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.

Monday, August 30, 2010

DENGUE/DHF UPDATE 2010 (45)

***************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





In this update:

Americas

[1] US Virgin Islands: fatality suspected

[2] Martinique and Guadeloupe

[3] Mexico (Nayarit)

[4] Honduras

[5] Colombia (Magdalena)

[6] Venezuela

[7] Peru (Piura)

[8] Brazil (Roraima)

Asia

[9] Philippines (national)

[10] Philippines (Zamboanga)

[11] Taiwan

[12] Thailand

[13] Viet Nam (Central Highlands)

[14] India (Delhi)

[15] India (Orissa)



******

[1] US Virgin Islands: fatality suspected

Date: Fri 27 Aug 2010

Source: Virgin Islands Daily News [edited]







A St John woman who was transferred last week [week of 16 Aug 2010]

to a Miami hospital with possible dengue fever symptoms died there 20

Aug [2010] from complications, her husband said. VI [Virgin Islands]

Health Department epidemiologist Eugene Tull said earlier this week

[week of 23 Aug 2010] that he had no information about a possible

death from dengue fever.



Health Department spokeswoman Eunice Bedminster said Thursday [26 Aug

2010] that the department was not aware of any deaths from the

territory's dengue fever cases but had been investigating since

receiving inquiries from reporters Monday [23 Aug 2010].



Tull said earlier this week that so far this year [2010], there have

been 8 confirmed, laboratory positive cases of dengue fever in the

territory, 3 probable cases with lab results pending, and 15

suspected cases. All of those were in the St Thomas/St John District,

except for 2 of the suspected cases, which were on St Croix, he said.



[Byline: Joy Blackburn]



--

Communicated by:

HealthMap Alerts via ProMED-mail





[The attribution of the woman's death to dengue virus infection is

speculative. ProMED-mail awaits confirmation (or not) as further

information becomes available. It is clear, however, that locally

acquired dengue virus infections are occurring there.



Maps showing the location of the US Virgin Islands can be accessed at

.

and the HealthMap/ProMED-mail interactive map at

- Mod.TY]



******

[2] Martinique and Guadeloupe

Date: Wed 25 Aug 2030

Source: Xinhua News Agency [edited]







The death toll from an outbreak of dengue fever in the French

Caribbean islands of Martinique and Guadeloupe about [within the

last] 6 months has risen to 18, local media reported on Tuesday [24

Aug 2010]. About 26 000 people have been infected with the

mosquito-borne disease [virus] in Martinique and 13 of them have died.



Some 33 000 cases have been reported in Guadeloupe and 5 have died,

with the 5th victim, a 16-year-old teenager, having also suffered

from sickle cell anemia, an inherited blood disease, said Patrick

Portecop, director of the local emergency department. He said

patients who have sickle cell anemia or diabetes must be given

special care if they were infected with dengue fever [virus].

Portecop added that no cases of DHF, which is much more dangerous

than the classic type, had been reported yet in Guadeloupe.



Army troops were called out Monday [23 Aug 2010] to join an

anti-mosquito campaign.



[Editor: Lin Zhi]



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A HealthMap/ProMED-mail interactive map showing the location of

Martinique and Guadeloupe in the Caribbean can be accessed at

.

Maps of the islands can be seen at

. - Mod.TY]



******

[3] Mexico (Nayarit)

Date: Tue 24 Aug 2010

Source: La Jornada [in Spanish, trans. Mod.TY, edited]







The director of Municipal Health, Alejandro Hernandez Suzawa,

reported that in the Santiago Ixcuintla municipality, 2 people died

from DHF and 76 residents of this area have the disease: 37 with

classical dengue fever and 39 with DHF. He added that the constant

rains in the region has been a factor that favored rapid reproduction

of the _Aedes aegypti_ mosquito.



[Byline: Myriam Navarro]



--

Communicated by:

ProMED-PORT





[This is an extraordinarily high ratio of DHF to dengue fever cases,

which would be expected to be around 10 percent DHF cases or less.



A map showing the location of Nayarit state in west central Mexico

can be accessed at

.

