State of Emergency Declared in Hawaii over Mosquitoes

Mosquitoes Become Enemy No. 1 in Hawaii

Hawaii Gov. Ige has declared a state of emergency to prevent the spread of mosquito-borne diseases, like the dengue outbreak on Hawaii Island.

“There have been no locally acquired Zika cases in the U.S. or Hawai‘i, and we’d like to keep it that way,” said Ige in a statement. “This is about getting in front of the situation across the state. I will be coordinating planning efforts with the Hawai‘i Emergency Management Agency, all county mayors and Civil Defense coordinators.”

The Department of Health has identified a new case of dengue fever, bringing the total to 255 since the outbreak began in September 2015. “On Hawai‘i Island, dengue fever cases continue to be fewer and farther between. However, the battle is not over and state continues to focus resources to break the cycle of dengue fever infection and transmission,” officials said.

Dengue Fever and Zika virus (ZIKV) share the same vector, mosquitoes of Aedes species (A. Aegypti & A. albopictus), and public health officials are concerned ZIKV could make its way to the Aloha State.

The same mosquitoes are also responsible for the spread chikungunya viruses.

Aedes aegypti mosquito

Aedes albopictus mosquito

 

FIRE-EARTH expects the Gulf of Mexico Border States to also declare states of emergency over the mosquitoes in the near future.

Related Links

• ZIKV Infection: Local Transmission in United States February 13, 2016
• State of Emergency Declared in Hawaii over Dengue Fever February 9, 2016

State of Emergency Declared in Hawaii over Dengue Fever

Dengue Fever and ZIKV share the same vector: mosquitoes of Aedes species

Hawaii County has declared a state of emergency amid the growing dengue fever outbreak in the state.

“A state of emergency for Hawaii County is authorized in order to prevent the continued spread of this outbreak and to eliminate the dengue fever virus from Hawaii Island,” said the mayor.

The state Health Department had confirmed 251 cases of dengue fever on Hawaii Island, including two potentially infectious individuals.

“The decision to issue an emergency proclamation is one made by professionals,” said Hawaii Gov. Ige. “There is a continuous conversation about it, as we proceed through an event and identify a course of action.”

Dengue Fever and Zika virus (ZIKV) share the same vector, mosquitoes of Aedes species (A. Aegypti & A. albopictus), and public health officials are concerned ZIKV could make its way to the Aloha State.

The same mosquitoes are also responsible for the spread chikungunya viruses.

Aedes aegypti mosquito

 

Aedes albopictus mosquito

Dengue Outbreak 2015 – 2016

Dengue Fever – Hawaii Island Outbreak

The Hawaii Department of Health (HDOH) is investigating a cluster of locally-acquired cases of dengue fever on Hawaii Island (the Big Island). Dengue is not endemic to Hawaii. However, it is intermittently imported from endemic areas by infected travelers. This is the first cluster of locally-acquired dengue fever since the 2011 outbreak on Oahu.  The Big Island and the rest of Hawaii remain safe destinations for visitors and residents.

• As of February 8, some 227 of the confirmed cases are Hawaii Island residents and 24 are visitors.
• 206 cases have been adults; 45 have been children (<18 years of age). Onset of illness has ranged between 9/11/15 – 2/1/16.
• A total of 1,124 reported potential cases have been excluded based on test results and/or not meeting case criteria (!)

 

Global Alert: Undiagnosed Deadly Illness in Cambodia

Mysterious new disease kills scores of children in Cambodia: WHO

A mysterious new illness has killed dozens of children in Cambodia, the World Health Organization (WHO) reported.

The symptoms start with high fever, followed by encephalitis, a swelling of the brain, leading to failure of the lungs and death.

• It takes 24 hours or less from the onset of symptoms to death.
• The victims were all under 7.
• Cases have been reported in 14 Cambodian provinces.
• The disease apparently has a death rate of greater than 98 percent.
• A Global Health Alert issued by WHO is posted below.

