Guest guest Posted May 18, 2009 Report Share Posted May 18, 2009 [1] Thai Binh Mon 18 May 2009 Source: Xinhua News Agency [edited] <<http://news.xinhuanet.com/english/2009-05/18/content_11394448.htm>http://news.\ xinhuanet.com/english/2009-05/18/content_11394448.htm> Cholera outbreak continues spreading north of Viet Nam --------------------- The northern Thai Binh province of Viet Nam reported 3 individuals had tested positive for cholera, making it the 9th locality to report the disease in the north-central region of the country, the Youth reported Monday [18 May 2009] The patients had eaten dog meat while working in Hanoi and showed symptoms of the disease after returning to their hometown, said the provincial Center of Preventive Health. Although there are no official figures so far, the number of individuals suffering acute diarrhea in Viet Nam has been reportedly increased over the past month. Meanwhile, the National Institute of Hygiene and Epidemiology reported samples of dog meat, both cooked and uncooked, from slaughterhouses in Ha Dong district of Hanoi had tested positive for the cholera bacterium. Viet Nam's health officials instructed local agencies to step up early detection of suspected cases to offer timely treatment and prevent the spread of the potentially deadly disease. [Editor: Mo Hong'e] -- Communicated by: ProMED-MBDS <<http://us.mc356.mail./mc/compose?to=promed-mbds (AT) promedmail (DOT) org>promed\ -mbds ****** [2] Thanh Hoa Sat 16 May 2009 Source: Thanh Nien News [edited] <<http://www.thanhniennews.com/healthy/?catid=8 & newsid=48891>http://www.thanhnie\ nnews.com/healthy/?catid=8 & newsid=48891> Acute diarrhea spreads to 8th province in north -------------- A patient with acute diarrhea at Thanh Loc Commune Medical Center in Thanh Hoa Province's Hau Loc District The northern Ninh Binh Province Friday [15 May 2009] reported that people were hospitalized with acute diarrhea to become the 8th locality in the northern and north-central regions to report a breakout. The central Bureau of Preventive Health said some of the patients also tested positive for acute diarrhea but did not disclose how many. Hanoi, Hai Phong and the provinces of Nam Dinh, Bac Ninh, Quang Ninh, Hai Duong and Thanh Hoa earlier reported outbreaks of acute diarrhea. Acute diarrhea has been raging in the northern and north-central regions, with dozens of patients admitted to hospitals. The Bureau's head, Nguyen Huy Nga, warned on Friday [15 May 2009] of a possible increase in the number of cases, pointing out that 50 to 70 percent of patients contracted the disease by eating dog meat. The movement of people can facilitate the further spread of the diarrhea, he said. Dr Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology, said the institute is investigating the source of _Vibrio cholera_ bacteria in the dog meat. " Some dogs may have eaten foods containing the bacteria, " he said. " Maintaining personnel hygiene and eating cooked and safe foods are basic requirements for fighting cholera. " The cholera pathogen has yet to be found in the water supply anywhere, he said, but many people discharge waste directly into water bodies, which threatens to spread the infectious disease. Enforcing prevention -------------------- Bui Quang Anh, head of the Animal Health Bureau, said his agency has instructed provinces to monitor slaughter of dogs and cats and take strict action against violators. The Hanoi Center for Preventive Health on Friday [15 May 2009] warned residents against consuming foods with a high risk of bacteria infection. They also encouraged residents to wash their hands with soap. The warnings have kept most people away from dog-meat eateries in the capital. Nevertheless, the trade in dog meat was busy as usual at Y La and La Duong villages in Ha Dong District, Thanh Nien found Friday [15 May 2009]. Many slaughterhouses and small traders of dog meat do not practice hygiene, and pour waste from the slaughter directly into the sewerage. In Ho Chi Minh City, the Department of Health on Friday [15 May 2009] instructed all health agencies to enforce preventive measures against the possible spread of acute diarrhea from the north and north-central regions. The department advised residents to avoid eating shrimp paste, nem chua (traditional fermented meat roll), and tiet canh (blood pudding), and practice hygiene. The HCMC Preventive Health Center also instructed its agencies to test tap water all around the city and supply lime powder or chloramine B to residents in areas without tap water. It ordered all medical centers to immediately report any suspected cases of cholera. -- Communicated by: PRO/MBDS Rapporteur Vern Weitzel ****** [3] Northern provinces Sat 16 May 2009 Source: Saigon Giai Phong (SGGP) Daily [edited] <<http://www.saigon-gpdaily.com.vn/Health/2009/5/70825/>http://www.saigon-gpdail\ y.com.vn/Health/2009/5/70825/> Diarrhea points to possible cholera outbreak ----------- An outbreak of acute diarrhea has been complicated by the spread of cholera in Northern provinces, the Ministry of