~c4/wU la

UNITED NATIONS NATIONS UNIES

WORLD HEALTH O R G A N I Z A T I O N

REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN

COMITE FiZGIONAL DE LA MEDITERRANEE ORIENTALE

b a t r i b m e session

ORGANISATION MONDIALE DE LA SANTE

BUREAU REGIONAL POUR LA M ~ D I T E R R A N ~ E ORIENTALE

RENSEICNl34EmS EPIDEMIOMGIQUES

Le Directeur regional a l'honneur de presenter au Cornit6 r 6 g i o m l l e rapport ci-annex6, s u r l l i n c i d e n c e , en 1951, 1952, 1953 e t durant la premiere moiti6 de 1954, des maladies quarantenaires dans l a r8gion.

REGIONdL COMMITTEE FOR THE EASTERN MEDITERRANEAN Fourth s e s s i o n

~c4/wU

18 August 1954

EPIDrnIGXX; ICAL INTELLIGENCE

The Regional Director has t h e honour t o submit t o t h e Regional Committee t h e attached r e p o r t on t h e incidence of quarantinable diseases i n t h e region during 1951, 1952, 1953 and t h e f i r s t half of 1954.

INCIDENCE D2.S MALADIES QUARA??TEi:AIRES IDENCE OF QUARANTINABLE DISEASES

IN

04iS LA RZGION

DURAHT

LES ANImS 1951 FOR

THB

1951. 1952.

1952

1952. 1953 ET

LF

l e r SCMF,STRE DE 1954:

AND

THE FIRST HALF OF 195L

h c a n t

La

periode considQr&e, il n'a 6% %ring t h e period under rsview, no signal6 a u m cas de p e s t e dans des pays cases of plague were reported from anY

de l a Region. of t h e countries i n t h e Region.

La

maladie s' e s t , t o u t e f o i s , manif e s G e The disease appeared,however, i n African dans des pays limitrophes de l a RBgion, ou c o u n t r i e s adjacent to,or i n d i r e c t

en communication d i r e c t e avec celle-ci. communication with,countries

i n

t h e Re- La p e s t e a 6 t 6 s i g n a l e e au CONGO BFJGE, au gion. Plague war" reportad from EELGUT KENIA, en NGANDA, a u TANGANYMA e t dans CONGO,I(ENYA,UGATTDd, TANGAIEIKA and IRJIOl?

1'UNION IlX ^L AF'RIQUE IXJ SUD, come s u i t : ^OF SIXTH AFRIC& a s follows:

I

AN CONGO

KENIA ImWA

-

0

OUGANDA TANGANYIKA UNION DE L'AFRIQUE

DL

SUD

UGANDA UNION OF SOUTH-AFRICA

0

1951

263

U

40 6

l b r e rnoitie de 1954 f i r s t h a l f of 1954

16

0 2

CHOLERA CI-IOIJmA

le

s e u l pays de l a R6gion

06

l e cholera a i t Q t B signale, a 6 t 6 l e PIHISTlJ:. Le nombre t o t a l de cas, on 1951, a e t 6 quelque peu moins &lev6 que c e l u i r a p p l r t 6 l'ann6e precedente. L'incidence a continue

a

d6cmiti-e d'annee en ann6e.

1 9 L 8 w l % Q U5.z

C 43509 31082 30102 21.815

D 23999 18070

1W

U 2 3 0

The only country i n t h e R .

cholera was reported was PAXISTNI. _T::c t o t a l number of cases during 1951.

I#%S somewhat lower than &he number reported t h e ycor beforo. T':.

decrease i n t h e incidence colltinued year a f t e r year.

Depuis septembre 1749, l e chol6ra e s t Since September 1949, cholera i n f e c t i o n demeure confine a u Bengale o r i e n t a l . has been confined t o East Bengal.

Depuis l o r s , l e cholera n 9 a Q t 6 No cases of cholera have been reported signal6 dans aucune a u t r e province du s i n c e t h a t d a t e from any of t h e o t h e r

Pakistan. provinces of Pakistan.

En 1952, 3 9 cas e t 19 decbs de c h o l h 39 cases and 1 8 deaths of cholera ont 6 t 6 rapportgs de Chittagong ( p o r t were reported from Chittagong (seaport) maritime) e t 225 cas, 79 d6cbs, de Dacca and 225 cases and 77 deaths were reported

(a6roport). from Dacca ( a i z p r t )

,

during 1952.

