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Cholera in Iran

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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (56): ASIA
*********************************************************
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*****

Cholera - Iran
Date: Thu 10 Oct 2013
Source: World Bulletin [edited]
http://www.worldbulletin.net/?aType=hab ... eID=120341


Some 214 cholera infection cases have been registered in Iran, Mohammad Nabavi, an official with the Center for Disease Management of the Ministry of Health and Medical Education said on Wed 9 Oct 2013. Nabavi added that 38 of the patients were Iranian citizens, the Fars news agency reported. He went on to note that 175 Afghans and one Pakistani citizen were also infected with cholera. "6 patients died from the infection," Nabavi said, adding that they were all illegal migrants.

On 25 Sep 2013, Iranian media outlets reported that cholera infection had spread to 10 provinces in Iran. The head of the Center for Disease Management of the Ministry of Health and Medical Education, Mohammad Mehdi Gouya, said that the infected persons are illegal migrants from bordering countries to the east [Afghanistan & Pakistan are across the eastern border of Iran, and both countries have had cholera this year (2013) -- see ProMED archives (33) & (50) below). - Mod.JW. Gouya added that cases of infection with cholera were registered in the provinces of Sistan-Balujestan and Kerman.

According to Iranian media outlets, cholera infection cases in Iran have been being registered for nearly 45 years. In 2012, 15 such cases were registered.

--
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[An interactive HealthMap of the country can be found at: http://healthmap.org/r/1Cfu. - Mod.LL]
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Malaria in Indien

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MALARIA - INDIA (02): UPDATE
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[1]
Date: Thu 9 Oct 2013
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 816607.cms


Malaria is turning virulent (severe), as doctors at PGI [Post Graduate Institute of Medical Education and Research] and Government Medical College and Hospital (GMCH) are coming across complicated symptoms, including renal failure, following the ailment. The condition is no more limited to chills and fever. The disease is also bringing along dengue-like dips in platelet counts and jaundice.

Besides Chandigarh, cases are pouring in from Karnal, Kurukshetra, Ropar, Yamunanagar, Kaithal and Saharanpur (UP), among others.

In the last 2 months [Aug-Sep 2013], 1148 samples have been collected from the 2 hospitals. "Of these, we found 30 positive for malaria. We have to get other tests and analyses done," said Dr Rakesh Sehgal, main investigator, PGI department of medical parasitology.

_Plasmodium vivax_ is the most common malaria found in India with a 50-80 percent prevalence. However, it does not result in complications as does falciparum, which is the most lethal form.

"We have been approached by medicine specialists at PGI and GMCH who have come across malaria cases in severe forms. These are due to vivax, but the symptoms are similar to the ones caused by falciparum. This is worrying. So we have started research to find the reason for the virulent form of malaria," said Dr Sehgal.

Cautious about the coming months when there might be a spurt in malaria cases, he said: "We will go to the areas where the incidence is high. The middle of the coming month [November] will be suitable for the survey, as malaria-causing mosquitoes breed during the season."

The unusual symptoms are baffling the doctors. "About 90 percent of our emergency is crowded with malaria cases of severe form. Patients are coming from Karnal, Kurukshetra, Ropar, Yamunanagar, Kaithal and Saharanpur (UP), among others," said a senior doctor of GMCH department of medicine.

Doctors have been seeing such cases for 2 to 3 years. Concerned over the increasing number of such patients over the years, PGI's medical parasitology department has initiated research to find out whether the genetics of malaria-causing parasites have changed or whether the response following the bite of the vector (on the human host) has undergone a change.

"We got worried when such cases started pouring in. We have entered into a collaborative study with GMCH to ascertain the cause. Once the cause is known, the problem can be tackled," he added.

[Byline: Shimona Kanwar]

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******
[2]
Date: 23 Aug 2013 [relevant in conjunction with [1] above]
Source: Business Standard [edited]
http://www.business-standard.com/articl ... 860_1.html


Orissa has recorded the maximum number of cases of malaria in the January-July period this year [2013], followed by Chhattisgarh, while Kerala registered the largest number of dengue victims, followed by Karnataka.

89 466 cases of malaria were reported from Orissa followed by Chhattisgarh, which recorded 31 940 cases. Jharkhand reported 26 489 cases, while Maharashtra reported 17 060 cases followed by Gujarat, Assam, West Bengal, Uttar Pradesh.

