H5N1

Paraguay: Rains trigger disease outbreaks in west

Via teleSUR: Lluvias en región occidental de Paraguay generan brote de enfermedades. [Rains in western Paraguay create outbreak of diseases] Excerpt, with my translation:

El reinició de las lluvias en el ya inundado departamento del Chaco, al occidente de Paraguay, ha generado el brote de una serie de enfermedades gastrointestinales, por lo que las autoridades han comenzado a tratar el agua con productors químicos que permitan asegurar su potabilización e iniciaron una jornada de vacunación masiva contra la influenza, la difteria, tétanos y neumococo. 

The return of the rains in the flooded department of the Chaco, in western Paraguay, has triggered the outbreak of a series of gastrointestinal disease, causing the authorities to begin treating the water with chemical products to ensure it safety. They have also launched a vaccination campaign against influenza, diphtheria, tetanus, and pneumococcus.

El director de Vigilancia de la Salud de Paraguay, Iván Allende, reportó que ya se registran casos de diarrea, mordedura de víboras e insectos. 

Iván Allende, director of Paraguay Health Surveillance, reported that they are now recording cases of diarrhea, snake bites, and insect bites.

Por su parte, la viceministra de Salud, Raquel Escobar, enfatizó que existe un peligro por la aparición del cólera y de otras enfermedades infecciosas. 

Meanwhile Raquel Escobar, the vice-minister of Health, emphasized that there is a danger of cholera and other infectious diseases.

Escobar advirtió que las enfermedades "se pueden disparar en los lugares inundados", por lo que justificó la necesidad de mantener la ya declarada alerta sanitaria.

Escobar warned that the diseases "can explode in flooded areas," and said that made it necessary to maintain the declared health alert.

Dominican Republic: Eight confirmed cholera cases in Tamboril

Via El Caribe: Salud Pública reporta ocho casos de cólera en Tamboril. [Public Health reports eight cholera cases in Tamboril] Excerpt, with my translation:

Salud Pública reportó este sábado ocho casos de cólera en el municipio de Tamboril, Santiago, mientras el Colegio Médico Dominicano asegura que son más los casos. Hasta el momento han fallecido cuatro por personas pro la enfermedad. 

Public Health this Saturday reported eight cases of cholera in the municipality of Tamboril, Santiago, while the Dominican Medical College asserted that there are more cases. So far, four persons have died of the disease.

Algunos afectados en la comunidad del Arenaso confirmaron que las autoridades han estado trabajando en la zona y abogaron por que permanezcan en la zona para evitar otras muertes. 

Some of those affected in the Arenaso community confirmed that the authorities have been working in the area and pleaded that they remain to prevent more deaths.

Las últimas dos víctimas por cólera fueron Juan Rafael Hilario y Ramón María Pichardo, ambos de la comunidad de Canca la Piedra.

The two latest cholera victims were Juan Rafael Hilario and Ramón Msría Pichardo, both from the community of Canca la Piedra.

Meanwhile, a report in El Día quotes the Minister of Public Health, Bautista Rojas Gómez, as saying that the outbreak is under control.

Chile: Cdiff spreading to more hospitals

Via LaTercera.com: Cuatro recintos notifican bacteria que brotó en ex Posta Central. [Four hospitals report bacteria that broke out in former Posta Central] Excerpt, with my translation:

Otros cuatro hospitales del país, en las regiones Quinta y Metropolitana, han notificado al Ministerio de Salud la presencia de pacientes contagiados con la bacteria Clostridium difficile, que se encuentra en condición de brote en la ex Posta Central. 

Another four hospitals in the country, in the Fifth and Metropolitan regions, have notified the Ministry of Health of the presence of patients infected with the Clostridium difficile bacteria, which has broken out in the former Posta Central.

La directora del Servicio de Salud Viña del Mar-Quillota, Margarita Estefan, indicó que en la zona existen dos recintos donde se ha debido aislar a pacientes para evitar la propagación de la bacteria. Un caso afecta al Hospital de Peñablanca, donde actualmente hay seis pacientes contagiados. Algo similar ocurre en el Hospital Gustavo Fricke, donde la infección afecta a entre 12 y 15 pacientes. 

