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Published Date: 2011-03-22 14:00:11
Subject: PRO/EDR> Measles update 2011 (05)
Archive Number: 20110322.0898

MEASLES UPDATE 2011 (05)
************************
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] Ukraine (Donetsk, 2010)
[2] India (Uttar Pradesh)
[3] Niger
[4] Congo DR (Maniema)
[5] Philippines (Central Visayas)
[6] Philippines (Cordillera)
[7] Australia (Queensland)
[8] Chile (Santiago)
[9] USA (Minnesota)
[10] USA (California)

******
[1] Ukraine (Donetsk, 2010)
Date: Sat 12 Mar 2011
Source: Donetskye Novosti [in Russian, trans. Mod.NR, summ., edited]
<http://dnews.donetsk.ua/2011/03/12/5893.html>

Rise of measles incidence rate in 2010 - Ukraine (Donetsk Region)
-----------------------------------------------------------------
As a result of disruptions in vaccine supply the level of immunity of
children has declined. In 2010, 20 cases of measles were recorded in
the Donetsk Region, where no cases had been recorded since 2007,
according to Viktor Denisenko chief public health physician of the
Donetsk region.

According to Viktor Denisenko another reason for the increase in
infectious diseases in the Donetsk Region, especially in the case of
measles in children is the negative attitude of the population to
vaccination. "Only 32 percent of our the population is convinced of
the need for vaccination."

--
Communicated by:
ProMED-RUS
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[A large outbreak of measles was registered in Ukraine in 2006, when
more than 4000 people contracted measles. Immunization against measles
and rubella in Ukraine planned for 2008 had to be abandoned following
the tragic death of a teenager in Kramatorsk, who had been vaccinated
against measles and rubella with a vaccine produced in India. Although
this vaccine was withdrawn the effects of hostile anti-immunisation
propaganda in the Ukrainian press is still being felt. - Corr.VM]

[The HealthMap/ProMED-mail interactive map of Ukraine can be seen at
<http://healthmap.org/r/0BZA>. A map showing the location of the
Donetsk Region in eastern Ukraine can be accessed at
<http://www.globalsecurity.org/military/world/ukraine/images/ukraine-map-3.gif>.
- Mod.CP]

******
[2] India (Uttar Pradesh)
Date: Mon 14 Mar 2011
Source: The Times of India (TOI), Times News Network (TNN) [edited]
<http://articles.timesofindia.indiatimes.com/2011-03-14/allahabad/28687666_1_measles-chicken-pox-highly-contagious-viral-disease>

Childhood diseases increase in Allahabad
----------------------------------------
Hospitals [in Allahabad, Uttar Pradesh] have been flooded with over a
dozen fresh cases of measles and chickenpox every day. Health experts
are taking serious note of the prevailing situation and have asked
people to adopt precautions [for their own protection], and they have
issued some guidelines in this respect.

Senior medical officer for community health, Dr SAM Meesum, stated
that: "Measles is a highly contagious viral disease, which affects
mostly children.'' He said the 1st sign of measles is usually a high
fever, which begins about 10 to 12 days after exposure to the virus,
and lasts 4 to 7 days. "A runny nose, cough, red and watery eyes, and
small white spots inside the cheeks can develop in the initial stage.
After several days, a rash erupts, usually on the face and upper neck.
After 3 days, the rash spreads, eventually reaching the hands and
feet.''

There is no specific treatment for measles and most people recover
within 2-3 weeks. However, particularly in malnourished children and
people with reduced immunity, measles may even cause serious
complications, including blindness, encephalitis, severe diarrhoea,
ear infection, and pneumonia.

Measles can be prevented by immunisation, he said. Severe
complications from measles can be avoided though supportive care that
ensures good nutrition, adequate fluid intake, and treatment of
dehydration with WHO-recommended oral rehydration solution. This
solution replaces fluids and other essential elements that are lost
through diarrhoea or vomiting. Antibiotics should be prescribed to
treat eye and ear infections, and pneumonia, Dr Meesum said.

Chickenpox is a common illness among children. An itchy rash of spots
that look like blisters can appear all over the body and may be
accompanied by flu-like symptoms. Symptoms usually go away without
treatment, but because the infection is very contagious, an infected
child should stay at home and rest until the symptoms are gone, he
added.

