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JAPANESE ENCEPHALITIS - INDIA (08 ): (UTTAR PRADESH, ASSAM)
**********************************************************
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 posting:
[1] Uttar Pradesh
[2] Assam

******
[1] Uttar Pradesh
Date: Sun 30 Aug 2009
Source: Press Trust of India (PTI) [edited]
<http://www.ptinews.com/news/256570_5-ch ... ses-to-210>


With 5 more children succumbing to encephalitis, the toll in the
division due to the disease has mounted to 210, official sources said.
5 more children have died due to encephalitis at BRD Medical College
[in Gorakhpur (UP)], while 145 patients are have been treated during
the last 24 hours, additional director health LP Rawat said, adding 22
fresh cases were admitted in different hospitals.

He said a total of 960 patients suffering from Japanese encephalitis
and acute encephalitis syndrome (AES) were admitted this year [2009]
to the medical college and other hospitals of the region, out of which
210 died.

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

[The number of encephalitis cases in Uttar Pradesh continues to
increase, and appears to be accelerating. - Mod.TY]

[The state of Uttar Pradesh can be located on the
HealthMap/ProMED-mail interactive map of India at
<http://healthmap.org/r/00Hk>. - Sr.Tech.Ed.MJ]

******
[2] Assam
Date: Sat 29 Aug 2009
Source: The Times of India (TOI), Times News Network (TNN) [edited]
<http://timesofindia.indiatimes.com/news ... 946281.cms>


India has started to record a complete age shift in those infected by
the Japanese encephalitis (JE) [virus] -- the vector borne viral
killer. Till now, scientists believed that in most JE endemic states,
the virus infected only the under-15 age group. However, a present
outbreak in Assam has the Union health ministry perplexed. Almost 74
percent of the cases reported till now in the state have been in the
above-15 age group.

Till now this year [2009], Assam has recorded 164 cases of acute
encephalitis syndrome (AES) -- a severe neurological condition
associated with significant morbidity and mortality. Of these, 91 have
now been lab confirmed to be caused by JE [virus]. AED has also killed
78 people since April [2009].

"Around 67 of these 91 JE cases (74 percent) are above 15 years of
age, with the eldest in this affected group being a 58-year-old. This
is highly unusual and we have no idea why it has happened. This is a
new trend," JE expert from international NGO Path Dr Pritu Dhalaria
told TOI.

Till now, India vaccinated only the under-15 age group with the JE
vaccine. However, this age shift trend has now made the Assam
government decide to vaccinate the entire population in the 7 worst
affected districts -- Sibsagar, Dibrugarh, Tinsukia, Jorhat, Kolaghat,
Dimaji, and Lakhimpur.

The government has estimated that 8 million doses of the vaccine will
be required to vaccinate the entire population in these districts. The
vaccine and operational hurdles will in total cost the state INR 15
crore [approx. USD 3.1 million. A crore is a unit in the Indian
numbering system equal to 10 million. - Mod.TY] "The state had just
one query -- will the vaccine be safe for adults? And it is. The
vaccine will have to be given in the same dose as for kids and is as
effective on adults. Nepal used the same strategy in 4 of its worst
affected districts in 2007," Dr Dhalaria said.

The vaccine will have to be imported from China, which Path is
facilitating. It will, however, take 6 months for the vaccines to
arrive. India has been completely dependent on China for its supply of
the SA14-14-2 anti-JE [virus] vaccine from China National Biotech
Group's Chengdu Institute. India first imported the Chinese vaccine in
February 2006 after a sudden outbreak of JE the previous year killed
over 1800 people.

The single shot vaccine made from a live attenuated virus (live cells
like bacteria grown in laboratory, infected with the JE virus and then
purified to make the vaccine) has 90 percent efficacy and costs around
INR 10 per dose [USD 0.21].

According to vector experts at NICD [National Institute of
Communicable Diseases], the age shift in Assam could have happened
because the adults didn't have immunity against the virus. "In known
endemic belts of Karnataka, Tamil Nadu, Andhra Pradesh, and Uttar
Pradesh, transmission usually occurred in children because adults have
some immunity against it due to repeated exposure. Maybe the virus is
spreading to new uninfected areas of Assam where lack of an earlier
outbreak has made even adults vulnerable," officials said.

