Sudan: New Yellow Fever Cases Registered in Central Darfur

Zalingei — The health minister of Central Darfur announced that new cases of yellow fever have been registered in the state, on Wednesday, 26 December.

However, Issa Mohamed Moussa Yousef explained that all patients come from the gold mining area of Jebel 'Amer, North Darfur, and stressed that Central Darfur has not recorded any new cases of the disease in more than two weeks.

Speaking to Radio Dabanga, the minister disclosed that one person died of yellow fever in the Roakirro locality and that another five people are infected; four of them are hospitalized in Zalingei and the other is being treated in Wadi Saleh.

This brings the total yellow fever death toll to 83 and infection cases to 443, Yousef pointed out.

The minister said that vaccination campaigns have been completed in the localities of Mukjar and Bindissey and added that the third phase of the campaign is about to be finalized in the Umm Dukhum locality.

"End of yellow fever"

Ishaq Ahmed Yaqoub, health minister of West Darfur, announced the "end of yellow fever" in the state.

He spoke with Radio Dabanga from the state's capital, El-Geneina, and asserted that West Darfur has not recorded any new cases of yellow fever for three weeks.

Nevertheless, the minister expressed concern about other diseases affecting the population, such as diarrhea, bronchitis and viral hepatitis.

Alike in Central Darfur, Yaqoub suggested that most yellow fever cases are coming from Jebel 'Amer.

Third phase in South Darfur

In the meantime, Ahmed al-Tayyeb, minister of health of South Darfur, announced the launch of the third phase of the vaccination campaign in the state, which will incorporate the remaining localities in the state by the end of this month.

The minister explained to Radio Dabanga that the second phase of the campaign is scheduled to be completed by 27 December and that by then 70 percent of the localities should have been covered.

According to al-Tayyeb, a total of 20 people have died of yellow fever in South Darfur and 174 were infected. He pointed out these figures were collected more than two weeks ago.

When asked by Radio Dabanga about the emergence of new diseases in the state, the minister divulged that cases of typhoid, hepatitis and schistosomiasis (also known snail fever) have been registered in some places.

He stressed, however, that work in underway to deal with these newly emerging diseases.

"Silent killer"

Bahr Idriss Abu Garda, federal minister of health, acknowledged the outbreak of schistosomiasis in Sudan during a workshop entitled "Schistosomiasis: A Silent killer".

During the workshop he declared that 80 percent of the population of Sudan are vulnerable to contracting the disease.

The minister revealed that about two million people are infected with schistosomiasis in North Kordofan. According to him, this is the highest infection rate in the country, at 70 percent, followed by East and South Darfur, with 64 and 42 percent respectively.

FDA approves 4-Strain Seasonal Influenza Vaccine

The US Food and Drug Administration (FDA) today approved a new 4-strain influenza vaccine for adults and children aged 3 years and older to help prevent disease caused by the seasonal influenza virus subtypes A and B contained in the vaccine.

Fluarix Quadrivalent (GlaxoSmithKline) is the first intramuscular vaccine to offer protection against 4 influenza strains, the company said.

Currently-administered trivalent (3-strain) influenza vaccines help guard against the 2 A virus strains most commonly occurring in humans and the B strain expected to be predominant in a given year, the company noted in a statement.

However, since 2000, 2 B influenza virus strains (Victoria and Yamagata) have cocirculated to varying degrees each influenza season. Various degrees of mismatch have occurred between the B strain included in trivalent vaccines and the B strain that actually circulated, causing an increased risk for influenza-related morbidity across all age groups.

The new 4-strain vaccine continues to help protect against the 2 A strains and also adds coverage against a second B strain.

"Trivalent influenza vaccines have helped protect millions of people against flu, but in 6 of the last 11 flu seasons, the predominant circulating influenza B strain was not the strain that public health authorities selected," Leonard Friedland, MD, vice president and director of clinical and medical affairs at GlaxoSmithKline North America Vaccine Development, said in a statement.

"Fluarix Quadrivalent will help protect individuals against both B strains and, from a public-health standpoint, can help decrease the burden of disease," he concluded.

The company said the vaccine will be available in time for the 2013-2014 influenza season. The company added it will also fulfill orders for its trivalent vaccines.

Fluarix Quadrivalent is not currently approved or licensed in any country outside of the United States.

The full US prescribing information will be available on the manufacturer's Web site.

Source

Comments: Given the inadequate efficacy of the currently available flu vaccine, this new vaccine shows considerably more promise in preventing Influenza. This is likely to benefit travelers especially during epidemics when air travel is a commonly implicated mechanism for rapid spread of illness.

