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Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+, 38 cases H1N1 confirmed

alert

Senior Moderator
Sounds like multiple causes, possibly including flu:

http://www.thehimalayantimes.com/fu...arkot‚+15+cases+reported+&NewsID=345099

Viral outbreak in Jajarkot? 15 cases reported

Added At: 2012-08-28 12:01 AM
Last Updated At: 2012-08-28 12:01 AM

JAJARKOT: Drug crunch has affected hundreds of people suffering from viral outbreak in Jajarkot district.

Over 15 cases of fever and pneumonia are reported in the District Hospital every day. At the same time, the shortage of drugs in many health centres and hospitals has further added to their woes.

DHO Chief Dr Bibek Kumar Lal complained that the centres have run out of medicines like Metro Nirajel, Paracetamol, Kotrin Jink, Iron tablet, Amoxicillin, Megapan, Metro injection and others. He said consumption of filthy water was to blame for the outbreak. Health centres are facing an acute shortage of medicines and the number of patients was soaring.

[snip]
 
Sagarmatha: Outbreak of unidentified diseases

Sagarmatha: Outbreak of unidentified diseases

Published Date: 2012-08-28 15:15:09
Subject: PRO/EDR> Undiagnosed illness - Nepal: (SA) RFI
Archive Number: 20120828.1261490

UNDIAGNOSED ILLNESS - NEPAL: (SAGARMATHA) REQUEST FOR INFORMATION
*****************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 23 Aug 2012
Source: eKantipur [edited]
http://www.ekantipur.com/2012/08/23/headlines/Viral-fever-epidemic-affects-life-in-districts/359180/


The only community hospital in Okhaldhunga district has been flooded with viral fever and typhoid patients in the last few days. Doctors have said viral fever and typhoid cases have been rising due to the contamination of drinking water in the rainy season.

The inflow of patients has been so high that the hospital has not been able to cope this number. Some of the patients have been kept in the training hall and even on corridors for lack of beds. The hospital has only 32 beds whereas the number of patients admitted is in the range of 45-50 daily, said a doctor at the hospital.

More than 150 patients a day have been coming for treatment at the OPD [outpatient department] alone. More than 3200 patients came for treatment in July 2012 alone.

Meanwhile, 2 schools at Mainaghat of Nawalparasi district have been closed after the spread of viral fever in the area. The schools had to be closed since most of the students have been affected by the disease. The people are worried that the viral fever might take epidemic proportion as there is lack of health workers at the local health posts and primary health centre.

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

[The posting spends much of its narrative regarding the illness referred to as "viral fever" which is allegedly spread by contaminated water. It is unclear what the etiology of this "viral fever" is and ProMED-mail would appreciate more information regarding the outbreak which apparently is differentiable from typhoid. - Mod.LL
 
Jhapa: Outbreak of unspecified "viral fever"

Jhapa: Outbreak of unspecified "viral fever"

http://www.thehimalayantimes.com/fu...mber+of+viral+fever+patients+up&NewsID=345146

Number of viral fever patients up

JHAPA: The viral fever has gripped at least half a dozen VDCs in Jhapa district.

The number of viral fever patients has increased at Khudunabari, Satasidham, Dharampur, Shivagunj, Panchgachhi and Shanischare, among other VDCs, according to Chief at the Khudunabari Health Post, Gopal Sharan.

Sharan said that around 70 patients have visited the Health Post daily for the health check up and treatment lately. The Health Post has referred some critical patients to other hospitals as well.

Infection of viral fever has been seen on patients of Ward No. 3, 4 and 5 of Khudunabari VDC, according to Assistant Health Worker at the Health Post, Khagendra Lingdel.

A local social worker, Moti Maya Khawas, said that the number of the viral fever patient visiting the local clinics is also on the rise.

Similarly, pressure of patients has increased at different health institutions in more than half a dozen VDCs. More than 100 students of Mechi English Boarding School, Maidhara, have been missing their classes as they have been suffering from viral fever.
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

ProMED has added another one. I have merged this thread from several outbreaks in several districts. There is no evidence whether or not any of the outbreaks are related.