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

[Measles and chickenpox are vaccine preventable mainly childhood
diseases. In India (at least until recently) only a single dose of
measles vaccine is administered at 9 months of age, rather than the 2
immunisations recommended elsewhere. Chickenpox virus vaccine is not
yet available In India.

The HealthMap/ProMED-mail interactive map of India is available at
<http://healthmap.org/r/0BZB>. A map of the states of India showing
the location of Uttar Pradesh can be accessed at
<http://www.mapsofindia.com/maps/india/indiastateandunion.htm>.
Allahabad can be located in the map of Uttar Pradesh at
<http://www.mapsofindia.com/maps/uttarpradesh/uttar-pradesh-district.htm>.
- Mod.CP]

******
[3] Niger
Date: Thu 10 Mar 2011
Source: Afrique en Ligne, Panafrican News Agency (PANA) report [in
French, trans., edited]
<http://www.afriquejet.com/afrique-de-l%27ouest/niger/niger-sante:-1.630-cas-de-rougeole-dont-un-mortel-enregistres-201103104380.html>

1630 cases of measles in Niamey
-------------------------------
As of 9 Mar 2011, 1630 cases of measles and one fatality have
occurred in Niger according to a report from the OCHA [UN Office for
the Coordination of Humanitarian Affairs] forwarded to PANA. According
to this report the most affected locality is Zinder region where there
have been 564 cases in Goure, 119 cases in Mirriah, 62 cases in
Tanout, and 62 cases in Magaria.

Last week [week of 1 Mar 2011], 94 cases of measles were registered
in comparison to 100 in the previous week according to the report. 289
cases have been recorded in Aguie in Maradi region, where the disease
still rages despite efforts during the past 3 weeks to contain the
outbreak. During the month of February [2011] a total of 403 cases
were registered, with 230 cases occurring in Aguie district.

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

[Local reports suggest that widespread malnutrition is a contributory
factor in this outbreak. Maps of Niger can be accessed at
<http://healthmap.org/r/008b>,
<http://www.mapsofworld.com/niger/maps/niger-map.jpg>, and
<http://en.wikipedia.org/wiki/Departments_of_Niger>. - Mod.CP]

******
[4] Congo DR (Maniema)
Date Mon 14 Mar 2011
Source: UN OCHA, ReliefWeb, UN Stabilization Mission in the
Democratic Republic of the Congo (MONUSCO) [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900sid/EGUA-8F2SU5?OpenDocument&RSS20&RSS20=FS>

Measles epidemic outbreak in southern Maniema
---------------------------------------------
More than 90 cases of measles were recently diagnosed in 3 health
centers in [southern] Maniema province. 3 people are reported to have
died from the epidemic. According to the Provincial Health Minister,
the territories so far affected are Kabambare, Kasongo, and Kibombo.
Medical personnel from different organizations have been meeting to
try and find ways to contain the disease. It has already reached
alarming proportions, according to Marie Claire Diwampovesa Nganzi, a
medical doctor specializing in epidemiology and Head of the World
Health Organisation (WHO) sub-office in Maniema. This, she said, can
now be described as a measles epidemic on a wide scale, and requiring
an immediate response from all relevant partners in the province.

The German Technical Cooperation Group (GTZ), through its support
project for the reinforcement of the health system -- known by the
acronym PARSS --, has already started providing care to affected
populations, while a team of the French NGO, Medecins sans Frontieres,
is busy assessing the exact extent of the epidemic.

A joint team from the UN Stabilization Mission in the DR Congo
(MONUSCO) regional office and UN agencies is preparing to visit the
affected area to help contain the epidemic.

