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  • #16
    EpiSouth Weekly Epi Bulletin – N°139 - 10 November 2010 – 16 November 2010 (Extract, edited)

    EpiSouth Weekly Epi Bulletin – N°139 - 10 November 2010 – 16 November 2010 (Extract, edited)


    [Source: EpiSouth, full PDF document, (LINK). Extract, edited.]

    EpiSouth Weekly Epi Bulletin – N°139 - 10 November 2010 – 16 November 2010

    The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. either the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


    INDEX e-WEB n°139
    • A(H5N1) Human and avian influenza – Hong-Kong
    • “INSIDE” Events: None
    • “OUTSIDE” Events:
      • Dengue, United States of America.


    Location: Hong-Kong Event: A(H5N1) – Human

    On November 17, 2010, Hong-Kong health authorities reported a human case of influenza A(H5N1). The case is :
    • 59 year-old woman ;
    • She presented 1st symptoms on November 2nd ;
    • Hospitalised on November 14, she is in critical condition ;
    • She travelled to Shanghai, Nanjing (Jiangsu province) and Hangzhou (Zhejiang province) in mainland China (cf. Figure 1) with her husband and daughter between October 23rd and November 1st.
    • Contacts with sick/dead poultry have not been documented but she visited market.

    • Hong-Kong has implemented a comprehensive influenza surveillance system.
    • The last human cases in Hong-Kong were reported in February 2003; These 2 cases were certainly infected in Fujian province, mainland China.
    • The last epizootic reported in Hong-Kong occurred in the 1st trimester 2009 (wild birds). The last epizooty among poultry was notified in 2008.
    • In mainland China,
      • The last human case in mainland China was reported in June 2010 in Hubei province.
      • The last epizootic was reported was in the 3rd quarter 2010 (wild birds) in Tibet (Xizang).
      • Veterinary surveillance and reporting in Mainland china is suboptimal, it is also likely that A(H5N1) human cases are under detected and/or under reported.


    Comments

    According to available information this case detected in Hong-Kong is very likely to have been imported from mainland China.
    • To date, the origin of contamination is unknown.
    • The occurrence of cases without documented contacts with poultry in a country where few human and animal cases have recently been reported is worrying. This also raises questions regarding actual A(H5N1) situation in mainland China .
    • Hong-Kong health authorities further investigate. The situation is followed up carefully.


    REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (NOT occurring in one or several EpiSouth countries)

    Location: United States of America Event: Dengue

    On November 11 2010, Florida’s health authorities reported an autochthonous case of dengue in metropolitan Miami (Miami–Dade County) (cf. Figure 1).
    • To date, the serotype is unknown.
    • Control measures have been strengthened in Florida’s State.


    Comments

    Since the 50’s, this is the 1st autochthonous case reported in Miami-Dade County, the most populated county of Florida.
    • In 2009, 27 autochthonous cases were reported in Key West (Monroe county).
    • In 2009, a seroprevalence survey conducted in Key West between July and September 2010 showed that 5% of inhabitants were positive for dengue virus.
    • Since the beginning of the year 2010, 59 autochthonous cases have been reported including 58 in Key West (sérotype 1) and 1 in Broward county (sérotype 3). In the mean time, 120 imported cases have been notified including 43 in Miami-Dade County.
    • Since 2009, increase in the number of reported autochthonous cases.
    • The situation is followed up carefully especially in touristic places such as Miami.

    -
    ------

    Comment


    • #17
      EpiSouth Weekly Epi Bulletin – N°140 - 17 November 2010 – 23 November 2010 (edited)

      EpiSouth Weekly Epi Bulletin – N°140 - 17 November 2010 – 23 November 2010 (edited)


      [Source: EpiSouth, full PDF document, (LINK). Extract, edited.]

      EpiSouth Weekly Epi Bulletin – N°140 - 17 November 2010 – 23 November 2010

      The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


      INDEX e-WEB n°140
      • A(H5N1) Human and avian influenza – None
      • “INSIDE” Events: None
      • “OUTSIDE” Events:
        • Cholera, Haiti, Dominican Republic, United States of America
        • Melamine-dairy products contamination, China.


      REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (NOT occurring in one or several EpiSouth countries)

      Location: Haiti/ Dominican Republic/ USA - Event: Cholera

      Reminder, Haïti
      • Since October 12, 2010, an important cholera outbreak is present in Haiti.
      • As of November 23, 2010, the Haitian Ministry of Health reported a cumulative number of 60,240 hospital visits, 25,248 hospitalizations, and 1,415 deaths due to cholera at the national level.
      • Cholera cases have been registered in all ten Haitian departments.

