Wüstenschiff

TOLLWUT - GERMANY (HAMBURG) EX MOROCCO
*******************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 19 Apr 2007
From: Christian Drosten <drosten@bni-hamburg.de>


Rabies, Human, Germany (Hamburg) ex Morocco
-----------------------------------------------
A 55-year-old man was referred to the University Medical Centre of
Hamburg, Germany, on Wednesday, 18 Apr 2007. He presented with fever,
nausea, paresthesias of the left hand, headache and difficulty
swallowing. His pet dog had been involved in a fight with a stray dog
in Moroccos 6 weeks previously, and he had been bitten in his left
hand when separating the fighting dogs.

Medical consultation was sought right after the injury, but no
vaccination was initiated. His 15-year-old dog was euthanized by a
veterinarian 4 weeks later, due to inability to stand up.

Rabies was 1st suspected in the beginning of the week by a local
hospital, which the patient consulted for fever and paresthesia. On
admission in Hamburg, RT-PCR for rabies virus nucleocapsid RNA in 2
different saliva samples and one corneal swab was positive. The
amplicon sequence showed 99 percent nucleic acid identity with a
genotype 1 rabies virus from Morocco. All other phylogenetic
neighbors stemmed from Morocco or Algeria.

The patient had received active and passive post exposure vaccination
in the local hospital on Tuesday [17 Apr 2007]. Deep sedation with
ketamine and midazolam was initiated on Thursday [19 Apr 2007].
Amantadine but no other antiviral drugs have been given.

Decision-making on further treatment is ongoing.

--
Christian Drosten & Stephan Schmiedel, Marcus Panning, Gerd Burchard,
Christian Gerloff, Ansgar Lohse
University of Hamburg Medical Centre & Bernhard Nocht Institute for
Tropical Medicine
Hamburg, Germany
<drosten@bni-hamburg.de>

[ProMED-mail thanks Dr Drosten for providing this report prior to its
general release. We hope that the patient will to respond to the
delayed post-exposure treatment. Visitors to Morocco should be made
aware of the continuing risk of exposure to canine rabies in that
country. - Mod.CP]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (17)
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Cholera - Namibia (Ohangwena) ex Angola (Cunene)
[2] Cholera - Angola (Benguela)
[3] Cholera - Angola (Cabinda)
[4] Cholera - Sudan (Southern)

******
[1] Cholera - Namibia (Ohangwena) ex Angola (Cunene)
Date: Wed 18 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com, New Era (Windhoek) report [edited]
<http://allafrica.com/stories/200704180599.html>


There is a diarrhea outbreak in the Ohangwena Region, which has
claimed 4 lives. Health authorities have detected 33 diarrhea cases
and 2 cholera cases have also been reported. The disease outbreaks
are suspected to have been spread through handwashing rites at
funerals where all mourners are required to wash their hands in a
single dish containing herbs after the burial.

According to the Permanent Secretary in the Ministry of Health and
Social Services, Dr Kalumbi Shangula, on 3 Apr 2007, a villager of
Onaame near Okatope Clinic in the Engela District died of a chronic
illness. Two days later, the widower of the deceased and 14 other
mourners contracted diarrhea. It is suspected that mourners who came
from Xangongo and Ondjiva in [Cunene (Kunene) Province] of Angola
could have spread the disease.

The 14 people have recovered after receiving treatment in Okatope
clinic. [An additional 19] mourners received treatment at Engela
Hospital; 8 of them were discharged while 11 were admitted. Of those
admitted, 4 have died and the others are reported to be in
satisfactory condition.

Shangula stressed, "Special attention is given to the practice where
all mourners have to wash their hands in one bowl after burial. This
can facilitate transmission. The community is urged to use
alternative ways of cleansing."

He appealed to the public especially those in areas where the disease
has been reported to ensure that people do not wash their hands in
the same water.

Regarding cholera cases, the Permanent Secretary reported that,
"_Vibrio cholera_, the causative agent was isolated in 2 patients. In
some specimens, salmonella was isolated."

Since February 2007, there had been no new cases reported, until now.
During the period November 2006 to early March 2007, 6 instances were
confirmed as cholera cases but in all the cases, the victims were
discharged after receiving treatment.

[Byline: Petronella Sibeene]

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

[The Ohangwena region of Namibia, which borders the Cunene Province
of Angola, can be found on a map at
<http://en.wikipedia.org/wiki/Ohangwena_Region>. - Mod.LL]

******
[2] Cholera - Angola (Benguela)
Date: Sat 14 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>


Over the course of the week [of 8 Apr 2007], health authorities at
the localities of Samande and Cambondongolo, southern Benguela
province, recorded 22 cases of cholera that claimed 9 lives.

In Samande 9 cases and 3 deaths were recorded. On the other hand, in
Cambondongolo, 45 km. (28 miles) from Cubal district, 13 cases and 6
deaths were notified in the same period, and 5 patients continue
receiving medical treatment at the local health center.

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

[Benguela is in west-central Angola and can be found on a map at
<http://www.un.org/Depts/Cartographic/ma ... angola.pdf>. - Mod.LL]

******
[3] Cholera - Angola (Cabinda)
Date: Wed 18 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press (ANGOP) [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=525396>


The municipal director of public health, Fernando Puna reported to
ANGOP (Angola Press) that 58 cases of cholera were registered in Buco
Zau district, northern Cabinda province, since early April 2007.
According to a source, 12 of these patients are still under medical
care in the municipal hospital, 2 of whom are in [serious condition].

In Puna's opinion, the poor quality of water and the deficient basic
drainage associated to the rains that have been falling in the past
days, are some of the main causes of the reappearance of cholera in
that northern part of Cabinda.

