And now Dengue in Madiera, Portugal

CDC / Dengue in Madeira, Portugal

Center for Disease Control and Prevention: Outbreak notice: December 20, 2012

 

What Is the Current Situation?

As of December 9, 2012, 2,050 cases of dengue fever have been reported from the Portuguese island of Madeira. There have been 58 cases of dengue reported in European travelers returning from Madeira.

At this time, CDC does not advise against travel to Madeira. However, travelers should protect themselves from mosquito bites.

 

What Is Dengue?

Dengue is an illness caused by a virus that is spread through mosquito bites. Symptoms include fever, headache, nausea, vomiting, rash, and pain in the eyes, joints, and muscles. Symptoms can take up to 2 weeks to develop after you are bitten by an infected mosquito but usually last one week. In severe cases, symptoms may include intense stomach pain, repeated vomiting, and bleeding from the nose or gums. See a doctor right away if you have these symptoms.

Travelers who go to tropical and subtropical regions are at risk of getting dengue. These areas include parts of the Caribbean, Central and South America , Western Pacific Islands, Australia (Queensland), Southeast Asia, and Africa. 

Dengue is more common in urban areas and is not usually seen at altitudes above 5,000 feet (1,500 meters). The mosquito that carries the dengue virus bites both day and night and is commonly found indoors as well as outdoors.

 

Clinician Information:

 

Early and proper diagnosis of dengue is important, as many other diseases may mimic dengue. Health care providers should consider dengue, malaria, chikungunya, and leptospirosis, depending on the itinerary and exposure, in the differential diagnosis of patients who have fever and a history of travel to tropical areas during the 2 weeks before symptom onset.

 

Source: CDC / Dengue in Madeira, Portugal

AVIAN INFLUENZA, HUMAN (64): 2012 CASE COUNT

A ProMED-mail post
Archive Number: 20121230.1475459
Date: Fri 28 Dec 2012

Source: The Poultry Site [edited]

http://www.thepoultrysite.com/poultrynews/27667/who-reports-32-cases-of-h5n1-in-humans-this-year

According to the World Health Organisation (WHO), there have been 32 cases of avian A(H5N1) influenza virus infection in humans so far this year [2012], 20 of whom have died.
According to the latest figures, published by WHO on 17 Dec 2012, most of the victims were in Egypt (11 cases; 5 deaths) but there were also 9 cases in Indonesia, 4 in Viet Nam, 3 in Bangladesh and Cambodia, and 2 in China.
Last year, 2011, there were 62 cases, of whom 34 died.
Since the emergence of H5N1 influenza in 2003, 610 people are reported to have become infected, 360 of whom have died.
Comments:
It is very important to keep monitoring Avian Flu cases, since this is a potential source of the next Flu Pandemic. It is important to remember that the present Flu vaccine does not cover the Avain Flu virus, and we do not have any innate immunity against this strain, leading to high morbidity and mortality due to this infection

INFLUENZA - (116): (USA), EARLIEST START IN A DECADE

A ProMED-mail post
Archive Number: 20121231.1476318
Date: Sat 29 Dec 2012

Source: The Washington Post, Associated Press report [edited]

