H5N1

Travelling again

My wife and I leave today for a week in eastern Quebec—specifically, Gaspésie, between the Gulf of St. Lawrence and the Atlantic. I'll try to post from time to time, but by all means use the links to keep yourself informed.  

MSF in DR Congo: South Kivu cholera outbreak threatens to spread out of control

Via MSF.org: Democratic Republic of Congo: South Kivu cholera outbreak threatens to spread out of control. Excerpt:

A recently declared cholera outbreak in South Kivu, Democratic Republic of Congo, threatens to spread out of control unless a full response is implemented, Médecins Sans Frontières (MSF) has warned. MSF teams are providing assistance in the towns of Minova, Bukavu, Bulengo, Numbi, Sebele, Nyange and Baraka, with the disease threatening to spread rapidly unless prevention measures are in place, including in the large towns of Minova and Bukavu. 

MSF is running four cholera treatment centres in Minova, Baraka, Sebele and Bukavu, and three treatment units in Bulengo, Nyange and Numbi. To ease the burden on the country’s Ministry of Health, MSF teams are treating the patients in these structures and have provided more beds and equipment to increase the response capacity of the different health structures. 

Since August, more than 1,200 patients have been treated by MSF for cholera in the different centres. There are currently 70 people being treated in Minova, 67 in Bukavu, 18 in Bulengo, and 22 in Baraka. 

In Baraka, MSF has installed nine chlorination points to disinfect water, and has also donated materials to the centres in Kabeya, Ruzizi and Uvira. MSF has also assigned its most specialised personnel to the health structures to help manage the fight against the disease, in collaboration with the country’s Ministry of Health. 

However, the response to prevent and stop the spread of the disease has so far not been effective. 

“We need to set up many more chlorination points, disinfect the houses of sick people, and carry out an awareness campaign as soon as possible,” said Francisco Otero y Villar, MSF head of mission in the Democratic Republic of Congo (DRC). 

In DRC, the dry season and a lack of water can force the population to get water from unhealthy sources, which fuels the spread of cholera. Many people in both Bukavu and Minova get their water from lakes or from other sources of non-drinkable water. Half of the cholera cases that have come to the Minova treatment centre are from a neighbourhood situated on the shores of Lake Kivu, which is not a source of drinkable water.

Saudi Arabia: No new MERS cases, two recoveries, one death on August 31

Via the KSA MOH Command and Control Center: MOH: '1 New Confirmed Corona Case Recorded'. Two Saudis have recovered, a 30-year-old woman in Dammam and a 46-year-old man in Hayel. A 69-year-old expatriate man in Jeddah has died.

WHO: Yellow fever – France – French Guiana

WHO has published Yellow fever – France – French Guiana. Excerpt:

On 22 August 2017, the National IHR Focal Point for France notified a confirmed fatal case of yellow fever in a 43-year-old Brazilian woman in French Guiana, with an unknown vaccination status. 

The patient was hospitalized on 7 August 2017 and died on 9 August 2017 at the Cayenne hospital from fulminant hepatitis. She may have visited a gold mining area near St. Elie (North center of the country). Investigations are currently ongoing in order to identify the patient's travel route. 

On 21 August 2017, the case was laboratory confirmed at the national reference center for arboviruses, Institut Pasteur Cayenne by RT-PCR. This is the first confirmed case diagnosed in this territory since 1998. 

In French Guiana, yellow fever is considered endemic. The overall immunization coverage is good as yellow fever vaccination is mandatory but immunization coverage might be low in specific populations like clandestine and illegal workers. Therefore, vaccination catch-up will be implemented in legal and illegal gold prospecting areas. 

Public health response 

French Guiana health authorities are implementing several public health measures: 

• An initial investigation was performed and further investigations are ongoing. 

• Vector control interventions are being implemented, especially in specific zones that the case visited. These include health facilities in Cayenne and Kourou, localities of the interior around Saint Elie, and in the Bas-Oyapock river area. 

• The feasibility of vaccination catch-up targeting workers in legal and illegal gold mining areas is considered. 

• Communication and messages on prevention measures for yellow fever are being disseminated in French Guiana, including to people who live in those areas. 

WHO risk assessment 

Yellow fever is an acute viral hemorrhagic disease that has the potential to spread rapidly and cause serious public health impacts in unimmunized populations. Vaccination is the most important means of preventing the infection. 

French Guiana is considered at risk for yellow fever transmission. A yellow fever vaccination certificate is required for travelers over one year of age. Vaccination coverage in French Guiana is optimal, however, the coverage in some populations such as clandestine workers, in mining areas could be sub-optimal and therefore at risk for yellow fever infections. 

While the exact place of infection remains under investigation, the most likely geographic area of infection appears to be around the border between French Guiana and Brazil along the Oyapock river. 

