Global & Disaster Medicine

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Xinmo, China: More than 140 people in southwestern China are feared to have been buried under an avalanche of mud and rocks when a hillside collapsed on Saturday

NY Times

  • 40 homes appeared to have been engulfed

 


Yemen: 37 079 suspected cholera cases and 196 associated deaths during the period 13 June to 19 June 2017.

WHO

Weekly update – cholera in Yemen, 22 June 2017

22 June 2017 – The Ministry of Public Health and Population of Yemen has recorded a total of 37 079 suspected cholera cases and 196 associated deaths during the period 13 June to 19 June 2017.

A cumulative total of 185 301 suspected cases of cholera and 1233 associated deaths have been recorded as of 21 June during this outbreak, which started in October 2016. The overall case-fatality rate is 0.7%; however, it is higher among people aged over 60.

WHO and health partners are actively supporting the Ministry through a cholera task force to improve cholera response efforts at the national and local levels. This includes the establishment of 18 diarrhoea treatment facilities and 28 oral dehydration centres, training of health workers to manage cases, water purification in communities, deployment of rapid response team to manage cholera cases investigations and respond to the outbreak, enhancement of Yemen’s disease early warning surveillance systems, and provision of emergency medical supplies to treatment facilities.

Cholera has affected around 268 districts in 20 governorates across the country. While cholera is endemic in Yemen, the country has experienced a surge in cholera cases since 27 April 2017.

WHO and the King Salman Centre for Humanitarian Aid and Relief recently agreed to provide around US$ 8.3 million through health partners to support 7.3 million people in 13 priority governorates with life-saving health services, medical supplies and cholera case management efforts.


2017 Wildland Fires and Potential Impacts to Critical Infrastructure

2017+Wildland+Fires+and+Potential+Impacts+to+Critical+Infrastructure:  Document

2017 Wildland Fires and Potential Impacts to Critical Infrastructure – 8 June 2017, has been posted to the Office of Cyber and Infrastructure Analysis (OCIA) page on the HSIN-Critical Infrastructure (CI) portal. This new product can be found under the Recent OCIA Products section of the portal.  

Scope Note
This product provides an overview of the National Interagency Fire Center (NIFC) Predictive Services Unit’s National Significant Wildland Fire Potential Outlook for June through September 2017. It examines the potential effects to U.S. critical infrastructure and is an update to the May 2016 Office of Cyber and Infrastructure Analysis (OCIA) Wildland Fires and Potential Impacts to Critical Infrastructure infographic. This update supports U.S. Department of Homeland Security (DHS) leadership; DHS Protective Security Advisors; and other Federal, State, and local agencies.
Key Findings
  • For June through September 2017, the NIFC predicts above normal fire potential across parts of Arizona, California, Florida, Georgia, Hawaii, Nevada, and New Mexico as fine fuels (twigs, needles, and grasses that ignite and burn rapidly) become available to burn.
  • Most areas of the United States are expected to see normal significant wildland fire potential throughout the fire season. It is important to note that normal fire activity still represents significant numbers of fires and acres burned.
  • OCIA assesses the critical infrastructure sectors most vulnerable to wildland fires are Emergency Services, Food and Agriculture, Healthcare and Public Health, Transportation Systems, and Water and Wastewater Systems.
Please read the attached document for further information regarding 2017 Wildland Fires Outlook.
Current Drought Conditions
According to the NIFC, overall drought conditions improved in May 2017. Southern Georgia and Florida saw preexisting extreme drought conditions worsen while abnormally dry conditions along the Mexico border with Arizona and New Mexico developed into a moderate drought. Abnormally dry conditions were also observed across portions of central and southern Texas as well as across portions of the Alaskan interior.
Please read the attached document for more information on the effects of wildland fires on critical infrastructure.
Coordination
This product was developed in coordination with the DHS/National Protection and Programs Directorate/Office of Infrastructure Protection/Sector Outreach and Programs Division, DHS/Federal Emergency Management Agency, U.S. Fire Administration, U.S. Department of the Interior/Office of Wildland Fire, and NIFC.
If you did not receive this OCIA New Product Alert directly, you can join the Critical Infrastructure Community of Interest (HSIN-CI) by sending your first and last name, your e-mail address, and your reason for requesting access to HSIN-CI to BOTH of the following addresses: HSIN.Outreach@hq.dhs.gov and HSINCI@hq.dhs.gov. HSIN-CI members can access all of OCIA’s past products and join Sector-specific COIs.
Access to the site will require the use of your assigned HSIN-CI user name and password. Upon linking directly to the site, the user can then also navigate within HSIN-CI as well as within those Communities of Interest to which they have access.
If you need to update your HSIN password, please click here to be directed to a self-service portal.  For technical assistance, you may contact the HSIN Help Desk or toll free at (866) 430-0162.
Please take the time and fill out the NPPD Customer Feedback Survey located on the last page of the product. Please direct any additional comments you were unable to address regarding the newly posted product to OCIA
The 2017 Wildland Fires and Potential Impacts to Critical Infrastructure Report is wholly UNCLASSIFIED and is approved for the widest dissemination.
2017 Wildland Fires and Potential Impacts to Critical Infrastructure Report can be accessed via the OCIA HSIN-CI page by clicking the following link:
This and other OCIA products are visible at the following websites:
Please include feedback and suggestions using the NPPD Feedback Survey located as a second attachment compared to its usual location on the last page of the product.

