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CHIKUNGUNYA (19): INDIA (KARNATAKA)
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India (Karnataka)
Date: Wed 3 Jun 2009
Source: Daijiworld.com [edited]
<http://www.daijiworld.com/news/news_dis ... +72+Taluks+>


Chikungunya, the viral disease transmitted by mosquitoes, has spread
to 72 taluks in the state, causing concern among officials and doctors
of the Health Department. [A taluk is an administrative division in
some Indian states and consists of a headquarters city with authority
over villages and municipalities within its jurisdiction. - Mod.TY]

Over 4190 suspected cases of chikungunya have been reported from 111
primary health centres of 72 taluks in 23 districts. Suspected cases
of chikungunya have been reported from all districts except Bidar,
Raichur, Koppal, Hassan, Dakshina Kannada and Udupi as of 1 Jun [2009].

The highest number of suspected cases of chikungunya is from Uttara
Kananda district (969) followed by Haveri (710) and Bangalore city
(308). No death due to the disease has been reported so far, sources
in the Department of Health and Family Welfare told The Hindu on
Tuesday [2 Jun 2009].

Scientists from the National Institute of Virology (NIV) Field
Station, Bangalore have visited some of the affected areas and tested
the blood samples of the victims. They collected samples of 1189
people. As many as 449 cases tested positive in the state, and 129 of
them are in Bangalore city alone, officials said.

The officials have appealed to the public to use clean containers and
drums for storing water and thus prevent the breeding of mosquitoes in
the stored water. In all districts, the department claimed to have
taken steps to control it. Both indoor and outdoor fogging had been
undertaken in 202 affected villages as part of preventive measures.
Sources said an irregular supply of drinking water in the slums of
Bangalore city and storage of water by residents in drums for weeks
are major reasons for breeding of mosquitoes and the spread of the
disease.

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

[A map of India showing the location of Bangalore in Karnataka can be
accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>.

The HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed?v=22.9,79.6,5>.
- Mod.TY]

DENGUE/DHF UPDATE 2009 (23)
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******
India (Kerala)
Date: Mon 8 Jun 2009
Source: Asianetindia.com [edited]
<http://keralaonline.com/news/dengue-out ... 49933.html>


Dengue fever has hit the Medical College campus here in
Thiruvananthapuram again, barely a month after the authorities had
managed to contain a major outbreak which had affected a large number
of house surgeons and laborers engaged in construction work on the campus.

In the past one week, at least 25 students of the nursing hostel and
the paramedical sciences hostel have been down with fever, and 4 of
them are currently hospitalised. With 3 cases already being confirmed
as dengue fever, this could be yet another outbreak of dengue, it is feared.

A team deputed by the district health administration and the
Prevention of Epidemics and Infectious Diseases Cell in Medical
College have commenced spraying activities in the affected areas
inside the MCH campus.

The outbreak in April 2009 had recorded at least 75 to 100 probable
cases of dengue, even though official figures spoke only about the 45
confirmed cases.

The epicentre of the outbreak had been found to be the new Super
Speciality block under construction, where water stagnation during
construction work had led to the massive breeding of _Aedes aegypti_
mosquitoes.

Those affected during the April 2009 outbreak -- the 1st one in the
district this year -- were mostly the residents of the House
Surgeons' Quarters (HSQ) and students of the nursing hostel. The
outbreak had affected the migrant labourers' camp as well as some
residential colonies adjacent to the MCH campus. One death had also
been recorded, that of a laborer engaged in aluminum fabrication work
in the construction site.

Following this outbreak, an intensive dengue containment and vector
control drive had been launched in Medical College campus by roping
in various departments, including the housekeeping divisions at
Medical College, the Medical Education division, the district health
administration, City Corporation as well as the ASHA and Kudumbasree workers.

A fever ward had been opened at the hospital with fever patients
confined under mosquito nets to prevent the infection being spread to
patients in other wards.

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

[One hopes that the involvement of individuals from various
departments and agencies is directed toward the elimination of _Ae.
aegypti_ breeding sites. Spraying may eliminate adults for a few
days, only to have new adults emerge from the breeding sites and
continue transmitting the virus.

Maps showing the location of Kerala state in southern India can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>,
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00d3>.
- Mod.TY]

HEPATITIS, VIRAL - PAKISTAN: (SINDH) FATAL
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Date: Tue 9 Jun 2009
Source: Regional Times [edited]
<http://regionaltimes.com/09jun2009/hear ... person.htm>


4 persons die of hepatitis, 460 other cases reported in New Saeedabad
---------------------------------------------------------------------
Due to consumption of contaminated water in village Jan Muhammad
Jamali near New Saeedabad [Matiari District, Sindh], 4 people have
died, while 460 others have been diagnosed with hepatitis. The
Regional Times learnt on Monday [8 Jun 2009] that after an outbreak
of diarrhea, which killed 3 persons in village Jan Muhammad Jamali a
few days ago, the deadly disease of hepatitis has spread due to
consumption of contaminated water. In this regard, it was learnt that
4 villagers have died in a few days, while 460 other hepatitis
positive cases have also been reported.

