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Epidemiological Alert: Oropouche in the Region of the Americas (PAHO. February 2, 2024)

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  • Epidemiological Alert: Oropouche in the Region of the Americas (PAHO. February 2, 2024)

    Epidemiological Alert: Oropouche in the Region of the Americas, 2 February 2024

    Format Situation Report Sources

    Posted 3 Feb 2024 Originally published 2 Feb 2024 Origin View original
    ​​In recent months, there has been an increase in the detection of cases of Oropouche fever in certain areas of the Region of the Americas. In addition, there is a heightened prevalence of dengue circulation reported in several countries in the region. In response to this, the Pan American Health Organization / World Health Organization (PAHO/WHO) shares with Member States recommendations for the differential diagnosis of the Oropouche virus and recommends strengthening vector control and personal protection measures for the population most at risk.

    Background in the Region of the Americas

    In the Americas, numerous outbreaks of Oropouche virus disease (OROV) have been reported in rural and urban communities in Brazil, Ecuador, French Guiana, Panama, Peru, and Trinidad and Tobago (1). In most of these outbreaks, people of both sexes and of all ages were affected. In populations with previous contact with the virus, children and young people were most affected (1).

    The circulation of the Oropouche virus is suspected to include both epidemic and jungle cycles. In the jungle cycle, primates, sloths, and perhaps birds are vertebrate hosts, although no definitive arthropod vector has been identified. In the urban epidemic cycle, humans are the amplifying host and OROV is transmitted mainly through the bite of the Culicoides paraensis mosquito that is present in the region, as well as Culex quinquefasciatus, which can also be a vector (1,2,3).

    Outbreaks of Oropouche virus in the last ten years have taken place mainly in the Amazon region.

    Current situation

    In Brazil, on 6 January 2024, the Health Surveillance Foundation (FVS as per its acronym in Portuguese) of the state of Amazonas published an epidemiological alert regarding the detection of cases of Oropouche virus (OROV) disease in this state. The alert reported that between December 2023 and 4 January 2024, the Central Public Health Laboratory of Amazonas (Lacen-AM as per its acronym in Portuguese) analyzed 675 samples, confirming OROV virus infection by molecular detection (PCR) in 199 (29.5%). Of this total, 94.9% (189) correspond to the municipality of Manaus, 2.5% (5) to the municipality of Presidente Figueiredo, 1% (2) to Maués, 1% (2) to Tefé and 0.5% (1) to Manacapuru (4).

    Between 2023 and 2024, in the state of Amazonas, 1,066 human cases with detectable results in the RT-qPCR for Oropouche virus were registered. Of these, 699 samples were from Manaus, 88 from Maués, 69 from Iranduba, 36 from Manacapuru, 32 from Presidente Figueredo, 29 from Parintins, 22 from Carauari, 21 from Itacoatiara, 17 from Rio Preto da Eva, 09 from Careiro, 08 of Borba and Coari, 06 of Novo Airão and Tefé. There is record of transmission in the municipalities of Alvares, Autazes, Barreirinha, Benjamin Constant, Beruri, Boa Vista do Ramos, Caapiranga, Canutama, Cordeiro da Várzea, Itamarati, Lábrea, Nova Olinda do Norte, Novo Aripuanã, São Paulo de Olivença, Tabatinga, and Tapauá (5).

    In addition, cases of OROV reported in the states of Acre and Roraima are under investigation.

    In Colombia, through a study published on 8 December 2022, conducted by the National University of Colombia, 87 cases of Oropouche virus disease occurred between 2019 and 2021 in four cities in the country: Cúcuta (3 cases), Cali (3 cases), Leticia (43 cases) and Villavicencio (38 cases) which were identified through retrospective laboratory analysis of samples from cases of acute febrile illness. The cases were confirmed using different serological, molecular and metagenomic sequencing techniques at the One Health Genomic Laboratory of the National University of Colombia Medellín Campus and their results were corroborated by the National Reference Laboratory of the National Institute of Health in 2023. Regarding the characterization of the cases, 35.6% (n=31) correspond to the 18-29 age group, 52% (n=45) are men, and 91.2% (n=80) of the cases correspond to samples collected in 2021 (6.7).

