Manual 18140492

Manual 18140492
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ISSN 0382-232X
Canada Diseases
Rapport hebdomadalre des
maladies au Canada
Weekly Report
Date of publication: 30 November 1991
Contenu du present numero:
Contained In this Issue:
265
Leishmanlasis . . . .
Human PlaQUe In 1990 . •
Notifiable Diseases Summary
Announcement . . . .
266
267
270
Leishmaniose . . . . . . . . .
La paste humaine en 1990 . . . . . . .
Sommaire des maladies adeclaration obligatoire
Annonce . . . . . . . . . . . . .
LEISHMANIASIS
(
265
266
267
270
Notes sur les maladies troplcales
Tropical Disease Notes
(
Date de publication: 30 novembre 1991
Vol. 17·48
LEISHMANIOSE
· An epidemic of Leishmaniasis (kala-azar or black fever) is
reported from the Northeast Indian state ofBihar with spread into
neighbouring Nepal. Some cases are also being reported in U.S.
Forces who served in th~ Gulf War, but there are no reports of any
Canadians being infected.
Une epidemie de leishmaniose (kala-azar OU fievre noire) a ete signalee
dans l'Etat du Bihar, au nord-yst de l'Inde et s'estpropagee au pays voisin, le
Nepal. Certains cas ont egalement ete observes au sein des forces armees
americaines qui ont pris part ala guerre du Golfe. 'A ce jour, aucun cas
d'infection n'a ete signale chez les Canadiens.
The Ministry of Health in the State Capital Patna have reported
27,000 cases this year and WHO estimates that there hate been
10,000 deaths, with the possibility of dramatic increases in these
figures.
,i.
·-·
Le ministere de la Sante situe aPatna, capitale du Bihar, a enregistre
27 000 cas de leishmaniose cette annee. De son cote, l'OMS estime a10 000 le
nombre de deces causes par la leishmaniose et croit que ce nombre pourrait
augmenter de fa~n considerable.
The causative protozoan infection is transmitted by sandflies.
Travellers to rural areas where this disease is being reported should
take very strict precautions to avoid being bitten by l)andflies because
no vaccines or prophylactic drugs are available.
Le protozoaire responsable de cette infection est transmis par un diprere, le
phlebotome. Les voyageurs qui se rendent dans les regions rurales OU sevit
cette maladie devraient prendre des precautions tres strictes afin d 'eviter de se
faire piquer par des phlebotomes, car il n' existe aucun vaccin contre la maladie
ni aucun agent prophylactique.
Preventive measures for the individual traveller are aimed at
reducing man-fly contact. Outdoor activities should be avoided when
sandflies are most active (dusk to dawn). Although sandflies are
primarily nighttime biters, transmission of leishmaniasis may occur
during the day if resting sandflies are disturbed. Sandfly activity in an
area may easily be underestimated, because sandflies are noiseless
fliers and occasional bites may not be noted.
Pour le voyageur, les mesures prophylactiques individuelles consistent a
reduire le contact avec les phlebotomes. n convient done d' eviter les activites a
I' exterieur durant les heures· ou les phlebotomes sont le plus actifs (du
crepuscule al' aurore ). s'ils piquent surtout durant la nuit, les phlebotomes
peuvent neanmoins transmettre la leishmaniose en plein jour s 'ils sont
deranges. Leur activite dans une region donnee peut facilement etre
sous-estimee, car ces insectes volent silencieusement et leurs piqiires peuvent
passer inaper¥ues.
Protective clothing and insect repellant should be used for
supplementary protection. Clothing should cover as much of the body
as possible and be tolerable in tlie climate. Wide-open collars and
loose sleeves and pant legs should be avoided. Repellant with DEBT
(N,N-diethyl-m-toluamide) should be applied to exposed skin and
under the edges of clothing, such as the ends of sleeves and pant legs.
Repellant should be applied according to the manufacturer's
instructions; repeated applications may be necessary under conditions
of excessive perspiration, wiping and washing. Although
impregnation of clothing with repellant may provide additional
protection, it does not eliminate the need for repellant on exposed skin
and should be repeated after every 5 washings.
Le port de vetements protecteurs et I'utilisation d 'insectifuges assurent une
protection supplementaire et sont done recommandes. Les vetements devraient
couvrir la plus grande surface du cozps possible tout en etant adaptes aux
conditions climatiques locales. Les vetements alarge encolure ainsi que les
chemises et les pantalons amples sont aeviter. Un insectifuge abase de DEBT
(N,N-diethyl-m-toluamide) devrait etre applique sur la peau exposee ou sur les
vetements, autour des poignets et des chevilles. n doit etre applique selon les
instructions du fabricant; une nouvelle application pourrait etre necessaire si
l'on transpire abondamment et si l'on se lave ou s'essuie la peau. Il est
possible d' obtenir une protection additionnelle en impregnant les vetements
d'insectifuge, mais cela n' elimine pas la necessite d' appliquer un insectifuge
sur toute surface de peau exposee; par ailleurs, il faut repeter cette operation
tous les 5 lavages.
I Secald OOll
I.I
Mal Re?rlra11on No. 6670
Health and Welfare
Canada
I COLf!IB< de la deuidilme ckma - Emig!s1nrnent n•
I
Santa et
Canada
Bien~tre
social
265
6670
Canada
I
Source: Tropical Health and Quarantine Division, Bureau of
Communicable Disease Epidemiology, LCDC, Ottawa.
