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Outbreak news

Health authorities in Indonesia are still monitoring the dengue fever outbreak. In 12 of the country's 32 provinces this year's outbreak has seen an unusually high number of cases; however, the case-fatality rate has been lower than in previous years.

The WHO have received preliminary reports of an outbreak of Lassa fever in the Kenema district of Sierra Leone.

An emergency vaccination campaign has been launched in Chad to combat an outbreak of meningitis A in the north-east of the country, in an area that forms part of the meningitis belt.

In Australia, this year's Ross River virus season has brought a record number of cases. More than 1,400 people have been infected, including almost 500 in metropolitan areas, reflecting the movement of mosquitoes into cities.

New SARS alert

The Chinese Ministry of Health reported several new cases of possible SARS in Beijing and in a province in east-central China in April. Four cases are suspected and five have been confirmed, including one fatality. All cases are believed to be linked to lapses in safety procedures in the National Institute of Virology in Beijing, where two of the infected individuals worked; the Institute has been temporarily closed, and all staff are in isolation. So far, there is no evidence of widespread transmission in the community — all cases are linked to chains of transmission based on close personal contact with an identified case. WHO/CDC

Drug-resistant gonorrhoea

Preliminary data showing that the number of cases of drug-resistant gonorrhoea in the United States increased significantly in 2003, particularly among men who have sex with men, have prompted the CDC to issue a recommendation that fluoroquinolones are no longer used as first-line therapy for this patient group. The CDC Gonococcal Surveillance Unit found that the occurrence of fluoroquinolone-resistant Neisseria gonorrhoeae had increased threefold between 2002 and 2003 in men who have sex with men. Alternative treatment options for some patients, depending on their case history, include ceftriaxone or spectinomycin, both of which must be administered by injection and are therefore more expensive. CDC

Africa Malaria Day

This year's Africa Malaria Day on April 25th focused on children, with the slogan 'Children for Children to Roll Back Malaria', and the campaign hoped to raise awareness in children and allow children and young adults to become advocates for malaria control in malaria-endemic countries. The day marked the fourth anniversary of the Abuja Declaration, a commitment by African leaders and governments to halve mortality from malaria by 2010, and Dr Ebrahim Malik Samba, the WHO's Regional Director for Africa, issued a statement calling on WHO Member States to intensify their efforts to reach the Abuja goal. The WHO Director also spoke to highlight the WHO's position that malaria-endemic countries should adopt artemisinin-based combination therapies. WHO

Focus on measles

The number of deaths from measles in the period 1999–2002 decreased by 30% worldwide, according to a recent announcement from UNICEF and the WHO. The goal of halving global measles mortality by 2005 could therefore be achievable. It is believed that a new WHO/UNICEF strategy — 80% routine immunization coverage combined with supplemental immunization activities in high-burden countries — has contributed to the reduction. The good news coincided with Vaccination Week in the Americas, when millions of people were expected to be immunized. However, measles is still a cause for concern in Japan, where the rates of measles mortality are higher than in other developed countries. Additionally, a small outbreak in America received press attention when it was traced to children who had been adopted from an orphanage in China. WHO/UNICEF/CDC