Wüstenschiff

ANTHRAX, HUMAN, BOVINE - ZIMBABWE (MASHONALAND EAST)
************************************************************
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: Tue, 6 Feb 2007 04:01:28 -0800 (PST)
From: Brent Barrett <salbrent@sbcglobal.net>
Source: The Herald (Harare)/AllAfrica.com
<http://allafrica.com/stories/200702060152.html>


Zimbabwe: Anthrax Outbreak Hits Wedza
-------------------------------------------
Three villages in Wedza district have been quarantined following an
outbreak of anthrax last month [?January 2007]. The matter came to
the fore after 6 people from the villages fell ill from disease after
consuming meat from slaughtered infected beasts. The persons
developed lesions similar to those seen on infected cattle but were
all successfully treated. [Sic]

No cattle movement is being allowed in and out of the 3 villages,
Goneso, Ruzane and Ushe. Slaughter of livestock in the villages has
also been put on hold until the stipulated 30-day vaccination period
expires. The animals were vaccinated on [13 Jan 2007].

Wedza district veterinary animal health inspector Mr Eliah
Mutsiwegota said 10 cattle died around the festive season leading the
district to vaccinate a total of 7159 beasts. Mr Mutsiwegota said the
district lost another 25 cattle due to tick-borne diseases such as
redwater fever and gall sickness.

---
ProMED-mail
<promed@promedmail.org>

[There seems to be a confusion in the description of the human cases.
Successful treatment would suggest that these 3 persons developed
cutaneous anthrax and not gastrointestinal anthrax. Cattle can
develop cutaneous anthrax but it is less common than the systemic
form arising from the ingestion of contaminated soil or bloody soils.
Either way, the local clinic is to be congratulated on the rapid
recognition and treatment of these patients.

To find Wedza, go to:
<http://www.fallingrain.com/world/ZI/0/Wedza.html> - Mod. MHJ]

MENINGOCOCCAL DISEASE UPDATE 2007 (06)
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
Uganda (West Nile)
Date: Wed 7 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: Independent Online [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 546C422982>


A meningitis epidemic in northwestern Uganda has killed 27 people,
infected about 930, and has been hampering efforts to return Sudanese
refugees home, officials said on Wed 7 Feb 2007.

Ugandan health officials said the government is embarking on a
program to vaccinate up to 400 000 people in the region wedged
between the border lines of Sudan and the Democratic Republic of Congo.

"By Tue 6 Feb 2007, up to 930 cases had so far been recorded, with 27
deaths," Dr. Patrick Anguzu, a senior health official in the West
Nile region told Deutsche Presse-Agentur dpa by telephone.

UN refugee officials said on Wed 7 Feb 2007 that a program to
repatriate some of the tens of thousands of Sudanese refugees back
home from Uganda is still under suspension due to the meningitis
outbreak, which began in early January 2007.

--
ProMED-mail
<promed@promedmail.org>

[The reported numbers of cases and deaths continue to increase. A map
of Uganda showing the West Nile Region in northwestern Uganda can be found at:
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>.
- Mod.LL]

Meningococcal disease in Burkina Faso
WHO - 07.02.2007

From 1 January to 31 January 2007, the Ministry of Health reported 789 suspected cases including 96 deaths (case-fatality rate, 12.2%) in the country. Ouargaye district has an attack rate above the epidemic threshold and another three districts, Banfora, Batie and Sapouy are in the alert phase. For more information about the threshold principle, see the article in the Weekly Epidemiological Record. Cerebrospinal fluid specimens have tested positive for Neisseria meningitidis serogroup A by latex test. The Ministry of Health is planning to conduct a vaccination campaign in Ouargaye this week.

Poliomyelitis im Tschad
WHO - 07.02.2007

On 23 January 2007, the Ministry of Health in Chad confirmed one new polio case (type 3). It is the first polio case in Chad since December 2005. A two-year-old girl from N'Djamena had developed paralysis on 26 November 2006. Genetic sequencing of the isolated poliovirus indicates that it is related to poliovirus circulating in northern Nigeria. In response to the confirmation of polio, the Ministry of Health conducted a nationwide mass immunization campaign on 25-28 January 2007, immunizing nearly 2.5 million children under the age of five years. The next polio immunization campaign in the country is scheduled for 24-26 February 2007.

