Dengue - 18 docs, 5 hospital staff infected

The biggest problem in India is something we all take for granted.

Home ›

Indian govt insists dengue outbreak no cause for panic Posted: 06 October 2006 0516 hrs     Photos 1 of 1 Activists stage a demonstration against dengue       NEW DELHI - India's health minister moved Thursday to ease widespread fears over an outbreak of deadly dengue fever, saying action was being taken and there was "no need for alarm". "The situation is being controlled. There is no need for alarm. There is no need to be panicked," Health Minister Anbumani Ramadoss told reporters after meeting with health ministers from four affected states. States will be provided with more insecticide, fogging machines and testing kits, the minister said. "We have moved to coordinate efforts. In the next few days to come we expect the cases to reduce," the minister added. Almost 40 people have died from the disease nationwide, including 15 in Delhi and seven in the southern state of Kerala, the minister said. The northern state of Uttar Pradesh has also reported seven deaths, local officials told AFP. But the minister refused to comment on the conditions of members of Prime Minister Manmohan Singh's family reported to be hit by the mosquito-borne virus. Singh's son-in-law and two grandsons were reported to be being treated in hospital for dengue fever symptoms. Television channels showed municipal fogging trucks spraying the prime minister's home on the suspicion that the three, who spend weekends at the official residence, were infected there, an Indian Express report said. The disease is transmitted to humans through the bites of infected Aedes mosquitoes and causes a severe, flu-like illness and internal bleeding. Some 2,900 infections have been reported across the country, almost a quarter of them in Delhi and its surrounding areas. Dengue infection rates in the capital have doubled over the last year, with the health ministry confirming 327 cases up to the end of September this year, compared to 160 for the same period last year. A dengue outbreak in Delhi claimed more than 400 lives in 1996 when 10,000 people fell sick. There is no specific treatment or vaccine against the illness but early detection can improve chances of survival. http://www.channelnewsasia.com/stories/afp_asiapacific/view/234155/1/.html

DENGUE/DHF UPDATE 2006 (34)
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[This is not a comprehensive collection of all dengue reports in the world
since the last update. To make updates more complete, ProMED-mail asks
readers to send reports of dengue outbreaks that they find to
<promed@promedmail.org>.]

[1] Fiji
[2] India - Delhi
[3] Taiwan
[4] Taiwan ex Vietnam
[5] Trinidad and Tobago

*******
[1] Fiji
Date: 28 Sep 2006
From: ProMED-mail <promed@promedmail.org>
Source: Fiji village [edited]
<http://www.fijivillage.com/artman/publish/article_33076.shtml>


The Health Ministry has issued a Dengue outbreak warning. According to
Ministry's records, 6 people were diagnosed with dengue fever this month
with most of the cases originating from Suva and Labasa.

However, the ministry is finding difficulties in determining whether these
are the actual figures as there may be other people who have yet to seek
medical attention.

The Senior Divisional Executives have been advised to issue directives to
all sub-divisional doctors to be vigilant in dengue surveillance, and
report promptly to the Ministry.

People are called on to clean their surroundings and bury all tins and
tyres that can be a breeding place for mosquitoes.

The last recorded outbreak of Dengue Fever in Fiji was in 1997-1998, when
24 000 people were affected and 13 people lost their lives.

--
ProMED-mail
<promed@promedmail.org>

[A map of Fiji can be accessed at:
<http://worldatlas.com/webimage/countrys/oceania/lgcolor/fjcolor.htm> - Mod.TY]

******
[2] India - Delhi
Date: 6 Oct 2006
From: ProMED-mail <promed@promedmail.org>
Source: The Peninsula on-line [edited]
<http://www.thepeninsulaqatar.com/Display_news.asp?section=World_News&subsection=India&month=October2006&file=World_News2006100683548.xml>


The mosquito-borne dengue disease continued to take its toll across India
yesterday with over 40 people reported dead and nearly 3000 suffering from
it even as the government maintained the situation did not merit epidemic
status.

