Date: Sun, 7 Jul 2019 18:22:45 +0200

Dhaka, July 7, 2019 (AFP) - Monsoon-triggered landslides in Rohingya refugee camps in Bangladesh have killed one person and left more than 4,500 homeless, aid officials said Sunday.   About 35 centimetres (14 inches) of rain fell in 72 hours before the landslides started Saturday in camps around Cox's Bazar that house more than 900,000 of the Muslim minority who fled Myanmar, the UN said.   Twenty-six landslides were reported in makeshift camps built on hills near the border with Myanmar. Trees there have been torn up to build huts and for firewood, leaving the terrain unstable.   UN refugee agency official Areez Rahman said about 30 shanty camps have been affected by the storms. One woman in her 50s died after being hit by a wall that collapsed, he told AFP.

Nur Mohammad, a 40-year-old Rohingya in the main Kutupalong camp, said 12 relatives had fled their tarpaulin-clad huts on the hills to take shelter with him.   "My home is already overcrowded. I'm worried how I will feed all these people," he said.   Officials said some 5,000 Rohingya on a strip of no man's land between Bangladesh and Myanmar had also been badly hit by the storms.   "Children are suffering from diarrhoea and we don't have enough drinking water," camp leader Dil Mohammad told AFP by phone.   He said most of the camp was knee deep in water as Myanmar authorities had put a dam on a nearby river.   Bangladesh's refugee commissioner Mohammad Abul Kalam said on Sunday emergency preparations were being made.

Monsoon storms killed 170 people in the refugee camp in 2017.    Last year the UN refugee agency moved 30,000 Rohingya out of areas considered at high risk of landslides and floods.   Some 740,000 Rohingya fled a military crackdown in Buddhist-dominated Myanmar's Rakhine state in August 2017, joining about 200,000 already living in camps across the border.   Bangladesh wants to relocate up to 100,000 of the refugees to a remote island in the Bay of Bengal but this is opposed by the refugees and international rights groups.
Date: Sun 23 Jun 2019
Source: The Independent [edited]
<http://www.theindependentbd.com/post/204431>

The number of encephalitis-affected children has almost doubled from last year's [2018's] count in different hospitals in Dhaka and elsewhere in the country. According to data provided by Institute of Epidemiology, Disease Control and Research (IEDCR), more than 1200 patients affected by encephalitis were admitted in different hospitals across the country till 20 Jun this year [2019]. The number of affected patients was about 650 in 2018.

Experts say that though the number of patients has increased this year [2019] from last year [2018], there is no cause for panic. However, they suggest all to remain alert about the disease. Recently, encephalitis has claimed 142 lives in neighboring India. But the condition of Bangladesh is still under control, say doctors.

Sources say 2-3 children affected by encephalitis have been admitted to the Dhaka Medical College Hospital (DMCH).

IEDCR director Dr Meerjady Sabrina Flora told The Independent that the number of affected patients has increased this year [2019]. "However, there is nothing to worry [about] right now," she said. "We collect data from across the country. Our surveillance team is working at the field level. In case of any trouble, we'll take immediate steps."

Dr Sayeeda Anwar, head of paediatrics at Dhaka Medical College Hospital, said there was nothing to worry.

Encephalitis, a rare life-threatening disease, is an inflammation of the brain tissue. The most common cause is viral infection. Symptoms of encephalitis can range from mild to severe. Mild symptoms include fever, headache, vomiting, stiff neck, and lethargy. Patients should call the doctor immediately if anyone displays symptoms of encephalitis.

There are 2 main types of encephalitis: primary and secondary. Primary encephalitis occurs when a virus directly infects the brain and spinal cord. Secondary encephalitis occurs when an infection starts elsewhere in the body and then travels to the brain.

Mosquitoes are carriers of this disease [virus]. In addition, the disease can spread if anyone eats fruits that are eaten by bats and birds.

