Outbreak of Chikungunya Fever in Emilia Romagna, Italy

05 September 2007

I would like to bring to your attention an outbreak of Chikungunya Fever in July and August in Ravenna in the Emilia-Romagna Region of eastern Italy.

Chikungunya Fever is a mild self limiting illness characterised by fever, joint pain, muscle pain and headache. Very occasionally it can produce more severe disease especially in elderly and debilitated patients. Treatment is symptomatic only (non-steroid anti-inflammatory medication and simple antipyretics). Currently, pregnant women, those living with significant immunosuppressive disease and patients suffering from severe chronic illness are being advised to consult their physicians prior to travelling to areas of high risk.

The causative agent, Chikungunya virus is an Arbovirus transmitted by Aedes mosquitoes. It is endemic in parts of Africa, Southeast Asia and on the Indian sub-continent. There have been a number of large outbreaks the most notable being in that in the Indian Ocean basin in 2006; during that outbreak there were over 250,000 cases on the island of Réunion alone.

In the outbreak in Italy, there have been over 150 cases to date; this being the first description of indigenously transmitted Chikungunya Fever in Italy. The Italian authorities have put in place control measures including fogging to control mosquito populations around the city of Ravenna. Beyond the area around Ravenna, the risk of Chikungunya is considered to be low.

Ravenna is located on the eastern Adriatic Italian coast, north of Rimini and San Marino and on a level with Bologna. It is very likely that Irish holidaymakers will have travelled or stayed in the area during the exposure interval of July-August 2007 and may have been exposed to local mosquitoes.

The National Virus Reference Laboratory will provide the necessary diagnostics. Serological testing (IgM and IgG) and PCR on individuals who have suspicious symptoms (further information is available here http://www.ndsc.ie/hpsc/A-Z/Vectorborne/ChikungunyaFever/Factsheet) can readily identify the presence of the virus and requires only a 10ml sample of clotted blood.

Further information can be found at: http://www.ndsc.ie/hpsc/A-Z/Vectorborne/ChikungunyaFever/ and http://www.eurosurveillance.org/ew/2007/070906.asp#1. In addition, the European Centre of Disease Prevention and Control (ECDC) provides information on Chikungunya at http://www.ecdc.eu.int/Health_topics/Chikungunya_Fever/Chikungunya_Fever.html.

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1st Benelux Workshop on Education and Training in Disaster Medicine

Brussels, Belgium

Arnhem, The Netherlands

Tuesday October 30 to Friday November 2 2007
Purpose The World Association for Disaster and Emergency Medicine (WADEM) initiated in 2003 a process of developing international standards and guidelines with respect to emergency health and disaster medicine. Following a number of preparatory meetings in Melbourne, Limelette, Barcelona, Athens andEdinburgh, an Issues Paper was published and discussed during an internationalconference in Brussels (October 29-30, 2004) (http://wadem.medicine.wisc.edu/IssuesPaper.htm). The general approach and conceptual framework has also been presented during the 2005 and 2007 World Conference on Disasterand Emergency Medicine in Edinburgh and Amsterdam http://wadem.medicine.wisc.edu/. The objective of the next round of expert meetings and workshops is to prepare an international consensus document (Policy Paper) formulating educational standards and guidelines, highlighting core competencies and training requirements for various situations where there exists a major threat to the health of a community.
Preliminary program for the Benelux Workshop
The Workshop comprises four days of three sessions each, with more or less the same scheme:

9h-12h: morning session: presentations, facilitated discussions, coffee break 12h-13h:lunch 14h-18h: afternoon session: presentations, facilitated discussions, coffee break 18h:diner 19h-21h:reporting session: conclusions & comparing notes

Day 1 and day 2 (in Brussels, Belgium) will further discuss educational standards and guidelines focusing on four majorcategories/themes:
  • NaturalDisasters, Complex Humanitarian Emergencies and International Relief Operations,

  • Public Health Crises, including Communicable Diseases

Day 3 and day 4 (in Arnhem, The Netherlands)

