Wüstenschiff

Rift Valley Fever in the United Republic of Tanzania
WHO - 23.03.2007

Reported outbreaks of Rift Valley Fever (RVF) among animals began on 18 January 2007 with the first human case reported at the beginning of February 2007 in Arusha region. A response team from the Tanzanian Ministry of Health, WHO Country Office, WHO Regional Office for Africa, Centers for Disease Control and Prevention carried out an initial investigation, including active case finding and specimen collection. Two cases from Arusha and Tanga were confirmed by the WHO-accredited Kenya Medical Research Institute (KEMRI) laboratory.

By mid-February 2007, 8 cases were reported: 4 fatal cases were confirmed by KEMRI, while the remaining 4 cases from Arusha, Mangara and Tanga were hospitalized.

The United Nations Emergency Coordination Group of WHO, FAO, UNICEF and WFP has been providing support to the Tanzanian Ministry of Health and Ministry of Livestock. In addition to continued technical and financial support, WHO has also provided training in patient care for clinical staff and in diagnostic techniques for laboratory staff. With UNICEF, WHO has also trained journalists and other media staff to increase public awareness about the disease and how to prevent it.

In mid-March, new clusters of Rift Valley Fever cases occurred. Fifty-eight suspected cases, included 14 deaths, with eight specimens confirmed positive were reported from Dodoma region. In addition, 60 new suspected cases were reported from Morogoro region.

WHO is concerned about the recent increase in human cases. It is particularly important to increase community awareness as well as to improve the coordination with veterinary services to contain the outbreak. A WHO outbreak response team from the Department of Epidemic and Pandemic Alert and Response and the Regional Office for Africa will be assisting the WHO Country Office in the assessment of the outbreak, including the cases in Dodoma and Morogoro, and refining the health component of the emergency response plan, including the early warning system, active case detection, case management and social mobilization.

RIFT VALLEY FEVER, OSTAFRIKA (24): TANZANIA (DODOMA)
*********************************************************
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Date: Thu 22 Mar 2007
From: Joseph Dudley <fnjpd@uaf.edu>
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Xinhua Agency report via COMTEX [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


As of 22 Mar 2007, the Rift Valley fever (RVF) outbreak deaths in
Tanzania have risen to 18 as 2 more people died of the disease on
Wednesday [21 Mar 2007], in Dodoma, [the country's designated capital.]

A local English newspaper, The Citizen, reported on Thursday [22 Mar
2007] that 2 more people had died of the deadly disease that already
had claimed the lives of 13 Dodoma residents up to Monday [19 Mar
2007] of this week.

Countrywide, 3 others have so far died of the disease that first
broke out in neighboring Kenya and spread into northern Tanzania
earlier this year [2007].

Early this week the Tanzanian Health Minister, David Mwakyusa,
confirmed that apart from these deaths, 79 people were suspected to
have contracted the deadly virus. These deaths and suspected cases
are scattered in the country's Arusha, Dodoma, Manyara, and Tanga
regions, 3 of them being in the north and one in the middle. The
Arusha region was the 1st in Tanzania to have reported RVF-caused
deaths in early February [2007], after 2 people were found dead on 31
Jan 2007 in the region.

In 1998, [there was an outbreak of] Rift Valley fever in Arusha
following a similar outbreak in Kenya and the disease killed at least
10 people in Tanzania between January and March that year.

Rift Valley fever, most common during years of heavy rainfalls, is a
viral disease that affects mainly animals such as cattle, buffalo,
sheep, and goats. But it can also affect humans. People contract RVF
mainly from bites of infected mosquitoes and the disease can also be
spread through direct contact with the blood or body fluids of an
infected animal. RVF can cause serious eye infection, inflammation of
the brain, severe bleeding (hemorrhage) and death.

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

[This new report adds 2 deaths to the RVF death toll in Tanzania, and
further defines the current geographical extent of the outbreak.

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]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (13)
**********************************************
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<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, diarrhea - Somalia
[2] Cholera - Somalia (Gedo, Banadir, Nugaal)
[3] Cholera - Somalia (Banadir, Gedo, Lower Shabelle)
[4] Cholera - Senegal (Dakar)
[5] Cholera - Uganda (Yumbe)
[6] Cholera - Angola (Cabinda)

******
[1] Cholera, diarrhea - Somalia
Date: Tue 20 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Reuters [edited]
<http://uk.reuters.com/article/homepageC ... 2020070320>


Acute watery diarrhea in Somalia has killed hundreds of people in
2007, the Minister of Health said on Tue 20 Mar 2007, as aid agencies
warned the nation was in the midst of a cholera outbreak.

"The death toll is in the hundreds (but) we don't believe there is
cholera in the country," Health Minister Qamar Adan Ali told Reuters
by telephone from Baidoa in southern Somalia.

The WHO (World Health Organization), however, said in a report this
week that acute watery diarrhoea has killed 251 people and infected
5602 since January 2007. Aid agencies say there is an epidemic of
cholera -- a bacterial disease spread mainly through contaminated
water -- in the Horn of Africa nation. Late in 2006, Somalia was
ravaged by the worst flooding in decades.

"There has been a continued increase in cholera cases reported in and
around Mogadishu. Over 200 cases have been reported by one hospital,"
said David Gilmour, Somalia country director for the aid agency CARE
International. "More worryingly, until there is unrestricted
humanitarian access across Somalia it is difficult to know the true
scale of this and other problems which are going unreported," he said.

Insecurity after a war between Islamists and government troops backed
by Ethiopian armour has made humanitarian missions all but impossible
-- never the easiest work in a nation in anarchy since a 1991 coup
ended central rule.

Floods, insecurity and a war-damaged infrastructure combine to raise
the risk of cholera in Africa. The disease has infected some 12 000
people already in 2007, mainly in a belt spreading from Angola to Congo.

[Additional reporting by Sahal Abdulle in Mogadishu]

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

[Cases of cholera in Somalia are often referred to as "acute watery
diarrhea". A map of the country can be found at:
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[2] Cholera - Somalia (Gedo, Banadir, Nugaal)
Date: Tue 20 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


An outbreak of acute watery diarrhea in and around the town of
Bardhere, southwestern Somalia, has killed at least 80 people in the
past 3 weeks, medical sources said on Tue 20 Mar 2007. "Fifteen
people have died in hospital and over 70 died in the town and the
villages around it," Bashir Usman, a doctor in the town, said.

The Bardhere hospital, which has not functioned properly for the past
10 years, is being used as a treatment center for Bardhere and
surrounding villages, Usman said.

A cholera task force was set up by the authorities 2 weeks ago to
deal with the outbreak, according to Abdifatah Muhammad Ali, of
Himilo Relief and Development Association, a local non-governmental
agency and part of the task force.

Usman said since the registration began 10 days ago, the hospital had
recorded 630 cases. "That, however, does not necessarily reflect the
real numbers," he said. "Our information is that many more people,
who are unable to get to the treatment center, are dying around
Bardhere and in the villages."

