EID Weekly Updates:
Emerging and Reemerging Infectious Diseases, Region of the Americas
Vol. 1, No. 5—8 August 2003
On 3 August 2003, the Ministry of Health of El Salvador reported a cumulative number of 56,847 cases of pneumonia and 312 deaths associated with pneumonia. In Epidemiological Week (EW) 31 (ending on 2 August 2003) 6,453 cases of pneumonia were detected (138 more than what was registered the previous week), with an average of 921 daily cases.
The national health authorities, together with technicians from PAHO and the Centers for Disease Prevention and Control (CDC) in Atlanta, USA, are conducting epidemiological studies to specify the causative agent and the risk factors related to mortality.
Source: Ministry of Public Health and Social Welfare, Office of the Director of Control and Epidemiological Surveillance, San Salvador, El Salvador.
On 7 August 2003, 164 cases of WNV infection were confirmed by the Centers by the Centers for Disease Control and Prevention in the United States. The cases were recorded in the states of Alabama (6), Colorado (72), Florida (4), Iowa (2), Kansas (1), Kentucky (1), Louisiana (15), Minnesota (4), Mississippi (5), Nebraska (6), New Mexico (2), North Dakota (1), Ohio (7), South Carolina (1), South Dakota (8), and Texas (29). Four deaths were registered: one in Alabama; one in Colorado, and two in Texas.
Additional information can be found on the CDC website.
Up to 6 August 2003, a total of 160 confirmed cases of jungle yellow fever have been reported to the Pan American Health Organization, with 70 deaths (see Table 1). This number represents almost double the number of annual cases reported over the two previous years.
Eighty percent (80%) of the cases (136) were identified in two large outbreaks in Brazil and on the Colombian-Venezuelan border.
The first outbreak was reported by the Ministry of Health of Brazil and occurred between January and April, in Minas Gerais State, located in the southwest region of the country. This outbreak accounted for 57 cases, with 23 deaths. It was controlled after a mass vaccination of all residents of the affected and neighboring counties.
The second outbreak is under investigation on the Colombian-Venezuelan border. It started in January with 3 cases in Venezuela and 5 cases in Colombia. Those cases have triggered the intensification of vaccination in the affected areas resulting in the disappearance of cases at that time. After 18 weeks without detecting cases, there was a resurgence of jungle yellow fever starting in the Epidemiological Week 25. To date, Colombia has reported 67 cases, all of them in the Department of Norte de Santander. Venezuela has reported 4 cases distributed between the Zulia and Tachira States. In Colombia, the outbreak is attributed to an intense migration to the affected area of people employed in the harvesting of an illegal crop. The two countries are attempting to control the outbreak by implementing vaccination campaigns. The urban areas near this outbreak are infested with Aedes aegypti; thus, this situation requires vigorous and timely implementation of all the recommended measures to prevent the reurbanization of the disease on the American continent.
PAHO is following up very closely on the situation and providing all necessary technical support to the countries to control this outbreak.
Table 1: Jungle Yellow Fever, Reported Cases and Deaths
On 23 July 2003, the General Office of Epidemiology of the Ministry of Health of Peru—in coordination with the Office of Epidemiology of Panama, with support from PAHO and in collaboration with the Centers for Disease Control and Prevention (CDC)—conducted epidemiological investigation following an early-morning forced landing when 29 passengers showed symptoms of food poisoning between 1:30 and the 4:30 a.m. Those affected were 55 US tourists, 30 of whom were going home after having been at the Biblical Institute of the Assembly of God in Peru. The age of those affected was between 14 and 18 years. The probable source of infection is still under investigation, though to date the findings indicate that the outbreak was not from food ingested in the plane or in the airport.
Complete information is available in Spanish on the website of the General Office of Epidemiology (Oficina General de Epidemiología / OGE) of Peru.
Source: Weekly Epidemiological Report (SE 29-2003), Ministry of Health of Peru.