Aktuelle Epidemien in Asien/Seidenstraße

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Malaria in Indien

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MALARIA - INDIA (06): (GOA, NEW DELHI, MAHARASHTRA, ANDHRA PRADESH), UPDATE
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[1]

Date: Wed 11 Jul 2012
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 812375.cms


There has been a sudden spurt in malaria cases detected at the Candolim primary health centre (PHC) in the last 2 weeks.

While 26 cases were detected in the 6 months till June 2012, the intense monsoon spell of the last 2-3 weeks saw 50 new cases of malaria being detected, according to medical officer in-charge Dr Sachin Govekar. "There has been a large influx of migrant labour in the last couple of weeks," he said. "I was a little worried in the last 15 days because of the large number of malaria cases. So we doubled our efforts, and I also requisitioned the services of a malaria inspector to bring the situation under control," he said.

He said staff from the Candolim PHC have been visiting areas from where the malaria cases have been reported to check all residents living in those localities. The blood samples are collected on slides and examined the same day at the laboratory at the PHC. If any more malaria cases are detected, then treatment is given on the same day by evening. Apart from this, they have also started fogging in some areas, besides taking other preventive measures. The cases have been reported from different areas of Candolim, Calangute and other neighbouring villages.

"After 2 weeks, we should not be having any problem," Govekar said. "Last year [2011], we had a total of 228 cases. This year [2012], I don't think there will be more than 150 cases." There have, however, not been any cases of filaria, chikungunya, dengue or Japanese encephalitis. The Candolim PHC had only recently held a workshop on vector-borne diseases to create awareness amongst villagers at the Calangute panchayat hall.

At the workshop, Govekar had cautioned that malaria is usually brought into the area by newly-arriving migrant labourers. Monsoon time is the peak season for malaria, he added.


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[2]
Date: Tue 10 Jul 2012
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 788168.cms


As the city welcomes the monsoon, it's not all reason to rejoice. Accompanying the rain each year are dengue, malaria and other mosquito-borne diseases.

This year [2012], there have been 5 confirmed cases of dengue and 86 cases of malaria, which is almost double the number of cases reported last year [2011] till 9 Jul 2011.

Municipal authorities held a meeting on Monday [9 Jul 2012] to discuss the ways to check the breeding of mosquitoes and intensify awareness programs. "One patient from Civil Lines, North Delhi was confirmed positive for dengue last week. Before this, we had a patient from Shahdara who was diagnosed with the mosquito-borne disease. The total number of dengue cases reported till date is 5," said Dr N K Yadav, municipal health officer. He said that meetings are being held regularly to take stock of the medicines and manpower needed to fight the disease.

"This year [2012], malaria cases have gone up to 86 as against 40 cases reported last year [2011] till this time of the year. No new chikungunya case has been reported though. Five cases of chikungunya were reported between January and February [2012]," Yadav added.

He said that with the arrival of the monsoon season, breeding of mosquitoes in stagnant water and in household items like coolers, flower vases, and unclean overhead tanks is common. A survey by the National Vector-Borne Diseases Control Program in the capital recently found mosquitoes breeding at more than 12 000 offices and households.

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[3]
Date: Sun 8 Jul 2012
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 740630.cms


Malaria cases are on the rise within NMC limits, though rural areas in the district have fared better in the 1st 6 months of the year [2012], according to the Nashik district malaria office, which has asked NMC officials to be cautious and carry out spraying to contain the chances of an outbreak. "Last year [2011], the number of malaria infection cases from January to June 2011 in the district were 1437, as against 901 cases this year [2012]. At the same time, Nashik city had reported 74 cases last year [2011] as against 100 cases this year [2012] from January 2012. The rise is too steep and a cause of concern. We have suggested several measures to the NMC as per the guidelines," district malaria officer Dr A S Bendre said.

Nashik is densely populated and hence the cleanliness issue becomes critical. Though it has not rained, the number of cases reported is a major cause of concern. The official, however, has strictly advised against fogging, as it is a short-lived measure. "Technically, the effect of fogging is effective only for 3 minutes indoors and is never recommended outdoors, as mosquitoes get a chance to move in the neighbourhood," Bendre said, suggesting residual spraying of places identified as high-risk areas.

The district has witnessed 5 cases of dengue so far (as against 10 last year [2011]). There have been no cases or outbreaks of chikungunya so far this year [2012] as against 37 patients and 9 outbreaks last year [2011]. The district last year witnessed 3652 cases of malaria, and 5 patients succumbed to it as against one death this year so far.

[Byline: Abhilash Botekar]

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[For the interactive ProMED-mail HealthMap of the Nashik area, see http://healthmap.org/r/2JJ_. - Mod.EP]

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[4]
Date: Sat 30 Jun 2012
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 510985.cms


It has only been about a fortnight since the onset of monsoon, and 30 malaria cases have already been reported in Hyderabad.

