EID Weekly Updates:
Emerging and Reemerging Infectious Diseases, Region of the Americas
Vol. 2, No. 7—19 February 2004
Since our last update on 12 February 2004, 6 new human cases of avian flu H5N1 and ensuing 3 deaths have been reported, which brings the total to 31 human cases and 22 deaths. To date, 2 countries have reported human cases; and 8 countries, epizootics among poultry.
Additional online information is available via the WHO Avian Influenza page, from the Newsroom of the Food and Agriculture Organization of the United Nations (FAO), and in an OIE Press Release entitled Avian Influenza has stopped spreading beyond the countres currently infected, among other press releases in the OIE Highlights section.
Sources (Consult for additional information.)
Over the past few weeks, Guatemala has reported to PAHO the existence of an outbreak of diarrheic disease. The outbreak began last month; based on information dated 31 January 2004, it has affected 28,255 people, of whom 17,032 are under five years of age.
Laboratory analyses carried out both in hospitals and by the various areas of the Ministry of Health, as well as the Guatemalan Institute of Social Security (Instituto de Guatemala del Seguro Social / IGSS) have identified rotavirus in 15%–60% of the samples taken.
During the first three weeks of the outbreak, the increase in relation to 2003 was 9%, falling to 4% in the fourth week. The outbreak has affected above all the health districts of Ixcan, Petén Sur Oriente and Escuintla, but has also spread to Guatemala, Sacatepéquez, Suchitepéquez, Quetzaltenango, San Marcos, El Progreso and Zacapa.
Since the beginning of February, the country has carried out continuous monitoring of hospital admissions, which have averaged 250 per day. This monitoring—along with declaring a state of national epidemiological alert and strengthening information, education and communication—has resulted in a greater demand for care and subsequently in the number of reported cases.
Prevention and control measures have been taken with regard to strengthening surveillance of detected cases and identifying risk groups, and increasing awareness among health-care professionals at all levels with a view to the early detection and proper treatment of diarrheic syndrome and dehydration.
In addition, there has been a review and strengthening of more structural aspects such as intra- and intersectoral coordination, internal and mass communication, and the existence of contingency plans as well as of medicines and other supplies necessary to respond to this type of emergency.
The rotavirus transmission is mainly transmitted via fecal-oral contact. The virus is stable in the environment and can remain viable for long periods of time. This permits transmission from contact with contaminated surfaces, water, or food. It is important for prevention and control measures to take these aspects into account.
There is no specific treatment for the disease. Two vaccines are currently being tested (Phase III trials), with promising preliminary results in terms of efficacy and safety. The principal strategy for dealing with such outbreaks consists of minimizing the mortality caused by dehydration as a result of the diarrheic syndrome. Approximately 1 out of every 40 children with gastroenteritis caused by rotavirus will require hospitalization and therapy providing fluids intravenosly. Compliance with the oral-rehydration standards set by the global WHO strategy for Integrated Management of Childhood Illness (IMCI) is extremely important in these cases.