Zoonotic Diseases

Diseases discussed here have a history of use as an agent for biological warfare, either in the U.S. or abroad. Its use may have been experimental or actual, and any detrimental consequences upon humans, animals or the environment may have been intentional or not, depending on the circumstances, the point in time, and the nature of the disease.

Tuesday, July 20, 2010

PRO/EDR> Dengue/DHF update 2010 (36) / Fla., Elsewhere

PRO/EDR> Dengue/DHF update 2010 (36)

ProMED-mail to promed-edr
show details 9:13 PM (3 hours ago)

A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] USA (Florida) negative
[2] USA (Florida, imported)
[3] Central America/Caribbean
[4] Colombia
[5] Philippines (Mindanao, Cebu)
[6] Thailand (Nakhon Ratchasima)
[7] Viet Nam (central)
[8] Malaysia (Sarawak)

[1] USA (Florida) negative
Date: Fri 16 Jul 2010
Source: Palm Beach Post [edited]

Test results for a suspected case of dengue fever in the Miami area
have come back negative. The Miami-Dade County Health Department
announced the 1st test results on Friday [16 Jul 2010]. According to
health officials, a Miami Beach man was suspected of contracting the
disease and has fully recovered.

A recent study found 5 percent of Key West residents show evidence
they have been exposed to the virus, but few became ill.

Communicated by:
HealthMap Alerts via ProMED-mail

[The earlier report of a suspected dengue case in the Miami area,
with risk of spread, was of concern. Fortunately, this case was
negative for dengue virus infection.

A HealthMap/ProMED-mail interactive map of the USA showing the
location of Florida in the southeast can be accessed at
. - Mod.TY]

[2] USA (Florida, imported)
Date: Fri 16 Jul 2010
Source: Gant Daily.com [edited]

Dengue fever warnings in Florida have now spread to the central
portion of the state. The Marion County Health Department has
received confirmation of a case in the county. The confirmation
prompted a request by the Marion County Commission to begin
conducting a mosquito spray in Citra, an unincorporated community in
the northeastern part of the county. "We have requested the mosquito
spray as a precautionary measure," said Dr. Nathan Grossman, director
of the Marion County Health Department, in a news release. "The risk
of transmission from this mosquito-borne disease is very low, but as
part of our mission to protect the health of Marion County citizens
we are taking additional steps to further reduce possible

Advisories were already in effect in Broward and Palm Beach counties
Thursday [15 Jul 2010] after health department officials revealed
that a Miami Beach man tested positive for the virus. The
announcement from the Miami-Dade Health Department follows reports
earlier in the week of what was described as a small outbreak of the
disease in Key West [Apparently, the Miami Dade case turned out to be
negative for dengue infection. See the report above. - Mod.TY].

[Byline: Ayinde O. Chase]

Communicated by:
HealthMap Alerts via ProMED-mail

[Fortunately, the 3 dengue cases detected in central Florida were all
imported and do not represent locally acquired infections, according
to a report in the 16 Jul 2010 edition of the Orlando Sentinel
However, if there are competent _Aedes_ mosquito vectors present in
the area, there is a risk of spread of the viruses in Central
Florida. Interestingly, the 17 Jul 2010 edition of KeysNet.com
cited Monroe County Health Department spokesman Chris Tittel, who
indicated that the 5 percent infection rate among Key West residents
was incorrect, and was really 5 percent of the sampled group, not the
total population of the Key, which was erroneously figured at 20 000
people. The report went on to say "We are not trying in any way to
minimize the seriousness of the presence of dengue in Key West, but
the spread of the disease is not out of control nor are the numbers
of cases that we have seen unexpected. We're seeking clarification
from the CDC on its report," county Health Department Administrator
Robert Eadie said. - Mod.TY]

[3] Central America/Caribbean
Date: Thu 15 Jul 2010
Source: Prensa Libre [in Spanish, trans. & summ. Mod.TY, edited]

Dengue this year [2010] is wreaking havoc in Central America and has
left at least 39 dead and more than 42 000 patients, while health
authorities reinforce educational campaigns to prevent and eliminate
the disease and to eliminate the mosquito that transmits it.

