Date: Thu, 25 Jan 2018 03:25:17 +0100

Asuncion, Jan 25, 2018 (AFP) - Authorities in Paraguay's capital Asuncion on Wednesday declared a state of emergency for a month after the Paraguay River burst its banks, leaving at least 20,000 people homeless.   The unseasonal high waters have washed over many poor neighbourhoods built along the banks.    About a half million people are in the capital, and 2.2 million in its metro area. The South American country has seven million people in total.

The capital city's council said it was moving to get food and water to the people hit by flooding.   Many of the displaced have been moved to higher areas of the low-lying capital, the national emergency office said.   Hundreds more of the displaced were setting up makeshift camps in plazas of the capital and on any small unoccupied spot they could find.   Forecasters said heavy rains in recent weeks were behind the river's rise.
Date: Wed 10 Jan 2018, 11:12 AM
Source: Ultima Hora, Paraguay [in Spanish, machine trans., edited]
<http://www.ultimahora.com/aumentan-casos-sospechosos-brucelosis-veterinaria-una-n1128091.html>

The Institute of Tropical Medicine confirmed 76 suspected cases of brucellosis in recent days while the fully confirmed cases remain at 21. They are mostly students and teachers of Veterinary UNA.

Miguel Cardozo, of the Institute of Tropical Medicine, explained that in the last days there were 76 cases that are under suspicion of brucellosis, after the clinical consultations of people who manifested some symptoms. Of the total, 4 people are in treatment for high suspicion of being carriers of the disease [see below - ProMED Mod.LL]. Cardozo indicated that brucellosis is a slow-growing bacterial disease that can appear 2 to 3 months after having been in contact with infected animals, so he urged people who were exposed to clinical examinations.

Those affected are mostly students and professors of the Faculty of Veterinary Sciences of the National University of Asuncion (UNA). Several months ago, an outbreak of brucellosis was detected in the institution where students, teachers and officials of the house of studies were exposed. The fact cost him the international academic accreditation he had. Finally, the case that occurred due to apparent negligence ended with the resignation of the dean of the Faculty of Veterinary Sciences of UNA. Cabrera was also charged for the crime of marketing harmful food, since it is presumed that the institution sold the milk of the infected animals.
===================
[The organism involved has been previously reported to be _B. melitensis_. Symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. It is not clear if the 4 individuals noted as "carriers" have been diagnosed as chronic brucellosis and if so what organs are involved. Additionally, a previous ProMED report noted a fatality which is not mentioned in this posting.

The signs and symptoms of brucellosis are extensive and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital.

The following is a recent review of caprine brucellosis:
Rossetti CA, Arenas-Gamboa AM and Maurizio E: Caprine brucellosis: A historically neglected disease with significant impact on public health. PLoS Negl Trop Dis. 2017 Aug 17;11(8):e0005692, available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560528/>.

Abstract
--------
"Caprine brucellosis is a chronic infectious disease caused by the gram-negative cocci-bacillus _Brucella melitensis_. Middle- to late-term abortion, stillbirths, and the delivery of weak offspring are the characteristic clinical signs of the disease that is associated with an extensive negative impact in a flock's productivity. _B. melitensis_ is also the most virulent _Brucella_ species for humans, responsible for a severely debilitating and disabling illness that results in high morbidity with intermittent fever, chills, sweats, weakness, myalgia, abortion, osteoarticular complications, endocarditis, depression, anorexia, and low mortality. Historical observations indicate that goats have been the hosts of _B. melitensis_ for centuries; but around 1905, the Greek physician Themistokles Zammit was able to build the epidemiological link between "Malta fever" and the consumption of goat milk. While the disease has been successfully managed in most industrialized countries, it remains a significant burden on goat and human health in the Mediterranean region, the Middle East, Central and Southeast Asia (including India and China), sub-Saharan Africa, and certain areas in Latin America, where approximately 3.5 billion people live at risk. In this review, we describe a historical evolution of the disease, highlight the current worldwide distribution, and estimate (by simple formula) the approximate costs of brucellosis outbreaks to meat- and milk-producing farms and the economic losses associated with the disease in humans. Successful control leading to eradication of caprine brucellosis in the developing world will require a coordinated Global One Health approach involving active involvement of human and animal health efforts to enhance public health and improve livestock productivity."

Maps of Paraguay can be seen at
<http://www.nationsonline.org/maps/paraguay-administrative-map.jpg>
and <http://healthmap.org/promed/p/4191>.

The City of Asuncion, Ciudad de Asuncion (<https://es.wikipedia.org/wiki/Asunci%C3%B3n>), is an autonomous capital district, not a part of any department. The metropolitan area, called Gran Asuncion, includes the cities of San Lorenzo, Fernando de la Mora, Lambare, Luque, Mariano Roque Alonso, Nemby, San Antonio, Limpio, Capiata, and Villa Elisa, which are part of the Central Department. The Asuncion metropolitan area has around 2 million inhabitants. - ProMED Mod.LL]
Date: Mon 30 Oct 2017
Source: Ultima Hora [in Spanish machine trans., edited]
<http://www.ultimahora.com/se-confirman-cuatro-casos-brucelosis-y-mas-40-son-sospechosos-n1115822.html>

The Directorate of Health Surveillance on Mon 30 Oct 2017, confirmed 2 new cases of brucellosis and with those there are 4 officially diagnosed cases [3 students and a teacher - ProMED Mod.LL]. In addition, there are 44 people suspected of being infected with the bacterium. The director of Health Surveillance of the Ministry of Public Health, Águeda Cabello, reported that students from the Faculty of Veterinary Sciences of the National University of Asunción (UNA) were infected with _Brucella_ after being in contact with livestock goats from the practice center of the San Lorenzo campus. All confirmed cases had contact with animals between the months of July and September 2017.

