H5N1

WHO: Preliminary dose estimation from Fukushima

WHO has published Preliminary Dose Estimation from the nuclear accident after the 2011 Great East Japan Earthquake and Tsunami. This is a downloadable PDF in English. The overview:

The earthquake and tsunami in Japan on 11 March 2011 led to releases of radioactive material into the environment from the Fukushima Daiichi nuclear site. This report describes a preliminary estimate of radiation doses to the public resulting from this accident. These doses are assessed for different age groups in locations around the world, using assumptions described in the report. 

The dose assessment forms one part of the overall health risk assessment being carried out by WHO of the global impact of the accident at the Fukushima Daiichi nuclear power plant. The health risk assessment is the subject of a separate WHO report which will be published in Summer 2012.

Yemen: Electricity outages double the spread of dengue fever in Hodeida

Via the Yemen Times: Electricity outages double the spread of Dengue fever in Hodeida. Excerpt:

“Ongoing power outages have doubled the spread of pandemics such as Dengue fever in Hodeida,” Abdulrahman Jar Allah, director of the Public Health Office in Hodeida, told the Yemen Times. 

He said that the governorate suffers from severe shortages of medicine used to treat the disease because money used for Dengue fever eradication campaigns has not been paid yet to them. 

He pointed out that by Wednesday the death toll of Dengue fever had risen to 15. As of one month ago, 750 were infected in different districts throughout Hodeida. 

“Among the deaths are women and children, most of whom died while receiving treatment in hospitals,” he added. 

Jar Allah called for the Ministry of Public Health and Doctors Syndicate to take responsibility in combating the disease that has spread widely throughout the governorate. 

“So far we aren’t certain that all cases of the disease outbreak are Dengue fever,” he cautioned, stating that “It may be a viral fever that spread from open swamps and sewers.  

“The Health Office in Hodeida is establishing a centre to follow up on the spread of the disease and medical and media campaigns will be launched in several districts in the governorate. Affected people will be checked and medicine will be given to them,” he said. 

“The Public Health Office and residents are worried that the ongoing spread of the disease will affect other districts,” he concluded. 

Mohammed Al-Haj is a 29-year-old man who was infected with the disease a few weeks ago but has since recovered after staying in Al-Amal Private Hospital for a week. 

He told the Yemen Times that “the disease has spread significantly, stating that most deaths are in rural areas. Dust and uncovered sewers are the causes of this disease,” he added. 

Sources in the Public Health Office asserted previously that 10 people from different districts in the governorate died from Dengue fever, in addition to hundreds infected. The infected are in critical condition.

Haiti: Ezili Dantò on Washington Post cholera editorial

Here it is just 6:00 a.m. in Vancouver, and I already have a must-read. Via Open Salon.com: Haiti: Ezili Dantò on Wash Post Cholera editoria. Ezili Danto is the founder and leader of the Haitian Lawyers Leadership Network, and her blog is on my Bloggers list. This is a long, articulate and angry polemic. Excerpt and then a comment:

The Washington Post editorial entitled "Really quite disastrous," supporting that more money be handed over to the NGOs on behalf of Haiti is simply unprofessional if not immoral. 

It is filled with inaccuracies and false declarations. It uses its powerful Washington D.C. platform and journalistic weight to make dangerous, irresponsible assertions and recommendations for Haiti hurt cholera victims. 

In advocating the expansion of more cholera vaccines in Haiti, the editorial claims that: 

"It would take just $40 million to administer oral vaccines to every person in Haiti...But until recently, international health organizations...preferred a systemic infrastructure fix." 

The US and international community ruling Haiti behind UN guns, did not FIRST decide to fix infrastructure, that is, clean up the water infrastructure in Haiti the UN poisoned. That's untrue. 

It would be more appropriate to say the UN, along with the silence of the World Health Organization (WHO) and the US with the active involvement of the Center for Disease Control and and Prevention (CDC) combine with the help of the unquestioning corporate media, like Washington Post, spent most of their time figuring out how to blame the cholera outbreak on Haiti than anything else. (HLLN analysis of Times’ cholera article) 

"The source of the cholera outbreak in Haiti" they uniformly opined, was not important. Or, these internationals would simply whine and wail to all and sundry the racist, capricious and facile catch-all: "Let's not play the blame game!" 

The UN, Obama's State Department, Paul Farmer, Billy and Hillary of the Bill and Hillary UN-Fund for Haiti, of course, back up the official UN position that the UN is not legally nor morally responsible for bringing a deadly disease to Haiti that's killed over 7,000, and infected more than 550,000 in less than two years. 

This perhaps clues us into why the Washington Post editorial maintains: "Groups representing thousands of Haitian cholera victims have demanded millions of dollars of reparations from the United Nations, citing the disease’s introduction by the peacekeepers. But the United Nations’ money, if it manages to raise any, would be more profitably spent on a much more aggressive cholera vaccination program." 

