H5N1

Uganda: Funding, health system constraints impede Marburg control

Via IRIN Africa: UGANDA: Funding, health system constraints impede Marburg control. Excerpt:

Uganda's Ministry of Health is facing serious financial and health system constraints as it battles to contain an outbreak of Marburg haemorrhagic fever that has killed eight people in the country's southwest. 

According to the Uganda Virus Research Institute, as of 27 October, nine patients - five in the southwestern district of Kabale, two in the western district of Ibanda, and two in the capital, Kampala - had tested positive for the highly infectious viral fever. 

Seven student nurses who attended to a Marburg patient at Ibanda Hospital, since deceased, have been quarantined for at least 21 days. A total of 436 people who have been in contact with Marbug patients have been listed for close observation in the districts of Kabale, where the outbreak was first detected on 19 October, Ibanda, Mbarara, Rukungiri, Kabarole and Kampala. 

From the same family as the Ebola virus, Marburg causes severe headaches and malaise, followed by bleeding from multiple sites. According to the US Centers for Disease Control and Prevention (CDC), the fatality rate for Marburg is between 23 and 90 percent. The virus, for which there is no vaccine or specific treatment, is transmitted by direct contact with the blood, body fluids or tissues of infected people. 

Constrained 

The health ministry has drawn up a 1.85 billion Uganda shilling (about US$740,000) supplementary budget to set up temporary isolation facilities and wards, purchase drugs and protective gear, pay health workers allowances, and pay for funerals, which are being handled by health officials. 

"We are constrained. We continue to lobby for support, not only financial but human resources, to address the situation," Christine Ondoa, Uganda's health minister, told IRIN. "We have approached the treasury for a supplementary budget for a faster response to the outbreak. We hope to get a positive response. We appeal to partners to come in." 

"We urge the treasury to release supplementary funds to the health ministry to help reduce the risks," said Joaquim Saweka, the UN World Health Organization (WHO) country representative for Uganda. "The funds will help the ministry to implement its intervention plans. If the funds are not allocated, their efforts will be worthless."

UN: Sandy's devastation in Haiti far worse than New York, New Jersey

Via UN Dispatch: Sandy’s Devastation in Haiti Way, Way Worse Than New York or New Jersey. Excerpt:

The world’s attention is understandably focused on the disaster wrought by Sandy in New York and New Jersey. Millions of good hearted Americans and people around the world are tapping into their wallets to donate to organizations helping people in New York and New Jersey recover from Sandy. 

The impulse to help those affected in New York and New Jersey is laudable, but if people want to help those worst affected by Sandy, they should start paying attention to the situation in Haiti. New York and New Jersey are the wealthiest parts of the wealthiest country on the planet and the USA has capable and well crafted disaster emergency response systems. 

The Northeast will eventually recover. The same cannot be said for Haiti. 

Haiti was spared a direct hit by Sandy, but the damage, death, and displacement caused by the storm is much, much worse than anywhere else on the planet right now. 

How bad is it?  200,000 people are left homeless; 54 people were killed; entire villages washed away. 

Worse, cholera spreads by water. Disruptions caused by the storm affects sanitation systems and impedes access to clean drinking water. A surge in cholera cases in Port au Prince has already been reported by aid agencies. That’s terrifying. 

But potentially more calamitous in the near and long term is the damage done to agriculture. This is the economic lifeline of many thousands of people and was literally uprooted by the storm. People are starting to use the word “famine” to describe what may befall Haiti in the coming days. That, of course, could lead to serious political instability.

Japan tsunami reconstruction money 'misspent'

Via BBC News: Japan tsunami reconstruction money 'misspent'. Excerpt:

Japan has spent funds intended for reconstruction after the 2011 earthquake and tsunami on unrelated projects, a government audit has found. 

Projects financed by the $150bn (£93bn) fund include roads in Okinawa, an ad campaign for Japan's tallest building and support for whaling research. 

Some 325,000 people remain displaced 18 months on from the disaster. 

In some areas little reconstruction work has been carried out, reports say. 

Some 19,000 people were killed or remain missing following the tsunami and earthquake that struck north-east Japan in March 2011. 

The government has passed a number of supplementary budgets to fund reconstruction efforts in affected areas. 

But a government audit showed money had been used for unrelated projects reportedly included on the basis that they could boost national economic revival. 

The findings come at a time when questions are being asked about the speed of Japan's reconstruction effort. 

Takashi Kubota, deputy mayor of Rikuzentakata, a fishing port where nearly half of the houses were destroyed, told the Associated Press news agency that "not one single new building yet" had been built in the destroyed downtown area. 

"In 19 months, there have basically been no major changes," he said. Speaking in parliament on Monday, Japanese Prime Minister Yoshihiko Noda promised that problems would be addressed.

Uganda: Ban meetings in districts with Marburg – MPs

Via The New Vision: Ban meetings in districts with Marburg – MPs. Excerpt:

MPs want public celebrations, meetings and gatherings suspended in marburg-affected districts. 

