Archive, EpiSouth Weekly Epidemiological Bulletin (2010)

[Giuseppe]

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 ? C?te 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: C?te 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 C?te 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 C?te 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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[Giuseppe]

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.

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[Giuseppe]

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.

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[Giuseppe]

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

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[Giuseppe]

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

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[Giuseppe]

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, Ha?ti

• 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 Ha?ti 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.

(...)
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[Giuseppe]

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 (s?rotype 1) and 1 in Broward county (s?rotype 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.

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[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?138 - 03 November 2010 ? 10 November 2010 (11/14/10, edited)

EpiSouth Weekly Epi Bulletin ? N?138 - 03 November 2010 ? 10 November 2010 (11/14/10, edited)


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

EpiSouth Weekly Epi Bulletin ? N?138 - 03 November 2010 ? 10 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?138

• A(H5N1) Human and avian influenza ? None
• ?INSIDE? Events:
  • West Nile ? Italy, Bulgaria and Greece
• ?OUTSIDE? Events:
  • Poliomyelitis- Congo

Location: World Event: A(H5N1) ? Human and Epizootic

No human cases reported this week

No influenza A(H5N1) epizootic reported this week


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

Location: Bulgaria, Italy, and Greece - Event: West Nile

• Bulgaria
  • On 3d of November, ministry of agriculture of Bulgaria reported to the OIE a West Nile equine outbreak (3 horses) in the village of Staro Oriahovo, located in Dolni Chiflik, in the Varna oblast (North-East part of Bulgaria)(cf. map 1).
  • Last outbreak was reported in October 2010 in Dobrich, first equine cases ever reported to OIE by Bulgaria (cf. Eweb n?133).
• Italy
  • On 4 November 2010, Italian health authorities reported new foci of West Nile virus infection in province of Compobasso, in Molise region (2 horses):
    • To date, regarding West Nile outbreaks in animals, health authorities reported:
      • 53 clusters in horses in the provinces of Trapani, Venice, Treviso, Campobasso, and Bologna.
• Greece
  • As of 12 November 2010, 261 human cases and 34 deaths have been reported (Greek MoH, Keel data).
  • Furthermore, on 4 November 2010, Greek health authorities reported 2 new equine West Nile outbreaks, located in Central Macedonia.

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

Location: Congo - Event: Poliomyelitis

• On 3 November 2010, Health authorities of the Republic of Congo have reported 120 suspected cases of poliomyelitis (acute flaccid paralysis) including 58 deaths.
• On November 9, 184 suspected cases including 85 deaths have been reported.
  • A wild poliovirus type 1 (WP1) has been isolated from four patients.
  • Almost all cases are reported in Pointe Noire, the economic capital of the country, in Kouilou region on the Atlantic coast. Other suspected cases were reported in southern regions (Niari, Bouenza Kouilou) and in Brazzaville, capital of the Congo (see Map 2).
• The first case occurred early October. Half of the cases were reported within 15 days.
• Most cases and deaths are young adults. Of 42 cases for which information is available:
  • 1 is less than 5 years;
  • 3 are between 7 and 13 years;
  • 33 are between 15 and 25;
  • 5 are between 26 and 58 years.
• As a response to this epidemic:
  • Surveillance of acute flaccid paralysis has been strengthened;
  • A vaccination campaign against polio is expected to begin November 12, 2010 in the regions of Kouilou and Cabinda, Angola border region. Other campaigns to cover the entire Congolese population are expected to begin November 18, 2010.

Comments

The last case of indigenous polio in the country dates back to 2000.

• According to preliminary results of epidemiological investigations and virus typing, it seems that the virus strain comes from Angola.
• In regard to the large number of reported cases, the unusual age distribution of cases the speed of the epidemic spread, the situation should be monitored carefully. Pointe Noire, the second largest city, has substantial international trade with African and European cities. The exportation of cases is possible, especially in this unusual age group (young adults).

