WEEKLY EPIDEMIOLOGICAL RECORD, No. 47,24 NOVEMBER 1995 » RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N» 47,24 NOVEMBRE 199S

Influenza Grippe

B elgium (12 November 1995). Influenza A was diag­ Belgique (12 novembre 1995). La grippe A a été diagnostiquée nosed in 2 sporadic cases in the northern and southern chez 2 cas sporadiques dans les parties septentrionale et méridiona­ parts of the country during the first week of November. le du pays au cours de la première semaine de novembre. C anada (16 November 1995).1 Influenza A(H1N1) virus C anada (16 novembre 1995).1 Le virus grippal A(H1N1) a été has been isolated from 4 cases in Saskatchewan. isolé chez 4 cas dans le Saskatchewan. Germany (15 November 1995). Influenza A has been Allemagne (15 novembre 1995). La grippe A a été diagnostiquée diagnosed in 2 sporadic cases in the southern part of the chez 2 cas sporadiques dans la partie méridionale du pays. Un cas a country. One was confirmed by isolation and further iden­ été confirmé par isolement du virus et identifié ensuite comme tified as influenza A(H3N2). Sentinel physicians partici­ étant un virus grippal A(H3N2). Les médecins sentinelles partici­ pating in influenza surveillance reported acute respiratory pant à la surveillance de la grippe ont signalé des infections respi­ infections in 10.8% of their patients in the second week of ratoires aiguës chez 10,8% de leurs patients au cours de la deuxième November, which is slightly more than expected. Some semaine de novembre, soit légèrement plus que prévu. Certaines regions reported a marked increase in respiratory tract régions ont signalé un net accroissement des infections du système infections and work absenteeism during November. respiratoire et de l’absentéisme au travail au mois de novembre. Portugal (16 November 1995). The incidence of in­ Portugal (16 novembre 1995). L’incidence des syndromes grip­ fluenza-like illness has increased since mid-Qctober and paux s’est accrue depuis la mi-octobre, atteignant 38,3 pour reached 38.3 per 100 000 population in the week ending 100 000 habitants au cours de la semaine qui s’est achevée le 12 November. Since the beginning of October, influenza A 12 novembre. Depuis le début octobre, la gnppe A a été diagnosti­ has been diagnosed m 18 cases; most have occurred since quée chez 18 patients; la plupart des cas sont survenus depuis la mid-October. mi-octobre. Switzerland (14 November 1995).2 Influenza A£H1N1) Suisse (14 novembre 1995).2 Le virus grippal A(H1N1) a été isolé virus has been isolated from a sporadic case in a 37-year chez un cas sporadique, un homme de 37 ans, dans le centre du ; old man from the central part of the country. The percent­ pays. Le pourcentage de patients soufflant d’un syndrome grippal j age of patients with influenza-like illness seen by sentinel vus par les médecins sentinelles a été faible en octobre et pendant la i physicians was low in October and during the first week of première semaine de novembre. j November. United Kingdom (20 November 1995.)1 Numerous iso­ Royaume-Uni (20 novembre 1995).1 De nombreux isolements ; lates of influenza A(H3N2) continued to be reported from de virus grippaux A(H3N2) ont continué d'être signalés en novem- ! all parts of England in November. Recently, 1 case of bre dans toutes les régions d’Angleterre. Récemment, 1 cas de influenza A(H1N1) was also confirmed by virus isolation. grippe A(H1N1) a également été confirmé par isolement du virus. Reporting on influenza and influenza-like illness con­ Les rapports sur la grippe et les syndromes grippaux ont continué de tinued to increase in England and Scotland during Octo­ s’accroître en Angleterre et en Ecosse au cours du mois d’octobre, ber while sentinel physicians in the Welsh surveillance tandis que les médecins sentinelles participant au système gallois system reported a decrease in the last week of October. de surveillance signalaient une diminution au cours de la dernière semaine d’octobre.

'SeeN o 46, 1995,p 331 1 Voir N“ 46, 1995, p. 331. ! See No 41, 1995, p. 296. 2 Voir N" 41, 1995, p. 296.

