Global & Disaster Medicine

Archive for October, 2018

CDC: So far in 2018, there are 72 confirmed cases of AFM.

CDC

Confirmed AFM cases reported to CDC: Aug-14 = 21, Sep-14 = 51, Oct-14 = 24, Nov-14 = 15, Dec-14 = 9, Jan-15 = 2, Feb-15 = 2, Mar-15 = 1, Apr-15 = 0, May-15 = 1, Jun-15 = 0, Jul-15 = 2, Aug-15 = 3, Sep-15 = 1, Oct-15 = 4, Nov-15 = 2, Dec-15 = 4, Jan-16 = 1, Feb-16 = 0, Mar-16 = 6, Apr-16 = 1, May-16 = 6, Jun-16 = 9, Jul-16 = 12, Aug-16 = 30, Sep-16 = 44, Oct-16 = 27, Nov-16 = 9, Dec-16 = 4, Jan-17 = 1, Feb-17 = 5, Mar-17 = 5, Apr-17 =3, May-17 =2, Jun-17 = 3, Jul-17 = 2, Aug-17 = 1, Sep-17 = 4, Oct-17 = 0, Nov-17 = 2, Dec-17 = 4, Jan-18 = 0, Feb-18 = 4, Mar-18 = 0, Apr-18 = 2, May-18 = 2, Jun-18 = 7, Jul-18 =6, Aug-18 = 18, Sep-18 = 23

At a Glance

  • CDC is concerned about AFM, a serious condition that causes weakness in the arms or legs.
  • From August 2014 through October 2018, CDC has received information on a total of 396 confirmed cases of AFM across the US; most of the cases have occurred in children.
  • Even with an increase in cases since 2014, AFM remains a very rare condition. Less than one in a million people in the United States get AFM each year.
  • While we don’t know the cause of most of the AFM cases, it’s always important to practice disease prevention steps, such as staying up-to-date on vaccines, washing your hands, and protecting yourself from mosquito bites.

Bangladesh: 12,764 new breast cancer patients are detected every year while the number of deaths from breast cancer is 6,846

Dhaka Tribune

“…..A recent survey of 246 patients by the National Institute of Cancer Research and Hospital medical oncology department,  social taboos and unawareness were the main reasons for unchecked breast cancer and delay in early detection.
The study found that 65.5% of breast cancer patients delayed their diagnosis by more than six months, although 83% of them found lumps in their breast  or had other symptoms of breast cancer…..”

 


Venice under water: Strong winds raised the water level over 5 feet before receding.


A 6.2-magnitude earthquake has struck central New Zealand, but no immediate reports of serious damage or injury.

Magnitude Mw 6.1
Region NORTH ISLAND OF NEW ZEALAND
Date time 2018-10-30 02:13:39.6 UTC
Location 39.06 S ; 175.00 E
Depth 225 km
Distances 248 km N of Wellington, New Zealand / pop: 382,000 / local time: 15:13:39.6 2018-10-30
79 km E of New Plymouth, New Zealand / pop: 49,200 / local time: 15:13:39.6 2018-10-30
67 km E of Waitara, New Zealand / pop: 6,400 / local time: 15:13:39.6 2018-10-30

Global view

The Guardian


Ebola Virus Outbreaks by Species and Size, Since 1976

Ebola Hemorrhagic Fever Distribution Map

aire ebolavirus, Bundibugyo ebolavirus, and Sudan ebolavirus are the three species of Ebola virus responsible for the larger outbreaks in Africa. Zaire ebolavirus, the most fatal Ebola virus, was associated with the 2014-2016 outbreak in West Africa, the largest Ebola outbreak to date with more than 28,600 cases. Other large outbreaks of Zaire ebolavirus have resulted in hundreds of cases in the Democratic Republic of the Congo (DRC) and Gabon. Smaller outbreaks of this species have also occurred in DRC and Gabon, as well as the Republic of the Congo and South Africa. Sudan ebolavirus, with a fatality rate of 50 percent, has been the cause of several outbreaks in Uganda and others near the border between South Sudan and DRC. Bundibugyo ebolavirus, discovered in 2007, was associated with two outbreaks, one in DRC and the other on the border of DRC and Uganda. Taï Forest ebolavirus, the only other Ebola virus found in West Africa to date, was the cause of one case identified in Côte d’Ivoire.

