkN]

UNDIAGNOSED ILLNESS - KENYA: (NAIROBI) EBOLA NOT
************************************************

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: Fri 23 Dec 2011
Source: Daily Nation [edited]
http://www.nation.co.ke/News/Ministry+a ... index.html


The Ministry of Health has allayed fears of an Ebola [haemorrhagic
fever] outbreak following the death of a woman at Kenyatta National
Hospital (KNH). At the same time, KNH Friday [23 Dec 2011] discharged
3 people who had been quarantined for being in contact with the
patient who died from excessive bleeding.

Findings by scientists from the Kenya Medical Research Institute
(KEMRI) and the Centres for Disease Control and Prevention (CDC)
showed that there were no traces of ebola[virus] or any other related
infectious [agent] in the blood samples taken from the body of the
woman. Blood from the patient was analysed in both KEMRI and CDC
laboratories and is negative for all viral hemorrhagic fever viruses
tested, including [ebolavirus] said the Director of Public Health
Sharif Shanaaz.

Viral haemorrhaic fever is characterised by fever and bleeding, which
can lead to shock and death in most cases. The viral haemorrhagic
fevers include Ebola, yellow fever, Marburg fever, and Rift Valley
fever among others. In the case of ebolavirus fever normally the early
signs of this infection start with tiredness, headache, sore throat,
then high fever before bleeding sets in from any body opening like the
mouth, nose, vaginal opening, or the anus.

Dr Shanaaz told reporters in Nairobi that the 29-year-old woman, who
was a restaurant attendant, might have died from bleeding possibly
caused by stomach ulcer or a related ailment. Tests showed that the
woman was not suffering from any infectious disease, but she was
vomiting blood, an indication that she might have had an ulcer.

On Thursday [22 Dec 2011], medics at the KNH Casualty department
received the patient in a state of heavy bleeding. Early suspicions
were that the woman who died immediately on arrival [might have been a
victim of Ebola haemorrhagic fever since her clothes were soaked with
blood. The 3 other people who had taken the woman to the hospital --
her father, another relative, and the taxi driver, were isolated in a
special ward until the tests on the deceased patient had been
conducted.]

According to a report in 2000 by the American Society of Tropical
Medicine and Hygiene, most viral haemorrhagic fevers are rare and
unpredictable epidemics. Rodents like rats and mice, and arthropods
such as certain insects are the main reservoirs for this type of
virus. [Bats are also likely vectors]. Dr Shanaaz said medics have yet
to find a cure for these diseases because of their unpredictable
nature, which makes it difficult to conduct experimental studies.

The Ministry's Head of the Division of Disease Surveillance and
Response Daniel Langat said that despite the results showing no traces
of the dreaded Ebola haemorrhagic fever, the government would continue
to monitor the situation. "Quarantine facilities will be retained, but
we would like to assure Kenyans and the entire public that we are all
safe."

In Africa, Ebolavirus was first associated with an outbreak of 318
cases of a haemorrhagic disease the Democratic Republic of Congo in
1976. Similar outbreaks have since been reported in Northern Uganda,
Democratic Republic of Congo and even South Sudan. In Kenya, there is
yet to be any officially confirmed case.

[Byline: Aggrey Mutambo]

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

******
[2]
Date: Fri 23 Dec 2011
From: SK Sharif [edited]


A 29-year-old female was brought to Kenyatta National Hospital on 22
Dec 2011. She was pronounced dead on arrival at the casualty. She had
been alright until 9 in the morning when she started vomiting blood.
There was no bleeding from other body orifices. There was no history
of travel outside Nairobi in the last 3 weeks. The hospital doctors
suspected viral hemorrhagic fever and wanted to rule out
[ebolavirus].

Blood samples were taken by CDC and KEMRI staff for testing. The tests
were negative for Ebola, Marburg, CCHF, yellow fever, and dengue by
RT-PCR. The tests were negative for Ebola and Marburg by antigen
capture ELISA tests. The samples were also negative for IgM antibody
ELISA for Ebola, Marburg, Lassa, yellow fever, dengue, chikungunya,
CCHF, and Rift Valley fever.