A HealthMap/ProMED-mail interactive map of Mexico can be accessed at

. - Mod.TY]



******

[4] Honduras

Date: Tue 24 Aug 2010

Source: Tiempo, Agence France-Presse (AFP) report [in Spanish, trans.

Corr.SB, edited]









Dengue fever has left 57 dead in Honduras so far this year [2010],

but the epidemic has begun to abate because there is less influx of

patients into hospitals, an official commission reported on Tuesday

[24 Aug 2010]. The National Commission on Certification of Dengue

released its latest statistical report, which stated that the death

toll [from the disease] had risen to 57, with the addition of 2 new

victims. It said there have been 5557 cases of DHF while cases of

classic dengue 50 028. A 6-year-old child in the Social Security

Hospital who died on Sunday [22 Aug 2010] is the last fatal victim of

the disease that raged since June [2010] and caused the collapse of

[service in] the 3 public hospitals in the capital.



So far, the campaigns to destroy breeding sites of the _Aedes

aegypti_ mosquito, which transmits the disease [virus], have been

unsuccessful, mainly due to constant winter [rainy season] rains in

Central America that will culminate in November.



On 22 Jun [2010], authorities decreed a "national emergency", when

there were 9 dead, and they have complained that the population

remains indifferent, despite the rapid progression of the disease

transmitted by the mosquitoes.



--

Communicated by:

HealthMap Alerts via ProMED-mail





[The 24 Aug 2010 edition of La Tribuna

(, in Spanish) indicated

that Tegucigalpa, the capital of Honduras, accounted for 53 percent

of the national total of dengue cases and San Pedro Sula and Olancho

for 10 percent each.



A map showing the departments of Honduras can be seen at

.

A HealthMap/ProMED-mail interactive map showing the location of

Honduras in Central America can be accessed at

. - Mod.TY]



******

[5] Colombia (Magdalena)

Date: Tue 24 Aug 2010

Source: El Informador [in Spanish, trans. & summ. Corr.SB, edited]







Dengue continues to be the cause for alarm among the citizens of

Santa Marta [Magdalena Department], although officially there are no

figures showing the increase, but the number of patients and the

health centers confirm that the situation is worsening.



The winter season, the stagnation of rain water, sewage and the lack

of prevention (measurers) by the Ministry of Health, are the

predominant factors for the presence of the mosquito [dengue virus]

vector around Santa Marta.



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A map showing the location of Santa Marta on the Colombia Caribbean

coast can be accessed at

.

A HealthMap/ProMED-mail interactive map of Colombia can be accessed at

. - Mod.TY]



******

[6] Venezuela

Date: Tue 24 Aug 2010

Source: El Universal [in Spanish, trans. & summ. Mod.TY, edited]







More than 3000 new dengue cases are reported each week. The Ministry

of Heath admits that up to 30 Jul [2010] there were 68 753 cases and

30 deaths [of which] 25 are confirmed and 5 are under study.



According to the analysis carried out by the Network of Medical

Science Societies of Venezuela, 49.8 percent of the dengue cases

occurred in the last 10 weeks, during which the most weekly cases in

9 years were reported. The network, in its Epidemiological Alert 146,

reported that these numbers indicate that "the epidemic is active"

and that the numbers reached in 30 weeks of 2010 are more than the

total number of cases in 2009, when 65 869 were recorded. Of the

total [dengue] cases, 6418 are DHF, 24.6 percent more than in 2009.



They noted that the analysis does not mention that the greatest

prevalence of hemorrhagic [dengue] is observed in children less than

a year of age, with an incidence of 68.9 per 100 000 population, 3

times more than the incidence in the rest of the age groups, which is

22.3 per 100 000 population.



[Byline: Giuliana Chiappe]



--

Communicated by:

ProMED-PORT





[The specific geographic locations, by state, are given at the source

URL above.



A map showing the states of Venezuela can be accessed at

.

A HealthMap/ProMED-mail interactive map of Venezuela can be accessed at

. - Mod.TY]



******

[7] Peru (Piura)

Date: Mon 23 Aug 2010

Source: Correo [in Spanish, trans. & summ. Mod.TY, edited]







The Piura Regional Health Directorate (DIRESA) Piura has reported a

total of 8166 [medical] visits for dengue up to epidemiological week

30 [25-31 Jul 2010]. The districts with greatest [dengue] risk are

Salitral (260), Castilla (170), Morropon (143), Bellavista (129), and

Piura (116) per 100 000 population.



