Typhoid confirmed in Mozambique (and Malawi)

[alert]

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Something is wrong. There has been no news for this outbreak in over a month. I would think that was because the outbreak was over, but I just found this. It is almost a month old, but this is inconsistent with everything above, both symptomatically, and in terms of the spread and distribution of cases. 26 new cases in one week is not an outbreak that is under control. And typhoid fever is not a neurological disease. Perhaps there was a compound outbreak here. Or perhaps this is a bad source.

I would appreciate anyone posting anything they can find on this outbreak, no matter how old or how poor the source. I am having trouble finding much of anything now. This outbreak has been going on for nearly five months, with CDC investigation underway for nearly three months. This is truly bizarre. Perhaps someone should call the CDC for more information. Is the outbreak still ongoing? Do we have new case/death counts? What has been detected/ruled out? Is the CDC team still in the area?

http://www.nationmw.net/newsdetail.asp?article_id=3453

Neno disease: 26 new cases registered
by NATION REPORTER (8/25/2009)

The mysterious Neno disease continues to rage in the areas of traditional authorities Dambe on the Malawi side and Tsangano in Mozambique with 26 new cases registered last week alone, the Ministry of Health has disclosed.
The disease, that was first reported in May this year, has so far killed at least 17 people, nine from Malawi and eight from Mozambique.
Secretary for Health Chris Kang’ombe Sunday said government is administering typhoid fever drugs to patients because most of them have symptoms of the disease.
"We still have the problem there. The signs and symptoms are mainly those of typhoid fever," said Kang’ombe.
He said there is need to improve people’s living conditions to combat the disease.
"People live in houses that have no windows and they live with their animals. There is also poor water supply," said the PS.
Five American health specialists arrived in the country last month to investigate the outbreak and worked with local authorities.
A Mozambican health official also told BBC’s Focus on Africa programme on Thursday that tests on the strange disease are being run in Malawi, Mozambique and at the United States Centre for Disease Control.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Finally. More news. The insertion of the word "HIV" may or may not be from the translator. I would appreciate it if anyone who speaks Portuguese would give their input. They may be talking about illness in people who already have HIV (is this an opportunistic infection?), or it may simply be a mistranslation.

Note the increase to 145 cases, which seems like only three cases in the past month, with no additional deaths. The "neurological" signs that were not clear in above posts have now been clarified as psychological symptoms.

Another article that suspects this is airborne - but only three cases in a month?? That doesn't seem like airborne. Unless it only affects people with HIV...

http://www.translate.google.com/tra...px?ReportId=86367&sl=pt&tl=en&history_state0=

MOÇAMBIQUE: Doença misteriosa deixa seropositivos mais vulneráveis

MOZAMBIQUE: HIV Disease mysteriously leaves the most vulnerable

Photo: Lucas Bonanno/PlusNews Photo: Lucas Bonanno / PlusNews
Serviços médicos limitados em Moçambique fazem doentes buscarem hospitais no Malauí Medical services are limited in Mozambique are patients seeking hospitals in Malawi
TSANGANO, 30 Setembro 2009 (PlusNews) - Uma doença misteriosa já matou 20 pessoas, entre elas seropositivos, no distrito de Tsangano, região noroeste do país, próxima à fronteira da província de Tete com o Malauí. Tsangano, 30 September 2009 (IRIN) - A mysterious disease has killed 20 people, including HIV, Tsangano district, northwest of the country near the border of the province of Tete to Malawi. Entre os óbitos, nove são moçambicanos e 11 malauianos. Among the deaths, nine are Mozambicans and Malawians 11.

A doença, que se suspeita tratar de “encefalite viral”, foi diagnosticada em 145 pacientes - 40 moçambicanos e 105 malauianos - nos últimos três meses em Tsangano. The disease, suspected case of "viral encephalitis", was diagnosed in 145 patients - 40 Mozambicans and Malawians 105 - the last three months in Tsangano. O surto foi iniciado em Maio passado, mas o primeiro caso só foi registado em Julho, na aldeia de Mwenjate (em Tsangano), a 60 km quilómetros da fronteira com o Malauí, onde abundam imigrantes malauinanos. The outbreak started in May, but only the first case was recorded in July in the village of Mwenjate (in Tsangano), 60 km kilometers from the border with Malawi, where immigrants abound malauinanos.

