So-net無料ブログ作成
前の10件 | -

Nipah in Bangladesh and elsewhere from 23 May 2018

4 dairies issued notices for keeping premises dirty [The Times of India, 25 May 2018]

by Sumita Sarkar

Nashik: The civic body on Wednesday issued notices to four dairies on Wadala Road for not keeping the premises clean. The municipal corporation has warned the owners of the dairies of strict action if they did not clean the premises within a week

Officials said this was part of a regular process but they were exercising caution since there has been an outbreak of the deadly Nipah virus in Kerala that have killed over a dozen people so far.

“We have given them a deadline of seven days to clean up their premises. The surrounding areas also should not be unclean due to their dairies and animals,” said an NMC official.

“They have been told to inform us whether their dairies are authorised or not. If it is unauthorised, we will inform the concerned department for appropriate action,” the official said.

He said the civic workers were keeping the city clean but there have been complaints that some areas were unclean due to dairies and animals.

Though the city is safe as yet from the Nipah virus, the civic body was making provisions for treatment in case of any untoward incident.

“We have an isolation ward in Dr Zakir Hussain Hospital for swine flu that is vacant for two years. It can be used in case of a Nipah breakout here. But the chances are rare as there are no fruit bats here, due to which the virus spreads. It is transmitted from bat to pig and from pig to humans. People travelling to Kerala and coming back should do check up immediately,” another NMC official said.

Stray animals to be transported to cattle ponds: The Nashik Municipal Corporation has asked owners of animals to keep them in stables. Or else, the civic body will take the animals to cattle pounds (kondwadas).

Stray animals are often seen blocking the roads and making it difficult for commuters to pass. Earlier, this month, a cow went berserk at Nashik Road, injuring some pedestrians. Following this incident, the NMC swung into action.

“We will transport the stray animals to the cattle pounds and impose fine on the owner. If no one claims the animals we will send them to ‘goshalas’,” an official said.

‘Early detection can reduce risk for Nipah patients’ [The Hindu, 25 May 2018]

25VZPG2DRZAHEERAHMED.jpg
Expert speak: Dr. Zahir Ahmed addressing the media in Visakhapatnam on Thursday.

Virus-hit may slip into coma, suffer organ failure in advanced stage, says doctor

The fatality of Nipah virus, though it affects the brain and respiratory system, can be reduced if detected early, Zahir Ahmed of Sneha Jyothi Swachanda Seva Samithi has said.

Addressing the media on Thursday, he said as the virus spreads from bats and pigs, one should not eat the fruits fallen on the ground and half eaten by birds.

“There is no direct treatment for Nipah virus . But an early detection can prevent its spread to critical body parts like brain and lungs,” he said.

Giving details about the symptoms Dr. Ahmed said like all virus infections, people infected with the virus might develop fever, headache, neck rigidity, drowsiness and confusion. “If not treated in time, it may lead to encephalitis and an infected person might slip into coma followed by organ failure,” he said and cautioned that it’s contagious through air and, nasal and mouth secretions.

Lab needed

Dr. Zahir pointed out that there was an immediate need to set up a virology laboratory in the State as the samples need to be sent to National Institute of Virology in Pune for testing now.

“Be it for Swine Flu or Anthrax, the samples have to be sent to NIV, Pune and much time is lot in the process. It’s time that the government set up a lab in the State, preferably in Visakhapatnam,” he said.

Nipah virus has already claimed 12 lives in Kerala, including a nurse.

Nipah virus: Two suspected cases reported in Hyderabad, samples sent to NIV-Pune [The New Indian Express, 24 May 2018]

By K Shiva Shanker

NIPAHbbb.jpg
A man selling surgical mask to the people coming to the Government Medical College Hospital in Kozhikode. (Photo | Manu R Mavelil)

Symptoms of infection caused by Nipah virus include encephalitis accompanied by Acute Respiratory Distress Syndrome (ARDS). Other symptoms include cough, cold, high-grade fever.

HYDERABAD: Two people who are suspected to be suffering from Nipah virus infection are admitted at hospitals in Hyderabad. Both the suspected patients are around 25-year-old and one among them has recently been to Kerala on a tour with a group of people. Both the patients are isolated and blood, swab samples are collected from the patients and sent to National Institute of Virology (NIV)-Pune.

Telangana Director of Medical Education Dr K Ramesh Reddy who stressed that there is no need for the public to panic said that as they did not want to take any chance, they sent the samples to test for both Nipah virus and Swine Flu as symptoms for both the infections overlap.

Symptoms of infection caused by Nipah virus include encephalitis accompanied by Acute Respiratory Distress Syndrome (ARDS). Other symptoms include cough, cold, high-grade fever. The presence of Nipah virus was first confirmed in Kerala on Sunday.

"One among the two suspected cases went to Kerala. I spoke to National Centre for Disease Control (NCDC) officials who are in Kerala who said that the place the man has been to is hundreds of kilometers away from localities where Nipah virus cases are reported. So chances for him to test positive are less. The samples will reach NIV-Pune by morning." said Dr Ramesh Reddy.

Usually, in such cases, a person is tasked to take the samples either through road, railway and seldom through airways. Telangana Health department officials have to wait for 24 to 48-hours from Friday morning to know results of Nipah virus tests.

The patient who has been to Kerala is admitted to Fever hospital in Nallakunta. A special ward is created to isolate the patient. In case of the second patient, sources said he was diagnosed with Enephalitis. "But the second patient, who is admitted into NIMS hospital, did not cross Hyderabad limits," sources said.

"We are fully geared up to handle emergencies. Separate wards with six to ten bed capacity are created in Gandhi Hospital, Osmania General Hospital. And if needed, we have the capacity to add 30 to 40 more beds," Dr Ramesh Reddy said. A meeting was held with superintendents of Gandhi Hospital, Osmania General Hospital and others on Thursday evening.

In Kerala, Lini, a nurse, who attended Nipah virus-infected patients, contracted the infection and died.

The DME said that they have taken precautions to protect their staff too. "We have personal protective suits and have placed orders for more. We will take care of our doctors and staff," he said.

It is learnt that Health department officials have checked on the others who travelled with the software engineer to Kerala. "Others do not have any health problem," sources said.

The 10 Latest Facts On Nipah Virus Including Symptoms And Checks [NDTV News, 24 May 2018]


by Dr Amit Gupta

nipah-virus-kerala-pti_625x300_1527142484970.jpg
Nipah is a rare virus spread by fruit bats, which can cause flu-like symptoms and brain damage

NEW DELHI: With 11 people killed by the brain-damaging NIPAH (NiV) virus in Kerala, here's an explainer of the outbreak, causes, symptoms and treatment:

1) The virus infects both animals and humans (a phenomenon known as zoonosis). It has joined the list of recent zoonotic outbreaks such as swine flu and bird flu. Interestingly, almost 60% of all infections in humans come from animals. It is no surprise that people working in close proximity with animals are particularly susceptible. Species of fruit bats are the presumed natural reservoirs of the Nipah Virus, though transmission from pigs has also been reported.

2) This virus has earned its scary reputation. It can kill between 40 to 100% of those affected. The incubation period (time from when the infection happens to symptoms appearing) ranges from 4 to 14 days. The early symptoms are pretty non-specific and can be confused with those with common colds/general viral infections.

3) The virus affects both the respiratory and neurological systems. In recent outbreaks in the Indian subcontinent, the lungs are often affected (75% of the cases). Patients may go through increasing breathlessness and may progress to severe oxygen hunger rapidly. It can also progress to encephalitis - which is an inflammation of the brain - and patients can slip into a coma. Encephalitis has a high rate of death and survivors can have long - term neurological issues such as a seizure disorder or personality changes.

4) There is no definitive treatment apart from supportive care. Supportive care means that the patients may need to be closely monitored and may be admitted to hospital. Patients may need respiratory support and may need to be put on the ventilator. There is as yet no vaccine for the Nipah virus.

5) For patients living away from the area of the outbreak - if you have symptoms which are flu-like, such as headaches and fever - you are far more likely to have common flu rather than Nipah. For those living in or around the area suspected, vigilance and seeking early advice would be sensible. Health professionals working in the outbreak areas are well sensitized to what to look out for and seeking direct counsel is more advisable than unverified information doing the rounds.

6) The portals of the WHO and Centre for disease control are excellent resources (as they has been for this article!), though the information tends to be written for professionals. Also, remember outbreaks tend to be pretty cloistered in small areas and can be brought under control with sensible quarantine and treatment protocols.

7) It would come as a surprise to many that is not the first outbreak in India. There were two outbreaks in West Bengal in 2001 and 2007 with 50 people killed. Similar outbreaks have taken place in Bangladesh. The mode of transmission includes person-to-person and contact with sick animals. However, the outbreaks in this part of the world were likely to be related to drinking infected raw date palm sap. That said, human-to-human spread is well-known, and of the cases reported from an outbreak in Siliguri, 75% occurred among hospital staff or visitors.

8) Outbreaks such as NIPAH are likely to become more common. Population density will make human-animal interactions more likely, increasing the chances of virus cross-infection. There is an increasingly recognised phenomenon of virus 'jumping' species. This means that bugs that primarily affected animal or bird species mutate with time and human beings become their new hosts. Swine and avail flu are examples of this phenomenon.

9) Telling people not to panic often tends to ensure that they do. It is, therefore, imperative that facts and advice must be available from trusted sources in clear and simple speak. A robust single portal source of information set up specifically for the particular outbreak should become the norm.

10) Kerala has declared that the outbreak has been contained. We owe this relief to the hundreds of medical professionals who risk their own lives when it comes to saving others. A poignant note written by Nurse Lini who succumbed whilst looking after patients has touched the hearts of thousands. She is a shining example of unassuming dedication and courage that the entire medical profession should be proud of.

Nipah: no need for panic, but be cautious [The Hindu, 24 May 2018]

By
G Venkataramana Rao

24VJFRUITBAT.jpg
Ripe fruits are eaten not just by parakeets, but also by fruit bats that spread the virus. | Photo Credit: G_RAMAKRISHNA

No commercial testing kits available, samples need to be sent to Pune
Though there is no need to panic, there is every need to be cautious about Nipah virus (NiV), say health and veterinary experts.

There is a popular belief that fruits eaten by parakeets are sweet and tasty. Though such fruits do not make it to the market, children and those who harvest fruit, eat them. The belief that these fruits are eaten only by parakeets is a misconception. Ripe fruits are eaten not just by parakeets, but also by fruit bats that spread NiV.

Animal Husbandry Deputy Director (Epidemiology) Rajeswara Reddy said the habit of consuming fruit that are half eaten on the tree is very dangerous in the light of the Nipah virus infection cases. Fruit Bats and pigs are natural reservoirs of NiV. There is a chance of the virus spreading from the fruit half eaten by bat to either humans or pigs, Dr. Reddy said.

Since NiV is zoonotic, people associated with pig rearing have a greater risk of being infected.

There are sizeable populations of pigs in Krishna, Prakasam, Guntur, Kadapa and Visakhapatnam, he added.

Former ESI hospital superintendent and epidemiologist T.V. Narayana Rao said there are no NiV cases recorded in the State so far. This may be because there is no means of confirming the virus here. No commercial kits are available for NiV. All samples have to be sent to the National Institute of Virology, Pune. This is holiday season and people should be cautious about where they go and what they eat. Kerala Tourism has already issued a travel advisory to avoid travelling to Kozhikode area because NiV spreads also from human to human, Dr. Rao said.

Second India state reports suspected Nipah cases as outbreak source eyed [CIDRAP, 23 May 2018]


Authorities in a second Indian state are investigating two suspected Nipah virus infections, both of them in people who had traveled to Kerala state where they had contact with infected patients, Reuters reported today, citing a health official in Karnataka state.

The cases involve a 20-year-old woman and a 75-year-old man from the city of Mangalore.

Both are receiving treatment, and their samples were sent for testing, with results expected by tomorrow, according to the report.

In another outbreak development, health officials in Kerala state said a bat-infested well in a house in Kozhikode district has been identified as the likely source of the Nipah virus outbreak, which has so far led to 10 deaths in two of the state's districts, Xinhua reported today. The well where the bats were found were in the home of the first patient who died in the outbreak. Some of the bats were caught and sent for lab testing, and the well has been sealed.

District health officials say 19 people are being treated, including two in critical condition, and 11 deaths have been reported, The Hindu, an English-language newspaper based in India, reported today.

Shri J.P. Nadda, India's health minister, said in a statement yesterday that two confirmed cases had a history of contact with the index case, and both patients were treated at Calicut Medical College Hospital, where they died from their infections. Seven patients are still hospitalized. Nadda urged the public not to believe rumors on social media and not to spread panic about the disease.

Nipah virus is primarily spread to humans from animals, with fruit bats as the natural hosts, but limited human-to-human transmission has been reported among family members and caregivers through contact with body fluids of infected patients, as occurred in past outbreaks in Bangladesh and India.

There are no treatments or vaccines targeted to Nipah virus, but it is a priority disease on the World Health Organization (WHO) research and development blueprint.

Fever surveillance mechanism in place in Nipah-hit villages [The Hindu , 23 May 2018]


‘No abnormal rise in number of fever patients this year’

Local health authorities are putting in place fever surveillance mechanisms in places such as Sooppikkada village in Changaroth grama panchayat and Cheruvannur, from where deaths caused by Nipah virus were reported in the district in the past two weeks.

Ali, health supervisor, community health centre, Perambra, said on Tuesday that all the fever cases in the villages were under observation.

Those related to the patients too would be kept under watch. He claimed that there had not been any abnormal rise in the number of fever patients this year.

“We had earlier conducted fogging and other mosquito eradication measures. Awareness camps were held to allay the fears of the residents too,” he said.

People had left their houses in Changaroth after the deaths.
Kudumbasree meeting

Meanwhile, the Kudumbasree district mission held a meeting, which was attended by the volunteers of the Community Development Societies in Changaroth and Cheruvannur. Health Minister K.K. Shylaja and Labour Minister T.P. Ramakrishnan were present.

It was decided to take up waste management campaigns and awareness programmes involving health officials. The volunteers would visit houses too.

Kannur on Nipah alert [The Hindu, 23 May 2018]


Collector chairs meet to review preparedness of hospitals, names nodal officers
The district administration on Wednesday directed hospitals to take necessary arrangements in view of the Nipah virus deaths in Kozhikode.

An emergency meeting of health officials was chaired by District Collector Mir Mohammed Ali to review preparedness of hospitals in case the infection is reported in the district.

The meeting was told that isolation wards and treatment facilities had been opened at the District Hospital, General Hospital at Thalassery, and the Pariyaram Medical College (PMC) Hospital.

Doctors N. Abhilash of the District Hospital (mobile number 9961730233) and Aneesh K.C. of the General Hospital, Thalassery, (9447804603) were appointed nodal officers to deal with Nipah virus infection treatment arrangements.

The meeting decided to conduct special awareness classes for staff in government and private hospitals. Facilities for ensuring individual safety would be made available in all hospitals. Blood, urine, and throat swab of patients suspected to have contracted Nipah virus infection would be collected at the District Hospital and the General Hospital and sent to the Virology Institute at Manipal for testing.
Private hospitals were asked to take special care in this regard, an official release said.

The PMC would be the referral centre for Nipah virus infection. Special fever clinics would be opened at taluk, general, and district hospitals.

The Collector instructed the Indian Medical Association (IMA) to open isolation wards and treatment arrangements at Koyili Hospital, AKG Hospital, and Dhanalakshmi Hospital here. All hospitals in the district should either have isolation wards or special spaces.

He said if Nipah cases were reported in hospitals, including private ones, they should be reported to the integrated disease surveillance programme desk at the District Medical Office here.

Kannur Mayor E.P. Latha, district panchayat president K.V. Sumesh, District Medical Officer-in-charge M.K. Shaj were among those present.

Cremation of 2 Nipah victims delayed after staff backed out in Kozhikode [Onmanorama, 23 May 2018]

dead-body.jpg.image.470.246.jpg


Kozhikode: The cremation of two victims of Nipah fever was delayed by several hours on Tuesday after employees at the crematorium on Mavoor Road here backed out ostensibly due to fear.

Rajan, a resident of Vattachira, and Ashokan of Ummathur had died on Tuesday morning and their bodies were taken out of hospital by 11 am, but the cremation couldn't be carried out until 5 pm.

A traditional cremation was planned for Rajan as the blower at the electric crematorium was not working. However, the crematorium workers refused and the body had to be shifted to the electric cremat orium workers refused and the body had to be shifted to the electric crematorium itself, though the blower was out of order.

In the absence of the blower, the cremation took five hours instead of the two-and-a-half hours that it normally takes. The kin of Ashokan also arrived there, but the workers entered into a heated exchange with them, forcing the district collector and the city corporation to intervene. It was then decided to entrust the task to a private agency.

The municipal corporation would pay the Rs 5,000 incurred, officials said.

Ashokan's kin Mohanan has lodged a complaint with the corporation against the workers who refused to cremate the body.

Ten people have so far lost their lives to the Nipah virus in the northern Kerala districts of Kozhikode and Malappuram. A total of 116 people, who had come in contact with the some of the infected people, have been put under quarantine - 94 at their homes and 22 in various hospitals, sources said.

Nipah advisory on travel to northern regions of Kerala issued [Covai Post Network, 23 May 2018]

vir.jpg

Kochi: The Kerala Government today cautioned people to avoid visiting Kozhikkode, Malapuram, Wayanad and Kannur to protect themselves against contracting Nipah virus that has claimed 11 lives and left many infected. Two persons are seriously ill.

An advisory issued said travellers to these districts should be more cautious. The infection remains highly localised and all cases are linked to one family from which three had died first.

“Surveillance is being conducted in the affected districts. The situation remains under control,” the advisory said. A total of 2,000 antiviral ribavirin tablets have already reached Kozhikkode and another 8,000 are expected to reach soon, according to health department sources. As many as people have been quarantined.

Health Minister KK Shailaja said it was an unprecedented situation and the Government was doing everything to prevent its proliferation. The main challenge before the Government was to prevent its spread as there was no clear preventive or curative treatment for Nipah spread by bats, pigs and infected people.

Meanwhile, the Government at a meeting praised the efficient support extended by the Union Government. Governor P Sathasivam advised people to remain cautious and not to panic.

Husband Of Nurse Who Treated Nipah To Get Job, MP Declares Caste-Based Result + More Top News [Indiatimes.com, 23 May 2018]


The Kerala government has announced a relief of Rs 10 lakh to the kids of Lini, a nurse who died while treating patients infected with Nipah virus.

The announcement was made by Kerala health minister KK Shailaja on Wednesday. The minister also announced to give a government job to Lini's husband Sajeesh, who now works the Middle East.

The government has also decided to provide an ex-gratia Rs 5 lakh each to the kin of those deceased due to infection from Nipah virus.

Meanwhile, the number of people seeking treatment for Nipah virus in various hospitals in the state has reached 18. Health authorities have directed to shut down all the anganwadis in four panchayats of Malappuram district where deaths due to Nipah virus have been reported.

Malappuram district also reported a suspected case of Nipah virus infection at government medical college hospital at Manjeri. Read this story in Malayalam

Kerala governor P Sathasivam on Wednesday appealed people of the state to follow the instructions of health department to stay safe from the viral infection. He also asked people not to panic over the rumours about Nipah virus.

Tense families flee Nipah fever zone amid calls not to panic [Onmanorama, 23 May 2018]

nipah-flee.jpg.image.784.410.jpg
Students wear protective masks as they visit patients with Nipah fever at the Perambra Taluk Hospital | Photo: Sajeesh P. Shankar.

Kozhikode: Over 50 families have emptied their houses at Koorachundu and Chakkittapara villages in Kozhikode district as fear of contracting the Nipah fever gripped them. Many have left their homes and have proceeded to kin's residences at distant locations as the Nipah fever have already claimed 11 lives already in Kozhikode and adjoining Malappuram district.

In Koorachundu panchayat some 22 families from wards 10, 11 and 12 have locked up homes and left. A few were seen sitting outside locked-up houses as they had no idea where to proceed.

The villagers also fear a repeat of the five dengue fever deaths that were reported in the area last year.

Chakkittapara villagers, meanwhile, are yet to come to terms with the death of nurse Lini, who had contracted the Nipah virus while attending to a family with Nipah fever. Her family has reportedly advised relatives to keep away.

Meanwhile, the health department asserted that there is no room for panic, though people have been advised to keep heightened vigil. The department and the panchayat authorities are striving to prevent the flight of families by launching an awareness drive.

The state cabinet will review the emergency situation created by Nipah fever on Wednesday. Measures to be adopted by the government to check the spread of the viral disease will be discussed.

Expert advice on Nipah Virus (NiV) [APN News, 23 May 2018]

by Dr. Ambanna Gowda

Bangalore: Experts at Fortis Hospital, Bannerghatta Road suggest measures and tips to avoid Nipah virus.

Nipah virus is a viral infection, bars and pigs are known source of infection, animal to human transmission is seen, in India and Bangladesh human to human infections are reported by CDC (centre for disease Co trip & prevention).

Symptoms:
• Clinically, fever high grade, headache, and body ache, severe form inflammation to the brain (encephalitis) are seen. 5 to 14 days is incubation period. Symptoms start in 3 to 10 days.
• Disorientation, drowsiness, breathing difficulty can occur. Rapid deterioration can also occur, may need intensive care for most of the patients with isolation care.
• Healthcare workers are affected due to the spread of infection.
• Diagnosis by viral culture (RT PCR), from throat (nasal swab).

Treatment:
・Supportive isolated
・Intensive care
・Barrier techniques for healthcare workers

Prevention:
• Avoid travel to endemic areas
• Washing hands
• Good hydration
• Immediate doctor consultation
• Govt must be proactive in implementing travel precautions
• Advisory notification at the earliest.

Nipah virus: Fruit markets hit badly; prices fall [Deccan Chronicle, 23 May 2018]

The trend is spreading into the city, and Guava and mango have entirely lost demand.

dc-Cover-j765vdssgv4mglfquatlfg47f0-20180523064401.Medi.jpg
Guava and mango have entirely lost demand in city’s fruit markets.

KOZHIKODE: Amid the Nipah scare, fruit markets at Perambra where the deadly disease first reported in the state, witnessed steady price fall. The trend is spreading into the city, and Guava and mango have entirely lost demand. Earlier mangoes were selling at Rs 70 per kg in Perambra.

"As the demand decreased, we are selling it for Rs 50, and still people are not ready to buy," says Jayaprakash V.K., a fruit dealer in Perambra. "All they ask for is fruits like pineapple and chiku." Although it's summer, juice stalls also face the similar slump in sales. They are in a dilemma and wonder whether it's out of the outbreak fear or because of fasting season.

"People drink flavoured and packed drinks," said a shop owner who preferred anonymity. "We are really panic-stricken and are not eating produces from our own land," says Devi K., a native of Perambra. "Further we are advised by health department even not to have food in plantain leaves," she told DC.

Dr Kafeel Khan Packs His Bags For Kerala to Treat Nipah Virus Victims [The Citizen, 23 May 2018]

“This is my work as a doctor”

NEW DELHI: Dr Kafeel Khan has been contacted by Kerala Chief Minister Pinarayi Vijayan to take up his offer to work for the victims of the deadly Nipah virus and is preparing to go for “as long as I am needed and the Nipah outbreak is curtailed.”

Khan has taken the decision amidst opposition from his family, with his mother reluctant to let her son leave after being in a state of uncertainty for eight months while he was in jail.

Asked about this Khan said “yes they are angry. My mother says I have got you back after so long and now you are leaving and that too to a place with this deadly disease. But I told her that I am a doctor, myt work is to treat patients, and this is my passion.”

Shortly after he spoke to The Citizen a letter written by a 31 year old nurse who died after treating a child infected with the Nipah virus went viral on the social media. Nurse Lini Puthusserry wrote to her husband saying she was not going to survive and asking him to look after her two little children, seven and two years old.

Khan who is still under suspension from the BRD Hospital where he had shot into prominence while trying to save encephalitis hit children from dying because of a shortage of oxygen supply, is still free to practice as a doctor. Asked why he had made the offer to go to Kerala he said that he had been treating encephalitis patients and saw that the symptoms were very similar with that of the new virus that is creating panic in Kerala. “I think I can help”, he said.

“ I can use my experience in treating encephalitis and as an intensive care specialist”, he said. Khan made it clear he was going alone and just till the virus was tamed.

Khan is on bail and the hearing on his case continues.He reached out to Nipah hit Kozhikode through the Facebook and initially received a positive response from the Chief Minister on FB stating, “Dr Kafeel Khan’s request to serve in the Nipah virus affected regions of Kerala has come to the attention of CM Pinarayi Vijayan. Even in the face of danger, innumerous doctors continue to toil for the benefit of society, without being mindful of their own well-being. Dr Kafeel Khan is one among them. Many medical professionals have expressed their interest to work in the Nipah affected areas of Kozhikode. The government of Kerala welcomes their service. Those who are interested to volunteer must contact the director of Health department or the Superintendent of the Government Medical College, Kozhikode.”

This has now been followed with a phone call from the CMs office firming the details. Responding to the speculation generated through sections of the media Khan made it very clear that for him this is One, a community service for which he does not want a salary;

Two he will be serving in Kerala till the Nipah outbreak;

Three, although Nipah is different, symptoms with encephalitis are similar and he feels he can use his experience for the patients;

Four, the court has not placed any restrictions on him to serve in any part of the country.

Nipah virus: Food safety advises vendors to check on source of fruits [Deccan Chronicle, 23 May 2018]

The sellers of blueberry, guava and mango were alerted on the need quality fruits and not to sell fruits the origin of which is not known.

dc-Cover-elg6lmgeb4b13hd3fcb4o9cb25-20160809132440.Medi.jpg


KOZHIKODE: The food safety department launched massive inspections in the city on Tuesday in the wake of Nipah scare. They create awareness among the public, fruit-juice stalls and wayside vendors against the deadly virus. The sellers of blueberry, guava and mango were alerted on the need quality fruits and not to sell fruits the origin of which is not known.

Food safety assistant commissioner P.K. Aleyamma said there is instruction from the food safety commissioner on launching an awareness campaign on the risk involved in consuming as well as selling fruits like Blueberry endearing for birds including bats.

"Though it is yet to be confirmed whether the origin of the disease was from bats, from the available information we have launched the campaign," she told DC. Meanwhile, the municipal corporation has convened an emergency meeting of health inspectors on Wednesday to streamline precautionary measures. Corporation standing committee chairperson (health) K.V. Baburaj told DC that the civic body had already issued directives to traders, street vendors and hoteliers on precautionary measures.

Nipah virus: Bat the villain? Don’t jump the gun, caution experts [The New Indian Express, 23 May 2018]

By Sovi Vidyadharan

ITS_NIPAH1.jpg
Image for representational purpose only.

Bats have always had a villainous persona thanks to Bram Stoker’s magnum opus ‘Dracula’.

KOZHIKODE: Bats have always had a villainous persona thanks to Bram Stoker’s magnum opus ‘Dracula’. Now, bats are being suspected of spreading the deadly Nipah virus in Kozhikode, if scientists of the National Centre for Disease Control (NCDC) are to be believed. But experts disagree with this theory on many counts. Even the Central Animal Husbandry Department has not subscribed to the NCDC theory as the spread has been very contained and no domestic animal was found to have contracted the disease.

“Had the virus been carried by bats, the magnitude of its spread would have been huge,” according to Dr R Sugathan, scientist at the Thattekkad Bird Sanctuary and one of the disciples of legendary ornithologist Dr Salim Ali. “Bats, especially fruit bats, are territorial mammals which do not go more than 50 to 100 km in search of food or nectar. The chances of infected bats in eastern India and Bangladesh coming into contact with bats here are highly improbable,” Sugathan added.

The ornithologist also ruled out the possibility of migratory birds spreading the disease from afar. “Usually, birds migrate when there is acute shortage of food in their habitat. And this happens mostly in the October to March season. Moreover, this strain of virus has not been detected in any sort of migratory birds yet,” Sugathan added.Going by the limited spread of the disease, it could be a case of contracting the disease initially through consumption of fruits or date syrups, which have been brought from other states or abroad, and possibly infected by the virus, believe experts.

Nipah virus claims 10 lives, Kerala Health Minister KK Shailaja visits hospital in Kozhikode

“If we examine the people who have contracted the disease, all of them have come into some type of close contact with each other. Had it been a bat-related infection, it would have had a wider spread and cases would have been unrelated,” said a virologist. Meanwhile, the authorities’ action of trapping bats from a well and sending samples collected from them for testing has received the flak from experts. According to Nameer P O, Professor and Head of the Department of Wildlife Science at College of Forestry, Thrissur, such actions are futile as only insect bats inhabit wells. “Insects bats have been roosting in many of the wells in the area for long. Until now Nipah virus has been identified only in fruit bats,” he added.

Workers refuse to cremate bodies of Nipah victims, govt steps in to sensitise [The News Minute, 23 May 2018]

by Sreedevi Jayarajan
Local newspapers reported incidents of crematorium workers and ambulance drivers refusing to handle Nipah victims for they were scared of the virus spreading.

Nipah_virus_22_5_1_750.jpg

Following reported incidents of crematorium workers refusing to cremate victims of Nipah virus, the district authorities in Kozhikode have been on a mission to dispel misconceptions about spreading of the virus.

Earlier, local newspapers had reported that crematorium workers on Mavoor Road refused to burn the bodies of two Nipah virus victims, Rajan of Vattachira and Ashokan, fearing contraction. The cremation was delayed by over 7 hours, finally taking place at 5pm on Tuesday after special team from Ivar Madam arrived from Palakkad. The kin of the deceased lodged a complaint with the corporation over the workers' refusal to cremate the body.

"The issue happened as the blower of the electric crematorium was not functioning properly.

Therefore a traditional crematorium was planned. Now, the issue has been fixed and no such hassles will take place," the Public Relation Office in Kozhikode confirmed to TNM.

Officers in the control room tasked with dispelling misconceptions and providing correct and timely information to the public also reaffirmed that with the right protective gear, handling victims of Nipah virus will not pose a threat to the staff, drivers or workers.

"All hospital staff and crematorium workers have been given gloves and masks to protect themselves. Such incident of non-cooperation only happens due to misconceptions about Nipah spreading. This natural creates fear among people. Technical measures have been taken to prevent transmission based on advice given by health experts," said the officers at the control room.

All doctors and nurses treating suspected or confirmed nipah victims are given protective coats apart from gloves and masks.

"Sanitizers and other cleansing liquids are placed everywhere. Victims are immediately moved to isolation wards in the hospitals after which there is hardly any human interaction. No deaf has been recorded since Tuesday. Those patients who have passed away are also immediately cremated in the district crematorium. Even family members are discouraged from attending cremation," said the official at the PRO.

Reports also stated that ambulance drivers were refusing to transport victims of Nipah. To tackle this, the government has allotted special ambulances in Perambra and Nadapuram districts in Kozhikode. These ambulances will only carry Nipah affected patients or those showing symptoms of the virus.

"Under the directive of the State government, all hospitals have set up isolation wards. Most of the patients are being treated in Kozhikode Medical College. Some are admitted to Baby Memorial Hospital and MIMS Calicut. All hospitals are equipped to take in Nipah patients,"

The authorities also confirmed that no random outbreak has happened and the situation is mostly calm now.

"Most of those admitted with symptoms were associated with the family in Perambra who contracted the virus initially. Even in the case from Malappuram, the patient had visited the hospital where they were being treated," the PRO said.

Authorities also confirmed that the government is contemplating other, more effective ways of disposing bodies of Nipah victims. However, decision is yet to be taken in this regard.

Panic as bat-borne virus kills 10, infects at least 13 more [CBS News, 23 May 2018]

Well.jpg
Animal Husbandry department and Forest officials inspect a well to to catch bats at Changaroth in Kozhikode in the Indian state of Kerala, May 21, 2018. GETTY

By ARSHAD R. ZARGAR

NEW DELHI -- An outbreak of a deadly virus that attacks the brain has killed at least 10 people in the southern Indian state of Kerala. Nipah virus, or NiV, has infected 13 other people, two of whom were in critical condition in hospital on Wednesday. Dozens of others were under surveillance.

Almost 100 people have been quarantined inside their homes in the state, which is a popular tourist destination.

Nipah is a highly infectious virus carried by fruit bats that causes inflammation of the brain in humans. The symptoms include fever and headaches, followed by drowsiness and confusion, leading to possible coma and death within a week. There is no cure known yet, and patients are only given supportive care. The virus is spread by infected bats, pigs or humans.

Eight of the dead are from Kerala's Kozhikode district, the hub of the outbreak, where multiple members of one family were the first to be infected. Two brothers from the family died on May 5 and their father is also infected and being treated in hospital. A female relative who was with them in hospital also died later.

india-nipah-960949218.jpg
Animal Husbandry department and Forest officials deposit a bat into a container after catching it inside a well at Changaroth in Kozhikode in the Indian state of Kerala on May 21, 2018. GETTY

While the cause of the outbreak is still being investigated, a team of health experts who visited the family's house have linked it to dead bats found in the home's water well. Authorities have sealed the well and sent the bat blood samples for medical tests. The report is expected on Friday.

With panic setting in, several families in Kozhikode district have evacuated their homes in the last four days, some Indian media reports said. Two people have died in the neighboring district of Mallapuram.

"There is no need to panic. All cases are linked to the one family in Kozhikode -- those who came in contact with them," Rajeev Sadanandan, Additional Chief Secretary, Health and Family Welfare Department in Kerala, told CBS News.

One of the 10 victims was a nurse who died on Monday after treating a Nipah patient in hospital. Lini Puthussery, 31, whose "selfless service" is being hailed as "heroic" left a note for her husband before dying.

"I am almost on my way. I don't think I will be able to see you. Sorry. Take care of our children properly… Lots of love," she wrote. Her body was cremated soon after her death over fears the virus could spread; her family wasn't able to see her.

india-nipah-960924748.jpg
Medical personnel wearing protective suits check patients at the Medical College hospital in Kozhikode, Kerala state, India, May 21, 2018 amid a deadly outbreak of the Nipah virus, carried mainly by fruit bats. GETTY

Government authorities have put Kerala state on high alert. Two "control rooms" in the worst-hit Kozhikode district have been set up to closely monitor the spread of the virus. Experts from the New Delhi-based National Centre for Disease Control (NCDC) and a top hospital have been sent to the state to try and contain the outbreak.

On Tuesday, Kerala Health Minister KK Shylaja said no new cases had been detected in 24 hours.

India's national Health Minister, J. P. Nadda, wrote on Twitter on Wednesday that he had instructed officials, "to leave no stone unturned in terms of proactively countering the Nipah virus threat."

A state government statement said "travelling to any part of Kerala is safe. However if travellers wish to be extra conscious, they may avoid Kozhikode, Malappuram, Wayanad, and Kannur districts."

There had been no travel advisories issued Wednesday morning by the Indian central government or the U.S. Embassy in New Delhi.

Nipah has killed more than 260 people in Malaysia, Bangladesh and India in outbreaks since 1998. The World Health Organization (WHO) describes Nipah infection as a "newly emerging zoonosis that causes severe disease in both animals and humans."

In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented, including in a hospital setting in India, the WHO says.

Nipah virus: What you need to know [CNN, 23 May 2018]

By Susan Scutti

160822121654-bat-cave-researchers-2-exlarge-169.jpg
Photos: Virus hunters search for the next deadly disease outbreak
two researchers carefully descend into Grootboom cave, located just miles away from the densely populated city of Johannesburg in South Africa.

160822121232-bat-close-up-exlarge-169.jpg
Photos: Virus hunters search for the next deadly disease outbreak There are 1,240 species of bats worldwide, which may explain why many viruses can be found inside them.

160822141058-virus-hunters-in-grootroom-cave-exlarge-169.jpg
Photos: Virus hunters search for the next deadly disease
The researchers from the University of Pretoria and the Center for Disease Control and Prevention (CDC) are tracking animals all around the world to create an early-warning system for diseases that affect humans. Here, they hunt for bats inside Grootboom cave.

160822121454-bat-cave-researchers-exlarge-169.jpg
Photos: Virus hunters search for the next deadly disease
The cave is inhabited by thousands of bats, any of which could be carrying deadly diseases such as Ebola, Marburg or rabies.

160822145236-screenign-bats-exlarge-169.jpg


(CNN)A little-known virus causing deaths in a southern Indian state has become a global cause for concern seemingly overnight.

Nipah virus has killed as many as three-quarters of patients during previous outbreaks. It is a zoonotic virus, meaning it is transmitted from animals to humans.

Nipah is also considered an "emerging" virus because its discovery occurred relatively recently: in the past two decades. Though there have been only a few outbreaks, Nipah is considered a public health threat because it can infect a wide range of animals while leading to severe disease and death in people, according to the World Health Organization.

Infection with Nipah virus can cause no symptoms, or it can cause fatal encephalitis (inflammation of the brain), with a range of possible illnesses between those two extremes.

The natural host is a particular family of bats, Pteropodidae, which can spread severe disease to farm animals including pigs, resulting in substantial economic losses.

The name comes from Sungai Nipah, a village in the Malaysian peninsula where the virus was identified after farmers became sick in 1998 and 1999.

How is it transmitted?

In past outbreaks, human infections are believed to have resulted from direct contact with sick pigs, including throat and nasal secretions or contaminated tissues, according to the US Centers for Disease Control and Prevention.

Eating fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats is also believed to have caused human infections.

Nipah virus can also spread directly from person to person, with family members or medical staff most at risk since transmission requires very close contact with the ill or deceased.

What are the signs of illness?

Between four and 14 days may elapse between the infection and a patient's first symptoms.

However, a 45-day incubation period has been reported, according to WHO.

Commonly, once infected, a person develops flu-like symptoms of fever, headaches, muscle pain, vomiting and sore throat. Sometimes, this is followed by dizziness, drowsiness, altered consciousness and signs of encephalitis. Some patients will develop severe respiratory problems, including pneumonia or acute respiratory distress that would require mechanical assistance to breathe.

In the most severe cases, encephalitis and seizures will progress to coma within 24 to 48 hours.

How deadly is it?

Scientists estimate the fatality rate at 40% to 75%, varying by outbreak. Most people who survive acute encephalitis brought on by Nipah virus make a full recovery, but some former patients report long-term neurologic conditions. About 20% of patients are left with seizure disorder and personality changes, while a small number relapse.

How is it treated?

There are no drugs or vaccines to specifically treat or prevent Nipah virus infection.

Supportive care is the recommended treatment, so health care workers and caretakers do their best to provide symptom relief, such as trying to bring down a fever by cooling a patient.

Where is it?

Outbreaks have occurred in Malaysia, Singapore, Bangladesh and India.

Patients are believed to have either had contact with animals, consumed raw date palm juice or had contact with infected people. Other regions and countries that are home to the related species of bat may also be at risk for Nipah virus infections, including Cambodia, Thailand, Indonesia, Madagascar, Ghana and the Philippines, according to WHO.

How common is it?

Nipah virus is very rare. From 1998 to 2015, WHO reported more than 600 cases, with subsequent high-fatality outbreaks occurring in India and Bangladesh, though the total number of people affected remains unknown.

The economics of epidemics and why prevention matters [BusinessLine, 23 May 2018]

by JINOY JOSE P

BL24THINKNIPAH.jpg


Is this about Nipah?

Yes, and more. Epidemics like Nipah, bird flu or Ebola time and again dent economies while causing serious damage to human lives. Take Nipah for example.
The zoonotic (spread from animal to human) virus claimed more than 100 lives and over a million pigs were culled following the virus outbreak in 1998-99 in Malaysia.

Oh!

According to a paper — ‘Economic Impact of Nipah Virus Infection Outbreak in Malaysia’ — by scholars from Obihiro University of Agriculture and Veterinary Medicine and National Institute of Animal Health in Malaysia, the country’s hog industry was badly hit after the outbreak.
In fact, pigs were the major livestock export from Malaysia to Singapore, where domestic pig production was banned in the 1990s. After Nipah, pork consumption dropped by about 30 per cent.

That’s a big blow!

Indeed. When the Severe Acute Respiratory Syndrome or SARS hit China in the early 2000s, JP Morgan, among many financial organisations, cut growth forecasts for Asian economies and said China’s economy would shrink in the first half of 2003 and grow by only 1.6 per cent in the year, from an expected 3.2 per cent. SARS lasted about seven months and during this period travellers cut back on flying. The damage to the airline industry alone was telling: Asia-Pacific airlines lost $6 billion in revenues and North American carriers, $1 billion.

Ouch!

Also, it takes a long time to recoup these losses and obviously this leads to job losses and dramatic fall in income levels of workers and other vulnerable communities. In a working paper, ‘Epidemics and Economics’, two scholars from Harvard School of Public Health — David E Bloom and David Canning — discuss the links between income and epidemics and argue that a more highly interconnected world may actually promote the occurrence of infectious disease epidemics.

That’s a flip side of globalisation.

In a way. But the Harvard scholars say that epidemics are most likely to arise and persist under conditions commonly created by poverty. Remember Charles Dickens’ graphic descriptions of overcrowded and poorly ventilated houses of the poor? He details how those conditions helped spread TB. The scholars, interestingly, say that more than anything else it is wealth that enables people to safeguard themselves against or mitigate the effects of risk from epidemics. “The links between epidemics and economics are broadly similar to those between health and wealth in general,” they note.

So poor socio-economic conditions play a big role, right?

Yes. Take the recent Nipah outbreak in Kerala. Even though over 10 people have died of the virus attack as we speak, many healthcare experts say that the spread of the virus was limited because of the better socio-economic conditions in Kerala and the high levels of awareness in the State.

Yes, one shudders to think of the Ebola effect in Africa!

An interesting study from the World Bank — ‘The Economic Impact of Ebola on Sub-Saharan Africa’ — in 2015 points out that Ebola, which began in Guinea in December 2013 and spread to Liberia and Sierra Leone, pulled down the GDPs of these African countries by several notches.

And later estimates suggest that the forecasts were almost realistic. That said, there is an interesting argument that countries and economies that are hit by such calamities tend to fight back faster.

Economists Elizabeth Brainerd and Mark Siegler some years ago looked at the 1918 flu epidemic, which claimed 40 million lives worldwide, and found that in America, where 675,000 people died of the flu, growth of income per head between 1919 and 1930 was high in States that were hit the most. So, in sum, every night has a dawn.

A weekly column that helps you ask the right questions
nice!(0)  コメント(0) 

MERS-CoV News update in 2016



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia [World Health Organization, 19 Dec 2016]


Between 6 and 13 December 2016 the National IHR Focal Point of Saudi Arabia reported ten (10) additional cases of Middle East Respiratory Syndrome (MERS) including two (2) fatal cases. Three (3) deaths among previously reported MERS cases were also reported.

Details of the cases

1. A 72-year-old male national living in Taif city, Taif Region. He developed symptoms on 9 December and was admitted to hospital on 10 December. The patient who has comorbidities, tested positive for MERS-CoV on 12 December. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation. The Ministry of Agriculture has been informed and investigation of camels is ongoing.

2. A 64-year-old female national living in Buridah city, Qassim Region. She developed symptoms on 3 December and was admitted to hospital on 9 December. The patient who has comorbidities, tested positive for MERS-CoV on 10 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU on mechanical ventilation.

3. A 59-year-old male national living in Mahayl Assir city, Assir Region. He developed symptoms on 28 November and was admitted to hospital on 8 December. The patient who has no comorbidities, tested positive for MERS-CoV on 10 December. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward. The Ministry of Agriculture has been informed and investigation of camels is ongoing.

4. A 60-year-old male national living in Mahayl Assir city, Assir Region. He developed symptoms on 28 November and was admitted to hospital on 4 December. The patient who has comorbidities, tested positive for MERS-CoV on 6 December. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms .The patient was in critical condition admitted to ICU on mechanical ventilation. He passed away on 6 December. The Ministry of Agriculture has been informed and investigation of camels is ongoing.

5. A 49-year-old male non-national living in Jeddah city, Jeddah Region. He developed on 30 November and was admitted to hospital on 6 December. The patient who has no comorbidities, tested positive for MERS-CoV on 7 December. The patient has no comorbid conditions. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

6. A 53-year-old male non-national living in Riyadh city, Riyadh Region. He developed symptoms on 4 December and was admitted to hospital on 7 December. The patient who has no comorbidities, tested positive on 8 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU on mechanical ventilation.

7. A 56-year-old male national living in Riyadh city, Riyadh Region. He developed symptoms on 3 December and was admitted to hospital on 6 December. The patient who has comorbidities, tested positive for MERS-CoV on 7 December. Investigation of history of exposure to the known risk factors is ongoing. The patient was in stable condition admitted to a negative pressure isolation room on a ward. His conditions deteriorated and he passed away on 10 December.

8. A 24-year-old male national living in Hofouf city, Al Ahssa Region. He developed symptoms on 24 November and was admitted to hospital on 3 December. The patient who has no comorbidities, tested positive for MERS-CoV on 5 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

9. A 78-year-old male national living in Riyadh city, Riyadh Region. He developed symptoms on 27 November and was admitted to hospital on 3 December. The patient who has comorbidities, tested positive for MERS-CoV on 5 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

10. A 58-year-old male national living in Afif city, Riyadh Region. He developed symptoms on 3
December and was admitted to hospital on 4 December. The patient who has no comorbidities, tested positive for MERS-CoV on 5 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

Contact tracing of household and healthcare contacts is ongoing for these cases.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the deaths of 3 MERS-CoV cases that were reported in a previous DON published on 19 December 2016 (case numbers 4, 5, and 9).

Globally, since September 2012, WHO has been notified of 1864 laboratory-confirmed cases of infection with MERS-CoV including at least 659 related deaths.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 Saudi Arabia reports more MERS cases; WHO updates risk assessment [CIDRAP News, 12 Dec 2016]

by Lisa Schnirring, News Editor,

Saudi Arabia's ministry of health (MOH) reported two new MERS-CoV cases over the weekend, and the World Health Organization (WHO) issued an updated risk assessment for the virus, its first since July 2015, noting that experts are still deeply concerned about continuing healthcare spread, though the outbreaks are smaller and stopped relatively quickly.

In other Middle East respiratory syndrome coronavirus (MERS-CoV) developments, South Korean researchers recently published their analysis of transmission patterns during the country's large hospital outbreak, which showed a connection between super-spreading events, doctor shopping, and emergency department visits.

MERS sickens two more Saudis

One of the new cases involves a 59-year-old Saudi man from Mahayel Aseer, located in the southwestern corner of the country, who became ill after direct contact with camels, the MOH said on Dec 10. The man is listed in stable condition.

The other newly reported patient is a 64-year-old Saudi woman from the central Saudi Arabian city of Buraidah who had primary exposure to MERS-CoV, meaning she probably didn't contract the virus from another patient. The woman is hospitalized in critical condition.

Also in disease updates over the weekend the MOH announced three more deaths in previously announced cases. All are middle-age to older adults who had pre-existing health conditions.

The developments boost Saudi Arabia's total from MERS-CoV to 1,506 cases, 625 of them fatal.

WHO: hospital outbreaks more frequent but smaller

The WHO said since its last MERS-CoV risk assessment in July 2015 that only one new country—Bahrain—has reported a case. Over the 17-month time period, 473 new illnesses were reported to the WHO, most of them from Saudi Arabia. These recent cases have largely been associated with transmission in healthcare settings, and camel exposure.

Overall, the epidemiology and transmission patterns haven't changed, with repeated spillovers from camels to people, with men older than 60 with underlying health conditions at the greatest risk for illnesses and severe disease. Experts noted improvements in the investigation of community-acquired cases, which has included testing camel herds near where human infections were found.

Since the last risk assessment, hospital-related outbreaks have become more frequent, but are generally smaller in size and sometimes involve several hospitals, according to the report. Healthcare-related outbreaks been reported in several Saudi Arabian cities, including Riyadh and Medina, which seem to have been stopped quickly with the implementation of infection prevention and control steps. The group noted that one such recent outbreak occurred in Riyadh in June, in which most cases were asymptomatic and identified through rapid contact tracing of healthcare and household contacts.

Such outbreaks aren't unexpected, but they are worrisome, because MERS-CoV is still a relatively rare disease that medical teams may not recognize, the group wrote. Early cases in healthcare setting can sometimes trigger large numbers of secondary cases among healthcare workers and patients. They said it's still not clear what exposures fuel transmission in health settings or what the role of environmental contamination may play.

They warned that until more is known about the mode of transmission and risk factors for infection, zoonotic cases that spark limited household transmission and possibly significant hospital-linked outbreaks are likely to continue, requiring consistent use of infection prevention and control steps.

South Korean hospital spread analysis

In research developments, South Korean scientists who studied the characteristics of people who transmitted MERS-CoV during a large hospital outbreak in 2015 found that of 186 cases, only 22 people passed the virus to other people. Five super-spreading events led to 150 illnesses. The team published its analysis on Dec 10 in an early online edition of Clinical Infectious Diseases.

Compared to nonspreaders, spreaders had higher host infectivity, along with wider and prolonged contacts. Super spreading events were marked by a larger number of contacts—approximately 10-fold higher—and a pre-isolation emergency department visit.

Doctor -shopping, thought to play a unique role in the rapid expansion of South Korea's outbreak, seems to create conditions suitable for super spreading events, with investigators noting that four of five patients identified as super spreaders transmitted the infection at two or more hospitals. "Therefore, strict ER triage and minimizing doctor-shopping during an outbreak’s early stage may help prevent super-spreading events," they wrote.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Oman [World Health Organization, 8 Dec 2016]


On 29 November 2016, the National IHR Focal Point of Oman reported one (1) additional case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

Details of the case

A 67-year-old male from Dakhlia Governorate developed symptoms on 18 November 2016, and was admitted to hospital on 20 November. The patient who has comorbidities, tested positive for MERS-CoV on 29 November. He has a history of exposure to animals (camels, goats and cows) in the 14 days prior to the onset of symptoms. The patient is in stable condition and was discharged from hospital. Contact tracing of household contacts is ongoing for the case. Investigation of camels is also ongoing.

Globally, since September 2012, WHO has been notified of 1842 laboratory-confirmed cases of infection with MERS-CoV, including at least 652 related deaths.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 Saudi officials announce 4 new MERS cases [CIDRAP News , Dec 5 2016]

by Lisa Schnirring, News Editor

prophets_mosque_medina-shabbir_siraj_2.jpg
Shabbir Siraj / Flickr cc
Prophet's Mosque in Medina, a city that has had 2 new MERS cases.

Saudi Arabia's Ministry of Health (MOH) reported four new MERS-CoV cases in the past 3 days, including two from the holy city Medina, as the World Health Organization (WHO) today fleshed out more details about nine of the country's recently reported cases, four of which had a history of contact with camels or raw camel milk.

The new cases are part of a small but steady stream of cases from the country in which MERS-CoV (Middle East respiratory syndrome coronavirus) was first detected 4 years ago.

One of 4 new cases involved camel contact

All of the newly reported MERS cases involve men. On Dec 2 the MOH announced two cases, those of a 62-year-old Saudi from Sakaka in the northwestern part of the country and a 73-year-old Saudi from Medina, located in west central Saudi Arabia. Both of the patients are listed in stable condition and had primary sources of infection, meaning investigators found they weren't likely exposed to another sick patient.

Yesterday the MOH reported that the virus sickened a 45-year-old foreign man in Riyadh. The man isn't a healthcare worker and is hospitalized in critical condition. Health officials also announced the death of a previously announced patient, a 68-year-old Saudi man from Al Kharj who had underlying health conditions.

The case reported today involves an 85-year-old Saudi man in Medina who had direct contact with camels before he got sick. He is hospitalized in critical condition. The MOH also announced the death of another previously reported patient, a 56-year-old Saudi man from Hafar Al Batin in the east central part of Saudi Arabia who had preexisting health conditions.

The 4 new illnesses lift Saudi Arabia's MERS-CoV total to 1,498, and the 2 latest deaths push the fatality count from the disease to 620. Fifteen patients are still being treated for their infections.

WHO report covers 9 recent cases

Meanwhile, the WHO shared more epidemiologic details about nine MERS-CoV reports submitted by Saudi Arabia between Nov 12 and Nov 27. Four of the patients had contact with camels or drank raw camel milk, two known sources of virus exposure. Investigators are still trying to pin down exposure sources for the other five patients.

Six of the cases involved men, and their ages range from 29 to 59. Illness onsets range from
Nov 2 to Nov 18. Aside from two cases from Hafar Al Batin, the patients hail from different cities. All but one of the individuals is a Saudi citizen. The expat is a 53-year-old man living in Buqayq who is hospitalized in stable condition.

The other patients are from Najran, Arar, Az Zulfi, Al Aflaj, Afif, and Tabuk. For the four patients who had a history of contact with camels or had consumed camel milk, health officials informed the agriculture ministry, which conducts follow-up investigation on the camels.

One of the patients died, a 59-year-old woman from Najran. She had been in critical condition in the intensive care unit, where she was placed on a ventilator. One of the patients is hospitalized in critical condition, and seven are listed in stable condition.

The WHO said health officials are still tracing the patients' household and healthcare contacts.