(...)
-
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[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?137 - 27 October 2010 ? 02 November 2010 (Extract, edited)

EpiSouth Weekly Epi Bulletin ? N?137 - 27 October 2010 ? 02 November 2010 (Extract, edited)


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

EpiSouth Weekly Epi Bulletin ? N?137 - 27 October 2010 ? 02 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?137

• A(H5N1) Human influenza ? None
• A(H5N1) Avian influenza ? Japan
• ?INSIDE? Events: none
• ?OUTSIDE? Events: none

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

No human cases reported this week.


Location: Japan - Event: A(H5N1) ? Epizootic

On October 29, 2010, Japanese authorities reported to the FAO a positive environmental sample of A (H5N1) HPAI in the prefecture of Hokkaido (northern Japan, cf. map 1).

• These are samples of faeces from wild birds collected on October 14, 2010.
• The identification of the virus does not mean the existence of local virus circulation: the island of Hokkaido is located along the routes followed by migratory birds.
• Other locations within the same prefecture were inspected.
• To date, no outbreak or animal human cases have been reported.

Comments

Japan is among the first affected Asian countries in 2003.

• In Japan, the last outbreak was reported in June 2008 in the province of Aomori (cf. eWEB n?12).

-
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[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?134 - 06 October 2010 ? 12 October 2010 (Extracts, edited)

EpiSouth Weekly Epi Bulletin ? N?134 - 06 October 2010 ? 12 October 2010 (Extracts, edited)


[Source: EpiSouth, full PDF Document (LINK). Extracts, edited.]

EpiSouth Weekly Epi Bulletin ? N?134 - 06 October 2010 ? 12 October 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?134

• A(H5N1) Human and avian influenza ? None
• ?INSIDE? Events:
  • Malaria ? Spain, Morocco
  • West Nile ? Mediterranean area: update
• ?OUTSIDE? Events:
  • Polio - Kazakhstan

Location: World - Event: A(H5N1) ? Human and Epizootic

No human cases reported this week.

No influenza A(H5N1) epizootic reported this week .


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

Location: Kazakhstan - Event: Polio

On 11 October 2010, the Kazakh health authorities have reported a case of indigenous poliomyelitis in a child of 7 years in the South Kazakhstan. 5 other cases are suspected.

• The child did not leave Kazakhstan.
• Vaccination campaigns have recently been performed in the country. This child was out of the targeted age group.
• Further campaigns are planned in this region, targeting children aged 0-15 years in the border regions of Kazakhstan and Almaty, Zhambyl, Kyzylorda and Mangistau.

Comments

On April 23, 2010, an outbreak of wild poliovirus (type 1) began in Tajikistan, while the European WHO region did not reported cases since 2002 (cf. eWEB n?110).

• The last WHO update, on 30 September 2010, reported 458 confirmed cases including 26 deaths (polio update in Tajikistan).
• Indigenous cases were reported in Russia (cf. eWEB n?113) and Turkmenistan.
• Given the location of the epidemic in Tajikistan and the frequency of asymptomatic infection by wild polio virus, a virus circulation in areas bordering Uzbekistan, Kyrgyzstan and Kazakhstan can not be excluded.

REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occuring in one or several EpiSouth countries)

Location: Spain - Event: Malaria

On October 8, 2010, a case of Plasmodium vivax has been reported by Spanish health authorities.

• The case is:
  • a 48 year old woman living in Huesca, Aragon (cf. map 2)
  • She never travelled outside the country, has not received recent treatment (transfusion), and does not live near an airport.
  • The samples were sent to the Institute Carlos III (Madrid), which confirmed the diagnosis of malaria on 1st October 2010.
  • The patient was treated and she?s in stable condition.
• The Anopheles atroparvus vector is present in all over Spain.
• To date, the origin of the contamination was not identified.

Comments

In Spain, the last indigenous cases were reported during the 1950s. Spain was declared malaria free by the WHO in September 1964.

• As in Spain, isolated cases of autochthonous malaria were reported in Greece (2009-2010), Albania (2010), France (Corsica - 2006) and Italy (1997, 2009).
• Such cases are due to local transmission from imported cases, unidentified, back from an endemic area in the presence of a competent vector.