For now, I am leaving the outbreak in Jumla (http://www.flutrackers.com/forum/showthread.php?t=191717) separate because unlike the ones in this thread, it has multiple fatalities and a far more precise symptomatic description.

Subject: PRO/EDR> Undiagnosed febrile illness - Nepal (02): (PR, GD) RFI
Archive Number: 20120830.1273598

UNDIAGNOSED FEBRILE ILLNESS - NEPAL (02): (PANCHTHAR AND GUMDA), REQUEST FOR INFORMATION
****************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Wed 29 Aug 3012
Source: The Himalayan, Himalayan News Service [edited]
http://www.thehimalayantimes.com/fu...chthar&sbquo;+50+cases+reported&NewsID=345346


Over 50 cases of fever have been reported so far in the District Hospital, Panchthar. A viral fever outbreak has hit hard Prangbung, Lungrupa, Memeng, Angsarang VDCs [Village Development Committees] and their headquarters, Phidim. In fact, Angsarang has been the most affected VDC. The number of students attending schools has dropped in the Angsarang-based Jyoti Secondary School after children suffered from the disease.

In the same way, Prangbung-based Kalika Secondary School also faced similar problems after a number of students fell sick.

According to the Principal Lungrungpa Parbat Lal Dangal of the Siddheshwori Secondary School, more than 60 students have remained absent in their terminal examinations.

Health workers said when the symptoms of viral fever are found, then the disease will affect the patient for a week. However, since it is transmissible, most of the people in the village have taken ill.

The number of viral fever patients has increased in the District Hospital. Over 50 cases of fever are reported so far. The viral outbreak which spread in Parbat's southern Barrachaur and Ranipani VDCs has not been controlled.

With the spread of viral fever and typhoid since a week, hundreds of people are being affected daily. A team of health workers along with the medicine has been sent to the affected areas.

Barrachar-based Jana Sewa Secondary School has been closed after the outbreak, while the numbers of students in the Ambari Secondary School and surrounding schools have decreased by 50 per cent. Ambari School's Principal, Ganesh Poudel, said that schools could not be conducted for the whole day as there are very few students, and most of them have been ill. More than 100 patients are reported in local clinics. Health worker Surya Bahadur Karki reported that among them, 80 per cent are fever patients and 20 per cent typhoid.

Similarly, maternal health worker Kopila Sharma said that over 80 cases of fever are reported in the Barrachaur Health Post. Dr Sagar Rajbhandari of the District Hospital, Parbat said viral fever has spread due to climate change and unclean drinking water consumption.

Likewise, Lamjung's Duipiple-ba-sed Bhairavkali Higher Secondary School has been shut after most students were affected by viral fever. The number of students going to school has dropped since a week, so the school has been closed after an emergency meeting of the School Management Committee held today [29 Aug 2012], reported committee chairperson Nirmal Gautam. He said that after the suggestions of doctors and health workers of the nearby health posts, they have decided to shut the school.

Viral fever has spread in Gorkha's Gumda 6, 7, 8 and 9 since Sunday [26 Aug 2012]. With its spread, the local Suryodaya Secondary School was shut for 3 days as the teachers and students have taken ill, reported the school's management committee chairperson Bhim Prasad Gurung. According to him, over 250 households have been affected with at least one member in each family taken ill. Patients have the symptoms of runny nose, headache and fever, reported Gurung. Local health centres have started to face the shortage of medicine after fever spread in their areas.

--
Communcated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>

[The description of the symptoms of the illness is insufficient to suggest a possible diagnosis. It appears to be prevalent in 2 separate districts of Nepal and to involve both children and adults, necessitating closure of schools. No fatalities are reported. More specific information from the region would be appreciated.
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral fever claims five in two days
Added At: 2012-08-31 11:35 PM Last Updated At: 2012-08-31 11:35 PM

PUSKAR THAPA
DAILEKH: Viral fever has claimed five lives, including that of an infant, in the last two days in Lalikanda of Dailekh.