--
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]

******
[4] Cholera - Sudan (Southern)
Date: Wed 18 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Reuters [edited]
<http://africa.reuters.com/top/news/usnBAN823982.html>


The joint report by the semi-autonomous south Sudan government and
the World Health Organization (WHO) said 5218 people had exhibited
cholera-like symptoms of acute watery diarrhea, and of those 140 died.

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 South can be found at
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf> - Mod.LL]

RIFT VALLEY FEVER, OSTAFRIKA ( 28 ): TANZANIA
***********************************************
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: Sat 21 Apr 2007
From: Joseph Dudley <fnjpd@uaf.edu>
Source: IPP Media Ltd [edited]
<http://www.ippmedia.com/ipp/guardian/20 ... 88881.html>


Tanzania: Rift Valley fever death toll now 89
-----------------------------------------------
A total of 89 people have so far died of Rift Valley fever (RVF),
Prime Minister (PM) Edward Lowassa said yesterday [20 Apr 2007].
Adjourning the 7th Bunge [parliament] session here yesterday, Lowassa
said out of that number, 56 were from the Dodoma Region. The PM said
some 249 people had contracted the disease since it was 1st reported
in the country in January this year [2007]. He said 73 patients had
been treated and discharged, while 87 remain in hospital. The PM said
Dodoma was the most affected region, with 55 people still being
admitted to hospital.

He said 46 600 cows, 56 900 goats and 32 800 sheep had been affected
by the disease. He said 5580 cows, 6866 goats and 3898 sheep had died
of the disease.

The PM said 1 620 000 doses of vaccine had been received so far and
distributed to 37 districts. A total of TZS 1.7 billion [USD 1.3
million] has been spent for the purpose. He said the government had
suspended cattle auctions and made dipping services compulsory in a
bid to control the disease.

The government will continue with a public education campaign to
educate people on how to avoid the disease.

[Byline: Juma Thomas]

--
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>

[Since previous government statements, the human death toll from Rift
Valley fever has increased to 89 from a figure variously given as
31-37 in early April 2007. It is clear that the outbreak has not yet
been contained and that the Dodoma remains the most severely affected
region of Tanzania.

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

TUBERCULOSIS, XDR - SÜDAFRIKA ( 08 ): WESTERN CAPE
***************************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 24 Apr 2007
Source: Independent Online [edited]
<http://www.int.iol.co.za/index.php?set_ ... 854C804288>


The number of patients needing treatment for extreme drug resistant
tuberculosis (XDR TB) in the Western Cape has risen from 21 to 22 as
of Mon 23 Apr 2007, on top of 3 deaths in the past month.

An 18th patient was admitted to the XDR TB isolation unit at Brooklyn
Chest TB Hospital in Milnerton on Mon 23 Apr 2007, the only unit of
its kind in the Western Cape, provincial health department
spokesperson Miranda Anthony said. Six men and 12 women are being
treated at the hospital. The youngest patient is an 11-month-old
girl, while the rest are between the ages of 18 and 58. The latest
patient is an adult female.

Four other patients are being treated for XDR TB in special isolation
hospital wards at 3 prisons in the province, Anthony said. Two are
being treated at Brandvlei prison in Worcester, one at Voorberg
prison in Porterville, and a 4th at Pollsmoor prison in Tokai.

Three women, aged 23, 26 and 43, have died in the past month at
Brooklyn Chest TB Hospital after brief illnesses.

Anthony declined to say where the patients came from, explaining that
the health department did not want people to get the impression that
XDR TB was more prevalent in one community than another. "We want to
emphasize that it can happen to anyone, anywhere. It doesn't matter
where you live," she said.

Anthony said all cases of XDR TB in the province were referred to
Brooklyn Chest, which has 24 beds in a unit designed for the
exclusive treatment of drug-resistant TB.

By the end of February 2007, the health department announced that it
was aware of only 2 cases of XDR TB, including the 11-month-old baby,
who is responding to treatment. In February 2007, the department of
health also said that 269 cases were reported in South Africa since
2005. The 1st 60 cases were reported in KwaZulu-Natal. In total, 184
people died. The latest statistics are not yet available.

[Byline: Karen Breytenbach]

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

[The number of cases of XDR TB continues to grow, especially in South
Africa. It is not stated in the posting how many of the total and of
those who died were infected with HIV as well.

The Western Cape Province of South Africa can be found on a map of
the country at:
<http://www.un.org/Depts/Cartographic/ma ... uthafr.pdf>.
Most of the country's provinces have had cases of XDR TB. - Mod.LL]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 ( 18 )
**********************************************
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 (Northeastern Province)
[2] Cholera - Kenya (Rift Valley Province)

******
[1] Cholera - Kenya (Northeastern Province)
Date: Wed 25 Apr 2007
Source: Kenya Broadcasting Corporation [edited]
<http://www.kbc.co.ke/story.asp?ID=42260>


[Following a cholera outbreak in the town of Mandera,] at least 3
people have died, among them a 4-year-old girl. Six others are
admitted at Mandera district hospital.

Area medical officer, Dr. Hassan Adan, says a team of medical
personnel has been dispatched to the affected areas in a bid to bring
the situation under control. Hassan said samples were sent to the
National public health laboratory where the results [were] positive
for cholera.

He said the 3 people died before samples had tested positive for the
highly contagious disease. The officer said the ministry will
intensify a public awareness campaign and appealed to members of the
public to cooperate in order to bring the disease under control.

[Byline: Clare Wanja/Kna]

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

[A map of Kenya can be found at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. Mandera
is in extreme northeastern Kenya close to the borders with Somalia
and Ethiopia. The next post relates to disease in the northwestern
part of the country. - Mod.LL]

******
[2] Cholera - Kenya (Rift Valley Province)
Date: Tue 24 Apr 2007
Source: The Standard [edited]
<http://www.eastandard.net/hm_news/news. ... 1143967742>


Health workers have been dispatched to a village in Turkana South
following a cholera outbreak that the International Committee of the
Red Cross (ICRC) says has killed 10 people. But speaking in Nakuru,
the Rift Valley provincial medical chief, Dr Simon Kibias, said only
3 deaths had been confirmed.

