H5N1

Vietnam: Mysterious skin disease returns, spreads

Via Thanh Nien Daily, a November 25 report I missed: Vietnam mysterious skin disease returns, spreads. Excerpt:

Authorities in the central province of Quang Ngai said Saturday a fatal skin disease is making a comeback after a hiatus of several months and is spreading. 

They said Pham Van Xi, 4, of Ba Vinh commune in Ba To District has symptoms of the condition which had earlier been found only in neighboring Ba Dien Commune, killing 24 people between April last year and July this year. 

Xi's is the first infection to be reported since. 

He was initially admitted to the Quang Ngai General Hospital with red blisters, liver-cell necrosis, and increased levels of liver enzyme. 

External symptoms include thickened skin and blisters on the hands and feet in the beginning, and death occurs due to multiple organ failure starting with the liver. 

Most patients have liver enzyme levels shooting up to four-20 times the normal level. 

The boy has since been sent to the Ho Chi Minh City Children’s Hospital No.2. 

Local officials said the disease, which peaked in March, April, and May, had infected 240 people in Ba Dien, many of them belonging to the same family. 

The health minister and foreign experts including those from the World Health Organization have visited the commune, but the disease remains a puzzle. 

Vietnamese officials have ruled out dioxin sprayed by the US during the war as the cause. 

But a high level of arsenic, 100 times the normal level, was found in the hair of a nine-year-old boy who died in May.

Indonesia and others see "embarrassing" rise in HIV

Via The International Herald Tribune: Indonesia and Others See 'Embarrassing' Rise in H.I.V. Infections. Excerpt:

A new United Nations report on H.I.V.-AIDS has some encouraging findings, notably dramatic reductions in new infections in southern Africa, although several countries in Asia now have infection rates 25 percent higher than they were a decade ago. 

One of those countries is Indonesia, the world’s fourth most populous nation. The health minister, Nafsiah Mboi, called the U.N. findings “so embarrassing,” especially in light of large expenditures on prevention programs in Indonesia. 

“I don’t know what mistakes I have made,” she told reporters. “It was shocking to me.” 

Statistics from Indonesia’s National AIDS Commission cited by The Jakarta Post show that condom use remains low, especially consistent use among sex workers. Ms. Nafsiah, 72, a pediatrician who was appointed to her post in June, has favored the distribution of free condoms to young people, an effort opposed by conservative lawmakers and religious groups in the predominantly Muslim country. 

Cho Kah Sin, the country director for the Unaids agency, suggested that Indonesia’s infection numbers appear higher because the epidemic reached full force there later than it did in other countries. 

Another country with worrisome statistics is the Philippines. 

Teresita Marie Bagasao, head of the Manila office of Unaids, told The Philippine Daily Inquirer that “while the absolute number of H.I.V. infections in the Philippines is still relatively low, the rate of increase in the number of cases is a cause for concern.” 

The Philippine Department of Health said there were an estimated 600 H.I.V. cases in 2001. Last year, the number of new infections was 4,600.

I couldn't find the report in The Philippine Daily Inquirer, but when I searched the paper's site for "HIV" and "Bagasao," I got scores of stories going back years, all quoting her as saying more or less the same thing.

Sudan: Central Darfur displaced demand yellow fever campaign

Via Radio Dabanga: C. Darfur displaced demand yellow fever campaign. Excerpt:

Displaced from Central Darfur camps are demanding that the state’s health authorities carry out vaccination campaigns against yellow fever in their vicinity, Radio Dabanga was informed on Thursday, 29 November. 

Residents from Bindissey, Mukjar and Umm Dukhun said their demands are especially necessary after some cases of yellow fever emerged in camps and surrounding villages in Central Darfur. 

“The outbreak of yellow fever in some camps requires authorities’ immediate intervention to protect the displaced”, a sheikh from Bindissey told Radio Dabanga. 

He noted that health authorities had previously announced on camps’ loudspeakers their plans to vaccinate the displaced. 

However, the sheikh continued, authorities declared at a later stage that the vaccination campaign would be focused on areas affected by the disease only, which did not include the three camps.    

Displaced from Umm Dukhun fear that the spread of yellow fever might get “out of control” around camps, especially after cases of the disease were reported in some areas south and east of Bindissey, they said.

In another report, Radio Dabanga says people from West Darfur are making a four-day trip to Central Darfur to be vaccinated against yellow fever. It also says that as of Friday 182 person in West Darfur have been diagnosed with yellow fever, and 49 have died of it.

