H5N1

Venezuela: Doctors report first diphtheria death in Caracas

Via Efecto Cocuyo: Médicos denuncian primera muerte por difteria en Caracas.[Doctors report first diphtheria death in Caracas] Excerpt, with my translation:

La información la confirmó el diputado a la Asamblea Nacional y presidente de la Comisión de Salud José Manuel Olivares y la infectóloga y miembro de la Sociedad Venezolana de Salud Pública Ana Carvajal. Cerca de las 5:30 am de este miércoles 30 de noviembre se registraba la primera muerte por difteria en Caracas desde que la enfermedad regresó al país. 

The report has been confirmed by National Assembly Deputy and Health Commission President José Manuel Olivares, and Ana Carvajal, the epidemiologist and member of the Venezuelan Society of Public Health. Around 5:30 a.m. this Wednesday, November 30, the first diphtheria death in Caracas was recorded since the disease returned to the country.

Como se había denunciando en días anteriores, la paciente tenía 32 años y contrajo la enfermedad por un vecino que viaja constantemente al estado Bolívar. Lo que más preocupa al gremio médico es que la fallecida trabajaba con atención al público y pudo haber contagiado a más personas.  

As had been reported in recent days, the patient was 32 years old and contacted the disease from a neighbour who travels regularly to Bolívar state. What most worries the medical group is that the woman was working in a public contact job and could have infected more persons.

Su hijo pequeño también dio positivo a la enfermedad, pero está recibiendo tratamiento en su casa al que está respondiendo favorablemente.  

Her young son also tested positive for the disease but is receiving treatment in his home and responding favourably.

La doctora Carvajal denunció que en el ente hospitalario había manejado el caso “con un hermetismo total y una opacidad completa de información” y que es de suma importancia que el ministerio de Salud informe qué está pasando. “Necesitamos saber cuántos casos se están presentando, cuántos indígenas se contagiaron en Bolívar, cuántos niños y cuántos adultos han fallecido. Eso es muy importante para las políticas sanitarias”, dijo Carvajal. 

Dr. Carvajal said that the hospital had managed the case with "total secrecy and complete opacity." and that it's of key importance that the Ministry of Health report what's going on. "We need to know how many cases are presenting, how many locals are infected in Bolívar state, how many children and adults have died. This is very important for health politics," Carvajal said.

Además de este caso, los doctores denuncian que hay un caso sospechoso en el Hospital Dr. Miguel Pérez Carreño, información que fue desmentida en la cuenta de Twitter del mismo.

In addition to this case, the doctors said there is a suspected case in the Dr. Miguel Pérez Carreño Hospital, which was denied on the hospital's Twitter feed.

Florida Health Zika update, November 30: Six new cases

Florida Health has posted its Department of Health Daily Zika Update for November 30. Excerpt:

There are two new travel-related cases today with one in Osceola and one in Orange.  

There are four new locally acquired cases today. All four involve Miami-Dade County residents and the department is investigating to determine where exposure occurred.  

The total number of Zika cases reported in Florida as of today is 1,219.

The details: 960 travel-related cases; 244 local cases; 15 undetermined cases; 173 cases involving pregnant women.

Vietnam: Don't worry too much about Zika

Via Saigon Giai Phong: People should not worry much about Zika: medical experts. Excerpt:

Infection cases of Zika in Ho Chi Minh City escalated, according to the municipal Department of Health.  

Currently, the health sector recorded 85 people who are positive for the virus. Worse, nine out of 85 people infected with the Zika virus in the city are pregnant women. Tu Du Maternity Hospital is keeping an eye on them. 

One of them suffered miscarriage naturally, one wanted to stop pregnancy as her pregnancy was not planned and one whose fetus did not grow, however, medical experts decided people should not worry too much about the disease.  

Deputy director of the Department of Health Tang Chi Thuong said that the city will cover test charges of patients infected with the Zika virus.

Zika and glaucoma linked for first time in new study

Via YaleNews, a news release: Zika and glaucoma linked for first time in new study. Excerpt:

A team of researchers in Brazil and at the Yale School of Public Health has published the first report demonstrating that the Zika virus can cause glaucoma in infants who were exposed to the virus during gestation.  

Exposure to the Zika virus during pregnancy causes birth defects of the central nervous system, including microcephaly. Brazilian and Yale School of Public Health researchers had reported early during the microcephaly epidemic that the virus also causes severe lesions in the retina, the posterior portion of the eye. However, until now, there has been no evidence that Zika causes glaucoma, a condition that can result in permanent damage to the optic nerve and blindness. 