An ICRC official based in Turkwel, who preferred to remain anonymous,
said the outbreak had claimed 10 lives in the past week. "The victims
succumbed after severe bouts of diarrhea and vomiting. Villagers have
told us that they have buried 10 bodies and taken dozens others
infected to hospital," said the official.

Health workers at Nakwamoru Catholic Mission Hospital said they were
treating 20 cholera patients.

The village is 70 km. (43.5 miles) from Marich, in West Pokot
District, where the disease recently killed 11 people. Villagers in
West Pokot and Turkana districts share the Muruny River, whose water
was suspected to be the cause of the outbreak.

Large populations from the 2 districts have no access to clean water.
Following the West Pokot outbreak, health authorities ordered the
closure of eating-places and warned residents to stop using the
river. But residents have to walk [a long distance] to the few
boreholes available.

[Byline: Osinde Obare]

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

MENINGOCOCCAL DISEASE UPDATE 2007 (15)
**************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

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

******
[1] Burkina Faso
Date: Fri 27 Apr 2007
Source: News24 [edited]
<http://www.news24.com/News24/Africa/New ... 41,00.html>


A meningitis epidemic that has claimed 1625 lives in the impoverished
west African nation of Burkina Faso since January 2007 has slowed,
the health ministry said on Thu 26 Apr 2007.

"The situation as of 18 Apr 2007 is the following: there have been a
total of 24 633 cases recorded and the number of deaths is 1625,"
said a report from the national committee managing the fight against
the disease. It also said that the epidemic was active in 6 districts
as opposed to 30 a month earlier [March 2007], and the death rate had
dropped from 8 percent in March 2007 to 6.6 percent so far in April
2007.

Meningitis is still plaguing the northern regions of Dori and
Gorom-Gorom, central Yako, and Sapouy in the south, and Kongoussi in
the east but the capital Ouagadougou has been taken off the list of
epidemic-hit zones, the report said.

Although Burkina Faso has by far the largest number of cases, Benin,
Chad, Ghana, Ivory Coast, Mali, Niger, Nigeria, and Togo have also
been affected to differing degrees.

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

[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] Sudan
Date: Fri 27 Apr 2007
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, International Federation of Red Cross and Red
Crescent Societies (IFRC) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


From 1 Jan to 8 Apr 2007, a total of 11 786 meningitis cases and 704
deaths have been reported in southern Sudan. In northern Sudan 775
cases and 43 deaths had been reported as of 17 Apr 2007. In total, 46
counties in 16 states of Sudan have so far been affected.

In response to the high rate of mortality as a result of the
epidemic, the Sudanese Red Crescent (SRC) and the International
Federation of Red Cross and Red Crescent Societies (IFRC) has
combined forces with Partner National Societies (PNSs), national
authorities, and United Nations (UN) agencies to promote a 3-month
intervention program focusing on vaccinations, assistance for
treatment in hospitals and health centres, a community education and
awareness campaign, as well as health education for SRC volunteers.

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

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

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

Date: 19 Apr 2007
Source: Panapress [trans. Mod.TY, edited]
<http://www.panapress.com/freenewspor.as ... 19/04/2007>


Lassa fever, recently declared to be occurring in northern and
central Liberia, has caused 5 deaths, announced a spokesman of the
Ministry of Health, Karson Kollie, on Wednesday [18 Apr 2007]. Kollie
stated that at least 13 people have been infected by this disease,
which is transmitted by the saliva of rodents, including rats [by the
excrement and urine of the multimammate mouse, _Mastomys natalensis_
- Mod.TY]. Kollie indicated that the registered cases of Lassa fever
have been concentrated in the localities of Bong, Lofa and Nimba.

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

[It appears that sporadic cases of Lassa fever continue in these
areas, although the numbers of cases in the earlier reports this year
[2007] are not available, and it is unclear whether there has been an increase.

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 (30): KENYA & TANZANIA
***********************************************
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ProMED-mail is a program of the
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[1]
Date: Tue 1 May 2007
Source: International Federation of Red Cross And Red Crescent
Societies (IFRC), Reliefweb [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db9 ... enDocument>


Rift Valley fever (RVF), a rare zoonotic viral disease, has claimed
155 lives in Kenya and caused huge losses of income in Kenya's
pastoralist communities. The outbreak of the disease has exacerbated
an already precarious food insecurity and livelihoods situation,
following the massive floods in Kenya and neighboring countries at
the end of 2006. A large number of animals were lost to the disease.

While Rift Valley fever is unfortunately familiar to farmers in
Kenya, Tanzania and other countries in the region, not much is known
about the virus causing the disease. It is transmitted primarily to
humans through contact with infected animal matter such as blood or
other fluids, as well as animal organs. Consumption of raw milk from
an infected animal, an important element in the diet of many nomadic
pastoralists in Kenya, is also thought to lead to infection. RVF is
also spread by livestock through mosquito bites. The infected
mosquito eggs are often laid around river banks and can stay dormant
for years until they get submerged. The eggs then hatch to mosquitoes
that spread the virus.

In Kenya, RVF has been well known for over 60 years. As early as
1913, a disease fitting the description of RVF was blamed for the
loss of sheep in the Rift Valley in Kenya. So far, there is no cure,
and doctors are only able to treat the symptoms. About one per cent
of people contracting RVF develop the disease in a severe form;
approximately half of those die. The last large outbreak was in 1997,
following heavy rains blamed on El Nino, when some 27 500 people were
infected, and 170 died in Garissa District.