US: Plans for new H5N1 research stir controversy

Via ScienceInsider: U.S. Plans for New H5N1 Science Reviews Ruffle Researchers. Excerpt:

Researchers are giving mixed reviews to a draft U.S. government plan to subject some grant requests for studies involving the H5N1 avian influenza virus to special reviews—and perhaps even require the work to be kept secret. 

Elements of the plan have been "very controversial within [the] U.S. government" committee that developed it, Amy Patterson, associate director for science policy at the National Institutes of Health (NIH) in Bethesda, Maryland, told a meeting of the National Science Advisory Board for Biosecurity (NSABB) earlier this week. 

Patterson unveiled the proposal—formally known as A Proposed Framework for Guiding HHS [the Department of Health and Human Services] Funding Decisions about Highly Pathogenic Avian Influenza H5N1 Gain-of-Function Research—at the 27 November meeting of NSABB, which advises the U.S. government on overseeing "dual use" biological research that could be used for good and evil. 

Although it would now apply to just a handful of potential studies, the framework "is going to raise a lot of questions and concerns among researchers," predicts microbiologist Ron Atlas of the University of Louisville in Kentucky who has worked on biosecurity policy issues for more than a decade for the American Society for Microbiology. 

Some influenza scientists are already calling the plan "misguided," while others predict it will make it impossible to obtain NIH funding for an entire subset of potentially useful studies. Others, however, say it represents a needed "step forward" in government efforts to reduce the terrorism and public safety risks associated with H5N1 studies. 

The debate is expected to get a full hearing over the next few months. NIH says that it will soon release for public comment a white paper describing the plan in detail. And it plans to present the framework for discussion at an international workshop on H5N1 research that it is holding in Bethesda from 17 to 18 December. 

"We definitely want to hear what other countries are thinking about this," Patterson said. 

"This is a global concern," Atlas says, and any U.S. policy "that can't be globalized is in the long run going to be ineffective."

Dengue fever hits Latin America hard

Via Vaccine News Daily: Dengue fever hits Latin America hard. Excerpt:

Costa Rica’s health minister recently said that there have been more than 160,000 confirmed cases of dengue fever in Latin America so far this year. 

The number of people infected in the region is certainly higher. In 2010, estimates of the number of people in Latin America infected by the mosquito-borne illness reached 1.5 million people. There have been more than 400 deaths from the illness reported this year, according to TheCostaRicaNews.com. 

Outbreaks of the illness have been reported throughout Latin America. A dengue outbreak has caused 32 deaths and infected more than 20,000 people in Peru alone. The Peruvian government recently declared a state of emergency for two months in order to facilitate the fumigation of nearly 70,000 homes.

Canada: Tuberculosis scare at University of Saskatchewan

Via CTV Saskatoon News: Tuberculosis scare at University of Saskatchewan. Excerpt:

A student at the University of Saskatchewan has been diagnosed with active tuberculosis. 

Health officials confirm the student is now getting treatment, but other students may have been exposed. 

The Saskatoon Health Region says the student was diagnosed earlier this week, after missing classes because of illness. 

University of Saskatchewan officials say they’ve been working closely with TB Control Saskatchewan, and the deputy medical health officer to identify students who were in the same classes as the infected student. 

Students who may have been exposed are being asked to attend a testing clinic, and have been provided with information about tuberculosis.

CIDRAP: Two Jordan cases in April shift novel coronavirus picture

Via CIDRAP, Robert Roos sums up what we know after an intense few days: Two Jordan cases in April shift novel coronavirus picture. Click through for the full report and links. Excerpt: 

Saudi Arabia's deputy minister for public health, Ziad A. Memish, MD, today suggested that the virus in the Saudi Arabian family cluster may be different from the strain in the earlier cases. 

"We think the virus in the last family cluster is different as it had significant spread among households while none of the previous cases behaved in a similar way," Memish said in e-mailed comments to CIDRAP News. Memish was among the authors of a description of Saudi Arabia's second novel CoV case, published this week in the Saudi Medical Journal. 

The Jordanian cases seem to confirm the need to watch for the novel virus in places beyond just Saudi Arabia and Qatar, as recommended by the WHO lately. Last week the agency called for broader vigilance, and yesterday it offered more detailed surveillance recommendations. 

The WHO reiterated those recommendations today. It said authorities should consider testing of patients with unexplained pneumonia, especially if they live in or visited the Arabian peninsula or neighboring countries. Any cluster of severe acute respiratory infections in healthcare workers should be carefully investigated, regardless of the location, the statement said. 

