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RIFT VALLEY FEVER - OSTAFRIKA (19): WILDLIFE, SUSPECTED
************************************************************
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International Society for Infectious Diseases
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[1]
Date: Wed 28 Feb 2007
From: Joseph Dudley <jdudley@eaicorp.com>
Source: The Standard, Nairobi [edited]
<http://www.eastandard.net/hm_news/news. ... 1143965439>


Buffalo deaths raise fears of RVF in wildlife
---------------------------------------------
The deaths of over 10 buffaloes in Hells Gate National Park have sparked
fears among local conservationists that Rift Valley fever (RVF) may have
spread to wild animals, especially since 2 of the animals died in a farm
where the 1st local case of the fever was reported.

Government officials said they are waiting for results of samples from the
dead animals to determine the cause of death. The officer-in-charge at the
park, Ms Lydia Kisoyan, confirmed the deaths.

[byline: Karanja Njoroge]

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

[Results from the laboratory are awaited with interest.

An earlier query from Dr Joe Dudley, the sender of the posting above,
enclosed a comment from Dr Michael Woodford (founder of IUCN (World
Conservation Union) Veterinary Specialist Group; Regional contact person
for Middle East, Western, and Central Asia, OIE Wildlife disease working
group) on the absence of current information regarding RVF in wildlife.
This, and additional raised queries, have been forwarded to Prof Glyn
Davies, a world authority on RVF. We are very grateful for his response,
which constitutes the following report. - Mod.AS]

******
[2]
Date: Sat 24 Feb 2007
From: Glyn Davies <fgdvirus@compuserve.com>


Wildlife and RVFV
-----------------
1. Field observations
I spent a great deal of time during RVFV (Rift Valley fever virus)
epizootic periods in Kenya observing the wild ruminants on properties
affected by RVFV in domestic animals and also communicating with cattle and
sheep farmers on RVF affected farms. At no time, did I nor anyone else, see
wild animals grazing RVFV infected areas with affected cattle, show any
clinical disease, which might have been due to RVFV. Abortions may have
occurred, however, but it is unlikely that these would have been detected,
due to the presence of wild carnivores that would scavenge fetal material.
Surveys were carried out in sera collected from wild ruminants and there
was evidence that cryptic RVFV infection had occurred in some species
(Davies 1975 & unpublished data). My conclusions were that infection by
RVFV did occur in these situations, but that this was subclinical, with the
reservation that abortion may have occurred in pregnant females, which was
difficult to observe or confirm.

There was a report from South Africa that springbok and blesbok were
aborting during a RVF epizootic, but this was not confirmed to be due to
RVF (Joubert, et al. 1951).

2. Experimental inoculations
Five adult female buffalo (_Syncercus caffer_) were inoculated with RVF
virus and viraemia was detected for cc 48 h in 4 of them. Two animals,
which were pregnant, aborted. Some RVF antibody was detected in wild
population samples from buffalo, but the samples were from ecological zones
where RVFV activity was unlikely to have occurred for some considerable
time: there had been no recent periods of epizootic RVFV activity before
the sampling (Davies & Karstad, 1981).

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

RIFT VALLEY FEVER - OSTAFRIKA (20): WILDLIFE, NOT
******************************************************
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[1]
Date: Mon 5 Mar 2007
From: Kariuki Njenga <KNjenga@ke.cdc.gov>


Tests performed on specimens from 8 dead buffalos from Baringo district
(not Hell's Gate) in Kenya were negative for Rift Valley Fever (RVF).
Baringo district has reported over 150 human cases of RVF, with 52 of these
confirmed by laboratory tests since late January 2007.

Polymerase chain reaction (PCR) testing of sera from the animals was
negative, strongly suggesting that the death was not due to RVF. Serologic
testing is ongoing.

--
M Kariuki Njenga, PhD
Virologist and Laboratory Director
GDD/IEIP-Kenya, Centers for Disease Control
Office: +254-20-271-3008; fax 271-4745
US Mail: Unit 64112, APO, AE 09831-4112
<KNjenga@ke.cdc.gov>

[Dr Kariuki Njenga is gratefully acknowledged for this first-hand
authoritative information. The reported results fall in line with Dr Glyn
Davies' comments, included in ProMED-mail posting Rift Valley fever -
Eastern Africa (19): wildlife, susp 20070304.0753: "I spent a great deal of
time during RVFV (Rift Valley fever virus) epizootic periods in Kenya
observing the wild ruminants on properties affected by RVFV in domestic
animals and also communicating with cattle and sheep farmers on RVF
affected farms. At no time, did I nor anyone else, see wild animals grazing
RVFV infected areas with affected cattle, show any clinical disease, which
might have been due to RVFV."

Recent coverage of RVF in the animal domain leaves room for improvement.

