Peru - outbreak of pneumonic plague

[alert]

Re: Peru - outbreak of pneumonic plague

Two of the four pneumonic plague cases have now been discharged, according to this article. Case #2, the 35-year-old doctor is definitely one of them. The other is likely case #5, although the gender has been changed again to female, and now she is listed as 3-years old.

It is possible that #5 has been reported as any age varying from 3-8 years old, and both genders, but is probably the same case (and might be the niece/nephew of case #1).

The two who remain critically ill are cases #1 and #3. Case #4 may have been discarded.

It is conceivable that cases #6 and #7 are the two septicemic plague cases.

http://www.rpp.com.pe/2010-08-03-da...-neumonica-en-la-libertad-noticia_284957.html

Spanish to English translationShow romanization
Tuesday, August 3, 2010 | 18:35 hrsDan discharged two patients hospitalized for pneumonic plague in La Libertad
Both were infected by a woman of 29 years from Chocop District, which was identified as the first case of pneumonic plague in La Libertad.

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Vs Bubonic plague. Recommendations to prevent pneumonic plague AUDIO: Eleven confirmed cases of plague in the north disinfected four thousand homes in Ascope by State pneumonic plague pneumonic plague infected in La Libertad is crítico Two of the four patients who were hospitalized with symptoms of pneumonic plague were discharged to recover successfully, according to the Technical Committee Chairman Regional Operational Pest Control, Pedro Diaz Camacho.

It is a medical resident who left the Intensive Care Unit (ICU) of Hospital Víctor Lazarte Echegaray three days ago and today was discharged with a girl of three years.

Both were infected by contact with the 29-year old from Chocop District, which was identified as the first case of pneumonic plague in La Libertad.

The two have returned to their homes under medical supervision from any complication, he said.

The specialist said that the other two cases of pneumonic plague: a woman of 29 years and fourth year student of medicine (21) continued detention and poor prognosis.

On the other hand, Diaz Camacho said that to date have been disinsected 4.200 12.000 dwellings of which are within the areas of risk by the epidemic outbreak of bubonic and pneumonic plague in the province Ascope Libertad.

He said already tapped all dwellings Chicama district, where he recorded most of the cases of bubonic plague.

Intervention has begun in seven towns in the rural district Rázuri, where they work in about 800 homes. Failure to intervene in rural and marginal urban districts of Santiago de Cao, and Chocop Cartavio.

Andina

 

[alert]

Re: Peru - outbreak of pneumonic plague

OK. This PAHO report via ProMED confirms several things. First, the fatal case in the 14-year-old is septicemic. Secondly, both cases #3 and #5 had onset prior to July 11, which means that case #5 was ill for at least two weeks before being recognized as pneumonic plague. The exposure would have occurred sometime before July 8 (when case #1 was hospitalized), so this does make sense. That individual is lucky to have recovered, and even luckier to have apparently infected no one else.

In response to the ProMED moderator's comments, all three additional pneumonic plague cases apparently result from person-to-person transmission via contact with the index case.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,83992

Archive Number 20100805.2652
Published Date 05-AUG-2010
Subject PRO/AH/EDR> Plague - Peru (03): (LL), PAHO

PLAGUE - PERU (03): (LA LIBERTAD), PAHO
**********************************************
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: Mon 2 Aug 2010
Source: PAHO [edited]
<http://new.paho.org/hq/index.php?option=com_content&task=view&id=3311&Itemid=2206>


During Epidemiological Week (EW) 28 of 2010, the Ministry of Health
of Peru confirmed the 1st case of pneumonic plague in a 29 year old
patient from the district of Chocope, province of Ascope, department
La Libertad. The presence of buboes had not been identified in the
patient. Subsequently 3 more cases were registered. They were
confirmed by rapid test.

As of EW 30, 17 cases of plague have been reported; of these 4 are
pneumonic plague, 12 are bubonic plague and 1 was septicemic plague
which resulted in death. The onset of symptoms for the last pneumonic
case was 11 Jul 2010. During the investigations, 10 isolates of _Y.
pestis_ were isolated from humans, rodents and domestic cats.