After the zoonotic disease in veterinary students became known, 420 samples were taken within the Faculty. Health Surveillance received 129 results, of which only 2 cases tested positive. Subsequently, 125 samples were tested and from that group the 2 additional positive cases were confirmed, this Mon 30 Oct 2017, adding to 4 officially. For this reason, the Public Prosecutor's Office accused the dean of the faculty of the crime of commercialization of harmful foods, since the outbreak occurred in 14 goats and despite being aware of it the sale of milk from these animals continued. For her part, the dean denied hiding the cases and said that as soon as she found out, she suspended the sale.
====================
[ProMED would like more information about how many of the diagnosed and suspected cases of brucellosis had symptoms consistent with clinical brucellosis and how many were asymptomatic but with positive _Brucella_ serology alone. Likewise, whether the organism is known to be _B. melitensis_.

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. The signs and symptoms of brucellosis are extensive and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital.

Maps of Paraguay can be seen at
<http://www.nationsonline.org/maps/paraguay-administrative-map.jpg>
and <http://healthmap.org/promed/p/4191>.

The City of Asuncion, Ciudad de Asuncion, (<https://en.wikipedia.org/wiki/Asunci%C3%B3n>) is an autonomous capital district, not a part of any department. The metropolitan area, called Gran Asuncion, includes the cities of San Lorenzo, Fernando de la Mora, Lumbar, Luque, Mariano Roque Alonso, Nemby, San Antonio, Limpio, Capiata, and Villa Elisa, which are part of the Central Department. The Asuncion metropolitan area has around 2 million inhabitants. - ProMED Mod.LL]
Date: Mon 16 Oct 2017 11:36
Source: EFE [machine transl, edited]
<http://www.ultimahora.com/estudiantes-veterinaria-se-contagiaron-brucelosis-n1113386.html>

Students of the Faculty of Veterinary Sciences of the National University of Asuncion were infected with brucellosis and they accused the authorities of not having been warned in time. The disease has its origin in animals. A veterinary student reported in Monumental AM that 2 of her colleagues were infected with brucellosis, a disease caused by a bacterium present in horses, cows and goats.

According to their statements, the authorities of the Faculty were aware that the animals were sick and, although they made a notification, it only arrived 2 days later to the students. Meanwhile, the students continued their practices. So far only 2 of them have been infected, but this week [week of Sun 15 Oct 2017] tests will be done to other students to see if they are in the same condition.

In addition, the veterinary student said that several people bought products of animal origin from the Faculty so there is a concern that they might have been infected as well. They requested the National Service of Quality and Animal Health (Senacsa) supplies and to have the corresponding quarantine appropriately applied.
==================
[Brucellosis (<http://www.medicinenet.com/brucellosis/article.htm>) is a disease that is thought to have existed since ancient times, as it was 1st described more than 2000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang's disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. The signs and symptoms of brucellosis are extensive, and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital. In this outbreak, it is not clear what symptoms the students had or whether they were just seropositive. ProMED would like more information about this episode.

The City of Asuncion, Ciudad de Asuncion, (<https://en.wikipedia.org/wiki/Asunci%C3%B3n>) is an autonomous capital district, not a part of any department. The metropolitan area, called Gran Asuncion, includes the cities of San Lorenzo, Fernando de la Mora, Lambare, Luque, Mariano Roque Alonso, Nemby, San Antonio, Limpio, Capiate, and Villa Elisa, which are part of the Central Department. The Asuncion metropolitan area has around 2 million inhabitants. - ProMed Mod.LL]

[While the posting does state horses can acquire the disease, brucellosis in horses should be noted is not a frequent occurrence. Horses can pass the disease to humans, but it is rare. - ProMED Mod.TG]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/4191>.]
Date: Wed, 27 Jul 2016 19:48:46 +0200

Asuncion, July 27, 2016 (AFP) - Paraguay reported its first two cases Wednesday of babies born with microcephaly linked to the Zika virus, which is blamed for a surge in the birth defect across Latin America.   "The central laboratory confirmed the birth of two babies with microcephaly caused by Zika," health ministry official Agueda Cabello told a press conference.

Since Zika, a mosquito-borne virus, was detected in Latin America last year, health authorities have sounded the alarm over a sharp rise in the number of infected mothers giving birth to babies with microcephaly, or abnormally small heads.

The World Health Organization has declared an emergency over the apparent link between the virus and the potentially debilitating or deadly birth defect.   Brazil has been the country hardest hit, with more than 1,000 confirmed cases of microcephaly blamed on Zika.

Spain reported the first case Monday of a baby born in Europe with microcephaly linked to Zika. The mother had caught the virus during a trip abroad, though authorities did not say where.   Zika, which causes flu-like symptoms and a rash, is mainly transmitted by the Aedes aegypti mosquito. It has also been shown to spread through sexual contact.
More ...