Global & Disaster Medicine

Archive for August, 2017

Ben Taub Hospital & Hurricane Harvey

Chron

“As of Monday morning, Ben Taub Hospital had not evacuated any of its patients. A Sunday late-night attempt to transport some pediatric patients was aborted because hard rain raised water levels around the facility to too high a level. A spokesperson said officials were hopeful daylight and lowered water levels would make the transfer possible today.

Ben Taub Hospital has asked for ambulance buses to help evacuate patients, those in critical care first, because flooding in its some basement areas has left it with only a two-day supply of dry food…..”

 


Saudi MOH: ‘1 New Confirmed Corona Case Recorded’

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Local transmission of chikungunya has been confirmed in south eastern France

WHO 

Chikungunya – France

Disease outbreak news
25 August 2017

Local transmission of chikungunya has been confirmed in south eastern France, with four cases diagnosed in the Provence-Alpes-Côte d’Azur region as of 23 August 2017. In addition, there is one probable case, and eight suspected cases.

The date of onset of symptoms of the first confirmed case was 2 August 2017. All four confirmed and one probable case had symptom onset during the period, 2 to 17 August 2017.

All 13 patients (four confirmed, one probable and eight suspected) are aged between 3 to 77 years old, and they all are inhabitants of the same district of the commune of Cannet des Maures in Var department, as announced by the Regional Health Authority (ARS).

These are not the first reported cases of chikungunya in France. Two autochthonous cases were recorded in the same area in 2010 and 11 cases in Montpellier in 2014. Nevertheless, chikungunya is an emerging disease in southern Europe, and an outbreak is considered unexpected. The vector Aedes albopictus is establishing itself in large part of the Mediterranean basin and beyond.

Public health response by French national authorities

According to the national response plan, the following actions are being taken:

  • Vector control measures around the house and working locations of the patients.
  • Blood testing of any suspected case.
  • Risk communication as coordinated by the regional health agency.

The entomological investigation on 10 August 2017 confirmed the presence of Aedes albopictus in the affected area. In addition, blood collection has been postponed in the affected area.

WHO risk assessment

There is a potential risk for international spread.

This is based on:

  • Aedes albopictus being established throughout the Mediterranean basin.
  • This vector having demonstrated capacity to sustain outbreaks of chikungunya in the past.
  • The currently affected area being highly touristic particularly in summer months and close to the border with Italy (with established populations of Aedes albopictus).

Chikungunya transmission was reported for the first time in Europe in 2007, in an outbreak in north eastern Italy. There were 205 cases recorded during that outbreak and it confirmed that mosquito-borne outbreaks by Aedes albopictus are plausible in Europe.

Asymptomatic infection with chikungunya can go undetected and therefore also increases the risk for spread. Additionally, excess rainfall in the affected areas in the coming months, could trigger further increase in transmission as observed in 2014.

WHO advice

Prevention of mosquito bites

Basic precautions should be taken by people within and travelling to this area of France to prevent mosquito bites during the day. These include the use of repellents, wearing long sleeves and pants, and ensuring rooms are fitted with screens to prevent mosquitoes from entering.

Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET, IR3535, or Icaridin. People should sleep under a mosquito bed net and use air conditioning or window screens to prevent mosquito bites. Mosquito coils or other insecticide vaporizers may also reduce indoor biting.

Vector control

Aedes albopictus thrives in a wide range of water-filled containers, including tree-holes and rock pools, in addition to artificial containers such as unused vehicle tires, saucers beneath plant pots, rain water barrels and cisterns, and catch basins.

Prevention and control relies heavily on reducing the number of these water-filled container habitats that support breeding of the mosquitoes. During outbreaks, indoor space spraying with insecticides may be used to kill flying mosquitoes along with measures to kill the larvae.

WHO also encourages strengthening monitoring of the mosquitoes and implementation of additional control as and when needed through arboviral disease networks within Europe. Awareness should also be raised about re-emerging vector-borne diseases among physicians and through social mobilization efforts in affected communities.

Blood safety

National blood services and/or authorities should monitor epidemiological information and strengthen vigilance to identify any potential transmission of chikungunya virus via transfusion. Appropriate safety precautions in line with measures taken to prevent other mosquito-borne disease transmission via transfusion should be taken based on the epidemiological situation and risk assessment.


Houston: America’s fourth-largest city under threat as storm deluge drops more than 22in of rain in a day.

The Guardian

 

 


Thousands of people have fled their homes following two days of violence in a deepening crisis in the state of Rakhine in Myanmar.