However, health department Sindh has decided to establish an
emergency hepatitis vaccination camp in village Jan Muhammad Jamali
on Tuesday (today [9 Jun 2009]). It is worthwhile to mention that
Sindh minister for health has taken serious notice of the matter and
directed the EDO [executive district officer] Health to provide
better health facilities to the villagers. The Sindh minister for
health has also initiated an inquiry into the outbreak of hepatitis
and appointed special secretary public health as inquiry officer. The
minister also directed the inquiry officer to present a report within
3 days.

[Byline: Danish Memon]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[This report does not indicate which etiological agent is involved in
this hepatitis outbreak. A 2007 report quoted Dr Sharif Ahmad Khan,
the national programme manager for prevention and control of
hepatitis, who said the percentage of hepatitis B in the country was
about 3-4 percent while those infected with hepatitis C reached 5-6
percent. "There are 5 types of hepatitis: A, B, C, D, and E."
"Hepatitis A and E occur due to consumption of unhygienic food or
contaminated water..." (see ProMED-mail archive no. 20070306.0796).

Sindh Province can be located on the map of Pakistan at
<http://www.lib.utexas.edu/maps/middle_e ... l_2002.jpg>
The HealthMap/ProMED-mail interactive map of Pakistan can be accessed at
<http://healthmap.org/r/00tz>. - Mod.TY]

PLAGUE, HUMAN - MONGOLIA: (BAYAN-OLGII), REQUEST FOR INFORMATION
****************************************************************
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Date: Thu 11 Jun 2009
From: Dan Silver
<dgsilver@yahoo.com>


People's Daily (<http://society.people.com.cn/GB/41158/9459758.html>)
reports that a 14-year-old in Mongolia's Bayan-Olgii Province
contracted plague after eating marmot on 29 May 2009. Symptoms
appeared on 2 Jun 2009.

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

[ProMED would appreciate more information regarding this case,
confirming the diagnosis and clinical presentation.

Plague is endemic in Mongolia. Marmots such as the Tarvaga, the
Tarbagan or Mongolian Marmot, _Marmota sibirica_, a large rodent
related to the American woodchuck (_M. monax_), are thought to be
significant zoonotic reservoirs for _Y. pestis_ in Eastern Asia. The
name marmot (<http://en.wikipedia.org/wiki/Marmot>) comes from French
marmotte, from Latin _mures monti_ "mountain mouse."

A map of the country of Mongolia can be found at
<http://www.un.org/Depts/Cartographic/ma ... ngolia.pdf>. The
province of Bayan-Olgii is in the extreme western part of the country.
- Mod.LL]

[Roast marmot ("boodog" in Mongolian) is a popular dish there, some
unlucky hunters catch plague every year. Recipes can be found at:
<http://www.e-mongol.com/mongolia_cultur ... ecipes.htm>
- Mod.JW]

China - Tollwut
12.06.1009

In Hanzhong, in der Provinz Shaanxi (Zentralchina), sind seit Ende März 11 Personen an der Tollwut verstorben. Im gleichen Zeitraum wurden mehr als 5.000 Personen auf Grund von Hundebissen behandelt. China ist derzeit nach Indien das Land mit den höchsten Fallzahlen bei Menschen und Tieren, speziell Hunden. Bei verdächtigen Tierkontakten ist sofort ein Arzt aufzusuchen. Eine vorbeugende Impfung wird vor allem bei vorhersehbarem Risiko und bei längeren Aufenthalten dringend empfohlen. Eine Beratung durch einen reisemedizinisch erfahrenen Arzt sollte rechtzeitig vor der Reise erfolgen. / Quelle: crm

BRUCELLOSIS, LIVESTOCK, HUMAN - KAZAKHSTAN: (WEST KAZAKHSTAN)
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Date: Mon 15 Jun 2009
Source: Meatinfo.ru [in Russian, trans.Mod.NP, edited]
<http://meatinfo.ru/news/read?nid=183017>


In the West Kazakhstan region, more than 10 000 cattle have been
infected by brucellosis. Ural meat processing plants are in
strengthened mode. Peasants are handing over large numbers of
infected cattle. To process large quantity of meat, meat-packing
plants work in the strengthened mode also, but the prices for sausage
in shops has not decreased.

