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Published Date: 2008-11-18 11:00:35
Subject: PRO/EDR> Dengue/DHF update 2008 (50)
Archive Number: 20081118.3636

DENGUE/DHF UPDATE 2008 (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>

In this update:
[1] India (West Bengal)
[2] India (Punjab)
[3] Pakistan (Punjab)
[4] Indonesia (Java)
[5] Malaysia (Pahang)
[6] Viet Nam
[7] American Samoa
[8] Dominican Republic
[9] Bolivia (Pando)
[10] Africa, Asia, India, South America

******
[1] India (West Bengal)
Date: Wed 12 Nov 2008
Source: The Statesman [edited]
<http://www.thestatesman.net/page.arcview.php?clid=10&id=257191&usrsess=1>

Dengue has surfaced in Jalpaiguri. The virus has been detected in a
boy today [12 Nov 2008] following blood tests, causing tension in the
district. The district health department has been alerted and
preparations are on to meet any adverse situation. The CMOH [chief
medical officer of health] Jalpaiguri, Mr Malay Ghosh, said "We are
keeping a watch on the surrounding areas of Hakimpara, the
neighbourhood from where the dengue patient hails. We would also take
necessary steps to prevent fresh cases of dengue in the district."

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Interactive maps of West Bengal, showing the location of Jalpaiguri
can be accessed at
<http://www.maplandia.com/india/west-bengal/jalpaiguri/>
and the HealthMap/ProMED-mail map at
<http://healthmap.org/promed/en?g=1269388&v=26.517,88.733,5>. - Mod.TY]

******
[2] India (Punjab)
Date: Tue 11 Nov 2008
Source: Express India [edited]
<http://www.expressindia.com/latest-news/dengue-outbreak-bathinda-health-officials-inspect-jail/383858/>

Fearing that dengue might grip Bathinda Central Jail, a team of
district health officials, led by civil surgeon Dr Neelam Bajaj,
today [11 Nov 2008] visited the prison and instructed the staff to
adopt precautionary measures.

The Health Department has been on tenterhooks due to a large number
of dengue cases reported in the city. "In Bathinda city alone, 10
confirmed cases have been reported and about 100 are suspected
cases," said district epidemiologist, Dr MS Gill, adding that the
number of confirmed cases in the district stood at 205 till date [up
to 11 Nov 2008].

Notably, the required machine for dengue treatment in Bathinda
hospital had developed a snag and could be made operational only in
mid-October [2008], before which patients were forced to go to Ludhiana.

"Today's [11 Nov 2008] visit was aimed at spreading awareness in the
jail, where dengue [mosquito virus vector] larvae were found a few
days ago," said Dr Bajaj. She said, "There was a suspected case of
dengue in the jail, which later tested negative. The inmate had a fatty liver."

Meanwhile, the Health Department carried out fogging inside the jail.
"We do not want to take chances. Even if it is viral fever, I have
instructed the jail's medical officer to conduct a test for dengue as
well," said Bathinda Jail superintendent captain LS Jakhar.

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

[It is not clear what the dengue treatment machine mentioned above
is. Perhaps it is a machine for diagnostic purposes, such as PCR
(polymerase chain reaction) or ELISA (enzyme-linked immunosorbent
assay) tests. Interestingly, there is a dengue outbreak across the
border in Pakistan (see the next item in this post).

Interactive maps showing the location of Bhatinda in Punjab,
northwestern India, can be accessed at
<http://www.maplandia.com/india/punjab/bathinda/bhatinda/>
and the HealthMap/ProMED-mail map at
<http://healthmap.org/promed/en?g=1276070&v=30.2,74.95,7>. - Mod.TY]

******
[3] Pakistan (Punjab)
Date: Wed 12 Nov 2008
Source: The Post (Lahore) [edited]
<http://thepost.com.pk/Arc_MainNews.aspx?bdtl_id=13444&fb_id=2&catid=14&date=11/12/2008&fcatid=14>

In the Punjab capital, Lahore, the number of the dengue fever
[cases], an infectious [virus] disease of the tropics transmitted by
mosquitoes and characterized by rash and aching head and joints, has
[reached] up to 684 with 91 fresh cases reported on Tuesday [11 Nov 2008].

According to the latest reports, at least 684 patients of dengue
fever have been admitted to different hospitals including 91 fresh
cases in Sir Ganga Ram Hospital in the metropolis. A report pointed
out that only 20 percent [of the] area could be sprayed against the disease.

The Institute of Public Health in its latest report has confirmed the
dengue virus in the blood of 91 patients who have been admitted to
the Ganga Ram Hospital. Dr Ranjha declared 50 areas of the Lahore
City as dangerous for dengue virus.

