Date: Wed, 18 May 2016 15:09:56 +0200

Copenhagen, May 18, 2016 (AFP) - The Black Sea coastal areas of Georgia and Russia face a high risk of a Zika virus outbreak, the World Health Organization warned Wednesday, while it also put Europe on alert ahead of the upcoming summer months.   "The likelihood of local Zika virus transmission, if no measures are taken to mitigate the threat, is ... high in limited geographical areas: the (Portuguese) island of Madeira (off Africa) and the north-eastern coast of the Black Sea," WHO said.   The reason for the high-level threat in those areas is the presence there of Aedes aegypti mosquitoes, which carry the Zika virus that health authorities say causes birth defects in new-borns, the UN global health agency said.

Another 18 countries in Europe "have a moderate likelihood" of a Zika virus outbreak, WHO warned.   "The overall risk of a Zika virus outbreak across the WHO European Region is low to moderate during late spring and summer," it said.   That was largely due to the presence of another mosquito species in those countries: the Aedes albopictus, which is less "prone" to causing outbreaks than its cousin in Latin America and the Caribbean, according to research by the Pasteur Institute.   Within the "moderate likelihood" group, France, Italy and Malta had the top three transmission likelihood scores.

The score was based on factors including climatic suitability for the mosquitoes, shipping and air connectivity, population density, urbanisation and history of previous outbreaks of viruses transmitted by insects or other animals.   "With this risk assessment, we at WHO want to inform and target preparedness work in each European country based on its level of risk," said Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

"We call particularly on countries at higher risk to strengthen their national capacities and prioritise the activities that will prevent a large Zika outbreak."   Recent scientific consensus is that Zika causes microcephaly, a form of severe brain damage in new-borns, as well as adult-onset neurological problems which can lead to paralysis and even death.   There is no vaccine or treatment for the virus, which in most people causes only mild symptoms -- a rash, joint pain or fever.
Date: Fri, 19 Jun 2015 12:59:59 +0200 (METDST)

Tbilisi, June 19, 2015 (AFP) - Georgian police on Friday were hunting down a tiger who escaped from the capital's flood-ravaged zoo after another tiger mauled a man to death before being killed.   "A large feline has been spotted by at least 15 local residents" on the outskirts of Tbilisi, Giorgi Metreveli, a professional hunter involved in the citywide police operation to locate the tiger, said in televised comments.   "The search for the animal is underway," he said.   The Rustavi 2 television channel broadcast a few photos of the tiger that local residents had taken with their mobile phones.

"Professional hunters equipped with tranquilliser darts have joined the police operation to hunt down escaped animals," Giorgi Gibradze, spokesman of Georgia's Crisis Management Council, told journalists.   He said an emergency call centre had so far received 47 reports about animals apparently spotted by people in neighbourhoods across Tbilisi, "but all of them turned out to be false alarms."   On Wednesday, a white tiger that escaped from the Tbilisi Zoo mauled a man to death in the city centre before being shot dead by police.   The zoo said on Thursday that several animals may still be at large.   "But we need to complete a thorough inventory of dead and survived animals to know for sure," a spokeswoman told AFP.

The flash flood at the weekend tore through central Tbilisi, wrecking the zoo and killing 19 people including three zoo workers.   Lions, tigers, bears and a hippo were seen roaming the flooded streets after the disaster and were either shot dead or recaptured and returned to their enclosures.   More than half of the zoo's 600 animals perished in the flood.   Animal rights activists have demanded an investigation into the handling of the disaster, insisting that some of the animals shot dead by police did not need to be killed.
Date: Mon 18 Aug 2014
Source: Trend [edited]
<http://en.trend.az/regions/scaucasus/georgia/2303467.html>

Another case of Crimean-Congo haemorrhagic fever was recently registered in Georgia's Shida Kartli region. One of the locals in the region was revealed about a week ago to have the symptoms of the disease.

Vaccination of Crimean-Congo haemorrhagic fever is being held in Shida Kartli region.

This April 2014, 2 people died from this disease in Georgia, and 13 cases of infection with Crimean-Congo haemorrhagic fever [virus] have been identified in Khashuri region of the country.

The disease poses a risk to human life, but in case of timely visit to the doctor, the patient can be saved, doctors say.

Currently, 5 people are undergoing treatment for the disease in the Infectious Diseases Hospital of Tbilisi, one of whom is a 6-year-old girl.

The National Center for Disease Control and Public Health of Georgia noted that the epidemiological situation in the country at present is not a cause for concern.  [Byline: Nana Kirtzkhalia]
===========================
[Cases of CCHF virus infection continue to pop up in Georgia this year (2014), with a total of reported cases now at 13. As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north.

CCHFV is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent.

ProMed Mod.CP (see ProMED-mail archive 20130501.1684736) cited information summarized from a review in The Lancet by Talha Khan Burki (Lancet 2012; 380(9857): 1897-8. doi:10.1016/S0140-6736(12)62097-2; <http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)62097-2/fulltext>): In its immature form, the tick feeds on small mammals. Later, the adult tick attaches itself to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding. Whereas infection in birds mostly tends to be abortive, ostriches are important hosts. In the mid 1990s, South Africa saw a CCHF outbreak at an ostrich abattoir.

