WEEKLY EPIDEMIOLOGICAL RECORD, No. 19, 7 MAY 1993 • RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N» 19, 7 MA11993

In all countries, and especially in countries neighbouring Tous les pays, en particulier les pays voisins de la Fédération de the Russian Federation and Ukraine, all efforts should be Russie et de l’Ukraine, devraient s’efforcer d’obtenir un taux de made to achieve at least 90% coverage with 3 primary doses couverture vaccinale des nourrissons d’au moins 90% par les 3 pre­ of DPT vaccine in infants and to reach a high coverage with mières doses de vaccin DTC et un taux élevé d’administration de booster doses, where such doses are part of the regular doses de rappel Hans les cas où ces rappels font partie du calendrier immunization schedule. de vaccination normal.

In flu e n z a G rip p e

Jam aica (10 April 1993). Serological investigation of cases Jam aïque (10 avril 1993). L’étude sérologique de cas de syndromes of influenza-like illness showed 2 cases of influenza B during grippaux a révélé 2 cas de grippe B en novembre et décembre 1992. November and December 1992. Additional cases of both D’autres cas de grippe A et B ont été ensuite détectés sérologjque- influenza A and B were subsequently detected serologically ment parmi des cas survenus dans plusieurs régions du pays en in cases from several parts of the country during January and janvier et en février. February. Spain (30 April 1993).1 The influenza epidemic was over at Espagne (30 avril 1993).1 L’épidémie de grippe était terminée à la the end of April. Influenza A(H3N2) virus was the main fin avril. Le virus grippal A(H3N2) a été le principal virus isolé au virus isolated during outbreaks in Barcelona and Madrid, cours des flambées de Barcelone et de Madrid, et la gnppe B le type and influenza B the most common influenza type in de grippe le plus fréquent à Grenade, Valladolid et Saragosse. Dans Granada, Valladolid and Zaragoza. In some regions the certaines régions les virus ont co-circulé (Provinces basques). viruses cocirculated (Basque Provinces). Tunisia (23 April 1993). Influenza A(H3N2) virus was Tunisie (23 avril 1993). Le virus grippal A(H3N2) a été isolé d’un isolated from a case during epidemics which affected several cas au cours des épidémies qui ont touché plusieurs régions du pays regions of the country at the end of February. à la fin février. United Kingdom (27 April 1993).2 Recent reports on Royaume-Uni (27 avril 1993).2 Les rapports récents sur les syn­ influenza-like illness from general practitioners indicate de­ dromes grippaux provenant des généralistes indiquent une diminu­ creasing influenza activity in England, Wales and Scotland. tion de l’activité grippale en Angleterre, au pays de Galles et en However, outbreaks continued to be reported in schools, Ecosse. Cependant, des flambées ont continué à être signalées dans nursing homes and hospital wards and numerous virus des écoles, des maisons de retraite et des salles d’hôpitaux et de isolates were investigated during April. Of the 216 influenza nombreux isolements de virus ont été étudiés pendant le mois virus isolates typed this season, 58% were influenza B, 29% d’avril. Sur les 216 isolements de virus grippaux caractérisées cette influenza A(H1N1) and 13% influenza A(H3N2). saison, 58% étaient des virus B, 29% des virus A(H1N1) et 13% des virus A(H3N2).

1 Sec No. 12, 1993, p. 87. ‘ Von N" 12, 1993, p 87. 1 See No. 15, 1993, p. 106. 2 Voir N" 15, 1993, p. 106.

Infected areas as at 6 May 1993 Zones infectées au 6 mai 1993 For enterai used in compiling this list, see No 10, p 72 Les cnteres appliqués pour la compilanon de cette liste sont puhliçs Amu le N° 10, p. 72 X - Newly reported areas X - Nouvelles ^nnes signalées

