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UNDIAGNOSED FEBRILE ILLNESS - INDIA: (TAMIL NADU) REQUEST FOR INFORMATION
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Date: Sun 9 Dec 2012
Source: FluTrackers [summ., edited]
http://www.flutrackers.com/forum/showth ... p?t=196136


[FluTrackers has posted a series of reports of febrile disease in Tamil Nadu (machine translated from Tamil) as follows:]

Date: Wed 5 Dec 2012
Source: Maalaimalar [summ., edited]
http://www.maalaimalar.com/2012/12/0514 ... death.html


A 5 year old girl and a 10 month old baby died of a mysterious fever in hospital.

******
Date: Wed 5 Dec 2012
Source: Tamil Murasu [summ., edited]
http://www.tamilmurasu.org/Inner_Tamil_ ... ?Nid=37549


A 6 year old girl and a 10 month old baby girl [same one as above?] died of a fever.

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Date: Fri 7 Dec 2012
Source: Maalaimalar [summ., edited]
http://www.maalaimalar.com/2012/12/0717 ... class.html


A 6 year old girl died in Melur Government hospital. So far, 52 people have died.

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Date: Sat 8 Dec 2012
Source: Maalaimalar [summ., edited]
http://www.maalaimalar.com/2012/12/0812 ... -deat.html


A 32 year old man died of fever.

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Date: Sat 8 Dec 2012
Source: Dinamalar [summ., edited]
http://www.dinamalar.com/News_Detail.asp?Id=601432


A 68 year old woman died of a fever in the Madurai government hospital. The fever has hit 5 people.

--
communicated by:
Ronan Kelly
<ronankelly@comcast.net>

[Other reports in this string, but not given above, start on 2 Dec 2012 and end on 17 Dec 2012. One report indicates that 20 people have been affected by the febrile disease, but an earlier report above indicates that there are 52. Some of the earlier reports mention "flu", but most do not.

The etiology of these cases apparently has not been determined. ProMED-mail would appreciate receiving more details, and especially laboratory results, as they become available.

A HealthMap/ProMED-mail interactive map showing the location of Tamil Nadu state can be accessed at http://healthmap.org/r/2kP3. - Mod.TY]

.................................................dk/ty/mj/sh

JAPANESE ENCEPHALITIS AND OTHER - INDIA (21): (UTTAR PRADESH)
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Date: Wed 19 Dec 2012
Source: Rediff [edited]
http://www.rediff.com/news/report/encep ... 121219.htm


With one more child succumbing to encephalitis, the death toll in the viral disease has mounted to 588 in eastern Uttar Pradesh this year [2012].

The child, hailing from Siddharthanagar, succumbed to the disease at BRD Medical College Hospital [in Gorakhpur] yesterday [19 Dec 2012], officials said on Wednesday [19 Dec 2012]. As many as 43 patients suffering from encephalitis are being treated at the hospital.

3494 patients of Japanese encephalitis and acute encephalitis syndrome have been admitted to different government hospitals of Gorakhpur and Basti divisions this year [2012], among whom 588 have died.

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[The number of fatal cases in Uttar Pradesh and nearby states has continued to climb steadily since June of this year (2012). As of 4 Oct 2012 there were 433 reported fatal cases and now that total has increased to 588 as reported above. The etiology of these encephalitis cases is not mentioned in the report above, but an article in the Times of India on 22 Oct 2012 indicated that with waterborne acute encephalitis syndrome (AES) now making up close to 95 per cent of the encephalitis cases across eastern Uttar Pradesh, there is a renewed focus on the water the area's children are drinking (see ProMED-mail archive no 20121023.1360246). Earlier reports attributed some or all of the encephalitis cases to Japanese encephalitis virus (JEV) infections. Still other reports associated the cases with polluted water, suggesting enterovirus infections. The JEV vaccination status of these cases has never been given in this or prior reports.