Location: Morocco - Event: Malaria

On 22 September 2010, the Moroccan Ministry of Health confirmed two cases of indigenous malaria Plasmodium falciparum in the district of Hay Hassani, Casablanca (North West, cf. map 3).

• To date, investigations have not identified other suspected cases.
• The origin of the contamination could be identified.
• Control measures have been taken by health authorities.

Comments

In Morocco, the last cases of malaria due to P. falciparum were reported in 1963.

• The last cases of malaria due to P. vivax were reported in the years 1973-80.
• Since May 2010, Morocco was declared malaria-free by WHO.
• To date, consequences for France are limited due to the absence of evidence of an active cycle of transmission.

Location: Mediterranean - Event: West Nile

Greece: On October 8, 2010, 5 new outbreaks (5 horses) were reported to the OIE, all located in Central Macedonia (an area already affected, cf. map 4).


Comments

The epidemiological situation in other Euro-Mediterranean countries remains unchanged.

-
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[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?133 - 29 September 2010 ? 05 October 2010 (10/08/10, edited)

EpiSouth Weekly Epi Bulletin ? N?133 - 29 September 2010 ? 05 October 2010 (10/08/10, edited)


[Source: EpiSouth, full PDF Document (LINK). Extracts, edited.]

EpiSouth Weekly Epi Bulletin ? N?133 - 29 September 2010 ? 05 October 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?133

• A(H5N1) Human and avian influenza ? None
• ?INSIDE? Events:
  • Dengue ? Croatia
  • West Nile ? Mediterranean area: update
• ?OUTSIDE? Events:
  • Chikungunya - China
  • Toxic Flood - Hungary

Location: World - Event: A(H5N1) ? Human and Epizootic

No human cases reported this week.
No influenza A(H5N1) epizootic reported this week .


REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occuring in one or several EpiSouth countries)

Location: Croatia - Event: Dengue

On 30 September, German health authorities have reported a case of dengue fever virus infection imported from Croatia.

• The case is:
  • a German tourist 72 years old
  • Having traveled in the south-east of Croatia on the Adriatic Sea coast, from 1 to 15 August 2010 (see Map 1);
  • He was symptomatic on 16th August 2010;
  • He has no history of vaccination against yellow fever and tick-borne encephalitis.
  • To date, the serotype is unknown
• Control measures, information and sensitization of clinicians and active case finding have been implemented. To date, no other suspect cases have been detected neither in the above mentioned area nor in the rest of the country
• Aedes albopictus, as the potential dengue vector is well established in Croatia but also in several Mediterranean countries (cf. Map2).

Comments

This is the first confirmed case of dengue fever acquired in Croatia. At this stage, the probable source of infection (index case) remains unknown, investigations are ongoing

• The detection of autochthonous dengue fever cases both in France (cf. eWEB n?130, 131) and Croatia constitutes a significant public health event although not unexpected due to the presence of A. albopictus in these 2 countries.
• At this stage, the risk of implantation of a sustained cycle of transmission appears limited.
• This has also to be put in perspective with the recent detection of indigenous chikungunya in southern France (eWEB n?132) as it illustrates the risk of autochthonous transmission in all Mediterranean countries where A. albopictus is present.
• The evolution of these two arboviruses in southern Europe is closely monitored.

REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (occurring in one or several EpiSouth countries)

Location: China - Event: Chikungunya

On October 3, 2010, Chinese authorities have confirmed several cases of chikungunya in Guangdong province (South of the country (see Map 3)

• The cases? details were not disclosed.

Comments

This is the first indigenous cases of chikungunya reported in China.

• The chikungunya virus has been detected in China in the 1980s:
  • among bats of Culex mosquitoes in the provinces of Yunnan and Hainan Island;
  • well as in samples taken from humans in these two provinces and Guangdong.
• Guangdong is the most populous province of China (80M). Imported cases have been described repeatedly in the capital, Guangzhou (Canton).

Location: Hungary - Event: Pollution (toxic flood)

After the break of a dike surrounding a pool of waste water in an aluminum plant, the Hungarian authorities have declared on October 05, 2010, a state of emergency in the departments of Veszprem, Győr-Moson-Sopron and Vas - located in the North West of the country (close to Slovak and Austrian Border) and upstream Budapest (see Map 4).

