H5N1

A welcome new scientific journal

I am delighted to welcome the journal of alternative facts to Flublogia. We always need another fair and balanced viewpoint on critical issues of public health and science in general. Believe me.

CIDRAP: H5N8 detected again in Nigeria, H5N1 in Cambodia

Via CIDRAP, Lisa Schnirring writes: H5N8 detected again in Nigeria, H5N1 in Cambodia.

Signaling continued activity of highly pathogenic H5N8 avian flu in Africa, Nigeria reported that the virus hit more farms, with three European countries reporting more outbreaks in poultry and wild birds. 

In developments with other high-path strains, Cambodia today reported its first H5N1 outbreak of the year, which affected backyard poultry.

Click or tap through for the details, which Schnirring as always provides with admirable concision.

Canada: BC Zika cases rise to 47 including three pregnant women

Via CBC News British Columbia: Zika virus: B.C. cases rise to 47 including 3 pregnant women. Excerpt:

The number of confirmed Zika cases continues to rise in B.C., with 47 people now diagnosed with the virus after travelling including three pregnant women, according to the B.C. Centre for Disease Control. 

Zika is a virus that's carried and transmitted by mosquitos in a number of countries, including Mexico, most of Central and South America, and parts of Florida and Texas. 

Most people who get Zika have no symptoms, but in pregnant women, infection can cause severe birth defects in a developing fetus, including microcephaly or an abnormally small head. 

That's why pregnant women, women who may want to become pregnant and their partners are warned against travelling anywhere with active Zika transmission.

"Pregnant women should really consider seriously whether their travel is necessary," said Dr. Eleni Galanis of the B.C. Centre for Disease Control.  

"I think it's very much an individual decision, but to my own patients and to my own family members and if I were pregnant, I would not take that risk."

Hundreds tested in BC each month 

All of the 47 B.C. Zika cases were acquired while travelling — some in resorts, some off the beaten path and some on extended stays, said Dr. Galanis.  

Mexico was the most commonly cited country among the travellers, she said.  

Travellers can and should take precautions to avoid getting bitten by mosquitos, such as wearing insect repellant and long-sleeve clothes, especially at dawn and dusk, said Dr. Galanis.  

But that might not be enough given the potential for severe complications, she said.  

"Even with all the greatest precautions in the world, you probably will get bitten once or twice. So then it's your decision to make about whether or not you want to take that risk." 

Each month, the B.C. CDC is seeing between zero and eight new Zika infections, out of the 200-300 tests conducted on returning travellers.

Cambodia reports outbreak of H5N1 bird flu in southeast

Via the Daily Mail Online: Cambodia reports outbreak of H5N1 bird flu in southeast.

Cambodia has reported an outbreak of the highly pathogenic H5N1 bird flu virus among backyard poultry in the southeastern part of the country, the World Organisation for Animal Health (OIE) said on Tuesday. 

The virus was found in chickens in the region of Svay Rieng last week, killing 68 birds and leading to the destruction of 322 others, the Cambodian farm ministry said in a statement posted on the OIE website.

I can't find the statement on OIE's site, even after a search. There is a mention, dated January 27, of the first outbreak in Cambodia of H7N3, a low-pathogenic strain. Nonetheless, it's reported to have killed 3,700 out of 4,000 free-ranging ducks.

ECDC on reversing the HIV epidemic: Europe needs to scale up prevention, testing and treatment

Via ECDC: Reversing the HIV epidemic: Europe needs to scale-up prevention, testing and treatment. Click or tap through to use links and download an ECDC overview of the situation. Excerpt:

​In a two-day conference organised in collaboration between the Maltese Presidency of the Council of the European Union and ECDC, HIV experts from across the European Union discuss how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030. 

“This conference arose from excellent collaborative work with ECDC and Malta’s commitment and recognition of the importance of placing HIV higher up on the EU agenda during its Presidency Term” says Mr Chris Fearne, Minister for Health, Malta. 

“We believe that concerted efforts must include all stakeholders: including governments, healthcare providers, civil society, people living with HIV and the specialised agencies like WHO and ECDC. We believe that tackling HIV is a regional, national, corporate and individual responsibility. They all have a role to play in terms of political commitment, preventive action, universal access to healthcare, affordability and access to medicines, testing, linkage to care , focus on key populations, zero tolerance to stigma AND individual behavioural responsibility.“ 

He added areas of action: “Scaling up of testing is essential to reach our first 90 target. We need to make better use of various settings to enhance testing, incorporate innovative approaches to testing and reduce the barriers, especially in key populations. Knowledge of HIV status ‘in unaware persons’ might also help reduce new HIV infections - those resulting negative may then take less risks, and if linked to care should achieve viral suppression, the third 90“.  

