Archive for December, 2018
Scorn for Humanity: Adam Lanza kept a spreadsheet of 400 mass murderers, detailing their massacres and the weapons they used
Monday, December 10th, 2018- Lanza murdered 20 children, six educators at Sandy Hook Elementary on 12/14/2012
- His list had 17 categories, including number of victims and what happened to killer
- It went all the way back to 1786 and ended with Derrick Bird’s 2010 massacre
Sandy Hook Elementary School Shooting
Latest research: Immune globulin shows promise for severe Zika thrombocytopenia
Monday, December 10th, 2018Elizabeth A Van Dyne, Paige Neaterour, Aidsa Rivera, Melissa Bello-Pagan, Laura Adams, Jorge Munoz-Jordan, Priscilla Baez, Myriam Garcia, Stephen H Waterman, Nimia Reyes, Lisa C Richardson, Brenda Rivera-Garcia, Tyler M Sharp; Incidence and Outcome of Severe and Non-severe Thrombocytopenia Associated with Zika Virus Infection — Puerto Rico, 2016, Open Forum Infectious Diseases, , ofy325, https://doi.org/10.1093/ofid/ofy325
“…..Of 37,878 patients with ZIKV infection, 47 (0.1%) had thrombocytopenia in the absence of an alternative etiology (1.4 cases/100,000 population), including 12 with severe thrombocytopenia. Most patients with thrombocytopenia were adult (77%) and male (53%). Platelet nadir occurred a median of six (range: 1–16) and five (range: 0–34) days after symptom onset for patients with severe and non-severe thrombocytopenia, respectively. Among patients with severe thrombocytopenia, all had bleeding, 33% were admitted to the ICU, and 8% died; 50% were treated for ITP. Among five patients with severe thrombocytopenia who received intravenous immunoglobulin, median platelet count increase was 112 X 10 9/L (range: 65–202 X 10 9/L). In contrast, among four patients who received platelet transfusion, median increase in platelet count was 8.5 X 10 9/L (range: -6–52 x 10 9/L)……”
A massive winter storm brought snow, sleet and freezing rain across a wide swath of the South on Sunday, causing dangerously icy roads, immobilizing snowfalls and power losses to hundreds of thousands of people.
Monday, December 10th, 2018
Nipah in India: The first recorded NiV outbreak in South India.
Sunday, December 9th, 2018Outbreak Investigation of Nipah Virus Disease in Kerala, India, 2018
“…..Results: During 2–29 May 2018, 23 cases were identified, including the index case; 18 were laboratory confirmed. The lineage of the NiV responsible for this outbreak was closer to the Bangladesh lineage. The median age of cases was 45 years; the sex of 15 (65%) was male. The median incubation period was 9.5 days (range, 6–14 days). Of the 23 cases, 20 (87%) had respiratory symptoms. The case-fatality rate was 91%; 2 cases survived. Risk factors for infection included close proximity (ie, touching, feeding, or nursing a NiV-infected person), enabling exposure to droplet infection. The public health response included isolation of cases, contact tracing, and enforcement of hospital infection control practices.
“Nipah virus (NiV) is a member of the family Paramyxoviridae, genus Henipavirus. NiV was initially isolated and identified in 1999 during an outbreak of encephalitis and respiratory illness among pig farmers and people with close contact with pigs in Malaysia and Singapore. Its name originated from Sungai Nipah, a village in the Malaysian Peninsula where pig farmers became ill with encephalitis. Given the relatedness of NiV to Hendra virus, bat species were quickly singled out for investigation and flying foxes of the genus Pteropus were subsequently identified as the reservoir for NiV….”
Transmission
Transmission of Nipah virus to humans may occur after direct contact with infected bats, infected pigs, or from other NiV infected people.
In Malaysia and Singapore, humans were apparently infected with Nipah virus only through close contact with infected pigs. The NiV strain identified in this outbreak appeared to have been transmitted initially from bats to pigs, with subsequent spread within pig populations. Incidental human infections resulted after exposure to infected pigs. No occurrence of person-to-person transmission was reported in this outbreak.
