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ALKHURMA VIRUS - SAUDI ARABIA: (MAKKAH)
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Date: Wed 6 Jan 2010
Source: OKAZ [in Arabic, machine trans., edited]
<http://www.okaz.com.sa/new/Issues/20100 ... 325138.htm>


Laboratory tests in Jeddah identified 4 cases of Alkhurma hemorrhagic
fever [AHFV] disease, which re-emerged following the tragic outbreak
in Jeddah [Makkah province]. These are the 1st cases after an absence
of about 10 years. The sources said AHFV was detected yesterday [5
Jan 2010] in 4 people living in neighborhoods north of the city who
were treated immediately in a health center. The Health Secretariat
of Jeddah conducted spraying of pesticides in the vicinity of the
houses of the 4.

In turn, the chairman of the Committee on Health and the Environment
of the Municipal Council of Jeddah, Dr. Hussein, was informed of the
need to intensify spraying, in order to prevent the spread of [the virus].

AHFV enters the human body and leads to internal bleeding. The
mortality rate of the disease is up to 25 percent of the total cases.
AHFV is transmitted by mosquitoes from one person to another [this
has not been demonstrated. See references below. - Mod.TY].

A municipal council member said that the disease was discovered for
the 1st time in Jeddah in 1994, with 4 cases. Cases of the disease,
which has gained the name AHFV, were [originally] believed to be
dengue fever infections. [The Madani 2006 reference below states that
the virus was first isolated in 1995, and that there were 6 cases. - Mod.TY]

[A team of researchers] at the University of King Abdul-Aziz, on
behalf of Sheikh Mohammed Hussein Al Amoudi, is working to diagnose
the virus and to highlight its characteristics and how to eliminate it.

It is noteworthy that the virus disappeared after the mid-1990s and
returned to the area again, according to the adviser to the minister
of health for infectious diseases, Dr Tarek Madani, in the beginning
of the new millennium.

In 2000, health authorities discovered 20 cases of the disease, and
noted that all reported cases of AHFV had ocurred south of Jeddah.

--
Communicated by:
ProMED-mail
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[Alkhurma virus is a flavivirus related to Kysanur Forest disease
virus. From 8 Feb 2001 to 9 Feb 2003, a total of 37 cases of acute
viral hemorrhagic fever were identified in Makkah, Saudi Arabia, and
20 of them were laboratory confirmed. Acute febrile flu-like illness
with hepatitis (100 percent), hemorrhagic manifestations (55
percent), and encephalitis (20 percent) were the main clinical
features. The case fatality rate was 25 percent. The original report
indicated that the virus seemed to be transmitted from sheep or goats
to humans by mosquito bites or direct contact with these animals. The
report above also indicated that the virus is mosquito transmitted,
although a 2007 report implicated soft ticks.

References
----------
1. Madani TA: Alkhumra [sic] virus infection, a new viral hemorrhagic
fever in Saudi Arabia. J Infect. 2005 Aug; 51(2): 91-7; abstract available at
<http://www.ncbi.nlm.nih.gov/pubmed/16038757>.
2. Charrel RN, Zaki AM, Fagbo S, de Lamballerie X: Alkhurma
hemorrhagic fever virus is an emerging tick-borne flavivirus. J
Infect. 2006 Jun; 52(6): 463-4.
3. Charrel RN, Fagbo S, Moureau G, Alqahtani MH, et al: Alkhurma
hemorrhagic fever virus in _Ornithodoros savignyi_ ticks. Emerg
Infect Dis. 2007 Jan; 13(1): 153-5; available at
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725816/>.

Jeddah on the coast of the Red Sea, can be located on the map at
<http://www.lib.utexas.edu/maps/middle_e ... l_2003.pdf>.
A HealthMap/ProMED-mail interactive map of Saudi Arabia can be
accessed at <http://healthmap.org/r/011Z>. - Mod.TY]

ALKHURMA VIRUS - SAUDI ARABIA (02): (MAKKAH) CORRECTION
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Date: Fri 22 Nov 2009
From: Shamsudeen Fagbo, DVM
<oloungbo@yahoo.com>


Kindly permit our comments on: Alkhurma virus - Saudi Arabia: (MK)
20100106.0056

In the 1st place, the recent 4 cases of Alkhurma hemorrhagic fever (AHF)
were NOT detected in January 2010. All the cases were linked to last year's
Hajj and diagnosed in the post Hajj period (late November/early December
2009). The date of exposure (22 Nov 2009) to the risk factor -- the
slaughtering or processing of slaughtered sheep -- was shared by all 4
cases. These unrelated cases were all diagnosed in different private
hospitals in Jeddah. Alkhurma hemorrhagic fever virus (AHFV) RNA was
detected at the Ministry of Health (MOH) Jeddah virology lab. Their
symptoms were successfully managed: they were discharged prior to the end
of last year [2009].

Secondly, only one of the patients resides north of Jeddah. One of the
other patients was a Taif-based butcher who slaughtered and processed sheep
in Makkah during the last Hajj season. He came to Jeddah to seek medical
attention for his illness. He could have had multiple, continuous exposures
to potentially infected animals. As such, these cases are in no way
clustered as the report suggests.

Thirdly, since an enhanced surveillance system was hitherto not in place,
it cannot be said that AHFV was absent for 15 years. Presently, the viral
hemorrhagic fever (VHF) surveillance in Jeddah is being enhanced to ensure
prompt clinical dengue virus infection: the MOH is immediately notified of
suspected dengue cases occurring in private and government health care
settings. Clinical dengue and AHF share symptoms and are considered
differential diagnoses for one another in this region. Clinically suspected
but laboratory negative dengue cases were tested for AHFV. All suspected
VHF cases are now tested simultaneously for dengue and AHFV infection.

As part of this enhanced surveillance, and 2 months prior to the last Hajj
season, blood samples of patients with clinically suspected dengue but
negative lab results (dengue IgM and IgG, dengue antigen test NS1 and PCR)
were further tested for chikungunya, Rift Valley fever, West Nile fever and
Alkhurma at the Jeddah virology lab. All tests were negative. In the past,
there have been clinically suspected dengue cases that were laboratory
negative by IgG and IgM serology as well as PCR. These cases were not
tested for AHFV infection (Ayyub, et al. 2006; Khan, et al. 2008).

