News Pouch 20 May 2019

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Pandemic Threats and Health Emergencies

News Pouch: 20 May 2019


  • Spotlight: Ebola situation
  • Spotlight: World Health Assembly 2019
  • 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

    WHO External Situation Report 41: 14 May 2019
    Following several major security incidents in recent weeks, there has been a continued steady increase in number of cases reported during the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. The increase is due to responders being unable to access communities while movements were restricted for security reasons. Particularly in Butembo and Katwa, response has been reduced to a “stop and go” pattern, where a day or two of activity is followed by a day or two of suspended or limited activity.
    Meanwhile, security measures have been strengthened at many healthcare facilities to aid the resumption of critical healthcare services.
    Community engagement efforts aimed at better integrating a range of response activities into communities, restoring trust between response workers and community members, and encouraging suspected cases to seek medical attention earlier to help improve their chances of survival, remain ongoing.
    A total of 110 new confirmed cases were reported this week; these numbers are likely to continue to increase due to a backlog, resulting from the interruption to the response activities. Most of these cases originated from hotspot areas within the Katwa, Mandima, Mabalako, Butembo, and Kalunguta health zones.
    As of 12 May 2019, a total of 1705 EVD cases, including 1617 confirmed and 88 probable cases, were reported. A total of 1124 deaths were reported (overall case fatality ratio 66%), including 1036 deaths among confirmed cases. Of the 1705 confirmed and probable cases with known age and sex, 56% (951) were female, and 29% (502) were children aged less than 18 years. The number of healthcare workers affected has risen to 101 (6% of total cases).
    click here to download the complete situation report (PDF).

    With more than 1,100 dead, Congo’s Ebola outbreak is only getting worse. Now doctors are forced to go undercover.

    Doctors go undercover to fight Ebola in violent eastern Congo

    Ebola Containment Efforts in DRC Threatened by Insecurity, Underfunding
    North Kivu: Civil society demands more soldiers, policemen and blue helmets in Butembo
    The civil society of North Kivu calls for the reinforcement of the presence of the FARDC, the police and the MONUSCO blue helmets in Butembo, current home of the Ebola epidemic. This increased strength will help deal with the attacks on teams responding to this disease, said Edgard Mateso, vice president of this structure. 
    Go to article

    Fights to end polio, contain Ebola made tougher by rising violence, research finds

    EU provides further €5 million in humanitarian aid in Democratic Republic of Congo

    We cannot scale down while Ebola escalates, says IFRC,-says-IFRC

    Nigeria still at moderate risk of Ebola outbreak

    Struggling with Scale: Ebola’s Lessons for the Next Pandemic (brief)


    Liberia's taste for bushmeat survives Ebola


    What Experts Doing For Ebola Survivors With High Potential of Blindness
    Antibody Responses Vs. Ebola Keep Evolving in Survivors, Months After Recovery Antiviral antibodies produced by survivors of Ebola infection continue to evolve and improve after recovery, according to a detailed study of the immune responses of four people who received care at Emory University Hospital in 2014.
    Go to article

    World Health Assembly 2019

    WHA 20-28 May 2019
    Key documents of the World Health Assembly
    Provisional agenda

    A72/1 Add.1
    Proposal for supplementary agenda item
    Of particular importance to the work of this network are the following documents concerning public health emergencies- preparedness and response, health effects of environment and climate change, and promoting the health of refugees and migrants
    Public health emergencies: preparedness and response
    Report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme

    Public health emergencies: preparedness and response
    WHO’s work in health emergencies

    Public health emergencies: preparedness and response
    International Health Regulations (2005)
    Annual report on the implementation of the International Health Regulations (2005)

    A72/11 Rev.1
    Implementation of the 2030 Agenda for Sustainable Development

    Universal health coverage
    Primary health care towards universal health coverage

    Health, environment and climate change
    Draft WHO global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments

    Health, environment and climate change
    Draft plan of action on climate change and health in small island developing States

    Access to medicines and vaccines

    Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues
    Antimicrobial resistance

    Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits
    Implementation of decision WHA71(11) (2018)

    Human resources for health
    Global strategy on human resources for health: workforce 2030

    Promoting the health of refugees and migrants
    Draft global action plan, 2019–2023

    Priority Diseases

    Why we need collective action and brave research
    The influenza surveillance data outputs on WHO website have been upgraded.

