14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.008 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation The health surveillance stations at points of entry in Brazil under the revised International Health Regulations - IHR/2005 C. GREGIS, F. V. Pascalicchio National Health Surveillance Agency (Anvisa), BRASILIA, DF, Brazil Background: The recent revision and update of the International Health Regulations, IHR (2005), provides a new approach to deal with international reaction to public health events and to ensure global health security. Therefore, it is a priority to build, strengthen and to mobilize the necessary resources. The National IHR Focal Point must notify within 24 hours all events which may constitute a public health emergency of international concern. This study aim to assess the effectiveness of Health Surveillance Units at points of entry in Brazil regarding health control of international travelers and epidemiological investigation conducted in accordance with the IHR (2005). Methods: It was analyzed the public health events notified to the Health Surveillance Units at points of entry that occurred in the first year after IHR (2005) entry into force in accordance with the attributes of usefulness, sensitivity, timeliness, and stability, and their relation with Malaria imported cases into Brazil at the same period. Results: Since 1975, Brazil has a broad national epidemiologic surveillance system to reporting infectious and no-infectious diseases and that enables the assessment and control of these events timely. Until 2007, the main activity at points of entry was the supply of the yellow fever vaccine and its verification when an international traveler was arriving from an affected country. At the first year, 26 suspected events of public health concern were reported by points of entry to central office after 4.2 days average, such as unknown death (6 events), chickenpox (5), malaria (4), tuberculosis (2), outbreaks of foodborne illness (2), and one of rubella, hanseniasis, acute fever illness, hepatitis, norovirus, conjunctivitis and accident. At the same time, 203 Malaria imported cases occurred among 30 percent of employees and 60 percent of cases arriving from Africa. Conclusion: The structure of the health surveillance at points of entry in Brazil has changed after the IHR/2005 implementation. The low sensitivity for detection of events in points of entry are in agreement with the relevant literature. There is the necessity of further research on imported cases of notifiable diseases and improvement of the investigation and notification to the central level.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.009 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Varicella (Chickenpox) outbreak in Bhutanese refugee camps in Eastern Nepal A. K. MISHRA 1 , O. Gorbacheva 1 , M. M. T. Hasan 2 , N. Rimal 3 1 International Organization for Migration, Jhapa, Nepal, 2 UNHCR Sub Office Damak, Jhapa, Nepal, 3 Association of Medical Doctors of Asia (AMDA), Jhapa, Nepal Background: Approximately 100,000 Bhutanese refugees live in seven camps in southeastern Nepal. For those offered resettlement to the USA, Canada, Australia, New Zealand, Denmark, Norway, or Netherlands, the International Organization for Migration (IOM) in Nepal conducts medical screening and arranges travel, moving up to 15,000 refugees annually. Varicella spreads primarily by airborne droplets and patients with infectious varicella are prohibited from the air travel. Varicella vaccine in Nepal is not licensed. In March 2009, an outbreak of varicella was detected at a refugee transit center (TC). Outbreak response was conducted jointly by UNHCR, IOM, and Association of Medical Doctors of Asia (AMDA), implementing partner for refugee camp health services. Methods: A varicella case was defined as an illness with acute onset of diffuse papulovesicular rash without other apparent cause. Refugees received additional health education regarding signs and symptoms of varicella and importance of limiting contacts with sick people. Prior to travel, medical staff screened departing refugees for fever and conducted careful skin inspection. For cases with imminent travel, cases and their family were deferred from travel or travel-related screening for 21 days. Refugees identified with varicella in TC were isolated until lesions crusted. Results: From 25 February to 25 May 2009, 473 cases of Varicella were registered (cumulative incidence 50 per 10,000 refugees). Among the seven camps, incidence ranged from 9 per 10,000 to 124 per 10,000; outbreak duration ranged from 37 to 87 days. The age ranged from 01 month to 30 years, mean 6.5 years. The incidence was the highest among children of 0-4 years (242 per 10,000), and decreased with each successive age group. Eight cases and their families (total 21 refugees) were deferred from travel for 21 days. 14 refugees and their families (total 63 refugees) were deferred from travel-related screening. 3,860 refugees departed during the outbreak period to United States. No refugees were reported to develop varicella during the flight or upon arrival to the final destination. Conclusion: In a setting with endemic varicella transmission, systematic surveillance, combined with isolation of cases, likely decreased transmission and prevented travel related outbreaks of varicella.
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