AFM in Kids: More Cases Confirmed by CDC

IN PROGRESS…

TIA [September 24, Confidential 10]
TNWG [October 22, Confidential 10]
MIRR [Nov. 14, Confidential10]

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FIRE-EARTH MIU – 111402

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FIRE-EARTH Report:

Paralyzing Illness AFM in kids: CDC Confirms 90 Cases

At least 90 kids in 27 states have been diagnosed polio-like neurological condition acute flaccid myelitis, aka AFM, so far this year, the Centers for Disease Control and Prevention (CDC) reported. The reported total includes 18 new cases since last week. CDC is also investigating an additional 162 cases for potential AFM infection.

In October, health officials in 26 states told NBC News they were investigating or had reported 87 cases of AFM.

About Acute Flaccid Myelitis

Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. This condition is not new. However, the large number of AFM cases reported since 2014, when we first started our surveillance for this condition, is new. The risk of getting AFM varies by age and year. We have seen increases in AFM cases every two years since 2014 and mostly in young children. Still, CDC estimates that less than one to two in a million children in the United States will get AFM every year. Since 2014, most patients (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM. All patients tested negative for poliovirus. We are working closely with national experts to better understand the possible causes of AFM and update our information on treatment. [CDC]

Symptoms

Most people will have sudden onset of arm or leg weakness and loss of muscle tone and reflexes. Some people, in addition to arm or leg weakness, will have:

• facial droop/weakness,
• difficulty moving the eyes,
• drooping eyelids, or
• difficulty with swallowing or slurred speech.

Numbness or tingling is rare in people with AFM, although some people have pain in their arms or legs. Some people with AFM may be unable to pass urine (pee). The most severe symptom of AFM is respiratory failure that can happen when the muscles involved with breathing become weak. This can require urgent ventilator support (breathing machine). In very rare cases, it is possible that the process in the body that triggers AFM may also trigger other serious neurologic complications that could lead to death. [CDC]

Diagnosis

AFM is diagnosed by examining a patient’s nervous system in combination with reviewing pictures of the spinal cord. A doctor can examine a patient’s nervous system and the places on the body where he or she has weakness, poor muscle tone, and decreased reflexes. A doctor can also do an MRI (magnetic resonance imaging) to look at a patient’s brain and spinal cord, do lab tests on the cerebrospinal fluid (the fluid around the brain and spinal cord), and may check nerve conduction (impulse sent along a nerve fiber) and response. It is important that the tests are done as soon as possible after the patient develops symptoms. [CDC]

AFM can be difficult to diagnose because it shares many of the same symptoms as other neurologic diseases, like transverse myelitis and Guillain-Barre syndrome. With the help of testing and examinations, doctors can distinguish between AFM and other neurologic conditions. [CDC]

Learn more about the type of information that helps to determine if a patient has AFM or not.

Possible Causes of AFM

Certain viruses are known to cause AFM including enteroviruses, such as poliovirus and enterovirus A71 (EV-A71), and West Nile virus. Since 2014, most patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM. All patients tested negative for poliovirus. Most patients had onset of AFM between August and October, with increases in AFM cases every two years since 2014. At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM. [CDC]

We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 404 confirmed cases of AFM since 2014, which points to the cause of their AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause. When a pathogen (germ) is found in the spinal fluid, it is good evidence that it was the cause of a patient’s illness. However, oftentimes, despite extensive testing of AFM patients, no pathogens are found in the spinal fluid. This may be because the pathogen has been cleared by the body or it is hiding in tissues that make it difficult to detect. Another possibility is that the pathogen triggers an immune response in the body that causes damage to the spinal cord. We are searching for what triggers AFM in some children who have had a fever and/or respiratory illness compared to most children who don’t get AFM. [CDC]

Treatment

There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. For example, neurologists may recommend physical or occupational therapy to help with arm or leg weakness caused by AFM. CDC is researching prognosis of AFM victims.

Prevention

Since we don’t know the cause of most of these AFM cases or what triggers this condition, there is no specific action to take to prevent AFM.

Certain viruses are known to cause AFM including enteroviruses, such as poliovirus and enterovirus A71 (EV-A71), and West Nile virus. [CDC]

Laboratory engineered virus?

See full report. [FEWW -ER05]

Related Links

• FIRE-EARTH Report: “Civilization Disease” – AFM

[Presented by FIRE-EARTH Science – MIU.]

• Full presentation available via FIRE-EARTH PULSARS.

FIRE-EARTH Top Ten Alerts

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Latest FIRE-EARTH DIRECTIVES, ALERTS, FORECASTS, BULLETINS and MESSAGES available via FIRE-EARTH PULSARS.

 

 

Another Feather in the Cap of Tourism: Waterborne Diseases

One-Third of Waterborne Infections Linked to Hotel Pools, Hot Tubs –CDC

Crypto parasite continues to cause most outbreaks and illnesses linked to pools and water playgrounds.

New data from the Centers for Disease Control (CDC) shows one-third of recreational waterborne infections are acquired in hotel pools or hot tubs.

The parasite, Cryptosporidium [“Crypto”] bacteria, which causes the majority of outbreaks and illnesses, is spread by swallowing water contaminated with feces.

Morbidity and Mortality Weekly Report (MMWR) – Outbreaks Associated with Treated Recreational Water — United States, 2000–2014

Outbreaks associated with exposure to treated recreational water can be caused by pathogens or chemicals in venues such as pools, hot tubs/spas, and interactive water play venues (i.e., water playgrounds). During 2000–2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water. These outbreaks resulted in at least 27,219 cases and eight deaths. Among the 363 outbreaks with a confirmed infectious etiology, 212 (58%) were caused by Cryptosporidium (which causes predominantly gastrointestinal illness), 57 (16%) by Legionella (which causes Legionnaires’ disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms), and 47 (13%) by Pseudomonas (which causes folliculitis [“hot tub rash”] and otitis externa [“swimmers’ ear”]). Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks. Overall, the outbreaks had a bimodal temporal distribution: 275 (56%) outbreaks started during June–August and 46 (9%) in March. Assessment of trends in the annual counts of outbreaks caused by Cryptosporidium, Legionella, or Pseudomonas indicate mixed progress in preventing transmission. Pathogens able to evade chlorine inactivation have become leading outbreak etiologies. The consequent outbreak and case counts and mortality underscore the utility of CDC’s Model Aquatic Health Code (https://www.cdc.gov/mahc) to prevent outbreaks associated with treated recreational water.

46 outbreaks infect more than 27,000 people

During 2000–2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water, which resulted in at least 27,219 cases and eight deaths. Etiology was confirmed for 385 (78%) outbreaks. Among these, 363 (94%) were caused by pathogens (including four caused by both Cryptosporidium and Giardia) and resulted in at least 24,453 cases. Twenty-two (6%) outbreaks were caused by chemicals and resulted in at least 1,028 cases. Among the 363 outbreaks with a confirmed infectious etiology, 212 (58%) were caused by Cryptosporidium, 57 (16%) by Legionella, and 47 (13%) by Pseudomonas. Of the 24,453 cases, 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. Of the 212 outbreaks caused by Cryptosporidium, 24 (11%) each affected >100 persons; four of these outbreaks each affected ≥2,000 persons. At least six of the eight deaths,^¶ which all occurred after 2004, were in persons affected by outbreaks caused by Legionella.

32% of infections acquired in hotels

Hotels** (i.e., hotels, motels, lodges, or inns) were the leading setting associated with 157 (32%) of the 493 outbreaks. Of the 157 hotel-related outbreaks, 94 (60%)^†† had a confirmed infectious etiology, 40 (43%) were caused by Pseudomonas, 29 (31%) by Legionella, and 17 (18%) by Cryptosporidium.^§§ Sixty-five (41%) hotel-related outbreaks were associated with hot tubs/spas, and 47 (30%) started during February–March. Among all 493 outbreaks, a bimodal temporal distribution was observed. The 275 (56%) outbreaks that started during June–August were predominantly caused by Cryptosporidium, whereas the 46 (9%) that started in March were predominantly caused by an unidentified etiology or pathogens other than Cryptosporidium. Negative binomial regression analysis indicated that during 2000–2007, the annual number of outbreaks caused by Cryptosporidium increased by an average of 25% (95% confidence interval [CI] = 7%–45%) per year. No significant trend was found after 2007.^¶¶ Poisson regression analysis indicated that during 2000–2014 the annual number of outbreaks caused by Legionella increased by an average of 13% (95% CI = 6%–21%) per year, and the annual number of Pseudomonas folliculitis outbreaks (a total of 41 outbreaks during 2000–2014) decreased by an average of 22% (95% CI = 14%–29%) per year.*** [Source: CDC MMWR]

FIRE-EARTH Conference: ‘Nightmare Bacteria’ (2)

• CJ
• IGE
• OCT
• TML
• TWM

FIRE-EARTH Medical Conference (041002)

Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus (MRSA), Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis…

[Genetic Legacy of Interbreeding with Neanderthals]

Background summary:

• Germs with unusual antibiotic resistance are widespread.
• At least 2 million Americans become infected with germs resistant to antibiotics each year and more than 23,000 die from these infections, CDC has revealed.
• Researchers have uncovered 221 instances of especially rare resistance gene in the so-called “nightmare bacteria” —carbapenem-resistant Enterobacteriaceae (CRE).
• CRE can kill if it gets into the bloodstream, urinary tract or lungs.
• “The report shows that in nine months in all states and Puerto Rico health departments in the AR Lab Network tested 5,776 samples of highly resistant germs.”
• One in four germ samples sent for testing had special genes that allow them to spread their resistance to other germs.
• About one in 10 screening tests, from patients without symptoms, identified an AR germ that spreads easily. “This means the germ could have spread undetected in that health care facility.”
• Resistance genes with the capacity to turn regular germs into nightmare bacteria have been introduced into 27 different states.
• Nightmare bacteria studies suggest fatality rate of up to 50 percent.