TYPHOID FEVER UPDATE 2012 (12): ZIMBABWE (HARARE)

A ProMED-mail post
http://www.promedmail.org
Archive Number: 20121209.1443859
Date: Wed 5 Dec 2012 
Source: Zimeye [edited]
http://www.zimeye.org/?p=68014

A life threatening typhoid outbreak has been reported in Harare's Dzivaresekwa high-density suburb and surrounding areas, about 10 km from the capital city. An alert was sent out last night [4 Dec 2012] through the Harare Residents Trust issuing caution to people in the area. It is reported that school children at Nhamburiko Primary School have recorded the highest figures of affected people to date.

Harare city council authorities have been blamed for the outbreak due to council's failure to provide clean water supplies to residents. The capital is not new to the bacteria [_Salmonella enterica_ serotype Typhi], and earlier this year [2012], environmental scientists revealed that many water sources across the city have been affected due to sewer spillage.

One Hararian protested against the mayor: "The Mayor looks down upon the poor and the marginalised. He thinks they are lazy and do not want to develop. But give him an opportunity, [and] he is convincing in his presentations but lacks on delivery and relevance to the citizenry."

A statement by the Harare Residents Trust reads: "Alert: There has been a typhoid outbreak in Dzivarasekwa. The local clinic has transferred about 15-16 people to Beatrice Infectious [Diseases] Hospital every day since last week. The most affected are the pupils at Nhamburiko Primary School. Harare City Council's failure to provide clean water to the residents is compounding the situation!"

Presidential Health consultant Dr Timothy Stamps has provided guidance on identifying typhoid as follows:

Typhoid is especially an urban disease. The diagnosis can only be made definitely by either a blood culture (which indicates that the infectious organism has gotten into the blood system) or by rectal swab/faecal culture of the causative organism. Indirect methods such as the Widal titre (O and H antigens) are of limited value, especially as an outbreak progresses.

The classical picture of typhoid fever is a temperature which is intermittent for the 1st week or so of the illness, then becoming persistent and sometimes very high, coupled with vague symptoms such as headache, weakness, sore joints, abdominal pains (especially in the appendix area), and constipation (kufufutirwa) rather than diarrhoea (manyoka).

Most typhoid sufferers react badly to aspirin, headache pills, or powders and in a generalised outbreak should be restricted.

Rose spots, which disappear on pressure, occur on the chest and upper abdomen in the 1st week of the disease; they are not easy to detect in most Zimbabweans.

KYASANUR FOREST DISEASE - INDIA - Confirmed

A ProMED-mail post
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Archive Number: 20121207.1442844
Date: Mon 3 Dec 2012
Source: Deccan Herald [edited]
http://www.deccanherald.com/content/296184/monkey-fever-confirmed.html

A medical report from the National Institute of Virology in Pune has confirmed that the recent death of monkeys in the Bandipur National Park limits was due to 'Kyasanur Forest disease' (KFD). 

The blood samples were sent to the centre soon after 12 monkeys died of the suspected fever at Alegowdanakatte camp in Maddur division, said Pushkar, the tiger reserve project director.

The daily wage workers of the Forest department too were affected by the epidemic.

Following the report confirming the prevalence of the KFD virus, a meeting of the veterinarians and the officials of the Forest department has been convened to discuss preventive measures. 

Soon, the residents in the surrounding villages will be administered a vaccine to check the spread of the infectious disease, he added. 

UNDIAGNOSED FATALITIES - NIGERIA

A ProMED-mail post
http://www.promedmail.org
Archive Number: 20121207.1442547
Date: Fri 7 Dec 2012

Source: All Africa, Daily Trust report [edited]

http://allafrica.com/stories/201212070831.html
At least 5 people have been confirmed dead, while 70 others are lying critically ill at the hospital following an outbreak of a yet to be diagnosed ailment. It was gathered that over 200 households in the border area of Mubi-South in Adamawa State have been affected.
On Wednesday [5 Dec 2012], Usman Lamorde, member representing Mubi-South in the state House of Assembly, confirmed the death toll, saying the nature of the disease has not been determined.
Speaking on the floor of the House, Usman Lamorde said over 200 households were affected in Nduku-Seranyi village. "This disease comes without warning, and by the time it is discovered, it's too late. The disease is characterized by excessive vomiting, diarrhoea, high fever, and in some instances, coughing, hence the need for urgent intervention," he said.
Following the motion, Speaker of the state Assembly, Umaru Ahmad Fintiri, ordered that health officials be deployed with immediate effect to curtail the spread of the disease.
When contacted, the state's Commissioner for Health, Mrs Lilian Stephen, said disease control personnel have moved to the affected areas, and that the state government is waiting for the outcome of the specimen sent for analysis.
According to her, samples have since been sent to the Federal Medical Centre (FMC) Gombe for analysis.
[Byline: Ibrahim Abdul'Aziz]