Usman blamed the outbreak on contaminated water drawn from wells. "We
suspect the problem is the water people are drinking," he said.

Floods, mostly in late 2006, displaced thousands of people in the
region, with large tracts of farmland and water points submerged.

Usman said they had enough oral rehydration salts, "but if the
situation does not improve soon, we will need to get more resources
to contain the outbreak". He said they had noticed a drop in the
cases coming into the hospital. "In the last 24 hours we have
recorded 17 cases, as compared to 30-40 cases in the past."

In a report last week, the UN Office for the Coordination of
Humanitarian Affairs for Somalia said: "Between 1 Jan and 10 Mar
2007, the number of acute watery diarrhea cases registered in
south/central was 5542, with 252 deaths." It said fatalities were
decreasing in most regions, but the capital, Mogadishu, "remains an
area of serious concern, due to difficulties in accessing affected
populations".

The self-declared autonomous area of Puntland, in northeastern
Somalia, is also experiencing an increase in cases of acute watery
diarrhea, "with 504 cases and 19 deaths reported between 26 Feb and
14 Mar 2007", OCHA (UN Office for the Coordination of Humanitarian
Affairs) said.

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

[The provinces of Banadir, where Mogadishu is located, and Gedo,
where Bardhere is located, are in southern Somalia and can be found
on a map of the country at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>.

The semiautonomous area of Puntland is a region in northeastern
Somalia, centered on Garowe (Nugaal region on the map listed above)
and can be found on a map of Somalia at
<http://upload.wikimedia.org/wikipedia/c ... land_2.PNG>.
- Mod.LL]

******
[3] Cholera - Somalia (Banadir, Gedo, Lower Shabelle)
Date: Tue 20 Mar 2006
ProMED-mail <promed@promedmail.org>
Source: International Herald Tribune, Associated Press report [edited]
<http://www.iht.com/articles/ap/2007/03/ ... omalia.php>


Doctors reported that as many as 22 people died in the past 24 (19-20
Mar 2007) hours in southern Somalia from a suspected cholera outbreak.

Doctors in Mogadishu and the southern Somalia towns of Afgoye and
Bardhere reported that 22 people died of cholera in their
jurisdictions or neighboring villages in the past 24 hours. A doctor,
Muse Shaikh Aden, reported that another 60 people have been admitted
to Bardhere's main hospital for treatment in the past 24 hours.

It is difficult to establish the full extent of the suspected cholera
outbreak because Somalia has not had a central medical authority for
16 years to coordinate a response to any disease outbreak or provide
details. The Horn of Africa nation has been mired in anarchy since
1991, when warlords overthrew dictator Mohamed Siad Barre and then
turned on one another.

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

[The provinces of Banadir, where Mogadishu is located, Gedo, where
Bardhere is located, and Lower Shabelle (Shabelle Hoose) where Afgoye
is located, are all in southern Somalia and can be found on a map of
the country at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[4] Cholera - Senegal (Dakar)
Date: Mon 19 Mar 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: The Point (Gambia) [edited]
<http://www.thepoint.gm/headlines1796.htm>


Senegalese authorities have recently disclosed a reoccurrence of an
outbreak of cholera, commonly known as "dirty hands disease."
Speaking on the outbreak, Professor Salif Sow, head of the Infectious
Diseases Service of the Fann Teaching Hospital in Dakar, disclosed
that 15 established cases of people affected by the cholera bacterium
have been registered in Dakar, one having since died.

Professor Sow, however, added that of the registered cases, 11 people
have already been treated and only 4 are still undergoing treatment
at the hospital. All the cases were confirmed after analysis made by
the laboratory of the bacteriology and infectious diseases clinic of
Fann Hospital in Dakar, said Professor Sow.

He pointed out that the cholera outbreak has also been noted in some
[other] areas -- Mbour, Bambey, Mbacke, and Touba, adding that all
the cases have been proved to [have originated in] Touba, where they
attended the grand Magal on 8 Mar 2007.

Health officials in the districts of Mbacke and Touba said the
outbreak of cholera is mainly caused by water consumption, which
[takes on great importance] every year as a result of the need of
millions of pilgrims who attend the grand Magal. This happens when
the water gets contaminated with germs and consumed by people. [The
officials noted] that the 1st cases of cholera in Senegal were
registered in Touba and Mbacke.

The Information and Education Health National Service has advised
people to be more cautious in matters of hygiene and to be vigilant
before the forthcoming Mauloud [when Senegalese Muslims celebrate the
birth of the prophet Mahomet. - CopyEd.MJ], scheduled for 31 Mar
2007, during which thousands of people are expected to gather to celebrate.

[Byline: Pape Noel Fall]

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

[The "grand Magal" or "great pilgrimage" in Senegal's national tongue
Wolof, is the annual festival of an indigenous Senegalese Muslim
brotherhood, the Mourides. It commemorates the exile to Gabon of
Sheikh Amadou Bamba in 1895 by French colonial authorities, and
attracts between one and two million people from all over Senegal and
beyond, from as far away as Europe and America - CopyEd.MJ]

[The Senegalese capital of Dakar is in the Dakar region in the
northwestern part of the country and can be found at
<http://www.un.org/Depts/Cartographic/ma ... enegal.pdf>.

A-Lan Banks also submitted this posting. - Mod. LL]

******
[5] Cholera - Uganda (Yumbe)
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>


Addressing district leaders last week, Alfred Yayi, in charge of
community health in the district, said 2 people have died out of 7
cases reported since 5 Mar 2007 in what appears to be a fresh wave of
the cholera epidemic in the district.

Dr Yayi said tests were being done to ascertain the disease. He said
the district task force was investigating the outbreak of the
epidemic to find ways of combating it. Dr Yayi said among the victims
was a 50-year-old woman who died in Yei Hospital in South Sudan but
the body was returned to Yumbe.

[Byline: Kefa Atibuni]

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

[The Yumbe district is in northwestern Uganda and can found at:
<http://www.un.org/Depts/Cartographic/ma ... uganda.pdf>. - Mod.LL]

******
[6] Cholera - Angola (Cabinda)
Date: Sat 17 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-f.asp?ID=517513>


Three cases of cholera have been reported in the provincial hospital
of Cabinda, in last 24 hours, informed the head of the Provincial
Department of Public Health and Control of Diseases, Razao Simao, on
Fri 17 Mar 2007.

Speaking to ANGOP, the source stated that, although the rains
continue hitting the region, the hospitalization cases tend to
[decrease], a sign that the population is using hygiene and
prevention measures.

About 1485 cholera cases, from which 19 resulted in deaths, have been
reported since January 2007 in the whole province. "4 de Fevereiro"
ward is the most affected zone with 364 cases, Simao explained.

