H5N1

Oral cholera vaccine and integrated cholera control in Haiti

Via The Lancet, a report by Louise C. Ivers, Paul E. Farmer, and William J. Pape: Oral cholera vaccine and integrated cholera control in Haiti. Excerpt:

There have been objections to integrating vaccine into the response. Initial resistance to deploying vaccine as a complementary tool in the fight against cholera occurred for various reasons: fear that using only the limited number of available doses would be inequitable and might trigger social unrest during an election year; fear that logistics capacity (especially for cold chain storage) would be insufficient to implement the programme effectively;8 concerns that use of the vaccine would reduce other prevention practices of good hygiene and use of potable water;8 concern that the project would interfere with a planned national campaign to reinforce other basic childhood vaccinations, including polio;11 and uncertainty about the use of vaccine in epidemic settings compared with endemic settings, in which oral cholera vaccines have been better studied.10, 12 

A new Haitian President and the nomination, in October, 2011, of a Minister of Health who viewed the situation with urgency and called for integrating vaccination into the ongoing response to cholera, brought a change in political will. 

The debate has occurred largely among those not at risk of waterborne disease. During the early stages of this pilot in both rural and urban Haiti, we found that communities were interested in the vaccine and uptake of the first dose has been high. Within 2 weeks of commencement, 52 000 first doses of the vaccine have been administered. 

The capacity of the health system in the region is being reinforced by the cholera vaccination programme through the promotion of the national childhood immunisation campaign; community health workers have been trained to better prevent and, failing that, refer cases; cold chain capacity has been expanded; and a new vaccine has been delivered through the public sector vaccination programme. 

There have, of course, been challenges. Days before the launch of the cholera vaccine programme, a national bioethics committee wrote to the Minister of Health objecting to the use of cholera vaccine, which delayed the start date beyond the onset of the rainy season. Some villages are now flooded making it difficult to access health posts. 

The delay also caused a scheduling overlap with a national polio campaign, which led to reduced cold chain storage space and additional planning to ensure an appropriate interval between cholera vaccine and oral polio vaccine for children. These challenges, however, have been far from insurmountable.

Zimbabwe: New cholera outbreak worries health officials

Via Voice of America: Isolated Fresh Cholera Outbreak Worries Zimbabwe Health Officials. Excerpt:

Zimbabwe's health ministry says it is concerned about a fresh cholera outbreak in Chiredzi, a district in Masvingo Province, where one person has died, with 22 others being treated at various clinics. 

Epidemiology and disease control director in the health ministry, Dr. Portia Manangazira, says the government has declared the outbreak, affecting a number of villages in the area, a national priority. 

She says her ministry is fighting to ensure the situation is contained to avoid a return to the 2008 epidemic where over 4,000 people lost their lives due to cholera nationwide. 

Manangazira told VOA health officials deployed on the ground have discovered a new strain in Chiredzi but said she was impressed with the way district officials have dealt with the outbreak. 

She said it is important that everyone in the country continues to be cautious with water that they are using for household purposes. 

"Residents should continue being vigilant, making sure they boil their drinking water and practice hygienic sanitary practices in order to curb cholera from resurfacing," said Manangazira. 

She urged local authorities to ensure their major water sources are revamped so residents can have access to clean and safe drinking water. 

Following the Chiredzi cholera reports, Harare is on high alert, deploying staff to ensure the communicable disease does not re-surface in the capital.

India: Gujarat gets ready to tackle leptospirosis

Via DNA: Gujarat govt gets ready to tackle leptospirosis. Excerpt:

The state government has come out with a leptospirosis manual to tackle the deadly disease, which claims a number of lives every year, particularly in South Gujarat, during the upcoming monsoon season. 

Health minister Jaynarayan Vyas said that the manual is a part of a series of precautionary steps initiated by health, agriculture and animal husbandry departments to control spread of leptospirosis during rains. 

“The infrastructure has been put in place at hospitals, primary health centres and community health centres to check leptospirosis. We are also focusing on creating awareness among the rural dwellers, especially farm labourers,” Vyas said. 

Leptospirosis mainly affects farmers from Surat, Tapi, Valsad and Navsari districts during monsoons. Around 80 to 100 people die every year because of the disease.

Uganda: Acholis take government to court over nodding disease

Via UGPulse: Uganda Government News: Acholis take government to court over nodding disease.

The people of Acholi have resorted to dragging government to court over the Nodding Disease syndrome in the area. 

Kitgum Woman Member of parliament for Kitgum district Beatrice Atim Anywar revealed this while speaking to journalists at parliament. 

Anywar said that a civil suit has already been filed to the high court challenging the Attorney General for government’s negligence over its suffering people. 