The diagnosis of Ebola [hemorrhagic fever] was most unlikely in this
case because of a very short history of illness and no history of
travel outside Nairobi in the preceding weeks. The profuse hematemesis
covered the patient and her clothes with blood and lead the clinicians
to believe that she was bleeding from the nose, ears, and skin. It
shows how important it is to get a proper history and examination
before making a diagnosis of a viral hemorrhagic fever.

--
Dr SK Sharif MBS, MMed, MSc
Director of Public Health and Sanitation
Ministry of Public Health and Sanitation
PO Box 30016-00100
Nairobi Kenya

via
ProMED-EAFR
<promed-eafr@promedmail.org>

[ProMED-EAFR would like to thank Dr Sharif for his rapid sharing of
the detailed information above on the official results of the rapid
investigation and laboratory findings on the case/patient. The
observation of the importance of a thorough history and physical
examination at the entry point is notable. - Mod.MPP]

[It is likely that infectious disease was not responsible for the
death of the patient. It remains true that up to the present there
have been no confirmed cases of Ebola haemorrhagic fever in Kenya.

The HealthMap/ProMED-mail interactive map of Kenya, showing the
location of Nairobi, can be accessed at http://healthmap.org/r/1zkN.
- Mod.CP]

LEISHMANIASIS, HUMAN - ALGERIA: (NAÂMA PROVINCE)
*************************************************

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: Thu Dec 29, 2011
Source: Le Quotidien d'Oran [machine trans., edited]
http://www.lequotidien-oran.com/index.php?news=5162346


Leishmaniasis is still rife in Algeria
--------------------------------------
At the end of 2011, according to a report of hospital services in the
daïra [subdistrict] of Mecheria, some 330 cases of cutaneous
leishmaniasis have been recorded in the subdistrict.

The rate of this disease is still growing, according to our source,
and the majority of [affected] households have been located in the
heart of urban centers, for example Mecheria, where there was
cutaneous leishmaniasis in almost all areas among children.

Several factors, from the same source, are at the origin of this
dangerous zoonosis. Mention is made, for example, of the absence or
inadequacy of appropriate chemical treatment, the degradation of
environmental health and the presence of urban stables favoring
proliferation of the sand fly, the leishmaniasis [vector].

[By H. S. Laradji]

---
Reported by:
ProMED-FRA
promed-fra@promedmail.org

[Leishmaniasis seems to have increased in Algeria over the past
decade. A recent study (Fendri AH et al. Leishmaniasis in Constantine
(Algeria): Review of five years (2006-2010) at the University
Hospital. Bull Soc Pathol Exot. 2011 Dec 23. [Epub ahead of print])
showed that children have the highest risk of both cutaneous and
visceral Leishmaniasis.

Another recent study describe the spread of _L. major_ from the arid
zones towards the semi-arid areas, particularly in the Soummam valley.
All isolates were _L. major_ MON-25, and the reservoir host was the
sand rat (_Psammomys obesus_), for the first time found in the
locality (Boudrissa A et al. Spread of Leishmania major to the north
of Algeria. Bull Soc Pathol Exot. 2011 Dec 14. [Epub ahead of
print]).
_Leishmania infantum_ with its reservoir in dogs is also found in
Algeria (Aït-Oudhia K et al. Canine Leishmania infantum enzymatic
polymorphism: a review including 1023 strains of the Mediterranean
area, with special reference to Algeria. Acta Trop. 2011;118:80-6).

HealthMap location: http://healthmap.org/r/1AYW - Mod. EP

A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/r/1A_U]

Kenia - Dengue
06.01.2012

In der Ortschaft Mandera im Nordosten des Landes (Grenzgebiet zu Äthiopien und Somalia) gab es im September und Oktober 2011 einen Erkrankungsausbruch. Die meisten Fälle traten in der 2. Septemberwoche auf, danach war die Rate an Neuerkrankungen kontinuierlich rückläufig. Mindestens 1.280 Menschen sind erkrankt, der Altersdurchschnitt betrug 18 Jahre. Dengue ist in den Sub-Sahara-Ländern endemisch, genaue Erkrankungszahlen sind kaum verfügbar aufgrund des Fehlens von effektiven Überwachungssystemen. Außerdem ähnelt die Infektion klinisch der Malaria, so dass Symptome fehlinterpretiert werden können. Schutz vor den überwiegend tagaktiven Überträgermücken beachten. / Quelle: crm
____________