However, Maharashtra, which reported 17 060 cases of malaria, recorded the highest number of deaths at 24 followed by Orissa (20). No fatalities due to malaria were reported from any other state.

Visceral leishmaniasis
----------------------
The country was by and large free of Kala azar [visceral leishmaniasis] except for the states of Bihar, Jharkhand and West Bengal, which reported 5982, 1442 and 337 cases respectively by 31 Jul 2013 [this year]. According to the latest figures submitted by the Union Health Ministry to the Lok Sabha today [23 Aug 2013], a total of 262 582 cases with 78 deaths were reported in the country.


--
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[Chandigar is located in the northwest part of India, an area endemic for _P. vivax_ and _P. falciparum_.

The finding that malaria produces thrombocytopenia [decrease in platelets] and jaundice is a result of late treatment and may not necessarily signal a more virulent form of the malaria parasite.

The posting does not mention which drug has been used for treatment. Resistance to chloroquine is widespread in _P. falciparum_ in India, and an artemisinin-based combination therapy, ACT, is preferred. _P. vivax_ should still be sensitive to chloroquine.

The 2nd report underlines that malaria is still endemic in several states of India. A recent review found that "Malaria cases in India started rising in 1970, peaking in 1976 to 6.45 million cases, and, thereafter, following the implementation of the Modified Plan of Operation in 1977, malaria cases declined and are now just over one million cases annually." However, the proportion due to _P. falciparum_ has in the same period increased from 10 to 50 percent (V. P. Sharma. Battling malaria iceberg incorporating strategic reforms in achieving Millennium Development Goals & malaria elimination in India. Indian J Med Res. 2012; 136: 907-925).

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2dpO. - Mod.EP]
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Unbekannte Krankheit in Indien

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UNDIAGNOSED DEATHS - INDIA (03): (GUJARAT)
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Date: Tue 15 Oct 2013
Source: The Indian Express [edited]
http://www.indianexpress.com/news/one-m ... t/1181609/


One more person in Surat died of the mystery fever on Friday [11 Oct 2013], taking the toll to 6. The victim of the mysterious fever died at Sufi hospital at Lalgate. He has been identified as a 24-year-old resident of Kadarshah ni Naal in Nanpura.

Suspecting it to be a rodent-borne disease, the Surat Municipal Corporation (SMC) has installed 73 rat traps in different parts of this area. It has sent 9 samples of blood, spleen, and liver of rats to the National Institute of Communicable Disease [NICD] in Delhi for laboratory tests.

This is a wake-up call for the city that was hit by the plague in the early 1990s, followed by a spell of leptospirosis after the 2006 catastrophic flood. The SMC officials have begun detailed investigations at Kadarshah ni Naal, which was under water for 3 days following torrential rains. Several patients from these areas complained of vomiting blood and fever. Many people in other areas in the city, like Chhaprabhatha, Singhanpore, Ved Road, and Kosad, are suffering from leptospirosis.

In charge health commissioner SMC, Dr Hemant Desai, said, "We have witnessed that there are many patients suffering from this mysterious fever. While some of them have been [diagnosed as cases of] leptospirosis, we have sent samples of rats to NICD in Delhi for detailed investigations. We will get the report on Monday [21 Oct 2013]. We are also carrying out the cleaning drive and making people more aware about the fever."

--
Communicated by:
Prabhjot Singh
<drprabhjot@gmail.com>

[This new account adds one further death attributed to an undiagnosed hemorrhagic fever, and the additional information that elsewhere in Surat City cases of leptospirosis have been confirmed. This information added credence to the suggestion by Jan Clement and Marc Van Ranst (in item [2] of ProMED-mail 'Undiagnosed deaths - India (02): (GJ) comments 20131014.2000971') that a rodent-borne hantavirus may be responsible for these fatalities. Hopefully this possibility will be considered in the current investigations of the outbreak at the Indian Institute of Virology in Pune and the National Institute of Communicable Disease in Delhi. - Mod.CP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/8OE5.]
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Chikungunya in Indien

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CHIKUNGUNYA (43): INDIA (TAMIL NADU)
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Date: Tue 15 Oct 2013
Source: Deccan Chronicle [edited]
http://www.deccanchronicle.com/131015/n ... ts-chennai


Doctors are seeing more dengue and chikungunya cases in the city. "The irregular rainfall has to be blamed for this. We see many fever cases than the usual ones," said a senior doctor at a government hospital. Apart from dengue, the doctor says they are also seeing viral fever that is similar to dengue. "When tested, such fever shows negative for dengue, so we treat it as viral fever," he adds.

