ProMED-mail post

Published Date: 2005-11-18 23:50:00
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2005 (45)
Archive Number: 20051118.3362

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2005 (45)
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In this update:
Asia
[1] Diarrhea, earthquake affected area - Pakistan (Kashmir)
[2]-[4] Cholera - India (Tamil Nadu)
Africa
[5] Cholera - Swaziland
[6] Cholera - Zambia
[7] Cholera - Guinea-Bisssau
[8] Cholera - Ghana
[9] Dysentery - Zimbabwe
[10] Cholera - Worldwide - WHO WER Notifications
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[1] Diarrhea, earthquake affected area - Pakistan (Kashmir)
Date: Mon, 14 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: Islamic Republic News Agency [edited]
<http://www.irna.ir/en/news/view/menu-239/0511145254092315.htm>

Over 400 cases of acute watery diarrhea have been identified in a camp in
the district of Muzaffarabad in Pakistan-administered Kashmir even as the
threat of a disease outbreak in this earthquake-stricken region of northern
Pakistan looms larger, a UN news service reported. 55 cases of acute watery
diarrhea have also been reported in a mountain village in the Muzaffarabad
district.
"This situation is explosive," said WHO's Dr John Watson, based in
Muzaffarabad. Acute watery diarrhea leads to severe dehydration and within
4 to 5 hours can lead to a dramatic drop in blood pressure. It can be fatal
if not treated quickly.
Over 2000 survivors are crammed in filthy tents in the Old University camp
in the city of Muzaffarabad. This is a "spontaneous" camp with tents and
makeshift shelters erected by quake survivors themselves. Conditions are
squalid. There is no water and the stench of sewage hangs in the air. The
existing sewage pipe is broken and there are no latrines, only rudimentary
holes in the ground.
Many residents of this camp have resorted to defecating in the grounds of
the camp along the wall that surrounds the compound. With rainwater mixing
with the mud and excrement into running streams of sludge, the camp is a
ticking time bomb for disease.
--
ProMED-mail
<promed@promedmail.org>
[Cholera has been reported in the area, and it is not clear how much of the
acute watery diarrhea is, in fact, cholera. - Mod.LL]
******
[2] Cholera - India (Tamil Nadu)
Date: Sat, 12 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: NDTV.com [edited]
<http://www.ndtv.com/template/template.asp?category=National&template=Monsoon&slug=Cholera+cases+on+the+rise+in+Chennai&id=81216&callid=1>

Incessant rains and consequent waterlogging in Chennai are turning into a
serious health hazard for people living in low-lying areas. 73 people,
including 40 children, have tested positive for cholera over the last 2
weeks, and the predictions of more rains have prompted the Union Health
Ministry to offer help for the region.
There have also been reports of the sewage water entering houses and
seeping into sumps. The Chennai Metro Water authorities have now urged
residents to be more cautious about the water they drink.
"Although we chlorinate the water, we would advise the people to drink only
boiled water," said V Thangavelu, MD, Chennai Metro Water.
******
[3] Cholera - India - Tamil Nadu
Date: Mon, 14 Nov 2005
From: T Jacob John <vlr_tjjohn@sancharnet.in>

India's south eastern coastal city of Chennai received heavy rains in the
last week of Oct and first days of Nov 2005 from the North East Monsoon.
Several low-lying areas, especially in the northern part of the city, are
flooded and relief and medical help operations are under full swing.
According to newspaper report (Malayala Manorama, Chennai edition, 6 Nov
2005), the city corporation has confirmed cholera in 11 of the nearly 200
persons hospitalized with diarrhea in the main city hospital for infectious
diseases at Thondiarpet.
Note: In India, the term cholera is applied only after microbiological
confirmation. Otherwise clinical cholera-like disease is called
gastroenteritis. _Vibrio cholerae_ is an aquatic microbe, usually resident
in plankton. In human intestines it replicates prolifically and are
discharged via feces. Floodwaters distribute them widely. The risk of
cholera is well recognized in flooded areas, but the pre-requisite is the
local environmental or endemic presence of the microbe. This condition
occurs in many parts of India and elsewhere.
--
T Jacob John
Retired Professor and Head
Departments of Clinical Microbiology and Clinical Virology
Christian Medical College
Vellore, India
<vlr_tjjohn@sancharnet.in>
[ProMED-mail thanks Dr John, a well-respected member of the world
infectious disease community, for this update. - Mod.LL]
******
[4] Cholera - India (Tamil Nadu)
Date: Tue, 15 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: NewIndPress.com [edited]
<http://www.newindpress.com/NewsItems.asp?ID=IET20051114101446&Page=T&Title=Southern+News+-+Tamil+Nadu&Topic=0>

The district administration has initiated measures to check the possible
spread of cholera in Veliambakkam village in Acharapakkam, Kancheepuram
district, following reports of the prevalence of cholera among a few of the
villagers here.
According to the medical sources, as many as 10 people of Veliyambakkam
village are suffering from diarrhea, which is one of the symptoms of cholera.
A team of doctors from the Acharapakkam primary health center have been
sent to the area in view of this. The team of doctors, led by deputy
director of health Chandrasekar, are camping in the village to be at hand
in case of any untoward incident.
******
[5] Cholera - Swaziland
Date: Mon, 14 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Swazi Observer [edited]
<http://www.observer.org.sz/main.asp?id=14205&Section=main>

