ProMed Dengue/DHF Updates, december 27 2007

[Gert van der Hoek]

Archive Number 20070918.3103
Published Date 18-SEP-2007
Subject PRO/EDR> Dengue/DHF update 2007 (35)



DENGUE/DHF UPDATE 2007 (35)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Brazil (general)
[2] Brazil (Ceara)
[3] Honduras
[4] Costa Rica
[5] Martinique
[6] Puerto Rico
[7] Singapore
[8] Philippines (Cebu City)

******
[1] Brazil (general)
Date: Sun 9 Sep 2007
Source: Terra Espana, Agencia EFE report [in Spanish, trans. & summ.
Mod.TY, edited]
<http://actualidad.terra.es/sociedad/articulo/detectados_brasil_casos_dengue_principios_1825467.htm>


In the 1st 7 months of the year [2007] Brazil registered a total of 438 949
dengue cases, 45 per cent more than in the same period in 2006 (302 461
[dengue cases]), the Ministry of Health announced today [9 Sep 2007].

The number of deaths caused by this disease rose from 77 in the 1st 7
months of 2006 to 98 between January and July of this year [2007].

The numbers up to July indicate that Brazil could register in 2007 the
greatest numbers of [dengue] cases and deaths in the country's history.
This [projection] is due [to the fact that] last year [2006] 345 922
[dengue] cases with 67 deaths were registered; these numbers have already
been surpassed this year [2007] and are lower only than those of 2002, when
the country suffered a serious epidemiological crisis from this disease,
with 794 000 registered [dengue] cases and 150 deaths.

The secretary of Health Surveillance of the Ministry, Gerson Penna,
indicated that the [dengue] cases this year [2007] are focal, and that [the
disease's] expansion is limited to 3 states.

Almost one third of the cases registered between January and July [2007]
were concentrated in the states of Mato Grosso do Sul (along the border
with Bolivia and Paraguay, countries which also suffered a serious [dengue]
epidemic this year [2007]), Parana, and Rio de Janeiro.

72 183 cases have been registered in Mato Grosso do Sul, 46 857 in Rio de
Janeiro, and 43 691 in Parana. Penna indicated that, "in these 3 states the
rains came before what was anticipated [normal] and lasted longer than the
usual time. This multiplied the number of [breeding sites] of the vector
mosquito."

In addition, dengue cases in Brazil are concentrated between the months of
January and May, during the southern hemisphere summer, when rains are more
frequent.

--
communicated by:
ProMED-ESP
<promed@promedmail.org>

[A map of Brazil showing states can be accessed at
<http://www.lib.utexas.edu/maps/americas/brazil.jpg>. - Mod.TY]

******
[2] Brazil (Ceara)
Date: Fri 7 Sept 2007
Source: Diario do Nordeste [in Portuguese, trans. & summ. Mod.TY, edited]
<http://diariodonordeste.globo.com/materia.asp?codigo=467949>


The secretary of Health of the (Ceara) state (SESA) confirmed yesterday, [6
Sep 2007] through its epidemiological bulletin, that there have been an
additional 21 cases of DHF [dengue hemorrhagic fever] in less than a week.
Of these, 10 were in Sobral, which now totals 25 confirmed [cases]. The
municipality leads in the increased numbers of this type of the disease
[DHF], with 3 people who died during the course of the year [2007], and a
total of 7 deaths in the [entire] state.

Of the 550 notified cases, 252 were discarded and 77 continue under
epidemiological investigation. The municipalities having cases under
investigation are: Fortaleza (24), Sobral (23), Caucaia (9), Quixada (3),
Tejucuoca (3), Itapipoca (2), Maracanau (2), Russas (2), Amontada (1),
Caninde (1), Cascavel (1), Pacajus (1), Taua (1), Martinopoles (1),
Monsenhor Tabosa (1), Parambu (1), beyond Uruburetama (1).

Leading the list of he greatest number of confirmed DHF cases are:
Fortaleza (103), Crato (17), Sobral (25), Caucaia (15), and Brejo Santo (13).

According to the latest SESA bulletin, as of yesterday [6 Sep 2007], 36 131
suspected [dengue] cases were registered in 181 municipalities, which
include 1143 new notifications. Of these, 20 946 are laboratory confirmed
[dengue] cases in 163 municipalities in Ceara and 15 185 samples were negative.

In Fortaleza the leading number of [case] occurrences in Regions III, V,
and VI, are Messejana (525), Joao (457), Bom Jardim (415), and Bom Sucesso
(368).

--
communicated by:
ProMED-PORT
<promed@promedmail.org>

[Ceara has suffered dengue outbreaks and epidemics for more than a decade,
and it is inevitable that dengue hemorrhagic fever cases are increasing. -
Mod.JLS

A map of Ceara State can be accessed at
<http://www.v-brazil.com/tourism/ceara/map-ceara.html>. - Mod.TY]

******
[3] Honduras
Date: Wed 12 Sep 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/article.asp?ID=%7B390488CA-B6EB-4FD8-8925-858EBCA102D6%7D)&language=EN>


Haemorrhagic dengue cases have increased 20-fold in Honduras this year
[2007], compared with 2006, admitted the country's health authorities on
Wednesday [12 Sep 2007].

The Health Ministry reported 895 cases of this most deadly variant of
dengue [DHF] just between January and August [2007], with only 46 cases
last year [2006].

Honduras health minister, Jenny Meza, recognized that her country appears
among the Central American nations with the highest rate of hemorrhagic
dengue, which has thus far killed 10 people.

Data also reveals that 18 000 Hondurans [this year (2007) have] suffered
classic dengue, about 5 times more than in 2006.

Meza highlighted the government efforts to raise the people's consciousness
of the danger and of the measures to avoid its propagation.

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

[A map of Honduras can be accessed at
<http://www.lib.utexas.edu/maps/americas/honduras.jpg>. - Mod.TY]

******
[4] Costa Rica
Date: Sat 15 Sep 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/article.asp?ID=%7B8D2A244C-C923-4375-AF36-9E00DA0F90CA%7D&language=EN>


Costa Rican authorities confirmed on Saturday [15 Sep 2007] that
hemorrhagic dengue has become an epidemic in the country, killing 2
children and affecting 180 people.

The Health Ministry reported that the number [of dengue cases] is 150 per
cent greater than the one reported in 2006, when 72 people were infected
and 1533 per cent higher than in 2004, with 11 cases only.

The 2 children died because of the fatal dengue hemorrhagic variant
transmitted by the _Aedes aegypti_ mosquito, confirmed health minister
Maria Luisa Avila on Saturday [15 Sep 2007].

Nevertheless, the ministry [is] investigating 9 other suspicious deaths of
dengue, most of them young adults.

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

[A map of Costa Rica can be accessed at
<http://www.lib.utexas.edu/maps/americas/costa_pol87.jpg>. - Mod.TY]

******
[5] Martinique
Date: Sun 16 Sep 2007
Source: The Globe and Mail, Associated Press report [edited]
<http://www.theglobeandmail.com/servlet/story/RTGAM.20070916.wdengue0916/BNStory/International/home>


Health officials in Martinique have declared a dengue epidemic after more
than 1000 suspected cases were reported in the last month [August 2007].

Since August, about 1300 people have been treated for symptoms and 40 of
them have been hospitalized, some for hemorrhaging, according to a
statement released by Martinique's health department. No deaths have been
reported, according to local media.

Heavy rains contributed to an increase in cases, according to government
officials, who urged residents to properly discard of garbage including
tires, coconuts, and old refrigerators.

Fumigation efforts were ordered in the northern and southern parts of the
island, which have been the most affected. Roughly 430 000 people live in
Martinique, a French overseas department.

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

[A map of the Caribbean islands showing the location of Martinique can be
accessed at <http://worldatlas.com/webimage/countrys/carib.htm>. A map of
Martinique can be accessed at
<http://go.hrw.com/atlas/norm_htm/mrtnique.htm>. - Mod.TY]

******
[6] Puerto Rico
Date: Fri 31 Aug 2007
Source: Univision.com, Associated Press report [in Spanish, trans. & summ.
Mod.TY, edited]
<http://www.univision.com/contentroot/wirefeeds/salud/7230552.html>


Puerto Rico is experiencing a dengue epidemic, which has caused 913
confirmed cases since January [2007]. The government will have access to
emergency funds to intensify fumigation against the mosquito vector.

"We are in a dengue epidemic and it is important that everyone knows that,
not to be alarmed, but to be concerned," the epidemiologist of the
commonwealth, Enid Garcia Rivera said on Friday [14 Sep 2007].

The official announced that the Health Department reinforced its plans to
control the epidemic, which since January [2007], has caused 3651 suspected
cases of the disease, of which about 25 per cent, (913 cases), have been
laboratory confirmed positives [for dengue virus infection].

Due to the increasing numbers of suspected cases, the Health Department
will have access to USD 2.9 million from an emergency fund of USD 5
million. These funds will be used to intensify fumigation and other
preventive strategies to avoid the continued increase of the epidemic.

Garcia Rivera explained that the epidemic surveillance system always uses
the initial suspected case statistics because the [laboratory] tests to
confirm dengue virus [infection] takes 2 weeks, which would delay
activation of the [control] system too much. "Using suspected case
[numbers] can provide a good estimation of what is occurring in the
population," explained Garcia Rivera.

The Health Department noted an increase in the number of dengue cases
during the last 2 weeks of June [2007], and in July, declared that there
was an epidemic.

--
communicated by:
ProMED-ESP
<promed@promedmail.org>

[It would be of interest to know which dengue virus type is circulating in
the Caribbean islands currently. Perhaps the US CDC Laboratory in Puerto
Rico can provide that information.

A map of the Caribbean islands showing the location of Puerto Rico can be
accessed at <http://worldatlas.com/webimage/countrys/carib.htm>. A map of
Puerto Rico can be accessed at
<http://www.lib.utexas.edu/maps/americas/puertorico.jpg>. - Mod.TY]

******
[7] Singapore
Date: Mon 10 Sep 2007
Source: Channel NewsAsia [edited]
<http://www.channelnewsasia.com/stories/singaporelocalnews/view/298992/1/.html>


On Monday [10 Sep 2007], 11 new cases of dengue were reported, 4 more than
Sunday [9 Sep 2007]. Of these new cases, 3 are from Bukit Batok -- one each
at Bukit Batok Central, Bukit Batok Street 11, and Street 34. This brings
the total number of cases from Bukit Batok so far this year [2007] to 114.

According to the National Environment Agency (NEA), the area continues to
be the number one hotspot, with the highest number of infections reported
in Bukit Batok Streets 31, 32, and 34. An NEA spokesperson said the recent
intermittent heavy rain may not help ease the situation much as most
breeding grounds have been found to be indoors.

Hong Kah Town Council, which oversees the common areas in Bukit Batok, said
it is continuing with its stepped up efforts to ensure that the affected
places do not remain a hotspot. These include increasing the frequency of
inspections at potential breeding grounds around the estate, and deploying
staff from other estates to help out.

[byline: Hasnita A Majid]

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[An interactive map of Singapore can be accessed at
<http://www.hot-maps.de/asia/singapore/singapore/homeen.html>. - Mod.TY]

******
[8] Philippines (Cebu City)
Date: Thu 13 Sep 2007
Source: Cebu Daily News [edited]
<http://globalnation.inquirer.net/cebudailynews/news/view_article.php?article_id=88338>


The [Cebu] City Health Department will recommend that 2 southern barangays
[districts] in Cebu City be placed under a state of calamity after dengue
claimed the lives of 7 children in less than 2 months.

City health officer Fe Cabugao will endorse to the City Council to declare
Bulacao and Pardo in a state of calamity due to dengue outbreak in the 2
villages, said Dr Raymond Ogan, Cebu City coordinator on dengue control.
"This is the request of the barangay officials in Pardo and Bulacao so they
can avail [themselves] of the emergency funds and use these to clean the
areas and help the victims," said Ogan.

The health department recorded deaths of 3 children aged 5 years in sitio
Tabacunal, barangay Pardo -- one in August [2007], one on 5 Sep [2007], and
the 3rd the next day [6 Sep 2007], and 4 children also died of dengue in
sitios Villabulsita and Charlieville in Bulacao.

Ogan said health officials were also alarmed by the 13 to 15 new cases each
in Pardo and Bulacao, which health personnel were monitoring.

Pardo's dengue cases from January to 10 Sep this year [2007] reached 33 and
34 in Bulacao.

A total of 697 dengue cases with 18 deaths were reported in Cebu City over
the same period. The figure was 10 per cent higher than the 528 dengue
cases with 15 deaths reported from January to 10 Sep last year [2006].

[byline: Jhunnex Napallacan]

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[A map of the Philippines showing the location of Cebu and Cebu City can be
accessed at <http://www.pacificislandtours.com/philippine-maps.html> and an
interactive map with the specific locations of the barangays mentioned
above at <http://www.tageo.com/index-e-rp-v-21-d-m3333381.htm>.

The WHO (World Health Organization) description of dengue fever and the
more deadly dengue hemorrhagic fever [DHF] can be found in ProMED-mail's
"Dengue/DHF update 20070514.1541". ProMED-mail thanks the contributors to
this update and encourages others to contribute reports also. - Mod.TY]

http://www.promedmail.org/pls/prome..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,39364

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Update, october 01 2007

Re: ProMed Dengue/DHF Update, october 01 2007

Archive Number 20071001.3237
Published Date 01-OCT-2007
Subject PRO/EDR> Dengue/DHF update 2007 (37)


DENGUE/DHF UPDATE 2007 (37)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] China (Fujian)
[2] Viet Nam
[3] Pakistan (Karachi)
[4] Latin America

******
[1] China (Fujian)
Date: Sun 30 Sep 2007
Source: China Daily, Xinhua News Agency report [edited]
<http://www.chinadaily.com.cn/china/2007-09/30/content_6149071.htm>


On Sunday [30 Sep 2007], health authorities said 39 dengue fever
cases have been confirmed in Putian City of east China's Fujian
Province. Thus far, 26 of the 39 patients in Hanjiang District of
Putian City have been cured and the others are in stable condition,
said the provincial health department.

The city has adopted "comprehensive prevention and control measures"
to curb the spread of the disease, said the department. All medical
and health institutions in the province have also strengthened
monitoring on the disease, it added.

The department reminded citizens of household sanitation and the
prevention of proliferation of mosquitoes, which transmit the disease [virus].

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Putian City is situated in the central part of the coastal area of
Fujian Province. Putian neighbors Fuzhou in the northeast and
Quanzhou in the southeast, and is separated from Taiwan by the Taiwan Strait.

[A zoomable map of Fujian Province showing the location of Putian
city can be accessed at
<http://encarta.msn.com/map_701510630/Fujian.html>. - Mod.TY]

******
[2] Viet Nam
Date: Wed 26 Sep 2007
Source: VietNamNet Bridge [edited]
<http://english.vietnamnet.vn/social/2007/09/745035/>


The incidence of dengue fever in Viet Nam has risen by almost 50
percent this year [2007] against last year [2006], reports the Health Ministry.

A medical worker instructs Dao ethnic minorities in the northern
mountainous province of Yen Bai's Quang Minh Commune to dip mosquito
nets in chemicals to prevent dengue fever.

About 68 000 people had been stricken with the mosquito-borne
disease, Preventative Health Department director Nguyen Huy Nga said
on Monday [24 Sep 2007]; 60 had died.

Most infections had occurred in southern Dong Thap, An Giang, Tien
Giang, and Ben Tre provinces and the total increase was about 48
percent, he said.

Ho Chi Minh [HCM] City-based Pasteur Institute National Dengue Fever
Programme representative Luong Chan Quang said more than 58 000
people had been infected in the Cuu Long (Mekong) Delta provinces by
the end of August [2007]. Deaths were put at 54-40 percent more than
last year [2006].

Infections in Tien Giang Province totalled 9800 with 9 deaths, Dong
Thap 8700 with 9 deaths, and An Giang 6000 with 6 deaths.

In HCM City, almost 5400 people had been stricken with dengue fever
-- 40 percent more than last year [2006 -- and 6 had died.

Quang warned that another serious outbreak was likely in the southern
delta before the end of the year [2007] if effective preventive
measures were not taken because people regularly stored water to
prepare for the dry season.

The _Aedes_ mosquito, which carries dengue fever, breeds in still or
stagnant water.

HCM City Preventive Health Department deputy director Nguyen Dac Tho
said about 350 people were being admitted to hospital each week with
dengue fever -- 50 more than last year [2006].

Inner city districts 8, 10, 11, Binh Thanh, and Binh Tan were the
worst affected. People in densely populated precincts stored more
water for their own use than others as did construction projects, said Dr Tho.

Dengue fever is most common among children under 10 but the number of
afflicted adults has increased this year [2007].

HCM City Tropical Diseases Hospital figures show that of about 150
people admitted to the hospital with dengue fever each week, more
than 100 were adults.

There are 4 types of the dengue fever virus that often result in
similar symptoms. This year [2007], the transmitted virus was usually
type 1 or type 2.

Haemorrhagic fever is a severe, often fatal, complication of dengue fever.

The HCM City People's Committee has mobilised measures to prevent
dengue fever across the city. Citizens are encouraged to clean around
their residences every Sunday and spray mosquito killer [insecticides].

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

[A map of Viet Nam can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg>.
- Mod.TY]

******
[3] Pakistan (Karachi)
Date: Thu 27 Sep 2007
Source: Daily Times [edited]
<http://www.dailytimes.com.pk/default.asp?page=2007%5C09%5C27%5Cstory_27-9-2007_pg12_4>


The Sindh Health Department's Dengue Fever Surveillance Cell reported
22 fresh cases of the disease in select hospitals across Karachi on
Wednesday [26 Sep 2007].

