H5N1

India: 850 dengue cases in six months in Thiruvananthapuram

Via The Times of India: 850 dengue cases in six months. Excerpt:

THIRUVANANTHAPURAM: The dengue cases in the state capital are heading for an all-time record, with 850 cases reported in six months this year. The dengue cases in the corporation area are also on the rise. 

According to the statistics from the district health administration 70% of the dengue cases reported from the district are from the corporation area. 

The state capital witnessed such an outbreak in 2010 and 2011 when 1,145 and 980 cases were reported. In 2006 it was 656, in 2007 it was 290, in 2008 it 503 and in 2009 it was 805 cases. But going with the pace the virus is spreading, the state capital is set record an all-time high this year. 

The worst ever dengue outbreak the state had witnessed was in 2003, when 3,546 cases were reported from the state and there were 68 deaths. That year the state capital reported 789 cases. However, the district health administration has made it clear that there was no cause for concern. 

"The number of cases is coming to the notice due to active surveillance of the disease. The effectiveness of disease surveillance lies in the fact that no dengue death has been reported in the district since January this year," said Dr T Peetambaran, district medical officer. 

Out of the 100 wards in the corporation, 42 have been declared fever hit. More cases of dengue were reported from places like Vattiyurkavu, Sasthamangalam, Poojappura, Karamana, Vallakadavu and Veli.

CIDRAP: News scan for June 26

Via CIDRAP: NEWS SCAN: H5N1 research freeze, CDC weighs lab review, H1N1 vaccine effectiveness in Scotland, TB coalition. Excerpt:

Vaccination for 2009 H1N1 pandemic flu proved effective in preventing laboratory-confirmed influenza as well as in reducing the number of emergency hospital admissions from influenza-related disorders in a nationally representative retrospective cohort study from Scotland published today in Lancet Infectious Diseases. 

The records of 38,296 persons of all ages receiving H1N1 vaccinations (99% getting Pandemrix and 1% Celvapan) from Oct 21, 2009, to Jan 31, 2010, were studied and compared with a cohort of unvaccinated persons. 

There were 924 emergency hospital admissions and 71 deaths in the vaccinated population for influenza-related morbidity, compared with 5,207 admissions and 579 deaths in the unvaccinated population over the nearly 24 million person-days of observation. 

The vaccine's effectiveness in preventing such hospitalizations was 19.5% (95% confidence interval [CI], 0.8%-34.7%). Its effectiveness in preventing laboratory-confirmed H1N1 flu in the entire cohort was 77.0% (95% CI, 0.8%-34.7%). 

The authors note that this figure is slightly higher than the 72% effectiveness for the vaccine found in separate case-control studies conducted in the UK and in the European Union.

Hong Kong: Man critical with Legionnaires' disease

Via the Hong Kong government website: Man critical with Legionnaires' disease.

The Centre for Health Protection is investigating a case of Legionnaires' disease involving a 58-year-old man. His condition is critical.   

He fell ill on June 18 and was admitted to Pamela Youde Nethersole Eastern Hospital's intensive care unit on June 23.   

He has no recent travel history and his home contacts have no symptoms.   

This is the 12th case of Legionnaires' disease reported to the centre this year. There were 17 cases in 2011 and 20 in 2010.

Butler: Freeze on mutant-flu research set to thaw

Via Nature News & Comment, a report by Declan Butler: Freeze on mutant-flu research set to thaw. Excerpt:

If you thought that the controversy was over, think again. Last week’s publication of the second of two papers describing how to make mammalian-transmissible forms of the H5N1 avian influenza virus merely closes one chapter of a smouldering debate about the risks of the research. That debate seems certain to reignite in the coming months once researchers lift a voluntary moratorium on the work. 

The research published last week, led by Ron Fouchier at the Erasmus Medical Centre in Rotterdam, the Netherlands, showed that introducing as few as five genetic mutations made the H5N1 virus capable of airborne spread between ferrets1, 2. It followed similar work published in May3 by Yoshihiro Kawaoka’s groups at the University of Wisconsin–Madison and the University of Tokyo. 

In December 2011, the US National Science Advisory Board for Biosecurity (NSABB) had recommended that only redacted portions of the papers should be published, mainly on the grounds that divulging the detailed methods could increase the risk of bioterrorism. But, after much wrangling, the NSABB in March finally agreed to the publication of updated versions of the full papers4. 

