H5N1

Canada deploys mobile lab to fight DR Congo Ebola outbreak

Via the Public Health Agency of Canada, a news release: Canada Deploys Mobile Laboratory to Assist in African Ebola Outbreak.

At the request of the World Health Organization, the Public Health Agency of Canada is deploying its mobile laboratory to help respond to an outbreak of Ebola in the Democratic Republic of Congo. The Honourable Leona Aglukkaq, Minister of Health, today commended the Agency’s humanitarian efforts.

“Our Government is committed to supporting global public health,” said Minister Aglukkaq. “As leaders in this field, we are pleased to assist our international partners in responding to this deadly outbreak to help save lives.” 

Agency scientists from the National Microbiology Laboratory in Winnipeg will set up its mobile lab in the affected region to provide rapid diagnostic testing, which is pivotal in responding effectively to the outbreak. On-site lab tests that can produce results in only a few hours allow for faster isolation of Ebola cases and better treatment for all patients. This reduces the risk of people who are infected from spreading the virus to others, which saves lives and helps contain the outbreak. 

“This is a very serious situation and the Agency is proud to assist in the response,” said Dr. Frank Plummer, Scientific Director General of the National Microbiology Laboratory. “It’s very important that the international community come together to help control an outbreak of this nature, both for humanitarian reasons and to protect the health of all global citizens.” 

The team is being led by Dr. Gary Kobinger, who has built a strong global presence with his research into Ebola and other viral haemorrhagic fevers. Recently, Dr. Kobinger and his team have received international recognition for the ground-breaking development of an Ebola treatment and vaccine. 

The Agency’s team also has extensive field experience from previous outbreaks around the world including in similar locations. They have developed an extremely agile and adaptable portable lab system that enables it to travel into the most remote and isolated regions and operate under difficult circumstances. 

Ebola virus is a highly contagious illness that causes death in 25 to 90 percent of all cases. Early symptoms of the disease are similar to non-life threatening illnesses such as Malaria, which is why early detection is critical to outbreak response. 

The National Microbiology Laboratory is Canada’s leading public health infectious disease laboratory and the only facility in Canada that is permitted to study and work with live fever viruses such as Ebola and other similarly highly infectious and deadly organisms.

Kenya : State on high alert over Rift Valley fever

Via Standard Digital News: Kenya : State on high alert over Rift Valley Fever plague.

The Government has raised an alert over the possibility of an outbreak of the dreaded Rift Valley fever in parts of the country. 

Following reports by the meteorological department that some areas will experience heavy rains, the Ministry of Livestock said mitigation measures were being put in place. 

According to the minister in charge Mohammed Kuti, surveillance was high in parts of North Eastern and Rift Valley. 

“The disease emerges whenever there are heavy rains and we have heightened our surveillance mainly in areas previously affected by the disease,” said the minister. 

Dr Kuti said his ministry had already released 300,000 and 500,000 doses of vaccine to pastoralists in Garissa and Baringo respectively. He called on pastoralists in areas previously affected by the disease to report any suspicious symptoms.

India: Now it's "dengue-like flu"

Via The Times of India: Dengue-like flu stumps doctors too. Never having heard of this, I'm stumped as well. Excerpt:

CHANDIGARH: If you are coughing, running fever which persists for over a week, the viral could be similar to dengue. City hospitals are getting patients coming with dengue-like symptoms, which make it difficult for doctors to figure out if it is dengue or dengue-like flu. 

Consequently the treatment gets delayed and if its dengue, the condition can become severe, making treatment difficult. 

Dr R S Bedi, a city-based paediatrician said, "Besides dengue cases we are seeing dengue-like flu in which too there is reduction in platelet count. There are around 20-25 children coming to my clinic with this condition." It is during this time of the season that there are dengue cases and also viruses which result in fever and body aches. 

"The fever continues for more than a week in flu and dengue cases. To confirm our diagnosis we recommend platelet count tests after three-four days of fever and continuous monitoring of the count," said Dr Bedi. Doctors recommend not getting platelet count done on the first day of the fever as this is bound to fluctuate. 

"Patients who come with fever and body aches get platelet count done on the first day. It is not necessary that the count will go below normal immediately. It might take three to four days. Some of these patients stop taking the right treatment and then the problem becomes severe and untreatable," said Dr Abhinav Sharma, a city-based physician. 

Panchkula-based paediatrician Rajendra Setty said, "We see 30-40 such dengue-like flu cases among children daily. Dengue is self-limiting and we do not advice antiplatelet drugs like ibuprofen (given during fever) as they also further reduce platelet count."

Hong Kong's novel coronavirus page

I should have picked this up when it was posted on September 28 by the Hong Kong Centre for Health Protection: Severe Respiratory Disease associated with Novel Coronavirus. As usual, Hong Kong has put together an excellent public information package (and for a virus we just learned about). Whether you're a health professional, a traveller, a layperson, or a member of the media, you'll find something useful here.