The MOH, drawing on presently available scientific data, concurs that AHFV
is a tickborne virus and a genetic variant of the Kyasanur Forest disease
virus. With this in mind, it is making concerted multidisciplinary efforts
to further our understanding of AHFV epidemiology and facilitate
evidence-based prevention. If it were mosquitoborne, the time lag between
exposure and clinical onset in these 4 cases would have ensured that
mosquitoes in their neighbourhoods were infected and thereby infected
others. Additionally, all the 4 cases were adults (range: 39-56; mean: 46):
there arises the entomological quagmire as to why our local mosquitoes
preferentially bite adults in a community where children and the young are
in greater numbers. Dengue, the main differential diagnosis for AHF as well
as the predominant mosquitoborne virus in the region, is known to affect
mostly the young (Ayyub, et al. 2006; Khan, et al. 2008).

In contrast, our epidemiological investigation indicated that the 4
patients were exposed to infected animal during slaughtering or meat
processing. Efforts to trace the source of sheep slaughtered for 3 cases
have so far been unsuccessful: though the sheep market was identified, poor
documentation of animal sales and movement stalled our efforts. Not
unexpected, there was hard tick infestation of goats, sheep and camels in
the market.

In summary, the present outbreak of the AHFV is sporadic and the potential
for spread highly limited. The MOH and the Ministry of Agriculture are
fully collaborating and following developments.

References
----------
Ayyub M, Khazindar AM, Lubbad EH, Barlas S, Alfi AY, Al-Ukayli S.
Characteristics of dengue fever in a large public hospital, Jeddah, Saudi
Arabia. J Ayub Med Coll Abbottabad 2006 Apr-Jun; 18(2): 9-13.
Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, et al.
Clinical profile and outcome of hospitalized patients during first outbreak
of dengue in Makkah, Saudi Arabia. Acta Trop 2008 Jan; 105(1): 39-44.

--
Ziad A Memish MD, FRCPC, FACP
Assistant Deputy Minister for Preventive Medicine
Shamsudeen F Fagbo DVM
Zoonotic Diseases Unit
Directorate of Communicable Diseases
Ministry of Health Riyadh 11176
Kingdom of Saudi Arabia
Noha A Dashash MB BS, DPHC, ABFM, SBFM
Naeema A Akbar MD, PD, FETP, ABCM, RICR
Ghaiath M Hussein MB BS, MHSc
Primary Health care and Preventive Medicine (MOH)
Jeddah

[ProMED-mail thanks Drs Memish, Fagbo, Dashhash, Akbar, and Hussein for
their correction of the earlier report of 6 Jan 2010 (archive number
20100106.0056), with comments based on the MOH's thorough epidemiological
investigation of the 4 cases of Alkhurma virus infection. The results of
their concerted multidisciplinary efforts to further understanding of AHFV
epidemiology and facilitate prevention are awaited with interest.

Jeddah, on the coast of the Red Sea, can be located on the map at
<http://www.lib.utexas.edu/maps/middle_e ... l_2003.pdf>.
A HealthMap/ProMED-mail interactive map of Saudi Arabia can be accessed at
<http://healthmap.org/r/011Z>. - Mod.TY]

DENGUE/DHF UPDATE 2010 (04)
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******

Yemen (Taiz)
Date: Tue 19 Jan 2009
Source: Yemen News Agency (SABA) [in Arabic, trans. Mahmoud Assamiee,
summ. Mod.TY, edited]
<http://www.sabanews.net/en/news203577.htm>


Since 1994, a strange and quiet mosquito has bred in Taiz. This kind
of mosquito transmits dengue fever [virus] among people so that the
pandemic increased in the city as the mosquito became established.

Despite differences over the number of infections with the disease
and fatal cases, all agree that the disease has become established in
Taiz and plagued the city amid ignorance of concerned bodies despite
of the fact that its danger is increasing. "If concerned bodies would
have intervened early, the matter would have been easier. We ignore
the disease, its reasons, and the environment in which it reproduces.
We do not even know the protection against the disease because we
didn't know it was dengue fever [until] only lately," said a Taizi citizen.

Physician Samir Sufian, director of Al-Rawdha Hospital, reveals the
size of the catastrophe affirming that public and private hospitals
receive cases of dengue fever. "Like any other public and private
hospital, we perform our duty and receive many cases, whether
infected with dengue fever [virus] or other cases suffering the same
complications of the disease," he said. "We have been receiving more
than 100 cases a day, all of them are not necessarily infected with
the disease [virus] but there are similar cases. Only 72 cases have
been hospitalized and [we] gave them blood platelets as the disease
reduces the blood platelets to under 60 000 units. All these cases
have recovered," he said.

Concerning fatalities, the director of Al-Rawdha Hospital indicates
that fatal cases have been occurring with the spread of the disease
but indicates "death could happen if there are accompanying
diseases." He estimated the number of mortalities has reached only 7
and there are similar fatal cases in other hospitals. " All of us are
responsible for society with all [its health] categories, the health
office is not solely responsible for deterring the disease and it is
not our responsibility to exaggerate the number of infections and
fatal cases," said Sufian.

However, the technical director of Al-Safwa Hospital, Abdurrahman
Saeed, affirms that the hospital has received hundreds cases during
the past 2 months, but he indicates that [dengue] infections with
disease have become rare during the past month. He expected that
fatal cases in Taiz are estimated in tens. "In our hospital, for
example, 3 fatal cases have been registered."

The secretary general of health, Abdul-Jalil Azuraiqi, says, "The
disease was not new, if concerned bodies had intervened early in
1994, the situation would have been better. The disease is now
terribly rampant and there are not enough efforts for combating it."
Concerning the victims of the disease, Azuraiqi says, " The number of
infected cases has exceeded 100 000 and 50 infected [individuals]
died; 7 physicians have been infected and one of them died."

Concerning state statements that the infection with the disease
[virus] does not exceeded 950 case and only one fatal case has been
confirmed, the secretary general of health says " there are 45 public
and private hospitals in Taiz governorate, 400 private clinics and
122 health centers even though government-related bodies have not
approved any statistics coming from these facilities and only
[recognize?] confirmed cases coming from the central laboratory [but]
even they are [under] review. However, we got our information from
colleagues in those hospitals, clinics, and centers."

Deputy minister of Public Health and Population for Health and
Planning Development, Jamal Nasher, says the ministry is working
through its office in Taiz to limit the pandemic by curing [treating]
all cases and helping the office to find diagnostic means to
recognize dengue fever. For his part Taiz deputy governor for
technical affairs, Abdul-Qader Hatem, says that the governorate has
adopted special strategy to fight dengue fever in Taiz. "The issue
has put all concerned bodies on alert to combat the disease. We and
the ministry's office here made a strategy [that] includes all duties
of concerned bodies because fighting the disease is not only the
responsibility of the health office but also [of] all concerned
bodies," he said.