District health officials who have recently woken up to the fact that the number of malaria cases are comparatively more than those reported last year [2011] are now busy planning ways and means to tackle the malaria menace in the state capital.

Officials said that cases are being reported from areas along river beds and small lakes. Puranapul, Kurmaguda, Ziyaguda, Uppuguda, Amberpet, Saidabad, Bholakpur, Indira Park, Sanathnagar, Banjara Hills and Jubilee Hills are some of the areas from where cases have been reported.

These are also the high risk areas in the city. However, all the cases are of _Plasmodiam vivax_ malaria which is less intense and can be medically managed, officials said.

"The city has grown leaps and bounds in the last few years, and we plan to map the high risk areas for active surveillance once again," said an official.

While corporate hospitals are registering sporadic cases of malaria (one or 2 a week), Fever Hospital superintendent Dr Shankar said that the hospital is getting one to 2 cases on a daily basis. Choked drains, potholed roads and stagnant water in the city are the breeding grounds for mosquitoes that cause the spread of the vector-borne disease.

While GHMC officials claim that fogging and anti-larval operations are being undertaken wherever required to curb the mosquito menace, year after year, there seems to be no respite for residents.

Controlling the vector born disease in the city is a challenging task for the authorities this year [2012]. Sources said that of the total 84 posts of health assistants, a significant 40 posts are lying vacant in the District Health and Medical Office, Hyderabad. The scene is worse when it comes to lab technicians who confirm the tests for the notifiable disease. Of the 14 posts of lab technicians, just 5 are filled.

Each health assistant is responsible for visiting 50 houses on a daily basis to figure out whether there are any fever cases. If the case is confirmed as malaria, radical treatment is provided to the patient. Due to the acute shortage of staff, the focus now is only on slums. "Even the slums are also not being covered completely," said an official.

Experts say that the annual malaria outbreaks can be effectively controlled if things are planned for accordingly.

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[For the interactive ProMED-mail HealthMap of Hyderabad, see http://healthmap.org/r/2JJ-.

The reports reflect the start of the monsoon season, and malaria transmission is on the increase in many states in India. New Delhi has previously been regarded as malaria free, but this assessment may have to be revised with increasing numbers of cases being reported. - Mod.EP]
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Japanische Enzephalitis in Indien - Assam

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JAPANESE ENCEPHALITIS AND OTHER - INDIA (10): (ASSAM)
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Date: Thu 12 Jul 2012
Source: Outbreak News [edited]
http://outbreaknews.com/2012/07/12/indi ... itis-assam


According to an India Blooms report, last week at least 22 people died of Japanese encephalitis in Assam's Sivasagar district. As many as 28 people are currently undergoing treatment at different block Public Health Centres (PHCs) in the district. "So far, 22 people have died of Japanese encephalitis in the district; 28 are undergoing treatment," said Additional Deputy Commissioner (Health) Sivasagar I Rahman.

According to reports, several cases of acute Japanese encephalitis syndrome (AES) emerged from different areas of the district. Several areas under the 8 block PHCs of Khelua, Geleki, Morabajar, Patsaku, Kalugaon, Dimow, Sapekhati and Metora have witnessed fast spread of the disease.

According to the World Health Organization (WHO), Japanese encephalitis is a viral disease that infects animals and humans. It is transmitted by mosquitoes and in humans causes inflammation of the membranes around the brain. Intensification and expansion of irrigated rice production systems in South and Southeast Asia over the past 20 years have had an important impact on the disease burden caused by Japanese encephalitis [virus infections].

Japanese encephalitis (JE) is a disease caused by a flavivirus that affects the membranes around the brain. Most JE virus infections are mild (fever and headache) or without apparent symptoms, but approximately one in 200 infections results in severe disease characterized by rapid onset of high fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and death. The case fatality rate can be as high as 60 per cent among those with disease symptoms; 30 per cent of those who survive suffer from lasting damage to the central nervous system. In areas where the JE virus is common, encephalitis occurs mainly in young children because older children and adults have already been infected and are immune.

The virus causing Japanese encephalitis is transmitted by mosquitoes belonging to the _Culex tritaeniorhynchus_ and _Culex vishnui_ groups, which breed particularly in flooded rice fields.

Japanese encephalitis is a leading cause of viral encephalitis in Asia with 30 000 - 50 000 clinical cases reported annually. It occurs from the islands of the Western Pacific in the east to the Pakistani border in the west, and from Korea in the north to Papua New Guinea in the south. Because of the critical role of pigs, its presence in Muslim countries is negligible. JE distribution is very significantly linked to irrigated rice production combined with pig rearing.

[Byline: Robert Herriman]

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[A 1 Jul 2012 report indicated that there were 20 deaths due to Japanese encephalitis virus (JEV) infections in Assam state (See ProMED-mail archive no. 20120701.1186667). Now there are 22. Assam has had recent outbreaks of JEV infections. One presumes that the above cases are laboratory confirmed as (JEV) infections. Other reports from northeast India mention AES but with JEV discarded or responsible for a minority of cases. In the above report, no mention is made of recent JEV vaccination campaigns in this area. Pigs can be amplifying hosts because they have a viremia of relatively long duration and a high enough titer to serve as a source of infectious blood meals for _Culex_ mosquitoes. Wading birds, such as herons, serve as reservoir hosts.

