WEEKLY EPIDEMIOLOGICAL RECORD, Ho. 43,25 OCTOBER 1991 • RELEVE HHDEMIOIOGIQUE HEBDOMADAIRE, If 43,25 OCTOBRE 1991 as unspecified hep arms. The number of cases reported as l'hépatite sans précision. Le nombre de cas signalés comme hépatite unspecified hepatitis continued to decrease in 1988, as sans précision a continué de diminuer en 1988 du fait que les méde­ physicians utilize more complete serological testing. cins ont recours à des épreuves sérologiques plus complètes.

Fig. 1 Incidence of viral hepatitis, by year, United States af America, Fig. 1 Incidence de l'hépatite virale, par année, Etats-Unis d'Amérique, 1952-1988 1952-1988

Y e a r - Année

Historically the incidence of hepatitis A in the United L'incidence de l'hépatite A aux Etats-Unis a connu des pointes States has had recurring peaks, with nationwide epidemics périodiques puisque des épidémies se produisent dans tout le pays spaced roughly 7 to 10 years apart. After 1971, the reported à peu près tous les 7 à 10 ans. A partir de 1971, l'incidence signalée incidence declined steadily until 1984, when cases began a diminué régulièrement jusqu'en 1984, année où il y a eu recru­ again to increase (Fig. 1). By the end o f1988, a 10% increase descence des cas (Fig. 1). A la fin de 1988, on a noté une augmen­ in the incidence rate over that reported in 1987 was evident, tation de 10% du taux d'incidence par rapport à celui qui avait été with an overall increase of 32% since 1983. While the signalé en 1987, l'augmentation globale étant de 32% depuis 1983. nationwide incidence has not reached the level of 1971, Alors que l'incidence sur le plan national n'a pas atteint le niveau epidemic activity has been increasing, particularly in de 1971, l'activité épidémique a augmenté, en particulier dans western states. Comparison of state incidence rates for l'ouest du pays. La comparaison des taux d'incidence de l'hépatite hepatitis A between 1987 and 1988 shows an increase in A dans les différents Etats entre 1987 et 1988 montre qu'il y a eu high-incidence states from west to east. Incidence rates for augmentation dans les Etats à forte incidence dans le sens ouest- hepatitis A have slowly increased since the mid-1980s in est. Les taux d'incidence de l'hépatite A ont lentement augmenté most regions; the most dramatic increases occurred in the depuis 1985 dans la plupart des régions; les augmentations les plus Mountain and Pacific regions, followed by slight declines spectaculaires concernaient la région des montagnes Rocheuses et in 1987-1988. la région du Pacifique, où il y a eu par la suite une légère diminurion en 1987-1988. The highest rates ofhepatitis A were observed in persons C'est dans les groupes d'âge des 20 à 29 ans que l'on a relevé le in the 20-29-year age groups. Children younger than plus grand nombre de cas d'hépatite A. Chez les enfants de moins 15 years of age had rates as high as a decade earlier; those de 15 ans, les taux étaient aussi élevés que 10 ans plus tôt; chez les younger than 10 years of age had rates higher than in 1980. enfants de moins de 10 ans, ces taux étaient plus élevés qu'en 1980. From 1975 to 1985, the incidence for the 20-24-year age De 1975 à 1985, l'incidence pour le groupe d'âge 20-24 ans a chuté, group dropped, then increased to current levels. In addition, puis est remontée au niveau actuel. De plus, on a signalé une aug­ increases in incidence were reported across all other age mentation de l'incidence pour tous les autres groupes d'âge. groups. (Based on: Hepatitis Surveillance Report No. 53, Dec. (D'après: Hepatitis Surveillance Report N° 53, Déc. 1990; US 1990; US Centers for Disease Control.) Centers for Disease Control.)

Infected areas as at 24 October 1991 Zones infectées au 24 octobre 1991 For criteria used m compiling this lise, see No 16,1991, pp, 115-116 Les cmeres appliqués pour la compflanon de certe liste sont publies dans le N" 16, 1991, pp 115-116 X - Newly reported areas X - Nouvelles signalées

