La Reunion: Outbreak History

[DB]

Re: Outbreak History

Re: Outbreak History

http://babelfish.altavista.com/babelfish/trurl_pagecontent?lp=fr_en&trurl=http%3a%2f%2fwww.clicanoo.com%2farticle.php3%3fid_article%3d121671

Veiled, c?est a fact and I can only deplore it : Saint-Andrew does not do anything to fight against this mosquito. Indeed, of the refuse, there are of them tons in wild deposits in all the city, of the carcasses of cars containing of l?eau in full centre town and nobody does anything. Frankly, in term of management of crisis, it n?y does not have only one person qualified in this blasted town hall. Look at the city of the Port, which s?organise to make circulate trucks to remove the refuse of all the districts of the city ! Why St Andre would make the same thing, because there, one n?en can more this CHIK, and nobody moves, nobody does not do anything has Saint-Andrew. Then if j?avais a council to be given to this town hall, c?est to clean the city which resembles a dump, and d?enlever these carcasses of cars which are everywhere, even in the centre town. DO SOMETHING !!!

http://babelfish.altavista.com/babelfish/trurl_pagecontent?lp=fr_en&trurl=http%3a%2f%2fwww.clicanoo.com%2farticle.php3%3fid_article%3d121658

HEALTH
The deferred re-entry
The vice-chancellor decided, yesterday, to defer to February 6 the date of the school re-entry in the colleges and colleges, in order to be able to finish the demoustication. Private L?enseignement s?est immediately aligned, and the primary schools should make in the same way, like l?a recommended the prefect.

[ January 27, 2006 ]

The children howl of joy, and the parents sigh of spite. Official L?annonce of the carryforward of the school re-entry at next 6 February made l?effet d?une yesterday bends in the majority of the réunionnaises families. Even if for an observant eye, this advertisement n?avait anything of surprising. Our preceding reports had shown the delay taken in the demoustication of the establishments. And some interlocutors had already evoked this possibility (to read below). But l?stubbornness of the authorities to proclaim that all would be ready within the deadlines had been right of many doubts. Jusqu?? yesterday morning. C?est the vice-chancellor himself which chose to answer the questions of the journalists on line, yesterday at the end of the morning. ?Nous wanted to make play the principle of precaution, justified Paul Canioni yesterday. By shifting the re-entry d?une week, we are now sure that the establishment will be treated against the moustiques?. If that n?a been able to be made front, always according to the vice-chancellor, c?est because of many constraints, like the rain or the lack of material. When stock was taken yesterday morning, only twenty chiefs d?établissements (headmasters of colleges or principal of colleges) had confirmed the end of the operations. And following a discussion with the prefect, the vice-chancellor made his decision yesterday : colleges and colleges will n?ouvriront that on February 6.

?VIDES SINCE DECEMBER 19 2005?

?Il has 112 establishments there, that is to say 600 hectares of land, including 300 hectares d?espaces verts?, the vice-chancellor specified, thus justifying his decision d?accorder an additional time with the agents d?entretien. Not question of d?accueillir the pupils in full meeting of pulverization d?insecticide. Little after midday, another news fell on the desk from the vice-chancellor : in dialogue with ḻassociation of the mayors, the prefect came d?étendre the carryforward from the school re-entry to the 530 primary schools (maternal and elementary) of l?île. Misfiring continued because certain mayors n?avaient obviously yet not announced a decision, yesterday afternoon, increasing confusion in the families. Then in l?après-midday, the director diocesan, temporarily out of the department, encased the step with the vice-chancellor : l?enseignement private catholic delayed to him also his school re-entry. If everyone puts d?accord, c?est thus l?ensemble of ḻacademy (except preparatory university and classes), that is to say more than 220000 pupils, who see their lengthened holidays d?une week. What makes obviously the happiness of the kids does not do that of the parents (to read below). As for the trade unions, they n?ont not of rather hard words against vice-chancellorship and prefecture, representatives of l?État in our island. Even if everyone s?accorde to recognize that the health of the children takes precedence over any other consideration, some, as the departmental president of ḻassociation of the Parents d?élèves of l?enseignement public (Peep) point out that ̴ḻepidemy of chikungunya (...) n?est not a recent phenomenon. The school establishments are empty since December 19, 2005 and it would have been judicious to envisage measurements of demoustication during this période?. However, this n?est not fault of d?avoir informed by the press...

Veronique Hummel

112 public secondary establishments were to be démoustiqués in five days : 72 colleges and 41 colleges. That is to say 600 hectares, including 300 green ha d?espaces, for nearly 100 000 pupils.

530 primary schools (including 24 private under contract) were also to be treated before the re-entry of their 121 000 schoolboys. Many d?entre they was occupied by centers of leisures during the holidays, which prevented any d?insecticide use. N private L?enseignement catholic represents 5 colleges, 4 colleges and 24 primary schools, is a total d?environ 15 000 pupils.

The strike notice for Monday January 30 falls from itself. On the other hand, the gathering envisaged Monday at 10 a.m. in front of the vice-chancellorship is maintained by the CGTR and l?Unatos-FSU.

A national movement of strike is announced for February 2. It will not be followed in the empty schools, perhaps but the trade unions will announce d?autres actions.

1,4 ton of curry poultry started to cook yesterday morning, in the central kitchen of the Titan college to the Port, which prepares 6000 meals per day. Impossible to preserve during ten days. This meat, which was to be consumed next Monday, is lost, except if l?on manages to give it to another community. Even problem with the central kitchen of the college Ambroise-Vollard, in Saint-Pierre, where the meat started yesterday to defrost.

R.A.S. with ḻuniversity

Unchanged program for the students réunionnais. In an official statement, ḻuniversity specified yesterday that ?des operations of demoustication was and will be carried out on the university sites (...). These operations (...) not requiring the closing of the various sites, the re-entries envisaged in the various components are not compromises?. Various sites and various faculties n?ont not same dates of re-entry ; d?autre share, certain students and researchers continued to attend the places during January. On the campus of Moufia, the demoustication was partially carried out the 18 janviers the last by a private company. The remainder of the field should be treated the next week. For the campus of the university Plug, l?institut of technology in Saint-Pierre and l?institut ḏadministration of the companies, interventions of private companies are envisaged in the current of the next week.

