H5N1

Israel: Health Ministry issues warning over dengue fever infection

Via Haaretz: Health Ministry issues warning over Dengue fever infection. Excerpt:

The tropical disease dengue fever is on the increase in Israel and it's only a matter of time until it becomes actively infectious here, according to a local expert. 

Dengue fever (also known as breakbone fever ) is a virus-caused disease that is spread by mosquitoes. Prof. Eli Schwartz, director of the Center for Travel Medicine and Tropical Diseases at the Sheba Medical Center, Tel Hashomer, recently published an article in the American journal Emerging Infectious Diseases. 

Schwartz noted that there has been an upswing in cases of Israelis stricken by the virus abroad and then diagnosed on their return home. The rise in such cases, in areas close to where the mosquito's presence in Israel is also increasing, multiplies the risk that the disease will become actively infectious here, although locally-spread cases have yet to be reported. 

Asian tiger mosquito are believed to have found their way to northern Israel in 2002 in cars imported through Eastern Europe; water in the tires provided the mosquitoes with breeding grounds. They spread from the north to the coast, and in 2010 they were even reported in Jerusalem. 

While the bite of the Asian tiger mosquito is only slightly more painful than that of the regular variety, the dengue virus may cause gastrointestinal bleeding and loss of body fluids, as well as anaphylactic shock (similar to a life-threatening allergic reaction ) and death.

Planning for cholera

Via The New York Times: Saving Lives in a Time of Cholera. Click through for the full article and a lot of links. Excerpt:

Cholera is on the rise around the world. Last year, according to Unicef, West and Central Africa had “one of the worst ever” cholera outbreaks. An outbreak in Haiti sickened 1 in 20 Haitians and killed more than 7,000 people. 

The World Health Organization estimates that there are between three million and five million cases of cholera each year, and between 100,000 and 120,000 deaths. New and more virulent strains are emerging in Asia and Africa, and the W.H.O. says that global warming creates even more hospitable conditions for the disease. 

In most parts of the world, the last few months have brought a respite. But April is the start of the rainy season, which is also the cholera season. 

Cholera should not be a terror. It is easy to treat if you know how. Countries that live permanently with endemic cholera, like  Bangladesh, see fewer than one death per 100 cases. But in recent epidemics in Zimbabwe, Somalia and Haiti, death rates in some areas have been reported at 10, 20 or even 50 percent. In countries unfamiliar with the disease, people don’t know the steps to take or have the tools they need. 

With cholera, speed matters. It can kill very quickly — in a few hours if victims are already malnourished. And since the incubation period for the cholera bacteria can be as short as two hours, it spreads fast. 

Until now, early action has been nearly impossible. Governments, fearing stigma and a loss of tourism, often cover up cholera, and international organizations sometimes go along with the fiction. Even when governments  do call cholera by its name and start inviting international help and expertise, the W.H.O. and Unicef are bureaucracies — and such invitations can come weeks after a widespread epidemic is under way.

A new partnership between two organizations that battle cholera will make it possible to get supplies and knowledge to cholera-stricken areas much faster. Early next month, AmeriCares, a United States-based  aid group that specializes in airlifting medical supplies into disaster zones, will finish assembling a group of pallets containing everything necessary to treat 15,000 cases of cholera.

AmeriCares says it can get those pallets from the assembly site in the Netherlands to anywhere in the world within 48 hours. The know-how will be brought — also at top speed — by doctors and nurses from the International Center for Diarrheal Disease Research, Bangladesh, the world’s leading cholera experts. 

Instead of waiting for an invitation from a government or international organization, the center will bring the medical help in right away, alongside AmeriCares. “Until now, we’ve waited for an invitation from the World Health Organization or Unicef or the local medical authorities to come in,” said Mark Pietroni, the center’s medical director. “That’s sometimes six weeks late.”

