WEEKLY EPIDEMIOLOGICAL RECORD, No. 31, 30 JULY 1993 • RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N» 3 1 ,3 0 JUILLET 1993 immunization coverage will miss older, susceptible children. que les services de vaccination systématique ont tendance à se Supplementary immunization activities will be required to concentrer sur les nourrissons, une stratégie qui se borne à élargir la eliminate the risk of major outbreaks of poliomyelitis in couverture vaccinale n’atteindra pas les enfants vulnérables plus endemic countries with falling immunization coverage. Ad­ âgés. Des activités de vaccination complémentaires devront être ditional resources, particularly vaccine, are urgently needed mises en œuvre pour prévenir le risque de graves flambées de polio­ if the poliomyelitis eradication initiative is to succeed. myélite dans les pays d’endémie où les taux de vaccination sont en déclin. 11 est devenu urgent d’obtenir des ressources supplémentai­ res, et en particulier des vaccins, si l’on veut que Fmiûative pour l’éradication de la poliomyélite atteigne son but.

Cholera Choléra

Afghanistan. The Ministry of Public Health has reported a Afghanistan. Le Ministère de la Santé publique signale qu’une cholera outbreak in various provinces of the country. The flambée de choléra sévit dans plusieurs provinces du pays. Le Gou­ Government, in collaboration with international agencies, is vernement, en collaboration avec des agences internationales, prend taking measures to control the situation. There is an urgent des mesures pour maîtriser la situation. Les besoins en eau potable et need for safe water and medical supplies . Morbidity and en médicaments sont urgents. On ne dispose pas encore de données mortality data are-not yet available. sur la morbidité et la mortalité.

Information that builds a better world Informations pour construire un monde meilleur Reliable information is the cornerstone for building the awareness, expertise, and Il est essentiel de pouvoir disposer d'informations fiables pour sensibiliser l'opinion et renforcer practical strategies necessary to improve the world at its heart: the health — les compétences techniques et les stratégies pratiques si l'on veut améliorer ce facteur physical, mental and social — of humanity. déterminant que représente pour l'humanité sa santé physique, mentale et sociale. For more than 40 years the development of reliable information has been one Depuis plus de 40 ans, la mise au point d'informations fiables est l'une des fonctions de of the functions of the World Health Organization. Charged to act as the wodd's l'Organisation mondiale de la Santé. Chargée de dinger et de coordonner l'action mondiale en directing and coordinating authority an questions of human health, WHO has matière de santé, l'OMS a mis en place toute une série de réseaux et de dispositifs pour developeda host of networks and mechanisms for generating data, applying facts obtenir des données, analyser les problèmes et proposer des solutions susceptibles d'améliorer to problems, and recommending solutions that w ill lead to sustained improvements durablement la santé. in health. Much of the information developed by WHO is made available to the worid La plupart des informations émanant de l'OMS sont diffusées dans le monde entier grâce through an extensive programme of publications, now numbering 7 periodicals and à un vaste programme de publications, qui comprend actuellement 7 périodiques et près de close to 80-new books each year. Some are practical manuals for use in preventing 80 ouvrages nouveaux chaque année. Ce sont pour certains des manuels pratiques à l'usage and controlling disease or developing quality health care. Others are unique des personnes chargées de prévenir et combattre la maladie et d'assurer des soins de santé de guides to Internationally accepted procedures, standards, or practice, introducing qualité; pour d'outres des guides uniques en leur genre, réunissant les procédures, normes ou uniformity to world medical care. Still others attack urgent technical problems with pratiques internohonalement acceptées qui ont introduit un élément d'uniformité dans les advice formulated and agreed upon by international groups of experts. soins médicaux dispensés dons le monde. D'autres encore traitent des problèmes techniques pressants et contiennent des recommandations formulées et approuvées par des groupes internationaux d'experts. Closely tied to the work of WHO, each of these publications articulates part of Ces publications, étroitement liées à l'activité de l'OMS, s'inscrivent dans le cadre d'un a global plan, conveying information that can push the world forward through the plan mondial et fournissent des informations susceptibles de faire progresser le monde en protection and promotion of health. favorisant la protection et la promotion de la santé • Requests for information should be addressed to: • Pour tous renseignements, s'adresser à: "Distribution and Sales, World Health Organization, Distribution et Ventes, Organisation mondiale de lo Santé, 1211 Geneva 27, Switzerland. 1211 Genève 27, Suisse