Dr Sivamurugan, orthopaedic surgeon of Soundarapandian Bone and Joint Hospital, says that he has been treating chikungunya cases for a few weeks now. "We had a chikungunya outbreak in 2006 with more elderly people getting affected. But this is not that severe, and the platelet count is not coming down. I have seen at least 20 patients in just 15 days with more people in the age group of 45-50 years. They complain of severe joint pain and swelling," he said.

Chikungunya virus is transmitted by _Aedes aegypti_ and _Aedes albopictus_ mosquitoes during daytime. Viral fever with upper respiratory infection and joint pain should be tested immediately, say doctors.

When contacted, a senior health official said the corporation had intensified its anti-mosquito operations to reduce the incidence of dengue and chikungunya cases in the city. "Fogging is being carried out to prevent breeding of _Aedes aegypti_ mosquitoes. We are also educating people to clean water containers," the official said, denying chikungunya cases in the city.

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[There have been scattered outbreaks of chikungunya virus infections in several localities around India this year (2013). This is the 1st report of an outbreak in Tamil Nadu state that has come to ProMED's attention. The total number of chikungunya cases in this outbreak is not given, but the number of cases seeking medical attention over the past 2 weeks is a clear indication that an outbreak is under way. It is not clear whether the diagnoses of chikungunya virus infection are based solely on clinical grounds or whether some or all are laboratory diagnosed as well. Cleaning or eliminating water containers is more likely to affect vector mosquito control than fogging would.

A HealthMap/ProMED-mail map showing the location of Chennai in Tamil Nadu state can be accessed at http://healthmap.org/r/2bxj. - Mod.TY]
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Denguefieber in Indien und Pakistan

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DENGUE/DHF UPDATE (83): ASIA
****************************
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:
Pakistan:
- Punjab province
- Mardan district, Khyber Pakhtunkhwa Province
- Swat district, Khyber Pakhtunkhwa province
India:
- National
- Delhi
- Haryana state
- Pune, Maharashtra state
- Jammu and Kashmir
- Fatehgarh Sahib, Punjab state
- Uttarakhand state


******

Pakistan:
- Punjab province
. 9 Oct 2013. Dengue 374 cases; Municipality most affected: Lahore 206 cases; Increasing.
http://www.kuna.net.kw/ArticleDetails.a ... anguage=en

- Mardan district, Khyber Pakhtunkhwa Province. 13 Oct 2013. Dengue hospitalized cases 173; Increasing.
http://www.nation.com.pk/pakistan-news- ... -in-mardan

- Swat district, Khyber Pakhtunkhwa province. 8 Oct 2013. Dengue (conf.) nearly 8000 cases; Deaths at least 22; Increasing.
http://www.irinnews.org/report/98900/pa ... -by-dengue

India:
- National
. 13 Oct 2013. Dengue 38 179 cases; Deaths 109; States most affected: Kerala more than 7000 cases with 23 deaths, Maharashtra 2681 cases with 31 deaths.
http://www.bbc.co.uk/news/world-asia-india-24440145

[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]

- Delhi. 15 Oct 2013. Dengue 3519 cases; Deaths (conf.) 5, (susp.) 6.
http://www.ndtv.com/article/cities/delh ... ted-432159

- Haryana state. 15 Oct 2013. Dengue 755 cases; Districts most affected: Gurgaon [dormitory suburd of New Delhi] 250 cases, Faribadad 212 cases.
http://news.outlookindia.com/items.aspx?artid=813610

- Pune, Maharashtra state. 6 Oct 2013. Dengue 420 cases; Dengue viruses circulating in the city: types 1, 2 and 3.
http://articles.timesofindia.indiatimes ... ctive-bite

- Jaipur, Rajastan state. 9 Oct 2013. Dengue 450 cases.
http://www.dnaindia.com/india/1901037/r ... -136-cases

- Jammu and Kashmir. 8 Oct 2013. Dengue 364 cases; District most affected: Samba 168 cases.
http://zeenews.india.com/news/jammu-and ... 81866.html