According to him, the strategy aims at eradicating the environment
where the mosquito spreads the dengue fever [virus] via eliminating
the factors [that] led to the mosquito establishment in the city.
These factors are dominated by personal behavior, like storing water
for a long time due to the lack of water in the city, and waste from
workshops, houses, and cars. Based on these factors, the strategy is
divided into 2 parts; the 1st one concerns solving the water crisis
while the 2nd is to clean the city of all trash to get rid of
[breeding sites] of the mosquito which spreads the disease [virus] in
addition to awareness campaigns on the dangers of the disease and
[for individuals,] how to protect themselves against it.

Director of Taiz Health Office, Abdul-Naser al-Kabab, says the
disease was established in the city and the water crisis is the main
reason. He said the 1st appearance of the disease in Taiz city was in
1994 with one confirmed case and another case found in Jeddah,
Kingdom of Saudi Arabia at that time. The disease appeared again in
2007 when 220 cases of the infection had been registered. While the
disease spread in 2008, with 360 confirmed cases, the pandemic became
rampant in 2009 to the degree that Taizi people have become
terrified. The number of infected cases has reached 906.

Concerning the fatal cases, he affirms that there is no single
[officially] confirmed case of dengue fever and there may be
fatalities whether in hospitals or at home because of the disease or
for other causes. He cited that the office has distributed forms to
hospitals to report on fatal cases due to the disease or other
reasons and they have not received any notifications or death
certificates from any hospital.

Over the procedures taken for facing the disease, al-Kabab said, "We
have established operational rooms [centers] to follow up on
everything new and then communicate with the different concerned
bodies; we have focused on public education since protection against
the disease depends on awareness of factors behind the spread of the
disease and the environment individuals live in. A house-to-house
spraying campaign has also been carried out in the 3 most affected districts.

[Byline: Abdul-Hamid al-Maqtari

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

[Although there are wide differences in the numbers of reported
dengue cases and fatalities cited in the report above, it is clear
that a major dengue outbreak has been occurring in Taiz. Descriptions
of a number of anecdotal dengue cases, including fatalities,
mentioned in this report were not included.

An interactive map showing the location of Taiz in southwestern Yemen
can be accessed at
<http://www.travelpost.com/ME/Yemen/Othe ... ap/2695532>.
A map of Yemen showing the administrative units (governorates) can be
accessed at
<http://lib.utexas.edu/maps/middle_east_ ... n_2002.jpg>.
A HealthMap/ProMED-mail interactive map of Yemen can be accessed at
<http://healthmap.org/r/013d>. - Mod.TY]

MUMPS - ISRAEL (03): (JERUSALEM) REQUEST FOR INFORMATION
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Date: Tue 26 Jan 2010
Source: Chen Stein-Zamir <chen.zamir@lbjr.health.gov.il>


Over the past 4 months some 600 cases of mumps have been reported in
the Jerusalem district and over 850 nationally in Israel, the majority
of whom (70 percent) have been male. Case investigation has shown that
the outbreak emerged in male attended religious high schools and
colleges (yeshivas). Female cases have been mainly secondary,
household contacts.

About 60 percent of patients had received 2 doses of MMR, another 20
percent had received one dose (13 percent age appropriate). As opposed
to previous outbreaks in Jerusalem where active case investigation
showed 95 percent of cases to be unvaccinated, only 20 percent of
cases in the present outbreak were unvaccinated.

The predominance of males, vaccinated individuals, and the low rate of
transmission to the surrounding community should, in our opinion, call
for further investigation.

--
Dr Chen Stein-Zamir
Jerusalem District Health Office
86 Jaffa Road
Jerusalem 94341
Israel
<chen.zamir@lbjr.health.gov.il>

[The situation in Jerusalem does not appear to be unique. Most
recently in August 2009, an outbreak of mumps originating in a summer
camp in Sullivan County, New York state became the largest mumps
outbreak since 2006, when the United States experienced an outbreak of
mumps with 6584 reported cases. The outbreak primarily affected
members of a tradition-observant (Jewish) religious community, in
spite of a high level of vaccination (see MMWR, November 12, 2009 /
58(Dispatch); 1-4 available at
<http://www.cdc.gov/mmwr/preview/mmwrhtm ... 8d1112a1_e>).

Elsewhere similar outbreaks have occurred in colleges and schools
where children and young adults may be living in close contact.

Dr Chen Stein-Zamir and colleagues have documented the current
Jerusalem outbreak at an earlier stage in some detail (see
Eurosurveillance 14(50), 17 Dec 2009 at
<http://www.eurosurveillance.org/ViewArt ... leId=19440>).
They concluded then that: "The reasons for the particular
characteristics of these recent mumps outbreaks are unclear. Possible
explanations include a combination of primary and secondary vaccine
failure, waning immunity, inadequate vaccine effectiveness, and
previous low immunisation coverage. Contributory factors include
living conditions in specific population groups such as college
freshmen, army recruits, and adolescent students in boarding schools."

Readers are invited to suggest other factors which might contribute to
the current situation in Jerusalem. - Mod.CP]

[The HealthMap/ProMED-mail interactive map of Israel is available at
<http://healthmap.org/r/013l>. - Sr.Tech.Ed.MJ]

ALKHURMA VIRUS - SAUDI ARABIA (03): (MAKKAH, NAJRAN)
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Date: Mon 1 Feb 2010
Source: The Saudi Gazette [edited]
<http://www.saudigazette.com.sa/index.cf ... 01/02/2010>


7 cases of Alkhurma flu [sic] no cause for alarm
------------------------------------------------
The Ministry of Health has confirmed 7 cases of the Alkhurma
hemorrhagic influenza in Makkah [Mecca] and Najran, but this was not
cause for alarm, according to Health Minister Dr Abdullah Al-Rabeah.
He said that there was a high rate of recovery from the flu even
though there is no specific medicine to treat sufferers. [It is
unfortunate that these cases are designated "flu", because Alkhurma
virus is a flavivirus totally unrelated to influenza virus.
Designating it as "flu" only serves to confuse the public. - Mod.TY]

Al-Rabeah was speaking in Riyadh Sunday [31 Jan 2010] at the launch of
an international scientific workshop being held to formulate a plan to
counter the Alkhurma disease. Also present at the event was Dr Fahd
Balghunaim, minister of agriculture.

