Cholera and other tropical diseases

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... first major cholera outbreak since 2012...

Cases in Iraq cholera outbreak rise to 121, but no new deaths: ministry
23 Sept.`15 - Iraq's first major cholera outbreak since 2012 has risen to at least 121 cases and spread to southern provinces along the Euphrates River, though no new deaths have been reported in days, the health ministry said on Wednesday.

The illness was detected last week in the town of Abu Ghraib, about 25 km (15 miles) west of the capital, where at least four deaths were recorded. Most of the new cases are in Babel province south of Baghdad. Cholera is spread mainly through contaminated water and food and, if untreated, can lead to death by dehydration and kidney failure within hours. Iraq's water and sewerage systems are outdated and infrastructure development has been hindered by years of war and neglect. Poor public services were a catalyst for street protests last month in Baghdad.

Health ministry spokesman Rifaq al-Araji has blamed the cholera outbreak on low water levels in the Euphrates, from where locals extract water for drinking or farming, and winter flooding that contaminated the river and shallow wells with sewage water. He said high summer temperatures may also have activated the bacterium that causes cholera. Temperatures topped 50 degrees Celsius (122 Fahrenheit) during July and August.

Araji said public awareness has helped keep the current outbreak under control. "If treatment is received within the first 24 to 48 hours of infection, there is no peril to the patient," he told Reuters by phone. The ministry said it certified four fatalities from cholera in Abu Ghraib last week. Medical sources previously put the death toll at six. Around 300 people were diagnosed with the illness in 2012 in the northern city of Kirkuk and the Kurdistan region. Five years earlier, at least 24 people died and more than 4,000 cases were confirmed.

Cases in Iraq cholera outbreak rise to 121, but no new deaths: ministry

 

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Not bad for a peanut farmer turned politician...

End of Guinea Worm in Sight for Carter Center
September 24, 2015 — Dracunculiasis is a parasitic infection that once afflicted millions primarily in Africa and parts of South Asia. Thanks to the efforts of former President Jimmy Carter and the Atlanta-based Carter Center working with government health ministries, the disease historically known as Guinea Worm is on the verge of becoming a historical footnote.

During Carter’s August announcement he was battling cancer, he made it clear he has plenty left to do. One big wish: “I would like for the last Guinea Worm to die before I do," he said. Guinea Worm is relatively unknown in the developed world. But elsewhere, it is a feared parasite that infects humans through contaminated drinking water. It grows and causes excruciating pain when emerging through the skin.

The global campaign to wipe out the disease started at the U.S. Centers for Disease Control and Prevention. “In 1980 CDC proposed that if we wanted to assess sustainable development, clean water systems around the world, the eradication of Guinea Worm would be an indicator of whether we’ve been able to do that," said CDC Director Tom Frieden.

In 1986, the World Health Assembly adopted a resolution calling for the complete eradication of Guinea Worm. That’s when the Carter Center stepped in. “We started out with 3.6 million cases. And I think we have two cases in South Sudan and one case in Ethiopia and one case in Mali and seven cases in Chad. That’s all the guinea worms in the world, and we know where all of them are," said Carter.

The path to complete eradication depends on Carter Center initiatives to monitor and filter drinking water. “It’s just an historic effort to be able to drive the incidence of disease from an estimated 3.5 million cases in 1986 to only 14 cases today as of today," said Director of Guinea Worm Eradication Program, Ernesto Ruiz-Tiben.

If those 14 cases are the last ones on earth, Guinea Worm would join smallpox as only the second human disease in history to be eradicated. “To think that because of President Carter’s leadership and work, and the CDC and our partners around the world, 80 million people will not have to go through that torture. That is a legacy that is just unbelievable and inspiring," said Frieden. For the World Health Organization to declare Guinea Worm eradicated, there must be zero cases of the disease for three calendar years. “The pressure is on us to try to finish what remains to be done as soon as possible," said Ruiz-Tiben.

End of Guinea Worm in Sight for Carter Center

 

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Filtering out disease from contaminated water...

Innovative Nano-Tech Water Filter Prevents Disease
October 02, 2015 - Access to clean water is a problem for hundreds of millions of people around the world. Now, a scientist and chemical engineer in Tanzania [East Africa] is working to change that by creating an innovative water filter that makes dirty water safe.

Askwar Hilonga said the filter can combat various water problems. He is concerned that in Tanzania “70 percent of households, of 9 million households, are not using any kind of filter.” The filter can absorb contaminants like copper, bacteria, viruses and pesticides, said Hilonga, who has been successfully trying out his product in Arusha.

It uses nanotechnology–manipulating matter to control individual atoms and molecules. Dirty water in buckets, connected to tubes, flows through sand to trap debris and harmful bacteria. A layer of “good” bacteria on top of the sand eats microbes that cause disease. Additional nanomaterials remove chemicals and other pollutants. “Before I had this filter,” said housewife Catherine Nanyaro, “I used to fetch water from the river, and sometimes I used it without boiling it because it is very time consuming to boil the water. I had many problems, like typhoid, and other diseases from the water.”

At a primary school, one filter is cleaning many liters of water. “We have a river 50 meters from here, and we saw that it is not healthy,” teacher Elena Ramos said. “Then we took water from the government supply, but we also saw that is was not going to be healthy. And we wanted the best things for our kids, so we decided to buy the filter.” Currently, each filter costs about 140 U.S. dollars. But Hilonga has received a U.S. government grant to help make his product more affordable and available commercially.

VIDEO

 

[shadow355]

About two years ago, I had a boil on the back of my neck that I had drained. The doctor in the plant medical department stuck it, twisting the needle as he opened up a hole for the pus to drain. About 8 hours later.....I had bad flu symptoms.

Approximately three months after that, I ordered a Orange Juice from a fast food restraint one morning. A fast food restraunt in the town north of where I work - it is at a intersection next to the sub shop. That day; I had bad flu symptoms.

