MENINGITIS, MENINGOCOCCAL - ETHIOPIA: SUSPECTED, REQUEST FOR INFORMATION
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Date: Thu 13 Mar 2014
From: Ota Masaki <masaki.ota@mb6.seikyou.ne.jp> [edited]
The Humanitarian Bulletin, a news release from the UN Office for Coordination of Humanitarian Affairs in Ethiopia reported on 10 Mar 2014 [http://reliefweb.int/sites/reliefweb.in ... 202014.pdf] that:
"The same regions [Amhara, Gambella, and SNNPR (Southern Nations, Nationalities, and People's Regions)] are reporting suspected cases of meningitis, with 66 cases reported during the past week. The meningitis outbreak was confined to Amaro woreda [district] of Segen Peoples zone, SNNPR. A 2nd outbreak is now suspected in Gedo zone, with 35 cases reported in Dilla town, Dilla Zuria, and Wenago woredas during the past week. The SNNP Regional Health Bureau is planning a mass vaccination campaign in the affected woredas using the limited meningitis vaccine available in the country. WHO reports inadequate meningitis vaccine stock in Ethiopia to reach the more than 2 million people at risk."
--
Ota Masaki, MD, PhD
<masaki.ota@mb6.seikyou.ne.jp>
<otam@jata.or.jp>
[Maps of Ethiopia can be seen at http://healthmap.org/r/1Ahu and http://en.wikipedia.org/wiki/Regions_of_Ethiopia (regions).
Ethiopia is one of the countries in the WHO African meningitis belt, a region in sub-Saharan Africa stretching from Senegal in West Africa to the Horn of Africa where the incidence rate of meningitis is very high (see map at http://wwwnc.cdc.gov/travel/images/map3 ... -large.png). Outbreaks of meningococcal meningitis are reported in the African meningitis belt each year during the hot, dry season, between December and June (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx).
_Neisseria meningitidis_ serogroup A is said to be the most commonly isolated pathogen in the African meningitis belt. However, outbreaks have also been caused by other _N. meningitidis_ serogroups, such as serogroup C (http://www.cdc.gov/meningitis/lab-manua ... 2-epi.html), W135 (http://www.expert-reviews.com/doi/abs/1 ... 84.5.3.319), and X (http://www.sciencedirect.com/science/ar ... 0X13004751), and in March 2012, a serogroup B outbreak occurred in Ethiopia (http://www.afro.who.int/en/clusters-a-p ... 2012-.html). No reports on meningitis were available for Ethiopia for 2013 (http://www.who.int/csr/don/2013_06_06_menin/en/) and we are not told the microbial etiology of the meningitis outbreak in the various regions of Ethiopia in the report above. ProMED-mail would appreciate information on the microbial causes of the meningitis outbreaks in Ethiopia from knowledgeable sources.
To control an outbreak, WHO recommends mass vaccination with the appropriate meningococcal vaccine in every involved district in an attempt to induce herd immunity, whereby transmission is blocked when a critical percentage of the population has been vaccinated (see http://www.who.int/mediacentre/factsheets/fs141/en/). Meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains. Meningococcal disease is most commonly due to serogroups A, B, C, Y, and W135. Rarely, outbreaks of meningococcal meningitis have been related to other serogroups, such as type X, which has occurred in Niger in 2006 and Burkina Faso in 2010.
Serogroup A, B, C, Y, and W135 polysaccharides are immunogenic in humans; serogroup B is poorly immunogenic, presumably because serogroup B polysaccharide resembles the human neural cell adhesion molecule. While effective capsular polysaccharides-based vaccines exist against serogroups A, C, W135, and Y, no similar vaccine is available against disease caused by serogroup B strains. However, a new protein-based, broad-spectrum meningococcal serogroup B vaccine has been developed. - Mod.ML]
Aktuelle Epidemien in Afrika
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Denguefieber und Chikungunya in Portugal ex Angola
DENGUE & CHIKUNGUNYA CO-INFECTION - PORTUGAL ex ANGOLA
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A ProMED-mail post
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Date: Thu 13 Mar 2014
Source: Eurosurveillance Volume 19, Issue 10 [summ., edited]
http://www.eurosurveillance.org/ViewArt ... leId=20730
Parreira R, Centeno-Lima S, Lopes A, Portugal-Calisto D, Constantino A, Nina J. Dengue virus serotype 4 and chikungunya virus coinfection in a traveller returning from Luanda, Angola, January 2014. Euro Surveill. 2014;19(10):pii=20730
--------------------------------------------------------------------------------
Summary:
A concurrent dengue virus [DENV] serotype 4 and chikungunya virus [CHIKV] infection was detected in a woman in her early 50s returning to Portugal from Luanda, Angola, in January 2014. The clinical, laboratory and molecular findings, involving phylogenetic analyses of partial viral genomic sequences amplified by RT-PCR, are described. Although the circulation of both dengue and chikungunya viruses in Angola has been previously reported, to our knowledge this is the 1st time coinfection with both viruses has been detected there.
Background [summarized]:
Although CHIKV/DENV coinfections were 1st reported in India in 1967 [13] and later confirmed in Sri Lanka (2008), Malaysia (2010) and Gabon (2007) [14-16], these coinfections are rarely notified.
Discussion:
Serological reports from the 1960s, the detection of DENV in travellers returning from Angola in the 1980s, and the detection of DENV1 and DENV2 in travellers in the 1980s and in 1999-2002 suggest endemic DENV activity in Angola. As far as CHIKV is concerned, the situation is a lot less clear. However, serological studies from the 1960s not only identified the presence of anti-CHIKV neutralising antibodies in the north of the country, but also allowed the isolation of 2 strains from a viraemic individual and wild-caught mosquitoes during an outbreak of Katolu Tolu (Kimbundu dialect for 'break-bone disease'), a dengue-like disease caused by the CHIKV, which occurred in Luanda in 1970.
The detection of DENV4 in the recent traveller is of interest, given that on 1 Apr 2013, the Angolan health authorities reported a dengue outbreak in the country, which was later shown to have been caused by DENV1, and the current description of DENV4 in Luanda may indicate the circulation of multiple DENV subtypes in the country.
--
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[The occurrence of dual DENV and CHIKV infections in an individual is clearly a rare event. With the infected woman's return to Portugal in January, a time of no vector activity, there was little chance of her being a virus source for ongoing transmission. Had either or both infections occurred during the warm season, the consequences might have been different had the infected individual landed in a locality where _Aedes_ mosquitoes were abundant and active, as happened with the introduction of dengue virus into Madeira Island in 2013 (see ProMED-mail archives cited below).
Maps of Angola can be accessed at http://www.un.org/Depts/Cartographic/ma ... angola.pdf and http://healthmap.org/r/1iGj. - Mod.TY]
******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 13 Mar 2014
Source: Eurosurveillance Volume 19, Issue 10 [summ., edited]
http://www.eurosurveillance.org/ViewArt ... leId=20730
Parreira R, Centeno-Lima S, Lopes A, Portugal-Calisto D, Constantino A, Nina J. Dengue virus serotype 4 and chikungunya virus coinfection in a traveller returning from Luanda, Angola, January 2014. Euro Surveill. 2014;19(10):pii=20730
--------------------------------------------------------------------------------
Summary:
A concurrent dengue virus [DENV] serotype 4 and chikungunya virus [CHIKV] infection was detected in a woman in her early 50s returning to Portugal from Luanda, Angola, in January 2014. The clinical, laboratory and molecular findings, involving phylogenetic analyses of partial viral genomic sequences amplified by RT-PCR, are described. Although the circulation of both dengue and chikungunya viruses in Angola has been previously reported, to our knowledge this is the 1st time coinfection with both viruses has been detected there.
Background [summarized]:
Although CHIKV/DENV coinfections were 1st reported in India in 1967 [13] and later confirmed in Sri Lanka (2008), Malaysia (2010) and Gabon (2007) [14-16], these coinfections are rarely notified.
Discussion:
Serological reports from the 1960s, the detection of DENV in travellers returning from Angola in the 1980s, and the detection of DENV1 and DENV2 in travellers in the 1980s and in 1999-2002 suggest endemic DENV activity in Angola. As far as CHIKV is concerned, the situation is a lot less clear. However, serological studies from the 1960s not only identified the presence of anti-CHIKV neutralising antibodies in the north of the country, but also allowed the isolation of 2 strains from a viraemic individual and wild-caught mosquitoes during an outbreak of Katolu Tolu (Kimbundu dialect for 'break-bone disease'), a dengue-like disease caused by the CHIKV, which occurred in Luanda in 1970.
The detection of DENV4 in the recent traveller is of interest, given that on 1 Apr 2013, the Angolan health authorities reported a dengue outbreak in the country, which was later shown to have been caused by DENV1, and the current description of DENV4 in Luanda may indicate the circulation of multiple DENV subtypes in the country.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The occurrence of dual DENV and CHIKV infections in an individual is clearly a rare event. With the infected woman's return to Portugal in January, a time of no vector activity, there was little chance of her being a virus source for ongoing transmission. Had either or both infections occurred during the warm season, the consequences might have been different had the infected individual landed in a locality where _Aedes_ mosquitoes were abundant and active, as happened with the introduction of dengue virus into Madeira Island in 2013 (see ProMED-mail archives cited below).
Maps of Angola can be accessed at http://www.un.org/Depts/Cartographic/ma ... angola.pdf and http://healthmap.org/r/1iGj. - Mod.TY]
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Hepatitis E in Uganda
HEPATITIS E - UGANDA (02): (KARAMOJA)
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Date: Sun 16 March 16 2014
Source: The Monitor [edited]
http://www.monitor.co.ug/News/National/ ... index.html
The death toll of hepatitis E epidemic in Napak District has hit 30. Sunday Monitor has learned that 1000 have been infected with the deadly viral infection since the breakout in the district in mid-2013. Dr James Lemukol, the district health director, said majority of the dead were pregnant mothers.
