BOA1

Welcome to A Time's Memory Blog

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A TIME'S MEMORY - Flu, Bugs & Other Accidents Blog - Year: XIII - Here, Reader, you will find many items if your interests are in the field of emerging threats to global or public health, with a perspective that is not mainstream. Thank to You for the interest!

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20 Jun 2018

Highly pathogenic #avian #influenza #H5, #Russia [sixteen #poultry #outbreaks] (#OIE, June 20 ‘18)

          

Title:

Highly pathogenic #avian #influenza #H5, #Russia [sixteen #poultry #outbreaks].

Subject:

Avian Influenza, H5 subtype, poultry epizootics in Russia.

Source:

OIE, full page: (LINK).

Code:

[     ]

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Highly pathogenic avian influenza H5, Russia

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Information received on 20/06/2018 from Dr Nikolay Vlasov, Deputy Head of the Rosselkhoznadzor, Ministry of Agriculture, Ministry of Agriculture, Moscow, Russia

  • Summary
    • Report type    Follow-up report No. 1
    • Date of start of the event    07/06/2018
    • Date of confirmation of the event    09/06/2018
    • Report date    20/06/2018
    • Date submitted to OIE    20/06/2018
    • Reason for notification    Recurrence of a listed disease
    • Date of previous occurrence    13/03/2018
    • Manifestation of disease    Clinical disease
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • Summary of outbreaks   
    • Total outbreaks: 16
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of    - Slaughtered
        • Birds    - 420698    - 15042    - 15027    - 3297    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Birds    - 3.58%    - 3.57%    - 99.90%    - **
          • *Removed from the susceptible population through death, destruction and/or slaughter
          • **Not calculated because of missing information
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive

(...)

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Keywords: OIE; Updates; Avian Influenza; H5Nx ; Poultry; Russia.

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#Ebola virus disease – #DRC (@WHO, June 20 ‘18)

          

Title:

#Ebola virus disease – #DRC.

Subject:

Ebola Virus Disease Outbreak in the Dem. Rep. of Congo, current situation.

Source:

World Health Organization  (WHO), full page: (LINK).

Code:

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Ebola virus disease – Democratic Republic of the Congo

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Disease outbreak news / 20 June 2018

The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo.

There is cautious optimism. Slightly over a month into the response, further spread of EVD has largely been contained.

However, in spite of progress, there should be no room for laxity and complacency until the outbreak is controlled. The focus of operations remains on intensive surveillance and active case finding.

Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case-patient in Iboko developed symptoms on 2 June 2018 and died on 9 June (Figure 1).

From 1 April through 18 June 2018, a total of 60 EVD cases1, including 28 deaths, have been reported from four health zones in Equateur Province. The total includes 38 confirmed, 14 probable and eight suspected cases.

Cases have been confirmed from three health zones:

  • Bikoro (n=24; 10 confirmed, 11 probable and three suspected cases),
  • Iboko (n=32; 24 confirmed, three probable and five suspected cases),
  • Wangata (n=4; all confirmed) (Figure 2).

Five cases were health care workers, of which four were confirmed cases and two died.

Of 1 706 contacts of cases registered to date, 244 contacts remain under active follow up as of 18 June 2018.

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Figure 1: Confirmed and probable Ebola virus disease cases by date of illness onset from 4 April through 18 June 2018 (n=52)

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Figure 2: Democratic Republic of the Congo, Ebola cases per Health Zone in Equateur province from 4 April through 18 June 2018 (n=60)

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Public health response

The Ministry of Health (MoH) is leading the response in the affected health zones with support from WHO and partners.

Priorities include:

  • the strengthening of surveillance and contract tracing,
  • laboratory capacity,
  • infection prevention and control (IPC),
  • case management,
  • community engagement,
  • safe and dignified burials,
  • response coordination and vaccination.

Additionally, to avoid the spread of the disease from affected provinces to non-affected provinces and to other countries, the Democratic Republic of the Congo has put into place cross-border surveillance at points of entry (neighbouring at-risk zones, provinces, countries, and at important travellers’ congregation points).

WHO continues to work closely with the Ministries of Health from nine neighbouring countries to strengthen preparedness in order to mitigate the risk of international spread.

