la lj

UNITED NATIONS NATIONS UNlES

WORLD H E A L T H O R G A N I Z A T I O N

CCE'JTE REGIONAL DE I,A

~ D I T E R P ~ O R ~ T A L Z

Point l j de l ' o r d r e du jour

ORGANISATION MONDIALE DE LA SANTE

BUREAU R ~ G I O N A L DE LA M ~ D I T E R R A N ~ E ORIENTALE

RENSEIWEKNTS EPIDZNIC W GIQUES

Le Directeur regional a l'honneur d e

ase enter

au Coxit& regional l e rapport ci-ancex6 sur l ' i n c i d e n c e , en 1950, 1951, 1952, 1953, 1954, 1955 e t durant l a premiere m o i t i 6 de 1956, des maladies quarantenaires dans la S g i o n .

REGICNAL CDMKITTEE FOR THE

E A S m MED1TEF.RAIiEA.N S&& Session

Agenda item 1 5

EM/~c6/10 13 August 19%

~ID~.IIDLOGICAL 12JTELLIGZNCE

The Regional Director has t h e honour to submit to the Regional Committee t h e attached r e p o r t on t h e incidence of quarantinable d i s e a s e s i n t h e region during 1 9 9 , 1951, 1952, 1953, 195.4, 1955 and the f i r s t h a l f o f 1956.

REMEIGIWNTS EPIDEMIOLC GIQTJES Depuis l a c r e a t i o n du Bureau r 6 g i o n d pour l a M6diterran6e o r i e n t a l e , il e s t survenu c e r t a i n s f a i t s en r e l a t i o n avec l e fonctionne- ment des s e r v i c e s 6pid6miologiques :

Zone d e s s d

La Turauig e t l ' b ont adh6rB au syst&e de renseignements 6pid6miolo- giques de l a r&gion, e t l e P & i s a , sans s e d6tacher du s e r v i c e Bpidgmio- logique de Singapour, s ' e s t j o i n t B c e systhme, p a r l ' e n w i e t l a k c e p t i o n d'informations p a r voie p o s t a l e a6rien- ne. Rbcemment (en mai 1956). l a

9e &sembl&e Mondiale de l a Sante a adopt6 une r6solution r a t t z c h a n t l a

B

l a S g i o n de i r Mkditerranee orientale.

EZlZnciDest

⁺ 1 '6- d' informations

Jusqu'au l e r octobre 1952, l a noti- f i c a t i o n d ' i n f o m t i o n s Qpid6miologiqucs B t a i t r 6 g i e p r 1 e s d i s p o s i t i o n s des Conventions s a n i t a i r e s i n te r n a t i o n a l e s de 1926' e t 194.4 e t p r l a Convention

a n i t a i r e i n t e r n a t i o n a l e de 1933 s u r l a Navigation &rienne.

Depuis l e l e r octobre 1952, l e REglement s a n i t a i r e i n t e r n a t i o n a l de 1951 ( a g l e m e n t no 2 de 1'OMS) se

trouve en vigueur e t s e s d.ispositions o n t remplac6 c e l l o s des ancionnes Conventions.

EPDEMIDIDGICAL IUTELLIGENCE

Since the establishment o f EMSO, c e r t a i n developments having a b a r i n g on t h e working of the epidemiological s e r v i c e s took place r

Area served

and adhered to t h e epidemio- l o g i c a l i n t e l l i g e n c e system of t h e region,

and &&&& while s t i l l adhering t o t h e

Singapore epidemiological service, joined t h a t system by sending and receiving information by air mail. Recently (May 1956), a r e s o l u t i o n was adopted @ t h e 9 t h World Health Assembly, assigning

Tunisia

t o the Eastern Yediterranean Region.

&&

^{m-~0vc P of}

~n~oOr:latiop

Up t o 1 October 1952, the r e p o r t i n g of epidemiological information was governed by the p m i s i o n s o f t h e I n t e r n a t i o n a l SanLtary knventions, 1926 and 194-4, and by t i e I n t e r n a t i o n a l Sznitary Convention f o r Aerial Navigation. 1933.

A s from 1 October 1952, the Intorno- t i o n a l Sanitary Fkgulations, 1951 ^(WK) Regulations No. 2) were put i n t o f o r c e

and t h e i r provisions superseded those of t h e former Conventions.

D @ c ~ / ~ D page ^- 2

A I'heure a c t u e l l e , tous lea pays de la Z g i o n s o n t Ti& par ce %glement,

U i e S a uarantenaire_s

En vertu du Gglemnt, u n ~ sixikme rnqladie cp arantenairc, la fievre r&currento, ^{s r} e s t ajoutge & l'ancien p o u p e de cinq maladics quarantenairos, et des i n f o m a t i o n s sur It incidence de la fihvre r 6 c u r r ~ n t e o n t comonc6 5 Btro m c u e i l l i e s ot difrZls6els dhs l e

d 6 h t de 11ann6e 1952,

) .

^P

En raison d ~ s st-antages decoulant de ltadoption psr t o u s l e a pays, d ~ n s leurs n o t i f i c a t i o n s &pid&miologiques

heZldomadaires, d

'

^une s e d n o convenue, commensant s m e d i B rninuit o t f i n i s s e x l t le samedi suivnnt k ~ i f i n u i t , e t f a c i l i -

tant a i n s f la coordination du syst&m de n o t i f i c a t i o n e t Z'&bablissemcnt d t 6 - tudes st n t i s tique s coxparzt i v o s

,

^{touts s}

3~ s administrations s m i t a i r e s des pays de laRg&on 0n-t accept&,

i

11 suite ^des ddmarches f a i t e s par LC x T e a u en

c o n f o m i t 6 d'une r4solutio~ du C 0 ~ t 6 G g i o n d , r h i er? s n tmisikme session, d t adopter la "sernaine &pid&miolo giquo"

dms l e u r s n o t i f i c a t i o n s . CODEPrn

Un nouvccu code &pid&niolo~ique [coDEPID) plus c o n p l o t ^que 1' m c i e n

code t616graph:que AA, e t bask sur un

A t present, a l l the countries in t h e region are boud by these Regulations.