  • Prehospital Preparedness for Mass Emergency Situations
  • MASH general hospital Preparedness in view of major internal & external emergencies For each scenario/sectors there will be a number of introductions and presentations to stimulate discussion and exchange of ideas, amongst others: on
  • the Sphere Project (Humanitarian Charter and Minimum Standards in DisasterResponse), Humanitarian Accountability Project, the Quality Platform, ALNAP, HPNHumanitarian Practice Network, i-R
  • epidemiological databases like CRED (Centre for Research on the Epidemiology of Disasters), ADPC (Asia Disaster Preparedness Center)
  • the WHO-HAC Phuket Papers and lessons learned from the 2004 Asian tsunami
  • pandemic preparedness in Europe, Australia,New Zealand
  • the conclusions of the 4th Joint EC/ECDC/WHO Workshop on Pandemic Influenza Preparedness of 25-27 September 2007
  • the Melbourne E&T program
  • the WHO-EU discussion paper on recent health crises in the WHO European Region
  • national training program for psychosocial support in Luxembourg
  • E&T for Saudi Hospitals, for the Morocco EMS
  • Prehospital health services in Greece, Belgium, the Netherlands,Australi
  • the Bologna Bachelor/Master standard

The objective of these 12 sessions is to develop educational standards and a detailed E&T curriculum following the approach presented in Wadem’s Issues Paper and the Utstein template proposing core competencies and electives based on systematic health need and risk assessments, linking “trauma profiles” with the typology and “pathophysiology” (events, hazards and parameters) for both generic core preparedness and identified scenarios/disaster types with references to existing guides or reference articles focusing on two levels:
  • training program for health professionals and continuing medical education
  • academic BaMa level

The 1st Benelux Workshop will be followed in the next 20 months by similar meetings in Asia, Canada and Europe and a dedicated Web Site. Seeking the broadest possible international input and inviting expert opinion and experiences in different fields, an exchange will be organized with relevant international agencies and NGO’s. An international consensus document will be published and presented at the 2009 World Conference on Disaster and Emergency Medicine (www.wcdem2009.org).

Venue The Workshops Conference will be held on day 1 and day 2 at the Amazone Conference centre in 1030 Brussels, Belgium. Part 1 will begin at 09.00 a.m. on Tuesday October 30 and end at 21.00 p.m. on Wednesday October 31, 2007. The second part will be held the premices of NIFV-Nibra at 6816 RW Arnhem, the Netherlands. Day 3 will begin at 09.00 a.m. on Thursday November 1 and end on day 4 at 18.00 p.m. on Friday November 2 2007. Participation and conference fees Participants should have responsibility for, or practical experience in Disaster Medicine or Major Incident Management, and can choose to attend the sessions of one, two, three or all four days. Please complete the attached registration form and return it by post or fax at your earliest convenience. Closing date for registration is October 14, 2007. The Applicant will receive a contract for participation in the conference. All conference fees should be paid before the deadline of October 14, 2007. The number of participants per sessions is limited to 12.

The standard fee for the four-day workshop of 600 EURO is inclusive of the cost of workshops, documents; modest standard accommodation (medium single room) for Tuesday, Wednesday and Thursday Night, group transport between Brussels-Arnhem and back; breakfast, lunch, coffee breaks, and dinner from Day 1 to Day 4. Additional nights can be booked at a rate of 100 euro/night. WADEM-member rate for the standard Conference Package is 550 EURO. Cancellations received in writing by October 14 will be accepted and fees refunded less a 100.00 EURO administration fee. Cancellations after this date cannot be accepted; however transfer of registration to another person will be accepted. Conference fees can be paid by VISA credit card (please write or fax to contact address) or by international money transfer to the following account. BANK ACCOUNT FOR PAYMENTS : ECOMED bvba Huart-Hamoirlaan 68 1030 Brussels, Belgium Bank accountnumber: 001-3397778-41 SWIFT or BI code : GEBABEBB IBAN code : BE880013 3977 7841


Non standard bookings and accommodation

Participants can also choose to attend one or more days at a rate of 150 euro/day. For special arrangements, e.g. double rooms or individual bookings of accommodation or transport please write for more information.

Further Information and Contact Address Participants requiring further information or interested persons wanting to send in contributions or comments, please contact Dr. Geert Seynaeve Fax: +32 2 2156469 E-mail: fa082693@skynet.be


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Neckties, Jewelry Banned for UK Doctors

