Today's Headlines: May 23, 2019
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Biological Agents & Infectious Diseases
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Ebola Responders on Edge as Virus Sickens 19 More
(
CIDRAP
) Against a backdrop of steadily rising Ebola cases, health officials in the Democratic Republic of the Congo are bracing for more attacks, as threats continue in the big epicenters of Butembo and Katwa, and are on the rise in smaller hots spots such as Lubero and Kalunguta, the World Health Organization said yesterday in a weekly situation report.
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Measles Outbreak Spreads to Maine, Cases Now in Half the Country
(
The Hill
) The measles outbreak has now spread to half the country, as Maine became the 25th state to report a confirmed case of the disease. According to the Maine Centers for Disease Control and Prevention, the case was confirmed in a school-age child in Somerset County on Monday. It's the first confirmed measles case in the state since 2017.
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United Nations Strengthens Ebola Response in Democratic Republic of the Congo
(
WHO
) With the Ebola epidemic in the Democratic Republic of the Congo now in its tenth month and the number of new cases increasing in recent weeks, the UN announced today measures to strengthen its response and end the outbreak. The Ebola epidemic has claimed more than 1,200 lives and the risk of spread to other provinces in the eastern Congo as well as neighbouring countries remains very high. A third of those who have fallen ill are children, which is a higher proportion than in previous outbreaks.
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Immune to Drugs: Antimicrobial Resistance Could Kill 10 Million a Year
(
Forbes
) The Centers for Disease Control and Prevention contends that, “Antibiotic resistance is one of the greatest public health challenges of our time.” And it’s true. Bacteria, viruses and parasites are growing evermore resistant to the drugs that have been developed to combat them. In fact, this resistance – antimicrobial resistance – has surged into a public health nightmare around the world.
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The Philippines Is Fighting One of the World's Worst Measles Outbreaks
(
NPR
) The measles outbreak got so bad in Manila, Philippines, that San Lazaro Hospital had to set up tents in the parking lot, the courtyard and even the landing at the top of the stairs outside the pediatric ward to house patients. "This ward would only accommodate 50 patients," says Dr. Ferdinand de Guzman, the head of family medicine at the hospital. "But at the height of the outbreak, [there were] 300 patients per ward."
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Ebola Response in DRC Undergoes “Important Shifts” as Violence Intensifies
(
IPI Global Observatory
) The April 19 murder of a World Health Organization official in the Democratic Republic of the Congo has brought to center stage the issue of escalating violence against Ebola responders. The WHO epidemiologist was killed and two others injured when gunmen stormed a hospital in Butembo, located in North Kivu province. Following the incident, doctors and nurses in Butembo threatened to strike unless government security forces did more to protect health workers.
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The Ebola Response Effort Is Struggling. Experts Say These Steps Could Help
(
STAT
) With Ebola response teams struggling to contain the outbreak in the Democratic Republic of the Congo, the World Health Organization and its partners can make changes to shore up their effort and try to prevent the crisis from escalating further, according to a handful of experts surveyed by
STAT
. The experts are wary of criticizing WHO officials and others trying desperately to stop the virus from spreading. Violence aimed at Ebola response workers and a refusal to cooperate with control measures in some communities has rendered this outbreak, the second largest on record, unlike anything the world of Ebola responders has seen before.
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Global Elimination of Chronic Hepatitis
(
New England Journal of Medicine
) Major advances have been made in the prevention and treatment of chronic hepatitis C virus and hepatitis B virus infections. Nonetheless, by causing cirrhosis, hepatocellular cancer, or both, HCV and HBV infections kill more than million persons each year, accounting for as many global deaths as those due to human immunodeficiency virus infection, tuberculosis, or malaria In fact, by 2040, deaths from chronic hepatitis are projected to exceed the combined mortality associated with HIV infection, tuberculosis, and malaria.
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Reinforcing the Front Lines of Disaster Response: ASPR Provides Critical Resources, Stronger Systems, and Lifesaving Training for EMS Professionals
(
ASPR Blog
) Emergency Medical Service personnel respond to emergencies every day and serve on the front lines of the medical response to disasters, terrorist attacks, and mass casualty incidents. The US Department of Health and Human Services is dedicated to supporting EMS personnel in enhancing and protecting the health and well-being of all Americans. As the HHS lead for coordinating the public health and medical response to disasters and other emergencies, the Assistant Secretary for Preparedness and Response is dedicated to supporting EMS personnel and agencies throughout the response continuum. We support agency readiness by ensuring they have the tools and resources needed to effectively and efficiently respond during disasters and to successfully recover and reconstitute after disasters affect their communities.