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

[The Angolan province of Cabinda is the most northern of provinces
and is separated from the rest of Angola by Congo DR. It can be found at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

PARALYTIC SHELLFISH POISONING - SOUTH AFRICA (WESTERN CAPE): RED TIDE
*********************************************
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Date: 19 Mar 2007
From: Steve Grenard <sgrenard@si.rr.com>
Source: Hisz.rsoe.hu [edited]
<http://hisz.rsoe.hu/alertmap/woalert_re ... 9&lang=eng>


A red tide warning has been issued for the Cape West coast and False
Bay. Grant Pitcher, the marine and coastal management principal
specialist scientist, says a long stretch of the coast has been
affected. The alarm was raised following reports that at least 3
people fell ill with paralytic shellfish poisoning after eating
seafood from the coast at Lamberts Bay.

Marine and coastal management has warned the public not to eat any
shellfish collected from the coast. Marine scientists are
investigating, and samples tested have found that a toxic red tide is
widespread all along the coast to as far north as Lamberts Bay.

Pitcher says: "There is another problem that is on the West Coast, up
in the St Helena Bay region near Lamberts Bay, where there are blooms
that are visually less impressive, but they have some toxic organism
in them, and these are causing shellfish to become toxic, and now we
have some reports, 3 separate incidences, of people becoming ill
having consumed shellfish in that area."

Meanwhile, non-toxic red tide blooms persist along the False Bay
Coast. Scientists have warned that if the blooms start to decay, it
could cause a rapid decline in oxygen in the water. And that could
lead to high scale mortalities of flora and fauna.

The Department of Environmental Affairs and Tourism has warned the
public not to eat any shellfish or lobster liver found on the West
Coast, following reports of 3 people becoming ill after eating
shellfish collected in Western Cape. The problem may be a result of a
toxic red tide, said the department in a statement on Friday [16 Mar
2007]. It is investigating, and samples are being tested, it said.
"Animals, such as lobsters, that feed on toxic shellfish can
accumulate the toxins in their digestive gland with no apparent
effect, but will accumulate toxins in their liver. Members of the
public are therefore advised not to eat lobster liver too."

The reported incidents appeared to display symptoms of paralytic
shellfish poisoning. Typical symptoms include tingling and numbness
of the mouth, lips and fingers, which usually occur within the 1st 30
minutes after the ingestion of toxic shellfish. Advanced symptoms
include dizziness, incoherent speech, uncoordinated limbs with slight
difficulty in breathing, and a rapid pulse. In severe cases it may
cause paralysis. Meanwhile, a non-toxic red tide persisted along
False Bay, the department said.

--
Steve Grenard
<sgrenard@si.rr.com>

[Red tide is caused by several toxic algae. Depending upon the effect
the toxin has, it is also known as paralytic shellfish poisoning
(PSP), because it causes shellfish to be toxic for consumption.

PSP is a significant problem in several geographic areas, especially
on both the east and west coasts of the U.S. Produced by several
closely related species in the genus _Alexandrium_, PSP toxins are
responsible for persistent problems due to their accumulation in
filter-feeding shellfish, but they also move through the food chain,
affecting zooplankton, fish larvae, adult fish, and even birds and
marine mammals.

_Alexandrium_ blooms generally do not involve large-cell
accumulations that discolor the water and may instead be below the
water surface, where they are not visible. Low-density populations
can cause severe problems due to the high potency of the toxins
produced. Furthermore, _Alexandrium_ spp. can grow in relatively
pristine waters, and it is difficult to argue that anthropogenic
nutrient inputs are stimulating the blooms. These characteristics are
important when considering mitigation and control strategies.

Often PSP is associated with red tides or algal blooms. Red tide is
caused by an organism called _Karenia brevis_, which in high
concentration can make the water look red. The organism releases a
toxin that paralyzes the respiratory system of fish and other marine life.

Airborne toxins, water spray, and splashes in an outbreak have kept
people from beaches while leaving others with irritated eyes and
throats. Red tide irritates the skin of people exposed to it and can
cause itchy eyes, scratchy throats, and coughs.

Harvesting from affected areas for personal consumption is
discouraged. Red tide poisoning symptoms include nausea and dizziness
and may last for several days.

Previously, the organism causing red tide was known as _Gymnodinium
breve_, but it has been reclassified in the taxonomy of
dinoflagellates. Its new name is _Karenia brevis_, or _K. brevis_.
Karenia was chosen in honor of Dr. Karen Steidinger, a prominent red
tide scientist from the Florida Marine Research Institute in St.
Petersburg, Florida
<http://www.marinelab.sarasota.fl.us/~mh ... date.phtml>. - Mod.TG]

[For a map of the affected area, see
<http://www.capewestcoast.org/RegionalIn ... oIndex.htm>. - Mod.MPP]

PLAGUE, BUBONIC (Beulenpest), FATAL - TANZANIA (MANYARA)
*******************************************
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 28 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: IPP Media, Guardian report [edited]
<http://www.ippmedia.com/ipp/guardian/20 ... 87237.html>


At least 8 people have died of plague in Endoji Village, Mbulu
District, in Manyara Region. The deadly disease is spread by rodents,
which have multiplied in large numbers in the area. The Mbulu
District Medical Officer, Dr John Gulisha, confirmed that 8 people
had died of the disease since 28 Feb 2007, when the 1st case was reported.

Despite the fact that medical reports indicate that only 8 people,
mainly children, had died of the disease, impeccable sources in the
village maintained that the death toll stood at 15 people.

Dr. Gulisha said symptoms of the ailment include swellings under the
armpits, high fever, and body fatigue.

Since the beginning of January 2007, rodents have invaded some
villages in Mbulu District. The situation deteriorated when villagers
started killing the rats. As more rats got killed and were discarded
at random, the bacterium [_Yersinia pestis_] that causes the disease
spread out quickly [through its flea vector - Mod.LL], causing more
infection to people, especially among children.

Dr. Gulisha said efforts had been made to control the spread of the
disease, including communicating with the Sokoine University of
Agriculture in Morogoro and the Ministry of Health and Social
Welfare. He called on villagers to cooperate with medical experts by
keeping their surroundings clean and avoiding arbitrary killing of
rats, because the practice [produced] a breeding ground of the epidemic.

[Byline: Charles Masayanyika]

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

[The description of symptoms suggests that the illness is bubonic
plague spread from rodent fleas. It may appear paradoxical that
killing of the rodents would cause more human cases, but the death of
rodents (either an epizooic or man-related extermination) will
produce infected and hungry fleas looking for a blood meal. If no
rodents are available, humans will do. The number of deaths is
reported (either 8 or 15) but no denominator of the total number of
cases of plague is given. Untreated bubonic plague has a case
fatality rate of 50-60 percent.

Most of the _Yersinia pestis_ reports that ProMED-mail has posted
from Africa have been from Congo DR and Uganda, although Tanzania
had one of the world's highest incidence rates in the 1980s. The
Manyara region of northeastern Tanzania can be found on a map at:
<http://en.wikipedia.org/wiki/Manyara_Region>. It is bordered on the
east by Tanga region, which includes Lushoto district where 64
suspected cases were reported in 1999 up to 22 Sep, with 2 deaths --
see 1999 ProMED archive below - Mod.LL/JW]

RIFT VALLEY FEVER, OSTAFRIKA (26): KENYA
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
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<http://www.isid.org>

Date: 27 Mar 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: AllAfrica.com, The Nation [edited]
<http://allafrica.com/stories/200703271150.html>


Kenya: 5 More Die of Rift Valley Fever
-----------------------------------------
5 people have died of complications associated with Rift Valley fever
(RVF) in North Eastern Province, a doctor said yesterday [27 Mar
2007]. Provincial medical officer of health Ahmed Omar told
journalists in his office that the 5 contracted the highly contagious
viral disease last December [2006]. They were treated and discharged
but died of post-recovery and treatment complications in Garissa and
Ijara districts.