In Guatemala, the government initiated a plan to eliminate mosquito
breeding sites after heavy rains caused by tropical storm Agatha,
which hit the country in May [2010], leaving 165 fatalities.

Cases of dengue occur each year in the rainy season in Central
America (May to November), but this year [2010], hospitals and
clinics in Honduras and Costa Rica are overwhelmed because the cases
have multiplied. "We cannot lower our guard; we must continue to
destroy the breeding of the mosquito," said the Costa Rican Health
Minister Maria Luisa Avila.

Various factors -- including poverty -- impede the eradication of the
_Aedes aegypti_ mosquito, the vector of the disease [virus] in its
classic and hemorrhagic varieties (which is much more severe), which
can be fatal if prompt medical attention is not received.

Dengue this year [2010] has left 19 dead in Honduras, 13 in
Guatemala, 5 in Nicaragua and 2 in Costa Rica. In the latter country,
which has the best health indices of the isthmus, disease cases have
increased by 590 percent compared to 2009. In El Salvador and Panama,
there have been no deaths, but cases have also multiplied, almost 8
times as compared to 2009 in the case of El Salvador.

The health authorities have recorded 16 500 cases of dengue fever in
Honduras, 12 000 in Costa Rica, 6197 in El Salvador, 6000 in
Guatemala, 1500 in Nicaragua, and 100 in Panama.

For many reasons, the people disregarded the recommendations of
destroying containers holding clean water or water tanks, sites for
mosquitoes to reproduce. Abandoned tires are also an ideal place for
breeding of vectors, so the authorities are campaigning to collect
and destroy them.

In Honduras, the Council of Ministers on 22 Jun [2010] declared a
"state of national emergency following the increase in dengue cases."
The disease caused 18 deaths last year [2009] and only 9 in 2008.

In Costa Rica, the Director of the National Program to Combat Dengue,
Rodrigo Marin, admitted this week that the campaign, unfolded in 2009
against H1N1 influenza, diverted attention and resources in the fight
against dengue. The priority was swine flu "because that was what was
killing people," said the official, who suspects that contributed to
the "explosion" of dengue cases observed this year [2010]. One of the
Costa Rican provinces whose tourism is most affected has been the
Guanacaste, bordering Nicaragua, where [service in] several hospitals
has collapsed [due to a high number of dengue cases].

In Nicaragua, the Health Ministry in late June 2010 began a national
campaign of spraying and training people with the support of the Army.

Communicated by:

[It would be of interest to know the economic impacts of the dengue
outbreak in Costa Rican tourist destinations, since tourism is a
major economic activity in that country.

A HealthMap/ProMED-mail interactive map showing the location of the
Central American countries mentioned can be accessed at
. - Mod.TY]

[4] Colombia
Date: Thu 15 Jul 2010
Source: Estadao [in Portuguese, trans. Mod.TY, edited]

Dengue deaths in Colombia have increased to 115 this year [2010], and
the number of reported cases of the disease has reached 112 802,
reported the Ministry of Social Protection this Wednesday [14 Jul
2010]. Of the 112 702 confirmed cases, 104 671 are classical dengue
fever, and 8031 are DHF or serious cases.

The departments [equivalent to states or provinces] having the
greatest number of fatal victims due to the disease are Valle del
Cauca (in the southwest), with 23 cases; Santander (in the
northeast), with 15 and Tolima (central), with 14.

The Ministry pointed out "the importance of continuing with all
strategies for integrated programs in order to mitigate the epidemic
at the national level."

In addition, there is a trend toward the reduction of the disease in
the departments of Boyaca, Caldas, Casanare, Caqueta, Cesar, Guainia,
Guaviare, La Guajira, Magdalena, Meta, Norte de Santander, Putumayo,
Quindio, Risaralda, Santander, Tolima, Valle, Vaupes and Vichada.

However, on the other hand, it was stated that there is a continuing
trend for more cases in the departments of Antioquia, with 11
victims, and in the Caribbean [coastal departments] such as Atlantico
and Sucre during the epidemic period.