Supporters of the research say that it could help public-health experts to detect ominous genetic changes in nature, providing an early warning of an emerging flu pandemic. 

Others are sceptical, and point out that an expansion of research to pursue this goal would probably see similar mutant viruses being created in dozens more labs worldwide — some of which may lack adequate biosafety standards. That would multiply the risk of an accidental release of a pathogen capable of sparking a pandemic. 

For now, the research moratorium agreed by 39 leading flu scientists in January and extended at a meeting convened by the World Health Organization (WHO) in Geneva in February5 is allowing the field to discuss how to proceed safely. 

The moratorium would only be lifted, experts at the meeting agreed, once funders and regulators had worked out the biosafety and biosecurity conditions that would allow such research to be conducted with reasonable guarantees of safety. The meeting also resulted in a public-relations campaign to influence public opinion about the research and its potential benefits.

Japan: Fukushima reactor building is tilting, Tepco not worried

Via The New York Times: Japan Reactor Building is Tilting But Is Not a Risk, Operator Says. Excerpt:

A heavily damaged reactor building at the tsunami-stricken Fukushima Daiichi nuclear plant has a slight tilt, but the tilt does not pose a risk to the integrity of the building, according to the plant’s operator. 

The Tokyo Electric Power Company, or Tepco, said in a report on Monday to Japanese nuclear regulators that at least two of the walls of the No. 4 reactor building are bulging outward at various points and that the building is tilting. The biggest bulge measured about 1.8 inches about a third of the way up the building, the report said. 

The latest findings could add to concerns over the state of the No. 4 reactor building, which houses on its upper floors a cooling pool filled with more than 1,000 spent nuclear fuel rods. 

Some experts say that the building — ravaged in a hydrogen explosion in the early days of the disaster in March 2011 — is not strong enough to support the fuel pool, especially if another earthquake hits the region.

Cambodia: 27 die in 29,510 malaria cases

Via Xinhua: Cambodia: 27 Die in 29,510 malaria cases in first 5 months. Excerpt:

Some 29,510 malaria cases were reported in Cambodia in the first five months of this year, claiming 27 lives, according to a report of the country's National Center for Parasitology, Entomology and Malaria Control on Tuesday. 

The report showed that the number of malaria cases declined by 11 percent compared with the same period last year, while casualties remained the same. 

Char Meng Chuor, director of the center, said that the decline was thanks to regular awareness campaigns by health officials and the distribution of mosquito nets to the disease-prone groups of people.

Lesotho: Food security goes from bad to worse

Via IRIN Africa: LESOTHO: Food security goes from bad to worse. Excerpt:

Initial estimates of the damage to Lesotho’s already ailing agricultural sector - caused by a year of too much rain followed by a year of too little - suggest that an unprecedented number of small-scale farmers harvested nothing this year. 

Heavy rains and flooding cut Lesotho’s maize production by nearly half during the 2010-11 farming season, causing the price of maize meal to increase by 24 percent between March 2011 and March 2012 and putting a heavy strain on the 40 percent of the population already living in extreme poverty. 

The 2011-12 season began with a prolonged period of drought which caused many small-scale farmers not to plant at all rather than gamble scarce resources on crops that would be vulnerable to frost. 

As a result, what should be a time of plenty has become an extension of the pre-harvest lean season for many. The precise number in need of humanitarian assistance will only become clear when the Disaster Management Authority (DMA) completes its annual food security and vulnerability assessment at the end of June, but a crop forecast by the Bureau of Statistics has already estimated major declines in both total area planted and yields. 

“It’s actually worse than last year, and we thought last year was the worst,” said Matseliso Mojaki, the DMA’s acting chief executive. “Maybe those heavy rains washed away some of the soil nutrients so even those who managed to plant didn’t get a good yield.”

According to the crop forecast, the overall area planted in the 2011-2012 agricultural year decreased by nearly 40 percent from the previous year and the total expected production of maize, the staple crop, fell by 77 percent. Yields of sorghum and wheat have also declined significantly. 

Survival for many of Lesotho’s subsistence farmers has been precarious for years as soil erosion resulting from poor farming practices, HIV/AIDS and increasingly unpredictable weather have all taken their toll. 

