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Archive Number 20091102.3779
Published Date 02-NOV-2009
Subject PRO/EDR> Dengue/DHF update 2009 (45)

DENGUE/DHF UPDATE 2009 (45)
***************************
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] Nicaragua
[2] Venezuela (Carabobo)
[3] Cape Verde
[4] Philippines (Kalinga)
[5] Viet Nam (national)
[6] Viet Nam (Delta, Hanoi)
[7] India (Delhi)
[8] Yemen (Taiz)

******
[1] Nicaragua
Date: Thu 29 Oct 2009
Source: Una Fuente, Milenio report [in Spanish, trans. Mod.TY, edited]
<http://www.unafuente.com/26-10-2009/8-muertos-en-nicaragua-por-dengue/>


[The news outlet] Milenio indicated today [29 Oct 2009] that the dengue 
outbreak, which has caused 8 deaths and more than 2000 infections, "will be 
under control" after reducing the lethality of the infection [numbers of 
cases?] and its transmission as a result of sanitary measures adopted in 
the cities of greatest incidence.

The minister of health, Guillermo Gonzalez, announced the dengue outbreak 
"will be under control" if the rains behave [normally] and the fumigation 
and abatement [larvicide in vector mosquito breeding sites - Mod.TY] plans 
are implemented in the most affected areas. In the past 2 weeks, the 
epidemic has entered a plateau of the outbreak, which will begin to reduce 
the infections although some neighborhoods of the capital still continue 
with levels of infestation "which deserve to be treated," stated Gonzalez 
in a press release.

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

[A map showing the administrative divisions of Nicaragua mentioned above 
can be accessed at 
<http://www.lib.utexas.edu/maps/americas/nicaragua_pol_97.jpg>. A 
HealthMap/ProMED-mail interactive map of Central America showing Nicaragua 
can be accessed at <http://healthmap.org/r/00X2>. - Mod.TY]

******
[2] Venezuela (Carabobo)
Date: Thu 29 Oct 2009
Source: Entorno Inteligente, El Carabobeno report [in Spanish, trans. 
Mod.TY, edited]
<http://www.entornointeligente.com/resumen/resumen.php?items=968037>


"The state of Carabobo is in an epidemic," alerted the director of the 
Enrique Tejeran City Hospital, Zoraida Nunez, in the face of the increase 
in the [number] of cases of the disease. At the beginning of the year 
[2009] between 2-3 cases were reported, 5 weeks ago some 12 patients 
presented [with dengue] and now, on average, we receive 20-30 [dengue] 
patients per week.

The epidemic shows 2 novel aspects, indicated Nunez: children are the most 
affected and it is more severe than in previous years. This Thursday [29 
Oct 2009] in a press conference, a historic 3 deaths were confirmed and 
tallied by CHET [national health statistics] as due to [the dengue] 
outbreak so far this year [2009]. The victims are an adolescent who died in 
March and 2 children who died in the past 30 days.

The physician based [her comments] in that "CHET is a reflection of what 
happens in the assistance network of the state" and commented that in many 
cases, the belief that suspected cases were due to influenza A [H1N1] 
contributed to a "delayed diagnosis" of dengue.

She recommended deploying teams for the cleanup of areas, abate treatment, 
and fumigation to Insalud [Carabobo Foundation Institute for Health], 
mayors, and communities in general. "There needs to be an intensive 
prevention campaign to combat the mosquito." In all of Carabobo [state], 
according to the latest Insalud bulletin, there are 729 positive [dengue] 
cases up to 17 October [2009].

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

[A map showing the states of Venezuela can be accessed at 
<http://www.lib.utexas.edu/maps/americas/venezuela.gif>. A 
HealthMap/ProMED-mail interactive map of Venezuela can be accessed at 
<http://healthmap.org/r/00YK>. - Mod.TY]

******
[3] Cape Verde
Date: Fri 30 Oct 2009
Source: WHO Global Alert and Response (GAR) Disease Outbreak News [edited]
<http://www.who.int/csr/don/2009_10_30a/en/index.html>


As of 28 Oct 2009, the Ministry of Health [MoH] has reported 3367 suspected 
cases of viral diseases of unknown etiology in 4 islands: Brava, Fogo, 
Maio, and Santiago. This is the 1st reported epidemic of dengue fever in 
Cape Verde.