Health Minister Anbumani Ramadoss said: ³The situation is not that of an
epidemic and we expect that the number of dengue cases will see a
decreasing trend in the next 2-3 days. So far we have recorded 2900 cases
of dengue from across the country. I would like to say that in spite of the
above numbers, the situation is under control. We are not complacent and
the situation is a matter of concern to the government,² he said.

He also briefed the cabinet meeting chaired by Prime Minister Manmohan
Singh, 3 of whose family members are feared to have been affected by
dengue, on the steps taken to contain the disease. ³There is absolutely no
need for panic,² Information and Broadcasting Minister P R Dasmunsi said
after the cabinet meeting here.

The worst affected by the dengue virus is the Capital where one more
patient died, taking the death toll to 17 even as over 50 fresh cases were
reported Thursday.

Acting on a petition, Delhi High Court yesterday sought explanations from
the Central and Delhi governments as well as the Municipal Corporation of
Delhi (MCD) on their failure to deal with the outbreak of dengue in the
Capital. Taking note of the dengue toll in Delhi, many states have sounded
an alert.

In Bihar, the total number of dengue cases rose to 12 yesterday with 5
cases reported from Bettiah and Saran districts. In Haryana and Punjab, the
number of suspected cases of dengue was on the rise even as health
authorities yesterday said that the situation was not alarming.

Veena Chug, Haryana¹s director of health services (malaria), said there
were 42 confirmed cases of dengue in the state, nearly half of them from
Faridabad district adjoining Delhi. She said that it was not confirmed that
a death in Faridabad was due to dengue. The government yesterday set up a
testing laboratory in Panchkula town adjoining the state capital
Chandigarh, as 6-7 suspected dengue cases were reported from Panchkula
district during the last 2 days. In Punjab, the number of suspected dengue
cases in various places was well over 150, with nearly 90 of them in
industrial hub Ludhiana itself. Punjab¹s Health and Family Welfare Director
Sukhdev Singh said that no deaths had been reported in the state due to dengue.

A dozen patients from Punjab and Haryana have so far come to hospitals in
Chandigarh for treatment.

--
ProMED-mail
<promed@promedmail.org>

[The dengue epidemic in India appears to be spreading and
accelerating.  ProMED awaits further information on the success of the
mosquito vector control efforts and on which dengue virus serotypes are
circulating in the various locations reported here. ProMED thanks Mary
Marshall, Brent Barrett, A-Lan Banks, Joe Dudley, and Rector Press
Intelligence for similar reports.

A map of India can be accessed at:
<http://www.lib.utexas.edu/maps/middle_east_and_asia/india_pol01.jpg>. -
Mod.TY]

******
[3] Taiwan
Date: 03 Oct 2006
From: Joe Dudley <jdudley@eaicorp.com>
Source: Taipei Times [edited]
<http://www.taipeitimes.com/News/taiwan/archives/2006/10/03/2003330226>


Facing an already severe dengue fever season, the government is making
efforts to keep the spread of the potentially deadly mosquito-borne disease
under control. As of Monday morning, there had been 282 reported cases of
dengue fever this year in Taiwan, most of which occurred in the Kaohsiung area.

"People have yet to realize the seriousness of the dengue fever situation
this year," according to Minister of Health Hou Sheng-mao.  "We've known
since June [2006] that this [was] going to be a bad year. In fact, it
reminds me of the year 2002," he said, referring to a dengue outbreak 4
years ago that sickened 5336 people and caused 21 deaths.

Hou appealed to citizens to adopt a proactive approach to dengue
prevention. "There is only one way to beat dengue fever, and that is to
stamp out the mosquito breeding grounds," he said.

To help combat the disease, the Legislative Yuan has also established the
Central Dengue Fever Control Command Center.   According to Hou, the
formation of the center will help marshal resources and coordinate action
across different government departments and municipalities.  He also saw
this campaign as a learning experience for further challenges that might
lie ahead in the area of disease control, such as avian influenza.