In

accordance with the h g u l a t i o n s , a sixth quarantinable ^disease, i .e

,

^relaps-

ing fever, was added t o the f o r m e r group o f five quarantinable d i ~ e c s e s , jnd i n f or- mation o n t h e incidence of relapsing fever s t d e d being collected and disseminated e a r l y in 1952.

E ~ i d e m i o l o ~ c a l week

In view of _the advantages deriving from the adoption by dl countries, in their weekly egiderniological n o t i f i c a t i o n s , of

agreed week, beginning at Saturday midnigh end ending ^at next Saturday midnight, for kho c o o r d i l ~ a t i o n o f the.system o f notifi- c a t i o n and f w making comparative statisti-

c& studies, all h e a l t h administrations of

countries in t h e region accepted, f o l l o w f a s t o p s taken by t h e o f f l c c in accordance with a msol uti on of t h e Third l i e g i o n d C o d t t e e , t o adopt the "cpideniological weekn i n t h e i r n o t i f i c a t i o n s ,

CODEPID

h new e p i d e m i o l o g i c a l code (LX)DEPID), moro conprehensive than the f o r m e r

AA Cablo Codo, a d based on t h e five-

systhme de c h i f f r e

i

c i n q l e t t r e s , a letter synbol systwn, was put i n t o dte u s an vigueur vers ^la f i n do f o r c o by t h e end o f 1953. It is now

Itannee 1953, Il e s t actuellenent _used by all the countries in the utilise gar tous Les pws do le %gion, _region-.

I IES Q.UARAFJTFNAW OF Q&iFWlIlJABIE: D I S X U

w

DURANT' I&S-WNEES 19

9,

IN TH% REGION FCm THZ YEARS 19s

51. 1 9 5 5 ET LA _{5dm 1955} AM] ^?

A?EMIFXE mITE DE 1955

PESTE PL AGm

Les d e r n i a r s caa do p s t c sumenus The last cases o f plappc! which occurrod d:ns des pays de la G g i o n f u r e n t in countries in t h e region wore n o t i f i e d n o t if 26s n u dates suivante s ^: on tho f o l l o w i n g d a t e s :

EGYPTE ALEXIlrdDBE EGYPT ALEXANDRIA

AOUT 194.7 AUGUST 1947 IRAK P ~ V I N C E (LIWA) D ' A I ~ A 1945

IRAQ &MIA PEDVINCE (LDJA) 1945

SYRIE SYRIA

PALESTINE IIAIFA e t (and) J r n A

Cepondant, au cours d~ la pgriode sous However, during the period under review, oxnman, la p e s t o f'ut s i g n d Q c dms d e w plague was reportod fmm two countries i~

pays dc ,la R6gion: t h e r e g i o n :

(1) En milt 1951: 351 cns de p e ~ t e (I) In _August 1951: 151 cases. of.bhbonfc.

bubontque ~t ,l cas de pestt: pulmonaire plague and 1 case o f p n ~ m n i c plague Furont s i q d 6 s EII villago de XHAWL&', were reported in KHAWLAK vill.age, RAZEH

k -1 a t RENI B M , au ^and BEN1 DAIIR, in YEMENm

(2) Dos recherche3 f c i t e s en 1952 (2) IritiesSigations nade in 1952 shonod

&v&l&rent lo prdsence druno infection ^the proscnco o f plague i n f e c t i o n in ~ i l d p e s b s s chez l e s .mngsurs salvages dans ^l-odents in Kurdistan Province in _IRAN, la province h Kwdistan, cn TO cases and 22 deaths worn reported f r o m La survcnance de

9

cas et 22 d6cbs fit Sanapdadj-Marwan. Nevertheluss, the no t i f i k e do Sanandad j-%wm. N h m o i n s ,

l a maladie f i t son a u p a r i t i o n dsns c e r t a i n s t e r r i t o i r e s a f r i c a i n s , lid- trophes d e pays de l a R6gion ou

directement r e l i B s B ccs ^pays:

CXINCE BELm KENIA OUGANDA BET,GIAN KiMaJ KENYA

-

U ~ A

moitie de

1956 C 11 6 ⁰

first

Depuis 1948, l e seul pays de l a G g i o n ob 18 cholera a i t 8 t 6 signal6 a 6 t 6 l e P ~ l c i s tan.

Par a i l l e u r s , au cours de l a pQriode sous examen, l ' i n f e c t i o n e s t demeude confine'e au Bengale o r i e n t a l , 2umn cas n'ayant 6 t 6 rapport&, depuis septenbre 1949, ^d'une a u t r e pmvince du Pakistan.

Le t o t & l e p l u s &lev& de cas de chol6ra a kt6 enregistre' en 1948. Ltincidcnce

anni.e, e n t r e 1948 e t 1952. Aprhs une

disease appearad i n c e r t a i n African c o u n t r i e s which are e i t h e r adjacent to, o r i n d i r e c t communication with, countrie i n t h e region:

UNION DE L'AFRIQUE DU SUD TANGANYIKA UNION OF

sum

^AFRICA

0 W*

0 27

263 26

@ 13

5 n

4

99 3

10 9

2 3

0 13

0 5

0 8

0 3

0 0

CHILEM

Since 1948, t h e only country i n t h e region where cholera was ,reported was Pakistan.

k r e o v e r , cholera i n f e c t i o n has been confined, during t h e period under review, t o East Bengjl, no cholera cases having

&en reported s i n c e September 1949 from any of t h e o t h e r provinces o f Pakistan.

The highest t o t a l number o f cases was reported during 1948. ^The incidence of cholera decreased, y e a r a f t e r year, betweea 1948 and 1952. After a marked i n c r e a s e i n 1953, t h e r e has been a sharp dmp wain i n tho incidence i n 1954.

