AFRICA/EGYPT – Copt Organisation asks President al Sisi to grant an amnesty to Copt youths wrongly condemned for offending Islam

Cairo – Karim Kamal, founder of the Union General of Copts for the Motherland, has asked the President of Egypt Abdel Fattah al Sisi to intervene regarding the case of a group of Copt youths recently accused of verbally offending Islam and sentenced to five years in prison. Kamal urges Egypt’s Head of State to grant amnesty to the young men in question. But the request, made public in the Egyptian media, also expresses harsh criticism of the law on blasphemy and offence to religion, misused to persecute innocent people, while extremists and fomenters of religious hatred go unpunished.
The case in question in the appeal addressed to al Sisi involves four Copt students charged with offending the Islamic religion, by sharing in the Spring of 2015 a video-clip of a few seconds, recorded on a mobile phone, in which they mime the scene of the slitting of the throat of a Muslim in prayer, imitating the horrendous executions carried out by Jihadists of the self-proclaimed Islamic State . At the end of February the Egyptian court in Minya issued a heavy sentence to the young men: three will serve five years in prison, and the fourth, not yet eighteen years old, will be sent to a guarded residence for minor offenders. .

Yehuda Glick invades Al-Aqsa after court ban lifted, Tuesday morning

PNN/Jerusalem

Israeli right-winger Yehuda Glick, known as the head of the Temple Mount Faithful group, was escorted – together with other settlers – under Israeli armed protection into the Al-Aqsa Mosque compound, in Jerusalem, days after an Israeli court lifted an order barring him entry to the Islamic holy site.

A statement by Al-Aqsa Foundation for Endowment and Heritage said that the rabbi and the settlers stormed the compound entering through Al-Magharbeh gate, provocatively toured the yard and performed their Talmudic rituals.

“When an extremist like Glick storms Al-Aqsa Mosque, this stirs up troubles and provokes Muslims. We hold the Israeli police responsible for that,” the director of the compound, Sheikh Omaal-Kiswani said.

"Yehuda and I Shall Ascend the Temple Mount Again"“Yehuda and I Shall Ascend the Temple Mount Again”

In a a short post on his Facebook page, Glick said:

“One year, four months and a few days ago, after an assassination attempt against me, while I was still in a life-threatening, critical condition, [my wife] Yafi said in an interview (which became the [Yedioth] magazine’s front page) ‘Yehuda and I Shall Ascend the Temple Mount Again.’ Today, with a heart filled with gratitude, we fulfilled it.”

Last week, a Jerusalem court acquitted Glick of assault charges and removed the ban against his going to the Temple Mount, where he works as “tour guide”.

The prosecution indicted him for pushing a Muslim woman on the ground at the Al-Aqsa compound, breaking her hand.

The case fell apart when the prosecution suspected that the 67-year-old Palestinian Ziva Badarna’s testimony was fake.

According to Haaretz, Glick was barred from entering the Al-Aqsa compound after a Jerusalem District Court Judge said that his presence there was “inflammatory,” particularly since he was accused of assaulting a woman during one of his visits there.

The judge commented that “there is a risk of violence breaking out if the defendent returns to the compound before the end of legal proceedings in his case.”

Yehuda and his wife Tuesday morning.Yehuda and his wife Tuesday morning.

Despite the court ban, Glick was escorted inside the compound by Israeli guards a handful of times last year.

In 2014 he survived an attempt on his life by a gunman in a drive-by shooting in Jerusalem.

He was seriously wounded in the incident. A Palestinian man suspected of being behind the shooting was killed in shootout with with Israeli police a day later.

Glick leads Israel’s extremist “Temple Mount” movement, which calls for building a Jewish temple where the iconic Al-Aqsa Mosque now stands.

The Dome of the Rock — located in the Al-Aqsa Mosque compound — is the third holiest site in Islam.

At the same time, it is venerated as Judaism’s most holy place, as it sits where Jews believe the First and Second Temples once stood.

Zika virus infection – Saint Vincent and the Grenadines

On 25 February 2016, the National IHR Focal Point of Saint Vincent and the Grenadines notified PAHO/WHO of the country’s first case of Zika virus infection.