The deputy head of the CDC, Chou Chih-hao, spoke of the government's novel
and more aggressive approach toward dengue prevention. "Those who allow
mosquito breeding grounds to persist on their property or ... who hamper
public sanitation efforts are now liable to be fined," he said. According
to Chou, it is not possible to eradicate the disease from Taiwan completely.

"Although they are not as active during the winter, mosquitoes survive from
year to year," Chou said. "Even an outbreak-free year does not signal that
dengue fever has died out completely," he said.

The objective of the new anti-dengue center is to keep the number of cases
below 500 this year -- roughly 1/10 the number of infected individuals
years ago.  Chou, however, acknowledges that it is an ambitious goal.  "We
are bracing ourselves for a warm winter," he said.

--
ProMED-mail
<promed@promedmail.org>

[It will be interesting to see if the threat of fines for residents having
dengue vector mosquito (_Aedes_) breeding sites on their properties will be
effective.  No mention is made of a public education program by the Central
Dengue Fever Control Command Center.  Education would seem requisite for
good public compliance.  Control by the threat of legal enforcement alone
would be difficult, given the ubiquity of mosquito breeding sites. - Mod.TY]

******
[4] Taiwan ex Viet Nam
Date: 4 Oct 2006
From: ProMED-mail <promed@promedmail.org>
Source: China Post [edited]
<http://www.chinapost.com.tw/taiwan/detail.asp?ID=91969&GRP=B>


A dengue fever outbreak in southern Taiwan could have been triggered by
dengue virus transmitted from Vietnam, a Center for Disease Control (CDC)
official said yesterday.

CDC tallies show that from the start of summer until 3 Oct [2006], the
number of indigenous dengue fever cases has totaled 291 in the country,
with 175 reported in Kaohsiung City, 110 in Kaohsiung County, 4 in Pingtung
County and one in Tainan City, all in southern Taiwan.

According to CDC Deputy Director-General Chou Chih-hao, people over the age
of 65 are the main age group affected by the disease this year, and the
dengue virus type 3 strain has been found in most of the patients.

An RNA comparison indicates that the virus strain discovered in the Taiwan
patients is 99.4 per cent similar to the strain prevalent in Vietnam, which
shows that Vietnam could be the source of the outbreak, Chou said.

He reasoned that some travelers to Vietnam could have been carrying the
disease when entering the country but were not detected by quarantine
authorities at the airport because they were not displaying any obvious
symptoms.

He noted that almost all indigenous dengue fever outbreaks occurring each
year in Taiwan have been traced to imported cases and that the Philippines
has been identified as the source of the outbreaks in the previous few years.

--
ProMED-mail
<promed@promedmail.org>

[Recognizing travelers incubating dengue virus infections is not yet
possible. Since importation of virus cannot be prevented, and in the
absence of a good tetravalent dengue virus vaccine, the alternative is
effective surveillance to detect cases as early as possible and the rapid
launch of vector control measures to prevent epidemic transmission of the
virus.

A map of Taiwan can be accessed at:
<http://www.lib.utexas.edu/maps/middle_east_and_asia/taiwan_pol92.jpg> -
Mod.TY]

******
[5] Trinidad and Tobago
Date: 3 Oct 2006.
From: Alfonso Rodriguez <ajrm_msds@yahoo.es>
Source: Trinidad Express, Trinidad & Tobago [edited]
<http://www.trinidadexpress.com/index.pl/article_news?id=161022948>


Several cases of dengue have been reported at the San Fernando General
Hospital and at private practitioners' offices in south Trinidad.

Some 12 cases of patients with dengue fever have been treated at the San
Fernando General Hospital and one patient from Palmiste reportedly had
dengue haemorrhagic [fever].  Up to yesterday he was reported in a stable
condition.