En 1953, l e s c h i r f r e s o n t B t k , respec- In 1953, 5 cases

- ⁴

d e a t h 3 and 410 tivement, de 5 cas,

4

dkcks e t 410 cas, cases

- ^lL&

deaths were reported

U4

d6cbs. respectively.

Ces d e w agglom6rations s e trouvent Both p o r t s a r e i n East Bengal.

dans l e Bengale o r i e n t a l .

FIEVRE J A UNE YELLOW FEVER

Quslques-uns des pays de l a R6gion s o n t Some of t h e c o u n t r i e s i n t h e Ragion a r e i n c l w dans l a zone a f r i c a i n e d9endQmicitQ included i n t h e African yexow f ever m a r i l e , ~ n a i s dans aucun do ces plys endemic area, b u t no cases of yellow il n'a

6 t Q

e n r o g i s t r 6 de cas de f i b r e f e v e r were recorded from any of these jaune au c o w s des ann6es 1951, 1952, countries during 1751, 1952, 1953 and t h e 1953 e t du l e r semestre de 1954. f i r s t h a l f of 1954.

D9autl-e p a r t l durant l a &me pkriode, On t h e o t h e r hand, d u r i n g t h e same I e s eas e t d6ces de f i h v r e jaune, ci-aprhs period, ^';he following' yellow f e v e r cases mentionnQs, ont d t 6 rapport& d 9 a u t r e s acd d - a t h s were reported fro:n t h e countries pays dSAfrique, s i t u e s dans l a zone

i n

tho yellow f e v e r endemic zone i n Africa!

dsendQmicit6 amarile:

Pays 1951 lq52 1953 l b r e moitid de 1954

Countries 1st h a l f of 1954

L D G ! 2 d

C D

AFRIQUE

CCCIDalTALE FRANCAISE FREITCI-I WEST ATF.ICA

CONGO BSLGE

-

^{BELGIAN CONGO 1 1 5 5 7 7 0 0}

COTE

EE

LBOR

-

^{WLD EOST 2 5 1 5}

^{6 6}

^{1 0 0 0}

N I G E R E

-

^NIGERIA

^u

^{8 42 8.U 8 0 0}

OUGAIDA

-

^{UGANDA 0 0 1 1 0 0 0 0}

I1 n s c s t pas r a r e quo l a v a r i o l e s o i t import& A LDJN e t en EYPIE, en r a i s o n de l e u r p o s i t i o n s u r l e s routes du conrmepce i n t e r n a t i o n a l . Toutefois, depuis l a

seconde moiti6 de 1951, aucun cas de c o t t e maladie n'a QtQ signal6 en WiPTE. Depuis l a msme d a t e , l a sov.le p o u s s ~ o survenue ?I ADEN a ou l i o u on 1954, lorsque 67 cas f u r e n t e n r e g i s t r 6 s a u cours du premier semestre de 13ann6e.

Importation of m a l l p o x n o t infrequently occurs i n LD3N and EGYPT, owing t o t h e i r geographical s i t u a t i o n on i n t e r n a t i o n a l t r a d e routos. No cases, however, ware reported from EGYPT s i n c e t h e second h a l f of 1951. Since t h o saqlo d a t e , tb only outbreak which occurred i n !.DEN was i n 1954 when 67 cascs were recorded during

4

the F r s t s i x months of t h e ycar.

Par s u i t c dcs d i f f i c u l t 6 s de communication 1 9 i n t e r i c u r du pays, l e s c h i f f r e s n o t i f i d s en ETIIIOPIE, a u s u j c t do l a variolo, no pourraient s t r e tenus pour comrlots. Coper~dant, en juger par 10 nombre de cas s i g n a l i s , l'incidencc de l a maladie a haussd au cours des t r o i s dernibrcs anndesr

Due t o d i f f i c u l t i e s of i n t e r n a l

communications, n o t i f i c a t i o n of s m l l p o x i n THIOPL1 could not bo taken a s

complete. However, incroasc i n t h e incidcnce of t h i s diseaso, a s judged from t h e number o f n o t i f i e d cases, i s n c t i f i e d during t h c l a s t t h r o e years c