Bien quc l e s c h i f f r o s do lf3nn& 1955

e t du premier senestre de 1956 d e n t accus6 une l k g b r e aumentntion, il e s t

de toutc Qvidence que, dms 1' miserable, 1' incidents du c h o l d r n tecd graduelle-

ment

b

d6croftrc au Pakistan, FEWE JAUIIE

Aucun cas do fikvre j ~ u n a n f n dta' s i e d Q d'un dcs pays do la r k g i o n au cours dc fa p&.riodo sous examcn.

Toutefois, un p e t i t nonbre da cas o n t 6t6 n o t i f i g s , durant c c t t e n6r.1~ pGrfode, dc s e p t p q s faisant p a r t i c de la zone af r i c n i n a dv end6mici66 amrile, c o m e

il _{e s t} indiqug d,ms It: tableau ci-zprks:

Althougli t h e f i ~ w c s for 1955 and t h o P i r s t half o f 1956 showed a s l i g h t Pncreese, t b ~ r o i s convinckflg evidence that, on %ho wholo, t h e incidcncc of cholera is grzdualfy t a n d i n g t o

No yellow f o v c r ceses wore _reported f r o m any o f tho countries in the region during the p e r i o d under review. A,few cases of thc. d i s ~ s s e , howevcr, were n o t i f i e d f r o m seven countries i n t h e A f r i c a yellow f e v a r endemic zona, d u r i n g t h e sane

poriod, as shown in the Sollowing table :

-- - --

MQIE 0 CC D E 3 2 ALE

&!CAI% 0 0 1 1 1 1 2 2 0 0 0 0 0

EXCH \,EST AFPJCA

E

DE L'OR

-

^{13 5 2 5}

^{1 5 6}

^{6 1 0 0 0 3 3 0}

IeD mJST

CZRf A 1 1 1 3 8 4 2 8 1 8 8 3 2 2 2 0 0

GAM3A-UGUJD A O O 0 0 1 I 0 0 0 0 0 0 0 0

--

^{..- -__I I-..--}

-

^-.-

'Em

^{rnBE 1 0 0 0 0 0 2 0 4} 2 2 ( 0 ) 0 0 ⁰

d o n t 1 susp.inp,

-

^{incl. 1} susp. imp*

VARIOLE S Y ~ L ~ X

Des cas i q o r t 6 s do v a r i o l e sont h p o r t o d cases of smellpox a r e froquen fr8querxient s i g n a l e s dl~& ce q u i reported from Aden, owing t o

-

i t s geograp s'explique par l a ' s i t u a t i o n gkographique c d 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 rou de ce port, placi. s u r l e s routes du Since t h e opidernic outbreak which occurrq conmerce i n t e r n a t i o n d . Depuj l a pouss&in Aden P r o t e c t o r a t e i n 1949, t h e diseasa 6pid6nique surtrenue a a n s l e P m t e c t o r s t appeared again i n epidemic form i n 195L d'lldan en 1949, l a maladie ne s ' e s t only, when 67 c a s e s were recorded.

manifest6e de nouveau sous forne Qpid6- mique *'en 1954, annee durant l a q u e l l e 67 cas f u r e n t cnregistr6s.

Au cours de ces sopt dernieres annkes, During t h e l a s t s e v e n y e a r s , a n o u t b r e d une pouss6e de vario'le a eu l i e u en of smallpox occurred i n Saudi Arabia i n

k a b i e Saoudite. Com~nce'e on 1949, e l l e 1949 and l a s t e d u n t i l April ,1950.

s ' e s t m i n t e n u e jusquZen a v r i l 1950.

line nouvelle manifestation de l a mda- ^The d i s e a s e broke out again i n 1953, as d i e a &ti. constat& en. 1953, 'a p a r t i r de from February, with a total number o f 164 f6vr5er, avec un t o t d de 164 cas e t cases and 45 d e a t h s . On t h e o t h e r hand, 45 d&c&s. Par contrs, 7 cas soulement 7 cases only were recorded i n 1 9 5 4 ~ and ont i t 6 e n r e g i s t r g s en 1954) c t 1 cas 1 case a d 1 death i n 1955.

e t 1 dkces en 1955.

Depuis 1' +?6.6mLe 4e v a r i o l e survenue Since the epidemic of s d l p o x which eb ~~t~ en 1943 et ^{qui a} dur& jusqu'en occurred i n &YQ& i n 1943 3nd wKiC'n l a s t e d 19&, la,

mdazic

^{n * y a plus 6t;d} s i g n d e e unt51 1946, t h e d i s e a s e was only reported que sous f o m de cas import&. En a s imported, By v i r t u e of Egypt's

e f f e t , de pnr l a s i t u a t i o n geographique geographicd p o s i t i o n on i n t e r n a t i o n a l .de ce pays s u r l e s routos du connerce t r a d e routes, importation of snallpox-not-

i n t e r n a t i o n a l , l e s cas iq10FtQs de unfrequently occurs i n t h a t country.

v a r i o l & n l y sont pas rares.

est absolument manifeste que 11 inti- There i s convincing evidence t h a t t h e dence de la variola augmente dt en incidonce o f smallpox i s i n c r e a s i n g Year

mn6e en E t h i o a . a f t e r year i n Ethiouio.

Depuis l a pousa6e d e v a r i o l e qui a eu l i e u en 1948 e t en 1949 on

&&,

l ' i n - cidence de l a maladie. e s t retoikGe 22 un niveau rolativement bas, notxn:icnt au

cours des deux dernikres ann6es.

La v a r i o l e , en

h,

se n a i n t i e n t , depuis p l u s i e u r s ann6es, 'a un niveau d'incidence p l u t 6 t 81ev6. Une augmen- t a t i o n narqu6e d c c e t t e inicidenoe e s t rEv8lQe p a r i e s relev6s aff&ents.B 11.ann8e 1955 e t au premier semestre de 1956.

