Previous thread is here
Here are the English news sources I have located on Nepal to help things along. (From DennisC)
Pixie – at 20:45 (1 November 06) Recent Timetable for Nepal
Map of Nepal Administrative Divisions: http://tinyurl.com/yynvae
Malaria patients blocked by Rapti river
Saturday, November 04,2006
BANKE: Some critical patients suffering from malaria have been confined within their villages due to transportation problem in crossing Rapti river. Doctors have referred them to rush to hospital. Police, administration and the high level officials of the ministry of health are trying hard to arrange a helicopter but to no avail. “We have also talked to the Prime Minister for that, which is yet to be confirmed,” said Dr Mahesh Maskey, advisor of the ministry. The malaria epidemic that spread here in villages lately has already claimed over three dozen lives in the area.
Mary Quijano – at 14:03
In India, 17 infants have died in a certain hospital in the last 3 days from “infections”. (I saw this on the RSOE HAVARIA Emergency site today. I’ll try to find a source and come back) But: You all are such super sleuths, I am wondering if you can check to see if there are any connections of this spate of deaths in terms of location,symptoms etc to the nepalese outbreak. One other comment: way back in the thread, a posting said one villager commented that every member of her family was sick. Since usually the adult female mosquito (vector of malaria) only requires two blood meals to inoculate her eggs before laying, they either had 1. a very unusual, very hungry mosquito in their room one night, or 2. the bad luck to have their particular family run into a hoard of similarly infected mosquitoes with the unusual cerebral form of the plasmodium, or 3.it isn’t malaria. Following Occam’s razor, I vote 3.
Here is a link to the story: 22 kids die in 3 days at BC Roy
The normal death rate at the hospital is two to three in a day. “Almost 60% of the infants who died were born prematurely and grossly underweight — between 650 gm and 1.5 kg. It is very difficult to save such infants. The rest came to the hospital with severe infections,” said M K Chatterjee, the hospital’s vice-principalcum-superintendent.
The other babies were suffering from acute meningitis, encephalitis and septecemia. “A year-old child came to the hospital gasping.
It looks like it’s in India, not Nepal.
Nawty bits at 15:22 wrote “Severe malaria occurs most often in persons who have no immunity to malaria or whose immunity has decreased. These include all residents of areas with low or no malaria transmission, and young children and pregnant women in areas with high transmission.” So how could this possibly be what is killing all these people in an area where malaria is common? Granted, there were many children, but also many elderly, which doesn’t fit the profile. Were many of the victims pregnant?
As many as three people died of meningitis in southern Kapilvastu district over last two months, state run daily The Rising Nepal reported here on Sunday. “Two children of same family and a woman died of disease at Barkulpar village of the district, some 150 km south-west of Kathmandu. Three serious patients have been taken to Mission hospital in neighboring Palpa district on Friday,” according to the locals. Other two patients are undergoing treatment in the village, as they are unable to afford treatment cost, they said. The patients were having headache, fever, stomach problem, difficulties in speaking and lack of interest in eating foods as a result of the disease. The disease has spread in Tharu community that is considered as one of the underprivileged people of the country. Although the village is a far of just one kilometer from the east-west highway and accessible to major hospitals around region, the disease is spreading due to lack of awareness among people in the community, said another local Shri Niwas Chaudhary. Officials at the district health office said, however, they were not informed about the disease being spread in the village. “So, we could not reach there with treatment materials on time,” they added.
There is only one district separating Kapilvastu from Banke district, and both are on the Indian border. Still, there is no information available that might clarify what may be going on in this area.
There have been no WHO updates on what is happening in Nepal. In fact, if you look on the WHO website and look up Nepal under “Disease Outbreaks by Country,” the latest information they have listed there is from 1996 & 1997.
Pixie – at 10:59 “There have been no WHO updates on what is happening in Nepal”
I guess that that means: 1) WHO has looked and there is nothing going on in Nepal and it is all a mistake, 2) WHO is not doing their job and does not care about the loss of life, or 3) WHO knows what is going on and is covering up and hoping no one notices.
I have a feeling it is #3 since if we know, then WHO would know (after all some at the CDC are reading our papes) - especially with the doctors leaving the hospitals (to conferences ?) and the hospitals fumigating their ICU’s.
I am still hoping that all this is just a “mixed bag” of cases just to the floods and lack of communication.
Comment: If my math is correct then this area of Spain has experienced a 58% increase in meningitis this year. I also read an article yesterday regarding an upsurge in meningitis in Africa. I don’t remember where off hand. I will try to track down the article.
Increase in viral meningitis cases reported in the Autonomous Region of Madrid, Spain, 2006
Between 1 January and 16 September 2006, the Epidemiological Surveillance Network of the Autonomous Region of Madrid detected 446 cases of viral meningitis, an increase of 260 compared with the same period in 2005. Viral and bacterial meningitis have been mandatorily notifiable diseases in the Autonomous Region of Madrid since 1997. Clinical and epidemiological data are collected through a structured questionnaire for every case. No changes in the reporting pattern have been observed in recent years.