Al-Rabeah assured the public that there was no need to be concerned
because there has only been a limited number of people afflicted with
the disease since 1994.

He said the workshop was being held in terms of royal directives to
take preventive measures against the disease. "The ministry and
related authorities have taken many preventive and precautionary
measures against the Alkhurma disease," he said. Al-Rabeah said that
joint committees and working teams consisting of experts from the
Kingdom and abroad have been formed to develop a national plan for
countering the Alkhurma hemorrhagic flu.

The teams would determine the epidemiological characteristics of the
disease, the way it is transmitted, and develop methods of combating
and controlling the disease and preventing it from spreading.

In his speech, Balghunaim dealt with the support the leadership
provides to the health sector. He said the participation of the
Ministry of Agriculture in efforts to counter the disease was a
national duty.

Dr Ziyad Meimish, assistant undersecretary of the Ministry of Health
for Preventive Medicine, gave a brief history of the disease. Then the
participants were divided into working groups to discuss the national
plan.

The Alkhurma virus is passed on to humans by ticks that live on
animals such as sheep, goats, and camels. Pets such as cats and
rabbits can also carry the ticks.

Preventive measures include wearing gloves when handling raw uncooked
meat. Also, livestock should be checked periodically to ensure that
they are free of ticks. Suitable insecticides should be used to kill
the insects [ticks are not insects. - Mod.JW] on the animals.
Furthermore, people should not drink unpasteurized milk [since related
flaviviruses can be transmitted through the milk of infected
livestock. - Mod.JW].

[Byline: Nawaf Afit]

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

[The number of cases of Alkhurma hemorrhagic fever (AHF) has increased
from 4 to 7 in the past 2 months. The dates of the 3 recent AHF
infections are not indicated in the report above. The previously
reported 4 recent cases of AHF were linked to last year's Hajj and
diagnosed in the post Hajj period (late November/early December 2009).
The date of exposure (22 Nov 2009) to the risk factor -- the
slaughtering or processing of slaughtered sheep -- was shared by all 4
cases (see the report from Drs Shamsudeen Fagbo, Ziad A Memishand, and
colleagues in ProMED archive no. 20100123.0254).

A map of Saudi Arabia showing the location of Makkah (Mecca) and
Najran can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... l_2003.pdf>. A HealthMap/ProMED-mail interactive map of Saudi Arabia can be accessed
at
<http://healthmap.org/r/008R>. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (01): ISRAEL
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******
Shigellosis - Israel (Haifa District)
Date: Wed 6 Jan 2010
Source: The Jerusalem Post [edited]
<http://fr.jpost.com/servlet/Satellite?c ... 2FShowFull>


A total of 17 children and 2 adults from the Arab village of Barta'a
in Wadi Ara arrived this week [week of 4 Jan 2010] at the emergency
room of Assaf Harofeh Medical Center in Tzrifin.

Showing high fever, bloody stools and confusion, they were diagnosed
with infection with the _Shigella_ bacteria that cause dysentery.

The infection apparently came from drinking polluted water from a well
in the village. They were given liquids and antibiotics, and the
Health Ministry was informed.

[Byline: Judy Siegel-Itzkovich]

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

[Wadi Ara or Nahal Iron is an area within Israel that is mostly
populated by Arabs. It is mostly within Israel's Haifa District which
can be see on a map of Israel at
<http://www.un.org/Depts/Cartographic/ma ... israel.pdf>. - Mod.LL]

DENGUE/DHF UPDATE 2010 (20)
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******
Saudi Arabia
Date: Sun 25 Apr 2010
Source: Bio Med [summ. & edited]
<http://biomedme.com/countries/saudi-ara ... _8225.html>


The municipality has pointed the finger at the Mayor's Office and
called for a new strategy to tackle dengue fever after 94 new cases
were detected in Jeddah last week, bringing the total number of cases
in the 1st 15 weeks of 2010 to 363.

Reports show that despite intensified efforts by the mayoralty in
spraying the city and drafting in emergency teams, dengue has
continued to spread in the south Jeddah districts of Ghulail, Mada'in
Al-Fahd, and Al-Karantina. "The situation will continue as long as
the Misk Lake continues to rise and provide the perfect breeding
ground for dengue-bearing mosquitoes," Akhdar said. "I have
repeatedly voiced my concerns over the imminent public health danger
posed by the Misk Lake, but have had no response." Akhdar also
criticized delays in sewer works that, he said, had resulted in a
"notable increase in insects and rodents."

[Byline: Jamal]

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

[This report reflects an unfortunate misconception about breeding
sites of dengue virus vectors -- _Aedes_ mosquitoes -- which in this
case are probably _Ae. aegypti_. This mosquito breeds in and
immediately around buildings, not in lakes or sewers. Vector control
requires surveillance and treatment to eliminate water catchments or
apply larvicides where the vectors are located. Fogging will provide
only temporary vector population reduction.

A HealthMap/ProMED-mail interactive map of Saudi Arabia showing the
location of Jeddah on the coast of the Red Sea can be accessed at
<http://healthmap.org/promed/en?v=24.1,44.5,5>. - Mod.TY]

DENGUE/DHF UPDATE 2010 (22)
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In this update:
[1] Saudi Arabia (Jeddah)
[2] Saudi Arabia (Jizan)
[3] Yemen (Aden)
[4] Brunei

******

[1] Saudi Arabia (Jeddah)
Date: Tue 4 May 2010
Source: Saudi Gazette [summ. & edited]
<http://www.saudigazette.com.sa/index.cf ... 0050271104>


A day after 5 government agencies met to discuss ways to combat an
outbreak of dengue fever -- which has already infected hundreds of
people -- officials from the mayoralty and the health affairs
department started blaming each other for the situation.

Over 200 people contracted the disease over the past 2 weeks. A total
of 750 cases over the past 16 weeks have been confirmed.

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

An interactive map showing the location of Jeddah on the coast of the
Red Sea in western Saudi Arabia can be accessed at
<http://www.maplandia.com/saudi-arabia/a ... h-airport/>.
A HealthMap/ProMED-mail interactive map of Saudi Arabia can be accessed at
<http://healthmap.org/promed/en?v=24.1,44.5,5>. - Mod.TY]

******
[2] Saudi Arabia (Jizan)
Date: Thu 6 May 2010
Source: [in Arabic, machine trans., edited]
<http://ksa.daralhayat.com/ksaarticle/138350>


The Directorate General of Health Affairs in Jizan region launched a
campaign to raise awareness of dengue fever under the slogan "[the
fight] against dengue is everyone's responsibility" under the
auspices of the Emir of Jizan, Prince Muhammad ibn Nasser, who
inaugurated the exhibition of the campaign in the King Fahad Central
Hospital, and met with field teams to participate in the campaign.

