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MEASLES UPDATE (13)
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[1] Georgia
Date: Tue 26 Mar 2013
Source: Rocbalt [in Russian, trans. Mod.CP, edited]
http://www.rosbalt.ru/exussr/2013/03/26/1110342.html


The number of measles cases in Georgia is incasing. 142 of 403 cases have been hospitalized, according to the National Centre for Disease Control of Public Health Department of the Republic. Compared with statistics from previous years, in 2013 Georgia recorded a significant increase in prevalence of measles. A representative of the National Centre for Disease Control and Public Health, Amiran Gamkrelidze, said that measles immunization will be available without charge for all children and individuals under the age of 30.

According to Georgia Online, measles in Georgia has infected 162 persons aged 20 to 29 years of age. Currently, 96 are older than 30 years of age, 37 are adolescents (15 to 19 years), 22 are teenagers (10-14 years), 17 are children (aged 5 to 9 years) and 47 are infants aged from one to 4 years. In addition, measles was diagnosed in 22 babies.

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[A map of Georgia can be accessed at: http://www.geographic.org/maps/new1/georgia_maps.html. - Mod.CP]

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[2] Pakistan (Punjab)
Date: Mon 25 Mar 2013
Source: Daily Times, APP report [edited]
http://www.dailytimes.com.pk/default.as ... 013_pg13_6


Over 6000 cases of measles were reported in 4 months in different parts of Punjab, mostly in Lahore, during the current surveillance drive, stated Director Health Services for EPI Punjab, Dr Tanveer Ahmed. 60-70 cases of measles are being reported every day in different parts of the province, he added. He stated further that 19 deaths of children had been reported so far including in Gujranwala, Rajanpur, Rahim Yar Khan, Kasur and Lahore district.

"The vaccination and surveillance drive has been stepped up to control the threat. It is also part of the strategy to mop up and vaccinate areas with measles patients," said the director. He said that intensive vaccination was also launched in Rahim Yar Khan and adjoining tehsils [an administrative division - CopyEd.MSP] near the Sindh border so that the virus will be prevented from spreading into Punjab. Dr Ahmed said that measles vaccination was available at all hospitals in Lahore and that parents should get their children, up to the age of 5, vaccinated without delay.

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MEASLES UPDATE (14)
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[1] Benin (Atakora)
Date: Thu 21 Mar 2013
Source: La Presse du Jour [in French, trans. Corr.SB, edited]
http://www.lapressedujour.net/?p=22893


Many cases of measles have been reported, in recent days, in the health zone of Materi-Tuieta-Cobly [Atakora department], suggesting an epidemic in the area.

A fever of 39 to 40 deg C [102.2-104 deg F], a runny nose, dry cough, conjunctivitis, lacrimation [shedding tears], edema [swelling] of the eyelids, puffy eyes, diarrhea, abdominal pain, anorexia, vomiting, are some typical signs of measles exhibited by many children in the health area of Materi-Tuieta-Cobly. The number of children with these signs (of the disease) is increasing, with the situation becoming a full-blown measles epidemic.

It should be noted that measles is a disease caused by a virus of the family _Paramyxoviridae_ and it causes respiratory disease. Measles, a highly contagious viral disease, is the most common eruptive disease accompanied by fever. Its complications can be rapidly fatal to humans.

The head doctor of this health zone, Dr Oke Raimi, is aware of this fact. He has taken immediate measures to contain the disease, including increasing the staff in some facilities to allow for the immediate care of the many cases already recorded, and those that could be coming, without delay, and assured that steps will be taken for the rapid evacuation to the zonal hospital, Saint John of God in Tanguieta, for intensive care of cases suffering complications.

[Byline: Boniface Kolawole Biaou]

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[Benin, formerly known as Dahomey, is one of Africa's most stable democracies. Benin is severely underdeveloped, and the economy relies heavily on trade with its eastern neighbour, Nigeria. - Mod.CP

Maps of Benin can be seen at http://www.africa.upenn.edu/CIA_Maps/Benin_19841.gif and http://healthmap.org/r/6dG7. - Sr.Tech.Ed.MJ]

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[2] Nigeria (Gombe)
Date: Tue 2 Apr 2013
Source: Leadership [edited]
http://leadership.ng/nga/articles/51349 ... onths.html


The Gombe State Ministry of Health said on Tuesday [2 Apr 2013] it had recorded 173 suspected cases of measles in 4 local government areas in the last 3 months. The areas are Gombe, Balanga, Dukku, and Nafada.

The State Epidemiologist, Dr Joshua Abubakar, told the News Agency of Nigeria (NAN) in Gombe that out of the cases, 10 were confirmed and currently undergoing treatment. Abubakar said the figure represented cases reported from January [2013] to date. He said when such reports were received, the ministry would immediately conduct immunisation mop-ups in the areas concerned. The epidemiologist attributed the cause to lack of adequate immunisation coverage in the areas. He, however, said that lack of political commitment and will during the immunisation campaign was a major setback. Abubakar, however, commended partners for development such as UNICEF, WHO, and the National Primary Health Care Development Agency for their contributions. He also urged them not to relent in their efforts. "If local government councils would pay their counterpart funds for immunisation frequently, I am sure there would not be a problem," he said.

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[Low immunization coverage still comes up as the reason for the escalating number of measles cases countrywide, calling for mop-up campaigns in the immediate term and, subsequently, a review of the country's measles control strategy to address the setbacks and reinforce strong areas of the program.

Maps of Nigeria can be seen at http://www.un.org/Depts/Cartographic/ma ... igeria.pdf and http://healthmap.org/r/6dG5. - Mod.JFW]

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[3] Pakistan (Islamabad Capital Territory)
Date: Fri 5 Apr 2013
Source: The Express Tribune [edited]
http://tribune.com.pk/story/531287/meas ... ee-months/


To date 9 children have been admitted to the Pakistan Institute of Medical Sciences (PIMS) Children's Hospital after being clinically diagnosed with measles and other complications like pneumonia. This was stated by PIMS Spokesperson Dr Waseem Khawaja on Thursday [4 Apr 2013].

According to the World Health Organisation's (WHO) Weekly Epidemiological Bulletin -- Disease early warning system (DEWS) and response in Pakistan, 59 cases of measles have been reported in the Islamabad Capital Territory (ICT) so far this year [2013]. According to the WHO, this figure climbs to a staggering 8532 cases across the country, including 218 deaths.

Dr Javed Hayat, head of the infectious diseases section at Holy Family Hospital (HFH), informed The Express Tribune that 7 cases of measles had been reported at the hospital this week [week of 1 Apr 2013]. He said over 160 cases of the disease had been reported at HFH so far this year [2013] with a majority of the victims coming from Rawalpindi. He added that many children who had been vaccinated against the disease were still suffering from it [incompletely vaccinated children can still get it], but said the situation was under control.

DEWS Senior Surveillance Officer Dr Musa Rahim confirmed that 8 cases of measles had been reported in different areas of Islamabad last week including Bhara Kahu, Tarlai, Tarnol, and Sabzi Mandi and Golra Sharif. Rahim said peak incidences of measles usually occurred in March and April and therefore he wasn't overly concerned with the current number of reported cases. He stressed the need to focus on the suburbs of the federal capital, as these areas were most vulnerable to the disease.

