H5N1

US/Canada: The politics of Haitian public health

Via The Globe and Mail, a report from The Canadian Press in Washington: Clinton e-mails reveal Canadian foreign service enmity towards Harper Tories. Excerpt and then a comment:

A U.S. official expressed amazement at how deeply detested Canada’s Conservative government was by some employees of the Foreign Affairs Department. 

That impression was described in a note sent three years ago to Hillary Clinton, who was then the secretary of state and whose e-mails are now being publicly released. 

It was contained in a message where a U.S. official described how his colleagues across the border pleaded for his help lobbying the Canadian government not to cut a program for Haiti. 

The U.S. special co-ordinator for Haiti said Canadians were worried about budget cuts that would have slashed down an operation from 11 employees to four, for a country that was ostensibly a major Canadian foreign policy priority. 

“I was a little astonished at how openly the career folks at the foreign and assistance ministries disliked their new political masters and wanted us to convince them not to cut Haiti,” said Tom Adams, in a May 2012 e-mail forwarded to Clinton and released Monday. 

“In my many years here I have never seen such open disloyalty with a change of administrations. Although the political appointees told me there was no need to have the Secretary talk to Baird about Haiti, the senior career folks, on the margins, implored me to have this done.” 

The dynamic described in that e-mail was on public display recently after the federal election, when employees at the foreign ministry cheered during a visit from their new Liberal bosses. 

Clinton replied that she was happy to call her counterpart John Baird, if necessary. The presidential contender’s e-mails are now being released in instalments, after an uproar over her use of a private home-based server that couldn’t be searched for freedom of information requests.

I have no idea what the Canadian program for Haiti might have been, but it would have had some impact on the public health of that unfortunate country. 

We Canadians have had a complex relationship with Haiti: A lot of Haitians have immigrated here, especially to French-speaking Quebec, and our former Governor-General Michaëlle Jean, born in Haiti, was (and remains) very popular.

 

But we've also trained Haiti's national police force, not the nicest guys in the world, and we've failed to discourage the Americans from their ham-handed treatment of Haiti. We have failed to promote fair and honest elections there, or to help build institutions that a true democracy might have grown upon.

 

I am not surprised, though, that our foreign service detested our previous Conservative government, including its sometime foreign minister John Baird. Stephen Harper's Tories hated the very idea of a truly impartial civil service; they wanted everyone from mailroom clerks to ambassadors to promote the Conservative government and its every whim. The foreign service was intellectually and morally another species from its Tory political masters.

 

If the Haitian earthquake and cholera outbreak had happened before the Harper Conservatives took power in 2006, I like to think we could have done more good. But no country engages with Haiti out of sheer altruism; if they can't get something for themselves by screwing ten million poor black people, they don't want to get involved at all. And that includes both the United States and Canada.

Brazil: Pernambuco state spending US$6 million to tackle Aedes-borne diseases

Via Blog da Folha: Government announces R $ 25 million to tackling Aedes-borne infections. Excerpt from an edited Google translation:

As anticipated by the Folha Blog, the State Government will invest R $25 million[US$6.46 million] within the Coping State Plan of Aedes aegypti-Borne Diseases. The state Secretary of Health, José Iran Costa, gave details on the afternoon of Monday (30), at the Convention Center Hotel Canarius in Gravatá, in Agreste. The event will be attended by municipal managers of various locations of Pernambuco. 

Of this amount, R$15 million[US$3.875 miilion] will be used to build 15 Regional Centers of Attention for children with microcephaly. Another $5 million will be invested in media and a civil defense campaign. The $5 million remaining will be used for the purchase of field material and PPE. 

According to the secretary, the primary challenges are raising public awareness; elimination of outbreaks of mosquitoes in homes and public spaces; search for new technologies; regular distribution of larvicide and insecticide; emergency purchase of equipment and supplies; effective strategies for training of endemic agents and professionals in the health units.

CIDRAP: Zika virus spreads to more countries

Via CIDRAP, Lisa Schnirring writes: Zika virus spreads to more countries. Excerpt:

In quickly evolving developments, more countries in the Americas reported Zika virus cases, as Brazil—one of the hardest hit countries—reported more microcephaly cases, which health officials suspect might be related to infections in pregnant women. 

In a pair of updates, the European Centre for Disease Prevention and Control (ECDC) weighed in on the spread of mosquito-borne Zika virus to more countries and the possible connection to complications, which may also include Guillain-Barre syndrome (GBS) and congenital neurological malformations. 

Also, the World Health Organization (WHO) said it has been notified of Zika virus infections in Guatemala and El Salvador, with infectious disease news sources flagging foreign language media reports suggesting that illnesses have been detected in Paraguay and Venezuela. 

Zika virus infections, spread by Aedes mosquitoes, have rapidly spread to new parts of the Americas since 2014 and continues to sicken people in other parts of the world. Symptoms are similar to dengue fever, but usually milder, lasting 4 to 7 days. 

