H5N1

India: H5N1 in Kerala "under control"

Via The Indian Express: Bird flu under control in Kerala, 1.80 lakh birds culled.

Kerala government said the avian influenza which had hit the duck-rearing Central Kerala’s Kuttanad region has been brought under control. So far, 1.80 lakh [180,000] ducks have been culled and the operation would be wound up on Monday with culling of another batch of 50,000 poultry. 

Health Minister V S Shivakumar said the virus which was identified as H5N1 has not hit humans so far. Six samples were collected from persons with symptoms of avian flu, but all of them were negative. However, the government has equipped the hospitals in Alappuzha to face the situation if humans were found affected with H5N1. The health department has put under observation around 3 lakh[300,000] persons and visited 80,000 households in the affected areas, said the minister. 

Although duck deaths have been reports from many part of Central Kerala, tests showed they were not due to avian influenza. The government has decided to extent the financial assistance to the duck farmers who had lost their bird even before the avian influenza was confirmed.

Ebola in Liberia: Eight new cases in Monrovia

Via FrontPageAfrica, a December 1 report: ‘No Ebola’ In Politics: Liberia Takes Eye off Ball; 8 New Cases. Excerpt:

Long before the Supreme Court put the brakes on campaign and political activities leading to this year’s senatorial election, the deadly Ebola virus appeared to have taken a backseat to politics. The virus which has so far claimed some 7,244 lives in West Africa, according to the latest World Health Organization (WHO) numbers, has Liberia in the driver’s seat accounting for the lion's share with 4,181 deaths since the outbreak hit in March. 

To date, a total of 16,169 people had been infected with Ebola and 6,928 of these had died in the three countries at the center of the outbreak - Sierra Leone, Guinea and Liberia – according to the WHO. Health workers have been among the worst hit, with 340 deaths out of 592 cases. 

Liberia’s next door neighbor, Sierra Leone, which, according to the WHO was still seeing a rapid spread of Ebola in many parts of the country, reported 1,461 deaths from 6,802 cases. This was 63 deaths and 203 cases more than reported on November 26. 

Guinea, where the outbreak began nearly a year ago, meanwhile counted 1,284 deaths out of 2,123 cases. This was 24 deaths and 11 cases more than reported earlier. Mali has reported eight confirmed cases, with six proving fatal. 

Nigeria, which had reported eight Ebola deaths, and Senegal, which saw only one case, had recorded no new cases for 57 days. Both countries have now been declared Ebola-free. 

In Liberia, which has seen a drastic decline in recent weeks have been struggling to deal with the issue of complacency complicated by a senatorial election campaign period, which has broken all the rules of what to do to avoid infection from the virus. 

In the past few days, since the National Elections Commission lifted the lid on campaign activities a number of incidents at two campaign-related events have led many to wonder whether Liberia is prematurely uncorking the champagne bottle in anticipation of an early celebration. 

At the PHP Community last Wednesday, rival supporters of football legend George Weah of the Congress for Democratic Change and Robert Sirleaf an independent candidate and son of President Ellen Johnson Sirleaf, came face to face in the PHP community. Cars were vandalized and supporters from both camps sustained injuries as the two rival groups threw stones at each other and chanted slogans of war. Both Weah and Sirleaf have traded blame for the incident. 

Sirleaf declared: “The perpetrators of this wanton act of violence must be brought to justice. Our campaign journey will remain a peaceful one throughout the entire democratic process, as we have faith in the good people of Montserrado County whom deserve a positive future.” 

Eight New Cases at ELWA 2 

Weah and the CDC in turn blamed Sirleaf’s supporters for starting the fracas. The next two days, supporters of Weah and the CDC took to the streets in massive numbers as the football legend officially launched his Senatorial bid. But concerns have been pouring in regarding the safety and risks the congestions of a large number of people is having on the efforts the international community exerting to fight Ebola in the country. 