    In Peru, from 2016 to 2022, 94 cases of Oropouche were reported in 6 departments of the country: Madre de Dios, Cusco, San Martín, Cajamarca, Loreto and Ayacucho. In 2022, 8 cases were reported. Of the total accumulated cases, 45% occurred in 2016, the year with the highest cumulative incidence rate of 0.14 cases per 100,000 population, with outbreaks reported in Madre de Dios, Cusco and Ayacucho (8).

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
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    Amapá Brazil
    /https://en.wikipedia.org/wiki/Amap%C3%A1

    -----------------------------------------


    Translation Google

    Two cases of Oropouche fever in Amapa where health monitoring is in place

    Two cases of Oropouche fever have been recorded since the start of the year in the municipality of Mazagão, 600 km from Oiapoque. This led to a strengthening of health surveillance to prevent further contamination. The first reports of this virus in Guyana date from 2020.

    Catherine Lama • Published on May 21, 2024 at 1:14 p.m., updated May 21, 2024 at 8:06 p.m.

    Since the beginning of the year, Amapaense health services have detected 75 suspicious samples of the Oropouche virus (OROV), two of which were actually confirmed in March in Mazagão with RT-PCR. Special surveillance has been put in place by the Health Surveillance Superintendency (5SVS) to prevent the phenomenon from spreading. This virus is transmitted by the midge Culicoides paraensis, also known as sand flies. It causes symptoms similar to those of dengue such as headaches, muscle pain, fever, nausea, which complicates the diagnosis. To avoid falling victim to Oropouche fever, you must combat the proliferation of insects in stagnant water and wear protective clothing.

    The village of Saül affected by the Oropouche virus in 2020

    The Oropouche virus was reported for the first time in 2020 in Guyana, more precisely in the commune of Saül where 37 cases were recorded between August and September 2020. Most of these affected people were mainly men (60%) of a average age of 35 years.

    As already indicated, the WHO (World Health Organization) recommends vector control measures in order to eradicate larval breeding sites and to increase individual prevention through the use of repellent products and the wearing of protective clothing.

    “In the Americas, outbreaks of Oropouche virus disease have been reported in rural and urban communities in Brazil, Ecuador, Panama, Peru and Trinidad and Tobago, and now in French Guiana . ” indicates this newsletter to be found HERE…



    ---------------------------
    See also:

    WHO: Oropouche virus disease - French Guiana, France (13 October 2020)
    Source: https://www.who.int/csr/don/13-october-2020-oropouche-french-guiana-france/en/ Oropouche virus disease - French Guiana, France Disease Outbreak News 13 October 2020 On 30 September 2020, the French Guiana Regional Health Agency (ARS) reported the first detection of Oropouche virus (OROV) in French Guiana. On 22
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

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    • #3
      bump this

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      • #4
        Epidemiological Alert Oropouche in the Region of the Americas - 9 May 2024

        DOWNLOAD(370.78 KB)
        Considering the detection of Oropouche fever cases outside of the Amazon region in Brazil during the last month, alongside reports of widespread dengue circulation by several countries and territories in the Region of the Americas, the Pan American Health Organization/World Health Organization (PAHO/WHO) urges Member States to implement the recommendations for the differential diagnosis of Oropouche virus (OROV) and to bolster measures for entomological surveillance, vector control, and personal protection for populations at higher risk.
        9 May 2024

        -----------------------------------

        From the PDF link above:

        Epidemiological Alert
        Oropouche in the
        Region of the Americas
        9 May 2024


        Considering the detection of Oropouche fever cases outside of the Amazon region in Brazil
        during the last month, alongside reports of widespread dengue circulation by several
        countries and territories in the Region of the Americas, the Pan American Health
        Organization/World Health Organization (PAHO/WHO) urges Member States to implement
        the recommendations for the differential diagnosis of Oropouche virus (OROV) and to
        bolster measures for entomological surveillance, vector control, and personal protection for
        populations at higher risk.

