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Folder 2011

Documents

pdf 1 March 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

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Durante la semana epidemiológica 6 del 2011, Haití registró un descenso en la tasa de incidencia semanal a nivel nacional, la cual pasó de 11,4 a 5,1 casos de cólera por 10.000 habitantes. Esto correspondió a un incremento de 2,2% en el registro de casos nuevos con respecto a la semana anterior.  A nivel sub-nacional, dos departamentos aumentaron su tasa de incidencia semanal (Centre y Grand Anse). La tasa de letalidad hospitalaria a nivel nacional durante la semana epidemiológica 6 del 2011 fue de 1,3% mientras que la tasa de letalidad global para el mismo periodo fue de 1,9%.

Mientras tanto, en República Dominicana el Ministerio de Salud Pública informó que desde el inicio del brote hasta la SE 6 del 2011 fueron confirmados por laboratorio 426 casos, incluidas tres  defunciones.

pdf 11 January 2011: Cholera – situation in Haiti and Dominican Republic – update  Published Popular

3480 downloads

Epidemiological AlertsIn Haiti, during this 52nd epidemiological week, there has been a decrease in the incidence rate in two departments in the north and a turn in the departments in the south. While Dominican Republic, registered 154 cases of cholera distributed in 13 of the 31 provinces of the country; 66.9% of the cases were hospitalized.

pdf 15 July 2011: Multi-Resistant Neisseria gonorrhoeae – situation in the Americas  Published Popular

3179 downloads

Epidemiological Alerts In light of the identification by scientific communities of a strain of gonorrhea resistant to all microbial treatments available for sexually transmitted infections (STIs), the Pan American Health Organization recommends informing health workers, institutions, and nongovernmental organizations that work in the prevention and control of STIs about the risk of resistance in this strain, and in particular strengthen the surveillance in each country regarding the appearance of strains with an unusual profile. The Organization also recommends promoting the use of STI prevention methods.

pdf 17 February 2011: Dengue - situation in the Americas – update  Published Popular

3512 downloads

Epidemiological AlertsThrough this epidemiological alert the Pan American Health Organization is reporting the current dengue situation in the Region and recommending to its Member States to continue and reinforce the actions of prevention and control that involve all government actors and/or non guvernamental and above all, the community.

pdf 17 March 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3083 downloads

Epidemiological Alerts During Epidemiological Week 8 of 2011, at the national level, Haiti registered a decrease in the weekly incidence rate, which decreased from 10.2 cholera cases per 10,000 inhabitants in EW 7 to 7.6 cases per 10,000 inhabitants in EW 8. This was linked to an increase of 3.1% in the new cases registered as compared to the previous week. At the sub-national level, five departments (Grand Anse, Nord Est, Nord Ouest, Sud Este y Nord) registered an increase in their weekly incidence rate.

While in the Dominican Republic, the Ministry of Health reported a total of 759 laboratory-confirmed cases of cholera, including six fatal cases, since the beginning of the outbreak up to EW 9.

pdf 18 January 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3615 downloads

Epidemiological AlertsIn Haiti, during the first EW of 2011 a decrease of 47% in the national incidence rate in comparison to previous week was reported. While in Dominican Republic the Ministry of Public Health informed that in the first week of the 2011 8 new cases were confirmed, raising the cumulative incidence to 160 cases. No deaths have been reported.

pdf 18 March 2011: Dengue – situation in the Americas – update  Published Popular

3600 downloads

Epidemiological AlertsThe high activity of dengue during the first trimester of 2011 in several countries in the southern hemisphere in the Region of the Americas has necessitated the rapid implementation of management plans on both the local and national levels. This allows for an opportunity to reiterate the importance of the Integrated Management Strategy for the prevention and control of dengue (IMS-Dengue). Up to Epidemiological Week (EW) 9 of 2011, a total of 50,617 cases in the Region of the Americas have been reported, including 1,153 cases of severe dengue and 58 fatalities.

pdf 19 August 2011: Dengue in the Americas – update EW 31  Published Popular

3123 downloads

Epidemiological AlertsThe purpose of this alert is to provide an update on the 2011 dengue situation in the Region and to call upon national authorities from the countries which at the beginning of this year's second semester could be in a greater risk of dengue (Central America, Mexico and the Caribbean) to prepare their integrated response mechanisms to prevent deaths from dengue.