BBC

“…..Fighting erupted when Rohingya fighters attacked 30 police stations on Friday and clashes continued on Saturday……”

 


Experiencing Hurricane Andrew: Eyewitness Account

Miami Herald, 1992

“…..One thing is gone: a trailer park, behind the motel. Pieces of it are lying everywhere. On the road. In the street. On the motel’s second floor terrace.

Alvarez and I go back to our original room, and find it totaled. The mattress is in the back parking lot. Our suitcases are missing.

In fact, we find most rooms everywhere are blown to bits. No ceilings. Only a few walls. Maybe four rooms survived. Luckily, we were in two of them…..”


Active Shooter & Bronx-Lebanon Hospital: A crucial trial run for the new antiterrorism tactics including a system in which armed officers escort paramedics to the periphery of mass shootings to save bleeding victims; the fast response of elite officers armed with long guns (180 police vehicles arrived at the hospital in minutes); and a new doctrine in which the first officer on the scene goes in fighting, no matter what.

NY Times

 


The U.S. Department of Agriculture(USDA) Prepares for Hurricane Harvey

USDA

USDA Prepares for Hurricane Harvey

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Release No. 0091.17

Contact: USDA Press Office
Phone: (202) 720-4623
Email: press@oc.usda.gov

USDA Prepares for Hurricane Harvey

USDA Reminds Individuals and Small Businesses that USDA Offers Disaster Assistance Programs to Help

 

WASHINGTON, Aug. 25, 2017 – The U.S. Department of Agriculture(USDA) reminds rural communities, farmers and ranchers, families and small businesses in the path of Hurricane Harvey that USDA has programs that provide assistance before, during and after disasters. USDA staff in the regional, State and county offices in Texas and Louisiana are ready to help.

“American farmers and ranchers can handle adversity, and USDA is here with resources so they don’t have to go it alone. Our thoughts and prayers are with those preparing for Hurricane Harvey to make landfall, and USDA stands with them and is ready to assist in any way we can. We have USDA employees in every county in this nation, and our people can help with a variety of services that may be useful in natural disasters like this one,” said Agriculture Secretary Sonny Perdue.

USDA’s Operations Center is activated 24/7 keeping the Secretary and USDA’s leadership team informed. An Incident Management Team stood up today and will remain in effect thorough the incident. USDA has important roles in both response and recovery to hurricanes and stands ready to support the American people who rely on it each day.

In a continuing effort to better serve the public, USDA partnered with the Federal Emergency Management Agency and other disaster-focused organizations and created the Disaster Resource Center (https://www.usda.gov/topics/disaster) website. This central source of information utilizes a searchable knowledgebase of disaster-related resources that are powered by agents with subject-matter expertise. The new Disaster Resource Center website and web tool now provide an easy access point to find USDA disaster information and assistance.

USDA also encourages residents and small businesses in the potential impact zones to contact the following offices to meet their individual needs:

Property and Shelter

When floods destroy or severely damage residential property, USDA Rural Development can assist with providing priority hardship application processing for single family housing. If a disaster designation is declared, USDA, USDA Rural Development can issue a priority letter for next available multi-family housing units. While these programs do not normally have disaster assistance authority, many of USDA Rural Development programs can help provide financial relief to small businesses hit by natural disasters, including low-interest loans to community facilities, water environmental programs, businesses and cooperatives and to rural utilities. More information can be found on the Rural Development website or by contacting the State Offices.

Food Safety and Food Assistance

Severe weather forecasts often present the possibility of power outages that could compromise the safety of stored food. The USDA Food Safety and Inspection Service (FSIS) recommends that consumers take the necessary steps before, during, and after a power outage to reduce food waste and minimize the risk of foodborne illness. FSIS offers tips for keeping frozen and refrigerated food safe and a brochure that can be downloaded and printed for reference at home. If you have questions about the safety of food in your home, call the USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) on weekdays from 10 a.m. to 4 p.m. ET or visit AskKaren.gov to chat live with a food safety specialist, available in English and Spanish.

Owners of meat and poultry producing businesses who have questions or concerns may contact the FSIS Small Plant Help Desk by phone at 1-877-FSIS-HELP (1-877-374-7435), by email at infosource@fsis.usda.gov, or 24/7 online at http://www.fsis.usda.gov/wps/portal/fsis/topics/regulatory-compliance/svsp/sphelpdesk.