The 1st samples tested have been laboratory confirmed as dengue virus 
serotype 3 by the Institute Pasteur Dakar, the WHO Collaborating Centre for 
Arbovirus and Viral Haemorrhagic Fevers (VHF) and Global Outbreak Alert and 
Response Network (GOARN) partner.

The government has established a ministerial committee of vector control 
lead by the prime minister including all ministries involved in containing 
the outbreak. The measures taken include clinical management, vector 
control, and social mobilization. A rapid surveillance and reporting system 
through SMS messaging systems has been established by the MoH and the 
public IT agency with WHO collaboration.

On 26 Oct [2009] a team from the WHO Regional Office for Africa, 
Intercountry Support Team and the Institute Pasteur Dakar arrived to 
support Cape Verde in investigating the outbreak. The team will provide 
laboratory, entomology, and epidemiology support and set up laboratory 
diagnostics at the Hospital Agostinho Neto. The team will further initiate 
vector control activities and the recording and analysis of epidemiological 
trends. GOARN will provide additional assistance to health authorities in 
Cape Verde.

-- 
communicated by:
ProMED-mail rapporteur Marianne Hopp

[A HealthMap/ProMED-mail interactive map of Cape Verde can be accessed at 
<http://healthmap.org/r/00Xw>. - Mod.TY]

******
[4] Philippines (Kalinga)
Date: Wed 28 Oct 2009
Source: Manila Bulletin [edited]
<http://www.mb.com.ph/articles/226899/kalinga-dengue-outbreak-lifted-zero-rabies-eyed>


The Cordillera office of the Center for Health Development (CHD-CAR) [in 
Kalinga] recently rescinded the dengue outbreak and heightened alert in 
this province following a significant reduction in the number of cases in 
the previous monitoring period over the past several weeks. For the past 
week, dengue fever cases in the province have dropped to only 7, which is 
an indication that people in the different critical areas have already been 
properly informed on how to prevent the worsening of the outbreak that 
could prove to be deadlier once it is not controlled.

Tabuk [the provincial capital], where about 90 per cent of the dengue fever 
cases were recorded, prompted the CHD-CAR to declare a dengue outbreak last 
July [2009] when the number of cases reached 101 in just a few days, the 
highest so far in 3 years. Since the dengue outbreak broke out last June 
[2009], local health authorities conducted weekly monitoring on the trends 
of the dengue fever cases in the different parts of the province. From 
January to the present [28 Oct 2009], the provincial health office reported 
it was able to record 3 dengue-related deaths. The weekly monitoring graphs 
of the local health department showed the cases of dengue started to drop 
on 22-29 Aug [2009] until the alert and outbreak was recently lifted.

A dengue outbreak was declared in the province in 2006 following the 
epidemic in 2005, when 7 dengue-related deaths were recorded.

[byline: Dexter A See]

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

[Tabuk, the capital of Kalinga province, can be located on the 
HealthMap/ProMED-mail interactive map of the Philippines at 
<http://healthmap.org/r/00YL>. A map of the Cordillera administrative 
region on northern Luzon Island can be accessed at 
<http://en.wikipedia.org/wiki/Cordillera_Administrative_Region>. - Mod.TY]

******
[5] Viet Nam (national)
Date: Sun 25 Oct 2009
Source: Saigon Giai Phong (SGGP) Daily [edited]
<http://www.saigon-gpdaily.com.vn/Health/2009/10/75409/>


The Ministry of Health said on [24 Oct 2009] that, within the last month, 
55 out of 63 provinces in Viet Nam recorded 17 140 cases of dengue fever 
with 14 deaths.

