News Pouch 4 April 2019

To view images in this newsletter, please allow images and html options. 

View this email in your browser

Pandemic Threats and Health Emergencies

News Pouch: 4 April 2019


  • Spotlight: Ebola
  • Updates and News on main Outbreaks
    • Priority Infectious Diseases
      • Influenza
      •  VBD, and more
  • One Health
    • Biodiversity and ecosystem
    • Food Security and Safety
    • AMR
    • Health in Emergencies and Disasters
    • Climate Change
    • Urban Health
    • Migration Health
    • Global Health
    • Contact us


    Ebola Outbreak Situation

    Ebola Virus Disease - External Situation Report 35
    As of 31 March 2019, a total of 1089 EVD cases, including 1023 confirmed and 66 probable cases, were reported; the new probable case is from Vuhovi. A total of 679 deaths were reported (overall case fatality ratio 62%), including 613 deaths among confirmed cases. Of 1089 confirmed and probable cases with reported age and sex, 58% (629) were female, and 29% (318) were children aged less than 18 years. The number of healthcare workers affected has risen to 81, including 28 deaths. Despite these setbacks, it should be noted that the recent shift in strategy of increasing community outreach from earlier weeks, is gradually yielding tangible results on the ground.

    DRC Ebola Outbreak Spreading At Fastest Rate Since Beginning 8 Months Ago, WHO Says
    Institutional Trust and Misinformation in the Response to the 2018– 19 Ebola Outbreak in North Kivu, DRC: A Population-Based Survey
    The current outbreak of Ebola in eastern DRC beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease.
    Go to article
    The genesis of the Ebola virus outbreak in west Africa
    Open Access
    Early transmission and case fatality of Ebola virus at the index site of the 2013–16 west African Ebola outbreak: a cross-sectional seroprevalence survey
    Open Access
    Research Provides Framework for Developing Ebola Virus Therapeutic Under Animal Rule
    The US Army Medical Research Institute of Infectious Diseases today announced that, for the first time, the US Food and Drug Administration (FDA) has provided formal regulatory agreement for use of an animal model to support development of a drug candidate, remdesivir, for treating deadly Ebola virus infections.
    Go to article

    New approach to tackle Ebola and other deadly infections
    MRC HIU scientists have isolated therapeutic antibodies from healthy volunteers exposed to the Ebola vaccine but not Ebola virus itself, suggesting that protective therapies could be developed from people who are disease-free.
    New Ebolavirus, Found in Bats, More Widespread Than Thought
    The ebolavirus species, named Bombali, is one of two currently not known to infect humans. This is the first time any ebolavirus has been found in wildlife in Kenya or other countries along the east coast of Africa.

    Priority Diseases

    Handbook for Developing a Public Health Emergency Operations Centre Part A: Policies, Plans and Procedures

    Handbook for Developing Public Health Emergency Operations Centre Part C: Training and exercises

    Diseases cost the African Region $2.4 trillion a year, says WHO
    The WHO estimates that nearly 630 million years of healthy life were lost in 2015 due to the diseases afflicting the population across its 47 Member States in Africa, now amounting to a loss of more than 2.4 trillion international dollars ($) from the region’s gross domestic product value annually.
    Go to article
    Response to “Prepublication Communication of Research Results”: The Need for a Coordinated Wildlife Disease Surveillance Laboratory Network
    » Abstract   » Full text HTML   » Full text PDF

    Soap and superbugs: 2 bln people lack water at health facilities

    The 5 May 2019 hand hygiene campaign is themed 'Clean care for all - it's in your hands.'
    All information can be found on the 5 May 2019 web page Sign up to the campaign if not already
    The 5 Moments for Hand Hygiene are not just for hospitals, every setting should be targeted which will in turn support people centred quality health services and quality health for all.
    Also watch out for - 1) a forthcoming promotional video message with key messages on health for all and clean care for all 2) a short animation video promoting IPC as a core part of quality health for all 3) the 3 May Webber teleclass - register now