Infected areas as at 23 November 1995 Zones infectées au 23 novembre 1995 For entera used m compiling this list, see No. 45, 1995, p, 323 Les cmères appliqués pour la comptlaooa de cene lure soar publies dans le N° 45, 1995, p. 325. X - Newly reported areas X - Nouvelles zones signalées

Plague • Peste Ambohmahasoa S. Pref La hbertad Department Utge Province Manandroy Dismct America • Amérique (Area not specified - Zone non Zaire Province Ambontra S Préf Bolivia - Bolivie précisée) Afnco • Afrique Ambatomarina Dismct La Pax Department Lambayeque Department Renin • Bénin Ambohimahazo Dismct Departement de FAiUmtique M adagascar Franz Tamayo Province (Area not specified - Zone non Ambovombe Centre Sud Yungas Province preasée) S Pref d’Aliada Antananarivo Province AnHipa District Cue, de Cotonou Ambohdrammo S Pref Valle Grande Province Piura Department Anjoma N ’Ankona District Ayabaca Province S Pref. de Toffo Amanananvo-Avaradrano S. Pref. Anjomâ Navona District Brazil • Brésil Département de PAtacora Ambatolampy S. Pref Canales District Ankazoambo Dismct Bahia State Lagunas Dismct Département de Borgou Anfozorçbe S, Pref Binnnga M uuapio Ivato Dismct Moniero District Département de Mono Antananarivo S Pref Ivony Dismct Candeal Mumapio Antananarivo District Paimas District Département de Zou T alata-Vohimena Dismct Central Municipio Sapiilica Dismct Antamfotsy S. Pref Tsarasaoga District Conceiçfto Municipio Burkina Faso Antsirabe l S Pref. Suyo Dismct Fandruuia S. Pref. Feira de Santana Municipio Huancabamba Province BouîgCfU Province Antsirabe II S. Préf Fiadanana Dismct Iraquara Municipio Ambodiala District Fianarantsoa l S.. Préf. C de la Froncera Dismct Burundi Irecë Mumapio Can chaque District Ambohitsimanova District Mahatsmjo Dismct Bubanza Province Itaberaba Municipio Huancabamba District Ampasatanety District Fianarantsoa II S. Pref Jussara Municipio Bubanza ArrnnftiHi»mfnr Manaadona Dismct Andoharanomanso District Piura Province Cibitoke Arrondissement Renrolândia Mumapio Las Lomas Dismct Soamndranny District Fianarantsoa H District Riacb&o do Jacuipe Municipio Bujumbura Province Tsarofar Dismct Manandruma S, Préf Senhor do Bonfixn Municipio Bujumbura Arrondissement Viaaninkarena District Mahajar.ga Province Asia • Asie Burun Province Scmnha Municipio Viet Nam Anvommamo S. Pref Toamasnui Province Teofilandia Municipio Makamba Arrondissement Moramanga S. Préf\ Gia-Lat-Công Turn Province Betafo S Prèf Paroiba State Lam Dong Province Rumonge Arrondissement Akkamisy-Anattvata District Mozambique Araba Municipio Phû Khdn Province Guega Province Fanandnana S Prèf Tete Province Barra de S Rosa Mumapio Gitega Arrondissement Farautko S. Pref Mutarara Dismct Cuban Mumapio Manjakandnana S. Préf Cameroon • Cameroun Tanzania, Doited Rep. of Olivedos Mumapio Cholera ■ Choléra Province de l ‘Extrème~Nord Miannamo S. Préf Tanzanie, Rép.-Unie de Queimadas Mumapio Anaiavory Dismct Remigio Mumapio Africa • Afrique Diamare Département Tanga Region Logone-et-Chan Département Anosibe Ifanja District Lushoto Dismct Solânea Mumapio Angola Mayo-Daoai Département Remvohitra S Prèf Tanga Dutmct Bengo P ro m u Soavtmndnana S. Préf P eru • Pérou Bsnguela Province Mayo-Sava Département Ambatoasana Centre Uganda • Ouganda Cajamana Department Cabinda Province Msyo-Tsanaga Département Tstnanomandidy S. Prèf Western Region Chota Province Huambo Province Province Littoral Aruswmana Province Ncbbi Dismct Llama Dismct Huila Province Moungo Département Andapa S Pref Zaire • Zaire Miracosta District KuandcbKubango Province Woun Département Doany Dismct H aul Zaire Province Tocmoche District Kunene Province Province du Nord Ftanaranuoa Province hurt Sub-Region SanM igud Province K m nza'N oru Province Bcnoue Département Ambatofinandrahana S, Pref Mahagi Administrative Zone Nan choc Dismct Kxoama-Sul Province Province de l'Ouest Ambondromisotra Dismct Zimbabwe San Gregono Dismct Luanda Province Haut Nkam Departement Andreiambohura Dismct Mauxbdeland North San Miguel District Luanda, Cap Mifi Département Bkvonotany District Lupane Dismct San Pabb Province Malanga Province Province du Sud Soamhercnana District Nkayi Dismct Son Louis District Namtbe Province Qcéan Département