The cumulative incidence detected for the period was 7 cases per 100 000 inhabitants (compared with 3/100 000 for the same period in 2005). Three quarters of the cases were in children under 15 years of age, and 58% of all cases were male. The patients’ ages ranged from 1 month to 73 years (median age = 5 years). The age group with the highest incidence is 1–4 years (55 cases per 100 000), in children younger than 1 year (53 cases per 100 000) and in children aged 5–9 years (46 cases per 100 000) (Figure. 1). Eleven per cent of cases were linked to other cases, particularly through household and school contact.
<snip>
The report provides a nice bar chart. Click on “Increase in viral meningitis cases reported in the Autonomous Region of Madrid, Spain, 2006″
Comment: I found the article I had mentioned above at 18:01
ETHIOPIA: Acute watery diarrhoea claims 279 lives
NAIROBI, 25 Oct 2006 (IRIN) - Acute watery diarrhoea has continued to spread alarmingly in Ethiopia, with the death toll rising to 279 and 29,880 people infected, despite efforts by the government and humanitarian agencies to control the epidemic since April, the United Nations humanitarian agency said on Wednesday.
<snip>
Meanwhile, a meningitis outbreak in the Southern Nations Nationalities and People’s Region has claimed the lives of 10 people in the past 10 days, according to OCHA, which quoted the Federal Ministry of Health as saying 596 suspected cases of meningitis had been reported.
“Last week, three samples were sent to Addis Ababa and only one tested positive for meningococcal meningitis. The Federal Ministry of Health has sent meningitis rapid diagnostic kits to 11 regions,” according to OCHA.
Earlier this year, 621 cases of meningitis, among them 32 deaths, were reported in three regions in Ethiopia. In June the Health Ministry appealed for US$2.6 million for meningitis control.
Early symptoms of meningitis include fever, which is followed by a rash and vomiting. Patients suffer stiffness before unconsciousness and death. The meningitis bacteria are transmitted through droplets of respiratory or throat secretions
<snip>
Killer disease in Banke was malaria, not dengue [ 2006–11–6 ]
From Indira Aryal
BANKE (Piparhawa), Nov. 5: Laboratory test in the epidemic areas of Banke district identified Falciparum malaria instead of dengue, which was suspected earlier.
A total of 32 people have died and several hundred suffered from fever, headache, cough and severs in the 10 VDCs of the district. Around 1,200 people were affected by malaria in four VDCs and 521 people were tested positive for falciparum malaria and the rest by vivax malaria. Twelve serious cases have been referred to Bheri Zonal Hospital.
<snip>
http://www.gorkhapatra.org.np/content.php?nid=5748
Comment: This website is a government news site. That fact can be looked upon in a couple of ways, (ie-the info is direct from the Nepal government so it is more correct, or the info has been tailored/manipulated to suit it’s needs) decide for yourself.
It is interesting to compare this article with the previous article on this subject by this news site. Click on the article cited on the bottom of the page titled: “Sherchan tells MPs about situation of dengue”
Okieman – at 08:20
In the article Dr. Maskey says “the major cause of death was malaria, but there are also deaths from other diseases. If it were only malaria the toll would not have been so high.”
What were those other diseases? Generally speaking, I enjoy a cliffhanger. Not in these instances however.
I’m going back to the Egypt papers today to look for follow up reports to the salmenella outbreaks from last week. I’m curious if there are new reports of meningitis this many days after the diarrhoea/salmonella/food poisening/sewage contaminated water/gas station chemical incidence (which coincidentally occured in two seperate governanotes. They are probably still pointing fingers.
Part of me says that the meningitis reports are just every day, run of the mill, garden variety, meniningitis. But the other part of me can’t ignore the fact that every day, run of the mill, garden variety meningitis attacks the same age group as H5N1 and it presents with respiratory illness. So in my mind it bears watching.
Thanks all!
Comment: I find that Xinhua is usually pretty accurate with details like numbers, etc.
32 people die of malaria in mid-western Nepal
(Xinhua) / 2006/11/06 / http://tinyurl.com/y85lev
A total of 32 people died of malaria in 10 villages of Banke district in mid-western Nepal, the Epidemiology and Disease Control Division said on Monday.
According to the division, nearly 4,500 people of Gangapur, Phattepur, Naraijapur and Holia villages in the district, some 500km west of Kathmandu, are under risk of catching the disease.
Director of the division Dr. Manas Kumar Banergi said nearly 1,500 people were affected by the disease and some 600 among them had tested their blood.
According to the division, the area is flood prone and this year mosquitoes, the source of malaria, are seen breeding in the water which remained after the flood.
Teams of medical practitioners have been engaged in the field and Advisor to Minister for Health Dr. Mahesh Maskey is leading a team working in the field.
Banergi has expressed his hope that the disease will be contained within 35 days.
Can somebody calculate the R0 if we now have 1500 cases?