Wrong to d?avoir reason too early

It is wrong to d?avoir be right too early. Vincent Baugé, secretary-general of the national Trade union of the agents of national ḻEducation and the local authorities (Snaen-CT-Unsa) had, Wednesday 18 with the prefecture, survey the finger to propose a carryforward d?une week of the school re-entry. Already, at this tripartite meeting devoted to the transfer of Tos towards the Area and the Department, some expressed doubts about the possibilities of treatment in times. It s?est sharply makes give to its place by the representative of the prefect, on the topic : ?Non, not, not. It is necessary to think of the pupils ; you n?êtes not here in committee paritaire?. Circulate, has nothing there to say. Eight days after, the same prefecture gives its agreement for the carryforward of the re-entry, always for many pupils, it s?entend. ?C?est a total error of the préfecture?, show Vincent Baugé. Questioned yesterday by the journalists, the vice-chancellor Paul Canioni promised that the days of lost courses would be caught up with, in particular in the classes of final.

 

[DB]

Re: Outbreak History

Re: Outbreak History

These are the numbers for how an outbreak of H5N1 Avian Influenza might
unfold in La Reunion.
Population: 776,948.

Day 1: 0 people sick
Day 28: 31 people sick
Day 49: 613 people sick
Day 77: 25,181 people sick
Day 86 (Peak): 39,383 people sick
Day 98: 15,848 people sick
Day 112: 1,807 people sick
Day 126: 170 people sick
Day 147: 8 people sick
Day 168: 1 people sick
Day 182: 0 people sick

An efficient human-to-human strain of H5N1 Avian Influenza in La Reunion
should see numbers somewhere in the range of 40k at it's peak.

Information from newspapers:

Dec 28th 2005: 6,273 official cases, 30,000 semi-official
January 19th 2006: At the beginning of October, the virus which had been
benign for 6 months, became rather dangerous. There is not a family which
does not have patients, and communities are devastated. The subject is
taboo. The virus has already gained the ability to pass from the sick, old
or weakened people.
January 20th 2006: 10,383 listed cases. Doctors mentioned there might be
40,000 cases, maybe more

The January 19th article describes a change in the nature of the virus
sometime in early October.

Based on the expected number of infections from the data above you are
looking around 80-90 days if the start date is early October and the end
data in Dec 28th. If an efficient human-to-human strain of H5N1 Avian
Influenza was present than according to the data we should see somewhere in
the range of 25,181 to 39,383 people sick based on day 77 and day 86
respectively.

On Dec 28th 2005 the official numbers reported were 6,273.
On Jan 19th 2006 the official numbers reported were more than 7600.
On Jan 20th 2006 the official numbers reported were 10,383.
On Jan 26th 2006 the official numbers reported were 22,167.

The semi-offical case numbers as reported on Dec 28th 2005 are 30,000 and as
of Jan 20th 2006 there are reports of possibly 40,000 or 50,000.

Due to the projected case numbers for an efficient human-to-human strain of
H5N1 Avian Influenza and the semi-offical case numbers, there is very strong
possiblity that the malady affecting La Reunion is H5N1 Avian Influenza.

Furthermore, the elapsed time between the virus changing from benign to
dangerous was reported as 6 months. This is important point that should not
be overlooked since recent data from the 1918 pandemic showed that a 'less
virulent' strain of the virus had been circulating starting in March/April
of 1918 and it was not until September/October did a more virulent form of
the virus appear.

Information from forums/blogs/commentaries:

1) Only for my family, of 26 people, 9 developed the disease with same the
sympt?mes (fever sup with 40?C, pains with the articulations, cephalgias,
eruptions cutaneous, vomiting, diarrhoeas, asthenia, mouth ulcers).

The epidemiology report:

Statistics from cases from Feb 22, 2005 to Dec 25, 2005.

Total cases: 6190

580 cases with hemmorhagic symptoms (gingivorragies, h?matome, ?pistaxis,
purpura)
696 diarrhea
895 respiratory/breathlessness
1001 nausea vomiting
1437 cutaneous eruption
2172 headache (migrane/ maybe worse)
2533 muscle pains
2756 Fever
2757 Arthritis like symptoms

Facts:

Only in very rare cases do mosquito born diseases infect members of the same
family. It would be almost impossible to find a case where 9 members of the
same family caught the same mosquito born disease at the same time.

In 1918 the Spanish Flu was nicknamed "The purple death" because of the
hemmorhagic symptoms of the victims.

In 1918 the Spanish Flu caused work stoppage in upwards of 40%.

As of Jan 25th 2006 less than 1% of all cases in La Reunion have been
confirmed as Chikungunya.

This means 99% of the cases are NOT Chikungunya.

6 confirmed deaths.

Based on the projected infection rates, symptoms, distance between mild
cases and severe cases, size of family clusters and failure to confirm 99%
of the cases reported, the disease that is plaguing La Reunion does not
match Chikungunya.

The disease in La Reunion most closely matches the events of 1918 and the
expected scenario of an H5N1 Avian Influenza outbreak.


---------------------------------------------------------------------------
Cases are now in France:

http://www.afrik.com/forum.php3?id_article=9190

"At the moment, I am in the hospital in France. I just came back from spending 8 days in La Reunion and I returned Wed., 1/19. Before yesterday evening I had a brutal fever of 102 degrees plus and it was impossible to walk on my joints, my shoulder and sharp "corbaturee." The doctors in the hospital have not revealed this illness as anything but the flu but I have all the symptoms of Chikungunya. In short, in any case I have to say that that that fever is monsterous and that the "corbatures" are painful. And here in this city they are not informed about Chikungunya."

http://www.curevents.com/vb/newreply.php?do=newreply&p=278776​

 

[DB]

Hemmorrhagic symptoms and bleeding occurred frequently in 1918 influenza
victims, and has also occurred in the Turkish H5N1 victims.

Fatma Ozcan--Turkish victim of H5N1 bird flu:
"She was from Dogubayazit - the same town where three siblings died of bird flu about 10 days ago - and was bleeding from her mouth and throat when she was brought to the hospital."
http://news.scotsman.com/latest.cfm?id=76162006



Here is info on the hemorrhagic symptoms in 1918 from this link:

http://www.nap.edu/openbook/0309095042/html/60.html


Symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, ?One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred? (Ireland, 1928:57). A German investigator recorded ?hemorrhages occurring in different parts of the interior of the eye? with great frequency (Thomson and Thomson, 1934b). An American pathologist noted: ?Fifty cases of subconjunctival hemorrhage were counted. Twelve had a true hemotypsis, bright red blood with no admixture of mucus?. Three cases had intestinal hemorrhage? (Ireland, 1928:13). The New York City Health Department?s chief pathologist said, ?Cases with intense pain look and act like cases of dengue ? hemorrhage from nose or bronchi ? paresis or paralysis of either cerebral or spinal origin ? impairment of motion may be severe or mild, permanent or temporary ? physical and mental depression.