“Até então desconhece-se a etiologia [estudo das causas] da doença e também não podemos avançar com exactidão o número de seropositivos entre os óbitos. "So far it is unknown etiology [study of the causes] of the disease and also can not move forward with certainty the number of deaths among HIV-positives". Ainda estamos a trabalhar para apurarmos os dados sobre as mortes e os detalhes da doença”, disse ao PlusNews, Luísa Cumba, directora provincial da saúde (DPS), da província de Tete. We are still working to establish data on deaths and the details of the disease, "he told IRIN, Luisa Cumba, provincial director of Health (DPS), the province of Tete.

As autoridades de saúde em Tete adiantam que a doença tem vários sintomas associados: dor de cabeça, febre alta, dificuldades respiratórias, rigidez dos membros, diarreias, vómitos e evolui para perturbações psicológicas. Health authorities in Tete submit that the disease has many symptoms: headache, high fever, breathing difficulties, stiffness of the limbs, diarrhea, vomiting and progresses to psychological disorders.

Devido à falta de resposta médica contra o surto, alguns doentes moçambicanos estão a receber tratamento no Hospital rural de Neno, no Malauí. Due to lack of medical response against the outbreak, some patients are Mozambicans receiving treatment at the Hospital of rural Neno, Malawi.

A povoação de Mwenjate tem uma única unidade sanitária, que não é capaz de responder ao surto da doença, admitiu Cumba. The village of Mwenjate has [only one] facility, which is not able to respond to the outbreak of the disease, admitted Cumba.

Contaminação Contamination

As formas de transmissão da doença ainda são desconhecidas, mas há suspeitas desta propagar-se por meio de contacto interpessoal, pelo ar. The forms of transmission of the disease are still unknown, but there are suspicions that spread through interpersonal contact and by air.

“Suspeitamos que a doença transmita-se por via respiratória. "We suspect that the disease is transmitted by respiratory route. A rápida propagação da doença é devido às más condições higiénicas da população. The rapid spread of the disease is due to poor hygienic conditions of the population. Muitos ficam aglomerados em cabanas devido ao frio, o que aumenta a probabilidade de contágio”, explicou Cumba. Many are crowded into huts due to cold, which increases the likelihood of contagion, "said Cumba.

Uma equipe médica foi deslocada para socorrer a população, através de um “tratamento aleatório” dos doentes. A medical team was moved to assist the population through a "random treatment" of patients. Os casos mais graves são referidos para o hospital malauiano. The most serious cases are referred to the hospital Malawi.

A mesma equipe está igualmente a desenvolver uma campanha de higiene individual e colectiva entre a população. The same team is also developing a campaign of individual and collective hygiene among the population.

Tratamento Treatment

Cumba explicou que actualmente os casos diagnosticados estão sendo tratados com simples antibióticos. Cumba explained that currently diagnosed cases are being treated with simple antibiotics.

“Dificilmente podemos identificar o tratamento sem a etiologia da doença. "We can hardly identify the treatment without the etiology of the disease. Mas guiando-se pela suspeita, estamos a tratar todos os casos com antibióticos”, disse. But while referring to the suspect, we treat all cases with antibiotics, "he said.

Uma equipe médica do Centro de Controlo e Prevenção de Doenças dos Estados Unidos (CDC em inglês) deslocou-se em Agosto para investigar a doença. A medical team of the Center for Control and Prevention in the United States (CDC in English) went in August to investigate the disease.

“O CDC tem grande experiência e especialistas na identificação e mitigação de etiologias de doença. "The CDC has extensive experience and experts in the identification and mitigation of disease etiologies. Esperamos a qualquer altura os resultados da sua investigação para definitivamente podermos lidar com ela”, concluiu Cumba. We at any time the results of its investigation to finally be able to handle it, "he said Cumba.

ac/cb ac / cb


Tema(s): (IRIN) Cuidados/Tratamento, (IRIN) PVHS/ONGs Theme (s): (IRIN) Gender Issues, (IRIN) HIV / NGOs

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Here is a second translation of the same article. The issue seems to revolve around the word "seropositivos", which the first translator translates as HIV-positive people, whereas the second one simply does not translate it.

Seropositive simply means that you tested positive for an illness, but it seems to be being used idiomatically to mean HIV. It clearly does not mean positive for the mystery illness, as we don't know its etiology.

