H5N1

Wuhan Municipal Health Commission announces pneumonia epidemic

Via Hubei Ribao: Wuhan Municipal Health Commission Announces Pneumonia Epidemic. Unfortunately, it tells us very little we didn't already know. The Google translation:

Hubei Daily (Reporter Yu Jinyi) On December 31, 2019, the Wuhan Municipal Health Commission notified the pneumonia epidemic situation in Wuhan: Recently, some medical institutions in Wuhan have received a number of pneumonia patients, all of which are related to South China Seafood City. 

After receiving the report, the Wuhan Municipal Health and Health Commission immediately conducted a case search and retrospective investigation related to South China Seafood City in the city's medical and health institutions. 

Twenty-seven cases of pneumonia have been found, of which 7 are in serious condition, and the remaining cases are stable and controllable. Two patients are expected to be discharged in the near future. The clinical manifestations of the cases were mainly fever, a few patients had difficulty breathing, and chest radiographs showed bilateral lung infiltrative lesions. 

At present, all cases have been isolated for treatment, follow-up investigations and medical observations of close contacts are ongoing, and hygiene investigations and environmental sanitation disposals for South China Seafood City are ongoing.  

Wuhan City has organized clinical, epidemiological, and virological expert consultations with Tongji Hospital, Provincial CDC, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan Infectious Diseases Hospital, and Wuhan CDC. The experts have transitioned from disease and treatment. 

According to analysis of epidemiological investigations and preliminary laboratory tests, the above cases are of viral pneumonia. So far, the investigation has not found any obvious human-to-human transmission, and no medical staff infection has been detected. 

The detection of the pathogen and the investigation of the cause of the infection are ongoing.

China: 27 quarantined in Wuhan due to viral pneumonia

Posted early on New Year's Day in People's Daily: 27 quarantined in Wuhan due to viral pneumonia.

Twenty-seven people infected by viral pneumonia have been quarantined in the Hubei provincial capital of Wuhan, and those who were in close contact with them are being watched closely as the local health authority investigates the cause of the infection.

Seven of the infected are in critical condition, while the others are "stable" with "controllable" symptoms, according to a media release from the Wuhan Municipal Health Commission on Tuesday. 

Two patients may be discharged from hospital in the coming days, it added. 

Their main symptom is fever, though a few of them also have breathing difficulties. "So far, no person-to-person transmission has been found as the investigation continues. No medical worker has been infected," the release noted.  

The commission recently received reports from some medical institutes that they received patients, infected with viral pneumonia, who work in a local seafood market. 

White-clad medical workers were busy spraying sanitizer in the market with their faces masked, as shown in some videos uploaded on Tuesday morning. The operation of the market, however, has not been interrupted.  

Without responding directly to online rumors that these cases may be related to severe acute respiratory syndrome, widely known as SARS, the release said viral pneumonia is "preventable" and "controllable".  

"Those with the symptoms, especially persistent fever, should seek medical services in a timely manner," it said. 

People's Daily reported, however, that the cases in Wuhan are unlikely to have been caused by the SARS virus.  

"Multiple medical professionals in Wuhan said the causes for the viral pneumonia have yet to be identified and no conclusion could be made that they are related to SARS as the online hearsay stated," the newspaper said on its Weibo account. 

Even if they are caused by the SARS virus, Wuhan citizens don't need to worry because "there has been a mature system to control and cure" it, the newspaper said, citing undisclosed professionals.  

A team dispatched by the National Health Commission has arrived in Wuhan to facilitate local authorities in their work.

Hong Kong beefs up border checks against mystery illness

Via RTHK: HK beefs up border checks against mystery illness.

Hong Kong health authorities are beefing up health checks at border checkpoints as authorities in central China investigate an outbreak of a Sars-like disease in Wuhan that has sickened 27 – with seven in a critical condition.  

Health Secretary Sophia Chan convened a meeting with the Hospital Authority, the Health Department, and infectious diseases expert Yuen Kwok-yung on Tuesday night, before announcing that people who have acute respiratory symptoms and fever, and have travelled to Wuhan over the past fortnight, may be placed in isolation in hospital. 

