H5N1

Saudi Arabia: Three new MERS cases as of noon February 29

 

Via the KSA MOH Command and Control Center: MOH: '3 New Confirmed Corona Cases Recorded'. The cases are all in men; two Saudis, one 72 and the other 68, are both reported as having had contact with camels. A 30-year-old expatriate looks like part of a family cluster in Riyadh. At three are in stable condition.

No deaths or recoveries are reported. The numbers are now 12 cases under care, 742 recoveries, 1,309 total, and 555 deaths.

Hong Kong: CHP notified of ninth imported case of Zika virus infection in Mainland

Via the Centre for Health Protection: CHP notified of ninth imported case of Zika Virus Infection in Mainland. Excerpt and then a comment:

The Centre for Health Protection (CHP) of the Department of Health (DH) received notification today (February 29) of the ninth imported case of Zika Virus Infection in the Mainland from the National Health and Family Planning Commission and the Health and Family Planning Commission of Guangdong Province, and again urged the public, particularly pregnant women, those planning pregnancy and immunocompromised patients, to adopt strict anti-mosquito measures during travel.        

According to the health authorities in the Mainland, the male patient aged 23 lives in Venezuela and arrived in Guangdong on February 19. He developed skin rash on February 26 and sought medical attention on the same day. The case was subsequently laboratory confirmed by the Health and Family Planning Commission of Guangdong Province. At present, the male patient is hospitalised for isolation and management in Enping, Guangdong. He is now in stable condition. The patient did not pass through Hong Kong.       

 "Routine health surveillance on the body temperature of inbound travellers at all boundary control points is ongoing. Suspected cases will be referred to healthcare facilities for follow-up. However, at present, around 70 to 80 per cent of infected people are asymptomatic and most can recover fully. Therefore, we again urge those arriving from Zika-affected areas to apply insect repellent for 14 days upon arrival to reduce the risk of transmission," the spokesman for the DH said.

We seem to be learning more about Zika in Venezuela from China than from Venezuela itself. The Venezuelans are saying very little, and this is, I think, the third Zika case in China that originated in Venezuela. 

ECDC: CDTR, week 8

ECDC has published Communicable disease threats report, 21-27 February 2016, week 8. Click or tap through to download the PDF. The abstract:

The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 21-27 February 2016 and includes updates on Zika virus, measles and seasonal influenza.

Honduras: Pregnant woman has Guillain-Barré, possibly Zika

Via STAT, a report by The Associated Press: Honduras: Pregnant woman has Guillain-Barre, possibly Zika. Excerpt:

Health officials in Honduras say a 29-year-old pregnant woman showing symptoms of the Zika virus has been diagnosed with Guillain-Barre syndrome, a rare disorder that causes paralysis. 

Honduran authorities say it could be the first case in the Central American nation with both conditions. 

University Hospital spokesman Miguel Osorio says officials are waiting for laboratory tests in the United States to determine whether the woman has been infected by Zika, which is carried by mosquitoes and has been spreading rapidly in Latin America.

Wiping out the mosquito species carrying the Zika virus is a good case for gene modification

Via the South China Morning Post, a good column by Gwynne Dyer: Wiping out the mosquito species carrying the Zika virus is a good case for gene modification. Excerpt:

It was a typically anodyne statement by the World Health Organisation: “Given the magnitude of the Zika crisis, WHO encourages affected countries and their partners to boost the use of both old and new approaches to mosquito control.” Anodyne, that is, until you realise what they mean by “new approaches”.

Zika is a mosquito-borne virus that is spreading panic around the world. It was first linked to microcephaly – a developmental defect in infants – only last year in Brazil. The WHO estimates it may infect 3 to 4 million people in the Americas alone this year – and its “new approach” is to exterminate the mosquitoes. Literally. 

An alternative would be to develop a vaccine for the virus – but that would take up to 10 years, and the crisis is now. Zika has already been detected in 30 countries. The pressure is on to do something fast. 