H5N1 controversy: The Hague wants new bird flu kept secret

Via Radio Netherlands Worldwide: The Hague wants new bird flu kept secret. Excerpt:

The Dutch government wants to block the publication of a controversial article on a deadly bird flu strain engineered by the Rotterdam Erasmus Medical Centre to prevent the information from falling into the hands of terrorists. 

Last week the US National Science Advisory Board for Biosecurity dropped its opposition to the publication of two articles that were to appear in two leading scientific journals, Science and Nature. Earlier this week, US scientists who conducted similar research announced their results at an international conference. The Dutch Economy Ministry first wants the Rotterdam researched to apply for an export permit. 

The Dutch research team, led by Ron Fouchier, caused controversy last year because it had developed a bird flu strain that could be transmitted by air. Though the lab research involved ferrets, the new strain could conceivably also infect people. Mr Fouchier described the virus as “probably one of the most dangerous viruses one can make.” Soon after Japanese-American researchers reached the same conclusion.

India: Dengue in Madurai

Via Deccan Chronicle: Dengue strikes again. Excerpt:

Dengue reared its ugly head again with news coming out on Friday of two people from Ramanathapuram allegedly dying of dengue last month, even as 12 patients, including five children, who tested positive for dengue were shifted from Srivilliputhur Government Hospital to the Government Rajaji Hospital (GRH) in Madurai. 

Doctors at GRH treating dengue-hit patients said there were two dengue related deaths, but both had gone unreported. “There were two deaths last month, one a woman of 25-30 years and a boy of about 10 years of age. They hailed from Ramanathapuram and were confirmed patients of dengue,” a doctor said requesting anonymity. 

The condition of the two three-year-old boys who were shifted to GRH on Thursday night and on Friday were being treated for dengue is stable. “The boys are well,” said Dr S. Balasubramaniam, deputy director of health services, Virudhunagar. 

With two more cases reported on Friday, the number of dengue-infected patients has reached 12 in one week. All the patients hailed from Indira Colony, T Managaseri village and Srivilliputhur in Virudhunagar district, he said. 

A medical team, comprising a health officer, five nurses and five health inspectors and an assistant was camping in the affected villages and monitoring the situation, Dr Balasubramaniam said. “There are about 330 households in the colony and the outbreak is confined only to that area till now,” he said. 

He said children with low immunity levels were the most vulnerable and needed to be given attention. Out of the 12 cases, five are children in the 0-5 years age group.

Vietnam: More on the HFMD outbreak

Via IRIN Asia: VIETNAM: Mild disease turns deadly for children. Excerpt: 

A dangerous strain of the typically non-lethal hand-foot-and-mouth disease (HFMD) has affected more than 21,000 persons - mostly children younger than five - killing 16 thus far in Vietnam, according to the Ministry of Health. 

“Despite being a benign viral infection in developed countries, the strain EV71 of HFMD is causing multiple deaths of children under five here in Asia. We are especially worried about South Vietnam, where lots of children are in informal [hygienically unregulated] crèches while their parents work,” Bhupinder Tomar, representative of the International Federation of Red Cross and Red Crescent Societies (IFRC) in Vietnam, told IRIN. 

HFMD’s symptoms are fever, sores in the mouth and blisters on the hands and feet. The disease spreads by direct contact with fluids from infected persons and there is no specific treatment. Most of the viruses that cause HFMD are benign, but EV71 can be fatal.

El Salvador: Dengue cases triple those in 2011

Via La Prensa Gráfica: Salud prevé un año epidémico por el dengue. [Health foresees an epidemic year for dengue] Excerpt, with my translation:

Los casos de dengue en el país se han triplicado este año respecto a 2011. El viceministro de Políticas de Salud, Eduardo Espinoza, fue directo en decir que las cifras no son nada alentadoras ya que hasta la semana epidemiológica 12 (que cerró el domingo pasado), el Ministerio de Salud ha confirmado 1,010 casos de dengue. En 2011, en el mismo período, se contaban 349. 

