H5N1

Coston's mini-course on NDM-1

Mike Coston at Avian Flu Diary is a master of the mini-course post, in which he brings us up to speed on a given topic with a detailed and well-documented discussion. Here's his latest: NDM-1: A Matter Of Import. Excerpt:

Short of seeing an extremely high mortality influenza pandemic, I can think of no looming medical crisis more dire than the growing threat of antimicrobial resistance. The World Health Organization, the ECDC, and the CDC all consider the spread of antibiotic resistant organisms to be an extremely urgent public health concern.

Go read it. 

Zimbabwe: Nearly 89,000 HIV+ children fail to access ARVs

Via The Herald Online: Nearly 89 000 children fail to access ARVs. Excerpt:

More than half of the children living with HIV and Aids are failing to access anti-retroviral drugs despite the pediatric formulations being available, senior health officials have said. 

About 150 000 children between the ages of 0 and 14 years are HIV-positive and of these, nearly 89 000 who are in need of the drugs are failing to access them. 

National Prevention of Mother to Child Transmission and Pediatric HIV Care and Treatment Co-ordinator in the Ministry of Health and Child Welfare Dr Angela Mushavi said only 45 percent of HIV-positive children in need of the drugs were on ARVs. 

Dr Mushavi was speaking on the sidelines of a capacity building workshop for journalists reporting on pediatric infections organised by the Elizabeth Glaser Pediatric Aids Foundation. 

“Uptake is still very low. We are not putting enough numbers of children on ARVs,” Dr Mushavi said. 

She attributed the low uptake to inadequate officials initiating anti-retroviral therapy and the centralisation of laboratories, among other reasons. 

In Zimbabwe, a special test, which detects the presence of the virus in children is only done in Harare at the National Microbiology Reference Laboratory and initiation of ARVs is only done by doctors. 

Dr Mushavi said Government was in the process of decentralising and was looking forward to opening laboratories in Bulawayo and Mutare. 

“When we started in 2007, there were few samples and it was okay to operate with just one laboratory, but now more and more samples are coming in.

“More than 1 000 sites countrywide are sending samples to the laboratory hence the long waiting periods before results are sent back to their site.” 

It takes about a month for the laboratory to send back results to their original site.

Uganda: Families of 300 nodding disease children receive support

Via New Vision: Families of 300 nodding children receive support. Excerpt:

Over 300 nodding disease children in northern Uganda have received humanitarian aid to alleviate their plight. Parents of the affected children received the items from health centres where their children have been admitted and at their homes.   

A caravan of humanitarian aid spearheaded by Uganda Women’s Network distributed items in the districts of Gulu, Pader, Lamwo and Kitgum for the suffering families.   

The items were purchased by women rights activists in support of the affected children with nodding syndrome and their families. 

“We were prompted to raise funds for victims of nodding disease since they were mainly children and their mothers taking care of them needed support,” Betty Kugonza, the support officer of human rights unit of Action Aid Uganda said.   

The items worth sh20m [US$8,000] included beans, sugar, posho, soya, clothes and soap. Dr. Francis Okumu a senior medical superintendent of Padibe Health Centre IV said the affected children needed nutrition supplements and the humanitarian aid came in time.   

Okumu said families affected by the nodding syndrome can’t afford nutrition supplements because they are expensive and the parents don’t have any source of income.   

Lillian Jane Adee the in charge of Palbek Kal Health Centre III pointed out that the affected children were in dire need of food supplements because government’s ratio doesn’t come in time.   

“The affected families are each given four Kilograms of posho and beans to last two weeks and this is not adequate,” Adee said. Rose Ober a mother to four-year-old affected child thanked women rights activists for the support.

India: Nine more encephalitis deaths in Bihar

Via The Bihar Times: Encephalitis claims 9 more lives in Bihar, toll now 159. Excerpt:

Nine more children have died of acute encephalitis syndrome (AES) in Bihar's Gaya, Muzaffarpur and Patna districts, taking the state's toll from the disease to 159 in the last three weeks, officials said here Saturday. 

"Fresh AES cases have been reported from all the 10 identified districts where the disease has spread," a health department official here said. 

Additional Secretary (Health) R.P. Ojha said that of the 409 children detected with AES symptoms, 159 have died and 82 others have been admitted to various hospitals in the state. The rest have been discharged after treatment. 

According to health officials, AES, a mosquito-borne disease, has claimed lives of 100 children in Muzaffarpur district alone - the highest figure in the state. Most of these children died at the Sri Krishna Memorial College and Hospital and the Kejriwal Charitable Hospital. 

