Ebola August 2014: Updates on the Deadly Outbreak

Source: 21stcentech.com

Continuing coverage of the Ebola Epidemic affecting West Africa with the potential to spread to a wider region. The 1st article in the series can be found here.

The Fight Ramps Up

The 2014 Ebola outbreak “is moving faster than our efforts to control it..this is an unprecedented outbreak accompanied by unprecedented challenges. And these challenges are extraordinary,” said Margaret Chan, director-general of the World Health Organization (WHO) in response to the continued devastation in Africa where the outbreak has claimed at least 932 lives, including that of Sierra Leone’s leading Ebola expert Dr. Sheikh Umar Khan, and over 1700 cases.  The WHO announced on August 6th that it will convene a special panel to deliberate the use of experimental drugs in an attempt to control the outbreak with innovative measures.

Dr. Umar Khan, 39, one of Sierra Leone’s Ebola experts who died of Ebola. Source: bbc.com

The US Centers for Disease Control  (CDC) has raised its Emergency Operations Center Response to the Ebola epidemic to a Level One, its highest level of response.  Level One has occurred only 2 other times in the CDC’s history: Hurricane Katrina in 2005 and the H1N1 Outbreak in 2009. The CDC has 240 staff members working on the Ebola response and 30 members in the affected regions with more en route.

Many organizations such as US Peace Corps have already evacuated hundreds of volunteers from the most severely affected areas in West Africa. The situation has garnered international concern and the World Health Organization recently announced allocation of $100 million in funds to provide much needed supplies and officials to reverse the disease’s overwhelming tide and plans to send another 50 specialists to West Africa to help control the outbreak. But as efforts are escalated to treat those infected, containment protocols have also been expanded:

– The CDC has issued a Level 3 travel warning (highest level) for US citizens that severely discouraged from all nonessential travel to those countries hardest hit by the virus: Guinea, Sierra Leone and Liberia

– In Sierra Leone the government has announced plans to quarantine the hardest hit regions and to deploy security personnel to assist healthcare workers in their efforts to combat the disease

– Liberia has declared that all non-essential government personnel will be placed on a thirty-day long complusory leave and is making plans to close all schools temporarily

– Meanwhile from Nigeria to New York, vigilance has been increased at airports for passengers arriving from endemic regions with symptoms consistent with the Ebola virus. Dr. Jay Varma, deputy commissioner for disease control at the New York health department has reassured the public that any such affected individual would be briefly quarantined at the airport before being transported to an area hospital for further evaluation.

Map of Ebola Crisis

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Magnitude 6.1 Earthquake Rocks China

A 6.1 magnitude earthquake has struck China’s Yunnan Province near the Qiaojia County of Zhaotang prefecture. Reports so far suggest that at least 390 have been killed and hundreds are missing due to the devastation, though rescuers are still searching for trapped survivors. The rescue efforts have been complicated by recent mudslides in the area which have made some roads impassable, NPR reports. Additionally, over 1,400 have been injured, 12,000 homes have collapsed and at least 30,000 have sustained damaged. A resident described the scene as a “battlefield after bombardment”. While the USGS is reporting the earthquake to be of magnitude 6.1, the China Earthquake Networks Centre is rating the quake at 6.5

A paramilitary police officer carries an elderly man on his back after an earthquake hit Yunnan province China on Aug. 3. Picture courtesy of The Chicago Tribune

A paramilitary police officer carries an elderly man on his back after an earthquake hit Yunnan province China on Aug. 3. Picture courtesy of The Chicago Tribune

The United States Geological Survey has previously expressed concerns about the infrastructure in the area, saying: “Overall, the population in this region resides in structures that are highly vulnerable to earthquake shaking, though some resistant structures exist. The predominant vulnerable building types are unreinforced brick masonry and ductile reinforced concrete frame construction.”

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Mental Health Preparedness: Psychological Protection Prior to a Disaster

This is the second in a three-part series on post traumatic stress disorder following disasters. Part One, PTSD in Emergency Workers, can be found here.

General Public at Risk

Over 2/3 of the general population will experience some significant traumatic event in their lifetime, and 1/5 of Americans will undergo such an event in any year. One review of the literature found that the prevalence of PTSD in direct victims can range from 30-40%, in rescue workers 10-20%, and 5-10% in the general population.

PTSD in Natori Japan

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New Cholera Vaccine: Less Expensive Option to Contain Outbreaks

Though cholera mainly affects children in developing countries, the US is still at risk for outbreaks of this potentially lethal infection following natural disasters or terrorist attacks that disrupt access to clean water and sanitation systems. The manufacture of a safe, rapidly effective oral vaccine will be beneficial for both those in endemic areas and those in non-endemic countries.

Vibrio cholerae bacteria. (Courtesy of cnn.com)

Global Burden of Cholera

Official statistics show that global cholera cases are approximately 200,000-500,000 per year.  However, current research shows that these reported figures only represent 5-10% of actual cholera cases, and it actually affects 3-5 million people and causes over 100,000 deaths per year.

Global Cholera Cases (Courtesy of Who.int)

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Public Health Crisis on the US Border: Health & Immigration Policies Collide

Children Escaping Violence & Poverty

Over 50,000 undocumented children (UAC) have entered the United States through the Southwestern border in the last 8 months, creating what some a calling a humanitarian crisis. As many as 90,000 children are expected to enter the country by the end of the year.