Growing list of Zika detections 

The WHO said in separate statements that it was notified of a locally acquired case in Guatemala, a patient who got sick on Nov 11, and reports from El Salvador of three locally acquired cases. In both instances, the US Centers for Disease Control and Prevention (CDC) lab in Fort Collins confirmed the findings. 

It said officials are taking prevention and control steps and are looking for additional cases. The WHO urged countries in the Americas to maintain the capacity to detect Zika cases and to prepare their health systems to take on more burden from the disease. 

In a Nov 27 epidemiological update, the ECDC said the first two locally acquired cases have been reported from Mexico, one from Chiapas state, in the southeastern part of the country, and the other from Nuevo Leon state, located in the northeastern region. Aside from the already mentioned countries, other locations reporting cases this year include Colombia, Suriname, Cape Verde, Fiji, Vanuatu, Samoa, New Caledonia, Solomon Islands, and Indonesia. 

In addition, ProMED Mail, the reporting service of the International Society for Infectious Diseases, flagged a media report from Paraguay that said health officials have detected six locally acquired Zika infections. Meanwhile, FluTrackers, an infectious disease news message board, yesterday posted a media report from Venezuela that said 17 cases have been detected. 

More microcephaly cases reported 

The WHO is now reporting 739 microcephaly cases in newborns from northeastern Brazil, affecting 9 of the country's states, according to a Nov 27 statement. The WHO first acknowledged Brazil's unusual spike in cases on Nov 20, when 399 cases from 7 states were reported. 

In its latest statement, the WHO investigations are underway into the cases, which include one death. It said technical experts have been deployed to help Brazil's health ministry with arbovirus virology, epidemiology, and disease surveillance.

Beijing’s ‘crazy bad’ smog cloud could have a silver lining

Via The Globe and Mail, a report by Nathan Vanderklippe: Beijing’s ‘crazy bad’ smog cloud could have a silver lining. Excerpt:

When engineers were building the system that tweeted air-quality updates from the U.S. embassy in Beijing, they never expected it to hit 500, a number so far into the “hazardous” zone that it seemed apocalyptic. 

So they set “crazy bad” as the automated description for an air-quality index of 500 and above.  

It was a joke. They never expected it to happen – and could never have fathomed that those two words might help spur a radical new willingness in China to fight global warming. 

Then in 2010, the joke made global headlines when it suddenly appeared on Twitter, bearing the official imprimatur of the U.S. government. It was quickly deleted and replaced with “beyond index.” 

It has since reappeared with depressing regularity – including on Monday, when by 9 p.m. the average Beijing air-quality index had reached 611. Southwest of the city it touched 938. Authorities halted construction work, shut down some factories and closed freeways. Schools cancelled classes. 

The smothering blanket of air rendered the sun a dull orange and provided an ugly backdrop to the start of the Paris climate talks, where Chinese President Xi Jinping is expected to lead a delegation eager to build consensus for strong new measures against global warming.

The latest Beijing average is 476, with numerous local readings in the 500s; southwest Beijing is 710. The report goes on to say that 4,000 Chinese die daily from air pollution. President Xi and his delegation had better have some really good ideas.

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

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded'. So yesterday's new case in Buraidah has at least not set off a new cluster.

The numbers are one case under care, 728 recoveries, 1,278 total, and 549 deaths.

ECDC: CDTR, week 48

ECDC has published Summary of public health threats, CDTR week 48/2015. Click or tap through to use the links and download the full report. The summary:

​The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals about active public health threats. This issue covers the period 22-28 November 2015, and includes updates on Zika virus infection, Ebola virus disease and Influenza A(H5N1). 

Zika – Multistate (world) 

The first cases of Zika virus infection (ZIKV) infection have been reported in Guatemala and El Salvador. There are still ongoing outbreaks in Colombia, Brazil and the Pacific. 

Possible links between ZIKV infection in pregnancy and microcephaly of the foetus have been under investigation since October 2015 when the Brazilian Ministry of Health reported on an unusual increase in cases of microcephaly after the ZIKV outbreak in the north eastern states. Similar findings have also been reported from French Polynesia.

Ebola virus disease – West Africa – 2014–2015 

Three confirmed cases of Ebola virus disease were reported from Liberia 

In the week leading up to 22 November, WHO reported a family cluster of three confirmed cases of Ebola virus disease (EVD) from Liberia, a country that had been previously declared Ebola-free two times this year, in July and September. In addition, 149 contacts have been identified, including ten health workers who had close contact with one of the cases prior to his isolation. Investigations to establish the origin of infection are at an early stage. 

Influenza A(H7N9) –China – Monitoring human cases 

One new case of avian influenza A(H7N9) notified in China 

On 24 November, one new case of Influenza A(H7N9) was reported from the Guangdong province in China. Since the detection of the virus in 2013, 681 cases have been reported with 275 deaths.