Chan said Hospital Authority staff have been told to be on alert for such cases, and private doctors will be urged to refer any suspicious cases to the government. She also called on members of the public to maintain good hygiene and keep away from animals or animal droppings when travelling in the mainland. 

The minister said mainland authorities have found no indication that the disease – a viral type of pneumonia – can be spread among people, nor have any medical personnel fallen sick so far.  

Hospital Authority chief Tony Ko said no suspected case has been identified so far.  

But Professor Yuen said the current outbreak in Wuhan bears some similarities to the 1997 bird flu outbreak, and the Sars outbreak in 2003, as everyone who has fallen ill is linked to the same seafood market in the mainland city; and that around 25 percent of the victims are seriously ill. 

“At this stage, according to information from the mainland, we don’t know what kind of virus is involved. However we have reason to believe that this may be a new, emerging infectious disease that is similar to Sars or bird flu”, Yuen said. 

But he added that he thinks there’s only a “slim chance” that Hong Kong could be affected by another mass outbreak like Sars. 

He said health authorities are now much better equipped to deal with such emergencies, with much better tests, expertise on respiratory illnesses, infection controls, and communications with their mainland counterparts. 

“There’s no need to panic, but the level of alertness needs to be heightened”, he said.

See also this earlier RTHK report citing an expert saying it's too soon to suppose that SARS is back.

Hong Kong takes emergency measures as mystery ‘pneumonia’ infects dozens in China’s Wuhan city

Via the South China Morning Post: Hong Kong takes emergency measures as mystery ‘pneumonia’ infects dozens in China’s Wuhan city. Excerpt:

Hong Kong health authorities are taking no chances with a mysterious outbreak of viral pneumonia in the central Chinese city of Wuhan, warning of symptoms similar to Sars and bird flu as they step up border screening and put hospitals on alert. 

“The situation in Wuhan is unusual, and we are not sure about the reasons behind the outbreak yet,” said Secretary for Food and Health Sophia Chan Siu-chee said after an urgent night-time meeting with officials and experts on New Year’s Eve. “Since we are now in the holiday season, and Hong Kong has close transport ties with Wuhan, we must stay alert.” 

With Wuhan reporting 27 infections so far, Chan said the Department of Health would increase vigilance and temperature screening at every border checkpoint, including the city’s international airport and high-speed railway station in West Kowloon. 

Hospital Authority chief executive Tony Ko Pat-sing said frontline medical staff had been alerted at public and private hospitals.

“So far, there are no suspicious pneumonia cases in public hospitals,” he said. “But once we suspect cases, including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients into isolation.” 

Experts from the University of Hong Kong have also been enlisted to conduct faster genetic testing of virus samples. 

News of the outbreak in Wuhan came to light after an urgent notice from the city’s health department, which told hospitals to report further cases of “pneumonia of unknown origin”, started circulating on social media on Monday night.

The notice invoked memories of the 2002 and 2003 outbreak of severe acute respiratory syndrome, which killed hundreds of people in mainland China and Hong Kong.

Over the past month, 27 patients in Wuhan – most of them stall holders at the Huanan seafood market – have been treated for the mystery illness. 

The Wuhan municipal health commission said seven of the patients were seriously ill. Two had nearly recovered and were about to leave hospital, while the remaining patients were in a stable condition. Most patients had fevers and some were short of breath. 

The health commission’s initial investigations, which included clinical diagnosis and laboratory tests, suggested all 27 were viral pneumonia cases.

Hong Kong: CHP closely monitors cluster of pneumonia cases on Mainland

Thanks to Mike Coston, Giuseppe Michieli, and Ian Mackay for alerting me to this report by the Centre for Health Protection: CHP closely monitors cluster of pneumonia cases on Mainland. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health is today (December 31) closely monitoring a cluster of pneumonia cases in Wuhan, Hubei Province, and has contacted the National Health Commission for further information.         

According to an announcement from the Health Commission of Hubei Province, a number of pneumonia cases related to a local seafood market was recently reported in Wuhan. The Wuhan Municipal Health Commission has commenced investigation and so far identified 27 cases. Among them, seven cases were serious and the remaining were stable. Symptoms were mainly fever while a few had presented with shortness of breath. All patients are isolated and receiving treatment. Contact tracing of close contacts and medical surveillance are ongoing.        