Either way, someone should send this to ProMed, as it is the first news on this outbreak in well over a month.

http://babelfish.yahoo.com/translat...px?ReportId=86367&lp=pt_en&btnTrUrl=Translate

MOÇAMBIQUE: Mysterious illness leaves seropositivos more vulnerable

Photo: Lucas Bonanno/PlusNews
Limited medical services in Moçambique make sick people to search hospitals in the Malauí
TSANGANO, 30 September 2009 (PlusNews) - a mysterious illness already killed 20 people, between seropositivos them, in the district of Tsangano, region the northwest of the country, next to the border to the province of Tete with the Malauí. Between the deaths, nine are moçambicanos and 11 malauianos.

The illness, that if suspicion to deal with “viral encefalite”, was diagnosised in 145 patients - 40 moçambicanos and 105 malauianos - in last the three months in Tsangano. I occasion it was initiated in passed May, but the first case alone was registado in July, in the village of Mwenjate (in Tsangano), the 60 km quilómetros of the border with the Malauí, where immigrant malauinanos abundam.

“Until then it is unaware of etiology [study of the causes] of the illness and also we cannot advance with exactidão the number of seropositivos between the deaths. Still we are to work to select the data on the deaths and the details of the illness”, said to the PlusNews, Luísa Cumba, provincial directora of the health (DPS), of the province of Tete.

The authorities of health in Tete advance that the illness has some symptoms associates: high fever, migraine, respiratory difficulty, rigidity of the members, diarreias, vomit and evolves for psychological disturbances.

Due to lack of medical reply I occasion against it, some moçambicanos sick people are to receive treatment in the agricultural Hospital from Neno, in the Malauí.

The population of Mwenjate has an only sanitary unit, that it is not capable to answer I occasion to it of the illness, admitted Cumba.

Contamination

The forms of transmission of the illness still are unknown, but it has suspicion of this to spread by means of interpersonal contact, for air.

“We suspect that the illness is transmitted for saw respiratory. The fast propagation of the illness must to the bad higiénicas conditions of the population. Many are accumulations in huts due to the cold, what it increases the probability of I infect”, explained Cumba.

A medical team was dislocated to help the population, through a “random treatment” of the sick people. The cases most serious are related for the malauiano hospital.

The same team is equally to develop a campaign of individual and collective hygiene between the population.

Treatment

Cumba explained that currently the diagnosised cases are being treated with simple antibiotics.

“Hardly we can identify the treatment without the etiology of the illness. But guiding itself for the suspicion, we are to treat all the cases with antibiotics”, said.

A medical team of the Prevention and Control center of Illnesses of the United States (CDC in English) dislocated itself in August to investigate the illness.

“the CDC has great experience and specialists in the identification and mitigação of illness etiologies. We wait to any height the results of its inquiry definitively to be able to deal with it”, concluded Cumba.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

It's not a translation error - this article has been picked up by a Portuguese AIDS blog here:

http://criasnoticias.wordpress.com/...teriosa-deixa-seropositivos-mais-vulneraveis/

So apparently this outbreak does have something to do with HIV/AIDS. I can understand now why this outbreak has taken over five months to diganose. Perhpas this is a new opportunistic infection, or perhaps an unusual presentation of HIV?

 

[Emily]

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Alert, this article might shed some light on what's happening. Closing the Day Hospitals would expose the HIV patients to more diseases at the general hospitals, and it sounds like some abruptly lost access to their anti-retroviral drugs. I don't know enough about HIV protocols to know, but I wonder if dropping the medications suddenly could trigger a neurological disorder?

http://allafrica.com/stories/200908031502.html
Maputo ? Hundreds of HIV-positive Mozambicans and their supporters marched through the streets of Maputo on Monday in protests against the decision by Health Minister Ivo Garrido to close the "Day Hospitals" that catered exclusively for HIV/AIDS patients.

They marched for two kilometres down one of Maputo's main thoroughfares, Eduardo Mondlane Avenue, singing and waving placards against the measure, in force since March 2008. The march ended at the Health Ministry, where a message was delivered to Garrido.

"We want to express our indignation at the closure", said Cesar Mufaniquice, coordinator of the Movement for Access to Anti-Retroviral Treatment in Mozambique, who read out to the crowd the message delivered to the Minister.

There used to be 23 Day Hospitals, operating out of health units across the country. In March 2008, Garrido ordered their closure, and the integration of HIV/AIDS patients into ordinary hospitals. At the time, the Minister argued that the Day Hospitals were counter-productive, because they worsened the stigma against HIV-positive people, and became "foci of discrimination".

