Earthquake and Tsunami

Reports of consultants

Draft Summary Report of Investigation of a suspected unusual event of Dying Crows of unknown Etiology in post tsunami, Maldives, 2005

Demographic information

LINE LISTING OF SAMPLED FEBRILE CASES

F = Fever  R = Rash  H = Headache  M = Myalgia/arthralgia   C =  Convulsion

Acknowledgment

I am thankful to DG-HS, MOH, Dr. Abdul Azeez Yoosuf , Mr.Ibrahim Shaheem Deputy Dir. Gen. DHS, MOH Maldives,  Dr Jorge Mario Luna WHO Representative to Maldives , Dr.N.Kumara Rai Dir.CDS , Dr.S.A Abdullah Coordinator CDC , Dr.J.P.Narain  Coordinator HIV/AIDS and TB, Dr.Rajesh Bhatia R.A BCT  WHO/SEARO, Institute of Virology Pune India, Australian Animal  Health Laboratory , Geelong , Australia for their guidance and to Dr.E.A.Padmasiri, Dr.Ayana Yeanabat, Dr.Christina Drummond, Mr.Habeeb, Mr.Abdul Latheef and other  colleagues for all their kind cooperation and support to make this investigation possible.

References

1.      James Chin, MD, MPH, Editor.2000.Control of Communicable Diseases Manual 17 th Edition,  pp 48 – 50.

2.      US NAMRU – 2  A WHO CC for Emerging Diseases .2001.Outbreak Response Training Manual.Jakarta , Indonesia.

3.      Centers for Disease Control and Prevention.Guidelines for Surveillance, Prevention, and Control of Epidemic/Epizootic West Nile Virus in the United States.U.S.Departement of Health and Human Services Public Health Service, Center for Disease Control and Prevention, NationalCenter for Infectious Diseases Division of Vector – Borne Infectious Diseases.Fort Collins , Colorado 3 rd Revision.2003.

Delhi17 February 2005.

( Dr.I Nyoman Kandun )

STP-CSR WHO/SEARO

O:\TSUNAMI-26 DEC.04\Dr.Kandun.rept-NoonuAtoll-Deadcrows.doc

Glossary and definitions ( * ) :

Zoonosis ( zoonoses, plural ): An infection of infectious disease transmissible under natural conditions directly or indirectly between humans and other vertebrates ( adapted WHO. 1959). The transmission must be between animals and humans, and the direction of transfer is immaterial.

Four principal types of zoonoses :

1.      Anthropozoonosis : diseases acquired from other vertebrate experiencing enzootic or epizootic disease ( e.g., plague, rabies, leptospirosis, arboviroses, trichinosis, toxoplasmosis, scrub typhus ).

2.      Zooanthropozoonosis : diseases primarily of human origin that may be acquired by other vertebrates ( e.g., amebiasis, tuberculosis ).

3.      Amphixenosis : diseases common to humans and other vertebrates ( e.g., influenza, salmonellosis, Chagas disease, schistosomiasis, leptospirosis, certain mycoses ).

4.      Parazoonosis : accidental or incidental infections of humans with animal disease agents ( e.g cysticercosis, toxocariasis, hantaviruses, other arboviruses ).

Based on the disease agents life cycle, there are four broadly defined biological categories of zoonosis.

1.      Direct - Zoonoses : the disease transmitted directly ( non propagative transmission ) from an infected  vertebrate host to a susceptible vertebrate host by direct contact, by contact with fomite, or by mechanical vedtor without any apparent changes in trhe agent (e.g. rabies, anthrax, brucellosis, plague, trichinosis ).

2.      Cyclo – Zoonosis : diseases requiring more than one vertebrate host species, but no invertebrate host, in order to complete the development cycle of the agent ( e.g. human taenisasis, echinococcosis ).

3.      Meta – Zoonosis : diseases transmitted biologically by invertebrate vectors ( e.g. arthropods ) or develops ( cyclodevelopmental ), and involves an obligatory extrinsic incubation ( prepatent ) period before transmission to another vertebrate host is possible.In general a meta zoonotic disease forms a complex relationship involvingseveral vertebrate hosts ( reservoirs, amplifying hosts ) and an obligate intermediate invertebrate host to complete the parasites life cycle.

- Plague                                   :  rodent – flea – human

- Schistosomiasis                    :  dog/cattle/rodents – snail – human

- Japanese encephalitis         :  pig – mosquito – human

- Malaria                                  :  human – mosquito - human    

Malaria is not considered a true zoonosis as transmission of the 4 human malaria parasites is almost entirely restricted to a human -  mosquito – human cycle.Other animal reservoirs ( non human primates ) are not believed to be epidemiologically important.

4.   Sapro – Zoonoses  : disease having both vertebrate host and non – animal development  site or reservoir.Organic material, soil, plants, aqutic environments are considered non  - animal ( e.g. some mycoses and algal infections , larva migrans ( hookworm ), some free living amoeba.

            Reservoir                    : any person, animal, arthropod, plant, soil or substance ( or combination of these ) in which an infectious agent resides and multiplies, on which it depends for survival, and where reproduces itself in such a manner that it can be transmitted ( directly or via a vector ) to a susceptible host.