Since 2012 when MERS-CoV was first detected in humans the WHO has received reports of 1,841 cases, at least 652 of them fatal. By far the largest portion of them are from Saudi Arabia.



 MERS infects 3 more in Saudi Arabia [CIDRAP News, Nov 29, 2016]

by Lisa Schnirring, News Editor

camel_closeup-jon_connell.jpg
Jon Connell / Flickr cc

Today Saudi Arabia's health ministry reported three new MERS-CoV infections in men who hail from different parts of the country, as the World Health Organization (WHO) provided more details on six cases reported earlier this month, two of whom had been exposed to camels or camel milk.

New cases from 3 different cities
In its daily update today, the Ministry of Health (MOH) said the patients are all Saudi citizens who have symptoms, including a 50-year-old from Riyadh who is in critical condition, a 78-year-old from Rejal Alma in the southwestern corner of the country who is also listed as critical, and a 59-year-old from Yanbua near the western border who is in stable condition.

None of the men are healthcare workers and all had primary sources of infection, meaning they likely weren't exposed to another patient infected with Middle East respiratory syndrome coronavirus (MERS-CoV).

The new cases lift Saudi Arabia's overall total number of cases to 1,491, which includes 618 deaths. Eleven people are still being treated for their illnesses.

WHO fleshes out six recent cases

In a related development, the WHO yesterday revealed more epidemiological information about six cases reported by Saudi Arabia between Nov 3 and Nov 10, and also noted two deaths in cases covered in other recent updates.

Camel contact and consumption of raw camel milk, known MERS-CoV risk factors, were noted for two of the patients, a 53-year-old man from Alkharj and a 52-year-old man from the city of Bahrah in Makkah region. The MOH said it has notified the agriculture ministry about the camel connections and investigations are underway.

For four of the cases, authorities still don't know how the patients contracted the virus.
Illness onsets range from Oct 26 to Nov 2. Six of the patients are men, ages 52 to 94, and one of the cases involves a 58-year-old woman. Four patients are hospitalized in critical condition, and two are listed as stable.

Two patients are from Alkharj, but there is no indication of a connection between the two. Two are from Buraidah, without an apparent connection. The other patients are from Najran and Bahrah.

Tracing of household and healthcare contacts is still ongoing for the six cases, the WHO said.

Saudi Arabia also reported two more deaths from MERS-CoV, patients whose illnesses were detailed in the WHO's Nov 11 update on the disease. They include a 41-year-old Saudi man from Buraidah and 72-year-old man from Riyadh, both of whom had underlying health conditions and had been hospitalized in critical condition.

Since September 2012 when the first human MERS-CoV illnesses were detected the WHO has received 1,832 reports of lab-confirmed cases, most of them from Saudi Arabia. So far at least 651 deaths have been linked to the virus'



 WHO details recent Saudi hospital MERS cluster [CIDRAP News, Nov 11, 2016]

by Lisa Schnirring, News Editor

hospitalventilator.jpg
sudok1/ iStock

The World Health Organization (WHO) today fleshed out details of a MERS-CoV outbreak at a hospital in Hofuf, a cluster that included four cases plus an ambulance driver who took the index patient to the hospital.

The data on the hospital outbreak is part of a report on 13 Middle East respiratory syndrome coronavirus (MERS-CoV) cases, 4 of them fatal, reported from the country between Oct 15 and Oct 29.

MERS-CoV is known to spread easily in hospital settings, where the virus has been responsible for several outbreaks, some of them large.

Health worker, patients among hospital cluster
The index patient is thought to be a 73-year-old Saudi man from Hofuf who started having symptoms on Oct 10 and was admitted to the hospital in stable condition 3 days later. He had a history of contact with camels and he consumed raw camel milk. His condition deteriorated and he died on Oct 18.

His ambulance driver, who had driven the patient to the hospital before the man's MERS-CoV infection was detected, is a 40-year-old man who got sick on Oct 19 and was hospitalized the following day. He is currently in stable condition in home isolation.

The other three patients in the hospital cluster are a 33-year-old female health worker who took care of the index patient and two patients who were already hospitalized for unrelated conditions. The healthcare worker's asymptomatic infection was identified during contact tracing, and she is in stable condition in home isolation.

One of the patients infected during their hospital stays is a 61-year-old Saudi man who was admitted to the hospital for catheterization the same day as the index patient and came down with symptoms 6 days later. An investigation into the epidemiological links with other MERS-CoV cases is underway, and the man is listed in stable condition.

The other patient who contacted the virus in the hospital is a 55-year-old foreign man who was admitted to the outbreak hospital on Oct 2 after having a heart attack. He started having MERS-CoV symptoms on Oct 20 while still hospitalized. He had been in critical condition when he died on Oct 22. Officials are still probing the links he had to other MERS-CoV cases.

Other cases include pair of household contacts
Of the other eight cases detailed in the WHO report, two involved contact with camels or consumption of raw camel milk, while exposure to the virus is still under investigation for five.

For all the cases with a camel connection, health officials notified the agriculture ministry, and investigations in the animals are underway.

Two of the cases are a household cluster, involving a 58-year-old foreign man who got sick while working in Arar and his 65-year-old male household contact whose symptomatic MERS-CoV infection was found during contact tracing. The younger man had underlying health conditions and died of his infection, and his household contact is hospitalized in stable condition.

The other six patients include a 41-year-old man from Buraidah who is in critical condition, a 46-year-old man from Hofuf who is in stable condition, a 72-year-old woman from Najran who is in stable condition, a 53-year-old man from Abha who died, a 47-year-old man from Buraidah who is in stable condition, and a 72-year-old man from Riyadh who is in critical condition and on a ventilator.

Since September 2012, when the virus was first detected in humans, the WHO has received 1,826 reports of MERS-CoV cases, including at least 649 deaths. Most of the cases are from Saudi Arabia, where a small but steady stream of infections is still occurring.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia [WHO Disease outbreak news, Nov 11, 2016]

Between 15 and 29 October 2016 the National IHR Focal Point of Saudi Arabia reported thirteen (13) additional cases of Middle East Respiratory Syndrome (MERS) including four (4) fatal cases.

A MERS outbreak has affected a hospital in Hofouf city, Al Ahssa Region. Four (4) cases are associated with this hospital outbreak. These cases are:

• A 73-year-old male reported to WHO on 15 October (believed to be the index case, see case number 13 below).

• A 33-year-old female reported to WHO on 17 October (see case number 12 below).

• A 61-year-old male reported to WHO on 21 October (see case number 7 below).

• A 55-year-old male reported to WHO on 23 October (see case number 4 below).

One additional case is also associated with the index case but not with the hospital outbreak. This case is a 40-year-old male reported to WHO on 21 October (ambulance driver who transferred the index case before he was identified as a MERS case and isolated, see case number 6 below).

A Rapid Response Team was dispatched and extensive contact tracing was initiated. A total of 27 healthcare contacts and 14 patients in the hospital were traced. Elective admissions have been suspended at the center, and necessary prevention and control measures put in place.
Details of the cases

• A 41-year-old male national living in Buridah city, Qassim Region. He developed symptoms on 12 October and was admitted to hospital on 27 October. The patient who has comorbidities tested positive for MERS-CoV on 28 October. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation.

• A 65-year-old male non-national living in Arar city, Northern border Region. He developed symptoms on 24 October and was admitted to hospital on 25 October. The patient who has no comorbidities, tested positive for MERS-CoV on 26 October. He is one of the household contacts of the 58-year-old MERS case reported to WHO on 23 October (see case number 5 below) and was identified through tracing contacts. Currently the patient is in stable condition admitted to a negative pressure room on a ward.

• A 46-year-old male non-national living in Hofouf city, Al Ahssa Region. He developed symptoms on 18 October and was admitted to hospital on 22 October. The patient who has comorbidities, tested positive for MERS-CoV on 23 October. He had a history of contact with camels and their raw meat in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure room on a ward. Ministry of Agriculture was informed and investigation of camels is ongoing.

• A 55-year-old male non-national works living in Hofouf city, Al Ahssa Region. He was admitted to the hospital, currently affected by the MERS outbreak, due to myocardial infarction on 2 October. On 20 October, while hospitalized, he developed symptoms and tested positive for MERS-CoV on 22 October. Investigation of possible epidemiological link with the MERS cases detected in the same hospital is ongoing. The patient was in critical condition admitted to ICU. He passed away on 22 October.

• A 58-year-old male non-national works living in Arar city, Northern border Region. He developed symptoms on 14 October and was admitted to hospital on 20 October. The patient who has comorbidities tested positive for MERS-CoV on 22 October. Investigation of history of exposure to the known risk factors is ongoing. The patient was in critical condition admitted to ICU but not on mechanical ventilation. He passed away on 27 October.

• A 40-year-old male national living in Uaryarah city, Eastern Region. He developed symptoms on 19 October and was admitted to hospital on 20 October. The patient who has no comorbidities tested positive for MERS-CoV on 21 October. On 13 October, he transported the 73-year-old MERS case reported to WHO on 15 October (see case number 13 below) by an ambulance to the hospital, currently affected by the MERS outbreak before the case was identified and isolated. Currently the patient is in stable condition in home isolation.

• A 61-year-old male national living in Hofouf city, Al Ahssa Region. He was admitted to the hospital currently affected by the MERS outbreak on 13 October for catheterization. On 14 October, he developed symptoms while hospitalized. The patient tested positive for MERS-CoV on 20 October. Investigation of possible epidemiological link with the MERS cases hospitalized in the same hospital is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

• A 72-year-old female national living in Najran city, Najran Region. She developed symptoms on 13 October and was admitted to hospital on 16 October. The patient who has comorbidities tested positive for MERS-CoV on 20 October. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.

• A 53-year-old male national living in Abha city, Assir Region. He developed symptoms on 9 October and was admitted to hospital on 19 October. The patient who has comorbidities tested positive for MERS-CoV on 20 October. Investigation of history of exposure to the known risk factors is ongoing. The patient was in critical condition admitted to ICU but not on mechanical ventilation. He passed away on 22 October.

• A 47-year-old male non-national living in Buridah city, Qassim Region. He developed symptoms on 10 October and was admitted to hospital on 15 October. The patient who has no comorbidities tested positive for MERS-CoV on 17 October. He has a history of contact with camels and consumption of their raw milk in the two weeks prior the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward. Ministry of Agriculture was informed and investigation of camels is ongoing.

• A 72-year-old male national living in Riyadh city, Riyadh Region. He developed symptoms on 13 October and was admitted to hospital on 17 October. The patient who has comorbidities tested positive for MERS-CoV on 17 October. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU on mechanical ventilation.

• A 33-year-old female non-national in the hospital, currently affected by the MERS outbreak and living in Hofouf city, Al Ahssa Region. She is asymptomatic but identified through tracing contacts of the 73-year-old male MERS case reported to WHO on 15 October (see case number 13 below). The patient who has no comorbidities tested positive for MERS-CoV on 15 October. Currently she is in stable condition in home isolation.

• A 73-year-old male national living in Hofouf city, Al Ahssa Region. He developed symptoms on 10 October and was admitted to the hospital, currently affected by the MERS outbreak on 13 October. The patient who has comorbidities tested positive for MERS-CoV on 14 October.

He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. The patient was in stable condition admitted to a negative pressure isolation room on a ward but his conditions deteriorated and he passed away on 18 October.

Ministry of Agriculture was informed and their investigation is ongoing.

Contact tracing of household and healthcare contacts is ongoing for these cases.

Globally, since September 2012, WHO has been notified of 1826 laboratory-confirmed cases of infection with MERS-CoV including at least 649 related deaths have been reported to WHO.

WHO risk assessment
The current health care associated cases reported are not changing the overall risk assessment but are underlying the need for continued surveillance and application of Infection prevention and control measures.

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 MERS in Saudi Arabia: WHO update [Outbreak News Today, Nov 1, 2016]


The World Health Organization (WHO) published the following update on the Middle East Respiratory Syndrome (MERS) situation in Saudi Arabia:

Between 16 September and 10 October 2016 the National IHR Focal Point of Saudi Arabia seven (7) additional cases of Middle East Respiratory Syndrome (MERS) including one (1) fatal case.

Untitled8.png
Image/CIA

Details of the cases

• A 28-year-old male non-national living in Hail city, Hail Region. He developed symptoms on 5 October and was admitted to hospital on 8 October. The patient who has no comorbidities, tested positive for MERS-CoV on 9 October. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently the patient is in stable condition admitted to a negative pressure room on a ward.

• A 51-year-old female national living in Alkharj city, Riyadh Region. She developed symptoms on 22 September and was admitted to hospital on 27 September. The patient who has comorbidities, tested positive for MERS-CoV on 29 September. She has a history of contact with camels in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure room on a ward. Ministry of Agriculture has been informed and investigation of camels is ongoing.

• A 52-year-old male national living in Wadi Ad-Dwaser city, Riyadh Region. He developed symptoms on 12 September and was admitted to hospital on 19 September. The patient who has comorbidities, tested positive for MERS-CoV on 22 September. Investigation of history of exposure to the known risk factors in the 14 days prior to onset of symptoms is ongoing. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation.

• A 43-year-old male non-national living in Riyadh city, Riyadh Region. He developed symptoms on 15 September and was admitted to hospital on 22 September. He tested positive for MERS-CoV on the same day. The patient has no comorbid conditions. Investigation of history of exposure to the known risk factors prior to the onset of symptoms in the 14 days is ongoing. Currently the patient is in stable condition admitted to a negative pressure room on a ward.

• A 78-year-old female national and living in Skaka city, Aljouf Region. She developed symptoms on 16 September and was admitted to hospital on 18 September. The patient who has comorbidities, tested positive for MERS-CoV on 20 September. She has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure room on a ward. Ministry of Agriculture has been informed and investigation of camels is ongoing.

• A 50-year-old male national living in Shaqra city, Riyadh Region. He developed symptoms on 11 September and was admitted to hospital on 15 September. The patient who has comorbidities, tested positive for MERS-CoV on 16 September. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure room on a ward. Ministry of Agriculture has been informed and investigation of camels is ongoing.

• A 70-year-old male national living in Hail city, Hail Region. He developed
symptoms on 8 September and was admitted to a hospital on 13 September. The patient who has comorbidities, tested positive for MERS-CoV on 15 September. Investigation of history of exposure to the known risk factors is ongoing. The patient was in stable condition admitted to a negative pressure room on a ward but his conditions deteriorated and he passed away on 27 September, 2016.

Contact tracing of household and healthcare contacts is ongoing for these cases.

Globally, since September 2012, WHO has been notified of 1813 laboratory-confirmed cases of infection with MERS-CoV including at least 645 related deaths have been reported to WHO.

According to the Saudi Arabia Ministry of Health, as of Oct 29, the kingdom has seen 1470 MERS cases, including 615 deaths.



 Pasteur Institutes acknowledge unauthorized import of MERS samples on a flight from Seoul to Paris [Science Magazine, 24 Oct 2016]

By Tania Rabesandratana

si-MERSvirus.jpg
An artist's conception of the MERS virus.

A researcher from the Pasteur Institute Korea (IPK) in Seoul brought samples taken during the country's outbreak of Middle East respiratory syndrome (MERS) on an intercontinental flight last year without the appropriate paperwork, hoping to get them studied at the Pasteur Institute (IP) in Paris. Both institutes have acknowledged the incident, which IP says was a breach in French biosafety protocol. But both say the trip never put anyone in danger, because the samples had undergone a treatment that would have killed any living virus.

The story was first reported earlier this month by English-speaking newspaper The Korea Times, which wrote that a researcher from IPK had transported samples containing the MERS virus on a Korean Air flight from Seoul to Paris on 11 October 2015—a few months after a MERS epidemic outbreak that sickened 186 people and killed 38 in South Korea. IPK “committed serious biosecurity breaches, which could have resulted in the loss of many lives, and tried to cover it up,” the newspaper alleged.

In a statement issued today, IPK sought to downplay the issue. A review conducted with IPK’s safety committee has shown that the samples were treated with glutaraldehyde fixative, a standard virus inactivation protocol, the statement says; as a result, they were noninfectious and did not need any special approval from the airline to be taken onto the flight. (The samples traveled in the aircraft's baggage hold, the institute also says, not in the researcher’s cabin luggage, as The Korea Times claimed.)

IP in Paris—which is separate from 33 other Pasteur Institutes around the world—also says the newspaper’s story is inaccurate and says emails quoted in the piece that were attributed to IP President Christian Bréchot were not authentic. In a phone interview with ScienceInsider, Bréchot admitted that the import broke biosecurity rules, however, and that the samples were destroyed after arrival for that reason.

We did not even open the box. We do not know if the samples were infected in the first place, and even if they were, the cells were inactivated anyway.”
Christian Bréchot, Pasteur Institute

According to email correspondence with the incriminated IPK scientist, which ScienceInsider has seen, IP only found out about the samples after they landed in the research unit of Félix Rey, the head of IP's structural virology lab. “I forgot to mention … that I brought 3 Vero cell pellets that has [sic] been inactivated after infection with environmental samples collected from MERS units,” the IPK researcher wrote in an email to Rey on 16 October, after a meeting in Paris. (Vero cells are isolated from monkey's kidneys and can be used in the lab as host cells to study the growth of viruses.) The scientist asked Rey's team to “reconfirm the presence of viruses via [electron microscopy] analysis.” The researcher did not respond to an email request, and ScienceInsider was not able to confirm whether she had indeed sent this message.

A week later, Rey wrote back that his research unit could not receive and handle the samples because they came without approval from France's National Agency for Medicines and Health Products Safety, which regulates the production, use, transport, import, and export of so-called highly pathogenic microorganisms and toxins (MOTs). “I regret to inform you that the microscopy platform cannot treat this sample because, even if the samples are inactivated, MERS coronavirus is classified as MOT and as such, requires a special procedure to import the samples,” Rey wrote on 23 October. “I also have to inform you that specialised personnel of Institut Pasteur has by now destroyed those samples.”

“We did not even open the box,” Bréchot says. “We do not know if the samples were infected in the first place, and even if they were, the cells were inactivated anyway.”

The Korean Centers for Disease Control and Prevention (CDC) in Seoul is currently investigating the case at IPK’s request. "We are verifying whether IPK violated the High-Risk Pathogens safety management regulation in Infectious Disease Control and Prevention Act,” Haeng Seop Shin, deputy director of CDC's Division of Biosafety Evaluation and Control, wrote in an email to ScienceInsider. IPK is making all relevant documents available for the inquiry, such as lab log books and minutes of internal committee meetings, says Roberto Bruzzone, IPK’s interim CEO since March, who was a board member of the institute at the time the transfer happened.

IPK is a private, nonprofit health research organization. It was set up in 2004 in collaboration with IP in Paris, the Korean research ministry, and Geongyi province.

With reporting by Mark Zastrow in Seoul.



 MERS cover-up [Korea Times, 12 Aug 2016]

By Oh Young-jin

Oh_Young-jin-2(28).jpg


Have you forgotten about the deathly panic that was triggered by the onset of Middle East Respiratory Syndrome (MERS) last year? To jog your memory, it started in May and brought the nation to a standstill for fear of the insidious contagion. Thirty eight of 186 patients in the top-rated Samsung Medical Center and 15 other hospitals ended up dead.

Here is one unreported case that will give you back your goose bumps.

On one day in October, a virologist working for a joint venture research center, whose name you can easily recognize, boarded a flight departing from Seoul for a major European city.

In her carry-on that she took to the cabin with her were three separate samples of the MERS virus.

It was an official trip but she didn't tell her employer that she was carrying the samples.

As a matter of fact, she stole the samples from her own lab, entering the storage area without logging herself in. Footage from the surveillance camera showed her inside.

More importantly, she didn't declare it at Incheon International Airport or to the airline she was flying on. Under international regulations, she was required to have hazardous material carried by air cargo and to inform the airline about the contents. For this kind of hazardous cargo, the Korean authorities have to decide whether to allow it to travel outside the country and the authorities of the state of arrival should give their permission after being made aware of the materials and the travel itinerary.

All the rules were broken.

The result was the risk of immediately endangering the lives of passengers and the spreading the virus through secondary and tertiary contagions. It was not clear whether the samples were incapacitated or not. If the vials carrying the samples were ruptured, potentially she could have infected many passengers because the confined atmosphere of the cabin provides all the right conditions for the virus to be spread by air and phlegm.

It has yet to be established whether any passenger from that flight or those whom she came into contact with later contracted the disease.

The chilling thing is that the scientist who broke all pertinent rules is neither a mad scientist nor a novice. She is supposed to be a U.S.-trained virologist who worked at the U.S. National Institute of Health and was trained in handling deadly pathogens by the FBI and U.S. Center for Disease Control and Prevention (CDC); and led the pertinent safety committee in the institute in question. Her theft of the samples was made known after the probe started in January 2016.

Her boss was lied to and misled to believe that all procedures were adhered to.

She also acted very strangely when she arrived at her destination, the European lab.

When her contact was not there, she left the samples with a secretary. It was not clear whether the secretary was told about the contents or if proper handling procedures were observed.

Did the authorities in both countries come to know of this serious incident?

There appears there was a cover-up attempt in Korea or in Europe.

Two Europeans _ the head of the institute and his chief virologist _ didn't report this regulatory breach to the authorities and failed to carry out an investigation. The head of the European institute was being replaced for reasons that may or may not be related to the incident.

The Korean virologist emailed her European counterpart about leaving the samples and copied it to her boss, ensuring that all procedures were followed to the letter.

When the board of the Korean lab was informed of the incident, the chairman told the institute president to keep his mouth shut, telling him that if it was known to the outside, it would be like saying goodbye to any budget increase.

After it was proved that she lied, the institute president, her boss, fired her and the Korean government sent investigators to the lab. The head investigator said that she should be in jail but no action was taken, obviously, considering that it was at the height of MERS crisis.

This whistle-blower's account has been used in my column on two premises: the lessons of this incident are very important in handling any epidemics and key facts will be checked thoroughly about people, names of institutes and others that are not fully identified. The follow-up pieces with key information may be forthcoming, depending on further investigation.

The whistle-blower is a virologist and claimed that the MERS virus in Korea had mutated during the MERS crisis, which was denied by the authorities at the time. Early this year, the government corrected itself and admitted that it had indeed mutated.

In a way, the government has a need not to tell everything because, in the case of the MERS crisis, it could have caused greater panic. In the post-crisis follow-up measure, it is expected to come clean about the things they keep secret because it serves as an education process to inform the public, which is indispensable in making the right decisions in the future.

By keeping the public in the dark, the government either thinks light of the taxpayers' ability to learn, or more regrettably, sticks to the anachronistic thought that it is not the servant of the people but their master. We want to break that presumptuous attitude of the government, and hope this case shows it.



 MERS ‘Super-Spreader’ Infected 82 People In South Korea: Study [Asian Scientist Magazine, 14 Jul 2016]

A single ‘super-spreader’ patient in an overcrowded emergency room was linked to nearly half of the 186 MERS-infected patients in South Korea, according to researchers.

The-MERS-Coronavirus-On-A-Global-Journey-2z82cv5vgkb0njgnzdjfuo.jpg


AsianScientist (Jul. 15, 2016) - Researchers tracing the movements of patients at a South Korean hospital have identified how Middle East Respiratory Syndrome (MERS) virus was transmitted from a single ‘super-spreader’ patient to a total of 82 individuals. ‘Super-spreaders’ are patients who infect disproportionally more secondary contacts than others also infected with the same disease.

The study, published in The Lancet, maps the transmission of South Korea’s first outbreak of MERS coronavirus (MERS-CoV) and the case of the highest transmission of MERS from a single patient outside the Middle East. In this case, the patient was warded in an overcrowded emergency room and spread the virus to patients, visitors and health-care workers over a span of three days.

In between May and July 2015, a MERS-CoV outbreak in South Korea corresponded to 186 confirmed cases within two months. The ‘index patient,’ from whom the outbreak first originated, was a man aged 68, otherwise known as Patient 1. He had travelled to Bahrain, the United Arab Emirates, Saudi Arabia and Qatar between 18 April and 3 May, 2015 before returning to South Korea.

He was isolated on 18 May under suspicion of MERS; however, before arriving at Samsung Medical Center, Patient 1 had already transmitted the virus to several individuals in other hospitals, including another man, Patient 14, with whom he shared a ward. Patient 14 ended up being the ‘super-spreader’ who eventually caused the hospital outbreak at Samsung.

A total of almost 1,600 people were estimated to have been exposed to Patient 14 in the emergency room, with a total of 33 patients, eight healthcare workers, and 41 visitors infected between 27-29 May alone.

In contrast, Patient 1 was in contact with 285 other patients and 193 healthcare workers, but no further transmissions occurred at the hospital between presenting to the emergency room on 17 May and being isolated on 18 May. However, it is worth noting that Patient 1 had previously infected 28 other patients in another hospital.

The authors say that the difference in transmissibility between Patient 1 and Patient 14 could be caused by a number of factors, such as time from the onset of disease, symptoms, duration of contact, pattern of movement and the spread of the virus itself.

“Overcrowding is an important issue for this outbreak, but also a common feature of modern medicine, which should be of concern to governments and health-care providers in the context of future possible outbreaks,” said study authors Professor Chung Doo Ryeon and Dr. Kim Yae-Jean from the Division of Infectious Diseases at the Samsung Medical Center in Seoul, South Korea.

“Emergency preparedness and vigilance in hospitals, laboratories, and government agencies are crucial to the prevention of further large outbreaks—not only of MERS-CoV infections, but also other emerging infectious diseases.”

The article can be found at: Cho & Kang et al. (2016) MERS-CoV Outbreak Following a Single Patient Exposure in an Emergency Room in South Korea: an Epidemiological Outbreak Study.



 Study maps transmission of MERS virus in South Korean hospital from one 'super-spreader' patient [The Lancet, 10 Jul 2016]

160710094054_1_540x360.jpg
A new study demonstrates the potential for outbreaks of MERS Coronavirus (MERS-CoV -- the virus behind MERS) from a single spreader, as has been previously documented for SARS (Severe Acute Respiratory Syndrome).

Summary

Tracing the movements of patients at a South Korean hospital has helped identify how Middle East Respiratory Syndrome virus was transmitted from a single super-spreader patient in an overcrowded emergency room to a total of 82 individuals over three days including patients, visitors and health-care workers. The study maps the transmission of South Korea's first outbreak of MERS virus and the case of highest transmission of MERS virus from a single patient outside the Middle East.

Tracing the movements of patients at a South Korean hospital has helped identify how Middle East Respiratory Syndrome (MERS) virus was transmitted from a single super-spreader patient in an overcrowded emergency room to a total of 82 individuals over three days including patients, visitors and health-care workers.

The study, published today in The Lancet, maps the transmission of South Korea's first outbreak of MERS virus and the case of highest transmission of MERS virus from a single patient outside the Middle East.

The study demonstrates the potential for outbreaks of MERS Coronavirus (MERS-CoV -- the virus behind MERS) from a single spreader, as has been previously documented for SARS (Severe Acute Respiratory Syndrome).

The authors say that as long as the MERS transmission in the Middle East continues, governments and health-care providers should be prepared for emerging infections.
Since it was first identified in 2012, MERS-CoV has spread to 27 countries. Patients develop severe acute respiratory illness with symptoms of fever, cough and shortness of breath.

Approximately 3-4 out of every 10 patients reported with MERS-CoV have died, most of whom had an underlying medical condition.

Previous studies have suggested that the potential for MERS-CoV to spread to large numbers of people was low.

However, an outbreak in Saudi Arabia in 2013 saw one patient transmit the virus to seven others, raising concerns about so-called super-spreaders -- patients who infect disproportionally more secondary contacts than others also infected with the same disease.

In between May and July 2015, there was a MERS-CoV outbreak in South Korea, where 186 cases were confirmed within 2 months.

The 'index patient' (where the outbreak originated) was a man aged 68, otherwise known as Patient 1, who had travelled to Bahrain, the United Arab Emirates, Saudi Arabia and Qatar between 18 April and 3 May 2015 before returning to South Korea. He first visited the Samsung Medical Center in Seoul on 17 May, and was isolated on 18 May under the suspicion of MERS and finally diagnosed with MERS on 20 May.

However, before arriving at Samsung Medical Centre, Patient 1 had already transmitted the virus to several individuals in other hospitals, including another man (Patient 14), aged 35 with whom he shared a ward. Patient 14 was admitted to Samsung Medical Center with no information on possible exposure to MERS-CoV on 27 May -- and it was this patient who led to the hospital outbreak at Samsung.

Samsung Medical Center is a large 1982-bed hospital with an emergency room that sees more than 200 patients a day. The research team did a retrospective investigation of the outbreak at the hospital, including a review of closed-circuit security video footage and electronic medical records.

A total of 1576 people were estimated to have been exposed to Patient 14 in the emergency room and a total of 82 people -- 33 patients, 8 health-care workers, and 41 visitors -- were infected between 27-29 May (table 1).

Exposed people were classified into different groups depending on their proximity to Patient 14.

Patients staying in the same zone of the emergency room as Patient 14 had the highest risk of infection (20% [23/117 patients]), compared with 5% (3/58) in those with brief exposure to Patient 14 at the registration area or the radiology suite of the emergency room, and 1% (4/500) in other patients who stayed in different zones.

The risk of infection was 2% (5/218) in health-care workers, and 6% (38/683) in visitors. Nine cases were not included in the analysis due to a lack of reliable data.

On average, the incubation period was 7 days but there was wide variation depending on the proximity to Patient 14 -- 5 days for patients in the closest proximity to Patient 14 (group A) to 11 days for patients further away (group C).

There were no confirmed cases of patients or visitors who visited the emergency room on 29 May, after Patient 14 had been isolated, and who were exposed only to potentially contaminated environment.

In contrast, Patient 1 was in contact with 285 other patients and 193 health-care workers but no further transmissions occurred at the hospital between presenting to the emergency room on 17 May and being isolated on 18 May.

However, Patient 1 had previously infected 28 other patients in another hospital. The authors say that the difference in transmissibility between Patient 1 and Patient 14 could be caused by a number of factors such as time from onset of disease, symptoms, duration of contact, pattern of movement and the spread of the virus itself.

Study authors Professor Doo Ryeon Chung and Yae-Jean Kim, Division of Infectious Diseases at the Samsung Medical Center, Seoul, South Korea, warn that the results of this study need to be interpreted with caution due to the retrospective nature of the analysis but say: "This study is the first to document the spread of MERS-CoV virus through a hospital by providing specific infection risk depending on the proximity of patients to the infected patient. Our results show the increased potential of MERS virus infection from a single patient in an overcrowded emergency room.

Overcrowding is an important issue for this outbreak but also a common feature of modern medicine which should be of concern to governments and health-care providers in the context of future possible outbreaks.

Emergency preparedness and vigilance in hospitals, laboratories, and government agencies are crucial to the prevention of further large outbreaks not only of MERS-CoV infections, but also other emerging infectious diseases."

Writing in a linked Comment, Professor David S Hui from the Department of Medicine & Therapeutics and Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, China, says: "The data suggest that the location (and hence the timing) of exposure to Patient 14 was an important factor in determining the attack rate and incubation period.

Several other predisposing factors to this superspreading event included failure to implement strict isolation of patients and quarantine of contacts at the first outbreak hospital (Pyeongtaek St Mary's Hospital), poor communication and knowledge of patient movement between hospitals, overcrowding in the emergency room, inadequate ventilation with only three air changes per h, and limited availability of isolation rooms in the emergency room...

Failure in infection control and prevention in health-care facilities has resulted in large numbers of secondary cases of MERS-CoV infection involving health-care workers, existing patients, and visitors in Saudi Arabia and several other countries in the past few years.

Common risk factors include exposure to contaminated and overcrowded health-care facilities, poor compliance with appropriate personal protection equipment when assessing patients with febrile respiratory illness, application of potential aerosol generating procedures (eg, resuscitation, continuous positive airway pressure, nebulised drugs), and lack of proper isolation room facilities."

Story Source:
Materials provided by The Lancet. Note: Content may be edited for style and length.

Journal Reference:
Sun Young Cho, Ji-Man Kang, Young Eun Ha, Ga Eun Park, Ji Yeon Lee, Jae-Hoon Ko, Ji Yong Lee, Jong Min Kim, Cheol-In Kang, Ik Joon Jo, Jae Geum Ryu, Jong Rim Choi, Seonwoo Kim, Hee Jae Huh, Chang-Seok Ki, Eun-Suk Kang, Kyong Ran Peck, Hun-Jong Dhong, Jae-Hoon Song, Doo Ryeon Chung, Yae-Jean Kim. MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. The Lancet, 2016; DOI: 10.1016/S0140-6736(16)30623-7☞ Lancet  

nice!(0)  コメント(0) 

Nipah in Bangladesh and elsewhere from 21 till 22 May 2018

Nipah virus death toll at 10, food safety inspectors to check fruits & vegetables in Kerala [The Print, 22 May 2018]


by HIMANI CHANDNA With inputs from Rahiba R. Parveen

2018_5img21_May_2018_PTI5_21_2018_000193B-e1526994183215.jpg
Animal Husbandry department and forest officials collect bats from a well of a house after the outbreak of 'Nipah' virus, Kerala | PTI

Fruit bats are the natural host of the Nipah virus; 2 persons are critical and 9 are under surveillance in Kerala hospitals.

New Delhi: The Kerala government Tuesday confirmed 10 deaths from Nipah virus infection even as the country’s food safety regulator constituted a team of 30 officials to check fruits and vegetables sold across the state.

Two persons are stated to be critical and nine are under surveillance in hospitals.

“However, no new case has been reported in the past 24 hours,” K.K. Shylaja, Kerala health minister told reporters.

According to the World Health Organization, fruit bats are the natural host of the Nipah virus.

“While these (food safety) inspectors will do the manual checking of fruits and vegetables to find bat bites, they will also collect samples of ‘clean fruits’ for the further testing in the laboratories,” M.G. Rajamanickam, food safety commissioner at Food Safety and Standards Authority of India (FSSAI), Kerala, told ThePrint.

FSSAI, an autonomous body under the health ministry, is also suspecting the role of water in the spread of the disease further.

“We are also testing water samples,” Rajamanickam said.

“It is widely advised to wash fruits and vegetables before consuming. But what if the water itself is contaminated by bat excreta or saliva?” Rajamanickam asked.

Current status

Nipah virus (NiV), according to doctors, is a newly-emerging zoonosis (a disease which can be transmitted to humans from animals) that causes severe disease in both animals and humans.

There is no effective antiviral therapy for this infection.

“Once the symptoms begin, there is an increased likelihood of the person going into a coma just two days after getting infected,” said Dr K.K. Aggarwal,former president of the India Medical Association.

“The first line of defence is to avoid exposure and quarantine those who have already contracted the virus,” he added.

How it was detected

Investigators from the National Centre for Disease Control (NCDC) found many bats in the well of the house in Perambra in Kerala from where the initial death was reported.

A few of them were caught and sent to the laboratory to confirm whether they are the cause of the disease or not.

Officials have now sealed the well.

Dr Devendra Sehra, senior consultant, General Medicine at Maharaja Agrasen Hospital in Delhi said that people coming from Kerela must be investigated as symptoms of Nipah virus infection is similar to that of swine flu.

“The initial presentation is non-specific, characterised by the sudden onset of fever, headache, muscle pain, nausea and vomiting. Neck rigidity and photophobia are also observed,” said Dr Sehra.

The infection is diagnosed through ELISA test, carried out by the National Institute of Virology, Pune.

A little-known, rare, and extremely deadly virus has emerged and killed people in India — here's what to know about Nipah virus [Business Insider, 22 May 218]

by Kevin Loria

• At least nine people have reportedly died and 25 more have been infected in an outbreak of the Nipah virus in India.

• Nipah is a deadly virus that can be transmitted between people. It has killed between 40% and 75% of infected people in past outbreaks.

• Fruit bats are the natural host of the disease, and t here is no cure or vaccine.

At least nine people in southern India have died in cases linked to an outbreak of the rare and extremely deadly Nipah virus, according to a report by the BBC.

Nipah is considered a newly emerging deadly virus — scientists only found out that it could jump from bats to other species, including humans, within the past 20 years. The disease is currently incurable and can be transmitted from person to person. It has killed between 40% and 75% of infected people in most outbreaks.

These statistics indicate that Nipah has the potential to cause a deadly pandemic, which is why the World Health Organization lists Nipah as an urgent research priority, alongside diseases like Ebola and SARS.

Of the nine people who have died so far in the city of Kozhikode in Kerala, three cases of Nipah have been confirmed. Results from the other six are still being tested, and at least 25 more people have been hospitalized.

A little-known virus

Nipah first appeared in Malaysia in 1998, when 265 people became infected with a strange illness that caused encephalitis, or brain inflammation, after they came into contact with pigs or sick people. In that outbreak, 105 people died, a fatality rate of 40%.

Since then, there have been a number of smaller outbreaks in India and Bangladesh, with about 280 infections and 211 deaths — an average fatality rate of 75%.

When the first infections jumped from pigs to humans, authorities killed more than a million pigs to try to stop the spread of the disease. Since then, however, researchers have identified several fruit bat species as the natural hosts of the virus. In some cases, humans have been infected after drinking sap from date palms that bats may have contaminated.

The BBC reported that in the most recent outbreak, mangoes bitten by bats were found in a home where three of the deceased patients lived.

Symptoms for Nipah have varied depending on the outbreak. Many patients first experienced fever and headache, followed by drowsiness and confusion. Some patients have also shown respiratory flu-like symptoms while infected. In other cases, symptoms progressed to a coma within a day or two.

People who survive the initial infection can have lasting health issues, including personality changes and persistent convulsions. In some cases, the virus has re-activated in patients months or years after exposure, causing illness and death.

Close contact with sick animals or people can spread the disease — in the current outbreak, at least one of the deceased people was a nurse who treated sick patients. A study of Nipah virus transmission suggested that infected patients' saliva is likely to spread the infection.

For now, the priority is to identify the remaining Nipah cases to ensure the disease doesn't continue to spread.

Nipah virus outbreak in Kerala: Signs and symptoms of NiV, transmission, treatment, prevention [Times Now Digital, 22 May 218]

The National Institute of Virology, Pune, confirmed the presence of Nipah virus Kerala. Nipah virus (NiV) is a newly emerging zoonosis that causes severe disease in both animals and humans.

1526844244-nipah.PNG.jpg
Nipah virus in Kerala |Photo Credit: Thinkstock

Kozhikode/Thiruvananthapuram: Two more people have died due to Nipah virus (NiV) infection in Kerala, taking the total number of deaths caused by the rare virus to five till Tuesday, May 22, 2018. Earlier, on Sunday (May 20, 2018), the National Institute of Virology, Pune, confirmed the presence of Nipah virus in three samples that were already sent to the institute. Meanwhile, Kerala Health Secretary Rajiv Sadanandan asked people not to panic and said that it can be managed, adding the government has already started their work towards fever deaths. He added there was a similar issue in Bangladesh and it has been managed well.

According to the World Health Organisation (WHO), Nipah virus (NiV) is a newly emerging zoonosis that causes severe disease in both animals and humans. The Nipah virus, also known as Nipah Virus encephalitis, was first identified in Malaysia and Singapore in 1998-1999, when it caused disease in pigs and humans. During the 1998-99 outbreak, the virus affected 265 people and about 40 percent of those patients who were hospitalized with the severe nervous disease died from the infection.

What causes Nipah virus? How does it spread?

The organism which causes Nipah Virus encephalitis is an RNA virus of the family
Paramyxoviridae, genus Henipavirus. NiV is closely related to Hendra virus, which is an acute, viral respiratory infection of horses and humans that have been reported in Australia.

The disease spreads through fruit bats, also known as‘fl ying foxes,’ of the genus Pteropus - natural reservoir hosts of the Nipah and Hendra viruses. Transmission of the virus to humans takes place via direct contact with infected bats, infected pigs, or from other NiV infected people.

Humans were apparently infected with Nipah virus only through close contact with infected pigs during the 1998-99 outbreak in Malaysia and Singapore. However, in 2004, humans became infected with NiV after consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission of NiV has been reported in Bangladesh and India.

What are the signs and symptoms of Nipah virus?

Basically, NiV infection in humans is linked to encephalitis - inflammation of the brain- characterized by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death. According to the CDC, symptoms can progress to coma within 24-48 hours. In some cases, patients may develop a respiratory illness during the early part of their infections.

How is Nipah virus treated? Is there a cure for NiV?

In humans, the primary treatment for Nipah virus is intensive supportive care. The drug ribavirin has been shown to be effective against the viruses in vitro. However, the clinical efficacy of ribavirin remains inconclusive to date in human trials.

Unfortunately, there is no specific NiV treatment or a vaccine for either humans or animals.

How can you prevent getting Nipah virus infection?

Since human-to-human transmission of Nipah virus has been documented, standard infection control practices are important in preventing the spread of the disease. Health workers should take proper precautionary measures when caring for infected patients or handling and submitting laboratory samples to avoid hospital-acquired infections.

Avoiding exposure to sick pigs and bats in endemic areas, not drinking raw date palm sap, and not consume fruits that have fallen on to the ground can help prevent Nipah virus infection.

Kerala nurse taking care of Nipah patients dies; death toll rises to 10 [The Times of India, 22 May 218]

by K R Rajeev

KOZHIKODE: Lini (31), the nurse at Perambra Taluk Hospital who died on Monday after possibly getting exposed to the deadly virus while tending to a Nipah virus + infected patient, died without even getting a chance to bid adieu to her loved ones, including her two kids and husband.

With Lini’s death, the toll has now gone up to 10. On Sunday, the toll had risen to nine with the death of six more persons who had shown symptoms of the disease. Of this, two deaths were reported from Kozhikode and four from Malappuram district.

Nii.jpg


The stamp of sacrifice was there at her funeral, too. Her family from Chembanoda region near Peruvannamuzhi allowed the health department to cremate at an electric crematorium in the city without taking the body home to avoid the spread of the virus. “In her last days, she realised she had contacted a possibly-fatal infection after the youth from Changaroth — whom she had attended to in the initial stages — died. She lived to help others and her death has become a sacrifice,” said her maternal uncle V Balan.

Her two children, Sidharth (5) and Rithul (2), couldn’t give their mother one last kiss. On hearing that Lini was sick, her husband Sajeesh had come home from the Gulf two days ago.

Rajeev Sadanandan, additional chief secretary, department of health & family welfare, said the virus was confirmed in tests conducted at a Pune institute on samples of the three deceased from a family at Changaroth. He said the department has not been able to ascertain the extent of the spread of the disease as the virus has an incubation period of four to 18 days.

Tourism minister Kadakampally Surendran condoled her death and shared on Facebook the final letter she wrote to her husband who was in the Gulf.

"I don’t think I’ll be able to meet you. Please look after our children. Take them with you to the Gulf; don't be all alone like our father, please.” Lini, who was working as nurse at a private hospital in Kozhikode was appointed to Perambra Taluk Hospital last September on a contract basis.

"Lini had told me that she had attended to a patient from Changaroth who had initially sought treatment for fever at Perambra hospital and after the news of the patient’s death at a Kozhikode hospital, she was so sad and had said that the she had felt that the symptoms shown by the patient was unusual,” Avalam Hameed, a neighbour of Lini said.

United Nurses Association (UNA) state vice president Suneesh AP said that Lini had passed away in her line of duty and that the government should step in to offer help to the family.

"UNA representatives will visit the house of Lina soon and would provide our support. The government too should provide aid to the family,” he added.

The staff of the Perambra Taluk hospital came to work on Monday wearing black badges to mourn her demise.

Five dead in India from Nipah virus, dozens quarantined [Arab News, 22 May 218]

The virus has so far claimed five victims in southern India, while 90 people have been quarantined

1196571-2096420255.jpg


NEW DELHI: A deadly virus carried by fruit bats has killed at least five people in southern India and more than 90 people are in quarantine, a top health official said Tuesday.

“We can confirm that five people have died from the Nipah virus,” Kerala state health surveillance officer K.J. Reena told AFP. The death toll has risen from three overnight.

“We traced 94 people who had come in contact with the ones who died and they have been quarantined as a precaution,” Reena added.

Nipah has a mortality rate of 70 percent, according to the World Health Organization and there is no vaccination.

Kerala Nurse Died After Treating Nipah Patient, Left Heartbreaking Note [NDTV, 22 May 218]

by Sneha Mary Koshy & Deepshikha Ghosh

nurse-lini_625x300_1526968387541.jpg
Nipah virus: Kerala nurse Lini Puthussery left an emotional note to her husband before she died

Lini Puthussery, 31, died due to Nipah virus infection. She was in the team that treated the first victim of the Nipah virus in Kerala's Kozhikode

"I am almost on my way, take care of our children..." a young nurse in Kerala scribbled in a note for her husband, in a hospital isolation unit for victims of the deadly new Nipah virus. Lini Puthussery, 31, couldn't see her family one last time. She was cremated quickly on Monday so the infection wouldn't spread.

Lini had two little children, aged seven and two. She was in the team that treated the first victim of the virus at Perambara hospital in Kozhikode.

"Saji Chetta, I am almost on my way. I don't think I will be able to see you. Sorry. Take care of our children properly. Our innocent child, take him to the gulf. They shouldn't be alone like our father. Lots of love..." she wrote in the note that has been widely shared on social media and has moved many to tears.

"Nurse Lini died in our battle against the Nipah virus. She died trying to save patients infected by it. She was just 31 and was a mother of two little kids. If she is not a martyr, I don't know who is," tweeted Dr Deepu Sebin, chief executive of DailyRounds, a network of doctors.

A nurse who took care of a ‪#NIPHAVirus patients & succumbed to same. Her body was cremated with extreme urgency to prevent any possible spread and even her family could not pay due respect. Respect to Lini &a reminder that healthcare workers take immense personal risk to serve us

Kerala Chief Minister Pinarayi Vijayan said nurse Lini Puthussery's "selfless service will be remembered".

The Perambara hospital confirms the nurse was cremated soon after her death, with her family's consent, and no one could meet her. "We can confirm that five people have died from the Nipah virus," Kerala state health surveillance officer KJ Reena told news agency AFP.

The three who died earlier were all from the same family -- two brothers in their early twenties and a woman relative who had been with them at the hospital. The father of the brothers is reportedly being treated for the virus. Dead bats were found in a well of the family's home.

About a dozen more people have died after high fever and other symptoms of the virus in Kozhikode and neighbouring Malappuram. Unconfirmed reports suggest two more nurses are admitted to the Kozhikode Medical College hospital with high fever.

nipah-virus-kerala_625x300_1526968498603.jpg
Nipah virus infection symptoms include breathing trouble, brain inflammation, fever, headache, drowsiness and delirium

The Nipah virus or NiV infection, spread mainly by fruit bats, has symptoms like breathing trouble, brain swelling, fever, headache, drowsiness, disorientation and delirium. A patient can fall into coma within 48 hours. It travels through direct contact with a patient.

There is no vaccine for the virus yet, says the World Health Organisation. The main treatment for those infected is "intensive supportive care", according to the UN health body.

Kerala is on high alert over the infection and two control rooms have been opened in Kozhikode. A central team has also been sent to the district to help the state administration.

There is no vaccination for Nipah which has killed more than 260 people in Malaysia, Bangladesh and India in outbreaks since 1998.

Nipah victims should be quarantined, say experts [The New Indian Express, 22 May 218]

Nipahvvv.jpg
People wear masks to keep the Nipah virus at bay while shopping at a supermarket at Perambra in Kozhikode | T P Sooraj

Quarantining Nipah virus victims at the area where the virus has been detected is the best way to contain the spread of disease, experts say.

KOCHI: Quarantining Nipah virus victims at the area where the virus has been detected is the best way to contain the spread of disease, experts say.

They say moving patients, affected by a transmittable disease, to other locations could result in the spreading of the virus. Only minimum mobility is often advised in such cases.

They were responding to reports that a woman affected by the Nipah virus was brought to a hospital in Kochi from Kozhikode.

"In case of an epidemic, a patient is supposed to be kept in confinement. Standard precautions suggest disease has the possibility of being transmitted through all potential ways. We should also make sure that the virus does not spread to other geographical areas which would worsen the situation. To ensure this, guidelines suggest the patient should be kept in isolation, with minimum visitors and minimum mobility," said Dr Indhu P S, head of Community Medicine at the Thiruvananthapuram Medical College.

Moving an infected patient to another area is a complex issue as its conflicts with people's rights. "When it comes to individual cases, it is always a grey area. The question is of individual rights and the rights of the society. When bird flu and H1N1 threat came, movements were restricted. This was not to violate the human rights of the patient. However, the standard procedure is minimum movement," she said.

"Bats live in common roosts and only travel up to a few kilometres for food. So if the outbreak happened in one area, the chances of it becoming widespread is less. It is rather like rabies.

The mutation happens in the bat's body and then transmits through human contact," said P Sugathan, ornithologist.

Experts advise with proper precautions, Nipah outbreak can be contained.

Amit Shah, BrahMos, Nipah virus, Justice Loya: Top stories of the day [Jagran Josh, 21 May 218]

by Jagran Josh

nipahvirus.jpg


The Nipah virus has so far claimed three lives in Kerala while one person is undergoing treatment and 8 others are under observation in Kozhikode district, Health minister K K Shylaja today said.

The three deaths, which occurred over the past fortnight, were from the same family, including two siblings in their early twenties.

Unaware of her death, Ridhul and Siddharth wait for mother's return [Mathrubhumi English, 21 May 218]

by KP Nijeesh Kumar

imagennnn.jpg

It was on Sunday Lini succumbed to the deadly Nipah viral fever..

Five-year-old Ridhul and two-year-old Siddharth haven’t been informed of the death of their mother Lini yet. They know that their mother has to work in nightshifts. Hence they are not making a fuss about it, but it’s only a matter of time. Everyone is dreading to face the questions these children are going to raise and has no idea how they can be consoled.

This is the situation at Lini’s home, the nurse who lost her life after attending to two Nipah infected patients. It was on Sunday that Lini succumbed to the deadly Nipah viral fever.

Everyone around Lini remembers her as a compassionate soul whose life was dedicated to taking care of patients.

Lini decided to become nurse after her father, even after chronic treatments and hospital visits, died years back leaving three daughters behind. Finding general nursing is not enough, she had done her BSc nursing degree from Bengaluru Pavan School of Nursing. She had paid back the education loan taken for this recently.

Earlier she had tried working at MIMS hospital in Kozhikode. But couldn’t repay the loan with that. Her family had approached the government to write off the loan, but no one helped. With no other options, she took the daily wages job under NRHM scheme at the Perambra Taluk Hospital.

Lini was the daughter of Chembanada Korathippara Puthussery Nanu and Radha. She was married to Vadakara native Sajeesh who works as accountant in Bahrain.

Sajeesh had flown from Bahrain here after knowning about Lini’s condition, but was instructed not to see her as there are chances the virus might spread.

Lini was cremated at the West Hill electric crematorium.

News Track NIPAH: Everything you need to know about the deadly virus [Onmanorama, 21 May 218]

By Iram Khan

The Nipah virus kills 10 people in the southern parts of India. To everyone who is unaware, the southern states of India have been put on high alert to avoid exposure to such a disease.

The virus is spreading at a high alarming rate.

1526879761.jpeg


Here is everything you should know about the Nipah virus, and the ways to avoid it.

1. What is Nipah?
Nipah is a deadly virus which is contagious from its basic nature (can be easily spread from humans to animals and converse too). Abbreviated as ‘NiV’ is solely responsible for killing many lives in Kerala.

2. How did it start?
A disease that started in Kampung Sungai Nipah, Malaysia back during 1998-1999. The host that time responsible was a pig, this deadly disease started spreading from pigs to human.
Later in 2004, it was also recognized in Bangladesh but the host was date palm sap. Recently in India, the disease has been recognized but the transmission has been human to human in a highly clean place of a hospital.

3. What are the symptoms?
The symptoms that are evident to cause the disease are not so severe respiratory syndrome, small infections, fatal encephalitis. These can be spread from pigs, cows, sheep etc to animals and can be infected to animals also.

4.how to find a solution?
There is no solution diagnosed with the deadly disease yet. Intense care is the only way out.

5.what are the precautions?
It Is advised to stay away from animals and date palm sap as they have been the major source of spreading in the other countries.

Be safe and healthy.

Nipah spreading fear, bodies not handed over to relatives [Onmanorama, 21 May 218]

Kozhikode: The bodies of two patients, who reportedly died after infection from Nipah virus, were no t handed over to the relatives and instead cremated at the electric crematorium here by the health d epartment officials, to avoid any chances of the disease spreading.

nipah-virus-graphics.jpg


The bodies of Lini Puthusseri, a nurse at Perambra taluk hospital and Janaki, wife of Venu, Cheruvannur, near Perambra were cremated on Monday.

One person, who attended the funeral of the brothers who died in Changaroth, is suspected to have contracted the disease and is undergoing treatment at government medical college hospital here.

