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Published Date: 2006-11-28 00:00:00
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2006 (47)
Archive Number: 20061128.3377

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2006 (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:
Africa
[1] Diarrhea, fatal - Namibia (Omusati)
[2] Cholera - Angola (Huila)
[3] Cholera - Zambia (Copperbelt)
Asia
[4] Cholera - China
Oceania
[5] Cholera-like illness - Australia (New South Wales)
Americas
[6] Shigellosis - USA (Wyoming)
[7] Cholera - Worldwide - WHO WER Notifications
******
[1] Diarrhea, fatal - Namibia (Omusati)
Date: Fri, 24 Nov 2006
From: Brent Barrett <salbrent@sbcglobal.net>
Source: New Era [edited]
<http://www.newera.com.na/page.php?id=221>

Opuwo has been struck by an acute diarrheal disease that has so far
killed at least 4 people. Some cases, according to a report by the
Epidemiology Division at the Opuwo Hospital, to the Permanent
Secretary of Health and Social Services Dr Kalumbi Shangula, have
been detected at Outapi in the Omusati Region.
Dr Shangula yesterday confirmed that acute gastroenteritis has been
reported in Opuwo with 22 cases officially known so far. The disease,
he said, could be caused by polluted water or other pathogens.
Depending on the source of the disease, the disease can be
infectious, he said.
Since 1 Nov 2006 when the first case is suspected to have been
brought for medical attention, 22 people including 3 Angolans were
admitted to the Opuwo hospital. Among the first cases reported was on
7 Nov from Otjimuhaka clinic, 140 km from Opuwo. Around the same
time, an increase in the disease's trend was observed.
Indications are that 2 people from the community died, with one of
them dying before reaching the hospital while the other 2 died in
hospital. A report said it was believed that the epicenter of the
disease is a village some 7 kilometers into Angola from the Namibian
border along the Kunene River, with sources across the river saying
one nurse had succumbed to a disease with similar signs and symptoms.
All cases had specimens taken and sent to both local and the Windhoek
National Institute of Pathology laboratories but cholera and typhoid,
which were suspected, were not isolated. From 4 laboratory specimens
sent to Windhoek, some tested positive for _Giardia lamblia_ and none
tested positive for cholera and typhoid.
An analysis of the situation indicates that 9 cases, which represents
35 percent, came from Opuwo although the report said it was not yet
clear whether the patents are coming from Opuwo or are just using the
Opuwo physical address while seeking medical attention. Two cases
are from Otuzemba, while other districts Oukongo, Onkankwa, Etilyasa,
Etapela, Omuhama, Okanguati, Ovinyange and Orokapare have reported 1
case each.
Although the most affected age is above 16 years, included are 2
children of less than 1 year of age. Four of the patients do not have
their ages indicated and the ages of those that died could not be
identified. The majority of the patients (14) are females with men
numbering 8.
[Byline: Michael Liswaniso]
--
Brent Barrett
Indianapolis, IN, USA
<salbrent@sbcglobal.net>
[Although giardiasis was found in some specimens, it is less likely
than cholera to cause fatal disease.
A map of Namibia shows Opuwo in the northwestern part of the country.
The provinces of Angola bordering on the region have had cholera
outbreaks. The map can be found at:
<http://www.1clickdirectory.com/pictures2/NAMIBIA%20MAP.jpg>
ProMED thanks Brent Barrett for the posting. - Mod.LL]
*****
[2] Cholera - Angola (Huila)
Date: Mon, 20 Nov 2006
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=489120>
At least 14 people died of cholera over the weekend, at Lubango's
Central Hospital south Huila province, the head of the provincial
department of Public Health and Control to Endemic Diseases, Felix
Januario, announced Mon, 20 Nov 2006.
He stated that the situation is worrying the local health
authorities, because in the aforementioned period 142 patients
affected by the disease were hospitalized. Januario pointed out the
non-observance of preventive measures, on the part of the population,
as the main cause of increase of cholera cases, mainly in the
provincial capital Lubango.
Tchioco, Mitcha and Mapunda wards, outskirts of the city, are
considered as the most critical in the spread of the disease,
although the districts of Chibia and Quilengues are the nidus of
infection.
--
ProMED-mail
<promed@promedmail.org>
[A map of Angola showing that Huila province can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>. -
Mod.LL]
******
[3] Cholera - Zambia (Copperbelt)
Date: Mon, 20 Nov 2006
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Times of Zambia (Ndola) [edited]
<http://allafrica.com/stories/200611201323.html>