He said the transmission of the disease in the community is still high yet some development partners who had been supporting the district to fight the epidemic through community mobilization on hygiene have slowed down their efforts due to lack of money. He said the increasing number of infected people proves there's no improvement. The most affected areas are Lorengechora and Iriiri, the highly populated sub-counties in Napak.
"The disease situation has gone up and I am worried it might double since some of the instrumental developmental partners are running short of funds," Dr Lemukol said. "The low coverage of pit-latrines in the district which stands at 22 percent and few clean water sources, are the major challenges hindering the fight against hepatitis E in Napak," he added.
A source at the Ministry of Health told this newspaper that the minister, Dr Ruhakana Rugunda, has called a meeting in Kampala to discuss ways to tame the epidemic.
[Byline: Steven Ariong]
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[The current outbreak of the fecal-oral transmitted hepatitis E virus in the Karamoja subregion of northern Uganda continues with a mortality most prominent in pregnant women. This association has been found with the virus and pregnant women since the initial descriptions of HEV several decades ago.
In rare cases, hepatitis E can result in acute liver failure and death. Overall population mortality rates from hepatitis E range from 0.5 to 4.0 percent. Fulminant hepatitis does occur more frequently during pregnancy. Pregnant women are at greater risk of both obstetrical complications and mortality from hepatitis E, which can induce a mortality rate of 20 percent among pregnant women in the 3rd trimester, especially in outbreaks in the Indian subcontinent and Africa.
As discussed in Navaneethan U, Al Mohajer M, Shata MT: Hepatitis E and pregnancy: understanding the pathogenesis.
Liver Int. 2008;28:1190-1199, the high mortality rate in pregnancy has been thought to be secondary to the associated hormonal (estrogen and progesterone) changes during pregnancy and consequent immunological changes. These immunological changes include downregulation of the p65 component of nuclear factor (NF-kappaB) with a predominant T-helper type 2 (Th2) bias in the T-cell response along with host susceptibility factors, mediated by human leucocyte antigen expression. Thus far, researchers were unable to explain the high HEV morbidity in pregnancy, why it is different from other hepatitis viruses such as hepatitis A with similar epidemiological features and the reason behind the difference in HEV morbidity in pregnant women in different geographical regions. - Mod. LL]
[For a map of Uganda showing the Karamoja subregion, see http://commons.wikimedia.org/wiki/File:Karamoja.png. - Mod.MPP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/97.]
*************************************
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: Sun 16 March 16 2014
Source: The Monitor [edited]
http://www.monitor.co.ug/News/National/ ... index.html
The death toll of hepatitis E epidemic in Napak District has hit 30. Sunday Monitor has learned that 1000 have been infected with the deadly viral infection since the breakout in the district in mid-2013. Dr James Lemukol, the district health director, said majority of the dead were pregnant mothers.
He said the transmission of the disease in the community is still high yet some development partners who had been supporting the district to fight the epidemic through community mobilization on hygiene have slowed down their efforts due to lack of money. He said the increasing number of infected people proves there's no improvement. The most affected areas are Lorengechora and Iriiri, the highly populated sub-counties in Napak.
"The disease situation has gone up and I am worried it might double since some of the instrumental developmental partners are running short of funds," Dr Lemukol said. "The low coverage of pit-latrines in the district which stands at 22 percent and few clean water sources, are the major challenges hindering the fight against hepatitis E in Napak," he added.
A source at the Ministry of Health told this newspaper that the minister, Dr Ruhakana Rugunda, has called a meeting in Kampala to discuss ways to tame the epidemic.
[Byline: Steven Ariong]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The current outbreak of the fecal-oral transmitted hepatitis E virus in the Karamoja subregion of northern Uganda continues with a mortality most prominent in pregnant women. This association has been found with the virus and pregnant women since the initial descriptions of HEV several decades ago.
In rare cases, hepatitis E can result in acute liver failure and death. Overall population mortality rates from hepatitis E range from 0.5 to 4.0 percent. Fulminant hepatitis does occur more frequently during pregnancy. Pregnant women are at greater risk of both obstetrical complications and mortality from hepatitis E, which can induce a mortality rate of 20 percent among pregnant women in the 3rd trimester, especially in outbreaks in the Indian subcontinent and Africa.
As discussed in Navaneethan U, Al Mohajer M, Shata MT: Hepatitis E and pregnancy: understanding the pathogenesis.
Liver Int. 2008;28:1190-1199, the high mortality rate in pregnancy has been thought to be secondary to the associated hormonal (estrogen and progesterone) changes during pregnancy and consequent immunological changes. These immunological changes include downregulation of the p65 component of nuclear factor (NF-kappaB) with a predominant T-helper type 2 (Th2) bias in the T-cell response along with host susceptibility factors, mediated by human leucocyte antigen expression. Thus far, researchers were unable to explain the high HEV morbidity in pregnancy, why it is different from other hepatitis viruses such as hepatitis A with similar epidemiological features and the reason behind the difference in HEV morbidity in pregnant women in different geographical regions. - Mod. LL]
[For a map of Uganda showing the Karamoja subregion, see http://commons.wikimedia.org/wiki/File:Karamoja.png. - Mod.MPP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/97.]
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Malaria in Angola
MALARIA - ANGOLA: (CABINDA)
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Date: Fri 14 Mar 2014
Source: Prensa Latina [edited]
http://www.plenglish.com/index.php?opti ... 1&Itemid=1
A total of 44 535 cases of malaria and 41 dead were reported on January and February [2014] in the Angolan province of Cabinda, said today [14 Mar 2014] the chief of the regional department of Public Health, Maria Carlota Tati.
From that number, 14 592 were children under 5 years, 10 397 between 5 and 14, and 16 543 adults living in that area, 400 km [249 mi] North from Luanda, she said the press.
Tati made reference to the need for technicians to improve in diagnosis and know the symptoms not to confuse fever with malaria, taking into account cases of high temperature due to dengue, which symptoms are similar to malaria.
She also talked about preventive measures like the use of mosquito nets and to eliminate stagnant water in containers, tires and cans.
Angola reduced the number of malaria cases from 3 million to 2 million, which is an achievement, recently said the Secretary of State for health, Carlos Alberto Masseca.
According to data from the Health Ministry, about 20 000 people every year died due to malaria in this country, but currently the number is lower at 5000, which shows the efforts to eradicate the disease.
Biological products made in Cuba have shown efficiency in the elimination of the mosquito _Anopheles_, which carries the virus [malaria is caused by a protozoan parasite, not a virus. - Mod.EP] of malaria.
The participation of Cuban collaborators in the campaign to eradicate the disease through fumigation and other preventive actions has also helped in the efforts.
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Communicated by:
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[Malaria is endemic in Angola including Cabinda province, which is separated from the rest of Angola by a narrow strip of territory belonging to the Democratic Republic of the Congo. The reported mortality (World Malaria Report 2013 http://www.who.int/malaria/publications ... n.pdf?ua=1) has slowly declined since 2003 and the last reported figure is approximately 25 per 100 000 population. The bed net coverage is below 20 percent, and an alternative strategy to the increased use of larvicides, as suggested here, would be to increase the use of bed nets especially among children. - Mod.EP
Maps of Angola can be seen at http://www.geoatlas.com/medias/maps/cou ... la_pol.jpg and http://healthmap.org/promed/p/14778. - Sr.Tech.Ed.MJ]
***************************
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 14 Mar 2014
Source: Prensa Latina [edited]
http://www.plenglish.com/index.php?opti ... 1&Itemid=1
A total of 44 535 cases of malaria and 41 dead were reported on January and February [2014] in the Angolan province of Cabinda, said today [14 Mar 2014] the chief of the regional department of Public Health, Maria Carlota Tati.
From that number, 14 592 were children under 5 years, 10 397 between 5 and 14, and 16 543 adults living in that area, 400 km [249 mi] North from Luanda, she said the press.
Tati made reference to the need for technicians to improve in diagnosis and know the symptoms not to confuse fever with malaria, taking into account cases of high temperature due to dengue, which symptoms are similar to malaria.
She also talked about preventive measures like the use of mosquito nets and to eliminate stagnant water in containers, tires and cans.
Angola reduced the number of malaria cases from 3 million to 2 million, which is an achievement, recently said the Secretary of State for health, Carlos Alberto Masseca.
According to data from the Health Ministry, about 20 000 people every year died due to malaria in this country, but currently the number is lower at 5000, which shows the efforts to eradicate the disease.
Biological products made in Cuba have shown efficiency in the elimination of the mosquito _Anopheles_, which carries the virus [malaria is caused by a protozoan parasite, not a virus. - Mod.EP] of malaria.
The participation of Cuban collaborators in the campaign to eradicate the disease through fumigation and other preventive actions has also helped in the efforts.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[Malaria is endemic in Angola including Cabinda province, which is separated from the rest of Angola by a narrow strip of territory belonging to the Democratic Republic of the Congo. The reported mortality (World Malaria Report 2013 http://www.who.int/malaria/publications ... n.pdf?ua=1) has slowly declined since 2003 and the last reported figure is approximately 25 per 100 000 population. The bed net coverage is below 20 percent, and an alternative strategy to the increased use of larvicides, as suggested here, would be to increase the use of bed nets especially among children. - Mod.EP
Maps of Angola can be seen at http://www.geoatlas.com/medias/maps/cou ... la_pol.jpg and http://healthmap.org/promed/p/14778. - Sr.Tech.Ed.MJ]
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Meningokokken-Meningitis in Ghana
MENINGITIS, MENINGOCOCCAL - GHANA: (NORTHERN) SUSPECTED, FATAL, REQUEST FOR INFORMATION
****************************************************************************
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Date: Mon 17 Mar 2014
Source: CitiFMOnline, Ghana News Agency (GNA) report [edited]
http://www.citifmonline.com/?p=6637
An outbreak of cerebrospinal meningitis (CSM) has been reported in 4 districts in the Northern Region [of Ghana], leaving one person dead. An 18-year-old student of Yendi Senior High School has died of the disease.
