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DENGUE/DHF UPDATE 2009 (39)
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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 (North-West Frontier Province)
Date: Mon 28 Sep 2009
Source: Daily Times [edited]
<http://www.dailytimes.com.pk/default.as ... 2009_pg1_6>


Dengue fever claims 7 lives in Haripur
--------------------------------------
Dozens of new dengue fever cases have been reported in various parts of
Haripur [district, North-West Frontier Province] after 7 people died from
the virus, a private TV channel reported on Sunday [27 Sep 2009]. According
to the channel, at least 7 patients diagnosed with dengue fever died last
week [week of 20 Sep 2009] in Khanpur, Pind Gujran, Khoi Nara, Raniwah, and
other parts of Haripur. Dozens of new dengue patients have also been
admitted to hospital, the channel added.

Talking to the channel, Pakistan Muslim League-Nawaz Member National
Assembly Sardar Muhammed Mushtaque urged the health department to send
doctors to the area to help deal with the situation. At least 25 deaths and
as many as 1800 dengue fever cases have been confirmed in the country. This
is posing a serious problem for the country and is putting further strain
on an already inadequate health infrastructure.

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[An interactive map showing the location of Haripur in Pakistan's
North-West Frontier Province can be accessed at
<http://www.maplandia.com/pakistan/n-w-f ... d/haripur/>. A
HealthMap/ProMED-mail interactive map of Pakistan can be accessed at
<http://healthmap.org/r/00Sm>. - Mod.TY]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (24)
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>


******

Cholera - Pakistan (Punjab)
Date: Mon 28 Sep 2009
Source: Frontier Post [edited]
<http://www.thefrontierpost.com/News.asp ... n&nid=2801>


A sudden outbreak of cholera has taken the life of a child besides
seriously affecting the health of dozens of people in the village Garah
Aashiq of Tehsil Parova, reliable sources reported here on Sunday [27 Sep
2009].

The main reason behind the outbreak of cholera is said to be constant use
of contaminated and polluted water by poor villagers. Dozens of affected
people have been admitted in the local hospital for the last 2 days, whose
families are greatly worried over the pitiable condition of the poor patients.

A water testing team of Peshawar, during its recent visit, has already
declared the water supply system of the tehsil Parova, especially of the
union council Naiveala, severely injurious for health. It said that after
the testing of the water, a number of announcements were also made in the
local mosques in order to convince the people not to drink the contaminated
water, but to no avail, as they have no alternative.

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

[The area is close to Dera Ismail Khan in the south eastern Punjab province
of Pakistan, which can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... kistan.pdf>. - Mod.LL]

ENCEPHALITIS, UNIDENTIFIED - INDIA (03): (UTTAR PRADESH)
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<http://www.promedmail.org>
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International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 1 Oct 2009
Source: The Times of India, Press Trust of India (PTI) report [edited]
<http://timesofindia.indiatimes.com/news ... 075578.cms>


[In Gorakhpur] 6 more children succumbed to encephalitis taking the toll in
the viral fever in the district this year [2009] to 356. The fresh deaths
took place yesterday [30 Sep 2009] at the BRD Medical College Hospital. 41
new patients of suspected encephalitis have also been admitted to the
hospital. Additional director health LP Rawat said 258 patients are being
treated at BRD Medical College Hospital and 32 in other government
hospitals in the region.

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

[The death toll continues to climb from 293 reported on 16 Sep 2009 to the
356 reported currently in the Gorakhpur area of Uttar Pradesh. Previous
reports (see archives, below) have attributed some of the cases to Japanese
encephalitis virus (JEV) infection and others to an acute encephalitis
syndrome of unidentified etiology not caused by JEV. It is not clear what
the etiology of the cases is in this current report.

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

Pakistan - Dengue
02.10.2009

Aus verschiedenen Landesteilen u.a. aus der Hauptstadt Islamabad, Karachi und Haripur (NW) werden Dengue-Ausbrüche gemeldet. Schutz vor überwiegend tagaktiven Stechmücken beachten. / Quelle: crm

CHIKUNGUNYA (36): INDIA (ORISSA), SUSPECTED
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 2 Oct 2009
Source: WebIndia123.com [edited]
<http://news.webindia123.com/news/Articl ... 53829.html>


Hundreds of people, irrespective of their age and sex, in 4 villages in the
Delang block of Puri district have been afflicted by an unidentified fever
during the last few weeks. According to Bishnu Prasad Mahapatra, a victim
of the disease, the affected persons experience high fever for a couple of
days followed by pain and swelling in their knees and other joints. Though
the fever recedes after taking medicines, the pain and the swelling
continues to persist.

