Africa - Congo - 500+ cases, 200 deaths in polio outbreak

[Gert van der Hoek]

Health-Congo: Eight killed in outbreak


Epidemic Poliomyelitis-Congo - An outbreak related to polio, which has been raging for nearly two weeks in Pointe-Noire, the main economic and industrial center of Congo has already eight dead and twenty cases were reported, announced Tuesday the Congolese Ministry of Health.

'Patients admitted to hospitals exhibit symptoms of influenza. They also have paralysis starting with the legs and then reach the members', said Director General of Health, Prof. Alexis Dockekias Elect.

'This epidemic is related to polio that has raged, with the difference that this time, the disease affects teenagers and adults, unlike polio, which mainly affects young children,' said Prof. Elect Dockekias.

According to the DG of Health, the disease is probably caused by a virus that invades the digestive tract.

The Congolese Ministry of Health has already taken the World Health Organization (WHO), in accordance with the provisions concerning international health epidemics.

However, Professor Elect Dockekias urged the public not to panic but to observe basic hygiene measures in consuming only water drinking.

'Water should be boiled before consumption, one can also use the products recommended by health services to citizens,' said the DG of Health.

Due to the lack of drinking water in some districts of Pointe-Noire, especially in the periphery, people can consume water from wells and boreholes some poorly maintained that, when the rainy season, are hotbeds multiplication of many parasites, bacteria and viruses that cause epidemics.

Brazzaville - 02/11/2010

Afriquejet

 

[alert]

Re: Congo-Brazaville - 8 killed in polio outbreak

Re: Congo-Brazaville - 8 killed in polio outbreak

While the title of this thread indicates this outbreak is due to polio, the agent responsible for this outbreak has not been determined.

The fact that a majority of the cases are older, in addition to the apparently high mortality and symptomatic differences, might inidcate that polio is not the cause of this outbreak. Nearby Angola has reported a non-polio paralytic outbreak (http://www.flutrackers.com/forum/showthread.php?p=374941) in the past month, which is believe to be either TSP or cassava poisoning.

This should be sent to ProMED.

 

[alert]

Re: Congo-Brazaville - 8 killed in polio outbreak

Re: Congo-Brazaville - 8 killed in polio outbreak

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85621

Archive Number 20101102.3973
Published Date 02-NOV-2010
Subject PRO/AH/EDR> Undiagnosed paralytic illness - Rep. of Congo: (PN), RFI

UNDIAGNOSED PARALYTIC ILLNESS - REPUBLIC OF
CONGO: (POINTE-NOIRE), REQUEST FOR INFORMATION
******************************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 2 Nov 2010
Source: Casafree [Trans. by Mod.MPP, edited]
<http://www.casafree.com/modules/news/article.php?storyid=52171>


Congo: 8 dead in Pointe-Noire in an epidemic related to poliomyelitis
---------------------------------------------------------------------
An epidemic similar to poliomyelitis has been
raging in Pointe-Noire, the principal economic
and industrial center of the Congo, for nearly 2
weeks. There are already 8 deaths and 20 cases
reported, the Congolese Ministry of Health announced on Tuesday [2 Nov 2010].

"Patients have been admitted to hospitals with
symptoms of an influenza-like illness. They also
have paralysis starting with the legs and
[ascending] to the upper extremities." said the
Director General [DG] of Health, Professor Alexis Elira Dockekias.

"This epidemic is very similar to poliomyelitis
which has raged [in the past] with the difference
that this time the disease is affecting teenagers
and adults, unlike polio, which mainly affects
young children," said Professor Elira Dockekias.

According to the DG of Health, the disease is
probably caused by a virus that invades the digestive tract.

The Congolese Ministry of Health has already
notified the World Health Organization (WHO), in
accordance with the provisions concerning
international health epidemics [this probably
refers to the International Health Regulations (IHR)].

However, Professor Elira Dockekias urged the
public not to panic but to observe basic hygiene
measures in consuming only potable water.

"Water must be boiled before consumption; one can
also use the products recommended by health
services to citizens," said the DG of Health.

Due to the lack of potable water in some
districts of Pointe-Noire, especially in the
periphery [outside of the center of town], people
can consume water from wells and some poorly
maintained boreholes that, during the rainy
season, serve as homes for multiplication of many
parasites, bacteria and viruses that cause epidemics.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The brief description of the disease sounds like
an ascending paralysis that is often seen with
Guillain-Barre syndrome (GBS) -- an autoimmune
disease with an inflammatory demyelination of
peripheral nerves. GBS often follows a
respiratory or gastrointestinal illness (notably
following campylobacteriosis -- see ref. 2
below). The illness presents with a subacute
onset of progressive and symmetrical weakness in
the legs and arms, with loss of reflexes. Sensory
abnormalities are seen as well as involvement of
cranial nerves, and paralysis of respiratory
muscles also can occur. In areas with good
supportive care, there is low case fatality rate.

Some notable distinctions between GBS and polio
include the observation that 90 percent of those
with paralytic disease related to poliovirus
infection have residual paralysis, whereas
approximately 90 percent of those with GBS have
complete recovery from their paralysis. Another
distinction is that the neurologic disease seen
with poliovirus infection involves pure motor
deficit with sensory sparing, whereas GBS
typically has significant sensory deficits along with the motor impairment.

GBS has also been associated with organophosphate poisoning (see ref. 1 below).

The newswire does not give further details on the
clinical picture to know if the paralysis is
flaccid or spastic, the latter having been
associated with a disease known as konzo, related
to cyanide toxicity from cassava (see ref.4 below).

There have been cases of paralytic disease
similar to that seen with poliomyelitis
associated with infection with enterovirus 71
(see ref. 6), and a report of a polio like
paralysis with Echovirus 7 infection (see ref. 5).

