While the declining trend in new plague case reports and reduction in hospitalizations due to plague is encouraging, WHO expects more cases of plague to be reported from Madagascar until the typical plague season ends in April 2018. Sustaining ongoing operations, including active case finding and treatment, comprehensive contact identification, follow-up and antibiotic treatment, rodent and flea control, and safe and dignified burials is crucial during the outbreak and through the plague season as it is critical to minimize bubonic plague infections and human-to-human transmission of pneumonic plague.Based on available information and response measures implemented to date, WHO estimates the risk of potential further spread of the plague outbreak at national level remains high.
Source: WHO | Plague – Madagascar
Current risk assessmentThe risk assessment is in the process of being reviewed based on the evolving situation. While the current outbreak began with one large epidemiologically linked cluster, cases of pneumonic plague without apparent epidemiologic links have since been detected in regions across Madagascar, including the densely populated cities of Antananarivo in the central highlands and Toamasina on the east coast of Madagascar. Due to the increased risk of further spread and the severe nature of the disease, the overall risk at the national level is considered very high.
Source: Avian Flu Diary: WHO SitRep #7: Plague In Madagascar
The Ebola epidemic in West Africa may have surprised most of the medical establishment – this is the first such outbreak in the region – but the risk had been steadily rising for at least a decade. The risk had grown so high, in fact, that this outbreak was almost inevitable and very possibly predictable.All that was needed was to see the danger was a bat’s eye view of the region. Once blanketed with forests, West Africa has been skinned alive over the last decade. Guinea’s rainforests have been reduced by 80%, while Liberia has sold logging rights to over half its forests. Within the next few years Sierra Leone is on track to be completely deforested.This matters because those forests were habitat for fruit bats, Ebola’s reservoir host. With their homes cut down around them, the bats are concentrating into the remnants of their once-abundant habitat. At the same time, mining has become big business in the region, employing thousands of workers who regularly travel into bat territory to get to the mines.
Source: How saving West African forests might have prevented the Ebola epidemic | Vital Signs | The Guardian
We’ve a new update from the Madagascar MOH on their ongoing plague outbreak – that while dated the 13th – is a summary of activity through the 12th. The trajectory of the outbreak continues to be concerning, with 561 cases now reported across 35 districts Remarkably, of those, 415 (74%) are pneumonic plague, which is normally a relatively rare presentation which spreads as a respiratory illness. Updates from the MOH are in French, and are often presented in formats that make machine translation difficult, but we can piece together the gist from the following PDF file.
Source: Avian Flu Diary: Madagascar: Pneumonic Plague Update From the MOH
On 23 August 2017, a 31-year-old male from Tamatave, visiting Ankazobe District in central highlands, developed malaria-like symptoms. On 27 August, he developed respiratory symptoms during his journey in a shared public taxi from Ankazobe District to Tamatave (via Antananarivo). His condition worsened and he died. His body was prepared for a funeral at the nearest hospital, Moramanga District Hospital, without safety procedures. Additionally, 31 people who came into contact with this case either through direct contact with the primary case or had other epidemiological links, became ill, and four cases of them died.The outbreak was detected on 11 September, following the death of a 47-year-old woman from Antananarivo, who was admitted to a hospital with respiratory failure caused by pneumonic plague. The public health authorities Direction de la Veille Sanitaire et de la Surveillance Epidémiologique (DVSSE) immediately launched field investigations.As of 28 September 2017, a total of 51 cases (suspected, probable and confirmed) of pneumonic plague, including 12 deaths were reported in the country. The diagnosis was confirmed by the Institut Pasteur de Madagascar by polymerase chain reaction test and using rapid diagnostic test.In addition to the 51 suspected, probable and confirmed cases of pneumonic plague, and during the same period another 53 cases of bubonic plague including seven deaths have been reported throughout the country. One case of septicaemic plague has also been identified and they were not directly linked to the outbreak.
