H5N1

Hong Kong: CHP reports two new H7N9 cases in Mainland

The Centre for Health Protection has issued a March 1 news release: CHP notified of two additional human cases of avian influenza A(H7N9) in Mainland. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health (DH) yesterday (February 28) received notification of two additional human cases of avian influenza A(H7N9) in Zhejiang from the National Health and Family Planning Commission.      

The cases in Zhejiang involve two girls aged 6 and 7 who are currently hospitalised for treatment.      

As of yesterday, a total of 369 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (138 cases), Guangdong (81 cases), Jiangsu (42 cases), Shanghai (41 cases), Fujian (20 cases), Hunan (16 cases), Anhui (nine cases), Jiangxi (six cases), Beijing (four cases), Henan (four cases), Guangxi (three cases), Shandong (two cases), Guizhou (one case, imported from Zhejiang), Hebei (one case) and Jilin (one case).

US: Treasure Island cleanup exposes Navy’s mishandling of its nuclear past

Via The Bulletin of the Atomic Scientists: Treasure Island cleanup exposes Navy’s mishandling of its nuclear past. Treasure Island was created in San Francisco Bay for the 1939 International Exhibition. Excerpt:

After the exposition, the island was set to become a civilian airport—until the United States entered World War II. The Navy seized the land for the Treasure Island Naval Station and demolished the expo’s Art Moderne structures, leaving just the terminal and two hangars. In the spaces around them rose a little village of beige one-  and two-story sheds.

For years, the base served its purpose until, in 1993, it landed on a decommission list. The military decamped, dismantling and cleanup began, and a few years later some former Navy housing was turned into city-subsidized rentals. By 2007, the Navy was well into the process of preparing the land for full transfer to civilian control. 

That year, cleanup operations shifted from removing Navy industrial toxins and sludge to identifying any lingering radioactive waste. New World Environmental, a contractor working for the Navy, assigned specialist Robert McLean to conduct a preliminary radiation survey. 

That was how McLean found himself cruising through neighborhoods built near former US Navy training academies, with a Ludlum radiation meter poked out of his truck window. He did not expect to find much; just the year before, a Navy-commissioned historical report had suggested there was little likelihood that significant radioactive waste would be found on the island. And by then, hundreds of San Franciscans were living in modest townhouses on Treasure Island and neighboring Yerba Buena Island–with the Navy’s assurances that doing so was perfectly safe. 

 Then, the sensor needle hopped. 

“We picked up readings from inside the truck, without even getting out of the vehicle,” said McLean, speaking publicly about his discovery for the first time. That first detection was not the last.  

“We found radiation, contaminated materials, in playgrounds and in areas that had previously been playgrounds,” said McLean, 52, who livesin North Carolina. “We found it in front yards. We found it underneath sidewalks and along the roadways.” 

Months went by. With each new finding of radioactivity, it seemed the Navy would incrementally raise its estimates of how much waste might have been left behind on the island. 

McLean tried to blow the whistle, calling Kent Prendergast, radiation health division chief for the California Department of Public Health. 

“McLean indicated that he was concerned regarding the fact that they are finding radium sources … at many locations on the west side of Treasure Island,” Prendergast wrote in an internal email dated June 25, 2008. McLean “was concerned that the sources could represent a hazard to children or something the bad guys could use to make a dirty bomb.” 

McLean reported finding radium pieces that emitted enough radiation for a person at close range to receive, in an hour, five times the maximum radiation a nuclear worker is allowed to absorb in a year. Ionizing radiation increases cancer risks; eating or breathing traces of radioactive material can subject human cells to decades of bombardment that further raises those risks. 

In addition to the dangerously radioactive radium pieces, McLean’s readings showed that soil surrounding the objects was contaminated with traces of the material. Concentrations were not high enough to be certain people would be harmed, but such an unexpected discovery is supposed to prompt a thorough examination. 