    A new Sub-Saharan Africa HPAI Situation Update from FAO/EMPRES – Animal Health
    Human Antibody Reveals Hidden Vulnerability in Influenza Virus  
    The ever-changing “head” of an influenza virus protein has an unexpected Achilles heel, report scientists funded by the National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health. The team discovered and characterized the structure of a naturally occurring human antibody that recognizes and disrupts a portion of the hemagglutinin (HA) protein that the virus uses to enter and infect cells. The investigators determined that the antibody, FluA-20, binds tightly to an area on the globular head of the HA protein that is only very briefly accessible to antibody attack. The site was not expected to be vulnerable to such a strike. 
    Go to article
    USDA Enhances African Swine Fever Surveillance Effort
    The US Department of Agriculture (USDA) is furthering its overall African Swine Fever (ASF) preparedness efforts with the implementation of a surveillance plan. As part of this plan, the Animal and Plant Health Inspection Service (APHIS) will work with the swine industry, the states, and veterinary diagnostic laboratories to test for ASF. 
    Go to article
    ASF Asia Update for 16 May from FAO/EMPRES - Animal Health.
    * Hong Kong Special Administrative Region, China detected ASF for the first time.
    * Hau Giang, Phu Tho, Binh Phuoc, and Khanh Hoa Provinces, Viet Nam reported ASF outbreaks for the first time.
    * Viet Nam destroyed more than 1,300,000 pigs in an effort to halt further spread.  

    Study: Older age, high viral load associated with yellow fever deaths
    A study published yesterday in The Lancet Infectious Diseases tracked the clinical outcomes of 76 Brazilian patients with yellow fever to establish predictors of mortality and found older age, elevated neutrophil count, and higher viral load all tied to higher death rates.
    "Identification of poor outcome markers could help guide resource allocation and strategies to provide intensive care for patients with potentially severe disease, supporting a rational approach during disease outbreaks," the authors concluded. The study was funded by the Sao Paulo Research Foundation.
    May 16 Lancet Infect Dis study

    Emergency Assistance for Zika: USAID Supported Activities Overseas but Could Improve Funds Tracking and Response Planning
    The Zika virus appeared in the Western Hemisphere in May 2015 and spread to many countries in less than a year. Zika can have mild or unnoticed symptoms, but it can also cause severe birth defects…In response, USAID supported a range of activities overseas, including mosquito control, public awareness, and research. However, USAID didn't track Zika funding by country and took longer than desired to get response efforts launched in some countries.
    Go to article

    Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
    Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017.
    Go to article
    Notes from the Field: Measles Outbreaks from Imported Cases in Orthodox Jewish Communities — New York and New Jersey, 2018–2019
    On October 1, 2018, the Rockland County (New York) Department of Health (RCDOH) alerted the New York State Department of Health (NYSDOH) of an unvaccinated teenaged traveler with diagnosed measles. During the next 17 days, RCDOH learned of an additional six unvaccinated travelers with measles.
    Go to article
    Current Vaccination Policies May Not Be Enough to Prevent Measles Resurgence
    Current vaccination policies may not be sufficient to achieve and maintain measles elimination and prevent future resurgence in Australia, Ireland, Italy, the UK and the US, according to a study published in the open access journal BMC Medicine.
    Go to article

