DENGUE/DHF UPDATES (38): 30 SEP 2002 ************************************ A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> In these updates: [1] & [2] Hong Kong SAR [3] Taiwan [4] DengueNet (WHO) ****** [1] Date: Wed 25 Sep 2002 From: Pablo Nart <p.nart@virgin.net> Source: South China Morning Post (via Newsline), Tue 24 Sep 2002 [edited] Hong Kong SAR: third locally acquired dengue fever case confirmed ----------------------------------------------------------------- Yesterday, 2 more local cases of dengue fever were confirmed, as the government launched an all-out publicity campaign to try to stem the spread of the potentially fatal disease. The 2 workers, aged 28 and 38, from a Ma Wan construction site, contracted the disease earlier this month, laboratory tests revealed. They have since recovered. The pair work on the same construction site as a third man in whom dengue fever was confirmed on Sat 22 Sep 2002. To guard against the widening outbreak, the Department of Health will ask all 10 000 public and private doctors in Hong Kong to be alert for symptoms of the disease. It will also step up health education programmes in all 1300 primary and secondary schools -- organising talks for teachers, students, and school staff on how to reduce the risk of the disease spreading. The moves came after a special joint meeting by 16 government departments yesterday to discuss strategy in combatting the outbreak. Deputy Director of Health Dr Leung Pak-yin, who chaired the meeting, said the department was issuing letters to all doctors, keeping them informed of the latest developments and reminding them to notify the department of any new outbreak. Blood samples were taken yesterday from about 100 workers at the Ma Wan construction site where the 3 confirmed cases were discovered. Dr Leung said the Food and Environmental Hygiene Department would complete its inspections on all 500 construction sites across the territory today to ensure that the builders followed preventive measures. So far, 43 prosecutions and 20 warnings have been issued against site owners for failing to keep their sites clean. University of Hong Kong Professor of Microbiology Yuen Kwok-yung said that the news of locally acquired cases of dengue fever should sound an alarm. "It means there are infected mosquitoes in Hong Kong," he said. It is now imperative to take risk reduction measures "to reduce the number of mosquitoes in high-risk areas such as construction sites and for people to prevent mosquito bites," Professor Yuen said. The World Health Organization's regional adviser, Dr Allan Schapira, said: "The fundamental measure is very simple: elimination of open stagnant water in containers, including cans, jars, tires, gutters, vases, bottles. This requires an active effort by the health and environment authorities and by each family." He said dengue fever has been endemic in South East Asia for centuries and Hong Kong was on the northern fringe of the high risk area. Because of its location, Hong Kong had reported small outbreaks of imported dengue cases in recent years. Dr Schapira said the role of travellers was important in the spread of dengue. "An infected traveller can trigger a new epidemic." The risk of death could be "close to zero" with proper timely treatment. ****** [2] Date: Mon 20 Sep 2002 From: Pablo Nart <p.nart@virgin.net> Source: BBC International Reports (Asia), Sun 29 Sep 2002 [edited] Hong Kong: dengue fever spreading --------------------------------- The BBC Monitoring service reports that the local dengue fever outbreak in Hong Kong has spread beyond Ma Wan Island. Health officials have just confirmed that a case has been found in Cheung Sha Wan. (Information obtained from Radio TV Hong Kong audio website on Sun 29 Sep 2002) ****** [3] Date: Mon 30 Sep 2002 From: Pablo Nart <p.nart@virgin.net> Source: World News Connection (via Newsline)/ CNA, Tue 24 Sep 2002 [edited] Taiwan: dengue fever continues to spread ---------------------------------------- The Department of Health (DOH) under the executive Yuan reported on Tue 24 Sep 2002 that the number of reported dengue fever cases in Taiwan had reached 2505 as of that day. DOH officials said that Kaohsiung County and Kaohsiung City together comprise the worst-affected area, with 2410 cases. Because the epidemic is mostly concentrated in the greater Kaohsiung area, the risk of an outbreak of the more serious dengue hemorrhagic fever has also heightened there, the officials said, adding that at present, 38 such cases have been reported, all in the greater Kaohsiung area. Officials have urged the public to help eradicate the disease by getting rid of standing water in their neighborhoods, where the mosquitoes that carry the disease breed. They also warned that violators of related hygiene regulations will be subject to fines. ****** [4] Date: Mon 30 Sep 2002 From: ProMED-mail <promed@promedmail.org> Source: Eurosurveillance Weekly, Volume 6, Issue 39, Thu 26 Sep 2002 [edited] <http://www.eurosurv.org/update/> DengueNet WHO’s internet based system for global surveillance of dengue and DHF --------------------------------------- Globally, 2.5 billion people live in areas where dengue viruses are transmitted. The disease is now endemic in more than 100 countries in Africa, the Americas, the eastern Mediterranean, South East Asia, and the Western Pacific. South East Asia and the western Pacific are most seriously affected (1). It is estimated that 50 million dengue infections occur each year, with 500 000 cases of dengue hemorrhagic fever (DHF) and