H5N1

Saudi Arabia: Jeddah doctors resign over MERS scare

Via the Saudi Gazette, a report evidently written before today's new cases were announced: Doctors resign over coronavirus scare. Excerpt:

At least four consultant doctors at Jeddah’s King Fahd Hospital have resigned this week following their reported refusal to treat people affected by MERS coronavirus, a section of the Arabic press reported on Tuesday. 

A consultant female internist on Monday tendered her resignation to the hospital’s director, according a report in Makkah newspaper. 

The hospital director sent a letter to the director of Health Affairs in Jeddah in which he asked to take ‘appropriate action’ on the resignation of the doctor from the Ministry of Health service. He noted that the doctor’s resignation follows her refusal to treat coronavirus affected patients. 

Medical sources at the hospital said that three consultant doctors have also resigned from the hospital for the same reason during the last three days.     

A foreigner has died from MERS in Jeddah, where authorities have sought to calm fears over the spreading respiratory illness, the Health Ministry said on Monday. 

The death of the 70-year-old man brought the toll of the Middle East Respiratory Syndrome in the Kingdom to 69 fatalities. 

Four new cases of infection were registered, bringing the Kingdom’s total to 194, the ministry said.

The current numbers are 205 cases and 71 deaths. Under the circumstances, the doctors may be right to refuse treat patients when infection control is manifestly inadequate.

Saudi Arabia: Official statement on six new MERS cases in Jeddah

Via the KSA MOH MERS page: Health: Registration 6 cases of infection (Corona) new in Jeddah. The Google translation:

In the context of the work of epidemiological investigation and ongoing follow-up carried out by the Ministry of Health for the virus, "Corona" that causes Acquired Middle East respiratory MERS CoV Ministry announces the registration of six cases of HIV infection in Jeddah.  

first citizen at the age of 54 years, and receiving treatment intensive care. 

and the second citizen of the age of 52 years old, has passed away, may he rest in peace. 

third of a resident at the age of 41 years old, and his condition is stable. 

fourth of a resident at the age of 54 years, and his condition is stable. 

fifth citizen working field of health, and at the age of 28 years, and his condition is stable. 

sixth resident works for the health field, and at the age of 35 years old, and his condition is stable. 

were examined 200 samples, have demonstrated passivity, except as noted above.

The Saudi tally is now 205 cases and 71 deaths. We continue to see healthcare workers among the cases, which says something about infection control in Jeddah. I just hope the Saudis are telling WHO more about these cases than these detail-free statement, and that at least one of the cases can be traced to a distinct non-human source.

April 16, 2014: MERS breaks out

I got an email from Mike Coston at Avian Flu this morning that woke me up with no need for coffee: MERS in the last few hours has turned up in Malaysia and the Philippines, while 6 new cases are reported in Jeddah, Saudi Arabia: 

Here are Mike's posts: Malaysian MOH Statement On Imported (Fatal) Case Of MERS-CoV.

Philippines Quarantines Asymptomatic MERS Case & Contacts

Jeddah MERS Cluster Grows by 6 More Cases

On top of that, Mike has a post on WHO's new update on the UAE MERS cluster, plus a referral to Dr. Ian Mackay's latest analysis of MERS cases. 

This is going to be one of those days.

Yemen: Don't worry about MERS (updated and corrected)

Via Al Thawra, which broke the news of Yemen's first MERS case: Health: no fear of discovery of a case infected with crowns. Excerpt from a Google translation:

The Ministry of Public Health and Population. The discovery of the infected crowns in Yemen no reason to fear and anxiety. 

An official source at the ministry, "The Ministry of Public Health and Population are in continuous coordination with the World Health Organization and the countries that emerged where HIV infections mentioned to complete the Supported by the organization in such conditions, which are implemented in any country discovers the cases of infected crowns." 

source also confirmed that the national network of disease surveillance and epidemiology of the Ministry of Health on a high level of vigilance and operating in accordance with the mechanisms and scientific plans internationally accredited .. reassuring citizens that there is no reason to worry.

It goes on like that for two more paragraphs, but not a word about the present state of that MERS patient.

Update and correction: In searching other Yemeni media, I found an April 13 report in Yemeni Post, an English-language paper, saying that the man had already died. If true, this fact was unmentioned in other early reports on the case.

Chile: Government's new tally in Valparaíso: 12,500 homeless

Via BioBioChile: Gobierno entrega nuevo balance post incendio en Valparaíso: Suben a 12.500 los damnificados.[After the fire, government delivers a new tally: 12,500 homeless] The full report, with my translation:

Un nuevo reporte sobre la tragedia que afecta a la ciudad de Valparaíso entregó esta noche el Gobierno de Chile. 

The government of Chile tonight delivered a new report on the tragedy afflicting the city of Valparaíso.

