NY Times

**  Only 22 cases of Guinea worm disease were reported in 2015,

**  126 cases reported in 2014.

**  When the campaign began, there were an estimated 3.5 million cases of Guinea worm infestation

**  The cases were spread across 20 villages in four countries (Chad, Ethiopia, Mali, and South Sudan)

** Guinea worms have been found in hundreds of dogs in Chad, raising the danger that they have found a new host.

**  Guinea worm and polio are the two diseases now closest to being eliminated.

**  There were only 70 cases of polio paralysis in the world last year, all in Pakistan and Afghanistan.

CDC

Causal Agent:

Dracunculiasis (guinea worm disease) is caused by the nematode (roundworm) Dracunculus medinensis.

Life Cycle:

Humans become infected by drinking unfiltered water containing copepods (small crustaceans) which are infected with larvae of D. medinensis . Following ingestion, the copepods die and release the larvae, which penetrate the host stomach and intestinal wall and enter the abdominal cavity and retroperitoneal space . After maturation into adults and copulation, the male worms die and the females (length: 70 to 120 cm) migrate in the subcutaneous tissues towards the skin surface . Approximately one year after infection, the female worm induces a blister on the skin, generally on the distal lower extremity, which ruptures. When this lesion comes into contact with water, a contact that the patient seeks to relieve the local discomfort, the female worm emerges and releases larvae . The larvae are ingested by a copepod and after two weeks (and two molts) have developed into infective larvae . Ingestion of the copepods closes the cycle .

NY Times

CDC

Background:

The Centers for Disease Control and Prevention’s (CDC) Influenza Division collects, compiles, and analyzes information on influenza activity year-round in the United States and produces FluView, a weekly influenza surveillance report, and FluView Interactive. The U.S. influenza surveillance system provides information in five categories collected from nine data sources. This is the first report of the 2015-2016 influenza season, which began on October 4, 2015.

The five categories and nine data components of CDC influenza surveillance are:

• Viral Surveillance:U.S. World Health Organization (WHO) collaborating laboratories, the National Respiratory and Enteric Virus Surveillance System (NREVSS), and human infection with novel influenza A virus case reporting;
• Mortality:National Center for Health Statistics (NCHS) Mortality Surveillance System, 122 Cities Mortality Reporting System and influenza-associated pediatric deaths;
• Hospitalizations:Influenza Hospitalization Network (FluSurv-NET) including the Emerging Infections Program (EIP) and three additional states;
• Outpatient Illness Surveillance:U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet);
• Geographic Spread of Influenza:State and territorial epidemiologists’ reports.

An overview of the CDC influenza surveillance system, including methodology and detailed descriptions of each data component, is available at: http://www.cdc.gov/flu/weekly/overview.htm.

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Synopsis:

During week 1 (January 3-9, 2016), laboratory data indicated that influenza activity increased slightly in the United States.

• Viral Surveillance: The most frequently identified influenza virus type reported by public health laboratories during week 1 was influenza A, with influenza A (H1N1)pdm09 viruses predominating. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was low.

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• Novel Influenza A Virus: One human infection with a novel influenza A virus was reported.

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• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below their system-specific epidemic threshold in both the NCHS Mortality Surveillance System and the 122 Cities Mortality Reporting System.
• Influenza-associated Pediatric Deaths: One influenza-associated pediatric death was reported.
• Influenza-associated Hospitalizations: A cumulative rate for the season of 1.5 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
• Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 2.0%, which is below the national baseline of 2.1%. Four of 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and one state experienced high ILI activity; New York City and seven states experienced low ILI activity; 42 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
• Geographic Spread of Influenza: The geographic spread of influenza in Guam, Puerto Rico, and nine states were reported as regional; 11 states reported local activity; the U.S. Virgin Islands and 28 states reported sporadic activity; and the District of Columbia and two states reported no influenza activity.

NY Times

“……The Columbia students were on a trip organized by Global Brigades, a student-run nonprofit dedicated to bringing health care and economic development programs to communities in Latin America and West Africa……”

NBC News

Hawaii Department of Health

The Hawaii State Department of Health (DOH) has received laboratory confirmation from the U.S. Centers for Disease Control and Prevention (CDC) of a past Zika virus infection in a baby recently born with microcephaly in a hospital on Oahu. The mother likely had Zika infection when she was residing in Brazil in May 2015 and her newborn acquired the infection in the womb. Neither the baby nor the mother are infectious, and there was never a risk of transmission in Hawaii.

