NEWS SCAN: West Nile outbreak grows, widespread dengue in India, yellow fever in Sudan

Nov 7, 2012

US West Nile cases top 5,000, including 228 deaths
Over the past week the US Centers for Disease Control and Prevention (CDC) received reports of 163 more West Nile virus (WNV) infections along with 5 more deaths, pushing the nation's total this year to 5,054 cases and 228 deaths, according to an update today. The pace of new infections and deaths is up from the previous week's, when 116 new cases and 4 new fatalities were reported. So far 2,559 of the WNV cases involved the neuroinvasive form of the disease. The CDC reiterated that this year's WNV season is the worst since 2003. Nearly 80% of cases have been from 12 states, with Texas bearing the largest burden, reporting a third of all infections.
Nov 7 CDC WNV case chart
In a related development, Maine officials recently reported the state's first-ever WNV case, a patient from Cumberland County who started having symptoms on Oct 1, which included fever, encephalitis, and meningitis, according to an Oct 31 statement from the Maine Department of Health and Human Services (MDHHS). The patient had not traveled during the exposure period, and officials consider the case to be locally acquired.
Oct 31 MDHHS press release

Experts say dengue is widespread and vastly underreported in India
Dengue virus infections are widespread in India, and extreme underreporting of cases makes the problem worse, according to experts quoted in the New York Times yesterday. The government counts only lab-confirmed cases reported in public hospitals, which totaled 30,002 for this year through October, compared with 18,860 cases for all of 2011. Scott Halstead, MD, a tropical disease expert, estimated the true number of annual cases at 37 million, with 227,500 hospitalizations. Manish Kakkar, MD, MPH, a specialist at the Public Health Foundation of India, said India's "massive underreporting of cases" has contributed to the disease's spread. Other experts told the Times that India's failure to build an adequate dengue surveillance system has hindered awareness of the illness's vast extent, discouraged efforts to clean up its sources, and slowed the quest for a vaccine. A recent, as yet unpublished study found that dengue is about as prevalent in West Bengal as in Thailand, where almost everyone is infected in childhood, the story said. It noted that up to 80% of dengue infections cause only mild symptoms, but 20% are more serious and 1% are life-threatening. Four strains of dengue viruses exist, and a person who has a second infection with a different strain than the first may suffer a serious illness. "The great danger of having hundreds of millions of people in India with undiagnosed and unacknowledged primary infections is that a sudden shift in the circulating dengue strain could cause a widespread increase in life-threatening illnesses," the story said.
Nov 6 Times story

Yellow fever outbreak in Sudan grows to 194 cases, 67 deaths
Suspected cases of yellow fever in Sudan have reached 194, including 67 deaths, according to an update yesterday from the World Health Organization's (WHO's) eastern Mediterranean regional office. The outbreak has affected 17 localities in Central, South, West, and North Darfur states and now has a case-fatality fate of 34.5%, the office said. The outbreak, which began in late September, has expanded by 91 cases and 25 deaths since the WHO's last update on Nov 2. About 83% of cases are from Central Darfur. WHO officials are working with Sudanese authorities to vaccinate people and to train more than 225 health workers on surveillance, case management, outbreak investigation, and infection prevention and control.
Nov 6 WHO update
Nov 2 WHO update

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