Sources at Dailekh District Public Health Office said Jaisara Thapa, 56, Ramshila Nepali, 55, and one-year-old Ram Bahadur Thapa succumbed to the disease today while Bhakta Bahadur Budha, 55 and Bhim Bahadur Thapa, 60, died yesterday. DPHO Chief Dr Sushil Bhandari said all the five from Lalikanda VDC Ward No 5 died while being rushed for treatment. ?We have been informed that more than 200 have fallen ill in Lalikanda,
...
http://www.thehimalayantimes.com/fu...l+fever+claims+five+in+two+days&NewsID=345621
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

One more dies of viral fever in Dailekh
Several schools shut due to outbreak of disease in Dailekh, Baitadi

PRAKASH ADHIKARI


DAILEKH, AUG 31 - A man died of viral fever at Lalikada VDC in the district on Friday. A local resident Chakra Bahadur BC said Ramshila Khadka, 55, died while being taken to a clinic at Dharampokhari. Khadka was vomiting and had fever.
With this, five persons have died of the disease in the past three weeks in the VDC, according to locals.
However, the District Public Health Office (DPHO) is yet to confirm that victims?Khadka, Bhakta Bahadur Buda, Jaisara Thapa, Ram Bahadur Thapa and Bhim Bahadur Thapa?died of viral fever.
Chakra Bahadur BC said that many people were suffering from the disease for the past three weeks. ?At least one person from almost every household is suffering from the disease,? he said.
He said that the patients vomited and exhibited symptoms of headache and common cold.
...
http://www.ekantipur.com/the-kathma...re-dies-of-viral-fever-in-dailekh/239061.html
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral death toll rises to six in Dailekh
Added At: 2012-09-02 1:05 PM Last Updated At: 2012-09-02 1:25 PM
THT ONLINE
DAILEKH: Viral death toll has risen to six as one more minor succumbed to the disease last night.

The deceased is three-year-old girl Basanta BK of Goganpani VDC.

...

Shanti Higher Secondary School and Parbati Primary School have been shut as scores of viral fever patients have taken ill in the district.
...
http://www.thehimalayantimes.com/fu...h+toll+rises+to+six+in+Dailekh+&NewsID=345740
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral outbreak hits Dailekh villages
Added At: 2012-09-02 11:32 PM Last Updated At: 2012-09-02 11:32 PM

HIMALAYAN NEWS SERVICE
DAILEKH: More than 450 people in two remote villages of Dailekh have been affected by viral fever outbreak, officials said today as death toll from across the district reached six.

Although a medical team has been deployed in Lalikanda VDC, which takes around two days to reach from the district headquarters, the team is facing a shortage of medicine and has not been able to reach neigbouring Goganpani village, also affected by the disease.

Around 200 people are learnt to have been affected by the disease in Goganpani. Lalikanda VDC Secretary Karna Bahadur Thapa said more than 250 people have fallen ill in his village.
...
http://www.thehimalayantimes.com/fu...outbreak+hits+Dailekh+villages+&NewsID=345851
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral fever grips Chitwan


RATNAGAR, Chitwan, Sept 3: The number of people suffering from viral fever has excessively increased in Chitwan district.

According to Bharatpur Hospital, viral fever patients have increased by 50 per cent more in second week of this month as compared to last month.
...
http://www.myrepublica.com/portal/index.php?action=news_details&news_id=41018
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Source: http://www.thehimalayantimes.com/fullNews.php?headline=Viral+outbreak+hits+in+Tahanu&NewsID=345966


Viral outbreak hits in Tahanu
Last Updated At: 2012-09-03 11:24 PM
HIMALAYAN NEWS SERVICE

DAMAULI: Viral outbreak has gripped the residents of Chhang, Manapang and Jamune village development committees of Tahanu district.

Everyday 30-35 cases of viral fever with symptoms of headache, fever and vomitting are reported at the Tharpu Health Post, the health post in-charge Ais-howaryachandra Bhattarai said...
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

40 fall ill of viral fever in Khotang
Added At: 2012-09-05 10:53 AM Last Updated At: 2012-09-05 10:53 AM

KHOTANG: Forty people have fallen sick due to viral fever at Halesi in Khotang district, the Sub-health Post, Halesi stated.