He also warned that the fever could reemerge in the region with the
onset of long rains, which have pounded parts of Ijara in the last 2
weeks. According to Dr. Omar, the 5 died after developing
meningo-encephalitis, a condition linked to post-recovery, a nervous
system and brain disorder that attacks those who had contracted RVF
but were discharged after recovery.

A surveillance medical team that visited parts of Garissa and Ijara
districts last week found 3 of the victims had died in the Liboi and
Fafi areas of Garissa. They had, in December [2006], been admitted to
the isolation unit of Garissa Hospital after testing positive for
RVF; 2 of the victims were women, while the 3rd was an 18-year-old
herdsman. The other 2 who died in Ijara had previously been admitted
to Masalani health centre in January 2007. The 2 herdsmen are said to
have died on their way to seek medical attention at Masalani district hospital.

Dr. Omar also said the medical team had further found several cases
of blindness among patients who were discharged from hospital between
December 2006 and January 2007. He asked those who had been
discharged from various health centers to report back to hospital
should they show post-recovery complications. According to the
doctor, 354 people infected at the height of the fever outbreak
recovered, while 106 died in Garissa, Ijara and Wajir, which had been
the epicenter of the disease before it spread to other parts of the country.

Most of those affected by the fever, which mainly affects livestock
but spreads to humans through mosquito bites, were herdsmen. Their
infections were attributed to their close contact with infected animals.

According to Dr. Omar, flooding could fuel a resurgence of the fever
because the _Aedes_ mosquitoes -- which transmit the fever -- get the
virus after feeding on infected animals. They then transmit the virus
to their eggs, and new generations of infected mosquitoes may hatch
from such eggs. The eggs hatch during heavy rains, leading to an
increase in the number of mosquitoes.

[Byline: Hussein Abdullahi]

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

[A map of Kenya showing some of the locations mentioned above is accessible at
<http://www.masai-mara.com/mmvmk.htm>.
- Mod.CP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (14)
**********************************************
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 - Liberia (Grand Cape Mount)
[2] Cholera - Angola (Luanda)
[3] Cholera - Rwanda (Western Province)


******
[1] Cholera - Liberia (Grand Cape Mount)
Date: Mon 26 Mar 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: Liberian Observer (abstract) [edited]
<http://www.liberianobserver.com/news/fu ... Mount.html>


Residents disclosed a major outbreak of cholera that has killed 2
children and left several other people diagnosed with the disease in
the diamond- and gold-rich district of Kporkpa, Grand Cape Mount County.

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

[Grand Cape Mount County is the westernmost county in Liberia. It
borders in the north with Sierra Leone and can be located on a map of
Liberia at
<http://www.un.org/Depts/Cartographic/ma ... iberia.pdf>. - Mod.LL]

******
[2] Cholera - Angola (Luanda)
Date: Thu 29 Mar 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=520575>


In the past 72 hours, Luanda's health authorities have detected 90
cases of cholera, without deaths. [The cases have occurred] in 3 of
the 9 districts, mainly affecting women and children.

The physician of the Provincial Public Health Department, Isabel
Massacolo, told ANGOP this Thu 29 Mar 2007, that the cases, at an
average of 45 per day, were reported in the districts of Sambizanga,
Cacuaco, and Cazenga. The source added that compared to the previous
period, there was a reduction of 32 cases.

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

[Luanda, the capital, is where this prolonged outbreak of cholera
began. It can be found in northwest Angola at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

******
[3] Cholera - Rwanda (Western Province)
Date: Tue 27 Mar 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: AllAfrica.com, The New Times (Kigali) report [edited]
<http://allafrica.com/stories/200703270444.html>


Barely a month after a cholera outbreak in areas of Nyagatare
District, Eastern [or East] Province, the deadly contagious disease
is now being reported in Rubavu District [Western Province].

The outbreak of the disease, according to some health officials in
the district, has caused panic among many residents who have called
for urgent government intervention.

On 22 Mar 2007, the Ministry of Health issued a press statement
confirming the outbreak of cholera in the area. The ministry also
indicated that at least 55 cholera cases have so far been reported.
No deaths have occurred yet.

Ministry officials attributed the main cause for the outbreak of the
disease in the district to poor hygiene, contaminated water, and
uncontrolled movements of people from affected areas.

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

[A map of Rwanda's administrative divisions can be found at
<http://en.wikipedia.org/wiki/Rwanda#Adm ... _divisions>. - CopyEd.MJ]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (15)
**********************************************
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 - Kenya (Rift Valley)
[2] Cholera - Angola (Huambo)
[3] Cholera - Angola (Benguela)
[4] Cholera - Angola (Cunene)
[5] Cholera, river water - South Africa (Northern Cape)

******
[1] Cholera - Kenya (Rift Valley)
Date: Thu 5 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Kenya Broadcasting Corporation [edited]
<http://www.kbc.co.ke/story.asp?ID=41922>


Following an outbreak of cholera, 5 people have died and others have
been admitted in health centres at Merich in West Pokot district.
Kapenguria medical officer of health, Dr Evans Kiprotich, said 3 of
the 5 died while undergoing treatment at Ortum mission hospital.

Speaking to Kenya News Agency in Kapenguria, Kiprotioh said the
victims were dying from a painless diarrhea. He said the victims were
said to have taken contaminated water, leading to the diarrhea.

[Byline: Jane Nyambune]

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

[The West Pokot district is in the Rift Valley province of Kenya, in
the west part of the country bordering Uganda. A map of Kenya can be
found at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

******
[2] Cholera - Angola (Huambo)
Date: Mon 2 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com, Angola Press Agency (ANGOP) (Luanda) report [edited]
<http://allafrica.com/stories/200704021181.html>


During the last 72 hours, 8 cases of cholera were detected in 6
localities of the outskirts of Huambo city, increasing the number of
people affected by the outbreak in the region to 882, ANGOP learned
on 2 Apr 2007.

The 8 cases, so far nonfatal, were registered in the wards of
Kambinga (2), Kalomanda (1), Sao Luis (1), Kapango Sub-Urban (2),
Kalombringo (1), and Benfica Sul (1). Of these patients, 6 have been
hospitalized in the Cholera Treatment Centre of Huambo's Regional
Hospital.

The cholera outbreak was officially declared on 24 Nov 2006, in
Huambo city, and already has claimed 43 lives.