IS it possible to get injected with the flu? Is it possible to have someone put a flu culture in your drink so you get the flu? About five years ago, I was terribly sick and extremely weak for 5 days straight.......Was I "Cultured" then?


Shadow 355

 

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Developed Ivermectin, the world's leading malaria-fighting drug...

3 share Nobel medicine prize for tropical disease drugs
Oct 5,`15 -- The Nobel prize in medicine went Monday to three scientists hailed as "heroes in the truest sense of the word" for saving millions of lives with the creation of the world's leading malaria-fighting drug and another that has nearly wiped out two devastating tropical diseases.

Tu Youyou - the first-ever Chinese medicine laureate - turned to ancient texts to produce artemesinin, a drug that is now the top treatment for malaria. Inspired by traditional Chinese medicine, Tu discovered that a compound from the wormwood plant was highly effective against the malaria parasite, while working on a project for the Chinese military during the Cultural Revolution. She will share the 8 million Swedish kronor (about $960,000) award with Japanese microbiologist Satoshi Omura and William Campbell, an Irish-born U.S. scientist.

Omura and Campbell created the drug avermectin, whose derivatives have nearly rid the planet of river blindness and lymphatic filarisis, diseases caused by parasitic worms and spread by mosquitos and flies. They affect millions of people in Africa, Latin America and Asia, leaving sufferers blind or disfigured and often unable to work. The Nobel committee said the winners, who are all in their 80s and made their breakthroughs in the 1970s and '80s, had given humankind powerful tools: "The consequences in terms of improved human health and reduced suffering are immeasurable," the committee said.

The Carter Center called the three laureates "heroes in the truest sense of the word, saving lives through medicine." Campbell, 85, is a research fellow emeritus at Drew University in Madison, New Jersey. He told the AP he made his main discovery in 1975 while working at pharmaceutical company Merck. "It was a great team effort," said Campbell, who now lives in North Andover, Massachusetts. He said the award came as a "huge surprise."

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Cholera outbreaks becoming a problem in Africa, Middle East...

WHO: Cholera Outbreaks Threaten Africa, Mideast
October 22, 2015 — The World Health Organization is stepping up efforts to control multiple cholera outbreaks in Africa and the Middle East to prevent the disease from spreading and threatening the health of thousands of people.

More than 10,700 cholera cases and 170 deaths are reported in five countries in the Eastern Mediterranean and African regions, Iraq, Bahrain, Kuwait, Democratic Republic of Congo and Tanzania. WHO officials say they are alarmed at the prospect of this deadly disease spreading if urgent control measures are not taken. WHO's Dr. Dominique Legros, who heads U.N. agency's Department of Pandemic and Epidemic Diseases, says he is particularly worried about the cholera situation in the African Region where the worst El Nino conditions in the past 20 years are forecast.

Displaced South Sudanese child receives oral cholera vaccine in a camp for internally displaced people in Juba​

He says this weather phenomenon is expected to trigger torrential rains in the coming months and cause an upsurge in water-borne diseases, including cholera. “The last time we had that situation in Eastern Africa was in 1997-‘98 in four countries of the region: Tanzania, Uganda, Mozambique, Kenya," he said. "At that time, we had within two years 200,000 cases of cholera and 8,000 deaths ... we have to really be ready for this and try to control the outbreak as soon as possible.” Tanzania has nearly 5,000 cases of cholera including 74 deaths. The capital, Dar Es Salaam, is hardest hit with 3,500 cases reported since mid-August.

WHO has recorded nearly 4,000 cases of cholera, including 95 deaths in Democratic Republic of Congo. Legros says a team is being sent to Equateur Province, the scene of a recent cholera outbreak, to see how to prevent spread of the disease down the Congo River. Iraq has more than 1,800 cholera cases and one death reported. Legros says a vaccination campaign is planned at the end of the month in Erbil and Dohuk to try to contain the disease. “We have alerted all the countries of the region affected by the Syrian crisis to get them prepared for a possible extent of the cases towards other countries of the Middle East,” he said, adding that control efforts are being hampered by a vaccine shortage. Legros notes last year only two million doses of cholera vaccines were available in Africa where about 40 million people are exposed to this fatal disease.

WHO: Cholera Outbreaks Threaten Africa, Mideast

 

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23 Confirmed Cases Of Dengue Fever In Hawaii...

State launches ‘Fight the Bite’ campaign to stop dengue fever in Hawaii
November 9, 2015 - The Hawaii State Department of Health Monday launched “Fight the Bite,” a statewide public education campaign that seeks to end the spread of dengue fever in Hawaii.

Its launch was announced in partnership with the County of Hawaii in Kailua-Kona. So far, there have been 27 confirmed cases of dengue fever on Hawaii Island. One unrelated case of dengue fever was also confirmed on Oahu. “The health and safety of our community and visitors is paramount, and the Department of Health is working collaboratively with all of our partners – including fellow state agencies, the Counties, healthcare providers, business leaders, nonprofit service providers and more – to address this important situation and end the spread of dengue fever in Hawaii as quickly as possible,” said Virginia Pressler, M.D., director of the Hawaii State Department of Health.

Hawaii County Mayor Billy Kenoi announced a series of public information meetings that will offer the community an opportunity to learn more about “Fight the Bite” and engage with county and state officials. The first meet took place Monday evening at Yano Hall with dozens in attendance. “I’m a Kona coffee farmer here in Captain Cook and I’m interested in making sure if I have mosquitoes on the property, I can get rid of them and to find out exactly what’s going on with dengue fever,” said farmer Mark Schultise. “I think the community needs to be involved and any time you can have people educated about a subject, there’s less panic and less worry, and I think that’s an obligation to the town and public is to be informed,” said Waimea resident Gary Jarvill. “The County of Hawaii has been working closely with the State Department of Health to respond quickly and efficiently to the cases of dengue fever in Hawaii and we are dedicated to minimizing its impacts on Hawaii Island and the state,” Kenoi said.