Memish agreed on the need for wider surveillance, commenting, "We have been saying all along that cases of novel coronavirus are not limited to KSA [the Kingdom of Saudi Arabia] and Qatar. And today's announcement from WHO about the two cases from Jordan in early April 2012 is an evidence supportive of our suspicions. 

"No country in the world screens all pneumonia patients for novel coronavirus except KSA and Qatar, and as long as this is the case no novel coronavirus cases will be recovered anywhere else," he added.

Jordan: April reports on the novel coronavirus

Via The Jordan Times for Saturday, April 21, 2012: Zarqa hospital staff ‘cured’ after disease outbreak. Excerpt:

Seven people affected by an outbreak of infectious disease that originated in Zarqa Public Hospital’s Intensive Care Unit were in good condition Saturday, and all but one had been released from hospital, according to a Health Ministry statement. 

The ministry on Friday closed the ICU following an outbreak of infectious disease, believed to be pneumonia, that affected seven nurses, one of whom died on Thursday, one doctor, and the brother of one of the nurses. 

In a statement carried by the Jordan News Agency, Petra, on Saturday, the ministry’s Secretary General Daifallah Lozi said six nurses and the deceased nurse’s brother had been “completely cured” after receiving treatment. 

The six nurses who were referred to Prince Hamzeh Hospital were discharged after being treated, he said, adding that the brother was in "good shape" and would be discharged after undergoing final tests to make sure he is free of the disease. 

Louzi said that the ministry is currently conducting laboratory tests to determine the cause of the illness and that the hospital is now receiving patients as usual, with no remaining danger to hospital staff, Petra reported. 

In a statement sent to The Jordan Times on Friday, Lozi said an investigation had proven that the ICU was the source of the outbreak. 

The ICU will reopen after being sterilised, he said, adding that infection control measures were being taken in other facilities in the hospital, which were receiving patients as normal. 

Management error? 

Meanwhile, nurses working at the hospital faulted the management for not implementing the infection control measures as soon as the first case was diagnosed. 

“The management refused to let us wear masks, claiming that other patients would be terrified if they saw us with masks as they would think there was an infectious disease spreading in the hospital,” a nurse, who spoke on condition of anonymity, told The Jordan Times on Friday.

Here's another Jordan Times report from April 22. What I haven't yet found is a report on the second Jordanian death.

These reports turned up through a Google search, which also found April 20 reports from Pandemic Information News and FluTrackers. Nothing stops the newshounds!

The outbreak looks like human-to-human spread—especially with the brother of the dead nurse among those contracting the virus.

Haiti faces a hungry winter

Via ReliefWeb, a report from the Famine Early Warning System: Haiti Food Security Outlook - October 2012 through March 2013. Key points:

• Following a series of different shocks to crop production country-wide since June, food security is steadily deteriorating more quickly than expected. Crop losses and ensuing losses of seasonal income and savings have propelled what are normally minimally food-insecure areas into IPC Phase 2 (stressed). 

• Damage caused by Hurricane Sandy in late October could heighten food insecurity levels in certain departments like the Southeast and the West. A number of communes, particularly Pointe Raquette and Bainet in the country’s Western and Southeastern Departments, respectively, could be facing crisis levels of food insecurity (IPC Phase 3) between January and March of next year. 

• Staple food prices are unusually high in the aftermath of these shocks, which have caused a decrease in crop production. This is especially hard on poor rural and urban households dependent on market purchase for their food needs. October prices for certain staples such as beans, for example, were already up by 40 percent from July.

CIDRAP: News scan for November 30

Via CIDRAP: NEWS SCAN: Tamiflu benefits, pertussis surge in UK, change in meningitis reporting, Uganda Ebola update, persistent hospital bug. Excerpt:

In the most recent update on Uganda's Ebola outbreak, the health ministry reported seven infections and four deaths, a decrease from the number of cases reported on Nov 23, the World Health Organization (WHO) said today. 

Some of the cases reported on Nov 23 were listed as probable, and testing has ruled out some of them, the WHO said. The earlier update said 10 cases (six confirmed and four probable) had been reported. 

Today's update also reflects one less death than the five reported in the earlier update. The WHO said field teams are continuing to investigate suspected cases reported by communities, but they are facing a major challenge because some communities believe witchcraft, not Ebola, is the cause of the deaths despite ongoing intensive awareness campaigns about the disease. 

Social mobilization teams are working with traditional healers and religious leaders to boost awareness of Ebola prevention and control, according to the WHO.