--

Communicated by:

ProMED-PORT





[A map showing the Piura region in northern Peru can be accessed at



A map showing the political divisions of Peru can be accessed at

.

A HealthMap/ProMED-mail interactive map of Peru can be accessed at

. - Mod.TY]



******

[8] Brazil (Roraima)

Date: Mon 23 Aug 2030

Source: Secretaria de Vigilanica em Saude, Departamento de Vigilancia

Epidemiologica [in Portuguese, trans. & summ. Mod.TY, edited]







Technical note: isolation of dengue virus serotype 4 in Roraima, Brazil

----------------------------------------------------------------------

On 30 Jun 2010, the Roraima Secretariat of Health notified the

Secretariat of Health Surveillance of a suspected case of dengue

virus serotype 4. The case was locally acquired in Boa Vista, capital

of the state, and was detected by a sentinel virus monitoring unit.

The initial diagnosis was made by RT-PCR and virus isolation

techniques, processed in the Roraima Central Laboratory and confirmed

by tests at the Instituto Evandro Chagas (IEC). Subsequently, 19

samples were sent to IEC where 2 more cases and one suspected cases

were confirmed as dengue virus 4, all locally acquired in Boa Vista.



In synthesis, to date 3 cases have been confirmed in Boa Visa and 9

continue as suspected [cases], 8 of which were locally acquired in

Boa Vista and one in the Canta municipality [35 km/22 mi] from the capital].



--

Communicated by:

ProMED-PORT





[To see the note in full, with more details, graphs, and maps see the

source URL above. - Mod.LJS]



[The report above provides more details about the identification of

dengue virus 4 in Roraima than in previous reports. The 23 Aug 2010

edition of Estadao

(,

in Portuguese) reported that dengue virus 4 returned to Roraima after

a 28 year absence. Its return increases the risk of an epidemic,

since most of the population will not be immune to that virus. All 4

viruses circulate in neighboring Venezuela, with which Roraima shares a border.



A map showing the states in Brazil can be seen at

.

A HealthMap/ProMED-interactive map of Brazil can be accessed at

. - Mod.TY]



******

[9] Philippines (national)

Date: Tue 24 Aug 2010

Source: Sun Star Manila [summ., & edited]







The number of dengue cases in the country continues to surge with the

figure already nearing 55 000 based on the figures released by the

Department of Health (DOH)-National Epidemiology Center (NEC)

Tuesday, 24 Aug [2010]. In its Disease Surveillance Report from the

period of 1 Jan-14 Aug [2010], the NEC noted that there are now 54

659 cases reported in hospitals in the Philippines. "This is 74.9

percent higher compared to the same time period last year [2009],

which was only at 31 248," the report added. The deaths due to dengue

were also higher with 429 recorded compared to the 327 in 2009 during

the same period.



The DOH had repeatedly stressed that the most effective way to fight

dengue is by practicing their 4-S strategy -- Search and destroy,

Self-protective measures, Seek early treatment and Say, no to

indiscriminate fogging.



--

Communicated by:

ProMED-mail





[The numbers of cases in various provinces are given at the source URL above.



A map showing the provinces in the Philippines can be accessed at

.

A HealthMap/ProMED mail interactive map of the Philippines can be accessed at

. - Mod.TY]



******

[10] Philippines (Zamboanga)

Date: Wed 25 Aug 2010

Source: Inquirer Mindanao [summ. & edited]







Officials have declared a dengue fever outbreak with the increase in

number of people being afflicted by the mosquito-borne disease

[virus]. August [2010] has not even ended yet but figures from the

city (Zamboanga] health office showed that 314 dengue fever cases

have been registered since the start of the month. The city health

office said 20 patients in this city have died of the disease since

January [2010]. Dr Rodelin Agbulos, city health officer, said from

January-24 Aug [2010], a total of 1584 dengue cases had been

reported. He said half of the city's 20 villages were responsible for

the surge in dengue cases. Mayor Celso Lobregat said the city

government has decided to resort to fumigation to control the spread

of the disease.



