H5N1

Hawaii: Dengue threat over

Via Hawaii News Now: Health Department closes Dengue probe, still urges vigilance. Excerpt:

The state Department of Health has officially closed its investigation into a possible outbreak of dengue fever on Oahu, but still urged families to remain vigilant against the disease. 

Five people became ill due to confirmed cases of dengue fever in late February, but no further cases were identified since then. 

More than 70 volunteers went door to door in Kalihi Valley Saturday, passing out information about how to stop the spread of mosquito-borne diseases. 

Gov. Neil Abercrombie and Lt. Gov. Brian Schatz proclaimed the day "Great Hawaii Mosquito Swat Day." 

"More than a hundred blood samples were drawn and analyzed," said Dr. Kate Gaynor, director of the Hawaii Medical Reserve Corps. "I think we can officially say that there's no circulation of dengue fever in Hawaii right now."

That's very good news. But the Saudi Gazette reports that Jeddah's 800 anti-dengue staff will now be permanent employees. And in Sri Lanka, The Nation says dengue "rages in Colombo," with almost 5,000 cases in the first four months of the year.

India: Two in intensive care with cholera

Via the Deccan Herald, a report from Halebidu, in Karnataka, southwest India: Cholera: Two in ICU. Excerpt:

Two people who were taken ill after drinking contaminated water, were shifted to intensive care unit (ICU) following deterioration in their health at District Government Hospital in Hassan, on Saturday. 

Timmegowda (60) and Nanjamma (43), residents of Dyavappanahalli in Belur taluk of the district were admitted to the hospital on Friday and their blood samples had tested positive for cholera, the doctors said. 

As many as 30 people suffering from diarrhoea were treated at the hospital till Friday night. The number rose to 72 on Saturday. However, the disease is under control, the doctors added. 

“It is found that polluted water had mixed with drinking water which led to the outbreak of the disease. Steps have been taken to provide safe drinking water to the residents of Dyavappanahalli,” Dr Hemalatha, surveillance officer of the Health department said.

US: Tuscaloosa's aftermath

Via MyFoxAL.com: Update on Tuscaloosa from Mayor Maddox. The report tell us the city has suffered 39 confirmed deaths, over 1,000 injuries, and 570 missing persons. But this was the paragraph that caught my attention:

Maddox mentioned that there is a "desperate need" for individuals who speak Spanish and would be able to help translate for the Hispanic people who have suffered from the tornadoes and need help. Anyone who can assist with Spanish translation is encouraged to call 205-248-5045.

So Tuscaloosa has a large number of unilingual Hispanics living among a large number of unilingual anglophones, and a very small number of people who are bilingual. That suggests to me that the Hispanics are recent arrivals who have not yet had to learn much English, and the majority of the population haven't had to learn any other language at all.

This suggests to me that disaster preparedness should certainly include extensive programs teaching new immigrants English as a second language, whether in school or in the workplace. And the schools of Alabama should be teaching Spanish as a second language to every students, preferably starting in kindergarten.

Dengue on Saturday

When I visit NewsNow: (dengue), it's sometimes hard to pick just one report. Today is a good example—not lots of reports, but they're scattered from South Asia to South America:

India: Boy dies of suspected dengue. Three dengue cases in New Delhi

 Nepal: Terai districts prepare to fight dengue.

 Paraguay: Over 12,000 confirmed dengue cases, with 38 deaths.

 Brazil: Mato Grosso state reports an average of 46 new dengue cases every day.

 Mexico: Yucatán reports a diminution of dengue cases.

Japan: Volunteers in earthquake-hit areas exceed 130,000

In some places, too much help is a hindrance. Via The Daily Yomiuri: Volunteers in earthquake-hit areas exceed 130,000. Excerpt:

More than 130,000 people have volunteered their time and energy to help with disaster relief in Iwate, Miyagi and Fukushima prefectures since the March 11 Great East Japan Earthquake, according to a Yomiuri Shimbun survey. 

During the Golden Week holidays, the average number of volunteers working in the areas each day will likely triple to around 8,000, the survey showed. 

Offers of help have been so numerous that some local governments have decided to temporarily stop accepting volunteers--partly because they were not prepared to handle the flood of people expected during the holiday period and also to prevent overcrowding and confusion on the roads. 

Social welfare councils in the prefectures that coordinate volunteer activities have urged people to check beforehand on the conditions and needs in disaster-hit areas. 

According to the disaster volunteer coordination office of the Cabinet Secretariat, each prefecture has a volunteer center, as do 66 municipalities. In Iwate Prefecture, there are 20 municipal centers. Miyagi Prefecture has 17, and Fukushima Prefecture has 29. 