POLIOMYELITIS - WORLDWIDE: 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] Cameroon
[2] Nigeria

******
[1] Cameroon
Date: 7 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: Polio Eradication website [edited]
<http://www.polioeradication.org/casecount.asp>

Sequencing of the recent Cameroon case (a type 1 with onset of
paralysis on 6 Dec 2007) indicates that [it is] genetically linked to
poliovirus currently circulating in northern Nigeria.
An immunization response in Cameroon is currently being finalized.
--
ProMED-mail
<promed@promedmail.org>

******
[2] Nigeria
Date: 7 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: Polio Eradication website [edited]
<http://www.polioeradication.org/casecount.asp>

Seven new cases were reported in the past week from northern states.
Nigeria's most recent case had onset of paralysis on 17 Dec [2006].
Preparations are ongoing for the next scheduled Immunization Plus
Days (IPDs), to be held in northern states on 1-4 Mar 2007 using
monovalent oral polio vaccine type 1 (mOPV1).
--
ProMED-mail
<promed@promedmail.org>

[Given the recent confirmation of a wild poliovirus (WPV) type 3
poliovirus in Chad genetically similar to those circulating in
Nigeria (see section [1] above), one wonders if there is the need for
a follow-up immunization activity using vaccine containing poliovirus
type 3. - Mod.MPP]

HEPATITIS C - ÄGYPTEN
*******************
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: Wed 7 Feb 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: AllAfrica.com, IRIN report [edited]
<http://allafrica.com/stories/200702070355.html>


Egypt: 5 million infected with hepatitis C virus
-----------------------------------------------
At least 5 million people in Egypt are infected with the hepatitis C
virus (HCV), a new committee formed by the country's government to
tackle the disease has stated. It added that action must be taken now
to combat rising mortality.

"The annual infection rate is more than 70 000 new cases, of which at
least 35 000 would have chronic hepatitis C," said Dr. Manal
el-Sayed, Professor of Pediatrics at Cairo's Ain Shams University and
member of the National Hepatitis Committee, which is currently
formulating an action plan to fight the disease.

Hepatitis C virus is a lethal virus which can cause liver cirrhosis
and cancer. Egypt has one of the highest prevalence rates of the
virus in the world, say specialists. An estimated 10-15 percent of
the population, some 8-10 million people, are carrying hepatitis C
virus antibodies, meaning that they either have or at one time had
the virus. Five million of those are actively infected, according to
government figures. No vaccine is available for HCV although it can
be treated with a combination of drugs if detected early enough.

Egypt's very high prevalence of HCV is largely the legacy of
government campaigns prior to 1980 to treat rural populations for
schistosomiasis (or bilharzia), a water-borne disease which at one
time was endemic in Egypt. The treatment campaigns, which involved
repeated injections, did not follow rigorous hygiene standards and as
such spread blood-borne HCV throughout the population.

As it may take up to 30 years for a patient to display symptoms of
HCV infection or for the disease to become active, the full extent of
the problem has only recently become known. "The main risk factor,
according to all the studies done in Egypt, is treatment in the past
for schistosomiasis," said Dr. Amr Kandeel, Director of the
Communicable Disease Department at the Egyptian Ministry of Health
and Population. "At that time, the Ministry treated people in the
villages without using disposable syringes," he added.

In addition to cases among the older population, new infections are
still being recorded, due to poor medical practices and behavioral
factors. Deaths from liver disease are, therefore, expected to
increase in Egypt within the next 20 years. "If we consider that by
the year 2020 we are going to have so many patients who are having
liver failure and liver cancer, treating them now is more effective
than leaving them to that outcome," said el-Sayed.

Egypt's hepatitis committee is now making plans to prevent and treat
hepatitis C. Treatment of HCV is usually done with a drug called
Interferon [interferon-alpha?]. However, the most typical type of HCV
in Egypt has about a 40 percent resistance to the drug. Although
research is ongoing, no more effective treatment is yet available.
Nevertheless, the committee has succeeded in brokering a deal with
the manufacturers of Interferon to supply the drug to Ministry of
Health hospitals for 1/3rd of the usual price, and treatment under
the committee's program has begun in selected centers.

Even with the cost of Interferon reduced, the financial burden of
Egypt's HCV problem is huge. The committee estimates that of the 5
million people actively infected with the virus, around one million
currently need treatment. A year's treatment for a person with signs
of liver damage from HCV costs around LE 25 000 (about USD 4500), a
sum few can afford.

In January this year [2007], the committee began fundraising
activities with the help of NGOs [non-governmental organizations] and
international organizations including USAID [United States Agency for
International Development], the World Health Organization and UNICEF.
The committee hopes to be able to provide free treatment to those most in need.