In 2009, there were nearly 71 000 registered cases of classical
dengue fever and DHF, compared with an average of 42 000 in the
previous years. Last year [2009], 44 people died of dengue in

Communicated by:

[A map showing the Colombian departments mentioned above can be accessed at
A HealthMap/ProMED-mail interactive map of Colombia can be accessed at
. - Mod.TY]

[5] Philippines (Mindanao, Cebu)
Date: Tue 13 Jul 2010
Source: MB.com.ph [edited]

Despite the government's all-out campaign against the spread of
dengue fever, the deadly mosquito-borne disease continues to claim
more lives on [reported on] Tuesday [13 Jul 2010], with the death
toll in Mindanao rising to 15, while 11 other persons were reported
to have died in Cebu.

Health authorities noted the rise of cases attributed to the dreaded
disease in at least 2 regions in Mindanao, with 4065 persons reported
infected as of Tuesday [13 Jul 2010]. In Northern Mindanao --
comprising the provinces of Misamis Oriental, Bukidnon and Camiguin
-- at least 10 persons succumbed to the disease among the 2345 cases
reported from January to June this year [2010], health authorities

In Northeastern Mindanao -- comprising the provinces of Agusan del
Norte, Agusan del Sur, Surigao del Sur and Surigao del Norte and the
cities of Butuan, Bislig, Surigao, Tandag, Bayugan and Cabadbaran --
health authorities also reported the deaths of 5 persons, mostly
children, while 1720 were stricken with the disease in the past 6
months. In Cagayan de Oro alone, the City Health Office recorded 500
dengue cases, including 5 deaths, from January to June this year
[2010]. Last year, cases only reached 300 during the same period. Of
the recorded cases this year, Bukidnon had 517, higher from last
year's 47 cases [in 2009]. Dr. David Mendoza, head of the
Epidemiology Department of the Department of Health (DoH), said the
province is now being referred to as the "dengue hotspot" in the

In Misamis Oriental, Provincial Health Officer Dr. Ignacio Moreno
said they have already recorded 571 cases from January to June this
year [2010], a far cry from the 171 cases recorded during the same
period last year. At least 10 deaths were recorded in the province's
571 dengue cases, Moreno said. Most of the dengue cases in the
province came from the municipality of Tagoloan, where 118 residents
were reported infected. The 1st fatality was recorded in the town, in
Barangay Natumolan. Other barangays in the town with high incidence
of dengue cases include Poblacion with 35 and Sta. Cruz, 28.

Moreno said, for 2 years there had been no dengue case reported in
Barangay Natumolan. Aside from Tagoloan, the other areas in Misamis
Oriental with high incidence of dengue cases include Gingoog City
with 86 and Villanueva, 54. From January to June this year [2010],
Gingoog City also had 86 cases of dengue, while Villanueva town had
54. Personnel of the DoH in Caraga region and Region 10 have been
mobilized to help community health officers in stopping the spread of
the dreaded disease.

Health officials in the 2 regions asked the local government units
(LGUs) to continue without let up their massive information campaign
against dengue. Health officials also tapped the Department of
Education (DepEd) in the massive information drive.

In Caraga region, most of the victims have been admitted in various
hospitals in the cities of Butuan, Surigao and Bislig and provincial
and community hospitals in the 4 provinces and 3 other component
cities in the region. Health officials in the field said 5 deaths
were reported in the Caraga region, 2 from Surigao City and one each
from Cabadbaran City, Magallanes, Agusan del Norte and San Francisco,
Surigao del Norte.

Based on the DoH-Caraga disease surveillance report, Butuan had the
highest number of dengue cases, with 432.