at least 12 000 deaths, mainly among children. Only a small proportion of these cases are reported to the World Health Organization (WHO). Current reporting of dengue/DHF is not standardised. Many different epidemiological institutions and laboratories collect data and present and report it in different formats; this makes interpretation and comparability at regional and international levels difficult. In order to address these problems, WHO has created DengueNet <http://www.who.int/denguenet> in response to the WHO resolution on dengue fever/DHF prevention and control adopted at the 55th World Health Assembly in May 2002, which asked member states to "build and strengthen the capacity of health systems for surveillance, prevention, control and management of dengue and DHF." It also emphasised the importance of strengthening laboratory diagnosis in affected countries (2). DengueNet has been developed in collaboration with the WHO collaborating centre for electronic disease surveillance at the Institut National de la Sante et de la Recherche medicale (INSERM), Paris, France and is an internet-based surveillance tool managed as a central database to collect and analyze standardized epidemiological and virological data. It has been developed in line with the principles devised by the Pan American Health Organisation (PAHO) for epidemiological and laboratory surveillance of dengue/DHF in the Americas. It is designed to collate the data in a timely manner and to display realtime important indicators such as incidence data, case fatality rates (CFR), frequency and distribution of dengue and DHF cases, numbers of deaths, and distribution of circulating dengue virus serotypes, as well as to provide historical data. These data will be available from all the participating countries. At present, DengueNet provides global dengue statistics from 1955 to 2001, which can be accessed on the internet and may be useful to public health researchers and for national and international agencies for advocacy purposes. Implementation of the full realtime use of the system will undergo pilot testing soon. The first meeting on DengueNet implementation was held from 9 to 11 Jul 2002 in Puerto Rico to discuss how the pilot testing will work and which countries will participate. All 15 countries from the Americas represented at the meeting agreed to take part in the pilot test. The next stage is for the participants to approach their national authorities to obtain official authorisation to take part in DengueNet and these approaches will be assisted by WHO country representatives. The pilot testing is expected to take 3 to 6 months after which, if successful, lessons learnt from this exercise will be incorporated into an implementation framework for South East Asian and Western Pacific regions in 2003. Countries in these areas have indicated a keen interest in this project as the burden of morbidity and mortality caused by dengue in these regions is considerable. DengueNet will be a useful tool for finding out where dengue fever is occurring globally, and may help clinicians to consider dengue as a differential diagnosis for patients presenting with fever after time spent in a dengue endemic country. Health professionals advising travellers from Europe will be able to use this information to formulate the correct advice for those going to countries/areas endemic for dengue or experiencing dengue epidemics. Information about circulating serotypes may be a valuable resource for advising travellers who have already been infected with dengue about the increased risk of DHF if they become reinfected with a different serotype. References: 1.WHO. Dengue and dengue haemorrhagic fever. Fact sheet No 117. Revised April 2002 <http://www.who.int/inf-fs/en/fact117.html> 2.WHO. DengueNet WHO’s internet based system for the global surveillance of dengue fever and dengue haemorrhagic fever (Dengue/DHF). Wkly Epidemiol Rec 2002; 77: 300-4. <http://www.who.int/wer/pdf/2002/wer7736.pdf> Reported by Jo Lawrence <jlawrence@phls.org.uk>, Public Health Laboratory Service Communicable Disease Surveillance Centre, London, England. -- ProMED-mail <promed@promedmail.org> [see also: Dengue/DHF updates (37): 23 Sep 2002: correction 20020923.5386 Dengue/DHF updates (37): 23 Sep 2002 20020923.5384 Dengue/DHF updates (01): 14 Jan 2002 20020115.3265 2001 --- Dengue/DHF updates (21): 18 Dec 2001 20011218.3058 Dengue/DHF - China (Hong Kong, Macau) (04) 20011015.2529 Dengue/DHF - China (Hong Kong, Macau) 20010831.2077 Dengue/DHF updates (01): 8 Jan 2001 20010108.0064 1998 --- Dengue/DHF, imported - Taiwan ex Thailand 19980828.1714 Dengue, imported - Taiwan ex S.E. Asia 19980805.1503 Dengue, imported - Taiwan 19980711.1313 Dengue, imported - China (Hong Kong) 19980513.0942 1997 --- Dengue - Taiwan: background 19970623.1343 Dengue alert - Taiwan 19970617.1282] ................jw/cp/pg/sh *##########################################################* ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. The reader assumes all risks in using information posted or archived by ProMED-mail. ISID and its associated service providers shall not be held responsible for errors or omissions or held liable for any damages incurred as a result of use or reliance upon posted or archived material. ************************************************************ Visit ProMED-mail's web site at <http://www.promedmail.org>. Send all items for posting to: promed@promedmail.org (NOT to an individual moderator). 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