Disclaimer: The opinions, interpretations, conclusions, and recommendations contained herein are those of the respective author(s) and do not reflect the official views or policies of CEEZAD.
Janurary 11, 2019
Three people have been hospitalized in Chuka, Kenya, after eating tainted meat. The individuals are being treated for suspected anthrax and are in critical condition, according to a local news report. In addition, some 10 others were treated at other facilities and discharged. It is believed they ate anthrax-infected cow, and officials sent livestock officers to affected areas to investigate the situation.
In December, Igembe deputy county commissioner James Kosgei cautioned area residents against consuming uninspected meat during this festive season. These cases reminds people of the wisdom of that official caution and tell us that risk of the disease is still active in that area in spite of any attempts at vaccination.
The Chubut Ministry of Health stated the child who was admitted to the Epuyen Hospital two days ago and then taken to Bariloche was confirmed as a "positive" hantavirus case after tests done by the Malbran Institute. With this case, the number affected by this disease (which is transmitted by the long-tail mouse), increases to 14 including 5 fatalities.
In the last part of the official announcement, the Chubut Ministry of Health indicated that "the contingency team continues to work in Epuyen, focusing their action on selective respiratory isolation of people classified as close contacts [of the patient]," adding that the child is currently in stable condition.
Epuyen, with a population of approximately 4,000 inhabitants and the epicenter of the outbreak, is located in the extreme northwest of Chubut province, in the Andean region. About 220 blood samples have been taken to test for those who are potentially infected.
The samples were taken from people who were at the quinceanera, where presumably the outbreak started. Samples also included the so-called "continent population," that is, those neighbors with whom the potential bearers of the virus made close contact, as well as the population at risk of the municipality and health personnel.
Algeria: Peste des Petits Ruminants
A total of six cases of peste des petits ruminants (PPR) were discovered and confirmed during the past week in the locality of Ain Kheyar (wilaya of El Tarf). The cases are being reported by the APS on Jan. 4, citing the director Agricultural Services (ASD).
The results of samples taken from sheep in Ain Kheyar confirmed that 6 head of sheep are suffering from PPR, said Kameleddine Benseghir. In the same context, he said that a suspicion of a PPR outbreak in Chihani commune was also reported, detailing that 25 head of sheep from this area have undergone the usual tests in order to confirm or deny PPR infection.
A "special device" was immediately set in motion, Benseghir added, saying that the measures include the closing of the weekly livestock markets in Bouhadjar, Ain Assel, and Drean for a month. In addition, an inter-wilayas movement ban and new regulations requiring permits for livestock transport have been implemented.
The same official also mentioned the mobilization of a monitoring brigade at the level of the dairas of the wilaya (subdivision of a province) in order to preserve the livestock.
At least eight people are reportedly receiving treatment after consuming meat infected with anthrax in Zvimba. Sources privy to the development alleged that the disease has affected several cattle in the area, which is home to the former president Robert Mugabe. The affected people are from Kasanze and Chirau villages, under Chief Chirau.
Last year, following reports of the suspected anthrax cases, the government received $30,000 toward the purchase of drugs and management of the disease.
Zvimba district senior veterinary animal health inspector Chemhere Nyamangara also confirmed the suspected cases at a stakeholders' meeting. He said: "It is worrying that despite efforts to educate people on the dangers of eating meat of an animal that has fallen ill or died due to unknown reasons, people still eat it, exposing themselves to danger. People should immediately notify the Department of Veterinary Services whenever they suspect anthrax symptoms both in human beings and in livestock.”
He encouraged people to avoid opening carcasses of cattle that die of natural causes to reduce contamination of pastures by anthrax.
Uganda: Crimean Congo Hemorrhagic Fever
Residents in Kingura village in Bwijanga Sub County Masindi are living in fear after a resident died of what they said was acute fever. Medical officials have confirmed an outbreak of Crimean-Congo fever in Masindi District in Western Uganda. The disease has been confirmed and the deceased patient was buried by officials from the World Health Organization and medical officials from the Ministry of Health.
"There is a health worker who died at the end of December 2018, and the blood sample tested positive for the hemorrhagic fever," said Emmanuel Ainebyoona, the senior public relations officer at the Ministry of Health. He said the deceased was given a supervised burial by medical officers to ensure that mourners are not exposed to any possible infection.
Asked about what the government is doing to handle the outbreak, Ainebyoona said medical officers are on the ground to educate the public and following up on any suspected cases that may be reported. "The public should remain calm and report to medical officers any suspected cases," he added.
The Masindi District health officer, Dr. John Turyagaruka, urged residents to stay calm, saying that the tests indicated that it was not Ebola, but instead Crimean-Congo hemorrhagic fever.
The Bwijanga Sub County chairperson Olivia Mugisa wants the residents to be informed on how to protect themselves from the disease. "We need health experts on the disease to screen our locals so that we can understand who is sick for emergency attention," she said.
According to WHO, onset of symptoms is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion. After 2-4 days, the agitation may be replaced by sleepiness, depression and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable hepatomegaly (liver enlargement).
The Panama Ministry of Health has reported an increase in cases of hantavirus infection in Los Santos Province, Republic of Panama, to the Pan American Health Organization/World Health Organization. During 2018, a total of 103 confirmed cases of hantavirus infections have been reported at the national level, 99 of which were reported in Los Santos Province. In Los Santos Province, 51 cases were classified as hantavirus fever (HF) without pulmonary syndrome, and 48 cases were classified as hantavirus pulmonary syndrome (HPS), including 4 deaths.
Of the 51 HF cases, 41 percent were female, 55 percent aged between 20-59 years, with 76 percent occurring between June 2018 and November 2018.
Of the 48 HPS cases, 56 percent were female, 67 percent aged between 20-59 years, with more than half of the cases occurring in February 2018 (17 percent) and between June 2018 and September 2018 (42 percent).
Of HPS cases, 4 deaths were reported (2 female, 2 male, all aged over 60 years).
Cases were confirmed by serology and polymerase chain reaction (PCR). Sequencing determined that the type of virus associated with this outbreak is Choclo virus, which was was first isolated in 1999 in the western Republic of Panama.
Hantavirus cases have been reported in the Republic of Panama since 1999. In the last 5 years, transmission has been documented in Los Santos, Herrera, Veraguas, and Cocle provinces. During 2018, cases have been reported in Los Santos, Herrera, Cocle and Veraguas provinces. Since the reservoir for hantavirus is sylvatic rodents and transmission can occur when people come in contact with rodent habitats, the current increase in hantavirus cases in the Republic of Panama could be related to changes in the abundance and distribution of rodent species, as well as strengthened surveillance and laboratory capacity at the provincial level. Environmental and ecological factors affecting rodent populations can have a seasonal impact on disease trends.
Health officials in Bani Walid municipality [Misratah district] in northwest Libya are reporting an outbreak of the disfiguring parasitic disease leishmaniasis, according to a local media report.
So far, 290 cases have been reported although it is not clear when this upsurge of cases began.
The report notes that Director of the Office Ayman al-Hawadi said that the disease has become a nightmare for residents in Bani Walid, especially in the absence of medical treatment. al-Hawadi goes on to call on competent authorities to save the city from a health disaster in the same report.
In a Libya Observer report, Chairman of the Commission for the Management of Medical Supply Service, Tahir Bakhir, said medication for leishmaniasis disease will be available by next week. However, he noted that no more than 5,000 doses will be available.
In December, Bakhir warned that leishmaniasis will increase during the months of January and February, to reach thousands of cases.
Leishmaniasis is caused by the protozoan leishmania parasites, which are transmitted by the bite of infected female phlebotomine sandflies -- flies that are 3 times smaller than a mosquito. According to the World Health Organization, there are an estimated 700,000 to 1 million new cases annually, and they cause 20,000-30,000 deaths each year.
Nigeria: Lassa fever
In the final week of 2018, 22 new confirmed cases were reported from Edo (9), Ondo (6), Bauchi (5), and Taraba (2) states with five new deaths in Ondo( 2), Bauchi (2) and Taraba (1) states. There was also one probable case from Ondo state
For the year, a total of 3,498 suspected cases have been reported. Of these, 633 were confirmed positive, 20 probable, 2,853 negative.
Since the onset of the 2018 outbreak, there have been 171 deaths in confirmed cases and 20 in probable cases. Case Fatality Rate in confirmed cases is 27.0 percent. Twenty-three states have recorded at least one confirmed case across 93 local government areas.
Eighty per cent of all confirmed cases are from Edo (44%), Ondo (25%) and Ebonyi (11%) states. Twenty patients are currently being managed at Irrua Specialist Teaching Hospital treatment Center (9), Federal Medical Center Owo (6), Bauchi (3), FCT(1) and Plateau (1) States.
A total of 9,643 contacts have been identified from 23 states. Of these 421 (4.4%) are currently being followed up, 9,089 (94.3%) have completed 21 days follow up while 15 (0.2%) were lost to follow up. 118 (1.2%) symptomatic contacts have been identified, of which 38 (0.4%) have tested positive.
United States: Pigeon Paramyxovirus
As reports of mourning and Eurasian collared dove die offs in the Kuna area of Idaho filter in to Fish and Game offices, forensic testing on several dead birds from the area has pinpointed the cause of death as pigeon paramyxovirus, a strain of paramyxovirus that is common to pigeons and doves.
Similar dove die offs were recently reported in the Idaho city area, while a large pigeon die off occurred during summer in Mountain Home due to a different strain of paramyxovirus.