As of epidemiological week (EW) 31 of 2011, a total of 890,756 dengue cases, including 10,840 severe dengue cases and 488 dengue caused deaths, had been reported in the Region of the Americas.

pdf 2 February 2011: Dengue – situation in the Americas – Update  Published Popular

3654 downloads

Epidemiological AlertsThrough this epidemiological alert the Pan American Health Organization is reporting the current dengue situation in the Region and recommending to its Member States to continue and reinforce the actions of prevention and control that involve all government actors and/or non gubernamental and above all, the community.

pdf 20 April 2011: Influenza A(H1N1) 2009 – probable outbreaks – situation in the Americas  Published Popular

5516 downloads

Epidemiological AlertsSince the beginning of 2011, in the region of the Americas, there have been significant outbreaks of influenza A (H1N1) 2009, that while geographically limited, have generated a significant demand on health services. This situation is not unexpected. Since the end of the pandemic (2009-2010), the influenza A (H1N1) 2009 virus, continues to circulate on a global level like a seasonal strain, periodically causing important outbreaks in various continents. Considering the possibility of outbreaks occurring on account of the influenza A (H1N1) 2009 virus in the countries of the Region, national authorities should be prepared to mitigate the resulting impact.

pdf 20 May 2011: Cholera – situation in Haiti and Dominican Republic – update  Published Popular

3301 downloads

Epidemiological AlertsIn Haiti, since the beginning of the cholera outbreak, starting epidemiological week (EW) 42 in 2010, until May 10th, 2011, the MSPP registered a total of 302,401 cholera cases of which 53.8% (162,651) required hospitalization and 1.7% (5,234) died (global case-fatality rate). Since EW 19 an increase in the number of new hospitalizations is observed in comparison with previous weeks, especially in the South-East and North-West departments and in the capital city, Port-au-Prince. Additionally, Artibonite and Centre continue to report new cases.

Since epidemiological week (EW) 16, the Dominican Republic's surveillance system is registering an increase in the number of suspected cases of cholera, principally in the peripheral area of Santo Domingo, near the river Ozama and Isabela. The increase of cases in Santo Domingo concurs with a raise in the temperature and frequency of rains, which originated flooding in different areas of Santo Domingo.

pdf 22 December 2011 Human rabies transmitted by wildlife  Published Popular

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Epidemiological AlertsIn the last years, human rabies transmitted by bats has resurfaced as a public health problem in the Americas.During 2011, events of human rabies transmitted by bats were reported in Ecuador and Peru and bats infected with rabies virus were detected in Argentina, Brazil, Chile, Cuba, Costa Rica and Honduras. Additionally, cases of human rabies transmitted by dogs were reported in Bolivia, Brazil, Guatemala, Haiti and Peru. As such, the Pan American Health Organization/World Health Organization (PAHO/WHO) reiterates the recommendations made through the 30 August 2010 Epidemiological Alert, concerning prevention and control strategies.

pdf 22 June 2011: Cholera – situation in Haiti and the Dominican Republic – Update  Published Popular

2784 downloads

Epidemiological AlertsIn Haiti, the Ministry of Public Health and Population (MSPP) case surveillance system reported that as of EW 19 there was an increase in the number of new cholera cases and new hospitalizations in Port-au-Prince and in the Centre and Sud Est departments. For EW 22 and 23, five other departments (Arbonite, Grand Anse, Nippes, Nord and Ouest) experienced an increase in the number of new cases and new hospitalizations. This increase coincides with the start of the rainy season in Haiti.

In Dominican Republic, the Ministry of Public Health reported that since the beginning of the outbreak up to EW 23 of 2011 there were 1,727 confirmed cases (191 in 2010 and 1,536 in 2011), including 46 deaths. The municipalities of Santa Domingo Este and Oeste, Distrito Nacional, San Pedro de Macoris, Santiago and San Cristóbal registered the highest rates of cholera transmission in the past two weeks.

pdf 22 November 2011 Carbapenemases of type New Delhi Metallo-β-lactamase (NDM)  Published Popular

3207 downloads

Epidemiological Alerts Due to the recent finding of carbapenemasas of New Delhi metalobetalactamasa (NDM) type in isolations of Klebsiella pneumoniae in Guatemala, the Pan American Health Organization/World Health Organization (PAHO/WHO) emphasizes the importance of the surveillance and detection in the Region of this resistance mechanism that increases morbidity and mortality of the infections associated with health care.

pdf 22 September 2011 Poliomyelitis due to wild poliovirus  Published Popular

2695 downloads

pdf 23 February 2011: Cholera – situation in Haiti and Dominican Republic – update  Published Popular

3305 downloads

Epidemiological AlertsDuring the epidemiological week 5 of 2011, at national level, Haiti registered an increase in the weekly incidence rate, which went from 8.1 cholera cases per 10,000 inhabitants in EW 4 to 11.4 cases per 10,000 inhabitants in EW 5. This was linked which is an increase of 5.2 % in the new case registered when compared to the previous week. At subnational level, three departments registered an increase in their weekly incidence rate (Nord, Nord Est and Ouest).