A HealthMap/ProMED-mail interactive map showing the location of Assam state can be accessed at http://healthmap.org/r/00J-. - Mod.TY]
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Japanische Enzephalitis in Indien - Uttar Pradesh

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JAPANESE ENCEPHALITIS AND OTHER - INDIA (11): (UTTAR PRADESH)
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Date: Thu 12 Jul 2012
Source: Business Standard [edited]
http://www.business-standard.com/genera ... 129/31540/

An 11-year-old boy today succumbed to encephalitis at BRD Medical College hospital here taking this year's toll due to the viral disease in Eastern Uttar Pradesh to 129. As many as 11 patients, suffering from suspected encephalitis, were admitted to the hospital during past 24 hours, a senior health official said.

A total of 658 encephalitis patients were admitted in different government hospitals of Gorakhpur and Basti division this year, of whom 129 died, officials said. The cases have been coming from 7 districts of Gorakhpur-Basti divisions, Bihar and Nepal.

At least 90 per cent of the cases were reported to be of acute encephalitis syndrome which is caused by the viruses present in contaminated water, while rest 10 per cent cases were of Japanease encephalitis [virus infections] caused by mosquito bite, additional director health, Diwakar Prasad said.

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[Encephalitis cases continue to occur in northeastern India and Nepal. Although there is no explicit diagnosis of the viruses associated with contanminated water, that does suggest enteroviruses as the main etiologic agents involved in these cases, with just 10 per cent due to infection with Japanese encephalitis virus.

A HealthMap/Promed-mail interactive map showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/01r4. - Mod.TY]
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Denguefieber in Pakistan und Indien

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DENGUE/DHF UPDATE 2012 (29)
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- India (Karnataka state). 14 Jul 2012. More than 30 persons were suffering from fever in the last 3 weeks. Ten persons were, therefore, submitted to tests, and 3 were found to be suffering from dengue [virus infection]. As many as 69 cases have been reported from the district so far. Bangarpet has had 39, Kolar 11, Malur 6, Mulbagal 7 and Srinivaspur taluk has had 6 cases.
http://www.deccanherald.com/content/264 ... -gram.html.

[A HealthMap/ProMED-mail interactive map showing the location of Karnataka state can be accessed at http://healthmap.org/r/007C. - Mod.TY]

- Inda (Delhi). 10 Jul 2012. As the city welcomes the monsoon, it's not all reason to rejoice. Accompanying the rain each year is dengue. So far this year [2012], there have been 5 confirmed cases of dengue. http://articles.timesofindia.indiatimes ... -n-k-yadav

[A HealthMap/ProMED-mail interactive map showing the location of Delhi can be accessed at http://healthmap.org/r/0G3P. - Mod.TY]

- Pakistan (Karachi, Sindh province). 15 Jul 2012. As many as 9 more new dengue fever cases were reported in the city on Saturday [14 Jul 2012], taking the total number of cases to 105. The total of suspected cases is 105, of them, 103 cases are confirmed with dengue virus [infection].
http://www.nation.com.pk/pakistan-news- ... ed-in-city

[A HealthMap/ProMED-mail interactive map showing the location of Karachi in Sindh province can be accessed at http://healthmap.org/r/1kc-. - Mod.TY]
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Chikungunya in Indien - Rajasthan

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CHIKUNGUNYA (07): INDIA (RAJASTHAN)
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Date: Mon 16 Jul 2012
Source: Daily Bhaskar [edited]
http://daily.bhaskar.com/article/RAJ-JP ... 29275.html


There is a significant rise of chikungunya [virus infection] cases in the Pink City [Jaipur]. According to the health department's records, in the microbiology lab of SMS [Sawai Man Singh] Hospital from January 2012 until now [15 Jul 2012], 29 cases of chikungunya [virus infection] have been detected.

Chikungunya is an insect-borne virus transmitted to humans by mosquitoes. The infection causes an illness with symptoms similar to dengue fever. The fever can go up to 104 F [40 C] and creates pain in the joints of the infected person.

"In the rainy season, mosquitoes find breeding ground due to water logging, and chikungunya cases increase. The diseases [virus] is caused [is transmitted] by _Aedes_ mosquitoes," Director Public Health Dr BR Meena said. "Seeing the rainy season, we are conducting anti-larvae activities, and door-to-door surveys are being conducted. The rapid response teams have been alerted in Jaipur and across the state. All the CMHOs have been instructed to undertake spraying of anti-mosquito medicines in their respective areas," she added.

