Global & Disaster Medicine

Archive for July, 2017

A dengue outbreak has killed at least 21 people in India’s southern state of Kerala in the past three weeks.

Reuters

 


7/20/2012: A 24-year-old gunman goes on a rampage at a movie theater in the Denver suburb of Aurora, killing 12 people—the youngest a 6-year-old girl—and injuring at least 70 others.

History Channel


The Detwiler Fire has mushroomed to 46,000 acres (18,000 hectares), an increase of about 20,000 acres (8,094 hectares) compared with the day before, and is threatening some 1,500 structures.

Reuters

 


Global Health: 2.1 billion lack access to safe, readily available water at home, and 4.5 billion lack safely managed sanitation

UNICEF

2.1 billion people lack safe drinking water at home, more than twice as many lack safe sanitation

WHO, UNICEF release first global estimates for water, sanitation and hygiene for the Sustainable Development Goals

© UNICEF/UNI112853/Pirozzi
While drinking water from a hand pump, a child smiles, in Mzuzu, the capital of Northern Region and the third largest city, by population, in Malawi.

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12 JULY 2017 GENEVA/ NEW YORK – Some 3 in 10 people worldwide, or 2.1 billion, lack access to safe, readily available water at home, and 6 in 10, or 4.5 billion, lack safely managed sanitation, according to a new report by the World Health Organization (WHO) and UNICEF.
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12 JULY 2017 GENEVA/ NEW YORK – Some 3 in 10 people worldwide, or 2.1 billion, lack access to safe, readily available water at home, and 6 in 10, or 4.5 billion, lack safely managed sanitation, according to a new report by the World Health Organization (WHO) and UNICEF.

The Joint Monitoring Programme report, Progress on Drinking Water, Sanitation and Hygiene: 2017 Update and Sustainable Development Goal Baselines, presents the first global assessment of “safely managed” drinking water and sanitation services. The overriding conclusion is that too many people still lack access, particularly in rural areas.

“Safe water, sanitation and hygiene at home should not be a privilege of only those who are rich or live in urban centres,” says Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “These are some of the most basic requirements for human health, and all countries have a responsibility to ensure that everyone can access them.”

Billions of people have gained access to basic drinking water and sanitation services since 2000, but these services do not necessarily provide safe water and sanitation. Many homes, healthcare facilities and schools also still lack soap and water for handwashing.  This puts the health of all people – but especially young children – at risk for diseases, such as diarrhoea.

As a result, every year, 361 000 children under 5 years die due to diarrhoea. Poor sanitation and contaminated water are also linked to transmission of diseases such as cholera, dysentery, hepatitis A, and typhoid.

“Safe water, effective sanitation and hygiene are critical to the health of every child and every community – and thus are essential to building stronger, healthier, and more equitable societies,” said UNICEF Executive Director Anthony Lake. “As we improve these services in the most disadvantaged communities and for the most disadvantaged children today, we give them a fairer chance at a better tomorrow.”

Significant inequalities persist
In order to decrease global inequalities, the new SDGs call for ending open defecation and achieving universal access to basic services by 2030.
Of the 2.1 billion people who do not have safely managed water, 844 million do not have even a basic drinking water service. This includes 263 million people who have to spend over 30 minutes per trip collecting water from sources outside the home, and 159 million who still drink untreated water from surface water sources, such as streams or lakes.

In 90 countries, progress towards basic sanitation is too slow, meaning they will not reach universal coverage by 2030.

Of the 4.5 billion people who do not have safely managed sanitation, 2.3 billion still do not have basic sanitation services. This includes 600 million people who share a toilet or latrine with other households, and 892 million people – mostly in rural areas – who defecate in the open. Due to population growth, open defecation is increasing in sub-Saharan Africa and Oceania.

Good hygiene is one of the simplest and most effective ways to prevent the spread of disease. For the first time, the SDGs are monitoring the percentage of people who have facilities to wash their hands at home with soap and water.  According to the new report, access to water and soap for handwashing varies immensely in the 70 countries with available data, from 15 per cent of the population in sub-Saharan Africa to 76 per cent in western Asia and northern Africa.

Additional key findings from the report include:

• Many countries lack data on the quality of water and sanitation services. The report includes estimates for 96 countries on safely managed drinking water and 84 countries on safely managed sanitation.

• In countries experiencing conflict or unrest, children are 4 times less likely to use basic water services, and 2 times less likely to use basic sanitation services than children in other countries.