The majority of cases were from the southern part of the country, and the victims were hospitalized in Kantha Bopha children’s hospitals in the capital Phnom Penh and Siem Reap, according to reports.

Magnetic resonance imaging (MRI) scans of a brain with encephalitis. It has resulted in a large lesion (orange). Source: NHS/UK

WHO has issued the following Global Alert:

Global Alert: Undiagnosed illness in Cambodia

4 July 2012 – The Ministry of Health of the Kingdom of Cambodia has notified WHO of an outbreak of an undiagnosed illness which has affected 62 children, of which 61 have died since April 2012.

The majority of cases were from the southern part of the country, and were hospitalised in a children’s hospital in Phnom Penh. The symptoms observed are high fever, followed by respiratory and/or neurologic symptoms with rapid deterioration of respiratory functions.

WHO is working with the Ministry and other partners to investigate the outbreak, to identify the cause and source of the illness. Assistance is being provided in the area of field epidemiology and active case finding.

See also:

• Superbugs Invasion Has Begun Posted on May 19, 2012
• Encephalitis Kills 200 in Bihar, India  Posted on June 19, 2012
• Gonorrhea: First superbug strain found Posted on July 12, 2011
• Resurgence of C. difficile in Ontario, Canada Posted on July 4, 2011
• New superbug spreading from India Posted on August 11, 2010

Philippines Terminally Impacted?

Our thanks to EDRO Moderators for their input and direction

Ketsana, Parma and Melor: Harbingers of Bad Times Ahead?

Did the Three Storms Spell the Beginning of the End for the Philippines as We Know it?

On September 26, 2009 FEWW called the floods caused by storm Ketsana Philippines Worst Floods in Living Memory. Soon the fool extent of the human-enhanced disaster unfolded, as Tropical Storm Ketsana poured more than a month’s worth of rain on Manila in just a few hours.

About 300 people were killed in the Philippines worst floods in living memory caused by tropical storm Ketsana on September 26, which swamped about half a million homes in the Manila and nearby regions. By mid day September 27, about 80 to 90 percent of the Philippines capital was still submerged under water.

Commuters wade through waist-deep floodwaters following heavy rains brought about by tropical storm Ketsana (locally known as Ondoy) Saturday Sept. 26, 2009 in Manila, Philippines. At least five people have been killed after nearly a month’s worth of rain fell in just six hours Saturday, triggering the worst flooding in the Philippine capital in 42 years, stranding thousands on rooftops in the city and elsewhere as Tropical Storm Ketsana slammed ashore. (AP Photo/Bullit Marquez). Image may be subject to copyright.

FEWW Moderators expected Typhoon Parma to expand the destruction, and for the first time mentioned the probability of Manila collapsing.

Finally Parma Arrived!

Parma came, but for fleeting moments it looked like it could spare the Philippines main Island of Luzon. FEWW Moderators weren’t deceived, however. Driven by a more powerful storm, Typhoon Melor, which pinwheeled the by now weaker storm, ensuring that it would stay over northern Luzon for the next few days, Parma caused another round of deluge in Northern Luzon.

Could Manila Collapse?

On October 1, 2009, as Parma became a “super Typhoon, the moderators proposed:

Could Manila collapse as a result of devastation caused by the combined impact of the storms Ketsana, Parma (and  Melor, next week), as well as possible earthquakes triggered by landslides and massive mud avalanches, AND a highly probable catastrophic eruption of TAAL VOLCANO?

And suggested:

One way to find out is to wait and see! Another, is to stay tuned to FEWW forecasts and comments posted on this blog.

By Saturday October 10, 2009 at least 265 people were confirmed dead as landslides and flooding caused by Parma in the previous two days, the officials said.

A total of 265 people were confirmed dead in landslides and flooding caused by Parma in the past two days. Photo: AFP. Image may be subject to copyright.