The JE virus is transmitted to humans via the bite of an infected
mosquito. The mosquitoes usually get infected when feeding on domestic
pigs [or wild birds. - Mod.TY] that already carry the virus. The
_Culex tritaeniorhynchus_ group of mosquitoes is the primary
transmitter of JE [virus] to humans.

If a mosquito bites an infected animal and then bites a human, the
person can become infected with the JE virus. After a person is
bitten, the JE virus invades the central nervous system, damaging the
brain and spinal cord. Immunization is the most effective approach to
prevent the disease.

[Byline: Kounteya Sinha]

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

[The report does not indicate how many of the cases above in Uttar
Pradesh were confirmed cases of Japanese encephalitis virus infection,
and how many were caused by another, as yet undetermined, etiologic
agent. In Assam, 91 of the 164 cases of acute encephalitis syndrome
were due to JE virus infection, but the etiologic agent in the
undiagnosed 73 cases has yet to be established. Previous ProMED-mail
reports posted this year (2009) suggest that a mixed outbreak is
occurring in these 2 Indian states. ProMED is interested in receiving
additional information about the 2nd agent as soon as that information
becomes available.

The state of Assam can be located on the HealthMap/ProMED-mail
interactive map of India at
<http://healthmap.org/r/00J->.
A map showing the location of Indian states including Uttar Pradesh
and Assam in north eastern India can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>.
- Mod.TY]

ECHINOCOCCOSIS - KAZAKHSTAN: (AQMOLA)
***************************************
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: 25 Aug 2009
Source: IA "kt.kz" [trans. Corr.ATS, edited]
<http://www.kt.kz/index.php?lang=rus&uin ... 1153495275>


An official responsible for prevention of parasitic and vector borne
diseases in the region has informed the news agency that there was
2.8-fold increase in the incidence of hydatid disease over the past 7
months.

He also reported that there are cases among children, and these cases
have a particularly severe course. The frequent routes of infection
are contacts with wild carnivores during hunting and consumption of
contaminated water, berries and greens in the wild.

Any organ can be affected, but the most frequent are the liver (in
43.2 percent of cases), the lungs (in 42.3 percent of cases) and the
brain (in 14.5 percent of cases).

The recommended prophylaxis is to avoid close contact with dogs, limit
garden activities, wash berries and greens properly before
consumption, and boil water.

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

[In background information provided in our 2007 posting (see below),
3-6 percent of the population in Kazakhstan are _Echinococcus_
seropositive. A recent purgation study from Kazakhstan found that 13
percent of dogs in the community were infected with _Echinococcus
granulosus_ and 5 percent with _E. multilocularis_. The study
concluded that there is significant transmission of _E. granulosus_ to
humans in this community, which may be may associated with poverty.
There is little evidence of _E. multilocularis_ transmission to humans
(Torgerson PR et. Al. Trop Med Int Health. 2009;14:341-8 ). Thus it
seems that a main transmission route to humans is exposure to eggs
from dog feces.

Lifecycles and pictures of _Echinococcus_ can be found at
<http://www.cdc.gov/ncidod/dpd/parasites ... efault.htm>.
- Mod.EP]

DENGUE/DHF UPDATE 2009 (35)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Pakistan (Karachi)
Date: Sun 6 Sep 2009
Source: The News International (Pakistan) [edited]
<http://www.thenews.com.pk/updates.asp?id=86517>


Over 500 suspected patients of dengue virus have reported in various
hospitals of Karachi while the Health Department has [not] made the
dengue [unit] fully functional yet. According to sources the exact
number of dengue cases cannot be determined, as the dengue cell is
still non-functional.

The health experts have said that cases of dengue affected patients
have started appearing in Karachi. The majority of these patients are
being treated in private clinics and hospitals and a very small
number is coming to government hospitals.

The number of dengue patients is feared to rise following the recent
heavy rains. The health experts have advised the people not to let
water stand anywhere in their houses and streets.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[A map of Pakistan showing the location of Karachi on the south coast
can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... l_2002.jpg>
A HealthMap/ProMED-mail interactive map of Pakistan can be accessed a
<http://healthmap.org/r/00tj>. - Mod.TY]

CHIKUNGUNYA (31): INDIA (ANDHRA PRADESH)
****************************************
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 7 Sep 2009
Source: Desimeet.com [edited]
<http://www.desimeet.com/news-snippets/7 ... ities.html>


The spate of seasonal diseases in twin cities took another turn, with
authorities on Sunday [6 Sep 2009] confirming the presence of
chikungunya in twin cities [of Hyderabad].