The disease poses no health risk to humans or pets but can impact other domestic poultry. Persons with backyard chickens are encouraged to keep their birds isolated from wild doves and pigeons and not feed chickens in areas frequented by wild doves or pigeons.
The mourning dove hunting season is closed, but invasive Eurasian collared doves continue to be harvested. Upland hunters should avoid harvesting any live birds found on the ground that appear weak or sick. As a precaution, potentially sick birds should not be handled by hunters or hunting dogs, because while there is no risk to humans or pets, birds infected with the virus could have other diseases as well.
Kuna-area residents feeding birds are advised to stop feeding doves for the next few weeks to reduce further transmission of the virus to other birds. All persons feeding birds should practice good feeder hygiene, which includes removing waste, or excess feed, every week, cleaning feeders and feeding areas using a 10-percent bleach solution followed by rinsing in clean water, and also maintaining any watering areas in clean condition.
People noticing multiple dead pigeons or doves at, or near, bird feeders can report the event at https://idfg.idaho.gov/report/doves. Because Fish and Game staff are aware of the outbreak, no follow-up calls will be made.
In the event that dead birds are encountered, wear rubber gloves or use plastic bags to handle the carcasses, which can be disposed of with other household trash. While bird virus outbreaks are occasionally seen in Idaho, they tend to be localized, affect a relatively small number of birds, and are short lived.
Togo: Lassa Fever
The Togo government confirmed last week a Lassa fever case reported in Doufelgou district [Kara region] in the north of the country, according to an Agence de Presse Africaine report. This was a hemorrhagic fever case, according to officials.
Lassa fever is a rare but potentially life-threatening viral hemorrhagic disease. The risk of infection is low but can occur if someone comes into contact with an infected person's blood or bodily fluids. Lassa fever cannot be spread through casual contact, including skin to skin contact, without exchange of bodily fluids. Those at highest-risk would be health care workers treating patients in facilities known to have Lassa fever and family members caring for infected patients.
Early diagnosis and supportive care are essential. One should consult a medical professional if he or she has been in direct contact with an infected person within the past 3 weeks and have symptoms of Lassa fever, which include: fever, chest, stomach or back pain, cough, vomiting, diarrhea, or mucosal bleeding.
The Seremi de Salud [Regional Health Ministerial Secretariat] of Los Lagos has confirmed this year's first case of infection by hantavirus in the Chilean region.
The patient, a female employee of the Health Service of Chile, was taken to Santiago after it was confirmed that she had been infected with the virus in Epuyén, Argentina (which is located 4 hours from Palena). The woman resides in the city of Palena, in the Los Lagos Region, and remains hospitalized in the Puerto Montt Hospital.
"During the dawn of today we received the information on the blood tests of the patient from the province of Palena, that were undergone at the Universidad de Católica de Chile-- which is a certified center for the realization of this type of exams, and it confirmed a case of hantavirus," informed Marcela Cárdenas, a health officer in Los Lagos.
Hantaviruses are spread via the urine, saliva, and feces of infected rodents and the infection is contracted via contact with contaminated surfaces or via inhalation of contaminated air.
The most common symptoms of the virus infection are similar to those of influenza: fever, muscle aches, and fatigue. Other possible symptoms include headaches, dizziness, chills, nausea, vomiting, diarrhea, and abdominal pain and respiratory distress leading to hantavirus cardiopulmonary syndrome. Hantavirus infections are fatal in roughly one-third of cases.
Those present in Chile should avoid exposure to potentially rodent-infested areas. Individuals exhibiting the aforementioned symptoms are advised to seek immediate medical treatment.
The death of a male elephant calf in Similipal continues to be shrouded in mystery. The carcass of the male calf was found in TL-5 under Badamahulia beat of Badabalipusi section within Kedumunduli range two days back. The tusks were intact and there were no injury marks on the decomposed carcass. While a forest officer who was promised anonymity said anthrax could be the cause of the elephant's death, another officer attributed it to infection. Divisional Forest Officer of Karanjia Prasanna Kumar Behera offically said the elephant calf is suspected to have died of 'infection'.
A veterinary team, comprising Piyush Soren of Similipal Tiger Reserve, Khanim Tangmaiee, Harekrushna Moharana Bhandari, and Jagyandatta Pati conducted an autopsy on the carcass. In the past, anthrax has claimed 8 elephants in the region. While four adults died of the disease in Dukura and Kaptipada ranges, an equal number was killed by anthrax in Rairangpur and Karanjia forest divisions. One of them was reportedly an elephant of Dalma forest in neighboring Jharkhand, which had snuck into Karanjia.
In October 2017, a 20-year-old female elephant was found dead near Phulbadia village bordering Similipal National Park. While wildlife activists claimed that the animal died due to poaching, forest officials suspected anthrax to be the cause of its death.
The forest officials have asked the local veterinary office to vaccinate domestic animals living near the periphery areas of Similipal to prevent the spread of anthrax. Sources said the elephant population has drastically come down in the last 20 years in the park due to poaching and anthrax.
Nepal: Avian influenza
On Jan. 6, a 45-year old pregnant woman and her two family members, residents of Dandapauwa-6, Ramkot, Kathmandu visited the outpatient department of Sukraraj Tropical and Infectious Disease hospital. They presenting with a 4-day history of fever, cough, sore throat, chest pain, and weakness.
According to them, they have a poultry chicken farm, where nearly 700 chickens have died in the last week alone and are still dying at a rate of approximately 150/day. According to them, chickens are showing symptoms of coughing, sneezing, nasal discharge, and dying quickly. Chickens were tested positive for influenza A by rapid diagnostic test.
Samples were further sent to higher center to identify its subtypes.
It is not yet known whether the patients had also contracted with avian influenza virus from their flock, as suggested since they also developed influenza-like illness soon after their chicken have died of similar symptoms. Influenza A (H1N1) pdm09 virus is also concurrently circulating in Kathmandu.
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated Jan. 7:
Since the beginning of the epidemic, the cumulative number of cases is numbered 627, of which 579 are confirmed and 48 are probable. In total, there were 382 deaths (334 confirmed and 48 probable) and 221 people recovered.
Ninety-eight suspected cases are under investigation.
There are two new confirmed cases, including 1 in Oicha and 1 in Katwa.
Five new deaths are of confirmed cases, including 3 in Butembo, 1 in Beni, and 1 in Katwa.
Years of conflict and damage to the infrastructure in Hama have contributed to creating an environment where the parasitic skin disease Leishmaniasis can spread within the local communities. The disease, known locally as the 'Aleppo Boil', is spread by the bite of infected sand-flies that thrive in the piled-up waste and damaged sewers in the streets of Hama.
UNICEF, with its partners, is helping fight Leishmaniasis through awareness-raising campaigns in 13 of the most affected villages of Hama and its rural villages. Health workers in Hama are training young people on how to lead group discussions and peer-to-peer information sessions about the causes, detection and treatment of Leishmaniasis. Young people were also trained on the behavioral changes necessary to foster an environment unfavorable for the disease.
Recurring displacement of infected children and families coupled with incorrect livestock handling practices have further spread the infection in rural Hama. "I didn't know that dung could be a place for the 'Aleppo Boil' parasite to live," says Amira, a local livestock keeper from Jarjisa in rural Hama, who took part in one of the sessions. Amira's husband and 3 children were all infected with Leishmaniasis.
UNICEF helped raise the awareness of children, families, frontline health workers, community leaders, school teachers and livestock keepers in Hama and the rural outskirts, through 13 volunteer mobile teams (comprised of health workers and young people) aiming to put an end to the epidemic.
January 4, 2019
China: African Swine Fever
African swine fever [ASF] has spread to several southern Chinese provinces, with severe and swift outbreaks that have led to the culling of scores of pigs in a country that is considered to be the world's largest consumer and producer of pork. The disease was first detected in the northernmost regions of China in early August. The virus has now spread to Guangzhou City in Guangdong Province -- the southernmost province on the mainland.
According to a Dec. 25 article by Hong Kong media Apple Daily, local authorities in Guangzhou culled more than 6,000 pigs at a farm in Huangpu District, after local authorities temporarily put the owner of the farm and her dozen employees under house arrest at an unknown hotel.
Apple Daily journalists reported seeing workers with face masks operating manning excavators in Huangpu District, trying to bury the culled pigs. The intense stench of the dead pigs could be detected a few dozen meters away.
The female farm owner, a retired soldier who wasn't identified, had recently purchased the 6,000 pigs from the nearby Guangxi region. It was determined that these pigs were infected with the virus because some of them had already died by the time they were shipped to her farm.
According to Apple Daily, the latest case in Guangzhou places the number of Chinese provinces, municipalities, and regions with known cases of the African swine fever at 23, with a total of 101 reported outbreaks.
Guangzhou isn't the only city in Guangdong affected by the outbreak. According to Taiwanese media, 11 pigs died from the disease at a farm in Zhuhai City. And China's Ministry of Agriculture and Rural Affairs said that at a pig farm in Huizhou City, 11 pigs died from the disease, while 11 others had been infected.
Chinese media also reported that a local food shipping company had been directed by the provincial government of Guangdong that all cross-city shipment of live pigs would be banned.
Benin: Lassa fever
Minister of health Benjamin Hounkpatin confirmed four new cases of Lassa hemorrhagic fever in Benin, including one in Cotonou. This occurred in the period of 15-26 Dec.
In the case of Cotonou, a 28-year-old has been infected. His case was detected on Dec. 24, but his illness commenced the previous week. He had a fever, a cough, a cold, and fatigue. Due to the persistence of the cough and cold, and with the appearance of traces of blood in nasal discharge, the alert was given.