338 WEEKLY EPIDEMIOLOGICAL RECORD, No. 47, 24 NOVEMBER 1995 « RELEVÉ ÉPIDÉMIOLOGIQUE HEBDOMADAIRE, N" 47,24 NOVEMBRE 1995

Provmee du Sud-Ouest Kano State Parana State Hidalgo State Visakhapamam D u m a Manyu Departement Katsmtt State Pernambuco State Jalisco State Assam State Mèmé Département Kiuara State Piaui State Mexico State Delhi Territory Lagos State Rw de Janeiro State Mtchoaam State Gujarat State Cape Verde • Cap-Vert Rio Grande do Norte State Boa Vista Island - Ile de Boa Vis ta Niger State Morelos State Haryana State Brava Island - Ile de Brava Ogun State Rondôma State Neuvo Leon State Karnataka (Mysore) State Fogo Island - Be de Fogo Ondo State Sào Paulo State Oaxaca State Bangalore D ism a Maio Island - De de Mai© Oyo State Sergtpe State Puebla State Bidar Distria Porto Novo Island - De de Porto Plateau Seau Colombia • Colombie Queretaro State Chi tracuiga D ism a Novo Rivers State Amazonas Department Quintana Roo State Gulburga District XSal Island - De de Sal Sokoto State Antioquia Department San Luis Potosi State Hassan District Sonora State Koiar Distria Santiago Island - He de Santiago Rwanda Atlanaco Department XSfio Nicolau Island - De de Sào Cyangugu Préfecture Bobvar Department Tabasco State Mandya Distria Tamavltpas State Ruchar District Nicolau Gtseityi Préfecture Boyaca Department Sfio Vicente Island - De de Sào Cajdas Department Tloxcaia State Tumkur D ism a 1 1 Vicente S&o Tom e and Principe Caqueta intendency Veracruz State Kerala State Sfio T om é-et-Principe Cauca Department Yucatan State Madhya Pradesh State Chs** • Tchad Lemba District Cesar Department Zacateca State Maharashtra State Ratka Préfecture Sfio Tomé Akola Dum ct Bel Préfecture Chaco Department Nicaragua Senegal • Sénégal Cordoba Department Boaco Department Amrawaei District Büane Préfecture Nagpur Disma .., Chari Bagiam i Préfecture Région de Dakar Cundmamarca Department Carazo Department Département de Dakar Guajtra Department Chmandega Department Nanded District Gusra Préfecture Osmanabad District Kanem Préfecture Departement de Püone. Hilda Department Chontaks Department Département de Rufisque Magdalena Department Esteli Department Parhham D um a Lac Préfecture Pune D ism a Logone Occidental Prefecture Région de Diourbd Meta Department Granada Department X Departement de Mbacke Nartno Department Jmotega Department Sangh Distnct Logons Orientai Préfecture Thane District Njamena Préfecture X Département de Touba Norte de Santander Department Léon Department Puntumayo Department M adnz Department Manipur State Ouaddai Prefecture Sierra Leone Punjab Stale Tandjüe Préfecture Northern Province Quindta Department Managua Department Risaralda Department Masaya Department Tamil Nadu State C ôte d ’ivoire Katnbia District Anna District Western Provmee Sort Andres Intendency Matagalpa Department San José del Guathare Department Chingleput D ism a Département du Nord Freetown Nueva Segovia Department X Touba Sous-Préfecture Santa Pe de Bogota Department . Madras Disma Rio San Juan Department Madurai Disma Departement de POuest Somalia • Somalie Santander Department Rivas Department Giuglo District Baidoa District Sucre Department North Arcot D ism a Panam a Man Sous-Préfecture Bardera District