[Byline: Sehrish Wasi]

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[Maps of Pakistan can be seen at http://www.lib.utexas.edu/maps/middle_e ... l_2002.jpg and http://healthmap.org/r/6dG6. Islamabad is the capital city of Pakistan and the 9th largest city in the country. Located within the Islamabad Capital Territory (ICT), the population of the city has grown from 100 000 in 1951 to 1.15 million as of 2011. - Mod.CP

MEASLES UPDATE (15)
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[1] Nigeria (Lagos)
Date: Mon 8 Apr 2013
Source: Vanguard, allAfrica.com [edited]
http://allafrica.com/stories/201304080611.html


Following reported outbreaks of measles in some states, the Lagos State Government over the weekend advised residents to be vigilant and report any suspected cases, dead or alive, to the nearest health facility in the state or the directorate of disease control in the state Ministry of Health without delay.

Commissioner for Health Dr Jide Idris, who spoke on behalf of the government, explained that the reported outbreak of the disease called for immediate action. He said there was need for mothers and caregivers to take measures that would reduce the risk of their children contracting the disease.

Such measures include: Exclusive breastfeeding of babies for the 1st 6 months; routine immunization of children and ensuring that the schedule is completed by the child's 1st birthday (measles vaccine at 9 months); ensuring the administration of Vitamin A from the age of 6 months; and the keeping of a sick child at home away from school and play to rest and prevent infecting other children.

He said: "If measles is suspected in any child, his/her mother or caregiver should ensure regular and thorough hand washing of her hands, ensure that such a child receives vaccine before leaving the hospital if not covered with immunization, cleanse all contaminated materials and objects including toys, and return to the hospital for follow up, while health workers are advised to be on the alert and report more than usual cases of measles in their facilities to the Ministry of Health."

Idris explained that immunization was key to the prevention of the disease, stressing that people who do not vaccinate their children put other children at risk and urged the people to take responsibility for their health and call 08160070600 or 08023213333 for any case of the disease.

He added that signs and symptoms of suspected measles include high fever, cough, runny nose and red eyes. The appearance of whitish spots in the mouth and rashes that spread from the head to the rest of the body strongly suggest measles," Idris stated.

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[2] Pakistan (Lahore)
Date: Sat 13 Apr 2013
Source: The News Tribe [edited]
http://www.thenewstribe.com/2013/04/13/ ... s-40-mark/


Another fatal outbreak of measles has claimed 4 lives in the province of Punjab. The children died in the Meo hospital of the provincial capital Lahore on Saturday [13 Apr 2013]. According to hospital sources, the ages of the infants ranged from 2 to 4 years, and they belonged to the Rawi road and Mari Pora areas.

The total number of lives lost to measles in Lahore has increased to 40, while the number of those affected in the province has risen to 8350.

In a deadly outbreak last year [2012], a large number of lives were lost due primarily to a lack of appropriate vaccination in the country.

[Byline: Hassa Siddiqui]

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MEASLES UPDATE (16)
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[1] Nigeria
Date: Thu 18 Apr 2013
Source: Leadership [edited]
http://leadership.ng/nga/articles/52286 ... ction.html


Debating an ongoing measles outbreak which has killed 36 children and hospitalised about 3588 in northern Nigeria, according to Senate figures, federal lawmakers say widespread suspicion and deliberate misinformation on the vaccine has aggravated the spread of the epidemic.

Also, Senators passed for 2nd reading a Bill for an Act to repeal the "archaic" 1926 Quarantine Act and enact the Nigeria Public Health (Quarantine Isolation and Emergency Health Matters Procedure) to prevent the introduction, spread of, and regulate steps for the containment of dangerous infectious and communicable diseases, organisms and agents in Nigeria. The Quarantine Bill was referred to the Senate committees on health and agriculture for further legislative work. The report is expected in 2 weeks.

Senate President David Mark accused certain interests of distorting facts about the vaccines for measles, polio and other preventable diseases for "political reasons." Coming on the heels of the recent killing of 10 polio vaccinators in Kano state, a proposal to provide security backup for vaccinators failed as Senators rejected the move at plenary. Mark's disclosure was a sequel to a motion for an "urgent sensitization and awareness campaign, and a supply of vaccines to measles affected areas," sponsored by Sen. Danladi Sankara (Jigawa, PDP) and 28 others.

Mark [stated]: "There is no doubt that people go about deliberately misinforming the ignorant in the society about the consequences of routine immunisation or vaccination. Well, some use it for political reasons. If you look at the states that are affected currently, it is more prevalent in the northern states, and I think that all of us from the northern states must have the courage to go back to our constituencies and educate our people that this (vaccination) is the right thing for them to do."

[Byline: Edegbe Odemwingie and Jonathan Nda-isaiah]

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[2] Pakistan (Lahore)
Date: Fri 19 Apr 2013
Source: The Frontier Post [edited]
http://www.thefrontierpost.com/article/6625/


Measles has killed 12 children and affected dozens in Lahore in the past one week, the Frontier Post News desk reported. During the last 24 hours, 23 children were admitted in Mayo Hospital and 22 in Children's Hospital; of them 3, hailing from Lahore, succumbed to the fatal disease.

In district Jhang, 10 children have died of measles in the past 3 months, while in Multan, 195 have been affected.

Lahore is badly affected by the disease; however, measles cases have also been reported in other cities of the province.

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[3] Pakistan (Sindh)
Date: Thu 18 Apr 2013
Source: The International Tribune [edited]
http://tribune.com.pk/story/536965/new- ... -outbreak/


The newly appointed Sindh Chief Secretary (CS), Muhammad Ijaz Chaudhry, has directed the health secretary to submit a report on the measles outbreak in the province. On his 1st day at work, Chaudhry noted that 3000 children were affected by measles, and nearly 120 were killed across Sindh. The new CS has also asked for a report on strikes by the Hyderabad taluka municipal staff from the local government secretary within 2 days. He demanded a comprehensive report with facts and solutions from the relevant departments.

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MEASLES UPDATE (17)
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[1] Congo DR (Orienale)
Date: Mon 22 apr 2013
Source: Radio Okapi [In French, trans. by corresp. SB, edited]
http://radiookapi.net/en-bref/2013/04/2 ... rois-mois/


82 cases of measles reported in three months in Orientale province
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The WHO epidemiologist in charge of emergencies and Humanitarian actions in Orientale Province, Colin Ngobila, said Monday, 22 Apr 2013, that 82 cases of measles have been reported since March [2013] in the Health zones of Duruma, Dungu, Aba and Faradje in Haut-Uele district (Orientale Province). Epidemiologist Ngobila called for a strengthening of the Expanded Vaccination Programme (PEV in French) in these health areas. He declared that: "We promote the proper management of cases including vitamin therapy and we also require strengthening of the routine Systematic PEV, i.e. the PEV routine vaccination that is given to children before their first birthday."

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[2] Syria
Date: Mon 22 Apr 2013
Source: Digital Journal [edited]
http://www.digitaljournal.com/pr/1197728

Cases of Measles Have Been Detected in Northern Syria and in the Refugee Camps
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UOSSM [Union of Syrian Medical Relief Organisations] reports that more than 40 cases of measles have been detected in North Syria and the refugee camps, distributed as follow: 10 cases of measles in Aleppo, 2 of them fatal. A report by the Jordan Times recorded that 13 cases of measles have so far been detected among Syrian refugees in Jordan, accordion to a Health Ministry official (http://jordantimes.com/13-cases-of-meas ... n-refugees).