“There is going to be the 50th independence anniversary celebration in Mbarara on November 2. Such gatherings should be suspended until these places are declared marburg-free,” Dr. Medard Bitekyerezo, the Mbarara municipality MP, appealed yesterday.  

He was responding to a statement by health minister Dr. Christine Ondoa on the status of marburg outbreak in the districts of Kabale, Mbarara, Ibanda and Kabarole. 

Ondoa reaffirmed the Government’s efforts to avoid the spread. “We are going to suspend public gatherings and meetings in places of the outbreaks. Uganda is an epidemic-prone country and disease outbreaks are frequent and more funds and personnel are needed for this division,” she said.

India: Akhilesh Yadav announces compensation for encephalitis victims in Uttar Pradesh

Via NDTV: Akhilesh Yadav announces compensation for encephalitis victims in Uttar Pradesh. Excerpt:

Lucknow: In his first visit to Gorakhpur after the encephalitis outbreak claimed more than 465 lives this year, Uttar Pradesh Chief Minister Akhilesh Yadav announced that compensation will be given to those who die because of encephalitis each year. 

50,000 Rupees [US$928] will be given to those who lose their children to this killer disease. A lakh [US$1,856] would be given to the survivors who are permanently disabled. 

Akhilesh Yadav also announced that 500 hundred extra beds will be provided to the Baba Raghav Das (BRD) Medical College in Gorakhpur, the biggest in the region. The hospital will also be equipped with MRI Machines. 

Interestingly Akhilesh Yadav did not visit the BRD medical college which is the only government hospital that caters to encephalitis patients in the region. He made these announcements at the centenary celebrations of an engineering college in Gorakhpur.

Novartis flu shots OK'd by Health Canada

Via CBC News: Novartis flu shots OK'd by Health Canada. Excerpt:

Health Canada has lifted its hold on Novartis flu vaccines. 

The department has told the provinces and territories that had bought Novartis products that the vaccines are safe to use. 

The decision means provinces that have either suspended their flu shot clinics or had to scramble to use vaccines made by other companies can resume normal operations. 

The decision follows a risk assessment the department did using information from European regulatory agencies and the company. 

Health Canada suspended use of the Novartis vaccines last Friday after several European countries stopped using two of the company's vaccines, Fluad and Agriflu.

India: When a scientist’s H5N1 warnings and suggestions went unheard

Via DNA: Avian flu: When a scientist’s warnings and suggestions went totally unheard. Excerpt:

In 2006, the bird flu scare was all around although no incidences of bird flu were reported anywhere around Bangalore. But now, despite thousands of birds dying due to the avian influenza at the Central Poultry Development Organisation & Training Institute (CPDOTI) in Hesaraghatta, authorities are yet to take cognisance of an expert’s advice given through an editorial in Current Science six years ago. 

While the occurrence of the dreaded H5N1 avian influenza has been confirmed at the CPDOTI at Hesaraghatta, near the city, the state government might not have the necessary know-how or the facilities to tackle it effectively, warns Prof R Uma Shaanker, a crop physiologist from the University of Agricultural Sciences who had, as early as 2006, advised the state government to place contingency plans to tackle the disease through a guest editorial on the scientific journal, Current Science. 

For one, the very suddenness with which the avian influenza took the authorities by surprise showed that forecasting the disease had completely failed, he said. 

There needs to be a good monitoring and forecasting system in place by the government, said Shaanker. The forecasting programme can be built on any number of epidemiological models that are available. 

However, Shaanker’s editorial in Current Science had failed to attract the attention of the state government in being prepared for the worse-case scenarios. He lamented the lack of manpower to “undertake epidemiological studies” (studies pertaining to effect of a certain disease on a population and its spread trends), which are necessary for forecasting disease outbreaks and spreads. 

“I am afraid that right now the government does not have any such programme in place,” he said. Although he told DNA on Tuesday — six years after the article appeared — that the warning applies even more now than ever before, the civic and health machinery in Bangalore has not budged an inch, leaving all the work to the state department of animal husbandry to primarily restrict disease spread from birds in the epicentre zone outwards.

Sandy's aftermath: Leptospirosis, typhus, and plague?

Via Mother Nature Network: Has Hurricane Sandy forced diseased rats out of the subway? Excerpt:

As New Yorkers woke up to massive power outages, burning homes, the closure of major transportation arteries, downed trees, streets awash with water and an utterly crippled public transit system, there’s still more to worry about.   

New York City’s infamous rodent population.   

Although nobody has taken an exact count, it’s generally estimated that there are more rats than inhabitants (8.3 million) in the city that never sleeps, with some estimates going as high as 32 million. 

Horror stories of colossal, teeming rat populations residing deep in the belly of the subway system is a bit of a myth, but many of the tunnels and stations are still pretty packed with rats, earning the city the distinction of Worst Rat City in the World. And with Hurricane Sandy’s deposit of massive amounts of water into the subterranean system, many of the rodents may be flooded out of their underground abodes.   

