Vol. 2 Issue 2, March 26, 2012
Content
Overview of reported outbreaks in the WHO African Region Cholera Meningitis
Ongoing outbreaks
Lassa Fever in Nigeria
Typhoid in Zimbabwe
Meningitis in Burkina Faso
Meningitis in Uganda
Meningitis in Ethiopia
Meningitis in Benin
Nodding Syndrome in Uganda
Meningitis in Cote d’Ivoire
Anthrax in Lesotho
Introduction
In this issue, a general overview of outbreaks that occurred within the WHO African Region between January and February 2012 is provided as well as a summary of ongoing outbreaks as reported by Member States.
...
Cholera
Between January and February 2012, a total of 10 691 cases and 178 deaths were reported from 13 countries resulting in a CFR of 1.7% (Table 1). DR Congo and Sierra Leone accounted for 86% of the total number of cases and 65% of the total number of deaths (Figs. 3 and 4).
...
Meningitis
Between 01 January and 11 march 2012, a total of 6 634 cases and 646 deaths have been reported from 14 countries (Table 2). The overall CFR was 9.7%. 20 districts from 9 countries experienced meningitis epidemics during the period under review.
...
Ongoing outbreaks
Lassa Fever in Nigeria
At the beginning of 2012, WHO was notified by The Federal Ministry of Health in Nigeria of an outbreak of Lassa fever. As of March 22, 2012, 623 cases, including 70 deaths (CFR 11.23%) have been recorded from 19 of the 36 States since the beginning of the year. Of these, 108 have been laboratory confirmed. Three doctors and four nurses were reported to be among the fatalities.
...
Typhoid in Zimbabwe
Fig. 9. Distribution of typhoid cases by date of onset, 10 October 2011 - 12 March 2012
Since 10 October 2011, Harare City has been experiencing an outbreak of Typhoid Fever. Between 10 Oc-tober 2011 and 04 March 2012, a total of 3 772 cases have been reported without deaths. Since the beginning of 2012 till March 04, 2649 cases were recorded. On the reporting epidemiological week 9 (week ending 4 March 2012), 198 new cases were reported from Harare (n=177), Bindura (n=18) and Chegutu (n=3). The distribution of cases by places of residence and date of onset is shown in Figure 8 and 9, respectively.
...
Meningitis in Burkina Faso
The Ministry of Health in Burkina Faso notified WHO on March 19, 2012 of a meningococcal meningitis epi-demic in Solenzo and Sindou districts. As of 11 March 2012, a total of 1966 cases and 212 deaths were re-ported resulting in a case fatality of 10.8%. The epidemic thresholds were crossed during epi week 8 (week ending 26 February 2012). Figures 10 and 11 show the geographic distribution of the ongoing meningitis out-break and the weekly distribution of meningitis cases in Burkina Faso, respectively. Preventive and control measures are ongoing.
...
Meningitis in Uganda
The districts of Amuru and Kiryandongo are reporting suspected Meningitis epidemics. While the attack rates had reached the epidemic threshold in epi-weeks 8 and 9 in both districts, the number of cases has since re-duced to below alert thresholds. Laboratory analysis conducted in Lacor Hospital in Gulu district and Central Public Health Laboratory (CPHL) did not isolate any causative agents. Additional samples had been collected from the suspected cases to confirm the causative organism.
As of March 20, 2012, twenty six (26) suspected cases of meningitis from Amuru district with 5 deaths (CFR=19.23%) have been reported. The initial cases were reported in epidemiological week 5 and increased gradually, attaining a peak of 10 cases in epi weeks 8 and 9 - translating to an attack rate (AR) of 18.6 cases per 100,000 population. The cases have since then reduced to an average of 1 (or less) case per day. The disease has predominantly affected persons below the age of 45 years with the most affected age-group be-ing children 1-14 years.
In Kiryandongo district a cumulative of 44 suspected cases, with six 6 deaths (CFR 13.6%) have been report-ed between January 28 and March 20, 2012. Most of the cases have been recorded in the 15-29 year age-group but significantly high numbers have been reported in the 1-14 year and 30-44 years age-groups.
...