[Byline: Matthieu Ilunga]

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

[The HealthMap/ProMED-mail interactive map of Congo DR can be seen at
<http://healthmap.org/r/0BZC>. Maps showing the country's regions and
departments can be accessed at
<http://www.maplibrary.org/stacks/Africa/Democratic%20Republic%20of%20Congo/index.php>.
- Mod.CP]

******
[5] Philippines (Central Visayas)
Date: Sun 20 Mar 2011
Source: Panay News, Philippine Information Agency (PIA) report
[abbreviated & edited]
<http://www.panaynewsphilippines.com/cebu%203.htm>

DOH buoys measles advocacy with new confirmed cases
---------------------------------------------------
The Department of Health 7 (DOH-7) has strengthened its campaign
against measles, a communicable disease, as 2 new cases were confirmed
in Central Visayas. The new cases brought to 7 the number of measles
cases in the region since January 2011. DOH-7 measles-rubella campaign
point person Dr Nayda Bautista said the 2 new cases came from 2
highly-urbanized cities in Cebu. "Outbreaks have already been declared
in the National Capital Region and in Regions 4, 9, and 11," Bautista
revealed.

Bautista however, said the incidence of measles in the region has
declined compared to last year's [2010] figure from January to
mid-March where there were 10 confirmed cases.

Due to the rising incidence of measles in some parts of the country,
the DOH is undertaking a one-month-long measles house-to-house
vaccination campaign for children less than 8 years old. Bautista said
they are targeting 1.4 million children to be vaccinated in the
region. The total target nationwide is 14 million children. Measles
vaccines for Cebu and Negros Oriental will arrive this week. A total
of 140 000 [10 dose] vials have been allocated to Central Visayas.
Although 1 to 4 year old children are the most vulnerable to develop
measles, Bautista said measles does not spare adults.

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

[The HealthMap/ProMED-mail interactive map of the Philippines is
available at <http://healthmap.org/r/07GE>. The regions of the
Philippines can be seen at
<http://en.wikipedia.org/wiki/Regions_of_the_Philippines>. Central
Visayas, also designated as Region VII, is located in the central part
of the Visayas island group. It consists of 4 provinces -- Bohol,
Cebu, Negros Oriental, and Siquijor -- and the highly urbanized cities
of Cebu City, Lapu-Lapu City, and Mandaue City. - Mod.CP]

******
[6] Philippines (Cordillera)
Date: Sat 19 Mar 2011
Source: Baguio News Updates, Philippine Information Agency (PIA)
report [edited]
<http://www.baguionews.net/news/index.php?option=com_content&view=article&id=5206:doh-confirms-increase-in-measles-cases&catid=1:baguio-news&Itemid=9>

DOH confirms increase in measles cases
--------------------------------------
The Department of Health (DOH-CAR) confirmed in a kapihan [group]
forum, on Wed [16 Mar 2011], that there is an increasing [number] of
measles cases recorded not only in the Cordillera [Administrative
Region, CAR] but also in other parts of the country. According to
DOH-CAR Regional Epidemiology and Surveillance Unit head, Dr Nicolas
Gordo, there were 476 recorded measles cases in the region in 2010, 81
of which were laboratory confirmed. [Subsequent] to this, 95 cases
have also been recorded, where 15 were laboratory confirmed during the
1st 8 weeks of this year [2011]. Gordo said this may still increase as
they are still awaiting the results of other tests they submitted for
confirmation at the Research Institute for Tropical Medicine in
Manila.

Meantime, DOH-CAR Local Health Support Division chief Dr Amelita
Pangilinan explained that there was a national anti-measles campaign
in 2008 but it has failed to reach the targeted 95 percent of children
nationwide. In the Cordillera, we only averaged about 80 percent of
the target, which is why there is also an increase in the number of
un-immunized children, she said. Relative to this, Pangilinan
reiterated the health department's call to support this year's
"Iligtas sa Tigdas ang Pinas" nationwide measles rubella (MR)
vaccination campaign which will start on 4 Apr 2011. [This]
door-to-door MR vaccination campaign aims to eliminate the occurrence
of both common measles (tigdas) and rubella (German measles) cases.

Gordo also reiterated the importance of [getting] children immunized
as based on the last national anti-measles campaign (in 2008), 20
percent of the 40 000 target or about 8000 children has not been
reached or immunized, which makes them vulnerable or susceptible to
measles and rubella, complications could lead to the death of a
child.

[Byline: Lito Dar]

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

[Overall the Philippines had almost achieved elimination of measles
by 2006, but subsequently the situation has deteriorated
progressively.

