Drought Brings Famine and Disease to Horn of Africa

As the Horn of Africa – including Ethiopia, Somalia, Kenya, and Djibouti - faces its worst drought in over 50 years, thousands of Somali refugees seek shelter in the capital city of Mogadishu and in refugee camps in northeastern Kenya and southeastern Ethiopia. The Dadaab refugee camps in Kenya have swelled to a population of over 400,000, as Somalis walk for 15 to 20 days prior to arrival in search of food and water. The Dolo Ado camp in Ethiopia continues to see an average of 200-300 Somalis arrive each day.  In just the past 2 months, facing imminent starvation and death, an estimated 220,000 have fled their drought-stricken farms.

The situation in the Horn of Africa continues to worsen with confirmed cases of cholera and dengue in Somalia (including Mogadishu) and measles outbreaks in refugee camps (with the hardest hit being the Dolo Ado camp in Ethiopia). The United Nations (UN) has warned that the situation could become “unbearable,” as the famine is expected to spread throughout southern Somalia in the next 4-6 weeks.

In such an unstable region of the world, delivering aid is challenging, however international organizations are responding. For the first time in five years the UN airlifted emergency aid into Mogadishu, and an additional 800 metric tons of food is on its way to East Africa. Furthermore, the World Health Organization (WHO) has launched a vaccination campaign along the Kenya-Somalia border to protect over 200,000 malnourished children from diseases such as measles and polio. 

Visit the World Food Program’s Website at www.wfp.org to learn more about the ongoing humanitarian crisis in the Horn of Africa or to make a donation.

Legionnella at the Playboy Mansion, Meningitis in the Ukraine and on US college campuses, Cholera update, and Chlamydia in New Brunswick

Meningitis in Ukraine
On February 11th, in Zakarpatie, about 60 people were hospitalized, suspected of having the deadly disease - meningitis. Most of the patients are associated with a local Roma camp. The town is in a panic and many are afraid of becoming infected from the Roma people. Parents are not letting their children outside and most others are trying to stay indoors.  “Everybody is scared, the same as last year during the outbreak of the swine flu.” Locals say that the Roma district had suffered from meningitis in the past, but do not recall such a widespread event.

It is suspected that an epidemic of meningitis has the potential to touch other parts of Ukraine. On January 28, in Svyatoshynskyi district of Kiev, a second-grade boy died from meningitis while other children were infected.

The most common symptoms of viral meningitis are high fever, vomiting and headache. Meningitis can be life-threatening and is therefore classified as a medical emergency.

На Закарпатье уже госпитализировано около 60 пациентов с подозрением на смертельную болезнь - менингококк. Большинство заболевших - это представители местного цыганского табора.

В городе паника - люди боятся заразиться от цыган. Местные не пускают детей на улицу и сами стараются меньше выходить. "Все перепуганы, как в прошлом году во время эпидемии "свиного гриппа".   Местные говорят, что в ромском районе и раньше болели менингитом, но такой мощной эпидемии не припоминают.

Похоже эпидемия менингококка может затронуть всю Украину. 28 января в Святошинском районе Киева от менингита умер второклассник. Признаки вирусного менингита - температура до 40, рвота, головная боль.  

Chlamydia Epidemic in New Brunswick
New Brunswick has issued a warning over the growing number of cases of chlamydia, particularly among youths.  “If you are under 30 and you are breathing you need a chlamydia test," stated the deputy chief medical officer.  Although over 1,800 New Brunswick youths have been diagnosed, a focus group has revealed that most youths in New Brunswick are unaware of the risks infection poses.  Chlamydia is a sexually transmitted disease that can lead to infertility in both women and men if untreated (although sterility is a very rare complication in men).  Having chlamydia also increases the likelihood of becoming infected with HIV if exposed to it.

Cholera Spreading in Ghana, Côte d’Ivoire and Papau New Guinea
The number of deaths in Greater Accra, Ghana from cholera has risen to six with 505 cases recorded as of February 14.  The 1st case was reported on January 10, and the number of cases has continued to rise despite the government’s efforts to combat the outbreak by offering free treatment to those affected and undertaking a public education campaign.

Eleven are now dead and 252 cases suspected due to a cholera outbreak in Côte d’Ivoire’s capital of Abidjan.  The epidemic began in Adjame on January 21 and is being attributed to garbage piling up throughout the city. An educational campaign as well as free treatment of cases are both being conducted in an attempt to stop the outbreak.