By coincidence, something fast is available. Austin Burt, an evolutionary geneticist, raised the idea of a “gene drive” that would spread some desirable quality (like immunity to malaria) through an entire population in a relatively short time. By last year, scientists had a genetically modified (GM) mosquito whose offspring do not survive into adulthood.

Ny an even wilder coincidence, the species of mosquito was Aedes aegypti, best known as a vector for dengue fever and also the main transmitter of the Zika virus. Oxitec, the company created to exploit this new technology, is already field-testing the GM version of the insect—in Brazil.

UK: Ebola nurse Pauline Cafferkey discharged from Royal Free

Thanks to Ebola Radar for tweeting about this report from The Royal Free Hospital: Pauline Cafferkey discharged. The complete statement:

Pauline Cafferkey has today (Sunday 28 February) been discharged from the care of the Royal Free Hospital following her admission due to a complication related to her previous infection by the Ebola virus. 

We can confirm that Pauline is not infectious. The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic.

The Guardian has the story, with considerable background on her case and those of other survivors' post-Ebola problems.

Nigeria: Eight die of Lassa fever in Plateau state in three months

Via TheCable.ng: 8 die of Lassa fever in Plateau in 3 months.

Kunden Deyin, the commissioner for health in Plateau, says the state has recorded eight deaths, 13 confirmed cases and 50 suspected cases of Lassa fever from December 2015 till date. 

Deyin said this in Jos on Sunday and added that the state had commenced aggressive sensitisation and awareness campaigns in Jos-Bukuru metropolis and in the 17 local government areas. 

He said that the campaigns aimed to enlighten the people on how to prevent the disease and ensure that the menace was nipped in the bud. 

“Lassa fever is transmitted through the urine and excreta of a rat that serves as a reservoir for the Lassa virus and this rodent is usually attracted to dirty and flirty environments,” he said. 

“The ministry, through its sensitisation campaign, is making an effort to educate the populace on the importance of keeping a clean environment and on the need to ensure that all foods are stored in rodent-proof containers.” 

Deyin urged residents of Jos to refrain from drying food stuff, as rats could excrete on them. 

“We embarked on this social mobilisation because we believe that prevention is better than cure,” he said. 

Deyin also said that the ministry was in liaison with traditional and religious leaders on the need to sensitise their wards and congregations on the importance of promoting good community and personal hygiene. 

He said this was the surest means of discouraging rodents from entering their houses. 

Deyin said the ministry had trained 54 laboratory scientists from the 17 local government areas to ensure that basic precaution methods were practised and 20 morticians on how to decontaminate corpses. 

He also said that the ministry had procured drugs, Personal Protective Equipment and other materials to ensure that standard precaution methods were observed.

A global defence system to fight virus threats is urgently needed

Via The Guardian: A global defence system to fight virus threats is urgently needed.

Ebola was a preventable tragedy. Its lessons are now abundantly clear. A report this week from a UN high-level panel completes a cycle of four comprehensive inquiries. Its conclusions align with those reached by experts convened by the WHO, US National Academy of Medicine and the London School of Hygiene and Tropical Medicine. There is an agreed road we must take. 

First must come a fitter body. Just as robust health protects individuals, robust health systems protect everyone. When Ebola spread to rich countries, it was rapidly contained. It was in three countries with very poor health infrastructure that the disease took devastating hold. 

Guinea, Sierra Leone and Liberia are not the only countries that lack essential capacity. Only a third of governments even claim to have implemented the basic requirements of the 2005 International Health Regulations. There is no process for monitoring compliance and no accountability. Neither is much aid available for countries that cannot afford basic systems. States that detect outbreaks often delay reporting, as economic consequences are severe and incentives and compensation absent. 

This cannot be resolved at national level. Governments of every country must recognise that investing in public health protects their citizens. Richer nations must recognise that helping others to achieve basic standards is not altruism but a self-interested cost of security. As the spread of Sars to Canada showed, pathogens do not care for borders. Pandemic defences are as strong as their weakest links. There must be incentives for declaring outbreaks, and more available aid. 

