Friday, November 30, 2012

WHO reports three more cases of new coronavirus, two from Jordan

Three more cases of individuals infected with the novel coronavirus have been confirmed and reported to the World Health Organization (WHO) bringing the total number of confirmed cases to nine, according to a WHO Global Alert and Response Nov. 30.
The latest three cases, which were all fatal, occurred in Saudi Arabia and Jordan.
According to the notice, the latest confirmed case from Saudi Arabia occurred in October 2012 and reported to the WHO Wednesday.The case is from the family cluster of the two cases confirmed last week.
In addition to the Saudi case, two cases from Jordan were reported to the WHO today. They occurred in April when Jordan was experiencing number of severe pneumonia cases. The Jordanian Ministry of Health sought assistance from the WHO, who in turn sent NAMRU-3 to perform laboratory testing.
At the time of the initial testing, the NAMRU-3 lab testing came up empty for a variety of respiratory virus, including coronaviruses.
The novel coronavirus currently seen in parts of the Middle East was not discovered; therefore, testing was not available.
In October 2012, after the discovery of the novel coronavirus, stored samples were sent by MOH Jordan to NAMRU-3. In November 2012, NAMRU-3 provided laboratory results that confirmed two cases of infection with the novel coronavirus, according to the Global Alert and Response.
Coronaviruses are a large family of viruses which are known to cause illness in humans and animals. This novel strain has never previously been detected in humans or animals.
As of today, there has been a total of nine laboratory-confirmed cases of infection with the novel coronavirus that have been reported to WHO – five cases (including 3 deaths) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.
Symptoms associated with the novel coronavirus have been acute, serious respiratory illness, which presented with fever, cough, shortness of breath, and breathing difficulties.
The two clusters (Saudi Arabia, Jordan) raise the possibility of limited human-to-human transmission or, alternatively, exposure to a common source. Ongoing investigation may or may not be able to distinguish between these possibilities.
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Thursday, November 22, 2012

Yellow fever mass vaccination campaign begins in Darfur

The 10-day mass vaccination campaign, designed to target 2.2 million people in 12 localities in Darfur, began Nov. 20, according to a World Health Organization Global Alert and Response Nov. 22.

The yellow fever outbreak, which has affected 26 localities in Darfur, has seen a total of 459 suspected cases including 116 deaths as of last Saturday.

An outbreak investigation team led by the Ministry of Health, with support from WHO, are in the field to assess the extent of the outbreak and prioritize areas for the mass vaccination campaign.

According to the WHO, yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients. The yellow fever virus is an arbovirus of the flavivirus genus, and the mosquito is the primary vector. It carries the virus from one host to another, primarily between monkeys, from monkeys to humans, and from person-to-person.

Once contracted, the virus incubates in the body for 3 to 6 days, followed by infection that can occur in one or two phases. The first acute phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve and their symptoms disappear after 3 to 4 days.

One confirmed case of yellow fever in an unvaccinated population should be considered an outbreak and a confirmed case in any context must be fully investigated, particularly in any area where most of the population has been vaccinated.

There is no specific treatment for the viral illness but it can be contained using bed nets, insect repellents and long clothing.

Prevention of this viral disease is through vaccination.