The patient is a 34-year-old female who visited on 16 February a health centre in Union Island after experiencing fever, headache, chills, cough and weakness of the lower extremities. She was kept for observation at the hospital overnight. The patient has no history of travel in the 30 days prior to being admitted to hospital. No clusters of febrile-like illness were noted on the island.

UK PHE: Updated Travel Advice For Pregnant Women Traveling To Areas With Zika Virus

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Credit CDC – Zika In The Americas

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While establishing a causal link between Zika and Microcephaly may still be months away, as more pregnant women are diagnosed with the infection (including via sexual transmission), some public health agencies around the world are doubling down on their travel advice for pregnant women.

Previously the UK `encouraged’ pregnant women to consider avoiding travel to areas where Zika is spreading, today they change that to recommending that pregnant women postpone non-essential travel to such areas until after pregnancy.

It’s an incremental change, signifying a ratcheting up of concern, but it also gives the PHE another opportunity to repeat the message, and their advice on avoiding the sexual transmission of the virus from male partners who have recently traveled to Zika prone areas.

Zika virus: updated travel advice for pregnant women

From: Public Health EnglandFirst published:1 March 2016

Pregnant women advised to postpone non-essential travel to areas with active Zika virus transmission.

Public Health England (PHE) and the National Travel Health Network and Centre (NaTHNaC) have been carefully monitoring the evolving Zika virus outbreak in South and Central America and the Caribbean and are now issuing updated travel advice for pregnant women and advice on preventing sexual transmission.

Travel and pregnancy

It is recommended that pregnant women should postpone non-essential travel to areas with active Zika transmission until after pregnancy. This is a change to the previous advice which encouraged pregnant women to consider avoiding travel and seek travel health advice.

In addition it is recommended that women should avoid becoming pregnant while travelling in an area with active Zika virus transmission, and for 28 days following return home. If a woman develops symptoms compatible with Zika virus infection on her return to the UK, it is recommended she avoids becoming pregnant for a further 28 days following recovery.

If a woman develops symptoms compatible with Zika virus infection on her return to the UK, it is recommended she avoids becoming pregnant for a further 28 days following recovery.

Advice has also been updated for healthcare professionals. In the event that travel to an area with current active Zika virus transmission cannot be postponed, the pregnant traveller or those planning pregnancy should discuss with their healthcare provider the risks which Zika may present. In addition, the use of scrupulous mosquito bite avoidance measures both during daytime and night time hours (but especially during mid-morning and late afternoon to dusk, when the mosquito is most active) should be emphasised, and an information leaflet provided.

Preventing sexual transmission

A number of cases of sexual transmission of Zika virus have been reported, and in a limited number of cases, the virus has been shown to be present in semen. The risk of sexual transmission of Zika virus is thought to be very low.

Our advice:

  • condom use is advised for male travellers if their partner is pregnant, during travel and for the duration of the pregnancy
  • if there is a risk of pregnancy, or pregnancy is planned, condom use is advised during travel and for 28 days on return from an active Zika transmission area if the male traveller does not have any symptoms compatible with Zika virus infection. If a clinical illness compatible with Zika virus infection has been suspected or confirmed, this advice should be followed for 6 months following the start of symptoms.
  • even if not pregnant or planning to be, couples who wish to reduce the very low risk of virus transmission may consider using condoms if the man has had clinical illness compatible with Zika infection

Lancet: Zika/GBS Case Control Study – French Polynesia

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Until it sparked a large outbreak on Yap Island in 2007, the Zika virus had kept a very low profile; causing sporadic and mild infections as it slowly spread out of Africa into equatorial Asia (India, Indonesia, Malaysia, Pakistan) during the 1970s and 1980s.

Yap Island (pop. 7,000) in the Western Pacific was the first large outbreak of Zika recorded, with more than 70% of the island’s population estimated to have been infected (see (see 2009 EID Journal Zika Virus Outside Africa by Edward B. Hayes), although no serious illness or deaths were reported. 

Zika re-emerged in 2013 in French Polynesia (pop. 276,000), and quite unexpectedly there, we began get reports of more severe illness associated with Zika infection (see Zika, Dengue & Unusual Rates Of Guillain Barre Syndrome In French Polynesia). The number of cases was small, but estimated to be 20 times greater (cite Eurosurveillance) than normal.

In 2015, when Zika began circulating widely in Brazil (and later spreading to much of South & Central America), we began to get similar reports of unexpectedly high GBS numbers in the region, although their association to Zika infection was far from established.

