Turkish Embassy in Tajikistan

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Turkish Embassy in Tajikistan

From: "Santino Severoni"

To: '"Amb- Akif Ayhan,Turkey¹" ; '"Amb Amar Sınha, India'"

, "'Amb. Margaret Skok. Canada"' '"Amb Ramazan Abdulatıpov Russıa'" '"Amb Tracey Ann Jacobson, USA'" 1" . '"Amb. Yerlan Abıldayev. Kazakhstan'" . '"Amb. Zuo Xueliang, Chına' . '"Charge d'affaıres of Korean Embassy'"

; '"Charlotte Adriaen"' "Chınra Bronchı, VVorld Bank'" ; '"Embassy of Uzbekıstan"' ; "'Embassy of Afghantstan'" ¹ "'Embassy of Azerbaijan"' ; "'Embassy of Japan" [e-mail]>; '"Embassy of Kyrgyzstan¹" <ınfo@kgembsssy tj> '"Embassy of Türkmenistan¹" , '"Eva Lılthman Sıda'" , '"Farıd Garakhanov'" "Hasan Karrabı ; '"Henry Zipper de Fabianı, French Ambassador¹¹¹ "'Hongvvei Gao. UNICEF'" : '"Iraman Embassy"' , '"Lucas Moers, IMF'" . "'Makoto Ojiro, ADB"¹ , '"Marzia Nazarova'" , '"Mathıeu le Blan, EBRD'" ; '"Mıchael Jones"' ; "Ms Dons Hertrampf German Ambassador'" ; '"Münir Merali. AKDN¹" , '"Mykola Kurylchyk, IAEA'" '"Nıcolas Guıgas. Dty Country Dırector'" '"Princıpals T J'" «prıncıpals.ljfgundp org>; "'Rastıslav Vrbensky" ; "'Rudolf Schoch, SDC'" : "Russıan Embassy'" "'Santino Severonı. WHO'" , "'Trevor Moore, UK Ambassador"

, "'WFP, Zlatan Milisic'" , 'Yoshihırc
Nakayama, Japanese Embassy'"
Sent: 07 Ağustos 2009 Cuma 20 11

Subject: Tursunzoda outbreack updatıng

Dcarall:

! ollcnving t!ıc nc\vs rcports and runıours circulaling about a outhreak ot' l IcnuıiThagic l'cvcr in

l ursunAida disıritl, (,60 kilomctres vvcsl üi'Dushanhe). Wllü vvould likc to ctınlirm liıat l .IK hcalth

aulhorise are eurrcntly iacing thc managemcnt of a Congo Oimca Haenıorrhagic ("ever outhreak.

Since 26 ol July somc cascs of palicnl wilh haemorrhagic fcver sympıoms reportcd to l ursun/uda Infcctivc Hospital. SS1-.SS and Mol l art- activciy cngaging in managing ıhc ongoing oulbrı-ak. since ılıcn 3 palients dıed in ıhc past vveek (last ycsterday) Mol l invcstigatıon ınıssion u as sond >cstcrda\ and loda\ to l ursun/oda Disiricl and eurrcntly 11 mohile tcanıs arc dispatchcd lo asscss ıhc siuıatıon in ali hoıısehold ol'ıhc disırict.

( urrenlly thc situation appeıırins; to be thc follovving:

• 5 cascs orhcınorrhagic tcver vvcrc confırmcd clinically and on thc hascs of loca! laboralory

Icsls. Ihcsc 5 palients (including a hospilal hcalth vvorkcr) arc eurrcntly tındcr trcatıncnl al

l ursun/oda l lospiıal.

• 
  3 palients dicd lor hucmorrlıagic i'cvcr during last wcek and lası \vcre vcstcrday.
  
• 
  2-\ palicnls \verc admittcd and eurrcntly undcr obscrvation (nıa'ınly ıclaııvc ör e^poscd 10
  eonlact \\ilh tonlîrmcd cascs). Thcsc 24 palients İÇ\vill convinuo to show abscncc of
  symploms will be dischargcd by thc hospital next Monday.
  
• 
  Currcntly \V110 is vvorking closcly wilh Moil and SSKSS lo mangc thc ongoiny oulbrcak:
  

Dpon SSl'SS requcst lwo Wl 1O exerls will be arriving in the coming days to assisi the i J K hcalth aulhority on thc infeclion control and to providc training on case managcmcnı to ıhc hospilal hcalth vvovkcrs.

Pauc 2 of

.2)3

• 
  Kibovirin drugs \vill be provided by WHO in ordcr to secure appropriatcd medical ireatmcnt U ı
  infcctcd palienls.
  
• 
  \VI K) rcquesled 20ü Personal l'rotcction Kils ibr hcallh vvorkers and cpidemiologic
  invesügation leams that vvill be shipped ouı from WHO Cicneva vviıhin comıne days.
  

As correctly rcported «n thc ıncdia Vira! hemorrhagic fevers arc animal and humarı illncsses causcd by dislincl lamilics ol' RNA viruses. Ali lypcs of VH1^; are charactcrızcd by l'ever and blccding disordcrs and ali can progrcss to high [ever. shock and dcaih in extrcme cases. Somc of ıhc VIII-ai'.cnts uuısc rclativcly mikl illncsscs. such as thc Scandinavian ncplıropalhia cpidcmica. oihcrs. such as thc Alrican I-.bola virüs, can causc severe, lil'c-lhrealenıng cliscasc.