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

[A map of Angola showing the provinces of Huambo and Benguela (see
[3] below) -- adjacent to each other -- in southwestern Angola can be
found at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. Cunene
(see [4] below) is more to the south separated from Huambo and
Benguela by Huila province. - Mod.LL]

******
[3] Cholera - Angola (Benguela)
Date: Sun 1 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Government of Angola report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


[The provincial health department of south Benguela province reported
2605 cases of cholera in the 1st half of 2007.]

Information still shows that, since the beginning of the cholera
outbreak in the province, on 11 Mar 2006, until 31 Dec 2006, the
provincial health department detected 9785 cases with 562
[fatalities].

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

******
[4] Cholera - Angola (Cunene)
Date: Tue 3 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com, Angola Press Agency (ANGOP) (Luanda) report [edited]
<http://allafrica.com/stories/200704030859.html>


Some 193 new cases of cholera were notified, without any fatalities,
from Jan to Mar 2007, in the districts of Ombandja and Kwanhama, in
Angola's southern province of Cunene.

Speaking to ANGOP on Tuesday [3 Apr 2007], Cunene's health director,
Eduardo Haiumba, noted that the new reported cases were blamed on the
failure of citizens, living on Ondjiva city's outskirts, to use clean
drinking water.

Since the disease outbreak, in September 2006, health officials have
notified 1915 cases of cholera, with 72 deaths in the districts of
Kahama, Cuvelai, Curoca, Ombandja, Kwanhama, and Namacunde.

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

******
[5] Cholera, river water - South Africa (Northern Cape)
Date: Wed 4 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Pretoria News [edited]
<http://www.pretorianews.co.za/index.php ... Id=3766138>


Laboratory tests on water samples in various sections of the Vaal
River revealed traces of cholera, the Northern Cape health department
said yesterday, 3 Apr 2007.

The department said the traces were found "specifically at Barkly
West, Spitskop, Schmidtsdrift, the Vaalharts weir in Warrenton and
the Vaalharts canal system". Treated water was safe for all purposes
as tests on samples were negative for cholera, it was revealed.

"Environmental conditions are favorable for cholera and other
waterborne diseases and the public is alerted not to drink any
untreated or raw surface water from any source."

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

[A map showing the Northern Cape and Vaal River can be found at:
<http://encarta.msn.com/map_701517322/Vaal.html>. - Mod.LL]

LASSA FEVER - LIBERIA: REQUEST FOR INFORMATION
**************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue Apr 2007
From: A-Lan Banks <A-Lan.Banks@thomson.com>
Source: Liberian Daily Observer
<http://www.liberianobserver.com/news/fu ... Fever_Hits_
Rural_Liberia.html>


Lassa Fever Hits Rural Liberia
--------------------------
Liberia's Chief Medical Officer Dr. Bernice Dahn has disclosed the
emergence of Lassa fever in Nimba county, in rural Liberia. She said
in Monrovia that from investigations conducted in Bong and Nimba
counties, the disease has resurfaced in rural Liberia.

[Byline Edwin M. Fayia, III]

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

[As the full article was not available to us without a paid
subscription, more information on this outbreak from knowledgeable
sources would be greatly appreciated.

A map of Liberia showing Nimba and Bong counties can be found at:
<http://www.lib.utexas.edu/maps/africa/l ... l_2004.pdf>. - Mod. TY]

ANTHRAX, HUMAN, BOVINE - GUINEA-BISSAU (OIO)
*************************************************
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 9 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Yahoo News, AFP report [edited]
<http://news.yahoo.com/s/afp/20070409/hl ... 0409170726>


One person died and a further 7 were infected in a recent anthrax
outbreak in Guinea-Bissau that was apparently caused by eating bad
meat, the health ministry said on Monday [9 Apr 2007].

Between 24 Mar and 6 Apr 2007, 8 cases of the disease were recorded
in Bissaora, a town [70 km. (44 miles)] north of the capital Bissau,
said the ministry's director general, Placido Cardoso.

"The people affected by the disease had eaten contaminated meat
during a traditional mass circumcision ceremony," he said.

Cardoso did not say where the bad meat had come from but said a
veterinary team had been sent to the region.

He added that 5 [cases of anthrax infection in cows] had been
recorded in Quinhacam village, in the same area, and the local
population had been warned against eating meat of uncertain origin.

In 2005, 5 people died during an anthrax epidemic in several villages
in the Mansoa region, east of Bissau.

Anthrax is an infectious disease caused by the _Bacillus anthracis_
bacteria, found in wild cattle and domestic livestock. It can be
caught by humans through exposure to infected animals or their
undercooked meat.

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

[A review of the ProMED-mail reports of outbreaks involving both
humans and cattle indicates the wide geographic distribution. We know
that anthrax is a worldwide problem but it useful to remember that
zoonotic transmission occurs fairly frequently. The method of
transmission between cattle and humans may result in gastrointestinal
or cutaneous anthrax depending on the circumstances of the outbreak
and its location. In fact, this outbreak serves to remind us of the
potential of human gastrointestinal anthrax when cattle die suddenly
while appearing to be relatively healthy and therefore are regarded
as viable meat. - Mod.PC

A map of Guinea-Bissau is available at
<http://www.un.org/Depts/Cartographic/ma ... ineabi.pdf>. - CopyEd.MJ]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (16)
**********************************************
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 - Comoros
[2] Cholera - Somalia (Middle Juba, Hiran)
[3] Cholera - Somalia (Mogadishu)
[4] Cholera - Somalia (Middle Juba)
[5] Cholera - Kenya (Rift Valley)
[6] Cholera - Angola (Luanda)
[7] Cholera - Angola (Bie)

*****
[1] Cholera - Comoros
Date: Fri 13 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: United Nations Children's Fund (UNICEF) / Relief Web [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


On 26 Feb 2007 the vice-president in charge of
the Ministry of Health and Social Affairs of
Comoros, the National Emergency Unit and the
World Health Organization (WHO) officially
declared a cholera outbreak after confirmation of
several cases by the laboratory of the city
hospital El Maarouf. A total of 39 cases has been
confirmed, a significantly smaller number than
during earlier outbreaks. Approximately 50
percent of the cases that have been reported are
children below the age of 15, and 47 percent are women.

The epidemic broke out in a very densely
populated and vulnerable area of the capital of
Moroni where people live in decayed and
overcrowded houses. Household rubbish is piled up
around the houses, due to the country's poor
waste management system. Distribution of water
also has become more and more problematic, and
the capital's inhabitants do not succeed in
getting their daily ration of drinking water. The
water canal system is broken down and more than
40 percent of the water is lost along the way.
Often the only option left for the population is
to use rainwater collected in unprotected
cisterns, which contributes to the risk of
contamination and spread of the disease.

Cyclone Gamede also contributed to the
overcrowding in houses. People have been
sheltered by neighbors and friends, and the
overcrowding contributes to the risk of diseases outbreaks including cholera.

Past experience in the country concerning the
management of cholera epidemics has shown that
controlling the spread of the disease is
particularly difficult in coastal villages.
People there often do their laundry near the sea,
in pools that are created during high tide. These
tide pools are also sometimes use as toilets. The
poor hygiene practices hinder efforts towards
disease control, and contribute to a rapid spread
of cholera and other infectious diseases.