As Pointe-Noire is a coastal city, the
possibility of exposure to a neurotoxin in
seafood such as seen in paralytic shellfish
poisoning or tetrodotoxin is also there,
especially with the description of the outbreak
as "raging", suggesting an acute process.

That being said, the most common etiology of an
outbreak of a poliomyelitis-like illness is
infection with wild poliovirus (WPV). The
observation that the majority of cases are in
teenagers and adults may well represent the
accumulation of pockets of susceptibles at older
ages following the interruption of WPV
transmission in the area due to intensive
National Immunization Days through the years of
the polio eradication efforts. The last reported
cases of WPV associated polio reported in the
Congo were in 2000 (WPV1 date of onset 29 Sep
2000 and WPV3 date of onset 28 Nov 2000 -- see
<http://www.polioeradication.org/Dataandmonitoring/Poliothisweek/Wildpolioviruslist.aspx>).

What is unusual here is the reported CFR of
approximately either 28.6 percent or 40 percent
(the article is unclear if the 8 deaths were
included in the count of 20 cases or if they were
in addition to the 20 cases mentioned)... -- very high for both polio and GBS.

On checking the ProMED-mail archives, in 2006
there was a report of 7 fatalities and an
additional 24 individuals hospitalized in
Maranhao Brazil with an undiagnosed paralytic
illness (see Undiagnosed neurologic syndrome,
deaths - Brazil (Maranhao): RFI
20060622.1727). (This was the heralding event
for an investigation that identified a large
outbreak of beriberi -- thiamine deficiency -- in
the state of Maranhao, related to
citreoviridin-producing _Penicillum citreonigrun_
grow in the rice stored in the affected region -- see ref 7 below)

Clearly more information from knowledgeable
sources on the clinical presentation of cases,
incubation period, along with information from
laboratory studies would be very much appreciated.

 

[Gert van der Hoek]

Re: Congo-Brazaville - 8 killed in polio-like outbreak

Re: Congo-Brazaville - 8 killed in polio-like outbreak

Recent articles on polio in Dem Rep of Congo; the cases were detected during a vaccination campaign.


DRC: 14 cases detected with the wild poliovirus, Kasai-Occidental, the province most affected

September 23, 2010


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


Kasai-Occidental: seven new cases of wild polio detected

September 30, 2010


source: Radio Okapi

 

[alert]

Re: Congo-Brazaville - 8 killed in polio-like outbreak

Re: Congo-Brazaville - 8 killed in polio-like outbreak

This is the same article as the one that starts this thread, but it is in English and has not gone through a machine translator, so it gives a slightly clearer depiction of what is going on.

Of note is that the article says that polio itself is prevalent in the area, which is in error. The ProMED post indicates no WPV cases in a decade, which agrees with the latest WHO polio data (http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx). So there may be additional errors in the report below.

http://www.afriquejet.com/news/afri...-kills-8-in-congolese-city-2010110359985.html

Congo: Polio-like epidemic kills 8 in Congolese city
News - Africa news .Health-Congo - An epidemic, similar to poliomyelitis, which has been ravaging Pointe-Noire, Congo's major economic and industrial centre, for nearly two weeks, has killed eight people, the Congolese Ministry of Health announced here Tuesday. About 20 new cases have also been reported, the ministry said.

'Patients admitted in hospitals exhibit influenza-like symptoms. They also have paralyses affecting lower limbs first before reaching the others,' said Congo's Director General of Health, Pr. Alexis Elira Dockekias.

'This epidemic is similar to polio, which is already prevalent here, with the sole difference being that it affects adolescents and adults, unlike polio, which mainly affects youth and children,' said Dockekias.

According to the Congolese health official, the disease is probably caused by a virus that affects the digestive tract.

The Congolese Ministry of Health has already referred the issue to the World Health Organization (WHO), pursuant to international health measures relating to epidemics.

However, Dockekias urged the Congolese people not to panic but to observe basic hygiene measures by drinking clean water only.

'Water must be boiled before consumption, one can also use the products recommended by health services to citizens,' he said.

Due to the scarcity of potable water in some districts of Pointe-Noire, especially on the outskirts, people sometimes consume water from wells and some poorly maintained boreholes, which, during the rainy season, are hotbeds for the propagation of many parasites, bacteria and viruses that cause epidemics.

 

[alert]

Re: Congo-Brazaville - 8 killed in polio-like outbreak

Re: Congo-Brazaville - 8 killed in polio-like outbreak

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1050,85631

Portuguese to English translation
Archive Number 20101103.3982
Published Date 03-NOV-2010
Subject PRO / POR> Disease ni ?? ? ?? identified: Congo


UNIDENTIFIED DISEASE: CONGO
*****************************
A message / Una mensaje / of ProMED-mail <http://www.promedmail.org>
ProMED-mail and a program of / es un program de la International Society
is
Infectious Diseases <http://www.isid.org>

Date: Wednesday / Miercoles, 03 November / Noviembre 2010
De: Promed-Port <Promed-Port@promedmail.org>
Source: Panapress [02.11.2010]
http://www.panapress.com/freenewspor.asp?code=por015256&dte=02/11/2010

Eight people die of an epidemic similar to polio in Congo

Brazzaville, Congo (PANA) - An epidemic poliomyelitis-like registered
about two weeks in Ponta Negra, the main economic center and
Industrial Congo, has already killed eight in 20 reported cases, announced
This Tuesday the Congolese Ministry of Health

"Patients admitted to hospitals exhibit flu-like symptoms.
They also begin to paralysis in lower limbs after
reach the upper limbs, "said Director General of Health, Alexis
?lire Dockekias.