While in Dominican Republic, the Ministry of Health reported a total of 380 laboratory-confirmed cases of cholera and three deaths from the beginning of the outbreak to EW 5.

pdf 25 November 2011: Influenza Like Illness – recommendations  Published Popular

3296 downloads

Epidemiological AlertsOn 22 November, the United States of America - International Health Regulation National Focal Point reported a cluster of influenza like illness cases among three children. Rapid influenza diagnostic tests performed were positive for influenza A. Molecular testing confirmed an influenza triple reassortant (influenza A (H3N2) (SOtrH3N2)) virus, and genomic sequencing confirmed they were S-OtrH3N2 viruses with the M segment gene from the pH1N1 virus. In this regard, the Pan American Health Organization/World Health Organization (PAHO/WHO) would like to stress to its Member States the importance of the recommendations specified in the PAHO-CDC Generic Protocol for Influenza Surveillance.

pdf 26 January 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3586 downloads

Epidemiological AlertsIn Haiti, during the second EW of 2011 and for the third consecutive week, Haiti has registered a decrease in the weekly incidence rate at the national level. It decreased from 24.1 to 12.7 and to currently 10.1 cholera cases per 10,000 inhabitants. Three departments located in the north of the country, increased their weekly incidence rate (Nord, Nord Est, and Artibonite). At the national level, the in-hospital case fatality rate for week 2 of 2011 stayed at 1.3%. Very similar to the previous week which was 1.2%.

While in the Dominican Republic, the Ministry of Public Health reported the first death caused by cholera in the province of Altagracia. Since the beginning of the outbreak in SE 45 of 2010 and as of to SE 2 of 2011 there were 244 laboratory confirmed cases.

pdf 26 July 2011: Cholera – situation in Haiti and the Dominican Republic – update  Published Popular

2623 downloads

Epidemiological AlertsIn Haiti, the national number of cases and hospitalizations has decreased in the past three weeks, following the increase which occurred between EW 20 and 25. At the local level two departments, Nord and Nord Ouest, recorded an increase in the number of new cholera cases and new hospitalizations since EW 22. Meanwhile, Port-au-Prince and the Centre, Grand Anse and Nippes departments which had recorded an increase in cases between EW 22 and 23, have recorded a decline for the past three weeks.

While in Dominican Republic, the Ministry of Public Health reported that since the beginning of the outbreak up to EW 29 of 2011 they recorded a total of 13,200 suspected cholera cases and confirmed 87 deaths due to cholera. The Distrito Nacional and the provinces of Elías Piña, San Cristóbal, San Juan, San Pedro de Macoris, Santiago and Santo Domingo Este and Oueste registered the highest rates of cholera transmission.

pdf 28 April 2011: Measles or Rubella – recommendations to the travelers  Published Popular

3590 downloads

Epidemiological AlertsPAHO also recommends that any resident of the Americas planning to travel to other regions of the world should be protected against measles and rubella prior to departing on their trip. Travelers who have not been vaccinated against measles and rubella are at risk of contracting these diseases when visiting countries where the viruses are currently circulating. Special efforts should be made to ensure vaccination for women of childbearing age in order to prevent possible infections caused by the rubella virus during pregnancy.

pdf 28 June 2011: Haemolytic Uraemic Syndrome (HUS) and infection by Enterohaemorrhagic E. coli (EHEC) – situation  Published Popular

3158 downloads

Epidemiological AlertsSince epidemiological week 23, the number of new HUS and non-HUS STEC cases has declined significantly in the European Union states. Nevertheless, the cumulative number of cases from Germany continues to rise, primarily owing to delays in notification. Investigations conducted by the German authorities indicate that the vehicle of the bacterium responsible for the outbreak, is bean and seed sprouts.

On 24 June, France reported a cluster of 8 cases, all adults (six women and two men) presenting bloody diarrhea; of which seven have developed HUS. E. coli O104:H4 has been confirmed in three patients. Preliminary investigative findings suggest that locally grown sprouts might be involved.