    More US measles cases, links to international travel noted
    International travel and low vaccination rates have combined to ignite outbreaks.
    More »
    Measles and the Canonical Path to Elimination
    Measles is highly infectious and can be dangerous. The classic 1968 vaccine is highly effective, and it should be possible to eliminate measles. Graham et al. found that measles transmission changes as vaccination coverage and birth rates (that is, the rate of arrival of susceptible individuals into the population) change in a country in response to socioeconomic variables. As a result, measles everywhere follows the canonical mode of decline in response to vaccination campaigns.
    Go to article

    A proposed novel approach to TB drug financing

    Four new polio cases in Pakistan as study tackles partial-dose vaccination
    The study supports WHO guidance for conserving vaccine during shortages.
    More »
    Polio's donor fatigue
    The Global Polio Eradication Initiative launched a new five-year strategy incorporating both what has worked in the past, as well as new tools and approaches toward a polio-free world. What it didn't launch with? Enough money. Creeping donor fatigue has left the new strategy with a funding gap of $3.27 billion.
    Here's the story.

    One Health  

    White House Releases Global Health Security Strategy  
    The U.S. has released a Global Health Security Strategy defining actions the administration will take to prevent, detect, and respond to infectious disease threats, and to work with its partner countries to that end. The U.S. has reiterated its strong support for the GHSA and the JEE process to help advance these goals. The Strategy adopts a whole-of-government approach, involving various departments and agencies. The Strategy emphasizes the need for collaboration with non-governmental partners, including the private sector and NGOs, mentioning the PSRT as a critical partner in maintaining and sustaining international capacity.
    You can access the Strategy here.

    Regional Collaborations in Global Health Security   
    The CDC’s newest issue of Updates from the Field highlights regional collaborations as a cornerstone of global health security. Regional collaborations allow us to strengthen communication, consolidate functions, create efficiencies, and accelerate progress in preventing, detecting and responding to disease threats.
    Learn more about how the CDC is using a regional approach to connect people and systems around the world to better fight public health threats here.

    A call for clinicians to act on planetary health

    Africa Regional Facilitator Training for the tripartite Joint Risk Assessment (JRA) held in Dakar from 7 to 9 May 2019
    Regional epidemiologists, and other technical level representatives from WHO, OIE and FAO headquarters, regional, and country level offices came together to be trained on the use of the JRA tool and on how to run pilot workshops throughout the region.

    Evaluation mission using FAO’s Surveillance Evaluation Tool (SET) in Ghana from 18 to 28 March 2019
    Ghana marks the 14th country where SET has been implemented, and action plans developed for each country have already shaped surveillance capacity-building activities in many countries.
    Biodiversity and Ecosystem
    Summary for policymakers of the global assessment report on biodiversity and ecosystemservices
    Díaz et al. (2019) report that up to one million species are threatened with extinction, with severe implications for our health and wellbeing.
    Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES)
    Food Security and Safety

    ILRI’s support for South-South partnership to improve food safety in Asia

    Food safety and the Sustainable Development Goals

    Perspective: The public health case for modernizing the definition of protein quality
    propose a modernized definition of protein quality that incorporates the quality of health and environmental outcomes associated with specific food sources of protein.
    Climate and livestock policy coherence analysis in Kenya, Ethiopia and Uganda
    Livestock in Kenya, Ethiopia, and Uganda play an important role in food security, livelihoods, income, and gross domestic product (GDP). Livestock sector growth in response to growing demand for animal-sourced food requires policy guidance to avoid increasing livestock sector exposure to climate risks and increasing sector greenhouse gas emissions. This analysis examines 40 climate, agriculture, livestock, development, land, and environment policies...