The fears are compounded amid new reports Sunday that eight new cases were tested positive at the ELWA II facility run by Dr. Jerry Brown. Brown confirmed to FrontPageAfrica Sunday that all eight suspected cases brought to the facility Saturday evening tested positive for the virus. The suspected cases all came from central Monrovia reportedly around the Camp Johnson Road area.

The long report concludes:

In Jenewonde, Grand Cap Mont Country, one of the many hotspots of Ebola, the situation remains dire. The needed help is yet to arrive, and though the death rate has decreased, residents of the town fear there might be a surge if nothing is done to move the sick out quickly. 

 

A team of FrontPageAfrica reporters who visited the area Sunday found fifty persons, including children and pregnant women, under quarantine, complaining of no food to feed them, a recurring theme in most parts of the country lagging behind despite a massive pouring of international goodwill.

 

As the world responds to an SOS from Liberia and other countries hit by the outbreak, nagging issues like these and those involving health care workers' benefit and starvation in quarantined areas remain as burning an issue as one would expect, competing for the highlight reels. 

 

So is Ebola, a deadly virus, which for now appears to be lost in a sea of political intrigue and lingering uncertainty over the fate of an endgame in post-war Ebola-hit Liberia.

Ebola in West Africa: Banbury warns of "huge risk" of spread

Via BBC News: Ebola crisis: Huge risk of spread - UN's Anthony Banbury. Click through for a video. Excerpt:

The head of the UN Ebola response mission in West Africa has told the BBC there is still a "huge risk" the deadly disease could spread to other parts of the world. 

Tony Banbury declined to say if targets he had set in the fight against Ebola, to be achieved by Monday, had been met. 

The targets were for the proportion of people being treated and for the safe burial of highly infectious bodies. 

The UN boss was speaking in Freetown, one of the worst affected areas. 

On Sunday in Sierra Leone's capital, bulldozers were clearing large areas for a new burial ground. 

At the clearance site, near a rubbish tip, car after car was arriving with bodies, and several hundred workers were digging graves. 

In October, Mr Banbury told the UN Security Council that by 1 December, "70% of all those infected by the disease must be under treatment and 70% of the victims safely buried if the outbreak is to be successfully arrested". 

This interim goal - the ultimate UN goal is zero Ebola deaths - was set to try to bend down the upward curve in the graph of cases. 

Mr Banbury said the 70% targets were being met in "the vast majority" of areas in the three worst-affected countries - Guinea, Sierra Leone and Liberia. 

"But in some areas", he said, "including here in Sierra Leone - especially in the capital Freetown and in the town of Port Loko - we are falling short. And it is in those areas where we really need to focus our assets and our capabilities".

I hope that on December 1, 2015, I am not posting a damn thing about Ebola. But I expect, realistically, that I will be—while the world's governments and media are turned to some other threat.

Ebola in Sierra Leone: Citizens call for improved water service

This does not bode well. Via Awoko.org, a November 28 report: Citizens call for improved water service. Excerpt:

As the country goes proper into the dry season, citizens of Freetown are beginning to worry how they are going to cope with life without adequate water supply, especially with the present Ebola crisis, which also needs huge amounts of water to contain. 

Awoko sought the views of some citizens, especially in the eastern part and those residing in hill top communities who were concerned about the huge challenges they face daily to access water for use, which sometimes is accessed through unsafe channels. 

A mother of three, Mabinty Koroma, explained that the economic situation in the country is not easy, and Guma Valley has added extra burden on her life, because there is no pipeborne water in her locality, as a result, her children walk for miles to access water. 

Abraham Conteh, who resides at central Freetown said he has pipe borne water in his area, but it does not flow daily, which also is unacceptable in a city, with over two million residents. 

He noted that each time, Guma Valley goes on air, officials will allay the fears of the public that the institution is undergoing a restructuring process, and all will be fine soon, and that’s where it will end; all talk and no action to deliver the service. 

Another resident of Hill Station, Mohamed Timbo, in a very disappointed and frustrated mood, informed Awoko that for several years, he has been purchasing water from Guma Valley and most times it is not delivered on time. 