Brazil: Recife and Pernambuco state declare emergency because of dengue, chikungunya and Zika

Via Diario de Pernambuco: Recife and Pernambuco in emergency because of dengue, chikungunya and zika. Recife is Brazil's biggest city in the northeast, with 3.7 million people in the metropolitan area. It's the capital of the state of Pernambuco, with over 9 million persons. The Google translation, edited:

Emergency Situation decrees were signed on Sunday morning in Pernambuco and in Recife. The measures, which should come into effect from Tuesday, were taken by Governor Paulo Camara and the mayor of Recife, Geraldo Julio, due to the dengue epidemic and the increase in cases of dengue, chikungunya and Zika, transmitted by Aedes aegypti. 

The decrees authorize the adoption of any administrative measures necessary for the immediate response by the Government to the current situation. The decrees, which should be published in the Official State Gazette and the municipality on Tuesday, also designate the Health Departments, the state and the municipality, as coordinators of all actions under the Government of Pernambuco and Recife City Hall on the issue. 

The ordinance makes official the Task Force to Combat Aedes aegypti in the Pernambuco capital and puts all bodies and public of the city entities in the face of the emergency, coordinated by the City Health Department. 

"The government cannot restrain efforts in a situation of this gravity. We will do everything in our power and bring the population to face this fight together," said Mayor Geraldo Julio.

"We will do whatever is necessary, under the State Government to the 2014 framework and 2015 is not repeated in 2016. We need the unity of the government and civil society. Together, working to overcome this which is the largest health crisis in Brazil," said Paulo Camara. 

According to the governor, given the seriousness and gravity of the proliferation of the dengue virus, Zika and chikungunya in the national territory, the country's public health agencies are issuing warnings to take emergency measures to mitigate their epidemiological effects.

Pakistan: Seventh polio case surfaces in Sindh

Via The Express Tribune: Crippling virus: Seventh polio case surfaces in Sindh.

The seventh polio case of Sindh surfaced on Friday late evening, taking the total cases of the country to 43 so far this year. 

The three-year-old boy, Hasnain, son of Asadullah, resident of Allah Dad union council, Buzdar district, Khairpur Mirs, has been confirmed to be suffering from polio. The left leg of the boy has been affected by the virus. 

The health officials confirmed that Hasnain was administered polio vaccine three times during the routine immunisation. 

Among the seven cases, one case has been confirmed from Karachi while six others are from different districts of the Sindh province. It is the first case from Khairpur Mirs district this year.

We might reasonably ask about the quality of the vaccine that Pakistan's vaccination teams are risking their lives to deliver.

China: Don't drink the water, and don't breathe the air

Via Beijing Air Pollution: Real-time PM2.5 Air Quality Index (AQI): As of 10:00 a.m. Monday, Beijing time, the PM2.5 index is 480 (hazardous). But take a look at the local readings. You'll see remarkable variations , from lows of 129 to highs ranging from 594 to 692.

The capital of the world's largest country is choking itself to death. And if it stops doing so, the world's economy crashes.

Sweden: Refugees beg to leave 'inhuman' Malmö shelter

The Swedes are having problems. Via The Local.se: Refugees beg to leave 'inhuman' Malmö shelter. Excerpt:

Refugees sheltering in Malmö's 2013 Eurovision venue are begging to leave, with one describing it as a "prison" with "inhuman conditions", while Swedish nurses working there have been pulled out because of the health risks.  

Basim Salim, 40, who has fled Iraq with his three daughters, told Sweden's Aftonbladet newspaper that conditions at the Malmömässan conference hall had become "completely inhuman".    

“Please help us here. We have been here for three nights and can not take any more,” he said. “Some people have been here for five nights. This is not a good place for children, it really isn’t. Everyone here is angry and wants to get out. It is like a prison."     

A policeman from Stockholm sent to help keep order at the hall wrote on Facebook that he himself had had trouble breathing inside the centre, where nearly 1,000 refugees have been crammed over the past two weeks.    

“It stings and itches in your eyes and nose,” the policeman wrote on Facebook, according to Expressen newspaper. “The health services have withdrawn the two nurses they had there because it is not a suitable workplace.”    

The policeman wrote that children, many of them with high fevers, were forced to sleep on pieces of cardboard deposited on the concrete floors.   

“All those poor children. I was stepping over children’s legs and arms, all sticking out under the sheets where they lay cheek by jowl in a row, sleeping on bits of cardboard laid out on the concrete floors,” he wrote.     

“Happy children, sad children, children with 40C fevers who are getting neither food nor medicine.”    

He said that the more than 900-1,000 people staying at the centre had to share just six toilets between them.    

Rebecca Bichis from Migrationsverket told Expressen that the nurses had now returned, but were now operating from a mobile home parked outside the hall.