"We would also like to appeal to the international community to help
with this campaign by whatever means possible," said el-Sayed. Due to
the cost and difficulty of treating chronic HCV patients, promoting
awareness to prevent the disease, and detecting those infected before
they develop liver damage are critical factors. "We are going to
promote screening for high-risk populations, including healthcare
professionals who are at risk from needle injuries, and those who are
undergoing repeated blood transfusion treatment," said el-Sayed. The
hepatitis committee has stressed the need for good infection control
programs in hospitals and among healthcare professionals to stem the
transmission of the virus. The Egyptian Ministry of Health is
cooperating through its National Infection Control Program, which
began in 2003.

Those at risk of new HCV infections in Egypt are not just those in
medical contact with existing patients, however. The children and
relatives of individuals affected during the schistosomiasis campaign
are also a high-risk group, as widespread behavioral practices --
such as the re-use of syringes, sharing of toothbrushes and even
circumcision -- all increase the risk of contracting blood-borne
viruses such as HIV and Hepatitis C. And although the circumcision of
girls is officially banned in Egypt, the practice still continues,
placing girls who are being circumcised at a very high risk of
contracting HCV. "Sometimes there is a sort of celebration for mass
circumcision in certain communities. Girls are at a higher risk,
because it is a very bloody procedure. However, female circumcision
has dramatically decreased, with more awareness and a ban by law,"
said el-Sayed.

As part of its Unite for Children, Unite Against Aids campaign,
UNICEF Egypt has also been trying to raise awareness of the more
common dangers of contracting HCV. Changing people's behavior and
attitudes toward blood safety is key, according to Wessam el-Beih,
UNICEF's Unite Against Aids Egypt coordinator.

(This IRIN report does not necessarily reflect the views of the United Nations)

--
ProMED-mail
<promed@promedmail.org>

[It remains to be seen whether interferon treatment alone will have a
significant effect on chronic hepatitis C virus infection in Egyptian
patients. Sequence comparison between isolates of hepatitis C virus
(HCV) indicated that HCV can be classified into a series of distinct
genotypes, and genotype 4a is the most prevalent hepatitis C
virus-genotype (85 percent) in Egypt (see, for example: J Egypt
Public Health Assoc. 1998;73(1-2):41-55). Only 21 percent of Egyptian
patients responded to interferon treatment. It may be necessary to
combine interferon and ribavirin (an RNA virus replication inhibitor)
treatment to have any appreciable effect on chronic hepatitis C
infections in Egypt. - Mod.CP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (07)
***********************************************
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:
Africa
[1] Cholera - Ethiopia (Ogaden)
[2] Cholera - Rwanda (East Province)
[3] Cholera - Somalia (Middle Shabelle, Lower Shabelle)
[4] Cholera - Somalia

******
[1] Cholera - Ethiopia (Ogaden)
Date: Thu 8 Feb 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: Sudan Tribune [edited]
<http://www.sudantribune.com/spip.php?article20166>

The Ogaden National Liberation Front (ONLF) wishes to alert the
international community to the rapidly spreading outbreak of cholera
in the Ogaden. This outbreak has already resulted in the deaths of
dozens of people in eastern Ogaden with over 40 victims in the city
of Qabri Dahare alone.
The ONLF wishes to make clear that all aid agencies are welcome in
Ogaden and encouraged to come to the immediate aid of the victims of
this cholera outbreak.
--
ProMED-mail
<promed@promedmail.org>

[A map of Ethiopia showing the area of Ogaden (or Somali Ethiopia)
can be found at:
<http://newsimg.bbc.co.uk/media/images/4 ... map203.gif>
- Mod.LL]

******
[2] Cholera - Rwanda (East Province)
Date: Thu 8 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The New Times (Kigali) [edited]
<http://allafrica.com/stories/200702080832.html>

The outbreak of cholera in the Nyagatare District has so far claimed
12 [lives] with about 400 suspected to be infected, The New Times has
learned. Among the areas reportedly most affected are the Nyagatare
main prison in Nyagatare Town, and sectors of Rukomo, Tabagwe, and Karama.
The health officials in Nyagatare hospital said that the number of
cholera victims is increasingly outweighing the capacity of the
hospital and called for immediate attention from other health service
providers and development agencies.
The District Director of Health services, Justin Rwagasore, when
contacted last week, acknowledged the outbreak of cholera in the area
and admitted that over 180 people in the hospital have symptoms of the disease.
The International Committee of the Red Cross (ICRC), in conjunction
with Red Cross Rwanda has intervened to help the cholera victims.
According to Dr. Luc from the ICRC, and an expert in the fight
against epidemics including cholera, a technical team has already
arrived in the district to assess the situation in the affected area
and explore avenues of intervention.
Rwagasore said, "The situation is worsening since the epidemic has
reached the crowded Nyagatare prison and over 47 people have been
reported infected with cholera. But the ICRC has come to intervene
and the local leaders in the district are pledging to give more
support to deal with the issue."
[Byline: Godfrey Ntagungira]
--
ProMED-mail
<promed@promedmail.org>