One of the tools epidemiologist’s use to find risks for a specific outcome is a case-control study, where they compare laboratory-confirmed cases to a large number of unaffected controls, matched for age, sex, and by neighborhood. 

While a case control study is not enough to prove causation, it can often provide compelling evidence of a link or an association between two or more events.

Although the exact cause of Guillain Barre Syndrome isn’t known, we do know it often follows an infection (bacterial or viral), and it has been seen in both Dengue and Chikungunya patients in the past. 

Last night the The Lancet published a case control study conducted in French Polynesia which finds additional evidence supporting the idea that Zika may cause Guillain Barre Syndrome.

The abstract may be read at the link above, while the full study can be downloaded as a  PDF (204 KB).


Nicely summarizing their findings, The Lancet published a press release yesterday, which also includes comments from an accompanying editorial comment (see Zika virus and Guillain-Barré syndrome: another viral cause to add to the list).

The Lancet: Zika virus might cause Guillain-Barré syndrome, according to new evidence from French Polynesia

The Lancet

Analysis of blood samples from 42 patients diagnosed with Guillain-Barré syndrome (GBS) during the Zika virus outbreak in French Polynesia provides the first evidence that Zika virus might cause GBS, a severe neurological disorder, according to new research published in The Lancet today. Based on the analysis of data from French Polynesia, if 100000 people were infected with Zika virus, 24 would develop GBS.

(SNIP)
 

The aim of the study was to determine the link between Zika virus infection and GBS. Since French Polynesia is also prone to outbreaks of dengue virus, the researchers also wanted to see whether dengue virus was an additional risk factor for GBS. 

All 42 patients with GBS diagnosed at the Centre Hospitalier de Polynésie Française in Papeete, Tahiti were included in the study. Researchers recruited two control groups. The first control group (CTR 1), matched for age, gender and island of residence, consisted of 98 patients who attended the same hospital but did not have a fever. The second control group (CTR 2) consisted of 70 patients who tested positive for Zika virus infection, but did not develop any of the neurological symptoms associated with GBS. Blood samples were collected from all patients. 

Most (88%) of the patients with GBS reported symptoms of Zika virus infection approximately 6 days before the onset of neurological symptoms. While none tested positive for a Zika virus infection once in hospital, blood tests showed that 41 (98%) were carrying Zika virus antibodies, and all (100%) had neutralizing antibodies against Zika virus. 

By comparison, only 54 (56%) of the patients without a fever (CTR 1 group) were carrying Zika virus neutralizing antibodies. Most patients with GBS (95.2%) had signs of past dengue virus infection, as did most patients in the two control groups (88.8% in CTL 1; 82.9% in CTL 2). The authors therefore concluded that, in this case, past infection with dengue virus did not increase the risk of GBS among patients infected with Zika virus. 

All 42 patients were diagnosed with a type of GBS called ‘acute-motor axonal neuropathy’ (AMAN), but few carried the biological markers typically associated with AMAN, suggesting a previously unknown disease mechanism. The patients in the study generally recovered faster than is usually expected with GBS.

Of the 42 patients with GBS, 16 (38%) were admitted to the hospital’s intensive care unit and 12 (29%) required breathing assistance. On average, patients were hospitalised for 11 days, but those in intensive care remained for longer (51 days). Three months after discharge, 24 (57%) patients were able to walk without assistance. No patients with GBS died.

(Continue . . .)

Interestingly, this study finds those affected had a type of GBS called acute-motor axonal neuropathy’ (AMAN), which is normally associated with pediatric cases in China.  The authors wrote:

No clear pathophysiological mechanism for the Guillain-Barré syndrome could be identified, because the typical AMAN-associated anti-ganglioside antibodies were rarely present.

The authors also looked for evidence that prior infection with Dengue might increase the risks of developing GBS, but found no evidence to support that idea.

Like all studies, this one suffered from some limitations.  It was relatively small, testing for Zika infection was retrospective, and based on ELISA testing for IgM and IgA antibodies, and not RT-PCR tests. 

 

Still, this adds to the evidence that Zika can, at least on rare occasions, cause serious illness.  We’ll need to get more information in order to know if GBS is more common with Zika infection than with other flavivirus infections like Dengue or Chikungunya.