The last plague outbreak reported in the province of Ascope occurred
in the locality of Santa Clara, in the district of Casa Grande
between August and September 2009. During the outbreak, 15 cases were
reported, of which 9 cases were confirmed by laboratory.

Among the current outbreak control measures carried out by the
national and local authorities of Peru are:
- Active search for contacts and secondary cases; beginning of
chemoprophylaxis use on the contacts;
- Strict monitoring of the implementation of biosafety measures by
the health workers;
- Strengthening of the laboratory network for collecting and
processing samples;
- Implementation of an environmental management program.

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

[This is a PAHO confirmation report of the outbreak. ProMED waits to
see exactly how many cases will be reported and how many of the
pneumonic cases represent person-to-person spread. - Mod. LL]

 

[Giuseppe]

Re: Peru - outbreak of pneumonic plague

This is the full PAHO epidemiological alert document cited in the above ProMedMail.org post:

Epidemiological Alert: Plague Outbreak in Peru (2 August 2010) (PAHO, edited)

[Source: Pan American Health Organization (PAHO), Regional Office of the World Health Organization, full PDF Document (LINK). Edited.]

Epidemiological Alert: Plague Outbreak in Peru (2 August 2010)


During Epidemiological Week (EW) 28 of this year, the Ministry of Health of Peru confirmed the first case of pneumonic plague in a 29 year old patient from the district of Chocope, province of Ascope, department La Libertad. The presence of buboes had not been identified in the patient. Subsequently 3 more cases were registered. They were confirmed by rapid test.

As of EW 30, 17 cases of plague have been reported; of these four are pneumonic plague, 12 are bubonic plague and one was septicemic plague which resulted in death. The onset of symptoms for the last pneumonic case was 11 July.

During the investigations, 10 strains of Y. pestis were isolated from humans, rodents and domestic cats

The last plague outbreak reported in the province of Ascope occurred in the locality of Santa Clara, in the district of Casa Grande between August and September 2009. During the outbreak, 15 cases were reported, of which 9 cases were confirmed by laboratory.

Among the current outbreak control measures carried out by the national and local authorities of Peru are:

• Active search for contacts and secondary cases; beginning of chemoprophylaxis use on the contacts.
• Strict monitoring of the implementation of biosafety measures by the health workers.
• Strengthening of the laboratory network for collecting and processing samples
• Implementation of an environmental management program.

Source: Peru IHR- National Focal Point


In light of this situation the Pan American Health Organization is submitting the alert on the need for strengthening active surveillance in the zoonotic foci; as well as to prepare and implement a program for environmental management in order to reduce the risk of dissemination from these foci.


Introduction

Plague continues to pose a threat to public health given the persistence of the infective agent in nature. It is a predominantly rural disease, although outbreaks are recorded in urban areas in some countries of Africa, reason for which the risk of urban transmission should not be underestimated.

In the Region of the Americas the countries that have historically recorded cases were Bolivia, Brazil, Ecuador, Peru, and the United States.

A review carried out by the World Health Organization (WHO) on the cases of plague recorded during 2004-2009 demonstrated that during that period 12,503 cases of plague were reported at the global level; including 843 deaths in 16 countries of Africa, Asia, and the Americas. Of these, 1.2% corresponded to the Region of the Americas, with a case-fatality rate of 4.1%. The countries in the Region that recorded cases during that period were Peru and the United States.

Under the International Health Regulations (2005), pneumonic plague is one of the events that should be evaluated using the Annex 2 decision instrument; due to its potentially serious impact on public health and its potential for quick international spread.


Laboratory Diagnosis

The diagnosis and the confirmation of plague require laboratory tests. The confirmation is carried out through the isolation and identification of Y. pestis through the culture of samples from the patient. Depending on the type of presentation of the disease, the samples to be analyzed could be the aspirate of the buboes, the blood, or the sputum.

Infection can also be confirmed examining serum samples obtained in the early and late phases of the infection (seroconversion). Rapid tests currently exist for which use in the field has been validated to rapidly detect the presence of antigens of Y. pestis in patients. Facing the suspicion of cases of plague, samples should be collected and sent for laboratory testing.