Reports from medical doctors in the southern area, and in particular
Palmiste, St Johns and Philippine, have reported an increase number in the
cases of dengue.

Hospital sources confirmed the dengue reports, and said: "The number of
reported cases is greater than usual, but expected now because of the rains."

[Byline: Louis B Homer]

--
ProMED-mail
<promed@promedmail.org>

[A map of Trinidad can be accessed at:
<http://www.caribseek.com/Caribbean_Maps/map-of-trinidad-and-tobago.shtml>
- Mod.TY]

WHO describes dengue fever as a severe, flu-like illness that affects
infants, young children, and adults, but seldom causes death. The clinical
features of dengue fever vary according to the age of the patient. Infants
and young children may have a non-specific febrile illness with rash
(although some infants and very young children may develop shock syndrome,
with sudden loss of circulating fluid volume, and die). Older children and
adults may have either a mild febrile syndrome or the classical
incapacitating disease, with abrupt onset and high fever, severe headache,
pain behind the eyes, muscle and joint pains, and rash.

Dengue hemorrhagic fever is a potentially deadly complication that is
characterized by high fever, hemorrhagic phenomena -- often with
enlargement of the liver -- and in severe cases, circulatory failure. The
illness commonly begins with a sudden rise in temperature accompanied by
facial flush and other non-specific constitutional symptoms of dengue
fever. The fever usually continues for 2 to 7 days and can be as high as
40-41 C (104-105.8 F), possibly with febrile convulsions and hemorrhagic
phenomena. In moderate DHF cases, all signs and symptoms abate after the
fever subsides. In severe cases, the patient's condition may suddenly
deteriorate after a few days of fever; the temperature drops, followed by
signs of circulatory failure, and the patient may rapidly go into a
critical state of shock and die within 12-24 hours or quickly recover
following appropriate volume replacement therapy. There is no specific
treatment for dengue fever. However, careful clinical management by
experienced physicians and nurses frequently saves the lives of DHF
patients. With appropriate intensive supportive therapy, mortality may be
reduced to less than one percent. Maintenance of the circulating fluid
volume is the central feature of DHF case management.
<http://www.who.int/mediacentre/factsheets/fs117/en/>

ProMED-mail thanks the contributors to this update. - Mod.TY]

5388 people needed to be test in the last 5 days. That is a lot.

Is there any connections with all these virus popping up lately or have I just been spending to much time with my buddy Perry Noid?

Chicken fear in fever zone

SOUMEN BHATTACHARJEE

Baduria (North 24-Parganas), Oct. 7: A mysterious fever suspected to be chikungunya, which has affected over 2,000 people in Baduria, has sparked a fear of chickens and other birds. Many residents are unaware that it is mosquitoes that cause chikungunya, not chickens — the result of the state health department’s inability to clear the confusion in people’s minds. “We have heard of dengue but not of chicken-guna. All of us in our village have stopped eating chicken. The disease must have origin- ated from birds,” said an upset Sanjib Das of Ramchandrapur. “Can it be treated or will we die if we are infected?” he asked. Most patients flocking to the health clinics suffer high temperature, body ache and vomiting.Das said the first case of the fever surfaced in early September. The district health department was informed but did not heed the warning.Kusum Kumar Adhikary, the chief medical officer (health) of the district, said: “We have collected blood samples and sent them to the School of Tropical Medicine in Calcutta and the National Institute of Virology in Pune for tests. So far, only a single case of dengue has been confirmed.” “More than 25 patients had to be admitted today,” said A. Khara, a physician of Rudrapur Rural Hos- pital. “I have treated quite a few patients so far and the symptoms seem to be that of chikungunya.” A team of experts will visit Baduria on Monday and collect blood samples. http://www.telegraphindia.com/1061008/asp/bengal/story_6842541.asp

Karnataka has more than 750,000 suspected cases and Maharashtra over 260,000. Several instances of a fever have been reported in a village in North 24-Parganas in Bengal, but it has not been established yet whether the infection is chikungunya. ( )

__________________________________________________

 

This does not sound good!!

