Showing posts with label dengue. Show all posts
Showing posts with label dengue. Show all posts

Wednesday, May 14, 2008

Dengue epidemic raging on in Rio de Janeiro

This years dengue epidemic is raging on in Rio de Janiero, with 76,385 cases reported in the city alone until 9th May this year, according to ProMedMail (see also here). In the whole state of Rio, 134,643 cases have been reported so far. In the state of Rio, 106 deaths occured due to dengue, with 3 additional cases between 4th and 10th May. 64 of these deaths occured in Rio de Janeiro.

At the same time, the governor of the state Rio Grande do Norte declared a state of emergency due to the 19,157 dengue cases, 78 DHF cases and 2 deaths reported until 3rd May this year in 154 cities in the state.


Thursday, March 20, 2008

ICEID 2008

On March 18th, I visited the International Conference of Emerging Infectious Diseases (ICEID 2008) in the Hyatts Regency Hotel, in Atlanta, GA. Even though I was only able to attend half a day of this conference, I felt that it was incredibly useful and highly worth the trip from Athens to Atlanta. In general, the meeting was very well organized, with several concurrent sessions in the morning. I was able to attend 3 sessions on arboviral disease.

At first, Thomas Monath from the Kleiner Perkins Caufield and Byers Pandemic and Biodefense Fund talked about the challenges and possible solutions of dengue control. Tom Monath has been a major force behind the development of dengue vaccines, personally working on the ChimeriVax dengue vaccine at Acambis. He gave a thorough introduction to dengue and then summarized the status of the dengue vaccines under development. He mentioned that there is a lot of genetic plasticity within dengue serotypes, which was unknown to me. Also, he acknowledged that there is a prolonged convalescence period even for dengue fever, characterized by weakness and fatigue, which is usually not included in the burden of disease studies. He featured a highly useful and intuitive diagram showing the variety of societal, economic, ecological and evolutionary components that lead to the increasing incidence and geographic range of dengue. In terms of the US, he acknowledged that dengue is present in south Texas, and has the potential to spread further north. On one of his maps, northern Argentina was shown to have Aedes aegypti, which I wasn't aware of either (although not surprising given the proximity of Paraguay and Brazil). He also warned about the widespread distribution of Aedes albopictus in the US, which is although less capable vector of dengue as Aedes aegypti is, could nonetheless drive an epidemic in Hawaii in 2001. He mentioned that Aedes albopictus might be present on the west coast of the US, however, this is not mentioned in the recent paper on the distribution of Aedes albopictus (although I might have misunderstood).

Monday, March 10, 2008

Immunohistochemistry suggested to differentiate between yellow fever and dengue

The recent yellow fever epidemic in Paraguay with a number of urban cases highlighted the importance of differentiating between dengue and yellow fever in areas where these two Flaviviruses cocirculate. Dr. C.J. Peters at the University of Texas Medical Branch suggested on ProMedMail to use immunohistochemistry for this purpose. Immunohistochemistry localizes the antigens (virus) of the specific disease by presenting labeled antibodies. This method works in fixed tissues which are much easier to obtain from outbreaks in remote locations than fresh tissue or blood samples. He also lists a number of examples when such a method was shown to be effective for yellow fever.
This method seems to be low-tech and efficient, probably cheap method, which I, coming from Hungary, can appreciate.

Two people died of DHF on Tonga; Dengue spreading in NE Queensland

Dengue haemorrhagic fever has claimed the lives of a 23-year old man and an infant during the last week, reports ProMedMail. According to local sources, the number of dengue fever cases tripled relative to last year, with more than 200 cases [over an uncertain period]. Interestingly, the report states that the epidemic occurred between June and December. Recommendations to the public in the report include using mosquito nets, which might not have much effect as Aedes aegypti is a day-biting mosquito.

The same report announces that the number of dengue cases in Port Douglas, North Queensland, Australia reached 14, despite control efforts by mosquito trapping and spraying. As usual, residents are urged to remove potential breeding sites. The report includes interesting notes of previous outbreaks with 30 cases in Cairns in 2003 and a large outbreak of 500 cases in 1997-98 in the same area. I noticed that the link at the end of the report is erroneous. The proper link is <http://www.health.qld.gov.au/dengue>. Interestingly, this local health authority website seems to be out-of-date, showing only 6 cases in total for the current outbreak.

Wednesday, January 23, 2008

PRO/EDR> Dengue/DHF update 2008 (02) – Honduras

Date: Tue 6 Jan 2007
Source: Yahoo Noticias, Salud [in Spanish, trans. & summ. Mod.TY, edited]
<http://espanol.news.yahoo.com/s/ap/080106/salud/amc_med_honduras_dengue>


In 2007, 15 people died and more than 29 112 were affected [infected]
by dengue in Honduras, authorities reported on Sunday [4 Jan 2008].