Medical teams sent to south India amid deadly virus outbreak [Bristol Herald Courier, 21 May 218]


NEW DELHI (AP) — A deadly virus has killed at least three people in southern India, officials said Monday, with medical teams dispatched to the area amid reports that up to six other people could have died from the disease and others are ill.
The three fatalities from the Nipah virus were all from the same family, said Kerala state health minister K.K. Shailaja.

There is no vaccine for Nipah, which can cause raging fevers, convulsions and vomiting. The only treatment is supportive care to control complications and keep patients comfortable. It has a mortality rate of up to 75 percent.

Media reports say five more people have died from high fevers in recent days, as well as a nurse who had treated people infected with the virus. But medical workers have not yet confirmed what killed those people. At least eight others sick with Nipah symptoms are being monitored.

People who had been in contact with Nipah victims have been put into isolation, Shailaja said.
Nipah, which was first identified during a late 1990s outbreak in Malaysia, can be spread by fruit bats, pigs and through human-to-human contact.

A team from India's National Centre for Disease Control has been sent to the coastal region of Kerala, where the outbreak occurred.

"We are closely monitoring the situation," India's health minister, J.P. Nadda, said in a statement.

All you need to know about the Nipah virus [ABP Live, 22 May 2018]

index.php.jpg


New Delhi [India], May 22 (ANI): The swearing-in ceremony of Karnataka chief minister-elect H. D. Kumaraswamy, scheduled to be held on May 23 in Bengaluru, will see a multitude of eminent politicians among the attendees.

Among the confirmed attendees are United Progressive Alliance (UPA) chairperson Sonia Gandhi, Congress President Rahul Gandhi, Bahujan Samaj Party chief Mayawati, West Bengal chief minister Mamata Banerjee, Andhra Pradesh chief minister N. Chandrababu Naidu.
Delhi Chief Minister Arvind Kejriwal, his Kerala counterpart Pinarayi Vijay, former Uttar Pradesh chief minister and Samajwadi Party chief, Akhilesh Yadav, Rashtriya Janata Dal leader and son of former Bihar chief minister Lalu Prasad Yadav, Tejaswi Yadav, Telangana Chief Minister K. Chandrashekhar Rao, along with son K. Taraka Rama Rao will also be present to witness Kumaraswamy's swearing-in.

Other notable guests will include the founder of Rashtriya Lok Dal, Ajit Singh (also an ex-Union Minister), actor-turned-politician and founder of Makkal Needhi Mayyam, Kamal Haasan and Dravida Munnetra Kazhagam (DMK) chief M.K. Stalin.

On Monday, Kumaraswamy met with Sonia Gandhi and Rahul Gandhi in the national capital to discuss various key aspects of the alliance and governance of the state.

According to Congress leader R. Surjewala, Kumaraswamy suggested he would continue to seek guidance on governance of the state from the Congress leaders as welfare and development of the state is his party's primary focus, while also stating that he sought a long-term alliance with Congress.

On Saturday, Kumaraswamy was invited by Karnataka Governor Vajubhai Vala to form the government in the state, after Bharatiya Janata Party's (BJP) B.S. Yeddyurappa stepped down ahead of the floor test in the state assembly.

While Kumaraswamy was earlier expected to swear-in as Karnataka Chief Minister on Monday, the ceremony later got pushed to May 23 due to the death anniversary of former Prime Minister Rajiv Gandhi. (ANI)

Presence of Nipah virus confirmed [The Hindu, 21 May 218]

Two more suspected deaths reported in Kozhikode district

The Health Department has confirmed Nipah virus (NiV) infection for the first time in the State with the blood and body fluid samples of two persons who died of viral fever in the past fortnight in Kozhikode district indicating the presence of the zoonotic disease.

At the same time, two more are suspected to have died in similar circumstances on Sunday.

Director of Health Services R.L. Saritha told the media late Sunday night that laboratory results from National Virology Institute, Pune, had confirmed that the deceased were infected with the virus.

Three members of a family from Sooppikkada village in the Changaroth grama panchayat limits in Kozhikode had died in the past two weeks due to viral encephalitis and myocarditis. Blood samples of two among them and one of their family members were sent to the virology institute for tests.

Meanwhile, the names of those who died on Sunday were given as Ismail of Koottalida and Janaki Amma of Perambra.

However, it was yet to be confirmed whether they were infected with NiV. Nine persons, including some of the family members of the deceased from Changaroth, and those who had interacted with them, are undergoing treatment at government and private hospitals in Kozhikode and Kochi.

Infection can lead to acute respiratory syndrome and fatal encephalitis among humans.

The virus is capable of causing diseases in domestic animals too. There is no vaccine for the disease and the only form of treatment is supportive medicines. Fever clinics and special wards will be set up in private and government hospitals and a seven-member task force has been formed to monitor the overall activities. This was decided at a meeting chaired by the Collector at the civil station here on Sunday.

A control room has been opened at the District Medical Officer’s office (Ph: 0495-2376063).

Central team coming

Meanwhile in New Delhi, Union Health Minister J.P. Nadda has directed the Director of National Centre for Disease Control (NCDC) to visit Kozhikode to assist the State government in the wake of death of two persons due to Nipah virus.

A Central team will also be visiting the State to monitor the situation.

All arrangements in place to tackle Nipah virus: KK Shailaja [Free Press Journal, 21 May 2018]

iStock_000074443795_Large.jpg.image_.784.410.jpg


Kozhikode: After three confirmed deaths due to the Nipah virus (NiV), and reports on eight other patients awaited, Kerala Health Minister K.K. Shailaja on Monday said things are under control and there is no need to panic. “All the periphery hospitals of the Kozhikode Medical College hospital are fully equipped to tackle the fever. All those who have fever need not rush to the medical college itself.

“At the moment, eight patients are currently in treatment. Their samples have been sent to Pune and results are awaited,” said Shailaja. Nipah virus (NiV), spread by fruit bats that infects both animals and humans, has claimed the lives of two brothers and their aunt in Perambara within a few weeks, and now eight more people are under close observation.

Transmission of NiV takes place through direct contact with infected bats, pigs or from other NiV-infected people. “The health officials visited the house of Sabith and his brother, who passed away due to Nipah virus, and found there was a well in their house that was unused but had lots of bats. “The authorities have sealed the top of the well to ensure that the remaining bats do not come out,” said Shailaja.

She also added that people were being educated to ensure that they do not eat any fruits that fall down from trees. “Awareness programmes have already begun and more and more medical teams from the Centre, the Indian Medical Association and private hospitals are being readied.

“The first Central team has already arrived and another one is arriving tomorrow (Tuesday),” said Shailaja and added that all patients coming down with fever must not panic. The state government has sanctioned an emergency fund of Rs 20 lakh to the Kozhikode Medical College to tackle the present fever outbreak.

Nipah virus attacks social media, govt issues warning [Onmanorama, 21 May 2018]

nipah-istock.jpg.image.784.410.jpg


The State health department has said it is the sole authority in declaring someone as affected by Niph virus and the general public should not be swayed by the multifarious and misleading messages on social media.

Sounding a tone of caution, department sources said ingestion of secretions/fluids were the cause of the disease and the disease does not spread through air, water or mosquitoes. Also, the possibility of spread was high confined places and people should desist from turning in to the medical college on the basis of baseless Whatsapp messages.

The department said in a release that all deaths and fevers were not due to Nipah and people should seek treatment at the nearest public health centre to confirm the symptoms first.

Intensive supportive treatment and rest were needed and a long curative time was characteristic of Nipah, it said.

Nipah virus identified in Kozhikode fever deaths [Free Press Journal, 21 May 2018]

Kozhikode/Thiruvananthapuram : The cause of death of two people, ostensibly suffering from fever, in Kozhikode has now been confirmed to be due to the Nipah virus (NiV), spread by fruit bats and causing severe disease in both animals and humans, a top official said on Sunday.

Kerala Health Secretary Rajiv Sadanandan told IANS that they have now got the confirmation from the National Institute of Virology, Pune.

“A central team of the Indian Council of Medical Research is arriving at Kozhikode tomorrow (Monday). There is no reason for any panic at all, as this can be managed and we have already started our work towards that. There was a similar issue in Bangladesh and it has been managed well. We have already informed the Centre about this,” he said.

While three members of a family at Perambara in Kozhikode died within weeks after what seemed to be common fever aggravated quickly, two more family members were being treated at the Medical College hospital and one of them has also tested positive. Two more deaths, due to fever, were reported from Kozhikode on Sunday.

Nipah virus outbreak: 10 things about the disease that has claimed lives in Kerala [Bangalore Mirror, 21 May 2018]

Some reports suggest that 10 people have lost their lives and many are being reviewed after a deadly virus outbreak in Kerala. Union Minister J P Nadda on Monday directed the Director of National Centre for Disease Control (NCDC) to visit Kerala's Kozhikode district to assist the state government in the wake of the death of three people due to Nipah virus. As many as 10 people, who died due to high fever in the state, were suspected to be under the same viral influence.

Union Minister J P Nadda on Sunday directed the Director of National Centre for Disease Control (NCDC) to visit Kerala's Kozhikode district to assist the state government in the wake of death of three people due to Nipah virus.

Ni-1.jpg


The ministry has constituted a multi-disciplinary team headed by the Director of National Centre for Disease Control (NCDC) , which has reached there today.

Ni-2.jpg


“We are closely monitoring the situation. I have spoken to Shri Alphons and Smt K Shailaja, Health Minister, Kerala and assured them all support of the Central government. I have also dispatched a Central team to assist the State government and initiate required steps,” the Union Health Minister said in a statement from Geneva.

Here are 10 things you need to know about the deadly disease

# Nipah virus (NiV) infection in humans has a range of clinical presentations, from asymptomatic infection to acute respiratory syndrome and fatal encephalitis, according to the World Health Organisation (WHO).

# Some doctors have termed it as Nipah virus, while others said it was zoonotic, and that the spread is fast and fatal.

# Nipah virus is spread by fruit bats and causes severe disease in both animals and humans.

# The mortality rate, in case of infection, is reported to be 70 per cent. The virus can be transferred from a human through close contact, body fluids, saliva and cough.

# The symptoms lead to fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death

# Nipah Virus is also capable of causing disease in pigs and other domestic animals.

# There is no vaccine for either humans or animals.

# The primary treatment for human cases is intensive supportive care, according to the World Health Organistion.

# In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats, the WHO informs. The disease was first identified in Malaysia in 1998.

# As per the WHO data, over 600 people cases of Nipah virus human infections have been reported.

Nipah virus kills at least 11 in India, sparks alert [gulfnews.com, 21 May 2018]

Disease was first reported in 2001 in India and again six years later, with the two outbreaks claiming 50 lives

3462179484.jpg

The deadly Nipah virus is carried mainly by fruit bats.

NEW DELHI: A deadly virus carried mainly by fruit bats has killed at least 11 people in southern India, sparking a statewide health alert Monday.

Initial reports state three people had died from the deadly virus, but this was later revised to six, then to 11, according to the Indian Express.

Nipah virus: Family members of the patients admitted at a hospital wear safety masks as a precautionary measure after the 'Nipah' virus outbreak, in India. PTI

At least five other deaths in the state of Kerala are being investigated for possible links to the Nipah virus, which has a 70 percent mortality rate.

Kerala's Chief Minister Pinarayi Vijayan has urged citizens to stay vigilant and follow instructions from the health department.

"Health department is doing everything possible to save the lives of the infected & prevent the advance of virus," his office posted on Twitter.

The victims all died in Calicut district, said Kerala health secretary Rajeev Sadanandan.

Samples tested in government labs confirmed the presence of the Nipah virus in three deaths, while Sadanandan said the cause of other suspicious deaths could only be confirmed through tests.

"We have sent blood and body fluid samples of all suspected cases for confirmation. It will take 24-48 hours for the results to come."

India's health minister rushed medical experts to the state after a local politician reported that residents were panicking in Calicut.

The team would "initiate required steps as warranted by the protocol for the disease", J.P. Nadda said on Twitter.

The three who died included two siblings in their early twenties, the Press Trust of India reported.

A nursing assistant who had treated them also died Monday while the father of the victims was undergoing hospital treatment, PTI reported.

Neighbours told local media the siblings who died had eaten fruit picked from a compound where they were building a home.

A bat was found in the well of their home which was later sealed, PTI quoted state health minister K. K. Shylaja as saying.

Flu-like symptoms

Nipah induces flu-like symptoms that often lead to encephalitis and coma. Fruit bats are considered the main carrier of the virus for which there is no vaccination, according to the World Health Organization.

Nipah was first identified in Malaysia in 1998.

It spread to Singapore and more than 100 people were killed in both places.

On that occasion, pigs were the virus hosts but they are believed to have caught it from bats.

In India the disease was first reported in 2001 and again six years later, with the two outbreaks claiming 50 lives.

Both times the disease was reported in areas of the eastern state of West Bengal bordering Bangladesh.

Bangladesh has borne the brunt of the disease in recent years, with more than 100 people dying of Nipah since the first outbreak was reported there in 2001.

In Bangladesh in 2004, humans became infected with Nipah after eating date palm sap that had been contaminated by infected fruit bats.

Deadly Nipah virus claims victims in India [BBC News, 21 May 2018]

_101654111_gettyimages-952698702.jpg


Health officials in the south Indian state of Kerala say nine people have died in confirmed and suspected cases of the deadly Nipah virus.

Three victims have tested positive for the virus in the past fortnight. The results from the remaining six samples will be available later on Monday.

Twenty-five others have been hospitalised with symptoms of the infection in Kozhikode, officials said.

Nipah is an infection which can be transmitted to humans from animals.

There is no vaccination for the virus which has a mortality rate of 70%.

Nipah virus is also "top of the list" of 10 priority diseases that the WHO has identified as potentials for the next major outbreak.

Kerala's health secretary Rajeev Sadanandan told the BBC that a nurse who treated the patients had also died.

"We have sent blood and body fluid samples of all suspected cases for confirmation to National Institute of Virology in Pune. So far, we got confirmation that three deaths were because of Nipah," he said.

"We are now concentrating on precautions to prevent the spread of the disease since the treatment is limited to supportive care."

_101653902_calicut976.png.jpg

Fruit bats are considered to be the natural host of the virus.

Health officials said they had found mangoes bitten by bats in a home where three people died of the suspected infection.

What is Nipah virus?

• Nipah virus (NiV) infection is a newly emerging disease which can be transmitted to humans from animals. The natural host of the virus are fruit bats

• The infection was first identified in 1999 during an outbreak of encephalitis and respiratory illness among pig farmers and people with close contact with pigs in Malaysia and Singapore

• Nearly 300 human cases with over 100 deaths were reported in that outbreak. In order to stop it, more than a million pigs were euthanized, causing tremendous trade loss for Malaysia

• Nipah virus infection can be prevented by avoiding exposure to sick pigs and bats in endemic areas and not drinking raw date palm sap

• Symptom of the infection include fever, headache, drowsiness, respiratory illness, disorientation and mental confusion. These signs and symptoms can progress to coma within 24-48 hours

• There is no vaccine for either humans or animals

(Source: WHO, Centers for Disease Control and Prevention)

Nipah virus claims three lives in India, more than 40 being tested [CNN, 21 May 2018]

By Manveena Suri

180521105409-01-nipah-virus-india-0521-exlarge-169.jpg
A deadly virus carried by fruit bats has killed at least three people in southern India.

New Delhi (CNN)Three people in the southern Indian state of Kerala have died of the Nipah virus.

Two brothers in their late 20s and their aunt, 50, died from the virus in Kozikhode district, according to Dr. Reena KJ, the state's assistant director of public health.

The father of the two men, 56, is currently on life support and in a "delirious state," said Reena.

180521105504-02-nipah-virus-india-0521-medium-plus-169.jpg
Officials in Kerala inspect a well to catch bats that can carry the Nipah virus.

The virus, which can be spread by contact with animals or humans, can develop from headache and drowsiness to a coma within days, according to the US Centers for Disease Control and Prevention. Treatment is limited to supportive care.

The first death was reported Saturday, after which the country's health ministry and the World Health Organization were contacted, the office of Kerala chief minister, Pinarayi Vijayan, wrote in a tweet Monday.

A statewide alert has been given to remain vigilant and a 24-hour control room opened, added Vijayan.

Fluid samples have been taken from 14 people who visited the deceased in the hospital, along with 27 members of hospital staff who had come into contact with them during their treatment, according to Reena.

She added that deaths in other districts where people presented with the symptoms of the Nipah are also being tested, Reena said.

Government reassurances

India's Health Ministry has deployed a response team to Kerala.

The country's union minister of health and family welfare, JP Nadda, said in a statement that his department was "closely monitoring the situation" and has "dispatched a Central team to assist the State government and initiate required steps."

The state government has made assurances that the "health department is doing everything possible to save the lives of the infected and prevent the advance of virus."

A subsequent tweet urged private hospitals to "not deny treatment for anyone suffering from fever."

About Nipah virus

The Nipah virus can cause a range of symptoms in those infected, including fever, headache, confusion and disorientation. More severe symptoms include acute respiratory syndrome -- where the lungs cannot get enough oxygen to the body -- and fatal encephalitis, an inflammation of the brain.

The virus is known to infect both humans and animals, with certain species of fruit bat being natural hosts. People can become infected after contact with infected bats, pigs or humans.

There is no vaccine against Nipah and the only treatment option is supportive care, according to WHO.

Nipah virus was first identified during a 1998-1999 outbreak in Malaysia, where almost 300 people were infected and more than 100 died, according to the CDC. More than a million pigs were euthanized to halt the spread of the illness. The virus was named after the village of Kampung Sungai Nipah, where pig farmers contracted the disease.

There have been subsequent outbreaks in India and Bangladesh, with more than 600 reported human cases between 1998 and 2015, according to the WHO. Many parts of Asia, as well as Australia, Madagscar and Ghana are at risk of outbreaks.

The virus is on the WHO's list of epidemic threats in need of urgent research and development.
nice!(0)  コメント(0) 

Ebola outbreak News from 19 May 2018

Ebola Outbreak on 'Epidemiological Knife Edge'; Tobacco Abx [MedPage Today, 23 May 2018]

by Molly Walker

The ninth Ebola outbreak in the Democratic Republic of the Congo grows more worrisome, with an additional 14 cases and four deaths reported, for a total of 58 cases (including five healthcare workers) and 27 deaths as of May 21, the World Health Organization said Wednesday. They focused on three concerning factors about the outbreak: that it has spread to the large city of Mbandaka, that five healthcare workers have been infected, and that there are three or four separate epicenters, including "three chains of transmission," each with the potential to expand. Officials described the outbreak on an "epidemiological knife edge" in terms of whether or not containment will be successful.

Back home, the E. coli outbreak linked to romaine lettuce continues, with 23 more reports of ill people in three more states last week, bringing the case count to 172 in 32 states. Hospital admissions now total 75, including 20 people with hemolytic uremic syndrome. But the CDC said it is "unlikely" that any contaminated lettuce from this growing region is still available, as its shelf life has passed.

The CDC also said a Salmonella outbreak linked to dried coconut appears to be over, with a total case count of 14 cases in eight states.

Inovio Pharmaceuticals announced that phase I trial participants maintained a "durable and robust immune response" six months after receiving the final dose of its HIV vaccine, PENNVAX-GP. (Pipelinereview.com)

Antifungal drug resistance, which impacts crops and livestock, could potentially threaten food security on a global scale. (Science)

A small clinical trial will be conducted by the NIH with two monoclonal antibodies to treat Middle East respiratory syndrome coronavirus (MERS-CoV), the first to test these agents in people.

Researchers found that increased presence of certain types of bacteria in the placenta may increase the risk of spontaneous preterm birth. (ScienceDaily)

Can a protein found in the tobacco plant lead to the development of a new type of antibiotic? (Nature Communications)

A third of all outbreaks of waterborne disease from 2000 to 2014 were linked with hotel pools and hot tubs. (Morbidity and Mortality Weekly Report)

UTILITY Therapeutics announced that the FDA designated injectable mecillinam and oral prodrug pivmecillinam as Qualified Infectious Disease Products to treat complicated urinary tract infections.

The National Institute of Allergy and Infectious Diseases (NIAID) filed an investigational new drug application to conduct a phase IIa clinical trial at Vanderbilt University with ILiAD Biotechnologies' intranasal pertussis vaccine BPZE1, the company announced.

Congo Ebola vaccination campaign rolled out [Stuff.co.nz, 22 May 2017]

BY SALEH MWANAMILONGO

Congo authorities have begun an Ebola vaccination campaign in a northwest provincial capital of the African country in a major effort to stem an outbreak that already has spread from rural towns into a city of more than 1 million people.

The vaccination drive started a day after the health ministry announced that a nurse had died from Ebola in Bikoro. The rural northwestern town is where the outbreak announced in early May began.

The death toll now stands at 27.

There are 49 hemorrhagic fever cases: 22 confirmed as Ebola, 21 probable and six suspected, according to Health Minister Oly Ilunga.

"We have established surveillance mechanisms and are following all cases and contacts," he said. "The response is well-organised because we have also put in surveillance measures at the entry and exit points of Mbandaka."

In a hopeful sign, two patients who were confirmed as positive for Ebola have recovered and are returning to their homes, where they will be monitored, Ilunga said.


1526940089256.jpg
Two dozen vaccinators, including Congolese and Guineans who administered the vaccine in their country during the 2014-2016 outbreak, are in Mbandaka to start injecting the 540 doses that have arrived. (File photo)

They have left the hospital "with a medical certificate attesting that they've recovered and can no longer transmit the disease because they have developed antibodies against Ebola," he said.

The virus, however, remains longer in semen in many cases and therefore can be transmitted through sexual contact for some months after recovery.

Congo's health delegation, including the health minister and representatives of the World
Health Organisation and the United Nations, have arrived in Mbandaka, the northwestern city of 1.2 million where Ebola cases have been identified, to launch the vaccination campaign Monday.

Dr Eric Ekutshu, a doctor in the Wangata health zone in Mbandaka, received the vaccine Monday at a ceremony presided over by officials.

"I'm glad I have received the vaccine against Ebola," he said. "I ask the others (contacts and nursing staff) to get vaccinated to protect themselves. Everyone must adhere to this vaccination campaign with the goal of protection."

Guillaume Ngoie Mwamba, director of the Expanded Program on Immunisation, was the first Congolese to receive the vaccine in Mbandaka.

1526940089256-2.jpg
Members of a Red Cross team don protective clothing before heading out to look for suspected victims of Ebola, in Mbandaka, Congo.

"This is to give a message of safety and assurance to all of the population exposed to the epidemic," he said.

Two dozen vaccinators, including Congolese and Guineans who administered the vaccine in their country during the 2014-2016 outbreak, are in Mbandaka to start injecting the 540 doses that have arrived, the health minister said.

It will take five days to vaccinate about 100 registered patients, including 73 health care staff, who have had contact with patients and their relatives in the Wangata and Bolenge health zones of Mbandaka, he said.

The vaccination campaign will then move to the other two affected areas, the Bikoro and Iboko health zones.

More than 7500 doses are available in Congo, WHO said Monday, adding that an additional 8000 doses will be available in the coming days.

The vaccine, provided by US company Merck, is still in the test stages, but it was effective toward the end of the Ebola epidemic that killed more than 11,300 people in Guinea, Sierra Leone and Liberia from 2014 to 2016.

A major challenge will be keeping the vaccines cold in this vast, impoverished, tropical country where infrastructure is poor.

1526940089256-3.jpg
There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhoea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 per cent of cases, depending on the strain.

Congo President Joseph Kabila and his Cabinet agreed Saturday to increase funds for the Ebola emergency to more than US$4 million.

The Cabinet also endorsed the decision to provide free health care in the affected areas and to provide special care to all Ebola victims and their relatives.

The US Agency for International Development has said that it has provided an initial US$1 million to combat the Ebola outbreak. The funds are going to WHO in support of its joint strategic response plan with Congo's government.

The spread of Ebola from a rural area to Mbandaka has raised alarm since the virus can spread more quickly in urban areas. The fever it causes can lead to severe internal bleeding that is often fatal.

"It's concerning that we now have cases of Ebola in an urban centre, but we're much better placed to deal with this outbreak than we were in 2014," WHO's director-general, Tedros Adhanom Ghebreysus, said at the UN health agency's annual meeting in Geneva on Monday.

"I am pleased to say that vaccination is starting as we speak today."

Tedros said he is "proud of the way the whole organisation has responded to this outbreak, at headquarters, the regional office and the country office."

This is Congo's ninth Ebola outbreak since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with the bodily fluids of those infected.

While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Kinshasa, Congo's capital of 10 million people, but was effectively contained.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhoea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 per cent of cases, depending on the strain.

Vaccination method that wiped out smallpox gets unleashed today on Ebola [Ars Technica, 22 May 2017]

by BETH MOLE

As Ebola outbreak flares, experimental vaccine gets trial by fire.

GettyImages-961020312-800x534.jpg
Enlarge / Nurses working with the World Health Organization administer the Ebola vaccine to a local doctor at the town hall of Mbandaka on May 21, 2018 during the launch of the Ebola vaccination campaign.

With more than 7,500 doses of an experimental vaccine against Ebola, health officials today began a vaccination campaign to try to thwart the latest outbreak of the deadly virus in the Democratic Republic of the Congo.

According to the World Health Organization, the campaign will start with healthcare workers operating in areas affected by the outbreak. Then officials will focus on a “ring vaccination” strategy, which targets people who have had contact with someone with a confirmed case of Ebola, as well as people who have had contact with those contacts. (This creates rings of vaccination around each case, hence the name). These defensive social circles ensure that those most vulnerable to contracting the virus are protected while also preventing the spread of the virus from the most likely sources. The same strategy was critical during the campaign in the 1960s and ‘70s to eradicate smallpox—the only human disease that has ever been successfully wiped out.

The Ebola-vaccination campaign will take place in the DRC’s northwestern Equator Province (Province de l’Équateur), where there have been 46 confirmed, probable, or suspected cases, including 26 deaths, as of May 18. Officials have already identified 600 contacts and contacts of contacts of cases. Nearly all cases and contacts have been in the remote town of Bikoro. But officials counted four confirmed cases in Mbandaka, a provincial capital with more than a million residents. This has raised concerns about the potential for the outbreak to explode.

The more than 7,500 doses of vaccine already in the DRC are enough to cover approximately 50 rings of 150 people, the WHO notes. An additional 8,000 doses are on their way to the country, arriving in the next few days.

The experimental vaccine—rVSVΔG-ZEBOV—has not been approved by relevant regulatory authorities, but the WHO has given it the greenlight under an expanded access/compassionate-use protocol. The organization has reason to be optimistic that the vaccine will squash the outbreak.

Trial by fire

The vaccine is a live, chimeric virus capable of replicating in cells. It has the backbone of the relatively harmless vesicular stomatitis virus, which tends to infect cattle and only causes mild disease in humans. This engineered virus also carries the code for Ebola’s glycoprotein. This is a protein that hangs on the outside of Ebola viruses and allows them to invade and infect human cells. On the vaccine virus, the protein can prompt the human immune system to develop protective responses against the real Ebola.

In early work, rVSVΔG-ZEBOV protected mice, hamsters, guinea pigs, and non-human primates from Ebola. In 2015, an international team of researchers conducted trials of ring vaccination in Guinea and Sierra Leone, vaccinating nearly 6,000 within 117 rings. The results suggested that the vaccine was generally safe and 100-percent effective at preventing Ebola. None of those vaccinated developed Ebola virus disease, whereas there were 23 cases among contacts in the trial who were either not vaccinated or received a delayed vaccination.

Despite high hopes for the vaccine in this outbreak, the ring campaign won’t be easy to pull off in such a remote area of the DRC. “Implementing the Ebola ring vaccination is a complex procedure,” Dr. Matshidiso Moeti, WHO regional director for Africa, said in a statement. “The vaccines need to be stored at a temperature of minus 60 to minus 80 degrees centigrade, and so transporting them to and storing them in affected areas is a major challenge.”

So far, WHO, local health authorities, Médecins Sans Frontières (MSF aka Doctors Without Borders), and other partners have established an air bridge and have used helicopters and motorbikes to get around and deliver supplies. They’ve also transported the vaccine in containers that maintain sub-zero conditions for up to a week and have set up freezers in Bikoro and Mbandaka.

As officials scramble, they hope the efforts are enough. “We need to act fast to stop the spread of Ebola by protecting people at risk of being infected with the Ebola virus, identifying and ending all transmission chains, and ensuring that all patients have rapid access to safe, high-quality care,” Dr. Peter Salama, WHO deputy director-general for Emergency Preparedness and Response, added in a statement.


Morning Break: Ebola Vaccinations; Bed-Sharing Defended; Therapeutic Tears [MedPage Today, 21 May 2017]

- Health news and commentary from around the Web gathered by the MedPage Today staff

Ebola vaccinations are set to begin in the Democratic Republic of the Congo, where four cases are now confirmed in Mbandaka, a large city on the banks of the Congo River. (Reuters)

The FDA has approved sodium zirconium cyclosilicate (Lokelma) for treating hyperkalemia in adults, says drugmaker AstraZeneca. This comes 2 years after the agency rejected the drug, known then as ZS-9, due to manufacturing issues.

NPR casts doubt on the risks of mother-baby bed-sharing.

"Why the Pharmaceutical Industry Is Giving Up the Search for an Alzheimer's Cure," blares a headline at Quartz. But the story underneath it says something quite different.

As Hawaii's volcanic eruption begins to dump lava into the ocean near populated areas, a new health risk emerges: "laze," a toxic airborne mixture of steam, hydrochloric acid, and tiny glass particles. (USA Today)

And Hawaii News Now reports a more prosaic health effect, as a man's lower leg was shattered by lava spatter as he stood on a third-floor balcony.

CNN investigates overuse of ADHD medications among children and teens, finding 150,000 calls to poison control centers over a 15-year period.

Insys, the company accused of bribing doctors to prescribe its fentanyl sublingual spray
Subsys, brings a similar product containing buprenorphine to an FDA advisory committee tomorrow. (Fortune; FDA)

Cindy Winebrenner, MD, recounts shedding "therapeutic tears" with a patient. (Kevin MD)

The weekend's New York Times Magazine carried a medical theme, with stories of hands-on medicine, "trip doctors," and more.

FDA chief Gottlieb says the agency is exploring whether it can require drug companies to disclose prices in direct-to-consumer ads. (STAT News)


MIT chemists hope manmade ‘xenoproteins’ can help battle diseases like Ebola [The Boston Globe, 21 May 2017]

By Elise Takahama

AFP_1578Q8.jpg
Traffic was seen a street northwest of the Democratic Republic of the Congo as 45 cases of Ebola virus has been recorded in the region.

The new outbreak of the deadly Ebola virus last week has health officials scrambling to find solutions, and MIT chemists said Monday they may be on their way to finding one — through the creation of massive numbers of “xenoproteins.”

The researchers have been working for four years to create tens of millions of new amino acids, ones that are completely manmade and not found in nature, said Brad Pentelute, an MIT chemistry professor and the senior author of the recent study, which was published in the journal Proceedings of the National Academy of Sciences.

Amino acids are the building blocks of proteins. The researchers have used the manmade amino acids to create many new artificial proteins, or xenoproteins, he said.

Now, the researchers are hoping they can use the xenoproteins in the fight against Ebola, anthrax, and other deadly, infectious diseases.

“A lot of folks have been working hard to incorporate one or two non-natural amino acids into a protein, but what we can do is install the whole non-natural sequence and still have a functional molecule,” Pentelute said.
total:0

Although some might be wary of manmade proteins, the new xenoproteins are more stable, easier to administer, and manufactured more quickly, Pentelute said. They also won’t degrade as quickly and, unlike drugs assembled with natural proteins, don’t have to be refrigerated, which means you could carry these drugs around in your pocket, he said.

Plus, he said, many drugs today are artificially-crafted anyway.

“The big thing is that a lot of drugs can be immunogenic and they degrade and you have to keep them in refrigerators. They’re not very stable,” he said.

Here’s how it works.

The scientists use the non-natural amino acids to create a class of xenoproteins — a process that only takes hours, Pentelute said. From that class, the researchers identify the specific ones that would successfully bind to particular antibodies, such as the one that attacks the Ebola virus. Once the xenoproteins attach themselves to the antibody and virus, they turn off the ability of the virus to live in a host, neutralizing the disease, he said.

The researchers have found that xenoproteins work to stop the Ebola virus in cell tissue, and animal tests are underway, Pentelute said. There is currently no antiviral drug for Ebola licensed by the US Food and Drug Administration.

The group is working with John Dye with the US Army Medical Research Institute of Infectious Diseases, Pentelute said.

Congo planned to begin administering an experimental vaccine

“The hope is that we can discover molecules in a rapid manner using this platform, and we can chemically manufacture them on demand,” Pentelute said in an MIT statement. “And after we make them, they can be shipped all over the place without refrigeration, for use in the field.”

Pentelute said it’s likely these new proteins could be the answer to more than Ebola and anthrax.

“We’re also looking at ways to use this as a method to activate the immune system to treat cancer,” he said. “There’s all sorts of broad applications of the technology toward cancer, and toward other diseases. That’s why we’re so excited.”

Congo began an Ebola vaccination campaign Monday in a northwest provincial capital in a major effort to stem an outbreak that has already made its way from rural towns into a city of more than 1 million people. So far, 27 people have died, The Associated Press reported.

Ebola vaccinations begin in Congo [Science News, 21 May 2017]

BY HELEN THOMPSON

052118_HT_ebola-ticker_feat.jpg
On May 21, nurses began vaccinating people in Mbandaka, the city that became the site of the first urban cases in Congo’s Ebola outbreak last week, as well as in Bikoro, the rural epicenter of the outbreak.

Emergency teams responding to the ongoing Ebola outbreak in Congo began on May 21 inoculating those most at risk of contracting the virus: health workers and people who have come into contact with Ebola victims. It’s the first real-world test for an experimental vaccine, rVSV-ZEBOV. In field trials in Guinea and Sierra Leone in 2015, this vaccine effectively protected people from Zaire ebolavirus — the same type of Ebola now circulating in Congo.
In this latest outbreak, 49 people have developed cases of hemorrhagic fever consistent with Ebola, and The Washington Post is reporting that 27 have died. The outbreak is centered in the rural Bikoro region but nearly a handful of cases have been reported in the city of Mbandaka.

Using a “ring vaccination” strategy, health care workers are offering shots not just to the people who’ve had contact with Ebola victims, but also to a second ring of people who’ve had contact with the first group. In that way, the World Health Organization and its partners hope to disrupt the chain of transmission.

Merck, the company that makes the vaccine, has donated 8,640 doses to the emergency response effort. That’s more than enough for 50 rings of 150 people. Another 8,000 doses are expected to become available soon, according to the WHO.

Health officials are optimistic. “Today marks a turning point in how we deal with Ebola,” WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama said on Twitter.

Congo to begin vaccinating against Ebola on Monday [Andover Townsman, 20 May 2017]

By SALEH MWANAMILONGO

KINSHASA, Congo (AP) - Congo will begin administering an experimental Ebola vaccine Monday in Mbandaka, the northwestern city of 1.2 million where the deadly disease has infected some residents, Congo's health minister announced.

"The vaccination campaign begins tomorrow, Monday, in Mbandaka, capital of the province. It will target, first, the health staff, the contacts of the sick and the contacts of the contacts," Minister of Health Oly Ilunga told The Associated Press Sunday.

The death toll of the current Ebola outbreak has risen to 26.

Initially, the campaign will target 600 people, mainly medical staff, contacts of suspected cases, and those who have been in contact with the contacts, said Ilunga. Officials are working urgently to prevent the disease from spreading beyond Mbandaka, which lies on the Congo River, a busy traffic corridor, and is an hour's flight from the capital.

More than 4,000 doses are already in Congo and more are on the way, according to officials.

The vaccine is still in the test stages, but it was effective in the West Africa outbreak a few years ago.

A major challenge will be keeping the vaccines cold in this vast, impoverished, tropical country where infrastructure is poor.

Four new cases have been confirmed as Ebola, said the health ministry in a statement released early Sunday. A total of 46 cases of hemorrhagic fever have been reported, including 21 confirmed cases of Ebola, 21 probable and four suspected.

Congo President Joseph Kabila and his Cabinet agreed Saturday to increase funds for the Ebola emergency to more than $4 million. The Cabinet also endorsed the decision to provide free health care in the affected areas and to provide special care to all Ebola victims and their relatives.

The spread of Ebola from a rural area to Mbandaka has raised alarm as Ebola can spread more quickly in urban centers. The fever can cause severe internal bleeding that is often fatal.

The risk of Ebola spreading within Congo is "very high" and the disease could also move into nine neighboring countries, the World Health Organization has warned. The WHO, however, stopped short of declaring the outbreak a global health emergency. WHO said there should not be restrictions to international travel or trade.

While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Kinshasa, Congo's capital of 10 million people, but was effectively contained.

The outbreak was declared more than a week ago in Congo's remote northwest and its spread has some Congolese worried.

"Even if it's not happening here yet, I have to reduce contact with people. May God protect us in any case," Grace Ekofo, a 23-year-old student in Kinshasa, told AP.

Schools in Mbandaka are implementing preventive measures by instructing students not to greet each other by shaking hands or kissing, said teacher Jean Mopono, 53.

"We pray that this epidemic does not take place here," Mopono said.

The WHO appears to be moving swiftly to contain this latest epidemic, experts said. The health organization was accused of bungling its response to the earlier West Africa outbreak -the biggest Ebola outbreak in history which resulted in more than 11,000 deaths.

There is "strong reason to believe this situation can be brought under control," said Robert Steffen, who chaired the WHO expert meeting last week. But without a vigorous response, "the situation is likely to deteriorate significantly," he said.

This is Congo's ninth Ebola outbreak since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with bodily fluids of those infected.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.

HOSPITALS’ SHUTDOWN AMID EBOLA NEXT DOOR: So much fear inside us – Experts [Vanguard, 20 May 2017]

By Chioma Obinna

The nation’s health sector is in crisis. With the shutdown of federal and state health facilities, patients are groaning. The situation is dicey. Reason: The facilities mostly serve the common man who doesn’t have the resources to access medical care in private hospitals. Meanwhile, his accessing healthcare in public institutions now is like the camel passing through the eye of the needle because the institutions have been shut down by striking health workers.

deserted-wardbb.png
Deserted ward at a General Hospital.

Whereas the affluent and our political leaders catch the next available flight to Europe, America, India, China, among others, for medical tourism with tax payers’ money, the common man is at the mercy of the health workers who are on indefinite strike following the Federal Government’s failure to honour the agreement it purportedly signed with them.

Government claims to have met 14 of their 15 demands, but the workers, under the aegis of Joint Health Sector Union, JOHESU, say their flagship demand (adjusted Consolidated Health Salary Structure, CONHESS) must be met before they return to work. The situation took a twist when doctors, through the Nigerian Medical Association (NMA), threatened to down tools should government listen to the health workers. The NMA said listening to the non-medical staff will trigger unrest in the health sector. Although doctors and nurses are not on strike, there is little they can do to meet the needs of patients in the face of a critical segment of the health sector embarking on industrial action. For instance, the implication of the JOHESU action is that doctors and nurses cannot proceed with patients needing laboratory tests because officials manning the laboratories are members of the striking union.

And although the country has no common boundary with DR Congo where new Ebola Virus Disease (EVD) is raging with seven of the 19 victims dead, the experience of 2014, which saw a victim from Sierra Leone bringing EVD to Nigeria, is still fresh in mind and has left many Nigerians asking if they are safe especially amid the health workers’ strike.

Strike bites harder

Entering some of the government-owned facilities as the health workers’ strike bite harder last week, you will imagine how Nigeria got it wrong? A walk round the waiting areas and corridors of the facilities, where a handful of helpless patients were seen waiting hopelessly, will move you to tears. Many general and teaching hospitals that used to be a beehive of activities were virtually ghost towns. For some of the critically ill patients who usually thronged the hospitals, the option must have been to relocate to private hospitals, even if it means paying through their noses. The ones seen around were obviously patients who had no means to look for succour in private hospitals.

“God, help me. Don’t let my enemies laugh at me”, one of the embattled patients was heard soliloquising when Sunday Vanguard visited Lagos University Teaching Hospital (LUTH) on Friday.

A word with the woman, who later identified herself as Mrs. Joan Ebuka, showed that she had come all the way from Imo State for a laboratory test for an undisclosed ailment for her seven-year-old child. The little girl, in pains, was a pathetic sight and obviously in need of urgent medical attention.

Sadly, the strike had caught up with the little child as officials, who should do the test are on strike, the mother told Sunday Vanguard in a tone reflecting her helplessness.

She said she was turned back and told to return whenever the strike was called off.

“My daughter is dying. I hope the strike is called off soon so that she can do the test to facilitate her treatment. Our health system is in shambles and a strike of this nature can only worsen the situation for poor people like me. I appeal to government to negotiate with the workers so that we can be attended to”.

Although, doctors at the hospital were seen attending to some patients, health workers, who would have filled the gap for a seamless operation, were nowhere to be found.

As of 2pm when Sunday Vanguard left the premises, some patients were still hanging around hoping to be attended to.

The relative of one of such patients, Kazeem, told our reporter that they never had any idea there was a strike going on before coming to LUTH.

At Igbobi Orthopaedic Hospital, the Federal Medical Centre, Ebute Meta, among other health institutions owned by the Federal Government in Lagos, the situation was not different. The few patients around were not attended to, even when doctors and nurses were ready to work.

Health workers at the Lagos State government-owned hospitals were also in total compliance with the JOHESU strike. As of the time of visit to the hospitals, only skeletal services were offered by consultants and resident doctors.

From the Lagos State University Teaching Hospital, LASUTH, to the Island Maternity Hospital, Lagos Island Hospital, Randle General Hospital, Surulere and Akerele Primary Healthcare Centre, the situation was the same.

The health records, pharmacy and laboratory departments of the hospitals were closed and no nurse was seen at their duty posts including the wards.

At the laboratory department of LASUTH, it was found that only few tests were being carried out by doctors on ground since laboratory scientists were not there.

Some patients, who spoke to Sunday Vanguard, lamented that government had failed them following incessant strikes in the health system.

Some of them, who had rushed from Federal Government hospitals to LASUTH, were disappointed as they had no premonition that health workers in the hospital were also on strike.

One of them, Ade Adedayo, said: “We were at LUTH last Monday, but because of the strike we decided to come here. On getting here, they said health workers are also on strike. I just wasted my resources and time coming here”.

Adedayo said he came because he urgently needed the services of a physiotherapist because of a hip issue.

“I am sure many people have died because of this strike. Why is our government doing this?”

At the Lagos Island General Hospital and Lagos Island Maternity Hospital, when Sunday Vanguard visited, the various departments, including the eye clinic, emergency centre, radiology section, paediatrics unit and the administrative section, were paralysed as JOHESU members stayed away from work.

Some old patients were, however, seen waiting to be attended to by doctors at the emergency section of both hospitals.

At the maternity session of the Island Maternity Hospital where nurses are always on ground to help pregnant women, no nurse was seen. Only pregnant women were seen waiting to see doctors.

Some of the pregnant women appealed to government to urgently attend to the demands of the striking health workers as they claimed they will soon give birth.

One of them, Mrs. Nkechi, who said she was almost due to be delivered, stated: “I want to have safe delivery. I don’t want to have complications during child-birth especially because I know that doctors cannot do it alone”.

ward-2.png


No new patients

A doctor in the hospital said workload for him and fellow doctors and nurses arising from the health workers strike was enormous but pointed out that they were trying to cope.

“Health workers are on strike but we are attending to old patients and emergencies. We are not admitting new patients in my department to ease the pressure”.

Also at Primary Healthcare Centres, PHCs, nurses, who were usually seen, were conspicuously missing.

Effects of strike

The Chief Medical Director (CMD) of the Nnamdi Azikiwe University Teaching Hospital, NAUTH, Nnewi, Prof. Anthony Igwegbe, vividly revealed the effect of the strike when he said that though doctors in the hospital were working, they operated only at insignificant level of 20 per cent of their capacity because of the JOHESU strike.

Igwegbe said the effect, in terms of services and income, was enormous on the hospital. While appraising the situation within the referral medical institution, he appealed to the striking workers and government to consider patients’ plight and resolve the disagreement.

Since the strike, which started precisely on the midnight of Tuesday, April 17, hospitals across the country have been shut down. This is not unconnected with the fact that JOHESU members comprise about 90 per cent of the health workforce. The members are drawn from five associations namely the Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated Institutes, SSAUTHRIA, Nigerian Association of Nigerian Nurses and Midwives (NANNM), the Non Academic Staff Unions, NASU, Medical and Health Workers Union, NHWU, and the Nigerian Union of Allied Health Workers, NUAHP.

The workers are demanding, among other things, the adjustment of the Consolidated Health Salary Structure, CONHESS, implementation of court judgments and upward review of retirement age from 60 to 65 years, payment of arrears of the skipping of CONHESS10, and employment of additional health professionals.

New twist

In a related development, NMA threatened to resume its 2014 suspended strike should government accede to the demands of the striking health workers. The National President of the association, Dr Francis Faduyile, and Secretary General, Dr Olumuyiwa Odusote, in a press statement, said their position was informed by the extension of the strike to states and local government- owned health facilities.

They also warned that no award should be given to non-medically qualified health professionals as it will violate the agreements of 2014 NMA entered into with government.

The JOHESU demands have seen government going back and forth with the Minister of Health, Prof Isaac Adewole, saying government had no agreement with the union only to reverse himself by claiming that government had met 14 of the 15 demands of the workers while the last demand was being addressed.

waiting-patients.png
Skeletal service at a Teaching Hospital.

No going back

Speaking on the strike, the Vice Chairman of JOHESU, Com. Obinna Ogbonna, said the workers’ patience had been over stretched and could no longer be taken for granted.

According to him, they decided that unless government met their flagship demand, the strike would continue.

He accused the three Ministers of Health and Labour and Employment of being biased on the issue as they are doctors.

“The flagship demand is the adjusted CONHESS. If they do the right thing, we will resolve the problem immediately. But we don’t want a situation where the Nigerian Medical Association, NMA, will be the one deciding what government gives to us”, he said.

“They (NMA) cannot subjugate or suppress us. When they were making their own demands, nobody stopped them. Now that we are doing our own, which is not even up to what they collected and government is considering it, they are blocking us. Please let the average Nigerians know the truth”.

Asked if government had met the 14 demands as claimed by the Minister of Health, Ogbonna said none of the demands had been addressed.

“Yesterday at our meeting with government, we asked the minister pointedly where the circular for the 14 demands they met emanated from. He was taken aback. These are political statements to make the people believe that JOHESU is evil.

“The CONHESS cuts across every one of our demands. When they do it, we will reconsider going back to work but that is not to say we are jettisoning our other demands. We will sit down and look at the rest so that the pressure will no longer be on them.

“But we will get alert before we go back to work”.

Ebola: Risk of outbreak

As the Federal Government, JOHESU and NMA continued their war of words, health watchers fear that EVD may be next door.

They also fear that judging from the last outbreak in Nigeria, identification of a case of Ebola anywhere in the world, not to talk of a country as near as Congo, remains a challenge which should spur all the members of the health community to sheathe their swords and put their house in order before the country is caught unawares like it happened in 2014.

Instructively, the Chairman of JOHESU, Biobelemoye Joy Josiah, failed to allay that fear when he warned that “none of our members will be involved in any Ebola screening until government does the needful.”

The Chairman of the union at LUTH, Com. John Adetokumbo Shaba, echoed similar sentiment. “During the period of Ebola crisis in 2014, the NMA was on strike and heaven did not fall. For us, when we get to there we will know how to cross the bridge. Let the government do the needful”, he said.

As a precautionary measure, the Federal Government had, last week, ordered screening of travellers from Congo and neighbouring countries after the fresh outbreak of the haemorrhagic fever in Congo.

Port Health Services workers at the airports who, apart from giving vaccination against yellow fever as a major requirement for travelling to many African countries, help with the health screening of passengers, are JOHESU members.

But investigations by Sunday Vanguard showed that only top officials of the Port Health Services are carrying out skeletal services because of the strike.

However, the General Manager, Corporate Affairs, Federal Airports Authority of Nigeria, FAAN, Mrs. Henrietta Yakubu, recalled that since the first recorded case of the virus in Nigeria in 2014 through an American-Liberian, Patrick Sawyer, who flew in from Sierra Leone, the agency had not relaxed its surveillance at the airports in order to forestall re-occurrence.

“All the equipment and personnel used in combating the virus in 2014 are still very much at the airports. We have always had thermal scanners in our airports that monitor temperature of passengers and capture their pictures”, Yakubu said, last week.

As of 13 May, according to the World Health Organisation, WHO, a total of 39 Ebola cases had been reported in Congo .

As an Ebola Outbreak Threatens to Spread Even Wider, A New Vaccine Gives Hope 
 [Fortune, 19 May 2018]

By CLIFTON LEAF

imageBy CLIFTON LEAF.jpg
The latest Ebola outbreak in Congo is spreading. JOHN WESSELS AFP/Getty Images

The World Health Organization has raised the threat level for an outbreak of Ebola in the Democratic Republic of the Congo after additional suspected cases of the disease were identified in Mbandaka, a Congo River port city with over a million residents. Mbandaka, importantly, also serves as a hub for traffic across equatorial Africa—a region where national borders can be especially “porous,” making the risk of international spread all the greater, says an emergency committee of the WHO.

The new suspected cases of the disease follow the reports of 45 others and 25 deaths across the country since April 4. Fourteen of those cases were confirmed as Ebola, according to the global health organization, which now assesses the risk of much wider spread in the region to be “very high,” the agency’s second-highest threat level.

The WHO now says nine countries neighboring Congo are “at high risk of spread.”

In what could be a milestone of progress—and I emphasize “could be”—the threat of outbreak will be met this time with a new weapon, a vaccine that has been demonstrated in at least some human trials to have “high protective efficacy and effectiveness to prevent Ebola virus disease.”

The Merck vaccine rVSV-ZEBOV, developed at the Public Health Agency of Canada’s National Microbiology Laboratory, was tested in several thousand people who were either contacts or “contacts of contacts” of individuals with confirmed Ebola virus disease after a 2015-16 outbreak in Guinea, West Africa. None of those vaccinated developed the disease after 10 days, even as 16 people in the unvaccinated comparator group did, according to a report in the Lancet. It remains unclear how long that apparent protective effect will last, though evidence suggests than antibodies to the disease in vaccinated individuals can last two years or more.

At least a few researchers have suggested that there should be a question mark on this recent study, despite the large number of people tested. But public health officials are moving forward with what they call a “ring vaccination.” The WHO tweeted out on Wednesday that “A first batch of 4000 #Ebola vaccine doses” had just arrived in Kinshasa, the Congo’s capital city.

We will see soon enough if we’ve reached a turning point in one of the greatest public health challenges around.
nice!(1)  コメント(0) 

Zoonotic canine flu from 10 Mar 2018

What You Need To Know About A Potentially Deadly Canine Influenza Outbreak In Brooklyn [Gothamist, 16 May 2018]

BY ANDRES O'HARA

051618dogs.jpg


Veterinarians are sounding the alarm about an outbreak of canine influenza in Brooklyn. The malady can cause cause flu-like symptoms in dogs, including coughing, sneezing, nasal discharge, and loss of appetite. But for up to 10% of dogs, this flu could be fatal, even if it is aggressively treated, says Dr. Natara Loose, the veterinarian at The Neighborhood Vet in Brooklyn. Veterinarians are strongly encouraging that dog owners get their pets vaccinated for the flu and get the booster two weeks later. There is no guarantee that the vaccine fully protects against the flu, but it can greatly minimize the symptoms.

Once a dog has the illness, it takes three to five days for it to develop symptoms, and the dog can be contagious up to 30 days after contracting the illness. According to the American Veterinary Medical Foundation, most dogs recover in 2-3 weeks, but even after recovery, a dog could be contagious for weeks.

Dr. Loose said that she had three reported cases in her clinic that were contracted from a doggy day care, and she knows of three other reported cases from the same doggy day care. (Dr. Loose declined to identify the day care, citing patient confidentiality.) Loose said that there are no concrete figures on the number of dogs infected, since there is no central database and there are multiple labs testing for this disease. But Dr. Loose confirmed that there are four other cases from a local ER in Brooklyn, and in her view the Williamsburg/Greenpoint area seems to be a hub for this virus.

A veterinarian at Crown Heights Animal Hospital said they received reports of a case of canine influenza from the veterinary clinics BluePearl and VERG-Brooklyn. Dr. Carey Hemmelgarn, a veterinarian at Blue Pearl, said that they have treated two confirmed cases of the flu, and 30 cases of coughing dogs who could have the flu. She said that VERG-Brooklyn was experiencing similar rates. Most people don't want to test their dog for the flu (the test is $300), and instead just treat their dog with antibiotics, said Dr. Hemmelgarn.

The flu strains H3N8 and H3N2 are highly contagious. Up to 80% of dogs exposed to the virus will contract it. The flu is airborne and contagious up to 25 feet, according to Dr. Loose.

Any place with a high concentration of dogs increases the likelihood of catching the illness, and dogs do not have to touch each other to spread the virus.