On peut reduire les contacts avec le phlebotome par des moyens
mecaniques, par exemple, en entourant les lits de filets protecteurs et en
posant des moustiquaires sur les fenetres et les portes. Pour que la
protection soit efficace, les mailles doivent etre fines (au moins 18 mailles
au pouce lineaire, et meme davantage selon certaines sources), car le
phlebotome est beaucoup plus petit qu'un moustique (environ un tiers de la
taille de ce demier). Des filets protecteurs aux mailles aussi fines peuvent
se reveler intolerables sous des climats chauds. La vaporisation d'un
aerosol abase de permethrine sur les filets protecteurs et les moustiquaires
et l' application d. insecticides aeffet remanent dans les pieces habitees
peuvent egalement se reveler utiles.
Source : Division de la Sante tropicale et quarantaine, Bureau de
l' epidemiologie des maladies transmissibles, UCM, Ottawa.
International Notes
Notes lnternatlonales
Man-fly contact can be reduced by mechanical means, such as
bed nets, and the screening of doors and windows. Fine mesh
netting (at least 18 holes to the linear inch, some sources say even
finer) is required for an effective barrier against sandflies, which are
much smaller than mosquitoes (about one third the size). Such
closely woven bed nets may be intolerable in hot climates.
Impregnation of mosquito nets and window screens with
permethrin aerosol may provide some protection, as well as
spraying of quarters with residual-action insecticide.
HUMAN PLAGUE IN 1990
LA PESTE HUMAINE EN 1990
In 1990, 1,250 cases of human plague recorded in 12 countries
were notified to WHO; 137 patients died. These figures exceed the
corresponding figures for 1989 (770 cases, 104 deaths), and the
average figures per year (855 cases with 98 deaths) for the previous
10 years (1980-1989), when 8,554 plague cases with 981 deaths
were reported from 21 countries. In 1990, the global case-fatality
rate was 10.7% as compared with 13.5% in 1989 and an average of
11.5% per year in the previous 10 years.
En 1990, 12 pays ont notifie al'OMS 1 250 cas de peste humaine, dont
137 mortels. Ces chiffres sont superieurs tant a ceux de l' annee precedente
(770 cas, 104 deces) qu'a la moyenne annuelle (855 cas, 98 deces) pour les
10 annees precedentes (1980-1989), durant lesquelles 8 554 cas, avec 981
deces, avaient ete declares par 21 pays. Le taux mondial de letalite a ere de
10,7 % en 1990, contre 13,5%en1989et11,5 % en moyenne annuelle sur
les 10 annees precedentes.
As in 1989, the highest number of cases was detected in Viet
Nam (32% of the world total), followed by the United Republic of
Tanzania (29%) and Madagascar (18%).
De meme qu'en 1989, c'est au VietNamqu'aete enregistre le plus
grand number de cas (32 % du total mondial), suivi de la Republique-Unie
de Tanzanie (29 %) et de Madagascar (18 %).
Africa
Afrlque
Seven hundred and six plague cases with 102 deaths were
reported from 4 countries in Africa (56% and 74% of the
corresponding figures recorded in the world, re~pectively).
En Afrique, 4 pays ont declare au total 706 cas de peste, avec 102
deces, ce qui represente 56 % des cas et 74 % des deces enregistres dans le
monde au cours de cette periode.
United Republic of Tanzania: Three hundred and si_!ty-four
plague cases were reported from this country, df which~32 were
fatal; this figure represents a 10-fold increase q\,er 1989. Nearly all
the cases of human plague were recorded wiflWi the bounds of
Lushoto District, Tanga Region. Two peaks iiLfue incidence of
plague were observed during the year: in •January (95 cases, 5
deaths) and in December (140 cases, 6 deaths) which accounted for
65% of the total number of cases recorded in the country. During 4
months (June-September) the country was free from human plague.
Six cases of pneumonic plague were detected in the Muhibili
Medical Centre, Dar es Salaam during a 2-week period. Shortly
before onset of illness, 5 of the patients had visited Lushoto
District; the sixth victim of the disease was a nurse who contracted
plague from one of the patients.
Republique-Unie de Tanzanie : Trois cent soixante-quatre cas, dont 32
deces, ont ere declares, soit 10 fois plus que l'annee precedente. Presque
tous ces cas se sont produits dans le district de Lushoto (Region de Tanga).
L'incidence de la peste a marque 2 pies, l'un en janvier (95 cas, 5 deces) et
l'autre en decembre (140 cas, 6 deces), qui font ensemble 65 % de tousles
cas enregistres dans le pays en 1990, alors que pas un seul cas n' a ete
constate de juin aseptembre (4 mois). Six cas de peste pulmonaire ont ete
vus au Centre medical de Muhibili (Dar es-Salaam) sur une periode de 2
semaines. Peu avant le debut de leur maladie, 5 des patients s 'etaient
rendus dans le district de Lushoto; la sixfome victime etait une infirmiere
contarninee par l 'un des malades.
Madagascar: A total of 228 cases and 59 deaths were reported.