- Fatehgarh Sahib, Punjab state. 15 Oct 2013. Dengue 101 cases.
http://www.hindustantimes.com/Punjab/Pa ... 34987.aspx

- Uttarakhand state. 8 Oct 2013. Dengue "nearly" 352 cases; Deaths last 2 weeks 3.
http://www.business-standard.com/articl ... 133_1.html
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Malaria in Indien

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MALARIA - INDIA (03): COMMENT
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Date: Fri 18 Oct 2013
From: Ronan Kelly ‪<ronankelly@comcast.net>‬ [edited]


Updates on malaria in India
---------------------------
I just read the post [Malaria - India (02): update archive no 20131016.2005503] and would like to offer some clarifications/updates to the Business Standard article dated 23 Aug 2013.

The data provided in that article was up to [30 Jun 2013] for most states, with the exception of Arunachal Pradesh, Jharkhand, Madhya Pradesh, Nagaland, Delhi, Lakshadweep, and Puducherry [or Pondicherry] which were late reporting.

The most recent update (to 31 Aug 2013) by the National Vector Borne Disease Control Program is located at http://nvbdcp.gov.in/malaria-new.html.

In summary, from over 67 million blood slides examined, 477 660 cases [7 per 1000] of malaria had been identified from 35 states and territories. Of those cases, 254 477 (53.3 percent) were identified as _Plasmodium falciparum_. 185 confirmed deaths were reported. Details from each state are provided at the link above. In Himachal Pradesh, for example, none of the 91 cases was identified as _P. falciparum_, but in Meghalaya, Tripura, Mizoram, and Odisha, _P. falciparum_ was around 95 percent of a combined total of 170 366 cases.

--
Ronan Kelly
Senior Moderator, FluTrackers
<ronankelly@comcast.net>

[ProMED-mail thanks Ronan Kelly for this update on malaria in India. - Mod.EP

There are an awful lot of fevers mimicking malaria in India. - Mod.JW

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

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DENGUE/DHF UPDATE (86): ASIA
****************************
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:
India
- Delhi
- Bhopal and vicinity, Madhya Pradesh state
- Jammu and Kashmir state
- Punjab state
- Batala, Punjab state
- Allahabad and vicinity, Uttar Pradesh state
Pakistan (Swat district, Khyber Pakhtunkhwa province)


******

India
- Delhi
. 23 Oct 2013. Dengue 4034 cases; deaths (conf.) 6, (susp.) 6. Increasing.
http://www.indiatvnews.com/news/india/- ... 29484.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]

- Bhopal and vicinity, Madhya Pradesh state. Dengue 91 cases.
http://timesofindia.indiatimes.com/city ... 213673.cms

- Jammu and Kashmir state. 18 Oct 2013. Dengue more than 600 cases. Districts most affected: Samba, Jammu, Kathua, Rajouri.
http://freepresskashmir.com/dengue-coun ... al-042018/

- Punjab state. 17 Oct 2013. Dengue (conf.) 1152 cases; deaths 3. District most affected: Ludhiana 283 cases.
http://www.hindustantimes.com/punjab/lu ... 36448.aspx

- Batala, Punjab state. 19 Oct 2013. Dengue past 15 days 200 cases.
http://www.hindustantimes.com/punjab/am ... 37358.aspx

- Allahabad and vicinity, Uttar Pradesh state. 16 Oct 2013. Dengue, 83 cases.
http://timesofindia.indiatimes.com/city ... 219701.cms

Pakistan
Swat district, Khyber Pakhtunkhwa province
. 19 Oct 2013. Dengue 8457 cases; deaths 57 (official toll 36).
http://tribune.com.pk/story/619423/more ... d-shangla/

[Maps of Pakistan can be accessed at http://www.ezilon.com/maps/images/asia/ ... kistan.gif and http://healthmap.org/r/872c. - Mod.TY]
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Denguefieber in Indien und Pakistan

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DENGUE/DHF UPDATE (88): ASIA
****************************
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:
India:
- Delhi
- Visakhapatnam, Andhra Pradesh state
- Goa
- Kanpur, Uttar Pradesh state
Pakistan:
- Punjab province
- Rawalpindi, Punjab province
- Karachi, Sindh province
- Swat Valley Khyber, Pakhtunkhwa province