Humans can’t catch canine influenza, but can spread it to dogs through their hands or their clothing. It remains contagious on hands for up to 12 hours, and on clothing for up to 24 hours, so dog owners should wash their hands and change their clothes regularly if they think they have come in contact with a sick dog, said Dr. Loose.

Dog walkers could spread the disease if they are petting dogs with the flu and not washing their hands or changing their clothes, and it could be spread if they use the same leash or safety collar on many different dogs. Dr. Loose recommends that people who use dog walkers should ask if any of the dogs they walk have experienced symptoms of canine influenza, and what they are doing to prevent its spread.

If you suspect that your dog has the flu, you should call your vet immediately, and your dog should be taken directly to a quarantine room in the vet’s office. Do not escort your dog in through the reception area, because it could infect any other dog waiting there. It is even possible the flu strain could spread to cats, but there have been no reported cases of that happening in New York.

One of our readers contacted us to say that his dog, a three year old hound, contracted influenza. He said that his regular doggy daycare reported 5 cases of suspected kennel cough, but that those could have been the flu. When his dog began to develop a cough, his girlfriend took the dog to their veterinarian. The vet reacted like it was an emergency and said that they would have to bleach all the rooms that the dog had been in. The dog is currently recovering at home under quarantine, and has been prescribed a round of antibiotics.

Attention Dog Owners: Canine Influenza [Brooklyn Heights Blog (blog), 11 May 2018]

by Teresa Genaro

Heather-Thomson-and-Minnie2-225x300.jpg
Photo: Dr. Heather Thomson and Minnie, taken by Teresa Genaro

From the good folks at Brooklyn Heights Veterinary Hospital, we learned today that there have been at least two confirmed cases of canine influenza in our borough. They sent us this helpful link from Merck Animal Health.

Although the bivalent flu vaccine is not mandated by New York City or State, BHVH recommends that all dogs receive it, and are now strongly recommending it, given the local cases. They advise that no vaccine is 100% effective at stopping transmission, the vaccine may help reduce the severity of the symptoms if your dog gets infected.

Symptoms of canine influenza:

• High fever (103+ºF)
• lethargy
• loss of appetite
• cough (dry or with sputum)
• nasal discharge (usually clear in the early stages but may become yellow and/or pink-tinged).

If your pet shows any of these symptoms, avoid taking your dog to places s/he might have contact with other dogs and contact your veterinarian.

The canine influenza vaccine requires two injections, two to four weeks apart, and annual boosters. If you’d like to have your dog vaccinateed, you can contact BHVH at bhvh59@gmail.com or 718.624.1200.

Brooklyn Heights Veterinary Hospital is located at 59 Hicks St, corner of Cranberry.

What’s new with dog flu? [dvm360, 5 May 2018]

By Sarah J. Wooten

veterinary-young-fawn-mixed-breed-puppy-laying-on-striped-bed-450px-shutterstock-564777532.jpg


What’s going on with canine influenza? Well, there’s a website and a week, and now the Canadians are involved. Here’s what you need to know to keep your patients safe.

Did you know that there is now an annual Dog Flu Prevention Week? In response to the thousands of dog flu cases reported last year and recent outbreaks, Merck launched the Inaugural Dog Flu Prevention Week on April 16.

With flu in focus, I’ve gathered some updates and tips from Jason W. Stull, VMD, MPVM, PhD,
DACVPM, an assistant professor at The Ohio State University and owner of Island Dog Consulting.

Some quick flu facts:

Here are some factoids from dogflu.com (Merck's new resource) to get started:

• Unlike human flu, canine flu is not seasonal. It’s a year-round problem, and the most commonly affected dogs are middle-aged, not puppies or seniors.

• Dogs infected with canine influenza are potentially infectious for up to three weeks after onset. Dr. Stull recommends advising clients with confirmed dog flu to keep their dogs home and isolated from other dogs for four weeks.

• The H3N2 strain produces only mild disease, but it’s extremely infectious and easily vectored on human hands and clothing. Once flu has been introduced into a veterinary hospital or other group setting, it spreads like wildfire.

• There is no evidence that canine flu infects humans.

Current hot spots

Santa Clara, California, and Reno, Nevada, are currently experiencing canine flu outbreaks. Not to be left out, Canada has now joined the club with its first canine flu cases confirmed, including an outbreak in central Ontario with 25 confirmed cases—most likely linked to a shipment of rescue dogs from Asia. To stay current on outbreaks, Dr. Stull recommends bookmarking Cornell’s page or visit the Worms and Germs blog, both of which have up-to-date disease surveillance maps.

GASP! You’re in a hot spot! Here’s what to do …

Keep calm, says Dr. Stull, and follow these tips:

Understand the vaccine. Even though the bivalent canine influenza vaccine reduces the risk of a dog contracting canine influenza, it doesn’t provide sterile immunity. Much like the human influenza vaccine, it reduces the clinical signs if a dog is infected and consequently reduces the number of cases and helps control spread of the disease.

Proactively reach out to at-risk patients. Send out an email informing your clients of the risk and highlight the need to vaccinate at-risk patients, such as those that travel, go to doggie daycare, participate in dog shows and so forth.

Check your infectious disease prevention protocols. If you have gaps in your infectious disease prevention protocols, influenza will reveal them. Influenza travels quickly and overwhelms a facility. Dr. Stull can tell stories of clinics where one flu suspect infected the whole hospital, where veterinary staff infected their own dogs, and where doggie daycare and grooming facilities had to be shut down for decontamination.

According to the AVMA, canine influenza virus may persist in the environment for approximately two days and be viable on hands for 12 hours and on clothing for up to 24 hours. It appears to be easily killed by disinfectants, so follow proper handwashing and biosecurity protocols. Patients suspected of having the flu should not be allowed to enter or exit through the main entrance or permitted in the waiting room. Dr. Stull advises keeping these patients in the car, and, if possible, conducting the exam in the vehicle; the employee should wear personal protective equipment (gloves and a gown at minimum).

Why wait? Vaccinate!

Part of the challenge of preventing canine influenza outbreaks is helping people realize the risks and encouraging a proactive approach. It’s hard to talk a client into yet another vaccine during a wellness visit when they’ve already agreed to a battery of core vaccines. The good news is that there’s a bivalent vaccine available (remember when we had to give separate vaccines for H3N2 and H3N8?), so it’s at least one less poke.

People have a basic human need for autonomy and like to be involved in choosing what happens to their pets. With this in mind, try my tips for educating clients:

Canine influenza is a lifestyle vaccine: not every dog needs it, and one size does not fit all.

Give the client the opportunity to take the AAHA risk assessment test while they’re sitting in the waiting room or exam room to determine which vaccines their pet needs.

Ask clients to read a dog flu fact sheet (see examples here and here) while they’re waiting for the doctor and then ask if they have questions and if they’d like their dog to receive the flu vaccine during their visit.

Human medicine does a huge marketing push for influenza vaccines every year at the beginning of flu season. While canine flu is year-round, you may be able to piggyback on the awareness surrounding human flu and gain greater compliance through the parallels drawn to human health. Consider hosting an influenza vaccine fair with low- or no-cost exams on a Saturday either at your clinic or at a local health fair. People are more likely to say yes if you focus on a single vaccine.

Use dogflu.com to educate your clients and your staff. There’s a free downloadable infectious disease handbook, an interactive outbreak map that spans several years, and tips for everyone (including groomers, dog walkers, concerned pet parents and veterinary professionals).

Manage disease risk in group settings

Places where dogs come together, such as dog shows, dog parks, and training and boarding facilities, are at highest risk for disease spread and need the most disease prevention attention, says Dr. Stull. Funded by a grant from the American Kennel Club, a team from Ohio State University put together a website detailing everything you need to know about infection control in group settings, including a white paper for clients, an open access article from JAVMA, an infectious disease risk calculator and fact sheets you can use to protect your business and your patients.

Dog flu concerns arriving earlier than normal in Louisville this spring [WDRB, 1 May 2018]

By Joel Schipper

16657260_G.jpg


LOUISVILLE, Ky. (WDRB) -- The Kentucky Humane Society closed its intake facility on Steedly Drive on Sunday because three dogs have cases of the flu. It's 10 off-site adoption centers will remain open, but it won’t be taking in any more dogs for the time being.

On Monday afternoon, more than 100 dogs played and joined their owners on the great lawn of Waterfront Park for the Fest-a-ville HappyTail Hour. It’s areas like that where lots of dogs gather that veterinarians say poses the greatest risk for dogs to catch the virus.

“Last year, we didn’t see anything till June, really. So I am still waiting for the other shoe to drop,” said Veterinarian Kurt Oliver at the Lyndon Animal Clinic. “The industry is all over this trying to find answers, but I don’t know if the answers are there yet.”

In 2017, the Louisville area had the most number of dog flu cases than any other area in the country. Officials also say shelter dogs were vaccinated for both strains of the dog flue starting in June 2017 when the virus was first detected in the city.

In cases where the dog flu may be present, staff at Lyndon Animal Hospital will greet owners and the pets in the their cars and treat the animals there so they don’t have to come into the clinic.

The series of two vaccinations are given out two to four weeks apart and aside from washing clothing and dog toys, is one of the surest ways at preventing the virus from spreading

“If [the flu] continues and gets worse, it might make us reluctant to want to take our dogs out," said Dee Spence, who brought her four-month old french bulldog puppy to Monday's event at Waterfront Park. "Really wouldn’t want anything to happen to it. It’s like a child. You would like to think that anyone that has a dog treats it like a family member.”

The Kentucky Humane Society will be halting their dog intake for approximately two weeks until the quarantined dogs are cured of the virus.


Canine Influenza Outbreak Treated by Danville Veterinarian [GlobeNewswire (press release), 22 Mar 2018]

DANVILLE, Calif., March 22, 2018 (GLOBE NEWSWIRE) -- A San Ramon Valley veterinary clinic implemented a community initiative working with local dog owners due to a canine influenza outbreak affecting bay area dogs in the Danville area. As a result, those affected received vaccinations and the outbreak is now over.

“I am happy to report we have gotten a handle on the influenza outbreak,” says Danville veterinarian Jeff Johnson. “It’s been an uphill battle, but everyone in the community came together and worked hard to get this under control. We have been able to educate everyone on the signs of this influenza and have successfully administered vaccinations to keep the outbreak at bay.”

There were over 400 dogs confirmed with the canine influenza. Although highly contagious, the diligence of the community in locating these dogs contributed to catching it in the early stages.

Because this was such a new occurrence, owners were not aware of how this outbreak could be transmitted. They now know it can be passed from one sick dog to another, or the virus can be brought into the home through clothing or shoes once they have been exposed to a dog who has been infected. While most dogs are not seriously affected, some can experience fatal pneumonia as a result of this influenza.

Working together makes a huge difference in the way these situations are handled. In Danville, most dog groomers and kennels are now requiring proof of the vaccine being administered prior to having dogs enter their facility. Service dog groups in the area have also implemented this requirement.

“Our overall goal is to ensure every animal receives the treatment they need to remain healthy,” says Johnson. “Just like adults, animals get sick too. Understanding why and how this can happen will assist in keeping outbreaks at a minimum. Adults get flu vaccines every year, and animals should be treated the same way.”

About The Veterinarian: In addition to treating canine influenza, Tassajara Veterinary Clinic treats heartworm, dental diseases, pet allergies and pet ear infections with preventive care and general surgery. The clinic recommends all pets visit the veterinarian once a year for a checkup. This includes a full physical exam, which includes gum and teeth cleaning if needed. If they are not a previous patient, providing a full medical history on the animal is necessary.

Dog owners should remain vigilant on this issue and make sure their pet has all their required vaccinations. To determine whether or not your dog has signs of canine influenza, and for more information, contact the Tassajara Veterinary Clinic at 925-736-8387 today or visit http://www.tassajaravet.com/.


Canine influenza cases confirmed in Northumberland [northumberlandnews.com, 13 Mar 2018]


by Karen Longwell

CB_Z_DogFlu2___Super_Portrait.jpg
OBOURG -- Dr. Amanda Johnson, an associate veterinarian with Midtown Animal Hospital, checked Daisy, a boxer, who does not have the flu but H3N2 canine influenza cases were recently confirmed in Northumberland. - Karen Longwell / Northumberland News

NORTHUMBERLAND — A new canine influenza virus has been found in Northumberland.

As of March 12, there were six confirmed cases of the H3N2 canine influenza in Northumberland, said veterinarian Dr. Brent Steele, owner of Midtown Animal Hospital in Cobourg. The virus is from Asia and new to Canada, so Canadian dogs do not have immunity to the virus, said Dr. Steele.

“This is a brand new bug ... it’s now in the area,” said Steele.

Steele wanted to inform the dog owners about the disease and suggested dog owners contact their veterinarian to see if the vaccine is advisable. Like human flu vaccines, a canine flu vaccine does not guarantee protection but reduces risk.

Most dogs that develop influenza do not get seriously ill, according to Scott Weese’s Worms and Germ blog from the University of Guelph Centre for Public Health and Zoonoses. Dogs with signs of respiratory disease, such as a cough, decreased appetite, nasal and eye discharge and fever, should be kept away from others dogs for at least three weeks, said Weese. If a dog with potentially infectious respiratory disease is taken to a veterinarian, the veterinary clinic should be informed in advance so the clinic can take precautionary measures to prevent the spread of the virus.

The cases in Northumberland were all linked to one source, said Weese. How H3N2 influenza got to Northumberland is still being investigated. Testing of dogs who had contact with dogs with influenza, as well as other dogs in the area with flu-like disease, is underway.

Infected dogs can shed influenza virus for a short time prior to the onset of disease, meaning dogs that appear healthy are still a potential source of infection.

Canine H3N2 influenza virus is different than the human H3N2 influenza virus. There is no known human risk from H3N2 canine influenza virus. However, the risk of a type of mixing together of human and canine virus is a potential concern, according to Weese’s blog.

The virus was first found in late December in the Windsor area and was later found in the Muskoka region.


Cases of canine influenza in Ontario linked to imported rescue dogs [CityNews, 10 Mar 2018]

BY CRISTINA HOWORUN

Canine influenza — a relatively uncommon, yet potentially fatal respiratory disease — has been spreading through Ontario.

The infection is so rare in Ontario that most dogs aren’t vaccinated against it, which makes the recent outbreak even more troubling.

Ontario dogs haven’t been exposed to the strain and aren’t immunized against it, which has enabled it to spread quickly from a handful of dogs in central Ontario to an estimated 100 dogs.

The strain has now been found as far away as Grimsby, and has led to at least one dog’s death.

The source is believed to be mainland China.

Last month, several adult dogs were imported from China through a rescue group. They arrived with their vaccination records, but the Canadian Food Inspection Agency (CFIA) does not require adult dogs to be quarantined or examined by a veterinarian upon arrival.

“When the dogs arrive at the airport, and I think this is a surprise for a lot of people, they aren’t looked over,” said Nicole Tryon, who picked up the dogs on Feb. 13.

“They come in as cargo, as commercial goods. [Customs checks] to make sure they have rabies vaccinations. They barely look into the kennels, nothing.”

According to the CFIA website and Canadian Border Services Agency (CBSA) guidelines, in most cases, imported pets do not require veterinary exams upon arrival or mandatory quarantine periods.

“We’ve had concerns about importing for quite a while,” said the Ontario Veterinary College’s Scott Weese, one of the authors of a 2016 report calling for tougher regulations.

“We know that when you move animals across big distances, they bring things with them and that can include a variety of diseases — and the flu has been one of those concerns. We could see this was likely to happen at some point as there are very little restrictions on how you move dogs between countries.”

Based on data collected from rescue groups, Weese believes about 6,200 rescue dogs entered Canada in 2014. But the CFIA doesn’t track all imported dogs; only very specific types require import licences.

Most of the group’s recommendations, including the accurate tracking of imported dogs, do not appear to have been adopted by the agency.

“We don’t have a lot of regulation for the animals that come in,” Weese said. “The main concern is rabies vaccination, and even that is fairly lax.”

Tryon expressed concerns about the dogs’ coughs almost immediately, but was assured by the rescue agency manager that they were suffering from the much less severe kennel cough.
The dogs spent several days in Tryon’s care with her dogs, before she took them into her home and they interacted with several other dogs.

Tryon said her dogs became ill, and oral swabs sent to a lab revealed they had contracted canine influzena. She quickly quarantined the dogs, which received antibiotics and care and are recovering.

“It’s scary,” she said. “It spread so quickly and it forced my dog’s daycare centre to close for the past few weeks to stop it from spreading. It’s costing them lots of money to stay closed and to lose out on boarding clients, but it’s the only responsible thing to do.”

Weese recommends getting your dog vaccinated if you live in or visit affected areas, including Orillia, Bracebridge or Gravenhurst

An H3N2 canine influenza vaccine is available in Canada and efforts are underway to ensure an adequate vaccine supply is present, he said.


Area vets: Dog flu season is just getting started [Longview Daily News, 10 Mar 2018]

by Marissa Harshman

While flu season appears to be winding down for humans, it may be heating up for man’s best friend.

Area veterinarians are warning dog owners about an outbreak of canine influenza and urging them to vaccinate high-risk dogs. The recommendation comes after cases of canine influenza were confirmed in Grants Pass, Ore., and, just last week, Walla Walla.

The outbreak of the H3N2 strain of canine influenza began in San Francisco in December.

Veterinarians have confirmed more than 400 cases in the outbreak — the bulk of which are in the Bay Area — with many more suspected.

The recent cases in the Pacific Northwest aren’t reason to panic, said veterinarian Sandy Willis, a small animal internist at Phoenix Lab in Mukilteo, Wash. and past-president of the Washington State Veterinary Medicine Association. But dog owners should take notice because the viral respiratory disease is quite contagious, she said.

“Mortality isn’t high, but morbidity is,” Willis said. “A lot of animals can potentially get infected.”

The virus is spread between dogs much like influenza viruses are spread between humans: through droplets expelled during coughing and sneezing — and, for dogs, barking. The virus can also remain viable on surfaces for up to 48 hours, on clothing for 24 hours and on hands for 12 hours, according to the American Veterinary Medical Association.

“Virtually all dogs exposed to canine influenza virus become infected,” according to the American Veterinary Medical Association website. Humans cannot be infected with canine influenza, and infection in cats is rare. But the ability for the virus to spread quickly among dogs prompted DoveLewis Veterinary Emergency & Specialty Hospital in Portland and some local veterinarians to recommend immunization for at-risk dogs.

“It’s sort of a lifestyle situation,” said Dr. Vanessa Hawkins, veterinarian at East Padden Animal Hospital in Vancouver. “Not every single dog needs to go out and get the vaccine.”

Dogs that come into contact with other dogs are at higher risk for contracting the virus. That includes canines that regularly visit dog parks, doggie day cares, grooming and boarding facilities and dog shows. Dogs that recently traveled to or from the outbreak area in California are also at higher risk, as well as rescue animals, senior dogs and dogs with heart disease or lung disease.

East Padden Animal Hospital sent a notice to its patients last month, advising owners to consider the vaccine if their dog fits the high-risk criteria. While there aren’t any local cases yet, Hawkins said she won’t be surprised to see the virus reach Southwest Washington.

Many local animal rescue groups partner with organizations in California and bring dogs to the metro area, Hawkins said. A dog may appear healthy but actually be infected with the flu and not yet showing symptoms. An asymptomatic dog could introduce the virus to the local community, where it could quickly spread, she said.

The most common sign of illness is a cough that lasts 10 to 21 days. Other symptoms include sneezing, thick nasal discharge, lethargy, anorexia and fever. Dogs infected with the H3N2 strain may start showing respiratory signs two to eight days after infection, according to the American Veterinary Medical Association.

There are no medications to treat canine flu, but veterinarians may recommend supportive care to keep the dog hydrated, manage the cough and treat secondary bacterial infections. Most dogs recover within two to three weeks.

The canine influenza vaccine can protect dogs for one year. Not all veterinary clinics carry the vaccine, so dog owners should check with their clinic to ensure it’s available.

East Padden Animal Hospital has a bivalent vaccine, which protects against the two strains of canine influenza (H3N2 and H3N8). The vaccine comes in two doses: the initial shot and a booster three weeks later. Each shot is $45 at the east Vancouver animal hospital; dogs not established as patients will also need an exam, which costs $55.

nice!(0)  コメント(0) 

Ebola outbreak News from 2 May till 18 May 2018


WHO Decides Not To Declare International Health Emergency Over Ebola OutbreakH1N1 'swine' flu strain showing up in Calif., U.S.
 [HuffPost, 18 May 2018]

By Lauren Weber

5afed0cf2000006505b91e67By Lauren Weber.jpg
(DENIS BALIBOUSE / REUTERS) Director-General of the World Health Organization Tedros Adhanom. The WHO on Friday decided not to declare the Ebola outbreak in Democratic Republic of Congo an international health emergency.

WHO cited the fast response to the outbreak and pending use of a vaccine in the Democratic Republic of Congo.

The World Health Organization on Friday decided not to declare the Ebola outbreak in the Democratic Republic of Congo an international health emergency.

The quick response by the central African nation and WHO, the deployment of global health resources, and the pending use of an experimental vaccine make an international health emergency declaration unnecessary, said Dr. Robert Steffen, chairman of WHO’s emergency committee. A “vigorous response” to the deadly outbreak still needed to continue, and “without that the situation is likely to deteriorate significantly,” Steffen said at a news conference in Geneva.

A WHO declaration of international health emergency aims to draw global attention and trigger an escalated international response to a crisis with the potential to affect the world. WHO has only made such declarations four times since regulations were enacted in 2007: for swine flu in 2009, polio and Ebola in 2014, and Zika in 2016.

If the Ebola outbreak spreads further, Steffen said, committee members may reconsider whether to declare an international emergency.

Though 14 cases of Ebola have been officially confirmed in the Democratic Republic of the Congo, 31 suspected or probable cases have been recorded, and the outbreak has spread to an urban area. In 25 cases, patients have died, Dr. Oly Ilunga Kalenga, the country’s minister of health, said in a statement. Four cases, including one of the fatalities, were in Wangata, a health zone in the regional capital of Mbandaka, home to 1.2 million people on the Congo River.

The move of the disease to an urban area located on what some have called the “superhighway of Central Africa” caused the WHO to revise its assessment of public health risk to “very high” at the national level and “high” at the regional level. The WHO still considers global risk from the outbreak to be “low.”

Steffen said nine neighboring countries have been supplied with equipment and personnel to monitor potential spread of Ebola. Airport exit screenings have begun at the Democratic Republic of Congo’s capital of Kinshasa, and WHO is moving to screen people at ports along the Congo River.

More than 570 people who may have had contact with someone suspected of being ill are being tracked, according to Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general.

“We were really encouraged by what we had seen,” Tedros said of the response to the outbreak he saw during a visit last weekend. “There is strong coordination with government and partners.”

Tedros said more than 7,000 doses of an experimental vaccine are being sent, and some should be available beginning Sunday. WHO officials cited the vaccine as a key aid in tracing contacts, as it encourages people to be honest about possible Ebola exposure.

WHO advises other countries against imposing travel or trade restrictions on the Democratic Republic of Congo, which “needs our support & solidarity,” Tedros added in a tweet.
WHO said it has secured almost $9 million of the $26 million it needs from the international community to contain the outbreak. In contrast, the 2014-2016 Ebola outbreak in West Africa that killed more than 11,300 people and infected 28,000 cost $3.6 billion to fight.

“The decision by WHO not to call a public health emergency of international concern is the right one for the time being,” Dr. Jeremy Farrar, director of Wellcome Fund, a U.K. philanthropy that has donated $2.7 million to the outbreak, said in a statement.

“These measures, heightened surveillance in surrounding countries and coordinated global action give us the best possible chance to protect the communities and healthcare workers most at risk of Ebola,” Farrar continued. “However, we can’t predict how the outbreak will progress, and the WHO must keep the situation under frequent review.”

Jeremy Konyndyk, who helped lead the Obama administration response to the 2014 Ebola outbreak, told HuffPost WHO made the right call “for now,” as the threshold for an international emergency declaration is “rightfully pretty high.”

When the 2014 outbreak was declared an international emergency, “weekly new case counts were in the hundreds, across three countries, and accelerating,” said Konyndyk, now a senior policy fellow for the Washington-based Center for Global Development. “That declaration should have been made sooner, but even so, the current situation in DRC is nowhere close to that. New case counts are around 2-4 per day, in a single country, and not accelerating.”

That WHO considered the emergency declaration only 10 days after being notified about the first cases ― a contrast with the months-long delay in the 2014 outbreak ― shows the seriousness of the response, Dr. Ashish Jha, director of the Harvard Global Health Institute, told HuffPost.

Jha said he agreed with WHO’s decision, but said the spread of Ebola to an urban area is highly concerning.

Other experts, including former Obama administration Ebola czar Ronald Klain, also urged continued caution.

NEWS Congo's health minister says Ebola has spread to a city, a worrying development in the country's northwest [Tampabay.com, 17 May 2018]

KINSHASA, Congo (AP) — Congo's health minister says Ebola has spread to a city, a worrying development in the country's northwest.

Can an Experimental Ebola Vaccine Put a Stop to the Latest Outbreak? [Smithsonian, 17 May 2018]

By Brigit Katz

ap_18137479319051.jpg
A health care worker wears virus protective gear at a treatment center in Bikoro, Democratic Republic of Congo, the epicenter of the latest outbreak. (Associated Press)

Over 4,000 doses of the vaccine have arrived in the Democratic Republic of the Congo

An Ebola outbreak is currently underway in the Democratic Republic of the Congo. Health officials have identified 42 suspected, probable and confirmed cases, and 23 people have died. The disease has spread from the remote rural region where it began to Mbandaka, a city of nearly 1.2 million people, prompting fears that it will become hard to control. But a new vaccine may be able to stop the outbreak in its tracks.

As Julia Belluz reports for Vox, more than 4,000 doses of an experimental Ebola vaccine have arrived in the DRC, with another 4,000 expected to arrive in the coming days. The vaccine, known as rVSV-ZEBOV, was first created in the early 2000s, but this marks the first time that it has been used to control a new outbreak.

There are five species of Ebola; rVSV-ZEBOV protects against a strain known as Zaire, which is the one that most commonly infects humans. As Megan Jula explains in Mother Jones, the vaccine works by “trick[ing] the body into thinking it has been infected with Ebola and launching an immune response.”

Clinical trials suggest that the vaccine works very well. When it was first developed by the Public Health Agency of Canada in 2003, rVSV-ZEBOV was shown to be 100 percent effective in monkeys. But there was little interest from the pharmaceutical industry until a major Ebola outbreak in West Africa killed more than 11,000 people between 2014 and 2016. The pharmaceutical company Merck bought the rights to the vaccine in 2014.

According to Nurith Aizenman of NPR, rVSV-ZEBOV was first tested on humans in 2015, when around 7,500 people in West Africa were innoculated. Researchers used what is known as a “ring vaccination”; when a person became infected, their contacts—family, friends, neighbors—were all vaccinated, and then those individuals’ contacts were vaccinated as well.

In the past, Ebola has been controlled by isolating the sick before they can infect anyone else, but this method has not proven particularly successful at stopping Ebola’s spread through large cities. The ring vaccination method, on the other hand, was highly effective. The results of the clinical trial showed that not a single person who received the rVSV-ZEBOV went on to contract Ebola. And even when some members of an infected person’s “ring” were not vaccinated, overall transmission was reduced by about 75 percent.

“That is a big deal,” Ira Longini, a biostatistician at the University of Florida who was involved in the trial, tells Aizenman, “It’s very unusual.”

The vaccine is not yet licensed, but the government of the DRC has formally asked that it be deployed under “compassionate use” protocol, which describes the use of a medical product that is still being investigated. Health officials will monitor patients for 84 days after vaccination, according to the World Health Organization (WHO). Tom Geisbert, one of the lead researchers who developed rVSV-ZEBOV, tells Jula of Mother Jones that some patients have reported “little muscle aches and pains” after receiving the vaccine. But, he added, “I would rather have a headache than Ebola.”

Administering the vaccine in Bikoro, the remote epicenter of the latest outbreak, won’t be easy. The vaccine must be kept in an environment between minus 76 and minus 112 degrees Fahrenheit, which is hard to do in a region where there is no electricity, Peter Salama, the WHO deputy director general of emergency preparedness and response, tells Jula.

But if rVSV-ZEBOV proves safe and effective, it could change the way that health officials respond to Ebola—and ensure that the disease never again reaches epidemic proportions.

‘Major, major game-changer’: Ebola spreads to big Congo city [Washington Post, 17 May 2018]

By Saleh Mwanamilongo and Carley Petesch

SASY6WCZ5QI6RGEJA66MCMT7JM.jpg
In this photo taken Saturday, May 12, 2018, health workers don protective clothing as they prepare to attend to patients in the isolation ward to diagnose and treat suspected Ebola patients, at Bikoro Hospital in Bikoro, the rural area where the Ebola outbreak was announced last week, in Congo. Congo’s latest Ebola outbreak has now spread to Mbandaka, a city of more than 1 million people, a worrying shift as the deadly virus risks traveling more easily in densely populated areas. (Mark Naftalin/UNICEF via AP) (Associated Press)

KINSHASA, Congo — Congo’s Ebola outbreak has spread to a crossroads city of more than 1 million people in a troubling turn that marks the first time the vast, impoverished country has encountered the lethal virus in an urban area.

“This is a major, major game-changer in the outbreak,” Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, warned on Thursday.

A single case of Ebola was confirmed in Mbandaka, a densely populated provincial capital on the Congo River, Congo’s Health Minister Oly Ilunga said late Wednesday. The city is about 150 kilometers (93 miles) from Bikoro, the rural area where the outbreak was announced last week.

Medical teams rushed to track down anyone thought to have had contact with infected people, while WHO continued shipping thousands of doses of an experimental vaccine.

A total of 44 cases of Ebola have been reported in Congo in this outbreak: three confirmed, 20 probable and 21 suspected, according to WHO. Twenty-three of those people have died.

Until now, the outbreak was confined to remote rural areas, where Ebola, which is spread by bodily fluids, travels more slowly.

“We’re certainly not trying to cause any panic in the national or international community,” Salama said. But “urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Mbandaka, a city of almost 1.2 million, is in a busy travel corridor in Congo’s northwest Equateur province and is upstream from the capital, Kinshasa, a city of about 10 million. It is an hour’s plane ride from Kinshasa or a four- to seven-day trip by river barge.

Salama also noted Mbandaka’s proximity to neighboring countries, including Central African Republic and Republic of Congo.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

Those exposed will for the first time in Congo receive Ebola vaccinations, the health minister said. WHO has sent 4,000 doses to Congo and said it will dispatch thousands more in the coming days as needed.

“This is a concerning development, but we now have better tools than ever before to combat Ebola,” Tedros Adhanom Ghebreyesus, WHO director-general, said of the new urban case.

The vaccine has been shown to be highly effective against Ebola. It was tested in Guinea during the outbreak that killed more than 11,300 people in West Africa from 2014 to 2016.

WHO has said it will use the “ring vaccination” method. It involves vaccinating contacts of those feared infected, contacts of those contacts, and health care and other front-line workers.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.
___
Petesch reported from Dakar, Senegal. AP reporter Jamey Keaten in Geneva contributed to this report.

WHO concerned as one Ebola case confirmed in urban area of Democratic Republic of the Congo [World Health Organization, 17 May 2018]

One new case of Ebola virus disease (EVD) has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people in Equateur Province in northwestern Democratic Republic of the Congo.

The Ministry of Health of the Democratic Republic of the Congo announced the finding, after laboratory tests conducted by the Institut National de Recherche Biomédicale (INRB) confirmed one specimen as positive for EVD.

Until now, all the confirmed Ebola cases were reported from Bikoro health zone, which is also in Equateur Province but at a distance of nearly 150 km from Mbandaka. The health facilities in Bikoro have very limited functionality and the affected areas are difficult to reach, particularly during the current rainy season, as the roads are often impassable.

"This is a concerning development, but we now have better tools than ever before to combat Ebola," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO and our partners are taking decisive action to stop further spread of the virus."

WHO is deploying around 30 experts to conduct surveillance in the city and is working with the Ministry of Health and partners to engage with communities on prevention and treatment and the reporting of new cases.

"The arrival of Ebola in an urban area is very concerning and WHO and partners are working together to rapidly scale up the search for all contacts of the confirmed case in the Mbandaka area," said Dr Matshidiso Moeti, WHO Regional Director for Africa.

WHO is also working with Médecins Sans Frontières (MSF) and other partners to strengthen the capacity of health facilities to treat Ebola patients in special isolation wards.

As of 15 May, a total of 44 Ebola virus disease cases have been reported: 3 confirmed, 20 probable, and 21 suspected.

WHO partners in the DRC Ebola response include:

The International Federation of Red Cross and Red Crescent Societies (IFRC), the Congolese Red Cross (Congo ICRC), the Red Cross of the Democratic Republic of the Congo (DRC ICRC), Médecins Sans Frontières (MSF), the Disaster Relief Emergency Fund (DREF), the Africa Centers for Disease Control and Prevention (Africa-CDC), the US Centers for Disease Control and Prevention (US-CDC), the World Food Programme (WFP), UNICEF, UNOCHA, MONUSCO, International Organization for Migration (IOM), the FAO Emergency Management Centre – Animal Health (EMC-AH), the International Humanitarian Partnership (IHP), Gavi – the Vaccine Alliance, the African Field Epidemiology Network (AFENET), the UK Public Health Rapid Support team, the EPIET Alumni Network (EAN), and the International Organisation for Animal Health (OIE) and and the Emerging Diseases Clinical Assessment and Response Network (EDCARN). Additional coordination and technical support is forthcoming through the Global Outbreak Alert and Response Network (GOARN) and Emergency Medical Teams (EMT).

Spread Of Ebola In Congo A 'Game Changer' [NPR, 17 May 2018]

by AMY HELD

ap_18137479319051_wide-a47752960b3aadec5007c081abc7793e803ca6c9-s1400-c85.jpg
A health care worker wears virus protective gear at an Ebola treatment center in Bikoro, Democratic Republic of the Congo. The country's latest outbreak has spread to a city of more than 1 million people.
John Bompengo/AP

A new case of Ebola has emerged in an urban area of Democratic Republic of the Congo, a troubling development in the country's new outbreak of the contagious and often fatal virus. Until now, the outbreak had affected a rural area.

Dr. Oly Ilunga, Congo's minister of health, announced Wednesday that a suspected case was confirmed in Mbandaka, a city of about 1.2 million people, and the capital of the Équateur Province.

DdWMnapXkAAZ2VL.jpg-small.jpg


"We are moving to a new phase of the epidemic," Ilunga says.

Mbandaka is located fewer than 100 miles from the rural area of Bikoro, where an outbreak was announced last week, and where, until now, all of the cases had been limited.

As of Wednesday, a total of 44 Ebola cases had been reported in this latest outbreak, including 23 deaths. Three cases have been confirmed, while 20 are probable and 21 are suspected.

The Congolese government says it is providing free health care in all of the affected health zones.

Ministry of Health officials say epidemiologists are working to identify those who may have come in contact with suspected cases, while workers are monitoring people's movement along regional water and land routes.

Mbandaka is located by the banks of the Congo River and serves as a vital travel hub.

WHO is deploying about 30 Ebola experts to the outbreak zone and says they will work with locals "to engage with communities on prevention and treatment and the reporting of new cases."

Most Ebola cases are spread through person-to-person transmission, according to the WHO.

People can become infected via bodily fluids or secretions — like blood, stool, saliva or semen — if they enter the body through broken skin or a mucous membrane. As a result, health workers and family members of infected people are at higher risk of infection.

But an experimental Ebola vaccine — two years in the making — is providing some hope in the fight against the disease.

As NPR's Nurith Aizenman has reported, the vaccine proved enormously effective during a large-scale trial in Guinea during the waning months of a recent massive Ebola outbreak in West Africa. And now global health experts are rushing to get the vaccine into Congo.

The Ministry of Health says it received 5,400 doses on Wednesday. Health care workers and others who have been in contact with infected people will be targeted first.

There have been numerous outbreaks of Ebola in recent decades, including in Congo. But they have mainly been small-scale events in remote areas.

The Ebola outbreak declared in West Africa in 2014 departed from that pattern, with the disease spreading from rural areas to densely populated towns and cities, fueling the largest Ebola epidemic in history.

More than 11,000 people died. Several cases reached Europe and the United States.
Now the emergence of a case in Congo's Mbandaka city has officials anxious to avoid a similar escalation.

WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama tweeted that the virus's introduction to an urban area is a "game changer."

"The challenge just got much much tougher," he writes.

NEWS Congo receives first doses of Ebola vaccine amid outbreak [Reuters, 16 May 2018]

GENEVA/KINSHASA (Reuters) - The first batch of 4,000 experimental Ebola vaccines to combat an outbreak suspected of killing 23 people arrived in Congo’s capital Kinshasa on Wednesday.

The Health Ministry said vaccinations would start at the weekend, the first time the vaccine would come into use since it was developed two years ago.

The vaccine, developed by Merck and sent from Europe by the World Health Organization, is still not licensed but proved effective during limited trials in West Africa in the biggest ever outbreak of Ebola, which killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014-2016.

Health officials hope they can use it to contain the latest outbreak in northwest Democratic Republic of Congo.

Peter Salama, WHO’s deputy director-general for emergency preparedness and response, said the current number of cases stood at 42, with 23 deaths attributed to the outbreak.

“Our current estimate is we need to vaccinate around 8,000 people, so we are sending 8,000 doses in two lots,” he told Reuters in Geneva.

“Over the next few days we will be reassessing the projected numbers of cases that we might have and then if we need to bring in more vaccine we will do so in a very short notice.”

Health workers have recorded confirmed, probable and suspected cases of Ebola in three health zones of Congo’s Equateur province, and have identified 432 people who may have had contact with the disease.

Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe
WHO spokesman Tarik Jasarevic said the supplies sent to Congo included more than 300 body bags for safe burials in affected communities. The vaccine will be reserved for people suspected of coming into contact with the disease, as well as health workers.

“In our experience, for each confirmed case of Ebola there are about 100-150 contacts and contacts of contacts eligible for vaccination,” Jasarevic said. “So it means this first shipment would be probably enough for around 25-26 rings - each around one confirmed case.”

The vaccine is complicated to use, requiring storage at a temperature between -60 and -80 degrees Celsius.

“It is extremely difficult to do that as you can imagine in a country with very poor infrastructures,” Salama said.

“The other issue is, we are now tracing more than 4,000 contacts of patients and they have spread out all over the region of northwest Congo, so they have to be followed up and the only way to reach them is motorcycles.”

The outbreak was first spotted in the Bikoro zone, which has 31 of the cases and 274 contacts. There have also been eight cases and 115 contacts in Iboko health zone.

The WHO is worried about the disease reaching the city of Mbandaka with a population of about 1 million people, which would make the outbreak far harder to tackle. Two brothers in Mbandaka who recently stayed in Bikoro for funerals are probable cases, with samples awaiting laboratory confirmation.

The WHO report said 1,500 sets of personal protective equipment and an emergency sanitary kit sufficient for 10,000 people for three months were being put in place.

Reporting by Amedee Mwarabu and Fiston Mahamba in Kinshasa, and by Tom Miles and Cecile Mantovani in Geneva; Editing by Peter Graff, Sofia Christensen, Edward McAllister and Richard Balmforth

NEWS NCAA Calls For High Vigilance To Prevent Ebola [Naija News, 15 May 2018]

By Faderera Falade

Nnamdi-Azikiwe-International-Airport.jpg


The Nigerian Civil Aviation Authority , has today called om all airlines especially those operating international and regional trips to ensure there is a high level of vigilance, so as to prevent the spread of Ebola Virus.

The call was made by the General Manager, Public Affairs, NCAA, Mr Sam Adurogboye, in Lagos.

Adurogboye said that a circular with Ref. No. NCAA/DG/AMS/Vol.1/196, dated May 11, 2018 and signed by the agency’s Director General, Captain Muhtar Usman, had been dispatched to all the airlines.

He said that the airlines were notified about the recent outbreak of Ebola on May 8 in the Democratic Republic Of Congo.

He however stated that the outbreak in DRC, had yet to be declared by the World Health Organisation, as a Public Health Event of International Concern.

“Notwithstanding, the NCAA, Federal Ministry of Health and all other relevant agencies have been taking concerted steps to ensure the virus does not creep into Nigeria.

“Therefore to forestall the EVD infiltration, the regulatory authority has therefore directed all airlines to carry out these measures in the interim.

“Pilots-in-Command of an aircraft are to report to Air Traffic Control any suspected case of communicable disease onboard their flights in line with Nig.CARs 18.8.22.4,” he said.

Adurogboye said that in case of any suspected case of communicable disease on board an aircraft, aircrew were to fill the General Declaration (Gen Dec) and Public Health Passenger Locator forms in line with Nig. CARs 18.8.17.4 and 18.8.22.5, respectively.

He added that the filled form would be submitted to the Port Health Services of the destination Aerodrome.

He said that airlines should ensure that they have on board, valid and appropriate first aid kits, Universal Precaution kits and Emergency Medical kits in line with Nig. CARs 7.9.1.12.

He said that they were to enlighten passengers of the plane on the disease and also to report any suspected case.

“Airlines are to contact Port Health Services for clearance before importing human remains into the country.

“Airlines are to report to the authority in writing of any suspected case of communicable disease in flight,” he said.

He said that these steps would prevent the importation of any communicable disease into the country through Nigeria’s air borders, especially the airports.

Global pandemic White House, Congress Need To Do More To Address Disease Threats [Kaiser Family Foundation, 15 May 2018]

by Bill Berry

Capital Times: Bill Berry: White House missing in action in pandemics fight

“…Just last week came word that health officials with the World Health Organization fear a new outbreak of the deadly Ebola virus may spiral out of control in the Democratic Republic of the Congo in Africa. This, almost unbelievably, came in the exact week when the Trump White House announced Rear Adm. Tim Ziemer was leaving his post as senior director for global health security and bio-threats. Further, the office doesn’t exist anymore. Further still, the administration announced plans to ask Congress to cut $252 million in unused funding for Ebola that was allocated in 2014. Maybe Congress will ignore this nonsense. Oh, and four years after the U.S. pledged to help the world fight infectious disease epidemics such as Ebola, the Centers for Disease Control and Prevention has announced it is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out. … Meanwhile, no one knows who at the White House would be in charge of a pandemic now…” (5/14).

NEWS Ebola has infected dozens so far in Congo, killing 19, WHO says [Washington Post, 14 May 2018]

By Kristine Phillips

Nineteen people have died of Ebola in Congo as health officials plan to send an experimental vaccine to prevent the spread of the virus that killed thousands in West Africa a few years ago.

The World Health Organization said there have been 39 confirmed and suspected cases of Ebola over the past five weeks as the virus spreads across three rural areas covering nearly 40 miles in the northwest part of the country. Among the dead were three health-care workers. Health officials are following up with nearly 400 people identified as contacts of Ebola patients.

The global health agency announced last week its plans to send the vaccine, developed in 2016 by the pharmaceutical company Merck. Health officials hope that the vaccine, which was given to people in Guinea in West Africa during a trial in 2015, could be a game-changer in preventing Ebola from spreading, The Washington Post’s Siobhán O’Grady wrote last week.

Among the 5,837 people who received the vaccine, called rVSV-ZEBOV, no one came down with Ebola 10 days after vaccination.

Tedros Adhanom Ghebreyesus, the WHO’s director-general, told reporters Monday that the agency has received permission from Congo officials to import the vaccine, which he hopes would arrive by the end of this week.

“Everything is formally agreed already. The vaccine is safe and efficacious and has already been tested. I think we can — all is ready now to really use it,” he said.

The WHO has a stockpile of 4,300 doses of the vaccine in Geneva, Stat News reported. Merck also has committed 300,000 doses of the vaccine for emergency use.

Ghebreyesus said he has traveled to the remote area to assess health needs.

“Being there is very, very important. If a general cannot be with its troops in the front line, it’s not a general. ... We have to go and show that that should really stop, and if my life is at risk, my life is not better than anyone,” said Ghebreyesus, a former Ethiopian health minister and the first African to become WHO’s director-general. “We have to be where the problem is.”

HBNBXD3LVU4AFM2M2K5IFRQMLU.jpg
Health workers wear protective equipment as they prepare to tend to suspected Ebola patients May 12 at Bikoro Hospital, the epicenter of the latest Ebola outbreak in Congo. (Mark Naftalin/AFP/UNICEF)

The WHO first learned of the outbreak May 8, when Congo's Ministry of Health confirmed two cases of Ebola in the town of Bikoro, now the epicenter of the outbreak and located in the country’s Equateur province, which has a population of about 2.5 million people.

“We are very concerned and planning for all scenarios, including the worst-case scenario,” Peter Salama, WHO's deputy director-general of emergency preparedness and response, said at a United Nations briefing in Geneva on Friday, according to Reuters.

Transporting the vaccines to the affected area would be logistically challenging. Salama said the area is about 15 hours away by motorbike from the closest town and lacks the necessary infrastructure, Reuters reported. He said Friday that the WHO plans to send up to 40 experts by the weekend and clear an airstrip for supplies.

The country has experienced eight Ebola outbreaks over the past four decades. The most recent happened last year, when four people in Likati in the northern part of the country died. An outbreak in 2014 killed 49 people.

The largest Ebola outbreak in history ravaged the West African countries of Sierra Leone, Guinea and Liberia. Nearly 30,000 confirmed and suspected cases were reported. About 11,300 died from 2014 to 2016.

The WHO has acknowledged its bungled handling of the massive outbreak, saying it failed to recognize early that the West African countries that severely lacked health infrastructures were at imminent risk. According to a draft internal document obtained by the Associated Press, nearly everyone “failed to see some fairly plain writing on the wall.”

By early September 2014, more than 1,800 had died in Sierra Leone, Guinea and Liberia, and the global health community still had no coordinated response. President Barack Obama later dispatched up to 3,000 military personnel to West Africa, an effort with a $750 million price tag.

Symptoms of Ebola usually manifest eight to 10 days after exposure. These include fever, headache, diarrhea, vomiting and hemorrhage.

Here's how the virus spreads and how contact tracing works to stop outbreaks. (Gillian Brockell/The Washington Post)
How the Ebola virus spreads☞ https://www.washingtonpost.com/news/to-your-health/wp/2018/05/14/ebola-has-infected-dozens-so-far-in-congo-killing-19-who-says/?utm_term=.aa7821172b80

Ebola virus disease – Democratic Republic of the Congo [World Health Organization, 14 May 2018]

Since the publication of the first Disease Outbreak News on the Ebola outbreak in Equateur province, Democratic Republic of the Congo on 10 May 2018, an additional seven suspected cases have been notified by the country’s Ministry of Health. Importantly, since the last update, cases have been reviewed and reclassified, and some discarded.

From 4 April through 13 May 2018, a total of 39 Ebola virus disease cases have been reported, including 19 deaths (case fatality rate = 49%) and three health care workers. Cases were reported from the Bikoro health zone (n=29; two confirmed, 20 probable and 7 suspected cases), Iboko health zone (n=8; three probable and five suspected cases) and Wangata health zone (n=2; two probable cases). To date, 393 contacts have been identified and are being followed-up. Wangata health zone is adjacent to the provincial port city of Mbandaka (population 1.2 million). Response teams on the ground are in the process of verifying information on reported cases. Case numbers will be revised as further information becomes available.
Public health response

• The Ministry of Health in the Democratic Republic of the Congo is coordinating the response.

• WHO is working with the Ministry of Health and MSF to conduct ring vaccination using the investigational recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV).

• In Bikoro, Iboko, and Mbandaka health zones, the Ministry of Health along with WHO and partners are engaged in strengthening surveillance for new cases, carrying out contact tracing, case management, and community engagement, ensuring safe and dignified burials, and coordinating the response.

• WHO is deploying 50 public health experts to support the Ministry of Health with response activities.

• An air bridge for supplies and personnel will be established by the United Nations Humanitarian Air Service (UNHAS) starting 13 May with daily flights scheduled from Kinshasa to Mbandaka and Mbandaka to Bikoro.

• WHO has released $1 million US dollars from the contingency fund for emergencies, the United Nations has released $2 million US dollars from the Central Emergency Response Funds, and the Welcome Trust has provided 2 million pounds sterling for critical research needs.

• The WHO Director General, Deputy Director General for Emergency Preparedness and Response together with the WHO Regional Director for Africa will be in Kinshasa on 13 May to review operations and discuss further support to the Ministry of Health.

WHO risk assessment

Information about the extent of the outbreak is still limited and investigations are ongoing. The cases are being reported from remote locations that are difficult to access. However, the proximity of the affected area to the Congo River, which links to the Republic of the Congo and the Central African Republic, increases the risk of cases occurring in neighboring countries. Currently, WHO considers the public health risk to be high at the national level, moderate at the regional level, and low at the international level. As further information becomes available, the risk assessment will be reviewed.

At present, this event does not meet the criteria of a public heath event of international concern as defined in the IHR (2005) 1, and does not warrant the convening of an Emergency Committee under the IHR (2005).

WHO advice

WHO advises against any restriction of travel and trade to Democratic Republic of the Congo based on the currently available information. WHO continues to monitor travel and trade measures in relation to this event, and currently there are no restrictions of the international traffic in place.

For more information on Ebola virus disease, please see the link below:

Ebola Virus Disease fact sheet
☞ http://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease


1 “Public health emergency of international concern” means an extraordinary event which is determined, as provided in these Regulations: (i) to constitute a public health risk to other States through the international spread of disease and (ii) to potentially require a coordinated international response”. International Health Regulations (2005).

Merck's experimental Ebola shot gets set to fight deadly new outbreak in Congo [FiercePharma, 14 May 2018]

by Eric Sagonowsky

Merck1.png
International health agencies are working to deploy Merck's investigational Ebola vaccine against a new outbreak in the Democratic Republic of Congo. (Merck)

As the death toll mounts in a new Ebola outbreak in the Democratic Republic of Congo, health officials are preparing to deploy Merck & Co.'s experimental vaccine against the virus. The pharma giant revved up the development project amid a major Ebola breakout in 2014 and 2015.

The new outbreak—so far limited to remote areas in the Congo—started in early April, according to a Monday update from the World Health Organization. Of the 39 people infected, 19 have died, translating into a 49% fatality rate. The agency is working with Gavi, the Vaccine Alliance; Médecins Sans Frontières; and the DRC's Ministry of Health to introduce the shot in a ring vaccination approach, a WHO spokesperson confirmed Monday.

But because Merck's Ebola shot hasn't yet won regulatory approval, officials must obtain an importation license, plus establish a "formal agreement on the research protocols," WHO spokesperson Tarik Jašarević told FiercePharma.

Jašarević added that "all steps are finalized and approvals obtained," but that he couldn't predict when vaccinations will begin. In its update Monday, WHO said the outbreak is a high public health risk in the country, moderate regionally and low internationally. Cases have been documented near the Congo River, which could carry the virus to nearby countries.

A Merck spokesperson said the company is working with WHO and MSF to introduce the vaccine, adding that thousands of shots are ready to go, with "4,300 doses of the investigational V920 vaccine prepositioned with the WHO in Geneva to support rapid deployment to the outbreak area."

The company's own stockpile contains more than 300,000 emergency use dose equivalents, she said. The V920 vaccine was initially engineered by scientists from the Public Health Agency of Canada’s National Microbiology Laboratory and later licensed to a subsidiary of NewLink Genetics. In late 2014, as the Ebola outbreak in western Africa peaked, Merck licensed the candidate from NewLink Genetics, planning to accelerate development.

Under the ring vaccination approach, after an Ebola case is recorded health workers vaccinate anyone who might have interacted with the infected person, such as family members and their contacts.. Merck's shot demonstrated 100% efficacy in a previous phase 3 ring vaccination study.

Healthcare workers and others who could encounter the virus will also be vaccinated as part of the outbreak response. Last month, WHO expert advisers on vaccination met and recommended that the shot be deployed under a ring vaccination strategy should an outbreak emerge.

Last year, an outbreak in the country spanned 42 days and claimed four lives, according to the WHO. Officials prepped the vaccine for potential use against that outbreak, but never deployed the shot.

An Ebola outbreak in 2014 and 2015 killed more than 11,000 people in West Africa, leading to frustration and anger in the scientific community that a vaccine wasn't yet available. Zika followed a year later, making it even more clear that the current vaccine development system wasn't adequately addressing possible threats.

Since then, governments, nonprofits and pharma companies have come together to form the Coalition for Epidemic Preparedness Innovations, an international group designed to prepare for potential epidemics before they happen. The group set the MERS-CoV, Lassa and Nipah viruses as its initial targets.

Biotechs Themis and Inovio have picked up grants from the coalition to conduct vaccine research against Lassa and MERS.

Ebola virus disease – Democratic Republic of the Congo [World Health Organization, 14 May 2018]

Since the publication of the first Disease Outbreak News on the Ebola outbreak in Equateur province, Democratic Republic of the Congo on 10 May 2018, an additional seven suspected cases have been notified by the country’s Ministry of Health. Importantly, since the last update, cases have been reviewed and reclassified, and some discarded.