In the Americas Region, a total of nine E. coli O104:H4 STEC cases have been identified, of which six cases are confirmed (five in the United States and one in Canada).

pdf 28 October 2011: Dengue – situation in the Americas  Published Popular

2730 downloads

Epidemiological AlertsDengue and severe dengue pose a public health problem in the tropical and subtropical areas of the Region of the Americas. During 2011, Member States reported 979,774 cases of dengue, of which 15,860 presented serious forms requiring hospitalization and 692 deaths. Historical data on the number of cases and deaths registered was surpassed this year with dengue outbreaks in Paraguay, Panama and in the countries and in the non-Hispanic Caribbean, such as Aruba, the Bahamas, and Saint Lucia. The introduction of Dengue 4 was also observed in Panama and in some states of Brazil where it had not previously circulated.

In light of this situation, the Pan American Health Organization/World Health Organization (PAHO/WHO) reminds Member States, especially those located in the southern hemisphere of the recommendations to reduce morbidity, fatality and the social and economic burden generated by dengue outbreaks and epidemics.

pdf 3 January 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3442 downloads

pdf 3 June 2011: Haemolytic Uraemic Syndrome (HUS) and infection by Enterohaemorrhagic E. coli (EHEC) – situation  Published Popular

2964 downloads

Epidemiological AlertsHaemolytic uraemic syndrome (HUS): It is a life-threatening disease characterized by acute renal failure (uraemia), haemolytic anaemia, and a low platelet count (thrombocytopenia). It results from EHEC infection, and it is estimated that up to 10% of EHEC-affected patients may develop HUS. The mortality rate has decreased during the last few years and with appropriate treatment is between the 3% and 5%.

It can cause neurological complications (such as seizure, stroke and coma) in 25% of HUS patients and chronic renal sequelae, usually mild, in around 50% of survivors. EHEC or STEC is a severe strain of E. coli bacterium that is commonly found in the gut of animals, mainly ruminants. EHEC produces toxins, known as verotoxins or Shiga-like toxins because of their similarity to the toxins produced by Shigella dysenteriae. They can cause severe foodborne disease. STEC is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products and raw milk, contaminated water, direct contact with animals or contact with infected people. Symptoms of disease include abdominal cramps and diarrhoea, which may be bloody. Fever and vomiting may also occur.

pdf 3 October 2011: Poliomyelitis due to wild polio virus – response protocol  Published Popular

2907 downloads

Epidemiological Alerts The Protocol for responding to imported cases of poliomyelitis due to wild poliovirus has the following objective: Prevent the occurrence of national poliomyelitis epidemics caused by the importation of wild polio virus, prevent the outbreak from spreading among countries in the Americas and prevent renewed circulation of wild polio virus in any country that experiences an imported case.

pdf 31 January 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3369 downloads

Epidemiological AlertsIn Haiti,during the third EW of 2011 Haiti registered an increase in the weekly incidence rate at the national level, which went from 10.1 cholera cases per 10,000 inhabitants in EW 2 to 13.6 cases per 10,000 inhabitants in EW 3, which is an increase of 6.9% in the new case registrered when compared to the previous week. Of all the departments, six, increased their weekly incidence rate (Centre, Ouest, Nippes, Sud Est, Nord-Est, and Nord-Ouest) and four showed a decrease (Artibonite, Grande Anse, Nord and Sud). The hospitalization case fatality rate at the national level in EW 3 of 2011 was 1.5%, two decimals above the previous week.

While in the Dominican Republic, the Ministry of Public Health informed that since the beginning of the outbreak in EW 45 of 2010 to EW 2 of 2011, there were 263 cases confirmed by laboratory and one death that happened in EW 2.

pdf 7 June 2011: Cholera – situation in Haiti and the Dominican Republic – update  Published Popular

2909 downloads

Epidemiological AlertsIn Haiti, the Haitian Ministry of Public Health and Population (MSPP) case surveillance system eported that as of EW 19 there was an increase in the number of hospitalized patients in Port-au-Prince and the Centre department. This increase coincides with the beginning of the rainy season in Haiti.

While in Dominican Republic, the Ministry of Public Health informs that since the beginning of the outbreak up to EW 20 of 2011 there were 1,329 laboratory confirmed cases (191 in 2010 and 1,138 in 2011), including 27 deaths. The Distrito Nacional and the provinces of Santiago, San Pedro de Macorís, La Romano and the border provinces of Independencia and Elías Piña also registered an increase in cases with respect to the previous weeks.

pdf 7 June 2011: Haemolytic Uraemic Syndrome (HUS) and infection by Enterohaemorrhagic E. coli (EHEC) – situation  Published Popular

3153 downloads

Epidemiological AlertsDeveloped by the Robert Koch Institute to be applied to HUS-cases associated with the 2011 Germany outbreak.