UN: World population to hit 9.8 billion by 2050

UN

21 June 2017 – The world population is now nearly 7.6 billion, up from 7.4 billion in 2015, spurred by the relatively high levels of fertility in developing countries – despite an overall drop in the number of children people have around the globe – the United Nations today reported.

The concentration of global population growth is in the poorest countries, according to World Population Prospects: The 2017 Revision, presenting a challenge as the international community seeks to implement the 2030 Sustainable Development Agenda, which seeks to end poverty and preserve the planet.

“With roughly 83 million people being added to the world’s population every year, the upward trend in population size is expected to continue, even assuming that fertility levels will continue to decline,” said the report’s authors at the UN Department of Economic and Social Affairs.

At this rate, the world population is expected to reach 8.6 billion in 2030, 9.8 billion in 2050 and surpass 11.2 billion in 2100.

The growth is expected to come, in part, from the 47 least developed countries, where the fertility rate is around 4.3 births per woman, and whose population is expected to reach 1.9 billion people in 2050 from the current estimate of one billion.

In addition, the populations in 26 African countries are likely to “at least double” by 2050, according to the report.

That trend comes despite lower fertility rates in nearly all regions of the world, including in Africa, where rates fell from 5.1 births per woman from 2000-2005 to 4.7 births from 2010-2015.

In contrast, the birth rate in Europe was 1.6 births per woman in 2010-2015, up from 1.4 births in 2010-2015.  “During 2010-2015, fertility was below the replacement level in 83 countries comprising 46 per cent of the world’s population,” according to the report.  The lower fertility rates are resulting in an ageing population, with the number of people aged 60 or over expected to more than double by 2050 and triple by 2100, from the current 962 million to 3.1 billion.  Africa, which has the youngest age distribution of any region, is projected to experience a rapid ageing of its population, the report noted.

“Although the African population will remain relatively young for several more decades, the percentage of its population aged 60 or over is expected to rise from five per cent in 2017 to around nine per cent in 2050, and then to nearly 20 per cent by the end of the century,” the authors wrote.

In terms of other population trends depicted in the report, the population of India, which currently ranks as the second most populous country with 1.3 billion inhabitants, will surpass China’s 1.4 billion citizens, by 2024.

By 2050, the third most populous country will be Nigeria, which currently ranks seventh, and which is poised to replace the United States.

The report also noted the impacts of the flows of migrants and refugees between countries, in particular noting the impact of the Syrian refugee crisis and the estimated outflow of 4.2 million people in 2010-2015.