He stated that the northern city areas were the most dangerous for
dengue virus [transmission], while Farooq Gunj, Misri Shah, Ghorray
Shah, Chahmiran, Badr Colony, Shaadbagh, Sanda, Ravi Road, Choburji,
Baghbanpura, Gujjarpura Township, and Guwalmandi are also included in
the dangerous list.

In different hospitals, special seminars have also been organized to
make [staff] aware of the dengue attack.

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

[The dengue outbreak in Lahore continues, with the number of cases
increasing from 437 in a 7 Nov 2008 report (ProMED-mail archive no.
20081111.3545) to 684 in the current report, above.

A map of Pakistan showing the location of Punjab state can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/pakistan_pol_2002.jpg>
Lahore can be located on the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/promed/en?g=1172451&v=31.55,74.344,7>. - Mod.TY]

******
[4] Indonesia (Java)
Date: Mon 17 Nov 2008
Source: Pikaran Rakyat Online [in Indonesian, machine trans., edited]
<http://www.pikiran-rakyat.com/index.php?mib=news.detail&id=43258>

The Health Office of Banyumas Regency, Central Java, has classified
the status of the dengue fever outbreak as an extraordinary event. In
the outbreak, the number of dengue cases has increased [by a factor
of 2] from the previous year [2007]. Up until mid-November [2008]
there have been 551 cases recorded with 5 deaths. The budget for
[mosquito insecticide application] to control the dengue outbreak was
exhausted a month ago.

The head of the health service of Banyumas, Gempol Suwandono, said
that the outbreak was classified as an extraordinary event because
there are increasing cases that are twice those of months or years
earlier. In 2007 the number of cases was not more than 241 with 2
deaths. "This year [2008] there are increasing cases by more than 100
percent, hence the extraordinary event status of our state as a
dengue outbreak in the region of Banyumas," said Gempol Monday (17 Nov [2008]).

According to Gempol, of the 5 victims who died, 2 died this month
[November 2008]. The victims were residents Pekunden Village,
Banyumas and Sokaraja Kidul. The victims died due to the late
treatment, as patients come to health centers or hospitals when they
are in serious condition.

In the near future the health service will be fogging or fumigating
in a number of locations or environments where there are dengue
outbreak cases, but acknowledged the funds for the fogging budget for
2008 have been out since a month ago. The agency has to apply for
additional funds from the Banyumas regional government.

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

[This situation illustrates the difficulty in dealing with financing
of emergency response measures for unexpected outbreaks. Budgets are
prepared months in advance, often long before the time when it
becomes apparent that there is an emergency situation. The demands
for funding of socially important programs always exceed the funding
available in developing countries.

A map of Indonesia showing the location of Java can be accessed at
<http://encarta.msn.com/map_701513466/java.html>
The HealthMap/ProMED-mail interactive map of Indonesia can be accessed at
<http://healthmap.org/promed/en?g=1650095&v=-3.6,109.6,5>. - Mod.TY]

******
[5] Malaysia (Pahang)
Date: Wed 12 Nov 2008
Source: NST Online [edited]
<http://www.nst.com.my/Current_News/NST/Wednesday/National/2399481/Article/index_html>

Stricter enforcement and better cooperation from the public have
helped reduce the number of dengue fever cases in the state this year
[2008] by more than 55 percent.

As of 8 Nov [2008], only 1044 cases were recorded, compared with 2338
cases within the same period last year [2007].

Only one death was reported this year [2008] compared with 4 fatal
cases throughout the corresponding period last year [2007].

State health director Datuk Dr Rosnah Ismail said 54 percent of the
dengue fever cases were reported in Kuantan and Temerloh.

"We are focusing on these 2 areas to reduce the number of cases
further," she said at the presentation of "Free from Dengue" badges
to boy scouts from 23 schools [in Kuantan] yesterday [11 Nov 2008].
The students received the badges from Menteri Besar Datuk Seri Adnan Yaakob.

Dr Rosnah said health officials had checked a total of 423 699
premises in the state this year [2008] and found 5276 to contain
dengue mosquito breeding grounds.

"Our records show that 90 percent of the victims were infected with
dengue fever at home," she said, adding that only 30 percent sought
treatment within 3 days of having the fever.

She said the delay in getting treatment would lead to complications
and, in some cases, the victims could succumb to the disease.

Such a delay could also spread the disease, as the victims could be
bitten by other _Aedes_ mosquitoes, which would transfer the virus to
others in the neighbourhood.

On the boy scouts, Dr Rosnah said a special dengue eradication
programme involving the youth was introduced at 3 schools [in
Kuantan] in 2006. She said the boy scouts acted as agents to help
people become more aware about the disease and take action to stop it
from spreading. They also check premises and destroy potential
breeding grounds for the _Aedes_ mosquitoes.