Infected areas as at 29 July 1993 Zones infectées nu 29 iwllet 1993 For criteria used in compiling this list, see No. 10, p. 72 Les oiteres appliqués pour la compilation de cette liste sont publiés dans le N° 10, p- 72 X - Newly reported areas X - Nouvelles zones signalées

Fvmaranuoa Provmce Plague « Peste Uganda • Ouganda Remigio MmucipiP Choiera • Choléra Ambawfinandrahana S Préf Western Région Solanea Mumcipio Ambondromisotra Dismet Nebbi Dismet Africa • Afrique Africa • Aftique Andrcfambohitra Dismet » Pérou M ad ag ascar Bevonotany Dismet Zaïre • /aire Cajamarca Department A ngola Antananarivo Province Soamherenana District H a u t Z a ïre Province Chaut Provmce » . Bengo Provmce Ambohidratrtmo S Pré/. AmbohmtaJiasoa S. Préf Mahagi Administrative Zone Llama District Hwiguffa Provm ce Antanananvo-Avaradrano S Préf Manandroy District Miracosta District Huambo Provmce AmbatalampyS Pref. AmbosaraS. Préf America «Amérique Tocmoche District HuÛa Provmce Anjocorobe S Préf. Ambatomarwa Dismet S a n M ig u el Provm ce Kuando-Kubango Provmce Antananarivo S Préf Amhnhiinaliay-n District Bolivia - Bolivie N anchoc Dism et Kunene Provmce Antananarivo District Ambovombe Centre La Paz Department Kmanza-Norte Provmce Aniamfoisy S. Pnf. Andina District Franz Tamayo Province San Miguel District Kwanza-Sul Province Antsirabe I S. Préf. Anjoma N ’Ankona District Sud Yungas Provmce San Pablo Provmce Luanda Province Antsirabe II S. Préf Anjoma Navona District Valle Grande Province T jianHfij Q p . Ambodiala Dismet Ankazoambo District Matanga Provmce Ambohirsimanova District Ivaxo District Brazil • Brésil Nanube Provmce Ampasacanecy District Ivony Dismet Bahia State Uige Provmce Manandona District Talata-Vbhimena District Buitmga Muniapio Zaïre Province randeal Mnnnipin Soamndranny District Tsarasaotra Dismet Henîn • Réeie Tsaro&r District Fandnana S. Préf Central Mumcipio P aimas Dismet Département de PAtlonaque Vinaninkareoa District Fiadanana District Conceiçâo Mumcipio Anvommama S. Préf Feira de Santana Mumapio S. Préf d