So far 30 cases have been reported. Out of that number, 23 were reported from Yendi, 2 from the Mion District, one from the Zabzugu District, and 2 from the Saboba District. [This adds up to 28. Perhaps there were 2 from other districts? - Mod.LM] The Yendi Municipal Disease Control Officer, Awuni Mbabila, made this known when he briefed the Yendi Municipal Epidemic Management Committee at a meeting in Yendi last Friday.
He said those with severe head and neck pains should report to a health facility. Mr Mbabila said an analysis of cases had been done by person, place, and time to present a clear picture of the situation. He said the Hospital Epidemic Management Team had moved to the affected areas in the municipality to assess the situation and also educate residents on the disease. According to him, health workers at the sub-districts were also carrying out intensive public sensitisation on the disease to avoid an outbreak.
The Yendi Municipal Chief Executive, Issah Zakaria, said CSM was becoming alarming in the municipality and it was for that reason that the emergency meeting was called to discuss how the outbreak could be contained. The meeting was attended by representatives of the Ghana Armed Forces, the Ghana Police Service, the Ghana Red Cross, the Veterinary Service, the Environmental Health Unit, the Information Services Department, as well as religious leaders and assembly members,
The meeting appealed to the health authorities to supply CSM vaccines to the Yendi Hospital to enable it to carry out massive vaccination to avoid an outbreak.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The Northern Region, the largest in area of Ghana's 10 regions, is divided into 26 districts (http://en.wikipedia.org/wiki/Districts_ ... ern_Region). For a map of Ghana that shows the Northern Region, see http://en.wikipedia.org/wiki/Regions_of_Ghana. Yendi, Zabzugu, and Saboba are adjacent districts and their locations can be found on a map of the Northern Region at http://upload.wikimedia.org/wikipedia/c ... tricts.png. Mion is a new district that was carved from Yendi in 2012 (http://www.ghanadistricts.com/districts/?news&r=6&_=216).
Ghana is one of the 21 countries in the African meningitis belt, a region in sub-Saharan Africa where the rate of incidence of meningitis is very high. The other countries in the African meningitis belt are Gambia, Senegal, Guinea-Bissau, Guinea, Mali, Cote d'Ivoire, Benin, Togo, Burkina Faso, Niger, Nigeria, Cameroon, Chad, Central African Republic, Sudan, South Sudan, Uganda, Kenya, Ethiopia, and Eritrea (http://wwwnc.cdc.gov/travel/pdf/yellowb ... ngitis.pdf). Outbreaks of meningococcal meningitis are reported in the African meningitis belt each year during the hot, dry season, between December and June (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx). _Neisseria meningitidis_ serogroup A has been the most commonly isolated pathogen in the African meningitis belt.
However, since the introduction of the meningococcal A conjugate vaccine in countries of the African meningitis belt in 2010, the WHO noted a decrease in the number of cases of meningitis; in fact, the number of cases in 2013 was the lowest recorded during the epidemic season in the last 10 years (http://www.who.int/csr/don/2013_06_06_menin/en/). In addition, _Neisseria meningitidis_ serogroup A was noted to be no longer the predominant pathogen.
According to the WHO Meningitis Weekly Bulletin for the 1st 9 months of 2013 in the African meningitis belt (Table 3, http://www.meningvax.org/files/Bulletin ... tember.pdf), of the bacterial pathogens identified, _Streptococcus pneumoniae_ was the most frequent (404 cases), followed by _N. meningitidis_ serogroup W135 (229 cases). _N. meningitidis_ serogroup A was identified in only 22 cases.
In Ghana in particular, a bacterial pathogen was identified in 59 of 303 CSF specimens (19.5 percent); _Streptococcus pneumoniae_ was the most frequent bacterial pathogen (26 cases) identified; _N. meningitidis_ serogroup W135 was found in 14 cases, serogroup B in 2 cases, serogroup A in no cases; other meningococcal serogroups in 15 cases, and other pathogens in 2 cases.
We are not told the microbial etiology of the meningitis outbreak in the various districts of Ghana in the report above. Because meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains, laboratory confirmation of the serogroup causing an outbreak is important so that the appropriate vaccine is used. ProMED-mail would appreciate information on the microbial causes of the meningitis outbreaks in Ghana from knowledgeable sources. - Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/10659.]
****************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Mon 17 Mar 2014
Source: CitiFMOnline, Ghana News Agency (GNA) report [edited]
http://www.citifmonline.com/?p=6637
An outbreak of cerebrospinal meningitis (CSM) has been reported in 4 districts in the Northern Region [of Ghana], leaving one person dead. An 18-year-old student of Yendi Senior High School has died of the disease.
So far 30 cases have been reported. Out of that number, 23 were reported from Yendi, 2 from the Mion District, one from the Zabzugu District, and 2 from the Saboba District. [This adds up to 28. Perhaps there were 2 from other districts? - Mod.LM] The Yendi Municipal Disease Control Officer, Awuni Mbabila, made this known when he briefed the Yendi Municipal Epidemic Management Committee at a meeting in Yendi last Friday.
He said those with severe head and neck pains should report to a health facility. Mr Mbabila said an analysis of cases had been done by person, place, and time to present a clear picture of the situation. He said the Hospital Epidemic Management Team had moved to the affected areas in the municipality to assess the situation and also educate residents on the disease. According to him, health workers at the sub-districts were also carrying out intensive public sensitisation on the disease to avoid an outbreak.
The Yendi Municipal Chief Executive, Issah Zakaria, said CSM was becoming alarming in the municipality and it was for that reason that the emergency meeting was called to discuss how the outbreak could be contained. The meeting was attended by representatives of the Ghana Armed Forces, the Ghana Police Service, the Ghana Red Cross, the Veterinary Service, the Environmental Health Unit, the Information Services Department, as well as religious leaders and assembly members,
The meeting appealed to the health authorities to supply CSM vaccines to the Yendi Hospital to enable it to carry out massive vaccination to avoid an outbreak.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The Northern Region, the largest in area of Ghana's 10 regions, is divided into 26 districts (http://en.wikipedia.org/wiki/Districts_ ... ern_Region). For a map of Ghana that shows the Northern Region, see http://en.wikipedia.org/wiki/Regions_of_Ghana. Yendi, Zabzugu, and Saboba are adjacent districts and their locations can be found on a map of the Northern Region at http://upload.wikimedia.org/wikipedia/c ... tricts.png. Mion is a new district that was carved from Yendi in 2012 (http://www.ghanadistricts.com/districts/?news&r=6&_=216).
Ghana is one of the 21 countries in the African meningitis belt, a region in sub-Saharan Africa where the rate of incidence of meningitis is very high. The other countries in the African meningitis belt are Gambia, Senegal, Guinea-Bissau, Guinea, Mali, Cote d'Ivoire, Benin, Togo, Burkina Faso, Niger, Nigeria, Cameroon, Chad, Central African Republic, Sudan, South Sudan, Uganda, Kenya, Ethiopia, and Eritrea (http://wwwnc.cdc.gov/travel/pdf/yellowb ... ngitis.pdf). Outbreaks of meningococcal meningitis are reported in the African meningitis belt each year during the hot, dry season, between December and June (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx). _Neisseria meningitidis_ serogroup A has been the most commonly isolated pathogen in the African meningitis belt.
However, since the introduction of the meningococcal A conjugate vaccine in countries of the African meningitis belt in 2010, the WHO noted a decrease in the number of cases of meningitis; in fact, the number of cases in 2013 was the lowest recorded during the epidemic season in the last 10 years (http://www.who.int/csr/don/2013_06_06_menin/en/). In addition, _Neisseria meningitidis_ serogroup A was noted to be no longer the predominant pathogen.
According to the WHO Meningitis Weekly Bulletin for the 1st 9 months of 2013 in the African meningitis belt (Table 3, http://www.meningvax.org/files/Bulletin ... tember.pdf), of the bacterial pathogens identified, _Streptococcus pneumoniae_ was the most frequent (404 cases), followed by _N. meningitidis_ serogroup W135 (229 cases). _N. meningitidis_ serogroup A was identified in only 22 cases.
In Ghana in particular, a bacterial pathogen was identified in 59 of 303 CSF specimens (19.5 percent); _Streptococcus pneumoniae_ was the most frequent bacterial pathogen (26 cases) identified; _N. meningitidis_ serogroup W135 was found in 14 cases, serogroup B in 2 cases, serogroup A in no cases; other meningococcal serogroups in 15 cases, and other pathogens in 2 cases.
We are not told the microbial etiology of the meningitis outbreak in the various districts of Ghana in the report above. Because meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains, laboratory confirmation of the serogroup causing an outbreak is important so that the appropriate vaccine is used. ProMED-mail would appreciate information on the microbial causes of the meningitis outbreaks in Ghana from knowledgeable sources. - Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/10659.]
-
Birgitt
- Moderator
- Beiträge: 35387
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Lassafieber in Nigeria und Liberia
LASSA FEVER - NIGERIA, LIBERIA
******************************
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 24 Mar 2014
Source: WHO Outbreak Bulletin [edited]
http://www.afro.who.int/index.php?optio ... temid=2593
Lassa Fever in Nigeria
----------------------
Nigeria continues to experience an outbreak of Lassa fever in different parts of the country. From 1 Jan 2014 to 16 Mar 2014, a total of 208 cases including 17 deaths (CFR: 8.2 per cent) were reported from 19 LGAs [Local Government Areas] within 9 states as shown in figures 6 & 7 [see the source URL]; 83 per cent (173/208) of the cases were reported from Edo state. A total of 27 cases were laboratory confirmed.