Dr Tawfik Chamaa, UOSSM spokesperson, said; "Measles is one of the most contagious, and deadly of all childhood diseases. However, it is preventable by vaccination. It is very imperative to undertake a wide campaign of vaccination to the displaced Syrian children, and those in the refugee camps. Those children have already missed their vaccination schedule due to displacement and the ceasation of vaccination programs in several areas across Syria, in addition to the high susceptibility among children to acquiring infectious disease, due to the harsh environmental conditions, the crowded area in the refugee camps, and the poor nutritional status many of them are suffering from." Dr Chamaa, added, " We call on WHO and UNICEF to conduct an urgent wide vaccination program on Syrian children, inside Syria and in the refugee camps."

UOSSM expresses its gratitude to the Jordanian Ministry of Health, Abdullat, for launching the initiative campaign to vaccinate the Syrian children in [the] refugee camp, according to the Jordan Times,"on Saturday to inoculate 90 000 Syrian refugees against measles and 24 000 against polio. In addition, 22 000 will receive vitamin A doses. Since the launch of the campaign, 3528 Syrians have been vaccinated against polio and 23 000 against measles, while 6985 were given vitamin A."

The UOSSM is a coalition of humanitarian and non-governmental organizations, created following the deadly events in Syria, to provide medical and humanitarian aid to Syrians. UOSSM was established by 14 organizations, and includes hundreds of physicians of mainly Syrian origin distributed in the United States, Canada, Europe and in different Arab countries.

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[3] Pakistan
Date: 24 Apr 2013
Source: The Express Tribune [edited]
http://tribune.com.pk/story/539790/meas ... eady-here/

The epidemic isn't near; it's already here
------------------------------------------
It's easy to get lost in the numbers. Easy to forget that every digit is a life put in danger, or a life lost. Less than 4 months into this year, there have already been 25 401 reported cases of measles. Thus far, 146 children across the country have lost their lives due to this easily preventable disease, and there are fears that this may only percent be the beginning.

Documents obtained by The Express Tribune paint a grim picture of what lies ahead: out of 7000-plus laboratory confirmed measles cases that surfaced in 2012, a staggering 60 percent of children were not given even a single dose of measles vaccine, while 20 percent were vaccinated with only one dose. Of those confirmed cases, 68 percent were below 5 years of age and 32 per cent were less than 10. The country's official estimate of 1st and 2nd dose measles vaccine coverage was 75 percent and 53 percent in 2011 and 80 percent and 53 percent in 2012, respectively. Not only are the numbers of immunised children declining alarmingly, the actual coverage is considered to be far lower than what the official figures claim. This is evident, the documents say, from the thousands of measles cases that have
emerged across the country from 2012 until now.

"These shocking statistics clearly reflect the main reason behind the measles outbreak in the country and the utter failure to ensure optimal coverage of routine immunisation," said an Expanded Programme on Immunisation (EPI) official who wished not to be named. "With such poor and embarrassing coverage what message are we giving to theworld on the eve of World Immunisation Week, which starts from 24 April [2013]?" he asks.

It's not as if there wasn't ample warning, he says. The recent outbreak in Sindh should have been a wake-up call, but those responsible just kept sleeping, with the result that the epidemic travelled to Punjab. Now, Punjab tops the list with 16 608 cases and Sindh leads with 62 deaths. "The provincial and federal governments' attitude is clearly reflected by their delay in releasing the amount allocated to launch emergency measles Supplemental Immunisation Activities (SIA) in flood-prone areas by June 2013," said the official.

The total amount required for SIA is $65 million, out of which $35 million is being paid by the Alliance for Vaccines and Immunisation (GAVI), a global health partnership, while the Pakistani government has to generate the remaining $30 million. International donors have given a cold shoulder to Pakistan, and thus far Punjab has allocated $14 million and Sindh $4 million. Neither province has actually released the amount yet. Balochistan has not yet shown any interest while the federal government has requested the finance ministry for financial assistance but has not yet received any response. "If Pakistan fails to raise this amount by the end of May [2013], then it will be impossible to carry out the SIAs in the country and the lives of over 62 million children between the ages of 9 months to 10 years will be at risk," he warned.

World Health Organisation's (WHO) focal person on the measles outbreak in Pakistan, Dr Qamarul Hasan, said the reason for the epidemic is because children are either not vaccinated at all or only partially vaccinated. "Pakistan is one of the top 5 countries in the world having the highest number of unvaccinated children. Of course, no sensible mind can say this is a satisfactory achievement," he said. Suggesting steps to control the epidemic, he said the WHO recommends improving both the 1st and 2nd dose coverage to at least 95%, and then sustaining that level. Along with this, he says a nation-wide measles campaign has to be launched targeting all children below 10 years. And finally, Hasan said the government needs to ensure accountability at all levels for the effective and efficient utilisation of its own and donors' resources. At this point in time, none of these measures seem to be being carried out, and every passing day only increases the danger to Pakistan's children.

(By Sehrish Wasif)

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MEASLES UPDATE (18)
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[1] Georgia (Tbilisi)
Date: Wed 24 Apr 2013
Source: MIR24 TV [in Russian, trans. Mod.NP, edited]
http://mir24.tv/news/society/6939157


In Georgia (Tbilisi) measles cases now exceed 1000. Although vaccination can be obtained free of charge at clinics, compared with previous years, in Georgia the population is contracting measles more frequently. To date, the number of infected persons is approaching the critical point when the outbreak could become an epidemic.

According to Paata Imnadze, head of the scientific council of the National Center for Disease Control, "This is still only an outbreak, but the situation is developing such that it may reach epidemic proportions. Mostly adults are being affected because they have no immunity, as in 2008 when a mass vaccination campaign had to be undertaken. [Then] it was planned to vaccinate millions of people, but only 500 000 were vaccinated. Now we are seeing the consequences of the refusal of many to accept vaccination. Not so long ago, 2 measles deaths were reported: an 11-month-old child and a 19-year-old man. Measles cannot be cured and the best protection is vaccination. The new vaccination programme will cover all regions of Georgia.

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[2] Gabon (Libreville)
Date: Wed 1 May 201
From: Nkoghe Dieudonne <dnkoghe@hotmail.com> [edited]


A measles outbreak began in Libreville (Gabon) and its surrounding area in January 2013. The Gabonese Ministry of Health declared an epidemic after confirmation by the Virology Laboratory of the Libreville University of Health Sciences. To date, 23 cases have been laboratory-confirmed, and other samples from suspected cases are currently being collected throughout the country. The Gabonese government implemented an outbreak response based on a national immunization campaign and vitamin A administration. These activities initially took place from [19-23 Mar 2013] and concerned children aged from 9 months to 10 years living in Libreville and the neighboring commune of Owendo. Subsequently, more than 250 000 children were vaccinated in health centers, approved immunization sites, and primary schools, with support from WHO and UNICEF. The results of this campaign are being analysed.

Measles is a highly contagious disease caused by a morbillivirus. It only affects humans, is transmitted by aerosols, and rapidly spreads through the community, mainly affecting children under 5 years of age. Vaccination is currently the best preventive treatment. Measles is the leading cause of vaccine-preventable deaths in this age class. Several measles outbreaks occurred among children under 5 years of age in 2011 in African countries, including Nigeria, Angola, Democratic Republic of Congo, Sierra Leone, and Ethiopia, in spite of high measles-containing vaccine (MCV) coverage. Older children and young adults were affected in other outbreaks in Burkina Faso, Namibia, Malawi, and South Africa.