Cholera cases continue to be recorded in Papau New Guinea (PNG) due to a lack of government funding and an initially poor response to the outbreak. Over 10,000 cases and 483 deaths have been recorded in 7 of 19 PNG provinces since the outbreak began in September 2009.

Playboy Mansion Hit with Legionnaires’ Disease
On February 3, Hugh Hefner hosted a fundraiser for Jenny McCarthy's Generation Rescue Autism Foundation at the infamous Playboy Mansion in Holmby Hills in California. Unfortunately, many of his guests became very sick within 24 to 48 hours after leaving the event with severe flu-like symptoms such as coughs, chills, fevers, and respiratory infections. Investigators discovered that these people were experiencing a mild form of Legionnaire’s Disease, Pontiac Fever. So far, 170 people have been reported with the disease.

Pontiac Fever is a respiratory infection caused by the Legionnella bacteria, which is typically found in water-delivery systems such as shower heads, hot tubs and air conditioners. The Playboy Mansion spread may be linked to a fog machine. Symptoms usually persist for 8-10 days, but resolve themselves without any antibiotics.

The Playboy Mansion is only one of various DOMAINfest Global Conference locations in Santa Monica under investigation for helping spread the disease.

Meningitis on campus
Two US universities have seen meningitis cases recently.  In New York, a St. Lawrence University junior has been diagnosed with bacterial meningitis.  At St. Lawrence, approximately 95% of the students have been vaccinated.  At Texas A&M, a 20-year old junior living off-campus died of bacterial meningitis on Friday.  He was the second student this academic year to be infected at Texas A&M.  Texas’ one-year old law requiring meningococcal vaccination does not apply to students living off-campus.  

Pneumoccal and meningococcal meningitis are the most common forms of bacterial meningitis.  The pnemococcal vaccine routinely given to children under 2.   The Advisory Committee on Immunization Practices (ACIP) recommends everyone between 11-18 years of age be vaccinated against meningococcal meningitis.  According to the National Meningitis Association, there are 1500 cases of bacterial meningitis every year.  Many states and schools require the vaccine for incoming freshman.  For more information on the vaccine, visit the CDC’s site.

Cholera in Venezuela, Meningitis in a Florida Prison, and More Weekly Updates

Cholera Spreads to Venezuela
The Cholera outbreak in Haiti beginning in October has infected nearly 210,000 people and killed more than 4,000. This terrible disease spread to a neighboring country, the Dominican Republic, where there have been 238 registered cases and one recent death.
       
On January 22, a wedding was held in the Dominican Republic and 452 people ate lobster that was infected with the Cholera bacteria. Upon returning to Caracas, Venezuela, the wedding guests may have brought Cholera with them. The Venezuelan Health Minister, Eugenia Sader, reports that one-by-one, people who attended the wedding are being checked for the infection. So far, 135 people in Venezuela are being treated for Cholera.
       
It is unclear what the consequences may be as twelve of the Venezuelans infected with the Cholera bacteria are still in the Dominican Republic, but four others have traveled to the United States, Mexico and Spain. Health officials are encouraging anyone exposed to this bacterium to get tested, even if they are not showing any symptoms, which include intense diarrhea, vomiting and nausea.

Meningitis Confirmed in Florida Prison
Last week, the Martin County Health Department released an official press release stating that a confirmed case of meningococcal meningitis had been identified in a prison inmate at the Martin Correctional Institution in Indiantown, Florida. As of January 26th, 2 additional inmate - 1 confirmed and 1 suspect - have been admitted to the Martin Memorial Hospital for treatment. As a precautionary measure, the facility was placed on temporary lock-down - not admitting any new inmates, and some staff and inmates were placed on antibiotics. Those who refused treatment were placed into quarantine for a minimum of 10 days. Meningococcal Meningitis is an incredibly fast acting bacterial disease with high fatality - causing inflammation in the lining of the brain and death in approximately 15 percent of cases, even with the availability of antibiotic treatment.