Pixie – at 10:07
I can give an estimate. Assuming that we had 14 cases in mid Aug, 1500 cases now (not the 4000) and guessing at a 7 day exposure/incubation period: I get R0 of 1.53. (the 11 root of 1500/14
But we don’t really know how many cases we had back on Aug 18 or the length of time from exposure to contagious. However, if there are more cases now than back then, the R0 is greater than 1.
This is just a “ball park estimate”. Perhaps someone else can give a better estimate.
What if we start not with August, but just limit ourselves to Banke district happenings. Things started to move there around Oct. 18th with the suspected dengue cases at Nepalgunj medical hospital.
I’d like to start with the “malaria” cases in Banke, but they seem to have sprung fully-formed at the 400 case level on Oct. 14th. Does anyone have any information about when the “malaria” outbreaks started in the 5 villages in Banke? If we calculate an R0 from there, it will be much higher as the spread has been fast.
They are telling us, basically, to expect as many as 4500 total cases by the end of 35 days as that is the number they have stated is “under risk of catching the disease.” If we have 1500 cases now and they expect 4500 within 35 days, what would that R0 be? Somebody over there seems to have made some calculations to come up with that 4500 number, and I would assume they are using the current spread rate they’ve already seen to come up with that estimate.
Pixie – at 10:56 Here to “show my work”.
35 days or 5 “cycles” of 7 day (exposure/contagious guess) n=5 starting with 1500 ending with 4500
R0 = 5th root of (4500/1500) = 1.25. but these are all just estimates since there is so much we don’t know.
I think it is also useful to monitor the spread/ the scatter of similar outbreaks against a date of first reports in other areas. The rate/ incidence of (possible) new cases showing up in other geographical regions will indicate far better if it is what they claim it to be, or something else altogether that we need to be concerned against. Personally, I doubt that it is an H5N1 outbreak, but we could usefully start to track this as a blueprint for future monitoring.
So - can we summarise any other regions that qualify for a similar type of outbreak? Sri Lanke? India? Where else? And dates of first reports?
My concern is (and always has been) that: yes, there is dengue and yes, there is malaria and other diseases. However, history has shown that in the early stages of a panflu outbreak, these diseases ‘mask’ the presence of panflu because of ‘presumptive diagnosis’. The answer is rigorous testing; testing is expensive. So most likely, we will not become aware of a sustained outbreak of panflu until it is too late. Not to belabour the point, if you have 100 sick, you test them all, and 50 are +ve; what is wrong with the others?? Now if you are a poor country and can only test 25… well you get the idea. I’m just not confident we’re testing for H5N1 like we should.
WHO should be testing for H5N1 at the major outbreaks where flu symptoms are being presented—that’s what you do in stage 3 of a pandemic alert. Is that too much to ask?
This can’t be HSV1 according to my logic:
link : “If there is laboratory confirmation of the diagnosis of herpes encephalitis in the young child, it would be very unusual to see a cluster of 3 cases in the same family. Given that, other diagnoses to explain the cluster of 3 cases of a febrile illness associated with epistaxis (bleeding from the nose) should be investigated. More information from knowledgeable sources in Dubai would be very much appreciated. Mods.DK/MPP]”
flumonitor—
About a week or so ago there was some activity on a PNG thread. There appeared to be a case of latent period and onset time in a couple villages.
What are they talking about?!
http://tinyurl.com/ygn9gf : “Date: 12 Nov 2005 From: ProMED-mail <promed@promedmail.org> Source: Times of India [edited] http://timesofindia.indiatimes.com/articleshow/1290358.cms --- What sets alarm bells ringing is that, unlike JE, this suspected encephalitis has an average death rate of 60 percent and an incubation period as short as 6 hours. This means that saving lives is a much bigger challenge. ---“
enza – at 11:24 WHO should be testing for H5N1 at the major outbreaks where flu symptoms are being presented—that’s what you do in stage 3 of a pandemic alert. Is that too much to ask?
Enza, I have rarely seen H5N1 testing in any area, in any country, where chickens have not died. China and Indonesia do test for H5N1 in the absence of dead chickens occasionally, but only at the point that they have someone on a ventilator and have no other answer. In Indonesia, I don’t believe anyone who presents with flu symptoms is tested for H5N1 unless they also say clearly and distinctly that they have been in an area where chickens have died, and preferably can state that they have had direct contact with dead chickens. Otherwise, no H5N1 testing. That stubborn requirement to link H5N1 in patients with dead chickens (even on the part of the top doctors in these areas, who have been won over to this thinking…) is the single biggest risk we face in not acknowledging the beginning of a pandemic.
As an example, Kalimantan had hospitals “overrun” with patients presenting with dengue symptoms. Not one of them was tested for H5N1, I believe, because Kalimantan had been (up until then) one of the last remeining “bird flu-free” provinces in Indonesia. No way anyone there was going to get tested for H5N1 - no chickens had been dying.