British hospitals are banning neckties, long sleeves and jewelry for doctors -- and their traditional white coats -- in an effort to stop the spread of deadly hospital-borne infections, according to new rules published Monday. Hospital dress codes typically urge doctors to look professional, which, for male practitioners, has usually meant wearing a tie. But as concern over hospital-born infections has intensified, doctors are taking a closer look at their clothing. "Ties are rarely laundered but worn daily," the Department of Health said in a statement. "They perform no beneficial function in patient care and have been shown to be colonized by pathogens." The new regulations would mean an end to doctors' traditional long-sleeved white coats, Health Secretary Alan Johnson said. Fake nails, jewelry and watches, which the department warned could harbor germs, are also out. Johnson said the "bare below the elbows" dress code would help prevent the spread of Methicillin-resistant Staphylococcus aureus, or MRSA, the deadly bacteria resistant to nearly every available antibiotic. Popularly known as a "superbug," MRSA accounts for more than 40 percent of in-hospital blood infections in Britain. Because the bacteria is so hard to kill, health care workers have instead focused on containing its spread through improvements to hospital hygiene. A 2004 study of doctors' neckties at a New York hospital found that nearly half of them carried at least one species of infectious microbe. In 2006, the British Medical Association urged doctors to go without the accessories, calling them "functionless clothing items." The dress code comes into force next year. By RAPHAEL G. SATTER Associated Press Writer 10:51 AM EDT, September 17, 2007 LONDON Το σχόλιο αυτό μας το έστειλε η Αγορίτσα Μπάκα και την ευχαριστούμε


The State of the World’s Children 2007 examines the discrimination and disempowerment women face throughout their lives – and outlines what must be done to eliminate gender discrimination and empower women and girls. It looks at the status of women today, discusses how gender equality will move all the Millennium Development Goals forward, and shows how investment in women’s rights will ultimately produce a double dividend: advancing the rights of both women and children.

τι είναι ο πυρετός Chikungunya ;

Chikungunya fever is a viral illness that is spread by the bites of infected mosquitoes. Chikungunya fever typically lasts from five to seven days and frequently causes severe and often incapacitating joint pain which sometimes persists for much longer periods. It is rarely life-threatening. There is no specific treatment for the disease but analgesics and non-steroidal anti-inflammatory medication may be used to reduce the pain and swelling. Aspirin should be avoided.

There is no vaccine against this virus, so preventive measures depend entirely on avoiding mosquito bites which occur mainly during the daytime, and eliminating mosquito breeding sites.

To avoid mosquito bites:

  • wear clothes that cover as much skin as possible;
  • use mosquito repellents on exposed skin and on clothing in accordance with label instructions;
  • use mosquito nets to protect babies, older and sick people and others who rest during the day. The effectiveness of mosquito nets can be improved by treating them with WHO-recommended insecticides.
  • use mosquito coils and insecticide vaporizers during the daytime.

The Aedes mosquitoes that transmit chikungunya virus breed in a wide variety of rain-filled containers which are common around human dwellings and workplaces, such as water storage containers, saucers under potted plants and drinking bowls for domestic animals, as well as discarded tyres and food containers.

To reduce mosquito breeding:

  • remove discarded containers from around the house;
  • for containers that are in use, turn them over or empty every 3–4 days to prevent mosquito breeding including any water-filled containers indoors. Alternatively, completely cover them to keep out mosquitoes.

Between February and October 2006 alone, more than 1.25 million people in India and south Asia were infected with the chikungunya virus. Other large-scale outbreaks of chikungunya fever have occurred in countries of east and central Africa, and the Indian Ocean countries, including Comoros, Gabon, Madagascar, the Maldives, Mauritius, Mayotte, Reunion (France) and the Seychelles. In September 2007, a chikungunya outbreak following an imported case has been notified in northern Italy. The dramatic resurgence and geographic extension of chikungunya in recent years underlines our vulnerability to emerging infectious diseases spread by insects and emphasizes the importance of sustained control programmes as an essential component of health security.

Related links

Chikungunya fever epidemic in India Chikungunya fever archive

Η ανάγκη συνεργασίας σε διεθνές επίπεδο σε θέματα υγείας πιο επίκαιρη από ποτέ

Υπογράφτηκε στις 5 Σεπτεμβρίου στο Λονδίνο μνημόνιο συνεργασίας μεταξύ διεθνών φορέων με σκοπό την ενδυνάμωση και περαιτέρω εμβάθυνση της συνεργασίας στον τομέα της υγείας καθώς και την επίτευξη των αναπτυξιακών στόχων χιλιετίας που αφορούν σχετικά θέματα. Στόχος του νέου φορέα συνεργασίας, στον οποίο μετέχουν οι παρακάτω φορείς GAVI Alliance, Global Fund to Fight AIDS, Tuberculosis and Malaria, Joint United Nations Programme on HIV/AIDS (UNAIDS), UNICEF, United Nations Population Fund, World Bank, και World Health Organization είναι η διάδοση της γνώσης αλλά και η παροχή τεχνικής βοήθειας και χρηματοδότηση με στόχο ένα αποτελεσματικό και βιώσιμο σύστημα υγειάς για όλους. Δείτε περισσότερες πληροφορίες εδώ
Απο την Κα Εβίκα Καραμαγκιώλη