Ministry of Health spokesperson Canisius Banda has disclosed that 85
more new cholera cases have been recorded in Chiengi district where 5
people have so far died of the disease.
Dr Banda said in an interview yesterday that the cholera center in
the area had continued to receive new cases and that the situation
had worsened hence the appeal by the ministry of Health to Government
to close the border between Zambia and the Democratic Republic of
Congo (DRC) in Chiengi and other parts of Luapula Province.
"The decision to close the border was arrived at in conjunction with
the ministry of Home Affairs following the deaths. Closure of borders
can happen anywhere as long as the move is done to save lives," he
said. Dr Banda also revealed that the Lusaka District Health
Management Team (LDHMT) had started carrying out sensitization
campaigns in areas prone to cholera outbreaks.
He named Chawama, Matero and Kanyama as some of the townships where
medical personnel had started the sensitization programs, saying the
ministry did not want to wait until people died.
--
ProMED-mail
<promed@promedmail.org>
[Chiengi is in the Copperbelt Province which has its northern border
with Congo DR. The province can be seen at:
<http://www.un.org/Depts/Cartographic/map/profile/zambia.pdf>. -
Mod.LL]
******
[4] Cholera - China
Date: Wed, 22 Nov 2006
From: ProMED-mail <promed@promedmail.org>
Source: Chinese Ministry of Health [translated by Mod. RY; edited]
<http://www.moh.gov.cn/newshtml/15794.htm>

Oct 2006 tally of the total incidence and fatality of cholera
nationwide for China [translated from the official MOH statistics of
China:
Cholera Incidence / Fatality
22 / 0
--
ProMED-mail
<promed@promedmail.org>
[No other information about these cases is given, such as whether
they are imported or not. - Mod.LL]
******
[5] Cholera-like illness - Australia (New South Wales)
Date: Wed, 22 Nov 2006
From: Brent Barrett <salbrent@sbcglobal.net>
Source: Australian Broadcasting Corp [edited]
<http://www.abc.net.au/news/newsitems/200611/s1795504.htm>

The New South Wales Health Department is warning against eating raw
whitebait after a possible outbreak of cholera in inner Sydney. Tests
are being carried out on 3 Sydney women who are showing symptoms of
cholera.
The women became ill after buying raw whitebait, which is believed to
have been sourced from China, from fish shops in the inner city over
the last few days.
The Health Department's director of communicable diseases, Dr Jeremy
McAnulty, says the women are being tested at Royal Prince Alfred and
Concord hospitals. Dr McAnulty says health officials are working with
food authorities to withhold the whitebait from sale.
"There have been 3 of these cases in a couple of days or so,
suggesting that it is not that uncommon to eat raw whitebait," he
said. "This was in the cooking process, so perhaps people sample it
while they're cooking, so I guess the message is because whitebait --
the whole fish -- can contain fish guts, there's the possibility they
can be contaminated with fish germs."
--
Brent Barrett
Indianapolis, IN, USA
<salbrent@sbcglobal.net>
[No new information regarding these cases has come forth. Cholera
itself is not an enteric fish organism but rather can contaminate the
fish itself. The etiology of these cases is still pending, as a
variety of other pathogens may cause an acute and profuse watery
diarrhea syndrome.
ProMED thanks Brent Barrett for this posting. - Mod.LL]
******
[6] Shigellosis - USA (Wyoming)
Date: Tue, 21 Nov 2006
From: Pablo Nart <pablo.nart@terra.es>
Source: Billings Gazette [edited]
<http://www.billingsgazette.net/articles/2006/11/21/news/wyoming/74-shigellosis.txt>

The number of people coming down with shigellosis, a gastrointestinal
infection caused by bacteria, has grown to at least 35 as of Mon, 20
Nov 2006, according to the Indian Health Service and the Wyoming
Department of Health.
The disease causes diarrhea, fever, stomach cramping, and sometimes
bloody stools, said Kelly Weidenbach, surveillance epidemiologist
with the Wyoming Department of Health. "A Shigella outbreak of this
size is considered rare in Wyoming," Weidenbach said.
At least 12 local children have been hospitalized over the past few
months because of the disease. Weidenbach said the majority of the
cases have been among elementary school-aged children.
--
Pablo Nart
<pablo.nart@terra.es>
[Since the infection can be spread with a very low inoculum of
organisms, shigellosis (unlike salmonellosis or cholera) can be
spread directly from person-to-person easily.
ProMED thanks Pablo Nart for this posting. - Mod.LL]
*****
[7] Cholera - worldwide - WHO WER notifications
Date: Fri, 24 Nov 2006
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Epidemiological Record [edited]
<http://www.who.int/wer/2006/wer8147/en/index.html>

Notifications of cholera received from 17 to 23 Nov 2006
---------------------------------------------------
Country / Dates / Cases / Deaths
Africa
Burundi / 30 Oct-12 Nov 2006 / 107 / 0
Tanzania / 2-29 Oct 2006 / 895 / 19
Americas
Canada / 15 Sep-6 Oct 2006/ 1(1i) / 0
(i) = imported cases
--
ProMED-mail
<promed@promedmail.org>
[ProMED would like more information regarding the imported Canadian
case of cholera including the serotype and country of origin. -
Mod.LL]

See Also