H5N1

North China Plain threatened by deadly heatwaves due to climate change and irrigation

Via Nature Communications: North China Plain threatened by deadly heatwaves due to climate change and irrigation. This is very alarming. The abstract:

North China Plain is the heartland of modern China. This fertile plain has experienced vast expansion of irrigated agriculture which cools surface temperature and moistens surface air, but boosts integrated measures of temperature and humidity, and hence enhances intensity of heatwaves. 

Here, we project based on an ensemble of high-resolution regional climate model simulations that climate change would add significantly to the anthropogenic effects of irrigation, increasing the risk from heatwaves in this region. Under the business-as-usual scenario of greenhouse gas emissions, North China Plain is likely to experience deadly heatwaves with wet-bulb temperature exceeding the threshold defining what Chinese farmers may tolerate while working outdoors. 

China is currently the largest contributor to the emissions of greenhouse gases, with potentially serious implications to its own population: continuation of the current pattern of global emissions may limit habitability in the most populous region, of the most populous country on Earth.

DR Congo: Emergency management activated against an unknown disease that has killed 15 in Mangina, North Kivu

Via Radio Okapi: North Kivu: emergency management activated against an unknown disease that has killed 15 Mangina. The Google translation:

The North Kivu provincial health minister, Martial Kambumbu, announces the response to an undetermined disease that has already killed 15 people in two weeks , in the rural commune of Mangina, 30 km southwest of the city. from Beni. Twenty-six cases of this disease were reported in two months. it is manifested by diarrhea, fever and vomiting. 

"I wanted to assure you that the response is a national response and the emergency management is already activated so that we can take the situation in hand, as soon as possible," said Martial Kambumbu. 

According to him, the nurses' strike is one of the causes of the belated knowledge of this situation in the region. "We have to confirm that there has been a phenomenon and there have been cases that have not been well managed at the grassroots level and this has been happening since May. As you know, the nurses were on strike, they could not transmit the information at the level of the hierarchy and it is this serious fault which causes us a lot of concerns," said Martial Kambumbu. 

He indicated that the alerts were well analyzed at the provincial level and that the samples are in Beni, Butembo and Goma but also at the National Institute of Biomedical Research (INRB) of Kinshasa.

As California burns, many fear the future of extreme fire has arrived

Via The Guardian: As California burns, many fear the future of extreme fire has arrived. Excerpt:

Recent wildfires in California are notable for their ferocity. At least six people have died, including two firefighters, in the past month in fires that continue to blaze, and 44 died as a result of last year’s wine country fires. The conflagrations have also spawned bizarre pyrotechnics, from firenados to towering pyrocumulus clouds that evoke a nuclear detonation. These events are not aberrations, say experts. They are California’s future.  

As of Monday morning, the Carr fire had burned more than 98,000 acres, and containment stood at 20%, with more than 5000 structures threatened. In the evening, Cal Fire began lifting evacuation orders, allowing residents mostly on the east side of the fire to return home.  

Awareness of fires “is not just because the news is covering it more”, said Michael Wehner, a senior staff scientist at the Lawrence Berkeley National Laboratory. “More acres are burning. That is almost certainly due to climate change.”

As the climate shifts, so does fire behavior. Summers are longer and drier. Sometimes the winter rains are meager for years, as in the recent five-year drought. Sometimes, like this year, they are torrential, producing explosive plant growth that, several months later, desiccates into prime accelerant. The needle is moving, but where it will stop is anybody’s guess. 

“Climate change is continuing to unfold,” said Anthony LeRoy Westerling, a professor of management of complex systems at the University of California, Merced. “The impacts from it will probably accelerate. There won’t be a new normal in our lifetimes.”

Chinese vaccine scandal unlikely to dent childhood immunization rates

Via Nature News & Comment: Chinese vaccine scandal unlikely to dent childhood immunization rates. Excerpt:

Problems with two Chinese-made vaccines — one of which was distributed to clinics and possibly injected into hundreds of thousands of children — have led to arrests and made international headlines. But researchers who study vaccination in China don’t expect a major effect on the country’s high immunization rates.  

Widespread support for immunization programmes combined with strict vaccine requirements for children starting school means that most parents will continue vaccinating their children, they say. 

“I don’t think there’ll be an appreciable drop in vaccine coverage but it could impact when people get vaccines, and where the vaccines come from,” says Abram Wagner, an epidemiologist at the University of Michigan in Ann Arbor who has interviewed Chinese parents about their views on immunization.