Forty of the 55 people who had come to the sub-health post seeking treatment for headache, fever and fainting were found to be suffering from viral fever, said Assistant Health Worker Ram Kumar Bhagat.
...
http://www.thehimalayantimes.com/fu...+ill+of+viral+fever+in+Khotang+&NewsID=346094
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Source: http://www.thehimalayantimes.com/fu...hanpur&sbquo;+Khotang+districts&NewsID=346222

Viral fever outbreak sweeps across Kanchanpur? Khotang districts

Hospitals scrambling to manage patients
Added At: 2012-09-05 11:32 PM
Last Updated At: 2012-09-05 11:32 PM
HIMALAYAN NEWS SERVICE

MAHENDRANAGAR/KHOTANG: A massive viral fever outbreak sweeping across Kanchanpur and Khotang has resulted in health facilities chock-a-block, with hundreds of patients rushing for treatment every day.

Shiva Dutta Bhatta, Senior Public Health Administrator, said around 1,000 viral fever patients are visiting health centres in the district every day...

...Death toll in Dailekh seven

DAILEKH: Viral fever death toll has reached seven in the last one week in Dailekh with one more patient succumbing to the disease on Wednesday...
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral fever death toll eight in Dailekh
Added At: 2012-09-06 10:33 PM Last Updated At: 2012-09-06 10:33 PM

HIMALAYAN NEWS SERVICE
DAILEKH: One more person succumbed to viral fever today, taking the death toll in the district to eight.

Durga Dhakal, 17, of Layatibindrasaini died while being taken to Nepalgunj for treatment. Deceased Dhakal?s father said the whole village has been under the grip of viral fever. Five villagers died in Lalikanda last week, one in Goganpani and Karna Bir Kami in Badalamji yesterday.

Viral fever that first stalked the eastern part of the district last week has now reached the western region. Dr Sunil Bhandari said a medical team was being prepared for the affected areas.
...
http://www.thehimalayantimes.com/fu...er+death+toll+eight+in+Dailekh+&NewsID=346341
 
Re: Nepal: Widespread viral fever outbreaks, several fatalities - swine flu suspected in some cases

Re: Nepal: Widespread viral fever outbreaks, several fatalities - swine flu suspected in some cases

Minor girl succumbs to viral fever in Kailali

Added At: 2012-09-07 3:40 PM Last Updated At: 2012-09-07 3:40 PM

She was admitted to the Nursing Home two days ago.
KAILALI: A child died from viral fever in Kailali district today.

The deceased is identified as three-year-old Radhika Jora of Shreepur VDC-3 in the district.
...
http://www.thehimalayantimes.com/fu...cumbs+to+viral+fever+in+Kailali&NewsID=346384

Viral fever outbreaks in Nepal, 9 die
Xinhua | 2012-9-7 15:49:46
By Agencies

At least 9 people have died in different places of Nepal after suffering from viral fever in the first week of September.

At least 6 people died in Dailekh district, western part of Nepal and 3 died in Chitwan district, some 146 km west of Nepali capital Kathmandu.

Although the exact numbers are difficult to produce, the number of patients suffering from viral fever has increased in the past week, according to general physician at a local hospital Dr. Shiven Prasad Gupta.

"Viral fever is easily transmitted through regular contacts. In some homes, the entire members of the family are suffering from the viral fever," Dr. Gupta informed.
...
http://www.globaltimes.cn/content/731767.shtml
 
Last edited:
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

It is unfortunate that there is no identification of 'viral fever'; from the report above, it distinguishes typhoid from 'viral fever', so this suggests that typhoid diangostics are carried out. Therefore the description 'viral fever' likely excludes typhoid cases.

Some reports indicate pneumonia as well as fever and headache and the pattern of spread sounds as if a primary causative agent could be flu or similar respiratory virus. It would be helpful if they ruled flu in or out in the area and made a positive ID of the pathogen, so it can be subtyped and if necessary, genetically characterised to make sure we dont have something new that is transmitting well between humans given the rate of spread and high described attack rates.