“If we take a look at the available data, we can see that Europe needs to improve its HIV response in several areas”, says ECDC Acting Director Andrea Ammon. “Currently, two out of three EU/EEA countries tell us that they do not have sufficient funding for prevention interventions. And every one in seven people living with HIV in the region are not aware of their infection. 

"To reduce the number of new HIV infections in Europe, we need to focus our efforts in three main areas: prioritising prevention programmes, facilitating the uptake of HIV testing, for example by introducing new approaches like community-based testing or self-testing to diagnose those infected. And, of course, easier access to treatment for those diagnosed”.

Yemen war erases decade of health gains; many children starving: UNICEF

Via Thomson Reuters: INTERVIEW-Yemen war erases decade of health gains, many children starving - UNICEF. Excerpt:

Yemen has lost a decade's worth of gains in public health as a result of war and economic crisis, with increasing numbers of children succumbing to malnutrition, the United Nations' Children's Fund (UNICEF) said on Tuesday.  

An estimated 3.3 million people, including 2.2 million children, across the Arab peninsula's poorest country are suffering from acute malnutrition, and 460,000 under the age of five have severe acute malnutrition, the agency said.  

The most severe form leaves young children vulnerable to life-threatening diarrhoeal diseases and respiratory infections. 

"What worries us is the severe acute malnutrition because it is killing children," Meritxell Relano, UNICEF representative in Yemen, told Reuters in Geneva.  

"Because of the crumbling health system, the conflict and economic crisis, we have gone back to 10 years ago. A decade has been lost in health gains," she said, with 63 out of every 1,000 live births now dying before their fifth birthday, against 53 children in 2014.  

Children and pregnant and lactating women are most heavily affected by the malnutrition crisis in the northern province of Saada, in the coastal area of Hodeida and in Taiz in the south, she said. 

UNICEF mobile teams aim to screen more children and reach 323,000 severely malnourished children this year, up from 237,000 last year, Relano said, adding that partner agencies would target the rest.  

The Yemeni conflict, which pits a Saudi-led Arab coalition against the Iran-allied Houthi movement, has left more than half of the country's 28 million people "food insecure", with seven million of them enduring hunger, the United Nations has said.

Saudi Arabia: No new MERS cases, one death as of noon January 31

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded. A 75-year-old Saudi man in Taif has died. No recoveries are reported.

Branswell: Can the WHO end its money crunch before it gets worse?

Via STAT, Helen Branswell writes: Can the WHO end its money crunch before it gets worse? Excerpt:

It’s anyone’s guess which of the three candidates still in the race to become the next director-general of the World Health Organization will emerge victorious when WHO’s 194 member states vote in May. 

But ask anyone what the next director-general’s biggest challenge will be and you’ll hear the same answer — especially from the woman the candidates are vying to succeed. 

“My successor needs to continue to address the financing of WHO,” Dr. Margaret Chan, who recently passed the 10-year mark in office, told STAT in an interview. “There’s no two ways about it.”

The global health agency Chan has led since Jan. 4, 2007 is perennially strapped for cash. Its guaranteed funding — the dues paid by member states, which make up only 20 percent of the annual budget and can be spent at the agency’s discretion — has been frozen for more than a decade. 

But there’s reason to think that the WHO’s financial situation could soon become more dire. While 80 percent of the agency’s budget has come from a dozen or so countries and donors in the past, that money comes with taut strings attached. If the world manages to reach a long-sought goal — eradicating polio — a big chunk of the voluntary contributions WHO receives could disappear. 

There may also be politics at work. A rise in nationalist sentiment in much of the world, including in the United States, is raising questions about global commitment to multilateral agencies like the WHO. 

Given the agency’s fiscal challenges, Chan has served notice she will ask for a 10 percent increase in members dues — assessed contributions in the vernacular of United Nations agencies — at the WHO’s annual meeting, the World Health Assembly, in May. Her request may not be granted. 

She sought an increase when the WHO’s 2016-2017 budget was set — at a time when the agency’s Ebola response was being critiqued and roundly slammed — and was rebuffed. A meeting last October to discuss the issue indicated some but not overwhelming support for her upcoming request.  