WHO: Three in five babies not breastfed in the first hour of life

WHO has published 3 in 5 babies not breastfed in the first hour of life. Excerpt:

An estimated 78 million babies – or three in five – are not breastfed within the first hour of life, putting them at higher risk of death and disease and making them less likely to continue breastfeeding, say UNICEF and WHO in a new report. Most of these babies are born in low- and middle-income countries.  

The report notes that newborns who breastfeed in the first hour of life are significantly more likely to survive. Even a delay of a few hours after birth could pose life-threatening consequences. Skin-to-skin contact along with suckling at the breast stimulate the mother’s production of breastmilk, including colostrum, also called the baby’s ‘first vaccine’, which is extremely rich in nutrients and antibodies. 

“When it comes to the start of breastfeeding, timing is everything. In many countries, it can even be a matter of life or death,” says Henrietta H. Fore, UNICEF Executive Director. “Yet each year, millions of newborns miss out on the benefits of early breastfeeding and the reasons – all too often – are things we can change. Mothers simply don’t receive enough support to breastfeed within those crucial minutes after birth, even from medical personnel at health facilities.”

Breastfeeding rates within the first hour after birth are highest in Eastern and Southern Africa (65%) and lowest in East Asia and the Pacific (32%), the report says. Nearly 9 in 10 babies born in Burundi, Sri Lanka and Vanuatu are breastfed within the first hour. By contrast, only two in 10 babies born in Azerbaijan, Chad and Montenegro do so.* 

“Breastfeeding gives children the best possible start in life,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We must urgently scale up support to mothers – be it from family members, health care workers, employers and governments, so they can give their children the start they deserve.”

The association between suicide deaths and putatively harmful and protective factors in media reports

Via CMAJ: The association between suicide deaths and putatively harmful and protective factors in media reports. The abstract:

BACKGROUND: Exposure to media reporting on suicide can lead to suicide contagion and, in some circumstances, may also lead to help-seeking behaviour. There is limited evidence for which specific characteristics of media reports mediate these phenomena. 

METHODS: This observational study examined associations between putatively harmful and protective elements of media reports about suicide in 13 major publications in the Toronto media market and subsequent suicide deaths in Toronto (2011–2014). We used multivariable logistic regression to determine whether specific article characteristics were associated with increases or decreases in suicide deaths in the 7 days after publication, compared with a control window. 

RESULTS: From 2011 to 2014, there were 6367 articles with suicide as the major focus and 947 suicide deaths. Elements most strongly and independently associated with increased suicides were a statement about the inevitability of suicide (odds ratio [OR] 1.97, confidence interval [CI] 1.07–3.62), about asphyxia by a method other than car exhaust (OR 1.72, CI 1.36–2.18), about suicide by jumping from a building (OR 1.70, CI 1.28–2.26) or about suicide pacts (OR 1.63, CI 1.14–2.35), or a headline that included the suicide method (OR 1.41, CI 1.07–1.86). 

Elements most strongly and independently associated with decreased suicides were unfavourable characteristics (negative judgments about the deceased; OR 1.85, CI 1.20–2.84), or mentions of railway (OR 1.61, CI 1.10–2.36) and cutting or stabbing (OR 1.59, CI 1.19–2.13) deaths, and individual murder-suicide (OR 1.50, CI 1.23–1.84).  

INTERPRETATION: This large study identified significant associations between several specific elements of media reports and suicide deaths. It suggests that reporting on suicide can have a meaningful impact on suicide deaths and that journalists and media outlets and organizations should carefully consider the specific content of reports before publication.

DR Congo: An undiagnosed outbreak in North Kivu (updated)

Google Maps

Thanks to Pathfinder at FluTrackers for tweeting about this outbreak. Via Radio Okapi: Nord-Kivu : une maladie inconnue fait 15 morts en deux semaines à Mangina.[North Kivu: Unknown disease in Mangina leaves 15 dead in two weeks] Excerpt from the Google translation, and then another, somewhat contradictory, report:

An unknown disease characterized by diarrhea, fever, and vomiting has been observed for two months in the rural district of Mangina, about 30 km southwest of the city of Beni (North Kivu). According to the chief medical officer of the Mabalako / Mangina health zone, Dr Germain Kamaliro, in the last two weeks, fifteen deaths have been recorded in the twenty-six identified cases.  