1Eres 23 somaines do 1954 1 s t 23 weeks of 1954

Aprbs l o d d c l i n notable constate M t e r t h e marked d e c l i n e i n t h e incidence dans 19incidoncc d.e l a val-iolo en of smallpox i n WAN, i n 1949, t h e roturns WAN, en 1949, l e s relcves p o r t a n t f o r 1950, 1951, 1952 and 1953 show a s u r l c s ann6es 1950, 1951, 1952 e t p a d u a l decroase i n t h o incidence of t h e 1953 rdv8lent m e d i m b u t i o n gra- discase.

d u e l l e de l'incidencc dc c e t t e maladic.

Pcu do changement e s t survenu Thcrc has been l i t t l o changa i n t h o dans l'incidcnce h a b i t u e l l c de l a usual incidonce of smallpox i n IWLQ during v a r i o l o en I B L K a u cours dc ccs t h e l a s t t h r e e years. However, a marked doux dernibros annges. Toutefois, i n c r e a s e i s noticed during t h e f i r s t unc dicrr,issancc notable peut h a l f of 1954.

S t r e consLtat60 dans l o i c r somestre de 1954,

L'incidence de la v a r i o l e a u The incidence of s m l l p o x i n PdKJ5Tt.N PAKf.5Tl.N e s t tombee a u t i e r s environ during 1952 droppea n e a r l y t o one t h i r d de c e q u ' e l l e a v a i t dt6 17ann8e of t h a t i n tho proceding ycarr l4,589 prec6dente: U.589 cas en 1952 c c n t r c cases i n 19.52 a s a g a i n s t 43,620 i n 1951.

43.620 en 1%1. C e t t e diminution This decroase i n incidonce continued

a continue en 1953, e t l e nombre during 1953, and t h e t o t a l number of cases t o t a l des cas o s t tombs'

2

5.063, dropped t o 5,063.

I1 e s t de t o u t e Qvidence qv.e l a There i s convincing evidenco t h a t smallpox v a r i o l e e s t en rdgression constante1 i n f e c t i o n i s continuously decreasing : 1.237 cas o n t 6.td rappol.tes au cours 1,237 cases were reported during t h e f i r s t des premihres 24 somaines de l'ann6e

24

weelcs of 1954.

1954.

De mai 1950

a

mars 1953, aucun cas From Yay 1950 u n t i l March 1953, no c a s e s de v a r i o l e n'a d t 6 rapport6 dJLMBIE of smallpox were reported from S!ZUDI

~~

SAOUDITE. En f brier 1953, l a v a r i o l e I n February 1953, smallpox broke out again s ' e s t de nouveau d6clared dans l e pays.in t h e country. Altogether,

164

cases of Ilu t o t a l , 1& cas de v a r i o l e y ont

e't6

smallpox were reported during 1953 and o n l y s i g n a l i s en 1953 e t 7 seulement au seven cases during t h e f i r s t six months cours du l e r semestro de 1954. of 1954.

11 r g s u l t o manifcstement des relcvBs r c l a t i f s

s.

l a v a r i o l e a u SCUDLN

:.:GLO-EGYPTIEN, qu9apr&s une p6riode de t r o i s ans (1949, 1950 e t 1951) dwcant lnquolle 1 9 i n c i d e n c e de la.

m?.ladic s ' c s t l ~ ~ i n t e n u e ov. nivoau he.bitue1, uno augmentation notable o s t survcnue en 1952, e t l a maladie s ' c s t d6clar;e sous formc 6pidGmique, notommcnt dans l a province du Darfour.

I1 s cmble que c 9 e s t de 19i*~friquc i ~ u a t o r i a l e F r z n p i s e quo 1 9 i n f e c t i o n s 9 e s t i n t r o d u i t e dnns c e t t e province.

Les rc1cvi.s a f f Q r e n t s a m onndes 1952 e t 1953 a i n s i qu9au l e r seinestre do 1954 rdv?lcnt 19existencc d9une assoz f o r t e dpid6mie do vs.riole dsns l o pays.

TYPHUS

Lu c o w s do 1.1 p&iodo consid;rdee, l e typhus s 9 e s t manifest; sous forme s p r a d i q u e $ CHYPRE, cn ERYTHREE, en IP':Q, en JOWLNIE, au LIBLN, en LIBYE ( ~ r i ~ o l i t a i n e )

,

^allPP!<ISTLN c t en SYI1IE.