Leptospirosis in Brazil
On February 2nd, an outbreak of leptospirosis was reported in two cities of Rio de Janeiro State in Brazil, with Teresópolis reporting 2 confirmed cases and Nova Friburgo reporting 26 confirmed cases. Leptospirosis is known to occur most frequently in the weeks after heavy rainfall or flooding, both of which occurred late last month in Rio de Janeiro state. Leptospirosis is spread through direct contact with an infected host and also via exposure to water or soil contaminated with fluids from an infected host.

Hepatitis A Hovers over Mato Grosso
In Brazil’s Mato Grosso state, 32 cases of Hepatitis A were confirmed by the state Secretary of Health in the city of Santo Antônio do Leste (located 379 kilometers south of Cuiabá). There is concern that this outbreak may spread to cities nearby, such as Paratinga (located 389 kilometers from Cuiabá). Secretary of Heath representatives are recommending that schools be postponed for 30 days and that daycare facilities follow suit. Hepatitis A is a virus spread via the ingestion of fecal matter (according to the Centers for Disease Control and Prevention this infection may occur with fecal matter “even in microscopic amounts’’) from an infected host.

Australia Disbanding Outbreak Team and the Changing Face of HIV in China

http://healthmap.org/en/?ps=148  (Australia's alerts this year)

Australia to discontinue infectious disease investigation team:
Australia is one of very few industrialized nations without a national disease control center.  For the past 20 years, outbreak investigations have been preformed through the Master of Applied Epidemiology program at Australian National University (ANU).  Funding has run out, raising concerns among public health experts.  Professor Robert Douglas of ANU explained that the group played a role in “stemming the spread of about 200 epidemics, including severe acute respiratory syndrome (SARS), Hendra virus, the swine flu and food-borne infections.”  To see a map of outbreaks in Australia this year, please click here.

Cholera on Daru Island
A cholera outbreak in Papua New Guinea’s (PNG) Daru Island has Austalian official worried.  This outbreak is an extension of last year’s cholera outbreak in mainland PNG.   At least 16 people have died.   While 274 of the Torres Strait Islands are owned by Australia, Daru Island belongs to PNG.  Australia has enacted travel restrictions between the Torres Strait Islands and PNG to reduce the likelihood of cholera’s spread.  They have also sent emergency support to help combat the outbreak.

HIV in China
Recently, China released figures that as of September this year, there are 360,000 HIV positive cases in the country, among whom 130,000 have progressed to AIDS and 60,000 have died. Furthermore, HIV was the number one killer among all infectious disease-related deaths. In recent years, China has seen a shift in HIV demographic from high risk populations such as IV drug users and plasma sellers to the general population who contract the disease via heterosexual transmission. Multiple provinces and autonomous regions also reported this similar trend and an increase in HIV cases and deaths each year. While the country has made enormous strides over the years in reducing the stigma around the disease and promoting a message of tolerance and awareness through public education and propaganda, those infected with HIV still experience heavy discrimination and poor access to medical and social support. Just yesterday, in China’s first ever lawsuit over employment-discrimination against people who are HIV-positive, the court ruled against the defendant, citing that the city education bureau had correctly followed public service standards in assessing its teaching candidates.

Dengue in Brazil and Miami:
Since January 2010, Brazil has seen a 90% increase in deaths from Dengue as compared to the same period last year.  Many of the deaths have been from type 1 Dengue, which had been largely absent in Brazil since the 1990s. Health officials are particularly concerned about the dramatic increase in cases, as Brazil now enters its six-month rainy season. During this time frequent downpours cause standing water to become mosquito breeding ponds. The health ministry is launching a campaign to educate the public through TV and radio ads as well as through the distribution of flyers.

In other Dengue news, Miami has reported its 1st case of dengue fever in 50 years. This news comes 4 months after health authorities announced 1000 probable cases in Key West, FL. This news marks the likely resurgence of dengue in the state of Florida.

H1N1 Resurfaces:
In Harare, Zimbabwe 1 case of H1N1 has been confirmed  and 5 others are suspected. The public was notified of the cases via the state-owned Zimbabwe Broadcasting Corporation, which stated via the Deputy Minister of Child Health and Welfare Dr. Mombeshora that Zimbabwe possesses enough medicine to protect the public in the event of an H1N1 outbreak. For the combined areas of Harare, Masvingo, and Matabeleland North and South,  a total of 15,453 cases of H1N1 were suspected as of last Friday, November 5th.