[Prepared by an affiliated team of medical experts.]

Report 041002 available via FIRE-EARTH PULSARS.

FIRE-EARTH Conference: Antibiotic Resistant ‘Nightmare Bacteria’

• CJ
• IGE
• OCT
• TML
• TWM

FIRE-EARTH Medical Conference (040902)

Nightmare Scenario: Antibiotic Resistant Genes Spreading Resistance to other Germs

[Genetic Legacy of Interbreeding with Neanderthals]

Background summary:

• Germs with unusual antibiotic resistance are widespread.
• At least 2 million Americans become infected with germs resistant to antibiotics each year and more than 23,000 die from these infections, CDC has revealed.
• Researchers have uncovered 221 instances of especially rare resistance gene in the so-called “nightmare bacteria” —carbapenem-resistant Enterobacteriaceae (CRE).
• CRE can kill if it gets into the bloodstream, urinary tract or lungs.
• “The report shows that in nine months in all states and Puerto Rico health departments in the AR Lab Network tested 5,776 samples of highly resistant germs.”
• One in four germ samples sent for testing had special genes that allow them to spread their resistance to other germs.
• About one in 10 screening tests, from patients without symptoms, identified an AR germ that spreads easily. “This means the germ could have spread undetected in that health care facility.”
• Resistance genes with the capacity to turn regular germs into nightmare bacteria have been introduced into 27 different states.
• Nightmare bacteria studies suggest fatality rate of up to 50 percent.

[Prepared by an affiliated team of medical experts.]

Report 040902 available via FIRE-EARTH PULSARS.

Types of Fungal Diseases –CDC

Hormones, medicines, and changes in the immune system encourage fungal growth and cause infection

About 1.5 million different species of fungi are found on Earth, with 300 of those known to cause infections and sicken people. Fungi live outdoors in soil and on plants and trees as well as on many indoor surfaces and on human skin.

 Aspergillosis

Caused by the fungus Aspergillus and usually occurs in people with lung diseases or weakened immune systems.

Candidiasis

Caused by the yeast Candida. Candidiasis can occur in the mouth and throat, vagina, or the bloodstream.

Types of Candidiasis

• Candida infections of the mouth, throat, and esophagus
• Vaginal Candidiasis
• Invasive Candidiasis

Global Emergence of Candida auris

Candida auris is an emerging fungus that presents a serious global health threat. Healthcare facilities in several countries have reported that C. auris has caused severe illness in hospitalized patients. C. auris is often resistant to multiple antifungal drugs.

C. neoformans infection

Caused by Cryptococcus neoformans, which can infect the brain (meningitis) in people with HIV/AIDS.

Fungal eye infections

Different types of fungi can cause eye infections. These are rare but can develop after an eye injury.

Mucormycosis

A rare infection that mainly affects people with weakened immune systems.

Ringworm

A common fungal skin infection that often looks like a circular rash.

Blastomycosis

Caused by the fungus Blastomyces, which lives in moist soil in parts of the United States and Canada.

Coccidioidomycosis (Valley Fever)

Caused by Coccidioides, a fungus that lives in the southwestern United States and parts of Mexico and Central and South America.

C. gattii infection

Caused by the fungus Cryptococcus gattii, which lives in soil in tropical and sub-tropical areas, the United States Pacific Northwest, and British Columbia.

Histoplasmosis

Caused by the fungus Histoplasma, which lives in the environment, often in association with large amounts of bird or bat droppings.

Pneumocystis pneumonia (PCP)

Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii. Most people who get PCP have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines that lower the body’s ability to fight germs and sickness. Image: Pneumocystis jirovecii in the lung of an HIV/AIDS patient.

Sporotrichosis

Caused by the fungus Sporothrix, which lives throughout the world in soil and on plants.

Other pathogenic fungi

Exserohilum and Cladosporium are two examples of environmental molds.

Source: CDC

Drug-Resistant ‘Japanese Fungus’ Spreads to 200 Patients in 55 UK Hospitals

Candida auris: An emerging fungus that presents a serious global health threat –CDC

Healthcare facilities in several countries including the UK, United States, Japan, Venezuela, Colombia, India, Pakistan, Oman, Kuwait, Israel, South Africa and Spain have reported that C. auris has caused severe illness in hospitalized patients.

• Some strains of C. auris are resistant to all three major classes of antifungal drugs [including the first-line anti-fungal drug fluconazole.] This type of multidrug resistance has not been seen before in other species of Candida.
• Also of concern, C. auris can persist on surfaces in healthcare environments and spread between patients in healthcare facilities. [CDC]

C. auris was first identified in Japan eight years ago. The first case in Britain was detected in 2013, and has since spread to at least 200 patients in 55 UK hospitals.

On July 14, 2017, the US case count was updated to 98 across nine states, with a total of 68 cases in New York, and 20 in New Jersey.

• The superbug is linked with bloodstream, wound and ear infections (otitis). 
• Several strains of C. auris appear to be rapidly evolving.

#Health Dangers of a Deadly Fungus: The Candida auris 'Superbug' https://t.co/PCM588DNxH pic.twitter.com/OKjDgEoHml

— HealthpremiumNY (@healthpremiumNY) August 13, 2017

Public Health England (PHE)

“As at the beginning of July 2017, 20 separate NHS Trusts and independent hospitals in the United Kingdom had detected over 200 patients colonised or infected with Candida auris,” PHE said.

“Three hospitals have seen large nosocomial [within hospital] outbreaks that have proved difficult to control, despite intensive infection prevention and control measures, though two of these outbreaks have been declared over and one is seeing significantly fewer numbers of new acquisitions.

 “Over 35 other hospitals have had patients known to be colonised with Candida auris transferred to them.”

A “biosafety” unit at Porton Down, Britain’s infamous chemical weapons lab, has been testing fungicidal activity of a variety of disinfectants and antiseptics, UK media reported.

Related links:

• https://www.cdc.gov/fungal/diseases/candidiasis/candida-auris.html
• https://www.gov.uk/government/collections/candida-auris

EPILEPSY IN THE U.S. AT AN ALL TIME HIGH –CDC

At least 1.2 percent of the U.S. population reported active epilepsy in 2015

At least 3.47 million people living with epilepsy, as CDC reports a rising trend with the disorder. , Data released in CDC’s Morbidity and Mortality Weekly Report  provides for the first time epilepsy estimates for every state.

The data show the disorder is widespread. In 2015, about 3 million U.S. adults and 470,000 children had active epilepsy (under treatment or with recent seizures). The number of adults with active epilepsy rose from 2.32 million in 2010 to 3 million in 2015. The number of children with the condition increased from 450,000 in 2007 to 470,000 in 2015. These increases are likely due to population growth.

“Millions of Americans are impacted by epilepsy, and unfortunately, this study shows cases are on the rise,” said CDC Director. “Proper diagnosis is key to finding an effective treatment – and at CDC we are committed to researching, testing, and sharing strategies that will improve the lives of people with epilepsy.”

Epilepsy is a disorder of the brain that causes seizures. Different conditions can cause epilepsy, such as stroke, brain tumor, head injury, central nervous system infections, or genetic risks.

Key findings from analysis of epilepsy rates

The CDC study provides national and state-specific estimates of epilepsy prevalence based on the 2015 National Health Interview Survey, and the National Survey of Children’s Health, and the 2014 Current Population Survey.

• Overall, 1.2 percent of the U.S. population (3.4 million people) reported active epilepsy in 2015.
• The number of cases of active epilepsy among adults ranged from 5,100 in Wyoming [pop: 5.8 million] to 367,900 in California [pop: 39.5 million.]
• The number of epilepsy cases among children ranged from 800 in Wyoming to 59,800 in California.
• Eleven states had more than an estimated 92,000 people with epilepsy.
• Data from 2010-2015 indicate increases in the number of persons with active epilepsy, probably because of population growth.

CDC’s Epilepsy Program:  www.cdc.gov/epilepsy.

FIRE-EARTH Alert: Outbreak of Multidrug-Resistant Salmonella Heidelberg Infections

Multistate Outbreak of Multidrug-Resistant Salmonella Heidelberg Infections  –CDC

• CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) are investigating a multistate outbreak of multidrug-resistant Salmonella Heidelberg infections.
  • Twenty-one people infected with the outbreak strain of Salmonella Heidelberg have been reported from 8 states.
  • Illness onset dates range from January 11, 2016 to October 24, 2016.
  • Eight ill people were hospitalized, and no deaths have been reported.
• Epidemiologic, traceback, and laboratory findings have linked this outbreak to contact with dairy bull calves purchased from livestock markets in Wisconsin. Dairy bull calves are young, male cattle that may be raised for meat.
• The Wisconsin State Laboratory of Hygiene and CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory conducted antibiotic-resistance testing on clinical isolates collected from ill people infected with an outbreak strain of Salmonella Heidelberg.
  • All isolates were multidrug resistant.
  • Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients.