While humans have been reported to be sick and dying of RVF in Kenya since
the beginning of December 2006, the 1st official notification on cases in
animals (sheep, goats, cattle, and camels), which reportedly had started on
4 Dec 2006, were submitted to the Office International des Epizooties (OIE;
World Organisation for Animal Health) from Kenya on 9 Jan 2007; see
notification, including map, at
<http://www.oie.int/wahid-prod/public.ph ... ortid=4487>.

Human cases in Somalia were initially reported on 12 Jan 2007, following
rumors of abortions in cattle, which have, so far, not been confirmed -- by
laboratory tests -- to be related to RVF.

Tanzania reported outbreaks in sheep, goats, and cattle on 12 Feb 2007,
reportedly having started on18 Jan 2007; see notification, including map,
at
<http://www.oie.int/wahid-prod/public.ph ... ortid=4782>.
The 1st human cases were reported from Tanzania at the beginning of
February 2007, so far without WHO confirmation. For background and past
experience, see also Dr Peter Roeder's contribution in ProMED-mail posting
Rift valley fever - Eastern Africa: Somalia, Kenya 20070112.0164.

Domestic ruminants, namely sheep followed by goats and cattle, are known to
demonstrate high susceptibility, manifested by mass abortions while
mortality in young lambs and kids expected to reach nearly 100 per cent.

A detailed, useful review of RVF in humans and animals is available at
<http://www.fao.org/ag/AGAinfo/subjects/ ... s/rvf.html>.
- Mod.AS]

******
[2]
Date: Sat 3 Mar 2007
From: Joseph Dudley <jdudley@eaicorp.com>
Source: Allafrica.com, Arusha Times [edited]
<http://allafrica.com/stories/200703040119.html>


Distribution of vaccines against the Rift Valley Fever (RVF) has started in
infected areas according to the minister for livestock development, Mr
Anthony Diallo.

The 1st batch of vaccines against the deadly disease arrived from South
Africa last Friday [2 Mar 2007]. The vaccine is administered to livestock.
About 500 000 doses, were ordered by the government 2 weeks ago and were
immediately dispatched for distribution in affected areas -- Arusha,
Manyara, Kilimanjaro, Morogoro, and Tanga regions. "The distribution of the
vaccines has already started and we want to see it speeded up," Mr Diallo
told reporters.

Officials and experts have urged inhabitants of Arusha to handle and
prepare carefully meat and other animal products before eating them. Meat
and milk should not be consumed raw or half done. Signs and symptoms of RVF
[in humans] include flue-like illness with fever, weakness, back pain,
dizziness, and weight loss. Diagnosis can be made by laboratory tests.

--
Joseph P Dudley, PhD
Chief Scientist
EAI Corporation
Rockville MD 20852
<jdudley@eaicorp.com>

[Timely livestock vaccination will reduce economical losses of breeders; it
can also be an effective means of preventing cases of human RVF, if
adequate vaccination coverage and herd immunity are achieved.

The vaccine obtained by Tanzania from South Africa is probably commercial
live-attenuated (Smithburn) vaccine produced in Onderstepoort. This vaccine
will confer protecting antibody levels within a relatively short period but
is known to be abortogenic. Should pregnant animals be vaccinated,
subsequent abortions might cause reluctance of herders to vaccinate or to
cooperate with the vaccinators. Directions for use are available at
<http://bigfive.jl.co.za/pdf_files/p2153.pdf>.

The safer, inactivated, vaccine requires booster vaccinations and is more
laborious and expensive. This is the vaccine of choice in non-endemic
situations (RVF-free countries/regions) and prior to the commencement of
outbreaks in endemic regions. Directions for use are available at
<http://bigfive.jl.co.za/pdf_files/p2146.pdf>. - Mod.AS]

MENINGOCOCCAL DISEASE UPDATE 2007 ( 10 ): WEST AFRICA
**************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 5 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://www.alertnet.org/thenews/newsdes ... ce33d7.htm>


The death toll from a meningitis epidemic in Burkina Faso rose to 324
on Fri 2 Mar 2007, and the UN says outbreaks and deaths have also
been recorded in 7 other West African countries in 2007.

Burkina Faso is by far the hardest hit country in the region, with
almost 1000 additional people infected in the last week bringing the
total number of recorded cases to 3625, according government health
authorities. Outbreaks have been recorded in 5 out of 53 health
districts, with 14 other districts on alert.

Elsewhere in the region the worst hit country is Cote d'Ivoire with
100 cases and 28 deaths followed by, 84 cases and 14 deaths in Niger,
73 cases and 6 deaths in Mali and 68 cases and 16 deaths in Benin,
according to figures provided by the UN humanitarian coordination
agency (OCHA). Other cases have been reported in Ghana, Togo and
Guinea.

According to OCHA and the Burkina Faso government, the number of
vaccines in the region is insufficient to stop the epidemic from
spreading. Last week the Canadian embassy in Ouagadougou announced it
would provide Burkina Faso with US $188 000 worth of vaccines but the
country's health minister Alain Yoda said that a comprehensive
preventive vaccination campaign would require [US] $1.6 million.