Bien *'en g8n6ral.L'incidence do l a v a r i o l e m P P a i s t a s o i t 6lev6e, une conparaison e n t r e . l e s c h i f f r e s a f f k r e n t s aux ann8es 1951, 1952, 1953 e t 1954

r6vkle n e t t s w n t une r6gression marqu8.e e t continue de l a maladie. Les relev8s de 11ann6e 1955 e t du l o r semestre de 1956 nlindiquent.auoun changemnt d a s cetke tendance..

Bu cours de l a pc'riode soun exmen, une 6pidBmie de v a r i o l e a 6 c l n t 6 en Somdie britanniaue, en 1953 e t 1954. Depuis l e mois, d'octobre 1954 i4..:nty a plus 6t6 sign&& de cas de c e t t s rialadie.

Pg&s p l u s i e u r s ann6es d'absence a z v a r i o l e s ' e s t m n i f e s t 6 e sous une

forne 6pid6nique en bdis (adninistra- tion f i d u c i a i r e i t a l i e n n e ) en f 6 v r i e r 1954. Les c h i f f r e s a f f 6 r e n t s 22 ltann6e 1955 e t ~u l e r semestre cie 1956 montrent que 11kpid6nie a p r i s fin.

Since t h e outbreak of s d l p o x which broke out i n 1948 and 1949 i n

Iraq,

t h e incidence of t h e disense returned t o a r e l a t i v e l y low l e v e l , e s p e c i ~ l l y during tine l a s t two years.

S d l p o x has, f o r rmny years, mamntained a r e l a t i v e l y high l e v e l of incidence in

Iran.

^A marked increase i n incidence i s noticed from the r e p o r t s f o r 1955 and the f i r s t h a l f of 1956.

Although, i n general, t h e incidence of s ~ d l p o x i n Pakistan i s high, ^a continuous marked decrease i s c l e s r l y shown by compar- ing the f i g u r e s f o r the years 1951, 1952, 1953 and 1954. lhe returns f o r 1955 and the f i r s t h a l f of 1956 show no change i n t h i s trend.

During the period under review, an epidemic of smallpox broke out i n B r i t i s h Somdiland i n 1953 and 1954. NO cases of snallpox have been reportod since

October 1954.

A f t e r many years of absence, %ldlpox broke out i n an epidenic form i n Somalia

( I t a l i a n Trust ~ d n i n i s t r a t i o n ) i n F e b r u w 1954. The f i g u r e s f o r 1955 and the f i r s t half of 1956 show t h a t the epidemic i s teminated.

Des kpiddmies de v a r i o l a sont signn- Smallpox epidemics a r e reported every l Q e s , de temps B a u t r e , au

m.

now and then from t h e

w.

^{The last}

La dernihre a 6 c l a t Q en 1952, s e v i s s a n t epidemic broke o u t i n 1952, mainly i n n o t d n t dans l a province du Darfour. Darfur Province. Tne incidence of the L'incidence de l a maladie e s t demeuree disease has r e m i n e d h i & during t h e l a &

Qlevke au cours de ces quatre dernihres four years.

annkes.

TYPHUS EPIDENIQ-UE ET ~IbiWRE RECUIIEITE EPIDEMIC TYPHUS AND RELAPSING EXER Seuls, l e t m h u s k DOW: e t l a Only Louse-borne t ~ h u s anci &ouse-b=

r6currente b DOU sont considkrks c o r n p l a ~ s i n e f e w a r e considered a s q d a r m k maladies quarantenaires susceptibles de nable d i s e e s e s a g a i n s t which i n t e r n a t i o n a l faire l ' o b j e t , sur l e plan i n t e r n a t i o n a l , preventive mecsurcs, m a ~ r be t,&en according de mesures pr&ventivos, aux tcm!cs t o t h e I n t e r n a t i o n a l S a n i t a r y Regulations.

du Gglement s a n i t a i r e i n t e r n a t i o ~ a l .

I1 y a tcujours un c e r t a i n nombre de There i s s t i l l a certain numher of pays de l&%gion q u i ne s p d c i f i e n t c o u n t r i e s i n t h i s Region which do n o t pas l e type de tyohus ou de f i e v r e re- specify t h e type of typhus and relapsing

currente rzpportks dens l e u r s relevks f e v e r i n t h e i r epidemiological r e t u r n s . Qpidkmiologiques.

La consequence en c s t que des m esures h a r m t i n o measures, roba ably unjustified q u a r w t e n a i r e s , probablement i n j u s t i f i 6 e s F e conseqilently taken a g a i n s t a r r i v a l s sont p r i s e s & l'Qgard de l e u r s pi-uvennn- from such c o u n t r i e s by others.

ces p a r d'autrcs pays.

11 importe, des l o r s , que l e s p ~ s , It i s e s s e n t i a l , t h e r e f o r e , t h a t en s i g n a l a n t des cas de typhus Ou de countries

soesifv

t h e type .of typhus o r fihvre r 6 w r e n t e , s p 6 c i f i e n t l e type relapsing f e v e r on .reporting t h e s e

de la maladie, d i n d ' & i t e r l ' 9 o s i - dise?.ses, i n order t o avoid measuras being t i o n de telles nesures B l c u r s provenax- taken a g a i n s t a r r i v a l s - from t h e i r

ces. t e r r i t o r i e s .

TYPHllS TYPIWS

Le typhus e9id6mique (h a $ti$ E p i d e ~ i c (louse-borne) typhus was report- signal.6, au cours de l a periode sous ed, during t h e period under review, from

examen, dl-, dl-, de

m,

^{du E d ,}

w, ^h,

^{Pakistan, and}

Pakistan, de e t de !I'umuie. Il

w.

