H5N1

Mexico: H7N3 outbreak now in 13 farms

Via El Universal: Suman 13 granjas con gripe aviar. [Farms with avian flu total 13] Excerpt, with my translation:

El Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria (Senasica) informó que de las 34 granjas que han sido inspeccionadas en Guanajuato, se ha detectado influenza aviar A-H7N3 en 13, todas de la empresa Bachoco. 

The National Service of Agroalimentary Health, Safety and Quality [Senasica] reports that of 34 poultry farms inspected in Guanajuato state, H7N3 avian flu has been detected in 13, all belonging to Bachoco.

Al dar un reporte del operativo implementado en el estado por el brote de gripe aviar, especificó que en total han sido vacunadas un millón 900 mil aves y han sido sacrificadas 735 mil 237. 

In a report on the operations implemented in the state because of the outbreak, Senasica said that 1.9 million birds have been vaccinated and 735,237 have been culled.

Añadió que hasta el momento se han analizado 2 mil 700 muestras de laboratorio para constatar o descartar la presencia de la enfermedad en las granjas supervisadas, de las cuales 21 están libres del virus. 

It added that at the moment 2,700 lab tests are under way to confirm or deny the presence of the disease in the supervised farms, of which 21 are free of the virus.

El Senasica explicó que, así como lo señaló el titular de la Sagarpa, Enrique Martínez, el virus se mantiene contenido en las granjas de Bachoco. 

Senasica said that as stated by the head of Sagarpa, Enrique Martínez, the virus remains contained in the farms owned by Bachoco.

Añadió que ayer se enviaron a la región 20 millones de vacunas —adicionales al millón 900 ya utilizadas— para aplicarse como medida preventiva.

It added that yesterday 20 million vaccine doses were sent to the region, in addition to the 1.9 million already used, as a measure of prevention.

If you read Spanish, you may want to check Bachoco's website for its avian flu FAQs. This is a big company, with 800 poultry farms across Mexico, and it seems to handling the crisis communications challenge pretty well.

Nigeria: Radio station licence suspended over polio killings

Via allAfrica.com, a Vanguard report: Nigeria: Polio Killings - NBC Suspends Wazobia FM Licence. Excerpt:

No fewer than 16 Journalists with Wazobia FM station in Kano may have lost their job following the withdrawal of the station's broadcast license by the Nigeria Broadcast Commission, yesterday. 

Vanguard gathered that the affected staff includes 9 presenters and 6 newsroom staff. 

Wazobia FM Kano ran into trouble waters when it aired a controversial programme "Sanda Girma" that the authorities claimed instigated the populace against polio vaccination and led to killings in the ancient city. 

The presenter of the programme, Yakubu Musa, and Malam Mubaraq, a news room staff are standing trial over their alleged role in the saga.

But no word on catching the actual killers.

Cholera in Cuba: From Kathmandu to Havana

Via Havana Times.org, a very good article on the subject: Cholera in Cuba: From Kathmandu to Havana. The author is an American medical student at Cuba's Latin American School of Medicine, and working at Salvador Allende Hospital in Havana's Cerro district. Excerpt from a long, informative report:

It probably came from Nepal, via Haiti. The United States Center for Disease Control says the current strain of cholera ravaging Haiti, Cuba’s neighbors to the east, came from United Nations troops from Nepal. The Nepalese troops, like most people in Haiti, let their human waste drain into a river (the Artibonite) where it flourished and spread throughout the countless mountain streams in the western half of Hispaniola. 

Then one day someone, maybe a doctor, student, tourist or fisherman, brought the disease to Cuba. It is a story as old as the arrival of Columbus. New world, meet old world. Play nice. 

In December we heard about Cholera in eastern Cuba. The government didn’t say anything at first. Then they said there were some cases, and a few deaths, but everything was under control. 

Interestingly before Cholera ever arrived to Cuba it had arrived various times to the Dominican Republic, Venezuela, and Miami (which, geographically, happens to be in the United States of America). 

Cuba probably avoided being in the early group of recipients due to travel restrictions of individual Cubans (which changed January 14th), and the “National Epidemiological Control Program” which places doctors and most foreign medical students in a 5-14 day quarantine after arriving to Cuba from abroad. 

Of course I could be off base, and maybe the Cholera in Cuba came from an indigenous reservoir. Or maybe it was an act of bioterroism. But both of these ideas are more ridiculous than probable. 

So while Cholera made its debut in Eastern Cuba the residents of La Havana talked about yet another problem coming from “el oriente”. 