Since the beginning of the year [2009], Viet Nam has seen over 74 242 
dengue cases, an increase of 16.8 per cent over the same period last year 
[2008]. Of the total, 58 have died, 6 less compared to last year [2008].

Hanoi has seen the highest increase of people infected in the country, with 
8000 patients so far this year [2009], 15 times higher than last year 
[2008]. It is also the capital city's worst dengue outbreak in the past 10 
years.

[byline: Trung Kien]

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

[To date, more than 74 242 cases and 58 deaths of dengue infection have 
been reported in Viet Nam in 2009, which indicates a significant increase 
in dengue infection, as 58 000 cases and 44 deaths were reported on 27 Sep 
2009 (see prior PRO/MBDS posting: Dengue - Viet Nam (16) 20090930.3404).

As of 25 Sep 2008, more than 56 100 cases and 52 deaths of dengue infection 
had been reported nationwide in 2008, with more than 10 000 cases and 5 
deaths reported from Ho Chi Minh City (see prior PRO/MBDS posting Dengue - 
Viet Nam (16): Ho Chi Minh City 20081025.3368).

According to WHO's Regional Office for the Western Pacific (WHO/WPRO) 
available at <http://www.wpro.who.int/sites/mvp/data/dengue/>, there were 
57 102 cases and 44 fatalities of dengue fever (DF) and dengue hemorrhagic 
fever (DHF) reported in Viet Nam during 2009 as of week 37 (7-13 Sep 2009), 
with an incidence of 66.19 per 100 000 population and a case fatality rate 
of 0.08 per cent.

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]

******
[6] Viet Nam (Delta, Hanoi)
Date: Sun 1 Nov 2009
Source: Look At Vietnam, Tuoi Tre (Youth) report [edited]
<http://www.lookatvietnam.com/2009/11/dengue-fever-worsening-in-mekong-delta.html>


Dong Thap Province reported Thursday [29 Oct 2009] a dramatic increase in 
the number of dengue fever patients this year [2009] to 2452 so far, 111.6 
per cent more year-on-year, according to the provincial preventive health 
center. So far, 3 Dong Thap children have died from the illness.

Soc Trang Province also reported high dengue rates, with over 5000 people 
hit by the mosquitoborne disease since the beginning of this year [2009]. 7 
of them have died in the province where an estimated 170 patients are 
admitted to hospitals every week with the fever. Only 2 deaths related to 
dengue were recorded in Soc Trang last year [2008]. By June this year 
[2009], 2400 people in Soc Trang had contracted the disease, a 13 per cent 
increase yet on year.

The delta provinces of Hau Giang and Bac Lieu as well as the city of Can 
Tho have recorded 6 dengue-related deaths in total.

In the north, Hanoi has been with its largest dengue outbreak in 10 years, 
with over 8000 patients reporting dengue-like symptoms, 15 times the figure 
for the same period last year [2008], according to Ministry of Health 
statistics cited by local newswire Cong An Nhan Dan [People's Public 
Security Newspaper] early this week [week of 26 Oct 2009]. But 60 per cent 
of those patients with classic dengue symptoms have tested negative for the 
disease and are suspected of having contracted the similar chikungunya 
virus carried by the _Aedes albopictus_ mosquito. The ministry has yet to 
verify whether the cases are indeed of chikungunya [virus infection].

According to the health ministry, over 74 000 people have acquired dengue 
in Viet Nam this year [2009], up 17 per cent year-on-year. Cong An Nhan Dan 
said 58 of those patients had died.

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

******
[7] India (Delhi)
Date: Sun 1 Nov 2009
Source: Trak.in News, Indo Asian News Service (IANS) report [edited]
<http://trak.in/news/366-cases-of-dengue-in-delhi/19156/>


New Delhi, Nov 1 (IANS): Fourteen cases of dengue were confirmed on Sunday 
morning [1 Nov 2009], taking the total number of cases of the vector-borne 
disease in the national capital to 366, a health department official said.