Additional health secretary and in-charge of the surveillance cell,
Dr Shakil Malik, giving details of these cases, told APP [Associated
Press of Pakistan] that 20 of the patients are positive and they are
waiting for the report on the other 2.

The hospitals that dispatched reports include Liaquat National
Hospital, Ziauddin Hospital, Bismillah Taqee Hospital, and Zainab
Panjwani Hospital. "Since we just reactivated the cell on Tuesday [25
Sep 2007], it will take time before we make contact with all the
hospitals scattered across the city," he said. To a question, he said
that around 170 suspected cases of dengue fever have been reported
from across the city this year -- from January [2007] to date. He
also referred to the report the provincial health department received
from a local laboratory (Mid Citi Lab) that tested 24 OPD [out
patient department] patients between August [2007] and now. Of these
individuals, 12 came out positive.

--
Communicated by:
ProMED Rapporteur Brent Barrett

[Karachi is located on the Arabian Sea. A map of Pakistan can be
accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/pakistan_pol_2002.jpg>.
- Mod.TY]

******
[4] Latin America
Date: Sat 29 Sep 2007
Source: Associated Press [edited]
<http://ap.google.com/article/ALeqM5i86GcnUASvmXnPi9bBXcqngijdSQD8RVA16O4>


Dengue fever is spreading across Latin America and the Caribbean in
one of the worst outbreaks in decades, causing agonizing joint pain
for hundreds of thousands of people and killing nearly 200 so far
this year [2007].

The mosquitoes that carry dengue are thriving in expanded urban slums
scattered with water-collecting trash and old tires. Experts say
dengue is approaching record levels this year [2007] as many
countries enter their wettest months.

"If we do not slow it down, it will intensify and take a greater
social and economic toll on these countries," said Dr. Jose Luis San
Martin, head of anti-dengue efforts for the Pan American Health
Organization (PAHO), a regional public health agency.

The US Centers for Disease Control and Prevention (CDC) in Atlanta
has posted advisories this year [2007] for people visiting Latin
American and Caribbean destinations to use mosquito repellant and
stay inside screened areas whenever possible.

"The danger is that the doctors at home don't recognize the dengue,"
said Dr. Wellington Sun, the chief of the CDC's dengue branch in San
Juan, [Puerto Rico] "The doctors need to raise their level of
suspicion for any traveler who returns with a fever."

Dengue has already damaged the economies of countries across the
region by driving away tourists, according to a document prepared for
a PAHO conference beginning Monday [1 Oct 2007] in Washington.

Some countries have focused mosquito eradication efforts on areas
popular with tourists. Mexico sent hundreds of workers to the resorts
of Puerto Vallarta, Cancun, and Acapulco this year [2007] to try to
avert outbreaks.

Health ministers from across the region meet at the PAHO conference
and San Martin said he will urge them to devote more resources to dengue fever.

The tropical virus was once thought to have been nearly eliminated
from Latin America, but it has steadily gained strength since the
early 1980s. Now, officials fear it could emerge as a pandemic
similar to one that became a leading killer of children in Southeast
Asia following World War II.

Officials say the virus is likely to grow deadlier in part because
tourism and migration are circulating 4 different strains across the
region. A person exposed to one strain may develop immunity to that
strain -- but subsequent exposure to another strain makes it more
likely the person will develop the hemorrhagic form.

"The main concern is what's happening in the Americas will
recapitulate what has happened in Southeast Asia, and we will start
seeing more and more severe types of cases of dengue as time
progresses," Sun said.

So far this year [2007], 630 356 dengue cases have been reported in
the Americas -- most in Brazil, Venezuela, or Colombia -- with 12 147
cases of hemorrhagic fever and 183 deaths, according to the Pan
American Health Organization. With the spread expected to accelerate
during the upcoming rainy season in many countries, cases this year
[2007] could exceed the 1 015 000 reported in 2002, according to San Martin.

In Puerto Rico, where 5592 suspected cases and 3 deaths have been
reported, some lawmakers called this week for the health secretary to resign.

In the Dominican Republic, which has reported 25 deaths this year
[2007], the health department announced Thursday [27 Sep 2007] that
it would train 2.5 million public school students to encourage
parents and neighbors to eliminate standing water.

Researchers have not yet developed a vaccine against dengue and Sun
said that for now, the only way to stop the virus is to contain the
mosquito population -- a task that relies of countless, relentless
individual efforts including installing screen doors and making sure
mosquitoes are not breeding in garbage.

"It's like telling people to stop smoking," he said. "They may do it
for a while, but they don't do it on a consistent basis and without
doing that, it's not effective."

While dengue is increasing around the developing world, the problem
is most dramatic in the Americas, according to the CDC.

Health officials believe the resurgence of the malaria-like illness
is due partly to a premature easing of eradication programs in the 1970s.

Migration and tourism also have carried new strains of the virus
across national borders, even into the United States, which had
largely wiped out the disease after a 1922 outbreak that infected a
half-million people.

Mexico has been struggling with an alarming increase in the deadly
hemorrhagic form of dengue, which now accounts for roughly one in 4
cases. The government has confirmed 3249 cases of hemorrhagic dengue
for the year through 15 Sep [2007], up from 1924 last year [2006].

The CDC says there is no drug to treat hemorrhagic dengue, but proper
treatment, including rest, fluids, and pain relief, can reduce death
rates to about one percent.

San Martin said he use the meetings starting Monday [1 Oct 2007] to
urge enforcement of trash disposal regulations, more investment in
mosquito control and new incentives for communities to participate.
"It is a battle of every government, every community and every
individual," he said.

[Byline: Michael Melia]

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

The WHO (World Health Organisation) description of dengue fever and
the more deadly dengue hemorrhagic fever [DHF] can be found in
ProMED-mail's "Dengue/DHF update 20070514.1541". ProMED-mail thanks
the contributors to this update and encourages others to contribute
reports also. - Mod.TY]

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,39526

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Update, october 08 2007

Re: ProMed Dengue/DHF Update, october 08 2007

Archive Number 20071008.3312
Published Date 08-OCT-2007
Subject PRO/EDR> Dengue/DHF update 2007 (38)



DENGUE/DHF UPDATE 2007 (38)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Pakistan (Karachi)
[2] Philippines
[3] Micronesia (Yap)
[4] Honduras
[5] Dominican Republic (Bani)
[6] Mexico (Torreon)
[7] Caribbean, Latin America

******
[1] Pakistan (Karachi)
Date: Mon 8 Oct 2007
Source: The Post [edited]
<http://thepost.com.pk/NatNewsT.aspx?dtlid=122222&catid=2>


The number of dengue fever patients is steadily increasing in the city,
with the total number of patients registered at 601, including 590
admissions and 11 outpatients, on Saturday [6 Oct 2007] since August this
year [2007].

Dr Shakil Malik, additional health secretary and oordinator, Dengue Fever
Monitoring Cell of Sindh Health Department, told Associated Press of
Pakistan on Saturday [6 Oct 2007] that 98 dengue fever patients are
currently hospitalized in different health care facilities of Karachi.

The data made available to media was said to be based on daily reports from
10 - 13 different hospitals of Karachi. "As per available data, 272 of the
601 dengue cases were positive, 206 negative and 126 cases are yet to be
confirmed," the monitoring cell coordinator said. He appealed to all
hospital administrators as well as general physicians to support the Cell
in data compilation.

"This will ultimately help the public, as we would be able to chalk-out an
effective preventive strategy in accordance to serotypes of the ailment
identified among each of the patients," he said.

Dr Shakil in this regard also appealed to all the medical facilities to
apprise the cell of the exact nature of dengue cases being brought to them
and also the associated deaths. He acknowledged confusion with regard to
deaths reported by the media and mentioned that there had been an instance
when a man, fully recovered from dengue fever, died of a heart attack but
was claimed to be a victim of dengue.

It is through media we come to know of cases and dengue induced deaths, but
these are never officially reported to us, thus creating distress among the
masses. "The disease is there, but the fact also remains that it is
preventable, and each of us in our individual capacities has to protect
ourselves against it," the additional health secretary said.

To a query regarding instances of malaria, he said cases of both
falciparium malaria and vivax malaria were reported during the recent past,
and that the health department has a strategy in place and measures
strictly adopted to contain and prevent these cases. He said that while
malaria-causing mosquitoes flourish in stagnant filthy water, the _Aedes
aegypti_ mosquitoes breed in clean water stored in uncovered tanks,
buckets, utensils, flower vases etc.

"We can definitely get rid of the ailments through concerted efforts on
part of government, civic agencies and citizens in their individual
capacities," he commented. He advised people to ensure spraying
insecticides or even discarded motor oil on pools and puddles of water so
that a screen is created preventing breeding of mosquitoes.

Application of mosquito repellent oil, coils, use of mosquito nets, hygiene
and cleanliness, ensuring that all parts of the body are duly covered to
avoid mosquito bites and timely referral to doctors in case of persistent
fever and cold were also strongly advised by the health department official.

--

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

[This report is somewhat confusing. This article indicates that there were
601 registered dengue cases reported, although 206 of these were listed as
negative. So it is not clear if these 206 were dengue cases or not.
Although it is useful to know which dengue virus serotypes are circulating
in the population, it is not necessary to have this information in hand
before mounting a vector mosquito control effort. Elimination of water
catchments to prevent aedes mosquito breeding is the same irrespective of
the dengue viruses being transmitted. Insecticide fumigation of adult
mosquitoes may also provide temporary reduction of virus transmission, but
unless breeding sites are eliminated, the epidemic is likely to continue as
new adults are recruited into the vector population. Where aedes mosquitoes
are breeding in drinking water storage containers, motor oil application
should not be used.

Karachi is located on the Arabian Sea. A map of Pakistan can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/pakistan_pol_2002.jpg>.
- Mod.TY]

******
[2] Philippines
Date: Thu 4 Oct 2007
Source: Sun Star [edited]
<http://www.sunstar.com.ph/static/ceb/2007/10/04/news/after.4.000.dengue.cases.in.just.one.week.with.cebu.city.listing.1.000th.victim.this.year.html>


The government has issued a nationwide dengue fever alert after recording
more than 4000 cases in the 2nd week of September [2007], the health
department said yesterday [3 Oct 2007]. It had recorded 24 689 cases of the
mosquitoborne disease in all since January [2007], with 283 deaths.

The head of the National Epidemiology Center, Eric Tayag, said in the
statement that he expected a sharp increase in the number of cases in
September and October 2007: "It's during this period that we expect the
disease to proliferate due to the wet weather," he said.

In Cebu City, regional and city health officials warned the Cebu City
Council that the worst is yet to come after the city recorded its 1000th
dengue case.

As of 30 Sep [2007], 73 of Cebu City's 80 barangays have already been
affected by the dengue virus, infecting a total of 1000 individuals, mostly
children aged 6-10 years old. There have been 25 deaths recorded in Cebu
City from 1 Jan to 30 Sep [2007].

Central Visayas also saw an increase of 214 dengue cases in just one week.
The number of cases is 48 per cent higher than the same period last year
[2006].

Cebu City has the largest number of dengue cases in the region. The city
has been declared a hotspot, particularly in Barangays Pardo and Bulacao.

The total number of dengue cases from 1 Jan to 29 Sep this year [2007]
reached 3420 cases, according to the Regional Epidemiology and Surveillance
Unit (Resu) 7 of the Department of Health (DOH).

The previous Resu report was for 22 Sep [2007], with 3216 cases.

In the same period last year [2006], there were only 2316 cases, or 48.1
per cent fewer. There were also 86 deaths in the region this year compared
with last year's 51.

Cebu City officials will meet later this week to come up with plans on the
most efficient way to fight dengue, especially after families reportedly
spent at least P30 million [USD 673 733] to treat the 1000 patients.

During the council session yesterday [3 Oct 2007], Vice Mayor Michael Rama
said he was surprised to learn about the number of dengue cases in the
city, which make up 34.2 per cent of the 3216 cases recorded in Central
Visayas as of 22 Sep [2007]. Rama is worried that the increasing number of
dengue cases could turn off tourists from coming to the region, considered
the country's tourism hub.

Dr Jonathan Neil Erasmo, DOH 7 dengue program coordinator, and City Health
Department Chief Fe Cabugao urged the councilors to pass measures that will
help in the dengue prevention campaign, such as intensifying the waste
segregation and other sanitation programs as a way of eliminating the
breeding sites of mosquitoes.

Cabugao also said that contrary to what the councilors are hoping, Cebu
City cannot be dengue virus-free since it is already endemic to the city,
which means dengue cases will arise throughout the year.

The health officials also urged the public to implement the 4-S in the
campaign against dengue: search and destroy breeding sites of mosquitoes,
seek immediate consultation, self protection and saying "no" to
indiscriminate fogging unless there is a dengue outbreak in the area.

--

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

[A map of the Philippines can be accessed at
<http://www.lib.utexas.edu/maps/islands_oceans_poles/philippines.gif>. -
Mod.TY]

******
[3] Micronesia (Yap)
Date: Sat 6 Oct 2007
Source: Pacific Daily News [edited]
<http://www.guampdn.com/apps/pbcs.dll/article?AID=/20071006/NEWS01/710060311/1002>


An outbreak of a deadly mosquitoborne virus in Yap has prompted local
health officials to be on the lookout for the possible transmission of the
disease to the island.

At least 6 cases of the dengue fever virus in Yap have been confirmed --
including one fatal case -- since the samples were tested late last month
[September 2007], according to a release from the Guam Department of Public
Health and Social Services.

With the rainy season in full swing and the routine transit of people to
and from Yap, Public Health is pushing forward with its campaign to prevent
the disease from occurring on the island, said Rosanna Rabago, an
environmental health specialist supervisor with the Bureau of Animal and
Vector Control. The island has had just one case of dengue fever reported
so far this year [2007]. The individual contracted the disease while in the
Philippines, Rabago said. The preventive measures also are in response to
the warning from the World Health Organization that an outbreak of dengue
in the Western Pacific would be likely in the upcoming years.

The outbreak also comes at a time when Yap continues to battle the Zika
virus, which is similar to dengue but with milder symptoms. Public Health
also has kept watch for that mosquitoborne disease on Guam, Rebago said.

"Guam, by far, has been very lucky," Rabago said. "We're fortunate that we
have not had to worry about any of these diseases establishing on the
island, and we hope that remains the case. We need to be vigilant and
continue to increase public awareness and education in regards to
mosquitoborne disease education."

Mosquitoes breed in areas with standing water, a major concern for Public
Health since it has continued to rain on the island over the last few
months, she said. "People need to be aware that even the smallest container
that holds water can have the potential to be a mosquito breeding site,"
Rebago said. "It's just more prevalent during the rainy season."

[byline: Lacee AC Martinez]

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

[A map of Micronesia can be accessed at
<http://www.lib.utexas.edu/maps/islands_oceans_poles/micronesia_pol99.jpg>.
- Mod.TY]

******
[4] Honduras
Date: Tue 2 Oct 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/Article.asp?ID=%7BAE152665-B759-4D57-A61F-17F00EA67702%7D&language=EN>


Honduran sanitary authorities called the government to supply funds to
fight the dengue epidemic. Official reports number the cases at 22 123,
including 1060 with the hemorrhagic strain, and 12 have died. The current
figures surpass the 2006 reports, with 5200 cases of classic dengue, 63
with hemorrhagic and 5 fatalities.

Interim health minister Jenny Meza requested some USD 423 000 to assist the
capital and 3 departments [equivalent to states or provinces. - Mod.TY]
that already issued an alert since the rainy season is not over.

--

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

[A map of Honduras can be accessed at:
<http://www.lib.utexas.edu/maps/americas/honduras.jpg>
- Mod.TY]

******
[5] Dominican Republic
Date: Thu 4 Oct 2007
Source: La Republica [in Spanish, trans. & summ. Mod.TY, edited]
<http://www.listindiario.com.do/app/article.aspx?id=31437>


Dozens of children and adolescents ill from dengue are interned in public
and private medical centers in this city, which, in the past 3 weeks, has
caused great absenteeism from schools.

Just in the Nuestra Senora de Regla hospital, 10 infants were admitted with
classic dengue fever, 3 were released and one was referred to the Robert
Reid Cabra Children's Hopital in Santo Domingo.

The disease is mainly attacking the childhood population 2-14 years of age.

Although the illness preferentially attacks the population in poor
neighborhoods, this time the outbreak extends to sectors [of the city] of
the middle class, such as Las Marias and Riviera del Sur.

The children hospitalized in the pediatric isolation unit of the hospital
are between 2 and 13 years of age and come from the Villa Majega, Santa
Cruz, Pueblo Nuevo y Santa Elena neighborhoods, while others come from
rural areas such as Galion, Matanzas, Sombrero and others.

The epidemiologist of the Provincial Health Directorate, Dr Agustina
Martinez, said that the number of cases has increased considerably, "it
seems that new [dengue] cases are appearing in children who are infected
[with dengue virus] for the 1st time." She said that the situation is most
serious in those areas where potable water is not available so that the
neighbors necessarily have to store water, and these storage sites become
permanent [mosquito] breeding areas.

Both Drs Tolentino and Fremio Casado, the pediatrician in charge of the
pediatric unit of the Nuestra Senora de Regla hospital, agreed in signaling
that dengue is everyone's problem, affirming that, "the population has to
cooperate in the elimination of the [mosquito] breeding sites in their
[household] patios and other places [since ] the [government] authorities
do not have the capability to go to all homes and sites of mosquito
breeding at the same time."

