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DENGUE/DHF UPDATE 2009 (53)
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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] Australia (Queensland)
[2] Indonesia (East Kalimantan)
[3] Mexico (Jalisco)
[4] Mexico (south)
[5] El Salvador
[6] Argentina (Santa Fe)
******
[1] Australia (Queensland)
Date: Tue 22 Dec 2009
Source: The Sydney Morning Herald, Australian Associated Press (AAP)
report [edited]
<http://news.smh.com.au/breaking-news-national/authorities-fear-dengue-fever-outbreak-20091222-lawz.html>
Health authorities are nervous [that] an outbreak of dengue fever
during the Christmas holiday season will be difficult to contain.
Queensland Health has confirmed 12 dengue fever cases in Townsville,
north Queensland.
There are 2 strains of the mosquito-borne virus circulating in the
city, with 9 people diagnosed as having [dengue virus] type 1 and 3
as having [virus] type 3 dengue fever.
A Queensland Health spokesman said the wet season combined with the
fact that people travel more in the Christmas holidays made it
difficult to contain the virus. "There is concern over Christmas of
people moving about and the need to keep this under control," he told
AAP. "We want family and friends to wear insect repellant and to
clean up in the yard. For those people leaving their homes over
Christmas they must remember to not leave anything in the open that
can collect water and become a breeding ground for mosquitoes."
More than 1000 people across north Queensland were infected with the
virus during the previous outbreak, which began in November last year
[2008], including an elderly woman who died due to complications in
March [2009].
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[Halting the dengue outbreak during the holiday season will be a
challenge for the Queensland health authorities.
An interactive map of Queensland showing the location of Townsville
can be accessed at
<http://www.maplandia.com/australia/queensland/brisbane/brisbane/>.
A HealthMap/ProMED-mail interactive map of Australia showing the
state of Queensland can be accessed at
<http://healthmap.org/r/011n>. - Mod.TY]
******
[2] Indonesia (East Kalimantan)
Date: Mon 28 Dec 2009
Source: The Jakarta Post [edited]
<http://www.thejakartapost.com/news/2009/12/28/dengue-outbreak-west-kutai-kills-two-and-infects-hundreds.html>
Dengue fever has hit West Kutai regency, East Kalimantan, infecting
hundreds of Dayak tribespeople this month [December 2009] and killing
2 in the past week when the only doctor on duty was away for
Christmas. Beatrix, a nurse at the Long Hubung health center, West
Kutai, said most of the dengue fever patients were children under the
age of 12. "This month [December 2009], hundreds of local people have
contracted dengue fever," she said.
She said those who were seriously ill were transferred to Sendawar
General Hospital in Sendawar, the regency capital, 30 kilometers
[18.6 mi] from Samarinda, the provincial capital. She said patients
who were not in a critical condition, were given medication and sent
home as the health center did not offer inpatient facilities. She
said medical teams found it difficult to deliver proper services
because of the limited health facilities in remote areas.
Beatrix said dozens of villages in the Mahakam Hulu area depended on
the health center, which employed only one medical doctor. She said
the doctor was in Surabaya for Christmas when the deaths occurred,
adding, "there is no replacement doctor until the new year."
She said poor transportation was also another problem faced by
medical healthcare practitioners. She said medical workers would use
small wooden boats (locally known as ketinting) to navigate rivers to
reach remote villages. Patients in critical condition would be forced
to spend hours on overland transportation to reach the general
hospital.
Beatrix called on the villagers to be vigilant of floods during the
rainy season, which is usually followed by widespread dengue
infections. She said the Mahakam Hulu area was prone to flooding at
the end of the year.
Meanwhile, local tribal leaders conducted a ritual to clean their
neighborhoods to prevent further outbreaks. Instead of fumigating,
the tribal leaders, mostly old women, walked around their villages
and cited Dayak-language prayers. The tribes believe the ritual is
able to disperse evil spirits and the disease.
