Date: Thu 23 May 2019
Source: BNI Burma News International [edited]
<https://www.bnionline.net/en/news/greatest-outbreak-schistosomiasis-cases-arakan>

Arakan state [now Rakhine state] has the largest outbreak of schistosomiasis cases among 14 states and regions in Myanmar, said Dr. Kyi Lwin, head of the Department of Public Health in Arakan State. "The outbreaks of schistosomiasis are still discovered here. Diarrhoea is also prevalent here. Arakan has the most rampant cases of schistosomiasis in Myanmar," Dr. Kyi Lwin told the media in a campaign held on [21 May 2019] at U Ottama Hall in Sittwe to prevent schistosomiasis disease caused by parasitic worms from freshwater snails.

Currently, children are the worst affected group with schistosomiasis, which can lead to anaemia, a life- threatening condition, said Dr. Phyu Phyu Aye, Director of Health Education Division. "[The] parasitic worms eat all the nutrients in the body and cause anaemia, so, it affects children the worst," she said.

To prevent the disease, people need to access clean food and safe water to ensure personal hygiene and good health.
====================
[Arakan state was renamed Rakhine state 30 years ago. Schistosomiasis has probably been endemic but neglected for decades. The region has seen conflict between the Burmese state, Rakhine nationalists and Rohingya rebels. In more recent times, Rakhine state has been notable for the exodus of refugees into neighbouring countries because of military operations by the Myanmar Army against the Rohingya minority (<https://en.wikipedia.org/wiki/Arakan>). - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Myanmar: <http://healthmap.org/promed/p/148>
Rakhine State, Myanmar: <http://healthmap.org/promed/p/6638>]
Date: Sun 31 Mar 2019
Source: Eleven [edited]
<https://elevenmyanmar.com/news/schistosomiasis-transmission-reported-in-shan-and-bago>

The transmission of schistosomiasis, also known as snail fever and bilharzias, has been reported in Inle of Shan State and Shwegyin Township in Bago Region, Rakhine State, according to the Ministry of Health and Sports.  From October 2016 to June 2018, 302 people were infected with schistosomiasis.

Dr. Than Tun Aung, Deputy Director-General of the Public Health Department said: "The ministry has stepped up its efforts to control the spreads of schistosomiasis as the cases are reported in some regions and states in addition to Rakhine State. The ministry will draft a plan to carry out the prevention and control of schistosomiasis.

The ministry has asked for technical and other aid from the World Health Organization (WHO). We are also cooperating with experts from Imperial Collage London."  The use of less fly-proof latrines may compound the problem. The department will coordinate with the Rakhine State Chief Minister, the Social Affairs Minister and related ministries to effectively prevent and control the spreads.  According to the laboratory tests from [1 Oct to 1 Nov 2018], 520 out of 980 suspected patients were found to have been infected with schistosomiasis.

The Union Minister has directed officials to inform the Rakhine State government about the prevention and control of schistosomiasis and distribute pamphlets to raise awareness of this among departmental officials. Experts from the WHO (headquarters), WHO South East-Asia Region and the Chinese Center for Disease Control and Prevention (CDC) are conducting surveys, in cooperation with relevant departments.

The disease is spread by contact with fresh water contaminated with the parasites. These parasites are released from infected freshwater snails.
=====================
[A recent comprehensive review of schistosomiasis in Southeast Asia (Gordon CA et al. Asian Schistosomiasis: Current Status and Prospects for Control Leading to Elimination. Trop Med Infect Dis. 2019 Feb 26;4(1). pii: E40) reviews the epidemiology of schistosomiasis in the region. A total of 3 species are present: _S. japonicum_, _S. mekongi_ and _S. malayensis_. All are zoonotic infections with 46 mammalian definitive hosts identified thus far for _S. japonicum_, _S. mekongi_ have been found in dogs, and _S. malayensis_ in rodents.

