H5N1

On pandemics and the odds of human extinction

Via The Atlantic: You're More Likely to Die in a Human Extinction Event Than a Car Crash. This article is based on Global Catastrophic Risks 2016, a report by the Global Challenges Foundation. Excerpt:

Any year, there’s always some chance of a super-volcano erupting or an asteroid careening into the planet. Both would of course devastate the areas around ground zero—but they would also kick up dust into the atmosphere, blocking sunlight and sending global temperatures plunging. (Most climate scientists agree that the same phenomenon would follow any major nuclear exchange.) 

Yet natural pandemics may pose the most serious risks of all. In fact, in the past two millennia, the only two events that experts can certify as global catastrophes of this scale were plagues. The Black Death of the 1340s felled more than 10 percent of the world population. Eight centuries prior, another epidemic of the Yersinia pestis bacterium—the “Great Plague of Justinian” in 541 and 542—killed between 25 and 33 million people, or between 13 and 17 percent of the global population at that time. 

No event approached these totals in the 20th century. The twin wars did not come close: About 1 percent of the global population perished in the Great War, about 3 percent in World War II. Only the Spanish flu epidemic of the late 1910s, which killed between 2.5 and 5 percent of the world’s people, approached the medieval plagues. Farquhar said there’s some evidence that the First World War and Spanish influenza were the same catastrophic global event—but even then, the death toll only came to about 6 percent of humanity. 

The report briefly explores other possible risks: a genetically engineered pandemic, geo-engineering gone awry, an all-seeing artificial intelligence. Unlike nuclear war or global warming, though, the report clarifies that these remain mostly notional threats, even as it cautions: 

[N]early all of the most threatening global catastrophic risks were unforeseeable a few decades before they became apparent. Forty years before the discovery of the nuclear bomb, few could have predicted that nuclear weapons would come to be one of the leading global catastrophic risks. Immediately after the Second World War, few could have known that catastrophic climate change, biotechnology, and artificial intelligence would come to pose such a significant threat.

Zika epidemic declared in Guadeloupe

Thanks to Lucie Lecomte for sending the link to this report in Le Monde: L’épidémie de Zika officiellement déclarée en Guadeloupe. Edited excerpt from the Google translation:

A Zika epidemic was officially declared in Guadeloupe, Friday, April 30. Nearly 2,100 patients were identified. 

"We are witnessing in recent weeks a dynamic acceleration of the spread of the virus; this is why I decided to move to an epidemic phase," said the Prefect Jacques Billant, to the press. 

The teams in the field will be strengthened with the recruitment of 160 community health prevention officers hired on contracts financed 95% by the state. The communication with the public will also be enhanced, focusing on pregnant women.  

No microcephaly detected

The number of people showing signs of the disease who consulted doctors has been steadily increasing for four consecutive weeks in Guadeloupe. Four hundred and twelve cases were laboratory confirmed and 30 of the 32 municipalities of the archipelago are affected. 

Among the confirmed cases, 16 were pregnant women. No microcephaly has been detected to date, or any Guillain-Barré syndrome. But another neurological complication, myelitis, was identified.

Nicaragua: Zika virus cases rise to 157

Via Hoy, an ACAN-EFE report: Aumenta a 157 la cifra de enfermos de zika en Nicaragua.[Zika virus cases in Nicaragua rise to 157] Excerpt, with my translation:

El número de enfermos de zika en Nicaragua subió a 157, según un reporte divulgado este viernes por el Ministerio de Salud, que mantiene en 24 el número de mujeres embarazadas afectadas. 

The numbes of Zika cases in Nicaragua has risen to 157, according to a report released Friday by the Ministry of Health, while the number of infected pregnant women remains at 24.

Con relación al informe anterior, aumentó en uno el número de infectados, dijo la coordinadora del Consejo de Comunicación y Ciudadanía, Rosario Murillo, quien leyó el reporte sanitario. 

Since the previous report, the number of cases has risen by one, said Rosario Murillo, coordinator of the Council of Communication and Citizenship, who presented the health report.

La cantidad de mujeres embarazadas infectadas con el zika se mantiene en 24, precisó. 

The number of pregnant women with Zika remains at 24, she said.

La funcionaria indicó que 89 de los 157 afectados son originarios del departamento de Managua, seguido de Nueva Segovia (19), Masaya (17), León (12), Chinandega (6), Rivas (5), Carazo (3), Granada (3), Matagalpa (2), y Jinotega (1). 

The official said that 89 of 157 cases are in Managua department, followed by Nueva Segovia (19), Masay (17), León (12), Chinandega (6), Rivas (5), Carazo (3), Granada (3), Matagalpa (2), and Jinoteg (2).

El Gobierno informó el 27 de enero pasado de los dos primeros casos de zika en Nicaragua, donde se aplica un plan de exterminio de mosquitos, criaderos y larvas.

The government reported the country's first two Zika cases on January 27; a plan is in operation to eradicate mosquitoes, breeding site, and larvae.