Within a week the disease spread through Praharajpur, Sripratap Pur and
Pidhapatana villages, Mr Mahapatra said. The visiting doctors were
administering conventional medicines to the patients, advising to wait till
the report comes from labs, he added.

Puri chief district medical officer Dr D N Sarangi said a team of medicos
had been sent to the area and blood samples were collected from the
affected patients. The samples were sent to the testing laboratories of the
state and Delhi for diagnosis.

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

[ProMED-mail would be interested in receiving information concerning the
laboratory results confirming or rejecting chikungunya virus as the
etiological agent in this outbreak.

A map of the east coast of India showing the location of Puri can be
accessed at <http://encarta.msn.com/map_701515836/puri.html>. A
HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Ph>. - Mod.TY]

JAPANESE ENCEPHALITIS - INDIA (10): (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: Thu 10 Oct 2009
Source: PR Web [edited]
<http://www.individual.com/storyrss.php? ... 99f58e9df9>


With 4 deaths, the toll of Japanese encephalitis [virus; JEV] victims
has now been raised to 379 in the northern Indian state of Uttar
Pradesh, a senior Indian Health official said Saturday. "A total of
2182 patients suffering from the deadly vector-borne disease were
admitted to Baba Raghav Das Medical College in the recent past in
Gorakhpur in the eastern part of the state. According to latest
reports, 379 patients have died so far this year. The condition of
some patients are also serious and the toll may mount," the official said.

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

[The death toll continues to climb from 356 reported in ProMED
archive 20091001.3420 to 379 currently in the Gorakhpur area of Uttar
Pradesh. This report does not indicate if these cases were laboratory
confirmed as JEV. Previous reports have attributed some of the cases
to JEV infection and others to an acute encephalitis syndrome of
unidentified etiology not caused by JEV. The current report indicates
that the cases are caused by JEV.

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

DENGUE/DHF UPDATE 2009 (41)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
India (Madhya Pradesh)
Date: Thu 8 Oct 2009
Source: Prokerala.com, Indo-Asian News Service (IANS) report [edited]
<http://www.prokerala.com/news/articles/a84419.html>


Mosquitoborne dengue fever is fast spreading in Madhya Pradesh, with the
disease having claimed at least 9 lives in the past 3 months and affecting
more than 300 people, health officials said on Thursday [8 Oct 2009].

Though at least 192 cases of dengue have been confirmed by the Bhopal-based
Gandhi Medical College alone, the district malaria officer Padmakar
Tripathi last week [week of 28 Sep 2009] put the figure at 103 confirmed
cases. The government, however, still put the number of those affected by
dengue in the capital at 57 and 163 in the entire state.

"We get at least 10 to 15 dengue patients every day and the hospital is
almost full," said Ajay Goenka, a doctor with the private Chirayu Hospital
here. Private practitioners say that the actual number of dengue affected
people will be much higher if the patients in private hospitals and rural
areas are taken into account. Gopal Batini, a doctor with the private
Ayushman Hospital also said that the number of patients would be much
higher than the official figures. "The hospital is almost full because of
dengue," he said.

Director (of health) of Madhya Pradesh government Ashok Sharma told IANS:
"9 people have died from dengue in Madhya Pradesh in the past 3 months,
while 129 others -- of which 57 are in the state capital -- are affected by
the disease. It's true that most dengue patients, as many as 57, were in
the state capital, followed by 33 in Indore, 17 in Balaghat, and 12 in
other districts. 3 people died of dengue in Bhopal and Indore each. One
each succumbed in Ashoknagar, Satna, and Balaghat."