"Only those who need emergency medical attention are being admitted," said another official, Anil Sharma.

"We are facing a severe manpower and resource crunch as suspected dengue patients are pouring in from all over to AIIMS but we don't have infrastructure to deal with this situation," said Sharma, a doctor at AIIMS where one medical student died of the disease earlier this week and more than a dozen of his colleagues remain stricken.

AIIMS spokesman Shakti Gupta said: "The health ministry must ensure that other city hospitals are also pressed into service to handle this dengue deluge."

Scuffles broke out at overcrowded Safdarjung Hospital where people were also queuing for diagnosis and treatment.

"I have been standing in the queue with my handicapped son since 5:00 am and we have been waiting more than seven hours," shouted one man in the line, Umesh Gujjar.

They are burning anything that might harbour the vectors and spraying their drinking water with insect repellents  thus hurting their much needed drinking water .http://au.news.yahoo.com/world/india.html

This looks as though this situation is just about out of control.  The most troubling point is that they can't pinpoint exactly what disease is at work here.  I personally take stock in what the villagers themselves believe is going on here...

Mosquitos are biting infected people and spreading it as we type.It seems to spread rather fast.Is the next new age weapon going to be a jar of mosquitos?

Full Article:  http://www.theindiancatholic.com/newsread.asp?nid=3815

From Doctor's in Karachi end of Sept.2006

 

Referring to the fact that the cases of Dengue Fever are being constantly reported to the local doctors and that these are mild to moderate to severe categories of the ailment, identified as Dengue Viral Fever, Dengue Hemorrhagic Fever and Dengue Shock Syndrome, the experts stressed for adequate diagnostic/laboratory facilities at both central and provincial levels.

This was said to be extremely pertinent in the backdrop that Dengue Shock Syndrome and Congo Hemorrhagic Fever present with almost similar conditions that is extensive bleeding from oral cavities as epistexsis (nasal bleeding), haemopysis (bleeding from respiratory tract) gastro intestinal tract etc.

It thus becomes extremely difficult for the doctors to differentiate between the exact type of infection and handle it accordingly.

Referring to existent confusion it was reiterated that clinical diagnosis not only put medical professionals at risk but also efficiently hamper proper treatment under these conditions.

It was further pointed out that since Dengue Viral Fever also present with symptoms as Thrombocytopenia (low blood count) also registered in case of Malaria, Leukemia or/and septicemia thus it is also all the more necessary to have adequate facilities helping early laboratory diagnosis.

It may not be out of context to mention that National Institute of Health Sciences presently refers all suspected cases of Congo Crimean Fever to South Africa for confirmation.

Doctors also underscored need for proper Referral Facilities so that suspected cases may be referred to identified hospitals without any delay—APP

 http://www.pakobserver.net/200609/30/news/topstories08.asp?txt=Karachi%20in%20grip%20of%20Dengue%20Viral%20fever

The Health Secretary said the issue which is of deep concern is the fact that second infection to the individual suffering from Dengue Viral Fever, at one point of time, even after a few years enhances his risk to be inflicted with Dengue Hemorrhagic Fever and then even to Dengue Shock Syndrome. 

“In Karachi where we have been witnessing outbreak of Dengue Viral Fever for last some years are now registering cases of Dengue Hemorrhagic Fever,” he said.

The Sindh Health Secretary said during the current month only all major tertiary hospitals in city including Civil Hospital -Karachi, Jinnah Post Graduate Medical Center, Liaquat National Hospital and Aga Khan Hospital reported admitting an average six to seven cases of suspected Dengue Hemorrhagic Fever.

Necessary investigations and Laboratory Tests conducted at National Institute of Health - Islamabad and/or Aga Khan University Hospital confirmed 70% of these 25 cases to be Dengue Hemorrhagic Fever while the remaining 30% remained non specified,” he said. so if you have dengue once you can get it again and again and then maybe you will die from dengue ...............second or third time round .