This comes at a time when the number of cases of dengue fever in
Jazan as of the end of April [2010] was 156, which were distributed
equally between the 2 sectors Samtah and Jizan. The Assistant
Director of Health for primary care in the region of Jazan, Dr. Ahmad
Sahli, commented on the importance of awareness in the disease
campaign for dengue fever, pointing out that international experience
in combating the disease proved that control without the
participation of the community is not feasible because the mosquito
vectors of dengue fever [virus] are there in the home. He noted that
the campaign was launched through 2 main areas: 1st, a drive-through
from house to house to field visit homes and work on the distribution
of leaflets for awareness of dengue fever in ways that are simple for
all, and 2nd, to drive through the community for the 141 task force,
aimed at schools and social gatherings in the markets and clubs in
order to spread awareness of the disease.

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

[An interactive map showing the location of Jizan in southwestern
Saudi Arabia, on the Red Sea coast, can be accessed at
<http://www.maplandia.com/saudi-arabia/jizan/jizan/>. - Mod.TY]

******
[3] Yemen (Aden)
Date: Tue 4 May 2010
Source: Change [in Arabic, machine trans., edited]
<http://www.al-tagheer.com/news17282.html>


Among the students, it is said that a number of them studying in the
province of Hadramout colleges of the University of Aden left there
and returned to their areas infected with dengue fever virus, where
they had visited the most populous districts of Aden.

In a statement to Change, one of the students said: "Dengue fever has
spread in the province of Aden and has produced unusual fear, which
led a number of students to leave the province." He noted that during
the 5 days he was lying in a hospital bed for medical treatment, his
condition has not improved yet due to the severity of fever [virus]
transmitted to him and to the weakness of hospital services.

[Byline: Omar Makarem]

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

[The Thu 6 May 2010 edition of News Yemen (in Arabic)
(<http://www.newsyemen.net/view_news.asp? ... 5_06_43677>)
reported an outbreak of dengue in Dhala and the presence of the
mosquito vector there, but no case numbers were given.

A map showing the location of Aden on the coast of the Arabian Sea
can be accessed at
<http://www.nationsonline.org/oneworld/m ... p_Aden.htm>.
A map showing the location of Dhala in interior northern Yemen can be
accessed at
<http://en.wikipedia.org/wiki/Emirate_of_Dhala>.
A HealthMap/ProMED-mail interactive map of Yemen can be accessed at
<http://healthmap.org/promed/en?v=15.9,47.6,5>. - Mod.TY]

******
[4] Brunei
Date: Thu 29 Apr 2010
Source: Asia One Health [edited]
<http://health.asiaone.com/Health/News/S ... 13104.html>


From January to the 1st week of April this year [2010], 77 people
contracted dengue fever in the country. The number surpasses the 37
cases recorded for all of 2009, according to the Ministry of Health.

Senior Public Health Officer Kamaludin Mohamad Yassin from the
Entomology and Parasitology Unit under the ministry's Environment
Health Services, said the increase in the number of cases is
alarming. This marks a rise of 24 cases during the 1st week of April
alone this year [2010], as it was stated in an earlier report that
there were only 53 cases from January to the beginning of April 2010.
The report also stated that for the 1st time, Brunei has reported 2
cases of dengue haemorrhagic fever, which is a more virulent form of
dengue [disease] whereby a patient bleeds through his skin, nose or eyes.

"Even though this figure is small compared with some of our
neighbouring Southeast Asian countries, this is still a worrying
figure when taking into context the size of our population," said the
senior public health officer on the sidelines of the Ministry of
Health's briefing on dengue fever and environmental hygiene yesterday
[28 Apr 2010] at the Muhibah Hall, Brunei-Muara District Office. He
told the media that a majority of these cases were from Kampong Ayer,
where pools of stagnant water can be found due to poor sewage
management. "There are areas in Kampong Ayer with a lot of rubbish
floating in the water. This rubbish is not being cleared or taken
care of appropriately, which results in a breeding place for the
_Aedes_ mosquitoes," he said, explaining that the _Aedes_ mosquito is
a known vector for carrying the dengue virus. [Rubbish can collect
fresh water, the breeding sites for _Aedes_ mosquitoes. However,
sewage is not a breeding site. - Mod.TY]

Kamaludin added that other possible causes for the increase of the
disease, seen not only in Brunei but throughout the whole world,
included the unusually high rainfall experienced in the Sultanate
during the 1st 3 months of the year [2010] and also the storage of
water in homes. "We have to keep the water covered to prevent the
mosquitoes from breeding," the senior public health officer said.
With this in mind, Kamaludin added that the public cannot be
complacent in trying to prevent dengue fever.

During his presentation, the senior public health officer told
participants of the briefing that of the total 77 cases recorded this
year [2010], 67 were from the Brunei-Muara District. Kuala Belait had
5 cases followed by Tutong with 4 and Temburong, one case. As much as
86 percent of this year's infection was recorded from Kampong Ayer, a
change in trend compared to the previous 5 years when only an average
of 13 percent of the Sultanate's cases were from the water village.

Asked if there were any "serious" cases recorded recently, Kamaludin
recalled only one, which occurred in 2009. "But this person had
underlying chronic illnesses. ... The virus lowered his immunity,
which made him more susceptible to other illnesses," said the senior
public health officer.

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

[The location of Brunei on the north coast of Borneo Island can be
accessed on the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/promed/en?v=4.5,114.8,5>. - Mod.TY]

DENGUE/DHF UPDATE 2010 (37)
**************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Yemen
Date: Thu 15 Jul 2010
Source: Yemen Times [edited]
<http://www.yementimes.com/defaultdet.aspx?SUB_ID=34409>


A report by the Yemeni government today 13 Jul [2010] said that
dengue fever claimed 12 lives in Hadramout governorate and 1142
others were infected with the disease. Last week 7 children died of
the epidemic in Hajjah and 200 people are inflicted with the
epidemic, medical sources in Hajjah said.

More than 1100 cases were reported in Shabwa. Al-Jumhoori Hospital in
Taiz earlier reported 525 cases, but numbers are likely higher now.
Other governorates suffering from the outbreak include Aden, Abyan,
and Lahj.