Plague • Peste Andina District Sernnha Mumcipio Benguela Province Province de l’Ouest Aûjoma N’Ankona District Teofilandîa Mumcipio Huambo Province Haut Nkam Departement Africa • Afrique Anjomà Navona Dismet Parodia State H uila Province Mifi Departement Ankazoambo Dismet Araba Mumcipio Kuando-Kubango Provoice Province du Sud M adagascar Ivato Dismet Barra de S Rosa Mumapio Knriene Provoice Ocean Departement Antananarivo Province Ivony District Cuban Mumcipio Kuianza-Norie Province Provence du Sud-Ouest A m bohxdratnma S Pref Talata-Vohimena Dismet Olivedos Mumcipio Ksoanza-Sul Province Manyu Departement Antanananvo-Avaradrano S Prefi Tsarasaotra District Queunadas Mumcipio Luanda Province Meme Departement Ambatolampy S Prèf Fandnana S. Préf Remigio Mumcipio T jnanrlitj Cap Anjozorobe S Prèf Fiadanana Dismet Solânea Mumcipio M alanga Province fïhaH • Tchad Antananarivo S Prèf Botha Prefecture Fianarantsoa I S Préf • Pérou Namtbe Province Antananarivo District Mahatsinjo District Utge Province B et Prefecture Cajamarca Department Antamfacsy S. Prèf Fianarantsoa II S Prèf Zaïre Province Biitine Prefecture Antsirabe J S Prèf. Andoharaaomaitso District Chota Province Chan Bagumm Prefecture Antsirabe IIS Pref Fianarantsoa Q District Llama Dismet Rpnin m Rénin Guera Prefecture Ambodiala District Manadnana S. Prèf Miracosta District Departement de l’Atlanuque Kanem Préfecture Ambohirsimaaova District M ahqjanga Province Tocmoche Dismet S. Préf d’Allada Lac Préfecture San M iguel Province Ampasatanety District Toamasma Province Cire, de Cotonou Logone Occidental Prefecture Manandiina District Moramanga S Préf Nanchoc District S. Prêt de Toffo Logoue Oriental Prefecture Soamndrariny District San Grcgono Dismet Departement de l'Atacora Njamena Prefecture Tsarofar District Tanzania, United Rep. of San Miguel District Département de Borgou Ouaddai Prefecture Vinamnkarena Dismet Tanzanie, Rép.—Unie de San Pablo Province Departement de Mono Tandjde Prefecture Arwonimamo S Prèf Tanga Region San Louis District Département de Zou Betafo S Prèf Lushoto Dis met Piura Department C ôte d ’Iv o ire Alakamisy-Anaavato Dismet Tanga Dismet Ayabaca Province Burkina Faso Département de l’Ouest Fanandnana S Prèf Zaire • Zaïre Canales Dismet Boidgou Province Man Sous-Préfecture Lagunas Dismet FaratsthoS. Pref H aut Zaire Province B nw indî flh a n a Manjakandnana S Prèf Montera District Mahagi Administrative Zone P aimas Dismet Bubanza Province Accra Region Muinnanvo S Pref Bubar&a Arrondissement Analavory Dismet America • Amérique Sapülica Dismet Accra District Anosibe Ifanja District Suyo Dismet Cibitoke Arrondissement Greater Accra District Bujumbura Provoice Ashanti Region Remvahttra S Prèf Bolivia - Bolivie Huancabamba Province La Paz Department Central Region Soavtnandnana S. Pref C. de la Fromera Dismet Bujumbura Arrondissement Ambatoasana Centre Franz Tamayo Province Canchaque Dismet Burun Province Upper East Region Tsiroattomandidy S. Prèf Sud Yungas Province Huancabamba Dismet Makamba Arrondissement Volta Region Anmranana Province Valle Grande Province Piura Province Rumonge Arrondissement Gitega Province Guinea • Guinée Andapa S Prèf Brazil • Brésil Las Lomas Dismet Gitega Arrondissement Conakry Province Doany Dismet Bakia State Forecanah Prefecture Fianarantsoa Province Binunga Mumcipio Asio • Asie Cameroon • Cameroun Ambatofinandrahana S Prèf Candeal Mumcipio VietNam Province de l’Extrême-Nord Kenya Ambondronusotra Dismet Central Mumapio Gia-Lai-Công Turn Province Diamare Departement (Area not specified - Zone non Andrefkmbohitra Dismet Conceiçâo Mumcipio Lâm Dông Province Logone-et-Chan Departement précisée) Bcvonotany Dismet Feira de Santana Mumcipio Phü Khâtt Province Mayo-Danai Département Liberia • Libéria Soamherenana Dismet lraquara Mumcipio Mayo-Sava Departement Ambohimahasoa S Pref Irecë Mumcipio Bong County Mayo-Tsanaga Département Montserrado County Manandroy Dismet Icaberaba Mumapio Choiera • Choléra Province Littoral Arnbosttra S Prèf Jussara Mumapio Africa • Afrique Moungo Departement Malawi Ambatomanna Dismet Retirolândia Mumcipio Woun Departement Central Region Ambohimahazo Dismet Riachâo do Jacuipc Mumcipio Angola Province du Nord Lilongwe District Ambovombe Centre Senhor do Bonfim Mumcipio Bengo Province Benoue Departement Southern Region 138 WEEKLY EPIDEMIOLOGICAL RECORD, No. 19, 7 MAY 1993 • RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N® 19, 7 MAI 1993