Health minister Yoganand Shastri took the decision following reports that the Aedes Aegypti mosquitoes might be breeding in such places.

"Fountains and other such water bodies would be closed only till the dengue threat persists," said Shastri after he chaired a meeting to review the dengue position in the Capital. The water in these fountains would be drained out to prevent mosquito breeding.

Chief Minister Sheila Dik****, meanwhile, claimed that the dengue outbreak was now "under control". Emerging from a Cabinet meeting on the disease, the Dik**** said there was no dearth of platelets in government hospitals.

The government has also decided to lend a helping hand to the Municipal Corporation of Delhi. Shastri has instructed nine deputy commissioners, responsible for district administration, to monitor the dengue control programme on a priority basis. The minister pledged all financial support to the MCD for the purchase of equipment like fogging machines to control the outbreak.

The state government also gave an area wise break-up of the dengue cases reported in different civic zones of the city. According to the figures, the Central Zone has reported the highest number of cases (110) followed by Najafgarh (72), Shahdara North (70), Shahdara South (46), Civil Lines (33), Rohini (36), City (6), Karol Bagh (48), West Zone (45), South Zone (37) and Narela (10). Health department officials said 23 cases have also been reported in NDMC areas also.

Interestingly, the government is yet to compile the figures of dengue patients admitted in private hospitals. "We would be able to get the figures soon as the primary focus of the department is treatment rather than compiling statistics," said an official who attended the meeting chaired by the health minister.

10 more cases in Ghaziabad

Assistant chief medical officer of Ghaziabad AK Dhawan said 10 confirmed dengue cases were reported on Monday, taking the total figure to 108 confirmed cases in the district. A private hospital has also reported suspected cases of chikungunya. Dr S Chakarvorty of Metro Hospital said, "Two suspected chikanguniya cases have been reported this week. Though last week, a sample was sent to National Institute of Communicable Disease (NICD) but it could not be tested. Another suspected chikanguniya case has been reported on Monday. About 30 suspected dengue cases were reported today." ESI Hospital authorities said they had postponed surgeries to tackle the dengue outbreak.

  52 photos from Delhi , the lines of  people , the sick , the staff , more sick , safe site . http://news.yahoo.com/photos/ss/events/hl/100406indiamosquito;_ylt=Agwsc6X_1k2uX5.dlgfsxAuKOrgF;_ylu=X3oDMTA3bGk2OHYzBHNlYwN0bXA-

US on alert for chikungunya

I am very concerned over this post above for two reasons.  First it is about time someone over there aknowledged the reality something "else" is causing all these deaths.  I don't expect anyone to voluntarily admit it might be bird flu at least not until the bodies are stacked up 3 high which looks like it won't be too much longer.  Secondly I have a friend who was scheduled to go to India next month on business and before I could say don't go he told me he pulled the plug on his trip saying his contact over there said we are having a very bad outbreak over here and that it may be a bad time to come over. 

Candles wrote: Dengue Virus Arrives in Nepal Districts bordering India are on high alert Shekhar K.C (shekhar)       Published 2006-10-12 04:36 (KST)    Reacting to the news, the Ministry of Health is starting various programs to check dengue. The ministry has also issued notices to all health officials to take necessary precautions. The chief of disease control at the Department of Health Services, G. D. Thakur, has urged that measures be taken at Nepal's airport since around a half dozen flights operate between Kathmandu, the capital, and various Indian cities on a daily basis.

Cruiser wrote: Candles wrote: Dengue Virus Arrives in Nepal Districts bordering India are on high alert Shekhar K.C (shekhar)       Published 2006-10-12 04:36 (KST)    Reacting to the news, the Ministry of Health is starting various programs to check dengue. The ministry has also issued notices to all health officials to take necessary precautions. The chief of disease control at the Department of Health Services, G. D. Thakur, has urged that measures be taken at Nepal's airport since around a half dozen flights operate between Kathmandu, the capital, and various Indian cities on a daily basis. Last time I checked dengue was not contagious so what up with the necessary precautions at Nepals airport?

