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A ProMED-mail post
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International Society for Infectious Diseases
In this update:
[1] Croatia
[2] Cases in various countries:
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[1] Croatia (Peljesac peninsula)
Date: 3 Mar 2011
Source: Eurosurveillance, vol 16 No. 9. [summarized, edited]
Summary
After [providing] information about a dengue case in Germany acquired
in Croatia, health professionals and the public in Croatia were
alerted to assess the situation and to enhance mosquito control,
resulting in the diagnosis of a 2nd case of autochthonous dengue fever
in the same area and the detection of 15 persons with evidence of
recent dengue infection. Mosquito control measures were introduced.
The circumstances of dengue virus introduction to Croatia remain
unresolved.
Introduction
_Aedes albopictus_ was for the 1st time recorded in Croatia in 2004
in the area surrounding Zagreb. Within 2 years, _Ae. albopictus_ was
found on the entire territory of the Adriatic coast from northern
Istria to Dubrovnik in the south. According to routine monitoring of
mosquitoes and published articles, _Ae. albopictus_ is now permanently
established in the coastal but not yet in the continental areas of
Croatia.
Discussion
After France, Croatia is the 2nd country in Europe in which
autochthonous transmission of dengue infection has been shown, which
had not been recorded in Europe since the epidemic in Greece in 1925
to 1928.
The assumption that the German tourist acquired dengue fever in the
region of the Peljesac peninsula was confirmed by the identification
of a 2nd case of dengue fever in a local citizen who had not travelled
outside the area. Although the antigen was not confirmed by RT-PCR in
the acute serum of the patient, taken 6 days after illness onset, the
presence of specific IgM antibodies (IgG was negative) pointed to
acute infection. This was confirmed in a sample taken on day 19 of the
illness when IgM and IgG antibodies were found.
Of the 14 samples taken from the Croatian patient's neighbours, none
of whom had travelled outside Croatia, 9 were IgG-positive, and we
assume that these were relatively recent infections, because 7 of them
were also IgM-positive. Some of them reported having an influenza-like
disease in August and early September [2010]. Moreover, DENV-specific
antibodies were found in 5.4 per cent of the anonymous serum samples
collected in October 2010 by the laboratory that covers the area of
Peljesac and Korcula. In this panel, 5 of the 6 DENV-positive sera
showed borderline or positive values of IgM antibodies against DENV.
Based on the available serological and epidemiological data, we,
therefore, assume that a cluster of acute DENV infections occurred in
the area, most probably during August and September 2010.
Reference:
Gjenero-Margan I, Aleraj B, Krajcar D, Lesnikar V, Klobucar A,
Pem-Novosel I, Kurecic-Filipovic S, Komparak S, Martic R, Duricic S,
Betica-Radic L, Okmadzic J, Vilibic-Cavlek T, Babic-Erceg A, Turkovic
B, Avsic-Zupanc T, Radic I, Ljubic M, Sarac K, Benic N,
Mlinaric-Galinovic G. Autochthonous dengue fever in Croatia,
August–September 2010. Euro Surveill. 2011;16(9):pii=19805.
--
Communicated by:
HealthMap Alerts via ProMED-mail
[This report presents another example of the consequences of the
spread and establishment of an introduced dengue virus vector
mosquito, _Aedes albopictus_. It will not be surprising to see future
cases of locally acquired dengue and chikungunya virus infections when
these viruses are introduced into areas where there are relatively
abundant population of this mosquito. In the current focus above,
presumably dengue virus transmission has ceased with the onset of cold
weather.
A HealthMap/ProMED-mail interactive map of Croatia showing the areas
mentions can be accessed at
******
[2] Cases in various countries: Philippines (Pangasinan), - Indonesia
(Jakarta), Saudi Arabia (Jeddah), USA (Miami, Florida), Honduras,
Brazil (Sorocaba, Sao Paulo state), Brazil (Bauru, Sao Paulo state),
Brazil (Araraquara, Sao Paulo state), Brazil (Itu, Sao Paulo state),
Brazil (Cambe, Parana), Brazil (Parana), Brazil (Rio de Janeiro
state), Brazil (Volta Redonda, Rio de Janeiro state), Brazil
(Amazonas), Brazil (Ceara), Brazil (Rio Grande do Sul)
- Philippines (Pangasinan). 1 Mar 2011. The numbers of those
afflicted with the [dengue] viral disease continue to climb in
Pangasinan province in the past 2 months according to the local office
of the Department of Health (DOH) today [1 Mar 2011]. The DOH reports
a total of 157 people have been found positive with dengue, resulting
in 3 deaths thus far.