The tendency to increased incidence of plague in this country
continued. As in 1989, the disease was observed mainly in 2
provinces: Antananarivo (77 cases, 34 deaths) and Fianarantsoa
(146 cases, 24 deaths). Sporadic cases occurred in the Provinces of
Toamasina (4 cases, l death) aiio Mahajanga (1 case). The main
peak in the incidence of plague was in January-March (62% of all
cases in the country). The second peak ( 19% of the total) was
observed in October-November.
Madagascar : Un total de 228 cas et 59 deces a ete declare.
L'incidence delapeste a continue as'elever. Comme en 1989, c'estdans 2
provinces surtout que la maladie a ere observee : Antananarivo (77 cas, 34
deces) et Fianarantsoa (146 cas, 24 deces). Des cas sporadiques se sont
produits dans les provinces de Toamasina (4 cas, 1 deces) et deMahajanga
(1 cas). L'incidence de la maladie a marque un pie important en
janvier-mars (62 % de I' ensemble des cas) et un second en
octobre-novembre (19 % des cas).
Suite ala page 269
Continued on page 269
266
(
'
(_ , i
HEALTH AND WELFARE CANADA - SANTE BIEN-ETRE SOCIAL CANADA
Notifiable Diseases Summary - Sommaire des maladies declaration obligatoire
New Cases Reported for the Month Ending 30 June 1991 - Nouveaux cas declares pour le mois se terminant le 30 juin 1991
a
Disease
1dle
ICD-9
CIM-9
Canada1
Mo Cum. Cum.
Mais
91
90
290
558
AIDS-Sida
042-044
897
Amoeblasls - Amlblase
006
133
2
Botulism - Botullsme
005.1
Brucellosis - Brucellose
023
229 1037
712 3904
Campylobacterlosls Campylobacterlose
008.41'
Chancrold - Chancre mou
099.0
2
Chickenpox - Varlcelle
052 1714 7807
2342 18833
Chlamydia, genital Chlamydlose genltala
099.81'
001
1
1
Cholera - Cholera
Diphtheria - Diphtllrle
032
Glardiasls - Glardlase
007.1
452 3673
Gonococcal Infections 881 3859 6391
Infections gonococclques<1l
098
Gonococcal Ophthalmla neonatorum 2
Ophtalmle gonococclque du nouveau-nil 098.4
22
174
Haemophilus influenzae B (all Invasive) (Invasive) H. lnfluenzae 912!
320.0,038.41'
Hepatitis A - Hapatlte A
070.0,070.1
192 1091
070.2,070.3
296 2591
Hepatitis B - Hapatlte B
5
Hepatitis C - Hapatlte c
Hepatitis non-A, non-B 14
Hapatite non-A, non-B
Herpes Simplex (congenital/neonatal) Herpes (conganltal/naonatal)
771.21'
Leglonellosls - Leglonellose
482.41
6
37
030
2
11
Leprosy - Lapre
Usteriosls (all types) Llstarlose (taus genres)
027.0, 771.22'
Malaria • Paludlsme
084
100
282
·055 1407 4473
• ~~fes - Rougeole
/
8
_1gltls, pneumococcal Ef7
-.•• dningite pneumocoques
320.1
3"6
Meningitis, other bacterial
-3
Autres manlngltes bactarlennes''-'l
Meningitis/Encephalitis viral 10
.72
Mllnlnglte/encaphallte virafel•>
Menlngococcal Infections •
20
Infections manlngocoques
036
072
42
218
Mumps - Orelllons
Paratyphoid - Paratypho1de
002.1-002.9
2
11
Pertussis • Coqueiuche
033
93 1177
020
Plague - Paste
Poliomyelitis - Pollomyallte
045
Rabies - Rage
071
6
Rubella - Rubaole
056
104
374
Congenital Rubella-Rubaoie conganitale 771.0
3
Salmonellosls - Salmonellosel•>
643 3434
003
Shlgellosls - Shigellose
004
79
669
Syphllls:
Early, Symptomatic 15
186
Symptomatlque, racente
091
Other Syphllls - Autres syphilis
090,092-097
108
601
037
1
Tetanus - T8tanos
Trichinosis - Trichlnose
124
5
01"0-01-8
629
Tuberculosis - Tuberculose
54
21
002.0
Typhoid • Typho"lde
3
36
154
Verotoxigenic E. coli E. coll varotoxlnoganes
008.01'
060
Yellow Fever - Fiavre jaune
-
a
a
'1.
a
211
Mo Cum. Cum.
Mais
91
90
527
454
3
801
1393
23
13356
11019
-1
-
-
1
-
7
2300
-
1
4
2
-
56
58
52
51
247
144
1191
-
-
-
-
-
-
4
-
-
-
-
8
8
8
4
-
-
-
-
-
-
2
-
765
854
4
73
10
-
18
-
-
21
133
-
-
-
-
-
2
-
-
1
1
2
1
-
10
36
-
4
3
-
1
4
3
2
-
-
183
990
6
1
-
105
136
-
2
5
158
-
-
-
-
-
2
-
111
-
-
10
22
-
-
6
-
74
-
-
Mo cum. Cum.
Mols
91
90
115
47
-
New Brunswick
Nouveau Brunswick
24
28
-
17
2
749
1786
-
Mo Cum. Cum.
90
Mais
91
-
31
23
-
Mo Cum. Cum.
Mols
90
91
Nova Scotia
Nouvelle Ecosse
-
9
14
-
-
-
-
-
72
Mo Cum.
Mols
91
Cou.