He wondered why can’t Guma provide pipeborne water in the city, instead of selling water in tankers, which is expensive, and most times, pipes are cut or stolen, because management does not take responsibility to ensure that all pipes are laid properly, as prescribed in the water regulation. 

Another citizen, John Coker, said that water is a big challenge, but that should not deter the water company from meeting the demands of the public, instead of always making excuses.

India: Malaria outbreak hits anti-Naxal ops

Credit: The Indian Express

Via The Indian Express: Malaria outbreak hits anti-Naxal ops. The Naxalites are a loosely organized guerilla movement calling itself Maoist. 

An outbreak of malaria in Bastar has severely impacted the security forces on the Naxal front. At least one policeman, Govind Tamga, has died and over 400 have been affected by the disease in the last 10 days. Besides the personnel, a huge number of villagers have been hit by the disease. 

The situation is compounded by the lack of medicare in Bastar as the region has only one major hospital in Jagdalpur, which lacks capacity to treat the influx of patients. The male ward of the hospital is brimming over and over 50 personnel of the state police and the CRPF have to lie on the floor. The Bastar IG has asked the government to provide immediate help. 

“Our operations have been affected. We have asked the state government to immediately take note of the situation and ensure medicare for policemen,” said IG S R P Kalluri. 

“We have given special instructions to our forces posted in sensitive areas,” he said. 

Such has been the impact that at least two anti-Naxal operations in the region were to be curtailed last week as the personnel were hit by the disease in forests, forcing the commanding officers to order an immediate retreat. 

Bastar’s malaria officer Sanjay Basak said the sudden outbreak of malaria is a serious issue. “So far we were giving them chloroquine and primaquine for malaria, but these have proved ineffective. We have taken advice from the WHO’s officers about other medicines,” he added. 

While some policemen, whose condition turned serious, have been airlifted to Raipur, at least 200 are still in police camps of interior areas and yet to receive medicare. 

Speaking to TV reporters, the personnel admitted  to hospital said they were not given proper care and were forced to spend on their own.

UK: Air pollution to blame for 60,000 early deaths per year, government to be warned

Via The Independent: Air pollution to blame for 60,000 early deaths per year, Government to be warned. And if it's this bad in the UK, imagine how many Chinese are dying to keep their country prospering (and us in cheap consumer goods). Excerpt:

Air pollution, largely from diesel vehicle road traffic, may be to blame for as many as 60,000 early deaths in Britain each year, the Government’s scientific advisors are set to warn it. 

The Sunday Times newspaper reports that the Committee on the Medical Effects of Air Pollutants, an official advisory body, will publish a report next year showing that the premature death toll caused by road traffic pollution is around twice as high as originally thought. 

The official death toll for air pollution in the UK is currently 29,000, but this does not take into account levels of the gas nitrogen dioxide, which is mainly emitted by diesel engines whose deadly effects are not included in the existing official count. 

Though the Committee is still finalising the figures, Frank Kelly, the professor of environmental health at King’s College London who chairs it, told the newspaper that new calculations taking into account nitrogen dioxide levels  “would increase air pollution’s contribution to the total death rate from 5%-9% across the UK to 10%-18%”.  

The effects are particularly “distressing” for people who live in urban areas where pollution spurs the development of lung and heart diseases. People with existing conditions, including asthma, are particularly at risk. 

“Since more than 60% of the population live in urban areas, where pollution is the highest, and they are breathing polluted air over decades, the additional small risk accumulates to these distressing figures,” he explained. 

The government agency Public Health England confirmed last week that NO2 was killing far more people than previously realised. 

“When we include NO2 there will be a significant increase in the mortality figures from air pollution,” said Sotiris Vardoulakis, group leader in air pollution at the organisation. 

The warning came as the European Court of Justice ordered the British government to clean up illegal air pollution in Britain's cities. 

Environmental group Client Earth, which brought the case before the court, said the ruling would "save lives". 