The Wuhan Municipal Health Commission announced that assessment by relevant experts revealed that the cases were compatible with viral pneumonia. For the time being, no obvious human-to-human transmission has been observed and no healthcare workers have been infected. The causative pathogen and cause of infection are still under investigation.        

Locally, while surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.        

The CHP's Port Health Division conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases with serious infectious diseases identified will be immediately referred to public hospitals for isolation, treatment and follow-up. The CHP has also informed the Hospital Authority about the cluster of pneumonia cases in Wuhan.        

Travellers are reminded to wear surgical masks and seek medical attention if they present with respiratory symptoms, and reveal their travel history to doctors. The CHP will continue to closely monitor the latest situation of the cluster of pneumonia cases in Wuhan and update the surveillance criteria and testing strategies accordingly.

Mike Coston has three posts on the outbreak and the response in Hong Kong and Taiwan. A quick check of Wuhan media didn't turn up anything, but I'll keep looking around.

DRC: 21 days without a new case of Ebola in the city of Beni

Via Koma Ebola: 21 days without a new case of Ebola in the city of Beni . The Google translation:

For the first time since the beginning of the epidemic, the sub-coordination of Beni totaled this Sunday, December 29, 2019, 21 days without new case of Ebola and its CTE without case of a patient positive for the Ebola virus. It was the coordinator of the Ebola response to Beni who said so on the occasion of the release of a last patient from the contacts from Lwemba.  

For his part, the father of the child discharged from the CTE of Beni this Sunday, thanks a lot the nursing staff for having saved his son.  

This result is undoubtedly the effort of the response team with the support of the community which is starting to see Ebola can be avoided by respecting the rules of hygiene recommended by the response teams and the support of these teams by the community. 

If this cooperation continues, the Ebola virus disease will be wiped out in Beni.

Beni Ebola: 8 new survivors left the treatment center in Mangina

Via 7sur7.cd: Beni-Ebola: 8 new survivors left the treatment center in Mangina. The Google translation:

8 people recovered from the Ebola virus disease left the Mangina treatment center, in the sub-coordination of Mabalako, 30 Kms north of Beni-ville (North Kivu), this Tuesday, December 31, 2019. 

The healed victims include 5 women and 3 men. They all came from the health area of Aloya and Bingo, in the province of Ituri (northeast of the DRC). The latter were, after discharge, reintegrated into the community.   

The Mangina sub-coordination team urges residents to trust health experts to eradicate this lethal epidemic.    

“At the end of the year, we have just discharged 8 healers. The 8 people enter the list of Ebola winners. It's really a big party, because it's really an important number. It is a message to the community to say that coming to the CTE is not synonymous with death,” said N'saka Bill Faustin, president of the Mangina sub-coordination.   

In North Kivu as in Ituri, the Ebola epidemic is declining. Last Wednesday, 5 people had left the Mangina treatment center. The latter had just spent more than 10 days in this health facility. 

DRC Ebola: CMRE update, December 30 December

CMRE has published Situation épidémiologique du 30 décembre 2019. Excerpt from the Google translation:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH AND SOUTH KIVU AND ITURI AT 29  DECEMBER 2019   

Monday, December 30, 2019 

Since the start of the epidemic, the cumulative number of cases has been 3,376, of which 3,258 confirmed and 118 probable. In total, there were 2,232 deaths (2,114 confirmed and 118 probable) and 1,106 people healed. 

• 443 suspected cases under investigation; 

• 2 new cases confirmed in North Kivu, including 1 in Katwa and 1 in Mabalako; 

• No new deaths from confirmed cases, including: 

o No community deaths have been recorded; 

o No death among the confirmed cases; 

• 1 healed person leaving the CTE in North Kivu in Beni;  

• No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 164 (approximately 5% of all confirmed / probable cases), including 41 deaths; 

• Katwa again reported a confirmed case after 88 days of silence.

The data presented in this table are likely to change later, after in-depth investigations and after redistribution of cases and deaths in their respective health zones. 