She said this is similar to polio epidemic reported earlier,
the only difference being that this time, the disease also affects the
adolescents and adults, in contrast to polio that affects mainly
young people and children. "

This disease is needed, is probably due to a virus that affects the
digestive tract.

The Congolese Ministry of Health has informed the World Health Organization
(WHO), in accordance with international sanitary
related to epidemics.

However, ?lire Dockekias urged people not to be concerned but
observe the basic hygiene measures, consuming only water.

"The water should be boiled before consumption. You can also use the
products they recommend hygiene services to citizens, "said the
Director General of Health

Due to lack of drinking water in several districts of Ponta Negra, especially
in the outskirts, people sometimes use water from wells and some
poorly maintained water points that, during the rainy season, are
breeding sites of various parasites, bacterium and viruses in the origin of
epidemics.

Comment:
[Ascending paralysis, potentially fatal, usually due to insufficient
Respiratory suggests Guillain Barre. The etiology may be
infectious, but many cases are unusual. A cluster of cases of
syndrome points to an exogenous poisoning? ljs]
------------------------------------------------

 

[alert]

Re: Congo-Brazaville - 58 killed in large polio outbreak

Re: Congo-Brazaville - 58 killed in large polio outbreak

Polio confirmed. And this is a HUGE outbreak.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85648

Archive Number 20101104.3996
Published Date 04-NOV-2010
Subject PRO/EDR> Poliomyelitis - worldwide (26): Rep. of Congo

POLIOMYELITIS - WORLDWIDE (26): REPUBLIC OF CONGO
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 4 Nov 2010
Source: WHO Global Alert and Response (GAR) [edited]
<http://www.who.int/csr/don/2010_11_04a/en/index.html>


Polio in Congo -- 4 Nov 2010
---------------
An acute outbreak of poliomyelitis is occurring in the Republic of
Congo, with 120 cases of acute flaccid paralysis and 58 deaths. Half
the cases have been reported in the past 10 days, with the 1st case
occurring in early October [2010]. Two cases have been confirmed to
have been caused by wild poliovirus type 1, and laboratory testing continues.

Most cases are in young adults: among those cases for which age data
is available (43) at this time, 33 are between the ages of 15-25
years. Only one is under 5 years old, 3 are between 7 and 13 [years
old] and 5 are between 26 and 58 [years old].

The outbreak is due to imported poliovirus. Congo had recorded its
last case of indigenous polio in 2000. Investigations are ongoing to
determine definitively the origins of the virus.

Nearly all cases have been reported from the port city of Pointe
Noire, with cases also reported from Dolisie (2), Kayes, Bouenza,
Brazzaville, and Mvouiti (one each).

The Government of Congo has alerted the public to the outbreak and
launched an emergency response plan, with support from key partners,
including WHO, UNICEF and the US CDC. At least 3 nationwide
vaccination campaigns are expected, using monovalent oral polio
vaccine [mOPV] and targeting the entire population. The number,
geographic extent and target age groups of further campaigns will be
determined by the Government based on the evolving epidemiology. It
is anticipated that a multi-country campaign will be required to
cover bordering at-risk areas. New cases continue to be reported every day.

It is important that countries across central Africa and the Horn of
Africa strengthen AFP surveillance, in order to rapidly detect any
poliovirus importations and facilitate a rapid response. Countries
should also strengthen population immunity levels to minimise the
consequences of any virus introduction. As per recommendations
outlined in WHO's International Travel and Health, travellers to and
from Angola and DR Congo should be fully protected by vaccination.

Given the recent progress achieved in Nigeria (98 percent reduction
in cases this year [2010] compared to the same period in 2009), very
high priority is being given to rapidly controlling persistent
transmission such as in Angola and stopping new outbreaks such as in Congo.

For more information, see the Global Polio Eradication Initiative at
<http://www.polioeradication.org/>.

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[On 2 Nov 2010, there was a ProMED-mail post on an outbreak of as yet
undiagnosed polio-like illness in Pointe Noire, Republic of the Congo
that mentioned 8 fatalities and 20 cases (see Undiagnosed paralytic
illness - Rep. of Congo: (PN), RFI 20101102.3973). In that report,
the newswire mentioned that the majority of cases were in teenagers
and young adults. After mentioning non-polio etiologies for acute
flaccid paralysis, this moderator had the following comment: "That
being said, the most common etiology of an outbreak of a
poliomyelitis-like illness is infection with wild poliovirus (WPV).
The observation that the majority of cases are in teenagers and
adults may well represent the accumulation of pockets of susceptibles
at older ages following the interruption of WPV transmission in the
area due to intensive National Immunization Days through the years of
the polio eradication efforts. The last reported cases of WPV
associated polio reported in the Congo were in 2000 (WPV1 date of
onset 29 Sep 2000 and WPV3 date of onset 28 Nov 2000; see
<http://www.polioeradication.org/Dataandmonitoring/Poliothisweek/Wildpolioviruslist.aspx>)."

The above report from the Global Alert and Response unit of WHO
confirms that the etiology of this outbreak is in fact WPV and
confirms that there had not been identification of WPV-associated
polio in the Republic of the Congo since 2000.

This moderator also highlighted the seemingly high case fatality rate
(CFR): "What is unusual here is the reported CFR of approximately
either 28.6 percent or 40 percent (the article is unclear if the 8
deaths were included in the count of 20 cases or if they were in
addition to the 20 cases mentioned) ... very high for both polio and
GBS." The above WHO report reflects an even higher CFR of 48.3
percent (120 with 58 deaths). This moderator wonders if this is a
reflection of significant underreporting of cases at this early stage
in the identification of the outbreak where the most severe cases
(and fatalities) are recognized 1st, and only later will the true
magnitude of this outbreak be documented.