West Africa's semi-arid Sahelian countries, sometimes referred to as
the "meningitis belt", are hit each year by outbreaks of bacterial
meningitis during the dry seasons between December and June.
Dust-laden winds along with cold nights combine to lower people's
immunity to respiratory tract infections.

The countries in the region are among the poorest in the world and
vaccinations are usually administered only after an outbreak has
occurred.

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

[A user-friendly interactive map of the region can be found on the
original URL. - Mod.LL]

RIFT VALLEY FEVER - OSTAFRIKA (21): KENIA, VACCINATION
***********************************************************
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Date: Tue 6 Mar 2007
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: IRIN via Reuters [edited]
<http://www.alertnet.org/thenews/newsdes ... 93d799.htm>


KENYA: Livestock vaccination stems spread of RVF
-----------------------------------------------
An ongoing livestock vaccination campaign against an outbreak of Rift
Valley Fever (RVF) has stemmed the spread of the disease in Kenya,
where the mosquito-borne illness, which affects both animals and
humans, has killed 154 people since December 2006, officials said on
Tuesday [6 Mar 2007].

"We have not received any new (livestock) cases, although our
extension officers are still carrying out surveillance in the
affected districts," said William Maritim, senior veterinary officer
with the disease control unit of the Ministry of Livestock and
Fisheries.

At least 1.5 million livestock (cattle, sheep, and goats) are
targeted for vaccination in the ongoing campaign in 33 districts
where RVF cases have been reported. The worst affected districts were
Garissa, Ijara and Wajir in Northeastern Province, Tana River and
Kilifi districts in Coast Province, and Kirinyaga and Maragwa
districts in Central Province.

"We are also in the process of procuring an additional 750 000 doses
of vaccine to sustain the exercise," Maritim said.

The vaccination project, which began in Garissa on 8 Jan 2007, is
moving towards the Rift Valley Province, where the disease was 1st
reported in 1931. RVF causes spontaneous abortions and death in
animals.

Most of the vaccines have been imported from South Africa, at
approximately USD 0.37 a dose.

The RVF virus is spread to humans from livestock via the aedes
mosquito, which breeds rapidly during floods [and by direct contact
of humans with infected animal tissues - Mod.AS]. The Northeastern
Province, inhabited by nomadic pastoralists, was hit by devastating
floods in the last 3 months of 2006 after heavier than normal
rainfall.

It can be transmitted through contact with infected animal material,
such as blood or other body fluids, or organs. Consumption of milk, a
staple for many pastoral people, is also thought to lead to
infection. Symptoms in humans include bleeding through the nose and
mouth and liver failure.

The government imposed a ban on the slaughter of livestock in the
affected areas when RVF was 1st reported, leading to the closure of
livestock markets in a region where people depend on animals for
income and food. The ban has since been lifted, but a restriction on
livestock movement is still in force.

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

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (11)
**********************************************
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 - Somalia (Lower Shabelle, Gedo)
[2] Cholera - Sudan (Upper Nile)
[3] Cholera - Angola (Huila)
[4] Cholera - Angola (Luanda)

******
[1] Cholera - Somalia (Lower Shabelle, Gedo)
Date: Mon 5 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and Shabelle Media Network (Mogadishu) [edited]
<http://allafrica.com/stories/200703050361.html>


At least 40 children [with a] cholera-related disease had been
admitted to Banadir maternal hospital, south of the capital Mogadishu
on Sunday [4 Mar 2007]. Asho Mohammed Abdi, the forewoman of Banadir
medical staff, told Shabelle that 20 to 40 infected children have
been admitted to the hospital.

Abdi said, "37 people, most of them children, with watery diarrhea
were brought to Banadir hospital today, 5 Mar 2007," and called on
the residents in Mogadishu to preserve the sanitation of their environment.

On Sun 4 Mar 2007, 5 children died form watery diarrhea in the Gedo
provincial settlements, in southern Somalia. Ibrahim Isak, a medical
officer in Bardhere, told Shabelle that a large number of children
had been beset by the infection in the past few days, while the
disease is also killing older people. An older woman and 4 children
died from diarrhea on [Sat 3 Mar 2007]; in addition, at least 13
children are admitted to the hospitals in Bardhere every day.

[Byline: Aweys Osman Yusuf]

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

[Cases of cholera in Somalia are often referred to as "acute watery
diarrhea". The provinces of Lower Shabelle (Shabelle Hoose), where
Mogadishu is located, and Gedo, where Bardhere is located, can be
seen on a map at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[2] Cholera - Sudan (Upper Nile)
Date: Sun 4 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: United Nations Mission in Sudan (UNMIS) News Bulletin [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Health conditions in Malakal continue to deteriorate as acute
diarrhea, suspected to be cholera, claims more lives with 81 reported
cases and 11 deaths. Sanitary health interventions and campaigns
around water sources are needed to avoid a widespread epidemic in
Malakal and along the bank of the Nile into Jonglei State.