  • Since the launch of the vaccination intervention on 21 May through 17 June, a total of 3 137 people have been vaccinated in Iboko (1 434) Wangata (834), Bikoro (779), Ingende (77), and Kinshasa (13). Populations eligible for ring vaccination include front-line health professionals, people who have been exposed to confirmed EVD cases (contacts) and contacts of contacts.
  • Active surveillance activities are ongoing, including daily follow-up of contacts of cases, active case search at community and health facility levels, real-time investigation of alerts, and laboratory testing of all suspected cases to confirm or exclude EVD.
  • Infection prevention and control supplies, including personal protective equipment and disinfectants, have been provided to health facilities in eight health areas, namely: Mapeke, Bokongo, Itipo, Londo, Bokando-Bouna, Mpangi, Lokango, and Boutela.
  • Community awareness activities continue in Iboko, Bikoro, Mbandaka Wangata and Bolenge. In Iboko, more than 140 households were visited this week. Cellule d’Animation Communautaire (CAC) teams conducted house-to-house visits in Bokongo, Mapeke, B.Buna and Loondo health areas. In Mbandaka, awareness raising activities was carried out in ports and small markets along the river. Community awareness involving street leaders is also being carried out in Mbandaka, Wangata and Bolenge, where rumours and community concerns are being addressed.
  • WHO is providing technical advice on the use of investigational therapeutics under the Monitored Emergency Use of Unregistered Interventions (MEURI) framework and provision of essential medical supplies. Four of the five investigational therapeutics are in-country and all protocols have been approved by the Ethics Review Board (ERB). This is the first time such treatments have been available during an Ebola outbreak.
  • As of 18 June 2018, WHO has deployed a total of 271 technical experts in various critical functions of the Incident Management System (IMS) to support response to the EVD outbreak, including 31 experts from the Global Outbreak Alert and Response Network (GOARN) partner institutions. A WHO anthropologist and risk communication experts have trained Ebola responders on community engagement, including safe burial and contact tracing.
  • As of 19 June 2018, 26 countries have implemented entry screening for international travellers coming from Democratic Republic of the Congo, but there are currently no restrictions of international traffic in place. WHO continues to monitor travel and trade measures in relation to this event.
  • A joint partnership project was initiated by WHO, IOM, IFRC, UNHCR, and other partners to reinforce cross border coordination activities between the Democratic Republic of the Congo, Congo and the Central African Republic.
  • As of 19 June 2018, no cases were detected at ports on the River Congo closed to Kinshasa (Muluku, KinkolĂ©, Ngobila) as well as in the international and main national airports in Kinshasa (Ndili, Ndolo). As of 16 June 2018, 9 716 travelers were screened, in Mbandaka, 538 travellers in Irebu, and 100 travelers in Iboko.
  • As of 20 June no exported case was reported. The risk of missed cases able to travel outside of Equateur Province and internationally during the incubation period (two to 21 days) was considered very low. However, it was decided to maintain exit screening at points of entry and congregation sites as a precautionary measure and to prepare a deactivation plan for after the end of the outbreak.
  • WHO is supporting neighbouring countries to systematically assess and take action on Ebola preparedness, and to develop national contingency response plans. A regional readiness and preparedness plan has been developed and published, outlining activities to ensure that the nine neighbouring countries can detect and contain Ebola should it be introduced. The regional readiness and preparedness plan requires US$ 15.5 million.


WHO risk assessment

WHO considers the public health risk to be very high at the national level due to the serious nature of the disease, insufficient epidemiological information and the delay in the detection of initial cases, which makes it difficult to assess the magnitude and geographical extent of the outbreak.

WHO has assessed the public health risk to be high at the regional level. Nine neighbouring countries, including the Republic of Congo and the Central African Republic, have been advised that they are at high risk of spread, and preparedness activities are being undertaken.

At the global level the risk currently remains low.

This risk assessment is continuously being reviewed as further information becomes available.


WHO advice

The International Health Regulations Emergency Committee was convened by the WHO Director-General on 18 May 2018, and advised against the application of any travel or trade restrictions to the Democratic Republic of the Congo in relation to the current Ebola outbreak.

Flight cancellations and other travel restrictions may hinder the international public health response and may cause significant economic damage to the affected country.

The Emergency Committee also advised that exit screening, including at airports and ports on the Congo river, is considered to be of great importance. However, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.

Although the Emergency Committee stated that the conditions for a PHEIC are not currently met, the Committee issued comprehensive public health advice2.

WHO travel advice was issued on 29 May 20183, aiming to sensitize travellers on how to reduce the risk of exposure and where to obtain appropriate medical assistance in case of EVD like symptoms after possible exposure , considering the risk of an international traveller becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is low, even if the visit included travel to areas where primary cases have been reported.

In addition WHO in collaboration with transport and travel partners (ICAO, IATA) are working together to increase travellers’ awareness, vigilance on board of conveyances and points of entry and stress on the importance of establishing and maintaining a public health emergency contingency plan at POE in a multisectoral approach, pursuant to the IHR requirement.

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{1} The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are official information reported by the Ministry of Health.

{2} http://www.who.int/news-room/detail/18-05-2018-statement-on-the-1st-meeting-of-the-ihr-emergency-committee-regarding-the-ebola-outbreak-in-2018

{3} http://www.who.int/ith/evd-travel-advice-final-29-05-2018-final.pdf?ua=1

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Keywords: WHO; Updates; Ebola; DRC.

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#Measles – #Japan (@WHO, June 20 ‘18)

          

Title:

#Measles – #Japan.

Subject:

Measles outbreak in Japan, current situation.

Source:

World Health Organization (WHO), full page: (LINK).

Code:

[     ]

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Measles – Japan

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Disease outbreak news / 20 June 2018

On 16 May 2018, Japan’s National International Health Regulations Focal Point (NFP) notified WHO of an ongoing outbreak of measles in Japan.

