CBS

AP

NCDC

• In the reporting Week 14 (April 02-08, 2018) eight new confirmed cases were recorded from five States –
• From 1st January to 8th April 2018, a total of 1781 suspected cases have been reported from 20 states. Of these, 408 were confirmed positive, 9 are probable, 1351 are negative (not a case) and 13 are awaiting laboratory results (pending) 
• Since the onset of the 2018 outbreak, there have been 101 deaths in confirmed cases, 9 in probable cases. Case Fatality Ratio in confirmed cases is 24.8%

WHO

CSU

J Infect Dis

“…..We enrolled 150 index Ebola cases and 838 contacts; 83 (9.9%) contacts developed Ebola during 21-day follow-up. In multivariable analysis, risk factors for transmission included index case death in the household, Ebola symptoms but no reported fever, age <20 years, more days with wet symptoms; and providing care to the index case (P<0.01 for each). Protective factors included avoiding the index case after illness onset and a piped household drinking water source (P<0.01 for each).….”

Business Standard

• Twelve injured passengers were rushed to the hospital and are in critical condition.
• The bus rolled into a 200ft-deep gorge.

NY Times

Chlorine Sarin Mustard

NY Times

NY Times

CDC

Synopsis:

• Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. Since early March, influenza B viruses have been more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories remains elevated.
• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
• Influenza-associated Pediatric Deaths: Five influenza-associated pediatric deaths were reported.
• Influenza-associated Hospitalizations: A cumulative rate of 99.9 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 2.4%, which is above the national baseline of 2.2%. Seven of 10 regions reported ILI at or above region-specific baseline levels. Two states experienced high ILI activity; eight states experienced moderate ILI activity; New York City and 12 states experienced low ILI activity; and the District of Columbia, Puerto Rico, and 28 states experienced minimal ILI activity.
• Geographic Spread of Influenza: The geographic spread of influenza in 11 states was reported as widespread; Guam, Puerto Rico and 26 states reported regional activity; the District of Columbia and 10 states reported local activity; and the U.S. Virgin Islands and three states reported sporadic activity.

NY Times

SAMS

“Following a brief ceasefire that only lasted for a couple of days, the city of Douma, East Ghouta, was again subjected to heavy shelling that resulted in dozens of casualties and hundreds of injuries. The attacks included the systematic targeting of medical centers and civil defense teams, resulting in the  the destruction of the majority of the civil defense centers and a large number of ambulances and rescue vehicles, heavily paralyzing the medical capacity of the city

On Saturday, April 7th, at 7:45 PM local time, amidst continuous bombardment of residential neighborhoods in the city of Douma, more than 500 cases -the majority of whom are women and children- were brought to local medical centers with symptoms indicative of exposure to a chemical agent. Patients have shown signs of respiratory distress, central cyanosis, excessive oral foaming, corneal burns, and the emission of chlorine-like odor.

During clinical examination, medical staff observed bradycardia, wheezing and coarse bronchial sounds. One of the injured was declared dead on arrival. Other patients were treated with humidified oxygen and bronchodilators, after which their condition improved. In several cases involving more severe exposure to the chemical agents, medical staff put patients on a ventilator, including four children. Six casualties were reported at the center, one of whom was a woman who had convulsions and pinpoint pupils. 

Civil Defense volunteers have reported more than 42 casualties found dead in their homes, with similar clinical symptoms of cyanosis and corneal burns. Civil defense volunteers were unable to evacuate the bodies due to the intensity of the odor and the lack of protective equipment. The reported symptoms indicate that the victims suffocated from the exposure to toxic chemicals, most likely an organophosphate element.

Following the chemical attack, the target site and the surrounding area of the hospital receiving the injured were attacked with an explosive barrel, which hindered the ability of the ambulances to reach the victims.

The Syrian American Medical Society (SAMS) and the Syrian Civil Defense (White Helmets) have documented nearly 200 uses of chemical weapons in Syria since 2012. Previous United Nations Security Council Resolutions on this matter have failed in stopping the use of chemical weapons in Syria.……”