Global & Disaster Medicine

Archive for August, 2019

Investigating a cluster of Middle East respiratory syndrome (MERS) cases in a women-only dormitory in Riyadh, Saudi Arabia

Van Kerkhove MD, Aswad S, Assiri A, Perera RAPM, Peiris M, El Bushra HE, et al. Transmissibility of MERS-CoV infection in closed setting, Riyadh, Saudi Arabia, 2015. Emerg Infect Dis. 2019 Oct [date cited]. https://doi.org/10.3201/eid2510.190130

“…..We hypothesize that the increased human-to-human transmission within villas resulted from the clustering of the women’s activities. For example, the same women who lived together typically ate and socialized together, worked together, and traveled to and from work together. These activities added to the likelihood of intense direct physical contact among the women and probably facilitated limited but effective human-to-human transmission within their residence.….”

 

 


New study: What yellow fever patients are likely to die?

Lancet

“……Therefore, 76 patients with confirmed yellow fever virus infection, based on detectable yellow fever virus RNA in blood (74 patients) or yellow fever virus confirmed only at the autopsy report (two patients), were included in our analysis. 27 (36%) of 76 patients died during the 60 day period after hospital admission. We generated 14 complete yellow fever virus genomes from the first 15 viral load-detectable samples. The genomes belonged to a single monophyletic clade of the South America I genotype, sub-genotype E. Older age, male sex, higher leukocyte and neutrophil counts, higher alanine aminotransferase, aspartate transaminase (AST), bilirubin, and creatinine, prolonged prothrombin time, and higher yellow fever virus RNA plasma viral load were associated with higher mortality. In a multivariate regression model, older age, elevated neutrophil count, increased AST, and higher viral load remained independently associated with death. All 11 (100%) patients with neutrophil counts of 4000 cells per mL or greater and viral loads of 5·1 log 10 copies/mL or greater died (95% CI 72–100), compared with only three (11%) of 27 (95% CI 2–29) among patients with neutrophil counts of less than 4000 cells per mL and viral loads of less than 5·1 log 10 copies/mL. ….”


The death toll from a late-night suicide bombing at a crowded wedding party in the Afghan capital rose to at least 63 with another 182 wounded.

CBS


Heavy rains have hit the Turkish city of Istanbul, flooding streets and basements, stranding drivers on roads and disrupting rail and ferry services.

CBS


Myanmar and Bangladesh are to make a fresh attempt to begin repatriating the Rohingya Muslims

Guardian

‘…..A document prepared by UN agency UNHCR to be sent to the Rohingya community to inform them of the repatriation plan said: “The Government of Myanmar has confirmed that 3,450 Rohingya refugees are eligible to return. This is a welcome first step as it acknowledges that your right to return is recognized.”……’


7 people were hospitalized in ICU with a potentially fatal lung toxin after vaping cannabis or CBD oils

County of Kings PH

NEWS RELEASE
Contacts:
Nancy Gerking  Assistant Director of Public Health Phone (559) 852-2574
FOR IMMEDIATE RELEASE
DANGER OF VAPING CANNABIS OR CANNABIDIOL (CBD) OILS
HANFORD – Dr. Milton Teske, Health Officer, with the Kings County Department of Public Health is issuing a warning regarding the dangers of vaping cannabis or CBD oils. Since June, seven cases of Acute Respiratory Distress Syndrome (ARDS) have been identified, requiring hospitalization and respiratory support among previously healthy adults. Some of these patients’ conditions were so severe they were admitted to the intensive care unit and required respiratory support through mechanical devices.
The first symptoms of ARDS are feeling like you can’t get enough air into your lungs, rapid breathing, a low blood oxygen level, low blood pressure, confusion, and extreme tiredness.  If you are experiencing any of these symptoms seek immediate medical treatment.
A reported common exposure among these patients is that they have been vaping cannabis or CBD oils. At this time, no infectious cause has been identified.
One pattern also observed during the investigation is that all of the cases to date have involved the purchasing of vape cartridges from “pop-up shops”.  Pop-up shops are temporary shops that open for an undetermined amount of time, advertise by word of mouth, and will move locations frequently.  These pop-up shops are not licensed retailers and do not follow any current regulations or safety practices, including selling only products that have been tested for contaminants. Under no circumstances should you vape cannabis or CBD oils obtained from a “pop-up shop”.
Although cannabis or CBD oil use is legal in California, if you are going to use cannabis or CBD oil or a combination of both, be cautious, and only purchase from a licensed retailer.
The Kings County Department of Public Health has partnered with the California Department of Public Health for continued investigation and surveillance.
For more information on cannabis or vaping uses go to:
http://bit.do/letstalkcannabis
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html


