ProMED-mail post

Published Date: 2011-07-08 02:43:38
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2011 (20)
Archive Number: 20110708.2061

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (20)
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In this update:
Americas
[1] Cholera - USA (Puerto Rico) ex Dominican Republic Asia
[2] Cholera - China (Hong Kong SAR), locally acquired
[3] Cholera - Pakistan (Sindh)
[4] Cholera - Nepal (Kathmandu)
[5] Cholera - Afghanistan (Kandahar, Zabul)
Africa
[6] Cholera - Zimbabwe (Masvingo, Manicaland)
[7] Cholera - Zimbabwe (Matabeleland)
[8] Cholera - Ghana (Central Region)
[9] Cholera - Nigeria (Gombe)
[10] Cholera - Nigeria (Niger)

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[1] Cholera - USA (Puerto Rico) ex Dominican Republic
Date: Mon 4 Jul 2011
Source: Associated Press [edited]
http://www.washingtonpost.com/world/americas/puerto-rico-1st-cholera-case-confirmed-in-us-island-in-traveler-from-dominican-republic/2011/07/04/gHQAbmT6xH_story.html

Puerto Rico is reporting the American island's 1st case of cholera
linked to the current outbreak in neighboring Hispaniola.

Health secretary Lorenzo Gonzalez Feliciano said Mon 4 Jul 2011 that
the case involved a 70 year old man who had visited the Dominican
Republic for a week. Gonzalez said the man is hospitalized in San
Juan. Privacy laws prohibited them from releasing more information
about the case.

Health officials believe the disease is unlikely to spread because of
better sanitation on Puerto Rico.

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[2] Cholera - China (Hong Kong SAR), locally acquired
Date: Wed 6 Jul 2011
Source: Hong Kong Government [edited]
http://7thspace.com/headlines/388456/confirmed_cholera_case_under_investigation.html

The Centre for Health Protection (CHP) of the Department of Health
today (6 Jul 2011) is investigating a confirmed case of cholera and
reminds people to observe good personal, food and environmental
hygiene, whether in Hong Kong or traveling abroad.

The case involves a 25 year old man who developed diarrhea on 27 Jun
2011. He attended Alice Ho Miu Ling Nethersole Hospital for medical
consultation but did not require hospitalization. Laboratory tests
later showed that culture of his stool specimen yielded _Vibrio
cholerae_ [serotype] O1 [biotype] Ogawa.

The patient has been admitted to the isolation ward of Princess
Margaret Hospital and is in stable condition. He did not have history
of recent travel. His home contacts have no symptoms of cholera.

This is the 1st case of cholera reported this year [2011]. There were
9 cholera cases in 2010, none in 2009, and 7 in 2008.

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[As a short review, the flagellar (H) antigens of _V. cholerae_ are
shared with many water vibrios and, therefore, are of no use in
distinguishing strains causing epidemic cholera. The O (somatic)
antigens, however, do distinguish strains of _V. cholerae_ into more
than 200 known serotypes. Almost all of these strains of _V. cholerae_
are nonvirulent. Until the emergence of the Bengal (O139) strain
(which is "non-O1"), a single serotype, designated O1, has been
responsible for epidemic cholera.

There are 3 distinct O1 biotypes, named Ogawa, Inaba, and Hikojima,
each of which may display the "classical" or El Tor phenotype. The
biotypes are distinguished by their expression of surface antigens A,
B, and C. Ogawa contains antigens A and B; Inaba antigens A and C; and
Hikojima antigens A, B, and C. The latter serotype is relatively rare.
- Mod.LL

Hong Kong can be seen on the HealthMap/ProMED-mail interactive map at
http://healthmap.org/r/026P. - Sr.Tech.Ed.MJ]

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[3] Cholera - Pakistan (Sindh)
Date: Tue 5 Jul 2011
Source: Daily Times [edited]
http://www.dailytimes.com.pk/default.asp?page=2011%5C07%5C05%5Cstory_5-7-2011_pg12_8

Sindh chief minister Syed Qaim Ali Shah has taken notice of a news
item, which appeared in a section of the Press regarding reported
non-awareness of Sindh government about 4 cholera cases. An official
statement issued here on Monday [4 Jul 2011] said that the paper
alleges that cholera, a waterborne disease, has been reported in
Karachi, but there was no heed to the health threat that may become an
epidemic within a short span of time. The chief minister has directed
Sindh Secretary Health to take preventive, precautionary and
pro-active action and also called for a report of such cases.

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[4] Cholera - Nepal (Kathmandu)
Date: Thu 30 Jun 2011
Source: Republica [edited]
http://www.myrepublica.com/portal/index.php?action=news_details&news_id=32941

At least a dozen patients admitted in different hospitals of the
capital have tested positive for cholera. Since all the patients are
residents of Kathmandu, the doctors say the disease might have already
spread, making drinking water in several parts of the capital unsafe.

The Sukraraj Tropical and Infectious Disease Control Hospital, Teku
has detected 11 cases of cholera in the past 2 weeks. According to the
hospital's research unit, cholera was confirmed in patients admitted
in the hospital for the treatment of diarrhea. The patients are from
Kritipur, Sitapaila, Kalanki, Kalopul and other locations of the
capital.

Dr Rajesh Shah, a member of the research unit said the "[serotype] 01
[biotype] Ogawa" strain of cholera was detected in all the patients.
Shah warned of more cases in the coming days, as, everyday, more than
15 new patients afflicted with diarrhea come to the hospital for
treatment.