[byline: Jose Dicen]

--
communicated by:
ProMED-PORT <promed@promedmail.org>

[The situation in the poor neighborhoods without piped water illustrates
the need to store water in and around homes which, in turn, provides
breeding sites for aedes mosquito vectors. Public education and cooperation
are essential to reduce vector populations and halt dengue virus transmission.

A zoomable map of the Dominican Republic showing the location of Bani can
be accessed at <http://www.maplandia.com/dominican-republic/peravia/bani/>.
- Mod.TY]

******
[6] Mexico
Date: Mon 26 Sep 2007
Source: La Lagun4.com [in Spanish, trans. & summ. Mod.TY, edited]
<http://lalagun4.com/?c=117&a=11681>


Humberto Flores Munoz, epidemiologist in Sanitary Jurisdiction 06,
announced that the disease [dengue] has been detected in the Jose R
Mijares, Polvorera, Camilo Torres and other bordering neighborhoods [which]
are being fumigated in order to protect the inhabitants [from dengue virus
transmission].

There are about 40 [dengue] cases. Fortunately, the disease has not spread
to other populated areas of the city.

To avoid dengue spread, it is recommended that citizens observe all the
recommendations of the health authorities. Firstly, that they do not have
receptacles where water accumulates, which is where the mosquito vector breeds.

--

communicated by:
ProMED-PORT <promed@promedmail.org>

[A zoomable map of Mexico showing the location of Torreon can be accessed
at <http://www.maplandia.com/mexico/coahuila/torreon/>. - Mod.TY]

******
[7 ] Caribbean, Latin America
Date: Fri 5 Oct 2007
Source: Reuters [edited]
<http://www.alertnet.org/thenews/newsdesk/NA5209573.htm>


Dengue, a mosquitoborne virus that causes high fever, nausea, and painful
body aches, is reaching epidemic levels in the Caribbean and Latin America,
health officials say. Changing weather patterns as well as increased
tourism and migration have raised its prevalence, according to a Pan
American Health Organization (PAHO) report released this week.

The disease is raging now during the wettest time of year for most
countries in the region. The virus, which has 4 distinct strains [there are
4 distinct dengue viruses. - Mod.TY], usually keeps victims bed-ridden for
a week with painful flu-like symptoms. About 5 per cent of cases develop
into the more severe and sometimes fatal hemorrhagic form marked by
internal and external bleeding.

Victims can also die from dehydration if they do not receive prompt
treatment, which normally includes bed rest and hydration. Severe cases can
require hospitalization.

PAHO expects dengue cases in the hemisphere to top one million this year
[2007]. It has logged 630 356 cases so far this year [2007], 11 per cent
more than for all of 2006. Of those, 12 147 were of the severe hemorrhagic
type, and 183 people died.

The US Centers for Disease Control and Prevention recently issued a dengue
outbreak notice that included Puerto Rico, Guadeloupe, Martinique, Mexico,
Nicaragua, and Brazil.

Puerto Rico's health department on Friday [5 Oct 2007] said it was seeing
more than 500 new cases weekly and had recorded 6175 so far this year, with
4 confirmed deaths. With no vaccine available, public health experts rely
on fumigation and other campaigns to control mosquitoes. On Friday [5 Oct
2007], Health Department employees handed out educational material on
street corners, urging people to eliminate potential breeding grounds for
mosquitoes and seek medical attention at the 1st sign of the disease. "We
need the commitment and participation of all sectors of society to be able
to prevent and control dengue," Puerto Rico state epidemiologist Enid
Garcia Rivera said. "Given the amount of rain these days, the dengue
mosquito can reproduce at astonishing speed."

The Dominican Republic has reported more than 6000 cases and 30 deaths this
year [2007], according to local press reports.

Mexico has reported 67 562 cases, with 5212 developing into the hemorrhagic
form, according to PAHO.

Guadeloupe registered 899 cases. Health officials in Martinique declared a
dengue epidemic last month [September 2007] with more than 1300 cases
reported, and Jamaica has had about 100 cases.

A report delivered at the PAHO conference this week in Washington
identified unprecedented population growth in crowded urban areas, where a
lack of basic services can help mosquitoes breed, as one factor behind the
surge. Travel and tourism help also spread the disease, according to the
report, "Dengue Prevention and Control in the Americas." It also cited
"radical, destabilizing" climate changes as a result of global warming, as
well as cyclical weather patterns that have increased the intensity and
duration of the region's rainy seasons.

Dr Raul Castellano, the PAHO coordinator in Puerto Rico, said nearly every
country in the region was trying to control the disease but greater efforts
were needed. "It's very difficult because it takes changing people's
behavior. Fumigation in the streets won't work because we have to go inside
people's houses," he said. "We have to break the chain of the mosquito
[reproduction and virus transmission. - Mod.TY]."

[byline: John Marino]

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[ProMED-mail would appreciate receiving any information about which of the
4 dengue viruses are circulating in the countries mentioned above.

The WHO (World Health Organisation) description of dengue fever and the
more deadly dengue hemorrhagic fever [DHF] can be found in ProMED-mail's
"Dengue/DHF update 20070514.1541". ProMED-mail thanks the contributors to
this update and encourages others to contribute reports also. - Mod.TY]

http://www.promedmail.org/pls/prome..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,39619

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Update, october 24 2007

Re: ProMed Dengue/DHF Update, october 24 2007

Archive Number 20071024.3457
Published Date 24-OCT-2007
Subject PRO/EDR> Dengue/DHF update 2007 (41)

DENGUE/DHF UPDATE 2007 (41)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] Cayman Islands

[2] Jamaica

[3] Barbados

[4] Mexico

[5] Honduras

[6] Brazil (Sao Paulo)

[7] Brazil (Rio de Janeiro)

[8] Brazil (national)

******
[1] Cayman Islands
Date: Mon 22 Oct 2007
Source: Cayman Netnews [edited]
<http://caymannetnews.com/news-2828--1-1--.html>


A total of 2 cases of dengue fever have been reported on Grand
Cayman, leading to fears of an outbreak in the Cayman Islands.

Commenting on the situation, Leader of Opposition Hon. McKeeva Bush
said, "I am concerned and dismayed that there are 2 confirmed cases
of dengue fever present on Grand Cayman and that there has been no
announcement from the Government to alert the public of the situation."

According to Mr. Bush, Government made a statement several weeks ago
asking people to be careful when they visit countries that have the
presence of dengue fever. At the same time, the Government suggested
that there were no active cases in the Cayman Islands, Mr. Bush alleged.

"This is most ingenuous of the Government since there are 2 confirmed
cases, one in George Town and one in West Bay," he said.

The Mosquito Research Control Unit (MRCU) is responsible for aerial
spraying of chemicals that kill adult and larval mosquitoes. However,
it is understood that one of its pilots has resigned, reducing the
emphasis that can be put on aerial prevention of the disease.

"They say that it is imported and isolated, as these 2 individuals
had travelled to 2 different countries before coming here," he said.

The Cayman Islands receives large numbers of immigrants and tourists,
many of whom tour the region before arriving here.

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

[It is not clear if these 2 cases are imported, which seems likely,
and not dengue virus infections acquired locally. If imported, they
are indeed isolated, and may not be a source of further virus
transmission. The article makes no mention about the status of _Aedes
ageypti_ mosquitoes on the islands.

A zoomable health map showing the location of the Cayman Islands can
be accessed at:
<http://healthmap.org/promed?v=19.3,-81.2,6>. - Mod.TY]

******
[2] Jamaica
Date: Sat 20 Oct 2007
Source: Jamaica Gleaner [edited]
<http://www.jamaica-gleaner.com/gleaner/20071020/lead/lead6.html>


The Ministry of Health and Environment yesterday reported that there
were 282 confirmed cases of dengue fever and 1770 suspected cases,
noting that this was a significant increase over the past week [week
of 14 Oct 2007].

The ministry also noted that there were 11 suspected cases of the
deadly dengue haemorrhagic fever.

Meanwhile, Dr. Sheila Campbell-Forrester, chief medical officer of
health said she was concerned that householders are not taking
prevention methods seriously.

"The most effective way to stop dengue is through the action of
householders ridding their surroundings of mosquito breeding sites,"
said Dr. Campbell-Forrester.

She noted that unless people clean up around the home and yard, there
will be a difficulty in reducing the cases of dengue fever.

Dr. Campbell-Forrester said persistent rains have also interrupted
control measures and produced more breeding sites for mosquitoes.

[Byline: Petrina Francis]

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

[A zoomable health map of Jamaica can be accessed at:
<http://healthmap.org/promed?v=18.2,-77.3,6>. - Mod.TY]

******
[3] Barbados
Date: Thu 18 Oct 2007
Source: Nation News.com [edited]
<http://www.nationnews.com/story/303483509607883.php>


There were 255 cases of dengue fever recorded in Barbados up to the
end of September [2007] but no related deaths, says Chief Medical
Officer Dr. Joy St. John.

And she is urging continued vigilance, as there are 592 suspected
cases of the viral illness. However, she also said there were no
reported cases of the potentially deadly dengue haemorrhagic fever.

Speaking to the media yesterday morning [17 Oct 2007] after the
official opening ceremony of the National Blood Bank at Jemmotts
Lane, St. Michael, St. John urged householders and businesses to
ensure their surroundings were free from "mosquito breeding sources."

The health professional explained that the Ministry of Health and
private sector partners were doing their utmost to decrease the
mosquito population.

St. John said the updates on clinical management had been circulated
to doctors and the medics were cooperating with the Ministry of
Health by following the guidelines and informing of suspected cases.

She also said that while people did not like the fogging, it was
"very effective" in stopping "the transmission of the dengue virus
from an infected person to someone who does not have it."

[Byline: Donna Sealy]

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

[Fogging provides short-term reduction of transmission by killing
adult mosquitoes. Long-term vector reduction requires elimination of
larval breeding sites, so that new adult mosquitoes are not produced.

A zoomable health map showing the location of Barbados can be accessed at:
<http://healthmap.org/promed?v=13.2,-59.6,5>. - Mod.TY]

******
[4] Mexico
Date: Sun 21 Oct 2007
Source: China View [edited]
<http://news.xinhuanet.com/english/2007-10/21/content_6917220.htm>


Dengue fever has left 6 people dead in Mexico so far this year, with
some 22 943 Mexicans infected with the disease, local media reported
on Saturday [20 Oct 2007].

Among the patients, some 5000 were infected with the fatal
hemorrhagic variant, Secretary of Health Jose Angel Cordoba
Villalobos was quoted as saying. With a booming tourism, the epidemic
has spread to more places in Mexico, he said.

In 2000, only one case of hemorrhagic variant was found in every 50
dengue cases, but this year [2007] the ratio has jumped to nearly one
in 5, he noted. In Mexico the existing 4 dengue virus [infections]
may develop into the hemorrhagic variant, but luckily the mortality
caused by the virus is still low, he added.

Dengue fever, a viral infection spread by the _Aedes aegypti_
mosquito, is a serious health problem in many Central American and
Caribbean countries. Its symptoms include high fever, nausea, rash,
backache and headache. Most mainstream dengue cases are not fatal,
but the hemorrhagic variant, which causes severe internal bleeding as
blood vessels collapse, kills one in 20 of the infected.

The World Health Organization said the only way to fight dengue is to
stamp out [vector] mosquitoes.

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

[The high proportion of DHF cases suggests that there may be
significant under-reporting of non-DHF dengue virus infections. - Mod.TY]

******
[5 ] Honduras
Date: Wed 10 Oct 2007
Source: Terra [in Spanish, trans. Mod.TY, edited]
<http://actualidad.terra.es/sociedad/articulo/aumentan_honduras_trece_muertos_dengue_1926115.htm>


The number of deaths in Honduras caused by DHF so far in 2007
increased to 13, the Secretary of Public Health announced
today [10 Oct 2007].

The official report did not provide specific details about the 13th
fatal DHF victim. At least 1230 cases of the DHF type [of dengue
infection] have been registered up to now. Health authorities have
registered 24 207 cases of classic dengue [fever].

The report added that the region of the Central District, which
includes Tegucigalpa, the Honduran capital, has had the greatest
incidence of fatal [dengue], followed by the departments [state or
province equivalents. - Mod.TY] of Cortez, in the north along the
Guatemalan border, El Paraiso y Olancho, both in the eastern part of
the country, along the Nicaraguan border.

In 2006, the number of DHF deaths was 6.

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

[A zoomable health map of Honduras can be accessed at:
<http://healthmap.org/promed?v=14.8,-86.6,5>. - Mod.TY]

******
[6] Brazil (Sao Paulo)
Date: Fri 19 Oct 2007
Source: Folha de Sao Paulo (in Portuguese trans. & summ. Mod.TY, edited]
<http://www1.folha.uol.com.br/folha/cotidiano/ult95u337893.shtml>


Dengue epidemic hits 127 Sao Paulo [state] cities
---------------------------------------------
One in every 5 municipalities in Sao Paulo [state] is facing a dengue
epidemic a little more than 2 months after the beginning of summer, a
season when this disease usually become worse. There have been 16
deaths this year [2007] in the state. Of the 645 Sao Paulo cities,
127 have registered in this year [2007] at least 300 cases per 100
000 inhabitants, a level used by the Ministry of Health as the
criterion for characterization as an epidemic. The calculations were
based on the dengue disease registers of the Sao Paulo Center for
Epidemiologic Surveillance and population data of IBGE.

In the entire state, the situation has not been characterized as
epidemic. With 65 860 cases among 41 million inhabitants, the index
is 161 cases per 100 000 inhabitants.

During the start of the national campaign against dengue on Wednesday
[16 Oct 2007], the Minister of Health Jose Gomes Temporao affirmed
that the country "is living [through] a dengue epidemic," despite the
fact that the index [of cases per 100 000] is less than the criterion
[number] for it. In Brazil, there have been 481 316 people infected
[with dengue virus] in a population of 190 million inhabitants, or
253 [dengue] victims per 100 000 inhabitants.

He recalled that the number of cases of the disease increased 49.77
percent from January to September [2007], in relation to the same
period in 2006. In Sao Paulo the current number now is 24 percent
above that of all last year [2006] and 12 times more than in 2005,
when there were 5400 [dengue] cases.

Small cities are in a worse situation in Sao Paulo state. Sales is
the leader [in numbers of dengue cases] where 1 in 20 people had
dengue this year [2007].

The city of Sao Paulo, with 2339 [dengue] cases, is still considered
under control, but other medium-sized cities such as Sao Jose do Rio
Preto, Campinas, Ribeirao Preto and Bauru are facing epidemics.

During the cold season, when the mosquito vector has difficulty in
reproducing and the numbers of [dengue] cases normally diminish, the
numbers of cases registered by CVE did not stop. There were 400 in
July, 79 in August and 25 in September [2007].

None the less, Affonso Viviani Junior, director of SUCEN
(Superintendency of Endemic Control) of the Secretariat of Health of
the state, stated that the number of 127 cities with a [dengue]
epidemic index does not reflect the reality of the disease at this
moment. "This number appears [high] because the case index is
cumulative. Cases from the first epidemiological week are in this
[case] total. The behavior of the virus in recent weeks is outside of
any epidemic situation," he said.

According to Viviani, the circulation of the virus continues in a
maximum of 20 municipalities. "Up until mid-year [2007] we had
registered almost 65 000 cases. The other weeks since then until now
do not exceed 1000."

The Governor [of Sao Paulo state], Jose Serra, and the Secretary of
Health, Luiz Roberto Barradas Barata, yesterday [18 Oct 2007] said
that the state was having a [dengue] epidemic. Barradas repeated that
the percent increase of dengue in the state in relation to last year
[2006] is less than the peak of the national index.

Despite that the situation is not considered alarming, the costs to
the state for dengue in 2007 is R 40 million [22 309 000 USD. -
Mod.TY], double that of last year [2006]. The state also contracted
120 field agents for mosquito control.

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

[A zoomable health map of Brazil showing Sao Paulo and other states
can be accessed at:
<http://healthmap.org/promed?v=-10.8,-53.1,4>. - Mod.TY

******
[7] Brazil (Rio de Janeiro)
Date: Fri 19 Oct 2007
Source: People's Daily Online [edited]
<http://english.people.com.cn/90001/90782/90880/6286805.html>


Some 55,467 cases of dengue have been registered in Brazil's Rio de
Janeiro state since January [2007], more than in the 4 years prior
put together, according to statistics reported on Thursday [18 Oct
2007] by Brazil's Health Ministry.

The most affected municipality is Rio de Janeiro with 20 378 cases.
"We clearly face an epidemic in the state. There has been a 50
percent growth in the number of cases in 2006, just like the rest of
the country," epidemiologist Edmilson Migowsky said.

The situation could get worse, Migowsky said, because only 1/3 of the
people affected presented defined symptoms and normally only 10
percent of the cases are officially reported.

So far, 18 people have already died [of dengue virus infection] in
Rio de Janeiro state.

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

******
[8] Brazil (national)
Date: Wed 17 Oct 2007
Source: O Estado de Sao Paulo [in Portuguese, trans. & summ. Mod. TY, edited]
<http://txt.estado.com.br:80/editorias/2007/10/17/ger-1.93.7.20071017.4.1.xml>


Dengue increases and the Minister admits that there is an epidemic in
the country
---------------------------------------------------
Brazil is experiencing a dengue epidemic. The number of [dengue]
cases reached 481 300 between January and September [2007],
practically 50 percent more than in the same period in 2006.