Mali Togo Canar Province Ayacucho Department Arbil Govemorate Kayes Region Golfe D istna Carchi Province Cajamarca Departmeta Babil Govemorate Kayes Cercle Kioto Distnct Chimborazo Province Callao Province Baghdad Govemorate Koultkoro Région Kozah D istna Cotopaxi Provtnce Cuzco Department Dohuk Govemorate Nora Cercle Lacs D istna El Oro Provtnce Huancavehca Department Dyala Govemorate Ogou Distna Esmeraldas Province Huanuco Departmaa Karbala Govemorate Mauritania • Mauritanie Sotouboua D istna Galapagos Province lea Deparoneta Mesan Govemorate Nouakchott District Vo Dismct Guayas Province Jumn Department Nineveh Govemorate l n R egion Yoto Distnct Imbabura Province La Libertad Department Salah El-Din Govemorate Hodh el Chargui Sulaimamyah Govemorate Uganda * Ouganda Loja Province Lambayeque Departmaa 2 • R ég io n Los Rios Province Luna Department Tamim Govemorate Hodh el Gharbi Kasese D istnct M anabi Province Loreto Department Tikar Govemorate 3* R eg io n Zaire • Zaire M orona Province Madré de Dios Department Wasit Govemorate Assaba et Guidimakha H aut Zaire Province Napo Province Moquegua Department Malaysia • Malaisie 4* R égion K ivu Province Pastaza Provtnce Pasco Department Gorgol Kedah State Shaba Province Pichmcha Province Piura Departmait Kub&ng Pasu D istna 5' R égion Sucumbios Province Puna Departmaa Brakns Zambia • Zambie Penang State Tungurahua Province San M artm Department Timor Laut Dismct 6* R eg io n Central Province Zamora-Chmchipe Provtnce Tactia Department Trarza Lusaka S a b a h HI Salvador Tombes Departmaa Tawau D ism a Copperbelt Province Ucayah Departmaa Eastern Province General Region S a r a w a k Luapula Province M etropolitan Region Surinam e Simunjan D ism a Ciubuto District Northern Province Occidental Region Marounjne District Nepal * Népal Chokwe District Southern Province Oriental Region Venezuela Battadi Dismct Guijà District Paracentral Region Macia District Zimbabwe Anzoaugui State Jhapa D ism a M amcaland Province French Guiana Apure State Khatmandu Dismct Xai-Xai District Mushonaland Central Guyane française Aragua State Viet Nam Borinas State Inkambane Province Mashonaland East fiiigtwwala Birth Trt Thién Province Carabobo State Mashonaland West Province Nghta Bath Provtnce Alta Verapaz Departmeta Delta Amacuro State * Inhamme Distnct Masvmgo Province Phu Khanh Province Baja Verapaz Department Federal District Maxixe Distnct M idlands Province Chimaltenango Department Morrumbene Distnct Guanco State Europe America • Amérique Chtqumula Department Merida State E l Progreso Departmeta Ukraine Zavala Distnct M iranda State Argentina Escumtla Department Monagas State Manupole M onica Province Jujuy Province Guatemala Department Chimoio Distnct Nueva Esparta State Nicolaev Region M endoza Province Huehuetenango Department Sucre State Odesskaya Region Guro Distnct Salta Province Izabal Department Sussundenga Distnct Tachira State Tucuman Province Jalapa Department Zulta State Oceania • Océanie Tambara Distnct Jutiapa Department Province Peten Department Asia «Asie Tuvalu Boane Distnct Cayo District Quetzallenango Department Nanumea Island Toledo District Manhica Distnct Quiche Department Bhutan * Bhoutan Nuitao Island Maputo City Bolivia • Bolivie Retalhuleu Department Mongar Distna Matutume Distnct Beni Department Sacatepequez Department Pemagatsel Dismct Yellow fever • Fièvre jaune Moamba Distnct Chuquisaca Department San Marcos Department Phuntsholmg Dismct X Cochabamba Department Santa Rosa Department Punakha District Afnca • Afrique (Districts not yet specified - Samdrupjongkhar Dismct E l A lto D ep a rtm e n t Sololâ Department Angola Zones non encore précisées) La Paz Department SuchüepeqwiZ Department Tashigang Dismct Thimphu D istna Bengo Province Oruro Department Totomcapqn Deparanent T iianda PrOVmCe Beira City Potest Department Zacapa Departmeta ramhAHia • Cambodge Buzi Distnct Cam eroon • f*.aim»r