        Background

        In the Region of the Americas, outbreaks of Oropouche virus (OROV) during the last ten years
        have occurred mainly in the Amazon region. Historically, numerous outbreaks of OROV
        disease have been reported in both rural and urban communities in Brazil, Colombia,
        Ecuador, French Guiana, Panama, Peru, and Trinidad and Tobago (1).

        OROV is transmitted to humans primarily through the bite of the Culicoides paraensis midge
        that is present in the Region of the Americas, as well as the Culex quinquefasciatus mosquito
        which can also be a vector (1-3).

        Summary of the situation

        In 2024, 5,193 confirmed cases of Oropouche have been reported in four countries in the
        Region of the Americas: the Plurinational State of Bolivia, Brazil, Colombia, and Peru. Since
        the last epidemiological update on Oropouche by the Pan American Health Organization
        (PAHO), Brazil and Bolivia have reported cases in areas where no autochthonous cases had
        previously been reported (4-7).


        In Bolivia during 2024, as of epidemiological week (EW) 18, 1,856 suspected cases of
        Oropouche have been reported, of which 313 have been confirmed by real-time RT-PCR
        laboratory tests. Transmission has been identified in three departments and laboratory
        confirmation in 16 municipalities, with four new municipalities reporting confirmed cases since
        the last update. Of the cases registered, 66% (n=235) were in the department of La Paz,
        followed by Beni with 21% (n=68) and Pando with 3% (n=10). Regarding the distribution of
        cases by sex and age group, 51% (n=157) corresponded to female cases, with the highest
        proportion of cases among the 30-39 age group at 21% (n=66) of the total number of cases
        (6-9).

        In Brazil, between EW 1 and EW 18 of 2024, 4,583 confirmed cases of OROV were detected.
        Most of the cases detected had a probable site of infection in municipalities of the Northern
        states of Brazil. The Amazon region is considered endemic, accounts for 93% of the cases
        reported in the country: Amazonas (n=2,910), Rondônia (n=1,113), Acre (n=163), Pará (n=52),
        Roraima (n=7), and Amapá (n=1). Additionally, autochthonous transmission has been
        identified in three non-Amazonian states where no autochthonous cases had previously been
        reported: Bahia (n=273), Espírito Santo (n=33), and Piauí (n=10). In addition, cases reported in
        the states of Rio de Janeiro (n=10), Santa Catarina (n=7), and Paraná (n=1) are under
        investigation to establish the probable site of infection. Regarding the distribution of cases by
        sex and age group, 52% (n=2,396) correspond to male cases and the highest proportion of
        cases is registered in the 20-29 years of age group with 21% (n=977) of the cases (5, 10).

        In Colombia, between EW 1 and EW 18 of 2024, 38 confirmed cases of Oropouche were
        detected in three departments of the country: Amazonas (n=35), Caquetá (n=1), and Meta
        (n=1); in addition, one case was identified from Tabatinga, Brazil. Cases were identified
        through a retrospective laboratory case-finding strategy implemented by the Colombian
        National Institute of Health (INS per its acronym in Spanish) from dengue surveillance.
        Regarding the distribution of cases by sex and age group, 61% (n=23) correspond to male
        cases and the highest proportion of cases is registered in the 10-19 years of age group with
        44% (n=17) of the cases (11).

        In Peru, between EW 1 and EW 18 of 2024, 259 confirmed cases of Oropouche have been
        reported in four departments, the highest number of cases reported to date in this country.
        The departments where confirmed cases were reported are Loreto (n=182), Madre de Dios
        (n=43), Ucayali (n=26), and Huánuco (n=8). Regarding the distribution of cases by sex and
        age group, 51% (n=131) were male, with the highest proportion of cases among the 30-39
        years of age group with 40% (n=104) of cases (12).