This time around, the 1st case of RVF was reported in Gurufa, Garissa
on 7 Dec 2006. Almost simultaneously, outbreaks were reported in a
number of other districts, including Ijara, Wajir, Tana River and
Isiolo, all of which had suffered from the extensive flooding in
Kenya's North Eastern Province.

Nearly 700 suspected cases of RVF were recorded in Kenya, according
to the Ministry of Health, with 155 deaths. The worst affected
districts were Garissa, Ijara and Wajir districts in North Eastern
Province, Tana River and Kilifi districts in Coast Province, and
Kirinyaga and Maragwa districts in Central Province.

The outbreak lead to a government-imposed ban on the slaughter of
livestock in the affected areas, which led to the closure of key
livestock markets, as well as a ban on movement and slaughter of
animals. This accentuated the precarious situation of pastoralists'
welfare, particularly in North Eastern Province. The ban on the
slaughter of animals has now been lifted in Garissa, Ijara, Mandera
and Wajir districts in North Eastern Province. However, the animal
quarantine is in force awaiting review through a veterinary
department investigation.

At the peak of the RVF outbreak, the Kenya Red Cross Society was
engaged in social mobilization activities targeting health workers
and the affected communities. Access to affected areas in Garissa
posed the greatest challenge due to flooding in the area. With the
assistance of Emergency Response Units (ERUs) from sister societies
around the world and other partners, the Kenya Red Cross assisted in
the establishment of Special Wards in Garissa Provincial Hospital and
Ngao Sub-District Hospital in Garsen.

The ward in Ngao Sub-District Hospital was established with support
from the Japanese and Australian Red Cross and MSF-Spain. The Kenya
Red Cross also worked with the MoH to institute timely and effective
care to suspected and/or confirmed RVF cases. The Medical ERUs helped
to train medical personnel working in local health facilities on
universal precautions, early case detection and referral.

Significant government vaccination campaigns targeting 1.5 million
livestock (cattle, sheep and goats), as well as other preventive
activity is ongoing in 33 districts where RVF cases have been
reported. Other interventions include supportive case management;
enhanced surveillance; community mobilization/public health education
and veterinary intervention, like the ban on slaughtering of animals
currently in force in the Marigat and Makutano parts of Baringo.
Vector control is also ongoing through the spraying of high risk
animals with synthetic pyrethroid.

According to the World Health Organization, RVF can be prevented by a
sustained program of animal vaccination. Live, attenuated and killed
vaccines have been developed for veterinary use. The live vaccine
requires only one dose and produces long-lived immunity, but the
presently-available vaccine may cause abortion if given to pregnant
animals. The killed vaccines do not cause these unwanted effects, but
multiple doses must be given to produce protective immunity. This may
prove problematic in endemic areas.

The available vaccine is only for use with livestock. In humans, an
inactivated vaccine has been developed. This vaccine is not licensed
and is not commercially available, but has been used experimentally
to protect veterinary and laboratory personnel at high risk of
exposure to RVF. Other candidate vaccines are under investigation.

In neighboring Tanzania, the National Society has organized a one-day
seminar on RVF in the capital city of Dodoma with participation of
local authorities, Tanzanian Red Cross volunteers and representatives
of local townships and villages. Following the seminar, the
volunteers went back into villages to educate local communities on
this epidemic.

A total of 90 people in Dodoma were infected, and 19 of those lost
their lives. The total number of RVF deaths in Tanzania now stands at
33. The majority of Dodoma residents are livestock keepers, and the
deaths of large numbers of livestock simply mean a dwindling of
people's economic resources, Mr. Yunus Rugaiyamu, the Regional
Administrative Secretary, lamented and added that "we must cooperate
and work together in order to get rid of this killer disease in our region."

The number of Tanzanian regions with suspected cases of RVF has
continued to rise, now standing at 8: Arusha, Manyara, Tanga,
Kilimanjaro, Dodoma, Morogoro, Singida and Iringa. In Dar es Salaam,
Regional Commissioner Mr. A Kandoro has announced a tentative ban on
the sale of meat grilled at roadside stalls (kebabs) and urged the
community to watch their eating manners as a precautionary measure,
while leading authorities asked everyone to raise their level of
alertness against the disease's entry into the city.

Responding to the outbreaks, the Tanzanian Red Cross has distributed
100 mosquito nets, 200 blankets and 2 tents through the Regional
Medical Officer in Dodoma to be used at established treatment camps,
while another 100 mosquito nets will be distributed by Dodoma Red
Cross to RVF-affected families. The Society also provided 4000
leaflets to give health education to the local communities.

[Byline: Everlyn Kemunto & Anthony Mwangi, Kenya Red Cross, and
Stella Marealle, Tanzania Red Cross]

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

*****
[2]
Date: Wed 2 May 2007
Source: Daily News, Dar es Salaam [edited]
<http://www.dailynews-tsn.com/page.php?id=6601>


Rift Valley Fever (RVF) patients admitted to health facilities in
Dodoma region have dropped to 35 from 137 last month [April 2007],
indicating significant gains in controlling the killer disease, which
has wreaked havoc on the meat industry here, the Regional
Commissioner (RC), Mr William Lukuvi, has said.

Addressing a May Day rally at the Jamhuri Stadium here yesterday [1
May 2007], Mr Lukuvi said by yesterday morning the Dodoma Regional
Hospital had 20 RVF patients, Mirembe Hospital 11, Mvumi Mission
Hospital had 2 and Kongwa and Mpwapwa district hospitals had one
each. The disease has killed more than 50 people in the region.

However, the RC cautioned against eating meat from sick or dead cows,
warning traders to sell only meat certified by health and veterinary
officers. Some patients have been in coma since last February [2007],
he warned.