Health workers have been conducting dialogues with residents on how

to clean up their surroundings to prevent the breeding of

dengue-causing mosquitoes. Other preventive measures have been

undertaken by providing public schools, situated in so-called endemic

areas, with anti-mosquito-treated curtains. Parents were also advised

to ensure that their school children were protected by insect

repellent lotion and enjoin them to wear long pants and long

sleeved-shirts when possible.



[Byline: Charlie Senase]



--

Communicated by:

HealthMap Alerts via ProMED-mail





Zamboanga City, on the southwestern-most tip of Mindanao Island can

be located on the HealthMap/ProMED mail interactive map of the Philippines at

. MOd. TY]



******

[11] Taiwan

Date: Tue 24 Aug 2010

Source: Focus Taiwan [edited]







The Taipei City Department of Health on Tuesday [24 Aug 2010]

announced the 1st reported case of indigenous dengue fever in the

city for 2 years. The department does not yet know how the patient,

who has not recently traveled out of the country or even Taipei City,

was infected with the mosquito-born disease [virus], the officials

added. So far this year [2010], 31 cases of confirmed dengue fever

infection were reported in Taipei City, 30 of which were determined

to be imported cases, the department said.



Citing data from the [Taiwan] Centers for Disease Control (CDC) under

the Department of Health, the officials said dengue fever cases in

Taiwan occurred earlier than usual this year [2010] due to global

warming that led to a suitable climate for mosquito breeding.

According to CDC statistics, the number of recorded indigenous dengue

fever cases in the country has risen to 30 since March, mostly in

Taiwan's southern areas of Kaohsiung and Tainan. CDC Deputy

Director-General Chou Chih-hao warned that as 18 of the cases were

reported last week [week of 16 Aug 2010], it appeared that the

outbreak was accelerating.



Recently, temperatures in Taiwan have hovered around 25-30 deg C

[77-86 deg F]. With afternoon showers common in the summer, it is

easy for the mosquitoes that can spread dengue fever to reproduce if

people allow stagnant water to remain in containers, Chou said.



[Byline: Chen Li-ting, Chen Hung-chin, Elizabeth Hsu)



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A map of Taiwan can be accessed at

.

A HealthMap/ProMED-mail interactive map showing the location of the

island of Taiwan can be accessed at

. - Mod.TY]



******

[12] Thailand

Date: Mon 23 Aug 2010

Source: The Nation [edited]







A total of 7 people died from dengue fever last week [week of 16 Aug

2010], bringing the nationwide toll from the disease to 70 deaths out

of some 60 000 dengue fever patients this year [2010], Public health

minister Jurin Laksanawisit said Monday [23 Aug 2010].



Two of the dengue fever deaths last week [week of 16 Aug 2010] were

in Krabi, while Chiang Rai, Phetchabun, Lop Buri, Chachoengsao, and

Nakhon Si Thammarat reported one death each. As the dengue fever

outbreak is so severe this year [2010], Jurin has instructed all

provincial health chiefs to monitor and control the disease as well

as urging people with suspicious symptoms of dengue fever to see

doctors immediately.



The situation so far this year [2010] is 83 per cent higher than last

year's [2009], with an average of 230 new cases detected per day.



The Southern region had 14 361 cases, Northern region 8843 cases,

Central region 15 871 cases, and Northeastern region 15 517 cases. Of

these, 7 patients were less than 28 days old, and 409 cases were over 65 years.



--

Communicated by:

PRO/MBDS





[According to the newswire above, 7 fatalities due to dengue

infection were reported in Thailand during the week of 16 Aug 2010.

Recently, dengue outbreaks have also been reported in neighboring

countries such as Viet Nam (see prior PRO/MBDS posting Dengue - Viet

Nam (10): 20100818.2863).



According to the Thai Ministry of Public Health, Bureau of

Epidemiology (BOE)'s report of the situation of dengue infection in

Thailand, between 1 Jan 2010 and 20 Aug 2010, available in Thai at

, a

total of 57 948 cases and 70 deaths were reported nationwide. The

attack rate was 91.32 per 100 000 population. The case fatality rate

was 0.12 percent.



