KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 400+ fatalities - Dengue, malaria, H1N1, others suspected

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

From Kanpur city as opposed to Kanpur Dehat/ Ramabai Nagar - more confirmation of dengue in the region.

Hindi to English translation
Two dozen dengue and chikungunya Zajamu Oct 31, 11:03 pm

Kanpur, City Correspondent: dirt of the city in a neighborhood of chikungunya and dengue to cry havoc. The area of Zajamu Rasulabad Inn of the Ram Rai. Here more than two dozen people are vulnerable to these diseases. Pile of dirt, filling the sewer here identifies became contaminated water supply is also a big problem. Spraying of mosquito larvae and the absence of anti Afagiang empire. In the absence of several months cleaning Councillor has expressed resentment against the people.

Place - place Bjbjate garbage pile and drains even infectious diseases like dengue spreads is ever and sometimes diarrhea. Consequent Faisal (4), Afiafa (3), Huriya (2), Moin (5), Deepak (15), Shankar (50), Zaheer (40), Amjad (32), Arshad (16), Zubair (22 ) Two dozen people, including chikungunya and dengue is vulnerable to. People do not say that Ssafaikarmee months. Tanriyoan half a dozen dirty and chemical-rich water at the plot fills in the blank. Councillor Haji Faiayaj often been complained of, but did not get rid of the problem.

A dozen new dengue patients

Medical College Mikroboyolawji Department weekly report 12 new patients of dengue confirmed. The week 98 samples had come. At the same time here has been 120 confirmed dengue patients. According to the urban malaria officer Dr AK Singh, Kanpur, five new patients, four Ramabai Nagar, Unnao and two is a Farrukhabad.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6867368.html

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Hatmapur is (I think) in Kanpur Nagar.

Hindi to English translation
Nov 01, 01:38 am Here
Hatmapur, Representative: Last come the BSF on Peakware leave young vulnerable to dengue Asne died Sunday afternoon.

Are told that the village of Patara area resident Jagdishpur Jaipal Singh Chandel, son of Ram Mohan (30) in the young to the post of BSF were deployed in Siliguri. After coming on vacation with family living in the village, Ram Mohan high fever Thursday morning came, a prominent doctor whose treatment he located the city was built. According to the investigation conducted by family doctors in Rammohan was confirmed to be dengue. Ram Mohan died after being freaked afternoon

http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6867940.htm

 

[Vibrant62]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Let us assume for a minute that the vast majority of these deaths are indeed from dengue fever.

The WHO factsheet on dengue fever says
http://www.who.int/mediacentre/factsheets/fs117/en/

CharacteristicsDengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death.

The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a fever with rash. Older children and adults may have either a mild fever or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.

Dengue haemorrhagic fever (DHF) is a potentially deadly complication that is characterized by high fever, often with enlargement of the liver, and in severe cases circulatory failure. The illness often begins with a sudden rise in temperature accompanied by facial flush and other flu-like symptoms. The fever usually continues for two to seven days and can be as high as 41°C, possibly with convulsions and other complications.

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 to 24 hours, or quickly recover following appropriate medical treatment (see below).

Treatment
There is no specific treatment for dengue fever.

For DHF, medical care by physicians and nurses experienced with the effects and progression of the complicating haemorrhagic fever can frequently save lives - decreasing mortality rates from more than 20% to less than 1% . Maintenance of the patient's circulating fluid volume is the central feature of DHF care.




The news reports of these deaths have included quite a few reports of sudden illness and death within a short space of time - and given that DHF is supposed to be 'rare', the numbers of infected would have to be vast... Additionally, with the right treatment, even DHF should have a low mortality rate of close to 1%.. So what is going on here?

It is also far from clear how often actual dengue testing is carried out as opposed to an observational diagnosis.

So even if this IS dengue that is primarily responsible for causing deaths here, it is possibly not behaving 'normally' for dengue. So we have to consider the possibilities of a new form of dengue, or a unique severity caused by co-infections, or?