All five subway tubes beneath the East River between Lower Manhattan and Brooklyn and the Steinway tube between Midtown and Queens are filled with water, water that needs to be pumped since it won’t recede on its own. Where will the rats go? 

Rick Ostfeld of the Cary Institute of Ecosystem Studies in Milbrook, N.Y., told the Huffington Post, "Rats are incredibly good swimmers, and they can climb." He adds that they will escape the floods and head for safer ground, such as apartments and other buildings by humans.   

According to the U.S. Fish & Wildlife Service:   

•Rats can climb brick walls, trees, and telephone poles, and walk across telephone lines. 

•Rats can safely fall from a height of 50 feet. 

•Rats can jump three feet in the air from a flat surface and leap more than four feet horizontally. 

•Some species of rats can swim more than a mile in open water, and can tread water for up to three days. 

•Some species of rats can travel through sewer pipes and dive through water plumbing traps.

Ostfeld notes that the result of a deluge of displaced rats looking for dry shelter could result a rise in infectious diseases carried by urban rats, including leptospirosis, hantavirus, typhus, salmonella and even the plague.

The other day I saw a rat on the edge of our local park; I wasn't worried, because the park also has a family of barred owls who must consider rats pretty tasty. Still, flushing millions of rats out of New York's subterranean world is more likely to be a problem for New York people than a bonanza for New York owls.

Hurricane Sandy puts renewed pressure on food supply in Haiti

Thanks to Jake Johnston for tweeting the link to this Christian Science Monitor report: Hurricane Sandy puts renewed pressure on food supply in Haiti. Excerpt:

“In and around the [southern] city of Les Cayes, there is flooding everywhere,” says Pélèg Charles, a spokesman for the charity Oxfam UK, from his office in the capital Port-au-Prince. “It’s disastrous.… But we won’t know how bad it really is for several days.” 

Contaminated water and devastated crops 

Mr. Charles says that Oxfam has already received reports of some 150 new cases of cholera since the storm pulled out of the Caribbean this weekend. 

“We will not know for five to seven days if there is a new outbreak,” he says, “but we’re very worried about the spread.” 

Cholera can spread quickly in contaminated water, and has killed more than 7,000 Haitians and sickened hundreds of thousands others since an outbreak began in October 2010. 

Sandy was the second deadly storm to hit the country since late August, when Hurricane Isaac killed at least two dozen. 

“Most of the agricultural crops that were left from Hurricane Isaac were destroyed during Sandy,” Prime Minister Laurent Lamothe told Reuters. At least a dozen bridges were destroyed and a key route that connects Haiti and the Dominican Republic was severely damaged, according to the government.  

The impact on food security is a top concern for government officials. Recent spikes in food costs have contributed to social unrest in recent months, marked by nationwide demonstrations to protest double-digit rises in the costs of staples like rice and cooking oil.

MSPP's last cholera report was for October 19. I have no idea when the next tally will be published, but it's likely to be incomplete—maybe more incomplete than usual, given the impact of Sandy. 

It's striking that the political hot button isn't cholera, which was imported by foreign political intervention. Apparently Haitians don't mind enduring what amounts to accidental germ warfare against them. But mess with the price of rice and cooking oil, and you go too far.

India: No specialist to control dengue, malaria in Noida

Via The Times of India: No specialist to control dengue, malaria in Noida.

NOIDA: With dengue cases in Noida reportedly quadrupling this year as compared to previous years, health officials have blamed absence of district-level entomologists as the prime reason for the problem. An entomologist specializes in identification and control of vector-borne diseases. There is a single post, given out on a contractual basis, which has been lying empty for almost a year. 

Moreover, there are two posts of entomologists at the state-level, both of which are lying vacant. 

At a recent congregation of health secretaries of the country who had met the Union health minister to review the National Rural Health Mission, it was revealed that Uttar Pradesh, which is one of the worst affected state by vector-borne diseases, doesn't have a single state entomologist. Moreover, 65% of the posts for zonal entomologists, including the one for Noida, are also lying vacant. 

This is in spite of clear recommendations given to the UP health department by the union health ministry to strengthen their infrastructure to deal with vector-borne diseases. The Union health ministry had listed 'filling up of vacant posts, regular monitoring supervision, programme implementation and improving surveillance' as one of the top three recommendations for the state. 

Health officials explained that entomologists make up the first line of defence against dengue, malaria and other vector-borne diseases. 

"A public entomologist's primary concern is to focus on the population biology of vector-borne infections. They seek to understand how pathogens perpetuate over time and devise methods for reducing the burden that they impose on human health," said Ashok Mishra, CMS, district hospital, Noida. 

While the health department has confirmed only 18 cases of dengue in the district, suspected cases of dengue and malaria have touched 151 and 441, respectively. This clearly shows that the problem of vector-borne disease in the district is spiralling out of control. 

"The contract given to an entomologist is for 11 months. However, once the previous contract expired, no one was hired by the state and the post is currently empty," said a senior health official.