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

[This news release, which does not give the time span when these
cases occurred, lists the outbreak under West Darfur. Malakal,
however, is the capital of the Upper Nile state in eastern Sudan as
shown at <http://en.wikipedia.org/wiki/Upper_Nile>. The Jonglei state
is just south of Upper Nile. - Mod.LL]

******
[3] Cholera - Angola (Huila)
Date: Fri 2 Mar 2007
From: ProMED-mail <promed@promemdmail.org>
Source: AllAfrica.com and Angola Press Agency (Luanda) [edited]
<http://allafrica.com/stories/200703020552.html>


The Department of Public Health and Control of Endemics has
registered 15 cases of cholera over the last 48 hours in southern
Huila province. The statement was released on Fri 2 Mar 2007, by the
Institution's Acting Director, Felix Januario.

He said that the cases occurred in the provincial capital, Lubango
city, and in district of Chibia.

Some 221 people, out of more than 5000 cases, died of cholera in
Huila province since April 2006.

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

[A map of Angola showing Huila and Luanda (posting below) can be
found at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

******
[4] Cholera - Angola (Luanda)
Date: Wed 7 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=514914>


About 610 cholera cases, from which 10 resulted in deaths, were
registered from January to 6 Mar 2007 by the Municipal Health
Department of Cazenga, in Luanda.

Speaking to ANGOP this Wed 7 Mar 2007, the local health director,
Zola Messo, said that 15 to 20 patients are hospitalized daily.

The source added that the [presence] of puddles obstructs patient
access to health centers and most of the time they arrive in critical
condition. The director expressed worry with the spreading of the
cholera outbreak in the district, mainly in the wards of Vila da
Mata, Calowenda, and Curtume, areas that are considered critical.

Nine people have been hospitalized in the past 24 hours, however,
without claiming any lives.

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

PLAGUE - UGANDA (MASINDI) (03): PNEUMONIC
*****************************************
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ProMED-mail is a program of the
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<http://www.isid.org>

Date: Thu 8 Mar 2007
From: Joseph Dudley <fnjpd@uaf.edu>
Source: New Vision [edited]
<http://www.newvision.co.ug/D/8/13/553076>


The pneumonic plague that hit Masindi district killing at least 9
residents in Mutunda sub-county has been contained, the Ministry of
Health has announced. Out of 19 cases, 11 have been discharged in the
last 2 weeks. No new cases have been reported in the same period.

The ministry, however, advised the public to put up flea control
measures and kill rats to contain the outbreak. Yesterday [7 Mar
2007], the health minister, Dr. Stephen Malinga, advised residents to
ensure an environment free of rodents even though the disease had
been successfully controlled. "We cannot therefore, sit back and say
all is done. We have to get rid of rats which carry fleas."

[Byline: Fred Ouma]

--
Joseph P. Dudley, PhD
Research Associate
Institute of Arctic Biology
University of Alaska, Fairbanks
USA
<fnjpd@uaf.edu>

[Although one of the previous postings described the cases as
bubonic, it appears that the disease was pneumonic plague as
previously stated. It is important to reemphasize that bubonic plague
is spread to man from the bite of an infected (usually rodent) flea,
not from another person. Pneumonic plague can develop related to
bacteremic spread of _Yersinia pestis_ from a bubo (secondary plague
pneumonia) or, as primary plague pneumonia, aerolized directly from
another person with the respiratory form of _Y. pestis_. - Mod.LL]

RIFT VALLEY FEVER, OSTAFRIKA (22): TANZANIA (DODOMA)
************************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 14 Mar 2007
From: Joseph Dudley <fnjpd@uaf.edu>
Source: allAfrica.com, The Nation (Nairobi) [edited]
<http://allafrica.com/stories/200703141208.html>


Rift Valley fever (RVF) has struck the Dodoma region of Tanzania
killing 10 people. According to Zawadiel Mchome, the Dodoma Regional
Administrative Secretary, Tanzanian authorities had already put the
Bahi and Chamwino districts under livestock quarantine. The 10
[deaths occurred] in the past month, he said [as he opened] a 2-day
workshop for stakeholders in the war against HIV/Aids in the Dodoma
region.

Mr Mchome has been the 1st regional official to confirm the existence
of the fatal disease (RVF) after efforts by journalists to [obtain
information about it] from other regional authorities failed. "We
have lost a number of people without knowing exactly what was behind
their deaths, until recently when we [established that] it was the
deadly RVF," he said. However, he could not reveal the names of the
deceased or their places of origin.