Margarita Estefan, Director of Viña del Mar-Quillota Health Services, said that in the region two hospitals have had to isolate patients to stop the spread of the bacteria. One case affects Peñablanca Hospital, where six patients are currently infected. Something similar has occurred in Gustavo Fricke Hospital, where the infection has affected 12 to 15 patients.

Estefan, sin embargo, explicó que en ambos recintos los contagios corresponden a la tasa habitual de infección intrahospitalaria por acción de la bacteria, debido a que se trata de hospitales de alta complejidad. “No hay alarma ni tenemos brote. No hay algo más allá de lo que sabemos que tenemos normalmente (...) esta bacteria está en hospitales del mundo entero y se da donde tenemos pacientes complejos e inmunodeprimidos”, dijo Estefan. 

Nevertheless, Estefam said that in both hospitals the cases reflect the usual intrahospital rate of bacterial infection, since these are highly complex hospitals. "There's no alarm and we don't have an outbreak," she said. "There's nothing there more than we're used to having. ... this bacteria is in hospitals around the world, and we see it where we have patients with complex conditions and immune deficiencies."

En la Región Metropolitana, los hospitales San Juan de Dios y San Borja Arriarán también han notificado contagios, según confirmó Ricardo Bustamante, el médico del equipo de control de infecciones del Minsal, quien descartó que exista un brote en estos recintos. “Ellos notificaron una variación de casos (de contagio)”, precisó Bustamante. 

In the Metropolitan Region, San Juan de Dios and San Borja Arriarán hospitals have also reported cases, according to Ricardo Bustamante, a doctor in the Ministry's infection-control team. He dismissed the idea that those hospitals have an outbreak. "They reported a variation in (infection) cases," Bustamante said.

A estos casos se suma la denuncia que hizo ante el Ministerio de Salud un grupo de médicos del Instituto Nacional del Tórax, acusando que en diciembre pasado se produjo un brote de aspergilosis -enfermedad producida por gérmenes- en cuatro pacientes trasplantados de pulmón y que no habría sido notificado. En el recinto se informó que el caso no correspondería a un brote.

These cases can be added to the denunciation made to the Ministry of Health by a group of doctors from the National Thorax Institute, charging that last December an outbreak of aspergillosis—a disease caused by germs—in four lung-transplant patients was not reported. The hospital said that the case did not correspond to an outbreak.

Ecuador: Climate will increase dengue statistics

Via El Universo: Cifras de dengue se dispararían por clima. [Climate will increase dengue statistics] Excerpt, with my translation:

Debido a la rigurosidad de la temporada invernal, el Ministerio de Salud advierte que para las próximas semanas se espera que se presenten condiciones extraordinarias favorables para la transmisión del dengue, porque este año las lluvias superaron los promedios esperados. 

Owing to the rigor of the winter season, the Ministry of Health warns that the next few weeks will present extraordinarily favourable conditions for dengue transmission, since rainfall exceeded the expected average.

En 15 semanas epidemiológicas de este año se cuantifican 5.066 casos del tipo clásico y en igual periodo del 2011 fueron 1.533, lo que indica que la cifra aumentó más del triple. Mientras, la cantidad de casos del hemorrágico (denominado grave por las autoridades), en 15 semanas de este año suman 81 y en el mismo lapso del 2011 hubo 20, por lo que la cifra se cuadriplicó. 

In this year's 15 epidemiological weeks, 5,066 classic dengue cases have been recorded. In the same period in 2011 there were 1,533, showing that cases have more than tripled. Meanwhile, the number of severe dengue cases has been 81 this year, quadruple the 20 recorded in the same period last year.