Vinamnkarcna D u m a Bevonotany District Plague • Peste Andoharanomauso Dismet Brazil • Bré&il Anvomnamo S Préf Soamherenana District Fianarantsoa ïï Dismet Bahia State Betafo S. Pref Ambohonahasoa S. Pref M anadham S. Préf Binunga Mumcipio Africa • Afrique Alakamisy-Ananvato District Manandroy District M ahajanga Province Candea] Mumapio Famndnana S . P r é f Ambositra S , P r é f Toamasma Province M adagascar Central Mumcipio Faratsûio S Pref Ambaromanna District Moramangu S , P r e f Aniarutnanva Province Coneeiçào Mumcipio Manjakandnana S Pref Amhnhimal-iayri District Ambohidratnmo S Préf Tanzania, United Rep. of Feira de Santana Mumcipio Miannanvo S Pref Ambovombe Centre Antanananvo-Avaradrano S , P r e f Tanzanie, Rép.-Unie de Iraquara Mumcipio Analavory Dismet Andma Dismet Ambarolampy S Fret' Tanga Region lrccê Mumcipio Anosibe Itanja District Anjoma N'Ankona District Artjozorabe S Pref Lusboto Dismet ïtaberaba Mumcipio Remvohitra S. Pref Anjoma Navona District Antananarivo S, P r e f Tanga Dismet Jussard Mumcipio Soainnottdnana S Pref Ankazoambo Dismet Antananarivo District Reurolândia Mumcipio Ambatoasana Centre Ivato Dismet Zaïre • Zaïre Antatufotsy S Pref Riachâo do Jacuipe Mumcipio Tsuvanomandidy S. Préf Ivony Dismet H aut Zaïre Province Antsirabe IS Préf Secbor do Bonfim Mumcipio Antstranam Province Talata-Vohimena Dismet Mahagi Administrative Zone Antsirabe IIS Préf Scmnha Mumcipio Artdapa S. Pref Tsarasaotra Dismet Ambodiola District America •Amérique Teofilandia Mumcipio AmhohitKimannva DlSUlCt Do any District Fandnana S. Préf - Bolivie Paraiba State Ampasacanety District Fumaranuca Province Fiadanana Dismet Department Araba Mumcipio Manandona District Ambaiofinandrahana S . P r é f Fxamranwa IS Pref Barra de S Rosa Mumcipio Scamndranny District Axnbondromisotra Dismet Mahatsmjo Dismet Cuban Mumcipio Tsarofar District AnHrafamhnhirrn District Futnaratasoa II S. Pref Valle Grande Province Olivedos Mumcipio

318 WEEKLY EPtDEMKHOCKAl RECORD, No. 4 3,25 OCTOBER 1991 • RE1EVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N* 4 3 ,2S OCTOBRE 1991