“We are saddened by the events that have affected this mother and her newborn,” said DOH State Epidemiologist Dr. Sarah Park. “This case further emphasizes the importance of the CDC travel recommendations released today. Mosquitos can carry serious diseases, as we know too well with our current dengue outbreak and it is imperative that we all Fight the Bite by reducing mosquito breeding areas, avoiding places with mosquitos, and applying repellant as needed.”

To date, there have been no cases of Zika virus acquired in Hawaii. Since 2014, the department has identified six persons in the state who acquired their infection in another country. Physicians are required to report all suspected cases of Zika virus and more than 75 other reportable diseases in the state. Physician reporting is crucial to conducting an effective disease surveillance program in Hawaii.

“In this situation, an astute Hawaii physician recognized the possible role of Zika virus infection, immediately notified the Department of Health, and worked with us to confirm the suspected diagnosis,” said Dr. Park. “We rely on our exceptional medical community to be our eyes and ears in the field to control and prevent the spread of illness in Hawaii.”

The department sent a Medical Advisory to physicians statewide today as a reminder that while Zika virus is not endemic in the U.S., it can be acquired in a number of countries and travel history should always be considered.

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon. There is no vaccine to prevent or medicine to treat Zika.

Reuters

NY Times

NASA:  In western Africa, just south of the Sahara Desert, lies the landlocked nation of Burkina Faso. Despite the limited natural resources in this arid savannah, the nation experienced a 200 percent increase in urban population between 1975 and 2000. Much of that growth occurred in the capital city of Ouagadougou, where unplanned settlements sprang up along the city’s perimeter. Between 1960 and 1993, Ouagadougou experienced a 14-fold increase in area.

Over the years, NASA’s Landsat satellites have observed the increase in Ouagadougou’s extent. The Landsat 7 satellite captured the top image on October 16, 2006, and the Landsat 5 satellite acquired the bottom image on November 18, 1986. In these false-color images, vegetation appears bright green, bare or sparsely vegetated ground ranges in color from beige to gray-green, and water ranges in color from navy to electric blue. Paved surfaces and buildings appear pink-purple.

The 2006 image shows how urbanization radiated out from the city center, filling nearly the entire frame. Urbanization has increased especially in the east and south; in the 1986 image, random shapes of green and brown fill the area; in the 2006 image, that area is predominantly pinkish purple. Likewise, a crooked line of vegetation that is visible north of Bois de Boulogne in 1986 has all but disappeared in 2006.

In both images, the Ouagadougou airport appears as a conspicuous diagonal line near the center of the image. In 1986, the airport lies fairly close to the city’s outskirts. In 2006, continued urbanization has surrounded the airport with cityscape. Southwest of the airport, the beginnings of urbanization appear in 1986, and that urbanization is more pronounced in 2006.

Lakes and rivers near the top and right edges of the image show different colors between 1986 and 2006; the color change likely results from differences in sediment or organic matter suspended in the water.

In 2008, the United Nations Environment Programme (UNEP) published Africa: Atlas of Our Changing Environment highlighting changes detected by remote sensing, and providing overviews of each nation’s progress toward environmental sustainability in the late twentieth and early twenty-first century. UNEP found that, in the 1980s, Ouagadougou’s growth resulted predominantly from rural-to-urban migration. After that time, the population increased primarily from natural growth—birth rates exceeding death rates. The growth led to an explosion of unplanned settlements. Unplanned settlements may conflict with sustainable development goals, and they make it harder for the government to provide basic services, such as drinking water.

Despite growing urbanization, however, UNEP found that Burkina Faso made progress in some key areas of environmental sustainability. Protected areas increased slightly from 1990 to 2005, and per capita carbon dioxide emissions dropped slightly over roughly the same period. Meanwhile, access to better sources of drinking water and sanitation increased from 1990 to 2004, and the proportion of urban dwellers living in slums decreased slightly from 1990 to 2001. Nevertheless, water scarcity, desertification, and deforestation all threatened the country’s future health.

• References
• United Nations Environment Programme. (2008). Africa: Atlas of Our Changing Environment. Division of Early Warning and Assessment, United Nations Environment Programme, Nairobi, Kenya.

CDC HAN

Recognizing, Managing, and Reporting Zika Virus Infections in Travelers Returning from Central America, South America, the Caribbean, and Mexico

USA Today

**  At least 30 hostages, including a Burkina Faso minister, have been evacuated from Splendid Hotel in the country’s capital, Ouagadougou.