Por otra parte, en el mismo periodo del año pasado solo se registraba un muerto por dengue hemorrágico, mientras que hasta ahora el Ministerio enumera siete víctimas: 3 en Guayas y 4 en Manabí, pero no considera al menor fallecido en Santo Domingo la semana pasada. Ya serían 8 los muertos.

As well, in the same period last year only one death from severe dengue was recorded, while this year the Ministry has counted seven victims: three in Guayas and four in Manabí, but it has not yet counted the child who died in Santo Domingo last week. That would make eight deaths.

Dominican Republic: Four die with cholera symptoms in three days

Via Hoy Digital, more on the outbreak: Cuatro personas  fallecen con síntomas de cólera en tres días. Excerpt, with my translation:

TAMBORIL, SANTIAGO. Un anciano de 76 años, residente en el barrio Los Apontes,  se convirtió en la cuarta persona que en los últimos tres días muere al presentar síntomas asociados al cólera. 

An old man of 76, resident of Los Apontes neighbourhood, has become the fourth person in three days to die with symptoms of cholera.

El fallecido es Ramón Antonio Pichardo, quien falleció a las 8:00 de la noche del jueves en su casa, después de presentar diarrea y vómitos. 

The dead man is Ramón Antonio Pichardo, who died at 8:00 pm Thursday in his house, after suffering diarrhea and vomiting.

El deceso se produjo a menos de 24 horas de que al fallecido le iniciaran los síntomas. 

The death occurred less than 24 hours after symptoms began.

De acuerdo con Filiberto Martínez, vecino de la víctima, Pichardo vivía solo y no fue llevado a ningún centro asistencial. 

According to Filiberto Martínez, a neighbour of the victim, Pichardo lived alone and was not taken to any help centre.

Martínez se quejó de que fue pasadas las 10:00 de la mañana de ayer cuando se presentaron a la comunidad representantes de Salud Pública y  que fueron los vecinos quienes debieron dar la asistencia al enfermo. 

Martínez complained that it was after 10:00 am yesterday when Public Health representatives arrived; he said they were the neighbours who should have helped the sick man.

Otras personas residentes en esta localidad presentan los mismos síntomas, incluida una hija del fallecido. 

Other persons living in the locality are presenting the same symptoms, including a daughter of the dead man.

El temor se ha apoderado de la población y se ve a muchas personas usando “tapabocas” y desinfectantes para las manos, como medida de prevención. 

Fear has empowered the population, and many people can be seen using masks and hand disinfectants as measures of prevention.

Las ambulancias permanecieron casi todo el día  transportando a afectados de diarrea a los centros de salud.

Ambulances were active almost all day, carrying diarrhea patients to health centres.

Nepal: False alarm over suspected B2B H5N1

Via The Himalayan Times: No bird flu in Saptari‚ it was CRD.

RAJBIRAJ: Officials have confirmed that death of a large number of chicks at Phattepur in Saptari district was not because of bird flu. 

Senior Livestock Doctor at District Livestock Service Office, Kashinath Yadav, said the fowls died of chronic respiratory disease (CRD), not due to bird flu. 

Farmers and locals at the area were terrorized fearing bird flu after over 100 chicks died within five days at a poultry farm of local Sagamlal Chaudhary.

Chile: C. difficile becomes a big political issue

Via LaSegunda.com, a nosocomial infection has turned into a political dispute: Médicos y Salud se enfrentan por brote de bacteria en la Posta: Piden exhumar a Zamudio. [Doctors and Health confront each other over bacterial outbreak in Posta; call to exhume Zamudio] Excerpt, with my translation:

Una fuerte polémica  luego de que los diputados José Luis Castro (PS) y Marco Antonio Núñez (PPD) denunciaran que la Posta Central y otros dos hospitales (San Juan de Dios y San Borja Arriarán) están afectados por brotes de la potencialmente mortal bacteria Clostridium difficile, conocida también como "la bacteria asesina". 

Two deputies, José Luis Castro (PS) and Marco Antonio Nuñez (PPD), have triggered a major controversy. They claim that Posta Central and two other hospitals (San Juan de Dios and San Borja Arriarán) are affected by outbreaks of the potentially lethal bacteria Clostridium difficile, also known as the "killer bacteria."