Queuoadat» Mumapio Kozah Dismct • Pérou Sulaimamyab Governorate Remigio Mumapio Accra Regum Lacs Dismct Amazonas Department Tamim Governorate Solâaea Mumapio Accra Dismet Ogou District Ancash Department Tikar Governorate Greater Accra Dismet Sotouboua Dismct Peru • Pérou Apunmac Department Central Région Cajamarca Department Vo Dismct Arzqutpa Department Malaysia • Malaisie Upper East Région Yoro Distnct Chota Promue Ayacucho Department Sabah Volta Regum TJama DlStOCt Zaire «Zaire Cajamarca Department X Tawau D istna Miracosta District G uinea * Guinée H aut Zaire Provmce Cusco Department S a r a w a k Tocmocbe Dismet Conakry Province Kivu Provmce Huancavehca Department X Sununjan D um a S a n M ig u e l P ro vin ce Forecanah Prefecture Shaba Provmce Huamico Department Nepal • Népal Naachoc District Liberia • Libéria Tamiiia «Zambie lea Department Baitadi D um a San Gregono District Junm Department Bong County Central Promue Khatmandu D istna San Miguel District La Ltbertad Department Montserrado County Lusaka M et N am San Pablo Provmce Lamboyeque Department M alawi Copperbelt Prom ue Both Tn Then Province San Louis District Luna Department Central Region Northern Luapula Provmce Ngfrn Buih Provmce Ptura Department Callao D u m a Lilongwe Dismet Southern Province PhuKhanh Promue Ayabaca Provmce Luna Dismct Southern Region Canales District Loreto Deportment Europe Lagunas District M ali America «Amérique M adré de Dus Department Montera District Maquegua Department Romania * Roumanie Plumas Dismet Bolivia • Bolivie Pasco Department Brada Distnct SapUlica District Koultkoro Région La Paz Department Piura Department Costantsa District Suyo District Tulcea Dum a Brazil • B résil Puiu Department Huancabamba Provmce Mauritania oMasritanie Amazonas State San M aran Department Ukrainian SSR • C. de la Frontera District Nouakchott District M ato Grosso State Taena Department RSS d'Ukraine Canchaque Dismet I r e R égion S3o Paulo Department Tumbes Department Mattupole Huancabamba District Hodh el Chargui Ucayah Department Ntcolaev Region Chile • C hih Ptura Provmce 2 e R égion Odesskaya Region Las Lomas Dismet Hodh el Gharbi Antofagasta Province Asia «Asie 3 e R egion Bernardo Q'Htfgms Provmce Asia «Asie India • lnd> Yellow fever • Fièvre jaune Assaba et Giudimakha Coqutmbo Province VietNam Andhra Pradesh State 4 e R egion Los Lagos Province Afnca • Afrique Gia-Lai-Công Tum Provmce Osoroo Hyderabad D u m a Gorgol Angola Lâm Dông Promue Santiago Provmce Visakhapatnam District 5 e R eg u n Bengo Province Phû Khan Provmce Assam State Brakna Colom bia • Colom bie Luanda Provmce Della Territory 6 e R eg u n Amazonas Department Choiera • Choléra Gujarat State r.n«nwu>ii « Cameroon Trarza Anaoqiaa Department Haryana State Provmce de l'Extréme-Nord Africa • Afrique Bobvar Department M ozambique Karnataka (Mysore) State Mayo Sava Departement Angola Boyaca Department Cabo Delgado Promue Bangalore District Mayo Tsanaga Departement Bengp Provmce Caldas Department Pemba City Bidar Distnct frfutihiq e G am bie Benguela Promue Cauca Department Gaza Provmce Chitradurga D u m a Huambo Province Chaco Department Upper River Division M aputo Provmce Gulburga D u m a Huüa Promue Cordoba Department • Guinée Maputo City Hassan D u m a KuandthKubango Promue Cundmamarca Department Sigum Region Nampula Provmce Kolar District Huda Department Ktmene Provmce Malcma District Mandya District M ali M eta Department Kwaitza-Noru Promue Nampula District Raichar D u m a Kayes Région Kwanza-Sul Provmce Nanno Department Nuusa Provmce Tumkur Duma Kim Cercle Luanda Promue Ruaralda Department Koultkoro Région Mecanhdai Distnct Kerala State Luanda, Cap San José del Guavutn Department Sofala Promue M adhya Pradesh State Dioüa Cercle Malanga Promue Santa Fe de Bogota Department Cercle Beira City M aharashtra State Narntbé Provmce Santander Department Kan Cercle Tete Province Akola D u m a Uige Promue Sucre Department Moanze Dismct Amrawau D istna Kolokam Cercle Zaïre Provmce Tohma Department Tete City Nagpur Distnct Nigeria • Nigeria Valle Department Renin • Réniti Zambezia Provmce Nandad Duma Anambra State Département de lAüwitupie Mopeia Dismct Ecuador « Equateur Osmanabad D u m a Bauch State S Pré£ d'Ailada Quelunane District Azuay Province Parbhant D u m a Bendel State Cire de Cotonou Niger Bolivar Provmce Pune D u m a Benue State S Prcf. de Toffo D ijfa Département Cailar Provmce SangU D istna Cross R iver State Departement de lAiacora Dosso Département Carchi Provmce Thane D u m a Kaduna State Chimborazo Promue Département de Borgou Marads Département M anipur State Kwara State Cotopaxi Provmce Département de Mono Niamey Département Punjab State Lagos State Departement de Zou Tahoua Département E l Oro Province Tamil Nadu State Niger State Esmeraldas Province Anna D u m a O gu n S ta te Burkina Faso Tdlabery Departement Galapagos Provmce Chingleput D u m a O n d o S ta te Boulgou Promue Zmder Département Guayas Promue Madras D istna O y o S ta te Burundi Nigeria ■ Nigeria Jmbabura Provmce Madurai D istna Plateau State Akuia Ibom State Loju Province North Arcoi D istna Bubansa Promue Sudan • Soudan Abuja State Los Rios Provmce Pudukkottai D istna Bubanza Arrondissement Territory South of 12° N Cibitoke Arrondissement Anambra State M anabt Province Thanjavur D istna Bauch State Territoire situe au sud Bujumbura Province Marona Province Tkuchirapalli D istn a du 12° N Bujumbura Arrondissement Bendel State Pastaza Provmce Tirunelvelli D ism a Benue State Burun Promue Puhmcha Provmce Vellore D u m a Zaïre «Zaïre Makamba Arrondissement Bortu State Sucumbus Province Vilkpuram D u m a Territory North o f 10° S Rumonge Arrondissement Gongola State Tungurahua Prom ue U tta r P ra d esh S ta te Territoire situe au nord lin o S ta te Onega Provmce Zamora-Chnchtpe Province West Bengal State du 10° S. Gitega Arrondissement Kaduna State Calmrra K a n o S ta te Pi Salvador Central Region Amenta • Aménque Cameroon • Cameroun Katsma State 1nHitn>dn • TfiHnnwat» M etropolitan Region Provmce de l'Extréme-Nord Kwara State Java Baras Province Bolivia • Bolivie Diamare Département Lagos State Occidental Region Tangerang Regency Bem Department Logone-et-Chan Departement Niger State Oriental Regum Kalimantan Selatan Provmce Ballman Province Paracentral Region Mayo-Danai Departement O g im S ta te Banjar Regency 1 tenez Province Cochabamba Department Mayo-Sava Département O n d o S ta te Guatem ala Banjannasin Muxuapalny Mayo-Tsawaga Département O y a S ta te Amaaddn Department Hulu Sungai Selatan Regency Ayopayo Province Carrasco Province Promue Littoral Plateau State Escumda Department H nln Sungai Tengab Regency Chapare Provmce Moungo Département Riven State Guatemala Department Hulu Sungai Utara Regency Woun Departement Sokoio State Huehuetenango Department Tabalong Regency La Paz Department M aluku Province Larecaja Province Prom ue du Nord Rwanda Quetzaltenango Department Benouc Departement Maluku Tengah Regency Murillo Province Cyangugu Prefecture Retalhuleu Department San Marcos Department Sumatera Barat Provmce Chad «Tchad Gisenyt Prefecture Solola Department Solok Regency Quinum Province Batha Prefecture Sao Tom e and Principe Suchuepequez Department Sud Yungas Province B et Prefecture Sfio Tomé-et-Principe Santa Cruz Department Totomcapan Department Al- Governorate Bdtuie Prefecture T-emba District Al-Anbar Governorate Andres Ibaüez Province Chan Bogumni Prefecture M exico • M exique Sào Tome Al-Mathna Gnvemnrate Cordillera Province Guera Prefecture Campeche State Florida Province Tanzania, United Rep. of Ai-Najef Governorate Kanem Prefecture Chapas State Tanzanie, Rép.-Unie de Al-Qadisiya Governorate Gutierrez Province Lac Préfecture D tstnto federal Arusha Region Arbil Governorate Ichilo Provmce Logone Occidental Prefecture Hidalgo State Kilimanjaro Regun Brazil • Brésil Logone Oriental Préfecture Mexico State M a ra R eg u n Governorate Amapa Ternary Njamena Prefecture Oaxaca State M tuara Regun Dohuk Governorate Macapa Mumapio O uaddai Prefecture Puebla State Rukua Regun Dyala Governorate Amazonas State Tandjik Préfecture Tabasco State Tanga Regun Governorate Canutama M umacpio Veracruz State Côte d'Ivoire Togo Mesan Governorate Joào Figueuedo Mumapio Département de l'Ouest Golfe Dismct Panam a Managing Mumapio Mao Sous Prefecture Kioto Dismct Danen Province Salah El-Din Governorate Manaus Mumapio 319 WEEKLY EPIDEMIOLOGICAL RECORD, Ho. 43,25 OCTOBER m l • RELEVE EPIBEMIOtOGKHIE HEBDOMADAIRE, N' 43,25 OCTOBRE1991