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Tuesday, November 20, 2012

CDC recommends polio booster for travelers to 25 countries

The serious, paralyzing viral disease, polio, has not been seen in the United States in over 30 years; however, it is present endemically in three nations and cases appear occasionally in non-endemic nations.
The Centers for Disease Control and Prevention (CDC) is advising travelers to 25 endemic and non-endemic countries to ensure they receive a polio booster prior to travel, according to CDC travel notice Nov. 19.
The destinations include Afghanistan, Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, China, Congo, Democratic Republic of the Congo (DRC), India, Iran, Mali, Niger, Nigeria, Pakistan, Rwanda, Sudan and South Sudan, Tajikistan, Tanzania, Turkmenistan, Uzbekistan, Uganda and Zambia.
Globally, the number of polio cases is down significantly compared to 2011, according to the Global Polio Eradication Initiative.
As of Nov. 14, there have been 187 polio cases reported, down from 520 during the same time frame in 2011.
The decrease in polio cases are giving the experts hope that this debilitating disease could finally become eradicated.
182 of the cases come from the three endemic countries: Nigeria (101), Pakistan (54) and Afghanistan (27). Five cases have been reported from one non-endemic country, Chad.
Polio is caused by the poliovirus types 1, 2 and 3. All three types cause paralysis, with wild poliovirus type 1 being isolated from paralysis cases most often.
This viral infection is primarily spread from person to person through the fecal-oral route; however, in places where sanitation is very good, transmission though throat secretions may be considered more important.
Polio is recognized in about 1 percent of infections by flaccid paralysis, while over 90 percent of infections are unapparent.
Paralysis of poliomyelitis is usually asymmetric and the site of paralysis depends on the location of nerve cell destruction on the spinal cord or brain stem. Legs are affected more often than the arms.
Paralysis of the respiration can be life threatening.
Most cases of polio are in children under the age of five.
The CDC offers the following recommendations for travelers to protect themselves:
Get vaccinated for polio.
  • Talk to your doctor to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling.
  • Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected. If you are traveling with children, be sure that they have been fully vaccinated, too.
Follow safe food and water practices.
  • Eat foods that are fully cooked and served hot.
  • Eat and drink dairy products that have been pasteurized.
  • Eat only fruits and vegetables that you can wash with safe water and peel yourself.
  • Drink only bottled or boiled water or beverages that have been bottled and sealed (carbonated drinks or sports drinks). Avoid tap water, fountain drinks, and ice.
Practice good hand hygiene.
  • Wash hands often with soap and water. If soap and water are not available, you can use an alcohol-based hand cleaner.
  • Wash hands especially before eating, drinking, or preparing food and after using the bathroom, changing diapers, and coughing or sneezing.
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Saturday, November 17, 2012

Hong Kong reports spikes in chickenpox and scarlet fever

Chickenpox  Image/CDC
Hong Kong health officials are reporting increases in the two childhood illnesses recently, prompting them to alert school administrators and the public in general,according to a Centre for Health Protection (CHP) press release Nov. 14.
The two childhood infections, chickenpox andscarlet fever, have spiked in the past month according to CHP data.
Specifically, the CHP reports they have received 743 cases of chickenpox notifications in October, as compared with 390 in September. The weekly number of notification of chickenpox has been gradually increasing from 147 in the week ending October 6, to 239 in the week ending November 10.
Similarly, the weekly number of scarlet fever cases recorded has also increased from 10 in the week ending October 6 to 33 in the week ending November 10.

Health officials have issued letters health care professionals and school management to alert them to the increases and offer advice.
Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes two distinct diseases; varicella (chickenpox) is the primary infection, and later when VSV reactivates, herpes zoster (shingles).
Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.
The disease is characterized by fever and a red, itchy skin rash of that usually starts on the abdomen, back or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then breaks, crusts over, and leaves dry brown scabs.
The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract and genitals.
Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days).
This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis and secondary bacterial infections.
Infection with this virus usually gives lifelong immunity, though second attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.
Scarlet fever is a form of group A strep disease that can follow strep throat.
In addition to the symptoms of strep throat, a red rash appears on the sides of your chest and abdomen. It may spread to cover most of the body.
The rash appears as tiny, red pinpoints and has a rough texture like sandpaper. If you press the rash it loses color and turns white. You may also see dark red lines in the folds of skin.
Also you may get a bright strawberry-red tongue and a rosy face, while the area around the mouth remains pale. Skin on the tips of the fingers and toes often peel after you get better.
You may also have fever, nausea and vomiting in more severe cases.
You get scarlet fever the same way you get strep throat; through direct contact with throat mucus, nasal discharge and saliva from an infected person.
Scarlet fever is usually diagnosed by doing a throat culture or a rapid strep antigen test. Treatment, like with strep throat, is with antibiotics.
The CHP offers the following advice to the public to help prevent these two diseases:
  • Maintain good personal and environmental hygiene;
  • Keep hands clean and wash hands properly;
  • Cover nose and mouth while sneezing or coughing and dispose nasal and mouth discharge properly;
  • Wash hands after sneezing, coughing or cleaning the nose;
  • Maintain good ventilation;
  • Avoid visiting crowded places with poor ventilation;
  • Refrain from work or school and wear surgical mask and seek medical advice promptly if fever or symptoms of respiratory tract infection develop; and
  • parents can approach their family doctors for further advice and information on chickenpox vaccination
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Wednesday, November 14, 2012