A team of Saudi medical experts visited Hadramout in June and said
the lack of modern testing equipment complicates diagnostic efforts,
"A diagnostic machine that can trace the virus in the blood from the
1st day of infection is not available in Hadramout. Doctors depend on
the count of antibodies in the blood, which appear only after 7 days
from infection."

Doctors and residents in affected areas have complained about the
Health Ministry's lack of attention on the outbreak. In April [2010],
a hospital director in Taiz died from the disease, 2 months after the
outbreak was reported to the Health Ministry. The Health Ministry
made no efforts to prevent the spread of the disease in Taiz,
generating public protests which were broken up by police.

The district of Milhan has 100 000 residents and 16 medical
facilities that are woefully under equipped. Only 4 have generators,
one has microscopes and the rest lack electricity and a basic
laboratory.

Dengue fever is a mosquito-borne [virus] infection and education
campaigns should highlight the danger of stagnant water, open-liquid
containers and standing rainfall in areas where mosquitoes breed.
Yemen is suffering from severe water scarcity. Rural women can spend
up to 7 hours a day hauling water.

[Byline: Jane Novak]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[A map showing the location of Hajjah and the other governorates
mentioned in Yemen can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... n_2002.jpg>
A HealthMap/ProMED-mail interactive map of Yemen can be accessed at
<http://healthmap.org/promed/en?v=15.9,47.6,5>. - Mod.TY]

MUMPS - ISRAEL (04): YESHIVA STUDENTS
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 23 Jul 2010
Source: The Jerusalem Post [edited]
<http://www.jpost.com/HealthAndSci-Tech/ ... ?id=182330>


Health Ministry unfazed by mumps
--------------------------------
There have been 3400 reported cases of the mumps since January
[2010], 2400 of them in the Jerusalem area alone -- compared to 6 to
10 cases during an ordinary year, according to National Council for
the Child Chairman Dr. Yitzhak Kadman.

Kadman asked the Health Ministry this week [19-23 Jul 2010] for an
explanation, since the mumps/measles/rubella (MMR) vaccine is
generally given to protect children from these infectious viral
disease.

Last November [2009], the Health Ministry's epidemiology department
issued a directive about mumps, saying that within the 2 months
before that date, there had been an outbreak of the disease, that 78
percent of the patients had been males aged 10 to 24 -- and that most
had occurred in haredi yeshivot [orthodox religious boarding schools
for males] in Jerusalem, Bnei Brak, Petah Tikva and Modi'in Illit.

The number of cases in kindergartens and schools has been small, Dr.
Itamar Grotto, the Ministry's Chief of Public Health, told The
Jerusalem Post on Thursday [22 Jul 2010].

"The origin of the outbreak was in haredi yeshivot in Brooklyn, New
York, and in New Jersey [see ProMED-mail references below. - Mod.CP],
but there are also reports of mumps out of Holland, England, and
Germany in recent months that had nothing to do with the haredi
community," he asserted.

"We are not worried," Grotto added. "It is under control." The number
of cases has been on the decline since March [2010]. The Ministry
urges everyone to make sure children get vaccinated with the MMR
vaccine, even though no vaccine offers 100 percent protection, and
this particular vaccine is less effective than others that protect
against childhood diseases. [This is true only of the mumps component
of the triple vaccine. - Mod.CP] Most people who get the MMR vaccine
at age one and age 6 are protected against mumps, Grotto assured.

The Ministry has sent information in recent months to the haredi
media and to rabbis and yeshivot.

[Byline: Judy Siegel-Itzkovich]

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

[The situation in Jerusalem does not appear to be unique. Most
recently in August 2009, an outbreak of mumps originating in a summer
camp in Sullivan County, New York state, became the largest mumps
outbreak since 2006, when the United States experienced an outbreak
of mumps with 6584 reported cases. The outbreak primarily affected
members of a tradition-observant (Jewish) religious community, in
spite of a high level of vaccination (see MMWR, November 12, 2009 /
58(Dispatch); 1-4 available at
<http://www.cdc.gov/mmwr/preview/mmwrhtm ... 8d1112a1_e>).
Elsewhere similar outbreaks have occurred in colleges and schools
where children and young adults may be living in close contact.

Over 4 months up to mid-January 2010 some 600 cases of mumps had been
reported in the Jerusalem district and more than 850 nationally in
Israel, the majority of whom (70 percent) have been male. Case
investigation showed that the outbreak emerged in male-attended
religious high schools and colleges (yeshivas). In view of the fact
that the number of cases since January has risen to 3400 (2400 in the
Jerusalem area) the Ministry of Health's optimism seems misplaced.

The HealthMap/ProMED-mail interactive map of Israel is available at:
<http://healthmap.org/r/013l>. - Mod.CP]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (12): WEST ASIA, REQUEST
FOR INFORMATION
********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Diarrhea, fatal, troops - Syria: RFI
[2], [3] Diarrhea, fatal - Yemen: RFI

******
[1] Diarrhea, fatal, troops - Syria: RFI
Date: Tue 13 Jul 2010
Source: World Tribune [edited]
<http://www.worldtribune.com/worldtribun ... _07_13.asp>


Syria's military was said to be fighting a mysterious epidemic that
has killed several soldiers and delayed programs. The Syrian
opposition asserted that an unknown disease has been raging through
Syrian Army barracks, particularly in the north. The opposition said
the suspected epidemic has killed several people and delayed a
recruitment program.

"The enrollment of new conscripts has been postponed to the beginning
of next month [August 2010] rather than this month," the opposition
West Kurdistan Society said.

In a statement on 12 Jul 2010, the society, which reports on the
Kurdish minority in Syria, said an undetermined number of soldiers
have died of the "unknown disease." On 10 Jul 2010, the statement
said, 10 Army recruits were rushed to a hospital in the northeastern
city of Qamishli and were reported in critical condition.

The Syrian military has not acknowledged the epidemic. But officials
have confirmed that Syrian hospitals were treating many people for
exhaustion and other illnesses related to the current heat wave in the
Levant.

This marked the 2nd report by the Syrian opposition of an epidemic
that has struck the Army. The 1st report said many Syrian soldiers
were hospitalized by what appeared to be dysentery. The disease was
attributed to a lack of water, food, and poor sanitary conditions in
Syrian military training camps.

"There has been a lot of speculation about the reasons for this
disease, some blaming the vaccines given to new soldiers, which may
have been corrupted," the West Kurdistan Society said. "Others
attributed the cause to the state of the weather as there is a wave of
intense heat and high temperatures. Some attribute it to a bacterial
contamination in water and food in the barracks, and so far this is
limited to members of the military, not Syrian civilians."

