H5N1

Officials: No bird flu in southeast Alabama

Via The Brewton Standard: Officials: No bird flu in southeast Alabama. Excerpt:

Public health officials have ruled out bird flu as a cause in a cluster of respiratory illnesses that have hospitalized several and killed two people in southeast Alabama. 

The Alabama Department of Public Health and the Houston County Health Department have determined the illnesses are a combination of influenza A, rhinovirus, the virus associated with the common cold, and bacterial pneumonia. 

“This is good news. Testing has ruled out avian flu and novel coronavirus,” said State Health Officer Dr. Don Williamson. 

Earlier this month, seven patients were admitted to the hospital with fever, cough and shortness of breath with no known cause for their illness. 

Public health officials began an epidemiological investigation to interview the families of the patients about travel and exposure. Specimens were requested and submitted to the ADPH Bureau of Clinical Laboratories in Montgomery. 

Of the seven patients whose specimens were submitted, six were found to be positive for either influenza A, rhinovirus or a combination of the two, and three patients were found to have bacterial pneumonia. Two of the seven patients eventually died.

H7N9: More pneumonia patients than usual in Shanghai?

Thanks to Lucie Lecomte for sending the link to this story in WantChinaTimes.com, which seems to be a Taiwanese news source: Shanghai and Zhejiang deaths bring H7N9 bird flu toll to 6. But the key part of the story is buried at the end:

Reports on the internet on Thursday said Dongzhimen Hospital in Beijing has identified a case of H7N9, creating fear that the virus may have spread beyond the Yangtze River Delta region. The hospital issued an official statement refuting the rumor and warned of possible legal action against any person or party spreading such reports. 

A respiratory specialist in Shanghai cited by Hong Kong's Wen Wei Po said his hospital has recently admitted more pneumonia patients than usual. The mortality rate among these patients was also higher, at 20%-30%. It is definitely possible that the patients have contracted H7N9, he said. 

A local taxi driver said he is concerned by the prospect of another epidemic, saying he was told by his employer to sterilize his car daily during the SARS outbreak 10 years ago but he has not been given a similar order regarding bird flu.

I'll take this under advisement, but it's not hard news yet and may never be.

H7N9 virus not detected in Thai tourist death

Via Xinhua: H7N9 virus not detected in Thai tourist death. Excerpt:

KUNMING, April 5 (Xinhua) -- A 14-year-old Thai tourist died from severe pneumonia on Thursday morning in southwest China's Yunnan Province, but no H7N9 virus was detected, local health authorities said Friday. 

The teenager with a 119-member tourist group arrived in Yunnan Province from Bangkok on March 23. 

He developed symptoms of a cough and runny nose en route from Shangri-La County to Lijiang City on March 26. 

The boy was sent to a hospital in Lijiang on the morning of March 28 after he developed breathing difficulties and coughed up pink, frothy sputum. 

He was transferred to the First People's Hospital of Kunming, capital city of Yunnan for treatment on Wednesday morning, but died in hospital after rescue efforts failed on Thursday morning. 

According to the disease control and prevention departments of Yunnan, test results from the boy for H7N9 (a new strain of bird flu), H5N1 and H9N2 were negative. 

Other members of the tourist group have returned back to Thailand except the boy's father. No other person from the group had symptoms of a cough or fever. 

To date, Yunnan Province has had no reports of H7N9 infections. 

Meanwhile, 16 prefectures and cities across the province have been informed to strengthen the prevention of the H7N9 bird flu virus. All medical institutions are required to investigate pneumonia with unknown causes, and manage and offer treatment for those patients.

Nigeria: Malaria, diarrhea, pneumonia killing children

Via allAfrica.com, a report in Daily Trust: Nigeria: Malaria, Diarrhea, Pneumonia Killing Children - Unicef. Excerpt:

Malaria, diarrhea and pneumonia have being identified as the three main diseases that are responsible for killing children in their thousand in the country. 

The United Nation Children's Fund (UNICEF) Chief of Field Office, Mr. Charles Nzuki said this yesterday at an interactive meeting with media practitioners under the UNICEF 'A' Field Office in Enugu. 

Nzuki said that the international agency has recorded progress in the areas of reduction of child mortality which he said is an excellent result towards achieving MDG4 by 2015. 

Statistically according to him, the under-five mortality and infant rates are falling drastically, adding that 24 percent of all under-five child deaths occurs in the neonatal period. 