1 3 9 WEEKLY EPIDEMIOLOGICAL RECORD, No. 19,7 MAY 1993 • RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N" 19, 7 MAI 1993

Gutierrez Province Ribas do Rio Pardo Mumapio Caqueta Intendenaa Ecuador • Equateur Rio Negro Dismct Ichilo Province Sidrolôndia Mumapio Belen de lob Andaquies M orvna-Sautiago Province Rio Tambo Dismct Sinope Mumapio Mumcipio Napo Province Saapo Dismct Brazil • Brésil Terenos Mumapio El Doncello Mumapio Humayacu District Loreto Department Amapd Territory Mmas Genus State San Vicente de Caguân Pastaza Province Ucayali Province Macapa Muxuctpio Bonfinopohs Mumapio Mumapio Sucumbios Province Contamana District Amazonas State Francisco Dumont Mumcipio Casanare Intendenaa Zamora-Chmchipe Province Purus Dismct Canutama Municicpio Mirabela Mumapio Hato Corozal Muniapio Madré de Dtos Department Jo&o Figueiredo Muniapio Paracatu Mumapio Peru • Pérou M anu Province Tamara Mumcipio Madré de Dios Dismct Maaaqum Mumcipio Unai Mumapio Yopal Mumapio Ayacucho Department Manaus Mumcipio P a ra S ta te Huanta Province Manu Dismct Cesar Department Tambopata Province Marafl Mumcipio AJenquer Mumapio Valiedupar Mumapio San Jose Sannllana District Nova Olinda do None Almeinm Mumcipio Cusco Department Inamban Dismct Altamira Muniapio Chaco Department Las Piedras Dismct Mumcipio Rio Sucio Mumapio La Convention Province Novo Airad Mumcipio Araguaia Mumapio Echarate District Tambopata District Tefé Mumcipio Faro Mumapio Cundsnamarca Department Kitani Dismct Puna Department Urucara Mumcipio Moate Alegre Mumapio Maya Mumapio Maranura District Sandia Province Goias State Prainha M nninpin Guaxnare Intendenaa Santa Ana Dismct San Juan del Oro Dismct Alto Paraiso Mumcipio Rendençào Mumapio Miraflores Mumapio Huanuco Department San Roman Dismct Bela Vista Mumcipio S&o Domingos do Capim San Juan del Guaviare Huamakes Province Vilcabamba Dismct Caiapoma Mumcipio Mumcipio Mumcipio Monzon Dismct San M artin Department Damolândia Mumcipio Sen. José Porfino Mumapio M eta Intendenaa Leoncio Prado Province Formosa Mumcipio Tailandia Mumcipio Cabuyaro Mumapio Aloma Robles Dismct Bellavista Dismct Goias Velho Mumapio Tucurui Mumapio La Pnmavera Muniapio Aucayacu Dismct Mara Rosa Mumapio Xinguara Mumapio San Carlo de Guaroa J.C Castello Dismct Nova Cnxas Mumapio Rondonia State Leoncio Prado District Lamas Dismct Cacoal Mumcipio Mumcipio Tabalazos District Planaltina Mumapio Villavicenao Mumapio Monzon Dismct Santa Cruz Muniapio Roranna Territory P Luyando Dismct M