Of 57 948 cases and 70 deaths, 27 251 cases were attributable to

dengue fever (DF), 29 387 cases and 21 deaths were dengue hemorrhagic

fever (DHF), and 1310 cases and 49 deaths were dengue shock syndrome

(DSS). The highest attack rate (per 100 000 population) was reported

in the 10-14 years old age group (302.82), followed by the 5-9 years

old age group (238.56), 15-19 years old age group (208.98), 20-24

years old age group (116.99), and 0-4 years old age group (103.83).
Regarding dengue fever (DF), the 5 provinces with the highest attack

rates of DF (per 100 000 population) were Chantaburi (173.07), Yala

(146.05), Trat (143.94), Satun (142.39) and Naratiwat (127.76).

Highest attack rates were reported in southern region (82.39 per 100

000 population), followed by northern region (42.23), northeastern

region (35.83), and central region (34.12). More detailed information

is available in Thai at .



Regarding dengue hemorrhagic fever (DHF), the 5 provinces with the

highest attack rates of DHF (per 100 000 population) were Pattani

(160.34), Songkha (151.51), Chantaburi (144.61), Narathiwat (138.67),

and Krabi (131.56). Highest attack rates were reported in southern

region (89.78 per 100 000 population), followed by central region

(45.92), northeastern region (35.07), and northern region (34.72).

More detailed information is available in Thai at

.



Regarding dengue shock syndrome (DSS), the 5 provinces with the

highest attack rates of DSS (per 100 000 population) were Burirum

(14.05), Nakhon Panom (10.43), Chiang Mai (6.96), Tak (6.43), and

Krabi (6.15). Highest attack rates were reported in northeastern

region (3.22 per 100 000 population), followed by southern region

(2.71), northern region (1.93), and central region (0.71). More

detailed information is available in Thai at

.



For maps showing Thailand's provinces, see

and regions, see

.

For the interactive HealthMap/ProMED-mail map of Thailand see

. - Mod.SCM]



******

[13] Viet Nam (Central Highlands)

Date: 25 Aug 2010

Source: Saigon Giai Phong (SGGP) Daily [summ. & edited]







The central highlands province of Kon Tum said last Thursday [26 Aug

2010] it had recorded over 600 patients infected with dengue fever

[virus], one of whom succumbed to the disease. The provincial

Preventive Health Centre announced that the fever had spread to 9

districts so far.



The Central Highlands Institute of Epidemic Prevention has supplied

Gia Lai with 500 litres of chemicals to spray areas with mosquito larvae.



Until now, 1456 people have contracted dengue fever in Da Nang

Province, an increase of 6 times compared to the same period last

year [2009], and one person has died.



In Phu Yen Province, dengue fever has been recorded in 27 out of 114

communes. Dr Nguyen Thanh Truc, deputy director of the Phu Yen

Department Health said the province had recorded 2380 cases of dengue

fever as of 17 Aug [2010]. Provincial authorities had announced 3

days earlier that the fever had spread across the province.



[Trans. Cong Dung]



--

Communicated by:

ProMED-mail Rapporteur Mary Marshall



[Additional details with specific cities involved in the area are

given at the source URL above.



Maps of Viet Nam are available at

(regions),



(provinces), and

. - Mod.TY]



******

[14] India (Delhi)

Date: Sun 29 Aug 2010

Source: The Indian Express [summ. & edited]







Dengue cases increased alarmingly in the national capital as 59 more

patients tested positive for the vector-borne disease [virus], taking

the total number of people being affected by it to 800. The national

capital has recorded 2 confirmed and 3 suspected dengue deaths this

season [2010].



The MCD [Municipal Corporation of Delhi] said it has deployed

additional staff to tackle the situation in the worst-hit Central and

South Delhi, from where 271 cases have been reported so far. It is

also maintaining round-the-clock surveillance near all the

Commonwealth Games venues, municipal commissioner KS Mehra said.



--

Communicated by:

ProMED-mail Rapporteur Mary Marshall



[Dengue cases for specific localities within municipal Delhi are

given at the source URL above.



The 23 Aug 2010 edition of News-Views

()

reported on Delhi's efforts to reduce _Aedes aegypti_ breeding sites.