The patient was placed in isolation, and his result from the laboratory came back positive for Lassa fever. Subsequently, the patient was isolated and put on treatment.
According to the details provided by Hounkpatin, there is no indication of travel by the patient to an epidemic locality of Lassa fever. According to the patient's statements, there is no known contact with rodents.
Taking advantage of this opportunity, the minister reassured the public that public health measures are underway. He also reminded people of the behaviors that will help avoid becoming infected. This involves washing hands regularly with soap and water; avoiding contact with stool, sperm, urine, saliva, vomit, and contaminated objects from a person suspected to be ill or dead from Lassa; and protecting food and keeping it in a safe place, out of reach of rodents.
It should be recalled that 7 cases have been recorded since the beginning of the epidemic to date, including 5 positive cases.
United States: Newcastle Disease
During the week of Dec. 14-20, the US Department of Agriculture's (USDA) Animal and Plant Health Inspection Service (APHIS) confirmed 17 additional cases of virulent Newcastle disease (vND) in Riverside County, California. This includes 16 cases in backyard exhibition birds and one commercial case.
Affected flocks are quickly euthanized. Together, these actions will help prevent additional disease spread and eradicate the disease more quickly.
USDA is announcing confirmed vND cases weekly. Cases are still being tested and confirmed as they are identified. If there is a finding in a new state or a different segment of industry, the USDA will issue an announcement for that case immediately, as we did for this week's commercial case. A complete list of confirmed cases are available at www.aphis.usda.gov/animalhealth/vnd.
vND has not been found in commercial poultry in the US since 2003. No human cases of Newcastle disease have ever occurred from eating poultry products. Properly cooked poultry products are safe to eat. In rare instances, people working directly with sick birds can become infected. Signs are usually mild and limited to conjunctivitis. Infection is easily prevented by using standard personal protective equipment.
Samples from the flocks were tested at the California Animal Health and Food Safety Laboratory System (CAHFS). The APHIS National Veterinary Services Laboratories in Ames, Iowa, confirms all findings. APHIS is working closely with the California Department of Food and Agriculture to respond to these findings and to conduct an epidemiological investigation. Federal and state partners are also conducting additional surveillance and testing in the area.
Algeria: Foot and Mouth Disease
The governor of the El Bayadh province has issued a decision to close livestock markets across the country's territory for a month to avoid sheep and goats from contracting foot and mouth disease [FMD]. Governor Mohamed Jamal Khanfar told APS that the decision taken Dec. 26 is a preventive measure to avoid and prevent the spread of the disease among cattle herds.
For his part, the state director of the agricultural interests on behalf of the province, Said al-Hawari, said that the El Bayadh province has 9 livestock markets, of which 3 are large markets in Bougtob, El Bayadh and El Abiodh Sidi Cheikh, and the other 6 are located in Ghassoul, Brezina, El Maharra, Rogassa, Tismouline and Boualem. The spokesperson added that this decision comes after the detection of some cases of sheep suspected as infected with FMD, pending the outcome of veterinary tests.
The Veterinary Services launched a vaccination campaign, which will cover 50,000 sheep.
Israel: Foot and Mouth Disease
Foot-and-mouth disease [FMD] serotype-O has been confirmed in a ranging beef cattle herd in Kibbutz Ortal, Golan Heights. This strain is similar to the one identified in other recent outbreaks.
In Kibbutz Shamir, Upper Galilee, 30 clinical FMD cases were observed in a group of 300 fattening male calves. This group was vaccinated a month ago.
An FMD outbreak in December is unusual and concerning. Farmers and practitioners are advised to verify and adhere to the timely application of primary and booster vaccinations.
Since April 2018, FMD serotype-O has been affecting cattle, sheep, wild ruminants (gazelles, captive deer), and wild boar in north and northeastern Israel.
United States: Chronic Wasting Disease
The Tennessee Wildlife Resources Agency (TWRA) is enacting the Chronic Wasting Disease (CWD) response plan, following a preliminary positive detection of CWD in white-tailed deer in Hardeman and Fayette counties. The response plan involves a coordinated effort between TWRA, Tennessee Department of Agriculture, and other partners.
Seven deer in Fayette County and 3 in Hardeman County have preliminarily tested positive for CWD. Additional samples are being tested, and the TWRA is actively trying to contact the hunters who harvested these deer.
"Once arrangements are made, TWRA will be encouraging hunters harvesting deer in these areas to submit their deer for testing," said Chuck Yoest, TWRA CWD coordinator.
"Hunters are our biggest ally in managing chronic wasting disease in Tennessee if it is confirmed here," said Dr. Dan Grove, wildlife veterinarian, University of Tennessee Extension. "Besides submitting deer from the to-be-defined CWD zone, the most important thing everyone needs to do is follow the regulations for moving harvested deer.
Although CWD has no known risk to the health of humans or livestock, it is a contagious and deadly neurological disorder that affects members of the deer family. It is transmitted through animal-to-animal contact, animal contact with a contaminated environment, and contaminated feed or water sources. It is the most significant threat to the deer population nationwide, as it is 100% fatal to deer and elk.
Wildlife agencies across the country are working to inform the public about CWD, its deadly results, and possible impacts to economies. Currently, 25 states and 3 Canadian provinces have documented CWD. Last week, Mississippi announced a preliminary CWD-positive, hunter-harvested deer in Marshall County, which became the closest to Tennessee and the 4th overall this year  in Mississippi. Other confirmed cases have previously been made in the border states of Arkansas, Missouri, and Virginia.
Nigeria: Yellow Fever
In the Dec. 10-16 reporting week, 13 new positive cases from Edo (9), FCT (3), and Ekiti (1) states were confirmed at WHO regional reference laboratory, Institut Pasteur, Dakar (IP Dakar).
From the onset of the outbreak in September 2017 to date, 3,902 suspected cases have been reported from all 36 states and the FCT in Nigeria.
Of the 3,295 samples that were collected and tested, 185 were presumptive positive in-country and were sent for confirmation to IP Dakar.
So far, 78 positive cases from 14 states (Kwara, Kogi, Kano, Zamfara, Kebbi, Nasarawa, Niger, Katsina, Edo, Ekiti, Rivers, Anambra, FCT, and Benue states) have been confirmed at IP Dakar.
Since the onset of the outbreak, 13 deaths in IP Dakar-confirmed cases and 27 deaths in presumptive positive cases have been recorded. Case fatality rate [CFR] among presumptive positive and IP Dakar-confirmed cases is 14.6% and 16.7%, respectively.
Yellow fever preventive mass vaccination campaigns have been conducted in 6 states (Borno, Kebbi, Niger, Plateau, Sokoto, and the FCT) between Nov.22 and Dec. 2, bringing the total states covered by preventive mass vaccination campaign to 12.
A multi-agency national emergency operations center at NCDC is coordinating the national response.
Nigeria continues to report sporadic cases of monkeypox since the beginning of 2018.
In the reporting month, 15 new suspected monkeypox cases were reported, out of which 6 confirmed cases were recorded in 5 states (Rivers -1, Bayelsa -2, Delta -1, Cross Rivers -1, Edo -1)
A total of 114 suspected, 45 confirmed, one probable cases and one death have been reported in 2018. The 45 cases confirmed were recorded in 13 states (Rivers, Bayelsa, Delta, Oyo, Cross River, Edo, Enugu, Imo, Lagos, Plateau, Abia, Anambra, and Nasarawa)
Since the beginning of the outbreak in September 2017, 311 suspected cases have been reported in 26 states. Of these, 132 confirmed cases in 17 states (Rivers, Bayelsa, Cross River, Imo, Akwa Ibom, Lagos, Delta, Edo, FCT, Abia, Oyo, Enugu, Ekiti, Nasarawa, Benue, Plateau, Anambra) and 7 deaths were recorded.
Genetic sequencing suggests multiple sources of introduction of monkeypox virus into the human population with evidence of human-to-human transmission.
Males are more affected with 73.3% of confirmed cases in 2018.
Persons within the 21-40 age group are more affected.
Iran: Schmallenberg Virus
A recently discovered virus known to infect ruminants in parts of Europe might infect horses, as well: Researchers have just identified antibodies to the Schmallenberg virus, transmitted by flying insects, in 10 Iranian horses.
They are the first horses worldwide to test positive for these antibodies, the scientists said.
In screening for antibodies in cattle, sheep, and goats, as well as in horses, the researchers discovered, unexpectedly, that members of the equine species tested positive along with the other species, said Mehdi Rasekh, DVM, DVSc, an assistant professor of large animal internal medicine at the University of Zabol Faculty of Veterinary Medicine, in Iran.
"The results surprised us because the positive response was expected in ruminants but detecting antibodies against Schmallenberg virus in horses was a new finding in the world," Rasekh said.
Scientists discovered the Schmallenberg virus in 2011 in Germany and The Netherlands, where it infected cattle, sheep, and goats, he said. Those infections generally led to fever, fetal malformations, and abortion.
Like African horse sickness (AHS) and bluetongue virus, Schmallenberg virus is transmitted by biting midges. With climate change and greater human and animal movement, these tiny winged insects are crossing borders and bringing with them an increased disease risk.
Concerned about the spread of midge-borne diseases into neighboring Turkey, Rasekh and his fellow researchers conducted a serological survey of at-risk species in Iran. They conducted blood tests on a random population of three species of ruminants as well as on 200 randomly selected horses.
They weren't surprised to find positive results in the cattle, sheep, and goats, given Turkey's close proximity with its seropositive population, Rasekh said. However, as many as 5 percent of the tested horses also had positive results.