“We identified the first case where Zika virus appears to have affected the development of the anterior chamber or front portion of the eye during gestation and caused glaucoma after birth,” said Dr. Albert Icksang Ko, professor at the Yale School of Public Health and co-author of the study published in the journal Ophthalmology. 

Ko has longstanding research collaborations in Brazil and has worked with local scientists since Zika first appeared in the Americas to better understand the birth defects that are caused by the virus and the risk factors for Zika Congenital Syndrome.  

While conducting their investigations of the microcephaly epidemic in Salvador in Northeast Brazil, the researchers identified a three-month-old boy who was exposed to Zika virus during gestation. While no signs of glaucoma were present at the time of birth, the infant developed swelling, pain, and tearing in the right eye. The research team diagnosed glaucoma as the cause of symptoms and together with local ophthalmologists, performed a trabeculectomy, an operation that successfully alleviated the pressure within the eye. 

While this is the first known incidence of glaucoma in an infant with the Zika virus, clinicians treating patients with Zika should be aware that glaucoma is another serious symptom of the disease that should be monitored, said the investigators. Additional research is needed to determine if glaucoma in infants with Zika is caused by indirect or direct exposure to the virus, either during gestation or postpartum.

H5N8 bird flu found at small poultry farm in Germany

Via Reuters: Bird flu found at small poultry farm in Germany. Excerpt:

A case of high risk H5N8 bird flu has been found on a small farm in Mecklenburg-Vorpommern in east Germany, state authorities said on Wednesday.  

The farm has about 300 chickens, ducks and geese, said the Mecklenburg-Vorpommern state agriculture ministry.  

H5N8 bird flu has been found in over 370 wild birds in Germany since the present outbreak started in early November. Three large farms have also suffered outbreaks along with a series of small farms, hobby poultry owners and zoos.  

The country's government has imposed tougher sanitary rules for farms and warned it may order all poultry to be kept inside. 

Several European countries and Israel have found cases of H5N8 bird flu in the past few weeks and some have ordered that poultry be kept indoors to avoid the disease spreading.

Most outbreaks involved wild birds but Germany, the Netherlands, Hungary and Austria also reported cases in duck and turkey farms where poultry had to be culled.  

The first case in wild birds in France was discovered this week.

Singapore Zika update, November 30: No new cases

The National Environment Agency has published its Zika Cases & Clusters update for November 30. Again, no new cases are reported, and the map of Singapore shows no clusters except for Bedok, which has had no new cases in two weeks.

US: Meeting with Trump emboldens anti-vaccine activists

Via STAT: Meeting with Trump emboldens anti-vaccine activists. Excerpt:

The discredited researcher who launched the anti-vaccine movement met with Donald Trump this summer — and found him sympathetic to the cause. Now, with Trump preparing to move into the White House, leaders of the movement are newly energized, hopeful they can undermine decades of public policy promoting childhood vaccinations.  

At the most basic level, they’re hoping Trump will use his bully pulpit to advance his oft-stated concern — debunked by an extensive body of scientific evidence — that there’s a link between vaccines and autism.  

“For the first time in a long time, I feel very positive about this, because Donald Trump is not beholden to the pharmaceutical industry,” movement leader Andrew Wakefield told STAT in a phone interview.  

“He didn’t rely upon [drug makers] to get him elected. And he’s a man who seems to speak his mind and act accordingly. So we shall see,” said Wakefield. A former doctor whose medical license was revoked, Wakefield launched the movement to question the safety of vaccines nearly two decades ago with a fraudulent study (which has since been retracted) suggesting that a widely administered vaccine against measles, mumps, and rubella can cause autism. 

Wakefield and a small group of like-minded activists spent nearly an hour with Trump in the closing months of the presidential campaign. “I found him to be extremely interested, genuinely interested, and open-minded on this issue, so that was enormously refreshing,” Wakefield said.

Though he would be a powerful ally, there are limits to what Trump can do to undercut evidence-based vaccination policies.  

Public health experts said it’s unlikely Trump will pack federal agencies with activists who would change the recommended childhood vaccine schedule or otherwise steer shifts in federal vaccination policy. The evidence that vaccines are safe and effective is so overwhelming, they said, that such a move would prompt a huge outcry from scientists and many politicians on both sides of the aisle.  

But experts said there could be a cultural impact of having a doubter in the Oval Office. 

Those who seek to undercut trust in vaccines “see in Donald Trump a fellow traveler — someone who, like them, is willing to basically ignore scientific studies and say, ‘This is true. Vaccines cause autism because I believe it’s true,’” said Dr. Paul Offit, the head of the infectious diseases department at Children’s Hospital of Philadelphia.