      Dominican Republic
      • On November 17, 2010, health authorities in the neighboring Dominican Republic reported the first imported case of cholera.
        • The case is a Haitian man returning from Haiti and living in Higuey, a city located in the Eastern part of the country, near the Punta Cana resort of (see Figure1).
      • On November 19, 2010, Dominican health authorities reported the first 2 autochthonous cases of cholera.
        • These cases are relatives, a grandmother and her 3-month-old granddaughter, living in a neighbourhood located in the Eastern part of the capital city, Santo Domingo.
      • Control Measures have been set by the Health authorities.

      Unites States of America
      • On November 17, 2010, Florida health authorities reported the first imported case of cholera in Collier County. The case is a woman who visited relatives in Haiti.


      Comments
      • The cholera outbreak in Haïti is not under control.
      • The occurrence of imported cases in the Dominican Republic and in the United States is not unexpected given the close relations between these countries and Haiti.
      • Moreover, the occurrence of limited transmission around imported cases in the Dominican Republic is not unexpected.
      • In the future, the occurrence of other imported cases is not excluded, mainly in the neighbouring countries, French American. Departments included.
      • In the Dominican Republic, the risk of sustained transmission of V. cholerae O1 remains moderate given safer water and sanitation supply and a less strained health system than in Haiti. However, this risk still exists considering the lack of environmental health in some of the areas of the country.
      • In this context and because of the large number of tourists travelling to the Dominican Republic, the situation is followed up carefully.


      Location: China - Event: Melamine contamination

      On November 15, 2010, Xiangfan health authorities in Hubei province (see Figure 2.) reported that a large stock of dairy products produced in Xiangtan in the neighbouring Hunan province was contaminated with melamine.
      • Since June 2010, production has been banned but some of these products are still circulating in local markets around Xiangtan.
      • The level of melamine in these products is 2 times higher than allowed by health regulations in the country.


      Comments

      In 2008, nearly 300,000 children (including 6 deaths) exposed to melamine reported suffering from nephrolithiasis and renal insufficiency (see E-web n°26).
      • On July 9, 2010, Chinese authorities reported seizing 64 tons of dairy products and 12 tons of milk powder contaminated with melamine, in Qinghai province in the Western part of the country
      • The importation of dairy products from China to major urban areas where the Chinese community is important can not be excluded. The situation will be followed up carefully.

      (...)
      -
      -------

      Comment


      • #18
        EpiSouth Weekly Epi Bulletin - N° 141 - 24 November-30 November 2010 (Extract, edited)

        EpiSouth Weekly Epi Bulletin - N° 141 - 24 November-30 November 2010 (Extract, edited)


        [Source: EpiSouth, full PDF document, (LINK). Extract, edited.]

        EpiSouth Weekly Epi Bulletin - N° 141 - 24 November-30 November 2010

        The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


        INDEX e-WEB n°141
        • A(H5N1) Human influenza – None
        • A(H5N1) avian influenza – Vietnam and Japan
        • “INSIDE” Events: None
        • “OUTSIDE” Events: None

        REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (NOT occurring in one or several EpiSouth countries)

        Location: Vietnam and Japan - Event: A(H5) / A(H5N1)

        Vietnam
        • New A(H5N1) avian influenza poultry farm outbreaks have been identified in two northern provinces in Vietnam:
          • Dien Chau District, Nghe An Province,
          • Y Yen District, Nam Dinh Province

        Japan
        • A chicken die-off has been reported on 29/11/2010 in a chicken farm (raising 20,000 chickens) near the town of Yasugi, Shimane Prefecture, Chugoku Region, in the south-west Honshu island.
        • Culling and quarantine measures have been implemented.
        • Rapid tests performed have identified highly pathogenic influenza A(H5). Confirmation and identification tests results are pending.
        • If a hihgly pathogenic A(H5N1) avian influenza strain was to be confirmed, this would be the first poultry farm affected by this virus in Japan since January 2007 (wild birds were also found positive for A(H5N1) in April 2008).