An interactive HealthMap/ProMED-mail map of India showing the location of Gorakhpur, Uttar Pradesh state, can be accessed at http://healthmap.org/r/3h8J. - Mod.TY]

DENGUE/DHF UPDATE 2012 (69): ASIA
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- India. 20 Dec 2012. Dengue, cities most affected: Kolkata 3321 cases, Chennai 988 cases, Mumbai 907 cases; Dengue virus most common type 2.
http://myhealthbowl.com/latest-health-n ... -in-india/

[Maps of India can be seen at
http://www.mapsofindia.com/maps/india/i ... al-map.htm and
http://healthmap.org/r/1pSH. - Mod.TY]

LEISHMANIASIS - PAKISTAN (03): (KHYBER)
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Date: Fri 28 Dec 2012
From: Mubashir Khan <mubashirbangash@gmail.com> [edited]


Unfortunately, cutaneous leishmaniasis (CL) cases are widespread in different parts of Khyber Pakhtunkhwa province of Pakistan.

This province is one of the backward and remote provinces of Pakistan. The CL cases have been reported from all over this province throughout the year [2012]. Khyber agency is about 100 km from Kohat, where I am based and working on leishmaniasis.

During my PhD, I worked on CL in 3 districts of this province, Kohat, Karak, and Hangu. There are hundreds of cases in all of these 3 districts plus hundreds of extra cases which remain unnoticed.

It is very unfortunate that there is no case recording system for leishmaniasis being practised in any of the government or private hospitals of Pakistan, so hundreds of cases remain unnoticed. The toll of CL in this province is increasing day by day.

I have done molecular identification of leishmania species in these districts by PCR and RFLP [restriction fragment length polymorphism]. _L. tropica_ is the prevailing species in this part of Pakistan. _L. major_ was also characterized in some of the samples, but most of such patients with _L. major_ had travel history to Afghanistan and some endemic parts of Pakistan, like Balochistan and Sindh province, where _L. major_ is the prevalent species. Moreover, sand flies have been trapped in the study districts, and we need to identify the species. The mass movement of internally displaced people (IDPs) from tribal areas (military operation zones) of Khyber Pakhtunkhwa province has resulted in bringing the infection to urban areas of this province.

There is another very important issue which I want to highlight here, which is the unavailability of specific treatments (Glucantime injections, Sanofi Aventis Co.) in local hospitals. These injections are very expensive (about 2000 Pakistani rupees [USD 20] for one box containing 5 ampules of 5 cc each, and the average cost for full treatment is up to USD 80.

The expense of treatment depends upon the severity and the number of lesions. Poor people are unable to afford the high cost of this medicine, which is not registered in Pakistan and is usually smuggled in from Afghanistan or provided to some health authorities by WHO in limited amounts, not accessible to poor people.

We want help from international agencies if somebody can help us in this regard. We have personally treated about 100 patients free of charge, and they were successfully treated by Glucantime injections (special thanks to Dr. Kasbari Mohammad, Agency for Food, Environmental and Occupational Health Safety (ANSES), France for his personal efforts and financial help).

I am already working under the kind supervision and guidance of Dr. Kasbari Mohammad (ANSES, France), who has trained me in leishmaniasis research. We need further help from scientific people who can collaborate with our university in scientific research, as there are many areas untouched in this part of Pakistan, and also, unfortunately, we don't have too many experts in this field in Pakistan.

--
Dr. Mubashir Hussain
Ph.D, M.Phil, DVM (Gold Medal)
Lecturer, Department of Microbiology
Kohat University of Science & Technology (KUST)
Kohat, 26000, Pakistan
<mubashirbangash@gmail.com>

[ProMED-mail thanks Dr Hussain for these important data on leishmaniasis in the tribal regions of Pakistan.

It is well known that leishmaniasis was increasing dramatically in Afghanistan under the Taliban regime (see ProMED reports below), and it is no surprise that in the difficult situation in Pakistan [across the international border] with internally displaced persons, leishmanisis is not under control there either.

ProMED is happy to relay Dr Hussain's request for support and his contact information. - Mod.EP

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

LEPROSY - PAKISTAN: (SINDHI)
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Date: Thu 20 Dec 2012
Source: The News International [edited]
http://www.thenews.com.pk/Todays-News-4 ... -KMC-chief


The administrator of Karachi Metropolitan Corporation (KMC), Muhammad Hussain Syed, has said that 40 per cent of up to 500 people, who got infected with leprosy every year in the country, belonged to Karachi. So it is totally wrong to state that this disease has been spreading in only colder regions or the north of the country.

