Infectious diseases: July 2009 Archives
Trachoma, the leading infectious* cause of blindness in the developing world, has been eliminated from Ghana, Mexico, and Saudi Arabia, according to a press release from the Carter Center and the International Trachoma Initiative. Ghana is the first sub-Saharan African country to purge the disease.
Elimination of trachoma** was achieved by using the so-called SAFE strategy of the World Health Organization—which includes eyelid surgery, antibiotics (ie, azithromycin), facial cleanliness, and environmental improvements. The strategy was used successfully 3 years ago to wipe out trachoma in Iran, Morocco, and Oman and is the basis of the WHO's Alliance for the Global Elimination of Blinding Trachoma by the year 2020.
Azithromycin (Zithromax) is currently being donated by Pfizer, in conjunction with the Edna McConnell Clark Foundation. The drug company and the foundation originated the International Trachoma Initiative in 1998.
* Caused by the bacteria Chlamydia trachomatis.
** Defined by WHO as 1) elimination of blinding cases of trachomatous trichiasis through surgery (or at least offering surgery to all cases); 2) reducing cases of trachomatous follicular conjunctivitis in adults to fewer than 1 per 1000; and 3) reducing the prevalence of trachomatous follicular conjunctivitis in children (age range, 1-9 years) to less than 5%.
Image of trachomatous conjunctival scarring from WHO trachoma grading cards.
To conserve overtaxed resources—particularly laboratory resources—the World Health Organization will no longer provide its usual tabulated updates for the number of swine flu (H1N1) cases worldwide. Instead monitoring will focus on seminal cases in newly affected countries, clusters of fatal or otherwise severe cases, and evidence of unusual transmission. Details of the policy change were provided in a briefing note posted yesterday at the WHO web site.
WHO reports that the "overwhelming majority" of H1N1 cases have been mild, with spontaneous recovery, despite the fact that the virus has spread with "unprecedented speed." Confirming these cases with laboratory testing, however, is "extremely resource-intensive," WHO writes. "In some countries, this strategy is absorbing most national laboratory and response capacity, leaving little capacity for the monitoring and investigation of severe cases and other exceptional events."
For countries well ensconced in the H1N1 pandemic, surveillance procedures will now mirror those used to assess seasonal influenza activity. Countries with "well-established laboratory-based surveillance systems" will monitor any changes in the H1N1 virus.
According to WHO's most recent (and last) global update, on July 6, a total of 94,512 H1N1 cases had occurred throughout 135 countries or territories. The overall mortality rate remains steady, at 0.45% (429 deaths).
The latest update from the World Health Organization reveals the number of swine flu cases worldwide at 77,201—a nearly 50% increase from the June 22nd update. Deaths total 332 (up from 113) for an unchanged mortality rate of 0.43%.
H1N1 cases have now been reported in 120 countries or territories, and related deaths have occurred in 17. Countries disproportionately affected by new cases (where more than 500 cases have occurred) include Thailand, the United Kingdom, Brazil, Peru, and Spain. The number of swine flu deaths in the United States now surpasses those in Mexico.
|
Country |
Cases |
Deaths |
|
Brazil |
680 |
1 |
|
Honduras |
118 |
1 |
|
Philippines |
861 |
1 |
|
Spain |
717 |
1 |
|
Uruguay |
195 |
1 |
|
Colombia |
93 |
2 |
|
Costa Rica |
279 |
2 |
|
Dominican Republic |
108 |
2 |
|
Guatemala |
254 |
2 |
|
Thailand |
1414 |
3 |
|
United Kingdom |
6538 |
3 |
|
Australia |
4090 |
7 |
|
Chile |
6211 |
12 |
|
Canada |
7983 |
25 |
|
Argentina |
1587 |
26 |
|
Mexico |
8680 |
116 |
|
United States |
27,717 |
127 |