The Nallakunta Fever Hospital had received a patient with chikungunya
like symptoms from Amberpet. Laboratory tests revealed that the
patient has tested positive for chikungunya.

The district authorities informed that medical teams are fanning out
the Amberpet area to find mosquito breeding grounds, as chikungunya,
a vector-borne ailment, spreads by the bite of the _Aedes_ mosquito.
"Our surveillance has improved because now we are coordinating with
private hospitals. Earlier, only Fever Hospital cases used to get
reported. Now, private hospitals are reporting cases directly to us."
says District Medical and Health Officer Ch Jaya Kumari.

It may be recalled that it was in 2006 when chikungunya and dengue
broke out on a large scale in the State capital and elsewhere.
Chikungunya is a debilitating, but non-fatal, viral illness spread
through _Aedes aegypti_ mosquitoes, which are infected by chikungunya
virus. It is not a contagious ailment and is only spread through
mosquito bites. The _Aedes aegypti_ mosquitoes only bite in during day time.

Chikungunya starts suddenly with fever, hills, headache, nausea,
vomiting, joint pains, and rashes. "Only supportive treatment like
analgesic is given for pains. Getting plenty of rest and isolation
from mosquitoes and symptomatic treatment should be given," Dr Jaya
Kumari said.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Chikungunya virus infections are being reported recently from
various parts of India. Now it has been reported from central India
(Hyderabad).

Hyderabad can be located on the HealthMap/ProMED-mail interactive map
of India at
<http://healthmap.org/r/00M0>. - Mod.TY]

RABIES, HUMAN, ANIMAL - KAZAKHSTAN (SOUTH)
************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Kazakhstan (South)
Date: Fri 4 Sep 2009
Source: today.kz News Service [translated by AS, edited]
<http://www.today.kz/ru/news/kazakhstan/ ... beshenstvo>


Rabies cases notified in South Kazakhstan
-----------------------------------------
The Ministry of Emergency Situations of Kazakhstan has announced that
local doctors diagnosed 2 cases of rabies in the South Kazakhstan
Oblast last Tuesday [1 Sep 2009].

The 1st case occurred in the Abayskoe Region of Shimkent where a
72-year-old man was admitted to the hospital with symptoms of rabies.
3 people who had been in contact with the victim are now under
medical observation.

A similar case has been has been notified in the village of Karatobe
in the Sayrmskoe Region. The victim in this case was an 80-year-old
man. Anyone who had been in contact with the victim is now under observation.

The circumstances of infection, the sources of infection and the
conditions of patients have not been announced.

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

[The HealthMap/ProMED-mail interactive map of South Kazakhstan can be
accessed at:
<http://healthmap.org/r/00Oe>. - Mod.CP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (22)
***********************************************
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 - India (Mumbai)
[2] Cholera - India (Gujarat)


*****
[1] Cholera - India (Mumbai)
Date: Fri 11 Sep 2009
Source: Express News Service [edited]
<http://www.indianexpress.com/news/kalba ... ts/515597/>


The congested Kalbadevi area has witnessed a sudden increase in
cholera cases, with 9 persons from the locality already admitted to
hospitals in the last 2 days. The area houses an enormous amount of
contaminated water, one of the major causes of the disease. The
Brihanmumbai Municipal Corporation (BMC) has started screening
residents in the area.

Until late Thursday evening [10 Sep 2009], 9 people were admitted to
Kasturba Hospital, while 2 were admitted to GT Hospital with cholera
symptoms, including vomiting, diarrhea and fever. The patients are
from Ramnath Sadan, a makeshift godown [a waterside warehouse -
Mod.LL] where a floating population of about 15 to 20 resides. All of
them tested positive for cholera in the hanging drop test to
ascertain the organism.

--
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]

******
[2] Cholera - India (Gujarat)
Date: Fri 11 Sep 2009
Source: Express News Service [edited]
<http://www.indianexpress.com/news/one-c ... ed/515635/>


A cholera case was reported from Lachras village of Narmada district
on Thursday [10 Sep 2009]. An 18-year-old youth treated at Rajpipla
Civil Hospital has been confirmed as a positive case of cholera.
Incidentally, 3 adults have died in the area in the last 3 days after
they complained of diarrhea.