Treatment of patients and infection prevention measures in health facilities

The early detection and treatment are essential in order to reduce complications and case-fatality. The administration of antibiotics and the support treatment lead to the cure of the patient, provided that it is diagnosed on time.

In case of pneumonic plague it is recommended to isolate the patients. The duration of this precaution should be of up to 48 hours after the treatment is begun.

In order to prevent infections in the health facilities, it is encouraged to rigorously carry out the standard precautions, which include: washing hands with soap and water or glycerinated alcohol, and the use of gloves prior to contact with mucous membranes, broken skin, and for contact with excretions or secretions. Cleansing the environment is also recommended, with the use of soap and water.

Aerosol-generating procedures (intubation, cardiopulmonary resuscitation, bronchoscopy, surgery and autopsy) can be related to a greater risk of transmission of the infection. The number of health workers present in these procedures should be limited. All the present health workers should use respirators (N-95) against respiratory particles.


Recommendations

• Implement or strengthen active surveillance in the zoonotic foci and the rapid response designed to reduce the exposure during the epizootic outbreaks.
• Conduct investigation in order to identify the species of fleas and other animals involved in the enzootic cycle of plague in the Region.
• Prepare and implement a program for environmental management in order to reduce the risk of spread in the zoonotic foci.
• When facing the occurrence of cases it is important to identify the most likely source of infection in order to implement the appropriate sanitation and control measures.
• Alert the health workers in the areas with active transmission of plague on the clinical manifestations of the disease and the case definition.

Bibliographical References

1. World Health Organization. Weekly Epidemiological Record. No. 6, 2010, 85, 40-45.
2. World Health Organization. Fact Sheets. Plague. Available at: (LINK)
3. Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
4. Kool JL. Risk of person-to-person transmission of pneumonic plague. Clin Infect Dis 2005; 40(8): 1166-72.
5. Organizaci?n Panamericana de la Salud. Prevenci?n y control de la infecci?n en enfermedades respiratorias agudas con tendencia epid?mica y pand?mica durante la atenci?n de la salud Tema I: Transmisi?n. Precauciones est?ndares y precauciones adicionales. OPS 2010.

Plague (ICD-10 A20)

Plague is a zoonotic disease whose infectious agent is the Yersinia pestis bacterium. It affects mainly small animals and their fleas. Humans can also be infected through the bite of an infected flea, the most common form of transmission, although it could also occur through direct contact with an infected person; inhalation; and rarely by ingesting infected material.

Plague can pose a serious threat to public health. The plague case-fatality rate for untreated cases ranges between 30-100%.

The incubation period is from 3 to 7 days. It initially presents itself as influenza-like symptoms: sudden fever, chill, headache, malaise, vomit and nausea. Subsequently, one of the three forms of clinical manifestations of the Yersinia pestis infection may be developed, which depend on its route of transmission:

• Bubonic plague (ICD-10 A20.0):
  • is the most common form. The bacillus penetrates the skin starting on the bite by the infected flea and travels through the lymphatic system up to the closest node which consequently becomes inflamed due to the replication of the Y. pestis in its interior. This causes the bubo, which is very painful and can suppurate in advanced stages of the infection.
• Septicemic plague (ICD-10 A20.7):
  • occurs when infection spreads through the bloodstream. Commonly the advanced stages of bubonic plague result in this clinical form.
• Pneumonic plague (ICD-10 A20.2):
  • is the most virulent and least common of the clinical forms. It tends to be the secondary dissemination form of an advanced bubonic infection. It can also be the result of the inhalation of infected respiratory droplets and can be directly transmitted from one person to another. Untreated it is always fatal.

-
-----

 

[alert]

Re: Peru - outbreak of pneumonic plague

This new case does not appear to be a contact of the previous four and may have caught the illness from a non-human source. With an onset date of August 1st, it is well beyond the incubation period of contacts of the first four anyway.

Hopefully, his contacts are being given preventative antibiotics now.