Meningitis in Ethiopia
The National Public Health Emergency Management Center of Ethiopian Health and Nutrition Research Insti-tute received reports of an increased number of suspected meningitis cases from Kemata Tembaro, Wolyita, Hadya Zones and Halaba Special districts (locally called Woredas ) of the Southern Nations Nationalities and Peoples (SNNPR) Region since the 6th of February 2012. As of 8th March 2012, a total of 58 suspected cas-es with 0 death were reported from 12 woredas and 3 administrative towns. The suspected cases were dis-tributed over different places at different times and hence do not constitute outbreak but most of them (54%) are reported from Kachabira Woreda of Kembata Tembaro Zone. In Kachabira woreda with population of 133,304, the suspected meningitis cases started to increase from the 4th epi week and reached peak in the 6th epi week indicating that it is an outbreak. The cases start declining from the 7th epi week on wards. The most affected age group is 2 - 30 Years (65%). Due to late prepositioning of Rapid Diagnostic Test (Pastorex), only 5 samples were collected and tested using RDT and three out of the 5 samples tested posi-tive for meningococcal meningitis serogroup B (further laboratory investigation is being undertaken to validate and document the finding)
...
Meningitis in Benin
The Ministry of Health of Benin notified WHO of an outbreak on meningitis during the epi-week 7 (week end-ing on 19 February 2012. As of 11 March 2012, a total of 381 cases and 38 deaths (CFR 10%) were reported from the following three districts in epidemic: Nikki (70 cases and 6 deaths, CFR:8.6%), Tanguieta (57 cases and 7 deaths, CFR: 12.3% ) and Perere district (44 cases and 4 deaths, CFR: 9% ). The Districts of Cobly, Natitingou, Kalale, Materi, Matitingou and Sinende are in alert.
...
Nodding Syndrome in Uganda
The Uganda Ministry of Health reported a mysterious disease condition, referred to as “Nodding Syndrome”, being reported in the Northern Uganda districts of Kitgum, Pader and Lamwo. The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunted growth. The investigations revealed that the disease was a new type of epi-lepsy that was reported to have affected at least 3,000 children in the districts of Kitgum, Lamwo and Pader in Northern Uganda. As of February 14, it is estimated that a total of 3,094 suspected cases with 170 deaths have occurred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. The disease presentation suggests that this is possibly a new type of epilepsy that is characterized by head nod-ding episodes that consist of repetitive dropping forward of the head. There is deterioration of brain function in some of the victims, and malnutrition with growth retardation; many children have dropped out of school.
...
Meningitis in Cote d’Ivoire
An ICG request submitted by national authorities for 300,000 doses of Meningitis Vaccine W135 (including devices) has been approved and mass vaccination campaigns in the 2 epidemic districts i.e. Tengréla (total population - 93,583) and Kouto (total population – 121,897) were conducted.
WHO Country Office has been working with the health authorities in strengthening epidemiological surveil-lance; distribution of supplies, refresher training of health workers on case management and sensitization of the population
Fig. 16. Geographic distribution of meningitis in Cote d’Ivoire, 11 March 2012
Affected districts
The Ministry of Health in Cote d’Ivoire has reported an outbreak of meningococcal meningitis in Central and Northern parts of the country. As of 11 March 2012, a total of 281 cases including 39 deaths were reported .
The Institut Pasteur in Abidjan confirmed the presence of Neisseria meningitidis W135 from samples collect-ed in Tengréla and Kouto districts; while streptococcus pneumoniae was isolated in samples from Bouaké northeast. More laboratory samples are being tested from districts reporting suspected cases for characteri-sation.
...
Anthrax in Lesotho
On 06 March 2012, one of the local radio stations in Lesotho reported an event where people seemed to be having sores on their body after eating meat of animals that died in their villages and skinning of dead ani-mals. It was reported that many animals such as cows and donkeys had died. Around 300 suspected human cases with 3 deaths were reported from three villages (Masaleng Ha Janki, Ha Popa and Mampusi villages) of Berea district. Out of 98 suspected cases in Masaleng Ha Janki, 58 presented with signs and symptoms of Anthrax.
Cases presented with painless black eschar skin lesions/blisters, swelling below the jaws and neck and swelling of the limbs especially hands and arms, abdominal pains, fever and diarrhea.