In 2006, the number of fatal victims of this disease was 9, and there
were 7800 affected [by it].

In 2007, 4156 DHF cases were registered nationally.

"We cannot hide the significant increase in dengue [cases] in the
country in the past year [2007]," the Minister of Health, Jenny Meza,
told the press.

This situation [the increase in dengue cases] occurred despite the
army units, public employees and students having circulated in the
neighborhoods of the main cities of the country to help remove scrap
metal, fumigate houses and destroy _Aedes aegypti_ dengue virus
mosquito vector breeding sites.

The government constantly asks the population to eliminate standing
water in their homes, specifically in bowls, bottles, tires and
flower vases, where this insect breeds.

Official statistics indicate that in 6 years, more than 60 000 dengue
cases have been registered in Honduras.

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

[It would be interesting to know how successful the campaign has been
in eliminating or reducing _Aedes aegypti_ breeding sites and whether
lessons were learned that would improve vector control efforts in the
coming year. Given the increase in numbers of dengue cases in 2007,
these efforts were not as successful as the Honduras health
authorities had hoped.

An interactive ProMED health map showing Honduras and its location in
Central America can be accessed at:
< http://healthmap.org/promed?v=14.8,-86.6,5>.
- Mod.TY]

PRO/EDR> Dengue/DHF update 2008 (02) – Venezuela

Date: Tue 6 Jan 2008
Source: El Universal [in Spanish, trans. & summ. Mod.TY, edited]
< http://noticias.eluniversal.com/2008/01/06/pol_art_aragua-declarada-zon_661002.shtml>


The Director of Epidemiological Services of the Health Corporation in
the state of Aragua, Luis Dorta, announced that the central area was
closed in 2007 "as an alert zone" due to the proliferation of dengue
virus [transmission] and said that a continuation of the increase in
the number of cases could result in an epidemic this year [2008].

He pointed out, however, that the meteorological conditions during
the next months are favorable for combating the virus, [the mosquito
vectors of which] reproduce in containers of clean water. "We hope
that as we enter summer, the season in which there is no rain, we can
combat the problem."

Dorta stated that during the past year [2007], 3518 cases of dengue
fever were registered, of which 156 were DHF. With respect to these
cases, he pointed out that for every 21 dengue cases, one was DHF. He
stated that in the last 5 months of the year [2007], 8 deaths caused
by this disease were registered, of which 6 were children under 10 years old.

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

[A map showing the Venezuelan states, including the location of
Aragua, can be accessed at:
<http://www.crwflags.com/FOTW/FLAGS/ve(.html>.
- Mod.TY]

PRO/EDR> Dengue/DHF update 2008 (02) – Brazil

Date: Wed 8 Jan 2008
Source: Folha Online [in Portuguese, trans. & summ. Mod.TY, edited]
< http://www1.folha.uol.com.br/folha/cotidiano/ult95u361474.shtml>


In Para, 3 people died with symptoms of dengue hemorrhagic fever
(DHF) within the past 8 days. One of these ill individuals was from
Belem and the other 2 from Redencao (southern part of the state). In
the region, another 5 persons died with similar symptoms since November [2007].

The situation indicates that there is an outbreak of dengue in the
region, according to Rodolfo Skrivan, Director of the regional public
hospital of Araguaia, located in Redencao. The hospital receives
patients from the other 14 nearby municipalities.

"Dengue is seasonal. In some seasons of the year, there is greater
[dengue] incidence. The peak of illnesses was anticipated in February
or March, the rainy season. This worried us because, since we had
anticipated it, it might have been worse," the director stated.

The agency affirmed that it would send a team to Redencao to analyze
the situation. But, according to the adjunct secretary [of health]
with portfolio, Walter Amoras, the quantity of cases can not be
classified as an outbreak since the cases are scattered over 15
cities in the southern part of the state. "This indicates that the
municipalities are not taking a lesson from the situation. They are
not educating the public correctly."

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

[Dealing with the occurrence of dengue requires more than simply
educating the public. - Mod.LJS]

[A map of Brazil showing the location of Para, as well as the other
states, can be located at
<http://www.lib.utexas.edu/maps/americas/brazil.jpg>.
- Mod.TY]

************************************************************
Date: Wed 9 Jan 2007
Source: Extra Online [in Portuguese, trans. & summ. Mod.TY, edited]
< http://extra.globo.com/rio/plantao/2008/01/09/rjtv_82_casos_de_dengue_em_9_dias_no_rio327947436.asp>


In the past 9 days, from Tuesday of last week [1 Jan 2008] through
this Wednesday [9 Jan 2007], 82 cases of dengue have been registered
in Rio de Janeiro. The number of dengue cases is being brought up to
date. This Wednesday [9 Jan 2007] the Municipal Secretary of Health
indicated that in 2007, 23 585 dengue cases were confirmed.