The city government of Ishinomaki, Miyagi Prefecture, has decided not to accept new individual volunteers during Golden Week. There are more than 1,000 volunteers active in the city each day--the largest number in the prefecture--and the city government said they have more than enough help.

Ishinomaki Senshu University has served as the city's volunteer reception center since March 15. Currently, more than 1,000 people are staying in tents or cars near the center. 

The city government was spooked by the prospect of a huge surge in volunteers. Anticipating more than 2,000 people could inundate Ishinomaki during Golden Week, the city government worried whether it would be able to organize them all.

Fukushima: Cabinet nuclear advisor resigns in protest over government response to plant crisis

Via The Mainichi Daily News: Cabinet nuclear advisor resigns in protest over government response to plant crisis. Excerpt:

A nuclear advisor to the Cabinet has resigned in protest against government stopgap measures that deal with the ongoing nuclear crisis in Fukushima Prefecture. 

Toshiso Kosako, 61, a University of Tokyo professor specializing in radiation safety, submitted a letter of resignation to the Prime Minister's Office on April 29. 

During a press conference held at the Diet building later that day, Kosako, who was named a special advisor to Prime Minister Naoto Kan on March 16, criticized the government's handling of the crisis at the Fukushima No. 1 Nuclear Power Plant as shortsighted. 

In particular, Kosako protested against the government's decision to revise the maximum permissible level of radiation exposure among children up to 20 millisieverts per year, saying, "Should I approve that decision, I would no longer be a researcher. I would not want my children to be exposed to that amount of radiation." 

Kosako revealed the Cabinet did not accept his advice that outdoor school activities for elementary and junior high school students near the crippled power station be restricted to prevent them from being exposed to over 1 millisievert of radiation per year. 

"It is quite rare for nuclear power plant workers dealing with radioactive materials to be exposed to 20 millisieverts of radiation per year. I cannot allow infants and children to be exposed to such high levels of radiation from an academic as well as humanitarian point of view." 

He also pointed out that the government was slow in applying the System for Prediction of Environmental Emergency Dose Information (SPEEDI) and disclosing its data, even though nuclear safety guidelines stipulate the system be implemented immediately in an emergency. 

"The government has ignored the law and taken stopgap measures, failing to bring the crisis under control promptly," he said.

Japan: Gov't estimates 3 years for removal of debris from disaster areas

Via Japan Today: Gov't estimates 3 years for removal of debris from disaster areas. Excerpt:

The Environment Ministry estimates that it will take three years for the three prefectures in northeastern Japan worst hit by the March 11 earthquake and tsunami to finish removing massive piles of debris left by the disaster, the ministry said Saturday. 

Up to around 24.9 million tons of debris mainly from collapsed houses are assumed to be scattered around Iwate, Miyagi and Fukushima prefectures, according to the ministry. The amount is about 1.7 times the debris seen in the 1996 Great Hanshin Earthquake. 

The actual amount of debris is expected to be larger as the assumption does not include rubble from wrecked vessels and vehicles. 

The removal process is expected to be delayed due to the lack of temporary disposal sites for rubble, according to the ministry. 

The Iwate prefectural government said it will need some 3 million square meters of land to temporarily store a total of 6 million tons of debris scattered around the prefecture, but has been able to secure only 40% of the land needed so far. The prefecture has relatively little flat land because of its deeply indented coastline. 

The ministry said the prefecture may have to ask neighboring prefectures to lease land for disposal purposes.

Japan: Psychiatrists aid traumatized foreigners

Via The Japan Times: Psychiatrists aid traumatized foreigners. Excerpt:

A group of psychiatrists who have been providing mental health support for foreign residents has set up an emergency committee to aid non-Japanese suffering from stress and trauma from the March 11 earthquake and tsunami. 

"Those who are suffering the most are the elderly, children, the handicapped and foreigners. And foreigners are particularly prone to become isolated, suffer from a lack of information in their mother tongue, easily become confused by false rumors and suffer from growing anxiety," said Fumitaka Noda, president of the Japanese Society of Transcultural Psychiatry and professor of psychiatry at Taisho University in Tokyo. 

"It's really important to provide them with accurate information, and then to listen and understand their anxiety," said Noda, who has been providing mental health care services to foreigners in Japan for 18 years, especially to refugees.

Comprised of psychiatrists and other mental health professionals, the transcultural psychiatry society established the Transcultural Mental Health Emergency committee March 19 to help foreigners directly affected by 3/11. 