Desde la Intendencia Regional de la comuna porteña, fue el ministro del Interior, Rodrigo Peñailillo, el encargado de difundir el detalle de los afectados. 

From the city's Regional Intendency, Interior Minister Rodrigo Peñalillo was the person in charge of disseminating the details about those affected.

En este sentido, el secretario de Estado reveló que la cifra de los damnificados, es decir las personas que perdieron todo con el incendio, subió a 12.500 aproximadamente. 

The minister revealed that the total number of homeless, persons who lost everything in the fire, has risen to about 12,500.

Lo anterior, ya que las casas completamente siniestradas -por ahora- suman más de 2.900 en 1.090 hectáreas. 

For now, the number of houses completely destroyed is over 2,900 distributed over 1,090 hectares.

Además, Peñailillo confirmó que cerca de 1.200 vecinos del puerto se encuentran pernoctando en los 9 albergues establecidos. 

As well, Peñalillo confirmed that about 1,200 resident are now living in the 9 established hostels.

Junto con destacar el trabajo de voluntarios y las fuerzas de orden del país, la autoridad explicó que durante la jornada se inició con éxito la labor de remoción de escombros. 

As well as highighting the work of volunteers and the country's forces of order, he said the the work of removing debris had begun successfully during the day.

“Todos han visto como nuestros compatriotas han enfrentado con entereza dos grandes emergencias, ambas muy lamentables”, dijo Peñailillo, quien agregó que se espera para este miércoles el “control total de la emergencia”. 

"Everyone has seen how our compatriots have fully confronted two great emergencies, both regrettable," said Peñalillo, who added that he hopes to see "total control of the emergency" on Wednesday.

Finalmente, el ministro informó que a contar del jueves 17 y hasta el domingo 20 del presente mes se llevará a cabo una restricción vehicular en todo Valparaíso, para permitir un mejor acceso de los vehículos de emergencia y de ayuda a las zonas afectadas.

Finally, the minister said that from Thursday April 17 to Sunday April 20 a ban on vehicles will be in force in all of Valparaíso to permit better access for emergency and aid vehicles in the affected zones.

If only 10% of the homeless are in government hostels, the rest have either left the city or (more likely) moved in with friends and family. The overcrowding is likely to be serious, and a public health concern.

Guinea: WHO reports on Ebola survivors

WHO has published Surviving a deadly virus – some in Guinea have recovered from Ebola. Excerpt:

When Abdullah D. saw a doctor in the hospital close to his home in Conakry in late March 2014, he had high fever, headaches and felt very weak. The doctor immediately called in the infectious disease experts who arranged for Abdullah to be admitted to the country’s isolation facility at Donka, one of the biggest hospitals in the Guinean capital Conakry. When a laboratory test confirmed that Abdullah was infected with Ebola, he was devastated. 

"I spent 10 days in the isolation ward,” says the 29-year-old father of twins who works as a retailer in the Guinean capital. “I was convinced that I would never again see my wife and kids.” 

Abdullah was cared for by specialists from the Guinean Ministry of Health supported by doctors and nurses from Médecins Sans Frontières (MSF) and WHO, who are working together to run the isolation ward at Donka Teaching Hospital.  

Good care of Ebola patients improves odds of survival 

"Abdullah was very weak and unwell when he first arrived at Donka," says Dr Tom Fletcher, a WHO infectious disease expert who came to Guinea to help with the outbreak response. "I wasn’t sure he would survive. But his case shows that the care people are getting in the isolation ward is crucial and improves their odds of survival." 

There is neither a vaccine nor a specific treatment for Ebola virus disease. People who are severely ill with the disease require intensive medical support including oral rehydration salts or an intravenous drip for extra fluids, antimicrobial medicines, pain killers and nutritious food. The earlier they go to hospital and get appropriate care the higher their chance of survival. 

By 14 April 2014, more than 100 people had been confirmed or suspected of having contracted Ebola in Guinea and more than half had died. But to-date, 9 patients who were admitted to this hospital have recovered and returned home in good health. 

Overcoming stigma 

But recovery is not always the end of the battle for former Ebola patients. Many find it difficult to be accepted by their neighbours who are fearful of the disease. 

Fanta S., a 24-year-old teacher from Conakry, who returned home after laboratory tests showed she was no longer infected with Ebola, felt the stigma of the disease. 

“Many people were shocked to see me alive and looked at me as if they were seeing a ghost,” she said during a check-up at hospital a few days after her release. “My family supported me, but I closed myself up in my room and cried for two hours.” She is still not sure when she will be allowed back at work. 

Doctors and nurses at Donka fought for Abdullah’s life for 5 days. Finally, his condition improved and his fever went down. When he had gone a couple of days without any symptoms including fever, diarrhoea, vomiting or bleeding, they took a new blood sample. 