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Ebola Virus Outbreaks by Species and Size, Since 1976

Country Town Cases Deaths Species Year
Dem. Rep. of Congo Bikoro ongoing ongoing Zaire ebolavirus 2018
Dem. Rep. of Congo Likati 8 4 Zaire ebolavirus 2017
Dem. Rep. of Congo multiple 66 49 Zaire ebolavirus 2014
Multiple countries(https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html#areas) multiple 28652 11325 Zaire ebolavirus 2014-2016
Uganda Luwero District 6* 3* Sudan ebolavirus 2012
Dem. Rep. of Congo Isiro Health Zone 36* 13* Bundibugyo ebolavirus 2012
Uganda Kibaale District 11* 4* Sudan ebolavirus 2012
Uganda Luwero District 1 1 Sudan ebolavirus 2011
Dem. Rep. of Congo Luebo 32 15 Zaire ebolavirus 2008
Uganda Bundibugyo 149 37 Bundibugyo ebolavirus 2007
Dem. Rep. of Congo Luebo 264 187 Zaire ebolavirus 2007
South Sudan Yambio 17 7 Sudan ebolavirus 2004
Republic of Congo Mbomo 35 29 Zaire ebolavirus 2003
Republic of Congo Mbomo 143 128 Zaire ebolavirus 2002
Republic of Congo Not specified 57 43 Zaire ebolavirus 2001
Gabon Libreville 65 53 Zaire ebolavirus 2001
Uganda Gulu 425 224 Sudan ebolavirus 2000
South Africa Johannesburg 2 1 Zaire ebolavirus 1996
Gabon Booue 60 45 Zaire ebolavirus 1996
Gabon Mayibout 37 21 Zaire ebolavirus 1996
Dem. Rep. of Congo Kikwit 315 250 Zaire ebolavirus 1995
Côte d’Ivoire (Ivory Coast) Tai Forest 1 0 Taï Forest ebolavirus 1994
Gabon Mekouka 52 31 Zaire ebolavirus 1994
South Sudan Nzara 34 22 Sudan ebolavirus 1979
Dem. Rep. of Congo Tandala 1 1 Zaire ebolavirus 1977
South Sudan Nzara 284 151 Sudan ebolavirus 1976
Dem. Rep. of Congo Yambuku 318 280 Zaire ebolavirus 1976

*Numbers reflect laboratory confirmed cases only.


17 more cases of Ebola and 10 more deaths in the ongoing outbreak in the far eastern reaches of the Democratic Republic of the Congo (DRC).

SITUATION ÉPIDÉMIOLOGIQUE DANS LES PROVINCES DU NORD-KIVU ET DE L’ITURI

Lundi 29 octobre 2018

La situation épidémiologique de la Maladie à Virus Ebola en date du 28 octobre 2018 :
  • Au total, 274 cas de fièvre hémorragique ont été signalés dans la région, dont 239 confirmés et 35 probables.
  • Sur les 239 confirmés, 139 sont décédés et 73 sont guéris . Les autres sont hospitalisés dans les différents Centre de Traitement d’Ebola (CTE) installés.
  • 32 cas suspects en cours d’investigation.
  • 7 nouveaux cas confirmés, dont 4 à Beni et 3 à Butembo.
  • 4 nouveaux décès de cas confirmés, dont 3 à Beni et 1 à Butembo.
  • 3 nouveaux guéris, dont 2 à Butembo et 1 à Beni.
  • 5.991 contacts à suivre à ce jour.