NEWS  

NOTHING TO REPORT 

VACCINATION  

• 4,068 people were vaccinated, until December 26, 2019, with the 2nd vaccine Ad26.ZEBOV / MVA-BN-Filo (Johnson & Johnson) in the two health areas from Karisimbi to Goma; 

• Since the start of vaccination on August 8, 2018 with the rVSV-ZEBOV vaccine, 260,063  people have been vaccinated; 

• Approved on October 22, 2019 by the Ethics Committee of the School of Public Health at the University of Kinshasa and on October 23, 2019 by the National Ethics Committee, the second vaccine, called Ad26.ZEBOV / MVA-BN -Filo, is produced by the firm Janssen Pharmaceuticals for the company Johnson & Johnson; 

• This new vaccine complements the first, rVSV-ZEBOV, a vaccine used until then (since August 08, 2018) in this epidemic manufactured by the pharmaceutical group Merck, after approval by the Ethics Committee on May 20, 2018. It was recently pre-qualified for certification.   

ENTRY POINT SURVEILLANCE  

• Since the start of the epidemic, the cumulative number of travelers checked (temperature taken) at health checkpoints is 133,025,864 ;   

• To date, a total of 109 entry points (PoE) and health control points (PoC) have been established in the provinces of North Kivu and Ituri in order to protect the country's major cities and avoid the spread of the epidemic in neighboring countries.

The history of measles: From a 1912 genome to an antique origin

Via bioRxiv: The history of measles: from a 1912 genome to an antique origin. Abstract:

Many infectious diseases are thought to have emerged in humans after the Neolithic revolution. While it is broadly accepted that this also applies to measles, the exact date of emergence for this disease is controversial. Here, we sequenced the genome of a 1912 measles virus and used selection-aware molecular clock modeling to determine the divergence date of measles virus and rinderpest virus. This divergence date represents the earliest possible date for the establishment of measles in human populations. 

Our analyses show that the measles virus potentially arose as early as the 4th century BCE, rekindling the recently challenged hypothesis of an antique origin of this disease.

See this excellent article by Kai Kupferschmidt in Science for a discussion of the study.

Canada: How the opioid crisis is hammering BC’s north

Via The Tyee: How the Opioid Crisis Is Hammering BC’s North. Excerpt:

Quesnel seems like the kind of small town you’d pick to raise a family or retire.

The community of about 10,000 people on the Fraser River is surrounded by forests and mountains — a place to escape big city problems.  

But Maclean’s magazine says Quesnel’s crime stats make it the third most dangerous place to live in Canada.  

Two years ago, the community about 120 kilometres south of Prince George didn’t even make the magazine’s list of the most dangerous 229 communities. 

People told The Tyee they hardly recognize the town, which — like many communities across the north — has been grappling with a spike in crime and drug use.

“People are living in fear and are reluctant to come downtown or leave their homes,” said Debra McKelvie, who owns a floral shop in the city’s downtown. “We are faced with aggressive panhandling, being followed into our banks and having our windows smashed out of our vehicles by addicts looking for anything of value to fuel their drug habits.  

“We have a lovely downtown, and we’re trying desperately to hang onto it.”  

In Quesnel, crimes like drug trafficking, robbery and breaking and entering have risen to three to four times the national average. Three other northern B.C. communities placed high on the Maclean’s list of most dangerous communities — Terrace at 11, Prince George at 14, and Prince Rupert at 20.  

Northern and Interior communities are struggling with the opioid crisis and resulting crime and homelessness. 

The public and media focus has been on Vancouver. But Northern Health and the Vancouver Coastal Health Authority had almost the same rate of illicit drug deaths in the first 10 months of 2019, according to the BC Coroners Service. 

In Quesnel, McKelvie and other residents have formed Quesnel in Action, a citizens’ group calling for increased services for addiction and mental health. The group has held two recent rallies and collected more than 900 letters from concerned residents, which have been forwarded to federal and provincial governments.  

“My place of business has been broken into,” she says. “The business community is getting hit the worst. I can’t think of any business that hasn’t been broken into or that somebody hasn’t attempted to break into.”  

Melanie MacDonald is the executive director for Quesnel Shelter and Support Society and works directly with Quesnel’s homeless population through the Seasons House emergency shelter. She cautions against linking the entire homeless population with drugs and crime. But the impacts of the opioid crisis can’t be ignored, she says.