At a press conference Monday attended by Kenoi, Pressler, and state epidemiologist and chief of the health department’s disease outbreak control division Dr. Sarah Park, Civil Defense Administrator Darryl Oliveira said all parties involved had their first briefing Wednesday, Nov. 4, and to start setting up an emergency operating center to alleviate and mitigate any further outbreak of dengue fever. “We are getting a lot of reports of ‘Well, I might have this,’ from the public who says, ‘I didn’t see my doctor but it sounds like I might have this,'” Park said, “and right now our threshold is low to test these people because we are in the middle of an outbreak investigation.”

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Mosquito-borne chikungunya may cause Encephalitis...

Mosquito-borne chikungunya may cause fatal brain infection
Nov. 30, 2015 -- Encephalitis in patients infected with the chikungunya virus is far more common than previously thought, according to a new study of an outbreak.

The outbreak on Reunion Island, located in the Indian Ocean, lasted from 2005 to 2006, and affected about 300,000 people. Researchers said they mounted the study to find out if people who suffered neurological problems when they contracted the virus were still afflicted three years later. Chikungunya, which originated in Africa, was first seen in the Western Hemisphere in the Caribbean island of St. Martin, however has since spread to other islands in the region, as well as Central and South America, and been seen as far north as Florida, Georgia and North Carolina.

The virus is spread by mosquitoes, causing fever, joint pain, headache, muscle pain, joint swelling and rash. Most people recover from the painful illness, but joint pain may become chronic. Infants and the elderly already were thought to be at higher risk of death from the virus, even before the higher rates of potentially deadly brain inflammation were found by researchers. The risk of encephalitis is especially high for infants and people over 65, researchers reported in the study, published in the journal Neurology. The overall rate of encephalitis, or inflammation of the brain, was also reported by researchers as higher than the rate of occurrence in the United States due to West Nile or any other cause between 1999 and 2007.

With cases of chikungunya continuing to increase, researchers are advising travelers to effected countries be more vigilant at trying to prevent mosquito bites.​

A total of 24 people had encephalitis linked to chikungunya, which equates to an incidence rate of 8.6 per 100,000 people. The rates are much higher for infants and the elderly, however, as 187 per 100,000 infants and 37 per 100,000 people over age 65 experience brain inflammation because of the virus. The death rate for people with chikungunya-associated encephalitis was 17 percent, and between 30 and 45 percent of patients who had encephalitis had persisting disabilities after recovering.

More than 600,000 cases of chikungunya, and 76 deaths, have been reported this year, according to the Pan-American Health Organization. Overall, there have been more than 1.7 million reported cases in 45 countries. "Since there is no vaccine to prevent chikungunya and no medicine to treat it, people who are traveling to these areas should be aware of this infection and take steps to avoid mosquito bites, such as wearing repellent and long sleeves and pants if possible," said Dr. Patrick Gérardin, a researcher at Central University Hospital in Saint Pierre, Reunion Island, in a press release.

Mosquito-borne chikungunya may cause fatal brain infection

 

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Deadly Asian bacterial disease more widespread than previously believed...

Risk of Deadly Melioidosis Rises, Study Finds
January 11, 2016 — Melioidosis, a deadly bacterial disease most frequently found in Asia, is more widespread than previously believed and resists a wide range of antibiotic treatments, a just-issued study reports.

The new journal Nature Microbiology on Monday published findings that the little-known disease likely is present in 79 countries, including 34 that have never reported it. Research was conducted at the Mahidol Oxford Tropical Medicine Research Unit (MORU) here and the University of Washington in the northwestern U.S. city of Seattle, among other institutions. The study estimates the disease kills nearly as many people as measles, which the World Health Organization cited as responsible for almost 115,000 fatalities in 2014. Melioidosis causes more deaths annually than dengue or leptospirosis, both of which are health priorities for numerous international health organizations.

A patient with dengue rests under netting at a hospital in Allahabad, India. The mosquito-borne disease often is a greater priority than melioidosis, which a new study finds is more widespread and dangerous than previously believed.​

It’s caused by Burkholderia pseudomallei, a highly pathogenic bacterium commonly found in soil and water. It is contracted through the skin, lungs or by drinking infected water. Symptoms can include fever, weight loss, body aches, coughing and headaches, among other signs, according to the U.S. Centers for Disease Control and Prevention. Patients are frequently misdiagnosed as having pneumonia or suffering from sepsis, a potentially life-threatening complication of an infection. "Doctors will try to rule out whether [patients] have malaria or dengue infection by rapid diagnostic tests," MORU’s Dr. Direk Limmathurotsakul told VOA. If neither is confirmed, "doctors will suspect that any bacterial infection is the cause of the pneumonia and sepsis" and will prescribe antibiotics, he said.

Disease resists many drugs

But this particular bacterium is resistant to a wide range of antimicrobials, including penicillin. Treatment with ineffective antimicrobials can result in fatality rates exceeding 70 percent, according to specialists. "If they die, they die. If they survive, they survive" without the actual ailment being known, said Direk, one of the world's most prominent specialists on melioidosis.

Green spots locate confirmed melioidosis cases in Thailand’s Ubon Ratchathani province.​

The bacterium is especially common in Asia. The study predicts high infections rates throughout Southeast Asia, notably in Vietnam and India, where there is especially low awareness about it among medical practitioners. The tropical zones of Australia are also considered at high risk for melioidosis, as are East Asia and the Pacific, sub-Saharan Africa and South America. Some areas in Central America, southern Africa and the Middle East are also at risk, according to researchers.

Diabetes, kidney disease raise risks

 

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Man vs. the mosquito...

Vaccine to Guard Against Dengue Fever Is Almost at Hand
March 16, 2016 - Researchers are on the cusp of a commercially available vaccine to prevent dengue fever, a viral disease spread by mosquitoes that threatens half of the world’s population. In addition, a vaccine against the Zika virus, a close relative of dengue, will most likely enter clinical trials this year.