Above from this link:

http://www.nap.edu/openbook/0309095042/html/60.html



The data from Reunion is flawed and guesswork at this point. Lab diagnostics are sorely needed.

 

[DB]

http://www.chikungunya.net/evolution/evolutioncadre.htm

EPIDEMIE DE CHIKUNGUNYA A LA REUNION
Situation au
23 janvier 2006

The device of monitoring rested until now on the active and retrospective research of the cases by the teams of antivectorielle fight in the entourage of the patients announced by the doctors, the toll-free number and the analysis laboratories of medical biology. This system, recommended by the World Health Organization for the monitoring of the viral infections to vectorial transmission makes it possible to identify the hearths of transmission and provides a reliable census of the cases as long as the teams of ground are in measurement of investiguer the totality of the descriptions. However, since the week of December 19, 2005, the epidemic reaches a level such as the capacities of investigation of the teams are with saturation and the number of located cases is lower than reality in the hearths where the epidemic is most active. It is in particular the case for the commune of Saint-Louis. The monitoring by a network sentinel then is adapted better to this type of situation by allowing the follow-up of the temporal tendencies of the epidemic. The data provided by the doctors of the network sentinel animated by the regional Observatory of health showed that they were overall well correlated with the total number of cases over the period during which the collection of the cases could be regarded as exhaustive). This new method replaces the old one starting from the 51?me week of 2005. However, this device, in its current configuration, will not make it possible to have a precise evaluation of the total number of cases taking into account relative the small proportion of liberal doctors implied in the network. Moreover, this basic device is supplemented by the description of the serious cases by the establishments of health and the monitoring of the death certificates mentioning the chikungunya, whatever is the level of causality. The geographical localization of the cases is obtained starting from the descriptions of the doctors except network sentinel and the evaluation on the ground by the teams of antivectorielle fight.

Epidemiologic situation

general Tendency

On the whole, 430 cases were notified by the 31 doctors sentinels of network GROG since the beginning of the epidemic, including 84 during week 2 of 2006. The curve below presents the evolution of the tendency since the beginning of the epidemic starting from the data of the doctors of the network sentinel. Its profile is superposable with that of the total number of cases until December 18, 2005.

The epidemic of chikungunya to the Meeting knew a first peak of width limited to May before decreasing the arrival of the southern winter parallel to. From mid-July, the incidence was stabilized during more than two months. The incidence increased again starting from the beginning of October, initially in a moderate way. Since mid-December, the epidemic abruptly changed scale and knows an exponential growth. The epidemic peak does not seem yet not reached.

Estimate of the number of cases

From the number of cases declared by the doctors of the network sentinel, it is possible to estimate the number of real case. However, the number limited doctors of the network and the fact that the epidemic develops by hearths which do not relate to in a homogeneous way the unit of the island, involve a risk of inaccuracy in the estimate. Under these reserves, one can apply a weighting coefficient calculated according to historical series' (report/ratio case totaux/GROG for the period when the active research of the cases could be regarded as exhaustive). According to this method, recommended by the report/ratio of the mission of the IGAS, the number of estimated cases, that they or not consulted a doctor, rises on the whole with 22167 cases, including 5633 the number of new cases which have occurred during the second week of January, last week for which the results of the GROG are sufficiently complete to be exploitable. Whatever the method of calculation used to estimate the number of cases, on which work continues, the current tendency is clearly in an exponential dynamics. In addition, 4254 cases were announced by the doctors of the island (except GROG) since the request which them was made by it on December 26, 2005, including 1408 since January 19, 2006. To date, on the whole of the period (February 22 - January 23), 2424 cases were confirmed biologically. All the age groups are touched, however the most 30 years are more particularly concerned, especially at the women (60% of the well informed cases). One does not note significant modification of the principal clinical and demographic characteristics of the cases during the evolution of the epidemic.

Serious and atypical forms

At January 23, 4 certificates of deaths which have occurred since the beginning of January 2006 mention the chikungunya among the diseases having caused or contributed to the death. They are 3 respectively old women of 82, 91 and 94 years and of a 48 year old man reaches chronic pathology. The certificates do not comprise information on the biological confirmation of the infection. 22 serious or atypical forms of infections by the virus chikungunya were reported by the device of monitoring to January 23, 2005, 13 at the new-born baby (including 3 post-native) and 9 in the adult. For the totality of the adults and 6 new-born babies, they are neurological attacks (my?lo-m?ningoenc?phalite, syndrome of Guillain-Barred). The clinical evolution and of the imagery are rather favorable but the retreat is insufficient to evaluate with precision the possible after-effects. To date, two adults have a urinary incontinence s?quellaire. In addition, the hospital doctors announce the risk of d?compensations related to the effects of the chikungunya on the general state of the vulnerable people (immunod?prim?s, nobody old, people reached of chronic, new-born pathologies). The device of monitoring is in the course of adaptation to identify the cases of chikungunya requiring acts of maintenance of vital faculties. The new device of monitoring does not make it possible to directly follow the evolution of the rate of hospitalization. This one could however be estimated starting from the hospital data provided by the ARH.

 

[DB]

http://www.chikungunya.net/temoignages/maladepage.htm#T0601261630

Date: 26/01/2006 - 16h30
Expediteur: Laurence
Ville: Paris
Mail:
Rubrique: Témoignage d'un malade

Je suis une jeune réunionnaise de 25 ans enceinte de 4 mois et revenue de St Pierre le 9 janvier 2006 avec le virus encore en période d’incubation.
Dès le lendemain dans la soirée, la fièvre est apparue mais je pensais qu’il s’agissait d’un simple coup de froid du au changement de température hélas !
Le surlendemain, je me retrouvais clouée au lit avec une fièvre de cheval et les articulations complètement bloquées. Evidemment, je pense de suite au Chikungunya et j’en parle au médecin qui reste effaré devant les symptômes que je présente : fièvres, arthralgies, vomissements, céphalées, anorexie et surtout des hémorragies locales de ce genre là :