• There are big gaps in service between urban and rural areas. Two out of three people with safely managed drinking water and three out of five people with safely managed sanitation services live in urban areas. Of the 161 million people using untreated surface water (from lakes, rivers or irrigation channels), 150 million live in rural areas.

Note to editors

Multimedia content available here http://weshare.unicef.org/Package/2AMZIFLPXSFB
Safely managed drinking water and sanitation services means drinking water free of contamination that is available at home when needed, and toilets whereby excreta are treated and disposed of safely.

Basic services mean having a protected drinking water source that takes less than thirty minutes to collect water from, using an improved toilet or latrine that does not have to be shared with other households, and having handwashing facilities with soap and water in the home.

Sustainable Development Goal 6 is to ensure availability and sustainable management of water and sanitation for all. The JMP monitors progress on the following two targets:

• 6.1 By 2030, achieve universal and equitable access to safe water and sanitation for all.
• 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.
The JMP also contributes to monitoring of SDG 1 “to end poverty in all its forms everywhere”, and “to SDG 4 to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all” by contributing data on basic water, sanitation and hygiene for the following targets:

• 1.4 By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services.
• 4.a Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all.

Safe water, sanitation and hygiene are also essential to SDG 3 “Ensuring healthy lives and promote wellbeing for all at all ages”. Under SDG target 3.9, countries are working to substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination by 2030.  Additionally, safe water, sanitation and hygiene are needed to reduce maternal mortality and to end preventable deaths of newborns and children as called for in SDG targets 3.1 and 3.2.

About the JMP
The WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene is the official United Nations mechanism tasked with monitoring country, regional and global progress, and especially towards the Sustainable Development Goal (SDG) targets relating to universal and equitable access to drinking water, sanitation and hygiene. Thanks to the globally supported household surveys, JMP analysis helps draw connections between use of basic water and sanitation facilities and quality of life, and serves as an authoritative reference to make policy decisions and resource allocations, especially at the international level.


A new antibody-based assay distinguishes Zika from similar viral infections

Eureka

“A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology company, is a simple, cost-effective way to determine if a person’s infection is from the Zika virus or another virus of the same family, such as dengue and West Nile viruses….”

PNAS

“…..This study demonstrates that the antibody-based assay we developed and implemented in five countries has high specificity and sensitivity in the detection of recent and past ZIKV infections. The ZIKV nonstructural protein 1 (NS1) blockade-of-binding ELISA assay is a simple, robust, and low-cost solution for Zika surveillance programs, seroprevalence studies, and intervention trials in flavivirus-endemic areas….”


Protection against cholera from killed whole-cell oral cholera vaccines

CholeraVaccine-2017:  Document

“….In conclusion, kOCVs are effective in reducing the risk of cholera. Although vaccination alone will probably not lead to elimination of cholera, it can provide an important stopgap while improved water, sanitation, and health-care infrastructure are provided to vulnerable populations. More work is needed to understand how and when to best use existing vaccines and to design new and more effective ones. However, the past three decades of evidence points towards kOCV being a safe, effective, and important tool to fight cholera…”


Diagnostic Delays in 537 Symptomatic Cases of MERS-CoV Infection in Saudi Arabia

International Journal of Infectious Diseases

Abstract

Background

Although the literature indicates the potential outcomes of a patient’s delay in seeking medical support is associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in patients with Middle East Respiratory Syndrome − Coronavirus (MERS-CoV). This study aims to estimate the median time interval of confirmed diagnosis after symptom onset and identify its potential predictors in Saudi Arabian MERS patients.

Methods

A retrospective study involved patients confirmed with MERS who were publicly reported by the World Health Organization (WHO).

Results

537 symptomatic cases of MERS-CoV infection were included. The median time between symptom onset and confirming MERS diagnosis was 4 days (IQR: 2-7), ranging from 0 to 36 days. According to a negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (> 65 years) (RR = 1.42), non-healthcare workers (RR = 1.74), patients with severity of illness (RR = 1.22), those with unknown sources of infections (RR = 1.84), and those who were in close contact with camels (RR = 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown sources of infections (aRR = 1.68) and those in close contact with camels (aRR = 1.58).

Conclusion

The time interval from onset until diagnosis was greater in older patients, non-healthcare workers, patients with severity of illness, patients with unknown sources of infections, and patients in close contact with camels. The findings warrant educational intervention to raise the general public awareness on the importance of early-symptom notification.


Hurricane 06E (Fernanda) Warning

 


TS Don

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M 6.4 – 98km WNW of Camana, Peru

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