Spotlight News of the Week

Spotlight News of the week:

Polio re-emerges in north-east Afghanistan for the first time in over 10 years:
A new case of polio was identified in the north-east Afghan province of Kunduz bordering Tajikistan, a region that had been polio-free for over a decade. It was initially believed that the source of transmission came from neighboring Tajikistan that is currently experiencing a large polio outbreak. However, it is now believed that the virus may have been carried over by recent refugee immigration from flood-ravaged Pakistan. In response, the Afghanistan Ministry of Health has launched a large-scale vaccination campaign with plans to vaccinate 1.5 million children in five nearby provinces from September 5-7.

What was once a highly infectious and fatal disease that left countless children irreversibly paralyzed, polio is now eradicated from most of the world and remains endemic in only four countries: Afghanistan, India, Nigeria, and Pakistan. Although aggressive vaccination campaigns have decreased the number of cases worldwide by 99% from 350,000 in 1988 to 483 in 2001, the number has since hovered around 1,000 each year.

Additional News highlights

Anthrax in Bangladesh:
Bangladesh has been experiencing an anthrax outbreak among humans and cattle. At least 327 people have been infected, and India is concerned that animals moving across the shared border could bring the disease to Punjab or Haryana.

West Nile Virus in Europe:
Many European countries have seen West Nile Virus cases recently. Although the virus has been seen in Europe before, it is rare in many countries. Greece is seeing widespread cases for the first time with 15 dead and 158 sick. Russia’s southern Volgograd region has had 206 cases and 5 deaths since July 16. Romania has 7 cases and 2 deaths. Hungary first saw the virus in 2003 and now reports two patients being treated. Western Turkey currently has 4 cases and reports 3 deaths. Sicily has reported 49 cases in horses.

Cholera in Cameroon:
Cameroon is facing its worst outbreak of cholera in a decade. Since May 2010 the Health Ministry of Cameroon has confirmed over 5,500 cases and 350 deaths due to cholera in the Nord and Extreme-Nord regions of the country. UNICEF has launched a communications campaign to spread prevention and awareness messages to over 1.6 million school children at risk in a region with limited access to latrines and clean drinking water.

UPDATE: Cholera Far from Under Control in Zimbabwe

To date over 60,000 people have been infected with cholera, and more than 3,100 are dead. Despite international efforts to control the outbreak, the World Health Organization (WHO) has called for additional, urgent measure to be taken, as the outbreak is still far from being under control.

Related Articles (more at www.HealthMap.org):

http://www.who.int/mediacentre/news/releases/2009/cholera_zim_20090130/en/index.html

http://www.straitstimes.com/Breaking%2BNews/World/Story/STIStory_332256.html

http://www.oxfamamerica.org/newsandpublications/press_releases/school-in-a-time-of-cholera-health-risk-threatens-return-to-school-for-zimbabwean-children

Cholera Outbreak in Zimbabwe Continues

Cholera is caused by infection with the bacterium Vibrio cholerae, and symptoms include profuse watery diarrhea, vomiting, and leg cramps. Without treatment, death can occur within hours due to dehydration and shock. The bacterium that causes cholera is spread by contaminated drinking water or food.

In Zimbabwe, the lack of safe drinking water, poor sanitation, deteriorating infrastructure, and reduced numbers of healthcare workers reporting to work have all contributed to the continued worsening of the current outbreak of cholera. Countless media reports and news from various on-line sources continue to emphasize the severity of the situation in Zimbabwe. A reported 31,000+ people have been infected and over 1,600 have died. While cholera can be successfully treated with the immediate use of oral rehydration salts, many have limited access to healthcare. This has pushed the case fatality rate from the typical 1% to 5.7% (up to 50% in some more remote areas).

Despite monetary aid pouring in from countries throughout the world and aid from the WHO, Doctor’s Without Borders, the International Federation of the Red Cross, and many others, the most recent week’s report showed both an increase in deaths outside health centers as well as an increase in cases over previous weeks. With the rainy season having just begun, the likelihood of further spread of the outbreak appears likely. The red bubble on HealthMap.org may remain over Zimbabwe well into the spring of 2009.

http://reliefweb.int/rw/rwb.nsf/db900SID/SKAR-7MWJ59?OpenDocument
http://www.thetimes.co.za/News/Article.aspx?id=911573
http://www.scoop.co.nz/stories/WO0901/S00004.htm
More related articles available at www.HealthMap.org