Meanwhile, at least 11 persons died due to dengue in Cebu province in
the 1st half of the year [2010], the Integrated Provincial Health
Office (IPHO) said on Tuesday [13 Jul 2010]. IPHO Dengue Coordinator
Rosalinda Jao said the number of fatalities this year [2010]
represented an increase of nearly 50 percent of the fatalities
recorded in the same period last year. The 11 fatalities were
reported in the localities of Argao, Asturias, Ginatilan, Moalboal,
Medellin, Compostela and Pinamungajan. Aside from the fatalities, Jao
said 548 dengue cases have been recorded from January to June this
year, or 180 cases more compared to the 368 cases recorded in the
same period of last year [2009]. Danao City recorded the highest
number of cases with 64, followed by Asturias town and Talisay City
with 52. Toledo City had 44 cases, while Carmen recorded 19.

Meanwhile, another R5 million [USD 107 632] worth of "impregnated"
mosquito nets will be installed in 24 elementary schools in Region 10
following a "near epidemic proportion" of dengue cases, according to
the regional director of the DoH, Dr. Jaime Bernadas. The 24 schools
will be the 2nd batch that will be receiving World Health
Organization recommended nets made of "Olyset Net" fibers. Another
batch is expected to receive the mosquito nets within this year
[2010]. "These nets are already available for the 24 schools; we are
now just waiting for these schools for their proper implementation,"
Bernadas said. Last March 2010, the DoH started giving impregnated
nets to 12 pilot schools, worth P3 million [USD 64 579]. Bernadas
said they based their distribution of curtains according to the most
reported cases within the area.

Based on the regional data as of 9 Jul 2010, a total of 2667 dengue
cases were reported from 29 hospital sentinel sites in the region,
about 233 percent higher compared to the same period last year
[2009], which only reported 800 cases. There were 41 deaths already,
compared to 9 deaths last year. The province of Bukidnon ranks 1st in
the provincial level, with an increase of 930 percent, with the
municipality of Kalilangan, Bukidnon having the most number of cases.

Health authorities said maintaining cleanliness is the best way to
avoid the spread of the disease. They urged the public to help battle
dengue-causing mosquito species _Aedes aegypti_ by eliminating
possible breeding sites. These mosquitoes are day-biting and thrive
in clean but stagnant water. The DoH warned that with the onset of
the rainy season, dengue outbreaks would likely occur in affected
areas, particularly in low-lying areas where children are mostly
victims. In Cebu City, the City Health Department is advising
residents to keep their surroundings clean and implement measures to
prevent the dengue mosquitoes from breeding.

Durinda Macasucol, assistant city epidemiologist, issued the appeal
after announcing a 112-percent rise in dengue cases in the city from
January-May this year [2010] when compared to the dengue cases over
the same period last year [2009]. Macasucol said she expected the
increase in dengue cases to continue with the start of the rainy
season. Macasucol said the health department is intensifying
anti-dengue campaigns such as mist spraying, fogging operations, and
declogging of canals where mosquitoes are expected to breed.

[Byline: Mike U. Crismundo and Mars W. Mosqueda, Jr.]

Communicated by:
HealthMap Alerts via ProMED-mail

[A maps showing the locations of the Philippine provinces can be accessed at
A HealthMap/ProMED-mail interactive map of the Philippines can be accessed at
. - Mod.TY]

[6] Thailand (Nakhon Ratchasima)
Date: Fri 16 Jul 2010
Source: National News Bureau of Thailand [edited]

The Nakhon Ratchasima Provincial Public Health Office has warned
local residents of the prevalence of dengue fever, with over 1000
infected patients and 3 fatalities so far. According to the latest
report, more than 1000 people in Nakhon Ratchasima province have been
infected with dengue fever, 3 of whom have succumbed to the disease.
Over 300 of the total patients were reported in June 2010 alone.

MD Varunyu Sattayawongtip, medical service officer of the Nakhon
Ratchasima Provincial Public Health Office, stated that public health
officials in all 32 districts of the province had already been tasked
with educating the locals on how to protect themselves from the
disease. All stagnant waters in the area, which could serve as
mosquito breeding grounds, are also being sprayed with larvicide on a
continuous basis.

As reported by the Bureau of Epidemiology, 4000 people living in the
lower northeastern part of Thailand, such as Nakhon Ratchasima,
Chaiyaphum, Buri Ram and Surin provinces, have been infected with
dengue fever [virus], while 4 of them have died.