The Minister of Health, Jose Gomez Temporao, issued an alert
yesterday [16 Oct 2007], classifying the situation as "unjustifiable"
and "unacceptable" during the initiation of a national mobilization
campaign against the disease. Temporao also referred to the 121
deaths registered in the first 9 months of this year [2007], which is
less than the 150 deaths confirmed in 2002, the worst year for this
disease in the country.

According to Temporao, this high [death] index represents a
deficiency in [medical] attention for DHF [cases]. According to
Health Ministry data, there were 481 300 cases registered for the
country. During the same period last year [2006] there were 321 300 cases.

The Minister indicated that of this total this year [2007], 1067
persons contracted DHF, principally in the state of Mato Grosso do
Sul, Sao Paulo, Rio de Janeiro, Parana and Maranhao. In comparison
with the number of registered cases in 2006, the southern region had
the greatest increase in the [case] curve (828 [additional cases], 16
percent [increase]), followed by the east-central [region] (99, 95
percent increase), northern [region] (31 cases, 34 percent),
northeaster [region] (30 cases, 43 percent) and southeastern [region]
(19 cases, 81 percent).

In the recent [situation], the increase in [dengue] cases was boosted
by Rio (75 cases, 64 percent) and by Sao Paulo (20 cases, 75
percent), for a total of 64 310 [cases] notified up to September,
versus 53 259 [notified cases] in the same period last year [2006].
Minas and Espirito Santo presented negative results [compared to
2006], -5 [fewer cases], 22 percent [decline] and -27,92 percent, respectively.

"This is an epidemic. And this epidemic is worrisome," said Temporao,
citing the difficulty of combating _Aedes aegypti_, vector of the
disease [virus], and the variety of virus serotypes which "put
obstacles" in the way of vaccine development.

"Unhappily, this vaccine is not on the nearby horizon," indicated the Minister.

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

[This situation now has become a ritual: every new health minister
(which have not been few), who shows fear, surprise and worry about
dengue, begins a group of new initiatives.

Dengue is controlled by a continuous effort, without interruptions,
not with bursts of actions that later cease or diminish ... and
requires years and years of work. - Mod.LJS]

[The WHO (World Health Organization) description of dengue fever and
the more deadly dengue hemorrhagic fever [DHF] can be found in
ProMED-mail's "Dengue/DHF update 20070514.1541." ProMED-mail thanks
the contributors to this update and encourages others to contribute
reports also. - Mod.TY]

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,39798

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Update, october 30 2007

Re: ProMed Dengue/DHF Update, october 30 2007

Archive Number 20071030.3516
Published Date 30-OCT-2007
Subject PRO/EDR> Dengue/DHF update 2007 (42)

DENGUE/DHF UPDATE 2007 (42)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] Martinique

[2] Netherlands Antilles

[3] Belize

[4] Costa Rica

[5] Viet Nam

[6] Pakistan: (Lahore)

[7] Pakistan: (Karachi)
******

[1] Martinique
Date: Thu 25 Oct 2007
Source: International Herald Tribune, Associated Press report [edited]
<http://www.iht.com/articles/ap/2007/10/25/news/CB-GEN-Martinique-Dengue.php>


An elderly man in Martinique has become the 2nd person to die from dengue
fever this year [2007] on the Caribbean island, the health department said
on Thursday [25 Oct 2007].

The victim, who was in his 60s, died at a hospital Tuesday [23 Oct 2007].
He and a man in his 70s who died last month [September 2007] had both
contracted the hemorrhagic form of the mosquitoborne illness, officials said.

Authorities in Martinique, which declared a dengue epidemic in August
[2007], have announced more than 6400 suspected cases on the French
overseas department of about 430 000 people.

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

A zoomable map of Martinique and its location in the Caribbean can be
accessed at <http://www.maplandia.com/martinique/>. - Mod.TY]

******
[2] Netherlands Antilles
Date: Thu 25 Oct 2007
Source: The Daily Herald (St. Maarten) [edited]
<http://www.thedailyherald.com/news/daily/k138/dengue138.html>


As some parts of the Caribbean and Latin America continue their efforts to
stem the tide of dengue cases, the Netherlands Antilles is keeping a close
eye on the situation.

Of the 269 lab tests for dengue done in the Netherlands Antilles between
January and early October [2007], 165 were suspected dengue cases, 53 were
confirmed to be dengue fever, and one case in Curacao was confirmed to be
dengue hemorrhagic fever [DHF].

The report Update Dengue Fever 2007 compiled by the Curacao-based
Epidemiology and Research Unit shows that no lab tests were done for Saba
and St Eustatius so far this year [2007].

According to the report, a total of 25 dengue lab tests were done for St.
Maarten between January and early October [2007]. Of these, 14 were
suspected cases, 4 were confirmed to be dengue fever, and 7 tested negative.

The monthly breakdown shows that the highest number of suspected dengue
cases for St Maarten (4) was reported in August [2007], followed by January
[2007] when 3 cases were reported. The last confirmed dengue case (one) was
in September [2007]. The other confirmed cases were in March (2) and July
(one).

In Curacao a total of 195 tests were done, 37 of which were confirmed
dengue cases, 125 were suspected cases, 32 were negative, and one was
confirmed dengue hemorrhagic fever.

In Bonaire a total of 49 tests were done, 12 of which were confirmed dengue
fever, 26 were suspected cases, and 11 tested negative.

The data for the report were compiled thorough a laboratory-based
surveillance system, a collaboration between Analytic Diagnostic Centre
(ADC) and the Epidemiology and Research Unit of the Medical and Public
Health Services.

Head of the Preventative Section of Sector Health Care Affairs (SHCA) in St
Maarten, Dr Rachel Eersel, who had stated earlier that 11 suspected cases
had been reported via the local health surveillance system, said the
figures in the report did not show any alarming trends in St Maarten. She
had said earlier that some 11 suspected cases of dengue had been reported
on the island for the entire year 2006. The figures in the report, Eersel
said, are from lab tests done by the ADC lab in St Maarten and do not
include figures from French St Martin. She said some people went to the
French side for their tests and SHCA was working with French St Martin
health authorities to get a clearer picture of the number of cases for both
sides of the island. She said a close eye was being kept on the situation.

Head of the Veterinary and Hygiene Department, Tony Boyrard, had told this
newspaper in an earlier interview that the current weather conditions were
not favourable for fumigating. "We are monitoring everything and it doesn't
make sense to do fumigation at the moment," Boyrard had said, "because when
it rains the residue of the insecticide that will be left on trees will be
washed away and won't have any real effect. If we fumigate right now we
also risk the mosquitoes developing a resistance to the insecticide and if
we do get a dengue outbreak here it will be twice as difficult to control
it." Boyrard had said fogging would start as soon as weather conditions
permitted.

[byline: Judy Fitzpatrick]

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

[Spraying trees with insecticides would be of limited value in controlling
_Aedes aegypti_ mosquitoes, as these dengue virus vectors breed and feed in
and immediately around human habitations and other buildings. The key to
long term vector control is elimination of the water catchments in which
this mosquito breeds.

A map of the Netherlands Antilles can be accessed at
<http://graphicmaps.com/webimage/countrys/namerica/caribb/stmartin.htm>. -
Mod.TY]

******
[3] Belize
Date: Fri 26 Oct 2007
Source: Caribbean Broadcasting Corporation (CBC) [edited]
<http://www.cbc.bb/content/view/13052/45/>


Belize on Friday [26 Oct 2007] confirmed 80 cases of "classical" dengue
fever since the start of the year [2007] and appealed to residents to take
all necessary precautions against the spread of the disease.

An official statement said that most of the cases were in the Corozal
district and Belize City and reported only "one confirmed case of dengue
hemorrhagic fever".

"The Ministry of Health is addressing the increased number of cases seen
recently in Belize with insecticide spraying and treatment of mosquito
breeding sites," the statement said, urging citizens to help stem the
spread by washing water storage containers at least once a week, changing
the water in flower pots every 4 to 5 days and avoid having containers that
can collect water on their premises.

The statement urged citizens travelling to countries where dengue fever is
epidemic to take all necessary precautions to reduce their risk of
acquiring the disease and named countries like Grenada, Jamaica, St Lucia,
St Vincent, Suriname, Puerto Rico, Guadeloupe, Martinique, Mexico,
Guatemala, Salvador, and Honduras that have had dengue fever outbreaks this
year [2007].

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

[The focus on citizen responsibility for eliminating vector mosquito
breeding sites is laudatory. It would be interesting to know what public
education efforts are being made, and with what success. A zoomable health
map of Belize can be accessed at
<http://healthmap.org/promed?v=17.2,-88.7,5>. - Mod.TY]

******
[4] Costa Rica
Date: Sat 27 Oct 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/article.asp?ID=%7B7F47D4DB-94DA-46C1-B973-84B489FB46C1%7D&language=EN>


Costa Rica's Caja de Seguro Social [CCSS; the national social security
system that includes health care. - Mod.TY] has reported since January
[2007] over 24 000 cases of dengue, including 4000 children under 14. The
CCSS says the disease, transmitted by _Aedes aegypti_ mosquitoes, has
affected over 940 children of 4 years [of age], 1230 between 5-9 years, and
1989 10-14 years.

So far there have been 6 fatalities, including 2 babies less than 12
months, and 250 people contracted the very aggressive and lethal
hemorrhagic strain.

The most affected areas are Guanacaste and Puntarenas on the Pacific coast
and Limon, in the Caribbean. There have also been over 60 cases in the
capital [San Jose].

Specialists claim that a child with dengue is 15 times more prone than an
adult to die.

CCSS Health Development director, Jose Miguel, Rojas announced a sanitation
and prevention drive to eliminate the mosquito breeding sites.

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[If any Central American country can launch an effective, citizen-based
vector control program, Costa Rica, with its relatively small population,
fairly good infrastructure, and high literacy rate, should be able to. The
2007 rainy season, still going on, has been unusually wet in Costa Rica,
which may be related to the intensity of dengue virus transmission there.

A zoomable health map of Costa Rica can be accessed at
<http://healthmap.org/promed?v=10,-84.2,5>. - Mod.TY]

******
[5] Viet Nam
Date: Thu 25 Oct 2007
Source: Viet Nam News, Nhan Dan (The People) report [edited]
<http://vietnamnews.vnagency.com.vn/showarticle.php?num=01DOM251007>


The Ministry of Health has ordered provinces and cities to adopt stringent
measures to prevent and control dengue fever as the risk of new outbreaks
is high in flood-prone areas. Nearly 80 000 cases of mosquitoborne dengue
fever have occurred nationwide this year [2007], 68 of them fatal. The
southern provinces of Dong Thap, Tien Giang, and An Giang continue to lead
the country in the number of cases.

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

[A zoomable health map of Viet Nam can be accessed at
<http://healthmap.org/promed?v=14.9,108.5,5>. - Mod.TY]

******
[6] Pakistan: (Lahore)
Date: Thu 25 Oct 2007
Source: The News International [edited]
<http://www.thenews.com.pk/daily_detail.asp?id=77043>


The total number of recorded dengue fever cases has risen to 11 in Punjab,
including 8 in Lahore alone, said reports [arriving at the] provincial
Directorate General of Health Services.

In Sir Ganga Ram Hospital on Wednesday [24 Oct 2007], 3 fresh patients have
been confirmed dengue fever positive here besides 5 dengue fever cases
detected in the provincial metropolis before yesterday [24 Oct 2007].

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

[A zoomable health map of Pakistan can be a accessed at
<http://healthmap.org/promed?v=30,69.4,5>. - Mod.TY]

******
[7] Pakistan: (Karachi)
Date: Wed 24 Oct 2007 [edited]
<http://www.thenews.com.pk/daily_detail.asp?id=76890>


The dengue fever patients' number in the city has risen to 1527 since
August [2007], a provincial health official said on Tuesday [23 Oct 2007].

Around 48 new cases were reported from different areas on Tuesday [23 Oct
2007]. The official said that 2 hospitals, which were earlier reluctant to
share information about dengue fever patients, started giving reports about
those admitted there. The number of patients, according to this
information, appears to have increased.

As many as 110 patients tested positive for dengue [virus infection] were
still admitted in the hospitals. The official said a total 534 cases tested
positive and 11 of these had died.

Doctors said that there were several issues associated with dengue fever.
The concerned authorities, they allege, are not aware of ways to deal with
it. Doctors were also not trained on how to diagnose and manage dengue
cases properly. Without proper management, the case fatality rate of dengue
hemorrhagic fever can exceed 20 per cent. Modern intensive supportive
therapy may reduce the rate to less than one per cent.

Dengue fever is caused by 4 types of dengue viruses known as dengue 1, 2,
3, and 4. If an individual is infected with type 3, the person develops
antibodies against dengue 3 virus. This infection is known as primary
dengue infection (1st time infection). If this person is later infected
with the same dengue 3, there will be no relapse [reinfection] as the
person will have become immune. However, if this person is infected with a
dengue virus other than type 3, there will be [may be. - Mod.TY] severe
infection (known as secondary infection -- 2nd time, 3rd time, and so on).

Dr Rafiq Khanani, associate professor and senior pathologist at the SMC
[Sindh Medical College] and DUHS [Dow University of Health Sciences] said
on Tuesday [23 Oct 2007] that many doctors not knowing this fact discarded
the diagnosis of dengue fever if dengue IgG is present. Several
laboratories are offering only IgM antibody test and are missing this
important group of patients by giving a dengue IgM negative report to
infected individuals, he added.

Another problem is that dengue test kits are from different manufacturers
and a large number of kits detect dengue type 2 only -- resulting in a
large number of negative reports, Khanani believed. He suggests that
authorities ensure that kits available are up to standards, tests are done
properly by qualified personnel/laboratories, and doctors be trained to
interpret reports.

Another important aspect of dengue, which is not recognised commonly, is
that a majority of those infected have no symptoms and infection can be
detected only if a dengue antibody test is performed. Khanani pointed out
that the World Health Organization had a programme known as DEWS [dengue
early warning system]. It requires a system for early reporting of
infectious diseases so that appropriate control measures are instituted in
timely manner. However, implementation strategy is poorly understood and,
therefore, these diseases assume epidemic proportions.

[byline: Imtiaz Ali]

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

[The reluctance of hospitals to report dengue virus infections is
dismaying. Good surveillance, supported by competent laboratory services,
is essential to rapid case detection and focused mosquito vector control
efforts. Help in establishing reliable diagnostic techniques is available
through the WHO, and are clearly needed here.

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,39865

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, november 5 2007

Re: ProMed Dengue/DHF Updates, november 5 2007

Archive Number 20071105.3600
Published Date 05-NOV-2007
Subject PRO/EDR> Dengue/DHF update 2007 (43)

DENGUE/DHF UPDATE 2007 (43)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] Cayman Islands

[2] Pakistan: (Lahore)

******
[1] Cayman Islands
Date: Tue 30 Oct 2007
Source: Caymanian Compass [edited]
http://www.caycompass.com/cgi-bin/CFPnews.cgi?ID=1026189


There are now 20 reported dengue fever cases in the Cayman Islands.
There is one confirmed case, one negative case, and 18 awaiting
results. Of the suspect patients, 7 have no recent travel history to
countries with dengue fever, which means the _Aedes aegypti_ mosquito
could be spreading the dangerous tropical disease locally.

Out of the 20 reported cases, 3 of the patients tested negative and
will have to be retested. "It takes a minimum of 5-7 days after
symptoms develop for the test to detect [dengue virus antibody rise.
- Mod.TY] fever," said medical officer of health Dr. Kiran Kumar. "As
a result all negative tests need to be followed by a 2nd round of tests."

Although dengue fever is not endemic to the Cayman Islands, the
_Aedes aegypti_ mosquito is present on Grand Cayman and its
population is estimated to have surged by 1300 percent in the
aftermath of Hurricane Ivan.

However, recent samples indicate populations may be down due to
spraying and other targeted programmes, said Bill Petrie, director of
the Mosquito Research and Control Unit (MRCU).

Since 1st receiving confirmation of a dengue fever case in Grand
Cayman 15 Oct [2007], the MRCU has been targeting both areas where
_Aedes aegypti_ numbers are known to be high and areas around the
homes of patients.

The mosquito is thought to be most prevalent in areas of George Town
particularly Windsor Gardens and parts of West Bay. The mosquito,
which mainly lives and breeds around residential areas flies only
relatively short distances. This means it is critical that residents
upturn any standing water in and around their home for their own
safety, Mr Petrie said.

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[It begins to look like indigenous dengue virus transmission is occurring here.

A zoomable health map showing the location of the Cayman Islands can
be accessed at
http://healthmap.org/promed?v=19.3,-81.2,6 and a map with named
urbanized areas can be accessed at
http://www.caymanactivityguide.com/Cayman.htm. - Mod.TY]

******
[2] Pakistan: (Lahore)
Date: Sun 4 Nov 2007
Source: The Post [edited]
<http://thepost.com.pk/Arc_CityNews.aspx?dtlid=126944&catid=3&date=11/04/2007&fcatid=14>


As many as 12 new patients including a woman and her child were
diagnosed with having dengue fever on Saturday [3 Nov 2007]. The
number of dengue fever patients has risen to 70 after the addition of
fresh cases in Lahore during the last 3 weeks. Luckily, neither any
case of dengue hemorrhagic fever (DHF) nor dengue shock syndrome
(DSS) was reported from any corner of the city. Moreover, no death
was reported owing to the said fever. Around 50 patients have so far
been discharged from public hospitals after their recovery.