Bururt Province Aktua Ibom State Chile* Chili Jaltsco State Kolar Dismct Makamba Arrondissement Anambra State Antofagasta Province Mexico State Mandya Dismct Rumonge Arrondissement Baucht State Bernardo O'Higgms Province Mtchoacan State Raichar Dismct Gttega Province Bendel State Coqutmbo Province Morelos State T nmlmr District Guega Arrondissement Benue State Los Lagos Province Neuvo Lean State Kerala State Madhya Pradesh State C am eroon * C am eroun B o n a S ta te Osomo Oaxaca State Gongola State Santiago Province Puebla State Maharashtra State Province de l‘Extrême-Nord Akola Dismct Diamant Département Im o S ta te Tarapacd Province Queretaro State Kaduna State Quintana Roo State Amrawan Dismct Logone-ct-Chan Département Pjilnwihia « K a n o S ta te San Luts Potost State Nagpur Dismct Mayo-Danai Département Katsma State Amazonas Department Sonora State Nandad Dismct Mayo-Sava Département Kuiara State Antwquta Department Tabasco State Osmanabad Dismct Mayo-Tsanaga Département Lagos State Atlantico Department Tamauhpas State Parbham Dismct Province Littoral Niger Slate Bolruar Department Tlaxcala State Pune Dismct Moungo Département O gun S ta te Boyaca Department Veracruz State Sangli District Woun Departement O ndo S ta te Caldas Department Yucatan State Thane Dismct Province du Nord Oyo S ta te Caqueta Intendency Zacateca State Mantpur State Benoué Département Cauca Department Punjab State Plateau State N icaragua Province de 1‘O uest Rivers State Cesar Department Tamil Nadu State Haut Nkam Département Sokoto State Choco Department Boaco Department Anna District Mifi Département Cordoba Department Carazo Department Chmglepui Dismct R w anda province du Sud Cundmamarca Department Chmandega Department Madras Dismct Ocean Département Cyangugu Préfecture Guajira Department Chômâtes Department Madurai Dismct Province du Sud-Ouest Gisenyi Prefecture Huüa Department Estelt Department North Arcot Dismct Manyu Département Sao Tome and Principe Magdalena Department Granada Department Pudukkottai District Même Département Léon Department Sâo Tomé-et-Principe M eta Department Thanjavur Dism ct Nanno Department Managua Department • T chad Lemba District Tiruchirapalli Dismct Norte de Department Masaya Department Tirunelvdli Dismct Batha Préfecture Sâo Tom é Matagalpa Department Bet Prefecture Puntumayo Department Vellore Dism ct Nueva Segovia Department Bdtute Préfecture Sw aziland Qumdio Department VilUpuram D ism ct (Area not specified - Zone non Risaralda Department Rio San Juan Department Uttar Pradesh State Chart Bagumm Préfecture Rivas Department Guera Préfecture précisée) San Andres Intendency West Bengal State San José del Guamare Department Kanem Préfecture Tanzania, United Rep. of Panama Calcutta Lac Préfecture Santa Fe de Bogota Department Colon Province Tanzanie, Rép.-Unie de Santander Department Indonesia * Indonésie Logone Occidental Préfecture Arusha Region Comarca de San Bias East Nusa Tenggara Province Logone Oriental Préfecture Sucre Department Danen Province Dares Salaam Region Tohma Department Suroba Barat Regency Njamena Préfecture Panama Province Tlala D is m c t Valle Department Lampung Province O uaddaï Préfecture Kinondom District Peru • Pérou Lampung Barat Regency Tandjik Préfecture C o sta R ica Kilimanjaro Region Amazonas Department North Sulawesi Province C ôte d ’iv o ire Mara Region Limon Province Ancash Department Bolaang Mongondow Regency Moaara Region S a n José Province Département de POuest Aptmmac Department Iran, Islamic Rep. of Ruktca Region • Kqiiatwii» Man Sous-Préfecture Areqmpa Department Iran, Rép. islamique d* Tanga Region Ayacucho Department fitinna Azuay Province Khuzestan Province Togo B o liva r Province Cajamarca Department Accra Région Callao Province Ira q Accra District Golfe District Conor Province Kioto District Carchs Province Cuzco Department Al-Basra Govemorate Greater Accra Dismet Huancavehca Department Ashana Region Kozah District Chimborazo Province Al-Aobar Govemorate Huanuco Department Central Region Lacs Dismct Cotopaxi Province Al-Mathna Govemorate Ogou District E l Oro Province lea Department Al-Najcf Govemorate Upper East Region Junsn Department Volta Region Sotouboua District Esmeraldas Province Al-Qadisiya Govemorate Vo Dismct Galapagos Province La Libertad Department Arbil Govemorate G uinea * G uinée Yoto Dismct Guayas Province Lambayeque Department Babil Govemorate Conakry Province Imbabura Province Luna Department Baghdad Govemorate Forécanah Préfecture Uganda * Ouganda Loja Province Loreto Department Dohuk Govemorate Kasese District Madré de Dios Department K enya Los Rios Province Dyala Govemorate Z aire • Z a ïr e Manabt Province Moquegua Department Karbala