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Source: World Health Organization (WHO)This material has been condensed from information on the WHO Internet site. A link to this site can be found under 'Related sites' on the CDI homepage.
St. Louis encephalitis
United States of AmericaAn outbreak of St. Louis encephalitis (SLE), a viral infection transmitted by mosquitos, was reported for the first time in New York City in early September. Of the 11 cases, 3 have died. Another 80 cases are being investigated, of which approximately 10% are considered probable cases of SLE, based on clinical criteria. Of the 11 cases mentioned above, 9 were in older adults aged 58-87 years; the other 2 were aged 38 and 15. The course of the illness in these younger patients has been less severe.
As the laboratory-confirmed cases were in residents of Queens (8), Brooklyn (1) and South Bronx (2), local authorities have undertaken vigorous measures to control the mosquito population, by spraying the entire city with malathion (by air) or resmethrine (on the ground). Active surveillance for human cases and mosquitos continues.
GhanaAn outbreak of cholera has been reported in the Builsa district of the Upper East region, one of the frontier districts with Burkina Faso. As at 23 August, 269 cases with 9 deaths had been reported from 3 of the 6 subdivisions of the district, including areas classified as hard to reach because of flooding and muddy terrain at this time of the year. Laboratory investigations have confirmed cholera, Inaba subtype. Measures so far taken include intensive public education campaigns aimed at prevention and early reporting of cases for treatment, mobilisation of stocks for case management at regional level and dispatch of regional-level rapid response teams. The regional authorities are also involved in social mobilisation for diarrhoeal disease prevention in neighbouring districts. Cholera is endemic in Ghana. As at 31 August 1999, a total of 3,997 cases and 100 deaths had been reported to WHO. There has been an increase of almost 1,000 cases in the last month.
Somalia - UpdateCholera is endemic in Somalia. As at 31 August 1999, a total of 6,964 cases have been reported to WHO this year. The disease is appearing in new areas and since 1 August, 3-4 cases of watery diarrhoea have been registered every day at Bosaso hospital; 190 cases have been admitted, of which 84 were males and 106 females (F:M ratio, 1.26:1). The age group most affected has been > 5 years (60% of cases). There have been 15 deaths (case-fatality rate, 8%).
Over 90 % of cases are from the same residential area. Investigations have shown that they had been drinking from 100 wells located in that same area, adjacent to pit latrines.
Three control committees have been set up in Bosaso town, namely for social mobilisation, water and sanitation, and case management. The wells, which have been shown by analysis to be positive for vibrios, are being chlorinated. UNICEF is working on a piped-water project for the area.
Sierra LeoneThe Ministry of Health and Sanitation has reported an outbreak of cholera to WHO, with 134 cases and 1 death between 1 and 6 September. Of 8 stool specimens sent for laboratory tests, 6 were positive for Vibrio cholerae O1 subtype Ogawa. Tests have revealed sensitivity to tetracycline, doxycycline and cotrimoxazole.
WHO and other partners have been supporting the Ministry in taking appropriate control measures, e.g. reactivation of the cholera task force, establishment of specific subcommittees (for surveillance, case management and sanitation) and of cholera treatment centres. Mass health education campaigns are being carried out and communications networks are being strengthened. Available supplies are adequate for the treatment of 3,000 cases.
This article was published in Communicable Diseases Intelligence Volume 23, No 10, 30 September 1999.