World Health Organization (WHO): Zika Virus is a Public Health Emergency of International Concern (PHEIC)
The first meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) (IHR 2005) regarding clusters of microcephaly cases and other neurologic disorders in some areas affected by Zika virus was held by teleconference on 1 February 2016, from 13:10 to 16:55 Central European Time.
The WHO Secretariat briefed the Committee on the clusters of microcephaly and Guillain-Barré Syndrome (GBS) that have been temporally associated with Zika virus transmission in some settings. The Committee was provided with additional data on the current understanding of the history of Zika virus, its spread, clinical presentation and epidemiology.
The following States Parties provided information on a potential association between microcephaly and/or neurological disorders and Zika virus disease: Brazil, France, United States of America, and El Salvador.
The Committee advised that the recent cluster of microcephaly cases and other neurologic disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern (PHEIC).
Based on this information, the WHO Director-General declared a Public Health Emergency of International Concern (PHEIC) on 1 February 2016.
Resurgence of a disease that was “eliminated” from the United States in 2000
In medical history, measles was 1st identified as a unique disease by the Persian physician Rhazes in the 9th century when he published the text titled The Book of Smallpox and Measles. Measles is an ancient disease that used to have a profound global impact causing hundreds of thousands of deaths and millions of cases each year. In the 16th century, a measles epidemic caused the deaths of two-thirds of the population of Cuba in one year, and two years later, it killed half the population of Honduras. In the 1850’s, a measles outbreak caused the death of 20% of the population of Hawaii. From 1840-1990, it is estimated that measles has killed approximately 200 million people worldwide.
Global Need for Coordination of Efforts
The International Health Regulations (IHR) is a structural body created to increase Global Health Security and prevent national public health emergencies from becoming global crises. The IHR were first implemented in 1969 focusing on plague, cholera, yellow fever and small pox. Several years later in 1995, the reemergence of plague in India and Ebola in Democratic Republic of Congo (DRC) created the need to revise and update the IHR. This led to the creation of a network of technical collaborations among existing institutions and networks, which would pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance: the Global Outbreak Alert and Response Network (GOARN). Most recently, the GOARN has focused on the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Alert and response operations functions include:
- Event-based surveillance, multi-hazard rapid risk assessment and event-based risk communications
- Critical information and communications platforms for decision support
- Operations and logistics platforms for any WHO response to international public health risks.
Pertussis Epidemic affecting California and much of the US
Another day, another vaccine-preventable illness is on the rise. I described the current measles outbreak in an earlier post , and so that we do not run of out diseases to discuss, a new one has recently captured media attention. So far in 2014, 3,498 cases of Whooping Cough, or Pertussis, have been reported in California – more than all that were reported in 2013, Nationally, 24% more cases have been reported than in January to April 2013. Pertussis outbreaks occur cyclically, peaking every 3-5 years, with the last peak in 2010. A vaccine-preventable disease, Pertussis infection begins as a cold-like illness associated with mild cough and fever. Within 1-2 weeks, however, the severe, characteristic cough begins and can continue for weeks. Infants, however, may not cough, but may suffer from dangerous fits of apnea, or pauses in breathing. In vaccinated children the symptoms’ duration and severity is lessened. The CDC’s website further describes the disease characteristics.
Severe Pandemic in West Africa
A deadly pandemic has been brewing in western Africa since December 2013. This latest outbreak of the deadly Ebola Virus Disease (EVD) began in the Republic of Guinea and then spread to Sierra Leone and Liberia. To date, 344 suspected and confirmed cases of EVD have been reported in Guinea, 112 in Sierra Leone, and 13 in Libera. Since emerging in 1976 in Sudan and Congo, EVD outbreaks have occurred 33 times.
Measles is Back and it’s Entirely Our Fault
If you haven’t heard by now, the measles virus is on the rise in the United States. As of May 23, 2014, 288 cases have been reported in 18 states with 15 distinct outbreaks making up 79% of the reported cases this year.
Middle East Respiratory Syndrome-Coronavirus (MERS-CoV), a novel Coronavirus in the same family as the Coronavirus that caused Severe Acute Respiratory Syndrome (SARS), has caused 339 illnesses and 102 deaths in Saudi Arabia . However, the WHO has only reported 262 laboratory-confirmed cases. Six Middle Eastern countries have reported MERS (Saudi Arabia, Qatar, United Arab Emirates, Jordan, Oman, Kuwait) and 5 other countries have reported traveler-associated MERS cases (United Kingdom, France, Tunisia, Italy, Malaysia). On May 2nd, the United States became the 6th county to report a traveler-associated MERS case. According to the CDC, an American healthcare worker flew back to the US from Saudi Arabia on April 24th, connecting in London and Chicago before taking a bus to Indiana. He is currently hospitalized and in stable condition. US Public Health officials are tracing the US MERS patient’s travel itinerary and attempting to contact other travelers who may have been in close contact with the affected individual. Currently, the US government has not issued any warnings to travelers to avoid the affected countries or to change travel plans.