In comparison with the last [several] years, the quantity of infected
cattle has increased repeatedly. More than 230 000 heads of cattle
have been examined. The greatest quantity of infected heads of cattle
has been revealed in Dzhangalinsky, Akzhaiksky, Dzhanibeksky
districts. But, according to experts of regional territorial
inspection of the Ministry of Agriculture, it is not an epidemic.
Simply since this year [2009] more exact technique of revealing
brucellosis has begun to be applied. However conditions remain
extremely serious. An expanded meeting devoted to brucellosis, took
place in regional administration. The problem of recycling of sick
cattle became rather actual. Sanitary meat can be used after thermal
processing for manufacture of sausages and canned meat. In order to
avoid the further distribution of a dangerous infection of sick cows
it is necessary to slaughter animals, but not all peasants hurry to
cull the animals who support them. According to Farukh Mukhanov, the
main expert of territorial inspection, not in all districts the work
for reception and sending on meat-packing plants is led at an
appropriate level of sanitation.

Nevertheless, at meat-packing plants with which have been concluded
agreements for processing of infected meat, an intense situation
already has developed in connection with shortage of industrial
resources. But at such surplus of raw materials, the price for
sausage in shops, breaking all laws of economy, remain stably high.

In total in the region for last months 9 persons have already been
infected by brucellosis. In Uralsk there is a real danger to catch
this disease, buying milk on numerous, uncontrollable spontaneous
points of trade or from travelling milkmen.

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

[Difficult epidemiological and epizootic conditions connected with
this brucellosis outbreak have developed in a number of republics of
Central Asia, in particular, in Kazakhstan and Kyrgyzstan. On 9 Jun
2009 ProMED-RUS reported brucellosis in 30 people and 2000 cattle in
the Atyrausky area of Kazakhstan (archive no. 20090609.91293).
Among the reasons for this situation are low veterinary supervision
over agricultural animals and the sanitary-and-hygienic control of
the dairy production, insufficient volume of preventive actions, in
particular, vaccination among the persons entering into group of
risk, and agricultural animals. Improvement of quality of brucellosis
diagnostics in the republic has led to sharp growth of detectability
of this disease among animals and, as a consequence, to diagnosing it
in the people who had direct contact to them. - Mod.NP]

[Both _Brucella abortus_ and _B. melitensis_ are reportedly present
in Kazakhstan. The reservoir of _B. abortus_ is, generally, cattle
and of _B. melitensis_, goats and sheep, though cross infections may
occur. It will be helpful if the identity of the bacterium involved
in the outbreaks described becomes available. - Mod.AS]

[West Kazakhstan region can be located on the administrative map of
Kazakhstan at
<http://www.un.org/Depts/Cartographic/ma ... zakhst.pdf>.
The HealthMap interactive map of Kazakhstan is available at
<http://healthmap.org/r/00tV>. - Sr.Tech.Ed.MJ]

[see also:

CHIKUNGUNYA (22): INDIA (KARNATAKA), SUSPECTED
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Date: Sun 21 Jun 2009
Source: The Times of India [edited]
<http://timesofindia.indiatimes.com/Citi ... 681618.cms>


Open drains, garbage scattered everywhere, bad roads, no drinking
water facility, and now viral fever, these have added to the
unhygienic condition of citizens of the Silicon City.

For the past month, 350-500 patients have been visiting
Kadogondanahalli Primary Health Centre (PHC) every day for viral
fever and chikungunya check-ups. Even the staff are affected by the
diseases.

With no proper place to treat patients due to the ongoing
construction of the Community Health Centre (CHC), patients are
treated in dilapidated staff quarters. Even the PHC staff has no
place to sit.

The health centre's only pharmacist has just returned after a bout of
chikungunya. Out of 3 "group D" employees, one of them who had been
working for 18 years in the PHC recently died after complaining of
fever, and another recovered from a week-long viral fever.

There has been a regular flow of patients from Venkateshpura, D J
Halli, K G Halli, Nagawara, Kavalbyrsandra, Hegdenagar and
Govindapura.

Short of staff with just 2 doctors and a nurse deputed from Ghousia
Hospital, the place continues to treat patients in an unhygienic
environment.

The radiologist has been deputed to Raj Bhavan for want of equipment
at the centre. The junior health assistant and field staff posts have
not been filled up.

At the health centre, a man who has suffered from chikungunya for the
past 2 months said: "More than 60 percent of the people are suffering
from viral fever and chikungunya because of the unhygienic conditions
here. We lack even a basic facility like a public bathroom, due to
which even the campus is littered."

Fortunately, another resident said 3 private organizations held a
camp and distributed medicine to 3000 patients recently.

Residents of Rashadnagar said they have not received drinking water
for the past 6 months. "Holding health camps and distributing
medicine or fogging are not the solutions. With no drinking water
facility, how are we going to live?" a resident asked.

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

[This report does not indicate if any of these indicated chikungunya
virus infections have been laboratory confirmed. There is no
indication of what the etiology of the "viral fever" cases mentioned
in this report might be. Dengue virus infection is one of many
possibilities. ProMED would appreciate receiving information about
laboratory results that would support a diagnosis of chikungunya or
other virus infections that might be involved in the current
situation. Lack of a reliable water system usually results in water
storage in homes and other buildings, providing breeding places for
_Aedes aegypti_ mosquitoes, the vector for chikungunya and dengue
viruses.