[The Nyagatare district is the northernmost district of the East (or
Eastern) Province of Rwanda. Its location can be found at:
<http://www.answers.com/topic/east-province-rwanda>. - Mod.LL]

******
[3] Cholera - Somalia (Middle Shabelle, Lower Shabelle)
Date: Thu 8 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and Shabelle Media Network (Mogadishu) [edited]
<http://allafrica.com/stories/200702080350.html>

At least 30 children have died of watery diarrhea in settlements
around Jawhar 90 km (55 miles) north of the capital Mogadishu, the
main town of Middle Shabelle province, southern Somalia. Reports from
Jawhar indicate that in this week alone 30 children under the age of
5 have died of the diarrhea-related disease.
Dr. Abdullahi Hussein Moalim, the director of Jawhar hospital, told
Shabelle Media Network on Thu 8 Feb 2007, that many more children
were gravely ill of the disease, calling on the international relief
agencies to bring medical supplies into the area immediately. More
than 350 cholera patients have been placed in the Inter-SOS hospital
in Jawhar in the past weeks.
Doctors in Middle and Lower Shabelle provinces say the number of
watery diarrhea-related deaths is increasing as people are forced to
use contaminated water from flood swamps and the river. More than 50
children are believed to have died in Middle Shabelle province alone
in the past 2 weeks, doctors say.
[Byline: Aweys Osman Yusuf]
--
ProMED-mail
<promed@promedmail.org>

[A map of Somalia can be found at:
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>.
Middle Shabelle (Shabelle Dhexe on the map) and Lower Shabelle
(Shabelle Hoose on the map) are in the southeastern part of the
country. - Mod.LL]

******
[4] Cholera - Somalia
Date: Thu 8 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: Los Angeles Times [edited]
<http://www.latimes.com/news/nationworld ... ines-world>

A cholera outbreak in Somalia has killed more than 115 people and
hospitalized 724 in towns where people were forced to use
contaminated water from a flooded river, doctors said Wed 7 Feb 2007.
Tests conducted by the international group Doctors Without Borders
confirmed the cholera outbreak in towns along the Shabelle River. The
river flooded this year [2007], leaving tens of thousands homeless in
a country with little ability to respond because it in effect lacks a
government.
"At least 115 people, 53 of them children, have died from cholera in
4 districts in the last 4 weeks," said Dr. Abdulahi Hussein Malin,
who works in a hospital in Jawhar. Infants have been especially
affected, said Dr. Hawo Abdi Mumin, who works with the Somalian Red
Crescent Society.
"People use water from the river, which is contaminated because of
the floods, because they have no access to clean water."
--
ProMED-mail
<promed@promedmail.org>

TUBERCULOSIS, XDR - SÜDAFRIKA(03)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] Eastern Cape
[2] Western Cape

******
[1] Eastern Cape
Date: Thu 8 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: The Herald Online [edited]
<http://www.theherald.co.za/herald/news/n01_08022007.htm>

Five people have died from extensively drug-resistant tuberculosis
(XDR TB) in the Eastern Cape, authorities confirmed yesterday, 7 Feb
2007. The provincial health department said that of the 33 patients
diagnosed with the killer strain at the Jose Pearson Hospital in
Bethelsdorp since last October 2006, 5 had died. Jose Pearson houses
about 250 patients from across the province diagnosed with
multidrug-resistant tuberculosis (MDR TB).
At least 303 cases of XDR TB have been recorded in the country since
it was 1st identified last year [2006] at Tugela Ferry Hospital in
KwaZulu Natal. Of the 1st 53 patients diagnosed, 52 died.
Provincial health spokesman Sizwe Kupelo said 2 of the Eastern Cape
patients had been from Port Elizabeth -- KwaDwesi and Zwide
respectively -- and the others had been from Humansdorp, Jansenville,
and Mdantsane. Three of the patients died in January 2007, Kupelo said.
"The other 28 patients are kept in isolation and are being treated at
the hospital. Their family members were also screened for XDR TB," Kupelo said.
Although no new TB drugs or diagnostics have been developed in the
past 30 years, the health department is currently importing 2 drugs,
capreomycin and para-amino salicylic acid, to treat MDR and XDR TB.
These drugs were initially taken off the market in the 1980s because
of their severe side effects such as stomach problems, anorexia and
diarrhea. However, they are once again being manufactured
internationally on a limited scale because they are more effective at
treating MDR and XDR than regular TB drugs.
In March 2006, in line with a WHO decision by African health
ministers, a TB Crisis Management Plan was launched by Health
Minister, Manto Tshabalala-Msimang. The plan focuses on 4 districts,
which have a quarter of the national TB caseload. These are Amathole
and Nelson Mandela Bay in the Eastern Cape, eThekwini in KwaZulu
Natal, and the Johannesburg metro in Gauteng. However, despite these
measures, the number of cases remains high, the WHO says.
[Byline: Nwabisa Nofemele]
--
ProMED-mail
<promed@promedmail.org>

