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Medical Alerts Monthly Summary

 Medical Special Security Advisories

Ukraine  November 01, 2009 21:43 GMT
Pandemic flu outbreak, school closures and other public health restrictions
An outbreak of pandemic (H1N1) 2009 influenza in the western region of the country has prompted the government to implement a number of measures to reduce spread of the disease.

In mid-October a  More

Cape Verde  October 31, 2009 11:49 GMT
First outbreak of Dengue
Dengue fever has been reported for the first time in Cape Verde. The islands of Brava, Fogo, Maio, and Santiago have recorded over 3,000 suspected cases. Laboratory testing on initial  More

Egypt  October 27, 2009 09:42 GMT
Air pollution over Cairo: health concerns
The capital city of Egypt is experiencing a blanket of smog, labelled by the media as "black cloud", hovering over its skies. The deterioration in air quality is attributed to  More

Philippines  October 26, 2009 03:43 GMT
Leptospirosis outbreak: A health implication of Tropical Storm Ketsana
On September 26, areas of Luzon Island were struck by major tropical storm known locally as Typhoon Ondoy (or Tropical Storm Ketsana). It caused severe flooding in the capital Manila  More

Tanzania  October 24, 2009 08:39 GMT
Cholera outbreak in the north
An outbreak of cholera has infected thousands of people and has caused around 60 fatalities in northern Tanzania. The Tanga region alone has reported over 3,400 cases (More

Nigeria  October 24, 2009 00:25 GMT
Cholera in Adamawa state
An outbreak of cholera which began in mid-August has killed over 75 people in Adamawa state. The areas of Maiha, Mubi South, Michika, Madagali, Girie, and Hong are  More

Indonesia  October 21, 2009 06:02 GMT
Rabies risk in Bali, vaccine in short supply locally
An ongoing outbreak of rabies amongst dogs on the resort island of Bali has seen 3 human deaths from the disease in August. The death toll in mid-October was more  More

India  October 21, 2009 04:47 GMT
Japanese encephalitis outbreak in Uttar Pradesh
An outbreak of Japanese encephalitis in the Gorakhpur district of Uttar Pradesh (see map) has killed at least 13 children within a three-day period in mid-October. In 2009, over 420 deaths  More

Cameroon  October 17, 2009 00:35 GMT
Cholera outbreak in the north
A sudden increase in cases of cholera is occurring in the north of Cameroon, in the North and Extreme North (see map). The outbreak has killed more  More

South Africa  October 13, 2009 23:54 GMT
Measles outbreak in Johannesburg; elsewhere in Gauteng province
There is a measles outbreak in Johannesburg, where over 30 people have been infected during September. Cases have been reported in each of the city's regions.

Some of the infected people report previously being vaccinated against  More

Vietnam  October 07, 2009 09:31 GMT
Dengue in northern provinces
Vietnam has registered a large increase in the number of dengue cases in 2009. A surge in infections has been noted in August and September, particularly in the north of  More

Guatemala  October 03, 2009 22:48 GMT
Dengue in Izabal
An outbreak of dengue fever is underway in the department of Izabal (see map), especially in the towns of Puerto Barrios and Livingston. Health officials have declared a  More

Indonesia  October 03, 2009 04:56 GMT
Health implications and International SOS response to earthquake in West Sumatra
A series of earthquakes have left parts of West Sumatra province devastated, and raised the health and safety risks for the area.  Padang, the province's capital city, is the hardest hit.

At  More

Cameroon  October 02, 2009 02:30 GMT
Yellow fever confirmed in Southwest province
One case of yellow fever has been confirmed in Cameroon's Southwest province, and more than 50 other people have symptoms and are being tested.

A 61-year-old man from Kotto 1 - Bomboko village,  More

American Samoa  October 01, 2009 21:13 GMT
Tsunami causes injury, raises disease risk
A tsunami caused by an 8.3 magnitude earthquake has injured people in the Samoan Islands and raised their risk for flood-related illness.

The earthquake struck the morning of September 30. Both  More

Samoa  October 01, 2009 05:14 GMT
International SOS responding to tsunami
International SOS has mobilized a response team to Samoa, which includes a senior doctor and operations manager. The team will assess the situation and provide immediate assistance to members.

An undersea earthquake measuring  More




 Medical Special Security Advisories

Ukraine    November 01, 2009 21:43 GMT

Pandemic flu outbreak, school closures and other public health restrictions

An outbreak of pandemic (H1N1) 2009 influenza in the western region of the country has prompted the government to implement a number of measures to reduce spread of the disease.

In mid-October a rise in influenza-like illness was noted in the Ternopil, Lviv and Ivano-Frankivsk, Chernivtsi regions, with a number of severe cases of pneumonia and several deaths. The outbreak has been confirmed to be at least in part due to pandemic flu. Estimates are that across the country, more than 80,000 people have had a flu-like illness. Over 2,000 are hospitalized, about half of them children.  Over 130 people are or have required treatment in intensive care units. Two deaths are in children, the remainder in adults between the ages of 20 to 50 years. Pregnant women have been affected.

In an update on November 1, the Ministry of Health advises of the death of 4 health care workers, 2 in Lviv and 2 in Ternopil. The total number of deaths associated with the outbreak has reached 60.

The Ministry of Health (in Ukrainian) describes a very rapid spread of the disease, with features of the illness which are consistent with the features of pandemic flu seen globally (severe disease in people with underlying health problems, pneumonia which is very difficult to treat and follows a "fulminant" course). Due to testing limitations, confirmation of H1N1 virus is delayed.

Amongst measures introduced to try and limit spread of flu are closures of schools, and restrictions on large public gatherings for three weeks. Cinemas and other entertainment establishments have been closed, and preventative measures have been strengthened at transport hubs, including airports and train (subway) stations, as well as market places and commercial establishments.

The Disease
Influenza H1N1 is a new strain of influenza virus, causing a respiratory illness in humans. It was first discovered in April 2009, and for a time was referred to as "swine" or "pig" flu because it is similar to influenza viruses that infect pigs. The virus has spread to many countries, and caused outbreaks in the general community.

The majority of people infected develop a mild illness. Symptoms are similar to seasonal influenza - fever, sore throat, cough, headache, muscle pains, runny nose. It also causes vomiting and diarrhea. In some people, a severe illness with a rapidly progressive pneumonia develops, and can be fatal Pregnant women and people with health issues (obesity, asthma, other lung conditions, heart disease, diabetes, weakened immune system) appear to be at higher risk for severe illness, although people without any underling health problems may aslo develop severe disease.

The disease is thought to be spreading in the same way as seasonal flu - through the droplets an infected person generates when they cough, sneeze or talk. People who are in close contact (within 1 to 2 meters) can be infected when they inhale the droplets directly, or touch them with their hands and then transfer them to their eyes, nose or mouth.

Most people recover on their own, however the illness can be treated with antiviral medications (Tamiflu or Relenza). Severe cases may require hospitalization and intensive care management. Prevention is through attention to hygiene, and specific pandemic influenza H1N1 2009 vaccination. Vaccine is mostly in limited supply, and may be restricted to national priority groups.

International SOS Comment

International SOS is monitoring the situation closely. For the latest information see the Pandemic Preparedness Website In particular the Flu News, Public Health Restrictions and Ukraine country page.