Tohma Department Pudukkoctai D ism a Belet Ucn District Valle Department Colon Provmee Thanjavur Distria D jibouti Bossaso Distnct Comarca de San Bias Tiruchirapalii District Costa Rica Danen Province Tmmelvelli Distria G hana Kismayo Distnct Limon Province Accra. Regiûu Mogadishu District Panama Province Vellore D u m a San José Province VjlUpuxam District Accra Distria Swaziland Peru • Pérou Greater Accra D ism a P-Knaiift» ■ ]Rfp^tf»nF Amazonas Department Uttar Pradesh State (Area not specified - Zone non West Bengal State Ashanti Region précisée) A zuay Province Ancash Department Central Region Bolivar Province Apurtmac Department Calcutta Eastern Region Tanzania, United Rep. of Cailar Province Arequtpa Department Inrinpçgia • Indonésie Upper East Region Tanzanie, Rép.-Unie de Carchi Province Ayacucko Department East Nusa Tenggara Province Valia Region Arusha Region Chimborazo Province Cajamarca Department Sumba Barat Regency Western Region Dar es Salaam Region Cotopaxi Province Callao Province Lampung Province Ilala Dismet E l Oro Province Cuzco Department Lampung Barat Regency Guinea • Guinée Kmondoni Disma Esmeraldas Province Conakry Province Huancavdica Department North Sulawesi Province Kilimanjaro Region Galapagos Province Huanuco Department Bolaang Mongondow Regency Forccanah Préfecn|re Mara Region Guayas Province lea Department Guinea-Bissau Mtuiata Region Imàabura Provmee J w m Department Iran, Islamic Rep, of Iran, Rép. islamique d’ Guinée-Bissau Rufma Region Leya Province La Ltbertad Department Ardebü Province (Area not specified - Zone non Skmyanga Region Los Run Province Lambayeque Department précisée) Tanga Region Manabt Province Ltm a Department East Azarbaqan Province Morona Province Kordestan Province Kenya Togo Lento Department West Azerbaijan Province (Area not specified - Zone non Golfe District Napo Province Madré de Dios Department Iraq précisée) Kioto District Pastaza Province Moquegua Department Pichsncha Province Pasco Department Al-Basra Govemoraie Liberia ■ Libéria Kozah Dismci Al-Anbar Govemorate Lacs D istria Sucumbws Province Piura Department Bong County Tungurahua Province Puno Department Al-Mathna Govemorate Montserrado County Ogou District Zamom-Chmchipe Province Sotouboua District San Moran Department Al-Najef Govemorate M alawi Vo Distnct Hi Salvador Tacna Department Al-Qadmya Govemorate Arbil Govemorate - Northern Region Yoto District Central Region Tombes Department Babil Govemorate Chitipa District Metropolitan Region Ucayah Department Karonga District Uganda * Ouganda Baghdad Govemorate Kasese Distinct Occidental Regum Surinam e Southern Region Oriental Region Marowgae District Dohuk Govemoraie Zaire • Zaire Paracentral Region Dyala Govemorate M ali Venezuela Karbala Govemoraie , Kayes Région Haut Zaire Province K nnt Province French Guiana Anzoàtegut State Mesan Govemorate Kayes Cercle Guyane française Apian State Nineveh Govemorate KauHkoro Region Shaba Province fiiiatnwifllfl Aragua State Sa lab El-Dra Govemorate Mara Cercle TamKLj « 7 mnhi^ A lia Verapaz Department Bawias State Sulaimaniyah Govemorate Atopn Region CentralProvmce Carabobo State Tamim Govemorate Ségou Région T lIMlra Bqa Verapaz Department ' Chtmaltenango Department Delta