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

[As can be seen on this map
<http://www.lib.utexas.edu/maps/africa/comoros.gif>
the nation of Comoros is a group of islands
located between the continent of Africa and Madagascar. - Mod.LL]

*****
[2] Cholera - Somalia (Middle Juba, Hiran)
Date: Mon 9 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Shabelle Media Network [edited]
<http://www.shabelle.net/news/ne2710.htm>


More than 19 people, mostly children, have died
of diarrhea in settlements situated in provinces
of Middle Juba and Hiran in central and southern
Somalia, government officials said on Mon 9 Apr 2007.

The disease killed 16 people including children
and adults in Anole, Bur-Fulle, Rahole and Barta
villages of Middle Juba (Juba Dhexe) in one day
[9 Apr 2007]. The governor of the Middle Juba
region Hajir Bile Sugal with officials of the
World Vision relief organization made survey on
the health condition in these villages. There is
no medical service in the settlements of central
Somalia at this time of acute diarrhea.

Meanwhile, 3 children among the displaced people
from Mogadishu, the Somalia capital, have been
killed by the cholera-like diarrhea in Beledwein
town, provincial capital of Hiran, according to
Shabelle correspondent Omar Kiyow.

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

[Cases of cholera in Somalia are often referred
to as "acute watery diarrhea". A map of the
country showing the provinces as well as
Mogadishsu can be found at:
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

*****
[3] Cholera - Somalia (Mogadishu)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Medecins Sans Frontieres (MSF) / Relief Web [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Since cholera was confirmed in Mogadishu on 19
Mar 2007, MSF has treated more than 800 patients.
However, the worsening violence is making it
increasingly difficult for patients to access
MSF's cholera treatment center (CTC), which
opened 2 weeks ago. The violence is also
preventing MSF from reaching other areas of the city.

"So far we have received more than 800 patients,
40 percent are children," says Henry Rodr�ez,
medical coordinator from MSF Spain in Somalia.
"This is more than the total number of cholera
patients MSF has treated in the last years in
Mogadishu, where MSF has worked for 15 years and
responded to 12 different cholera epidemics.

"The cause of this growth is mostly because other
health structures which normally work in other
areas of Mogadishu are not able to do so due to
the violence. It's also impossible to do the
things necessary to try and control the outbreak,
like supply clean water or establish points for oral rehydratation."

The MSF clinic in Mogadishu, which provides care
for more than 100 000 people each year, has
verified that because of the fighting the
population cannot access the scarce health
services (hospitals, health centers) that
continue to function in the Somali capital.

The fighting has caused massive displacement as
people flee towards the outskirts of the capital
and other cities, like Jowhar. There are reports
of tens of thousands of displaced people, who are
being received by extended family or friends.
Many who do are living under trees without
shelter, food or water. The security conditions
impede the operative capacity of MSF and the
result is that these people do not have access to the necessary assistance.

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

*****
[4] Cholera - Somalia (Middle Juba)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Shabelle Media Network [edited]
<http://www.shabelle.net/news/ne2723.htm>


A total of 4 children in a single family has died
of a cholera-like diarrhea in Bu'ale town, the
provincial capital of Middle Juba region in the
south of Somalia, a local official said on Wed 11 Apr 2007.

Local medical sources confirmed to Shabelle Radio
that the 4 children killed by the diarrhea were 2
twin brothers and 2 sisters while their mother was sick of the disease.

There is medical service in Bu'ale as the cases
of diarrhea are increasing. The governor of
Middle Juba region, Hajir Bile Sugaal, told
Shabelle Radio by the phone that he was very
worried about the worsening condition in the region.

"There is shortage of medicine, there are no
relief organizations operating here and the
number of people with the disease is increasing" said Bile.

He urged to the international relief agencies'
health organizations to provide medical supplies
to diarrhea-affected areas to save the victims.

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

*****
[5] Cholera - Kenya (Rift Valley)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Nation (Nairobi) [edited]
<http://allafrica.com/stories/200704110162.html>


A nationwide alert has been sounded following the
death of 10 people from cholera in the expansive
West Pokot district. Local health facilities are
grappling with a high number of patients,
following revelations that 76 people have been
infected with the killer disease in Sigor division.

A total of 10 people is already in Ortum Mission
Hospital, Sigor and Marich Health Centers -
straining medical facilities. There are 4 others
are Ortum, one in Sigor and 4 in Marich. Shocked
by the quick spread of the disease, health
authorities have ordered the closure of all
eating establishments in the area and asked
residents to be very careful about the foods and
drinks they consume. The Health ministry has also
announced plans to conduct an aggressive campaign
to educate people on ways of preventing cholera.

However, acting Rift Valley provincial medical
officer Simon Kibias said cholera had been
confirmed in only one of the admitted patients.
He said specimens had been sent to the ministry
of Health's central laboratory and the Kenya
Medical Research Institute, Nairobi, for further analysis.

Dr. Kibias, who was accompanied by the province's
public health officer, Isaac Ruto, and the West
Pokot district medical health officer, Dr. Evans
Kiprotich, said diarrhea had been detected in
most of the 76 cases. Residents fear that the
deaths will increase since health facilities are
scarce. People travel for more than 100
kilometers (about 60 miles) to get treatment.

The 1st case of the disease was reported on 26
Mar 2007 in the semi-arid area. Getting clean
water in the district is very difficult. Many
villagers depend on the perennial Muruny River.
The area is dry and hot. The residents are mainly
pastoralists. They water their livestock in
Muruny River, besides using it for their own sustenance.

Frequently, people swim and bathe in the river.
Although there are 3 boreholes, 2 of them have
broken down. The one which is functioning is in
Masol village, about 17 kilometers from Marich
where the first case of the disease was reported.
Many residents do not draw water from the
borehole, saying it is located far away. They
entirely depend on the river. The other
non-functional boreholes are in Sigor and Marich trading centers.

[Byline: Peter Ng'etich and Edward Koech]

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

[The West Pokot district is in the Rift Valley
province of Kenya, in the west part of the
country bordering Uganda. A map of Kenya can be found at:
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

*****
[6] Cholera - Angola (Luanda)
Date: Thu 12 Apr 2007
From: ProMED-mail <promed@p[romedmail.org>
Source: AllAfrica.com and Angola Press Agency (Luanda) [edited]
<http://allafrica.com/stories/200704120147.html>


A total of 12 new cases of cholera was reported
from 9-10 Apr 2007, in Luanda's high density
district of Sambizanga, the local Health
delegate, Monteiro Ant�, told Angola Press
Agency. According to the official, the new cases
followed the heavy rains that hit the capital recently.

The rains and poor sanitation in the area are
factors that affect the health authorities'
effort to control the disease, the source also
stated. A total of 686 cases of cholera has been
recorded in Sambizanga since Jan 2007, killing 17 people.