This death toll from the deadly storms now stands at 611 with dozens more reported missing. Two weeks after Ketsana struck, up to 350,000 people are still packed into temporary evacuation centers. More than 3 million people have been affected.

But the Philippines worst nightmare hasn’t even started.

The specter of infectious disease outbreaks looms over the Philippines. Up to 3 million people in the country are immediately threatened by the very high risk of outbreaks of water-, sanitation-, and hygiene-related disease as well as foodborne epidemics including cholera, hepatitis A and E, typhoid fever, and shigellosis (caused by Shigella dysenteriae type 1 (Sd1), according to health officials.

The factors that are increasing health risks include:

• Malnutrition
  • compromises natural immunity,
  • leads to more frequent occurrences of infections
  • Infections become more severe and prolonged
  • communicable diseases become more difficult to diagnose and treat
  • pose significant threat to public health
  • infants and children are particularly at risk

• Disruption in power and fuel supplies with immediate impact on
  • drinking water
  • sanitation
  • personal hygiene
  • food production hygiene, refrigeration  and cooking facilities
• Displaced population and overcrowding
  • overcrowding in temporary relief centers would heighten the risk of acquiring
    • acute respiratory infections (ARI)
    • measles
    • meningitis.

By end of November/early December 2009, additional exposure to disease-carrying vectors such as mosquitoes could increase the risk of

• dengue
  
• malaria

As well as rarer diseases such as

• chikungunya
• hantavirus
• Japanese encephalitis

Disruption of Critical Services caused by flooding would prevent access to

• health and social and security
• medical, obstetric and surgical emergencies

Rainfall from Typhoon Parma

Typhoon Parma spent nearly a week pouring heavy rain on the northern half of the Philippine island of Luzon. This image shows both the storm’s track and the rainfall that accumulated between October 2 and October 8, 2009. The rainfall data are from the Multisatellite Precipitation Analysis, which includes rainfall observations from many satellites that are calibrated to match more detailed rainfall observations from the Tropical Rainfall Measuring Mission (TRMM) satellite. The satellites recorded more than 700 millimeters (28 inches) of rain in places, shown in dark blue.

The heaviest rain fell on the mountain range that runs north to south along the length of the island, the Cordillera Central. Damages came from landslides on the slopes of the mountains and from floods caused by water flowing out of the mountains west to the South China Sea. The largest area of heavy rain sits over the Lingayen Gulf, the “u”-shaped body of water on the western shore of Luzon near the bottom of the image. One province in this region, Pangasinan, was between 60 and 80 percent flooded. The highest death toll came from another province, Benguet, a little north and east of Lingayen Gulf, where landslides impacted several villages.

The storm came ashore from the east and crossed the northern tip of the island on October 3, 2009. Under the influence of nearby Typhoon Melor, Parma stalled offshore, unleashing yet more rain on Luzon while spinning in place on October 4-5. Finally, the storm reversed direction and moved back across the Philippines toward Typhoon Melor on October 7. By October 8, Melor’s influence on Parma weakened, and Parma moved west again to make its third trip across Luzon Island. Many of the areas of heavy rain coincide with areas that likely saw Parma’s most intense inner bands more than once throughout the course of the week.

NASA Earth Observatory image by Jesse Allen, using near-real-time data provided courtesy of TRMM Science Data and Information System at Goddard Space Flight Center. Caption by Holli Riebeek. [Edited by FEWW]

Related Links:

• Images of the Day: Super Typhoon Melor
• Could Typhoon Melor Drag Parma Back to Philippines?
• When Will Global Food Shortages Begin Biting

• “Twin-engine” hurricanes, “Supercharged” Typhoons
• Super Typhoon Parma May Churn Manila to Vanila
• Philippines Extreme Rain from TS Ketsana

• Manila Flooding Could Trigger Quakes
• Philippines: Worst Floods in Living Memory
• Philippines Worst Ever Flood Casualties Climb a Notch

• Earth undergoing significant geophysical disturbances
• Typhoon Melor Leaves a Trail of Destruction in Japan
• Typhoon Melor Arriving in Japan, Leaving Lasting Impression

Chikungunya Makes West Nile Look Like Nappy Rash

Chikungunya is coming!