From 4 April through 13 May 2018, a total of 39 Ebola virus disease cases have been reported, including 19 deaths (case fatality rate = 49%) and three health care workers. Cases were reported from the Bikoro health zone (n=29; two confirmed, 20 probable and 7 suspected cases), Iboko health zone (n=8; three probable and five suspected cases) and Wangata health zone (n=2; two probable cases). To date, 393 contacts have been identified and are being followed-up. Wangata health zone is adjacent to the provincial port city of Mbandaka (population 1.2 million). Response teams on the ground are in the process of verifying information on reported cases. Case numbers will be revised as further information becomes available.
Public health response

• The Ministry of Health in the Democratic Republic of the Congo is coordinating the response.

• WHO is working with the Ministry of Health and MSF to conduct ring vaccination using the investigational recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV).

• In Bikoro, Iboko, and Mbandaka health zones, the Ministry of Health along with WHO and partners are engaged in strengthening surveillance for new cases, carrying out contact tracing, case management, and community engagement, ensuring safe and dignified burials, and coordinating the response.

• WHO is deploying 50 public health experts to support the Ministry of Health with response activities.

• An air bridge for supplies and personnel will be established by the United Nations Humanitarian Air Service (UNHAS) starting 13 May with daily flights scheduled from Kinshasa to Mbandaka and Mbandaka to Bikoro.

• WHO has released $1 million US dollars from the contingency fund for emergencies, the United Nations has released $2 million US dollars from the Central Emergency Response Funds, and the Welcome Trust has provided 2 million pounds sterling for critical research needs.

• The WHO Director General, Deputy Director General for Emergency Preparedness and Response together with the WHO Regional Director for Africa will be in Kinshasa on 13 May to review operations and discuss further support to the Ministry of Health.

WHO risk assessment

Information about the extent of the outbreak is still limited and investigations are ongoing. The cases are being reported from remote locations that are difficult to access. However, the proximity of the affected area to the Congo River, which links to the Republic of the Congo and the Central African Republic, increases the risk of cases occurring in neighboring countries.

Currently, WHO considers the public health risk to be high at the national level, moderate at the regional level, and low at the international level. As further information becomes available, the risk assessment will be reviewed.

At present, this event does not meet the criteria of a public heath event of international concern as defined in the IHR (2005) 1, and does not warrant the convening of an Emergency Committee under the IHR (2005).

WHO advice

WHO advises against any restriction of travel and trade to Democratic Republic of the Congo based on the currently available information. WHO continues to monitor travel and trade measures in relation to this event, and currently there are no restrictions of the international traffic in place.

1 “Public health emergency of international concern” means an extraordinary event which is determined, as provided in these Regulations: (i) to constitute a public health risk to other States through the international spread of disease and (ii) to potentially require a coordinated international response”. International Health Regulations (2005).

Ebola 'kills 17 people' in the Democratic Republic of Congo raising fears of an epidemic [Daily Mail, 8 May 2018]

By ALEXANDRA THOMPSON and STEPHEN MATTHEWS

・Three residents of the Democratic Republic of Congo died in May last year
・Ebola is one of the deadliest viruses ever and killed at least 11,000 in 2014
・The lethal pathogen spread across the world over two years, reaching the US
・British nurse Pauline Cafferkey was left critically ill after treating patients
・World Bank study suggested Earth is not ready for an inevitable pandemic

At least 17 people are today feared to have died from a new outbreak of Ebola in the Democratic Republic of Congo.

Health officials in the African nation have confirmed two people have the virus - but there has been 21 suspected cases in total - raising fears of an epidemic.

It comes just three years after the Ebola pandemic that killed at least 11,000 people across six countries, including a sole fatality in the US.

Ebola is already considered one of the most lethal pathogens in existence, and the new outbreak has been branded a 'public health emergency'.

Experts fear it could have an 'international impact', considering how quickly the virus decimated West Africa between 2014 and 2016.

0A8DA36900000514-5316963-image-a-6_1516989080046X.jpg
Two confirmed cases of Ebola have been announced in the Democratic Republic of Congo

Read more: http://www.dailymail.co.uk/health/article-5704371/Democratic-Republic-Congo-confirms-two-Ebola-cases-10-cases-suspected.html#ixzz5EzuqXX2D
Follow us: @MailOnline on Twitter | DailyMail on Facebook

The World Health Organization declared there has been 21 suspected cases of viral haemorrhagic fever and 17 deaths in the Equateur province, in the past five weeks.

Congo - situated escaped the brutal Ebola pandemic, finally declared over in January 2016 - but it was struck by a smaller outbreak last year.

Four DRC residents died from the virus in 2017. The outbreak lasted just 42 days and international aid teams were praised for their prompt responses.

The new outbreak is believed to be occurring in the northwestern town of Bikoro - 324 miles (522km) north of capital Kinshasa.

Confirmed cases

Jean Jack Muyembe, head of the national institute for biological research in the DRC, today confirmed the two cases and 10 more suspected.

Two out of five samples collected tested positive for a Zaire strain of Ebola at the Institut National de Recherche Biomédicale in Kinshasa.

But the WHO today also stated there has been 21 suspected cases since the start of April, including 17 deaths - all of which occurred before the outbreak was confirmed.

'Our country is facing another epidemic of the Ebola virus, which constitutes an international public health emergency,' the Congo Health Ministry said.

'We still dispose of the well trained human resources that were able to rapidly control previous epidemics.'

Controlling the outbreak

The WHO, Médecins Sans Frontières and Provincial Division of Health traveled today to Bikoro in an effort to stem the outbreak.

A team of epidemiologists, logisticians, clinicians, and other infection experts are expected to be deployed in the coming days.

The WHO has released £738,000 ($1mn) from its Contingency Fund for Emergencies to support response activities for the next three months.

This is DRC’s ninth outbreak of Ebola since the discovery of the virus in the country in 1976. The virus - endemic in the country - is named after the Ebola river.

Health experts credit an awareness of the disease among the population and local medical staff's experience treating for past successes containing its spread.

Congo's vast, remote geography also gives it an advantage, as outbreaks are often localised and relatively easy to isolate.

Ikoko Impenge and Bikoro, however, lie not far from the banks of the Congo River, an essential waterway for transport and commerce.

Further downstream the river flows past Kinshasa and Brazzaville, capital of Congo Republic - two cities with a combined population of over 12 million people.

Neighbouring countries alerted

Neighbouring countries have been alerted about the new outbreak. DRC borders Angola,
Zambia, Tanzania, Uganda, South Sudan, Central African Republic, Rwanda, Burundi and the Republic of Congo

Ebola is often fatal if untreated. Around 50 per cent of patients die, according to the WHO. It is transmitted to people from wild animals and can be spread from human to human.

Dr Peter Salama, WHO deputy director general, said: 'Our top priority is to get to Bikoro to work alongside the Government of the DRC and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak.

'Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.'

Not ready for a pandemic

The outbreak comes after the World Bank stated last year that Earth isn't ready for an 'inevitable' pandemic, after stimulating four possible scenarios.

The research was done in an attempt to assess why the global response to the Ebola pandemic was so sloppy and to fill those gaps before another disaster strikes.

The 2014 international Ebola response drew criticism for moving too slowly and prompted an apology from the WHO.

A study released last year also suggested disease 'superspreaders' fueled the transmission of the 2014 Ebola epidemic.

Researchers found there was just a small number of so-called 'superspreaders' - highly infectious people who infect many others - in West Africa.

At least two thirds of the victims who contracted the virus can be traced back to this small group.

WHAT IS EBOLA AND HOW DEADLY WAS IT?

Ebola, a haemorrhagic fever, killed at least 11,000 across the world after it decimated West Africa and spread rapidly over the space of two years.

The pandemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The country, rocked by back-to-back civil wars that ended in 2003, was hit the hardest by the fever, with 40 per cent of the deaths having occurred there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN?

An analysis, published in the New England Journal of Medicine, found the outbreak began in Guinea - which neighbours Liberia and Sierra Leone.

A team of international researchers were able to trace the pandemic back to a two-year-old boy in Meliandou - about 400 miles (650km) from the capital, Conakry.

Emile Ouamouno, known more commonly as Patient Zero, may have contracted the deadly virus by playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN?
EEBO.jpg


Figures show nearly 29,000 people were infected from Ebola - meaning the virus killed around 40 per cent of those it struck.

Cases and deaths were also reported in Nigeria, Mali and the US - but on a much smaller scale, with 15 fatalities between the three nations.

Health officials in Guinea reported a mysterious bug in the south-eastern regions of the country before the WHO confirmed it was Ebola.

Ebola was first identified by scientists in 1976, but the most recent outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS?

Scientists believe Ebola is most often passed to humans by fruit bats, but antelope, porcupines, gorillas and chimpanzees could also be to blame.
It can be transmitted between humans through blood, secretions and other bodily fluids of people - and surfaces - that have been infected.

IS THERE A TREATMENT?

The WHO warns that there is 'no proven treatment' for Ebola - but dozens of drugs and jabs are being tested in case of a similarly devastating outbreak.

Hope exists though, after an experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people. The results were published in The Lancet journal.

WHO Declares Ebola Outbreak After Democratic Republic Of The Congo Confirms 2 Cases [HuffPost, 8 May 2018]

By Lauren Weber

5af1dbe22000002e00b90d87.jpg


This is the second outbreak in under a year for the central African country.

The World Health Organization has declared an outbreak of Ebola after the Democratic Republic of the Congo confirmed two cases of the deadly viral hemorrhagic fever.

At least 10 more cases are suspected in the northwestern town of Bikoro, Dr. Jean-Jacques Muyembe-Tamfum, the head of the DRC’s National Institute for Biomedical Research, said Tuesday.

In the past five weeks, the DRC has seen 21 suspected cases with Ebola-like symptoms and 17 deaths.

A team of experts from WHO, Doctors Without Borders and the central African country’s Provincial Division of Health traveled on Tuesday to the outbreak area. WHO said in a statement that it is working with the DRC government to “rapidly scale up its operations and mobilize health partners using the model of a successful response to a similar EVD [Ebola virus disease] outbreak in 2017.”

According to Doctors Without Borders spokesperson Brienne Prusak, the humanitarian medical organization has been supporting the DRC Ministry of Health on the ground in its investigation of the current outbreak since last Saturday.

“Time is of the essence,” WHO spokesperson Tarik Jasarevic told HuffPost. “The faster you get to the core of the outbreak and the quicker you get in place those necessary measures ― isolating those people who are sick, identifying contacts they know ― it [increases] the chances you have that the virus will not spread somewhere else.”

All means of air travel and other transportation methods are being used to get to the town quickly, Jasarevic said. He noted that the team is currently in discussions about setting up a mobile laboratory unit and whether to deploy some of the Ebola vaccine.

Last year’s DRC outbreak was contained shortly before an agreement on using the vaccine was reached, so its potential use this year would mark its first deployment in the country.

Ebola is considered endemic in the DRC, and this is the second outbreak there in less than a year. Last May, an outbreak in the northern part of the country led to eight infections and four deaths.

The virus typically spreads among humans in one of two ways: through exposure to animals that carry it ― often bats or bushmeat (that is, wild animals caught and eaten in the region, such as monkeys, antelope and rats) ― or through exposure to bodily fluids of infected patients. The average fatality rate for Ebola is 50 percent.

The last major Ebola outbreak that swept through West Africa officially ended more than two years ago, killing approximately 11,300 people and infecting 28,600. Global health experts have called WHO’s failure to quickly raise the alarm and adequately respond to that epidemic, which began in 2014, an “egregious failure.”

The difference in response between 2014 and now is “night and day,” according to Loyce Pace, the president and executive director of the Global Health Leadership Council, a membership organization that lobbies for global health priorities. In this “new normal,” Pace said the world health community must immediately dispatch resources and enlist international actors to fight outbreaks.

“The global health community collectively has learned its lesson,” she said, although she added that some pandemic preparedness issues still need to be worked out.

While the global health community has improved its mobilization efforts, U.S. leadership is sending mixed messages.

Recently, Congress almost doubled global health security funding for the U.S. Agency for International Development and the Centers for Disease Control and Prevention. But President Donald Trump’s stance has been to cut such global health aid. Previous versions of the president’s budgets have called for spending reductions at the CDC, USAID and the Global Fund.

Trump’s newly proposed rescissions package includes the taking back of $252 million not spent on the 2014-16 Ebola outbreak. While technically the money was aimed at the Ebola outbreak, officials have been directing the remaining funds toward other public health outbreaks, such as the Zika virus.

This kind of mixed government messaging undermines the U.S. as a world leader and, more importantly, harms global preparedness and commitment to fighting potential pandemics, Pace said.

“We need to keep our foot on the gas when it comes to global health security,” Pace argued.

“We don’t necessarily know what the next Ebola or Zika could be, and it’s pretty irresponsible not to stay ahead of the curve considering the resources we have as a country.”

Trump’s track record on Ebola itself includes his infamous tweets (over 100 of them during the last major outbreak) lobbying to close U.S. borders and institute a travel ban against those infected ― steps that public health experts said would worsen the problem by driving people to hide their travel.

Donald J. Trump
kUuht00m_normal.jpg
@realDonaldTrump The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great-but must suffer the consequences! 10:22 AM - Aug 2, 2014 • 
2,625 • 
7,438 people are talking about this Twitter Ads info and privacy


Amy Pope, a senior Obama administration counterterrorism official who worked on that outbreak, told The Hill last week that Trump’s tweets contributed to the escalating national fear of the deadly virus.

The president has yet to comment publicly about the new outbreak.

New Ebola outbreak declared in Democratic Republic of the Congo [World Health Organization, 8 May 2018]

EboCon.jpg


The Government of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease (EVD) in Bikoro in Equateur Province today (8 May). The outbreak declaration occurred after laboratory results confirmed two cases of EVD.

The Ministry of Health of Democratic of the Congo (DRC) informed WHO that two out of five samples collected from five patients tested positive for EVD at the Institut National de Recherche Biomédicale (INRB) in Kinshasa. More specimens are being collected for testing.

WHO is working closely with the Government of the DRC to rapidly scale up its operations and mobilize health partners using the model of a successful response to a similar EVD outbreak in 2017.

“Our top priority is to get to Bikoro to work alongside the Government of the Democratic Republic of the Congo and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak,” said Dr Peter Salama, WHO Deputy Director-General, Emergency Preparedness and Response. “Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.”

The first multidisciplinary team comprised of experts from WHO, Médecins Sans Frontières and Provincial Division of Health travelled today to Bikoro to strengthen coordination and investigations.

Bikoro is situated in Equateur Province on the shores of Lake Tumba in the north-western part of the country near the Republic of the Congo. All cases were reported from iIkoko Iponge health facility located about 30 kilometres from Bikoro. Health facilities in Bikoro have very limited functionality, and rely on international organizations to provide supplies that frequently stock out.

“We know that addressing this outbreak will require a comprehensive and coordinated response. WHO will work closely with health authorities and partners to support the national response. We will gather more samples, conduct contact tracing, engage the communities with messages on prevention and control, and put in place methods for improving data collection and sharing,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.

This is DRC’s ninth outbreak of EVD since the discovery of the virus in the country in 1976. In the past five weeks, there have been 21 suspected viral haemorrhagic fever in and around the iIkoko Iponge, including 17 deaths.

“WHO is closely working with other partners, including Médecins Sans Frontières, to ensure a strong, response to support the Government of the Democratic Republic of the Congo to prevent and control the spreading of the disease from the epicentre of iIkoko Iponge Health Zone to save lives," said Dr Allarangar Yokouide, WHO Representative in the DRC.

Upon learning about the laboratory results today, WHO set up its Incident Management System to fully dedicate staff and resources across the organization to the response. WHO plans to deploy epidemiologists, logisticians, clinicians, infection prevention and control experts, risk communications experts and vaccination support teams in the coming days. WHO will also be determining supply needs and help fill gaps, such as for Personal Protective Equipment (PPE). WHO has also alerted neighbouring countries.

WHO released US$ 1 million from its Contingency Fund for Emergencies to support response activities for the next three months with the goal of stopping the spread of Ebola to surrounding provinces and countries.

Building on the 2017 response

Ebola is endemic to the Democratic Republic of the Congo. The last Ebola outbreak in the Democratic Republic of the Congo occurred in 2017 in Likati Health Zone, Bas Uele Province, in the northern part of the country and was quickly contained thanks to joint efforts by the Government of DRC, WHO and many different partners.

An effective response to the 2017 EVD outbreak was achieved through the timely alert by local authorities of suspect cases, immediate testing of blood samples due to strengthened national laboratory capacity, the early announcement of the outbreak by the government, rapid response activities by local and national health authorities with the robust support of international partners, and speedy access to flexible funding.

Coordination support on the ground by WHO was critical and an Incident Management System was set up within 24 hours of the outbreak being announced. WHO deployed more than 50 experts to work closely with government and partners.

The Ebola virus causes an acute, serious illness which is often fatal if untreated. The average EVD case fatality rate is around 50%. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

Ebola outbreak MAPPED: Killer disease outbreak in Congo sparks fear of pandemic [Express.co.uk, 8 May 2018]

By SEBASTIAN KETTLEY

THE Ebola virus threat is on the loose again following a fresh outbreak of the killer disease in the Democratic Republic of Congo in West Africa, officials confirmed on Tuesday. But where is the latest Ebola outbreak located this time?

Two fresh cases of the deadly Ebola virus were confirmed today in the northwest of the country, the National Institute for Biological research confirmed.

Jean Jack Muyembe, head of the Institute, revealed officials are concerned an additional 10 infections are suspected.

The fresh outbreak of Ebola is now the ninth time the deadly virus has spread in Congo since its discovery in the 1970s.

The Congo Ministry of Health is expected to make a public statement about the fresh outbreak later today.

Where is the new outbreak of Ebola virus?

The latest victims to fall prey to the painful disease were found in the northwestern town of Bikoro.

The small town on the shores of Lake Tumba is a typical market town with an estimated population of just over 7,400 people in 2012.

Biko sits roughly 361km southwest of the capital Brazzaville and 376km southwest of major hub Kinshasa.

The outbreak comes less than a year after eight people were infected in the remote areas of Mabongo and Nambwa.

Ebola-virus-outbreak-map-disease-Congo-Bikoro-Africa-956794.jpg
Ebola OUTBREAK: Two cases of Ebola were confirmed today by officials in Congo

Ebola-virus-outbreak-map-disease-Congo-Bikoro-Africa-1335056.jpg
Ebola outbreak: The infections were discovered in the lakeside town of Bikoro

Four of the infected people died as a result of contracting the virus.

The Ebola virus causes an acute, serious illness which is often fatal if untreated World Health Organisation


The Ebola outbreak was officially contained and ended on July 2, 2017 according to the World Health Organisation (WHO).

Dr Tedros Adhanom Ghebreyesus, WHO director-general, said at the time: “With the end of this epidemic, DRC has once again proved to the world that we can control the very deadly Ebola virus if we respond early in a coordinated and efficient way.”

What is the Ebola virus?

Ebola is a deadly viral disease also known as Ebola haemorrhagic fever.
Symptoms include the sudden onset of fever fatigue, muscle pain, headache and sore throat.

At later stages of infection, victims succumb to vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function. In many cases, this is followed by internal and external bleeding.

Ebola is believed to be transmitted to humans by contact with infected animals such as bats, which can contract the virus without succumbing to it.

The virus often spreads when eating infected bushmeat and humans transfer it to one another through contact with bodily fluids.

The disease was named after the Ebola river in eastern Congo where the deadly virus was first discovered.

Mortality rates for Ebola infections hover around 50 percent, and past outbreaks ranged anywhere from 25 percent to 90 percent mortality rates.

Ebola-virus-outbreak-map-disease-Congo-Bikoro-Africa-1335058.jpg
Ebola outbreak: The last Ebola panic took place last year when four people died

Ebola-virus-outbreak-map-disease-Congo-Bikoro-Africa-1335063.jpg
Ebola outbreak: The biggest virus pandemic on record took place in West Africa between 2014 and 2016

According to the WHO, there is no licensed treatment proven to be effective, but early therapies and preventative measures are under development.

The WHO disease guide reads: “The Ebola virus causes an acute, serious illness which is often fatal if untreated.

“Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in what is now, Nzara, South Sudan, and the other in Yambuku, Democratic Republic of Congo.

“The latter occurred in a village near the Ebola River, from which the disease takes its name.”

The largest Ebola outbreak to date occurred between 2014 and 2016 in West Africa, which began in Guinea and quickly spread to the neighbouring Sierra Leone and Liberia.

Taking the gamble out of Ebola outbreaks [Lehigh University Engineering News, 2 May 2018]

20180501-taking-the-gamble-out-of-ebola-outbreaks.jpg
Left to right: Javier Buceta and Paolo Bocchini, Lehigh University

Lehigh research pair awarded NIH grant to assess spread of disease
Roll a typical 6-sided die and the chance that it will land on any given side is one in six. With a pair of dice, the probability of rolling an ordered pair is one in 36.
When it comes to predicting Ebola outbreaks, we are not so lucky.

Ebola is a zoonosis -- a viral disease transmitted from animals to humans. Once symptoms appear after direct contact with infected body fluids, the risk of death is between 25 and 90 percent. Patients typically succumb to low blood pressure due to internal and external bleeding.

The highly contagious virus first appeared in 1976, when it infected 600 people in two separate outbreaks in the tropical regions of sub-Saharan Africa. One of the outbreaks was near the Ebola River, after which the virus is named.

Fast forward to 2014, and the disease had spread to Guinea, Liberia and Sierra Leone where it was responsible for the deaths of more than 11,000 people over a 2-year period.

The carriers of the Ebola virus are believed to be fruit bats, which are not affected by the disease. In that respect, the bats are known as reservoirs, meaning they naturally harbor disease-causing organisms and serve as potential sources of disease outbreaks.

Bats, our only flying mammal, are reservoirs for more than 60 zoonoses -- including rabies and SARS as well as Ebola. Though bats are essential members of the global ecosystem, where they assist in seed dispersal, pollination and nocturnal predation of an enormous number of insects, they are also especially adept at harboring and spreading disease. To make matters worse, Ebola outbreaks are intermittent, and little is known about when, where or how the next one will occur.

To better predict Ebola outbreaks and contain them before they spread, two Lehigh University researchers were awarded a grant in April 2018 from the National Institutes of Health (NIH) to develop a forecasting tool to estimate the risk.

The grant, "Risk Assessment of Ebola Outbreaks through Probabilistic Modeling of Chiroptera
Zoonotic Dynamics and Socioeconomic Factors," will apply computational analysis to project the spread of disease, which in turn will facilitate the preemptive deployment of resources as well as the application of focused mitigation plans.

Javier Buceta, associate professor of bioengineering and chemical and biomolecular engineering, together with Paolo Bocchini, assistant professor of civil and environmental engineering, are the principal investigators of the project.

"Bat migration patterns are affected by complex factors, including temperatures and weather patterns," Bocchini said. "Knowing the probabilities of how, and in what direction, an outbreak will occur can allow officials to rapidly direct doctors and supplies, as well as apply proper prevention and mitigation strategies."

The risk of an Ebola outbreak goes well beyond humans contracting the disease.

"The Ebola virus decimates the great ape population, which poses a conservation hazard," Bocchini continued. "Ebola represents a major threat worldwide through the potential global spread of infections, so an outbreak can have dramatic humanitarian as well as economic consequences."

The study aims to manage the uncertainty associated with a prediction by integrating a broad set of factors.

"We are studying the bat's migratory pattern due to environmental pressures, and we also plan to consider socioeconomic, cultural and demographic factors of the population to better understand what determines the risk of an outbreak," Buceta said.

Their methodology encompasses tools from computational epidemiology, engineering, data science and uncertainty quantification.

"To understand the ecology of the zoonotic niche, we are developing compartmental epidemiology models that include resource dynamics, variability, climate change and bat mobility," Buceta continued. "Our model will be calibrated with factual satellite data by means of different regression models."

Nigeria will be used as a case study. "We have leveraged as much as possible the fact that Lehigh has UN-NGO status to obtained support from the president of Nigeria’s Center for Public Health," Buceta said.

Non-Governmental Organizations (NGOs) partner with the United Nations by contributing valuable information and ideas, advocating for positive change and providing essential operational capacity during emergencies.

The end result of the research will be a tool that predicts the probability of Ebola outbreaks and the dynamics of the zoonotic niche. The team has named the tool PAREO (Predictive Analysis of the Risk of Ebola Outbreaks), at http://probabilisticmodeling.org/pareo.

"Our ultimate goal is to shift the current research paradigm in the context of Ebola to evaluate, probabilistically, the risk of hemorrhagic fever spreading in humans," Bocchini said.

Buceta added, "This project will be the culmination of an interdisciplinary collaboration among our teams, spurred from the Probabilistic Modeling Group we coordinate at Lehigh."

The three-year NIH grant runs through March 2021.
nice!(0)  コメント(0) 

Zoonotic Swine Flu News from 2 till 5 May 2018

Clark County influenza death toll reaches 57 [News3LV, 5 May 2018]

by Marvin Clemons

db59d053-6111-4ea6-9dbe-b55b327d6ef8-large16x9_flu.deaths.mgn.4.23.18.jpg


LAS VEGAS (KSNV) —
Influenza deaths in Clark County have reached 57 this winter with the older age groups being the most affected by the disease.

The flu statistics were released Friday by the Southern Nevada Health District, which tracks diseases and health issues in Southern Nevada.

For the week ending the last Friday in April, 38 of the deaths came in the 65 plus age group while 13 who died were from 50 to 64 years of age.

Two people who died were 25 to 49, one was 18 to 24, two were 5-17 and one was 4 years old or less.

There were 1,314 influenza cases reported and 953 hospitalizations through April 28.
Last year through the end of April, there were 13 deaths, 430 hospitalizations and 625 reported influenza cases.

Nationally, the levels of influenza-like illnesses being reported now are as high as the peak of the swine flu epidemic in 2009, and exceed the last severe seasonal flu outbreak in 2003 when a new strain started circulating, said Anne Schuchat, the U.S. Centers for Disease Control and Prevention’s acting director.

Swine flu, which swept the globe in 2009 and 2010, sickened 60.8 million Americans, hospitalized 274,304 and killed 12,469, according to CDC data. Deaths from the current outbreak will likely far outstrip those of the 2009-2010 season.

Where Does the Flu Come From? The South [Chicagomag.com, 4 May 2018]

BY TIM BALK

flu-chain-590cb449.jpg
A map shows the “causality field” of influenza’s emergence. PHOTO: ELIFE

The region’s warm, humid air and low average pressure make it more likely to trigger an epidemic than cities like Chicago.

Turns out the flu has a flight pattern.

Back in February, researchers at University of Chicago published findings drawn from scads of data related to the American flu season. Looking at health care records from nine flu seasons, they painted a picture of the disease’s march across the country.

The researchers found that the illness tends to emerge in the southeast, and suggest that the region is a particularly susceptible breeding ground due its humid weather and highly connected communities.

Chicago asked Ishanu Chattopadhyay, the study’s lead researcher, some questions about his team’s analysis.

With weather playing into this, is this a silver lining to these miserable Chicago winters?
One of the things to note here is that infections do not seem to start from large population areas. So they do not seem to start from Chicago, they do not seem to start from New York City. Which is the first very surprising thing. If you just ask someone which place would be more likely to trigger an influenza epidemic, people might just go with common sense, and say ‘places which are more populated.’ But that doesn’t seem to be what the dynamic is. Once the flu season is on its way, you’ll have much more incidents as the population goes up, but that’s not where it starts from.

And for the weather thing, if you look at the most important factors—places with high mean maximum specific humidity, high average temperature, low average pressure—that’s kind of what is important. All these factors come together to create this perfect storm. That does not happen in Chicago. It only happens in the southern and the southern-eastern states.

flu-map2.jpg
A map shows the most likely places for the flu to emerge and spread. PHOTO: ELIFE

Should you be leery of your friends at flu season?

I don’t know to what extent that particular effect directly contributes to the thing. Why is the South more socially connected? Maybe it’s warmer so people can go out and mingle more? That was what we thought of. But does that really explain the complete thing? If you think about New York City, people are always mingling because there are too many people.

Your study likens the movement of the flu to a forest fire. We all know from Smokey Bear that forest fires are preventable. Is the flu outbreak preventable?

If you cut down or restrict certain travel habits in certain seasons, you can do it. Whether that it is actually practical to implement or not is a different question. But the model that we came up with finally, which has 47 different variables—that is pretty accurate.

We had nine seasons of data, so we constructed the model with six seasons of data, held back three seasons worth of data and applied the model to see how well it does on out-of-sample data. And it does pretty well. The accuracy gives you an A under-the-curve of 80 percent, which is pretty good. So you can predict how the flu is going to move around in the country. If you know that then you can selectively try to manage the connectivity between different states, and that might interfere with the flu pattern quite well.

If that is the only concern—interfering with the dynamics of influenza—then yeah, sure, we can do it. The question is: are people willing to say: diverge air traffic or reroute certain things so that the airports which seem to be at a higher risk are avoided somewhat? That’s probably not really feasible. People are not that scared of influenza. If this was Ebola, yeah, all these things would be done. Now the truth is, every year, the number of deaths from influenza is—there are different estimates—roughly about 30,000 in the U.S. alone. That’s an incredible number.

People don’t really realize how serious it is.

Are there certain parts of the country that have been flu-proof?

No. It gets everywhere sooner or later.

Preparing for the possibility of a pandemic [Baltimore Sun (blog), 4 May 2018]

By Dan Roderick's

Listen to the episode in the player below, or through your favorite podcast app.
Roughly Speaking episode 384:

Book critic Paula Gallagher recommends a new non-fiction title, "The Feather Thief: Beauty, Obsession and the Natural History Heist of the Century," by Kirk Wallace Johnson.

Baltimore County executive Kevin Kamenetz, a candidate for the Democratic nomination for governor of Maryland, and his running mate, Valerie Ervin, talk about the opioid epidemic.

Kamenetz announced Wednesday that the county would open a 70-bed on-demand treatment facility in Owings Mills.

Michael Reisch, professor of social justice at the University of Maryland School of Social Work, gives his take on the sturdy Trump base -- why people who might be hurt by the president's policies stick with him.

Dr. John Cmar, an expert in infectious disease on the staff of Sinai Hospital in Baltimore, gives some perspective to Bill Gates' most recent warning that the world could face a flu pandemic like the one that killed millions -- and 675,000 in the United States -- 100 years ago.

A pandemic is coming, and American politics have set us up for failure [The Diamondback, 3 May 2018]

By Nate Rogers

imagesoooooo.png


Views expressed in opinion columns are the author's own.

In the not-so-distant future, a highly infectious virus has killed a large portion of the world's population. The death toll is unclear, but it's in the tens or hundreds of millions, perhaps even billions. Those still alive — lucky enough not to contract a deadly strain of H7N9 influenza — will reflect on what brought them here.

Some might think about the four horsemen of the apocalypse. They had, after all, just survived a plague of biblical proportions. With the benefit of direct experience, they might add a fifth: fiscal conservatism.

It sounds like overdramatic science fiction, but it shouldn't. We live in an era with the constant threat of doom looming over us climate change, terrorism, nuclear war. But pandemic will likely get us first.

Even though it's the most plausible of apocalypses, we're not powerless to prevent it. We have the scientific knowledge, and the international aid capabilities, to stop dangerous outbreaks of highly infectious diseases well before they become global pandemics. The only thing standing in the way is funding.

Shortsighted cuts to science research and foreign aid tip the scales in pathogens' favor. Congress and the Trump administration must increase funding for science research and readiness. If they continue to ignore this microscopic threat, they could be responsible for the deaths of millions.

The next pandemic would not be the first to wreak havoc on global health. The 2014 Ebola outbreak in West Africa claimed around 11,325 lives. That's dwarfed by the 2009 H1N1 flu pandemic, which took upward of 151,700 to 575,400. 1,232,346 people have been diagnosed with AIDS since the epidemic's inception in the early '80s. Easily topping that, the catastrophic 1918 Spanish flu pandemic infected a third of the Earth's population and killed about 50 million people.

We could be on the verge of a similar outbreak. The world's increasing population density means humanity is more vulnerable than ever to highly infectious diseases. Such a risk demands decisive action to fund research and preparedness. Instead, a perfect storm of budget cuts and negligence has put us on course for a pandemic.

Global health experts agree that the United States isn't prepared to handle a worldwide outbreak of a highly infectious virus, and the Trump administration's attitude toward research and aid isn't helping matters. The administration has proposed cutting the state department's funding by more 25 percent, which could severely compromise its ability to provide crucial aid early on in an outbreak.

The same budget proposal roughly maintains 2017 levels of funding for the National Institutes of Health. Increased NIH funding would spur more research into viruses that could cause the next pandemic. Meanwhile, the Centers for Disease Control and Prevention is set to exhaust the funding allowing it to help developing nations improve their ability to detect and respond to epidemics. Without oversight, outbreaks in developing nations could spread nearly unchecked.

To put it succinctly, the United States is scaling back efforts to prevent a pandemic. We're asking for a fight we won't win.

There are already candidates for the next pandemic virus. H7N9 currently doesn't spread easily between humans, but it has killed up to 39 percent of those infected. An outbreak of a more transmissible but similarly deadly mutation would be devastating, and that mutation could happen at any time. Acting now would minimize the damage. Policy makers need to treat that day as an inevitability — not science fiction.

Swine flu breaks out again in Tamilnadu [News Today, 2 May 2018]

By Naomi N

swine-2.jpg


Chennai: Cases of Swine flu are once again making the rounds in the State, but top officials have said that public need not worry about the communicable disease.

According to data from Union Health Ministry, 65 cases and two deaths have been recorded already. However, officials have asked people not to panic as several precautionary measures have been laid out.

Speaking to News Today, Principal Secretary to the government, Health and Family Welfare department, J Radhakrishnan said,”It is downgraded as seasonal flu for which vaccines and medication are being administered by the government. There is nothing alarming about it. As of now, vaccines are advised to the health workers and high risk groups and not the general public.”

He also said that there has to be a general awareness of hand washing and hygiene. From the beginning of the year until 22 April, 65 cases and two deaths have been reported.

Across the State, from January, over 3,000 people were screened for swine flu and among them over 60 were positive, reports say. It may be recalled that in 2017, officials reported 3,315 cases and 17 deaths.

Health officials are ensuring that the hospital staff who care for the patients are also vaccinated. Those who are undergoing treatment are stable, sources said.

FEVER FACTS

In swine, an influenza infection produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite.

It can affect people of all ages.

Virus spreads the same way regular seasonal fl u does.

SEE BIGGER PICTURE, MEDIA TOLD

Radhakrishnan said that the media, while reporting on such communicable diseases, has to see the bigger picture. The focus, he said, should be on tackling and eradicating the disease, rather than putting out numbers.

Swine flu cases have officials worried [The New Indian Express, 2 May 2018]

By Sinduja Jane

While it was dengue that kept health department on its toes last year, this year, it is swine flu that is keeping officials busy as 65 cases and two deaths have been reported in the State already, acc

CHENNAI: While it was dengue that kept health department on its toes last year, this year, it is swine flu that is keeping officials busy as 65 cases and two deaths have been reported in the State already, according to a Union Health Ministry report.Though, according to officials, cases of swine flu, a seasonal influenza, are seen only in winter, the trend is changing. Last year, the spike was in February-March, but this year so far only over 60 cases and two deaths have been reported.

Its a seasonal influenza and cases are reported usually in winter. But, last year, it was different. So, we are not taking chances and we are prepared, said K Kolandaswamy, Director of Public Health.A Union Health Ministry report showed that between January and April 22, 65 cases and two deaths have been reported. Last year, 3,315 cases and 17 deaths were reported while officials shifted their focus to dengue. The officials said the health department has taken all precautionary measures to prevent swine flue cases this year. We have taken all precautionary measures to control the cases.

From January, over 3,000 people were screened for swine flu and among them over 60 were positive. Now, we have two people with swine flu cases undergoing treatment and they are stable. A last year-like situation will not be repeated this year, the official said. Meanwhile, sources said the Directorate of Public Health had procured H1N1 (swine flu) vaccine for staff who handled these cases. But, many staff refused to take the vaccine saying, its not swine flu season.

There are cases, so the government procured H1N1 vaccines for staff, but since many refuse to take it, they are lying in drug warehouses. Its off season. Even if they take, the strain of the virus changes and the vaccine might not be effective, a source said. Kolandaswamy said it is a must for staff who handle cases, but not recommended for public.

We are promoting handwashing and also general public hygiene to contain the infection. We hope there will be no cases like last year .Last year, dengue was the most challenging to officials though other diseases also relatively spiked, including swine flu. In 2016, there were 122 cases and two swine flu deaths. In 2015, there were 898 cases and 29 deaths were reported. Last year, there were 23,035 cases and 63 dengue deaths were reported, and in 2016, 2,531 cases and five deaths were reported. However, officials claim there are no dengue cases so far this year.

Bill Gates makes push for universal flu vaccine, stepped-up efforts to address future pandemics [HSPH News, 2 May 2018]

Michelle-Williams_Bill-Gates_470x313.jpg


In conversation with Harvard Chan School Dean Michelle Williams, Gates calls for innovative ideas to combat infectious disease outbreaks

May 2, 2018 – Innovative new treatments, improved health care delivery systems, and a coordinated global response are among the strategies needed to help the world prepare for future pandemics, Bill Gates, co-chair of the Bill & Melinda Gates Foundation, told Michelle A. Williams, Dean of the Faculty at Harvard T.H. Chan School of Public Health, on April 27, 2018 during a Q&A before a packed audience at the World Trade Center in Boston.

The conversation followed his announcement of the Bill & Melinda Gates Foundation’s plan to award a $12 million Grand Challenge, in partnership with the Page family, to accelerate the development of a universal flu vaccine. “The goal is to encourage bold thinking by the world’s best scientists across disciplines, including those new to the field,” he said.

The Microsoft co-founder was in Boston to deliver the 128th annual Shattuck Lecture, “Epidemics Going Viral: Innovation vs. Nature.” The event was sponsored by the Massachusetts Medical Society and the New England Journal of Medicine.

The Gates Foundation aims to prevent more than 11 million deaths, 3.9 million disabilities, and 264 million illnesses by 2020 through vaccine coverage and support for polio eradication. Immunization has led to the eradication of smallpox, a 74% reduction in childhood deaths from measles over the past decade, and the near-eradication of polio, according to the organization. Yet one in five children worldwide are not fully protected with even basic vaccines. As a result, an estimated 1.5 million children die each year—one every 20 seconds—from vaccine-preventable diseases such as diarrhea and pneumonia.

Two-pronged approach

In response to a question from Williams about what he looks for when assessing big ideas, Gates said he began to focus on global health in the late 1990s after the World Bank reported that a relatively small number of diseases were responsible for a large proportion of deaths in developing countries, and not in countries in the developed world. He learned that medications and other tools already existed to treat many of the diseases, but that poorly functioning health delivery systems in many developing nations kept treatments from reaching the populations. “We took a two-pronged approach, funding both the ‘upstream’ areas of research—promising research that wasn’t getting much funding—and ‘downstream’ areas,” such as improving primary care delivery systems in nations like Nigeria, he said.

Gates noted that progress is being made in reducing child mortality. Increased understanding of the important role of nutrition, maternal and infant care, as well as a better understanding of the immune system are among the factors helping to reduce mortality in some areas. He cited a recent clinical trial in which a few doses of an inexpensive antibiotic given over two years reduced childhood deaths from diarrhea and other diseases. “It’s a very promising example of working upstream and downstream and really solving the problem here and now while thinking about how to work out the mechanisms,” Williams said.

When asked how to “close the deal” on malaria, Gates said antibiotic resistance in recent years has contributed to a resurgence of the disease after progress had been made.

Nevertheless, he said he is very hopeful about malaria because of digital tracking of mosquitoes and other promising research efforts underway. “Centers like Harvard and Oxford using low-cost digital technology are making us a lot smarter about what’s going on with this disease,” he said.

Referring to the role of mosquitos in transmitting malaria, Williams said, “These bugs are making us have to work harder and deploy tools and think about behaviors in ways that we wouldn’t otherwise.”

Coordinated global approach

In his lecture Gates said, “The global community eradicated smallpox, a disease that killed an estimated 300 million people in the 20th century alone. We are on the verge of eradicating polio, a disease that 30 years ago was endemic in 125 countries and that paralyzed or killed 350,000 people a year. And today, nearly 21 million people are receiving lifesaving HIV treatment, thanks primarily to the support of the world community,” he said. “America’s global HIV initiative, PEPFAR, was the catalyst for world action on the AIDS crisis. It’s an example of the kind of leadership we need from the U.S. [as part of a] broader effort to make the world safer from other infectious disease threats. “With strong bipartisan support, PEPFAR has saved millions of lives and shown that national governments can work together to address pandemics,” he said.

Gates stressed that the world needs to prepare for infectious disease outbreaks as it does for war. “What the world needs—and what our safety, if not survival, demands—is a coordinated global approach. Specifically, we need better tools, an early detection system, and a global response system.” This includes doing simulations, war games, and preparedness exercises to better understand how diseases will spread, and how to deal with things like quarantine and communications to minimize panic, he said. Better coordination with military forces is needed to move people, equipment, and supplies on a mass scale during an outbreak. In addition, the pharmaceutical industry needs to step up efforts to get new treatments out more quickly, he said.

“Somewhere in the history of these collective efforts is a roadmap to create a comprehensive pandemic preparedness and response system. We must find it and follow it because lives—in numbers too great to comprehend—depend on it,” Gates said.

– Marge Dwyer


CGD Blog Post Highlights Experts’ Remarks On Global Health Security, Pandemic Preparedness [Kaiser Family Foundation, 2 May 2018]

Center for Global Development’s “Global Health Policy Blog”: It’s (Past) Time We Prepare for the Next Pandemic

Rebecca Forman, research assistant for the global health policy team at CGD, discusses takeaways from a panel discussion at a recent Center for Strategic & International Studies (CSIS) event on U.S. leadership in global health and health security, writing, “While the group highlighted the scary realities that pandemics present, they also expressed optimism and explored ideas for how we can improve on pandemic preparedness … The bottom-line? The next pandemic is just a matter of when. It’s (past) time that we prepare” (5/1).

Lessons Learned From Pandemics Past Prepare Us for a Healthier Future [GlobeNewswire (press release), 2 May 2018]

DMC-Logo-BILINGUAL-RGB.jpg


Defining Moments Canada Brings Stories of Canada’s Spanish Flu Pandemic to Life
A National Online Commemorative Research Project
for Teachers, Students, Heritage Organizations and Community Groups Across Canada
www.definingmomentscanada.ca/www.momentsdeterminants.ca

TORONTO, May 02, 2018 (GLOBE NEWSWIRE) -- Defining Moments Canada/Moments Déterminants Canada, a heritage education organization, today announced the launch of its innovative new digital platform commemorating the centenary of the Spanish Flu pandemic in Canada, in partnership with the Department of Canadian Heritage.

At an event held at the Royal Canadian Military Institute in Toronto, key government officials, historians, educators, students and media gathered to preview the technology and launch the innovative, new national storytelling platform. The goal of the national commemorative initiative is to engage Canadians young and old in the creation of an online, historical mosaic memorializing the heroes of this pandemic via the platform of stories, photos, and videos from across the country.

The Spanish Flu pandemic commemorative project platform is designed to encourage students and community groups to actively explore, research and re-tell the untold stories of how this pandemic affected Canadians coast to coast in 2018-19, the centenary years of the Pandemic.

The Honourable Mélanie Joly, Minister of Canadian Heritage, describes the project as “innovative” and notes that “using inventive teaching methods, the project encourages students to explore untold stories and seek out connections that capture the devastating impacts that the pandemic had on individuals and their communities.”

“The 1918 Spanish Flu pandemic was one of the deadliest health disasters in all of human history,” added the Honourable Ginette Petitpas Taylor, Minister of Health. “We’ve come a long way since then, thanks in large part to developments in modern medicine like safe and effective vaccines. This anniversary is a chance to reflect on the importance of these live-saving developments and recognize those helped get us to where we are today."

Defining Moments Canada/Moments Déterminants Canada is the shared vision of Neil Orford and Blake Heathcote, creators of a new and innovative way to teach and commemorate Canada’s history using twenty-first century digital tools and storytelling skills.

“The Spanish Flu pandemic had a massive impact on the shared history of Canadians,” says Neil Orford, Project Leader for Defining Moments Canada/Moments Déterminants Canada.

“The participants are the driving force behind this commemoration and our hope is to shine a light on the importance of this historical event and uncover stories untold from voices unheard.”

Working in collaboration with the Department of Canadian Heritage, Library and Archives Canada (LAC), Huron College, Western University, and dozens of Canadian school boards, organizations, and institutions, Defining Moments Canada/Moments Déterminants Canada uses this innovative, twenty-first century digital medium to honour and share historical events, illuminating the untold stories of ordinary Canadians in communities across the country.

As a 'capstone' event in the commemoration of the Pandemic centenary, work has also begun on a National Symposium scheduled for May 2019, at which the 'best' of the commemorative projects from across Canada will be featured and honoured.


How New Yorkers responded to the 1918 Flu Pandemic [6Sqft (blog), 2 May 2018]

BY CAIT ETHERINGTON

May 2018 marks the centennial of one of the world’s greatest health crisis in history—the 1918 flu pandemic. In the end, anywhere from 500,000 to 1 million people worldwide would die as a result of the pandemic. New York was by no means spared. During the flu pandemic, which stretched from late 1918 to early 1920, over 20,000 New Yorkers’ lives were lost.

However, in many respects, the crisis also brought into relief what was already working with New York’s health system by 1918. Indeed, compared to many other U.S. cities, including Boston, New York suffered fewer losses and historians suggest that the health department’s quick response is largely to thank for the city’s relatively low number of deaths.

1918-flu-kansas.jpg
An emergency hospital during the influenza epidemic in Camp Funston, Kansas, via Wiki Commons

May 1918: The flu makes its first appearance

As reported in the New York Times on September 22, 1918, just as the flu was beginning to ravage the city’s population, the flu first appeared in May 1918 in Spain. While the flu would remain widely known as the “Spanish influenza,” it quickly spread to other countries across Europe, including Switzerland, France, England, and Norway. Already a global world, it wasn’t long before the flu started to travel overseas via ill passengers. As reported in the New York Times, “In August, this disease carried by ocean liners and transports, began to make its appearances in this country, and within the past two weeks the occurrences of the malady in the civilian population and among soldiers in the cantonments have increased so greatly in number that Government, State, and municipal health bureaus are now mobilizing all the forces to combat what they recognize to be an approaching epidemic.”

1918-flu-3.jpg
The Health Board urged New Yorkers to wear masks with the phrase, “Better ridiculous than dead.” Via the National Archives and Records Administration

A Quick and Effective Response from New York’s Health and Housing Authorities

As Francesco Aimone argues in a 2010 article on New York’s response to the 1918 flu pandemic, although newspapers reported that the first cases of influenza came via the port on August 14, 1918, roughly 180 earlier cases of active influenza arrived on vessels in New York City between July 1 and mid-September. Indeed, as Aimone reports, “Approximately 305 cases of suspected influenza were reported throughout the voyages of 32 ships’ port health officers examined from July through September, including victims who died while at sea or recovered from their illness.” However, health officials did not discover any secondary outbreaks of influenza until after August 14, 1918.

Aimone’s study further emphasizes that despite the fact that New York City was home to an active international harbor, the city ultimately managed to contain its influenza cases through a number of measures, which included those connected to housing. Most notably, the Health Department opted for a “two-tiered approach to isolating cases of influenza.” As Health Commissioner Royal S. Copeland told The New York Times on September 19, “When cases develop in private houses or apartments they will be kept in strict quarantine there. When they develop in boarding houses or tenements they will be promptly removed to city hospitals, and held under strict observation and treated there.” While most cases were moved to hospitals, as hospital spaces filled up, the city opened other designed spaces and at one point even turned the Municipal Lodging House, the city’s first homeless shelter on East 25th Street, into a care facility for those suffering from influenza.

However, the Department of Health was not solely responsible for helping fight the spread of influenza during the 1918 pandemic. When more public health inspectors were needed, inspectors were reassigned from the Tenement House Department. Among other tasks, housing inspectors undertook a house-to-house canvas to attempt to find previously undocumented cases of flu and pneumonia.

1918-flu-1.jpg
A NYC street sweeper wears a mask while working. Via the National Archives and Records Administration

The Goodwill of New Yorkers

While the city’s quarantining program was generally effective, it was ultimately contingent on the goodwill and cooperation of New Yorkers. Without the proper staff to enforce isolation orders, isolation remained a voluntary measure. In essence, enforcement of the isolation orders was either self-imposed by the ill or imposed on the ill by their families. New Yorkers also helped contain the spread of influenza by abiding with the myriad of other enforcements regulating everything from when they rode public transit to their handkerchief use. In fact, close to one million leaflets were distributed during the crisis aimed at educating the public on how their everyday practices could play a key role in containing the spread of influenza.

In the end, proportionate to the population, New York City fared better than most U.S. cities with a rate of 3.9 deaths per thousand residents. Indeed, compared to the twenty largest cities in the United States, only Chicago and Cincinnati reported lower mortality rates than New York City. A combination of a well-developed health department, understanding of the link between health and housing conditions, and the goodwill of New Yorkers all played a key role in combatting the pandemic.
nice!(1)  コメント(0) 

West Nile Fever News from 5 May 2018

Opinion | West Nile virus and Lyme disease: reducing your risks in Muskoka [www.muskokaregion.com, 25 May 2018]

by Dr. Charles Gardner

Some simple measures will ensure your safety and that of your family, says Dr. Charles Gardner

EDT_MRC_Dr_Super_Portrait.jpg
Dr. Charles Gardner - SDMHU photo

MUSKOKA — With winter well behind us, many people are happily heading into the garden, on the trail, to the water, enjoying the sun and the warm, fresh air.

Any outdoor activity, be it cycling, walking, paddling or just enjoying time in a park with friends and family, provides an opportunity to increase physical activity, benefiting overall health. There is a growing body of research showing that the time spent in green spaces — whether in parks, playing fields, forests or gardens — provides benefits for your mental and physical well-being.

There are some risks in the outdoors from bugs that can transmit disease through their bite, and the news media have focused a good deal of attention on Lyme disease and West Nile virus.

However, the outdoors can be safely enjoyed with the application of some knowledge about prevention.

Some species of mosquitoes can carry West Nile virus. They prefer to breed in urban or suburban settings, in stagnant water in storm sewers, bird baths or ditches. Removal of standing water on your property helps to reduce this risk. Mosquitoes are most active at dawn and dusk, and so the use of personal protection to prevent insect bites should be taken to reduce risk.

Generally the number of people diagnosed with the disease is low in Simcoe Muskoka, but there was some increase in cases last year.

Lyme disease is an infection from the bite of a tick. There are many kinds of ticks, but only the blacklegged tick is known to spread Lyme disease in Ontario. These ticks prefer tall grass or shrubs where they may attach to any animal or person that brushes by. Unlike mosquitoes a tick’s bite causes no sting or itch, and because of their size may go undetected. In Simcoe Muskoka, health unit surveillance has shown a gradual increase in the number of blacklegged ticks.

Public Health Ontario produces an annual map of estimated risk areas for Lyme disease. This year’s map for the first time includes two portions of Simcoe County, where blacklegged ticks were found through active surveillance. Blacklegged ticks have also been submitted from other areas in Simcoe and Muskoka.

Both Lyme disease and West Nile virus can cause flu-like symptoms that begin with headaches, achy muscles and joints, fatigue and fever. Lyme disease often comes with the warning of a rash in the shape of a bull's-eye at the site of the bite.

To reduce your risks, wear loose fitting, light-coloured clothing and use repellents such as DEET or icaridin applied to clothing or on exposed skin. When hiking it also is recommended to tuck socks over pant cuffs, and stick to the centre of trails away from underbrush.

Ticks will cling to the skin for as long as a week. However, removing ticks that are found in less than 24 to 36 hours reduces the risk that they will transmit disease. Showering within two hours of coming home from a hike will help wash any ticks from the body. Doing a body check for ticks following activity in grassy and wooded areas is recommended. If you find a tick attached to your body, or notice a bull's-eye shaped rash developing, it is recommended that you seek medical attention for an assessment. It would also be helpful to bring the tick in a plastic bag or jar for submission.

These simple measures will ensure your safety and that of your family while you enjoy all that the outdoors of Simcoe and Muskoka has to offer.

More helpful information on dealing with mosquitoes and ticks can be found on the health unit’s website at www.simcoemuskokahealth.org/bugsthatbite.

West Nile Virus found in county [Mountain Democrat, 25 May 2018]

El Dorado County health officials received confirmation that a bird found in the South Lake Tahoe area of El Dorado County has tested positive for West Nile virus, the first for 2018.

The finding was announced in a press release issued May 22.

The bird, a Stellar’s Jay, was collected on May 7.