[A map of India showing the location of the Bangalore area in
Karnataka can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>.

The HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed?v=22.9,79.6,5>. - Mod.TY]

Indien - Malaria
22.06.2009

Mit Beginn der Monsunzeit werden aus mehreren Bundesstaaten steigende Fallzahlen gemeldet. In Rajasthan wurden dieses Jahr bereits 7.000 Malaria-Erkrankungen registriert, davon 500 von Plasmodium falciparum dem Erreger der Malaria tropica verursacht. Auch Mumbai (Bombay), Orissa (O) und West-Bangalen (NO) meldeten vermehrt Malaria-Erkrankungen. Expositionsprophylaxe und Mitnahme eines Standby-Präparates werden empfohlen. / Quelle: crm

CHIKUNGUNYA (23): INDIA (KARNATAKA)
***********************************
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ProMED-mail is a program of the
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<http://www.isid.org>

Date: Sat 27 Jun 2009
Source: Sahil Online [edited]
<http://www.sahilonline.org/english/news ... 4&viewed=0>


Chikungunya cases are on rise in Sirsi, Siddapur, Yellapur, and Mundgod
taluks. [A taluk is an administrative subdivision of a district. - Mod.TY]
Most of the hospitals in Sirsi town are flooded with chikungunya patients.
The doctors said that the places are having many cases of chikungunya and
viral fever.

According to sources, in Yellapur taluk, out of 11 306 patients tested, 176
are suffering from chikungunya and one has dengue fever, most of the
patients take treatments at private hospitals, said medical officer Dr GN
Ashok Kumar.

Chikungunya or viral fever cases have been reported from most of the
villages in the Mundgod taluk. Many patients are even unable to visit
hospital due to weakness.

Lack of rain is the reason attributed to the increase of chikungunya,
dengue, and viral fevers. These diseases are hindering the farm activities
in all these taluks.

[posted by Aynaz]

--
communicated by:
ProMED-mail rapporteur Susan Baekeland

[If there are only 176 confirmed chikungunya virus infections of the 11 306
patients tested, on wonders what the etiology of the other 11 136 cases
might be. Again, as in previous recent posts from Karnataka, "viral fever"
is mentioned, without indicating what pathogen is causing it (see
ProMED-mail archive no. 20090621.2282). The report also indicated that
there was one confirmed dengue case, so presumably some or all of the
non-chikungunya cases were tested for dengue virus infection as well.

An interactive map showing the location of the taluks mentioned above can
be accessed at
<http://www.maplandia.com/india/karnatak ... d/mundgod/>. The
HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/007C>. - Mod.TY]

CHIKUNGUNYA (25): INDIA (GOA)
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<http://www.isid.org>

******
India (Goa)
Date: Sat 4 Jul 2009
Source: Times of India [edited]
<http://timesofindia.indiatimes.com/Citi ... 735978.cms>


Of the 35 cases of chikungunya this year [2009], 29 confirmed cases were
reported in May 2009.

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

[Apparently, a small outbreak of chikungunya virus transmission has been
occurring in Goa in 2009. It would be of interest to know if transmission
is continuing and if there have been new cases after May 2009.

A map of India showing the location of Goa can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>. The
HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed?v=22.9,79.6,5>. - Mod.TY]

CHIKUNGUNYA (25): INDIA (GOA)
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
India (Goa)
Date: Sat 4 Jul 2009
Source: Times of India [edited]
<http://timesofindia.indiatimes.com/Citi ... 735978.cms>


Of the 35 cases of chikungunya this year [2009], 29 confirmed cases were
reported in May 2009.

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

[Apparently, a small outbreak of chikungunya virus transmission has been
occurring in Goa in 2009. It would be of interest to know if transmission
is continuing and if there have been new cases after May 2009.

A map of India showing the location of Goa can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>. The
HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed?v=22.9,79.6,5>. - Mod.TY]

MENINGITIS, MENINGOCOCCAL - INDIA (06): (MEGHALAYA)
***************************************************
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ProMED-mail is a program of the
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<http://www.isid.org>

Date: Fri 3 Jul 2009
Source: Times of India [edited]
<http://timesofindia.indiatimes.com/Indi ... 734597.cms>


A total of 257 people have lost their lives due to suspected
meningococcal meningitis in Meghalaya since 2008, the state government
said on Friday. In 2008, 130 people (10 of them confirmed) died of the
disease. This year, so far, 127 (4 confirmed) people have succumbed to
the disease. However, more than 2000 cases have so far been reported
from the state, health minister Mukul Sangma told the Assembly.

