Date: Wed 30 Dec 2009
From: Patricio Leite (translated and edited)

Three people are sick with malaria in the Madeira archipelago of Portugal. One is in intensive care for complications of the disease in the Central Hospital of Funchal; the other 2 remain hospitalized but stabilized.

These people from Madeira were working in Equatorial Guinea and returned for the Christmas holidays. There is a 4th, a Brazilian national who also may be infected and is undergoing diagnostic tests.

Although they are cases of imported malaria, it is noteworthy that the archipelago of Madeira has a sub-tropical humid climate, conducive to the development of emerging diseases which are usually more prevalent in the tropics.

For example, for about the last 3 years the presence of the vector _Aedes aegypti_ has been documented, and it is now endemic in Madeira, posing the threat of dengue in the short term. In the archipelago, including the island of Porto Santo, weather conditions have allowed the survival of _Anopheles_.

Studies indicate that the next 30 years will see the emergence of diseases in Madeira, such as dengue, yellow fever, and malaria.
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Patricio Leite, MD
Specialist in General & Family Medicine
Regional Health Administrator for Lisbon & the Tejo Valley, Ministry
of Health, Portugal
Ex-collaborator of Travel Medicine Consultation, Institute of Hygiene
& Tropical Medicine,
New University of Lisbon
Portugal
========================
[Portugal reported 41 imported malaria cases in 2008 (Source: <http://data.euro.who.int/cisid/>). The climate of Madeira in December with temperatures below 20 C do not support local transmission of _Plasmodium falciparum_. Malaria is endemic in Equatorial Guinea, and the risk of infection is high without proper prophylaxis.

The introduction of dengue fever is a possibility, as in most of southern Europe. The introduction of yellow fever is a risk because the vector is present; however, yellow fever is limited to tropical areas, and Madeira probably does not, at present, have a climate which supports sustained transmission of yellow fever. - ProMed Mod.EP]
Date: Fri, 30 Oct 2009 14:17:50 +0100 (MET)

MALABO, Oct 30, 2009 (AFP) - Heavy rain deluged a city in Equatorial Guinea, killing a woman with an electric shock as water surged through a street criss-crossed by electric cables, national radio reported Friday.   The woman died Wednesday in Bata, the economic capital of the west African country, radio said.   Storms caused widespread damage and paralysed the city centre for several hours, the radio reported.
Date: Mon 10 Nov 2008
Source: Terra, EFE News Agency report [in Spanish, trans. CopyEd.MJ, edited]
<http://actualidad.terra.es/sociedad/articulo/ninos-mueren-distintos-hospitales-epidemia-2876425.htm>

At least 10 children have died in various hospitals in Equatorial Guinea as a result of a measles epidemic declared in the country 2 weeks ago, according to EFE [News Agency] sources confirmed today [10 Nov 2008] by the Health Ministry.  Although an official of the Ministry of Health and Welfare declined to give details, medical sources contacted by EFE said the epidemic is affecting hundreds of children up to 9 years [of age] in several districts of the mainland and in Malabo, capital of the country.

Reports of the NGO 'Family Care' claim that one in 6 children born in this sub-Saharan country, which was a Spanish colony until 1968, dies before reaching 2 years, because health [services] in rural communities are limited to small first-aid clinics with minimal material.