The f i g u r e s recorded showed t h a t r 6 s u l t e des c h i f f r e s indiques que l a the disease a p p a r e d generally i n bhese maladie s e m a i n f s s t a i t gdn6rjlement countries i n the u s u a l sporadic form.

dans ces pays sous l a forme sporadique Nevertheless, no cases of epidemic typhus h a b i t u e l l e . Toutefois, il n ' a 6% noti- irere reported from &&&&& o r &,r& during f i e aucun c a s de typhus 6pid6mique du 1955.

Pakist- n i de && au cours de l t a n n 6 e

1955.

n

a &€dement Q t 6 conste.t& un d e c l i n It i s a l s o noted t h a t t h e r e has been a dans l ' i n c i d e n c e de l a maladie en

h,

declinc i n the incidence of t h e disease i n au Pakistan, en $grie e t en Turauie,

EU cours des t m i s d e r n i b e s annees.

En E t h i o r r i ~ , apri.s une hausse nota- ble de l ' i n c i d e n c e du Lyphus en 1952, l e s

c h i f f r e s a f f e r e n t s aux ann6es suivantes e t comprenant t a n t l e typhy~s Qpid6mique ('a p o w ) que .le typhus m r i n

( B

puces) revklent une Qlhvation continue e t gra- duelLe du niveau d' incidence, d' mn8e

h,

Pal;istan, and during t h e

l a s t three years.

In Ethiopia, a f t e r the marked increase i n the incidence Of typhus fevnr i n 1952, t h e f i g u r e s xecorded i n t h e following years, which comprise both the epidemic (louse- borne) and murine (flea-borne) types, show gradual and continuous increase, year X t e r year.

en ann6e.

Les c h i f f r e s concernant l e typhus The f i g u r e s of (endemic) typhus reported (end8mique) n o t i f i e s d 9 I s r a e l continuent from I s r a e l a r e s t i l l r e l a t i v e l y high.

k 8 t r e relativement 6leves. I1 e s t ibwever, i t seems evident t h a t t h e r e has cependant Bvident que, durnnt ces t r o i s been a continuous decline i n - t h e incidence dernihres ann8es, il y a eu un d6clin of t h e disease during the p a s t i h r e e years.

continu du taux d'incidence de l a maladie.

FIFJRF, B3CURn;SNTE RELAPSING FEVER

Dans le Gglement sanitaire interna- Louse-homa relapsing fever has been add8 t i o n a l , l a fihvre rkcurrente

il.

noux s in the International S a n i t a r y Regulations, 6tG ajoutge aux autres cinq d a d i e s t o t h e other f i v ~ quarantinable diseases quarantenaims i faisaient pr8c6dement previously t h e subject _{o f} I n t e r n a t i o n a l l'objet des Conventions sanitalres i n t e r - Sanitary Convantions.

natf onales-

I1 e s t nianmoins constat8 que les It is noted, however, t h a t t h e figures for donnees foumies par tous l e s pays de r e l a p s i n g fovor recorded fmm ^-11 the coun- la %gion sur la flevre r6currante

-

^{tries i n t h e region, except}

^CirbfLlS, m,

exception f a i t e pour C h ~ ~ r c , Israel, &&Q ,and So,nnlia (under I t a l i a n u n i s - la e t la S o d i e (sous adminis- tration are n o t i f i e d without

snocifioatlaa

tration i t d i e n n e l - s o n - t n o t i f i G e s sans of t h e type o f r e l a p s i n g f o v e r *

0 . .

du type de fihvro &cur- rente.

Par contre, les relev& &manant de On thc other hand, m t w s f m m b m , g

-,

^d'

^&a,

^{de jordmie} ( & p i s

.I&&,

Jordan (since 4 October 1954) ^and le 4 octobre 1954) e t de Somalie (under Italian ~dministration) in- administration i t d i e n n e ) s p d c i f i e n t que d i c a t e the tY?e of relapsing f ~ o r as

tick-

l a f i h e rgcurrente o s t du typc ^-3.

..-

h E E *

Au cours de la periods sous exmen, During _{t h e} period wldor review, few spo- quelques cas sporadiques de f i k v r e r a d i c cases of r e l a p s i n g fever ^recorded rente o n t Qt.4 n o t i f i d s d'Er~thr&~, d ' w , f m m h i t r e a p