As mentioned in the prior ProMED-mail post (Poliomyelitis - worldwide
(25): importation related 20101104.3994), one of the challenges
facing the polio eradication effort is a rapid recognition of WPV as
the etiology of AFP cases in countries that have interrupted
transmission of the WPV years earlier, and the population and
clinicians reject polio as part of the differential diagnosis. The
above report mentions that the 1st case had a date of onset in early
October 2010 -- suggesting that time from identification of a
suspected case to confirmation in the Congo was approximately one
month -- very different from that seen in Tajikistan where the
interval was approximately 2.5 months.

For a map of the Republic of Congo showing Pointe-Noire, see
<http://www.ecoi.net/file_upload/dh935_01460con.gif>. Pointe-Noire is
located on the Atlantic Coast. For the interactive HealthMap/ProMED
map of the Republic of the Congo, see <http://healthmap.org/r/0f0G>. - Mod.MPP

 

[alert]

Re: Africa - Congo- 58 killed in polio outbreak

Re: Africa - Congo- 58 killed in polio outbreak

This seems to be a mashup of the first report (unknown disease), and latest report (polio confirmed). Of note is that the total death toll reported here is 8, not 58.

http://www.irinnews.org/Report.aspx?ReportID=91003

BRAZZAVILLE, 5 November 2010 (IRIN) - An epidemic akin to polio, which has raged for nearly two weeks in the main commercial city in southern Congo, Pointe-Noire, has already killed eight, and several dozen cases have been reported, say health officials.

"Patients admitted to hospitals have flu-like symptoms. They are also presenting with paralysis starting in the lower limbs which spreads to the upper limbs, "said Director-General of Health Alexis Elira Dockekias.

"This epidemic is related to the recent polio outbreak. The only difference is that this time the disease affects adolescents and adults, unlike polio which affects mainly the young and children," he said, adding that those affected by the epidemic are aged 15-45.

He called on the public "not to panic but to observe strict hygiene measures: boiling drinking water; washing vegetables properly; and cooking cassava [the staple food] thoroughly."

The outbreak was confirmed by the World Health Organization (WHO), which said on its website on 4 November: "There is a serious outbreak of polio in the Republic of Congo:120 cases of acute flaccid paralysis (a syndrome related to polio) and eight deaths.

"Two cases were confirmed as having been caused by poliovirus Type 1," said WHO which is awaiting test results for the other cases.

Half the cases were reported in the last 10 days, the first cases having occurred in early October, according to WHO, which said polio had disappeared from the country since 2000.

Congolese health authorities say people in Pointe-Noire have been facing "serious drinking water problems" over the past few weeks.

 

[alert]

Re: Africa - Congo- 58 killed in polio outbreak

Re: Africa - Congo- 58 killed in polio outbreak

http://www.voanews.com/english/news...-Brazzaville-Hits-Young-Adults-106765288.html

Polio Outbreak in Congo-Brazzaville Hits Young Adults
Ricci Shryock | Dakar 05 November 2010

Photo: R. Shryock/UNICEF
UNICEF officials provided vaccines for children in Senegal during an immunization campaign in March 2010
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WHO Says New Vaccine Could Eradicate Polio
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At least two cases of polio and more than 100 cases of paralysis have been reported in Congo-Brazzaville in the past month. Authorities are launching a nationwide vaccination campaign to stem the outbreak.

At least two cases of polio have been confirmed in Congo-Brazzaville over the past month, but Guido Borghese, the principal advisor for child survival and development for the United Nations Children's Fund's West and Central Africa office, says it is possible the outbreak is much more widespread.

"We have the confirmation yesterday that at least there are two cases that have been confirmed, but there are a total of 120 cases of paralysis [and] 58 deaths have been reported," said Borghese. "And these cases have not yet been confirmed, but it is possible that likely they will be also caused by the polio virus. But I repeat, that to-date, only two cases have been confirmed among the 120 cases."

Borghese said that these cases are occurring in young adults ages 15 to 25, and no children have so far been reported as having the virus.

"What is important to know is that this epidemic is not concerning children," he said. "The people that are affected by the epidemic are young adults over the age of fifteen, and apparently, these people fifteen years ago were not immunized, because the situation of the country was quite unstable. And vaccination campaigns were not carried out fifteen years ago. So these people are not vaccinated and are vulnerable to the polio virus."

Though the cases are focused in Congo-Brazzaville, specifically in the city of Pointe-Noire, Borghese said the virus may have been imported from neighboring countries such as the Democratic Republic of Congo or Angola.

The government and international partners are planning to launch a nationwide vaccination campaign, and UNICEF has contributed $3.3 million to provide vaccines for residents up to the age of 30. The campaign is scheduled to start on November 11.

UNICEF officials warn the population to follow safe food and water practices, and added that people traveling to the area should be vaccinated.

 

[alert]

Re: Africa - Congo- 58 killed in polio outbreak

Re: Africa - Congo- 58 killed in polio outbreak

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1050,85656

Archive Number 20101105.4003
Published Date 05-NOV-2010
Subject PRO / POR> Poliomyelitis: Congo


POLIO: CONGO
*****************
A message / Una mensaje / of ProMED-mail <http://www.promedmail.org>
ProMED-mail and a program of / es un program de la International Society
is
Infectious Diseases <http://www.isid.org>

Date: Friday / Viernes, 05 November / Noviembre 2010
De: Promed-Port <Promed-Port@promedmail.org>
Source: Associated Press [05/11/2010]
http://www.estadao.com.br/noticias/vidae, burst-of-polio-issue-58-mort
es-in-congo, 635110.0. htm

Polio outbreak causes 58 deaths in Congo

The authorities in the capital Brazzaville have warned the population of the outbreak and
launched an emergency plan

An outbreak of polio recorded in the month of October has infected 120
people and caused 58 deaths in the Republic of Congo.