He reiterated the focus of the agency in the states of Imo, Anambra, Ebonyi, Rivers, Cross Rivers, Enugu, Bayesa, Benue, and Akwa Ibom which is to strengthen routine immunization for all under 5 children and integrated maternal neonatal child health intervention. 

According to him continued partnership between the agency, government and other partners will deliver quick impact intervention to increase the coverage in immunization to reduce the preventable disease among the children in the states covered. 

The UNICEF 'A' Field Office regretted that despite all effort on child survival, a huge population of children still remain without access to safe drinking water.

Just to put some numbers to this: According to WHO, in 2008 Nigeria saw 1,076,613 deaths in children aged under 5 years. Of those, 201,368 died of diarrhea. Malaria killed 217,357. Pneumonia killed 177,212.

China: SARS ruled out in death cases

Via China.org.cn, a Shanghai Daily report: SARS ruled out in death cases. Excerpt:

Health authorities have ruled out SARS, bird flu or a new SARS-like virus in the deaths of two people from the same family at Shanghai No. 5 People's Hospital. 

The hospital said three members of the Li family had been admitted between February 14 and 24 for symptoms including a high fever and coughing. 

All three, aged 55, 69 and 87, were diagnosed as having pneumonia. 

Since they were from the same family, the hospital reported the case to the Minhang District Center for Disease Control and Prevention for investigation. The pneumonia diagnosis was confirmed. 

However, microbloggers raised fears that they might have been infected by SARS. 

The Shanghai Public Health Center, the city's designated facility for infectious disease diagnosis and treatment, did checks and ruled out the disease. 

Officials from the Shanghai Health Bureau said the Shanghai Center for Disease Control and Prevention investigated the case and it, too, ruled out SARS. 

The 55-year-old Li died of severe pneumonia and respiratory failure last week. The 87-year-old suffered multi-organ failure and died on Monday. 

The 69-year-old is still in hospital, in isolation and receiving treatment. 

Doctors said they were seeing a rising number of patients suffering from pneumonia due to the changing seasons. None of the other patients had any connection with the Li family.

US: CRKP "worse than MRSA"?

Via The New York Times: Pneumonia Strain Has Spread. Click through for important links. 

Infection with Klebsiella pneumoniae is a serious danger to older hospitalized patients, with an estimated mortality rate as high as 40 percent. It has generally been treated with broad-spectrum cephalosporin antibiotics. Another class of antibiotics, carbapenems, is used as an antibiotic of last resort for the most persistent infections. 

But now carbapenem-resistant Klebsiella strains, or CRKP, are appearing across the nation, even outside of health care facilities. 

A study in the March issue of Infection Control and Hospital Epidemiology reports that the proportion of Klebsiella cases resistant to cephalosporins increased to 11.6 percent in 2010 from 5.3 percent in 1999. The proportion resistant to carbapenems increased to 4.5 percent in 2010 from less than 0.1 percent in 2002. 

The senior author, Ramanan Laxminarayan, a researcher at the Center for Disease Dynamics, Economics and Policy in Washington, D.C., compared the problem to that of methicillin-resistant Staphylococcus aureus. 

“There’s a similarity to MRSA, which prior to the early 2000s was not seen in the community, and it was very surprising when it showed up,” he said. 

“But there had already been new drug developments for MRSA. The problem with CRKP is that we don’t have any new drugs. This could wind up being worse than MRSA.”

US: CDC FluView for week 2

CDC has published its Weekly Report: Influenza Summary Update for week 2 (January 6-12). The synopsis of a very long and detailed report:

During week 2 (January 6-12), influenza activity remained elevated in the United States, but decreased in some areas. 

• Viral Surveillance: Of 12,360 specimens tested and reported by collaborating laboratories, 3,638 (29.4%) were positive for influenza. 

• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold. 

• Influenza-Associated Pediatric Deaths: Nine influenza-associated pediatric deaths were reported. 

• Influenza-Associated Hospitalizations: A cumulative rate for the season of 18.8 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported. Among all cases, 49.6% were in adults 65 years and older. 

• Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 4.6%; this is above the national baseline of 2.2%. All 10 regions reported ILI above region-specific baseline levels. Thirty states and New York City experienced high ILI activity; 10 states experienced moderate activity; 7 states experienced low activity; 3 states experienced minimal activity, and the District of Columbia had insufficient data. 