Public concern over air pollution is making its way back on the political agenda, with researchers earlier in the year warning it could be linked to autism and schizophrenia. 

The effects of the gas are particularly pronounced in London, where the Greater London Authority already recognises that it prematurely kills 2,600 Londoners each year; one in 12 of the total.

Ebola crisis stretches MSF's means

Lucie Lecomte sends the link to this Wall Street Journal report: Ebola Crisis Stretches Doctors Without Borders’ Means. Excerpt:

MSF’s work in Macenta shows how it has come to the rescue of governments and other relief organizations. But it also reflects the strain on the group from the continuing crisis.  

After a slow start, other aid organizations and governments have joined the Ebola battle in Guinea, Liberia and Sierra Leone. The U.S. has dispatched nearly 3,000 military personnel to West Africa to train health-care workers and build as many as 17 clinics, some of which are now operating. The U.K. and Save the Children recently opened a clinic in Sierra Leone, and several treatment centers recently opened in the Liberian capital of Monrovia, run by groups from China, Sweden, and Cuba. 

But MSF still is handling the bulk of cases in all three countries. It has more than 3,400 people working on the crisis in West Africa, operating six MSF clinics with 600 beds. MSF said it had treated more than 60% of all Ebola patients in the West Africa outbreak as of the end of October. This month, it was also tapped to help run a clinical trial of two experimental drugs at its West African treatment centers. 

MSF says it often has to care for patients even after discharging them, pay gravediggers and tank up ambulances that have run out of gas. MSF supplies other aid groups with protective suits and body bags from its own stockpiles. It has even stepped in to help draft reliable maps of Guinea’s remote forested regions. 

“When it comes to logistics, MSF is an elephant,” said Abdourahmane Batchily, Guinea’s Ebola coordinator for the district of Guéckédou. “We’d be nowhere without them.” 

MSF raised about $1.3 billion last year from individual donations, foundations and governments, but handling all things Ebola has created serious staffing and logistical strains.

“We’ve been stretched to our limits,” said Armand Sprecher, an MSF physician who has served three stints in West Africa during the outbreak. “The size of what’s going on has pushed us past where we thought we could be.” 

During other crises, MSF has typically sent expatriate doctors and nurses into the field for stints of six months or more, but because Ebola work is so stressful, it is rotating them every five to six weeks. 

Founded in 1971 by a group of French doctors, the NGO today has become a one-stop shop for West African governments seeking quick solutions to the Ebola crisis. 

At a meeting of Guinea’s National Ebola Coordination agency this month, its chief, Sakoba Keita, sought volunteers to train a group of Cuban doctors and nurses, who arrived in October with no equipment and or qualifications for dealing with Ebola. 

Dr. Keita turned to Mr. Ponçin of MSF, asking him to train some of the Cubans. “This isn’t a request,” Dr. Keita said. “It’s an order, Marc.” The 52-year-old French biologist said MSF would train them as soon as possible.

Ebola in Guinea: Scare about a suspected case in Labé

Lucie Lecomte sends the link to this report in AfriqueZoom.info: Guinea: Psychosis around a suspected case of Ebola in Labe. The Google translation, lightly edited:

A Guinean national who has long lived in Mali came home sick this week in Labé. Originally from Tounny Prefecture, Tountouroun sub prefecture of Labé, the young man who complained of high fever accompanied by intense vomiting sowed psychosis in the population of Labe. 

Informed, the health authorities visited the place to examine the patient. When asked by your online daily AfriqueZoom.info , the regional director of health in Labé wanted to put the record straight and to reassure the population. 

According to Dr. Houdy Bah, this patient showed signs similar to Ebola but nothing for now confirms that it is Ebola before the results of examinations expected within 48 hours. 

The samples were taken and sent to Conakry to examinations. 

At last, the young man died and his funeral took place this Sunday, November 30, 2014 in the presence of the health authorities and the Red Cross. 