During a visit to Marie Adelaide Leprosy Centre in Saddar on Wednesday [19 Dec 2012], the administrator of KMC said that Pakistan had been able to overcome the leprosy epidemic and the figure had decreased to 400 to 500 victims annually. The KMC chief announced a Rs1 million [USD 10 270] grant to Marie Adelaide Centre for rendering valuable services in the field. He said that India ranked number one on the list of countries with patients as every year some [126 000] people there contracted infected with the disease every year. Brazil was second on the list, he said.

He said that the World Health Organization (WHO) had been cooperating in various countries, including Pakistan, for free-of-cost treatment for leprosy patients. He said that at the outset of proper treatment for the skin disease, large ratio of the infecting bacteria died out while the chances of transmission to people in the surroundings of the infected person also decreased.

He said that in case of ill-treatment and lack of attention, bacteria of chronic disease had the ability to get transmitted to people in the immediate surroundings of the patient. He said that guardians and elders of persons suffering from leprosy should immediately consult a doctor in order to avoid disability. He said that leprosy is a 100 per cent curable disease but the aliment should be properly diagnosed and followed by speedy treatment. The KMC administrator, on the occasion, praised the services of Dr Ruth Pfau in the treatment and arrest of leprosy disease in the country.

The chief executive of the Leprosy Centre, Mervyn Lobo, in his briefing on the occasion said that Marie Adelaide had been running 170 centres in Pakistan and Azad Kashmir for treating thousands of leprosy patients along with patients suffering from tuberculosis. The Marie Adelaide Centre in Saddar had the ability to admit 34 patients at a time and rendered treatment free-of-cost.

The administrator offered to assist the management of the Marie Adelaide Leprosy Centre to open up more leprosy treatment centres in the Landhi, Korangi, and North Karachi.

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[Leprosy is a chronic disease caused by a bacillus, _Mycobacterium leprae_ (http://www.who.int/mediacentre/factsheets/fs101/en/). _M. leprae_ multiplies very slowly and the incubation period of the disease is about 5 years. Symptoms can take even as long as 20 years to appear. Although leprosy is not highly contagious, because patients with the lepromatous form of leprosy excrete enormous numbers of leprosy bacilli in their nasal secretions (that is, are multibacillary), a patient with untreated lepromatous leprosy poses increased risk for transmission of the infection to close, long-term contacts, such as household members. As the organism is also present in skin lesions in these patients, skin contact is thought to be another mode of spread. Because the organisms that are shed by lepromatous patients can persist on surfaces in the environment, fomites are also a potential source of infection. Casual and short-term contact does not seem pose a risk for spread the disease.

Leprosy is treated with dapsone, rifampin, and clofazimine. These drugs are provided by WHO free to all patients in the world since 1995; see http://www.novartis.com/corporate-respo ... rosy.shtml. Patients are no longer infectious after the 1st dose of the treatment regimen. Patients with paucibacillary leprosy treated with rifampin and dapsone are cured within 6 months and multibacillary patients treated with rifampin, dapsone, and clofazimine are cured within 12 months. Between 1985 and 2005, more than 15 million leprosy cases were cured globally.

Pakistan belongs to the WHO Eastern Mediterranean Region (EMR), which reports only a small proportion of the global new leprosy cases. Leprosy has been eliminated as a public health problem (that is, has a prevalence of less than 1 case per 10 000 population) from all countries of the EMR, except South Sudan (http://www.emro.who.int/health-topics/leprosy/). Some countries in the EMR still have a few districts that have not achieved elimination, such as Sudan, Egypt, and Yemen. South Sudan is the only country from the EMR among the 17 countries globally reporting more than 1000 new cases annually. Sudan, Egypt, Pakistan, and Yemen report between 300 and 900 new cases per year. Morocco, Afghanistan, Islamic Republic of Iran, and Somalia report fewer than 100 new cases annually.

India, Brazil, and Indonesia are the 3 countries that have the greatest number of leprosy cases. The top 10 countries in new case detections in 2005 are India, Brazil, Indonesia, DR Congo, Bangladesh, Nepal, Mozambique, Nigeria, Ethiopia, and Tanzania. Together, they constitute about 96 per cent of year 2005's global new case detections.

