Global & Disaster Medicine

Archive for December, 2015

PAHO: Cases of chikungunya in the Americas and Caribbean rose by only 1,191 last week, marking the second straight week of low numbers and bringing the outbreak total to 1,790,681.

Chikungunya, el virus que encorva



Zika Virus Outbreaks: Here and There


Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection

18 Dec 2015

No autochthonous cases of Zika virus infection have been reported in EU Member States so far in 2015. In the past month, one imported case was reported in the Netherlands in a traveller who returned from Suriname on 29 November 2015 after a 3-week holiday in that country.
Autochthonous transmission of Zika virus infection has been reported in Brazil since April 2015. As of week 47/2015, 18 states in Brazil have reported locally-acquired cases [1].
Other countries in the region
As of 17 December 2015, nine countries in the Americas, in addition to Brazil, report confirmed locally-acquired cases in 2015: Colombia, El Salvador, Guatemala, Mexico, Panama, Paraguay, Suriname, Honduras and Venezuela [2,3].
Pacific region
Since the beginning of 2015, sporadic autochthonous cases have been reported in Samoa, Fiji, New Caledonia, the Solomon Islands, and Vanuatu [4]. New Zealand reported two imported cases from Samoa.
On 3 November 2015, the Cape Verdean Ministry of Health reported an outbreak with around 1 000 suspected cases [5]. Seventeen out of 64 blood samples that were sent for confirmation to the Pasteur Institute in Dakar were positive for Zika virus [6].
Complications potentially linked to Zika virus infection
Microcephaly and central nervous system malformations Brazil
Possible links between Zika virus infection in pregnancy and microcephaly of the foetus have been under investigation in Brazil since October 2015 when the Brazilian Ministry of Health reported an unusual increase in cases of microcephaly following the Zika outbreak in the north-eastern states.
As of 12 December 2015, 2 401 suspected cases of microcephaly, including 29 deaths, have been notified in Brazil in 549 municipalities in 20 states. Of these 2 401 cases, 134 were confirmed as being related to Zika virus infection according to the applied case definition, 102 were discarded and 2 165 are still under investigation [7,8]. In week 49/2015, six new states reported suspected cases: Espírito Santo, Mato Grosso, Minas Gerais, Pará, São Paulo and Rio Grande do Sul [8].
Table 1. Distribution of the number of suspected cases of microcephaly notified in Brazil in 2015, as of 17 December 2015 (n = 2 401)
Brazilian states Cases of microcephaly under investigation Confirmed cases* Discarded cases*
Pernambuco 874 29 17
Paraíba 322 19 30
Bahia 316 0 0
Alagoas 107 0 0
Rio Grande do Norte 101 35 4
Ceará 79 0 0
Mato Grosso 72 0 0
Rio de Janeiro 57 0 0
Maranhão 56 0 7
Tocantins 43 0 7
Piauí 39 0 0
Minas Gerais 33 0 2
Sergipe 33 51 34
Espírito Santo 14 0 0
São Paulo 6 0 0
Goiás 4 0 1
Mato Grosso do Sul 3 0 0
Pará 3 0 0
Distrito Federal 2 0 0
Rio Grande do Sul 1 0 0
Total 2 165 134 102
*According to case definition reported in [7].
Guillain–Barré syndrome
Investigations of an association with Zika virus infection and Guillain–Barré syndrome (GBS) are ongoing in Brazil and French Polynesia following reports of co-occurrence of GBS cases during Zika outbreaks.
ECDC published its latest rapid risk assessment on 10 December, which includes information for travellers to areas with circulation of Zika virus:

1. Ministério da Saúde (Brazil). Monitoramento dos casos de dengue, febre de chikungunya e febre pelo vírus Zika até a Semana Epidemiológica 47, 2015. Vol. 46, Nº 42, 2015. [Internet]. 2015. Available from:
2. Secretaría de Estado en el Despacho de Salud. Communicado [Internet]. Tegucigalpa: Secretaria de Salud en Honduras; 2015 [cited 2015 Dec 17]. Available from:
3. World Health Organization. Disease Outbreak News: Zika virus infection – Suriname [Internet]. Geneva: World Health Organization (WHO); 2015 [updated 2015 Nov 13; cited 2015 Nov 13]. Available from:
4. European Centre for Disease Prevention and Control. Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome [Internet]. Stockholm: ECDC; 2015 [cited 2015 Dec 10]. Available from:
5. ProMED-mail. Zika virus – Suriname, Cape Verde [Internet]. 2015 [cited 2015 Nov 06]. Available from:
6. Ministério da Saúde (Capo Verde). Ministério da Saúde confirma infecção por Vírus Zika no concelho da Praia [Internet]. Santiago Island2015 [updated 2015 Nov 2; cited 2015 Nov 2]. Available from:
7. Ministério da Saúde (Brazil). Monitoramento dos casos de Microcefalias no Brasil, até a semana epidemiológica 48, 2015. Boletim Epidemiológico da Secretaria  de Vigilância em Saúde. Vol. 46, Nº 41, 2015. [Internet]. 2015. Available from:
8. Centro de operações de emergências em saúde pública sobre microcefalias. Monitoramento dos casos de microcefalias no brasil informe epidemiológico Nº 04/2015 – semana epidemiológica 49 (06/12 a 12/12/2015) [Internet]. 2015 [cited 2015 Dec 5]. Available from:—Informe-Epidemiol–gico—SE-49—15dez2015—10h.pdf.