        ...​​
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • #5
          Rare Oropouche virus spotted in several cities for the first time, Cuba authorities say

          BY NORA GÁMEZ TORRES UPDATED MAY 30, 2024 2:56 PM

          Earlier this week, the Cuban Ministry of Health said it had confirmed cases of the illness in the rural town of Songo La Maya and Boniato, on the outskirts of Santiago de Cuba city.
          ...
          The country’s top epidemiology official, Dr. Francisco Durán, said on state television that cases were also found in four municipalities in the province of Cienfuegos in central Cuba: Abreu, Rodas, Aguada, and Cumanayagua.
          ...



          ----------------------------------------------
          Translation Google

          Information note from the Ministry of Public Health

          BY MINSAP EDITORIAL · MAY 27, 2024


          The Pan American Health Organization (PAHO) has issued an epidemiological update on the presence in the Region of the Americas of Oropouche Fever , a virus transmitted by vectors of the genus Culicidae (mosquitoes) and Culicoides (gnats), exposing habitual transmission of the same in communities rural and urban areas of Brazil, Colombia, Ecuador, French Guiana, Panama, Peru and Trinidad and Tobago. So far this year, the disease has been reported in the Plurinational State of Bolivia, Brazil, Colombia and Peru.

          The clinical picture that manifests as a consequence of the disease is mild, preceded by an incubation period of 5 to 7 days, which is characterized by fever, headaches, muscle and joint pain, and sometimes vomiting and diarrhea are also reported. No serious or critical cases or deaths have been reported associated with the virus. There is no specific treatment, only general measures to relieve symptoms.

          Through the monitoring and surveillance actions of non-specific febrile syndromes in the province of Santiago de Cuba, the presence of the Oropouche virus was identified in two Health areas of the municipalities of Santiago de Cuba (Ernesto Guevara) and Songo La Maya (Carlos J. Finlay), based on samples studied at the national reference laboratory of the Pedro Kourí Institute (IPK).

          All cases have evolved favorably with improvement in symptoms between the third and fourth day after the onset of the disease.

          Entomo-epidemiological actions are developed to cut the chain of transmission and achieve control of the disease in the shortest time possible.

          Ministry of Public Health
          Republic of Cuba


          https://salud.msp.gob.cu/nota-inform...lud-publica-8/
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • #6
            A little-known virus on the rise in South America could overwhelm health systems
            ...
            5 JUN 20243:05 PM ET BYSOFIA MOUTINHO

            A little-known pathogen named the Oropouche virus is on the move in South America, alarming scientists and public health experts. Brazil has reported 5530 cases so far this year, compared with 836 in all of 2023. Bolivia, Colombia, and Peru have seen upticks as well. Although the virus has traditionally been endemic in the Amazon Basin, it is now sickening people far from the rainforest. In May, Cuba reported its first cases.
            ...
            What worries us most is the expansion of a disease that was practically restricted to the Amazon, which has a very low-density population, to areas with greater population density,” says Marcus Lacerda, an infectious disease researcher at the Oswaldo Cruz Foundation (Fiocruz).
            ...
            For the few scientists who study Oropouche fever, none of this was a big surprise. Since 2000, the virus has increasingly ventured outside its endemic region, says virologist Socorro Azevedo at the Evandro Chagas Institute, a research center for tropical diseases in the Brazilian Amazon. “What we are seeing is a chronicle of a tragedy foretold,” she says.
            ...
            Oropouche fever is not known to have killed anyone, but a few suspected fatalities are under investigation, says Fiocruz virologist Felipe Naveca. “As the number of infected people increases, so does the chance that we will discover unexpected impacts,” says Naveca, who notes that Zika, a disease that seemed relatively innocuous at first, led to a wave of babies born with an underdeveloped brain from women infected with the virus. The Oropouche virus can also infect the brain, he points out.

            Controlling Oropouche is a challenge. C. paraensis is “a neglected vector for a neglected disease,” says Joaquim Pinto Nunes Neto, an entomologist at Evandro Chagas. “No one has cared about studying how to control it.”
            ...