h,

^{- 9}

Bri.tish

d ' h , de

m,

^{de -1 i e} w i a q g ,

~~~~

&&Q and ^-+

du et d e

&&,

N&-ins, fl c s t m i f e s t e m ~ n t &Ldcnt Nevertholoss, t h e - is convincing ovidsnGe

ququn dgclin continu e t sensible de 1' in- _{t h a t} t h e r o is a ~ k e d continuous decline

oidence de la fi&vro r6currcntn ( h ^tiques)in m l a p s i n g fever (tick-homo) in

h&&

s'est produit en

%w

^{(sous adminis- (under} I t a l i a n i i d n i n i s t r a t i o n ) d u r i n g the t r a k i o n i t a l i o n n e ) au cours do css t r o i s ^{p a s t t h r m} Yenrs*

On constatc 6.galernent q t ~ l il n t a 6 t 6 It i s d s o n o t e d t h a t no cases of relaps- signal6 ^{aunrn cas} de fiEvre r 6 c u r r e n t c i n g fcver (kick-borne) have b e n reported

( A tiques),dc m , c n 1 9 5 4 , 1955 e t f r o m - during1954, 1955 and t h c Xa p r d 8 m r n o i t i E dc 1956. first h a l f o f 1956.

e t

m,

^{au cours} do l a p 6 r i o d o sous d u r i ~ g the pcrj-od undor review shor~ no

examen, n e r6vklen.t ^{auci i.2} chaagement evidozlce of any cllmge in ;;l?r: u s u a l inciclcncc d z l s Itincid-.nce habikdellc dt: la of r e l a p s i n g Pcvfir (ticlc-borne ).

fiBvrc r 6 c u r r ~ n t 2 ( B t i q u c s ) *

II samble qut an E m , il n t y a It seems that there i s no change i~ t i e -

eu aucun changomn t dans I' incidence zcarly incidcncc o f r e l a p s i n g fever i n mnuelle de la f i b r e r6currcn t?,

u,

^{which has alwap bcon} r e l a t i v a l y l a q u e l l o s' sst tou jours inaintenuc 5 h i g h dnring the p n s t s o w n years.

an niveau relativemcst haut au cours de ccs s c p t d e m i h r e s mndos.

E ~ R C G / ~ O page 13

CO$lNjES X3CAPITLUTIVES ^(x) CONCZFXANT L

'

IiU'CIDEiiCZ DEs _MAI.ADI:S QUARANTENAI32S EN 1950, 1951, 1952,

1953, 1954, 1955 ET DL?.UIT LT l a r S D Z S T R E DE 1956

CUMULATIVE DATA (x) O i i TE I!!CIDZIEE OF QUARMJTI:!ABLZ DISEASES I N 1 9 P , 1 9 51, 1952,

1953, 1954, 1955 AND THE F I R S T H4LF OF 1956

(x) Sauf indicatio.? contra.ire, l c s c h i f f r e s c i t k s p o r t e n t s u r unc p&riodo de quatre senaines.

Four-weelfly Cigurcs, unless otherwise specified.

PAYS PAKISTAN

COUNTHIES T r n L

-

GNI4EFS 1955 1956

~~

^{C D}

.

^G

^D

. .

-

_J ^VII _VIII ³⁸⁰ ₁₅₄

. . .

^{203 92}

^{. .}

T!n'LL 1952 TOTLL

1951 TOTIIL 1950 TOTiiL

1949 TrnbL 1948

a

-

c h i f f r e s

p m v % s ~

Provisional figures.

E&!/Rc~/~o page 16

PAYS

.

4FJiBIE SEOUDITE

COUNTRIES ADEN SNDI ARABLA

AbNEES 1955

.

¹⁹⁵⁶

.

^{1955 1956}

YEARS C. D.

.

^{C. D.}

.

^{C . D.}

. . .

^{6, D.}

J I

o

0 . 0 0 . 0 0 . n

o

F I1 0 0 . 0 0 .

.

0 0 .

. .

0 0

x

I11 0 0 . 0 0 . 0 0 . 0 0

. . .

A I V 0 0 . 0 0 . 0 0 . 0 0

M V 0 0 . 0 0 . 1 1 .

.

0 0

J V I 0 0 .

.

0 0 . 0 0 .

.

-

^{V I I 0 0 .}

.

^{0 0 .}

.

J V I I I 0 0 . 0 9 -

.

A Ix 0 0 . 0

0 .

S X 0 0 , 0 0 .

0 X I 0 0 0

Q . .

N X I 1 0 0 . 0 0 .

D X I 1 1 0 0 . 0 0 .

TOTAL 0 0 . 1 1 .

.

1955

.

*

m m

0 0 .

1952

. .

TOTAL 2a 0 .

1951

. .

TOTAL 4a 0 .

1950

.

a

-

^Cas i m p o r t k s i m p o r t e d c a s e s

E@ 6/10 page 17

VARIOLE

-

^SMALLWX

(suite) (contd)

- ^--

PAYS EGYPTE

.

^ETHIOPIE

COUNTRIES EGYPT

.

^ETHIOPIA

. .

A I V 0 0 .

_.

0 0

.

^{22 0}

.

^{22 2}

M V 0 0 .

.

0 0

. .

^{13 0}

.

^{38 0}

J V I 0 0

. _.

^{l a 0 .}

_.

^{5 0}

.

^{65 5}

-

^{V I I 0 0 . 7 0 .}

.

J V I I I 0 0 .

.

^{11 0 .}

A I X 0 0 .

.

^{20 0 .}

S X 0 0 .

_. . .

^{50 0 .}

.

0 X I 0 0 . 3 1 1 .

. . .

N X I I O 0 , 48 0 .

. . .

D X I 1 1 0 0 .

_. . .

^{23 0 .}

.

. .

TO TaL 0 0 .

,

283 2 .

1955

. _{. .} .

TOTAL 0 0 ^{a •} 368 2 .

1954 •

TOTAL 0 0 ,

.

^{188 1}

.

^.

1953

_. . . .

^t

TOTAL 0 0 .

.

⁸⁰

^-

1952

. _. .

TOTAL 2 0 ⁴

.

⁴⁴

^- .

1951

.

TOTAL 9 0

.

⁶²

^-

1950

. . .

a

-

^Cas i m p o r t s imported case

