Global & Disaster Medicine

Archive for August, 2017

While flooding is a natural disaster, the scale of the human tragedy in Freetown is very much man-made.

Amnesty International

‘…..“The authorities should have learned lessons from previous similar incidents and put in place systems to prevent, or at least minimise, the consequences of these disasters. Devastating floods are now an annual occurrence in the country’s capital. Yet, due to a lack of regulation and insufficient consideration for minimum standards and environmental laws, millions of Sierra Leoneans are living in dangerously vulnerable homes.”
The right to adequate housing under international law requires that every home be ‘habitable’, which includes providing protections against disasters such as this. However, poor regulation and failures to ensure environmental factors are part of urban planning in Sierra Leone often result in structures being built that are both unsafe and situated in dangerous locations…..’

 


2 killed and 6 others hospitalized in a stabbing attack in the Finnish city of Turku

CNN

https://www.youtube.com/watch?v=Xj2iOF359Wc

https://www.youtube.com/watch?v=42ktuyfsHCA

 

 


Fatal Terror Attack in Barcelona

https://nyti.ms/2v5sV9z

https://nyti.ms/2vIOakV

NY Times, 8/18/17

 

 


Barcelona: Police shoot dead 5 men in car also attacking pedestrians several hours after the Las Ramblas van attack

Washington Post

  • The 5 suspects in the nearby seaside resort of Cambrils tried to mow down pedestrians in the early hours of the morning
  • 1 a.m. on Friday, police responded to an attack near the boardwalk of the beach town of Cambrils, 60 miles southwest of Barcelona
  • An Audi had plowed into a crowd.
  • The police exchanged fire with the men in the car, killing four immediately while a fifth later died of his injuries. Six others were injured, including a police officer.
  • More than a hundred people from at least 24 nationalities were hurt and the death toll could rise above 13.

 


Barcelona, Spain: AT LEAST 13 DEAD, 100 HURT IN SPAIN TERROR ATTACK

CNN


With some 400 bodies recovered from the mudslides and flood that devastated Sierra Leone’s capital, Freetown, the dead are being buried in mass graves.

NY Times

https://www.youtube.com/watch?v=AI93gmMry0E

 


Konzo: An irreversible upper-motor neuron disorder affecting children dependent on bitter cassava for food.

Lancet

Cognitive and motor performance in Congolese children with konzo during 4 years of follow-up: a longitudinal analysis.  Boivin, Michael J et al.  The Lancet Global Health , Volume 5 , Issue 9 , e936 – e947

“…..Motor and cognitive performance continues to be significantly impaired in boys with konzo at 2-year follow-up compared with boys without konzo. Because these impairments are associated in part with exposure to poorly processed cassava as measured by urinary thiocyanate, interventions are urgently needed to ensure improved processing of cassava to detoxify this food source…..”


The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate locally acquired Cyclospora infections in three provinces.

PHAC

August 11, 2017 – Update

This notice has been updated to include 26 additional cases of locally acquired Cyclospora that have been added to the outbreak investigation.

Why should you take note?

The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate locally acquired Cyclospora infections in three provinces. The source of the outbreak has not been identified. Previous outbreaks in Canada and the United States (US) have been linked to imported fresh produce. The investigation is ongoing.

The risk to Canadians is low. Cyclospora is not found in water or food grown in Canada. The parasite is most common in some tropical and subtropical regions such as the Caribbean, South and Central America, South and South East Asia, the Middle East, and Africa. In Canada, non-travel-related illnesses due to Cyclospora occur more frequently in the spring and summer months. Illnesses among travellers can happen at any time of year. Cyclospora infections can be prevented by ensuring you are consuming fresh produce grown in countries where the parasite is not common, such as Canada, the US and European countries.

What is Cyclospora?

Cyclospora is a microscopic single-celled parasite that is passed in people’s feces. If it comes in contact with food or water, it can contaminate food and cause infection in the people who consume it. This causes an intestinal illness called cyclosporiasis. It is unlikely for Cyclospora to be passed from one person to another.

Investigation Summary

In Canada, a total of 130 cases have been reported in three provinces: British Columbia (13), Ontario (115) and Quebec (2). Individuals became sick between May and mid-July of this year. The majority of cases (53%) are male, with an average age of 47 years. The investigation into the source of the outbreak is ongoing. To date, no multi-jurisdictional outbreaks of Cyclospora have been linked to produce grown in Canada.

The outbreak investigation is active and the public health notice will be updated on a regular basis as the investigation evolves.

Who is most at risk?

People living or travelling in tropical or subtropical regions of the world who eat fresh produce or drink untreated water may be at increased risk for infection because the parasite is found in some of these regions.

Most people recover fully; however, it may take several weeks before an ill person’s intestinal problems completely disappear.

What should you do to protect your health?

It can be difficult to prevent cyclosporiasis. This is because washing produce does not always get rid of the Cyclospora parasite that causes the illness. You can reduce your risk by:

  • cooking produce imported from countries where Cyclospora is found; and
  • consuming fresh produce grown in countries where Cyclospora is not common, such as Canada, the United States and European countries.