La diminution constanfe de l 9 i n c i d e n - ce du typhus en EGYFTE semblc conti- nuer. 181 cas ont 6th c n r c ~ s t r d s en 1949, 106 en 1950, 101 en 1951 e t sculcmcnt 64. en 1552. Les c h i f f r e s unrcgistrds en 1753 n9indiovent pas unc eugmentation notable de l 9 i n c i - donce do l a maladie.

Fa FPHIOPIE, on constate une

nugmontation notable de 19incidence du typhus (dpid6mique u t murin) en 1952 c t 1753. Les c h i f f r c s enre- gistrBs pour 1951, 1952 e t 1953 sont

1.483,

2.075 e t 2.337, rospoctivoment.

LC ncmbre de cns s i g n a l & c u cours dcs prcmisros 23 wmaines do 1954 montrent que c e t t c augmdntation ccntinuora durnnt c o t t e ann6e.

Depuis 1951, on peut constator unc d6croissance graduellc notoblo da

19incidence du typhus on IR'.IJ.

L2cxistenco du typhus EpidCmiquc n9cst pas s i g ~ a l e ' o on ISR1EL. Cepen-

dent, il y a 6 t d e n r o g i s t r d 793,

734

e t 528 cas de typhus cnd6mique en 1951, 1952 o t 1953, rcspectivcmcnt.

From tho r e t u r n s of s m z U p x i n

;,MGM-EGYPTI"J SW.N, it seems evident t h a t a f t e r a eriod of 3 yoars (1949, 1950 and 19517, during which t h e incidence of smallpox has been n e a r l y w i t h i n u s u n l ~ a markcd i n c r e a s e was noticed i n 1952, and tho disease broke o u t i n an epidemic form, mainly i n Darfur Province. The i n f e c t i o n appears t o have been introduced t o t h i s province from French Equatorial Lfrica. The r e t u r n s f o r 1952, 1953 and t h e f i r s t half of 1954 show t h e presence of a r a t h e r b i g epidemic of

smallpox i n tho country.

During t h e period under review, typhus fevcr appeared i n sporadia form i n CYPELS, mITRE'-9 IRAQ, JOF&N, LFBi.lJON, L I B U ( T r i p o l i t a n i a )

,

PI.KTST1.N LND SYRIA.

Thc stcady dccrcasc i n t h e incidence of typhus fcvor i n EGYPT seems t o continue.

1 8 1 cases wore rocordcd i n

1949,

106 i n 1950, 101 i n 1951 and only 64 i n 1952. The f i g u r e s rocorded d u r i n g 1953 showed no marked i n c r e a s e i n t h e incidence of t h e dise?se.

I n ETHIOPIA, t h e r e i s a marked i n c r e a s e i n the incidence of typhus f e v e r (epi- domic and murino) i n 1952 and 1953.

The f i g u r e s recorded i n 1951, 1952 and

1953

o r e 1,483, 2,075 and 2,337, respectivoly. Tho number of casoe reported during t h e f i r s t 23 weeks i n 1954 show t h a t t h e i n c r e a s e i n incidence w i l l continue d u r i n g t h i s year.

Since 1951J t h e r e i s a marked gradual decrease i n tho incidance of typhus f e v c r i n W.N.

Epidemic typhus i s not seportcd i n ISW.EL. Nevertholess, 793,

734

and 5.28 cases of endemic typhus were rccordod i n 1951, 1952 and 1953, respectivoly.

Durant l c ~ pdriode sous examen, il y a cu une augmentation t r b s s c n s i b l e do 19incidence du typhus on LIBYE ( ~ ~ b n a ~ ~ u o ) . &0 cas y ont 6tB e n r o g i s t r 6 s en 1752 c c n t r e 5 sculemcnt durant 1'annQe pr6cddcnte.

Par contro, il c s t p a t e n t que l c typhus e s t cn rdgression depuis 1952,

During t h e period undcr roviow, t h c r e was a very marked increase i n t h c

incidonce of typhus fever i n LIBYA ( ~ y r e n a i c a )

.