The Cordillera Administrative Region (CAR) is located in northern
Luzon and is composed of the provinces of Abra, Apayao, Benguet,
Ifugao, Kalinga, and Mountain Province, as well as Baguio City, the
regional center. See maps at <http://healthmap.org/r/0BZN> and
<http://en.wikipedia.org/wiki/Regions_of_the_Philippines>. - Mod.CP]

******
[7] Australia (Queensland)
Date: Sun 20 Mar 2011
Source: Goldcoast.com.au [edited]
<http://www.goldcoast.com.au/article/2011/03/20/300645_gold-coast-news.html>

Measles alert for the Queensland Gold Coast
-------------------------------------------
Health authorities are concerned about another possible measles
outbreak on the Gold Coast after a shopping centre worker tested
positive for the illness yesterday [19 Mar 2011]. Channel 10 News
reported last night that a worker at the Westfield Helensvale shopping
centre has been confirmed as suffering from measles.

Anyone who shopped at the centre yesterday should be alert for the
symptoms of measles which include cold-like symptoms, such as runny
nose, watery eyes, swollen eyelids, and sneezing; red eyes and
sensitivity to light; a mild to severe temperature, which may peak at
over 40.6 deg C (105 deg F) for several days, then fall but go up
again when the rash appears; tiny greyish-white spots (called Koplik's
spots) in the mouth and throat; tiredness, irritability, and general
lack of energy; aches and pains; poor appetite; dry cough, and
red-brown spotty rash.

Queensland Health advises anyone who thinks they may have these
symptoms to seek immediate medical advice. Gold Coast Public Health
Medical Officer Dr Don Staines said measles was extremely contagious
and in the worst circumstances could result in death. He said anyone
born during or since 1966 who had not had 2 doses of measles, mumps,
or rubella vaccine or had proven measles to visit their GP for a free
vaccination.

[Byline: Cate Swannell]

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

[This report provides no information regarding the source of the
infection.

Maps of the Gold Coast region of Queensland can be accessed at
<http://healthmap.org/r/0BZP> and
<http://www.goldcoastaustralia.com/map-southeast-qld.html>. Helensvale
is a suburb of Brisbane. - Mod.CP]

******
[8] Chile (Santiago)
Date: Fri 18 Mar 2011
Source: Terra Chile, UPI (United Press International) report [in
Spanish, trans. Mod.JT, summ., edited]
<http://www.terra.cl/actualidad/index.cfm?id_cat=302&id_reg=1615413>

Imported case of measles
------------------------
The Ministry of Health has reported that on 16 Mar 2011 the Institute
of Public Health confirmed an imported case of measles in a
10-month-old infant. The Secretariat of Public Health has launched an
immediate investigation to prevent spread of infection through the
child's contacts. It has been established that the origin of the
disease was through the mother, who previously had travelled to a
country where the disease is present.

The Undersecretary of Public Health has sent a statement to all
Seremi [ministerial regional secretariats] in the country to be alert
to the possibility of new cases and initiated a search for people who
may have been in contact with the affected child.

The last case of measles in Chile, also imported, was reported in
2009. It should be noted that since 1992 there has been no indigenous
transmission in Chile.

In Chile, children should receive 2 doses of the vaccine that
protects against measles and rubella. The 1st at 12 months and the 2nd
in the 1st year of basic education. Additionally, every 5 years,
vaccination campaigns are initiated to prevent the occurrence of
outbreaks of the disease which is in process of eradication in the
Americas.

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

[The HealthMap/ProMED-mail interactive map of Chile, showing the
location of Santiago, can be accessed at
<http://healthmap.org/r/0BZQ>. - Mod.CP]

******
[9] USA (Minnesota)
Date: Thu 17 Mar 2011
Source: Star Tribune [edited]
<http://www.startribune.com/local/118182029.html>

Minneapolis measles cases tied to fears of vaccine
--------------------------------------------------
3 more children under the age of 5 have developed cases of measles in
Minneapolis, state health officials reported Thursday [17 Mar 2011],
including 2 Somali children who were not vaccinated because of fears
about vaccine safety.

In all, 4 cases of measles have been reported in Minneapolis in the
past 2 weeks, according to the Minnesota Department of Health. 3 of
the children were hospitalized, and all are said to be recovering. The
latest cases involve children between the ages of 23 months and 4
years, who fell ill between 1 and 9 Mar 2011, the health department
said.