Any confirmation of the cause of death of the polar bear? http://tinyurl.com/wfxv2
flumonitor – at 11:14
“So - can we summarise any other regions that qualify for a similar type of outbreak? Sri Lanke? India? Where else? And dates of first reports? “
Outbreak of Dengue Fever in Saudi November 5, 2006
JEDDAH: Saudi media reported an outbreak of Dengue Fever in Jeddah this week. Hospital officials have so far reported four cases of dengue fever in Saudi Arabia. There have been no cases of dengue fever reported in Kuwait.
According to local reports agricultural engineer, Mohammed Habib Bukhari, has warned against a larger scale dengue fever outbreak in Jeddah.
He said stagnant pools of water left over by an abrupt, but severe downpour last week were a fertile breeding ground for dengue fever-carrying mosquitoes. Bukhari pointed out that some 40 swamps around the King Abdul Aziz International Airport in addition to the Mesk Lagoon, Jeddah’s dumping area, and the stagnant pools covering several parts of southern Jeddah were high risk areas.
Dengue is caused by the bite of the female Aedes aegypti mosquito breeding in stagnant water. It is marked by high fever, joint pain, skin rashes and a sharp drop in platelets in the blood that can prove fatal.
Several dozen people have died from the virus in a recent outbreak in India.
Bangladesh November 5, 2006
Mosquito menace adds to people’s woes Rizanuzzaman Laskar
The sudden surge of mosquito menace in the city over the last few weeks continues to aggravate the woes of city dwellers.
The sudden increase of mosquitoes has created a fear in the minds of people who dread that a dengue epidemic might be on its way to plague their lives.
Despite the rapid increase of mosquitoes, Dhaka City Corporation (DCC)’s negligence in dealing with this menace continues to frustrate the city dwellers.
<snip>
Another official blamed the general people’s indifference towards cleanliness of their premises to be a major reason of the increase in mosquitoes. “If they continue to depend on us to eradicate mosquitoes and don’t keep their premises clean, then they are bound to be disappointed,” he said.
He also blamed wetlands, ponds and canals located in the fringes of city to be the major breeding grounds of mosquitoes. “We urge our field workers to cover up an addition of one kilometre area beyond our accounted vicinity to prevent mosquitoes from migrating.”
<snip>
November 5, 2006
6 people died from Malaria in Jalpaiguri (regional proximity to Bangladesh)
Comment: For tracking purposes would it be useful to consider opening a new thread for reporting Dengue, Chick, and Malaria outbreaks?
We urge our field workers to cover up an addition of one kilometre area beyond our accounted vicinity to prevent mosquitoes from migrating.”
-------------------------------------------------------------------
Comment:
I’m not a mosquito expert but the Aedes mosquito basically is a house mosquito. They stay around the place they’re born. They don’t migrate kilometres. The Aedes which causes Dengue and Yellow Fever is controlled by screens, and emptying containers around your house with standing water. While a good wind might blow some of them around they by nature hover in the bushes etc waiting for the flesh to come outside so they can feast. Fish in ponds and canals eat mosquito larvae as do insects so there are many strange mosquito comments in these articles. Either that are the entire eco-system is out of whack.0
Mosquitos…..Misquitos…… Misquitos invading the world.
Typhoid epidemic outbreaks in central Nepal
The outbreak of typhoid epidemic at Manthali, the headquarters of Ramechhap district in central is getting increased, the National News Agency RSS reported on Monday. More than 200 locals suffered from typhoid within last week in the area, the report said. Around 10–15 typhoid patients are undergoing treatment in the district hospital and Tamakoshi Community hospital each day, according to the report.
<snip>
http://english.people.com.cn/200611/06/eng20061106_318838.html
What are the signs and symptoms of typhoid fever? Persons with typhoid fever usually have a sustained fever as high as 103° to 104° F (39° to 40° C). They may also feel weak, or have stomach pains, headache, or loss of appetite. In some cases, patients have a rash of flat, rose-colored spots. The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood tested for the presence of S. Typhi .
Link to CDC website for discription of typhoid fever:
Link to Encarta map showing the location of Ramechhap district:
Ramechhap District map:
Mystery illness claims 3
Rautahat: An unidentified disease in Sakhuawa VDC of Rautahat has claimed the lives of three persons over the last two days. The condition of two others affected by the disease is critical. The outbreak has claimed Ram Naresh Yadav’s wife Nitu Devi, 20, Bir Jogi Yadav’s wife Kanti Devi, 21, and Dinesh Giri, 21, locals said. Nitu and Kanti died on Monday while Dinesh died on Sunday. A health team has been sent to the site, said the District Public Health Office. — HNS
Map of Nepal Districts
Map of Rautahat District (has location of Sakhuawa)
A total of 32 people have died and several hundred suffered from fever, headache, cough and severs in the 10 VDCs of the district. Around 1,200 people were affected by malaria in four VDCs and 521 people were tested positive for falciparum malaria and the rest by vivax malaria. Twelve serious cases have been referred to Bheri Zonal Hospital.
When no medical facility was available locally many suffering took medicines prescribed by fake doctors coming from across the border. Hirduram Dhobi, 30, of Piparhawa said he took medicines prescribed by doctors coming from bordering of India. The fever was controlled for a few days and then starts again. He has been suffering from fever and headache for the last 10 days. Dhobi has been taken to Bheri Zonal Hospital. It took a lot of time for the team coming from Kathmandu to convince him to go to the hospital.
