H5N1

CIDRAP: Eleven more MERS cases in Saudi Arabia, two in Jordan

Via CIDRAP, a report by Lisa Schnirring: Eleven more MERS cases in Saudi Arabia, 2 in Jordan. Excerpt:

Saudi Arabia's health ministry reported 11 more MERS-CoV cases in the past 3 days, 9 of them in Riyadh where a hospital-linked outbreak is under way, and Jordan's media is reporting 2 more cases, pushing the number of recently detected cases there to 6. 

Details in the Jordanian media reports, published in Arabic and flagged by an infectious disease news message board and blog, are scanty, but suggest the possibility that some may be linked to hospital spread. A flare-up of MERS-CoV (Middle East respiratory syndrome coronavirus) is occurring in Jordan after 8 months of no cases. 

Disease activity in Jordan and in neighboring Saudi Arabia are raising concerns, coming just weeks ahead of the busy international travel season surrounding the Hajj religious observance in Saudi Arabia. 

Saudi numbers rise steadily 

In separate announcements over the past 3 days, Saudi Arabia's Ministry of Health (MOH) reported 11 new lab-confirmed cases, 9 in Riyadh, 1 in Ha'il in the north central part of the country, and 1 in Najran, a city in the southern part of the country that has now reported four cases since early August. 

The country also reported 7 more MERS deaths, 6 in Riyadh and 1 in Najran. All but one of the deaths involved previously announced patients. 

Of the 9 new cases in Riyadh, 8 likely have links to the hospital outbreak centered at King Abdulaziz Medical City, a large National Guard hospital in the city. Seven of the 8 patients were contacts of a suspected or confirmed MERS-CoV case in the hospital or in the community, and the contact status is still under review for the eighth patient. 

Two of Riyadh's newest cases are in foreign healthcare workers, a 24-year-old man who is hospitalized in critical condition and a 33-year-old woman whose condition is listed as stable.

WHO: Guinea Ring Vaccination trial extended to Sierra Leone to vaccinate contacts of new Ebola case

Via WHO's Regional Office for Africa: Guinea Ring Vaccination trial extended to Sierra Leone to vaccinate contacts of new Ebola case. Excerpt:

Freetown, Sierra Leone – 31 August 2015: Detection of a new case of Ebola virus disease in Kambia, Sierra Leone after the country had marked almost three weeks of zero cases has set in motion the first ‘ring vaccination’ use of the experimental Ebola vaccine in Sierra Leone. 

A team of experts in ring vaccination has travelled from Conakry, Guinea to join a large WHO and Ministry of Health team already in the district where the new case has been reported. The source of the Ebola virus transmission is being investigated and all the people who may have been in contact with the infected person are being traced. 

“Although no-one wanted to see more cases of Ebola virus disease in Sierra Leone, we kept all our teams on alert and ready to respond and close down any new transmission” said Dr Anders Nordstrom, WHO Representative in Sierra Leone. 

Heightened surveillance for Ebola virus disease in Sierra Leone includes swabbing all people who have died at home and testing those swabs for Ebola virus. On Saturday, 29th August, a swab taken from a woman who died aged around 60, in the village of Sella, Tonko Limba, Kambia district, tested positive for Ebola virus. 

Members of the team currently conducting the ring vaccination trial in Guinea, drove from Conakry in Guinea to Kambia, Sierra Leone on Sunday to begin work.  

The Guinea team were met in Kambia by another team from Freetown, who had been trained and prepared last week by WHO in order to be ready should there be any new Ebola virus infections in Sierra Leone. 

The Guinea ring vaccination trial is a Phase III efficacy trial of the VSV-EBOV vaccine (Merck, Sharp & Dohme) which is being conducted by WHO and partners*. Interim results published last July show that this vaccine is highly effective against Ebola. The ‘ring vaccination’ strategy involves vaccinating all contacts -the people known to have come into contact with a person confirmed to have been infected with Ebola (a ‘case’) - and contacts of contacts.  

Following publication of those results, the Sierra Leone government requested that the trial be extended to Sierra Leone. The WHO Sierra Leone country office immediately sent a team to Guinea to organize this, ensuring that all the correct procedures and protocols are followed. WHO and partners then trained 18 Sierra Leonean health care workers on implementation of the study protocol.