Sources said 24 people from the area have been admitted to Civil
Hospital and Mehta Clinic in Rajpipla. While Dr Suman, Rajpipla Block
Health Officer, accepted that one cholera case has been reported at
Lachras, he refused to accept that the 3 died after drinking
contaminated water. While a post-mortem report of Tadvi revealed that
she suffered from heart disease, post-mortem of the other 2 could not be done.

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

[Vadodara District is a district in the eastern part of the state of
Gujarat in western India. The city of Vadodara (Baroda) is in the
western part of the district. Gujarat can be seen on a map at:
<http://en.wikipedia.org/wiki/Gujarat>. - Mod.LL]

CHIKUNGUNYA (32): INDIA (TAMIL NADU) 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 14 Sep 2009
Source: Sify News [edited]
<http://sify.com/news/fullstory.php?a=jj ... in_Madurai>


Over 1000 suspected chikungunya cases have been reported at various
places in the city [Madurai] in the last one week, Health department
officials said on Monday [14 Sep 2009]. Private hospitals in
Chinthamani, Melamadai, Vilachery, Karimedu, and Ponnagaram had
reported cases of suspected chikungunya. Patients complained of fever,
headache, and severe joint pain, they said. Officials of government
Rajaji hospital said they were getting 25 suspected cases daily for
the past 2 weeks and most of them were from Madurai.

Directorate of Public Health officials said since people showed
symptoms of chikungunya with swollen feet, they had collected blood
samples of 2635 persons and sent for testing. They would know about
the extent to which the mosquito that induced fever [transmitted the
virus] had spread only after receiving the results, another official
said.

Preventive measures had been taken, they added, including sprinkling
bleaching powder, fogging pesticides, and removal of stagnant water in
these areas.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[A report from Tamil Nadu state on 4 Aug 2009 indicated that
chikungunya virus was circulating there (see ProMED-mail archive no.
20090805.2763). This 14 Sep 2009 report, if confirmed, indicates that
virus transmission there is continuing and perhaps accelerating.

Interactive maps of Madurai and vicinity in Tamil Nadu state, India,
can be accessed at
<http://www.maplandia.com/india/tamil-na ... i/madurai/>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00OE>. - Mod.TY]

CHIKUNGUNYA (33): INDIA (TAMIL NADU)
************************************
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 16 Sep 2009
Source: Zeenews.com [edited]
<http://www.zeenews.com/news563998.html>


As many as 63 persons in Keezhakarai and surrounding villages in
Ramanathapuram district [Tamil Nadu] have been confirmed with
chikungunya [virus infection], deputy director of health Uma Maheswari
said on Wednesday [16 Sep 2009]. The results of blood tests of the
patients had been received from Virudhunagar Government Hospital and
it had been confirmed that they had chikungunya [virus infections],
she said.

Some of the patients got admitted into hospitals while several others
were not willing to come even to the government hospital despite
persuasion by the officials, she said. "As of now we cannot get the
exact number of people affected by the chikungunya [virus]," she said,
adding steps were being taken to prevent the spread of chikungunya
[virus].

Meanwhile, patients with symptoms of dengue fever also had been
admitted to some hospitals in the area, she added.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Re that last sentence, the symptoms of chikungunya & dengue fevers
are very similar, so one wonders why they think some people have
dengue rather than chikungunya virus infection before the lab results
have come back. - Mod.JW.]

[Chikungunya virus transmission continues in Tamil Nadu state, first
reported recently from the interior of the state as suspected (see
ProMED-mail archive no. 20090914.3237) and now on the coast, where it
is laboratory confirmed.

A map showing Ramanathapuram district in Tamil Nadu state in south
India can be accessed at
<http://www.mapsofindia.com/maps/tamilna ... apuram.htm>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Ph>. - Mod.TY]

CHIKUNGUNYA (33): INDIA (TAMIL NADU)
************************************
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 16 Sep 2009
Source: Zeenews.com [edited]
<http://www.zeenews.com/news563998.html>


As many as 63 persons in Keezhakarai and surrounding villages in
Ramanathapuram district [Tamil Nadu] have been confirmed with
chikungunya [virus infection], deputy director of health Uma Maheswari
said on Wednesday [16 Sep 2009]. The results of blood tests of the
patients had been received from Virudhunagar Government Hospital and
it had been confirmed that they had chikungunya [virus infections],
she said.

Some of the patients got admitted into hospitals while several others
were not willing to come even to the government hospital despite
persuasion by the officials, she said. "As of now we cannot get the
exact number of people affected by the chikungunya [virus]," she said,
adding steps were being taken to prevent the spread of chikungunya
[virus].