Cholera’s arrival to La Havana probably happened around the First of January, the biggest travel holiday for Cubans. Someone traveled from the eastern end of the island to the Capital and they brought Cholera to La Havana. 

I heard about the first suspected cases the second weekend of January. I say “suspected cases” because the confirmatory diagnosis of the disease is done at the Institute of Tropical Medicine in Municipio Playa, where all patients were quickly transferred too. 

Anyway, the word on the street, and in the hospital hallways, was that these early cases all originated in Cerro. This is the same neighborhood where I live and where the hospital I work at, Hospital Salvador Allende, is located.

Hong Kong: Health chief responds to virus fears

I love the Hong Kong health department because its people are so fussy, and they want their clients to know everything except maybe who washes the test tubes. This new post on the government website is an example: Health chief responds to virus fears. Excerpt:

Secretary for Food & Health Dr Ko Wing-man has reassured the public the Government will be transparent, as fears are aroused over Severe Respiratory Disease associated with Novel Coronavirus.   

Dr Ko told the media today whenever there is a suspected case, particularly patients with a travel history to the Middle East who need to perform a rapid test, the Government will release information to the public as soon as possible.   

Yesterday, frontline staff were on heightened alert when a patient who had travelled to the Middle East was admitted to a public hospital with fever and symptoms of upper respiratory infection. He tested positive for influenza B, but negative for Novel Coronavirus.   

Dr Ko said they are observing the patient and may repeat the test.   

On rumours of new cases of the virus, he said there were at least two incidents where rumours were proven untrue. Such rumours will not affect the health care system, he added.

US: The impact of sequestration on Americans' health

The elected representatives of the United States are about to do medicine on a nationwide, even global scale: In fact, by allowing sequestration to impose enormous spending cuts on March 1, the politicians will be committing malpractice—forcing the shutdown of critically important public-health, surveillance, and research programs.

A report by Research!America, Sequestration: Health Research at the Breaking Point, details the expected impact. Click through to download the complete report as a PDF. Among the consequences of a 7.8 per cent sequester cut:

$2.39 billion from the National Institutes of Health, as much as the NIH spent in 2011 on hundreds of rare and common diseases including West Nile virus, hepatitis A and B, and cerebral palsy.

$445 million from the CDC, more than the $426 million CDC spent in 2011 on its immunization grant program, which support reduction of vaccine-preventable disease and infrastructure for dissemination, surveillance, and outbreak control.

$538 milion from the National Science Foundation, almost 75 per cent of the NSF 2011 budget for all research in biological sciences. 

The 7th NCoV death: A Saudi report

Via the Saudi Gazette: New Saudi case takes coronavirus death toll to seven. Excerpt:

An old woman admitted to a hospital in Riyadh with a new virus from the same family as SARS has died, taking the global death toll from the previously unknown disease to seven. 

The Saudi health ministry informed the World Health Organization (WHO) that the patient was hospitalized on Jan. 29 and died on Feb.10, WHO said in a statement. 

A laboratory confirmed on Feb. 18 that the person had died from the so-called novel coronavirus, or NCoV, it added. 

This brings to 13 the number of cases of the virus that have so far been reported to WHO since it was first detected in the middle of last year, with six previous fatalities – three in Saudi Arabia, two in Jordan and one in Britain. 

Undersecretary of the Ministry of Health for Public Health Dr. Ziyad Meimish reassured the public that there was no cause for concern, as the death of the woman was an individual case. 

He said that a prevention plan is being carried out by the Ministry of Health for coronavirus and all influenza viruses in the Kingdom. 

The news comes just days after a person suffering from the virus died in hospital in central England Sunday. 

That patient, who had a pre-existing health condition, was one of three people in the same family with the virus, which appeared to have been caught by one of the family members during a recent visit to the Middle East and Pakistan.

Haiti: The legality of Article 29

Via the blog Opinio Juris: UN Flatly Rejects Haiti Cholera Claim. Click through to read a very interesting post. Excerpt:

Section 29 of the Convention on Privileges and Immunities of the UN requires the United Nations to “make provisions for appropriate modes of settlement of […] disputes arising out of contracts or other disputes of a private law character to which the United Nations is a party”. 

This provision mitigates the absolute de facto immunity of the United Nations, and August Reinisch has argued that the rationale of Section 29 is to ensure due process of law and to protect fundamental human rights. 