About 30 countries in Africa, Asia, and Europe have reported CCHF. The tick is found no further than 50 degrees north latitude, which cuts across Russia, Ukraine, central Europe, and France; the latter 2 regions are not considered to be at any immediate risk; the _Hyalomma_ spp. ticks are present, but there is no serological evidence of CCHF. The distribution of known cases across the Middle East and Africa is patchy; ticks are present in the whole of this region, but in many countries, it seems harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks; and countries such as Angola and Algeria seem not to be at risk.

Only 4 countries report more than 50 cases per year: Iran, Russia, Turkey, and Uzbekistan (although, it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics).

A HealthMap/ProMED-map of Georgia can be accessed at
<http://healthmap.org/promed/p/36365>. - ProMed Mod.TY]
Date: Mon 26 May 2014
Source: Democracy & Freedom Watch [edited]
<http://dfwatch.net/meningitis-cases-rise-to-306-in-georgia-outbreak-98989>

The number of confirmed cases of viral meningitis in the last 2 months in Georgia has jumped to 306. According to Georgia's National Center for Disease Control and Public Health (NCDC), 169 of the cases were in Tbilisi, 51 in Kutaisi, 18 in Adjara, 11 in Rustavi, and one isolated case in each of a number of cities and towns all over Georgia.

[Over the weekend (24-25 May 2014)], 7 new cases were registered in Kutaisi. 38 patients are receiving medical treatment at the hospital in that 2nd largest Georgian city.

The minister of health has repeatedly said that there is no cause for alarm about the viral meningitis outbreak. Also NCDC representatives have said that this kind of thing happens every four years. The last two times viral meningitis peaked was in 2010 and 2006.

Nonetheless, authorities view the situation serious enough that kindergartens and schools up to 6th grade were closed until [27 May 2014] to, as they say, implement additional sanitary measures. TV news showed schools buildings being decontaminated.

The ministry also called on the parents themselves and schools staff to take additional hygiene measures to protect children, most importantly, by providing for a strict personal hygiene, and washing hands frequently. Dining areas should be thoroughly cleaned with disinfectants.

It further said that in schools, pupils should not share utensils like plates and forks. If the 1st symptoms of meningitis are noted, immediately see the doctor. Parents should monitor that their children are following all the hygiene rules.

Schools that have had cases of meningitis must be [?de]contaminated.
===============
[The number of cases of viral meningitis in Georgia has more than doubled -- from 142 cases when last reported on 21 May (ProMED-mail post Viral meningitis - Georgia 20140524.2496603) to now 306 cases on 26 May. The age range of cases is 2 to 34 years and none were said to be severely ill in the prior ProMED-mail post. The cases seem to be occurring throughout Georgia. Apparently the specific virus causing this outbreak has not been identified as yet, even though there were said to be similar outbreaks of viral meningitis in Georgia in 2006 and 2010 (ProMED-mail post Viral meningitis - Georgia 20140524.2496603). However, there were no ProMED-mail posts of viral meningitis outbreaks in Georgia in prior years.

Maps of Georgia can be seen at
<http://www.mapsofworld.com/georgia/maps/georgia-political-map.jpg>
and <http://healthmap.org/promed/p/84>. - ProMed Mod.ML]
Date: Wed 21 May 2014
Source: Democracy and Freedom Watch [edited]
<http://dfwatch.net/schools-closed-in-georgia-due-to-outbreak-of-viral-meningitis-49006>

An outbreak of viral meningitis has spread in schools and kindergartens in Georgia the last few weeks, with 142 confirmed cases so far. Kindergartens and schools up to 6th grade will be closed until 27 May [2014], while sanitary measures are being implemented. This was decided Wednesday [21 May 2014] at a session between staff of the education and health ministries.

But health minister Davit Sergeenko says there is no reason for panic. "Viral meningitis may peak within a 4 year time frame, but it doesn't get severe," Sergeenko said at a press conference on Wednesday [21 May 2014]. He said all the cases are only of medium or light severity. Of the patients, 87 are receiving medical treatment at Iashvili hospital in Tbilisi, he said.

About 15 of the cases are in Kutaisi, Georgia's 2nd largest city, and 4 in Batumi on the Black Sea coast. The youngest patient is 2 years old and the oldest 34.

The health minister says there is no vaccine for the virus causing this outbreak. One of the most effective ways to avoid infection is through good personal hygiene. At the press conference, Sergeenko underlined that there have been no severe cases among all the patients, but added that he has a plan prepared in case the outbreak gets worse. Later, it was announced that the Health Ministry and Education Ministry had decided at a session to close all kindergartens and schools up to 6th grade until 27 May [2014] to tackle the outbreak by beefing up sanitary measures.

Georgia usually has about 150 cases of meningitis in a year, but once every 4 years the number of cases peaks, as it did in 2006 and 2010.

Parents should be on guard and if they see that a child is irritated, lacks appetite or has fever, headache or other symptoms, they must immediately take them to a doctor.

Viral meningitis may be caused by a variety of viruses. Meningitis may also be caused by a certain type of bacteria, and this type of the disease is fatal in about 10 per cent of cases.
===================
[Viral meningitis can be caused by a variety of viruses. Enteroviruses such as Coxsackie and echoviruses are the commonest, although mumps, herpes simplex and polio can be the cause in some instances. The viruses involved in the outbreak above are not specified. Closure of schools and emphasis on personal hygiene are prudent measures under the circumstances. This is the 1st ProMED-mail post of viral meningitis in Georgia, although the above report indicates that outbreaks have occurred there in recent years.

A HealthMap/ProMED-mail map showing the location of Georgia can be accessed at
<http://healthmap.org/promed/p/84>. - ProMed Mod.TY]
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