******
[2] Western Cape
Date: Sat 3 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: Bush Radio News [edited]
<http://bushradionews.blogspot.com/2007/ ... -cape.html>

Two cases of the extensively drug-resistant (XDR TB) have been
identified in the Western Cape. The provincial health department
confirmed that an 11-month-old baby girl was being treated in
Brooklyn Chest TB Hospital. The other patient, a woman from the
Eastern Cape, is being treated in isolation at Lentegeur Hospital.
Last year [2006], over 300 cases of XDR TB were reported across the
country: 263 cases in KwaZulu-Natal, 10 cases each in the Eastern
Cape and the North West, 8 in Gauteng, 6 in Free State, 3 in Limpopo,
and 2 in the Northern Cape. But none were reported in Mpumalanga and
the Western Cape, reports say.
[Byline: Chanel September]
--
ProMED-mail
<promed@promedmail.org>

[The presence of XDR TB in an 11-month-old child underscores the
observation that much of the disease is due to acquisition of the
resistant bug, not selection of resistance in a patient non-adherent
to therapy for an initially more sensitive mycobacterium. Young
children with TB usually mean active disease in close family members
or other caretakers.

A map of South Africa showing the Eastern and Western Cape Provinces
as well as the other provinces mentioned above can be found at:
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf> - Mod.LL]

SCHLAFKRANKHEIT - SÜDAFRIKA EX MALAWI
*****************************************
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 12 Feb 2007
From: Lucille Blumberg <lucilleb@nicd.ac.za>


Four cases of trypanosomiasis imported from Malawi
-----------------------------------------------
Trypanosomiasis was confirmed in 4 travelers to Malawi in the last
month. The travelers were from Canada, Great Britain and Australia,
respectively; all had a history of travel in the preceding 1-3 weeks
to the Kasunga National Park, and 2 had also traveled to the Vwasa
Marshes National Park in northern Malawi. All the patients presented
with acute onset of fever; one patient had a trypanosomal chancre,
and trypanosomiasis was confirmed in all patients on peripheral blood
smear.

Thrombocytopenia was noted in 2 patients; one patient experienced
hallucinations, and one patient developed a hepatitis either as an
adverse reaction to suramin or as a complication of disease.
Examination of cerebrospinal fluid was normal in all patients. To
date, all patients have responded well to suramin treatment,
administered in South Africa. East African trypanosomiasis is an
uncommon but acute often fulminant and potentially fatal disease in
travelers that is frequently missed or misdiagnosed as malaria.

In November 2005, 2 travelers were also treated in South Africa for
trypanosomiasis acquired in the Kasunga National Park, Malawi. Since
2001 a total of 18 cases of East African trypanosomiasis have been
treated in South Africa in travelers to Malawi, Tanzania, Zambia,
Zimbabwe and Kenya.

Tourists visiting game reserves in central and east African countries
should be alerted to the danger of this disease for which there are
no effective preventive measures, but which if acquired, requires
expert diagnosis and treatment.

