Global & Disaster Medicine

Hagibis now a tropical depression

CNN

“……The storm made landfall just before 7 p.m. Saturday local time on the Izu Peninsula, southwest of Tokyo, bringing hurricane-force winds and heavy rains which led to widespread flooding. More than 230,000 people were evacuated ahead of the storm, with emergency orders issued for many cities around the greater Tokyo area.

Along with the 15 deaths, Japan’s Fire Disaster and Management Agency said about 140 people had been injured and nine remain missing…..”

One person is still missing after a Hard Rock Hotel collapse in New Orleans kills 2 and injures 18


Hagibis pummels Japan: four deaths, millions under evacuation warnings, rivers flooded and normally busy streets deserted.


10/12/1918: The 1918 Moose Lake/Cloquet fire rages through Minnesota, killing hundreds of people and leaving thousands homeles


Here comes Hagibis


LA Wildfires: 2 dead and 100000 evacuated


New: The Saddleridge Fire


Significant Hazards For Three Areas of the U.S.

National Weather Outlook

SPC Products Overview

Northeast sector loop

Risk Area (sq. mi.) Area Pop. Some Larger Population Centers in Risk Area
Extreme 6,031 2,978,087 San Bernardino, CA…Fontana, CA…Santa Clarita, CA…Rancho Cucamonga, CA…Thousand Oaks, CA…
Critical 9,671 4,672,773 Riverside, CA…Glendale, CA…Oxnard, CA…Ontario, CA…Moreno Valley, CA…

Fatal Visceral Leishmaniasis–like Disease

Maruyama et al. Non-Leishmania Parasite in Fatal Visceral Leishmaniasis–like Disease, Brazil. Emerging Infectious Diseases DOI: 10.3201/eid2511.181548 (2019).

“…..During 2011–2012, we characterized 2 parasite strains, LVH60 and LVH60a, isolated from an HIV-negative man when he was 64 years old and 65 years old (Table; Appendix). Treatment-refractory VL-like disease developed in the man; signs and symptoms consisted of weight loss, fever, anemia, low leukocyte and platelet counts, and severe liver and spleen enlargements. VL was confirmed by light microscopic examination of amastigotes in bone marrow aspirates and promastigotes in culture upon parasite isolation and by a positive rK39 serologic test results. Three courses of liposomal amphotericin B resulted in no response. At the third hospital admission, the illness resembled diffuse cutaneous leishmaniasis, in which several disseminated papular skin lesions were observed (Appendix Figure 1, panel A), and a skin biopsy revealed macrophages filled with amastigotes (Appendix Figure 1, panel B), which his liver biopsy results also showed (Appendix Figure 1, panel C). During this third admission, the LVH60a strain was isolated from the skin. Dermal lesions known as post–kala-azar dermal leishmaniasis (PKDL) have rarely been reported in Brazil (13), and the clinical aspect of the disseminated papular skin lesions on this patient differed from the clinical presentation of PKDL. Because his illness did not respond to therapy, the patient underwent splenectomy. He died of disease and surgical complications...…”

Experimental infection of BALB/c mice with LVH60 and LVH60a clinical isolates obtained from a 64-year-old man with fatal visceral leishmaniasis–like illness, Brazil. LVH60 was isolated from bone marrow, LVH60a from a skin lesion biopsy. Female BALB/c mice were infected intravenously with 107 stationary-phase promastigotes. After 4 weeks of infection, spleen and liver samples were collected. Parasite loads were determined by a limiting dilution assay of spleen and liver homogenates and are expres


Melioidosis & Hurricanes

Guendel I, Ekpo LL, Hinkle MK, Harrison CJ, Blaney DD, et al.:
Melioidosis after Hurricanes Irma and Maria, St. Thomas/St. John
District, US Virgin Islands, October 2017. Emerg Infect Dis. 2019;
25(10): 1952-1955. doi: 10.3201/eid2510.180959.
“…..Furthermore, emergence of melioidosis after extreme weather events has been well documented, and cases were likely acquired locally from storm-related exposure to flooded soil, surface water runoff, or generation of coarse aerosols….”
Cutaneous melioidosis lesion in case-patient 1 after hurricanes Irma and Maria, St. Thomas/St. John District, US Virgin Islands, October 2017. This lesion was on the left anterior thigh and had a diameter of 2 cm. Shown is a tender, shallow, ulcer productive of purulent material surrounding by erythema and a focal area of induration. Scale bar indicates 1 cm.
Cutaneous melioidosis lesion in case-patient 1 after Hurricanes Irma and Maria, St. Thomas/St. John District, US Virgin Islands, October 2017. This lesion was on the left anterior thigh and had a diameter of 2 cm. Shown is a tender, shallow, ulcer productive of purulent material surrounded by erythema and a focal area of induration. Scale bar indicates 1 cm.
https://youtu.be/dDYurfzVdYQ
https://www.youtube.com/watch?v=HGi9q2XJMt8
https://youtu.be/dDYurfzVdYQ?t=6

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