"But the situation is under control and preventive measures are being
carried out," he said. Around 10 lakh [one million] doses of vaccines
from the World Health Organisation (WHO) have been procured till now
and a free vaccination campaign in 3 affected districts is being
organised by the state government. Response teams have been
constituted to identify places where the vaccination campaign would be
taken up in due course, he added.

"Extensive awareness programmes have been taken up and preventive
medicines are being distributed free," the health minister said.

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

[When last reported by ProMed-mail in mid-February 2009 (Meningitis,
meningococcal - India (04): (NE) 20090217.0661), there were said to
be 165 deaths in Meghalaya in just the 1st month of 2009; whereas, the
current report above says that there were only 127 deaths in Meghalaya
in all of the 1st 6 months of 2009. In mid-February 2009, the epidemic
also involved neighboring Indian states of Tripura and Mizoram, as
well as an adjacent region (Chittagong Hill Tracts) of Bangladesh.
Meningococcal serogroup A was said to be the culprit. At that time,
ProMED-mail reported that a vaccination program was underway, and from
the current report is still underway.

Meghalaya, a mountainous Indian state, is located between the
northeastern border of Bangladesh and the Indian state of Assam. A
HealthMap/ProMED-mail interactive map of India that shows the states
of Meghalaya, Tripura, and Mizoram can be found at
<http://healthmap.org/promed/en?v=22.9,79.6,5>.
A map of Bangladesh showing the location of the Chittagong Hill Tracts
that borders the Indian state of Mizoram can be found at
<http://www.traveljournals.net/explore/b ... tract.html>. -
Mod.ML]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (18 )
***********************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
Asia
[1] Cholera - Pakistan (North-West Frontier Province)
[2] Diarrhea, fatal - Nepal (Midwestern Region)
[3] Cholera - India (Gujarat)
[4] Cholera - India (Karnataka)

******
[1] Cholera - Pakistan (North-West Frontier Province)
Date: Sun 5 Jul 2009
Source: XinHuaNet [edited]
<http://news.xinhuanet.com/english/2009- ... 657410.htm>


At least 8 people died, and scores of others have been admitted in
hospitals following a cholera outbreak in a district of northwestern
Pakistan, health authorities said Sunday [5 Jul 2009]. The private
NNI news agency quoted Dr. Muhammad Aslam, executive health officer
of the Dera Ismail Khan district, as saying that a team of doctors
had been sent to the area with vaccines, and the health department
was ready to face the challenge, adding that more vaccination would
be sent to the area if needed.

Aslam said that about 800 locals of the Naivela Union Council of the
Dera Ismail Khan district had not received vaccination due to
shortage of vaccine. He added that the reason behind the outbreak was
unhygienic water and scorching heat.

In most parts of the Dera Ismail Khan district, power remains
suspended for nearly 14 to 16 hours, and tube wells in the area are
also closed, locals residents were quoted as saying. The NNI said
that the residents complained that they were compelled to drink
polluted water and feared that cholera could break out in other parts
of the district.

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

[Dera Ismail Khan is one of the 24 districts in the North-West
Frontier Province of Pakistan. The capital of the district is the
town of Dera Ismail Khan. In Pakistan, it is often abbreviated to D.
I. Khan. A map of Pakistan showing the location of the province,
which borders both Afghanistan and India, can be found at:
<http://www.un.org/Depts/Cartographic/ma ... kistan.pdf>. D.
I. Khan is located in the extreme south of the province. - Mod.LL]

******
[2] Diarrhea, fatal - Nepal (Midwestern Region)
Date: Tue 7 Jul 2009
Source: Nepal News [edited]
<http://www.nepalnews.com/archive/2009/j ... news06.php>


Jajarkot, a remote Midwestern district, remains gripped by a diarrhea
epidemic, with the death toll reaching 65 by Tuesday morning [7 Jul
2009]. According to latest reports, 5 additional deaths were reported
in Salma, a remote village. The news of these deaths came days later.

The reports of diarrhea deaths in Jajorkot have continued to come to
light over the past few days. Though local authorities said medical
teams have been dispatched to the affected areas, the diarrhea
epidemic has worsened.

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

[The etiology of the outbreak is not stated and may be either
bacterial dysentery or cholera. Jajorkot district in the central part
of the Midwestern Region can be found on a map at:
<http://ncthakur.itgo.com/map04.htm>. - Mod.LL]

******
[3] Cholera - India (Gujarat)
Date: Thu 9 Jul 2009
Source: Times of India [edited]
<http://timesofindia.indiatimes.com/Sura ... 759375.cms>


Four new patients diagnosed with cholera have been admitted to New
Civil Hospital in Surat, taking the number of patients to 22 on
Wednesday [8 Jul 2009].

Of the 22 cholera patients reported in the past one month, more than
half are from Udhana zone of Surat Municipal Corporation, which has
done little to curb the disease despite repeated demands from locals
to carry out sanitation drives.