Instead, it prompted the bureaucratic equivalent of warfare, with state health officials on one side pushing for Treasure Island to be scoured more thoroughly for radioactivity and Navy officials and their contractors on the other, claiming there was no need.

If this seems bizarre and implausible, you were probably born long after the end of nuclear testing in the atmosphere. In the 1950s and 60s, the American military simply didn't care about the effects of radiation on people—even the citizens who paid for them.

I can still remember John F. Kennedy's witty response at a press conference, when an H-bomb was planned to be launched into space and detonated in the Van Allen radiation belt.

"Well, we asked Dr. Van Allen and he didn't mind," said JFK. Ho ho ho.

The H-bomb was launched, and blacked out electrical systems all over the Pacific Ocean. And that's how we learned about the electromagnetic pulse that a high-altitude nuclear explosion can cause.

Meanwhile, fallout from atmospheric tests in Nevada was drifting gently onto countless Americans, inducing untold numbers of cancers and premature deaths. As I tried to point out in a recent Tyee book review, the American nuclear threat to America is far from over. We are always a far more dangerous enemy to ourselves than any outside menace.

Islamic group slams anti-polio vaccine fatwas

Via Al Arabiya News:, a February 27 report: Islamic group slams anti-polio vaccine fatwas. Excerpt:

An Islamic group met Wednesday to quash fatwas (religious edicts) ruling that polio vaccines cause infertility, Al Arabiya News Channel reported.  

“The whole world rejects such fatwas that polio vaccines cause infertility,” Abbas Chouman, a senior official at Cairo’s al-Azhar University - regarded as the highest seat of learning of Sunni Islam - told Al Arabiya News Channel during the two-day meeting by the Islamic Advisory Group (IAG) in the Saudi city of Jeddah. 

Strict 

The strict fatwas banning vaccines against polio were observed in Pakistan, Afghanistan, Nigeria and Somalia. 

According to the World Health Organization (WHO), polio cases have decreased by over 99 percent since 1988, from an estimated 350,000 cases in more than 125 endemic countries then, to 223 reported cases in 2012. 

However, in parts of Afghanistan, Nigeria and Pakistan, the disease remains widespread. 

In late 2013, WHO and UNICEF launched a polio vaccination campaign for 23 million children in the Middle East after dozens of cases were discovered in conflict-ridden Syria. 

The strain of the disease detected in Syria is related to a strain that originated in Pakistan and has also been found in sewage samples in Egypt, Israel and the West Bank and Gaza Strip.

Myanmar suspends all MSF operations in the country

Via The Irrawaddy, a long report on a growing scandal: Myanmar Suspends All Aid Operations of MSF. Excerpt:

The government has suspended all operations of Médicine Sans Frontièrs (MSF) in Burma following disagreements over the implementation of aid programs in Arakan State, where the group offered vital medical aid to Rohingya Muslims. 

MSF said in a statement Friday night that it was “deeply shocked by this unilateral decision and extremely concerned about the fate of tens of thousands of patients currently under our care across the country.” 

The President’s Office spokesman Ye Htut told The Irrawaddy earlier on Friday that MSF Holland’s projects in Arakan State had violated certain conditions of its memorandum of understanding (MoU) with the government. 

He said the alleged violations had led to a government decision to refrain from renewing the current MoU, which had expired last year. 

On Friday afternoon, it seemed that discussions were still ongoing on whether or not MSF operations in other regions could continue, but a MSF statement released around 8 pm said all medical aid operations had come to an end. 

“Today, for the first time in MSF’s history of operations in the country, HIV/AIDS clinics in [Arakan], Shan and Kachin states, as well as [Rangoon] division, were closed and patients were unable to receive the treatment they needed,” MSF said. 

“TB patients were unable to receive their life-saving medicine, including drug-resistant TB patients. This decision by the Union Government will have a devastating impact on the 30,000 HIV/AIDS patients and more than 3,000 TB patients we are currently treating in Myanmar.” 

