DENGUE/DHF UPDATE 2010 (02)

ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update
[1] Cambodia
[2] Nicaragua (Leon)
[3] Brazil (Mato Grosso do Sul)

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[1] Cambodia
Date: Tue 5 Jan 2010 e
Source: Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2010-01/05/content_12757444.htm>


Cambodia has seen a rise in reported cases of dengue fever in 2009, as 
local media reported on Tuesday [5 Jan 2009], citing health officials 
here. Ngan Chantha, director of dengue control at the Ministry of 
Health, was quoted by the Cambodia Daily as saying that there were 11 
652 cases and 37 deaths reported in 2009 compared with 9456 reported 
cases and 65 deaths in 2008. While infections increased 30 percent, 
deaths were down by half, he said. When asked whether the number is 
expected to increase in 2010, Chantha said it would depend on how well 
individuals protect themselves and their families from the 
mosquito-borne virus.

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

[Dr Michael J. Bangs, Public Health & Malaria Control, PT Freeport 
Gold & Copper, Kuala Kencana, Papua Indonesia 
(<Michael_Bangs@fmi.com>) reported to ProMED that the apparent 
dramatic improvement in reduction of dengue mortality is laudable and 
a direct reflection of the concerted country-wide effort by the 
Cambodian Health Ministry for expanding control interventions and 
disseminating practical information to the general public about the 
disease and its prevention.

While the absolute number of reported cases dropped 71 percent between 
2007 and 2009, one obvious but missed piece of information derived 
from the annual statistics is the equally dramatic reduction in the 
case fatality rate during the last 3 years. From 2007 to 2009, the CFR 
had declined nearly 70 percent. This exemplary outcome is likely the 
result of the combined outgrowth of greater awareness of people 
stricken with dengue to seek immediate medical attention, better 
access to medical facilities, and improved medical response and 
management of cases.

Regionally, both Thailand and Viet Nam have also demonstrated 
improvement in managing severe dengue cases and reduction in the CFR. 
These countries represent valuable lessons for other countries (e.g. 
Indonesia) that continue to struggle desperately with the increase in 
disease incidence and the serious consequences it imposes on 
individuals and society. Implementation is always easier said than 
done, but Cambodia's positive trend provides needed optimism amid 
growing concern about the global expansion of this important and 
common disease.

A HealthMap/ProMED-mail interactive map of Cambodia can be accessed at 
<http://healthmap.org/promed/en?v=12.7,104.9,5>. - Mod.TY]

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[2] Nicaragua (Leon)
Date: Sat 9 Jan 2010
Source: Google/EPA [in Spanish, trans. Mod.TY, edited]
<http://www.google.com/hostednews/epa/article/ALeqM5gnyB8IzrbeN9CTeIPv9BYI8Txb-w>


Nicaragua's Ministry of Health (MINSA) declared a state of health 
emergency in the Leon municipality, 90 km (56 mi) northwest of [the 
capital] Managua, in facing an outbreak of DHF, which has now claimed 
one victim, a health source reported today [9 Jan 2009]. On Friday [1 
Jan 2010], health authorities of this municipality declared the alert 
after confirming the death of a woman due to dengue and the 
hospitalization of 2 pregnant women and a youth of 12 years of age, 
the Director of the Leon Oscar Danilo Rosales Arguello Teaching 
Hospital, Luis Rocha, reported to the press today [5 Jan 2010]. At 
least 10 cases of dengue [virus] serotype 3 [infections] have 
presented in the Leon municipality, added this source.

The MINSA Director of Epidemiology in Leon, Gilberto Moreno, reported 
to the press that the death of the patient from dengue [virus] 
serotype 3 [infection], which causes severe hemorrhages and a picture 
of severe symptoms, has provoked emergency measures to deal with this 
outbreak.

The authorities launched a cleanup day, with fumigation and cleanup in 
the neighborhoods of the city to control the breeding sites of the 
mosquito _Aedes aegypti_, the transmitter of dengue [virus], which 
prefers [to breed in] pools of clean water and bites during the day.

During 2009, 2726 cases of suspected classical dengue were recorded 
and 78 of DHF, the most dangerous [form of the infection], including 8 
deaths.

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

[A map showing the location of Leon in northwest Nicaragua can be seen 
at <http://lib.utexas.edu/maps/americas/nicaragua_pol_97.jpg>.
A HealthMap/ProMED-mail map of Nicaragua can be accessed at 
<http://healthmap.org/promed/en?v=12.8,-85,5>. - Mod.TY]

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[3] Brazil (Mato Grosso do Sul)
Date: Fri 8 Jan 2010
Source: Fonte: Campo Grande News [in Portuguese, trans. Mod.TY, edited]
<http://www.campogrande.news.com.br/canais/view/?canal=8&id=278550>


Like Campo Grande, the Dourados municipality also now faces a dengue 
epidemic. According to the municipal Secretariat of Health, cases 
reported in December [2009] increased by 100 percent over November 
2009, and this year there was an increase of people with symptoms of 
the disease seeking treatment in health units.

In December 2009, 118 cases were reported, of which 40 were confirmed, 
and 58 are awaiting results of laboratory tests. Last month [December 
2009], 59 cases had been reported. Public health points to the rainy 
season and the neglect of the population as factors responsible for 
the proliferation of the _Aedes aegypti_ mosquito and consequent 
increase of the disease.

According to the Department of Health, in 2008, there were 1199 
reported suspected dengue cases, of which 787 were confirmed, 350 were 
discarded [as not dengue], and 62 are still pending the outcome of 
investigations.

The Director of Health Surveillance, Eliza Hidalgo Pereira Moraes, 
said next week there will be a mapping of the city to identify the 
areas of the city where the majority of cases appeared from October 
2009 to the present. The goal is to perform emergency actions in these 
neighborhoods to contain the spread of the disease.