On the other hand, the Dodoma regional veterinary officer, Dr Samson
Mwanuko, said Bahi and Chamwino have been confirmed to have the
disease. Without releasing statistics, Dr Mwanuko said the 2
districts have been under quarantine since last Monday [12 Mar 2007].

[Byline: Lucas Lukumbo]

--
Joseph P. Dudley, Ph.D
Chief Scientist,
EAI Corporation
&
Research Associate,
Institute of Arctic Biology - University of Alaska Fairbanks
Department of Earth Science - University of Alaska Museum
<fnjpd@uaf.edu>

[A map of Tanzania showing the location of the Dodoma region,
northeast of the centre of the country, can be accessed at
<http://www.un.org/Depts/Cartographic/ma ... nzania.pdf>.
These deaths may represent a westerly spread of the outbreak, but the
places of origin of the victims are not revealed unambiguously. -
Mod.CP]

Meningococcal disease in Sudan - update
WHO - 15.03.2007

From 1 January to 11 March 2007, the Ministry of Health of the Government of Southern Sudan (MoH) reported 6 946 suspected cases of meningococcal disease including 430 deaths (case-fatality rate, 6.19%) in 9 out of 10 states of Southern Sudan. Due to delayed and irregular reporting these, figures should be considered provisional. Currently the most affected counties are Aweil West, Juba, Mundri East, Rumbek, Tonj South, Wulu and Yirol.

In a one week period from 4 to 11 March, a total of 1 541 suspected cases including 81 deaths were reported. The Ministry of Health of the Government of Southern Sudan, WHO and its partners have carried out a mass vaccination campaign in 4 counties; Aweil town (MoH), Kajo-Keiji (Médecins sans Frontières (MSF) - Switzerland), Tonj-East (MSF- Switzerland) and Yambio (International Medical Corp) . Mass vaccination campaigns are ongoing in Aweil West (MSF-France) and scheduled to start in Bor, Juba, Nimule, and Rumbek in mid-March.

A technical team from WHO Headquarters and the Regional Office is currently in South Sudan to strengthen WHO’s technical support to the Ministry of Health of the Government of Southern Sudan including surveillance, field investigation, mass vaccination, case management, logistics and coordination.

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (12)
**********************************************
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 - Somalia (Banadir, Gedo, Lower Shabelle)
[2] Cholera - Angola (Benguela)

******
[1] Cholera - Somalia (Banadir, Gedo, Lower Shabelle)
Date: Tue 13 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: GaroweOnline, Associated Press report [edited]
<http://www.garoweonline.com/artman2/pub ... ours.shtml>


At least 42 people, mainly children, have died in the last 24 hours
from a suspected cholera outbreak in southern Somalia, doctors said
on Tue 13 Mar 2007. More than 240 others have been hospitalized, and
doctors fear more deaths because of the lack of proper medical
facilities or medicines in the war-ravaged country.

"The children are dying from the disease because of a lack of access
to proper medical centers," said Dr Ahmed Nour Afey, who works at a
provincial hospital in Marka town, in the Lower Shabelle region,
about 90 km. (56 miles) south of the capital, Mogadishu. "Most of
them die on their way to hospitals at the main towns in the region."

This latest outbreak has occurred in 3 southern regions of Somalia --
Banadir, Gedo, and Lower Shabelle. According to doctors, the 1st
cases were reported in December 2006, in 4 central regions of the
country, but have now spread.

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

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

******
[2] Cholera - Angola (Benguela)
Date: Tue 13 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica, Angola Press Agency (Luanda) report [edited]
<http://allafrica.com/stories/200703130842.html>


From January to February 2007, 91 cases of cholera, from which 6
resulted in deaths, were reported by the municipal hospital of
Balombo, south Benguela province.

According to the official in charge of the local health sector,
Augusto Cacope, in spite of adequate medical treatment provided by
the hospital, local residents fail to stick to preventive measures
for the disease, prompting countless cases in the region. Cacope, who
did [not] reveal any statistical data, said that the Cavisselo suburb
in Balombo municipality registered the highest number of cholera cases.

From April to December 2006, Balombo district recorded 299 cases of
cholera, from which 15 resulted in deaths.

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

[A map of Angola showing the province of Benguela can be found at:
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

MENINGOCOCCAL DISEASE UPDATE 2007 (11)
**************************************
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] Africa (Burkina Faso, Congo DR, Sudan, Uganda)
[2] Burkina Faso

******
[1] Africa (Burkina Faso, Congo DR, Sudan, Uganda)
Date: Fri 16 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Int. Fed. of Red Cross and Red Crescent Societies (IFRC),
ReliefWeb, World Health Organization (WHO) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Two months into the dry season in the African 'Meningitis Belt', 15
595 cases including 1670 deaths have been reported to the WHO from 4
countries: Burkina Faso, the Democratic Republic of the Congo, Sudan,
& Uganda. Of these, Uganda and the Democratic Republic of the Congo
are at the extreme south of the 'Meningitis Belt', which stretches
from Senegal in the west to Ethiopia in the east, an area with an
estimated population of 300 million. The samples taken show that
these cases are caused by _Neisseria meningitidis_ serogroup A, the
most common serogroup in Africa.