Conversely, person-to-person transmission of Nipah virus in Bangladesh and India is regularly reported. This is most commonly seen in the family and caregivers of Nipah virus-infected patients. Transmission also occurs from direct exposure to infected bats. A common example is consumption of raw date palm sap contaminated with infectious bat excretions.
Signs and Symptoms
During the Nipah virus disease outbreak in 1998-99, 265 patients were infected with the virus. About 40% of those patients who entered hospitals with serious nervous disease died from the illness.
Long-term sequelae following Nipah virus infection have been noted, including persistent convulsions and personality changes.
Latent infections with subsequent reactivation of Nipah virus and death have also been reported months and even years after exposure.
Treatment
Treatment is limited to supportive care. Because Nipah virus encephalitis can be transmitted person-to-person, standard infection control practices and proper barrier nursing techniques are important in preventing hospital-acquired infections (nosocomial transmission).
The drug ribavirin has been shown to be effective against the viruses in vitro, but human investigations to date have been inconclusive and the clinical usefulness of ribavirin remains uncertain.
Passive immunization using a human monoclonal antibody targeting the Nipah G glycoprotein has been evaluated in the post-exposure therapy in the ferret model and found to be of benefit.
12/8/1881: A fire at the Ring Theater in Vienna, Austria, kills at least 620 people and injures hundreds more
Saturday, December 8th, 2018
- The theater’s iron fire curtain was not lowered
- Available water hoses were not used immediately.
- The stage managers panicked and shut off the gas totally, cutting off light in the theater.
- The balconies became clogged as the exits jammed.
- A fire brigade brought ladders, but they were too short to reach even the first balcony.
- Some people jumped from the balconies, not only killing themselves but also crushing people on the ground floor.
Portugal: First Case of Tularemia
Saturday, December 8th, 2018Case Report
“……A previously healthy 47-years-old male developed abruptly malaise, high fever (40°C) and chills only 3 days after walking and sleeping in the countryside of the island of Bornholm (Denmark) during summer season. He also reported profuse night sweats, a small left infraclavicular non-painful cutaneous lesion. The patient did not report outdoor activities in the month before and did not recall any tick bite. Three days later the fever vanished and he was first observed in a hospital in Berlin. He was prescribed with amoxicillin/clavulanate 875mg/125mg twice-a-day for 7 days.
On the 15th day of disease, he was observed in Portugal because of ongoing malaise. During the observation he did not complain of respiratory symptoms nor headache.
He presented a non-pruritic macular erythematous rash of the trunk, a non-painful left infraclavicular cutaneous lesion covered with a black crust suggestive of a skin eschar and multiple small painless, non-adherent cervical, and axillar lymphadenopathies……”
At least 6 dead and 100 injured during a stampede of panicked concertgoers in Corinaldo, Italy
Saturday, December 8th, 2018Nigeria: As of Nov 25, 2018, a total of 3,510 suspected YF cases, including 74 deaths (the case-fatality rate is 2.1%).
Saturday, December 8th, 2018
A yellow fever outbreak has been active in Nigeria since September 2017, with all 36 States plus FCT reporting at least one suspected case.
A multi-agency national Emergency Operations Centre is coordinating the national response.
A new cluster of suspected cases of yellow fever was reported in Edo state on 22 November 2018. Since 9 September 2018, a total of 36 suspected cases, 2 presumptive positives including 8 deaths have been recorded.
Thirteen additional samples from Edo state were tested at a Nigeria laboratory outside the yellow fever laboratory network and nine samples were reported as positive. Aliquots of these samples have been sent to the World Health Organisation yellow fever reference laboratory, IP Dakar for confirmatory testing.
A National Rapid Response Team has been deployed to Edo State and is working with the Edo State Ministry of Health and the World Health Organisation and other partners.
The Rapid Response Team’s focus has been finding cases, sensitization of health workers and communities, entomological surveillance etc in order to define an appropriate response.
A planned yellow fever preventive mass vaccination campaign targeting 20,461,805 persons in six states (Borno, Kebbi, Niger, Plateau, Sokoto and the FCT) commenced on 22nd November 2018.