    The WHO biweekly global influenza update
     The latest FluNet summary of lab-confirmed data from GISRS
    H7N9 Disease Situation Update from FAO/EMPRES – Animal Health
    Influenza surveillance: determining the epidemic threshold for influenza by using the Moving Epidemic Method (MEM), Montenegro, 2010/11 to 2017/18 influenza seasons
    The efficacy, effectiveness, and immunogenicity of influenza vaccines in Africa: a systematic review
    Several factors known to interfere with influenza immunisation, such as malaria, HIV, and malnutrition were under-represented in this Review and require further study. Substantial gaps exist in our understanding of influenza vaccine performance across all WHO high-risk groups in Africa. Filling these knowledge gaps is vital to guide future influenza vaccine policies.
    Bird Flu Detected in Cuttack
    A team of veterinary doctors and experts culled more than 600 ducks and 66 chickens on Sunday following confirmation of bird flu (H5N1) in the city. An outbreak of bird flu was suspected after death of ducks in the Duck Breeding Centre and Dairy Farm at Khapuria.
    Go to article
    How Mosquitoes Sniff Out Your Sweat
    It’s actually very difficult to attract mosquitoes. It may not feel that way on a warm and sticky summer night. But every time a mosquito sneaks up to an animal thousands of times its size to feed, it is trying to pull off something extremely dangerous, said Matthew DeGennaro, a mosquito geneticist and professor at Florida International University.
    Go to article
    Dengue Outbreak during Ongoing Civil War, Taiz, Yemen
    We identified dengue in ≈51% of patients given a clinical diagnosis of suspected dengue in Taiz, Yemen, during 2016. The cosmopolitan genotype of dengue virus type 2 was most common; viruses appeared to have originated in Saudi Arabia. Damage to public health infrastructure during ongoing civil war might enable dengue to become endemic to Yemen.
    Go to article

    Yemen witnessing another sharp increase in reported cases with number of deaths continuing to increase
    Endemic Zika virus transmission: implications for travellers

    Long-term circulation of Zika virus in Thailand: an observational study
    Zika Virus in Peridomestic Neotropical Primates, Northeast Brazil
    » Abstract   » Full text HTML   » Full text PDF
    Linking Bird and Mosquito Data to Assess Spatiotemporal West Nile Virus Risk in Humans
    » Abstract   » Full text HTML   » Full text PDF
    Predicting Yellow Fever Through Species Distribution Modeling of Virus, Vector, and Monkeys
    » Abstract   » Full text HTML   » Full text PDF
    The Influence of Climate and Livestock Reservoirs on Human Cases of Giardiasis
    » Abstract   » Full text HTML   » Full text PDF
    Travellers as sentinels of chikungunya epidemics: a family cluster among Finnish travellers to Koh Lanta, Thailand, January 2019
    Epidemiology of Lyme borreliosis through two surveillance systems: the national Sentinelles GP network and the national hospital discharge database, France, 2005 to 2016
    Epidemiological Characteristics of an Urban Plague Epidemic in Madagascar, August–November, 2017: An Outbreak Report
    Madagascar accounts for 75% of global plague cases reported to WHO, with an annual incidence of 200–700 suspected cases. In 2017, a pneumonic plague epidemic of unusual size occurred. The extent of this epidemic provides a unique opportunity to better understand the epidemiology of pneumonic plagues, particularly in urban settings.
    Go to article
    Will we reach the Sustainable Development Goals target for tuberculosis in the European Union/European Economic Area by 2030?
    Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth
    Despite the significant progress made in the fight against HIV/AIDS in the U.S., HIV prevention and treatment disparities among certain populations remain a national public health concern. Common prevention and treatment paradigms often inadequately consider and address the needs of adolescents and young adults, particularly those who are racial, ethnic, and sexual minorities. The newest NAM Perspectives discussion paper tackles the need for differentiated care that can be adapted to unique ecological and developmental factors that shape the needs of minority adolescents and young adults. 
    Read the discussion paper >>