Il y a de quoi être impressionné surtout quand la zone touchée se trouve être votre poitrine (le service des maladies tropicales de la Pitié Salpêtrière possédant les photos originales, c’est donc une autre photo qui se trouve ici pour illustrer l’hémorragie locale).
La grossesse ne me permettait pas de prendre certains médicaments, j’ai du donc prendre mon mal en patience et lutter avec du paracétamol contre le virus. La fièvre disparaît le 3ème jour pour laisser la place aux douleurs articulaires très aigues m’empêchant de me déplacer, de m’asseoir, de faire ma toilette etc. La peau est alors hypersensible et les doigts ne supportent pas le contact de l’eau ou du savon.
Puis surgit les éruptions cutanées sur tout le corps (sauf le ventre) accompagnées bien entendu des démangeaisons qui vous laissent éveillé quasiment toute la nuit en pleurs. Chaque déplacement demeure une souffrance sans fin et les douleurs aussi intenses soient elles n’amènent que les pleurs et les cris nécessaires à supporter le tout.
Une semaine passe donc ainsi. Et malgré tout dans mon malheur, j’ai la chance d’être entourée de mes amis et de mon frère qui sont venus m’assister pour les repas, les courses et autres besoin vitaux.
Enfin, je commence à me sentir mieux, j’arrive même à me déplacer seule avec l’aide d’un balai. On a donc une lueur d’espoir, on se dit que c’est bientôt la fin !
Mais c’était sans compter la combativité du virus, une nouvelle semaine commençait donc sans que je puisse quitter mon lit.
Psychologiquement ça devient dur !
Les jours passent et se ressemblent, une amélioration de mon état général pointe son nez en fin de 2ème semaine. Une consultation d’urgence à la maternité permet de me rassurer sur l’état de santé de mon bébé mais un suivi particulier reste indispensable durant toute ma grossesse.
Et me voici à présent dans ma 3ème semaine avec mes hémorragies qui cicatrisent enfin, toujours les céphalées, la fièvre qui revient aléatoirement, la grande fatigue persistante et les douleurs articulaires aux pieds mais je marche et je suis autonome !
Même si je ne sais pas comment sera demain, il faut toujours rester optimiste et garder la foi pour ne pas laisser ce virus pernicieux nous pourrir la vie !

Translation:
This is someone reporting from Paris:

I am a young person réunionnaise 25 years enclosure 4 month old and returned from St Pierre on January 9, 2006 with the virus still in incubation period. As of the following day in the evening, the fever appeared but I thought that it acted of a simple blow of cold of to the change of temperature alas! Two days later, I found myself nailed with the bed with a raging fever and the completely blocked articulations. Obviously, I think of following Chikungunya and I speak about it to the doctor who remains frightened in front of the symptoms that I present: fevers, arthralgies, vomiting, cephalgias, anorexia and especially of the local haemorrhages of this kind there:

There is what to be impressed especially when the touched zone is being your chest (the service of the tropical diseases of Salpêtrière Pity having the original photographs, it is thus another photograph which is here to illustrate the local haemorrhage). The pregnancy did not enable me to take certain drugs, I have thus to bear my troubles patiently and to fight with paracetamol against the virus. The fever disappears the 3rd day to leave the place with the very acute articular pains preventing me moving, sitting me, from making my toilet etc. The skin is then hypersensitive and the fingers do not support the contact of water or the soap. Then emerges the cutaneous eruptions on all the body (except the belly) accompanied of course by itchings which leave you waked up almost all the night in tears. Each displacement remains a suffering without end and the also intense pains are they bring only the tears and the cries necessary to support the whole. One week thus passes thus. And despite everything in my misfortune, I have the chance to be surrounded of my friends and my brother who came to assist me for the meals, the races and other need vital. Lastly, I start to better smell me, I am even able to only move with the assistance of a brush. One thus has a glimmer of hope, one thinks that it is soon the end! But it was without counting the combativeness of the virus, a new week thus started without I being able to leave my bed. Psychologically that becomes hard! The days pass and resemble each other, an improvement of my general state points its nose at the end of the 2nd week. An emergency consultation with maternity makes it possible to reassure me on the health of my baby but a particular follow-up remains essential during all my pregnancy. And me here now in my 3rd week with my haemorrhages which heal finally, always the cephalgias, the fever which returns by chance, great persistent tiredness and the articular pains with the feet but I walk and I am autonomous! Even if I do not know how will be tomorrow, it is always necessary to remain optimistic and keep the faith not to let this pernicious virus rot us the life!

 

[DB]

Troops help fight virus
http://www.theaustralian.news.com.au/common/story_page/0,5744,17975689%255E31477,00.html
AP
January 30, 2006


PARIS: French Prime Minister Dominique de Villepin has ordered hundreds of extra soldiers be sent to help battle a mosquito-borne virus that has infected 15,000 people on the French island of Reunion in the Indian Ocean.

Four hundred soldiers will be sent to Reunion, almost tripling the present military deployment, along with dozens more medical experts to fight the Chikungunya virus, which has no vaccine or cure.

The deployment, in part to reduce the mosquito population, was taking place "without delay", said a statement from the Prime Minister's office.

Mr Villepin also instructed Health Minister Xavier Bertrand to go to Reunion, east of Madagascar, and planned to convene a meeting of government ministers on the issue on Mr Bertrand's return.

Chikungunya, a rare infection that is usually not life-threatening, can cause muscle and joint pain, rash and fever.

France's Health and Overseas Affairs ministries said, without elaborating, that about 20 recent cases "with complications" had been identified.

The Overseas Affairs Ministry said that 10,000 to 15,000 cases have been counted on La Reunion. No vaccine or cure has been identified, it said.

 

[DB]

Re: Outbreak History

Re: Outbreak History

MACHINE TRANSLATED

http://babelfish.altavista.com/babelfish/trurl_pagecontent?lp=fr_en&trurl=http%3a%2f%2fwww.clicanoo.com%2farticle.php3%3fid_article%3d121856

HEALTH
Ten dead and twenty-eight serious cases
The figure was announced last Friday at the time d?une meeting in Drass. Four, they are from now on 10 deaths which is charged indirectly to the disease. And if the in-patients represent the visible part of l?iceberg, c?est to the immersed part which must daily face the liberal doctors and male nurses. A domestic industry for the latter, and without idle period, for in particular reassuring a growing population with l?inquiétude. In Sainte-Suzanne, Samuel Coupoussamy, male nurse, doubled his working hours, a service 7 jours/7, not easily extensible. A point on which the minister of Health will have to bring answers, whereas reinforcements are announced on the Department, just like ḻamelioration of the services d?aides in residence.