The RC also said that business at the Dodoma abattoir was picking up
"slowly." He said the abattoir, with capacity to slaughter 200 cows a
day, handled only 6 yesterday [1 May 2007]. Business at the facility
had virtually stopped.

[Byline: Sosthenes Mwita]

--
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley, Ph.D

[According to these reports, the number of recorded human cases of
RVF in Kenya now totals 700, including 155 fatalities, and 90,
including 19 fatalities, in the Dodoma region of Tanzania. Overall,
there have been 33 RVF deaths in Tanzania. The most recent data from
the Dodoma region of Tanzania suggests that the outbreak is abating.

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

[Dr Glyn Davies wrote in ProMED, Rift Valley fever, Eastern Africa
(25): Tanzania (Dodoma), WHO 20070324.1024: "There may have been
alterations to the [epizootic] curve, which have followed the
effective transmission of virulent RVF virus caused by the widespread
vaccination programs. These may have involved hundreds of thousands
of animals, which would not have been otherwise affected...
Vaccination with the Smithburn MLVV (modified live virus vaccine)
strain or any other vaccine is totally contraindicated at any time
when active virus transmission is taking place... Vaccination of
animal populations during periods when RVF virus is actively being
transmitted by vectors will serve to propagate the virus very
effectively by needle passage. The virus is readily transmitted by
infected needles from animal to animal."

And the more animals that are infected, the greater the chances of
mosquito-borne transmission to humans. - Mod.JW]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (19)
**********************************************
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
[2] Cholera - Namibia

******
[1] Cholera - Somalia
Date: Mon 30 Apr 2007
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN) [edited]
<http://allafrica.com/stories/200705010257.html>


An outbreak of cholera and acute watery diarrhea is adding to the
dire humanitarian conditions endured by the homeless in camps around
the Somali capital, Mogadishu, medical sources said on Mon 30 Apr
2007. Hundreds of thousands of civilians have been displaced by 3
months of heavy fighting in the city.

"We have had 1111 cases of cholera in our camp alone," said Hawa
Abdi, a doctor, whose 26-hectare (64-acre) compound, 20 km. (12.5
miles) south of Mogadishu, has been turned into a camp for displaced
people. She said most of the patients were being cared for under
trees. The mortality rate was still low, with only 15 deaths since
the outbreak began in March 2007, she said.

However, the displaced were getting weaker, she added, and diseases
were likely to spread due to overcrowding and lack of proper
sanitation facilities, and claim more lives. "If conditions do not
improve soon, it [the mortality rate] will most certainly go much
higher," said Abdi.

She said she was receiving reports on deteriorating health conditions
from other camps where the displaced from Mogadishu have assembled.
"I suspect the problem is related to the water people are drinking
and the total lack of sanitation in the camps," she added.

In a report last week [27 Apr 2007, see
<http://ochaonline2.un.org/Default.aspx? ... rg/somalia>
- CopyEd.MJ], the United Nations Office for the Coordination of
Humanitarian Affairs (OCHA) said the number of cholera/acute watery
diarrhea cases in southern and central Somalia since 1 Jan 2007 was
estimated at more than 17 000, with 600 deaths. The report said the
cases were primarily concentrated in Mogadishu and the Lower Shabelle
region, where most of the displaced went. "With continuing
displacement and the onset of the Gu [long] rains, the number of
cases is expected to continue to rise," OCHA warned.

Abdi said her facility, which was receiving about 30 patients per
day, was running out of such basic supplies as oral rehydration
salts. "We are getting more and more people by the day and the
supplies we have are not going to last very long."

--
Communicated by:
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
Mogadishu can be found at
<http://www.un.org/Depts/Cartographic/ma ... omalia.pdf>. - Mod.LL]

******
[2] Cholera - Namibia
Date: Wed 2 May 2007
Source: AllAfrica, New Era (Windhoek) report [edited]
<http://allafrica.com/stories/200705020227.html>


There has been an increase in the number of people dying from cholera
and diarrhea in Ohangwena Region over the past 2 weeks.

The Deputy Permanent Secretary in the Ministry of Health and Social
Services, Simwanza Simenda, confirmed to New Era [that as of 1 May
2007, 9 people had] died from cholera with another 26 cases under treatment.

Since February 2007 when the disease was detected in Namibia, there
were no new cases reported until last month [April 2007,] when 33
diarrhea cases and 2 cholera cases were noted. Health authorities
suspect that the disease spread through hand-washing rites at
funerals where all mourners are required to wash their hands after
the burial in a single dish containing herbs. In one incidence, 23
mourners contracted diarrhea and were admitted to Engela hospital.

[Byline: Petronella Sibeene]

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

[The Ohangwena region of Namibia, which borders the Cunene Province
of Angola, can be found on a map at
<http://en.wikipedia.org/wiki/Ohangwena_Region>. - Mod.LL]

Rift Valley Fever in Kenia, Somalia und Tanzania
WHO - 09.05.2007

Tanzania

From 13 January to 3rd May 2007, a total of 264 cases including 109 deaths (case-fatality ratio, 41%) of Rift Valley Fever (RVF) was reported in Tanzania. Rift Valley Fever (RVF) was reported in 10 out of the 21 regions of Tanzania: 12 cases were reported in Arusha region, 1 in Dar es Salaam, 156 in Dodoma, 4 in Iringa, 6 in Manyara, 50 in Morogoro, 5 in Mwanza, 5 in the Pwani, 24 in Singida, and 1 in Tanga regions. Only severe cases of RVF were detected through surveillance and of the 264 cases, 154 (60%) were laboratory confirmed.