    Antimicrobial Resistance Is Being Called A Sustainable Development Issue

    On the Evolutionary Ecology of Multidrug Resistance in Bacteria
    We test predictions from this model in six bacterial datasets and find them to be qualitatively consistent with observed trends. The higher than expected frequencies of multidrug resistance are often interpreted as evidence that these strains are out-competing strains with lower resistance multiplicity. Our work provides an alternative explanation that is compatible with long-term stability in resistance frequencies.
    Go to article

    Stewardship / Resistance Scan for May 17, 2019

    • Northern Ireland AMR plan
    • Rapid susceptibility tests
    • Unnecessary abx for respiratory infections

    More »

    Emergencies and Disasters

    Outbreaks and Emergencies Bulletin, Week 19: 06 - 12 May 2019
    The WHO Health Emergencies Programme is currently monitoring 68 events in the region. This week’s edition covers key ongoing events, including:

    • Cyclone Idai in Zimbabwe, Malawi and Mozambique
    • Ebola virus disease in Democratic Republic of the Congo 
    • Dengue fever in Mauritius
    • Measles in Chad
    • Humanitarian crisis in Ethiopia.

    Week 19: 06 - 12 May 2019
    WHO's 'Grade 3' responses
    Ebola may be top of mind at this year's meetings, but it's not the only major emergency WHO is responding to. The agency is responding to nine Grade 3 emergencies — the most serious response classification — in conflict-affected countries such as Yemen and Myanmar, as well as health needs associated with natural disasters such as Cyclone Idai in Mozambique. A recent report showed donors and partners have "increased confidence" in WHO's leadership in emergencies, but it shared concerns on the efficacy and sustainability of the organization's current response configuration, given the number of Grade 3 emergencies WHO is managing — including the Ebola response in DRC — and the resulting shortfalls in financing.

    WHO emergency risk communication package rolls out globally

    see also: Emergency risk communication (ERC) 5-step capacity-building package


    Command-and-control, emergency powers, and the failure to observe United Nations disaster management principles following the 2009 L'Aquila earthquake

    Rising heat scorches recovery efforts in cyclone-hit Indian state
    More than 10 million have been affected by the worst summer cyclone in the state in 43 years, according to government data

    Deadly tsunami cracked using social media
    A super-fast tsunami that ravaged an Indonesian island last year, killing thousands, was almost certainly triggered by underwater landslides. That’s the conclusion of a detailed reconstruction of the disaster that scientists have made using surveillance-camera and video footage harvested from posts on YouTube and other social networks. The findings suggest that tsunami warning systems should be upgraded in coastal regions where there is a risk of landslide-triggered events, which can arrive much more quickly than other tsunamis.
    Nature | 5 min read
    Reference: Geophysical Research Letters paper

    ‘Disaster resilient’ farming reduces agriculture risks, yields economic gains, says new UN agriculture agency report
    Disaster risk reduction at farm level: Multiple benefits, no regrets
    This report assesses and identifies solutions with special relevance for smallholder farmers: DRR good practices that work at farm-level and which, with small investments, can have a significant positive impact on the resilience of their livelihoods. It evaluates the cost-effectiveness and socio-ecological suitability of different specific DRR interventions, with the intention of providing decision-makers and farmers both with reliable assessments...

    Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events
    Disaster risk reduction in conflict contexts: The state of the evidence
    This working paper reviews the state of the evidence on disaster risk reduction (DRR) in conflict-affected contexts. It is intended to stimulate a more explicitly political consideration of disaster and DRR studies, and to ‘reroot’ disaster studies in the political realm. Consideration of DRR in conflict raises important questions about normative conceptions of and approaches to DRR, including the centrality of the state, the position...
    Report of the International Seminar “Rapid International Response to Biological Incidents: Lessons for the Biological Weapons Convention”
    This report summarizes the main issues raised by the speakers in their presentations and related discussions. Furthermore, the Seminar Agenda and Speakers’ biographies are annexed to this report.
    Go to article
    Namibia is under a state of emergency
    after a prolonged drought has left 500,000 people in need of food, with the government calling for international aid.
    Back-to-back heat waves to become more frequent and dangerous


    Climate Change

    Climate Change Microbiology — Problems and Perspectives (
    The signs of climate change are undeniable, and the inevitable impact for Earth and all its inhabitants is a serious concern. Ice is melting, sea levels are rising, biodiversity is declining, precipitation has increased, atmospheric levels of carbon dioxide and greenhouse gases are alarmingly high, and extreme weather conditions are becoming increasingly common. But what role do microorganisms have in this global challenge?
    Go to article