Besides affecting West Kutai, the disease has also surfaced in
Balikpapan. The Balikpapan Health Agency recorded 891 dengue fever
cases since November [2009]. 12 of the patients died, including 11
children and one adult. The agency predicted cases of dengue fever
would still be high in December and January due to heavy rain.
Earlier, the Central Java Health Agency said 190 people had died from
dengue fever from January to October this year [2009]. Last year
[2008], the agency recorded 229 deaths from the disease and 329 the
year before [2007].
[Byline: Nurni Sulaiman]
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[This report illustrates the difficulty of dealing with disease
outbreaks in remote locations where access to medical care is limited
or absent. The West Kutai is a regency in the Indonesian province of
East Kalimantan. The regency covers an area of 33 052 sq km (12 760
sq mi) and has a population of approximately 136 000 people.
A map showing the location of East Kalimantan in Indonesia can be accessed at
<http://en.wikipedia.org/wiki/East_Kalimantan>.
A HealthMap/ProMED-mail map of Indonesia can be accessed at
<http://healthmap.org/r/011r>. - Mod.TY]
******
[3] Mexico (Jalisco)
Date: Wed 24 Dec 2009
Source: El Informador [in Spanish, trans. & summ. Mod.TY, edited]
<http://www.informador.com.mx/jalisco/2009/165145/6/dengue-el-virus-que-emigro-de-la-costa-a-la-ciudad.htm>
A disease that was commonly considered tropical has upended the
Jalisco state's health sector in 2009. This concerns the dengue virus
which, in other years has been exclusive to places with humid
climates, but passed from being a costal problem to an [interior]
urban one.
The Guadalajara metropolitan area experienced an epidemic [of dengue
virus infection] in addition to the no less important human influenza
epidemic. What is atypical is not the presence of the virus, rather
that Guadalajara has not had the affliction for a long time.
The situation was on-coming. Since late 2008, international and
national epidemiologists warned that the mosquitoes were adapting to
all climates and all environments, as one of the consequences of
climate change.
In 2009, [dengue virus] types 1 and 3 circulated in Jalisco, the
latter with more hemorrhagic repercussions. At the close of this year
[2009] up to epidemiological week 49, which covers 6-12 Dec [2009],
the Jalisco [total] reached 4697 cases, of these 776 DHF [cases],
exceeding the number of one of the worst epidemics in the state, when
there were 4508 [cases] in 1988.
In addressing the problem expected this year [2009], the Jalisco
Secretariat of Health in April [2009] initiated operations to combat
he mosquito that transmits dengue [virus]. The [vector control]
operations were in coordination with the metropolitan governments, so
that families get rid of pots, tires, and other articles that could
retain water in the coming rainy season.
The head of the Health Observatory of the University of Guadalajara,
Marco Antonio Castillo Moran, stated on one occasion that in Jalisco
there is an important underreporting of dengue cases, that is to say
that the official data reflect only a part of the problem. He claimed
that for every case of dengue, there were 13 that were not registered
by the state Secretariat of Health, due to the fact that laboratory
tests to confirm [infection by the] virus were not done in all
patients who were then diagnosed [as dengue virus infections] based
only on clinical symptoms. After not having accepted this on several
occasions, the health secretariat stated that by the end of the month
of October [2009], Jalisco had about 20 000 probable cases of the
disease. This December [2009], the official indicated that 2009 will
end with at least 60 000 probable [dengue] cases. A few days ago the
secretary of health, Petersen Farah, agreed that 2010 could be a
critical year as regards dengue, if the populace does not take the
necessary [preventive] measures for which they are responsible;
although the epidemic is controlled currently, the problem may be
reactivated in the 1st months of the coming year [2010].
As virus transmission continued, it was decided to make a clean sweep
in the Guadalajara Metropolitan Area.
According to the Pan American Health Organization, Jalisco has had
3921 cases of classical dengue fever and 776 cases of DHF, for a
total of 4697 cases.
--
Communicated by:
ProMED-PORT
<promed-port@promedmail.org>
[This very lengthy article describes the 2008-2009 history of dengue
in the general Guadalajara metropolitan area, including an unreported
outbreak in Santa Maria Tequepexpan. The report mentions suspicions
that _Aedes aegypti_ have become resistant to the insecticides being
used for vector control.