No outbreaks had previously been reported in Gabon. From 2009 to 2012, 155 measles cases including 45 deaths were reported, while MCV coverage was estimated at 55 percent in 2007 and 35 percent in 2011. The CIRMF [Centre International de Recherches Medicales de Franceville /International Centre for Medical Research in Franceville] rapid-reaction task force implemented an active surveillance strategy and a research program through sentinel sites in Libreville (North West), Franceville, Koulamoutou (South East), and Makokou (North East). The 1st findings show that older children and young adults are also affected. The surveillance strategy has revealed the spatial and temporal pattern of the epidemic, and the research program has identified the circulating strains.

Ongoing work will show whether the epidemic is due to low MCV coverage or to a non vaccine strain [no such strains are known to exist - Mod.LM].

--
Dr Nkoghe Dieudonne, MD PhD
Ministry of Health, Libreville
Gabon- Centre International de Recherches Medicales de Franceville (CIRMF)
Gabon
<dnkoghe@hotmail.com>

[Drawing from the measles-containing vaccine (MCV) trends presented in the report and the fact that older and young children are affected by measles in the outbreak, low MCV coverage with accumulation of unvaccinated cohorts is likely to be one of the factors for the current outbreak. The national measles control strategy therefore needs to be reviewed and updated to address the current implementation gaps.

Maps of Gabon can be accessed at http://www.lib.utexas.edu/maps/africa/g ... l_2002.jpg and http://healthmap.org/r/6EsR. - Mod.JFW]

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[3] Pakistan (Lahore)
Date: Mon 6 May 2013
Source: The Daily Times Pakistan [edited]
http://www.dailytimes.com.pk/default.as ... 013_pg13_3


Another 2 measles-affected children, an 8-year-old and a 9-month-old, died at the Ganga Ram and Children's Hospital on Sunday [5 May 2013], while 67 new cases have been admitted in different hospitals across the city during the last 24 hours.

At least 11 000 cases of measles have been reported in Punjab during the last 5 months with an addition of around 141 new cases during the last 24 hours, including 52 from city hospitals.

Additional Director EPI, Dr Nazir Hussain said that during the special anti-measles campaign, the health department had set a target of at least 3 million children in Lahore district and vaccinators had achieved the target of over 2.5 million while the drive had been extended for 2 days till 7 May 2013, to vaccinate the remaining school children.

According to health department officials, at least 64 deaths have been reported so far while most deaths occurred in Lahore, Gujranwala, Rajanpur, Rahim Yar Khan, and Kasur.

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[4] Turkey
Date: Tue 30 Apr 2013
Source: Hurriyet Daily News, Anatolia News Agency report [edited]
http://www.hurriyetdailynews.com/measle ... &nid=45897


The Health Ministry has intensified its measles vaccination efforts after the cases increased to 3000 between 2012 and 2013, due to a virus that entered the country from Romania.

Almost 3000 measles cases were seen in several cities between 2012 and 2013, due to a virus which came from abroad, said an official from the Ministry, adding that these cases had decreased over the past few weeks. In 2011, only 110 measles cases were seen across Turkey, but this number increased since May 2012 due to a virus which was first carried to Istanbul by a music group who came from Romania, according to the Public Health Agency of Turkey deputy head Mehmet Ali Torunoglu. Some of these cases were treated in intensive care units but there were no casualties, he added. "The cases were first seen in Istanbul and then spread to other cities," said Torunoglu, adding that the majority of cases were observed in big cities such as Ankara, Gaziantep, Sanliurfa, and Adana.

Torunoglu said that the cases had decreased in the past weeks. "We used to have around 200 cases in a week. But for the past 4 weeks, our cases decreased to 100 to 200 a week. We are expecting fewer cases in the coming weeks as the incidences decrease during summer time," he said. One third of these cases were seen in children younger than 1-year-old. Also, one third of these cases were among those above the age of 20, he added. Those between one and 19 years of age catching the disease had either not been vaccinated or could not develop immunity despite being vaccinated, Torunoglu added.

"We are working on the vaccination to prevent the spread of this disease. It is usually seen in those of a younger age. We decreased the age of vaccination to 9-month babies on the decision of the Science Council. We repeat the vaccine when they turn 1 year old," said Torunoglu yesterday [29 Apr 2013]. "Also, the family doctors invite those between 1 and 4 years of age who have not completed their vaccinations. We extraordinarily vaccinated the pre-school children this year [2013]. We won't vaccinate pre-school children next year," he added.

Despite the increase in cases last year [2012], the ministry claims that there is no epidemic, but rather a controlled increase in the number of cases. "These cases are still widely seen in Europe. These may enter Turkey due to the human traffic and may spread to Turkey. The Science Council said that this was not an epidemic, but a controlled increase in cases," said Torunoglu. He said that one dose of the vaccination could not protect 100 percent, and those with only one dose were still at risk if they encountered the virus.

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MEASLES UPDATE (19)
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[1] Sudan (Bahr El Arab, East Darfur)
Date: Mon 6 May 2013
Source: Radio Dabanga [edited]
http://www.radiodabanga.org/node/48201


An outbreak of measles is spreading in the Bahr El Arab locality of East Darfur state, a resident told Radio Dabanga. According to the source, the 1st cases of measles were diagnosed 2 months ago, with infection quickly spreading, especially among children, pregnant women, and the elderly.

Health authorities reacted with a partial vaccination campaign, but the disease has since re-emerged. Residents are now complaining of a high incidence and deaths due to measles in addition to the lack of treatment and comprehensive vaccination. The witness said that the areas worst affected are Sibdu, Tagatiq, Hiraiz, Butah, Ihaimir, Abuasal, Jalal, WarrellFitis, El Malam, and Silwajy, and appealed to the health authorities to speed-up combating and containing the disease.

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[2] Pakistan (Lahore, Punjab)
Date: Tue 7 May 2013
Source: The Frontier Post [edited]
http://www.thefrontierpost.com/article/10469/


Over 10 929 cases of measles have been reported in Punjab [province] during the last 5 months with an addition of 141 new cases including 52 from city hospitals, during the last 24 hours [6-7 May 2013]. According to health department officials, at least 64 deaths have been reported so far while most deaths occurred in Lahore, Gujranwala, Rajanpur, Rahim Yar Khan, and Kasur.

Meanwhile, Director General Health Services Punjab Dr Tanveer Ahmed said on investigation it was found that a majority of deaths in Lahore were caused by severe pneumonia and delay in reaching hospitals.

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MEASLES UPDATE (20)
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******
[1] Georgia (Tbilisi)
Date: Tue 7 May 2013
Source: Novostimira.com [In Russian, trans. Mod.NP, edited]
http://novostimira.com/novosti_mira_55324.html


In Georgia now 3150 cases of measles
--------------------------------
Today, the National Center for Disease Control and Public Health of Georgia reported that in the last 14 days more than a thousand cases of measles had been recorded. To date, the number of cases has exceeded 3150 people, 985 of whom were hospitalized. Most cases were recorded in the Georgian capital Tbilisi, where the number of cases is now 205. In addition, cases of measles virus infection were recorded in 48 cities and regions of the country. All of these data are provided by the Georgian medical authorities. Measles affects people of all ages, from children to the elderly. More than a thousand cases were people from 20 to 29 years old. Already there have been 2 deaths, an 11-month-old girl and a 19-year-old male. Currently the Center cannot predict precisely when the epidemic will subside.