    "Environmental Change and Human Health: An Assessment of the Economic Significance of Global Warming and Air Pollution for Planetary Health"
    The Rockefeller Foundation Economic Council on Planetary Health released a new paper exploring the health impacts of global warming and air pollution.
    Read here

    European state of the climate 2018: Summary
    2018 was one of the three warmest years on record for Europe. It began with a relatively cold period across most of the region. Throughout the rest of the year, northern, central and western Europe experienced sustained warm and dry conditions, while the south, in particular areas along the Mediterranean coast, saw a long period of repeated heavy rainfall events, making spring and summer in those regions amongst the wettest on record.
    full report:

    In coal we trust: Australian voters back PM Morrison's faith in fossil fuel
    The re-elected coalition government last year scrapped a bipartisan national energy plan and dumped then-prime minister Malcolm Turnbull because he was viewed as anti-coal

    Air pollution may be damaging ‘every organ in the body’

    Emissions on the rise for first time in four years, UN agency warns
    A new report released on Tuesday by the United Nations Environment Programme (UNEP) shows that global carbon dioxide (CO2) emissions rose again during 2017 after a three year hiatus, highlighting the imperative for countries to deliver on the historic Paris Agreement to keep global warming to below 2°C above pre-industrial levels.



    Climate Change and Worker Health Science Fellow
    NRDC is seeking a two-year, full-time Climate Change and Worker Health Science Fellow who can provide subject matter expertise and conduct multi-disciplinary research and analysis on the occupational health effects of climate change. As part of the Federal Policy team of NRDC’s Climate and Clean Energy Program, the Fellow also will develop broadly accessible communication materials about occupational health and climate change to support NRDC’s community partnerships, public outreach, and advocacy on climate and clean energy policies (including climate adaptation).
    Apply here

    Urban Health

    What does social inclusion mean for a resilient city? A policy note on urban floods
    Cities today face an unprecedented risk of natural hazards compounded by serious governance challenges. How can cities ensure that in building resilience, they address the needs of those most at risk of being excluded? How can they develop strategies that simultaneously foster resilient infrastructure and social inclusion?
    Third Healthy City Design 2019 International Congress & Exhibition
    The Healthy City Design 2019 International Congress & Exhibition is a global forum for the exchange of knowledge on the research, policy and practice of designing healthy and sustainable cities and communities. The plenary theme this year is "Designing for utopia or dystopia? People and planetary health at a crossroads."
    Organized by: SALUS Global Knowledge Exchange.
    October 14-15, 2019. London, England.
    Learn more. 

    Migration Health

    WHO takes action to promote the health of refugees and migrants
    Climate now biggest driver of migration, study finds

    Gone with the wind: International migration

    Global Health

    Vaccine hesitancy
    WHO has identified vaccine hesitancy as one of the biggest global health threats of 2019. Here's alook at the global issue, and an on-the-ground investigation from Nigeria, where reporter Paul Adepoju bought an official yellow fever travel document for $8.50, with no evidence of immunization.  

    Vaccination Lags Behind in Middle-Income Countries 
    Indonesia, Iraq and South Africa now rank among the ten countries with the highest number of under-immunized children worldwide, even though these countries are richer than many of their neighbours. What is going on?
    Go to article

    The Lancet Commission on diagnostics: advancing equitable access to diagnostics

    Smarter Research & Development to Tackle Global Health Priorities
    WHO’s new Science Division launched an online resource to guide the development of new health products for which there are limited markets or incentives for research and development. An essential tool for realizing universal health coverage, the Health Product Profile Directory aims to promote research and development for products to combat neglected diseases and threats to global health, including antimicrobial resistance and diseases with pandemic potential.
    Go to article




    Knowledge sharing

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

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