*****

India:
- Delhi
. 24 Oct 2013. Dengue 4207 cases; Deaths (conf.) 6 (susp.) 8.
http://www.pardaphash.com/news/delhi-wi ... mqatXC-2So

[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]

- Visakhapatnam, Andhra Pradesh state. 21 Oct 2013. Dengue (susp.) 68 cases.
http://timesofindia.indiatimes.com/city ... 457646.cms

- Goa. 26 Oct 2013. Dengue 109 cases; Deaths 1; Increasing.
http://www.daijiworld.com/news/news_dis ... _id=197517

- Kanpur, Uttar Pradesh state. 26 Oct 2013. Dengue 531 cases. Increasing.
http://timesofindia.indiatimes.com/city ... 716391.cms

Pakistan:
- Punjab province
. 27 Oct 2013. Dengue Punjab 6767 cases.
http://www.nation.com.pk/pakistan-news- ... -day-after

[Maps of Pakistan can be accessed at
http://www.ezilon.com/maps/images/asia/ ... kistan.gif
and http://healthmap.org/r/872c. - Mod.TY]

- Rawalpindi, Punjab province. 21 Oct 2013. Dengue (susp.) 140 cases; Increasing.
http://www.dailytimes.com.pk/default.as ... 013_pg11_4

- Karachi, Sindh province. 26 Oct 2013. Dengue 2076 cases; Deaths 18; Municipality also affected: Hyderabad 369 cases.
http://www.nation.com.pk/pakistan-news- ... gue-deaths

- Swat Valley Khyber, Pakhtunkhwa province. 25 Oct 2013. Dengue 8734 cases.
http://www.dailytimes.com.pk/default.as ... 2013_pg7_5
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Chikungunya in Indien

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CHIKUNGUNYA (44): INDIA (GUJARAT)
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Date: Tue 29 Oct 2013
Source: Times of India [edited]
http://timesofindia.indiatimes.com/city ... 837768.cms


The health department has recorded an increase in the number of patients with chikungunya [virus infection], which was 113 as of October this year [2013].

In October last year [2012], there were only 14 cases of chikungunya [virus infection].

--
Communicated by:
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[Ahmedabad is experiencing a mixed outbreak of chikungunya, dengue, and malaria, all mosquito-transmitted pathogens.

The above report does not mention specific vector control measures, especially elimination of _Aedes_ breeding sites to reduce chikungunya and dengue virus transmission. The report also does not indicate whether these cases have been confirmed by laboratory tests.

There were there were 39 cases in Ahmedabad as of mid-August 2013 (see ProMED-mail archive no. 20130813.1870987). The outbreak has continued on into October 2013, and the report above does not indicate that it has ended.

A HealthMap/ProMED-mail map showing the location of Gujarat state can be accessed at http://healthmap.org/r/1iSU. - Mod.TY]
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Cholera in Indien

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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (59): ASIA
*********************************************************
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*****

Cholera - India (Karnataka)
Date: Wed 30 Oct 2013
Source: The Hindu [summ., edited]
http://www.thehindu.com/news/national/k ... 286163.ece


A total of 12 more cases of suspected cholera were reported on Tuesday, 29 Oct 2013, in Holalu village [Karnataka state], where a farmer died of the epidemic on Thursday, 24 Oct 2013. The number of cholera cases has risen to 210, T.N. Marigowda, Mandya District Health Officer, told The Hindu here on Tuesday, 29 Oct 2013.

Of the fresh cases, 6 have been referred to the Mandya Institute of Medical Sciences (MIMS) Hospital here and the others are admitted to the Primary Health Centre (PHC) in Holalu. The patients are out of danger now, he said.

The Department of Health and Family Welfare has taken a serous note of the rise in cholera cases in the village. Geetha Nyamagowda, Director, Department of Health and Family Welfare, who visited the village, said all possible steps would be taken to tackle the spread of the waterborne disease in Holalu. Meanwhile, the district administration has decided to replace damaged water pipes in the village. The officials deployed an earthmover to remove pipes that have either developed cracks or have caught rust.

In Sorab taluk, 3 persons have died of cholera in Kamarur village in this month [October 2013], according to Shimoga District Health Officer Shivanna Reddy. The Department of Health and Family Welfare has provided medical treatment for 60 persons suffering from diarrhea and vomiting.