She said that the Acholi people want to see justice being done by ensuring that courts of law direct government to compensate the families of over 200 victims of Nodding disease. 

However after transporting a number of children with the Nodding syndrome to Mulago Hospital government pledged to offer treatment to all the vulnerable children in the area but the families claim no treatment to the affected children has been given.

Carbon dioxide levels hit 400 in Arctic

Next time you shiver, it won't be because of the cold. Someone's walking on your grave. Via The Washington Post, a report by The Associated Press: When hitting 400 is not good: Levels of key greenhouse gas pass milestone, trouble scientists. Excerpt:

The world’s air has reached what scientists call a troubling new milestone for carbon dioxide, the main global warming pollutant. 

Monitoring stations across the Arctic this spring are measuring more than 400 parts per million of the heat-trapping gas in the atmosphere. The number isn’t quite a surprise, because it’s been rising at an accelerating pace. Years ago, it passed the 350 ppm mark that many scientists say is the highest safe level for carbon dioxide. It now stands globally at 395. 

So far, only the Arctic has reached that 400 level, but the rest of the world will follow soon. 

“The fact that it’s 400 is significant,” said Jim Butler, global monitoring director at the National Oceanic and Atmospheric Administration’s Earth System Research Lab in Boulder, Colo. “It’s just a reminder to everybody that we haven’t fixed this and we’re still in trouble.” 

Carbon dioxide is the chief greenhouse gas and most of it lasts about 100 years in the air, but some of it stays in the atmosphere for thousands of years. Some carbon dioxide is natural, mainly from decomposing dead plants and animals. Before the Industrial Age, levels were around 275 parts per million. 

For more than 60 years, readings have been in the 300s, except in urban areas, where levels are skewed. The burning of fossil fuels, such as coal for electricity and oil for gasoline, has caused the overwhelming bulk of the man-made increase in carbon in the air, scientists say.  

It’s been at least 800,000 years — probably more — since Earth saw carbon dioxide levels in the 400s, Butler and other climate scientists said. 

Until now. 

Readings are coming in at 400 and higher all over the Arctic. They’ve been recorded in Alaska, Greenland, Norway, Iceland and even Mongolia. But levels change with the seasons and will drop a bit in the summer, when plants suck up carbon dioxide, NOAA scientists said. 

So the yearly average for those northern stations likely will be lower and so will the global number. 

Globally, the average carbon dioxide level is about 395 parts per million but will pass the 400 mark within a few years, scientists said.

Vietnam: Two more die of unknown skin disease in Quang Ngai

Via TuoiTreNews.vn: Two more die of unknown skin disease in Quang Ngai. Excerpt:

While health authorities have yet to identify the cause of the mysterious skin disease in central Quang Ngai Province, two more people died in Ba To District in the past 3 days, taking the death toll to 23 so far. 

34-year-old woman, Pham Thi Trieu, in Reu Hamlet, Ba Dien Commune, died at 10 am on May 30 at the provincial General Hospital while 9-year-old boy, Pham Van T, died on May 28 in the same hamlet. 

Luong Ngoc Khue, head of the Health Ministry’s Department of Medical Examination and Treatment, said the hair samples taken from the boy contained arsenic at a level 100 times higher than the country’s acceptable limit. 

The disease has so far spread to five communes in Ba To district, including Ba Dien, Ba Ngac, Ba Xa, Ba Vinh and Ba To, of which Ba Dien is leading with the most cases. 

The mysterious skin disease that first occurred in the district on April 19, 2011 is characterized by thickened skin (keratosis) over the palms and soles, causing stiffness in the limbs and ulcers on victims' hands and feet that look like burns. 

There has been no disease in the world so far that is exactly identical to the strange syndrome in Quang Ngai, Health Deputy Minister Nguyen Thanh Long said at recent conference.  

Most of the patients have elevated liver enzymes, but they do not suffer from infectious diseases since no symptoms of infection have been found, according to the results of patient blood tests made by Japan’s Nagasaki University, he said.

Cote d'Ivoire: Two dead in cholera outbreak

Via allAfrica.com, a report from the US Embassy in Abidjan: Cote d'Ivoire: An Outbreak of Cholera Claims the Lives of Two People in the Coastal Town of Adiake.

A report in Nord Sud Quotidien (p. 8) noted that an outbreak of cholera has been reported in Adiake, a coastal town in eastern Cote d'Ivoire. 

Citing a report by the World Health Organization (WHO), which sent a team to the site to assess the situation, the paper noted that the epidemic has so far killed two individuals. A total of US $500,000 is needed to respond to the outbreak, the paper added.