Haiti takes on elephantiasis one mouth at a time

Via The Washington Post: Haiti takes on dreaded disease elephantiasis one mouth at a time. Excerpt:

In JACMEL, Haiti — In a sunny courtyard of the Evelina Levy School for Girls, hundreds of girls in blue uniforms did their part to rid Haiti of an ancient and reviled disease. 

They lined up in pairs to get three pills dropped into their mouths. They swallowed them down with a quarter-cup of water. They got a second medicine, a flavored tablet, to chew as they walked back to class. 

Two middle-aged women treated 12 girls every 2 1/2 minutes, one pouring the water and the other shaking out the pills. Another woman ticked the columns for age, sex and drug on a white form with a green pen. 

“Mass drug administration” is easy if your target is elementary school students. It’s harder when you want to reach nearly everyone else in a country of 10 million people. 

That is the goal Haiti set this year in its campaign against a parasitic infection called lymphatic filariasis that is present in 80 percent of the country. Spread by mosquitoes, in severe cases it leads to permanent swelling of an arm or leg. That condition, called “elephantiasis,” can be grotesque and life-changing. In men, the worms can cause a swelling of the scrotum that is even more stigmatizing. 

Lymphatic filariasis is a “neglected tropical disease,” the name for a group of maladies that have disappeared from industrialized countries or never existed there. Others include onchocerciasis (“river blindness”), schistosomiasis (“snail fever”), soil-based intestinal worms, and the eye infection trachoma. For 1.9 billion people, most of them poor, they are still threats.

China renews quarantine requirement for coronavirus

Via China Daily: China renews quarantine requirement. Excerpt:

China's top quarantine authorities on Sunday renewed its order to boost quarantine measures to prevent the entry of a new type of coronavirus following a World Health Organization (WHO) report. 

The new coronavirus has left a Qatari citizen dead and a British citizen who had traveled to Saudi Arabia in critical condition in a London hospital,  the WHO report said Saturday. 

Noting that there is no evidence so far of person to person transmission of the new type of coronavirus, WHO said that no additional confirmed cases have been reported till Saturday. 

In a statement, China's General Administration of Quality Supervision, Inspection and Quarantine again demanded for intensified body temperature monitoring and other medical inspections on travelers from Britain, Saudi Arabia and Qatar. 

The administration also requires travelers from the three nations to inform China's entry-exit inspection and quarantine institutions immediately if they develop acute respiratory symptoms such as fever, cough or shortness of breath.

Picard on the novel coronavirus

Via The Globe and Mail, public-health reporter André Picard offers a Q&A session: Why you shouldn’t worry about the new mystery virus. Excerpt from an informative article:

Public-health officials around the world have been alerted to be on the lookout for a new respiratory disease caused by a previously unknown coronavirus. This has raised fears that “the next SARS” has arrived. 

So far, only two people, a 60-year-old man from Saudi Arabia and a 49-year-old man from Qatar who recently visited Saudi Arabia, are known to have been infected. The former died and the latter is recovering in a London hospital. So why is this pathogen getting so much attention? 

What is this new virus? 

It is a coronavirus, in the same family as the common cold and SARS (sudden acute respiratory syndrome). It does not yet have an official name, but British scientists have dubbed it “London1_novel CoV2012.” 

Why the concern if only two people have been infected? 

When a novel pathogen arises – one that hasn’t been seen in humans before – there is very little natural immunity, which means that, theoretically at least, it could spread very rapidly. Coronaviruses like this one attack the lungs, causing fever, cough and breathing difficulties. 

Where did the new virus come from? 

The source of the virus has not yet been identified. It could be an existing, innocuous coronavirus that mutated to become more dangerous or could have jumped from another species. London1_novel CoV2012 is genetically similar to bat coronaviruses, suggesting that it may have jumped to humans from bats. SARS was originally believed to have jumped from civets to humans in China, but there is some evidence it originated in bats. 

How does this disease spread? 

Coronaviruses generally spread in droplets when an infected person coughs or sneezes. In this case, however, there is no evidence that the virus can spread from human to human. The two men who have been identified with the disease seem to have contracted it separately, months apart. 

Is this ‘the next SARS’? 

Despite the newspaper headlines, Gregory Hartl, spokesman for the World Health Organization, is pretty categorical: “This is not SARS, it will not become SARS, it is not SARS-like.” 

But the WHO is monitoring the new pathogen carefully, he added, because of the lesson learned from SARS, that a new coronavirus can spread quickly and be deadly. There are also fears the virus could mutate and spread more easily. 

In fact, even before SARS hit, there were predictions that the next pandemic would be caused by a coronavirus. That is because coronaviruses evolve quickly and can jump species more readily than other viruses.