As many as 47 children have died at the Patna Medical College Hospital (PMCH) and 12 at Gaya's Anugrah Narain Medical College Hospital. 

Alarmed by the situation, state Health Minister Ashwani Kumar Choubey has asked the striking junior doctors of the PMCH to resume work. 

"We have cancelled leaves of doctors in the all the affected districts and alerted hospitals to provide prompt treatment," Choubey said. 

A team from New Delhi is in Muzaffarpur, around 75 km from here, to help contain the fatal viral disease.

This seems like a dramatic increase in deaths. On June 7 I posted a report saying the death total was just 36.

Sri Lanka: Sharp rise in dengue cases

Via ColomboPage.com: Sharp rise in dengue cases prompts emergency meeting of Sri Lankan health officials. Excerpt:

Sri Lanka's Minister of Health Maithripala Sirisena has called an emergency meeting of the Presidential Task Force on Dengue Prevention to address the sharp rise in the dengue cases and deaths in the country. 

A meeting of the health officials will be held on Monday to probe the causes for the sudden increase in dengue cases to determine whether there were any lapses in the preventive measures adapted by the health ministry to control the spread of the disease recently. 

The secretaries of the 12 ministries of the Task Force and the officials of those ministries are called to attend the meeting. The officials are to consider on the need to include various sectors to the task force to combat the spread of the disease, the state-run radio SLBC reported. 

According to the Epidemiology Unit figures so far in the year there have been 12,165 dengue cases and 65 deaths from the disease. Out of the 65 deaths, 25 have been reported from Colombo district, the most populated district in the country. 

Country's hospitals, especially the National Children Hospital in Colombo, have been overcrowded recently with hundreds of dengue patients every day. 

The resurgence of the mosquito-borne menace has made the Health Ministry to warn the public of an impending epidemic stage at the end of the month.

Japan nuclear restart gets PM's approval

Via The Guardian: Japan nuclear restart gets PM's approval. Excerpt:

Japan is to resume the use of nuclear power for the first time since last year's triple meltdown at Fukushima Daiichi power plant after the government on Saturday approved the restart of two idled reactors. 

The decision to restart reactors three and four at Oi power plant in western Japan could pave the way for the resumption of operations at other atomic facilities, amid concern over power shortages during peak demand this summer. 

The prime minister, Yoshihiko Noda, announced the restart after securing support from the mayor of Oi and the governor of Fukui prefecture, where Oi is located. 

"Having won local consent, reactivating [the reactors] is now the government's final decision," Noda said. "We are determined to make further efforts to restore people's trust in nuclear policy and safety regulations." 

Japan's last working reactor was turned off in early May, leaving it without nuclear power for the first time in more than 40 years. 

Four reactors at Fukushima Daiichi were destroyed by the 11 March 2011 tsunami and another 50 around the country were taken offline for regular maintenance. Oi is the first plant to pass simulation "stress tests" introduced last year to address public concern over safety. 

Noda has pushed hard for the Oi restart under pressure from the powerful business lobby, which feared disruption to manufacturers. He was expected to give approval after the mayor of Oi, Shinobu Tokioka, gave his backing to the move earlier this week. 

Tokioka said nuclear safety experts had convinced him the plant could withstand a natural catastrophe similar to the one that struck Fukushima Daiichi. 

He added that he was concerned about the effect prolonged closure would have on the local economy and the prospect of power shortages in the Kansai region of western Japan, home to 24 million people and with an economy the size of Australia's. 

About 10,000 demonstrators gathered outside Noda's office on Friday night in last-ditch attempt to derail the restart. Anti-nuclear campaigners accused the prime minister of rushing into a decision and ignoring lingering concerns over safety. 

"Prime minister Noda's rushed, dangerous approval of the Oi nuclear power plant restart ignores expert safety advice and public outcry, and needlessly risks the health of Japan's environment, its people and its economy," said Junichi Sato, executive director of Greenpeace Japan.

Haiti: Cholera and red tape

Via AlterPresse.org: Haiti-Cholera: The epidemiological surveillance system in failure, according to MSF. I linked to this report yesterday, but missed some important information at the end of the story. From an edited Google translation:

For its part, the MSF Head of Mission in Haiti, Thierry Goffeau, indicates in a brief report that since the beginning of the year 2012, 9,800 patients were treated at Port-au-Prince and in Leogane in cholera MSF cholera treatment centers (CTC). 