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[Chikungunya virus is endemic in many parts of India, and sporadic cases occur there frequently. The last cases of chikungunya virus infection reported by ProMED-mail were in 2007. Although the local health department is criticized in the above report for failure to prevent monsoon-related diseases, control of _Aedes_ mosquito vectors of the virus is difficult.

A HealthMap/ProMED-mail interactive map showing the location of Jaipur in Rajasthan can be accessed at http://healthmap.org/r/1pX1. - Mod.TY]
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Chikungunya in Indien - Rajasthan

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CHIKUNGUNYA (07): INDIA (RAJASTHAN)
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Date: Mon 16 Jul 2012
Source: Daily Bhaskar [edited]
http://daily.bhaskar.com/article/RAJ-JP ... 29275.html


There is a significant rise of chikungunya [virus infection] cases in the Pink City [Jaipur]. According to the health department's records, in the microbiology lab of SMS [Sawai Man Singh] Hospital from January 2012 until now [15 Jul 2012], 29 cases of chikungunya [virus infection] have been detected.

Chikungunya is an insect-borne virus transmitted to humans by mosquitoes. The infection causes an illness with symptoms similar to dengue fever. The fever can go up to 104 F [40 C] and creates pain in the joints of the infected person.

"In the rainy season, mosquitoes find breeding ground due to water logging, and chikungunya cases increase. The diseases [virus] is caused [is transmitted] by _Aedes_ mosquitoes," Director Public Health Dr BR Meena said. "Seeing the rainy season, we are conducting anti-larvae activities, and door-to-door surveys are being conducted. The rapid response teams have been alerted in Jaipur and across the state. All the CMHOs have been instructed to undertake spraying of anti-mosquito medicines in their respective areas," she added.

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[Chikungunya virus is endemic in many parts of India, and sporadic cases occur there frequently. The last cases of chikungunya virus infection reported by ProMED-mail were in 2007. Although the local health department is criticized in the above report for failure to prevent monsoon-related diseases, control of _Aedes_ mosquito vectors of the virus is difficult.

A HealthMap/ProMED-mail interactive map showing the location of Jaipur in Rajasthan can be accessed at http://healthmap.org/r/1pX1. - Mod.TY]
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Hepatitis B in Indien - Kerala

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HEPATITIS B - INDIA (02): (KERALA) ALLEGATION OF MALPRACTICE
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Date: Mon 16 Jul 2012
Source: Manorama Online, Malayan edition [edited]
http://english.manoramaonline.com/cgi-b ... d=11565535


Hepatitis B epidemic: Beware of the lab needle jab

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Officials of the government health service suspect unsafe clinical practices [employed] by the mushrooming of private medical laboratories, could be behind the recent spurt in large number of hepatitis B cases in the state. While the officials does not discount other causes like sex work, men who have sex with men (MSM) and infected mothers passing it on to their children during childbirth, they feel that private labs should be brought under the scanner to check the spread of such communicable diseases.

Dr A.S. Pradeepkumar, [deputy] director of Public Health Services (PH) says that cases of hepatitis B have doubled compared to last year [2011]. Clusters of such cases were mostly found in Malappuram, Kozhikode and Kollam according to him. Other places, where many cases of hepatitis B were reported are Changnacherry and Pathanamthitta.

In the case of Kottayam district, most cases have been identified in Athirampuzha panchayat, says District Medical Officer Dr N.M.Aysha Bhai. Precautionary measures such as awareness campaigns to educate the people about this disease were held in the Kottayam Medical College Hospital. Infected patients were transferred to different hospital and vaccinations were given to their relatives, she said.

The lack of awareness about the disease is also hampering the initiatives to check the spread of the disease. Kottayam District Medical Media Officer Domy.J feels that campaigns were not effective as people were not interested. "They thought that it was a water borne disease and not a blood-borne disease", he said. "All want to undergo tests and get vaccinated. But we do not have the budget to give vaccinations to everyone and moreover we have only [enough] vaccine for children below 5 years," says Domy. Some officials feel that tackling hepatitis B was an issue that needed state level planning and response. But no protocols were put in place.

Reacting to the allegations against the private labs by the government medical authorities, a microbiologist at a private lab said, "We do not re-use medical instruments due to fear of losing our jobs. It's the government hospitals that follow such unsafe practices. They accused us to save their skin," the micro-biologist alleged.

Clinical pathologists who work in premium private labs such as DDRC, Dianova and Premier say they use only auto-disposable syringes. They also follow strict safety guidelines and diligently use incinerators to destroy used needles. The medical waste is collected by an IMA-led agency IMAGE (Indian Medical Association Goes Eco-friendly).

Dr Punnen Kurian Venkadathu, Director of Tropical Institute of Ecological Sciences (TIES), Kottayam feels that there could be some truth in allegations by the government health authorities. "Some private companies sell recycled syringes in bulk for a song to these private labs. If an auto-disposable syringe is sold for Rs.2 [USD 0.036] each in the market, these private companies will recycle the used syringes and sell it for 50 ps [paise - 50 ps is equal to 0.5 rupees, or 0.01 USD] each," says Dr Punnen.