In northern Uganda, 2961 cases including 105 deaths have been
reported in several areas. A vaccination campaign has been completed
in some areas and is continuing in others. WHO and Medecins sans
Frontieres (MSF) are working together to contain the outbreak.

In southern Sudan, 6946 cases including 430 deaths have been reported
from 9 out of 10 states.

In Burkina Faso 4958 cases including 432 deaths were reported.

In the Democratic Republic of the Congo, 730 cases and 84 deaths have
been reported.

The International Coordinating Group (ICG) on Vaccine Provision for
Epidemic Meningitis has so far released 1.1 million doses of vaccine
to respond to the outbreak in southern Sudan and is ready to provide
additional doses if needed. Around 1.5 million people in affected
counties have been targeted in a mass vaccination campaign organized
by the National authorities, WHO, MSF, International Medical
Services, as well as other NGOs (non-governmental organizations)
present in the area, and supported by UNICEF (United Nations
Children's Fund), OCHA (United Nations Office for the Coordination of
Humanitarian Affairs), and the European Community Humanitarian Office
(ECHO). The affected areas are known to host large numbers of
returnees, as well as displaced populations living in areas not
easily accessible and dispersed population settlements.

Vaccination campaigns are ongoing in Burkina Faso, where the ICG has
already released 530 000 doses. WHO is present in the field in all
the affected countries, assisting with the surveillance and control
measures. The WHO and partners have provided drugs for case
management as well as emergency supplies for outbreak investigation
and technical guidance for outbreak control and management.

In the African 'Meningitis Belt', enhanced epidemiological
surveillance and prompt case management with oily chloramphenicol --
the standardized antibiotic treatment -- are used to control
epidemics. At the same time, WHO and partners recommend reactive mass
vaccinations targeted at the highest risk groups, usually people
between the ages of 2-30 years. Every district that is in an epidemic
phase, as well as adjoining districts that are in the alert phase,
should be targeted for vaccination. It is estimated that a mass
immunization campaign, promptly implemented, can prevent 70 percent of cases.

This season, the ICG secured some 8 million doses as an emergency
stockpile. There are 5.5 million doses currently available. Despite
concerns about a shortage of vaccine, WHO estimates that some 15
million doses are still available on the market, which countries can
purchase. Furthermore, to rapidly address the potential shortage of
vaccine supply, WHO decided to assess the status and production
capacity of polysaccharide manufactures worldwide. One manufacturer,
Bio-Manguinhos in Brazil, was identified as the strongest and
quickest alternative for scaling-up vaccine supply in the short and
medium term. In partnership with the Finlay Institute in Cuba,
Bio-Manguinhos is working with WHO to ensure a supply of up to 10
million doses of bivalent AC meningitis vaccine by the next epidemic season.

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

[A map of Africa showing the 4 countries discussed can be found at
<http://www.un.org/Depts/Cartographic/ma ... africa.pdf>. - Mod.LL]

******
[2] Burkina Faso
Date: Fri 16 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: USA Today, Associated Press report [edited]
<http://www.usatoday.com/news/world/2007 ... itis_N.htm>


Health officials reported that 22 districts in this West African
nation have been declared epidemic zones, following the death of more
than 400 people in a meningitis outbreak. The deaths are out of
nearly 5000 meningitis cases since January 2007 in Burkina Faso, a
country inside what the WHO calls Africa's 'Meningitis Belt', the agency said.

A statement released by the country's ministry of health said that
while 22 districts have been classified as epidemic zones, another 15
are on alert, and 4 are inside the densely populated capital.

--
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[A map of Burkina Faso can be found at
<http://www.un.org/Depts/Cartographic/ma ... urkina.pdf>. - Mod.LL]

TUBERCULOSIS, XDR - SOUTH AFRICA (06)
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International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 16 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Independent Online, Cape Times report [edited]
<http://www.iol.co.za/index.php?set_id=1 ... 822C794951>


According to South African acting health minister Jeff Radebe, a
total of 314 cases of extensively drug resistant tuberculosis (XDR
TB) have been confirmed countrywide, with 214 deaths.

The majority of cases occurred in KwaZulu-Natal (228), with 201
deaths. Treatment is being given to 27 people. Radebe said 203 of the
cases were in Masinga, with most deaths occurring there.

"This is an area of concern as it is not yet clear why this area is
most affected and the reasons for such high deaths. We will be
working with the province to conduct an epidemiological assessment of
the XDR TB epidemic in the area," Radebe said.