The dengue virus infects an estimated 400 million people in 120 countries each year. While the symptoms, including a rash, are usually not serious, the disease nonetheless kills some 25,000 people annually. Most succumb to a dreaded hemorrhagic form of the disease. In a clinical trial, the new vaccine against the dengue virus, for now called TV003, was 100 percent effective in preventing the disease in a study involving 50 volunteers.

A nurse prepares an emergency test to diagnose dengue at a medical care unit in the Sao Sebastiao neighborhood of Brasilia, Brazil​

Twenty-four of the participants who received the experimental vaccine were exposed to the virus and not one became infected. By contrast, all of those in the control group, who were not vaccinated, became infected. “To see that we got 100 percent protection against infection gives us great confidence in moving forward that the vaccine is going to work. So we were extremely excited,” said Anna Durbin, an infectious-disease specialist at Johns Hopkins University’s Bloomberg School of Public Health in Baltimore, Maryland. She was a principal investigator. There are four versions of dengue. Symptoms become more severe each time a person is infected. So a vaccine has to protect against all four types.

Existing vaccine

There is already a dengue vaccine called Dengvaxia. While it raises protective immune system antibodies against dengue, people still get sick. TV003 successfully shielded those involved in the study against a mild strain of dengue 2, the most aggressive of all the disease types. TV003 requires only a single dose compared with multiple shots of Dengvaxia. A five-year clinical trial involving 17,000 people in Brazil is in the works. But Durbin said there would probably be enough data by 2018 to seek regulatory approval. Clinical trials are also expected to begin in September or October of a vaccine against the Zika virus, an emerging threat also spread by mosquitoes. It has been linked to brain defects in newborns, and also to the paralytic disease Guillain-Barre syndrome. Efforts to fight Zika could also help the fight against dengue.

Enclosed in a mosquito net, Nadia Gonzalez recovers from a bout of dengue fever at a hospital in Luque, Paraguay​

Zika is "sort of like a cousin to dengue," Durbin said. "And what that means is that the recombinant DNA technology that the NIH [National Institutes of Health] has developed for Zika virus will be able to be ... applied quite easily to dengue because it has the same genetic structure.” NIH scientists developed the successful dengue vaccine that researchers reported upon in the journal Science Translational Medicine. Durbin said the aim is to give the dengue vaccine to children before they become infected for the first time. Any Zika vaccine would likely be targeted to women of childbearing age as a way to combat any potential birth defects associated with the disease.

Vaccine to Guard Against Dengue Fever Is Almost at Hand

See also:

Kenya on High Alert for Yellow Fever
March 17, 2016 — Kenya has reported its first case of yellow fever in 25 years. The patient, who died while receiving treatment, is thought to have arrived five days ago from Angola, a country that is fighting to stop the outbreak of the disease.

The patient was diagnosed with the virus at an advanced stage, according to Dr. Jackson Kioko, acting director of the Kenya Medical Service. "We screened him, and we found out that he had a yellow fever virus and, of course, he presented himself to us in three advanced stages when he had a renal and liver failure,” Kioko said. “He succumbed because he presented himself to the facility too late."

Staff members of a teaching hospital receive the first vaccination treatment for yellow fever in El Geneina, West Darfur​

The yellow fever virus is transmitted by an infected mosquito and found in tropical regions of Africa and Latin America. Symptoms of yellow fever include headache, vomiting and fatigue. Statistics from Angolan health officials show that more than 50 people have recently died of the virus, and 250 are infected. The Angolan government has vaccinated half a million people against yellow fever, and health officials are targeting another million.

High alert

Kenya is on high alert at its entry points, Kioko says. "We've sent an alert notice to our all health workers to all hospitals, public and private, to ensure that they are on high alert,” Kioko said. Consequently, “all people who have traveled to high-risk countries where Ebola have been reported … [are] put on the list of suspicion and we are able to investigate them thoroughly." There is no specific treatment for yellow fever. In serious cases, patients are admitted to a hospital and given supportive care, such as pain relievers and intravenous fluids to ward of dehydration.

Kenya on High Alert for Yellow Fever

Related:

To Stop Zika, Aedes Aegypti Mosquito Must Be Controlled
March 17, 2016 - Scientists are in a race against time in their efforts to stop the spread of the Zika virus. The World Health Organization estimates that as many as 4 million people could be infected with the Zika virus by the end of the year and, of course, the biggest fear is the virus' link to birth defects.

Until there's a vaccine against the Zika virus, controlling it comes down to controlling the Aedes aegypti mosquito that carries it. Countries in Latin America are aggressively spraying insecticides to kill adult mosquitoes, but more needs to be done. Professor Peter Armbruster studies the Aedes albopictus, a mosquito that carries dengue, a virus related to Zika, at his laboratory at Georgetown University in Washington, D.C. "Outdoor spraying has limited effectiveness in that these mosquitoes breed in a wide variety of container types that typically aren't going to be exposed when widespread spraying occurs," Armbruster said.

Health agents remove plastic bottles during an operation to eradicate the Aedes aegypti mosquito in Niteroi, Brazil​

The mosquito that carries the Zika virus lays its eggs in old tires, water cisterns, bottle caps — any place where there's a drop or two of water. "Insecticides can also be used to target the larval stages where the mosquitoes are living in their aquatic habitats," Armbruster said. The downside to insecticide use is that other insects are also killed, and it leads to broad environmental exposure to insecticides.