²⁴⁰ cc ses wore rccordod i n 1952 a s a g a i n s t 5 cases only i n t h c preceding year. There i s cvidsnce, howevel-, that typhus i n f e c t i o n has bccn decrcasing s i n c e 1952.

LJ3 TYPHUS PIbW1IS IXS RFPUGIES TYPHUS FEVW ILMONG THE PP.L;STINE

DE

P~.USTINE RIG?==

Le typhus s ' e s t t e u j o u r s ~ n i f c s t i . sous forn~e sporadique parmi l e s

rQfugids. Cependcnt, depyis l a dornikro poussee aigue de typhus

3

p u x , survcnue dans l e nerd de l a v a l l Q e du Jourdain, en mil 1951, un s c u l cas do typhus, survenu en a v r i l 1953, a Q t 6 s i g x l d .

FIEVRF:

RM:UIW3iTE ET FIEVFE A

Lcs rbcsntcs dpiddmius de f i & m e rkcurrenta qui s e sont d6clardes avcc une &ande oxtension, o n t ddnontrd l a nf5cessitd d ' 6 t a b l i r , par un accord i n t e r n c t i o n c l , des r k e l c s d c s t i n e e s 5 combattre c c t t e m l c d i e ; a u s s i dans l e Rbglernent

S a n i t a i r c I n t e r n a t i o n a l , 10 f i b v r e r6currcnte a-t-cllo 6% a j o u G e aux cinq m l e d i e s q u i avc.icnt pr6c&

d e m e n t f s i t l ' o b j c t de conventions s o n i t a i r e s i n t e r n a t i o n o l e s .

Typhus f e v e r has always appeared s p o r a d i c a l l y among t h e rcfugecs.

However, s i n c e he l a s t sharp outbreak of louse-borne typhus which occurred i n tho northern part of tho J a r d a n v a l l c y during t h e month of 1.pril 1951, one case only of typhus ws reported i n A p r i l 1953.

RELC.PSIK AND TICK FEVW The r e c e n t occurrcncc of widcsprcad epidemics of r c l a p s i n g fovor has indicated t h e need f o r i n t o r n a t i o n a l l y agread r u l e s f o r i t s control; t h e r e f o r e , i n thc

I n t e r n a t i o n a l S a n i t ~ r y Regulations, r e l a p s i n g fever has boon added t o t h e f i v e diseascs previously t h e s u b j c c t of I n t e r n c t i o n a l S a n i t a r y Conventions.

Ce q u i s u i t e s t un expos6 de The incidonce of r e l a p s i n g f e v e r i n 19incidcncc do l a f i b v r e r d c u r r e n t c t h e countries of t h c Region during t h e dcns l e s pays de l a RQgion nu period Jenuary 1951

-

Junc 1954, i s cours de l a pdriode janvicr 1951

-

a s followsr

j u i n 1954.

Des cas sporadiques sculemcnt de S r a d i c cases only of relapsing fever f i a v r c r d c u r r c ~ ~ t e , ou de fiEvre

3

an o r t i c k f e v e r werc recordsd from t i q u e s , ou l e s d e w typos en m6me

d r

CYPRUS, PR2NCH SOKriLILI.ND, EiLN, IRI,Q temps, o n t 6t6 e n r e g i s t r & s ,$ CHYPRE* ISRBEL, BRITISH SOM[,LIIY,ND, L.S. SU1G.N

en SOtC.LIT; FPd'.>TC.JCI.ISE, en IUN, en and SYRU..

IR(.Q, en ?STL'.FL, en SOVLLII: B3ITANNI- QUE, a u S0'ITDi.N L.E. c t en Sl3.E.

Dcs c h i f f r e s rcl?tivement i'lev&s R e l a t i v e l y high f i g u r e s werc recorded ont d t Q e n r o g i s t r e s en J(RMKIEI i n J(XWi, among t h e P a l c s t i n c refugces pnid 1 0 s r 6 f u 6s de Palestine _{and i n} SOMtUIUEB) (under I t a l i a n

c t cn SOMgLlE a d m i n i s t r r t l o n Adudnis t r a t i o n )

.

i t c l i o n n e )

.