‘Thunderstorm asthma’ kills eight in Australia

Via The New York Times: ‘Thunderstorm Asthma’ Kills 8 in Australia. Excerpt:

When David McGann left his office in Melbourne just after 5 p.m. to cycle home, a stifling heat had settled across the city, and the temperature was peaking at 95 degrees. 

A hot, gusty northerly wind picked up. Rain clouds had gathered across the skyline, but there was little relief. “It was the hottest day of the season,” said Mr. McGann, 35, who manages accounts at a law practice. “By the time I got home and had a swim, my chest had started to tighten.” 

Mr. McGann’s partner, Kelli Morris, kissed him goodbye at their apartment to join teammates playing in a nighttime netball competition. When she returned, he was on the couch, sitting quietly, struggling for breath. The inhaler he found after rummaging through drawers was five years past its expiration date. 

Mr. McGann was one of thousands of people in Melbourne having an attack of thunderstorm asthma. They flooded the city’s emergency rooms, swamped ambulance call lines and joined lines around pharmacies during six hours on Nov. 21. All were struggling for breath. About 8,500 people went to hospitals. Eight have died, and one remains in intensive care more than a week after a thunderstorm surged across Melbourne, carrying pollen that strong winds and rain broke into tiny fragments.  

Perennial ryegrass seeds were swept up in whorls of wind and carried from four million hectares of pasturelands (about 9.9 million acres) that lie to Melbourne’s north and west. If broken into fragments, they are so fine that they can be inhaled.  

So many people became ill so quickly that some of the state’s crisis medical teams were stretched beyond their limits. Firefighters and police officers stepped in where paramedics were overloaded. Triage centers at 10 hospitals struggled with admissions across Melbourne, Australia’s second-largest city, with a population of 4.4 million in the greater metropolitan area and suburbs. 

“This was a health emergency of an unprecedented scale,” said Jill Hennessy, the minister for health and ambulance services in Victoria State, announcing a statewide inquiry. “We have an obligation to ensure that we learn every lesson there is to learn from this event.” Days later, she pledged $375 million to add 450 paramedics and build more ambulance stations.  

The crisis started just after 6 p.m. and gathered pace so swiftly that paramedics were taking one call for help every four and a half seconds. Ninety minutes later, 175 people across the city were seriously ill, struggling to breathe, and 140 of them were so short of breath that they were considered at risk of dying. Paramedics knew they were in dire straits.

Canada: Carfentanil linked for first time to drug overdose death, BC police say

This has been a notably crappy day in a notably crappy month. Not only did Donald Trump get elected in the US, our own glamour-puss prime minister Justin Trudeau today aligned himself with Trump by authorizing a deeply stupid expansion of a pipeline that will pump bitumen right into Vancouver harbour, there to be exported to Asian nations. They in turn will export it back to us in the form of crap consumer goods while venting ever more carbon dioxide into the atmosphere. Trudeau actually called it "growing the economy." 

And on top of that, CBC News British Columbia tells us that Carfentanil linked for 1st time to drug overdose death, B.C. police say. Excerpt:

The highly toxic opioid carfentanil has been detected for the first time in a drug overdose death in B.C., according to the provincial coroner. 

Vancouver police said they were called to an East Vancouver home near Nanaimo and Dundas streets on Nov. 17 by an individual who was concerned for a colleague. He had failed to show up for work or respond to phone calls, which was out of character, police said. 

With the help of the building manager, police were able to get into the man's suite and found the 39-year-old dead inside. 

They found an unknown drug and drug paraphernalia inside the apartment and sent them to a Health Canada laboratory for testing, which confirmed the presence of carfentanil —  a deadly opioid 100 times more toxic than fentanyl.  

Earlier this month, carfentanil was found for the first time in a drug seizure on the Downtown Eastside.  

Vancouver police Staff Sgt. Randy Fincham said this is the first confirmed death linked to carfentanil in Vancouver.  

"Unfortunately, we suspect this death won't be the last." 

Omani affected with MERS virus

Via Muscat Daily: Omani affected with MERS virus.

The Ministry of Health said on Tuesday that an Omani has been affected with Middle East Respiratory Syndrome (MERS) virus. 

In a statement, the ministry said that the case came to light when the 67 year old Omani man visited a hospital for a check-up due to severe breathing problems.  

The ministry said the patient is receiving the best care in a government hospital and is responding well to the treatment.