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Archive Number 20091201.4109
Published Date 01-DEC-2009
Subject PRO/EDR> Dengue/DHF update 2009 (49)

DENGUE/DHF UPDATE 2009 (49)
***************************
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] Malaysia
[2] Viet Nam (Hanoi)
[3] Australia (Queensland)
[4] USA (Florida)
[5] Paraguay (Concepcion)
[6] Brazil (Rondonia)

******
[1] Malaysia
Date: Thu 26 Nov 2009
Source: The Star Online [edited]
<http://thestar.com.my/news/story.asp?file=/2009/11/26/nation/20091126121228&sec=nation>


The Health Ministry announces a nationwide dengue [alert] with 819  
cases and 3 deaths, 2 in Malacca and one in Penang. Health deputy  
director-general Datuk Dr Hasan Abdul Rahman said an additional 99  
cases were reported last week bringing the total to 819 cases.

Stating that the increase was drastic, he added that if the public do  
not take the necessary precautions, the number of cases could increase  
to 1600 next month [Dec 2009].

He was speaking to reporters after a dialogue session on the dengue cases.

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

[A map of Malaysia showing the administrative divisions can be accessed at
<http://lib.utexas.edu/maps/middle_east_and_asia/malaysia_adm98.jpg>
A HealthMap/ProMED-mail interactive map of Malaysia can be accessed at
<http://healthmap.org/promed/en?v=2.6,113.2,5>. - Mod.TY]

******
[2] Viet Nam (Hanoi)
Date: Fri 20 Nov 2009
Source: VietNamNet Bridge [edited]
<http://english.vietnamnet.vn/Health/200911/Hanoi-two-more-die-of-dengue-fever-879908/>


Hanoi: 2 more die of dengue fever
---------------------------------
Dengue fever has killed 2 more patients in Hanoi, reported the Hanoi  
Department of Health on [19 Nov 2009]. The victims are a 53-year-old  
woman in Ha Dong district and a 15-year-old boy in Dong Anh district.  
In late September [2009], the capital also had 2 fatal cases.

Following accusations of covering the number of deaths, the Health  
Ministry asked the Hanoi Department of Health, the National Hospital  
of Infectious and Tropical Diseases, and the Bach Mai Hospital to  
verify the number.

After the check, the Hanoi Department of Health confirmed the official  
figures were accurate. The numbers of people suffering dengue fever in  
Hanoi are going down. However, there are still several serious cases  
infected with [dengue] virus type 2.

According to the Health Ministry, Viet Nam had more than 77 000 dengue  
fever patients in 33 out of 63 provinces and cities in January-October  
[2009] period. The number of patients rose by 7.3 percent year-on-year  
while the number of deaths fell by over 11 percent.

Notably, the number of dengue fever patients in the southern region  
was reduced in both the number of cases and deaths while there were  
increases in other regions in the country, especially the north, where  
figures were 4-fold.

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

[Although the monsoon ends and winter has started to set in, the  
number of dengue cases is still increasing in the northern part of  
Viet Nam. As of 24 Oct 2009, 74 242 cases and 58 deaths were  
identified since January 2009, with 17 140 cases and 14 deaths  
reported during September 2009 (see prior PRO/MBDS posting Dengue -  
Viet Nam (17) 20091025.3677). To date, more than 77 000 cases of  
dengue infection have been reported in Viet Nam from January to  
October 2009.

Summaries of the number of reported cases of dengue fever and dengue  
hemorrhagic fever (DF/DHF) in the Western Pacific region by country  
are available from WHO's Regional Office for the Western Pacific  
(WHO/WPRO) at
<http://www.wpro.who.int/sites/mvp/data/dengue/>. As per this report,  
as of 7-13 Sep 2009 there were 57 102 cases and 44 deaths of dengue  
fever (DF) and dengue hemorrhagic fever (DHF) reported in Viet Nam  
during 2009. During 2008, a total of 96 451 cases and 97 deaths were  
reported for the whole year.