90.
227
101
92
2
1031
185
59
3
794
-
-
-
-
16
-
-
-
-
-
835
6503
7776
-
-
-
-
269
934
57
-
326
50
2
6
24
53
32
101
38
796
-
-
-
-
-
-
2
-
1
3
-
1
2
9
60
75
-
3
72
2
31
5
29
49
125
255
959
104
1123
-
-
-
-
-
-
2
-
-
-
1
-
-
-
-
1
-
-
-
-
-
-
-
-
-
-
-
-
-
-
16
2
-
-
-
-
-
-
-
-
-
-
-
-
-
-
7
1
-
-
-
3
1
-
-
5
23
26
50
13
66
-
-
1
7
6
-
-
-
-
1
-
-
-
-
-
49
-
-
1
-
142
1
10
7
1'76
1
4381
-2
2
-2
-
-
-
-
-
-
-
56
75
207
49
i
27-~
.,
2
-
167
1
2450
567
-
6
-
2
54
-
-
75
166
-
-
174
Quebec
Quebec
-
-
2
-
-
-
-
-
-
3
5
-
-
3
-
-
-
3
1
-
-
-
2
23
3
-
1
-
-
6
5
-
1
8
8
90
72
15
-
-
-
3
2
-
56
-
-
16
-
-
1
-
-
3
-
-
2
1
21
29
3
267
30
1
144
-
-
-
-
-
-
2
1
82
-
-
-
-
-
-
-
-
-
-
-
-
2
2
4
2
44
1
-
1
-
5
9
3
8
19
1
14
-
-
-
-
-
-
164
-
-
1
-
-
-
-
5
185
12
17
-
3
8
1
3
-
-
-
9
-
3
-
-
-
1
1
9
48
Includes aD 098 categories except 098.4
Includes buooal celluliis or epiglottitis 484.3 in a child <5 years with no olher causative organisms Isolated
Includes enoephali6s
All other categories except Haernophilus 320.2, List.,iosis 027.0, Meningoccooal 036, Pneumocoooal 320.1
and Tub ..ooloois 013.0
; 'categories except Measles 055, Mumps 072, PoUornyefitis 045, RubeUa 056 and Yellow Fever 060
1\, .udes Typhoid 002.0 and Paratyphoid 002.1 to 002.9
--.~0-9 oodes used in the list may be incomplete. All 5 digit codes are unofficial and
are for LCDC surveillance purposes ooly.
t May not represent national total if data korn !he provinces are incomplete.
(t)
(2)
(3)
(4)
Prince Edward Island
lie-du-Prince-Edouard
Newfoundland
Terre-Neuve
7
-
(1)
(2)
(3)
(4)
-
-
-1
-
-
-
-
-
-
-
-
1
1
40
105
9
-
1
-7
-
-
-
1
1
-
-
-
2
10
-
-
-
-
-
-
2
5
4
6
-
-
2
-2
-
-
-
31
3
749
168
957
221
2
-
78
-
90
5
151
2
124
14
3
10
-
18
14
4
4
15
77
82
-
-
-
-
-
8
24
-
-
-
-
-
-
-
-
-
1
-
3
-
Cornprend butes !es rubriques 098, eaul 098,4
Cornprend oelluite buooale ou epiglol!ite 464,3 chez un enfant <5 ans dtez qui aucun autre mioroorganisme causal n'a eta isole
Cornprend encllphalite
Tooles Jes autres rubriques sauf II HaemophiUus 320,2, isteriose 027.0, II menlngoccques 036, II poeumoooques 320,1 et
tub'"ouleuse 013,0
(5) Tooles Jes rubriques, sauf roogoole 055, orelllons 072, po6orny91ite 045, rubllole 056 et fibvre jaune 060
(6) Saul typholde 002,0 et pS1atypholde 002,1 a002,9
• Les codes de la CIM·9 figurant dans la lisle ne son! peut·he pas oomplets, Ouant aux oodes a5 ohillres,
ifs ne sont pas officials, ayant ell> elablis uniquement aux ins de la surveilanoe du LLCM.
' II se peutque oe ohllfi'e ne represenle pas le total natiooal si Jes doonees provenant des pr<Mnces son! inoompl~les.
267
Notifiable Diseases Summary (Concluded) - Sommaire des maladies a declaration obligatoire (fin)
New Month Ending 30 June 1991
Disease
Maladle
ICD-9
CIM-9
Mo cum. Cum.
91 90
Mols
AIDS-Sida
042-044
200 200 166
Amoeblasls - Amlblasa
006
40 383
Botulism - Botulisms
005.1
Brucellosis - Brucallose
1
023
Campylobacterlosis 349 2353
008.41.