Endorsing the profiteering 

The editorial seems written by the big pharmaceutical lobbyists or their patron doctors. It maintains that justice for the Haiti cholera victims is "more profitably served" if the UN gives, whatever monies it manages to raise to pay for the damages it caused when it poisoned Haiti's waterways and the Haiti cholera victims, back to Paul Farmer's pharmaceutical friends to buy their own drugs. That's clearly more just, presumably, than awarding money damages to the hurt Black Haitian and systematically detoxifying the land and waterways the UN troops poisoned? 

This level of indifference and proposed profiteering is almost as alarming as that of the un-named "groups representing thousands of Haitian cholera victims." That group is led by the Institute For Justice and Democracy in Haiti (IJDH), has the UN-big pharmaceutical and CDC-affiliated doctor, Paul Farmer on its board and claims to be the lead lawyers defending the human rights of the Haiti cholera victims.

I generally agree with her views about the editorial and the attitudes behind it. But I'm struck by the criticism of IJDH, which she goes on to describe as "carpetbaggers and scalawags." This reflects a complexity in Haiti cholera politics that I hadn't been aware of.

Haiti: Baby dies of cholera after return from treatment at U of Iowa

Via KCRG.com: Baby Treated at UI Hospitals Dies After Return to Haiti. Excerpt:

Surgery changed the outlook for a Haitian baby brought to the United States by an Iowa City couple, but it was a common disease that took the little girl’s life at home. 

Bedica Ermilus likely died of cholera after being returned to her family in Haiti, said Dr. Christopher Buresh, 36, an emergency physician at University of Iowa Hospitals and Clinics who made arrangements for the then 3-month-old girl’s surgery at UI Children’s Hospital in March. 

“It’s been really hard,” Buresh said Wednesday night. “We’ll never really know what it was.” 

Bedica became ill with a fever, vomiting and diarrhea just days after returning to Haiti. Despite efforts of community health workers and her family, she died May 17 at nearly 5 months old. 

Cholera, which causes diarrhea and dehydration, can spread by drinking contaminated water or eating contaminated food. The bacterial disease is rare in the United States, but an outbreak that started after Haiti’s earthquake in 2010 saw an upsurge this spring. 

“Babies are really susceptible to it,” Buresh said. “What’s sad is the same day she died, I bet there were 500 or 1,000 other babies who died of the same thing.”

Cholera in eastern Uganda sparks fears as torrential rains persist

Via Xinhua: Cholera in eastern Uganda sparks fears as torrential rains persist. Excerpt:

Persistent torrential rains in the eastern Ugandan district of Mbale and Pallisa have sparked fears that the cholera outbreak there is likely to spread to neighboring districts. 

From two deaths registered at the onset of the outbreak in Mbale district in March, the number rose to 12 in April and currently stands at 21 out of the 303 confirmed cases, according to the district health statistics. 

National statistics released by the Ministry of Health recently put the death toll of cholera cases at 73, although other reports say about 100 people have succumbed to the disease countrywide. 

The number of people affected has increased to 3,111 from 2,200 in March in 13 districts of northern, eastern and western Uganda. 

In eastern Uganda, especially Mbale district which is the epicenter of the disease, experts attribute the outbreak to the heavy rains that carry human waste to the water sources from which people draw water. 

Some families do not have latrines and therefore use the bush to ease themselves. This practice according to experts is likely to spread the disease further. 

At the isolated treatment center in Namatala health center in Mbale town, four patients have been lately admitted including a seven-year-old child from neighboring Butaleja district. 

Paul Waniahe, the officer in charge of the health center, told Xinhua on Tuesday that they were witnessing a rebound of cholera cases. 

Records at the health unit indicate that while a total of 143 patients were admitted in March, the number declined to 31 in the subsequent month, but has lately risen to 53.

Haiti: OCHA on the cholera situation

Via ReliefWeb, OCHA has published Haiti: Cholera Snapshot (Published on May 2012) and a Humanitarian Bulletin, May 2012, both PDFs. The first includes some tables and graphs, including one showing a bad spike in cholera deaths late in April. 

The second, a multi-page document, deals with several issues, not just cholera. But it tells us that "the number of daily new cholera cases has more than quadrupled between 8 and 10 April." It also repeats the dubious PAHO warning of "200,000 to 250,000" cases this year, and notes that "the non-payment of salaries of community brigadiers and staff working in the cholera treatment centers and units managed by authorities [=MSPP] remains a major concern."

While I'm grateful for this information, it's still frustrating to get it weeks late. OCHA makes an understandable fuss about the lack of funding from international donors, but more money might be forthcoming if we got news about cholera instead of just history.

Thailand: Dengue fever death in Phuket raises concerns

Via International Travel Insurance Journal: Dengue fever death in Phuket raises concerns. Excerpt:

An expatriate resident of Phuket is reported to have died from mosquito-borne dengue fever in April, the first such death on the island this year. 

Although deaths from the disease on Phuket are comparatively rare, the director of the Phuket Provincial Health Office, Dr Sak Tenchaikul, is warning of an increase in cases in 2012. 

The total number of confirmed cases this year is already over 150 – a significant increase from 2011 – and Sak is advising residents and tourists to take necessary precautions such as adding fish to ponds and not allowing pools of water to collect, as mosquitoes tend to breed in those areas. Local authorities will usually fumigate to rid infested areas of mosquitoes.