Accreditation of clinical labs is not at present mandatory in the state. A lab can be set up if you have certification from a local body. While many of the premium clinical labs have opted for the voluntary accreditation programme under the National Accreditation Board for Testing and Calibration Laboratories (NABL), several others that operate in rural areas and towns do not have them. The proposed Kerala Clinical Establishments (Registration, Regulation and Accreditation) Bill now plans to make the accreditation mandatory and also has provisions for grading the labs.

[Byline: Lydia Jose]

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[Hepatitis B virus is transmitted between people by contact with the blood or other body fluids (i.e., semen and vaginal fluid) of an infected person. Modes of transmission are the same for the human immunodeficiency virus (HIV), but hepatitis B virus is 50 to 100 times more infectious. Common modes of transmission in developing countries are: perinatal; early childhood infections, inapparent infection through close interpersonal contact with infected household contacts, unsafe injections practices; blood transfusions and sexual contact. Further information can be obtained from the WHO Factsheet at: http://www.who.int/mediacentre/factshee ... index.html.

Hepatitis B is preventable with a safe and effective vaccine that has been available since 1982. This vaccine is 95 percent effective in preventing hepatitis B virus infection and its chronic consequences. Hepatitis B is endemic in many parts of India. Most people in the region become infected with hepatitis B virus during childhood. In these regions, 8-10 percent of the adult population are chronically infected.

Medical malpractice has been frequently reported in India (see ProMED-mail archived reports below). The accusations and counter-accusations related in the above press report suggest that there has been little improvement in the situation. However, adequate supplies of hepatitis B vaccine at affordable cost may be the underlying problem.

Kottayam is a city in the Indian state of Kerala. It is located in central Kerala and is also the administrative capital of Kottayam district. A map of Kerala state, showing the location of Kottayam can be accessed at: http://kottayam.nic.in/. The interactive HealthMap of the Indian state of Kerala can be accessed at: http://healthmap.org/r/28JB. - Mod.CP]
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Denguefieber in Indien

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DENGUE/DHF UPDATE 2012 (30)
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- India (Chikmagalur, Karnataka state). 16 Jul 2012. With the increase in number of dengue cases registered in Chikmagalur, the District Health and Family Welfare Department has taken measures to detect the dengue cases through door to door survey. As many as 18 dengue cases have been registered in the district during the season. In Tarikere taluk 16 cases have been reported so far. Blood tests of 30 persons suffering from the symptoms of dengue of Jaladihalli and Hirekanavangala villages were conducted, of which 12 cases tested positive. When the blood samples of a few persons from Shivani and other villages were tested, 2 dengue cases were detected.
http://www.deccanherald.com/content/264 ... galur.html

[A HealthMap/ProMED-mail interactive map showing the location of Chikmagalur in Karnataka state can be accessed at http://healthmap.org/r/2NN2. - Mod. TY]
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Cholera in Indien und Nepal

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CHOLERA, DIARRHEA & DYSENTERY UPDATE 2012 (33): ASIA
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[1] Cholera - India (Tamil Nadu State)
Date: Sun 22 Jul 2012
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 085659.cms


Even as a 60-year-old woman died of suspected cholera, a Chennai Corporation press release said 18 people were being treated at Kilpauk Medical College (KMC) and 7 others at Communicable Diseases Hospital (CDH) with diarrhea.

But data sourced by TOI from KMC revealed that since Wed 18 Jul 2012, 60 people were admitted to KMC with complaints of loose stools, vomiting and dehydration. The hospital sent 10 people including 4 children to CDH. "Of the 4 children, one has tested positive for cholera in a level one test; 3 others were clinically diagnosed as cases of suspected cholera," said KMC dean Dr P Ramakrishnan, who added that there is no reason for panic. The hospital has been receiving several patients from Chetpet, Ayanavaram and Perambur with symptoms of diarrhea. "We have referred 10 suspected cholera cases to CDH. We have asked Chennai Corporation and Metrowater for further action."

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[2] Cholera - India (Punjab State)
Date: Sat 21 Jul 2012
Source: Hindustan Times [edited]
http://www.hindustantimes.com/Punjab/Pa ... 93116.aspx


As feared, 3 confirmed cases of cholera were reported from Badungar Colony on Fri 20 Jul 2012; 3 people had died on Thu 19 Jul 2012 in the colony due to suspected diarrhea cases. The health department had taken 13 stool samples for cholera. "3 samples have been found positive for cholera. We have taken 14 more stool samples for cholera tests. An ambulance has been permanently deployed in the area till further orders. A team of epidemiologists is also camping in the colony," said Dr VS Mohi, civil surgeon, Patiala.

All the cholera-hit patients have been put under special surveillance in Government Rajindra Medical College and Hospital, he said.