Child Hand Immigration Camp

Many children are being sent to the United States alone without any adult supervision by family members hoping that by entering the United States their children will be spared the harsh realities of gang violence, drug cartels and civil unrest in their home countries. Categorized as Unaccompanied Alien Children (UAC), these children hail mostly from Mexico, Guatemala, El Salvador, Honduras and Ecuador.

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Horrific Tragedy of Ukraine Civil War: Malaysian Airlines Flight MH17

Civilian Plane Shot Down by Surface to Air Missile

A Malaysian Airlines Boeing 777 was shot down on July 17, 2014 by a missile that was possibly fired from a surface to air weapon.  Flight MH17 was traveling from Amsterdam to Kuala Lumpur and had 280 passengers and 15 crew on board.  Currently, no known survivors have been reported.  The plane had left Amsterdam at 12:15 p.m. (local time) and was estimated to arrive in Kuala Lampur International Airport on Friday at 6:10 a.m. (local time), according to Malaysia Airlines. The last known contact with the plane was at 4:21 P.M. (local time).  The plane was traveling at an altitude of approximately 33,000 feet.  Malaysian Airlines has released a partial list of passenger nationalities based on currently available flight manifest data:

  • 154 Dutch
  • 27 Australian
  • 23 Malaysian
  • 11 Indonesian
  • 6 UK
  • 4 German
  • 4 Belgian
  • 3 Philippines
  • 1 Canadian

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PTSD in Emergency Workers

This is the first of a series of posts which will cover post-traumatic stress disorder (PTSD).

EMTs, Paramedics, Fire Fighters, Police Officers, Emergency Department Personnel. These brave individuals serve to protect, to save, and to heal us in times of our greatest need. Aid workers are dispatched around the world to respond to natural and man-made disasters such as earthquakes, hurricanes, and war. Just as our nation’s soldiers and veterans battle the effects of post-traumatic stress disorder (PTSD), so do our first responders. Worldwide 1 in 10 emergency workers have PTSD. Ambulance personnel are the hardest hit, with over 1 in 5 ambulance personnel meeting criteria.

http://articles.latimes.com/2011/sep/01/news/la-heb-911-illness-mental-physical-20110901

Image courtesy of the LA Times

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Aleppo Evil: The Skin Disfiguring Parasite Spreading across Syria

Sandflies & Civil War

The Syrian civil war has set the stage for the reemergence of a rare infectious disease. Transmitted through the bite of the sandfly, Leishmaniasis is a parasite that can affect many different parts of the body. The most prevalent form in the Middle East is called Cutaneous Leishmaniasis, which causes disfiguring welts and scarring of the skin. A more lethal variant known as Visceral Leishmaniasis can also damage the spleen and liver.

Since the Syrian conflict began in 2011, the number of Leishmaniasis cases has skyrocketed from 3,000 to over 100,000. Water shortages and poor sanitation have combined to create conditions ripe for the transmission of the disease. To make matters worse, the pentavalent antimonial drugs used to treat Leishmaniasis are becoming increasingly scarce.  In times of conflict, Public Health tools such as surveillance, multi-sector response, and international collaboration rapidly diminish states Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine and President of the Sabin Vaccine Institute.

A Syrian refugee being treated for Leishmaniasis in Kilis, Turkey

A Syrian refugee being treated for Leishmaniasis in Kilis, Turkey

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Hurricane Arthur Reminds Coastal Residents to Stay Vigilant During Hurricane Season

Hurricane Arthur was the first named storm of the hurricane season, making landfall in North Carolina last Thursday and affecting the northeast United States and southeast Canada. The storm’s 100 mph wind speeds and heavy rain reminded residents of coastal areas always to remain vigilant during hurricane season.

Courtesy of wired.com. Animation: Hal Pierce/NASA

 

Hurricane Arthur, the first named storm of the hurricane season and the first to hit the United States since Hurricane Sandy in October 2012, made landfall in North Carolina Thursday, July 3, as a Category 2 hurricane. Arthur disrupted the region’s Independence Day celebrations before it weakened to a Category 1 and then a post-tropical storm as it moved along the northeast and affected parts of Canada on Saturday.

Despite the initial 100 mph winds, Arthur didn’t do much damage to homes or businesses in North Carolina, but it did manage to spoil the holiday weekend for many—4th of July parades and firework shows were cancelled due to the heavy rain.

Additionally, an estimated 44,000 people were without power the next morning. However, the damage was mitigated fairly quickly, with only 5,000 people left without power by that same afternoon.

No injuries or deaths were reported after the storm.

“We’ve always felt that it was better to overreact than underreact,” said North Carolina Governor Pat McCrory, “Gladly this storm was more underwhelming than anticipated, which was very good news.”

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Chikungunya: The Global Spread of a Re-emerging Virus

African Mosquito-borne Virus Arriving in Western Hemisphere

Chikungunya virus, an arthropod-borne virus thought to have originated in Central/East Africa with first known human infections reported in Tanzania in 1955, has re-emerged with newly documented cases in the Caribbean and the United States raising concerns of among health officials for a new epidemic. The virus is transmitted to humans through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Though cases have been documented in countries in Asia and Africa and even Italy in 2007, the previously “tropical” disease is surprising health officials with its capacity for global spread. Also adding to official concerns: the newly reported cases in the Caribbean mark the first instance that the disease has been spread by locally infected mosquitoes among people who have not travelled to endemic areas recently.

Geographic Distribution of Chikungunya

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