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

[It appears that the dengue outbreak in Lahore may be accelerating.
ProMED-mail would appreciate additional information about new cases
and any mosquito vector control measures that are being taken.

A zoomable health map of Pakistan can be a accessed at
<http://healthmap.org/promed?v=30,69.4,5>.

The WHO (World Health Organization) description of dengue fever and
the more deadly dengue hemorrhagic fever [DHF] can be found in
ProMED-mail's "Dengue/DHF update 20070514.1541." ProMED-mail thanks
the contributors to this update and encourages others to contribute
reports also. - Mod.TY]

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,39961

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, november 12 2007

Re: ProMed Dengue/DHF Updates, november 12 2007

Archive Number 20071112.3670
Published Date 12-NOV-2007
Subject PRO/EDR> Dengue/DHF update 2007 (44)

DENGUE/DHF UPDATE 2007 (44)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] Cayman Islands: correction
[2] Jamaica
[3] Honduras
[4] Costa Rica
[5] Paraguay
[6] Pakistan: (Lahore)
[7] Pakistan
******
[1] Cayman Islands: correction
Date: Wed 7 Nov 2007
From: Alan Wheeler <Alan.Wheeler@gov.ky>


Re: Dengue/DHF update 2007 (43) 20071105.3600
---------------------------------------------
The official dengue count [in the Cayman Islands] is now 5 cases (4
from Jamaica, one from Nicaragua). These figures have been released
by the Public Health Department. MRCU's [Mosquito Research & Control
Unit] unofficial testing by RT-PCR [reverse transcriptase-polymerase
chain reaction] has shown 5 positive samples of [dengue virus]
serotype 2 from Jamaica and a serotype 4 from Nicaragua. [The] 24
other samples have all tested negative by PCR. Because we are not an
official diagnostic lab we are unable to release these figures. [Dr.
Wheeler later authorized the report of these figures. - Mod.TY]

I am still concerned about the conclusion that there is any evidence
of local transmission given that in every confirmed case there is
evidence of recent (less than 7 days) travel to a dengue endemic
country. All the "suspected cases" of local transmission have tested
negative by PCR and IgM ELISA [enzyme-linked immunosorbent assay.]
The hospital is awaiting the results of the convalescent sample to
confirm they are IgG negative. Given the results we have I would
conclude that as yet there is no evidence of local transmission. MRCU
control operations are maintaining _Aedes aegypti_ and _Aedes
albopictus_ populations at relatively low levels and I am hoping that
we can maintain Cayman free from local dengue transmission.

--
Dr Alan Wheeler
Assistant Director, Research
Mosquito Research & Control Unit
Cayman Islands
<Alan.Wheeler@gov.ky>

[ProMED-mail thanks Dr. Wheeler for his prompt response correcting
the speculation that dengue virus was being transmitted on the Cayman
Islands. One hopes that their efforts to keep mosquito vector
populations at low levels are successful in preventing local
transmission of dengue viruses there.

A zoomable health map showing the location of the Cayman Islands can
be accessed at
<http://healthmap.org/promed?v=19.3,-81.2,6>
and a map with named urbanized areas can be accessed at
<http://www.caymanactivityguide.com/Cayman.htm>. - Mod.TY]

******
[2] Jamaica
Date: Fri 9 Nov 2007
Source: Caribbean360.com [edited]
<http://www.caribbean360.com/News/Caribbean/Stories/2007/11/09/NEWS0000005104.html>


The deaths of 4 people in a Jamaican parish have been attributed to
dengue fever.

Chief medical officer for the parish of St Elizabeth, Dr Derrick
Ledford, was quoted by RJR News as making the claim at a meeting of
the Parish Council Thursday morning [8 Nov 2007]. Ledford added that
through there were 50 reports claiming to be dengue fever related;
only 4 autopsies have actually confirmed the victims were killed from
the disease.

Jamaica joins Martinique in reporting recent dengue fever deaths.

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

A zoomable health map showing the location of Jamaica in the
Caribbean and details of the island can be accessed at
<http://healthmap.org/promed?v=18.2,-77.3,6>. - Mod.TY]

******
[3] Honduras
Date: Tue 6 Nov 2007
Source: Yahoo, Noticias, Associated Press report [in Spanish, trans.
& summ. Mod. TY, edited]
<http://espanol.news.yahoo.com/s/ap/071106/salud/amc_med_honduras_dengue>


Some 14 people have died and more than 26 500 have been affected by
dengue in Honduras so far this year [2007].

The most recent victim is a girl who died this weekend [3-4 Nov 2007]
in the state hospital of San Pedro Sula, about 180 km (112 mi) north
of Tegucigalpa [the capital. - Mod.TY]

Up to October 2007, 26 539 classic dengue [fever] cases and 1503 DHF
[dengue hemorrhagic fever] cases have been registered in the country,
according to information from the Secretariat of Health.

DHF caused the deaths of 6 people in 2006, with 7800 Hondurans
affected [by dengue virus infections].

This situation has occurred despite teams from the army and civil
service employees who have gone through the main neighborhoods of the
country to remove trash, fumigate houses, and destroy breeding sites
of the dengue vector mosquito, _Aedes aegypti_.

The government has constantly asked the population to eliminate water
catchments in their homes, specifically bowls, bottles, and tires,
where this insect proliferates. The mosquito reproduces in fresh
water puddles left by the tropical downpours during the rainy season
in Honduras.

Official statistics indicate that in 6 years more than 60 000 dengue
cases have been registered in Honduras.

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

[A zoomable health map showing the location of Honduras in Central
America and the main Honduran cities can be accessed at
<http://healthmap.org/promed?v=14.8,-86.6,5>. - Mod.TY]

******
[4] Costa Rica
Date: Fri 9 Nov 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/article.asp?ID=%7BDDA6E73B-15C9-41A3-A82B-7E002E896283%7D)&language=EN>


Costa Rican health authorities warned on Friday [9 Nov 2007] that
they are deeply concerned over the increase of cases of hemorrhagic
dengue in the country, with 288 people infected and 7 deaths reported
since January [2007].

Official figures revealed the number of cases have increased by 300
percent over that reported in 2006, when only 72 people had the
hemorrhagic type.

A total of 24 000 cases of classic dengue have been reported, with
children as the most affected, and probabilities that babies will be
born infected, thus increasing infant mortality risks.

In a recent report the Health Ministry informed that the provinces of
Guanacaste, Puntarenas [both on the Pacific coast], and Limon
[Caribbean coast - Mod.TY] bear 98.6 percent of all serious cases.

The report indicates the number of patients with classic dengue
decreased 35 percent, but the hemorrhagic type shows an alarming rise.

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

[A zoomable health map showing the location of Costa Rica in Central
America, and the 3 provinces mentioned can be accessed at
<http://healthmap.org/promed?v=10,-84.2,5>. - Mod.TY]

******
[5] Paraguay
Date: Fri 9 Nov 2007
Source: Prensa Latina [edited]
<http://www.plenglish.com/article.asp?ID=%7BA5CAD57D-07A6-4DBE-9653-AEA57B406486%7D)&language=EN>


[As many as] 300 Paraguayans might get dengue hemorrhagic fever
[because of] the threat of a new epidemic in Paraguay, said sanitary
authorities in this South American country Friday [9 Nov 2007].

The Public Health Ministry Surveillance director, Gualberto Pinanez,
said more than 28 000 sick people with classic dengue fever and 54
with hemorrhagic fever have been reported, which might be worse with
the arrival of high temperatures.

The number of cases has not increased rapidly but Pinanez called the
population to contribute in the struggle to eliminate mosquito nests
to avoid propagation.

Hundreds of Paraguayans could die if it is not possible to stop the
extension of the disease, the official said after specifying that the
biggest incidence of cases takes place in the departments of Asuncion
and Central, both with high index of larvae infestation.

Meanwhile, environmental brigades, integrated by public officials and
sanitary specialists, carry out raking works [prioritization? -
Mod.TY] and elimination of foci of the _Aedes aegypti_ mosquito in
the area of the capital.

The objective is to stop a turnaround of the disease and make the
population aware about the importance of its participation in the
prevention tasks Hugo Quintana, director of the mentioned sanitary
region, emphasized.

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

[A zoomable map of Paraguay can be accessed at
<http://healthmap.org/promed?v=-23.2,-58.4,5>

******
[6] Pakistan: (Lahore)
Date: Sun 11 Nov 2007
Source: The Post [edited]
<http://thepost.com.pk/Arc_CityNews.aspx?dtlid=128002&catid=3&date=11/11/2007&fcatid=14>


The City District Health Department's Dengue Fever Monitoring Cell
reported 11 new cases of dengue fever at different hospitals of the
City [Lahore] in 2 days. After the confirmation of 11 more patients,
the total number of dengue victims has risen to 110. Out of them, 88
patients had been discharged after necessary treatment, while the
rest of the patients are being treated at public or private hospitals.

According, to District Officer Health Headquarters Lahore Dr Capt (r)
Muhammad Hanif, 11 dengue fever cases were confirmed by the Punjab
Institute of Public Health where serological tests of their blood
samples showed that they had dengue virus positive [results].

According to him, 6 patients were admitted to Sheikh Zayed Hospital
including [patients from] Nawan Kot Multan Road, a resident of Mughal
Pura, a resident of Akram Park Shadbagh, a resident of Main Bazaar
Awan Town, and of Grand Battery Stop Multan Road.

The 3 patients admitted to Shalimar Hospital were: a resident of
Siraj Pura of Daroghawala, a resident of Lahore Railway Station, and
a resident of Shalimar Town. Moreover, [a patient from] Empress Road,
who is currently admitted to a private clinic, and one of Shafee
Park, Sandha, [admitted] to Family Hospital are 2 other patients who
became the victims of dengue fever.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[A zoomable health map of Pakistan can be a accessed at
<http://healthmap.org/promed?v=30,69.4,5>. - Mod.TY]

******
[7] Pakistan
Date: Sun 11 Nov 2007
Source: Daily Times [edited]
<http://www.dailytimes.com.pk/default.asp?page=2007%5C11%5C11%5Cstory_11-11-2007_pg11_2>


The National Institute of Health (NIH) has diagnosed 9 cases positive
for the dengue virus out of the 55 referred to it by the Islamabad
hospitals over the past few months, said NIH Chief Executive General
(r) Masood Anwar. He said that of these 9 cases, 2 patients had been
admitted at the Pakistan Institute of Medical Sciences (PIMS), 2 at
the Polyclinic, 2 at the Kahuta Research Laboratories (KRL) Hospital,
and 3 at Shifa International Hospital. He said the hospitals sent the
NIH blood samples of the patients suspected of suffering from the
disease where the Institute tested the samples and informed them
about the results. "We know which hospital is sending in how many
samples for pathological tests and nothing more than that," he said
when asked the names of the patients suffering from dengue fever.

He informed Daily Times that 9 cases of dengue fever had been
confirmed at different hospitals in Rawalpindi. He further said that
so far out of the 105 cases suspected in [Punjab], 90 had tested
positive whereas of the 2100 suspected cases in Sindh, 720 were
positive. There have been only 30 possible dengue cases reported in
the NWFP [Northwest Frontier Province], of which 15 cases are
positive, whereas there is no dengue case reported from Balochistan.
When contacted, all the concerned hospitals, however, denied that any
patient admitted therein had been diagnosed with the dengue virus
[infection]. A PIMS spokesperson said the hospital had yet to
received any report from the NIH about the samples sent there.

[Byline: Jamila Achakzai]

--
http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40043

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, november 12 2007

Re: ProMed Dengue/DHF Updates, november 12 2007

Archive Number 20071120.3749
Published Date 20-NOV-2007
Subject PRO/EDR> Dengue/DHF update 2007 (45)

DENGUE/DHF UPDATE 2007 (45)
***************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] St. Lucia

[2] Brazil (Sao Paulo state)

******
[1] St. Lucia
Date: Sun 11 Nov 2007
From: Caribbean Broadcasting Corp. [edited]
http://www.cbc.bb/content/view/13261/45/


The island has been hit by a major dengue outbreak, with some 13
reported cases since last month [October 2007], health authorities
here have said.

Last month [October 2007], the nation was placed on an alert for an
outbreak of the mosquito borne illness, which has already resulted in
deaths in neighboring Martinique.

Authorities said while there have so far been no deaths, the number
of cases so far reported is one short of the total number reported
last year [2006].

The government's Chief Medical Officer, Josiah Rambally, told CMC
over the weekend that most of the cases were recorded in the capital
Castries and that everything possible is being done to ensure that no
deaths result.

"We have a team of health and environmental officers visiting
communities around the island in an effort to control the spread of
the illness," he said.

"They will be checking to see if anyone has fever and the environment
around homes, ensuring that possible sources of mosquito breeding are
eliminated."

Rambally said that fogging teams have also been operating in areas
prone to mosquito infection to eliminate the adult mosquitoes and
applying insecticide that will kill the mosquito larvae and pupae.

"We are appealing to the public to assist in this by doing what they
can to reduce the number of breeding places for mosquitoes, such as
old tires, coconut shells, and any items where water can stagnate,
facilitating the breeding of mosquitoes," he said.

Dr. Rambally said the outbreak of dengue has become a source of
concern with the number of cases of death reported around the region.

"Whenever there is an outbreak anywhere, especially places where we
travel to, it's easy for people to come back and cause an outbreak in
their country of origin, so we need to increase our vigilance," he said.

He said that every year the island needed to go on the alert for
dengue, but more so in this period, given the fact that Martinique
has reported an outbreak of dengue virus type 4.

"We are not saying that St. Lucians should cease all travel to
Martinique, but those going there need to be aware of the clear and
present danger of being infected," he said. St. Lucia has recorded 2
major outbreaks of dengue fever, with the most recent being in 2002.

The Ministry of Health has been advising persons against the
indiscriminate disposal of garbage in drains and ravines, as this can
result in breeding sites for mosquitoes.

It has also urged persons experiencing high fever associated with
headache and joint pain to seek immediate medical attention.

"We have a surveillance system in place so that anyone with these
symptoms needs to seek immediate medical attention, and we would want
that report to get to the Ministry so we can implement our control
measures," Dr. Rambally said.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[An interactive ProMED health map of St. Lucia, showing its location
in the Caribbean, can be accessed at:
http://healthmap.org/promed?v=13.9,-61,5. - Mod.TY]

******
[2] Brazil (Sao Paulo State)
Date: Thu 15 Nov 2007
Source: O Estado de Sao Paulo [in Portuguese, trans. & summ. Mod.TY, edited]
http://txt.estado.com.br/editorias/2007/11/15/ger-1.93.7.20071115.8.1.xml


This year [2007] in Sao Paulo state, classical dengue fever killed
more people than dengue hemorrhagic fever (DHF). From January 2007 up
until the present, according to the state's Secretary of Health,
there have been 18 deaths from classical dengue fever and 16 from
DHF. These 2 numbers are attention-getting because dengue deaths have
been associated more with the hemorrhagic form of the disease. Deaths
resulting from classical dengue fever are less frequent.

In the evaluation of Dr. Luiz Jose de Souza, Director of the Dengue
Evaluation Center of Campos dos Goytacazes, the high number of deaths
from classical dengue in Sao Paulo could be related to the
dissemination in the state of dengue virus 3, which is more
aggressive than the other dengue virus types, and to the lack of
physician preparation to diagnose the disease correctly.

Of the 34 deaths that occurred this year [2007] in Sao Paulo, most of
them, 15, were registered in the month of March.

Although still not over, 2007 has now been the year with the greatest
number of dengue cases in the history of Sao Paulo. Up until now, 78
600 people have been recorded infected. The previous record was in
2001, when there were 51 700 dengue cases in the state.

The Secretary said, however, that the situation is not out of
control. He affirmed that they are working with the prefectures in
order to combat the foci of mosquito transmission and to correctly
diagnose this disease.

--
Communicated by:
ProMED-PORT promed@promedmail.org

[It is difficult to ascertain with confidence what the data are.
Dengue is dengue, and the definition of DHF many times is inadequate;
many ill patients do not meet the case definition. It is high time we
worked with a different set of definitions. - Mod.JLS]

[An interactive ProMED health map of Brazil, showing the location of
Sao Paulo state can be accessed at:
http://healthmap.org/promed?v=-10.8,-53.1,4.

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40136

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, november 26 2007

Re: ProMed Dengue/DHF Updates, november 26 2007

Archive Number 20071126.3825
Published Date 26-NOV-2007
Subject PRO/EDR> Dengue/DHF update 2007 (46)

DENGUE/DHF UPDATE 2007 (46)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] Jamaica

[2] Philippines

[3] Indonesia: (Java)

******
[1] Jamaica
Date: Mon 19 Nov 2007
Source: Radiojamaica.com [edited]
<http://www.radiojamaica.com/content/view/3117/26/>


The Ministry of Health is reporting that the number of suspected
cases of dengue fever has doubled in one month. Health minister Ruddy
Spencer said last month [October 2007] the Ministry's numbers showed
that 2046 persons were suspected to have dengue fever. However, he
said the number as of Saturday [17 Nov 2007] reflected a drastic
increase of up to 4260 suspected cases island wide.

The ministry reports that 18 persons have died from dengue fever. The
ages of those who have died from the disease range from 4 months to
79 years. Of these, 9 were children under 18 years old.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[It is interesting to note that several of the dengue fever cases
reported on the Cayman Islands were acquired on Jamaica (see
ProMED-mail archive no. 20071112.3670), illustrating the risk for
dengue virus dissemination posed by travelers incubating this disease.