But the AIDS activists say that this was a mistake, and that in reality they are suffering more stigma now than previously. Furthermore, when they are mixed with patients sufferings from other diseases, they find that the health professionals do not have the patience to care for them appropriately.

They say that with the transfer to normal hospitals, medical files have gone missing, which has led to several HIV-positive patients interrupting the life-prolonging anti-retroviral treatment.

Others say that, although they are receiving treatment, this is far below the level of care at the Day Hospitals, where they had benefited from personalised treatment, and had been able to accompany, step by step, progress in their viral load.

The activists accuse Garrido of failing to consult with anybody about the advantages and disadvantages of the measure. They called him "a dictator, because he decided to close the Day Hospitals without prior consultation with civil society, or with the patients, and much less with the medical staff".

Speaking to AIM, Percina Narsone of the DREAM programme of the Italian NGO, the Sant'Egidio Community, one of the main organisations providing anti-retroviral therapy, said that the closure of the Day Hospitals had made the problem of access to anti-retrovirals more serious, particularly for those patients transferred from the Day Hospitals to the ordinary hospitals.

"The patient has no information about his health status, and often the medical staff don't have it either", she said.

Worse still, the state-of-the-art molecular laboratory that the DREAM programme used to run in Maputo Central Hospital, which carried out tests on patients' viral loads, has been closed. Currently the tests are done abroad, with longer delays and thus less efficiently.

DREAM has been able to keep its own Day Hospitals operating, but their managers do not know what their future will be. Many AIDS patients have been trying to join the DREAM programme, but some have been turned away because the programme managers do not know how long it will continue.

"The Day Hospitals were a genuine centre of excellence, a centre of human dignity", said the message to Garrido.

After receiving the message from the activists, the Minister said it was always his intention and that of the government to care for sick people, and never to damage their interests.

Garrido said that in 2005 there were just 6,000 HIV-positive people receiving treatment in 12 Mozambican health units. Now the number had risen to over 145,000 patients treated in more than 200 units.

"In the shift from 6,000 to over 140,000 patients, it's normal that problems happen", said Garrido. He promised that his team will continue to care for HIV-positive people, and will work to find a solution to the problems raised by the activists.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Maybe, but that really doesn't fit the epidemiology on this one. This outbreak is confined to two villages (I hope), with about a 15% attack rate in each village and a little under a 15% CFR within days. If this were related to some change in HIV medication, one would expect to see much wider spread with a much lower attack rate (and probably a lower CFR, as even without treatment, HIV takes years to kill).

It is conceivable that this is some opportunistic infection, and that 15% of the population in those villages is HIV positive.

The article gives no justification for why HIV is suspected to be involved at all, so it is tough to make a judgment at this point.

 

[Emily]

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

I think you are right - that does look like clusters of pretty uniform symptoms. Maybe the HIV link is the vulnerability like you said.

It is conceivable that this is some opportunistic infection, and that 15% of the population in those villages is HIV positive.

http://allafrica.com/stories/200906120678.html
"Maputo ? The Mozambican government regards the HIV prevalence in the south of the country as "alarming", since the incidence of the virus is much higher than the national average of 16 per cent among Mozambicans aged between 15 and 49.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

There are many agents that can cause some pretty bizarre neurological illnesses in AIDS patients (cytomegalovirus (CMV), for example) that typically do not affect immunocompetant people.

This could be another one, or even just a cluster of a known one, aggravated by the high concentration of HIV-positive people in the two villages.

We know that 145 people took ill, and 20 of them are now dead. Very few, if any, cases had onset after about 8/15, so anyone who is still ill has been ill for six weeks. Have the other 125 people recovered? There has been no indication in any of the articles whether they ahve recovered, or are still ill. An opportunistic infection like this in AIDS patients would likely have a very low recovery rate.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

. And typhoid fever is not a neurological disease.

http://en.wikipedia.org/wiki/Typhoid

I just did a closer look into the symptoms of typhoid above. Actually, typhoid is a pretty good fit for this outbreak. The story went dead well over two months ago, and I had assumed that it was an unknown agent and had been contained. The other possibility here is that this was a typhoid fever outbreak, and was cured (by the antibiotics), with the outbreak ending in late August. But why did is take six weeks to diagnose? And why didn't we get a confirmation?