The report stated that the MCD has issued 45 532 legal notices

against owners of property where water stagnation was found. A total

of 6125 persons have been prosecuted. Mosquito breeding has been

detected in 44 743 houses in various parts of the city. Other reports

indicate that city officials are concerned about dengue virus

transmission continuing into October [2010] when the Commonwealth

Games will be held in Delhi.



A HealthMap/ProMED-interactive map of India showing the location of

Delhi can be accessed at

. - Mod.TY]



******

[15] India (Orissa)

Date: Fri 27 Aug 201

Source: IBN Live, Press Trust of India (PTI) report [edited]







At least 7 persons died and about 50 others were affected in an

outbreak of dengue in Orissa's tribal-dominated Malkangiri district

in past 3 weeks, official sources said today [27 Aug 2010]. The

deaths were reported from Padia, MV-67, and Materu villages under

Padia block of the district during the period, chief district medical

officer (CDMO) Rabindra Kumar Nath said adding 5 of the deaths took

place in last week alone.



Though most of the patients, showing symptoms of high fever, had

undergone treatment at the local primary health centre (PHC)

initially, several had to be shifted to Visakhapatnam in neighbouring

Andhra Pradesh later, he said. Blood tests of the patients at

Visakhapatnam detected dengue [virus or antibodies?], Nath said

adding about 50 persons suffering from the disease were currently

undergoing treatment at various hospitals and health authorities took

steps to deal with the situation.



A team of experts and doctors visited the affected areas to ensure

proper treatment of patients besides taking preventive steps against

the disease through mosquito control, sources said. An awareness

drive has also been launched to check spread of the disease.



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A map showing the Indian states can be accessed at

.

Malkangiri District can be located on the map of Orissa state at

.

A HealthMap/ProMED-mail interactive map of India can be accessed at

. - Mod.TY]



[see also:

Dengue/DHF update 2010 (44) 20100826.3010

Dengue/DHF update 2010 (43) 20100819.2891

Dengue/DHF update 2010 (42) 20100817.2847

Dengue/DHF update 2010 (41) 20100810.2726

Dengue/DHF update 2010 (40) 20100805.2651

Dengue/DHF update 2010 (39) 20100804.2636

Dengue/DHF update 2010 (38) 20100727.2520

Dengue/DHF update 2010 (37) 20100720.2435

Dengue/DHF update 2010 (36) 20100719.2429

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 (31) 20100701.2196

Dengue/DHF update 2010 (30) 20100627.2152

Dengue/DHF update 2010 (29) 20100622.2085

Dengue/DHF update 2010 (28) 20100618.2043

Dengue/DHF update 2010 (27) 20100616.2009

Dengue/DHF update 2010 (26) 20100607.1903

Dengue/DHF update 2010 (25) 20100601.1821

Dengue/DHF update 2010 (24) 20100524.1722

Dengue/DHF update 2010 (23) 20100517.1620

Dengue/DHF update 2010 (22) 20100510.1528

Dengue/DHF update 2010 (21) 20100503.1439

Dengue/DHF update 2010 (20) 20100426.1347

Dengue/DHF update 2010 (19) 20100420.1279

Dengue/DHF update 2010 (18) 20100412.1190

Dengue/DHF update 2010 (17) 20100405.1094

Dengue/DHF update 2010 (16) 20100329.0982

Dengue/DHF update 2010 (15) 20100323.0922

Dengue/DHF update 2010 (14) 20100322.0910

Dengue/DHF update 2010 (13) 20100316.0840

Dengue/DHF update 2010 (11) 20100308.0753

Dengue/DHF update 2010 (09) 20100302.0685

Dengue/DHF update 2010 (08) 20100222.0597

Dengue/DHF update 2010 (07) 20100216.0537

Dengue/DHF update 2010 (06) 20100208.0426

Dengue/DHF update 2010 (05) 20100201.0346

Dengue/DHF update 2010 (04) 20100125.0277

Dengue/DHF update 2010 (03) 20100119.0211

Dengue/DHF update 2010 (02) 20100111.0131

Dengue/DHF update 2010 (01) 20100104.0038]

...................................dk/mpp/sb/ty/mj/dk



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