    Maternal immunisation to improve the health of HIV-exposed infants


    Pakistan and Nigeria report four more polio cases
    In its weekly report today the Global Polio Eradication Initiative (GPEI) today noted four new polio cases, two from Pakistan involving wild poliovirus type 1 (WPV1) and two from Nigeria involving circulating vaccine-derived poliovirus type 2 (cVDPV2).
    In Pakistan, the WPV1 cases are in Khyber Pakhtunkhwa tribal district in a patient with a Feb 14 paralysis onset and in Karachi in a person with a Feb 25 paralysis onset. The country has now reported six polio cases for 2019. Nigeria's cases are in Borno and Kwara states, with polio onsets of Feb 14 and Feb 20, respectively. The pair of new cases brings the country's total for the year to four. Nigeria is experiencing two cVDPV2 outbreaks, one in Jigwa state that resulted in spread to other parts of Nigeria as well as to neighboring Niger, and one in Sokoto state.
    Mar 29 GPEI report

    Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – the Kingdom of Saudi Arabia
    From 1 through 28 February 2019, the National IHR Focal Point of Saudi Arabia reported 68 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 10 deaths. Of the 68 MERS cases reported in February, 19 cases occurred in cities other than Wadi Aldwasir. This Disease Outbreak News update describes the 19 cases. Among these cases, fifteen were sporadic, and four were reported as part of two unrelated clusters. Cluster 1 involved two cases in Buridah city; and Cluster 2 involved two cases in Riyadh city. The link below provides details of the 19 reported cases.
    Go to article

    Prices up in Us, as ASF Hits Chinese Trade
    Pig prices in the US have been rallying sharply in the last few weeks, while commentators highlight that there is optimism that the African Swine Fever (ASF) situation in China, will relieve the pressure on an otherwise oversupplied market. On Friday, March 15, China’s Ministry of Agriculture and Rural Affairs reported its pig herd had fallen by nearly 17% in February compared with the previous year. Within this, the sow herd also reportedly fallen by more than 19%.
    Go to article
    China MOA Reports a New ASF Outbreak In Hubei
    Over the past month the focus on African Swine Fever has switched from China to Vietnam, based primarily upon the number outbreaks reported by each country's MOA.
    Go to article
    Why New York Hasn't Contained the Largest and Longest Measles Outbreak in Decades
    To contain a measles outbreak, a newly infected person has to work in tandem with state and local health authorities, providing information on when their symptoms began and whom they may have exposed during the nine days they are contagious. Most people do. Then there are those who refuse.
    Go to article

    Study notes rising death rate in 2015-17 measles outbreak in Mongolia
    As measles outbreaks grow in many nations, including the United States, a study today on a previous outbreak in Mongolia demonstrates just how deadly the disease can be, while the WHO issues a call for full vaccination coverage in the Western Pacific in the wake of a huge outbreak in the Philippines. Australia, Cambodia, China, Hong Kong, Japan, Laos, New Zealand, South Korea, Singapore, and Vietnam have also reported cases. The agency encouraged comprehensive vaccination campaigns to make sure all children are protected. "Measles spreads like wildfire," said Regional Director Takeshi Kasai, MD, PhD. "It is the most contagious human disease, and it's very good at seeking out and spreading among even small groups of people who are not immune."
    Mar 29 J Infect Dis study
    Mar 29 WHO news release

    One Health  

    Utilizing general human movement models to predict the spread of emerging infectious diseases in resource poor settings
    HEVnet: a One Health, collaborative, interdisciplinary network and sequence data repository for enhanced hepatitis E virus molecular typing, characterisation and epidemiological investigations

    Biodiversity and Ecosystems

    Can nature deliver on the sustainable development goals?


