H5N1

Canada: Another aftershock off Haida Gwaii

Via The Vancouver Sun: 5.1 M earthquake recorded off Haida Gwaii; no tsunami alert issued. Excerpt:

A 5.1 M earthquake east of the southern coast of Haida Gwaii was recorded at 8:15 p.m. Wednesday, though authorities say there is no tsunami danger. 

The earthquake happened about a kilometre under the ocean floor and about 97 km east of the island community of Sandspit, according to an National Oceanic and Atmospheric Administration bulletin issued at 8:20 p.m. Wednesday.

India's encephalitis deaths: Do health officials know ground realities?

Via The Times of India: Encephalitis deaths: Do health officials know ground realities? Excerpt:

LUCKNOW: The state health and family welfare minister Ahmad Hasan has assured all possible steps to arrest the rising encephalitis death toll. But perhaps the message has not reached the health department which remains insensitive towards the issue. 

In October last year, Manav Seva Sansthan had urged the National Human Rights Commission to take a note of deaths of children in eastern districts of UP. They backed their plea with proper facts, figures, documents and pictures. The commission took the letter as a complaint and asked the state health department to submit a reply. 

However, the state health department has furnished a reply to the same just a few weeks ago. Moreover the kind of reply submitted also reflects the level of seriousness of health officials. 

It's a common knowledge that a minimum of two patients share a single bed in the encephalitis wards of BRD Medical College, Gorakhpur, during the disease season. And three to four children sharing the same bed during the peak season is a common sight. But the health authorities refuse to believe this. 

In point number 3 of the complaint, the petitioner said, "the pathetic situation of poor children affected by JE virus can be understood from the fact that four to five children are treated on a single bed." The health department's reply in this regard was disappointing. 

"It is submitted that the action is at the end of the administration of the medical college... how do they manage patients but seldom has it got full occupancy even in the extreme conditions. Anyhow, the medical college is constructing a separate 100-bedded ICU." 

The state health department continued to stress that they were best possible arrangements have been made to ensure that children got the best of treatment right from district hospital to the level of community health centre. But the claim falls flat on the ground zero. TOI went for a field visit to block CHC Kasia in Kushinagar district. This centre admitted only one patient of encephalitis in 2011. However, it has referred 66 suspected patients to the district hospital. 

Yogesh Dube, member, national commission for protection of child rights, summoned top health officials to Delhi and asked them to explain why children in encephalitis affected districts were dying. 

Extremely dissatisfied over the measures taken by the state government to check encephalitis, Dube had told TOI, "the situation has not changed an inch since the previous season. We can see four children sharing a bed in BRD medical college and ill-equipped health facilities even now. The government hasn't done anything concrete."

Hong Kong: Bird flu expert to lead push for first vets' school

Via The Standard: Bird flu expert to lead push for first vets' school. Excerpt:

City University has hired a senior government official who was closely involved with outbreaks of bird flu to head a team that is planning the territory's first veterinary medicine school. 

Veterinarian and epidemiologist Howard Wong Kai-hay left his post as principal veterinary officer after 16 years at the Agriculture, Fisheries and Conservation Department early last month to become executive director of CityU life sciences programs. 

Wong also helped draft food safety laws that came into effect last year when he was seconded to the Food and Health Bureau. 

He said his job at CityU is to establish a vets' school that will find "a synergy or a focal point" for its existing life sciences programs, such as biology, bioengineering and biotechnology. "We are not just looking at a vets' school in isolation of everything else. 

"There is a lot of collaboration that could be done even with public health, for example, with other universities." 

Wong, who earned his veterinary medicine degree at Cambridge University and master's degree in preventive veterinary medicine at the University of California, said CityU will build a small-animal hospital on campus. 

He said the university expects to launch the six-year veterinary medicine course in 2014-15, with 30 students. 