Kongo, Demokratische Republik - Infektionskrankheiten
09.01.2012

Hohes Risiko für Darminfektionen, speziell Durchfallerkrankungen einschließlich Ruhr und Cholera landesweit. Die seit Februar 2011 herrschende Cholera-Epidemie hat nach UNO-Angaben bislang zu mindestens 575 Todesopfern geführt. In einigen Regionen des Landes konnten die Erkrankungszahlen durch intensivierte Behandlungsmaßnahmen verringert werden, aber es werden weiterhin Fälle gemeldet, u.a. auch aus der Hauptstadt Kinshasa. Alle Formen der Virushepatitis kommen im Land vor. Angesichts des desolaten Gesundheitswesens ist davon auszugehen, dass der Polio-Erreger in der DRC weiterhin zirkuliert. Insgesamt 101 Fälle wurden 2010 gemeldet. 2011 gab es 92 gemeldete Fälle. Der Erreger wurde wahrscheinlich aus Angola importiert. Schlafkrankheit und Tollwut sind weit verbreitet, Risiko auch für örtliche Auftritte von Pest, vor allem im NO des Landes, für Affenpocken sowie viralen hämorrhagischen Fiebern. / Quelle: crm

Gruß
Birgitt

TYPHOID FEVER UPDATE 2012
*************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

******
Zambia
Date: Mon 9 Jan 2012
Source: Zambia Daily Mail [edited]
http://www.daily-mail.co.zm/index.php/p ... up-to-2094


The number of patients treated for typhoid in Mufulira's Mupambe township has risen to 2094. Two people have so far died of the diarrheal disease, which broke out in December 2011.

Ministry of Health spokesperson Reuben Mbewe said: "As of Fri 6 Jan 2012, we had 2094 patients who were attended to for suspected typhoid, out of which 119 were admitted to various health centres, while 79 were discharged since the outbreak of the disease 2 weeks ago," Dr Mbewe said. He said 2 deaths have so have been recorded in Mupambe since the outbreak of the disease 2 weeks ago.

Dr Mbewe said Mufulira recorded 12 new cases of typhoid on 6 Jan 2012, and 17 patients were treated and discharged from various health centres. He said the situation in Mupambe is slowly stabilising, and residents have continued to visit the mobile clinic for medical check-ups.

[Byline: Nkombo Kachemba]

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

[A ProMED HealthMap is available at http://healthmap.org/r/1Dk_. - CopyEd.MSP]

Sambia - Darminfektionen
13.01.2012

Risiko für Durchfallerkrankungen landesweit; Cholera tritt während der Regenzeit (Oktober bis März) regelmäßig auf. Im Mpulungu Distrikt (Grenze zu Tansania) sind Anfang November 2011 erneut Cholera-Fälle aufgetreten, nur knapp einen Monat, nachdem dort die Infektion eingedämmt werden konnte. Seit Dezember 2011 gibt es einen Typhus-Ausbruch in der Stadt Mufulira an der Grenze zur Demokratischen Republik Kongo. Hygiene und ggfs. Impfschutz beachten. / Quelle: crm

Gruß
Birgitt

LASSA FEVER - NIGERIA: (EBONYI) NOSOCOMIAL
******************************************
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 18 Jan 2012
Source: The Nation [edited]
http://www.thenationonlineng.net/2011/i ... aliki.html


A doctor has reportedly died of [a] viral haemorrhagic fever, otherwise known as Lassa fever, in Ebonyi State. Some other doctors are being treated for the disease at the Federal Teaching Hospital (FTH), Abakaliki [capital of Ebonyi State].

Though no official confirmation has been made by the Ministry of Health, doctors have raised the alarm over the outbreak of the disease. Some doctors at the FTH, who spoke to our reporter, regretted the outbreak of the disease, adding that doctors are prone to it since they are exposed to infected patients. The doctors called for quick intervention by the Federal Ministry of Health to forestall the spread of the disease.