As no credible source (that AIDS blog was a weak/biased source for several reasons) has come out since August 17, I doubt I will hear any more on this outbreak, but it is nice to have another possibility other than novel agent.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

TYPHOID CONFIRMED!!!!!!!!

http://translate.google.com/transla...h?q=tsangano&hl=en&lr=&tbo=p&num=20&tbs=qdr:w

Tsangano: febrile syndrome of undetermined origin / Typhoid
O distrito de Tsangano situa-se a norte da prov?ncia de Tete e ? limitado a Norte Pelo distrito de Ang?nia e Malawi, a Sul pelo distrito de Moatize e Changara, a Este pelo Malawi e Oeste pelos distritos de Macanga e Ang?nia. Tsangano The district is located north of Tete province and is bordered on the north by district Ang?nia and Malawi to the south by the district of Moatize and Chang, east and west by Malawi in the districts of Macanga and Ang?nia. Possui uma popula??o de 170.796 habitantes. It has a population of 170,796 inhabitants.

N?o existe registo de ocorr?ncia de surtos naquela comunidade contudo, a 29 de Junho de 2009, foi reportado pelo Malawi ao Minist?rio da Sa?de de Mo?ambique a exist?ncia de casos de doen?a desconhecida na aldeia de Dackson. There is no record of outbreaks in that community, however, on 29 June 2009, was reported by the Malawi Ministry of Health of Mozambique, the existence of cases of unknown disease in the village of Dackson. Os mesmos estavam a ser tratados no Hospital Distrital de Neno no Malawi devido as raz?es descritas acima. They were being treated in Neno District Hospital in Malawi due to the reasons described above.

A doen?a era caracterizada por febres, dores de cabe?a, dores de barriga, rigidez da nuca, dores das costas, dificuldade em caminhar, dificuldade em falar entre outros sintomas. The disease was characterized by fever, headaches, stomach pains, stiff neck, back pain, difficulty walking, difficulty with speech and other symptoms. Estes sintomas levaram a suspeitar de v?rios diagn?sticos entre eles: Mal?ria, Meningite, Tifo epid?mico, envenenamento qu?mico e Encefalite viral. These symptoms led to suspicion of various diagnoses including: Malaria, Meningitis, Epidemic typhus, chemical poisoning and viral encephalitis. Contudo, os resultados laboratoriais n?o possibilitaram a confirma??o dos diagn?sticos acima eo tratamento era sintom?tico e deferenciado para os diversos pacientes. However, the laboratory results did not allow confirmation of the above diagnostics and treatment was symptomatic and deference to other patients. Por outro lado, po facto da doen?a ser autolimitada dificultou na identifica??o do diagn?stico. On the other hand, that he be self-limited disease difficult to identify the diagnosis.

V?rias equipas com elementos do Minist?rio da Sa?de, Direc??o Provincial de Sa?de de Tete com apoio da Organiza??o Mundial da Sa?de (OMS) e do Centro de Controlo de Doen?as de Atl?nta (CDC) em Mo?ambique estiveram envolvidos na investiga??o deste surto. Several teams with elements of the Ministry of Health, Provincial Health Tete with support from the World Health Organization (WHO) and the Center for Disease Control in Atlanta (CDC) in Mozambique were involved in the investigation of this outbreak. Actualmente sabe que este sindrome febril se trata de febre tifoide. Now know that this syndrome is fever of typhoid.

 

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Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

There are several other links at that site, indicating that the outbreak is ongoing with more deaths, but it has been confirmed as typhoid. It took a whopping FOUR MONTHS to confirm!!1

 

[alert]

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Re: Outbreak of mystery illness in Mozambique (and Malawi)

Would someone please add the words "- Typhoid confirmed" to the title of this thread?

And send that last article to ProMed. They posted two RFIs on this outbreak under undiagnosed fatalities. Nice to see that the CDC confirms this after all.

A lot of us (both FT members and reporters in source above) made some really bad potential diagnoses. Several of the above sources seemed to imply that this was an airborne viral encephalitis. That would be 0-for-3 - not airborne, not viral, not encephalitis.

 

[alert]

Re: Typhoid confirmed in Mozambique (and Malawi)

http://www.bernama.com/bernama/v5/newsworld.php?id=456947

Typhoid Outbreak In Mozambique's Western Province

MAPUTO, Nov 21 (Bernama) -- Typhoid fever, which has a high lethality rate if it is not treated immediately, has struck 111 people in Tsangano district in the western Mozambican province of Tete, the Mozambique News agency (AIM) reported citing a local daily.