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

[Gujarat province is located in westernmost India, bordering
Pakistan, and can be found on a map at:
<http://upload.wikimedia.org/wikipedia/c ... ap.svg.png>.
- Mod.LL]

******
[4] Cholera - India (Karnataka)
Date: Mon 29 Jun 2009
Source: The Times of India [edited]
<http://timesofindia.indiatimes.com/Hubl ... 717352.cms>


Cholera is spreading through Tumkur city rapidly, with 5 reported to
have died due to the illness and with 30 people being treated at
different hospitals. As the illness spread through the extensions of
Indira Nagar and SLN Nagar of Kathysandra of the city last week, the
district hospital doctor confirmed the deaths of 3 on Friday [26 Jun
2009] and 2 others on Saturday [27 Jun 2009].

Nearly 10 persons suffering from cholera were admitted to the
district hospital and are being treated for the disease. Others from
this area are also admitted to private hospitals.

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

[Tumkur is a city in the southwestern Indian province of Karnataka.
The province can be found on a map of the country at:
<http://upload.wikimedia.org/wikipedia/c ... nataka.png>.
- Mod.LL]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (19)
**********************************************
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:
Asia
[1] Cholera - Pakistan (Federal Capital Territory, North-West Frontier Province)
[2] Cholera - India (Mumbai)
[3] Diarrhea - India (West Bengal)
[4] Cholera - India (Punjab)
[5] Diarrhea, fatal - Nepal (Mid Western Region)


******
[1] Cholera - Pakistan (Federal Capital Territory, North-West Frontier Province)
Date: Mon 20 Jul 2009
Source: The News International [edited]
<http://www.thenews.com.pk/print1.asp?id=188937>

National Institute of Health (NIH), Islamabad, has confirmed
existence of the bacterium _Vibrio cholerae_ that causes cholera in
the federal capital and in camps setup for internally displaced
persons (IDPs) at Mardan, Nowshera, and Charsadda [North-West
Frontier Province].

Reliable sources at the NIH informed "The News" that the institute
tested a patient positive for cholera recently. They said the patient
was from Islamabad and underwent treatment at Federal Government
Services Hospital (FGSH) in Islamabad. "A few cases of cholera in the
camps of IDPs in Mardan, Nowshera, and Charsadda have also been
tested positive," the sources added.

Many health experts believe that rapid spread of gastrointestinal
diseases in town could not be controlled so far because the public
has no awareness of how to prevent and control gastroenteritis and
like diseases including cholera.

Experts believe that in most parts of the country, sewerage is
continuously contaminating streams, lake springs, wells, and other
drinking water sources that increase chances of prevalence of
gastrointestinal diseases including cholera.

[Byline: Muhammad Qasim]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Maps of Pakistan showing the area noted can be found at
<http://www.un.org/Depts/Cartographic/ma ... kistan.pdf>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00tj>. - Mod.LL]

******
[2] Cholera - India (Mumbai)
Date: Mon 20 Jul 2009
Source: The Times of India (TNN) [edited]
<http://timesofindia.indiatimes.com/NEWS ... 796386.cms>

So far, 3 persons, including 2 children, have tested positive for
cholera in the city [Mumbai] but the BMC officials said on Sunday [19
Jul 2009] that only one of these 3 cases has cholera and the patient
has been transferred to the infectious diseases specialty at Kasturba
Hospital in Chinchpokhli.

"The others are only cases of acute gastroenteritis," said Dr Daksha
Shah, who heads the epidemiological cell of the BMC. "There are 3
hanging drop positive cases in GT Hospital, but the results of this
tests are not as specific as a culture test to prove cholera," said
Dr J Thanekar, chief executive officer of the BMC. The culture test
is considered as the gold standard test for cholera.

Congress corporator from Colaba, Vinod Shekhar, said he had met 2
patients with cholera, one of whom was in a serious condition.
"Everything is being done to see that the disease does not spread,"
he said.

Civic doctors have been visiting the slum since Sat 18 Jul 2009, and
testing people. They have also been distributing tablets. Water
tankers were also supplying fresh water to the slum. The BMC has also
collected 10 water samples from the area.

[Byline: Roana Maria Costa]

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

[A map of the southern city island of Mumbai (Bombay) can be seen at
<http://www.mapsofindia.com/maps/maharas ... ai-map.htm>.
The city's location on the western coast of India can be seen at
<http://www.lonelyplanet.com/mapshells/i ... /india.htm>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BT>. - Mod.LL]

******
[3] Diarrhea - India (West Bengal)
Date: Sat 18 Jul 2009
Source: OneIndia, Asia New International (ANI) report [edited]
<http://news.oneindia.in/2009/07/18/wate ... engal.html>

Residents of several districts in West Bengal, after having endured
the aftermath of cyclone Aila in May 2009, now grapple with an
outbreak of diarrhea. Waterborne diseases are spreading among the 6.8
million people affected by the [25 May 2009] cyclone. So far
diarrhoea has killed 28 persons and another 85 000 diarrhea cases
have been reported from across the state.