Con un certificado médico en mano, demostraron que Daniel Zamudio -el joven gay fallecido el 27 de marzo en la Posta tras una golpiza- tenía la clostridium en su cuerpo. De inmediato el abogado de los supuestos victimarios anunció que pedirá exhumar el cuerpo, pretendiendo comprobar que el ataque de sus defendidos no fue el que causó la muerte del muchacho. 

With a medical certificate in hand, they showed that Daniel Zamudo—the young gay man who died in the Posta on March 27 after a beating—had C. difficile in his body. Immediately the lawyer for his attackers announced he would ask for the body to be exhumed, in the hope of proving that the attack by his clients was not the cause of the boy's death.

La situación ha enfrentado a médicos del recinto que aseguran la masividad del brote y autoridades del Ministerio de Salud que sostienen que la situación está controlada. La primera denuncia sobre el brote de la bacteria fue hecha anoche por un grupo de facultativos que dijo que desde julio de 2011 al menos 36 pacientes han muerto infectados por este germen, mientras que otros 186 también se han visto afectados por la Clostridium difficile.

The situation has pitted the hospital's doctors, who confirm the massiveness of the outbreak, against the Ministry of Health, which insists that the situation is under control. The first denunciation over the bacterial outbreak was made last night by a group of doctors who said that since July 2011 at least 36 patients have died infected by this germ, while another 186 have also been infected by Clostridium difficile.

Xinhua has more details on the issue. I gather the two politicians who protested about the outbreak are also doctors, and government spokesman Andrés Chadwick thinks they've behaved very irresponsibly. 

Dominican Republic: Now at least 4 deaths in new cholera outbreak

Hoy Digital today has several stories about the cholera outbreak in Santiago province. Here's the most recent: Colegio Médico afirma cólera es una realidad en Santiago. [Medical College affirms that cholera is a reality in Santiago] Excerpt, with my translation:

El Colegio Médico Dominicano manifestó hoy su preocupación por la situación que vive Tamboril y otras zonas de Santiago donde se originó un brote de cólera que ha causado la muerte a, por lo menos cuatros personas, aunque las autoridades solo han confirmado una. 

The Dominican Medical College today expressed its concern about the situation in Tamboril and other regions of Santiago where an outbreak of cholera has caused the deaths of at least four persons, though the authorities have confirmed only one.

De acuerdo con la entidad profesional, unas 300 personas han tenido que recibir asistencia en diferentes centros de salud al presentar sintomatología asociada a la enfermedad. 

According to the College, some 300 persons have required help in different health centres after presenting symptoms associated with the disease.

Detalló el CMD que en una visita realizada ayer a Santiago contactó que en el hospital de Tamboril había 22 internos, tres niños y 22 adultos presentando síntomas de la enfermedad. 

The DMC said that in a visit yesterday to Santiago it learned that the Tamboril hospital had three children and 22 adults with cholera symptoms.

En el Centro Médico del Cibao los internos con similares síntomas eran 17, de los cuales los análisis de laboratorio habían confirmado la enfermedad. 

The Cibao Medical Centre has 17 patients with similar symptoms whose laboratory tests have confirmed the disease.

En la Clínica Unión Médica de la “Ciudad Corazón”, según el Colegio Médico, hay 22 ingresados, dos de ellos en cuidados intensivos. De estos 17 están confirmados como cólera, aseguran los galenos. 

In the Ciudad Corazón Medical Union Clinic, the College says there are 22 patients, two of them in intensive care. Of these, the doctors say 17 are confirmed cholera cases.

Otros centros con personas ingresadas que presentan los síntomas de la enfermedad son el Hospital Regional José María Cabral y Báez con nueve y el del Seguro Médico para Maestros (Semma) con seis.

Other centres with patients presenting symptoms of the disease are the José María Cabral y Báez Hospital, with nine, and Teachers' Medical Security with six.