Ebola returns to Uganda


At least two people from Luweero District in Uganda died from Ebola hemorrhagic fever (HF); just slightly more than a month after the Uganda Ministry of Health (MoH) declared the Ebola outbreak in Kibaale district over,according to a Daily Monitor report Nov. 14.
The two deceased patients were laboratory confirmed Ebola- Sudan strain positive by the Central Public Health Laboratory.
In addition, two other individuals who died from Luweero District are highly suspected to have succumbed to the lethal virus.
Luweero District Health Officer, Dr. Joseph Okware, these individuals were tested for Marburg virus and tested negative.
The Uganda Ministry of Health officially declared a Marburg outbreak on Oct. 19. As of 28 October 2012, a total of 18 cases and 9 deaths, including a health worker, have been reported from five districts namely Kabale district, in south-western Uganda, Kampala (the capital city), Ibanda, Mbarara and Kabarole. Nine of the cases are laboratory confirmed.
During the course of the previous Ebola outbreak, in which the last case was reported on Aug. 3, a total of 24 probable and confirmed cases were recorded, of which 11 were laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe. A total of 17 deaths were reported in that outbreak.
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Monday, November 12, 2012

What is Sparganosis?

Sparganosis is an infection with the larval stages of diphyllobothriid tapeworms, other than Diphyllobothrium latumthat belong to the genus Spirometra.
Most cases of sparganosis are reported from the Far East; however, cases are seen worldwide including rare reports out of the US.
The life cycle is very similar to D. latum. The adult Spirometra tapeworms live in the intestines of dogs and cats. When the pet defecates, tapeworm eggs are released into the environment. The eggs hatch in water where this stage of the parasite is ingested by copepods. The copepod is then ingested by a second intermediate host such as an amphibian or reptile where the plerocercoid larvae is developed.
When a dog or cat eats the frog or reptile, the life cycle is complete. Humans serve as an accidental host and the life cycle cannot be completed.
People typically are infected with sparganosis when they drink water contaminated with infected copepods, by eating raw or undercooked frog or snake or using the animals flesh as a poulice to an open wound.
The symptoms of sparganosis in humans depend on where the migrating larvae end up. The subcutaneous tissue is the most frequent location. Here painful nodules are the norm. If the larvae migrate to the brain, however, much more serious neurological symptoms will ensue.
Diagnosis of sparganosis is typically made by recovering the larvae from the lesion or nodule. There is currently no recommended treatment for sparganosis other than surgically removing the larval cestode.
Since sparganosis is so rare, prevention strategies in public health have not been of great importance.
The obvious preventive measures would be identifying and avoiding drinking contaminated water, not eating raw or undercooked frogs, etc and avoid poulticing inflamed lesions.
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World Pneumonia Day is observed today

Streptococcus pneumoniae   Image/CDC

Killing more than 1 million children annually,pneumonia is by far the leading cause of death in children under five years of age. This is why the observation of World Pneumonia Day is so important in raising awareness about this deadly killer of children, according to the Prevent Pneumonia Facebook page Nov. 12.
Established in 2009, World Pneumonia Day is marked every year on November 12th to:
  • Raise awareness about pneumonia, the world’s leading killer of children under the age of five;
  • Promote interventions to protect against, prevent and treat pneumonia; and
  • Generate action to combat pneumonia.
The Global Coalition Against Child Pneumonia provides leadership for World Pneumonia Day and is comprised of over 140 NGOs, academic institutions, government agencies and foundations.
Pneumonia is one of the most solvable problems in global health and yet a child dies from the infection every 20 seconds.
The Global Coalition Against Child Pneumonia is working to save millions of lives through protecting children against pneumonia with proper nutrition through exclusive breastfeeding, preventing pneumonia with new and existing vaccines, particularly Hib vaccine and Pneumococcal conjugate vaccine and treating pneumonia by training health workers to recognize symptoms of pneumonia and increasing access to appropriate antibiotic treatment.
According to the World Health Organization (WHO), pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.
Some key facts about pneumonia include:
  • Pneumonia is the leading cause of death in children worldwide.
  • Pneumonia kills an estimated 1.2 million children under the age of five years every year – more than AIDS, malaria and tuberculosis combined.
  • Pneumonia can be caused by viruses, bacteria or fungi. Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) are the top two bacterial causes of pneumonia, while respiratory syncytial virus (RSV) is the most common viral cause of pneumonia.
  • Pneumonia can be prevented by immunization, adequate nutrition and by addressing environmental factors.
  • Pneumonia can be treated with antibiotics, but around 30% of children with pneumonia receive the antibiotics they need.
How can you help with the fight against childhood pneumonia?
Follow the World Pneumonia Day campaigns on Facebook and Twitter. In addition, you can donate to the GAVI Alliance where just $10 can provide one child with a lifetime of protection.
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Friday, November 9, 2012

Clorox offers educational tools for norovirus, C. diff prevention

In an effort to help healthcare professionals prevent and contain HAI's caused by norovirus and Clostridium difficile, Clorox Healthcare is offering free prevention tool kits, training materials and free samples of their products via their website.

