H5N1

Hurricane Matthew goes to category 5

Via the National Hurricane Center: Hurricane MATTHEW Public Advisory. Excerpt:

At 1100 PM EDT (0300 UTC), the eye of Hurricane Matthew was located near latitude 13.3 North, longitude 72.3 West. Matthew is moving just south of due west near 7 mph (11 km/h). A turn toward the west-northwest is forecast on Saturday, followed by a turn toward the northwest on Sunday. On the forecast track, the center of Matthew will move north of the Guajira Peninsula tonight, move across the central Caribbean Sea on Saturday, and be approaching Jamaica late Sunday. 

Data from an Air Force Hurricane Hunter plane indicate that the maximum sustained winds have increased to near 160 mph (260 km/h) with higher gusts. Matthew is a category 5 hurricane on the Saffir-Simpson Hurricane Wind Scale. Some fluctuations in intensity are possible this weekend, but Matthew is expected to remain a powerful hurricane through Sunday.  

Hurricane-force winds extend outward up to 45 miles (75 km) from the center and tropical-storm-force winds extend outward up to 205 miles (335 km). 

The minimum central pressure estimated by a reconnaissance aircraft was 941 mb (27.79 inches).

Hurricane MATTHEW public advisory

Via the National Hurricane Center: Hurricane MATTHEW Public Advisory. Excerpt:

HURRICANE MATTHEW ADVISORY NUMBER 11 

NWS NATIONAL HURRICANE CENTER MIAMI FL AL142016 

500 PM EDT FRI SEP 30 2016  

...MATTHEW RAPIDLY STRENGTHENS TO A POWERFUL CATEGORY 4 HURRICANE... 

...HURRICANE WATCH ISSUED FOR JAMAICA... 

 SUMMARY OF 500 PM EDT...2100 UTC...INFORMATION 

LOCATION...13.5N 71.6W 

ABOUT 75 MI...120 KM N OF PUNTA GALLINAS COLOMBIA 

ABOUT 465 MI...750 KM SE OF KINGSTON JAMAICA 

MAXIMUM SUSTAINED WINDS...140 MPH...220 KM/H 

PRESENT MOVEMENT...WSW OR 255 DEGREES AT 9 MPH...15 KM/H 

MINIMUM CENTRAL PRESSURE...949 MB...28.03 INCHES 

WATCHES AND WARNINGS

CHANGES WITH THIS ADVISORY: 

The government of Jamaica has issued a Hurricane Watch for Jamaica.  

A Tropical Storm Watch has been issued for the southwestern coast of Haiti from the southern border with the Dominican Republic to Port-Au-Prince. 

SUMMARY OF WATCHES AND WARNINGS IN EFFECT: 

A Hurricane Watch is in effect for... 

* Jamaica  

A Tropical Storm Warning is in effect for... 

* Colombia/Venezuela border to Riohacha  

A Tropical Storm Watch is in effect for... 

* Haiti from the southern border with the Dominican Republic to Port-Au-Prince  

A Hurricane Watch means that hurricane conditions are possible within the watch area. A watch is typically issued 48 hours before the anticipated first occurrence of tropical-storm-force winds, conditions that make outside preparations difficult or dangerous.  

A Tropical Storm Warning means that tropical storm conditions are expected somewhere within the warning area, in this case in the next 12 hours.  

A Tropical Storm Watch means that tropical storm conditions are possible within the watch area, generally within 48 hours.  

Interests elsewhere along the coasts of Venezuela and Colombia and elsewhere in Hispaniola should monitor the progress of Matthew. Interests in eastern Cuba should also monitor the progress of Matthew.

Venezuela: 17 diphtheria deaths since April in Bolívar state

Via Efecto Cocuyo: Denuncian que los muertos por difteria son 17 y el miedo crece en Bolívar. [Protests over 17 diphtheria deaths; fear is growing in Bolívar] Excerpt, with my translation:

“Haremos un cerco de inmediato. Tenemos un equipo desplegado para realizar una jornada de vacunación”, dijo Francisco Rangel Gómez, gobernador del estado Bolívar, en su programa Gobierno al Día del martes 27 de agosto. Esas declaraciones, más la confirmación de 13 casos -también hechas por él- es la única información que se maneja sobre la difteria.  

"We will seal up this outbreak at once. We have a team deployed to carry out a vaccination campaign," said Bolívar state governor Francisco Rangel Gómez on his program Government Today on Tuesday, August 27. These declarations, plus the confirmation of 13 cases (also reported by him) are the only information available on diphtheria.

Américo de Grazia y José Manuel Olivares, ambos diputados de Mesa de la Unidad Democrática ante la Asamblea Nacional, denunciaron que las muertes por la enfermedad en el estado Bolívar ascienden a 17 desde el mes de abril, y que el gobierno regional no solo no ha procedido diligentemente: hace un empeño por ocultarlas. 