Other options

Other techniques use the Wolbachia bacterium to either sterilize the males or render the mosquitoes incapable of transmitting the virus. Some researchers are working to genetically modify the mosquito. Assistant professor Alexander Franz is doing that at the University of Missouri Department of Veterinary Pathobiology. "We try to manipulate mosquitoes in such a way that they are resistant to these viruses. This way the transmission cycle can be interrupted," he said. Franz said that in the past, his research group was able to produce genetically modified mosquitoes that were resistant to dengue. The idea is to release the virus-resistant mosquitoes into the wild, where they breed with wild mosquitoes and pass on the particular gene that resists the virus. Another route is one being followed by Oxitec, a British firm that has modified the male mosquito so its offspring die before they can reproduce. Oxitec scientist Derric Nimmo told VOA that trials in the Cayman Islands and Brazil have reduced the wild mosquito larvae by more than 80 percent.

A technician from the British biotec company Oxitec holds with a bag of blood to feed Aedes aegypti mosquitoes that were genetically modified to produce offspring that don't live​

Nimmo said that, once the Aedes aegypti mosquito population falls to a level where it's no longer a threat, communities can monitor their numbers to determine if additional modified mosquitoes need to be released or if insecticides can do the job. With a plant in Brazil and a larger one in the works there, Oxitec is perhaps the company closest to having a ready solution. Armbruster said the most effective approach will involve a combination of methods. "The most effective approach to suppressing the populations is going to be to take an integrated strategy that combines things like these genetically modified mosquitoes as well as traditional use of insecticides and elimination of breeding habitat," he said. In the meantime, millions of pregnant women are depending on these scientists to come up with something quickly to spare their babies from the risk of enduring lifelong disabilities linked to Zika.

To Stop Zika, Aedes Aegypti Mosquito Must Be Controlled

 

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Doctors without Borders brings cholera vaccine to Zambia...

MSF Begins Cholera Vaccination Campaign in Zambia's Capital
April 09, 2016 - The medical charity Doctors Without Borders/Médecins Sans Frontières has begun the largest-ever oral cholera vaccination project in Zambia’s capital, Lusaka, the organization announced Saturday in a statement.

MSF is closely collaborating with the Zambian Ministry of Health and the World Health Organization to vaccinate more than 570,000 people in two weeks, the statement said. Eight MSF international staffers, 19 Zambian Ministry of Health personnel and 1,135 community volunteers from Lusaka are conducting the campaign, which began Friday, at 39 sites in four of the most affected townships of Lusaka — Kanyama, Bauleni, George and Chawama.

The goal is to curb a cholera epidemic that began in February in Lusaka’s overpopulated township areas. As of Thursday, 664 cases and 12 deaths had been reported in the city, MSF said. About 1.2 million people live in overcrowded informal settlements within Lusaka. They are at the highest risk of cholera each rainy season, which normally ends in April.

MSF Begins Cholera Vaccination Campaign in Zambia's Capital

See also:

Study: Parasites Prompt Need for Safe Waste Management
April 08, 2016 - Swiss study in Uganda underlines need for increased protective measures for urban farmers and marginalized groups

People who live in rapidly expanding urban areas of low income countries are at the greatest risk of intestinal parasitic infection, according to a new study. Contact with human and animal fecal matter in areas where safe management of wastewater and fecal waste is lacking causes infections such as hookworms and intestinal protozoa. The study was conducted by researchers from the Swiss Tropical and Public Health Institute and their colleagues in Uganda. They examined the prevalence and risk factors for intestinal parasitic infections in the growing suburbs of Kampala, where only a small proportion of wastewater is treated. The vast majority of the city's wastewater is discharged without treatment into open storm water channels, jeopardizing the health of people who come into contact with it.

Fish waste products from the fish processing plants are dried in the sun in Masese, before being sold to the Congo for protein Masese, Uganda​

Dr. Samuel Fuhrimann, the study's lead author, says the findings call for increased protective public health measures for urban farmers and marginalized groups. The study also found that wastewater can be successfully recycled to boost food production. “The study was conducted within the framework of the Resource Recovery and Reuse project with a clear focus on urban centers in low and middle income countries," said Fuhrimann. "There we had one major recourse, which was wastewater, and this generated a lot of livelihood when it is reused, especially in the urban settings. The high nutrient loads and the all-year-round availability has a lot of gains for agriculture and aquaculture in these settings.”

The study used a cross-sectional survey of five groups totaling about 950 people. The pool included people who would likely be at risk of contact with the wastewater, including workers at wastewater facilities, workers collecting fecal sludge from pits using vacuum trucks, urban farmers and slum dwellers. While the examination of only one stool sample was used per person, Fuhrimann says the results raise important issues concerning the proper treatment of fecal waste. “As urbanization continues at a rapid pace, this poses special challenges for the safe management of the wastewater and also fecal sludge, which is actually collected from pit latrines," said Fuhrimann, adding that some 90 percent of Kampalans rely on pit latrines for toilets, causing a huge challenge for safe waste management.

Reducing health risks

 

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Granny says it's one o' dem end time plagues...

WHO: Angola Yellow Fever Outbreak Spreads to DRC
April 12, 2016 - The World Health Organization said Monday at least 21 people in the Democratic Republic of Congo have died from yellow fever connected to an outbreak in neighboring Angola.

The WHO said that as of March 22 there were at least 151 suspected cases in the DRC. It warned that with the high number of people moving between the two countries, a high proportion of people susceptible to infection and the presence of the type of mosquito that transmits yellow fever, there is a "serious risk" for the disease to spread further.

Democratic Republic of the Congo​

The outbreak began in December in Angola's capital, Luanda, and has since spread to most of the country's provinces with more than 1,100 total cases. At least 168 people have died in Angola.

Kenya also reported one death and one other infection from people who had traveled to Angola. The WHO launched a vaccination campaign targeting 6.5 million people to try to prevent further spread of the disease.

WHO: Angola Yellow Fever Outbreak Spreads to DRC

 

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Yellow Fever outbreak in Angola...

WHO Issues Yellow Fever Warning As Deadly Outbreak Grows
Wednesday 27th April, 2016 - At least 258 people have been killed by the disease.

