The English language daily Kathmandu Post said that the outbreak of the disease in Belapur village in Dadeldhura district, about 525-km west of the capital, created "lots of problems" for the villagers there and in adjoining villages, as over 400 people were reported sick with the disease.

Kathmandu Post reported that there were no health workers to staff the village health post in Belapur village, and even the district hospital at the district headquarters in Dadeldhura was without a doctor.

According to the newspaper, those who died showed "strange symptoms" that included headaches and respiratory problems.

Quoting local people, the newspaper reported that the victims died "wherever they caught the deadly disease".

"Some died while working in the farms, while others fell dead while grazing cattle," the newspaper reported.

The newspaper quoted Shuvesh Raj Kayastha, chief of the Mahakali Zonal hospital in Mahendranagar, about 80-km south of Dadeldhura, as saying that the disease could be a viral infection.

He feared that the disease could be similar to severe acute respiratory syndrome (SARS).

--- IANS    How many dead ?? some died while working on farms , while others fell dead while grazing cattle " .

Apparently this kills pretty quickly, whatever it is, for the people to die in the fields.  I am probably misinformed, but I did not think that SARS killed that quickly. Anyone?

BY SANGEETA RIJAL

KATHMANDU, Oct 10 - India is one of many Asia-Pacific countries that have been identified by the World Health Organization (WHO) as at risk from dengue and health officials say that aircraft flying from India to Nepal may bring in the dengue virus. Dengue has killed significant numbers of people and affected hundreds recently. Apart from the open boarder, Nepal has airline flights coming in every day from several cities in India.

According to Dr. G. D. Thakur, chief of disease control at the Department of Health Services, entry by a single Ades Agepti (a type of mosquito that causes dengue epidemics) can breed thousands of others and airplane flights from India to Nepal every day pose the highest risk at present." He said that Indian airports are not mosquito-free. According him, Singapore Airport is the only airport in the region that is mosquito-free. Also, some samples tested at the National Public Health Laboratory for Japanese Encephalitis were sent to Bangkok out of suspicion of dengue last year. But despite all these risks, the government does not as yet have a dengue testing policy, although it has the required machinery.

"The government doesn't have a policy of testing for dengue and it will take about a year more to set up the lab even though it has started working with the WHO in this regard," a source at the National Public Health Laboratory said. However, Dr. Thakur claimed a lab could be set up within a few weeks. "We will start phasewise meetings with WHO from Tuesday in this regard as it has assured us of providing kits for the testing of about 200 samples," he said. Thakur said that dengue is also known as an urban and semi-urban disease which breeds in stagnant but clean water and comes under the Japanese Encephalitis group. Ades Albo Pictus, brother of Ades Agepti according to Dr. Thakur, has been found in Dhangadi, Kailali, Nawalparasi, Chitwan, and a few places in Lalitpur district, but he said that it is not dangerous like Ades.

He also said that since there is no vaccine for dengue the first and foremost thing that government needs to do is to focus on disease management, which it is doing. "We have an integrated vector management program, which means mosquito control," he said. He also said that the Ades Agepti is a daytime biter and does not transfer from human to human. The country has a machine for dengue testing at the Vector Born Disease Research and Training Center in Hetauda although it has remained malfunctioning since the past three years, and at the National Public Health Laboratory there are no kits. According to Dr. Thakur, it costs one million rupees for the testing of 100 samples.

People's News/The Kathmandu Post

good one, hoosier mom!

Epidemic Hazard - Asia

Event summary
GLIDE Number	EH-20061031-8195-NPL
Event type	Epidemic Hazard	Date / time [UTC]	31/10/2006 - 06:25:16 (Military Time, UTC)
Country	Nepal	Area	-
County / State	-	City	Nepalgunj area
Cause of event	Unknow	Log date	31/10/2006 - 06:25:16 (Military Time, UTC)
Damage level	Heavy	Time left	-
Latitude:	N 28° 3.000	Longitude:	E 81° 37.020
Number of deaths:	20 persons	Number of injured persons:	Not or Not data
Evacuated:	-	Infected	300
-
DESCRIPTION
A mysterious disease has killed at least 20 people in two villages of west Nepal over the past 10 days, and hundreds more are sick, a health official said on Tuesday. "People suddenly catch high fever, start shivering, faint and then die," said Ram Bahadur Chand, a senior official the district public health office in Nepalgunj, 321 km (201 miles) west of the capital, Kathmandu. Local media reports put the death toll at 36 from four remote villages near Nepalgunj. "We have 20 confirmed deaths so far and more than 300 people are suffering from the unknown disease," said Chand. He said 200 blood samples had been collected and medical workers had reached the affected villages. Each year Nepal's rickety health infrastructure run by a mere 1300 doctors in 87 hospitals around the country deals with hundreds of thousands of cases of pneumonia, cholera, fever, diarrhoea and tuberculosis. Many of the poor Himalayan nation's 26 million people are either unable to afford the cost of medical treatment or do not have access to basic health care. < =text/> function kezel(box,link1,link2) { if (box.style.display=='none') { box.style.display=''; } else { box.style.display='none'; } link1.style.display='none'; link2.style.display=''; } function linkset(box,link) { box.style.display='none'; link.style.display='none'; }

Great outline Muriel, I have not had time to do this sortof thing, but I did keep thinking about previous months and reports from Nepal that were suspicious.  Thanks for listing them !

Here is what I found on Malaria doesn't mentions stomach aches and vomiting...

What are the symptoms of malaria?

Symptoms include fever, chills, sweats and headache, and in some instances may progress to jaundice, blood coagulation defects, shock, kidney or liver failure, central nervous system disorders and coma. Cycles of chills, fever and sweating occurring every one, two or three days is a good indicator of malaria in a person recently returning from a tropical area.

When and for how long is a person able to spread malaria?

Untreated or inadequately treated cases may be a source of mosquito infection for one to three years depending on the strain of Plasmodium. Direct person to person transmission does not occur. Stored blood products can remain infective for 16 days.