Similarly, a cholera case has been identified at Kanti Children's
Hospital. "Cholera has been detected in a child admitted in the
hospital," Dr Tirtha Raj Burlakoti, director of the hospital, said. He
added that 77 patients with diarrheal disease have been treated in the
hospital within 2 weeks.

Likewise, Patan Hospital also said that cholera has been detected in
some of the diarrheal patients.

[byline: Arjun Poudel]

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[5] Cholera - Afghanistan (Kandahar, Zabul)
Date: Wed 22 Jun 2011
Source: Wakht New Agency [edited]
http://www.wakht.com/en/020003.php

Cholera was spreading in Kandahar and Zabul provinces in which 7
people including children had died and as many were under medical
treatment, an official said on Wed 22 Jun 2011.

Expressing concern over the critical spread of the disease, director
for Zabul Provincial Rural Rehabilitation Department RRD, Eng. Ghulam
Qader told Wakht News agency that the disease had been found 6 days
back in the Isqah Zai village of Maroof district of Kandahar province,
where 14 children have died. He said also that 30 people have been
affected by cholera in Salam village, Atghar district Zabul province,
where 5 had died and 24 were under treatment.

Nearly 18 lost their lives as a result of cholera disease outbreaks
in southern Kandahar province last week.

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[6] Cholera - Zimbabwe (Masvingo, Manicaland)
Date: Thu 7 Jul 2011
Source: Newsday [edited]
http://www.newsday.co.zw/article/2011-07-07-cholera-claims-9

Nine people died recently, while 194 were hospitalized following a
fresh outbreak of cholera in Chiredzi, a senior provincial health
official confirmed on Thu 7 Jul 2011.

Masvingo provincial medical director Robert Mudyiradima told NewsDay
that the most affected areas include Lapache, Umbono and Nyahombe in
Lowveld district. He said the latest outbreak, believed to have
started in neighboring Chisumbanje Tea Estates in Manicaland, had left
194 people hospitalized.

"As you are aware, Chiredzi borders Manicaland, where the disease was
1st detected. We believe farm workers moving in search of jobs brought
the disease to Chiredzi. That is why Chiredzi has been a problem
area."

[byline: Tatenda Chitag]

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[7] Cholera - Zimbabwe (Matabeleland)
Date: Wed 6 Jul 2011
Source: Daily Nation [edited]
http://www.nation.co.ke/News/africa/Diarrhoea+outbreak+kills+10+children+in+Zimbabwe/-/1066/1195456/-/dtxv89/-/

At least 10 children have died from a suspected diarrhoea outbreak
which has affected over 200 children in Zimbabwe's 2nd city of
Bulawayo over the past month, a state daily said on Wed 6 Jul 2011.

"More than 200 children suffering from the disease were admitted
during the month of June 2011," The Herald newspaper quoted an
official at the government-run Mpilo Hospital as saying.

"Ten children have died. Technicians at our laboratories are
analysing stools to determine the cause of the disease."

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[8] Cholera - Ghana (Central Region)
Date: Thu 7 Jul 2011
Source: Joy News/Ghana [edited]
http://news.myjoyonline.com/health/201107/68816.asp

Health authorities in the Abura-Asebu-Kwamankese District of the
Central Region have intensified education to minimize the spread of
cholera cases at Moree, a fishing community near Cape Coast.

Reported cases have increased from 45 to 55 in less than 2 days. So
far, 2 people are reported dead. The staff of the hospital has been
beefed up to fight the menace.

The Abura-Asebu-Kwamankese District Director of Health Services,
Gifty Ankrah, says health education in the area has been intensified.

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[9] Cholera - Nigeria (Gombe)
Date: Thu 30 Jun 2011
Source: Nigerian Observer [edited]
http://nigerianobservernews.com/30062011/news/Other%20News/othernews14.html

Dr Abubakar Joshua, the epidemiologist in charge of the Preventive
Health Service in Gombe State Ministry of Health, told newsmen that
tests had confirmed an outbreak of cholera.

Joshua said that the ministry received reports of the outbreak of
gastro-enteritis from Bajoga town in Funakaye Local Government Area on
15 Jun 2011 and from Nafada town of Nafada Local Government Area on 23
Jun 2011, with a total of 104 recorded cases.

"When we received a report of gastro-enteritis, we had to collect
stool samples and analyse them to see the causative agent, and we
found that it was cholera. Out of the 5 patients that we met in
General Hospital, Nafada, 2 of them tested positive to the organism
that causes cholera."

Joshua said that 3 deaths were recorded in Nafada and 2 in Bajoga.

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[10] Cholera - Nigeria (Niger)
Date: 30 Jun 2011
Source: Nigerian Tribune [edited]
http://tribune.com.ng/index.php/community-news/24309-cholera-kills-13-in-niger

No fewer than 13 people have been reported dead following as outbreak
of cholera in Niger State, Dr Usman Mohammed, the state director of
primary health services, has said. He explained that out of the 32
samples of the 457 cases reported to the health ministry, 18 of them
were confirmed to have contacted cholera.

"The state had recorded 13 deaths from the confirmed cases of
cholera, following the outbreak of the disease from 1 Jun 2011 to date
[30 Jun 2011]. All the cases of cholera recorded in the state are
confined to Minna, the state capital, although we have reported cases
of diarrhea in Paikoro and Bosso Local Government areas."

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See Also