Between 17 and 22 May, a period that corresponds to the peak of cholera this year in Port-au-Prince, MSF has treated 72% of the cases. 

The latest report from the Department of Public Health and Population (MSPP) reported more than 7,000 dead (7, 260 people died of cholera) in the country between October 18, 2010 and June 10, 2012. 

"In May 2012, we have already sounded the alarm about the lack of support from the international community and preparedness activities of Haitian health authorities," says Goffeau, who says he noticed the red tape of state especially in the department of Artibonite that caused an explosive situation.  

"A number of cholera treatment centers in distress [in Artibonite] are under threat of closure or strike following the non-payment of wages to employees," he said. 

"The money is there but not disbursed," says Goffeau. He said the situation had a direct impact on the population by causing the deaths of several patients because of a lack of support.

So the MSPP is still not meeting its payrolls. And if the money is indeed there but not being paid to those who've earned it, the MSPP is part of the problem.

India: Dengue spreading to new areas

Via The Hindu, a report from Thiruvananthapuram: Dengue spreading to new areas. Excerpt:

Intermittent rain is threatening to take the dengue fever case load in the district to explosive proportions as short spells of rain followed by sunny days are very conducive to the breeding of Aedes aegypti mosquitoes, the vector primarily responsible for transmitting dengue fever in urban areas. 

Heavy rainfall will wash away the breeding grounds of the vectors and reduce the vector density, while intermittent rain will give time for the vectors to lay eggs, which will hatch out in the sun, entomologists point out. 

State Health officials are dogged by another worry—the alarming manner in which dengue fever cases have been spreading into new geographic terrains. 

Till two days ago, more than 70 per cent of the cases in the district were being reported from areas within the city Corporation limits. But now more and more cases are being reported from the suburbs. 

Of the 14 confirmed cases of dengue reported on Friday in the district, all, except four, cases are from the rural areas and that too the Vilappil block. 

SPECIAL ALERT 

A special alert has been sounded in Vilappil block for health workers to intensify source reduction and other control measures as the 10 dengue cases were reported from Balaramapuram, Pallichal, Maranellore, Malayinkeezh and Kalliyoor, all under Vilappil block. 

SUSPECTED CASES 

Apart from the confirmed cases, 22 suspected cases of dengue have also been reported from various parts of the district. 

As many as 1,293 new fever cases were reported from the district on Friday. 

A total of 175 suspected cases and 140 confirmed cases of dengue have been reported from the district so far this June.

Six diseases you don't know enough about

The Tyee has published my article Six Diseases You Don't Know Enough About: polio, cholera, dengue, Chagas, nodding disease, and the still-mysterious Quang Ngai skin disease. The introduction:

After 20 years of the World Wide Web, we who use it remain largely parochial in our interests. Unless we're looking for a cheap resort in the Caribbean or the lowest airfare to Bangkok, we don't seem interested in exploring the rest of the world. 

That same ease of travel, however, has brought other countries' illnesses right to our doorsteps. As I've seen on my blog H5N1, much of the world is fighting diseases that we've rarely heard of -- and that we don't want to think about. 

But we should be aware of them. Some could well turn up in Canada the way SARS did in 2003. Others pose serious social and political problems in their host countries that we may have to deal with through foreign aid or even military involvement. 

So here is a list of diseases that the rest of the world knows all too well, from the very common to one that doesn't even have a name yet.

CIDRAP: WHO report sums up Northern Hemisphere flu season

Via CIDRAP, Lisa Schnirring writes: WHO report sums up Northern Hemisphere flu season. Click through for the full report and links. Excerpt:

The 2011-12 flu season in most temperate countries of the Northern Hemisphere started later than usual, except for North Africa, and was mild in many countries, the World Health Organization (WHO) said today in a wrap-up report. 

The circulating flu strains varied widely by country and even by region, according to WHO report, which appeared in its Weekly Epidemiological Record. For example, in North America, the 2009 H1N1 virus predominated in Mexico, with H3N2 dominating in the United States, and influenza B taking the lead in most parts of Canada. 

In temperate parts of Asia, influenza B peaked first in China and Mongolia, followed by a rise in H3N2 activity later in the season. The reverse pattern was seen in South Korea and Japan. 

Many countries saw doctors' visits for flulike illness at or below last season's levels, but Japan reported its highest number of confirmed flu cases since 2002, except for during the 2009 pandemic period, the WHO report said.