        Comments

        • With the onset of winter, the observed increase in reported avian outbreaks is not unexpected.
        • Along with Thai Nguyen, Quang Nam, Gia Lai, Guang Ngai and Ha Tinh provinces (see Map 1), there are now a total of seven Vietnamese provinces that have been affected since June of 2010.
        • The occurrence of human cases in Vietnam in the coming weeks is to be feared.
        • Although avian outbreaks have not been identified in Japan for more than two years, the current A(H5) avian outbreak is located in a part of the Archipelago that has been affected by A(H5N1) in the past.
        • On October 29, 2010, Japanese authorities had reported to FAO that an environmental sample taken around wild birds in Hokkaido Prefecture (north of Japan) had returned positive for A(H5N1).
        • Available epidemiological information does not suggest a change in the epidemiology of the A(H5N1) virus.

        (...)


        Table 1: Epidemiological characteristics of A(H5N1)-related events between June 2010 to November 2010.

        [Country Area - Date - Event details]
        • China - Tibet Province - June 2010 - Confirmed A(H5N1) in wild birds
        • China - Hubei province - June 2010 - Confirmed A(H5N1) in a human case (deceased)
        • Vietnam - Thai Nguyen & Quang Nam - June 2010 - Confirmed A(H5N1) outbreak in poultry farms
        • Vietnam - Gia Lai Province - July 2010 - Confirmed A(H5N1) outbreak in poultry farms
        • Vietnam - Quang Ngai & Ha Tinh Provinces - September-October 2010 - Confirmed A(H5N1) outbreak in poultry farms
        • Japan - Hokkaido Prefecture - October 2010 - A(H5N1) virus identified in environmental samples around wild birds
        • China - Shanghai, Nanjing, Zhejiang Provinces - November 2010 - Area of possible infection source in a confirmed human A(H5N1) case diagnosed in Hong Kong
        • Vietnam - Nge An & Nam Dinh Provinces - November 2010 - Confirmed A(H5N1) outbreak in poultry farms
        • Japan - Shimane Prefecture, Chugoku region - November 2010 - Confirmed A(H5) outbreak in a poultry farm

        -
        -----

        Comment


        • #19
          EpiSouth Weekly Epi Bulletin – N°142 - 1st December 2010 – 07 December 2010 (Extract, edited)

          EpiSouth Weekly Epi Bulletin – N°142 - 1st December 2010 – 07 December 2010 (Extract, edited)


          [Source: EpiSouth, full PDF document, (LINK). Extract, edited.]

          EpiSouth Weekly Epi Bulletin – N°142 - 1st December 2010 – 07 December 2010

          The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


          INDEX e-WEB n°142
          • A(H5N1) Human influenza – Egypt, Indonesia
          • A(H5N1) Avian influenza – Rep. of Korea, Nepal
          • “INSIDE” Events: none
          • “OUTSIDE” Events:
            • Mauritania: Rift Valley fever


          Location: Egypt - Event: A(H5N1) – Human

          • On 8th December 2010, the Egyptian Ministry of Health reported to WHO the 113th case of A(H5N1) human infection.
          • The 1st case is:
            • A 30 year-old woman from Gharbia Governorate (cf. map 1)
            • She developed symptoms on 28 November and was hospitalised on 1st December 2010.
            • She died on 2nd December 2010
            • Investigations indicate exposure with sick and dead poultry.
          • Since the 1st case of bird flu in Egypt, the case count is 113 cases including 37 deaths.


          Comments
          • In Egypt, the last human case was reported in August 2010 in Qalyubia governorate (cf. eWEB n°128).
          • The available information does not indicate a change in the epidemiology of the virus in Egypt.


          Location: Indonesia - Event: A(H5N1) – Human
          • On 8th December 2010, the Indonesian health authorities reported a human A(H5N1) influenza infection in a 21 years-old patient, resident of Bandung.
          • The patient was under treatment in an intensive care unit since 22nd November 2010. The source of the infection is still unknown.
          • The patient is recovering and will be discharged soon.
          • In Indonesia, the last human case was reported on October 2010, in Jakarta and Java West provinces (cf. eWEB n°135).


          Location: Rep. Korea - Event: A(H5N1) – Epizootic
          • On 8th December 2010, the Korean Ministry of Health reported to OIE the detection of a (H5N1) highly pathogenic avian influenza virus a wild bird (in a mallard duck), in the Cholla-Bukdo province (cf. map 3).


          Location: Nepal - Event: A(H5N1) – Epizootic
          • On 6 December 2010, The Nepalese health authorities reported to the OIE A(H5N1) influenza infecting poultry farms of the Naranayi zone, in the South of the country (cf. map 4).
          • In Nepal, the last epizootic was reported on March 2010 in the Seti zone (cf. eWEB n°106).