Next we need a sharper brain. Better infrastructure cannot prevent every emergency, and an international agency with legitimacy is needed to plan and execute swift, effective responses. There is no viable candidate besides the WHO, but it lacks the capacity or culture required. Margaret Chan, its director general, has to her credit acknowledged this and established an emergency response programme and a $100m contingency fund. 

This is progress, but will take us only so far. The budget is insufficient and must be replenished when spent: a UN panel recommends tripling resources to $300m and raising national WHO subscriptions by 10% to make funding sustainable. The response unit needs a powerful director backed by an independent board who can cut through WHO’s regional and national bureaucracies. Chan is about to begin her final year as director general. Establishing this capacity would be a fine legacy.

The final requirement is a better immune system. That means a transformed approach to research and development of vaccines and drugs. 

All four reports agree on the need for public, private and philanthropic sectors to step up investment in R&D for diseases where industry lacks much prospect of a market return. When such research takes place at all, it generally relies on the goodwill of pharmaceutical companies prepared to take a loss – Ebola vaccines are a prime example. That isn’t sustainable, not when we know of dozens of threatening pathogens for which, like Ebola in 2014 and Zika today, we have no vaccine or cure. 

As traditional vaccine and drug development timelines are too slow for emergency response, we must invest in technologies that enable more rapid deployment. Zika, a mosquito-borne disease, has demonstrated the need for transformative control of the way diseases are transmitted. Debates over the risks and benefits here need to be evidence-based. These technologies will be useful beyond pandemic outbreaks, for diseases such as malaria which kill and disable every day.

Mediterranean migrant, refugee arrivals in Europe top 120,000

Via the IOM: Mediterranean Migrant, Refugee Arrivals in Europe Top 120,000. Excerpt:

Migrant and refugee arrivals in Greece and Italy have exceeded 120,000 in 2016, having reached the 100,000 milestone earlier this week, almost four months earlier than in 2015. As of 25/2, Greece alone had received some 111,099 arrivals since the beginning of the year, according to IOM estimates. 

During the same period, over 418 migrants and refugees have also lost their lives trying to cross the Mediterranean, with the Eastern Mediterranean route between Turkey and Greece continuing to be the deadliest, accounting for 321 migrant deaths. During the same period in 2015, 428 migrants died in the first two months of the year. 

According to IOM Greece, 3,348 arrivals were registered on 24 February. These are not the actual daily arrivals, but the number of migrants who have officially been recorded by the Greek authorities after their arrival. This procedure can take a few days. 

According to updated data from the Greek authorities 67,415 migrants crossed into Greece in January of which approximately 44 percent were male, 22 percent female and 34 percent children. 

The main departure country was Turkey and the main landing points were the Greek islands of Lesbos, Kos, Samos, Rhodes, Kalymnos, Megisti, Leros and Chios. 

IOM Greece staff are present in the islands of Crete, Samos, Kos and Lesbos, working closely with the authorities to identify vulnerable migrants, including unaccompanied minors, the elderly, migrants with medical needs, and families with children. Vulnerable groups are referred to the authorities to be given the necessary care. 

Meanwhile in Italy, 1,085 migrants were rescued at sea in the last 2 days and brought to Pozzallo (531) and Augusta (554). Rescuers also brought five bodies to Augusta – three women and two men from Sub-Saharan Africa – who died during the journey. 

"The news of these five deaths is deeply concerning. These migrants probably asphyxiated because of the overcrowding on board. Overloading the boats is a common practice by smugglers who promise safe passage to destitute migrants but want to maximize their profits. It is well known that overcrowding on the boats is common and deadly,” said Federico Soda, Director of the IOM Coordination Office for the Mediterranean in Rome.

Saudi Arabia: One new MERS case as of noon February 28

Via the KSA MOH Command and Control Center: MOH: '1 New Confirmed Corona Cases Recorded'. The new case is a 30-year-old expatriate man in Riyadh, a household contact of an earlier case; he is in critical condition. No new recoveries or deaths are reported.

The numbers are now nine cases under care, 742 recoveries, 1,306 total, and 551 deaths.