The Eastern Cape had 33 cases, with 5 fatalities, and 27 people on
treatment. One patient was transferred. Gauteng had 13 cases, with 2
fatalities, while the North West had 10 cases with 4 deaths, Radebe
said. The Free State had 8 cases, with 2 deaths, 5 people were on
treatment and one patient had defaulted. The Northern Cape and
Western Cape also had 8 cases each, with no fatalities. Limpopo had 5
cases, with one death, 3 people on treatment and 1 defaulting.
Mpumlanga had one case of XDR TB and the person was also on treatment.

Radebe said his department had ensured that all multidrug-resistant
TB patients currently on treatment were tested for 2nd-line
susceptibility to ensure early detection of XDR TB. "Close contacts
of all confirmed XDR TB patients have been screened and tested for TB."

To cope with the demand the National Health Laboratory Services
increased staffing in the laboratories that conduct 2nd-line drug
susceptibility testing. Radebe said that the department, together
with the Medical Research Council and a Geneva-based foundation,
would embark "on a demonstration project to evaluate the feasibility,
impact, and cost effectiveness of 2 rapid methods to diagnose resistant TB".

The test would enable results within 2 days for 1st-line
susceptibility and 2nd-line drug testing would be done sooner,
reducing the turn-around time of 10 to 12 weeks for confirmation of
2nd-line drug susceptibility, he said.

[Byline: Angela Quintal]

--
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<promed@promedmail.org>

[The data below shows the different case fatality rate (CFR) in
different provinces. The number of total cases adds up but the deaths
add up to 215, one more than the total deaths reported in the posting.

Province / Total cases / Total deaths / CFR (percent)
KwaZulu-Natal / 228 / 201 / 88
Eastern Cape / 33 / 5 / 15
Gauteng / 13 / 2 / 15
North West / 10 / 4 / 40
Free State / 8 / 2 / 25
Northern Cape /8 / 0 / 0
Western Cape / 8 / 0 / 0
Limpopo / 5 / 1 / 20
Mpumlanga / 1 / 0 / 0
Total / 314 / 215 / 68

The dramatic difference in CFR in KwaZulu-Natal to some extent may
represent the natural history of XDR TB in HIV-infected individuals
without treatment, as many of the initial cases died even before the
organism grew in culture. A decreased CFR may represent more rapid
culture methods (such as liquid media), earlier empiric institution
of 2nd-line agents, or the infection occurring in
non-immunocompromised hosts. - Mod.LL

A map of South Africa showing the provinces can be found at:
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf> - Mod.LL]

Meningococcal disease in Burkina Faso - update
WHO - 19.03.2007

From 1 January to 11 March 2007, the Ministry of Health of Burkina Faso reported 7 333 suspected cases including 583 deaths (case-fatality rate, 8%). Twenty two districts are currently over the epidemic threshold including three districts in the capital, Ouagadougou. Cerebrospinal fluid specimens from all affected areas have tested positive for Neisseria meningitidis serogroup A by latex test and/or culture.

The first phase of a vaccination campaign targeting 1 million people has been completed in 6 districts and is on-going in a further 2 districts. The bivalent vaccine has been secured from The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control as well as from the security stockpiles held by the Ministry of Health of Burkina Faso.

The ICG has now also approved the release of 3 350 000 additional doses of bivalent vaccine for use in further vaccination campaigns in thirteen epidemic districts, including the entire city of Ouagadougou. A first shipment of 1 165 000 doses of this vaccine is scheduled to arrive early this week.

Undertaking large scale vaccination campaigns places heavy financial and operational burdens on countries. WHO, Médecins sans Frontières, Plan Burkina, and UNICEF are providing technical and/or financial support to the Ministry of Health of Burkina Faso in the coordination and implementation of the response to the outbreak.

Over US$ 1.2 million are still urgently needed to overcome the financial shortfall/gap that will allow all necessary vaccination campaigns in the country to be implemented in full.

MENINGOCOCCAL DISEASE UPDATE 2007 (12)
**************************************
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Uganda (West Nile)
Date: Tue 20 Mar 2007
From: ProMED-mail <promed@promedmail.org.
Source: AllAfrica.com, The Monitor (Kampala) report [edited]
<http://allafrica.com/stories/200703191883.html>


The meningitis epidemic that hit the West Nile region in [January
2007] has claimed [another] 23 lives. Health officials said despite
the ongoing vaccination in the district, there are still sporadic
cases of the disease.

District Chairman Rashid Govule Iyiga, has appealed to residents to
report any suspected cases of the disease to the nearest health
center instead of taking patients to witch doctors.

[Byline: Kefa Atibuni]

--
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[Past postings on this Ugandan outbreak have reported serogroup A as
well as the relatively unusual serogroup X.