[Reported by: Lucille Blumberg, John Frean, Willi Sieling, Hussein Pahad]

--
Dr. Lucille Blumberg
National Institute for Communicable Diseases
No.1 Modderfontein Road, Sandringham
Johannesburg, South Africa
<lucilleb@nicd.ac.za>

[ProMED appreciates receiving this report from Dr. Blumberg and
colleagues. Trypanosomiasis has been emerging for almost a decade in
Africa. In 2001, tourists visiting Tanzania acquired trypanosomiasis,
and recent outbreaks in Angola, Congo, Zimbabwe and probably Sudan
have underlined that the infection is not under control. The recent
report illustrates that Malawi also is an endemic country, with cases
in the indigenous population not being reported, but travelers
infected show that the infection is endemic in the area. More
information on African trypanosomiasis can be found at the Programme
Against African Trypanosomiasis (PAAT) website:
<http://www.fao.org/ag/againfo/programme ... /home.html>.
- Mod.EP]

Gelbfieber in Togo - update 3
WHO - 12.02.2007

The mass vaccination campaign is scheduled to begin today in Savanes and Kara regions where three cases of yellow fever were laboratory confirmed (see previous report). Yellow fever reappeared in these regions after an absence of more than 20 years. The campaign will target children more than 9 months old in 11 districts in these 2 regions. The vaccine (1 500 000 doses) has been provided by the The GAVI Alliance emergency stockpile, through the International Coordinating Group (ICG) on Vaccine Provision for Yellow Fever Control. ECHO has provided funding for the campaign. An additional two cases of yellow fever were reported at the end of January, one in Kara region(Kozah district) and the other in Maritime region (Lacs district); both cases were laboratory confirmed by Institut Pasteur, Dakar, Senegal. An investigation was carried out by the Ministry of Health, assisted by the WHO Regional Office for Africa and the WHO country office. Containment measures, including a vaccination campaign in Maritime region are currently being assessed.

RIFT VALLEY FEVER, EASTERN AFRICA (15): TANZANIA
***********************************************
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 11 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: People's Daily online, Xinhua News agency [edited]
<http://english.people.com.cn/200702/11/ ... 49171.html>


Tanzania: 4 hospitalized in North for suspected RVF infection
-----------------------------------------------
Four people have been hospitalized in a north Tanzanian hospital for
fear of having contracted Rift Valley fever (RVF), according to
reports on Sat 10 Feb 2007. The local English newspaper Daily News
quoted Arusha Regional Medical Officer Naftari King'ori as confirming
that the 4 people had been admitted into the Mount Meru Hospital,
where the country's 1st 2 victims of the disease died on 31 Jan 2007.

Tanzanian Prime Minister Edward Lowassa called on local government
officials to coordinate efforts to contain the spread of the disease.
He told lawmakers on Friday [9 Feb 2007] in Dodoma that the
government had already ordered vaccines and would soon start
vaccinating livestock in the country, which has a cattle population
of 18.5 million. Tanzania has already banned livestock movement to
and from neighboring Kenya and started scrutinizing all livestock
meant for human consumption after the disease had killed 2 local
residents and a Kenyan visiting northern Tanzania.

In 1998, Rift Valley fever broke out in Arusha following a similar
outbreak in Kenya, and the disease killed at least 10 people between
January and March of that year. Rift Valley fever is a viral disease
that affects mainly animals such as cattle, buffalo, sheep and goats.
But it can also affect humans. The disease is most common during
years of heavy rainfalls.

--
ProMED-mail
<promed@promedmail.org>

[If confirmed positive, these cases will represent a significant
incursion of Rift Valley fever into the human population of Tanzania.
So far, little information has been released regarding the extent of
penetration of the disease into livestock in the Arusha region, which
is adjacent to the outbreak in eastern Kenya.

A map of Tanzania can be viewed at
<http://www.uhuru7.com/images/tanzania_rel_2003.jpg>.
- Mod.CP]

RIFT VALLEY FEVER - EASTERN AFRICA (16): TANZANIA (ARUSHA), CATTLE,
SHEEP, GOATS, OIE
***********************************************
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: 12 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: OIE Disease Information, WAHID, Vol. 20 - No. 7 [edited]
<http://www.oie.int/wahid-prod/public.ph ... ex&admin=0>


Rift Valley fever, Tanzania
-------------------------------
Information received on 12 Feb 2007 from Dr. Johnson O. Mollel,
Director of Veterinary Services, Veterinary Services, Ministry of
Livestock Development, Dar Es Salaam, Tanzania

... there were 6 new outbreaks reported on 18 Jan 2007 in
the region of Sale, Ngorongoro, Arusha. Each outbreak involved
cattle, sheep and goats with the largest number being 1800 cattle,
1290 sheep and 1370 goats in both the 1st and 2nd reported outbreak.
Individual outbreak information can be found at the OIE's WAHID
interface referenced above ...
--
ProMED-mail
<promed@promedmail.org>