    Could diversity protect forests from pests?
    According to a continent-spanning analysis of the relationships between forest tree diversity and pestilential invasion, having more species can help protect forests.
    Read More

    Call for inputs:
    Interested in the process to agree a post-2020 biodiversity framework? Stakeholder or decision-maker? UN Biodiversity invites parties and observers to comment on the post-2020 global biodiversity framework discussion document until 15 April:

    How humans shape a mountain
    This week’s Nature Podcast explores how Mount Kilimanjaro’s climate modulates the effects of human land use on the ecosystems of Africa’s highest mountain. Also in the podcast this week, ‘plastic crystals’ show peculiar properties under pressure and could be used in refrigeration.
    Nature Podcast | 30 min listen
    Subscribe to the Nature Podcast on iTunes or Google Podcasts.

    Earlier springtime disrupts insect and bird lives—and it’s worse than expected

    Culling invasive predators could save 9.4% of the world’s at-risk species

    Food from the oceans: first space-based indicator of zooplankton dynamics

    International Land Coalition Rangelands Initiative launches website


    Expanding livestock production in Asia and Africa key to environmental as well as human welfare gains—New study


    Stewardship / Resistance Scan for Apr 01, 2019

    • Rapid diagnostics partnership
    • Resistance genes in live poultry
    • Illegal antibiotic Rx in Sri Lanka

    More »

    Stewardship / Resistance Scan for Mar 29, 2019

    • Multidrug-resistant E coli in food
    • XDR-TB outcomes
    • Restaurant chain antibiotics pledge

    More »

    Evidence needed for antimicrobial resistance surveillance systems
    Abstract [HTML] ¦ Article [HTML] ¦ Article pdf

    Microbiome companies look beyond the gut for new therapies
    Hospital cleaning: a trial assessing a cleaning bundle and its effect on health-care-associated infections
    Read this Article
    An environmental cleaning bundle and health-care-associated infections in hospitals (REACH): a multicentre, randomised trial
    Antibiotics: an assessment of prescriptions for febrile children in European emergency departments
    Read this Article
    Characterizing Antimicrobial Use in the Livestock Sector in Three South East Asian Countries (Indonesia, Thailand, and Vietnam)
    A framework was developed to characterize the antimicrobial use/antimicrobial resistance complex in livestock systems in Indonesia, Vietnam, and Thailand. Farm profitability, disease prevention, and mortality rate reduction were identified as drivers toward antimicrobial use in livestock systems.
    [...] Read more.
    Antibiotic Resistance in Pacific Island Countries and Territories: A Systematic Scoping Review
    Several studies have investigated antimicrobial resistance in low- and middle-income countries, but to date little attention has been paid to the Pacific Islands Countries and Territories (PICTs). This study aims to review the literature on antibiotic resistance (ABR) in healthcare settings in PICTs
    [...] Read more.
    Mapping and Analysing Potential Sources and Transmission Routes of Antimicrobial Resistant Organisms in the Environment using Geographic Information Systems—An Exploratory Study
    Antimicrobial resistance (AMR) is one of the leading threats to human health worldwide. The identification of potential sources of antimicrobial resistant organisms (AROs) and their transmission routes in the environment is important for improving our understanding of AMR
    PDF Full-text
    Antibiotic Stewardship—Twenty Years in the Making
    In the last 20 years, efforts were made to optimize antibiotic use in hospitals across the world as a means of addressing the increasing threat of antibiotic resistance. Despite robust evidence supporting optimal practice, antibiotic decision-making remains sub-optimal in many settings,
    PDF Full-text
    Something Borrowed, Something New: A Governance and Social Construction Framework to Investigate Power Relations and Responses of Diverse Stakeholders to Policies Addressing Antimicrobial Resistance
    While antimicrobial resistance (AMR) has rapidly ascended the political agenda in numerous high-income countries, developing effective and sustainable policy responses in low- and middle-income countries (LMIC) is far from straightforward, as AMR could be described as a classic ‘wicked problem’. Effective policy responses
    PDF Full-text
    Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems
    This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing
    PDF Full-text
    Combatting Antibiotic Resistance Together: How Can We Enlist the Help of Industry?
    The development of antibiotics needs to be supported through new financial stimuli, including help from the public sector. In exchange for public support, industry should be asked to do what is in their power to help curb the inappropriate use of antibiotics.
    PDF Full-text
    A comparative analysis of prophylactic antimicrobial use in long-term care facilities in Ireland, 2013 and 2016

    Emergencies and Disasters

    WHO AFRO - Outbreaks and Emergencies Bulletin - Week 13/2019
    The WHO Health Emergencies Programme is currently monitoring 66 events in the region including:

    • Response to the tropical cyclone in southern Africa
    • Ebola virus disease outbreak in the Democratic Republic of the Congo
    • Meningitis outbreak in Togo
    • Lassa fever outbreak in Liberia.