According to data from the World Health Organization (WHO), the most contaminated
are adults and the number of diagnoses increased in the last 10 days.

"Polio is most commonly fatal in adults, with a rate of 25% of
cases, while in children the mortality rate is between 5% and 10%, "
declared the spokesman of WHO, Fadela Chaib.

The authorities in the capital Brazzaville have warned the population of the outbreak and
launched an emergency plan with support from WHO and UNICEF, with
vaccination campaigns aimed at the entire population of the country.

"Every day we recorded new polio cases," the agency warned, insisting
travelers from neighboring countries such as Angola and Democratic Republic of
Congo (DRC) also vaccinate.

Comment:
[ProMED-PORT [had] a hunch that was not confirmed (the "exogenous poisoning" in the above post - alert). It is even
poliomyelitis virus serotype 1.

Because so lethal? The incidence was in adolescents and young adults, where
disease is of course more serious.

Because in adolescents and young adults. No doubt this is a? Pocket?
inadequately vaccinated and who have benefited so far from a low risk
of acquiring polio.

The current campaign of the eradication program in Africa and Asia, aimed at
only children under 5 years old. This strategy should change? ljs]

 

[Gert van der Hoek]

Re: Africa - Congo - 65 killed in polio outbreak

Re: Africa - Congo - 65 killed in polio outbreak

machinetranslated

Saturday, November 6, 2010

Outbreak of acute flaccid paralysis: pathology identified

It is a poliovirus that causes the disease. This virus, like polio, has already killed 65 people on the 144 cases recorded to date in Pointe-Noire.

Given the extent of damage, the Crisis, which met on November 5 in Pointe-Noire wants to go fast in prevention. The response plan provides for vaccinating the entire population without distinction.

- snip -

According to John of God Balenda, "pending confirmation of test results justify the late announcement of the disease. It was impossible to raise the alarm because the patients concerned initially consisted mainly of adults, even if there were a minority among their children.

Today, as the results are confirmed and we know that this is poliovirus, which is the cause, we are able to organize a response. Support those who are already ill should be effective, but the most effective solution is to prevent direct [through] mass vaccination. "


Read more

 

[Pathfinder]

Re: Africa - Congo - 65 killed in polio outbreak

Re: Africa - Congo - 65 killed in polio outbreak

French to English translation (Google)

Flash-Health
Monday, November 8, 2010 at 6:30:00
db38643
(Congo-Brazzaville)

Outbreak of acute flaccid paralysis: the World Health Organization announces a massive vaccination campaign

Africa regional office of the World Health Organization (WHO) announced on November 5, in Brazzaville, the start of a vaccination campaign to combat the polio outbreak raging for weeks in the Congo.

"At least three vaccination campaigns will be conducted on a large scale, as of November 12, 2010, beginning with Pointe-Noire and targeting the whole population. There are also plans to organize additional campaigns in the rest of the country and in neighboring districts of neighboring countries, "said a statement.

The outbreak of acute flaccid paralysis, which broke out in Pointe-Noire, is spreading to other cities. Cases have been recorded in Brazzaville, Dolisie and Mvouti Kayi, the statement said. It was also confirmed that acute flaccid paralysis was caused by poliovirus type 1.

For three weeks, sixty of people died, most of whom are young adults aged 15 to 29 years. It is likely that the low immunity of the population is due to the disruption of immunization services during periods of instability in the country. "The polio vaccination coverage among children under five years was generally good in the Republic of Congo over the last decade," says WHO.

Thierry Noungou

http://www.brazzaville-adiac.com/in..._id=43894&cat_id=3&oldaction=home&regpay_id=0

 

[Gert van der Hoek]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

machinetranslated

08-11-2010

More than 150 deaths following an outbreak of wild poliovirus in Congo

APA-Brazzaville (Congo) More than 150 deaths were recorded in Congo following an outbreak of wild poliovirus has declared two weeks ago in the cities of Pointe Noire and Dolisie, respectively located in the departments of Kouilou and Niari in south of the country, APA learns from the Congolese Ministry of Health.

In addition, more than a thousand people have been hospitalized patients in health facilities in Pointe Noire and Dolisie, said Sunday an authority of the Ministry of Health.

The disease is manifested by lower limb paralysis that prevents the subject of walking, paralysis of respiratory muscles, a fever with temperatures above 38 degrees Celsius, headache, hoarseness, vomiting and muscle spasms in the neck cause death 45 minutes they are triggered.

"The Congolese government has implemented a plan to deal with this epidemic requires a vaccination campaign which will start in Pointe-Noire and Dolisie next week and take place in three phases with one week apart," said Dr. Gangou Narcisse, spokesman for the socio-cultural center.

For Narcissus Gangou, "the Congolese in partnership with its partners in health that are the World Health Organization (WHO), United Nations Children's Fund (UNICEF), will deliver on the cities of Pointe Noire and Dolisie more than one million vaccines for the vaccination campaign. "

read more

 

[Gert van der Hoek]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

CONGO: Polio cases confirmed

Nairobi, 9 November 2010 (IRIN) - At least 94 people have died, with 201 cases of acute flaccid paralysis reported in the Republic of Congo (ROC), since 5 November. Four cases have been confirmed as wild poliovirus type 1, says the UN World Health Organization (WHO).

?This is because [for the last] 15 years, immunization campaigns have not been carried out due to the country?s political instability. People who were not vaccinated are vulnerable to the polio virus,? Rod Curtis, a communications officer with WHO?s Global Polio Eradication Initiative, told IRIN.

Most affected are people aged between 15 and 72.

Improving water and sanitation practices can help but in an emergency situation like this, one of the fastest and most effective ways of stopping the outbreak is through cross-border mass immunization because of population movements, said Curtis.