On 20 March 2018, a traveller from overseas was diagnosed with measles in Okinawa prefecture, and thereafter additional cases of measles were reported from across the prefecture and later from other prefectures.

In light of the situation, on 11 and 26 April 2018, the Ministry of Health, Labour and Welfare (MHLW) circulated two alert notices.

The national trend in notifications and reports of new measles cases from Okinawa Prefecture have both declined in recent weeks (onset date of the most recent case in Okinawa was 10 May).

Okinawa Prefecture officially declared the outbreak over on 11 June, after four weeks had passed since this last case. This report provides the latest information on the epidemiologic situation of measles in Japan, including outbreak cases in Okinawa Prefecture and the other cases, and indicates the need for continued vigilance.

From 1 January through 20 May 2018, 161 cases of measles were diagnosed, including 145 (90%) laboratory-confirmed cases (99 cases of measles and 46 cases of modified measles).

Eighty-nine cases are male and 72 cases are female, and the median age is 29 years-old (range: 0‒58 years).

Cases were reported from the following prefectures: Okinawa (88 cases); Aichi (25 cases); Fukuoka (17 cases); Tokyo (11 cases); Saitama (six cases); Ibaraki and Kanagawa (three cases from each prefecture); Yamanashi and Osaka (two cases from each prefecture); and Chiba, Shizuoka, Hyogo, and Yamaguchi (one case from each prefecture).

The suspected location of infection was Japan for 136 cases, overseas for 12 cases, and unknown for the remaining 13 cases.

Among the total cases, to date, information for 30 cases regarding their isolated measles virus genotype have been received through the national surveillance system; excluding one case with vaccine strain, 25 were genotype D8 and four were genotype B3.

Cases of imported measles continue to occur in Japan. Japan has successfully eliminated endemic measles transmission and sustained this status since March 2015 through both high vaccination coverage and rapid detection of and response to every case of measles.

In 2016, routine vaccination coverage was 97% for the first dose (one year of age) and 93% for the second dose (year before entrance to primary school, usually five years of age); serological surveys have confirmed that the proportion of antibody-positive (particle agglutination titer ≥16) individuals aged two years or more has remained at 95% or above nationally.


Public health response

Specific actions implemented by the MHLW and local governments for the ongoing situation include:

  • Active epidemiological investigations, contact tracing and monitoring of close contacts for all cases.
  • Risk communication and circulation of alerts to medical professionals, including the importance of considering measles as a possible diagnosis and implementation of appropriate infection control measures in medical settings.
  • Encouraging appropriate implementation of routine immunization for measles and catch-up immunization for those with low immunity against measles.


WHO risk assessment

Measles is a highly contagious viral disease that remains one of the leading causes of mortality among young children globally, despite the availability of a safe and effective vaccine.

Transmission from person-to-person is airborne, as well as by direct or indirect contact of secretions (nasal, throat) of an infected person.

Initial symptoms, which usually appear 10–12 days after infection, include high fever, runny nose, bloodshot eyes, cough, and tiny white spots on the inside of the mouth.

Several days later, a rash develops, starting on the face and upper neck and gradually spreads downwards. A patient is infectious four days before the start of the rash for up to four days after the appearance of the rash.

While there is no specific antiviral treatment for measles, vitamin A is recommended by WHO for all children infected with measles regardless of their country of residence, as it is associated with reduced morbidity and mortality.

In March 2015, Japan was verified as having achieved measles elimination (defined as interruption of endemic measles virus transmission for at least 36 months).

Nevertheless, outbreaks caused by imported cases may occur sporadically.

The risk of a large measles outbreak in Japan is low due to the control measures put in place and sensitive surveillance to detect cases promptly. However, the possibility of exported cases cannot be fully ruled out because of the high volume of international travellers.


WHO advice

In light of continuous reports of imported measles cases, WHO urges all Member States to:

  • Vaccinate to maintain homogeneous coverage of 95% with the first and second doses of measles, mumps, rubella (MMR) vaccine in all municipalities. Conduct risk assessments to identify populations at risk of being missed by vaccination activities and proactively take corrective actions to fill immunity gaps, including development of special communication and immunization strategies as needed.
  • In settings with low incidence and high risk of importation of measles virus, vaccinate populations at high risk of exposure to imported measles (without proof of vaccination or immunity against measles and rubella), such as health workers, people working in tourism and transportation (hotel and catering, airports, taxi drivers, etc.).
  • Ensure that policies and procedures are in place to reduce risk of hospital-associated transmission of measles, such as appropriate triage and airborne isolation of suspected measles cases; avoiding unnecessary hospitalization of mild measles cases; and ensuring that only measles-immune healthcare workers care for suspected measles cases.
  • Promote medical consultation prior to travel in order to vaccinate all non-immune international travellers who missed their recommended measles doses. In addition, this consultation will include information about the most important health risks, determine the need for any other vaccinations and/or medication and identify any other medical items that the traveller may require.
  • Strengthen epidemiological surveillance of measles for timely detection of all suspected cases of measles in public and private health care facilities and ensure that: cases are investigated within 48 hours of detection; and that adequate and appropriate laboratory specimens are collected for both serological and molecular tests at the first contact with suspected cases. Ensure that operational resources and training are adequate so that case investigations and laboratory sample transportation for case confirmation can be performed at all subnational levels.
  • Ensure that resources are in place at all levels so that measles outbreaks can be rapidly investigated and immunization response measures can be rapidly implemented. These contingency resources may include dedicated funds and rapid response teams; identification of flexible resources and public health personnel who may serve as surge capacity if large-scale investigation or immunization response is required; and a stock-pile reserve of measles-rubella (MR) vaccine and supplies. Ensure that national plans and standardized operating procedures for measles outbreak response are developed and updated.