In the 1st 9 days of 2008, 82 people had dengue disease. As of
Tuesday [1 Jan 2008], only 14 of them had been [laboratory?] confirmed.

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

******************************************************************
Date: Mon 5 Jan 2007
Source: Diario do Nordeste in Portuguese, trans. & summ. Mod.TY, edited]
<http://diariodonordeste.globo.com/materia.asp?codigo=501274 >


Ceara had 9.8 percent of the nation's dengue cases, with notification
of 24 793 cases of classical dengue.

72 new cases of dengue were registered in the state of Ceara, with 3
DHF cases and 69 classical dengue fever cases during the 1st week of
2008, according to the Weekly Epidemiology Dengue Bulletin released
yesterday [4 Jan 2007] by the Secretariat of Health of the state (SESA).

The number of deaths did not change, remaining at 10 confirmed cases.

In Ceara state, DHF has now reached 295 confirmed cases versus 292
the week before. In total, 651 cases were notified, of which 318 were
discarded [negative for dengue], and 38 were still being
investigated, according to SESA.

In Fortaleza, 118 DHF cases were confirmed, with one death. "We are
investigating 16 suspected deaths, which have still not been
confirmed," stated Dr. Manoel Fonseca, Coordinator of Health
Promotion and Protection of SESA.

Sobral municipality is in 2nd place, with 47 confirmed cases of DHF
and 3 deaths, and Caucaia is in 3rd place, with 20 [DHF] cases and one death.

The 1st bulletin of 2008 confirmed a total of 24 793 cases in 167
municipalities in Ceara. In the last week of last year [2007], there
were 24 724 confirmed cases of classical dengue. Fortaleza led [in
numbers of cases] in the dengue epidemic, with 11 687 cases of
confirmed classical dengue, "50 percent of all the cases," stated
Fonseca. In 2nd place was Sobral, with 1753 cases.

Despite Ceara being the state with the highest incidence of DHF in
the northeast, Manoel Fonseca clarified that there was a reduction in
the [case] fatality rate, which was over 8.7 percent in 2006, going
[down] to 3.3 percent last year [2007].

The doctor admitted, however, that in the last 3 years, the number of
dengue cases has remained high. "This year [2008], the cases will
still be high, now that we have 3 types of the virus: dengue 1, 2 and
3. In the interior, the outbreak of [dengue virus] 3 still may occur," he said.

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

***********************************************************************
Date: Tues 7 Jan 2008
Source: Aquidauana News [in Portuguese, trans. & summ. Mod.TY, edited]
< http://www.aquidauananews.com/index.php?action=news_view&news_id=119586>


The arrival of summer promises to bring big problems to the Brazilian
population in the next months. According to the data from the
Ministry of Health, there is a trend that will reach a record
[number] of dengue [cases].

Between January and September of the past year [2007], the number of
recorded [dengue] cases in the country was 50 percent above that of
2006. Just during this period, there were more than 480 000 [dengue
cases] registered, with 121 deaths. Given the control measures
carried out by the government, it is very likely that this year's
[2008] summer will surpass the outbreak of 2002, when 800 000
[dengue] cases were registered. This [projection is made] because
during this past winter, a period of little rain and [usually] fewer
cases, the [case] numbers did not fall.

Sao Paulo state is another area that worries the specialists.
Research carried out during the same period points out that the
region registered more than 64 000 [dengue] cases. Of the 645 Sao
Paulo
[state] cities, 127 had indices of at least 300 cases
registered per 100 000 inhabitants. Small and medium-sized cities,
such as Sao Jose do Rio Preto and Bauru e Ribeirao Preto, have
suffered epidemics of this disease.

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

[It is difficult to make predictions with even a modicum of
precision. Estimating that dengue virus transmission will continue in
2008 is to state the obvious. Apparently, Brazil has gotten to the
same dengue outbreak situation as Central America and Southeast Asia,
with intense dengue virus transmission year after year. - Mod.LJS]

PRO/EDR> Dengue/DHF update 2008 (02) – Bolivia

Date: Mon 5 Jan 2008
Source: ABS Digital [edited]
<http://www.abc.com.py/especiales/dengue/articulos.php?pid=383697>


At least 50 confirmed cases of dengue fever and about 500 suspects
were detected in central Bolivia after recent rains, flooding and
river flooding occurred in the area.

The person responsible for monitoring diseases at the Bolivian
Ministry of Health, Juan Carlos Arraya, told EFE that almost all the
patients are in the tropical region of Chapare, in the central
department of Cochabamba.