          REPORT of NEW HEALTH EVENTS OCCURING OUTSIDE THE EPISOUTH AREA (Not occurring in one or several EpiSouth countries)

          Area: Mauritania - Event: Rift Valley fever
          • On 7th December 2010, the Mauritanian authorities reported an outbreak of Rift Valley fever (RVF).
          • 30 cases including 17 deaths have been reported in the Adrar wilaya (Map 5).
          • To date information regarding specific location and cases details are not available.
          • According to the Ministry of rural development,
            • Abnormal mortality in camels has been reported.
            • The 7 first analysed samples were negative for RVF, analysis are on going for 32 additional samples.
            • The initial veterinary investigation carried out in the affected camel herds would be in favour of pasteurellosis.
            • Control measures have been implemented


          Comments
          • Occurrence of Rift Valley fever (RVF) is known in Mauritania since the 80’s. Human outbreaks were reported in 1987-88, 1998 and 2003 and circulation among small ruminant has been regularly reported since 1987.
          • To date, no RVF epizootic has been confirmed and the source of human infection remains unclear.
          • Cross border spread to neighbouring countries (either human or animal) cannot be excluded

          -
          -----

          Comment


          • #20
            EpiSouth Weekly Epi Bulletin – N°143 - 08 December 2010 – 14 December 2010 (Extract, edited)

            EpiSouth Weekly Epi Bulletin – N°143 - 08 December 2010 – 14 December 2010 (Extract, edited)


            [Source: EpiSouth, full PDF document (LINK). Extract, edited.]

            EpiSouth Weekly Epi Bulletin – N°143 - 08 December 2010 – 14 December 2010

            The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


            INDEX e-WEB n°143
            • A(H5N1) Human influenza –none
            • A(H5N1) Avian influenza – Rep. of Korea
            • “INSIDE” Events: none
            • Malaria: Germany ex-Libya
            • “OUTSIDE” Events: none


            Location: World - Event: A(H5N1) – Human

            No human cases reported this week


            Location: Rep. Korea - Event: A(H5N1) – Epizootic
            • On 12th December 2010, the Korean Ministry of Health reported to OIE the detection of a A(H5N1) highly pathogenic avian influenza virus in 2 wild birds (eagle owls), in the Chungcheongman-do province (cf. map 1).
            • In the Rep. of Korea, the last A(H5N1) epizootic was reported on 8th December 2010 in the Cholla-Bukdo province (cf. eWEB n°142).
            • South Korea was the 1st country to officially notify A(H5N1) outbreak in poultry in December 2003 in the Chungchong-bukto province


            Comments

            The available information does not indicate a change in the epidemiology of the virus.


            REPORT of NEW HEALTH EVENTS OCCURING OUTSIDE THE EPISOUTH AREA (Not occurring in one or several EpiSouth countries)

            Area: Germany ex-Libya - Event: Malaria
            • GeoSentinel, the global surveillance program of the International Society of Travel Medicine (ISTM) based in Germany reported a Plasmodium falciparum malaria case in a German traveller who returned from Libya.
            • The case is a professional tour guide who returned to Germany on 27 November 2010 from a 20-day tour to Libya where she arrived on 7 November 2010:
              • After flying into Djerba in Tunisia, she travelled overland for the next 20 days visiting Sabratha, Ghadames, Akakuks mountains, Waw an Namus and the Mandara lakes (cf. map 2).
              • She became ill on 24 Nov 2010 (fever).
              • She had no underlying illnesses and has never had malaria before.
              • Blood has been sent to CDC Atlanta for genotyping the parasite in order to investigate potential link with another known isolate or case.
              • Past history travel: she travelled to Turkey in September and Mali in February 2010, she visited Senegal and Niger in 2009 but she had no illnesses during or after any of those trips.
              • Given the typical incubation period for P. falciparum in a non-immune host, it is most likely that this case was acquired in Libya. Acquisition in Turkey or in the other countries she had visited is less likely to be epidemiologically linked.


            Comments
            • Libya is free of malaria since 1973 (no autochthonous cases) but has reported imported cases (8-37 cases annually) from African countries and Libyan travellers to those countries.
            • Malaria is rare in desert regions and the natural climate of Libya protects it from transmission. However the re-emergence of the parasite is possible.
            • At least 7 species of competent Anopheles are present in various parts of Libya. Malaria epidemics have occurred in the past in the Fezzan region (South west of the country).
            • To date, consequences for neighbouring EpiSouth countries are limited due to the absence of evidence of an active cycle transmission.