Piparhawa is the worst affected VDC with small children to old people suffering from the disease. Eleven people died in the VDC alone and all of the 25 huts in the village have at least one or two suffering form the disease.
A medical team by Dr. Mahesh Maskey, advisor at the Minister for Health and Population Amik Serchan, local team from Banke district, a team for laboratory test from Hetuda have been mobilised in the area to assess the situation and provide services. The team found that was falciparum malaria.
Those affected were brought to the health camp organised by Epidemiology and Disease Control Unit (EDCU) under the MoHP, Nepalgunj Nursing Hospital and World Health Organisation (WHO). Six teams from different organisations have been mobilising in the area.
While this article is about typhoid in Nepal, it shows the major problems it is having regarding diagnosis and treatement of any illnesses in this country: lack of physicians.
No doctors for typhoid patients in Ramechhap [ 2006–11–7 ] RSS RAMECHHAP, Nov. 6: The outbreak of in and around Ramechhap bazaar and Manthal of the district is getting increased.
More than 200 locals suffered from typhoid within this week in the area.
The problem has been surfaced in treatment due to the lack of doctors in the hospital.
Around 10–15 typhoid patients are undergoing treatment in District hospital and Tamakoshi community hospital each day.
The main cause of the disease is said to be the use of contaminated water.
The outbreak has been explicit in various areas including Ramechhap, Manthali, Matauli, Sunarpati, Bhalubazor, Sukajwor of the district, said doctors.
There is no doctor in district hospital though there has been three posts for doctors.
Similarly Primary health post of Manthali has remained doctor less for last four years.
There have been the stocks of medicines, said In-charge of District Health Office Biswo Ram Shrestha, but to the contrary locals complained that they did not receive any medicines from the hospital.
Studies have proven that H5N1 infected migratory waterfowl excrete the virus in their feces into the water, where it can survive for several days as I recall. So, here we have all these outbreaks of diseases related to flooding and mosquitos, and I am wondering 1. Is it possible for people to become infected from drinking, cooking with or bathing in water containing H5N1 virus particles? and 2. Have researchers ever definitively tested and ruled out the possibility of transmission of H5N1 by mosquitos?
Mary Quijano – at 21:05 I think that the news reports from various governmental agencies have stated that we do not have to worry unless we are surrounded by dead chickens… <grin>
To answer your question, there has been speculation on the various flu sites about the spread of the virus via mosquitos (especially after the news that the virus was found in the blood of some of the infected patients), but I am not aware of any published studies that have specifically tested mosquitos for the virus. The only study I am aware of in regard to insect vectors and H5N1 was in flies.
Comment: An editorial, from the government sponsored paper. The rest of the news from Nepal is very upbeat today, as the government has just signed an agreement with insurgents that has been long in coming.
Editorial
Effective Response [ 2006–11–7 ] TheRisingSun http://tinyurl.com/y2d5ah
THE quick and timely response of the government in the areas of Banke district which were hit by the outbreak of malaria has, indeed, saved many lives. The sudden outbreak of malaria took some lives as it was not reported in time and took time to dispatch the necessary team of medical workers and medicines. As soon as the government received the information, it promptly sent a team of doctors and other supporting staff to the areas. The people in the areas have appreciated the quick response of the government. Initially, some medical workers and others had suspected the sudden outbreak of the disease as that of dengue, which had caused panic among the medical workers, local people and authorities. The investigation has proved that it was a kind of malaria for which treatment is easily available in Nepal. The local people have also heaved a sigh of relief as the disease is now being controlled due to the efforts of the medical workers. This instance should open up the eyes of the authorities that there must be preparedness to tackle such eventualities.
Although the government has accorded high priority to the health sector, the health status of Nepal is one of the poorest in the world. Thousands of people including children and pregnant women die of diseases which can easily be prevented if medical services were provided in time. However, many people, who are poor and illiterate and live in rural and remote areas, do not have easy access to heath services. They have little knowledge about hygiene and sanitation and other preventive measures. As a result, these people have often been victims of the outbreaks of such diseases. The government has opened up hospitals in all 75 districts, and heath centers and health posts in many villages. However, these hospitals, health centers and health post are of little benefit to the villagers when needed most. It is so because doctors and trained/qualified health workers do not stay in the villages and districts. This was also the case in the villages of Banke district where malaria had broken out. According to the local people, there are health posts, but they are without health workers. Had there been health workers, the people would not have suffered so badly. Thus, measures must be taken so that health workers stay where they have been posted so that people get timely health care services. As the government has adopted the policy of “Health For All?, it must be translated into action. For this, co-operation from every sector is highly needed.
A new story from the Himalayan Times. They are still referring to the sick people as having an unidentified disease that is spreading:
Dozen more fall sick
HNS Rautahat:
An unidentified disease that has spread in Sakhuawa VDC of Rautahat for a week has affected 12 more people.