The interactive HealthMap/ProMED-mail map showing the location of
Jamaica in the Caribbean can be accessed at
<http://healthmap.org/promed?v=18.2,-77.3,6>. - Mod.TY]

******
[2] Philippines
Date: Tue 20 Nov 2007
Source: Philippine Information Agency [edited]
<http://www.pia.gov.ph/?m=12&fi=p071120.htm&no=41>


As of 9 Nov [2007], Capiz registered some 332 dengue cases with 5
deaths already. Records from the Provincial Health Office (PHO) of
Capiz show that from 70 dengue cases in September [2007], these have
significantly declined to 25 cases in October with one death.

Sanitary inspector Jane delos Reyes disclosed that from 1-9 Nov
[2007] alone, the province has registered 2 deaths due to the dreaded
day-biting mosquito carrying dengue virus.

In [the] 11-month period [in 2007], the highest number of cases was
registered in August with 87 cases, followed by 83 and 70 cases in
July and September, respectively, delos Reyes revealed.

She said that January [2007] registered the lowest number of dengue
cases, which were noted at 2, followed by 5 cases each in March and
April, and 6 cases each in February and May.

From January to 9 Nov [2007], Roxas City posted the highest number of
cases -- 121 with one death --, delos Reyes said, adding that the
Mambusao town registered 38 cases also with one death, followed by
Dumalag with 36 cases.

Sapian has recorded 22 and Dumarao has also 22 cases with one death,
while the municipalities of Cuartero, Dao, and Panitan have 12 cases
each, she said.

The other mortalities were recorded in Maayon and Ivisan, she said.

Last month [October 2007], the Department of Health (DOH) has issued
a nationwide dengue fever alert after recording more than 4000 cases
in the 2nd week of September.

The Department recorded 24 689 cases of the mosquito-borne disease
since January [2007], with 283 deaths.

Dr Eric Tayag, head of the National Epidemiology Center, said that a
sharp increase in the number of cases in September and October [2007]
was expected because it was during that period that the disease
proliferated due to the wet weather [with a corresponding increase in
breeding sites of the _Aedes_ dengue virus vector mosquito. - Mod.TY]

There is no known cure or vaccine to fight dengue fever, which is
transmitted by a bite of the white-spotted mosquito known as _Aedes
aegypti_, Tayag said, pointing out that most of those [people] killed
tend to be children and old people who have weak resistance to the
virus.

[Byline: Jemin B. Guillermo]

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

[The HealthMap/ProMED-mail interactive map of the Philippines can be
accessed at
<http://healthmap.org/promed?v=11.7,122.9,5>. - Mod.TY]

******
[3] Indonesia: (Java)
Date: Wed 21 Nov 2007
Source: Surya online [in Indonesian trans. anonymous contributor,
summ. & edited]
<http://www.surya.co.id/web/index.php?option=com_content&task=view&id=26629&Itemid=37>


As is happening in the Kediri Regency during November [2007], 7
patients were treated in Amelia's Hospital. In the regency since
early in the year, 1201 dengue sufferers, including 18 people dying,
were recorded.

As for the Mojokerto Regency, 129 villages were maintained as endemic
for dengue. From 18 subdistricts in the Mojokerto Regency, only
Trawas was declared free of dengue.

These data were provided to Surya, on Tuesday [20 Nov 2007], by
Kediri Sigit Rahardjo Kabag of the Humas Regional Government, and
section head Kesehatan of the Mojokerto Regency, Dr Noer Widijantoro.

The data in RS Amelia Pare, reported that 7 dengue patients there
were children from Gedangsewu, Pare; Mojokerep, Kecamatan Plemahan;
and Fake, Kecamatan Puncu. These children improved and returned home.

In Mojokerto, the team of Dr Noer Widijantoro carried out intensive
public education about prevention, handling, and eradication of the
mosquitoes, _Aedes aegypti_ that breed in endemic dengue [virus]
villages. Dia added, for 3 successive years, many villagers have been
attacked by dengue.

The Jatirejo area had 12 of the most seriously [affected] dengue
villages, followed by 11 villages in the Sooko subdistrict and 10
villages in the Kutorejo subdistrict. 3 subdistricts needed the extra
treatment, he explained.

--
Communicated by:
Anonymous contributor (name withheld by request)

[Interestingly, Java also has an outbreak of febrile disease
attributed to infection by chikungunya virus. Assuming both viruses
are circulating, this possible situation of 2 simultaneous outbreaks
of viruses, which produce similar symptoms underscores the need for
laboratory confirmation. However, the approach for disease control,
_Aedes_ vector mosquito reduction, would be the same.

An interactive map of Java, Indonesia can be accessed at
<http://encarta.msn.com/map_701513466/Java_(island).html>.

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40223

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, november 26 2007

Re: ProMed Dengue/DHF Updates, november 26 2007

Archive Number 20071203.3905
Published Date 03-DEC-2007
Subject PRO/EDR> Dengue/DHF update 2007 (47)

DENGUE/DHF UPDATE 2007 (47)
****************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Philippines (Antique)
[2] Philippines (Mountain Province)
[3] Indonesia (Bondowoso, Java)
[4] Indonesia (Jombang, Java)
[5] British Virgin Islands
[6] St. Maarten
[7] Brazil (Campinas)
[8] Brazil (Alagoas)
[9] Europe

******
[1] Philippines (Antique)
Date: Thu 29 Nov 2007
Source: News Today [edited]
<http://www.thenewstoday.info/2007/11/29/dengue.cases.in.antique.up.html>


Dengue cases in the province surged to 463 as of 26 Nov 2007 said
Mildred Quilino, Information Officer, Provincial Health Office.

"The weather conditions these days are so conducive for dengue
mosquitoes to breed. Scattered rain showers with sunny days are
favorable to dengue mosquitoes to thrive and multiply," Quilino
added. Almost every week, Delegate Angel Salazar Memorial Hospital
reported admission of dengue suspected cases.

The municipality of Tobias Fornier has the highest number of cases
with 123, San Jose with 119, Hamtic with 51, Anini-y, 47 and
Bugasong, 14 cases. Despite surging cases, Quilino said that most
cases are being managed and treated in the local hospitals. Only few
and extreme cases are brought to Iloilo for treatment.

PHO reiterated its campaign to local government units, communities
and families to double their efforts to fight dengue mosquitoes.
"There is no substitute to cleanliness and proper sanitation. We do
not only eradicate mosquitoes but also get rid of other water borne
and contagious diseases," said Quilino. The public is also reminded
to bring dengue suspected patients to the nearest health centers for
proper treatment.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[An interactive ProMED health map of the Philippines can be accessed at:
<http://healthmap.org/promed?v=11.7,122.9,5>
and a map of San Jose, Antique, Philippines at:
<http://en.wikipedia.org/wiki/Imageh_locator_antique_san_jose.png>.
- Mod.TY]

******
[2] Philippines (Mountain Province)
Date: Fri 30 Nov 2007
Source: Northern Philippine Times [edited]
<http://northphiltimes.blogspot.com/search/label/Mountain%20Province>


The dreaded dengue disease has afflicted 45 residents at latest
count, and the number is rising, health officials said. Nenita
Lizardo, head of the provincial health office reported this statement
saying this was alarming. Lizardo said health personnel earlier
recorded 30 cases in September [2007], but this went up to 45 in
October [2007] with 55 percent of these cases from Bontoc.

Lizardo said that there is a need to advocate the 4-S program against
dengue. The 4-S means' search and destroy' eliminating all breeding
sites for the mosquito, proper waste disposal, covering of water
containers, and cleaning of roof gutters and drains.

The program protection measures advocate use of long sleeves and
pants, installing screens on doors and windows, use of mosquito nets
and adopting a healthy lifestyle to boost resistance. Lizardo advised
constituents to seek consultation, as there was no drug or vaccine
for dengue. "Dengue suspects must be brought to the nearest health
facility immediately, and there should be no self- medication," she
said, adding indiscriminate fogging should only be done during
outbreaks and epidemics [She doubtless meant that fogging should be
focused on areas where dengue virus transmission and cases were
occurring, not indiscriminately anywhere. - Mod.TY].

[Byline: Berlin McIntosh]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Bontoc is the capital of the Mountain Province, and a map showing
the location of that province can be accessed at:
<http://en.wikipedia.org/wiki/Imageh_locator_map_mountain_province.png>.
- Mod.TY]

******
[3] Indonesia (Bondowoso, Java)
Date: 3 Dec 2007
Source: Jawa Pos [in Indonesian, trans., summarized, edited]
<http://www.jawapos.co.id/index.php?act=detail_radar&id=183162&c=91>


The Kecamatan Kota Bondowoso Territory was not yet free from endemic
[epidemic] dengue fever. As of yesterday [2 Dec 2007], the Kota
Subdistrict contributed most to the number of dengue sufferers,
whereas dengue incidence was lower in the area of mountains like
Sempol, Wringin, or Cermee. Data from the health service indicated
that the number of residents suspected of dengue fever reached 26. Cases were most frequent in the Kota Subdistrict territory, following
Tegalampel, Grujugan, and the Tenggarang Subdistrict.

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

******
[4] Indonesia (Jombang, Java)
Date Fri 30 Nov 2007
Source: Jawa Pos [in Indonesian, trans., summarized., edited]
<http://www.jawapos.co.id/index.php?act=detail_radar&id=182961&c=109>


The attack of the dengue fever in Jombang has not stopped. Yesterday
[29 Nov 2007], at least 3 sufferers who were known positive for
dengue [virus infection] were of concern. The 3 sufferers, who were
treated intensively in the Cukir Community Health Centre, were
residents of the Sentanan Desa Grogol Village, Kecamatan Diwe and
Jombang villages.

Dengue has been seen since last October [?2006 or ?2007] when rains
began. During the period from January [2007] until this October 2007,
there have been 489 dengue fever sufferers, of whom 14 died.

From January until October 2006, the numbers of dengue sufferers who
received medical treatment were 256, of whom 17 died.

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

[The numbers of deaths in this reported outbreak are not clear. Have
14 or 17 individuals died? The popular press in Java is currently
reporting outbreaks of febrile disease across the island attributed
to infection by chikungunya virus (see archive no. 20071201.3876)
but, unlike reports of dengue fever, without citation of official
reports of laboratory confirmation. The symptoms of disease caused by
these 5 viruses (chikungunya plus the 4 dengue viruses) can be
similar, underscoring the need for laboratory diagnosis.

An interactive map of Java, Indonesia can be accessed at
<http://encarta.msn.com/map_701513466/Java_(island).html>. - Mod.TY]

******
[5] British Virgin Islands
Date: Fri 30 Nov 2007
Source: BVI News online [edited]
<http://www.bvinews.com/default.asp?sourceid=&smenu=198&twindow=&mad=&sdetail=3899&wpage=1&skeyword=&sidate=&ccat=&ccatm=&restate=&restatus=&reoption=&retype=&repmin=&repmax=&rebed=&rebath=&subname=&pform=&sc=1924&hn=bvinews&he=.com>


The Ministry of Health has today [30 Nov 2007] received confirmation
of 2 cases of dengue in the British Virgin Islands (BVI). Director of
Health Services Dr. Irad Potter says that as the Ministry of Health
continues to monitor the results of other suspected cases of dengue,
it has stepped up its vector control activities through the
Environmental Health Division's Dengue Surveillance Unit. He urges
residents to guard against mosquito bites and to reduce mosquito
breeding around homes and property in order to keep the number of
cases in the BVI to a minimum.

"Blood samples have been sent to the Caribbean Epidemiology Centre
(CAREC) to confirm the status of other suspected cases of dengue, and
we are awaiting the results. Of the 14 specimens that have been sent
off for testing, 9 have come back; 2 of the 9 are positive. The
specimens take at least 4-6 weeks to be processed. Persons suspected
of having dengue are treated based on their clinical presentation by
their doctor," Dr. Potter said.

Dr. Potter noted that in light of recent outbreaks in the region,
persons who have traveled to Puerto Rico, Dominican Republic,
Martinique and Guadeloupe and are experiencing painful flu-like
symptoms of high fever, nausea and painful body aches within 3 to 14
days of their travel should seek medical attention.

Dengue virus, which can also cause a rash in infected persons, is
spread through the _Aedes aegypti_ mosquito commonly found in the
BVI. The Director of Health Services advised that due to the
heightened awareness in the sub-region related to dengue, suspected
cases are being investigated and followed up to rule out or confirm
the presence of the virus.

All _Aedes aegypti_ inspectors are up and about surveying public and
private spaces. However, mosquitoes reproduce at a rapid rate.
Therefore, surveys of private and work spaces must be completed by
residents themselves to break the mosquito cycle.

In September [2007], the Environmental Health Division issued an
advisory putting residents and visitors of the BVI on high alert in
response to dengue outbreaks in Puerto Rico and Guyana.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[It is not clear from this report if the 2 dengue virus infections
were acquired elsewhere or on the British Virgin Islands.

An interactive ProMED health map of the British Virgin Islands can be
accessed at: <http://healthmap.org/promed?v=18.4,-64.6,7>. - Mod.TY]


******
[6] St. Maarten
Date: Thu 29 Nov 2007
Source: De Telegraaf [in Dutch, trans., edited]


This year [2007], there have been 18 cases of dengue found on the
Antillean island of St. Maarten. This is the highest number of cases
of this disease ever detected on the island in a year. Therefore, a
warning has been declared.

Earlier this month [November 2007], Aruba has taken measures to
prevent a dengue outbreak.

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

[A map of St. Maarten showing its location in the Caribbean can be accessed at:
<http://graphicmaps.com/webimage/countrys/namerica/caribb/stmartin.htm>.
- Mod.TY]

******
[7] Brazil (Campinas)
Date: Sat 24 Nov 2007
Source: Cosmo On Line [in Portuguese, trans., summarized Mod.TY, edited]
<http://www.cosmo.com.br/cidades/campinas/integra.asp?id=213454>


Campinas has officially confirmed 5035 dengue cases since January
[2007]. However, the Secretary of Health is expecting cases of this
disease to total 13 000, taking into account the 8000 notified
suspected cases which are not expected to be laboratory confirmed
within the medium-term. "Despite this, we have opted to consider
these cases as positive," explained the Health Surveillance
Coordinator (COVISA), Salma Balista.

She pointed out that among these cases, some may not be dengue, but
as the absolute majority [of these cases] were notified at the peak
of the epidemic in the 1st semester of 2007, chances are that they
are really dengue. "From the point of view of [dengue] control and
prevention measures, this does not change anything, as actions are
launched based on suspected [disease], since serological results [for
confirmation] take time. But in terms of a map of the actual
situation, and the definition for the patient, [this] is important,"
observed Salma.

"It is always difficult to know the exact number of cases in a large
epidemic, such as we are facing [now]. But, with 5000, 10 000 or 15
000 cases, the logistics of preventive work is the same," affirmed
the Secretary of Health, Jose Francisco Kerr Saraiva.

He recalled that, as determined by the ministry and the Secretary of
Health, those municipalities which had an incidence of over 300
[dengue] cases per 100 000 inhabitants -- Campinas had an incidence
coefficient of 475 cases per 100 000 inhabitants -- do not need to do
more than carry out serological tests to confirm occurrences [of
dengue cases]. This disease can be confirmed on the basis of
clinico-epidemiological criteria.

Since the beginning of 2007, COVISA has received 21 000 notifications
of suspected cases of the disease. Of the 5035 officially
[laboratory] confirmed cases, 20 were DHF and 65 were dengue with
complications resulting in 2 deaths. Another 2 deaths included
[individuals] living in other cities of the region, who died in
Campinas hospitals.

[Byline: Dema Medeiros]

--
Communicated by:
LISAS
<http://lisas.anvisa.gov.br>

[An interactive ProMED health map of Brazil showing all the states
can be accessed at: <http://healthmap.org/promed?v=-10.8,-53.1,4>. - Mod.TY]

******
[8] Brazil (Alagoas)
Date: Sat 24 Nov 2008
Source: Gazeta [in Portuguese, trans., summarized Mod.TY, edited]
<http://www.prensaescrita.com/diarios.phpcodigo=POR&pagina=http://gazetaweb.globo.com>


An open public meeting will be held this Saturday [24 Nov 2007] with
representatives of the State Committee to Combat Dengue and the State
Public Ministry with the objective of stimulating the public to
combat, in their residences, the breeding sites of the mosquito that
transmits dengue [virus], referring to "D Day", the national [day]
for mobilization against dengue.

From January [2007] until the beginning of this month [November
2007], 11 207 classical dengue [fever] cases were registered in the
state [Alagoas - Mod.MPP]; 454 DHF cases with complications were
registered, with 12 deaths in the municipalities of Maceio, Colonia
Leopoldina, Palmeira dos Indios, Penedo and Santana do Mundau.

The municipalities in which 80 percent of the cases were concentrated
are considered priority [areas] including: Maceio, Marechal Deodoro,
Arapiraca, Penedo, Santana do Ipanema, Teotonio Vilela, Maragogi,
Palmeira dos Indios, Delmiro Gouveia, Paripueira, Barra de Santo
Antonio, Coqueiro Seco, Satuba, Barra de Sao Miguel, Santa Luzia do
Norte, Messias, Rio Largo, Pilar and Uniao dos Palmares.

--
Communicated by:
LISAS
<http://lisas.anvisa.gov.br>

******
[9] Europe
Date: Wed 28 Nov 2007
Source: Tehran Times [edited]
<http://www.tehrantimes.com/index_View.asp?code=158053>


A mosquito that can carry the deadly dengue fever virus is moving
north and has crossed the Swiss Alps, health authorities in the
canton of Aargau said.