Campylobactarlose
Chancrold - Chancre mou
2
099.0
Chickenpox - Varlcelle
052
Chlamydia, genital 853 7251
Chlamydlosa genltale
099.01·
Cholera - Cholera
001
Diphtheria - Dlphterle
032
Glardlasis - Glardlase
146 1513
007.1
319 2801
Gonococcal Infections Infections gonococclques(ll
098
Gonococcal Ophthalmia neonatorum Ophtalmle gonococcique du nouveau-na 098.4
45
3
Haemophllus influenzas B (all Invasive) (Invasive) H. Influenzas B<21
320.0,038.41'
58 341
Hepatitis A - Hepatlle A
070.0,070.1
67 1038
Hepatitis B - Hapatlte B
070.2,070.3
Hepatitis C - Hapatlte c
13
Hepatitis non-A, non-B Hepatite non-A, non-B
Herpes Simplex (congenital/neonatal) Herpes (congenital/neonatal)
771.21'
19
2
Leglonellosls - Leglonellose
482.41
8
1
030
Leprosy - Lepre
Usterlosls (all types) 027.0, 771.22"
Usterlosa (taus genres)
084
30 135
Malaria - Paludisma
055 1369 4348
Measles - Rougeola
24 ,('
5
Meningitis, pnaumococcal 320.1
Manlnglte pneumocoques
v
13
Meningitis, other bacterial
·.
Autres manlngitas bactarlannes<"''
l
2
Meningitis/Encephalitis viral 1:li'; Menlnglta/ancephallta vlra10<5J
7f/ 4
Manlngococcal Infections 036
Infections menlngocoquas
90
17
072
Mumps - Oralllons
7
002.1-002.9
1
Paratyphoid - ParatyphoYda
033
19 306
Pertussis - Coqualuche
020
Plague - Pasta
Pollomyelltls - Pollomyellta
045
071
Rabies - Raga
60
056
14
Rubella - Rubeola
Congenital Rubella-Rubaola congenltala 771.0
189 1270
Salmonallosls - Salmonallosa<•I
003
004
26 258
Shlgallosls - Shlgellosa
Syphllls:
12 149
Early, Symptomatic 091
Symptomatlqua, racanta
62 460
090,092-097
Other Syphilis - Autras syphilis
1
037
Tetanus - Tetanos
124
Trichinosis - Trlchlnosa
010,010_
39 540
Tuberculosis - Tuberculose
002.0
9
1
Typhoid - Typho'Cda
28 137
Veroioxlgenic E. coll 008.01'
E. coll verotoxlnogenas
060
Yellow_ Fever - Flevre jauna
-
-
a
a
~
a
-
-
SYMBOLS
. Not reportable
.. Not available
_ No cases reported
Mo·cum.'Cum.
Mols 91 90
12
16
3
27
-
-
-
-
-
-
-
-
20
-
-
-
235
371 2308 2389
-
-
6
-
Mo Cum. cum.
Mols
91 90
-
4
37
11
16
49
72
56
49
71
53
178
295
97
276
-
-
1
-
-
-
-
-
-1
2
-
-
-
-
-
-
-
92
96
-
-
588 1089
1443
-
-
-
-
-
1
1
69 369 307
-
1128 5794 8757
-
-
200
-
183
776
633
-
-
740 1263
-
-
1
1
-
-
891
728
1
936
781
-
-
-
-
494 579
126 707 609
188
98
12
1
1
1
-
4
7
33
80
141
408
326
463
-
-
1
3
2
2
4
-
-
8
7
-
-
10
8
27
36
-
6
52
15
36
20
33
1
11 146 155
57
12
69
-
-
-
-
-
-
-
2
2
3 .
-
-
-
-
-
-
9
-
-
44
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1
2
1
9
2
2
2
1
-
-
-
-
-
-
-
-
-
-
-
-
-
6
6
-
-
-
-
-
-
1
1
1
3
1
-
-
-
-
1
1
3
3
4
7
2
-
6
2
B
1
-
-
1
-
-
-
-
12
13
11
9
14
11
57
6
2
103
43
24
44
67
27
-
B
9
.1
3
1
-
-
-
-
1
-
1
-
-
-
-
-
-
1
3
2
2
1
1
10
5
3
10
24
1
10
1
6
7
-
2
3
3
12
23
2
13
15
-
-
-
2
-
1
9
12
56
70
11
32
41
-
39
-
-
1
49
102
-
-
-
-
-
-
-
-
1
-
28
3
61 185
21
15
-
1
-
1
7
2
-
-
-
4
39
23
-
-
-
6
-
-
-
77
-
85
6
240
55
-
3
14
1
5
54
2
11
46
1
17
-
-
-
-
-
non obligatoire
.. Non disponible
Aucun cas declares
-
219
3
155
149
-
431 3939
-
-
-
30
-
39
-
4
29
-
-
-
-
78 390 376
60
11
54
-
-
-
107
19
468
110
41
1
431
104
6
1
2
-
2
17
-
8
7
18
39
-
-
-
-
2
-
23
34
35
-
-
-
-
-
-
3
12
2
5
3
29
5
3
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
40
1
-
-
1
-
1
-
14
-
19
24
123 . 259
23
-
87
-
-
-
-
-
-
-
4
-
-
-
-
-
-
162 188
85
-
-
-
1
18
-
-
7
85
6
1
2
1
-
-
-
-
-
-
-
-
-
-
3
31
1
1
-
-
--
-
20
109
-
1
-
1
41
-
j
.,
-
3
-
19
25
-
-
3
-
17
33
-
-
1
Mo Cum. Cum.
90
Mols
91
2
3
602
-
-
-
107 615
-
1
-
287
423
151 115
25
1.7
3
-
-
11
304
411
-
/
28
44
61
-
Northwest Territories
Tarrlltolres du Nord ouest
Yukon
Mo Cum. Cum.
Mo Cum. Cum.