HUS Clinical criteria: A clinical picture of acute enteropathogenic HUS is defined by the presence of at least two of the following three criteria:
1. Hemolytic anemia
2. Thrombocytopenia ? 150,000 cells/mm3,
3. Renal dysfunction

Laboratory confirmed cases: Positive result in at least one of the following tests:

Detection of Shigatoxin

  1. Culture of the pathogen and isolation only from stool AND detection of Shigatoxin Stx2 using ELISA on the E. coli culture,
  2. Mixed culture of the pathogen, enriched stool cultures or isolation of E. coli AND nucleic acid amplification test (e.g. PCR) for detection of the shigatoxin gene stx2 from the same sample

Indirect (serological) detection

  1. Detection of ant-LPS-IgM-antibodies against E.coli Serogroups (once markedly increased titre/concentration, e.g., using ELISA, Western Blot)
  2. Marked change between two consecutive samples in titreconcentrarion of anti-LPS-IgG-antibodies against E.coli serogroups e.g.; using ELISA)

Suspect HUS case: Case with a clinical picture of acute enteropahogenic HUS as assessed by the attending physician, but not formally meeting the clinical criteria (at least two of three) identified above, are classified as suspect cases regardless of laboratory confirmation.

pdf 8 June 2011: Haemolytic Uraemic Syndrome (HUS) and infection by Enterohaemorrhagic E. coli (EHEC) – situation  Published Popular

2877 downloads

Epidemiological AlertsNew Case Definition

Starting 8 June 2011, European Union (EU) Members States are reporting case according to a new case-definition.

Possible Epidemic Case: Any person who developed in or after 1 May 2011;

  • STEC diarrhea defined as acute inset of diarrhea or bloody diarrhea AND at least one of the following criteria:
  1. Isolation of an E coli strain that produces Shiga toxin 2 (Stv2) or stx2 gene.
  2. Direct detection of stx2 gene nucleic acid in feces without strain isolation.
  • STEC HUS defined as hemolytic uremic syndrome (HUS) defined as acute renal failure and at least one of the following clinical criteria
  1. Microangiopatic hemolytic anemia
  2. Thrombocytopenia

Probable Epidemic Case Any possible epidemic case of STEC diarrhea or STEC HUS AND during the exposure period of 14 days before the onset of illness, meeting at least one of the following epidemiological criteria:

  • Stay in Germany or any other country where a confirmed case has probably acquired infection;
  • Consumption of food product obtained from Germany;
  • Close contact (e.g., in a household) with a confirmed epidemic case.

Confirmed Epidemic Case Any person meeting the criteria for a possible case, AND Isolation of a STEC strain of serotype O104:H4

OR isolation of a STEC strain of serotype O104 AND fulfilling epidemiological criteria for a probable case. EU Members States are reporting number of probable and confirmed cases and deaths.

pdf 8 March 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3231 downloads

Epidemiological Alerts During Epidemiological Week 7 of 2011, at the national level, Haiti registered an increase in the weekly incidence rate, which increased from 5.1 cholera cases per 10,000 inhabitants in EW 6 to 10.2 cases per 10,000 inhabitants in EW 7. This was linked to an increase of 4.2% in the new cases registered as compared to the previous week. At the sub-national level, five departments (Centre, Nippes, Ouest, Sud y Nord) registered an increase in their weekly incidence rate.

While in the Dominican Republic, the Ministry of Health reported a total of 470 laboratory-confirmed cases of cholera, including four fatal cases, since the beginning of the outbreak up to EW 7.

pdf 9 February 2011: Cholera – situation in Haiti and Dominican Republic – Update  Published Popular

3772 downloads

Epidemiological AlertsIn Haiti,during the fourth EW of 2011 Haiti registered a decrease in the weekly incidence rate at the national level, which went from 13.6 cholera cases per 10,000 inhabitants in EW 3 to 8.1 cases per 10,000 inhabitants in EW 4. At department level, three departments (Artibonite, Grande Anse, Nord and Sud) increased their weekly incidence rate. The in-hospital case fatality rate at the national level in EW 4 of 2011 was 1.0%.

While in the Dominican Republic, the Ministry of Public Health informed that since EW 45 of 2010 to EW 4 of 2011, there were 336 cases confirmed by laboratory and one death that happened in EW 2.