WHO

• “…Since 6 June 2016, health clinics in IDP camps in Borno State have seen increasing numbers of measles cases. From early September until late October, 744 suspected cases of measles, and 2 deaths, were reported from WHO-established EWARS reporting sites. The majority of these children had never been vaccinated against measles and most of them were aged less than 5 years….”

Key facts

• Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.
• In 2015, there were 134 200 measles deaths globally – about 367 deaths every day or 15 deaths every hour.
• Measles vaccination resulted in a 79% drop in measles deaths between 2000 and 2015 worldwide.
• In 2015, about 85% of the world’s children received one dose of measles vaccine by their first birthday through routine health services – up from 73% in 2000.
• During 2000-2015, measles vaccination prevented an estimated 20.3 million deaths making measles vaccine one of the best buys in public health.

CIDRAP

• Administering the vaccine intradermally rather than subcutaneously could increase the available doses at least twofold.
• In June the same panel approved a plan to stretch limited yellow fever vaccine supplies—drained by outbreaks in Angola and the Democratic Republic of Congo—by using one-fifth of the regular dose.

Keeping your hands clean is one of the most important steps you can take to avoid getting sick and spreading germs to the people around you. Many diseases and conditions are spread by not cleaning your hands properly. Here are five important things you might not know about washing your hands and why it matters.

1. Soap is key. Washing your hands with soap removes germs much more effectively than using water alone.[i] The compounds, called surfactants, in soap help remove soil and microbes from your skin. You also tend to scrub your hands more thoroughly when you use soap, which also helps to removes germs.[ii]

2. It takes longer than you might think. The optimal length of time to wash your hands depends on many factors, including the type and amount of soil on your hands. Evidence suggests that washing your hands for about 15–30 seconds removes more germs than washing for shorter periods.[iii] CDC recommends washing your hands for about 20 seconds, or the time it takes to hum the “Happy Birthday” song twice from beginning to end.

3. It’s all about technique. Make sure to clean the spots on your hands that people miss most frequently. Pay particular attention to the backs of your hands, in between your fingers, and under your nails. Lathering and scrubbing your hands creates friction, which helps to remove dirt, grease, and germs from your skin.

4. Don’t forget to dry. Germs can be transferred more easily to and from wet hands, so you should dry your hands after washing.[iv] Studies suggest that using a clean towel or letting your hands air dry are the best methods to get your hands dry.[v],[vi],[vii]

5. Hand sanitizer is an option. If you can’t get to a sink to wash your hands with soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Make sure you use enough to cover all surfaces of your hands. Do not rinse or wipe off the hand sanitizer before it is dry.[viii]

Note: Hand sanitizer may not kill all germs, especially if your hands are visibly dirty or greasy,[ix] so it is important to wash hands with soap and water as soon as possible after using hand sanitizer.

Why it Matters

Remember, clean hands save lives. Diarrheal diseases and pneumonia are the top two killers of young children around the world, killing 1.8 million children under the age of five every year.[x] Among young children, handwashing with soap prevents 1 out of every 3 diarrheal illnesses [xi] and 1 out of 5 respiratory infections like pneumonia worldwide.[xii],[xiii]

October 15^th is Global Handwashing Day

Handwashing is for everyone…everywhere. Global Handwashing Day is an opportunity to support a global and local culture of handwashing with soap and water, shine a spotlight on the state of handwashing in each country, and raise awareness about the benefits of washing your hands with soap. Although people around the world clean their hands with water, very few use soap to wash their hands because soap and water for handwashing might be less accessible in developing countries.

Get Involved!

• Organize or participate in a handwashing event in your school or community. Find educational resources and materials and planning tools.
• Celebrate virtually on Twitter and Facebook. Look for and use the hashtag #GlobalHandwashingDay, download pre-drafted educational social media messages, and share CDC’s Global Handwashing Day digital button.
• Make sure you and your family know when and how to wash your hands properly.
• Share the science behind handwashing.

