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Archive Number 20090724.2616
Published Date 24-JUL-2009
Subject PRO/EDR> Cholera, diarrhea & dysentery update 2009 (20)
CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (20)
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
Asia
[1] Cholera - Nepal (Mid Western Region)
[2] Diarrhea, fatal - Nepal (Mid Western Region)
[3] Cholera - India (Mumbai)
[4] Cholera - Somalia (Bay, Lower Shabelle regions)
Africa
[5] Cholera - Burundi (Bujumbura)
[6] Diarrhea, fatal - Uganda (Busia)

******
[1] Cholera - Nepal (Mid Western Region)
Date: Wed 22 Jul 2009
Source: Kantipur.com [edited]
<http://www.kantipuronline.com/kolnews.php?&nid=205593>


The causative agent of cholera, _Vibrio cholerae_, has been detected 
in stool samples collected from Jajarkot district where more than 150 
persons died of diarrhea in recent weeks.

When 5 suspected samples were subjected to laboratory test in 
Kathmandu following the Ministry of Health and Population directives, 
the cholera causing bacterium was detected in 3.

Though it was believed that cholera was eradicated from Nepal, the 
disease broke out in Saptari in 2007. Since then it has been endemic 
in the country.

For confirmation, the stool samples are collected and sent to the 
National Public Health Laboratory (NPHL) in Teku for laboratory 
confirmation.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

The Jajarkot district is located in the Mid Western Region and can be 
found on a map at
<http://ncthakur.itgo.com/map04.htm>.
The HealthMap/ProMED-mail interactive map of Nepal is available at
<http://healthmap.org/r/00BY> - Mod.LL]

******
[2] Diarrhea, fatal - Nepal (Mid Western Region)
Date: Thu 23 Jul 2009
Source: AsiaNews [edited]
<http://www.asianews.it/index.php?l=en&art=15863&size=A>


More than 200 people have died in a diarrhea epidemic in Western 
Nepal, the most remote and poorest region of the country, which has 
spread unchecked for over 2 months. Rukum, Rolpa, Surkhet, Jajarkot 
districts are most affected by the epidemic. In these areas the lack 
of adequate roads and hospitals are adding to a rapid spread of the 
disease. Dozens of people are infected every day in the villages. In 
many cases the bodies of dead lie in the fields contaminating the 
waterways. A considerable increase [in the number] of the victims is 
expected in the coming months.

Despite the fact that the 1st deaths occurred about 3 months ago, the 
government is only now intervening to stop the spread of the epidemic 
to the rest of the country. After an initial visit, Mon 20 Jul 2009, 
the Prime Minister Madhav Kumar assured the people declaring to have 
taken special measures to tackle the epidemic quickly. He 
acknowledged the responsibilities of institutions stating that "this 
situation is due to a lack of coordination of the competent 
authorities."

Meanwhile, the younger population is fleeing from the affected 
districts for fear of contagion, leaving the elderly alone in the 
villages.

[Byline: Kalpit Parajuli]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[As noted in the 1st report above, at least some, if not all, of the 
diarrhea has been found to be cholera.

The districts mentioned are located in the Mid Western Region and can 
be found on a map at
<http://ncthakur.itgo.com/map04.htm>. - Mod.LL]

******
[3] Cholera - India (Mumbai)
Date: Wed 22 Jul 2009
Source: The Times of India (TOI) [edited]
<http://timesofindia.indiatimes.com/articleshow/4804903.cms>


A day after a cholera case was confirmed in the city [Mumbai], 3 more 
patients from GT Hospital, CST, were reportedly transferred to 
Kasturba Hospital for Infectious Diseases on Tuesday [21 Jul 2009] on 
suspicion of the water-borne ailment.

BMC [Mumbai Municipal Corporation] executive health officer Jairaj 
Thanekar, however, said, "There are no more positive cases and no 
more patients have been transferred."