In terms of migration, “although international migration at or around current levels will be insufficient to compensate fully for the expected loss of population tied to low levels of fertility, especially in the European region, the movement of people between countries can help attenuate some of the adverse consequences of population ageing,” the authors wrote.


Cindy makes landfall: Blamed for widespread coastal highway flooding, rough seas, scattered power outages, building damage caused by high winds, and 1 death.

National Weather Outlook

Southern Mississippi Valley sector loop

cone graphic


WHO training enables Syrian doctors and nurses to provide health care in Turkey

WHO

WHO training enables Syrian doctors and nurses to provide health care in Turkey19-06-2017

 

“We and the Turkish doctors are working like brothers and sisters.” These are the words of Muhammed Hattab, 1 of more than 3 million Syrian refugees now living in Turkey – the country with the highest number of refugees in the world. A doctor who fled his home in Aleppo more than 2 years ago, Muhammed did not know whether by leaving northern Syria he was also abandoning his profession and the career he had built in his home country. However, thanks to a joint programme of the WHO Country Office in Turkey and the Turkish Ministry of Health, he has been able to begin a new chapter of his life and career, working in the Turkish national health system and providing care for his fellow Syrians in Turkey.

In 2016, the Turkish government enacted a law that allows Syrian health professionals to enter the workforce in the Turkish health system, with the aim of both integrating Syrian professionals into the health system and also ensuring that Syrian refugees can receive health care without encountering language or cultural barriers. In order to implement this law, the Public Health Institution of Turkey, associated with the Ministry of Health, and the WHO Country Office developed an adaptation training for Syrian health workers living Turkey – including doctors, nurses and midwives. The initiative is supported financially by the European Civil Protection and Humanitarian Operations (ECHO).The training provides classroom and practical coursework, resulting in a certificate that authorizes Syrian health-care workers to practice in refugee health centres established in Turkey and to deliver health services to Syrian refugees.

Since the trainings began in November 2016, over 380 doctors and 360 nurses and midwives have received vocational competence certificates, allowing them to serve refugee populations in Turkey. Ultimately, they will staff the 260 refugee health centres and 600 refugee health units that the Ministry of Health has opened and will establish in the future. These centres and units provide primary health care, with services offered to Syrian refugees free of charge.

“This project in Turkey was the salvation for Syrian doctors,” says Muhammed. “With this programme, we felt like doctors for the first time in 2 years.”

WHO and Ministry of Health collaborate to provide training and support for Syrian health workers

While the health-care profession has general underlying principles that are universal across different parts of the world, some important regulations and practices differ greatly from country to country. The adaptation training seeks to give Syrian health workers the knowledge and experience they need in order to be fully competent and skilled in the Turkish setting. They must first apply for the programme and go through a selection process. Once approved by the Ministry of Health, they undergo a 1-week classroom training with Turkish university professors and lecturers, followed by 6 weeks of on-the -job training in a Refugee Health Centre. By working under the mentorship of Turkish health professionals for several weeks, they are able to familiarize themselves with the Turkish health system and prepare to provide care within this system. They are also evaluated at each stage of the training process before becoming certified to work in Turkey, helping to ensure good results for Syrian patients in the country.

“These trainings are not only a way to address language barriers but a good example of the collaboration between national and international partners in Turkey to help the integration of Syrian medical doctors, nurses and midwives to serve the community of refugees. We appreciate that the Government of Turkey, the Ministry of Health and Turkish health staff ensure equitable access to health services. And we consider this a one-of-a-kind collaboration among WHO, academia and the Ministry of Health to set an example for other countries, accommodating high numbers of refugees and migrants,” comments Dr Pavel Ursu, WHO Representative to Turkey.

WHO supports the classroom portion of the training, in collaboration with the Ministry, and is committed to making sure that Syrian health professionals are equipped with the essential theoretical background for their future career. In addition, WHO provides trainees with financial support for the duration of practical training to cover living expenses and travel costs.