New polio strain from Pakistan hits Afghanistan

A ProMED-mail post
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Archive Number: 20121203.1435756
Officials say newly-discovered Sabin-Like ([type]2) [polio virus that is genetically similar to the oral polio vaccine is referred to as a vaccine-derived poliovirus -- VDPV, and when there are 2 or more cases of the same genetically lined virus, it is considered to be a circulating vaccine derived poliovirus -- cVDPV) poliomyelitis originated in Balochistan. 
With the Independent Monitoring Board recommending travel restrictions on polio endemic countries, reports of the transmission of a newly-discovered poliovirus strain from Pakistan to Afghanistan is likely to complicate an already tough situation for Islamabad.
Two Afghan children, living close to the border with Pakistan, have been paralysed by the Sabin Like (2) poliomyelitis [cVDPV2], officials in the Polio Programme told The Express Tribune. The cases were reported from Afghanistan's Kandahar province 2 days ago -- one in Panjwai district and the other in Spin Boldak, they added. The World Health Organisation (WHO) has confirmed the 2 new cases.
According to the officials, genetic sequencing has confirmed the new polio strain originated in Balochistan's Killa Abdullah district. They said Sabin Like (2) [cVDPV2] poliomyelitis develops in children with an extremely poor record of routine immunisation -- a situation rampant in Balochistan.
Since 2006, polio vaccination teams have repeatedly missed an estimated 50 000 children in Killa Abdullah, derailing efforts to eradicate the virus in the country. This is not the 1st case of poliovirus transmission from Pakistan to a neighbouring country either. Last year [2011], 16 children in China's Xinjiang province were paralysed after being infected by a polio strain originating in Pakistan.
"The paramedic association and health department of Balochistan continues to hold the polio-eradication campaign hostage in Killa Abdullah through unfair demands... It has now resulted in embarrassment for Pakistan before the world community," an official of the Expanded Programme on Immunisation (EPI) told The Express Tribune on condition of anonymity.
WHO senior coordinator for polio eradication Dr Elias Durry said the organisation was monitoring the situation in Balochistan closely.
"We are seriously concerned about the new poliovirus strain and are recommending urgent steps to the provincial government to contain the outbreak," said Dr Durry. The only way to contain the spread of the virus is by conducting 3 to 4 high-quality polio vaccination rounds in the infected districts and their nearby areas," he said.
Meanwhile, a special WHO delegation, led by internationally acclaimed polio eradication expert Dr Mohammed Mohammedi, has reached Balochistan and is holding in-depth discussions with the provincial government over ways to combat the outbreak.
"We have asked the provincial government to hold 3 emergency polio campaigns each in Quetta, Killa Abdullah, and Pishin districts during a span of 30 days to control the spread of the virus to other parts of the country," said Dr Mohammedi, adding that the 1st campaign in the 3 districts was scheduled for [10 Dec 2012].
Pakistan has reported a total of 56 polio cases this year [2012] so far. A massive 181 cases were reported in 2011.

CDC / Cholera in the Dominican Republic, update

Center for Disease Control and Prevention: Outbreak notice: November 28, 2012

 

What is the Current Situation?

 

An outbreak of cholera has been ongoing in the Dominican Republic since November 2010. According to the Dominican Ministry of Health (Ministerio de Salud Publica y Asistencia Social [MSP]), as of November 3, 2012, 6,622 suspected cholera cases and 47 suspected cholera-related deaths have been reported for 2012.

What is Cholera?

 

Cholera is a bacterial disease that can cause diarrhea and dehydration. Cholera is most often spread through the ingestion of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated by water containing cholera bacteria or by being handled by a person ill with cholera.

 

How can Travelers Protect themselves?

Most travelers are not at high risk for getting cholera, but people who are traveling to the Dominican Republic should exercise caution to avoid getting sick.

CDC recommends that all travelers prepare a travel health kit when going abroad. If you are planning travel to the Dominican Republic, CDC advises packing the following supplies in your travel health kit to help prevent cholera and to treat it.

• A prescription antibiotic to take in case of diarrhea
• Water purification tablets
• Oral rehydration salts

Dukoral vaccine is not available in USA but is available in Canada.

• Drink and use safe water*
• Wash your hands often with soap and safe water*
• Use toilets; do not defecate in any body of water
• Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables ( Boil it, cook it, peel it, or leave it.)
• Clean up safely in the kitchen and in places where the family bathes and washes clothes

Before departing for the Dominican Republic, talk to your doctor about getting a prescription for an antibiotic. If you get sick with diarrhea while you are in the Dominican Republic, you can take the antibiotic, as prescribed. Also, remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.

If you have severe watery diarrhea, seek medical care right away.

 

Source: CDC / Cholera in Dominican Republic, update