FEMA SitRep 10/29/18: Yutu and US Territories

FEMA

Safety and Security: • Saipan: 1 confirmed fatality

Food, Water, Sheltering: • Emergency boil water advisory remains in effect for all of Saipan and Tinian • Staged and stored food and water sufficient for all projected planning factors • Saipan: 50% of grocers, 62% of restaurants and 31% of retailers have re-opened • Shelters/Occupants: 13 (-2) / 874 (-66) across CNMI; all Rota shelters have closed Health and Medical: Saipan: Hospital fully operational, at capacity; planning to open a medical support shelter • San Antonio Satellite Health Clinic open Mon – Sat Tinian: Medical Center structurally compromised; damage assessments are ongoing

Energy: • 60% of gas stations open on Saipan; both gas stations on Tinian closed due to lack of power • Utility crews have begun to restore power on Saipan and Tinian o Saipan: 8 out of 9 power feeders are down; feeder to hospital was energized, 35 FEMA generator in place; o Tinian: 4 out of 4 power feeders down; power plant damaged, 80-90% damage to distribution structures; expect to return station to service within 24-48 hours o Rota: Power nearly 99% restored, planning to move crews from Rota to Tinian

Communication: • Exchange connection between islands is on generator power with 96 hour capacity • All cell towers on Saipan and Rota remain on generator power

Transportation: • Public transportation systems not operational • All sea ports open with no restrictions • Airports: o Saipan: Inbound flights limited to returning residents and humanitarian assistance;; repairs ongoing but no estimated time for completion; Mobile ATC Tower inbound Nov 1 o Tinian: Open for humanitarian relief flights only; outbound commercial flights for tourists • Major roads and most secondary roads are accessible

State/Local Response • CNMI EOC at Full Activation • Governor declared a State of Emergency; directed Guam Homeland Security/Office of Civil Defense • to lead local government efforts o Governor directed all non-critical government employees to report to work today, Oct 29, to assist in preliminary damage assessments and prepare offices to reopen o Guam Guardsmen expected to begin duty on Saipan as early as Tuesday, Oct 30

FEMA HQ/Federal Response • FEMA-3408-EM-CNMI approved Oct 23; FEMA-4404-DR-CNMI approved Oct 26 • FEMA Region IX RWC at Steady State, continues to monitor • FEMA Region IX IMAT-2 deployed to Saipan; LNOs in Guam, Rota and Tinian • FEMA Region VII IMAT deployed to CNMI (already deployed for Mangkhut) • FEMA NRCC: Effective 8:00 a.m. EDT today, Oct 29 (10:00 p.m. ChST today, Oct 29) o Response Operations Cell (ROC) will transition to day shift, and to Enhanced Watch for night shift o Shift changes, and transitions between day shift ROC operations and night shift Enhanced Watch operations will occur at 8:00 a.m. and 8:00 p.m. EDT (10:00 p.m. and 10:00 a.m. ChST) • FEMA HQ ISB team and MERS assets deployed • HHS: Federal Health Coordinating Officer, DMAT, IMT personnel and LNOs deployed; three CDC SMEs will arrive in Saipan today, Oct 29, to provide public health technical assistance • USACE: 249th Engineer BN ‘Prime Power’ deployed


A Lion Air Boeing 737 MAX 8 from Jakarta, the capital, to the city of Pangkal Pinang off the island of Sumatra, had crashed into the sea. Number of victims unknown so far;

Reuters

See the source image


Filing of Federal Charges against Robert Bowers of Baldwin, PA

Department of Justice

Department of Justice
U.S. Attorney’s Office
Western District of Pennsylvania

FOR IMMEDIATE RELEASE
Saturday, October 27, 2018
                                                                           Statement on Filing of Federal Charges

PITTSBURGH – Scott W. Brady, United States Attorney for the Western District of Pennsylvania, and Robert Jones, Special Agent in Charge of the Federal Bureau of Investigation, issued the following statement today in response to media inquiries:

“On Saturday, October 27, 2018, at 8:05 p.m., U.S. Magistrate Judge Robert C. Mitchell signed a criminal complaint charging Robert Bowers of Baldwin, Pa., with 29 counts setting forth federal crimes of violence and firearms offenses. The crimes of violence are based upon the federal civil rights laws prohibiting hate crimes. The FBI in Pittsburgh is leading the investigation.”