Prof. Khan Abul Kalam Azad, chairman of the medicine department of DMCH, said the disease resistance among children was low. In this case, there is no alternative to vigilance. "If we can take enough protection to protest this disease in due time, we'll able to minimise the number of patients in Bangladesh," he added.
========================
[The above report, quoting health authorities, implicates aetiological agents responsible for these cases of encephalitis only indirectly. It mentions disease transmitted by mosquitoes, which implies cases due to infection with Japanese encephalitis (JE) virus. Bangladesh is well within that geographic area where JE virus is endemic. The officials also mention fruit eaten by bats, implying Nipah virus infection. Giant flying fox fruit bats (_Pteropus_ spp) are reservoir hosts of Nipah virus. The bats contaminate fruit as well as palm sap in collection pots, with cases occurring following human consumption in the Bangladeshi "Nipah belt" annually. Interestingly, no mention is made of other etiologies of encephalitis proposed in neighboring India, including consumption of lychees, as causes of acute encephalitis syndrome of children.

Encephalitis cases have been reported in Bangladesh before. Research from Bangladesh, published in the July 2017 edition of The American Journal of Tropical Medicine and Hygiene (see Ref. 1), has proven that it is not the fruit but a banned pesticide that is the actual culprit.

It would be interesting to know if laboratory tests have been done to confirm or rule out possible etiological agents of these recent cases in Bangladesh. Any further information from knowledgeable sources would be highly appreciated. - ProMED Mod.TY]

[Ref. 1: Islam MS, Sharif AR, Sazzad HMS, et al.: Outbreak of Sudden Death with Acute Encephalitis Syndrome Among Children Associated with Exposure to Lychee Orchards in Northern Bangladesh, 2012; The American Journal of Tropical Medicine and Hygiene; 2017: 97(3): 949-957. doi:
<https://doi.org/10.4269/ajtmh.16-0856>.
<http://goo.gl/F9VRMC>.

HealthMap/ProMED-mail map:
Bangladesh: <http://healthmap.org/promed/p/153>]
1st April 2019
https://www.aa.com.tr/en/asia-pacific/rainstorm-lightning-kill-10-kill-in-bangladesh/1439210

Rainstorm, lightning kill 10 kill in Bangladesh

DHAKA, Bangladesh 

At least 10 people were killed and dozens other injured as a tropical storm lashed different parts of Bangladesh, including capital Dhaka, on Sunday evening, local media reports said. The storm, coupled with gusty winds and lightning uprooted trees, sunk a boat, blew away bricks from buildings and collapsed a wall, reports said citing police and Met Office as sources. Of the deceased, six were killed in Dhaka, including a woman and her five-year-old son who drowned when a boat capsized in River Buriganga during the storm. Two people were killed as bricks from under construction buildings fell on them. A 45-year-old woman was killed after a tree fell on her and a rickshaw puller died as a wall collapsed on him.

Authorities had to close down river routes and operations of flights at Dhaka’s international airport for about two hours, the New Age newspaper reported.  Also, four people including two teenage sisters were struck dead by lightning on Sunday, the report added.  According to Dhaka Medical College and Hospital sources, at least 18 people came to the hospital with minor injuries after the storm. Both April and May are very prone to seasonal storms in the South Asian country with hundreds of rivers.

Date: Fri 15 Mar 2019
Source: Prothom Alo [edited]
<https://en.prothomalo.com/bangladesh/news/192569/3-of-a-family-infected-with-Nipah-virus>

The 3 members of a family from Baliadangi upazila's [2nd-lowest tier of regional administration] Ujarmoni village in Thakurgaon [district] are suspected to have been infected with the deadly Nipah virus, reports United News of Bangladesh [apparently later confirmed as Nipah virus; see below. - ProMED Mod.TY].

The victims include a 28 year old mother; her son, aged 8; and her daughter, aged 4. They were taken to Rangpur Medical College Hospital on Thursday [14 Mar 2019], said ABM Maniruzzaman, the resident medical officer of Baliadangi Upazila Health Complex. He said the victims had been suffering from fever for the last 3 days. They also reported headache and vomiting. The trio was 1st taken to Thakurgaon Modern Sadar Hospital and later shifted to RMCH.