Sharma claimed that necessary steps had been taken to control dengue and
the district medical officers had been directed to remain in contact with
private hospitals and send information about those affected. But a source
in the state health department said: "Surprisingly, none of the
government-run hospitals have single donor platelet phaeresis (SDPP)
machines -- the mechanism required for collection of platelets and plasma
for effective treatment of dengue cases." Secretary of Health Department SR
Mohanty said that procurement of the SDPP machines for Indore, Bhopal,
Ujjain, and Jabalpur hospitals was in the pipeline and they would be made
available soon.

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

[It would be of interest to know specifically what steps are being taken to
control dengue transmission in this area.

A map of Madhya Pradesh in central India 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/00Vk>. - Mod.TY]

CHIKUNGUNYA (40): INDIA (TAMIL NADU), SUSPECTED
***********************************************
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International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 20 Oct 2009
Source: Express Buzz [edited]

Many villagers in Meenakshipuram, Durairajapuram, Anaikaraipatti,
Visuvasa puram, Ammapatti, Sillamarathupatti and Silamalai in Bodi
block of Theni district were found to be suffering from high fever.
Diagnosis showed that many of them were suffering from chikungunya
[virus infection].

More than 1200 patients came to the Bodi Government Hospital in Theni
from Meenakshipuram, Durairajapuram and Anaikaraipatti villages. More
than 400 of them were found to be suffering from chikungunya [virus
infection]. Since the hospital has only limited bed strength, most of
them were treated as outpatients and asked to go home.

Many of them from Meenakshipuram are so ill that they are unable to
get back to their village and are waiting for admission. Only a
limited number of patients have been admitted to the hospital.
Patients from the villages come to the government hospital for want
of proper facilities in the primary health centres in their areas.
Bodi hospital itself is handicapped without adequate staff and proper
stocks of medicines.

Thirumurugan, block medical officer of Dombucherry, said that they
found an outbreak of chikungunya in Ammapatti village but they had
brought it under control. Now this ailment had spread in some
villages, including Meenakshipuram. Doctors have collected blood
samples and had sent them for analysis.

The Department of Health had taken various measures to check the
spread of this disease, including spraying of chemicals, fogging and
clearing waste materials. Special camps are also being organised in
villages to detect cases of chikungunya, the block medical officer said.

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

[The statement that blood samples were being sent to a laboratory for
analysis suggests that the chikungunya virus infections are being
diagnosed on clinical grounds. Laboratory results for confirmation
(or not) would be of interest and ProMED would appreciate receiving
this information.

A map of Tamil Nadu showing the location of the Theni district can be
accessed at <http://en.wikipedia.org/wiki/Theni>
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]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2009 (26)
************************************************
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, diarrhea - India (Assam)
[2] Cholera - Tajikistan (Kublyarskiy)

*****
[1] Cholera, diarrhea - India (Assam)
Date: Thu 15 Oct 2009
Source: Indopia [edited]
<http://www.indopia.in/India-usa-uk-news ... h/10/11/10#>


Cholera and diarrhea have claimed 10 lives, including those of 7
children, and affected 10 180 people in Barpeta district during the
last 15 days, a senior official said today [15 Oct 2009].

Since the outbreak of the diseases on 29 Sep 2009, deaths had been
reported from 7 villages of Hazipara, Khandakapara, Dioliapa,
Zaenikura, Joshihati Char, Baglaipara and Kadong Char, Sub-divisional
District Magistrate, Bikash Choudhury said.

4 mobile medical teams, each group consisting of a doctor and 5
paramedical staff, are moving in the villages and providing
treatment, he said. In addition, 119 affected people have been
treated at Howly health centre so far.

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

[Assam is in northeastern India and can be found on a map at
<http://en.wikipedia.org/wiki/Assam>. - Mod.LL]


*****
[2] Cholera - Tajikistan (Kublyarskiy)
Date: 15 Oct 2009
Source: centrasia.ru [Trans. - Mod.ATS] [edited]
<http://www.centrasia.ru/newsA.php?st=1255449600>


Recently the epidemiologic situation on cholera deteriorated in
Tajikistan, which is due to inadequate preventive activities due to
the lack resources.

A cholera outbreak was reported on 13 Oct 2009 and all 3 of the
patients died. On the next day, 4 other patients were admitted and
their condition remains serious. There was another outbreak of
cholera in July 2009 in the same place. The investigation showed that
the source of the infection was tap water from the city of Kublyar.
The water possibly got contaminated from the sewer system.