EIvT/~c6/10 page 18

VUIOLE

-

^SMALLPOX

( s u i t e ) (contd)

--

PAYS IMK

COUNTRIES IRAQ (m) IUN

F I1 2a 0 . 0 2

. . .

^{63 9}

.

^{211 7}

M I11 1 0 .

.

2 0

. .

^{29 0}

. ^*

^{78 7}

A I V 3 0 . 0 0

. .

^{1 4 0}

. ^.

^{30 0}

M _J V _{V I} 9 0 2 0

.

^{28 1}

. .

^{373 56}

3 0 .

_.

5 1

.

, 73 2

. .

^{104 7}

-

^VII

. .

^{23 2 .}

.

J V I I I 0 0 .

. .

^{43 1 .}

A M 0 0 .

. .

^{53 2 .}

S X 0 0 .

. .

^{88 18}

. .

0 X I 32 4 .

_. .

^{31 7}

.

^.

N X I 1 1 1 . 51 5 .

. .

^-a

D X I 1 1 12 0

'. . . ^.

^{23 0 .}

.

-rl."---.r

.

^I

--

^---La-

.

TOTAL 72 5 .

.

^{540 48}

.

1955

.

TOTAL 1954

TOTAL 1952 TOTAL 1951 TOTAL 1950

a

-

^Cas i m p o r t & b

-

^{50 semaines}

imported c a s e s 50 weeks

(m)

-

c h i f f r e s mensuels x

-

c h i f f r e s p r o v i s o i r e s monthly f i g u r e s p r o v i s i o n a l f i g u r e s

~ R

5/10

C page 1 9

VARIOLE

-

^SMALLPOX

( s u i t e ) ( c o n t d )

P,"IYS

.

:OX&IE ( ~ r i t ) A

COmTilIES PAKISTAN

.

;O~%LIL~I:ID ( ~ r i t )

-

^{V I I 294 127}

. .

^,

. .

J V I I I 197 85 ^• 0 0 .

. .

A IX _{150 87}

. .

⁰

.

^{0 .}

.

S X 135 50 0 0 ,

. .

0 X I 1 0 1 50 ^• 0 0 .

. . .

N X I 1 91 52

. .

⁰

.

^{0 .}

.

D X I 1 1 243 109

. .

⁰

.

^{0 .}

TOTAL 3256 1230 , 0 0 .

1955

.

^a

. .

TOTAL 2509 698

. .

^{630 0 .}

1954

. . .

TOTAL 5063 1426 ^•

,

248 0 ,

1953

. . . .

TOTAL 14589 4420

.

^{0 0 .}

1952

. .

I

. .

TOT,% _{43620 15411} h 0 0 .

1951

.

•

. ^.

TOTAL 22478 7588

.

^{0 0 .}

1950

. . . . . ^.

A V a r i o l a minor ou Alastrirn V a r i o l a minor o r A l a s t r i m

E?#Rc 6/10 page 20

VARIOLE

-

^SbRLLPOX

( s u i t e ) ( c o n t d )

PAYS SOMALIE ( a h . I t a l S A

.

^SOUDAN

COUNTRIES SOMALIA ( 1 t a l . a d d (m) SUDHB

ANNEES 1955

,

1956 1955

.

¹⁹⁵⁶

W B S C. • C.

.

^{C* D.}

.

^{C. D.}

-

^{V I I}

J V I I I 0

.

TOTAL 737

. -

TOTAL 0

.

^{3545 529}

.

1953

. . .

TOTAL 0 •

.

^{1260 185}

.

1952

. ^.

0 TOTAL

1 9 5 1

TOTAL 0 ⁼

.

1950

(fl)

c h i f f r e s m e n - l e i s

.

monthly f i g u r e s

A

-

V a r i o l a minor ou A l a s t r i m v a r i o l a minor o r A l a s t r i m B

-

V a r i o l a major e t v a r i o l a minor

v a r i o l a major and v a r i o l a minor

E ~ $ / R c ~ / ~ o page 21

VARIOLE

-

^SWLLPOX

(suite) (contd)

PAYS SYRIE

COUNTRIES SYRIA

J I F I1

hf I11 A

Iv

M

v

J VI

-

^VU.

J

VIII

A

M

S

x

0

xx

N XI1 D XI11

TOTAL 0

. . .

1955

. _{. .}

TOTAL 7

. .

1954

_. .

TOTAL 3

. .

1953

. .

^•

.

TOTAL 2

. .

1952

. .

TOTAL 2

.

^•

1 9 5 1

. . .

^•

TOTAL 1 4

. .

1950

. .

TYPHUS EPIDFNIQUE ET AUTRES RICIC3T!CSIOSES EPIDD!IC TYPHUS AI\D OTHER iiICKFllTSIBL DISEASES

-

PAYS C I I Y E Z BGYPTZ

COUbTPPilIES CYP~US (m) T EGYPP

KDlEES 1955

.

^{1956 1955 1956}

-

^{V I I 2 1 .}

J V I I I 0

TOTAL 1955 TOTAL

19 54

TOTAL 1952 TOTAL 1951 TOTAL

19 50

(m) c h i f f r e s mensueis mont.11~ figures ( t )

B

t i q u e s

tick-borne

TYPHUS EPIDEMIQUE ET AUT.IES RICidTSIOSES ( s u i t e ) EPIDEMIC TYPHUS ANE OTm3 AICKEXTSIkL DISEbSES (contd)

PAYS

-

E R Y T W ETRIDPIE

COWTRIES

- ^ERITREA

^{(m) N ETHIOPIA- X}

ARA'EES 1955 1956 1955 19 56

YEARS

--

^{C L D C L D C D C D}

-

^{V I I}

J V I I I A I X S X 0 X I

TOTAL L

.

^{2867 25}

1955

TOTAL L

.

^{273-4 53}

. .

19 54

TOTAL 8 0 - 2407 41

.

1953

TOThL 7 0 .

.

2075 5 1

.

1952

TOTILL 34 0 . U83 17

1951

T0Tl.L 3 5 0 -

. ^114.4

⁸⁴

1950

.

(m) c h i f f r e s mensuels mont.~ly f i g u r e s

N typhus, forme non s n e c i f i e e typhus, type not s p s c i f i e d X y compris typhus murrn

including nurine ty&u.S

L c h i f f r e s f i e r a n t sons l l E t h i o p i e f i g u r e s recorded under Ethiopia

ENJRcG/~o

page 24