For more information, please see the links below:

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Keywords: WHO; Updates; Measles; Japan.

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#Ebola Virus Disease #Outbreak in #DRC – #Situation #Report No. 11 (@WHO, June 20 ‘18)

          

Title:

Ebola Virus Disease Outbreak in DRC – Situation Report No. 11.

Subject:

Ebola Virus Disease Outbreak in the Dem. Rep. of Congo, current situation.

Source:

World Health Organization (WHO, IRIS database), full page: (LINK).

Code:

[     ]

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Keywords: WHO; Updates; Ebola; DRC.

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19 Jun 2018

#Avian #Influenza [#H7N9, #H5N6, #H5N1] #Report - June 10 – 16 ‘18 (Wk 24) (#HK CHP, June 19 ‘18)

          

Title:

#Avian #Influenza [#H7N9, #H5N6, #H5N1] #Report - June 10 – 16 ‘18 (Wk 24).

Subject:

Avian Influenza Viruses, H5-H7-H9 subtypes, global poultry panzootic and human cases in China and worldwide.

Source:

Centre for Health Protection (CHP), Hong Kong PRC SAR, full PDF file: (LINK).

Code:

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Avian Influenza Report - Reporting period: June 10 – June 16, 2018 (Week 24) (Published on June 19, 2018)

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Avian Influenza Report is a weekly report produced by the Respiratory Disease Office, Centre for Health Protection of the Department of Health. This report highlights global avian influenza activity in humans and birds.

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VOLUME 14, NUMBER 24

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Keywords: HK PRC SAR; Updates; China; Worldwide; Avian Influenza; H5N1; H5N6; H7N9; Human; Poultry.

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18 Jun 2018

#Zika #Virus #Research #References #Library–June 18 2018 #Update, Issue No. 121

          

Title:

#Zika #Virus #Research #References #Library–June 18 2018 #Update, Issue No. 121.

Subject:

Zika Virus Infection and relate complications research, weekly references library update.

Source:

AMEDEO, homepage: http://www.amedeo.com

Code:

[  R  ]

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This Issue:

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  1. VALENTINE GC, Seferovic MD, Fowler SW, Major AM, et al.
    • Timing of Gestational Exposure to Zika Virus is Associated with Postnatal Growth Restriction in a Murine Model.
      • Am J Obstet Gynecol. 2018 Jun 11. pii: S0002-9378(18)30492.
  2. KUMAR PANDEY R, Ojha R, Mishra A, Kumar Prajapati V, et al.
    • Designing B- and T-cell multi-epitope based subunit vaccine using immunoinformatics approach to control Zika virus infection.
      • J Cell Biochem. 2018 Jun 14. doi: 10.1002/jcb.27110.
  3. DAI L, Wang Q, Song H, Gao GF, et al.
    • Zika Virus Envelope Protein and Antibody Complexes.
      • Subcell Biochem. 2018;88:147-168.
  4. RAGHUNATH P.
    • Does Zika Virus Really Causes Microcephaly in Children Whose Mothers Became Infected with the Virus during Their Pregnancy?
      • Iran J Public Health. 2018;47:613-614.
  5. BARRETT ADT.
    • Current status of Zika vaccine development: Zika vaccines advance into clinical evaluation.
      • NPJ Vaccines. 2018;3:24.
  6. KOBLISCHKE M, Stiasny K, Aberle SW, Malafa S, et al.
    • Structural Influence on the Dominance of Virus-Specific CD4 T Cell Epitopes in Zika Virus Infection.
      • Front Immunol. 2018;9:1196.
  7. GUEDES GR, Coutinho RZ, Marteleto L, Pereira WHS, et al.
    • Signifying Zika: heterogeneity in the representations of the virus by history of infection.
      • Cad Saude Publica. 2018;34:e00003217.
  8. MASMEJAN S, Baud D, Musso D, Panchaud A, et al.
    • Zika virus, vaccines and antiviral strategies.
      • Expert Rev Anti Infect Ther. 2018 Jun 13. doi: 10.1080/14787210.2018.1483239.
  9. SUKLA S, Ghosh A, Saha R, De A, et al.
    • In-depth molecular analysis of a small cohort of human and Aedes mosquito (adults and larvae) samples from Kolkata revealed absence of Zika but high prevalence of dengue virus.
      • J Med Microbiol. 2018 Jun 13. doi: 10.1099/jmm.0.000769.
  10. ALVES LV, Mello MJG, Bezerra PG, Alves JGB, et al.
    • Congenital Zika Syndrome and Infantile Spasms: Case Series Study.
      • J Child Neurol. 2018 Jan 1:883073818780105. doi: 10.1177/0883073818780105.
  11. DE MORAES CG, Pettito M, Yepez JB, Sakuntabhai A, et al.
    • Optic neuropathy and congenital glaucoma associated with probable Zika virus infection in Venezuelan patients.
      • JMM Case Rep. 2018;5:e005145.
  12. FINK SL, Vojtech L, Wagoner J, Slivinski NSJ, et al.
    • The Antiviral Drug Arbidol Inhibits Zika Virus.
      • Sci Rep. 2018;8:8989.
  13. GUERRA-REYES L, Iguiniz-Romero RA.
    • Performing purity: reproductive decision-making and implications for a community under threat of zika in iquitos, Peru.
      • Cult Health Sex. 2018 Jun 11:1-14. doi: 10.1080/13691058.2018.1469790.
  14. GUEVARA JG, Agarwal-Sinha S.
    • Ocular abnormalities in congenital Zika syndrome: a case report, and review of the literature.
      • J Med Case Rep. 2018;12:161.
  15. MANN TZ, Haddad LB, Williams TR, Hills SL, et al.
    • Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review.
      • Paediatr Perinat Epidemiol. 2018 Jun 8. doi: 10.1111/ppe.12478.
  16. DRAZ MS, Venkataramani M, Lakshminarayanan H, Saygili E, et al.
    • Nanoparticle-enhanced electrical detection of Zika virus on paper microchips.
      • Nanoscale. 2018 Jun 8. doi: 10.1039/c8nr01646.
  17. STRANGE DP, Green R, Siemann DN, Gale M Jr, et al.
    • Immunoprofiles of human Sertoli cells infected with Zika virus reveals unique insights into host-pathogen crosstalk.
      • Sci Rep. 2018;8:8702.
  18. MULLER JA, Harms M, Kruger F, Gross R, et al.
    • Semen inhibits Zika virus infection of cells and tissues from the anogenital region.
      • Nat Commun. 2018;9:2207.
  19. POPIK W, Khatua A, Hildreth JEK, Lee B, et al.
    • Phosphorodiamidate morpholino targeting the 5' untranslated region of the ZIKV RNA inhibits virus replication.
      • Virology. 2018;519:77-85.
  20. CARRAN S, Ferrari M, Reluga T.
    • Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence.
      • PLoS Negl Trop Dis. 2018;12:e0005997.
  21. PATERNINA LE, Rodas JD.
    • Sampling Design and Mosquito Trapping for Surveillance of Arboviral Activity.
      • Methods Mol Biol. 2018;1604:89-100.
  22. MATHE P, Egah DZ, Muller JA, Shehu NY, et al.
    • Low Zika virus seroprevalence among pregnant women in North Central Nigeria, 2016.
      • J Clin Virol. 2018;105:35-40.
  23. VASILEVA WAND NI, Bonney LC, Watson RJ, Graham V, et al.
    • Point-of-care diagnostic assay for the detection of Zika virus using the recombinase polymerase amplification method.
      • J Gen Virol. 2018 Jun 13. doi: 10.1099/jgv.0.001083.
  24. CODRINGTON J, Roosblad J, Baidjoe A, Holband N, et al.
    • Zika virus outbreak in Suriname, a report based on laboratory surveillance data.
      • PLoS Curr. 2018;10.
  25. RODRIGUEZ-MORALES AJ, Cardona-Ospina JA, Ramirez-Jaramillo V, Gaviria JA, et al.
    • Diagnosis and outcomes of pregnant women with Zika virus infection in two municipalities of Risaralda, Colombia: Second report of the ZIKERNCOL study.
      • Travel Med Infect Dis. 2018 Jun 9. pii: S1477-8939(18)30139.

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Keywords: Research; Abstracts; Zika References Library.

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#RiftValley #fever – #Kenya (@WHO, June 18 ‘18)

          

Title:

#RiftValley #fever – #Kenya.

Subject:

RVF outbreak in Kenya, current situation.

Source:

World Health Organization (WHO), full page: (LINK).

Code:

[     ]

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Rift Valley fever – Kenya

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Disease outbreak news / 18 June 2018

On 8 June 2018, the Ministry of Health (MoH) for Kenya confirmed an outbreak of Rift Valley fever. The first patient was admitted to a hospital in Wajir County in north-eastern Kenya on 2 June with fever, body weakness, and bleeding from the gums and mouth.

The patient reported having consumed meat from a sick animal; the patient died the same day.

On 4 June, two relatives of the index patient were admitted.

Blood samples were collected and sent to the Kenya Medical Research Institute, one of which was confirmed positive for Rift Valley fever on 6 June.