For a map of Viet Nam with provinces, see
<http://en.wikipedia.org/wiki/File:VietnameseProvincesMap.png>. The  
interactive HealthMap/ProMED-mail map with direct links to other  
outbreaks in Viet Nam and surrounding countries reported on  
ProMED-mail and PRO/MBDS can be accessed at
<http://healthmap.org/r/008c> - Mod.YMA]

******
[3] Australia (Queensland)
Date: Thu 26 Nov 2009
Source: 7 News [edited]
<http://au.news.yahoo.com/a/-/newshome/6519154/dengue-fever-spreads-across-state/>


2 new cases of dengue fever have been confirmed in north Queensland.  
Authorities launched a warning 2 weeks ago after 3 cases of imported  
dengue fever were confirmed in Cairns and one case was detected in  
Townsville.

Queensland Health says it is on the alert for more cases of dengue  
fever in the state's north. Dr Steven Donohue, from the Department's  
Tropical Population Health, says 2 more locally acquired cases of  
dengue have been found in the Townsville suburb of Heatley. "They  
haven't travelled anywhere, which is a worry because we've been  
concerned that this could be the start of another big dengue  
outbreak," he said. "They got sick around the end of October, early  
November [2009], and it did take a little while to find out what they  
had.

"But fortunately we think now that we can link them both to a person  
who's come from overseas sick and probably also had dengue." Dr  
Donohue says he does not know if more cases will emerge. "We're not  
exactly sure because although we've done intensive mosquito control  
now around all of those households," he said, "the problem is they  
weren't diagnosed immediately and therefore there has been an  
opportunity since then for it to spread further, so we've sent  
warnings to all the doctors."

No more cases of dengue have been confirmed in Cairns.

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

[The imported dengue cases coming into Australia from dengue virus  
endemic areas are not surprising. However, the 2 locally acquired  
cases are of concern, given the outbreak in northern Queensland last  
year (2008).

[An interactive of Queensland showing the locations of Townsville and  
Cairns 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/promed/en?v=-25.7,134.5,4>. - Mod.TY]

******
[4] USA (Florida)
Date: Mon 23 Nov 2009
Source: University of Florida News [summ. & edited]
<http://news.ufl.edu/2009/11/23/dengue/>


University of Florida mosquito researchers are watching with a wary  
eye as dengue virus returns to the state after more than 50 years. By  
late last week, 20 cases of locally transmitted dengue had been  
confirmed in Key West. Monroe County officials have issued a health  
alert and launched an education campaign urging residents to eliminate  
water sources in and around their homes where mosquitoes can breed.

"We haven't seen dengue in Florida in a long time, but this does give  
us evidence that we can have it again," said Roxanne Connelly, an  
associate professor of medical entomology with UF's [University of  
Florida's] Institute of Food and Agricultural Sciences.

Besides the dengue re-emergence in the Florida Keys, Connelly, based  
at the Florida Medical Entomology Laboratory in Vero Beach, said  
health officials were surprised by a door-to-door survey of Key West  
residents. Connelly and Jonathan Day, a medical entomology professor  
at the Vero Beach laboratory, collaborate with the health and  
vector-control officials. After some 240 residents allowed health  
officials to draw a small blood sample, test results showed that 41  
percent had been exposed to the dengue virus or other Flavivirus,  
either through exposure to one of the viruses or through vaccinations,  
such as the yellow fever vaccine. [This is a key point. Flavivirus  
antibodies are notoriously cross-reactive in many serological tests.  
The tests used in the serological survey are not specified. Other  
flaviviruses are endemic in Florida, including West Nile and St. Louis  
encephalitis viruses. - Mod.TY] "Much like a lot of other  
mosquito-borne diseases, some people can have it and no!
t have any symptoms, while others end up very sick," Connelly said.

The last big dengue epidemic in Florida was in 1934 and left more than  
25 000 Floridians ill, Day said. Researchers don't expect this  
outbreak to reach beyond Monroe County, but it's a strong reminder for  
Floridians to be on guard.

Dengue is spread by 2 mosquito species, commonly known as the yellow  
fever mosquito and Asian tiger mosquito. Both lay eggs on the sides of  
water-filled containers. The yellow fever mosquito is mostly confined  
to South Florida, while the Asian tiger mosquito is found throughout  
the state, though not in the Florida Keys.

