Global & Disaster Medicine

Archive for January, 2019

Pakistan has the highest infant mortality rate in the world

Venezuela: The only South American country with infant mortality rates that have risen back to 1990s levels

Thompson Reuters

“……Venezuela’s infant mortality rate – defined as the number of deaths under one year of age – was 21.1 deaths per 1,000 live births in 2016 – up by 1.4 times the rate in 2008.
This is the equivalent to levels recorded in the late 1990s, meaning 18 years of progress may have been lost…..”

For the first time, the type of deadly Ebola virus responsible for recent epidemics has been found in a bat in West Africa


“……Knowing which types of bat carry Ebola may help health officials prevent outbreaks by educating the public about how to prevent contact with the creatures…….”

See the source image

Where will the US public go for antivirals in a pandemic?

Public Views on Alternative Methods for Antiviral Distribution and Dispensing During an Influenza Pandemic
Gillian K. SteelFisher, Hannah Caporello, Anita Patel, Lisa M. Koonin, Ericka McGowan, Eran Ben-Porath, and Robert J. Blendon
Published Online:
“…..The Centers for Disease Control and Prevention, in coordination with state health departments, has plans to distribute antiviral drugs from federal stockpiles in the case of a pandemic. These plans are currently under review and include evaluation of the benefits of pharmaceutical supply chain distribution and dispensing of antivirals through community pharmacies. ……
Overall, there was widespread support for the proposed system, and a majority predicted they would be likely to get antivirals in pharmacies compared to public health clinics. However, preference for using pharmacies dropped substantially when even modest fees were introduced. Those without insurance were less likely to say they would get antivirals and, along with those in lower income groups, were more likely than others to use public health clinics at all cost points. Further, sizable proportions expressed concerns about side effects, a desire to wait until symptoms got worse, and hesitation about using drugs beyond the labeled expiration dates. …..”

Japanese researchers described two H3N2 flu viruses with mutations that may increase resistance to the new flu antiviral baloxavir marboxil (Xofluza)

Takashita Emi, Kawakami Chiharu, Morita Hiroko, Ogawa Rie, Fujisaki Seiichiro, Shirakura Masayuki, Miura Hideka, Nakamura Kazuya, Kishida Noriko, Kuwahara Tomoko, Mitamura Keiko, Abe Takashi, Ichikawa Masataka, Yamazaki Masahiko, Watanabe Shinji, Odagiri Takato, on behalf of the Influenza Virus Surveillance Group of Japan. Detection of influenza A(H3N2) viruses exhibiting reduced susceptibility to the novel cap-dependent endonuclease inhibitor baloxavir in Japan, December 2018. Euro Surveill. 2019;24(3):pii=1800698.

Gubareva Larisa V, Mishin Vasiliy P, Patel Mira C, Chesnokov Anton, Nguyen Ha T, De La Cruz Juan , Spencer Sarah, Campbell Angela P, Sinner Mallory, Reid Heather, Garten Rebecca, Katz Jackie M, Fry Alicia M, Barnes John, Wentworth David E. Assessing baloxavir susceptibility of influenza viruses circulating in the United States during the 2016/17 and 2017/18 seasons. Euro Surveill. 2019;24(3):pii=1800666.

Figure 1. Influenza Virus Features


Tuberculosis, Hurricane Maria, and Puerto Rico, 2017


“On September 20, 2017, Hurricane Maria made landfall in Puerto Rico as a Category 4 storm, with sustained winds of 130–156 miles per hour, and 15–40 inches of rain causing catastrophic flash floods. The storm destroyed electricity and communication systems, left large areas without water service, and caused widespread damage to critical infrastructure, transportation, health care, and agriculture. On the sixth day after the event, 58 (84%) of 69 hospitals on the island had no electric power or fuel for generators (1). The devastation led to declaration of a major disaster, just 10 days after a similar declaration for Hurricane Irma, a Category 5 storm that left 1 million Puerto Ricans without electricity after its center passed approximately 57 miles north of Puerto Rico (2,3). Although the island’s entire population was affected by Hurricane Maria, the poorer, more remote, and economically disadvantaged communities, as well as those with larger numbers of bedridden and elderly persons, fared worse (4) because they had less access to already depleted health care services, more fragile homes, and no alternative means for electricity generation…….”

1/24/1939: An 8.3-magnitude earthquake centered in south central Chile leaves 50,000 people dead and 60,000 injured.



The Saudi Arabian Ministry of Health (MOH) recorded two new cases of MERS in recent days

22/01/2019 19-1783
MERS in Riyadh city: 66-year-old male in Riyadh city, Riyadh region

Contact with camels: No

Case classification: Primary, community acquired

Current status: Hospitalized

“…..The new cases likely lifts on the global total since 2012 to 2,288 cases, at least 806 of them fatal.….”

So far in 2018, there are 201 confirmed cases of AFM in 40 states.

States with confirmed cases of AFM, 2018 (N=116)

The number of confirmed cases in the Democratic Republic of the Congo (DRC) Ebola outbreak has jumped by 19



Mardi 22 janvier 2019

La situation épidémiologique de la Maladie à Virus Ebola en date du 21 janvier 2019 :
  • Depuis le début de l’épidémie, le cumul des cas est de 699, dont 650 confirmés et 49 probables. Au total, il y a eu 433 décès (384 confirmés et 49 probables) et 246 personnes guéries.
  • 252 cas suspects en cours d’investigation.


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