Crimcan-Congo haemorrhagic fcvcr (CCHH) is a viral haemoiThagic fcvcr by Nairovirus group Although primarily a y.oonosis, sporadic cases and outbreaks oi'CCHK affcctıng humans do occur. Thc dısease is cndemie in many countrics in Africa, l.vurope and Asia including Central Asian Couııtries, in thc past ycars. cases ör outbreaks havc bccn rccorded in Kosovo. Albania. Iran. Pakistan, l'urkcy and Central Asia

Healthcare \vorkers in endemic arcas should be awarc of thc illness and ıhe correct inl'cclion coıılrol proccdurcs to protect Ihemselvcs and thcir palients from thc risk of nosocomial (hospital-acquircd) infcclion.

ikımans \vho bccomc inlcctcd vvith CC1I1¹' acquirc thc virııs from dircct contacl vvith hlood ör ollıcr inlcctcd tissucs from livcstock during Ihis lime. ör they may become inlcctcd from a ııck bile. l lıc majority ol" cases havc occurrcd in those involvcd \vilh ıhc livcstock industry. such as aurıcultural vvorkci's. slaughtcrhoLisc workcrs and vctcrinanans.

Thc incubalion pcriod is usually öne to thrcc days. with a maximum of nine days. Thc incubatıon pcrıod lollovving contact wiılı ınlccted blood ör tissucs is usually fi ve to six days, \vilh a documcnicd ma.ximıım ol' 13 days.

Önsel of symptoms is suddcn. \vith fcvcr. aching musclcs. di//incss, ncck paın and stiffncss. backac'nc. hcadachc. l here may be nausca, vomıling and sorc Ihroaı carly on. \vhich may be accompanicd by diarrhoca and gencralised abdominal pain. Othcr clinical signs wlııch cmorgc incluclc lachycardia (tast hcart raic). and a pctechial rash (a rash causcd by blcedıng into thc skin). such as in ıhc mouth and throat, and on thc skin. The petechiac may gıvc way to haemorrhagic phcnoınena.

l hc nıortality rate from CCHF is approximatcly 30%, vvith dcath occurring in ıhc sccond wcck of illness. in ılıose palients \vho rccovcr, improvement generally begins on thc ninth ör tenth dav allcr Ihc önsel of illness

Dcspıte ıhc scnous clinical onset lajikistan is an endemic country ibr C.'ongo Crimca l Icnıorrhagic fcvcr \\ith m-coıınlry capacily and expcricncc to contro! this discasc. WI K) docs not recommcnd ıravcl rcstrictıons. Addilional informalion will be providcd in thc coming days wıih thc cvol\ ing ol ıhc situation.

Mv besi i'euards

t>r. Sfl^tLiA,o Severce

Wİ1C) Rcprcscntalıvc/I Icad of Country Office WHOOi'üeeinTajikistan

08.08.2009

UN llousL- • 2. "VT.r.V C'cnter 37/1. Bokhtar Sır..

Ousliiuıbe. l ajikisuın

Tel: [phone]

l^:ax: 199248701 1484

Mob: -992 9ü 776 72 Ki

c-nıaıl: ssc

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HFAİJH ÇARE

THREE DİE OF HEMORRHAGİC FEVER İN TURSUNZODA DISTRO

DUSHANBE. Augusi 7, 2009, Asia-Plus /Nargis Hamroboyeva/ Thrce rcsıdents of the Tursunzoda district, some 60 kilometers west of Dushanbe. have died of hemorrhagic fever, Asia-Plus has learned from Azamjon Mirzoyev, Deputy Health Minister also Tajikisfan Head Sanitary Physician.

"Arnong them are Ihe brolhers Kholmanov. 50 and 47. from the village ot Zıyoratut and the 47-year-old head of the infectious dıseases department wıthm thc local central district hospital Askar Umarov," the deputy mınısler said. ümarov dıed of Ihe disease yesterday.

According to him, the first case of the disease was reported in Ihe village of Ziyoratut on Juiy 27. "To this date, five persons have been diagnosed with hemorrhagic fever; three of them died," said Mirzoyev. "24 persons that were in contact with those having contracted the disease are currently under thc çare of physidans. Antiepidemic measures have been taken in Ziyoratut." No new cases of hemorrhagic fever have been reported so far. he added.

Ihe viral hemorrhagic fevers (VHFs) are a diverse group of ammal and humarı illnesses that are caused by five distinct lamilies of RNA vıruses: the Arenaviridae, Filoviridae, Bunyaviridae, Togaviridae, and Flavivirıdae. AH types of VHF are characterized by fever and bleeding disorders and ali can progress to high fever, shock and death in extreme cases. Sorne of tho VHF agorıls cause reialıvely mild illnesses, such as the Scandinavian nephropathia epidernıca. wnıle others, such as thc African Ebola virüs, can cause severe, lılc-threatening dıseaso.

The Arenaviridae include the vıruses responsible for Lassa fever and Argentine. Bolivian and Venzuelan hemorrhagic fever. The Bunyaviridae ınciude the merrıbers of the Hantavirus genus that cause hemorrhagic fever with rcnat syndrorne (HFRS), the Crimean-Congo hemorrhagic fever (CCHF) virüs from the Nairovirus genus, and the Rift Valley fever (RVF) virüs from the Phlebovirus gonus. The Filoviridae include Ebola and Marburg vıruses. Finatly, the Flaviviridae include dengue, yellovv fever, and two viruses in the tick-borne encephalitic group cause VHF: Omsk hemorrhagic fever virüs and Kyasarıur Foreist disease virüs.