India: Dengue cases unusually high this year in Chennai

Via The Times of India: Dengue cases unusually high this year. Excerpt:

The Chennai Corporation has reported 15 dengue cases this month, taking the tally this year to 130 cases, civic officials said adding that anti-mosquito fogging operations had been intensified. According to statistics, this is the highest number of dengue cases between January and May since 2008. 

"The spread of dengue and malaria in summer is rare as the mosquito density is low due to absence of water stagnation. But this year, it is higher than previous years," said a senior corporation health official. 

For more than one week, corporation health officer P Kuganantham had denied that there were any dengue cases in the city. Health officials said many areas, especially in Adyar, were being surveyed for conditions conducive to mosquito breeding. 

"In summer, many people store water in containers that could be breeding point of mosquitoes. So we are doing random checks," said an official. 

Officials said that fogging would be conducted on Tuesdays (5am-7 am) and Thursdays (4pm- 6pm) in 200 wards. 

"We have deployed more staff for fogging operations especially in Royapuram, Anna Nagar and Tondiarpet. If we find a case in any locality, all preventive measures will be taken. Recently, we conducted a similar drive in Kalakshetra Colony," the official said. 

People coming from southern districts such as Tirunelveli, Virudhunagar and Madurai are being screened at the Central railway station, Egmore Railway Station, Koyambedu bus terminus and the Tondiarpet terminus. 

Officials said the situation in the city was not alarming, but said there was a possibility of the virus spreading from passengers from southern districts.

CERF: Fighting cholera in the Republic of Congo

Via OCHA: CERF: Fighting cholera in the Republic of Congo. Excerpt:

The diarrhoea and vomiting started before dawn. By 8 am, 12 year old Steward Okoulokami was weak and losing weight. His panicked father, Dimitri, packed Steward into a canoe and took him to the Congolese capital, Brazzaville. 

“In the morning around 8am, when I looked at my son, he had lost a lot of weight and looked like a skeleton,” explains Dimitri. “So I thought, no - I must go to Brazzaville. When we got to Brazzaville, he was hospitalised and we spent 5 days there. On the 6th day we left and now he is alive and in good health.” 

Dimitiri and his family live on Isle M'bamou, a large island of 13 villages on the Congo river, not far from the twin capital cities of Brazzaville and Kinshasa. There is no electricity, running water or hospital on the island, so when the cholera outbreak hit, it was devastating. No one knew what it was or where it came from. While Steward survived, his cousin was not so lucky. 

“For my nephew, it was a short illness,” explains Dimitiri. “When he started having diarrhoea, we noticed that he became like a skeleton in only half a day. He lasted only one day. By the second night he was dead.” 

The cholera outbreak that devastated Isle M'bamou originated in the northern DRC before moving down and across the river into the Republic of Congo. When the outbreak reached Brazzaville, squatter settlements with poor sanitation were the worst hit. Makeshift latrines feed directly into the same stream in which children play and people bathe. 

In response, the Central Emergency Response Fund (CERF) allocated US$1.3 million to support the UN Children’s Fund, UNICEF, and the World Health Organization (WHO) in launching a series of initiatives to treat, combat and prevent the disease.

Uganda: Ministry launches larvicides for malaria fight

Via The Monitor: Ministry launches larvicides for malaria fight. Excerpt:

The Ministry of Health has introduced larvicides as an alternative in the fight against malaria as the country struggles to eliminate the disease by 2020. 

Larviciding will complement the already existing public health interventions such as timely diagnosis and treatment, use of long lasting insecticide-treated mosquito nets and indoor residue spray. 

The new technique involves application of chemicals or biological agents to mosquito breeding habitats to kill mosquito larva. 

Dr Grace Nambatya, the chairperson technical coordination committee of the larviciding programme, said the ministry has chosen to explore the method as a way of reducing vector breeding sites to the strictest minimum wherever possible. 

“We will be spraying outside and targeting breeding sites of anopheles mosquitoes, which are the malaria vectors,” Ms Nambatya said. 

Ms Nambatya was representing the Health Minister, Dr Christine Ondoa, at the launch of larvicide method at Wakiso District Headquarters on Tuesday. 

As part of the integrated vector management approach, she said they will apply a locally-available product called Temophos (Abate), which has been used in the eradication of Guinea worms on mosquito breeding sites in northern Uganda. 

The chemical is also currently being used for onchocerchiasis (river blindness) control in Hoima District and is the same insecticide widely used in animal disease control interventions in the country. 

In Uganda, malaria is the number one cause of death, morbidity and poverty. 

According to statistics, the country spends $658m (about Shs1.6 trillion) to malaria annually, which is equivalent to 10 per cent of the Ministry of Health budget. 

Dr Myers Lugemwa of the National Malaria Control Programme (NMCP), said Uganda is ranked fourth next to Democratic Republic of Congo among the most malaria-infested countries in the world.