WHO emphasizes that sustained political commitment and adequate resources for leprosy services are required, especially for currently under-served population groups such as remote rural areas, urban slums, migrant labor, to sustain elimination at national levels, and progress towards further reducing the burden of leprosy. Also strengthening integration of leprosy services into the general health system through capacity building and skill development is required to ensure and sustain quality leprosy services, including diagnosis and treatment and prevention/care of disabilities (http://www.who.int/lep/resources/SEAGLP20062.pdf).

Karachi is a coastal city in the south of Pakistan, with an estimated population of 21 million people in 2012. It is the world's largest city in terms of population, and is Pakistan's main seaport and its centre of banking, industry, economic activity and trade, as well as the capital of the province of Sindh (http://en.wikipedia.org/wiki/Karachi).

Pakistan may be found on the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/2NT8. - Mod.ML]

DENGUE/DHF UPDATE (01): ASIA
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- India (Pune, Maharashtra state). 4 Jan 2013. Dengue deaths since 15 Aug 2012, 15; 15 Dec 2012 to date, 3.
http://timesofindia.indiatimes.com/city ... 879960.cms

[Maps of India can be seen at http://www.mapsofindia.com/maps/india/i ... al-map.htm and http://healthmap.org/r/2gZV. - Mod.TY]

CHIKUNGUNYA (01): INDIA (ODISHA)
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Date: Sun 6 Jan 2013
Source: Business Standard, Press Trust of India report [edited]
http://www.business-standard.com/genera ... am/105340/


Chikungunya disease has resurfaced in Ganjam district of Odisha, prompting health officials to gear up to prevent its spread.

At least 4 persons have tested positive for chikungunya so far at Bichhanapalli village under Ganjam block, official sources said today [6 Jan 2013]. "Blood samples sent to the microbiology department of MKCG Medical College and Hospital have tested positive for chikungunya [virus or antibody?]," said additional district medical officer (public health) LK Rath.

[The] outbreak of chikungunya in Bichhanapalli was reported when a number of people complained of fever with joint pain. A team of doctors from Berhampur visited the village and collected blood samples for testing as the clinical symptoms of the patients pointed to mosquito-borne viral disease.

Rath, however, said there is no need to panic as no fresh case of fever has been reported from the village. A team of doctors, led by district malaria officer (DMO) US Mishra along with paramedics visited the area 2 days ago to treat affected persons and sensitise people about the disease.

The main reason for outbreaks of chikungunya, malaria, dengue, and Japanese encephalitis is water stagnation, in which larvae originate and spread infection, said a doctor. People should take steps to prevent water stagnation to prevent breeding of mosquitoes, he added.

The team also created awareness to destroy stagnant water and dry water-logging spots in the village, said the DMO. "The diseases are under control as health officials have taken several steps to prevent their spread," Mishra said.

While the district reported over 500 dengue cases in 2012, around 30 people mostly from Boxipalli, a predominantly fisherman village in the district, suffered from chikungunya [virus infections].

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[These 4 or more 2013 cases of chikungunya virus infections may be a continuation of the 2012 outbreak in the same locality mentioned in the report above. Chikungunya virus is endemic in India and cases appear sporadically in diverse locations, such as the Ganjam district. If the chikungunya virus vector mosquitoes, _Aedes aegypti_, are present, as is likely, the occurrence of additional cases can be expected unless the vector control efforts are effective. There is no commercially available chikungunya virus vaccine.

A HealthMap/ProMED-mail map showing the location of Odisha state can be accessed at http://healthmap.org/r/4Jpq and a map showing the location of Ganjam district at http://en.wikipedia.org/wiki/Ganjam. - Mod.TY]

DENGUE/DHF UPDATE (05): ASIA
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- India (Punjab state). 21 Jan 2013. Dengue deaths in 2012, (conf.) 8 cases. http://punjabnewsline.com/news/Punjab-b ... ittal.html

[Maps of India can be seen at http://www.mapsofindia.com/maps/india/i ... al-map.htm and http://healthmap.org/r/1pSH. - Mod.TY]

Indien - Pilgerreise
22.01.2013

Von Mitte Januar bis Ende Februar findet in Allahabad (Uttar Pradesh, N) die große Kumbh Mela statt. Dies ist die weltgrößte religiöse Veranstaltung, insgesamt werden etwa 100 Millionen Pilger und ca. 1 Million Touristen aus dem Ausland erwartet. Impfschutz (auch Meningokokken, Typhus und Cholera) und, soweit möglich, persönliche Hygiene beachten. / Quelle: crm

Gruß
Birgitt

MALARIA - INDIA: (GOA, ANDHRA PRADESH)
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[1] Goa

Date: Sat 26 Jan 2013
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 191019.cms


A few malaria cases have been reported among the local population and staff of barges anchored at the dry docks along the Zuari river at Cortalim (Goa).