Amid rising concern over a deadly outbreak of yellow fever spreading from Angola, the World Health Organization on Tuesday urged travelers to the African country to heed its warnings and get vaccinated. At least 258 people have been killed and there have been around 1,975 suspected cases of the mosquito-borne disease since an epidemic erupted in December 2015. It has already grown to become the worst outbreak in decades. Yellow fever is transmitted by the same mosquitoes that spread the Zika and dengue viruses, although it is a far more serious disease with death rates as high as 75 percent in severe cases requiring admission to hospital.

Angola's outbreak has already spread to other countries in Africa, including the Democratic Republic of Congo (DRC), and at least 11 cases of yellow fever have been imported into China in people traveling from Angola. "Cases of yellow fever linked to this outbreak have been detected in other countries of Africa and Asia," WHO director-general Margaret Chan said in a statement. "We are particularly concerned that large urban areas are at risk and we strongly urge all travelers to Angola to ensure they are vaccinated against yellow fever and carry a valid certificate."

High-rise buildings are seen behind informal settlements in Luanda, Angola, where a yellow fever outbreak has health experts worried​

The WHO's regional office for Africa said last week that yellow fever in people who traveled from Angola has been reported in China (11 cases), DRC (10 cases with 1 in Kinshasa) and Kenya (2 cases). It said three further cases have been reported in Uganda, but these patients had no history of travel to Angola. The WHO "is working with neighboring countries such as the DRC, Namibia and Zambia to bolster cross-border surveillance with Angola and information sharing to prevent and reduce the spread of infection", it said.

Jack Woodall, a yellow fever expert who formerly worked for the WHO and the U.S. Centers of Disease Control and Prevention, said he is worried the outbreak could spread rapidly along a major trucking route from DRC to Uganda's capital Kampala."Surveillance of this trade route should be intensified and vaccination of people living along it should be top priority," he said. A spokesman for the WHO in Geneva said a nationwide vaccination program that began in Angola in February has reached 7 million people. But experts are warning the world's stocks of yellow fever vaccines are under sever pressure form the outbreak, with some calling for a radical switch in strategy to use a tenth of the normal dose and aim to cover more people.

WHO Issues Yellow Fever Warning As Deadly Outbreak Grows

 

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Global Shortage of Yellow Fever Vaccine...

What is Behind the Global Shortage in Yellow Fever Vaccine?
May 05, 2016 — Globally, around 80 million doses of yellow fever vaccine are made each year; manufacturers say it can be hard to predict how much vaccine will be needed and that they can't afford to over produce

Angola is battling a yellow fever outbreak amid a global shortage of the vaccine. Cases have also been reported in the Democratic Republic of Congo, Kenya, Uganda and China. Health experts worry about further spread. There is no treatment. Mass immunization is the only way to stop yellow fever, but producing more of the vaccine is not easy.

Making of a vaccine

The Institut Pasteur de Dakar is one of four places in the world that make the yellow fever vaccine. Recording is prohibited inside the institute, but there is nothing to hear. The halls are quiet. Two walls of windows separate us from the sterile labs where technicians work in head-to-toe protective gear. Each week, a carton of special, pathogen-free chicken eggs arrives from Germany. Technicians inject the embryos, one by one, with the live virus. That’s a first step. What follows is weeks of extraction, mixing, incubation and safety checks. It can take up to six months to produce a batch of usable vaccine. Globally, around 80 million doses of yellow fever vaccine are made each year. The Institut Pasteur can produce up to 10 million doses.

Meeting global needs

Antoine Marie Diatta is the quality control manager for yellow fever vaccine production at the institute. He said unfortunately our production capacity can’t always meet the global needs. It’s the same for other manufacturers, he said. This can be a problem when there is an epidemic, he said, because then there is an immediate need to vaccinate a large number of people. It can be hard to predict how much vaccine will be needed. Yellow fever vaccines can be stored for up to three years, but manufacturers can't afford to over produce, as Diatta explained. He said money is invested to make each batch of vaccine and you must wait for your return. It’s not easy. He said while you wait to sell, you still need to pay salaries and update equipment, but your money is tied up. Yellow fever is endemic to 34 countries in Africa. It is spread through the bite of an infected mosquito. A single dose of the vaccine can protect you for life.

Adam Abdalah (L), a farmer from West Darfur's Adar, accompanies his son Yassim Adam who is being treated for yellow fever at the Teaching Hospital in El Geneina​

UNICEF’s chief of child survival and development in Angola, Samson Agbo, said 80 percent of people living in high-risk areas need to be vaccinated to prevent an epidemic. In many parts of Africa, immunization rates are below 60 percent. “The high-risk countries are known. Ideally, those high-risk countries should have a very strong immunization programs, which means you are reaching every child," said Agbo. "We need to invest more if we want to prevent occurrences like this, this kind of outbreak.” Nearly 2,000 cases have been reported in Angola since the outbreak began in October 2015. A mass vaccination campaign was launched in February, using 6 million doses from emergency stockpiles.

Averting an outbreak

 

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These tropical disease are mostly caused due to dirty and infectious water and food.

 

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WHO cuts back yellow fever vaccine dosage to eke out supplies...

WHO backs cut in yellow fever vaccine dose to eke out supplies
June 17, 2016 - World Health Organization advisers have recommended using a fifth of the standard dose of yellow fever vaccine in the event of a global shortage to combat the worst outbreak of the deadly disease in decades.

Fears of a widening outbreak of the mosquito-borne disease were fuelled this week by a spike in cases in the Democratic Republic of Congo (DRC), which now says it has seen more than 1,000 suspected cases since March. "Experts agreed to propose if necessary, if there is a shortage of vaccine, to divide the vaccine by five," WHO spokesman Tarik Jasarevic said on Friday, reporting on a meeting this week. "One fifth of a dose according to their evidence would be sufficient to provide immunity for at least 12 months." Reuters previously reported that a move to stretch vaccine supplies in this was likely.