Found this from down under

Candles wrote: Cruiser wrote: Candles wrote: Dengue Virus Arrives in Nepal Districts bordering India are on high alert Shekhar K.C (shekhar)       Published 2006-10-12 04:36 (KST)    Reacting to the news, the Ministry of Health is starting various programs to check dengue. The ministry has also issued notices to all health officials to take necessary precautions. The chief of disease control at the Department of Health Services, G. D. Thakur, has urged that measures be taken at Nepal's airport since around a half dozen flights operate between Kathmandu, the capital, and various Indian cities on a daily basis. Last time I checked dengue was not contagious so what up with the necessary precautions at Nepals airport?   Found this from down under As Dr Paul Reiter (Centers for Disease Control and Prevention, USA) explained at the 1999 Dengue Symposium in Cairns: “People are vectors of the dengue virus, travelling the world, infecting mosquitoes.” http://www.health.qld.gov.au/dengue/dengue_fever/australia.asp

Talk about a "Catch 22"!  I must admit I hate the taste of Skin-so-Soft!

  <> The Health Ministry warned the region remains prone to outbreaks of the potentially deadly disease because of favorable breeding weather conditions, reports Xinhua news agency.

The public was urged to help in the mosquito eradication program.

The report said China reported 502 dengue cases in September but there were no fatalities. Most of those cases were in south China's Guangdong Province, where 492 cases have been reported.

Dengue causes severe fever and can lead to vomiting, nausea and body rash. It can cause severe pain in the joints. Some dengue strains can cause internal bleeding and death.
http://www.physorg.com/news79807045.html

DENGUE, CHIKUNGUNYA - A STATUS REPORT
	15:32 IST

DENGUE A total number of 4737 cases and 92 deaths have been reported from India as a whole including Delhi as on 13.10.2006 upto 12.30 hrs. Situation report of Dengue in Delhi (upto 12.30 hrs.,13.10.2006) A total number of 1278 cases and 22 deaths have been reported from Delhi, NCR and other States. Out of these, 843 cases have been reported from Delhi, while 435 cases are from the NCR and other states. The 435 cases from outside Delhi includes 140 cases from Haryana, 221 cases from Uttar Pradesh, 12 cases from Rajasthan and 62 from others. Situation report of Dengue in other states (upto 12.30 hrs.,13.10.2006) Apart from Delhi upto 13.10.2006, the maximum number of dengue cases have been reported from Kerala (794), followed by Rajasthan (456), Gujarat (441), , West Bengal (405), Uttar Pradesh (349) Tamil Nadu (307), Punjab (250), Maharashtra (240), Haryana (100), Karnataka (90) and Andhra Pradesh (27). CHIKUNGUNYA Situation report of Chikungunya (upto 12.30 hrs.,13.10.2006) A total number of 1610 confirmed cases and no death have been reported from India as a whole including Delhi as on 13.10.2006 upto 12.30 hrs. < didn't we read death counts > A total number of 24 cases have been reported from Delhi and NCR region. Apart from Delhi, the maximum number of confirmed Chikungunya cases have been reported from Maharashtra (679), followed by Karnataka (294), Andhra Pradesh (248), Gujarat (145), T.N. (111), M.P. (62) Kerala (38) and Pondicherry (9). http://pib.nic.in/release/release.asp?relid=21308 SRK/Hb               Authorities said the country had 1.32 million suspected cases of suspected chikungunya but had managed only to confirm 1,602 of the viral disease.  < still testing maybe > Both dengue and chikungunya cause high fever, joint and muscle pain, vomiting and skin rashes. http://www.alertnet.org/thenews/newsdesk/B76663.htm