Τραγικές οι συνέπειες της περιορισμένης χρήσης οπιοειδών φαρμάκων στις αναπτυσσόμενες χώρες

Εκατομμύρια ασθενείς σε αναπτυσσόμενες χώρες, κυρίως της Αφρικής, είναι καταδικασμένοι σε αφόρητους πόνους λόγω της απροθυμίας γιατρών και κυβερνήσεων να χορηγήσουν μορφίνη. Το γεγονός αυτό οφείλεται στην καχυποψία των αρχών και τις υπερβολικές πεποιθήσεις των γιατρών για την επικινδυνότητά της. Σύμφωνα με τον Παγκόσμιο Οργανισμός Υγείας εκτιμάται ότι κάθε χρόνο 4,8 εκατομμύρια καρκινοπαθείς με μέτριο έως έντονο πόνο δεν λαμβάνουν την απαραίτητη αναλγητική αγωγή. Το ίδιο συμβαίνει και με 1,4 εκατ. άτομα με AIDS στο τελικό στάδιο, καθώς και με εκατομμύρια άλλους που υποφέρουν λόγω εγκαυμάτων, τραυμάτων, διαβητικής νευροπάθειας και άλλων επώδυνων νοσημάτων. Σε αντίθεση με έξι δυτικές χώρες -ΗΠΑ, Καναδάς, Γαλλία, Γερμανία, Βρετανία Αυστραλία- που καταναλώνουν το 79% της νόμιμης παραγωγής μορφίνης οι φτωχές και μέσου εισοδήματος χώρες, όπου ζει το 80% του παγκόσμιου πληθυσμού, περιορίζονται στο 6%. Στις περισσότερες αφρικανικές χώρες ειδικότερα όπου η ιατρική χρήση της μορφίνης επιτρέπεται, μόνο οι γιατροί και ορισμένοι φαρμακοποιοί μπορούν να τη χορηγούν. Στην Σιέρα Λεόνε για παράδειγμα το πρόβλημα είναι ότι υπάρχουν μόνο 100 γιατροί σε όλη τη χώρα - ένας ανά 54.000 κατοίκους. Δεδομένου δε ότι δεν υπάρχουν καν αξονικοί τομογράφοι, και οι ασθενείς είναι συχνά καταδικασμένοι σε θάνατο, η μορφίνη θα μπορούσε τουλάχιστον να απαλύνει τα συμπτώματα. (www.in.gr) The International Narcotics Control Board (INCB) World Health Organization (WHO)
Απο την Κα Εβίτα Καραμαγκιώλη

Global Symposium +5 "Ιnformation for Humanitarian Action"

Global Symposium +5 "Information for Humanitarian Action" will take place in Geneva, Switzerland, from the 22 - 26 October 2007 at the Palais des Nations. Its purpose is to bring together a community of practice on humanitarian information and shared knowledge. Η πληροφορία αυτή μας ήρθε απο την Κυρία Εβίκα Καραμαγκιώλη και την ευχαριστούμε

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The World Health Report 2007 - A Safer Future Στην ετήσια αναφορά του για το 2007 ο Παγκόσμιος Οργανισμός Υγείας αναφέρεται στην ανάγκη εμβάθυνσης της διακρατικής συνεργασίας για την αντιμετώπιση πανδημικών φαινομένων επισημαίνοντας ότι ο παγκοσμιοποιημένος τουρισμός και το διεθνές εμπορίου αποτελούν σημαντικές αιτίες για την γρηγορότερη εξάπλωση τους. Όπως έχει επισημανθεί όχι μόνο από τον εν λόγω φορέα αλλά και την ΕΕ και όπως έχει επιβεβαιωθεί και στην πράξη μόνο μέσα από την ανταλλαγή πληροφοριών, την αμφίδρομη επικοινωνία αλλά και την συντονισμένη συνεργασία εθνικών αρχών, φορέων δημόσιας υγείας και διεθνών οργανισμών αρωγής, είναι δυνατή όχι μόνο η αντιμετώπιση αλλά κυρίως η πρόληψη ανάλογων καταστάσεων. Εβίκα Καραμαγκιώλη