An outbreak of plague in Hlegu, Burma in 1977.

An outbreak of plague occurred in Hlegu Town, Burma in February and March 1977. Altogether 14 bubonic plague cases, with 2 deaths were reported, mostly children under 15 years of age. Twice as many males as females were affected. A retrospective investigation showed that a rat fall took place in the last week of January. Only 9.5% of the rodents which died in the epizootic were found to be infected with Y. pestis; this apparent low infection rate probably resulted from the inclusion in the survey of some dead rats which died of other causes. 14.5% out of 48 trapped rodents were found to be serologically positive. The general flea and cheopis indices were rather high, perhaps because fleas were found to be partially resistant to DDT and also because spraying of insecticide did not effect fleas on the hosts. The cheopis index in Hlegu Town was 1.17, and less than 0.5 in Hlegu suburb (Yankin-Yat) where no epizootic was reported. An active case search revealed 76 suspected plague cases out of which 11 were found to have bubonic plague. A field trial showed that plague vaccination during the outbreak did not result in a rise of detectable antibodies in persons inoculated.

Epidemiological features of skin diphtheria infection in Rangoon, Burma.

A survey for skin diphtheria was carried out on 493 patients with skin lesions who were attending Veneral Diseases & Dermatology Clinic in Rangoon in 1971. 63.8% of the patients had C. diphtheriae in their skin lesions. All ages and both sexes were equally affected. Skin lesions yielding C. diphtheriae on culture were indistinguishable from those associated with other bacteria including ecthyma, pyoderma and secondarily infected with parasitic infections. Out of 108 strains tested 18.5% were found to be toxigenic, mainly intermedius. No toxigenic gravis strain was encountered. No relation existed between the type of lesion and the type or toxigenicity of the infecting strain. 75% of these toxigenic strains were isolated from children under 5 years of age. The phage types of toxigenic strains isolated were: II-IV, XII, Ph r, 8, 19-20, III, IVII and IV.

Clinical and laboratory studies on haemorrhagic fever in Burma, 1970-72.

This three-year serologic study of 2 060 children with a clinical diagnosis of haemorrhagic fever, who were admitted to the Children's Hospital and other hospitals in Rangoon, has shown that the etiology of the illness was multiple. Of all these patients, 347 (16.8%) had a dengue infection (96 with primary and 251 with secondary dengue infections), 510 (24.7%) had chikungunya infections, 55 (2.7%) had simultaneous chikungunya and dengue, 263 (12.8%) had influenza A infections, 62 (3.0%) had influenza B, 12 (0.6%) had measles, and there were 811 (39.4%) for whom no etiology could be established. Epidemiological and clinical features and laboratory findings are discussed. Evidence is presented for human infections with all four types of denguevirus in Rangoon.