--
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[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1-eG.]
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Japanische Enzephalitis in Indien

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JAPANESE ENCEPHALITIS AND OTHER - INDIA (20): (UTTAR PRADESH)
*************************************************************
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Date: Thu 31 Oct 2013
Source: NDTV, Press Trust of India report [edited]
http://www.ndtv.com/article/india/encep ... 479-440072


During the past 24 hours, 6 more children died to encephalitis in the district, taking the death toll to 479 this year [2013], health officials said today [31 Oct 2013].

The 6 died at the Baba Raghav Das Medical College Hospital (BRD-MCH) here yesterday [30 Oct 2013]. They belonged to different district of eastern Uttar Pradesh.

As many as 15 patients of encephalitis were admitted to the hospital during the past 24 hours, they said.

A total of 2335 encephalitis patients have been admitted to hospitals this year [2013], the officials said.

Over 200 patients are being treated at BRD MCH at present, they said.

--
Communicated by:
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[The death toll from encephalitis in eastern Uttar Pradesh has increased from 358 for this year (see ProMED-mail archive no. 20131009.1992629) reported on 9 Oct 2013 to 479 in the above report some 3 weeks later. As with previous reports of viral encephalitis in Uttar Pradesh state, there is no indication of the proportion of these cases due to Japanese encephalitis virus infections or to other, undetermined causes. Dr. Lloyd Olson noted that is important to remember that not all acute central nervous syndromes in children are inflammatory or infectious (see ProMED-mail archive no. 20131011.1995836). In his comment, he indicated that the histopathologic features from autopsies conducted on 40 children in Udorn, northeastern Thailand, reported in the Amer J Clin Path 1971; 56: 558-71, were characterized by those findings as associated with acute Reye syndrome. This report also details the evidence pointing to acute aflatoxin poisoning as the etiology of the condition in Udorn. The reports from Uttar Predesh provide no information about the similarity of cases and autopsy findings in India compared to those reported from Thailand. ProMED would be interested in the results of such a comparison.

A HealthMap/ProMED-mail map of India showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/1-k3. - Mod.TY]
Birgitt
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Denguefieber in Indien, Nepal und Pakistan

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DENGUE/DHF UPDATE (89): ASIA
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In this update:
India:
- National
- Rajkot, Gujarat state
- Mumbai, Maharashtra state
- Pune, Maharashtra state
- Jagatsinghpur district, Odisha state
- Rajasthan state
- Allahbad, Uttar Pradesh state
- Lucknow, Uttar Pradesh state
- Punjab state: year to date
- Punjab state: recent
- Ludhiana district, Punjab state
Nepal (Jhapa district, Eastern region)
Pakistan:
- Punjab province
- Rawalpindi, Punjab province
- Sindh province


*****
India:
- National
. 3 Nov 2013. Dengue as of 28 Oct 2013, 55 063 cases; Deaths 138. This is the worst outbreak in 10 years.
http://timesofindia.indiatimes.com/indi ... 146647.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]

- Rajkot, Gujarat state. 29 Oct 2013. Dengue 353 cases.
http://timesofindia.indiatimes.com/city ... 841063.cms

- Mumbai, Maharashtra state. 2 Nov 2013. Dengue virus types circulating 2, 3.
http://timesofindia.indiatimes.com/city ... 087915.cms

- Pune, Maharashtra state. 28 Oct 2013. Dengue, of 51 blood samples tested from cases this year [2013], 35 due to Dengue virus type 2, 11 to type 1, 5 to type 3.
http://timesofindia.indiatimes.com/city ... 788171.cms

- Jagatsinghpur district, Odisha state. 22 Oct 2013. Dengue 137 cases following the cyclone.
http://newindianexpress.com/states/odis ... 849070.ece

- Rajasthan state. 28 Oct 2013. Dengue 2300 cases, however the report also indicates around 2500 cases, the highest number in 7 years; Increasing.
http://www.dnaindia.com/india/report-de ... an-1910185

- Allahbad, Uttar Pradesh state. 29 Oct 2013. Dengue 126 cases.
http://timesofindia.indiatimes.com/city ... 841940.cms
[This report also notes 4402 cases in Delhi, an increase of nearly 200 cases since 24 October 2013.]