"Of course, this means new challenges for the equine industry," he said.
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 30 Dec 2018:
Since the beginning of the epidemic, the cumulative number of cases is 598, of which 550 are confirmed and 48 are probable. In total, there were 363 deaths (315 confirmed and 48 probable) and 204 people healed.
47 suspected cases are under investigation.
Two new confirmed cases, including 1 in Komanda and 1 in Mabalako.
Two new deaths of confirmed cases (all community deaths): 1 in Mabalako and 1 in Komanda.
November 26, 2018
Sweden: Newcastle Disease
Poultry producers have been reminded of the risks of pigeons spreading Newcastle disease following a disease outbreak in Sweden. The Swedish outbreak was reported last month at a large commercial farm on the western coast, which held 5,000 laying hens. Presence of the disease, which led to egg drop and eggs without shells but no increase in mortality, was caused by a virulent avian avulavirus type-1, according to PCR and gene sequencing.
Sweden does not allow vaccination for Newcastle Disease, with the industry willing to take the consequences of single outbreaks from time to time.
The UK's Animal and Plant Health Agency said avian avulavirus type-1 is highly variable in its ability to infect different avian species and can cause differing severity of the disease.
Following further laboratory investigations, the latest outbreak in Sweden has been shown to be pigeon paramyxovirus. The pathotype sequence is indicative of virulent Newcastle disease, similar to that found in pigeons found dead in the same county in September. This implicates wild birds as the source of virus introduction into the commercial farm of fully susceptible non vaccinated birds. It also confirms that the virus is not the same as the Newcastle disease virus genotype isolated in Belgium in recent months.
Uganda: Crimean Congo hemorrhagic fever
Uganda's health ministry has spoken out on reports of an Ebola outbreak in Rukungiri district, days after 2 patients succumbed to an Ebola-like-disease.
The Tower Post has seen a communication between 2 Rukungiri district leaders indicating the death of patients with signs similar to those of Ebola. According to the communication, a patient died at Nyakibale Hospital of what would later be confirmed as Crimean-Congo hemorrhagic fever.
By the time the communication had been exchanged, the results from another patient had not been returned. On Nov. 10, another patient, from Rwakaterera Village, Burombe Parish, Ruhinda Sub County, was also admitted in the same hospital, showing similar signs. The second patient died the same day.
On Nov. 13, the junior health minister in charge of healthcare, Joyce Moriku, presented a statement on the Ebola outbreak in the DR Congo and the government's preparedness to handle any outbreaks in the country. "As of today," said minister Moriku, "there is no confirmed case of Ebola in Uganda." Moriku added that the ministry of health "remains on the highest alert ever and, together with partners, efforts have been put in place to not only screen but also to manage any identified suspect cases in specially established Ebola treatment centers."
United States: Brucellosis
Wyoming state veterinarian, Dr Jim Logan, has been notified by the Wyoming State Veterinary Laboratory and the National Veterinary Services Laboratory that there is a new case of brucellosis in a cattle herd in Teton County, which is in the Wyoming brucellosis designated surveillance area (DSA). Serologic testing at both laboratories has shown reactor level results on 5 animals from one herd. Further testing, including bacterial culture, will be conducted to confirm serology results.
Logan and assistant state field veterinarian, Dr Thach Winslow, are working with the owner of the infected cattle and are conducting an epidemiologic investigation. The herd with known Brucella spp.-positive animals is under quarantine at this time. No sexually intact cattle can be moved from the quarantined premises until conditions of the quarantine release are met. At this time, Logan does not believe there are any additional herds epidemiologically linked to this case. This case is not related to the case found in early October in Park County, and there is no epidemiologic link between the 2 cases.
Brucellosis is a bacterial disease that can cause cattle, elk, and bison to abort their pregnancies, typically late term. All of Wyoming's brucellosis cases since 1988 have been determined to have been caused by transmission from infected wildlife to cattle or domestic bison. For more information, contact the Wyoming Livestock Board field office.
China: African swine fever
China's agricultural ministry confirmed on Nov. 16 the first outbreak of deadly African swine fever [ASF] in the south west province of Sichuan, the country's top pig-producing region, raising the likelihood of a major impact to pork supplies in coming months. The outbreak was found on a farm of 40 pigs in Yibin city, in Sichuan's southeast. This is the 18th province or municipality to have reported an outbreak of ASF since the highly contagious disease was detected in China in early August.
Sichuan produced almost 66 million pigs for slaughter last year, according to official data, more than any other province. Sichuan provincial authorities last week issued a regulation banning the import of all live hogs and hog products from other regions in a bid to keep the disease out. Yibin is close to Sichuan's borders with Chongqing municipality and Guizhou province, both of which have already reported outbreaks. There is no cure and no vaccine for ASF, and the virus can survive for weeks in pork and animal feed.
On Nov. 16, the Ministry of Agriculture and Rural Affairs received a report from the China Center for Animal Disease Control and Prevention, that a wild boar from Hanjiang district of Baishan city, Jilin province, had been tested and found positive for virus nucleic acid of African swine fever [ASF]. The diagnosis was made by the China Center for Animal Health and Epidemiology.
After the outbreak, the Ministry of Agriculture and Rural Affairs and the State Forestry Bureau immediately dispatched a supervision team to the local area to carry out an epidemiological investigation. The local authorities have started to apply the emergency response mechanism according to the requirements, and carried out harmless treatment and disinfection measures for sick and dead wild pigs, strengthened inspections of local wild boars, strictly restricting the stocking of nearby pigs, and inspected the areas with wild boar activity that surround pig farms. At present, the measures above have been implemented.
In China, wild boar density is estimated at between 2 and 5 head/sq.km, with densities put at 2.24 head/sq.km in some forests in north eastern China, and even higher in the south eastern coastal areas. In Guangdong Province Nature Reserve, wild boar density was estimated at between 4.87 and 5.15 head/sq.km.
Japan: Classical swine fever
A second case of classical swine fever [CSF] was detected in Gifu Prefecture Nov. 16 at a park, after the nation's first case in decades was reported in September at a nearby pig farm. The Gifu Prefectural Government culled all 21 pigs kept at the Chikusan Center Park after confirming earlier in the morning through tests that two of them were infected with what is also known as hog cholera. The virus affects only pigs and wild boars and has an almost 100 per cent fatality rate.
Already 49 wild boars in the prefecture have been found to be infected with the virus, and 2 of them were found in the park in late September 2018. But the pigs in the park had shown no signs of infection at that time, according to the prefecture. The park said it will close until Nov. 25 due to disinfection and epidemic control work.
Farm minister Takamori Yoshikawa urged all prefectures to take measures to prevent wild boars from entering pig farms, deeming them to be the cause of the outbreak. Eight Gifu pig farms near the affected park have been banned from shipping their pigs and meat outside the area.
Following the CSF infection at a Gifu farm just 8 km southeast of the park in September 2018, Japan suspended exports of pork and related products from across the country. But the ban on shipments had been lifted for some markets after individual negotiations, and Tokyo does not plan to stop exports to those destinations following the latest case, according to farm ministry officials.
Thirteen human anthrax cases were recorded at Sesfontein in the Kunene Region after 35 residents consumed the meat of livestock which died of unknown disease. No deaths have been reported, and the disease has since been contained says Health and Social Services permanent secretary, Ben Nangombe.
In a joint statement signed by both the Ministry of Health and Social Services and that of Agriculture, a total of 92 small stock died from the outbreak in Sesfontein, while 23 buffalo died in the Bwabwata National Park. The ministries are collaborating in the matter and have informed all farmers and the general public about the danger in the affected areas.
Post exposure prophylactic medicines have also been administered thus far to 44 people in the areas of Omiriu and Okamba yOzongombo in Kunene. Symptoms and signs in humans include swollen and painful lymph glands, vomiting, abdominal pain, headaches, loss of appetite, fever, and sore throat.
Hippos in Luangwa River in Chama district in Muchinga Province are reportedly dying from suspected anthrax disease. Confirming the development to ZANIS, Chama district commissioner Leonard Ngoma said a team from the University of Zambia has since visited the affected areas to collect samples for testing.
Mr. Ngoma said results from the samples taken are yet to be released to confirm whether the hippos are dying from suspected anthrax or whether it is because of overpopulation. He said the affected areas are mainly in Chikwa and Chifunda Chiefdoms involving close to 8 villages.
The district commissioner has since discouraged people in the area from eating meat from the carcasses and any other animal that may have died from unknown causes, as this could be a source of infection which could lead to severe illness and even death. In October of 2016, anthrax broke out in Chama district affecting over 40 people. The outbreak was blamed on people handling, cutting, cooking, and eating meat from hippos that had died from anthrax in the Luangwa River.
Last month, the cabinet approved 3 bills and resolved to reduce the hippo population along the Luangwa River following reports of damage to the environment. The current population of the hippos in Luangwa River is 13,000, which is beyond the carrying capacity of 9,000 on a 270 km stretch. This has caused considerable damage to the environment and river banks and continues to threaten the sustainability of the river system.
Nigeria: Foot and mouth disease
Strange cases of foot and mouth disease ravaging animals in different parts of Yobe State are scaring livestock farmers living there. Cases of the disease were said to have been found in communities in Jakusko, Fune, Nangere, Tarmuwa, Potiskum, Damaturu, Fika and Gulani.