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[2] Pakistan (Punjab)
Date: Sun 19 May 2013
Source: Pakistan Observer [edited]
http://pakobserver.net/detailnews.asp?id=207306


LHC summons 3 MS on measles outbreak
---------------------------------
The Lahore High Court [LHC] summoned medical superintendents [MS] of Jinnah Hospital, Services Hospital and Mayo Hospital for [21 May 2013] on plea against the measles outbreak. Justice Muhammad Khalid Mehmood Khan passed the orders a plea filed by Judicial Activism Panel, a public interest litigation firm besides seeking a reply from Punjab government.

Earlier, the petitioner's counsel contended that the government had failed as measles related deaths continued. The counsel alleged that corrupt health officials were responsible for deaths and demanded action against them. The court after hearing arguments summoned the 3 said medical superintendents in person for [21 May 2013]to know about steps taken to control measles.

Meanwhile, With 146 new cases reported during the last 24 hours, the number of measles cases reported in the Punjab in last 5 months has reached to 12 490. According to health departmentofficials, at least 87 deaths have been reported so far while mostly deaths occured in Lahore, Gujranwala, Rajanpur, Rahim Yar Khan and Kasur. During the last 24 hours, around 146 cases of measles were reported from Punjab, including 56 from city hospitals. Meanwhile, Director General Health Services Punjab Dr Tanveer Ahmed talking to media persons said that on investigation it was found out the majority of deaths in Lahore were caused by severe pneumonia and delay in reaching hospital.

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MEASLES UPDATE (21)
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*****

Pakistan (Punjab)
Date: Mon 20 May 2013
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2013/05 ... o-measles/


Death toll hits 90 as 3 more succumb to measles
-----------------------------------------------
3 children died of measles on Monday [20 May 2013] bringing the overall death toll in Punjab to 90 since January [2013]. The deceased children were undergoing treatment in Children's Hospital Lahore. 9000 children were affected by measles in Punjab, rousing the provincial health authorities to launch a children's vaccination week between 24-30 April[2013]. However the measles outbreak has still not been controlled, causing deaths across the country.

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[1] Pakistan (Punjab)
Date: Mon 27 May 2013
Source: Geo TV News, [edited]
http://www.geo.tv/GeoDetail.aspx?ID=102691


At least 10 children have died during the last 2 days in Punjab [province] as the overall death toll from the measles outbreak rose to 117 in the province. Over 14 000 children are suffering from the disease in Punjab and the Lahore High Court [LHC] has summoned a report over the rising number of measles cases.

According to the Punjab Health Department, during the last 48 hours 5 children in the Children's Hospital, 4 in Mayo Hospital, and one child in Jinnah Hospital lost the battle to measles in Lahore.

The death toll at the Children's Hospital over the last month has risen to 57, 54 in Mayo Hospital, and 7 in Jinnah Hospital. Caretaker prime minister Najam Sethi has directed concerned departments to take all necessary steps to control the outbreak of measles. Meanwhile, during the hearing of the measles death case, justice Khalid Mahmood remarked that the spread of the disease despite the vaccination drive was a great cause of concern. The LHC has summoned concerned officials from the provincial health department along with the record for Wed 29 May 2013.

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******
[2] Pakistan (Punjab)
Date: Thu 30 May 2013
Source: The Pakistan Observer [edited]
http://pakobserver.net/detailnews.asp?id=208333


With 210 new cases reported during the last 24 hours, the number of measles cases reported in Punjab during last 6 months has reached 14 600. According to health department officials, the death toll has so far risen to 117 with most of the deaths occurring in Lahore, Gujranwala, Rajanpur, Rahim Yar Khan, Kasur, and Sialkot. During the last 24 hours, around 210 cases of measles were reported from Punjab, including 59 from city hospitals.

Meanwhile, director general Health Services Punjab Dr Tanveer Ahmed talking to media said that on investigation it was found that the majority of deaths in Lahore were caused by severe pneumonia and delay in reaching hospitals. However, measles vaccination is available in all hospitals of the city, in ample quantity, and patients were being treated at free of cost. He appealed to parents to get their children up to 5 years of age vaccinated against measles without any delay and to cooperate with vaccinating teams.

Meanwhile, the Lahore High Court on Wednesday [29 May 2013] sought a report from the Health Department [by] 11 Jun 2013, about the steps taken to control measles during the past 3 years.

[Director general [DG], Punjab Health Department, Dr Tanvir Ahmad said] that the measles vaccine was of international standard and it was being provided to 12 million children. However, the court asked that if the vaccine was of international standard then why were children dying? The DG replied that vaccine was effective for only 85 per cent.

The court observed that there were 30 million children, if 4.5 million die then did it not make any difference? The petitioner's counsel Azhar Siddique pointed out that no measles campaign [had been] launched for the last 4 years. However, the DG said that the campaign was launched in 19 districts of Punjab and vitamin A was also provided along with the vaccine, if required.

The court observed that if dengue could be rooted out in one year then measles could also be controlled. To a court query, the DG said that INR 243 million [about USD 4.3 million] was spent on measles campaign in Lahore. He said that measles fatality rate was 5 per cent in the world, 2.5 per cent in Asia, but it was only 0.8 per cent in Pakistan. The court observed that the measles fatality rate should be zero and that if there was any problem of funding, the court should be apprised as it was necessary to save children lives. The court adjourning the matter until 11 Jun 2013, requested a report from the health department and ordered that steps be taken for keeping the vaccine as per international standards.

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[1] Pakistan (Punjab)
Date: Fri 7 Jun 2013
Source: Central Asia Online [edited]
http://centralasiaonline.com/en_GB/arti ... wsbrief-13


[As of] 6 Jun 2013, 3 more children have died of measles in Punjab bringing the death toll to 138 in the province since January [2013], media reported. The recent deaths were reported in Faisalabad, claiming the lives of a 4-year-old child from Chinot, a 2-year-old from Jaranwala, and 2-year-old from Faisalabad.

The provincial health department plans to immunise more than 10 million children during a 3-day campaign in 12 sensitive districts starting 24 Jun 2013

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******
[2] Pakistan (Punjab)
Date: Sat 8 Jun 2013
Source: The Hindu, Press Trust of India (PTI) report [edited]
http://www.thehindu.com/news/internatio ... 794566.ece


Measles has claimed the lives of 10 more children in Pakistan's Punjab province over the past 2 days, taking the toll in an outbreak of the disease to 148. Since the outbreak in the province a month ago [around 6 May 2013], 3 to 5 children have been dying of measles every day. According to a spokesman of the Health Department, the death toll in Lahore alone is 80. Since Thursday [6 Jun 2013], 3 children succumbed to the disease in Lahore, 2 each in Faisalabad and Hafizabad districts, and one each in Toba Tek Singh, Mandi Bahauddin, and Gujranwala.

At least 195 more cases of measles were reported in Punjab, including 19 in Lahore on Friday [7 Jun 2013], the spokesman said.