“In [Arakan] state, MSF was unable to provide primary health care to the tens of thousands of vulnerable people in camps displaced by the ongoing humanitarian crisis or in isolated villages,” the group said. 

“There is no other medical non-government organization that operates at the scale of MSF with the experience and infrastructure to deliver necessary life-saving medical services,” the group said. 

MSF Holland has operated in Burma since 1992 and implements medical aid projects in Arakan, which has suffered from inter-communal violence between Rohingyas and the Buddhist Arakanese majority, and in Shan, Kachin and Karen states, which are affected by ethnic conflict. 

The US Embassy said on Friday afternoon that it was aware of the reported suspension of MSF operations and voiced concern over the impact on local communities. 

“The United States encourages the Union Government to continue to work
with the international community to provide humanitarian assistance to
communities in need and to ensure unfettered access for humanitarian
agencies, in accordance with international standards,” the embassy said. 

Ye Htut said he attended meetings in Naypyidaw with Health Ministry officials Friday, where MSF was informed of supposed wrongdoings during aid work in Arakan State. 

He said MSF had deployed more foreign staff than it was allowed to, had failed to stay impartial and neutral, and had run a medical care clinic for newborns against the wishes of the government. 

“I told them how they had violated their agreement at a meeting today and … they admitted that they have some weak points,” he said, adding that Arakan State authorities and local communities had also urged the central government to halt MSF aid work. 

“For example, we only allow them to have 19 foreign staff [in Arakan], but we found on the ground that they have 39 persons who were foreigners… and there were many persons who did not have registration to treat patients.” 

Ye Htut went on to claim that MSF “only gave medical treatment to Bengalis,” before adding, “We are not against the whole MSF, we are only against some foreigners who working with MSF.” 

Asked if he thought that government decision to halt MSF operations would hurt the international image of the Thein Sein government, Ye Htut said,   “I do not think they would take this view because there are many NGOs working in our country. [The international community] will know we did it to those who violated agreements.” 

Burma’s government does not recognize the approximately 1 million Rohingyas in northern Arakan State as citizens, and refers to the Muslim group as “Bengalis” to suggest that they are illegal immigrants from neighboring Bangladesh.

According to Quandl, a good source for statistics, Myanmar in 2010 spent US$17 per capita on health (Australia spent US$4,774). No country with such low health spending can afford to reject so much as a box of Band-Aids, never mind the services of a first-rate NGO like MSF.

Egypt: Health ministry says woman's death not confirmed as MERS

Via Hashmasr.com, an Egyptian news site: Health denies the death of a woman in Aswan from Corona virus. The full report, in a Google translation:

Denied Dr. Amr Kandil, First Undersecretary of the Ministry of Health for Preventive Medicine, Health cited some news sites about the death of Lady of Kom Ombo in Aswan as a result of being infected with "Corona", pointing out it's just a case of suspicion did not confirm yet, as he was taking a sample of the situation and sent to the central laboratories for analysis to determine the cause of death, stressing again that Egypt is free of Corona virus so far. 

He said, "Kandil" in a statement Friday, "The case of the death of his master at the age of 56 years and was the lead Umrah in Saudi Arabia two weeks ago, and arrived in Aswan on Thursday, and the lady was detained in one of the hospitals Medina, in performing Umrah as a result of suffering from pneumonia, and after I arrived yesterday Aswan, was transported to a hospital in the governorate and received the necessary treatment, "noting that the case has been transferred to a hospital in Assiut university at the behest of her family and she died upon arrival the hospital.

Myanmar expels Doctors Without Borders, accuses group of dissension

Via The Globe and Mail: Myanmar expels Doctors Without Borders, accuses group of dissension. Excerpt:

Médecins sans frontières (Doctors Without Borders) has been kicked out of Myanmar after two decades of caring for sick people in one of the world’s poorest countries, and the group said Friday that the decision risks tens of thousands of lives. 