Health authorities have cautioned the vessels' owners and others to maintain hygiene in the area. A press note issued by the Cortalim primary health centre (PHC) states that the Captain of Ports has been informed about the large number of vessels docked along the riverfront of the village due to the halt in mining operations in Goa.

The hanging tyres on the sides of the barges filled with water are the perfect breeding grounds for mosquitoes, and this has led to some barge workers and locals contracting malaria, the note states.

Cautioning against the consequences of not maintaining hygiene in the area, the note stresses: "This will lead to serious consequences if the rate of infection goes on increasing." All owners, masters of barges, shipyards, dry docks, passenger launches and other fishing trawlers have been advised to prevent stagnation of water in such tyres. "The simplest way could be to drill a hole at the bottom of the tyres so that the water drains out," the statement concludes.

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[2] Andhra Pradesh
Date: 13 Jan 2013
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 963020.cms


Poor vector-control measures by Greater Hyderabad Municipal Corporation (GHMC) have led to a massive rise in malaria cases in the twin cities, experts said on Wednesday [9 Jan 2013]. Hyderabad recorded 51 malaria cases in December 2012 against 5 cases in the previous year.

What has been more disconcerting for authorities is that there were 9 cases in the last 9 days alone, official records from the malaria wing of the Directorate Of Health states. "Normally, during November and December, the mosquito-borne diseases decline, but the high numbers this year [2013] only reflect that the vector control measures such as spraying are not being taken care of adequately," said a general physician, who has seen several cases in the last week.

Experts said mosquitoes are breeding despite the fact that there were no unusual rains this season. "The malaria parasite disappears over the winter, but in Hyderabad, the mosquito-borne disease is continuing to haunt people," said another specialist.

The majority of cases are being reported from the Old City and Amberpet, said Dr D Shalini Devi, chief medical officer, GHMC. "Areas along the Musi belt are contributing to the high numbers. We have conducted medical camps in these areas," said Dr Shalini. She said during the month of January [2013], a total of 13 malaria cases were reported. However, residents claim that no action is being taken by the GHMC despite complaints. They also said that the Old City remains the most neglected area when it comes to healthcare services.

"We have not seen a single medical camp being organised in our area in Puranapul. We have been complaining to the officials about the mosquito menace in our area, but no action has been taken," said M Mallanna, a local trader. Amberpet, Bahadurpura, Uppuguda, Vattepally, Toli Chowki, Hakimpet, Seven Tombs, Golconda, and Mehdipatnam are some of the areas that continue to suffer from the mosquito menace.

Last year [2012] during the monsoon season, the government organised several anti-malaria campaigns in the city, where they highlighted how mosquito-borne diseases like malaria, dengue and chikungunya can be controlled by effective measures taken by residents. Officials said public participation is required to control the spurt of vector-borne diseases, but people generally do not bother clearing stagnant water or cleaning coolers regularly.

Malaria is among the top 5 killer diseases which affect millions of Indians every year, and despite several measures undertaken by the central government, the menace continues.

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[Goa is a major tourist destination, and the report demonstrates that there is a human reservoir, and once the transmission potential increases, the numbers of human cases also increase. Hyderabad, Andhra Pradesh is usually considered a low risk area for malaria. Both reports emphasize that malaria is still a public health concern in India. - Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2JK1.]