In Sanjay Colony, where more than 100 cases of gastroenteritis were reported last week, 4 patients were found to be suffering from cholera.

Meanwhile, 41 new cases of gastroenteritis were reported from Badungar Colony on Fri 20 Jul 2012. The total number of patients suffering from gastroenteritis in the colony has now reached more than 165.

Patiala deputy commissioner GK Singh and municipal commissioner Gurlavleen Singh Sidhu visited the affected area on Fri 20 Jul 2012. Singh said a medical team was carrying out a door-to-door survey of the area to conduct tests of the patients. Out of 14 samples of water taken from the area following the outbreak of the disease, 4 were found unfit for consumption.

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******
[3] Diarrhea - Nepal (Nuwakot District)
Date: Fri 20 Jul 2012
Source: The Himalayan Times [edited]
http://www.thehimalayantimes.com/fullNe ... sID=340361


The cause of last Tuesday's [17 Jul 2012] diarrhea outbreak in Shikharbesi VDC-4, 7, 8 and 9, with 200 persons taken ill, was believed to be the consumption of cattle meat from a dead cow, said a health worker.

According to a local health volunteer, Sirmendo Tamang, the villagers developed diarrhea in large numbers after they feasted on a dead buffalo's meat at the house of local Kanchho Tamang in Shikharbesi-9 about a week ago.

"Despite my advice, they consumed the meat and began falling sick," Tamang said. Over 200 persons have been taken ill due to the diarrhea outbreak in Shikharbesi VDC-4, 7, 8 and 9 since Tue 17 Jul 2012.

The outbreak came under control by Fri 20 Jul 2012 after a joint team of health workers from the district hospital supported by different local health facilities set up a health camp in the village and began treating the patients.

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[The etiology of this outbreak of diarrheal illness is unclear and could, indeed, be related to eating something else or drinking something rather than the dead buffalo.

Readers should be directed to a nicely written seminar on cholera published in the Lancet recently: (Harris JB, LaRocque RC, Qadri F, Ryan ET, Calderwood SB: Cholera. Lancet 2012;379: 2466-2476) http://www.ncbi.nlm.nih.gov/pubmed/22748592
- Mod.LL]

[The HealthMap/ProMED-mail interactive map of the country is available at http://healthmap.org/r/1COd.]
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Kala-Azar in Indien

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LEISHMANIASIS, VISCERAL - INDIA: (BIHAR)
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Date: Thu 19 Jul 2012
Source: Crofs Blogs [edited]
http://crofsblogs.typepad.com/h5n1/2012 ... bihar.html


Medecins Sans Frontieres (MSF), which provides medical humanitarian aid worldwide, is waging a war against kala azar [visceral leishmaniasis] in Bihar.

Hundreds have benefited since MSF started its project in Vaishali in 2007. In March 2012, the Switzerland-headquartered body formally joined hands with the Bihar government.

A disease transmitted by the sand fly, Kala Azar has killed in the past few decades many hundreds in Bihar, the state worst hit by it. Over 70 people died last year [2011].

Since 1988, MSF has treated more than 100 000 kala azar patients in Sudan, Ethiopia, Kenya, Somalia, Uganda and Bangladesh besides India. Its doctors provide liposomal amphotericin B, a safe and effective drug.

MSF says that it has treated more than 10 000 patients with an initial cure rate of over 98 percent in the last 5 years in Vaishali as well as neighbouring districts.

All treatment is free of cost, says MSF project coordinator Delphine Altwegg. It says it cured around 2000 patients each year in the last 5 years.

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[Kala azar or visceral leishmaniasis is endemic in India. A recent study (Singh N et al. Animal reservoirs of visceral leishmaniasis in Bihar, India. J Parasitol. 2012 Jul 5. [Epub ahead of print]; http://www.ncbi.nlm.nih.gov/pubmed/22765517) found goats to be an important reservoir.

The distribution of leishmaniasis in Bihar has been mapped (Bhunia GS et al. Localization of kala-azar in the endemic region of Bihar, India based on land use/land cover assessment at different scales. Geospat Health. 2012;6:177-93).

More information on leishmaniasis can be found at the CDC and WHO websites (http://www.cdc.gov/parasites/leishmaniasis/index.html, http://www.who.int/leishmaniasis/en/). - Mod.EP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1*O9.]
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Hepatitis B und C in Pakistan

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HEPATITIS B AND C - PAKISTAN: INCIDENCE
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Date: Sat 28 Jul 2012
Source: The International News [edited]
http://www.thenews.com.pk/Todays-News-6 ... -hepatitis

12 million Pakistanis infected with hepatitis
------------------------------------------------------
ISLAMABAD: With a national prevalence of 4.9% for hepatitis C and 2.4% for hepatitis B, Pakistan is currently facing an epidemic of viral hepatitis. According to the World Health Organisation (WHO), 12 million Pakistanis are infected with hepatitis, the major causes for the spread of which include frequent use of
therapeutic injections, re-use of syringes, inappropriate sterilisation practices and poor hospital waste management.