Breeders from the affected areas told the Daily Trust that the scourge manifested shortly after the rainy season and that it had so far claimed many animals. The chairman of Kullen Allah Cattle Breeders Association (KACBA) in Fika, Muhammad Alhaji Hassan, said he lost three cows to the disease. Alhaji Hassan said, "The 'boru disease' (FMD) was brought into the state by white migratory cattle from Chad and Cameroon through Adamawa. I have never seen this kind of 'boru disease' in camels. It looks like the FMD in cows," he said.
He noted that the contagious disease had killed animals in Maluri, Gudi, Manawaji and other Fulani settlements in a short period of time. "Months before now, our animals had suffered from lung disease, and now, it's 'boru' (FMD). It took the intervention of veterinary doctors sent by the state government to curtail the spread of the disease," he said. He stated that the disease could have been fatal if not for the mass animal vaccination that the livestock received early this year.
The national president of KACBA, Khalil Muhammad Bello, said he had received reports from affected areas and that he had forwarded them to the Yobe State Pilot Livestock Development Program for immediate action. "I'm happy to inform that our people have started receiving drugs and treatment at area offices across the state. Wherever the livestock farmers have a problem, they will contact us to link them with the nearest area office for treatment," he explained.
United States: Norovirus
Evacuees who fled the Camp Fire in California are facing norovirus outbreaks in shelters. The Butte County Public Health Department said that 145 people have been sick with vomiting and/or diarrhea since the shelters opened to evacuees, and 41 people were experiencing symptoms at four different shelters as of Nov. 14th. Twenty-five people have been to the hospital for medical support, the health department said in a statement. "The number of sick people is increasing every day," the statement said.
About 9,700 homes were destroyed and 141,000 [151,000 as of Nov. 19] acres burned in the fire. Seventy-seven people have died due to the fire, and more than 600 [1,000 as of Nov. 19] are missing. The Butte County health department is working with the Red Cross, state and federal partners to reduce the spread of the illness at the evacuation shelters, according to the statement released on Nov. 15. Some of the actions being taken include establishing separate shelters for sick evacuees, active monitoring of shelter residents and protective equipment for medical staff.
Norovirus, which is sometimes called stomach flu or a stomach bug, is "a very contagious virus that causes vomiting and diarrhea," according to the US Centers for Disease Control and Prevention. It leads to 19 to 21 million cases of acute gastroenteritis in the United States every year.
Agriculture officials in Victoria, Australia reported responding to positive identification of anthrax in a sheep on a property near Swan Hill over the weekend. Victoria's Chief Veterinary Officer, Dr. Charles Milne, said the affected property had now been quarantined and appropriate bio-security protections were in place.
Dr. Milne said it was not unusual for incidents of anthrax to be detected in cattle and sheep in the region, with several farms in the Swan Hill area affected in March 2017, as well as a property in March this year.
"Incidents tend to occur during the warmer months when it is drier and livestock forage deeper into the soil when eating grass," Dr. Milne said. "We are well prepared to handle these incidents and we are currently contacting local farmers and veterinarians." Dr. Milne said all sheep on the affected property had now been vaccinated and appropriate disposals were taking place today.
The current evidence suggests that one property has been affected. Agriculture Victoria will continue to work with nearby farmers, veterinarians and the local community to monitor the situation.
United States: Chronic wasting disease
Test results from 3 deer harvested in Blaine County have tested positive for chronic wasting disease.
The deer were harvested within the 2018 priority surveillance area, which includes the northern half of Blaine County. As a result, the northern part of Blaine County -- north of U.S. Highway 2 -- has been designated a CWD-positive area. A previously existing CWD-positive area includes all of Liberty County. FWP [Fish, Wildlife, and Parks] has notified the hunters who submitted the samples.
To prevent the spread of CWD to other portions of Montana, the brain and spinal column of deer, elk or moose harvested within either CWD-positive area cannot be transported outside of the associated transport restriction zone, or TRZ, which includes Toole, Liberty and Hill counties, and with this latest detection has been expanded to include Blaine and Phillips counties. Hunters are reminded not to leave this expanded TRZ with whole deer, elk or moose carcasses from either CWD-positive area but should consider processing the animal within the TRZ or only removing quarters and deboned meat with no spinal column or head attached.
Hunters also need to be aware that because of this new detection of CWD, FWP is relying on collecting more samples from the area to determine disease prevalence among the deer population and its potential distribution. This information is critical for FWP in developing a plan for managing the disease.
The epidemiological situation of the Ebola Virus Disease dated Nov. 19:
Since the beginning of the epidemic, the cumulative number of cases is 373, of which 326 are confirmed and 47 are probable. In total, there were 217 deaths (170 confirmed and 47 probable) and 110 people healed.
Seventy-one suspected cases are under investigation. No new cases are confirmed.
There is 1 new confirmed case death and two new people have been healed in Beni.
Since the beginning of vaccination on Aug. 8th, 32,626 people have been vaccinated, including 16,210 in Beni.
November 16, 2018
Pakistan: Crimean Congo hemorrhagic fever
Reports on the number of dengue and Crimean-Congo hemorrhagic fever/CCHF virus cases in the past 4 years were presented before the National Assembly on November 7th. Since 2015, Congo virus has infected 613 people. Of these people, 148 died due to the disease.
Balochistan was the most affected by the virus, as 424 were infected. In Sindh 63 cases were reported while Punjab and Khyber Pakhtunkhwa each reported 51 cases. Thirteen cases were reported in Islamabad and 5 in Federally Administered Tribal Areas.
The Congo virus is spread through ticks on animals.
Since the beginning of the epidemic, the cumulative number of cases is 339; 301 are confirmed and 38 probable. In total, there have been 212 deaths (composed of 174 confirmed and 38 probable cases).
Ireland: Hand, foot and mouth disease
Hand-foot-mouth disease [HFMD] cases are on the rise in Ireland. With children back at school, there is a rapid increase in cases, and parents are being urged to look out for the signs. HFMD is a common, mild illness caused by a type of enterovirus. The disease gets its name from the non-itchy rash that develops on the palms of your hands and soles of your feet. It can also cause ulcers in your mouth and make you feel generally unwell, although some people have no symptoms.
According to the Health Service Executive (HSE), the disease is very contagious and is common in children under 10 years of age. However, adolescents and adults can also be affected. The first symptoms of HFMD include fever and feeling unwell, loss of appetite, sore throat, and small red spots in the mouth, throat, and skin.
Later symptoms include the following: After 1-2 days, red spots in the mouth will develop into painful ulcers, particularly around the tongue, gums, and inside of the cheeks. The spots are flat or raised, sometimes with blisters, and smaller than chickenpox sores. It may be difficult to eat, drink, and swallow.
Any red spots on the skin will turn into a non-itchy rash over another 1-2 day period. The rash develops on the palms of the hands, the soles of the feet, and between the fingers and toes. In some cases, spots also develop on the buttocks and genitals.
To prevent HFMD, always wash your hands after going to the toilet and handling nappies, and before preparing food. If your child has HFMD, encourage them to wash their hands regularly; avoid sharing utensils with people who are infected with HFMD; and make sure that shared work surfaces are clean.
Japan: African swine fever
A highly contagious African swine fever [ASF] virus has been detected in the luggage of a traveler from Shanghai at Tokyo's Haneda airport, the farm ministry said on November 9th. Pork-filled dumplings brought by the traveler on Oct. 14 have tested positive for the virus, becoming the second case of the virus brought to Japan from overseas.
ASF was reported in China in August of this year, while no domestic infections in Japan have been reported so far. It is regarded as more lethal than classical swine fever, also known as hog cholera, and there is no effective vaccine to protect pigs from the deadly disease.
According to the Agriculture, Forestry and Fisheries Ministry, the dumplings were homemade and uncooked. Both African and classical swine fevers pose no direct threat to human health.
Experts in Uganda have been making calls to control Anthrax infections in their country. Speaking during the 4th National Field Epidemiology Conference at Imperial Royale hotel, Dr. Alex Ario (the acting director of the Uganda National Institute of Public Health Ministry of Health) called on the public to ensure animal health if the country is to control anthrax.
Over 200 people have been infected with anthrax in four districts in West Nile and South Western Uganda. According to the Ministry of Health officials, many people were at risk of contracting the disease, which is common in animals. The 236 cases have been recorded in the districts of Arua, Kiruhura, Isingiro and Kween from 2017 up to Nov. 12.
Arua district in Uganda has had the highest number of anthrax in humans with a total number of 102 reported since 2015. Isingiro district came second with 60 cases reported last year, 52 cases in Kween district and 22 in Kiruhura were registered this year.
Dr. Alex Ario said if government does not address the problem of anthrax from animal side, it will continue to spread and affect more people. He however noted with concern that some farmers cannot afford the cost to vaccinate their animals against anthrax. He urged the government to come up with a policy on vaccination of animals. "In some cultures however, instead of getting rid of animals which have died from anthrax, these animals are eaten by people," he noted. It is against this background that Ario called for a need to put in place a policy to burn the animal once it is found to have died of anthrax.
Dr Willy Nguma, the Arua district veterinary officer said at the moment at least 150,000 animals including cows, sheep, goats and pigs are at risk of anthrax. He said the outbreak from 2017 to 2018 left over 1,000 animals dead. Nguma said sudden death is one of the signs of anthrax in animals.
Nigeria: Lassa fever
In the Oct. 29-Nov. 4 reporting week, 5 new confirmed cases were reported from Edo (3), Ondo (1) and Ebonyi (1) state with 2 new deaths in Edo (1) and Ebonyi (1) This year, a total of 2,950 suspected cases have been reported from 22 states. Of these, 553 were confirmed positive, 17 probable, 2,380 negative.