References

[i] Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011 Jan;8(1):97-104.

[ii] Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011 Jan;8(1):97-104.

[iii] Jensen D, Schaffner D, Danyluk M, Harris L. Efficacy of handwashing duration and drying methods. Int Assn Food Prot. 2012 July.

[iv] Patrick DR, Findon G, Miller TE. Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect. 1997 Dec;119(3):319-25.

[v] Gustafson DR, Vetter EA, Larson DR, Ilstrup DM, Maker MD, Thompson RL, Cockerill FR 3rd. Effects of 4 hand-drying methods for removing bacteria from washed hands: a randomized trial. Mayo Clin Proc. 2000 Jul;75(7):705-8.

[vi] Huang C, Ma W, Stack S. The hygienic efficacy of different hand-drying methods: a review of the evidence. Mayo Clin Proc. 2012 Aug;87(8):791-8.

[vii] Jensen D, Schaffner D, Danyluk M, Harris L. Efficacy of handwashing duration and drying methods. Int Assn Food Prot Annual Meeting. 2012 July 22-25.

[viii] Widmer, A. F., Dangel, M., & RN. (2007). Introducing alcohol-based hand rub for hand hygiene: the critical need for training. Infection Control and Hospital Epidemiology, 28(1), 50-54.

[ix] Pickering AJ, Davis J, Boehm AB. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. J Water Health. 2011 Sep;9(3):429-33.

[x] Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012 Jun 9;379(9832):2151-61.

[xi] Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;1:CD004265.

[xii] Rabie T and Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review.Trop Med Int Health. 2006 Mar;11(3):258-67.

[xiii] Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372-81.

Posted on October 14, 2016 by Blog Administrator

Tags Global Handwashing Day, handwashing, public health

WHO

14 September 2016, Mecca – The World Health Organization (WHO) has today concluded its mission to Saudi Arabia to support the Ministry of Health in ensuring a safe pilgrimage season (Hajj). So far there has been no major health threat or event of concern, with no major disease outbreak reported among the nearly two million pilgrims attending the holy sites.

In preparation for the Hajj, the Ministry of Health, together with WHO, conducted a strategic health risk assessment of the health hazards that might occur during the pilgrimage. Based on the requirements of the International Health Regulations (2005), the Ministry put in place several public health mitigation measures covering areas such as infection prevention and control, points of entry, laboratories, coordination, risk communication and community engagement. Additionally many measures have been put in place to reduce the effects of high temperatures on pilgrims, including awareness campaigns on preventing sun strokes and heat exhaustion.

Preliminary information indicates a decrease in morbidity and mortality from seasonal influenza compared to last year. This might be related to the Ministry of Health’s decision to make seasonal influenza vaccine compulsory for all internal pilgrims. Some countries also vaccinated their pilgrims against seasonal influenza in accordance with Saudi Arabia’s health requirements for the Hajj.

No cases of Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported so far among the pilgrims. Of 344 samples collected and tested by the national public health laboratory, none was found to be positive for MERS-CoV.

WHO has shared the conclusions and recommendations of the mission with the Ministry of Health, noting the importance of documenting and sharing experiences and good practices for improving public health preparedness for future Hajj seasons.

For more information:

Rana Sidani, Senior Communication Officer
Mobile: +20 1099756506
E-mail: sidanir@who.int This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Mona Yassin, Communication Officer
Mobile: +20 1006019284
E-mail: yassinm@who.int

Medscape:  Enhance Preparedness

India,

Bangladesh,

Bhutan,

South Korea,

Indonesia,

Maldives,

Myanmar,

Nepal,

Sri Lanka,

Thailand

Timor-Leste,

WHO

Hundreds killed and health facilities seriously damaged in earthquake in central Italy

25-08-2016

WHO

CDC

Symptoms

• The majority of persons infected with yellow fever virus have no illness or only mild illness.
• In persons who develop symptoms, the incubation period (time from infection until illness) is typically 3–6 days.
• The initial symptoms include sudden onset of fever, chills, severe headache, back pain, general body aches, nausea, and vomiting, fatigue, and weakness. Most persons improve after the initial presentation.
• After a brief remission of hours to a day, roughly 15% of cases progress to develop a more severe form of the disease. The severe form is characterized by high fever, jaundice, bleeding, and eventually shock and failure of multiple organs.

