Tag Archives: pandemic

Seychelles MOH: Update On Plague Alert

Public health is hard and complex.

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Unlike in Madagascar, where the number of confirmed and suspected plague cases is approaching 700, the news from the Seychelles continues to be positive. 

After their  MOH  Reported 1 Imported Plague Case ex Madagascar early last week we’ve seen an aggressive public health response (see Seychelles Implements New Measures Against Pneumonic Plague) and so far, at least – no additional confirmed cases have been reported. 

As the following update (released about 6am EST today) from the Seychelles MOH describes, new arrivals are being screened, hundred of contacts are being monitored and are receiving prophylactic antibiotics.

Press Release: Update on Plague Alert

The multisectoral IDSR committee met again this morning Saturday to discuss the current alert on the plague. The outbreak in Madagascar is expanding into new districts with new cases and deaths reported daily. 

Suspected Case update (A total of 13 people remain admitted in isolation)

  • •The index patient (probable case) is still admitted on the hospital ward and has no symptoms and is stable. Today is the 6th day of treatment and as per clinical guidelines, the patient is no longer infectious. He remains to complete his antibiotic course
  • •The other eleven (11) patients in the hospital remain stable on treatment and asymptomatic. This includes the foreign national.
  • •One person was admitted yesterday with relatively mild symptoms; dry cough and history of fever. She is asymptomatic today.
  • Contact tracing and surveillance
  • •None of the 320 contacts (which include mostly teachers) related to the probable case and receiving antibiotic prophylaxis has developed symptoms. They are all off surveillance as of today. They however need to complete the antibiotic prophylaxis course.
  • •The total number of people admitted at the military academy for active surveillance are 19. None of them have developed any symptoms.

– Eleven (11) family members of the first probable case, presently at Perseverance military training academy will be discharged home tomorrow at 10:00 am if no one develop symptoms.

– One (1) family member on active surveillance at Baie St Anne Praslin hospital

-Three (3) Seychellois nationals returned from Madagascar via Nairobi on 12th October. They remain well and are receiving prophylaxis.

-Two (2) Italians who arrived on 12th October will be leaving Seychelles tonight

-Two (2) Australian and one (1) Japanese arrived last night from Mauritius after having spent time in Madagascar. The Japanese will leave the country tomorrow and the Australians will remain in active surveillance for 7 days before being released on 20th Oct if they do not develop any symptoms to continue their holiday until 29th October.

•A total 577 children and 63, (640) teachers at Anse Boileau Primary School and crèche have been given antibiotic prophylaxis. This is a precautionary measure in view of a potential contact with an admitted child.

•Should anyone who is on prophylaxis develop fever, cough or other symptoms, they should contact their health centre, the Hotline 141 or Dr Jastin Bibi on 2723739 or Dr Naomi Adeline 2711818

•Regional Health facilities (Beau Vallon, English River, Les Mamelles, Anse Boileau health centres and Anse Royale and Baie Ste Anne Hospitals) are being used to assess contact and provide prophylaxis.

•The PHA is reinforcing the advisory to prevent people to travel to Madagascar for the time being.

•Hotline 141 is active and people can call for information and advice.


Early Reports of Flu From Around The Country

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Credit CDC  – PDF Guide

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Even though it is still only late September, we are already beginning to see scattered reports of seasonal influenza across the country – easily a month earlier than usual. A few headlines from the past 24 hours (excluding the swine variant outbreak in Maryland) include:

Officials urge influenza vaccination as Colorado sees early uptick in hospitalizations – The Denver Channel

Doctors say flu season is starting earlier than usual – kgw.com ·Portland OR

An Early Start To The Flu Season | Husker Radio – Nebraska

No children under 12 allowed on Children’s Hospital patient floors starting Oct. 1 – Birmingham AL

While seasonal influenza’s peak may still be months away, it is not too early to get the flu shot – it takes two weeks to kick in – and to start taking winter flu hygiene (covering coughs, washing/sanitizing hands, staying home when sick) seriously.

We’ve seen a good deal of speculation over what kind of flu season the Northern Hemisphere can expect after the recent particularly rough flu epidemics in Australia, Hong Kong, and Southern China (see UK: NHS Warns Of A Potentially Rough Flu Season Ahead), although in truth, flu is not easily predicted.

What we do know is that H3N2 appears to be the dominant subtype right now, and years where H3N2 dominates tend to be more severe – particularly for those over the age of 65.  We also know we are coming off two relatively moderate flu seasons (see chart below), and acquired community immunity may be a bit low.