Amacuro State Tikar Govemorate Tombouctou Région CopperbeU Province Federal District Wasit Govemorate Easton Province Cktqusmula Department M auritania » M auritanie E l Progreso Department Guanco State Luapula Province Merida State Lao People's Democratic Nouakchott District Escumtla Department Republic l n Région Northern Province Miranda Suae Southern Province Department République démocratique Hodh cl Chargui Managas State populaire lao 2 1 Région Nueva Esparto State Hodh el Gharhi America «Amérique Sucre State Attapue Province Argentina • Argentine Bokeo Province 3* Région Junapa Department Tachsra State Jtçity Province Zuha State - Kahammouane Province Assaba et Guiritmakha Mendoza Province Petèn Department 4* Région Luangnantiha Province Salta Province Quetzaltmango Department Asia «Asie Louangprabang Province Gorgol Tucuman Province Quiche Department OuodomxayPmtnnce Së Région Department Afghanistan Saravanne Province Brakna Belize Sacaupéqmz Department Badakhshan Province SavcumakhetProvince Cayo District 6* Région Baghlan Province Phine D ism a Trarza Toledo District Santa Rosa Department Balkh Province Sayaboury Province M ozam bique Bolivia • Bolivie Sololà Department Helmand Province Sekong Province Bern Department Suchaepéquez Department Herat Province Cabo Delgado Provmee M yanm ar Ancuabe District Chuquisaca Department Totomcapan Department Kabul Province Kandahar Province > Yangon Dmston Chiure District Cochabamba Department Yangon Sefala Province E l Alto Department Kaptsa Province Guyana Kunduz Province Beira Dry La Pae Department Region l (Baraia/Watm) Nepal • Népal Oruro Department . Region II (PtmtemmfSupenaam) Nangarhar Province Baiiadj District N iger Potosi Department 1 Zabul Provmee ' Jhapa Distria D iffa Département H onduras Riberalta Department Bhutan • Bhoutan Khatmaodu Disma Dossc Département Santa Cruz Department Camoyagua State Maradi Département Choluteca Department Mongar District Philippines Tartja Department Pemagatsd Disma National Capital Region Niamey Département Tupiza Department Cortes Department Tahoua Département E l Paraiso Department Phuntshohng District Region 4 Tiüabésy Département Brazil ■ Brésil Francisco Morazan Department Punakha District Aurora Province Zmder Département Acre State Samdrupjongkhar Distnct Cavite Province Otnoa State Tashigang Distnct Atagoas State Santa Barbara Department Mindoro Province N igeria * Nlgéria Amapa State Valle Department Thimphu Disma Palawan Province Abuja State Amazonas State Yoro Department Cambodia • Cambodge Rizal Province Aktoa IbatH State Bahia State Kampot Province Region S Anambra State Ceard State Mexico • Mexique Kompong Cham Provmee Albay Province Baucki State Distrito Federal Suae Campeche State Camanncs Norte Province Bendel State Espinto Santo State Chiapas State China • Chine Camannes Sur Province Benue State Marar.h&o State Chihuahua State (Area not specified - Zone non précisée) Caianduanes Pçoyinçe , Bomo State Mato Grosso Stfttft Colima State Masbace Province Gongola State Minas G erm State Distrito federal India • Inde Sersogon Province Jmo State Para State Guanajuato State Andhra Pradesh State Region 6 Kaduna State Paraiba Stats Guerrero State Hyderabad Distnct Dodo Province

