BBC

https://www.youtube.com/watch?v=csWKB1DQuzI

History

LA Times

EID

Using national surveillance data for 120,111 human anthrax cases recorded during 1955−2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. After 1978, incidence decreased until 2013, when it reached a low of 0.014 cases/100,000 population. The case-fatality rate, cumulatively 3.6% during the study period, has also decreased since 1990. Cases occurred throughout the year, peaking in August. Geographic distribution decreased overall from west to east, but the cumulative number of affected counties increased during 2005−2014. The disease has shifted from industrial to agricultural workers; 86.7% of cases occurred in farmers and herdsmen. Most (97.7%) reported cases were the cutaneous form. Although progress has been made in reducing incidence, this study highlights areas that need improvement. Adequate laboratory diagnosis is lacking; only 7.6% of cases received laboratory confirmation. Geographic expansion of the disease indicates that livestock control programs will be essential in eradicating anthrax.

Health Security

Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events.  Nolen Leisha D., Traxler Rita M., Kharod Grishma A., Kache Pallavi A., Katharios-Lanwermeyer Stefan, Hendricks Katherine A., Shadomy Sean V., Bower William A., Meaney-Delman Dana, and Walke Henry T.. Health Security. December 2016, 14(6): 419-423. doi:10.1089/hs.2016.0060.

“…..At least 31 (74%) individuals who initiated PEP did not complete either the recommended 60 days of antimicrobial therapy or the 3-dose vaccine regimen. Among the 29 that discontinued the antimicrobial component of PEP, most (38%) individuals discontinued PEP because of their low perceived risk of infection; 9 (31%) individuals discontinued prophylaxis due to PEP-related minor adverse events, and 10% cited both low risk and adverse events as their reason for discontinuation. Most minor adverse events reported were gastrointestinal complaints, and none required medical attention……”

CBS

Washington Post

• The Islamic State has previously cited traditional Christmas markets as viable marks in their wave of terror in Europe
• Revulsion and angst over the strike at a joyous symbol of the region’s Christmas traditions
• Italy said it would ramp up security for Christmas events, including Pope Francis’s appearance at St. Peter’s Square
• The Czechs pledged “massive” security at public events on Christmas and as the country rings in the new year
• French officials said security at Christmas markets were immediately reinforced

WHO

Details of the cases

• An 85-year-old male national living in Madinah city, Madinah Region. He developed symptoms on 14 November and was admitted to hospital on 15 November. The patient who has comorbidities, tested negative for MERS-CoV on 17 and 26 November. Due to persistence of symptoms, a third nasopharyngeal swab was collected on 2 December and the patient tested positive for MERS-CoV on 3 December. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in critical condition admitted to ICU on mechanical ventilation. The Ministry of Agriculture has been informed and investigation of camels is ongoing.
• A 45-year-old male non-national living in Riyadh city, Riyadh Region. He developed symptoms on 27 November and was admitted to hospital on 2 December. The patient who has comorbidities, tested positive for MERS-CoV on 3 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation.
• A 62-year-old male national living in Skaka city, Aljouf Region. He developed symptoms on 26 November and was admitted to hospital on 30 November. The patient who has comorbidities, tested positive for MERS-CoV on 2 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
• A 73-year-old male national living in Madinah, Madinah Region. He developed symptoms on 26 November and was admitted to hospital on 29 November. The patient who has comorbidities, tested positive for MERS-CoV on 1 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
• A 60-year-old female non-national living in Hofuf city, Al Ahssa Region. She developed symptoms on 28 November and was admitted to hospital on 30 November. The patient who has comorbidities, tested positive for MERS-CoV on 1 December. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
• A 68-year-old male national living in Khayber city, Madinah Region. He developed symptoms on 25 November and was admitted to hospital on 28 November. The patient who has comorbidities, tested positive for MERS-CoV on 30 November. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation. The Ministry of Agriculture has been informed and investigation of camels is ongoing.
• A 90-year-old male national living in Mahad Althahab city, Madinah Region. He developed symptoms on 28 November and was admitted to hospital in Riyadh on 29 November. The patient who has comorbidities, tested positive for MERS-CoV on 1 December. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure isolation room on the ward. The Ministry of Agriculture has been informed and investigation of camels is ongoing.
• A 59-year-old male national living in Yanbu city, Madinah Region. He developed symptoms on 22 November and was admitted to hospital on 27 November. The patient who has comorbidities, tested positive for MERS-CoV on 28 November. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation.
• A 78-year-old male national living in Regal Almaa city, Assir Region. He developed symptoms on 24 November and was admitted to hospital on 26 November. The patient who has comorbidities, tested positive for MERS-CoV on 28 November. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
• A 50-year-old male national living in Riyadh city, Riyadh Region. He developed symptoms on 21 November and was admitted to hospital on 27 November. The patient who has no comorbidities, tested positive for MERS-CoV on 28 November. Investigation of history of exposure to the known risk factors is ongoing. Currently the patient is in critical condition admitted to ICU but not on mechanical ventilation.
• A 35-year-old male national living in Taif city, Taif Region. He developed symptoms on 23 November and was admitted to hospital on 26 November. The patient who has no comorbidities, tested positive for MERS-CoV on 28 November. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward. The Ministry of Agriculture has been informed and investigation of camels is ongoing.
• A 47-year-old female national living in Riyadh city, Riyadh Region. She developed symptoms on 25 November and was admitted to hospital on 26 November. The patient who has comorbidities, tested positive for MERS-CoV on 28 November. Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward. She is one of the household contacts (mother) of the 29-year-old female MERS case reported on 17 November (See DON published on 5 December 2016, case number 4) and was identified through tracing of contacts.

NY Times

“…..Gunmen….had a large cache of weapons, explosives and suicide vests in the apartment where they had been living…..

The discovery of the cache suggested that the men were preparing for multiple deadly attacks……”

USA Today