Staff of the Teaching Hospital receiving the first vaccination treatment for yellow fever in El Geneina, West Darfur​

The normal full dose of the vaccine confers life-long protection and the WHO emphasised that the low dose endorsed by its independent experts was designed specifically for emergency mass vaccination, not for routine immunisation. More research is also needed to see if low doses will work for young children, who may have a weaker immune response, and practical challenges remain over obtaining the right syringes. The current yellow fever epidemic started in Angola but a major outbreak in the DRC's capital city of Kinshasa, which has a population of more than 12 million, is a big worry for healthcare officials.

The global stockpile of yellow fever vaccines has already been depleted twice this year to immunize people in Angola, Uganda and the DRC. It currently stands at 6 million doses but this may not be enough if there are simultaneous outbreaks in multiple densely populated areas. Almost 18 million doses have been distributed for emergency vaccination campaigns so far in the three African countries. Concerns about limited vaccine supplies have been building for some time, with a group of medics calling for low-dose use in an article in The Lancet journal back in April.

A mother holds her child suffering from yellow fever at a hospital in Luanda​

Yellow fever is transmitted by the same mosquitoes that spread the Zika and dengue viruses, although it is a much more serious disease. The "yellow" in the name refers to the jaundice that affects some patients. Although approximately 6 million vaccine doses are kept in reserve for emergencies, there is no quick way to boost output when there is a surge in demand since production, using chicken eggs, takes around 12 months. Manufacturers include the Institut Pasteur, government factories in Brazil and Russia, and French drugmaker Sanofi. The current outbreak of yellow fever was first detected in Angola in late December 2015.

WHO backs cut in yellow fever vaccine dose to eke out supplies

 

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Yellow fever frontline...

Angola's front line against yellow fever
Tue, 21 Jun 2016 - Angola is struggling to contain a yellow fever outbreak that has killed more than 300 people since December and is threatening other countries.

In the green and shaded gardens of the Americo Boavida Hospital in Angola's capital, Luanda, women in colourful printed dresses wait patiently for visiting hours to begin. It is one of the biggest hospitals in the city, serving almost two million people. Malaria is the most common killer here, but since December last year they have had to counter another, potentially more dangerous, mosquito-borne virus: Yellow fever. In its 16 June report, the World Health Organization (WHO) said that 345 people are reported to have died from yellow fever in the last seven months among more than 3,000 cases in Angola. Not since 1971 has there been such a serious outbreak, and the reasons why it has happened now are complex and many.

Dr Fortunato Silva, the clinical director at Americo Boavida, says that this outbreak is more worrying not only in relation to the number of cases, but also the number of deaths. He thinks some of the reasons for this may include the virus becoming more virulent, immunity levels amongst the population dropping and most critically, people not vaccinating as they should. "Ninety patients have been hospitalised with fever, jaundice and haemorrhaging, since 23 February," Dr Silva said. "There have been 33 deaths, which is a very high mortality rate. All of them had tested negative for malaria." Angola's health system is well regarded, and there are established countrywide vaccination and awareness programmes.

Since 1989, babies have been vaccinated against yellow fever at the age of nine months, and children cannot attend school unless they have a valid yellow fever certificate. Despite this, Dr Silva says, something is not working, and there are questions that need to be answered in terms of public health strategies. Dr Francisco Songane, the representative in Angola for the UN children's fund, Unicef, describes what is happening as "a major crisis". He says critical time was lost between samples being taken, tests being run, and results finally arriving three weeks later. By the time confirmation of yellow fever came, it had spread from the densely populated area of K30, part of the capital's Viana district, and then across the entire city.

The spread of yellow fever

* Angola - 345 reported deaths, 3,137 suspected cases

* Democratic Republic of the Congo - 71 reported deaths, 1,044 suspected cases (not all linked to Angola)

* Kenya - two suspected cases (travellers returning from Angola)

* China - 11 suspected cases (travellers returning from Angola)

Source: WHO

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New Guinea was not a good place to fight a war.

 

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WHO responding to yellow fever outbreak...

WHO to Provide Emergency Yellow Fever Vaccines on Angola-DRC Border
June 23, 2016 - The World Health Organization (WHO) will launch emergency vaccination campaigns for Yellow Fever along the border between Angola and the Democratic Republic of Congo, it announced Thursday.

The WHO emphasized that preventing further international spread of the disease is the current priority. “While WHO is working with partners and vaccine manufacturers to increase vaccine production and replenish the emergency stockpile currently being used for this outbreak, it is vital to interrupt transmission, especially in cross-border areas to rapidly bring this outbreak under control and halt further international spread,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.

The initial phase of the campaign will begin in July, and will focus on areas along the border with the most trade and activity to try to prevent further international spread of the disease. Working in a 75-100 kilometer belt spanning the Angola-DRC border and targeting areas such as capital city Kinshasa will create an "immune buffer to prevent further international spread" of the virus, according to the WHO.

As of June 13th, three countries, China, Kenya, and the DRC, have reported cases of Yellow Fever connected to the Angola outbreak. So far, over 15 million doses of the Yellow Fever vaccine have been delivered to Angola and the DRC, but lack of funding, urgent need, and the difficulty of making the vaccine have resulted in significant shortages.

WHO to Provide Emergency Yellow Fever Vaccines on Angola-DRC Border

See also:

Key African Anti-Venom About to Permanently Run Out
June 24, 2016 — It sounds like a tale of corporate greed: A particularly effective African anti-venom soon will be completely unavailable because its manufacturer decided it was not profitable. Remaining stocks of the drug expire at the end of June.

The situation has prompted aid groups like Doctors Without Borders to sound the alarm over the imminent shortage of Fav-Afrique, which treats bites from 10 types of snakes. “We are upset about the decision of Sanofi Pasteur to stop Fav-Afrique because we need the anti-venom,” said Dr. Monica Rull, a health advisor for Doctors Without Borders. “We need an anti-venom that is polyvalent and it’s easy to use, not thinking too much about which type of snake has bitten the patient.” The aid group estimates that 30,000 Africans die of snakebites each year.