Abdullah waited impatiently for the results and was incredibly pleased and relieved when he heard that the sample was negative. 

“I felt as if I was reborn and could not wait to hug my twins again,” he says. “The doctors really took great care of me and I’m telling everyone that people who are infected need to go to the hospital.”

I don't understand the stigma attached to Ebola survivors. They are among the toughest and luckiest people on the planet. Rather than being of catching sickness from them, people should be touching them (gently) to pick up their luck and strength.

UAE: MERS poses no threat to public health, say health officials

Via Khaleej Times: Mers poses no threat to public health, say health officials. Excerpt:

Health officials on Tuesday reassured residents that the Mers virus does not pose a danger to public health after it emerged that three more people have been infected in the capital. The three may have been in contact with others who carried the virus but they showed no symptoms at all, said the Health Authority-Abu Dhabi (Haad). 

Saudi Arabia is also urging its citizens to stay calm after it reported 16 cases over the past nine days, including two deaths. 

Patients showing no symptoms rid themselves of the virus  within a fortnight, but are quarantined in hospital in the UAE. 

Speaking to Khaleej Times, Dr Abdulaziz N. Alagaili, director of the Mammals Research Chair at King Saud University, who co-authored a study with Dr. Thomas Briese in February, which proved the existence of the virus in camels in Saudi Arabia for 20 years, said whether the Mers virus circulates in camels for many years or just recently has no impact on the safety of meat or other camel products. 

“The only place in camels where we know for sure that the virus is present is in the nasal secretion of infected animals (and probably also in saliva). Thus, this can serve as a source of contamination by which other camel products can be tainted. Cooked meat is not considered dangerous,” the scientists said. 

They said no information is available on the safety of camel’s milk, but person-to-person transmission is not unexpected. “However, health care personnel in the UAE and elsewhere should be trained and wear appropriate personal protection equipment to avoid such preventable exposures,” said the authors of the study. The results showed an estimated three-quarters of camels in Saudi Arabia had evidence of Mers infection. It confirmed that camel-to-human transmission is possible, a link which could help control the spread of the disease. 

“We have currently no indication of virus spread from camels to other animal species, including rodents, but this possibility cannot be excluded,” they said. 

Meanwhile, the Saudi health ministry has sent text messages to the country’s 30 million residents to check its website. People have been asked to call a free hotline and check its official Twitter account for updates on the coronavirus. 

“The virus doesn’t spread easily between people, and no cases have been observed related to crowds, in schools or at football stadiums,” the Saudi Press Agency reported, citing a ministry official.

Mali: No Ebola cases confirmed

Via ReliefWeb, good news from AFP: No cases of Ebola fever in Mali confirmed after analysis (government). Excerpt from a Google translation:

The laboratory analysis of ten samples of suspected cases of hemorrhagic fever in Mali have excluded the presence of Ebola virus in this country, where no new suspected cases have been recorded, said Tuesday the Malian government. 

Following the first suspected cases of hemorrhagic fever detected on Malian soil in early April, the authorities had sent a total of ten samples from reference laboratories in the United States and Senegal they are tested for Ebola, explained Minister of Health, Ousmane Koné, during a press conference in Bamako. 

"All ten samples (a) given a negative result. This means that today's date, Mali knows no suspect or confirmed cases of Ebola haemorrhagic fever," said M . Koné. 

"Nevertheless, we recommended our structures to remain vigilant and keep control with the same rigor," said he added. 

Asked about the fate of patients initially considered suspects, the minister's entourage said they remained under medical supervision, but without providing further details. 

April 3, Bamako announced it had found three suspected cases of hemorrhagic fever, which were immediately placed in isolation until the results of the analysis of samples taken from them. 

All working in an area on the border between Mali and neighboring Guinea, countries experiencing an epidemic of viral haemorrhagic fever in part due to Ebola, according to the Ministry of Health. 

According to the latest toll released Monday by the World Health Organization (WHO), a total of 168 cases of hemorrhagic fever (including 108 deaths) have been reported since the beginning of the year in Guinea. Of these 168 cases, 71 were confirmed by laboratory analysis to be due to Ebola. 

The Ebola virus, highly contagious, spread to neighboring Liberia where six cases were confirmed on 26 suspected cases of hemorrhagic fever, including 13 deaths, according to the same report, which had reported six suspected cases in Mali all under medical observation pending the results of the analyzes. 

As explained by the Minister Ousmane Koné, the ten samples examined include samples from the first suspected cases, as well as other made later. 

"We had the advantage of receiving the support of a U.S. high-level institute in our laboratories, in collaboration with our research structures. Together, we examined ten samples" consist of "nine cases and blood taken from a corpse came from the Guinea" cell, said Mr. Koné.