- Lucknow, Uttar Pradesh state. 31 Oct 2013. Dengue 565 cases.
http://timesofindia.indiatimes.com/city ... 966869.cms

- Punjab state: year to date. 28 Oct 2013. Dengue approximately 2000 cases.
http://www.business-standard.com/articl ... 758_1.html

- Punjab state: recent. 1 Nov 2013. Dengue last 24 hrs 59 cases; Deaths to date 7.
http://dawn.com/news/1053400/dengue-kil ... ches-seven

- Ludhiana district, Punjab state. 1 Nov 2013. Dengue 1137 cases; Municipality most affected: Ludhiana 685 cases.
http://www.hindustantimes.com/punjab/lu ... 46322.aspx

Nepal
Jhapa district, Eastern region
. 29 Oct 2013. Dengue 130 cases; Increasing.
http://www.myrepublica.com/portal/index ... s_id=63804

[A HealthMap-ProMED-mail map of Nepal can be accessed at http://healthmap.org/r/92e5. - Mod.TY]

Pakistan:
- Punjab province
. 1 Nov 2013. Dengue 891 cases.
http://www.thenews.com.pk/Todays-News-5 ... s-reported

[Maps of Pakistan can be accessed at http://www.ezilon.com/maps/images/asia/ ... kistan.gif and http://healthmap.org/r/1iGJ. - Mod.TY]

- Rawalpindi, Punjab province. 28 Oct 2013. Dengue 350 cases.
http://www.thenews.com.pk/Todays-News-6 ... Rawalpindi

- Sindh province. 2 Nov 2013. Dengue 3730 cases; Municipality most affected: Karachi 3217 cases; Deaths 22; Increasing.
http://www.thenews.com.pk/Todays-News-4 ... city-to-20
Birgitt
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Unbekannte fieberhafte Erkrankung in Indien

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UNDIAGNOSED FEBRILE ILLNESS - INDIA (03): (UTTAR PRADESH) REQUEST FOR INFORMATION
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Date: Wed 6 Nov 2013
Source: The Times of India [edited]
http://articles.timesofindia.indiatimes ... age-kakori


More than 200 persons in Sikrauli village of Kakori in the [Uttar Pradesh] state capital [Lucknow] have taken ill with a mystery fever. Health officials are camping in the village to manage and monitor the situation. Chief medical officer (CMO), Lucknow, Dr SNS Yadav, claimed no death has been reported so far.

The matter caught the attention of the health officials on Sunday evening [3 Nov 2013] after health officials received an SMS stating that more than 50 per cent of the 10 000 residents of Sikrauli village were in the grip of a mystery fever. The message sent alarm bells ringing and a health team rushed to the village to take stock of the situation.

The team comprising the CMO and additional CMO (vector borne diseases control) organised a camp in the village where 200 persons were listed as sick till Tuesday evening [5 Nov 2013]. CMO Dr Yadav claimed that the patients have been given medicines to control fever.

He suspects the fever is of viral origin, though a confirmed report would come only after laboratory tests. "We have sent the blood sample of some patients to lab to ascertain the cause of illness," he said.

Dr Yadav blamed poor civic condition in the village as a contributory factor to the disease situation. "The sewage and garbage disposal systems in the village are in a bad state owing to acute shortage of safai workers [those engaged in 'unclean' occupations such as sanitation work]. The onus of cleaning the village lies on just one man," he claimed.

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[A reported more than half of the village -- 5000 people -- coming down simultaneously with a non-fatal febrile illness is remarkable and of significant concern. However, the above report gives little information upon which to speculate concerning the etiological agent that might be responsible. The fact that vector control specialists have been called in suggests that vector-borne diseases such as chikungunya and dengue viruses might be suspected. The mention of sewage and garbage disposal systems being in bad condition suggests that the health authorities may suspect enteroviral or bacterial diseases. Until laboratory tests are completed, the etiology of this outbreak will remain unknown. ProMED would appreciate receiving additional information concerning additional cases and the results of the laboratory tests as they become available.