Marti Mumapio Almemm Mumapio Tamara Mumapio P a n «Pérou Ucayali Province Contain ana D u m a Nova Olrnda do None Altamira Mumapio Yopal Mumapio Ayacucho Department Purus Dutnct Mumcipio Araguaia Mumapio Cesar Department Huanta Provmce Novo Airaô Mumcipio Faro Mumapio Valledupar Mumapio San Jose Sannllana District M adré de Dios Department Manu Province Tcfc Mumcipio Monte Alegre Mumapio Chaco Department Cusco Department Madré de Dios D ism a Urucara Municipio Frunbs M uniapio Rio Sudo Mumapio La Conveucton Provmce Manu D ism a Gatos State Rendençâo Mumapio Cundmamarco Department Echarate District Tombopata Province Alio Panuso Muniapio Sâo Domingos do Capim Maya Mumapio Kitam Dismct Inamban District Bela Vista Municipio Mumapio Gucrviare Intendenaa Maranura District Caiapoma Mumcipio Sen. Jose Porfino Mumapio Mirallores Mumapio Santa Ana District Las Piedras D ism a Tambopata D um a Darooltadu Muoiapio Tailandia Muniapio San Juan del Guaviare Huanuco Department Pum Department Formosa Mumcipio X Tucurui Mumapio Mumcipio Huamahes Province Saiuka Province Goias Velho Muoiapio Xinguara Municipio M eta Intendenaa Monzon Dismct San Juan del Oro District Mara Rosa Mumcipio Rondoma State Cabuyaro Mumapio Leonao Prado Province Nova Cracas Mumapio Cacoal Muniapio La Prunavera Mumapio Aloma Robles District San Roman Dismct Vilcabamba Dismct Plamilnna Mumapio Rorasma Tem uty San Carlo de Guaroa Aucayacu District Santa Cruz Mumapio Bonfim Mumapio Mumapio J C Castello Dismct San M artin Department MaraiüiaÔ State Ganmpo Mutum Mumapio Villancenao Mumcipio Leonao Prado Dismct Huailaga Province Beilavista D ism a Grajuu Mumapio Maloca Caju Mumcipio Vista Hermosa Mumapio Monzon District Norte de Santander Department Saposoa D ism a Logo da Pedra Mumcipio Colombia • Colombie P Luyando District Montes Altos Muoiapio Cucuta Mumapio Lamas Provmce Antioquui Department Rupa Rupa Dismct Tibu Mumcipio f amax District Mau Grosso State Anon Mumapio MaraiUm Province Cucuta Intendenaa Tabalazos D ia n a Antôrno Joào Mumapio Taraza Muniapio Cholon D ism a Toledo Mumapio M artscal Caceres Province Diamannno Mumapio Yondo Mumapio Junm Department Jardim Mumapio Putumayo Intendenaa Campamlla D u m a Arauca Intendenaa Chanchamayo Province Puerto Asis Muniapio San M artin Provmce Nova Manoga Mumapio Arouca Muniapio Chanchamayo District Plaado de Castro Muniapio Santander Department Juan Guerra D ism a Samvena Mumapio Per «me D ism a Sidroliadiu Mumapio Bucaramanga Mumapio Sauce D u m a Boyaca Deportment San l u is Sevaro D ism a Smope Mumapio Cimitarm Mumapio Tocache Provmce Chita Mumapio Viloc Disma El Carmen Mumapio La Polvora D u m a Teranos Mumapio Puerta Boyaca Mumapio Satspo Provmce Vichada Department Nuevo Progreso D u m a Mum Gerais State Caqueta Intendenaa Covinali D ism a Bcnfiaopolis Mumapio Puerto Trujillo Municipio Mara man Dlt>mct Tocache Duma Belèn de los Andaquies Uchiza Dutnct Franasco Dumont Mumapio Ecuador • Equateur Pangoa Dismct Mumapio Ucayah Department Mirabela Mumapio M orona-Santiago Pm tvice Pichanah District El Doncello Mumapio Coronet Porailo Provmce Paracatu Mumapio Napo Province Rio Negro D ism a San Vicente de Caguân Callena D u m a Umu Mumapio Humavacu District Rio Tambo Disma Mumapio Padre AbaJ Provmce Para State Pastaza Provoice Saapo Dismct Casanare Intendenaa Padre Abad D u m a Aleoquer Muniapio Ha to Coro2al Mumapio Zamora-Chntchipe Province Loreto Department