DENGUE/DHF UPDATE (07): ASIA
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- India (Pune, Maharashtra state). 23 Jan 2013. Dengue 32 cases; Deaths 2.
http://timesofindia.indiatimes.com/city ... 142560.cms

[Maps of India can be seen at
http://www.mapsofindia.com/maps/india/i ... al-map.htm and
http://healthmap.org/r/1pSH. - Mod.TY]

HEPATITIS C - INDIA: (JAMMU AND KASHMIR), REQUEST FOR INFORMATION
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Date: Tue 29 Jan 2013
Source: Kashmir Times [edited]
http://www.kashmirtimes.com/newsdet.aspx?q=11631


The outbreak of hepatitis C in a remote village of Takiya-Magam, Kokernag has not only created panic among the residents of the area but has also left the health experts in a state of worry as they are yet to find out its exact cause.

After the reports that out of more than 1000 samples taken from the village during last 2 weeks 300 people have tested positive, a team of health and drug officials today [29 Jan 2013] visited the village and educated the people about the precautions to be taken to avoid catching the virus.

Chief Medical Officer [CMO], Anantnag Dr Gulzar, confirming the outbreak of the viral disease in the village, said they are trying to arrive at the exact source of the epidemic. "There could be many reasons for the spread of the disease, including the use of [contaminated] needles and sexual intercourse, but as far as the number of people having been infected so far is concerned, we cannot conclude that these could be the only reasons. We, too, are surprised over the spread of the virus at such an alarming pace," the CMO said. He further said 30 percent of the cases having acquired the virus have never been administered injection. "We talked to most of the people suffering from the disease, but most of them said that they have never been injected in their lives. So, we too are surprised as to what actually led to it," the CMO added.

He said that he along with a team of experts today [29 Jan 2013] rushed to the village to educate the people about the do's and don'ts. "Keeping the alarming situation in consideration, we have started a campaign in the whole area to make the people aware about the precautions to be taken," the CMO said.

Though the chemists operating in the area are being blamed for the spread of the epidemic by some locals, the officials say that they have not found any evidence against the chemists which could suggest their involvement.

"After the detection of several cases of hepatitis C in the village earlier this month [January 2013], a team of drug officials headed by assistant drug controller Anantnag rushed there and suspended the licenses of all the 3 medicates of the village for 10 days. However, during the investigations, none of them was found involved in [any] kind of mischief. Later, it was on the demand of the people of the village [that] all the 3 medical shops had to be unlocked by the district drug authorities," said a drug official wishing anonymity.

Meanwhile, the Pharmacists Association Anantnag said the pharmacists are being targeted under a well planned conspiracy. "Some cases had been detected in the area 3 years back, and the health authorities were in slumber during all these years. Now, when the epidemic has engulfed the whole village, the authorities, in order to save their necks, started putting blame on the pharmacists. If any of the pharmacists are found involved in some kind of mischief, the association will not leave it to the government but will itself burn down his shop. I can tell you with confidence that it is only an attempt to victimise the pharmacists of the village," said president of the Pharmacist Association, Majid Majeed.

Villagers have accused the authorities of leaving the entire populace of the village at the mercy of the chemists. "The village [comprises] at least a population of 7000, but so far, the authorities have not bothered to establish even a small dispensary in the area. Last time, when their shops were closed by the authorities, we had to approach the administration for unlocking their shops as there is no other option for the patients of the area. Now, if the authorities blame them for the spread of the epidemic, then why did they not bother to set up even a small health center in the village," said Sarpanch of the village.

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[Jammu and Kashmir is the northernmost state of India. It is situated mostly in the Himalayan mountains. Jammu and Kashmir shares a border with the states of Himachal Pradesh and Punjab to the south and internationally with the People's Republic of China to the north and east, and the Pakistan-administered territories of Azad Kashmir and Gilgit-Baltistan to the west and northwest, respectively. Formerly a part of the erstwhile Princely State of Kashmir and Jammu, which governed the larger historic region of Kashmir, this territory is disputed among China, India and Pakistan. Pakistan, which claims the territory as disputed [1] refers to it alternatively as Indian-occupied Kashmir or Indian-held Kashmir, while some international agencies such as the United Nations [2] call it Indian-administered Kashmir. The regions under the control of Pakistan are referred to as Pakistan-occupied Kashmir or PoK within India and Pakistan-administered Kashmir generally.

Jammu and Kashmir consists of 3 regions: Jammu, the Kashmir valley, and Ladakh. Srinagar is the summer capital, and Jammu is the winter capital. A map of Jammu & Kashmir can be accessed at: http://www.satp.org/satporgtp/publicati ... ticle1.htm.