While this case is reported as pneumonic, no symptomatic description of the specific case is given. And the mention of pain in lymph nodes as a general description of plague might be an indication that this is a bubonic case.

http://www.laindustria.pe/index.php?option=com_content&task=view&id=17604&Itemid=5

Spanish to English translationShow romanization
-------------------------------------------------- ------------------------------


11 year old boy would pneumonic plague
Friday, August 6, 2010
One child under 11 years of age has become the new suspected case of pneumonic plague in La Libertad. This was confirmed yesterday Industry Committee Chairman Regional Technical pest control operator and hospital epidemiologist Belén, Pedro Diaz Camacho, who revealed that dropped the first test is positive.


"It's a boy from Chiquitoy, in the province of Ascope, who is admitted to the pediatric hospital EsSalud, Victor Lazarte Echegaray, under the watchful eye of doctors. Although the first test that was applied was positive, we are still waiting for PCR results to be forwarded from the National Institute of Health (Lima). These discarded whether or not the disease, "he said.

However, he maintained that way to prevent the doctors are providing the same medical treatment as though it were a patient with pneumonia confirmed. Moreover, said that presented the symptoms of discomfort from 1 August last, but the parents took him to the nearest health center due to ignorance. However, recently the following days (August 2) was transferred first to the Bethlehem hospital and then to Lazarte Echegaray.

Camacho Diaz also revealed that the number of confirmed cases of pneumonic plague in four and recommended maintaining the population liberteña be alert to any sign of fever or pain in the area of the lymph nodes.

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

You can get to Lima

Experts call for review vehicles from the north by infected rats.
Alert Lima, infected rats in the north of the country can get to Lima, so it is necessary to take urgent preventive measures to avoid the emergence of cases of bubonic plague in the capital and other cities, said the director of the Institute of Tropical Medicine Faculty of Medicine of the Universidad Nacional Mayor de San Marcos (San Marcos), Jos? Mar?a Guevara Dr. Duncan.
One of the measures to be taken by the responsible institutions are the immediate control of the entry of trucks coming from infected areas and rodent control, said the expert, because the disease is transmitted via fleas infected by rodents .

Local Governments
The municipalities, regional governments and health authorities should work together to prevent the emergence of outbreaks in the districts of the capital, especially in impoverished areas that lack adequate safety measures.
Another alarming concern to the Faculty of Medicine, San Fernando, is the emergence of the variant of the plague made in recent years, known as pneumonic plague, which attacks the lungs, and its transmission is given ill patient healthy patient through the air, which makes it the most dangerous and deadly variant of this plague, especially if it is not treated in time, as the systemic spread within the body faster than normal fever, said Dr. Duncan Guevara.

Recommendation
It recommended that the danger exists, the cases of febrile patients attending the emergency should be treated with the antibiotic ciprofloxacin in its generic version which would advance the treatment while conducting the analysis.

The data
Bubonic plague appeared in the country early last century, the years 1903 through ships that arrived at Callao from Europe and America. In the capital there have been no cases, however you must be alert. :tiphat:http://www.expreso.com.pe/edicion/index.php?option=com_content&task=view&id=110371&Itemid=35

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Report plague negative
Health Sub strengthens prevention


A negative report possible cases of pneumonic plague, and has the address of epidemiology at the Health Sub Luciano Castillo Colonna, was announced the general director Ana Maria Palacios Farfan, who emphasized that we are not an alarm but only prevention.

Sullana .- Ana Mar?a Palacios As reported, there is no probable cases or deaths of humans or animals infected with the bacteria that causes illness, however, said that since 16 July, the area of Epidemiology sent to all establishments Health, the policy that contains an epidemiological alert, which displays information about the current situation, and above all, the recommendations should be taken into account.

Palacios had an impact on the recommendations as strengthening measures for infection control in health services, focusing on Ayabaca endemic areas and the immediate reporting of patients considered as probable bubonic or pneumonic, without waiting for an accurate diagnosis, but provide immediate treatment, which will be free.
For his part, Director of Health of the People of the subregion of Health, Walter Vegas Olaya, said the health agency has a budget amounting to 435 000 soles, as well as personnel and supplies sufficient to cope with a possible such outbreak of epidemic.