SOURCE: https://www.cdc.gov/

‘Evidence of Zika Virus Infection in Brain and Placental Tissues’

Morbidity and Mortality Weekly Report (MMWR)

Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015

The following are field notes from Brazil on ZIKV infection posted in the latest issue of CDC’s Morbidity and Mortality Weekly Report

Zika virus is a mosquito-borne flavivirus that is related to dengue virus and transmitted primarily by Aedes aegypti mosquitoes, with humans acting as the principal amplifying host during outbreaks. Zika virus was first reported in Brazil in May 2015 (1). By February 9, 2016, local transmission of infection had been reported in 26 countries or territories in the Americas.* Infection is usually asymptomatic, and, when symptoms are present, typically results in mild and self-limited illness with symptoms including fever, rash, arthralgia, and conjunctivitis. However, a surge in the number of children born with microcephaly was noted in regions of Brazil with a high prevalence of suspected Zika virus disease cases. More than 4,700 suspected cases of microcephaly were reported from mid-2015 through January 2016, although additional investigations might eventually result in a revised lower number (2). In response, the Brazil Ministry of Health established a task force to further investigate possible connections between the virus and brain anomalies in infants (3).

Since November 2015, CDC has been developing assays for Zika virus testing in formalin-fixed, paraffin-embedded (FFPE) tissue samples. In December 2015, FFPE tissues samples from two newborns (born at 36 and 38 weeks gestation) with microcephaly who died within 20 hours of birth and two miscarriages (fetal losses at 11 and 13 weeks) were submitted to CDC, from the state of Rio Grande do Norte in Brazil, for histopathologic evaluation and laboratory testing for suspected Zika virus infection. All four mothers had clinical signs of Zika virus infection, including fever and rash, during the first trimester of pregnancy, but did not have clinical signs of active infection at the time of delivery or miscarriage. The mothers were not tested for antibodies to Zika virus. Samples included brain and other autopsy tissues from the two newborns, a placenta from one of the newborns, and products of conception from the two miscarriages.

FFPE tissues were tested by Zika virus reverse transcription-polymerase chain reaction (RT-PCR) targeting the nonstructural protein 5 and envelope genes using general methods for RT-PCR (4), and by immunohistochemistry using a mouse polyclonal anti-Zika virus antibody, using methods previously described (5). Specific specimens from all four cases were positive by RT-PCR, and sequence analysis provided further evidence of Zika virus infection, revealing highest identities with Zika virus strains isolated from Brazil during 2015. In the newborns, only brain tissue was positive by RT-PCR assays. Specimens from two of the four cases were positive by immunohistochemistry: viral antigen was noted in mononuclear cells (presumed to be glial cells and neurons within the brain) of one newborn, and within the chorionic villi from one of the miscarriages. Testing for dengue virus was negative by RT-PCR in specimens from all cases.

For both newborns, significant histopathologic changes were limited to the brain, and included parenchymal calcification, microglial nodules, gliosis, and cell degeneration and necrosis. Other autopsy tissues and placenta had no significant findings. Tests for toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and HIV were negative in the two mothers who experienced miscarriages. Placental tissue from one miscarriage showed heterogeneous chorionic villi with calcification, fibrosis, perivillous fibrin deposition, and patchy intervillositis and focal villitis, while tissue from the other miscarriage had sparsely sampled normal-appearing chorionic villi.

This report describes evidence of a link between Zika virus infection and microcephaly and fetal demise through detection of viral RNA and antigens in brain tissues from infants with microcephaly and placental tissues from early miscarriages. Histopathologic findings indicate the presence of Zika virus in fetal tissues. These findings also suggest brain and early gestational placental tissue might be the preferred tissues for postmortem viral diagnosis. Nonfrozen, formalin-fixed specimens or FFPE blocks are the preferred sample type for histopathologic evaluation and immunohistochemistry, and RT-PCR can be performed on either fresh frozen or formalin-fixed specimens. To better understand the pathogenesis of Zika virus infection and associated congenital anomalies and fetal death, it is necessary to evaluate autopsy and placental tissues from additional cases, and to determine the effect of gestational age during maternal illness on fetal outcomes.

Suggested citation for this article: Martines RB, Bhatnagar J, Keating MK, et al. Notes from the Field: Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016;65(Early Release):1–2. DOI: http://dx.doi.org/10.15585/mmwr.mm6506e1er

Related Links

• Pharma Phleecing: It’s Déjà vu All Over Again! February 9, 2016
• Tonga Declares Zika Outbreak February 5, 2016
• Zika Virus Sold Online February 4, 2016
• ZIKV: Health Emergency Declared in 4 Florida Counties February 4, 2016

• ZIKV Update – Feb. 3, 2016 February 3, 2016
• Zika Virus Outbreak Result of Bioweapon? February 2, 2016

• WHO Declares Microcephaly Cluster a ‘Public Health Emergency of International Concern’  February 2, 2016
• ZIKV: Additional Information on Transmission January 29, 2016
• ZIKV: Media Sensationalism Forcing WHO to Overreact? January 28, 2016
• ZIKV: CDC Adds Two More Countries to Travel Warning List  January 27, 2016
• ZIKV Found in Australian Travelers Returning from S. America January 26, 2016

• ZIKV Emergency: New Warnings Issued by Colombia, Ecuador, El Salvador & Jamaica January 23, 2016

Additional Links

ZIKV

• CDC Issues Travel Warning as Zika Virus Epidemic Continues to Spread January 16, 2016
• Zika Virus: Coming to a Place Near You…  January 5, 2016
• Disasters/ Significant Events – Dec 25, 2015 Posted on December 25, 2015
• Most Dangerous Pathogens  December 12, 2015
• ZIKV – Emerging Virus May Cause Severe Birth Defects  December 4, 2015

DENGUE

• Latest Dengue Fever Outbreaks January 20, 2016
• Top Emerging Diseases Likely to Cause Major Epidemics December 12, 2015
• ZIKV – Emerging Virus May Cause Severe Birth Defects December 4, 2015
• Dengue Fever Kills 204 in Taiwan  December 16, 2015
• State of Emergency Declared in East Java  January 26, 2015
• Dengue Fever Outbreak Prompts State of Emergency in Brazil City  January 21, 2013
• State of emergency in Marshall Islands as dengue outbreak spirals  October 29, 2011
• Chikungunya Makes West Nile Look Like Nappy Rash  September 19, 2009

ZIKV: Additional Information on Transmission

 Microcephaly:  Zika virus or Guillain-Barré syndrome?

ZIKV is transmitted primarily by Aedes aegypti mosquitoes (1,7). Aedes albopictus mosquitoes also might transmit the virus. Aedes aegypti and Ae. albopictus mosquitoes are found throughout much of the Americas, including parts of the United States, and also transmit dengue and chikungunya viruses.

In addition to mosquito-to-human transmission, Zika virus infections have been documented through:

• Intrauterine [in mother’s womb, or uterus] transmission resulting in congenital infection
• Intrapartum [during the act of birth] transmission from a viremic mother to her newborn
• Sexual transmission
• Blood transfusion
• Laboratory exposure

There is a theoretical concern that transmission could occur through organ or tissue transplantation, and although Zika virus RNA has been detected in breast milk, transmission through breastfeeding has not been documented.

The Brazil Ministry of Health has reported a marked increase in the number of infants born with microcephaly in 2015, although it is not known how many of these cases are associated with Zika virus infection. Guillain-Barré syndrome also has been reported in patients following suspected Zika virus infection. Studies are under way to evaluate the risks for Zika virus transmission during pregnancy, the spectrum of outcomes associated with congenital infection, and the possible association between Zika virus infection and Guillain-Barré syndrome.

There is no commercially available test for ZIKV. The virus testing is performed in the United States at CDC and four state health department laboratories.

Source: Hennessey M, Fischer M, Staples JE. Zika Virus Spreads to New Areas — Region of the Americas, May 2015–January 2016. MMWR Morb Mortal Wkly Rep 2016;65:55–58. DOI: http://dx.doi.org/10.15585/mmwr.mm6503e1

What is Guillain-Barré syndrome (GBS)?

Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis. GBS can cause symptoms that usually last for a few weeks. Most people recover fully from GBS, but some people have long-term nerve damage. In very rare cases, people have died of GBS, usually from difficulty breathing.

• The background rate for GBS in the U.S. is about 80 to 160 cases of GBS each week, regardless of vaccination.

What causes GBS?

Many things can cause GBS; about two-thirds of people who develop GBS symptoms do so several days or weeks after they have been sick with diarrhea or a respiratory illness. Infection with the bacterium Campylobacter jejuni is one of the most common risk factors for GBS. People also can develop GBS after having the flu or other infections (such as cytomegalovirus and Epstein Barr virus). On very rare occasions, they may develop GBS in the days or weeks after getting a vaccination.

 

ZIKV Infection Cases Reported in Illinois

Two pregnant Illinois women test positive for the Zika virus

Two pregnant Illinois residents, who recently traveled to countries where Zika virus is spreading, have tested positive for the virus, said the Illinois Department of Public Health. 

The latest development follows the case of a ZIKV infected infant in Hawaii who was born with microcephaly, on January 17, 2016.

The following statement was issued by the Illinois Health Department:

Two Illinois Residents Test Positive For Zika Virus

SPRINGFIELD (January 19, 2016). The Illinois Department of Public Health (IDPH) is alerting the public of the potential of contracting Zika virus while traveling abroad.  Zika virus is spread to people through mosquito bites, similar to West Nile virus or dengue fever.  While illness is usually mild and severe disease requiring hospitalization is uncommon, there is a possible link between Zika virus infection in pregnant women and subsequent birth defects.

Two pregnant Illinois residents who recently traveled to countries where Zika virus is found have tested positive for the virus.  Physicians are monitoring their health and pregnancies.

