26 March, 2009

Cerebral Spinal Meningitis (CSM) spreads in Nigeria

A Cerebral Spinal Meningitis outbreak has killed more than 156 people throughout Nigeria. Jigwa, Kano, Bauchi, Yobe, and Katsina states are currently among the worst hit. A graver report from UNICEF states that the death toll is much steeper with 9,086 cases and 562 deaths. Out of four West African countries in the midst of meningitis outbreaks (Nigeria, Niger, Burkina Faso, and Mali), Nigeria is currently reported to be the most affected.

Due to Nigeria’s location, in sub-Saharan Africa’s “Meningitis Belt”, seasonal epidemics expectedly occur in a cyclic pattern. Dry weather, dusty winds, cold nights, and large populations living in overcrowded conditions leave people vulnerable to respiratory infections and are among some of the reasons behind the Meningitis Belt’s high burden of meningococcal disease.

(Picture source: http://www.reliefweb.int)

Cerebral Spinal Meningitis (CSM) is most often caused by the bacteria Neisseria meningitides. Bacterial meningitis is an infection of the meninges, the thin covering of the brain and spinal cord. Symptoms of the disease include stiff neck, high fever, rash, headache, vomiting, and confusion. Even with rapid diagnosis, 5-10% of patients typically die within 24-48 hours of symptom onset. Although sometimes fatal, CSM is most often treatable with antibiotics administered upon hospital admission.

The rapid spread of the disease is due to the ease in which the bacteria are transmitted. Droplets of respiratory or throat secretions transmit the bacteria through methods such as kissing, sneezing, coughing, and sharing of eating or drinking utensils.

A preventative vaccine is available, and is routinely recommended for adolescents 11-18 years of age. However, in the African Meningitis Belt, routine immunization is not practical, as the vaccine typically protects for only 3-5 years. Even with large-scale coverage, vaccination efforts in this part of the world would not provide sufficient herd immunity to protect the population at large. Therefore, control measures used during epidemics, in places such as Nigeria, include enhanced epidemiological surveillance, prompt case management, and mass vaccinations in areas involved in an outbreak.

(Picture source: http://www.doctorswithoutborders.org)

Related articles (more available at http://www.HealthMap.org):

PRO/EDR> Meningitis, bacterial - Africa (02): Nigeria, WHO meningitis region

Nigeria: Parent Seeks Action on Meningitis

West African Meningitis Outbreak Kills 931: UNICEF

16 March, 2009

Rabies Outbreak Kills 93 Children in Angola

Within the past three months, a rabies epidemic has claimed the lives of at least 93 children in Angola’s capital city of Luanda. With the population of the city exceeding 4.5 million, most in Luanda live in slums with unhygienic conditions.

Hospital physicians were unable to save any of the children due to a global shortage of rabies immunoglobulin and vaccine, both required for post-exposure treatment before the onset of symptoms. Due to the high number of deaths within such a short time period, the World Health Organization (WHO) has called for a thorough investigation.

Luanda’s large stray dog population has been identified as the cause of the rapid spread of the disease. Despite this, stray dog control programs have been impossible to implement due to the city’s lack of any appropriate veterinary services. (Exposure to stray dogs is approximated to be the cause of over 90% of all human exposures to rabies worldwide per the United States Centers for Disease Control and Prevention.)

Rabies is a vaccine preventable viral disease, however, according to the WHO, more than 55,000 people each year die of rabies, with 30-50% being children under the age of 15. Most deaths due to rabies occur in countries with inadequate public health resources and limited access to preventative treatment. The rabies virus attacks the central nervous system causing symptoms that include paralysis, hydrophobia, hallucinations, and encephalitis. Once clinical symptoms of rabies appear, the disease is inevitably fatal.

Related Articles (More available at www.healthmap.org):

Angola: Record rabies outbreak kills 93 children

Rabies: Canine & Human – Angola: Luanda

Rabies Outbreak in Angola, Caused by Roaming Dogs, Kills 93 Children

10 March, 2009

Northeastern United States: Lethal Disease Decimates Bat Populations

An emerging fungal disease, termed White-Nose Syndrome due to the white fungus typically found on the faces of afflicted bats, is spreading throughout the Northeastern section of the United States. Sick and dead bats have been found in unprecedented numbers in caves from Vermont to Virginia. In some areas 90-100% of the bats observed were dying.

Many species of bats are at risk in states including: New York, Vermont, New Hampshire, Massachusetts, Connecticut, New Jersey, and Pennsylvania. To date it is estimated that 75% of the bat population in these states have been killed. The loss of bats could have very serious ecological consequences, as bats are the primary predators of night-flying insects (including damaging crop and forest pests).

First reported during the 2006-2007 winter season in the central part of New York state, the unidentified fungus causes the mammals to wake from hibernation weeks early, before insects are available for them to eat. The bats are then unable to make it through the rest of winter and often end up severely emaciated or dead.

Bat researchers do not know what is causing the disease to spread, and are working in numerous locations to find the source of the fungus.

(Map Credit: courtesy of Cal Butchkoski, Pennsylvania Game Commission)

Related Articles (More available at www.healthmap.org):

Fungal Disease Found on NH Bats: http://www.myfoxboston.com/dpp/news/local/Fungal_disease_found_on_NH_bats_022209

White-Nose Syndrome, Bats – USA (05): Pennsylvania:

White-Nose Syndrome: The Threat Grows:

02 March, 2009

The Return of Polio

The Amuru district of Uganda is now treating its first case of polio in 12 years, a 16 month old baby boy from the Awer camp for displaced persons. The African Regional Reference Laboratory in South Africa confirmed the case to be positive with wild polio virus type one. In 2006, the World Health Organization (WHO) had declared Uganda free of Polio. A country is declared free of polio when there are no cases of the disease for 10 years.

Uganda has struggled to keep polio from re-entering the country. In 2008, Uganda’s Ministry of Health warned that it was under threat of importing the wild polio virus from neighboring Democratic Republic of the Congo and Sudan. Both neighboring countries had previously confirmed cases, which led to the launch of polio immunization programs in Uganda’s bordering districts.

With the now confirmed re-entry of polio, an emergency vaccination program has begun for all children under 5 years of age (the main group affected by polio). With even one child infected with polio, all children are at risk of contracting the disease, as it is capable of rapid person-to-person spread among unimmunized populations.

The wild polio virus is a highly infectious disease with no cure. It invades nerve cells of the brain or spinal cord, and can cause total paralysis within hours. Among those that become paralyzed, 5-10% die when the muscles that control breathing become immobilized. The WHO’s Global Polio Eradication Initiative, launched in 1988, works worldwide on efforts to prevent this debilitating disease.

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