EID Weekly Updates:
Emerging and Reemerging Infectious Diseases, Region of the Americas
Vol. 2, No. 16—24 April 2004
Main Updates index
- Acute Diarrheal Syndrome and Identification of Two Cholera Cases in the Municipality of São Bento do Una, Pernambuco State, Brazil
- Follow-Up on Outbreak of Bat-Transmitted Human Rabies in Pará State, Brazil
From Epidemiological Weeks (EWs) 4 to 11, an increase in the number of cases of acute diarrhea has been detected in the municipality of São Bento do Una, state of Pernambuco, Brazil, similar to the peak that occurred during the first trimester of last year.
Two cases with serious acute diarrhea tested positive for Vibrio cholerae O1 Ogawa (a girl of 2 years of age and a male of 39) in a São Bento do Una neighborhood. The cases occurred in 27 March and 6 April 2004. Samples from the examinations carried out identified toxigenic strains in these two patients. Results from ongoing studies will later show the genotypical characterization of this strain. The environmental samples and feces samples taken from other patients from the same neighborhood tested negative for cholera.
Epidemiological monitoring of acute diarrhea cases has been intensified in all the municipalities, as well as surveillance of drinking-water quality. Prevention and control activities include distributing hypochlorite to the population, as well as intensive activities to ensure safe drinking water distribution. The public is being informed of what to do, and health-care professionals are being trained on how to identify and treat new cases, as well as on how to procure the necessary input for adequate case management.
Since second semester 2001, no cholera cases from this strain have been detected. Between 1991 and 2001, 168,598 cases of cholera were reported to the Ministry of Health, the last being reported in 2001 and all originating in the northeastern region. During 2002 and 2003, Vibrio cholerae 01 Ogawa was isolated in 6 environmental samples from the northeastern states, though the results of the analysis carried out turned out negative for toxigenic strains.
Health authorities are investigating the current identification of cholera cases in the municipality of São Bento do Una. For the time being, it is not possible to say that Vibrio cholerae is the agent responsible for the increase of diarrhea cases, since no toxigenic strains have been identified in other clinical and environmental samples. Ongoing research will elucidate the factors implied in such an increase and in the occurrence of the two cholera cases.
Additional Information
- Cholera. Washington, DC: Pan American Health Organization / World Health Organization (PAHO/WHO), Communicable Disease Unit, Emerging and Reemerging Diseases.
- Technical Note—20 April 2004: Occurrence of Acute Diarreal Diseases and Cholera Cases in São Bento do Una, Pernambuco State, Brazil (Nota técnica—20/04/2004: Ocorrência de Doença Diarréica Aguda e casos de cólera em São Bento do Una - PE). Brazilia: Ministry of Health, Department of Health Surveillance (Ministério da Saúde do Brasil, Secretaria de Vigilância em Saúde). (in Portuguese)
Source: Report to PAHO by the Ministry of Health of Brazil.
Follow-Up on Outbreak of Bat-Transmitted Human Rabies in Pará State, Brazil
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To follow up on the outbreak of bat-transmitted human rabies detected in the city of Portel, state of Pará, Brazil, in January 2004, the last report from the Department of Health on 16 April indicates that 2 more cases have been confirmed since our update last week, bringing the total to 15 cases of confirmed human rabies. Another 2 people are considered suspected cases (see Table 1). The samples of biological material taken for human diagnostic purposes have been submitted to the Evandro Chagas Institute as well as to the Pasteur Institute in São Paulo, which have identified the viral strain Desmodus rotundus in said samples. The first case in this outbreak occurred on 2 March 2004; and the last, on 1 April. There are ongoing epidemiological investigations of new cases as well as identification of the colonies of bats in the affected municipalities. There has been continued vaccination of dogs and cats in the affected area, and the nearby cities considered at risk. |
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Additional Information
- Rabies. Washington, DC: Pan American Health Organization / World Health Organization (PAHO/WHO), Veterinary Public Health Unit.
- Tecnical Note—16 April 2004: Human Rabies Transmitted by Bats in Pará State, Brazil (Nota técnica—16/04/2004: Raiva humana transmitida por morcegos no município de Portel, Estado do Pará). Brazilia: Ministry of Health, Department of Health Surveillance (Ministério da Saúde, Secretaria de Vigilância em Saúde;). (in Portuguese)
Sources: Reports to PAHO from the Department of Health, Pará (Secretária da Saúde, Pará/SES-PA) and the Department of Health Surveillance (Secretária de Vigiláncia em Saúde/SVS), Brazil.