• Geographic Spread of Influenza: Forty-eight states reported widespread geographic influenza activity; 2 states reported regional activity; the District of Columbia reported local activity; Guam reported no influenza activity, and Puerto Rico and the U.S. Virgin Islands did not report.

Bangladesh: 72 deaths in cold wave

Via ReliefWeb, a report from the IFRC: Bangladesh: Cold wave.

A cold wave has struck the northern districts of the sub-Himalayan regions of Bangladesh claiming more than 72 lives as per the assessment data of BDRCS and local administration, mostly children due to hypothermia. 

According to the Disaster Management Information Centre on 26 December 2012, around 22 districts have been affected by the cold wave, notably the districts of Panchagarh, Thakurgaon, Dinajpur, Nilphamary, Lalmonirhat, Rangpur, Kurigram, Gaibandha, Bogra, Joypurhat, Naogaon, Nawabganj, Rajshahi, Natore, Sirajganj, Pabna, Mymensing in the north, Moulvibazar in the east and certain districts in the south, namely Kushtia, Jessore, Faridpur and Madaripur. 

According to the BDRCS concerned units, people living in open and public spaces like bus and railway stations, and daily labourers and slum dwellers are most vulnerable to cold wave as they cannot afford warm clothes. As per the reports received from various units, more than 50 per cent of population in the district is affected by the cold wave. 

The number of pneumonia and diarrhoeal patients, mostly older population and children, continues to increase due to the sweeping bone-chilling cold wave in the sub-Himalayan regions in the past week. 

The extreme cold and the lack of sunlight is expected to hamper the natural growth of crops, including Boro (winter rice variety) seedlings. Failure of cash crops may result in unemployment of agro-labour and investment of share croppers and induce poverty of marginal farmers.

Meanwhile, The Times of India reports 129 deaths due to cold in its northern states.

Pakistan: Over 300 child measles deaths in 2012

Via ReliefWeb, an AFP report: Pakistan suffers 'record' child measles deaths. Excerpt:

More than 300 Pakistani children died of measles last year, a staggering increase on the previous 12 months and a result of three consecutive years of flooding, officials said Tuesday. 

The United Nations' World Health Organization said 306 children died of the highly infectious illness last year, 210 of them in the southern province of Sindh, where the worst floods occurred in 2010, 2011 and 2012. 

The WHO said 64 children died of measles in Pakistan in 2011, 28 of them in Sindh. It was not immediately able to provide statistics for earlier years. 

"Most of the affected children died due to post-measles complications such as pneumonia, post-measles encephalitis and diarrhoea," said WHO spokeswoman Maryam Yunus. 

The UN body said most of the cases occurred between October and December in northern districts of Sindh, but was unable to provide a breakdown. 

"Most of (the) children who have died because of suspected measles are reported from the districts affected by the floods for (the) last three years," said Yunus. 

She said WHO investigations had shown that malnourishment was a major reason for such a high number of deaths of children in Sindh. 

"Floods, displacements and food shortages have played a major role behind these deaths," she added. 

A Pakistani health ministry official said more than half the deaths in Sindh occurred in the last three months of the year, with 50 children dying in December alone.

Uganda: Child mortality remains high

Via The Daily Monitor: Child mortality remains high in Uganda. Excerpt:

Although child mortality has been on the decline, a new report shows that Uganda is one of 24 developing countries where 100 deaths per 1,000 live births are still registered. 

According to the World Health Organisation (WHO), the 24 countries were responsible for more than 80 per cent of deaths of children under five years last year. WHO says worldwide, more than 7 million children below the age of five died in 2011 alone. 

Currently, Uganda’s under five mortality rate is 131 per 1,000 live births, the highest rate in East Africa. Kenya’s mortality rate is 107 per 1,000 live births, Tanzania, 122 while Rwanda is at 23. Uganda’s statistics improved from 146 deaths per 1,000 births in 2005. 

The president of the Uganda Pediatrics Association, Dr Jane Achan, said malaria, pneumonia, diarrhoea, malnutrition and HIV/Aids are the major causes of child deaths in the country. 

Although most of these diseases are preventable, Dr Achan said interventions have fallen short of universal coverage and many children are being left out. 

“Mosquito net coverage is, for instance, at only 45 per cent, few children are on oral rehydration therapy or Zinc for diarrhea and even fewer on PMTCT. We are not achieving any universal coverage for interventions and it needs to be scaled up and sustained,” she said.