Since the onset of the 2018 outbreak, there have been 143 deaths in confirmed cases and 17 in probable cases. Case fatality rate (CFR) in confirmed cases is 25.9%.
Twenty-two states have recorded at least one confirmed case across 90 Local Government Areas (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe, Ekiti, Kaduna, Abia, Adamawa and Enugu); 18 states have exited the active phase of the outbreak while 4; Edo, Ondo, Ebonyi and Delta states, remain active.
Eighty-two percent of all confirmed cases are from Edo (46%), Ondo (23%) and Ebonyi (13%) states.
Ten patients are currently being managed at Irrua Specialist Teaching Hospital (ISTH) treatment Center (4), Federal Medical Centre (FMC) Owo (4), and Federal Teaching Hospital Abakiliki (2).
A total of 8,587 contacts have been identified from 22 states. Of these 512 (6%) are currently being followed up, 7,946 (92.5%) have completed 21 days follow up while 15 (0.2%) were lost to follow up. 114 (1.3%) symptomatic contacts have been identified, of which 36 (0.4%) have tested positive from 5 states (Edo - 20, Ondo - 8, Ebonyi - 3, Kogi - 3, Bauchi - 1 and Adamawa - 1).
November 9, 2018
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated Nov. 6:
A total of 308 cases of hemorrhagic fever were reported in the region, 273 confirmed and 35 probable. Of the 273 confirmed, 156 died and 91 are cured. The others are hospitalized in the different Ebola treatment centers.
Thirty-nine suspected cases are under investigation. There are 3 new confirmed cases, 2 in Beni and 1 in Vuhovi [North Kivu]. There are 2 new confirmed fatalities, including 1 in Butembo [North Kivu] and 1 in Vuhovi. There are 3 new recoveries in Beni.
The response teams in Beni were visited by a large delegation composed of the Minister of Health, Dr. Oly Ilunga Kalenga, the Governor of North Kivu Province, Julien Paluku, the United Nations Under-Secretary-General for peacekeeping operations, Jean-Pierre Lacroix, WHO Director-General Dr. Tedros Adhanom Ghebreyesus, and the UN Special Representative in the DRC, Leila Zerrougui.
The delegation began the day at the emergency operations center of the response, where National Response Coordinator Dr. Ndjoloko Tambwe Bathe presented the epidemiological situation, challenges and progress of the response. The Coordinator agreed, on behalf of all stakeholders in the response, with the Merit Certificate awarded to congratulate them on the work done in this Ebola outbreak, which is the most complex epidemic in the history of the country.
At the end of the visit, the Minister of Health warmly congratulated the teams that have so far managed to prevent this epidemic from turning into a real human tragedy, resulting in thousands of deaths across the country. Although the number of new confirmed cases reported daily has slightly decreased in recent days, the situation remains extremely critical.
Nigeria: Lassa fever
In the reporting week of Oct. 22-28, 9 new confirmed cases were reported from the states of Ondo (4), Edo (4), and Ebonyi (1), with 2 new deaths in Edo (1) and Ondo (1) and a probable case from Ebonyi.
From January through October, a total of 2,834 suspected cases have been reported from 22 states. Of these, 548 were confirmed positive, 17 are probable, and 2,264 are negative (not a case).
Since the onset of the 2018 outbreak, there have been 141 deaths in confirmed cases and 17 in probable cases. The case fatality rate in confirmed cases is 25.7 percent.
Twenty-two states have recorded at least one confirmed case across 90 local government areas
Eighty-two percent of all confirmed cases are from Edo (46 percent), Ondo (23 percent), and Ebonyi (13 percent) states.
A total of 8,454 contacts have been identified from 22 states. Of these, 389 (4.6 percent) are currently being followed up with, 7,946 (94 percent) have completed 21 days follow-up, while 15 (0.2 percent) were lost to follow-up. 109 (1.3 percent) symptomatic contacts have been identified, of which 36 (0.5 percent) have tested positive from 5 states: Edo (20), Ondo (8), Ebonyi (3), Kogi (3), Bauchi (1), and Adamawa (1).
Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels.
China: African swine fever
China has found 3 new African swine fever [ASF] cases on small pig farms in Shanxi, Hunan, and Yunnan provinces, the Ministry of Agriculture and Rural Affairs said. The herds at the affected farms together total 390 pigs, the ministry said on its website.
Beijing has not yet said how the disease entered the country, but the ministry found 62 percent of the first 21 outbreaks were related to the feeding of kitchen waste, a statement published on its website said.
The outbreak of ASF in China could lead to increased exports of Irish pigmeat from Ireland to China in the medium term, director of Meat Industry Ireland Cormac Healy has said. "In the short term, it could lead to more domestic product coming onto the market, which would dampen import demand
He added that if significant culling within the domestic Chinese pig herd takes place, it should create greater import opportunities.
Bulgaria: African swine fever
The first cases of infection with African swine fever (ASF) virus were found in 4 wild boars in the Dobrich region of northeastern Bulgaria. The boars were shot at a hunting farm on the land of the village of Bulgarevo, the Bulgarian Food Safety Agency (BFSA) announced Nov. 1.
By an order of the BFSA Executive Director, Dr. Damyan Iliev, measures have been imposed to prevent and limit the spread of the infection in accordance with the existing legislation. Areas of restriction have been created, and oversight of wild and domestic swine has been enhanced.
The BFSA will conduct ongoing ASF clinical examinations in domestic swine and will take samples from all dead wild boars and domestic pigs, as well as from any showing signs of the disease. The samples will be taken in line with the implementation of the Disease Prevention and Control Program in Bulgaria. Measures for domestic pigs are taken to prevent transfer of the virus between wild and domestic animals.
At a meeting of the Regional Epizootic Commission in Dobrich Nov. 2, the participants discussed the control measures and their implementation. Farm biosecurity is a key factor in protecting domestic pigs from getting infected with the ASF virus. Therefore, the BFSA reminds all that pigs in "backyard farms" should be kept in enclosures with enhanced biosecurity and should not have contact with wild pigs.
China: Avian influenza
The Macau Health Bureau was warned by Chinese health authorities that a fatal bird flu human infection case had been registered in the Guangxi Zhuang Autonomous Region, bordering with Guangdong province.
A 44-year-old Chinese driver from Hechi in Guangxi Zhuang was said to have contracted the influenza A virus H5N6 sub-type, having shown symptoms on Oct. 18 and sent for medical treatment on Oct. 21.
Separate news reports have indicated that the man died Oct. 27 from severe respiratory illness.
According to the bureau, since 2014 bird flu cases have been registered in the Chinese provinces of Sichun, Guangdong, Yunnan, Hubei, Hunan, Anhui, and in Guangxi Zhuang, with Macau health authorities having maintained close communication with health entities in China and neighboring regions, and with the World Health Organization (WHO).
Human contraction with the influenza A virus H5N6 subtype was first reported in China in early May 2014, with all known cases having happened in this country.
This avian influenza virus originated from influenza viruses that mainly affect birds and poultry, such as chickens or ducks. It is considered a low virulent strain for avian populations, but with the clinical manifestation in humans considered severe, with acute respiratory illness and pneumonia able to occur.
United States: Hand, foot and mouth disease
In the past 2 weeks, 5 Western Washington University students have been diagnosed with hand-foot-mouth disease, causing Dr. Emily Gibson, director of the Student Health Center, to post an advisory on Twitter.
"We are aware of a small cluster of hand-foot-mouth disease among WWU students -- this virus is more typically seen in young children, but can result in symptoms in adults that can last up to a week, and it is very contagious," Dr. Gibson wrote in the Tweet.
In an email to The Bellingham Herald, Dr. Gibson said Western sees sporadic hand-foot-mouth disease cases most years, but not usually the small cluster they've seen this year. Dr. Gibson also said that larger outbreaks of more than 100 cases have been seen at colleges on the East Coast this fall.
"This is a mild viral illness that typically afflicts young children," Dr. Gibson said in the email. "It is now being seen more in college populations among non-immune individuals and is easily spread through coughing, sneezing, or sharing utensils and drinks. The symptoms, which can include fever, body aches, cough, runny nose, and lesions in the mouth, on the hands and feet, usually resolve in 5 to 7 days."
When students are diagnosed, Dr. Gibson said, the Student Health Center recommends they remain isolated, including not attending class, to reduce the risk of the virus spreading.
Belgium: African swine fever
The Boerenbond [Farmers Union in Flanders, Belgium] argues for a decisive and joint approach to the overpopulation of wild boars. This is necessary to reduce nuisance and prevent possible spread of African swine fever into pig farms, says the organization.
"With the regularity of a clock, reports appear in the press of shunted gardens, traffic accidents caused by wild boars, and troubled civilians who notice wild boars on their streets. But farmers have been complaining for a long time, especially in the province of Limburg, about the damage that wild boars inflict on agricultural crops. There is now the threat that wild boars could spread African swine fever," the Boerenbond wrote in a press release Nov. 5.
With a view to planned consultation this and next week between the governors of Limburg and Antwerp and the various other stakeholders, the organization will list some points of interest.
For example, they argue for the appointment of a wild boar coordinator who must ensure that the parties involved meet more quickly and make clear agreements so that the Boerenbond has a clear overview of the number of wild boar and their location. This is necessary in order to be able to find out to what extent the actions on the ground meet the effort to reduce the wild boar populations in Flanders, it says.
The agricultural organization also demands more opportunities for hunting. They suggest using night vision goggles and infrared cameras and allowing the use of silencers under certain circumstances.