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

[A map of the land-locked country of Tajikistan can be found
at: <http://www.un.org/Depts/Cartographic/ma ... jikist.pdf>. - Mod.LL]

CHIKUNGUNYA (42): INDIA (KARNATAKA)
***********************************
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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: Thu 29 Oct 2009
Source: The Times of India, Times News Network (TNN) report [edited]
<http://timesofindia.indiatimes.com/city ... 177672.cms>


In the past week, nearly 20 reports of chikungunya cases were
registered at the PHC [primary health care] at Nidagundi town of
Basavana Bagewadi taluk. [A taluk is an administrative subdivision of
a district. - Mod.TY] Confirmation of blood tests of all the patients
for malaria is awaited.

According to the district nodal officer, S L Lakkannavar, only one
death due to chikungunya has been registered in the district till the
1st week of October [2009].

Doctors asked the villagers to take necessary actions to curb the
disease, by keeping their houses and surrounding areas clean. All the
areas in Nidagundi town were fogged, after the PHC doctors who visited
the areas found them unhygienic.

The doctors also advised the people to immediately take blood tests at
the district hospital, if they had any symptoms of chikungunya [virus
infection].

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

[Since chikungunya virus infections are very rarely fatal, the one
fatality reported here is unusual. It would be of interest to know if
the person who died had other underlying medical problems. The most
recent report of chikungunya virus transmission in Karnataka state was
on 27 Jun 2009 (see ProMED-mail archive no. 20090629.2351).

An interactive map showing the location of Nidagundi in Karnataka
state, India can be accessed at
<http://www.maplandia.com/india/karnatak ... nidagundi/>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/00Yl>. - Mod.TY]

JAPANESE ENCEPHALITIS - INDIA (11): (BIHAR)
*******************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 29 Oct 2009
Source: Khabrein.info, Kuwait News Agency (KUNA) report [summ. & edited]
<http://www.khabrein.info/index.php?opti ... &Itemid=68>


The viral disease Japanese encephalitis has claimed as many as 30
lives in India's northern state of Bihar so far this year [2009],
while 105 others are undergoing treatment, reported the Press Trust of
India (PTI).

Citing official figures, the report said that 3children died and 21
cases of the Japanese encephalitis disease were reported in 2006,
while the death toll rose to 164 in 2007 during which 336 cases were
reported. In 2008, as many as 46 children died of the disease and 198
were affected.

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

[This is the 1st 2009 report of Japanese encephalitis cases in Bihar
state. It would be of interest to know if these cases occurred as a
focus in the same place in Bihar state, or were scattered, and the
dates of their occurrence.

A map showing the location of Indian states, including Bihar, 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/00Yx>. - Mod.TY]

JAPANESE ENCEPHALITIS - INDIA (12): (UTTAR PRADESH) REQUEST FOR INFORMATION
***************************************************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 1 Nov 2009
Source: DNA India [edited]


7 more children succumbed to the deadly encephalitis here today [1 Nov
2009], taking the toll of the viral fever in the district this year
[2009] to 471. Additional Director of Health, LP Rawat, said 29
patients suffering from the fever have been admitted to various
hospitals in the region. He said a total of 2738 patients suffering
from Japanese encephalitis (JE) and acute encephalitis syndrome (AES)
were admitted this year to BRD Medical College and other hospitals of
the region; out of this number, 471 died. The dead include 3 each from
Kushinagar and Deoria and one from Gorakhpur.

Chief medical officer of Gorakhpur RN Mishra said that all children
below 15 years would be immunised for JE in a campaign to be launched
around autumn next year [2010] in all districts of Gorakhpur division.
Joint Secretary (immunisation) in the Union Health Ministry Shakuntala
Gamlani had asked local authorities last month [October 2009] to
launch an immunisation drive.

Japanese encephalitis is caused by mosquito bite, while acute
encephalitis syndrome spreads through contaminated water. Both affect
the central nervous system and brain causing paralysis and death.

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

[This is yet another report of an encephalitis outbreak in the
Gorakhpur area of Uttar Pradesh. The outbreak is of apparent mixed
etiology, including JE virus and an undesignated agent reportedly
responsible for the acute encephalitis syndrome that is due to
something other than JE virus. ProMED would appreciate receiving
information about the agent(s) responsible for that syndrome,
indicating its relation to contaminated water.