Mols
91
90
Mols 91
90
-
SIGN ES
. A declaration
-
2
British Columbia
ColombleBrltannlqua
Alberta
Mo Cum. Cum.
91 90
Mols
2
3
-
Periods se terminant le 30 juin 1991
Saskatchewan
Manitoba
Ontario
-
1
4
-
-
-
1
1
1
-
-
-
-
-
-
-
28
-
-
-
-
-
4
4
-
24
-
-
6
-
-
1
-
2
15
18
-
-
-
-
1
-
-
-
-
-
-
-
-
1
1
13
-
2
14
-
-
-
-
-
-
-
-
-
-
6
2
-3
9
-
-
-
4
2
-
-
SOURCE:
SOURCE:
Disease Surveillance Division
Laboratory Centre for Disease Control
Health and Welfare Canada
Ottawa, Ontario K1A OL2
.Tel.: (613) 957-0334
Division de la surveillance des maladies transmissibles
Laboratoire de Jutte contre la maladie
Santa et Bien-etre social Canada
Ottawa (Ontario) K1A OL2
Tel.: (613) 957-0334
268
t_
(Suite)
(Continued)
a
Botswana: Plague cases continued to be detected in Boteti
District until the beginning of April; the outbreak started in October
1989 among children in a primary school. Plague affected 6
neighbouring villages situated in the area of a natural focus. ill
1990, 70 cases with 3 deaths were reported during the outbreak,
compared with 103 cases with 9deathsin1989. fu all cases the
bubonic form of plague was observed; 72% of the patients were
under 15 years of age. Fever was noted in only 55% of the cases
and enlarged lymph nodes in 99%. The commonest lymph node
type was cervical (44%), followed by groin and axillary. Specific
plague antibodies were detected in 71 % of the patients examined in
the 10 days following treatment with streptomycin, tetracycline,
and, in complicated cases, chloramphenicol. At the beginning of the
outbreak a few patients apparently died of septicemic plague which
later was confirmed by postmortem findings.
Botswana: Des cas de peste ont continue se manifester dans le
district de Boteti jusqu I au debut avril; l' epidemie avait eclate en octobre
1989 chez les elev es d 'une ecole primaire. La maladie a touche 6 villages
voisins situes dans une region qui est un foyer naturel de peste. En 1990,
l'epidernie a entraine 70 cas, avec 3 deces, contre 103 cas et deces en 1989.
Dans taus les cas, il s 'agissait de peste bubonique; 72 % des malades
avaient mains de 15 ans. La fievre n'etait presente que dans 55 % des cas,
mais une hypertrophie des ganglions lymphatiques dans 99 % des cas. Les
bubons etaient principalement situes sur le cou (44 %), l'aine et l'aisselle.
Des anti-corps specifiques ont ete trouves chez 71 % des patients examines
dans les 10 jours suivant le traitement par.la streptomycine, la tetracycline
et, dans les cas compliques, le chloramphenicol. Au debut de l 'epidemie,
quelques malades sont marts, apparemment de peste septicemique, ce qui a
ete ulterieurement confirme par les resultats des autopsies.
Kenya: Forty-four cases of plague were reported, of which 8
were fatal. In early February, 19 cases-and 4 deaths were reported
from Machakos District, Eastern Province. Another 3 suspect cases
and 1 death occurred in the same area in October. In late August, 22
cases and 3 deaths occurred in Nairobi.
Kenya : Quarante-quatre cas de peste ont ere r!lppOrtes, dont 8 deces. Au
debut de fevrier, 19 cas et 4 deces ont ere signales dans le district de
.
Machakos, Province orientale. Trois autres cas suspects et 1 deces se sont
produits dans la meme region en octobre. Ala fin d' aofit, 22 cas et 3 deces
sont survenus Nairobi.
The Americas
Les Amerlques
Forty-eight plague cases with 6 deaths were reported from 4
countries; Bolivia, Brazil, Peru, and the United States of America
representing 4% of the world total number of cases and deaths.
Les 48 cas de peste, avec 6 deces, declares par 4 pays (Bolivie, Bresil,
Etats-Unis d' Amerique et Perou) representent 4 % du total mondial des cas
et des deces.
Brazil: There were 18 plagues cases in 7 municipalities of
Bahia State; all the patients recovered. Most of the cases occurred
among children under 14. From August to October and in
December, the country was free from human plague. There was
only 1 locality where 2 plague cases were recorded within 5 days.
fu 1989, 26 plague cases had occurred in 2 states: Bahia and
Paraiba; all the patients had recovered.
Bresil: Dix-huit cas de peste ont ete emegistres dans 7 municipalites de
l'Etat de Bahia; taus les malades - pour la plupart ages de moins de 14 ans ont gueri. Aucun cas n' a ere signale d I aofit aoctobre, ni en decembre. Dans
un endroit seulement, 2 cas sont apparus mains de 5 jours d'intervalle. En
1989, il y avait eu 26 cas de peste au total - sans aucun deces - dans 2 Etats
(Bahia et Paraiba).
Peru: Two plague outbreaks, involving 18 patients, were
reported from the Departments of Piura and Cajamarca. The first
~tarted at the end of March and lasted 10 days. -Six of the 9 reported
.'.Cases occurred in children. All the patients, except for a19-year-old
boy, recovered. The second outbreak lasted alffiost a mbnth, from
August to September, involving 9 patients betWeen the ages of 10
and 90, of which 3 died. The deaths occurred 6n the fourth to eighth
day of the illness. fu 1989, no plague manifes(ations had been
recorded in this country.