So far this year, West Nile virus activity in dead birds has been reported in El Dorado, San Mateo and Santa Clara counties.

Confirmation of the West Nile virus positive bird means the virus is circulating between birds and mosquitoes and there is heightened risk of infection in humans. Therefore it’s important to take precautions.

Last year, two West Nile virus positive birds were identified in Garden Valley and South Lake Tahoe.

So far this year, no human cases of West Nile Virus have been reported in the county.

West Nile virus can be transmitted to people through the bite of an infected mosquito.

Mosquitoes get the virus when they feed on infected birds. The illness is not spread from person-to-person. While most people infected with the virus show no symptoms, some may have high fever, severe headache, tiredness and/or a stiff neck that can last several days to several weeks.

The most serious cases of West Nile virus infection can lead to encephalitis, an inflammation of the brain, which can be fatal.

Mosquito surveillance programs are in place throughout the county. Activities include trapping and identifying mosquitoes, treating neglected swimming pools, and reporting and testing dead birds. The El Dorado County Public Health Division conducts human surveillance activities and health care providers are asked to routinely test human cases of viral meningitis and encephalitis for West Nile virus.

To help prevent West Nile virus, county health officials recommend draining standing water around property and keeping water in swimming pools, ponds and water troughs circulating or treated with “Mosquito Dunks” or mosquito fish.

Apply insect repellent that contains DEET or another approved substance (e.g. picaridin, oil of lemon eucalyptus or IR 3535) on exposed skin when outdoors.

Dress in long sleeves and pants when outdoors among mosquitoes. Mosquitoes are most active at dusk and dawn.

Make sure doors and windows have tight-fitting screens, kept in good condition.

Report dead birds and tree squirrels to the State West Nile Virus hotline at (877) WNV-BIRD (877-968-2473) or online atwestnile.ca.gov. Wear gloves and place the dead bird or squirrel in a double plastic bag if you dispose of it yourself.

Mosquito problems and neglected swimming pools should be reported to the Environmental Management Division at (530) 621-5300 on the West Slope or (530) 573-3450 in South Lake Tahoe.

Does West Nile Virus Affect Midwest Ruffed Grouse Populations? [WXPR, 25 May 2018]

By KEN KRALL

grouse.jpg
Ruffed Grouse
CREDIT WIKIPEDIA.ORG

The effects of West Nile Virus on bluejay and crow populations have been well documented.

Those species have been hit hard by the virus, transmitted by mosquitos. It also can affect humans.

Research is beginning in the upper Midwest about the possibility the virus also affecting ruffed grouse populations, a prized bird among hunters.

DNR ecologist Mark Witecha says Minnesota and Michigan wildlife officials are collaborating with Wisconsin on the research. Ruffed Grouse populations cycle upward and downward, but instead of hearing more birds during what should have been an 'up' year, hunters didn't see that many.

Pennsylvania officials have reported a link between West Nile Virus and downward trends in Ruffed Grouse populations there...

"....I've been following a little bit of the research coming out of Pennsylvania about West Nile Virus. As such, I started to take action on a potential collaborative efforts that could be done in the Upper Great Lakes states with our neighbors in Minnesota and Michigan, given that we are the top three grouse hunting states in the country..."

Last year, Michigan had 12 cases of West Nile Virus in grouse populations. Prior to 2017, only one case had been reported in Michigan. One case 15 years ago was reported in Minnesota and it is yet to be detected in Minnesota.

Witecha says there is no evidence to date the virus is affecting grouse populations in
Wisconsin, but he says it is worthy of research. He's hoping hunters and outdoor enthusiasts will help out. About 300,000 hunters go for the elusive bird each year across the upper
Midwest states. More information is on the DNR website.

Horse owners encouraged to vaccinate against West Nile Virus [tahlequah Daily Press, 18 May 2018]

Animal Industry Services of the Oklahoma Department of Agriculture, Food, and Forestry is encouraging horse owners to take precautions and vaccinate their animals to protect against the West Nile Virus and Eastern Equine Encephalitis.

In years past, Oklahoma averaged approximately 40 cases per year of positive diagnoses of mosquito-carried diseases in horses.

The bird population serves as the reservoir for the viruses, and mosquitos then transmit the virus to horses and humans. Mosquitos most likely to transmit WNV and EEE lay their eggs in small pools of standing water. Once the adult mosquitos hatch, they can become infected with both WNV and EEE after feeding on an infected host, such as a bird carrying the virus. Within 10-14 days, the mosquito can transmit the virus to both humans and horses.


"Signs of West Nile Virus include weakness, fever, incoordination, seizures, blindness and difficulty getting up," said Assistant State Veterinarian Michael Herrin, D.V.M.

Oklahomans can reduce the risk of both EEE and WNV by eliminating standing water which serves as a breeding area for mosquitos. Horse owners are encouraged to not let water stagnate in birdbaths or water tanks, and keep unused equipment that can collect water, such as a wheelbarrow, turned over when not in use. Water troughs should be emptied and flushed twice a week to remove potential mosquito eggs. When possible, owners should reduce horses' outdoor exposure at dawn and dusk, the times of day when mosquitos carrying the viruses are most active.

In addition, ODAFF recommends vaccinating horses against tetanus, equine herpes virus, equine influenza, and rabies.

Equine vaccines are available as individual vaccines or in combination. Horse owners should always work with their veterinarian to determine the best product to use for their horses depending on the way the horse is used and housed. A common combination vaccine provides protection against West Nile, Eastern and Western Equine Encephalomyelitis, tetanus, influenza, and two strains of EHV. Rabies vaccine is typically an individual vaccine.

ODAFF recommends horse owners and event managers remain at a heightened level of awareness, implement biosecurity practices to minimize potential exposure, consult with a veterinarian on an appropriate vaccination schedule, and report any suspicious illness or neurologic disease.

Richfield woman warns others to be aware of mosquitoe bites [KMVT, 15 May 2018]

By Ricardo Coronado

RICHFIELD6.jpg


RICHFIELD, Idaho (KMVT/KSVT) As flowers bloom and the sun starts to shine so are those pesky flying creatures. Mosquitoes are known to carry illnesses and one of them includes the West Nile Virus.

Health experts say the virus is uncommon in the Gem State. In 2017 six cases where investigated in the Magic Valley, three came back confirmed.

From 2012 to 2016, 98 cases were reported in Idaho. 2013 saw the highest number of reported cases totaling up to 40. A Richfield woman became one those cases.

"I started to get really sick and I felt I had the flu — really bad headache, body aches so bad I couldn't move," said Alma Brown, who contracted West Nile in 2013. "I had it all. I just though it was the flu so I'd let it go."

After a rash appeared on her skin, she knew it was time to check it out.

"From head to toe, literally was just covered in the rash," said Brown. "Got a phone call from the health department stating that it was positive for West Nile."

There's no specific treatment or vaccines for the virus.

Christi Skuza, a public nurse and epidemiologist at South Central Public Health District Twin Falls Office, said the first reported case of West Nile Virus in Idaho was in 2004.

"Most of the time the people that contract West Nile they go camping outside of Idaho and then they come back with symptoms. So we don't see a lot in our area," Skuza said.

Skuza said there are options to avoid mosquitoes bites.

"We recommend try not be out those evening to early morning hours. If they're out, (wear) long pants, long sleeve shirts if they can. Obviously use any kind EPA approve bug repellent," Skuza said.

Here are some tips on how to win the war against mosquitoes [Tri-City Herald, 12 May 2018]

BY ANNETTE CARY

KENNEWICK, WA

Mosquitoes have started to hatch in the Tri-City area, and in only a few weeks the flying, biting pests could be at their seasonal peak.

Weather and river levels can affect when the insects are most prevalent, but in the Tri-Cities they typically peak in the first or second week of June, said Angela Beehler, manager of the Benton County Mosquito Control District.

In some years, the first detection of the West Nile virus, which can cause a potentially serious or even fatal illness, is in late May, she said.

The district already is on the attack, checking for areas of standing water while also spreading larvacide from the ground and from planes in riverside areas difficult to reach on foot.

Help us deliver journalism that makes a difference in our community.

Our journalism takes a lot of time, effort, and hard work to produce. If you read and enjoy our journalism, please consider subscribing today.

Evening fogging, or spraying, for the adult insects will start either when the first West Nile virus of the season is detected or when the district judges enough mosquitoes are present for it to be beneficial.

The worst years for West Nile are hot and dry, like 2015 was, Beehler said. That year, Benton County had 12 people reported sickened by West Nile, and 27 mosquito samples were positive for the virus.

Mosquito Control granules.jpg
Tyler Willis, an employee of the Benton County Mosquito Control District, holds bacteria laced granules that are deadly to mosquito larvae. He uses a backpack sprayer resembling a leaf blower but is outfitted with a hopper to distribute the granules into the air flow. Bob Brawdy

The National Weather Service is predicting that this could be a hotter and drier than usual summer in Eastern Washington, although it's too soon to predict the upcoming mosquito season.

Hot weather causes eggs to develop into adults in as little as four days. And limited water means mosquitoes and birds that carry the virus may be clustered in the same area.

There are steps you can take now to help protect your family and your neighborhood.

Get rid of standing water

Mosquitos lay eggs in standing water.

It can be in birdbaths, potted plants with saucers, children's outdoor toys, tarps on garden equipment or any trash as small as a bottle cap that can hold water.
Roof gutters should be cleaned of leaves to make sure water flows freely and does not accumulate.

Water in birdbaths and wading pools should be drained twice a week. If water cannot be drained, it should be treated once a month with a larvicide.

The Benton and Franklin mosquito control districts also will provide mosquitofish, a guppy-size fish that eats mosquito larvae before they can hatch in decorative ponds and water troughs.

The fish cannot be used in bodies of water connected to natural waterways or canal systems.

Forms to order the fish are available at mosquitocontrol.org for those in the Benton district and at fcmcd.org for the Franklin district.

If you have a neighborhood nuisance spot for breeding mosquitoes, such as an unused swimming pool, report it to your local mosquito district.

Keep them off your skin

Mosquitoes are most active from dusk to dawn, and areas with many of the insects should be avoided then.

Cover up in infested areas with long sleeves, long pants and a hat.

Use an effective mosquito repellent. DEET, picaridin, IR3535, oil of lemon eucalyptus and 2-undecanone all work. The Environmental Protection Agency has more information about choosing a repellent at bit.ly/BugSprayChoice.

Don't use insect repellent on babies younger than 2 months or oil of lemon eucalyptus on children younger than 3 years, says the Centers for Disease Control.

Also, don't put repellent on children's hands because they may put their hands in their mouths. Use your hands to wipe repellent on a child's face rather than spraying repellent on the face.

More tips

If you have trouble with biting mosquitoes sheltering in trees and shrubs during the heat of the day, insecticide sprays with the ingredient permethrin are available.

However, the Benton mosquito control district urges caution because the spray also can kill beneficial insects, including bees. Don't use more than recommended and don't spray flowering plants.

Horses are susceptible to West Nile virus, but can be protected with a vaccination and regular boosters.

Know the signs of West Nile. Symptoms may appear about 15 days after a mosquito bite, although about 80 percent of people will not show any signs of infection.

However, about one in 150 people with the virus will be seriously ill. They may have a high fever, neck stiffness, muscle weakness, paralysis and possibly permanent neurological effects.

Avoid tick- and mosquito-borne illnesses [Shelbyville Daily Union, 11 May 2018]

SPRINGFIELD ? As the weather warms up, we’re starting to see ticks and mosquitoes. The Illinois Department of Public Health (IDPH) is reminding people about simple precautions they can take to avoid bites.

“Ticks can carry diseases like Lyme disease, spotted fever, and ehrlichiosis, while mosquitoes can carry West Nile virus,” said Illinois Department of Public Health (IDPH) Director Nirav D. Shah, M.D., J.D. “These diseases can cause anywhere from mild to severe illness, and even death in some cases. To protect yourself from both, use insect repellent that contains DEET and follow some simple precautions.”

According to the Center for Disease Control and Prevention, disease cases from mosquito, tick, and flea bites have tripled in the U.S. during the 13 years from 2004 through 2016. Reported cases from mosquito and tick bites in Illinois have increased by more than half (58%) from 2005 to 2016.

Ticks

Many tick-borne diseases have similar symptoms. The most common symptoms can include fever, chills, aches and pains, and rash. Within two weeks following a tick bite, if you experience a rash that looks like a bull’s-eye or a rash anywhere on your body, or an unexplained illness accompanied by fever, contact your doctor. Early recognition and treatment of the infection decreases the risk of serious complications. Tell your health care provider the geographic area in which you were bitten or traveled to help identify the disease based on ticks in that region.

A fairly new virus called Bourbon virus has been associated with tick bites and has been found in a limited number of cases in the Midwest and southern U.S. People diagnosed with Bourbon virus disease have symptoms including fever, fatigue, rash, headache, other body aches, nausea, and vomiting. They also had low blood counts for cells that fight infection and help prevent bleeding. Some people who were infected later died.

Ticks are commonly found on the tips of grasses and shrubs. Ticks crawl?they cannot fly or jump. The tick will wait in the grass or shrub for a person or animal to walk by and then quickly climb aboard. Some ticks will attach quickly and others will wander, looking for places like the ear, or other areas where the skin is thinner.

Simple tips to avoid ticks bites include:

? Wear light-colored, protective clothing ? long-sleeved shirts, pants, boots or sturdy shoes, and a head covering. Treat clothing with products containing 0.5 percent permethrin.

? Apply insect repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.

・Walk in the center of trails so grass, shrubs, and weeds do not brush against you.

・Check yourself, children, other family members, and pets for ticks every two to three hours.

・Remove any tick promptly by grasping it with tweezers, as close to the skin as possible and gently, but firmly, pulling it straight out. Wash your hands and the tick bite site with soap and water.

Mosquitoes

The most common mosquito-borne illness in Illinois is West Nile virus. West Nile virus is transmitted through the bite of an infected Culex pipiens, or “house” mosquito. Mild cases of
West Nile virus infections may cause a slight fever or headache. More severe infections are marked by a rapid onset of a high fever with head and body aches, disorientation, tremors, convulsions and, in the most severe cases, paralysis or death. Symptoms usually occur from 3 to 14 days after the bite of an infected mosquito. However, four out of five people infected with West Nile virus will not show any symptoms. People older than 50 are at higher risk for severe illness from West Nile Virus.

There are some simple precautions you can take to Fight the Bite. Precautions include practicing the three “R’s” ? reduce, repel and report.

・ REDUCE make sure doors and windows have tight-fitting screens. Repair or replace screens that have tears or other openings. Try to keep doors and windows shut.
Eliminate, or refresh each week, all sources of standing water where mosquitoes can breed, including water in bird baths, ponds, flowerpots, wading pools, old tires, and any other containers.

・ REPEL when outdoors, wear shoes and socks, long pants and a long-sleeved shirt, and apply insect repellent that contains DEET, picaridin, oil of lemon eucalyptus or IR 3535, according to label instructions. Consult a physician before using repellents on infants.

・ REPORT report locations where you see water sitting stagnant for more than a week such as roadside ditches, flooded yards, and similar locations that may produce mosquitoes. The local health department or city government may be able to add larvicide to the water, which will kill any mosquito eggs.

Additional information about ticks and mosquitoes can be found on the IDPH website.

Tips on protecting yourself from the West Nile virus [WIFR, 10 May 2018]

By Kourtney Adams

ROCKFORD, Ill. (WIFR) -- Illinois had 90 confirmed West Nile virus cases last year, three of them in Winnebago County. Mosquitoes are the main carrier of the disease. Now that the weather's warming up, we'll see more of the bugs out and about.

"West Nile virus has been detected at least in mosquitoes and birds every year in our county for the past 15 years," said Ryan Kerch, the Environmental Health Supervisor with the Winnebago County Health Department.

Cases of West Nile tripled in the U.S. in the past 13 years according to the Centers for Disease Control and Prevention. Health officals say now's the time to take precautions like stopping mosquitoes from laying eggs around your home to prevent contracting the disease.

"Most people who contract the virus won't show any signs, for those who do the symptoms include a headache, fatigue, fever, and cramps, things similar to like the flu. It's most likely going to affect very young, very old, or people with compromised immune systems. Those are the people who are most at risk for that developing into a form of encephalitis, which can have much more severe consequences," said Kerch.

The health department suggests we follow the three R's, reduce, repel, and report. First, reduce the number of sites where mosquitoes might breed.

"Getting rid of stagnant water is really the biggest one; these mosquitoes typically don't fly too far from where they breed, so the fewer places that they've got to lay their eggs, the less likely that there's going to be mosquitoes around your home," said Kerch.

Second, you can repel the bugs by wearing long sleeve clothing, use insect repellent that contains DEET, and hire companies to spray your home.

"It's a general repellent, so it's either going to kill or repel them. So as they come to the structure, it will eliminate them or they will fly away. We come once in the spring, once in the summer, and once in the fall. We provide three exterior treatments. It’s really effective on the boxelder bugs, the stink bugs, the wasps, and it helps kill and repel the mosquitoes, the spiders, and earwigs, so basically just about any insect," said Zach Patnou, the Manager at Midwest Pest Control.

Finally, make sure to report dead birds and stagnant water to the health department.

"We receive funding from the state to do West Nile Virus surveillance and prevention. We collect mosquito samples and dead birds to test for the presence of West Nile Virus. This is an indicator of potential human cases. The more mosquitoes and birds that we find early in the season tend to correlate with how many human cases we might see over a year," said Kerch.

Water that sits in used tires is a big breeding ground for mosquitoes as well. That's why the Winnebago County Health Department will host a free tire recycling drive on June 9.

VECTOR-BORNE ILLNESSES ARE ON THE RISE: ZIKA, LYME, AND WEST NILE DISEASES ARE AMONG THEM [WMFE, 8 May 2018]

by Danielle Prieur (WMFE)

Mosquitos.jpg


Tick-borne illnesses have more than doubled in the United States over the past decade. University of Florida researcher Derrick Mathias says even though there were some cases of Lyme disease reported in Florida, the majority of illnesses came from mosquitoes. He says people should still actively prevent against tick bites.

“If anyone has a tick and you pull a tick off yourself, and you have any symptoms whatsoever within the next couple of weeks after that, it is advisable to see a physician and to keep that tick if you can.”

The Centers for Disease Control and Prevention says there were more than 640,000 cases transmitted by infected ticks, mosquitoes, and fleas over the past decade. Almost 60 percent of these were tick-related, as humans expand into their natural habitat.

PEOPLE Health Squad: Dr. Travis Stork on How to Protect Yourself from Zika, West Nile and Lyme Disease [PEOPLE.com, 8 May 2018]

BY SOPHIE DODD

Summer may be the carefree season of rose-fueled rooftop parties, backyard BBQs and long-awaited vitamin D exposure, but all those outdoor activities and skin-baring outfits also mean more exposure to potentially deadly tick and mosquito bites.

According to the Centers For Disease Control and Prevention, cases of illnesses stemming from tick, mosquito and flea bites ? such as Zika, West Nile and Lyme disease ? have tripled over the last 13 years, and the United States is not “fully prepared” for what’s to come.

The likelihood of contracting these diseases skyrockets in the summer, but there are steps you can take to protect yourself and your family. In order to safely make the most of the upcoming warmer months, we spoke with with Dr. Travis Stork, an ER physician, host of The
Doctors and a member of PEOPLE’s Health Squad, to find out everything you need to know about these diseases and how to avoid them.

imageDis.jpg


Knowing how they’re spread is a good place to start. Lyme disease is contracted through the bite of an infected tick, while Zika and West Nile virus are spread through infected mosquitos. Zika can also be passed through sex with an infected partner, or a pregnant woman to her fetus, increasing the risk of serious birth defects .

Pregnant women are especially encouraged to avoid areas with Zika outbreaks, like Florida and the Caribbean. “Many people infected with Zika won’t have symptoms or will only have mild symptoms,” he explains. “However, a pregnant woman, even one without symptoms, can pass Zika to her developing fetus.”

Recognizing the symptoms of these diseases is another crucial step to preventing their deadly consequences. “Early signs of Lyme disease include a rash that follows a bulls-eye pattern and can sometimes expand beyond initial bite site,” says Dr. Stork. He explains that flu-like symptoms such as chills, fever, body aches and fatigue can also accompany the rash.

Dogs bitten by an infected tick can also contract Lyme disease, so it’s important to check them for ticks and tick bites when they come inside, as only 5-10% of them show symptoms (lameness and joint stiffness).

imageIM.jpg
Courtesy The Doctors

Symptoms of West Nile virus, although they only occur in about 20% of people who contract it, are headaches, body aches, joint pain, rashes, vomiting or diarrhea. While anyone can contract the virus, it is most prevalent in people over the age of 50 and those with weaker immune systems.

Symptoms of Zika (which Dr. Stork reminds us don’t always show) include fever, rashes, headaches, joint pain, conjunctivitis and muscle pain.

If you or a family member start showing any of these symptoms, he suggests seeing your healthcare provider immediately. “They can discuss your symptoms with you and order additional testing to ensure you are correctly diagnosed.”

“The best way you can protect yourself from any of these diseases is to avoid areas where they thrive,” Dr. Stork tells PEOPLE. “Lyme disease-carrying ticks are most prevalent in the wooded areas, tall grass and lawns and gardens that we tend to play, hike and relax in during summer months, so people really have to be proactive in protecting themselves.”

He suggests avoiding tall grasses and always checking for ticks after being outside.

Mosquitos thrive near standing water and are most active starting at dusk, so if you find yourself outside in the evenings, be sure to wear insect repellant with DEET and cover up with long-sleeves and pants whenever possible.

Lastly, if you’re planning a trip this summer, Dr. Stork recommends checking the CDC’s website to see if there’s a risk of contracting these diseases where you’re going. “The CDC is a great resource for travelers and maintains up to date records on cases of these disease and others reported around the world. Always check out their website before traveling to [see] if there is a warning for where you are headed.”

Mosquito season starting, so defend yourself against West Nile Virus [Madison.com, 7 May 2018]

by Bill Novak

Wisconsin's unofficial state insect, the mosquito, will soon be biting it's way through the summer, so health officials are advising residents to guard themselves against the itch-causer and something much worse - West Nile Virus.

Recent heavy rains could hurry the arrival of mosquitoes, since they lay their eggs in standing water, and there's plenty of that in anything that can hold water, such as bird baths, flower pots, buckets and the like.

"It's important to empty and scrub, turn over, cover or throw out containers that hold water around our homes, to minimize mosquito populations," said John Hausbeck, environmental health supervisor for Public Health Madison and Dane County.

Public Health monitors for mosquitoes that carry West Nile Virus, and also works with the public by having residents report sick or dead blue jays and crows, two birds that indicate the presence of West Nile Virus.

Residents can call 800-433-1610 to report sick or dead crows and blue jays.

How can you prevent mosquito bites?

・Wear long-sleeved shirts and long pants from dusk to dawn if outside, because that's when mosquitoes are most active.

・Install or repair window and door screens so mosquitoes can't get inside.

・Use EPA-registered insect repellents.

・Treat clothing and gear with permethrin, or buy treated items. Permethrin was developed in the 1970s and is one of the most effective repellents against mosquitoes and ticks.

West Nile Virus Returns to Greece
 [PrecisionVaccinations), 7 May 2018]

by Danielle Reiter, RN

beach-3259685.jpg


There is not a vaccine to prevent or medicine to treat West Nile Virus

May 7th, 2018 – During 2017, the West Nile virus returned to Greece after a 2-year hiatus.

And, these West Nile Virus (WNV) cases emerged in the southern territories of Greece, which has not previously reported WNV cases, according to findings presented at the 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).

The first outbreak of West Nile in Greece was recorded in 2010 and was considered to be the largest epidemic in Europe since 1996.

A total of 197 patients with the neuroinvasive disease were reported in 2010, of whom 33 (17%) died.

Most outbreaks in western Europe have been caused by WNV Lineage 1. However, in eastern Europe, Lineage 2 has been responsible for human and bird mortality, particularly in Greece.

Professor Athanassios Tsakris, head of the Microbiology Department at the University of Athens Medical School, and his team of researchers diagnosed 45 cases from blood samples.

Twenty-six patients, or 57.8% of the new cases, were diagnosed with WNV neuroinvasive disease while the remaining 19 patients, or 42.2%, were determined to have WNV fever.
The five patients who died during this latest outbreak were over the age of 70.

WNV was first isolated in the West Nile District of Uganda in 1937. The disease was carried by mosquito-infected migratory birds from Africa, spreading the virus through Europe and into Russia.

Although some infected birds, especially crows and jays, frequently die of infection, most birds survive.

West Nile reached North America in 1999 and has been detected in over 300 species of dead birds.

As of January 9, 2018, 47 states and the District of Columbia have reported 2,002 West Nile virus infections to the Centers for Disease Control and Prevention (CDC) in 2017.

Of these, 67 percent were classified as neuroinvasive diseases, such as meningitis or encephalitis. The case fatality rate in patients with neuroinvasive illness ranges from 4% to 14% and can reach 15–29% in patients over 70 years old.

Since there is not a vaccine or medicine that prevents West Nile virus, the best way to protect yourself is by preventing mosquito bites, says the CDC.

Atlanta Holds Top Spot on Orkin's 2018 Mosquito Cities List [PR Newswire (press release), 7 May 2018]

Texas, Louisiana and Florida clench most spots with 15 collective cities

ATLANTA, May 7, 2018 /PRNewswire/ -- For the fifth year in a row, the Atlanta area tops pest control leader Orkin's Top 50 Mosquito Cities list, released today. Atlanta is followed on the list by Dallas, which jumped four spots from last year, New York and Washington, D.C.

Texas holds the most spots on this year's list with seven cities, followed by Florida and Louisiana with four cities each.

1Mos.jpg
Mosquito season starts when Spring temperatures arrive, and they are most active in temperatures above 80 degrees.

"Mosquitoes continue to be a major health concern, especially in the summer months," said Orkin entomologist, Chelle Hartzer. "According to the CDC, vector-borne diseases like Zika virus and West Nile virus have tripled since 2004. These mosquito-borne diseases may have serious side effects."

Mosquito season starts when Spring temperatures arrive, and they are most active in temperatures above 80 degrees. Breeding season is usually July through September, while peak West Nile virus season is usually not until late August through September or even October in some areas. Temperatures need to be around freezing before mosquitoes will start to die off for the winter.

Orkin's Top 50 Mosquito Cities list ranks metro areas by the number of new mosquito customers served from April 1, 2017 to March 31, 2018. The list includes both residential and commercial treatments.

1. Atlanta
2. Dallas-Ft. Worth, Texas (+4)
3.New York (+1)
4. Washington, D.C. (-2)
5. Chicago (-2)
6. St. Louis, Mo. (+20)
7.Houston
8. Miami-Ft. Lauderdale, Fla. (-3)
9.Kansas City, Mo. (+15)
10. Charlotte, N.C. (-1)
11. Detroit (-3)
12. Memphis, Tenn. (+2)
13.Nashville, Tenn. (-3)
14. Tampa-St. Petersburg, Fla. (-3)
15. Raleigh-Durham, N.C. (+2)
16. Los Angeles (+13)
17. Philadelphia (+4)
18. Birmingham, Ala. (+18)
19. Orlando-Daytona Beach-Melbourne, Fla. (-7)
20. Austin, Texas (+17)
21. Mobile-Pensacola, Fla. (-6)
22. Grand Rapids-Kalamazoo-Battle Creek, Mich. (-4)
23. Norfolk-Portsmouth-Newport News, Va. (-10)
24. Indianapolis, Ind. (+11)
25. Phoenix, Ariz. (-5)
26. Albany-Schenectady-Troy, N.Y. (+8)
27. Lafayette, La. (+5)
28. Baton Rouge, La. (+12)
29. New Orleans, La. (-2)
30. Richmond-Petersburg, Va. (-7)
31. Greenville-Spartanburg, S.C., Asheville, N.C (-9)
32. Minneapolis-St. Paul, Minn. (-2)
33. Boston (-14)
34. Wichita-Hutchinson, Ka. (+40)
35. Tulsa, Okla. (+14)
36. Hartford-New Haven, Conn. (-5)
37. San Antonio, Texas (+2)
38. Springfield, Mo. (+79)
39. Abilene-Sweetwater, Texas (+18)
40. Oklahoma City (+48)
41. Waco-Temple-Bryan, Texas (+15)
42. Baltimore, Md. (-14)
43. Huntsville-Decatur, Ala. (+10)
44. Shreveport, La. (-2)
45. Portland-Auburn, Maine (+17)
46. Knoxville, Tenn. (-13)
47. Cleveland-Akron-Canton, Ohio (-22)
48. West Palm Beach-Ft. Pierce, Fla. (-32)
49. Bangor, Maine (-4)
50. Harlingen-Brownsville-McAllen-Weslaco, Texas (+21)

Although the spread of Zika virus in the U.S. has significantly decreased, from 5,168 cases in 2016 to 433 cases in 2017, it remains a concern as there is no treatment, cure or vaccine for the virus. One of the best strategies for eliminating mosquito-borne diseases is to reduce populations of the mosquitos that spread them.

Below are the most common mosquitoes in the U.S.:

Aedes aegypti Mosquitoes: The Aedes aegypti (commonly called the yellow fever mosquito) mosquito can carry and spread Zika virus and has been found in more than 20 states from coast to coast. Unlike other mosquito species, Aedes aegypti mosquitoes bite during the day and night.

Culex Mosquitoes:These mosquitoes are in every state and can carry and spread West Nile virus. They are most common at dusk and dawn.

Anopheles Mosquitoes: In addition to spreading Malaria, which has been considered eradicated from the United States, Anopheles mosquitoes can transmit dog heart worm and other viruses. They have been found in every state and are most active at dusk and dawn.

Reducing items that attract mosquitoes and actively working to prevent them from reproducing and moving inside the home are the best protection from mosquito bites.

"After mating, females typically seek a blood meal to aid in egg production. She often lays them in standing pools of water. Egg numbers vary from species to species but can be as much as over 100 eggs in a single laying," said Hartzer.

Orkin recommends the following tips to help residents protect against mosquitoes:

Eliminate Mosquito-Friendly Conditions in and Around Your Yard

・Any object that has the potential to hold water should be removed or cleaned out frequently, as mosquitoes can breed in just an inch of standing water.

・Clean gutters to avoid rainwater build up. Be sure to check for puddles that form on the roof from rain water, leaking pipes or even condensation from air conditioners.

・Change water weekly in bird baths, fountains, potted plants and any containers that hold standing water.

・Keep pool water treated and circulating.

・Trim shrubbery, as adult mosquitoes like to rest in dark areas with high humidity, such as under the leaves of lush vegetation.

Prevent Mosquitoes from Biting

Wear loose-fitting, long-sleeved shirts and long pants. Mosquitoes can bite through tight clothing.

Apply an EPA-registered mosquito repellent containing products such as DEET, picaridin or IR3535.

Eliminate Entry Points

・Inspect doors and windows for drafts or openings around their perimeters and window air conditioning units. Install weather stripping around doors and utilize caulk around window frames.

・Ensure that window screens are securely in place and free of holes or tears.

・Keep doors tightly closed. A propped-open door is a welcome mat for mosquitoes to enter your home.

For more mosquito information and prevention tips, visit our Mosquitoes page.

About Orkin, LLC

Founded in 1901, Atlanta-based Orkin is an industry leader in essential pest control services and protection against termite damage, rodents and insects. The company operates more than 400 locations with almost 8,000 employees. Using a proprietary, three-step approach, Orkin provides customized services to approximately 1.7 million homeowners and businesses in the United States, Canada, Mexico, Europe, South America, Central America, the Middle East, the Caribbean, Asia, the Mediterranean and Africa. Orkin is committed to studying pest biology and applying scientifically proven methods. The company collaborates with the Centers for Disease Control and Prevention (CDC) and eight major universities to conduct research and help educate consumers and businesses on pest-related health threats. Since 2014, Orkin's Start with Science[トレードマーク] initiative has donated $670,000 to fund science and math projects in public schools across the nation. Learn more about Orkin at Orkin.com. Orkin is a wholly-owned subsidiary of Rollins Inc. (NYSE: ROL). Follow us on Facebook and LinkedIn.

West Nile virus outbreak in humans and epidemiological surveillance, west Andalusia, Spain, 2016 [One Health, 5 May 2018]

Authored by Nuria Lopez-Ruiz, Maria del Carmen Montano-Remacha, Enric Duran-Pla, Mercedes Perez-Ruiz, Jose Maria Navarro-Mari, Celia Salamanca-Rivera, Blanca Miranda, Salvador Oyonarte-Gomez, Josefa Ruiz-Fernandez

Eurosurveillance Volume 23, Issue 14, 05/Apr/2018  ☞
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.14.17-00261

Oklahoma Woman Survives West Nile Virus [News On 6, 5 May 2018]

TULSA, Oklahoma -

16691735_G.jpg


An Oklahoma woman who survived West Nile is doing what she can to warn others about the virus.

Kristen Acosta was on a float trip on the Illinois River in Tahlequah when she started coming down with the symptoms. She says it took doctors a little while to figure out was she had.

Eventually, a Mercy Hospital infectious disease doctor figured it out.

Oklahoma County Public Health Protection Director Phil Maytubby says last year, the county found West Nile-infected mosquitos sixty different times in their mosquito traps. Maytubby says that's 3 times more than we've ever had in Oklahoma history.

"It is life-threatening, and I feel very blessed like I am a success story. I feel there are many people who are not here and I feel like I am speaking for all of them,” said Acosta.

Health workers say the best thing people can do is make sure they don't allow water to stand and become a breeding ground for mosquitoes.

Four people died from West Nile in Oklahoma last year.

Yukon woman hospitalized by West Nile urges others to protect themselves [NewsOK.com, 5 May 2018]

by Meg Wingerter

w640-1afa5510be4578530d470e543a6d4a19.jpg
Kristen Acosta, of Yukon, was hospitalized due to complications from West Nile virus five years ago. She said it took her 18 months to feel normal again, and she still has some lingering memory problems. [Photo by Meg Wingerter, The Oklahoman]

Oklahoma City YUKON Kristen Acosta never knew something as small as a mosquito bite could put her in the hospital.

Acosta, of Yukon, hadn't had any significant health problems until about five years ago, when she came down with a high fever while visiting friends in Tahlequah. It felt like someone was pounding on the back of her head, to the point that she could barely walk because of the pain.

Doctors in Tahlequah did a spinal tap, but weren't sure what was causing her symptoms. She transferred to Mercy Hospital in Oklahoma City, where they did another spinal tap and diagnosed meningitis caused by West Nile virus, Acosta said.

Meningitis is inflammation of the membranes surrounding the brain and spinal cord.

There's no medication to treat West Nile virus, so the team at Mercy focused on trying to reduce her pain, which still was severe, Acosta said. She spent a week and a half in the hospital, then a few more weeks recuperating with family before she could live independently again.

“Cognitively, it just makes things overwhelming,” she said. “You can be asleep more than you're awake.”

About 80 percent of people infected with West Nile virus experience no symptoms, according to the Centers for Disease Control and Prevention. Most of those who do get sick have flu-like symptoms that resolve on their own, though some experienced lingering fatigue or weakness.

Less than 1 percent of people experience complications as severe as Acosta's, such as meningitis or encephalitis, which is inflammation of the brain. Those cases can cause seizures, coma or death.

Few cases last year

Last summer, the local health department collected reports of only five West Nile infections in Oklahoma County, said Phil Maytubby, director of consumer protection at the Oklahoma City-County Health Department. It's too early to speculate how this season could go, though.

The risk of mosquito bites is highest if several weeks of hot and dry weather follow a heavy rain that leaves stagnant water where mosquitoes can lay their eggs, he said.

The local health department held an event Thursday afternoon to urge residents to reduce their risk of mosquito-borne diseases. The most important things to do are to use a DEET-based insect repellant, to wear long pants and sleeves while outdoors and to dump out even small amounts of standing water, Maytubby said.

“If everyone would just wear insect repellant, we might not even have to be out here” discussing prevention, he said.

While mosquitoes carry many diseases, West Nile is the primary threat in Oklahoma, Maytubby said. Horse owners can vaccinate their animals against West Nile, but there's no approved version for humans.

Acosta urged even healthy young people to learn from her experience and take precautions.

She said it took her about 18 months to feel normal again after her hospitalization, and she still sees a neurologist because of lingering concerns about her memory.

“I still have to see a lot of specialists,” she said. “My medical team is significantly bigger than it was before.”
nice!(0)  コメント(0) 

Zoonotic Swine Flu News from 6 till 10 May 2018

Swine flu threatens to make a comeback in KZN [Citizen, 10 May 2018]

By Earl Baillache

Corbis-42-22258676.jpg


Consider having this year’s flu vaccine administered in a bid to ward off contracting it.

Swine flu has reared its head again in Amanzimtoti, three years after the first cases were reported, South Coast Sun reports.

The H1N1 virus, also known as swine flu, is a respiratory disease caused by a particular influenza virus strain.

The disease adopted the name ‘swine flu’ because of its similarities to a flu strain found
among pigs. Symptoms are often similar to that of the usual flu, and when the disease emerged locally in 2015, South Africans were urged not to panic should they learn they had contracted it.

Western Cape health department spokesman Mark van der Heever said in 2016 that swine flu was part of SA’s seasonal strain. A swine flu diagnosis requires a medical diagnosis after clinical testing.

There are two recent cases at Kingsway Hospital, according to a patient who has been hospitalised as a result of the severity of her symptoms. Kingsway Hospital was approached for comment to confirm this but no response was forthcoming.

Renae Botha (56) of Warner Beach was admitted to hospital on Wednesday, May 2, with what she and the doctors originally thought was a bad case of flu. “I was on antibiotics, but it wasn’t getting any better, and I just felt worse,” she said from her hospital bed a week later, on Wednesday, May 9.

Renae was diagnosed with pneumonia on Friday, May 4, before doctors confirmed it was swine flu. “It started with flu-like symptoms and headaches. It seemed like I couldn’t get rid of the flu.” Renae said she travelled through Transkei a month ago, and may have contracted the virus there. She is currently in high care, but hopes to be discharged on Friday, May 11.

swineflu-Medium.jpg


Some people are at higher risk for becoming seriously ill if they’re infected with swine flu.
These include:

• Adults over age 65;
• Children under five-years-old;
• Young adults and children under age 19 who are receiving long-term aspirin (Bufferin) therapy;
• People with compromised immune systems (due to a disease such as AIDS);
• Pregnant women;
• People with chronic illnesses such as asthma, heart disease, diabetes mellitus, or neuromuscular disease.

Swine flu is very contagious. The disease is spread through saliva and mucus particles. People may spread it by:

・Sneezing;
・Coughing;
・Touching a germ-covered surface and then touching their eyes or nose.

The symptoms of swine flu are very much like those of regular influenza. They include:

• Chills;
• Fever;
• Coughing;
• Sore throat;
• Runny or stuffy nose;
• Body aches;
• Fatigue;
• Diarrhoea;
• Nausea and vomiting.

Methods for managing the symptoms of swine flu are similar to the regular flu:

・Get plenty of rest. This will help your immune system focus on fighting the infection.

・Drink plenty of water and other liquids to prevent dehydration. Soup and clear juices will help replenish your body of lost nutrients.

・Take over-the-counter pain relievers for symptoms such as headache and sore throat.

Consider having this year’s flu vaccine administered in a bid to ward off contracting it.

Penn library book discussion will focus on 100th anniversary of Spanish Flu pandemic [Tribune-Review, 10 May 2018]

by PATRICK VARINE

phottt.jpg


Vaccines are available now, but even today, the prospect of catching the flu is still dangerous for young children and senior adults.

And yet the modern flu season isn't nearly as frightening as what happened a century ago this year, when the Spanish Flu of 1918 circled the globe, sickening 500 million people worldwide and killing between 20 and 50 million, including about 675,000 Americans, according to History.com.

On May 21, Penn Area Library officials will host a 6:30 p.m. discussion of author Laura Spinney's " Pale Rider: the Spanish Flu of 1918 and How It Changed the World ."

Spinney traces the influenza pandemic as it travels across the globe, exposing man's vulnerabilities, drawing on recent research in virology, epidemiology, psychology and economics.

Below, see a History Channel video outlining the basics of the 1918 pandemic:

Oklahoma Flu-Related Deaths Now Number 283, Weekly Flu Report States [News On 6, 10 May 2018]

BY DEE DUREN

The Oklahoma Department of Health reports no new flu deaths have taken place between May 2 and May 8, 2018. However, the total number of deaths attributed to flu-related causes has risen by two.

Last week, 283 deaths were reported in the Oklahoma State Department of Health's weekly flu summary. This week, that number is 285.

Hospitalizations with positive influenza tests are now numbered at 4,737.

Influenza is a highly contagious respiratory illness caused by a virus which is spread by infected people coughing, sneezing or touching a surface handled by others. Its impact can be severe in some cases, especially among seniors, young children, pregnant women and people with underlying medical conditions, according to the CDC.

The CDC states the best way to prevent the flu is to get vaccinated.

Officials: 285 Oklahomans died from the flu this season [kfor.com, 10 May 2018]

OKLAHOMA CITY – New data from the Oklahoma State Department of Health shows that hundreds of Oklahomans lost their lives to the flu virus this season.

So far this year, officials with the Oklahoma State Department of Health say that 285 people have died from the flu since September. Fortunately, none of those deaths occurred within the last week.

Also, health experts say 2 people had to be hospitalized within the last week due to the flu virus, bringing the total number of hospitalizations to 4,737 this season.

According to data released by the health department, it appears as though the peak of flu season occurred in January. Since then, the number of new flu cases has dramatically dropped.

flu1.jpg
Credit: Oklahoma State Department of Health

Health reports state that almost all of the patients who died from the virus were over the age of 50.

Data shows that 26 of those who died from the flu were between the ages of 18-years-old and 49-years-old. Health officials also say a child under the age of 4-years-old died from the virus, and one child between the ages of 5-years-old and 17-years-old also died from the flu.

The Centers for Disease Control and Prevention say you should be vigilant with washing your hands, avoid touching your eyes and mouth, get plenty of sleep and eat healthy to help give your immune system a boost.

If you get sick, look out for severe aches and pains in your muscles and joints, notable fatigue and weakness, headaches and a high fever.

If you are experiencing those symptoms, call a doctor as soon as possible. Experts also say you should not go to work or school if you have a fever.

Prolonged flu season puzzles doctors [WJTV, 10 May 2018]

by Liz Carroll

JACKSON, Miss (WJTV) - It usually peaks in February and March.

But a local physician says he's seen a number of patients with the flu in the last two weeks. So what might seem like allergies could be something else.

"A lot of people out there may have the flu and they have the symptoms of the flu, but they may think that they just have allergies, but the deal is the flu symptoms and the allergy symptoms can be very similar," said Dr. Timothy Quinn.

Over the past two weeks, Quinn says he's treated five people who tested positive for flu.

"I've been in practice for 14 years and ive never seen the flu season linger all the way
into the month of may as it has this year."

A pesky pollen season is one major cause of the lingering season.

"If someone is allergic to the pollen and they get the congestion they are actually more
acceptable to catching the flu because they become a better host for the flu and their immune systems are slighty compromised."

He also contributes the extended season to an unusual strain.

"Usually when they manufacture the flu shot they base it on the strains for the previous years, but this year there are alot of strains that were not present in the last few years
which makes it so a lot of people are not protected even though they got the flu shot."

So if you think you might have the flu - or an allergy - go ahead and see your doctor

"Because the medicine is not very effective unless started within the first 48 to 72 hours of
developing these symptoms."

Three new flu deaths reported in NC as season comes to an end [WRAL.com, 10 May 2018]

RALEIGH, N.C. — Three people died as a result of the flu last week in North Carolina as the devastating flu season reaches its end.

So far this season, the flu has killed a record 382 people statewide. The vast majority of deaths have been among people age 65 and older.

The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Some people — such as older people, young children and people with certain health conditions — are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year.

It is not too late in the season to get a flu shot. The flu season can run into May.

Flu symptoms include:

• A 100-degree or higher fever or feeling feverish (not everyone with the flu has a fever)
• A cough and/or sore throat
• A runny or stuffy nose
• Headaches and/or body aches
• Chills
• Fatigue
• Nausea, vomiting and/or diarrhea (most common in children)
html_validator_ignore

Do you know the difference between a cold and the flu?

Similarities

Both the cold and flu are viruses, meaning they cannot be “cured” by antibiotics, and both will abate on their own timetables. The cold and flu also share some symptoms, such as headaches, potentially a sore throat, fatigue or weakness, and aches and pains.

The cold and flu also share a similarity in what they are not – neither is a version of the ‘stomach flu,’ or 24-hour bug. The “stomach flu” as it’s commonly known, is usually viral gastroenteritis, and is unrelated to either the common cold or influenza.

Differences

The main difference of course between the flu and the common cold are the severity and duration of symptoms. The flu tends to have a faster onset of symptoms, which can include fevers as high as 104 F, chills, exhaustion and severe aches. It will be difficult to carry out your normal daily routine with the flu, and the fever will often last between three to five days, with tiredness and fatigue lasting up to two to three weeks.

The common cold usually only lasts a day or so, and most healthy adults can continue to work and be productive throughout the illness. Fevers are rare, as are complicating factors and other related illnesses.

The most important difference is that flu is also potentially deadly to children beneath the age of 6 months and in the elderly (65 years and older), while the cold will likely be a nuisance that needs monitoring but is not cause for alarm.

Northlanders urged to get flu jabs as 'Aussie flu' surfaces [New Zealand Herald, 10 May 2018]

By Danica MacLean, Danica MacLean

TOT7DW5KYBHCBL2BJ4FSTLSETQ.jpg


The impending arrival of a "life-threatening" Australian flu strain has Northland health officials worried about how hard the virus will hit the region.

Northlanders are being encouraged to get the flu vaccine as authorities await the arrival of a strain of the influenza virus from the northern hemisphere.

Northland DHB microbiologist Dr David Hammer said this year's flu season is likely to be "fairly severe" if the northern hemisphere experience is anything to go by.

He said the DHB is awaiting the arrival of influenza A (H3N2) - nicknamed the "Aussie flu" - from the northern hemisphere.

The DHB has already seen a "small handful" of cases amongst foreign visitors in the past few months. They presented to the emergency department in Whangārei but were not admitted.

Authorities have updated this year's flu vaccine to include immunisation against the life-threatening flu strain A (H3N2).

The flu season in Australia last year was the worst since the 2009 "bird flu" pandemic, with more than twice the number of people admitted to hospital with influenza than is typical. The strain was linked to a rise in hospitalisation and deaths in the northern hemisphere.

ESR health physician Sarah Jefferies said countries such as Britain reported moderate to high levels of influenza and influenza-like illness during their 2017/2018 season.

She said the World Health Organisation recommended a change in the southern hemisphere vaccine for 2018 which better covers the strains of influenza detected in the 2017 southern hemisphere season and the northern hemisphere 2017/18 seasons.

Jeffries said there are four seasonal influenza viruses circulating globally and the vaccine covers all four strains. She said it is difficult to predict exactly what strains of seasonal virus will end up circulating in New Zealand's 2018 season. But the "life-threatening" Aussie flu had health officials worried.

"The health impacts of flu this year will depend on how well New Zealanders use preventative measures like immunisation and good hygiene practices, how the strains which circulate compare to viruses we've had previously, which cause natural immunity, and to the strains in the vaccine, which also generate immunity."

Jefferies said last year was a low-activity season in New Zealand, where influenza-like illness remained below the seasonal average. She said 2016 was also a very low-activity season.

"In view of the recently low-activity years, it would not be unreasonable to anticipate an increase in activity this year relative to the low seasons we've had recently."

Last year in the Northland DHB area the number of GP visits for flu-type symptoms peaked at
74 for every 100,000 in the week starting June 19. The national historical average seasonal rate for the same week is 48.4 per 100,000.

During the week beginning July 3 last year, there were 46 Healthline calls for influenza-like illness for every 100,000 people in the Northland DHB area.

Jefferies said the best option for prevention is immunisation, and the vaccine is free for older people, pregnant women and those with certain medical conditions.

So far 53 per cent of Northland DHB staff have been vaccinated. Acting chief executive Jeanette Wedding said the DHB is tracking well towards its target of 85 per cent.

"The higher the rates of vaccination for health professionals, the fewer people get infected," Wedding said.

About 400 New Zealanders die directly or indirectly each year from influenza, but figures are not available for Northland flu-related deaths.

Meanwhile, a stomach bug with flu-like symptoms appears to be hitting Whangārei hard. A post on the Northern Advocate Facebook page had several comments from parents whose children had been hit with the bug. Several people said it had passed from one member of the family to another.

ESR is launching an online dashboard which will provide up-to-date information on how the flu is tracking and its severity. The dashboard is aimed at health professionals but members of the public will be able to see it too.

It will include information on flu activity, flu severity, and which viruses are occurring this season.

Symptoms of the flu include:

-sudden onset of illness
-high fever
-headache
-a dry cough
-illness lasting 7-10 days

About one in four New Zealanders are infected with the flu each year. Many people won't feel sick at all but can still pass it on to others.

Flu viruses are mostly spread by droplets made when people with flu cough, sneeze or talk.

Other ways to protect yourself and your family:

-wash and dry your hands often
-stay away from people who are sick
-stay away from work, school or visiting people in hospital if you're unwell
-cover your coughs and sneezes

Health Unit reports higher number of flu cases in London [Globalnews.ca, 9 May 2018]

By Andrew Graham

11226801.jpg
The flu shot remains the best protection against both strains of influenza.
Jeff McIntosh / The Canadian Press / File

The Middlesex-London Health Unit has published its findings for the latest flu season. The report covers influenza surveillance in the Middlesex-London region.

Since September of last year, the region saw over 800 confirmed cases of influenza, 422 of which were influenza A while the rest were influenza B.

The numbers are higher than usual. Since 2014 confirmed cases of influenza varied between 300 and 500. Another increase was found in hospitalizations: 457 were recorded since September. Last year’s flu season only saw 258.

The Health Unit reported 70 outbreaks of influenza, seven of which happened in hospitals, long-term care facilities and retirements.

This year also saw a spike in influenza B. The B strain usually accounts for 10 per cent of confirmed cases, but this year that number jumped to bit over 50 per cent.

Stephen Turner is director of environmental health and infectious diseases for the Health Unit. He is also London’s Ward 11 councillor.

Turner told 980 CFPL why the B strain was so prevalent this year.

“It might’ve been because of a larger influenza A presence last year and some people still had some immunity left over,” said Turner.

“It could be a question of how many people got their flu shot last year.”

The report also reveals a total of 43 flu-related deaths, all of which were among people 50 or older.

Turner said those deaths often had other factors involved.

“Most cases tend to be where people are living in close quarters, in hospitals and in long-term care facilities. In those places, we try to make sure that everyone is immunized as best as possible,” said Turner.

Despite increases from last year, the findings show the flu season is drawing to a close.

Between April 22 and April 28, Middlesex-London saw only six confirmed cases and zero deaths. The highest number of cases was reported between Jan. 7 to Jan. 13, which saw 92 with the flu.

Along with good hygiene practices such hand-washing and sneezing into sleeves as opposed to hands, Turner added that the flu shot remains the best protection against influenza.

The Health Unit will continue to monitor influenza when the next flu season rolls around in September.

A look at why the flu proved to be so deadly this year [The Gazette: Eastern Iowa Breaking News and Headlines, 9 May 2018]

Flu can make other chronic health problems worse

This year’s flu season was more severe than most — the Centers for Disease Control and Prevention reported more hospitalizations and more flu-associated deaths than in previous years. Here in Iowa, there were more than 1,700 influenza-associated hospitalizations, public health officials reported.

What’s more, there were more than 8,500 non-influenza respiratory viruses in Iowa, according to the Iowa Department of Public Health.

Most people who catch the flu will recover in less than a week — but complications can occur, which can be life threatening.

The flu, which is highly contagious and spreads quickly, can easily turn into pneumonia, bronchitis, sinus or ear infections. It also can make chronic health problems worse.

“There was an increased mortality and morbidity rate in certain high-risk populations,” said Dr. Hafiz Hashmi, a pulmonologist at UnityPoint Health Cedar Rapids. Those most at risk are those 65 and older, those with chronic medical conditions such as COPD, diabetes, lung cancer and chronic liver disease, and pregnant patients, including those who are two weeks postpartum.

Flu symptoms include fever, aching muscles, chills and sweats, headache, fatigue, sore throat and nasal congestion. Flu season typically runs from October to May, with cases peaking in December, January and February.

Meanwhile, pneumonia symptoms include chest pain when you breathe or cough, fatigue, shortness of breath, nausea, vomiting or diarrhea, and fever, sweating and shaking chills.

U.S. Must Take Action To Improve Influenza Preparedness, Experts Say [Kaiser Family Foundation, 9 May 2018]

Axios: Pandemic flu is #1 health security concern: WH official

“The U.S. won’t be ready to face a flu pandemic until it improves its vaccines, health care infrastructure, and coordination with other countries — all of which are top priorities for the White House, a National Security Council official said Monday. Speaking at a symposium hosted by Emory University and the Centers for Disease Control and Prevention, multiple public health officials said they agree the U.S. isn’t ready, and needs to improve its yearly seasonal vaccines, which range in effectiveness from below 30 percent to 70 percent…” (O’Reilly, 5/8).