In Pakistan, many patients have lost their lives at the hands of quacks, who are known for mismanagement of hepatitis. "Pakistan needs to institute strictest possible laws to end quackery so that unwary patients don't end up losing their lives. Mismanagement of hepatitis B and C can lead to liver cancer. It is, therefore critical that only qualified specialists be consulted for treatment," Dr. Tashfeen Adam, head of the department of gastroenterology at the Pakistan Institute of Medical Sciences (PIMS) stated on the eve of World Hepatitis Day here on Friday [27 Jul 2012]. He said, there has been a 25% increase in the number of hepatitis patients reporting this year, as compared to last year, and attributed the same to rising public awareness.

Sharing relevant data, PIMS spokesman Dr. Waseem Khwaja disclosed that between 350 to 400 patients suffering from various digestive diseases are treated in the Out-Patient Department of Gastroenterology at PIMS every day. Sixty percent of these patients are diagnosed with hepatitis, and 2% new cases are diagnosed while screening of surgical cases. Moreover, 2300patients have been admitted and treated for complications of hepatitis like bleeding, drowsiness, infections and coma, since January 1, 2012, and five percent of the hospital's emergency is occupied by patients suffering from complications of hepatitis.

Dr. Waseem said, 3500 patients of hepatitis C are receiving free interferon therapy from Zakat and Pakistan Baitul-Mal funds at PIMS. Two types of free interferon injections are being provided to hepatitis C patients. The executive director of PIMS Dr. Mehmood Jamal also stressed the need for patients to consult qualified doctors for treatment of hepatitis.

Research by WHO shows that hepatitis can be acute or chronic, and may result in serious complications or even death. Viral hepatitis affects 1 in every 12 people worldwide. It affects those close to them too. Around 500 million people worldwide are chronically infected with two types of blood-borne hepatitis: hepatitis B and C. Approximately 1 million people die each year from related complications, most commonly from liver diseases including liver cancer.

In the Eastern Mediterranean Region, 17 million people are living today with hepatitis C infection, and approximately 4.3 million people are infected with hepatitis B infection every year.

The key message of World Hepatitis Day is that hepatitis is preventable. Everyone can get this disease, yet it rarely affects those who consciously guard against it. Hepatitis is caused by a group of viruses that infect the liver through either consumption of contaminated food and water or exposure to unsafe blood and infected body fluids.

Everyone has a role to confront hepatitis. At the community and individual level, certain behavioral practices increase the risk of these infections substantially, for example reuse of razor blades and injection syringes, by traditional healers and tattooists and harmful behaviors such as sharing needles and drug abuse. Provision of safe food and water would greatly prevent hepatitis A and E. Within health facilities, screening of blood and blood products, safe injection practices and clean dental work can significantly reduce the risk of infection from hepatitis B and C.

On the occasion of World Hepatitis Day, WHO's Regional Director for the Eastern Mediterranean Dr. Ala Alwan has urged policy-makers, civil society, and health professionals to combine efforts to confront this silent epidemic. In a message, Dr. Alwan has drawn attention to the fact that the chronic nature of hepatitis B and C infection calls for strong focus on screening, care and treatment. "With early detection and appropriate management, it is possible to change the quality of life of millions of people who are living with this disease," he has stressed.

(By Shahina Maqbool)

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[Viral hepatitis is the leading cause of liver cancer and cirrhosis worldwide. Approximately 1 in 12 persons, or around 500 million people, have chronic viral hepatitis and most of them do not know they are infected. In order to raise awareness of this hidden epidemic, the World Health Assembly and the President of the United States designated July 28th as World Hepatitis Day in 2012.

This report describes commendable efforts to combat hepatitis C virus infection in Pakistan, whereas the incidence of hepatitis B remains very high despite the availability of a cheap and effective vaccine. Implementation of routine vaccination for hepatitis B has drastically decreased rates of new infection in some areas of the world. Yet despite the availability of the hepatitis B vaccine, only about 1 in 5 infants globally receive the hepatitis B vaccine at birth, which is necessary to prevent mother's infected with hepatitis B from spreading it to their newborns.

A HealthMap/ProMED-mail interactive map of Pakistan can be seen at http://healthmap.org/r/1orI. - Mod.CP]
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Cholera in Indien

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CHOLERA, DIARRHEA & DYSENTERY UPDATE 2012 (35): ASIA
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Cholera - India (Punjab State)
Date: Fri 27 Jul 2012
Source: IBN [edited]
http://ibnlive.in.com/generalnewsfeed/n ... 29273.html


At least 117 gastroenteritis patients were admitted to the Civil Hospital at Dasuya in Punjab where spread of cholera and gastroenteritis cases was reported in some districts. Senior Medical Officer of the Civil Hospital Dr Naresh Kansra said the number of gastroenteritis patients in the hospital had increased to 117 today from 79 on 26 Jul 2012. A 2-year-old child in a critical condition was referred to the Institute of Medical Sciences, Jalandhar, the SMO said. Meanwhile, 64 of the admitted patients had been discharged today [27 Jul 2012], Kansra said, adding that 3 mobile teams of medical staff were attending to the patients in the hospital.