Treatment

• No specific treatments have been found to benefit patients with yellow fever. Whenever possible, yellow fever patients should be hospitalized for supportive care and close observation.
• Treatment is symptomatic. Rest, fluids, and use of pain relievers and medication to reduce fever may relieve symptoms of aching and fever.
• Care should be taken to avoid certain medications, such as aspirin or other nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), which may increase the risk of bleeding.
• Yellow fever patients should be protected from further mosquito exposure (staying indoors and/or under a mosquito net) for up to 5 days after the onset of fever. This way, yellow fever virus in their bloodstream will be unavailable to uninfected mosquitoes, thus breaking the transmission cycle and reducing risk to the persons around them.

Outcome

• The majority of infected persons will be asymptomatic or have mild disease with complete recovery.
• In persons who become symptomatic but recover, weakness and fatigue may last several months.
• Among those who develop severe disease, 20–50% may die.
• Those who recover from yellow fever generally have lasting immunity against subsequent infection.

WHO

WHO

Summary

• As of 10 August 2016, 69 countries and territories (Fig. 1, Table 1) have reported evidence of mosquito-borne Zika virus transmission since 2007 (66 of these countries and territories have reported evidence of mosquito-borne Zika virus transmission since 2015):
  • 52 countries and territories with a first reported outbreak from 2015 onwards (Table 1).
  • Four countries are classified as having possible endemic transmission or have reported evidence of local mosquito-borne Zika infections in 2016.
  • 13 countries and territories have reported evidence of local mosquito-borne Zika infections in or before 2015, but without documentation of cases in 2016, or with the outbreak terminated.

• The Cayman Islands, a British Overseas Territory in the Caribbean, is the latest territory to report locally-acquired mosquito borne Zika virus infection.
• Since February 2016, 11 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route (Table 2).
• As of 10 August 2016, 15 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection. Canada is the latest country to report a case of congenital malformation associated with a travel-related case of Zika virus infection. Four of the 15 total countries reported microcephaly cases born from mothers in countries with no endemic Zika virus transmission but who reported recent travel history to Zika-affected countries in the WHO Region of the Americas (Table 3).
• As of 10 August 2016, the United States Centers for Disease Control and Prevention (US-CDC) reported 15 live-born infants with birth defects and six pregnancy losses with birth defects with laboratory evidence of Zika virus infection.
• As of 10 August 2016, 16 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases (Table 4). Grenada is the latest country to report a case of GBS associated with a confirmed Zika virus infection.
• In Guinea-Bissau, on 29 June 2016, Institute Pasteur Dakar (IPD) laboratory technicians confirmed that three of 12 samples tested positive for Zika by PC-R. All 12 samples tested negative against IgM Zika. One additional sample from a recent case also tested positive for Zika virus infection. All four samples were sent to IPD on 1 July for gene sequencing and the results are pending. Results from the 22 additional samples collected from the Bijagos archipelago and sent to IPD are negative with ELISA and PCR testing. The same samples were also sent to Dakar for confirmation. A further total of 12 new samples were collected and results are still pending.
• Two cases of microcephaly have been reported in the Western region of Gabu in Guinea-Bissau. The family members of the two children with microcephaly have not travelled outside Guinea-Bissau. The investigations regarding these two cases are ongoing. Trainings for regional health staff on the Zika case definition and other areas are planned to help ensure that cases are detected efficiently and effectively.
• The joint mission by staff from the WHO Regional Office for Africa and from WHO headquarters to Guinea-Bissau has concluded and priority activities and gaps were identified as the following: additional financial resources to reinforce leadership and coordination mechanisms of the Emergency operations Centre (EOC); reinforcement of epidemiologic and entomologic surveillance systems; increasing laboratory capacity at three levels; strengthening of response to Zika cases in terms of detection, community involvement and risk communication; and continued monitoring of Zika virus and its complications.
• Zika virus test kits have been made available by the local authorities at the Central Public Health Laboratory in Rio de Janeiro in Brazil and symptomatic athletes, volunteers, visitors and residents are encouraged to get tested.
• WHO has developed advice and information on diverse topics in the context of Zika virus.