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

[The effective use of boy scout volunteers to find _Aedes_ mosquito
breeding sites and educate the public presents an interesting model
for dengue prevention and control that may be useful in other places.

Interactive maps showing the location of Pahang state and Kuantan
city an be accessed at
<http://www.travelpost.com/AS/Malaysia/Pahang/Kuantan/map/2820657>
and the HealthMap/ProMED-mail map at
<http://healthmap.org/promed/en?g=1735227&v=3.8,103.333,7>. - Mod.TY]

******
[6] Viet Nam
Date: Tue 11 Nov 2008
Source: Thanh Nien News [edited]
<http://www.thanhniennews.com/healthy/?catid=8&newsid=43611>

Dengue fever claims 69 lives in southern region
-----------------------------------------------
The Ho Chi Minh City Pasteur Institute said yesterday [10 Nov 2008],
20 southern cities and provinces have seen a total of 69 deaths from
58 635 dengue fever cases this year [2008].

HCMC [Ho Chi Minh City] has seen 11 648 cases, followed by Ca Mau
Province with 6655, and Dong Nai Province with 5744.

Binh Duong Province has seen 10 fatalities, the highest in the
country, from a total of 3916 dengue fever patients.

The number of cases and deaths is smaller compared to the same period
last year [2007], but figures are expected to rise in the remaining
months of the year.

[Byline: Quang Minh Nhat]

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

[The outbreak of dengue fever is spreading further in Viet Nam with a
reported increase in dengue fever cases and fatalities from the
southern provinces of Ho Chi Minh City, Ca Mau, Dong Nai, and Binh Duong.

A recent dengue fever outbreak occurred in Nghi Xuan District of Ha
Tinh Province, where 54 cases were reported (see prior PRO/MBDS
posting Dengue - Viet Nam (17): Ha Tinh 20081111.3550).

For maps of Viet Nam with provinces, see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg> and
<http://www.angelfire.com/co/hongnam/vnmap.html>.
The HealthMap/ProMED-mail interactive map of Viet Nam can be accessed
at <http://healthmap.org/promed?v=14.9,108.5,5>.
This map shows other outbreaks in Viet Nam and surrounding countries
that have been reported on ProMED-mail and PRO/MBDS. The postings can
be directly accessed through this map. - Mod.YMA]

******
[7] American Samoa
Date: Thu 13 Nov 2008
From: Alice E Hadley <ahadley@guam.net>

American Samoa's dengue count has risen to 400 confirmed cases since
January 2008 with our emergency room and various other clinics at our
hospital and outlying health centres being swamped daily with people
seeking advice and treatment for dengue-like symptoms and for dengue
follow-up treatment, which includes platelet count and intravenous
fluids if needed.

To date we have one dengue related death, a 10-year-old boy. Ages [of
dengue patients] range from the youngest being 2-years-old and the
oldest being 73-years-old. There has been little to zero travel
associated with this outbreak since it began in January of this year
[2008], with the only travel associated with a couple of participants
from the Festival of Pacific Arts earlier this year.

We are still waiting for typing confirmation from Hawaii from samples
that were sent out earlier this month [November 2008]. Weekly health
updates from the Department of Health continue with also television
reminders regarding our island's 3D campaign:
- Dress appropriately when outdoors,
- Drain all standing water that accumulates in containers and,
- DEET -- use of an insect repellant containing this mosquito repellant.

[Prepared by:
Sharmain Edwards
Surveillance Nurse ASG Dept Health
<sharmain@doh.as>]

--
Alice E Hadley, MLS, AHIP(D)
Medical Library
US Naval Hospital, Guam
<ahadley@guam.net>

[ProMED-mail thanks Alice Hadley for forwarding this report and
Sharmain Edwards for preparing it.

Interactive maps of the South Pacific islands, including American
Samoa, can be accessed at <http://www.mapsouthpacific.com/pacific/index.html>
and the HealthMap/ProMED-mail map at
<http://healthmap.org/promed/en?g=5880801&v=-14.333,-170,5>. - Mod.TY]

******
[8] Dominican Republic
Date: Mon 17 Nov 2008
Source: El Nacional [in Spanish, trans. & summ. Mod.TY, edited]
<http://www.elnacional.com.do/article.aspx?id=63295>

Large mounts of trash that could cause an outbreak of dengue
hemorrhagic fever [DHF] have accumulated in the locality of Villa
Altagracia [San Cristobal province] after the Secretariat for the
Environment and Natural Resources closed a trash dump, which for 2
months operated provisionally at km 57 of the Duarte highway, while
the municipal council sought other locales for the dump. There is no
more space available in the provisional dump and the open spaces for
dumping of trash have been sealed. Garbage is accumulating because
the municipal council has yet to find a new site.