During 2012 and 2013, a total of 1723 suspected cases including 112 deaths (CFR 6.5 per cent) and 1195 cases including 39 deaths (CFR 3.3 per cent) were reported respectively.
The Federal and State governments with support from WHO and other partners are responding to the outbreak by reinforcing active surveillance and public enlightenment; and sensitizing clinicians on case management protocol and Standard precautions, among others.
Lassa Fever in Liberia
----------------------
The Ministry of Health (MOH) of Liberia has notified WHO of an outbreak of Lassa fever in a UN Mission in Liberia Kakata camp, Margibi County. A total of 14 cases including one death were reported from 27 Feb 2014 to 10 Mar 2014. A total of 11 of the cases had been reported among UN Mission in Liberia (UNMIL) Kakata camp peace keepers, 2 among UNMIL civil/UNPOL [United Nations Police] in the camp, while one case is from the neighboring community related to cases in the camp. All the 14 cases have been laboratory confirmed to be due to Lassa fever. Although Lassa fever is endemic in Liberia and occurring as sporadic cases in Bong, Nimba and Lofa counties, this is the 1st time a case has been reported in Margibi County which is close to Montserrado County where the national capital city, Monrovia is located.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Lassa fever virus is endemic in Nigeria. This is the 4th report of cases of Lassa fever virus for Nigeria in 2014 that ProMED-mail has posted. Cases have occurred sporadically in Liberia and this is the 1st report for 2014. Mod.CP provided an excellent summary of Lassa fever (ProMED-mail archive no. 20130911.1937742): "Lassa fever is an acute viral illness that occurs in West Africa. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the 1st cases originated. The virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic, or animal-borne. Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80 percent of people infected with the virus, the remaining 20 percent have a severe multisystem disease. Lassa fever is an endemic disease in portions of West Africa. It is recognized in Guinea, Liberia and Sierra Leone as well as Nigeria. However, because the rodent species which carry the virus are found throughout West Africa, the actual geographic range of the disease may extend to other countries in the region. Individuals at risk are those who live in or visit areas with a high population of _Mastomys_ rodents infected with Lassa virus or are exposed to infected humans.
"Primary transmission of the Lassa virus to humans can be prevented by avoiding contact with _Mastomys_ rodents, especially in the geographic regions where outbreaks occur. Storing food away in rodent-proof containers and keeping living areas clean help to discourage rodents from entering homes. When caring for patients with Lassa fever, further transmission of the disease through person-to-person contact or nosocomial routes can be avoided by taking preventive precautions against contact with patient secretions (together called VHF [viral hemorrhagic fever] isolation precautions or barrier nursing methods) [http://www.cdc.gov/ncidod/dvrd/spb/mnpa ... manual.htm]. Such precautions include wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection control measures, such as complete equipment sterilization; and isolating infected patients from contact with unprotected persons until the disease has run its course. The disease can be treated.
"Signs and symptoms of Lassa fever typically occur 1-3 weeks after the patient comes into contact with the virus. These include fever, retrosternal pain (pain behind the chest wall), sore throat, back pain, cough, abdominal pain, vomiting, diarrhea, conjunctivitis, facial swelling, proteinuria (protein in the urine), and mucosal bleeding. Neurological problems have also been described, including hearing loss, tremors, and encephalitis. Because the symptoms of Lassa fever are so varied and nonspecific, clinical diagnosis is often difficult. The anti-viral drug ribavirin can be used in treatment of severe cases. Currently, there is no protective vaccine."
A HealthMap of Nigeria can be accessed at http://healthmap.org/promed/p/62 and of Liberia at http://healthmap.org/promed/p/54. - Mod.TY
The 2-fold difference between the CFR in Nigeria for 2012 & 2013 could be explained by the possibility that a smaller proportion of the suspect cases in 2013 were actually Lassa fever, with the rest being due to other causes. It would be interesting to study the unconfirmed cases to discover what other diseases cause syndromes that are being reported as suspected Lassa. - Mod.JW]
******************************
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 24 Mar 2014
Source: WHO Outbreak Bulletin [edited]
http://www.afro.who.int/index.php?optio ... temid=2593
Lassa Fever in Nigeria
----------------------
Nigeria continues to experience an outbreak of Lassa fever in different parts of the country. From 1 Jan 2014 to 16 Mar 2014, a total of 208 cases including 17 deaths (CFR: 8.2 per cent) were reported from 19 LGAs [Local Government Areas] within 9 states as shown in figures 6 & 7 [see the source URL]; 83 per cent (173/208) of the cases were reported from Edo state. A total of 27 cases were laboratory confirmed.
During 2012 and 2013, a total of 1723 suspected cases including 112 deaths (CFR 6.5 per cent) and 1195 cases including 39 deaths (CFR 3.3 per cent) were reported respectively.
The Federal and State governments with support from WHO and other partners are responding to the outbreak by reinforcing active surveillance and public enlightenment; and sensitizing clinicians on case management protocol and Standard precautions, among others.
Lassa Fever in Liberia
----------------------
The Ministry of Health (MOH) of Liberia has notified WHO of an outbreak of Lassa fever in a UN Mission in Liberia Kakata camp, Margibi County. A total of 14 cases including one death were reported from 27 Feb 2014 to 10 Mar 2014. A total of 11 of the cases had been reported among UN Mission in Liberia (UNMIL) Kakata camp peace keepers, 2 among UNMIL civil/UNPOL [United Nations Police] in the camp, while one case is from the neighboring community related to cases in the camp. All the 14 cases have been laboratory confirmed to be due to Lassa fever. Although Lassa fever is endemic in Liberia and occurring as sporadic cases in Bong, Nimba and Lofa counties, this is the 1st time a case has been reported in Margibi County which is close to Montserrado County where the national capital city, Monrovia is located.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Lassa fever virus is endemic in Nigeria. This is the 4th report of cases of Lassa fever virus for Nigeria in 2014 that ProMED-mail has posted. Cases have occurred sporadically in Liberia and this is the 1st report for 2014. Mod.CP provided an excellent summary of Lassa fever (ProMED-mail archive no. 20130911.1937742): "Lassa fever is an acute viral illness that occurs in West Africa. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the 1st cases originated. The virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic, or animal-borne. Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80 percent of people infected with the virus, the remaining 20 percent have a severe multisystem disease. Lassa fever is an endemic disease in portions of West Africa. It is recognized in Guinea, Liberia and Sierra Leone as well as Nigeria. However, because the rodent species which carry the virus are found throughout West Africa, the actual geographic range of the disease may extend to other countries in the region. Individuals at risk are those who live in or visit areas with a high population of _Mastomys_ rodents infected with Lassa virus or are exposed to infected humans.
"Primary transmission of the Lassa virus to humans can be prevented by avoiding contact with _Mastomys_ rodents, especially in the geographic regions where outbreaks occur. Storing food away in rodent-proof containers and keeping living areas clean help to discourage rodents from entering homes. When caring for patients with Lassa fever, further transmission of the disease through person-to-person contact or nosocomial routes can be avoided by taking preventive precautions against contact with patient secretions (together called VHF [viral hemorrhagic fever] isolation precautions or barrier nursing methods) [http://www.cdc.gov/ncidod/dvrd/spb/mnpa ... manual.htm]. Such precautions include wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection control measures, such as complete equipment sterilization; and isolating infected patients from contact with unprotected persons until the disease has run its course. The disease can be treated.
"Signs and symptoms of Lassa fever typically occur 1-3 weeks after the patient comes into contact with the virus. These include fever, retrosternal pain (pain behind the chest wall), sore throat, back pain, cough, abdominal pain, vomiting, diarrhea, conjunctivitis, facial swelling, proteinuria (protein in the urine), and mucosal bleeding. Neurological problems have also been described, including hearing loss, tremors, and encephalitis. Because the symptoms of Lassa fever are so varied and nonspecific, clinical diagnosis is often difficult. The anti-viral drug ribavirin can be used in treatment of severe cases. Currently, there is no protective vaccine."
A HealthMap of Nigeria can be accessed at http://healthmap.org/promed/p/62 and of Liberia at http://healthmap.org/promed/p/54. - Mod.TY
The 2-fold difference between the CFR in Nigeria for 2012 & 2013 could be explained by the possibility that a smaller proportion of the suspect cases in 2013 were actually Lassa fever, with the rest being due to other causes. It would be interesting to study the unconfirmed cases to discover what other diseases cause syndromes that are being reported as suspected Lassa. - Mod.JW]
-
Birgitt
- Moderator
- Beiträge: 35387
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Cholera in Sambia und Namibia
CHOLERA, DIARRHEA AND DYSENTERY UPDATE (11): AFRICA
***************************************************
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] Cholera - Zambia (Northern Province)
[2] Cholera - Namibia
******
[1] Cholera - Zambia (Northern Province)
Date: Thu 27 Mar 2014
Source: AllAfrica [edited]
http://allafrica.com/stories/201403281103.html
Cholera, which was recorded in Mpulungu in January 2014, has persisted, although there is a decline in the number of new infections.
Acting Northern Province medical officer Lawrence Phiri said the fear was that the water-borne disease, which thrives in unsanitary conditions, would now spread to the flooded areas of Kaputa District.
Dr Phiri was briefing Health Minister Joseph Kasonde, who is in Northern Province to flag off government health projects. He said a team of medical personnel had arrived in Kaputa and begun distributing chlorine to disinfect contaminated water supplies. "Only Mungwi has above 50 per cent of health centres having more than 2 qualified staff," he said.