[Mapping the extent of RVF spread in animals is crucial for the
effectiveness of control measures in animals and of steps for the
protection of humans from exposure. In particular, reliable, rapid
field tests are essential. Advice and technical assistance might be
obtained from OIE's (sole) reference laboratory for RVF: Dr. G.H.
Gerdes, Onderstepoort Veterinary Institute, Onderstepoort 0110, South
Africa, Tel: (27.12) 529.91.14 Fax: (27.12) 529.94.18,
<oneillm@arc.agric.za>. - Mod.AS]

[Clearly, this is a disease in which both people and animals are
dying. The prevalence in the ruminant herds reported here is low,
around 2-3 percent, but the case fatality rate of those infected
appears to be above 50 percent no matter what the species. Of course,
ruminants suffer significant loses, act as amplifiers of the virus
but also should serve as a warning to people in the area, because the
disease is often transmitted by mosquitoes to humans or people are
exposed to infected ruminants directly.

The location of these outbreaks is indeed unfortunate as they have
progressed through the new year 2007. Outbreaks have occurred in both
Kenya and now Tanzania. The new outbreak can be seen on the map
provided by OIE's WAHID interface referenced above. Unfortunately,
they are now occurring in the general area of the world famous
Serengetti, Masai Mara, Ngorongoro, Arusha and Mt. Kilimanjaro
tourist areas. The outbreak in Kenya centered around Garissa, which
is not a hub of international traffic. In either case, the outbreaks
will likely occur in both people and animals. So, I would echo the
comments of Mod.AS and encourage the development of the best
information and geographical and epidemiological data possible.
Unfortunately, this outbreak has been a case in which we have
ecological and animal early warning systems in place but lack the
disease prevention delivery systems necessary to prevent human
infection.

A general map of the area can be viewed at
<http://www.uhuru7.com/images/tanzania_rel_2003.jpg>.
- Mod.PC]

Namibia: 50 New Cholera Cases Reported At Outapi - Death Toll Up to 7
13.02.2007 - Brigitte Weidlich

Outapi - HEALTH authorities are getting ready to tackle a cholera outbreak in the Outapi area, where 50 cases of the water-borne disease have been reported. The Health Ministry has activated its Health Emergency Preparedness and Response Committee, a senior official said yesterday. Since November, some 250 cholera cases have been reported in the country. The first outbreak was reported in the Opuwo area of the Kunene Region in November and five people died from the disease, which is caused by a germ that enters the intestines through dirty and contaminated water. The disease reportedly came from Angola ... mehr

MENINGOCOCCAL DISEASE UPDATE 2007 (07)
**************************************
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] Uganda (West Nile)
[2] Sudan

******
[1] Uganda (West Nile)
Date: Fri 9 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and New Vision (Kampala) [edited]
<http://allafrica.com/stories/200702090254.html>

At least 63 people out of a cumulative total of 1607 confirmed new
cases have died of meningitis in the West Nile region since the
epidemic broke out in mid-December 2006. A total of 1534 cases have
since been successfully treated.

Addressing journalists in Kampala yesterday, 8 Feb 2007, health
minister Stephen Mallinga said the epidemic was, however, on the
decline following mass vaccination campaigns against the disease. He
said a "significant decline" had been registered in the Koboko and
Arua districts, and also in the Kotido district in Karamoja, where
the epidemic was 1st reported before it spread to the West Nile
region. However, Adjumani and Yumbe still experienced sporadic cases.
[Byline: Fred Ouma]
--
ProMED-mail
<promed@promedmail.org>

[A map of Uganda showing the affected districts in the West Nile
Region in northwestern Uganda can be found at:
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>. - Mod.LL]

******
[2] Sudan
Date: Wed 7 Feb 2007
From: ProMED-mail <promed@promedmail.org>
Source: News24.com [edited]
<http://www.news24.com/News24/Africa/New ... 22,00.html>

A meningitis epidemic has killed 76 people in 8 Sudanese states since
the end of 2006, said the United Nations (UN) on Wed 7 Feb 2007.

"An epidemic of meningitis has spread to 8 states since the end of
2006 -- central, western and eastern Equatoria, Lakes, western and
northern Bahr el-Ghazal, Jonglei, and Warrap states," said the United
Nations Mission in Sudan (UNMIS). "As of 1 Feb 2007 about 780 cases
have been reported with 76 deaths," said the UNMIS.
--
ProMED-mail
<promed@promedmail.org>

[A map of Sudan showing the affected areas can be found at:
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf> - Mod.LL]

RIFT VALLEY FEVER - EASTERN AFRICA (17): KENYA
**********************************************
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 12 Feb 2007
From: Joseph Dudley <jdudley@eaicorp.com>
Source: The East African Standard (Nairobi) [edited]
<http://allafrica.com/stories/200702121364.html>


Kenya: Five more die of rift valley fever
-----------------------------------------
Five people, including 4 members of a family died of the dreaded Rift
Valley fever (RVF) in the Tana River and Baringo districts. The 5
died as the Ministry of Health warned Kenyans against handling
animals suspected to be infected with the disease.