• Approximately 1 million cubic meters of toxic sludge containing heavy metals has flooded several villages.
• To date, 120 people were injured and 4 died.
• The flow caused by toxic red mud that spread after this industrial accident reached the Danube, threatening the ecosystem of the River.
• Water samples collected at the confluence of the Raab River and Danube revealed a rate slightly more alkaline than normal, between 8.96 and 9.07 (normal is 8).
• Measures of restraint of toxic flood have been implemented by the authorities.

Comments

Investigations are underway to determine the ecological consequences for the fauna and flora of the region.

• This event may constitute a public health emergency of international concern. The risk remains to be assessed for people living downstream on the Danube, especially in Croatia, Romania and Serbia

REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA + NEIGHBOURING COUNTRIES

West Nile Update ? 07th October 2010.

• Except the increase number of human and equine cases in already affected countries, the main new features regarding WNV are
  • BULGARIA
    • On 04th October 2010, the Bulgarian Health authorities has notified to the OIE about West Nile fever virus infections in 5 donkeys, in the North-East part of Bulgaria. These are the first equine cases ever reported to OIE by Bulgaria.
  • SPAIN
    • On 06th October 2010, the Spanish Ministry of health has confirmed a 2nd human case of West Nile in the Cadiz province: a 77 years old man from Benalup-casas viejas.
    • He was hospitalised on 28th September 2010 and recovered.
    • This case is the second WN human case in Cadiz which already reported in September equine cases (cf. eWEB n?130) and a 1st human case (cf. eWEB n? 132)
    • For more details regarding other countries, please refer to the West Nile thematic note posted on 6th October 2010.

(...)
-
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[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?132 - 22 September 2010 ? 28 September 2010 (Edited)

EpiSouth Weekly Epi Bulletin ? N?132 - 22 September 2010 ? 28 September 2010 (Edited)


[Source: EpiShouth, full PDF Document: (LINK). Edited.]

EpiSouth Weekly Epi Bulletin ? N?132 - 22 September 2010 ? 28 September 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?132

• A(H5N1) Human influenza ? None
• A(H5N1) Avian influenza ? None
• ?INSIDE? Events:
  • Chikungunya ? France
  • West Nile ? Mediterranean countries: Morocco, Spain
• ?OUTSIDE? Events: none

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

No human cases reported this week.


Location: world - Event: A(H5N1) ? Epizootic

No influenza A(H5N1) epizootic reported this week .


REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occuring in one or several EpiSouth countries)

Location: France - Event: Chikungunya

On 24 September, the French authorities confirmed the occurrence of the 1st indigenous case of chikungunya fever in France, Frejus (Var district cf. map 1). On 27 September a 2nd autochthonous case, epidemiologically linked to the index case has been confirmed.

• The cases are:
  • Two 12-year old girls, both symptomatic on 18 September including fever, arthralgia, myalgia, rash and headache.
  • They are both resident in Frejus, living in the same neighbourhood and frequenting the same school.
  • The serotype is currently unknown.
• Var is a French district (South-east of France) where Aedes albopictus is established since 2004.
• Enhanced seasonal surveillance system of chikungunya and dengue fever has been implemented in this area of France since 1st January 2006 from May to November. Both cases have been detected through this system.
• To prevent any further spread of the virus, the epidemiological surveillance and control measures have been strengthened, including entomological investigations, active case finding around the cases and public information.

Comments

Although the risk of widespread epidemic is considered limited it cannot be excluded. The detection of new autochthonous cases is likely to happen until November, end of the mosquito season.

• The detection of 2 autochthonous cases of dengue fever 10 days prior to this event in South East of France, emphasizes the need to closely follow-up the situation of arboviruses in the region.
• Map 1. Frejus, city in Var district, France.

REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occurring in one or several EpiSouth countries)

Location: Turkey, Spain, Italy - Event: West Nile

Morrocco, equine cases

• On 28 September 2010, the Moroccan Institute for Food Safety (ONSSA) has reported an outbreak of equine West Nile fever in a newly affected region; Grand Casablanca.
• Since 17 September 2010, a total of 24 equine cases including 10 deaths in 23 foci has been reported in 3 regions: Rabat-Sal?, Chaouia-Ouardigha and Grand Casablanca (cf. map 2).
• Grand Casablanca is the most populated region of Morocco.

Spain, human case

• On 27 September 2010, Spanish health authorities have reported a case of WN fever in Cadiz, Andalusia.10 foci of equine WN fever have been reported in Andalousia from 10 to 24 September 2010 (9 in Cadiz, 1 in Sevilla) (cf.map 3)

Comments

In Morocco, the active case finding around equine foci has not found any human cases.

• In Spain, the last human case reported was in 2004.
• The epidemiological situation in other countries of the euro-mediterranean area remains unchanged (cf. map 4, EpiSouth Thematic Note ).

-
------

[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?131 - 15 September 2010?21 September 2010 (9/25/10, edited)

EpiSouth Weekly Epi Bulletin ? N?131 - 15 September 2010?21 September 2010 (9/25/10, edited)


[Source: EpiSouth, full PDF Document (LINK). Edited.]

EpiSouth Weekly Epi Bulletin ? N?131 - 15 September 2010?21 September 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?131

• A(H5N1) Human influenza ? None
• A(H5N1) Avian influenza ? None
• ?INSIDE? Events:
  • Dengue ? France
  • Plague ? Algeria (article)
• ?OUTSIDE? Events: none

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

No human cases reported this week.


Location: world - Event: A(H5N1) ? Epizootic

No influenza A(H5N1) epizootic reported this week .


REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occuring in one or several EpiSouth countries)

Location: France - Event: Dengue

• Following the confirmation of the 1st indigenous case of dengue fever in France, Nice (Alpes-Maritimes, cf. map 1) last 10th September 2010 (cf. eWEB n?130), the French Ministry of Health reported on 19th September 2010, a second autochthonous case of dengue fever.
• This second case has been reported by the enhanced surveillance system implemented in this area (French South East) during this season (1st May to 30 November).
• Both patients recovered.
• To date, the number raise is limited and cases are located in a defined geographical area. Nevertheless, the state services are mobilized to prevent the spread of the virus.
• It was decided to strengthen the measures already in place (epidemiological and entomological surveillance and mosquito control measures) around the area of residence of affected individuals.
• A careful search for other cases in the vicinity of the first patient aims to identify those potentially affected.
• The mosquito bit trip (25-50 feet around his place of birth). Therefore, health authorities call on residents in and around Nice to adopt a number of preventive measures.

Comments

The risk of development of an epidemic is considered limited, but can not be excluded, due to the significant presence of the tiger [mosquitoes] and the touristic area of the C?te d?Azur region.


REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occurring in one or several EpiSouth countries)

Location: Algeria - Event: Plague

An article published in the Emerging Infectious Diseases Journal (17th September 2010) by the Pasteur Institute of Algiers, the Mediterranean University of Marseille and the University hospital of Laghouat, describes retrospectively several cases of plague diagnosed in July 2008 in the province of Laghouat (550 km southwest of Algiers, cf. map 2).

• In July 2008, 4 patients in total were admitted to Laghouat University hospital (included one death).
• All were nomads living in a 24-person camp in Thait El Maa in the Laghouat area.
• No patients reported contact with sick animals.
• These cases were officially communicated to WHO.
• In Algeria, the last human plague re-emergence was reported in 2003 in Oran area.

Comments

Plague is often perceived as a sensitive issue and is regularly a cause of false alerts (cf. eWEB n?44).

• Plague is endemic among wild rodent in several areas of North Africa and sporadic human cases may occur in regions where plague circulated among wildlife (cf. map 3).
• In recent years, several foci linked with wild rodent have reappeared.
• More recently, on 14th June 2009, Libya Arab Jamahiriya reported 12 bubonic plague cases (including 1 death) in the North East coast of the country (cf. eWEB n?65). This outbreak occurred in a semi-nomadic setting.
• The occurrence of sporadic plague cases or small cluster in rural areas in not an unexpected event. This event does not to be considered as an alert.