“There is virtually no risk to Illinois residents since you cannot contract Zika virus from another person, but only through the bite of an infected mosquito,” said IDPH Director Nirav D. Shah, M.D., J.D.  “But since this is a time of year when people travel to warmer climates and countries where Zika virus is found, we are urging residents, especially pregnant women, to take preventive measures when traveling in affected countries and check health travel advisories.”

The Centers for Disease Control and Prevention (CDC) issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing, including:

Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico. [See below for the full list.]

This alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant.  However, additional studies are needed to further characterize this relationship.

Until more is known, CDC recommends that pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing.  Pregnant women, women trying to become pregnant, or women who are thinking about becoming pregnant and must travel to one of these areas should talk with their doctor or other health care provider first and strictly follow steps to avoid mosquito bites during the trip.

The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes).  Symptoms can last from several days to weeks.  There is no vaccine to prevent or medicine to treat Zika virus infection.

When traveling to countries where Zika virus has been reported, all travelers should take steps to prevent mosquito bites, such as using use insect repellent, wearing long sleeves and pants, and staying in places with air conditioning or that use window and door screens.  More information about Zika virus can be found on the CDC website.  CDC has also developed interim Zika virus guidelines for health care providers in the United State caring for pregnant women.

Countries with past or current evidence of Zika virus transmission

Countries that have past or current evidence of Zika virus transmission —CDC

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.
AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

Related Links

• Baby Born with Brain Damage in Hawaii Infected by Zika Virus January 17, 2016
• CDC Issues Travel Warning as Zika Virus Epidemic Continues to Spread  January 16, 2016
• Zika Virus: Coming to a Place Near You…  January 5, 2016
• Disasters/ Significant Events – Dec 25, 2015 Posted on December 25, 2015
• Most Dangerous Pathogens  December 12, 2015
• ZIKV – Emerging Virus May Cause Severe Birth Defects  December 4, 2015

 

CDC Issues Travel Warning as Zika Virus Epidemic Continues to Spread

U.S. health officials warn pregnant women against traveling to Latin America, Caribbean countries

Explosive outbreaks of Zika, a dangerous tropical disease linked to birth defects, have prompted the  U.S. health officials to issue a travel alert for people traveling to regions and countries where Zika virus (ZIKV) transmission is ongoing: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.

CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for the above-listed areas.

This alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

CDC recommends special precautions, out of an abundance of caution, for pregnant women and women trying to become pregnant:

• Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who must travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update this travel notice as information becomes available. Check the CDC travel website frequently for the most up-to-date recommendations.

Currently, there is no vaccine to prevent or medicine to treat Zika. Four in five people who acquire Zika infection may have no symptoms. Illness from Zika is usually mild and does not require hospitalization. Travelers are strongly urged to protect themselves by preventing mosquito bites:

• Wear long-sleeved shirts and long pants
• Use EPA-registered insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
  • Insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant and nursing women and children older than 2 months when used according to the product label. Oil of lemon eucalyptus products should not be used on children under 3 years of age.
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents).
• Stay and sleep in screened-in or air-conditioned rooms.

In addition to the steps announced today, CDC is working with public health experts across the U.S. Department of Health and Human Services (HHS) to take additional steps related to Zika. CDC is developing interim guidance for pregnant women as well as sharing additional information about Zika with public health officials, clinicians and the public.  In addition, efforts are underway across HHS to develop vaccines, improved diagnostics and other countermeasures for Zika.

Countries with past or current evidence of Zika virus transmission

Countries that have past or current evidence of Zika virus transmission (See below for list)

Background:

CDC scientists tested samples provided by Brazilian health authorities from two pregnancies that ended in miscarriage and from two infants with diagnosed microcephaly who died shortly after birth. For the two full-term infants, tests showed that Zika virus was present in the brain. Genetic sequence analysis showed that the virus in the four cases was the same as the Zika virus strain currently circulating in Brazil.  All four mothers reported having experienced a fever and rash illness consistent with Zika virus disease (Zika) during their pregnancies.

Locally acquired Zika was reported for the first time in Brazil in May 2015, and the virus has since been reported in 14 countries and territories in Latin America and the Caribbean:  Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and Commonwealth of Puerto Rico.

According to Brazilian health authorities, more than 3,500 microcephaly cases were reported in Brazil between October 2015 and January 2016.  Some of the affected infants have had a severe type of microcephaly and some have died.  The full spectrum of outcomes that might be associated with infection during pregnancy and the factors that might increase risk to the fetus are not yet fully understood. Health authorities in Brazil, with assistance from the Pan American Health Organization, CDC, and other agencies, have been investigating the possible association between Zika virus infection and microcephaly in infants. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

In the past, outbreaks of Zika virus infection have occurred in Africa, Southeast Asia, and the Pacific Islands.  Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito.  About one in five people infected with Zika virus will develop symptoms, which include fever, rash, joint pain, and conjunctivitis (pink eye). Other commonly reported symptoms include myalgia, headache, and pain behind the eyes. The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon and case fatality is low. Guillain-Barré syndrome has been reported in patients with probable Zika virus infection in French Polynesia and Brazil . Research efforts will also examine the link between Zika and GBS.

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

Related Links

• Zika Virus: Coming to a Place Near You…  January 5, 2016
• Disasters/ Significant Events – Dec 25, 2015 Posted on December 25, 2015
• Most Dangerous Pathogens  December 12, 2015
• ZIKV – Emerging Virus May Cause Severe Birth Defects  December 4, 2015

ZIKV – Emerging Virus May Cause Severe Birth Defects

Brazil records six fold increase in microcephaly: Report

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease (Zika) are fever, rash, joint pain, and red eye. The illness is usually mild with symptoms lasting from several days to a week, according to CDC.

Zika virus (ZIKV) is a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis viruses. In 2007 ZIKV caused an outbreak of relatively mild disease characterized by rash, arthralgia, and conjunctivitis on Yap Island in the southwestern Pacific Ocean. This was the first time that ZIKV was detected outside of Africa and Asia. The history, transmission dynamics, virology, and clinical manifestations of ZIKV disease are discussed, along with the possibility for diagnostic confusion between ZIKV illness and dengue. The emergence of ZIKV outside of its previously known geographic range should prompt awareness of the potential for ZIKV to spread to other Pacific islands and the Americas. [Edward B. Hayes/CDC]

Zika may be responsible for an “unprecedented epidemic in Brazil and is quickly spreading through Latin America may be responsible for a spike in severe birth defects,” said a report.

Brazilian government has warned that the virus could be responsible for a dramatic rise “in cases of microcephaly, a severe birth defect in which the brain fails to develop properly and the head is much smaller than normal. Children with microcephaly frequently have developmental delays, learning disabilities, impaired motor function, and seizures.”  However, the connection remains to be proven.

“Microcephaly can be caused by genetic factors, infections, or injuries. In recent years, there have been between 150 and 200 cases in Brazil per year. As of 30 November, more than 1200 cases had been reported in 10 states, all of which have also reported Zika virus infections, says Ana Maria Bispo de Filippis, head of the flavivirus laboratory at the Oswaldo Cruz Institute in Rio de Janeiro, Brazil.”

Brazil’s northeastern state of  Pernambuco has recorded at least 487 microcephaly cases so far this year, compared with an average of 10 cases per year between 2010 and 2014, said the report.

“The virus has been found in the amniotic fluid of two fetuses diagnosed with microcephaly via ultrasound. It has also been found in tissues of a baby with microcephaly that died shortly after birth. It seems that in some cases the virus can cross the placenta and infect the fetus directly, says Patricia Garcez, a neurodevelopment expert at the Federal University of Rio de Janeiro in Brazil. It’s possible that the virus then attacks brain cells, she says. If that happens during the key phases of brain development in the first 3 to 4 months of pregnancy, the overall size of the brain would be dramatically reduced, leading to microcephaly.”

Additionally, health authorities in French Polynesia reported “17 cases of unusual central nervous system birth defects following a Zika outbreak there in 2013 and 2014.”

Unpreventable and Untreatable!

There is no vaccine to prevent or medicine to treat Zika. When traveling to countries where Zika virus or other viruses spread by mosquitoes have been reported, travelers should protect themselves from this disease by taking steps to prevent mosquito bites.

Geographic Distribution

Outbreaks of Zika virus disease (or Zika) previously have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika virus likely will continue to spread to new areas. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. [CDC]

Countries that have past or current evidence of Zika virus transmission (as of December 2015)

Source: CDC

Countries that have past or current evidence of Zika virus transmission

AFRICA:  Angola*, Burkina Faso, Cameroon, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*

AMERICAS: Brazil, Colombia, El Salvador, Guatemala, Mexico, Paraguay and Suriname

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Solomon Islands and Vanuatu

*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.

U.S. Deadly Heroin Epidemic Reaches New Heights

UPDATED

Heroin Addiction more than doubled among young adults ages 18–25 in 10 years: CDC

Heroin addiction and related overdose deaths are climbing in the U.S. In 2013, an average of 2.6 people—3.6 male and 1.6 female—per 1,000, or a total of about 800,000 people across the nation, were addicted to the deadly opioid drug, with 2.9 people per 100,000 killed by overdose, according to a report published by the Centers for Disease Control and Prevention (CDC).

The number of male heroin-addicts in the U.S. increased by 50% from 2.4 to 3.6 per 1,000 people, and the female from 0.8 to 1.6 (up 100%), between the period 2002-2004 and 2011-2013.