The same study (Gordon CA et al.) includes a map of Myanmar indicating the endemic area, the Rakhine State. There is no information on which species are found in Myanmar, key information to be able to develop an informed control strategy including both infections in human and the animal hosts. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Myanmar: <http://healthmap.org/promed/p/148>]
Date: Wed 13 Mar 2019
Source: Outbreak News Today [abridged, edited]
<https://protect2.fireeye.com/url?k=f1990222-adbf3679-f19bfb17-000babd905ee-9fb072da3799a6cc&u=http://outbreaknewstoday.com/myanmar-reports-measles-death-measles-vaccination-campaign-yangon-49499/>

Last month [February 2019], Myanmar health officials reported a measles death in a young child in Mandalay region, according to local media. In 2017 and 2018, Myanmar reported 1293 and 1330 measles cases, respectively. About 75% of these cases were in those under 15 years of age.

From 17-28 Feb [2019], health officials held a measles supplementary immunization campaign in 7 townships of Yangon region. Yangon region accounted for about 50% of cases nationwide [in 2018]. The campaign targeted from those from 9 months up to 15 years of age in the townships of Hlaingtharyar, Insein, Mingaladon, Dagon East, Dagon Seikkan, Dagon South and Shwepyithar.

Measles has risen dramatically in Myanmar in recent years. In 2014 and 2015, 122 and 6 cases were reported in the country, respectively. This of course has risen to more than 1300 cases last year [2018]. Health officials say the cumulative number of unimmunized children in Myanmar reached a level where the country would face measles outbreak.
========================
[HealthMap/ProMED-mail map of Myanmar:
<http://healthmap.org/promed/p/148>]
Date: Tue, 19 Feb 2019 10:52:24 +0100
By Ye Aung THU

Nyaung Shwe, Myanmar, Feb 19, 2019 (AFP) - Myanmar's famed Inle Lake has enchanted tourists for decades with its floating gardens and the graceful leg-rowing style of its fisherman, but experts warn the lake is drying up and urgent action is needed to avoid disaster.   Each year around 200,000 foreigners and one million locals visit Inle -- a vast, serene body of water surrounded by verdant hills.   Many criss-cross the lake on small wooden boats to visit stilted villages of the Intha ethnic minority.

Others glide soundlessly overhead in hot-air balloons as farmers tend to drifting fields of tomatoes below, grown on the water on layers of decomposing vegetation.   Fishermen elegantly propel their boats with their leg curled round a large oar.   But there is a "darker side" to this seemingly bucolic idyll, says Martin Michalon, a researcher into the impact of development on the lake.   As farmers race to produce higher yields, pesticides and fertilisers are slowly poisoning the water.   Inle is also shrinking at an alarming rate.   "One century ago, it was six metres (nearly 20 feet) deep in rainy season... now it is never more than three metres deep," explains Michalon.

Deforestation to clear land for development and slash-and-burn farming is thought to be largely to blame, with silt flowing into the lake from surrounding hillsides.   But water extraction for irrigation and increased numbers of tourists could also be putting undue strain on the water table.   If conditions at the lake deteriorate, then tourism -- the area's most powerful economic driver -- will also likely be affected.   Urgent action is needed to avoid Inle experiencing this "double disaster" in the next few years, warns Michalon.   Political will to help save Inle Lake has so far not been translated into action.   "There is very loud commitment, but on the ground very little changes," he added.
Date: Sun 25 Nov 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/schistosomiasis-more-than-500-hundred-test-positive-in-rakhine-state-in-october-30033/>

The Myanmar Ministry of Health and Sports reported earlier this month [November 2018] (computer translated) that of the nearly 1000 suspect schistosomiasis cases tested in Rakhine state, 520 were _Schistosoma mansoni_ IgG (Elisa) positive.

In addition to Rakhine, some people with schistosomiasis were detected in Shwe Kyin of Bago region and Inn Lay of Shan state.

Prevention, treatment and diagnosis for schistosomiasis is a collaboration between the WHO, the Chinese CDC, and local health authorities.
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[Once schistosomiasis is established in an area it is to be expected that there are many cases not yet diagnosed. The incubation period may be years and infections with a few symptoms are common. Thus, the number and the area under investigation are expected to increase. It is also important to survey the appropriate water sources for the presence of the intermediate host, the snails. - ProMED Mod.EP]

[Maps of Myanmar: <http://www.nationsonline.org/maps/myanmar_map.jpg>
and <http://healthmap.org/promed/p/6638>]
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