Treyfish
Moderator
In this update:
[1] Paraguay
[2] Brazil
[3] Fiji
[4] Hong Kong ex Indonesia
******
[1] Paraguay
Date: Thu 26 Apr 2007
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, International Federation of Red Cross and Red
Crescent Societies (IFRC) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/RMOI-72MUYR?OpenDocument>
Background and current situation
--------------------------------
As of 14 Apr 2007, the Ministry of Public Health and Social Welfare
(MoH) recorded a total of 25 955 confirmed cases of classic dengue
fever since the start of the year [2007] and throughout the current
dengue fever outbreak. There are 52 cases of the hemorrhagic strain
of the virus [DHF cases, not necessarily virus strain. - Mod.TY]
confirmed by laboratory to date, and an additional 43 suspected
cases. [The virus has officially claimed 13 deaths], with 6 deaths
attributed to hemorrhagic dengue/shock, 5 to classic dengue/visceral,
and 2 with serotype unknown [the report probably means syndrome
unknown, rather than virus serotype. - Mod.TY].
There are still doubts regarding the official number of cases of
dengue fever in the country. Health workers continue to argue that
official figures fall between 80-100 percent short of actual cases
registered by the MoH and that the actual number of suspected cases
may therefore be in the realm of at least 100 000. The results of a
survey undertaken by authorities in the Central Department indicate
that [the virus has infected the 19.9 percent of the department's
population] since the start of the year [2007]. The MoH maintains
that real figures are lower than this, and furthermore that more
precise figures will only be recorded at the end of the outbreak with
assistance provided by the Pan-American Health Organization (PAHO).
At the beginning of April [2007], the Government recorded an overall
decline in the number of consultations and new cases of dengue in the
country, although there are significant variations across the
country. According to the MoHs recent estimates, the number of dengue
consultations has decreased by 70-80 percent in the capital,
Asuncion, and in the Central Department, and is replaced by a rapid
increase in the number of consultations due to high rates of acute
respiratory infections (ARIs) after heavy rains and abrupt
fluctuations in temperature. However, whilst the Commission for the
Closure of Cases reports that there has been a slow decline in the
number of potential dengue cases in the cities of San Lorenzo, Luque,
and Fernando de la Mora, in other areas the rates of infection are
still worryingly high -- for example in Lambare, where 50 new cases
are still being reported per day.
Since the Government declared a state of national emergency due to
the dengue outbreak, national and local authorities have carried out
several actions: The Secretariat of National Emergencies (SEN), who
is coordinating the national campaign and joint activities conducted
by the Ministry of Environment and the MoH, mobilised teams of health
promoters working on dengue prevention at community level, and teams
of personnel conducting fumigations with insecticide. The MoH
accepted the Central Department's plan to jointly fumigate
neighbourhoods to eliminate the mosquito vector starting in Villa
Elisa, Nemby, and Ita, where it is hoped that more precise data (on
morbidity and mortality rates, decline rates of the virus [infection]
and of the adult mosquitoes following fumigation activities) will be
recorded during the implementation of this departmental plan.
To illustrate the proportions that the issue is taking nation-wide,
the authorities in the capital city of Asuncion have identified and
are set to prosecute 19 property-owners (under Law 716, which
sanctions procedures against those who commit offences to the
environment) who failed to comply with regulations to clean empty or
abandoned plots that have been identified as prime locations where
mosquito larvae are produced. These measures have been taken within
the framework of the dengue prevention campaign and in the fight
against the disease.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It will be interesting to see if legal sanctions are enforceable and
provide sufficient motivation for property owners to eliminate the
water catchments that are larval habitats for _Aedes aegypti_ vector
mosquito breeding. The source link above provides a map or Paraguay
and shows the areas where the dengue epidemic has been occurring. - Mod.TY]
******
[2] Brazil
Date: Tue 24 Apr 2007
From: Luciano Goldani <lgoldani@ufrgs.br>
[In response to a ProMED-mail inquiry about dengue cases in Rio
Grande do Sul state, Dr. Goldani response follows. - Mod.TY]
Actually, all the approximately 200 suspicious and 11 confirmed cases
of dengue have been described in the north and northwest region of
Rio Grande do Sul (cities of Girua and Erechim), approximately 600
km. (373 miles) from Porto Alegre. As you know, this state was a free
zone of dengue. Other cities nearby, Girua and Erechim, are also
reporting suspicious cases of dengue. Those regions have been facing
immigration of rural workers from a highly endemic area of dengue,
Mato Grosso do Sul state.