Powerful typhoon makes landfall on Japan's main island

Via The Japan Times: Powerful typhoon makes landfall on Japan's main island. Excerpt:

A powerful typhoon that was traveling northeastward Sunday along the coast of western Japan made landfall on the main island of Honshu after hammering the southern islands of Okinawa, where it killed a man and injured more than 50 people while causing extensive blackouts, the weather agency said. 

At 7 p.m., Typhoon Jelawat made landfall in Aichi Prefecture in central Japan, with the season's 17th typhoon moving through the Japanese archipelago, the Japan Meteorological Agency said. 

In the village of Yomitan in Okinawa Prefecture, 29-year-old Nobuhiro Bando was confirmed dead after being washed away by high tides while he was fishing. A survey by Kyodo News on local police showed that at least 116 people had been injured across the nation on Sunday. 

In Osaka's Chuo Ward, a 51-year-old female tourist from Australia was taken to a hospital after she was injured by a tree trunk that fell and hit her on the head. 

The municipal government of the central Japan city of Nagoya briefly issued an evacuation advisory for a total of 57,000 people in 21,000 households amid fear of flooding due to rising water levels of rivers in the city. The Ishinomaki city government in Miyagi Prefecture in northeastern Japan, issued an advisory for 11,000 people in 4,700 households in Miyagi Prefecture. 

As of 11 p.m., the typhoon was located near the eastern Japan city of Maebashi in Gunma Prefecture, moving northeast at a speed of about 55 km per hour with an atmospheric pressure of 975 hectopascals at its center and packing winds of up to 180 kph. 

The city of Hachioji near Tokyo recorded winds of 137.2 kph, while the cities of Fujinomiya and Hamamatsu in Shizuoka Prefecture saw 120 millimeters of rain per hour, prompting the weather agency to issue a warning for a record-breaking deluge in a short period.

US: Outbreak of H3N2v in Pennsylvania, 2011

The October issue of Emerging Infectious Diseases is now online. This is one of the expedited articles: Outbreak of Influenza A (H3N2) Variant Virus Infection among Attendees of an Agricultural Fair, Pennsylvania, USA, 2011. The abstract:

During August 2011, influenza A (H3N2) variant [A(H3N2)v] virus infection developed in a child who attended an agricultural fair in Pennsylvania, USA; the virus resulted from reassortment of a swine influenza virus with influenza A(H1N1)pdm09. 

We interviewed fair attendees and conducted a retrospective cohort study among members of an agricultural club who attended the fair. Probable and confirmed cases of A(H3N2)v virus infection were defined by serology and genomic sequencing results, respectively. We identified 82 suspected, 4 probable, and 3 confirmed case-patients who attended the fair. 

Among 127 cohort study members, the risk for suspected case status increased as swine exposure increased from none (4%; referent) to visiting swine exhibits (8%; relative risk 2.1; 95% CI 0.2–53.4) to touching swine (16%; relative risk 4.4; 95% CI 0.8–116.3). 

Fairs may be venues for zoonotic transmission of viruses with epidemic potential; thus, health officials should investigate respiratory illness outbreaks associated with agricultural events.

Mexico: New dengue serotype "more dangerous than hemorrhagic"

Via El Universal, a September 28 report: Sinaloa alerta por serotipo de dengue más letal. [Sinaloa alert over more lethal dengue serotype] Sinaloa state is in northwest Mexico, on the coast of the Gulf of California. Excerpt, with my translation:

El secretario de Salud estatal, Ernesto Echeverría, pidió a la población mantener limpios sus patios de envases o recipientes que acumulen agua, ante la presencia en algunos estados de un nuevo serotipo de dengue más letal. 

State Health Secretary Ernesto Echeverría has asked the public to keep its patio containers and water-accumulating vessels clean, given the presence in some states of a new, more lethal dengue serotype.

Señaló que en Sinaloa, en donde se mantiene desde hace dos años una intensa campaña de eliminación del mosquito aedes aegypti, circulan sólo los serotipos uno y dos, por lo que este año sólo se han presentado 53 casos nuevos, de los cuales nueve son hemorrágicos. 

He said that in Sinaloa, which has maintained an intense two-year campaign to eliminate the Aedes aegypti mosquito, only serotypes 1 and 2 are circulating. For this reason only 53 new cases have been identified, of which 9 are hemorrhagic.

El funcionario destacó que entidades como Yucatán, con tres mil 300 casos, y Veracruz con seis mil casos de dengue, han detectado un tercer serotipo, más peligroso que el hemorrágico, que puede ser letal si los pacientes no se atienden de forma oportuna.

The official emphasized that state like Yucatán, with 3,300 cases, and Veracruz, with 6,000, have detected a third serotype, more dangerous than hemorrhagic, which can be lethal if patients are now attended to promptly.

It's not clear from the report if this is dengue serotype 3 or a wholly new serotype. A population that hasn't been exposed to a given serotype in several years can be vulnerable to it when it does return. And a person who's already caught one serotype is at higher risk of developing hemorrhagic (severe) dengue if infected with a different serotype.