Américo de Grazia and José Manuel Olivares, both deputies of the Democratic Union in the National Assembly, denounced the deaths caused by the disease, saying that deaths in Bolívar state from the disease have risen to 17 since April and that the regional government has not just proceeded slowly; it's making an effort to conceal those deaths.

“Está siendo registrada como un absceso de retrofaringe, que es una enfermedad que se parece pero que no tiene efectos tan mortales y contagiosos” declaró De Grazia. “Es una epidemia y, como si esto fuera poco, el Gobierno se mantiene en silencio, por eso es nuestra responsabilidad alertar”, comentó Olivares.

"It's being reported as an abscess of the pharynx, which is a similar disease but doesn't have such deadly and contagious effects," said De Grazia. "It's an epidemic and as if it was no big concern, the government remains silent. So it's our duty to alert the public," said Olivares.

MMWR: Characteristics of children aged <18 years with Zika virus disease acquired postnatally

Via MMWR, an early release report: Characteristics of Children Aged <18 Years with Zika Virus Disease Acquired Postnatally — U.S. States, January 2015–July 2016. Excerpt from the discussion section:

This series of 158 children with postnatally acquired Zika virus disease corroborates previously published reports suggesting that the clinical course of Zika virus disease is typically mild in children, as it is in adults. In this case series, only two children were hospitalized, and no deaths occurred. Serious complications of Zika virus disease, such as Guillain-Barré syndrome, were not reported for any children in this analysis. 

However, health care providers should be aware of potential serious consequences of Zika virus disease, including neurologic manifestations, and should notify state health departments of all Zika virus disease cases.  

Severe disease following Zika virus infection in children has rarely been reported. Two deaths possibly associated with postnatally acquired Zika virus disease have been reported among children, including a Brazilian girl aged 16 years with possible hemorrhage and a Colombian girl aged 15 years with sickle cell disease who developed severe acute respiratory distress syndrome, hemothorax, and splenic sequestration. 

Guillain-Barré syndrome and meningoencephalitis also have been reported rarely among children during the recent outbreak in Brazil.** No deaths or neurologic complications following Zika virus infection in children were reported after outbreaks in Yap State, Micronesia, or French Polynesia. Further evaluation is needed to determine the incidence of severe disease manifestations, risk factors for more severe illness, and long-term outcomes of postnatally acquired Zika virus infection in children.  

Almost half of the pediatric patients with Zika virus disease in this series were aged 15–17 years, with a slight female preponderance. The relatively higher proportion of cases in females and older children might be related to health care–seeking or testing bias (e.g., girls who are or might become pregnant might be more likely to seek care or to be tested) or older children being more likely to travel and thus to be exposed to Zika virus. In addition, clinicians might be less likely to suspect Zika virus infection in younger children, because the signs and symptoms (rash and fever) are nonspecific and similar to those associated with other childhood rash illnesses (e.g., roseola or scarlet fever) or drug reactions.

Florida Health Zika update, September 30: 16 new cases

Florida Health has published its Department of Health Daily Zika Update. Excerpt:

There are 11 new travel related cases today with three in Orange, two in Miami-Dade, one in Palm Beach and five involving pregnant women. Please visit our website to see the full list of travel-related cases. 

There are five new non-travel related cases today in Miami-Dade County. 

• One case is a Miami-Dade County resident that had exposure in Miami Beach. 

• Four cases are Miami-Dade County residents and the department is investigating where exposure occurred.

Today's case count: 711 travel-related cases; 124 local cases; 97 cases involving pregnant women; 15 non-resident cases; one undetermined case. Total: 948 cases.

Iceland’s Katla volcano moved up to yellow alert

Thanks to Mike Coston at Avian Flu Diary for reminding me of this potential disaster. Via Iceland Monitor: Iceland’s Katla volcano moved up to yellow alert. Excerpt:

Following a fresh series of tremors at Katla in South Iceland this lunchtime, the Icelandic Met Office has raised the status of the famous volcano on its ‘Aviation Colour Code Map for Icelandic Volcanic Systems’ from green to yellow.  

“An intense seismic swarm is ongoing since yesterday morning (29 September) at Katla volcano. An intense pulse, the largest one if compared with the previous activity, started today at 12:02 (30 September) with several earthquakes around magnitude 3 or larger,” reads the website.

“No seismic tremor has been detected until now in the caldera. Due to the unusually high level of unrest at the Katla volcano we rise the aviation colour code from green to yellow.”

WHO: Yellow fever situation report, September 30

WHO has published its weekly Yellow fever situation report for September 30. Click or tap through to download the full report. The key updates:

Angola epidemiological update (as of 22 September): 

• The last confirmed case had symptom onset on 23 June. 

Democratic Republic of the Congo epidemiological update (as of 27 September): 

• The last confirmed non-sylvatic case had symptom onset on 12 July. 