The outbreak has already claimed the lives of three persons, including two women as of Monday. However, the District Public Health Office has not yet sent doctors and medicines to the affected area.
The patients show symptoms like stomach-ache, headache, high fever and vomiting, said a local, Jaya Ram Yadav. Akhalesh Thakur, a health worker involved in the treatment, said about 50 people had fever and they were given medicine of malaria after collecting their blood samples.
Bump
Any word on Nepal?
Bump
Since the Maoist/Nepal peace agreement a few days ago, news coming from the areas where the illnesses were taking place has dried up. Not a word about how people are doing - not even a positive statement that everything is under control or is getting better.
The lastest I can find on this mysterious illness in Nepal, is 10/31/06, in the Nepalgunj area. “People suddenly catch high fever, start shivering, faint, and then die.” Alertmap has 700 people sick on this date.
I’m not sure if this should go in the India thread or here, but hcw’s in Pakistan are being told to shut up.
Reader – at 04:49 I had read a report from Pakistan a couple of days ago about a “mystery illness” that was almost identical to the one that was being reported in Nepal - then the news reports suddenly stopped. I guess this is why there are no further reports of illness coming out of the area….
Found one more dengue article about Pakistan:
Dengue Fever patients reaches 3530 Wednesday November 08, 2006 (2040 PST)
ISLAMABAD, NOV 8 (Online): The number of Dengue Fever suspected patients has climbed up to the 3530 including 1300 confirmed cases of the virus in different parts of the country. After the confirmation of nine patients in the twin cities, the number of effected patients has reached 179 in Islamabad and Rawalpindi during the last twenty-four hours. According to the statistics given by the ministry of health, in the last twenty-four hours 95 patients were brought to the different hospitals of twin cities over suspicion on dengue fever while 122 more cases were confirmed all over the country .
In twin cities, the situation is also worsening. The death of 35 patients is confirmed on the official level in which 33 patient died of deadly virus in Sindh and 2 in Peshawar.
Reguarding Pakistan, I read this morning that the number of parients is up to 4000. I think it was alert map.
That should have been 4000 dengue patients. Sorry.
doesnt BF make one hemmoroage as well ?..I twas listed on rsoe havaria map, this morning stating that the situation is catastrophic…later most of all the epidemic symbols vanished from the world map, Yesterday there were multitudes of them on the map..something is not right with this
nann- yes I noticed that too. The world map seems to have settled down some, for some reason. I check that map religiously, and notice symbols vanishing at some point during the day.
At this time of year, I don’t know how mosquitos could survive in this part of Pakistan; and biting so many people?
enza – at 20:54 yea, strange.
cottontop at 18:19, found an article on that…
excerpt- “A total of 4,098 patients with symptoms similar to those of dengue fever had been aadmitted to different hospitals across Pakistan till Saturday, said a press release issued by the health ministry.”
The rest is posted here on the Lookout Post for Southern Asia thread.
I remember reading an article a month or more ago regarding dengue in Pakistan. A health official was quoted as saying the weather was cooling and with it mosquito activity and the expectation of decreased dengue cases. If memory serves there was a decline to 9 new cases the previous day which the health official used as proof that the emergency was essentially over.
So, if it isn’t dengue nor malaria, what could it be?
IF in fact there are no new cases then it may in fact have been dengue.
Regrettably if there are progressively more new cases then the news will not get out until it’s useless news- we won’t be told.
That’s called a “pandemic start”
The problem is with this “cold weather dengue” that Enza and Thilina were speaking of. Some parts of India and Pakistan are still warm enough for the mosquitos to flourish - in Karachi it is quite warm, for example. But in Islamabad/Rawalpindi, where there have been continuing new cases of illness with the symptoms of dengue emerging, the weather has been too cold at night for several weeks now for the mosquitos to be flourishing there. There maybe shouldn’t really be “progressively more cases” in that area now, but that’s what we’re still seeing.
It’s been a bit too cool in the Banke district of Nepal lately for mosquitos to flourish, too.
In Karachi the weather is now sunny 27C
In Nepalganj, sunny 30C and in Nepalgunj, sunny 31C
So it still can e dengue or malaria.
It’s the nighttime temperatures that don’t fit. Temps under 19 degrees C are supposed to make life more difficult for the mosquitos, and hinder their reproduction.
Nighttime temps for Nepalgunj for the next 5 days:
12 12 12 12 11 http://tinyurl.com/y8x38s
Nighttime temps for Islamabad/Rawalpindi for the next 5 days:
12 12 14 12 12 http://tinyurl.com/ymsp22
Ah, ok. Any news from Nepal?
This is an article about a Nepalese family confronting rabies in their 8-year-old daughter. The story is long, and very sad, but it really illuminates the uneasy co-existance of Western and traditional medicine in many places in the world.
Thinlina – at 10:38
Nope. There’s been no update on the malaria in Banke district, Nepal, since Nov. 6th when we last heard of the 32 deaths in several villages.