A cholera outbreak has been reported in the Shiselweni region, the
government has confirmed. A spokesman for the Ministry of Health and Social
Welfare in the region Makinati Shongwe said a number of areas in the area
had been noted in the past few weeks. Cholera cases were noted in Liba,
Matsanjeni, Mtsambama among others.
"We urge people living in and around these areas to be cautious; they must
ensure they construct toilets and not relieve themselves anywhere. Cholera
is a contagious disease with deadly consequences, hence the necessary
precautions must be observed. These include pouring a teaspoon of
decontaminant into a 25 liter container of water before drinking, and
washing hands after visiting the toilet," Shongwe stated.
The spokesman advised those who had observed signs of cholera to seek
treatment as soon as possible to avoid any fatal consequences or spread of
the disease. "They should seek treatment from the nearest health facility.
A mixture of salt and water must also be provided for those with symptoms,"
he advised.
In 2004, the Shiselweni region had a number of fatalities reported as a
result of cholera.
[byline: Njabulo Dlamini]
******
[6] Cholera - Zambia
Date: Sat, 12 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: Todayonline.com [edited]
<http://www.todayonline.com/articles/83936.asp>

Zambia has recorded 274 cases of cholera, 7 of them fatal, since the
disease broke out in the country in Aug 2005.
Health minister Sylvia Masebo said the capital city, Lusaka, was the
hardest hit with about 150 cases and warned that the situation was likely
to worsen with the onset of the rainy season. "We have recorded 274 cases
of cholera in Lusaka, Central, Copperbelt, and North-Western provinces
between 13 Aug and 9 Nov 2005," Masebo said Sat, 12 Nov 2005. Zambia has
recorded 274 cases of cholera, 7 of them fatal, since it broke out in the
country in Aug 2005.
Masebo said the capital city, Lusaka, was the hardest hit with about 150
cases and warned that the situation was likely to worsen with the onset of
the rainy season.
******
[7] Cholera - Guinea-Bissau
Date: Mon, 14 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: XinHuaNet.com [edited]
<http://english.people.com.cn/200511/14/eng20051114_220961.html>

The cholera outbreak in Guinea-Bissau is finally being brought under
control and the epidemic could be declared over next month, according to
reports reaching here from Bissau on Sat, 12 Nov 2005.
The spokesperson with the Bissau Health Ministry, Lamine Indjai, said local
citizens were finally following the authorities' recommendations on
prevention of the water borne disease and new cases have fallen
"significantly" in recent weeks.
Since an epidemic was declared in Jun 2005, cholera has claimed 364 lives
from the 22 202 cases registered by the Bissau health authorities by 28 Oct
2005.
******
[8] Cholera - Ghana
Date: Thu, 17 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: Choice FM Ghana [edited]
<http://www.choicefmghana.com/Nov%2017%20Cholera%20deaths%20hit%2053%20%96%20GHS.htm>

Ghana Health Service says the a total of 53 cholera deaths so far have been
recorded with Ashanti Region leading with 23 deaths. GHS warned that the
disease was likely to spread to other places before it subsided later
during the dry season.
It said in a press release that a total of 2450 cholera cases had been
reported with the Ashanti Region recording 1429 cases. Greater Accra Region
recorded 800 cases with 11 deaths, Eastern Region recorded 120 cases with
no deaths; Central Region had 12 cases with 1 death; Western recorded 27
cases with no deaths; Northern recorded 29 cases with 9 deaths and Upper
East recording 6 cases with no deaths.
The release noted that a major wave of the epidemic had spread across the
West Africa Sub-Region involving countries like Burkina Faso, Niger, Mali,
Senegal, Liberia, Mauritania, Guinea and Guinea Bissau with more than 42
000 cases and more than 700 deaths.
******
[9] Dysentery - Zimbabwe
Date: Fri, 11 Nov 2005
From: Alfonso Rodriguez <ajrm_msds@yahoo.es>
Source: All Africa & The Herald News (Harare)
<http://allafrica.com/stories/200511110311.html>

Harare and Chitungwiza have been hit by an outbreak of dysentery with over
200 cases reported in Mbare and at 3 residential blocks in Chitungwiza in
the last few weeks.
Chitungwiza is already enforcing a strict quarantine of its patients as
part of efforts to prevent further spread.
Polluted open water is thought by health officials to the most likely
source of the outbreak. The sewerage system in Chitungwiza has been a cause
of concern with streams of human waste flowing in the town since the
beginning of 2005.
Chitungwiza General Hospital chief executive officer and renal specialist
Dr Obadiah Moyo yesterday confirmed that the hospital was under pressure
from an increased number of diarrheal patients who have been flocking there
for treatment. "We have so far dealt with 43 cases from Chitungwiza alone
in the last 2 months. In all cases the investigations we conducted showed
we were dealing with dysentery," Dr Moyo said.
Mbare recorded at least 80 cases a week in Oct 2005, prompting the acting
director of city health services, Dr Stanley Mungofa, to notify the
Minister of Health and Child Welfare, Dr David Parirenyatwa, of the outbreak.
--
Alfonso Rodriguez, MD
<ajrm_msds@yahoo.es>
******
[10] Cholera - Worldwide - WHO WER Notifications
Date: Fri, 18 Nov 2005
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Epidemiological Record, 18 Nov 2005
<http://www.who.int/wer/2005/wer8046/en>

Notifications of cholera received from 11 to 17 Nov 2005
--------------------------------------------------------
country / dates / cases / deaths
Africa
Guinea 8 - 16 Oct 2005 / 220 / 2
Liberia 17 Oct - 6 Nov 2005 / 198 / 0
Sao Tome & Principe 6 Oct - 8 Nov 2005 / 306 / 9
Asia
India 18 Sep - 8 Oct 2005 / 378 / 3
--
ProMED-mail
<promed@promedmail.org>

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