At this stage and according to the preliminary data, this case is not epidemiologically linked to the sylvatic yellow fever outbreaks reported from Brazil since January 2017. Sequencing and comparison with yellow fever virus strains from other countries is needed to understand the potential link between the different outbreaks and the evolution of yellow fever virus. 

Based on the information currently available regarding epidemiological situation and early public health actions, the potential for large epidemic and international spread exists but is limited and could be further reduced by vaccination.

WHO EMRO: 591,100 cholera cases in Yemen as of August 30

WHO EMRO has published its Daily Epidemiological Update for August 30: 591,100 cholera cases and 2,035 deaths since the outbreak began on April 27, just four months ago. In 24 hours, an additional 5,573 Yemenis have contracted cholera and two more persons have died.

Arkema: Explosions and black smoke reported at chemical plant

Via The New York Times: Explosions and Black Smoke Reported at Chemical Plant. Excerpt:

As water began to recede in some parts of flood-ravaged Houston and as Harvey, now a tropical depression, shifted its wrath to the Beaumont-Port Arthur area of Texas, there were reports early Thursday that a chemical plant at risk of exploding had done just that.  

There were two explosions at the Arkema plant in Crosby, about 30 miles northeast of downtown Houston, around 2 a.m., the French chemicals company that owns the plant said in a statement.  

It said there was a risk of further explosions at the site. 

“We want local residents to be aware that the product is stored in multiple locations on the site, and a threat of additional explosion remains,” Arkema said.

Press CBS19, the Houston affiliate, reported the two explosions at the plant and showed photos of black smoke. The blasts were also reported by Fox 26. 

The company had already ordered all workers to leave the damaged plant, and Harris County ordered the evacuation of residents within a 1.5-mile radius. After the explosion, at least one Harris County deputy was taken to the hospital after inhaling fumes from the plant, the Harris County Sheriff’s Office said on Twitter.  

Later, the sheriff’s office tweeted that company officials believed that the smoke inhaled by the 10 deputies was “a nontoxic irritant.” 

Richard Rowe, the chief executive of Arkema’s North American division, told Reuters that the company had expected the chemicals to catch fire. 

The Arkema plant manufactures organic peroxides, which are used in making plastic and other materials. When the chemicals warm, they start to decompose, which creates more heat and can quickly lead to a rapid, explosive reaction. Some organic peroxides also produce flammable vapors as they decompose.  

The plant was shut down last Friday in anticipation of the storm, and a skeleton crew of 11 was left behind to ensure that the chemicals, which are kept in cold storage, remained safe.  

But Arkema said the plant had been without power since Sunday, and the torrential rains and flooding had damaged backup generators. With the storage warehouse warming up, the crew transferred the chemicals to diesel-powered refrigerated trailers, but some of those stopped working as well.

Harvey aftermath: A Texas chemical plant could explode — and the town evacuates

Via The Washington Post, more on Arkema: Harvey aftermath: A Texas chemical plant could explode — and the town evacuates. Excerpt:

CROSBY, Tex. — Officials evacuated this small town east of Houston Wednesday afternoon as they braced for the imminent explosion of a chemical plant that was ravaged by floodwaters from Hurricane Harvey. 

Volatile chemicals at the plant, which is standing in six feet of water, could catch fire or explode at any moment in coming days, officials said. Owned by the French firm Arkema, the facility’s coolant system and inundated backup power generators have failed, according to the company. The plant lost primary power and then two sources of emergency backup power, said Richard Rowe, chief executive of Arkema’s North American unit.  

Local media reported a mandatory evacuation zone was established for a 1.5-mile radius as the last workers attempted to resolve the problem. Police cruisers and SUVs sealed off access to the Crosby plant on Highway 90, which connects Houston and Beaumont. Parts of the highway nearby were underwater. 

“We have lost critical refrigeration of the materials on site that could now explode and cause a subsequent intense fire,” Rowe said. “The high water and lack of power leave us with no way to prevent it.”

The plant manufactures organic peroxides, a family of compounds used in everything from pharmaceuticals to construction materials such as counter tops and pipes. But the material must remain cold otherwise it can combust. 

A continuous flow of trucks, many hauling boats to participate in flood rescue efforts, approached the police barricade near the facility Wednesday afternoon only to be turned away as Crosby Volunteer Fire Department trucks crisscrossed the highway cut-through roads.

Arkema: Status of plant in Crosby, Texas

Google Maps

Via Arkema's website, an August 29 news release: Status of Plant in Crosby, Texas. Events today seem to have overwhelmed the company's PR: 

The Arkema site in Crosby, Texas has been shut-down since Friday.  

The site anticipated the storm, and safely shut down all operations before hurricane landfall. The facility has had extraordinary levels of rain, receiving approximately 40 inches by Monday afternoon. The site has been heavily flooded and without electric service since early Sunday morning. Back-up generators have largely been inundated with water. A small ride-out crew of eleven people had remained on site for some days.  