The yellow fever mosquito is prevalent in the Old Town part of Key  
West, Day said, and has an affinity for a local cemetery full of  
rain-catching urns and vases. Many of the recent dengue cases were in  
the Old Town area, he said. Unlike many mosquitoes that are active in  
the morning and evening, the yellow fever and Asian tiger mosquitoes  
are unusual in that they will bite in broad daylight.

Connelly advises residents to take a careful look at their homes and  
yards, looking for even tiny amounts of standing water. Boat tarps,  
birdbaths, gutters, empty soda cans -- anything that will hold water  
should be suspect and emptied or discarded. Pet dishes emptied every  
few days aren't a worry, she said. And while it's not as common,  
residents can inadvertently breed mosquitoes indoors, she said. One  
way: Small decorative bamboo plants hold just enough water to interest  
a mosquito looking to lay eggs.

Other suggestions for residents include wearing long pants and sleeves  
when possible and wearing a repellent that includes the active  
ingredient DEET.

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

[Air conditioning and window screens present barriers to _Aedes  
aegypti_ entering houses.

A map showing the location of the Florida Keys can be accessed at
<http://www.florida-keys.fl.us/maps/mainmap.htm>. A map of the Florida  
Keys themselves can be accessed at
<http://www.islamoradaislander.com/images/FKY-map.jpg>.
A HealthMap/ProMED-mail interactive map of the USA showing the state  
of Florida can be accessed at
<http://healthmap.org/promed/en?v=40,-97.6,4>. - Mod.TY]

******
[5] Date: Wed 18 Nov 2009
Source: Ministerio de Salud Publica y Bienestar Social [in Spanish,  
trans. TY/JW, edited]
<http://www.mspbs.gov.py/ver_noticia.php?id=5050>


Dengue alert: Public Health identified dengue [virus] 1 in the  
outbreak in Puentezino, Concepcion
----------------------

This is reported in the bulletin released by the office of the  
Director General of Health of the MSPyBS [Ministerio de Salud Publica  
y Bienestar Social]. Health Authorities urge the population, despite  
the probability of rainfall being low during the current week, to not  
cease their work in identification and elimination or inactivation of  
potential breeding sites of _Aedes aegypti_, to reduce the  
proliferation of the [dengue virus] vector and the risk of virus  
transmission.  To date, there is a total of 52 confirmed cases of the  
disease in our country.

According to reports from Health Surveillance, in the past week 50  
reports of suspected dengue cases were entered in the [reporting]  
system. As for confirmation, the total is 52 (including one case from  
Mexico), in the period corresponding to EW [epidemiological weeks] 41  
- 46; this is because in the current week 24 new cases have been  
confirmed, all coming from La Suerte and San Clemente neighborhoods of  
the Sgto. Jose Felix Lopez (Puentezino) locality, Concepcion, the  
place where the outbreak is currently registered.

According to results released by the Central Public Health Laboratory,  
the [dengue virus] serotype currently circulating in this area is  
DEN-1, which is different from the serotype recorded for the outbreak  
in Yvy Yau and Horqueta, in Concepcion, at the end of 2008 and the  
beginning of 2009, which was identified as DEN-3.

Within the framework of these events, from 9-13 November [2009] the  
SENEPA  visited the area with dengue cases in Puentezino, with the aim  
of assessing the situation of the outbreak reported there.  They  
carried out an active search for fever [cases] according to the  
epidemiological data cards for dengue and found that new febrile cases  
were present, and so they proceeded to take [blood] samples for the  
diagnostic laboratory.

Also, they observed breeding sites that were positive for _Aedes  
aegypti_, among them various tanks for water storage that could not be  
emptied; they were treated with larvicides, and recommendations were  
given for their proper use. They carried out chemical [insecticide]  
control with heavy and light-weight machines, with advance  
verification of the concentration of insecticides used for barriers  
and calibration of the heavy machines.

The also carried out an entomological evaluation with the "La Suerte"  
company, in which they investigated 100 houses, with an infestation  
rate of 13 percent.  They reported that after cleaning up [trash] with  
students and local SENEPA personnel, they achieved a reduction in the  
household infestation indexes to 1 percent.  During the clean-up 220  
used tires and 3 tons of trash were eliminated.