339 WEEKLY EPIDEMIOLOGICAL RECOUD, No. 47, 24 NOVEMBER 199S • RELEVE ÉPIDÉMIOLOGIQUE HEBDOMADAIRE, N» 47,24 NOVEMBRE 1995

Région 7 Gambia * Gambie La Pas Department Guamare intendenaa Maratlon Province Cebu Province Upper River Division Larccaja Province Miraflores Mumcipio Cholon Disinct Région S Munllo Province San Juan del Guaviare Junm Department G hana Chanchamayo Province Leyte North Province Upper West Region Nor Yungas Province Mumcipio Leyte South Province Meta Intendenaa f!hanphamayn DiStnCt Jinpa Dismet Quinuni Province Samar Western Province Sud Yungas Province Cabuyaro Mumapio Perene Distna Région 9 Guinea • Guinée Santa Crus Department La Prunavera Mumapio San Luis Sevaro D u m a Zamboanga City Siguin Région Andres Ibanez Province San Carlo de Guaroa Viloc D u m a Satipo Province Zamboanga Norte Province liberia • Libéria Cordillera Province Mumcipio Region I I Florida Province Villavicencio Mumapio Covinali D u m a Davao City Bossa County Vista Hennosa Mumapio Mazaman Dum a Buchanan Dismet Guuerrez Province Gen Santos City Ichilo Province Norte de Santander Department Pangoa D istna Région 12 Mali Cucuta Mumcipio Jhchanali D u m a Cocabato City Kayes Region Brazil • Brésil Tibu Mumcipio Rio Negro District Kita Cercle Amapa Territory Cucuta Intendenaa Rio Tambo D u m a Viet Nam Macapa Mumapio Sanpo Disma Btnft Tn Then Province Koultkoro Région Toledo Mumapio DioÜa Cercle Amazonas State Putumayo Intend&naa Loreto Department Ngkta Bmh Promue ! Careiro Mumapio Ucayali Province Phù Khâtth Province Kangaba Cercle Puerto Asis Mumapio Kan Cercle ; MarankaS State Santander Department Contamana D um ct Kolokani Cercle Barra do Corda Mumripoo Bucaramanga Muniripio Purus D u m a Europe Mirador Mumapio Cimitarra Mumapio Madré de Dios Department Republic of Moldova Nigeria • Nigeria Para State El Carmen Mumapio Manu Province République de Moldova Atumbra State Agua Azul do None Vtchada Department Madré de Dios Distna Ctusinev Raion (region) Bauch State Mumapio Puerto TruuUo Mumapio Manu Dismet Slobozajskiy Raion (region) Bendel State Alenquer Mumapio Tambopata Province Stefan-Voda Raion (region) Benue State Sào Felix do Yingu Ecuador • Equateur lmunban Dutnct Tiraspol Raion (region) Cross Rtver State Mumapio Morona-Sannago Province Las Piedras D ism a Kaduna State Tucumâ Mumapio Napo Province Tambopata D um a Russian Federation Kmora State Humayacu D istna Pasco Department Fédération de bno State P-«lnmKia • ffnlninhi^ Pastaza Province Puno Department Autonomous Rep. o f Dagestan Lagos State Annoquta Department Sucumbios Province Sandui Province Rep. autonome de Dagestan Niger State Anon Mumapio Zamora-Chtnchpe Province San Juan del Oro Distna Ukraine Ogun State Taraza Mumapio San Roman D ism a Cherson Ondo State Yondo Mumapio P eru • Pérou VUcsbamba D ism a Nicolaev Region Oyo State Arauca Intendenaa Amazonas Department San Afarart Department Odesskaya Region Bateau State Aiauca Mumapio Artcash Department Huailaga Province Saravena Mumapio Ayacucho Department Bellavuta D ism a Republic o f Cruaea Sudan • Soudan République de Crimée Boyaca Deparment Huanta Province Saposoa D u m a Territory South of 12° N. Chita Mumapio San Jose Sanullana D u m a Lamas Prowue Simferopol Territoire smié au sud Simferopol Oblast Puerta Boyaca Mumapio Cusco Department Lamas D u m a du 12° N. Caqueta Intendenaa La Convention Province Tabalazo6 District Zaire • Zaire Belen de los Andaquies Echarne Distna M anual Caceres Province Yellow lever • Fièvre jouie Territory North of 10° S Mumapio Kitani District Campamlla D istna Territoire situé au nord El Doncello Mumapio Maranura Dum a San Martin Province Africa • Afrique du 10° S. San Vicente de Caguan Santa Ana D ism a Juan Guerra Distna Angola Mumapio Huanuco Department Sauce Dutnct Sengo Province Casemate Intendenaa Huamaites Province Tocache Province Luanda Province America • Amérique Haio Corozal Mumapio Monzon D istna La Polvora D u m a Cameroon • Cameroun Bolivia • Bolivie T amara MlUUOplO Leoncio Prado Province Nuevo Progreso D u m a Promue de PExtrérne-Nord Bem Department Yopal Mumcipio Alozua Robles D u m a Tocacbe Duma Mayo Sava Département Balhvian Province Cesar Department Ancayacu D u m a Uchiza D u m a Mayo Tsanaga Departement Itenez Province Valledupar Mumapio J C TVyrrirr Ucayali Department Cochabamba Department Choco Department Leoncio Prado Distna Corond Portillo Province Gabon Ayopayo Province Rio Suao Mumapio Monzon Disma Callerta D istna Province Ogooue-lvmdo Carrasco Province Cundmamarca Department P Luyando D u m a Padre Abad Province Makouko Chapare Province Maya Mumapio Rupa Rupa D u m a Padre Abad D um a