Govemorate (Area not specified. - Zone non Pasco Department Me&an Govemorate précisée) Haut Zaïre Province Morotta Province Kivu Province Napo Province Piura Department Nineveh Govemorate L iberia » L ibéria Shaba Province Pastaza Province Puno Department Salah Et-Din Govemorate Bong County Pichtncha Province San Martm Department Sulaimamyah Govemorate Montserrado County TawiKla • 7 a«nKi# Sucumbtos Province Taata Department Tamim Govemorate Central Province Tungurahua Province i Tombes Department Tikar Govemorate M alawi Lusaka Ztunart^Chsnchtpe Province ' Ucayak Department Wasit Govemorate Central Region Copperbelt Province S u rin am e Lilongwe District Eastern Province El Salvador Lao People’s Democratic Southern Region Luapula Province Central Region ! Marotuqne District R epublic Northern Province Metropolitan Region I République démocratique M ali Occidental Region Kayes Region Southern Province i Aitzoategia State populaire lao Oriental Region Savannakhet Province Kayes Cercle Z im babw e Apure State Paracentral Region Phine Dismct Kaulîkoro Région Marucaland Province Aragua State Nara Cercle Mashonaland Central French finlama Bartnas State Malaysia * Malaisie Guyane française Carabobo State Mauritania * Mauritanie Mashonaland East Kedah State Mashonaland West Province Delta Amacuro State Kubang Pasu Dismct Nouakchott District Federal District l n Région Masvmgo Province Alta Verapaz Department Penang State Midlands Province Guanco State Timor Laut District Hodh el Chargui Baja Verapaz Department Menda State 2* Région Ckunaltenango Department Sabah Miranda State Tawau Dismct Hodh el Gharbi Amenco • Amérique Chiqmmula Department Monagas State 3* Région E l Progreso Department S araw ak Argentina • Argentine Nueva Esparto. State Simunjan District Assaba et Gmdimakha Escutnda Department Sucre State 4* Region Jujuy Province Guatemala Department Nepal • Népal Mendoza Province Tachvra State Gorgol Huehuetenango Department Zulta State Baitadi Dismct 5* Region Salta Province Izabal Department Tucuman Province Jhapa Dismct Rrnlcna Jalapa Department Khatmandu Dismct 6s Region Jtmapa Department Asia «Asie B elize X Tajikistan • Tadjikistan Trarza Coya District P e th t D epartm ent X Afghanistan Quetzahenango Department M ozam bique Toledo District (Areas not specified - V iet N am Qwché Department Zones non précisées) Bmk Tn Thun Province Inhambane Province Bolivia • Bolivie Retalhuleu Department Maxue District Rhiffan • Rhifrutttw Ngkto Buth Province Bern Department Sacatepequez Department Phû Khânh Province Momimbcne Dismct Chuqutsaca Department San Marcos Department Moogar District Monica Province Cochabamba Department Santa Rosa Department Pemagatscl Dismct Chimoio Dismct Europe El Alto Department Sololâ Department Phuntsholing Dismct U kraine Sussundenga Dismct La Paz Department Suduupéquez Department Punakha Dismct Maputo Province Oruro Department Totomcapcm Department Samdrupj ongkhar District M anupole Maputo City Potost Department Zacapa Department Tashigang District Nicolaev Region Nampula Province Thimphu Dismct Odesskaya Region Nampula City Rsberalta Department G uyana Santa Cruz Department Region I (Banna/Watm) Cambodia • Cambodge Sofala Province Tartja Department Oceania • Océanie Beira City Region II (Pomeroan/Supenaam) Kompong Cham Province Tuptza Department T uvalu Nhamatanda Dismct H o n d u ras C hin a * Nanumea Island Zambesta Province Braril • Brésil Inhassunge Dismct Choluteca Department (Area not specified - Nuaao Island Alagoas State Cortes Department Zone non précisée) Mocuba District Amapa State Namacurra Dismct E l Parasso Department Amazonas State Francisco Morazan Department In d ia * Nicoadala District Bahia State Andhra Pradesh State YeDow fever • Fièvre jaune Quelunane District Santa Barbara Department Gears S ta te VaBe Department Hyderabad Dismct Africa • Afnque N iger Maranhao State Yarn Department Visakhapatnam Dismct A ngola Diffa Département M a to Grosso S ta te Assam State Mexico • Mexique Dosso Département Mmas Gerais State Delhi Territory Bengo Province Maradt Departement P ard S ta te Campeche State Gujarat State Luanda Province Niamey Département Paraiba. S ta te Gluapa? State Haryana State Cameroon • Cameroun Pernambuco State Chihuahua State Tahoua Département Karnataka (Myiore) State Province de l'Extrême-Nord TiUabery Département Piaui State Cohma State Bangalore District Rio de Janeiro State Distrito federal Mayo Sava Département Ztnder Département Bidar Dism ct Mayo Tsanaga Département Rio Grande do Norte State Guanajuato State Churadurga Dismct Nigeria • Nlgéria Rondôma State Guerrero State Gulburga Dismct Abuja State Sergipe State H idalgo s*f**+- Hassan District Upper River Division