So far, 17 people died after having contracted the disease.

Ministry of Health spokesperson Leonardo Chavane told reporters that this disease spreads due to poor hygiene and infected water.

"It also will spread through faecal contamination," Chavane said, adding that teams of health workers are now in Tsangano, educating the local population on how to treat water so that it becomes safe to drink, and on the hygiene measures necessary to avoid infection.

As for the Mozambican outbreak of swine flu, Chavane said the situation is stationary.

Over the past week, a further two suspected cases were identified, bringing the total to 130.

However, only 57 cases have been confirmed, and to date there have been two deaths.

 

[alert]

Re: Typhoid confirmed in Mozambique (and Malawi)

http://allafrica.com/stories/200911200959.html

Mozambique: Typhoid Outbreak in Tete
20 November 2009

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Maputo ? The supposedly mysterious disease that has been claiming victims in Tsangano district, in the western Mozambican province of Tete, has been identified as typhoid fever, reports Friday's issue of the Maputo daily "Noticias".

The disease has struck an area near the Malawian border. 111 people are known to have contracted it, 17 of whom have died.

The disease was identified after a joint investigation by medical teams from Mozambique, Malawi and the United States Centre for Disease Control (CDC).

Explaining the findings of the teams, Ministry of Health spokesperson Leonardo Chavane told reporters that typhoid has a high lethality rate, particularly when it is not treated immediately.

Because poor hygiene and infected water spread the disease through faecal contamination, teams of health workers are now in Tsangano, educating the local population on how to treat water so that it becomes safe to drink, and on the hygiene measures necessary to avoid infection.

As for the Mozambican outbreak of swine flu (or, to give it its scientific name, H1N1 influenza), Chavane said the situation is stationary. Over the past week, a further two suspected cases were identified, bringing the total to 130.

However, only 57 cases have been confirmed, and to date there have been two deaths.

 

[alert]

Re: Typhoid confirmed in Mozambique (and Malawi)

And finally the Google news source posts what we at FT have known for a month (and the CDC apparently knew for two months): This outbreak was typhoid. I suspect ProMed will now pick this up and resolve their undiagnosed fatalities RFIs from this summer.

And to correct the confusion in cases counts: The 17 deaths in 111 cases are only in Mozambique - they do not include the cases in Malawi. That's why earlier reports had higher numbers.

 

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Re: Typhoid confirmed in Mozambique (and Malawi)

And the last article generates a ProMed EAFR report. Finally. Notably, the related links do not include the two undiagnosed fatalities postings on the main server from July; I don't think ProMed realizes yet that this is the same outbreak - it just took four months to confirm.

http://eafr.promedmail.org/

ProMED-EAFR:East Africa

View printable version
Published Date
2009-11-23 01:37:51
Subject
PRO/EAFR> Typhoid fever - Mozambique: (Tete) conf
Archive Number
20091123.203864
Full Text
TYPHOID FEVER - MOZAMBIQUE: (TETE) CONFIRMED
********************************************
Date: Fri 20 Nov 2009
Source: All Africa.com, AIM (Mozambique Information Agency) report
(Mozambique) [edited]
http://allafrica.com/stories/printable/200911200959.html


Mozambique: typhoid outbreak in Tete
------------------------------------
The supposedly mysterious disease that has been claiming victims in
Tsangano district, in the western Mozambican province of Tete, has
been identified as typhoid fever, reports Friday's [20 Nov 2009]
issue of the Maputo daily "Noticias".

The disease has struck an area near the Malawian border. 111 people
are known to have contracted it, 17 of whom have died. The disease
was identified after a joint investigation by medical teams from
Mozambique, Malawi, and the United States Centre for Disease Control
(CDC).

Explaining the findings of the teams, Ministry of Health spokesperson
Leonardo Chavane told reporters that typhoid has a high lethality
rate, particularly when it is not treated immediately.

Because poor hygiene and infected water spread the disease through
faecal contamination, teams of health workers are now in Tsangano,
educating the local population on how to treat water so that it
becomes safe to drink, and on the hygiene measures necessary to avoid
infection.

--
Communicated by:
ProMED-EAFR


[This outbreak of typhoid in Tsangano district, Tete province,
highlights the need to improve local capacity for conducting field
epidemiology investigations including lab confirmation as well as
improving hygiene and access to safe water.