The Kurdish group said Syrian hospitals were overflowing with soldiers
and civil servants believed infected by the epidemic. The report said
Syrian physicians have failed to reach a diagnosis and were hampered
by poor equipment and training. So far, at least 14 soldiers, all of
them new recruits, were said to have died in the epidemic. The Kurdish
group cited deaths in military hospitals in Harasta and Teshrin.

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

[The etiology or etiologies of the gastrointestinal disease in the
soldiers is not clear. - Mod.LL]

[Qamishli can be located via the HealthMap/ProMED-mail interactive map
of Syria at
<http://healthmap.org/r/01K5>. - Sr.Tech.Ed.MJ]

******
[2] Diarrhea, fatal - Yemen: RFI
Date: Thu 1 Jul 2010 [accessed Fri 9 Jul 2010]
Source: Al-Sahwah, Sanaa [edited]
<http://www.alsahwa-yemen.net/arabic/sub ... 1/2067.htm>


A total of 4 persons including a child died in a diarrhea epidemic
last week [week of 21 Jun 2010] in Lahij governorate and 127 others
are affected by this outbreak. Meanwhile, 7 children died of the
epidemic in Hajjah governorate during the last week and 200 people
were inflicted with the epidemic, medical sources in Hajjah told
Sahwah Net.

--
Communicated by
Michelle Sellors
Specialist Nurse Travel Health
MASTA Ltd
<michelle.sellors@masta.org>

[The etiology or etiologies of the gastrointestinal disease in the
Yemeni population is not clear. - Mod.LL]

[The Health/ProMED-mail interactive map of Yemen is available at
<http://healthmap.org/r/01K6>. - Sr.Tech.Ed.MJ]

******
[3] Diarrhea, fatal - Yemen: RFI
Date: Tue 6 Jul 2010
Source: Mareb Press [in Arabic, trans. Corr.SB, edited]
<http://marebpress.net/news_details.php? ... lng=arabic>


The increased spread of a diarrheal epidemic has caused speculation in
the province of the Hajj Directorate, where medical sources said that
the rural hospital is receiving more than 15 cases a day while sources
for Marib Press said that the cases showed symptoms of diarrhea, acute
vomiting and abdominal pain, and were treated with fluids and
intravenous fluids.

According to Dr Ayman Mohsen Alhabayli, the number (of patients) with
the disease has reached 183 and the deaths so far are 4. Marib Press
stated that the 4 cases died in the home or during the ambulance
transport to hospital, but there have been no deaths in the hospital.

Doctors at Ibn Khaldoun Haj [said] that symptoms of the epidemic are
like cholera. The government reported that the results of laboratory
tests sent to the Sana'a central laboratory ruled out (cholera). The
hospital director, Khaled Ahmed Awad Sobeihi, said that the last case
(in Marib) was 30 years ago.

The correspondent for Marib Press states that the epidemic resulted
from bacterial contamination of water. He pointed out that despite the
closure of wells and workshops (and the use of) chlorine in water
wells, the epidemic is still on the rise.

[Byline: Anis Mansour]

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

WEST NILE VIRUS - ISRAEL
************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 2 Aug 2010
Source: Haaretz [edited]
<http://www.haaretz.com/print-edition/ne ... d-1.305379>


West Nile fever is spreading in Israel, although the number of cases
remains low. 12 cases of the disease, which generally surfaces in the
summer, have been confirmed and another 12 patients are thought to be
suffering from the illness. The disease is spread to humans by
mosquitoes, which are infected with the virus by birds. Incidence of
the fever has been centered in the Tel Aviv area.

West Nile causes flu-like symptoms, headaches, rashes, and
conjunctivitis, and in 8 percent of cases meningitis, which can
affect the nervous system and even cause death. An 87-year-old woman
from Ramat Efal who had a history of heart and metabolic conditions
died of West Nile fever [virus infection] this summer [2010]. 2
patients remain hospitalized with symptoms of meningitis. Most of
those affected are over 65 or are suffering from chronic illness. The
largest recent outbreak in Israel occurred in 2000 when more than 400
caught the fever and 29 people died of it.

The Health Ministry recommends taking measures to avoid contact with
mosquitoes, including wearing long sleeves, using window screens,
using mosquito repellent, and eliminating standing water where
mosquitoes breed.

[Byline: Dan Even]

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

[West Nile virus has been identified previously in clinical human and
equine cases and in mosquitoes and birds in Israel.

A HealthMap/ProMED-mail interactive map of Israel can be accessed at
<http://healthmap.org/r/00JC>. - Mod.TY]

DENGUE/DHF UPDATE 2010 (41)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>


******
Yemen
Date: Fri 6 Aug 2010
Source: Saba net [edited]
<http://www.sabanews.net/en/news221660.htm>


Study [shows] 200 deaths of dengue fever in Taiz, Aden; over 100 000 infected
-----------------------------------------------------------------------------
A recent study has revealed spread of the dengue fever epidemic in a number
of provinces in Yemen, the reported on Friday [6 Aug 2010].
The study, prepared by Dr Naji al-Hajj of the University of Sana'a, a
researcher at the biotechnology and the nanotechnology, indicated that many
public and private hospitals have recorded a noticeable increase in the
number of the infected cases, with the lack of accurate diagnosis in many
cases.

The study revealed that there are 1000 cases infected with the disease, 600
cases of them in public and private hospitals in Aden province, and that
public hospitals in Aden admit up to 30 cases per day.

The study pointed out that 400 cases are in the Public Hospital of Ibn
Khaldon in the southern city of Lahj, while statistics issued by medical
sources says that 233 cases have been discovered in Shabwa province, among
them 40 infected cases and 193 suspected cases in the 9 districts of the
province. According to the study, the number of deaths that have been
recorded so far in Aden reached 150 cases of various ages.

The official declarations, announced in Taiz province, indicated that the
infected cases do not exceed 950 cases and there is only one case of death,
the study pointed out. The study [reported that] the number of cases
exceeded 100 000, with nearly 50 deaths. In addition, 7 physicians have
been infected by the disease, and one of them died.

Moreover, the study pointed out that in Hodeidah province and adjacent
areas, many reports showed that the disease is now prevalent with shortage
of control efforts and that this epidemic may have become out of control.

