PAHO NEWS:  Press Releases, Job Vacancies, and Other 
Information from the Pan American Health Organization 
(PAHO) via the Canadian Society for International Health 
(CSIH) [log in to unmask]; Technical Representative in 
Canada for PAHO
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  Measles Vaccinations Urged for Displaced Persons in Central America
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Washington, D.C., 18 November 1998 - The victims of Hurricane Mitch living 
in displaced persons camps and shelters, as well as the health workers 
assisting them, should be vaccinated against measles, according to the Pan 
American Health Organization.

Past experience has shown that due to the high population density in these 
camps, there is a high risk for outbreaks of infectious diseases,including 
measles.  Moreover, the recent influx of large numbers of disaster 
personnel into Central America increases the risk of measles virus 
importations.  Indeed, many of the public health workers now entering the 
region are coming from parts of the world where measles remains endemic, 
the health organization, known as PAHO, said.Mortality from measles is, 
however, preventable, and immunization against the disease should be a high 
priority in emergency relief programs, the Pan American Health Organization 
said.  Efforts are clearly needed to prevent 
measles outbreaks among camps of displaced persons.
     
The group at highest risk for dying from measles are children less than 1 
year of age.  Maternal measles antibody generally wanes between 6 and 9 
months of age.  Therefore, it is recommended that the age of measles 
vaccination be reduced to 6 months of age in these camps.  Infants 
vaccinated before 12 months of age should receive a second dose of measles-
containing vaccine after their first birthday.
     
While most people in Central America between 2 and 20 years of age probably 
have been previously vaccinated in the measles eradication efforts,some may 
have escaped vaccination and others have been vaccinated, yet for one 
reason or another, failed to respond to the vaccine and thus remain 
susceptible to the disease. The recent large measles outbreak in Brazil 
suggests that there may be a relatively large number of young adults in 
Latin America who remain susceptible to measles, the health organization 
cautioned.
     
Young adults living in the conditions of a displaced persons camp may be at 
high risk for coming into contact with measles virus.  Most people born 
before 1960, however, likely had natural measles disease and do not need to 
be vaccinated.   For the above reasons, it would seem reasonable to 
indiscriminately administer measles vaccine to infants, children, 
adolescents and young adults residing in displaced persons camps.
     
Based on the above information, the following specific recommendations
are made:
     
1. To prevent measles outbreaks , those from 6 months to 35 years of age 
who are living in displaced persons camps should receive measles-containing 
vaccine. The vaccine should be administered as soon as they enter an 
organized camp or settlement. Having previously been vaccinated or having a 
history of measles disease are not contraindications receiving the vaccine. 

2. Emergency public health personnel, both national and international, 
should be routinely vaccinated against measles, regardless of age.

3. The vaccine of choice is either measles-rubella (MR) vaccine or measles-
mumps-rubella    (M-M-R) vaccine.  If neither of the above vaccines is 
available then single-antigen measles vaccine may be administered.

4. The occurrence of measles in a displaced persons camp is not a 
contraindication to conducting an immunization campaign.
     
     
For more information please call Eugenio Gutiérrez,
tel (202) 974-3728, fax (202) 974-3143,
Office of Public Information,, email:  [log in to unmask], 
http:\\www.paho.org
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Innovative System Helps Countries Keep Track of Relief Supplies
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Washington, November 20, 1998-- The passage of Hurricane Mitch, which
caused more than 10,000 deaths and left hundreds of thousands of families 
homeless in Central America, is proving yet again the importance of SUMA-
the Humanitarian Supply Management System developed by the Pan American 
Health Organization.
     
As formal and informal relief efforts are organized throughout the world to 
send goods to central American countries, the affected countries are 
overwhelmed by the flood of relief supplies that arrive without any 
planning or organization, posing serious logistic and management problems 
for national authorities. "SUMA is a tool that can manage humanitarian 
relief supplies, from the time pledges are made by donors, to their entry 
into the disaster area and their storage and distribution," said Dr.Hugo 
Prado of PAHO's Emergency Preparedness and Disaster Relief program.
     
As soon as Mitch hit, personnel trained to handle the SUMA system began to 
mobilize to help the most affected countries. In Honduras, SUMA efforts are 
concentrated in 5 main entry points: La Ceiba, San Pedro Sula, Puerto 
Cortez, Palmerola, and San Lorenzo. 15 SUMA volunteers are working full-
time at the SUMA warehouses in Tegucigalpa. The health sector has 
centralized its activities at the Olympic Village. PAHO is hiring a full-
time pharmacist to work at the village. All medicines warehoused in other 
places or points of entry are being moved to the Olympic Village.

