Global & Disaster Medicine

Archive for June, 2018

6/30/1900: 4 German ships burn at the Hoboken docks in New Jersey, killing more than 300

History

See the source image

See the source image

 


“At least 100 migrants died in a shipwreck occured off Tripoli. 3 young children among the dead. The actual number of missing still uncertain.”

CNN


North American Monsoon: June 15 – September 30

Monsoon Season or “The Monsoon”
Definition: Large scale weather pattern that causes summer thunderstorms to develop.  Moisture transported northward from Gulf of Mexico and eastern Pacific due to a reversal in wind patterns, resulting in a distinct “rainy season” over western North America. Thunderstorms with heavy rain can cause severe flooding. These storms can be powerful and sudden.

Typical Monsoon Season:

• Rainfall is not continuous over space or time

• Varies considerably and usually comes in distinct “burst” periods of heavy rain

• Accounts for over 50% of annual precipitation in northwest Mexico and Southwest U.S.

Associated Hazards

• Deadly, unexpected lightning

o A clap of thunder indicates a thunderstorm is within 10 miles

o Lightning can strike up to 60 miles away from the nearest rainfall • Local damaging straight-line winds (100+ mph)

• Flash floods, especially at low water crossings

o Water can rise quickly downstream from heavy rain, even when the thunderstorm is miles away

o Six inches of fast-moving flood waters can knock you off your feet

• Excessive heat (higher humidity and hot temps)


Global motorcyclists: A unique methodology to identify traffic hotspots around the world and then try to find answers to extinguish them

DUKE

“…..Crowdsourcing. They would survey motorcyclists about road traffic “hotspots”—areas of high-density crash locations—in the region. They hypothesized that the people who spend their days traversing across town would have valuable insights that could help inform future road safety interventions. It turns out they were right.  Staton, Vissoci, Østbye and Luciano Andrade, a post-doctoral researcher working with Staton, initially tested this method in Kigali, Rwanda, and Galle, Sri Lanka, in collaboration with Stephen Rulisa in Rwanda and Vijitha Da Silva in Sri Lanka. They asked moto drivers in Rwanda and tuk-tuk (three-wheel) drivers in Sri Lanka to identify dangerous locations in the region and label the severity of danger of each location. Then, the researchers compared police data to the information the drivers provided.

The study not only showed that data from these “high road utilizers” aligned well with police data, but also identified potential additional hotspots. The research team also found that this crowdsourcing approach is less costly than collecting police data and is easily reproducible, adaptable and interpretable. They were able to replicate the study in Moshi, Tanzania, a year later in collaboration with KCMC researcher Mark Mvungi and got similar results…..

The next step….is to formulate targeted, cost-effective interventions to minimize the risk in these traffic hotspots. These interventions might include measures such as adding speed bumps; improving road pavement conditions, visibility and signage; and promoting helmet use……”


WHO’s latest research: Heat-stable carbetocin is as safe and effective as oxytocin in preventing postpartum haemorrhage.

WHO

WHO study shows drug could save thousands of women’s lives

27 June 2018

News Release
Geneva
A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-income countries, according to a study led by the World Health Organization (WHO) in collaboration with MSD for Mothers and Ferring Pharmaceuticals.
Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure.

The study, published today in the New England Journal of Medicine, has shown an alternative drug – heat-stable carbetocin – to be as safe and effective as oxytocin in preventing postpartum haemorrhage. This new formulation of carbetocin does not require refrigeration and retains its efficacy for at least 3 years stored at 30 degrees celsius and 75% relative humidity.

“This is a truly encouraging new development that can revolutionize our ability to keep mothers and babies alive,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.

Approximately 70 000 women die every year because of post-partum haemorrhage – increasing the risk that their babies also die within one month.

The clinical trial, the largest of its kind, studied close to 30 000 women who gave birth vaginally in 10 countries: Argentina, Egypt, India, Kenya, Nigeria, Singapore, South Africa, Thailand, Uganda and the United Kingdom.

Each woman was randomly given a single injection of either heat-stable carbetocin or oxytocin immediately following the birth of her baby. The study found that both drugs were equally effective at preventing excessive bleeding after birth.

Since both drugs in the study were kept in at the temperatures required to ensure maximum efficacy of oxytocin, the trial may underestimate the benefit expected with heat-stable carbetocin use in real-life settings where oxytocin may have degraded due to exposure to higher temperatures.

“The development of a drug to prevent postpartum haemorrhage that continues to remain effective in hot and humid conditions is very good news for the millions of women who give birth in parts of the world without access to reliable refrigeration,” says Dr Metin Gülmezoglu, from the Department of Reproductive Health and Research at WHO.

The next step is regulatory review and approval by countries.

WHO will ask its Guideline Development Group to consider whether heat-stable carbetocin should be a recommended drug for the prevention of postpartum haemorrhage.

About the study

This WHO study, also referred to as the CHAMPION (Carbetocin HAeMorrhage PreventION) trial, was funded by MSD for Mothers. Heat-stable carbetocin was provided by Ferring Pharmaceuticals, the product innovator and oxytocin was provided by Novartis for the study. The study was conducted under a collaborative arrangement between WHO, MSD for Mothers and Ferring Pharmaceuticals. Following the positive results from the trial, the parties will now work to advance affordable access to this lifesaving drug in countries that have a high burden of maternal deaths.

6/29/1995: The Sampoong department store in Seoul, South Korea collapses, killing more than 500 people.

History

 


During 1998–2013, there were 972 raw produce outbreaks reported resulting in 34 674 outbreak-associated illnesses, 2315 hospitalisations, and 72 deaths.

Epidemiology and Infection

Produce-associated foodborne disease outbreaks, USA, 1998–2013

“…..Raw produce outbreaks were most commonly attributed to vegetable row crops (38% of outbreaks), fruits (35%) and seeded vegetables (11%). The most common aetiologic agents identified were norovirus (54% of outbreaks), Salmonella enterica (21%) and Shiga toxin-producing Escherichia coli (10%). ….”


Capital Gazette: Hit, but still on the job!

Capital Gazette

“…….Five dead, others ‘gravely injured’ in shooting at Capital Gazette newspaper in Annapolis ……”


Active shooter reported at Capital Gazette newsroom in Annapolis

Washington Post


Clinical differences between Dengue and Zika

EID

Yan G, Pang L, Cook AR, Ho HJ, Win MS, Khoo AL, et al. Distinguishing Zika and dengue viruses through simple clinical assessment, Singapore. Emerg Infect Dis. 2018 Aug [date cited]. https://doi.org/10.3201/eid2408.171883

“…Conjunctivitis strongly indicated Zika virus infection (odds ratio [OR] 30.1, 95% CI 9.57–94.44; p < 0.001). In contrast, fever (OR 0.05, 95% CI 0.01–0.47; p = 0.008), myalgia (OR 0.20, 95% CI 0.08–0.48; p<0.001), and headache (OR 0.12, 95% CI 0.05–0.30; p<0.001) were more prominent in patients with DENV infection.

Further, DENV patients tended to have thrombocytopenia (median platelet count 132 × 109/µL, range 15–386 × 109/µL) and monocytosis (median monocyte count 0.50 × 109/µL, range 0.11–1.70 × 109/µL), whereas Zika patients tended to have normal platelet (median 225 × 109/µL, range 128–326 × 109/µL; p<0.001) and monocyte (median 0.35 × 109/µL, range 0.13–1.00 × 109/µL; p = 0.021) counts……”


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