[ January 30, 2006 ]


Not four, but ten. Announced last Friday with the professionals of health at the time d?une meeting in Drass by the general manager of the medical day before itself, the number of deaths, induced by the disease on already weakened people, does not cease growing. The worsening factor of the virus at people at the risk from now on clearly is thus posed, to l?image of the influenza, recall to l?origine d?une ten death each year in France. Result : a concern growing within the population, whereas the families must sometimes look after in residence of the people often old and strongly decreased by the disease. Reason why, Samuel Coupoussamy, former male nurse with the urgencies, n?a been able that to cross his/her children this week. Even if l?homme has l?habitude not to count its hours (its last holidays go up with more than two years), the meters have tendency to s?affoler since ten days. Between Saturday evening and Sunday afternoon, l?infirmier had already traversed more than 200 kilometers between the littoral and the tops of Sainte-Suzanne, with the bedside d?une ?hécatombe?, whose name is from now on on the lips of all Réunionnais. It estimates to have multiplied its workload by two in only one week, leaving him only little time to rest.

THE ONLY CONTACT

A work with the daily newspaper, of day like night and 7 days a week. In more of the score of case that Samuel follows daily, of which some heavily medicalized require sometimes jusqu?? four visits day labourers, l?infirmier is perceived as a comfort for families worry, being sometimes smelled deprived, having to only take care on people often old and strongly weakened by the virus. With l?image of Roulof, in the district of the Navy, whose mother must, only, to take care d?une young girl and of three old people, its parents and an aunt. If two d?entre them recently contracted the dengue, his/her mother, diabetic, have been it nailed on the couch for Saturday by the chikungunya. Except the attending practitionar, Samuel is the only contact of the family. A difficulty whereas the mother, only person ?ressource? hearth to take care of the care, also owes s?absenter to work the week. L?infirmier does not count any more the calls on his portable for a council, a visit in more of his work, subjected a medical regulation before. L?homme has the sometimes appearance of a social worker.

TO ACCENTUATE THE DEVICE

?Nous let us be a little the eyes and the arms of the doctor on the terrain?, summarize the professional. L?homme n?hésite d?ailleurs not to put the hand at the paste to pulverize, even distribute free anti-mosquito products to the residence of its patients. Just like certain lavished care, not to exceed per annum the annual quota of care male nurses, fixed at 20 000 by the Social security. In its eyes, whereas l?évolution of ḻepidemy remains still unknown, there exists aujourd?hui a ̴ḏaccentuation need for the devices d?aide to domicile?, by in particular calling upon the auxiliaries of life affiliated to the CCAS, ?principalement for the families more modestes?. ?Un better work of proximity is made feel, but also coordination between the social workers and the professionals of santé?, l?infirmier continues. Side of the Sihou family, to Village Desprez, one is said stripped whereas 10 members out of 13 were touched by the virus, of which the latest to date, the father, is 89 years old. Strongly medicalized, this last requires several visits on behalf of l?infirmier, then qu?avant to contract the disease, ?il continued to go and make bicycle in the quartier?, tell Samuel. Before taking again the round of its patients, direction the tops of Sainte-Suzanne... with a little chance, it was not to miss the dinner.

Philippe Madubost

- 10 dead and several serious cases L?information emanate from the general manager of the medical day before itself, Gilles Brücker, present last week in the Department. Information relayed by a source authorized and revealed with the professionals of health of the Meeting, last Friday. In weekend, ten deaths whose chikungunya was notified by the doctors on the certificate of death had been entered, like several very serious cases listed in the various intensive care units from l?île. Let us recall that if the virus n?est not aujourd?hui regarded as mortal, his factor worsening on already fragile people (new-born babies, old people, patients reached of chronic disease...) n?est to show more. An additional reason for each one to very take the disease with serious, without falling for as much in the psychosis, and d?appliquer all protection measures necessary.





Reinforcements awaited the private clinic the message wants to be reassuring. Even if the services could be sometimes ?débordés?, the reorganization operated since allows aujourd?hui to answer ?? all the hospitalizations necessary, here or elsewhere. It n?y does not have a refusal of patients for lack of place?, affirm the director of the Saint-Benoît cheese private clinic, Alain Philibert. An answer permitted by ?une mobilization of all services?, and then qu?un reinforcement in manpower for the services d?urgence and of medicine is awaited, specifies the person in charge, in particular a doctor additional urgentist. In parallel, three nurses were already recruited in CDD by the private clinic which also pointed out the personnel on leave and fact call at the Red Cross to face the extra work, estimated at 50% by a doctor urgentist. Direction like medical personnel, nobody spares his efforts since many days to face the needs, then qu?une score d?employés them were also affected by the virus. ?L?ARH already ensured us of the assumption of responsibility 100% of the cost of the hours supplémentaires?, Alain Philibert continues, without still being able to specify the d?heures number carried out in addition, as the exact number of requirement as a personnel. With the private clinic, from day to day with l?afflux patients are faced : 60 people Friday, including approximately 30% reached by the virus. By using all the means available, while doubling in particular, even more, the capacities of the boxes d?urgences, initially intended for only one person.

 

[DB]

http://www.chikungunya.net/_discusschikun/0000029b.htm

yesterday is Sunday with 12 noon, on the small road with the river of the rollers (on the right-hand side while going towards the port) direction round point of crowned heart, a dog burst on the right side, it is inflated, the legs in the air, of the flies everywhere, it makes very hot, window opened, stink of corpse, since how long there? BUT It IS NOT ALL: today Monday, nothing was done, even chie?, even corpse, very similar except that his belly... good ok I pass the details to you, MORALITY if the authorities do not show the example...

 

[DB]

A French tourist that went to La Reunion. Upon returning from their trip to La Reunion they died.

Here is the link:
http://www.clicanoo.com/article.php3?id_article=121996

 

[DB]

http://www.chikungunya.net/_discusschikun/000003cb.htm

MACHINE TRANSLATED BELOW

infos : 50 000 cas officiels, 15 000 par semaine, 22 formes graves, 20 d?c?s, 20 hospitalisat? jour ? St Paul, patients dans les couloirs sans mousticaires, une dame dit : "j'ai envie deme suicider tellement j'ai mal". Plan pr?fecture : font venir 800 militaires de plus (forces arm?es, dixit le pr?fet), produits gratuits pour les pers. au minimum vieillesse, 8 cas b?b?s tr?s grave, 5 points d'acueil SDF, patrouilles de SAMU social, aides aux entreprises : report de charges, Police et gendarmerie surveillance des d?pots sauvages. A la question nous sommes en ?tat de catastrophe sanitaire, le pr?fet r?pond : "nous sommes en crise". -question sur l'efficacit? non av?r?e des produits de d?mousrication, r?ponse : "trop t?t pour le dire, que les gens se rassurent, il n'y a pas de risque majeur, les habitants ne risquent rien. cette maladie est inconnue et n'a jamais fait l'objet d'?tudeson a voulu montrer que l'?tat a su se mobiliser, l'?pandage est in?fficace, le moustik peut d?velopper des r?sistance aux produits." Question pourquoi pas avoir agi plus t?t? r?ponse :"je suis arriv? en mi-parcours de l'?pid?mie, je ne veux pas porter de jugement sur mon pr?d?cesseur, oui j'ai des regrets et remords". - Les entreprises demandent une reconnaissance de l'?tat de catastrophe ?pid?miologique par l'?tat. la crise touristique : 10 000 annulations de nuit?s, soit 200 000 euros environ soit un an de budget de comm du CTR. - Selon Huguette Bello : mise enplace d'une commission parlementaire mardi prochain.