Read more (IRIN)

 

[Pathfinder]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

French to English translation (Google)

Congo - Brazzaville: A polio epidemic kills hundreds of people
Arsene Severin
November 9, 2010

The Government of Congo - Brazzaville launch Friday (Nov. 12) on the city of Pointe-Noire (south) and neighboring regions a mass vaccination campaign against polio. It is a response to an epidemic of "wild poliovirus type 1, which has killed 101 people out of 204 registered cases.

"It's too much dead" for this number of cases. "It's a real disaster", has alarmed IPS, Dr. Jean Vivien Moumbouli, research director at the National Laboratory based in Brazzaville, the Congolese capital.

"This is a very serious epidemic that kills within 48 hours," hammered on his side, told reporters, Dr. Alexis Dokekias Elect, Director General of Health.

According to the Directorate of fight against the disease, the epidemic has already killed 97 people in Pointe-Noire, the economic capital, two people Dolisie and Nkayi a person, in the southwest. Another death was recorded last week in Brazzaville.

Elect Dr. Dokekias announced a case from the north of the country, and received at Brazzaville on Monday, November 8.

The Center for control and disease prevention, based in Atlanta, USA, and where the samples were examined, it is a "wild polio virus type 1, highly virulent.

Dr. Moumbouli says the disease has no cure. "You can put the patient on antibiotics just to alleviate the pain. If he leaves, he will live with disabilities," he said.

In Pointe-Noire, the epicenter of the epidemic, people are helpless. The government communicates very little about the disease. "We do not even know what it is, so we speculate about the disease," lamented John Bakala, a resident of the town of Loandjili where the largest number of victims.

"My father aged 45 has contracted the polio. But the doctors did not want to approach him, fearing themselves to be contaminated. I was very shocked," testified IPS Hermane Bouity, whose father, died a few days later, was detained in hospital Adolphe Cisse Pointe-Noire.

All cases are referenced in the two general hospitals in the ocean city: Loandjili and Cisse. "We may not be overwhelmed, but we fear ourselves," he confessed, under anonymity, a nurse at the hospital Loandjili.

Even non-governmental organizations (NGOs) are desperate. "We do not know what precautions to take, because we know nothing about this disease. People are abandoned," blasted IPS Mackosso, secretary general of the Justice and Peace Commission, an NGO close to the Catholic Church, based in Pointe-Noire.

"It's unfortunate for our country that has more than six billion dollar budget, we had no laboratory quality control of consumer goods," he lamented.

"The government is fully responsible for the spread of this epidemic, because it does not communicate. On television and national radio, we see nothing, and we hear nothing," complained Roch Euloge N'zobo of the Congolese Observatory of Human Rights, an NGO based in Brazzaville. "There has been considerable inefficiency in the government's reaction," he told IPS.

Informed three weeks after the first cases in early October, the authorities first wanted to know the nature of the pathology. This is only the beginning of November they began timidly to communicate. "It is a virus that attacks the nervous system, which paralyzes the entire body and kills," said Dr. Elect Dokekias to state media.

"We must observe basic hygiene. The virus is found in feces and transmitted orally. But poor hygiene, it may be in the water, vegetables or fruit," he explained.

"The vaccines arrive very late. Those who suffer will not be saved because it takes at least three weeks for it to act," he said, bitterly, Anatole Bikou, a medical representative in Pointe-Noire.

The vaccination campaign which begins November 12 for first all residents of Pointe-Noire, and the rest of the country's population then. It requires 12 million doses of vaccine, said Dr. Dokekias Elect.

The United Nations Children's Fund (UNICEF) has announced funding of five million doses from its stockpile in Copenhagen, Denmark. UNICEF research, however, some three million dollars to complete this stock with other vaccines.

Asked by IPS, the head of the National Expanded Programme on Immunization (EPI), Dr. Edward Ndinga, did not wish to communicate on the number of doses that owns the Congo.

"We have nothing, we expect the international community to help us," commented N'zobo.

The point made last July by EPI revealed that the rate of vaccination coverage against polio in the Congo was 90 percent. And the last wild polio virus has been detected since 2000. That is why authorities suspect a virus from a "neighboring country".

According to the World Health Organization, Angola still has 25 cases of wild poliovirus, and 28 cases are registered in the Democratic Republic of Congo. Among the cases detected in Pointe-Noire, four are from Cabinda, an Angolan province neighboring Congo. "We dropped a little border epidemiological surveillance," laments Dr. Dokekias Elect.

http://fr.allafrica.com/stories/201011090558.html

 

[alert]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

http://eafr.promedmail.org/

Published Date: 2010-11-09 15:34:44
Subject: PRO/EAFR> Poliomyelitis, wild type - Congo Republic (02): WHO
Archive Number: 20101109.215008

POLIOMYELITIS, WILD TYPE - CONGO REPUBLIC (02): WHO
***************************************************



Date: Fri 5 Nov 2010
Source: WHO Regional Office for Africa press release [edited]
http://www.afro.who.int/en/media-ce...adults-in-congo-calls-for-more-vigilance.html

Polio outbreak among adults in Congo calls for more vigilance
-------------------------------------------------------------
After 10 years with no detected wild poliovirus (WPV) transmission in the Republic of Congo, an outbreak has been reported. As at 5 Nov 2010, 134 cases of acute flaccid paralysis (AFP) were
reported over a period of 3 weeks in the Republic of Congo. The epicenter of these cases is Pointe Noire. There is evidence that the disease is spreading to other cities in Congo with cases and deaths being reported from Brazzaville, Dolisie, Kayes, and Mvouiti. The cause of this paralysis has been confirmed as wild poliovirus type 1.