Surprisingly, temperatures otherwise usually lower than 20 deg C (68
deg F) in the fall in Rio Grande do Sul have exceeded 30 deg C (86
deg F) this year [2007]. It looks like that dengue has spread all over Brazil.
--
Dr. Luciano Goldani
Chief, Infectious Diseases Unit
Hospital de Clinicas de Porto Alegre
Brazil
<lgoldani@ufrgs.br>
[ProMED thanks Dr. Goldani for his comments. It will be interesting
to see if the numbers of dengue cases decline as autumn temperatures
become lower in this part of Brazil.
A map of Brazil can be accessed at
<http://www.lib.utexas.edu/maps/americas/brazil.jpg>. - Mod.TY]
******
[3] Fiji
Date: Thu 26 Apr 2007
Source: Radio New Zealand International [edited]
<http://www.rnzi.com/pages/news.php?op=read&id=31769>
Dr Josaia Samuela says there has also been an upsurge of dengue fever
with 40 people now affected.
Meanwhile, the Secretariat of the Pacific Community, or SPC
epidemiologist, Dr Tom Kiedrzinski, says people need to be aware of
how to combat dengue. "Dengue is an episodic problem in the region
with epidemic outbreaks from time to time. It is really important
that the population in the countries be ready for that, especially
during the warm and wet season. It can be tackled with proper
education among the population." Dr Tom Kiedrzinski says people
should use insect repellent, sleep under a mosquito net and contact
their doctors if they discover the symptoms.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Since the dengue virus vector, _Aedes aegypti_, is a day-biting
mosquito, mosquito repellent is likely to be more effective to
prevent dengue virus transmission than sleeping under bed nets,
except for daytime naps.
A map of Fiji can be accessed at:
<http://www.mapsouthpacific.com/fiji/index.html>. - Mod.TY]
******
[4] Hong Kong ex Indonesia
Date: Fri 27 Apr 2007
Source: Health and Community News.gov.Hong Kong [edited]
<http://www.news.gov.hk/en/category/healthandcommunity/html/4ba8f149-0150-40bc-92d7-4b5958048796.htm>
The Centre for Health Protection has confirmed an imported dengue
fever case, involving a 59-year-old North Point woman. She travelled
to Indonesia from 29 Mar-15 Apr [2007] and came down with fever,
headache, and a rash on 11 Apr [2007].
She was admitted to Ruttonjee Hospital on 15 Apr 2007 and discharged
on 23 Apr 2007. Her travel companion had no symptoms.
It was the 6th imported dengue fever case reported this year [2007].
Last year [2006], there were 31 cases, all imported.
--
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley, Ph.D.
[The WHO (World Health Organization) describes dengue fever as a
severe, flu-like illness that affects infants, young children, and
adults but is seldom fatal. The clinical features of dengue fever
vary according to the age of the patient. Infants and young children
may have a non-specific febrile illness with rash (although some
infants and very young children may develop shock syndrome, with
sudden loss of circulating fluid volume, and die). Older children and
adults may have either a mild febrile syndrome or the classical
incapacitating disease, with abrupt onset and high fever, severe
headache, pain behind the eyes, muscle and joint pains, and rash.
Dengue hemorrhagic fever [DHF] is a potentially deadly complication
that is characterized by high fever, hemorrhagic phenomena -- often
with enlargement of the liver --, and in severe cases, circulatory
failure. The illness commonly begins with a sudden rise in
temperature accompanied by facial flush and other non-specific
constitutional symptoms of dengue fever. The fever usually continues
for 2 to 7 days and can be as high as 40-41 deg C (104-105.8 deg F),
possibly with febrile convulsions and hemorrhagic phenomena. In
moderate DHF cases, all signs and symptoms abate after the fever
subsides. In severe cases, the patient's condition may suddenly
deteriorate after a few days of fever; the temperature drops,
followed by signs of circulatory failure, and the patient may rapidly
go into a critical state of shock and die within 12-24 hours or
quickly recover following appropriate volume replacement therapy.
