International surveillance reports
International Surveillance Report - 17 to 30 March 2007 (ISR #7-07)
This report aims to increase awareness of infectious disease outbreaks outside of Australia by providing a summary of major outbreaks rather than a comprehensive list of all outbreaks. This report contains information on outbreaks for the period 17 to 30 March 2007.
International Surveillance Reports
CHIKUNGUNYA: Sri Lanka
Laboratory-confirmed chikungunya cases continue to be reported from Sri Lanka. The most affected districts are Batticaloa, Colombo, Jaffna, Kalmunai, Mannar, Puttalam, and Trincomalee. Surveillance activities for chikungunya fever cases are continuing in sentinel hospitals in Sri Lanka. (The current outbreak of chikungunya in Sri Lanka was first reported in International Surveillance Report dated 15 December 2006. Outbreaks have continued to occur across the Indian Ocean during this time). Source: ProMED 20 March 2007.CHOLERA: Africa and India
Outbreaks of cholera or acute watery diarrhoea syndrome have continued in the Congo, the Democratic Republic of the Congo, Somalia and the Sudan.New outbreaks of cholera have been reported from India (8 cases reported between 1 and 27 January 2007) and Senegal (15 cases reported from the capital Dakar, with suspected outbreaks related in several other areas all thought to have originated in Touba, where an annual Muslim festival had been held). A new outbreak has also been reported from Uganda (7 suspected cases CFR 30%, in the Yumbe district in the 2 weeks since 5 March 2007).
Source: All Africa 20 March 2007; WHO Weekly Epidemiological Record 23 March 2007; ProMED 13 and 20 March 2007. (Cholera is considered endemic to all of these countries. Source: GIDEON accessed 2 April 2007.)
DENGUE FEVER: Cook Islands, Latin America and Southeast Asia
Cook Islands
Up to 700 cases of dengue fever have been reported on the island of Rarotonga since the beginning of the outbreak last year (up from 548 cases reported in International Surveillance Report #5-07). Local control measures are being implemented in an effort to curb the outbreak. Source: Radio New Zealand International 4 March 2007.Latin America
The Pan-American Health Organization has warned that the entire Latin-American region should take precautions to prevent outbreaks of dengue fever in what is expected to be a difficult year for controlling the disease.Argentina
In the three weeks to 13 March 2007, Argentina confirmed 156 cases of dengue fever, with a further 600 suspected cases under investigation in provinces bordering Paraguay (Formosa, Misiones and and Salta). Source: ProMED 11 and 14 March 2007.Bolivia
Since the commencement of the outbreak in January 2007, 910 cases of dengue have been confirmed with 93% of cases reported in the eastern province of Santa Cruz bordering Paraguay. The remaining cases have been reported in the provinces of Beni, Chuquisaca and Cochabamba (located in north, southwest and central Bolivia respectively). Source: ProMED 26 March 2007.Top of page
Brazil
Data from the Ministry of Health (current as of 24 February 2007) states that 67,847 dengue cases have been reported (44,067 in the state of Mato Grosso do Sul). Five cases have officially been attributed to dengue haemorrhagic fever. Cases are also being reported from Sao Paulo state including the death of a tourist who contracted dengue in Itanhaém on the south coast. Between 1 January and 18 March 2007, 7,808 cases have been reported from Sao Paulo state with rapid increases occurring during the last fortnight. Source: ProMED 20 and 26 March 2007.Mexico
Between 1 January and the end of February 2007, 1,589 suspected cases of dengue were reported from Mexico, an increase of 380% compared with the same period of 2006. Authorities are focussing control efforts on three tourist areas: Puerto Vallarta, where 5 Canadian tourists became infected earlier in 2007 (the Puerto Vallarta outbreak was reported in ISR#3-07 dated 2 February 2007), Cancun and Acapulco. Dengue fever is not unusual in Mexico, with approximately 4,000 cases reported per year in 2005-2006. Source: ProMED 30 March 2007; Yahoo! News 30 March 2007; GIDEON accessed 2 April 2007.Nicaragua
Twenty dengue cases (including two fatalities from dengue haemorrhagic fever) have been reported in the capital Managua and the areas of San Rafael del Sur, Masachapa and Tipitapa. An alert has been issued for affected municipalities and local control measures have been implemented. Dengue fever is not unusual in Nicaragua, with 1,350 cases reported in 2006. The last major outbreak was in 1998 when 13,600 cases were reported. Source: ProMED 26 March 2007; GIDEON accessed 2 April 2007.Panama
Since the beginning of 2007, authorities have confirmed 714 dengue fever cases compared to 236 for the whole of 2006. Source: GPHIN (Factiva) 20 March 2007.Paraguay
Latest official figures (between 1 January and 14 March 2007) report 19,577 suspect dengue cases and 46 dengue haemorrhagic fever cases (CFR 21.7%). Far higher case numbers have been reported by international media: up to 400,000 cases in the year to 23 March 2007. The circulating virus is serotype DEN 3. There have also been reports of atypical dengue presentations. The outbreak continues to be concentrated in the capital Asuncion and 4 departments: Capital (incidence rate = 1166.6 per 100 000), Cordillera (392.3), Central (388.4), and Concepción (336.5). Other affected departments include Amambay and Paraguari. Source: ProMED 20 and 23 March 2007; BBC News 2 March 2007.Peru
The Ministry of Health reported 931 dengue fever cases including 2 deaths between 1 January and 17 March 2007. In 2006, Peru reported 5,500 cases of dengue fever, which was a drop of 30% compared to 2005 case numbers. Source: GPHIN (Factiva) 20 March 2007; The Lima Bean 17 March 2007.Top of page
Uruguay