'Polyvalent' anti-venoms

Rull said there are other anti-venoms available in Africa, but none are as effective as Fav-Afrique, and few are polyvalent — meaning they can treat multiple poisons. That matters because patients often can’t accurately identify the species of snake that attacked them. But the sad story of the demise of Fav-Afrique is a complicated one, says Dr. Jean Lang of pharmaceutical company, who contends governments and donors are equally responsible for this poisonous situation. Lang was part of the team that developed Fav-Afrique two decades ago. He spoke to VOA from Sanofi Pasteur’s facility in Lyon, France.

A member of the Amazonian Tatuyo tribe holds a snake while waiting for tourists in his village in the Rio Negro (Black River) near Manaus city, Brazil​

While tests have shown that Fav-Afrique is very effective, he says his product has commercial disadvantages. Production is lengthy and complicated, and it will take at least two years to make a batch to replace the one that is now expiring. Fav-Afrique has to be refrigerated — a tall order for rural African clinics — and treatment is expensive, with the average patient needing multiple courses that total about $500. “The people who decide at the ministry of health of these African countries, of course considering the price of the product ... when you face a five-fold cheaper product and you consider they are equivalent, because you are not a scientist or a physician,” he said.
Fav-Afrique's demise

When the company decided in 2010 to discontinue Fav-Afrique, they announced they would share the technology with anyone who wanted to resume production. No one has stepped up, Lang says. He says he is worried the death of Fav-Afrique is a symptom of a bigger disease in the healthcare industry. He says his company is urging donors, governments and aid organizations to step up to fund essential pharmaceuticals like vaccines and anti-venoms.
“I think there are vaccines that are also under threat because no one realizes that even with the market failure, we are going below some fair return for investments,” he said. “And that’s apparent to us with the measles vaccine, for example. So there are other vaccines that, if we don’t rethink, most of the new vaccines we are making are driven out of the business cases of our company.” As the boardroom battle rages over who will pay for these lifesaving medications, the burden is now falling to those who can least afford it — patients, who may pay with their lives.

Key African Anti-Venom About to Permanently Run Out

 

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Red Cross requesting fund to fight Yellow Fever Outbreak...

Red Cross Asks for $1.4 Million to Fight Yellow Fever
July 06, 2016 - The Red Cross launched a $1.4 million emergency appeal Wednesday to fight the spread of yellow fever in Angola, which faces its worst outbreak in 30 years.

The International Federation of Red Cross and Red Crescent Societies (IFRC) said in a statement that it would work with the Angola Red Cross to reach 9 million people by engaging communities and promoting health care and hygiene. “The need for a large-scale community engagement approach is increasingly important as vaccination campaigns scale up,” said Dr. Julie Lyn Hall, IFRC Director of Health. “As much as we try to provide solutions, it is the communities who are the drivers of the response and are the key to the success of it.

A nurse displays a vial of yellow fever vaccine in Brasilia, Brazil. So far, over 15 million doses of the Yellow Fever vaccine have been delivered to Angola and the neighboring Democratic Republic of Congo.​

So far, over 15 million doses of the Yellow Fever vaccine have been delivered to Angola and the neighboring Democratic Republic of Congo, but lack of funding, urgent need, and the difficulty of making the vaccine have resulted in significant shortages.

Yellow fever is an acute viral disease transmitted by infected mosquitoes. The mosquito that transmits the virus is the same one responsible for the Zika virus, dengue fever and Chikungunya. The yellow fever virus is usually very mild, and most people who are infected have few or no symptoms. However, about 15 percent of patients become severely ill and up to 50 percent of those die if left without treatment.

@IFRC Red Cross Asks for $1.4 Million to Fight #YellowFever in #Angola

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Shortage of Syringes Hampers Congo's Fight Against Yellow Fever
July 05, 2016 — A shortage of syringes is hampering plans to vaccinate people in Democratic Republic of Congo against a yellow fever epidemic despite the arrival of more than one million doses of vaccine, health officials said on Tuesday.

Congo's government declared a yellow fever epidemic last month in the capital Kinshasa and two other provinces near the border with Angola. The World Health Organization (WHO) says some 1,400 suspected cases of the hemorrhagic virus in Congo have resulted so far in 82 deaths and is particularly concerned about conditions in Kinshasa, a city of 12 million with poor health services and a climate conducive to mosquitoes. The disease has killed 350 people in Angola since December. The WHO plans to begin a vaccination campaign in the province of Kwango near the Angolan border on July 20 but the U.N. body's spokesman in Congo, Eugene Kabambi, said the country had only about four million syringes but needed 10 million.

Kabambi said some 1.08 million vaccine doses had arrived in Kinshasa in recent days, but declined to say when he thought more syringes might be delivered. Health officials are reluctant to begin the vaccination campaign in only one zone in densely-populated Kinshasa for reasons of public safety and order. "If we only organize in Kisenso, there will be huge crowds coming to Kisenso to obtain the vaccine and that could become unmanageable," Kabambi said, referring to the first zone officials plan to target in the capital city. "So we're going to wait a little to obtain more [syringes]."

Global vaccine shortage

The global stockpile of yellow fever vaccine stands at about 6 million doses after having been depleted twice this year to immunize people in Angola, Uganda and Congo. The current method for making vaccines, using chicken eggs, takes a year. Health officials plan to administer a fifth of the standard dose in Kinshasa due to the shortage of the vaccine. The lower dosage provides temporary protection against the disease but does not confer lifelong immunity.

More than one million people were vaccinated in Kinshasa during a campaign from May 26-June 4 in two health zones. But the effort was hampered by disorganization as residents of other districts flocked to the vaccination sites, preventing many local residents from receiving the injection. Kabambi said other regions along the Angolan border would eventually be vaccinated, depending on how many more doses are made available, in order to create an "immune buffer".

Shortage of Syringes Hampers Congo's Fight Against Yellow Fever