See the Clorox offer here

Norovirus   Image/CDC
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Tuesday, November 6, 2012

Darfur yellow fever death toll at 67

The number of fatalities associated with the yellow fever outbreak in Central, South and West Darfur, has more than doubled in the past week according to an AFP report Nov. 6.
According to a joint report from the SudanMinistry of Health (MoH) and the World Health Organization (WHO) Monday, 194 suspected yellow fever cases have been reported, including 67 deaths.
This is up from 84 suspected cases, including 32 deaths on Oct. 29.
In addition, the number of districts reporting cases has increased from nine last Friday to 17 today.
A yellow fever vaccination campaign is slated to begin in early December.
According to the WHO, yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients. The yellow fever virus is an arbovirus of the flavivirus genus, and the mosquito is the primary vector. It carries the virus from one host to another, primarily between monkeys, from monkeys to humans, and from person-to-person.
Once contracted, the virus incubates in the body for 3 to 6 days, followed by infection that can occur in one or two phases. The first acute phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve and their symptoms disappear after 3 to 4 days.
One confirmed case of yellow fever in an unvaccinated population should be considered an outbreak and a confirmed case in any context must be fully investigated, particularly in any area where most of the population has been vaccinated.
There is no specific treatment for the viral illness found in tropical regions of Africa but it can be contained using bed nets, insect repellents and long clothing.
Prevention of this viral disease is through vaccination.
As a side note, in addition to the yellow fever outbreak in Darfur, North Darfur is also reporting a spike in measles in the past week.
Measles cases in North Darfur has increased to 77, as opposed to the 52 cases registered before Eid al-Adha (Oct. 26-28, 2012), according to health officials.
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Monday, November 5, 2012

Human hookworm vaccine candidate, Na-GST-1, progressing in clinical trials


Part I of the clinical trials for a human hookworm vaccine candidate, which began in late 2011, concluded with promising safety results. The vaccine candidate will now begin Part II of the study, according to a Sabin Vaccine Institute press release Nov. 5.
Part I of the study, which took place in Belo Horizonte, Brazil, included vaccinating healthy adults with vaccine candidate Na-GST-1 who have never been exposed to the parasitic roundworm and observe them for health and safety issues.
The next stage of Phase I clinical trial will include vaccinating 66 healthy, hookworm-exposed adults in hookworm endemic Americaninhas, Brazil.
The volunteers, ages 18-45, will receive three shots over a four month period and monitored for the vaccine’s safety and volunteer immune response.
“Eventually, a human hookworm vaccine will be used to protect children at risk of infection. Because the hookworm-exposed population being vaccinated in Part II of this trial is representative of the eventual target population, we’re closer to making this goal a reality,” said Dr. David Diemert, the trial’s principal investigator.
Dr. Peter Hotez, president of the Sabin Vaccine Institute said, “A human hookworm vaccine will help more than 600 million people worldwide who currently suffer from the infection.”
According to the release, the trial is being conducted in partnership with a team based at the Oswaldo Cruz Foundation (FIOCRUZ) of the Brazilian Ministry of Health, a member of the Sabin Vaccine Institute Product Development Partnership (Sabin PDP).
Hookworm is the second most common intestinal roundworm in humans worldwide, only behind Ascaris lumbricoides, with an estimated half a billion people infected at any one time.
There are two species that are human pathogens; Ancylostoma duodenale which is found in Africa, India, Europe and China, and Necator americanus, which is found in the Americas. However, many areas are endemic for both species.
Hookworm disease caused by N. americanus is the prevailing species in the southeastern United States.
You get hookworm in areas of unsanitary conditions where people defecate on the ground and the climate is favorable. Warm, moist climates and sandy soil are the environments hookworms thrive in. Infective larvae can survive up to a month in the soil under ideal conditions.
Hookworm is not an issue in cold climates because the larvae cannot survive.
People get infected by walking barefoot over contaminated soil where the hookworm larvae can penetrate the skin. It is a particular problem in farmers in developing nations worldwide. Also, small children get it by sitting bare-butt on the ground that has hookworm.
Ancylostoma duodenale may also be acquired orally, transmammary and transplacentally.
After the larvae penetrate the skin, it is carried in the bloodstream to the heart and then the lungs. Here they climb the windpipe and are swallowed to the intestines where they mature to adults.
In the intestines, the adults attach and suck blood. The blood loss can be significant depending on the amount of worms present. A. duodenale drinks more blood per worm (0.2-0.3 ml) per day thanN. americanus (0.03 ml), and are therefore more pathogenic.
The symptoms you may see depends on what stage of infection the person is in. During invasion when the larvae initially penetrate the skin, there may be a severe allergic reaction known as “ground itch”.
While the larvae are migrating through the lungs, an infected person may experience a mild pneumonia with a cough.
When adults are in the intestines, symptoms may include diarrhea, pain, and nausea.
In very heavy infections, blood loss can reach 100 ml per day, resulting in iron deficiency anemia and weakness due to blood loss.
In addition, protein deficiencies, enlarged liver and spleen (“pot-bellied children”) and developmental disorders like mental, physical and sexual may occur in severe hookworm disease.
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Thirty hippos die in anthrax outbreak at Kruger National Park