"For two months, there has been a phenomenon that is affecting the population, which is characterized by the emission of liquid stools and vomiting and then death either by epitaxy or by fever. It's been at least two weeks since we found that there is really a surge of cases, Until then we have 15 deaths out of the 26 cases identified since May, " said Dr. Germain Kamaliro.   

He announced the sending to Goma and Kinshasa samples of the samples for analysis.   

"As the samples are being sent to the laboratory at Goma and Kinshasa by tomorrow, it is the results that can confirm that there is a problem," continued Dr. Germain Kamaliro.   

He said, however, that it is not a haemorrhagic fever, "because for haemorrhagic fever there is bleeding in all the orifices. " 

"At the moment this disease is first located in the rural commune of Mangina and all patients are treated in the reference center of Mangina and we have also noted some sporadic cases in other structures such as the health area of Linzo who referred to Mangodomu, " added Dr Germain Kamaliro. 

The FluTrackers report, from Actualite.cd, is different. Excerpt from the Google translation, and then a comment:

At least 17 people died of an unknown disease in the town of Mangina and in the city of Beni (North Kivu). Mangina is located 30 kilometers west of the city of Beni.

According to health officials, the victims have nasal bleeding and haemorrhagic vomiting. 14 people died in July in Mangina and 3 others in the city of Beni.

"Since April we have registered 26 suspected cases in the health air of Mangina. For this month of July, at least 14 people died of this unknown disease. At first we thought of a witchcraft but over time we did not understand that it is a disease that comes under two tables: the person has manifested nasal haemorrhage and haemorrhagic vomiting. We have issued alerts and forwarded the information to the area, we are waiting for the authorities of the provincial health directorate for other responses on this disease, " explained this Monday at ACTUALITE.CD, Dr. Alain Musondolya of the center Mangina reference health. 

Something certainly seems to be amiss in North Kivu, but we'll have to wait for the test results. Beni is near the borders of Rwanda and Uganda, and about a nine-hour drive from Kampala.

Update: Many thanks to Irene Lai of International SOS, who sent the link to this July 30 DRC Ministry of Health update. The Google translation:

Reported fever cases in Mabalako Health Zone, North Kivu Province

Kinshasa, July 30, 2018 -  This Saturday, July 28, 2018, the Provincial Health Division of North Kivu has notified 25 cases of fever in the health area of ​​Mangina, located about 30 km southwest of the city of Beni. 
 
Samples have been collected and are being sent to Kinshasa for analysis by the National Institute for Biomedical Research (INRB). 
 
An investigative team from the General Directorate for the Fight Against Disease (DGLM) composed of three experts, including two epidemiologists and a biologist, will arrive in Beni as early as Tuesday, July 31, 2018 to support the provincial team.
 
The Ministry of Health instructed health professionals in the province to respect individual protection measures. In addition, the Ministry invites the population in the areas concerned to remain calm, vigilant and to respect the hygiene measures, in particular the regular washing of the hands.

Canada: 130 overdose calls in one day match record for BC paramedics

Via CBC News: 130 overdose calls in 1 day match record for B.C. paramedics. Excerpt:

Paramedics in B.C. recently equalled a record for suspected overdose calls in one day, despite a slight drop in overdose deaths so far in 2018 compared to 2017. 

B.C. Emergency Health Services said there were 130 calls for suspected overdoses on July 27, which matches a record set in April 2017. There were no fatalities among those calls. 

Linda Lupini, an executive vice-president for the service, says the load is a strain for paramedics, who were on the front lines of the opioid epidemic long before a state of emergency was declared April 14, 2016.  

"It's very hard on them," she said. "We do a lot of work with resiliency and debriefing to keep them in a state where they can continue to respond." 

Link to income assistance 

Lupini says the 130 calls came two days after income assistance was distributed. 

The B.C. Coroners Service says more fatal overdoses occur during the days following income assistance payments. 

Lupini says the service often sees an average of 50 calls on those Wednesdays, with spikes up to 80 or 90 on the following days — 130, though, is unusual. 

She says most likely another contributing factor was more toxic illicit drugs circulating on the streets than usual.

'Taking its toll' 

"The overdose crisis is taking its toll on British Columbia," Lupini said. 

The service says the people most at risk of dying from an opioid overdose are those who use alone.  

Lupini says officials are working to reduce stigma around drug use so that people can get support.  