Heroin use has more than doubled among young adults ages 18–25 in the past decade, while overdose related deaths have soared to 8,200—a threefold jump—in just three years (2010–2013).

Heroin use has increased across the US among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes. Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid painkillers. As heroin use has increased, so have heroin-related overdose deaths. Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013. States play a central role in prevention, treatment, and recovery efforts for this growing epidemic. —CDC

According to the report:

• The heroin-related overdose death rate increased 286% from 2002 to 2013.
• The heroin-related overdose death rate increased from 1.0 to 2.7 persons between 2010 and 2013.
• The main drivers of heroin epidemic are non-Hispanic whites, women and wealthy people.
• Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013.

Heroin use is part of a larger substance abuse problem

• Nearly all people who used heroin also used at least 1 other drug. Most used at least 3 other drugs.
• Heroin is a highly addictive opioid drug with a high risk of overdose and death for users.
• People who are addicted to…
• Alcohol are 2 times more likely to become addicted to heroin.
• Marijuana are 3 times more likely to become addicted to heroin.
• Cocaine are 15 times more likely to become addicted to heroin..
• Prescription opioid painkillers are 40 times more likely to become addicted to heroin.

SOURCE: National Survey on Drug Use and Health (NSDUH), 2011-2013.
SOURCE: Multiple Cause of Death Files from the National Vital Statistics System, 2002-2013.
SOURCE: CDC Vitalsigns, July 2015

Where does the heroin come from?

Heroine is manufactured  from Opium. About 90% of the world’s heroin originates in Afghanistan. The deadly drug has a market value of about $70 billion, with a worldwide captive audience of 25 million addicts. Heroin is killing more than 1 million people each year (conservative estimates).

About 10 kilograms of opium is used to manufacture one kilogram of heroin.

Based on recent data on the morphine content of Afghan opium, the heroin conversion ratio, which describes the amount of opium needed to produce a kilogram of heroin, has been updated. For converting opium to pure heroin base, a ratio of 18.5:1 is estimated; for heroin of export quality [impure heroin of 52% purity with morphine content 12.3% in the opium and 34% laboratory efficiency,] a ratio of 9.6:1 [9.1:1 to 10.2:1] is estimated. —UNODC

In 2007, Afghanistan cultivated 193,000 hectares of opium poppies, and favorable weather conditions helped produce opium yields of 42.5 kg per hectare compared with  37.0 kg/ha previous year, according to the United Nations Office on Drugs and Crime (UNODC).

“As a result, in 2007 Afghanistan produced an extraordinary 8,200 tons of opium (34% more than in 2006), becoming practically the exclusive supplier of the world’s deadliest drug (93% of the global opiates market). Leaving aside 19th century China, that had a population at that time 15 times larger than today’s Afghanistan, no other country in the world has ever produced narcotics on such a deadly scale.”

In 2013, The Drug Enforcement Administration seized a total of 2,196 kilograms of heroin in the U.S., up from about 500 kilograms annually between 2002-2008.

In the same year, coalition forces seized about 41,000 kilograms of opium out of about 5,500,000 kilograms produced in Afghanistan, and destroyed a tiny fraction of poppy fields in the country.

In 2014, Afghanistan’s poppy cultivation increased 7 percent, to a record 224,000 (200,000-250,500) hectares; however, the yield was lower than the 2007 record crop year due to poor weather. Potential opium production was estimated at 6,400 metric tons, an increase of17% on 2013 production (5,500 tons), while total eradication of opium poppy decreased by 63%, to only 2,692 hectares, according to UNODC.

[Afghanistan national average price of dry opium, weighted by regional production, was US$133/kg in 2014, down 23% from previous year.]

State of Emergency Declared in Dallas County due to Bird Flu

UPDATED

“You can’t dump your infected bird carcases in our backyard” —Dallas County

Dallas County officials have declared a state of emergency amid the state’s outbreak of avian influenza, according to a news release.

The resolution forbids “the transportation of poultry and poultry waste within a mile of poultry raising facilities. The state of emergency will allow county road officials to place barricades near facilities within the county,” said a report.

“John Benson, a spokesman with Iowa Homeland Security & Emergency Management, said Dallas County’s state of emergency is similar to the one put in place last week by Gov. Terry Branstad, but with efforts supplemented at a local level

“As many as 3.5 million birds killed because of avian influenza outbreaks in northwest Iowa might be driven across the state and disposed of in a private landfill in Mills County.”

Read more…

Bird Flu Claims 4.8 Million More Iowa Chickens

State of Iowa

• Birds Affected: 23,130,698  [additional cases pending]
• Detections Reported: 30
• First Detection Reported: April20, 2015
• Last Detection Reported: May 7, 2015

Poultry producers in NW Iowa have been overwhelmed disposing of more than 23 million birds infected by the deadly virus, officials said.

At least 44 chicken, turkey, and duck flocks have been infected with the HPAI H5 [HPAI H5N8, HPAI H5N2 and HPAI H5N1] virus in 12 counties across Iowa, 11 in the northwest and Madison County.

More than 23 million additional infected birds, or about 45 percent of the state’s egg-laying flock, are slated to be destroyed including more than 22 million laying hens, and an estimated one million turkeys and ducks, according to reports.

The deadly virus has now spread to 30 million birds across at least 18 U.S. states; 13 states have experienced outbreaks in poultry flocks and 5 states have detected H5 in wild birds.

Update on Avian Influenza Findings – Poultry Findings Confirmed by USDA’s National Veterinary Services Laboratories

• Birds Affected: 29,907,671  [additional cases pending]
• Detections Reported: 142
• First Detection Reported: December 19, 2014
• Last Detection Reported: May 7,  2015

Commercial Flocks Infected in at least 13 States: Arkansas, California, Idaho, Iowa, Kansas, Minnesota, Missouri, Montana, North Dakota, Oregon, South Dakota, Washington and  Wisconsin.

Wild Flocks with Infection Found in at least 5 States: Kentucky, Nevada, New Mexico, Utah and Wyoming.

CDC Influenza Division – Key Points: HPAI H5

• Increased outreach, reporting and surveillance activities in the United States followed the detection of HPAI H5N2 among commercial poultry flocks in Canada in early December 2014.

• USDA has reported
  • HPAI H5N8 virus in California, Idaho, Oregon, Utah, Washington, and Nevada.
  • HPAI H5N2 virus in Washington, Idaho, Oregon, Minnesota, Missouri, Arkansas, Kansas, Wyoming, Montana, South Dakota, North Dakota, Wisconsin, Iowa and Kentucky.
  • HPAI H5N1 virus in Washington.
  • H5 virus in a wild bird in New Mexico, but diagnostic test did not determine the neuraminidase (NA).

• HPAI H5N8, HPAI H5N2 and HPAI H5N1 viruses with this combination of genes had not been detected previously in the United States.

 Background

• ‘Unprecedented’ Flu Outbreak Baffles Scientists April 22, 2015
• U-S Bird Flu Outbreak Continues to Spread April 22, 2015
• Flu Deaths Rising Globally  February 15, 2015
• Flu hits epidemic levels in U.S.  January 2, 2015
• ‘Highly Contagious’ Strain of Bird Flu Discovered in Holland November 17, 2014

Superbug Outbreak Could Kill 80,000 —UK Govt

New antibiotic-resistant infections could kill 80,000 Britons in a single outbreak

An outbreak of a drug-resistant infection caused by new superbugs could kill up to 80,000 people in the UK alone, according to a UK Government report.

Some 200,000 people would be infected by a widespread bacterial blood infection that is resistant to existing drugs, says the report.

The report warns:

“An increasingly serious issue is the development and spread of AMR (antimicrobial resistance), which occurs when drugs are no longer effective in treating infections caused by micro-organisms.

“Without effective antibiotics, even minor surgery and routine operations could become high-risk procedures, leading to increased duration of illness and ultimately premature mortality.

“Much of modern medicine (for example, organ transplantation, bowel surgery and some cancer treatments) may become unsafe due to the risk of infection. In addition, influenza pandemics would become more serious without effective treatments.”

Influenza pandemics would become more serious without effective treatments, the report says.

“If a widespread outbreak were to occur, we could expect around 200,000 people to be affected by a bacterial blood infection that could not be treated effectively with existing drugs, and around 80,000 of these might die.

“High numbers of deaths could also be expected from other forms of antimicrobial resistant infection.”

Antibiotic-resistant infections kill about 25,000 people die annually across Europe each year.

U.S. Travel Concerns

More than two million people in the U.S. are infected by drug-resistant superbugs every year, and at least 23,000 die of related infections, according to US Centers for Disease Control and Prevention (CDC).

CDC recently reported that international travelers were bringing back and spreading a drug-resistant bacteria called shigella sonnei in the US.

Shigellosis is an acute infection of the intestine caused by Shigella bacteria. There are 4 species of Shigella: Shigella dysenteriae, S. flexneri, S. boydii, and S. sonnei (also referred to as group A, B, C, and D, respectively), said CDC.

[S. sonnei strain UCN59, which causes bloody diarrhea and fever, has been found to be
resistant to ampicillin, trimethoprim, sulfonamides, and cotrimoxazole but susceptible to quinolones, third-gen-eration cephalosporins, and doxycycline, said a report.]

Shigellosis is an infectious disease caused by a group of bacteria called Shigella. CDC

Shigella Transmission 

Transmission occurs via the fecal-oral route, through direct person-to-person contact, or indirectly through contaminated food, water, or fomites. As few as 10 organisms can cause infection. Only humans and higher primates carry Shigella. In the United States, S. sonnei infection is usually transmitted through interpersonal contact, particularly among young children in day care settings. Foodborne outbreaks have been linked to contaminated foods commonly consumed raw, as well as infected food handlers. Outbreaks have also been traced to contaminated drinking water, swimming in contaminated water, and sexual contact between men.