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Experts Identify Steps to Improve Hospital Stewardship Programs
(
CIDRAP
) A panel of experts in antibiotic stewardship has identified steps that hospitals can take to improve their antibiotic stewardship programs, highlighted by two emerging strategies that go beyond current guidelines. The two strategies—handshake stewardship and diagnostic stewardship—were identified by participants in a May 2018 meeting convened by the Joint Commission, a nonprofit organization that accredits US hospitals, and the Pew Charitable Trusts.
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Millions of Health-care Facilities Lack WASH Services
(
Lancet Infectious Diseases
) Proper water, sanitation, and hygiene are vital for infection prevention and curbing antimicrobial resistance, yet millions of centres lack even basic facilities. Talha Burki reports. 896 million people worldwide rely on health-care facilities with no water service, according to a joint report by WHO and UNICEF. The authors also noted that 1·5 billion people use facilities with no sanitation, and that every year 17 million women in the world's poorest countries give birth in health-care centres with inadequate water, sanitation, and hygiene (WASH).
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Retrospective versus Real-time Ebola Virus Sequencing
(
Lancet Infectious Diseases
) In
The Lancet Infectious Diseases
, Placide Mbala-Kingebeni and colleagues report the effect of retrospective viral genome analysis of the 2018 Équateur Province Ebola virus disease outbreak in the Democratic Republic of the Congo. They describe the outputs of an international response, working with local scientists, using in-country, whole-genome sequencing. The 2018 Democratic Republic of the Congo EVD outbreak was the ninth recorded in the country. 54 cases were reported with 33 fatalities, resulting in a case fatality rate of approximately 60%, which is in line with that of the much larger 2013-16 west African outbreak.
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Preparing for the Next Ebola Outbreak: In-country Genomic Capacity in Africa
(
Lancet Infectious Diseases
) The resurgence of Ebola virus disease in Équateur province in the Democratic Republic of the Congo in May 2018, is an important reminder of the difficulties of predicting when and where the next outbreak will occur. The subsequent July 2018 outbreak of EVD in the Democratic Republic of the Congo has affected about 1000 people and the outbreak has the highest case fatality rate (62%) for EVD to date. Conflict, insecurity, poverty, mistrust, poor health systems, and other factors have been implicated in sustaining the outbreak. The response to the July 2018 EVD outbreak in North Kivu Province has highlighted the positive impact of lessons learnt during the 2013-16 EVD outbreak in west Africa.
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On the Evolutionary Ecology of Multidrug Resistance in Bacteria
(PLOS Pathogens
) Resistance against different antibiotics appears on the same bacterial strains more often than expected by chance, leading to high frequencies of multidrug resistance. There are multiple explanations for this observation, but these tend to be specific to subsets of antibiotics and/or bacterial species, whereas the trend is pervasive.
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On the Utilization of Polygenic Risk Scores for Therapeutic Targeting
(
PLOS Genetics
) The promise of personalized genomic medicine is that knowledge of a person’s gene sequences and activity will facilitate more appropriate medical interventions, particularly drug prescriptions, to reduce the burden of disease. Early successes in oncology and pediatrics have affirmed the power of positive diagnosis and are mostly based on detection of one or a few mutations that drive the specific pathology. However, genetically more complex diseases require the development of polygenic risk scores that have variable accuracy.
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Honey, I Shrunk the Lab: Emerging Microfluidics Technology and Its Implications for Chemical, Biological, and Nuclear Weapons
(
Center for the Study of Weapons of Mass Destruction – National Defense University
) Emerging microfluidics technology has significant extant and potential implications for chemical, biological, and nuclear weapons threats. Picture a computer chip, but instead of wires, tiny channels through which liquids flow and mix. Such “lab on a chip” devices enable far greater control over chemical reactions than traditional bulk, batch chemistry. Flow chemistry, including both microfluidics and nanofluidics, is already being used in the chemical, medical, and pharmaceutical industries.
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Published by Johns Hopkins Center for Health Security
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