The USDA Food and Nutrition Service (FNS) coordinates with state, local and voluntary organizations to provide food for shelters and other mass feeding sites. Under certain circumstances, states also may request to operate a disaster household distribution program to distribute USDA Foods directly to households in need. In addition, FNS may approve a state’s request to implement a Disaster Supplemental Nutrition Assistance Program (SNAP) when the President declares a major disaster for individual assistance under the Stafford Act in areas affected by a disaster. State agencies may also request a number of disaster-related SNAP waivers to help provide temporary assistance to impacted households already receiving SNAP benefits at the time of the disaster. Resources for disaster feeding partners as well as available FNS disaster nutrition assistance can be found on the FNS Disaster Assistance website.

Crop and Livestock Loss

The USDA Farm Service Agency (FSA) administers many safety-net programs to help producers recover from eligible losses, including the Livestock Indemnity Program, the Emergency Assistance for Livestock, Honeybees, and Farm-Raised Fish ProgramEmergency Forest Restoration Program (EFRP) and the Tree Assistance Program. The FSA Emergency Conservation Program provides funding and technical assistance for farmers and ranchers to rehabilitate farmland damaged by natural disasters. Producers located in counties that received a primary or contiguous disaster designation are eligible for low-interest emergency loans to help them recover from production and physical losses. Compensation also is available to producers who purchased coverage through the Noninsured Crop Disaster Assistance Program, which protects non-insurable crops against natural disasters that result in lower yields, crop losses or prevented planting. USDA encourages farmers and ranchers to contact their local FSA office to learn what documents can help the local office expedite assistance, such as farm records, receipts and pictures of damages or losses.

Producers with coverage through the RMA administered federal crop insurance program should contact their crop insurance agent. Those who purchased crop insurance will be paid for covered losses. Producers should report crop damage within 72 hours of damage discovery and follow up in writing within 15 days.

Community Recovery Resources

If a natural disasters that lead to imminent threats to life and property declaration is issued, the USDA Natural Resources Conservation Service (NRCS) can assist local government sponsors with the cost of implementing recovery efforts like debris removal and streambank stabilization to address natural resource concerns and hazards through the Emergency Watershed Protection Program. NRCS staff is coordinating with state partners to complete damage assessments in preparation for sponsor assistance requests. NRCS also can help producers with damaged agricultural lands caused by natural disasters such as floods. The NRCS Environmental Quality Incentives Program (EQIP) provides financial assistance to repair and prevent excessive soil erosion that can result from high rainfall events and flooding. Conservation practices supported through EQIP protect the land and aid in recovery, can build the natural resource base, and might help mitigate loss in future events.

USDA National Institute of Food and Agriculture provides support for disaster education through the Extension Disaster Education Network (EDEN). EDEN is a collaborative multi-state effort with land-grant universities and Cooperative Extension Services across the country, using research-based education and resources to improve the delivery of services to citizens affected by disasters. EDEN’s goal is to improve the nation’s ability to mitigate, prepare for, prevent, respond to and recover from disasters., EDEN equips county-based Extension educators to share research-based resources in local disaster management and recovery efforts. The EDEN website offers a searchable database of Extension professionals, resources, member universities and disaster agency websites, education materials to help people deal with a wide range of hazards, and food and agricultural defense educational resources.

For complete details and eligibility requirements regarding USDA’s disaster assistance programs, contact a local USDA Service Center (http://offices.sc.egov.usda.gov/locator/app). More information about USDA disaster assistance (PDF, 118 KB) (http://www.usda.gov/documents/fact-sheet-usda-programs-assist-individuals-small-businesses.pdf) (PDF, 118 KB) as well as other disaster resources is available on the USDA Disaster Resource Center website.

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West Texas Service Center map can be found at https://offices.sc.egov.usda.gov/locator/app?service=page/CountyMap&state=TX1&stateName=Western%20Texas&stateCode=48

East Texas Service Center map can be found at

https://offices.sc.egov.usda.gov/locator/app?service=page/CountyMap&state=TX2&stateName=Eastern%20Texas&stateCode=48

Louisiana Service Center map can be found at

https://offices.sc.egov.usda.gov/locator/app?service=page/CountyMap&state=LA&stateName=Louisiana&stateCode=22

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How do Hurricanes form?

https://nyti.ms/2jVsLwM

https://nyti.ms/2vy5k1b

 

 


Making landfall……

According to the NHC website, the eye of Hurricane Harvey hit between Port Aranas and Port O’Connor, Texas. It warns that “catastrophic flooding” is expected, with some locales getting as much as 40 inches of rain through the middle of next week. ….


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