Epidemiology

Worldwide, Shigella is estimated to cause up to 165 million cases of disease and 600,000 deaths annually. Shigella spp. are endemic in temperate and tropical climates. Transmission of Shigella spp. is most likely when hygiene and sanitation are insufficient. Shigellosis is predominantly caused by S. sonnei in industrialized countries, whereas S. flexneri prevails in the developing world. Infections caused by S. boydii are uncommon. S. dysenteriae is even more uncommon, but makes up ≥25% of all Shigella spp. isolated in sub-Saharan Africa and South Asia. Shigella spp. are detected in the stools of 5%–18% of patients with travelers’ diarrhea. In a FoodNet study of travel-associated enteric infections diagnosed after return to the United States, Shigella was the third most common bacterial pathogen isolated by clinical laboratories (of note, these laboratories do not test for enterotoxigenic Escherichia coli, a common cause of travelers’ diarrhea). Most infections caused by S. dysenteriae were travel-associated (56%). Many infections caused by S. boydii (44%) were acquired while traveling, but infections caused by S. flexneri and S. sonnei were less often associated with travel (24% and 12%, respectively). Risk of infection caused by Shigella spp. is highest for people traveling to Africa, followed by Central America, South America, and Asia.

Flu hits epidemic levels in U.S.

Influenza Activity Continues to Increase in U.S.

Mortality due to influenza and pneumonia has reached “epidemic” levels in the U.S. as flu activity spreads in 36 states, reported the Centers for Disease Control and Prevention (CDC).

Pneumonia and Influenza (P&I) Mortality Surveillance:

During week 51 (December 14-20, 2014), 6.8% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was at the epidemic threshold of 6.8% for the week.

Between October 1, 2014 and December 20, 2014, 2,643 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 9.7 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (38.3 per 100,000 population), followed by children aged 0-4 years (13.4 per 100,000 population). Among all hospitalizations, 2,529 (95.7%) were associated with influenza A, 100 (3.8%) with influenza B, nine (0.3%) with influenza A and B co-infection, and five (0.2%) had no virus type information. Among those with influenza A subtype information, 760 (99.9%) were H3N2 virus and one (0.1%) was 2009 H1N1.

Synopsis for week 51 [Mirrored from CDC]

• Viral Surveillance: Of 21,858 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 51, 6,152 (28.1%) were positive for influenza.
• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was at the epidemic threshold.
• Influenza-associated Pediatric Deaths: Four influenza-associated pediatric deaths were reported.
• Influenza-associated Hospitalizations: A cumulative rate for the season of 9.7 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
• Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 5.5%, above the national baseline of 2.0%. All 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and 22 states experienced high ILI activity; six states experienced moderate ILI activity; New York City and eight states experienced low ILI activity; 14 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
• Geographic Spread of Influenza: The geographic spread of influenza in 36 states was reported as widespread; Guam, Puerto Rico, and 10 states reported regional activity; the District of Columbia, the U.S. Virgin Islands, and two states reported local activity; and two states reported sporadic activity.

Influenza activity was “widespread” in 36 states during week 51, according to the CDC’s latest FluView report. The states included Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington, Wisconsin and Wyoming.

First Ebola Case Diagnosed in the U.S.

GLOBAL HEALTH EMERGENCY
EMERGING & RE-EMERGING INFECTIOUS DISEASES
VIRAL HEMORRHAGIC FEVERS
DEADLY EBOLA DIAGNOSED IN TEXAS
EBOLA EPIDEMIC IN WEST AFRICA
SCENARIOS 797, 444, 333, 080, 011
.

Ebola outbreak devastating West Africa could spread globally

The first case of Ebola in the United States has been diagnosed in a person who had traveled to Dallas, Texas from Liberia, the Centers for Disease Control and Prevention (CDC) confirmed.

The patient had no symptoms when leaving West Africa, but developed symptoms about four days after arriving in the U.S. on September 20, said CDC.

The person fell ill on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26. After developing symptoms consistent with Ebola, he was admitted to hospital on Sept. 28. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The laboratory test results confirmed Ebola infection.

“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”

Symptoms of Ebola include

• Fever (greater than 38.6°C or 101.5°F)
• Severe headache
• Muscle pain
• Weakness
• Diarrhea
• Vomiting
• Abdominal pain
• Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

Recovery from Ebola depends on the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years. [Source: CDC]

Global Health Emergency

WHO declared the Ebola outbreak in West Africa  a ‘Public Health Emergency of International Concern,’ under the International Health Regulations on August 8, 2014.

Related Links

• Ebola: 1.4 Million Cases by January 20, 2015? September 24, 2014
• Ebola Outbreak Declared Global Health Emergency  August 8, 2014
• Ebola Outbreak: Public Health Emergency Declared in Sierra Leone July 31, 2014
• EBOLA Epidemic Spreading in West Africa June 19, 2014

Ebola: 1.4 Million Cases by January 20, 2015?

GLOBAL HEALTH EMERGENCY
EMERGING & RE-EMERGING INFECTIOUS DISEASES
VIRAL HEMORRHAGIC FEVERS
DEADLY EBOLA HF EPIDEMIC
EBOLA OUTBREAK IN WEST AFRICA
SCENARIOS 797, 444, 333, 080, 011
.

Ebola Cases in Sierra Leone and Liberia Could Reach 1.4 Million by January —CDC

Up to 1.4 million people in West Africa could be infected with the Ebola virus by January 20, 2015, according to researchers at the U.S. Centers for Disease Control and Prevention (CDC).

CDC says it has has developed a dynamic modeling tool called Ebola Response that allows for estimations of projected cases over time in Liberia and Sierra Leone.

The agency’s estimate ranges between 550,000 and 1.4 million. The top range assumes that the number of cases, which currently stands at nearly 6,000, according to the World Health Organization (WHO), is underreported by a factor of 2.5 and should be adjusted to 15,000.

Projecting Ebola Case Estimates

CDC has used the Ebola Response modeling tool to calculate Ebola cases through mid-January in Sierra Leone and Liberia. The model estimates a range of between 550,000 and 1.4 million cases by January 20, 2015. The top range of the case estimate, 1.4 million, is explained by the model’s assumption that cases are significantly underreported by a factor of 2.5.

The World Health Organization has projected that Ebola outbreak could infect 20,000 people by early November, failing rigorous infection control measures, and become an endemic disease in the region.

The death toll is at least 2,811 out of 5,864 reported cases, according to the U.N. agency.

CDC analysis, published in the journal Morbidity and Mortality Weekly Report (MMWR), projects the cases in Liberia doubling every 15 to 20 days, and those in Sierra Leone doubling every 30 to 40 days.

Global Health Emergency

WHO declared the Ebola outbreak in West Africa  a ‘Public Health Emergency of International Concern,’ under the International Health Regulations on August 8, 2014.

Related Links

• Ebola Outbreak Declared Global Health Emergency  August 8, 2014
• Ebola Outbreak: Public Health Emergency Declared in Sierra Leone July 31, 2014
• EBOLA Epidemic Spreading in West Africa June 19, 2014

MERS Deaths Surge to 282 in Saudi Arabia

EMERGING & RE-EMERGING INFECTIOUS DISEASES
DEADLY MERS VIRUS
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Saudi Arabia revises up MERS mortalities

Saudi Arabian health officials finally admitted that many more people have died from the MERS infection than previously reported. 

The Saudi health ministry on Tuesday said that a review of data on Middle East Respiratory Syndrome Coronavirus (MERS-CoV) had shown that there were in fact 688 cases in the country with 282 mortalities reported.

Before the review, the ministry’s latest figures were 575 infections, with 190 deaths.

The new figures increase the official mortality rate from MERS to 41 percent, up from 33 percent previously.

The announcement came a day after the country’s deputy health minister was fired. The sacking followed that of the health minister in April.

MERS-CoV Cases Worldwide

FIRE-EARTH Models project the total cases of MERS-CoV infections worldwide at 804 with 363 mortalities, as of June 3, 2014. See also previous projection.

What’s MERS?

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness  caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus (MERS-CoV).”

Symptoms

MERS symptoms include fever and pneumonia leading to kidney failure and often death. Most victims who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

MERS was first reported in Saudi Arabia in 2012.

Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died.

MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. –CDC

Countries with Lab-Confirmed MERS – Reported Cases Since April 2012

• Egypt
• France
• Greece
• Italy
• Jordan
• Kuwait
• Lebanon
• Malaysia
• Netherlands
• Oman
• Philippines
• Qatar
• Saudi Arabia
• Tunisia
• Turkey
• United Kingdom (UK)
• United Arab Emirates (UAE)
• Unites States of America (USA)
• Yemen

Source of MERS

MERS-CoV has been “extraordinarily common” in camels since the 1990s, and it may have evolved after being passed to humans, according to a recent study.  The virus has been found in camels in Qatar and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV.

Doctors Resigning for Fear of Infection

At least four doctors at a Jeddah hospital resigned in April after refusing to treat MERS patients for fear of infection, said reports.

MERS a Year Ago

A total of 38 infected cases had been reported in Saudi Arabia, 49 worldwide, as of May 30, 2013.