The failure to launch an immunisation campaign against measles and the failure to purchase the vaccine were said to be the main reasons for the outbreak. After assuming charge, Punjab Chief Minister Shahbaz Sharif held a meeting on Friday [7 Jun 2013] to review the outbreak and approved an action plan to protect children against the disease and called for a vigorous campaign against the disease. "All steps will be taken on an emergency basis to save children, and I will personally review the situation every week, while the Chief Secretary will hold a meeting every day," Mr Sharif said. He directed officials to speed up the process of buying vaccines without waiting for support from international donors.

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[1] Pakistan (Punjab)
Date: Sat 8 Jun 2013
Source: Sahil online, PTT News Agency [edited]
http://www.sahilonline.org/english/news ... &nid=18495


Measles has claimed the lives of 10 more children in Pakistan's Punjab province over the past 2 days, taking the toll in an outbreak of the disease to 148. Three to 5 children have been dying of measles every day since the outbreak in the province a month ago. According to a spokesman of the Health Department, the death toll in Lahore alone is 80.

Since Thursday [6 Jun 2013], 3 children succumbed to the disease in Lahore, 2 each in Faisalabad and Hafizabad districts, and one each in Toba Tek Singh, Mandi Bahauddin and Gujranwala. At least 195 more cases of measles were reported in Punjab, including 19 in Lahore on Friday [7 Jun 2013], the spokesman said. The failure to launch an immunisation campaign against measles and the failure to purchase the vaccine were said to be the main reasons for the outbreak.

After assuming charge, Punjab chief minister Shahbaz Sharif held a meeting on Friday [7 Jun 2013] to review the outbreak and approved an action plan to protect children against the disease and called for a vigorous campaign against the disease. "All out steps will be taken on an emergency basis to save children, and I will personally review the situation every week, while the Chief Secretary will hold a meeting everyday," Mr Sharif said. He directed officials to speed up the process of buying vaccines without waiting for support from international donors.

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[2] Pakistan (Islamabad)
Date: Mon 10 Jun 2013
Source: Pakistan Daily Times [edited]
http://www.dailytimes.com.pk/default.as ... 013_pg11_5


After Sindh and Punjab, the capital and its rural areas are under the threat of a measles epidemic. According to hospital sources, around 40 measles patients, almost all of them children, are brought to the Polyclinic Hospital and Pakistan Institute of Medical Sciences (PIMS) of the federal capital everyday. The Polyclinic Hospital spokesman, Dr Sharif Astori, said that 15 to 20 measles-affected children were brought to the OPD [outpatients department] of the hospital and provided treatment, though no patient has been admitted. The doctor said that the disease had not become an epidemic so far. On the other hand, the PIMS Hospital spokesman, Dr Waseem Khawaja said that dozens of measles patients were brought to the OPD of the hospital daily and provided proper treatment. He said that a few children were admitted who were later discharged after recovery.

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[3] Pakistan (Lahore)
Date: Sun 9 Jun 2013
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2013/06 ... o-measles/


Punjab chief minister [CM] Shahbaz Sharif on Saturday [9 Jun 2013] said that an independent investigation had been ordered to inquire about dozens of infant deaths from measles in the province. The CM said this while addressing the convocation of College of Physicians and Surgeons in Lahore. He lauded the response of the [medical] community to the devastating floods of 2010 and the outbreak of dengue fever. Shahbaz said countries like Indonesia, Sri Lanka and Thailand were very impressed with the expertise of Pakistani doctors in dealing with the dengue fever outbreak and urged the doctors to keep up with the good work.

Meanwhile, measles on Saturday [9 Jun 2013] claimed 2 more lives, raising the number of deaths in the province to 146. According to health department officials, the deaths were reported one each from Children Hospital Lahore (an 8 month old), and from Allied Hospital, Faisalabad (a 24 month old). As many as 201 new cases of measles were reported from Punjab, including 40 from Lahore hospitals, increasing the total number of cases to 16 620 during the last 6 months.

Meanwhile, Health Services Punjab director general Dr Tanveer Ahmed said that during an investigation, it was found that a majority of deaths in Lahore were caused by severe pneumonia and delay in reaching hospitals. He urged the people to cooperate with the vaccinators and to contact doctors without any delay in case of symptoms of measles in their children.

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[4] Pakistan (Lahore)
Date: Tue 11 Jun 2013
Source: The Express Tribune [edited]
http://tribune.com.pk/story/561774/meas ... prevented/


The Lahore High Court on Tuesday [11 Jun 2013] said action will be taken against Punjab chief minister Shahbaz Sharif and others responsible if deaths caused by the measles outbreak in the province are not prevented, Express News reported. The court questioned director general (DG) Health Punjab Dr Tanvir Ahmed about measures taken to control the damage caused by the outbreak. The DG Health informed the court that children have been vaccinated, and this will help reduce the number of deaths considerably. Expressing dissatisfaction over the response from DG Health, the court asked Punjab CM and other health department officials to submit their reports over the issue to the court by the next hearing.

According to official reports, more than 1500 children are suffering from measles. As many as 129 children have died in the province so far. According to the World Health Organization (WHO), the number of measles cases in Pakistan increased from 4000 in 2011 to 14 000 in 2012. As many as 306 children died of measles in the country last year [2012], most of them in flood-stricken areas.

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MEASLES UPDATE (25)
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[1] Syria (North)
Date: Tue 18 Jun 2013
Source: News24, Agence France-Presse (AFP) report [edited]
http://www.news24.com/World/News/Measle ... a-20130618


An epidemic of measles is sweeping through parts of northern Syria, with at least 7000 people affected because the ongoing civil war has disrupted vaccination programmes, Medecins sans Frontieres (MSF) said on Tuesday [18 Jun 2013]. "The main factor leading to the worsening of the situation and to outbreaks has been the disruption of routine immunisation activities," MSF said. Consequently, vaccination coverage for measles has dropped from around 80 percent to almost zero among young children, it added.

Only 13 cases were reported throughout the country in 2010 and 26 in 2011, according to World Health Organisation (WHO) data. Now at least 7000 people have been infected, with the disease spreading more quickly in part because of the large number of Syrians displaced by the conflict and living in close quarters.

In a bid to stem the epidemic, MSF has been conducting an immunisation programme in parts of northern Syria that are largely rebel-controlled. The group said it had vaccinated more than 75 000 children in the provinces of Aleppo, Raqa and Idlib. But the war has made the process difficult. "Queues for vaccinations had to be avoided for fear that they might attract air strikes or rocket attacks," MSF said. The group also warned that while the mortality rate associated with the current measles outbreak was low, infection would render children more vulnerable to other diseases at a time when basic healthcare is increasingly unavailable. "Complications arising from measles can be life-threatening," the group said. "Apart from the direct victims of the violence in Syria, mortality rates are rising, especially among the most vulnerable, due to the lack of preventative measures such as vaccinations and the lack of access to basic healthcare," MSF said.

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[2] Nigeria (North)
Date: Thu 20 Jun 2013
Source: Premium Times, News Agency of Nigeria (NAN) report [edited]
http://premiumtimesng.com/news/139220-m ... -nema.html


The National Emergency Management Agency (NEMA) said a measles outbreak in the northern part of the country has killed 36 children and infected more than 4000 people so far. The agency's North Central Coordinator, Mohammed Abdulsalam, said this at a workshop in Jos [Plateau state] on Thursday [20 Jun 2013].