An outbreak of Lassa fever was first reported in the state in 2008. Several people died. They included 2 doctors and other health workers. Last year [2011], 4 people said to be residing at the Military cantonment, Nkwoagu, near Abakaliki also died of the disease.

The government said it has set up an emergency response team for the treatment and control of outbreaks of communicable diseases, such as Lassa fever, gastroenteritis, and meningitis, usually associated with dry season. The commissioner for health, Sunday Nwangele, said this while addressing stakeholders in Abakaliki. Nwangele said epidemiologists from the ministry had been deployed to health facilities in the state to check the possible spread of the disease. He urged the people to report any suspected case to a hospital or the epidemiology unit of the ministry. The commissioner said the ministry had procured drugs for the treatment of the disease, adding that more was still expected from the Federal Ministry of Health.

[byline: Gbonnaya Obinna)

--
communicated by:
Olutayo Olajide Babalobi, (DVM, MPVM, PhD; FCVSN)
ProMED-EAFR (Anglophone Africa) Veterinary Moderator
Department of Veterinary Public Health and Preventive Medicine,
Faculty of Veterinary Medicine,
University of Ibadan
Ibadan, Nigeria


******
[2]
Date: Wed 18 Jan 2012
Subject: Daily Times Nigeria [edited]
http://dailytimes.com.ng/article/lasaa- ... cmd-ebonyi


Following the death of the chief medical director of Igboji General Hospital Ikwo Ikwo LGA [local government area] of Ebonyi state by [a] viral haemorrhagic fever, the government said it has put in place an emergency response team for the treatment and control of outbreak of communicable diseases such as viral haemorrhagic fevers, gastroenteritis, meningitis associated with the dry season.

The commissioner for health, Dr Sunday Nwangele, who made the statement yesterday in Abakaliki while addressing key stakeholders in the health sector, noted that an outbreak of haemorrhagic fever, otherwise called Lassa fever, was first officially reported in Ebonyi state in 2008. According to him the disease had, in 2008, claimed the lives of some people including 2 medical doctors and other health workers and last year [2011], 4 people said to be residing at the Military cantonment, Nkwoagu near Abakaliki also died of the disease.

He said the recent case of the outbreak of the disease was being controlled by epidemiologists from the state ministry of health, who had been deployed to health facilities in parts of the state to check the possible spread of the disease. Though the commissioner said that the chief medical director was brought to the teaching hospital in a critical condition before he gave up, he urged the people not to panic but report any suspected case to a hospital or Epidemiology unit of the ministry for prompt medical attention.

The head of the epidemiology unit of the ministry, Dr Francis Onwe, said the unit had commenced the distribution of the drugs to hospitals across the state and advised people to report to hospitals if they experience symptoms such as stooling and vomiting of blood among others.

[byline: Nnamdi Akpa]

--
communicated by:
Shamsudeen Fagbo, DVM
Coordinator
Zoonotic Diseases Unit
Ministry of Health
Riyadh
Saudi Arabia


[Lassa viral haemorrhagic fever is an acute illness of 1-4 weeks duration that occurs in West Africa. The virus is a single-stranded RNA virus belonging to the virus family Arenaviridae. Lassa fever is known to be endemic in Guinea (Conakry), 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 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. The onset of the disease is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal may follow. Severe cases may progress to show facial swelling, fluid in the lung cavity, bleeding from mouth, nose, vagina, or gastrointestinal tract, and low blood pressure. Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the late stages. Deafness occurs in 25 per cent of patients of whom half recover some function after 1-3 months.

Lassa fever is a zoonotic disease, humans becoming infected from contact with infected animals. 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 excreta (urine and faeces).

Humans usually become infected with Lassa virus from exposure to excreta of infected _Mastomys_ rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of a person with Lassa fever. There is no epidemiological evidence supporting airborne spread between humans. Person-to-person transmission occurs in both community and health care settings, where the virus may be spread by contaminated medical equipment.

Further information can be obtained from the WHO website at http://www.who.int/mediacentre/factshee ... index.html.

A HealthMap/ProMED-mail interactive map of Nigeria can be seen at http://healthmap.org/r/1F4_. A map showing the location of Ebonyi state can be accessed at http://www.firstbanknigeria.com/annualr ... ebonyi.gif. - Mod.CP]