En ~ Y T H R Z E , unc augmentation In: ERITRGi, a mherked increaso i n notoblo do l'incidcnce s d t 6 constat6e incidence w s noted i n 1952. The en 1.952. Lcs c h i f f r e s t o t a u x t o t a l y e a r l y f i g u r e s f o r 1951 and 1952 annuols, pour 1951 e t 1952, o n t d t 6 were 11 and 235, respectively. Tho de 11 c t 235, rospcctivemcnt. Les cases n o t i f i e d during 1953 and t h c cas n o t i f i e s en 1953 e t . d u r a n t l o f i r s t k.lf of 1954 i n d i c a t e a f u r t h e r l e r scmostre de 1954 rdvblent que incrcasc.

c c t t c nugmfntation s ' e s t encore accen- tu6e.

L'augmentation de 19incidencc de l a The i n c r e a s e i n incidence of r e l a p s i n g f i k v r e recurrent@ en ETHIOPIE, f c k r i n ETHIOPL*., which was rocorded constat60 on 1950, a continud en 1951. i n 1950, continued i n 1751. Tho r e t u r n s

Los rclov6s a f f e r c n t s aux anndos 1552 f o r 1952, 1953 ~ n d t h e f i r s t h a l f of c t 1953 a i n s i qu9?. l a l k r e moiti6 1954 i n d i c a t e a f u r t h e r incroasc i n do 1954, indiqucnt unc eugmentation incidence:

encore plus dlev6c:

1947 1948 1949 1950 1 % 1 1552 1953 l b r o moitid de 1954 1st h a l f of

1954

CIMUL;.TTVE Di.TA ^{( 0 )} ON

THE

INCIDENCE OF Q W A N T I N L B L E DISUASES

IN

1s1, 1952, 1953

AND

THE F I Y T It:W OF

1954

( o ) Sauf indication c o n t r a i r c , 10s c h i f f r e s c i t 6 s portant s u r unc phriode de a u a t r e semaines

Four-weekly figures, unlass o t h d s e s p e c i f i d

PAPS

COUNTR E S

PAKISTAN TOTAL

dont

-

^{of which}

Bengale Orientale East Bengal

t - i -

'' -I --

-

VII 262 152 655 369 395 237

262 l 5 ? 655 369 395 237

i

I I

I

---

J V I I I

-

310 189 424 244 344 243

310 189 424 244 344 243

... ---- ^.- -. --- ^{... .}

I

^{Z &-}

^:

0 0 0 0 0 0 N O 0 0 0 0 \ O m rl0 0 0 0 0 0 0 0 0 Q

> I

< *

[ ^{s o}

0 0 0 0

CS

^O 0 0 0 0 OOP 0 0 0 0 0 0 0 0 0 0

Nrl

- ^{.. .-} - ..

----

^{... ...}

VARIOLE

-

^{SMALLPOX (contd. )}

TLiRQUlX TURKEY

(m)

0 0 0 0

5"

^{r l o N m d 0 0 r l o 0 0 0 0}

IRAN

D X I 1 1

1483 17 2075

5 1 2327b

41b

W 1

a

4

13

0

23 2

3

82

3

1 45

TL+/filn:/L4

183 1 181

13

127 2

8 0 5 0

3

0

12 0

N X I T

184 2 145 4 201

4

6 0 1 0 2 0

6

0 0

X I

154 3 223 0 248 2

3 0 1 0 0 0

2 0

0

:

0

wro ' s o i r e s p r o v i s i o n a l io-%s

1 0

-

A I V

50 0 124 5 126 5 259 3 1 2

0 7 0 0 0 1 0 24

I

0

S

X

152 1 182

2 201a

2a

5 0 8 0 0 0

5 0

J

V I I I

98 5 157 4 178

0

13

0 1 0

1 0 0

7 1 TWHUS

F I1

89 2 101

2 130

5 159 3 3

0 8 1 3 0 8 0 38 1

J I

68 1 9 1

1 112

1 13 6

4 2 0 7 2 2 0 4 0

16

0 page 1 4

PAYS COUNTRIES ET HIOPIE ITHIOPIA

y compris t. murin IncL. Murine typhus

I

A M

~:

74 1 186

5

ln

1

1 5 0 3 0 0 0

5 0 EPDEIITCIIE

M

I11 80

0 141

4 1

1 225

6 9 1 14

0 1 0 4 0 64 0

11 2 1952 C

D ANNEES

YEARS 1951 C

D 1952 C

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