Recommendations
The director of epidemiology at the subregional entity, Edward S?clupe Pozo, explained that the recommendations that deserve special attention are the strengthening of infection control measures in health services, particularly in the areas of critical patients with acute infections or tract.
It also recommended the immediate notification of patients who meet the criteria of the definitions of probable case of bubonic plague, such as the origin of endemic area presenting with fever between 39 and 40 degrees Celsius and pain in lymph node area, or probable cases pneumonic plague in addition to fever, a cough with expectoration of blood and respiratory distress. :tiphat:http://www.eltiempo.pe/agosto2010/edicion-06-08-2010/noticias/regional-400.html

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Negative report of bubonic plague
According to Ciro Magui?a, the epidemic could spread to other parts of the coast and Ancash, Lambayeque and Lima, the expansion would be through a complication of the disease, called pneumonic plague, "which is even more damaging."



The dean of the Medical College of Peru, said the plague could reach many places because the rodents may travel several kilometers and stay in areas with poor housing and high levels of poverty.

For its part, the Ministry of Health set up the National Committee on Prevention and Control of Plague, who is responsible for support of contingency measures to prevent the spread of evil.:tiphat:http://www.24horas.com.pe/nacionales/1281023379.php

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

LA CALETA HOSPITAL FROM elaborate his proposals Bubonic Plague
Friday August 6, 2010 1:26


Different areas of the Hospital La Caleta, including Zoonoses, Epidemiology, Medicine and Environmental Health, met yesterday to draw up proposals for preventive measures against the bubonic plague and raised today at a meeting of COPROSEC (Provincial Public Safety Committee) .

This was announced by the Director of the hospital, Dr. Z??iga Guiselle Prince, who stated that at the first meeting of COPROSEC has been exposed on the disease that is attacking the northern part of the country and has coordinated preventive measures, including rat control them not only in places where rodents abound, however, is to exhaust all possible mechanisms to implement them so they will not register any case in the city.

"In the Hospital La Caleta, work has begun training and to this end, four teams have traveled to the hospital area to raise human resource, we know there are other measures to be implemented at the macro level, but we we have been doing at the micro level and intra-hospital, "said the head of the Creek.

Meanwhile, he said, that we see the possibility of having an isolated area within the hospital, to be prepared in case you encounter a suspected case, which fortunately has not yet been registered.

"In the meantime, has been inspecting in Hospital Pharmacy, if all drugs are essential not only for this subject, but also by the friaje, and that at least is indispensable with drugs such as streptomycin and clorofenicol aminoglucosis" he said.

It should be noted that the last report received are 31 confirmed and suspected cases among Ascope Department in Liberty, of which 25 are of bubonic plague, pneumonic plague and two four septis?mica fever and there is less than 14 years died.

People should know that the symptoms of this disease is high fever, continuing with swollen lymph, abdominal pain, diarrhea and malaise, therefore, the early signs that this one person and above all, knowing that he has been exposed to contract evil, should go immediately to the nearest health post for the corresponding analysis. :tiphat:http://www.diariodechimbote.com/por...labora-sus-propuestas-frente-a-peste-bubonica

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

The General Manager Ramon de la Cruz said the health posts are on alert for a possible case of "bubonic plague" in our town.
Chimbotanos Hospitals on alert for bubonic plague

ESSALUD Manager. Ramon De La Cruz


Ramon de la Cruz said that in our town still has not confirmed any cases of patients infected with "Bubonic Plague," while the health posts and hospitals take preventive measures to prevent people from getting the disease.

DETAIL

Although the health sector are aware of the "Bubonic Plague," the majority of hospitals and health centers in Chimbote environments lack adequate to cover any cases of patients infected with this disease, threatening the health of the population.


Full alert. At the news of patients infected with the "bubonic plague" in the north, the Red North Pacific, South Pacific Network, in coordination with the various hospitals and health centers have launched the "Campaign for Prevention" to avoid possible cases of "bubonic plague" nationwide.

However, hospitals and health posts are not prepared to handle an emergency patient with bubonic or pneumonic plague also.

Another difficulty is that the Hospital La Caleta not have the necessary tools or with an appropriate environment for care for infected patients, ie missing the intensive care unit and health posts are in the same conditions as hospitals.