Cholera outbreak in Senegal Flambée de choléra aa Sénégal 17 November 1995. Despite the fact that cholera has been 17 novembre 1995. Bien que le choléra soit endémique dans les pays endemic in countries bordering Senegal for the past frontaliers du Sénégal depuis 2 ans, aucun cas de choléra n’a été 2 years, no cases were reported from Senegal until signalé dans ce pays jusqu’au 15 août 1995; depuis lors, 852 cas et 15 August 1995, since when 852 cases and 43 deaths have 43 décès ont été notifiés. Les cas sont survenus dans la région de been notified. The cases occurred in the Dakar Region, Dakar, les départements de Dakar et de Pikine étant particulière­ the Departments of Dakar and Pikine being particularly ment touchés, ainsi que dans la région de Diourbel. affected, and in the Diourbel Region. Poor environmental sanitation, insufficient water sup­ Une mauvaise hygiène de l’environnement, des approvisionne­ plies and an inadequate sewage system are primarily re­ ments en eau insuffisants et un système d’égouts inadéquat sont sponsible for difficulties in containing the spread of the responsables des difficultés rencontrées pour endiguer l’épidémie. outbreak. Immediate control measures by the newly- Les mesures de lutte immédiates prises par le comité national formed multisectoral national cholera committee for multisectoriel de surveillance et de lutte contre le choléra, récem­ cholera prevention and control, coordinated by the Direc­ ment établi et coordonné par le Directeur de l’Hygiène et de la tor of Hygiene and Public Health, include case manage­ Santé publique, comprennent notamment la prise en charge des ment, environmental sanitation, disinfection and selective cas, l’assainissement de l’environnement, la désinfection et une chemoprophylaxis, and a large-scale multimedia public chimioprophylaxie sélective, ainsi qu’une campagne multimédia education campaign. In view of the spread of the disease, d’éducation du public. Vu l’extension de la maladie, d’autres additional control measures include decentralization of mesures de lutte sont prises telles que la décentralisation des points cholera patient treatment points and control of street-food de traitement des malades du choléra, et le contrôle des aliments vendors. chez les vendeurs de rue.

dbmsu sm cm m sma ms m S Ê m M

Notifications received from 17 to 23 November 1995 Notifications reçues du 17 ou 23 novembre 1995 % C - cases, D - deaths, ... - data not yet received, C - cas, D - décès, . - données non encore disponibles, î - imported, r - revised, s - suspect i - importé, r - révisé, s - suspect

Choiera • Choléra Nigeria-Nigeria 1.VI-18X Asia • Asie ...... 67 0 C D Senegal - Sénégal* LIX-12.XI Iraq* 7-13.XI Africo • Afrique C D ...... 197(133j) 2 Cape Vente-Cap-Vert 9.X-5XI * See note above. - Voir note ci-dessus * These cases occurred m Sulaunaniyah Governor- ...... 879 4 ate. A WHO expert has gone to the area and a note Côte d'Ivoire 15.X-5.XI will appear in WER No, 48. - Ces cas sc stmt ...... 1 128 65 produits dans le gouvemorat de Sulaunaniyah. Un expen de l'OMS est sur place et une note paraîtra dans le REH N° 48.

340