Health authorities confirmed on 18 March 2007 the country's first case of locally-acquired dengue fever in Salto, a city 500 km from the capital, Montevideo. This follows reports of the first dengue case in a recently returned traveller from Paraguay (reported in International Surveillance Report #6-07). Source: ProMED 20 March 2007.Venezuela
Health officials have reported 9,986 cases of dengue fever in the year to 23 February 2007, up 43% from the same period in 2006. Forty-three percent of the cases are in the state of Zulia bordering Colombia – the largest number in any region. Lara state was the next worst hit, followed by Merida, Aragua, and Miranda. Source: ProMED 20 March 2007.Southeast Asia
Malaysia
From the beginning of January to 17 March 2007, the town of Subang Jaya on the outskirts of Kuala Lumpur has recorded 1,023 suspected dengue cases including 5 deaths. The Health Ministry said that for 2007, the number of suspected dengue infections stood at 12,086 cases. Source: ProMED 26 March 2007.Philippines
Dengue cases in 2007 have already reached 256 as of March 2007, slightly higher than the 234 cases recorded for the same period in 2006. Source: ProMED 26 March 2007.Vietnam
Since the beginning of 2007, approximately 5,000 cases of dengue fever have been reported, primarily in southern provinces. Large numbers of dengue cases are not unusual in Vietnam, with 49,400 cases reported (including 47 fatal in the south of the country) in 2005. Source: ProMED 26 March 2007; GIDEON accessed 2 April 2007.MEASLES AND MUMPS: Eastern Europe and North Korea
Bulgaria
Between 3 and 18 March 2007, Bulgaria reported 497 cases of mumps in an ongoing outbreak (earlier reported in ISR #6-07 dated 16 March 2007), contributing to a total of 997 cases in the year to 18 March 2007. In the previous year to 18 March 2006, 311 cases were reported. Source: ProMED 22 March 2007.Hungary
Between 5 January and 24 February 2007, Hungary reported 9 cases of mumps in a village in Heaves County, in the north of the country in people between 22 and 31 years old. All cases were epidemiologically-linked to a man who had returned from travel to the Ukraine in December 2006. Source: Eurosurveillance 29 March 2007. (There have been no recent outbreaks of mumps reported from the Ukraine. Source: GIDEON accessed 3 April 2007.)Serbia
Between January and 12 March 2007, 121 suspected cases of measles from one district in the north of the country (laboratory confirmation has been obtained for 78 of these cases). Most of the confirmed cases are from the Roma population, amongst whom vaccination coverage is low (anecdotally estimated at 50% in one community). The median age of confirmed cases is 13 years. In 2006 there were only 2 suspected cases reported in the whole of Serbia. Source: ProMED 15 March 2007; Eurosurveillance 7 March 2007.North Korea
Between November 2006 and 24 March 2007, North Korea reported 3,600 suspected cases of measles (4 of them fatal), with 600 of those cases reported in the last month. A UNICEF-led vaccination campaign is planned for April 2007. Source: ProMED 25 March 2007.Top of page
MENINGOCOCCAL DISEASE: Africa
Outbreaks of meningococcal disease are continuing in Burkina Faso and the Sudan.PLAGUE: Tanzania
Eight fatal suspected cases of bubonic plague have been reported from the Manyara region of Tanzania between 28 February and 28 March 2007. If confirmed, these would be the first cases of plague in Tanzania since 2002, when 19 cases were reported. Source: ProMED (IPP Media, Guardian report) 28 March 2007; GIDEON accessed 30 March 2007.POLIO: Global Update
Between 14 and 20 March 2007, 17 cases of polio were confirmed from three endemic countries, India (6), Nigeria (10) and Pakistan (1). Advance notice of 4 cases was given from re-infected countries, Democratic Republic of the Congo (3 cases from Equateur Province) and Somalia (1 case from Togdher Province). Source: Wild Poliovirus Weekly Update 21 March 2007.RIFT VALLEY FEVER: Tanzania
Tanzania
New clusters of Rift Valley fever are occurring in Tanzania with 58 suspect cases (8 confirmed positive; CFR – 24%) from the Dodoma region and 60 new suspect cases reported from the neighbouring Morogoro region. This represents a geographic extension of the outbreak, spreading south into Tanzania. The current outbreak began in Kenya in December 2006 with the first Tanzanian cases located in the northern Arusha region in February 2007. (Extension of the outbreak into Tanzania was first reported in International Surveillance Report #4-07). Source: WHO Update, 23 March 2007.SEASONAL INFLUENZA: Global Update
China and Russian Federation
Both countries continued to report high influenza activity between 5–18 March 2007 (weeks 10 – 11/2007) and continuing into week 12 (19–25 March 2007) for China (week 12/2007 data not available for the Russian Federation).Europe
Between 5 and 11 March 2007 (week 10/2007), Denmark, Estonia and Sweden all reported increasing influenza-like illness (ILI) decreasing by the end of week 11, with the exception of Denmark. Denmark is still reporting increased consultation rates in week 12/2007 after a peak in week 10/2007. By 25 March 2007, influenza activity in most European countries was back or almost back to levels seen outside the winter period. Compared to the 2005-06 season, peak consultation rates have been higher for 18/27 countries for which data are available. This is attributed to the circulation of influenza A (H3N2), the predominant European strain during the current season, which causes more severe illness than influenza B viruses (predominant during the 2005-06 season).United States
The United States continued to report decreasing ILI activity over weeks 10 – 12/2007. The percent of deaths due to pneumonia and influenza remained below the baseline level.Source: EISS Weekly Electronic Bulletin 16, 23 and 30 March 2007; WHO FluNet accessed 2 April 2007; CDC Weekly Influenza Update 10, 17 and 24 March 2007.