ea y
rs. An in
o v
vi
alua v
tion e
of the f
ield
f
ef
ic
y ac
of
F
e
e
d
b
a
c
k
L
o
o
p
f
r
o
m
D
a
t
a
e
n
e
r
a
t
e
d
a
t
F
e
v
e
r
S
t
u
d
y
i
n
S
a
n
g
k
h
l
a
b
u
r
i
,
T
h
a
i
l
a
n
d
R
e
l
a
t
e
d
s
e
r
o
s
u
r
v
e
i
l
l
a
n
c
e
f
o
r
f
e
v
e
r
h
a
s
b
e
e
n
c
o
n
d
u
c
t
e
d
District wide surveillance,
Seroepidemiologic
identify modes of
survey
transmission,
prevention, etc.
Local
Public
Sangkhlaburi
Periodic
Health
Analysis.
District
EIDs
residents
identified
Confirmatory
lab assays.
Definite Dx
30
ImprovedImprovedImprovedA
F
R
I
M
S
F
e
v
e
r
S
t
u
d
y
I
O
M
v
i
s
i
t
,
O
c
t
F
o
l
l
o
w
u
p
.
C
o
n
v
a
l
e
s
c
e
n
t
meflo uine documented the spreading of meflo uine
i
n
t
h
e
T
e
r
a
i
d
i
s
t
r
i
c
t
o
f
e
p
a
l
,
a
n
a
r
e
a
o
f
t
r
o
p
i
c
a
l
l
o
w
resistance to Sangkhlaburi along the
Thai Myanmar
l
a
n
d
s
n
e
a
r
t
h
e
b
o
r
d
e
r
w
i
t
h
I
n
d
i
a
a
n
d
i
n
t
h
e
K
a
t
h
m
a
n
d
u
, border
re uiring u
g r
ent
visi r
o e
n of Ministr
y of Health
a
l
l
e
y
.
P
r
e
l
i
m
i
n
a
r
y
T
e
r
a
i
d
a
t
a
b
a
s
e
d
o
n
H
A
I
a
s
s
a
y
s
treatment protocols for the
g r
i e
on. In contrast to
t
h
a
t
a
r
e
p
o
t
e
n
t
i
a
l
l
y
c
r
o
s
s
r
e
a
c
t
i
v
e
w
i
t
h
f
l
a
v
i
v
i
r
u
s
e
s
repor
ts from others, AFRIMS has also been un
leab
to
r
a
i
s
e
t
h
e
p
o
s
s
i
b
i
l
i
t
y
t
h
a
t
i
n
a
d
d
i
t
i
o
n
t
o
a
p
a
n
e
s
e
w
sho
a decrease in meflo uine resistance in
ietnam.
e
n
c
e
p
h
a
l
i
t
i
s
pur
e e
s p
v, o
Csi
h tieiksu
t n
yag, un
Antimalarial multidr
ug resistance appears to be eme
g r
ile enceph
a
y a
lle li
en tcis
e
p
h p
al u
it r
ei e
s
s p
v, . o
a s
n
p it
d
u i
eM
re
s v
u
pv r
oi y
s
r iti u
y r
s a
es ma
ing in angladesh.
,
e e
rv
w
Ho
no ar
temisinin resistant
be f
y o
T c
p
h a
re l
e ls
pean
ut.
c i ty of dengue results
P. falciparium
isolates
e v
ha
been found among wild
mitigate a
erg
aa
i.inst this being a plre
T ob
m in the
isolates from the
g r
i e
on.
The
ai Kw
erv
Ri
Christian Hospital along the Myanmar
efore t
yh
al, e
l
e sur ei v
llance in the Ka thmandu
border in
Thailand has
e v
d
pro
to be a useful site to
the
avr
s ie
d
n w
o
e e
nce to suggest that apanese
conduct sur ei v
llance for fu
e n
r d
e i
nftiated febrile ill
encephali
a tsi se w
ndemic there. Hepatitis
a sE w
nesses and identify
w ne
p
g a
e t
nh
s o
. ased on complet
noted to be the leading cause of acute hepatitis in
al d
ua e
ev
tions of the f
irst patients ,
Kathmandu .
leptospirosis is
w
no
g r
n e
i c
e o
d to be a
erv
y commonbut
v
y i p
o r
u e
sl
un d
aer
ppreciated cause of morbidity
and
.
mor
tality
Despite numerous Ixodid ticks, no
evidence for
orrelia
has
gd
e b
o
r u
r
i r
f
been found.
F
e
v
e
r
S
t
u
d
y
S
c
r
e
e
n
i
n
g
&
E
n
r
o
l
l
m
e
n
t
T
e
n
t
a
t
i
v
e
p
l
a
s
m
a
c
o
l
l
e
c
t
e
d
.
R
x
D
x
C
l
i
n
i
c
a
l
&
l
a
b
e
v
a
l
u
a
t
i
o
n
Another
w ne
sur ei v
llance f
inding is that melioidosis
i
n
c
l
u
d
i
n
g
d
i
p
s
t
i
c
k
s
.
S
y
n
d
r
o
m
e
D
x
khol
d u
e r
ria pseudomallei not
y onl
is
w
no
seen as
occur
ring in the
g r
i e
on but it is also
g r
n e
i c
e o
d as
being uite common.
Typhoid
erv
fe
outbreaks also
e v
ha
been documented and
y man
cases seem to
respond
y
wl
slo
to uinolones.
This
ea y
r AFRIMS
documented the f
irst
g r
n e
i c
e o
d case of hepatitis E
in Sangkhlaburi. Sur ei v
llance data also suggest the
f
irst repor
ts in Southeast Asia of Spotted
e e
rv
F
roup rick
ettsioses identical or c
y losel
related to
R
keitctsia helvetica
or
Riskettsia conorii Indian strain .
E
x
p
o
s
u
r
e
t
o
E
h
r
l
i
c
h
i
a
s
p
p
.
s
e
e
m
s
t
o
o
c
c
u
r
a
l
o
n
g
w
i
t
h
m
u
r
i
n
e
t
y
p
h
u
s
a
n
d
a
f
l
a
v
i
v
i
r
u
s
o
t
h
e
r
t
h
a
n
a
p
a
n
e
s
e
e
n
c
e
p
h
a
l
i
t
i
s
o
r
d
e
n
g
u
e
.
S
c
r
u
b
t
y
p
h
u
s
s
e
e
m
s
r
a
r
e
.
F
e
b
r
i
l
e
I
l
l
n
e
s
s
,
M
O
P
H
/
D
C
D
C
K
R
C
H
O
P
D
<
New Page 1
Budget Web Hosting