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WHOCDSCSRISR20001WHO Report on Global Surveillance of Epidemicpro


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Document on Subject : "WHOCDSCSRISR20001WHO Report on Global Surveillance of Epidemicpro"— Transcript:

1 WHO/CDS/CSR/ISR/2000.1WHO Report on Glob
WHO/CDS/CSR/ISR/2000.1WHO Report on Global Surveillance of Epidemic-proneInfectious DiseasesDepartment of Communicable Disease Surveillance andThis document has been downloaded from the WHO/CSR Web site. Theoriginal cover pages are not included. See http://www.who.int/emc for more information. © World Health OrganizationThis document is not a formal publication of the World Health Organization(WHO), and all rights are reserved by the Organization. The document may,however, be freely reviewed, abstracted, reproduced and translated, in part orin whole, but not for sale nor for use in conjunction with commercial purposes.The views expressed in documents by named authors are solely theresponsibility of t

2 hose authors. The mention of specific c
hose authors. The mention of specific companies or specificmanufacturers' products does no imply that they are endorsed orrecommended by the World Health Organization in preference to others of asimilar nature that are not mentioned. W R O G 26Plague is transmitted between rodents and other animals primarily via wild rodent fleas. Wild plague existsin natural foci independent of human populations and their activity. Domestic plague is intimatelyassociated with rodents living with humans and can produce epidemics in both human and animalpopulations.Humans are extremely susceptible to plague and may be infected either directly or indirectly. Indirecttransmission through the bite of a flea is the most co

3 mmon route of transmission between plagu
mmon route of transmission between plague-infected rodents and humans. Human infection can occur within the natural foci of plague but this israre. Infection occurs more frequently in human settlements when domestic rodents become infected.This can happen when the domestic rodents come into contact with infected wild rodents living in thesurrounding areas. Infected fleas leave the bodies of rodents killed by plague seeking a blood meal fromanother host and may bite human beings. Humans who contract the disease may subsequently becomeinfective to other people via the respiratory route.1Cases of human plague have been known from time immemorial.2 The first record of plague was anoutbreak among the Philis

4 tines in 1320 BC, described in the Bible
tines in 1320 BC, described in the Bible (I Samuel, V and VI). In the last twomillennia, plague has become widespread, affecting a large number of countries on most continentsduring several pandemics.The first pandemic that we are certain of, known as Justinian=s plague, occurred between 542 AD and546 AD, causing epidemics in Asia, Africa and Europe. It is estimated to have claimed nearly 100 millionvictims.The second plague pandemic is the well-known "Black Death" of the fourteenth century (1347–1350).This pandemic was the beginning of a number of outbreaks of plague, which ravaged Europe andAfrica in subsequent centuries.The third pandemic began in Canton and Hong Kong in 1894 and spread rapidl

5 y throughout the world,by rats aboard th
y throughout the world,by rats aboard the swifter steamships that replaced slow–moving sailing vessels in merchant fleets.Within 10 years (1894–1903) plague entered 77 ports on five continents. Plague became widespread ina number of countries. In India, there were over 6 million deaths from 1898 to 1908.3Prevention and controlMany natural foci of plague have been identified, and prevention and control measures have beendeveloped which make it possible to prevent plague outbreaks. Effective treatment methods enablealmost all plague patients to be cured if diagnosed in time. The use of these measures has led to a sharpreduction in the epidemicity of plague throughout the world. Today the distri

6 bution of plague coincideswith the geogr
bution of plague coincideswith the geographical distribution of its natural foci.Description of the dataWHO has data on the number of cases and deaths due to human plague notified to WHO under theInternational Health Regulations over the past 44 years (Table 3.1). Plague that can be transmitted via the respiratory route is known as pneumonic plague.2 Pollitzer R. Plague. Geneva, World Health Organization, 1954 (Monograph series).3 Datta KK. Plague epidemiology, prevention and control. National Institute of Communicable Diseases, Delhi, India,1994. 4 Madagascar reports all suspected cases of plague, including those that are not confirmed in laboratories.

7 Forexample in 1997, there were 2863 case
Forexample in 1997, there were 2863 cases of human plague reported, 1858 of which were bacteriologically negative. 5 Report on an Interregional Meeting on Prevention and Control of Plague, New Delhi. Geneva, World Health Organization,1995 (unpublished document WHO/CDS/BVI/95.4). WHO/CDS/CSR/ISR/2000.1 PLAGUE 31Mortality· Despite the availability of a number of highly effective therapeutic agents, mortality due to plagueConclusions1. Although there has been a general decline in the incidence of plague worldwide, the number of2. There has been a