...... 1 : . , .

Notifications received from 18 to 24 October 1991 Notifications reçues du 18 au 24 octobre 1991 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 - révisé, s - suspect

Choiera • Choléra America • Aménque C D Europe Africa • Afrique Brazil - Brésil 20JX-5.X C D C D .....12 0 Poland — Pologne 19.X Benin - Bénin 15VIÏÏ-30IX Ecuador - Equateur 22-28.IX . . . . l i 0 ...... 355 15 -.397 4 Bnm ania — BruiTnaniP 9-15 X Côte d'ivoire 3.X ‘ El Salvador 13-19.X ....43 5 ...... 604 116 . .. .83 4 Ghana 20.IX-10.X Mexico - Mexique 1UX-9.X ...... 1 175 72 .. 597 9 Liberia - Libéria i.vn-3o,ix Panam a 13-19 X Yellow fever • Fièvre jaune ...... 64 14 . 32 1 America «Aménque Malawi 30.IX1 Asia • Asie ...... 8 088 245 C D c D Brazil - Brésil 14-22. vn Rwanda 1.VI-3CUX Tnrlifl — fndft 1-31. VIII Para State ...... 411 25 .559 8 Tucurui M uniapio . ..1 1 Togo I.vra-30.DC Singapore - Singapour 29.IX-5.X ...... 1714 51 ....1 0 1 Date of nonfication/Date de notification.

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