            -
            ------

            Comment


            • #21
              EpiSouth Weekly Epi Bulletin – N°144 - 15 December 2010 – 21 December 2010 (Extract, edited)

              EpiSouth Weekly Epi Bulletin – N°144 - 15 December 2010 – 21 December 2010 (Extract, edited)


              [Source: EpiSouth, full PDF document, (LINK). Extract, edited.]

              EpiSouth Weekly Epi Bulletin – N°144 - 15 December 2010 – 21 December 2010

              The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


              INDEX e-WEB n°144
              • A(H5N1) Human influenza – Egypt
              • A(H5N1) Avian influenza – Japan
              • "INSIDE” Events:
                • Malaria: Morocco
              • “OUTSIDE” Events: none


              Location: Egypt - Event: A(H5N1) – Human

              On 15th December 2010, the Egyptian Ministry of Health reported a new A(H5N1) human infection (not yet reported to WHO).
              • The case is:
                • A 25 year-old woman from Beheira Governorate (cf. map 1)
                • She received drug tamiflu and is in stable condition
                • Investigations indicate exposure with sick and dead poultry.
              • Since the 1st case of bird flu in Egypt, the case count is 114 cases including 37 deaths.
              • In Egypt, the last human case was reported on 8th December 2010 in Gharbia governorate (cf. eWEB n°142).


              Comments

              The available information does not indicate a change in the epidemiology of the virus in Egypt.


              Location: Indonesia - Event: A(H5N1) – epizootics

              On 21st December 2010, the Japanese health authorities reported to OIE the detection of A(H5) highly pathogenic avian influenza virus in captive wild mute swans (zoo), in Toyama prefecture in the Hokuriku region (cf. map 2).
              • The zoo destroyed all captive birds kept in the moat.
              • Neuraminidase inhibition assay are ongoing.
              • In Japan, the last A(H5N1) epizootic was reported on 29th November 2010, in Shimane prefecture (cf. eWEB n°141).


              REPORT of NEW HEALTH EVENTS OCCURING INSIDE THE EPISOUTH AREA (Occurring in one or several EpiSouth countries)

              Area: Morocco - Event: Malaria

              On December 10, 2010, the public health services of the Grand Casablanca reported a case of Plasmodium falciparum in a woman, aged 46 years, having no notion of recent travel.
              • The diagnosis was confirmed by the National Reference Laboratory of the Ministry of Health.
              • The ministry of health declared that all control measures have been implemented and the patient has been treated.
              • The epidemiological and entomological investigations carried out have not identified a local cycle of transmission of the disease.
              • It is the third autochthonous case of malaria reported in the Grand Casablanca this year. On 22 September 2010, two indigenous cases were reported in the district of Hay Hassani, Casablanca (cf. eWEB n°134).


              Comments

              In Morocco, the last autochthonous cases of malaria due to P. falciparum were reported in 1963.
              • The last autochthonous cases of malaria due to P. vivax were reported in the years 1973-80.
              • Since May 2010, Morocco has been declared malaria-free by WHO.
              • To date, consequences for neighbouring countries seem limited due to the absence of evidence of an active cycle of transmission.

              -
              -----

              Comment


              • #22
                EpiSouth Weekly Epi Bulletin – N°148 - 12 January 2010 – 18 January 2011 (Extract, edited): Avian Flu in Egypt, Myanmar; Monkeypox in Congo RD; YF and Dengue in Ivory Coast.

                EpiSouth Weekly Epi Bulletin – N°148 - 12 January 2010 – 18 January 2011 (Extract, edited)


                [Source: EpiSouth, full PDF document (LINK). Extract, edited.]

                EpiSouth Weekly Epi Bulletin – N°148 - 12 January 2010 – 18 January 2011

                The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


                INDEX e-WEB n°148
                • A(H5N1) Human influenza – Egypt
                • A(H5N1) Avian influenza – Myanmar (Burma)
                • “INSIDE” Events: none
                • “OUTSIDE” events:
                  • Monkey Pox – RD Congo
                  • Yellow fever and dengue – Côte d’Ivoire


                Location: Egypt - Event: A(H5N1) – Human
                • On 18th January 2011, the Egyptian Ministry of Health reported a new A(H5N1) human infection.
                • The 121st case is:
                  • A 1,5 year-old child from Alexandria governorate (cf. map1).
                  • The child was hospitalised for high fever, cough, convulsion
                  • The child was treated by tamiflu and is in stable condition
                  • Exposure to infected domestic birds was documented.
                • In Egypt, the last human case was reported on 10th January 2011 in Giza Governorate (cf. eWEB n°147).
                • Since the 1st case of bird flu in Egypt, the case count is 121 cases including 40 deaths.