I will still be glad when the Delhi tests and analysis are back, just to be sure of what the precise problem is here, especially as it appears to be slowly spreading.

 

[alert]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

The more recent daily update found by RoRo indicated 110 cases and 4 deaths that day. So the CFR is about 4%. The symptoms reported do sound far more like DHF than classical dengue. And 20% as a fatality rate for DHF wouldn't surprise me here as the articles indicate that very little to no medical care is available, and many of the victims are badly malnutritioned and on the verge of starvation.

There is also the strong possiblility that most of these cases are co-ifnected with malaria - an earlier report (#45) in this thread indicates that at least 17 fatal cases also tested positive for malaria. In Lucknow, there are reports of dysentery as well because the stagnant water that is breeding the mosquitoes has contaminated the drinking water.

Also, the total population of Ramabai Nagar is large (over one million people), so there may be far more illnesses than just the severe reported ones, which would also balance the numbers. The number of reported ill may just include the DHF cases. We are seeing statements like "Every house has someone with fever".

The outbreak also appears to be slowing down as weather turns colder, as we are getting reports of 1-4 deaths a day in Kanpur, and 1-3 in Lucknow for most of the past week, compared with a peak day of 24 deaths in Kanpur and nine in Lucknow.

 

[Vibrant62]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

All valid points that are not unreasonable: however, the reported cases of 24 hours or less from fever onset to death does not fit the normal dengue profile, and it is this that bothers me the most. The rest is still educated guesswork at the moment in terms of relative numbers, and impossible to call for sure in any direction.

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

I think that the some of the reports indicate that one of the surprising things about this "viral fever" was that it lasted for up to 10 days which was longer than the regular 4-5 days. See post 23,26 above. There are also probably flu, malaria, meningitis and maybe other encephalitis deaths that are mixed in here adding to the confusing plethora of symptoms. It's also possible that a chikungunya outbreak is occurring simultaneously leading to some of the negative dengue tests.

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Hindi to English translation
Lalpur again strange fever outbreak, dozens ill Nov 01, 11:07 pm
Hatmapur, Representative: Lalpur village of Patara block area once again is in the grip of strange fever. Fever affected by the surrounding villages and dozens of doctors in the town of Patara are undergoing treatment.

A strange fever in September after a three deaths came from the village Lalpur discussion. Active for several days after the Health Department put the camp in the village to treat the patients had taken anti-larval spraying. Despite the outbreak of fever subsided in the village is not named. Rakesh Sonkar village's wife Usha (30), son of Dhani Dharrameedra (22), Madhuri (40) Rajendra wife, Pooja (16) daughter, Mr. Chandra Gupta, Suresh (16) son Ramesh Chandra Gupta, dozens of villages, including fever are vulnerable. According to villagers, despite the treatment people are not getting relief from fever. Dr. JP Verma refused medical officer in charge of information, saying that he will send the team on Tuesday.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6870602.htm

 

[alert]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Some of the rapid fatalities might be falciparum malaria deaths.

http://timesofindia.indiatimes.com/...b-diseases-fall-short/articleshow/6853958.cms


KANPUR: Caught in the deadly grip of vector-borne diseases, the industrial city has registered a sharp increase in the number dengue, malaria and viral fever cases in the past one month. Courtesy, the ill-equipped Kanpur Nagar Nigam (KNN), the urban local body that never galvanises into action when various diseases are spreading their tentacles in various localities.

Now that the diseases have taken the form of an epidemic, the high court has also issued strict directives to the municipal corporation to ensure cleanliness, garbage removal and continuous fogging in every area. At a time when confirmed dengue cases have reached a total of 114 and malaria to 766, the officials of nagar nigam are still not awake but make tall claims of regular cleaning of the city.

A contrasting picture came to light when TOI tried to gauge the grimness of the situation. For the accomplishment of any programme, manpower plays a crucial role. Both the urban malaria department and the nagar nigam are running short of manpower. In view of the vast city area, a team of at least 10,000 safai karamcharis are required. But KNN has to manage with only 5,000 sanitary workers. Keeping in mind the acute shortage of manpower, KNN has appointed 40 workers on contract basis so far.