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

[A map of Angola showing the provinces of Luanda
in the northwest part of the country and Bie (see
below) in Angola's central part can be seen at:
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

*****
[7] Cholera - Angola (Bie)
Date: Thu 12 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=523938>


Of the 224 people who have been diagnosed with
cholera, 10 died of this disease from Jan 2007 to
today [12 Apr 2007] in the south Bie province.
The director of the Cholera Treatment Center,
Andre Tomas Cassinda, reported this information
to the Angola Press in Kuito city today.

According to the source, most patients affected
by the cholera bacterium reside in the wards of
Cambulucuto, Cantinflas, Catemo, C�ra and
Cangoty, on the outskirts of Kuito city. Some
isolated cases have also been registered in the
districts of Katabola, Kamacupa and Chitembo.

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

LASSAFIEBER - LIBERIA (02): CONFIRMED
*************************************************
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 12 Apr 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: Reuters AlertNet [edited]
<http://www.alertnet.org/thenews/newsdes ... f047a1bd3a
2b920e.htm>


Liberia: Lassa fever returns as health sector crumbles
-------------------------------------------------------------
Liberia's almost non-existent health and sanitation infrastructure
was again brought into sharp focus this week as officials confirmed
that Lassa fever, [caused by] a virus transmitted by rats usually
found in areas with poor sanitation, is endemic for the 2nd time in 6
months in 3 Liberian counties [Lassa fever virus is endemic
continuously in _Mastomys_ rodents. Cases in humans occur
sporadically, as in this situation. - Mod.TY]

Liberia, which experienced a devastating 14-year civil war that ended
in 2003, last registered Lassa fever outbreaks in September [2006],
mostly in Nimba County. Health officials said at the time they did
not have the capacity to diagnose or treat the deadly disease but the
outbreak ended after the Chinese Embassy stepped in with funds for
medicines and testing kits.

Mildred Wesseh, a Ministry of Health spokesperson, told the
Integrated Regional Information Networks (IRIN) on Wednesday [11 Apr
2007] that the ministry has now confirmed a further 13 cases in Nimba
County, close to the border with Guinea and Cote d'Ivoire. Cases have
also been reported in Bong County (central Liberia) and Lofa (north),
according to the Health Ministry.

"We are very concerned about the active circulation of Lassa fever
[virus] and are now putting in place mechanisms to deal with the
disease, especially in the affected areas," Wesseh said.

She said 5 people suspected of having the disease died, but health
authorities had not confirmed whether the cause of death was Lassa.
Some 21 suspected cases have been reported but only 13 were
confirmed, and those who were currently infected with Lassa [virus]
were being given medication, she said.

Lassa is a viral haemorrhagic fever known to be endemic in Liberia,
Guinea, Sierra Leone and parts of Nigeria. It probably exists in
other West African countries as well, according to the World Health
Organisation (WHO).

Humans become infected with Lassa from contact with infected rodents.
The virus can also be transmitted from one human to another through
direct contact with body fluids. Rural dwellers, especially those
living in areas of poor sanitation or crowded living conditions, are
at greatest risk of contracting the illness, WHO says.

According to Liberia's Human Development Report (2006), by the end of
the country's civil war 95 percent of health facilities had been
destroyed and just 20 trained Liberian doctors were left in the
country, while the United Nations children's agency (UNICEF)
estimated in September 2006 that just 7 percent of people in rural
areas have access to clean drinking water.

The UN this week appealed for an additional USD 117 million in donor
assistance for Liberia to help rebuild basic social services. It
estimated that 70 percent of health facilities in the country were
still being run by international nongovernmental organisations.

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

[The tragic effects that civil war can have on health services, with
the resulting difficulty that public health officials in controlling
outbreaks and treating infected patients, is vividly illustrated in
this situation. Reducing rodent-human contact through improved
hygiene will be a goal difficult to achieve given the difficult
situation that Liberia faces in the aftermath of the war. ProMED
thanks A-Lan Banks for providing this same news release.

A map of Liberia showing Lofa, Nimba and Bong counties can be found
at: <http://www.lib.utexas.edu/maps/africa/l ... l_2004.pdf>. - Mod.TY]

RIFT VALLEY FEVER, OSTAFRIKA (27): TANZANIA (DODOMA)
*********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Sat 14 Apr 2007
From: "Joseph Dudley" <fnjpd@uaf.edu>
Source: ippmedia.com, Sat 14 Apr 2007 [edited]
<http://www.ippmedia.com/ipp/guardian/20 ... 88338.html>


Tanzania: State of Rift Valley fever spread bad
-----------------------------------------------
Many of the Rift Valley fever (RVF) patients admitted to hospitals
and health centres here are in critical condition, Dodoma Regional
Commissioner (RC) William Lukuvi has revealed. He made the revelation
in remarks on his recent tour of health facilities across the region
to assess the magnitude of the epidemic, which has claimed a national
total of 33 lives. The RC was addressing a meeting of guest house and
hotel owners here on Tuesday [10 Apr 2007], amid reports that the
deadly viral disease was digging in.

Dodoma is the region worst hit by the RVF outbreak, and Lukuvi
appealed to government officials, business people, owners of guest
houses and members of the public to step up measures to help prevent
the spread of the disease. "We cannot enjoy ourselves while our
voters are suffering. We have to relieve them of the problem,"
observed the RC, his appeal coming at a time when the National
Assembly is ending the 1st half of its ordinary 2-week meeting here.

Giving what he said were the latest figures, Lukuvi said the region
has 56 RVF patients admitted to health facilities, adding: "The
situation is critical. Some patients have been confined to hospital
beds for months but still show few signs of getting better." The RC
explained that most patients are unconscious, some having been in bed
for over 2 months, noting, "Medical officers and other staff are
doing what best they can do to arrest the situation but things remain
bad indeed. Those religious leaders endowed with God's healing powers
should pray for those (RVF) patients who have lost the ability to
pray for themselves."

Meanwhile, Lukuvi used the occasion to order authorities in the
region to arrest anyone found eating meat that veterinary experts
have not screened and passed as fit for human consumption. There have
been reports of some bars and restaurants here selling roast meat
despite a government ban and countrywide public education campaign
meant to alert wananchi ["citizen" in Swahili] against such behavior.

RVF is an acute, fever-causing viral disease that affects both
livestock and humans. It hit parts of northern Tanzania in February
[2007] after filtering in from Kenya, leading to human and animal
deaths and threatening the livelihood of pastoralist communities in
both countries. The Nairobi (Kenya)-based Centre for Disease Control
confirmed the presence of RVF in Tanzania on 1 Feb 2007after testing
samples collected by the Livestock Development Ministry in Arusha.
Abortions feared to be RVF-induced have been reported among livestock
herds in Kilosa, Tarime, Monduli and Simanjiro districts.

Joint response and control measures are overseen and coordinated by
the Livestock Development and Health and Social Welfare ministries,
local governments and nongovernmental organizations (NGOs). However,
quarantines and livestock deaths threaten to prevent pastoralists
from benefiting from the ongoing rains and the resultant good pasture
conditions.