2 3 1 WEEKLY EPIDEMIOLOGICAL RECORD, No. 3 1,3 0 JULY 1993 • RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N‘ 3 1,30 JUILLET 1993

Guinea • Guinée Quinum Province Francisco Dumont Mumcipio San Juan del Guaviare Junm Department Stgum Région Sud Yungas Province Mirabela Mumapia M um opio Chanchamayo Provmce Santa Crus Department Paracam Mumopio M eta Intendencui f!hnm?hamayf» District M ali Andrés Ibaûez Province Unai M um opio Cabuyaro Mumopio Perene District Kayes Région Cordillera Provmce P ara S ta te La Pnxnavcra Mumcipio San Luis Sevaro District Kita Cercle Florida Province Alenquer Mumcipio San Carlo de Guaroa Vüoc Distrust KouUkoro Région Gutierrez Province Almeinm Mumcipio M um opio Satspo Provmce DioOa Cercle Ichilo Province Altamira M ujucquo VUlavicenoo Muniopio Covinali District Kangaba Cercle Araguaia Mumopio Vîsta Hermosa Mumopio Mazaman District Kao Cercle Pinflftl • B j m ÎI Faro Mumopio Norte de Santander Department Pangoa District Kolokam Cercle Amapà Territory Monte Alegre Mumcipio Cucuta Mumcipio PichanaU Distnct K enya M acapâ Mumcipio Prainha M unidpio Tibu Munidpio Rio Negro Distnct R tfi Valley Provmce Amazonas State Rendençâo Mumdpio Cucuta lntendenaa Rio Tam bo District Banngo District Pannrama Municicpra Sào Domingos do Capun Toledo Mumopio Sanpo Distnct Elgeyo Marakwet Jo&o Figueiredo Mumcipio Mumcipio Putumayo lntendenaa Loreto Department M anaquin M um apio Sen. José Porfino Muniopio Puerto Asis M uniopio Ucayah Province Nigeria • Nigeria Manaus Mumcipio Tailandia Miuuapio Santander Department Anambra Stase Contamana District M araâ Mumcipio Tucurui Mumopio Rn raram an g a MlUUOpiO Purus Distnct Bauchs State Cimitarra Mumopio Nova Olinda do Norte Xinguara Mumopio Madré de Dws Department Bendel State El M um opio Mumcipio Rondoma State M anu Province Benue State Cacoal Mumopio Vuhada Department Novo Auaô M uruapio Madré de Dios Distna Cross River State Tefé Muruapio Roraxma Territory Puerto Trujillo Mumopio K adstna ft'’"**»™ Mumcipio Manu Distna Urucara Mumcipio Tambopata Provmce Ktoara State Garimpo Mutum Muniopio • E quateu r Goias State Inambari D ism a Lagos S Mt* Maloca Caju Muniopio Afonma-Santiago Provmce Alto Paraîso Mumcipio Las Piedras D istna Niger State Bela Vîsta Mumcipio Napo Province O gun S ta te • Colombie Tambopata Distnct Caiapoma Mumopio Antioqiaa Department Humayacu District Puno Department O ndo S ta te Pastasa Provmce Damolândia Mumopio Anon Mumopio Sandia Provmce O yo S ta te Formosa Mumcipio Sucumbtos Provmce Taraza Mumcipio San Juan del Oro Distnct Plateau State Goias Vclho Mumopio Zamora-Chmchtpe Provmce Yondo Mumopio San Roman District Sudan * Soudan M ara Rosa M um opio Arauca Lntendenaa Tem tory South of 12e N Nova Cnxas Mumcipio Peru • Pérou Vilcabamba Dismct Arauca M um opio San Martin Department Territoire situe au sud Planaitins Mimiripin Ayacucho Department Saraveoa Mumopio HuaUaga Provmce du 12® N, Santa Cruz Municîpîo Huanta Provmce Boyaca Department Bellavista District Zaire * Zaïre MaranhaÔ State f^hira Mimunpift San Jose Sannllana District Grajau Mumcipio Cusco Department Saposoa Discria Territory N orth of 10e S. Puerta Boyaca Mumopio Lago da Pedra Mumopio La Convention Provmce Lamas Provmce Territoire situé au nord Caqueté lntendenaa Montes Altos Mumopio Echaratc District T amas D istna du 10° S. Belen de los Andaquics Tabalazos Distna Moto Grosso State M um opio Kitant District Antômo JoSo M um opio £1 Donccllo Munidpio Maranura District M anscal Caceres Provmce Camapua Mnninpin San Vicente de Caguân Santa Ana District Campamlla District Am erica* Amérique Corgiûnho Mumopio M uniopio Huanuco Department San Martin Provmce Bolivia* Bolivie p iamanftnn MuniOpiO Casanare lntendenaa Huamahes Provmce Juan Guéna Distna Bent Department Jardim Mumopio Hato Corozal Mumopio Monzon District Sauce Distna Ballivtan Province Nova Mazmga Mumopio Tamara Mumopio Leonao Prado Provmce Tocache Provmce Itcnez Province Placido de Castro Mumopio Yopal Mumopio Aloma Robles Dismct La Polvora D istna Cochabamba Department Pocone M um opio Cesar Department Aucayacu District Nuevo Progreso D istna Ayopayo Province Pontes e Lacerda M um opio Valledupar Muniopio J C Castello District Tocache Distna Carrasco Province Ribas do Rio Pardo Mumopio Choco Department Leonao Prado District Uchiza Distna Chapare Province Sidrolândia Mumopio Rio Suoo Mumopio Monzon District Ucayah Department La Pas Department Sinope Mumopio Cundmamarca Department P. Luyando District Coronel Poràllo Provmce Larccaja Province Terenos Mumopio Maya Mumopio Rupa Rupa Distna Callena Distna Murillo Province. Mutas Gênas State Guavtare lntendenaa Marahon Provmce Padre Abad Provmce N or Yungas Province Bonfinopolis Mumcipio Miraflores Mumcipio Cholon District Padre Abad Distnct

