Madagascar: LOTS OF DEATHS
http://www.todayonline.com/articles/106658.asp
Fever grips Madagascar as doctors uncertain of cause
Wednesday March 15, 2006
Since early January, nearly all the residents of Madagascar's eastern port town of Toamasina have been struck by a fever, a symptom doctors have failed to attribute with certainty to either disease currently affecting the coastal population.
The medics suspect dengue fever or a crippling mosquito-borne disease called chikungunya, but they cannot exactly tell the cause as both illnesses have near identical symptoms, are spread by the same vector and have no known cure nor vaccine.
With the current rainy season, pools of stagnant water and leafy grass provide suitable breeding conditions for mosquitoes. Residents here also call it the "season of malaria."
"In the last three months, between 80 and 90 percent of Toamasina residents have had a fever," said Clarette Dinh-Van, a general physician operating a private clinic in Toamasina, home to some 200,000 people and Madagascar's largest port.
Early this month, health officials said the island had recorded its first cases of chikungunya, locally abreviated as "chik" and which is attributed to the deaths of some 93 people in the French overseas territory of Reunion.
They also announced cases of dengue fever, a disease characterised by a sudden high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain.
"Chik or dengue, we truly do not differentiate," said Sahondra Randriamamahatra, head doctor of Ankihirihy dispensary in Toamisina's slum city.
"The symptoms are very identical and we treat them the same way," he added.
Randriamamahatra said 288 cases of fever were reported in January, 1,159 last month and already 456 in the first week of March.
The vast Indian Ocean island lacks medical facilities to carry out proper diagnosis. Since last month about 20 blood samples were taken to France for analysis.
At the packed dispensary, two girls make their way through the crowd of patients, their bodies speckled with rashes and complain of joint pains before seeing the doctor.
"According to what I know, the symptoms of chik is swelling of joints. These two girls do not have swellings. To me it is dengue," Randriamamahatra said as he administered the diagnosis.
The approximate diagnosis is widespread and is blamed for many deaths due to the fever.
"In the last weeks, I spend days and nights in the hospital because my whole familiy has been affected," said Arnaud Mony, a district head in Toamasina.
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Every day, bodies are removed from the hospital. It was more intense in February," he added, referring to the town's biggest hospital.
Although authorities have engaged in a clean-up exercise to drain canals and clear garbage in order to destroy mosquito breeding grounds, just about 10 of Toamasina's 138 districts have been involved in the operation.
"Everytime it rains, mosquito breeding grounds emerge and what we are doing will not stop the virus," lamented Jean-Baptiste Beresaka, an official with the town's clean-up team. AFP
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Chikungunya: WHO Lies
http://www.newsone.ca/westfallweeklynews/s...lnews&id=154254
WHO chief says Indian Ocean fever fears exaggerated
Staff and agencies
08 March, 2006
By Nita Bhalla 2 hours, 21 minutes ago
PORT LOUIS - The media is over-reacting to a crippling mosquito-borne disease currently sweeping across the Indian Ocean region, the World Health Organization (WHO) said, adding that the disease is rarely fatal.
"Chikungunya" fever, a painful disease for which there is no cure or vaccine, has infected more than 180,000 people, mostly in Reunion but also in Mauritius, Seychelles, Mayotte and Madagascar, all located off the southeast coast of Africa.
"I think it is exaggerated. It is less alarming than what is being painted in the media," WHO director general Lee Jong-wook told a news conference late on Tuesday.
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If it was a real issue, we would go in the hospitals and see people are dying."
Lee, visiting Mauritius to launch a global report on chronic diseases, said he did not believe the chikungunya virus was generally fatal.
But he urged local populations to protect themselves by using repellent and removing mosquito breeding areas such as stagnant water pools and rubbish.
The tropical virus, first recognized in Tanzania in 1952, is marked by high fever and severe rashes and can be extremely painful, leaving its victims in a stooped posture. Symptoms can last from seven days to a few months.
The French volcanic island of Reunion has reported 186,000 cases and government officials say there have been 93 deaths which may be partly linked to the virus.
Health experts say the tropical virus can weaken the immune system, allowing other deadly diseases to set in.
Neighboring Mauritius has so far reported 1,500 cases and around 6,000 suspected cases and are awaiting the test results after a 33-year-old man died last month. Officials say the numbers of new cases are declining.
Seychelles has had over 1,000 cases, the French island of Mayotte has had 2,000 cases and Madagascar this week confirmed one case of the virus. The Indian ocean islands are concerned the impact the outbreak will have on their vital tourism sectors, but Jong-wook said the WHO would issue a statement to reassure people planning to visit the region.
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