As the only medical society in Japan that focuses on studies of foreigners who have mental health issues due to transcultural problems, the society is working closely with groups that support foreigners, including the Japan Foundation, to continue gathering information on people in need of professional help. 

It is also planning to teach supporters basic knowledge of mental health, so that when they spot signs of depression or posttraumatic stress disorder they can contact Noda and his colleagues.  

Mental health care has become more important as people recover from the initial shock of the disaster and gradually start to get a clear picture of what happened and what situation they are in, Noda explained. 

"As people start to look around, they begin to feel more clearly the sense of loss, and anxiety over the future. . . . Some may develop PTSD," Noda said. 

"Many suffer from numbness. Because they lost everything they had and they begin to wonder about the meaning of making an effort, making a commitment or loving someone." 

If such cases continue over a long period, then people need to seek professional help, Noda said.

Lancet: Artesunate for severe malaria

Via The Lancet: Artesunate for severe malaria. Excerpt:

There are over 1 million deaths a year from severe malaria, mostly in children in sub-Saharan Africa. Quinine has been the mainstay treatment but it is painful, complex to administer, and has serious side-effects. 

Last week, in the run up to World Malaria Day (April 25), WHO revised its malaria treatment guidelines to recommend parenteral artesunate rather than quinine as the first-line treatment for severe malaria in children. 

The evidence supporting this switch is overwhelming. Last year, the AQUAMAT trial undertaken in nine African countries, showed a significant mortality reduction of 22% in the artesunate group compared with the quinine group. And, more recently, a Cochrane review further supported the superiority of parenteral artesunate over quinine in both adults and children worldwide. 

The challenge now is to translate this evidence into practice and without delay. In a new report, Making the Switch, Médicins Sans Frontières makes a strong case for switching to artesunate, citing that around 195 000 lives would be saved each year. 

Rightly, they call for a global plan to be put in place led by the international community. WHO and Roll Back Malaria should assist with technical support and training. 

National governments need to lead by revising their guidelines. Given the higher cost of artesunate (US$3·3 to treat a child with severe malaria compared with $1·3 for quinine), donors need to put up the money to support the switch and give manufacturers confidence to produce quality artesunate. 

Traditionally, international donors have not supported treatment for severe malaria given the cheapness of quinine, but this must now change. As noted in the report, the additional yearly drug cost of $31 million for artesunate is a small price to pay.

Especially when you consider that the US government plans to spend a third of a trillion dollars on 2,443 F-35 fighter planes whose only purpose will be to blow stuff up real good while adding to the death toll.

If the self-styled Great Powers were really serious about their national security, they would find themselves far more secure on a planet where everyone had clean water, an effective sewage system, cheap and nutritious food, and adequate resources for public health. A third of a trillion dollars would pretty well cover that with a couple of hundred billion left over.

Cholera cases spike in Haiti due to rainy season

Via Partners in Health, aka Zanmi Lasante, easily the most credible NGO in the country: Cholera cases spike in Haiti due to rainy season. Excerpt:

Zanmi Lasante-supported cholera treatment centers and treatment units in Port-au-Prince, the Lower Artibonite, and the Central Plateau regions are seeing a worrisome rise in cholera cases.  

Though official numbers won’t be available until next week, Dr. Maxi Raymonville, ZL’s Director of Women’s Health, reports that the organization’s hospitals and clinics experienced a significant jump in the number of people contracting cholera during the first weeks of April. 

At the ZL cholera treatment centers and units in Mirebalais, near the site of the original outbreak, numbers were roughly triple what they were just a few weeks ago. 

In March, ZL saw a total of 5,136 patients presenting with symptoms of cholera across all 14 of its sites in Haiti. Of those patients seen, 2,459 required hospitalization for cholera. 

To Dr Raymonville and his colleagues, the spike in cases comes as no surprise. 

ZL knew that cases of cholera, like any waterborne illness or diarrheal disease, were likely to surge at the onset of the rainy season. While Dr Raymonville's team was prepared to treat more patients, he remains concerned that flooding will prevent people from accessing cholera treatment quickly. Since cholera often debilitates a person in less than 24 hours, it is critical that a patient be able to access medical care quickly. 

The rainy season arrives as Zanmi Lasante is making a concerted effort to transition its cholera work from an emergency response posture to an integrated proactive and preventative approach in recognizing that the disease is now endemic to Haiti. 

Yet, flooding at facilities in Boucan Carre and Thomonde is making it difficult to treat patients, and therefore inhibiting ZL’s ability to shift away from an emergency response mindset.