As of late this afternoon, the situation at the Crosby site had become serious. In order to ensure the safety of our ride-out team, all personnel have been evacuated from the site at this time. We are working with the Department of Homeland Security and the State of Texas to set up a command post in a suitable location near our site. We also have been in contact with other regulatory authorities, who are aware of this situation. 

Arkema manufactures organic peroxides at the Crosby plant. The primary challenge has been maintaining refrigeration for these products, which are stored at low temperature. The site lost refrigeration to all of its cold-storage warehouses when electrical power was lost and back-up generators were flooded. Our team then transferred products from the warehouses into diesel-powered refrigerated containers, and continued to monitor the situation.    

At this time, refrigeration on some of our back-up product storage containers has been compromised due to extremely high water, rising to levels that are unprecedented in the Crosby area. 

Arkema is limited in what it can do to address the site conditions until the storm abates. We are monitoring the temperature of each refrigeration container remotely. At this time, while we do not believe there is any imminent danger, the potential for a chemical reaction leading to a fire and/or explosion within the site confines is real.   

We have no higher priority than the safety of our employees, neighbors and the environment. We have been working without pause to keep our materials safe.

Chemical plant struck by Harvey now apt to explode

Via the Houston Chronicle: Chemical plant struck by Harvey now apt to explode. Excerpt:

Crosby fire officials are bracing for an explosion at the Arkema chemical plant in the city where floodwaters have knocked out power and generators needed to keep volatile chemicals stored at the facility cool. 

All employees of the plant at 18000 Crosby Eastgate Road were evacuated late Tuesday, as were resident from about 300 homes within a mile and a half of the plant. 

At a press conference Wednesday, Rich Rowe, Arkema's CEO said that if the volatile organic peroxides stored at the plant get too warm, some sort of explosion is inevitable. 

"There is no way to prevent an explosion or fire," Rowe said. 

Late Monday night, the facility lost power from both its primary supply and its backup generators. Employees moved the highly volatile organic peroxides into back-up containers to keep them cool. If that class of chemical gets too hot, it can cause fires or explosions.

The Crosby Fire Department evacuated its last employee Tuesday night. Eleven other staff members had been evacuated during the afternoon when the refrigeration in some of the back-up containers also started to fail. 

Once government officials saw the chemical inventories for the facility, they ordered the evacuation of nearby residents.

More than 1,000 died in South Asia floods this summer

It's not just Texas and Louisiana. Via The New York Times: More Than 1,000 Died in South Asia Floods This Summer. Excerpt:

MUMBAI, India — More than 1,000 people have died in floods across South Asia this summer, and as sheets of incessant rain pummeled the vast region on Tuesday, worries grew that the death toll would rise along with the floodwaters. 

According to the United Nations, at least 41 million people in Bangladesh, India and Nepal have been directly affected by flooding and landslides resulting from the monsoon rains, which usually begin in June and last until September. 

And while flooding in the Houston area has grabbed more attention, aid officials say a catastrophe is unfolding in South Asia. 

In Nepal, thousands of homes have been destroyed and dozens of people swept away. Elephants were pressed into service, wading through swirling waters to rescue people, and aid workers have built rafts from bamboo and banana leaves. 

But many people are still missing, and some families have held last rites without their loved ones’ bodies being found. 

“This is the severest flooding in a number of years,” Francis Markus, a spokesman for the International Federation of Red Cross and Red Crescent Societies, said by phone from Kathmandu, Nepal’s capital. 

Nepal’s flooded areas are the poorest parts of the country, where most families live in bare mud houses and rely on subsistence farming, he said. Those farms are now underwater, and thousands of people are stuck living under plastic tarps in camps for displaced people where disease is beginning to spread.

Asked how the situation in Nepal compared with that in Houston, Mr. Markus said, “We hope people won’t overlook the desperate needs of the people here because of the disasters closer home.” 

India has also suffered immensely. Floods have swept across the states of Assam, Bihar, Odisha, West Bengal and other areas. This weekend, Prime Minister Narendra Modi flew over the devastation in Bihar, where more than 400 people are believed to have died in floods in recent weeks. He pledged millions of dollars in assistance and urged insurance companies to send in assessors as soon as possible to help farmers cope with their losses. 

And the rain keeps coming. 

On Tuesday, Mumbai, the sprawling financial capital, was soaked to the bone. Nearly all day, the rain drummed down. As people scurried up the sidewalks, the wind tore umbrellas out of their hands. 

The sky seemed to fall lower and lower, pressing down on the building tops, cutting visibility to a few blocks, then a few yards. By midafternoon, it was so dark it felt like nightfall.

Busy intersections were deluged, and cars struggled to part the muddy, greenish waters. Several Mumbai television channels reported that more rain had fallen on the city in the past several days than any other time since July 2005, when severe flooding killed more than 1,000 people in this part of India.