Tsangano province is located in Tete province in western Mozambique,
on the border with Malawi, and can be located on the map at
http://www.un.org/Depts/Cartographic/map/profile/mozambiq.pdf and
the HealthMap/ProMED-mail interactive map at
http://healthmap.org/r/00Ab. - Mod.JFW]


[see also:
Typhoid fever - Uganda (03): (Bukwo) conf 20090825.201422
Typhoid fever - Uganda (02): (Bukwo) 20090818.201314
Typhoid fever - Uganda: (Bukwo) susp 20090720.200669]


[For additional background information on typhoid, available from the
general ProMED-mail list, the postings below can be found at
http://www.promedmail.org. - Mod.JFW]


[Typhoid fever update 2009 (01) 20090710.2472
Typhoid fever - USA: (TN) cluster 20090608.2120
2008
----
Typhoid fever update 2008 (08) 20081229.4095
Typhoid fever update 2008 (07) 20081118.3640
Typhoid fever update 2008 (06): Canada (BC) ex India 20081026.3386
Undiagnosed illness, fatal - Uganda: (KS), typhoid susp. 20080814.2524
Typhoid fever update 2008 (05): Philippines 20080312.0999]
...................................jfw/mj/be

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[alert]

Re: Typhoid confirmed in Mozambique (and Malawi)

This story refuses to go away. This is a ProMED EAFR post. Of note is that ProMED Main still has not issued a confirmation of the undiagnosed fatalities post that started this thread, SEVEN months ago.

http://eafr.promedmail.org/

Published Date
2010-02-14 12:36:24
Subject
PRO/EAFR> Typhoid fever - Malawi: (Southern Region)
Archive Number
20100214.205519
Full Text
TYPHOID FEVER - MALAWI: (SOUTHERN REGION)
*****************************************



Date: Fri 12 Feb 2010
Source: The Daily Times (Malawi) [edited]
http://www.bnltimes.com//content/view/2115/26/

Neno district has registered 15 more cases and 2 deaths of typhoid
fever in the month of January [2010], a new report released by Neno
District Health Officer has indicated. According to the report, the
increased number of deaths was due to people's late coming to the
hospital for medical attention.

Statistics show that a total of 425 cases with 43 deaths have been
reported from both Mozambique and Malawi. "Cumulatively, a total of
425 cases with 43 deaths have been reported from 24 villages (8 in
Mozambique and 16 in Malawi)," the report states.

It says out of the 425 cases, 289 are from Malawi while Mozambique
registered 136 cases. On the deaths, Malawi registered 26 cases
cumulatively while Mozambique had 17 cases.

Some of the affected villages in Malawi are Mtemankhawa,
Chiyembekeza, Moffat, Kalimedzako, Phambala, Chakhumbira, Kaingilira,
while Mozambique has villages such as Chinjobvu, Mchenga, Nkudzu,
Domwe and Tsangatsanga.

"There are more new cases being reported in Mozambican villages, but
communication and transport problems are hindering reporting of the
cases. There is need for active case surveillance within the new
villages also," the report says.

The report, however, indicates that intensive health education and
promotion is continuing despite rains and poor terrain. The disease
was treated as mysterious until medical experts from the United
States of America came to the country and established that the
disease was typhoid fever.

[Byline: Theresa Chapulapula]

--
Communicated by:
ProMED-EAFR


[This is another of the many cross-border outbreaks, with the current
one occurring at the Malawi-Mozambique border. The outbreak was 1st
confirmed in November last year [2010] (see ProMED-EAFR posting
20091123.203864) and was attributed to poor hygiene and fecal
contamination of water sources in the affected areas. The ongoing
health education campaigns need to be focused to address the poor
health care seeking behavior so as to reduce the number of deaths].

A map of Malawi showing the regions can be seen at
http://en.wikipedia.org/wiki/Regions_of_Malawi and the
HealthMap/ProMED interactive map of the country is available at
http://healthmap.org/r/017c. - Mod.JFW]

 

[alert]

Re: Typhoid confirmed in Mozambique (and Malawi)

http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/SVAN-83WLNL-full_report.pdf/$File/full_report.pdf

[snip]

Typhoid fever
outbreak in Neno and Tsangano districts: As of 8 March 2010, a cumulative
total of 466 cases with 43 deaths (CFR: 9.2%) have been reported
since the onset of the disease (5th May 2009). In total, 25 villages have
been affected among them 16 in Malawi and 9 in Mozambique*.