"There is no vet training of any sort in Hong Kong so we hope to develop these specialists in food safety and public health so they can raise the standard in the whole region and fill in gaps," Wong said yesterday. "The unique thing is we are doing it with Cornell University [in New York], the No1 vets' school and the oldest in the United States so the partnership with Cornell is fantastic." Cornell will help develop the curriculum and facilities. 

About 200 Hong Kong students go overseas each year to study veterinary medicine. 

Out of 600 registered vets, only 330 are practicing vets in the territory, 30 of whom work in the government and the remainder in the private sector.

India: Malaria, dengue (and typhoid) gang up in Delhi

Via the Hindustan Times: Malaria, dengue gang up in Delhi. Excerpt:

Vector-borne diseases are ganging up this season to give a headache to doctors who have found people being infected by multiple diseases simultaneously. 

Ask Shalini Bharti, 19, who survived a deadly mix of dengue, malaria and typhoid. When Bharti was admitted to south Delhi’s Moolchand hospital on October 11, her haemoglobin count was 7.7 g/dl and her platelet count had dropped to 75,000 per microlitre of blood. 

“In 10 minutes my fever would go from 100 degrees Fahrenheit to 108 degrees. I remained unconscious for the initial few days and it was only after the blood transfusion that my condition stabilised,” said Bharti. 

A first-year college student, Bharti had been diagnosed with typhoid but after she was admitted to the hospital, it was found that she had been suffering from malaria as well. 

“We immediately put her on anti-malarial drugs. A combination of all three diseases is usually a rare occurrence. She was critical but fortunate enough to have survived,” said Dr Srikant Sharma, consultant, internal medicine, Moolchand Medcity, Bharti’s treating doctor.

On October 20th, Bharti was finally discharged from the hospital, a day before her 19th birthday on October 21. 

Meanwhile, Delhi reported its third dengue death on Wednesday with an 11-year-old girl succumbing to the disease at Bhagwan Mahavir Hospital in Pitampura. Sejal, a student of class five, was admitted to the hospital on Monday. Her father runs an electronics shop in Moti Nagar. The total dengue cases also crossed the 1,000 mark, sitting at 1,019. 

But it is the deadly combination of diseases that has the doctors worried. Doctors are advising patients to take multiple tests if fever refuses to die down even after four days of medical care.

“People must not self medicate and certainly should not self-prescribe antibiotics as it will only worsen the condition,” said Dr Richa Diwan, head of department of medicine at Lok Nayak hospital.

WHO: Marburg haemorrhagic fever in Uganda - update

WHO has published Marburg haemorrhagic fever in Uganda - update.

31 OCTOBER 2012 - As of 28 October 2012, a total of 18 cases and 9 deaths, including a health worker, have been reported from 5 districts namely Kabale district, in south-western Uganda, Kampala (the capital city), Ibanda, Mbarara and Kabarole. The case fatality rate is 50%. 

The outbreak was declared by the Ministry of Health in Uganda on 19 October 2012. Blood samples from 9 cases have been confirmed for Marburg virus at the Uganda Virus Research Institute (UVRI). 

Currently, 13 patients have been admitted to hospital (2 in Kampala, 8 in Kabale, 3 in Ibanda) and their contacts are listed for daily follow up. The latest confirmed case was admitted to Ibanda district isolation ward on 26 October 2012. 

The World Health Organization (WHO) and international partners including, the Centers for Disease Control and Prevention (CDC), the Uganda Red Cross (URCS), African Field Epidemiology Network (AFENET) and Médecins-Sans-Frontières (MSF) are supporting the national authorities in outbreak investigation and response. 

The national task force has identified additional health care workers and epidemiologists to strengthen the teams in the field. Training of health workers on infection prevention and control, surveillance and clinical case management is ongoing. 

Social mobilization activities are being conducted which include the dissemination of IEC (Information Education Communication) material, sensitization on Marburg prevention and control and broadcast of information through radio channels. The first shipment of personal protective equipment (PPE) provided by WHO arrived over the weekend. 