When travelling to a region where Cyclospora is found,such as the Caribbean, South and Central America, South and South East Asia, the Middle East, and Africa, you can reduce your risk by:

  • avoiding food that has been washed in local drinking water;
  • drinking water from a safe source; and
  • eating cooked food or fruit that you can peel yourself.

What are the symptoms?

People infected with Cyclospora can experience a wide range of symptoms. Some do not get sick at all, while others may experience more severe symptoms. Few people get seriously ill.

Most people develop the following symptoms within one week after being infected with Cyclospora:

  • watery diarrhea
  • abdominal bloating and gas
  • fatigue (tiredness)
  • stomach cramps
  • loss of appetite
  • weight loss
  • mild fever
  • nausea

When you eat or drink contaminated food or water, it may take 7 to 14 days for symptoms to appear. If left untreated, you may have the symptoms for a few days to a few months. Most people have symptoms for 6 to 7 weeks. Symptoms may go away and then return.

If you become ill, drink plenty of water or fluids to prevent dehydration from diarrhea. If you have signs of illness and have reason to believe you have cyclosporiasis, contact your health care provider who may request a laboratory test to confirm the illness. Antibiotics may be given to treat the illness.

What the Government of Canada is doing?

The Government of Canada is committed to food safety. The Public Health Agency of Canada leads human health investigations of outbreaks and is in regular contact with its federal, provincial and territorial partners to monitor and take collaborative steps to address outbreaks.

Health Canada provides food-related health risk assessments to determine whether the presence of a certain substance or microorganism poses a health risk to consumers.

The Canadian Food Inspection Agency (CFIA) conducts food safety investigations into the possible food source of an outbreak.

The Government of Canada will continue to update Canadians if new information related to this investigation becomes available.

Additional information

Media Contact

Public Health Agency of Canada
Media Relations
(613) 957-2983


Somalia in crisis: Measles, Cholera, Drought, Famine

WHO

WHO and Federal Ministry of Health of Somalia call for urgent support to address measles outbreak in Somalia

16 August 2017 – As millions of people in Somalia remain trapped in a devastating cycle of hunger and disease, WHO and health partners are working with national health authorities to save lives and reach the most vulnerable with essential health services.

More than 2 years of insufficient rainfall and poor harvests have led to drought, food insecurity and a real risk of famine. Malnutrition, mass displacement as a result of the drought, and lack of access to clean water and sanitation have created ideal conditions for infectious disease outbreaks.

“Somalia is facing one of the worst humanitarian crises in the world. Millions of people, already on the brink of famine, are now at risk of rapidly spreading infectious diseases like cholera and measles. Normally, these diseases are easy to treat and prevent, but they can turn deadly when people are living in overcrowded spaces and are too weak to fight off infection,” said Dr Ghulam Popal, WHO Representative in Somalia.

Drought has led to a lack of clean water and the largest cholera outbreak in the last 5 years, with more than 57 000 cases and 809 cumulative deaths reported as of 31 July 2017. Health partners, together with national health authorities, scaled up its efforts to respond to this event by setting up cholera treatment centers in affected districts and providing support in water and sanitation to prevent the spread of the disease. In March, WHO and partners conducted Somalia’s first national oral cholera vaccination campaign, and successfully reached over 450 000 vulnerable people. Due to ongoing efforts, the number of cholera cases in Somalia has declined, from 13 656 cases of acute watery diarrhoea/cholera in May 2017 to 11 228 cases in June 2017.

Somalia is also facing its worst measles outbreak in 4 years, with over 14 823 suspected cases reported in 2017 (as of 31 July), compared to 5000–10 000 cases per year since 2014. The situation is especially critical for millions of under-vaccinated, weak and hungry children who are more susceptible to contracting infectious diseases. More than 80% of those affected by the current outbreak are children under 10 year of age.

In early 2017, WHO and partners, in collaboration with national health authorities, vaccinated almost 600 000 children aged 6 months to 5 years for measles in hard-to-reach and hotspot areas across the country. Despite these efforts, the transmission of measles continues, compounded by the ongoing pre-famine situation, continued mass displacement, and undernourished children living in unhygienic conditions.

In order to contain the outbreak, a nationwide campaign is planned for November 2017 to stop transmission of the disease, targeting 4.2 million children. The campaign will also intensify efforts to strengthen routine immunization and reach unvaccinated children to boost their immunity. As shown by the response to the cholera outbreak, with the right interventions, health authorities are confident that similar success may be seen in controlling the measles outbreak.

US$ 14.4 million (a cost of US$ 3.36 per child) is required by WHO and health partners to conduct the measles vaccination campaign in November 2017, of which WHO required US$ 6.8 million. To date, no funding has been received.


A 23-year-old Oklahoma man has been arrested after he tried to blow up a bank in downtown Oklahoma City using a vehicle bomb similar to the one that destroyed the federal building there in 1995

NY Times

 


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