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Credit CDC FluView

Despite our fixation with novel flu viruses, plain old seasonal flu kills as many as a half million people each year, and its severity can vary by more than 10-fold from one year to the next ( see MMWR: Estimates Of Yearly Seasonal Influenza Deaths).  From that 2010 report, we get estimates for the United States.

For deaths with underlying pneumonia and influenza causes (the most narrow definition of flu-related fatalities used) the models estimated a yearly average of 6,309 (range: 961 in 1986–87 to 14,715 in 2003–04) influenza-associated deaths.

Using a broader criteria (underlying respiratory and circulatory causes including pneumonia and influenza causes)  the models estimated an annual average of 23,607 (range: 3,349 in 1986–87 to 48,614 in 2003–04) influenza-associated deaths.

Seasonal flu viruses are also capable of picking up enhanced virulence due to small evolutionary changes (see EID Journal: Emergence of D225G Variant A/H1N1, 2013–14 Flu Season, Florida and When Influenza Goes Rogue), sometimes resulting in pockets of more severe disease around the world.

Simply put, the severity of the flu that arrives in Chicago or Miami this winter may differ greatly from what arrives in London, Moscow, or even Los Angeles.  

A few years ago the Census bureau reported that 1 in 4 households had just a single occupant – greater than at any time in the past century.

Currently, more than 32 million Americans live alone (see chart below), and while many of those are younger people who are waiting later to get married, a side effect of our longer lifespan and high divorce rate is that many of these single households are held by those over the age of 65.

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Whether we live alone by choice or by happenstance, we all share a common vulnerability.  If we get sick, or injured, there may be no one around to notice, or to help.

As a paramedic I saw a significant number of people who lived alone who either died, or spend miserable hours or even days incapacitated and unable to call for help, due to an illness or accident.

Another vulnerable group are households with only 1 adult, and minor children.  This too is a growing demographic, with more than 5 million households falling into that category.  If the adult falls seriously ill, then even more are potentially at risk.

Because of this, starting in 2007 I floated the idea of having `flu buddies’  –   someone you can call if you get sick, who will then check on you every day (by phone or in person), fetch food or medicines for you,  and who can call for medical help if your condition deteriorates. 

While I originally envisioned this for a pandemic scenario, it is just as valid and equally  important for those who live alone during regular flu seasons.

While we all hope this year’s flu season won’t be anything out of the ordinary, we can do things now – like getting the flu shot, practicing good flu hygiene, and being and having one or more `flu buddies’ – to reduce the impact should things turn out differently.

Guillain-Barré syndrome – France – French Polynesia

On 24 November 2015, health authorities in French Polynesia reported unknown and unspecified causes of morbidity and mortality in the context of concomitant outbreaks of Zika and dengue (serotypes 1 and 3) viruses. This update provides additional information on the clinical findings as well as the epidemiological and laboratory investigations of these cases.

Between October 2013 and April 2014, French Polynesia experienced the largest Zika virus outbreak ever recorded in the country. During this period of time, 32,000 patients (11.5% of the population) were assessed for the infection and 8,750 suspected cases were reported by the national surveillance system. Of the suspected cases, 383 were later laboratory-confirmed by reverse transcription polymerase chain reaction (RT-PCR).

State laws heighten influenza vaccination rates among health care workers

A new study from the University of Pittsburgh School of Medicine shows that state laws requiring health care works to receive their influenza vaccines can raise vaccination rates.

Between 2000 and 2005, New Hampshire and Maine were the only two states with flu vaccine requirement laws specifically for people working in the health care industry. In those five years, health care workers had a 22.5 percent average for their influenza vaccination rates.

Between 2006 and 2011, 19 other states added state laws for influenza vaccination requirements. When this happened, health care workers had a 50.9

percent average for influenza vaccination.

“Flu vaccination for all health care workers has long been recommended as one of the most effective ways to avoid infecting vulnerable patients with influenza, which kills thousands of people every year,” Dr. Chyongchiou Jeng Lin, lead author and associate professor in Pitt’s Department of Family Medicine, said. “State laws mandating that health care workers get flu vaccinations are an effective method to potentially save lives.”

The study, available in the Journal of the National Medical Association, analyzed influenza vaccination rates between 2000 and 2011. The researchers made scores for each of the states determined according to the law’s rigor.

“We’re finding that the higher the score — meaning the state has a law and includes components like a mandate or education — the greater the probability that the vaccination rate among health care workers will be higher,” Lin said.