Dengue cases in the country have tripled this year compared to 2011. Eduardo Espinoza, vice-minister of health, was direct in saying that the numbers are not encouraging since as of epidemiological week 12 (which ended last Sunday), the Ministry of Health has confirmed 1,010 dengue cases. In 2011, 349 were counted in the same period.

A esto se suma que entre el 1.º y el 6 de abril se registraron 202 casos sospechosos de la enfermedad, transmitida por el zancudo Aedes aegypti. El año pasado, en las mismas fechas, se contabilizaron 57. 

In addition, between April 1 and 6 202 suspected cases were recorded. Last year, 57 were counted in the same period.

“Nos tiene un poco preocupados, porque apunta a que esto va a ser un año epidémico de dengue. Ya se tienen preparadas las jornadas nacionales contra la enfermedad”, dijo Espinoza. El funcionario afirmó que ya se realizan algunas jornadas focalizadas. 

"It has us a little worried, because it indicate that this is going to be an epidemic year for dengue," Espinoza said. "National campaigns against the disease are prepared." He added that local campaigns have already been carried out.

El viceministro dio a conocer que el 39% de los casos proviene de San Salvador, un 14% de Cabañas y un 11% de Cuscatlán. 

The vice-minister made it known that 39 per cent of the cases are in San Salvador, 14 per cent in Cabañas, and 11 per cent in Cascatlán.

Las estadísticas generales refieren a que las sospechas generales de dengue han ido en aumento. Hasta el domingo pasado, la Dirección de Vigilancia Sanitaria de Salud contabilizaba 4,677 casos sospechosos de dengue clásico y 270 de dengue hemorrágico.

The general statistics indicate that suspected dengue cases have increased. Up to last Sunday, the Directorate of Sanitary Surveillance counted 4,677 suspected cases of classic dengue and 270 of severe dengue.

Japan: Future Tokyo quake could shake high-rise buildings at twice speed of March 2011 temblor

Via The Mainichi: Future Tokyo quake could shake high-rise buildings at twice speed of March 2011 temblor. Excerpt:

Long-period ground motion generated by the Tokai, Tonankai and Nankai earthquakes that are predicted to jolt extensive areas of eastern, central and western Japan, will shake high-rise buildings around Tokyo at twice the speed of that seen in the March 11, 2011 temblor, researchers predict. 

Seismologists predict that these quakes, which are expected to be triggered by the Nankai Trough that lies south of Japan's main island of Honshu, will likely register magnitude 9 -- equal to the Great East Japan Earthquake. 

A subcommittee of the Architectural Institute of Japan analyzed data of the Great East Japan Earthquake on seismometers across the country and predicted how the Tokai, Tonankai and Nankai quakes will affect high-rise buildings. 

Long-period ground motion generated by last year's temblor shook high-rise buildings in Shinjuku and other areas of the Tokyo metropolitan region. However, violent motion with a cycle of 2 to 6 seconds was limited. Rather, much movement had a cycle of more than 6 seconds. 

The speed of ground motion, which serves as an index for the intensity of shaking, reached 20 to 50 centimeters per second, about half the speed that high-rise buildings must be designed to withstand under the Building Standard Law. 

The subcommittee examined data on 45 high-rise buildings, which it had obtained from their owners, and confirmed that they did not shake largely during the temblor. 

In comparison, the researchers with the subcommittee predict that the Tokai, Tonankai and Nankai earthquakes will generate a large amount of long-period ground motion with a cycle of 2 to 6 seconds and a speed of about 50 to 100 centimeters per second. In some areas, the speed exceeds what buildings are designed to withstand. Researchers point out that if such motion continues for more than 10 minutes, it could damage high-rise buildings' basic structure. 

Buildings that are at least 60 meters high -- equal to 20 stories -- are legally defined as high-rise buildings. Experts have pointed out that high-rise buildings are vulnerable to long-period ground motion, and the owners of many high-rise buildings have begun to reinforce them to withstand such motion. 