• Five of the eight cases in Kinshasa province that were under investigation had a history of yellow fever vaccination have been ruled out as new yellow fever cases. Seven cases remain under investigation. 

• The reactive vaccination campaign in Feshi and Mushenge Health Zones in Kwango province will begin next week. 

• Republic of the Congo is planning a pre-emptive vaccination campaign. 

Analysis 

The continuing detection and investigation of suspected and laboratory positive cases demonstrate that active surveillance is functioning well in some areas. Nevertheless, it is important to note the inherent difficulties in surveillance and laboratory confirmation capacities. It remains possible that detection of a case could be delayed in some remote areas. A strong and sustained surveillance effort is therefore more crucial than ever.

Syria: MSF urges Syrian government and its allies to stop indiscriminate bombing in Aleppo

Via MSF.org: Syria: MSF urges Syrian government and its allies to stop indiscriminate bombing in Aleppo. Excerpt:

Amman  - Médecins Sans Frontières (MSF) demands that the Syrian and allied governments stop the bombing that is causing a bloodbath among civilians in the city. On 28 September, just hours before the UNSC met to discuss the implementation of resolution 2286 on the protection of medical facilities, two more MSF-supported hospitals were seriously damaged by bombing and went out of service. 

“Bombs are raining from Syria-led coalition planes and the whole of east Aleppo has become a giant kill box. The Syrian government must stop the indiscriminate bombing; and Russia as an indispensable political and military ally of Syria has the responsibility to exert the pressure to stop this,” says Xisco Villalonga, director of operations at MSF. 

According to the Directorate of Health in east Aleppo, from 21 to 26 September, those hospitals that are still functional in Aleppo reported receiving more than 822 wounded, including at least 221 children, and more than 278 dead bodies of which at least 96 were children. 

“All intensive care units are full. Patients have to wait for others to die so they can be moved to an available bed in intensive care. We only have three operating theatres and yesterday alone we had to do more than 20 major abdominal surgeries,” says Dr. Abu Waseem, manager of an MSF-supported trauma hospital in east Aleppo. “The hospital staff is working up to 20 hours a day – they cannot just go home and let people die.” 

The massive number of wounded is rapidly depleting the stocks in all hospitals. MSF succeeded in delivering a cargo of medical supplies into the city during the brief period where the siege was broken back in August, but has not been able to do so again. 

“Over the last months, we have done everything we could to keep supporting the hospitals in Aleppo. Now, with a complete siege on the city, attacks on humanitarian convoys and intensive bombing, we are powerless,” says Villalonga.

Field-deployable rapid detection of chikungunya

Via PLOS Neglected Tropical Diseases: A Field-Deployable Reverse Transcription Recombinase Polymerase Amplification Assay for Rapid Detection of the Chikungunya Virus. The abstract:

Background  

Chikungunya virus (CHIKV) is a mosquito-borne virus currently transmitted in about 60 countries. CHIKV causes acute flu-like symptoms and in many cases prolonged musculoskeletal and joint pain. Detection of the infection is mostly done using RT-RCR or ELISA, which are not suitable for point-of-care diagnosis. 

Methodology/Principal Findings 

In this study, a reverse transcription recombinase polymerase amplification (RT-RPA) assay for the detection of the CHIKV was developed. The assay sensitivity, specificity, and cross-reactivity were tested. CHIKV RT-RPA assay detected down to 80 genome copies/reaction in a maximum of 15 minutes. It successfully identified 18 isolates representing the three CHIKV genotypes. 

No cross-reactivity was detected to other alphaviruses and arboviruses except O'nyong'nyong virus, which could be differentiated by a modified RPA primer pair. Seventy-eight samples were screened both by RT-RPA and real-time RT-PCR. The diagnostic sensitivity and specificity of the CHIKV RT-RPA assay were determined at 100%. 

Conclusions/Significance 

The developed RT-RPA assay represents a promising method for the molecular detection of CHIKV at point of need.

WHO says 338 killed in eastern Aleppo in past week

Via Thomson Reuters: WHO says 338 killed in eastern Aleppo in past week. Excerpt:

Fighting in Syria's besieged eastern Aleppo has killed 338 people since Sept. 23, including 106 children, and 846 have been wounded, including 261 children, the World Health Organization said on Friday. 

"We are asking for four things: stop the killing, stop attacks on health care, let the sick and wounded out and let the aid in," Rick Brennan, WHO's head of emergency risk management and humanitarian response, told a U.N. briefing in Geneva. 

"The situation really is unfathomable."  

Russia and Syrian government forces launched a campaign to recapture the rebel-held sector of Aleppo, Syria's biggest city, this month, abandoning a ceasefire a week after it took effect.  

Brennan said he did not have details on the kinds of injuries, but it was obvious what to expect. 

"There will be shrapnel wounds, there will be blast wounds, there will be burns, penetrating injuries to the head, chest and abdomen. There will be lost limbs, there will be fractures. The range of injuries is pretty predictable."