A map of Mexico showing the states including Jalisco can be accessed at
<http://lib.utexas.edu/maps/americas/mexico_pol97.jpg>.
A detailed, zoomable map of Jalisco showing the locations mentioned
above can be accessed at
<http://www.maps-of-mexico.com/jalisco-state-mexico/jalisco-state-mexico-map-main.shtml>.
A HealthMap/ProMED-mail map of Mexico can be accessed at
<http://healthmap.org/r/010B>. - Mod.TY]
******
[4] Mexico (south)
Date: Mon 30 Nov 2009
Source: Tribuna (Campeche) [in Spanish, trans. & summ. Mod.TY, edited]
<http://www.tribunacampeche.com/index.php?option=com_content&view=article&id=10181:alerta-roja-por-alza-del-dengue&catid=23:primeraplana&Itemid=38>
[With] increasing cases of dengue in southern Mexico for which the
Health Secretariat at the federal level declared a red alert in the
states of Tabasco, Veracruz, Yucatan, and Campeche, preventive
measures are intensified in municipalities and communities where
there is little participation by the population. Jose del Carmen
Hernandez Ferrer, head of the Sanitary Jurisdiction No. 3, said the
red alert is not meant to alarm the public, rather it is a parameter
by which health authorities intensify actions that allow reduction of
the risks of infection.
Up until now, the most recent weekly report, registers a total of 105
dengue cases, of which 22 are DHF, and one death has now been
reported.
Asked about preventive actions, he said that 8 fumigation units have
been made available, as well as distribution of staff in communities
and neighborhoods for talks to prevent the spread of mosquito vector.
In the area of the southeast, dengue cases are increasing at alarming
levels as a result of the rains; in the case of the states of
Campeche and Veracruz, 5241 cases have been registered and in Yucatan
1247 illnesses have been reported. It is worth mentioning that
because these states are closely linked due to labor issues there is
constant migration within these states, and as a result the federal
Health Secretariat recommended that the local governments strengthen
actions that permit risk reduction.
In the national context, the Health agency has registered 105 000
probable dengue cases and some 55 000 confirmed [cases] for which the
southern states including Veracruz, Tabasco, Campeche, and Yucatan,
are on red alert to expand efforts which will permit risk reduction
of the _Aedes aegypti_ mosquito.
The recommendations given by the officials of the health sector are
cleanup and disinfection. This disease is cured by itself along with
the necessary medical care, which the patients must have in the
[acute] phase of the disease, so seeing a physician when symptoms
occur is vital to avoid suffering complications. However, the
recommendation is to carry out preventive measures to avoid the
proliferation of the insect and thus the risk of becoming ill.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[Dengue has been a serious problem in various states in Mexico in
2009. One hopes that it does not continue into 2010. - Mod.TY]
******
[5] El Salvador
Date: Fri 11 Dec 2009
Source: Latin American Herald Tribune [edited]
<http://www.laht.com/article.asp?ArticleId=348904&CategoryId=23558>
A 34-year-old woman has died from DHF in El Salvador, raising the
death toll from the disease to 11, deputy health minister Violeta
Menjivar said. More than 6500 cases of the classic type of the
disease have been registered, Menjivar said, adding that people
should take action to destroy the breeding grounds of the mosquitoes
that carry the disease.
Dengue, a serious viral disease transmitted by the _Aedes aegypti_
mosquito, is characterized by high fever, intense headaches, muscle
pain, gastro-intestinal problems, and rashes. DHF, in addition to
having symptoms associated with classic dengue, like fever,
headaches, and joint pain, can also produce internal bleeding.
The latest victim lived in the western province of Sonsonate and
received treatment when the disease was at an advanced stage,
Menjivar said.
As of 10 Dec [2009], 98 DHF cases had been registered in El Salvador,
compared to 41 as of the same date last year [2008], marking a 139
percent increase in cases of the disease, the Health Ministry said in
a bulletin.
