Date: Sun, 10 Mar 2019 18:40:33 +0100

Blantyre, Malawi, March 10, 2019 (AFP) - Floods in southern Malawi have killed 30 people and left over 230,000 people without shelter, a minister said on Sunday.   Homeland Security Minister Nicholas Dausi, whose ministry is also responsible for disaster management affairs, on Sunday visited people affected by the deluges in two of the 14 southern districts affected.   He said his ministry had received reports of 30 deaths and about 238,000 villagers losing their homes since the start of the incessant downpours earlier this week.   "Their immediate needs are food, tents, blankets and chlorine to treat drinking water and anti-malaria medication," he said.  
Date: Fri, 8 Mar 2019 19:45:30 +0100

Blantyre, Malawi, March 8, 2019 (AFP) - Floods caused by incessant downpours have left 23 people dead across Malawi, the country's Homeland Security Ministry said on Friday.   In addition to the confirmed deaths, 11 people were also been reported missing with around 110,000 affected, a statement said.   Twelve districts, all in the south of the country, had been blighted by the deluges.

Malawi defence force and police search and rescue teams were working in collaboration with the Malawi Red Cross, the statement added.   In one affected district, Mulanje, camps had been set up for displaced people, Commissioner Charles Makanga told AFP.   The rains also hit transport links with two major bridges submerged, cutting off access to Blantyre, Malawi's second largest city.   According to the country's Meteorological Department, sporadic downpours are due to continue until the middle of next week.
Date: Thu 31 Jan 2019
Source: Malawi News Agency via AllAfrica [edited]
<https://allafrica.com/stories/201901310483.html>

At least 19 people from Shaibu Village in Traditional Authority Mkanda in Mulanje have been recommended for rabies treatment after eating beef suspected to be from a rabid cow. Mulanje District Hospital Integrated Diseases Surveillance and Response Coordinator Masilina Kausiwa Msamanyada said the hospital received reports from Village Headman Shaibu on 24 Jan 2019 that more than 130 people in his area ate beef suspected to be from an infected cow that was bitten by a rabid dog. Msamanyada said following the tip, Mulanje District Hospital Rapid Response Team (DRRT) was sent for an investigation on 26 Jan 2019, when they confirmed the incident and assessed the affected people. "The team found that the cow had been sick for almost 4 days following the dog bite in December 2018, which was suspected to be rabid," she said. [Byline: Blackson Mkupatira]
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[Although pasteurized milk and cooked meat are not expected to contain infectious rabies virus, which is inactivated by heat, ingesting any product from a rabid animal is not recommended. It may be assumed that the decision to treat 19 of the 130 consumers of the beef was based upon the results of the epidemiological investigation; these 19 people might have been suspected of contact with the cow before, during, or immediately after the (illegal) butchering. Ideally, rabies in the biting dog and the cow should have been laboratory confirmed. - ProMED Mod.AS]
 
HealthMap/ProMED-mail map:
Malawi: <http://healthmap.org/promed/p/176>]
Date: Thu 27 Dec 2018
Source: Malawi234.com [edited]
<https://malawi24.com/2018/12/27/hippos-still-dying-in-malawi-45-deaths-recorded/>

The Department of Parks and Wildlife in Malawi says 45 hippopotamuses have died at Liwonde National Park since October [2018]. The hippos are dying due to an outbreak of anthrax at the national park, which is home to about 1900 hippos.

According to director of parks and wildlife, Brighton Kumchedwa, 12 hippos have died since [5 Dec 2018]. However, Kumchedwa noted that the number of recorded deaths per day is now decreasing. "In the past, we could register 5 deaths daily, but now the last recorded was on [24 Dec 2018], and the previous one was on [19 Dec 2018]," he said. He added that the tourism at the park is still thriving despite the deaths, which are happening only along the Shire River banks of the park.

According to Kumchedwa, to avoid further spread of the disease, the department covers carcasses with lime and buries them. "We were advised that burning the carcasses actually increases the spread of the [infection]," he said. [Not true. - ProMED Mod.MHJ]

The Department of National Parks and Wildlife 1st noticed carcasses of hippos floating on Shire River in Liwonde on [10 Oct 2018]. In November [2018], the death toll was at 22. Kumchedwa said it is the 1st time in Malawi for a lot of hippos to die in a short period of time.