infos: 50 000 official cases, 15 000 per week, 22 forms serious, 20 d?c?s, 20 hospitalisat? day with St Paul, patients in the corridors without mousticaires, an injury known as: "I want deme to commit suicide so much I have badly". Prefecture plan: make come 800 soldiers moreover (armed forces, dixit the prefect), produced free for the sea-green ones. at least old age, 8 very serious cases babies, 5 points of acueil SDF, patrols of social SAMU, assistances with the companies: carryforward of loads, Organizes and gendarmerie monitoring of the wild d?pots. With the question we are in a medical state of catastrophe, the prefect answers: "we are in crisis". - question about the not proven effectiveness of the products of demousrication, answer: "too early for the statement, that people reassure themselves, there is no major risk, the inhabitants do not risk nothing this disease is unknown and never was the subject of ?tudeson wanted to show that the state knew to be mobilized, spreading is in?fficace, the moustik can develop resistance to the products." Question why not of having acted earlier? answer:"je in semi-course of the epidemic, I arrived do not want to give opinion on my predecessor, yes I have regrets and remorse". - the companies require a recognition of the epidemiologic state of catastrophe by the state. the tourist crisis: 10 000 cancellations of nuities, either 200 approximately 000 euros or a year of budget of comm of the CTR. - According to Huguette Bello: setting enplace of a parliamentary commitee next Tuesday.

1) 50,000 official cases.
2) 15,000 cases a week.
3) Confirmed exponential growth.
4) People want to commit suicide because of the disease.

 

[DB]

http://www.breitbart.com/news/2006/02/02/060202183904.ny61htp1.html

Indian Ocean girds for spread of incurable crippling disease
Feb 02 1:39 PM US/Eastern

Nearly 2,000 people in the Seychelles have been infected with an incurable mosquito-borne disease that has spread to three Indian Ocean islands prompting health alerts, officials said.

Jules Gedeon, the Seychelles director for community health, said the number of people diagnosed with "chikungunya" was steadily rising since it was first reported in November and nearly 1,000 cases had been reported in January alone.

"We are still counting, but the number is quickly approaching 1,000 for this week," Gedeon told AFP, adding the country's security forces had been drafted for a nationwide mosquito eradication drive to stall the spread.

In addition, the health ministry announced Thursday it would take legal action against people who do not take measures to control mosquito breeding on their property.

Authorities in Madagascar and the overseas French territory of Reunion, where some 45,000 new cases have been reported since mid-December, have reported outbreaks.

Last week, the French government drafted 400 extra troops to help fight the mosquitoes that have been spreading the disease across Reunion since March.

On Madagascar, about 800 kilometers (500 miles) west of Reunion, a health official said Thursday that two more people had shown symptoms of the disease after dozens flocked to a hospital on the eastern side of the island with similar complaints in the past two weeks.

"Two patients admitted today at Toamasina hospital they had joint pains that strongly point at chikungunya," Mosa Milasoa, an official in Madagascar's health ministry, told AFP.

"Chikungunya" is Swahili for "that which bends up" and refers to the stooped posture of those afflicted by the crippling and extremely painful disease for which there is no known vaccine or cure.

It is characterized by high fever and severe rashes, and while non-fatal in itself and most people eventually recover, it can provide opportunities for other diseases to set in.

Health officials in the Seychelles attributed the recent sharp rise in cases of chikungunya to heavy rains that have been pounding the island since December.

No deaths have so far been reported, but it has affected several businesses as infected people have stayed home from work and the transport sector has been badly hit with bus schedules interrupted as drivers fall sick, they said.

 

[DB]

Over 50,000 cases total, 15,000 a week in La Reunion, back in December there were 6,000 cases. Now there are above 50,000 cases.

Almost 2,000 cases total, 1,000 for this week in Seychelles.
Madagascar is starting to get cases.

Whatever you want to call it, it is spreading fast and showing major exponential growth.

Dengue is endemic in SEA, dengue is a mosquito born disease, dengue does not spread this fast and dengue does not cause this type of disruption in a society.

So the question must be asked.

How is this so called chikungunya doing things that completely out of character for a mosquito born disease?

Maybe it is not a mosquito born disease.

 

[DB]

Summary

Summary

These are the numbers for how a pandemic might unfold in King County, Washington.

Population: 1,777,143 (http://quickfacts.census.gov/qfd/states/53/53033.html)
Day 1: 0 people sick
Day 28: 31 people sick
Day 49: 1,403 people sick
Day 77: 57,623 people sick
Day 86 (Peak): 90,122 people sick
Day 98: 36,267 people sick
Day 112: 4,136 people sick
Day 126: 390 people sick
Day 147: 19 people sick
Day 168: 1 people sick
Day 182: 0 people sick

Using this data I am going to show what might be expected in La Reuinon
Population: 776,948 (43.7% of King County, Washington). While these numbers may not be 100% accurate they should be close enough. (raina, if you could crunch these numbers that would be great)

Day 1: 0 people sick
Day 28: 31 people sick
Day 49: 613 people sick
Day 77: 25,181 people sick
Day 86 (Peak): 39,383 people sick
Day 98: 15,848 people sick
Day 112: 1,807 people sick
Day 126: 170 people sick
Day 147: 8 people sick
Day 168: 1 people sick
Day 182: 0 people sick

So if we were to have a efficient human-to-human strain in La Reunion we should see numbers somewhere in the range of 40k at it's peak.

In situations like this the best source of information is the newspapers.
Most of the information on the 1918 pandemic comes to us from the local newspapers.

In today's technology world we have the added benefit of forums, blogs and the ability to add our own comments on the news story.

In addition to these sources a epidemiology reports on this outbreak is available in French (http://www.orsrun.net/PointChik20051227.pdf).