Also, the General Manager of the Ancash ESSALUD Care Network, Ramon de la Cruz Castillo said health posts biosecurity practice is that health workers used masks and aprons when caring for patients in outpatient , triage and emergency in order to avoid any contamination as the "Bubonic Plague" and "Pneumonic Plague."

"The health centers take into account the biosecurity when caring for patients and to avoid possible infection of the bubonic plague, therefore, the Pacifica has informed all hospitals on the subject to be on alert," said Ramon de la Cruz.

On the other hand, health personnel health centers hoped that the authorities take into account the importance of this problem and to make it a clean up campaign in the various sectors of this jurisdiction.

"Hospitals are in a stage of preparation to adapt to these cases, also have made the prevention campaign, and we hope that this is not a case of bubonic plague," said Ramon de la Cruz.:tiphat:http://www.diariolaprimeraperu.com/online/chimbote/noticia.php?IDnoticia=12227

 

[Vibrant62]

Re: Peru - outbreak of pneumonic plague

Alert - do you know if it is possible to have asymptomatic cases of plague who may act as carriers? Could this be an issue here? I have not been able to find much of use.

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Friday August 6, 2010 - Bubonic plague can come in truck
Expert calls on the authorities to take preventive measures against this disease.

Rats infected with the deadly 'plague' could reach the capital in trucks that transport food and other supplies from northern Iraq, warned the director of the Institute of Tropical Medicine, Faculty of Medicine, San Fernando, Jose Duncan Guevara.

He said it is necessary that the authorities take urgent preventive measures to avoid the emergence of cases of so-called 'black plague' in Lima, such as controlling the entry of trucks coming from infected areas and rodent control.:tiphat:http://trome.pe/noticia/619329/peste-bubonica-puede-llegar-camiones

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Recommended eradication pigsty
Friday, August 6, 2010
Pacasmayo.
The total eradication of existing underground pigsty within the city limits as well as cleaning of canals, drains and removal of shrubs, among other actions requested by the competent authorities, the director of Health Center Pacasmayo, Yael Leyva Robles.

This as a precautionary measure to avoid the presence of bubonic plague in this town. At the same time, denied the statements made Health Minister Oscar Ugarte Ubilluz, in the sense that in cases of plague had Pacasmayo.

Yael Robles summoned the media to give advice about diabetes prevention and informed that it will meet next Monday the local authorities to develop a contingency plan at district level.

"On 4 August the Minister of Health had told the press that had been submitted Pacasmayo cases of bubonic plague. We have already reported that no suspected case, neither possible nor confirmed bubonic plague in the province of Pacasmayo" said.

But he added that the whole province is on yellow alert because they are adjacent to Ascope and therefore the authorities will be convened to develop a contingency plan.

He called on the authorities and other people like the Millers to attend the meeting, since a few days ago the first meeting failed because they did not attend most summoned.

Preventive measures
The medical center Director indicated released preventive measures at the level of housing and community should be taken.

He recalled that many years ago was presented Pacasmayo plague causing many deaths. According to the directives and regulations of the Ministry of Health, homes must make recommendations as is the case that when a person is indicated with symptoms of illness, you should go to the nearest health facility.

It also has to be storing food in rodent-proof containers, ie metal cans, glass, clay, among others. :tiphat:http://www.laindustria.pe/index.php?option=com_content&task=view&id=17611&Itemid=6

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

:tiphat:a video

Health: Northern Peru on alert for Bubonic plague

In Ascope City, Province Pacasmayo in Freedom, we detected several cases of bubonic plague, transmitted by rodents (rats), fleas, lice, etc.. When transmitted to humans becomes affect Bubonic and Pneumonic the lungs, the latter most lethal and contagious, as the dean of the medical college says it is more contagious than tuberculosis and influenza A-N1H1. The minister said are being sent 5 tons of insecticide to control the situation.:tiphat:http://www.peruvideos.tv/videos/ver/salud-norte-peruano-en-alerta-por-peste-bubonica.html

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Contingency plan is executed to prevent pneumonic plague, and
Chota .-
Given the warning on the possible occurrence of bubonic and pneumonic plague in northern Peru, the Sub-Directorate of Health (DISA) is working on a contingency plan to prevent the outbreak of these diseases in endemic areas Chota and the provinces of Santa Cruz.