[A HealthMap/ProMED-mail interactive map of Panagasinan, Philippines
can be accessed at
- Indonesia (Jakarta). 4 Mar 2011. Since January to March 2011, the
dengue fever case in North Jakarta reached 485 or lower compared to
same period last year [2010] by 723 cases.
[A HealthMap/ProMED-mail interactive map can be accessed at
- Saudi Arabia (Jeddah). 6 Mar 2011. In Jeddah, 33 cases of dengue
fever have been reported in the last 3 weeks, according to Health
Affairs Director Dr. Sami Badawood, adding that more infections were
likely in the coming weeks as the cool season comes to an end.
[A HealthMap/ProMED-mail interactive map showing the location of
Jeddah in Saudi Arabia can be accessed at
- USA (Miami, Florida). 2 Mar 2011. The 2nd locally acquired case of
dengue fever in Miami-Dade County was confirmed Wednesday [2 Mar 2011]
by the county Health Department. The Health Department said the person
showed symptoms of the illness, and lab tests confirmed it was dengue.
The person has fully recovered from the symptoms, the health
department said. The 1st case of locally acquired dengue in Miami-Dade
was reported this past November [2010]. That person also fully
recovered.
[One cannot help but wonder if this 2nd case is the result of a
recent importation of dengue virus, or if virus transmission continues
to smolder in the Miami area. It would be helpful to know whether the
current case is due to a dengue virus similar to any of the previously
reported recent cases in Florida.
A HealthMap/ProMED-mail interactive map showing the location of Miami
in Florida can be accessed at
Mod.TY]
- Honduras. 5 Mar 2011. The head of the Dengue Program of the
Honduras Ministry of Health, Roxana Araujo, reported today [5 Mar
2011] a "significant reduction" in dengue incidence that in 2010
produced the worst epidemic in 30 years with a total of 83 deaths. She
stated that since 1 Jan [2011] to date, 680 cases of classical dengue
fever have been registered, and during that same period last year
[2010], there were 2880. There are 5 DHF cases this year [2011], while
in the same period last year, there were 190, Araujo added.
[A HealthMap/ProMED-mail interactive map of Honduras can be accessed
at
- Brazil (Sorocaba, Sao Paulo state). 5 Mar 2011. The number of
confirmed dengue cases doubled in one week, putting the city health
authorities on alert. While a bulletin released by the Secretariat of
Health on 25 Feb [2011] indicated that there were 75 cases, a survey
made yesterday afternoon [4 Mar 2011] confirmed 148 cases in the city.
Only 17 are imported [from elsewhere].
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map showing the location of
Sorocaba, Saou Paulo state can be accessed at
- Brazil (Bauru, Sao Paulo state). 4 Mar 2011. On Thursday [3 Mar
2011], the municipal Secretariat of Health reported 45 new locally
acquired dengue cases in Bauru, totaling 435 cases of the disease up
to now (432 locally acquired and 3 imported) in 2011. In just 3 days,
the city counted 156 new dengue cases, and the Secretariat expects
that this year [2011] will be an epidemic one. It is always worthwhile
to compare [the number this year] with 2010, when the number of
reported cases was 648, with 485 locally acquired and 47 imported.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of Bauru in Sao Paulo state
can be accessed at
- Brazil (Araraquara, Sao Paulo state). 3 Mar 2011. An additional 33
dengue cases were confirmed in Araraquara. This year [2011], a total
of 146 people had the disease. Of these, just 2 were imported from
another city. The results of 129 reported cases are awaited.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map Araraquara in Sao Paulo
state can be accessed at
- Brazil (Itu, Sao Paulo state). 28 Feb 2011. The number of dengue
cases in Itu increased by 8. This week, the city recorded 4 more
locally acquired cases. With these, there are now 5 locally acquired
cases and anther 6 imported from other cities. The Itu Secretariat of
Health also reported that laboratory results from another 15
[suspected dengue cases] are awaited.
Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of Itu in Sao Paulo state
can be accessed at
- Brazil (Cambe, Parana). 4 Mar 2011. In Cambe, 853 dengue cases have
been registered with 26 cases [laboratory] confirmed.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of ICambe, Parana can be
accessed at
- Brazil (Parana). 3 Mar 2011. From January - 25 Feb [2011], Parana
reported 12 703 suspected dengue cases, with 2193 confirmed; 3 deaths
and 39 serious cases were reported. The Jacarezinho prefecture, in the
north of the state, declared an emergency situation, after 2 deaths
and 1253 reported [dengue cases]. This city is 2nd [in the state] in
the number of confirmed and suspected [dengue] cases. In the past 2
months [January and February 2011], Londrina has registered one death
and the most reported dengue cases in the entire state, with 4570.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of Parana can be accessed
at
- Brazil (Rio de Janeiro state). 3 Mar 2011. Rio de Janeiro is under
a state of alert for dengue. As of this past Monday [1 Mar 2011], the
municipal Secretariat of Health has registered 3640 [dengue] cases in
the city from January - February [2011]. This is the greatest number
since the epidemic of 2008, when 240 deaths were confirmed in the
state.
[in Portuguese, trans. Mod.TY, edited]
[With 7 dengue deaths in the state from 1 Jan - 28 Feb [2011], the
number of deaths is more than double that of 2010, when there were 3.
A HealthMap/ProMED-mail interactive map of Rio de Janeiro state can
be accessed at
- Brazil (Volta Redonda, Rio de Janeiro state). 4 Mar 2011. The city
is classified as one of "medium risk" [for dengue], said the city
Secretary of Health, Suely Pinto, this afternoon [4 Mar 2011]. There
are 35 cases of classical dengue fever and one of DHF. The reported
cases awaiting confirmation are 285, 2 of which are [suspected] DHF.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of Volta Redonda, Rio de
Janeiro state can be accessed at
Mod.TY]
- Brazil (Amazonas). 3 Mar 2011. With 15 548 reported cases as of
Tuesday [1 Mar 2011], Brazil's state of Amazonas is going through its
3rd dengue epidemic -- the 2nd-worst in its history -- only surpassed
by the 19 000 [dengue virus infections] in 2001 when dengue [virus]
types 1 and 2 were circulating. As of 1 Mar [2011], there were 9
confirmed dengue deaths, all due to dengue [virus] type 1 and 2
[infections]. An additional 4 deaths are under investigation to
determine whether they were due to dengue [virus infections].
According to health authorities, dengue [cases] are increasing, with
230 cases reported daily, 98 per cent with classical dengue fever. The
epidemic is occurring in 2 municipalities, the capital city Manaus,
with 10 798 cases as of last Wednesday [2 Mar 2011], and Tefe.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map Amazonas can be accessed at
- Brazil (Ceara). 3 Mar 2011. The number of dengue deaths in Ceara
reached 10. After the state Secretariat of Health reported that
number, the alert level increased, and the state runs a big risk of
suffering a new epidemic of the disease. According to the latest
bulletin, Ceara counted 3182 confirmed cases in 114 cities.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map of Ceara can be accessed at
- Brazil (Rio Grande do Sul). 1 Mar 2011. A possible dengue epidemic
is placing the units of the State Center for Health Surveillance on
alert. In recent days, there are now 288 reported cases in Rio Grande
do Sul, with 11 confirmed.
[in Portuguese, trans. Mod.TY]
[A HealthMap/ProMED-mail interactive map Rio Grando do Sul can be
accessed at
[see also:
Dengue/DHF update 2011 (09) 20110228.0665
Dengue/DHF update 2011 (08) 20110222.0579
Dengue/DHF update 2011 (07) 20110214.0498
Dengue/DHF update 2011 (04) 20110124.0292
2010
----
Dengue/DHF update 2010 (57) 20101115.4149]
.................................................sb/mpp/ty/msp/mpp
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