...
Content
Overview of reported outbreaks in the WHO African Region Cholera Meningitis
Ongoing outbreaks
Lassa Fever in Nigeria
Typhoid in Zimbabwe
Meningitis in Burkina Faso
Meningitis in Uganda
Meningitis in Ethiopia
Meningitis in Benin
Nodding Syndrome in Uganda
Meningitis in Cote d’Ivoire
Anthrax in Lesotho
Introduction
In this issue, a general overview of outbreaks that occurred within the WHO African Region between January and February 2012 is provided as well as a summary of ongoing outbreaks as reported by Member States.
...
Cholera
Between January and February 2012, a total of 10 691 cases and 178 deaths were reported from 13 countries resulting in a CFR of 1.7% (Table 1). DR Congo and Sierra Leone accounted for 86% of the total number of cases and 65% of the total number of deaths (Figs. 3 and 4).
...
Meningitis
Between 01 January and 11 march 2012, a total of 6 634 cases and 646 deaths have been reported from 14 countries (Table 2). The overall CFR was 9.7%. 20 districts from 9 countries experienced meningitis epidemics during the period under review.
...
Ongoing outbreaks
Lassa Fever in Nigeria
At the beginning of 2012, WHO was notified by The Federal Ministry of Health in Nigeria of an outbreak of Lassa fever. As of March 22, 2012, 623 cases, including 70 deaths (CFR 11.23%) have been recorded from 19 of the 36 States since the beginning of the year. Of these, 108 have been laboratory confirmed. Three doctors and four nurses were reported to be among the fatalities.
...
Typhoid in Zimbabwe
Fig. 9. Distribution of typhoid cases by date of onset, 10 October 2011 - 12 March 2012
Since 10 October 2011, Harare City has been experiencing an outbreak of Typhoid Fever. Between 10 Oc-tober 2011 and 04 March 2012, a total of 3 772 cases have been reported without deaths. Since the beginning of 2012 till March 04, 2649 cases were recorded. On the reporting epidemiological week 9 (week ending 4 March 2012), 198 new cases were reported from Harare (n=177), Bindura (n=18) and Chegutu (n=3). The distribution of cases by places of residence and date of onset is shown in Figure 8 and 9, respectively.
...
Meningitis in Burkina Faso
The Ministry of Health in Burkina Faso notified WHO on March 19, 2012 of a meningococcal meningitis epi-demic in Solenzo and Sindou districts. As of 11 March 2012, a total of 1966 cases and 212 deaths were re-ported resulting in a case fatality of 10.8%. The epidemic thresholds were crossed during epi week 8 (week ending 26 February 2012). Figures 10 and 11 show the geographic distribution of the ongoing meningitis out-break and the weekly distribution of meningitis cases in Burkina Faso, respectively. Preventive and control measures are ongoing.
...
Meningitis in Uganda
The districts of Amuru and Kiryandongo are reporting suspected Meningitis epidemics. While the attack rates had reached the epidemic threshold in epi-weeks 8 and 9 in both districts, the number of cases has since re-duced to below alert thresholds. Laboratory analysis conducted in Lacor Hospital in Gulu district and Central Public Health Laboratory (CPHL) did not isolate any causative agents. Additional samples had been collected from the suspected cases to confirm the causative organism.
As of March 20, 2012, twenty six (26) suspected cases of meningitis from Amuru district with 5 deaths (CFR=19.23%) have been reported. The initial cases were reported in epidemiological week 5 and increased gradually, attaining a peak of 10 cases in epi weeks 8 and 9 - translating to an attack rate (AR) of 18.6 cases per 100,000 population. The cases have since then reduced to an average of 1 (or less) case per day. The disease has predominantly affected persons below the age of 45 years with the most affected age-group be-ing children 1-14 years.
In Kiryandongo district a cumulative of 44 suspected cases, with six 6 deaths (CFR 13.6%) have been report-ed between January 28 and March 20, 2012. Most of the cases have been recorded in the 15-29 year age-group but significantly high numbers have been reported in the 1-14 year and 30-44 years age-groups.
...