When Ebola breaks out again elsewhere (as it likely will), the West Africans will be able to export the kind of hard-won expertise that Uganda sent to them.

Coston: Media reporting sixth MERS case In Jordan

Via Avian Flu Diary, Mike Coston has an important post: Media Reporting 6th MERS Case In Jordanian Cluster. Click or tap through for the full post, including some very useful links and background information. Excerpt:

Since the Jordanian Ministry of Health website isn’t posting updates we have to rely upon local media for updates on Jordan’s recent MERS outbreak.  Earlier today I posted on the 5th case in less than a week, and this afternoon we have word on a 6th case. 

The first two cases were described as having had recent travel outside of the country (1 to Saudi Arabia, the other not specified) while the latest four all appear to be locally acquired.

The very first MERS cases, retroactively identified, were a nosocomial outbreak among healthcare staff in a hospital in Zarqa, Jordan, in April 2012. Thereafter Jordan appeared to get off very lightly while Saudi Arabia took the brunt of cases. Maybe Jordanian hospitals' infection control improved, or maybe they were just lucky. 

Uganda: Are domestic pigs vectors for Ebola?

Thanks to Greg Folkers for sending the link to this article in Transboundary and Emerging Diseases: Assessing the Potential Role of Pigs in the Epidemiology of Ebola Virus in Uganda. The summary:

Uganda has experienced 4 Ebola outbreaks since the discovery of the virus. Recent epidemiological work has shown pigs are hosts for Ebola viruses. Due to their high reproduction rates, rapid weight gain, potential to provide quick financial returns and rising demand for pork, pig production in Uganda has undergone massive expansion. 

The combination of pork sector growth supported by development programmes and Ebola virus risk prompted a foresight exercise using desk, interview and spatial methods. 

The study found that the lack of serological evidence for specific reservoir species, the number of human index cases unable to account for their source of infection, domestic pig habitat overlap with potential Ebola virus zoonotic host environments, reported interactions at the human–pig–wildlife interface that could support transmission, fever in pigs as a commonly reported problem by pig farmers and temporal correlation of outbreaks with peak pork consumption periods warrants further research into potential zoonotic transmission in Uganda from pigs.

'No limit to refugees Germany can take in'

Via The Local.de, an encouraging report: 'No limit to refugees Germany can take in'. Click or tap through for the full story and many links. Excerpt:

Germany's top official dealing with refugees said on Monday that there was 'no upper limit' to Germany's capacity for taking in people in need of asylum. 

The comments from Manfred Schmidt, head of the Federal Office for Migration and Refugees (BAMF) are certain to provoke anger in some quarters of the political spectrum. 

Schmidt told Der Spiegel he was "convinced" that Germany and its citizens were prepared for the task that is entailed by taking so many people into the country. 

"There is an enormous engagement on the part of the German people. On the one hand you have Heidenau – but in reaction to that you can fill 100 or 200 volunteer positions," he said. 

Heidenau, a town in Saxony, was the scene of violent far-right protests in front of a planned refugee centre earlier in August. 

Schmidt made clear that the number of refugees Germany takes in will remain dependent on external conditions and not on quotas set in Berlin. 

"There can be no upper limit set on the intake of people who are fleeing persecution and need protection," Schmidt said. 

With Germany expecting 800,000 asylum applications during the course of 2015, Schmidt has had more work on his desk than in any previous year, and the backlog in applications is now estimated at a quarter of a million. 

But the ex-jurist said that the opening of extra offices and the building up of his workforce would soon start to make a difference.

You would think that if doltish governments like Hungary's didn't want refugees, they'd organize fleets of buses to move newly arrived refugees right to Germany. Then in a few years they could wonder why the Germany economy was still thriving.

Liberia: Ebola gone but scars remain

An editorial in FrontPageAfrica: Ebola Gone But Scars Remain: Survivors Deserve Better. Excerpt:

During a visit to Liberia, World Bank President Dr. Jim Yong Kim held meetings with Ebola survivors and, according to some survivors, he pledged the Bank’s support the recovery process of these survivors. 

Adter Ebola, the plight of these survivors, some of whom lost all family members, is very disturbing-no program has been developed to look after these survivors by providing them medical attention and other forms of support. 

IN Monrovia and all the counties, survivors continue to look up for assistance which is yet to come. 