    Nepal Storm Kills Dozens and Injures Hundreds
    A strong rainstorm has swept through southern Nepal, destroying homes, felling trees and leaving at least 28 people dead and hundreds more injured, the authorities said.
    Many of those killed were asleep in simple huts on Sunday night when powerful winds sent deadly debris flying through the air.

    Cyclone Idai Causes ‘Spike’ in Malaria Cases
    Cholera Is Spreading in Mozambique, and It’s Far From the Only Health Threat

    Nearly 900 000 doses of cholera vaccine arrive in Beira to support humanitarian response
    Shelter for man and beast: Can India's cyclone refuges protect all?
    Joint storm shelters for people and animals are in place - but making them work in practice is proving a challenge
    Iran floods force evacuations as U.S. denies sanctions harming aid efforts

    Could computers provide short-term warnings of the world’s worst floods?
    The threat of high water extends globally. By 2030, it’s estimated that 40% of global urban land will be in high-frequency flood zones.
    Danger still lingers two years after Colombia's deadly Mocoa landslide

    U.S. disaster aid won't cover crops drowned by Midwest floods

    Changing global patterns of urban exposure to flood and drought hazards

    Managed retreat due to rising seas is a public health issue
    Sea-level rise associated with climate change is a concern for many island ...
    See more

    Technological Hazards

    Dealing with cascading multi-hazard risks in national risk assessment: The case of Natech accidents
    Radioactive waste standoff could slash high tech’s supply of rare earth elements

    Climate Change

    Air-pollution science under siege at EPA
    Conflict within the US Environmental Protection Agency’s Clean Air Scientific Advisory Committee is raising worries that the group’s findings will be more influenced by politics than by science. At stake is the country's legally binding air-quality standards — and public health. The committee’s head, statistician Tony Cox, has long questioned the evidence linking fine particulate pollution to premature deaths. A previous chair, environmental engineer Christopher Frey, calls it “one of the most robust scientific findings in air-pollution health”.
    Nature | 6 min read

    Thailand prepares masks for ASEAN meeting due to air pollution

    Climate, conflicts set to plunge millions into food crisis
    War, extreme weather and economic woes in 2018 left more than 113 million in dire need of help. Conflict and insecurity were responsible for the desperate situation faced by 74 million people, or two-thirds of those affected, in 2018, said the the Global Network against Food Crises in its annual report.

    Effectively irreversible": Canada is warming twice as fast as the rest of the world, report says

    Bleaching has struck the southernmost coral reef in the world

    With half-measures against climate change, millions of people could feel the bite
    Climate change will expand the range of mosquito-borne diseases, as higher temperatures make it possible for mosquitoes to survive in more places for more of the year. But exactly who is at risk, where, and when is more complicated.
    Read More

    Urban Health

    E-collection – Urban design and health
    The world’s 7.5 billion people, in one chart

    Migration Health

    A climate migration crisis is escalating in Bangladesh
    “Bangladesh is one of the world’s most vulnerable countries to climate change ...
     See more

    U.S. aid cuts to Central America may backfire, fueling migration north - charities

    Global Health

    Five Major Court Battles over Trump's Health Agenda
    The Trump administration has found itself in court time and time again defending the president’s efforts to overhaul the American health care system.
    Go to article
    Measuring the efficiency of health systems in Asia: a data envelopment analysis
    WHO and ITU establish benchmarking process for artificial intelligence in health




    Knowledge sharing

    We welcome receiving your reports, articles and studies to share widely within our network.
    Please contact Dr. Chadia Wannous via email at