Kyasanur Forest disease (KFD), or monkey fever, has claimed ten lives and left 253 people ill in Karnataka, India. Deaths of a large number of monkeys have also been reported. Nearly 70 villages in Chikmagalur, Shimoga, Uttara Kannada, and Dakshina Kannada districts have been affected by the disease, which is known to thrive under prolonged periods of dryness.
As of May 14, nearly 800 people in 170 villages are on the suspect list. Last year's poor monsoon and the continuing dry spell is being blamed by state health officials for the outbreak of the disease. “The state government is vaccinating people in a 10 km radius [around] all the affected villages. Efforts are on to get everyone in the area vaccinated. Insecticides are being sprayed in a 5 km radius [around] the monkey deaths”, said a state health official. State authorities have placed a request for fresh batches of vaccines with the Bangalore-based Institute of Animal Health and Veterinary Biologicals (IAHVB), makers of the KFD vaccine. IAHVB joint director C Renuka Prasad said, “the state procured 113 000 doses last year. A verbal request has now been made for 130 000 doses”. Two doses of the vaccine, with annual booster shots, are needed to protect people against the disease. Once the disease occurs, it is treated symptomatically. This year's outbreak is the highest in recent years. Last year, 98 cases were confirmed out of the suspected 550 and six deaths were reported. “The number of cases has been increasing steadily in recent years. It is known to occur in cycles. This seems to be a peak year”, officials said.
KFD was first identified in March 1957 after reports of mass monkey deaths in Shimoga. A tick-borne infection, the aetiological agent is a virus isolated from Haemaphysalis spp ticks, found on dead monkeys, and occurs in human beings as a result of contact with these ticks. KFD, which does not occur anywhere else in the world is known to lead to a 5% death rate in human beings. In 1983, the virus infected an all-time high of 1555 people and claimed 180 lives. Some environmentalists blame widespread deforestation for the spread of the disease (Lancet Infect Dis 2001; April: 7).
Cases of hantavirus pulmonary syndrome have been reported in the states of Montana and Kansas in the USA. In Montana there were four cases in May, including two deaths. Unusually wet weather this spring is bringing out the deer mice that are the main carriers of the disease in Montana. Up to 15% of the state's deer-mice population carries the virus. In Kansas the two cases were slightly unusual in that they were husband and wife. While the wife survived the husband died. The death is the first hantavirus infection death in Kansas since 2000, and it may well be the first hantavirus diagnosis of two people in one family. However, health officials insist that the disease is not being transmitted from person-to-person, but that the couple were both working in an area where they were inhaling a lot of dust containing particles from rodent droppings. Public-health officials state that preventing the disease is key, and that stringent rodent control in and around the home is imperative.
In Wisconsin, USA, there are 20 suspected cases of monkeypox virus infection, at the time of going to press. At least 23 more cases are suspected in Indiana, ten in Illinois, and one in New Jersey. Nine cases have been laboratory conformed. The virus is thought to have jumped from pet prairie dogs to human beings, and is being reported as the disease's first appearance in the western hemisphere. Officials at the Centers for Disease Control and Prevention think the prairie dogs were probably infected by a Gambian giant rat, imported from Ghana, at a Chicago-area pet distributor, and that the virus was contracted by close contact from the prairie dogs.
An outbreak of hepatitis A spanning three states has prompted a federal public-health warning in Australia. The Communicable Diseases Network Australia said six cases from Tasmania, two from Victoria, and two from Queensland were believed to have been exposed to the virus while on tour in the Northern Territory in late April. Hundreds more may have been exposed to the disease, which is spread via person-to-person contact, or from water or food that has been inadvertently contaminated by an infected person. Tasmania has the largest proportion of cases so far. Close contacts of patients have been offered preventative immunisation. The incidence of hepatitis A, which is usually more common in travellers returning from overseas, has declined in Australia over recent decades with general improvements to hygiene.
Seven children are reported to have died from suspected Japanese encephalitis (JE) in northern Vietnam since early April. The children, all under the age of 5 years, died within 48 h of being brought to the hospital. They all experienced high fever and convulsions before falling into a coma. The WHO has not been asked for assistance. If the cause of infection is confirmed as JE, it is likely to deal a psychological blow to Vietnam coming less than a month after the country declared it had contained the spread of severe acute respiratory syndrome.
An influenza outbreak in a police residential college in Pretoria, South Africa has been confirmed to be caused by influenza A (H3N2) virus. Of the 2000 students approximately 600 developed influenza, and had not been previously immunised. Specimens (throat swabs and bronchial lavages) sent to the National Institute for Communicable Diseases for testing were positive for influenza H3 by a multiplex nested PCR. The positive specimens are being sequenced to establish the extent of drift from the A/Panama/2007/99 vaccine strain.