Municipal commissioner R Vikram Singh said: "Under the solid waste management (SWM) programme, the problem of staff crunch is handled by the private firm associated with it. Every month around 10-15 nagar nigam sweepers are taking retirement from the job. It is a difficult task to fill the vacant posts. Therefore we have asked the private company carrying out the solid waste management scheme in the city to increase the number of their workers. We are also appointing workers on contract basis."

He also claimed that the cleanliness drive was being carried out as per the expectations and the work had vastly improved in the past few days. "To tackle the unhygienic conditions prevailing in the city, garbage is now being collected in the night hours as well. The quantity of the collected garbage disposed at Panki has also increased, which is a proof of our efforts," said Singh.

Undoubtedly the staff crunch has affected the overall work of garbage removal. Presently, there are only seven modern litter centres, 63 permanent garbage houses and around 75 open areas under KNN for regular disposal of garbage. Besides, under the SWM scheme, containers have been placed in various localities for collection of garbage. But, the entire city is grappling with insanitary conditions as garbage is strewn everywhere.

Be it Ashok Nagar, Om Purwa or Faithful Ganj, a majority of the localities are in deplorable condition. Vijay Pal Singh, a resident of Ashok Nagar, said: "The containers placed for the collection of garbage remain unattended for two to three days and the litter spreads on the road. Despite several reminders, no timely action has been taken so far by the nagar nigam."

Speaking on similar lines, Ram Shankar, a resident of Om Purwa, said: "The garbage collected by the sweepers is thrown outside the garbage house leading to unhygienic conditions in the area."

Meanwhile, the urban malaria department has been facing a shortage of manpower. Presently 322 workers are deployed against the sanctioned post of 360. Only 24 superior field workers (SFWs) are deployed against the sanctioned post of 30 and over 103 inferiors field workers (IFWs) are appointed against the sanctioned posts for 120. Both IFWs and SFWs are the class IV employees who are assigned the duty to spray anti-larvae on stagnant water collected in a locality due to heavy downpour or due to sewage water.

Urban malaria officer AK Singh accepted the city was facing acute shortage of workers. He said: "The urban malaria unit in Kanpur came into operation in the year 1979. Since then the population has increased by threefolds but the sanctioned posts are still the same. Many of the current posts are lying vacant, thus affecting work."

But the health officials of KNN claimed they were carrying out fogging to kill deadly mosquitoes on a regular basis. The municipal commissioner said: "There are 12 fogging machines and ample amount of chemical to carry out fogging drives in the city and it has been done in various areas."

However, Mooven Beg, a resident of Lajpat Nagar, said: "This year fogging has not been carried out in our locality. The claims made by the nagar nigam are worthless as nothing has been done to control the mosquito menace in our area."




Read more: Efforts to curb diseases fall short - The Times of India http://timesofindia.indiatimes.com/...l-short/articleshow/6853958.cms#ixzz1448vprXf

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 372 fatalities - Dengue, malaria, H1N1, others suspected

Hindi to English translation
Deadly fever: three innocent handedly broke the Nov 02, 08:14 pm
Ramabai Nagar, our representative: strange fever outbreak in the district is not issued. Three innocent on Tuesday to come in the grip of the fever death toll to 375 so far has. While doctors and health personnel in government hospitals forced to wander casually Zolahchhap patient undergoing the treatment.

Havoc in the district the last two and a half months of strange fever of 375 people have died. Shafiq on Tuesday, the daughter of resident Mahmuadapur Arhamtul (eight months) died of the fever. According to family child had fever the past three days. Personal physician after treatment with recovery not see him bring the district hospital where doctors declared him dead. Mankapur Aramkesh daughter of the imagination (5) and Shahjahanpur Babli's son Rohit Gupta (13) died of the fever. District hospital emergency exists Dr. PK Jain said the family brought the baby was dead. Due to wrong treatment of innocent deaths. CMO Dr Ramesh Chandra Srivastava said that the health centers to recruit patients and negligence complaints are not to be. Surprise inspection of hospitals to meet the negligence action against the culprits will
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6872271.html

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Hindi to English translation
Strange woman's death from fever Nov 08, 11:46 pm
Kanpur, property representative: even if the cold weather gave a knock, but is not lacking in the killer diseases. On Monday, the strange fever Berro Kararhi a woman died. Meanwhile, dengue, malaria, chikungunya patients in hospitals are full. Haalo more than a dozen dengue patients are admitted.