The surveillance of RVF organized through the Integrated Disease Surveillance and Response (IDSR) program has been in place in Tanzania for several years. To investigate this outbreak a WHO team from the Department of Epidemic and Pandemic Alert and Response and the Regional Office for Africa has been assisting the WHO Country Office in the assessment of the outbreak and in refining the health component of the Tanzania Ministry of Health and Social Welfare (TMOHSW) and the Tanzania Ministry of Livestock Development (TMOLD) emergency response plan, including the early warning system, active case detection, case management and social mobilization.

A national investigation team conducted several field visits in the affected region to help with enhancement of surveillance, in-depth case investigations and active surveillance activities. The team also provided training in patient care for clinical staff and in safe sample collection and shipment for laboratory staff. The response to the outbreak was jointly organized by the Tanzania Ministry of Health and Social Welfare (TMOHSW) and the Tanzania Ministry of Livestock Development (TMOLD) in collaboration with the Kenya Medical Research Institute (KEMRI), the Centers for Disease Control and Prevention, WHO and FAO. The United Nations Emergency Coordination Group of UNDP, WHO, FAO, UNICEF and WFP have also outlined response plans in support of the Government strategy. These programmes include animal and human health interventions as well as sensitization and awareness campaigns at community level and among health care professions.

Kenia

From 30 November 2006 to 12 March 2007, a total of 684 cases including 155 deaths (case-fatality ratio, 23%) of RVF was reported in Kenya. Where all 333 cases were reported in North Eastern Province, 183 in Rift Valley Province, 141 in the Coast Province, 14 in Central Province, and 13 in the Eastern Province. Of the 684 reported cases, 234 (34%) were laboratory confirmed.

Somalia

From 19 December 2006 to 20 February 2007, a total of 114 cases including 51 deaths (case-fatality ratio, 45%) of Rift Valley Fever were reported in Somalia. Seventy-three cases were reported in Lower Juba region, 26 in Gedo region, 7 cases in Hiran region, 2 cases in Middle Juba region, 4 cases in Middle Shabelle region, and 1 case in Lower Shabelle region. Of the 114 reported cases, 3 (3%) were laboratory confirmed. During the outbreak response, the difficult security situation has continuously hampered surveillance and control activities in the affected areas.

MENINGOCOCCAL DISEASE 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:
[1] Sudan
[2] Nigeria (Jigawa)

******
[1] Sudan
Date: Wed 9 May 2007
Source: Sudan Vision Daily [edited]
<http://www.smc.sd/en/artopic.asp?artID=14394&aCK=EA>

The federal health minister, Dr Tabitha Butrus, has stated that 7690
meningitis cases have been reported in the south during the period from Jan
2007 to the end of Mar 2007, pointing out that the high tide of the disease
is now receding following the rainfalls.

The health minister further revealed that 1405 meningitis cases have been
recorded in the northern states during the period from Jan 2007 to the
first week of May 2007, explaining that fatalities rate reached 6.2 per
cent as compared to the international average of 10-15 per cent.

In response to a query yesterday made at the national assembly on the
spread of the disease, Dr Tabitha stressed that her ministry, aided by
international organizations, has mobilized efforts for controling the
disease through availing medications and organizing vaccination campaigns.

She, on the other hand, had denied that the cases so far listed, Kassala,
North Kordofan, and South Darfur, as 95 cases and 5 fatalities were
recorded in Kassala, 61 cases and 4 fatalities in Gadaref and 92 cases and
4 fatalities in South Kordofan. [A further report to clarify this statement
would be appreciated. - Mod.SH]

Referring to the marked shortage in meningitis vaccines, Tabitha argued
that the world is suffering an acute shortage of those vaccines for reasons
related to quality the vaccines produced by the main plant in France. She
disclosed that 812 500 doses have been dispensed during the vaccination
campaigns while GOSS Health Ministry has provided 180 000 doses to be used
for northern states following the ebb of the disease in the south.

--
contributed by:
ProMED-mail rapporteur Brent Barrett

[These numbers are lower for the south and higher for the north since the
last posting (Meningococcal disease update 2007 (15) 20070427.1374). A map
of Sudan can be found at
<http://www.un.org/Depts/Cartographic/ma ... /sudan.pdf>. - Mod.LL]

******
[2] Nigeria (Jigawa)
Date: Fri 4 May 2007
Source: AllAfrica.com and Vanguard (Lagos) [edited]
<http://allafrica.com/stories/200705040262.html>


Reports indicate that scores of infected persons have died of meningitis at
different hospitals in Jigawa State, while several others died at homes in
Dutse, Kazaure, Gumel, Birnin-Kudu, Hadejia and Ringim Local Government
Areas of the state.

Confirming the incident, the chief medical director of Birnin Kudu Federal
Medical Centre (FMC), Dr Bashir Umar said about 16 per cent of those
diagnosed with the disease that also come from neighboring states to the
hospital have already died as a result of the severity of the infection.

He said 4 infants were confirmed dead in a spate of 90 days at the FMC due
to the ravaging effect of the disease in Ningi Local Government of Bauchi
and Takai Local Kovernment Area of Kano State, adding that the hospital
management was compelled by the circumstance to write to the head of the
department, Birnin Kudu Primary Health Care, alerting it of the increase of
the incidence in the area.

Vanguard reported that the state commissioner for information, Alhaji
Muktar Birniwa, had in a press briefing last week denied the outbreak of
the disease in the area, stating that only neighboring states with Jigawa
were officially confirmed to experience the outbreak.

[byline: Aliyu Dangida]

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

[There seem to be some issues regarding the location of the outbreak.
Jigawa is the north eastern Nigeria bordering to the north Niger. A map of
the country can be found at
<http://www.un.org/Depts/Cartographic/ma ... igeria.pdf>. - Mod. LL]

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (20)
**********************************************
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
[2] Cholera - Namibia (Ohangwena)
[3] Cholera - Zambia (Lusaka)

******
[1] Cholera - Kenya
Date: Thu 10 May 2007
From: Kenya Broadcasting Corporation [edited]
<http://www.kbc.co.ke/story.asp?ID=42503>


The Ministry of Health has issued an alert of cholera outbreak in the
country. Addressing the press in Nairobi on Thu 10 May 2007, director of
medical services Dr James Nyikal confirmed 32 deaths and 528 cases in 8
districts in the country.