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/00Yx>. - Mod.TY]

JAPANESE ENCEPHALITIS - INDIA (13): (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: Wed 4 Nov 2009
Source: Press Trust of India (PTI) [edited]
<http://www.ptinews.com/news/361976_Thre ... eaches-481>


With 3 more children hailing from Kushinagar succumbing to encephalitis
today [4 Nov 2009], the toll due to the deadly brain fever has reached 481
since January [2009] in eastern districts of Uttar Pradesh.

Additional director of health LP Rawat said [in Gorakhpur] that 14 fresh
patients suffering from the fever were admitted to various hospitals in the
region. He said that a total of 2787 patients suffering from Japanese
encephalitis and acute encephalitis syndrome (AES) were admitted this year
[2009] to BRD Medical College Hospital [BRD MCH] and other hospitals of the
region. Of these, 481 died.

The additional director of health said that 174 patients suffering from
encephalitis are undergoing treatment at BRD MCH, while 9 patients are
admitted in government hospitals of adjoining districts.

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

[This report does not indicate the proportion of the 2787 cases that were
due to JE virus infection and that due to the unidentified etiologic agent
of acute encephalitis syndrome. A report from the USA Centers for Disease
Control and Prevention on a laboratory study of encephalitis patients from
this same area in Uttar Pradesh in 2006 reported that they identified an
etiologic agent in cerebrospinal fluid by using reverse transcription-PCR.
Their results showed positivity to enterovirus (EV) in 66 (22 per cent) of
306 patients. Sequencing and phylogenetic analyses of PCR products from 59
(89 per cent) of 66 specimens showed similarity with EV-89 and EV-76
sequences (see
<http://www.cdc.gov/eid/content/15/2/295 ... =eid2957_e>). This may
account for the statement in the previous ProMED-mail post (archive no.
20091101.3773) that AES is related to contaminated water.

A ProMED-mail rapporteur raised the interesting possibility that Nipah
virus infection is another possible etiological agent causing encephalitis.
Apparently, Nipah virus has not been included in tests of recent cases. He
wrote, "I wonder if Nipah virus should be considered as a differential
diagnosis here. Mangos are a major crop in Uttar Pradesh (1), and the
_Pteropus_ spp fruit bats that have been associated with Nipah outbreaks in
Bangladesh and Malaysia feed on mangos (2). Fruit bats feeding and roosting
in mango trees and other fruit trees in and around piggeries are thought to
have been the source of the 1st reported Nipah outbreaks in Malaysia. The
index farm for the earliest known Nipah outbreak in Malaysia actually had a
large mango tree overhanging the piggery where the pigs became infected
(3). Pigs in the area could be tested for evidence of possible exposure to
Nipah virus. Pigs are both a principal amplifying host for JEV, and able to
acquire subclinical infections with Nipah virus (4). Interestingly,
although birds are considered the primary amplifying host for Japanese
encephalitis virus, research in Australia has indicated that at least one
species of _Pteropus_ bats can also become cryptically infected with JEV
and transmit the JEV virus to mosquitoes (5).

References
----------
1. National Horticulture Mission Action Plan 2005-06, Uttar Pradesh.
Available at <http://www.nhm.nic.in/ActionPlan/ActionPlan_UP.pdf>.
2. Silbernagel E, Olson L. 2005: _Pteropus giganteus_ Animal Diversity Web.
Accessed 4 Nov 2009 at
<http://animaldiversity.ummz.umich.edu/s ... nteus.html>.

3. Chua KB, Chua BH, Wang CW. Anthropogenic deforestation, El Nino and the
emergence of Nipah virus in Malaysia. Malays J Pathol 2002; 24(1): 15-21.
Available at
<http://www.mjpath.org.my/past_issue/MJP ... tation.pdf>.

4. van den Hurk AF, Smith CS, Field HE, et al. Transmission of Japanese
Encephalitis virus from the black flying fox, _Pteropus alecto_, to _Culex
annulirostris_ mosquitoes, despite the absence of detectable viremia. Am J
Trop Med Hyg 2009; 81(3): 457-62. Available at
<http://www.ajtmh.org/cgi/content/abstra ... 457?ck=nck>.
5. Middleton DJ, Westbury HA, Morrissy CJ, et al. Experimental Nipah virus
infection in pigs and cats. J Comp Pathol 2002; 126(2-3): 124-36. Abstract
available at <http://www.ncbi.nlm.nih.gov/pubmed/11945001>.