Preventive and promotional activities as part of the project, taking place in areas at risk where in previous years there have been cases of bubonic plague.

"It is intervening in the districts of San Juan de Licup?s, Flame, Tocmoche, Miracosta, Catachan and Chancay Ba?os," the owner of the health sector in this province, Cesar Medina Guevara.

He explained that the work involves a number of activities implemented by the servers of Health in each jurisdiction. "It is the active search for suspected cases of bubonic plague, to meet any sample is taken for appropriate diagnosis," he noted.

Also, detailed, domiciliary visits are made and is coordinating with district mayors so they can support with inputs, so you can do the spraying and treatment of dwellings, since in this season in those places is usually the proliferation of rodents.

The health officials recommended that people be alert to the spread of this epidemic, because an infected person to be manifested clinical symptoms of swelling in the lymph nodes, with the possible consequence of presenting generalized septicemia. :tiphat:http://www.panoramacajamarquino.com...cia-para-prevenir-peste-bubonica-y-neumonica/

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Residents call for closure of farm birds for the presence of rodents in El Milagro
Thursday, August 5, 2010


About 20 families demanded the closure or relocation of a poultry farm located in the Mz "R", sector 7 of the town of El Milagro because of the presence of rodents.

The health authorities said they had increased by 20% the appearance of the rats in this area as a fumigation is necessary and training local people to prevent the spread of bubonic plague.:tiphat:http://trujilloinforma.com/index.php?option=com_content&task=view&id=6369&Itemid=1

 

[alert]

Re: Peru - outbreak of pneumonic plague

Alert - do you know if it is possible to have asymptomatic cases of plague who may act as carriers? Could this be an issue here? I have not been able to find much of use.

Not very likely, and not necessary for this outbreak. The bacterium is widespread in animals in the region (rats, cats, gunea pigs, etc.), so sporadic cases can be reported with no human contacts. Other than the four-person cluster of pneumonic plague and the possible transmission from the fatality to his younger sister, it is reasonable to assume that the rest of the cases are the result of exposure to infected fleas or animals.

 

[Vibrant62]

Re: Peru - outbreak of pneumonic plague

I was thinking of pneumonic plague in this query, and the rigour of contact tracing in Peru vis a vis do they need to go as far as tracing contacts of contacts to ensure that the transmission chain is stopped.

It is almost inevitable that further pneumonic cases will emerge at some point.

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Plague threatens to reach Trujillo
Saturday, August 7, 2010


After Lima, the Ministry of Health (MoH) confirmed that rodents trapped in the town carrying the bacteria Miracle 'yersinia pestis' (plague), the Health authorities and staff met yesterday to prepare an emergency plan preventive to prevent the outbreak and spread of diseases like bubonic plague and pneumonic. (Photo: Carlos Flores)


The discovery process began with the placement of 70 traps in the area 9 where there are about 20 blocks, in which prevail the yards.

There they caught the rats that were studied in a laboratory at the National Institute of Health in Lima, where he said Thursday at 4 pm, the animals were carrying the fleas carry the bacteria.

Although, the manager of Network Micro Hope, Carlos Herrera Vassallo, said no cases recorded in Trujillo in Sector 9 humble about 500 families are at risk for the evil that progressively attacks the body's defenses if is not taken adequate preventive measures.

"There is a method of placing the traps. The trap allows to know the rate of rodent fleas which are the bacteria are studied in the laboratory where they finally determines whether a carrier or not, "said the specialist.

A bugging
Given this warning, yesterday at the Health Center of El Milagro, the mayors of Huanchacho, Fernando Baz?n Pinillos, and the center village of El Milagro, Wilder Loyola V?squez, managers of the Micro Network of Hope and Health Network " Trujillo, Carlos Vasallo and Jose Herrera Villanueva Villanueva, among others, planned to take emergency measures such as buying flea and production of brochures.