They said it had not yet been determined whether the tiger mosquitoes
[_Aedes albopictus_] found so far are isolated individuals or part of
an established local colony.

_Aedes albopictus_ can also carry the chikungunya virus, which
infected more than 160 people in northern Italy earlier this year
[2007]. In Switzerland, it had only been found previously south of
the Alps, in the canton of Ticino.

The Swiss health ministry plans to make chikungunya, which was
described for the 1st time in Tanzania in 1952, a mandatory
reportable disease from next year [2008].

The mosquito is also present in southern France and parts of Spain,
as well as the United States, but the outbreak of chikungunya in
Italy is thought to have been the 1st outside the tropics.

Health experts meeting in Stockholm in September [2007] said European
countries must work to control tiger mosquito populations, but the
situation was not alarming.

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,40317

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, december 3 2007

Re: ProMed Dengue/DHF Updates, december 3 2007

Archive Number 20071211.3989
Published Date 11-DEC-2007
Subject PRO/EDR> Dengue/DHF update (48)

DENGUE/DHF UPDATE 2007 (48)
****************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Indonesia (Jakarta)
[2] Indonesia (Central Java)
[3] Indonesia (East Java)
[4] Indonesia (East Kalimantan)
[5] Indonesia (South Sulaweisi)
[6] Indonesia (North Sulaweisi)
[7] Pakistan (Rawalpindi)
[8] Brazil (Ceara)
[9] Brazil (Sao Paulo state)

[The series of 6 reports from Indonesia are of interest because they
indicate the extent of dengue cases across that geographically
extensive country and because the outbreaks are larger than those
experienced last year [2006]. - Mod.TY]

******
[1] Indonesia (Jakarta)
Date: Fri 9 Dec 2007
Source: The Kola Post [in Indonesian, trans., edited]
<http://www.poskota.co.id/news_baca.asp?id=42183&ik=3>


The Special Capital District of Jakarta occupied the 1st level of
dengue fever [outbreak classification] for the length of 2007.

According to the Department of Health [2007] data entered up to 5 Dec
[2007], 134 847 cases that were reported [Nationally? In Java? - Mod.
TY], 30 469 cases were from Jakarta.

More than 30 percent of the cases of dengue fever came from Jakarta,
the Head of Health Service Special Capital District, Dr. Wibowo
Sukijat, MPH, said on Thursday (6 Dec [2007]). This number is an
increase compared to the previous year [2006] when there were 24 932
cases with 39 deaths.

This year [2007], of the 30 469 [dengue fever] sufferers who were
treated, 81 died.

There were several factors in Jakarta that account for why this area
had the highest numbers of dengue fever cases, including bad
environment, the mobility of many inhabitants, the inhabitants's
substantial population, as well as increased temperatures, so virus
[transmission] has been increasingly raging.

The [dengue virus mosquito vector] control campaign has not yet given
optimal results.

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

[An interactive map of Java, Indonesia, showing the location of
Jakarta and other cities and towns can be accessed at
<http://encarta.msn.com/map_701513466/Java_(island).html>. - Mod.TY]

******
[2] Indonesia (Central Java)
Date: Sun 9 Dec 2007
Source: Jawa Pos [in Indonesian, trans., edited]
<http://www.jawapos.co.id/index.php?act=detail_radar&id=184467&c=109>


The spread of dengue fever in Jombang is increasingly worrying. As of
yesterday [8 Dec 2007], 537 [dengue fever] sufferers were given
intensive treatment in the Community Health Centre and the Hospital
in Jombang. Moreover, emergency status was given due to the increase
in dengue fever cases.

This case figure is more than twice that compared with last year
(2006), so a further increase must be guarded against, said the
Jombang head of Health Service, Dr. Andhy Bhinuko.

Moreover, the level of spread of the illness, which is caused by the
bite of [dengue virus carrying-] _Aedes aegypti_, has not stopped
throughout 2007. Usually in the period from May up to August no
[dengue] cases occur.

The increase in [dengue] cases became more apparent starting in
October [2007] when 21 sufferers were treated. In the following
month, November, the number jumped to 44 cases with the death of 2
people. The total dengue fever [2007] case load up to this December
was 537 people with 16 deaths.

The location where dengue has been spreading includes the Jombang
Subdistrict, Diwek and the Mojowarno Subdistrict. Areas at risk
include the Kudu Subdistrict, Jogoroto, Mojoagung and the Peterongan
Subdistrict.

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

[A Jawa Pos article published 4 Dec 2007
(<http://www.jawapos.co.id/index.php?act=detail_radar&id=183560&c=109>)
indicated that dengue virus transmission now occurs year around, and
not just during the rainy season. - Mod.TY]

******
[3] Indonesia (East Java)
Date: Mon 3 Dec 2007
Source: Jawa Pos [in Indonesian, trans. & summ., edited]
<http://www.jawapos.co.id/index.php?act=detail_radar&id=183489&c=91>


The Health Service indicated that the Bondowoso Regency responded to
the serious dengue fever epidemic in the Dadapan Village, Kecamatan
Grujugan after dozens of villagers underwent the intensive treatment
in the Daerah Hospital.

Fumigation was carried out by the officials and the Grujugan
Community Health Centre, not only outside the area [but also in] the
residents' houses. The fumigation was done to kill _Aedes aegypti_
mosquitoes that spread the dengue fever illness.

In addition to fumigation, powdered abate was distributed to
residents to kill larval _Aedes aegypti_ mosquitoes.

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

******
[4] Indonesia (East Kalimantan)
Date: Wed 5 Dec 2007
Source: Kompas [in Indonesian, trans. & summ., edited]
<http://www.kompas.com/ver1/Nusantara/0712/05/092501.htm>


During the Period January-November 2007, as many as 89 East
Kalimantan residents died from dengue fever. The number has increased
compared to last year [2006] which totaled 80 people from January to
December, said the Head of the East Kalimantan Health Section,
Sutarnyoto, in the office of East Kalimantan Governor, Samarinda, on
Wednesday (5 Dec [2007]). This is worrying, he stressed.

This year, 4276 people were infected by dengue fever; whereas, last
year [2006], according to Sutarnyoto, 2838 people were infected by
dengue fever.

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

[East Kalimantan, Indonesia, is located on the SE part of Borneo
Island and an interactive ProMED health map of this area can be accessed at:
<http://healthmap.org/promed?v=-2.6,120.9,5>. - Mod.TY]

******
[5] Indonesia (South Sulaweisi)
Date: Wed 5 Dec 2007
Source: Fajar [in Indonesian, trans. & summ., edited]
<http://www.fajar.co.id/news.php?newsid=48002>


The number of dengue patients in RSU Wahidin Sudirohusodo continued
to increase, on the basis of review of the number of patients from
October to the end of November [2007]. The number of dengue patients
in October totalled 54, in November was 100 and in December to date
(5 Dec 2007) there have been 5 cases.

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

[An interactive map of Sulaweisi, Indonesia, can be accessed at:
<http://encarta.msn.com/map_701516829/Sulawesi.html>

******
[6] Indonesia (North Sulaweisi)
Date: 11 Dec 2007
Source: Harian Komentar [in Indonesian, trans. & summ., edited]
<http://www.hariankomentar.com/hl001.html>


Dengue fever and dengue hemorrhagic fever is raging in North
Sulawesi. Many patients (in general children) suffered dengue in
Manado City, Kabupaten Bolmong, Sangihe and in a part of Minahasa. At
this time more than one hospital was filled with dengue patients.

The Head Health Service North Sulawesi, Dr. Christian Ti-laar,
immediately dismissed warning related the dengue outbreak [which
appeared] together with the rainy season at this time.

Dealing with the problem of the spread of dengue fever is more than
his [agencies] responsibility, the regency/the city [must be
involved, too] because, this always has been routine every year.

Therefore he was not surprised that hospital wards were filled with
patients, said Tilaar to the reporter, on Tuesday (04 Dec [2007]).
"Of course," he continued, "the spread of dengue fever illnesses was
already anticipated a long time ago before the arrival of the rainy season."

Until now the only [dengue] prevention is by waging war on mosquitoes
that cause the spread. The method is the "3M" [that eliminates _Aedes
aegypti_ mosquito breeding sites]. Abate larvacide was also given.
These measures can control mosquitoes for several weeks but must be
repeated for longer control.

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

******
[7] Pakistan (Rawalpindi)
Date: Tue 4 Dec 2007
Source: Daily Times
<http://www.dailytimes.com.pk/default.asp?page=2007%5C12%5C04%5Cstory_4-12-2007_pg11_4>


Two more suspected dengue fever patients were on Monday [3 Dec
2007] admitted to Rawalpindi General Hospital (RGH), raising the
number of suspected cases to 5. Doctors said the 5 infected
people, kept in quarantine, had visited Karachi and Peshawar and were
diagnosed with high fever, vomiting and shivering which were
symptomatic of dengue fever.

They said if proper measures like fumigation and spray of
insecticides were not taken immediately, the infection could assume
[epidemic] proportions.

Dr. Fayyaz Ahmad, Assistant Medical Superintendent (Administration),
told the Daily Times that blood samples of the [dengue] suspected
patients were taken and sent to the National Institute of Health
(NIH) for dengue serology on Monday [3 Dec 2007].

He said reports of 3 patients already admitted to the hospital had
been received, one of which was positive [for dengue antibody? -
Mod.TY]. He said the patient had been put in an isolated ward. The
hospital's private ward has been declared as an isolated ward and all
the 5 patients are being treated there.

Doctors took blood samples [from one patient] and sent them to the
NIH for diagnosis of both Congo [Crimean hemorrhagic fever] and dengue fever.

[Byline: Aamir Yasin]

--
Communicated by:
ProMED Rapporteur Brent Barrett

[It would be important to know if some of these patients are infected
with CCHF virus, which would pose a risk to hospital personnel & which
would require isolation, and dengue viruses, which would not. ProMED
would be interested to know if any of these turn out to be CCHF
patients.

Fumigation mentioned in this report would kill adult _Aedes_ dengue
vector mosquitoes, but halting or slowing of an epidemic would be
temporary. Without elimination of larval breeding sites, a new
generation of vector mosquitoes would soon emerge and virus
transmission would resume. - Mod.TY]

******
[8] Brazil (Ceara)
Date: Sat 8 Dec 2007
Source: O Povo [in Portuguese, trans & summ. Mod. TY, edited]
<http://www.opovo.com.br/opovo/fortaleza/750869.html>

The Secretary of Health for the state of Ceara (SESA) confirmed the
10th DHF death this year [2007] in the state, the latest in
Fortaleza. According to the weekly dengue bulletin published by SESA,
[dengue] deaths have been confirmed in Sobral (3 [deaths]), Juazeiro
del Norte (2), Caucaia (1), Salitre (1), Quixada (1) and Camocim (1).

Of an additional [27] suspected DHF deaths being investigated, 16 have
been registered in Fortaleza. The others occurred in Amontada (1),
Caninde (1), Caucaia (2), Itapipoca (2), Maracanau (2), Pacajus (1),
Taua (1) & Tejucuoca (1).

This year [2007] there has been notification of 631 DHF cases, of
which 284 have been [laboratory? Mod. TY] confirmed. This is the
greatest number of cases since 2003, when 291 cases were documented.
Up to the present [in 2007], 40 255 cases of classical dengue fever
have been registered in 182 of Ceara's 184 municipalities. Of these,
23 595 have been confirmed in 166 municipalities. The 1st dengue case
in Ceara occurred in 1986.

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

[The state of Ceara has been living with dengue for 10 years, and
unhappily the number of deaths has tended to increase. - Mod.LJS]

[It would be helpful to know if the case fatality rate has increased,
perhaps due to increased virus virulence or to problems with medical
management of DHF cases, or if there have been an increasing number
of DHF cases in the state. - Mod.TY]

[An interactive ProMED health map of Brazil showing the location of
states and cities including Ceara and Forteleza on the central
Atlantic coast, can be accessed at:
<http://healthmap.org/promed?v=-10.8,-53.1,4>. - Mod.TY]

******
[9] Brazil (Sao Paulo state)
Date: Sat 08 Dec 2007
Source: Cosmo On Line [in Portuguese, trans. & summ. Mod. TY, edited]
<http://www.cosmo.com.br/cidades/campinas/integra.asp?id=214339>


Dengue [virus] transmission, which had a rapid interruption in
October [2007], returned to hit Campinas. Over 20 cases have been
confirmed in 2 dozen neighborhoods.

"The situation is really worrisome, mainly because many of these
localities [having dengue cases] are slum areas, with poor sanitary
conditions and many [mosquito] breeding sites, which facilitate an
explosion of [dengue] cases", said the municipal coordinator of
dengue control actions, Andreia Von Zuben.

According to her, the confirmed cases in November [2007] are isolated
[instances] of [dengue] transmission, but indicate theat the [vector]
mosquito is proliferating with or without dry spells or the
intensification of rains. The total numbers of dengue cases confirmed
serologically this year [2007] in Campinas is 5050. However, the
Office of Health Surveillance expects that there will be 13 000
[dengue] cases with 8000 serologically confirmed.

Andreia explained that an explosion of [dengue] cases are expected
this summer, and will [result in] implementation of "focal blockades."

The focal blockade consists of triggering all the control actions
within an area of 300 meters around the building where the confirmed
case occurred. This includes elimination of [mosquito] breeding sites
and treating [others] with biological larvicides (BTI [_Bacillus
thurengiensis_ serovar _israelensis_. - Mod.TY] in areas of water
accumulation which can not be removed. "BTI does not pose any danger
to human health in the elimination of mosquito larvae," she said.

Other blockade measures include fogging with insecticides, treatment
with larvacides at points of risk such as [vehicle] tire and scrap
metal yards; proactive new suspected case detection, and
investigation of [areas of] all cases in order to identify mosquito
breeding sites.

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40416

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, december 18 2007

Re: ProMed Dengue/DHF Updates, december 18 2007

Archive Number 20071218.4074
Published Date 18-DEC-2007
Subject PRO/EDR> Dengue/DHF update 2007 (49)

DENGUE/DHF UPDATE 2007 (49)
****************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] Cayman Islands update
[2] Brazil
[3] Indonesia (Java)
[4] Singapore

******
[1] Cayman Islands update
Date: Mon 17 Dec 2007
Source: Cay Compass [edited]
<http://www.caycompass.com/cgi-bin/CFPnews.cgi?ID=1027259>


The number of people confirmed to have had dengue fever in the Cayman
Islands since October [2007] stands at 8, while a further person is
presumed to have had the tropical disease, the Public Health
Department has reported. But public health officials are confident
the disease has not spread locally, as all 9 patients had recently
travelled to countries with outbreaks of dengue fever.

The 8 confirmed and one presumed cases come from a total of 59 people
tested for the disease since early October [2007]. The rest of those
tested for the disease have either returned a confirmed negative
result or are thought unlikely to have had the disease, the
department said.

Although the wet season is now drawing to a close, meaning the number
of dengue cases should drop across the region, Director of Public
Health Dr. Kiran Kumar said his unit will be keeping a vigilant eye
out for cases of dengue fever. "We know that this is a time when a
lot of people are travelling to other parts of the region that have
dengue fever, so we are asking anyone who returns and experiences
dengue fever-like symptoms to seek medical treatment," he said.

Mosquito Research and Control Unit Director Mr. Bill Petrie said the
MRCU is finding lower numbers of mosquitoes, including the potential
dengue vector, _Aedes aegypti_ on Grand Cayman because of recent dry
weather.

Speaking Thursday morning [13 Dec 2007], he said there could be an
upswing of mosquito numbers in Cayman in the coming week, depending
on how much rain the remnant low passing over Cayman Thursday and
Friday [13 and 14 Dec 2007] brought. "I think we will see a general
increase in mosquito numbers but nothing massive," he said. "We have
larvicide pellets down already that are still active. That will give
us some measure of protection," he said.

"Making predictions about the weather these days is fraught with
danger, but our slow season for mosquitoes in typically from New
Year's onwards,'" he explained.

But Mr. Petrie pointed out that some other countries in the region
have continued to experience wetter conditions than the Cayman
islands have in the past month. This could have implications for
Cayman, he said. It might happen, that come the first few weeks of
the New Year [2008], we may see some more imported cases of dengue
fever from people travelling for Christmas and then returning to
Cayman," he said. "We have a contingency place in plan for that, in
case it does happen," he said.

Imported cases of dengue fever in the Cayman Islands over the past 2
months come at a time when parts of the Caribbean and Latin American
are experiencing some of the worst outbreaks of dengue fever in
decades. Although dengue fever is not endemic to the Cayman Islands,
hurricane Ivan in 2004 spawned a 1300 percent increase in the
population of _Aedes aegypti_ mosquitoes, a potential dengue fever
[virus] vector.

[Byline: James Dimond]

--
Communicated by:
ProMED Rapporteur Brent Barrett

[The Cayman Island health authorities are extremely well prepared to
deal with imported dengue fever virus, and recognize the risk of
importation during the holiday season just getting underway. They are
to be commended for their efforts at prevention of dissemination of
dengue virus from the imported cases they have had so far this year
(also see archive 20071112.3670).



******
[2] Brazil
Date: Thu 13 Dec 2007
Source: Atarde [in Portuguese, trans. & summ. Mod.TY, edited]
<http://www.atarde.com.br/brasil/noticia.jsf?id=815415.>


Dengue [virus] has infected 536 000 [people] this year [2007], the
government announced.
------------------------------------------------------------------------------

Yesterday [12 Dec 2007] the Ministry of Health announced the national
dengue [case] figures for 2007 up to November. The national case
figures registered for this disease were 536 519 for this period,
with 1275 of them DHF cases. Of these, 136 died. Compared with last
year [2006] there was an increase of 200 000 cases, which was
attributed to the occurrence of epidemics in Mato Grosso do Sul,
Parana, Rio de Janeiro and Pernambuco.