I hope there is someone alive…
Typhoid epidemic
SANKHUWASABHA: Typhoid has pounded Kimaghngwa village development committee of Sankhuwasabha, a bordering VDC to China which is some 50 miles away from the District Headquarters, Khandbari. “The headmaster of a local Mimalaya Primary School, Laya Bhote said there is no stock of medicine in the sub-health post. Bhote said more than 20 people have been seriously affected by typhoid. The disease has broken out since the mid of October. The patients are bound to return without treatment as the health workers deployed have no knowledge to check patients.
How might they have diagnosed it…
This is the thread that makes me queasy.
Mysterious disease kills animals [ 2006–11–17 ]
MOHATTARI, Nov. 16: Many domestic animals are dying at Shantitole, Hattilate of Mohattari due to an unidentified disease.
Talking to the The Rising Nepal, Gyan Bahadur Lama of Shantitole said that two buffaloes had died within a week while another was suffering from the disease.
He said that the symptoms of disease included swelling, bleeding from the skin and lack of appetite. And the animals died within 12 hours it caught of the disease.
He said that many goats and chicken had also died during the last week.
Nimbus – at 11:04 “He said that many goats and chicken had also died during the last week.”
This doesn’t sound good when an illness affects both mammals and birds and seems to be killing them very quickly. I wonder if the dead animals have been tested for any viral or bacterial diseases at this point? I certainly hope the people didn’t eat the dead animals….
It is a place of extreme poverty, so I wouldn’t place bets.
Standard practice is to slaughter sick animals and eat them before they die of natural causes.
It is a place of extreme poverty, so I wouldn’t place bets.
Standard practice is to slaughter sick animals and eat them before they die of natural causes.
Half a dozen health officials transferred
BY SANGEETA RIJAL
KATHMANDU, Nov 16 - Ministry of Health and Population has transferred half a dozen high level health officials. Some have been given additional responsibilities, while a few have been freed from their responsibilities and asked just to be present at the ministry.
Dr Shyam Sundar Mishra, director of National AIDS and STD Control Center who has been charged of distributing about two million rupees to the cadres of Nikshya Shumsher Rana, then health minister who was active in suppressing people’s movement during King’s direct rule, has been freed from his responsibility and has been asked to be present at the ministry.
“Despite my knowledge that a few officials were not good and capable at work I gave them enough time to improve themselves but nothing improved, so I had to transfer them,” said Amik Sherchan, deputy prime and health minister. Rajendra Pant has been appointed as acting director for the center. He was working at the center itself.
Similarly, Nanda Prasad Sharma, director of Health Service Department in the mid region has been transferred to Pokhara Regional Hospital, director of eastern region, Maha Nanda Prasad Mishra has been transferred to the western region and Padam Bahadur Chand of the western region has been transferred to the ministry and Shambu Raman Tiwari has been appointed as director of Management Department.
The ministry with about 32,000 employees having influence up to grassroots level is also about to transfer additional 92 officials, that include regional directors, ministry officials, chief of district health office and department heads, said a source at the ministry.
Three die of severe cold
Himalayan News Service Nawalparasi, November 16:
Three persons living in a camp set up for people displaced by flood in Nawalparasi died of cold yesterday while five others are critically ill.
Those who died of cold are 55 year old Dil Bahadur Pariyar, 50 year old Gohaba Majhi and 65 year old Maliram Majhi of Rajahar VDC 3 Piprahar, said former president of Majhi Musahar Bote Welfare Council Nawalparasi, Amar Bahadur Majhi.
Gunji Majhi, Prem Pariyar, Pabitra Singh Thakuri, Buddhi Bal Rana and Dhan Raj Tharu’s wife have fallen critically sick, he added.
One thousand one hundred fifty eight people of 204 familis of Piprahar and Laugai, who were displaced by the flooding Narayani river, are living in temporary camps.’‘’
Nawalparasi Chief district officer Govinda Khanal said he came about the news through media person and that he would inspect the area tomorrow.
Over dozen dengue cases diagnosed
GULARIYA, Nov 16 - Over a dozen persons in Bardiya district have been diagnosed with the dengue virus.
According to Rishi Kafle, a law practitioner at district headquarters who returned recently after treatment for dengue at Vivekananda Medical College in Lucknow, India, the dengue patients of Bardiya have been receiving treatment at various hospitals in Lucknow and other cities.
Yuvaraj Shrestha, president of Federation of Nepalese Journalists, Bardiya chapter, is among those who returned recently after treatment for the disease.
Kafle said that many other patients, who could not go to India for check-up and treatment, may suffered as they have no access to labs for diagnosis.
Similarly, four persons in Dang were also diagnosed with dengue recently. According to Dr. Bikram Gyawali of Primary Health Center at Tulsipur, the four, who are from Dumrigaun and Baruwagaun, were confirmed suffering from the disease after check-ups Kathmandu.
Meanwhile, a team of technicians from Epidemiology and Disease Control Division, Kathmandu that visited the two villages confirmed the presence of mosquitoes, which are primarily responsible for transmission of the disease from one person to another.