Public domain photo/  Zoophilia at en.wikipedia

An anthrax outbreak in the South African park has claimed the lives of 30 hippopotami in the past two weeks, according to a South African National Parks (SANParks) media release Nov. 5.
The outbreak north of Kruger National Park, which initially began in August, has killed dozens of hippos in the Letaba and Olifants Rivers recently.
Park officials are closely monitoring the situation.
“Members of the public are urged to report any sightings to the nearest camp and not to touch the carcases. The State Veterinarians are busy examining six carcases that were found over the weekend and will issue the results as soon as they’re available”, according to SANParks spokesperson, Reynold Thakhuli.
Thakhuli said that anthrax is a natural occurrence in the area.
Since 1960, eight major anthrax outbreaks have occurred in the Kruger National Park (1960, 1970, 1990, 1991, 1993, 1999, 2010 and 2012).
Anthrax is a pathogen in livestock and wild animals. Some of the more common herbivores are cattle, sheep, goats, horses, camels and deers.
It infects humans primarily through occupational or incidental exposure with infected animals of their skins.
Anthrax is caused by the bacterium, Bacillus anthracis. This spore forming bacteria can survive in the environment for years because of its ability to resist heat, cold, drying, etc. this is usually the infectious stage of anthrax.
When conditions become favorable, the spores germinate into colonies of bacteria. An example would be a grazing cow ingests spores that in the cow, germinate, grow spread and eventually kill the animal.
The bacteria will form spores in the carcass and then return to the soil to infect other animals.
The vegetative form is rarely implicated in transmission.
There are no reports of person-to-person transmission of anthrax. People get anthrax by handling contaminated animal or animal products, consuming undercooked meat of infected animals and more recently, intentional release of spores.
There are three types of anthrax with differing degrees of seriousness: cutaneous, gastrointestinal and inhalation.
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Sunday, November 4, 2012

Darfur yellow fever death toll continues to rise

Aedes aegypti Image/CDC

In a follow-up to a story last week, the number of yellow fever fatalities continues to rise in nine localities in Central, South and West Darfuraccording to a World Health Organization (WHO) Situation Report Nov. 2.
The WHO states, as of 1 November 2012, between the last week of September and the last week of October, 103 suspected cases, including 42 deaths (case fatality rate of 40.7%), have been reported from the districts of Zalengei, Nertity, Wadisalih, Azoom, Nyala, Sharq Algabal (Mershing), Kass, Geneina and Kernik.
This is up from 32 fatalities and 84 suspected cases reported on Oct. 29.
The Indo Asian News Service reported Nov. 5 (local time) that the death toll is at 50; however, the WHO has yet to put out this updated number.
The vast majority of cases have been report from Central Darfur (81.5 percent), while the remainder are reported from South Darfur (16.5 percent) and 2% are from West Darfur.
Seven out of ten cases are male with 75 percent of all cases seen are between ages 2- 29.
Technical support teams from Sudan’s Federal Ministry of Health are on ground in Central and South Darfur to conduct outbreak investigation and initiate response, entomological surveys in affected areas, as well as search for active cases.
2000 doses of yellow fever vaccine have been availed for health staff in the affected localities.
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Friday, November 2, 2012