Hepatitis C is a contagious liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C virus is usually spread when blood from an infected person enters the body of a susceptible person. It is among the most common viruses that infect the liver.

Hepatitis C virus is most commonly transmitted through exposure to infectious blood. This can occur through receipt of contaminated blood transfusions, blood products and organ transplants, injections given with contaminated syringes and needle-stick injuries in health-care settings, injection drug use, and being born to a hepatitis C-infected mother. Hepatitis C may be transmitted through sex with an infected person or sharing of personal items contaminated with infectious blood, but these are less common. Hepatitis C is not spread through breast milk, food or water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person.

The origin of the virus responsible for the outbreak affecting this village in Jammu and Kashmir has not yet been determined, and the outcome of further investigation is awaited. - Mod.CP

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

Indien - Malaria
01.02.2013

In Hyderabad (Andhra Pradesh, SO) wurden im Dezember 2012 51 Malaria-Fälle registriert. Dies ist für die Region und Jahreszeit ungewöhnlich hoch, im Vorjahr wurden im gleichen Zeitraum 5 Fälle gemeldet. In 2012 wurden landesweit mehr als 570.000 Fälle registriert, 157 Personen sind an Malaria gestorben. Auch in großen Städten (Delhi, Mumbai) ist ein guter Mückenschutz wichtig, da in Indien nicht nur im ländlichen Bereich Malaria-Erkrankungen auftreten. In ganz Indien sank die Zahl der bestätigten Malaria-Fälle/Jahr von ca. 2. Mio. im Jahr 2000 auf ca. 0,6 Mio. im Jahr 2012 ab, die Zahl der malariabedingten Todesfälle stieg leicht an. In ganz Indien wurden in 2011 offiziell etwa 1.278.760 Fälle bestätigt. Mindestens 463 Menschen sind an der Erkrankung verstorben. Es ist davon auszugehen, dass die tatsächlichen Fallzahlen mehrfach höher sind. Sehr guter Mückenschutz ist daher immer zu beachten, die Mitnahme einer Notfallmedikation (standby-Therapie) in der Regel sinnvoll und je nach Ausbruchslage und Risikoprofil auch eine Chemoprophylaxe zu diskutieren. / Quelle: crm

Gruß
Birgitt

DENGUE/DHF UPDATE (10): ASIA
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- India (Pune, Maharashtra state). 1 Feb 2013. Dengue 36 cases; Deaths 3. Decreasing; Predominant virus dengue 2, but types 1, 3, 4 present.
http://timesofindia.indiatimes.com/city ... 282763.cms

RABIES - INDIA: (GOA) CANINE, HUMAN
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Date: Mon 11 Feb 2013
Source: The Times of India, Goa [edited]
http://timesofindia.indiatimes.com/city ... 439519.cms


A 6 year old girl from Margao was diagnosed with rabies infection on Sunday [10 Feb 2013] at the Hospicio Hospital, Margao and is now undergoing treatment in an isolation ward. Confirming the diagnosis, the officiating medical superintendent of the hospital, P D Nasnodkar, said that although he was not aware of all the facts of the case, it appears that the patient had not received anti-rabies vaccine following a dog bite. The incident has caused a sense of alarm among the residents over the steep increase in the rise of the stray dog population in the city.

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[The incubation period for rabies is typically 1-3 months but may vary from under one week to over a year. The initial symptoms of rabies virus infection are fever and often pain or an unusual or unexplained tingling, pricking, or burning sensation (paraesthesia) at the site of the wound. Post exposure prophylaxis (PEP) consists of local treatment of the wound initiated as soon as possible after exposure, a course of potent and effective rabies vaccine that meets WHO recommendations, and the administration of rabies immunoglobulin, if indicated. Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death (see: http://www.who.int/mediacentre/factshee ... index.html).

As the unfortunate child in Margao, Goa is already exhibiting signs and symptoms of disease and has not received post exposure prophylaxis, her prospects of survival are poor.

A map of the Indian state of Goa ca be accessed at http://www.mapsofindia.com/maps/goa/goatourist.htm. - Mod.CP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2JK1.]