Follow the links below and watch the video to learn more about the ways WHO’s work supports Syrian refugees in Turkey.

World Refugee Day: #WithRefugees

Each year on 20 June, the world commemorates the strength, courage and perseverance of millions of refugees. In a world where violence forces thousands of families to flee for their lives each day, World Refugee Day offers an opportunity for the global public to once again show that it stands with them. The United Nations Refugee Agency launched the #WithRefugees petition in June 2016 to send a message to governments that they must work together and combine their efforts to ensure the health and well-being of the world’s refugees.


FEMA: Pet Preparedness

Pet Preparedness Infographic

 

Humane Society

High Tech: Identifying Lost Pets With Microchips

Despite your best efforts, accidents can happen. Someone leaves a door ajar, an intrepid pooch digs under a fence, and your best intentions go awry: Your pet escapes and gets lost. If he’s wearing a collar and identification tag, chances are good that you’ll get him back.

But what if the collar comes off?

To protect their pets, many owners turn to technology, in the form of identification microchips implanted in their pets. Microchips are tiny transponders, about the size of a grain of rice, that can be implanted in your pet’s skin by many veterinarians and animal shelters; some shelters implant one in all pets they place.

Microchips are a good back-up option for pet identification, but should never be the main one. Reading a microchip takes a special scanner, one that an animal control officer or shelter will have, but your neighbor down the street will not. And if Fido wanders off, it’s likely to be a private citizen who encounters him first. That’s why, in the event of accidental separation, identification tags are your pet’s first ticket home.

That said, microchips provide an extra level of protection in case your pet loses his collar and tags. Providing your pets with both tags and a microchip can help ensure a happy reunion if the unthinkable happens.

How and where are microchips placed?

Microchips are implanted just under the skin, usually right between the shoulder blades. This is done with a large-bore needle and doesn’t require anesthesia.

How they work

Each microchip contains a registration number and the phone number of the registry for the particular brand of chip. A handheld scanner reads the radio frequency of the chip and displays this information. An animal shelter or vet clinic that finds your pet can contact the registry to get your name and phone number.

Can a microchip get lost inside my pet?

Your pet’s subcutaneous tissue usually bonds to the chip within 24 hours, preventing it from moving. There’s a small chance that the chip could migrate to another part of the body, but it can’t actually get lost.

How long do microchips last?

Microchips are designed to work for 25 years.

Where can I get my pet microchipped?

Many veterinarians and some animal shelters implant microchips for a small fee. But—and this is very important—just getting a microchip isn’t enough—you also need to register your pet with the microchip company.

How do I register my pet?

Complete the paperwork that comes with the chip and send it to the registry, or do it online if that option is available.  Some companies charge a one-time registration fee while others charge an annual fee.  You’ll also receive a tag for your pet’s collar with the chip number and registry phone number.

Are there different types of chips?

Yes, and that used to be a problem. Competing microchip companies use different frequencies to send signals to scanners, and until recently there was no universal scanner that could read all the different frequencies. That was a problem if a pet had a microchip that a particular scanner couldn’t detect.

Many microchip companies now produce universal scanners and provide them to animal shelters and animal control agencies at no or very low cost. If your local shelters don’t have scanners, they can contact some of the major manufacturers to ask about getting one.

Are there different registries?

Yes, and that, too, used to be problematic. Different chip companies maintained separate databases. Now, some chip companies will register pets with any brand of chip Also, the American Microchip Advisory Council is working to develop a network of the registry databases to streamline the return of pets to their families.

Can a microchip replace my pet’s collar and tags?

No. Despite advances in universal scanners and registry procedures, microchips aren’t foolproof, and you shouldn’t rely on them exclusively to protect your pet. Universal scanners can detect a competing company’s chip, but they may not be able to read the data. And if shelter or vet clinic personnel don’t use the scanner properly, they may fail to detect a chip.

What if I move?