http://www.washingtonpost.com/national/health-science/early-flu-season-could-be-severe-experts-warn/2012/12/29/9ae51816-5045-11e2-839d-d54cc6e49b63_story.html?wpisrc=nl_headlines
The flu season in the United States is having its earliest start in nearly a decade, and health officials say this season [2012-2013] could be a bad one. Although flu is always unpredictable, the early nature of the cases and the predominant type circulating this year [2012] could make this a severe flu season, said officials at the Centers for Disease Control and Prevention [CDC]. But officials said the vaccine formulated for this year is well-matched to the strains of the virus seen so far and urged those who have not been vaccinated to get a flu shot.
In early December 2012, the CDC said it was noticing an increase in flu activity about a month before authorities normally see it, and the earliest since the 2003-2004 flu season. The primary strain this season is H3N2, an influenza A virus that has been associated in the past with more severe flu seasons.
Since the beginning of December [2012], "there has been increasing influenza activity in more parts of the United States and more cases of flu," said Joe Bresee, chief of epidemiology at CDC's influenza division, in an interview last week. "We have seen increasing trends that flu is increasing in the last few weeks of the year, and I wouldn't be surprised if we see that continue into the new year." Influenza often peaks in January, February or even later.
Reports of flu have been reported in 29 states, including Maryland and Virginia. As of 15 Dec 2012, higher-than-normal reports of flu-like illnesses had been reported in 12 states, most of them in the South and Southeast. They are: Virginia, Alabama, Georgia, Louisiana, Mississippi, Missouri, North and South Carolina, Tennessee, Texas, Illinois and Utah.
Based on data from the past 2 decades, during the years when H3N2 is the predominant flu strain, "there are more deaths and hospitalizations," Bresee said. It is not completely clear why. One factor may be that the elderly, who are at high risk for flu complications, tend to become sicker with the H3N2 strain than the other 2 common flu strains, he said.
But this flu season offers 2 bits of good news as well. Of the flu strains that are spreading this year [2012], about 80 percent are the influenza A type, and almost all of those are the H3N2 strain, Bresee said. That matches well with this year's flu vaccine, which includes the H3N2 strain. Flu vaccines are designed to protect against 3 influenza viruses that experts predict will be the most common during the upcoming season. The 3 kinds of influenza viruses that commonly circulate among people today are influenza B, influenza A (H1N1), and influenza A (H3N2). Each year, one flu virus of each kind is used to produce seasonal influenza vaccine.
Also, the Food and Drug Administration on 21 Dec 2012 expanded the approved use of Tamiflu [a neuraminidase inhibitor] to treat children as young as 2 weeks old who have shown symptoms of flu. The drug was previously approved to treat adults and children one year and older. The dose for children under one year old must be based on their exact weight.
Flu is extremely unpredictable. "You never know when the peak will occur or how big the peak will be," Bresee said. "If you've seen one flu year, it's just one flu year." Last winter's flu season [2011-2012], for example, set a new record for the lowest and shortest peak of influenza-like illness. The season began late and was mild compared with most previous seasons. The last time a regular flu season started this early was the winter of 2003-04, which proved to be one of the deadliest seasons in the past 35 years, with more than 48 000 deaths. The dominant type of flu back then was the same one seen this year [2012]. But experts said there is a critical difference between then and now: In 2003-04, the vaccine was poorly matched to the predominant flu strain. Also, health officials said more vaccine is available now, and vaccination rates have risen for the general public and for key groups such as children, pregnant women and health-care workers.
About 112 million Americans had been vaccinated by the end of November 2012, the CDC said. Manufacturers were expecting to produce about 135 million total doses this year [2012]. Flu vaccinations are recommended for everyone 6 months or older. On average, about 25 000 Americans die each flu season, according to the CDC.
Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches, and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications. A strain of swine flu that hit in 2009 caused a wave of cases in the spring and then again in the early fall. But that was considered a unique type of flu, distinct from the conventional strains that circulate every year, experts said.
Comments:
While this may not be true for India, it is still a good idea to cover everyone who is recommended the flu vaccine (as per IAP recommended high-risk category) as soon as possible.

IAP recommended vaccines for High-risk* children (Vaccines under special circumstances):  1. Influenza Vaccine, 2. Meningococcal Vaccine, 3. Japanese Encephalitis Vaccine, 4. Cholera Vaccine, 5. Rabies Vaccine, 6. Yellow Fever Vaccine, 7. Pneumococcal Polysaccharide vaccine (PPSV 23).

*High-risk category of children:
• Congenital or acquired immunodeficiency (including HIV infection)
• Chronic cardiac, pulmonary (including asthma if treated with prolonged high-dose oral corticosteroids), hematologic, renal
(including nephrotic syndrome), liver disease and diabetes mellitus
• Children on long term steroids, salicylates, immunosuppressive or radiation therapy
• Diabetes mellitus, Cerebrospinal fluid leak,  Cochlear implant, Malignancies
• Children with functional/anatomic asplenia/hyposplenia
• During disease outbreaks
• Laboratory personnel and healthcare workers
• Travelers
Source

PERTUSSIS - AFGHANISTAN: (BADAKHSHAN), FATALITIES

Promed

Subject: PRO/EDR> Pertussis - Afghanistan: (BD), fatalities 
Archive Number: 20130101.1477768

Date: Sat 29 Dec 2012

Source: PakTribune, Pakistan News Service [edited]

http://paktribune.com/news/Whooping-cough-kills-12-children-256076.html

The provincial governor spokesman said 12 children suffering from whooping cough died in a snow-bound district in the northeastern province of Badakhshan.
Spokesman Abdulmaroof Rasekh said the children were between the ages of 1 and 5 years old, and the deaths took place in Shoorian village bordering Tajikistan, located in Nasi Darwaz district of the province. He said local officials learned of the deaths last week. About 350 other children in the area are suffering from the whooping cough epidemic.
The village remains inaccessible from Afghanistan, so a health team was sent from Tajikistan 27 Dec 2012. The team is now treating the children and providing them nutritious food, Rasekh added.
Heavy snow has blocked access to 12 districts in Badakhshan, and teams are unable to reach other areas with potential health emergencies. Officials have said they will call in the Afghan National Army for help if needed.
--
Communicated by:
ProMED-mail from HealthMap Alerts
[The scope of this outbreak is not clear. Most pertussis-associated deaths are in quite young, unimmunized children who are in contact with older children or young adults with milder illness. Pertussis mortality can be minimized not only by immunization with trivalent vaccine against tetanus, diphtheria, and pertussis, but also by early antimicrobial intervention. Large populations of susceptible people in the developing world are the cause of large outbreaks of vaccine-preventable diseases.]