Zika virus and mosquito control

Thanks to Greg Folkers for sending the link to this new report in the Asian Pacific Journal of Tropical Disease: The recent outbreaks of Zika virus: Mosquito control faces a further challenge. The abstract:

The recent outbreaks of Zika virus infection occurring in South America, Central America and the Caribbean, represent the most recent of four key arrivals of arboviruses in the Western Hemisphere over the last 20 years. 

Zika virus is mainly vectored by Aedes mosquitoes. The development of effective and eco-friendly mosquito control methods is required in order to minimize the negative effects of currently marketed synthetic pesticides, including multidrug resistance. In this scenario, natural product research can afford solutions as part of integrated pest management strategies. 

In this review, we focused on neem (Azadirachta indica) products as sources of cheap control tools of Aedes vectors. Current knowledge on the larvicidal, pupicidal, adulticidal and oviposition deterrent potential of neem-borne products against the arbovirus vectors Aedes aegypti and Aedes albopictus is reviewed. 

Furthermore, we considered the rising importance of neem extraction by-products as sources of bio-reducing agents for the synthesis of nanoformulated mosquitocides. The last section examined biosafety and non-target effects on neem-borne mosquitocides in the aquatic environment. 

Overall, we support the employ of neem-borne molecules as an advantageous alternative to build newer and safer Aedes control tools, in the framework of Zika virus outbreak prevention.

Pakistan: Another polio case detected in Shikarpur

Via The Express Tribune: Another polio case detected in Shikarpur.

A four and a half-year-old boy in Shikarpur became the latest polio patient and the second in the same union council over the past two months, provincial health officials confirmed on Friday. The boy is believed to be the fourth such victim identified by the health authorities in Sindh. 

Acting District Health Officer (DHO) Dr Khurshid Kazi quoted the father of the victim, Ghulam Muhammad Jatoi, as saying that the child had received seven oral doses of anti-polio drops. 

After the detection of this polio case, the total figure of polio cases in Pakistan rose to nine since the beginning of this year. 

The disease is said to have affected the boy’s left leg and thigh and his left arm and forearm, while the date of onset for the virus is April 12. 

According to Kazi, the victim had a travelling history and the area was considered to be an isolated one because of tribal clashes. He added that children in the area were found to have genetically low immunity because of less focus on routine immunisation.

Daytime cooking ban in India as heatwave claims 300 lives

Via The Guardian: Daytime cooking ban in India as heatwave claims 300 lives.

With sizzling temperatures claiming more than 300 lives this month in India, officials have banned daytime cooking in some parts of the drought-stricken country in a bid to prevent accidental fires that have killed nearly 80 more people. 

The eastern state of Bihar this week took the unprecedented step of forbidding any cooking between 9am and 6pm, after accidental fires exacerbated by dry, hot and windy weather swept through shantytowns and thatched-roof houses in villages and killed 79 people. They included 10 children and five adults killed in a fire sparked during a Hindu prayer ceremony in Bihar’s Aurangabad district last week. 

People were instead told to cook to night. 

Hoping to prevent more fires, officials have also banned the burning of spent crops and religious fire rituals. Anyone defying the ban risks up to a year in jail. 

“We call this the fire season in Bihar,” Vyas, a state disaster management official who goes by one name, said. “Strong, westerly winds stoke fires which spread easily and cause great damage.” 

Much of India is reeling under a weeks-long heat wave and severe drought conditions that have decimated crops, killed livestock and left at least 330 million Indians without enough water for their daily needs. 

Rivers, lakes and dams have dried up in parts of the western states of Maharashtra and Gujarat, and overall officials say that groundwater reservoirs are at just 22 percent capacity. 

In some areas, the situation is so bad the government has sent tankers of water for emergency relief. Monsoon rains are still weeks away, expected to start only in June. 

At least 300 people have died of heat-related illness this month, including 110 in the state of Orissa, 137 in Telangana and another 45 in Andhra Pradesh where temperatures since the start of April have been hovering around 44C[111ºF]. 

That’s about 4-5C hotter than normal for April, according to state meteorological official YK Reddy. He predicted the situation would only get worse in May, traditionally the hottest month in India.

US: Why Zika needed an ounce of prevention

Via The Atlantic: Why Zika Needed an Ounce of Prevention. Excerpt:

Congress’s lack of concern about Zika mirrors that of the public. In a recent Kaiser Family Foundation tracking poll, only 16 percent of all people are very worried about Zika as a public-health threat. 

There is a great deal of risk to these attitudes, however, and Congress knows well from delayed action on previous epidemics that the American health-care system makes rapid responses to established diseases difficult and costly. The chances of spreading Zika have been low during the winter, as the Aedes aegypti mosquitoes that spread it are largely limited to breeding clusters in south Florida and southern Texas. But the virus’s range and ability to find footholds in those states will undoubtedly intensify as the summer comes. 

My colleague Adrienne LaFrance has identified the virus’s potential to “rival Hurricane Katrina” as a socioeconomic burden with wide distribution in poor mosquito-ridden areas across the country, especially in summer outbreaks. 

Summer months are also prime months for international travel—and this summer will involve particularly high rates of travel to and from Brazil, the site of the 2016 summer Olympics and the epicenter of the epidemic. From a public-health perspective, these factors alone justify a real investment in prevention, research, and mosquito control, but legislators are not public-health officials. 