Dr. Jack Nyamongo of the National Public Health Laboratory
Services/National Blood Transfusion Services said it was important
not to handle material from infected animals. He said veterinary
officers at Kabete were testing samples from a cow confiscated in
Ruai at the weekend to establish if the animal was infected with the
deadly virus.

Last evening [11 Feb 2007], the Director of Veterinary Services, Dr.
Joseph Musaa, said initial results indicated that the cow was
suffering from Lumpy Skin disease. [Lumpy skin disease is caused by a
poxvirus classified in the genus _Capripoxvirus_, which affects
certain breeds and crossbreeds of cattle in Africa. - Mod.CP].

The 4 family members succumbed to the killer fever after attending a
traditional wedding in the Tana River on Mon 12 Feb 2007. The victims
developed symptoms of the disease before bleeding to death barely 2
days after feasting on camel meat at a wedding ceremony in Anole
village, Madogo division. Three of the victims died in manyattas
[fenced settlements of several huts characteristic of Masai
communities. - Mod.CP], while the 4th was pronounced dead on arrival
at Garissa Provincial General Hospital, where 21 other villagers were
hospitalised.

North Eastern Provincial Medical Officer of Health, Dr. Omar Ahmed,
said more than 20 other villagers who attended the weekend function
had been put under observation after developing symptoms of the
disease. He said most of the affected villagers were treated [and]
subjected to periodic check-ups. Three of them were admitted to an
isolation unit in the facility. Omar regretted that most of the fresh
cases reported over the last 2 weeks followed disregard of the
slaughter ban. Madogo DO [District Officer], Mr. George Omolo, said
villagers reported the matter after 3 of the women who prepared the
camel meat collapsed and bled to death.

Preliminary reports indicated that the camel had been bought, Omolo
said. He said the pastoralist who sold the animal was among those
retained for specialised treatment at the hospital. Panicky
villagers, including those who ate cooked meat thronged local health
centres to establish their RVF status.

This brings to 114 the number of deaths reported in northern Kenya
since the outbreak of the disease, 2 months ago. In Baringo District
an 18-year-old man died bringing the death toll in the area to 16.
Medical Officer of Health, Dr. George Otieno, said the man who had
been receiving treatment at Kimalel Health Centre died on Saturday
[10 Feb 2007]. Nationally, 150 people have died of the disease in the
past 2 months.

Otieno said a team of health workers had been dispatched to the
affected villages in the Marigat and Kiserian divisions to fight the
disease. He identified the most affected villages where the fever has
taken its toll as Ngambo location, Sindan, Sandai, Logumgum, and
Salabani all in the Marigat division, and some parts of the Mukutani
division.

He said the government has supplied the district with 500 mosquito
nets and insecticides. But Otieno said the chemicals were still lying
at chemical stores in Kabarnet town, as the Government has not
released money to hire casual workers to spray houses in the affected
areas.

Baringo Central MP, Mr. Gideon Moi, visited patients in the Kimalel
and Marigat sub-district hospitals and distributed more than 2000
mosquito nets.

At the same time, farmers in Nakuru have asked the Government to
declare the fever a national disaster. Farmers meeting in Nakuru
yesterday [11 Feb 2007] criticised the Livestock Development ministry
[for the way it] handled the matter.

Meanwhile, fear of the disease spreading in Meru Central have led to
an order of closure of all abattoirs and butcheries in the area.

District veterinary officer, Dr. Daniel Karugu, said samples from
several suspected cows are being analysed. Neighbouring districts of
Isiolo, Meru North, and Meru South have reported cases of the disease.

--
Joseph P. Dudley, Ph.D.
EAI Corporation
4301 North Fairfax Drive, Suite 200
Arlington, VA 22203
USA
<jdudley@eaicorp.com>

[The total number of deaths in Kenya attributable to Rift Valley
fever virus infection has risen now to 150, the majority (114)
reported from northern Kenya plus, so far, a few cases in adjacent
regions of Somalia and Tanzania. Most deaths have been attributed to
consumption or contact with of meat from illegally slaughtered
animals.

High-resolution maps of Kenya can be accessed at:
<http://www.omnimap.com/catalog/int/kenya.htm> to locate some of the
administrative districts listed in this report. - Mod.CP]