Chikungunya is hyper-endemic in the islands of the Indian Ocean. Travel by air will import the infected mosquitoes and humans —Dr James Diaz

The ink hadn’t quite dried on

Arctic ice cover third-smallest area on record

in which the FEWW Moderators, discussing the dire effects of climate change on human health,  wrote:

‘Warmer [and dirtier] waters increase mosquito reproduction, which in turn increase the incidence of  mosquito-borne infectious diseases.’

When the news of  Chikungunya arrived.

Chikungunya, a mosquito-borne disease, much worse than the West Nile virus, could become the next nightmare epidemic in the US and Europe.

Stegomyia aegypti (formerly Aedes aegypti) mosquito siting on a human. Photo: USDA.

Who’s Afraid of Chikungunya?

“We’re very worried,” Dr. James Diaz of the Louisiana University Health Sciences Center told a meeting on airlines, airports and disease transmission sponsored by the independent U.S. National Research Council.

“Unlike West Nile virus, where nine out of 10 people are going to be totally asymptomatic, or may have a mild headache or a stiff neck, if you get Chikungunya you’re going to be sick,” he said.

“The disease can be fatal. It’s a serious disease [and] there is no vaccine.” Diaz added.

The virus can be carried by the Asian tiger mosquito, which is abundant in  Asia, Africa, Australia and New Zealand, as well as Europe, the Americas.

Chikungunya has also been reported in the islands of Mauritius, Seychelles and Reunion, in the Indian ocean, which are among prime beach resorts destinations visited by European tourists.

“It is hyper-endemic in the islands of the Indian Ocean,” Diaz told the meeting.

“Travel by air will import the infected mosquitoes and humans. Chikungunya is coming.” Diaz added.”

What’s Chikungunya

Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes.  Chikungunya virus is a member of the genus Alphavirus, in the family Togaviridae. Chikungunya fever is diagnosed based on symptoms, physical findings (e.g., joint swelling), laboratory testing, and the possibility of exposure to infected mosquitoes. There is no specific treatment for chikungunya fever; care is based on symptoms. Chikungunya infection is not usually fatal. Steps to prevent infection with chikungunya virus include use of insect repellent, protective clothing, and staying in areas with screens. Chikungunya virus was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been cited as the cause of numerous human epidemics in many areas of Africa and Asia and most recently in limited areas of Europe.—CDC

Chikungunya Distribution and Global Map

The geographic range of chikungunya virus is mainly in Africa and Asia.  Given the current large chikungunya virus epidemics and the worldwide distribution of Aedes aegypti and Aedes albopictus mosquitoes, there is a risk of importing chikungunya virus into new area through infected travelers. —CDC

Countries where people have become infected with chikungunya virus.
Benin	Mayotte
Burundi	Myanmar
Cambodia	Nigeria
Cameroon	Pakistan
Central African Republic	Philippines
Comoros	Reunion
Congo, DRC	Senegal
East Timor	Seychelles
Gabon	Singapore
Guinea	South Africa
India	Sri Lanka
Indonesia	Sudan
Italy	Taiwan
Kenya	Tanzania
Laos	Thailand
Madagascar	Uganda
Malawi	Vietnam
Malaysia	Zimbabwe
Mauritius
This list does not include countries where only imported cases have been reported.

Chikungunya Fact Sheet (CDC update: March 4, 2008)

Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been cited as the cause of numerous human epidemics in many areas of Africa and Asia, and most recently in a limited area of Europe.

What causes chikungunya fever?
Chikungunya fever is caused by a virus which belongs to the genus Alphavirus, in the family Togaviridae.

How do humans become infected with chikungunya virus?
Humans become infected with chikungunya virus by the bite of an infected mosquito. Aedes aegypti, a household container breeder and aggressive daytime biter which is attracted to humans, is the primary vector of chikungunya virus to humans. Aedes albopictus has also played a role in human transmission.