The health worker ratio for the province was at 40 per cent per 100 000 population, translating into one health worker for a population of 2500. The province, however, had adequate essential medicines and other medical supplies in the past year as all health facilities reported above 87 per cent availability.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[A HealthMap ProMED-mail map of Zambia can be accessed at http://healthmap.org/promed/p/170.]
******
[2] Cholera - Namibia
Date: Fri 21 Mar 2014
http://www.ifrc.org/en/news-and-media/n ... l---65292/
Namibia Red Cross volunteers head out to share messages on cholera prevention with villagers near the capital. As we wind our way past homes, down muddy tracks bordered by rubbish, I wonder how much more we will have to walk to reach the home of the woman with the pleading eyes. It is a hot day in this informal settlement on the outskirts of Namibia's capital, Windhoek, as 5 teams of Namibia Red Cross Society volunteers navigate similar winding routes in the heat and rain.
We are here to assess the situation in the informal settlements after a cholera outbreak in early February 2014. This is the 1st time cholera has been identified in Windhoek. It is a different strain from the outbreak which is affecting northern regions, and as of yet, there is no indication it will spread through the capital. However, health care workers are concerned. There have now been 39 suspected cases of cholera in Windhoek, with 3 confirmed cases. Following the death of a 60-year-old man in Katutura, just 8 km outside the capital, the Namibia Red Cross Society moved quickly. Five teams of volunteers were deployed to conduct 25 interviews with residents to better understand the situation and plan a response.
All over Windhoek's informal settlements, streets are overcrowded, and there is a lack of basic toilet facilities. In Katutura, where the 1st death from cholera was recorded, an estimated 200 000 people live in a settlement that is designed for less than 45 000 people. The toilets which are available are located near houses and are often broken. Water from broken toilets and other sources runs down roads and pools in dips in roads and shallow drains. Along these roads, children play with tires, rolling them through the dirt and water nearby.
Since November 2013, Namibia has been affected by cholera outbreaks which have affected the northern regions of Kunene, Omusati, Oshana and Ohangwena. 504 cases have been recorded, with 16 deaths. Education is critical, both for prevention and early treatment. If patients are treated early, the fatality rate can be less than one percent. If people go untreated, the severe, watery diarrhea and vomiting can kill within hours.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[A HealthMap ProMED-mail map of Namibia can be accessed at http://healthmap.org/promed/p/163.]
***************************************************
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] Cholera - Zambia (Northern Province)
[2] Cholera - Namibia
******
[1] Cholera - Zambia (Northern Province)
Date: Thu 27 Mar 2014
Source: AllAfrica [edited]
http://allafrica.com/stories/201403281103.html
Cholera, which was recorded in Mpulungu in January 2014, has persisted, although there is a decline in the number of new infections.
Acting Northern Province medical officer Lawrence Phiri said the fear was that the water-borne disease, which thrives in unsanitary conditions, would now spread to the flooded areas of Kaputa District.
Dr Phiri was briefing Health Minister Joseph Kasonde, who is in Northern Province to flag off government health projects. He said a team of medical personnel had arrived in Kaputa and begun distributing chlorine to disinfect contaminated water supplies. "Only Mungwi has above 50 per cent of health centres having more than 2 qualified staff," he said.
The health worker ratio for the province was at 40 per cent per 100 000 population, translating into one health worker for a population of 2500. The province, however, had adequate essential medicines and other medical supplies in the past year as all health facilities reported above 87 per cent availability.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[A HealthMap ProMED-mail map of Zambia can be accessed at http://healthmap.org/promed/p/170.]
******
[2] Cholera - Namibia
Date: Fri 21 Mar 2014
http://www.ifrc.org/en/news-and-media/n ... l---65292/
Namibia Red Cross volunteers head out to share messages on cholera prevention with villagers near the capital. As we wind our way past homes, down muddy tracks bordered by rubbish, I wonder how much more we will have to walk to reach the home of the woman with the pleading eyes. It is a hot day in this informal settlement on the outskirts of Namibia's capital, Windhoek, as 5 teams of Namibia Red Cross Society volunteers navigate similar winding routes in the heat and rain.
We are here to assess the situation in the informal settlements after a cholera outbreak in early February 2014. This is the 1st time cholera has been identified in Windhoek. It is a different strain from the outbreak which is affecting northern regions, and as of yet, there is no indication it will spread through the capital. However, health care workers are concerned. There have now been 39 suspected cases of cholera in Windhoek, with 3 confirmed cases. Following the death of a 60-year-old man in Katutura, just 8 km outside the capital, the Namibia Red Cross Society moved quickly. Five teams of volunteers were deployed to conduct 25 interviews with residents to better understand the situation and plan a response.
All over Windhoek's informal settlements, streets are overcrowded, and there is a lack of basic toilet facilities. In Katutura, where the 1st death from cholera was recorded, an estimated 200 000 people live in a settlement that is designed for less than 45 000 people. The toilets which are available are located near houses and are often broken. Water from broken toilets and other sources runs down roads and pools in dips in roads and shallow drains. Along these roads, children play with tires, rolling them through the dirt and water nearby.
Since November 2013, Namibia has been affected by cholera outbreaks which have affected the northern regions of Kunene, Omusati, Oshana and Ohangwena. 504 cases have been recorded, with 16 deaths. Education is critical, both for prevention and early treatment. If patients are treated early, the fatality rate can be less than one percent. If people go untreated, the severe, watery diarrhea and vomiting can kill within hours.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[A HealthMap ProMED-mail map of Namibia can be accessed at http://healthmap.org/promed/p/163.]
-
Birgitt
- Moderator
- Beiträge: 35387
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Denguefieber in Tansania
DENGUE/DHF UPDATE (26): AFRICA
*******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
*****
Africa
---
Tanzania. 27 Mar 2014. Dengue 140 cases; Deaths 1; District most affected: March Kinondoni. Dengue virus infections are not new in Tanzania; it was 1st reported in Dar es Salaam in June 2010 with 40 cases and again between May-July 2013 with 170 cases
http://www.ippmedia.com/frontend/index.php?l=66245.
[ProMED receives relatively few reports of dengue outbreaks in Africa. The question remains whether outbreaks seldom occur or whether they are not being diagnosed, or perhaps being misdiagnosed as malaria.
A HealthMap/ProMED-mail map showing the location of Tanzania in East Africa can be accessed at http://healthmap.org/promed/p/. - Mod.TY]
*******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
*****
Africa
---
Tanzania. 27 Mar 2014. Dengue 140 cases; Deaths 1; District most affected: March Kinondoni. Dengue virus infections are not new in Tanzania; it was 1st reported in Dar es Salaam in June 2010 with 40 cases and again between May-July 2013 with 170 cases
http://www.ippmedia.com/frontend/index.php?l=66245.
[ProMED receives relatively few reports of dengue outbreaks in Africa. The question remains whether outbreaks seldom occur or whether they are not being diagnosed, or perhaps being misdiagnosed as malaria.
A HealthMap/ProMED-mail map showing the location of Tanzania in East Africa can be accessed at http://healthmap.org/promed/p/. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35387
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Cholera in Nigeria
CHOLERA, DIARRHEA AND DYSENTERY UPDATE (12): AFRICA
***************************************************
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] Cholera - Nigeria (Plateau State)
[2] Cholera - Nigeria (Kaduna State)
[3] Cholera - Nigeria (Federal Capital Territory)
******
[1] Cholera - Nigeria (Plateau State)
Date: Fri 4 Apr 2014
Source: Punch [edited]
http://www.punchng.com/news/plateau-cho ... -hospital/
No fewer than 4 people have been reported dead and 113 others hospitalised in a fresh cholera outbreak in the Bassa and Jos North local government areas of Plateau State. A recent outbreak of cholera in Namu, in the Qua'an Pan Local Government Area of the state, has killed more than 30 people with hundreds hospitalized.
Our correspondent learned on Thu 3 Apr 2014 that 3 people died in Rukuba Bassa and one in Jos metropolis as a result of the epidemic.
The case in Jos North involved a 61-year-old caterer who was said to have complained of stooling and vomiting, symptoms related to diarrhea, on Sun 30 Mar 2014. The victim was rushed to the hospital, where she died on Tuesday morning [1 Apr 2014].
Our correspondent learned that in the process of cooking the food for the deceased's funeral, 5 other members of the family contracted the same disease and were admitted to the hospital.
Deputy Director, Epidemiology in the state Ministry of Health Dr. Raymond Juryit, who confirmed the incidents, said that the cholera outbreak in Bassa had been confirmed, while the situation in Jos North was under investigation.
[Byline: Jude Owuamanam]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[2] Cholera - Nigeria (Kaduna State)
Date: Wed 2 Apr 2014
Source: The Daily Trust [edited]
http://allafrica.com/stories/201404020233.html
Local authorities in Zaria, Kaduna State say 9 persons have died as a result of a cholera outbreak in the area, while over 50 others are being treated for the disease in various hospitals.
Though findings by our correspondent indicated that the casualty figure may be higher, Zaria LG chairman Lawal Balarabe said the report in his possession showed the number of deaths and others affected only [came from] government hospitals.
"Our record relies on reports from government hospitals. We have about 15 private hospitals that don't report to us; therefore, we can't know what is happening there," he said.
But our correspondent reports that cholera, which has been ravaging Zaria for some time now, has taken a higher toll in various governments and private hospitals as well as different communities.
In Sabon Gari LGA, for example, Marmara area is worst hit. Checks at the government-owned Major Ibrahim Abdullahi Memorial Hospital revealed that many patients are on admission and are buying drugs for treatment.
"Before we went on strike, many people died in this hospital, but I can't recall the number. When we resumed, I know that one person died. From the report I have from different areas of Zaria and environs, not less than 55 persons have died", a hospital source said, but Daily Trust could not independently verify the claim.