US Health Authorities Turn To Israeli Universal Flu Vaccine Maker To Ward Off Next Influenza Outbreak [NoCamels - Israeli Innovation News, 8 May 2018]


Renewed urgency for a better flu vaccine has again hit the headlines, as health officials in the United States sum up the outgoing flu season’s death toll and warn of possible future pandemics.

Hoping to keep the next possible influenza epidemic at bay, the National Institutes of Health this week announced its new Phase 2 clinical trial of investigational universal influenza vaccine — the M-001 vaccine candidate, developed and produced by BiondVax Pharmaceuticals based in Ness Ziona – which it hopes will prove protective against multiple strains of the virus.

“The 2017-2018 influenza season in the United States was among the worst of the last decade and serves as a reminder of the urgent need for a more effective and broadly protective influenza vaccine,” National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony S. Fauci, said in a May 4 statement.

Likewise, the Bill and Melinda Gates Foundation and Lucy and Larry Page recently announced a $12 million investment to push scientists toward finding a game-changing solution to end the threat from both seasonal and pandemic influenza.

“The goal is to encourage bold thinking by the world’s best scientists across disciplines, including those new to the field,” Gates told attendees at New England Journal of Medicine’s annual Shattuck Lecture in Boston last week.

Bill-Gates.jpg
Bill Gates at a TedTalk in 2011. Photo by Gisela Giardino via Flickr CC BY-SA 2.0

The 2017-2018 flu season in the US posted the highest death count among children in at least five years, health officials said.

Moreover, the Centers for Disease Control and Prevention showed that while flu vaccines usually prevent 40 percent to 60 percent of flu cases, this past year’s vaccines were just 36 percent effective overall.

The new trial — sponsored by the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH) – and being conducted under an FDA Investigational New Drug (IND), marks M-001’s clinical debut in the United States.

“We are pleased to participate in NIAID’s focus on the development of novel flu vaccines to improve protection against current strains and protect against emerging seasonal and pandemic threats,” said Dr. Ron Babecoff, BiondVax’s CEO.

The NIH-sponsored trial is being led by principal investigator Dr. Robert L. Atmar of Baylor College of Medicine in Houston. The study is being conducted at four US sites that are part of the NIAID-funded Vaccine and Treatment Evaluation Units (VTEUs).

“An effective universal influenza vaccine would lessen the public health burden of influenza, alleviate suffering and save lives. There are numerous paths of inquiry that the scientific community is pursuing, with each new study yielding more critical information and bringing us closer to our shared goal,” said Fauci.

Dr. Atmar said in a press release by Baylor that “there is a great need to develop a vaccine that protects against all strains of influenza and doesn’t need to be changed from year to year. We hope that this study is a step in that direction.”

The Gates-Page challenge, Ending the Pandemic Threat: A Grand Challenge for Universal Influenza Vaccine Development, comes during the centenary year of the 1918 Spanish flu pandemic that killed 50 million people around the globe. According to a simulation by the Institute for Disease Modeling, if a comparable contagious airborne pathogen were to occur today, more than 33 million people worldwide would die in six months.

“Bill Gates has been talking about finding a universal flu vaccine for years, that he’s sure there’s going to be another flu pandemic and that we’re not ready for it. Which is likely correct,” Joshua Phillipson, Business Development and Marketing manager for BiondVax, tells NoCamels. “The $12 million Grand Challenge to fund research of universal flu vaccines is for early-stage ideas, it is seed money. But it is important because this announcement fuels new interest.”

Initially developed in Professor Ruth Arnon’s lab at the Weizmann Institute of Science in Israel, M-001 is comprised of nine epitopes common to influenza virus strains including both influenza Type A and B. BiondVax has completed six clinical trials in Israel and Europe.

Phillipson says his company’s “universal flu vaccine is the most advanced in terms of clinical trials. No other candidate has completed this many clinical trials.”

The new US study will enroll up to 120 healthy volunteers between the ages of 18 and 49 years. Participants will be assigned randomly to receive either two doses of the experimental vaccine or a placebo. All participants will also receive an approved seasonal influenza vaccine. The scientists will evaluate the participants’ immune responses to both the experimental vaccine and to the seasonal vaccine.

vaccination-2725065_1280-200x300.jpg


Phillipson says the Israeli company has a pivotal clinical efficacy Phase 3 trial on the horizon as well. Co-funded by the European Union’s European Investment Bank (EIB), the trial will enroll 9,630 participants aged 50 years and older across four to six countries over a period of two flu seasons.

“Given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal modern-day pandemic occurring in our lifetimes,” Gates said.

Unless a universal flu vaccine can stop it, of course.

Trump Administration Views Influenza As Priority Health Security Issue, WH National Security Council Physician Says [Kaiser Family Foundation, 8 May 2018]

CIDRAP News: Experts review 1918 pandemic, warn flu is global threat

“The U.S. Centers for Disease Control and Prevention (CDC) partnered with Emory University to mark the 100th anniversary of the 1918 flu with a symposium about influenza pandemics: when and if they will strike, how ready the United States is to confront a pandemic, and how to do so. … Luciana Borio, MD, of the White House National Security Council, said the administration also sees the threat of pandemic flu as a global health crisis. ‘Flu is our number one health security issue,’ said Borio. ‘We do not close borders to control flu.’ Borio … said that a universal vaccine is a focus of the Trump presidency…” (Soucheray, 5/7).

Column: A Nation Totally Unprepared for Coming Pandemic [Valley News, 8 May 2018]

by Ronald A. Klain

Summer is coming. And if you think a warm-weather surge of mosquitoes and ticks is not as frightening as the fictional winter’s White Walkers from Game of Thrones, you haven’t read last week’s report by the Centers for Disease Control and Prevention on the rapidly escalating danger of infectious diseases spread by insects.

The CDC’s key findings: The number of Americans infected with such diseases, including Zika, West Nile and Lyme, has more than tripled in a decade, jumping from about 30,000 cases a year in 2006 to almost 100,000 in 2016. This total includes nine types of infections never before seen in the United States, including Zika and chikungunya. Looking ahead, 80 percent of state and local health departments are not ready for the insect-borne threat we are facing in just a few weeks.

Why the surge? Global travel is a major cause; as commerce, culture and tourism spread rapidly, so do diseases. Scientists also identify more infections, thanks to new research tools.

But there’s another factor slipped into the CDC report: Certain mosquitoes and ticks are “moving into new areas.” This anodyne language refers to the fact that, as temperatures and moisture rise across the United States, disease-bearing insects expand their reach. Thus, we face another risk posed by the threat that Trump administration officials dare not speak aloud: climate change.

Coincidentally, the day before the CDC’s report, a man who has worked mightily to save millions from disease threats — Bill Gates — went public with a recent conversation he had with President Donald Trump. Gates told Stat News that they had discussed Gates’ work to try to find a universal flu vaccine; his foundation has offered a $12 million prize for development of a vaccine in hopes of taming a pandemic flu threat that could take more than 30 million lives in a single year.

As generous as Gates is, however, no single individual has the resources to protect us from the growing array of infectious diseases confronting us: Only government action has that scope.

And although Gates said Trump was enthusiastic about the universal flu vaccine project, there are reasons to be skeptical that this president’s administration is up to the broader challenge. As Gates reminded the president, nearly a year and a half into his tenure, Trump still does not have a science adviser. John Bolton’s purge at the National Security Council pushed out the official there overseeing pandemic preparation, Tom Bossert. Trump’s controversial CDC director, Robert Redfield, has been busy explaining why he will, or won’t, get paid double what his predecessors made.

But the biggest challenge is Trump himself. When the United States faced the West African Ebola epidemic in 2014, Trump attacked science-based responses to the threat and essentially argued that President Barack Obama should leave American health-care workers in Africa to die when they were sickened while fighting the disease. (Obama didn’t, and they were saved.) Trump has“energized” the anti-vaccine movement that imperils all that Gates and his allies are trying to achieve. He has proposed an 80 percent reduction in programs designed to stop dangerous diseases overseas before they come to the United States.

The xenophobia that Trump preached during the 2016 campaign contributed to congressional delay as reports emerged about a Zika outbreak arriving here. Trump’s anti-immigration followers said that tougher immigration laws — not public-health measures — were the way to stop Zika. While Congress dithered, Zika took root in parts of Florida and Texas, and — for the first time in history — the CDC had to issue an advisory against travel to parts of the continental United States.

It doesn’t have to be this way. The solutions are well known: Empowered leadership at the White House. A public-health emergency fund that a president can quickly deploy before Congress acts. More investments in research, epidemic prevention, and well-equipped and trained teams at regional hospitals. Increased support for state and local public-health departments, our front-line defense. More research on vaccines and therapeutics, and clearer policies on their rapid approval and deployment. And most important: robust investment in global health security to help other countries identify, isolate and respond to outbreaks before they become global epidemics.

These ideas all have bipartisan origins and have had (at least until recent years) bipartisan support. But they require investing more money overseas in the face of a powerful isolationist headwind.

Later this month, the Smithsonian will open an exhibit called “Outbreak,” commemorating the 100th anniversary of the Spanish flu epidemic that killed more Americans than both world wars combined. We are far from prepared for the sort of threats that the exhibit highlights, and retreating from the world is no answer: There is no wall high enough to keep America safe from infectious diseases in today’s connected world. And summer is coming.

Ronald A. Klain, a Washington Post contributing columnist, was White House Ebola response coordinator from 2014 to 2015 and a senior adviser to Hillary Clinton’s 2016 campaign.

Mizoram: Diseases kill at least 1026 pigs [Morung Express, 7 May 2018]

At least 1026 pigs and piglets have died and 3639 others affected in Mizoram due to the outbreak of Porcine Reproductive and Respiratory Syndrome (PRRS) and Classical Swine Flu since March this year, officials said on Sunday. This is the third time Mizoram is witnessing the outbreak of PRRS. The disease had hit the State in 2013 and 2016.

Officials of State Animal Husbandry and Veterinary department said that the PRRS outbreak was confirmed to be originated from Zokhawthar village in Champhai district along the Mizoram-Myanmar border on March 17. Of the blood samples of 12 pigs taken from the village, 11 were tested positive and confirmed for PRRS at Disease Investigation Laboratory in Aizawl on March 21, the officials said.

The PRRS virus has also spread to more than 91 villages. While the outbreak of swine diseases has affected almost all the eight districts of the State, it was mainly concentrated in Aizawl, Serchhip and Champhai districts, the officials said.

“Report about the death of at least 1026 pigs and piglets have been received from different districts since March,” Dr. Hmarkunga, Joint Director, Animal Husbandry and Veterinary department said, adding that the deaths of the pigs were not caused by PRRS alone, but also by Classical Swine Fever (CSF). He said teams of veterinary doctors were sent to the affected areas to take stock of the situation. Dr. Hmarkunga added that at least 245 blood samples have been tested so far of which 133 were identified to be infected with PRRS and 90 others with CSF.

District Magistrates of Lunglei and Champhai had earlier issued order banning import of pigs and piglets from Myanmar and other neighbouring states and inter-village movement of pigs.

Meanwhile, an official statement said that experts from National Institute of High Security Animal Disease Laboratory, Bhopal visited Serchhip town and examined pigs there during April 20-23.

On May 3, two scientists from North Eastern Regional Disease Diagnostic Laboratory (NERDDL), Guwahati also came to Aizawl and imparted training to field officers of State Animal Husbandry and Veterinary department, the statement added.

1029 pigs die of disease [The Telegraph India, 7 May 2018]

by Henry L. Khojol

Aizawl: At least 1,029 pigs and piglets died and 3,639 others affected in Mizoram because of the outbreak of porcine reproductive and respiratory syndrome (PRRS) and classical swine flu (CSF) since March this year, officials said on Sunday.

Officials of the state animal husbandry and veterinary department said the PRRS outbreak originated from Zokhawthar village in Champhai district along the Mizoram-Myanmar border on March 17.

They said of the blood samples of 12 pigs taken from the village, 11 tested positive for PRRS at the Disease Investigation Laboratory here on March 21. The PRRS virus has spread to more than 91 villages, they said.

According to the officials, while the outbreak of CSF and PRRS has affected almost all the eight districts of Mizoram, these are mainly concentrated in Aizawl, Serchhip and Champhai districts.

PRRS, Classical Swine Flu Kill 1026 Pigs in Mizoram [NorthEast Today, 7 May 2018]


At least 1026 pigs and piglets have died and 3639 others affected in Mizoram due to the outbreak of Porcine Reproductive and Respiratory Syndrome (PRRS) and Classical Swine Flu since March this year, officials said on Sunday. This is the third time Mizoram is witnessing the outbreak of PRRS. The disease had hit the State in 2013 and 2016.

Officials of State Animal Husbandry and Veterinary department said that the PRRS outbreak was confirmed to be originated from Zokhawthar village in Champhai district along the Mizoram-Myanmar border on March 17. Of the blood samples of 12 pigs taken from the village, 11 were tested positive and confirmed for PRRS at Disease Investigation Laboratory in Aizawl on March 21, the officials said.

The PRRS virus has also spread to more than 91 villages. While the outbreak of swine diseases has affected almost all the eight districts of the State, it was mainly concentrated in Aizawl, Serchhip and Champhai districts, the officials said.

“Report about the death of at least 1026 pigs and piglets have been received from different districts since March,” Dr. Hmarkunga, Joint Director, Animal Husbandry and Veterinary department said, adding that the deaths of the pigs were not caused by PRRS alone, but also by Classical Swine Fever (CSF). He said teams of veterinary doctors were sent to the affected areas to take stock of the situation. Dr. Hmarkunga added that at least 245 blood samples have been tested so far of which 133 were identified to be infected with PRRS and 90 others with CSF.

District Magistrates of Lunglei and Champhai had earlier issued order banning import of pigs and piglets from Myanmar and other neighbouring states and inter-village movement of pigs.

Meanwhile, an official statement said that experts from National Institute of High Security Animal Disease Laboratory, Bhopal visited Serchhip town and examined pigs there during April 20-23.

On May 3, two scientists from North Eastern Regional Disease Diagnostic Laboratory (NERDDL), Guwahati also came to Aizawl and imparted training to field officers of State Animal Husbandry and Veterinary department, the statement added.

Experts review 1918 pandemic, warn flu is global threat [CIDRAP, 7 May 2018]

by Stephanie Soucheray

pipetting-qiagen.jpg


The US Centers for Disease Control and Prevention (CDC) partnered with Emory University to mark the 100th anniversary of the 1918 flu with a symposium about influenza pandemics: when and if they will strike, how ready the United States is to confront a pandemic, and how to do so.

"The more I learn about flu, the less I know," said Michael Osterholm PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, as he began his remarks on the challenges of anticipating the next pandemic.

Osterholm's sentiment was echoed by others throughout the day-long event. No one argued that the United States is prepared to face a flu pandemic, as experts explained the current status of avian flu viruses, a universal vaccine, and challenges to preparedness.

"I don't know what the virus will do," said Osterholm. "But history tells us that influenza comes back and comes back and comes back."

Devastating pandemic, related effects

He then argued that, during the next influenza pandemic, more people will die from the non-pandemic aspects of such a global health crisis. Illustrating his point with pictures of massive container ships that move goods across the globe, Osterholm said that the US economy is so inextricably linked to other countries, especially China's, that a pandemic would paralyze supply chains for both consumer and medical goods.

"A flu pandemic would result in unprecedented employee absenteeism," Osterholm said. He also noted that 30 of the most common generic medicines currently used in the United States are wholly or partially manufactured in China.

"Look at what happened with saline bags in Puerto Rico," said Osterholm, who predicted months before the devastating 2017 hurricanes that storms on the island would cause problems for US clinics and hospitals.

In a counterpoint to Osterholm's talk, Arnold Monto, MD, from the University of Michigan, said that he certainly did not disagree with Osterholm's conviction that the next pandemic would be deadly, but he said modern tools, including the flu vaccine, would mean it's unlikely the 1918 pandemic could ever be repeated.

Luciana Borio, MD, of the White House National Security Council, said the administration also sees the threat of pandemic flu as a global health crisis.

"Flu is our number one health security issue," said Borio. "We do not close borders to control flu."

Borio—who also confirmed that China is not currently sharing flu vaccine strain information nor any progress made on its development of a universal flu vaccine—said that a universal vaccine is a focus of the Trump presidency.

Few states fully prepared

Despite the macro threat of flu, there are small things state governments can do to more readily prepare for a coming pandemic.

In a talk about Trust for America's Health (TFAH's) annual readiness report, "Ready or Not?"

TFAH President and CEO John Auerbach, MBA, said no states were completely prepared for a pandemic (based on 11 criteria, and ranked from 1 to 10). Only five states had a preparedness ranking of 8 or 9, and half sat at a 5 or lower. The report was published in December.

Dwindling public health department budgets are a problem, Auerbach said, but so are public perceptions and actions during a pandemic.

"Only a handful of states mandate paid sick leave," Auerbach said. "So even if someone knows not to go into work when they're sick, if they think they're going to lose a paycheck, they still go in."

Nancy Messonnier, MD, head of CDC's National Center for Immunization and Respiratory Diseases, said that despite gaps in preparedness, the CDC is better equipped to handle a flu pandemic now than it was in 2009, when a novel H1N1 flu strain first emerged. Technologies, including mobile apps that help consumers find flu shots, and antivirals are putting the power to prevent and fight flu into patients' hands, she said.

Flu Season 2018 and the flu shot; did it work? [St George News, 6 May 2018]

FLU-FI-970x546.jpg
Composite image showing 3D illustration of a virus, St. George News

ST. GEORGE — Preliminary data show that the flu shot worked roughly one-third of the time this season, but when broken down by strain, the level of performance varied widely – as influenza outbreaks continued across the country for months.

Seasonal flu takes a heavy toll on Americans, and this year was particularly severe, largely due to the circulating flu strains, which are a mix of different strains of viruses. H3N2 commonly leads to more severe illness and a higher number of hospitalizations, according to the Centers for Disease Control.

The 2017-2018 flu season officially began Oct. 1, 2017, and the CDC’s most recent “Weekly U.S. Influenza Surveillance Report” released April 28 marked the 17th week.


utah-hospitalizations.png
Graph illustrating number of flu-related hospitalizations in Utah by week | Image courtesy of the Utah Health Department, St. George News

The effectiveness of the flu vaccination came into question this year. According to David Heaton, Southwest Utah Public Health Department public information officer, the flu vaccine was 36 percent effective overall this season, based on calculations by the CDC using data collected since February. However, Heaton said, that percentage taken alone doesn’t represent the entire picture.

“On any given year, the typical effectiveness level of a good vaccine is around 60 percent,” Heaton said, “and while 36 percent is low, that really doesn’t tell the whole story.”

Being that the vaccine protects against three different viruses, he said, each with varying effectiveness rates, that number is derived from averaging out all three.

For example, the H3N2, a particularly “nasty virus,” had an effectiveness rate of 25 percent, Heaton said, while the H1N1 strain, or “Swine Flu” virus left over from the deadly pandemic in 2009, had a 67 percent effectiveness rate, a level that is above average.

flu-utah.jpg
Graph showing flu-like activity by week in Utah | Image courtesy of the Utah Health Department, St. George News

The science behind vaccine development begins with testing flu strains coming out of the southern hemisphere that are present this year, he said, combined with strains that were present in the past.

Since the flu season opened, 220 people have been hospitalized within the Southwest Region, an area covering Beaver, Kane, Iron, Garfield and Washington Counties, according to a Utah Department of Health weekly update report dated April 28.

By comparison, Salt Lake County had the highest number of hospitalizations, with 986 during the same reporting period.

Statewide, the report shows nearly 2,140 individuals have been hospitalized, compared to 1,470 during the 2016-2017 season, and the risk of hospitalization nearly tripled for those who are over the age of 65, according to the data.

More than half of those admitted with the flu were over the age of 65, and less than 375 were between the ages of 50-64, with children ages 0-4 representing the lowest number, with 159 cases.

In Utah, 288 people have died so far this season.

Flu season 2017-2018 in Nevada

The number of deaths reported for Clark County, Nevada, was updated to 47, after an increase in flu activity prompted the Southern Nevada Health District’s Office of Epidemiology and Disease Surveillance department to team up with other agencies to review and update previously reported cases of flu.

nevada-weekly-flu-report-4-21.jpg
Graph showing number of flu cases, hospitalizations and death in Clark County, Nev. | Image courtesy of the Southern Nevada Health District, St. George News

Additionally, flu cases reported in Nevada’s Southern District saw a sharp increase from 2017 to 2018, according to a report released April 28.

Last year, 612 flu cases were reported, with 422 hospitalizations and 13 deaths, while the number of cases so far this year has more than doubled, with nearly 1,300 cases reported during the 2017-2018 season as well as 942 hospitalizations.

The death toll for 2017-2018 season rose to 51, nearly four times higher than the preceding year.

The number of flu cases statewide saw a sharp hike as well, with more than 11,000 cases, up from 8,570 the previous season, according to a report released in February by the Nevada Department of Health and Human Services.

The CDC data show that 357 people have died from flu-related illnesses to date.

Flu season 2017-2018 in Arizona

Arizona’s numbers are even more remarkable, with more than 21,260 flu cases reported during the 2017-2018 flu season, up from 2,561 – which is more than 730 percent higher, according to an Arizona Department of Heath Influenza Summary 2017-2018 Flu Season report recently released.

Additionally, the death toll has nearly tripled, with 785 deaths in 2017-2018, compared to 239 deaths the prior year, according to a CDC “Fluview” report.

The report also shows that by the beginning of February, the number of confirmed flu cases in Arizona surpassed the total seen during the H1N1 flu pandemic of 2009-10, with nearly 19,300 reported cases.

High death toll in children

This flu season was particularly deadly for children, and those under the age of 2 were at the highest risk. The CDC reported April 27 that there have been 160 flu-related deaths among children so far, up from 101 reported during the 2016-2017 flu season, a death rate nearly 60 percent higher.

In past seasons, more than 80 percent of the children who died were not vaccinated that particular year, according to the CDC.

The April report also shows the highest number of pediatric deaths – 43, or one-quarter of all flu-related deaths – were reported in Region 4, which includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.

Utah is in Region 8, which has one of the lowest number of pediatric deaths.

Since 2004, the first year the CDC began tracking flu-related deaths in children, the higher number of pediatric deaths is attributed to the H3N2 virus that dominated the influenza landscape this season, a strain that causes more severe symptoms, particularly in children.

The bigger picture

On average, the flu causes 30,000 deaths and 200,000 hospitalizations in the U.S., mostly among people 65 years or older, and this season 45 states declared widespread flu outbreaks, with severe levels reported across much of the country, according to the CDC.

yearly-lab-work-infographic-large-e1525447996608.png
Annual lab work on flu viruses from 2016-2017 data by the CDC | Image courtesy of the Centers for Disease Control, St. George News

Taking into account the vaccine carried a lower level of overall effectiveness, it still offers a higher level of protection than having no vaccine at all, Heaton said.

“We have thousands of usually older people who are hospitalized and die every year from the flu,” he said. “So, even with a lower level of protection, it will still prevent thousands of illnesses, hospitalizations and death.”

The CDC showed similar findings, and reported that even with the vaccine’s lower overall rate of effectiveness, much of the problem can still be prevented by an annual vaccination, which the agency states is proven safe and effective in combating seasonal flu.

In spite of this, vaccination rates among Americans remain low, and fewer than half of all persons were vaccinated against the flu in 2016. The age group with the lowest vaccination rate – 31 percent – are between 18 and 49 years of age. Further, less than half of all children were vaccinated during that period.

One factor that may influence the low vaccination numbers is the idea that the flu shot can cause the flu, which Heaton said is impossible.

Flu vaccines are made in such a way as to prevent infection. One way uses flu viruses that have been inactivated, so they are not infectious. Another is made using no flu viruses at all.

The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.

There is an additional agent that could cause an allergic reaction for those allergic to eggs, due to the fact that vaccines are produced by growing each individual dose of the vaccine inside of an egg, Heaton said, noting that the number of doses made is equal to the number of eggs used.

That may be changing in coming years, he added, as scientists are currently developing other mediums in which to grow the virus that wouldn’t include eggs.

Every year seasonal flu viruses cause substantial illness and death, much of which could be prevented. Health officials encourage everyone to get flu vaccinations, especially those at high risk of complications from the flu, including children younger than 5, adults age 65 and older and pregnant women. Children younger than 2 have the highest risk of developing complications from the flu.

It is especially important for people who are more susceptible to complications from flu get vaccinated, including those with chronic medical conditions like heart disease, diabetes, kidney disease or respiratory conditions. Anyone who care for babies younger than 2 months old should also be vaccinated.

According to the CDC, for the last 15 flu seasons, the average duration of a season has been 13 weeks, with possible ranges of one week to 20 weeks.

The week ending April 28 marked the 17th week for this year’s flu season, and it may not be over yet.

First British Spanish Flu pandemic victims were children at Scottish orphanage [Express.co.uk, 6 May 2018]

By BEN BORLAND

THE first British victims of the 1918 flu pandemic can today be identified as children from an infamous Lanarkshire orphanage who were buried in a mass grave.

Spanish-flu-scotland-955767.jpg
Spanish flu devastated the post-WW1 world

Spanish Flu was one of the deadliest disasters in human history, claiming up to 50 million lives around the world and killing more people in a single year than the Black Death of the 14th century.

At least 228,000 people died in the UK alone, and historians agree the first civilian outbreak of the virus occurred in Glasgow in May 1918. This is based on newspaper reports and medical evidence from the time, including an article in The Lancet by Dr A MacLean, the city’s assistant medical officer of health.

Headed ‘Outbreak of an acute febrile disease in three factories and an industrial school in Glasgow’, it revealed that all 436 victims recovered within a few days. However, it also reported a second outbreak a week later in Lanarkshire “attacking some 280 persons” and resulting in eight deaths in two “industrial schools” in the county.

Dr MacLean wrote: “It has been ascertained that a boy resident in the infected industrial home stayed at the Lanarkshire Orphanage from May 10th to 15th, the first case occurring there in the person of the boy who slept in the same dormitory.”

He went on to describe the symptoms of the disease, including death “frequently within 24 hours” and the terrifying hallmark of cyanosis which saw the worst affected victims turn blue.

There is no doubt that Spanish Flu ravaged many families but for it to happen to that particular group of boys at that time is yet another sad chapter in the history of Smyllum Alan Draper


Now, to mark the centenary of the Spanish Flu pandemic, the names of those eight young victims can be revealed for the first time.

All of them were inmates at the Smyllum Park orphanage in Lanark, run by the Daughters of Charity of St Vincent de Paul until it shut in 1981.

The child abuse inquiry in Edinburgh has heard weeks of harrowing evidence from former residents, with one describing a “culture of evil” at the home.

According to our research, the first person in Britain to fall victim to the virus was 15-year-old David Clabby. The son of Patrick, a general labourer, and Rose, he died at 9am on May 18, 1918, with a nun called Sister Angela signing the death register.

His death was initially put down to “acute enteritis” but later amended by Dr ATA Gourlay, medical officer at Lanark’s Lockhart Hospital, and John T Wilson, medical officer for the County of Lanark.

Smyllum-Park-spanish-flu-1332419.jpg
The first UK victims of Spanish Flu were at Smyllum Park orphanage where they were buried

Their report, submitted to the procurator fiscal in Lanark on July 4, 1918, states that David’s cause of death was “influenza (epidemic) 12 hours”. The next boy to die was 11-year-old Daniel Daisley, whose coal miner father William was dead and whose mother Margaret Mulgrew could presumably no longer cope with looking after him.

His death at 6.30pm on May 18, just one-and-a-half hours after he first displayed symptoms, was also ascribed to enteritis before Gourlay and Wilson amended the register.

The third victim was 13-year-old James McBrien, the son of shipyard labourer William (deceased) and Bridget. His death at 11.30am on May 19 was again put down to acute enteritis – a sudden bowel inflammation – before being corrected by the two medical officers.

Patrick Gaffney, 13, the son of deceased quarry miner James and Mary, was the next to succumb at 4.30am on May 20. The correction by Gourlay and Wilson reveals that Patrick fought the influenza virus for three days.

By now, the nuns must have realised something was terribly wrong and the next two victims were taken to the old County Fever Hospital in Motherwell. Thirteen-year-old Robert Woods – whose parents were registered as “unknown” – passed away at 7pm on May 22.

Although the cause was correctly identified as influenza, Gourlay and Wilson later amended the register to show him as the fifth victim of the epidemic. Three days later, at 4pm on May 25, 12-year-old Smyllum inmate John Donaghy also died from influenza at the fever hospital.

Once again, the medical authorities registered his parents as “unknown”.

Meanwhile, the disease continued to rage back at the orphanage and, at 4.45am on May 26, nine-year-old Francis McLuskie became the youngest victim of the epidemic.

His father, Edward, was a coal miner and his mother Bridget was dead, with the cause again being attributed to enteritis before being corrected by Gourlay as “supposed influenza”. The last victim of the outbreak was Malcolm Dow, also aged nine, who died at Smyllum at 8.30pm on May 28.

His father, Malcolm, was in a workhouse and his mother, Williamina, was dead. Gourlay correctly identified the cause as influenza. The appalling conditions at the orphanage are illustrated by the fact that another child died during the 10 days of the epidemic – Nicholas Quinn, eight, from tuberculosis on May 24.

In a final tragic twist, the eight influenza victims – along with young Nicholas – would most likely have been buried in the common ground at St Mary’s cemetery. Although the existence of this ‘mass grave’ has been known about for many years, it emerged last year that at least 400 youngsters from Smyllum had been interred there between 1864 and 1981.

Spanish-flu-1332420.jpg
Spanish Flu wiped out 50 million lives

Alan Draper, from the In Care Abuse Survivors group, said: “There is no doubt that Spanish Flu ravaged many families but for it to happen to that particular group of boys at that time is yet another sad chapter in the history of Smyllum.

“We will never know what conditions these children and young men had to endure but the fact they were able to go out to work suggests they were reasonably fit and healthy.

“They were maybe starting to look forward to the future and think about leaving the orphanage, maybe creating lives for themselves after a difficult childhood, and suddenly they were struck down by this deadly disease.

“Smyllum has been brought to people’s attention because of the abuse that took place there and the mass burial plot in the cemetery, and now it seems that it was also the first place in Scotland to suffer as a result of Spanish Flu.”

Smyllum-Park-UK-spanish-flu-etc-1332421.jpg
Smyllum Park was where Spanish Flu first hit the UK

Meanwhile, one of Scotland’s leading authors and historians has backed the creation of a memorial to those who died in the Spanish Flu pandemic. Trevor Royle, who has written more than 30 books on war and empire, is also a member of the Scottish Commemorations Panel set up to mark the centenary of the First World War.

He said: “Spanish Flu first came to the UK in May 1918 and the first cases were recorded in Glasgow. General medical opinion is that conditions of warfare in Europe where large concentrations of young people were in place helped to spread the epidemic very quickly.

“The death toll in Britain was less than a third of the 750,000 who died in the war but, even so, what is absolutely shocking about the epidemic is that it came at the tail end of the war.

“People at home had been horrified by seeing large casualties on the battlefield and suddenly they had to face up to many thousands more being killed on the civilian front, including many people who had survived the actual fighting.”

Mr Royle said Britain was “no stranger” to deadly epidemics, with a number of cholera outbreaks throughout the 19th century, but this was on a different scale.

The medical authorities did not know how to respond, with citizens even being urged to smoke more cigarettes to kill the germs in their lungs. Other advice, such as wearing face masks or washing tenement closes with disinfectant, would have been more effective.

Mr Royle added: “The Scottish health authorities thought the flu could be kept at bay by a daily dose of porridge.”

He said the panel had no direct funding and could not erect memorials but said he would be “very surprised” if the centenary of Spanish Flu wasn’t discussed at a conference in St Andrews in June. He added: “If there was a local initiative to do something in Lanark, we’d certainly support something like that.”

The source of the 1918 flu pandemic is shrouded in mystery, although some experts now believe the virus developed in the filthy and overcrowded British military camp at Étaples in France.

Others say it originated in the Far East and was spread to Europe by American soldiers when the USA entered the war in 1917, with some of the earliest confirmed cases recorded at army bases in Kansas.

spanish-flu-1332422.jpg
Returning soldiers brought Spanish Flu to the UK

The initial reports of this deadly new danger were quashed by both sides but newspapers were free to report on the illness ravaging neutral Spain, leading to the misleading nickname Spanish Flu.

Servicemen returning from the Western Front brought the flu home to Britain, with the first cases recorded in Glasgow then other ports, including Liverpool, Southampton and Portsmouth.

The first wave was comparatively mild and in June 1918 The Times reported that the “man in the street” had read about the epidemic in Spain and “cheerfully anticipated its arrival here”.
But the number of deaths continued to rise throughout the summer and a second wave in the autumn recorded far higher fatality rates, with the epidemic reaching its fearsome peak in October 1918. Schools, cinemas, theatres and any public buildings where large numbers might congregate were closed down, while church attendances fell as people tried to avoid infection.

Across Britain, children who had grown up in the shadow of a distant but devastating war on the continent began to sing a new skipping song:

I had a little bird, / Its name was Enza, / I opened the window. / And in-flu-enza.

Bill Gates Reckons There's Risk Of A Disease Coming That Could Kill Millions In Months [LADbible, 6 May 2018]

by Jess Hardiman

a35fa5c85aed86cd9c1a3b8ef06d508d.png
Credit: PA

Bill Gates reckons that there's a deadly disease on its way, and that it could kill 30 million within six months. Oh, and that we should prepare for it as we would for war. Not unnerving in the slightest, is it?

In a discussion about epidemics hosted by the Massachusetts Medical Society and the New
England Journal of Medicine on Friday, Gates explained that we're not ready for such a global pandemic.

Gates said that while it's great that we're pulling children around the world out of poverty and making strides in eliminating diseases like polio or malaria, it's not all good news.

"There's one area though where the world isn't making such progress," he said.

"And that's pandemic preparedness."

With new pathogens emerging all the time, it's also becoming worryingly easier for small groups or even individuals to create weaponised diseases, which could readily spread across the planet it no time.

Gates presented a simulation that had been created by the Institute for Disease Modeling.

This showed that a new pandemic - like the one that killed 50 million people back in 1918 - would now probably kill 30 million within six months.

Gates also said it's an issue that we're quick to prepare for something like war, but not pandemics or global flu.

He explained that if you told governments around the world that weapons were being created that held the power to kill 30 million, there would be an obvious sense of urgency about preparing people for the threat.

"In the case of biological threats, that sense of urgency is lacking," he said.

"The world needs to prepare for pandemics in the same serious way it prepares for war."

Gates also said that the one time the military pitched itself against a simulated war game against a smallpox pandemic, the result was 'smallpox one, humanity zero'.

Trying to throw a little bit of optimism our way, he did add that we're closer to achieving a universal flu vaccine - and that the Bill and Melinda Gates Foundation was offering $12 million grants to help its development.

However, we're apparently not good enough at identifying the threat that a disease can pose, or getting a strong response together quickly - as proven by the recent Ebola epidemic.

Well, we couldn't let anyone get too cheerful with all this sun now, could we? It was nice knowing you...

Bill Gates reckons an upcoming pandemic could kill 30 million people [Brag Magazine, 6 May 2018]

by Tyler Jenke

billgates.jpg


How’s your day treating you? Good? That makes sense, after all, the world is full of a lot of good news at the moment – North and South Korea appear to be getting along, they’ve caught the Original Night Stalker, and Childish Gambino is releasing new music again. Things couldn’t be better, right? Well, according to Bill Gates, you’d better take off those rose-coloured glasses and replace them with protective eyewear, because he reckons an upcoming pandemic could kill 30 million people in as quickly as six months.

Yes, as Business Insider reports, Bill Gates, a noted computer enthusiast and apparent buzzkill, has revealed that the world is not prepared for the onset of another global pandemic which, as history seems to indicate, is inevitable at some point.

“There’s one area though where the world isn’t making much progress,” Gates warned while speaking at a discussion about epidemics hosted by the Massachusetts Medical Society and the New England Journal of Medicine. “That’s pandemic preparedness.”

The 62-year-old went on to note how that despite usually being the optimistic one, he believes that individuals and groups could come together to create weaponised diseases which could spread around the globe with ease, taking advantage of the human population’s unpreparedness.

“In the case of biological threats, that sense of urgency is lacking,” Gates said. “The world needs to prepare for pandemics in the same serious way it prepares for war.”

Bill Gates also presented a simulation by the Institute for Disease Modelling which illustrates just how easily a new flu, similar to the one that killed 50 million people back in 1918, could wipe out a significant number of people.

However, the good news is, according to Gates, that there’s still time to prepare ourselves and start looking forward to the future. Maybe now might be the time to stock up on a bit of penicillin and drink up some fresh OJ to pump up those vitamin C levels, eh?

Bill Gates' apocalyptic 30-million death toll nightmare [WND.com, 5 May 2018]

Why his biggest fear is catastrophic global bio-terror attack

WASHINGTON – For billionaire Bill Gates, the scariest recurring nightmare is a global pandemic, triggered by a bio-terror attack, that kills 33 million people in 200 days, and he’s trying to reach out to new National Security Adviser John Bolton about a vaccination plan he believe can prevent it or mitigate its catastrophic effects.

Bill Gates says the U.S. government is falling short in preparing the nation and the world for the “significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.”

It could happen with the next great flu epidemic, he says – like the last one that occurred 100 years ago in 1918. That pandemic killed as many as 100 million worldwide, according to various expert analysis.

Gates says only the U.S. has the resources to prevent it, though it will require an organized global plan – one that currently does not exist.

The Microsoft co-founder now leads a foundation on global health, said he briefed President Trump, who encouraged him to follow up with top officials at the Health and Human Services Department, the National Institutes of Health and the Food and Drug Administration.

Gates made a presentation on his fears last week to the Massachusetts Medical Society.

If a highly contagious and lethal airborne pathogen like the 1918 influenza were to take hold today, nearly 33 million people worldwide would die in just six months, Gates noted in his prepared remarks, citing a simulation done by the Institute for Disease Modeling, a research organization in Bellevue, Washington.

Besides vaccines, Gates has other ideas about preparing for the worst.

“So, we need to invest in other approaches, like antiviral drugs and antibody therapies that can be stockpiled or rapidly manufactured to stop the spread of pandemic diseases or treat people who have been exposed,” he said in his speech.

While saying a flu epidemic could sweep the globe tomorrow, killing as many as 33 million people in its first 200 days, Gates’ nightmare is not even a worst-case scenario. Another leading flu expert says the next one could easily wipe out 300 million worldwide.

Dr. Jonathan Quick, chairman of the Global Health Council, said the flu virus is “the most diabolical, hardest-to-control, and fastest-spreading potential viral killer known to humankind.”

Gates and others say it could be spread deliberately and more rapidly with the advent of bio-terrorism.

Quick, meanwhile, paints a picture of medical supply shortages and energy systems crippled under the pressure and the collapse of the global economy.

“The most likely culprit will be a new and unprecedentedly deadly mutation of the influenza virus,” Quick said. “The conditions are right, it could happen tomorrow.”

Gates said that he’s optimistic that life keeps getting better for most people in the world through new immunization and interventions that are helping in eradicating diseases like polio and malaria. However, “there’s one area though where the world isn’t making much progress,” Gates said, “and that’s pandemic preparedness.”

He said that the world needs to prepare for pandemics in a way that military prepares for a war.

“In the case of biological threats, that sense of urgency is lacking,” he said.

“The next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus … or a super contagious and deadly strain of the flu,” Gates has warned.

Gates told one interviewer: “I rate the chance of a nuclear war within my lifetime as being fairly low. I rate the chance of a widespread epidemic, far worse than Ebola, in my lifetime, as well over 50 percent.”
nice!(0)  コメント(0) 

Zoonotic Bird Flu News - from 3 May 2018

Bird flu outbreak in Kathmandu [Himalayan Times, 26 May 2018]

H5N1 influenza virus, commonly known as bird flu, has been detected in two farms in the capital.

The virus was detected in farms belonging to Hira Tamang at Dharmasthali in Tarkeshwor Municipality and Shanti Tamang at Lambagar of the same municipality. After the bird flu was detected and confirmed in ducks, the authorities culled 5,451 ducks and 180 hens, besides destroying 3,720 eggs of ducks. Up to 250 kg feed was also destroyed. “We culled ducks and hens after ducks tested positive for bird flu,” said Dr Keshav Prasad Premy, joint secretary, Ministry of Agriculture, Land Management and Cooperatives.

According to the Chief of Epidemiology and Disease Control Division Dr Kedar Century, after the Directorate of Animal Health confirmed detection of bird flu it asked EDCD to send necessary manpower for assistance. “We sent our staff for investigation and they have collected throat swab of two people in the area who showed symptoms of bird flu,” added Dr Century.

As per World Health Organisation, H5N1 is a type of influenza virus that causes a highly infectious, severe respiratory disease in birds called avian influenza (or bird flu). Human cases of H5N1 avian influenza occur occasionally, but the infection doesn’t readily spread from birds to persons. However, when people get infected, the mortality rate is about 60 per cent.

The symptoms of H5N1 infection may include fever (often high) and malaise, cough, sore throat and muscle ache. Other early symptoms may include abdominal pain, chest pain and diarrhoea.

The infection may progress quickly to severe respiratory illness (for example, difficulty in breathing or shortness of breath, pneumonia, Acute Respiratory Distress Syndrome) and neurologic changes (altered mental status or seizures).

Decade of global health initiative GISAID lauded | Cape Times [Independent Online, 23 May 2018]

620x349Webstar.jpg
Independent Media executive chairman Dr Iqbal Survé, a Global Initiative on Sharing All Influenza Data trustee.

The Global Initiative on Sharing All Influenza Data (GISAID), which contributes to global health security with its data-sharing programme used to combat influenza, has gone from strength to strength as it celebrates a decade of enabling near real-time surveillance to respond to and mitigate seasonal and pandemic influenza, says GISAID trustee Dr Iqbal Survé.

GISAID, established in 2008, has been hailed “one the most successful global collaborations ever achieved” by luminaries such as Dr Robert Webster, the foremost expert on bird flu.

It comprises more than 8 000 scientists and over 1 000 institutions worldwide.

“It was started by a German family to look at how to assist, in particular, government to have information relating to viruses. It was was meant to assist with the avian flu virus and recently the ebola virus.

"I am very happy it has grown and become such a valuable resource for developing countries. Under the leadership of Peter Bogner, it has been going from strength to strength,” Survé said yesterday.

“The 10th anniversary of GISAID represents a landmark in global solidarity,” said Professor Lawrence Gostin, of the World Health Organisation (WHO) Collaborating Centre on National and Global Health Law at Georgetown University.

“A pandemic strain of influenza is perhaps the world’s greatest threat. Everything GISAID stands for – virus-sharing, cutting-edge research, open access and international co-operation to guarantee health security – couldn’t be more important.

"The GISAID’s unique sharing mechanism allows public health officials, scientists and industry to determine how the viruses have mutated and what specific interventions are needed.

"In 2013, when a new, lethal avian flu strain appeared in China, its authorities relied on GISAID to share genetic data of the virus, receiving accolades for its well-handled response to the outbreak."

To mark the occasion, global public health experts and leading researchers will emphasise the contributions of GISAID, while government officials from countries such as China and Brazil will recognise its importance at the 2018 World Health Assembly in Switzerland this week.

GISAID was formed when the paths of then US secretary of homeland security Michael Chertoff and an ex-senior studio executive at Time Warner, Bogner, crossed paths at the 2006 World Economic Forum.

To learn more about GISAID’s history, mission, research and goals, visit www.GISAID.org

Government relaxes poultry restrictions after four months of bird flu prevention zones [FG Insight, 25 May 2018]

by Lauren Dean

Avian Influenza Prevention Zones in England and Wales have been lifted with immediate effect.

Government relaxes poultry restrictions after four months of bird flu prevention zones

The government confirmed its decision on the back of updated veterinary risk assessment carried out by the Animal and Plant Health Agency (APHA) which confirmed the risk of incursion from wild birds had returned from high to low.

It comes exactly four months after the prevention zone was introduced to curb the risk of infection spreading following three separate findings of the H5N6 strain in wild birds in England and one in Wales.

The UK poultry sector was not hit by any outbreaks.

Cabinet Secretary Lesley Griffiths said: “In January I took action and declared the whole of Wales an Avian Influenza Prevention Zone in response to Highly Pathogenic Avian Influenza H5N6 findings in England.

Smart farms will feed chickens, battle bird flu [Korea Joongang Daily, 23 May 218]

22201816.jpg
Researchers from LG Innotek and the National Institute of Animal Science analyze data on chickens while monitoring them with cameras to develop artificial intelligence-powered smart poultry farms. [LG INNOTEK]

Korea’s avian influenza problem may soon meet its match, as smart farms that can feed chickens and detect bird flu are on their way.

LG Innotek, LG’s electrical components affiliate, announced Tuesday that it will develop farms equipped with artificial intelligence together with the National Institute of Animal Science. These smart farms are expected to maximize their poultry production and identify the spread of infectious avian diseases, all without human supervision.

The LG affiliate and the institute signed a memorandum of understanding on Monday for the joint project. The National Institute of Animal Science, controlled by the Rural Development Administration, is a government body that promotes technological solutions that advance livestock production.

One of the farms’ key features is automatic analysis of birds’ physical condition using cameras and sensors. The farms can determine the appropriate time to replenish birds with water and feed, and they can also sense changes in the weather and adjust temperatures and humidity levels to maintain an optimal environment for the poultry.

The cameras and sensors will also be able to identify the birds’ physical maturity to estimate when they will be available for consumption. The institute will analyze poultry behavior at different stages of maturity to accumulate big data that will be incorporated into the smart farm technology.

Besides increasing production, AI smart farms are expected to be able to identify chickens with avian influenza to prevent large-scale damage.

When the highly pathogenic H5N6 strain of avian influenza broke out in November 2016 in Korea, 33.1 million birds were slaughtered across 821 farms over three months. The poultry industry is estimated to have suffered 1 trillion won ($929 million) in damage.

If a chicken or duck is detected as carrying a contagious disease on a smart farm, they will be quickly located and removed before they can infect other poultry. Towards this end, LG Innotek will develop a deep-learning algorithm that will identify symptoms of infected birds using temperature and humidity sensors.

“It is our goal to make our lives safer and more convenient through innovative technology,” said Kwon Il-geun, chief technology officer at LG Innotek.

LG Innotek hopes to be able to apply smart technology to poultry farms by 2020.

Poultry farmers lose Rs7.068 million to bird flu [Himalayan Times, 21 May 2018]

By TILAK RIMAL

Khairhani-Chitwan.jpg A map of Khairahani Municipality in Chitwan which was declared bird flu contaminated following the death of 2,500 fowls. Photo: Google Maps


CHITWAN: Authorities have destroyed fowls and poultry products worth Rs7.068 million in contaminated zones successfully curbing an outbreak of severe H5N1 avian influenza which saw death of 2500 hens in the district, a week ago.

A slaughter drive was initiated by the authorities after Khairahani Municipality-9 and surrounding regions were declared contaminated with bird flu as two poultry firms in the regions witnessed 2500 fouls succumbing to the avian influenza.

According to the District Livestock Development Office (DADO) stats, 11,950 layers hen, 23 local breeds, 144 ducks, 4 broilers, 607 kg poultry feed and 12,726 eggs were disposed in the region.

According to DADO Chief, Chet Narayan Kharel, the office has forwarded a proposal to compensate poultry owners after valuing the breeding fowls at Rs500 and hens that already laid eggs at Rs350.

Provisions of the Bird Flu Control Directives of 2064 BS ensure 75 per cent of the destroyed assets in compensation to the poultry entrepreneurs.

After the slaughter, bird flu has been successfully contained in the region, Kharel added.

According to Nepal Egg Producers Association Central Chair, Trilochan Kandel, the total loss bore by the poultry farms stands at Rs7.068 million.

Slaughter-team resumes culling poultry in bird flu ‘contaminated areas’ [The Himalayan Times, 19 May 2018]

by TILAK RIMAL

CHITWAN: With the farmer’s protest coming to an end, a technical team deployed to slaughter fowls in the regions which were declared bird-flu-contaminated has resumed operations.

In response to the outbreak of severe avian influenza, a cabinet meeting on Thursday had taken the decision to kill domestic birds in the region.

A team dispatched from Kathmandu and District Livestock Office had reached Khairahni Municipality-9 after bird flu was detected in two poultry farms.

Although 2,500 hens were killed by the virus in two farms and 4,500 hens were culled by the authorities after cabinet’s decision, till Saturday morning, farmers had stopped the team protesting against the declaration of contamination zone.

The farm owners and others said that the team was biased while setting the perimeter of contamination zone. Moreover, farmers accused the team of culling out poultry in small farms leaving out the bigger ones.

According to Vice Chair of Nepal Egg Producers Association, Raghu Nath Bhatta, the aggrieved farmers said that the technical team has unfairly set the perimeter stretching out to 3 Kilo Metres in one direction and only 200 Metres on another.

“Moreover, the problem rooted as farmers were not involved while fixing the contamination periphery,” Bhatta added, “A resolution was made through talks between farmers, technical team and authorities.”

In instances of government’s decision to cull the poultry, the provisions ensure 75 per cent compensation of the total estimated value of culled-poultry to the farm owners.

According to the entrepreneurs, total investment in the poultry sector is more than Rs 70 Billion and half of the total investment has been channeled in Chitwan district.

WORLD OF BIRDS NEEDS R1M TO STAY OPEN [EWN, 19 May 2018]

by Kaylynn Palm

opl0hxsszheh0uahtykm.jpg
A yellow-billed hornbill seen at the World of Birds in Hout Bay, Cape Town. Picture: Facebook.com.

The organisation says they now intend on subdividing the property and sell some land to ensure the sanctuary continues as normal.

CAPE TOWN - World of Birds, the largest bird park in Africa, says it’s been hit hard by the avian flu and are now facing a financial crisis.

The bird park needs R1 million to avoid shutting its doors.

The organisation says they now intend on subdividing the property and selling some land to ensure the sanctuary continues as normal.

World of Birds has more than 3,000 birds and small animals.

Founder Walter Mengold says they’ve lost many birds because of the avian flu.

“After eight months, we’re still under quarantine. The cost of it, to disinfect everything in the part, the employees and material, together, it’s downturn.”

He adds that the number of visitors and tourists have also dropped, and World of Birds is in desperate need of assistance.

“This last summer season we’re not been able to pay back all the money. We know we’ll make it through the school holidays in June/July. But for the second half of this year, we do not yet know where the R1 million will come from.”

Avian flu hits Tainan farm, 1,050 geese culled [Focus Taiwan News, 19 May 2018]

By Chang Jung-hsiang and Ko Lin

5b010f367aef1.jpg
Photo courtesy of Animal Health Inspection and Protection Office (By Central News Agency)

Taipei, May 19 (CNA) A total of 1,050 geese on a farm in Tainan were culled after it was confirmed to be infected with the highly pathogenic H5N2 avian influenza virus, the city's Animal Health Inspection and Protection Office said Saturday.

Samples taken on May 16 from a poultry farm in Madou District were confirmed to be infected with this subtype of the avian flu virus, said Chuang Wei-chao (莊惟超), the office's deputy director.

Tainan has been hit by avian flu four times this year, the last time coming in April in Guiren District when 10,820 chickens were culled on an infected farm.

According to data released by the Cabinet-level Council of Agriculture (COA), 71 poultry farms in Taiwan have been affected by avian flu so far this year, resulting in 530,148 birds being culled.

NEWS H5N1 avian flu strikes layer farm in Nepal [CIDRAP, 18 May 2018]

Nepal today reported a highly pathogenic H5N1 avian flu outbreak at a layer farm, its first involving the strain since March of 2017, according to a notification from the World Organization for Animal Health (OIE).

The outbreak began on May 3 at a farm in Chitwan district in the south central part of the country.

Farmers noticed symptoms and sudden deaths in 72-week-old layers about 2 weeks after deaths were noted in free-range domestic ducks. The report suggests the virus killed 1,500 layers over a 2-week period, and culling is slated for the surviving poultry.

NEWS World of Birds faces financial crisis, closure [Independent Online, 18 May 2018]

by OKUHLE HLATI

620x349OKUHLE HLATI.jpg
World of Birds Wildlife Sanctuary and Monkey Park in Hout Bay File photo: INLSA

Popular tourist attraction the World of Birds Wildlife Sanctuary and Monkey Park in Hout Bay has cited the avian influenza disease as the major reason for selling a portion of the property to keep the doors open.

Africa’s largest bird park needs at least R1 million to carry on with their services through the next season.

The manager and co-owner of World of Birds, Hendrik Louw, said they were selling a prime piece of land of 4 000m², situated off Valley Road, for the first time in more than 40 years.