Availability of clean drinking water remains a serious challenge in
the worst affected North 24 Parganas [administrative unit] and South
24 Parganas districts.

After Aila all the tube-wells are under water and the villagers here
are suffering gastronomic problems. Because of a major water crisis
we have got diarrhea and are admitted to the hospital," said a
villager from Ghoshpur.

Health officials have disinfected over 7000 tube-wells and about 15
000 litres of safe drinking water pouches are being distributed in
the affected areas every day. Oral Rehydration Salts (ORS), Halazone
tablets, and bleaching powder solution are being distributed to check
an outbreak of diarrhea.

While the government has deployed 375 medical teams, NGOs and
international agencies, including the UNICEF, are providing aid to
over 50 000 families.

"After Aila a major challenge was to combat waterborne diseases,
which could have come out like the diarrhoea cases. The state and
UNICEF are responding to lessen the impact of these cases," said Anil
Gulati, a spokesman for the local UNICEF office.

At least 275 people died as cyclone Aila hit parts of coastal
Bangladesh and West Bengal state on 25 May 2009, triggering tidal
surges and floods and destroying hundreds of thousands of homes.

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[West Bengal in eastern India, adjacent to Bangladesh, can be found
on the map at
<http://www.grain.org/articles_files/wes ... lu-map.jpg>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BU>. - Mod.LL]

******
[4] Cholera - India (Punjab)
Date: Mon 13 Jul 2009
Source: The Indian Express [edited]
<http://www.indianexpress.com/news/112-m ... ed/488591/>

The total number of patients with cholera symptoms crossed the 300
mark in Dera Bassi on Sun 13 Jul 2009. While a total of 95 patients
were reported at the Civil Hospital and over a 100 at various private
clinics in the township through Sat 12 Jul 2009, on Sun [13 Jul
2009], 112 more cases came to light at the Civil Hospital, health
authorities said.

Senior Medical Officer (SMO) Dr Ram Kumar told Newsline that a total
of 207 cases have been reported in the last 3 days, of which 60 were
admitted while the rest were discharged after treatment. Medical
teams are conducting a door-to-door awareness campaign and chlorine
tablets are being distributed for free, he added.

As the number of beds at the Civil Hospital fell short, the
authorities had to arrange extra beds to accommodate the swelling
number of patients. However, 2 or 3 patients were seen sharing a
single bed at the hospital and the authorities also failed to provide
adequate number of bedsheets on the extra beds.

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

[Dera Bassi is a city and a municipal council in Mohali district in
the state of Punjab, India. Maps of India showing the northern state
of Punjab can be found at
<http://www.mapsofindia.com/maps/punjab/ ... on-map.gif>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BV>. - Mod.LL]

******
[5] Diarrhea, fatal - Nepal (Mid Western Region)
Date: Mon 13 Jul 2009
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... enDocument>

Highlights:
- District Public Health Office confirms 96 diarrhea related deaths
in Jajarkot District from 1 May 2009 to 12 Jul 2009
- 19 unconfirmed diarrhea related deaths reported in Rukum District
and 2 deaths in Dailekh District, currently under investigation
- District Line Agencies are coordinating response to outbreak
- Difficult access to remote affected areas delays response of
medical staff and delivery of supplies

Situation overview
------------------
1. The hilly districts of the Mid Western Region have been affected
by a diarrhea outbreak, in particular Jajarkot and Rukum Districts.
Jajarkot District was initially affected, with 96 diarrhea-related
deaths as of 12 Jul 2009, according to the District Public Health
Office (DPHO). Media reports indicate diarrhea related deaths are
increasing in Jajarkot and neighboring Districts, WHO is working with
the DPHOs to investigate the cause of the outbreak and verify the
epidemiological data.

2. Jajarkot is the worst affected District, which is attributed to
poor sanitation and hygiene by local health workers. The winter
drought, delayed monsoon rains, and dried up water sources increased
the risk of consuming contaminated water. Water quality and
availability and latrine coverage figures are unknown at this time.
The DPHO stated that the latrine coverage is very low and open
defecation is a common practice. In early May 2009, DPHO responded to
the initial diarrhea outbreak in remote communities in southern
Jajarkot District, which was difficult due to lack of logistical
access and locally available resources. On 14 May 2009, the Minister
for Health and Population (MoHP) including a team of doctors assessed
the diarrhea affected communities in the Mid Western Region. The
number of diarrhoea related deaths continued to rise. On 24 Jun 2009,
DPHO mobilized available medicine and health teams and requested
additional support from the Regional Health Directorate and MoHP.