Nyikal said West Pokot district had the highest number of infections with
151 cases, while Turkana district had recorded the highest number of deaths
at 9. He said the latest cases have been reported in Kisumu and Siaya
districts.

Dr Nyikal said the ministry has taken control measures but cautioned the
public to observe hygiene. At the same time, he has directed the provincial
administration to work closely with the public health officers to ensure
all households have a toilet.

[byline: Judy Maina]

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

[West Pokot and Turkana districts are in the Rift Valley province in north
western Kenya. Kisumu and Siaya are in south western Kenya in the Nyanza
province. A map of the country can be found at
<http://www.un.org/Depts/Cartographic/ma ... /kenya.pdf>. - Mod.LL]

******
[2] Cholera - Namibia (Ohangwena)
Date: Wed 9 May 2007
Source: AllAfrica, New Era (Windhoek) report [edited]
<http://allafrica.com/stories/200705090463.html>


Cholera and acute diarrhea cases are on the increase in the Ohangwena
Region with reports of more deaths and infection cases. A week ago, health
authorities reported 343 cases, including those of diarrhea. Now the number
has escalated to a record 475 of which 27 were confirmed as cholera.

In the Engela district of the Ohangwena Region, 10 deaths from acute
diarrhea have been reported so far. About 17 cases of diarrhea have been
found in Opuwo, while other affected areas are Ruacana and Okatope in the
north.

In a brief interview with New Era yesterday, permanent secretary of the
Ministry of Health and Social Services, Dr Kalumbi Shangula, said "In all
instances, they are imported cases. And the 10 deaths are due to a result
of acute diarrhea and not cholera," said Dr Shangula, adding that most of
the victims turn out to be elderly people with weak immune systems that
make them more prone to the disease.

However, public worry about the scare of a suspected cholera outbreak in
the north resulted in May Day celebrations last week being cancelled by the
National Union of Namibian Workers at Oshikango. The organizing union's
deputy secretary-general, Tadeus Erago, said that although the public rally
was organized and scheduled for the border town, it had to be [cancelled]
due to fear of a cholera outbreak. The union was advised by the local
health authority that it was not good to gather many people in one place
because this would result in the spread of the communicable disease.

The water [supply] in Oshikango remains closed due to non-payment by
municipal authorities. In view of this, the Ministry of Health and Social
Services is busy negotiating with Namwater [Namibia Water Corporation] to
re-open the water [supply] for the sake of good health.

[byline: Surihe Gaomas]

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

[The Ohangwena region of Namibia, which borders the Cunene Province of
Angola, can be found on a map at
<http://en.wikipedia.org/wiki/Ohangwena_Region>. - Mod.LL]

******
[3] Cholera - Zambia (Lusaka)
Date: Thu 3 May 2007
Source: Zambia National Broadcasting Corp. [edited]
<http://www.znbc.co.zm/media/news/viewne ... 1178548477>


A Ministry of Health spokesperson says the cholera outbreak that was
reported in Chongwe, Lusaka Province, seems to be contained. Canicius Banda
said the 27 patients from around the Luangwa Bridge area who reported to be
suffering from cholera have since been treated and discharged from St
Luke's Hospital.

Dr Banda has also disclosed that Matero cholera center in the capital,
Lusaka, has no patients and has since been closed.

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

[Lusaka is in south eastern Zambia and can be found on a map of the country
at <http://www.un.org/Depts/Cartographic/ma ... zambia.pdf>. - Mod.LL]

RIFT VALLEY FEVER - OSTAFRIKA (32)
***********************************
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 15 May 2007
Source: Daily News online, Dar es Salaam [edited]
<http://www.dailynews-tsn.com/page.php?id=6843>


Tanzania: Rift Valley fever cases decline in Dodoma
-----------------------------------------------
The number of Rift Valley fever (RVF) patients in Dodoma region has
dropped to 23 from 35 2 weeks ago. A report issued yesterday [14 May
2007] by Dodoma Regional Medical Officer Dr Frida Mokiti showed a
steady decline in RVF infections.

The death toll caused by RVF reached 55 since the disease erupted in
the region in early February this year [2007]. Until yesterday [14
May 2007] evening, the Regional Hospital had only 15 RVF patients.
Mirembe hospital, which had 18 patients 2 weeks ago, had only 5
yesterday. Mvumi Mission Hospital, which had 2 patients last week,
had only one yesterday.

Mpwapwa District Hospital is still grappling with the single RVF case
it had last week. Kondoa District Hospital has no RVF patient at the
moment after treating and discharging its 2 cases 2 weeks ago. Kongwa
still has its single patient, who was admitted a couple of weeks ago.

Haneti and Mtitaa dispensaries in Bahi district have successfully
treated and discharged their patients. Two weeks ago, Haneti had 3
RVF cases and Mtitaa had one. So far, a total of 42 patients have
been treated in various hospitals in the region and discharged.

The regional RVF report shows that since 1 Feb 2007, medical
facilities in the region have handled 120 RVF cases. The Regional
hospital has handled 70 cases, Mirembe Hospital (25), Kondoa (6),
Mpwapwa (6), Mvumi (5), Kongwa (4), Haneti (3), and Mtitaa (1).

Medical experts said the decrease was an indication that new
infections are fewer now and that the disease is likely to taper off
and disappear in a month or 2. Out of the 23 who were in hospital
beds yesterday [14 May 2007], only 15 have been proved positive for
the virus. Ten of them are in the Regional Hospital.