            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • #7
              Source: https://www.cubaheadlines.com/articles/283309


              Health Alert: Dengue and Oropouche Viruses Threaten Santiago de Cuba
              Sunday, June 9, 2024 by Sophia Martinez

              ​As the Oropouche virus continues to ravage the residents of Santiago de Cuba, claiming at least one victim, another threat has further complicated the already critical epidemiological situation in the eastern region. It has been confirmed that two serotypes of the dengue virus are circulating, potentially leading to severe forms of the disease.

              The Provincial Department of Vector Surveillance and Control issued an alert on Friday regarding the presence of two variants of the dengue virus. This comes at a time when "the territory shows a high infestation of the transmitting agent," particularly in the main municipality, Palma Soriano, Contramaestre, Mella, and San Luis, where most cases of the arboviral disease are reported...

              ...Meanwhile, the government has yet to release figures on those diagnosed with the Oropouche virus, which has already spread to Cienfuegos and Mayabeque and could be present in other Cuban provinces.

              The authorities of the regime also maintain complete silence on the deaths caused by this virus, although unofficial reports recently revealed the death of 22-year-old Santiago resident Richard Daniel Nieves Chaveco, who was hospitalized with symptoms of Oropouche.

              The university student, a resident of the II Frente municipality, died three days after being admitted to the Ambrosio Grillo Hospital in Santiago de Cuba with symptoms of the virus...




              Comment


              • #8
                Oropouche virus disease - Cuba

                11 June 2024

                Situation at a glance

                On 27 May 2024, the Ministry of Public Health of Cuba reported outbreaks of Oropouche virus disease from two provinces, Santiago de Cuba and Cienfuegos. Oropouche virus disease is an arboviral disease caused by the Oropouche virus (OROV). It is transmitted to humans through midge (small fly) or mosquito bites. To date, there is no evidence of human-to-human Oropouche virus transmission. This is the first detection of the disease in the country, therefore, the population is likely highly susceptible and there is significant risk of additional cases being detected.

                Description of the situation

                On 27 May 2024, the Ministry of Public Health of Cuba reported the first ever outbreak of Oropouche virus disease. A total of 74 confirmed cases were reported from Province of Santiago de Cuba (n=54), and from Province of Cienfuegos (n=20). These cases were detected through strengthened monitoring and surveillance actions following an increase in cases with non-specific febrile illness in the provinces of Santiago de Cuba, with the municipalities of Santiago de Cuba and Songo La Maya reporting 29 and 25 cases each; and in the province of Cienfuegos where eight cases were reported from Cienfuegos, five from Rodas, five from Abreu, and one each from Aguada de Pasajeros and Cumanayagua municipalities. OROV was identified in 74 samples of the 89 samples tested at the national reference laboratory of the Pedro Kourí Institute (IPK per its acronym in Spanish).

                The onset of the symptoms of the confirmed cases was reported between 2 May to 23 May with a peak of cases observed in epidemic week 21 (week ending 24 May). The most frequently reported symptoms were fever, lower back pain, headache, loss of appetite, vomiting, weakness, joint pain, and eye pain. Of the 74 confirmed cases, 36 are male, and 38 are female, and the median age is 34 years (range 6-72 years). The most represented age range is 15 to 19-years-old (12 cases).

                All cases showed signs of recovery between the third and fourth day after the onset of symptoms. No severe or fatal cases have been reported as of 5 June.

                Figure 1: Number of cases of Oropouche virus disease in Cuba by province



                Epidemiology

                Oropouche virus disease is an arboviral disease caused by the Oropouche virus (OROV), a segmented single-stranded RNA virus that is part of the genus Orthobunyavirus of the Peribunyaviridae family. The virus has been found to circulate in Central and South America and the Caribbean. OROV can be transmitted to humans primarily through the bite of the Culicoides paraensis midge, found in forested areas and around water bodies, or certain Culex quinquefasciatus mosquitos. It is suspected that viral circulation includes both epidemic and sylvatic cycles. In the sylvatic cycle, primates, sloths, and perhaps birds are the vertebrate hosts, although a definitive arthropod vector has not been identified. In the epidemic cycle, humans are the amplifying host and OROV is transmitted primarily through the bite of the Culicoides paraensis midge. To date, there is no evidence of human-to-human OROV transmission.