The government defended its decision, accusing the group of creating tensions and instability in violence-scarred Rakhine state, where it has faced repeated protests for treating members of the long-persecuted Rohingya Muslim minority.  

“Today for the first time in MSF’s history of operations in the country, HIV/AIDS clinics in Rakhine, Shan and Kachin states, as well as Yangon division, were closed and patients were unable to receive the treatment they needed,” the group said in a statement. 

As one of the nation’s biggest providers of HIV drugs, supplying treatment to 30,000 people, the group said it was “deeply shocked by this unilateral decision.” It also gives life-saving medicine to 3,000 tuberculosis patients. Even small treatment disruptions can lead to drug-resistant strains that are more difficult and expensive to fight. 

A confidential document dated Feb. 26 said Myanmar’s presidential office ordered the registration of Doctors Without Borders “to be cancelled.” Presidential spokesman Ye Htut told 7 Day daily on Friday that the contract had been cancelled nationwide. 

The spokesman criticized the aid group in the Myanmar Freedom newspaper for hiring “Bengalis,” the term the government uses for Rohingya. 

He also accused it of misleading the world about the attack last month in remote northern Rakhine, cut off to almost all foreigners, including journalists and aid workers. The United Nations says more than 40 Rohingya may have died, but the government has vehemently denied allegations that a Buddhist mob rampaged through a village, killing women and children. It says one policeman was killed by Rohingya and no other violence occurred. 

Ye Htut was quoted by the independent media outlet, the Democratic Voice of Burma, as saying that Doctors Without Borders claimed it had treated victims with gunshot and slash wounds. But he questioned that, saying the group refused to arrange a meeting between the government and the patients. 

“We see that their activities, instead of offering assistance in the region, are fuelling tensions and are detrimental to the rule of law,” he said. 

Doctors Without Borders said it treated 22 injured and traumatized Rohingya.

Canada: BC nurses endure 10 'code whites' a day for aggression

Via CBC News: B.C. nurses endure 10 'code whites' a day for aggression. Excerpt:

A CBC investigation has found incidents involving violent or potentially violent patients known as 'code whites' happen at least ten times a day in B.C.'s hospitals.   

A major investigation is underway in Kamloops, B.C. after a nurse was assaulted on a psychiatric ward at the Hillside Centre in December. 

B.C. Nurses Union regional chair Tracy Quewezance says the incident started with a psychiatric patient's simple request for toast. 

"[The nurse] had indicated that she was just busy with another patient and that she would be with him in a minute and the patient assaulted her, punched her in the face, held her down by her hair," says Quewezance. 

Top 5 hospitals for 'code whites' in 2013 

• Royal Jubilee Hospital in Victoria - 384 

• Nanaimo Regional General Hospital - 351 

• Hillside Centre in Kamloops - 288 

• Vancouver General Hospital - 275 

• Kelowna General Hospital - 198 

Quewezance says it took several workers to pull the man off of her. The man had been transferred to Kamloops from Colony Farm, a secure forensic mental hospital.   

Nurses say he had a long history of violence that was not clearly documented on his chart. 

"A week prior to that a nurse was kicked in the knee by this gentleman while she was trying to clean his room. Two days before this incident, he attacked another nurse as well,"  Quewezance said. 

She says the man cannot handle being told "no" but the nurse on shift learned that the hard way.

WHO: MERS update, February 28

WHO has published Middle East respiratory syndrome coronavirus (MERS-CoV) – update. Excerpt:

On 3 and 15 February 2014, the Ministry of Health of Saudi Arabia announced two additional laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection. 

Details of the cases provided to WHO are as follows: 

A 22-year-old man from the Eastern Region. He became ill on 3 February and was hospitalised on 9 February and died on 12 February 2014. The patient had an underlying medical condition. He had no reported history of contact with animals or a previously laboratory-confirmed case. 

