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Archive Number 20090629.2353
Published Date 29-JUN-2009
Subject PRO/EDR> Dengue/DHF update 2009 (26)

DENGUE/DHF UPDATE 2009 (26)
***************************
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] Philippines (Isabela)
[2] Viet Nam
[3] Sri Lanka
[4] Europe

******
[1] Philippines (Isabela)
Date: Sun 28 Jun 2009
Source: PhilStar.com [edited]
<http://www.philstar.com/Article.aspx?articleId=481865>


A dengue outbreak was declared in Isabela's Santiago City amid rising cases 
of people afflicted with the dreaded disease since January this year 
[2009], including 3 recent deaths, and among them a grade schooler in a 
neighboring town.

Likewise, classes had been suspended in a private elementary school for 3 
days over the week in the city's adjacent Ramon town, also in Isabela, 
following fears of possible spread of dengue among schoolchildren in the 
said south western town.

Santiago City's dengue outbreak declaration came after 181 cases of dengue 
had been reported there from January to June [2009] with at least 2 deaths, 
both girls, recently. Of these, 67 cases have been reported this month 
[June 2009] alone while at least 30 cases were monitored last May [2009], 
with health officials expressing alarm that cases may increase with the 
onset of the rainy season.

Health officials said the number of reported cases in the city were 
remarkably higher than in the same period last year [2008], prompting the 
declaration of a dengue epidemic throughout the city.

[byline: Charlie Lagasca]

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

[Santiago City, situated in the province of Isabela, 79 km (49 mi) south of 
Ilagan (provincial capital) and about 326 km (203 mi) North of Metro Manila 
on Luzon Island, can be accessed at 
<http://en.wikipedia.org/wiki/Santiago_City>. The ProMED-mail interactive 
map of the Philippines can be accessed at <http://healthmap.org/r/00uP>. - 
Mod.TY]

******
[2] Viet Nam
Date: Fri 26 Jun 2009
Source: Viet Nam News (VNS) [edited]
<http://vietnamnews.vnagency.com.vn/showarticle.php?num=01HEA260609>


Dengue fever on the rise in [southern central] provinces
--------------------------------------------------------
The number of dengue patients has increased sharply in [the southern 
provinces of the central region], according to local health authorities. By 
Wednesday [24 Jun 2009], more than 1000 cases of dengue fever had been 
confirmed in Phu Yen Province, 2 of which were fatal. The province was 
reported to be the dengue "hotspot" for the central region. In central 
Khanh Hoa province, more than 850 people have been hospitalised for the 
mosquito-borne disease so far this year [2009]. Meanwhile in central Ninh 
Thuan province, the disease hit 40 out of 63 wards with a total of 300 
patients.

Since the middle of this month [June 2009], the Nha Trang Pasteur Institute 
has supervised dengue patients in Phu Yen, Khanh Hoa, and Binh Dinh 
provinces, and asked local health authorities to spray chemicals to destroy 
the mosquito larvae.

According to the latest statistics of the Preventive Medicine and 
Environment Department, so far the country has had nearly 23 000 dengue 
cases, 22 of whom have died.

The number of patients increased by 40 per cent and the number of 
fatalities increased by 27 per cent compared with the same period last year 
[2008], said director of the department Nguyen Huy Nga.

To prevent dengue fever, the Ministry of Health had asked provincial 
authorities to sterilise the infected areas, hold talks about the disease, 
and help local residents clear bushes and sewers to prevent mosquitoes, 
said Nga.

Dengue fever had been included again this year [2009] in the national 
target programme, and a budget of VND 70 billion [USD 4 million] was set 
aside for prevention and control. Nga said about VND 30 billion [USD 1.8 
million] had already been disbursed to provinces and cities nationwide.

The remaining VND 40 billion [USD 2.2 million] would be used for 
preventative measures, including spraying chemicals to kill mosquitoes, 
increasing public awareness about prevention and control of the disease, 
and cleaning up the environment, he said.

-- 
communicated by:
PRO/MBDS rapporteur Vern Weitzel

[Over 1400 dengue fever patients and 4 deaths were reported in 27 locations 
during one week, and as of 24 Jun 2008, there were 19 859 total cases and 
20 deaths. Ho Chi Minh City was the province with the highest number of 
cases (see prior PRO/MBDS posting Dengue - Viet Nam (06) 20080625.1962).