Mauritania reports 34 human Rift Valley fever cases in past six weeks

Mauritania   Image/CIA

The West African country, which officially declared a Rift Valley fever outbreak 4 weeks ago, has reported 34 cases of the viral zoonotic disease since mid-September,according to a World Health Organization (WHO) Global Alert and Response Nov. 1.
The Islamic Republic of Mauritania Ministry of Health (MoH) reports from 16 September 2012 (the date of onset of the index case) to 30 October 2012, a total of 34 cases, including 17 deaths have been reported from 6 regions.
The six regions include Assaba, Brakna, Hodh Chargui, Hodh Gharbi, Tagant and Trarza. All the cases had history of contact with animals.
The most recent case was recorded Oct. 27. The MoH officially declared an outbreak Oct. 4.
Laboratory testing on patients was performed at the National Reference Laboratory of the National Institute of Public Health Research (INRS) in Nouakchott and at the Institut Pasteur in Dakar. Testing revealed 25 positive cases by ELISA and PCR.
Animal testing has shown virus circulation in several regions of Mauritania.
A task force has been put together to strengthen epidemiological surveillance in both human and animal health, education and awareness campaigns.
An international team of experts will be deployed to provide technical assistance starting Saturday.
The WHO says Rift Valley fever (RVF) is a viral zoonotic disease of domestic ruminants in Africa and, recently, the Arabian Peninsula that was first identified in Kenya in 1931. This mosquito-borne disease primarily affects animals but that also has the capacity to infect humans.
The vast majority of human infections result from direct or indirect contact with the blood, organs or aborted fetuses of infected animals. Such contact may occur during the care or slaughtering of infected animals or possibly from the ingestion of raw milk. Human infection can also result from the bites of infected mosquitoes.
Most human cases of RVF are generally mild; however, a small percentage of patients develop a much more severe form of the disease that appears as one or more of three distinct syndromes: ocular disease, meningoencephalitis and viral hemorrhagic fever.
Mauritania experienced an outbreak of RVF in 2010.
The WHO does not recommend any travel or trade restrictions with respect to Mauritania.
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Thursday, November 1, 2012

Maternal and neonatal tetanus eliminated in China: WHO

Neonatal tetanus  Image/CDC

A deadly disease that can occur as a result of unclean baby deliveries and umbilical cord care practices has been eliminated in the world’s most populous country, according to a World Health Organization (WHO)-China press release Oct. 30.
The WHO has confirmed that China has eliminated maternal and neonatal tetanus, a serious, life threatening disease for both the mother and her newborn.
The Chinese Health Ministry's Maternal and Child Health (MCH) programme implemented a strategy of improved antenatal care and promotion of clean and institutional deliveries to eliminate the disease.
In addition, upgraded hospitals and equipment, better trained obstetric staff and subsidized hospitalization in poorer, rural areas all contributed to the elimination of the disease.
The WHO confirmed the elimination by a comprehensive risk assessment exercise and community-based validation surveys.
The surveys revealed that of the over 1,400 women interviewed, 99 percent had hospital deliveries, the major component to preventing maternal and neonatal tetanus.
“The achievement came as a result of a number of different programmes in the Ministry of Health, other government sectors and partners working together for a joint goal to better improve the health of mothers and children and enhance the well-being of families and communities,” says Dr. Michael O’Leary, WHO Representative in China.
However, O’Leary adds, "The elimination does not mean that activities can stop; rather, it is the start of a new phase to sustain elimination through continued strong government commitment to the leadership of the Maternal and Child Health programme.”
According to the WHO, tetanus is acquired through exposure to the spores of the bacterium Clostridium tetani which are universally present in the soil. The disease is caused by the action of a potent neurotoxin produced during the growth of the bacteria in dead tissues, e.g. in dirty wounds or in the umbilicus following non-sterile delivery.
People of all ages can get tetanus. But the disease is particularly common and serious in newborn babies. This is called neonatal tetanus. Most infants who get the disease die. Neonatal tetanus is particularly common in rural areas where most deliveries are at home without adequate sterile procedures.
In 1988, the WHO estimated that 787,000 newborns died of neonatal tetanus. The most recent estimates from 2008 show that number down to 59,000, a 92% reduction from the situation in the late 1980s.
Today, there are still 34 countries that have not reached maternal and neonatal tetanus elimination status.
The WHO considers neonatal tetanus to have been eliminated when the incidence is less than one case per 1000 live births in every district in a country. Maternal tetanus is considered to be eliminated when neonatal tetanus has been eliminated.
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