There is no specific treatment for dengue fever. However, careful
clinical management by experienced physicians and nurses frequently
saves the lives of DHF patients. With appropriate intensive
supportive therapy, mortality may be reduced to less than one
percent. Maintenance of the circulating fluid volume is the central
feature of DHF case management. (Abstracted from the WHO website fact
sheet on dengue
<http://www.who.int/mediacentre/factsheets/fs117/en/>).:surrender:
http://tinyurl.com/34duj7
[1] Paraguay
[2] Brazil
[3] Fiji
[4] Hong Kong ex Indonesia
******
[1] Paraguay
Date: Thu 26 Apr 2007
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, International Federation of Red Cross and Red
Crescent Societies (IFRC) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/RMOI-72MUYR?OpenDocument>
Background and current situation
--------------------------------
As of 14 Apr 2007, the Ministry of Public Health and Social Welfare
(MoH) recorded a total of 25 955 confirmed cases of classic dengue
fever since the start of the year [2007] and throughout the current
dengue fever outbreak. There are 52 cases of the hemorrhagic strain
of the virus [DHF cases, not necessarily virus strain. - Mod.TY]
confirmed by laboratory to date, and an additional 43 suspected
cases. [The virus has officially claimed 13 deaths], with 6 deaths
attributed to hemorrhagic dengue/shock, 5 to classic dengue/visceral,
and 2 with serotype unknown [the report probably means syndrome
unknown, rather than virus serotype. - Mod.TY].
There are still doubts regarding the official number of cases of
dengue fever in the country. Health workers continue to argue that
official figures fall between 80-100 percent short of actual cases
registered by the MoH and that the actual number of suspected cases
may therefore be in the realm of at least 100 000. The results of a
survey undertaken by authorities in the Central Department indicate
that [the virus has infected the 19.9 percent of the department's
population] since the start of the year [2007]. The MoH maintains
that real figures are lower than this, and furthermore that more
precise figures will only be recorded at the end of the outbreak with
assistance provided by the Pan-American Health Organization (PAHO).
At the beginning of April [2007], the Government recorded an overall
decline in the number of consultations and new cases of dengue in the
country, although there are significant variations across the
country. According to the MoHs recent estimates, the number of dengue
consultations has decreased by 70-80 percent in the capital,
Asuncion, and in the Central Department, and is replaced by a rapid
increase in the number of consultations due to high rates of acute
respiratory infections (ARIs) after heavy rains and abrupt
fluctuations in temperature. However, whilst the Commission for the
Closure of Cases reports that there has been a slow decline in the
number of potential dengue cases in the cities of San Lorenzo, Luque,
and Fernando de la Mora, in other areas the rates of infection are
still worryingly high -- for example in Lambare, where 50 new cases
are still being reported per day.
Since the Government declared a state of national emergency due to
the dengue outbreak, national and local authorities have carried out
several actions: The Secretariat of National Emergencies (SEN), who
is coordinating the national campaign and joint activities conducted
by the Ministry of Environment and the MoH, mobilised teams of health
promoters working on dengue prevention at community level, and teams
of personnel conducting fumigations with insecticide. The MoH
accepted the Central Department's plan to jointly fumigate
neighbourhoods to eliminate the mosquito vector starting in Villa
Elisa, Nemby, and Ita, where it is hoped that more precise data (on
morbidity and mortality rates, decline rates of the virus [infection]
and of the adult mosquitoes following fumigation activities) will be
recorded during the implementation of this departmental plan.
To illustrate the proportions that the issue is taking nation-wide,
the authorities in the capital city of Asuncion have identified and
are set to prosecute 19 property-owners (under Law 716, which
sanctions procedures against those who commit offences to the
environment) who failed to comply with regulations to clean empty or
abandoned plots that have been identified as prime locations where
mosquito larvae are produced. These measures have been taken within
the framework of the dengue prevention campaign and in the fight
against the disease.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It will be interesting to see if legal sanctions are enforceable and
provide sufficient motivation for property owners to eliminate the
water catchments that are larval habitats for _Aedes aegypti_ vector
mosquito breeding. The source link above provides a map or Paraguay
and shows the areas where the dengue epidemic has been occurring. - Mod.TY]
******
[2] Brazil
Date: Tue 24 Apr 2007
From: Luciano Goldani <lgoldani@ufrgs.br>
[In response to a ProMED-mail inquiry about dengue cases in Rio
Grande do Sul state, Dr. Goldani response follows. - Mod.TY]
Actually, all the approximately 200 suspicious and 11 confirmed cases
of dengue have been described in the north and northwest region of
Rio Grande do Sul (cities of Girua and Erechim), approximately 600
km. (373 miles) from Porto Alegre. As you know, this state was a free
zone of dengue. Other cities nearby, Girua and Erechim, are also
reporting suspicious cases of dengue. Those regions have been facing
immigration of rural workers from a highly endemic area of dengue,
Mato Grosso do Sul state.