The last known outbreak of measles in the country occurred in April 2001, when more than 100 children lost their lives because in Equatorial Guinea basic concepts of hygiene and disease prevention are still poorly understood or misinterpreted by a large portion of the population.
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[Equatorial Guinea in sub-Saharan Africa can be located using the HealthMap/ProMED-mail interactive map at <http://healthmap.org/promed?v=1.7,10.3,6>. - ProMed Mod.CP]
Date: Mon 31 Dec 2007 From: Dan David --------------------------------------------------------------------------- Rabies was diagnosed in a 5-year-old boy from the Republic of Equatorial Guinea. The boy had been bitten in his neck by a stray dog 5 weeks before. He received treatment against tetanus but not rabies post-exposure prophylaxis. On 17 Dec 2007, the boy complained of a headache, general pain, and weakness. The day after, the boy refused to eat and drink, and showed incoordination. On 19 Dec 2007, the boy was hospitalized in the Israeli medical center "La Paz" in Bata city, with symptoms of encephalitis and hydrophobia. Rabies was suspected. On 21 Dec 2007, cerebrospinal fluid, saliva, and a skin biopsy were collected and sent to the Rabies Laboratory at the Kimron Veterinary Institute, Bet Dagan, Israel. Heminested RT-PCR [reverse transcriptase polymerase chain reaction] detected rabies virus [RNA] in saliva and skin biopsy. Molecular analysis of the PCR product showed 99 percent identity with canine rabies virus sequences from this region (Gabon). Rabies virus isolation in tissue culture and in suckling mice is ongoing. --------------------- Dan David, DVM, PhD Head, Rabies Laboratory Derech Hamacabim street, Kimron Veterinary Institute Bet Dagan 50250 Israel [Currently the World Health Organisation (WHO) 'Essential Rabies Maps' () contains no information on the incidence of rabies in Equatorial Guinea. Nonetheless it is likely that rabies is widespread in canids throughout West Africa in view of the close sequence similarity of the Equatorial Guinea sequences to the genome of a rabies virus isolated in the neighboring country of Gabon. The rapid diagnostic response of the Kimron Institute and wide dissemination of the information are welcomed. While little can be done now to aid the patient, the diagnosis should alert the healthcare authorities in the Republic of Equatorial Guinea to the need for immediate provision of post-exposure prophylaxis for persons bitten by stray dogs or wild canids, combined where feasible, with vaccination of domestic and feral dogs. The HealthMap/ProMED-mail interactive map of the Republic of Equatorial Guinea is available at - ProMed Mod.CP]
Date: Tue 26 Apr 2005 From: ProMED-mail Source: Afrique Centrale, Sat 23 Apr 2005 [trans. from French Mod.MPP; edited] --------------------------------------------------- The Minister of Health of Equatorial Guinea announced an "urgent alert" on Friday [22 Apr 2005?] for the general population of the country following the death of a man presenting with the symptoms of Ebola haemorragic fever in Bata, the 2nd largest city of the continental part of the country, according to a report on Sat 23 Apr 2005 on national radio. "Any patient with a very high fever and hemorrhaging from mouth, ears, nose and eyes, must be taken immediately to the nearest health centre" declared the Minister in a communique read on the national radio. The local heath authorities recommended also that: "Deceased individuals with the above symptoms should be buried immediately" in order to prevent spread of this virus [infection], which is fatal in the majority of cases. The text stated also warned against: "Handling a cadaver for washing or dressing, (....) and to avoid eating meat from monkeys or animals found dead in the forest." Bata, the economic capital, is situated in the continental part of Equatorial Guinea, bordering Gabon, a country that has had [outbreaks] of Ebola [fever] several times in previous years. Precautionary measures have been taken in several other central African countries, including Gabon, to prevent transmission of Marburg hemorrhagic fever, [which is caused by a virus] closely related to Ebola virus, and which, since October 2004, has been affecting Angola, where more than 240 persons have died [as a result of Marburg fever]. --------------------------- [The Afrique Central report reproduced above indicates that so far there has been no confirmation of the diagnosis of Ebola hemorrhagic fever. Other possibilities, such as yellow fever -- which has been active in the area -- have yet to be excluded. Further information is awaited. - ProMed Mods.MPP/CP] ======================= Date: Thu 28 Apr 2005 From: Irene Lai Training Exercise Responsible for Ebola Hemorrhagic Fever Alert ---------------------------------------------------- This report is apparently a miscommunication. There is no outbreak of Ebola haemorrhagic fever in Equatorial Guinea. I have received this information from a colleague in Equatorial Guinea. "Maybe you heard about an Ebola Case in Bata (Equatorial Guinea); they talked about it during the week-end on Radio France Internationale. According to a WHO representative, what really happened was that a training exercise was held to update medical workers on haemorrhagic fevers. Evidently some people thought that there really was an outbreak of Ebola!" ----------------------- Irene Lai International SOS [ProMED-mail appreciates this rapid response from Irene Lai which cancels the alert and allays fears of a new outbreak of haemorrhagic fever in west Africa. - Mod.CP]
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