The WHO Regional office has deployed an epidemiologist and a logistician to Uganda to support the response teams on the ground. In addition, a social mobilization expert from WHO Zambia Country Office and a logistician from the Regional Rapid Response Team network have been mobilized for immediate deployment. More experts are being identified by the Global Outbreak Alert and Response Network (GOARN). 

As the investigation into the outbreak continues, WHO and partners continue to support the national authorities as needed in the areas of coordination, infection prevention and control, surveillance, epidemiology, public information and social mobilization, anthropological analysis and logistics for outbreak response. 

Neighbouring countries have been contacted to strengthen cross border surveillance and preparedness to prevent cross border spread of the outbreak. 

WHO advises that there is no need for any restrictions on travel or trade with Uganda.

US: Florida man diagnosed with dengue fever recovering

Via GantDaily.com: Florida man diagnosed with dengue fever recovering. Excerpt:

A 19-year-old man from Seminole County, Florida has been recently diagnosed with dengue fever and is said to be recovering. 

The Orange County Health Department has confirmed Tuesday that they are investigating the locally acquired case of dengue fever reported near the Seminole-Orange County line by the University of Floria that has been validated by laboratory tests. 

Health department spokesman Dain Weister said that it is the first case of locally acquired dengue fever documented in either county since the 1960s. Both Seminole and Orange County Health Departments are investigating.

Haiti: 7,615 cholera deaths as of October 28

MSPP has released new cholera statistics on its Documentation page, this batch running from October 20 to 28. As usual, the daily totals and cumulative totals don't add up, but (also as usual) some departments are slow to report. Grande Anse seems not to have reported at all in this period.

In any case, the daily total for this October 20-28 is 2,651; the cumulative total has risen from 604,045 on October 19 to 606,951 on the 28th—a rise of 2,906. Either way, the totals reflect high daily numbers, in the high 200s or low 300s. October 27 saw a sharp spike from 286 the day before to 381, followed by a drop on the 28th to 184 (again, with some departments not reporting).

Daily deaths were high during this period, with 5 per day on October 20 and 21 and 4 on the 22nd. Total for the period was 25 deaths, but cumulative deaths since October 21 showed an increase of 27, from 7,588 on the 19th to 7,615 on the 28th. 

Unusually, MSPP has also posted two statements in French on the Documentation page. When I have a moment, I'll Google-translate them and post excerpts. 

India: Two dead as Cyclone Nilam crosses Tamil Nadu coast

Via The Times of India: Two dead as Cyclone Nilam crosses Tamil Nadu coast. Excerpt:

CHENNAI: Cyclone Nilam today swept across north Tamil Nadu coast near Mahabalipuram, about 55km from here, leaving two people dead, including a crew member of an oil tanker that ran aground off the city. 

The crew member drowned after a life boat carrying him and 21 colleagues capsized in choppy waters off Besant Nagar locality in south Chennai in high velocity winds just hours before the cyclone hit the coast. He was brought dead to a hospital while 15 others were rescued. 

They had attempted to escape using the life boat after the ship with 37 crew ran aground having been drifted by high velocity winds. Two others are in a serious condition, Chennai Port Trust officials said. 

Navy, Coast Guard and other agencies are searching for the remaining six. The other 15 remained onboard " Pratibha Cauvery", the officials said. 

In Puducherry, a 46-year old man slipped into the rough sea and drowned when he, along with his friends, was walking on the pier to see the sea conditions during the cyclonic storm. 

It was much relief to the authorities as the cyclone, forecast to be accompanied by wind speeds reaching 110 kmph, made the landfall with a maximum speed of only 65-75 kmph, saving the state of largescale destruction. 

About 4,000 people residing close to coast in Mahabalipuram, a famous tourist spot known for its temples and sculptures, were evacuated to safer places, officials said.