12/21/1988: A terrorist bomb exploded aboard a Pan Am Boeing 747 over Lockerbie, Scotland, killing 270 souls.

Landslide in China: 91 missing;

MCI in Las Vegas: Intentional or Accidental?

China: At least 91 missing one day after a mountain of excavated soil and construction waste buried dozens of buildings when it swept through an industrial park in Shenzhen.

USA Today

Sulfur Dioxide Down over China; Up over India


A landslide in the southern Chinese city of Shenzhen results in buildings destroyed and a search for the missing.

NY Times

**  At least 27 people were unaccounted for as of Sunday evening

**  1,500 rescue workers searching amidst the rubble



A fiberglass ferry crossing the Gulf of Bone with 110 passengers and 12 crew was overwhelmed by waves more than 3 meters high during stormy weather on Saturday afternoon. Scores missing, 39 rescued so far.

NY Times

**  Indonesian boat accidents have killed hundreds of people in recent years.

**  Boats are often overcrowded

**  Safety regulations are poorly enforced.

Date: 10/08/2013 Description: map of Indonesia © CIA Image

CDC- Ebola Response: Year in Review


Ebola Response: Year in Review

Posted on December 14, 2015 by Blog Administrator

A person washing their hands at a water station in West Africa

Throughout the month of December, Public Health Matters is conducting a series of year-in-review posts of some of the most impactful disease outbreaks of 2015. These posts will give you a glimpse of the work CDC is doing to prevent, identify, and respond to public health threats.

Getting to Zero

Getting to Zero was a theme and goal that dominated much of CDC’s attention in 2015. In January 2015, The World Health Organization reported that the Ebola epidemic had reached a turning point with the most impacted countries, Liberia, Guinea and Sierra Leone, seeing declines in the number of new cases of Ebola.  This turning point came after a year of battling the worst Ebola outbreak in history—resulting in over 20,000 cases by December 2014.

While the spread of the disease and U.S. media attention was at its peak in 2014, some of CDC’s most impactful and important work took place in 2015. This year’s response to the Ebola epidemic was marked with many challenges and accomplishments, new discoveries, and continuous hard work by hundreds of CDC staff. The dedication of CDC and its partners throughout the year has also led to the successful end of widespread Ebola transmission in Liberia and Sierra Leone.

Ebola Vaccine Trials

In April 2015, CDC, in partnership with The College of Medicine and Allied Health Sciences, University of Sierra Leone, and the Sierra Leone Ministry of Health and Sanitation, began a clinical trial to test the potential of a new vaccine to protect against the Ebola virus. This vaccine trial, known as Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE), is designed to help protect against Zaire ebolavirus, the virus that is causing the current outbreak in West Africa.

Person getting a vaccine“A safe and effective vaccine would be a very important tool to stop Ebola in the future, and the front-line workers who are volunteering to participate are making a decision that could benefit health care professionals and communities wherever Ebola is a risk,” said CDC Director Tom Frieden, M.D., M.P.H.  “We hope this vaccine will be proven effective but in the meantime we must continue doing everything necessary to stop this epidemic —find every case, isolate and treat, safely and respectfully bury the dead, and find every single contact.”

This vaccine trial, along with a series of other vaccine trials taking place in West Africa, represents an important step in the response to the Ebola epidemic. In addition to the tireless efforts being made to completely eliminate Ebola cases, efforts to discover a vaccine could prevent an outbreak of this size in the future.

Leaving Lasting Infrastructures for Health

Programs like STRIVE seek to contribute not only to the future of Ebola prevention research, but also to the future of health care capabilities in the areas impacted by the Ebola epidemic. The STRIVE study is strengthening the existing research capacity of institutions in Sierra Leone by providing training and research experience to hundreds of staff to use now and for future studies.

CDC is leaving behind newly created emergency operation centers (EOC) in countries affected by widespread Ebola outbreaks.   The ministries of health will fully lead these new EOCs, which will provide a place to train healthcare workers to be better prepared to conduct outbreak surveillance and response.

Additionally, 2015 brought the official announcement of plans to create the African Centres for Disease Control and Prevention (African CDC). First proposed in 2013, the African CDC will seek ongoing collaboration with other public health entities across the continent and the world to elevate health outcomes for all citizens. Partners will assist by implementing activities, supporting the establishment of regional collaborating centers, advising the African CDC leadership and staff, and providing technical assistance.

Celebrate the Successes, Look to the Future

2015 brought significant progress in the Ebola response. Yet, while the successes and improvements made to public health infrastructure in West Africa are important to celebrate, the work continues to get to zero and end the largest Ebola outbreak in history.

As we draw closer to our goal of zero cases of Ebola, we are reminded of how critical it is to identify, prevent, and respond to outbreaks to prevent future epidemics of this magnitude.

Posted on December 14, 2015 by Blog Administrator



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