There is an interesting video clip showing _Pteropus_ bats at
<http://www.indiavideo.org/kerala/land-a ... ox-586.php>."

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/00ZI>. - Mod.TY]

JAPANESE ENCEPHALITIS - INDIA (14): (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: Tue 10 Nov 2009
Source: Press Trust of India (PTI) [edited]
<http://www.ptinews.com/news/369904_7-di ... in-East-UP>


In Uttar Pradesh, 7 more children have succumbed to Japanese
encephalitis [virus infection-JEV], taking the toll in the deadly
brain fever to 30 this month [November 2009]. The deaths were reported
in Mahrajganj, Kushinagar, and Gorakhpur districts yesterday [9 Nov
2009], additional director (Health) P Rawat said. He said 16 new
patients suffering from the disease have been admitted to the BRD
Medical College in Gorakhpur.

Of the total 2839 cases of Japanese encephalitis and acute
encephalitis syndrome reported from the region this year [2009], 496
patients have died, Rawat said.

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

[The encephalitis cases continue in this region of Uttar Pradesh.
Again, there is no indication of the proportion of the cases that are
due to JEV infection and how many are due to another, as yet
unspecified, etiological agent. Without a specific determination of
the agent causing the acute encephalitis syndrome, it will be
difficult to devise and implement control or prevention measures. An
additional report published in another 10 Nov 2009 issue of the Press
Trust of India
(<http://www.ptinews.com/news/371110_Four ... ouches-503>) indicated that there have been 2864 cases in this area, with as many as 18 new patients admitted to local
hospitals.

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/00ZI>. - Mod.TY]

[The case fatality rate of nearly 20 percent is bad enough, but it can
go up to 30 percent for JE. Are they not vaccinating in UP? - Mod.JW]

JAPANESE ENCEPHALITIS - INDIA (15): (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: Tue 17 Nov 2009
Source: Daily News & Analysis (DNA), Press Trust of India (PTI) report [edited]
<http://www.dnaindia.com/india/report_en ... 15_1312922>


[In Gorakhpur, Uttar Pradesh, 9 more people, including 6 children,
have succumbed to encephalitis taking the toll to 515.

A total of 9 patients have died since last Friday [13 Nov 2009],
official sources said, adding the toll due to different types of
brain fever has reached 515 in eastern districts since January this
year [2009]. Here [Gorakhpur] and in Basti division, 16 new patients
suffering from the disease have been admitted to various government
hospitals since yesterday [26 Nov 2009], additional director health
LP Rawat said.

He said a total of 2947 patients suffering from Japanese encephalitis
[virus infection] and acute encephalitis syndrome (AES) were admitted
this year [2009] to BRD Medical College and other hospitals of the
region. Of this, 515 patients died.

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

[There is still no determination of the etiological agent responsible
for the acute encephalitis cases. Mod.EP pointed out that a previous
comment stated, "Encephalitis of enterovirus etiology has occurred
previously in this area, as reported in the following reference:
Sapkal GN, Bondre VP, Fulmali PV, Patil P, Gopalkrishna V, Dadhania
V, et al. 2009: Enteroviruses in patients with acute encephalitis,
Uttar Pradesh, India. Emerg Infect Dis. 15: 295-8 (full article
available at <http://www.cdc.gov/eid/content/15/2/pdfs/08-0865.pdf>).
JE has a clear seasonal variation and the present outbreak has been
going on since January this year (2009) and is increasing at a time
of the year when JE used to decrease (usual season May-October). With
the study above in mind perhaps we should more clearly ask for more
information on other viruses such as the enteroviruses found in the
study above." - Mod.TY]

[The case fatality rate of nearly 20 percent is bad enough, but it
can go up to 30 percent for JE. Are they not vaccinating in UP? - Mod.JW]

[What about those who do not die? This must be costing India a small
fortune, much more than the vaccine would cost. - Charles Calisher
<calisher@cybersafe.net>]

[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]