CDC

The Story Behind the Snapshot

At first glance, this photo taken on a set of concrete steps in Washington, D.C., may look like an ordinary group shot—but it took an extraordinary series of events to make it happen.

The photo shows colleagues from U.S. Department of Health and Human Services (HHS) and U.S. Department of Agriculture (USDA) standing alongside a team of 15 international experts from 13 different countries, known as the Joint External Evaluation Team. The team had been invited by the U.S. government to assess how well the country is prepared to prevent, detect, and respond to major public health threats. The goal was to receive an independent and unbiased evaluation of our capabilities.

We would never have arrived at this moment without these things: a wake-up call, a historic agreement, and a renewed commitment to work together to protect the world’s health.

Leading up to now: A brief timeline

Near the turn of this century, the emergence of diseases like severe acute respiratory syndrome (SARS) and H5N1 influenza was a big wake-up call and showed the world more clearly than ever that a health threat anywhere is a threat everywhere — what affects one country affects us all.

Eleven years ago, countries came together to sign the International Health Regulations (IHR), a historic agreement which gave the world a new framework for stopping the spread of diseases across borders. The IHR obligates every country to prepare for, and report on, public health events that could have an international impact.

However, five years after the IHR went into effect, nearly 2/3 of countries were still unprepared to handle a public health emergency.

Two years ago, the Global Health Security Agenda (GHSA) gave countries common targets they can work toward to stop infectious disease in its tracks. This led to the need for the Joint External Evaluation Team, an independent group that travels to countries to report on how well public health systems are working to meet global health security goals.

Last October, the Centers for Disease Control and Prevention (CDC) and the Office of the Assistant Secretary for Preparedness and Response (ASPR) began working together to arrange for the team to visit the U.S.

In May, the team’s five-day visit took place. Two days were spent in Washington, D.C., assessing federal response capabilities. The remaining three days were spent at CDC, because the agency works in nearly all of the 19 technical areas included in the evaluation.

On the final day of their visit in Atlanta, the evaluation team shared their preliminary results.

What the team found

They recognized the high level of scientific expertise within CDC and other federal agencies, and the excellent reporting mechanisms managed by the federal government.

They also identified opportunities for improvement in some areas, such as:

• Combining and utilizing data from multiple surveillance systems, including systems that monitor human, animal, environmental, and plant health
• Conducting triage and long-term medical follow-up during major radiological disasters
• Communicating risks quickly and consistently with communities across the country

They specifically recognized the challenges any federal public health system faces, and advised the U.S. to continue improving the understanding of the IHR among different federal and state agencies. Their observations will help drive improvements for programs throughout CDC and the nation.

The U.S. requested this unbiased review of its response capabilities and hopes that the entire world will do the same. Like other countries who have undergone this process, the U.S. will soon share the final report of the Joint External Evaluation with the public.

For More Information

• Global Health Security Agenda: https://ghsagenda.org/
• Joint External Evaluation: https://ghsagenda.org/assessments.html
• CDC and the Global Health Security Agenda: http://www.cdc.gov/globalhealth/security/ghsagenda.htm
• Global Health Security: http://www.cdc.gov/globalhealth/healthprotection/ghs/index.html
• International Health Regulations: http://www.cdc.gov/globalhealth/healthprotection/ghs/ihr/index.html