The 6572 classic dengue cases registered as of 10 Dec [2009]
represented an increase of 413 percent from the 1280 cases registered
as of that date in 2008, the ministry said.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
A map showing the provinces of El Salvador is available at
<http://www.lib.utexas.edu/maps/americas/elsalvador.jpg>.
A HealthMap/ProMED-mail map of El Salvador can be accessed at
<http://healthmap.org/r/011p>. - Mod.TY]
******
[6] Argentina (Santa Fe)
Date: Tue 22 Dec 2009
Source: Buenos Aires Herald [edited]
<http://www.buenosairesherald.com/BreakingNews/View/20576>
3 cases of people infected with dengue are being analyzed in the
Santa Fe province today [22 Dec 2009], as they come after one case,
which was recently confirmed to have been 'imported'. The 3 people
come from the city of Sunchales and their lives are 'not at risk'.
The Provincial Health authorities are investigating if this is a
'locally bred' form of the disease. The province's Health Minister
Miguel Angel Capiello, today [22 Dec 2009] announced measures to
fight dengue his area. Results should be available later today.
Cecilia Gabiani, the Hygiene and Health Regulations head in
Sunchales, said the 3 people are in good health, although 2 of them
had to be seen "under strict precautions."
All the area around the place where they lived was fumigated in case
mosquitoes infected with the disease were breeding there.
The north of Argentina suffered from a wave of dengue last summer
[2008-2009], for which health authorities are trying to avoid
repeating the same scenario this year.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
A map showing the location of Santa Fe Province in Argentina, can be
accessed at
<http://lib.utexas.edu/maps/americas/argentina_pol96.jpg>.
A HealthMap/ProMED-mail map of Argentina can be accessed at
<http://healthmap.org/r/011o>. - Mod.TY]
[see also:
Dengue/DHF update 2009 (52) 20091221.4300
Dengue/DHF update 2009 (51) 20091215.4248
Dengue/DHF update 2009 (49) 20091201.4109
Dengue/DHF update 2009 (48) 20091123.4016
Dengue/DHF update 2009 (46) 20091111.3898
Influenza pandemic (H1N1) 2009 (76): El Salvador, dengue co-infection
20091025.3695
Dengue/DHF update 2009 (43) 20091021.3625
Dengue/DHF update 2009 (42) 20091020.3609
Dengue/DHF update 2009 (39) 20090928.3393
Dengue/DHF update 2009 (37) 20090915.3240
Dengue/DHF update 2009 (33) 20090817.2908
Dengue/DHF update 2009 (32) 20090811.2864
Dengue/DHF update 2009 (31) 20090803.2723
Dengue/DHF update 2009 (28) 20090713.2501
Dengue/DHF update 2009 (22) 20090601.2040
Dengue/DHF update 2009 (21) 20090525.1952
Dengue/DHF update 2009 (20) 20090518.1868
Dengue/DHF update 2009 (19) 20090512.1774
Dengue/DHF update 2009 (18) 20090505.1677
Dengue/DHF update 2009 (17) 20090428.1595
Dengue/DHF update 2009 (16) 20090419.1485
Dengue/DHF update 2009 (15) 20090413.1412
Dengue/DHF update 2009 (14) 20090406.1341
Dengue/DHF update 2009 (13) 20090331.1227
Dengue/DHF update 2009 (12) 20090314.1049
Dengue/DHF update 2009 (11) 20090309.0972
Dengue/DHF update 2009 (10) 20090302.0854
Dengue/DHF update 2009 (09) 20090223.0762
Dengue/DHF update 2009 (08) 20090216.0650
Dengue/DHF update 2009 (06) 20090210.0603
Dengue/DHF update 2009 (05) 20090204.0487
Dengue/DHF update 2009 (04) 20090126.0357
Dengue/DHF update 2009 (03) 20090119.0242
Dengue/DHF update 2009 (02) 20090113.0133
Dengue/DHF update 2009 (01) 20090105.0041]
...................................sh/ty/mj/lm
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