The number of reported cases of dengue fever and dengue hemorrhagic fever 
(DF/DHF) in the Western Pacific Region, by country in 2009 (as of 15 Jun 
2009) is available at 
<http://www.wpro.who.int/NR/rdonlyres/3C44FCF3-78D2-4655-BBEC-046DC7E2BCBB/0/Dengue_WPRO_2009_300409.pdf>.A 
total of 16 655 cases and 14 fatalities of dengue fever and dengue 
hemorrhagic fever (DF/DHF) were reported in Viet Nam from January to May 
2009.- Mod. YMA

It is not clear what the Ministry of Health officials mean when they 
indicated that "infected areas" should be "sterilized". Areas are not 
infected by dengue virus, people in given areas are. Does "sterilization" 
mean vector control? - Mod.TY

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 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] Sri Lanka
Date: Tue 23 Jun 2009
Source: Spero News, Asia News report [edited]
<http://www.speroforum.com/site/article.asp?id=19686&t=Sri+Lanka%3A+Dengue+fever+outbreak+kills+146>


Dengue fever has broken out in Sri Lanka killing 146 people and infecting 
more than 10 000 people. About 35 per cent of the dead are housewives; 22 
per cent children. The most affected areas are Colombo, Kandy, Matale, 
Gampaha, Kalutara, Matale, and Kegalle. Health Ministry spokesman WMD 
Wanninayake said that new initiatives would be taken to counter the 
epidemic in the rural population.

Despite preventive measures taken months ago, the number of deaths is 
expected to grow from 85.

A combined programme with the assistance of the Ministries of Health, Local 
Government and Provincial Councils, Education, Police, and the Civil 
Defence Force personnel, is also in place to detect residents who fail to 
comply with orders issued by medical and public health officers 
(illustrated prevention brochures being handed out).

Dengue fever is a [viral] disease  transmitted to humans by mosquitoes that 
proliferate in swamps and marshland. Under Sri Lankan law local communities 
are responsible for the destruction of mosquito breeding grounds and keep 
the surrounding areas clean, but there is no enforcement process that would 
allow the authorities to pursue anyone for negligence.

-- 
communicated by:
ProMED-mail rapporteur Brent Barrett

[The _Aedes aegypti_ mosquitoes that transmit dengue viruses do not breed 
in swamps and marshlands. One would hope that this misinformation does not 
indicate that the vector control program will be focused on these habitats 
instead of on the water catchments in and immediately around houses and 
other buildings where this vector mosquito breeds.

A map of Sri Lanka can be accessed at 
<http://www.lib.utexas.edu/maps/middle_east_and_asia/sri_lanka_pol01.jpg>. 
A HealthMap/ProMED-mail interactive map of Sri Lanka can be accessed at 
<http://healthmap.org/r/00uQ>. - Mod.TY]

******
[4] Europe
Date: Thu 25 Jun 2009
Source: Eurosurveillance edition 2009; 14(25) [edited]
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19250>


Trends in the epidemiology of dengue fever and their relevance for 
importation to Europe
----------------------------------------------------------------------
[Author: Jelinek T. Berlin Centre for Travel and Tropical Medicine, Berlin, 
Germany]

In 2008, 43 per cent of the dengue cases [imported into Europe] were 
acquired by patients who returned from travel to countries in South East 
Asia, 14 per cent were imported from Latin America, 12 per cent from the 
Indian subcontinent, 11 per cent from the Caribbean, and 4 per cent from 
Africa. This distribution reflects 2 different aspects: worldwide dengue 
activity and countries' popularity as tourist destinations. Thailand, Viet 
Nam, and Indonesia are not only highly endemic areas for dengue viruses, 
but they are also very popular destinations for European tourists. Thailand 
alone is responsible for almost 30 per cent of all travel associated dengue 
infections in our network over the past 6 years. Current developments 
mirror the epidemics in South America, with stronger reporting from Bolivia 
and Argentina. In addition, unusually strong signals come also from 
Eritrea, Jordan, Pakistan, Papua New Guinea, South Africa, Dominican 
Republic, and Suriname.

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

[The full paper is available at the source URL above. - Sr.Tech.Ed.MJ

ProMED-mail does not usually report importations of pathogens such as 
dengue viruses where there is no likelihood of ongoing transmission in the 
receiving countries such as those in Europe. However, because of the 
establishment and spread of a competent dengue virus mosquito vector, 
_Aedes albopictus_, in southern Europe there is increased risk of dengue 
virus transmission there (see Development of _Aedes albopictus_ risk maps. 
European Centre for Disease Prevention and Control, Stockholm, 2009, 
available from 
<http://www.ecdc.europa.eu/en/files/pdf/Publications/0905_TER_Development_of_Aedes_albopictus_risk_maps.pdf>). 
- Mod.TY]

[see also:
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 (18) 20090505.1677
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 (08) 20090216.0650]

.................ty/mj/sh


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