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

[Giuseppe]

Archive, EpiSouth Weekly Epidemiological Bulletin (2010)

This archive contains the most recent EpiSouth bulletins.

[Giuseppe]

EpiSouth Weekly Epi Bulletin ? N?130 - 07 September 2010 ? 14 September 2010 (extracts, edited)

EpiSouth Weekly Epi Bulletin ? N?130 - 07 September 2010 ? 14 September 2010 (extracts, edited)


[Source: EpiSouth.org, full PDF Document (LINK). Extracts, edited.]

EpiSouth Weekly Epi Bulletin ? N?130 - 07 September 2010 ? 14 September 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?130

• A(H5N1) Human influenza ? None
• A(H5N1) Avian influenza ? None
• ?INSIDE? Events:
  • Dengue ? France
  • West Nile ? Mediterranean countries: Italy, Spain, Turkey
• ?OUTSIDE? Events: none

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

No human cases reported this week.


Location: world - Event: A(H5N1) ? Epizootic

No influenza A(H5N1) epizootic reported this week .


REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occuring in one or several EpiSouth countries)

Location: France - Event: Dengue

On 13 September, the French Ministry of Health confirmed the presence of the 1st indigenous case of dengue fever in France, Nice (Alpes-Maritimes, cf. map 1). This is an isolated case and no further cases have been reported to date.

• The case is a 64 years old man who developed suddenly fever, myalgia and asthenia on August 23rd:
  • He has neither history of recent international travel nor recent history of blood transfusion.
  • The serotype is currently unknown.
  • The patient is cured and healthy.
• Investigations detected in Nice 6 recent imported cases of dengue from the 24th July to 23rd August 2010. Within these 6 cases, four were confirmed PCR positive.
• The patient is living in Nice, located in a French department (Alpes-Maritimes) where Aedes albopictus is established and active during this season (1st May to 30 November).
• This case has been reported by the enhanced surveillance system implemented in this area (French South East) during this season.
• To prevent any further spread of the virus, the epidemiological surveillance and control measures will be strengthened. Mosquito control actions have been implemented around the area of the residence of the person who was affected.

Comments

Even if some elements are still under investigation, this patient has been considered as a confirmed autochthonous case of Dengue.

• The risk of development of an epidemic is considered limited, but can not be excluded, due to the significant presence of the tiger and other imported virus. In recent weeks, many cases have been imported from French West indies.

REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occurring in one or several EpiSouth countries)

Location: Turkey, Spain, Italy - Event: West Nile

Turkey, human cases

• On September 8, 2010, the Turkish Ministry of Health has confirmed seven human cases of West Nile with 3 deaths in five provinces (west of the country): Aydin, Isparta, Izmir, Manisa, and Sakarya

Spain, Equine cases

• On September 10, 2010, the Spanish Ministry of Agriculture and Fisheries has notified to the OIE two outbreaks of equine West Nile virus which occurred in late August (two horses), in Cadiz in Andalusia province (south of the country, cf. map 3).

Italy, Equine cases

• On September 14, 2010, the Italian health authorities have notified to the OIE an additional outbreak of equine West Nile virus in Trapani in Sicilia province, Italy (cf. map 4)

Comments

In Turkey, this is the first time that human cases are officially reported. However, various serological studies provided evidence of WN virus circulation in different regions of the country since the 1970s.

• In Spain, no equine outbreak was never officially reported to OIE before.
• However, seroprevalence studies in the Delta del Ebro (2001) and south of Spain (2007) indicated the presence of WN specific antibodies in serum with respective seroprevalence of 3.8% and 0.6%.
• In recent weeks, there has been an intensification of the West Nile virus circulation in Europe and the Mediterranean region (cf. eWEB n?125, n?126, n?127, n?128 and n?129).
• To date, nine countries reported cases (human or equine) in this region (cf. table 1 and map 4)
• Changes in the West Nile virus dynamic (number of cases and geographical extension) is closely monitored as an epidemic spread to other countries with migratory flows can not be excluded.

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