So far the administrative region of Labe has recorded no cases of Ebola.

Wikipedia tells us Labé is the second largest city in Guinea, with a population of 200,000. It also appears to be in an extensive part of northern Guinea that has yet to report a single confirmed case of Ebola. So the "psychosis" of the residents is understandable. And if the young man contracted Ebola in Mali, the Malians have something to worry about also.

"Securitizing" Ebola

Thanks to Lucie Lecomte for sending the link to the Council on Foreign Relations and an excellent article by Yanzhong Huang: The Downside of Securitizing the Ebola Virus by Yanzhong Huang. Excerpt and then a comment:

As of November 14, 99.8 percent of the cases had been found in three Western African countries (Guinea, Liberia, and Sierra Leone), and Spain and the United States were the only two non-African countries reporting Ebola cases. And in the United States, only four confirmed cases thus far have been found, and none of those who contracted the virus in the country have died. 

Yet fear and anxiety spread much faster than the virus in the United States. The problem is that in evaluating risks posed by an infectious disease, public health professionals have to consider the compound probability of contracting the disease and succumbing to its effects, but the general public tends to respond only to the likelihood of death in the event the disease is contracted. In a securitized policy context, with the threat of an infectious disease heightened by political leaders and media outlets, this perception gap has been further expanded, leading to panic and overreaction to the disease. 

If the securitization efforts are joined by more drastic government interventions, the fear and overreaction could impact the national and global economy. According to the World Bank, the vast majority of economic losses during a disease outbreak are attributed to uncoordinated and irrational efforts by the public to avoid infection. 

Mismanaging the Risks 

The logic of securitization often works against effective risk management. A study published in the medical journal The Lancet estimated that the risk of Ebola spreading to the United States was only 13 percent of the risk of spread to the United Kingdom or France combined. The securitization approach, however, often leads to heavy-handed government interventions that do not differentiate actual risks posed to communities, states, and populations.    

Indeed, it was not until the end of October that the U.S. Center for Disease Control (CDC) adopted targeted strategies that classify individuals into different risk categories. Also in October, Canada announced it would deny entry to foreign nationals traveling from Ebola hot spots in West Africa. 

Similarly, the governors of New York, New Jersey, and Illinois announced plans to quarantine all medical personnel returning from Ebola-ridden countries in West Africa. The same logic may fuel discrimination against certain groups of people. Some policymakers have called for tighter border restrictions, for fear that immigrants from Latin America may be carrying the disease, even though no confirmed cases have been reported in the region. 

Second, by pinpointing an existential threat that requires an emergency response, securitization tends to push disease responses away from civil society toward military organizations and law enforcement agencies that have the power to override freedoms and civil liberties. This is especially troublesome if the military is used to enforce quarantine or other containment measures and target sick and exposed people—not the virus itself—as the presumed enemy. 

But even if the military is not involved in rounding up individuals suspected of carrying the virus, a securitized policy context could have the unintended effect of breaking the trust between the general public and public health authorities by encouraging civilians to shun public health officials and health workers. 

This has been a major concern in West Africa, where lack of trust in the government is a major factor behind the surge of the Ebola cases and deaths. In countries hardest hit by Ebola, health workers and clinics have come under attack from panicked residents who mistakenly blamed health workers for bringing in the virus.

We've tended to tsk-tsk the West African culture with its concern for touching the dead at whatever risk to the mourners. But our own culture has guided our response just as dangerously. In the militarized "advanced" nations, if it's not an existential threat, it's not a threat at all. And if it is such a threat, the response will be the tried and true militarized one. 

As a Flublogian, I've tended to support the military response because it was the only one likely to get the needed resources out of North American and Europe. But it's a hammer in search of problems that look like nails, and we should be aware of the limits of our policy.

Saudi Arabia: No new MERS cases or deaths as of noon November 30

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded'. Nor have any deaths or recoveries been reported. 

The numbers remain at 11 cases under care, 454 recovered, 814 total, and 349 deaths.