The form of H3N2 that has circulated this season in Australia is antigenically different to the vaccine strain and seasonal H3N2 strains that have circulated in previous years, and so could be a good candidate.
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral fever claims 13 lives, infects 10,000: EDCD

ARJUN POUDEL

KATHMANDU, Sept 8: Thirteen people have died and over 10,000 have been infected by the seasonal viral fever that has spread across the country for the past one month.

Officials at the Ministry of Health and Population (MoHP) said that hundreds of patients who have developed symptoms of the viral infection are receiving treatment in health centers across the country.



According to the Epidemiology and Disease Control Division (EDCD) under the Department of Health Services (DoHS), Dailekh, Okhaldhunga, Khotang and Kanchanpur are among the most effected districts, forcing the local authorities to shut down schools to control possible spread of the disease.
...
http://www.myrepublica.com/portal/index.php?action=news_details&news_id=41234
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Source: http://www.thehimalayantimes.com/fu...eak&sbquo;+packed+with+patients&NewsID=346536

Doti falls prey to outbreak? packed with patients
Added At: 2012-09-08 10:42 PM
HIMALAYAN NEWS SERVICE

DIPAYAL: Health facilities in Doti district are crammed with patients suffering from viral fever and typhoid.

The number of patients has gone up considerably in the past one week, health workers said. Among the worst hit areas in the district include Latamandu VDC, Silgadhi Municipality, Pipalla and Rajpur. ..
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

It is unfortunate that there is no identification of 'viral fever'; from the report above, it distinguishes typhoid from 'viral fever', so this suggests that typhoid diangostics are carried out. Therefore the description 'viral fever' likely excludes typhoid cases.

Some reports indicate pneumonia as well as fever and headache and the pattern of spread sounds as if a primary causative agent could be flu or similar respiratory virus. It would be helpful if they ruled flu in or out in the area and made a positive ID of the pathogen, so it can be subtyped and if necessary, genetically characterised to make sure we dont have something new that is transmitting well between humans given the rate of spread and high described attack rates.

The form of H3N2 that has circulated this season in Australia is antigenically different to the vaccine strain and seasonal H3N2 strains that have circulated in previous years, and so could be a good candidate.

These viral fever outbreaks are typically linked to the monsoon season, so they tend to have something to do with water being where it shouldn't be. This produces breeding grounds for mosquitoes (resulting in malaria, dengue, chikungunya) and also contamination of drinking water (resulting in typhoid, dysentery, cholera, and leptospirosis).

I think the reason that they just call it "viral fever" is that no single agent is responsible for a majority of the cases, and it would be too expensive to try to diagnose every case. Typhoid gets singled out for diagnosis because it is the one diagnosis here where antibiotic treatment can make a dramatic difference in the portion of patients that survive.
 
Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Re: Nepal: Multiple outbreaks of "viral fever" and other unidentified illnesses, August 1, 2012+

Viral fever sweeps across Terhathum
Added At: 2012-09-08 10:46 PM Last Updated At: 2012-09-08 10:46 PM

HIMALAYAN NEWS SERVICE
MYANGLUNG: Following the viral fever outbreak, most of the locals at the Terhathum’s Aathrai’s Iwa VDC are suffering from fever, common cold and headache.

Iwa Health Post said most of the locals have fallen prey to the disease. Senior AHW Laxman Biswokarma at the Iwa Health Post said that four persons complaining of infection and typhoid have been referred to the neighbouring Panchthar District Hospital.
...
http://www.thehimalayantimes.com/fu...+fever+sweeps+across+Terhathum+&NewsID=346540

Most schools closed in Okhaldhunga
Added At: 2012-09-08 10:43 PM Last Updated At: 2012-09-08 10:43 PM

HIMALAYAN NEWS SERVICE
OKHALDHUNGA: The viral fever that broke out in Okhaldhunga district a week ago is yet to come under control, sources said.

Various VDCs including Mamkha, Ratmate, Diyale, Katunje, Mulkharka, Palapu, Rangadip, Patle, Bigutar, Sanitar have fallen prey to the outbreak. Most schools in the district have remained shut after both students and teachers were affected by viral fever.
...
http://www.thehimalayantimes.com/fu...t+schools+closed+in+Okhaldhunga&NewsID=346538
 
Last edited:
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