If this is a consequence of the current rainy season in Hispaniola, we can assume that cholera is spreading again in Haiti.

Brazil: Severe dengue cases double in Alagoas

Via Gazetaweb.com: Dobram casos graves de dengue em Alagoas. [Severe dengue cases double in Alagoas] Excerpt, with my translation:

Foram 88 casos notificados entre os meses de janeiro e abril de 2011 e, agora em 2012, levando-se em consideração o mesmo período, a quantidade de pessoas que está sendo investigadas com suspeita de ter sido infectada pela forma mais grave da doença, já chega a 153. Essa realidade está preocupando o Estado e, por isso, já na próxima segunda-feira (23), uma reunião vai reunir a Secretaria de Estado da Saúde (Sesau) e gestores de dezenas de cidades do interior. 

Between January and April 2011 88 severe dengue cases were reported; in the same period this year, the number of persons with suspected severe dengue has now reached 153. This reality worries the state, and for this reason a meeting has been called for Monday the 23rd between the State Secretariat of Health and managers from dozens of cities in the interior.

De acordo com a Superintendência de Vigilância Epidemiológica da Sesau, Alagoas já registrou, só nos quatro primeiros meses deste ano, 4.505 casos de dengue. Em 2011, foram 4.426 nesse mesmo lapso temporal, ou seja, houve um acréscimo de cercade 6% de forma geral. Entretanto, a informação que está ‘tirando o sono’ dos gestores púbicos é o número de casos considerados mais graves, cujos sintomas debilitam, ainda mais, as vítimas. 

According to the Superintendent of Epidemiological Surveillance, Alagoas has already recorded 4,505 dengue cases so far this year. In 2011 there were 4,426 in the same period, so cases have grown by 6 per cent. Meanwhile, public managers are saying that the number of cases considered more severe is growing.

“Quase dobrou a quantidade que, saltou, de 88 para 153 entre janeiro e abril. São pacientes que apresentaram complicações, a exemplo de sangramentos na gengiva, no nariz , na conjuntiva do olho, nas fezes, na membrana do pulmão, que tiveram sequentes quedas de pressão, que precisaram de internamento ou que foram acometidos por crises frequentes de vômito e dores abdominais”, explicou Sandra Canuto, superintendente da Vigilância.

Sandra Canuto, superintendent of Surveillance, said: "The number of cases almost doubled, from 88 to 153 between January and April. There are patients who present with complications. For example, bleeding from the gums, the nose, the eyes, in feces, in the lungs with a drop in pressure, all requiring hospitalization, or who suffered frequent crises of vomiting and abdominal pains."

CIDRAP: Flu news scan for April 20

Via CIDRAP: FLU NEWS SCAN: H1N1 in babies, vaccination in pregnant women, H5N1 in Bhutan, estimating pandemic mortality. Click through for all the reports and links to sources. Excerpt:

The World Health Organization (WHO) is working on a preliminary global mortality estimate for the 2009 H1N1 pandemic, and it recently posted an update on the work of a technical expert group that is in the early stages of gauging the impact. 

Two teams are working with the WHO to produce independent estimates with different methods, one from the US Centers for Disease Control and Prevention and one from the Netherlands Institute for Health Services Research. A technical committee that is overseeing the groups' work met in late October to review preliminary results and give feedback on the modeling processes. 

The WHO has said the number of confirmed 2009 H1N1 pandemic deaths is a gross underestimate, for several reasons. It said better estimates of the cases and deaths are needed to better understand the impact of the pandemic and how it measures up historically. 

"While the data for a definitive estimate of mortality will likely not exist for several years, and will never exist for some parts of the world, a preliminary estimate would be useful in the short term, and would serve to give a more realistic understanding of the true impact of the event than currently available reported mortality figures," the WHO said. 

Initial work presented at the October meeting was based on limited data from industrialized countries. As the next step, more countries, including some middle- and low-income countries, will provide data for the project this year, which should help the two groups further refine their estimates by the end of the year.