Nipah virus is transmitted from animals to humans and can also be transmitted through contaminated food or directly between people, according to the World Health Organisation. There is no vaccine for the virus, which is spread through body fluids and can cause inflammation of the brain.

The mother's husband said his wife and children fell sick after eating jujube [fruit of the _Ziziphus jujuba_ bush] on Wednesday night [13 Mar 2019].

Thakurgaon civil surgeon Abu Mohammad Khairul Kabir said their blood samples had been collected for testing. A medical team from the Institute of Epidemiology, Disease Control and Research is scheduled to visit RMCH.

In February [2019], 5 members of a family died mysteriously in Baliadanga upazila. It is unclear what caused their deaths [Nipah virus is suspected]. In 2001, Nipah virus was identified as the causative agent in an outbreak of human disease occurring in Bangladesh. Genetic sequencing confirmed this virus as Nipah virus, according to the Centre for Disease Control and Prevention.
======================
[This is the 2nd family in Bangladesh to have been infected by Nipah virus this year [2019]. Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and . . . they contaminate date palm sap or the fruit. [The above report suggests that the family may have eaten contaminated jujube fruit]. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April."

"It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur."

An image of a _Pteropus_ fruit bat can be found at
<http://upload.wikimedia.org/wikipedia/commons/3/3d/Pteropus_giganteus_fg01.JPG>. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Bangladesh: <http://healthmap.org/promed/p/153>
Rangpur Division, Bangladesh: <http://healthmap.org/promed/p/16030>]
Date: Mon 4 Mar 2019
Source: The Daily Star [edited]
<https://www.thedailystar.net/city/news/death-5-thakurgaon-nipah-virus-found-victims-body-1710307>

The Institute of Epidemiology, Disease Control and Research (IEDCR) has found the presence of Nipah virus in one of the 5 family members who died in Baliadangi upazila of Thakurgaon early in February [2019; upazilas are the 2nd lowest tier of regional administration in Bangladesh].  "Samples of one of the deceased were collected, and investigators detected presence of Nipah virus there," said IEDCR Director Meerjady Sabrina Flora in a statement yesterday [3 Mar 2019].

IEDCR formed 2 committees, which conducted investigations at Baliadangi Upazila Health Complex, Thakurgaon Sadar Hospital, Rangpur Medical College Hospital and various places of Baliadangi upazila between 25 Feb-1 Mar [2019].

During the time, investigators also collected samples of hospital doctors, nurses, health workers and family members of the victims, neighbours, and villagers. The investigation found that those who died had fever, headache, vomiting, and infection. Nipah virus was not found in samples of living persons of the family.  "In the investigation, it was not known if the deceased had a history of drinking raw date palm sap (a popular drink), but the investigators think 4 of the victims were infected by Nipah virus from the other," said the IEDCR statement.

Nipah virus generally transmits through drinking date palm sap infected by bats carrying the virus. Meerjady has advised all not to drink raw date sap.  If anyone is infected by Nipah virus, health personnel and family members should use masks and gloves when they take care of the patients, and wash hands with soap afterwards. The patients should be kept in isolated environment, she said.
====================
[Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251) "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and, as the above report indicates, they contaminate date palm sap or the fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As mentioned in comments in a previous post (ProMED-mail archive no. http://promedmail.org/post/20140113.2168940), local residents scarify the upper areas of palm trees to collect sap in large jars. The bats come to drink the sap and defecate and urinate in the sap. If the bats are shedding Nipah virus, it contaminates the sap. If the sap is consumed uncooked, humans that drink it can become infected. Local people say that cooking the sap adversely alters the flavour. However, skirts made of local bamboo can serve as a barrier preventing bats' access to the sap collecting sites. Person to person transmission can occur as well.

It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered, there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection is implemented, sporadic cases will continue to occur.

An image of a _Pteropus_ fruit bat can be found at
<http://upload.wikimedia.org/wikipedia/commons/3/3d/Pteropus_giganteus_fg01.JPG>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Bangladesh: <http://healthmap.org/promed/p/153>.]
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