"As of today (Sunday) morning, there were 366 confirmed cases of dengue in 
Delhi. This is no alarming figure since the numbers of those affected has 
been consistent," NK Yadav, chief medical officer of the Municipal 
Corporation of Delhi (MCD), told IANS. On Saturday [31 Oct 2009], the total 
number of cases recorded was 352.

In the past few months there have been 2 deaths recorded due to dengue –- a 
15 year old boy and a 9 year old boy.

Yadav said temperatures were warmer this year due to lesser rains during 
the monsoon and, therefore, there was not much breeding of mosquitoes. By 1 
Nov 2008 a total of 1070 cases of dengue had been recorded. "We were 
well-prepared to handle dengue and our domestic breeding checkers have been 
taking rounds of their respective areas since May," he said.

But much against the assurances of the MCD that the number of dengue cases 
in the capital is low, private hospitals have said that in reality the 
numbers are much higher than what is being said, a claim the civic agency 
denies.

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

[A HealthMap/ProMED-mail interactive map of India showing the location of 
Delhi can be accessed at <http://healthmap.org/r/00YM>. - Mod.TY]

******
[8] Yemen (Taiz)
Date: Fri 16 Oct 2009
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA), 
Integrated Regional Information Networks (IRIN) News [edited]
<http://www.irinnews.org/Report.aspx?ReportId=86616>


Hundreds of people in Taiz city, 250 km [155 mi] south of the Yemeni 
capital, Sanaa, have dengue fever and local hospitals are taking in new 
cases on a daily basis, according to health officials. "Since the new 
outbreak in September [2009], at least 350 cases have been confirmed and a 
further 1000 are suspected," Mohammed Mahmoud, manager of the government's 
National Malaria Control Programme (NMCP) in Taiz, told IRIN.

He said the number of infections had increased due to the widespread use of 
uncovered water tanks, particularly in the city's slums. "Swamps and open 
sewers contribute much to the reproduction of the vector, known as _Aedes_ 
(mosquito) that transmits the fever [virus]," Mahmoud said. [Water tanks 
certainly can serve as _Aedes aegypti_ breeding sites. Swamps and open 
sewers do not. - Mod.TY]

Many cases go undiagnosed and are not properly treated as most of those 
infected do not go to hospital for screening, said Huwaida al-Shathili, a 
professor at Taiz university's faculty of medicine. Al-Shathili said the 
number of dengue-infected cases may be many times more than those 
registered by NMCP, as symptoms can be difficult to detect.

Doctors say Taiz (population 500 000) has a fertile environment for 
mosquito breeding. "In Taiz, dengue isn't an epidemic it is a recurring 
disease in the governorate where stagnant water and pollution are 
commonplace. The disease appears every 2 or 3 years," al-Shathili noted. 
"Last year [2008], more than 300 cases were detected."

Spraying campaigns were undertaken in some parts of the city in September 
[2009] but results have been poor due to a lack of funding, according to 
Mahmoud.

"We proposed 2 massive spraying campaigns to cover all 94 000 houses in the 
city at a cost of YR 38 million [USD 190 000]," he said, adding that the 
Health Ministry had provided insufficient funding.

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

[Results may have been poor because space spraying provides only temporary 
reduction in vector populations of _Aedes aegypti_.

A map of Yemen showing the provinces can be accessed at 
<http://www.lib.utexas.edu/maps/middle_east_and_asia/yemen_admin_2002.jpg>. 
A HealthMap/ProMED-mail interactive map of Yemen can be accessed at 
<http://healthmap.org/r/00YN>. - Mod.TY]

[see also:
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 (41) 20091012.3524
Dengue/DHF update 2009 (40) 20091005.3454
Dengue/DHF update 2009 (39) 20090928.3393
Dengue/DHF update 2009 (35) 20090831.3065
Dengue/DHF update 2009 (34) 20090823.2977
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 (27) 20090706.2425
Dengue/DHF update 2009 (26) 20090629.2353
Dengue/DHF update 2009 (25) 20090622.2286
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 (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 (08) 20090216.0650]

.................yma/sb/lm/jw/ty/mj/sh



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