Global & Disaster Medicine

Archive for July, 2018

97 passengers and 4 crew were on board an Aeromexico flight that crashed after take-off Tuesday, but so far no deaths.




Carr Fire: One hospital evacuated; neonatal patients evacuated from another & 8 intermediate care facilities fully evacuated

FEMA Document

Carr Fire – Shasta County, CA
Current Situation

• Fire continues to spread in the north and south; progression into the city of Redding has slowed. Shifting winds in timber fuels combine with steep drainages below control lines are contributing to spot fires crossing lines.

• Fatalities / Injuries: 6 confirmed / 0

• Acres burned: 104k (+8,632); Containment: 23% (+6) • Structures / Homes: o Threatened: 4,012 homes (-966), 22 multiple residences, 12 commercial o Damaged: 209 structures (+44); 165 homes (+22) o Destroyed: 1,132 structures (+258); 818 homes (+161)

• Evacuations: Mandatory for approximately 35k (-4k) people

• Hospitals: o One hospital evacuated; neo-natal patients evacuated from another o Eight intermediate care facilities fully evacuated

• Shelters / Occupants: 5 open / 281 (-156)  occupants (ARC Midnight Shelter Count)

• Infrastructure: o Power outages: 3k customers*; Gas outages: 250 customers o Power grid is stable with excess capacity  o Trinity power plant continues operation; full grid restoration pending inspection
Carr Fire – Shasta County, CA

State / Local Response

• CA EOC at Full Activation; Southern REOC at Partial Activation (day shift only)

• Governor declared a State of Emergency for six counties
FEMA Response

• Emergency Declaration FEMA-3398-EM-CA approved July 28, 2018

• FMAG FEMA-5259-FM-CA approved July 23, 2018

• Region IX: o RWC at Steady State, continues to monitor o IMAT-2 deployed to CA EOC (supported by ESFs 1, 3, 4, 6, 7, 8, 12, & DCO) o LNOs deployed to CA EOC and Shasta County EOC • Staging Area established at Redding Municipal Airport o ISB Team and Cache deployed o Commodities prepositioned: Cots, blankets, meals, and water

2018’s monsoon season has brought crippling floods to many parts of SE Asia and in some cases, poor dam construction, deforestation and a lack of emergency preparations have worsened the effects.

NY Times

1 measles case in an international traveler returning to NYC in 2013 triggered an outbreak that sickened 58 people, most of them unvaccinated, and cost the city’s health department $395,000.

JAMA Pediatrics

“…..Between March 13, 2013, and June 9, 2013, 58 persons in New York City with a median age of 3 years (range, 0-32 years) were identified as having measles. Among these individuals, 45 (78%) were at least 12 months old and were unvaccinated owing to parental refusal or intentional delay. Only 28 individuals (48%) visited a medical health care professional who suspected measles and reported the case to the DOHMH at the initial clinical suspicion. Many case patients were not immediately placed into airborne isolation, resulting in exposures in 11 health care facilities. In total, 3351 exposed contacts were identified. Total direct costs to the New York City DOHMH were $394 448, and a total of 10 054 hours were consumed responding to and controlling the outbreak.….”

The Carr Fire rampaging in the area of Redding has destroyed 818 homes, 311 outbuildings, killed 2 firefightera and 4 civilians.

SF Gate

  • Now the ninth most destructive in the state’s history.
  • More than 27,000 people remain evacuated because of the blaze, which has burned for more than a week.

Pharmacist Views Antiviral Distribution and Dispensing During a Pandemic

Health Security

“Antiviral drugs are likely to be a frontline countermeasure needed to minimize disease impact during an influenza pandemic. As part of pandemic influenza preparedness efforts, the Centers for Disease Control and Prevention, in coordination with state health departments, has plans in place to distribute and dispense antiviral drugs from public stockpiles. These plans are currently under review and include evaluation of the benefits of commercial distribution and dispensing through community pharmacies…. Overall, pharmacists were highly receptive to this alternative system and voiced a willingness to participate personally, and most thought their own pharmacy would participate in such an effort. This was true across pharmacists with different personal and professional backgrounds, as well as those in different pharmacy settings. However, sizable shares of pharmacists said they were worried about facing shortages of the antivirals, the risk of exposure to disease for themselves and their families, managing their usual patients who need their prescriptions filled for medications other than antivirals, keeping order in the pharmacy, and potential liability concerns.”

Ultraviolet germicidal irradiation of influenza-contaminated N95 filtering facepiece respirators

Pandemic Influenza

Ultraviolet germicidal irradiation of influenza-contaminated N95 filtering facepiece respirators

Mills, Devin et al.

American Journal of Infection Control


Safe and effective decontamination and reuse of N95 filtering facepiece respirators (FFRs) has the potential to significantly extend FFR holdings, mitigating a potential shortage due to an influenza pandemic or other pandemic events. Ultraviolet germicidal irradiation (UVGI) has been shown to be effective for decontaminating influenza-contaminated FFRs. This study aims to build on past research by evaluating the UVGI decontamination efficiency of influenza-contaminated FFRs in the presence of soiling agents using an optimized UVGI dose.


Twelve samples each of 15 N95 FFR models were contaminated with H1N1 influenza (facepiece and strap), then covered with a soiling agent—artificial saliva or artificial skin oil. For each soiling agent, 3 contaminated FFRs were treated with 1 J/cm2 UVGI for approximately 1 minute, whereas 3 other contaminated FFRs remained untreated. All contaminated surfaces were cut out and virus extracted. Viable influenza was quantified using a median tissue culture infectious dose assay.


Significant reductions (≥3 log) in influenza viability for both soiling conditions were observed on facepieces from 12 of 15 FFR models and straps from 7 of 15 FFR models.


These data suggest that FFR decontamination and reuse using UVGI can be effective. Implementation of a UVGI method will require careful consideration of FFR model, material type, and design.”

Migrants and asylum seekers arriving in northern Greece are subject to “appalling reception and detention conditions,.”


After the quake: Hundreds of people are trapped on a volcano on the popular Indonesian tourist island of Lombok


Wildfires in Greece


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