A 67-year-old man from Riyadh. He became ill on 23 January and was hospitalised on 25 January. The patient had an underlying medical condition. He had no reported history of contact with animals or with a previously laboratory-confirmed case. 

Globally, from September 2012 to date, WHO has been informed of a total of 184 laboratory-confirmed cases of infection with MERS-CoV, including 80 deaths.

Measles outbreak on Costa Pacifica cruise ship

Via Cruise Law News: Measles Outbreak On Costa Pacifica Cruise Ship. Excerpt:

According to the Italian newspaper Il Messaggero a measles outbreak has occurred on the Costa Pacifica cruise ship. 

The newspaper says that dozens of cruise passengers were probably infected with the virus that causes measles. The cruise ship called on the port of Civitavecchia. 

59 infected crew members were sent ashore for medical treatment. 

Costa says, for what it's worth, that there have been no confirmed cases of passengers infected with the measles virus yet. 

A measles outbreak is very serious. There is a particular danger to women of childbearing age with measles.  U.S. based cruise lines vaccinate for measles because the virus is so virulent. 

Cruise expert Professor Ross Klein was the first in the U.S. / Canada to report on this disturbing outbreak. 

The health implications of fracking

Via The Lancet: The health implications of fracking. Excerpt:

What is known about the health effects of gas extraction by induced hydraulic fracturing of gas-bearing rock—ie, fracking? A workshop held on Nov 15, 2013, at the London School of Hygiene and Tropical Medicine and attended by scientists, public health professionals, and decision makers addressed this question. 

Fracking is at a very early stage in the UK, with only one shale gas well tested so far. This situation provides an important opportunity to gather information and to conduct studies of health and environmental effects before any large-scale development. 

Scientific study of the health effects of fracking is in its infancy,1, 2 but findings suggest that this form of extraction might increase health risks compared with conventional oil and gas wells because of the larger surface footprints of fracking sites; their close proximity to locations where people live, work, and play; and the need to transport and store large volumes of materials.3—6 

In the USA, where more than 52 000 shale gas wells have been drilled, data suggest that risks of environmental contamination occur at all stages in the development of shale gas extraction. Failure of the structural integrity of the well cement and casing,7 surface spills and leakage from above-ground storage, emissions from gas-processing equipment, and the large numbers of heavy transport vehicles involved are the most important factors that contribute to environmental contamination and exposures in the USA.2 

Environmental exposures include outdoor air pollutants (ie, volatile organic compounds, tropospheric ozone, and diesel particulate matter)2 and pollutants (ie, benzene, hydrocarbons, endocrine-disrupting chemicals, and heavy metals) in both ground8 and surface9, 10 water. 

Known occupational hazards include airborne silica exposure at the well pad.11 Toxicological data for the chemicals injected into wells (so-called frac fluid) indicate that many of them have known adverse effects on health, with no toxicological data available for some.2 

Assessment of potential risks has been difficult in the USA because drilling operators are not required to disclose which chemicals are used, but the UK Government has accepted the recommendation from the Royal Society and Royal Academy of Engineering Working Group on shale gas extraction1 for full disclosure.12 

Exposure and epidemiological studies—of which there are currently very few—are needed along the entire supply chain of shale gas to characterise and quantify associated health issues. The socioeconomic implications of shale gas development on local communities before, during, and after extraction, and how risks should be communicated, are also important research priorities. 

In addition to local health and environment threats, an important consideration is the contribution of shale gas extraction to greenhouse-gas emissions and, thus, to climate change. Although there is conflicting evidence about the comparative contribution of lifecycle greenhouse gases of shale gas relative to coal, evidence from the USA indicates that instead of replacing coal, shale gas has rapidly become an additional source of fossil fuel, leading to an increase in cumulative global greenhouse-gas emissions.13 

The degree to which shale gas extraction is developed should be based on comparisons with other energy options, including renewable energy sources, and greater investment in energy efficiency measures, taking full account of environmental, economic, and health implications.