As of 16 June, a total of 26 human cases have been reported from Wajir (24 cases) and Marsabit (2 cases) counties, including seven confirmed cases and six deaths (case fatality ratio (CFR) = 23%); six patients have been discharged while one is still hospitalized.

A high number of deaths and abortions among livestock, including camels and goats, has been reported in Garissa, Kadjiado, Kitui, Marsabit, Tana River, and Wajir counties. People living in these counties were reportedly consuming meat from dead and sick animals.


Public Health Response

Preparedness activities for Rift Valley fever have been ongoing since February 2018 in reaction to the heavy rains and flooding in Kenya. An alert was issued to all County Directors in February 2018 and a general national alert was communicated in May 2018.

The following actions have been taken since the outbreak was confirmed:

  • On 8 June, the MoH and Ministry of Agriculture convened an emergency meeting with the Ministry of Livestock (MoL) and key stakeholders. A health sector task force meeting was held, and partners pledged their support to Rift Valley fever control.
  • On 14 June, the MoH activated the Emergency Operations Centre, with an Event Manager and supporting technical team.
  • On 14 June, a multi-sectoral investigation teams has been deloyed in Wajir County to support the county health teams. Another team will soon be dispatched to support the Marsabit County team.
  • As part of ongoing preparedness activities, active surveillance for Rift Valley fever is being strengthened in affected and at-risk counties, as well as contact tracing in Wajir and Marsabit counties. In Wajir County, five treatment centres have been established.
  • Active case searching and community sensitization activities are ongoing in the affected areas. Guidelines for vector control and other informational materials have been dispatched to Wajir County, and messages are being disseminated through Community Health Volunteers.
  • A ban on slaughtering animals and restriction of livestock movement has been imposed in the affected areas.


WHO risk assessment

Outbreaks of Rift Valley fever are not uncommon in Kenya. The last documented outbreak occurred from November 2014 through January 2015 in north-eastern Kenya; in 2006, a large outbreak killed more than 150 people. The CFR has varied widely in documented outbreaks but the overall CFR tends to be less than 1%.

Kenya’s prior experience with responding to Rift Valley fever outbreaks combined with the preparedness activities undertaken over the preceding months is of benefit. However, the high number of reported deaths and abortions in livestock is concerning, especially because the event affects nomadic communities for which diet is predominantly based on animal products.

The high volume of movement of cattle and people in this area increases the risk of further spread of the outbreak both within Kenya, and to neighbouring countries.


WHO advice

Rift Valley fever is a mosquito-borne viral zoonosis that primarily affects animals but also has the capacity to infect humans.

The majority of human infections result from direct or indirect contact with the blood or organs of infected animals.

Herders, farmers, slaughterhouse workers and veterinarians have an increased risk of infection.

Awareness of the risk factors of Rift Valley fever infection and measures to prevent mosquito bites is the only way to reduce human infection and deaths.

Public health messages for risk reduction should focus on:

  • Reducing the risk of animal-to-human transmission resulting from unsafe animal husbandry and slaughtering practices. Practicing hand hygiene and wearing gloves and other personal protective equipment when handling sick animals or their tissues or when slaughtering animals is recommended.
  • Reducing the risk of animal-to-human transmission arising from the unsafe consumption of raw or unpasteurized milk or animal tissue. In endemic regions, all animal products should be thoroughly cooked before eating.
  • Reducing the risk of mosquito bites through the implementation of vector control activities (e.g. insecticide spraying and using larvicide to reduce mosquito breeding sites), use of insecticide-impregnated mosquito nets and repellents, and wearing light coloured clothing (long-sleeved shirts and trousers).
  • Restricting or banning the movement of livestock to reduce spread of the virus from infected to uninfected areas.
  • Routine animal vaccination is recommended to prevent Rift Valley fever outbreaks. Vaccination campaigns are not recommended during an outbreak as they may intensify transmission among the herd through needle propagation of the virus. Outbreaks of Rift Valley fever in animals precede human cases, thus the establishment of an active animal health surveillance system is essential to providing early warning for veterinary and public health authorities.

WHO advises against the application of any travel or trade restrictions to the Kenya based on the current information available on this event.

For more information on Rift Valley fever, please see the link below:

|-- WHO fact sheet on Rift Valley fever –|

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Keywords: WHO; Updates; Rift Valley Fever; Kenya.

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Highly pathogenic #avian #influenza #H5N6, #UK [infected #wildbirds, NI] (#OIE, June 18 ‘18)

          

Title:

Highly pathogenic #avian #influenza #H5N6, #UK [infected #wildbirds, NI].

Subject:

Avian Influenza, H5N6 subtype, poultry epizootics in the UK.

Source:

OIE, full page: (LINK).