Checks in other areas like Gyellesu revealed that 9 persons died from the disease. Other areas like Tudun Jukun, Dambo, Wuciciri, Dutsen Abba, and Tudun Wada also recorded casualties.
[Byline: Isa Sa'Idu]
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
******
[3] Cholera - Nigeria (Federal Capital Territory)
Date: 1 Apr 2014
Source: Vanguard [edited]
http://allafrica.com/stories/201404011283.html
The Nigeria Centre for Disease Control (NCDC) on Tue 1 Apr 2014 said it had begun investigations into the suspected cases of cholera in Mpape area of Abuja.
The Director of the centre, Prof. Nasidi Abdulsalam, told the News Agency of Nigeria (NAN) in Abuja that samples from affected people had been collected for laboratory testing. Mpape is a suburb of the Federal Capital Territory.
According to him, the situation will not be declared as an outbreak until the laboratory result is available. "For now, we cannot say it is outbreak of cholera, as the result has yet to be confirmed," he said.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/promed/p/62.]
***************************************************
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] Cholera - Nigeria (Plateau State)
[2] Cholera - Nigeria (Kaduna State)
[3] Cholera - Nigeria (Federal Capital Territory)
******
[1] Cholera - Nigeria (Plateau State)
Date: Fri 4 Apr 2014
Source: Punch [edited]
http://www.punchng.com/news/plateau-cho ... -hospital/
No fewer than 4 people have been reported dead and 113 others hospitalised in a fresh cholera outbreak in the Bassa and Jos North local government areas of Plateau State. A recent outbreak of cholera in Namu, in the Qua'an Pan Local Government Area of the state, has killed more than 30 people with hundreds hospitalized.
Our correspondent learned on Thu 3 Apr 2014 that 3 people died in Rukuba Bassa and one in Jos metropolis as a result of the epidemic.
The case in Jos North involved a 61-year-old caterer who was said to have complained of stooling and vomiting, symptoms related to diarrhea, on Sun 30 Mar 2014. The victim was rushed to the hospital, where she died on Tuesday morning [1 Apr 2014].
Our correspondent learned that in the process of cooking the food for the deceased's funeral, 5 other members of the family contracted the same disease and were admitted to the hospital.
Deputy Director, Epidemiology in the state Ministry of Health Dr. Raymond Juryit, who confirmed the incidents, said that the cholera outbreak in Bassa had been confirmed, while the situation in Jos North was under investigation.
[Byline: Jude Owuamanam]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[2] Cholera - Nigeria (Kaduna State)
Date: Wed 2 Apr 2014
Source: The Daily Trust [edited]
http://allafrica.com/stories/201404020233.html
Local authorities in Zaria, Kaduna State say 9 persons have died as a result of a cholera outbreak in the area, while over 50 others are being treated for the disease in various hospitals.
Though findings by our correspondent indicated that the casualty figure may be higher, Zaria LG chairman Lawal Balarabe said the report in his possession showed the number of deaths and others affected only [came from] government hospitals.
"Our record relies on reports from government hospitals. We have about 15 private hospitals that don't report to us; therefore, we can't know what is happening there," he said.
But our correspondent reports that cholera, which has been ravaging Zaria for some time now, has taken a higher toll in various governments and private hospitals as well as different communities.
In Sabon Gari LGA, for example, Marmara area is worst hit. Checks at the government-owned Major Ibrahim Abdullahi Memorial Hospital revealed that many patients are on admission and are buying drugs for treatment.
"Before we went on strike, many people died in this hospital, but I can't recall the number. When we resumed, I know that one person died. From the report I have from different areas of Zaria and environs, not less than 55 persons have died", a hospital source said, but Daily Trust could not independently verify the claim.
Checks in other areas like Gyellesu revealed that 9 persons died from the disease. Other areas like Tudun Jukun, Dambo, Wuciciri, Dutsen Abba, and Tudun Wada also recorded casualties.
[Byline: Isa Sa'Idu]
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[3] Cholera - Nigeria (Federal Capital Territory)
Date: 1 Apr 2014
Source: Vanguard [edited]
http://allafrica.com/stories/201404011283.html
The Nigeria Centre for Disease Control (NCDC) on Tue 1 Apr 2014 said it had begun investigations into the suspected cases of cholera in Mpape area of Abuja.
The Director of the centre, Prof. Nasidi Abdulsalam, told the News Agency of Nigeria (NAN) in Abuja that samples from affected people had been collected for laboratory testing. Mpape is a suburb of the Federal Capital Territory.
According to him, the situation will not be declared as an outbreak until the laboratory result is available. "For now, we cannot say it is outbreak of cholera, as the result has yet to be confirmed," he said.
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[A HealthMap/ProMED-mail map can be accessed at:
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Tollwut in Frankreich ex Mali
RABIES - FRANCE ex MALI
***********************
A ProMED-mail post
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Date: 4 Apr 2014
Source: BBC [edited]
http://www.bbc.com/news/world-europe-26882448
A man has died from rabies in a Paris regional hospital after visiting Mali.
France has eradicated rabies on its territory, officials say. It is an extremely rare case for France, where the disease was officially eradicated in 2001.
Officials did not explain how the man had caught rabies in Mali. The man's family and medics who treated him were sent to an anti-rabies centre for possible vaccination.
Africa accounts for nearly half the 55 000 human deaths worldwide from rabies every year, experts say. Bites from infected dogs are most often the source of rabies in humans, as the virus is carried in saliva. Human-to-human infection is extremely rare. Vaccination can save a patient if it is administered before symptoms appear.
There has been no case of rabies being contracted by humans in mainland France since 1923. Rabies has been diagnosed in about 20 patients in France since 1970, all of whom caught it abroad. The last death was in 2003.
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[The rabies situation in Mali is not clear. In the past 6 years, the only OIE report is of 7 cattle being affected in Koulikoro in 2008, and 6 of these died. With humans, there were no reports of human cases in 2008 or 2009; in 2010, there were 18 cases, all of whom died; in 2011, 28 human cases, and all died; in 2012, there were 209 cases, and 2 died (since clinical cases of rabies die, these "209" may just represent people bitten and vaccinated); and there were no human cases reported in 2013. Obviously, there is a background canine problem.
Mali is clearly a country to add to one's list that maybe one should consider getting vaccinated before getting on the plane. - Mod.MHJ
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/50.]
***********************
A ProMED-mail post
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Date: 4 Apr 2014
Source: BBC [edited]
http://www.bbc.com/news/world-europe-26882448
A man has died from rabies in a Paris regional hospital after visiting Mali.
France has eradicated rabies on its territory, officials say. It is an extremely rare case for France, where the disease was officially eradicated in 2001.
Officials did not explain how the man had caught rabies in Mali. The man's family and medics who treated him were sent to an anti-rabies centre for possible vaccination.
Africa accounts for nearly half the 55 000 human deaths worldwide from rabies every year, experts say. Bites from infected dogs are most often the source of rabies in humans, as the virus is carried in saliva. Human-to-human infection is extremely rare. Vaccination can save a patient if it is administered before symptoms appear.
There has been no case of rabies being contracted by humans in mainland France since 1923. Rabies has been diagnosed in about 20 patients in France since 1970, all of whom caught it abroad. The last death was in 2003.
--
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[The rabies situation in Mali is not clear. In the past 6 years, the only OIE report is of 7 cattle being affected in Koulikoro in 2008, and 6 of these died. With humans, there were no reports of human cases in 2008 or 2009; in 2010, there were 18 cases, all of whom died; in 2011, 28 human cases, and all died; in 2012, there were 209 cases, and 2 died (since clinical cases of rabies die, these "209" may just represent people bitten and vaccinated); and there were no human cases reported in 2013. Obviously, there is a background canine problem.
Mali is clearly a country to add to one's list that maybe one should consider getting vaccinated before getting on the plane. - Mod.MHJ
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/50.]
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RABIES - FRANCE ex MALI (02)
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Date: 4 Apr 2014
From: Merritt Clifton <anmlpepl@whidbey.com> [edited]
"The rabies situation in Mali is not clear." I'll agree with that. Indeed, it is paradoxical, because the occasional reports from Mali that I receive from humane workers make sparse mention of dogs, stray or otherwise. The major concerns they mention have to do with working ponies, donkeys, and horses. The 90 per cent of Malians who are Islamic rarely keep dogs.
Once in a while, someone mentions that dogs are persecuted, if seen, as a perceived threat to village poultry, or that among the 5 per cent of Malians who practice animism, dogs are sometimes sacrificed and then eaten. No one has ever mentioned abundant dogs though.
My guess is that what dogs there are in Mali are kept mainly by the 5 per cent of the population who are Christian, of whom about 2/3rds are Catholic and the rest mostly of evangelical churches.
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
http://www.animalpeoplenews.org
<anmlpepl@whidbey.com>
[I remember when I was in Somalia and traveled the length of the country that though very few Somalis kept dogs, they were in fact common, living off what they could find, frequently chased off, but valued as neighborhood "watch dogs", barking at any stranger appearing. If any of our subscribers have any information concerning a possible reservoir for rabies in Mali, it would be appreciated if they would share it. - Mod.MHJ
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/50.]
****************************
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Date: 4 Apr 2014
From: Merritt Clifton <anmlpepl@whidbey.com> [edited]
"The rabies situation in Mali is not clear." I'll agree with that. Indeed, it is paradoxical, because the occasional reports from Mali that I receive from humane workers make sparse mention of dogs, stray or otherwise. The major concerns they mention have to do with working ponies, donkeys, and horses. The 90 per cent of Malians who are Islamic rarely keep dogs.
Once in a while, someone mentions that dogs are persecuted, if seen, as a perceived threat to village poultry, or that among the 5 per cent of Malians who practice animism, dogs are sometimes sacrificed and then eaten. No one has ever mentioned abundant dogs though.