Although cases have occurred in persons aged 1 to 72 years, the majority have been in young adults aged between 15 and 29 years. A total of 62 deaths have been reported. Similar high death rates have
been reported in previous outbreaks in Cape Verde, Albania, and Namibia.

Although the actual origin of the poliovirus causing this outbreak is being investigated in laboratories in Franceville, Gabon; Kinshasa, Democratic Republic of Congo; Johannesburg, South Africa; and Atlanta, USA, preliminary findings indicate that the outbreak is due to virus importation from neighboring countries were wild poliovirus circulation is ongoing.

Polio immunization coverage among children under 5 years of age has generally been good in Congo over the past decade. The occurrence of polio in young adults indicates low immunity among this age group, likely due to the disruption of immunization services during periods of instability. Deficiencies in hygiene and sanitation infrastructure in the Congo are also compounding factors in this outbreak.

The Government of Congo, with support from WHO and other partners, has investigated and identified the cause of this outbreak. At least 3 large scale immunization campaign rounds, beginning on 12 Nov 2010 in Pointe Noire and targeting the whole population are to be conducted. Additional campaigns are also planned in the rest of the country and neighboring districts in the surrounding countries.

Surveillance has been enhanced through out the country and communication with neighboring countries initiated on the need to intensify vigilance and heighten surveillance.

Public awareness campaigns are being mounted to inform the population about the risk and the need to participate actively in the immunization campaign.

WHO, working with partners is mobilizing technical experts as well as vaccine to be used during the response campaigns.

This outbreak reminds us of the important role that good routine immunization, hygiene, clean water, and sanitation infrastructure play in infectious disease prevention, particularly polio eradication.

The Regional Director calls upon partners, NGOs, and the community in general to actively participate in the planned campaigns so that wild poliovirus circulation can be interrupted within the shortest possible time.

--
Communicated by:
ProMED-EAFR


Despite the good coverage for polio immunisation among children under 5 years, a huge polio outbreak has been reported in the Republic of Congo mainly affecting young adults aged (15-29) years. The virus has been determined to be an importation and is more likely to be the strain circulating in the neighboring Democratic Republic of Congo and Angola where wild poliovirus transmission has been
re-established. This highlights the eminent risk of further regional spread of the virus.

It is therefore important that countries across central Africa strengthen polio immunisation coverage and AFP (acute flaccid paralysis) surveillance in order to rapidly detect any poliovirus
importations and facilitate a rapid response.

 

[alert]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

http://hisz.rsoe.hu/alertmap/woalert_read.php?glide=EP-20101110-28473-COG

http://www.nytimes.com/2010/11/10/world/africa/10polio.html

An explosive outbreak of polio is taking place in the Congo Republic, with 201 cases of paralysis found in two weeks and 104 deaths, the World Health Organization said Tuesday. The government in Brazzaville, the nation’s capital, has declared an emergency and announced plans to vaccinate the entire population with oral drops three times with help from the W.H.O., Unicef and the United States Centers for Disease Control and Prevention. In Pointe Noire, the port city where most of the cases are concentrated, “We’ve got two hospitals with hundreds of paralyzed people and many dead,” Dr. Bruce Aylward, the W.H.O.’s director of global polio eradication, said in an interview from Geneva. “And a couple of things about this outbreak are different and deeply disturbing.” Polio normally strikes young boys and girls equally, killing no more than 20 percent of those it paralyzes; death ensues when paralysis moves up the spine to the nerves that control the breathing muscles. In Pointe Noire, 85 percent of the cases are in teenagers and adults, most victims are male, and the death rate is much higher.

However, Dr. Aylward said, as his team on its way there learns more, the outbreak could begin to look more typical, albeit still serious. “We’ve only heard about this in the last seven days,” he said. “This is very much under investigation.” Pointe Noire is unusual in that rebel activity has so cut off its roads that the city is “almost like an island,” he said, with few outside children visiting. Routine polio vaccination in central Africa began only in the 1980s and focuses on children under age 5, so few adults are protected. Also, the weakened live virus in the vaccine spreads in the same way the disease virus does, shed in feces. Because mothers and sisters tend to change babies’ diapers, they may have picked up that accidental form of protection. Also, the hospitals are probably seeing only serious cases, making the death rate artificially high. “We’re still dealing with the fog of war,” Dr. Aylward said. “We don’t have exact data.” In 1996, he noted, there was an adult outbreak in long-isolated Albania after a few years in which only children got the modern vaccine. It will take a few weeks to see whether the intense central African vaccination campaigns of the last few years can fence off this outbreak, Dr. Aylward said. He called the situation in the Congo Republic an unexpected setback in what had otherwise been a great year in fighting polio. Nigeria, long Africa’s polio hot spot, had a 98 percent drop in cases since 2009, and 14 of the 15 countries with outbreaks of the Nigerian strain snuffed them out. The Congo Republic outbreak is of an Indian strain that was first found in Angola in 2007 and is creeping north.

 

[alert]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

http://www.google.com/hostednews/af...docId=CNG.003c06434b83e46dca5d95fb4df7cf8e.81

Congo polio epidemic death toll hits 101
(AFP) ? 2 hours ago

BRAZZAVILLE ? A polio epidemic in southern Congo has killed 101 people since early October, authorities said Wednesday, more than a decade after the disease was considered to have been eradicated here.

The number of deaths had risen from 78 reported Tuesday, while the total number of cases registered was up from more than 180 to 204, a government health bulletin said.

The World Health Organisation (WHO) has partly attributed the outbreak in the central African country, which had not registered a case since 2000, to Congo's poor health and hygiene infrastructure.

The bulletin said the deaths included 97 in the coastal region of Pointe-Noire, two at Dolisie in the centre-west, one at Nkayi in the southwest and one in the capital Brazzaville.