Canada: Nunavik public health director pleads for cooperation in curbing TB outbreak

Via Nunatsiaq Online, a disturbing report from the Arctic: Nunavik public health director pleads for cooperation in curbing TB outbreak. Excerpt:

PUVIRNITUQ — With the number of active tuberculosis cases in Kangiqsualujjuaq now at 48 (up from 46 on May 25 and 33 earlier this month), Nunavik’s director of public health visited Puvirnituq May 30 to rally public support for efforts to end the largest TB outbreak Nunavik has seen since 2004. 

Since 2004, there have been 137 cases in Nunavik, Dr. Serge Déry told counsellors at the Kativik Regional Government meeting. 

Most TB cases during those past eight years were concentrated in Umiujaq, with 19 cases, Salluit with 17, Inukjuak with 11 and Puvirnituq with nine. 

This makes the outbreak in Kangiqsualujjuaq much larger than usual, he said. 

But what’s also new about the outbreak is that it’s continuing to expand in numbers, with 48 active cases diagnosed since November 1. 

That’s unusual, Déry said, and this requires “unusual procedures” to prevent its spread, he said, mentioning the portable x-ray machine that is now looking for TB within the lungs of 800 residents in the Ungava Bay community. 

Déry said he didn’t expect to have to place Kangiqsualujjuaq under quarantine. 

But the public health department can’t send in more x-ray machines, more doctors and more nurses, he said, because those measures alone won’t be able to curb the outbreak. 

So, Déry made a plea — also broadcast live on Nunavik’s Taqramiut Nipingat Inc. radio network — for more cooperation. 

He asked people who are found to be infected with TB to take their medication. That’s because many people, previously prescribed a nine-month or year-long course of treatment for “sleeping” TB, which has no symptoms, have now developed active TB. 

Probably they did not complete their prescribed treatment, Déry suggested.

Why polio just became a global health crisis

Via The Atlantic.com: Why Polio Just Became a Global Health Crisis—and a Global Governance Crisis. Excerpt:

Few people probably associate the phrase "global health emergency" with polio, a disease that has been around for 5000 years and is on a decades-long decline so steep that there are less than a thousand recorded cases left on Earth, and it no longer even seems real to many in the developed world. "Global health emergency" might sound applicable to HIV/AIDS, malaria, or cancer, but polio? 

And yet, that is exactly what happened late last Friday afternoon in Geneva, when the World Health Assembly, the governing body of the World Health Organization, declared polio a public health emergency, calling for the 194 member states to fully fund the Global Polio Eradication Initiative, and fill the currently $945 million gap in its budget for 2012-13. 

But this is about much more than just filling a budget shortfall: polio's threat is still very real, and the mission to finally stamp it out forever is a crucial one for reasons even bigger than the disease itself. 

Since the world decided to come together to eradicate polio in 1988, the disease has been almost entirely eliminated. It killed or paralysed more than 350,000 children each year in the 1980s, but there were just 650 recorded cases in 2011. In January, India celebrated its first polio-free year in history, leaving the disease endemic in just three countries: Nigeria, Pakistan and Afghanistan. The latest figures from the World Health Organization show only 60 cases so far in 2012. 

But polio is a different type of emergency than the ones we usually hear about in the news. Its biggest danger isn't the current number of cases, but the implications for failure: not only because a failure to eradicate could allow for a resurgence that could kill or disable thousands of children each year, but because of what it holds for the effectiveness of our global health systems itself.

Malaria diagnosis as a computer game

This sounds like a better use of one's time than Angry Birds. Via Rosemary Drisdelle's excellent blog on parasites: MOLT: An Internet Game for Diagnosing Malaria. Click through for the full post and a link to the game. Excerpt:

Twenty-four small images of red blood cells appear on the screen. Your job is to click on any that have a malarial parasite inside, removing the image. When you’ve removed all the infected cells, click on “Label all Negative” and another twenty-four cells appear. At the end, you’ll get a score and some information about how many correct choices you made. 

The game is called MOLT, and it was designed by the Ozcan Research Group at UCLA. Anyone can register and play. The idea is that anyone can be given some basic information about what malarial parasites look like in red blood cells and then be part of an accurate means of correctly diagnosing the disease without having to rely on experts in the field. This would be a huge improvement for malaria diagnosis in parts of the world where malaria kills millions each year and people skilled in diagnosis are rare. 

A pilot study of the game using 20 gamers produced results that were within 1.25% of the accuracy of actual experts adept at recognizing malaria, which is pretty impressive. One can imagine an arrangement where someone puts a blood film on a microscope somewhere in Asia or Africa, the images are sent out electronically to potentially millions of gamers around the world, and the answer comes back, positive or negative, in a very short time. If the pilot is any indication, the answer would agree, most of the time, with what an expert would have said. 

This has implications for lots of other things that are done by microscopy or other types of imagery: pap smears, fecal smears for parasites, pathology slides etc. It could be improved upon by adding automated scanning techniques and actual experts to the crowd of gamers. These things, plus a larger number of gamers would likely be even more accurate than the gamers used in the pilot. It’s exciting.