TYPHUS E?IDBv:IQUE ID.kZPTRES 3ICKETTSIOSES ( s u i t e ) EPIDBIIC T m U S l&D OTHER 2ICXflTSIAL DISUSES (contd)

PAYS IRAK P & N

COUNTRIES IRkp (m) E

-

BNNEES 1955 19 56 1955 1956

A

rv

1 0 . 3 0 2 0 . 1

1

v

^{1 0 . 3}

. . .

^{34 0 . 0}

J V I 1 0 .

.

^{10 0 .}

-

^{V I I 0 0 .}

J V I I I 2 0 .

. . .

^{10 0 .}

k IX 1 0 . 0 0 .

S X 0 0 .

.

^{1 0 .}

TOTAL 19 54

TOTAL 94 1 .

1951

(m) c h i f f r e s mensuels monthly f i g u r e s

E t y p s end6mique

h

p c e s ou typhus murin flea-borne endemic typhus o r murine ty&us X c h i f f r e s c r o v i s o i r e s

provisional f i g u r e s

TYPHUS EPIDEMIQUE

EP AUTRES

RICXFPTSrOSFS ( s u i t e ) EPIDEMIC TYRXJS AND OTHER RICKFPTSIkL D I S U a (contd)

-

^VII

J VIII

26

0 . 0 0 .

--

T r n U 397 0 . 0 0 .

l?55

TOTAL 3 53 0 . 0 0 .

19 54

E

typhus endgmique b puces ou typhus murin flea-borne typhus or murine typhus

(m) c h i f f r e s mensuels monthly f i g u r e s

N typhus forme nun s g c i f i d s typhus fever type not s p e c i f i e d

EMJRCG/IO

page 26

TWUS EPIDEMIQUE ET hUTRE3 RICKETTSIOSES ( s u i t e ) EPIDBKCC TYPHUS LiD O T m i i I G T C T S I & DlSEkSES (contd)

PB-S LIBYE

.

COUNTRIE3 LIBYA PAKISTAN

kNmEs 1955(ra)

.

^{19 56}

^-

^{1955 19 56}

YEW _C

D

^{C D, C D C D}

-

^{V I I 0 0 .}

J vIII 0 0 . 0 0 .

-

TOTAL 3 ^{1 0 .} 0 0 .

1955

T O T U 75

3 .

1

195L

TOTAL 260

1952

.

a dont 4 c a s suspects

of which 4 suspected cases (m) c h i f f r e s mensuels

monthly f i g u r e s

TYPHUS E?IDDlI(;UE AT hklPIRZi5 BICKETTSIOSES ( suite) EPIDEMlC TYPHUS hRD GTRE.1 L ~ I C K E T T S I ~ L D I S U S E S (contd)

PAYS

-

REPUGIES DE F ~ L ~ E S T I ~ SYTiIE

-

^{V I I}

J V I I I

E typhus endemique

B

p e e s ou typhus murin flea-borne e n d m i c typhus o r murine typhus

E%f/~c6/10 page 28

TYPHUS EPIQEMXQUE

ET-

AVTRES ilICI(EPTS1OSES (suite) EPIDEXIC TYPEUS AND OTH& FUEKETTSIkL DISEASES (contd)

J V I 1 0 .

-

^{V I I}

. .

J V I I I 1 _{0 .}

A M 1 0 .

.

TOTAL 194 8 .

1951

TOTAL 225

1950

E @ c ~ / ~ o

page 29

F m RECURRENTE

RELAPSING FEVER X

PAYS

G'KYPm . . ^Ef!TW

^!m)

C O W R ~

m m r

(m)

-

^{ER'LTREB - .}

AmEFS 19.55

.

¹⁹⁵⁶

. ¹⁹⁵⁹

¹⁹⁵⁶

Y E A X

c. -

^{C. e GI}

, c.

L ^c

I 0

I1 0

I11 0

Iv 0

v

0 V I 0 V I I VIII 0

M

0

X 0

X I 0 X I 1 0 X I 1 1 0

TOTAL

1955 0

TOTAL

1954 TOTAL

1953

3

TOTAL

. .

1952 b$

.

TOTAL

L

-

c h i f f r e s f i g u r a n t sor8 LtEfhiopie f i g u r e s recorded under Ethiopia

(m)- o h i f f r e s mensuels monthly f i g u r e s

X s& i n d i c a t i o n contraire, l e s c h i f f r e s concernent l a f i b r e rbcurrente non-sp8aif l4d

Unless otherwise indicated f i g u r e s r e f e r t o non-specified r e l a p s i n g fever.

E ~ R C ~ / ~ O page 30

FIEVRE RECURRENTE (su5.IB)

RELAPSING

FEVER

(contd)

PAYS ETHIOPIE

. ^{IRAQ m.}

^(m)

COUhTRE3 ETHIOPIA

BNNEES 1955

'

1956 1955 ^• 1956

YEARS CI D G.

D.

Cw D C. Do

J VIII a7 0

.

. . .

TOTAL

. . .

1955 1050 8 ^rn

.

1

^.

0 .

^.

TOTAL

.

1954

53@ 36

.

TOTAL

.

1955 73 20 40

TOTAL

* .

1951 2a8

9 .

TOTAL

.

1950 2860 12

.

F3

PrGsence des d e w vecteurs both vectors present.

(m) c h i f f r e s mensuels monthly figures.

FIEVRE RECURRENTE (suite) R E M I S I N G F E E R (contd)

PAYS

CDUNTRIES ISRAEL -(a) T

. .

F 11 4 ^' 0 0 2

. .

^I

I I I I 0 0

_. '. _.

^{3 3}

_.

A IV 0 I 0 1 2

. . .

4 V 3 * 0 * 1 3

. . .

J V I 1 1 3 ^• 24

-

^{V I I 2}

. . . .

J V I I I 2

.* .

¹

.

L

. .

A IX 1 ^L

.

^{5 a}

.

S X 0

. . .

⁵

. ^.

0 X I 2

. _. .

^{7 ..}

.

N X I 1 0

. _.

⁷

. .

D X I 1 1 0

.

⁴

. . .

. .. .

TOTAL 1 5

.

³⁸

1955

_. . _.

^s

_.

TOTAL 1 8

.

²⁵

^.

1954 • a b

*

.

TO TIIL ₂₂

.

^{50 •}

1953

. . .

TOTAL 47

. .

^{48 t}

1952

. . .

TOTAL 0

PT

-

pr6sence des deux,vecteurs both vectors present

(m)- Chiffres mensuels monthlv fieures