Mr. Abdulsalam said that the epidemic was ranked 3rd after draught and flood in emergency data of the 10 top natural disasters in Nigeria. He blamed the high rate of the epidemics in the country to illiteracy, ignorance, poor state of personal and environmental hygiene. He said that congestion and absence of community-based early [detection], reporting and surveillance system were also contributing factors.

The NEMA coordinator explained that the one-day workshop was aimed at creating awareness and sensitising stakeholders to the ways of mitigating the spread of cerebrum-spinal meningitis, measles, cholera and Lassa fever, especially during the rainy season. "Health matters are being given proper attention nationwide particularly by the Ministry of Health and other health-related agencies. And during raining season, there are some epidemics that do happen as a result of flooding, because of the nature of our environment.

"Some environment[s] are slum where you have dirt surrounding the people; the waste disposal system is very poor.

"So, people are vulnerable to all sorts of diseases which informed NEMA's decision to organise this workshop where we bring in experts from the health sector to enlighten us and the general public on what we need to do to avoid diseases, such as measles, cholera, meningitis and other diseases that are troubling our societies so that people will take caution and prevent the occurrence of such diseases," he said.

The NEMA boss said his agency wants to help avoid the loss of lives that has resulted from the measles epidemic. He said that the agency had carried out several awareness and sensitisation programmes in collaboration with state governments.

"We have carried out free immunisation exercises, monitoring the states' preparedness on epidemic and trained disease and surveillance notifications officers on effective reporting.

"Stakeholders must know the importance of working with NEMA to avoid more death cases in the country, especially this period as the rain has set in," he said. He urged the state Ministries of Health in the country to improve on mitigation efforts to prevent avoidable hazards from developing to disasters.

Also speaking, Joseph Kumba, Director, Public Health, Benue State Ministry of Health, called on parents to immunise their children and maintain good personal and environmental hygiene. He said such measures would help in the control of epidemics that may occur during the rainy season. "In this country, we have free routine immunisation that is given to every child under the age of 5. So, I [advise] mothers to take their [children under 5] to the nearest health facilities to ensure that they are immunised against measles, against other contagious diseases, and against polio. "For our own sake, the critical [factor] is our personal hygiene. Most epidemics that occurred in our environment are occurring because of poor environmental hygiene.

"I [advise] that if your source of water is not hygienically verified, it will be [necessary] to boil your water, filter it before taking it. If we take some of these precautionary measures, we will be able to control a lot of epidemics that would occur, especially during this rainy season," he said.

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[3] Pakistan (Punjab)
Date: Mon 17 Jun 2013
Source: The Nation [edited]
http://www.nation.com.pk/pakistan-news- ... s-reported


More and more measles patients continued to approach public sector hospitals in the [Punjab] province for treatment, enhancing the burden on already overloaded health facilities facing severe shortage of necessary drugs. On Sunday [16 Jun 2013], as many as 99 measles patients were admitted to different hospitals in the province, including 18 in Lahore. So far, 17 948 measles cases have been reported from across the province, including 5204 in Lahore.

The disease that broke out in Punjab virtually assumed shape of an epidemic as 6 to 10 measles-affected children were being reportedly taken on a daily basis [to] the 3 teaching hospitals from different parts of the district. Ironically, officials of the district health department termed the situation normal and under control, while the surge in cases of measles speaks otherwise.

HFH [Holy Family Hospital] Spokesman Dr Javed Hayat confirmed that a total of 6 children have been admitted in the hospital. He said that out of 6 children, 5 were brought from different areas of Rawalpindi and Islamabad while one [was brought] from Attock. He said that the doctors were medicating the patients and [that the] condition of all patients was stable.

So far, a total of 516 cases of measles have been reported in teaching hospitals including Benazir Bhutto Hospital, HFH and District Headquarters Hospital. Of the total number, 295 were only reported in HFH.

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MEASLES UPDATE (26)
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[1] Angola (Uige)
Date: Wed 26 Jun 2013
Source: Angop, Angola Press [In French, trans., edited]
http://www.portalangop.co.ao/motix/fr_f ... 61cc3.html


A total of 45 new cases of measles were registered between 17 and 23 Jun 2013 in Uige, according to the Angop news agency on 26 Jun 2013. According to a reliable source, these new cases were registered in the municipalities of Uige, Negage, Quimbele, Sanza Pombo, Songo, Ambuila, Buengas, Bungo Milunga and Maquela do Zombo. This source further stated that the municipality Uige is the worst affected with 9 cases.

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[2] Democratic Republic of Congo (Orientale)
Date: Fri 21 Jun 2013
Source: Radio Okapi (Kinshasa) [In French, trans., edited]
http://healthmap.org/ln.php?1793833&trt ... r=fr&u3409


A total of 356 measles cases with 4 deaths have been recorded since he beginning of January [2013] in the Isiro Health Area of Orientale province of the DRC [Democratic Republic of Congo]. The senior doctor of the Health Zone, Benjamin Anduguwe, stated on Fri 21 Jun 2013 that children in the age range from 0 to 5 years old were most affected by this disease. "At the present time, we have 4 times the number of cases observed in previous years, and a 3-fold increase since the beginning of the year. This is why we have designated this a measles outbreak. We have 10 health areas that are affected, including 7 in urban areas and 3 in rural areas," stated the Chief Medical Officer of Health for the Isiro area.

Dr. Benjamin Anduguwe regretted that most parents in this region preferred to treat their children at home rather than bringing them to health facilities where treatment is free. "There are parents who prefer to treat their children with traditional medicines." The senior doctor of the Isiro Health Zone stated that through the Expanded Program for Immunization (Pev), Isiro had received 2 consignments of aid sufficient to provide free treatment for all children of the district.

In April [2013], Dr. Granga Davuya, the Director of Immunization for UNICEF in the DRC, stated that as of that week, 607 000 children aged 0 to 7 years in the DRC had still not been vaccinated. According to him, the current epidemic of measles reflects the incompleteness of the vaccination programme in the DRC. To ensure that all children are protected, the coverage rate for the population must be greater than 95 percent, and this level of protection had not yet been reached in the DRC. He added, however, that by 2010 the vaccination camping had reduced the mortality rate among children under 5 years, from 213 in 2001 to 158 deaths per 1000 live births.

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Communicated by:
ProMED-mail
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[A map of the DRC, showing the location of Isiro in Orientale province can be accessed at http://www.mapsofworld.com/democratic-r ... l-map.html. - Mod.CP

A ProMED-mail HealthMap is available at http://healthmap.org/r/7rZi.]

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[3] Pakistan (Sindh)
Date: Wed 26 Jun 2013
Source: The Frontier Post, Pakistan Press International (PPI) report [edited]
http://www.thefrontierpost.com/article/22681/


As many as 43 measles cases have been reported in Sindh [province] in the month of June [2013], said Director Public Health on Wednesday [26 Jun 2013].

According to Director Public Health, 24 out of the 43 cases of measles, reported in Sindh province in June [2013], were reported in Mirpurkhas, 7 in Jamshoro, 5 in Badin, 4 in Dadu, 2 in Tando Muhammad Khan and one in Umerkot.

He said that one measles patient died in June [2013].

--
Communicated by:
ProMED-mail from HealthMap alerts
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[The situation in Sindh province of Pakistan, though serious, does not appear to be as dire as that previously reported in the Punjab province of Pakistan.

A map of the province of Sindh can be accessed at http://www.findpk.com/yp/html/sindh_.html. - Mod.CP

A ProMED-mail HealthMap is available at http://healthmap.org/r/2NT8.]