My guess is that what dogs there are in Mali are kept mainly by the 5 per cent of the population who are Christian, of whom about 2/3rds are Catholic and the rest mostly of evangelical churches.
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
http://www.animalpeoplenews.org
<anmlpepl@whidbey.com>
[I remember when I was in Somalia and traveled the length of the country that though very few Somalis kept dogs, they were in fact common, living off what they could find, frequently chased off, but valued as neighborhood "watch dogs", barking at any stranger appearing. If any of our subscribers have any information concerning a possible reservoir for rabies in Mali, it would be appreciated if they would share it. - Mod.MHJ
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/50.]
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Lassafieber in USA ex Westafrika
LASSA FEVER - USA ex WEST AFRICA
********************************
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Date: Fri 4 Apr 2014
Source: CDC press release [edited]
http://www.cdc.gov/media/releases/2014/ ... fever.html
The CDC and the Minnesota Department of Health (MDH) have confirmed a diagnosis of Lassa fever in a person returning to the United States from West Africa. The patient was admitted to a hospital in Minnesota on [31 Mar 2014] with symptoms of fever and confusion. Blood samples submitted to CDC tested positive for Lassa fever on [3 Apr 2014]. The patient is recovering and is in stable condition.
"This imported case is a reminder that we are all connected by international travel. A disease anywhere can appear anywhere else in the world within hours," said CDC Director Tom Frieden, M.D., M.P.H.
Lassa fever is a severe viral disease that is common in West Africa but rarely seen in the United States. A total of 7 other Lassa fever cases, all travel related, have been identified in the United States, with the last one reported in Pennsylvania in 2010. Although Lassa fever can produce hemorrhagic symptoms in infected persons, the disease is not related to Ebola hemorrhagic fever, which is responsible for the current outbreak in West Africa.
In West Africa, Lassa virus is carried by rodents and transmitted to humans through contact with urine or droppings of infected rodents. In rare cases it can be transmitted from person to person through direct contact with a sick person's blood or bodily fluids, through mucous membrane, or through sexual contact. The virus is not transmitted through casual contact. About 100 000 to 300 000 cases of Lassa fever, and 5000 deaths related to Lassa fever, occur in West Africa each year.
CDC is working with public health officials and airlines to determine the patient's travel route from West Africa and identify any passengers or others who may have had close contact with the infected person. Preliminary information indicates that the patient flew from West Africa to New York City and caught another flight to Minneapolis.
"Given what we know about how Lassa virus is spread to people, the risk to other travelers and members of the public is extremely low," said Martin Cetron, M.D., M.P.H., director of CDC's Division of Global Migration and Quarantine.
"Casual contact is not a risk factor for getting Lassa fever," said Barbara Knust, D.V.M., M.P.H., an epidemiologist in CDC's Division of High-Consequence Pathogens and Pathology, which performed the laboratory testing. "People will not get this infection just because they were on the same airplane or in the same airport."
As part of its investigation, CDC is working with the airlines to gather contact information for passengers and crew who were seated near the infected individual. CDC will provide passenger contact information to state and local health departments where the passengers live to notify them about their possible exposure.
For additional information about Lassa fever, see the CDC website at http://www.cdc.gov/vhf/lassa/.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
<promed@promedmail.org>
[Fortunately, cases of Lassa fever virus infection imported from endemic West African areas to countries where it does not occur often is rare. In endemic areas in Africa, nosocomial transmission occurs in the absence of barrier nursing. In the above case, the Minnesota hospital provided sufficient containment that no secondary cases occurred there. The West African country where the patient might have acquired the infection is not mentioned.
In endemic areas in West Africa, the rodent reservoirs are multimammate mice (_Mastomys_ spp.). In a study done in Guinea, the Natal multimammate mouse, _M. natalensis_, was the main Lassa fever virus host (see http://wwwnc.cdc.gov/eid/article/12/12/pdfs/06-0812.pdf). However, the taxonomy of _Mastomys_ is considered unresolved and species determination remains uncertain with 8 distinct species recognized, of which several coexist in Lassa fever-endemic areas (see http://wwwnc.cdc.gov/eid/article/12/12/ ... rticle.htm). An image of the Natal multimammate mouse can be accessed at http://cievsrio.files.wordpress.com/201 ... lensis.jpg.
A map of West Africa showing high and possible risk of Lassa fever virus infection can be accessed at http://www.infectionlandscapes.org/2013 ... fever.html. A HealthMap/ProMED map showing the location of Minnesota can be accessed at http://healthmap.org/promed/p/38378. - Mod.TY]
********************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Fri 4 Apr 2014
Source: CDC press release [edited]
http://www.cdc.gov/media/releases/2014/ ... fever.html
The CDC and the Minnesota Department of Health (MDH) have confirmed a diagnosis of Lassa fever in a person returning to the United States from West Africa. The patient was admitted to a hospital in Minnesota on [31 Mar 2014] with symptoms of fever and confusion. Blood samples submitted to CDC tested positive for Lassa fever on [3 Apr 2014]. The patient is recovering and is in stable condition.
"This imported case is a reminder that we are all connected by international travel. A disease anywhere can appear anywhere else in the world within hours," said CDC Director Tom Frieden, M.D., M.P.H.
Lassa fever is a severe viral disease that is common in West Africa but rarely seen in the United States. A total of 7 other Lassa fever cases, all travel related, have been identified in the United States, with the last one reported in Pennsylvania in 2010. Although Lassa fever can produce hemorrhagic symptoms in infected persons, the disease is not related to Ebola hemorrhagic fever, which is responsible for the current outbreak in West Africa.
In West Africa, Lassa virus is carried by rodents and transmitted to humans through contact with urine or droppings of infected rodents. In rare cases it can be transmitted from person to person through direct contact with a sick person's blood or bodily fluids, through mucous membrane, or through sexual contact. The virus is not transmitted through casual contact. About 100 000 to 300 000 cases of Lassa fever, and 5000 deaths related to Lassa fever, occur in West Africa each year.
CDC is working with public health officials and airlines to determine the patient's travel route from West Africa and identify any passengers or others who may have had close contact with the infected person. Preliminary information indicates that the patient flew from West Africa to New York City and caught another flight to Minneapolis.
"Given what we know about how Lassa virus is spread to people, the risk to other travelers and members of the public is extremely low," said Martin Cetron, M.D., M.P.H., director of CDC's Division of Global Migration and Quarantine.
"Casual contact is not a risk factor for getting Lassa fever," said Barbara Knust, D.V.M., M.P.H., an epidemiologist in CDC's Division of High-Consequence Pathogens and Pathology, which performed the laboratory testing. "People will not get this infection just because they were on the same airplane or in the same airport."
As part of its investigation, CDC is working with the airlines to gather contact information for passengers and crew who were seated near the infected individual. CDC will provide passenger contact information to state and local health departments where the passengers live to notify them about their possible exposure.
For additional information about Lassa fever, see the CDC website at http://www.cdc.gov/vhf/lassa/.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
<promed@promedmail.org>
[Fortunately, cases of Lassa fever virus infection imported from endemic West African areas to countries where it does not occur often is rare. In endemic areas in Africa, nosocomial transmission occurs in the absence of barrier nursing. In the above case, the Minnesota hospital provided sufficient containment that no secondary cases occurred there. The West African country where the patient might have acquired the infection is not mentioned.
In endemic areas in West Africa, the rodent reservoirs are multimammate mice (_Mastomys_ spp.). In a study done in Guinea, the Natal multimammate mouse, _M. natalensis_, was the main Lassa fever virus host (see http://wwwnc.cdc.gov/eid/article/12/12/pdfs/06-0812.pdf). However, the taxonomy of _Mastomys_ is considered unresolved and species determination remains uncertain with 8 distinct species recognized, of which several coexist in Lassa fever-endemic areas (see http://wwwnc.cdc.gov/eid/article/12/12/ ... rticle.htm). An image of the Natal multimammate mouse can be accessed at http://cievsrio.files.wordpress.com/201 ... lensis.jpg.
A map of West Africa showing high and possible risk of Lassa fever virus infection can be accessed at http://www.infectionlandscapes.org/2013 ... fever.html. A HealthMap/ProMED map showing the location of Minnesota can be accessed at http://healthmap.org/promed/p/38378. - Mod.TY]
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Denguefieber in Äthiopien und Nigeria
DENGUE/DHF UPDATE (28): AFRICA
**************************************************
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Ethiopia (Gode zone, Somalia region). 31 Mar 2014. Dengue 126 cases since mid-January 2014.
http://reliefweb.int/sites/reliefweb.in ... 202014.pdf
[A map of Ethiopia showing the Somalia region can be accessed at http://en.wikipedia.org/wiki/Somali_Region. - Mod.TY]
Nigeria (Edo state) 2 Apr 2014. Dengue. A 15 year old girl thought to have been infected with Ebola virus actually died of DHF.
http://allafrica.com/stories/201404021178.html
[Normally, ProMED-mail does not report single cases of DHF, but this unique case was initially thought to be due to an Ebola virus infection. Reports of dengue cases in Africa generally, and Nigeria specifically, are relatively rare.
A HealthMap/ProMED-mail map of Nigeria can be accessed at http://healthmap.org/promed/p/38426. - Mod.TY]
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**************************************************
A ProMED-mail post
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*****
Ethiopia (Gode zone, Somalia region). 31 Mar 2014. Dengue 126 cases since mid-January 2014.
http://reliefweb.int/sites/reliefweb.in ... 202014.pdf
[A map of Ethiopia showing the Somalia region can be accessed at http://en.wikipedia.org/wiki/Somali_Region. - Mod.TY]
Nigeria (Edo state) 2 Apr 2014. Dengue. A 15 year old girl thought to have been infected with Ebola virus actually died of DHF.
http://allafrica.com/stories/201404021178.html
[Normally, ProMED-mail does not report single cases of DHF, but this unique case was initially thought to be due to an Ebola virus infection. Reports of dengue cases in Africa generally, and Nigeria specifically, are relatively rare.