Ousmane Koné and his ministry have handled this very well, despite an unfortunate riot in Bamako over the siting of the suspected cases. The ministry's communiques on its website have been concise and reliable; that conveyed the seriousness of the situation far better than political rhetoric ever could.

Liberia: Protecting the borders against Ebola

Via the Daily Observer: BIN Commissioner Visits Lofa’s Borders. Excerpt:

The head of the Bureau of Immigration and Naturalization (BIN), Commissioner Lemuel Reeves, Monday, April 14, traveled to Lofa County to visit “every functioning border,” in that county. 

Speaking to our reporter in an exclusive interview at his BIN office last Tuesday, April 8, Commissioner Reeves explained that they were working closely with the Ministry of Health & Social Welfare to protect the public; especially around the border regions where the current Ebola virus outbreak in the country began. 

According to him, “there will be two border visitation teams; one will leave for the Southeastern region, and I will take the other team to Lofa where we will inspect those borders and come up with recommendations for the Health Ministry in the fight against this [Ebola] virus.” 

He expressed his opinion that closing the borders would not solve the problem of the virus being spread and added “We are working with the MOH and our other partners to protect the country against the spread of the virus while keeping the borders safe.” 

Mr. Reeves said BIN officers at various borders have received protective gear from the Health Ministry. 

He said that the country’s borders were very porous, with an unofficial estimate of over 130 illegal pathways being used by people from neighboring countries. 

“The visits to the various borders in the region are important because we need to know what is happening in those areas and what major things we can work on to stop the Ebola virus from spreading,” The Commissioner explained. 

According to him, BIN has been working closely with chiefs, villagers, and other community residents to protect the unofficial routes of entry into the country. He said that some villagers have been able to notify officers at the borders about illegal crossings taking place. As a result of this, measures have been put in place to watch the borders effectively.

Chile: "Incalculable" air operation to suffocate Valparaíso megafire

Via La Hora.cl: Inédita operación aérea para sofocar megaincedio.[Incalculable air operation to suffocate megafire] Excerpt, with my translation:

Para controlar los focos de incendio que afectan a la Región de Valparaíso desde la tarde del sábado, y que han dejado 2.100 viviendas completamente destruidas, el gobierno dio a conocer el despliegue de “una operación aérea inédita”. 

To control the hot spots of the fire that has struck the Valparaíso Region since Saturday afternoon, and which has left 2,100 households completely destroyed, the government made known the deployment of "an incalculable air operation."

La información fue entregada por el ministro secretario general de gobierno, Álvaro Elizalde, luego del comité de emergencia convocado por la Presidenta Michelle Bachelet y en el que participaron los ministros de Educación, Vivienda, Salud y Desarrollo Social, entre otros. 

The information was delivered by the Minister Secretary General of Government, Álvaro Elizalde, after a meeting of the emergency committee called by President Michelle Bachelet with the participation of the ministers of education, housing, health, and social development, among others.

En la ocasión, Elizalde precisó que “junto a las numerosas brigadas de Conaf, a las que se están sumando brigadas de empresas privadas, hay 21 aeronaves comprometidas en la operación. Estamos hablando de 13 helicópteros, siete aviones y un avión de reconocimiento”. 

Elizalde explained that "Together with the many brigades of Conaf, to which were added brigades from private enterprises, 21 aircraft are dedicated to the operation. We are talking about 13 helicopters, 7 planes, and a reconnaissance plane."

Asimismo, señaló que se sumarán seis aviones lanza agua, los que fueron facilitados por el gobierno argentino, y que serán utilizados en las labores de protección de otras zonas del país. 

He said an additional 6 water bombers, provided by Argentina, wll be used to protect other parts of the country.

“Se ha solicitado a los gobiernos amigos, especialmente al de Argentina, aeronaves que puedan cubrir las zonas que pudieran quedar desprotegidas”, indicó el ministro. 

"We asked friendly governments, especially Argentina, for airplanes that could cover the zones that might be left unprotected," the minister said.

CATASTRO/Housing losses

En el último informe entregado ayer por el gobierno, el ministro explicó que más de 100 casas se quemaron durante la noche del lunes, en la reactivación del fuego en el sector de Ramaditas, al igual que en parte de Laguna Verde. Con esto, un total de 2.100 viviendas habrían sido destruidas por el incendio. 

In the latest report issued yesterday by the government, the minister reported that over 100 houses burned on Monday night in the reactivation of the fire in Ramaditas, as well as in Laguna Verde. With these, a total of 2,100 household have been destroyed by the fire.

Además, la autoridad informó que hay 1.200 personas albergadas y ocho mil damnificadas. “Es desolador, pero el gobierno no los va a dejar solos”, expresó.

As well, 1,200 persons are living in hostels and 8,000 are homeless. "It is desolating," the report said "but the government is not going to desert them."