Code:

[     ]

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Highly pathogenic influenza A viruses (infection with) (non-poultry including wild birds) H5N6, United Kingdom

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Information received on 15/06/2018 from Dr Christine Middlemiss, Chief Veterinary Officer, DEFRA, Department for Environment,Food and Rural Affairs , London, United Kingdom

  • Summary
    • Report type    Immediate notification (Final report)
    • Date of start of the event    14/06/2018
    • Date of confirmation of the event    15/06/2018
    • Report date    15/06/2018
    • Date submitted to OIE    15/06/2018
    • Date event resolved    15/06/2018
    • Reason for notification    Recurrence of a listed disease
    • Date of previous occurrence    23/04/2018
    • Manifestation of disease    Clinical disease
    • Causal agent    Highly pathogenic influenza A virus
    • Serotype    H5N6
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • New outbreaks (1)
    • Outbreak 1 (WB AIV 2018 2-1)    - Armagh, Northern Ireland
      • Date of start of the outbreak    14/06/2018
      • Outbreak status    Resolved (15/06/2018)
      • Epidemiological unit    Natural park
      • Affected animals: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of    - Slaughtered
        • Greylag Goose:Anser anser(Anatidae) – … – 1    - 1    - 0    - 0
          • Affected population    One goose found dead in natural park.
  • Summary of outbreaks   
    • Total outbreaks: 1
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of    - Slaughtered
        • Greylag Goose:Anser anser(Anatidae)  - … – 1    - 1    - 0    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Greylag Goose:Anser anser(Anatidae)    - **    - **    - 100.00%    - **
          • *Removed from the susceptible population through death, destruction and/or slaughter
          • **Not calculated because of missing information
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Contact with wild species
  • Epidemiological comments   
    • A wild greylag goose was found dead and tested positive for H5N6 HPAI.
    • Sequence analysis indicates high homology to the virus isolated from a Buzzard in Northern Ireland on 23rd March 2018.
    • The event is resolved and no further reports will be submitted.
  • Control measures
    • Measures applied   
      • Vaccination prohibited
      • No treatment of affected animals
    • Measures to be applied   
      • No other measures
  • Diagnostic test results
    • Laboratory name and type    - Species    - Test    - Test date    - Result
      • AFBNI laboratory, Northern Ireland (National laboratory)    - Greylag Goose    - nucleotide sequencing    - 15/06/2018    - Positive
      • AFBNI laboratory, Northern Ireland (National laboratory)    - Greylag Goose    - real-time reverse transcriptase/polymerase chain reaction (RRT-PCR)    - 15/06/2018    - Positive
      • Animal and Plant Health Agency, Weybridge (OIE Reference Laboratory)    - Greylag Goose    - real-time reverse transcriptase/polymerase chain reaction (RRT-PCR)    - 15/06/2018    - Positive
  • Future Reporting
    • The event is resolved. No more reports will be submitted.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N6 ; Wild Birds; UK.

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Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia (@WHO, June 18 ‘18)

          

Title:

Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia.

Subject:

MERS, current epidemiological situation in the Kingdom of Saudi Arabia (KSA).

Source:

World Health Organization (WHO), full page: (LINK).

Code:

[     ]

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Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

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Disease outbreak news / 18 June 2018

Between 12 January through 31 May 2018, the National IHR Focal Point of The Kingdom of Saudi Arabia reported 75 laboratory confirmed cases of Middle East respiratory syndrome coronavirus (MERS_CoV), including twenty-three (23) deaths.


Details of the cases

Among these 75 cases, 21 cases were part of four distinct clusters (2 health care and 2 household clusters).

The details of these clusters are described below, followed by a table listing all 75 laboratory confirmed cases reported to WHO during this time period:

  • Cluster 1:
    • From 2 through 4 February, a private hospital in Hafer Albatin Region reported a cluster of three (3) health care workers in addition to the suspected index case (four [4] cases in total).
  • Cluster 2:
    • From 25 February through 7 March, a hospital in Riyadh reported six (6) cases, including the suspected index. No health care workers were infected.
  • Cluster 3:
    • From 8 through 24 March, a household cluster of 3 cases (index case and 2 secondary cases) was reported in Jeddah. No health care workers were infected.
  • Cluster 4:
    • From 23 through 31 May, a household cluster was reported from Najran region with eight cases including the suspected index case. This cluster is still under investigation at the time of writing. As of 31 May, no health care workers have been infected and the source of infection is believed to be camels at the initial patient’s home.

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As of 31 May, the total global number of laboratory-confirmed cases of MERS-CoV reported since 2012 is 2,220, including 1,844 cases that have been reported from the Kingdom of Saudi Arabia.

Among these cases, 790 MERS-CoV associated deaths have occurred since September 2012.

The global number reflects the total number of laboratory-confirmed cases reported to WHO under IHR to date. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with affected member states.


WHO risk assessment

Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels. MERS-CoV has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment.

WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting).

WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.


WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because, like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Community and household awareness of MERS and MERS prevention measures in the home may reduce household transmission and prevent community clusters.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, in addition to avoiding close contact with suspected or confirmed human cases of the disease, people with these conditions should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be or potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

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Keywords: WHO; Updates; MERS-CoV; Saudi Arabia.

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17 Jun 2018

#Influenza and other #Respiratory #Viruses #Research #References #Library – June 17 2018 Issue

          

Title:

#Influenza and other #Respiratory #Viruses #Research #References #Library – June 17 2018 Issue.