A seismic motion curbing system reduced the motion of the high-rise Shinjuku Center Building caused by the March 11 temblor by roughly 20 percent and halved the period of the shaking.

HFMD spreading in preschools in southern Vietnam

Via the Greater Mekong Subregion blog, a report from Saigon Giai Phong: HFMD spreading in preschools in southern Vietnam. Excerpt:

Ho Chi Minh City has reported 1,836 people infected with hand-foot-mouth disease and two deaths in the first three months of the year, said Dr. Le Minh Hung from the Department of Health. 

Dr. Hung was speaking at a meeting on April 4, to review the prevention of the disease in schools. He said that 35 per cent of the cases were reported in the 3 to 5-year-old age group, mostly pre-schoolers. 

Most of the children were living in the city’s suburban districts like Binh Tan, Binh Chanh, Thu Duc and Hoc Mon, said Dr. Hung. 

Nguyen Dac Tho, deputy director of the HCMC Preventive Health Centre, said it is a high risk factor that the disease is spreading among children in preschools. 

The Ministry of Health assessed that in the southern hub, the Mekong delta province of An Giang had the highest ratio of 451 infected children with four deaths in the first three months of the year. 

Ministry health officials revealed this figure at a meeting with the health department of An Giang Province. 

Medical workers also pointed out the reasons, such as late diagnosis and delayed treatment and a slow reaction to tackle cases by local medics.

Growing old with AIDS

Via Voice of America: Aging HIV/AIDS Survivors Create New Class of Patients. Click through for the full report and a video. Excerpt:

In sub-Saharan Africa, antiretroviral treatment (ART) has reduced the mortality rate among HIV-infected people by 20 percent. Many of the people receiving treatment who are now in their forties are expected to live well into their sixties. 

Dr. Till Barnighausen, of the Harvard School of Public Health, says there is a need to recognize this population and their unique health issues, issues which did not exist until recently. 

"We are now in a lucky situation that people infected with HIV in Africa and sub-Saharan Africa live to old ages," said Barnighausen.  "But with this prediction comes the challenge to prepare health and social systems to adequately respond to this new population, which will come into being over the coming decades." 

Dr. Barnighausen says these people will have special disease burdens, and their treatment will require special expertise.  For instance, new clinical trials are needed to learn whether antiretroviral treatments could interfere with drugs that HIV patients might be taking for other chronic conditions, such as diabetes and cardiovascular disease. 

"In old age this is really compounded by the fact that the physiology changes over the life course, by the fact that adherence to treatment might become reduced in older age. There are very specialized needs that have to be met in older patients," said Barnighausen. 

Dr. R. J. Simmonds is Vice President at Elizabeth Glaser Pediatric AIDS Foundation, a group committed to fighting HIV and AIDS specifically in women and children. He says the issue of aging has emerged as a new challenge of the HIV epidemic. 

"We are seeing that people are developing certain types of cancers at a higher rate - the combination of HIV and the treatment for HIV is leading to higher rates for diabetes, cardiovascular disease, Osteoporosis," Simmonds noted.

WHO confirms latest Cambodian H5N1 death

Thanks to Arkanoid Legent for sending the link to this April 5 WHO report: Avian influenza – situation in Cambodia – update. The story appeared here on April 2, but WHO for some reason was slow to confirm it.

The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus. 

The 6 year-old female from Kampong Chhnang Province developed symptoms on 22 March 2012. After initial treatment at the village, she was later admitted to hospital in Phnom Penh on 28 March. She died on 30 March. 

Infection with avian influenza A (H5N1) virus was confirmed by Institut Pasteur du Cambodge on 30 March. It was reported that the patient had contact with sick or dead poultry prior to onset of illness. 

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. In addition, a public health education campaign is being conducted to inform families on how to protect themselves from contracting avian influenza. 

To date, of the 20 cases reported in Cambodia since 2005, 18 have been fatal.