Although 82 percent of Lesotho’s population of 1.8 million engage in some form of agriculture, the amount this contributes to the country’s GDP has declined from 25 percent in the 1980s to 10 percent in the last decade and 7.7 percent following last year’s floods, according to the Bureau of Statistics. 

The cumulative effect of two poor or non-existent harvests on top of years of slowly declining productivity has pushed more and more Basotho to start employing what Hassan Abdi, a programme officer with the World Food Programme (WFP) describes as “negative coping mechanisms” such as selling off assets, taking children out of school and reducing meals.

H1N1 pandemic was 15 times deadlier than thought (updated)

Via Reuters, a startling, must-read report: 2009 swine flu outbreak was 15 times deadlier: study. Excerpt:

The swine flu pandemic of 2009 killed an estimated 284,500 people, some 15 times the number confirmed by laboratory tests at the time, according to a new study by an international group of scientists. 

The study, published on Tuesday in the London-based journal Lancet Infectious Diseases, said the toll might have been even higher - as many as 579,000 people. 

The original count, compiled by the World Health Organization, put the number at 18,500. 

Those were only the deaths confirmed by lab testing, which the WHO itself warned was a gross underestimate because the deaths of people without access to the health system go uncounted, and because the virus is not always detectable after a victim dies. 

The new study also shows the pandemic's impact varied widely by region, with 51 percent of swine flu deaths occurring in Africa and southeast Asia, which account for only 38 percent of the world's population. 

"This pandemic really did take an enormous toll," said Dr. Fatimah Dawood of the U.S. Centers for Disease Control and Prevention, who led the study. 

"Our results also suggest how best to deploy resources. If a vaccine were to become available, we need to make sure it reached the areas where the death toll is likely to be highest." 

Swine flu, caused by the H1N1 influenza virus, infected its first known victim in central Mexico in March 2009. By April it had reached California, infecting a 10-year-old, and then quickly spread around the world, triggering fears and even panic. 

The CDC warned Americans not to travel to Mexico if they could avoid it. Egypt ordered the slaughter of all the country's pigs in a misguided attempt to contain the virus, which was in fact spread from person to person. 

The fears reflected the unusual nature of the virus, which contained bits and pieces of bird, swine and human flu viruses, a combination never before detected. 

Scientists were unsure how transmissible or deadly this mongrel flu would be, but early signs were ominous: the World Health Organization declared swine flu a pandemic in June 2009, when labs had identified cases in 74 countries.

Update: Mike Coston at Avian Flu Diary has excellent commentary and background on this report.

India: 233 encephalitis deaths in Bihar

Via OutlookIndia.com: Encephalitis Toll in Bihar Rises to 233.

Encephalitis has so far claimed 233 children in ten districts of Bihar since May this year. 

Additional Secretary (Health) R P Ojha told newsmen today that a total 589 cases of encephalitis has been reported in the state during the period. 

There have been 163 deaths due to the disease at Sri Krishna Medical College and Hospital (SKMCH) and Kejriwal charitable hospital in Muzaffarpur, while 54 children have died at Patna Medical College and Hospital (PMCH). 

A total 11 children have died in the Anugrah Narayan Magadh Medical College and Hospital (ANMMCH) at Gaya, while remaining five deaths have taken place in Vaishali district, Ojha said. 

A meeting was held with officials of the 10 affected districts and it was decided for carrying out two-phasing fogging of Malathion and DDT to prevent outbreak of fever-related disease due to mosquito bite, he added.

Haiti: 7,299 cholera deaths as of June 20

The MSPP has posted two more days' worth of cholera statistics on its Documentation page, bringing us up to June 20. The deaths total for June 18 was 7,297, but that number was reduced by one on June 19. Here are the cases, hospitalizations, deaths, and departments where deaths occurred:

June 19: 150, 105, 0

June 20: 119, 80, 2 (1 Artibonite, 1 Grande Anse)

The MSPP has been highlighting departments that have not reported for the day, so these numbers are an approximation, and probably a serious undercount. The totals since the cholera outbreak began in October 2010:

Cases: 559,487

Hospitalizations: 301,848

Deaths: 7,299

It's also worth bearing in mind that these numbers indicate 5 per cent of the Haitian population have contracted cholera, and about 3 per cent have been hospitalized with it—in a very poor country that lost a considerable part of its healthcare personnel in the 2010 earthquake, and doesn't often pay the survivors.