“The sale of the land comes as we are faced with severe financial constraints so the critical fund-raising initiative is to keep this vital landmark and bird sanctuary operations. This is the aftermath of the bird flu. We lost over 500 birds and that includes wild birds that died in the property.

“Even though we’ve been clear of the disease over the last seven months, it’s a process to have the quarantine lifted,” Louw added.

He said the number of visitors had dropped as some reports had said humans could be affected by the outbreak.

“We’re not generating enough income and, with the economic decline, we are unfortunately now facing a financial crisis and are in dire need of funding.

"We have been forced to the point that we are looking at subdividing and getting rid of part of the property. We have got Seeff, a Hout Bay agent, involved and they are already advertising the property.

“The worst part is that if we are forced to shut down the park, 45 people would be unemployed and it would be a huge loss to wildlife because so many animals are in the sanctuary permanently and can’t be released.

“We don’t know where they could be placed or if there are enough facilities that can take them, so it’s a very stressful period. We have a lot of sleepless nights so we’re calling for anyone who can sponsor us to assist,” said Louw.

The park performs an important community service as a haven for sick and injured birds and small animals. It is the only organisation of its kind in Cape Town and is highly dependent on donations.

Seeff said that, according to Propstats data, vacant land in Hout Bay had sold for R1.7m to R3m. About R2.5m was expected from the sale of the property.

Economic Opportunities MEC Alan Winde said the park played an important role in sustaining and growing the province’s economy.

“The park is a popular tourist attraction, and a unique offering in the city. As such, it plays a role in generating tourism revenues, as well as creating jobs.

"While it is difficult to quantify the impact of the potential closure of the park, it is safe to say that it will definitely impact job creation, and tourism revenues in the city and in Hout Bay specifically.

“The development met with the park’s management earlier this year and, while the department cannot provide financial support, it can assist and guide the facility in developing a turnaround strategy, exploring new strategies to attract more visitors, and developing ways to generate additional revenue,” said Winde.

Bird flu detected in Chitwan [The Kathmandu Post, 18 May 2018]

bird-18052018072703-1000x0.jpg


May 18, 2018-The H5N1 influenza virus, commonly known as bird flu, has been detected in the poultry farm belonging to Rajan Chaudhary at Surtani in Khaireni Municipality-9 of Chitwan district.

After the bird flu was detected, the authorities have started slaughtering fowls in the area from Friday.

According to District Livestock Service Office, Chitwan, Chief Chet Narayan Kharel, the Livestock Service Department has confirmed about the detection of bird flu on Thursday midnight.

Kharel said that the birds within the radius of three kilometer from the affected area will be destroyed so as to prevent the virus from spreading.

NEWS Severe H5N1 bird flu reported in Chitwan [Himalayan Times, 18 May 2018]

By TILAK RIMAL

imagesHimalayan Times.jpg


CHITWAN: Khairhani Municipality in Chitwan district has reported an outbreak of H5N1 bird flu, authorities said.

The virus has killed 2,500 hens exposed in two poultry farms while the remaining domestic birds including ducks, hens and pigeons were culled by the city authorities.

According to Chief of National Avian Disease Investigation Laboratory, Dr Daya Ram Chapagain, the virus was detected after few samples of dead hens from poultry farms owned by Rajan Chaudhary and Laxman Chaudhary were brought to the laboratory.

In response to the outbreak of severe avian influenza, a cabinet meeting on Thursday took the decision to slaughter domestic birds in the surrounding areas, Dr Chapagain said.

Likewise, few areas of the municipality were declared contaminated with a ban on hauling birds, to and from, the contaminated areas in effect.

Prior to this, the H5N1 avian influenza was reported in the district five years ago.

The World Health Organisation has asserted that H5N1 is a type of influenza virus that causes a highly infectious, severe respiratory disease in birds.

“Human cases of H5N1 avian influenza occur occasionally, but it is difficult to transmit the infection from person to person. When people do become infected, the mortality rate is about 60 per cent,” WHO says.

Astral Foods reports improved results despite bird flu [Independent Online, 15 May 2018]

by SANDILE MCHUNU

620x349SANDILE MCHUNU.jpg
JSE-listed Astral Foods managed to report improved results in the six months to end March, despite avian influenza in the period .Picture: EPA

JOHANNESBURG - JSE-listed Astral Foods managed to report improved results in the six months to end March, despite avian influenza in the period.

Chief executive Chris Schutte said on Monday that although the avian influenza strain appeared to be under control, the winter season could see the disease resurface and Astral continued to monitor the situation.

Despite the challenges Astral Foods managed to report a 15 percent increase in revenue to R6.7 billion, up from R5.8bn, mainly on the back of improved poultry supply and demand balance, which gave both volume and price support. Operating profit increased by 392.6 percent to R1.04bn, up from R212 million, predominantly because of the significant improvement in the poultry division’s profitability. The group’s operating profit margin increased to 15.7 percent, up from 3.7 percent as compared to last year.

Schutte said, “We are experiencing higher levels of competitiveness as producers have expanded their broiler production numbers and the pork industry is currently selling product at very competitive prices. The continued high levels of poultry imports, especially from the US and Brazil, remain of grave concern.”

On average Astral Foods said the monthly total poultry imports for the period equalled 44 percent of local production or an average of 46 850 tons a month.

“I still believe the imports have a negative impact on the SA economy as it becomes difficult to create more jobs in the sector as it becomes complicated to reinvest in our business. Sadly the negotiations we had with the government to protect the local industry hasn’t led to a meaningful change in the number of imports,” Schutte said.

Astral Foods has three reporting divisions: poultry, fees and the rest of Africa.

The poultry segment reported an increase of 23 percent in revenue to R5.5bn, up from R4.5bn while operating profit increased to R836m, up from R22m.

In the feed segment, revenue declined by 10.2 percent to R3.1bn, down from R3.5bn as a direct result of lower feed selling prices on the back of the markedly lower maize prices following the record local maize crop for the 2017/2018 marketing year.

Operating profit increased to R192m, up from R184m with an operating profit margin at 6.2 percent.

Ron Klipin, a senior analyst at Cratos Capital, said the outlook for the company was good going forward as volumes and prices were up to provide a revenue figure up 15 percent.

“Individual quick frozen chicken (IQF) market volumes increased due to a gain in market share and the average daily weight gain for chickens continues to increase. Broiler production performance positive with higher efficiency factors,” Klipin said.

He added that capital expenditure for the group was likely to expand in the next three years by R1.3bn to increase capacity and efficiencies.

“This should enable the group to keep and/or increase market share. The increased capex investment should help increase market share from 27 percent to 31 percent, with major demand by groups such as Nandos looking to diversify its source of chicken supply,” Klipin said.

Sri Lanka’s TAFL March profit eroded by avian flu impact, tax hike [EconomyNext, 14 May 2018]

ECONOMYNEXT – Sri Lanka's Three Acre Farms (TAFL), a breeder farm and poultry processing firm, said net profit fell 12 percent to 166 million rupees in the March 2018 quarter from a year ago.

Production and exports were affected by an avian flu epidemic and a hike in corporate tax, it said in a stock exchange filing.

Sales rose four percent to 657 million rupees during the period.

Three Acre Farms reported earnings per share of 7.06 rupees for the March quarter. The stock was last traded at 103.80 rupees.

Chief Executive Officer Primus Cheng Chih Kwong said group profitability was adversely affected by a drop in Parent Stock Day Old Chicks (DOCs) production and export.

This was a result of import restrictions placed on Grandparent Stock DOCs caused by avian flu epidemic in the suppliers’ countries, he told shareholders.

“Moreover, the unsold Layer DOCs due to poor demand together with the increase in corporate tax rate had further narrowed the net profit margins.”

Group revenue increased during the period as a result of improved market conditions for Broiler Day Old Chicks, although the demand for Layer DOCs had been adversely affected by continued volatility in the table egg market, Primus Cheng said.
(COLOMBO, May 14, 2018)

5 out of 5 penguins test positive for avian flu at Boulder’s Beach [CapeTown ETC, 11 May 2018]

south-america-3166415_640.jpg
Published by Lucinda Dordley on May 11, 2018

Five out of five penguins from Boulder’s Beach penguin colony have tested positive for avian flu. An update received from state veterinarian and epidemiologist, Dr Laura Roberts, confirmed that five penguins tested from the colony, tested positive for the virus.

A total of 19 penguins have died since the avian influenza outbreak became known to the public in February this year.

“All possible precautions are being taken to limit the spread of the virus by people and their activities,” Roberts said. “As these are wild birds, containing the natural spread of the virus is not possible.”

Roberts added that a swift tern from Simon’s Town also tested positive for avian influenza.

The strain of avian influenza active at Boulder’s Beach is the H5N8 strain, which is also the strain of avian flu which can affect humans. The World Health Organization (WHO) states that although human infection of the H5N8 strain cannot be excluded, the likelihood of this occurring is low.

Merle Collins, regional communications manager of SANParks, has said that it should be reiterated although this virus is a very low risk to humans, it is a real threat to domestic poultry.

“This strain of avian influenza virus has been detected in a range of wild seabirds, such as swift, sandwich and common terns, African penguins and gannets.”

Roberts added that there is no treatment for avian influenza, for birds. The testing of ill birds is conducted at regular intervals to monitor the presence of the virus.

Birds with the following symptoms should be taken to a vet immediately:

– Sudden death without any signs

– Lack of coordination
– Purple discoloration of the wattles, combs, and legs
– Soft-shelled or misshapen eggs
– Lack of energy and appetite
– Diarrhea
– Swelling of the head, eyelids, comb, wattles and hocks
– Nasal discharge
– Decreased egg production
– Coughing, sneezing

The H5N8 strain has been detected in several countries in Europe, Africa and Asia over the past two years, with its spread aided by wild bird migrations. It is also highly pathogenic among fowl.

China, 3 European countries report more high-path avian flu [CIDRAP, 10 May 2018]

Over the past few days, China, Finland, Germany, and Sweden reported more highly pathogenic avian flu detections involving different strains, according to recent notifications from the World Organization for Animal Health (OIE).

In China, highly pathogenic H7N9 struck a layer farm in Ningxia province in the north, the same area where an outbreak was reported at another layer farm in the middle of April. In the latest event, the outbreak began on Apr 25, killing 2,210 of 86,000 susceptible birds.

Authorities culled the survivors to curb the spread of the disease.

Germany, Finland, and Sweden, meanwhile, reported new H5N6 detections in wild birds.

Germany's outbreak involved a Eurasian buzzard found dead on May 5 in North Rhine-Westphalia state, Finland's involved a white-tailed eagle found dead on Apr 27 near the city of Turku on the country's southwest coast, and Sweden's involved five white-tailed eagles found dead on Apr 19 in Skane County and on Apr 26 in Kalmar County, both in southern Sweden.

In other avian flu developments, Denmark on May 7 reported a low-pathogenic H5 outbreak at a commercial duck farm near the city of Handbjerg in the country's northwest. The virus was found on May 5 during surveillance for avian flu. All 20,900 ducks at the facility were destroyed.

Cull of 20,000 Danish ducks could have been avoided: farmer [The Local Denmark, 9 May 2018]

c096235d777f9996cd55c52fb40d6961dd66650572a470c6f7c368a01ed4b149.jpg


The culling of thousands of ducks after an outbreak of a mild form of bird flu might have been prevented, says the manager of the organic farm where they were raised.

The ducks were put down in Vinderup in northwestern Jutland due to an outbreak of a mild form of avian flu, TV2 and TV Midtvest report.

But that could have been avoided if producers at the organic farm had been provided with the means to keep wild birds away from their flock, duck farmer Martin Daasbjerg said according to TV Midtvest's report.

Daasbjerg said he was denied permission to use drones and fireworks to scare away wild birds from his business at the beginning of this year.

Regulations made it difficult for him to obtain permission, despite several attempts at acquiring the necessary permits, he said.

“We are talking about the Danish Veterinary and Food Administration, the Ministry of Environment and Food, aviation authorities and the police,” he added.

Ducks at Daasbjerg’s and other farms in the area are preyed upon by seagulls as well as other birds if these are not sufficiently deterred, according to the report.

A single wild bird infected with the avian flu virus landing amongst the ducks can result in one or more of the farm birds catching the disease, the final consequence of which is a large-scale cull like that at Vinderup, TV2 writes.

The Danish Agriculture and Food Council said it could not be certain about the potential export cost to Denmark of the issue.

But the council told TV Midtvest that sanctions against Denmark would have been tougher had the outbreak been of the more dangerous form of avian flu, rather than the milder pathogen discovered in the Vinderup ducks.

Thomas Danielsen, a member of the Environment and Food parliamentary committee with the governing Liberal party, said he would speak to Environment and Food Minister Jakob Ellemann-Jensen to find out “what we can and cannot do,” the broadcaster reports.

Daasbjerg said more flexible rules would both improve animal welfare and reduce the risk of a similar situation occurring again.

Stringent biosecurity required to contain bird flu outbreak [Creamer Media's Engineering News, 9 May 2018]

0000724783_resized_unknown1.jpg


Fears that the bird flu epidemic might flare up again have emerged following reports last month of new cases on farms in the North West Province and amongst sea birds along the Western Cape Coastline.

By the end of 2017, following the culling of more than four million birds, the disease was thought to be largely under control. Containment efforts cost the poultry industry R 954 million.

Winter brings the renewed risk of the disease being spread by migrating wild birds, a factor which has prompted the South African Poultry Association (SAPA) to say that it is bracing itself for another outbreak. The organization recommends strict biosecurity and farm management protocols to help decrease the chance of disease on farms.

“Aside from isolation, traffic control, pest control and dead bird disposal, cleaning and disinfecting is a fundamental aspect of biosecurity in commercial poultry production,” says Emma Corder, Country Manager of Nilfisk South Africa.

“Farmers are advised to work closely with cleaning industry experts to ensure their hygiene standards adequately address risks.”

According to the SAPA guidelines on the application of biosecurity on poultry farms, cleaning processes must ensure that workers that come into contact with birds must have clean hands and clothes, to mitigate against the potential for new contaminants being introduced from outside the immediate environment of the farm.

To avoid cross contamination, hands and boots should be disinfected regularly, before entering each new bird house. Equipment used inside the poultry houses should also be cleaned and disinfected prior to entering and after exiting the houses. Equipment should also never be shared between farms unless it has been thoroughly disinfected.

Modern cleaning technologies can effectively clean and disinfect facilities and environments on a farm.

“Producers need equipment to remove the HSNI virus which is responsible for causing bird flu. The virus is spread through direct contact with infected birds and their droppings or bodily fluids. Nilfisk’s MH series of hot water pressure washers can clean up to 210 bars at 90° Celsius and, when used with disinfectant, effectively neutralize these substances,” says Corder.

She recommends equipment that is designed to work well in a farm environment, such as their range of industrial cleaners and sweepers.

“They are powerful, robust and manoeuvrable and can effectively clean and remove contagious particles that are often spread by the movement of workers or equipment on site.”

Don’t chicken out [Business Line, 8 May 2018]

India has withdrawn curbs on US chicken imports, but phytosanitary concerns remain

In keeping with its hardline stance on trade matters, the US continues to press for damages against India on poultry import curbs, despite India having relaxed them in recent months.
Citing avian influenza concerns, India had for years virtually banned poultry imports from the US, prompting the latter to move the WTO. In 2015, the WTO ruled against India, saying that its curbs were disproportionate to the threat and constituted a non-tariff barrier. Since then, India has made two rounds of changes in its bird flu regulations, to bring them in line with WTO norms. Now, US poultry imports have started to arrive, but the US is yet to withdraw its claim of $450 million in annual damages to its industry, made before the ‘retaliatory panel’ of the WTO. Meanwhile, the WTO’s compliance panel is yet to rule on whether India’s amended regulations are acceptable. India erred in not entering into a ‘sequencing agreement’ with the US, which would have ensured that the ruling of the retaliatory panel shall not come into effect before that of the compliance panel. Even as the compliance panel’s rulings take time in coming, India should engage the US in an effort to get the case before the retaliatory panel withdrawn. The US, using all possible means to push exports, is merely pursuing a hard bargain.

Avian influenza concerns aside, US chicken leg imports are not without their phytosanitary problems. The US palate favours chicken breast, while the feet of the bird are exported to China where they find a ready market. Chicken legs are likely to have been frozen for months before they arrive here. Besides, the lower part of the bird is believed to contain high concentrations of antibiotics residue. The FSSAI should satisfy itself that the levels of such residue as well as the time period for which the meat is in a frozen state are within limits prescribed by Indian rules. In July 2015, the FSSAI had said that it “will develop a procedure for inspection and monitoring of slaughtering/processing plants before grant of market access.” The order added that exporting countries would have to provide the prescribed certifications to India. However, India should improve its food standards to ensure compliance. It is not clear whether the use of cheap GM corn and soyabean as feed in the US can have health implications. The domestic poultry industry, which cannot import such feed, may demand a level playing field, which could snowball into a controversy.

Even if imports are likely to be cheap, it may not find many takers in a country where people largely prefer fresh meat. However, a growing number of urban Indians eat out in fast-food joints, which may use such imported chicken. Hence, a host of regulatory and policy issues need to be sorted out.

Do more to keep birds away from eateries [The Straits Times, 8 May 2018]

by Yang Wen Yi (Ms)

nz_birds_080518.jpg
File photo showing birds eating leftover food from plates at a food court.PHOTO: ST FILE

I have eaten at several hawker centres and other open-air eateries that are frequented by birds of all kinds.

For instance, just the other day, my colleagues and I were having lunch at an eatery when a pigeon flew into the kitchen. It landed on the cutting board and began pecking at the half-cut cucumbers and other food ingredients.

We tried to inform the establishment, but the culprit flew off before we could get the staff's attention.

Don't get me wrong; I like birds. I have nothing against them. However, I think that they should be kept away from food for the sake of hygiene.

Although bird flu hasn't been in the news for quite a while, it remains a clear and present danger that deserves caution. Furthermore, stray birds may have parasites, and their dirty feet may carry all sorts of disease-causing microbes.

I do not want to hurt the establishment by revealing its name, but more needs to be done to protect our food from such birds.

This is not the first time I've seen birds invading kitchens.

Perhaps the National Environment Agency can work with Jurong Bird Park to deploy more strident anti-bird measures in our kopitiams. Nets and shiny objects come to mind.

Study gives new insights into avian influenza in Bangladesh [bdnews24.com, 8 May 2018]

bird-fluBangla.jpg
A study based on icddr,b’s decade-long surveillance has shed new light on the presence of highly pathogenic avian influenza virus in Bangladesh.

The virus which is commonly known as bird flu in Bangladesh is not considered a threat in the country.

But the 2007 to 2018 surveillance in both communities and live-bird markets suggests that the virus circulates round the year in Bangladesh.

“We have to closely monitor to identify avian influenza outbreaks at firm level,” said Dr Sukanta Chowdhury, an assistant scientist of icddr,b’s Infectious Diseases Division, while presenting a paper at a workshop on Tuesday.

The Department of Livestock Services and the Zoonotic Diseases Research Group of Programme for Emerging Infections under the Infectious Diseases Division of icddr,b co-organised the workshop to share findings from research on different zoonotic diseases, including avian influenza.

Avian influenza drew a lot of attention back in 2007-08 when it first hit Bangladesh.

Hundreds of thousands of poultry birds were culled. Later in 2011, it came back. One child died in 2013.

The government used to compensate farmers for culling sick birds in order to encourage them to report the illness which has the potential to cause a pandemic situation.

But after the 2012 when the compensation package was stopped due to a fund crisis, the issue began to lose attention.

Officials said this year they detected only one outbreak so far.

But icddr,b’s research suggests many more could be left undiagnosed.

It tested 8,246 waterfowls from the live bird markets during their surveillance period. Of them, 7 percent were found influenza-positive.

“Due to the pandemic potential, 7 percent means a lot. It is not like the other diseases. In many countries, even 1 percent is taken very seriously,” Chowdhury said, adding that the virus is constantly circulating in the air.

He said they also found the influenza virus positive in both commercial chicken and backyard chicken. “Even we found the virus in stools of healthy chicken that means they are shedding the virus without our knowledge.”

The findings also revealed the presence of the virus in the environment where the poultry is slaughtered. Poultry workers were also found suffering from the avian influenza, but none of them were hospitalised.

“The issue warrants more monitoring.”

But the human surveillance component of icddr,b was stopped in 2017 due to a fund crisis.

Chowdhury said the US CDC due to its fund crisis is now funding only the poultry surveillance.

“But you have to see it as ‘one health’ approach as the disease transmits to human from the poultry. So we have to do that [human surveillance],” he said.

Experts and senior government officials, including Fisheries and Livestock Secretary Raisul Alam Mondol, spoke at the workshop.

Latest News about the Avian Influenza (bird flu) [Danish Veterinary and Food Administration, Ministry of Environment and Food of Denmrk, 7 May 2018]

7 May 2018: Low pathogenic avian influenza detected in a duck holding in Denmark
On 5 May a detection of low pathogenic avian influenza H5 has been done in a holding with ducks near the town Vinderup in the municipality of Holstebro in the western part of Jutland.

The population of the holding consists of approximately 9.000 ducks and 12.000 ducklings.

There have not been clinical signs of disease among the animals. The ducks were tested in accordance with the Danish surveillance programme for avian influenza in poultry by routine sampling of blood samples.

Following an investigation of tracheal and cloacal swabs, low pathogenic H5 was detected in cloacal swabs by PCR followed by sequencing at the National Veterinary Institute the 5 May 2018.

The Danish Veterinary and Food Administration has established a restricted zone of 1 km around the holding and has implemented the necessary measures in accordance with Council Directive 2005/94/EC.

The birds at the infected holding will be killed and destroyed.There has not been any export of neither live birds nor poultry products from the establishment.

There are no other commercial poultry holdings within the restricted zone 1 km around the infected holding.

25 April 2018: Status on findings of highly pathogenic H5N6 in wild birds in Denmark
The National Veterinary Institute has confirmed further finding of wild birds infected with highly pathogenic avian influenza H5N6. The total amount of findings are 26 wild birds. Mainly Sea Eagles and common buzzards have been infected, but the infection has also been observed in other birds including hooded crows, gulls, swans and great cormorant. The findings have been made in Northern Jutland, Zealand, Lolland, Bornholm, Fyn and Als. See map for further details: http://fvst.gis34.dk/

11 April 2018: Status on findings of highly pathogenic H5N6 in wild birds in Denmark
The National Veterinary Institute has confirmed further finding of wild birds infected with highly pathogenic avian influenza H5N6. The total amount of findings are 13 wild birds. Mainly Sea Eagles have been infected , but the infection has also been observed in other birds including hooded crow, gulls, swan and common buzzard. The findings have been made in Northern Jutland, Zealand and Lolland.

23 March 2018: Detection of highly pathogenic H5N6 in four wild birds in Denmark.

A detection of highly pathogenic avian influenza H5N6 was done in four wild birds (White-tailed Sea Eagles). Two birds was found in the Northern part of Jutland (Hurup and Hjardemaal), one bird was found on Zealand (Naestved) and one birds was found on Lolland (Maribo). The findings were tested at the National Veterinary Institute in accordance with the specified procedures in the Danish surveillance programme for avian influenza by routine sampling of dead wild birds.

There have been no outbreaks of avian influenza in poultry in Denmark since an outbreak of highly pathogenic avian influenza on 21 November 2016. In connection with this outbreak, the Danish Veterinary and Food Administration implemented the control measures in accordance with the European Union's Council Directive 2005/94/EC.

According to point 8 of Article 10.4.1 in the OIE Terrestrial Animal Health Code “in-fection with influenza A viruses of high pathogenicity in birds other than poultry, including wild birds, should be notified in accordance with Article 1.1.3. However, a Member Country should not impose bans on the trade in poultry and poultry-commodities in response to such a notification, or other information on the presence of any influenza A virus in birds other than poultry, including wild birds". Therefore Denmark is still considered an avian influenza free country.

The Danish Veterinary and Food Administration continues to monitor the situation closely.


02 March 2018: Detection of highly pathogenic H5N8 in a wild bird in Denmark.

A detection of highly pathogenic avian influenza H5N6 was done in a wild bird (White-tailed Sea Eagle) in the municipality of Slagelse on Zealand, Denmark.

There are no reports of other affected birds in the area. The finding was tested at the National Veterinary Institute in accordance with the specified procedures in the Danish surveillance programme for avian influenza by routine sampling of tracheal and cloacal swabs.

According to point 8 of Article 10.4.1 in the OIE Terrestrial Animal Health Code “in-fection with influenza A viruses of high pathogenicity in birds other than poultry, including wild birds, should be notified in accordance with Article 1.1.3. However, a Member Country should not impose bans on the trade in poultry and poultry-commodities in response to such a notification, or other information on the presence of any influenza A virus in birds other than poultry, including wild birds.”

The Danish Veterinary and Food Administration continues to monitor the situation closely.

11 April 2017: Lifting of restrictions in relation to HPAI H5N8

The Danish Veterinary and Food Administration has decided to lift the restrictions imposed in November 2016 in relation to containment of poultry indoor or in runs covered by solid roof and in relation to exhibitions, gatherings and shows of poultry and other captive birds as of Wednesday 12 April 2017.

The decision is based on a risk assessment which conclude that the number of HPAI H5N8 positive wild birds have reduced within the last weeks to a level where it is acceptable to lift the provisions on containment of poultry.

Rules about biosecurity measures as feeding and watering under roof and separation between domestic ducks and geese from other poultry are always in force.


22 February 2017: Denmark has regained its status as an avian influenza free country
Denmark has regained its status as an avian influenza free country according to the requirements of article 10.4.3 of the OIE Terrestrial Animal Health Code after the detection of HPAI (H5N8) in a backyard poultry flock on 21 November 2016.

A final report on the outbreak is available under "Booklets/Reports". The report contains a description of the control measures applied including stamping out, cleaning and disinfection, establishment of protection and surveillance zones, screening in zones and the Danish surveillance programmes for avian influenza in poultry, other captive birds and wild birds.

7 February 2017: Detection of Infection with influenza A virus of high pathogenicity (H5N8) in birds other than poultry

Infection with influenza A virus of high pathogenicity in birds other than poultry has been confirmed in an open air museum in Maribo, in the municipality of Lolland on the Island Lolland. The birds (3 geese, 4 hens and a cock) have been killed today.

The birds were only kept for exhibition and they have not been used for the production of meat or eggs for consumption or for the production of other commercial products. No zones will be established.

22 December 2016: Lifting of high pathogenic avian influenza (HPAI) restriction zones

Today the 10 km surveillance zone was lifted, which was the last restriction zone out of the two restriction zones implemented due to the outbreak of HPAI Influenza in a backyard poultry flock at Skibstrupvej 24 in Ålsgårde, Denmark. The 3 km protection zone was lifted on 13 December 2016.

Provided that the situation will remain stable and no further outbreaks will be reported, then Denmark expects regaining the status of free from avian influenza on 22 February 2017 three months after the approved cleaning and disinfection according to OIE’s Terrestrial Animal Health Code Article 10.4.3. point 1.

29 November 2016: Status on highly pathogenic H5N8 in Denmark

Since the outbreak of HPAI H5N8 in the backyard hobby flock in the municipality of Helsingør there has not been any further outbreaks in Danish holdings. The situations is monitored closely by the Danish authorities and many preventive measures are implemented.

This is supported by the Danish CVO Per Henriksen, who explains “The entire industry in Denmark is working professionally with effective biosecurity in close collaboration with the Danish Veterinary and Food Administration”.

The Danish chicken production and food safety is still unaffected of the avian influenza H5N8.

The Danish Veterinary and Food Administration has initiated the screening of all poultry herds within the three km zone according to the EU legislation and take samples from ducks and geese for laboratory analyses for the presence of avian influenza.

21 November 2016: Detection of highly pathogenic H5N8 in poultry in Denmark.

A detection of high pathogenic avian influenza H5N8 has been done in a backyard poultry flock in the town Ålsgårde, in the municipality of Helsingør on Zeeland. The population of the backyard poultry flock consists of 35 ducks, 16 geese, 5 turkeys and 13 hens. There were clinical signs among the ducks. Geese, turkeys, and hens had no clinical signs.

Following an investigation of the tracheal and cloacal swabs from the ducks, high pathogenic H5N8 was detected by PCR followed by sequencing at the National Veterinary Institute.

The killing of all birds at the infected holding will be initiated today 21 November 2016.

There has been no export of poultry or eggs from the affected holding to other EU member states or third countries.

The Danish Veterinary and Food Administration has established a protection and surveillance zone of 3 and 10 km around the holding and are implementing the necessary measures in accordance with Council Directive 2005/94/EC.

There has been no export of poultry or eggs from the zones within the last 21 days.

The DVFA continues to monitor the situation closely and will keep you informed.

The last outbreak in Denmark of high pathogenic avian influenza in poultry was in 2006. .


14 November 2016:

Danish Veterinary and Food Administration has ordered that it is mandatory to keep poultry indoor. Ducks, geese, game birds and ostriches can be kept outside but must be fed under roof.


13 November 2016:

An outbreak of HPAI H5N8 has been detected in a chicken breeder holding in Germany which has delivered hatching eggs to a Danish hatchery. As preventive action, the Danish Veterinary and Food Administration has decided to destroy all eggs received from the affected holding within the last 21 days (the incubation period).

10 November 2016:
Detection of highly pathogenic H5N8 in wild birds in Denmark.
A detection of highly pathogenic avian influenza H5N8 in wild birds has been done at two localities in Denmark. Both findings were in tufted ducks.

The first detection of HPAI H5N8 was done in a single dead tufted duck found in a moat in the central Copenhagen near the area Christiania. There are no reports of other dead ducks in the area.

The second detection was done in 10 dead tufted ducks collected among up to 50 dead ducks in a wetland area near the town of Stege on the island of Moen southeast of Sealand.

The Danish Veterinary and Food Administration (DVFA) has taken precautionary steps and issued instructions that all free-range poultry should be kept in-door or confined under roof coverage.

The findings were tested at the National Veterinary Institute in accordance with the specified procedures in the Danish surveillance programme for avian influenza by routine sampling of tracheal and cloacal swabs.

The DVFA continues to monitor the situation closely.

9 November 2016:

Due to outbreak of highly pathogenic avian influenza H5N8 among wild birds in EU countries close to Denmark, Denmark is taking extra precaution in an effort to protect poultry against wild birds. In a press release to day The Danish Veterinary and Food Administration recommends commercial poultry holdings and owners of backyard poultry to keep their poultry inside. Findings of dead wild bird in Denmark will be investigated for avian influenza.

Low pathogenic avian influenza detected in a duck holding in Denmark [poultrymed, 7 May 2018]

On 5 May a detection of low pathogenic avian influenza H5 has been done in a holding with ducks near the town Vinderup in the municipality of Holstebro in the western part of Jutland.

The population of the holding consists of approximately 9.000 ducks and 12.000 ducklings.

There have not been clinical signs of disease among the animals. The ducks were tested in accordance with the Danish surveillance programme for avian influenza in poultry by routine sampling of blood samples.

Following an investigation of tracheal and cloacal swabs, low pathogenic H5 was detected in cloacal swabs by PCR followed by sequencing at the National Veterinary Institute the 5 May 2018.

The Danish Veterinary and Food Administration has established a restricted zone of 1 km around the holding and has implemented the necessary measures in accordance with Council Directive 2005/94/EC.

The birds at the infected holding will be killed and destroyed.There has not been any export of neither live birds nor poultry products from the establishment.

There are no other commercial poultry holdings within the restricted zone 1 km around the infected holding.

Hong Kong reopens Yuen Po Street Bird Garden [ecns, 7 May 2018]

1ba4d727177741a187c7401800d26a0f.jpg


Photo taken on May 4, 2018 shows Yuen Po Street Bird Garden in Mong Kok reopened after it's temporarily closed to the public for 21 days on April 13 following the detection of the H5N6 avian influenza virus in an environmental sample collected from a bird cage holding a hill myna at a pet bird shop. Yuen Po Bird Garden offers a glimpse of the traditional culture of songbird keeping in the surroundings of a traditional Chinese garden. (Photo: China News Service/Zhang Wei)

Taiwan slaughters 2,000 geese over bird flu [Hong Kong Standard (press release), 7 May 2018]

A goose farm in southern Taiwan's Yunlin County was found to have been contaminated by a subtype of H5 bird flu virus and 2,279 birds on the farm were culled, the 68th case of poultry farm infection this year, according to the Council of Agriculture yesterday.

Several geese on the farm in Yunlin's Sihu Township were confirmed as having contracted the virus, the council's Bureau of Animal and Plant Inspection and Quarantine said in a press release.

Officials called on all poultry farm operators to keep their birds warm and in a place with good ventilation as temperatures vary considerably between daytime and night time.

Danish authorities to cull 20,000 ducks to halt spread of bird flu [The Copenhagen Post - Danish news in english, 7 May 2018]

by Ben Hamilton

DUCKS-630x390.jpg
Some 20,000 more like this (photo: publicdomainpictures.net)

Current strain is not particularly dangerous, but it could open the door to one that kills all birds it infects

The Fødevarestyrelsen national food agency has recommended that 20,000 ducks should be killed to halt the spread of a strain of bird flu near Holstebro in northwest Jutland.

The H5 strain is low-pathogenic (LPAI), which means it is not considered particularly dangerous to the birds, and most cases do not result in death.

However, it is extremely contagious and could lead to the development of a high-pathogenic (HPAI) strain that will kill every bird it infects, warn experts.

Kill them all

The 20,000 birds in question are not displaying signs they are ill, concedes Stig Mellergaard, a chief veterinarian at Fødevarestyrelsen. But he is adamant the cull is necessary.

“It is important we find all the affected birds – even if they aren’t showing any signs they have the disease,” he said.

“In this way we can take precautions and ensure that as few birds as possible become infected, thus slowing down the disease before it develops and becomes highly pathogenic.”

A zone has accordingly been placed around the birds to prevent any further spread of the disease.

Bird flu reported at goose farm; 2,279 birds culled [Focus Taiwan News Channel, 6 May 2018]

by Yu Hsiao-han and S.C. Chang

201805060013t0001.jpg


Taipei, May 6 (CNA) A goose farm in southern Taiwan's Yunlin County was found to have been contaminated by a subtype of H5 bird flu virus and 2,279 birds on the farm were culled, the 68th case of poultry farm infection this year, according to the Council of Agriculture (COA) on Sunday.

Several geese on the farm in Yunlin's Sihu Township were confirmed as having contracted the virus, the council's Bureau of Animal and Plant Inspection and Quarantine said in a press release.

The bureau has reminded the farm's operators to disinfect the area following the standard operation procedure of destroying the geese.

Officials called on all poultry farm operators to keep their birds warm and in a place with good ventilation as temperatures vary considerably between daytime and nighttime.

Farm operators should also keep their poultry from coming into contact with local wild birds and migratory birds, said the bureau.

New threats of H7N9 influenza virus: the spread and evolution of highly and low pathogenic variants with high genomic diversity in Wave Five [Journal of Virology, May 2018]

Authored by Chuansong Quana,b, Weifeng Shic, Yang Yangd, Yongchun Yange, Xiaoqing Liuf, Wen Xug, Hong Lig, Juan Lic, Qianli Wangh, Zhou Tongb, Gary Wongb,d, Cheng Zhangb, Sufang Mab, Zhenghai Mai, Guanghua Fuj, Zewu Zhangk, Yu Huangj, Houhui Songe, Liuqing Yangd, William J. Liua, Yingxia Liuc, Wenjun Liub, George F. Gaoa,b,d and Yuhai Bib

ABSTRACT

H7N9 virus has caused five infection waves since it emerged in 2013.

The highest number of human cases was seen in Wave Five; however, the underlying reasons have not been thoroughly elucidated. In this study, the geographical distribution, phylogeny and genetic evolution of 240 H7N9 viruses in Wave Five, including 35 new isolates from patients and poultry in nine provinces, were comprehensively analyzed together with strains from first four waves.

Geographical distribution analysis displayed the newly-emerging highly pathogenic (HP) and low pathogenic (LP) H7N9 viruses were co-circulating, causing human and poultry infections across China. Genetic analysis indicated that dynamic reassortment of the internal genes among LP-H7N9/H9N2/H6Ny and HP-H7N9, as well as the surface genes between Yangtze and Pearl River Delta lineages resulted in at least 36 genotypes, with three major genotypes (G1, A/chicken/Jiangsu/SC537/2013-like, G3, A/Chicken/Zhongshan/ZS/2017-like and G11, A/Anhui/40094/2015-like).

The HP-H7N9 likely evolved from G1 LP-H7N9 by the insertion of a “KRTA” motif at the cleavage site (CS), then evolved into fifteen genotypes with four different CS motifs including PKGKRTAR/G, PKGKRIAR/G, PKRKRAAR/G and PKRKRTAR/G. Approximately 46% (28/61) of HP strains belonged to G3. Importantly, neuraminidase (NA) inhibitor resistance (R292K in NA) and mammalian adaptation (eg. E627K and A588V in PB2) mutations were found in a few non-human-derived HP-H7N9 strains. In summary, the enhanced prevalence and diverse genetic characteristics with mammalian-adapted and NAI-resistant mutations may have contributed towards increased numbers of human infections in Wave Five.


IMPORTANCE The highest numbers of human H7N9 infections were observed during Wave Five from October 2016 to September 2017.

Our results showed that HP-H7N9 and LP-H7N9 has spread virtually throughout China and underwent dynamic reassortment with different subtypes (H7N9/H9N2 and H6Ny) and lineages (Yangtze and Pearl River Delta lineages), resulting in a total of 36 and three major genotypes. Notably, the NAI drug-resistant (R292K in NA) and mammalian-adapted (eg. E627K in PB2) mutations were found in HP-H7N9 not only from humans, but also from poultry and environmental isolates, indicating increased risks for human infections.

The broad dissemination of LP- and HP-H7N9 with high genetic diversity, host adaptation and drug-resistant mutations likely accounted for the sharp increases in the number of human infections during Wave Five.

Therefore, more strategies are needed against the further spread and damage of H7N9 in the world.

Journal of Virology May 2018, Volume 92, Issue 10

Avian Flu Treatment Market to Reflect Steadfast Expansion During 2016-2026 [Digital Journal, 5 May 2018]


Future Market Insights has announced the addition of the “Avian Flu Treatment Market: Global Industry Analysis and Opportunity Assessment 2016-2026" report to their offering.

This press release was orginally distributed by SBWire
valley cottage, NY -- (SBWIRE) -- 05/04/2018 -- Avian influenza (AI), generally called bird flu, is an infectious viral disease of birds. I t is generally found in some species of water birds mainly in wild water fowl such as ducks and geese. Avian influenza virus sometimes infect poultry and other birds resulting in outbreaks. Avian influenza is usually rare in humans but sometimes it passes to human and other species due to close contact with the infected bird.

The common virus which can infect humans are A(H5N1) and A(H7N9). Avian flu viruses are characterized into two high pathogenicity or low pathogenicity. The risk of transmission of avian flu is in those people who work in poultry, travel to virus infected countries, contact with infected bird and by eating raw or under cooked meat or eggs. The A(H5N1) virus subtype, is highly pathogenic, the first infection in humans of this virus was reported in 1997 in Hong Kong. After that the virus has spread to Asia, Europe and Africa and have affected many countries on large-scale, causing millions of poultry infections, several hundred human cases, and many human deaths. These avian flu outbreaks in poultry have seriously impacted livelihoods, the economy and international trade in affected countries. The A(H7N9) virus subtype, is very rare and is of a low pathogenicity and its cases are reported only in China.

Avian flu symptoms depends of type of virus subtype infection. Preliminary symptoms of A(H5N1) virus include high fever, cough, diarrhea, headache, sore throat, runny nose, muscle ache. Also, lower respiratory tract problems emerge early in patients.

Request For Report Sample@ ☞ https://www.futuremarketinsights.com/reports/sample/rep-gb-2543

Avian Flu Treatment Market: Drivers and Restraints

Infection of avian flu virus is suspected and diagnosed on the basis of clinical representation, history of contact with infected case or a positive laboratory test. Thus, awareness will lead to better diagnosis, which in turn will drive the avian flu market. Avian flu pandemic at any point of time can drive the market in the future since the influenza virus different rates in different places such as in 2014, H5N8, a highly infectious subtype of avian influenza, caused disease outbreaks in poultry, starting from South Korea, followed by Asia, Europe, and North America.

Also, the various guidelines and recommendation from government authorities will lead to better diagnosis and treatment. However, resistance to existing antivirals can negatively impact the sales of antiviral drugs since it will lead to changes in treatment guidelines.

Avian Flu Treatment Market: Segmentation

The global avian flu treatment market is classified on the basis of treatment type, end user and geography.

Based on drug type, the global avian flu treatment market is segmented into the following:
Antivirals
Neuraminidase inhibitors
Ion channelM2 blockers
Combination treatment
Prophylactic antibiotics
Steroids and other immunosuppressants
Immunoglobulin
Ribavirin

Based on end user, the global avian flu treatment marketis segmented into the following:
Hospital
Institutional Health Centers
Clinics

Avian Flu Treatment Market: Overview

Global avian flu treatment marketis expected to witness healthy CAGR over the forecast period due to increase in awareness and diagnosis of avian flu. Increasing burden of avian flu on healthcare systems of endemic region such as Southeast Asia, China will lead to more stringent preventive measures in these regions. Treatment with the antiviral medications such as oseltamivir (Tamiflu) or zanamivir (Relenza) should be started immediately to stop disease progression. Also, it is being reported that the antiviral medicines amantadine and rimantadine should not be used in the case of an H5N1 outbreak occurs due to antiviral resistance. Authorities such as WHO, the World Organisation for Animal Health (OIE), and the Food and Agriculture Organization (FAO) are collaborating to assess and address the risk of avian flu

Request For Report Table of Content (TOC): ☞ https://www.futuremarketinsights.com/toc/rep-gb-2543

Avian Flu Treatment Market: Regional Overview

Region wise, the global avian flu treatment marketis classified into seven regions namely, North America, Latin America, Western Europe, Eastern Europe, Asia-Pacific, Japan, Middle East and Africa. North America has conventionally dominated the global market for avian flu treatment market due to heightened awareness and good reimbursement policies. Asia-pacific and Africa remains highly susceptible due to past endemics. Although the outbreak of avian flu remains unpredictable but recent outbreaks in France, Nigeria, and Vietnam will push the market.

Avian Flu Treatment Market: Key Players

Some of the players in global avian flu treatment market include Hoffmann-La Roche Inc.,
GlaxoSmithKline plc, Forest Pharmaceuticals Inc., and BioCryst Pharmaceuticals among others.

Egg crisis almost sparked a revolution in Iran [Poultry World, 4 May 2018]

by Vladislav Vorotnikov

Iran has lost 21 million birds due to outbreaks of the highly pathogenic avian influenza (AI) since the beginning of the current Iranian year, which started 21 March 2017, according to Dr Alireza Rafiepoor, the head of Iran Veterinary Organization. This resulted in a large price hike for eggs and protests in the streets.

AI was confirmed at 421 various sites, including many commercial poultry farms, slaughterhouses and processing facilities throughout Iran. Most of the outbreaks were registered in Isfahan, Guma and Yazd provinces, Dr Rafiepoor stated, speaking at a press-conference in late January 2018. Although the new wave of bird flu in the country has not brought any significant impact on the production of poultry meat just yet, it became a real challenge for the egg industry, as 73% of poultry culled as a result of the outbreaks were laying hens, according to Rafiepoor. Iran has lost nearly 30% of its laying hens during the past 12 months from its overall population of around 53 million layers, estimated in early 2017, according to the Tehran Chamber of Commerce.

35% price hike for eggs

Since May 2017 Iran has been experiencing a rise in egg prices which has never been seen before. Since early 2018 the price per 30 egg pack in retail ranges from IRR 126,000 to IRR 160,000 ($ 2.7 – $ 3.5). This is some 35% higher compared to the level registered in early 2017, according to estimations of the Iranian Central Bank. Iran annually consumes nearly 16 billion eggs, or 198 eggs per capita. So for a country where the economy is not in its best shape and the purchasing power of the population is low, such a sharp rise in the price level for a basic food stuff has had a major influence on citizens.

004_871_IMG_AIisaffectingmostlyeggfarmsinIran.jpg
AI outbreaks caused losses of some IRR 20 trillion ($480 million) for Iranian poultry farms, according to the Tehran’s Union of Producers of Egg-Laying Chicken. Photo: Vladislav Vorontikov

The egg price became a symbol for unrest

However, it seems that nobody was expecting that the price of eggs would become a symbol for Iran’s broader economic problems and that it would give a rise to the biggest wave of protests in nearly a decade that began on 28 December and are far from being completely over. The protesters claim that the price of eggs jumped from 50% to 200% depending on the province, compared to the previous year. Estimations, provided by the government authorities, in their opinion, were not completely accurate. Iranian authorities are taking urgent steps now to tackle the AI epidemic and bring the affected facilities back to business as soon as possible. It is believed that the riots that reportedly had already claimed the lives of 20 citizens would eventually calm down, once there is some kind of stability again on the domestic food market.

Bailout package

AI outbreaks caused losses of some IRR 20 trillion ($ 480 million) for Iranian poultry farms, according to Tehran’s Union of Producers of Egg-Laying Chicken. The current outbreak is worse than previous ones as losses have already reached record heights and keep on growing. The Iranian government allocated IRR 1 trillion (US$ 24 million) of state aid to be paid to the affected poultry farmers. This money was paid at the end of December to help poultry farmers, affected by the virus, to return to business despite the huge losses that they suffered.

002_565_IMG_Image1ed.jpg
The broiler industry wasn't affected on the same level as the layer business, but vigilance is in place. Photo: Vladislav Vorotnikov

Iran hits the brakes on egg exports

Amid falling production performance in the industry and to take advantage of the soaring prices on the domestic market, Iran poultry farmers nearly stopped egg exports. The most up-to-date information shows that the country exported only 3,700 tonnes of eggs in the period from March to June 2017 and that was nearly 6 times lower compared to the same period in 2016. Iran exported 40,000 tonnes of eggs in 2017, nearly 55,000 tonnes less than the previous year, as Iraq and Afghanistan banned the import of Iranian eggs and chicken in early December 2016 following the first major AI outbreaks, Iran’s Union of Producers of Egg-Laying Hens estimated.

Iran had the capacity to produce 960,000 tonnes of eggs, Hassan Rokni, the deputy Agricultural Minister said during a press-conference in October 2017. At the same time, the domestic consumption was estimated at 850,000 tonnes, so there was some surplus of production volumes in the market, when industry was operating at full capacities, according to him.

Neither, government agencies, nor the Union of Producers of Egg-Laying Chicken have issued a forecast on the expected production performance in the egg industry in 2017.

However, some local news media reported that AI affected capacities in the industry with the overall production performance of between 250,000 and 350,000 tonnes per year. This is expected to lead to severe domestic shortages up to 100,000 tonnes.

Iran turns to Turkey to fill the egg gap

On this background, Iran asked neighbouring Turkey to gear up the export of eggs to its market. Hasan Konya, the head of the Turkish Union of Egg Producers stated that the Iranian embassy in the country asked the leading egg companies in Turkey to arrange some shipments of eggs in order to close the gap between demand and supply in Iran. Mr Konya also said that due to the AI outbreaks, the prices for eggs in Iran jumped 2 to 3 times since the beginning of the most active phase of the epidemic in late 2016. He also suggested that the shortage of eggs in Iran would not be avoided within the coming five to six months. In the meantime, Iran agreed to cut import tariffs on eggs from 55% to 5%. Under these conditions Turkey will be able to direct 2,000 trucks with eggs to Iran in the months to come, according to Mr Konya. Turkey started exporting eggs to Iran in December 2017 and it was believed that these import supplies eventually would bring the prices for eggs at the Iranian market back to the normal level, Konya added.

Golemali Forhi, the spokesperson for the Iran Chamber of Commerce, confirmed in late January that Iran will have to import eggs within at least the coming six months. At the moment, the affected farms are growing chicks and recovering from the outbreaks, so the market should wait until the new poultry stock will be able to produce eggs.

003_67_IMG_vaccinationed.jpg
Iran lost 21 million birds, mainly layers, and tries to control the AI outbreak with vaccinations. Photo: Vladislav Vorotnikov

AI not under control

Some experts state that the anticipated recovery of the market may never happen. Iranian veterinary authorities could well fail in their attempts to stop the spread of AI throughout the country. Mehdi Masoumi-Esfehani, the deputy head of Tehran Chamber of Commerce, told the local media IRNA that bird flu, which so far had been affecting mostly egg farms, was gradually becoming a threat to broiler farms too. He expressed concerns that the virus could somehow mutate and change its form, so it would put the poultry industry in even greater danger.

Iran is producing 2 million tonnes of poultry meat per year, according to official statistical information. The country had to cull 5.5 million broilers since the beginning of the crisis and this only pushed the prices up by 6% since January 2018 on year-to-year comparison, according to the information of the Iranian Central Bank. The Agricultural Ministry earlier estimated that Iran could become the biggest exporter of chicken meat in the Middle East.

Habib Amini, a spokesperson of the ministry suggested that Iran could export up to 1 million tonnes of broiler meat per year to Saudi Arabia, UAE, Afghanistan, Russia and several other countries.

However, it seems that Iran should leave those plans behind for the time being. In the period from March to November 2017 the country exported only 16,000 tonnes of chicken, nearly three times lower, compared to the same period of the previous year. The outbreaks at broiler farms and the possibility of meat shortages in the future should also worry the government agencies. When meat was scarce in 2012 due to Western sanctions, it provoked an increased in prices for poultry at the domestic market by 25%, which led to the large-scale protests on the streets of Teheran, similar to the ones that took place just a month ago.

It is of great importance to the Iranian government to satisfy the needs of its citizens by controlling the negative effects of AI on poultry production, as a revolt could have serious implications.

A pandemic is coming, and American politics have set us up for failure [The Diamondback, 3 May 2018]

By Nate Rogers

004_871_IMG_AIisaffectingmostlyeggfarmsinIran.jpg
A CDC scientist transfers the H7N9 virus into vials for research. (Image via Wikimedia Commons)

Views expressed in opinion columns are the author's own.

In the not-so-distant future, a highly infectious virus has killed a large portion of the world's population. The death toll is unclear, but it's in the tens or hundreds of millions, perhaps even billions. Those still alive — lucky enough not to contract a deadly strain of H7N9 influenza — will reflect on what brought them here.

Some might think about the four horsemen of the apocalypse. They had, after all, just survived a plague of biblical proportions. With the benefit of direct experience, they might add a fifth: fiscal conservatism.

It sounds like overdramatic science fiction, but it shouldn't. We live in an era with the constant threat of doom looming over us climate change, terrorism, nuclear war. But pandemic will likely get us first.

Even though it's the most plausible of apocalypses, we're not powerless to prevent it. We have the scientific knowledge, and the international aid capabilities, to stop dangerous outbreaks of highly infectious diseases well before they become global pandemics. The only thing standing in the way is funding.

Shortsighted cuts to science research and foreign aid tip the scales in pathogens' favor. Congress and the Trump administration must increase funding for science research and readiness. If they continue to ignore this microscopic threat, they could be responsible for the deaths of millions.

The next pandemic would not be the first to wreak havoc on global health. The 2014 Ebola outbreak in West Africa claimed around 11,325 lives. That's dwarfed by the 2009 H1N1 flu pandemic, which took upward of 151,700 to 575,400. 1,232,346 people have been diagnosed with AIDS since the epidemic's inception in the early '80s. Easily topping that, the catastrophic 1918 Spanish flu pandemic infected a third of the Earth's population and killed about 50 million people.

We could be on the verge of a similar outbreak. The world's increasing population density means humanity is more vulnerable than ever to highly infectious diseases. Such a risk demands decisive action to fund research and preparedness. Instead, a perfect storm of budget cuts and negligence has put us on course for a pandemic.

Global health experts agree that the United States isn't prepared to handle a worldwide outbreak of a highly infectious virus, and the Trump administration's attitude toward research and aid isn't helping matters. The administration has proposed cutting the state department's funding by more 25 percent, which could severely compromise its ability to provide crucial aid early on in an outbreak.

The same budget proposal roughly maintains 2017 levels of funding for the National Institutes of Health. Increased NIH funding would spur more research into viruses that could cause the next pandemic. Meanwhile, the Centers for Disease Control and Prevention is set to exhaust the funding allowing it to help developing nations improve their ability to detect and respond to epidemics. Without oversight, outbreaks in developing nations could spread nearly unchecked.

To put it succinctly, the United States is scaling back efforts to prevent a pandemic. We're asking for a fight we won't win.

There are already candidates for the next pandemic virus. H7N9 currently doesn't spread easily between humans, but it has killed up to 39 percent of those infected. An outbreak of a more transmissible but similarly deadly mutation would be devastating, and that mutation could happen at any time. Acting now would minimize the damage. Policy makers need to treat that day as an inevitability — not science fiction.

Nate Rogers is a freshman physics major. He can be reached at nrogers2@terpmail.umd.edu.
nice!(1)  コメント(0) 
前の10件 | -