                Comments

                The available information does not indicate a change in the epidemiology of the virus in Egypt.


                Location: - Myanmar (Burma) - Event: A(H5N1) – Epizootic
                • On 18th January 2011, the authorities of Myanmar reported to OIE an outbreak of an A(H5N1) avian influenza virus in 8 poultry farm located in the Rakhine state (cf. map 2).
                • In Myanmar, the last A(H5N1) epizootic was reported on 5th February 2010 in poultry in Rangoon division (cf. eWEB n°99).
                • To date, only 1 human avian influenza case has been reported in Myanmar (2007).


                REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (Not occurring in one or several EpiSouth countries)

                Area: DR Congo - Event: Monkey Pox
                • Since November 2010, an outbreak of monkey pox is ongoing in the Democratic Republic of Congo (DRC) in the Equateur province, north-west of the country.
                • At least 114 cases including 5 deaths were reported by health centers in the district of South Ubangi, 80 km from Mbandaka (the capital of the province).
                • Other suspected cases were reported in the districts of Equateur, Tshuapa and the North-Ubangi district (Gbadolite municipality): cf. map 3.
                • Background on “small pox”
                  • The reservoir consists mainly of rodents and primates.
                  • The person transmission, initially considered rare, is currently important
                  • The clinic is similar to smallpox (no clinical differential diagnosis possible) and the lethality is estimated between 1 to 10% (in Africa).


                Comments
                • Since the 70's, outbreaks of monkey pox are regularly documented in the DRC and neighbouring Republic of Congo.
                • Since the early 2000s, the number of reported outbreaks is increasing, especially since the interruption of the smallpox vaccination that provided cross-protection against the Monkey pox.
                • In Equateur Province, outbreaks have been reported regularly in 2001, 2002 and 2009 (cf. eWEB n° 9, n°21 and n°87).
                • The occurrence of cases in forest areas with a low population density is not unexpected.
                • Due to the occurrence of cases close to urban centers - especially in the town of Gbadolite and border areas - the risk of exportation of cases to neighbouring countries (Congo and Central African Republic) and European countries can not be totally excluded.


                REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (Not occurring in one or several EpiSouth countries)

                Area: Côte d’Ivoire - Event: Yellow fever + dengue
                • On 29 July 2010, the Ivorian Ministry of Health reported an outbreak of hemorrhagic fever mainly in Abidjan and Grand Bassam (located on the coast, east of Abidjan) occurring since May 2010. The diagnosis of dengue and yellow fever (YF) has been reported.
                • Afterwards, tests carried out at Pasteur Institute in Abidjan (IPA) confirmed the co-circulation of 3 flaviviruses: yellow fever, Dengue (DEN 2 and DEN 3).
                • On 5 December 2010, the Ivorian health authorities reported:
                  • 635 suspected YF cases including 26 deaths in 17 health districts (including 7 in Abidjan and 10 inside the country) since early 2010.
                  • Targeted vaccination campaigns in Grand Bassam, Abidjan and Seguela districts.
                • During the week 48, 21 suspected cases including 11 deaths were reported in the center of the country: Katiola, Seguela, Beoumi & Mankono departments (see Map 3).


                Comments
                • Yellow fever is endemic in West Africa. Sporadic cases are regularly reported across Côte d’Ivoire.
                • YF virus is spread by different cycles of infection: urban, sylvatic and intermediate.
                • The recent data confirms the geographical spread of the YF epidemic in the center of Côte d’Ivoire.
                • This increase occurs in rural areas. The virus circulation in intermediate areas may involve risk of expansion in urban areas (cf. Yellow fever thematic note), largely because of the proximity of Bouake.
                • The co-circulation of different flaviviruses is not unexpected but complicates diagnosis and surveillance. In 2008, during an outbreak in Abidjan, the concomitant circulation of YF and dengue serotypes was also detected.
                • Vaccination campaigns have been planned but not yet implemented due to the current political situation.

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