NY Times

Individual asylum hearings mandated by law and international agreement:

“….Even a straightforward case, of a Syrian man interviewed this month near Nuremberg, consumed well over an hour, with translation for each question and answer.  The interviewing official then had to do the same for the man’s wife. At this pace, officials are lucky to handle four cases in a day, even working the 50-hour weeks…..”

Fox News

BBC

:….Jurors found police failures before and during the 1989 FA Cup semi-final led to the fatal crush…..”

Reuters

“….Under Australian law, anyone intercepted trying to reach the country by boat is sent for processing to camps on the tiny Pacific island of Nauru or to Manus Island off Papua New Guinea. They are never eligible to be resettled in Australia…..The detainees on Manus and Nauru are mostly refugees fleeing violence in the Middle East, Afghanistan and South Asia……”

WHO

“…..A 61-year-old, Saudi male was admitted on 29 March to a health care facility in Bahrain for an unrelated medical condition. He was screened for MERS-CoV, a routine procedure for those coming from Saudi Arabia, and tested negative for the infection. On 4 April, and while hospitalized, he developed symptoms. On 9 April, the patient tested positive for MERS-CoV. The patient had comorbidities. He owned a dromedary barn in Saudi Arabia and had a history of frequent contact with them and consumption of their raw milk. He had no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms. On 12 April, he was transferred to a hospital in Dammam city, Saudi Arabia but passed away on the same day…..”

WHO

WHO

Yellow Fever – China

Between 4 and 12 April 2016, the National IHR Focal Point of China notified WHO of 2 additional imported cases of yellow fever (YF). To date, a total of 11 laboratory-confirmed YF cases imported from Angola have been reported in China.

The tenth imported case is an 18-year-old male from Fujian Province, China, who had been living in Angola. On 12 March, he had onset of fever and other symptoms, and visited a local hospital in Angola. On 27 March 2016, the patient travelled to Fuzhou City, Fujian Province, China via Dubai, United Arab Emirates and Beijing, China. He was afebrile on arrival in China. On 28 March, the patient sought medical care. Yellow fever infection was confirmed by polymerase chain reaction (PCR) at the Fujian International Travel Health Centre. Test results were corroborated by the Fujian Centers for Disease Control (CDC). The patient was hospitalised in Fuzhou and remains under treatment.

The eleventh imported case is a 29-year-old male from Jiangsu Province, China, who had been working in Angola. On 5 April, he had onset of fever and other symptoms, and sought medical care at a local hospital in Angola. On 9 April, the patient was reported to have tested positive for YF in Angola by PCR. He flew back to China via Dubai, arriving in Beijing on 10 April. On arrival, the patient was transferred by ambulance to a hospital. His sample was tested at Beijing CDC and found to be positive for YF by PCR. On 12 April, expert consultation organised by the Beijing Health and Family Planning Commission confirmed the patient as an imported YF case based on the epidemiological history, clinical manifestations and laboratory findings. The case is currently stable.

Public health response

The Chinese government has taken the following measures:

• intensifying multi-sectoral coordination and collaboration,
• strengthening surveillance, vector monitoring and risk assessment,
• enhancing clinical management of yellow fever cases,
• conducting vector control activities,
• carrying out public risk communication activities,
• deploying a medical team to Angola to provide yellow fever vaccination to unvaccinated Chinese nationals.

WHO risk assessment

The report of yellow fever infection in non-immunized travellers returning from a country where vaccination against the disease is mandatory underlines the need to reinforce the implementation of vaccination requirements, in accordance with the International Health Regulations (2005). Furthermore, this report highlights the risk of international spread of yellow fever through non-immunized travellers. However, the risk of establishment of a local cycle of transmission in China is low due to the current climatic condition, which is unfavourable for the competent vector, the Aedes aegypti mosquito. WHO continues to monitor the epidemiological situation and conduct risk assessment based on the latest available information.

WHO advice

WHO urges Members States especially those where the establishment of a local cycle of transmission is possible (i.e. where the competent vector is present) to strengthen the control of immunisation status of travellers to all potentially endemic areas.

WHO does not recommend any travel or trade restriction to China based on the current information available.

WHO

Details of the cases

• A 54-year-old male from Najran city developed symptoms on 3 April and was admitted to a hospital on 12 April. He tested positive for MERS-CoV on 14 April. The patient has comorbidities and a history of frequent contact with dromedaries and consumption of their raw milk. Currently, he is in stable condition in a negative pressure isolation room at the hospital. The Ministry of Agriculture has been informed and investigation is ongoing.
• A 25-year-old male from Riyadh city was admitted to a hospital on 29 March due to an unrelated medical condition. On 10 April, and while hospitalized, he developed symptoms. The patient tested positive for MERS-CoV on 12 April. He was admitted to ICU with a MERS-CoV case (see below – case no. 9), between 2 and 4 April. He has no history of exposure to the other known risk factors in the 14 days prior to onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room at the hospital.
• A 73-year-old male from Riyadh city developed symptoms on 9 April and was admitted to a hospital on 11 April. The patient tested positive for MERS-CoV on 12 April. The patient has comorbidities. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU.
• A 71-year-old male from Khayber city developed symptoms on 3 April and was admitted to a hospital on 10 April. The patient tested positive for MERS-CoV on 11 April. The patient has comorbidities and a history of frequent contact with dromedaries and consumption of their raw milk. Currently he is in stable condition in a negative pressure isolation room at the hospital. The Ministry of Agriculture has been informed and investigation is ongoing.
• A 21-year-old male from Hofuf city developed symptoms on 9 April and was admitted to a hospital on the same day. The patient tested positive for MERS-CoV on 10 April. The patient has no comorbidities but has a history of frequent contact with dromedaries and consumption of their raw milk. Currently he is in stable condition in a negative pressure isolation room at the hospital. The Ministry of Agriculture has been informed and investigation is ongoing.
• A 59-year-old male from Dammam city developed symptoms on 6 April and was admitted to a hospital on 7 April. The patient tested positive for MERS-CoV on 8 April. The patient has comorbidities and a history of frequent contact with dromedaries and consumption of their raw milk. He has no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition in home isolation. The Ministry of Agriculture has been informed and investigation is ongoing.
• A 70-year-old male from Abha city developed symptoms on 2 April and was admitted to a hospital on 5 April. The patient tested positive for MERS-CoV on 6 April. The patient had comorbidities. Investigation of history of exposure to the known risk factor is ongoing. The patient passed away on 6 April.
• A 53-year-old male from Najran city underwent an elective surgery in a hospital on 18 March. He developed complications and was transferred to a different hospital on 2 April. The patient tested positive for MERS-CoV on 4 April. The patient has comorbidities. Investigation of history of exposure to the known risk factor is ongoing. Currently the patient is in critical condition admitted to ICU on mechanical ventilation.
• A 74-year-old male from Alkharj city developed symptoms on 20 March and was admitted to a hospital in Riyadh on 24 March. The patient tested positive for MERS-CoV on 4 April. The patient had comorbidities. Investigation of history of exposure to any of the known risk factor is ongoing. The patient passed away on 5 April.
• A 75-year-old female from Buraidah city was bed ridden for several years. She was admitted to a hospital in Buraidah on 12 March where the MERS-CoV outbreak occurred (see DON published on 14 March) for an unrelated medical condition. On 29 March, and while hospitalized she developed symptoms. The patient tested positive for MERS-CoV on 30 March. She had comorbidities. Investigation of exposure to any MERS-CoV cases hospitalized in the same hospital, shared healthcare workers or other known risk factors in the 14 days prior to the onset of symptoms is ongoing. The patient passed away on 29 March.