More here: http://www.kantipuronline.com/kolnews.php?&nid=91734
Bardiya and Dang are both on the Nepal/India border.
Typhoid hits Sankhuwasabha
SANKHUWASABHA, Nov. 15: Typhoid has pounded Kimaghngwa VDC of Sankhuwasabha district, a bordering VDC to China which is some 50 miles away from the District Headquarter, Khandbari.
The headmaster of a local Mimalaya Primary School, Laya Bhote said there is no stock of medicine in the sub-health post.
Bhote said more than 20 people have been serious with typhoid. The disease has broken out since the mid of October.
There are only a rural health worker, Pembha Bhote and a peon, Chhobhi Bhote in the Sub-Health Post. They said the patients return without treatment as they have no knowledge to check the patients nor have the capacity to know the medicine.
The people from the affected area have demanded the government send a team of health worker as soon as possible.
Tiger Lily – at 13:21
Three die of severe cold
Himalayan News Service Nawalparasi, November 16:
Three persons living in a camp set up for people displaced by flood in Nawalparasi died of cold yesterday while five others are critically ill.
Ok, pick one. You can’t have people dying of “cold,” while you have mosquitos spreading dengue and malaria, can you? Piprahar is near Nepalgunj, Nepal (to the northwest). http://tinyurl.com/sr8ds
Dang, Nepal, where Nimbus – at 14:06 has found reports of more dengue, is also very near Nepalgunj, about the same distance to the northeast that Piprahar is to the northwest. (About 50 miles, respectively). http://tinyurl.com/y48qu3
Is it hot enough near Nepalgunj for mosquitos to spread tropical diseases, or is it cold enough for people to die of the cold?
Nimbus – at 14:06
Similarly, four persons in Dang were also diagnosed with dengue recently. According to Dr. Bikram Gyawali of Primary Health Center at Tulsipur, the four, who are from Dumrigaun and Baruwagaun, were confirmed suffering from the disease after check-ups Kathmandu.
I find it really interesting that these suspected dengue patients were taken to Kathmandu. That is a long trip, and the city of Nepalgunj, which sports a six-year-old, state-of-the-art, medical university & teaching hospital is only around 50 miles away. Why weren’t they just taken to Nepalgunj?
Pixie – at 14:29
I re-read what Sniffles posted earlier this month on the Nepal I thread. I had forgotten all about it.
Sniffles - at 22:14 (11/02/06)wrote:
This is an editorial from the Kathmandu Post. I posted it in its entirety because cutting parts of it out to post would make it too difficult to read. After I read it, I had more questions than answers:
Dengue threat
By Dr Som P Pudasaini
The dengue virus, which recently threatened India’s West Bengal and Uttar Pradesh states sharing border with Nepal, should have caught Nepal’s attention. Although media had warned of possible dengue onslaughts on the districts bordering Indian states, the government ruled out any threat of dengue virus to Nepal. Unfortunately, the sheer lackadaisical approach has now given the government a wake-up call. In Banke district alone, nine cases of dengue have been confirmed so far. The death toll in Bardiya and other districts has crossed 36 in less than one month. And the number of patients admitted to various hospitals is increasing. The doctors who examined the patients at Nepalgunj Teaching Hospital have also admitted that dengue has now entered Nepal. Some government doctors seem to have been baffled when patients complain of body ache, shivering and sudden unconsciousness.
What is ridiculous is the way the doctors attended a Maoist-organized meeting in Nepalgunj amid the dengue onslaught. Bheri Zonal Hospital in Nepalgunj had virtually no doctors throughout Wednesday. The 12-patients who died of the “unknown” disease at Bheri Zonal Hospital last week certainly shows how the government doctors perform their duty. The doctors of Bheri Zonal Hospital have claimed the disease as “unknown”, while Nepalgunj Teaching Hospital has confirmed it a dengue virus. Is it because the government hospitals have no laboratory to examine the diseases? How could the doctors of Nepalgunj Teaching Hospital confirm it so soon? The diseases cited by the chief of the Epidemiology and Disease Control Division (EDCD) now raise some doubt. The EDCD chief-examined diseases may not be typhoid, Japanese Encephalitis, Falci Farum malaria and anemia, as he claims. Such medical examination may mislead health personnel.
The unknown disease has threatened the VDCs on the bank of the Rapti River. Many patients of Phattepur, Gangapur, Nagaikapur and Hardawai VDCs of Banke and Bardiya districts have been admitted to Indian hospitals across the border. Now the disease has spread to other adjoining VDCs surging in the form of new epidemic. The Ministry of Health has not confirmed yet whether the unknown disease is really dengue, though the government sent-medical teams had collected the blood samples four days ago. The delay in disclosing the details of the disease has claimed more lives and has not helped the patients. Besides, the government also failed to dispatch the medicines and medical teams on time to the unknown disease-hit VDCs. Above all, the Maoists cannot invite doctors forcefully for their meetings. They should realize that patients need doctors more than the “intolerant” Maoists for their gatherings.
the posts from this thread have been transferred to the new forum, they can be found in the Nepal II Diary