Meanwhile, patients with symptoms of dengue fever also had been
admitted to some hospitals in the area, she added.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Re that last sentence, the symptoms of chikungunya & dengue fevers
are very similar, so one wonders why they think some people have
dengue rather than chikungunya virus infection before the lab results
have come back. - Mod.JW.]

[Chikungunya virus transmission continues in Tamil Nadu state, first
reported recently from the interior of the state as suspected (see
ProMED-mail archive no. 20090914.3237) and now on the coast, where it
is laboratory confirmed.

A map showing Ramanathapuram district in Tamil Nadu state in south
India can be accessed at
<http://www.mapsofindia.com/maps/tamilna ... apuram.htm>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Ph>. - Mod.TY]

ENCEPHALITIS, UNIDENTIFIED - INDIA: (UTTAR PRADESH)
***************************************************
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: 16 Sep 2009
Source: Press Trust of India
<http://www.ptinews.com/news/286142_Ence ... -toll-293->

Encephalitis claims 5 more lives; toll 293
------------------------------------------
Gorakhpur (UP), Sep 16 (PTI) Five children today succumbed to
encephalitis here at a hospital here, taking the toll to 293 from the
disease in the region.

Official sources said the children were admitted to the Baba Raghav
Das Medical College Hospital.

Additional Director (Health) L P Rawat said that as many as 1425
patients had come to various hospitals of the region this year, out of
which 293 died.

Meanwhile, sources said 39 fresh patients having symptoms of
encephalitis have been admitted to various hospitals of the region,
including BRDMCH in the last 24 hours.

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


[It is still not clear if etiological agents other than Japanese
encephalitis virus are causing these cases. Previous reports from this
area term some of them as acute encephalitis syndrome that are not due
to Japanese encephalitis virus infections -- see ProMED archives below.

A map showing the location of Indian states, including Uttar Pradesh,
can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Hk>. - Mod.TY/JW]

HEPATITIS, VIRAL - PAKISTAN (03): SYRINGE REUSE
***********************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 19 Sep 2009
Source: Online News [edited]
<http://www.onlinenews.com.pk/details.php?id152166>
[This page is now blank, and an archive search does not locate it. - ProMED]


At least 16 patients undergoing treatment for hepatitis B and C
infections in various hospitals of South Punjab have died, while
several others are under treatment.

According to media reports, in the last 24 hours, 16 patients
diagnosed with hepatitis B and C and undergoing treatment in various
hospitals in Vehari, Burewal, Gago Mandi, Khanewal, Kabir Wala and
Mian Channu have died. Most deaths occurred in Vehari, where 7 people
died. Another 9 patients died of hepatitis in other local hospitals.

The reports said that hepatitis is spreading very fast, and the major
cause of spreading of the disease is use of a syringe more than once.
The death toll has risen to 42 during a single week.

In an interview with a private TV channel, director general Aslam
Chaudhry said steps are being taken to control the disease, and
vaccinations [against hepatitis B? - Mod.CP] are being given to
children under one year of age.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[If medical malpractice has been responsible for this outbreak of
disease, the medical authorities in Pakistan should reveal immediately
what measures are now in place to avoid a recurrence of such an
unfortunate incident.

The HealthMap/ProMED-mail interactive map of Punjab, Pakistan can be
accessed at: <http://healthmap.org/r/008Q>. - Mod.CP]

JAPANESE ENCEPHALITIS - INDIA (09): (UTTAR PRADESH)
***************************************************
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<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 20 Sep 2009
Source: China Daily, Xinhua News Agency report [edited]
<http://www.chinadaily.com.cn/world/2009 ... 713055.htm>


The semi-official Press Trust of India reported on [Sun 20 Sep 2009]
that 11 children have died of Japanese encephalitis in past 2 days,
bringing the toll to the epidemic in Gorakhpur district of Uttar
Pradesh, northern India, to 311 so far this year [2009].

A total of 1521 patients suffering from Japanese encephalitis and acute
encephalitis syndrome have been admitted to hospital this year [2009],
and 311 of them have died, said the report.

The deadly Japanese encephalitis fever is caused by a virus found in
pigs [and wild birds - Mod.TY] and is transferred to humans by mosquito
bite.

