News Scan for Oct 12, 2015

More chikungunya
Polio case in Laos
Cholera in Iraq, Americas
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PAHO reports 3,400 new chikungunya cases

The chikungunya outbreak in the Caribbean and the Americas continued to expand slowly, as the Pan American Health Organization (PAHO) added 3,409 new cases in its weekly update published late last week.

The previous 4 weeks saw increases of 4,857, 3,085, 12,694, and 4,472 cases, respectively. The total cases in 2015 have now reached 595,994, PAHO said in an Oct 9 update. The number of outbreak-related deaths stayed the same, at 62 for the year.

Most of the new cases were reported by Colombia, which in recent months has often noted the most cases. That country had 2,675 new cases last week, bringing its 2015 total to 337,809. Mexico reported 529 new infections, raising its 2015 total to 7,962 cases. As with past weeks, many countries have not provided a chikungunya update in weeks.

The outbreak, which began in December 2013 with the detection of the Americas' first locally acquired cases on St. Martin in the Caribbean, now involves 1,742,763 cases.
Oct 9 PAHO update


Polio confirmed in Laos as UN urges vaccination in Ukraine

A new polio case was confirmed in Laos, as two United Nations (UN) groups urged vaccination after two cases were confirmed in Ukraine 6 weeks ago and officials there have yet to respond.

The case in Laos involves an 8-year-old boy who died Sep 11, according to a World Health Organization (WHO) statement today. He had onset of paralysis on Sep 7, and tests confirmed poliovirus type 1.

Genetic sequencing confirmed last week that he virus is vaccine derived and suggest that it has been circulating in in the district of Bolikhan, in Bolikhamxay province, for more than 2 years. The district has chronically low immunization rates, reporting coverage of just 44% this year, the WHO said. Vaccination campaigns are planned for Bolikhamxay and adjacent provinces.

The agency said the risk of international spread from this case is low.
Oct 12 WHO statement

Meanwhile, 6 weeks after two polio cases were reported in Ukraine with no systematic follow-up immunization effort, the WHO and the UN Children's Fund (UNICEF) urged the country to act immediately, saying its delay is putting 1.8 million children at risk, the two agencies said in a joint press release.

On Sep 1, Ukraine's health ministry confirmed polio in unvaccinated children age 10 months and 4 years, and a mass vaccination campaign has not been deployed. Last week the WHO expressed concern that 3.7 million doses of UN-donated oral polio vaccine might be tossed after a parent group raised concerns, the Associated Press (AP) reported. The vaccines may have thawed on the plane to Ukraine, but Sanofi Pasteur, the vaccine's maker, said such temperature fluctuations would not affect efficacy.

In today's news release, Zsuzsanna Jakab, MD, PhD, WHO regional director for Europe, said, "The longer the polio virus is allowed to circulate in Ukraine, the higher the risk that this outbreak will spread and paralyse more children. We call on decision-makers and health care providers in Ukraine to take immediate action and vaccinate all children to urgently stop the transmission of the virus."
Oct 9 WHO/UNICEF press release
Oct 8 AP story


Iraqi cholera total climbs; cases continue in 3 Americas countries

The WHO today reported 62 more lab-confirmed cholera cases in Iraq, raising the country's quickly growing outbreak total to 1,263 cases in at least 15 governorates. The hardest-hit ones are Babylon, Baghdad, Al Diwaniyah, and Muthana.

A cholera task force from the Iraq Ministry of Health has set up a command and control center to coordinate the outbreak response, which has been stepped up in affected areas, including camps housing internally displaced people and refugees. As part of the efforts, bottled water and sanitation kits have been distributed and water distribution points have been established.

The task force is also undertaking sanitation improvements, such as enhanced sanitation at water treatment plants and regular cleaning of toilets and bathing facilities.

Discussions about the release of oral cholera vaccine from the international stockpile are under way, along with a risk assessment to identify priority groups for vaccination. The WHO said it has deployed an expert team to help Iraq's health ministry.

According to a WHO regional office update on Oct 8, the outbreak is centered in southern Iraq but appears to be spreading north. It also raised concerns about the added risk of international spread, due to a religious observance in Karbala that will draw millions of pilgrims from Iraq and other nations.
Oct 12 WHO statement
Oct 9 CIDRAP News scan "Cholera outbreak in Iraq tops 1,200 cases"

In other cholera developments, cases in Haiti and the Dominican Republic are running ahead of cases at this point in 2014, PAHO reported on Oct 9 in a regular update on the disease. Also, Cuba has reported 23 cases in Holguin province, which has suffered a drought and a shortage of safe drinking water.

In total, countries in the Americas have reported 22,950 cholera cases this year so far, 98% of them in Haiti.
Oct 9 PAHO cholera update

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