The latest statistics from the B.C. Coroners Service show that there were 109 drug overdose deaths in May 2018.

Book lifts lid on litany of mistakes in Ebola outbreak that killed 11,300 people

Via The Guardian: Book lifts lid on litany of mistakes in Ebola outbreak that killed 11,300 people. Excerpt:

A British doctor and Irish diplomat who worked on the frontline of the crisis in west Africa in 2014 say failures by international aid agencies and donors exacerbated the catastrophe. 

The World Health Organization and other global agencies have failed to learn sufficient lessons from the 2014 Ebola outbreak that killed more than 11,300 people in west Africa, a British doctor at the centre of the battle in Sierra Leone has said.  

Although the response to the most recent Ebola outbreak in the Democratic Republic of the Congo (DRC) was swift and effective, the international community’s long-term strategies have only marginally changed, said Oliver Johnson, who in a book with Irish diplomat Sinead Walsh lifts the lid on the extraordinary behind-the-scene failures four years ago.  

In Getting to Zero, the duo show how a litany of mistakes made in distant offices in New York, Washington, London and Geneva, combined with poor leadership in Sierra Leone and a weak health service, created a catastrophe that could have been prevented. 

Among those coming under fire are the British army, the Department for International Development and the US Center for Disease Control. 

The sharpest criticism is levelled at the WHO, which was slow to declare the Ebola outbreak an international emergency, but also failed to heed early alarm calls made by medics who were working in horrific conditions in the Kenema hospital, where British nurse Will Pooley contracted the virus. 

“WHO Kenema staff were screaming for months … but WHO leadership failed to take adequate action,” the authors note in the book. 

“Despite the enormous furore over their failures on Ebola, WHO has not initiated any other significant reforms,” they add. 

Through 85 interviews with responders, politicians and witnesses, Johnson and Walsh give first-hand accounts of the world’s failure to respond to Ebola in the first few months in 2014 – inaction that ultimately cost the lives of thousands.

Annals of health scares: Patient investigated for Ebola virus at Denver Health (updated)

Via the Denver Post: Patient investigated for Ebola virus at Denver Health. Excerpt and then a comment:

Colorado health officials scrambled to determine whether a man who recently worked with sick people in eastern Congo and became ill Sunday in Denver had contracted the deadly Ebola virus — and doctors also isolated an ambulance crew for testing and were looking for another person in metro Denver who may have had contact with the man. 

Denver Health and Hospitals officials Sunday night were waiting for test results from a state health lab but said that, based on an initial test in a special isolated unit, they do not believe the man has Ebola. A Colorado Department of Public Health and Environment (CDPHE) bulletin late Sunday said testing “is negative for Ebola.” 

The man had been working with sick and dead people in an area of eastern Congo where a recent outbreak of Ebola had largely dissipated with no new Ebola cases reported over the past 45 days.  On Sunday morning, he reported sudden severe symptoms at his residence in Denver, Denver Health chief medical officer Connie Price said. 

“We felt that, if he had Ebola, then he could be very communicable … We had no wiggle room to be wrong,” Price said. 

The man “became ill very suddenly this morning,” she said, declining to specify his exact symptoms but saying they could mimic illnesses including flu and appendicitis. “He is getting better, so that is good.” 

Three members of the ambulance crew that picked up the man — two of them paramedics, one a student — also were being held in isolation, and Denver public health officials were looking for a “significant other” who may have had contact with the man warranting testing as a precaution. 

Denver public health officials were “working through” how to handle the man’s residence before confirmatory testing for Ebola was complete, Price said Sunday afternoon outside the hospital. “We don’t think we’re going to have to do anything with his house because we don’t think he is going to be confirmed.”

If this man was in the eastern DR Congo, it's highly unlikely he was anywhere near Ebola. If he was in Bukavu, for example, he was 1,823 km by road from Mbandaka, near the epicenter of the recent outbreak.

Now, if he had been in the eastern Republic of the Congo he might just conceivably have been exposed to someone who'd popped across the Congo River from Mbandaka in the northwestern Democratic Republic of Congo. But they're two different countries with annoyingly similar names, and to the best of my knowledge the Republic of the Congo has never reported an Ebola case. The DR Congo health authorities seem to have monitored river traffic very effectively.

 

This fuss is more likely due to ignorance of central African geography than to a genuine case of Ebola.

Update: Unsurprisingly, the man has tested negative for Ebola.