Kararhi Slum Village's 45-year-old died of a fever of Kamalaoti. Councilor of the area Ranw Bajpei said that eight people have died in it. At equal risk of disease outbreaks from around the mess remains. Senior Physician Dr. Nandini Rastogi said the last two months is more than three hundred dengue patients treated. According to him the past week the number of patients decreased, but still requires caution.

Dengue child a month

According to pediatrician Dr. Vivek Saxena season came to a large number of dengue patients. This time in a month the child was found dengue. This season the outbreak of diseases due to the physicians had more work.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6888127.htm

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Hindi to English translation
Dengue victim's death in Kanpur Nov 11, 07:46 pm
Bcewara: Health Administration is known or not known, but dengue in the district. Young man suffering a dengue Bcewara area of Kanpur on Wednesday night in a private hospital died during treatment.
Village residents entering school Wyasspur Maehrwan Singh Yadav Yadav son came four days before the fever left her local doctors showed the drug but did not relax. Deteriorating condition of the family with her bring Etawah district hospital where serious case has been referred to see him Kanpur.

Family members of victims admitted to a private hospital in Kanpur range. According to family members there to check dengue Yadav told Access. Doctors involved in his treatment was too late by then. Twenty-four hours of admission died during treatment. When his body came home on Thursday in the village and village Kohram unleashed the wave of grief.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6895594.htm

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 375 fatalities - Dengue, malaria, H1N1, others suspected

Hindi to English translation
Fever broke two women own Nov 11, 09:22 pm
Ramabai Nagar, our representatives: the district on Thursday, two women died on the fever. Villagers alleged that the affected village health teams are missing, while doctors in government hospitals are not getting lost from the patient.

District released the last three months of the outbreak of disease deaths have been more than four Saikada. {Saikada (I think) means centenarian - in this context probably 400 - Ro} Indifferent to the mess officer due to illness and made the roster even after the cleaning is on paper. While the disease affected villages remain missing and the health teams of doctors in government hospitals are not meeting patient wandering. Sivally Anpre Jawahar Nagar Mohalla resident of the town by Sunil Kashyap's wife Pushpa (26) died of the fever on Thursday. According to family members with personal physician treating him was going on. Kanpur Haalo take seriously when it died in my way. According to the wife of Barhi small village Rajpur Anpre Bitana (30) to be in the grip of the fever died on Thursday. According to family doctors in government hospitals due to not getting the treatment he was undergoing personal physician. CMO Dr Ramesh Chandra Srivastava said the 24-hour presence in hospitals to ensure Chikitkasskoan efforts are being made. Health center in charge have been instructed to caution.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6896462.html

 

[Ronan Kelly]

Re: KANPUR, Uttar Pradesh: Post-Monsoon disease outbreaks 2010 - 400+ fatalities - Dengue, malaria, H1N1, others suspected

First report I've found from Kanpur Dehat in quite a while;

Hindi to English translation
Strange young woman with fever, including two deaths Dec 02, 12:11 am
Hatmapur, Anpre: curious because of the outbreak of fever on Wednesday, killing two people in the area.

Are told that the village residents Ahthehrua COMETA Sanakwar wife Sangeeta (19) high fever on Sunday evening came. Translator for the treatment of CHC has taken serious view state doctors had referred her Haalo. Sangeeta's family said Wednesday morning died during the treatment.

Similarly, the village of Patara area suffer fever in Lalpur Rafique (55) in a private hospital in the city Wednesday morning died during treatment. According to Rafiq family during the trial were confirmed to be dengue.

http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_6968750.html