Executive reports are being provided to national authorities, and digests 
are being sent to international relief agencies. 

For further information contact: Paulo Leite, 
tel (202) 974-3035, fax (202) 974-3143,
Office of Public Information, PAHO, 
http://www.paho.org.
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 Controlling Diseases After Mitch Will Cost Money
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Washington, November 23, 1998-Controlling communicable diseases in the 
countries devastated by Hurricane Mitch will require significant expenses 
to control disease-carrying mosquitoes and to ensure that water and food 
are not contaminated, according to Dr. Claude de Ville, Chief of the Pan 
American Health Organization's Emergency Preparedness and Disaster Relief 
Program.
     
Dr. de Ville, who just returned from Honduras and El Salvador, said, "One 
of our main concerns is control of communicable diseases.  While  we don't 
expect catastrophic outbreaks, that doesn't mean there will 
be no cases.  Cholera, malaria, dengue and leptospirosis are all present in 
Central America.  To control them, we must invest significant amounts in 
control of vectors, food, and water supplies." Floods also increase risk of  
schistosomiasis, dengue, yellow fever, malaria, hantavirus, and other 
diseases, according to PAHO experts. 
     
PAHO's Assistant Director, Dr. Mirta Roses, cited the latest figures on 
communicable diseases that have been reported to PAHO by Ministries of 
Health, noting that many doctors and epidemiologists are out 
looking for cases to ensure that any outbreaks are rapidly controlled and 
the people treated. As a result of this increased attention, reporting is 
also increased, she said.
     
El Salvador has reported six confirmed cases of cholera including one 
death, all related to contaminated food sold by street vendors near the 
border of Guatemala.Guatemala has reported 234 confirmed cholera cases with 
17 deaths, along with seven cases of leptospirosis, six cases of dengue, 
and 70 cases of malaria.  Cholera cases have appeared in different areas of 
the country, and all have been food-related.  Five confirmed cases of 
leptospirosis have been reported, four in Guatemala City and two in 
Esquintla. 
     
Nicaragua has reported 335 cholera cases and confirmed 301 in laboratories. 
The cases include 156 in Managua, 46 in Carazo, 25 in Masaya, 18 in 
Matagalpa, 16 in Chinandega, and 13 in Estelí, with the 
rest scattered in six other areas.  Nicaragua has also reported 264 
possible leptospirosis cases, of which 42 have been confirmed by 
laboratory, including 30 in Chinandega, 11 in Estelí, and one in Madriz.  
Seven people have died from leptospirosis, often transmitted by contact 
with water contaminated by rodent urine or feces. 
     
Honduras has reported 14 cases of cholera, 4 cases of leptospirosis with 
three deaths, 1,080 cases of dengue, 15 confirmed cases of dengue 
hemorrhagic fever with four deaths, and 1,567 cases of malaria, 
including seven deaths. 

Belize has reported a cholera outbreak in Saint Martin Village, with 11 
suspected and five confirmed cases, including one death.  The source of 
infection is thought to be contamined water from Roaring Creek, authorities 
said.
      
In all countries, health authorities have taken control measures to improve 
food safety and to guarantee the quality of water for human consumption, 
and have sent doctors and epidemiologists to areas where 
outbreaks have been reported to take control measures and educate the 
communities on preventive measures, Dr Roses said.  
     
Emergency supplies are arriving and being widely distributed, using the 
PAHO-designed SUMA Humanitarian Supply Management system, Dr. de Ville 
said, "but we already see in the field many unusable supplies and expired 
medicines." The real problem for Central America will be reconstruction and 
rehabilitation, Dr. de Ville said.  "The big item for the health sector in 
Honduras, for example, is reconstruction of the water system, which we 
estimate will cost some $180 million out of an estimated $220 million in 
health reconstruction costs, and is a very important priority."
     
Noting that PAHO has mobilized some 60 experts to the countries hardest hit 
by the hurricane, in addition to the 150 already there, Dr. de Ville 
said,We have a lot to learn from this disaster. Were we 
sufficiently prepared? Could we have done better? How can we emphasize 
disaster mitigation to ensure damages will not be so heavy next time?"  He 
said an evaluation meeting will be held on Hurricanes 
Mitch and Georges February 9th to 12th. PAHO, founded in 1902, provides 
technical collaboration in a broad range of fields including emergency 
preparedness and disaster relief. It works to improve health and living 
conditions in the countries of the Americas, and serves as the Regional 
Office for the Americas of the World Health Organization.

For further information contact: Daniel Epstein, 
tel (202) 974-3459, fax (202) 974-3143,
Office of Public Information, PAHO, 
http://www.paho.org.
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