The summary noted that the case fatality rate for DHF increased. This
year [2007], it reached 10.7 percent, practically double that of 2002
(the year of Brazil's largest epidemic of this disease), or 5.5
percent; in that same year the number of deaths was greater (150)
when there were 2714 DHF cases. According to the Ministry of Health,
44 percent of [this year's] cases occurred in cities with less than
100 000 inhabitants. Cities with more than 1 million people
constituted 14 percent of the cases.

[According to] the 2nd parameter [incidence] of the National Dengue
Control Program, by regions, states or municipalities those
classified as low incidence were those with less than 100 cases per
100 000 inhabitants. Those with medium incidence had between 100 -
300 cases per 100 000 inhabitants. Those areas considered to be at
high risk were those with an incidence greater than 300 [cases] per
100 000 inhabitants. The region with the worst record was the
Central-West, which registered 811 cases per 100 000 inhabitants,
with Mato Grosso do Sul having a concentration of 68 percent of the
notifications.

In the other regions, the Northeast registered 26 percent of the
cases nationally and the North region, with 46 012 cases, had the
lowest absolute number. The Southeast had an increase of 35 percent
in the number of cases compared to last year [2006]. The South, with
a increase of 827 percent this year over 2006, registered the
greatest increase between the 2 years due to the epidemic in Parana.
Rio Grande do Sul registered its 1st autochthonous dengue case
(confirmed by the presence of a [dengue virus] infected mosquito in
the state) with transmission in April, 2007. Santa Clara is the only
state which continues without autochthonous dengue [virus]
transmission.

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

An interactive ProMED map of Brazil, show the various states and
cities, can be accessed at:


******
[3] Indonesia (Java)
Date: Sat 15 Dec 2007
Source: Surya Online [in Indonesian, trans. & summ., edited]
<http://www.surya.co.id/web/index.php?option=com_content&task=view&id=29396&Itemid=89>


[As reported in archive no. 20071217.4062, since January 2007 until
last Monday (10 Dec 2007), there were reported more than 2000 dengue
fever cases in Jepara, Java. There also is a concurrent chikungunya
epidemic going on there.

An interactive map of Java, Indonesia, can be accessed at
http://encarta.msn.com/map_701513466/Java_(island).html. - Mod.TY]

******
[4] Singapore
Date: Tue 18 Dec 2007
Source: Channel Asia [edited]
<http://www.channelnewsasia.com/stories/singaporelocalnews/view/318076/1/.html>


A total of 13 construction workers have been infected with dengue
[virus]. They have been working at a construction site at the
junction of East Coast Road and Lorong N Telok Kurau.

It is the 2nd construction site which has recorded 10 or more cases
of dengue this year 2007.

Of the affected workers, 4 live near the construction site. Workers
at the site said their colleagues had been sent to Tan Tock Seng
Hospital and they have since recovered. They added that the workers
might return to work in the next 2 days. The workers also said that
officials from the Health Ministry and the National Environment
Agency have searched the site, but apparently could not find any
mosquito breeding ground.

--
Communicated by:
ProMED Rapporteur Brent Barrett

[An interactive ProMED HealthMap of Singapore can be accessed at:
<http://healthmap.org/promed?v=1.4,103.8,6>. Mod. TY]

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40512

 

[Gert van der Hoek]

Re: ProMed Dengue/DHF Updates, december 27 2007

Archive Number 20071227.4147
Published Date 27-DEC-2007
Subject PRO/EDR> Dengue/DHF update 2007 (50)


DENGUE/DHF UPDATE 2007 (50)
****************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] St. Barthelemy, St. Martin/St. Maarten
[2] Venezuela (Zulia and national)
[3] Venezuela (Carabobo)
[4] Philippines (Cebu)
[5] Indonesia (Central Java)

******
[1] St. Barthelemy, St. Martin/St. Maarten
Date: Tue 18 Dec 2007
Source: Woodshed Environment [edited]
<http://woodshedenvironment.wordpress.com/2007/12/18/dengue-kicks-up-in-sm-and-st-barths-again/>


Following a meeting on St. Barths [St. Barthelemy] on 3 Dec 2007 to
assess the dengue situation there, the working committee of experts
on infectious diseases and the Institut de Veille Sanitaire (IVS) of
French St. Martin have declared St. Barths and St. Martin in an
"epidemic alert phase."

Meanwhile Health authorities on Dutch St. Maarten announced on 27 Nov
2007 that the country was on a "pre-alert phase" for dengue in the
wake of lab confirmations of 18 cases on that day. The authorities
put out a cautionary note that the situation could turn into an
"epidemic phase" if all criteria for observation and tests were met.

French St. Martin health officials noted that the number of suspected
clinical as well as confirmed biological cases [presumably laboratory
confirmed. - Mod.TY] to and exceeded the pre-alert phase between
September and the end of November [2007]. They would not reveal the
total number of suspected cases they now have. But they did say that
9 cases, 7 adults and 2 children, were hospitalized. One of the
confirmed cases may well have progressed to the DHF stage of the
disease. There was no word of a DHF confirmation for that case. Based
on the history of this dengue event, it would be expected that all of
the patients were stricken with the dengue 1 virus serotype, the
predominant virus type on St. Martin. [Are other dengue virus types
in circulation there, as well? - Mod.TY]

The Dengue situation on St. Barths has been even more dramatic with a
sharp increase in suspected dengue in the last 2 weeks --
[epidemiological] weeks 47 and 48. By the very last week of that
month, the best estimate of suspected dengue on St. Barths was 50
cases. Several of them have been confirmed biologically, of these, 2
were reportedly in serious condition. It was unclear as to which
[dengue virus] serotype is in circulation on St. Barths.

At the beginning of the month [December 2007], the country was in the
pre-alert phase. This profile could well change as French experts
embark on a dengue review. Of the other adults with classic dengue, 5
were deemed to be severe, while the 6th was filed under serious.

Back on mainland St. Maarten, this time on the Dutch side, Health
Commissioner Maria Buncamper-Molanus has acknowledged, in essence,
that the dengue outbreak there is worsening. She has admitted that
the 18 cases they have recorded in the past 11 months is the highest
ever, even though slightly, since [the time that] data has been
collected and kept. And the numbers are climbing still on account of
the physician sentinel protocol already in place. St. Maarten has a
commitment from 7 physicians who issue weekly reports on communicable
diseases, including dengue, to the Health Commissioner.

A fogging exercise in conjunction with a public awareness campaign
has since gotten off the ground on the Dutch side. The focus of the
awareness campaign is to provide the public with detailed information
on what they should do to prevent the proliferation of the dengue
vector, the _Aedes aegypti_ mosquito.

The Dutch St. Maarten Hygiene and Veterinary Department is also
charged with the responsibility of doing contact tracing, which
entails the inspection of the living quarters and general premises of
the persons diagnosed with the disease and their immediate
neighbourhoods. Commissioner Buncamper-Molanus provided the rationale
for this saying that the public awareness programme "will have a
positive effect, as far as reducing the chances of further spreading,
but the public has to take the necessary action. We cannot
underestimate the importance of the public's role in keeping this
disease from spreading. It is we, the people of St. Maarten, who have
the biggest positive effect in stopping the spread of this disease."

[Byline: Israel]

--
Communicated by:
ProMED Rapporteur Brent Barrett

[A map of St. Maarten/St. Martin can be accessed at:
<http://www.stmaarten.org/Resources/images/martmap.gif> and a map of
St. Barthelemy at:
<http://graphicmaps.com/webimage/countrys/namerica/caribb/stbarts.htm>.
- Mod.TY]

******
[2] Venezuela (Zulia and national)
Date: Tue 25 Dec 2005
Source: Panorama, Venezuela [in Spanish trans. & summ. Mod. TY, edited]
<http://www.panodi.com/panodi/386422.html>


The number of people in Zulia ill [from dengue virus infection]
increased from 8181 in 2006 to 18 405 so far in 2007. Preventive
action is urged. The mosquito [_Aedes aegypti_] is adapted to the
urban environment and does not distinguish among social classes.

In 2007, 77 269 cases of classical dengue fever and DHF were
registered, an increase of 94 percent, which classified the disease
as epidemic, according to information from the Ministry of People's
Power for Health [MPPH]. The dengue cases in Zulia represent 24
percent of the national total and dengue increased 125 percent in the
region [over 2006]. The World Health Organization considers that [the
current epidemic] is related to the El Nino phenomenon.

Of the total of 77 269 dengue cases registered nationally, 18 405 are
in Zulia [state], a number which reflects more than double the cases
with occurred in Zulia last year [2006] during the same period.

According to the data provided by the Directorate General of
Epidemiology, Zulia leads in the number of dengue cases in the
country in marked contrast to the following states: Miranda (5.584
cases), Guarico (4.938) y Anzoategui (4.419). All [these] have been
declared dengue epidemic states.

The simultaneous presence of distinct [dengue virus] serotypes in a
given region increase the risk of possible outbreaks of DHF, of which
Zulia also has the greatest number: 1346 cases [of DHF] of a national
total of 6145.

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

[Like much of tropical Latin America this year, Venezuela appears to
be experiencing a serious dengue epidemic. It would be interesting to
be able to plot the distribution, and if possible movement, of the
various dengue virus types throughout the western hemisphere this
year. Molecular epidemiological analysis could provide a powerful
tool to track that movement, the accompanying changes in the viruses
over time and changes in virulence associated with those changes.

A map of Venezuela showing the states mentioned can be accessed at:
<http://www.lib.utexas.edu/maps/americas/venezuela.gif>. - Mod.TY]

******
[3] Venezuela (Carabobo)
Date: Tue 18 Dec 2007
Source: El Nacional [in Spanish trans. & summ. Mod.TY, edited]
<http://www.el-nacional.com/www/site/detalle_noticia.php?q=nodo/7534>


The most recent figures indicated that in Carabobo state 2750 dengue
cases have been reported, of which 2420 are positive [presumably
laboratory confirmed. - Mod. TY] and 35 await results.

The Governor of Carabobo, Luis Felipe Acosta Carlez, indicated that
the community councils, health committees, PSUV members,
communication media and other public and private institutions must
incorporate themselves in a united front to fight dengue. He issued
this call due to the increase in dengue [cases] and said that he
considers that, "the fight against dengue requires the participation
of all the organized sectors."

Atypical climatic conditions which have affected the entire country
have increased the breeding sites of _Aedes aegypti_, the mosquito
that transmits [dengue virus] in diverse communities in Carabobo,
mainly in the zone north of Valencia's where the greatest number of
[dengue] cases have occurred.

The Governor indicated that printed and audiovisual materials are
available for orientation about the prevention of dengue, treatment
and care of [patients] which this disease deserves. In coming days,
the Carabobo Health Institute will strengthen the [dengue] preventive
campaign in the 14 municipalities of the state and activate the
telephone number so that cases can be reported and the foci of cases
attacked more efficiently.

Humberto Trejo, President of the Health Corporation of Aragua,
although unable to indicate the exact number of dengue cases,
estimates that there have been at least 3000 dengue cases in the
entire state this year [2007]

He indicated that the 5 deaths due to dengue (4 were children) in the
state were caused by dengue [virus] 2, considered by the authorities
to be the most aggressive [virulent] and erratic with a tendency to
rapidly change [from dengue fever] into DHF. Comparing this year
[2007] to 2001, [he said], "there were more [DHF?] cases this year
because [in 2001] the virus was dengue 3, so the mortality [rate] was
not so high". [Because there are significant differences in virulence
both within and among dengue virus serotypes, these types of
generalizations oversimplify relationships of virus type and severity
of disease. Unfortunately there is no satisfactory animal model that
mimics human disease to explore virulence of different dengue virus
types and isolates. - Mod.TY]

Trejo does not discard the proliferation of the mosquito vector of
dengue [virus] _Aedes aegypti_ due to drinking water scarcity, which
obligates citizens to store water in kegs in an inadequate way so
that they become mosquito breeding sites.

Since July [2007], when the epidemiological alert began due to the
increase in [dengue] cases, health authorities have developed plans
to combat the _Aedes aegypti_ mosquito. The [authorities] activated
the plan "Operation Cachivache" which consists of community
elimination of all types of trash which could serve as mosquito breeding sites.

Trejo indicated that "we have achieved important successes related to
the prevention of the disease, although problems continue in the
zones of greatest human population, such as the municipalities south
of Maracay. The jurisdictions where the greatest concentration of
[dengue] cases are found continue to be Girardot and Marino.

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

******
[4] Philippines (Cebu)
Date: Fri 21 Dec 2007
Source: News Balita Ph [edited]
<http://news.balita.ph/html/article.php?story=20071221202225239>


At least 48 deaths were attributed to mosquito-borne dengue fever in
this city this year [2007], with 101 more residents falling ill
because of the virus, health officials said.

As of 18 Dec [2007] the City Health Department recorded a total of 48
deaths in Cebu City.

There were 1946 cases recorded from 1 Jan - 18 Dec [2007]. Despite
the continuous increase in the number of cases, the Cebu City Dengue
Task Force decided not to heed the mayor's suggestion of pouring used
oil into a suspected breeding site of dengue-carrying mosquitoes in
Barangay Labangon [a barangay is a defined neighborhood. - Mod.TY].

Instead of using used oil, the City Health Department and the task
force will use chlorine or larvacide, whichever is more effective and
economical and safer to use. Assistant City Epidemiologist Durinda
Macasoncol said the task force advised against the use of used oil
after sanitary inspectors visited the lagoon in Labangon.

The lagoon, measuring some 1.4 hectares [3.46 acres], is suspected to
be the major breeding site of mosquitoes in Labangon, which has the
highest number of dengue cases among all 80 barangays.

"We were supposed to pour used oil in the lagoon but it did not push
through because we learned it could be harmful to the ecosystem.
We're still studying what is the more effective and economical way of
doing it, either we use chlorine or larvicide," Macasocol said.

The lagoon, which was originally a deep excavation for a building the
Gaisanos planned to build, will also have to be drained, she said.
But Cebu City Mayor Tomas Osmena was irked upon knowing the task
force did not heed his order to pour used oil on the pond and
threatened to fire personnel in charge of the campaign against dengue
fever. "My God, we already lost 50 lives and they're talking about
saving the earth," Osmena said.

Although pouring used oil in the lagoon will kill the mosquitoes,
Masacol said they opted not to push through with the mayor's
suggestion because it will only be good for one to 2 days. "Whatever
we put there, it will only be good for a couple of days because the
water continuously flows out of the lagoon. We are studying this so
we can come up with something that has long-term benefits," Macasocol added.

--
Communicated by:
ProMED Rapporteur Brent Barrett

[This is an example of inappropriate action being proposed by a
political leader based on incomplete or inaccurate information. While
the lagoon may indeed be a breeding ground for mosquitoes, it is
highly unlikely that the dengue virus vector mosquito, _Aedes
aegypti_, is breeding there. _Ae. aegypti_ requires fresh water
catchments, usually in and immediately around houses and other
buildings. Efforts at control of dengue virus transmission should be
aimed at these _Aedes aegypti_ breeding sites. This report
illustrates the need for scientists to work closely with policy
decision makers, and for both to engage the public in elimination of
these mosquito vector breeding sites in their houses and other buildings.

A map of the Philippine provinces showing Cebu Province can be
accessed at: <http://www.chanrobles.com/philippinemapofprovinces.htm>
and an interactive ProMED health map showing the location of Cebu
City within the province can be accessed at:
<http://healthmap.org/promed?v=11.7,122.9,5>. - Mod.TY]

******
[5] Indonesia (Central Java)
Date: Fri 21 Dec 2007
Source: Suara Merdeka [in Indonesian, trans. & summ., edited]
<http://suaramerdeka.com/harian/0712/21/nas12.htm>


The Health Service of Central Java (DINKES) released the dengue fever
(DBD) data from January up until December 2007; there were 11 636
inhabitants infected including 217 people who died.

The DINKES head, Dr. Hartanto, mentioned that the number of people
who had dengue from 2006 only reached 10 924, including 220 who died.

The incidence of dengue cases in Central Java during January-November
2007 was 4.95 per 10 000 inhabitants, higher when compared with 2006,
which was 3.37 per 10 000 inhabitants. Thus, numbers of dengue cases
over the past 2 years have increased.

The spread of the [dengue] epidemic was greatest in 35 regencies in
the city. In [case] mapping by the Health Service, the epidemic area
currently spreads in 33 regencies of the city except Banjarnegara and
Wonosobo. This does not mean that Banjarnegara and Wonosobo have been
completely dengue free. Although there were some infected people, the
case number did not reach the numbers for epidemic status, he continued.

With the current spreading, the epidemic area was no longer in the
urban areas such as Semarang City, Solo, Salatiga, Kota Tegal, Kota
Pekalongan, and the Magelang City. However, currently the rural areas
have not escaped breeding of _Aedes aegypti_ mosquitoes.

Dr. Hartanto said that the eradication of the dengue could not only
rely fogging or fumigation as these actions only killed mature
mosquitoes, not larvae. Therefore, community efforts with the 3M
approach was needed: drain [water catchments], close breeding sites,
bury [articles than can hold water], and completely clean out larval
mosquitoes.

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

http://www.promedmail.org/pls/askus..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,40646