The story doesn't mention the fate of the oil tanker.

Uganda: Ministry of Health Marburg update

Via the Uganda Media Centre: Press Statement on the Update of Marburg Outbreak by Dr. Christine Ondoa, Minister of Health. Excerpt:

Today on behalf of the Ministry of Health, I take this opportunity to welcome you all to this press briefing organized to update you on the outbreak of Marburg in the country. 

You will recall that we declared an outbreak of this highly infectious disease on October 19th and since then the Ministry of Health and its partners have undertaken a number of interventions to control the spread of the disease. 

I wish to inform you that cases are now reported in the neighbouring districts of Ibanda and Mbarara. However, I want to assure you that the Ministry of Health and its partners are on the ground in the mentioned districts to contain the spread and manage the identified cases. 

To date, the death toll of both the probable and confirmed cases stands at eight, with the latest being a case that died at the isolation facility at Rushoroza Health Centre III on October 27th (Saturday). The case that was referred from Ibanda Hospital – Ibanda to Mbarara Regional Referral Hospital died on October 24th. 

I wish to clarify that since the onset of the outbreak, we have collected a total of 45 samples of which nine were confirmed positive; five in Kabale, two in Kampala and two from Ibanda. 

Working closely with the US Center for Disease Control and Prevention (CDC), we have set up a field diagnostic laboratory at Kabale Regional Referral Hospital. All samples from the affected neighbouring districts will hence be taken to this laboratory for quick diagnostics. This will shorten the time when we get results to three hours from the original 24 hours due to distance. Further serological testing will be undertaken at the Uganda Virus Research Institute (UVRI). 

Due to the presence of cases in other districts, we have established temporary isolation facilities to accommodate the suspected and confirmed cases. In Ibanda, a temporary isolation ward has been created at Ibanda Hospital, while plans are underway to set up a proper isolation facility by tomorrow. 

At Mbarara Regional Referral Hospital, a separate temporary has been designated for the suspect Marburg cases. A triage has also been set up at the casualty ward. 

We have assembled a team of experts to work in the newly established isolation facilities and they are expected in these districts today.  We also plan to undertake infection control procedures in these facilities as safety measures for the workers and the admitted patients. 

Today, the total number of cases admitted is 12. Eight are currently admitted at Rushoroza Health Center III in Kabale. Two confirmed cases, a couple (husband and wife) still remain admitted at Mulago National Referral Hospital. Another two suspect cases are currently admitted at Mayanja Memorial Hospital in Mbarara. 

There are seven suspect cases (student nurses) quarantined at Ibanda. These cases attended to the confirmed case that later died at Mbarara Regional Referral Hospital on October 24th. Other health workers who attended to the patient are closely being monitored.

WHO: Yellow fever hits Central and South Darfur

Via ReliefWeb, a report from WHO: Yellow fever hits Central and South Darfur.

On 29 October 2012, Sudan’s Federal Ministry of Health (FMoH) notified the World Health Organization (WHO) of a yellow fever outbreak in seven localities in Central and South Darfur. Since the first week of October, a total of 84 suspected cases including 32 deaths have been reported from the districts of Azoom, Kass, Mershing, Nertiti, Nyala, Wadi Salih and Zalingei. 

FMoH said that the immediate priority is to control the vector, reinforcing the disease surveillance system and raising public awareness on the prevention and control of this disease. Preparations for a mass vaccination campaign are underway to vaccinate the at risk population in Darfur. 

Yellow fever is spread by mosquitoes. There is no specific treatment for yellow fever, only supportive care to treat dehydration and fever, and blood transfusion if and when needed. It is a preventable disease with symptoms and severity varying from case to case. Protective measures like the use of bed nets and insect repellent are considered the best ways to contain an outbreak. 

Vaccination is the single most important measure for preventing yellow fever. 

FMoH, WHO, as well as health partners are working on ground to ensure timely containment of the outbreak.