Project BioShield over 15 years of progress

ASPR

Project BioShield Evolution: Fifteen Years of Bridging the ‘Valley of Death’ in the Medical Countermeasures Pipeline

Author: By Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response
Published Date: 7/17/2019 12:15:00 PM
Category: Innovations; Medical Countermeasures; National Health Security;

Saving lives in a public health emergency requires cutting-edge medical countermeasures: medications, vaccines, diagnostics, and more. In some types of emergencies, like an act of bioterrorism, some of those medical products have no commercial market. People don’t use an anthrax antitoxin every day – thank goodness. Yet that lack of commercial market also means pharmaceutical or biotech companies had only one possible buyer for their products: the federal government for stockpiling.

In 2004, Congress passed the Project BioShield Act to create a market for products necessary for disaster response but with limited or no commercial market. The Act provides HHS with a multi-year special reserve fund to support late-stage development and manufacturing, and the financial resources to buy these life-saving medical products for the American people to use in public health emergencies. In this way, Project BioShield is a critical part of the U.S. strategy for biodefense and our commitment to the American people.

Last month, Congress took action to further strengthen Project BioShield as part of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAIA). PAHPAIA increases the budget authorization and provides ten-year funding for product development. We know next-generation medical countermeasures aren’t developed overnight – in fact, getting a product across the finish line takes many years. Multi-year funding helps BARDA continue building the strong public-private partnerships needed to spur innovation and provide the private sector with the stability needed to produce potentially lifesaving medical countermeasures.

For example, smallpox is one of the most consequential infectious diseases in human history, responsible for nearly 300 million deaths in the 20th century alone. It is also a high-priority threat requiring federal agencies to develop strategies and countermeasures against this threat. Thanks to our partners at NIAID and DoD and the support of Project BioShield, last year our industry partner was issued an FDA approval for a treatment for smallpox via the animal rule. At present, there are now over 2 million treatment courses in ASPR’s Strategic National Stockpile to protect Americans in the event of a smallpox national security emergency.

However, we have found over the past 15 years the most practical and cost-effective approach is, whenever possible, to look at products that not only can be used for emergencies, but also have uses in daily medical care, such as burn care, the radiation effects cancer patients encounter, or seizures.

In some cases, we’ve worked with companies to expand indications for existing products. For example, three medical countermeasures are now FDA-approved to treat patients suffering bone marrow and blood cell damage from acute radiation syndrome. All three of these products were already licensed drugs used to treat patients undergoing radiation therapy for cancer. Project BioShield funding was used to conduct the critical studies needed to expand the indications for these products so they could also be used to treat the damage caused by acute radiation syndrome in a radiation emergency. Using such drugs is helpful in emergencies because healthcare facilities already stock the drugs, and clinicians are already familiar with using them.

We are using Project BioShield to support other new products with commercial market potential. For example, we supported a large study of a seizure treatment because seizures are one of the potentially deadly effects of nerve agents. The product is used commonly in preparing patients for surgery and for epileptic seizures; thanks to Project BioShield, the product is now approved as an antiseizure medication for status epilepticus and has been added to the Strategic National Stockpile for use in a chemical emergency response.

For 15 years, BARDA has been proud to partner with industry to develop cutting-edge medical countermeasures. Our country is better prepared to respond to health security threats because of Project BioShield. We look forward continued collaboration as we work to develop and produce medical countermeasures that can be used to save lives in the event of an emergency.


Krosa: One dead, 49 injured as tropical storm hits Japan


WHO: 10 new cases of Ebola have been confirmed in the Democratic Republic of the Congo (DRC), raising the outbreak total to 2,852, and 380 suspected cases are still under investigation.

WHO


Drowning or sinking islands: the story of Kiritimati

BBC

“…….Intensifying storms and weather-related events have displaced an average of 24.1 million people every year around the world since 2008, and the World Bank estimates that another 143 million people will be displaced by 2050 in just three regions: sub-Saharan Africa, South Asia and Latin America……..’

Locator Map for Kiribati

Pronounced "Ki-ris-mas," Kiritimati Island has a large infilled lagoon that gives it the largest land area of any atoll in the world. Captain Cook named the atoll Christmas Island when he arrived on Christmas Eve in 1777. Used for nuclear testing in the 1950s and 1960s, the island is now valued for its marine and wildlife resources. It is particularly important as a seabird nesting site, with an estimated 6 million birds using or breeding on the island, including several million Sooty Terns. Rainfall on Kiritimati is linked to El Nino patterns, with long droughts experienced between the wetter El Nino years. This image is a mosaic of four digital photographs taken on 16 January 2002 from the Space Station. Photo courtesy of NASA.

 


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