The federal complaint alleges that Bowers committed the following crimes on or about October 27, 2018, in the Western District of Pennsylvania:

• Eleven counts of Obstruction of Exercise of Religious Beliefs Resulting in Death (18 U.S.C. §§ 247(a)(2) and 247(d)(1))

• Eleven counts of Use of a Firearm to Commit Murder During and in Relation to a Crime of Violence (18 U.S.C. §§ 924(c)(1)(A) and 924(j)(1)

• Four counts of Obstruction of Exercise of Religious Beliefs Resulting in Bodily Injury to a Public Safety Officer 18 U.S.C. §§ 247(a)(2) and 247(d)(3))

• Three counts of Use and Discharge of a Firearm During and in Relation to a Crime of Violence (18 U.S.C. §§ 924(c)(1)(A) and 924(iii))

Link to Signed Bowers Complaint


FEMA-Yutu: Sunday, October 28, 2018 Sit Rep

FEMA

Communication: • Restoration of mobile services to Saipan: ( 2 resorts/hotels and 3 (+1) communities/village), Tinian: (1 community/village), Rota: (2 resorts/hotels, 1 village, and the library) • Exchange connection between islands is on generator power with 96 hour capacity • Saipan: all cell towers on generator power; fuel plan being executed • Rota: all cell towers on generator power; unable to access utility system to assess damage

Transportation: • All sea ports open with no restrictions • Airports: o Saipan: will open Oct 28 for commercial outbound passengers only; closed to incoming commercial traffic until farther notice; flight operations limited to humanitarian relief flights only o Tinian: open for humanitarian relief flights only o Rota: open • Major roads and most secondary roads are accessible and utility crews have begun to restore power on Saipan and Tinian

Safety and Security: • Saipan: 1 confirmed fatality

Food, Water, Sheltering: • Emergency boil water advisory remains in effect for all of Saipan and Tinian • Staged and stored food and water sufficient for all projected planning factors • Saipan: Commonwealth Utility Corporation provided water filling stations for residents • Saipan: 50% of grocers, 73% of restaurants and 31% of retailers have re-opened • Shelters/Occupants: 113 / 934 across CNMI; all Rota shelters have closed

Health and Medical: • Saipan: hospital fully operational, on power grid • Tinian: medical facility on generator power; emergency department open, air ambulance service operational

Energy: • 46% of gas stations re-opening on Saipan; fuel availability sufficient to meet normal purchasing needs, but heavy generator use may further deplete existing supplies • CNMI: 21 day fuel supply available based on all power generation facilities operating at normal rate; working on refueling plan • CNMI: 100% of customers without electric grid power (19k on Saipan, 1k on Tinian, 1k on Rota) Saipan: • Regular fuel shipment scheduled for October 31, but distribution may be challenging due to road debris Saipan: • Power Plant 4 should have 6 MW of generation ready at that location; CUC was completing repairs to feeder 1 and expects it to be online October 28; Power Plants 1 & 2 expected to be repaired and some units restarted within the next few days • Tinian: 4 out of 4 power feeders down; power plant damaged, 80-90% damage to distribution structures; expect to return station to service within 24-48 hours; 2-3 weeks fuel supply for generator power • Tinian: both gas stations on island are closed due to lack of power Rota: Power nearly 99% restored, and CUC planning to move crews from Rota to support Tinian

State/Local Response • CNMI EOC at Full Activation (24/7)

FEMA HQ/Federal Response • Emergency Declaration FEMA-3408-EM-CNMI approved October 23 • Expedited Major Disaster Declaration FEMA-4404-DR-CNMI approved October 26 • FEMA Region IX RWC at Steady State, continues to monitor • FEMA Region IX IMAT-2 deployed to Saipan; LNOs in Guam, Rota and Tinian • FEMA Region VII IMAT deployed to CNMI (already deployed for Mangkhut) • FEMA NRCC Response Operations Cell (ROC) activated (24/7) • FEMA HQ ISB team and MERS assets deployed • HHS: Federal Health Coordinating Officer, DMAT, and IMT deployed • USACE: 249th Engineer BN ‘Prime Power’ deployed

 


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