Surprisingly, temperatures otherwise usually lower than 20 deg C (68
deg F) in the fall in Rio Grande do Sul have exceeded 30 deg C (86
deg F) this year [2007]. It looks like that dengue has spread all over Brazil.
--
Dr. Luciano Goldani
Chief, Infectious Diseases Unit
Hospital de Clinicas de Porto Alegre
Brazil
<lgoldani@ufrgs.br>
[ProMED thanks Dr. Goldani for his comments. It will be interesting
to see if the numbers of dengue cases decline as autumn temperatures
become lower in this part of Brazil.
A map of Brazil can be accessed at
<http://www.lib.utexas.edu/maps/americas/brazil.jpg>. - Mod.TY]
******
[3] Fiji
Date: Thu 26 Apr 2007
Source: Radio New Zealand International [edited]
<http://www.rnzi.com/pages/news.php?op=read&id=31769>
Dr Josaia Samuela says there has also been an upsurge of dengue fever
with 40 people now affected.
Meanwhile, the Secretariat of the Pacific Community, or SPC
epidemiologist, Dr Tom Kiedrzinski, says people need to be aware of
how to combat dengue. "Dengue is an episodic problem in the region
with epidemic outbreaks from time to time. It is really important
that the population in the countries be ready for that, especially
during the warm and wet season. It can be tackled with proper
education among the population." Dr Tom Kiedrzinski says people
should use insect repellent, sleep under a mosquito net and contact
their doctors if they discover the symptoms.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Since the dengue virus vector, _Aedes aegypti_, is a day-biting
mosquito, mosquito repellent is likely to be more effective to
prevent dengue virus transmission than sleeping under bed nets,
except for daytime naps.
A map of Fiji can be accessed at:
<http://www.mapsouthpacific.com/fiji/index.html>. - Mod.TY]
******
[4] Hong Kong ex Indonesia
Date: Fri 27 Apr 2007
Source: Health and Community News.gov.Hong Kong [edited]
<http://www.news.gov.hk/en/category/healthandcommunity/html/4ba8f149-0150-40bc-92d7-4b5958048796.htm>
The Centre for Health Protection has confirmed an imported dengue
fever case, involving a 59-year-old North Point woman. She travelled
to Indonesia from 29 Mar-15 Apr [2007] and came down with fever,
headache, and a rash on 11 Apr [2007].
She was admitted to Ruttonjee Hospital on 15 Apr 2007 and discharged
on 23 Apr 2007. Her travel companion had no symptoms.
It was the 6th imported dengue fever case reported this year [2007].
Last year [2006], there were 31 cases, all imported.
--
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley, Ph.D.
[The WHO (World Health Organization) describes dengue fever as a
severe, flu-like illness that affects infants, young children, and
adults but is seldom fatal. The clinical features of dengue fever
vary according to the age of the patient. Infants and young children
may have a non-specific febrile illness with rash (although some
infants and very young children may develop shock syndrome, with
sudden loss of circulating fluid volume, and die). Older children and
adults may have either a mild febrile syndrome or the classical
incapacitating disease, with abrupt onset and high fever, severe
headache, pain behind the eyes, muscle and joint pains, and rash.
Dengue hemorrhagic fever [DHF] is a potentially deadly complication
that is characterized by high fever, hemorrhagic phenomena -- often
with enlargement of the liver --, and in severe cases, circulatory
failure. The illness commonly begins with a sudden rise in
temperature accompanied by facial flush and other non-specific
constitutional symptoms of dengue fever. The fever usually continues
for 2 to 7 days and can be as high as 40-41 deg C (104-105.8 deg F),
possibly with febrile convulsions and hemorrhagic phenomena. In
moderate DHF cases, all signs and symptoms abate after the fever
subsides. In severe cases, the patient's condition may suddenly
deteriorate after a few days of fever; the temperature drops,
followed by signs of circulatory failure, and the patient may rapidly
go into a critical state of shock and die within 12-24 hours or
quickly recover following appropriate volume replacement therapy.
There is no specific treatment for dengue fever. However, careful
clinical management by experienced physicians and nurses frequently
saves the lives of DHF patients. With appropriate intensive
supportive therapy, mortality may be reduced to less than one
percent. Maintenance of the circulating fluid volume is the central
feature of DHF case management. (Abstracted from the WHO website fact
sheet on dengue
<http://www.who.int/mediacentre/factsheets/fs117/en/>).:surrender:
http://tinyurl.com/34duj7