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Cholera: The Ministry of Health reports that the cholera situation remains the same as reported on 26 November. There is a cumulative total of eight cases and one death. The Ministry also reports that the 15 suspected cases which were hospitalized on 15 November tested negative for vibrio cholerae and were instead caused by food poisoning from staphilococus aureus. GUATEMALA: Cholera: New information received today from the Ministry of Health reports that in Weeks 44, 45 and 46 (1-21 November) 395, 511 y 456 suspected cases of cholera were reported respectively, bringing the total to 1362 suspected cases. During this post-Mitch period, 26 outbreaks of cholera were reported with 17 deaths, a case fatality rate of 1.25%. Leptospirosis: No new information has been received. To date the cumulative total of cases is six, with five confirmed. Dengue:lassic dengue has seen a certain rise in the last weeks, although hemorrahagic dengue has not been reported. Malaria:he situation is reported to be stable although there is a certain rising trend in Ixcan, Petén Sur Occidental and Petén Sur Oriental. NICARAGUA: Cholera: : The Ministry of Health reported that on 26 November, 25 new suspected cases of cholera were reported (7 in Estelí, 5 in Matagalpa, 5 in Masaya, 4 in Madriz, 3 in León and one in Chinandega. The Ministry of Health continues to strengthen basic sanitation measures, health education, and early diagnosis and treatment of cases. It also notes that daily notification rates may vary due to late reporting. Leptospirosis: On 26 November, nine new suspected cases of leptospirosis were reported: seven in Matagala and two in Rivas. The accumulated number of cases to date is 307. They number of deaths remains at seven, a case fatality rate of 2.28%. Dengue: The Ministry of Health reports 24 new suspected cases of classic dengue, 21 of which are in Leon, two in Rivas and one in Chontales. This disease has been denemic in Nicaragua during 1998, and the reported number of cases has risen in the last three weeks. Reported cases of hemorrhagic dengue have occurred in Leon (54 cases), and Chinandega (nine cases). Five deaths have resulted. Malaria: According to information from the Ministry of Health, the situation is stable. HONDURAS: Cholera: Based on daily reporting in shelters, on 26 November the Ministry of Health reported two suspected cases of cholera in Region 6. According to this report, of the total number of suspected cases reported through this information system, only one case has been confirmed by laboratory in Region 3. The total number of confirmed cases countrywide is three. Malaria:Based on daily reporting in shelters, on 25 November 139 new suspected cases of malaria were reported, bringing the cumulative total to 1,700 cases. Regions 4 and 8 report the highest number of reported cases. LeptospirosisOn 26 November two new suspected cases of leptospirosis were reported in the metropolitan area of Tegucigalpa, raising to 16 the cumulative number of cases. Of the 16 suspected cases, six have been confirmed in laboratoriess (all in Region 3) and there has been one death. Dengue: On 26 November, 29 new cases of classic dengue were reported, according to daily notification. To date, the cumulative total is 1,120. The number of cases of hemorrhagic dengue, as reported today, is 12, nine in the metropolitan region and three in Region 3. The eight cases in Region 4 are suspect and still under study. BELIZE: Two new suspected cases of cholera have been reported although there is no further information at the moment. Both cases occurred in Saint Martin Village (Cayo district) and have been hospitalized in Belmopan. All three rivers in the Cayo district on the Guatemala border have reported that water samples tested positive for the cholera virus. These rivers: Tencent Creek near the capital, Roaring Creek, and the Mopan River all originate in Guatemala and cross through Belize. This puts an estimated 90,000 persons who live in 20 towns along the rivers at risk. The cumulative number of cases to date is five, with one death. EPIDEMIOLOGICAL ANALYSIS NOVEMBER 26, 1998 Epidemic activity of cholera remains in the five affected countries. Guatemala has reported increases in the last three weeks and has the highest risk. Epidemic activity of leptospirosis also remains, principally in Nicaragua, with low reporting in Honduras and Guatemala. There is epidemic activity of dengue in Guatemala, Honduras, Nicaragua and El Salvador. Honduras reports cases one death from hemorrhagic dengue. PAHO continues to recognize the efforts made by the affected countries to control the occurrence of epidemics. The cholera situation in Guatemala is the most important epidemiological phenomenon in the subregion at the moment because of the risk it poses not only internally but also to neighboring countries should it spread. Therefore, PAHO reiterates the need to improve the epidemiological surveillance systems with regard to early detection and control of outbreaks that could erupt en any neighboring country. With regard to cholera, PAHO recommends the prevention and control measures mentioned previously:
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