There must also be a clear hunting policy in nature areas. In the nature reserves where nothing happens, Boerenbond believes that nature managers must fence these areas so that the population can no longer cause damage in agricultural areas and to private individuals.
Australia: Q fever
Reports suggest a recent spate of cases of Q fever in rural areas likely comes from closer human exposure to livestock during times of drought, according to Local Land Services District Veterinarian Dr. Erica Kennedy, who is encouraging farmers to get tested and vaccinated. It has been confirmed there have been reports of 4 cases in Nyngan alone.
Dr. Kennedy said the bacteria can be carried by cattle, goats, sheep and other domesticated and wild animals, infecting people through contact of birthing fluids or the inhalation of dust containing dried animal secretions, which can be spread by winds. Symptoms often appear like a very severe flu, and include high fevers and chills, severe sweats, severe headaches, muscle and joint pains and extreme fatigue.
Dr. Kennedy believes current dry conditions have increased people's exposure levels to livestock, which could be the cause for the recent spike in cases. "People are out feeding and around animals so much more so I wouldn't imagine prevalence of disease in the livestock in the region is getting higher ... I would say that people's exposure levels have increased," she said.
Dr. Kennedy said anyone in rural areas should be mindful when handling livestock, particularly birthing fluids, encouraging anyone who has contact with animals to get themselves tested then vaccinated. "If you're a producer out here or have anything to do with livestock you should really go and get tested and vaccinated if you haven't before," she said.
One of the key complications of the virus is chronic fatigue, which Dr. Kennedy said reinforces why producers in the region need to get tested and vaccinated. "The cost of chronic fatigue to a producer far outweighs the cost of vaccination. I think this just highlights that producers need to focus and look after themselves so they can then continue to be productive."
Ethiopia: Yellow fever
The World Health Organization is releasing more than a million doses of yellow fever vaccine from its emergency stockpile after the deadly mosquito-borne disease killed 10 people in southwestern Ethiopia, a WHO report said Nov. 5.
The outbreak was confirmed in Wolaita Zone of the Southern Nations, Nationalities, and Peoples' Region and has been traced back to a patient who fell ill on Aug. 21. It has caused 35 suspected cases of the disease.
"This outbreak is of concern since the population of Ethiopia is highly susceptible to yellow fever due to absence of recent exposure and lack of large-scale immunization," the WHO report said.
Symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue, and although only a small proportion of patients who contract the virus develop severe symptoms, about half of those die within 7-10 days.
All the confirmed cases came from Offa Woreda district, and there have been no more confirmed cases since an immediate reactive vaccination campaign was conducted there in mid-October, reaching around 31,000 people. However, the WHO said there was a risk of further spread of the disease, partly because of conflict in the region, and it was releasing 1.45 million doses of vaccine for a mass campaign that needed to take place "without further delay".
Ethiopia, the home country of WHO Director-General Tedros Adhanom Ghebreyesus, is within the geographic "yellow fever belt" and had frequent outbreaks until the 1960s, but no more until 143 cases were confirmed in the SNNP region in 2013, the weekly report said.
United States: West Nile virus
A West Nile virus case has been confirmed in a horse in Clarke County. The affected horse--a vaccinated 8-year-old Holsteiner stallion--developed mild ataxia, prominent skin twitching, and moderate behavioral anxiety. He has since fully recovered.
The Equine Disease Communication Center reported Nov. 1 that the Virginia Department of Agriculture and Consumer Services confirmed another case of equine WNV. This is the 7th case of WNV in Virginia horses confirmed so far this year, according to USDA Animal and Plant Health Inspection Service data.
A serum sample was positive on the IgM Capture ELISA performed at the Cornell University Animal Health Diagnostic Center, in Ithaca, New York. The affected horse has fully recovered, the EDCC said.
United States: Avian influenza
The Board of Animal Health detected a 2nd case of low-pathogenic avian influenza in a turkey flock. This detection came in Stearns County, Minnesota, following a case in Kandiyohi County. Minnesota Turkey Growers Association Executive Director Steve Olson says enhanced surveillance and tightened biosecurity helped with this detection.
He says they learned a lot from the highly pathogenic bird flu outbreak that hit Minnesota in 2015, which has helped in dealing with these 'low path' cases. Olson says he wouldn't be surprised to see additional low path cases, but the best deterrent will be colder weather.
Indonesia: Japanese encephalitis
Australian tourists in Bali are being told to take extra precautions because of an outbreak of a viral brain infections transmitted through mosquitoes.
Indonesia's Ministry of Health has revealed they're keeping close tabs on the deadly Japanese encephalitis after a spike of cases in Bali and Manado, in North Sulawesi.
The infection, a virus, is commonly transmitted to humans through mosquitoes, but birds, bats, cows, and pigs can also carry the disease. It can cause blindness, weakness, movement disorders, and in 30 percent of cases, death. The disease takes up to 15 days to develop with warning signs flu-like symptoms such as a headache, fever, and convulsions.
Ministry of Health Director of Surveillance and Quarantine, Vensya Sitohang, said in Nusa Dua Nov. 6 that Bali has had the most cases, followed by Manado, North Sulawesi, according to the ministry's data.
The ministry say they're now introducing a vaccine in Bali in the hopes it will prevent the transmission of the infection to other regions in the country.
Europe: West Nile virus
A terrifying disease spread by mosquitos is sweeping across Europe killing at least 170 people this year, with the majority of cases in the south of the continent as infection rates soar.
Last year, there were only 200 reported infections in the EU, with 25 people killed. But in 2018 there have been 1,460 reported cases of the potentially lethal sickness, according to the EU Health Commission.
The fever has ripped across Europe in 2018, killing 44 people in Italy, 42 in Greece, 42 in Romania, and 35 in Serbia. Fatalities in Kosovo (3), Bulgaria (2), the Czech Republic (1), and Hungary (1) have also occurred. Italy (550) and Serbia (410) have seen the highest number of cases.
Victims contract the virus from mosquitos that have fed on infected birds. Around 80 per cent of infected people have no symptoms, with about a fifth of those affected developing flu-like symptoms. Roughly one in 150 people get seriously ill with a high fever and meningitis.
Cold weather is helping to reduce the killer virus's impact. So far, nobody has caught the virus while in the UK. But with no vaccine to protect holidaymakers from West Nile virus, the NHS has warned British travelers to wear mosquito spray and use mosquito nets in affected countries.
November 2, 2018
China: African swine fever
China's agriculture ministry said Oct. 24 it would ban the feeding of kitchen waste to pigs after linking the practice to the majority of the early cases of African swine fever. Beijing has not yet said how the disease entered the country, but the ministry found that 62 percent of the first 21 outbreaks were related to the feeding of kitchen waste, a statement published on its website said.
"These outbreaks were mostly located in urban-rural boundaries and were particularly evident in several cases in early September in Anhui province," the statement said. Anhui is an eastern province whose capital, Hefei, is located about 258 miles west of Shanghai.
The virus was also detected in kitchen waste fed to pigs on a farm in the Inner Mongolia region. "After the provinces with outbreaks and neighboring provinces completely banned feeding of kitchen waste to pigs, the epidemic was greatly reduced, which fully demonstrates the importance of completely prohibiting the feeding of waste," the statement said.
Kitchen waste or swill is widely used in China to feed hogs, particularly by small farmers, as it is cheaper than manufactured pig feed. Regulations require that the swill must be heated to a certain temperature before being consumed, but industry experts say that step is often skipped.
The ministry also said in the statement that it will set up a registration system for vehicles transporting live hogs, poultry, and other livestock to control the spread of the disease better. The long-distance transport of live hogs has been the main channel for transmitting ASF across different regions. Vehicles transporting pigs and other animals will also no longer be allowed to use the "green channel" for priority on roads that is normally permitted for the trucking of fresh produce, added the ministry.
The statement also called for more slaughtering closer to farms and the use of refrigerated pork transportation to better manage the supply of livestock across different regions. China has promoted construction of new farms in the northeast in recent years, closer to its grain supplies. But the policy, which has not yet been accompanied by investment in new slaughterhouses, has led to large numbers of pigs being trucked long distances south.
Central African Republic: Monkeypox
In a remote southwestern pocket of the Central African Republic (CAR), Dr. Patrick Karume and his small team are on the jungle frontline to quarantine a rare outbreak of monkeypox. From a makeshift base in Zomea Kaka village, they trek 18 miles across muddy tracks to Bagandou, where a dozen children appear to have developed rashes characteristic of the virus, which in rare cases can be fatal.
Monkeypox virus, first identified in the Democratic Republic of Congo in 1970, has symptoms similar to human smallpox, if less severe. In May, the virus became a "public health threat," according to local CAR authorities. It was the latest outbreak detected in CAR since 2013, according to World Health Organization advisor Augustin Diebert.
Medecins sans Frontieres dispatched an emergency team to set up in Zomea Kaka after 3 cases of the virus were identified. Already they have quarantined 9 people, most of them children. "Monkeypox may be endemic to this area," Karume said, pulling off muddied boots after another trek out of their MSF base.
Before entering the "red zone" quarantine area cordoned off with a fence, everyone dons the required gear -- rubber boots, disposable overalls, masks and goggles. Nearby, a few meters away, their patients sit on benches eating breakfast. Some show traces of the virus on their faces. For some, crusts have discolored parts of their skin. Peeling is a sign of healing.
More than 1,000 students from universities and colleges in Beni invaded the city recently with a peaceful march to show their support for the Ebola response. For nearly 2 hours, students crisscrossed the areas of the city in which pockets of resistance had been recorded to convince the residents of these areas to collaborate with the teams of the response.