Related Links

• MERS Infection Kills More People  May 17, 2014
• 2ND Case of MERS Reported in U.S.  May 13, 2014
• First U.S. Case of Deadly MERS Virus Confirmed  May 3, 2014
• Saudi MERS Death Toll Reaches 102 April 28, 2014

Links to Other Infectious Diseases

• Ebola Kills 100 in West Africa April 5, 2014
• Ebola Spreads to Liberia, Senegal Shuts Border March 31, 2014
• Ebola Outbreak Kills Dozens March 23, 2014

• Marburg Hemorrhagic Fever Breaks Out in SW Uganda October 20, 2012
• Disaster Calendar – 28 July 2012 July 28, 2012
• Climate Change Spreads “Deadly Dozen” Diseases October 8, 2008

MERS Infection Kills More People

EMERGING & RE-EMERGING INFECTIOUS DISEASES
DEADLY MERS
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Saudi Arabia reports five new MERS cases and three additional deaths

Saudi health authorities reported five new Middle East Respiratory Syndrome Coronavirus (MERS-CoV) cases and three additional deaths from the infection on Friday.

The latest figures raise the total number of reported cases in Saudi Arabia to at least 520, including 163 fatalities

MERS Cases Worldwide

FIRE-EARTH Models project the total cases of MERS-CoV infections worldwide at 650 with 210 fatalities, as of May 17, 2014.

What’s MERS?

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness  caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus (MERS-CoV).”

Symptoms

MERS symptoms include fever and pneumonia leading to kidney failure and often death. Most victims who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

MERS was first reported in Saudi Arabia in 2012.

Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died.

MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. –CDC

Countries with Lab-Confirmed MERS – Reported Cases Since April 2012

• Egypt
• France
• Greece
• Italy
• Jordan
• Kuwait
• Lebanon
• Malaysia
• Netherlands
• Oman
• Qatar
• Saudi Arabia
• Tunisia
• Turkey
• United Kingdom (UK)
• United Arab Emirates (UAE)
• Unites States of America (USA)
• Yemen

Source of MERS

MERS-CoV has been “extraordinarily common” in camels since the 1990s, and it may have evolved after being passed to humans, according to a recent study.  The virus has been found in camels in Qatar and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV.

Doctors Resigning for Fear of Infection

At least four doctors at a Jeddah hospital resigned in April after refusing to treat MERS patients for fear of infection, said reports.

MERS a Year Ago

A total of 38 infected cases had been reported in Saudi Arabia, 49 worldwide, as of May 30, 2013.

Related Links

• 2ND Case of MERS Reported in U.S.  May 13, 2014
• First U.S. Case of Deadly MERS Virus Confirmed  May 3, 2014
• Saudi MERS Death Toll Reaches 102 April 28, 2014

Links to Other Infectious Diseases

• Ebola Kills 100 in West Africa April 5, 2014
• Ebola Spreads to Liberia, Senegal Shuts Border March 31, 2014
• Ebola Outbreak Kills Dozens March 23, 2014

• Marburg Hemorrhagic Fever Breaks Out in SW Uganda October 20, 2012
• Disaster Calendar – 28 July 2012 July 28, 2012
• Climate Change Spreads “Deadly Dozen” Diseases October 8, 2008

2ND Case of MERS Reported in U.S.

EMERGING & RE-EMERGING INFECTIOUS DISEASES
DEADLY MERS
SCENARIO 011
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MERS infected traveler from Saudi Arabia hospitalized in Florida: CDC

CDC has confirmed a second imported case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV)  in the United States. The patient is identified as a healthcare worker who resides and works in Saudi Arabia.

The first U.S. imported case of MERS was reported on May 2 in Indiana. Both imported MERS cases in the U.S. are healthcare workers who recently worked in and traveled from Saudi Arabia. However, the CDC says the two cases are unrelated.

“This second confirmed case of MERS in a person who worked in health care from an area of risk is not surprising,” said CDC Director. “To continue to strengthen our own health security, we need to increase our global ability to support other countries to help them find and stop threats such as MERS promptly, and to prevent them whenever possible.”

The patient flew  from Jeddah, Saudi Arabia to Orlando, Florida, via London, England, Boston and Atlanta on May 1. The patient reported feeling unwell during the flight with reported symptoms that include fever, chills and a slight cough. On May 9, the patient was admitted to the emergency department of a hospital in Florida. “The patient is isolated, being well cared for, and is currently doing well.”

The Florida Department of Health officials tested the patient for MERS Coronavirus (MERS-CoV), the virus that causes MERS. Those tests were positive, and CDC confirmed MERS-CoV infection in the patient late last night.

“Given the dramatic increase in MERS cases in the Arabian Peninsula, we expected and are prepared for additional imported cases,” said the assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases. “The reason for this increase in cases is not yet known, but public health investigations are ongoing, and we are pleased to have a team in Saudi Arabia supporting some of those efforts.”

MERS in Saudi Arabia

Reported MERS cases in Saudi Arabia climbed to 491 on Monday, including 147 deaths, the Health Ministry has confirmed.

Six new cases were reported yesterday including patients that are  in critical condition.

MERS Cases Worldwide

As of May 12th, 2014, “a total of 538 laboratory-confirmed cases including 145 deaths due to MERS Coronavirus infection have been reported.  Saudi Arabia alone has reported 450 lab-confirmed cases and 112 deaths,” according to CDC.  [The CDC figures do NOT coincide with the data released by the Saudi  Health Ministry. Editor]

What’s MERS?

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness  caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus (MERS-CoV).”

Symptoms

MERS symptoms include fever and pneumonia leading to kidney failure and often death. Most victims who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

MERS was first reported in Saudi Arabia in 2012.

Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died.

MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. –CDC

 Countries with Lab-Confirmed MERS – Reported Cases Since April 2012

• Egypt (see below)
• France
• Greece
• Italy
• Jordan
• Kuwait
• Lebanon
• Malaysia
• Oman
• Qatar
• Saudi Arabia
• Tunisia
• Turkey
• United Kingdom (UK)
• United Arab Emirates (UAE)
• Unites States of America (USA)
• Yemen

Source of MERS

MERS-CoV has been “extraordinarily common” in camels since the 1990s, and it may have evolved after being passed to humans, according to a recent study.  The virus has been found in camels in Qatar and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV.

Doctors Resigning for Fear of Infection

At least four doctors at a Jeddah hospital resigned in April after refusing to treat MERS patients for fear of infection, said reports.

Egypt’s Reports First Case of MERS-CoV

Egypt reported its first case  of MERS two weeks ago. A man in his twenties who  had recently returned from Saudi Arabia, and showed symptoms of the infection, tested positive for MERS-CoV, according to a report.

MERS a Year Ago

A total of 38 infected cases had been reported in Saudi Arabia, 49 worldwide, as of May 30, 2013.

Related Links

• First U.S. Case of Deadly MERS Virus Confirmed  May 3, 2014
• Saudi MERS Death Toll Reaches 102 April 28, 2014

Links to Other Infectious Diseases

• Ebola Kills 100 in West Africa April 5, 2014
• Ebola Spreads to Liberia, Senegal Shuts Border March 31, 2014
• Ebola Outbreak Kills Dozens March 23, 2014

• Marburg Hemorrhagic Fever Breaks Out in SW Uganda October 20, 2012
• Disaster Calendar – 28 July 2012 July 28, 2012
• Climate Change Spreads “Deadly Dozen” Diseases October 8, 2008

Drought, Rainstorms Affect Millions across CHINA

Global Disasters/ Significant Events – Sunday 12  May 2013

Drought Affecting 3.58 Million Hectares of Farmland

Scorching drought in China’s western and central regions has affected at least 3.58 million hectares of farmland, [that’s an area the size of Taiwan,] drought relief authorities said.

• Affected land used to grow crops totaled 2.13 million hectares, lower than the average acreage of 6.3 million hectares over the past few years, according to a statement from the State Flood Control and Drought Relief Headquarters.”

• At least 5.54 million people and 3.99 million livestock in the two drought-stricken regions are currently short of drinking water, the report said.

Rainstorms Destroy Thousands of Homes, Affect one million in southern and eastern China

Extreme Rain Events have battered southern and eastern China since last week, destroying thousands of homes, and affecting at least a million people, said a report.

As of Saturday, rainstorms have affected about 850,000 people, toppled more than 2,200 homes and forced 14,000 citizens to relocate in Hunan.

Rainstorms have affected about 196,800 people in east China’s Jiangxi Province, local authorities said Saturday.

As of 11 p.m. Friday, the heavy rain, which started from Tuesday, has battered 26 counties in Jiangxi, the provincial flood prevention and drought control headquarters said.

The storms have destroyed about 20,000 hectares of crops, and left tens of thousands displaced.

Other Global Disasters/ Significant Events 

Calif. Homes Sinking In Volcanic Grounds, Lakeport Community Evacuated

Homes in Lake County, about 100 miles north of San Francisco, are breaking apart and sinking into cavernous fractures that had first appeared as cracks in the ground.

“We have a dormant volcano, and I’m certain a lot of things that happen here (in Lake County) are as a result of that, but we don’t know about that,” county public works director Scott De Leon told Yahoo News.

Associated Press/Rich Pedroncelli – In this photo taken Monday, May 6, 2013 Robin and Scott Spivey walk past the wreckage of their Tudor-style dream home they had to abandon when the ground gave way causing it to drop 10 feet below the street in Lakeport, Calif. Officials believe that water that has bubbled to the surface is playing a role, in the collapse of the hillside subdivision that has forced the evacuation of 10 homes and the notice of imminent evacuation of another 10 in this upscale subdivision. (AP Photo/Rich Pedroncelli). More images…

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At least 40 killed, 100 injured as explosions shake Turkish town

At least 46 people were killed and 100 others injured, 50 of them seriously, after 3 powerful explosions shook the Turkish town of Reyhanli in the southern Turkish province of Hatay, near the border with Syria, authorities have said.