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

[The etiology of the encephalitis outbreak in this area remains
confusing, but the number of cases continues to increase. The report
above implies Japanese encephalitis virus (JEV) is responsible for
these cases, but a recent report (ProMED-mail archive no.
20090827.3015) indicated that less than half were due to JEV and the
remaining to "acute encephalitis syndrome" of unidentified etiology. It
would be of interest to know how many of the cases in the report above
were laboratory confirmed.

A map showing the location of Indian states, including Uttar Pradesh,
can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Hk>. - Mod.TY]

DENGUE/DHF UPDATE 2009 (38 )
***************************
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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: Sun 20 Sep 2009
Source: Village Tinto [edited]
<http://www.villagetinto.in/news/calangu ... -death-480>


Health officials at the Candolim Primary Health Centre stepped up
measures to curb the spread of dengue in the area. The action follows
the death of a 6-year-old boy from Calangute.

PHC Health Officer Dr Govekar said, "Besides other measures, we checked
for stagnant water at the construction sites in the area. However, we
did not observe much stagnant water, which may have been a cause for
concern."

While these measures are being carried out in the area of the boy's
residence in Naikawaddo, Calangute, this is merely a reactionary move.
What is called for is a pro-active move to check the unsanitary
conditions prevailing in the entire Calangute area where widespread
mosquito breeding is a major cause for concern.

The dengue count in Goa has gone up to 49 with one death.

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

[The Times of India, in its 18 Sep 2009 edition
(<http://timesofindia.indiatimes.com/news ... 024305.cms>) indicated that Goa physicians report a 10 - 15 percent increase in dengue in
2009.

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

UNDIAGNOSED ILLNESS - INDIA (03): (JHARKHAN), REQUEST FOR INFORMATION
*********************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 20 Sep 2009
Source: PTI News [edited]
<http://ptinews.com/news/292186_Mysterio ... ve-tribals>


11 tribals have died of a mysterious disease in one month in
Jharkhand's Latehar district, health officials said.

The toll reached 11 with 2 fresh deaths being reported from Champa
village in Mahuadand in the district today [20 Sep 2009], civil
surgeon of the district, Aron Tigga said.

Pradip Waski, an official of the disease surveillance programme, told
reporters that they were trying to learn more about the mysterious
disease and would take preventive measures after a surveillance team
examines the affected persons of the tribe and those living in the
nearby areas.

The civil surgeon said the district administration would accept the
help of the Centre if the situation demands it.

Giving details of the symptoms of the disease, he said the affected
persons took ill suddenly, suffered stomach problems, and the skin
turn yellow.

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

[The information is very scarce, but diarrhea and jaundice could be
signs of hepatitis A or leptospirosis among the most likely
diagnoses. If fever was present, malaria is another possibility.
Laboratory tests and more clinical information should solve the
puzzle.

More information on Latehar (Jharkhand) can be found at
<http://en.wikipedia.org/wiki/Latehar>. - Mod.EP]

UNDIAGNOSED ILLNESS - INDIA (04): (OR), 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 23 Oct 2009
Source: Kalinga Times [edited]
<http://www.kalingatimes.com/odisha_news ... _to_10.htm>


The deaths due to an unknown disease in Kandhamal district of Odisha
increased to 10 on Wed 23 Oct 2009, with 2 more persons breathing
their last at the MKCG Hospital at Berhampur.

Although the 1st death took place at Gudrigaon village of Kandhamal 6
days ago, the authorities had not been able to conduct the necessary
examination to know the cause of the deaths so far.

Even as the state government had sent a medical team, the death toll
was likely to rise, as 10 more persons were admitted to different
hospitals.

All the deaths had taken place in Gudrigaon village so far, though
some people from a neighbouring village had been taken ill with
similar symptoms.

While some were of the view that deaths could be due to cerebral
malaria, others were suspecting that the deaths were due to
consumption of poisonous mushrooms.

Meanwhile, a team of medical experts from the Regional Medical
Research Centre in Bhubaneswar left for Kandhamal to inquire about
the cause of the deaths, as they were suspecting that the deaths
could have taken place due to some viral infection.

--
Communicated by:
Andrew S.<mathleteowl@aol.com>


[It is very difficult to know what is happening without further
information. Orissa is not a high risk area for malaria, and the
report does not mention fever as part of the symptoms, which -- if
true -- rules out malaria with a high probability. ProMED will be
glad to post further information on the outbreak.

For information on Orissa State, see <http://da.wikipedia.org/wiki/Orissa>