Some observers suggest a funding increase would represent both a clean slate and a mandate for the agency’s next leader. “There’s not going to be a better time to do this than at the change of leadership,” said Dr. Jeremy Farrar, director of Britain’s Wellcome Trust charity. “They can say, ‘Look, this job is possible if you give the following resources.’”  

Others, such as Dr. Ashish Jha, director of the Harvard Global Health Institute, think the WHO has to prove that it has fixed its problems before countries will agree to pony up more cash.  

Jha, who was an author of an Ebola post-mortem that was critical of the WHO, acknowledged the agency is caught in a vicious cycle. Underfunding has undermined the WHO’s ability to do its job; its failings make member states less inclined to contribute more.

A clue to the mystery of Colombia’s missing Zika cases

Via Wired.com: A Clue to the Mystery of Colombia’s Missing Zika Cases. Excerpt:

In December of 2015, Magdalena Sanz Cortes was seeing patients at Texas Children’s Hospital and teaching classes in the ob-gyn department at the Baylor College of Medicine, when she got a call from Barranquilla, Colombia. Miguel Parra Saavedra, a gynecologist in the coastal metropolis, was worried by all the patients coming to his office showing signs of the mysterious Zika virus that had hit Brazil less than a year before. 

Alarming reports of microcephaly—abnormally small heads and brain damage caused by the Zika virus—were beginning to come out of Colombia’s neighbor to the east. Sanz Cortes and Parra Saavedra decided to start monitoring Barranquilla’s pregnancies to see if a similar wave would hit Colombia. 

It never did.  

In Brazil, more than 2,300 Zika-infected babies have been born with microcephaly since 2015. In Colombia, the world’s second largest outbreak has produced far fewer: only 82. Taking total population into account, that’s still more than an order of magnitude less. The disparity has bewildered public health officials, and caused many to question the link between the birth defect and Zika. 

The US Centers for Disease Control formally declared a causal link between microcephaly and the virus in April of 2016, citing a compelling accumulation of data from Brazil, including finding Zika virus in the brain tissue of affected infants. But Colombia’s microcephaly cases never materialized. 

By collecting detailed brain images of more than 200 developing fetuses from expecting mothers along the Colombian Caribbean coast, Sanz Cortes and Parra Saavedra think they have found something close to an explanation: Microcephaly wasn’t appearing in just a few cases, it was appearing in just the worst cases. Zika was still causing significant brain damage even in babies without below average-sized skulls.  

“We now suspect that microcephaly is just the end of the spectrum,” says Sanz Cortez, who presented the results of her team’s study at a meeting of the Society for Maternal-Fetal Medicine on Friday. “But the brain tissue stops growing well before that.” 

What this means for doctors, she says, is that simple head measurements are not enough to make a diagnosis for the suite of developmental defects caused by the virus—sometimes called congenital Zika syndrome. Physicians should also be using ultrasound and fetal MRIs to identify less obvious signs of infection. 

While early detection won’t change outcomes—doctors still don’t have a treatment for the disease’s congenital effects—it’s important for expectant mothers to mentally and emotionally prepare for the challenges ahead. Especially if those challenges aren’t obvious in the delivery room. 

Despite the fact that those results haven’t yet been peer-reviewed, they do match up with another recent study from a group of researchers in Seattle and Brazil who reported on 13 Zika-infected infants born with normal-sized heads. As they got older, these children began to develop new complications. Their heads didn’t grow as fast as the rest of their bodies; they had strange muscle weaknesses and spasms. MRIs showed that inside their skulls they had similar symptoms to the Colombian babies—decreased brain volume, too much fluid in certain brain tissues. 

That means there may be a lot of babies out there who have yet to show signs of congenital Zika defects. And if brain scans don’t expose them, time will.

Northeast China's Liaoning province reports two H7N9 cases

Via Xinhua: NE China province reports two H7N9 cases. Excerpt:

Northeast China's Liaoning Province on Monday reported two human H7N9 avian flu cases. 

The two patients, from cities of Shenyang and Chaoyang, respectively, are being treated and in stable conditions, the provincial health authorities said in a statement.  

In response to the disease, authorities in the two cities have taken disease control measures. 

In addition to Liaoning, human infections have also been reported in the provinces of Guangdong, Guizhou, Hubei, Henan, Hunan, Jiangxi and Shandong, as well as in Shanghai, Hong Kong and Macao.  

The public are advised to avoid direct contact with poultry and see doctors timely when developing symptoms including headache, fever and coughing. 

At least ten people have died from the virus since the start of the year, according to disease control centers in Henan, Guangdong and Hunan provinces.