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Yet another deadly coal mine blast in China

Death toll from a coal mine explosion on Saturday in southwest China’s Sichuan Province rose to 27, local authorities said.

• The blast occurred in Taozigou colliery, Luxian County in the city of Luzhou, according to officials.

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Bangladesh death toll rises to 1125

Death toll from the collapse of the Rana Plaza garment factory complex in Bangladesh rose to 1,126 by 3:00pm ( local time) on Sunday, after 16 additional bodies were discovered in the rubble, 19 days after the building collapsed, officials said.

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Novel Coronavirus Kills 2 More People in Saudi Arabia

Two more people have died from novel coronavirus (nCoV) in an outbreak in al-Ahsa region of Saudi Arabia, Reuters quoted a Saudi official as saying.

• The latest cluster of infections includes 15 confirmed cases, including 9 deaths, the official has reported.

From April 2012 to [May 8, 2013,] a total of 33 people from Saudi Arabia [2 others reported dead on May 12,] Qatar, Jordan, the United Kingdom, the United Arab Emirates, and France were confirmed to have an infection caused by the novel coronavirus, CDC reported.

• Saudi Arabia: 24 people; 13 of them died  [at least 15 dead as of May 12, 2013]
• Qatar: 2 people; both survived
• Jordan: 2 people; both died
• UK: 3 people; 2 died, 1 recovered
• UAE: 1 person; died
• France: 1 person, receiving treatment

Coronaviruses are a cause of the common cold. A coronavirus also was the cause of the severe respiratory illness called SARS (severe acute respiratory syndrome). SARS caused a global epidemic in 2003, but there have not been any known cases of SARS since 2004. This novel coronavirus is not the same coronavirus that caused SARS. —CDC

We know this virus has infected people since 2012, but we don’t know where this virus lives. We know that when people get infected, many of them develop severe pneumonia. What we don’t know is how often people might develop mild disease. We also know that most of the persons who have been infected so far have been older men, often with other medical conditions. We are not sure why we are seeing this pattern and if it will change over time. —WHO

The greatest global concern, however, is about the potential for this new virus to spread. This is partly because the virus has already caused severe disease in multiple countries, although in small numbers, and has persisted in the region since 2012. Of most concern, however, is the fact that the different clusters seen in multiple countries increasingly support the hypothesis that when there is close contact this novel coronavirus can transmit from person-to-person. This pattern of person-to- person transmission has remained limited to some small clusters and so far, there is no evidence that this virus has the capacity to sustain generalized transmission in communities. —WHO

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DISASTER CALENDAR – May 12, 2013 — 
SYMBOLIC COUNTDOWN: 1,035 Days Left 

Mass die-offs resulting from human impact and the planetary response to the anthropogenic assault could occur by early 2016.

• SYMBOLIC COUNTDOWN: 1,035 Days Left to ‘Worst Day’ in the brief Human  History
• The countdown began on May 15, 2011 …

GLOBAL WARNINGS

• WARNING: Human impact 2.85 x Earth’s diminishing carrying capacity
• WARNING: RAPID PLANETARY DECLINE IN PROGRESS!
• Europe: The First Phase of Collapse Has Started 
• United States: The First Phase of Collapse Has Begun

Global Disasters: Links, Forecasts and Background

• The First Wave of World’s Collapsing Cities
• Back to the Primordial Future
• The Fate of Energy Dinosaurs
• Mass Die-offs

Drought Disaster Declared in 4 States, Health Emergency in NY

DISASTER CALENDAR SYMBOLIC COUNTDOWN: 1,154 Days Left 

[January 13, 2013] Mass die-offs resulting from human impact and the planetary response to the anthropogenic assault could occur by early 2016.

• SYMBOLIC COUNTDOWN: 1,154 Days Left to the most Fateful Day in Human History
• Symbolic countdown to the ‘worst day’ in human history began on May 15, 2011 ...

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Global Disasters/ Significant Events

Drought disaster declared for dozens of counties across MN, MT, ND and SD, flue emergency in NY

The U.S. Department of Agriculture (USDA) has declared as drought disaster areas dozens of counties across Minnesota, Montana North and South Dakotas. The designations follow damages and losses caused by the recent drought.

• U.S. Drought 2013 Posted on January 11, 2013

Health emergency declared in NY state amid flu epidemic

New York State has declared a public health emergency, as a severe influenza outbreak tightened its grip across the country.

• About  20,000 cases of flu have been reported statewide so far this season, a rise of nearly 4 folds on the last season (4,400 confirmed cases in 2012).

• “We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Governor Cuomo said in a statement. “Therefore, I have directed my Administration, the State Health Department and others to marshal all needed resources to address this public health emergency and remove all barriers to ensure that all New Yorkers – children and adults alike – have access to critically needed flu vaccines Gov. Cuomo said .

• Public health officials in NY announced last week that flu-related illnesses had reached epidemic levels, killing at least 20 children nationwide.

• Forty-seven states reported widespread geographic influenza activity for the week between December 30, 2012 and January 5, 2013.

• CDC estimates that from the 1976-1977 flu season to the 2006-2007 season, flu-associated deaths each season ranged from a low of about 3,000 people to a high of about 49,000 people.

• Twenty-four states and New York City are now reporting high ILI activity. Additionally, 16 are reporting moderate levels of ILI activity. States reporting high ILI activity for the week ending January 5, 2013 include Alabama, Colorado, Delaware, Georgia, Illinois, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, and West Virginia, CDC said.

GLOBAL WARNINGS

• WARNING: Human impact 2.85 x Earth’s diminishing carrying capacity
• WARNING: RAPID DECLINE IN PROGRESS!
• Europe: The First Phase of Collapse Has Started 
• United States: The First Phase of Collapse Has Begun

Global Disasters: Links, Forecasts and Background

• The First Wave of World’s Collapsing Cities
• Back to the Primordial Future
• The Fate of Energy Dinosaurs
• Mass Die-offs

• 2010 Disasters [Links to 2010 Disaster Calendar]
• Mega Disasters
• 2011 Disaster Calendar
• 2012 Disaster Calendar

Rising Threat of Fungal Infections: Exserohilum Rostratum

DISASTER CALENDAR SYMBOLIC COUNTDOWN: 1,252 Days Left

[October 11, 2012] Mass die-offs resulting from human impact and the planetary response to the anthropogenic assault could occur by early 2016. 

• SYMBOLIC COUNTDOWN: 1,252 Days Left to the ‘Worst Day’ in Human History

• Symbolic countdown to the ‘worst day’ in human history began on May 15, 2011 ...

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Global Disasters/ Significant Events

Exserohilum Rostratum

Several of the meningitis patients who received epidural steroid injections (medication injected into the spine), have had strokes related to the infection, according to CDC. The meningitis was found to be caused by fungi that are common in the environment but rarely cause infection.

Exserohilum is a common mold found in soil and on plants, especially grasses. Exserohilum can cause keratitis (eye inflammation), subcutaneous phaeohyphomycosis, endocarditis (inflammation of the lining of the heart), osteomyelitis (bone infection), and sinusitis. (Source: CDC)

Fungal Meningitis Outbreak in the U.S.

• Case Count: 137  [October 10, 2012 5:45:00 PM EDT]
• States: 10
• Deaths: 12

West Nile Virus Infections

“Four thousand seven hundred and thirteen [4,713] human West Nile virus infections have been reported to CDC ArboNET [4,249 cases cited elsewhere on the CDC website] from Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.” CDC reported.

• 168 deaths reported
• Cases reported from 47 states and District of Columbia
• More than 70 percent of the cases have been reported in 8 states: Texas, Mississippi, Michigan, South Dakota, Louisiana, Oklahoma, Illinois and California.
• Texas reported about 40 percent of all cases.
• The Dallas-Fort Worth area has reported 33 deaths, the highest number in the country.
• “The Dallas Morning News reported Wednesday that health officials in Tarrant County, home to Fort Worth, may have vastly underreported cases of the serious neuroinvasive form of West Nile,” a report said.

WNV activity reported from 47 states and DC

West Nile virus (WNV) activity reported to ArboNET, by state, United States, 2012 (as of October 9, 2012). 

U.S. Agri Disaster Areas

USAD has designated 64 counties across six states as agricultural disaster areas. The disaster list also includes independent city of Charlottesville in Virginia and Northern Cheyenne Reservation in Montana.

• In Montana and surrounding states—Idaho and the Dakotas—losses have been caused by “the combined effects of early spring frosts and freezes, drought, excessive heat, high winds, wildfires, insects, hail, lightning and tornadoes that began Jan. 1, 2012, and continues.”

• North Carolina counties were designated as disaster areas due to losses caused by excessive rain and flooding that occurred May 14-16, 2012.

• In Virginia disaster areas were declared due to losses caused by excessive rain, hail, high winds and lightning associated with a derecho.

Global Disasters: Links, Forecasts and Background

• The First Wave of World’s Collapsing Cities
• Back to the Primordial Future
• The Fate of Energy Dinosaurs
• Mass Die-offs

• 2010 Disasters [Links to 2010 Disaster Calendar]
• Mega Disasters
• 2011 Disaster Calendar
• 2012 Disaster Calendar

GLOBAL WARNING

• WARNING: Human impact 2.85 x Earth’s diminishing carrying capacity
• WARNING: RAPID DECLINE IN PROGRESS!