A HealthMap/ProMED-mail map of India showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/96qY. - Mod.TY]
Birgitt
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Unbekannte fieberhafte Erkrankung in Indien

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UNDIAGNOSED FEBRILE ILLNESS - INDIA (04): (UTTAR PRADESH) REQUEST FOR INFORMATION
*********************************************************************************
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ProMED-mail is a program of the
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Date: Thu 7 Nov 2013
Source: The Times of India, Times News Network (TNN) [edited]
http://articles.timesofindia.indiatimes ... eak-kakori


As many as 36 new patients complaining fever were reported in Sikrauli village of Kakori area in the state capital [Lucknow] on Wednesday [6 Nov 2013]. With this, the total number of people in grip of a fever touched 236. Health officials now say that the cause of trouble is simple viral fever. Chief medical officer [CMO], Lucknow, Dr SNS Yadav said possibility of typhoid or any other vector-borne disease has been ruled out. "Lab reports have confirmed viral fever," he said.

The fever outbreak caught the attention of health officials on Sunday evening [3 Nov 2013] when they received a [text message] stating that more than 50 per cent of the 10 000 residents of Sikrauli village were in the grip of a mystery fever. The message sent alarm bells ringing and a health team was rushed to the village to take stock of the situation. The team comprising CMO and additional CMO (vector-borne diseases control) camped in the village.

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[This report adds little to the initial report of 6 Nov 2013 (ProMED-mail archive no 20131107.2043745), except that typhoid and vector-borne pathogens have been eliminated by laboratory tests. That would exclude chikungunya or dengue virus infections, but many other possibilities remain. The number of individuals affected is unclear. This and the previous report stated that half of the 10 000 village residents were infected, but the report above also indicates that the total number is 236. ProMED remains interested in receiving additional information about test results and new cases as this information becomes available.

A HealthMap/ProMED-mail map of India showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/96qY. - Mod.TY]
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Lepra in Indien

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LEPROSY - INDIA (04): (NORTHEAST) INCREASED INCIDENCE
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Date: Fri 8 Nov 2013,
Source: India TV News, Press Trust of India (PTI) report [edited]
http://www.indiatvnews.com/news/india/- ... 30168.html


The Centre has expressed concern at re-emergence of leprosy cases in certain pockets of the 8 northeastern states. Except for 4 districts of Assam, which recorded higher prevalence of leprosy than the national average, the [states in the] NE region are otherwise considered low endemic states. "It is a concern that the disease is re-emerging in certain pockets in the northeast," Dr CM Agrawal, Deputy Director General (Lep), Ministry of Health and Family Welfare, said.

The northeastern states reported 747 new cases [in the 1st 9 months of 2013] with Assam recording the most, 616 cases, Agrawal told PTI at the sidelines of a regional review meeting of state leprosy officers of the region.

Assam [with 616 cases] is followed by Nagaland (32 cases), Tripura (23), Sikkim (20), Mizoram (18), Arunachal Pradesh (17), Meghalaya (15), and Manipur (6).

In Assam, the most affected districts were Sivsagar and Tinsukia, which recorded 99 and 87 new cases respectively, followed by 42 in Sonitpur, 39 in Kamrup Metro, and 38 in Cachar district, Dr BL Deori, Joint Director of Health Services in Assam, said. All the other districts, except Chirang and Dima Hasao, registered new cases but their numbers were fewer.

Deori said the annual new case detection rate is 3.57 per one lakh [100 000] population with 63 cases in children this year [2013] alone, and over 1000 cases under treatment.

A total of 9 paramedical workers were also appointed in the most affected districts, she said.

In Nagaland, Dr KV Kimiki, State Leprosy Officer, said 30 cases were reported from Dimapur, while one each was reported from Kohima and Mokukchung districts.

Tripura reported 23 new cases and 69 patients are undergoing treatment, the official said.

Agrawal mentioned innovative approaches such as involvement of faith-based organisations or child-to-child approach in spreading awareness about leprosy.

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[For a discussion of leprosy in India, see moderator ML's comments in ProMED-mail posts Leprosy - India (03): (GJ) increased incidence, comment 20131006.1986913 and Leprosy - India (02): (GJ) increased incidence 20131005.1984154.

Northeast India, with a population of 38 857 769, is the eastern-most region of India connected to the rest of India via a narrow corridor between Nepal and Bangladesh. It comprises 7 contiguous states -- Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, and Tripura -- and the Himalayan state of Sikkim (http://en.wikipedia.org/wiki/Northeast_India). Almost 70 per cent of this population (26.64 million) lives in the state of Assam. The region is predominantly tribal and rural. For a map of the northeast region of India, see http://www.emapsworld.com/images/north- ... ia-map.gif. - Mod.ML

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2yW8.]
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