8 n obvious change in the distribution of
n obvious change in the distribution of plague morbidity by continent. Whereas3. Despite the availability of a number of highly effective therapeutic agents, mortality due to plagueReferencesPublications and DocumentsPlague manual: Epidemiology, distribution, surveillance and control, World Health Organization,WHO/CDS/CSR/EDC/99.2., Weekly Epidemiological Record, Vol. 74, 41, 1999.Human Plague in 1996, Weekly Epidemiological Record, Vol. 73, 47, 1998.Human Plague in 1995, Weekly Epidemiological Record, Vol. 72, 46, 1997.· For the last 45 years the mean perennial plague case fatality for the world (i.e. the average over the Table 3.1 Plague, cases and total number of deaths reported to WHO, and number

9 of countries reporting, 1954-1998 Afric
of countries reporting, 1954-1998 Africa 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 AngolaBurkina Faso1Dem. Rep. of the Congo42252235812266144168710468163278619143632311231082Libyan Arab JamahiriyaMadagascar 1 1717205721564289632910282613803South Africa 4835101174171222United Rep. of Tanzania 1 552513162491Total no. of cases11079107108504369241205354149192224814732Total no. of deaths2716414181514126884325No. of countries reporting75654546665345553 Includes suspected cases. Table 3.1 Plague, cases and total number of deaths reported to WHO, and number of countries reporting, 1954-1998 The Americas 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1

10 966 1967 1968 1969 1970 Argentina4531220
966 1967 1968 1969 1970 Argentina45312205349149333095542743725162810636392851154815728529310185807922407714032625819436917119242330El Salvador6824375033139681647212520066241458128United States of America1142311853351361Total no. of cases1711711151549893258343527424653841889223387424326Total no. of deaths9140445442265414333019No. of countries reporting45644456464555555 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 12212621622062141224026972051091411635411317185102410726Lao People's Dem. Rep.Mongolia203273227762122396834364812086324313Viet Nam 1 134415148291152973685,6194,1933,8504,056Total no. of cases1,6451,1124113092531634567943804064185,7694,3943,8864,109Total

11 no. of deaths663220209162214180266097556
no. of deaths66322020916221418026609755645015629427316182No. of countries reporting45654344342334433 1 Includes suspected cases. Table 3.1 Plague, cases and total number of deaths reported to WHO, and number of countries reporting, 1954-1998 Africa 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 Angola216Burkina FasoCameroonDem. Rep.of the Congo68362011241122758Libyan Arab Jamahiriya1619118Madagascar 1 316320385547582523114438243985299712South Africa 119340United Rep. of Tanzania 1 3224997656960312936034311Total no. of cases3712856183147931722032518659290594650215729Total no. of deaths941825413541151522194359594190No. of countries reporting2624545334363333 Includes s

12 uspected cases. Table 3.1 Plague, cases
uspected cases. Table 3.1 Plague, cases and total number of deaths reported to WHO, and number of countries reporting, 1954-1998 The Americas 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 Argentina14224296810262112112941691522914969711198591518237645891886573El SalvadorPeru11830831627111741344United States of America2128201618121318131940311710Total no. of cases216297185321521146489723142128182225500128162Total no. of deaths10283899115271241242919No. of countries reporting5444453423545543 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 30125681Lao People's Dem. Rep.Mongolia16317700275673591171737311659610356Viet Nam 1 3,9971,3405936673

13 1430618011116127196137104Total no. of ca
1430618011116127196137104Total no. of cases4,1861,4081,25838728513281248206179118Total no. of deaths1656639130526026141629121686No. of countries reporting2332222234323243 1 Includes suspected cases. Table 3.1 Plague, cases and total number of deaths reported to WHO, and number of countries reporting, 1954-1998 Africa 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Angola70Burkina FasoCameroonDem. Rep. of the Congo474369128939063682582Libyan Arab JamahiriyaMadagascar 1 23931702261371981471261,6292,863582825430South Africa Uganda49United Rep. of Tanzania 1 356647313641844483194750431985Total no. of cases8547049682,5602,5765,1011,161Total no. of deaths198138549811816813010612317326161No. o

14 f countries reporting434433463264 Includ
f countries reporting434433463264 Includes suspected cases. Table 3.1 Plague, cases and total number of deaths reported to WHO, and number of countries reporting, 1954-1998 The Americas 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Argentina2102612526181025491El SalvadorPeru10181206114209723398United States of America121542111310149548Total no. of cases8852304821158621438115554427Total no. of deaths9566322136111No. of countries reporting442423233433 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 610752935137898434131Lao People's Dem. Rep.73153122116488346100528876Viet Nam 1 10719637440594437481339170279220Total no. of cases1192104255052273862748Total no. of deaths8104929153

15 028851126125No. of countries reporting33
028851126125No. of countries reporting335554544451 1 Includes suspected cases. WWHHOO RREEPPOORRTT OONN GGLLOOBBAALL SSUURRVVEEIILLLLAANNCCEE OOFF EEPPIIDDEEMMIICC--PPRROONNEE IINNFFEECCTTIIOOUUSS DDIISSEEAASSEESS WWHHOO//CCDDSS//CCSSRR//IISSRR//22000000..11 PPLLAAGGUUE