Source: WHO | Plague – Madagascar
About 75% of counties on the US mainland have suitable habitat for Aedes mosquitoes, CDC researchers say.
Source: New US mosquito maps show potential hot spots for Zika, other diseases | CIDRAP
You guys up north: get your Flu shot! It may not be perfect and it make take too long to make, but it will give you a very solid, safe and known chance of avoiding getting pretty sick, and making others very sick, from one of several Flu viruses circulating in your community this season. And do you know what the chance for protection is if you don’t get vaccinated at all? Zero percent.
Source: Inoreader – Flu is bad…in many ways…
San Diego County is experiencing the third worst hepatitis A outbreak in the nation since a vaccine was introduced. L.A. officials fear the outbreak is headed north.
Source: San Diego is struggling with a huge hepatitis A outbreak. Is it coming to L.A.? – LA Times
officials in San Diego have scrambled for months to contain an outbreak of hepatitis A — vaccinating more than 19,000 people, putting up posters at bus stations and distributing hand sanitizer and cleansing wipes.
Despite those efforts, 16 people have died of the highly contagious virus in San Diego County and hundreds have become ill in what officials say is the nation’s second-largest outbreak of hepatitis A in decades.
Earlier this month, San Diego officials declared a public health emergency.
Though Los Angeles has so far escaped an outbreak, public health officials are hoping to head off a similar emergency. They say the virus could easily spread to Los Angeles because of its proximity to San Diego and the region’s large homeless population.
“We know it’s getting worse in San Diego so we’re really ramping up,” said Cristin Mondy, the county’s area health officer for a region that includes downtown Los Angeles.
In their efforts to get their outbreak under control, San Diego health officials have adopted a technique from L.A. that they hope will stop cases from spreading locally: washing the streets with water containing bleach.
“They didn’t have any outbreaks. We did. So we were like, ‘What’s going on there?’ ” said San Diego County public health officer Dr. Wilma Wooten. “That’s what we wanted to replicate here.”
While the overall prevalence of hypervirulent, drug-resistant K pneumoniae in China appears to be low, Chen said, what he and his colleagues are worried about is that it will likely increase in Chinese hospitals, presenting clinicians with more severe infections that don’t respond to the current arsenal of antibiotics.But with few new antibiotics in the pipeline, physicians will be forced to keep using what they have, which will only hasten the further emergence of multidrug-resistant pathogens, said David van Duin, MD, PhD, an antimicrobial resistance researcher at the University of North Carolina School of Medicine. “Emergence of combined increased virulence and resistance will force doctors to treat patients even more broadly upfront with last-line antibiotics, thus inducing additional resistance,” he said.And if the rapid global spread of the resistance gene MCR-1 is any example, these types of infections won’t be limited to China. The plasmid-mediated gene, which confers resistance to the last-resort antibiotic colistin, was identified in Escherichia coli bacteria in China in 2015, and since then has been detected in more than 30 countries. Other antibiotic resistance genes have demonstrated similar ability to spread rapidly via horizontal gene transfer. The genes and plasmids, and the bacteria that carry them, know no boundaries.”Multidrug-resistant organisms in one part of the world are a threat to patients everywhere,” van Duin said.
Source: New Klebsiella strains ‘worst-case scenario,’ experts say | CIDRAP
“We now need to find how widespread hookworm is across the US,” said Dr Peter Hotez, dean of the National School of Tropical Medicine, who along with Rojelio Mejia led the research team. Hotez, who has estimated that as many as 12 million Americans could be suffering from neglected tropical diseases in poor parts of the south and midwest, told the Guardian the results were a wake-up call for the nation.“This is the inconvenient truth that nobody in America wants to talk about,” he said. “These people live in the southern United States, and nobody seems to care; they are poor, and nobody seems to care; and more often than not they are people of color, and nobody seems to care.”
Source: Hookworm, a disease of extreme poverty, is thriving in the US south. Why? | US news | The Guardian