3. There are additional reports of diarrhea related deaths in Rukum,
Dailekh, Salyan, and Dolpa Districts. In Rukum District, unconfirmed
reports indicate an estimated 15 diarrhea related deaths, with about
10 VDCs adjoining to Jajarkot and Dolpa Districts affected by the
diarrhoea outbreak. In Dailekh District, the DPHO confirmed 2
diarrhea related deaths in VDCs [Village Development Committees]
bordering Jajarkot District on 25 Jun 2009 and 4 Jul 2009. In Salyan
District, the DPHO stated that there were 2 diarrhea related deaths
in the District on 2 and 3 Jul 2009, however, the situation is under
control. According to sources at the regional medical store, in Dolpa
District headquarters 25 police affected by the diarrhea are under
going treatment and dozens of people are affected in the villages
bordering to the Jajarkot.

4. Due to the logistic difficulties DPHOs are facing challenges to
provide the medical aid to the diarrhea affected population in the
remote villages. There were also shortages of the health workers and
medicine in some of the diarrhoea affected VDCs in Jajarkot and Rukum
Districts, which is being addressed by the DPHOs

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

[The etiology of the outbreak is not stated and may be either
bacterial dysentery or cholera. The districts mentioned in the Mid
Western Region can be found on a map at
<http://ncthakur.itgo.com/map04.htm>.
The HealthMap/ProMED-mail interactive map of Nepal is available at
<http://healthmap.org/r/00BY> - Mod.LL]

UNDIAGNOSED ILLNESS - INDIA: (GOA) REQUEST FOR INFORMATION
**********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 22 Jul 2009
Source: The Times of India (TOI) [edited]
<http://timesofindia.indiatimes.com/arti ... 805287.cms>


All 41 households at Mascavrem village in Sanguem have been affected
by the mysterious fever that has been raging through remote and rural
areas of the taluka [administrative division] for the last one month.
This was discovered by a team from the directorate of health services
(DHS) that rushed to the affected areas following a report in this
newspaper on Tuesday [21 Jul 2009].

The team also discovered that the disease had spread to nearby
villages. "We have taken blood samples of 25 patients from Mascavrem
and 16 from Danolem. In Mascavrem, we found that at least one member
of each of the 41 households had suffered from the fever. The samples
will be sent to the microbiology department of the Goa Medical
College (GMC) for tests. The exact cause of the disease will be known
only after we get the results," said Dr Ravindra Nadkarni, chief
medical officer (non-communicable diseases), who led the DHS team.
The DHS team visited Cavrem, Colomb, Curpem, and adjoining areas and
surveyed the villages to identify possible causes of the suspected
fever.

The team, it is learnt, discovered that an abandoned tank, used for
distilling country liquor by the locals, had developed into a
breeding ground for mosquitoes. The team is of the view that the
unhygienic conditions prevailing at the site had led to the spread of
vector-borne diseases in the villages. "We started looking for
possible mosquito breeding grounds and stumbled across this tank at
Mascavrem that had been breeding plenty of mosquitoes. The tank was
possibly used for distilling country liquor and was mysteriously
covered by coconut leaves to camouflage it," Dr Nadkarni told TOI.

He added that DHS would soon launch an awareness campaign to educate
the villagers about the need to eliminate all possible breeding
grounds for mosquitoes and ensure proper sanitation in their
surroundings. "We have fogged the area today [21 Jul 2009], but
awareness needs to be created among the villagers about the steps to
be taken to prevent vector-borne diseases," he added.

Health Services director Rajananda Desai said on Tuesday [21 Jul
2009] that she is monitoring the mystery fever in remote rural areas
of Sanguem taluka. "The local health centre had already taken steps
to identify the cause of the illness," Dr Desai said.

Meanwhile, private medical practitioner from Colomb, Dr Avdhut
Prabhudesai, continues to get fresh cases showing similar symptoms.
"I got 4 more cases today [21 Jul 2009]. It is imperative that the
health authorities act fast and take steps to control the epidemic to
alleviate the sufferings of the rural poor," Dr Prabhudesai told TOI
on Tuesday [21 Jul 2009]. He added that he got in touch with the
director of health services on Tuesday and briefed her about the
cases treated by him during the last 4 weeks.

Dr Prabhudesai has urged the authorities to conduct a thorough
investigation of the cases. "People from as far as Mangal and Devrem
are coming here for treatment which suggests that the epidemic is not
limited to Colomb alone," Dr Prabhudesai said.

[Byline: Govind Kamat Maad]

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[Since the only symptom reported here is fever, a diagnosis of the
etiological agent involved in these cases is not possible until the
laboratory results or a more complete clinical picture are available.
This report indicates that the local health officials and field staff
think that mosquitoes are involved in this spreading outbreak.
ProMED-mail would appreciate receiving additional information, and
especially laboratory results, as they become available.

Interactive maps of India showing the location of Sanguem in South
Goa district can be accessed at
<http://www.maplandia.com/india/goa/south-goa/sanguem/>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00Ce>. - Mod.TY]
...................................lm/ty/mj/lm