Meanwhile, civic health officials who had been sticking to their "no 
more cholera patients" line admitted that some of the water samples 
collected from the Ambedkar. Nagar slum in Colaba were "unfit for 
drinking. 3 of the 10 water samples drawn from the area were unfit 
for consumption and showed the presence of the _E. coli_ bacteria. 2 
of the "unfit" samples were from Shaparji while one was from Dhobi 
Ghat [a broad flight of steps leading down to the bank of a river]," 
said Thanekar.

The slum had drawn attention after patients landed up in hospitals 
with diarrhea and vomiting. One of them, a 35-year-old woman, was 
confirmed to be suffering from cholera. Civic officials from the 
water department blamed the contamination on the tanker water supply. 
On Tuesday [21 Jul 2009], health workers fanned out across the slum 
and screened 4000 people in Shaparji and another 1152 in Dhobi ghat, 
besides stepping up chlorination in the area.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[A map of the southern city island of Mumbai (Bombay) can be seen at
<http://www.mapsofindia.com/maps/maharashtra/mumbai-map.htm>.
The city's location on the western coast of India can be seen at
<http://www.lonelyplanet.com/mapshells/indian_subcontinent/india/india.htm>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BT>. - Mod.LL]

******
[4] Cholera - Somalia (Bay, Lower Shabelle regions)
Date: Tue 21 Jul 2009
Source: Horseed Media [edited]
<http://english.horseedmedia.net/news/24121.shtml>


Reports from Bay region, central Somalia, are confirming that at 
least 3 people have died so far from cholera, medical officers warn 
for lack of medicine. 2 children and an elderly woman were confirmed 
to be the latest victims of the cholera outbreak in Bay region. 
Regional medical officials say, more people are hospitalized for the 
disease, which is spreading in central Somalia.

"...we don't have enough medicine and more people are arriving in the 
hospital..." Said Baidoa hospital staff, where more than 8 people 
where hospitalized, yesterday [20 Jul 2009].

More cholera outbreak cases are reported from neighboring regions. In 
Lower Shabelle region 2 children were confirmed dead, and more than 
10 people were put into hospitals. Latest reports indicate that the 
cholera outbreak might spread to other regions in south and central 
Somalia.

[Byline: Mohamed Osman]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The Bay and Lower Shabelle (Shabelle Hoose on the map) can be found 
in southern Somalia on a map at
<http://www.un.org/Depts/Cartographic/map/profile/somalia.pdf>.
The HealthMap/ProMED-mail interactive map of Somalia is available at
<http://healthmap.org/r/00aM> - Mod.LL]

*****
[5] Cholera - Burundi (Bujumbura)
Date: Mon 20 Jul 2009
Source: Afrique en Ligne, Panafrican News Agency (PANA) report [edited]
<http://www.afriquejet.com/news/africa-news/burundi:-27-cholera-cases-reported-in-bujumbura-2009072132042.html>


Some 27 residents of the Burundian capital, Bujumbura, have been 
hospitalized for cholera, medical sources told PANA here Mon 20 Jul 
2009. According to the doctor of the municipal health centre in 
Bujumbura, Pascal Nday ongeje, a new case from Buyenzi, a popular 
neighborhood in the city centre, was detected Mon 20 Jul 2009.

Cholera broke out 11 Jul 2009 in 3 neighborhoods in the northern part 
of Bujumbura, and has since spread to other areas. No deaths have so 
far been recorded. The high prevalence of diarrheal diseases in the 
popular neighborhoods in Bujumbura has been blamed on poor sanitation 
and lack of potable water, among others.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Bujumbura is located in the western province of the same name and 
can be found on the maps at
<http://www.un.org/Depts/Cartographic/map/profile/burundi.pdf>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00Cs>. - Mod.LL]

******
[6] Diarrhea, fatal - Uganda (Busia)
Date: Wed 22 Jul 2009
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/17/688679>


Strange disease hits Busia, Uganda
----------------------------------
Experts from the health ministry are in Busia town to investigate a 
strange disease that has hit the area. The disease, which has 
symptoms similar to those of cholera, broke out in Soloa, Arubaine, 
Marachi A and B, and Mugungu villages. 7 people, including 2 
children, died after suffering from severe diarrhoea and vomiting. 
Over 20 others were admitted at Samia-Bugwe North Health Centre IV.