The government is planning to spend an estimated 15bn/- [USD 11 888
250] fighting RVF and 1.7bn/- [USD 1 347 335] has already been spent
on ordering vaccines from abroad, Prime Minister Edward Lowassa and
Livestock Development minister Anthony Diallo said recently. As of 31
Mar this year [2007], 200 441 head of cattle, 81 945 goats and 37 773
sheep had showed RVF symptoms around the country. Reports released a
few weeks after the outbreak said 568 head of cattle, 1063 goats and
434 sheep had died after developing symptoms similar to those of RVF.

(Byline: Privatus Lipili)

******
[2]
Date: Sat 14 Apr 2007
From: "Joseph Dudley" <fnjpd@uaf.edu>
Source: Daily News, Dodoma, Sat 14 Apr 2007 [edited]
<http://www.dailynews-tsn.com/page.php?id=6385>


Tanzania: Vice-president commends Rift Valley fever efforts
-----------------------------------------------------------
Vice-president Dr. Ali Mohammed Shein has commended efforts to
contain Rift Valley fever (RVF) in the Dodoma region. Dr. Shein made
the remarks yesterday [Fri 13 Apr 2007] when he visited Dodoma
Regional Hospital where he had gone to see RVF patients who are being
treated there.

The Dodoma Regional Commissioner, Mr. William Lukuvi, said here
yesterday that among the measures being taken include sensitising the
public about the disease and possible ways of fighting it. Briefing
the vice-president, Mr. Lukuvi further said that they have already
supplied [livestock] vaccination doses to districts; they are
supervising bathing of livestock, destroying mosquito breeding
grounds and enhancing efforts to keep the city clean.

The measures, he said, have proved successful as the number of
patients has been declining and until yesterday [13 Apr 2007]only one
person is reported to have been taken to the regional hospital. "The
number of patients that are continuing with treatment in several
health centres stands at 53 out now," he said. Since the outbreak of
the disease in the region, there have been 115 patients out of whom
37 died and 25 were treated and discharged, he said.

He thanked the prime minister's office for extending 300m/- [USD 237
765] to the region which will assist in the fight against the disease
and accelerate the implementation of strategies of containing the disease.

He also thanked the Tanzania Red Cross Society for sponsoring the
training of 56 villagers who will sensitise their communities and for
also handing out 200 mosquito nets and blankets.

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

[Dr. Dudley has pointed out significant discrepancies between these
press reports. The 1st report gives the mortality as 33, whereas the
Daily News report gives the mortality as 37. Furthermore the accounts
of the nature of the human patients illness are discordant. In the
1st report it is claimed that some patients have been confined to
hospital beds for months and are still showing few signs of
improvement Most patients are unconscious, some having been in bed
for more than 2 months. By contrast the 2nd report states that of 115
patients treated, 37 had died, 25 had been discharged and 53 remained
under treatment, making the case fatality rate (CFR) 32 percent on
the basis of these figures.

Mod.JW has commented that an earlier ProMED-mail post (see: Rift
Valley fever, Eastern Africa (26): Kenya 20070329.1083) on the
current RVF outbreak in East Africa stated that 5 patients died after
developing meningo-encephalitis, a condition linked to post-recovery,
a nervous system and brain disorder that attacks those who had
contracted RVF but were discharged after recovery. Of 354 people
infected at the height of the fever outbreak 106 died, again giving a
high CFR. These very late complications and high CFR deserve further
investigation since meningo-encephalitis is supposed to follow the
febrile phase in 5-10 days.

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

[Subscribers are referred to Dr Glyn Davies's comprehensive
explanatory commentary on the Tanzanian RVF situation in animals,
included in an archived ProMED-mail post 20070324.1024. One of his
main remarks addressed the vaccination of exposed livestock during
the peak of an outbreak, a procedure regarded by him to be highly
contraindicated.

The proper time for vaccination was immediately following the
publication of FAO's warning on the possible RVF activity in the Horn
of Africa, distributed in November 2006, prior to the onset of the
epizootic (see at
<http://alive.dcwebdesigners.com/data/fi ... _nov06.pdf>.
- Mod. AS].

Meningococcal disease in Burkina Faso - update 2
WHO - 17.04.2007

From 1 January to 8 April 2007, the Ministry of Health of Burkina Faso reported 22 255 suspected cases including 1490 deaths (case-fatality rate, 7%). Thirty-four districts are currently over the epidemic threshold. Cerebrospinal fluid specimens from all affected areas have tested positive for Neisseria meningitidis serogroup A by latex test and/or culture.

To date, vaccination campaigns have been completed in 15 districts in which 100% of the targeted population of 2.7 million people have been reached. This includes one million people in the capital, Ouagadougou. Vaccination campaigns are still on-going in a further 6 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 recent appeal for financial support for the vaccination campaigns has been positively received by the international community. Contributions have been forthcoming from European Commission Humanitarian Aid Department (ECHO), Medicos del Mundo, Médecins sans Frontières (MSF), Plan Burkina, the Swedish International Development Cooperation Agency (SIDA), UNICEF, the UN Central Emergency Response Fund , and the United States Agency for International Development (USAID), which will enable Burkina Faso to finance all necessary vaccination campaigns.

MENINGOCOCCAL DISEASE UPDATE 2007 (14)
**************************************
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] Sudan (Southern)
[2] Cameroon (Extreme North)

*****
[1] Sudan (Southern)
Date: Tue 17 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Reuters [edited]
http://www.alertnet.org/thenews/newsdesk/L17607900.htm


A meningitis outbreak that has swept across south Sudan since the
start of 2007 has killed 661 people, a report said on Tue 11 Apr
2007. The joint report by the semi-autonomous south Sudan government
and the World Health Organization said more than 11 000 people had
contracted meningitis since the start of 2007.

Meningitis outbreaks affect Sudan during the dry season, and the
disease has spread more rapidly since a 2005 north-south peace deal
ended 2 decades of civil war, easing movement as the region's health
infrastructure remained in tatters. Hundreds of thousands of south
Sudanese returning home after the peace deal are especially at risk
because they often live in crowded camps where infectious diseases can thrive.

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

[A map of Sudan showing the affected areas in the south (Central,
Western and Eastern Equatoria, Lakes, Western, and Northern Bahr
el-Ghazal, Jonglei, and Warrap states) can be found at:
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf> - Mod.LL]

*****
[2] Cameroon (Extreme North)
Date: Tue 17 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: XinHuaNet [edited]
<http://english.people.com.cn/200704/17/ ... 67194.html>


More than 10 people have died of meningitis epidemic in northern
Cameroon, the Ministry of Public Health said Mon 16 Apr 2007.

Nearly 100 meningitis cases were reported in the past 2 weeks in
Extreme North (Nord) province, said a delegate from the ministry,
adding that most of the cases were found in the regions of Mayo-Sava
and Mayo-Tsanaga.

Cameroonian authorities have sent health workers to the
disease-affected regions and transferred 200 000 doses of meningitis
vaccine to the province.

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

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