Officials said that the vaccination rate has dropped in Minnesota's
Somali community, largely because of misconceptions about the
vaccine's safety. Concerns about a possible link between the vaccine
and autism have spread in other communities as well, in spite of
medical reports debunking the connection. "Contrary to misinformation
that may still be circulating, the measles vaccine is safe and
effective," said Dr Edward Ehlinger, Minnesota Commissioner of Health.
"Without it, the risk of disease is real. Children can die from
measles."

In announcing the new cases, the health department included a
statement from Dr Abdirahman D Mohamed, chief of staff of the Axis
Medical Center in Minneapolis, who said he's aware of 4 unvaccinated
Somali children who have died of measles in the US and other
countries. "It is every parent's responsibility to vaccinate their
children for measles, mumps, and rubella to protect them against these
deadly diseases," he said. This year's [2011] 1st case of measles was
reported 4 Mar 2011 in an infant who was too young to be vaccinated.
Officials said they did not know whether the 4th child had been
vaccinated.

The symptoms of measles include fever, runny nose, cough, loss of
appetite, watery eyes, and a rash that begins at the hairline and
moves down the face, neck, and body, officials say. The rash usually
appears 2 to 3 days after the fever begins. "Measles can be a severe
infection and is very contagious if a person without immunity is
exposed to an infected person," said Dr Ruth Lynfield, the state
epidemiologist. "We strongly urge parents and health care providers to
ensure that children have received appropriate vaccinations."

[Byline: Maura Lerner]

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

[It is not clear why the Somali community of Minnesota in particular,
should have misconceptions about vaccine safety.

The HealthMap/ProMED-mail interactive map of the state of Minnesota
can be accessed at <http://healthmap.org/r/0BZR>. - Mod.CP]

******
[10] USA (California)
Date: Fri 18 Mar 2011
Source: RanchoBernardoPatch [edited]
<http://ranchobernardo.patch.com/articles/rancho-bernardo-residents-may-have-been-exposed-to-measles-by-poway-man-san-diego-county-says>

Measles exposure alert in San Diego County
------------------------------------------
A 27-year-old Poway man became ill after traveling overseas. As a
consequence people in Rancho Bernardo, Carmel Mountain Ranch, and
Poway may have been exposed to measles recently, San Diego County's
Health and Human Services agency announced Friday [18 Mar 2011].
According to the agency, a 27-year-old Poway man became ill after
traveling to the Philippines and Thailand, and visited several local
places, including the Radisson Suites Hotel Rancho Bernardo.

"Measles is highly contagious and is spread easily by coughing,
sneezing, or even coming in close contact with an infected person,"
County deputy public health officer Eric McDonald said in a statement.
"The individual visited several places during the time he was
infectious. Anyone who was at those locations during the same time,
and who develops a rash and fever, should contact their medical
provider by telephone and be evaluated for measles."

In an e-mailed statement a Radisson official said, "The California
Health Services Department notified the hotel that a former guest
reported an illness. At this time, there have been no reports of any
on-site illnesses within the hotel. The Management will continue to
cooperate with the Health Department on any further needs and assist
in any way necessary. This is normal protocol for the Department of
Health Services regarding lodging establishment state health
regulations." However, according to McDonald, people do not have to
worry about being at risk of the measles by visiting the 3 locations
now.

Measles can cause a rash, high fever, cough, runny nose, and watery
eyes, according to the agency. It can last for 2 weeks and can be
spread starting 4 days before a rash appears. Complications, which are
more common among children, can include diarrhea, ear infection, and
pneumonia. Death is also a possibility in severe cases.

Though there is no treatment for measles, bed rest, fluids, and fever
control are recommended. The agency recommends all people obtain a
measles vaccine.

[Byline: Hoa Quach]

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

[California can be located on the HealthMap/ProMED-mail interactive
map at <http://healthmap.org/r/0BZS>. San Diego County in the
southwestern corner of the state can be seen on the map at
<http://www.digital-topo-maps.com/county-map/california.shtml>. The
city of Poway can be found on the map at
<http://en.wikipedia.org/wiki/Poway,_California>. - Mod.CP]

See Also