You need to contact the company that registers the chip to update your information; otherwise, the chip will be useless. You may be charged a small fee to process the update.

What do I do if I adopt a pet who’s already been microchipped?

If you know what brand of chip your pet has, contact the corresponding registry to update the information. If you don’t know what type of chip your pet has, find a vet or animal shelter that can read it.


Fifteen new cases of polio have been confirmed in Syria

Reuters

‘……“We are very worried, because obviously if there is already one case of polio of a kid that is paralyzed it’s already an outbreak. We know for example that for one kid that is paralyzed there are almost 200 asymptomatic so it means that virus circulating, so it is very serious,” Jasarevic [WHO spokesman] said…….’

Poliomyelitis

Fact sheet
Updated April 2017


Key facts

  • Polio (poliomyelitis) mainly affects children under 5 years of age.
  • 1 in 200 infections leads to irreversible paralysis. Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.
  • Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 37 reported cases in 2016. As a result of the global effort to eradicate the disease, more than 16 million people have been saved from paralysis.
  • As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200 000 new cases every year, within 10 years, all over the world.
  • In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems.

Polio and its symptoms

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the fecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. 1 in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.

People most at risk

Polio mainly affects children under 5 years of age.

Prevention

There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.

Global caseload

Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then, to 37 reported cases in 2016.

Of the 3 strains of wild poliovirus (type 1, type 2, and type 3), wild poliovirus type 2 was eradicated in 1999 and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in November 2012.

WHO Response

Launch of the Global Polio Eradication Initiative

In 1988, the Forty-first World Health Assembly adopted a resolution for the worldwide eradication of polio. It marked the launch of the Global Polio Eradication Initiative (GPEI), spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and supported by key partners including the Bill & Melinda Gates Foundation. This followed the certification of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment to raise funds to protect all children from the disease.

Progress

Overall, since the GPEI was launched, the number of cases has fallen by over 99%.

In 1994, the WHO Region of the Americas was certified polio-free, followed by the WHO Western Pacific Region in 2000 and the WHO European Region in June 2002. On 27 March 2014, the WHO South-East Asia Region was certified polio-free, meaning that transmission of wild poliovirus has been interrupted in this bloc of 11 countries stretching from Indonesia to India. This achievement marks a significant leap forward in global eradication, with 80% of the world’s population now living in certified polio-free regions.

More than 16 million people are able to walk today, who would otherwise have been paralysed. An estimated 1.5 million childhood deaths have been prevented, through the systematic administration of vitamin A during polio immunization activities.

Opportunity and risks: an emergency approach

The strategies for polio eradication work when they are fully implemented. This is clearly demonstrated by India’s success in stopping polio in January 2011, in arguably the most technically-challenging place, and polio-free certification of the entire South-East Asia Region of WHO occurred in March 2014.

Failure to implement strategic approaches, however, leads to ongoing transmission of the virus. Endemic transmission is continuing in Afghanistan, Nigeria and Pakistan. Failure to stop polio in these last remaining areas could result in as many as 200 000 new cases every year, within 10 years, all over the world.

Recognizing both the epidemiological opportunity and the significant risks of potential failure, the “Polio Eradication and Endgame Strategic Plan 2013-2019” was developed, in consultation with polio-affected countries, stakeholders, donors, partners and national and international advisory bodies. The new Plan was presented at a Global Vaccine Summit in Abu Dhabi, United Arab Emirates, at the end of April 2013. It is the first plan to eradicate all types of polio disease simultaneously – both due to wild poliovirus and due to vaccine-derived polioviruses.

Future benefits of polio eradication

Once polio is eradicated, the world can celebrate the delivery of a major global public good that will benefit all people equally, no matter where they live. Economic modelling has found that the eradication of polio would save at least US$ 40–50 billion between 1988 and 2035, mostly in low-income countries. Most importantly, success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis.

 

 


All about Cindy

Southern Mississippi Valley sector loop    Southeast sector loop

cone graphic

[Image of WPC QPF U.S. rainfall potential]


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