REPORT ON THE EPIDEMIOLOGICAL SITUATION IN CENTRAL AMERICA
|
  |
A Report of the PAHO Emergency Task Force on Hurricane Mitch |
|
|
|
|
Cholera: On 25 November, the Ministry of Public Health reported two new cases of cholera in the department of Santa Ana. These cases had come in contact with a person from Guatemala, previously confirmed with cholera, who was staying with the two recently confirmed cases. Both cases were bacteriologically confirmed (01 Ogawa). Through 25 November, there have been eight cases and one death.
With respect to the outbreak reported on 19 November of 15 suspected cases that were hospitalized, the Ministry of Health reports that they continue under observation, but the test results have been negative.
In addition, the Ministry of Health has taken prevention measures in all cases, and emphasizes the execution of an intensive Communication and Health Education Plan.
GUATEMALA:
Cholera: No new information has been reported after 24 November. During the first weeks following Hurricane Mitch, the number of cases of cholera rose to 736, of which 170 were confirmed. There were three deaths, a case-fatality rate of 0.4%.
Leptospirosis: The Ministry of Health continues to report a total of six cases to date, of which five have been confirmed.
Dengue: No new information has been reported; however the country has been asked to update available information, given the fact that in Week 45 (8-14 November), an increase of more than 200 cases was reported over the previous Week.
Malaria: The country has been requested to provide additional information on this disease and its behavior since Hurricane Mitch struck, given the fact that prior to Mitch, Guatemala was registering a rising trend when compared to 1997.
NICARAGUA:
Cholera: The Ministry of Health has reported 19 new cases of cholera, 10 of which occurred in Managua; four in Matagalpa, two in Masaya; and one in Jinotega. 50% of the reported incidence of cholera is in Managua.
Through Week 45, 25 deaths from cholera were reported, the majority of which occurred along the Atlantic Coast and the Rio San Juan.
The Ministry of Health continues to strengthen basic sanitation measures, health education, and early diagnosis and attention to cases. It continues to note that daily reporting can vary because of late case reporting.
Leptospirosis: From 22 to 25 November, 70 new suspected cases were reported: 22 on November 23; 12 on November 24; and 36 on November 25. Chinandega with 38 cases and Esteli with 18 continue to be the most affected areas. To date, 298 suspected cases have been reported. The laboratory has processed 202 of these samples, and 48 resulted positive (23.8%). Seven people have died from leptospirosis, a case fatality rate of 2.4%.
Dengue: The Ministry of Health reports that dengue has been at an epidemic level during all of 1998, and an increase in reported cases has occurred in the last three weeks. Cases of hemorrhagic dengue have been principally reported in Leon (54 cases) and Chinandega (9 cases). Three people have died: two in Leon and one in Matagalpa.
Malaria: According to information from the Ministry of Health, the situation remains stable.
HONDURAS:
Cholera:There is no change in the situation previously reported. The Ministry of Health had reported 3 confirmed cases of cholera and several suspected cases in Regions 1, 3 and 4. The Ministry has strengthened health education among the population and has stepped up training of health personnel. The plan includes laboratories, epidemiological surveillance, health promotion, sanitation, and case management.
Malaria: Since the emergency began and through 24 November, daily reports based on information collected in shelters indicates 1649 cases of malaria. 54% of the cases are in Regions 3 and 4. No deaths have been reported. The Ministry of Health has reestablished the Weekly Epidemiological Surveillance Reporting System.
Leptospirosis: No new information is available since 24 November. The Ministry of Health reports five cases of leptospirosis. Four people have died. The eppidemiological team made up of national and international specialists is strengthening surveillance and early detection of this disease.
Dengue: Up to 24 November, the Ministry of Health had reported 1,080 cases of classic dengue, 440 of which are in Region 3. To date, 17 suspected cases of hemorrhagic dengue have been reported, of which 8 are under study.
BELIZE:
There is no change in the situation reported on 24 November. To date, five cases of cholera have been confirmed, resulting in one death.
EPIDEMIOLOGICAL ANALYSIS NOVEMBER 26, 1998
The epidemiological situation remains as reported on 24 November.
Epidemic activity of cholera remains in the five affected countries.
Epidemic activity of leptospirosis remains primarily in Nicaragua, with low reporting in Honduras and Guatemala.
Epidemic activity of dengue is in Guatemala, Honduras, Nicaragua and El Salvador. Honduras reports cases and death from hemorrhagic dengue.
PAHO continues to recognize the efforts made by the affected countries to control the occurrence of epidemics. The Organization also reiterates the need to improve the efficiency of epidemiological surveillance systems with regard to early detection, not only in the general population, but particularly in shelters where conditions that favor the transmission and outbreak of infectious diseases that have a potential to cause epidemics, remain present.
PAHO considers that the recommendations put forth in the report of 23 November remain valid, and consequently reiterates the need to set them in motion.
- Cholera:
- Strengthen health control measures, including basic hygiene measures, provision of safe water, and handling and consumption of food from street vendors, among the at-risk population, particularly in shelters.
- Intensify local epidemiological surveillance measures of cholera (active identification of cases) in the affected population.
- Implement social communication campaigns particularly in shelters and among the displaced population and native communities.
- Leptospirosis:
- Strengthen the local capacity to diagnose and quickly treat cases.
- Stimulate community participation in expanding the application of preventive measures and the early detection of suspected cases.
- Step up health surveillance measures, including rodent control.
- Hemorrhagic Dengue:
- Ensure that health authorities have prompt access to suspected cases.
- Intensify health measures to control vectors.
- Strengthen local community participation in the control of breeding sites of mosquitos.