Meningitis in Ethiopia
The National Public Health Emergency Management Center of Ethiopian Health and Nutrition Research Insti-tute received reports of an increased number of suspected meningitis cases from Kemata Tembaro, Wolyita, Hadya Zones and Halaba Special districts (locally called Woredas ) of the Southern Nations Nationalities and Peoples (SNNPR) Region since the 6th of February 2012. As of 8th March 2012, a total of 58 suspected cas-es with 0 death were reported from 12 woredas and 3 administrative towns. The suspected cases were dis-tributed over different places at different times and hence do not constitute outbreak but most of them (54%) are reported from Kachabira Woreda of Kembata Tembaro Zone. In Kachabira woreda with population of 133,304, the suspected meningitis cases started to increase from the 4th epi week and reached peak in the 6th epi week indicating that it is an outbreak. The cases start declining from the 7th epi week on wards. The most affected age group is 2 - 30 Years (65%). Due to late prepositioning of Rapid Diagnostic Test (Pastorex), only 5 samples were collected and tested using RDT and three out of the 5 samples tested posi-tive for meningococcal meningitis serogroup B (further laboratory investigation is being undertaken to validate and document the finding)
...
Meningitis in Benin
The Ministry of Health of Benin notified WHO of an outbreak on meningitis during the epi-week 7 (week end-ing on 19 February 2012. As of 11 March 2012, a total of 381 cases and 38 deaths (CFR 10%) were reported from the following three districts in epidemic: Nikki (70 cases and 6 deaths, CFR:8.6%), Tanguieta (57 cases and 7 deaths, CFR: 12.3% ) and Perere district (44 cases and 4 deaths, CFR: 9% ). The Districts of Cobly, Natitingou, Kalale, Materi, Matitingou and Sinende are in alert.
...
Nodding Syndrome in Uganda
The Uganda Ministry of Health reported a mysterious disease condition, referred to as “Nodding Syndrome”, being reported in the Northern Uganda districts of Kitgum, Pader and Lamwo. The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunted growth. The investigations revealed that the disease was a new type of epi-lepsy that was reported to have affected at least 3,000 children in the districts of Kitgum, Lamwo and Pader in Northern Uganda. As of February 14, it is estimated that a total of 3,094 suspected cases with 170 deaths have occurred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. The disease presentation suggests that this is possibly a new type of epilepsy that is characterized by head nod-ding episodes that consist of repetitive dropping forward of the head. There is deterioration of brain function in some of the victims, and malnutrition with growth retardation; many children have dropped out of school.
...
Meningitis in Cote d’Ivoire
An ICG request submitted by national authorities for 300,000 doses of Meningitis Vaccine W135 (including devices) has been approved and mass vaccination campaigns in the 2 epidemic districts i.e. Tengréla (total population - 93,583) and Kouto (total population – 121,897) were conducted.
WHO Country Office has been working with the health authorities in strengthening epidemiological surveil-lance; distribution of supplies, refresher training of health workers on case management and sensitization of the population
Fig. 16. Geographic distribution of meningitis in Cote d’Ivoire, 11 March 2012
Affected districts
The Ministry of Health in Cote d’Ivoire has reported an outbreak of meningococcal meningitis in Central and Northern parts of the country. As of 11 March 2012, a total of 281 cases including 39 deaths were reported .
The Institut Pasteur in Abidjan confirmed the presence of Neisseria meningitidis W135 from samples collect-ed in Tengréla and Kouto districts; while streptococcus pneumoniae was isolated in samples from Bouaké northeast. More laboratory samples are being tested from districts reporting suspected cases for characteri-sation.
...
Anthrax in Lesotho
On 06 March 2012, one of the local radio stations in Lesotho reported an event where people seemed to be having sores on their body after eating meat of animals that died in their villages and skinning of dead ani-mals. It was reported that many animals such as cows and donkeys had died. Around 300 suspected human cases with 3 deaths were reported from three villages (Masaleng Ha Janki, Ha Popa and Mampusi villages) of Berea district. Out of 98 suspected cases in Masaleng Ha Janki, 58 presented with signs and symptoms of Anthrax.
Cases presented with painless black eschar skin lesions/blisters, swelling below the jaws and neck and swelling of the limbs especially hands and arms, abdominal pains, fever and diarrhea.
...
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