Notifications received from 23 to 29 July 1993 Notifications reçues du 23 au 29 juillet 1993 C - cases, D - deaths,... - data not yet received, C — cas, D - décès,... - données non encore disponibles, i - imported, r - revised, s - suspect î — importe, r — révisé, s — suspect

Choiera • Choléra Asia «Asie C D Afnco • Afrique India - Inde 1-31.V C D ...... 287 3 M a la w i 23.IV-30 VI Tajikistan - Tadjikistan 21.VII1 . 439 14 ...... 7 2 Z im b a b w e 13.IV-30.VI 1 Date of notification/Date de la notification. 328 54

Areas removed from the infected area list Zones sunprimées de lu liste des zones infectées entre between 23 and 29 July 1993 le 23 et le 29 juillet 1993 For entena used in compiling this list, see No 10, p. 72 Les enteres appliqués pour la compilation de cette liste sont publiés dans le N 0 10, p. 72

Choiera • Choléra America • Amérique P a n am a Chepo Provmce Chtman Provmce

Telex: 415416 Fox: 788 0011 Télex: 415416 Fax: 788 0011 (Attention EPIDNATIONS for notifications of diseases subject to the regulations) (A l'attention d'EPIDNATIONS concernant les notifications des malodies soumises au règlement) Automatic telex reply service: Service automatique de réponse par télex: Telex 415768 Geneve followed by ZGC ENGL far reply in English Télex 415768 Genève suivi de ZGC FRAN pour une réponse en français Price of the Weekly Epidemiological Record Prix du Relevé épidémiologique hebdomadaire Annual subscription Sw. fr. 170.- Abonnement annuel fr. s. 170.- 7.600 7.93 ISSN 0049-8114 Pnnted in Switzerland

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