Information from the newspapers:

Dec 28th 2005: 6,273 official cases, 30, 000 semi-official (Post 23)
January 19th 2006: At the beginning of October, the virus which had been benign for 6 months, became rather dangerous. There is not a family which does not have patients, and communities are devastated. The subject is taboo. The virus has already gained the ability to pass from the sick, old or weakened people.
January 20th 2006: 10,383 listed cases. Doctors mentioned there might be 40,000 cases, maybe more

Febuary 2nd 2006: 50,000 listed cases. Doctors mentioned there might be 60,000 cases, maybe more

The January 19th article describes a change in the nature of the virus sometime in early October.

Based on the expected number of infections from the data above we are looking around 80-90 days if our start date is early October and our end data in Dec 28th. If an efficient human-to-human strain was present than according to the data we should see somewhere in the range of 25,181 to 39,383 people sick based on day 77 and day 86 respectively.

On Dec 28th 2005 the official numbers reported were 6,273.
On Jan 19th 2006 the official numbers reported were more than 7600.
On Jan 20th 2006 the official numbers reported were 10,383.
On Jan 26th 2006 the official numbers reported were 22,167.
On Feb 2nd 2006 the official numbers reported are above 50,000.


That however has been contradicted by the newspapers, doctors and residents of La Reunion as being underestimated.

The semi-offical case numbers as reported on Dec 28th 2005 are 30,000 and as of Jan 20th 2006 there are reports of possibly 40,000 or more

Due to the projected case numbers for an effcient human-to-human strain and the semi-offical case numbers we have hit a very strong possiblity for the existence of such a strain.

Furthermore, the elapsed time between the virus changing from benign to dangerous was reported as 6 months. This is important point that should not be overlooked since recent data from the 1918 pandemic showed that a 'less virulent' strain of the virus had been circulating starting in March/April of 1918 and it was not until September/October did a more virulent form of the virus appear.

Information from forums/blogs/commentaries:

Post 20: Only for my family, on 26 people, 9 developed the disease with same the sympt?mes (fever sup with 40?C, pains with the articulations, cephalgias, eruptions cutaneous, vomiting, diarrhoeas, asthenia, mouth ulcers).

As it has already been discussed, very rarely do mosquito born diseases infect many members of the same family. And I would challenge someone to find a case where 9 members of the same family caught the same mosquito born disease at the same time.

Post 22:


1) The Prefecture sets up a cell of permanent crisis which will gather persons in charge for the sub-prefectures, DRASS, DASS, WAX, SDIS, police force and gendarmerie.
2) Completely, the figures are underestimated
3) The hospital ones overflowed
4) " No direct death " Jusqu? aujourdhui, no death due to the chikungunya nest recorded, at least, no element makes it possible to corroborate that old people would have succumbed to the effects of the disease.


The epidemiology report:

Statistics from cases from Feb 22, 2005 to Dec 25, 2005.

Total cases: 6190

580 cases with hemmorhagic symptoms (gingivorragies, h?matome, ?pistaxis, purpura)
696 diarrhea
895 respiratory/breathlessness
1001 nausea vomiting
1437 cutaneous eruption
2172 headache (migrane/ maybe worse)
2533 muscle pains
2756 Fever
2757 Arthritis like symptoms

In some cases where hemorrhagic symptoms were displayed the following was seen:
purpura: is a purple rash, more than a rash a purple area on the skin
h?matome:Epanchement of blood in one surges natural or under the skin, consecutive with a rupture of vessels
?pistaxis: Nosebleed
Gingivorragies: bleeding of the gums or mouth

Age Distribution:
0-15: 749
16-30: 909
31-45:1532
46-60:1610
60+: 1390

Almost 2,000 cases total, 1,000 for this week in Seychelles.
Madagascar is starting to get cases, dozens already reported.

http://www.curevents.com/vb/newreply.php?do=newreply&p=287841​

 

[DB]

Re: Outbreak History

Re: Outbreak History

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/oct2605avflu.html
French island has 3 possible H5N1 cases

Oct 26, 2005 (CIDRAP News) ? Three people from the French island of Reunion who were exposed to birds during a recent visit to Thailand are suspected of having H5N1 avian influenza, and authorities are rushing samples to Paris for testing, according to a BBC News report.

A 43-year-old man was hospitalized in Saint-Denis, capital of the Indian Ocean island, on Oct 22 with weakness, headache, and a cough, the BBC reported. One test for H5N1 was inconclusive, but a second test was positive for H5N1, Reuters news service reported. The story did not say which tests were used.

The man was part of a group of 20 tourists who were in Thailand from Oct 12 to 19, Reuters reported. He and two fellow tourists suspected of having avian flu had close contact with birds at a park, the BBC said. Reuters said the other two people also were tested but results were not yet available.

Even if the tests don't show H5N1, the urgent response to the situation is representative of actions occurring worldwide as more countries try to manage and reduce the threat of the H5N1 virus to people and poultry.

 

[DB]

Health scare for Madagascar
02/02/2006 11:29 - (SA)


Antananarivo - Madagascan health officials said on Wednesday they fear an outbreak of an incurable crippling mosquito-borne disease that has ravaged the nearby Indian Ocean island of Reunion.

Dozens of people showing possible symptoms of the viral infection known as "chikungunya" have flocked to the main hospital on the island's second city of Toamasina since last week, prompting authorities to test for the illness.

"The patients have fever but I cannot yet say whether they are suffering from malaria or chikungunya, it is just a suspicion," said Dr Givance, the hospital chief.

Roland Rajonson, the secretary general of Madagascar's health ministry, told AFP that physicians from the capital had been sent to Toamasina on the east coast to look into the matter and would report back by the end of the week.

30 000 feared infected

"Yesterday (Tuesday), we deployed a team of doctors to the ground to investigate whether there were real cases of chikungunya," he said.

"To be really sure it is chikungunya, we must analyse blood samples," said Jean Marc Reynes a virologist in Antananarivo.

Chikungunya is Swahili for "that which bends up" and refers to the stooped posture of those afflicted by the crippling and extremely painful disease for which there is no known vaccine or cure.

It is characterised by high fever and severe rashes, and while non-fatal in itself and most people eventually recover, it can provide opportunities for other diseases to set in.

Chikungunya outbreaks have sparked deep concerns in the French overseas territory of Reunion, about 800km east of Madagascar, where at least 30 000 people are thought to have been taken ill since March.

The disease is suspected of having been a contributory cause of death in four people in their nineties.

Officials there estimate that 5 000 new cases have occurred since mid-January, prompting the French authorities to assign 400 more troops to efforts to combat the mosquitoes that are spreading the virus.