Dr George Oundo Bwire, the district health officer, said some of the 
patients had been discharged. "I cannot, therefore, say there is a 
cholera outbreak," Oundo said.

The Arubaine and Marachi leaders blamed the disease on the 
Busia-Kenya sewage system, which they said had overflowed into the 
village wells. They said residents started falling sick when the 
sewage started flooding. Oundo said an isolation centre had been 
created at the health centre, adding that some patients who were at 
the health centre before the outbreak, discharged themselves fearing 
that they would contract the disease.

He appealed to residents to report any suspected cases. However, some 
of the patients said they had eaten cassava and chapattis from 
Arubaine market.

One of the patients, a Marachi B resident, said he developed the 
symptoms 8 hours after he drunk water packed in kaveera (polyethylene 
bag).

[Byline: Egessa Hajusu]

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[A disease with fatalities that has symptoms like cholera may well be cholera.

The Busia district, which contains the town of the same name is 
located in southeastern Uganda, bordering on Kenya. Its location can 
be found on the maps at
<http://www.un.org/Depts/Cartographic/map/profile/uganda.pdf>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00Bf>>. - Mod.LL]

[see also:
Cholera, diarrhea & dysentery update 2009 (19) 20090720.2575
Cholera, diarrhea & dysentery update 2009 (18) 20090709.2469
Cholera, diarrhea & dysentery update 2009 (17) 20090429.1620
Cholera, diarrhea & dysentery update 2009 (16) 20090310.0991
Cholera, diarrhea & dysentery update 2009 (15) 20090212.0632
Cholera, diarrhea & dysentery update 2009 (14) 20090210.0604
Cholera, diarrhea & dysentery update 2009 (13) 20090204.0491
Cholera, diarrhea & dysentery update 2009 (12) 20090203.0474
Cholera, diarrhea & dysentery update 2009 (11) 20090128.0393
Cholera, diarrhea & dysentery update 2009 (10) 20090126.0355
Cholera, diarrhea & dysentery update 2009 (09) 20090122.0275
Cholera, diarrhea & dysentery update 2009 (08) 20090120.0245
Cholera, diarrhea & dysentery update 2009 (07) 20090116.0182
Cholera, diarrhea & dysentery update 2009 (06) 20090113.0140
Cholera, diarrhea & dysentery update 2009 (05) 20090112.0124
Cholera, diarrhea & dysentery update 2009 (04) 20090110.0107
Cholera, diarrhea & dysentery update 2009 (03) 20090107.0061
Cholera, diarrhea & dysentery update 2009 (02) 20090105.0038
Cholera, diarrhea & dysentery update 2009 (01) 20090102.0015
2008
----
Cholera, diarrhea & dysentery update 2008 (57) 20081231.4125
Cholera, diarrhea & dysentery update 2008 (50) 20081208.3854
Cholera, diarrhea & dysentery update 2008 (30) 20080702.2019
Cholera, diarrhea & dysentery update 2008 (10) 20080212.0563
Cholera, diarrhea & dysentery update 2008 (01) 20080104.0047
2007
----
Cholera, diarrhea & dysentery update 2007 (67) 20071231.4200
Cholera, diarrhea & dysentery update 2007 (60) 20071126.3824
Cholera, diarrhea & dysentery update 2007 (40) 20070924.3164
Cholera, diarrhea & dysentery update 2007 (20) 20070511.1509
Cholera, diarrhea & dysentery update 2007 (01) 20070105.0047
2006
----
Cholera, diarrhea & dysentery update 2006 (52) 20061229.3646
Cholera, diarrhea & dysentery update 2006 (50) 20061215.3528
Cholera, diarrhea & dysentery update 2006 (30) 20060724.2037
Cholera, diarrhea & dysentery update 2006 (10) 20060303.0675
Cholera, diarrhea & dysentery update 2006 (01) 20060106.0040]
...................................ll/mj/lm

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