Arraya explained that for the moment, there is no person suffering
from dengue hemorrhagic fever, the most serious type of the disease.

Of the 9 departments of Bolivia [equivalent to states or provinces],
6 (Cochabamba, Beni, Santa Cruz, Potosi, Chuquisaca and La Paz) have
been affected by floods, rains and flooding in recent weeks -- in
many cases caused by the climatic phenomenon "La Nina" -- which
caused at least 8 deaths and 2 missing persons.

In 2007, there was one fatality from dengue hemorrhagic fever and
1930 affected by the classical variant of the disease.

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

[A map of Bolivia showing the departments can be accessed at:
< http://www.lib.utexas.edu/maps/americas/bolivia_pol_2006.jpg>.

PRO/EDR> Dengue/DHF update 2008 (02) – Philippines(Cavite)

Date: Tue 8 Jan 2008
Source: WowPilippines [edited]
<http://luzon.wowphilippines.com/cavite/2008/01/08/bacoor-declares-dengue-outbreak/>


The municipal government of Bacoor, Cavite has declared a dengue
outbreak because of the growing number of people afflicted with the
disease, ABS-CBN News reported Tuesday [6 Jan 2008]. Based on
records, a total of 53 residents were admitted to hospitals due to
dengue from August last year [2007] up to this month [January 2008].
Of these patients, 5 died because of the disease.

[Byline: Glenrose]

--
Communicated by:
ProMED Rapporteur Brent Barrett

[A map of the Philippines showing Cavite Province on Luzon Island can
be accessed at:
<http://www.chanrobles.com/philippinemapofprovinces.htm>.
- Mod.TY]


PRO/EDR> Dengue/DHF update 2008 (02) - Cambodia

Date: Sun 4 Jan 2008
Source: China View [edited]
<http://news.xinhuanet.com/english/2008-01/04/content_7365534.htm >


A total of 407 Cambodian people died out of some [40 000] dengue
fever cases in 2007, which scored a 10 percent death rate, health
official Ngan Chantha said here on Friday [4 Jan 2008].

Kampong Cham province was the main place of dengue deaths because its
density of population was higher than other provinces, said the
official from the Health Ministry.

"The residents didn't clean the places around their houses and their
water tanks in a proper way, which caused tiger mosquitoes [_Aedes
albopictus_, although _Aedes aegypti_ doubtless is abundant there as
well. - Mod.TY] to transmit virus to people easily," he said. People
should pay more attention to their health care and sanitation, he said.

In 2007, the government spent about USD 3 million to contain the
epidemic, he said.

In addition, the World Health Organization, the World Bank, the Asian
Development Bank and other non-governmental organizations contributed
money to carry out the campaign, he added.

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

[In the last PRO/MBDS posting on dengue in Cambodia, there were
reports of more than 38 000 cases and 389 deaths (see Dengue -
Cambodia (06) 20071019.3413). The above newswires increase the total
burden caused by dengue virus in Cambodia during 2007 to almost 40
000 cases and 407 deaths.

According to background data available on the World Health
Organization (WHO), Western Pacific Regional Office (WPRO) website,
the outbreak in 2007 was the largest ever documented outbreak of
dengue in Cambodia. The prior major epidemic year was 1998, when
there were approximately 16 000 reported cases (see
<http://www.wpro.who.int/sites/mvp/epidemiology/dengue/cam_profile.htm >
or the WHO Global Health Atlas, DengueNet database
(<http://www.who.int/globalatlas/dataQuery/default.asp>),
where 16 216 cases are reported). While it is highly likely that the
increased number of reported cases is somewhat influenced by marked
improvements in disease surveillance activities in the country, an
almost 3-fold rise in reported cases is highly significant. In
addition, the 10 percent case fatality rate (CFR) reported in 2007
was the highest CFR reported since 1991, when the reported CFR was 9 percent.

According to the WHO Global Health Atlas, DengueNet database
< http://www.who.int/globalatlas/dataQuery/default.asp>,
all 4 dengue serotypes were isolated during 2007, with dengue virus
type 3 (DEN-3) being the most prevalent, followed by dengue type 2
(DEN-2), followed by types 1 (DEN-1) and 4 (DEN-4).

For a map of Cambodia with provinces, see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/cambodia_pol_97.jpg >.

Kampong Cham province is located in the central portion of the
country, just north/northeast of Phnom Penh, bordering Viet Nam on
the east. - Mod.MPP]

[ProMED thanks PD Dr med vet FVH Christian Griot; MPA Unibern
Direktor, Institut fur Viruskrankheiten und Immunprophylaxe,
Switzerland for providing a similar report of dengue in Cambodia. - Mod.TY]