[Byline: Boonsong Lipimas]

Communicated by:
HealthMap Alerts via ProMED-mail

[A map showing the provinces of Thailand can be accessed at
A HealthMap/ProMED-mail interactive map of Thailand can be accessed at
. - Mod.TY]

[7] Viet Nam (central)
Date: Sat 17 Jul 2010
Source: Thanhnien News [edited]

So far this year [2010], dengue fever outbreaks in Viet Nam's central
region have sickened thousands and claimed several lives, officials
said. The worst to be hit was the Khanh Hoa province, with 2170
reported cases of the mosquito-borne illness, the provincial
authorities reported Friday [9 Jul 2010]. According to the local
Center for Preventive Health, this year's massive outbreak was fueled
by poor mosquito eradication efforts.

Health officials in Binh Dinh have reported a 50 percent increase in
dengue cases, compared with last season's numbers [2009]. Binh Dinh
officials say they've had 676 cases, including 2 child deaths. Last
week, officials in the Phu Yen province announced reports of 929
cases and one death. Every day, new reports are trickling in from
Quang Ngai, Kon Tum and Gia Lai.

Experts and officials blamed the recent outbreak on hot weather
accompanied by rain: ideal conditions for _Aedes aegypti_ mosquitoes
to breed. Furthermore, locals lack the knowledge needed to implement
preventative measures (such as the covering or drainage of standing
water around the home), officials said.

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[A map showing the provinces in Viet Nam can be accessed at
A HealthMap/ProMED-mail interactive map of Viet Nam can be accessed at
. - Mod.TY]

[8] Malaysia (Sarawak)
Date: Tue 13 Jul 2010
Source: Crofstsblogs [edited]

Sarawak will intensify efforts to curb dengue fever, following an
increase in cases and deaths from the mosquito-borne disease [virus]
in the state. Deputy Chief Minster Tan Sri Dr George Chan said from
January to June this year [2010], a total of 2478 cases of dengue and
11 deaths -- 5 in Sibu, Kuching (two), and one each in Samarahan,
Betong, Miri, and Serian -- were recorded in the state.

He said the number of deaths had already exceeded last's year [2009]
death toll of 7. "I'm a bit disturbed by the number of dengue deaths
reported. We must take concerted effort to fight dengue. We are going
to take intensive efforts to reduce the number of dengue [cases],
especially in Sibu and Miri," he told reporters at his office here
Tuesday [13 Jul 2010], after attending a briefing by the State Public
Health Deputy Director, Dr Jamilah Hashim.

Dr Chan, who is also the state Disaster and Relief Management
Committee Chairman, said Miri and Sibu recorded 550 and 536 dengue
cases respectively for the 1st 6 months of this year [2010].

Communicated by:
HealthMap Alerts via ProMED-mail

[An interactive map of Sarawak on Borneo Island can be accessed at
A HealthMap/ProMED-mail interactive map of Malaysia can be accessed at
. - Mod.TY]

[see also:
Dengue/DHF update 2010 (35) 20100715.2372
Dengue/DHF update 2010 (34) 20100715.2368
Dengue/DHF update 2010 (33) 20100713.2342
Dengue/DHF update 2010 (32) 20100705.2240
Dengue/DHF update 2010 (30) 20100627.2152
Dengue/DHF update 2010 (29) 20100622.2085
Dengue/DHF update 2010 (27) 20100616.2009
Dengue/DHF update 2010 (25) 20100601.1821
Dengue/DHF update 2010 (24) 20100524.1722
Dengue/DHF update 2010 (22) 20100510.1528
Dengue update 2010 (21) 20100503.1439
Dengue/DHF update 2010 (20) 20100426.1347
Dengue/DHF update 2010 (17) 20100405.1094
Dengue/DHF update 2010 (15) 20100323.0922
Dengue/DHF update 2010 (11) 20100308.0753
Dengue/DHF update 2010 (08) 20100222.0597
Dengue/DHF update 2010 (06) 20100208.0426
Dengue/DHF update 2010 (03) 20100119.0211]

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