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

[The Ministry of Health is to be congratulated for its aggressive  
response to this dengue outbreak, and especially for the  
community-based efforts to reduce _Aedes aegypti_ breeding sites. -  
Mod.TY]

[A map of Paraguay showing its departments can be accessed at
<http://www.un.org/Depts/Cartographic/map/profile/paraguay.pdf>.
A HealthMap/ProMED-mail interactive map of Paraguay can be accessed at
<http://healthmap.org/r/00*z>. - Sr.Tech.Ed.MJ]]


******
[6] Brazil (Rondonia)
Date: Mon 23 Nov 2009
Source: Diario da Amazonia [in Portuguese, trans. & summ. Mod.TY,  
edited]  
<http://www.diariodaamazonia.com.br/diariodaamazonia/index2.php?sec=News&id=1160>


The risk of a dengue epidemic increases in Cacoal
-------------------------------------------------
The menace of an epidemic [of dengue] is imminent, since now the  
registered [number] of cases of the disease increases every day.  
Dengue became a further cause for concern in Cacoal.

Over the years cases have continued to rise, and there have already  
been more than 1000 cases. In the last month the increase has been  
alarming, with more than 70 new cases each week. As was reported in  
the press a little over 2 weeks ago, the Riozinho district, 10 km [6  
mi] from Cacoal is one of the sites with more disease. However, in the  
suburbs the situation also is considered critical.

  In addition to the water tanks not buried, after sanitation work,  
with the intensification of rains, water containers and domestic waste  
returned as a concern. There, clean, stagnant water [is the breeding  
site of] the mosquito that transmits the disease [virus], _Aedes  
aegypti_, which finds an environment that is conducive to its  
proliferation.

The neighborhoods with the greatest number of cases are those without  
basic sanitation work; currently most of the water tanks are not  
buried. In the entire municipality, there are 28 [health] agents  
working on orientation and notification ... notifying residents that  
they have 72 hours to clean up their yards. But usually this does not  
happen, because the agents do not impose penalties provided by law.  
According to one agent, it is very difficult to fight the disease only  
with guidance and the penalties would be a more effective way to  
prevent an increase in the number of cases of the disease.

According to information provided by a City Hall spokesperson, the  
municipal health organization also conducts joint efforts of cleaning  
yards and flower beds of the central city. The department emphasizes  
routine visits, for services in health education, advising residents  
house to house. "We have made 119 000 visits." he said.

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

[A map of the Cacoal region of Rondonia state can be accessed at:
<http://www.maplandia.com/brazil/rondonia/cacoal/>

A HealthMap/ProMED-mail interactive map of Brazil can be accessed at
<http://healthmap.org/promed/en?v=-10.8,-53.1,4> - Mod.TY]

[see also:
Dengue/DHF update 2009 (47)  20091115.3944
Dengue/DHF update 2009 (45)  20091102.3779
Dengue/DHF update 2009 (44)  20091026.3705
Dengue/DHF update 2009 (43)  20091021.3625
Dengue/DHF update 2009 (42)  20091020.3609
Dengue/DHF update 2009 (40)  20091005.3454
Dengue/DHF update 2009 (39)  20090928.3393
Dengue/DHF 2009 update (38)  20090921.3322
Dengue/DHF update 2009 (37)  20090915.3240
Dengue/DHF update 2009 (36)  20090907.3144
Dengue/DHF update 2009 (35)  20090831.3065
Dengue/DHF update 2009 (34)  20090823.2977
Dengue/DHF update 2009 (33)  20090817.2908
Dengue/DHF update 2009 (31)  20090803.2723
Dengue/DHF update 2009 (28)  20090713.2501
Dengue/DHF update 2009 (27)  20090706.2425
Dengue/DHF update 2009 (26)  20090629.2353
Dengue/DHF update 2009 (25)  20090622.2286
Dengue/DHF update 2009 (24)  20090614.2211
Dengue/DHF update 2009 (23)  20090608.2121
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 (07)  20090210.0610
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]
...........................................lm/ty/ejp/jw
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