Mercy Kromah, a 12- year old Ebola survivor who told FrontPageAfrica she lost both parents to the virus is still in a state of confusion not knowing where her life is going at the moment. 

The physical appearance of Mercy tells it all--rashes on the skin, poor look and visibly looking malnourished. She says since she was discharged from the MSF ETU on August 7, 2014, she has not visited a hospital because she can’t afford to pay for treatment. 

Like Mercy who lives in Monrovia, survivors in rural counties are far worse as one survivor from the remote village of Quewin in Grand Bassa County said one paracetamol tablet is sold in her village for L$30 and she cannot afford to buy a dose containing at least 12 tablets at the $30 price per tablet to take whenever she is experiencing severe headache. 

During the peak of the outbreak in Liberia, there was huge international support with the presence of many international non-governmental organizations on the ground but with the virus now defeated, it looks like the world has left the country. 

Although the virus is now gone but the scars are very visible and the desperate living conditions of many survivors is one big example of the indelible mark of Ebola on the country and its population.

Pakistan: Punjab lady health workers refuse to work in latest polio campaign

Via The Nation: Punjab lady health workers refuse to work in latest Polio campaign. Excerpt:

According to a Waqt News report, Punjab Lady Health Workers (LHWs) have refused to work in the latest Polio campaign. Punjab government will be starting the campaign from September 7 according to the report. 

LHWs have not been given their salaries for the past two months, amounting to Rs 90,000[US$864], owing to which they have refused to take part the upcoming campaign.

Sierra Leone: Dead woman tests positive for Ebola

Via Yahoo News, a Reuters report: Dead woman tests positive for Ebola in Sierra Leone.

The body of a woman who died in Sierra Leone has tested positive for the Ebola virus, less than a week after the last person confirmed to have had the disease was released from hospital, health officials said. 

The new death, if confirmed, would represent a setback for efforts to end an 18-month regional epidemic that has infected more than 28,000 people and killed more than a third of them. 

In the latest case, a 67-year-old woman from the Kambia District along Sierra Leone's border with Guinea, died on Saturday. 

Sierra Leone's chief medical officer Brima Kargbo told Reuters that two samples tested in Kambia had tested positive for Ebola. However, he said further tests were being carried out in Makeni, the main town in the Northern Province, and in the capital Freetown. 

"We are particularly concerned because Kambia has gone 50 days without a confirmed Ebola case, suggesting the possibility of an error," Kargbo said.  

He added that the woman worked as a trader, though people who knew her said she had not traveled recently. She now becomes the first new case in the country since Aug. 8.

Tanzania: Over 200 cholera cases, eight deaths

Via allAfrica.com, a report in the Tanzania Daily News: Tanzania: We Need Effective Strategies to Fight Cholera. Excerpt:

Three days ago, the Minister for Health and Social Welfare Dr Seif Rashid broke bad news, as he informed the media that eight people had died and more than 200 were admitted to hospitals in two weeks since cholera broke out in Morogoro and Dar es Salaam regions. 

We should remember that the outbreak was first announced in Dar es Salaam on August 15 this year and two days later some cholera cases were reported in Morogoro Region. 

Until yesterday, there were 230 cholera patients in Dar es Salaam and 34 in Morogoro. According to Dr Rashid, the disease is spreading fast in the two regions and in just eleven days, the disease has killed eight people. 

The first case was reported in Kinondoni district, before spreading to Ilala and Temeke districts. According to the minister, Kinondoni municipality is the most affected with 186 patients while Ilala and Temeke has 22 patients each.

Jordan records new case of MERS

Via Al-Bawaba: Jordan records new case of MERS.

A new case of Middle East Respiratory Syndrome (MERS) coronavirus-related infection has been registered in the kingdom, the Health Ministry said Sunday. 

The diagnosed 56-year-old patient suffers from diabetes, blood pressure-related diseases and kidney failure, said Mohammad Abdullat, director of the ministry’s communicable diseases control department. 

The patient also recently underwent open-heart surgery, Abdullat added. A team from the directorate is supervising the private hospital’s measures to prevent the spread of the infection and is also following up on the situation of the patient’s relatives and the medical staff who examined him. 

Since the MERS virus was first registered in Jordan in 2012, 17 cases have been recorded.