The latest country to be affected by H5N1, the human version of avian influenza, is Azerbaijan, where three cases have now become fatal.
Two of the cases were from the south-eastern rayon of Salyan, but occurred in different settlements. The first case was a 17-year-old girl, who died on the 23rd of February, and the second was a 20-year-old woman, who died on 3rd March. Although poultry deaths have been observed in the settlements in recent weeks, the cause of death has not yet been confirmed. The third case occurred in a 21-year-old woman from the central–western province of Tarter, who died on 9th March.
The WHO team, which has been present since February when outbreaks were reported in poultry, is currently investigating the situation in close collaboration with the Ministry of Health. Surveillance and diagnostic capacity has been stepped-up across the country resulting in the detection of additional patients with severe pneumonia, including some fatalities.
The H5N1 strain of avian influenza of the current wave was first identified in Vietnam, Southeast Asia, in December 2004. Recently, however, the spread of the virus has rapidly taken on a heightened speed. It has been reported that 35 countries have so far been affected by avian influenza, nine of which have been affected by the H5N1 strain, which include Vietnam, Thailand, Cambodia, Malaysia, Indonesia, China, Turkey, Iraq and Azerbaijan. The further 26 countries have reported infections in wild birds, poultry and in Germany, in cats and stone martens.
According to ornithologists, the only countries thought to be safe from avian influenza are Australia and New Zealand as they do not lie along the pathways of bird migration.
Bangladesh: poliomyelitis
The Ministry of Health and Family Welfare have reported a single case of polio, the first case to be reported in Bangladesh since August 2000. The virus was confirmed on the 8th of March in a 9-year-old girl from the Chandpur district of Chittagong division.
Genetic sequencing of the virus has revealed it is closely related to viruses from western Uttar Pradesh in India.
The Ministry of Health and Family Welfare recently announced that a nation-wide polio immunization campaign will be initiated on 16 April. Two additional campaigns will follow at 4-week intervals.
Southwest Indian Ocean: chikungunya and dengue
Throughout late February to March 3115 cases of chikungunya have been reported in La Reunion (Fr). Between January and March 2006, 25 patients with symptoms consistent with dengue fever were confirmed by laboratory analysis, 20 of which were suspected of coinfection with chikungunya.
In the same time frame further countries in the Southwest Indian Ocean have reported additional cases of chikungunya. Mayotte reported 2833 suspected cases, Mauritus, 6000 suspected and 1200 confirmed cases, and the Seychelles, 8818 suspected cases. Further cases have been reported in additional European countries in travelers returning from these areas.
Chikungunya, with occasional cases of coinfection with dengue, has been reported in the Andhra Pradesh state, India. Between December 2005 and February 2006, 5671 cases of fever with arthralgia have been reported. Over 2000 cases of chikungunya have been reported in the Maharashtra state, India, while 4904 of cases of fever associated with myalgia and headache have been reported in February and March.
A dengue virus outbreak, initiated in January 2006, has been reported in Toasmasina, Madagascar, with patchy incidence of chikungunya since February. In the Maldives, a further dengue outbreak began in January, with 602 suspected cases reported by the 5th of March.
Chikungunya and dengue viruses are transmitted to humans via infected mosquitoes. Control of the mosquitoes is the only current outbreak control method. This involves removal of their breeding sites, via treatment with insecticides.
A team from the WHO and the Regional Office for Africa has been sent to the Southwest Indian Ocean to assess the current control measures and discuss future strategies. In India a multidisciplinary national team is assisting the local health authorities to improve public health measures, including, control, surveillance and clinical management.
Southern Sudan: cholera
From 28th of January to the 3rd of March 2006, a total of 5634 cases with 127 fatalities of acute watery diarrhea have been reported.
The reported cases have been concentrated in the Yei and Juba towns of southern Sudan. The samples have been laboratory confirmed as containing Vibrio cholerae Inaba. Further reports have been received from the surrounding areas.
In response to these reports, surveillance and case management as well as health education has is now being strengthened.