Perou : Deux epidemies de peste, avec 18 malades, ont ete signalees
dans les departements de Piura et de Cajamarca. La premiere epidemie s 'est
declaree la fin du mois de mars et elle a dure 10 jours; 6 des 9 cas signales
concemaient des enfants. Un seul deces a ete emegistre, celui d'un garyon
de 9 ans. La seconde epidernie, en aofit-septembre, a dure pres d'un mois et
a touche 9 personnes (ages extremes, 10 et 90 ans), faisant 3 victimes. Les
deces sont intervenus entre le quatrieme et le huitieme jour de la maladie.
En 1989, le pays n'avait signale aucun cas de peste.
a
a
a
<
BoUvia: Ten cases of human plague were reported, of which 2
were fatal. All the cases occurred in La Paz Department.
Bolivie : On a emegistre 10 cas de peste humaine, dont 2 deces, tous
dans le departement de La Paz.
United States ofAmerica: There were 2 plague cases: 1 in June
and 1 in September. Bothof the patients recovered. A 47-year-old
woman fell ill in Prince Georges County, Maryland, after a visit to
Bolivia. The other case occurred in Fremont County, Colorado, in a
19-year-old girl. fu 1989, 4 plague cases had been recorded in
Colorado and New Mexico.
Etats-Unis d'Amerique: Deux cas de peste ont ete declares, l'un en
juin et l' autre en septembre. Les 2 personnes ont gueri. Dans le premier cas,
il s' agissait d 'une femme de 47 ans tombee malade dans le comte de Prince
Georges (Maryland) apres un voyage en Bolivie. Le second cas, dans le
comre de Fremont, Colorado, concernait une jeune fille de 19 ans. En 1989,
4 cas avaient ete emegistres, au Colorado et au Nouveau-Mexique.
Asia
Asle
Three countries reported 492 plague cases with 27 deaths: Viet
Nam, China and Mongolia, giving 39% and 20% of the
corresponding figures for the w9!l<! total, respectively.
Trois pays, le Viet Nam, la Chine etlaMongolie, ontdeclare 492 cas de
peste, avec 27 deces (respectivement 39 % et 20 % du total mondial).
Viet Nam: A total of 405 cases of human plague were reported
from this country, of which 20 were fatal. No epidemiologic details
were provided.
Viet Nam : Au total, 405 cas de peste humaine, dont 20 deces, ont ete
signales. Aucun detail epiderniologique n' a etc fourni.
China: The total number of plague cases reported from this
country was 75, with 2 deaths. No epidemiologic details were
provided.
Chine : Soixante-quinze cas dont 2 deces ont ere declares. Aucun detail
epiderniologique n' a ete fourni.
269
Mongolia: An outbreak of plague (9 cases, 5 deaths) occurred
in Bayankhongor Aimak (district) where, at the end of July, a
3-year-old girl died after 2 days of fever. Postmortem examination
showed the generalized form of plague. Epidemiologic
investigation revealed 8 additional cases of plague, of which 4 were
fatal. Later, by the end of September, there were 3 cases of bubonic
plague reported from this aimak and from 2 localities of Arkhangai
Aimak; 2 of the patients were children. The diagnosis of the
patients was confirmed immunologically. Thus the total number of
plague cases reported from Mongolia was 12, with 5 deaths (the
corresponding figures for 1989 were 5 and 3, respectively).
Mongolie: Une epidemie (9 cas, 5 deces) a eclate finjuillet dans I'aimak
(district) de Bayankhongor, ou une fillette de 3 ans est morte apres 2 jours de
fievre. L'autopsie a montre qu'il s'agissait d'une forme generalisee de peste. Une
enquete epidemiologique a revele 8 autres cas de peste, dont 4 deces. Un peu
plus tard, vers la fin de septembre, 3 cas de peste bubonique ont ete declares par .·
cet aimak et 2 autres localites de I'aimakd' Arkhangai; 2 des malades etaient desf
enfants. Le diagnostic a ete confirme immunologiquement. Au total done, le
'
nombre de cas declares en Mongolie a ete de 12, avec 5 deces (contre 5 cas et 3
deces en 1989).
Europe
Europe
L' URSS a declare 4 cas de peste, survenus dans 2 regions du Kazakhstan qui
The USSR notified 4 plague cases which occurred in 2 regions
of Kazakhstan, in areas of a natural focus of the disease. Two cases
were recorded within 8 days in Guriev Region. One of the patients
suffered from the bubo-septicemic form of plague. This case was
fatal. The clinical diagnosis was confirmed by the results of
laboratory examination. In the second case, the clinical diagnosis
was bubonic plague, but it was not confirmed bacteriologically due
to early intensive treatment; the patient recovered. Early in
September, 2 plague cases occurred in Aralsk, Kzyl-Orda Region.
Both patients contracted plague while slaughtering a sick camel.
The first patient died of bubo-septicemic plague. In the second
case, the bubonic form of plague was observed; the patient
recovered. In 1989, the USSR had recorded 2 cases of plague (1
death) in the same enzootic area.
Source: WHO Weekly Epidemiological Record, Vol 66, No44,
1991.