The city of Huanchaco bear the cost for the purchase of 3000 kilos of 'Carbar?n' dusting substance that will eliminate the fleas in four markets as Santa Rosa, July 28, Lord of Miracles, among others, as well as 23 institutions education. The brigades also will go to areas 9 and 8, and 170 farms in the vicinity.

"It is estimated that two kilos would be used for each house. The cost is high and make the effort to take extreme precautionary measures and prevent fleas infect humans. We are coordinating the substance by buying directly from Lima, "said the manager of the Micro Red de La Esperanza, Carlos Herrera.

It is important to add that also educate people coordinating the distribution of printed messages, which are urged to maintain cleanliness, the cleanliness of their homes and move out of the garbage and go to the nearest health center if suffering symptoms of diseases like plague and pneumonic plague (the second is the complication of the first).

"In the prison, El Milagro, both in men and woman, have taken the warnings of the case. It also recommends that people manage their solid waste and maintain cleanliness. From today (yesterday) started with the multimedia campaign, "said the manager of the Micro Network, Carlos Herrera. :tiphat:http://www.laindustria.pe/index.php?option=com_content&task=view&id=17639&Itemid=17

 

[Treyfish]

Re: Peru - outbreak of pneumonic plague

Fever may reach Trujillo
Saturday, August 7, 2010

After Lima, the Ministry of Health (MoH) confirmed that rodents trapped in the town carrying the bacteria Miracle 'yersinia pestis' (plague), the Health authorities and staff met yesterday to prepare an emergency plan preventive to prevent the outbreak and spread of diseases like bubonic plague and pneumonic.

(Photo: Carlos Flores) The screening process was initiated by placing 70 traps in the area 9 where there are about 20 blocks, in which prevail the yards.
There they caught the rats that were studied in a laboratory at the National Institute of Health in Lima, where he said Thursday at 4 pm, the animals were carrying the fleas carry the bacteria.
Although, the manager of Network Micro Hope, Carlos Herrera Vassallo, said no cases recorded in Trujillo in Sector 9 humble about 500 families are at risk for the evil that progressively attacks the body's defenses if is not taken adequate preventive measures.
"There is a method of placing the traps. The trap allows to know the rate of rodent fleas which are the bacteria are studied in the laboratory where they finally determines whether a carrier or not, "said the specialist :tiphat:http://www.noticiastrujillo.com/ind...=56&utm_source=twitterfeed&utm_medium=twitter

 

[alert]

Re: Peru - outbreak of pneumonic plague

I was thinking of pneumonic plague in this query, and the rigour of contact tracing in Peru vis a vis do they need to go as far as tracing contacts of contacts to ensure that the transmission chain is stopped.

It is almost inevitable that further pneumonic cases will emerge at some point.

It is tough to tell. Pneumonic plague is such a severe disease, especially untreated, that it is difficult to imagine that large numbers of cases are being missed. One article indicates that the pet cat of case #1 tested positive for the plague bacterium, so we have a probable exposure for that case. The remaining three confirmed cases had close contact with the index case. We are now well beyond the incubation period for all contacts of the four confirmed cases.

As far as tracing contacts of contacts, I don't think they need to do that, which is probably a very good thing. I'm not sure any country can do that in an outbreak in general. That is why although we can contain VHF, plague, and SARS outbreaks (which do not spread much via asymptomatic contacts), we can't contain flu pandemics (which do). At least that's my take on contact tracing.

Actually, contact tracing on a pneumonic plague outbreak is probably easier than on, say a SARS outbreak, because you can treat the contacts with antibiotics, preventing them from getting ill (and generating a whole new round of contacts) as opposed to merely quarantining them and waiting for them to fall ill and then thrace their contacts.

If more pneumonic cases emerge, they would almost certainly be the result of reintroduction of the bacteria from the animal source. The chain of transmission on that cluster has likely expired.

Pneumonic plague is extemely rare; one of the first articles in this thread indicates that this was the first example of person-to-person spread of pneumonic plague in Peru. There was an outbreak of plague in 1994 in Peru with over 1,100 cases, but apparently no person-to-person spread. The United States reports 10-20 plague cases per year, but has not had person-to-person plague transmission since 1924.