State television Wednesday showed pictures of a visit by Health Minister Georges Moyen to hospitals in Pinte-Noire, the country's economic and oil capital which has a population of 800,000.

"We only have two solutions available, vaccination and measures to ensure individual and collective health and hygiene," he said.

Congolese authorities plan to launch a country-wide vaccination programme on Friday against the virus, starting in Pointe-Noire.

After an absence of a decade, polio now appears to have returned with a vengeance, with the US Centers for Disease Control and Prevention also confirming the reappearance of type 1 polio -- one of three types of the virus.

The majority of Congolese who have contracted the virus to date are between 15 and 40 years who either did not receive enough immunization or none at all, according to health director Alexis Elira Dokekias.

Normally polio primarily affects children.

Dokekias on Tuesday denied polio's reappearance in Congo was due to lack of surveillance, noting the disease has broken out elsewhere over the past decade.

In Africa it has reappeared in neighbouring Democratic Republic of Congo and Angola, as well as Namibia and Cape Verde.

Polio has spread again in recent years with cases imported from some of the four endemic nations in Asia and Africa, mainly Nigeria, in a setback to global attempts to eradicate the crippling and sometimes lethal disease.

 

[alert]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

http://www.unicef.org/media/media_56792.html

Joint press release
Whole populations to be vaccinated in emergency response to polio outbreak
Young and old to be targeted in parts of 3 central African countries

BRAZZAVILLE, Republic of Congo/DAKAR, Senegal 11 November 2010 ? The first wave of mass polio immunization campaigns -targeting 3 million people of all ages- is to begin on Friday (12 November) to address an unusual outbreak of polio that is primarily claiming victims amongst adults. The campaign will take place in the coastal port city of Pointe Noire and in the Department of Kouilou in the Republic of Congo, 16 districts in the neighbouring province in the Democratic Republic of the Congo (DRC) and over the border in Angola.

This is the first vaccination response to the polio outbreak confirmed on 4 November in the Republic of Congo. Latest figures from 9 November, record a cumulative total of 226 cases of acute flaccid paralysis (AFP) with an unusually high mortality rate of 97 deaths. To date, four of the AFP cases have been confirmed as polio.

Most of the cases have involved young adults aged between 15 and 29. This illustrates that populations are at risk because they have not been exposed to a full immunisation. The giving of vaccination to all ages is intended to raise the general level of immunity to stop the spread of the disease.

?Every man, every woman, every child will be immunized irrespective of their past immunization status,? says WHO Regional Director for Africa, Dr Luis Sambo. ?This way we can be assured that everybody is reached, including young adults, whose immunity may be low.?

The first case of AFP was reported to a hospital in Pointe Noire on 1 October. Most of the cases - 159 - were reported between 11 and 31 October, with a peak of 73 cases between 18 and 24 October.

"The Government has a good assessment of the situation; it is worrying. Partners and resources are being mobilized to implement an appropriate response and to ensure a good take-up by the population ", said the Minister of Health and Population of the Republic of Congo, Prof. Georges Moyen.

UNICEF?s Regional Director for West and Central Africa, Dr Gianfranco Rotigliano added: ?We have to stem this fast-moving outbreak. The overriding priority is to vaccinate all people to prevent more cases and deaths as quickly as possible. We are at a critical juncture and stopping polio in Africa requires our absolute commitment?.

To date, health partners including WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, have secured some USD4.8 million, 1.7 million doses of oral polio vaccines (OPV), and deployed a multidisciplinary team of experts to support investigation of the outbreak, field activities and operational costs. Another 5 million doses of OPV from Copenhagen, Denmark, should arrive in Congo on 12 November.

?Rotary has mobilized emergency funding to respond to this outbreak,? said the Chair of Rotary?s Africa PolioPlus Committee, Ambroise Tshimbalanga Kasongo. ?With a quick response, we can stop the disease from further spread.?

Plans are underway to cover the rest of the population of the Republic of Congo from 18 to 22 November and follow this by two more nationwide rounds from 03 to 07 and 26 to 30 December. Parts of the DRC and Angola will also be covered during these rounds.

 

[tetano]

Re: Africa - Congo - 150 killed in polio outbreak

Re: Africa - Congo - 150 killed in polio outbreak

Polio kills 97 in Congo; mass immunisations planned


The United Nations Children's Fund (UNICEF) is poised to launch a mass polio immunisation campaign in the Republic of Congo, after an outbreak of the disease claimed at least 97 lives in just under a week, the agency said Thursday.

It has recorded a total 226 cases of acute flaccid paralysis - one of the main symptoms of polio - in the Central African country, mostly affecting young adults between 15 and 29-years-old.

Minister of Health Georges Moyen spoke of a "worrying" situation.

With help from the World Health Organisation (WHO), UNICEF plans to vaccinate 3-million people during the first immunisation wave.

"Every man, every woman, every child will be immunised irrespective of their past immunisation status," WHO regional director Luis Sambo said in a statement. "This way, we can be assured that everybody is reached."

"We have to stem this fast-moving outbreak," Gianfranco Rotigliano, UNICEF's regional director for West and Central Africa, added. "We are at a critical juncture and stopping polio in Africa requires our absolute commitment."

The vaccinations will initially target the coastal city of Pointe Noire and the department of Kouilou, where the outbreak was first recorded and has claimed the most victims.

UNICEF has secured 1,7-million doses of the oral vaccines, with another 5-million doses to arrive in Congo on Friday from Denmark.

The agency's goal is to immunise all of Congo's 4-million inhabitants by the end of the year. Border residents in neighbouring Democratic Republic of Congo and Angola are also to be targeted.

http://www.mg.co.za/article/2010-11-11-polio-kills-97-in-congo-mass-immunisations-planned