onacal Caceres Province Bonfim Mumapio Vista Hermosa Mumapio Campanula Dismct MaranhaS State None de Santander Department Rupa Rupa Dismct Grajau Mumapio Ganmpo Mutum Mumapio Maranon Province San M artin Province Mai oca Caju Mumapio Cucuta Mumapio Lago da Pedra Mumapio Tibu Mumapio Cholon Dismct Colombia * fVilnmhie Jiatm Department Sauce District Montes Altos Mumapio Cucuta Intendenaa M ato Grosso State Antioqiua Department Chanchamayo Province Tocaehe Province Antônio Jo&o Mumcipio Anon Mumapio Toledo Mumapio Chanchamayo Dismct La Polvora Dismct Camapua Mumapio Taraza Mumapio Putumayo Intendenaa Perene Dismct Nuevo Progreso Dismct Corguinho Mumcipio Yondo Mumapio Puerto Asis Mumapio San Luis Sevaro Dismct Diamantmo Mumapio Arauca Iritendenaa Santander Department Viloc Dismct Uchiza Dismct Jar dim Mumapio Arauca Mumapio Bucaramanga Mumapio Saapo Province Ucayah Department Nova Mannga Mumcipio Saravena Mumapio Cuxut&rra Mumapio Covinali District Coronel Poralio Province Plaado de Castro Muniapio Boyaca Department El Carmen Muniapio Mazaman District Callcna District Pocone Mumapio Chita Mumapio Vtchada Department Pangoa District Padre Abad Province Pontes e Lacer da Mumcipio Puerta Boyaca Muniapio Pueno Trujillo Mumcipio Pichanali District Padre Abad District

Ports designated in application of the International Ports notifiés en application du Règlement Health Regulations sanitaire international Amendments to 1992 publication Amendements à la publication de 1992

Turkey/Turquie

Insert - In s é re r

D EX Aliaga ...... X Eregli ...... X

DISEASES S U M . . REGULATIONS MALADIES SOUMISES A U REGLEUENT ]

Notifications received from 30 April to 6 May 1993 Notifications reçues du 30 avril to 6 mai 1993 C - cases, D - deaths,... - data not yet received, C - cas, D - décès, . - données non encore disponibles, i - imported, r - revised, s - suspect i - importé, r - révise, s - suspect

Cholera • Choléra America «Amérique C D C D G u a te m a la 7.111-3.IV • Africa Afrique Bolivia - Bolivie 28.11-27 1Q ...... 2 3 4 4 C D ...... 952 17 P e r u - P é ro u 4 HI-3.IV Mozambique 16-28.H1 Colombia - Colombie 11-27 Ol ...... 12 139 40 ...... 3646* 79* ...... 158 0 E c u a d o r - E q u a te u r 7-27.H Asia • Asie * Includes delayed reports. - Y compris les ...... 261 0 c D rapports reçus tardivement. El Salvador 18 IV-1 V In d ia — In d e 1-28,11 ...... 532 2 ...... 360 1

■ . . . . : M i l ' S , : ? ... -- ^ :

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