Earlier this month [December 2018], the government warned Malawians about the disease and urged people to refrain from grazing domestic animals in infected areas; avoid touching, opening, or eating dead wild animals; and avoid slaughtering sick animals for consumption.  [Byline: Russell Kondowe]
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[Burning carcasses is, in fact, the preferred and internationally recommended way of safely dealing with anthrax carcasses. But with large carcasses, burning presents a problem, whether assembling sufficient wood and fuel or using napalm or flamethrowers. Lime will aid decomposition, and burying the carcasses, whether by covering it with soil or putting it in a suitably deep pit and covering it with soil, is a good 2nd best. Just make sure that as much of the contaminated soil about the carcass is buried with it, preferably after spraying the soil with disinfectant (e.g., formaldehyde). Parks and Wildlife is faced with a formidable problem disposing of this many carcasses, even if this "lime and burial" method refers only to the latter dozen carcasses.

We are hoping it will be possible for the Malawian authorities to work out where and what the source of this hippo epidemic was and how it all came about. From the hippo-anthrax experiences in Zambia and Uganda, we know that, once initiated, they have the unfortunate habit of being repetitive. And even if one wanted to, dart-vaccinating 1900 hippopotami is not on the books. But by now, the surviving members of the affected mobs will have been exposed to sub-lethal doses of spores, and many will have developed antibodies. This should buy some time. Help has been offered to identify the strain involved.

For the OIE map for the location of this epidemic, see 30 Nov 2018 Anthrax - Malawi: (MA) hippopotamus, OIE
http://promedmail.org/post/20181130.6173946.

HealthMap/ProMED-mail map:
Machinga District, Southern Region, Malawi:
<http://healthmap.org/promed/p/29443>

For a description of the Liwonde National Park, see
<https://en.wikipedia.org/wiki/Liwonde_National_Park>. - ProMED MOD.MHJ]
Date: Wed 21 Nov 2018
From: Mariana de Mendonca Melo and Bart Rijnders
<b.rijnders@erasmusmc.nl> [edited]

A 66-year-old woman went to Malawi for 2 weeks (8-day safari). She visited several parks, which she does not recall the names of, but she does remember seeing a lot of tsetse flies when opening the car window to take pictures of the elephants at the Vwasa park near Rumphi.

On 17 Nov 2018 she returned to the Netherlands. On 18 Nov 2018 a chancre was observed on her back. She did not recall any insect bites. On 19 Nov 2018 she developed fever (39 deg C/102 deg F), and in the evening of 20 Nov 2018 she was seen at the emergency room of the Erasmus Medical Center in Rotterdam, with fever, headache, and intermittent vomiting but no neurological symptoms. Lab results showed mild thrombopenia (140 000) and C-reactive protein level of 40 as the only abnormalities. The presence of mobile trypanosomes were clearly visible in the blood of the patient.

Suramin was not available in the Netherlands or at the tropical institute in Antwerp [Belgium]. The WHO was contacted but informed us that medication can be ordered during office hours only. Therefore, the tropical institute of Basel [Switzerland] was contacted and supplied suramin. While waiting for the suramin to arrive, intravenous pentamidine was given.
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Contributed by:
Mariana de Mendonca Melo and Bart Rijnders
Erasmus Medical Center and Harbour Hospital Rotterdam
Rotterdam, the Netherlands
b.rijnders@erasmusmc.nl
============================
[ProMED thanks Drs. Mariana de Mendonca Melo and Bart Rijnders for reporting this case, which again shows that Malawi is endemic for African trypanosomiasis. The Vwasa wildlife reserve and Nyika National Park are close together in northern Malawi
(<http://www.malawitourism.com/pages/attractions/the_attraction.asp?AttractionsID=10>).

More information on African trypanosomiasis can be found at the Programme Against African Trypanosomiasis (PAAT):
<http://www.fao.org/ag/againfo/programmes/en/paat/home.html>. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Netherlands: <http://healthmap.org/promed/p/104>
Malawi: <http://healthmap.org/promed/p/176>]
More ...