MEASLES UPDATE (27)
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A ProMED-mail post
http://www.promedmail.org
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[1] Syria
Date: 18 Jun 2013
Source: Medecins Sans Frontieres (MSF) [abbreviated, edited]
http://www.msf.org/article243/syria-mea ... rian-needs


A measles epidemic is sweeping through districts of northern Syria, with up to 7000 known cases, an indication that humanitarian needs are increasing and the country's healthcare system is in a state of collapse after more than 2 years of civil war. Teams from the international medical organisation Medecins Sans Frontieres (MSF) have vaccinated more than 75 000 children in the provinces of Aleppo, Ar-Raqqah and Idlib in an effort to stem the epidemic among a population previously unused to outbreaks of this kind.

With the onset of violence in 2011, Syria's routine vaccination programme was disrupted throughout much of the country, leaving thousands of children unprotected. In addition, hundreds of thousands of people have fled their homes for camps for displaced people or overcrowded accommodations where sanitary conditions are poor. While mortality rates in the current outbreak remain relatively low, measles increases children's vulnerability to other infections, and when basic medical care is unavailable, complications arising from measles can be life-threatening.

The measles epidemic is a sign of the worsening humanitarian situation in northern Syria and the desperate situation in which much of the population is living. While MSF teams have vaccinated more than 15 000 children in the city of Aleppo and more than 22 000 in the rest of Aleppo province, it was a struggle to complete the vaccination campaign due to widespread violence and the fear that dominates people's lives. Queues for vaccinations had to be avoided for fear they might attract airstrikes or rocket attacks.

In Ar-Raqqah province, MSF has vaccinated 35 000 children so far in just one of the 3 districts. The partial coverage is due to security constraints and leaves thousands of children vulnerable to the disease.

In Idlib province, 164 cases of measles were reported in May 2013, and this figure increased in June 2013. This outbreak comes despite MSF's mass vaccination campaign in February 2013, when teams immunised 1900 children under the age of 5 in an area close to the border where more than 40 000 internally displaced people were living. MSF is planning to perform a 2nd mass vaccination in the camps and surrounding villages for all children under the age of 15. The target group could be anything from 10 000 to 30 000 children, as it is almost impossible to get accurate figures for the shifting population. The new surge in measles in the Idlib area is probably due to the continuous arrival of displaced people fleeing the fighting. A similar situation is unfolding in different parts of northern Syria.

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Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

[A ProMED HealthMap is available at http://healthmap.org/r/3aLZ.]

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[2] Congo DR (Bandundu)
Date: Sat 6 Jul 2013
Source: Radio Okapi [in French, machine trans. edited]
http://radiookapi.net/actualite/2013/07 ... res-tembo/


A dozen cases of measles have been reported on Fri 5 Jul 2013 in the area of rural health Tembo, 680 km from Bandundu city, capital of the province of Bandundu. The president of the local civil society, Jean Kayishi, says no deaths have been registered so far. He fears that the measles can reappear due to lack of appropriate treatments. Jean Kayishi says patients without means prefer to be treated according to traditional medicine.

The President of the Civil Society of Tembo requested the medical authorities to take appropriate action. "This disease has reappeared with the arrival of Congolese refugees expelled from Angola where the infection has been neglected," said Jean Kayishi in an interview with Radio Okapi. He noted that the area health authorities are involved but cannot contain the situation around Tembo.

We recall that last September 2012, measles affected 594 patients, 21 of whom died, in Kikwit, which is 800 km from the city of Tembo (Bandundu).

--
Communicated by:
ProMED-mail from HealthMap Alerts
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[Bandundu is one of the 11 provinces of the Democratic Republic of the Congo. It borders the provinces of Kinshasa and Bas-Congo to the west, Equateur to the north, and Kasai-Occidental to the east. The provincial capital is also called Bandundu (formerly Banningville).

In 1966, Bandundu was formed by merging the 3 post-colonial political regions: Kwilu, Kwango, and Mai-Ndombe. - Mod.CP

A ProMED HealthMap is available at http://healthmap.org/r/1Ahy.]

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[3] India (Orissa)
Date: Sat 6 Jul 2013
Source: Times of India, Berhampur [edited]
http://timesofindia.indiatimes.com/city ... 937480.cms


An expert team from Berhampur on Fri 5 Jul 2013 rushed to Ganjam's Dasiamaripalli village where a 4-year-old girl reportedly died of measles on Thursday [4 Jul 2013]. At least 20 others have been infected in the village over the past week. "At least a dozen children, aged between 2 and 7 years, have been admitted to MKCG Medical College and Hospital here. Their condition is stable," said chief district medical officer (CDMO) P K Kar.

A senior paediatric specialist, an epidemiologist, a consultant with World Health Organisation (WHO), a laboratory technician, and a medical team from the nearby hospital were in the village to treat the other patients, he said. A doctor told the Times of India that the disease spread because people did not report the incidents.

The residents claimed that the children suffered from the disease despite vaccination. Health department sources said a decision to re-vaccinate children in the village as well as in the adjoining areas would be taken up after studying the prevailing situation.

--
Communicated by:
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[Brahmapur (earlier known as Berhampur) (Oriya: nicknamed "The Silk City," is a city located in the eastern coastline of Ganjam district of the Indian state of Odisha, about 160 km (99 miles) south of the state capital, Bhubaneswar. It is one of the oldest and largest city of Odisha. It is famous for its silk saris, famous temples and its unique culture. The latest estimate of the population of the city is 355 823 (2011 census), making it the 4th most populous urban city in the Odisha state and 58th overall in India. Brahmapur (or Berhampur) also got the status of a Corporation after Bhubaneswar and Cuttack. - Mod.CP

A ProMED HealthMap is available at http://healthmap.org/r/2i2v.]

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[4] Pakistan (Punjab)
Date: Tue 2 Jul 2013
Source: Dawn Newspaper [edited]
http://x.dawn.com/2013/07/03/104-new-cases-of-measles/


About 20 707 cases of measles have been reported in Punjab province during the last 6.5 months with the addition of 104 new cases during the last 24 hours.

According to health department officials, at least 182 deaths have been reported so far, and most deaths occurred in Lahore, Gujranwala, Rajanpur, Rahim Yar Khan, Faisalabad, Sialkot and Kasur.

During the last 24 hours, around 104 cases of measles were reported in Punjab, including 24 in city hospitals.

--
Communicated by:
ProMED-mail from HealthMap Alerts
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[A ProMED HealthMap is available at http://healthmap.org/r/1iGJ.]

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[10] Pakistan (Punjab)
Date: Sat 6 Jul 2013
Source: The News International [edited]
http://www.thenews.com.pk/Todays-News-5 ... s-reported


LAHORE: More than 20 measles cases were reported in different hospitals of Lahore here Friday [5 Jul 2013], raising the toll of the patients to more than 5000 in the provincial metropolis so far. According to sources, total measles cases in Punjab had crossed the figure of 21 000 so far. Among them, 180 deaths have been reported in Punjab and 80 in Lahore alone.

--
Communicated by:
ProMED-mail from HealthMap Alerts
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[A map showing the location of the Pakistani province of Punjab can be accessed at: http://mappery.com/Pakistan-New-Provinces-Map-2. - Mod.CP

A ProMED HealthMap is available at http://healthmap.org/r/1iGJ.]