In Bonao City [Monsenor Nouel province] DHF as affected some 12
people thus far this month [November 2008], most of whom are minors.

The main centers for medical assistance [in the city] have recorded
an increased number of people [with dengue], most of whom have
required referral to the Santo Domingo and Santiago [health] centers.

[Byline: Fausto Antonio Genao, Tony Brito]

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

[Interactive maps of the Dominican Republic showing the location of
Villa Altagracia can be accessed at
<http://www.maplandia.com/dominican-republic/san-cristobal/villa-altagracia/>
and Bonao at
<http://www.maplandia.com/dominican-republic/monsenor-novel/bonao/>.
The provinces of San Cristobal and Monsenor Nouel can be seen on the map at
<http://www.lib.utexas.edu/maps/americas/dominican_republic_pol_04.jpg>
The HealthMap/ProMED-mail interactive map showing the location of the
Dominican Republic in the Caribbean can be accessed at
<http://healthmap.org/promed/en?&g=3491953&g=3511235&v=18.633,-70.25,5>.
- Mod.TY]

******
[9] Bolivia (Pando)
Date: Fri 14 Nov 2008
Source: Periodista Digital, Agencia EFE report [in Spanish, trans. &
summ. Mod.TY, edited]
<http://www.periodistadigital.com:80/salud/object.php?o=1027670>

The Bolivian government issued an alert today [14 Nov 2008] that
there is a dengue outbreak in the city of Cobija, capital of the
northern part of the Amazonian Pando department [state or province
equivalent. - Mod.TY] and on the border with Brazil, the director of
epidemiology, Juan Carlos Araya announced.

"We have reports of 17 cases of classical dengue in Cobija and 2
suspected cases of DHF, which are under control, receiving specific
treatment in the hospital," said Araya in a press conference in La
Paz [administrative capital of Bolivia. - Mod.TY]

The official explained that today [14 Nov 2008] a unit of the
Epidemiological Service, headed by an entomologist, left to work in
Cobija and in Puerto Rico, the other locale in Pando affected by the
[dengue] outbreak.

"They are working hard. They have now intervened in Puerto Rico and
Cobija, and today [14 Nov 2008], 2 pickup trucks from the central
area are taking more equipment, more adulticides and larvicides," he added.

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

[Cobija, capital of the department of Pando, is located on the border
of the Brazilian state of Acre, not far from its capital, Rio Branco.
The presence of _Aedes aegypti_ in small towns in regions with sylvan
yellow fever [virus] is extremely worrisome (Cobija has 25 000
inhabitants). - Mod.LJS]

[Los Tiempos.com of 14 Nov 2008 (in Spanish,
<http://www.lostiempos.com/noticias/14-11-08/14_11_08_ultimas_nac10.php>)
reported that to date during 2008 there have been 1252 confirmed
cases of classical dengue nationally, according to the official
epidemiological report.

A map showing the location of Pando department and Cobija in northern
Bolivia, can be accessed at
<http://www.lib.utexas.edu/maps/americas/bolivia_pop_1971.jpg>.
The HealthMap/ProMED-mail interactive map of Bolivia is available at
<http://healthmap.org/promed/en?g=3919998&v=-11.033,-68.733,5>. - Mod. TY]

******
[10] Africa, Asia, India, South America
Date: Fri 14 Nov 2008
From: Aravinda de Silva <aravinda_desilva@med.unc.edu>

With respect to the recent dengue cases reported in West Africa, I am
intrigued to learn that it is [dengue virus type 3] DENV-3. We have
demonstrated that DENV-3, genotype III viruses are native to the
Indian subcontinent and East Africa (see Messer, et al. Emerging
Infectious Diseases 9(7): 800-9; available at
<http://www.cdc.gov/NCIDOD/EID/vol9no7/03-0038.htm>).

Others and we have shown that a new clade of DENV-3, genotype III has
moved into Latin America and is currently expanding in the South and
East Asia as well. This new clade is also linked to large epidemics
of dengue fever and DHF in Asia and Latin America.

I am most curious to learn if the cases in West Africa are also
caused by this new clade of DENV-3 that is emerging in many parts of
the world. We are happy to assist any groups interested in comparing
these viruses to other genotypes of DENV-3.

--
Aravinda de Silva, MPH, PhD
University of North Carolina at Chapel Hill
Department of Microbiology and Immunology
C.B. # 7290, M.E. Jones Room 720
Chapel Hill, NC 27599
USA
<aravinda_desilva@med.unc.edu>

[ProMED-mail thanks Dr de Silva for the interesting information about
the distribution of DENV-3 and the appearance and spread of the
genotype III clade. We hope that anyone having isolates of West
African DENV-3 will accept the offer for genetic analysis of these
isolates and contact Dr de Silva. - Mod.TY]

See Also