Meanwhile, the region still faces a shortage of anti-Rift Valley
fever cattle vaccines following a massive response by livestock
keepers who drive their herds to vaccination centers daily only to
realize that there are not enough jabs to go around. The response has
also posed a challenge to the region, which has only a few veterinary
officers in rural areas. The region also faces a crippling shortage
of transport facilities for officials and veterinary officers.
Veterinary service tools and materials are also short.

[Byline: Sosthenes Mwita]

--
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley

[A detailed map of the 3 East African countries and the
provinces/districts affected by Rift Valley fever can be accessed at:
<http://www.who.int/csr/don/RVF2007050.jpg>.
- Mod.CP]

CHIKUNGUNYA - AFRIKA (GABON)
****************************
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: 11 May 2007
From: Eric Leroy <Eric.Leroy@ird.fr>


Chikungunya - Gabon
-------------------
A chikungunya outbreak has just been identified in Libreville, the capital
of Gabon in Central Africa. The Gabonese authorities have officially
declared this outbreak based upon laboratory confirmation of 51 of 96
suspected clinical cases by the Centre International de Recherches
Medicales de Franceville (CIRMF), Gabon, and the Faculte de Medecine de
Marseille, France. The laboratory confirmation was based upon real-time PCR
[polymerase chain reaction], sequence analysis, and virus isolation. A
national outbreak response network has been established by the Gabonese
authorities and WHO Afro.

This is the first laboratory confirmed outbreak of chikungunya in Gabon.
Chikungunya fever is an arthropod-transmitted viral disease. Arthralgia is
the most typical sign. The acute phase of the disease lasts for 2 to 4 days
with recovery in 5 to 7 days. The other typical signs/symptoms of the
disease include: fever, nausea, vomiting, headache, etc.

--
communicated by
Eric Leroy <Eric.Leroy@ird.fr>
Head of Emerging Viral Diseases Unit
CIRMF
Franceville, Gabon

******
[2]
Date: 14 May 2007
Source: Ministry of Health, Gabon [edited]


Chikungunya outbreak is developing in the area of Libreville, Gabon, as it
has been recently reported in newspapers. Since the beginning of May 2007,
an increasing number of febrile syndromes associated with arthralgia have
been recorded in the general population of the area and in a French
military camp located nearby. Previously, a total of 35 cases, including
French soldiers and members of their family or Gabonese regular employees
of the camp, were sampled for diagnosis of a febrile disease of possible
arboviral origin since 1 Jan 2007. Serum samples sent to the Institute of
Tropical Medicine of the French Armed Forces Medical Service (IMTSSA,
Marseilles, France) were analysed for the presence of antibodies against
dengue, West Nile, chikungunya and Rift Valley fever viruses. RT-PCR
[reverse transcription-polymerase chain reaction] for the detection of
dengue and chikungunya virus genomes was also performed.

Among these investigated patients, 4 were positive for anti-chikungunya IgM
[immunoglobulin M] and/or IgG [immunoglobulin G] and 7 patients without
detectable antibodies were found positive for chikungunya RT-PCR. Partial
sequencing of the strains confirmed the identification of chikungunya
virus. The analysed strains grouped with a Cameroonian strain(99 per cent
identity) isolated in 2006 (Peyrefitte et al. Emerg Infect Dis 2007: 13:
768-71).

These data support the role of a Central-African chikungunya strain in the
current outbreak declared by the Gabonese authorities. Today, the number of
daily cases has been estimated around 300.

--
communicated by
Dr Hugues Tolou, MD, PhD
Dr Marc Grandadam, PhD
IMTSSA, Unit E9 de Virologie Tropicale, Marseille, France
viro@imtssa.fr

******
[3]
Date: 12 May 2007
From: Didier Fontenille [translated by Sidi Coulibaly, edited]
Source: AFP <http://afp.com/francais/home> [available only to paid
subscribers. - Mod.JW]


The government of Gabon has announced series of measure to prevent against
chikungunya virus in Libreville (capital city of Gabon) and its
surroundings where a month earlier [April 2007] many cases of this unknown
disease occurred in the country.

An official in the ministry of health said to AFP that more than 5500 cases
have been notified since one month in the only one province of Estuaire
(Libreville). "We can talk about [an] outbreak" he added. "About more than
a month now, cases of unknown diseases have appeared in Libreville and
Owendo health centers."

Experts from the ministry of health, National Army and World Health
Organization (WHO) are mobilized to work out strategies to get the outbreak
under control.

--
communicated by
Didier Fontenille
Institut de Recherche pour le Developpement/Centre National de la Recherche
Scientifique 2724
BP 64501
34394 Montpellier Cedex 5
France
(through Sidi Coulibaly <sidi_couly@yahoo.ca>)

[This is the first outbreak of chikungunya virus infection in Gabon
reported by ProMED-mail, and we thank French and Gabonese colleagues, Drs
Leroy, Tolou, Grandadam, Fontenille, and Coulibaly for providing it.
ProMED-mail hopes that these colleagues will provide additional information
about the numbers of cases occurring and progress made to control this
outbreak. In addition, on 13 May 2007, Reuters
<http://www.alertnet.org/thenews/newsdesk/L13424543.htm> reported that the
minister of state for health Paulette Missambo of the Gabon government said
that 5000 suspected cases have been reported so far. Chikungunya has been
detected over the last month in patients in the capital Libreville and the
southern suburb of Owendo on the Gabon Estuary. ProMED thanks rapporteurs
Joseph P Dudley and A-Lan Banks for sending in this same Reuters report.

A map of Gabon can be accessed at
<http://www.lib.utexas.edu/maps/africa/g ... l_2002.jpg> - Mod.TY]