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

[A map showing the administrative divisions of Yemen can be accessed at
<http://www.lib.utexas.edu/maps/middle_e ... n_2002.jpg>.
A HealthMap/ProMED-mail interactive map of Yemen can be accessed at
<http://healthmap.org/promed/en?v=15.9,47.6,5>. - Mod.TY]

MUMPS - ISRAEL (05)
*******************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Sat 7 Aug 2010
From: a correspondent who has requested anonymity [edited]


ProMED-mail has received the following information from a reliable source:
With respect to the ongoing outbreak of mumps in Israel, there is local
concern that there has been complacency on the part of the Ministry of
Health (see prior ProMED-mail posting: Mumps - Israel (04): Yeshiva
students 20100723.2472). From personal experience, our 6 year old grandson
and his friends are ill with mumps (fortunately mild, uncomplicated cases).
They were vaccinated once, pending 2nd vaccination this coming year -- the
recommendation is for the 2nd dose to be given during the 1st year of
elementary school, using the Jeryl Lynn mumps vaccine. We have heard of
cases occurring following the booster dose, especially in schools.

As of 10 Jul 2010 (the most recent available weekly epidemiologic report),
the total number of reported confirmed cases this year [2010] is 4185
(compared with 6 confirmed cases during the same period in 2009).
Genotyping of the virus involved revealed strain G5 in Jerusalem, and later
on in Bnei-Brak a single nucleotide difference was detected. There has been
discussion that this nucleotide difference has had an impact on vaccine
efficacy in the country.

--
communicated by a correspondent who has requested anonymity

******
[2]
Date: Mon 2 Aug 2010
Source: Haaretz [edited]
<http://www.haaretz.com/print-edition/ne ... d-1.305379>


[The following information is the last paragraph in a newswire on the West
Nile virus outbreak in Israel. - Mod.MPP]
The Ministry has also noted a rise in the incidence of mumps in recent
months, with 4190 cases since the beginning of the year [January 2010]. A
ministry advisory committee has recommended a program of mumps
vaccinations, particularly in areas where the outbreaks have occurred,
notably in ultra-Orthodox communities.

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

[Subsequent to these reports further enquiries have elicited the following
information.
1. With respect to the ongoing outbreak of mumps in Israel, it seems that
the disease has become more widely spread, apparently affecting additional
sectors of the population [see prior ProMED-mail posting: Mumps - Israel
(04): Yeshiva students 20100723.2472]. As of 10 Jul 2010 (the most recent
available weekly epidemiologic report), the total number of reported
confirmed cases this year (2010) is 4185 (compared with 6 confirmed cases
during the same period last year - 2009). There is spread of disease in
kindergartens and elementary schools in central/coastal Israel, in addition
to Jerusalem. This includes children who have been MMR vaccinated, as well
as some of those duly boosted (with the Jeryl Lynn mumps vaccine) at the
age of 6-8. Genotyping of the prevailing G5 virus strain, reportedly
revealed a single nucleotide difference, initially in Jerusalem and later
on in Bnei-Brak. The possibility that this nucleotide difference has had
any impact on vaccine efficacy in the country has been a matter for
(inconclusive) discussion.

2. The following response to the 2 items above has been kindly received
from the Israeli Ministry of Health and is gratefully acknowledged: In
January 2010 the ministry of Health noted a rise in the incidence of mumps.
A ministry advisory committee has recommended a program of mumps
vaccinations, particularly in areas where the outbreaks have occurred,
notably in ultra-Orthodox communities. In recent months incidence has
decreased, but the outbreak is still ongoing after it peaked on April 2009,
with a total of 4190 cases since the beginning of the year. It should be
noted that the spread of the disease to the general population is limited:
case incidence is highest in the ultra orthodox community. - Mods.AS/CP

The HealthMap/ProMED-mail interactive map of Israel can be accessed at
<http://healthmap.org/r/00JC>. - Sr.Tech.Ed.MJ]

MUMPS - ISRAEL (05): CORRECTION
*******************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[This posting replaces ProMED-mail Mumps - Israel (05) 20100814.2799,
dated 7 Aug 2010, in which item [1] is a text that should have been
discarded following discussions with Israel's MOH.

ProMED-mail regrets the error. - Mods.AS/DK]

******
[1]
Date: Sun 8 Aug 2010
Source: a correspondent who has requested anonymity [edited]


With respect to the ongoing outbreak of mumps in Israel, it seems
that the disease has become more widely spread, apparently affecting
additional sectors of the population [see prior ProMED-mail posting
'Mumps - Israel (04): Yeshiva students 20100723.2472']. As of 10 Jul
2010 (the most recent available weekly epidemiological report), the
total number of reported confirmed cases this year is 4185 (compared
with 6 confirmed cases during the same period last year - 2009).
There is spread of disease in kindergartens and elementary schools in
central/coastal Israel, in addition to Jerusalem. This includes
children who have been MMR vaccinated, as well as some of those duly
boosted (with the Jeryl Lynn mumps vaccine) at the age of 6-8.

Genotyping of the prevailing G5 virus strain, reportedly revealed a
single nucleotide difference, initially in Jerusalem and later on in
Bnei-Brak. The possibility that this nucleotide difference has had
any impact on vaccine efficacy in the country has been a matter for
(inconclusive) discussion.

--
Communicated by:
a correspondent who has requested anonymity

******
[2]
Date: Mon 2 Aug 2010
Source: Haaretz [edited]
<http://www.haaretz.com/print-edition/ne ... d-1.305379>


[The following information is the last paragraph in a newswire on the
West Nile virus outbreak in Israel. - Mod.MPP]

The Ministry has also noted a rise in the incidence of mumps in
recent months, with 4190 cases since the beginning of the year
[January 2010]. A ministry advisory committee has recommended a
program of mumps vaccinations, particularly in areas where the
outbreaks have occurred, notably in ultra-Orthodox communities.

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

[The following response to the 2 items above has been kindly provided
by the Israeli Ministry of Health and is gratefully acknowledged:

"In January 2010 the Ministry of Health noted a rise in the incidence
of mumps. A ministry advisory committee has recommended a program of
mumps vaccinations, particularly in areas where the outbreaks have
occurred, notably in ultra-Orthodox communities. In recent months
incidence has decreased, but the outbreak is still ongoing after it
peaked on April 2009, with a total of 4190 cases since the beginning
of the year. It should be noted that the spread of the disease to the
general population is limited: case incidence is highest in the
ultra-orthodox community". - Mods.AS/CP

The HealthMap/ProMED-mail interactive map of Israel can be accessed
at <http://healthmap.org/r/00JC>. - Sr.Tech.Ed.MJ]