With this march, the Beni students officially launched the "Ebola Pas Chez Moi" campaign, which invites all citizens of Beni to respect the preventive measures and all the recommendations of the health authorities to stop the spread of the virus.
The Response Coordinator Dr. Ndjoloko Tambwe Bathe found the students at the end point at Kalinda Stadium to congratulate and encourage them in this initiative. He hopes that this involvement of students will help overcome the resistance, sometimes maintained by neighborhood youth in some active homes of the city.
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated Oct 30, 2018:
A total of 279 cases of hemorrhagic fever were reported in the region, of which 244 confirmed and 35 probable.
Of the 244 confirmed, 144 died and 81 are cured. The others are hospitalized in the different Ebola treatment centers (ETCs) installed.
Fifty-one suspected cases under investigation.
Three new confirmed cases, including 2 in Beni and 1 in Vuhovi. Vuhovi is a new health zone located between Beni and Butembo. He [the Vuhovi case] is the husband of a confirmed case who died at Butembo ETC on 26 Oct 2018. He refused to follow up and transfer to ETC. He died at the Vuhovi health center where the sample was taken.
4 new confirmed deaths, including 2 in Beni, 1 in Butembo, and 1 in Vuhovi.
7 new healed cases, including 6 in Beni and 1 in Butembo.
5,679 contacts followed to date.
There are 11 cases of hantavirus so far in 2018, the statistics of the Departmental Health Services (SEDES) of Tarija show. Four municipalities are affected by this disease.
Of the total cases of hantavirus infection, 3 died due to the disease; thus, epidemiologists speak of an elevated case fatality rate. The municipalities where these types of cases occur are: Carapari, Yacuiba, Padcaya, and Bermejo. The situation is most critical in the last municipalities mentioned.
The person responsible for SEDES Epidemiology, Claudia Montenegro, explained that the last case that occurred was in the Playa Ancha community in Padcaya. Because the disease was detected on time, it was possible to save the lives of these people. The [health] agency proceeded to block the disease; the municipality and Bermejo took action together to avoid more victims of the disease.
"Personnel of the health centers are capable of timely detection, and we know that there is a national alert, since Tarija has endemic municipalities and is working to prevent [hantavirus infections]," the official commented. Montenegro explained that the rains generated abundant food for the rodents, which increases their populations. This implies that this season has more risk of contracting hantavirus infections.
Since there is abundant wild-rodent presence, the management of rodent control is complicated: putting poison out would cause the death of other species inhabiting the wooded areas. This is why the recommendation for prevention includes placing metal on doors and windows and covering food and trash containers. It is also important to eliminate weeds around the house in order to reduce the possibility of contact with rodents that transmit the virus.
The NCDC is following up closely with the Ministry of Health Israel following the report of a confirmed monkeypox case in Israel on Oct. 13 with a travel history from Nigeria. Ten new suspected cases of monkeypox were reported from Ebonyi (4), Rivers (2), and Bayelsa (4).
Eight patient samples from the cluster of 10 suspected cases with epidemiological linkages to the 1st case in the UK were tested and found to be negative for monkeypox but positive for chickenpox. Two cases will require further investigation. Thirteen contacts of the first UK confirmed case were followed up in Nigeria for a period of 21 days. None became symptomatic.
NCDC continued to collaborate with PHE to investigate and strengthen control measures related to the 2 cases confirmed in the UK.
A total of 86 cases have been reported in 2018 from 16 states (Rivers, Akwa-Ibom, Bayelsa, Cross River, Delta, Ebonyi, Edo, Enugu, Imo, Lagos, Nasarawa, Oyo, Abia, Anambra, Plateau, and the FCT); 38 are confirmed, one probable, 10 awaiting results, and 2 deaths. One hundred sixteen confirmed and 280 suspected cases have been recorded from the beginning of the outbreak in September 2017.
Genetic sequencing suggests multiple sources of introduction of monkeypox virus into the human population with some evidence of human-to-human transmission.
France: West Nile virus
West Nile disease is spreading across southern Europe, including 24 confirmed cases in France, with experts calling it the "biggest epidemic seen in our country."
The Mediterranean area reported the first case of the virus in July 2018. There have now been 24 cases diagnosed across the Provence-Alpes-Cote d'Azur, Occitanie, and Corsica regions; as well as 550 cases in Italy and 300 in Greece.
West Nile virus is spread by Culex mosquitoes, which carry the virus from infected birds and horses into humans. The virus can only be carried by mosquitoes and cannot be spread from horse to human, or between humans themselves. The virus can go on to cause West Nile disease, with around 20 percent of infected humans going on to develop a fever.
When it shows up, after an incubation period of 3-15 days, flu-like symptoms will occur, including fever, headache, fatigue, joint and muscle pain. Older people over 50 are more at risk.
For 80 percent of infected people, there are no symptoms, but one in 150 will develop a severe case of the illness, causing neurological problems such as meningitis, paralysis or Guillain-Barre syndrome, which affects the nerves and immune system.
So far in France, 6 people have required hospitalization due to a severe case, but according to the Agence Régionale de Santé, they should all make a full recovery.
Central African Republic: Yellow fever
On Oct. 23, the Central African Minister of Health and Population, Pierre Some, formally recognized the existence in the Central African Republic city of Bocaranga of a case of yellow fever, whose signs were discovered in a woman aged 80 and confirmed by the Pasteur Institute of Bangui.
As a result, Mr. Somse announced the strengthening of epidemiological surveillance in the locality and response measures that have benefited from the support of the World Health Organization (WHO), the Pasteur Institute of Bangui, and the NGO CORDAID [Catholic Organization for Relief and Development Aid].
These measures, he added, include immunization, patient care, and community outreach to improve hygiene and sanitation.
Mr. Somse urged residents of so-called risk areas or forest areas to sleep under impregnated mosquito nets. He also advised people in these areas to immediately refer all people with yellow fever indications to health centers.
He described yellow fever as responsible for a mortality rate of between 25 and 50 percent of proven cases, manifested by jaundice caused by a virus. The disease, which is transmitted to humans through mosquitoes, he added, has a reservoir in primates, like monkeys.
On Oct. 28 District Collector P.S. Pradyumna directed the Animal Husbandry Department officials to immediately undertake the vaccination drive for cattle in a radius of approximately 6 miles with Kodandaramapuram village of Karveti Nagaram mandal as the epicenter of the suspected anthrax outbreak.
Joint director (Animal Husbandry) S. Venkat Rao told The Hindu that based on the instructions of the Collector, 13,000 vaccination doses were procured from other government veterinary hospitals, though the requirement was about 10,000 doses.
The official observed that the death of cattle at Kodandaramapuram village was first detected on Oct. 18, followed by a series of casualties.
A senior medical officer said that special teams were on the job of searching for the meat stocks in the surrounding villages of Kodandaramapuram as some residents had reportedly shifted the stocks outside. "We have already searched several houses and the meat found was destroyed. An appeal was also made to the public in Karveti Nagaram mandal through the field officials to destroy the dried or stored meat," he said.
A total of 7 villagers of Kodandarama Puram in Karveti Nagaram mandal were diagnosed with having anthrax at the government hospital at Puttur on Oct. 26. A 50-year-old person, who slipped into coma following infection of the digestive tract, was shifted to SVRR Hospital in Tirupati, where his condition is serious.
Personnel of the Animal Husbandry Department confirmed that 18 cows and buffaloes and 6 sheep had died during the last fortnight. About 6 stray dogs that had contracted the bacteria were on the prowl in the village, they said. It all started when a group of youth had skinned the carcass of 2 cows found dead in the fields in the village a fortnight ago and shared the meat among their families, the officials said. They further said that 18 head of cattle had died, and the villagers consumed the meat of the dead animal.
Senior Medical Officer P. Ravi Raju, after conducting preliminary tests, confirmed the outbreak of anthrax among 7 people at Kodandarama Puram.
In coordination with the MPDO staff and the Karveti Nagaram police, Dr. Raju searched the houses in the village and destroyed the meat stocks. Special parties had been dispatched in search of dried meat sent to the neighboring villages.
Nigeria: Lassa fever
The Nigeria Center for Disease Control (NCDC) has confirmed 3 new cases of Lassa fever in Ondo state, including a health worker, with 2 new deaths.
According to the NCDC, in the reporting week of Oct. 15, one new healthcare worker was infected in Ondo state and 41 healthcare workers have been affected since the onset of the outbreak in 7 states -- Ebonyi (16), Edo (15), Ondo (5), Kogi (2), Nasarawa (one), Taraba (one), and Abia (one) with 10 deaths in Ebonyi (5), Kogi (one), Abia (one), Ondo (2), and Edo (one).
The NCDC, which confirmed 2 new cases of monkeypox out of 10 new reported cases, noted that it is following up closely with the Ministry of Health in Israel.
The current leptospirosis outbreak in Northern Israel with 36 confirmed/probable and 583 suspected cases, has been a concerning health risk among all travelers visiting this region, but special surveillance seemed warranted for adolescents.
Israel is a popular summer destination among youths for camps, tours, and fresh-water recreational activities; making up to 40% of all visitors.
Therefore, physicians should have raised clinical awareness for young travelers returning from Israel with an acute febrile illness. Three cases of suspected leptospirosis, one confirmed, of teenaged travelers to Israel, have been reported.
All 3 patients had spent about 4 weeks in Israel in July/August and had visited affected bodies of water in the Golan Heights with various fresh water exposure (kayaking, swimming, or white-water-rafting).
All received treatment with ceftriaxone, doxycycline or azithromycin for 5-7 days and had made full recovery.