The UN’s position appears to be that the cholera claim is in the nature of a public (rather than a private law claim cognizable under Section 29) due to the political and policy issues it raises.   Nonetheless, there is no explanation in the letter itself as to why this should be considered a public law dispute. 

One key element of a public law claim would presumably be that the dispute arises between a state and the UN, but in this case it is absent because Haiti expressly elected not to participate in this dispute.  Perhaps another rationale is that the claim involves public law because the cholera outbreak arose pursuant to a Status of Forces Agreement with Haiti. 

Many elements of a “dispute of a private law character”, however, would appear to be present: the claim itself was essentially one of tort, the claimants were private individuals (represented by an NGO), and the remedy sought was monetary compensation.   This distinction clearly troubled the claimants lawyers as well, as their press release makes clear.

Haiti Libre has a story about the UN decision, but it's just the MINUSTAH press release. LeNouvelliste has the release also, in French. The report in AlterPresse is in French but Google will translate it fairly well. Inter Press Service News Agency says: UN lambasted for denying compensation to Haiti's cholera victims, but the "lambasting" is mostly the lamenting of the lawyers promoting the case against the UN. Unsurprisingly, MSPP has nothing about the UN on its website.

US: Radioactive waste leaking from (at least) 6 tanks at Washington state nuclear site

Via Reuters: Radioactive waste leaking from 6 tanks at Washington state nuclear site. Excerpt:

Six underground storage tanks at the Hanford Nuclear Reservation along the Columbia River in Washington state were recently found to be leaking radioactive waste, but there is no immediate risk to human health, state and federal officials said on Friday. 

The seeping waste adds to decades of soil contamination caused by leaking storage tanks at Hanford in the past and threatens to further taint groundwater below the site but poses no near-term danger of polluting the Columbia River, officials said. 

The newly discovered leaks were revealed by Governor Jay Inslee at a news conference a week after the U.S. Energy Department disclosed that radioactive waste was found to be escaping from one tank at Hanford. 

Inslee said he was informed on Friday by outgoing U.S. Energy Secretary Steven Chu that a total of six of the aging, single-walled tanks were leaking radioactive waste. 

"There is no immediate or near-term health risk associated with these newly discovered leaks, which are more than 5 miles from the Columbia River," Inslee said in a statement released by his office. "But nonetheless this is disturbing news for all Washingtonians." 

The governor said Chu told him that his department initially missed the other five leaking tanks because staff there did not adequately analyze data. 

"This certainly raises serious questions about the integrity of all 149 single-shell tanks with radioactive liquid and sludge at Hanford," he said.

Washington's next-door neighbours here in British Columbia won't be too thrilled about this either.

UK: Still just 3 NCoV cases, not 4

Via ProMED-mail, an email from Dr. Nick Phin of the Health Protection Agency, responding to a report I linked to here on February 21:

In relation to the above post, we would like to confirm that the HPA is not currently investigating any 4th possible case associated with the UK cluster of novel coronavirus. The latest clinical update from the HPA was published on Tuesday [19 Feb 2013] and the whole genome sequence of the 2nd UK case of coronavirus was published on Thursday [21 Feb 2013].

Yours faithfully,

Professor Nick Phin, Consultant Epidemiologist

Haiti: High tech versus cholera

Via PAHO's Haiti page (not its moribund Hispaniola cholera page): Information System via SMS. Excerpt:

SYMO is an information transmission system that streamlines geographically dispersed data into a single management center. The technology can be used even where Internet may not be working or where there are connection problems. Previously encoded SMS messages transmit information from the field to a central post where it automatically undertakes the following. 

• Evaluates content consistency, notifying the sender via SMS of any error 

• Sets up an alert when the value of the parameter being monitored exceeds the predefined alarm level 

• Stores in a database the information received. Historical reports, statistics can be subsequently performed etc. 

Success stories have been: 

• Monitoring of water quality through the residual chlorine in Dominican Republic and Haiti. An alert is sent when it detects that it is 0 mg/liter. The system automatically notifies operators and health officials via SMS and email. 

• Surveillance of cholera cases (hospitalizations and deaths) in Haiti, such that each day the number of cases and deaths in all the communities are reported from across the country - including from those with difficult access where information has not been readily available.

So the question arises: If a daily tally of hospitalizations and deaths is coming in from all over the country, including the mysteriously silent department of Grande Anse, why doesn't MSPP post a routine, complete, daily update on its Documentation page?

And another question: How many people in Haiti and the Dominican Republic have access to chlorinated water even at the best of times?