What can people do to prevent becoming infected with chikungunya virus?
The best way to prevent chikungunya virus infection is to avoid mosquito bites. There is no vaccine or preventive drug currently available. Prevention tips are similar to those for other viral diseases transmitted by mosquitoes, such as dengue or West Nile:

• Use insect repellent containing DEET, Picaridin, oil of lemon eucalyptus, or IR3535 on exposed skin. Always follow the directions on the package.
• Wear long sleeves and pants (ideally treat clothes with permethrin or another repellent).
• Have secure screens on windows and doors to keep mosquitoes out.
• Get rid of mosquito sources in your yard by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill holes in tire swings so water drains out. Keep children’s wading pools empty and on their sides when they aren’t being used.
• Additionally, a person with chikungunya fever should limit their exposure to mosquito bites to avoid further spreading the infection. The person should use repellents when outdoors exposed to mosquito bites or stay indoors in areas with screens or under a mosquito net.

What is the basic chikungunya virus transmission cycle?
Mosquitoes become infected with chikungunya virus when they feed on an infected person. Infected mosquitoes can then spread the virus to other humans when they bite them. Monkeys, and possibly other wild animals, may also serve as reservoirs of the virus. Aedes aegypti, a household container breeder and aggressive daytime biter which is attracted to humans, is the primary vector of chikungunya virus to humans. Aedes albopictus (the Asian tiger mosquito) has also played a role in human transmission is Asia, Africa, and Europe. Various forest-dwelling mosquito species in Africa have been found to be infected with the virus.

What type of illness does chikungunya virus cause?
Chikungunya virus infection can cause a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. “Silent” chikungunya virus infections (infections without illness) do occur; but how commonly this happens is not yet known. Chikungunya virus infection (whether clinically apparent or silent) is thought to confer life-long immunity. Acute chikungunya fever typically lasts a few days to a couple of weeks, but as with dengue, West Nile fever, o’nyong-nyong fever and other arboviral fevers, some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.

What is the incubation period for chikungunya fever?
The incubation period (time from infection to illness) can be 2-12 days, but is usually 3-7 days.

Can pregnant women become infected with chikungunya virus and pass the infection to their child?
Pregnant women can become infected with chikungunya virus during all stages of pregnancy and have symptoms similar to other individuals. Most infections will not result in the virus being transmitted to the fetus. The highest risk for infection of the fetus/child occurs when a woman has virus in her blood (viremic) at the time of delivery. There are also rare reports of first trimester abortions occurring after chikungunya infection. Pregnant women should take precautions to avoid mosquito bites. Products containing DEET can be used in pregnancy without adverse effects.

Can the virus be transmitted to a child by breastfeeding?
Currently, there is no evidence that the virus is transmitted through breast milk

What is the mortality rate of chikungunya fever?
Fatalities related to chikungunya virus are rare and appear to be associated to increased age.

How is chikungunya virus infection treated?
There is no vaccine or specific antiviral treatment currently available for chikungunya fever. Treatment is symptomatic and can include rest, fluids, and medicines to relieve symptoms of fever and aching such as ibuprofen, naproxen, acetaminophen, or paracetamol. Aspirin should be avoided. Infected persons should be protected from further mosquito exposure (staying indoors in areas with screens and/or under a mosquito net) during the first few days of the illness so they can not contribute to the transmission cycle.

Where does chikungunya virus occur?
The geographic range of the virus is primarily in Africa and Asia. For information on current outbreaks, consult CDC’s Travelers’ Health website (http://wwwn.cdc.gov/travel/default.aspx). Given the current large chikungunya virus epidemics and the world wide distribution of Aedes aegypti and Aedes albopictus, there is a risk of importation of chikungunya virus into new areas by infected travelers.

Content source:

Division of Vector Borne Infectious Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases

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