If a public-health argument does not persuade Congress, perhaps a cost argument might. The World Bank estimates that Zika might cost around .06 percent of the GDP of Latin American countries, with a grand total of $3.5 billion for the region. However, that estimation is optimistic, as it assumes a wide-scale, coordinated response and a possible vaccination to be developed. 

Brazil’s struggles to properly address its outbreak cast doubt on these assumptions, as does the lack of interest from rich countries in building coalitions to address the virus. Ongoing vaccine development is inherently risky, and researchers have been concerned with the risk of inoculation being connected to Guillain–Barré syndrome, a rare paralytic disease. All things considered, there is a real possibility of Zika becoming locally endemic—and a seasonal cost burden—throughout Latin America and the Caribbean.

Saudi Arabia: One new MERS case, one recovery as of noon April 30

Via the KSA MOH Command and Control Center: MOH: '1 New Confirmed Corona Cases Recorded'. The new case is a 70-year-old Saudi man in Hail; he is in critical condition. A 72-year-old Saudi man in Turaba has recovered. No deaths are reported.

The numbers are now nine cases under care, 783 recoveries, 1,379 total, and 587 deaths.

Kunduz: Initial reaction to public release of U.S. military investigative report on the attack on MSF trauma hospital

MSF yesterday published Kunduz: Initial reaction to public release of U.S. military investigative report on the attack on MSF trauma hospital. Excerpt:

The United States military today released its investigative report on the attack on the Médecins Sans Frontières (MSF) trauma hospital in Kunduz, Afghanistan on 3 October 2015. The attack killed 42 people, including 14 MSF staff members, and wounded dozens more. 

MSF was only able to access the report today, when it was made publicly available online, following a public briefing by the head of U.S. Central Command, General Joseph Votel. Yesterday, MSF received a two-hour verbal briefing from Gen. Votel and his team on the main findings and recommendations of the U.S. military investigation. 

MSF will take the time necessary to examine the U.S. report, and to determine whether or not the U.S. account answers the many questions that remain outstanding seven months after the attack. 

MSF acknowledges the U.S. military’s efforts to conduct an investigation into the incident. Today, MSF and other medical care providers on the front lines of armed conflicts continually experience attacks on health facilities that go un-investigated by parties to the conflict. 

However, MSF has said consistently that it cannot be satisfied solely with a military investigation into the Kunduz attack. MSF’s request for an independent and impartial investigation by the International Humanitarian Fact Finding Commission has so far gone unanswered. 

“Today’s briefing amounts to an admission of an uncontrolled military operation in a densely populated urban area, during which U.S. forces failed to follow the basic laws of war,” said Meinie Nicolai, MSF President. “It is incomprehensible that, under the circumstances described by the U.S., the attack was not called off.” 

The hospital was fully functioning at the time of the airstrikes. The U.S. investigation acknowledges that there were no armed combatants within – and no fire from – the hospital compound. 

“The threshold that must be crossed for this deadly incident to amount to a grave breach of international humanitarian law is not whether it was intentional or not,” said Nicolai. 

“With multinational coalitions fighting with different rules of engagement across a wide spectrum of wars today, whether in Afghanistan, Syria, or Yemen, armed groups cannot escape their responsibilities on the battlefield simply by ruling out the intent to attack a protected structure such as a hospital.”

Colombia: Zika update for week 16

The National Institute of Health has published its Boletín Epidemiológico for week 16. Click or tap through to download the PDF. The information on Zika and related issues begins on page 89. Even if you don't read Spanish, the tables and graphs are pretty clear. Here's my summary of some key points:

From the declaration of an epidemic in week 40 of 2015, through week 16 of 2016, 3,752 confirmed Zika cases as well as 71,435 clinically suspected cases have been reported. In week 16, 3,235 cases have been recorded, 1,794 this week and 1,441 cases reported late from other weeks. Of the new cases, 460 are confirmed and 2,775 suspected.

The following departments report 53.7% of cases: Valle del Cauca, Norte de Santander, Huila, Tolima, and Cundinamarca. Women made up 66.69% of cases. Persons aged 25-64 made up 60.64%; 13.97% were 25 to 29; 2.61% were in children less than a year old, and 3.44% in adults over 65.

Pregnant women with Zika

From the start of the epidemic through week 16, 2,008 confirmed Zika cases have been found in pregnant women, as well as 11,306 suspected cases who report having had symptoms compatible with Zika. The department with the most cases is Norte de Santander, with 2,408 (18.09% of the total).

Intensified surveillance for microcephaly and neurological conditions

Between weeks 1 and 16 of 2016, four confirmed cases of Zika-related microcephaly have been reported. Twenty cases were discarded and 26 remain under study.

Between December 15 and the end of week 16, 474 cases of neurological syndromes have been reported following illness with symptoms compatible with Zika. Of these, men made up 57.6% (273 cases); 12.7% (60 cases) were in persons over 65, followed by the 35-39 age group with 10.3% (49 cases). Guillain-Barré syndrome was diagnosed in 65.61% of cases reported under the special surveillance.