Subject:

Human and Animal Influenza Viruses, other respirator pathogens research, weekly references library update.

Source:

AMEDEO, homepage: http://www.amedeo.com

Code:

[  R  ]

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This Issue:

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  1. KO EJ, Lee Y, Lee YT, Kim YJ, et al.
    • MPL and CpG combination adjuvants promote homologous and heterosubtypic cross protection of inactivated split influenza virus vaccine.
      • Antiviral Res. 2018 Jun 6. pii: S0166-3542(18)30007.
  2. RUSSELL K, Herrick K, Venkat H, Brady S, et al.
    • Utility of state-level influenza disease burden and severity estimates to investigate an apparent increase in reported severe cases of influenza A(H1N1) pdm09 - Arizona, 2015-2016.
      • Epidemiol Infect. 2018 Jun 14:1-7. doi: 10.1017/S0950268818001516.
  3. SEGALOFF HE, Petrie JG, Malosh RE, Cheng CK, et al.
    • Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016.
      • Epidemiol Infect. 2018 Jun 8:1-9. doi: 10.1017/S0950268818001486.
  4. GREEN DA, St George K.
    • Rapid Antigen Tests for Influenza: Rationale and Significance of the FDA Reclassification.
      • J Clin Microbiol. 2018 Jun 13. pii: JCM.00711-18. doi: 10.1128/JCM.00711.
  5. TONG XC, Weng SS, Xue F, Wu X, et al.
    • Human infection of novel avian influenza A(H7N4) virus.
      • J Infect. 2018 Jun 10. pii: S0163-4453(18)30177.
  6. CAI H, Liu M, Russell CJ.
    • Directed evolution of an influenza reporter virus to restore replication and virulence and enhance non-invasive bioluminescence imaging in mice.
      • J Virol. 2018 Jun 13. pii: JVI.00593-18. doi: 10.1128/JVI.00593.
  7. NACHBAGAUER R, Shore D, Yang H, Johnson SK, et al.
    • Broadly-reactive human monoclonal antibodies elicited following pandemic H1N1 influenza virus exposure protect mice from highly pathogenic H5N1 challenge.
      • J Virol. 2018 Jun 13. pii: JVI.00949-18. doi: 10.1128/JVI.00949.
  8. FULTON BO, Sun W, Heaton NS, Palese P, et al.
    • The influenza B virus hemagglutinin head domain is less tolerant to transposon mutagenesis than that of the influenza A virus.
      • J Virol. 2018 Jun 13. pii: JVI.00754-18. doi: 10.1128/JVI.00754.
  9. PATIL G, Zhao M, Song K, Hao W, et al.
    • TRIM41-Mediated Ubiquitination of Nucleoprotein Limits Influenza A Virus Infection.
      • J Virol. 2018 Jun 13. pii: JVI.00905-18. doi: 10.1128/JVI.00905.
  10. CHAI W, Li J, Shangguan Q, Liu Q, et al.
    • Lnc-ISG20 inhibits influenza A virus replication by enhancing ISG20 expression.
      • J Virol. 2018 Jun 13. pii: JVI.00539-18. doi: 10.1128/JVI.00539.
  11. SHINDE V, Fries L, Wu Y, Agrawal S, et al.
    • Improved Titers against Influenza Drift Variants with a Nanoparticle Vaccine.
      • N Engl J Med. 2018;378:2346-2348.
  12. BURRELL A, Huckson S, Pilcher DV.
    • ICU Admissions for Sepsis or Pneumonia in Australia and New Zealand in 2017.
      • N Engl J Med. 2018;378:2138-2139.
  13. ZHOU J, Li C, Sachs N, Chiu MC, et al.
    • Differentiated human airway organoids to assess infectivity of emerging influenza virus.
      • Proc Natl Acad Sci U S A. 2018 Jun 11. pii: 1806308115.
  14. ENGELHARDT OG, Edge C, Dunleavy U, Guilfoyle K, et al.
    • Comparison of single radial immunodiffusion, SDS-PAGE and HPLC potency assays for inactivated influenza vaccines shows differences in ability to predict immunogenicity of haemagglutinin antigen.
      • Vaccine. 2018 Jun 9. pii: S0264-410X(18)30742.
  15. VALKENBURG SA, Li OTW, Li A, Bull M, et al.
    • Protection by universal influenza vaccine is mediated by memory CD4 T cells.
      • Vaccine. 2018 Jun 7. pii: S0264-410X(18)30818.
  16. FAN X, Su Q, Qiu F, Yi Y, et al.
    • Intranasal inoculate of influenza virus vaccine against lethal virus challenge.
      • Vaccine. 2018 Jun 4. pii: S0264-410X(18)30739.
  17. YOON JJ, Toots M, Lee S, Lee ME, et al.
    • Orally Efficacious Broad-Spectrum Ribonucleoside Analog Inhibitor of Influenza and Respiratory Syncytial Viruses.
      • Antimicrob Agents Chemother. 2018 Jun 11. pii: AAC.00766.

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Keywords: Research; Abstracts; Influenza References Library.

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