The West Nile area of Uganda is in the northwestern part of the
country and among the districts included are Arua/Maracha-Terego,
Adjumani, Yumbe, Koboko, Nebbi, and Moyo. The districts can be seen
on a map of the country at
<http://www.un.org/Depts/Cartographic/ma ... ganda1.pdf>. - Mod.LL]

RIFT VALLEY FEVER, OSTAFRIKA (23): TANZANIA (DODOMA)
*********************************************************
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Date: Tue 20 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: All Headline News [edited]
<http://www.allheadlinenews.com/articles/7006801203>


A [Rift Valley] fever epidemic has killed 16 people and infected at
least 100 others in the central region of Tanzania, David Mwakyusa,
Minister of Health, stated on Tuesday [20 Mar 2007].

Rift Valley fever (RVF), as it is popularly known in Tanzania, is a
mosquito-borne disease spread from infected livestock to humans.
Mwakyusa said the disease also claimed about 154 lives in less than 3
months on the border region of Kenya. At least 41 people are still
receiving treatment in hospitals in Tanzania after showing symptoms of RVF.

"The disease was first reported in Arusha and has not [now?] spread
to Dodoma where we are recording many new cases," Mwakyusa said,
according to BBC News.

Veterinary officials in Kenya said the ongoing domestic animal
vaccination campaign could be the cause of the rampant spread of RVF.
The RVF virus is transferred to humans from livestock through the
_Aedes_ mosquito, a species originally found in tropical and
subtropical zones. Symptoms include liver failure and bleeding from
the nose and mouth.

[Byline: Ihuoma Ezeh]

--
ProMED-mail


[A previous report from Tanzania on 14 Mar 2007, recorded 10 deaths
from RVF in the Dodoma region, although it was unclear whether these
were local cases or whether the disease had been contracted
elsewhere. This new report recording 16 deaths and 100 cases confirms
that RVF has spread from the border region with Kenya (around Arusha)
towards the central region of Tanzania.

A map of Tanzania showing the location of the Dodoma region, in the
centre of the country, can be viewed at
<http://www.un.org/Depts/Cartographic/ma ... nzania.pdf>. - Mod.CP]

MENINGOCOCCAL DISEASE UPDATE 2007 (13)
**************************************
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ProMED-mail is a program of the
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<http://www.isid.org>

In this update:
[1] Burkina Faso
[2] Elfenbeinküste

******
[1] Burkina Faso
Date: Wed 21 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com, UN Integrated Regional Information Networks
(IRIN) report [edited]
<http://allafrica.com/stories/200703220411.html>


Health authorities in Burkina Faso have launched a mass vaccination
campaign in the capital, Ouagadougou, to combat a rapidly spreading
meningitis epidemic that has claimed more than 800 lives.
"Ouagadougou has been hit to an extent that we did not expect," said
Jean Gabriel Wango, secretary general of the country's health ministry.

Authorities are dispatching 2 health agents to each of the city's 620
vaccination sites. The vaccinations, which are free of charge, were
to begin on Mon 19 Mar 2007, but officials said a shortage of health
workers prompted a delay by a day. Authorities sought additional
health workers from the medical school in Ouagadougou.

Health Minister Alain Yoda said it was necessary to take "robust and
rapid measures" in the capital to help stem the spread of meningitis
throughout the city and the rest of the country.

Since January 2007 at least 801 people have died of meningitis in
Burkina Faso among 10 796 who have been infected, according to the
Health Ministry. Of the nation's 55 health districts, 26 are
experiencing an epidemic and 11 others are on alert.

The Burkinabe health ministry said last week it had taken measures to
prevent possible theft of the meningitis vaccines. Every dose is
tagged with a number and the ministry has asked all health districts
to return the empty tubes to track their use.

Health authorities said they are investigating why in 2006, 6
districts with epidemics that benefited from a vaccination campaign
have had a resurgence of the disease in 2007.

--
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[All confirmed cases here have been of serogroup A. From the posting
of the epidemic in Burkina Faso, dated 16 Mar 2007, there were 4958
cases and 432 deaths. The next posting, only 3 days later, reports
7333 cases and 583 deaths. Now, 2 days later, the numbers have risen
to 10 791 cases and 801 deaths.

A map of Burkina Faso and its 45 provinces showing the capital city
of Ouagadougou, in the central part of the country, can be found at
<http://www.un.org/Depts/Cartographic/ma ... urkina.pdf>. - Mod.LL]

******
[2] Elfenbeinküste
Date: Wed 21 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com, UN Integrated Regional Information Networks
(IRIN) report [edited]
<http://allafrica.com/stories/200703220411.html>


In Cote d'Ivoire health authorities began a vaccination campaign on
Tuesday [20 Mar 2007] in Boundiali, 800 km. (497 miles) north of the
main city, Abidjan. Since mid-February [2007], 36 cases have been
reported in that region including 6 deaths, according to the United Nations.

--
ProMED-mail
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[An interactive map of northern Cote d'Ivoire showing Boundiali and
its relationship to Burkina Faso can be found at:
<http://www.maplandia.com/cote-d-ivoire/boundiali/>. - Mod. LL]