A HealthMap/ProMED-mail map of Nigeria can be accessed at http://healthmap.org/promed/p/38426. - Mod.TY]
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LASSA FEVER - NIGERIA (04): (PLATEAU STATE)
*******************************************
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Date: Wed 9 Apr 2014
Source: This Day Live [edited]
http://www.thisdaylive.com/articles/one ... au/175738/
One person has been confirmed dead and 5 others are lying critically ill in 2 hospitals following the outbreak of Lassa fever in Plateau State.
Confirming the outbreak and the death of one victim, the deputy director of epidemiology in the State Ministry of Health, Dr Raymond Juryit, said there are cases of suspected Lassa fever in the state and 4 of the infected people are being treated at the Bingham University Teaching Hospital (BUTH), Jos, while one other is hospitalised at a hospital in Jingri, Bassa local government area of the state. He also confirmed that one person died of the fever at BUTH.
Juryit also said that the state government was taking necessary measures to prevent a spread of the outbreak and had already taken specimens for confirmation.
[byline: Seriki Adinoyi]
--
communicated by:
ProMED-mail rapporteur Mary Marshall
[Lassa fever virus is endemic in Nigeria and there were cases of the disease in Plateau state in January 2013 (see ProMED-mail archive no. 20130131.1524034). As Mod.CP pointed out in his comment in that archived report, "In the countries of Africa, such as Nigeria, where Lassa fever is endemic, the disease is a significant cause of morbidity and mortality. While Lassa fever infection is normally mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. Exceptionally, Lassa fever is associated with epidemics, during which the case-fatality rate can reach 50 per cent. There is no preventative vaccine and treatment. The antiviral drug ribavirin has been used with success in Lassa fever patients."
The virus is a member of the family _Arenaviridae_ and causes acute hemorrhagic fever. It is transmitted to humans from contacts with food or household items contaminated with excreta of multimammate rats (_Mastomys_ spp). Virus transmission can occur in houses or in hospital environments or laboratories in the absence of adequate infection control measures.
Maps of Nigeria can be seen at http://www.ezilon.com/maps/africa/nigeria-maps.html and http://healthmap.org/promed/p/616. - Mod.TY]
*******************************************
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International Society for Infectious Diseases
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Date: Wed 9 Apr 2014
Source: This Day Live [edited]
http://www.thisdaylive.com/articles/one ... au/175738/
One person has been confirmed dead and 5 others are lying critically ill in 2 hospitals following the outbreak of Lassa fever in Plateau State.
Confirming the outbreak and the death of one victim, the deputy director of epidemiology in the State Ministry of Health, Dr Raymond Juryit, said there are cases of suspected Lassa fever in the state and 4 of the infected people are being treated at the Bingham University Teaching Hospital (BUTH), Jos, while one other is hospitalised at a hospital in Jingri, Bassa local government area of the state. He also confirmed that one person died of the fever at BUTH.
Juryit also said that the state government was taking necessary measures to prevent a spread of the outbreak and had already taken specimens for confirmation.
[byline: Seriki Adinoyi]
--
communicated by:
ProMED-mail rapporteur Mary Marshall
[Lassa fever virus is endemic in Nigeria and there were cases of the disease in Plateau state in January 2013 (see ProMED-mail archive no. 20130131.1524034). As Mod.CP pointed out in his comment in that archived report, "In the countries of Africa, such as Nigeria, where Lassa fever is endemic, the disease is a significant cause of morbidity and mortality. While Lassa fever infection is normally mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multi-system disease. Exceptionally, Lassa fever is associated with epidemics, during which the case-fatality rate can reach 50 per cent. There is no preventative vaccine and treatment. The antiviral drug ribavirin has been used with success in Lassa fever patients."
The virus is a member of the family _Arenaviridae_ and causes acute hemorrhagic fever. It is transmitted to humans from contacts with food or household items contaminated with excreta of multimammate rats (_Mastomys_ spp). Virus transmission can occur in houses or in hospital environments or laboratories in the absence of adequate infection control measures.
Maps of Nigeria can be seen at http://www.ezilon.com/maps/africa/nigeria-maps.html and http://healthmap.org/promed/p/616. - Mod.TY]
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Denguefieber in Tansania
DENGUE/DHF UPDATE (30): AFRICA
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******
[1] Tanzania (Zanzibar)
Date: Fri 11 Apr 2014
From: Camilla Rothe <rothe@bnitm.de> [edited]
On 11 Apr 2014, 2 German travelers (female 35, male 35) presented at Hamburg Tropical Institute with fever, back pain and extreme fatigue for 3 days. They had returned from a 2-week trip to Zanzibar on 5 Apr 2014.
The full blood count of the male traveler showed thrombocytopenia [low platelet count] of 78 000 per microliter [of blood]. Dengue rapid diagnostic tests for both travelers were positive. Serological results are pending.
--
Dr Camilla Rothe
Hamburg Eppendorf University Medical Centre
Dept. of Tropical Medicine
Hamburg, Germany
<rothe@bnitm.de>
[ProMED thanks Dr. Camilla Rothe for this firsthand report.
ProMED occasionally receives reports of dengue virus infection in individuals who have traveled to Africa and become infected there, however, without reports of cases of infection in local inhabitants in the areas where the travelers encountered their viruses. Clearly in the above cases, dengue virus was circulating in the areas that they visited.
A HealthMap/ProMED-mail map showing the location of Tanzania in East Africa can be accessed at http://healthmap.org/promed/p/. - Mod.TY]
******
[2] Tanzania (Dar es Salaam)
Date: Thu 10 Apr 2014
From: G. Makanga <gmakanga2000@gmail.com> [edited]
[During] an outbreak of dengue fever at Muhimbili University, a case of dengue fever was confirmed a few days ago after a middle-aged male developed high grade fever, headache, nausea and vomiting. [He was] initially managed as a case of malaria with no improvement.
Symptoms worsened over a period of 4 days, with aches, weakness, no rash, and no bleeding from the skin. His examination revealed fever, mild conjunctiva injection, no rash, and hypotension. Laboratory tests showed mild anemia, thrombocytopenia, leucopenia [decrease of white blood cells], and elevated AST, ALT. No malaria parasites [were seen] on a blood smear.
[He was] managed with I.V. fluids and broad spectrum antibiotics. A blood sample confirmed dengue [virus infection]. He made improvement upon conservative management. Two other similar cases were later reported in the same locality.
The University administration has now put up an alert for everyone to be vigilant and anyone with suspected symptoms to report to the emergency department.
--
Dr G. Makanga
Student at Muhimbili University
Dar es Salaam
Tanzania
<gmakanga2000@gmail.com>
[ProMED thanks Dr. G. Makanga for this firsthand report. Information coming directly from localities where dengue virus infections are occurring in Africa is especially appreciated.
The above case raises the question about how many dengue virus infections in Tanzania and other countries where malaria is common are being diagnosed as malaria in the absence of adequate laboratory testing. - Mod.TY]
*********************************************
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******
[1] Tanzania (Zanzibar)
Date: Fri 11 Apr 2014
From: Camilla Rothe <rothe@bnitm.de> [edited]
On 11 Apr 2014, 2 German travelers (female 35, male 35) presented at Hamburg Tropical Institute with fever, back pain and extreme fatigue for 3 days. They had returned from a 2-week trip to Zanzibar on 5 Apr 2014.
The full blood count of the male traveler showed thrombocytopenia [low platelet count] of 78 000 per microliter [of blood]. Dengue rapid diagnostic tests for both travelers were positive. Serological results are pending.
--
Dr Camilla Rothe
Hamburg Eppendorf University Medical Centre
Dept. of Tropical Medicine
Hamburg, Germany
<rothe@bnitm.de>
[ProMED thanks Dr. Camilla Rothe for this firsthand report.
ProMED occasionally receives reports of dengue virus infection in individuals who have traveled to Africa and become infected there, however, without reports of cases of infection in local inhabitants in the areas where the travelers encountered their viruses. Clearly in the above cases, dengue virus was circulating in the areas that they visited.
A HealthMap/ProMED-mail map showing the location of Tanzania in East Africa can be accessed at http://healthmap.org/promed/p/. - Mod.TY]
******
[2] Tanzania (Dar es Salaam)
Date: Thu 10 Apr 2014
From: G. Makanga <gmakanga2000@gmail.com> [edited]
[During] an outbreak of dengue fever at Muhimbili University, a case of dengue fever was confirmed a few days ago after a middle-aged male developed high grade fever, headache, nausea and vomiting. [He was] initially managed as a case of malaria with no improvement.
Symptoms worsened over a period of 4 days, with aches, weakness, no rash, and no bleeding from the skin. His examination revealed fever, mild conjunctiva injection, no rash, and hypotension. Laboratory tests showed mild anemia, thrombocytopenia, leucopenia [decrease of white blood cells], and elevated AST, ALT. No malaria parasites [were seen] on a blood smear.
[He was] managed with I.V. fluids and broad spectrum antibiotics. A blood sample confirmed dengue [virus infection]. He made improvement upon conservative management. Two other similar cases were later reported in the same locality.
The University administration has now put up an alert for everyone to be vigilant and anyone with suspected symptoms to report to the emergency department.
--
Dr G. Makanga
Student at Muhimbili University
Dar es Salaam
Tanzania
<gmakanga2000@gmail.com>
[ProMED thanks Dr. G. Makanga for this firsthand report. Information coming directly from localities where dengue virus infections are occurring in Africa is especially appreciated.
The above case raises the question about how many dengue virus infections in Tanzania and other countries where malaria is common are being diagnosed as malaria in the absence of adequate laboratory testing. - Mod.TY]