Meanwhile, the Municipal Council (MC) had replaced the leaking water supply pipes which were considered to be the main cause for spread of gastroenteritis. The MC was also supplying potable water through water tankers in the area as a precautionary measure, officials said. Dr Sardul Singh, SMO Civil Hospital here at Hoshiarpur, said that out of 10 seized water samples from the hospital wards, 9 were found un-potable. Out of 4 stool samples collected, he said, the _Vibrio cholerae_ bacterium was confirmed in 2 of them. Cholera had claimed the lives of 3 persons in Patiala district of Punjab recently.

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Japanische Enzephalitis in Indien - Uttar Pradesh

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JAPANESE ENCEPHALITIS AND OTHER - INDIA (12): UTTAR PRADESH
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Date: Mon 30 Jul 2012
Source: Punjab Newsline [edited]
http://www.punjabnewsline.com/content/c ... -146/53676


A 9-year-old child succumbed to encephalitis here taking the toll in the viral disease in eastern Uttar Pradesh to 146 this year [2012], health officials said here today [30 Jul 2012].

According to Additional Director (Health) Diwakar Prasad, the child from Mahrajganj district succumbed to the disease at BRD Medical College Hospital yesterday [29 Jul 2012].

He said that 18 new patients afflicted with suspected encephalitis have been admitted to the BRD MCH yesterday while 69 are being treated in different government hospitals of the region.

A total 756 encephalitis patients were admitted to these hospitals in the current year [2012], of which 146 died, Prasad said, adding that the dead include 19 patients from Bihar and one from Nepal.

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[The number of patients hospitalized with a diagnosis of encephalitis have climbed from 658 on 12 Jul 2012 (see ProMED-mail archive number 20120714.1201337) to 756 and fatalities from 129 to 146 as of 30 Jul 2012, a little over 2 weeks later. No etiological agent responsible for the above cases is mentioned in the current report, but the 12 Jul 2012 report indicated that at least 90 per cent of the cases were reported to be of an undiagnosed acute encephalitis syndrome that is caused by the viruses present in contaminated water, while remaining 10 per cent of cases were due to Japanese encephalitis virus (JEV) infections. As is usual in these reports, no mention is made of the vaccination status of the population for JEV in Uttar Pradesh and Behar states, where these cases most commonly occur.

A HealthMap/ProMED-mail interactive map showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/01r4. - Mod.TY]
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Denguefieber in Pakistan und Indien

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DENGUE/DHF UPDATE 2012 (31)
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- Pakistan (Karachi, Sindh province). 30 Jul 2012. At least 21 patients suffering from dengue fever have been admitted to the hospitals within a period of one week, Sindh Health Department's Dengue Surveillance Cell revealed. A total of 126 dengue cases have been reported since January of this year [2012]. The data is collected from hospitals registered with the government and update the concerned authorities on the matter regularly.
http://www.geo.tv/GeoDetail.aspx?ID=61255

[A HealthMap/ProMED-mail interactive map showing the location of Karachi in Sindh province can be accessed at http://healthmap.org/r/1kc-. - Mod.TY]

- India (Bengaluru (Balgalore), Karnataka state). 29 Jul 2012. Saturday [28 Jul 2012], 2 more people succumbed to dengue fever in the city, taking the death toll so far to 7.
http://www.deccanchronicle.com/channels ... s-city-617

[A HealthMap/ProMED-mail interactive map showing the location of Bangalore in Karanataka state can be accessed at http://healthmap.org/r/1Hg8. - Mod.TY]

- India (Delhi). 24 Jul 2012. On Monday [23 Jul 2012], 2 new cases of dengue were reported in the city, taking the total count of [deaths from] the mosquito-borne disease [virus] to 8 this season.
http://articles.timesofindia.indiatimes ... ito-dengue

[A HealthMap/ProMED-mail interactive map showing the location of Delhi can be accessed at http://healthmap.org/r/01Jf. - Mod.TY]
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Denguefieber in Pakistan und Indien

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DENGUE/DHF UPDATE 2012 (32)
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- Pakistan (Karachi, Sindh province). 3 Aug 2012. As of Friday [3 Aug 2012] 4 more dengue cases were reported in Karachi, making the total number of dengue cases reported in the city, as well as Sindh province, this year 134; all these cases are reported in Karachi.
http://www.brecorder.com/pakistan/gener ... achi-.html

- India (Mumbai, Maharashtra state). 2 Aug 2012. In the past 2 weeks, 3 dengue deaths have occurred. Only 3 cases of dengue were reported in the city in June. In July, the number jumped to 62.
http://www.hindustantimes.com/India-new ... 06791.aspx

Gruß
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