Health said on [15 May 2009]. Over 60 people were admitted to hospitals with acute diarrhea on [15 May 2009], bringing the number of victims to 200, including some testing positive for the virulent _Vibrio cholera_ [bacterium]. The ministry said most of the victims are Hanoi residents, with 46 from Dong Da District, 33 in Cau Giay District, and 29 in Hai Ba Trung District. The northern provinces of Quang Ninh and Hai Duong have reported their 1st cases of acute diarrhea, with one woman and 2 men receiving treatment. Eleven cases of acute diarrhea, including 4 with cholera, have been reported in the northern province of Bac Ninh, 30 km [19 mi] away from Hanoi. Medical workers are worried that the high number of people infected with cholera is pointing to an outbreak. Three districts in the northern province of Thai Binh have announced 7 cases of acute diarrhea, said the director of the province's Preventive Medicine center, Pham Van Diu. Most fell ill after they had eaten fresh vegetables, blood pudding, dog meat, and shrimp paste. As there has been an increase of diarrhea patients in hospitals, the Ho Chi Minh City Department of Health ordered officials to strengthen supervision of water sources in residential areas, foods in markets, roadside eateries and dog restaurants. [by Nguyen, Dai, Lam; translated by Dan Thuy] -- Communicated by: ProMED-MBDS Rapporteur Vern Weitzel [There are now 9 provinces in northern Viet Nam that have documented cholera cases since January 2009. Confirmed affected provinces include: Hai Duong, Quang Ninh, Thanh Hoa, Bac Ninh, Hai Phong, Nam Dinh, Hanoi, and Ninh Binh. Newswire reports have continued to suggest that eating dog meat, shrimp paste, and raw vegetables have been associated with disease. Newswire [1] is the 1st to provide investigative evidence documenting the presence of the _Vibrio cholerae_ organism in an implicated food. It would be interesting to see information from epidemiologic studies implicating the foods mentioned above, such as case control studies. From newswires in this posting as well as previous newswires, it is apparent that the expression " acute diarrhea " is associated with the clinical picture seen with cholera in Viet Nam, when laboratory confirmation of the disease is not available on the individual patient. Hence, one wonders if the earlier PRO/MBDS report on a diarrheal outbreak in Dong Nai Province, was in fact an outbreak of cholera that went unconfirmed. Clarification from knowledgeable sources would be appreciated. For maps of Viet Nam with provinces, see <<http://www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg>http:/\ /www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg> and <<http://www.angelfire.com/co/hongnam/vnmap.html>http://www.angelfire.com/co/hon\ gnam/vnmap.html>. For the interactive HealthMap/ProMED-mail map with direct links to other outbreaks in Viet Nam and surrounding countries reported on ProMED-mail and PRO/MBDS see <<http://healthmap.org/r/008c>http://healthmap.org/r/008c>. - Mod.MPP] [see also: Cholera - Viet Nam (05) 20090514.1805 Cholera - Viet Nam (04): RFI 20090513.1788 Cholera - Viet Nam (03) 20090512.1776 Cholera - Viet Nam (02): Hanoi 20090429.1613 Diarrhea - Viet Nam: Dong Nai, RFI 20090428.1606 Cholera - Viet Nam: Hanoi 20090426.1564 2008 ---- Cholera - Viet Nam (25): Ha Tinh 20081111.3549 Cholera - Viet Nam (24): Nghe An 20081014.3249 Cholera - Viet Nam (23) 20080823.2622 Cholera - Viet Nam (22) 20080805.2394 Cholera - Viet Nam (21) 20080729.2312 Cholera - Viet Nam (20): Hai Duong 20080728.2302 Cholera - Viet Nam (19): Hung Yen, Ha Nam 20080721.2204 Cholera - Viet Nam (18) 20080709.2087 Cholera - Viet Nam (17): RFI 20080629.2001 Cholera - Viet Nam (16) 20080628.1985 Cholera - Viet Nam (15): RFI 20080624.1951 Cholera - Viet Nam (14): WHO 20080422.1426 Cholera - Viet Nam (13) 20080418.1386 Cholera - Viet Nam (12) 20080415.1356 Cholera - Viet Nam (11): central, southern regions, RFI 20080410.1314 Cholera - Viet Nam (10): RFI 20080409.1299 Cholera - Viet Nam (09): Hai Duong, Ninh Binh 20080408.1288 Cholera - Viet Nam (08): RFI 20080403.1233 Cholera - Viet Nam (07): RFI 20080402.1209 Cholera - Viet Nam (06): RFI 20080328.1169 Cholera - Viet Nam (05): RFI 20080320.1071 Cholera - Viet Nam (04): Ha Tay, Hai Phong, RFI 20080318.1053 Cholera - Viet Nam (03): Hanoi 20080314.1021 Cholera - Viet Nam (02): hybrid strains 20080206.0491 Cholera - Viet Nam: Hanoi, RFI 20080108.0103 Food poisoning, fish filets - Norway ex Viet Nam: RFI 20080727.2295 2007 ---- Cholera - Viet Nam (03): RFI 20071208.3964 Cholera - Viet Nam (02): RFI 20071106.3613 Cholera - Viet Nam: north, RFI 20071104.3582 Diarrheal illness - Viet Nam (02): cholera confirmed, RFI 20071101.3549 Diarrheal illness - Viet Nam: north, shrimp paste susp, RFI 20071031.3536] ....................................mpp/mj/mpp *##########################################################* ************************************************************ ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. 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