Announcement
se trouvent dans un foyer naturel de peste. Deux de ces cas ont ete enregistres en
moins de 8 jours dans la region de Guriev. L'un des malades est decede; i1
souffrait d'une forme bubo-septicemique de peste. Le diagnostic clinique a ete ' ..
confirme au laboratoire. Dans le second cas, le diagnostic clinique de peste
bubonique n' a pu etre confirme bacteriologiquement en raison du traitement
precoce et intensif; le malade a gueri. Au debut de septembre, 2 cas de peste sont
survenus aAralsk, dans la region de Kzyl-Orda. Les 2 patients ont ete infectes en
abattant un chameau malade. Le premier est decede d 'une peste
bubo-septicemique. Le second, atteint de peste bubonique, a gueri. En 1989,
l'URSS avait enregistre 2 cas de peste (1 deces) dans la meme region d'enzootie.
Source: Re/eve epidemiologique hebdomadaire de l'OMS, Vol 66, n° 44, 1991.
An nonce
LA PREVENTION DES INFECTIONS NOSOCOMIALES
Montreal, Quebec
27·31 January 1992 ,,,
LA PREVENTION DES INFECTIONS NOSOCOMIALES
Montreal (Quebec)
Du 27 au 31 janvler 1992
1"'
fj
This 5-day basic course in the prevention of nosocQAtlal
infections, offered by the Association des prof{ssionne'is pour la
prevention des infections (APPi), will assist r~~ently appointed
infection control practitioners in the planning; ,pnplementation,
management, and evaluation of an infection Jontrol program. The
course will be presented in French only. The registration fee is
$350, and enrollment is limited to 25 persons. For fUrther
information and registration, contact:
Ce cours de base de 5 jours en prevention des infections nosocomiales, offe;'t,
par I' Association des professionnels pour la prevention des infections (APPi), a
pour but d'aider !es nouveaux praticiens de la lutte contre !'infection aplanifier,
amettre en oeuvre, adiriger et aevaluer un programme dans ce domaine. Il est
presente en franyais seulement. Les frais d 'inscription sont de 350 $ et le nombre
de participants est lirnite a25. Pour obtenir d' autres renseignements et pour
s 'inscrire, s, adresser a:
Suzanne Mayrand
1944 Saint-Germain Blvd.
Saint-Laurent, Quebec
H4L3Tl
Tel.(514) 747-3755
Suzanne Mayrand
1944, boul. Saint-Germain
Saint-Laurent(Quebec)
H4L3Tl
Tel. (514) 747-3755
The Caru.da DiJeasc1 Weekly RcportpreiCnll cum:nl information m infectious and othor dioc:liCI
for IUl'VCillancc purposes and U. availiiblo &cc of charge upon request. Mmy of tho articles
contain preliminary information e.nd furthor confirmation may be ob!llinod from tho 1ourcc1
quoli:d. Tho Department of Health and Welfi.re docs not UllllllO I"CllpOWibllity for accuracy or
aut.bonticity. Cantributiow arc wclcoou:d (in the officiil language of your choice) from anyooc
working in the health f10ld and will not preclude publication elscwbcro.
Sciontifio AdvU.ory Board:
Dr.1. Spika
Dr. K.Rozco
Editor:
Eleanor Pa.ulaon
AmnantBditor:
Dclktop PublU.hing
CirculAtion:
Nicole Beaudoin
1oanno Regnier
Gertrude Tardiff
Bllll>au of Comnnmicablo DU.Ca.so Epidemiology
Laboratory Centre for DU.Caso Control
T=y'• Pu11m>
fYITAWA, Ontario
Canada
KlAOL2
(613) 957-4243
(613) 957-1329
(613) 957-1788
(613) 957-0841
(613) 957-7845
(613) 957-0842
Lo Rapport hcbdomadairc dc1 maladies au Canada, qui foumit dc1 donn6o1 portinontc1 sur 101 maladies infi>cticulCI ct
101 autre1 maladies dam lo but de facilitor lour IUl'VCil!ancc, pout 8tre oblonu gratuilo1Mnt sur demando. Un arand
nombre d'articles nc contionncnt quo de1 dOOD6c1 sonnrtAirc1 maUi de1 mnscipmcntJ compl6montairc1pcuwnt8tro
obtonus en 1'addre1sant aux sources oit6c1. Le minirtCn> de la SIIl16 natlonalo ct du B~tro IOCill no pout 8tro
rcllJlOil!ablo de l'eXllotitudo, ni de l'authontlcit6 dc1 articlc1. Touto porlOI!llO ocuvrantdam lo d<maino do la awl6 cit
invit6c acollaborcr (dans la languc officiello de •on choix) ot la publication d'un article dam lo J¥Cscnt Rapport n'cn
cmpechc pu la publication allloun.
Groupe de cowcillcrs 1Cientifiquoo:
D'1.Spika
(613) 957-4243
D'K.Rozco
(613) 957-1329
R6dsctricc en cllCf:
Bloanor Pau11cm
(613) 957-1788
R6dactricc adjointo:
Nicolo Beaudoin
(613) 957-0841
(613) 957-7845
JMtiquo:
Joanne Regnier
DUitribution:
(613) 957-0842
Gertrude Tardiff
Bureau d'CpidCmiologic do1 maladio1 trAI11ntl11iblo1
Laba-atoire de luttc contrc la maladic
PnlTllilI»y
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270
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