Authorities in Reunion have delayed the beginning of the new school term in order to decontaminate schools and the island's tourism industry has expressed concern that the outbreak could hurt business.

http://www.news24.com/News24/Africa...1873433,00.html

 

[DB]

Island disease hits 50,000 people

A crippling mosquito-borne disease is spreading at an accelerating rate on the French Indian Ocean island of Reunion, health officials say.

They say the number of cases of the viral illness, known as chikungunya, had risen to 50,000, an increase of 15,000 in the past week alone.

The disease is not fatal, but those affected suffer high fever and severe pain. There is no cure or vaccine.

Hundreds of troops have been deployed on the island to eradicate mosquitoes.

Officials said the troops would be spraying the whole island against mosquitoes in the coming days.

The latest outbreak was first noticed there in February 2005 - but has spread at an accelerating rate since December.

Meanwhile, neighbouring territories are mobilising to contain the disease.

On the Seychelles - where 2,000 cases have been reported in the past four weeks - the army has been mobilised to exterminate mosquitoes, Reuters news agency reports.

The authorities in Madagascar also fear the disease may have reached their island, AFP news agency says.

Chikungunya fever is named after a Swahili word meaning "that which bends up" - referring to the stooped posture of those afflicted.

http://news.bbc.co.uk/2/hi/europe/4674376.stm

 

[DB]

Summary

Summary

These are the numbers for how a pandemic might unfold in King County, Washington.

Population: 1,777,143 (http://quickfacts.census.gov/qfd/states/53/53033.html)
Day 1: 0 people sick
Day 28: 31 people sick
Day 49: 1,403 people sick
Day 77: 57,623 people sick
Day 86 (Peak): 90,122 people sick
Day 98: 36,267 people sick
Day 112: 4,136 people sick
Day 126: 390 people sick
Day 147: 19 people sick
Day 168: 1 people sick
Day 182: 0 people sick

Using this data I am going to show what might be expected in La Reuinon
Population: 776,948 (43.7% of King County, Washington). While these numbers may not be 100% accurate they should be close enough. (raina, if you could crunch these numbers that would be great)

Day 1: 0 people sick
Day 28: 31 people sick
Day 49: 613 people sick
Day 77: 25,181 people sick
Day 86 (Peak): 39,383 people sick
Day 98: 15,848 people sick
Day 112: 1,807 people sick
Day 126: 170 people sick
Day 147: 8 people sick
Day 168: 1 people sick
Day 182: 0 people sick

So if we were to have a efficient human-to-human strain in La Reunion we should see numbers somewhere in the range of 40k at it's peak.

In situations like this the best source of information is the newspapers.
Most of the information on the 1918 pandemic comes to us from the local newspapers.

In today's technology world we have the added benefit of forums, blogs and the ability to add our own comments on the news story.

In addition to these sources a epidemiology reports on this outbreak is available in French (http://www.orsrun.net/PointChik20051227.pdf).

Information from the newspapers:

Dec 28th 2005: 6,273 official cases, 30, 000 semi-official (Post 23)
January 19th 2006: At the beginning of October, the virus which had been benign for 6 months, became rather dangerous. There is not a family which does not have patients, and communities are devastated. The subject is taboo. The virus has already gained the ability to pass from the sick, old or weakened people.
January 20th 2006: 10,383 listed cases. Doctors mentioned there might be 40,000 cases, maybe more

Febuary 2nd 2006: 50,000 listed cases. Doctors mentioned there might be 60,000 cases, maybe more

The January 19th article describes a change in the nature of the virus sometime in early October.

Based on the expected number of infections from the data above we are looking around 80-90 days if our start date is early October and our end data in Dec 28th. If an efficient human-to-human strain was present than according to the data we should see somewhere in the range of 25,181 to 39,383 people sick based on day 77 and day 86 respectively.

On Dec 28th 2005 the official numbers reported were 6,273.
On Jan 19th 2006 the official numbers reported were more than 7600.
On Jan 20th 2006 the official numbers reported were 10,383.
On Jan 26th 2006 the official numbers reported were 22,167.
On Feb 2nd 2006 the official numbers reported are above 50,000.


That however has been contradicted by the newspapers, doctors and residents of La Reunion as being underestimated.

The semi-offical case numbers as reported on Dec 28th 2005 are 30,000 and as of Jan 20th 2006 there are reports of possibly 40,000 or more

Due to the projected case numbers for an effcient human-to-human strain and the semi-offical case numbers we have hit a very strong possiblity for the existence of such a strain.

Furthermore, the elapsed time between the virus changing from benign to dangerous was reported as 6 months. This is important point that should not be overlooked since recent data from the 1918 pandemic showed that a 'less virulent' strain of the virus had been circulating starting in March/April of 1918 and it was not until September/October did a more virulent form of the virus appear.

Information from forums/blogs/commentaries:

Post 20: Only for my family, on 26 people, 9 developed the disease with same the symptômes (fever sup with 40°C, pains with the articulations, cephalgias, eruptions cutaneous, vomiting, diarrhoeas, asthenia, mouth ulcers).

As it has already been discussed, very rarely do mosquito born diseases infect many members of the same family. And I would challenge someone to find a case where 9 members of the same family caught the same mosquito born disease at the same time.

Post 22:


1) The Prefecture sets up a cell of permanent crisis which will gather persons in charge for the sub-prefectures, DRASS, DASS, WAX, SDIS, police force and gendarmerie.
2) Completely, the figures are underestimated
3) The hospital ones overflowed
4) " No direct death " Jusquà aujourdhui, no death due to the chikungunya nest recorded, at least, no element makes it possible to corroborate that old people would have succumbed to the effects of the disease.


The epidemiology report:

Statistics from cases from Feb 22, 2005 to Dec 25, 2005.

Total cases: 6190

580 cases with hemmorhagic symptoms (gingivorragies, hématome, épistaxis, purpura)
696 diarrhea
895 respiratory/breathlessness
1001 nausea vomiting
1437 cutaneous eruption
2172 headache (migrane/ maybe worse)
2533 muscle pains
2756 Fever
2757 Arthritis like symptoms

In some cases where hemorrhagic symptoms were displayed the following was seen:
purpura: is a purple rash, more than a rash a purple area on the skin
hématome:Epanchement of blood in one surges natural or under the skin, consecutive with a rupture of vessels
épistaxis: Nosebleed
Gingivorragies: bleeding of the gums or mouth

Age Distribution:
0-15: 749
16-30: 909
31-45:1532
46-60:1610
60+: 1390

Almost 2,000 cases total, 1,000 for this week in Seychelles.
Madagascar is starting to get cases, dozens already reported.

Confirmed Human to Human spreading of the disease. (http://www.alertnet.org/thenews/newsdesk/L02120157.htm)