                The disease symptoms are similar to dengue and start between four to eight days (range between three-12 days) after the infective bite. The onset is sudden, usually with fever, headache, joint stiffness, pain, chills, and sometimes persistent nausea and vomiting, for up to five to seven days. Severe clinical presentation is rare, but it may result in aseptic meningitis. Most cases recover within seven days, however, in some patients, convalescence can take weeks. There is no specific antiviral treatment or vaccine for Oropouche virus disease. Public health response

                Local and national health authorities are implementing the following public health measures:

                The country has established a plan to address arboviruses, which includes integrated and comprehensive actions by various entities, namely: Organization and Control of Contingency Actions; Vector Control and Entomological Surveillance; Epidemiological Surveillance; Medical Assistance; Environment and Community Participation; Research and Development; and Logistics.

                The actions in the plan include:
                • Temporary working groups activated to analyze the epidemiological situation and conduct field operations.
                • Definition of criteria for suspected and confirmed cases of the disease.
                • Training all personnel of the National Public Health System on arboviruses, including OROV.
                • Strengthening human resources for medical care in health areas with transmission.
                • Reinforcement of vector control actions including focal treatment in transmission and very high-risk blocks, adulticidal treatment and increased entomological surveillance in transmission areas.
                • Intensified environmental sanitation actions.
                • An informative note was issued on the situation.
                WHO risk assessment

                This is the first detection of the disease in the country, therefore, the population is likely highly susceptible and there is a significant risk of additional case detection. To date, there is no evidence of human-to-human Oropouche virus transmission.

                In the Region of the Americas, outbreaks of Oropouche virus disease have occurred mainly in the Amazon region over the past 10 years. The virus is endemic in many South American countries, in both rural and urban communities. Outbreaks are periodically reported in Brazil, Bolivia, Colombia, Ecuador, French Guiana, Panama, Peru, and Trinidad and Tobago.

                There is a risk of the disease spreading internationally as Cuba is an international tourist destination and the putative vector is widely distributed in the Americas region. Additionally, there are currently other countries with active OROV circulation.

                WHO advice

                The proximity of midge vector breeding sites to human habitations is a significant risk factor for OROV infection. Prevention strategies are based on control or eradication measures against the arthropod vectors and personal protection measures. Vector control measures rely on reducing midge populations through the eradication of breeding sites, achieved by reducing the number of natural and artificial water-filled habitats that support midge larvae, thereby reducing the adult midge populations around at-risk communities. Personal protection measures rely on prevention of midge bites using mechanical barriers (mosquito nets), insect repellant devices, repellent-treated clothing and anti-mosquito repellents. Chemical insecticides such as deltamethrin and N,N-Diethyl-meta-toluamide (DEET) have been demonstrated to be effective in controlling Culicoides and Culex species.

                Given its clinical presentation and considering that this is the beginning of the dengue season in the Caribbean and other vector-borne diseases in the Region of the Americas, laboratory diagnosis is essential to confirm cases, characterize an outbreak, and monitor disease trends.

                Since it is an emerging and poorly identified arbovirus in the Americas, the detection of a positive sample and confirmation of a case requires the use of Annex 2 of the IHR and its consequent notification through the established channels of the International Health Regulations (IHR).

                WHO advises against applying any travel or trade restrictions based on the current information available on this event.​
                ...

                On 27 May 2024, the Ministry of Public Health of Cuba reported outbreaks of Oropouche virus disease from two provinces, Santiago de Cuba and Cienfuegos. Oropouche virus disease is an arboviral disease caused by the Oropouche virus (OROV). It is transmitted to humans through midge (small fly) or mosquito bites. To date, there is no evidence of human-to-human Oropouche virus transmission. This is the first detection of the disease in the country, therefore, the population is likely highly susceptible and there is significant risk of additional cases being detected.
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

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